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HomeMy WebLinkAbout002-1014-60-000 Parcel 002-1014-60-000 01/30/2013 03:19 PM PAGE 1 OF 1 Alt. Parcel M 07.29.16.95A 002 - TOWN OF BALDWIN Current I ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner 0 - HAMBLETON, LILA M LILA M HAMBLETON 1062 220TH ST BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 1062 220TH ST SC 0231 SCH D BALDWIN-WDVILLE SP 1700 WITC Legal Description: Acres: 18.000 Plat: N/A-NOT AVAILABLE SEC 7 T29N R16W SE NE EXC W 369.6 FT & Block/Condo Bldg: EXC CSM IN VOL 4 PAGE 937 ORD, TOWN BALDWIN ALSO THE E 293' OF THE N 90' OF Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) LOT 1 CSM 4/937 07-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 10/23/2012 965909 EZ-U 07/29/2011 939479 QC 12/14/2009 908200 WD 05/28/1991 469710 903/364 QC more... 2012 SUMMARY Bill M Fair Market Value: Assessed with: 173690 Use Value Assessment Valuations: Last Changed: 04/20/2012 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 29,200 158,400 187,600 NO 08 AGRICULTURAL G4 7.450 1,800 0 1,800 NO 10 UNDEVELOPED G5 7.550 10,600 0 10,600 NO 06 Totals for 2012: General Property 18.000 41,600 158,400 200,000 Woodland 0.000 0 0 Totals for 2011: General Property 18.000 50,200 182,000 232,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch 510 Specials: User Special Code Category Amount 010-GARBAGE SPECIAL CHARGE 60.00 Special Assessments Special Charges Delinquent Charges Total 0.00 60.00 0.00 Form-STC- 104 AS BUILT SANITARY SYSTEM REPORT OWNER - _ e TOWNSHIP \ 4 SEC. ? T _N-R W ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I1,14R.83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM G 1 a ~r t L) 12) b aUa' g oc~ Ga I ~ "t 6 u^71^~ f BENCHMARK:. Describe the vertical reference point used .Elevation of vertical reference point: I .CD b Proposed slope at site: SEPTIC TANK:. Manufacturer:` S Liquid Capacity: /Doc) Number of. rings used: Tank manhole cover elevation: Tank Inlet Elevation:, Tank Outlet Elevation: Number of feet from nearest Road: Front,O Side,O Rear, O' feet From nearest-property line Front, OSide, ORear, feet Number of feet from: well, building: (Include this information of the above. plot plan)( 2 re erf ence dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model:tV 3tlL- Pump/Siphon Manufacturer: Pump Size. Elevation of inlet: 0 Bottom of tank elevation: R e. Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, 0Side,(DRear,() Ft._ Number of feet from well: C-)3 Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width: Length: 6 Number of Lines:- Area Built: 3 7~ .Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, (31'ear, 0 Ft. _ Number of feet from well: ;200 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, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: -Inspector: ~1~^• ay~~Sa r Dated: 7 Plumber on job: License Number: 3/84:mj wiscon~s r Department of Industry, PRIVATE SEWAGE SYSTEM County: afety an H•rmanRelations Safety and Buildings Division INSPECTION REPORT St. Croix nita GENERAL INFORMATION Se NE 4 F9CV2PR~~"90th St. sa14~151itNo.: Permit Holder's Name: ❑ City ❑ Village [5t Town of: State Plan ID No.: Paul Hambleton Baldwin CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: led, 1002-1014-60-000 .,"'-~.,,KS TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic . rl i 'aCf GLs Benchmark ~C, Dosing t Aera Bldg. Sewer Holding St/ V Inlet , TANk SETBACK INFORMATION Sfe C.z St! Outlet 3 gyp' (.