Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
020-1157-50-000
ti $I;u CD o C 3 r* ao~ FF ~ Q 'S L L y Z CD 2 = N N 0) C n W 3 3 N O Qt ID 0 a CO CCD A• CD CD A A C• W 0 N rn 7 7 CO CO CT 1 3 O 0 O 7 v O N N r ~ 00 CD (D CL N w CD -0 om CO O CO O O O O GS W U7 W 7 7 O _ v N O 7 N -n O O N N r~ 0 !CD CL (a CD CD j cn W a _0 CD c a O o on 3 O rn CD _ co co a y o co 0 N 0 c 3 II r. OOO~ n cc c U! N (A rn N t0 CD ~3 T o m w G h o C CD CD . - CL m N m CD CL Z Q D m 0 O a p (LSD (n • m N Cl) CD c /yam c m W ~ a Z = cb -i N A Z fD N C CL A 0 Z ~ N rn co CD (D Z fA 3 m ~ N Z A W f ~O O '~=S d Q 3 7 fD O C W (D Q'R N G ~O y O O= 0 CD N N C CD E Z (n - O 0> -m 0 a '0 o m ~cn0 N N (D 7 O g co N n cp O O O r` S o CD 0 3 CD a N ~ =fW (0 0) S N N t0 O OCD N QI ccD S O C (o O D co < CD °a co 0 A -4 3 0 00 m v EA O v CD c a r s M ~ O t~ 01 eo y N 4 0 et E r` N O 7 OOi F N rn CY) N N .tom t ~ Cl) O C a) y~1 $r c V N E' _ o a) O y O o Nt c o Z Cc--a ~y li c O O V ° 3 O U c J V t fa (L 3 M Z y E co H z d 0 z c > E c v _ col CM N to C w y d c • a cn .C 0 4) Q Z m z N z I - c I N i °a R m CL M a~ Q c o a` m h~ = N Vr) N rN WSJ 33 aL o z O o 0 (A J U m rn Z Z Z o o = 0 J c E m c a n m I t~ c w z (o N CL ai a O n N C m C E M 0 N _ Q E CD r°n v a rn 00 U I,- CO Q q 9 II ~ ~ € E ~ a> - - I C i C _ p C 75 y N y C(D~ a+ 7 a y L N •Q ~ O N= = O Z N Z~9 In Y .ICI I Cc V v~ d ~ € a I L IL E c . m r~ 3 r A c°~I !,ov~ici Parcel 020-1157-50-000 05i22i2006 08:02 AM PAGE 1 OF 1 Alt. Parcel M 26.29.19.882 020 - TOWN OF HUDSON Current ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - FETZER, WILLIAM J & MARY M WILLIAM J & MARY M FETZER 715 PENNY LA HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 715 PENNY LA SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 4.270 Plat: 2078-HIGH MEADOWS II SEC 26 T29N R19W HIGH MEADOWS II LOT 22 Block/Condo Bldg: LOT 22 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 26-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 05/0411999 602587 1424/224 WD 07/23/1997 1128/556 WD 07/23/1997 1 40 QC 07/23/1997 875/30 2006 SUMMARY Bill M Fair Market Value: Asses 0 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.270 61,800 177,800 5 239,600 NO I Totals for 2006: General Property 4.270 61,800 177,800 239,600 Woodland 0.000 0 0 • Totals for 2005: General Property 4.270 61,800 177,800 239,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 140 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 1 OZD- DEPA9. MEW.' OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 HUMAN RELATIONS MADISON, WI 53707 (H63.090) & Chapter 145.045) ' LOCATION: SECTION: TOWNSHIP/Wrl:! 'CiPJXL : L : BLK. NO.: SUBDIVISION NAME: 1E 1/ -"1/ z /T N/R E (orlOY - COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: tea( e O 2 USE OBSERVATI NO. BEDRMS rMMERCIAL DESCRIPTION: PROF TONS: TESTS: P PI~esidence 3 L_7N `~Repl ce o 3 , L RATING: S= Site suitable for system U= Site unsuitable for sys m CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: YS~TEM-IN•FI'tL H(OLDI~NG TANK: RECOMMENDED SYSTEM: Io i al) ' ~J ❑ ©S ❑ ❑ U EIS ❑ U LJ J ❑ U s' y C-1 If Percolation Tests are NOT required DESIGN RATE: if any portion of the tested area is in the v. under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRI BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) /..2 f $v~ hrS _54 ' B- J 1,4 > B- 1&7 >o , l 0 7 '11d ''eT w T. ' B- -7 'flq 51 EV- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. P RI D 1 PERT D PER INCH 3 P- 7 AM< P- P 9-he Cn in P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION Qs.2 ' I i ~ I ! j I I I i i I I ~ I I I I i I ~ 1 I ' ~ 1 I i ~ 1 I tN ZOT r"1~P 97.1e sl le. a7~ I ~lle m!