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HomeMy WebLinkAbout020-1266-20-000 o o N ti p w, m Is ~ c II a 0., o I `c I CD N i O I ( I w I I I zo ; c c U. 0 a I 3 M 0 Z rn w o Z I an d I N LLJ N I- U)i d m o I o z v c d z a o o m z c E v ~ M N CO o U) N c o O = t a o c a o c z I- z c c I d m E a N • 10 0 m a c '0 N 0 L N L O O c o o a 0 r- .0 N j LO N N N U cncn i~o a5 zo m (L CL CL EL N • ~ a ~ ~ O O I in J U = rn rn O 0 ~ v N ; HMO N a p > , y G c O O M C C N 0) C) o M 3 f0 y u a o rn o oo w 60' l oLn 66 o cvvvl C~ Q7 r Ow a r.- I~ I- N O 0 1.- N c, ~ N j 0 M 0 V) R U O N 2 O c fn d m € a Q ~ a D E r A ciao 0 coU DEPARTMENT OF REPORT ON SOIL. BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND CC P.O. BOX 7969 HUMAN RELATIONS PERCOLATION TESTS (11J) MADISON, WI 53707 21 (ILHR 83.090) & Chapter 145) L CATION: SECTI N: TOWNSHIPtMtllatCIPAt+Wv : T N NO.' BDIVISI N NAME: 5E'/4NE' Z3 /Ti-if N1111 E(o) HuOSoK) Cp Sue ~1, COUNTY: MAILING ADDRESS: Sf.c~oi x ~~y PA113cy Tot A3S'0'u yiG G/oyEz +~f~- /fvos~ ~S. Ss~olG USE - Z DATES OBSERVATIONS MADE NO./BEDRMS,: COMMER IAL DESCRIPTION: OFILE DESCRIPTIONS: PERCOLATION TESTS: G c 1-4gesidence A/l /f, ®New ❑Replace qppil_ ' I Q /`d j~ PQ IL r l J / RATING: S= Site suitable for system U= Site unsuitable for system 5C5 s) ShrT S~ L ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM: (optional) E ]S au FLIS ❑u a S ou a S Chu a S F]u cow----ric~,4 c-- 7;eE,vc Aes c,.#/ DR-40P dX r V r O~ DESIGN RATE: If Percolation Tests are NOT required If any portion of the tested area is in the C~ under s. ILHR 83.0915)(b), indicate: C-4- s$ ':M- Floodplain, indicate Floodplain elevation: " PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST. I HE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- /00.2-0. ?10 > i , O ' Pe 1501.1 . 51 ' u . S /1 O ' O'V c S ' G.r~ B. Z S 00, 0V J-16 > f. S s.S 7'4", c s F3 /C S:/.) _3,O' B-3 9,5 ioZ , s~ Ice- 1, s - 1 ~P s 3 s~ 2.0' /3/,N 5-11 A 'Ae 4.4 .St'/ S' e/ 114. Sy. B- os,1 Y - _ ' 15, c B- S 2q, 1 O -33' o 7 /S 3, 0 i 00 CS B- PERCOLATION TESTS EST DEPTH . WATER IN HOLE TEST TIME DR IN WATER L V L-IN H RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 P I D PER INCH P. 4AJ P- P- p. P- v Ptl- 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. r_. I 1 ! [ i WJ& ore ~Auriu~ P.,) /A; STof Uh-ST Sipes- 6F ~.4cKiS'U Pi'T 4 7` r 130ee # 3 - h,4p 5L e IPV1j0 iAJ6- T'O 0erp to of 5'' 0 . 4CW- ; T12-UAJ CId S AS ~ 'A (2 T o t rt5 I 1o AUotp p0G*;t_T_5 OF AI,5 501L ST1DUCTVeE1 . 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): +(};AE$ITE SEPTIC PLUMBING CO. - TESTS WERE COMPLETED ON: 6~5 O'NEIL RD., HUDSON, WIS. 54016 - l y 0 T-ULBRQI4T-- ADDRESS: Ro" "r;S. MaSrER PLUMBER LIC. N0.3307 M.P.R.S. CER IFICATION NUMBER: PHONE NUMBER (optional): CST SIGNATURE- DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 M. 10/83) - OVER - J _ vT 441f-0 k v! Rr _S rcF p N R,PfXJ ,0tvi.uF- Lor CO ~c SETS Ut R 7'. Q~ F. 1 ~,r. pue ; o P. h4 . £leuAr/6,1 ZZ / 0 0, Q ' I 70 Z~_ _ s~op~at e 1 qg~ NOMESITE SEPTIC PLUMBING CO. /oS X 655 O'NEIL RD., HUDSON, WIS. 54016 ~ ROBERT WRIGHT CST zyPL ' o ~3 'K Zy G~ `A4S. MASTER PLUMBER LIC. NO. 3307 M.P.R.S. P3 WAINN. tMSTALLER 6 DESIGNER LIC. NO. 00663 I J CL I Au I I s ~e -P s Gr:a~JkAL-i I pporose-v FbA(c'st'►F I ~ ~~oT ST~kfvl i I