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parcel, 020-1164-50-000 12/13/2004 04:24
PAGE 1 OF 1
F 1
Alt. Parcel 7.29.19.974-977 020 - TOWN OF HUDSON
Current ❑X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): Current Owner
* YARDLEY, THOMAS J & HONEYLAURA M
THOMAS J & HONEYLAURA M YARDLEY
313 HARSHMAN DR
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): • = Primary
Type Dist # Description " 2945 HARSHMAN DR
SC 2611 SCH D OF HUDSON
SP 1700 W ITC
Legal Description: Acres: 1.368 Plat: 1929-EDGEWOOD ESTATES
SEC 7 T29N R19W EDGEWOOD ESTATES LOTS Block/Condo Bldg: LOT 44
44, 45, 46, & 47
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
07-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
05/08/2000 622605 1508/608 WD
07/23/1997 763/626
07/23/1997 726/557
07/23/1997 726/555
2004 SUMMARY Bill Fair Market Value: Assessed with:
49035 235,700
Valuations: Last Changed: 06/06/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.368 37,900 144,400 182,300 NO
I
Totals for 2004:
General Property 1.368 37,900 144,400 182,300
Woodland 0.000 0 0
Totals for 2003:
General Property 1.368 37,900 144,400 182,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 134
Specials:
User Special Code Category Amount
018-RECYCLING SPECIAL ASSESSMENT 27.00
Special Assessments Special Charges Delinquent Charges
Total 27.00 0.00 0.00
, VS
~ S-0
AS BUILT SANITARY SYSTEM REPORT ^r+ ~O
OWNER TOWNSHIPU~S oT~
Q
SECTION T 2 y N-R / W ADDRESS
ST. CROIX COUNTY, W IS
~
A6
SUBDIVISION f~1t~00l7 LOT y`s LOT SIZE
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
INDICATE NORTH ARROW
SW TiP couc~ETF x/!17 /f7-
BENCHMARK: Elevation and description: 4::~,WVZ-w 5"k42 = /OO.O
r~oTio.ti 4o6- a,- wood fE crc~ 149eo vvQ ~oooG T
Alternate benchmark vw <,0,0,vc e. .4-'16.CIA710--i = //p. 9;6 -
Z.C/5Z1,,u6-: /pOO JI -Q - Cc~/ES~,~' Covac{L 7a
SEPTIC TANK:Manufacturer: Ave--' eu--k -S Liquid Cap. - po c> cy.-P'
Rings used: Manhole cover elev: SOS, y/Final grade elev: /0 s' 9/0%,9"o 01 Tank inlet elev.: ~o Tank outlet elev.: 103,72
x x
No. of feet from nearest road:Front Side Rear Ft.
X' ,
From nearest prop. line:Front/3s, Side Rear Ft.
No. of feet from: Well Buildin
g :.vEv T1l~,.~ - !V-7
(Include this information in the above plot plan)
(2 reference dimensions to septic tank)
SEE REVERSE SIDE
r
1 ~
PUMP CHAMBER
Manufacturer: L' id Capacity:
Pump Model: Pump/Sipho anufact.: Pump Size
Elevation of inlet: ottom of tank elevation
Pump on elev.: P p off elev.: Gallons/cycle:
Alarm: Man.: Switch Type: Location
Distance fro nearest prop. line: Front-, Side_, Rear-Ft.
Distance from: Well Building
SOIL ABSORPTION SYSTEM 3
X
Bed: Trench: Seepage Pit:
Width: Length Number of Lines: Area Built 13 - 13-S
Exist. Grade Elev. Proposed Final Grade Elev.
Fill depth to top of pipe: Z D ' 7'~a `/o
So , ~ ' T/a o
No. feet from nearest prop. line:Front~~ , Side a ,
No. feet from well: No. feet from building 3
HOLDING TANK
Manufacturer: Capacity:
No. of rings used: Elevation of bottom tank:
Elevation of inlet:
No. feet from nearest prop. line:Front , Side Rear Ft.
No. feet from: Well , building , nearest road
Alarm Manufacturer:
INSPECTOR: GJ
DATE:- ?i PLUMBER ON JOB :
LICENSE NUMBER:
6/90:cj
N,Ok"ESITE SEPTIC PLUMBING CO.
655 O'NEIL RD., HUDSON, WIS. 54016
ROBERT ULBRIGHT
.'dr$. MD TTER PLUMBER LIC. NO. 3307 M.P.R.S.
e sr ~r~ IN^, TALLER & DESIGNER LIC. NO. 00663
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' Q3'tdr AgYpartgenl-,§9Yustry'29.19.97PRIVATE NW TS 45 & 46,HARS N DR.
StWXGE SYSTEM Count
Labor and`H~SmanRelations
Safety and Buildings Division INSPECTION REPORT ST. CROIX
(ATTACH TO PERMIT) Sanitary Permit No.:
GENERAL INFORMATION 175665
Permit Holder's Name: ❑ City ❑ Village [Town of: State Plan ID No.:
TONER RICKY D & PAM HUDSON
CST SM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
/00"j (f- , 020-1164-50-000
TANK INFORMATION ELEVATION DATA A9200325
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic
_ ado Benchmark ~jh ~a ~r lC~o ~ ~
Dosing
Aeration Bldg. Sewer
Holding St/ Ht Inlet
y,'/o
TANK SETBACK INFORMATION St/ Ht Outlet / R, 7 10517,--
vent
BLDG. AirIto ntake ROAD Dt Inlet
TO P/ L WELL j-
Air
, 7, NA Dt Bottom
Septic / 13 T-
Dosing NA Header/ Man.
Aeration /a. i Sb
NA Dist. Pipe v4
Holding Bot. System o, qy' o
8, q
PUMP/ SIPHON INFORMATION Final Grade ~
,
4G .J
Manufacturer Demand
Model Number GPM
TDH Lift Lriction System TDH Ft
Forcemain Length Dia. Fi Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid pth
DIMENSIONS Jr ..3 DIMENSIONS
SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manuacturer:
SETBACK
INFORMATION TypeO L , CHAMBER Model N tuber:
System: 9 y;,4,/k -1Z 139 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
Depth Over Depth Over xx Depth Of xx Seeded/ Sodded 7;x_m ull ched
Bed /Trench Center Bed / Trench Edges Topsoil ❑ Yes
E] No ❑ Ys E] No
COMMENTS: (Include code discrepancies, pers~%present, etc.)
ye
-
'Th
.t ,
Plan revision required? ❑ Yes ❑ No
Use other side for additional information. N c 6
SBD-6710 (R 05/91) Date Inspector's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
s
DILHR SANITARY PERMIT APPLICATION
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 125 (045
8% x 11 inches in size. ❑ Check if revision to previous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROPERTY OWNER PROPERTY LOCATION
t~t *C/t ` Air Y, NV'/a, S 7 T L N, R 1(f E (or) W
PROP 1 OWNER'S MAILING ADDRESS
ARS j,~ e,y PFf LOT # ~r f of BLOCK #
CITY, STATE - ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
D.So-tJ S'~fCyG ~ GaG FdG~c~ov ~'T'n-T~s
NEAREST ROAD
II. TYPE OF BUILDING: (Check one) StateOwned ❑ V CI : ~ fjO~
LLAGE TM:
❑ Public V11 or 2 Fam. Dwelling of bedrooms- PARCEL TAX NUMBER(S) _J AWS
Ill. BUILDING USE: (If building type is public, check all that apply) Q _0 30-0 0 O
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 only one in line A. Check line B if applicable)
A) 1.E1 New 2. X Replacement 3. ❑ Replacement of 4.E] Reconnection of 511 Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit # _ Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy
13 Seepage Pit Pressure r t 43 El Vault Privy
14 ❑ System-In-Fill J;e S ~'f`G~ ✓r X 0
VI. ABSORPTION SYSTEM INFORMATION: L QtJ','~
1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FHVALOGRADE
REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) q,y 0 ELEVATION
l20 V H2O 0 ' 3~ /V 0 Feet O Feet
VII. TANK CAPACITY New 7-4-1k- Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION New lExisting Gallons Tanks Mat~S is Name Concrete structed Con- Steel glass Plastic App
Tanks Tanks
Septic Tank or Holding Tank L K L. El I r_1
Lift Pump Tank/Si hon Chamber 0 Li Li 1 1:1
Vlll. RESPONSIBILITY STATEMENT /paa e , GcJ/exz~x - & es ri-)
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:
/2. Whet!:~, AT 3907 7/S 3
Plumber's Address (Street, City, State, Zip Code): ~~4!