~t hur-t~~~ /C ffltz°66~~r j ~ /1zy2tl ~01 f5 . c✓ sv ~ wLtz ~.c~G~n-.ten r'K #s / ~ 3 cvG~-* i ; taarir~a~z I CLLF0.~ t' Q+ F / JT 'be 'e,,w' ;4,c /~ti fG ~~cr i e?"ex ~jt r r~r fai r~us rc le. ~ I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: ' DA`tJE FpGEFtTY PLUMBING 3 ~ ~ DDRESS: IC #3233 #1:3289 CERTI ICATI UMBER: PHONE NUMBERIoptionall: ug;qhts Road RIO ERTS, WISCONSIN CST SIG TUBE: Phone 749-3656 RIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. t-SBD-6395 (R. 02/82) - OVER - r DUS OEPAPITMENW OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION 7969 LABOR AND PERCOLATION TESTS (115) P.O. BOX 3707 HUMAN RELATIONS R Z MADISON, WI 53707 (H63.09(1) & Chapter 145.045) LOCATION: SECT ON: ITOWNSHIP/MUNICIPALITY: LOT NO.:BL (VISION NAME: 1/ 1/ /T N/R E (or) W COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: USE DATES OBSERVATIONS MADE NO. BEDRMS T~~IAL DESCRIPTION: PROFI E D SCR IONS: ER O A ON TESTS: ❑Residence F-6N.- ❑Replace RATING: S= Site suitable for system U_= Site unsuitable for system CONVENTIONAL: MOUNcD: ~IN-GROUND~ESSURE: SYSTEcM-IN-FILLHOLDIcNG TANK: RECOMMENDED SYSTEM: (optional) F-Is u J U J u [:]U F]J ~ J If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the yr under s.H63.09(5)(b), indicate: 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. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- / / Y O 1ltC I d ' Al T. ' I9 j IW J tar 9.8 /~f S ' ' Wars B 8 q5-, Y ~7p '13, B-9 fg, U t B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 P RI D PER INCH P- P P- P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION X3.2 ' i► ~ ~ I l ~ i j l' ~ ~ j l ~ ~ ~ I I I y I ~ , I I ~ I ' I I ITN I 1 i 1t i i ' I ~ I I I ~ ~ I ~ I j I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: DAVE FOGERI't 3 < 9 ADDRESS: ucenS@ CERTIFICA ION UMBER: PHONE NUMBER (opt ional): N3233 #3289 lghts Road R06 RM W)SCQNS(N CST SIGNATURr- Phone 749-3656 ! it DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER I ~ l q~~ iyzk~, M'" / DAVE FWERTY PLUMBING Lkensed Perk Tester & Piumber . ~ Fo #3233 eightad ~I /33" ---3y~--~I~~d --y R08EW.YWl XONN 4023 phone e Nsp pad 3 l~ q/yo d~ yzs~ l3 sf' ~o SCa(r J~=~lO~ it/S/~ CprGteft ~►ot' QsSu~re J~O ' 17 =~ovir►~ G = Oar t~ LOT SIZE/ACRES ~'•2 Acres NOTE: Location Map,, Directions and Financing Helps on reverse side. 200 tq 0 ^ O N~ 4.,~ ~ Pap a ~ L ~ IL 2Z J 3.F6a~ 0 •n 6 9 i. 3 6 6 P Form - S T C- 104 /10AS BUILT SANITARY SYSTEM REPORT OWNERw TOWNSHIP SEC T,,~?_N-R~W ADDRESS ~2-r 3 USX 1,/ ST. CROIX COUNTY, WISCONSIN SUBDIVISION j, A;yCte ,~S" LOT 2 2 LOT SIZE -:57 tyro PLAN VIEW Distances and dimensions to meet requirements of I1HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 6 i ~4~y ~Y6 INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used ws U ~ Elevation of vertical reference point: Proposed slope at site: .