I ! ~ ~ = J3~c KiY~ F i3o,C;,v~s r i L0 7` FoUA) SUP Lit Y00-5 S4e-r L FtA)CP P0.ST- o Spy-K, ~o T- L-fA.)1L . LC ~ - FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ~~'"Dy /f/i1 v cy ff-U1104) TOWNSHIP ~{vOSo SECTION 73 T Lf N-R f~ W ADDRESS ST. CROIX COUNTY, WISCONSIN 2f~li.tS SUBDIVISION SU-v ~iD(,-~= LOT LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM j INDICATE NORTH ARROW BENCHMARK: Elevation and description: ZEE. ri vp to~~oo a 7_ S114 Alternate benchmark SEPTIC TANK: Manufacturer: ~040-5 eotiC Liquid Cap. / 0 D c9 I Rings used: O Manhole cover elev: /0('-5P 'Final grade elev: Tank inlet elev.: Tank outlet elev.: 100 No. of feet from nearest road:Front X , Side , Rear Ft. From nearest prop. line:Front , Side , Rear Ft. > / No. of feet from: Well -70 Building: (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE k i PUMP CHAFER Manufacturer: Liquid Capacity: Pump Model: Pump/ phon Manufact.: Pump Size Elevation of inlet: Bottom of tank elevation Pump on elev.: Pump off elev.: Gallons/cycle: Alarm: Man.: Switch Type: Location Distance rom nearest prop. line: Front_, Side-, Rear-Ft. Dist ce from: Well Building SOIL ABSORPTION SYSTEM Bed: Trench: Seepage Pit: Width: 5 Length 76 Number of Lines: Z Area Built ~1^R3 'MP-PEie TPE-::/1 /0/, yo /0 0 Exist. Grade Elev. /©0,o' Proposed Final Grade Elev. /o 0.0 "o Ee- 'ee'v c z, Fill depth to top of pipe: 3 0 3 G S ' No. feet from nearest prop. Line:Front , Side X , Rear Ft. No. feet from well: No. feet from building 7 HOLDING TANK Manufacturer: Capacit No. of rings used: Elevation of b om tank: Elevation of inlet: No. feeV from nearest pr line:Front , Side , Rear Ft. No. feet from: Wel building , nearest road Alarm Manufa rer: INSPECTOR: DATE: PLUMBER ON JOB: LICENSE NUMBER: 6/90:cj J i ~Al ~fullf,I~ 0- /D' to ~ 04( Lo S 0 D 6E 3b I I -5 CA 467 Z0 ig Y ly iva° ' Q q~~S - 0 ID1 N~ k,A;165 k))kaC1f 761 0-(DJ 3 03 fox NS ".~Uij of Ito IeENG~ A S r76 y 7~P of . 98•h'~ ~ Tap of ~ ~ ~ °r of P04 ~I G o .rte S ~ NJ a Sy 0 T `2E f 'PT r puc co,vQD _ zoo, 0 frkS r T~EN~ Spy ~S sue. ~?1-~ p~~ ~Isr~r~~T~o~J PIS- • L sA f ~r9N%~.~ ~4SS►2r 6-,t7c uND~~e P % Pi - ~oCK C017t:~~J wider Sya~G.¢_'~ic 00MMITE SEPTIC PLUMWNG CO. 856 VIOL HUDSON, MS. 54016 ~ c_ ROOM ULBMGKT W16. MASTER PLLMMBER UC• No. 33c7 M.P.R.S. MANN. ROTALLER 8 DESIGNER UC. NO. 000 !~S0 DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING LABOR & HUMAN RELATIONS DIVISION P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION MADISON, WI 53707 State Plan I.D. Number: SE 4iNE 4, Sec. 23,T29-R19 ❑ CONVENTIONAL ❑ ALTERATIVE (If assigned) Town of Hudson Lot]6 Holding Tank El in-Ground Pressure E] Mound T*~ 1 NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECT 0 DA E: BENCH MAR (Permanent refere ce point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT EL T REF. PT. ELEV . 7 " , CIL _j:(W-d Name of Plumber: MP/MPRS o.: County: Sanitary Permit Number: Robert Ulbricht 3307 St:'Croix 135475 -44, Cc SEPTIC TANK/ 7 =f< c- e Xr= 3G MANUFACTURER: LIQUID CAPACITY: TANK INLET EL V.