5 S d 'NE<L TeX .
IX. COUNTY/DEPARTMENT USE ONLY
p Disapproved Sanitary Permit Fee (Includes Groundwater Da ti s ue in ent 'gnature (No Stamps)
Approved dP Surcharge Fee) ~2
❑ Owner Given Initial
Adverse Determination c7b 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. `-Four 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, usuafJy every Yto 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code administrator or the
State of Wisconsin, Safety & Buildings Rivisiom_608-2663815:
To be complete. and~aceurate this..sanitary permit application fnust 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-
II. 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 gagons, 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"rains/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) sofa test data on a 115`form; and F) all sizing information
GROUNDWATER SURCHARGE
1983 Wisconsin Act 410 included the creation of surcharges (fees) fora number of
regulated practices which can effect groundwater.
The monies collected through these surcharges are used forai9.o0f6ri'ng groundwater, ground-
water contamination investigations and establishment of standards.
SBD-6398 (R.11/88)
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), thenia 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 Ifl y 74 A4,Af 1 A-I-e~
Location of,propertyA/r1/4 N41114, Section , T~N-R~W
Township h4ypi-an-1
Mailing address _ 313 h~W, h-lci J
Address of site 5'011t~
Subdivision name G Od v Lot no. 'rf !P-
Other homes on property? yes n< No
Previous owner of property S
Total size of parcel
Date parcel-was created
Are all corners and lot lines identifiable? Yes No
Is this property being developed for (spec house)? Yes No
Volume Sand Page Number ~J_4 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 ~n the office of the County Register of
Deeds as Document No. _a 16 S 7 , . , 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
r ed in the office of County Register of deeds as Document
o.
signatur of applicant C applican
~3 2
Da e o ignature Dat of Sig ture
r
S T C - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER
ADDRESS 313 /0%'S4 / tf#4A/ - FIRE NUMBER_ l3
CITY/STATE ZIP
PROPERTY LOCATION:/'-"C 1/4lf~1/4, SECTION 7 , TZr N-RILW
TOWN OF_
St. Croix County,
SUBDIVISION_ LOT NUMBER y3 tV6
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
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.
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. C Co. Zoni Officer within
30 days of the three year expirati n d e
SIGNED:
DATE:
St. Croix co. Zoning Office
911 4th St.
Hudson, WI 54016
Tri
TORY i ""is irnse ~ V" iwawr w" eaten'
09Cu, ra. SsAts orb o!!D y
e, e~ ~~~fi2fi
' Trim Deed, made between !1J9QrnMd----- - - e~ot ►1~►
. iii !or Nwerd,0 ,
Grantor, r
all&......... Ricky. -D..._Stomr.and Pam.stoxlex,..rusband.~trxl.. 4:00 P
stife.,as_.Sur"i vorsup-.marital..groperty . 1
Psla_Stoner_A.also.-knmn..as Pamela..K._.-Stoner - :
Grantee,
Witness@th, That the said Grantor, for a valuable consideration
....G Zntoir-...... REI URN TO
eeaveys to Grantee the following des ribed real estate in . _ St . Croix
County, State of Wisconsin :
t -
Tax Parcel No: :.,l
Lots 44, 115, 46, 1+7 Edge-wood Estate:: to 'he
Town of Hudson.
4 si
10
{
This. -_is.-not - homestead property.
(is) (is not)
Together with all and singular .the hereditaments a:.a ereunto belonging;
And 'lrantor: _ i•
warrants that the title is good, indefeasible in fey ,impie amt i - j clear of encumbrances except
easements, restrict--Dn3 and ri pits-c`-': of record, if any. ?
~a
and will warrant and defend the same.
' 19th 86
Dated this - day , ` 19 4
(SEAL) ''-v rc7 ....(SEAL) `
~ar^✓1 j ornstad
(SEAL) ........(S&A;X.1E
AUTHNNTICATION ACHNOWLli*U2*11`
Sisnatrre(s) _ Lbx^~l 24ornstad STATE OF WISCONSIN
r si
- - County.
authentieated.this -19 _.day of n' 19 =1: Personally came before me this . ............day at
i~
, 19 the aboor namod
_
Kristina Ogland L indeer
TITLE: MEMBER STATE BAR OF WISCONSI N a
l= - . _ y., j
(If not,
y
authorized by ~ 7OFi.06, Wis. Stats.)
to r1, kr %%n to he the twrson who exwuted the
fl r. it,, ii strument and acknowledge the same.
INIS .^:;TRUMEN-, WAS rr 4F-F0 By a~R'.
.a
.C r PP
• Noh-v Public
(Sifnatar~ - n,oy be authenticated or acknowledyr• d. loth _N1 Commissinnt is permanent,,.(1f jja9,,
rq are not riveessary.)
date: -4- .....i ~ :s, r,>.
q •Names of persona signing in any caps 4th should be type..t or print" below their ettnaturaw.
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Labor and Human Relations U 901
'CGS yy d~~~ (Attach Soil Profile Location Map • To Scale - On A Separate, Signed Sheet) Madison.
/'/7`•TElJ Page / Z
cuaruararwn 3 Rio- ~3aoa[vK. CAr[ cvTff/1 v+v,sar v[u cov[w t~/" MAT[RVi atOralAa-[C rtao0 MAN ILI
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Aor 3//}/~ SffA_f~i~/ a~/UE crn hcU~ fO tJ ~larAr[ S~IQ~ C/5 T. GIeO!/C a.art~oworawe
DORM tOC/t ,v0 se rxar L9 /g Tow~~~J~~ /Ax AArIC[t M1AER
LOT$~q~ BLOCK ,SUBDIVISION ED6:6L4l00Z ANEW LREVtAC[
B-/ Horton Depth Dominant Color Mottles Structure llmnrnp FectoU LoaangGPO'sq. n.
In Munsell u. St. Cont. Color Texture Gr. 51. Sh. Consistence Roots Boundar Oepth Trench Bed
~-/0 /o yle 3/y S/ /.f s6 f' r>Nvf 2 of ccJ . Sf
Glcv = B o -syy /0 S/ , f SdK -,e 2 of
q''y 3z jy3~ sYX4/4 s/ 6(f,~I2 -C; w , s
C G- 72 to ye S/~e s/ D C, y,~ f c w 60Er ,~~o • S , y
l3,~tio~-v /
#o'?; z A co ,4y 4o,v TE r
B_2 Horizon Depth Dominant Color Mottles Structure Urnillnp Factor/ Loaanq.GPD sq. N.
In. Munsell u. St. Cont. Color Texture Gr. Sr. Sh. Consistence Roots Boundar Depth Trench Bed
Q 0-f /0 W 31y -2 ra^, 0 ,wt'r te 9 VF C 4V - 3~
Elev = 3 lp ye 414 3 n•+ (3~k n„ OCR 3 f C w Cp 5,
9y/Gr rz /7_ZS /o A 416 S/ 2- f 5J& f/2 3 cw
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B , ~1 I Houton Depth Dominant Color Mottles Structure Llmhlnp Factorr Loading GPD sq it.
,J In. Munsell u. St. Cont. Color Texture Gr. St. Sh. Consistence Roots Bounds Depth Trench Bed
a-& /oye 3/ j,-, sbK v 2 3 IF
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Additional Remarks: 1ZECOMMENDED SYSTEM TYPE: ~DU'yo d'V Ly' 1, Ry well,
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Other Sttt Featurts:
IV I'7-0 r " S,q,vp ~ r 2 3 /fill/ Pat ---9 71 0 System Elcvation -CST Signature Date Signed Telephone No. CST .
ur)"r-SITE SEPTIC PLUMBING CO.
%I1 r'IaEIL RD., HUDSON, WIS. 54016 6Y3r-:r 0 .cD"6
WIS MI" IU ER LIC. NO. 3307M.P.R.S. City Seals Zip
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B _ I Horizon F-/2
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Additional Remarks: RECOMMENDED SYSTEM TYPE: ~OU'y~ d'yLy'
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uTl TSITE SEPTIC PLUMBING CO.