-2Vent to ~ TANKTO P/L WELL BLDG. Venttake ROAD Dt Inlet ? c), 'ki Septic 75-& >5O NA Dt Bottom Dosing 5 NA Header / Man. S. s y Aeration Dist. Pipe S, Holding--- Bot. System I 3 PUMP/ SI N INFORMATION Final Grade Manufacturer Z4_/Q/ Demand 1 Model Number wC0 3//~ n TDH Lift Lrictiono,,g Systn.,50 TDHIQ,IgFt Hea oss Forcemain Length?~ Dia. 3 Dist. To Well'*>X(J T-~ 35 SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Depth DIMENSION C" DIMEN I N SYSTEM TO P/L BLDG WELL LAKE STREAM LEACHING ufacturer: SETBACK INFORMATION Type Of k)6(jY, CHAMP System: 11,4 O IT Ain el Number. DISTRIBUTION SYSTEM Header / Manifold „ Distribution Pipe(s) r x Hole Size x Hole Spacing Vent To Air Intake Length Dia. o~ Length 3 Dia. Spacing 3C SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Ar Bed / Trench Edges A, - Topsoil des' ❑ No Cj-"s ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) 7 Plan revision required? ❑ Yes P-go aa / q Use other side for additional information. .f,,]/ ` r - SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. SANITARY PERMIT APPLICATION COUNTY [7131LHR In accord with ILHR 83.05, Wis. Adm. Code .o. ,,,.a•e- C r ro iX STATE SANITARY Mus -Attach complete plans (to the county copy only) for the system, on paper not less than /heck `J'~~ 6/z ' x 11 inches in size. ❑ lf revisiapplication -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER / 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. 4 l - 31o PROPERTY OWNERl PROPERTY LOCATION Q LP / f ~eae ?l/lev n S~ '/4 /V~'/4, S T,Z9, N, R / 1[ (or & PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # io z zzo- X0 CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBE'R / Lea/o%c~%yr lt~. • 5 ~Z. d II. TYPE OF BUILDING: (Check one) CITY 11 NEAREST ROAD State Owned r7l VILLAGE: .3a J~W~ ~ 2Zo~1 ~f ❑ Public 01 or 2 Fam. Dwelling-# of bedrooms PA EL x NUMBER(S) Ill. BUILDING USE: (If building type is public, check all that apply) O~7 10 / O 00,0 1 ❑ Apt/Condo L 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 30 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. ❑ New 2. IN 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 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED(sq. ft.) (Gals/day/sq. ft.) (Min./inch) ~j , ELEVATION .LL 11-17-1 d 37.5 -379( 7Q9 .32/ ?5~ 7 Feet Q71 Z, Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks strutted Se tic Tank or Holdin Tank /nom /00a Lift Pump Tank/Si hon Chamber F001 - OU 1 VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Business Phone Number: Plumber's Name (Print): Plumber's Signature: (No Stamps) MP/MPRSW No.: 1 79 Plumber's Address (Street, City, State, Zip Code): IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuin Agent Signatur o Stamps) Surcharge Fee) Y'a Approved ❑ Owner Given Initial c Adverse Determination X. CONDITIONS OF APPROVALIREASONS FOR DISAPPROVAL: SBD-8398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. 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 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 3% 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 1,15 formm; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) ! SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations ~0 12 ~i PRIVATE SEWAGE PLAN APPROVAL Western Regional Offi 2226 Rose Street Ao t[Q LaCrosse, Wisconsin 60%i ,t ' an ~ ` pax - c BOLT'S PLBG & HTG Owner: PAUL HAMBLE '~r,O~NPGE w 820 MAIN ST 1062 220TH S BALDWIN WI 54002 BALDWIN WI 5 0 s RE: Plan Nunber: S91-.40436 Date Approved: June 27, 1991 Gallons Per Day: 450 Date Received: June 11, 1991 Project Name: HAMBLETON, PAUL Location: SE,NE,7,29,16W RESIDENCE Town of BALDWIN County: ST CROIX The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped 'conditionally approved'. This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. This