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HomeMy WebLinkAbout020-1181-80-000 C m CDo I o o O or v ~ ~ a I ~ N I ©0 3 N ;O_ I O I y - `O f6 I c m Ov °o I 0 ~ I y 3 a~ n a ~ I a~'i x I c z ~c I co LL c w O N U Q .C N M a, w E U) o ~ £ L Z d d 00 N H U) d m I o Z 1I ! c N F- ° E ` N N co v N N •Ra ~ (D N N a (D G, © _ o a~i Q Z m z N E w H E 1° C r r a~ ~1 O N i~ N N 0 a rz E 'D E H I.- H ~ U c 0 0 0 d ~N q N a a a 4 3 a _ N ) o U c rn V) r U } m rn C) O o ° C) C' E N n m d LO (n a) a) ¢ Q0 o O O LO E cn U) 0) 0 O O ^ c} ° 0) M + O 3 _ N c c O O L ~ I-O m c C c cU ~ p U _ W N C - _ N N ❑ r pj O N O "U W N Cj (n • i. N c6 c N ° m U y O N T 2 O -(n Cn C~ w # G a C a w CL 2 4) L w i A L) (L Om0 1 AS BUILT SANITARY SYSTEM REPORT OWNER 6// 1171 ,v,,,Ve G( TOWNSHIP SECTION T_2-L_N-R l 0 W ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION- C,ed'QR.L l/ ,5' LOT-2~1;_LOT SIZE 2 -A PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM i t lit o w < n S, r a INDICATE NORTH ARROW BENCHMARK:Elevation and description; Alternate benchmark SEPTIC TANK: Manufacturer: Liquid Cap._ leae Rings used: Manhole cover elev: Final grade elev: Tank inlet elev.: Tank outlet elev.: No. of feet from nearest road:Front-,~<--, Side , Rear Ft.l3Q From nearest prop. line:Front , Side, Rear Ft. 1-1.5- No. of feet from: Well ;dgr.- 41e , Building: /J (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: -Liquid Capacity: Pump Model:~Pump/Siphon Manufact.: Pump Size Elevation of inlet: Bottom of tank elevation Pump on elev.: Pump off elev.: Gallons/cycle: Alarm: Man.: Switch Type: Location Distance from nearest prop. line: Front_, Side, Rear_Ft. Distance from: Well Building SOIL ABSORPTION SYSTEM Bed: Trench: Seepage Pit: Width: Length 4 Number of Lines: Area Built 75-Z~) Exist. Grade Elev. Proposed Final Grade Elev. Fill depth to top of pipe: No. feet from nearest prop. line:Front , Side, Rear Ft. f No. feet from well: : ,i-No. feet from building 7 ` 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: DATE : PLUMBER ON JOB : LICENSE NUMBER: 6/90:cj ~Wi~Co'ILSpartmien~oT~ust28'29.19.1147 SW NE LOT 46 ALDRO RD. Laborand•Hu art Relations y PRIVAT9 SEWAGE SYSTEM County: man Sofety and Buildings Division INSPECTION REPORT ST. CROIX (ATTACH TO PERMIT) sanitary Permit No--. GENERAL INFORMATION 171496 Permit Holder's Name: ❑ City ❑ Village [Town of: State Plan ID No.: CEDAR HILLS DEV INC HUDSON CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 00 0 ~CLsti,r_(~ C S 1`ytie. 5 020-1181-80-000 TANK INFORMATION ELEVATION DATA A9200263 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark S ~ ►Ul~ I ` Dosing Aeration Bldg. Sewer Holding St/Ht inlet f $ g9 7 2- TANK SETBACK INFORMATION St / Ht Outlet a,U 8 q, S 6 TANK TO P/ L WELL BLDG. Airi to ntake ROAD Dt Inlet Ar I Septic S~ til o / NA Dt Bottom Dosing NA Header/ Man. / a Er, Aeration NA Dist. Pipe / d • g S, 74 Holding Bot. System 3 S~ g 7.~ PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft oss Forcemain Length Dia. I- Dist. To Well SOIL ABSORPTION SYSTEM BED / TRENCH Width Length No. Of Tr riches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 1 (0 -~y DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type O r CHAMBER Moe Number: System: A) 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 w Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed/ Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) 8~ 5~ Can,,, r , tr~ } Ia t 11 t ^ ! A" N ~ ' ~ Q+ + r Plan revision required? ❑ Yes ❑ No\ Use other side for additional information. -l 11) H vOr(' SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH r , SANITARY PERMIT NUMBER: ` SANITARY PERMIT APPLICATION DILHR In accord with ILHR 83.05, Wis. Adm. Code COUNTY STATE SANITA RMIT# -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ ~ 1 / 8% X 11 inches in size. Check f revisn t p vious 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 C l SW 114,41C- 4, Sat ff' W9, N, R /57 E (O W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # e-7-11 ~u d.S .Al Gv,' 1 ~ CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER LJt ~ G! ~ C~t~-Y tale C/ EAREST ROAD II. TYPE OF BUILDING: (Check one) El State Owned VILLAGE NTC OWN QF: L TAX N B ( ❑ Public 1 or 2 Fam. Dwelling-# of bedrooms 2- AR 111. BUILDING USE: (If building type is public, check all that apply) a a Q j L rl` rQ 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 70 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. W New 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 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 12. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) P1:;` pa 47/115- ELEVVATION Y'sd ' f A0 aZ ~'1 , 3 O t Feet Feet VII. TANK CAPACITY Site in gallons Total # of Prefab. Fiber- Exper. INFORMATION New xistin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank .4 Lift Pump Tank/Si hon Chamber I I El n El F-1 El Vill. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) M MPRSW No.: Business Phone Number: r'a 'Pi C Plumbers Address (Street, City, State, Zip Code): S'c D 6 IX. COUNTY/DEPARTMENT USE ONLY Disapproved a itary Permit Fee (Includes Groundwater a e ssue Issui gent Si nature (No Stamps) Approved ❑ Owner Given Initial Surcharge Fee) _ Adverse Determination 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 2, 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. 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 gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete fo• all septic, pump/siphon and holding tanks for this system. Check experimental approval only i' :anks 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 B'/ 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; close 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-8398 (R.11/88) L 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. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - w~ Owner of Property Or l/ Location of Property SG,/ P--', Section TAN-RW Township Mailing Address Address of Site Subdivision Name .Lot Number Previous Owner of Property A~; l Y., h QUA Total Size of Parcel Q e 4a-jg, e Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume and Page Number / ~~as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and page number, and the Seal of the Register of Deeds. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION 1 (We) centt6y that att statement.6 on thi,6 6onm ane true to the best o6 my (ou&) knowledge; that I (we) am (cute) the ownen(s) o6 the pnopenty dacnibed in this .in6o4mation 6o4m, by viAtue o6 a wa Aanty deed neconded in the 066.ice o6 the Cody Re9i,6ten o6 Veedh ab Document No. 411~?,179 ; and that I (We) pnedentty own the pnopoa ed A to bon the sewage dins pod b yb em (on I (we) have obtained an easement, to nun with the above debchi.bed pnopehty, bon the constnucti.on o6 6ai.d 4y6tem, and the came has been duty neconded in the 066.ice o6 the County Reg.iaten o6 Veede, as Ooeument No. r / SIGNATURE OIL OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED qj Wit - UMENT NO STATE BAR OF WISCONSIN FI M 11-1982 THIS SPACE RESERVED FOR RECORDING DATA ' LAND CONTRACT ~pr Individual and Corporate R "S S OFF!'' ~~:1,47. (TO BE USED FOR ALL TRANSACTIONS WHERE OVER 825,000 IS FINANCED TRANS CfIONSI NON-CONSUMER ST. CROIX Co., wis. Recd. for Record this 11 th Contract, by and between Harry J....Stewart, as Personal day of June A.D. 19 86- Representative of the Estate of Aldro Larsen a/k/a John Of 11:45 A AAA. Aldro _Larsen__aJk,/a. John Alro__My_re.................... n_*_. ("Vendor", James 0 Connell whether one or .more) and .William C . • Harwe *si.ngle man ("Purchaser", whether one or more). Vendor sells and agrees to convey to Purchaser, upon the prompt and full per- deputy formance of this contract by Purchaser, the following property, together with the rents, profits, fixtures and other appurtenant interests (all called the "Property"), _ in_____________ St_. Croix County, State of Wisconsin: RETURN TO See legal Description on Addendum Tax Parcel No 386 _ q.273 y . FF"F This --..--S_ not__________ homestead property. $ (is not) Purchaser a rees to urchase the Pro ert and to such lace as he shall name g p P Y Pay to Vendor at -p............................................... ce a e ll the sum of $__192.x500.00.................................... in the following manner: (a) $._.60.,uj!0.&0-.......................... at the execution of this Contract; and (b) the balance of $A2.,50Q,UQ together with interest from date hereof on the balance outstanding from time to time at the rate of teA_. 1Q7-)._....