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Sells. w " R s u ER LIC. NO. 3307 M.P.R.S. h~v1~Sv •v Gv/ S'
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=
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Additional 1lemarkt: RE OMMENDED SYSTEM TYPE:
h r ll or= c L~9 y w iP
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97, 60 CST Signature Date Signed Telephone No, CST e
$y51Cm Elcvation._ un-l-SITESEPTIC PLUMBING CO. ,
eJ O't"FIL RD., HUDSON, WIS. 54016
CST N-.1 R W ER LIC. NO. 3307 M.P.R.S. City '~jvvs4•lJ (.t7j s' Stale Zip
WIS Mir`~,1~ I
MINN. IN''` 'At LER 3 DESIGNER LIC. NO. 00663
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Steplzeff Dufflap.
ATTORNEY
600 THIRD STREET, P.O. BOX 285
HUDSON, WISCONSIN 54016
715-386-7620
FAX# 715-386-7649
May 24, 1993
Mr. Robert Ulbright
Homesite Septic Plumbing Company
544 O'Neill Road
Route 3
Hudson, Wisconsin 54016
RE: Richard and Pamela Stoner vs. Daryl Hjornstad,
Harvey Johnson, Johnson surveying, Inc. and
William Schumaker
Case No.
Dear Mr. Ulbright:
I talked to you over the phone approximately a month ago
regarding your installation of a new replacement septic system that
you installed on the Stoner property at 313 Harshman Drive, Hudson,
Wisconsin, in September of 1992. It is my understanding from our
conversation that you were of the opinion that the most probable
reason that the original septic system was leaking was due to the
fact that too much water was being used by the plaintiffs for the
size of the septic system. I believe you also indicated that there
is no evidence indicating that the original septic system was
installed negligently and that it would have to be dug up in order
to tell for sure.
Enclosed please find a rough draft of an Affidavit which I
have prepared which summarizes these points to be used in support
of William Schumaker's Motion for Summary Judgment and request that
you read it over and contact our office in order to set up a date
and time for you to come in and sign it in front of a notary
public. Our office telephone number is 386-7620. If you have any
questions, feel free to give us a call. Thank you for your
cooperation in this matter.
very sincerely,
DUNLAP LAW OPPICE
David L. Ostrowski
Law Clerk 2
DLO/mz s
Enclosure
ROUGH DRAFT
STATE OF WISCONSIN CIRCUIT COURT ST. CROIX COUNTY
Richard Stoner and
Pamela Stoners
AFFIDAVIT OF
Plaintiffs, ROBERT ULBRIGHT
VS. Case No. 92 CV 449
Daryl Hjornstad,
Harvey Johnson,
Johnson Surveying, Inc. and
William Schumaker,
Defendants.
STATE OF WISCONSIN )
) ss.
COUNTY OF ST. CROIX)
G
Robert Ulbripht, being first duly sworn on oath, states as
follows:
1. I am a plumber and installer and designer of sewer and
septic systems for Homesite Sept' ?umbing Company located at 655
O'Neil Road, Hudson, Wisconsin 54016.
2. I installed the replacement septic syst"- on the
plaintiffs' property.
3. I performed some soil tests on the plaintiffs' property
~met the site of their original septic system- nd at alt na e
G.+0-v Lam/ -4e7"'/
site and determined that the soil at ~e tie sites . 4~ s
suitable for a conventional septic 'system. w/~Ik 0;e ' 4-4~
/ue v S ' S
4. W14 installed ed aSrreplace ent conventional septic system on
the plaintiffs' property ba&vwan the backup site and the site of
the original septic system.
5. The original septic system that was installed on the
plaintiffs' property is still in the ground and is capable of being
reused.
6. There are many possible reasons why the original septic
system was leaking but the most probable reason was that too much
de C/I
water was being used by the plaintiffs for the size o the ox''iginal
system. -1
7. The replacement septic system that I installed on the
plaintiffs' property includes the original 1000 gallon existing
tank that was part of the old septic system, in addition to a new
800 gallon septic tank that I installed to increase the size of the
plaintiffs' septic system.
8. There is no evidence indicating that the original septic
system was installed negligently.
Dated this day of , 1993.
ROBERT ULBRI%HT
C
Subscribed and sworn to before me
this day of 1993.
Notary Public
St. Croix County, Wisconsin
My commission expires
ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
' r r r r r MINN* ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
_ Hudson, WI 54016-7710
(715) 386-4680 Fax (715) 386-4686
April 28, 2000
Mr. Thomas Yardley
15144 Dunbar Boulevard
Apple Valley, MN 55124
Re: Septic Evaluation at 313 Harshman Drive
Dear Mr. Yardley:
Our records indicate that the trench-type system that is being utilized on the above referenced property was
installed by Robert Ulbricht on 9/5/92. The system consists of three (3) trenches that are 5' x 81' and it is
sized for a four bedroom structure. The system was installed as code compliant.
On April 25 and April 27, 2000, I conducted a septic inspection on the Rick Stoner property at 313
Harshman Drive. At the time of the inspection, the sanitary system appeared to be functioning properly;
however, I was unable to locate the first septic tank coming from the house. There was no vent or
inspection pipe visible. I did not observe any water ponded in the vent pipe of the older bed-type system,
though there was approximately 12" of water noted in the vent pipe of the first trench closest to the home.
There was no water noted in the other two trenches. I would recommended that vent caps be installed on
the vents of the trenches instead of the inspection caps. This will allow the trenches to stay aerobic. You
can purchase the vent caps at any plumbing supply store.
Ponding results when microscopic bacteria and sludge plug the soil pores forming a clogging mat. This
closing mat descreases the soil's ability to dispose of the sewage effluent. Over time, this clogging mat
becomes thicker, causing less and less liquid to percolate through the system. As this mat becomes
progressively thicker it leads to failure of the systems. To prolong the life of the system is as simple as
fixing or replacing plumbing fixtures with water conserving fixture, reducing shower time, washing dishes
when the dish washer is full, avoid using a garbage disposal, using a wash machine with a suds saver
feature, etc.
The inspection of this sewage disposal system was based on a surface inspection of said system, and did not
involve any excavation or chemical analysis. Accordingly, there is the possibility of hidden defects in the
system not discoverable by this inspection. This does not in any way warrant or guarantee the continued
proper functioning or operation of this system. It is recommended that the system should be pumped once
every three years. Therefore, the prolonged life of this system may be dependent upon proper maintenance
of the system.
Should you have any questions, please contact me at (715) 386-4680.
Sincerely,
Kevin Grabau
Zoning Technician
YARDLEY 61L-4G3-4917 Vv-11-VV 1V-•au K.VJ.
vv s.vru.v
•V4/ I V/ VV invo 1.1.60 rnn i a a duv tvvv V1
J ST. CROIX COUNTY
f 1 WISCONSIN
ZONING OFFICE
GOVERNMENT CENTER
° r ° r - ~•t~f ST. CROIX COUNTY
1101 Carmlchael Road
M• Hudson, W1 54016.7710
(715) 386-4680
r'
SEPTIC INSPECTION / WATER TEST REQUEST FORM
Please specify desired test(s) & remit appropriate fee with
application. Outside water lines are often turned off during
winter months, making access to the home necessary. Please make
arrangements with this office to insure that entry can be gained.
0 Water VOC's $200.00 11i Septi.c $125.00
0 Water (Nitrate & Bacteria) $55.00 0 Nitrate & Bacteria
D Water (Lead Concentration) $21.00 retest $15.00
Vd A Re ested b M S
Owner: Rork. ne, 4u y = Q ~B
Address; 313 /1,W a- Address: ISIy _ ~Q.. 13
te.
o WI ZIP S_L Ft..._6 ZIP y
Telephone M: (Telephone : (RSa) a3- Y9_
_
Property address (Fire W & Street) : 3d LfSh0W'1 ,0,-A2
Location Secr,.~ r T_ N, RW, Town of Son
Realty firm: Lock Box Combo : Closing Date:
O gE CO .E~Ell 3Y, TpROPERTY OWNER
*PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORM*
Water sample tap location:
Is the dwelling currently occupied? Yes T V6
If vacant, date last occupied: p LD
Age of septic system: /ASTgt~ S. o 199 '11ZY ,.s
Septic tank last- pumped by: Z:&Z; GOt.)IJry safigyma~ Date:-'~ ..1.~~9
Previous Owner's Name(s): _
Have any of the following been observed?
❑Y I&N Slow drainage from house.