~A SEPTIC TANK: Manufacturer: &lp-nks Liquid Capacity: Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: I . Number of feet from nearest Road: Front,O Side&Rear, O 3 j /m0 feet .From nearest property line Front 10 Side,O Rear, O ? /od feet Number of feet from: well e , building: -5pD1 (Include this information of the above plot plan)( 2 reference dimensions to septic tank) RF.R RRVERSE STDR PUMP CHAMBER Manufacturer: d2ce4 S Liquid Capacity: Pump Model: 27 Pump/Siphon Manufacturer: Pump Size Elevation of inlet: df, 2-7 Bottom of tank elevation: dS, f Z Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: DG-Alarm Switch Type: ~~7-tom Number of feet from nearest property line: Front, O Side, O Rear, ~,077''Ft.7/ors Number of feet from well: Aj,7.1,f Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Area Built: C9~ Width: 1 Z Length: Number of Lines: Fill depth to top of pipe: ,2, Number of feet from nearest property line: Front, O Side, &ear, 0 Ft Number of feet from well: P s 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 frow building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: / Plumber on job: License Number : -4LY 7 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING • DIVISION LABOR & HUMAN RELATIONS P.O. BOX 7969 T29-R19 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION so 0 9,,/1(I b~e C . 26, -~I~">State Plan LD. Number: MR,,, CONVENTIONAL ❑ ALTERATIVE (If assigned) Town of Hudson Kinney Rd. Lot 22❑ Holding Tank ❑ In-Ground Pressure ❑ Mound F PERMIT HOLDER: Zj RESS OF PERMIT HOLDER: INSPECTION DATE: NAMED Tom Hanson Box 168, River Falls WI 54 2 -96 .'o BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: F. P, CST RE . T. EL Name of Plumber: PRSW No.: County: Sanitary Permit Number: David B. Fogerty MP/M3289 St. Croix 135506 SEPTIC TANK/ MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LO4E PROVIDED PR f G✓> y.'~ ) YES ❑ NO ❑ BEDDING: Ir NTDIA.: f, MATL.: HIGWTER NUMBER OF ROAD: PROPERTY WELL: BUILDINGSH n , C- t. ALARM: FEET FROM LINE: / ❑ YES NO < f ❑ YES ❑ NO NEAREST a O DOSING CHAMBER: MANUFA~C/TJURER: BEDDING LIQUID CAPACITY: P ~ EL PUMP/9Wh16 4 MANUFACTURER: WPROVI D: ARNING LABEL LOCKING OVER 1,(/.f f)S ❑ YES l NO My S ED NO YES ❑ NO PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH GALLONS PER CYCLE: FEET FROM LINE: t AIR INLET (DIFFERENCE BETWEEN In PUMP ON AND OFF ❑ YES NO NEAREST _ LENGTH: DIAMETER: MATERIAL AND MAR ING: {7 SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE - r . or or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN ~o , Q rIK~' the soil is dry enough to continue.) K CONVENTIONAL SYSTEM: = BED/TRENCH WIDTH: LENG NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID / TRENCHES: MATERIAL: PIT DEPTH: DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR.,PlPE~A ERIgINJ DISTR. NUMBER OF TPR OPE RTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: AB%V COVER: ELEV. INLET: ELEV. END: Al! PPES: FEET NE: AIR INETY. a ) 0 7 0 / MOUND SYS M 3 h ~r,d '113 ` (I-q/ 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: WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.: ELEVATION AND DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑ YES ❑ NO E] YES ❑ NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: El YES ❑ NO ❑ YES ❑ NO NEAREST C <f- ~ J et am in county file for audit. Sketch System on Reverse Side. SIGNAT E: TITL SBD-6710 (R. 06/88) SANITARY PERMIT APPLICATION ~JDILHR In accord with ILHR 83.05, Wis. Adm. Code cm. STATE STAR~/v~ERjut/YjT -Attach complete plans (to the county copy only) for the system, on paper not less than ~ " 8% x 11 inches in size. 1:1 check if~ Ision to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION Tom Hanson ne Y4 