----- per cent per annum until paid in full, as follows: See Payment Terms on Addendum Provided, however, the entire outstanding balance shall be paid in full on or before the-------- 11th day of June 19---4-Q- ( the maturity date). Following any default in payment, interest shall accrue at the rate of % per annum on the entire amount in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance). Purchaser, unless excused by Vendor, agrees to pay monthly to Vendor amounts sufficient to pay reasonably antici- pated annual taxes, special assessments, fire and required insurance premiums when due. To the extent received by Vendor, Vendor agrees to apply payments to these obligations when due. Such amounts received by the Vendor for payment of taxes, assessments and insurance will be deposited into an escrow fund or trustee account, but shall not bear interest unless otherwise required by law. Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any cXx]cXxcC]~C71g~cx2cx~7q amount may be prepaid without premium or fee upon principal at any time. tlzarx:~:,.~.fo-xxutac~x~slxe¢>atx~ci~iacai~ixaettl~xQS~wnilmao~mfx~ssxtaAlt In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long as the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be treated as unpaid principal) is less than the amount that said indebtedness would have been had the iARikt*}VA payments been made as first specified above; provided that monthly payments shall be continued in the event of credit of any proceeds of insurance. or condemnation, the condemned premises being thereafter excluded herefrom. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except: Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall be retained by Vendor until the full purchase price is paid. Purchaser shall be entitled to take possession of the Property on....... l:he_.de> g__hereof .3ax....... *Cross Out One. LAND CONTRACT-Individual and STATE BAR OF WISCONSIN Wisconsin Legal Blank Co. Inc. J Corporate FORM No. 11 - 1982 Milwaukee, Wis. n Purchaser promises to pay when due all taxes and assessments levied on the Property or upon Vendor's in:.'zP-st -in4k and to deliver to Vendor on demand receipts showing such payment. Purchaser shall keep the improvements on the Property insured against loss or damage occasioned by fire, ex- It r.ded coverage perils and such other hazards as Vendor may require, without co-insurance, through insurers approved by Vendor, in the sum of _n/a but Vendor shall not require coverage in an amount more than the balance owed under this Contract. Purchaser shall pay the insurance premiums when due. The policies shall contain the standard clause in favor of the Vendor's interest and, unless Vendor otherwise agrees in writing, the original of all policies covering the Property shall be deposited with Vendor. Purchaser shall promptly give notice of loss to in::orance companies and Vendor. Unless Purchaser and Vendor otherwise agree in writing, insurance proceeds shall he applied to restoration or repair of the Property damaged, provided the Vendor deems the restoration or repair to be nwlnically feasible. Purchaser covenants not to commit waste nor allow waste to be committed on the Property, to keep the Proper:- in rood tenantable condition and repair, to keep the Property free from liens superior to the lien of this Contract, and to comply with all laws, ordinances and regulations affecting the Property. Vendor agrees that in case the purchase price with interest and other moneys shall be fully paid and all conditions shall be fully performed at the times and in the manner above specified, Vendor will on demand, execute and deliver to the urchaser a Qlt~mlx De d in ,fee simple, of the Property, free and clear of all liens and encumbrances, except ersona'1 R resn aPtiv s any iens or encumbrances created ~y the act or default of Purchaser, and except: easements ,..protecti.ve__ .-cove.nant-s.-a£__recard,_.i£..any.,._and--zoning.