.Ely AN Sewage Back-up into dwelling.
❑Y ;AN Sewage discharge to ground surface or road ditch.
OY J&N Foul odors.
Other comments relative to system operation:_ 5-po: 4.....AM& ..~E
.9-nAfE,4.__..F~ht~t1~A
I certify that the above information is complete and true to the
best of my knowledge.
DATE:z
OWNERS SIGNATURE
1/94
APR-11.2000 11:00 612-423-49?? 96% P.01
Form- S T C - 104
AS BUILT SANITARY SYSTEM REPORT R.
OWNER TOWNSHIP SEC. T N-R~W
ADDRESS Cy` /VQ ST. CROIX COUNTY, WISCONSIN
/J la
N~..~.IS cv.~J 1,
SUBDIVISION LOT. LOT SIZE -
PLAN VIEW
Distances and dimensions to meet requirements of I•LHR 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
45
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1
INDICATE NORTH ARROW
BENCHMARK: Describe the vertical reference point used ,O..=YJ(a,'
~ ,
Elevation of vertical reference point: Proposed slope at site:
SEPTIC TANK: Manufacturer: ~N'1`r: Liquid Capacity: ri ~ G
Number of rings used: Tank manhole cover elevation:
Tank Inlet Elevation: Tank Outlet Elevation:
Number of feet from nearest Road: Front,O Side,@ Rear, O feet
From nearest property line : Front ,®Side 10Rear, 0 ' 3 feet
! f
building: 19
Number of feet from: well K
(Include this information of the above plot plan)( 2 reference dimensions to septic tani
SEE REVERSE SIDE
PUMP CHAMBER
R
Y
Manufacturer: Liquid Capacity:
x
Pump Model: Pump/Siphon Manufacturer: Pump Size
Elevation of inlet: Bottom of tank elevation:
t:
PPump off switch elevation: Gallons per cycle:
Alarm Manufacturer: Alarm Switch Type:
Number of feet from nearest property line: Front, O Side, O Rear, Ft.
Number of feet from well:
Number of feet from building:
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed: X Trench:
Width: Length : Number of Lines: =0 Area Built:/42s~
Fill depth to top of pipe: &2 li
Number of feet from nearest property line: Front, O Side, ® Rear, Pt
Number of feet from well: 1+
Number of feet from building:
(Include distances on plot plan).
SEEPAGE PIT
Size: Number of pits: Diameter:
Liquid depth: Bottom of seepage pit elevation:
Area Built:
Has either a drop box O or distribution box O been used on any of the above soil
absorbtion sytems? (Check one).
HOLDING TANK
Manufacturer: Capacity:
Number of rings used: Elevation of bottom of tank:
Elevation of inlet:
Number of feet from nearest property line: Front, O Side, O Rear, Q Ft.
Number of feet from well:
Number of feet from building:
Number of feet from nearest road:
Alarm Manufacturer:
Inspector:
Dated: !e;?Z.? Plumber on job:
License Number:
3/84:mj
f r
DEPARTIYIENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
LABOrk & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P`.b. BOX 7969 BUREAU OF PLUMBING
MADISON, Wl 53707
• ► ► XX CONVENTIONAL ❑ALTERNATIVE State Planl.D. Number
(If assigned)
❑ Holding Tank ❑ In-Ground Pressure ❑ Mound
NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE:
B 8 H Deve.2opment 836 St. Cuix $t. N., Hud6on, W1 54016
REF. PT. ELEV.: CST REF. P . ELEV..
BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN:
SW NGI, Section 7, T29N-R19W, Town of Hu6on,Lvt645-46, Edgewood Ezt.
Name of Plumber: MP/MPRSW No.: County Sanitary Permit Number:
(~U,i,?.Uam Schumaken 6382 St. cuix 75044
SEPTIC TANK/HOLDING TANK: WARNNG MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.:C TANK OUTLET/E LEVf.: ,ROOV(~ID DLABEL PLOCKING ROVIDED OVR-y
L eaUA_--' 'J J LS~YES ❑NO ❑YES 1aN0
BEDDING: VENT DIA.: VENT MATL: HIGH WATER NUMBER OF ROAD: LIN PERTV WELL: BUILDING. IAER NLOTRESH
ALARM: IFEET FROM 1 J 7 rT ~r-7
❑YES ❑NO 'u ❑YES NO NEAREST J
DOSING CHAMBER: WARNING MANUFACTURER. BEDDING: LIQUID CAPACITY PUMP MODEL. PUMP/SIPHON MANU ACTU PROVIDED: PROVIDED OVER
❑YES ❑NO ❑YES ❑NO ❑YES ❑NO
PUMP AND CONTROLS OPERATIONAL. MBER OF PR OPERTV WELL BUILDING. AIR NOT RESH
GALLONS PER CYCLE: ET FROM LINE
(DIFFERENCE BETWEEN
PUMP ON AND OFF) ❑YES ❑NO EAREST
ICN(~il~ DIAMETER. MATERIAL AND MARKING
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE
or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN
the soil is dry enough to continue.)
CONVENTIONAL SYSTEM: LloulD
BED/TRENCH WIDTH LENGTH NO.OF DISTR PIPE SPACING: COVER JINSIDE )IA #PITS DEPTH:
TRENCHES. , MAT RIAL: PIT
DIMENSIONS L' r
~hrv EL DEPTH FILL DEPTH IDLEV ISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL. NO. DIS NUMBER OF PROPERTY WELL: BUILDING: VENT FRESH
.
LINE AIR INLET
BELOW PIPES: ABOVE COVER. INLET ELEV. ENOC PIPES: FEET FROM = ~I
. f" -b OtS ! 2 NEAREST ~J 6s
MOUND SYSTEM:
Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM
and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA-
meets the criteria for medium sand. TIONS MEASURED.
❑YES ❑NO
PERMANENT MARKERS'. OBSERVATION WELLS.
SOIL COVER TEXTURE.
❑YES ❑NO ❑YES ❑NO
SEEDED MULCHED.
DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/ BED DEPTH OF TOPSOIL: SODDED.
CENTER. EDGES:
❑YES ❑NO ❑YES ❑NO ❑YES NO
PRESSURIZED DISTRIBUTION SYSTEM: FILL DEPTH ABOVE COVER:
: O.OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE:
W IDTH. LENGTH N
BED/TRENCH TRENCHES:
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING:
ELEV.. ELEV.. DIA.. ELEV.. PIPES: DIA.:
ELEVATION AND
DISTRIBUTION COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO APPROVED
INFORMATION HOLE SIZE HOLE SPACING. DRILLED CORRECTLY ❑ PLANS:
YES ❑NO ❑YES ❑ NO
PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING:
COMMENTS: FEET FROM LINE:
❑ YES El NO ❑ YES ❑ NO NEAREST
Sketch System on Ret 'n-i county file for audit.
Reverse Side. sIGNA TITLE DILHR SBD 6710 (R. 01/82)
'~,wls`onisin. APPLICATION FOR SANITARY PERMIT Y ~
• .D ILHR =L-OUNTY
• - OEGR~iT 1,LRBOOFFiS (PLB 67) UNIFORM SANITARY PERMIT #
~ IRIOUSTR4, LR MUTQf\ FELriTlOrlS '
-Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8%x 11 inches in size.
-See reverse side for instructions for completing this application. PLEASE PRINT
PROPERTY OWNER MAILING ADDRESS
18.1- J9 g- ve i, eAlT s'W,v C./l, 36' Tc cz,
P OPE/LRTY LOCATION CITY:
SGT' /4 AA14, S , To29'N, E (or) TOWN OF) LOT NUMBER BLOCK NUMBER SUBDIVIS ON NAME EST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER
LF0b%0& gill
TYPE OF BUILDING OR USE SERVED
A1 or 2 Family Number of Bedrooms: ❑ Public (Specify):
THIS PERMIT IS FOR A:
XL New System ❑ Tank Replacement ❑ Repair
❑ Replacement Soil Absorption System ❑ Revision ❑ Privy
❑ Alternate System ❑ Reconnection ❑ Petition for Modification
IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK.
14 Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank
❑ System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy
❑ Existing, For Which A Previous Permit Is On File, Permit # issued
❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions.