approval will expire two years from the date approved or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. The Section of Private Sewage has reviewed these plans for private sewage system code requirements only. These plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the Wisconsin Administrative code. This approval is for the following components only: - REPLACEMENT PETITION - REPLACEMENT MOUND Inquiries concerning this approval may be made by calling (608) 785-9348. r i 1 i S110-94234R. 011811 r I SAFETY & BUILDINGS DIVISION { State of Wisconsin 4 Department of Industry, Labor and Human Relations BOLT'S PLBG & HTG Page 2 Sincerely, ~ t GERARD M. SWIM Section of Private Sewage Division of Safety and Buildings } PPP039/0009n/12 cc: PAUL HAMBLETON X Private Sewage Consultant 1 x d s I I S110 642318. 011911 J i SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue P.O. Bog 7969 Madison, Wisconsin 53707 State of Wisconsin Department of Industry, Labor and Human Relations June 27, 1391 PAUL M 1BLETON 1062 220TIl STRIE'ET 3ALDIMN WI 54002 Plan I.O. ~;o. S91-40436-P Dear Mr. Dambleton: Re: Paul i9ar)bl Teton - Residence Private Sewage System SE, NE,l,29,16vI Town of Dal dwi n, St. Croix County, 141 Your petition for a variance to section ILiiR 33.13 (1)(d), i4iscoi'sin Ad: i ni s t.rati ve Code, has been reviewed. The rule being petitioned requires a niound system site to have a ini ni Enura of 24 inches of suitable natural soil. The variance requester was to install a rapl ceraenz iiound system on a site with 12 inches of suitable natural soil. The foilowin I coiililents were ;:fade in the poti t.i,.)n analysis: 1. In reviewi;ig the petition, it was ;voted t;iat 'the request was sifnilar to other petitions accepted :,y this departrient under petition nwabers S€9-03304, S89-03316, and S90-00072. 2. Based on the precedent establ i sheu by tiie previous petitions, this peti'ti on for variance is being processed as pen;-4 teed by Wisconsin Statute section 101.02 (6)(9). Departaent,a.l Action: Approved. SR D 0828 (R. 01191) - - 3 i SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue P.O. Bog 7969 Madison, Wisconsin 53707 State of Wisconsin Department of Industry, Labor and Human Relations PAUL IMNBL ETON Page 2 dune 27, 1991 This approval is chanted wi t+) t1he understanding that all of the petitioner's statements and any conditions of approval cited above will be carried out. Preparea try: Gerard Swig r Departr;a.mtal Signature* ( - Date: J~ iT%3 chary . - eyar; relli ec Director, Office of Division ~Zodes and Application GNS:'134j'PP3 Enc. cc: Leroy Jansky, Private Sewage Consultant - District. 5, Chippewa Falls Tho..zas Nelson, Zoning Adiiinistrator - St. Croix County Dale E. Hudson, HIP #6629 SRD 6928 i R. 01/01 ST. CROIX COUNTY WISCONSIN I ZONING OFFICE y ST. CROIX COUNTY COURTHOUSE ¢ 911 FOURTH STREET • HUDSON, WI 54016 FL&A - (715) 386-4680 June 5, 1991 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation of the Paul Hambleton property, located in the SE 1/4 of the NE 1/4 of Section 7, T29N-R16W, Town Baldwin, St. Croix County, revealed suitable soils at a depth of 12" which meets the A+4 rule with a 7" A horizon with an additional 5" to seasonal high ground water. This site should be suitable for a mound. Should you have any questions, please feel free to contact this office. Sincerely, James K. Th son Assistant Zoning Administrator cj ' C7ty~~rc-~ ~ YAWH By i 106 Z ZZ42:8 S yoo L e s T 3`/13 Sec . 