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COy~R / ~ PRO IDED: PROVIDED: (J G ~ '764 ~ ~~e~s / OV~ z YES ❑ NO ❑ YES NO BEDDING: VE#TDIA.: ViWT MAT L.: HIGH WATER UMBER OF ROAD: PROPERTY WELL: BUILDING: VENT T RESH C o . Go . ALARM: FEET FROM LINE / AIR INLE : NO ❑ YES NO NEAREST ~rC Y) L, g~ fS-6 ❑ YES MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVDED: ❑ YES ❑ NO ~ I ~ ❑ YES ❑ NO ❑ YES ❑ NO GALLONS PER CYCLE: MP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF PU ❑ YES ❑ NO NEAREST -10, SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: MATERIAL AND MARKING: or excavation. (If soil can be rolled W la Sri c ns ction shall cease until MAIN .57 ~ the soil is dry enough to continue.) / CONVENTIONAL SYSTEM: ,3Gi a az~ 1C BED/TRENCH WIDTH: LENGTH: F DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LI I TRENCHES: MATERIAL: DIMENSIONS GRAVEL DEPTH FDISTR. PIPE DISTR. PIPE DISTR. PIPATERIAL: ISTR. NUMBER OF PROPERTY WBUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELE LET: E ND: tj It T$ $ f tA.w Sa I SI FEET FROM LINE: AIR INLET: 7Z S~ 30 i/ n 3 - NEAREST 7 5 -76 MOUNDSYSTEM Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ❑ YES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ❑ YES ❑ NO ❑ YES ❑ NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEVATION AND ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.: DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑ YES ❑ NO ❑ YES ❑ NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST , ck' r, c C1 JrS~ • ~J~Z P ce.~ s X~ ~.cy rt1C-~ go. 9 0, s17 Sketch System on Re in county file for audit. Reverse Side. SIGNAT E: TITLE: SBD-6710 (R. 06/88) Q o I D~iLHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY JET O OR STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 3~ `7 8% x 11 inches in size. ❑ c ecTc 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. /U 117 PROPERTY OWNER i PROPERTY LOCATION IVAIJ C 6ffVSCTA) :!W %a,S Z3 T4,N,R E(or ow PROPERTY OWNER'S MAILING ADDRESS „n LOT # BLOCK # yG ~ u~. ~dC ~D CITY, STATE ZIP CODE PHONE NUMeEi~ SUBDIVISION NAME OR.~C~S% NUMBER #V 1P Ire -A,) t~br S46i6 oQQ 5 //66 CC77'~ II. TYPE OF BUILDING: (Check one CITY AREST OAD ! ❑ State Owned VILLAGE l l V J9S'O,J L ' El Public 1 or 2 Fam. Dwelling-~# of bedrooms - AR EL A NU R() , ORC)_ 431(60- Ill. BUILDING USE: (If building type is public, check Z11 that apply) /q, /3 o3 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.~ 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 22 In-Ground 42 ❑ Pit Privy 13 Seepage Pit Pressure a 43 ❑ Vault Privy 14 ❑ System-In-Fill 2m, 2 7j Eels Cl^ s X 7 S VI. ABSORPTION SYSTEM INFORMATION: '01 O 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM EV. 7. FINAL GRADE ELEVATTION REQUIRED (sq. ft.) PROPOSED (sq. ft.) (G'aals/day/sq. ft.) (Mt in./inch) 0, y~v 5 d 1-750 a (0 o 6 Feet Feet VII. TANK CAPACITY Site In allons Total # of Prefab. Fiber- Exper. INFORMATION New xistin Gallons Tanks Manufacturer's Name oncrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank Qd~~ Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signatur : (No Stamps) MP/MPRSW No.: Business Phone Number: ftis6zr ZIW14,7- AeWq~~~~ 1 33 o 7 Plumber S 's S Address (Street, City, State, Zip Code : D~N~7G J Y IX. COUNTY/DEPARTMENT USE ONLY X ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing A ent Signat a (No Sta ) Approved ❑ Owner Given Initial Surcharge Fee) IL~.o C"Ii- 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 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. s~ To be complete