Total #of Prefab. Site Steel Fiberglass Plastic
Gallons Tanks Concrete Constructed
Septic Tank Capacity
Lift Pump Tank/Siphon Chamber
Holding Tank capacity
Manufacturer:
IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure
Total #of Prefab. Site Steel Fiberglass Plastic
Gallons Tanks Concrete Constructed
Septic Tank Capacity
Lift Pump/Siphon Chamber
Manufacturer:
PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY:
(Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet):
39 //2s- ~(ZS ZrAe~l X Private ❑ Joint ❑ Public
I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans.
Name of Plumber (Print): / Signature: P PRSW No.: Phone Number:
14,11 /1-1 a 01 S Plumber's Address: Name of Designer:
COUNTY/DEPARTMENT USE ONLY
Signature of Issuing Agent: Fee:
j 1 Date: ❑ Disapproved
/~S J/ / t^ ❑ Owner Given Initial
'Approved Adverse Determination
Reason for Disapproval:
7 7-
Alternate course(s) of Action Available:
DILHR-SBD-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber
INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398'
t
To be complete and accurate the permit application must include:
1 Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in
a city, village or town);
2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant,
etc.);
3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks.
4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of
square feet to be installed;
5. Complete the section on water supply;
6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi-
fication, place your license number in the space provided and sign the permit in the signature block;
7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the
permit;
8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation.
Failure to comply will void the sanitary permit. i
9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable.
10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system,
depth of the system, type of system.
I
11. All revisions to this permit must be approved by the permit issuing authority.
12. A complete plan including a plot plan, drawn to scale or with complete dimensions.
I
13. Horizontal and vertical elevation reference points that are permanent and clearly shown.
14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s)
to system, building sewer and vent observation pipe(s).
15. The permit issuing agent may require a cross section drawing of the effluent disposal system.
TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems
must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning
your system, contact your local code administrator or the Bureau of Plumbing, DI LHR, State of Wisconsin.
1
APPLICATION FOR SANITARY PERMIT
STC - 100
This application form is to be completed in full and signed by the owner(s) of the
property being developed. Any inadequacies will only result in delays of the permit
issuance. Should this development be intended for resale by owner/contractor,("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 Property VJ, _Aj (j k, Section 7 T N - R W
Township n .t
Mailing Address d^ aid" ~4/
Subdivision Name Lot Number q - 7 Z
Previous Owner of Property
't'otal Size of Parcel late.
Date Parcel was Created
Are all corners and lot lines identifiable?._ Yes No
Is this property being developed for resale (spec house) ? _ Yes No
T as recorded with the Register of Deeds
Volume r and Page Number _ vff-
INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING:
1. Warranty Deed
2. Land Contract
3. Other recordings filed with the Register of Deeds Office
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
Mal), the the Certified Survey Map shall also be required.
PROPERTY OWNER CERTIFICATION
1 (we) ee&ti6y that aU statements on -thd,6 6o4m aJCe t,%ue to the best o6 my (oun)
knuwtedge; that 1 (we) am (ane) the owner(s) o6 the pn.openty de,6cAi,bed in •thib
.016u,unation 6onm, by vi tue o6 a waoanty deed %eco&ded in the 066ice o6 the
County Re.g•c s teA o6 Dee& as Document No. 99a y ; and that I (we)
p~te,aeii.#.-y own the pn.oposed .6 to bon the sewage posa .6ystem (on .I (we) have
obtained an easement, to nun with the above descA bed pnapenty, bo,% the
cons.oLucti.on o6 said system, and the carne has been duty %econded in the 066ice
v6 the County Regi6 teh o6 Deeds, as Document No.
Ao~tlli S
tiu'_ tSIGNATURE F OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE)
DATE SIGNED DATE SIGNED
I
r
1
J ~ t~~ ~ ~ n ~ , 1 1 V ~ cows e~aa eimieeamiella ~a t
F •1,!!!
OFFICE
S(b CgO1X 00.1AMR.
%ea for ReaXd 1Ms 11th
a ; C! ' day of AA #3,_ A.D. 19_$4
Mao 11:30 A M.
; .:.......:....i t" wbOw am ar t ea).
Vessdrr 40""'sMrM is `pq N - iMa K+ o sM ft s Per-
~ ~ pr~gsiely. will tM
(alt "M the -rmw nil
ia.-»-*. » Cw11Mli 3tsiti 49 WISSWAiaa aswws aerie 1t2XiLr
323.
8% of 404*40v~ 7. T2IUr RISK, EXCEPT the Hudson MI 54016
All r► S3Ij '4f Aft of Section 12, TOR Pared so
~r 1yg alp 'eyf State' Trunk
"~2 , , toe 8opth 32 rods thereof,
sodq 3ng4 Soutbtriy and
~ ~ ~F ly right-of-opts lire
ltld• b!
a_ s, a3.lq~st a oasVMlnt for ingress &W egross over a portion
of t t':±`'"it ►I2-29-20, Town of 8w1son, more fully
de f rilaed 0*-f j'ows colla#q at the East gwrtar-corner of said
SereMt n 321a y"400%6" N 10332.83 feet to the Ely right-of-way of
g.?~ `3$>e. we 034077 424'09 6:37.14 feet along said Ely right-of-way
of Ss.T.H. *35'° `tbrt 11p3tiy lie : eaf the property deeded to Arthur F.
winidoiff and x►ry ; 1fiL lf=f.:.'as recorded in Vol. 519, page 25, Doc.
No. 325163 in thle-`Mfice of trite St. Croix County Register of Deeds, being
This . "'IS .Aipt......_ hawwwow'~. DESCRIPTION CONTIMED ON ADDEND
OW to P4W to vasow at 1%t &wl s riesidaaoe or her written
ttno»um b tM feibwhug vow" Wit (a)•s..
at the ex+eutka of b fJogRl l t11r Uedaitme of = 8l,.325.QQr.--- together with interest from date
e►t i ...(1x41 per cut per annum
ArMal ct "00000 each, plus accrued interest, on or before the first
and saaond atmL ''et>dt th*.'i> x*zact, and the entire balance, plus accrued interest,
on or befte. of this Contract.
Sae attadled AMMM ftC ply for release of lots and application of payments
tilereto. Estiolatm-MIII&I iE to MUM fr 1984, payable in 1985, have been prorated at
closing; Parchaaw stall #bAS vsy°,the ent3r+e 1984 Taxes and subsequent years as due.
Previdari, bowaoir, tl'ie. s rA balance sball be paid in full on or before the._...~_~ day of
Fekmi"y (11ti+ "Ouldw date)
Ho11p vii-ow ase# daEarlt in De>44wevlM istaped elwH accrue at the rate of ...IQ.... % per annum on the entire amount
in default (?witieit s " K S. ISI M sd. delinquent interest mind, upon acceleration or maturity, the entire
principal bAswx )r
I>uiehllssK',
01IMssawl gnaw npseid a tdoAk Ors mW nwired issursetos presaiums wbet due MMMP
copies of receipts on Vendor's written request.
ParnAoft ahe8 be applied drat is lot~ on the am paid balsam at tM rate specified and then to principal. Any
al wWA aeay be pospod wi ba* ee upon principal at any time
In the ~ of say ps ettt.' Ab mistraet sW not be treated as is default with respect to payment so loin
as the unpaiit babense of prigelpal, and islarest (cull in such case accruing interest from month to month shall be treats:
as unpaid principal) is teas than the amunt that said indebtedness would have been had the monthly payments been
inade sa !trot' apeelfiN sba"; provided butt monthly payments shall be continued in the event of credit of any proceeds
of insurancie or .160 00. the +e d ptwaims being thereafter minded heretrom.
Purchaser states that Purchaser is satisfied with the title w shown by the title evidence submitted to Purchaser
for examination sampt: Within six (6) months hereafter, Vendor shall record a certified copy
of the death certificate of William F. Marty, and release of inheritance tax liens in
the matter of the Estate of William F. Marty, to the satisfaction of Purchaser's attorney.
Purchaser airrees to pay the cost of future t.th ivi-,lenc.. 1! title evidence is in the form of an ahvtrart, it shall
ht retwned by. Vendor until t1.o fill purchase price i.4 pnid, lilt 1't1rC1135.'T may Nrvf' Ix,w at)stracts pI"?.W_rr
rtxn.