7 No ~ Q, 90-dG ~ ~ N rlo. N 1 2y, 6 fJc ros B Z - 9/Z 5 ~ SEA NE5' Q3 - 93 ~O' -z 9/V RIG ui 13,M . Q - Denol e 5 j3encl~ /~Or~ Barn C* A mar' ),s 6of to►'n or Nof rn A GE ~ STE slol,'01 of S w, Corner of Use pfStTE SEW house. APP;k0V NtAfi1 R~A~W 1_A OR Aid 1NG~ LrXisl i seP4, c ~an 4 •,0~ G~l~y tden n T f~F ~rtiRUST I , f to t)CPARSME iViSl 1 6e, a L oi s an ~ a4o✓ -','lleol, 6Z.' 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G° h'« 1''r. er:: T Inch, . h(es) nJfA t p r t r f ~ t ~ ~ tkl~r,71~i t u rt T ! ° s S t , 4 4 ,1 , i l e +t.y ,}fl 4 4 r r n d r4ifr•'~ ~r k t' Y 1 kt S~ t r t •S: t 6t ; ' ) 't ~ 4 {r~! 4 1.` •I J I n,I l y~f # r .r }r3~ ~yr~, } t ` 4 1 `t t~ ti yxerr'°t' t .r {1jjyY4.+}7t1~ S ~'4 • G ,1t :~5l1~ Ft } } J ~t'~i, p i'1~'1'I'.^~r, ,1t t i..' i.l t ~1J/ t~ r• •'1~((kt, :it ~ 1 i''i) 't t I - ~ t' k r ~ `1 V I n ! Y , PAr1F 2 1,- F PUMP CHAMB_R CROSS SEC-!r7'J AIJG _°ECIFICA'I-10"!S VENT CAP `"C.I. VE'1JT PIPE S91-404 WEATHERPROOF APPROVED LOCAIMG 4.5, ^'ROM GOOR, JUNCTI.OU BOX MANHOLE COVER WINDOW OR FRESH 12"MIN. AIR INTAKE GRADE I I 4" MIIJ. COIJDUIT J,71 IRILET \NPGE SP OVIOE I 111 pR1,~t,TF I I I i AI IGHT SEAL I ~,JitlonaI4 APPROVED JOINT A I II APPROVED JC' W/ C.I. PIPE 15 I III W/C.I. PIPE EXTENDING 3'0 TlOI~'S I III ALARM EXTEU01uG ONTO SOLID SOIL a j Ali ~1tJIF~NELA I II ONTO SOLID 5 tiu'GS tv~ CL?AfjlMI:N C VtStON G I ON , ELEV. F T. COME G SCE PUMP - , OFF 0 CONCRETE DLOCK RISER EXIT PERMITTED OQLy IF TAUK MANUFACTURER HAS SUCH APPROVAL SEPTIC E SPEC.IFI.CATIOKIS DOSE TANKS MANUFACTURER: IkJUMBER OF DOSES: PER DAy TANK SIZE: son GALLOIJS ' DOSE VOLUME ALARM MANUFACTURER: INCLUDING 6AC;KFLOW: r~ / GALLOT MODEL IJUMBEK: CAPACITIES: A= V 3L1- INCHES OR GALLOi SWITCH TYPE: e►'JC~1YY - 5= Z. IIJCHES OR -3GALLCI PUMP MANUFAC.TURER:- Goew)l~~ C= p'/~/ CINCHES OR /Z7 GALLOL' MODEL MUMDEIC: Gf/z62~ 3111 D - - /-Z INCHES ORZPf'Z GALLOA SWITCH TYPE: - l~r°✓ l'ri,'`tl MOTE: PUMP AND ALARM ARE TO DE MINIMUM DISCHARGE RATE ? Gp((M INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEM PUMP OFF AAI IST;M&UTIO PIPE..,' `'0 FEET + MILAMUM NETWORK SUPPLY PRESSURE . . . . . . 2.5 FEET + FEET OF FORCE MAIN X a(?/ ' 100 FLFRICTIOIJ FACTOR. FEET TOTAL Dy►JAMIC. HEAD FEET IIJTER)IAL OIME1JSlO1Jt OF TAIJK: LF_K1&TH__7 11 ;WIDTH ;LIQUID DEPTH 51GUEO: LICEIJ$E AJUM ~ ~ - pp BER• DATE: `S 7~ bub mersible Effluent Performance of Curves Pumps . METERS FEET ~ 25 MODEL 3885 80 SIZE 3/4' Solids WE15H 70 S 20 WE10H 60 ~ WE07H 15 50 WE05H 40 10 30 WE03M 20 WE03L 5 0 0 0 10 20 30 40 5 60 70 80 90 100 110 120 GPM 0 10 20 30 m'/h CAPACITY ~GOULDS PUMPS. INC. SEhECA FAUS NEW YORK 13149 METERS FEET 120 MODEL 3885 35 110 WE15HH SIZE 3/4n Solids 30 100 90 25 80 70 Z 20 H ~ O ,15 50 WE05HH 40 10 30 20 5 10 0 0 lei -EE 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM L L / 0 10 20 30 m'/h ®1985 Goulds Pumps, Inc. ,,1 CAPACITY " z-. ~ ' /PAC'/C' IT < Effective July, 1985 6'EPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY.,- G DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX N WI 539069 HUMAN RELATIONS (H63.09(1) & Chapter 145.045) LOCATION: SECTION: OWNSHIP/MUNI IPALITY: LOT NO :BLK. N SUBDIVISION A E: s~ /TZ?N/R&9 (or W ~ / NTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: COU r-11 00 USE DATES OBSERVATI S MADE IP9 NO. BEDRMS.: COMMERCIAL D SCRIPTION: PROFILE DESCRIP IO ER O ATION TESTS: Residence -3 ❑New Replace -9/7 5-2 RATING: S= Site suitable for system U= Site unsuitable for system CONaVENTI NAL: M U S. a~ IN-GROUND-P UR :SYSTEM-IN-FILLHO~LDING TANK: RECOMMENDED SYSTEM 0nal) If Percolation Tests are NOT re uir DESIGN RATE: If an portion of the tested area is in the under s.H63.09(5)(b), indicate Q~ L Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTHA*. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- -5a-fia'-Of mo7~ 40~0~ s ►1s e -'y "586/si ~G' ~r.s~' • s'c to3.'ts~ 8 e B- 7- 3 B-Z 9/ 17- Mo"nin d 'S~~ " • 75 8•~s,'~ - ~7~ 13n f s- c B- -nor B - /5 75 B~si ' gn Si I~ I3►-~ s B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERS ELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 P R PER INCH P- / Z O ari 3tI '/Z'' GO P- Z' O - 41a12 e- -30 P- 3 Zzbn 30 -3 1, 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 X5•7 a I ` t € 3 r I E I e. 111 E i E C I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (printTESTS WERE COMPLETED ON: ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): CST Sl NATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - } Owi7er; ' YQW/1 By, ~ /oG Z ZZo'`-'S sue; 1?'7,P G6Z 9 64/n~io,'~~ SyooL csr'.35'13 Sec C. 7 QI - 9o•a~~ o~ N 1Y~lo s4crrs Q3 93'6 T 9N RAG w 73,M . Q - D~nol e S 8arn 1~CY1C17 ~"larn l'S 6of f ol'n oT lVol to s1ol,'ny A~- s•w• co,ner a ~ use W e s fe.-n Y" o r f se c~; a n of t.Je 1 ~ house. S7 159 I ~3S' 89.5' Ex►'sf; ~q q~ l04 I I /,louse 97 30.0 w I_ 93 gp' g0i o (p ' Mounal I Area 82 Do 57 I 50 zzoth st " 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 2,C2 J~ Location of property St 1/4 1/4, Section T_,L2 N-R_,ZQI_W Township ~I 1_0 1 71 Nailing address zoo r Jam. Address of site Subdivision name /'/A Lot number Previous owner of property Ole-- Total size of parcel Date parcel was created 71 Are all corners and lot lines identifiable? _ -Yes No Is this property being developed for resale (spec house)? Yes No Volume T'.3 and Page Number 52(~ 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 or 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 in the Office of the County Register of Deeds as Document No. 4z/ 710 ; and that I (We) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the same has been duly recorded in the Office of the ty Register of Deeds, as Document No. Signature of Owner nature of Co-Owner (If Applicable) S-~o date of Signature Date of Signature I H N H 9 r S T C 105 r, 9 ~ H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z d 9 OWNER/BUYER~~~/Y~I.CJ ROUTE/BOX NUMBER 1lO Sf Fire Number CITY/STATE~~~~.~; ZIP PROPERTY LOCATION: 14 Section 1 T _N, R. W, Town of _z />,6 / 6 St. Croix County, Subdivision Lot number A/~// 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. -3 0 I/WE; the undersigned, have read the above requirements and agree to mai,ntain,the_private sewage disposal system in accordance with N z the standards set forth, herein, as set by the Wisconsin Depart- v 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. r SIGNED DATE_ S~%Td-9/ 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. . I I • THIS NO. STATE BAR OF WISCONSIN FORM 3-1982 SPACE RESERVED FOR RECORDING DATA ~~~~q1.~ ~QUiT CLAIM nDEED V REGISTER'S OFFICE ST. CROIX CO., WI •_--___Dorothy__B,_ _ Klandrman• a~k~a__ Dorothy_--_••______________ - - - Recd for Record Klanderman - at MAY 2 81991 AAA quit-claims to __.P uJ. ._.W- .._H-a-mblet-on__.an-d..L.ila.•M, 8:30 Hambleton,.--h sbaxl~.-_and- w.i e,_-_.as.-_jo.i.nt qL- '0 &,,,& tenants ReginerofDeeds the following described real estate in __St • CrO1X _ County, State of Wisconsin: ReTURN TO Lila M. Hambleton The east 293 feet of the north 90 feet of I Lot 1, as described on Certified Survey - Map No. 364111 recorded on May 12 , 1980, Tax Parcel No: in Volume 4 at page 937 of Certified Survey Maps in the Office of the Register of Deeds for St. Croix County, Wisconsin. No new separate parcel is created by this conveyance. r vSFM .S1 PEF i i This .