-a.rdinance..requirements Purchaser agrees that time is of the essence and (a) in the event of a default in the payment of any principal or interest which continues for a period of ._.fZQ... days following the specified due date or (b) in the event of a default in performance of any other obligation of Purchaser which continues for a period of AD.... days following written notice thereof b.N• Vendor (delivered personally or mailed by certified mail), then the entire outstanding balance under this contract shall become immediately due and payable in full, at Vendor's option and without notice (which Purchaser hereby waives), and Vendor shall also have the following rights and remedies (subject to any limitations provided by law) in addition to those provided by law or in equity: (i) Vendor may, at his option, terminate this Contract and Purchaser's ri>~hts, title and interest in the Property and recover the Property hack through strict foreclosure with any equity of redemption to be conditioned upon Purchaser's full payment of the entire outstanding balance, with interest thereon from the date of default at the rate in effect on such date and other amounts due hereunder (in which event all amounts previously pail by Purchaser shall be forefeited as liquidated dama_es for failure to fulfill this Contract and as rental for the Property if purchaser fails to redeem) ; or (ii) Vendor may sue for specific performance of this Contract to compel immediate and full payment of the entire outstanding balance, with interest thereon at the rate in effect on the date of default and other amounts due hereunder, in which event the Property shall be auctioned at judicial sale and Purchaser shall he liable for any deficiency; or (iii) Vendor may site it law for the entire unpaid purchase price or any portion thereof; or (iv) Vendor may declare this Contract at an end and remove this Contract as a cloud on title in a quiet-title action if the equitable interest of Purchaser is insignificant; and (v) Vendor may have Purchaser ejected from possession of the Property and have a receiver appointed to collect any rents, issues or profits during the pendency of any action under (i), (ii) or (iv) above.Notwithstanding any oral or written statements or actions of Vendor, an election of any of the foregoing remedies shall only be binding upon Vendor if and when pursued in litigation and all costs and expenses including reasonable attorneys fees of Vendor incurred to enforce any remedy hereunder (whether abated or not) to the extent not prohibited by law and expenses of title evidence shall be added to principal and paid by Purchaser, as in- curred, and shall be included in any judgment. Upon the commencement or during the pendency of any action of foreclosure of this Contract, Purchaser consents to the appointment of a receiver of the Property, including homestead interest, to collect the rents, issues, and profits of the Property during the pendency of such action, and such rents, issues, and profits when so collected shall be held and applied as the court shall direct. Purchaser shall not transfer, sell or convey any legal or equitable interest in the Property (by assignment of any of Purchaser's rights under this Contract or by option, long-term lease or in any other way) •vithout the prior written consent of Vendor unless either the outstanding balance payable under this Contract is first paid in full or the interest conveyed is a pledge or assignment of Purchaser's interest under this Contract solely as security for an indebtedness of Purchaser. In the event of any such transfer, sale or conveyance without Vendor's written consent, the entire outstanding balance payable under this Contract shall become immediately due and payable in full, at Vendor's option without notice. Vendor shall make all payments when due under any mortgage outstanding against the Property on the date of this Contract (except for any mortgage granted by Purchaser) or under any note secured thereby, provided Purchaser makes timely payment of the amounts then due under this Contract. Purchaser may make any such payments directly to the Mortgagee if Vendor fails to do so and all payments so made by Purchaser shall be considered payments made on this Contract. Vendor may waive any default without waiving any other subsequent or prior default of Purchaser. All terms of this Contract shall be binding upon and inure to the benefits of the heirs, legal representatives, successors and assigns of Vendor and Purchaser. (If not an owner of the Property the spouse of Vendor for a valuable consideration joins herein to release homestead rights in the subject Property and agrees to join in the execution of the deed to be made in fulfillment hereof.) Dated this . . 11th June 19._86_.. day of ...-•---•---•-•-----•-•--•-•--..n.......................... . (SEAL) l_ r( EAL) . ` • iarry.._J.....Stewart.......................... ~r~; 444 ) •---...---(SEAL) ----~,(~2G...