Put +%ier shall heent-t'Ml to tyk,` -a,.i,,n .•f the i'ropcrt o!, Life V •'t' lit r%,t Xxy}L
11 AND t • •.I RACT --lndhidnal and '-Till It fin Nt<1.. ;1\ .n 1. . It •nw ,
OL,
M ilon whorl clan ll it11 w
"'die
111 act N deliver to Viadsr on
dearapd~,.i ,4 `
Purchaser shell its* the Itaspre -00 so an PNpwty how" us" eorerep par* act a" lisook 40 YWow my
eadar, in no sms of
ibY the ttaalance owsl owiw Wes Crain"
metals the standard dean bt fe~ Of so Ysa(Mrti anal, •alsis
of an policies am in I the ple"If shall be 400" wldh Vender. ,
insurance compaaial aid weed e. Udall Pwwww act Vender
be applied to ratios or vellisr of do Prperty, daauysi. provided dice w
economically feasible.
101i i
ire atawM lice
lsrdhwr eoveaaote set to ssa"bwwyU~ gate tllotr vole fie
~
so amplyyWWE na law i Ahm esss ;U te~latiaN as 9 dis Propoft.
Vender allress that in CON the pm'Nww PH" wfilh iaft"A aced ether siin~aftsli/I .
*hall be fully perfosmW at the times and tai the ssaaser above apeeifisd. Vender eft..
the Purchaser, a Warrlae ntty Desd, is toMsYyirs el dog Pespetty, tier aced aMar
~y asamnlime as wt fc lA ttlB. . Of Li H @.~
t'Seea Atttai .fec JA irov sf ens..
• .....+.w'..
Purchaser agrees that time is of Pahl eessa and (a) is the ewnd of a Aston is lilt plow" of aw Ilkift phi or
interest which continues for a period of days following the apsei(isd des 410 vor, 4" M Nis axle)) f s) dtlllwit An
performance of any other obligation of Purchaser which continues far a_perfird et daw o tea!
thereof by Vendor (delivered personally or mailed by certified mail), lhea) oa eatlrss a
!hall become immodistdy due and payable in full, at Vendor's option and withwt a 46" asaer heeeby
waives), and Vendor shalt also have the following rights and remedies lam M ally .-I a !lone) in
addition to than provided by law or in equity: (i) Vendor may, at his opd* terealmafe 10 }111i1no1t 'e
rights, title and interest is the Property and recover the Property hack mfr Y atrrkt tN awli et
redemption to be conditioned upon Purchaser's full payment of the entire mfls** t8i~t belso e, w~i h**Wt reenireas
~
the date of default at the rate in effect on such date and other amoastadueberetader wbiisb aws ,So Mwata:pev 0
paid by Purchaser shall be foreteited as liquidated damages for failure to fWf#1 1ok •taoerhrsia! Mal as 1"tr11 for the
Property if purchaser fails to redeem); or (ii) Vendor may sue for spedfle performaacil of 116 {9etllmi t to aonhpsl
immediate and full payment of the entire outetonding balance, with iat=*A thsrsoa at Pia tat! :fM .Mitt as dedst of
sad how
default and other amounts der hereunder, in which event the Property shalt be eacUsewd at }>r "Is
shall be liable for any deficiency- or (iii Vendor may sue at law for the entire mepaid parebatso or my Portion
thereof; or (iv) Vendor may dse~are'tbb Contract at an end and remove this Contr"e~ M% b► 9a
action if the equitable interest of Purchaser is insignificant; and (v) Vendor any have Pwn!Wrin'e-esthl iroaaarsseaiMOD'
of the Property and have a receiver appointed to collect any rents, issues or profits dorbW the of any action
under (i), iii) or (iv) above. Notwithstanding any oral or written statements or attioas of V M election of any,
of the foregoing remedies shall only be binding upon Vendor if and when pursued M ewsts amid expense,
including reasonable attorneys fees of Vendor incurred to enforce any remedy bertadtr (T=h4 almW or not t o the
extent not prohibited by law and expenses of title evidence shall he added to pritseipal 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 feredoemto of 4111k•L'onttt~~tR.. 1~rrdtarKr consents
to the appointment of a receiver of the Property. including homestead interest, to edNat Tonic, iaaooe, a1W of
the property during the pendency of such action, and such rents, issues. and profits when as Baas A sbap beheld and
applied as the court shall direct.
f>ty aMitnahent of any
* Purchaser shall not transfer, sell or convey utn' legal or equitable interest in the
Plana
of Purchaser's rights under this Contract or by option, long-term lease or in etbrr JIMMM)
* consent of Vendor stakes sides due ounce"- baiaree payable uader4m flli i 1 AM
* conveyed is a pledge or assignment of Purchaser's intert st under this Contract solely as security for an Indebtedness of
Purchaser. In the event of any such transfer, sale or conveyance without Vendor's written. do attire outstanding
* balance pay" under this Contract shall become immediately due and payable in ftdl, at ` without notice
Vendor shall make all payments when due under anv mortgage outtrtwwhq[ tNlsiriat,the oq eke dste of
this Contract (except for any mortgage granted by Purchaser) or under any note ssruresl . viiv $ed !">trobaser
makes timely payment of the amounts then due under this Contract. Purchaser may make an. pt is directly to
the Mortgagee if Vendor fails to do so and all iw. tuents .o made by Purchaser shall he considered yments made or,
this Contract.
Vendor may waive any default without waiting any other subsequent or prior default of'Partka r.
All terms of this Contract shall be binding upon and inure to the beneAM of the of legal represeatattves,
successors and assigns of Vendor and Purchaser. (If not an owner of the Propary the spates Vk4KadW file a valuable
eonsidcration joins herein to release homestead rights in the r.ubjeet Property and stress to join In the eseention of the
deed to be made in fulfillment hereof.)
Dated Phi, 23rd day of February 29' 84
B. & UNEWPME W, INC. (PurchaWr)
v t 11 i7. :.(ISFAL) BY' az-, (SEAL;
Anita P. Marty (Vendor) nald E. Bjo i ii3ent
%17' 01 tic.
(SEA,,) And: * '~•.(Slw~l,t
William C. Hazwell, Secraeta4
s•1: ~s
AUT88NTICATION ACENOWL)dDtltINS"
Signature(s) of 1lnita P. Marty, a single STATE OF WISCONSIN t 2
{ens. "
womant... ST. CROIX
Count;;.
authen'hvatOd th,s 23rddey of f'E3 Teary. , 1964 Personally came before me " P'74_ .day of
February, 19 64 the named
Donald E. Bjornstad, ~resfcellt: anRobert F. Wall William it Hartoell, , of said
TITi,F: 11F'.lti ER ~TATF: BAR OF 1% IS, oNSIN 0orporatlon, who actrrow~ ghat Oi&y
.'f fivers
ODUM • exectxtsd((~~tjjh~psyy~~~grlstnanei eta h o [
earl trv tl k Sotlo,% Wis. o£mr ne~,wnthi~~s~ iMUtl4lsthand
ts^
fu nt ti utnct to trflcnAw th saute.
/ 7
AA.
tai ll i,un J. Giit,t rt, Att', William J. 91 lbert
t :I 11-51 .111" mux l: S 1't TIP r
t. Croix
P.O. B(e x 321, lilt li'tdl W1 \ntar: i':d•)ic County, Wip.
'J. ILgt, AT} e'rnami--it,rt i~ r:a,:. race'. ]m(?QOlT;2ii000Kr.
1, I n♦1Ni1 T incl. uavtd ea. .i R.-rr.e.in, Far,. W. It-if+_ My Conimiss;on is Parnanent
L
,YM ,t
. 447
ADDENDU!! Page A
CONINOATION OF PROPERTY DESCRIPTION:
the lily l in* of the South 32 rods of said 88% "of of & AJO*, t 20 t
thence U901000'00"E along said Nly line of said ltiellolff prepMrtty for
249.49 feet to the centerline and Point of Degimi" of SWA ' 8 toot wide
easement, being described along said centerline aa. ell ~
N12055100"M 199.43 teat; thence My on a curve cowave ,!o hw My MVing
a radius of 99.45 feet, whose chord bears N46'03'•00wV 148.12- boti thence
N790151200M 111.50 feet, more or less, to the Ely right-Hof- o of S.T.H.
035 and the Point of Termination of said easemat. (FOt`.the parpbsse
of this description, all bearings are referenced to the:. It-404st
.
quarter-section line of Section 12-29-20, assumed X"1000'100* M,
SUBJECT TO recorded easements for e.ectric and telephone li0s.