---1 S _ not__________ homestead property. (is) (is not) Dated this 23rd------------------ day of ---May-----------------------•------------------------, 199-1.-.. (SEAL) EAL) * Dorot B. Klanderman5 (SEAL) --.......k1:.. (SEA,L J r V , ! O •r V e w AUTHENTICATION ACKNOWLEDG9E1gT - Signature (s) STATE OF WISCONSIN f~l,.,:r'`~ X1,4 { St Croix .--•-•....County. j authenticated this day of 19 Personally came before me this _ ._...._.__..._gay of Ma_y------------------------------- 19•.Q.1_. the above named __.._Darothy__B-__.Klansierman_________________________ TITLE: MEMBER STATE BAR OF WISCONSIN (If not- - authorized by § 706.06, Wis. Stats.) to me known to be the person who executed the fore ' instrument an acknowledge he same. THIS INSTRUMENT WAS DRAFTED BY Lila M. Hambleton * vonne M~ Schell No ?:Y Public St-e_..--.rOlX------------- County, Wis. (Signatures may be authenticated or acknowledged. Both My Commissions permanent. (If not, state expiration are not necessary.) date: l UB PAGE_ DOCUMENT No. STATE BAR OF WISCONSIN FORM 11 - 1982 THIS SPACE RESERVED FOR RECORDING DATA LAND CONTRACT Individual and Corporate 3, O.F)4L 7S I (TO BE USED FOR ALL TRANSACTIONS WHERE OVER ~['.j~ pp $25,000 IS FINANCED AND IN OTHER NON-CONSUMER "'•""'•-4TeP6 OFFICE t . ACT TRANSACTIONS)._. ST. I IFf t{ C()., WIC a . Booed, f47 r _ r, r• Contract by and betweenCdrr01]~--- .___KJ_anderman_.,and da Feb rs__15th Dorothy B. Klanderman,_ alk~a CarrQ~ i,__l{i~,neman__an Y of --A•O• 1985 Dorothy Iaanderman~ _1111sb4nd__and__zai•f-e,_.__as.._29~* I1d&n ntsat 8:30 A M. whether one or more) and.... aul__4V.___H~b~,e~Qa__~d------------ James O'Connell Lila M. FIB.mbleton_~---j~,uskzancl._~.nr ----s - boMlor tenant ("Purchaser", whether one or more). I~~"'nn~s n Vendor sells and agrees to convey to Purchaser, upon the prompt and full per- formance of this contract by Purchaser, the following property, together with the Deputy rents, profits, fixtures and other appurtenant interests (all called the "Property"), - - in S_t, ...CrQiX................................ County, State of Wisconsin: RETURN TO - Lila I3ambleton ..Ba_1.dw_i_ n,_._W1_5 4.O Q_2_ The Southeast quarter of the Northeast quarter _ M (SE1/4 of NE1/4) of Section Seven (7), Township Tax Parcel No................................... Twenty-nine (29) North, Range Sixteen (16) West except the West 369.6 feet thereof, and further except Lot 1, as described on Certified Survey Map No. 364111 recorded on May 12, 1980, in Volume 4 at page 937 of Certified Survey Maps in the Office of the Register of Deeds for St. Croix County, Wisconsin; and The East 950.4 feet of the South one-h alf of the South one-half (S1/2 of S1/2) of the Northeast quarter of the Northeast quarter (NE1/4 of NE1/4) of Section Seven (7), Township Twenty-nine (29) North, Range Sixteen (16) West. i I± I This ~..._.:__.ls------------- homestead property. (is) 446 neQ- ~j Purchaser agrees to purchase the Property and to pay to Vendor at _a lace..de P sa.gxiated---by--V do the sum of 6 Q_c O O O _ in the following manner: at the execution of this Contract; and (b) the balance of $ ra8 ,-aD Q----------------------- together with interest from date hereof on the balance outstanding _aEtl'1-7aid- dull; -a&- foRewsr as set forth in Exhibit 1 attached hereto and made a part hereof. ij Provided, however, the entire outstanding balance shall be paid in full on or before the...... 1St------------- day of Jams-ary....................... 49-20.1@ the maturity date). Following an default in of interest then 1n effect g any payment, interest shall accrue at the rate e_---- 96 gee-etr>rt on the entire amount in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance). li j j ~eadesse~xes~sk~~F~~s~#~>~I'~~,xx~C4~ax~cll~~rx►> triel rwiiaixea~5zxe,~StKt~>~$?t~c~Qst}bPtK~1S~Fb Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Aa)h =ariiom =rn tee=pie" =wilt 8~l€~ i 9~ ~a}~tc~rlti nl= .mgtiaiasf#@r=.: there may be no prepayment of principal without permission of Vendor.