and accurate this sanitary permit application must include: I 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. I V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (8.11/88) 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 o.f 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. ----------------------------------t--------------------------------------------- Owner of property ~wp r - ti C k LU4 SD.cJ Location of property s~ 1/4 /UF 1/4, Section 2-3 , T_~f_N-R W Township V0, 0 Mailing address 71Q IOU-4- t4 a~J 'S - O / Co ~o s sy Address of site A? 1,26 Lam-' Subdivision name Lot number Previous owner of property Total size of parcel ? Date parcel was created Are all corners and lot lines identifiable? es No Is this property being developed for resale (spec house)? Yes No Volume Y(a 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 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. ~S 0 0// ; and that I (We) presently own the proposed site for the sewage disposa system (or I (we) have obtained an easement, to run with the above described property, for the construe on of said m, and the same has been duly recorded in the Office of th C unty Reg,i er of Deeds, as Document No. Signat a of Owner Signa of Co-0 (If Applicable) ~ 5U Date of Signature Da of Signature r J THIS SPACE RESERVED FOR RECORDING DATA I • DOCUMENT No. STATE BAR OF WISCONSIN FORM 1-1982 WARRANTY DEED 1458011----- - ---Vo-- -869PaU-14~-- REGISTER° OFFICE ~I - This Deed, made between ___Grp-p-nwQod_-EAtarp.r .aea,___Inc-._. ST. CROO 0.1 W, eo Recrd for Rerd j A ff:; s710 - Grantor, Ct M and__ Randall _ Johnson _ and _ Nanc - _ L, Johnson - Reolster of Deeds Grantee, Witnesseth, That the said Grantor, for a valuable consideration...... I I conveys to Grantee the following described real estate in St..__craix----------- RETURN TO County, State of Wisconsin: _ Z _ - Tax Parcel No: Lot 6 of the Plat of SunRidge filed in the Office of the Register of Deeds for St. Croix County, Wisconsin, on September 22, 1989 in Volume 5 of Plats, at Page 71, II as Document No. 451750. i~ I I I i I I I ITAN SFII I ;I it FM 'I I This is_-no-t----- homestead property. OW (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And----- Greenwnnd..Enterprises,.--Ins:.-------------- . warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements and protective covenants or restrictions of record, if any I and will warrant and defend the same. Dated this C:2•7~--------------------- day of ---------------,4P -I-----•-----•---------- , 199Q_.._. --------------------------------(SEAL) ---------(SEAL) a: ES E. RUSCH, Pre ident (SEAL) (SEAL) * MARY___•._-RUSCH,__ Secretary/Treasurer See additional Notary on back AUTHENTICATION ACKNOWLEDGMENT Signature (s) STATE OF WISCONSIN ss. St. Croix County. authenticated this ________day of___________________________ 19______ Personally came before me this _/.~._!__day of - I`i/--------------------- 19.9G the above ,named Mary It. Rusch I - I TITLE: MEMBER STATE BAR OF WISCONSIN (If not, - authorized by § 706.06, is. Stats.) to me known to be the person -w- o executed the foregoing instrument and acknowledge the same. THIS INSTRI.IYIENT WAS DRAFTED BY Heywood & Cari by Walter Hod nsk --0--~------ j - P_. 0.