SUBDIVISION AND RELEASE OF LOTS:
Vendor agrees that Purchaser may subdivide said Property,,w'*ith all volts
associated therewith to be paid by Purchaser, and that will join
in execution of any plat(s), certified-survey map(s) amd;athtt instruments
necessary for such subdivision, except that vendor's interest shall not be
subordinated to any indebtedness incurred by Purchaser.
Purchaser may develop, improve and sell subdivided. lots;j.M r; fr,without
buildings being constructed thereon by Purchaser. Vetdtlf ~ to
release such lots upon sale thereof by Purchaser, by Yeador'8Q1~tion
of Warranty Deeds thereto to Purchaser; Purchaser shall prepare and fur-
nish at Purchaser's expense all such Warranty Deeds and"the associated
i Real Estate Transfer Returns, except the tins
Return conveying the remaining part of said Property which shall be at
Vendor's expense. Upon such release and conveyanee..ot *the value of
each released lot shall., for calculation of the to %isfat fteti be determined
by rounding off the acreage of the lot(s) releass& to the Est even
number and multiplying same by $1,500.00 per acre; the tramffer fee shall
be paid by Vendor. Upon conveyance of the remaining part of said Property,
the balance of the transfer fee not paid upon lot relowne.shall then be
paid by Vendor regardless of the acreage of such remaining,part.
Upon Vendor's release of lot(s) as aforesaid;,. Purchaser stash have paid or
shall then pay to Vendor an amount equal to 500 of the selling price paid
to Purchaser for such lot(s) released; provided, however, that the $10,000.00
annual payments due on the first and second anniversaries-of this Contract
shall be deemed advance payment toward such relesm -payftihte., thus entitling
Purchasers to release of lot(s) for sales up to $20,000.00 for each such
annual payment, and Purchaser shall be obligated only to pay 50t of the
selling prices that exceeds $20,000.00 aggregate with respect to such credit
for each annual payment. All payments received shall be,.applied first to
interest and then to principal. The $10,000.00 down payment paid at the
execution of this Contract shall not be applied to any release of lots,
but instead shall be deemed to be advance payment toward Vendor's release
and joinder in the dedication of public roads and of any parkland or
similar areas which Purchaser may be required to dedicate pursuant to the
subdivision of said Property. It is the belief of the parties that such
$10,000.()0 down payment, applied to release and dedication of hands to the
Town of Hudson for public use, is exempt from real estate transfer fee
pursuant to Sec. 77.25(2), Wis. Stats., and that transfer fees will thus be
due only upon $84,395.00, to be paid by Vendor as provided above.
i
Y ~
c .
Nothwithstanding the aforsaid method of calculatbW the t he paid
to Vendor for release of lots, rurchaser shall be OW96 i M Ouch
additional amount, if any, for lot releases to assusa thft Ow x*mjXibg
acreage not theretofore released as lots or drdiested to ! 1ti If
multiplied by $1,500.00 per acre, does not exceed the nNimiolag bilime
due under this Contract.
The foregoing provisions shall be deemed to modify afar *W&1cti,eq term
this Contract which prohibits or restricts transfer or c rYanco of
aid Property, to the extent necessary to give full force and effect,to
the foregoing provisions.
9
4
I
i
I
1 41
410744
REGISTERS OFFICE
ST.'CROIX CO., M%
Reic'd. for Record this 9th_
day of April A.D. 19_86
AFFIDAVIT A M,
pt
James O'Connell
STATE OF WISCONSIN)
SS -~•--togwow of Doods
ST. CROIX COUNTY )
I, James E. Rusch, Registered Wisconsin Land Surveyor, hereby depose
and say:
That I have surveyed and platted Edgewood Estates, located in the SE 1 /4
of the NE 1 /4 of Section 12, T29N, R20W, and in the SW 1 /4 of the NW 1 /4
of Section 7, T29N, R19W, Town of Hudson,: St. Croix County, Wisconsin;
That there is a proposed on-site liquid waste disposal system intended for,
and percolation test completed on Lots 46 - 47 of said plat;
That said system is intended to serve a home intended to be built on Lot 47
of said plat;
And that I make this affidavit to inform all future purchasers of said Lots
44 45, 46 and 47 of the possible existence of said system.
.,Subscribed and sworn to before me
this day of A Pp- 1 11986
. 1vl~y y 1 h~
Ngt~y+ry ublic, State of Wisconsin
Iv11y (c:imis=Sibn expires June 14, 1987
This instrument drafted by:
James E. Rusch
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S T C- 10 5
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SEPTIC TANK MAINTENANCE AGREEMENT o
St. Croix County z
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OWNER/BUYER '2y
ROUTE/BOX NUMBER Fire Number
•
CITY/STATE ZIP, Aa
PROPERTY LOCATION: 114, _14, section _Z IfN, R1,9_W,
Town of ~/iJI1 St. Croix County,
Subdivision oA Lot number ys y(o .
G'
Improper use and maintenance of your septic system could result in
its premature failure to handle wastes. Proper maintenance con-
sists 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 treat-
ment 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 systems properly
maintained
The property owner agrees to submit to St. Croix.County Zoning a
certification form, signed by the owner and by a master plumber,
journeyman plumber, restricted plumber or a licensed pumper veri-
fying that (1) the on-site wastewater disposal system is in proper
operating condition and (2) after inspection and pumping (if nec-
essary), the septic tank is less than 1/3 full of sludge and scum.
Certification form will be sent approximately 30 days prior to
three year expiration.
I/WE, the undersigned, have read the above requirements and agree
to maintain the private sewage disposal system in accordance with
the standards set forth, herein, as set by the Wisconsin Depart-
ment of Natural Resources. Certification form must be completed
and returned to the St. Croix County Zoning Off:Lre within 30 days
of the three year expiration date./
S I GN ED Gtr 7 /
DATE Z,//9 IS
St. Croix County Zoning Office
P.O. Box 98•
Hammond, WI 54015
715-796-2239 or 715-425-8363
Sign, date and return to above address.
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rIN PA iTMEN`I OF - REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
D IVISION
1A AND PERCOLATION TESTS (115) P.°. eDx 7969
i.i,Nv.JT1C7NS MADISON, WI 53707
(H63.09(1) & Chapter 145.045)
r7scw7';.: CTION: NSHI MUNICIPALITY: N : SU IVISION NAME:
/H 7 /T~9 N/R►g to v4 s~ E oor~ s
COUNTY: (OWNEFMRUYER'S NAME: MAILING A(
I C~ x t ~ ~ CQO IX J ~ ~ ; 540!
SE DATES 0111118E1tVA1"#AA&I
NO. BEDRMS. ]7MMERCIAL 0
4FIesidence I - New ❑Replace M16QG~ I ' 1N 27 Ig
5a►LS ~ 49 s~,~ , i tl
RATING: S- Site ~~suitable
for system Ua Site unsuitable for system ~~~~~'iQhitPREMME
:ISYSTrrM .ONV S CJY Mbl~LJ S ®U .S ❑U S L ❑ S R~NME ~f'tt,0 sTE •(+.~C
If Percolation Tests are NOT required DESIGN RATE: If any portion of the tasted arN ie In the
under s.H63.09(5)(b), indicate: CLASS 3 Floodploin, indicate Floodplain slwallon:,. "
,gK. = PROFILE DESCRIPTIONS '
BORING TOTAL R U T -INCH HA A AN DEPTH
NUMBER PTHAk, ELEVATION gSE V p TO BEDROCK IF OBSERVED A V Q,
B- 7_76 ,At AA 6-0,6$LLTS 0.6-/,0 It1 bo-1.7 99i'$* GQ
0-12 9etASLit6k RL-1-L4 ,4`5 D
+v > 776 40:75 tLmSS o,Y513-0r
►+S N*eCC46 3 o-4,0 h J4-L1~
B- G7 Z<,
I 7.76
Lo
L 2. z
.3 6 V'S 6
S- •ZC~ oS 7 ~•Zb 0-/,o AL Lrs J•t,-J.3 8eN5,L J.3-3.7 QN 5+4,+R
b
0 31-42 RtAS46*
IB- a-; L fRcLTS -0+6-24 S,L z.►- .7 t3~fv ~Eala
7-!0 SO > 736 -7! e&S46t Ca m
40 >8.40 6-6.6 9LL7---- R966-Z.15 6~ BRN5+be Cc~~+
B-
etc PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME WATER DR3P IN RA 1 S
NUMBER I S AFTER SWELLING INTERVAL-MIN. PER INCH
P-
P-
7
22
P_ o-z
P_
Pr
LOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable areas. Indicate scale or.dlstanas. Describe what are the hori-
ontal and vertical elevation reference points and show their location on he plot plan. Show the surface elevation, at all borings and the direction and percent
f land slope.