se Y4, S 26 T 29 , N, R 1 [(or W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # Rt. 3 Box 168 22 CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OB1•R 11. TYPE OF BUILDING: (Check one) CI NEAREST ROAD ❑ State Owned ❑ VILLAGE: Kinney Rd. ❑ Public [ill or 2 Fam. Dwelling-# of bedrooms 3 PA EL N BE ( ) 111. BUILDING USE: (If building type is public, check all that apply) 010 1 7 - S-0 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.E1 Reconnection of 5.0 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) ELEVATION 450 615 61 .73 .5 93. 1 Feet 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 Mks structed Se tic Tank or Holdin Tank 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 Znatur!e: Z MPRSW No.: Business Phone Number: David B. Fogerty .r2. 749 3656 Plumber's Address (Street, City, State, Zip Code): Foiterty Hats. Rd Roberts, W1 4023 IX. COU /DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater a e ssue issuing gent Si ure No Surcharge Fee) Approved I ❑ Owner Given Initial J Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Pib-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber J INSTRUCTIONS f' 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 subrr?' ed 1..i, the county, prior to, installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be PUMP ed"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 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 volurne; elevation differences, friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if ;required btftcounty; E) soil test data on a 1,1,1 form; and F) all Sizing information. ` - - - - - - - - - - - - - - - - - GRifl>fFIMOER iM CHARIE "r`fl • ( r 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The mgnies collected through these surcharges are used for monitoring groundwater, ground- _ water contamination investigations and establishment of standards. j"rT ten;,-, SBD-6398 (R.11/88) i IN DUS R,Y OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS USTRY, DIVISION LABOR AND CC P.O. BOX 7969 HUMAN RELATIONS PERCOLATION TESTS (11J) (F~ MADISON, WI 53707 (H63.090) & Chapter 145.045) LOCATION: SECTION: TOWNS H I P/Mtff1tCtPA Le I Y: LOT NO.: BLK. NO.: SUBDI VISION NAME: '/as z /T N/R 1,7 E (or - XIE COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: ALI e rU © 1 USE - S DATES OBSERVATI NS MADE rr~~~ NO. BEDRMS.: COMMERCIAL DESCRIPTION: r~ PROFILE DESCRIPTIONS: JPERCOLATION TESTS: LPResidence 3 L_7 New F-1 Replace 3 a 3 1 6 v RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUN~a URE: SYSTEM-INEA-FILLrOLDING T❑ANK: RECOMMENDED SYSTEM: (optional) If Percolation Tests are NOT required DDE IIGN RATE: D If any portion of the tested area is in the under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: _7 PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. CHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) I•~ f ~3n nrs. B- > ~ 2 1. . S' .~H B- 3A'~3aisrs. m 7 > ' B- /,o,/, I l o 7 icy w 1. ' B- OD, d' -Z,/'T~► ri►S. Fir It r ' n / •T i w B- ` `I , 3 7 ~6 .7 '13k1s 414'-a - 1, fa- sl PERCOLATION TESTS dv~r --s7 TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH P_ 7 c 3 P_ P- hG C " i n P_ P- I s- 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 Q3, 4 ' i.