__4x_ 229_ Hudson WI 54016 I y ' y y Notary Public -_7-- Count Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. -(if not, state expiration are not necessary.) date: 4-W!I7L1k%!!__aa.__________-•-__, 19.9?--.) II *Names of persons signing in any capacity should be typed or printed below their signatures. II ~i WARRANTY DEED STATF, BAR OF WISCONSIN Wisconsin Legal Blank Co. Inc. FORM No. 1 - 1982 Milwaukee, Wis. 1 L , I ,f ACKNOWLEDGMENT ' STATE OF WISCONSIN) )ss. + ST. CROIX COUNTY ) Personally came before me this 'day of - , 1990, the above named Jame E. Rusch, to me known to be the person who executed the foregoing instrument and acknowledge the same Notary Public, St. Croix Count , Wis. My Commission expires / STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County f/~✓'~y~/ OWNER/BUYER R4Va v416 CY 16 ROUTE/BOX NUMBER GlO U~- FIRE NO. CITY/STATE H upp 0'✓ ZIP S_V61 PROPERTY LOCATION: SF 1/4 1/4, Section Z , T 2f N, R__~f _W, Town of f /'gyp _r d'.", St. Croix County, Subdivision 5-0--q/ Lot No. 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 $3000 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 verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certification 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 Department of Natural Resources. Certification form must be completed and returned to the St.Croix junty Zonin fice within 30 days of the three, year expiration date. SIGNED DATE '?o St. Croix County Zoning Office P.O. Box 98 Hammond, WI 54015 (715) 796-2239 or (715) 925-8363 Sign, Date, and Return to above address DEPARTMENT OF REPORT O11TWIL. BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 HUMAN hELATIONS 1 / MADISON, WI 53707 (ILHR 83.0911) & Chapter 145) LOCATION: SECTION: TOWNSHIP!MtJ141CrPAtffiY: OT NO.: LK. NO.: SUBDIVISI N NAM : 5E 1/ NE 1/ ~ ./Tsl N/RIB E (o A HuOSo~ CP lsvo 1~DGE' COUNTY: MAILING ADDRESS: 5f Wi x A-11)y 3 . PA Oc y T0tj W o U yi G ~1 G/ovE•~ f2~ • yvos0a 4J.-S1. syolG USE - Z DATES OBSERVATIONS MADE BEDRMS.: r OMM R AL DES HIPTION: TESTS: .Residence WJ New ❑ Replace PF ~L - I Q Jrd P~' f I t~ ' RATING: S- Site suitable for system U- Site unsuitable for system 5C5 (D y SA-n Q c- SC L ONVENTI NAL: MOUN~`D: U IN-GROUND-PRESSURE: SYSTEM-IN-FI LL OLDING TANK: RECOMMENDED SYSTEM:loptional) ©S ❑ F H ❑ Y ©S ❑ Y ❑ ❑ ❑ J KI U CO auE,uTio.✓ G - W 6n-1 a ACS w 7*0 oX i t~ c G~ If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s. ILHR 83.0915)(b), indicate: GLA SS :I:V- Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL P H T GROUP DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION gSERVED EST. HE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- l I~,S /oo .20' ?10 > e /,Q' Aefly 51; S" 8V. 5- , 4.v ' T.~v v.c y ~ s 60 . D.~/3.~• Sr't /.O' N.-S AO' Oip e B- L S ao, 09, 'to > P. S 5-57 Teti c s B- 3 5 %z,sd ~''S ; s~ s mss. sr .1 Ix :1 io 'De 44 Sr/o Qa• sy. ,f:/► g.~ oS.gY~ p 2.0 ?Ie. S 15- dr s,~ • 3nE' s,•~, ' o,r. 4.~ - Sy, s: ~ o • r~,~ s./ /0 S, ) yr > C> 01 iG 7 mss. p A57 3, 0'4etAj e- PERCOLATION TESTS t EST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES t NUMBER INCHES AFTERSWELLING INTERVAL-MIN. - NtFiOD t P PER INCH P- AAJA -e p - P 51L ) ~ ~O * - r - L P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimuns ons 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 plott~ plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION.~~"` I , i I TN ~ I I I _ _ - _ _ OTC- C~4v ri o,• o~ /.v S Tit c crr T~o•~--- - SST s:v~ aF ~.4c K/Yb t~ A17- r-- _ 130ec 3 h.ao sL - Sr'LT Li• I YTENDrUG- 7-0 VePptA of 5, 0 l - PI,i4C!E T12.EAICAJ S AS Q To r _ p- J Tt7 Aootp pocke_r of TGIi5 5o1L ST-QuCT04?IE . I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME print - HOMESITE SEPTIC PLUMBING CO. TESTS WERE COMPLETED ON: 655 O'NEIL RD., HUDSON, WIS. 54016 11 - 1 f S 0 ADDRESS: -UEBRrGH`T- WIS. MASTER PLUMBER LIC. NO. 3307 M.P.R.S. CER IFICATION NUMBER: PHONE NUMBER Ioptionall: OWN lli=Al DER DESIGNER LC-KO- CST SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil rester, DILHR-SBO.6395 (R. 10/83) OVER o ;-l -1 0.7 14-00S ( .0 -1.50() a"Jtva,~ 7~~+5 . 5~► opt n $ ' C1 Nnoj ' 40, -107 III s~~r. ! 1 ~ I I (74~kts orb I i i o~Soa~~ I s ~ o, s ~ ~ Sz _ - of s ~ I rn I ~ 1 1 £9900 'ON 'Oll k13NJI930I kl311V1Slv1 Nlviin Fd r -S•k1•d-A LOU 'ON 'On 83Mnld kl31SVV 'S1M -7,fh,,p 1s-; 1Howsin J.N390k1 I , h~ F~I %oK •SI, 4 `NOSUnH '*QU 113N,0 999 1 S l 'OO JNIennld 3I1d3S 31193140H ?b ill -114 9, -se, doffs og _ OL I ,O' of °f i3 ~I d 60 toy '11aorv 'lcobdd+, cvl _ ~ Sao/~F/9 ~s3j~ 1p tA) IR G~ uS /4PPRox. NoRT(. 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NO. 00663 ;I I I I I ~ J I I r CL I I I I I I , I I ~ I t 1 I I I I I I 3 s 1 1 I I ~ P~ r ~ ZS AAy,PO[>~7J I i ~ s l~ { s - - - - s~4 . qo dove j > 3o ge - - I _ /-vrc-our of 7-,f ti,4- I I ~ I2or oS +t'D I I FFo k t S I~r F t 606-r 571 eep) 101e,-,4S T sLp7/c I IJ~~'y l,u/~oRTif,~T ,vo7F %o 4w-~I2 /$viGD{)2 73e OS - r . ~ G S>= ~En .yUS T 3.e itT Lo -r # S S T /D / Q oR `jiSLil~ Foc~u~, SL)pMy0p5 S4ef L t=t,vee poSZ- a Sow Lo T L;,uQ • - Fresh Air Inlets And Observation Pipe N, y Approved Vent Cap F j Minimum 12" Above Final Grade d f 4" Cost Iron 30 Above Pipe - Vent 91ps' 1o Final Grade w 4Awa#r a4L Or Synthetic Covering Min. 2" Aggregate Over Pipe Distribution 5 Tee Pipe 0 0 0 0 0 " Aggregate o Pertbroled Pipe Below V, Beneath Pipe 0 Coupling Terminating At j Bottom Of System Uv Fresh Air Inlets And Observation Pipe h J 0 Approved Vent Cap Minimum 12" Above Final Grade /0/,000. ~s. 36, Above Pipe 4" Cast Iron - Vent Pipe' 'o Final Grade ' 'Marsh Ploy'Or Synthetic Covering Min. 2" Aggregate Over Pipe Distribution s . y Tee Pipe 0 0 0 0 0 , aggregate Beneath Pipe ° Perforated Pipe Below f'. S US,~,~ o Coupling Terminating At Bottom Of System ' COgMERCIAL TESTING LABORATORY, INC. 514 Main street, P.O. Box 526 Colfax, Wisconsin 54730 715-962-3121 800 - 962.5227 ST. CROIX ZONING REPORT NO4 20129/01 PAGE 1 ST. CROIX COUNTY REPORT DATE: 3/27/97_ COURTHOUSE DATE RECEIVED: 3/25/92 HUDSON, WI 54016 ATTN: THOMAS C. NELSON OWNER: Randall 6 Nanci Johnson LOCATIONS 851 Mc Diarmid Dr., Hudson COLLECTOR: M. Jenkins DATE COLLECTED: 3-24-92 TIME COLLECTED: 11:30am SUM OF SAMPLE! Kitchen faucet DATE ANALYZED:3-25-92 TIME ANALYZED'42'#00pe COLIFORM: 0 /loom( INTERPRETATIONS Bacteriologically SAFE NITRATE--N: 3 ppm Above 10 ppm exceeds the recommended Public Drinking Water Standard. Conform Bacteria/100 ml - - Nitrate-Nitrogen, mg/L p 11 1 RfCFL , ED LAB TECHNICIANS Pam Gane MAR 3 Q sr ~ 2 w ~pEVfp~I ~ R'QI WI Approved Lab No. 19 2 NG / -i, w v p ( Means "LESS THAN" Detectable Level Approv PROFESSIONAL LABORATORY SERVICES SINCE 1952 t ST. CROIX COUNTY ZONING OFFICE St. Croix County Courthouse 911 4th Street Hudson, WI 54016 Telephone - (715)386-4680 The St. Croix County Zoning office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals. Completion of this form is essential so that the property can be located. Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning Office, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received. / WATER TESTING----------=-----------------FEE: $ 25.00 V (For nitrates and coliform bacteria) WATER TESTING FEE: $127.00 (For VOC'S) SEPTIC SYSTEM INSPECTION-----------------FEE: $25.00 (Determines if system is properly functioning at time of inspection) Property owner's name Randall L. Johnson and Nanci Johnson Buyer's ar,e: Michael Tremblay and Suzette Tremblay Property owner's address 851 McDiarmid Drive Hudson Wi Legal Description 1/4 of the 1/4 of Section , T N-R Town of Hudson Lot Number 6 Subdivision Name Sunridge Addition FIRE NUMBER LOCK BOX NUMBER Color of house Realty sign by house? If so, list firm: PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual requesting services: The First National ug,sb 'telephone Number 715-386-5511 ef REPORT TO BE SENT TO: The First n •1 Bank of Hudson o7 {`,:_..L1 .t to Closing d t~e ar 28, 1992 I 3 Signature_ -V ST. CROIX COUNTY ZONING OFFICE St. Croix County Courthouse 911 4th Street / Hudson, WI 54016 Telephone - (715)386-4680 he St. Croix County Zoning office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and V~ private individuals. Completion of this form is essential so that the property can be located. Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning Office, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received. I / WATER TESTING----------------------------FEE: $ 25.00 V (For nitrates and coliform bacteria) WATER TESTING FEE: $127.00 (For VOC'S) SEPTIC SYSTEM INSPECTION-----------------FEE: $25.00 (Determines if system is properly functioning at time of inspection) Property owner's name Randall L. Johnson and Nanci Johnson Buyer's are: Michael Tremblay and Suzette Tremblay Property owner's address 851 McDiarmid Drive Hudson Wi Legal Description 1/4 of the 1/4 of Section , T N-R Town of Hudson Lot Number 6 Subdivision Name Sunridge Addition IZ FIRE NUMBER LOCK BOX NUMBER 9 2O` 1a 6 6 ,)-6 ;irm/ Color of house Realty sign by house? If so, list f PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual requesting services: The First National 1 b Telephone Number 715-386-5511 t y,l~ Y jl REPORT TO SE T TO: The First i n dl Bank of Hudson o~ Fl:_ N Closing d e ar 28, 1992 1-4 ras`~ '332 Si nature 4 ' C.C;UN7Y ZON1NGOFFiCE ~ ST. CROIX COUNTY rY., J`~ 4s NWISCONSIN ZONING OFFICE ~rt.7'dk ST. CROIX COUNTY COURTHOUSE ti T 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 Mar. 24, 1992 Peg Starke The First National Bank of Hudson 307 Second Street Hudson, WI 54016 Dear Ms. Starke: An inspection of the septic system on the property of Randall and Nanci Johnson (buyer's are: Michael and Suzette Tremblay), located at 851 McDiarmid Drive, Hudson, WI was conducted on Mar. 24, 1992. At the time of inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating 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. ~.t- tMaJ rely, to Jenkins Assistant Zoning Administrator is I