__._ . (~EAL)L~ William C. Harwell A Q -J . - * :0 ;Q v 44, AUTHENTICATION ACKi' 0 LEDGMENT%,~'>>a .OF WISCONSIN Signature(s) STATE ss. St. Croix ..........................County. authenticated this ........day of.. 19 Personally came before me this A 4.11L lth......day of une 19..1W. the above named Harr J __-____y-_.. _-Stewart-_ and__ William • G,__ Harwell k TITLE: MEMBER STATE BAR OF WISCONSIN (If not, THIS 7706.06, Wis. Stats.) to me known to be the person 5.......... who executed the by fOregOlnS entand cknowledge the. same. IS INSTRUMENT WAS DRAFTED BY ._Lois..A,--Murray,__ HEYW001),__ CA]tl,.• HURRAY--• S, & SHERBURNE, P.O. BOX 229, P_ W~~ a~ Hudarn,' WI--- 4f}ifr Notary Public _---Ste--Croix ...................County. Wis. (Signatures cony be authenticated or acknowledged. Both My Commission is perr!Aan'ent. If no state expiration are not necessary.) date':, . t0 7) 19 Names of persons signing in any capacity should be typed or minted be! signatures. ' H a • ST C- 105 9 H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z d a H OWNER/BUYERT Cl l ROUTE/BOX NUMBER CI GL Fire Number CITY/STATE ~dlc S'ad W `6 ZIP PROPERTY LOCATION: Section T -04P N, R /8'W, Town of Q ~'s.✓ St. Croix County, Subdivision ~ecG~cr Lot number I Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- II sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank jumper. 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 m_ay_ 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 H three year expiration. o 'I. I/WE, the undersigned,, have read the above requirements and agree to maintain the private sewage disposal system in accordance with H the standards set forth, herein, as set by the Wisconsin Depart- 'b ment of. Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNED-G'~l ` D A'r E 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. DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR ANO P.O. BOX 7969 PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: ITOWNSHIP/pUNICIPALITY: LOT NO.: BLK. NO.: SW DIVISION", S~AME: A 1/ le /T29 N/R 19 E (or) W ols ts6tv C~dAR_ COSJNTY' OWg 'S BUYER'S NAME: MAILING ADDRESS: I- d wF~t IN "(At,~ u~So w 1 5'4016 USE DATES OBSERVATIONS MADE NO. BEDRMS.: 1COMMERCIAL DESCRIPTION: ~PROFI L DES P I NS: PER A I N TESTS: Residence - XNew ❑Replace ~Ly ` M- JULy3 99Z V` ,L kE . 66 p I L~%cCZ - RoRku *_LT RATING: S= Site suitable for system U= Site unsuitable for system 7::)0i4_<, CONVENTIONAL: M U ❑U IN GZS P❑U RE: SYSTS EM-I0 SG2TAN 7U . RECO~AMNIWTi u ALp Hall YRkNCNtS ESIN RATE: If Percolation Tests are NOT required D TIN any portion of the tested area is in the urider s. ILHR 83.09(5)(b), AIA indicate: `f~s Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH 1 OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) NUMBER DEPTH W. ELE B- 1%._73 or1E ? 2 2~'$z~t~ / ~i3e~M5 37~g eN~►S B Z 9,67 $9.98 ~(o ,6 /4"$~SLTS r2'8a~~ 4o"'~QNM~ Sa"BaNn,~- ,2 B- No > 7.17 ~7" 5c~s z~''$w,,~15~5~ 43''$aN AS B- 7,So 4 .S6 N6 > 7.56 sZ'" g~ s~Ts Z d" S c /5t" $arvAlS B-S 7.97 Q9.92 No.,,lI; > 7.67 Z''gLSz~~ zo''$Q~iS~ 70 $,w ri'IS B- PERCOLAtION TESTS c' TEST DEPTH WATER IN HOLE TESTTIME A~PRQ IN WATER LEVEL-INCHES RATE MINUTES NUMBER WQhM AFTERSWELLING INTERVAL-MIN. PERT D"' W. PERIOD2 PERIOD PER INCH P_ 1 2. o Nw4 .,%0 2 Z Z P- 2 .60 90.60 Z 'Z P- .6~ .6o y2 > > < P- + P_ EL6UA-nb P_ PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION 8.00 o f~~d~ .4EV~eS, 'r P TN Y I I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAM (print): TESTS WER COMPLETED ON: P, 44 ~y ADD_RFSS: CERTIFICATION NUMBER: PHONE N MBER(optional): 1N1 W) ~4 o a CST SI TURE: DISTRIBUTION. Original and one copy to Local Authority, Property Owner and Soil Tester. DILHfR-SBD-6395 (R. 10/83) - OVER - l • j/ J } w ee v 1 ~ 1 V 1 i i Z~r,112 s 72 i ,G - s ~a n A , J 1 REPT131 HUDSON ST. CROIX COUNTY ZONING PAGE 1 08/27/92 11:13 REQUESTS FOR INSPECTION WORK SHEETS FOR: -4/4&744* AREA: JT Aptivity: A9200263 8/28/92 Type: CONVSEPT Status: PENDING Constr: y Address: HUDSON 28.29.19.1147,SW,NE, LOT 46, ALDRO RD. Parcel: 020-1181-80-000 Occ: Use: Description: 171496 Applicant: CEDAR HILLS DEV INC Phone: Owner: CEDAR HILLS DEV INC Phone: Contractor: SCHUMACHER WILLIAM C. Phone: 386-3121 Inspection Request Information..... Requestor: SCHUMAKER, WM. one: Req Time: 14:08 Comments: J Items requested to be Inspected... Action Comments Time Exp 00012 FINAL INSPECTION Inspection History..... Itlifit 00012 FINAL INSPECTION