YSTEM ELEVATION _ 4 ► •oo
I _
i Ap
+
4 4
- ALT.'
63
SYS'i-Erh
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5K
S TE '
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ros. w
1~7', 2ci EV = 100. tom'-- nt
AAV
t;KKI"i" Kit"
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
dministrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
VAM TESTS WERE COMPLETED ON:
print)
A egg
CERTIFICATION NUMBER: PHONE NUMBER (optionali.i
407n `?-gat 1_ S4olb 3
CST SlG TUBE:
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DISTRIBUTION: Original and nnc copy to Local Authority, Prnnr:rty Owner and Soil Tester.
~?It_F1Ft-SRn i 395 IR. (17/R'~) - OVER -
ST. CROIX COUNTY
f WISCONSIN
ZONING OFFICE
N1111 ■ ■ ■ ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
• - i = _ _ Hudson, WI 54016-7710
- (715) 386-4680 Fax (715) 386-4686
April 28, 2000
Mr. Thomas Yardley
15144 Dunbar Boulevard
Apple Valley, MN 55124
Re: Septic Evaluation at 313 Harshman Drive
Dear Mr. Yardley:
Our records indicate that the trench-type system that is being utilized on the above referenced property was
installed by Robert Ulbricht on 9/5/92. The system consists of three (3) trenches that are 5' x 81' and it is
sized for a four bedroom structure. The system was installed as code compliant.
On April 25 and April 27, 2000, I conducted a septic inspection on the Rick Stoner property at 313
Harshman Drive. At the time of the inspection, the sanitary system appeared to be functioning properly;
however, I was unable to locate the first septic tank coming from the house. There was no vent or
inspection pipe visible. I did not observe any water ponded in the vent pipe of the older bed-type system,
though there was approximately 12" of water noted in the vent pipe of the first trench closest to the home.
There was no water noted in the other two trenches. I would recommended that vent caps be installed on
the vents of the trenches instead of the inspection caps. This will allow the trenches to stay aerobic. You
can purchase the vent caps at any plumbing supply store.
Ponding results when microscopic bacteria and sludge plug the soil pores forming a clogging mat. This
closing mat descreases the soil's ability to dispose of the sewage effluent. Over time, this clogging mat
becomes thicker, causing less and less liquid to percolate through the system. As this mat becomes
progressively thicker it leads to failure of the systems. To prolong the life of the system is as simple as
fixing or replacing plumbing fixtures with water conserving fixture, reducing shower time, washing dishes
when the dish washer is full, avoid using a garbage disposal, using a wash machine with a suds saver
feature, etc.
The inspection of this sewage disposal system was based on a surface inspection of said system, and did not
involve any excavation or chemical analysis. Accordingly, there is the possibility of hidden defects in the
system not discoverable by this inspection. This does not in any way warrant or guarantee the continued
proper functioning or operation of this system. It is recommended that the system should be pumped once
every three years. Therefore, the prolonged life of this system may be dependent upon proper maintenance
of the system.
Should you have any questions, please contact me at (715) 386-4680.
Sincerely,
l~
Kevin Grabau
Zoning Technician
YARDLEY 612-423-4977 04-11-00 10:46 P.01
U4/ IU/VV Blui% 1.1.60 AAA 110 JUU VVVV V1 %n%n VV I.VOALIIJ y1
f ,1 ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
s r a r a, - ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmlchael Road
Hudson, WI 54016.7710
(715) 386-4680
SEPTIC INSPECTION / WATER TEST REQUEST FORK
Please specify desired test(s) & remit appropriate fee with
application. Outside water lines are often turned off during
winter months, making access to the home necessary. Please make
arrangements with this office to insure that entry can be gained.
0 Water (VOC's)______ $200.00 8/Septic $125.00
Q Water (Nitrate & Bacteria) 0,55.00 0 Nitrate & Bacteria
D Water (Lead Concentration) $21.00 retest $15.00
Owner: R,Ck. a4 Requested by: hQntQS
A~17 6j*
ddress; 31 6146 Address: 15)y ~ 13
0.7~ WY ZIPS 0/6~ '1 _ ZIP ~S/ay
Telephone N4: ( ) 3RD-636y Telephone i (RSa) a3- ~t912_
Property address (Fire M & Street) : 3/3 Nars"how 16A c Lo at}on: Sec. T N, R W, Town of ~n
t o 'f~ 76-- y7 Se ~o ~ 6 des
Realty firm:*' Lock Box Combo: Closing Date:
OrtnX15 - A- ?Q10ney) GZo --I 1 b'-~ Sv
6 7 -boo • . l~ ,~i'~ TO PE „C . _LgD ,,9Y PROPERTY ONNIM 17
*PROV1DE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORMS
Water sample tap location:
Is the dwelling currently occupied? Yes 0 No
If vacant, date last occupied: _
Age of septic system: /1~5?A~ 712-y o ~-D
Septic tank last pumped by.
T$.~ co~1jr:y Sax►r1~Ttionl Date: t C:',.,,, cL9
Previous Owner's Name(s)
Have any of the following been observed?
❑Y )AN Slow drainage from house.
OY Al Sewage Back-up into dwelling.
OY1 Sewage discharge to ground surface or road ditch.
DY )ON Foul odors.
Other comments relative to system
I cortify that the above information is complete and true to the
best of my knowledge.
OWNERS SIGNATURE - DATE: 11121 oO
1/94
APR-11-2000 11:00 612-423-4977 96% P.01
- - - - - - - - - - - - - - _
2-2000 15:42 Corporate Security 612 728 8352 P.03 ,
ST. CROIX WUNi I Y
WISCONSIN
ZONING OFFICE
e r a - c ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
x- Hudson, Wt 54015.7710
(715) 366-4680
SEPTIC INSPECTION / WATER TEST REQUEST FORH
ease specify desired test(s) & remit appropriate fee with
plication. Outside water lines are often turned off during
nter months, making access to the home necessary. Please make
rangements with this office to insure that entry can be gained.
Water (VOCIs)_-- _ $2.00.00 8/septic $125.00
Water (Nitrate & Bacteria) $55.00 0 Nitrate & Bacteria
'Water (bead Concentration)$21.00 retest $15..00
ner: Rkk var~e~' Requested by: 'yAQru 5 T. r ~e
ddrees : _--3-i~~LsL41_._! ~r1e Address : 15114Y /yr
~lv~son w.r ZIPS o~6r ZIP q
-elephone Fly: (:2fir } 3g(a._.h3~y Telephone a3-
operty address (Fire W & Street) : 313 llaoshsw1 hr_ ~,C__..._
cation: I-, h, Sec. T N, R~ ~W, Town oF
Ion yr, yl 17 1',1 ~-xq e~~o_ ;T s
ealty firm: ' Lock Box Combo: Closing Date:
efny T'ohn564 Q ovmey) 7/5 - 386-?~11 -7
TO .~E co ~>✓ll ~Y'RaPFRTY OWNRR
PROVIDE. A SKETCH OF HOUSE & SEPTIC-SYSTEM ON REVERSE OF THIS FORM
i
ater sample tap location:
S the dwelling currently occupied? Yes D No
f vacant, date past occupied:
ge of septic system: O L-0
ti eptic tank last pumped try: co„C.c1r.V SfifiiMTeW Date: ~7
j _f2~
.revious Owner's Name(s)
lave any of the following been observed?
OY )4N Slow drainage from house.
oy 09 Sewage Back-up into dwelling.
' OY AN Sewage discharge to ground surface or road ditch.
Oy JON Foul odors.
t.her comment:, relative to systc:iu cl~cration:, c.... i
~.Q~._..F~NNt~ALy,...S!N. iN-M,4LflyfLQlV____....
certify that the alcove information is complete and true to the
est of my knowledge.
OWNERS SIGNATUREc~~ DATE: _y11 ~Il'~
/94