* 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 i' as unpaid principal) is less than the amount that said indebtedness would have been had the monthly payments been j made as first specified above; provided that monthly payments shall be continued in the event of credit of any proceeds r 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~I[eegbr i ii I Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall I) be retained by Vendor until the full purchase price is paid. Purchaser shall be entitle to take possession of the Property on.___.__.._.January 2 19 g 5 *Cross Out One. H.C.Mift, ompry M SrATF, BAR OF WISCONSIN " ® FORM No. 11 - 1982 Stock No. 13011 Purchaser promises to pay when du&ll taW9RAit;sses !ts levied on the Property or upon Vendor's interest in it and to deliver to Vendor on demand receipts showing such payment. Purchaser shall keep the improvements on the Property insured against loss or damage occasioned by fire, ex- tended coverage perils and such other hazards as Vendor may require, without co-insurance, through insurers approved by Vendor, in the sum of 5 8., 000 _ 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, $ik~t3l~4i-o~}rL~ftdf~gk7~rr~rTEFi~g,=t#~evr'fg~fr~h mil'lees'tw~n~^'L'he'~4"oP~t't5"'shlell'ifCltE~psSltetre►3CRi'"dCl!' Purchaser shall promptly give notice of loss to insurance companies and Vendor. Unless Purchaser and Vendor otherwise agree in writing, insurance proceeds shall be applied to restoration or repair of the Property damaged, provided the Vendor deems the restoration or repair to be economically, feasible. Purchaser covenants not to commit waste nor allow waste to be committed on the Property, to keep the Property in good tenantable condition and repair, to keep the Property free from liens superior to the lien of this Contract, and to comply with all laws, ordinances and regulations affecting the Property. Vendor agrees that in case the purchase price with interest and other moneys shall be fully paid and all conditions shall be fully performed at the times and in the manner above specified, Vendor will on the Purchaser, a Warrant demand, execute and deliver to y Deed, in fee simple, of the Property, free and clear of all liens and encumbrances, except any liens or encumbrances created by the act or default of Purchaser, and except: cements._? eggorried a .•of-__i:h s._date in the office of the Register of Deds for St. !roix . ~oun ty-----------------------------------------------------------------•....._ . 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 ...6.9_ 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 ...6.0... days following written notice thereof by Vendor (delivered personally or mailed by certified mail), then the entire outstanding balance under this contract shall become immediately due and payable in full, at Vendor's option and without notice (which Purchaser hereby waives), and Vendor shall also have the following rights and remedies (subject to any limitations provided by law) in addition to those provided by law or in equity: (i) Vendor may, at his option, terminate this Contract and Purchaser's rights, title and interest in the Property and recover the Property back through strict foreclosure with any equity of redemption to be conditioned upon Purchaser's full payment of the entire outstanding balance, with interest thereon from the date of default at the rate in effect on such date and other amounts due hereunder (in which event all amounts previously paid by Purchaser shall be :forfeited as liquidated damages for failure to fulfill this Contract and as rental for the Property if purchaser fails to redeem) ; or (ii) Vendor may sue for specific performance of this Contract to compel immediate and full payment of the entire outstanding balance, with interest thereon at the rate in effect on the date of default and other amounts due hereunder, in which event the Property shall be auctioned at judicial sale and Purchaser shall be liable for any deficiency; or (iii) Vendor may sue at law for the entire unpaid purchase price or any portion thereof; or (iv) Vendor may declare this Contract at an end and remove this Contract as a cloud on title in a quiet-title action if the 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), 00 or (iv) above. Notwithstanding any oral or written statements or actions of Vendor, an election of any of the foregoing remedies shall only be binding upon Vendor if and when pursued in litigation and all costs and expenses including reasonable attorneys fees of Vendor incurred to enforce any remedy hereunder (whether abated or not) to the extent not prohibited by law and expenses of title evidence shall be added to principal and paid by Purchaser, as in- curred, and shall be included in any judgment. Upon the commencement or during the pendency of any action of foreclosure of this Contract, Purchaser consents to the appointment of a receiver of the Property, including homestead interest, to collect the rents, issues, and profits of the Property during the pendency of such action, and such rents, issues, and profits when so collected shall be held and applied as the court shall direct. Purchaser shall not transfer, sell or convey any legal or equitable interest in the Property (by assignment of any of Purchaser's rights under this Contract or by option, long-term lease or in any other way) without the prior written consent of. Vendor unless either the outstanding-balance payable ifl ed r-this Con ract`is fiTSt-paid -iri-Tu-11- or-he interest" conveyed is a pledge or assignment of Purchaser's interest under this Contract soley as security for an indebtedness of Purchaser. In the event of any such transfer, sale or conveyance without Vendor's written consent, the entire outstanding balance payable under this Contract shall become immediatelydue 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 loins 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 2.nd.............................. day of Jana-a 'y-•-•-•---------•---------••--•---..._., 19---$ . ~'(_v,C. - - - -:72c'---. EAL) .Q ~t'l,''~-•-- ..........(SEAL) Carroll W.'Klanderman Paul W. Hambleton t f .(SEAL).//!.. .-(SEAL) Dorothy B. Klanderman Lila M. Hambleton AUTHENTICATION ACKNOWLEDGMENT Signature (s) o-f arroll...T .-.__K.l.anderMan-,•- STATE OF WISCONSIN Dorothy B. Klanderman, Paul W. SS. Hamb2•et' ° ~1r8 'z;i2' T e . • County. e t' ted this ~'MT-M]' J ax.... 19$.x1. Personallcame before me this ................daY of 19 the above named Thomas R. Schumacher TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) to me known to be the person who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY • i Baldwin,, WI 54002 Notary Public County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) *Names of persons signing in any capacity should be typed or printed date : 19.........) below their signatures. `