-_ - [-7 T 1 1 77~ 3 E I E a E i t ; LOT t 3 /14 ttt I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: pA~IE FOGERTY PLUMBING 3 ~ ADDRESS: I #3233 foster & CERTIFICATIOfN UMBER: PHONE NUMBER (optional): Fogerty Heights Road ROBER S, WISCONSIN CST SIG TUBE: Phone 749.3656 DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - ' S i INSTR 3CTIONS COMPUTING FORM 115 - -6395 To be a compl accurate soil test, your report must include: 1 . Complete= le i; 2. Th Jy indicate whether this is :dence or commercial project; 3. VI numoi Brooms or commercial use fined; 4. =WN or felt_ t system; E the suit ping boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL SYSTEMS )LED OUT BASED ON SOIL CONDITIONS; 0, I _ the = ' own here for writing profile descriptions and completing the plot plan; 7. P LEG IBIL accurately locating your test locations. P--`- to scale is preferred. A ,t may desired; 8. ur he d vertical elevation reference point ar( gin, and are permanent; '1 applo} . °s as to dates, narnes, addresses, flood pla ,i percolation test: exernp- )od plain, elevation) does not apply, place N.A. in the apprnniiate box, 1 . current address and your Certification number; tribute as required. AL_L_ SOIL TESTS MUST BE FIL VTH THE z _d)THORIT . :IN 30 DAYS OF COMPLETION. ABRREVIAT CERTIFIE- r ERS (;r. T~ 11 ` 10") BR - I {3 - 10", SS (under 3") L'e ~-~3rrti F . m Sind r - Fat; Y =r, R L root - ciav yy SE d F1 VV &X 0! 1 VRP TE, E. art Iln,l;., R3lntP to I Frit o tart of any construe' n. L P~4 TRYI~VT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS 7BOR DL.(STR'Y, DIVISION MA N'RELATIONS PERCOLATION TESTS (115) MADISON W 53707 (H63.09(1) & Chapter 145.045) Z LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BL (VISION NAME: 1/ 1/ /T N/R E (or) W COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: I PROF( DESCRIPTIONS: R LATION TESTS: ❑Residence ❑New ❑Replace Il RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: S STEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) ❑ S ❑u ❑ S ❑u ❑ S ❑u ❑ S ❑u ❑ S ❑u If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: l Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 7 / Y o dke / d At B- 9' 8 > 7y B- ?y pf, -7 An -C fF B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD3 PER INCH P- P- P- P-_ P_ PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori• zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION 4 ' fi E TN 1 # __4 I l 3j 1 -t- E fi F i 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. NAME (print : TESTS WERE COMPLETED ON: DAVE FOGER f I PL0** yo ADDRESS: (-jam CERTIFICATION UMBER: PHONE NUMBER (optional): #3233 waiiahts #3289 Road ROBE S~ W)$CQPISI CST SIGNATURE- Phone 749-3656 17 DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - • L /17 0A ( 'ke- 44rw ~At - IN TRUCTIONS m COMPLETING FORM 115 - SKID - 6395 To i complete and accurate soil test, your r t include: 1. C ~ regal descript r; 2. _ 'n must { ndicate whether tl sidence or cornea 3. N number of 1gas or commercii1 vied; 4. r ;v or replacem rn; 5. Cr he suitabili _)xes. A SITE IS e RLE FOR A ( ~ ONLY IF ALL O" '`-TEMS OUT BASED f ~.D L CONDITION: 6. the ab own here for vvr _rig profile descril rig the plot plan; 1. OIS(r- urately locating your test locations. is preferred. A ,:red; rrtical elevation ref, ,r:e point are and are penman nt; 9. t, dates, names, ,;ses, flood percolation test: exerYip- i ain, elevation} rtply, in the ap!r,-o;, k, x; 1 3. it address land yc `ication as required. ALL .01L TE< BE FILED TH THE LOCA`_ t1THOPI- ;TH11 AYS OF COMPLETION. L. __IATIC~ ' CERTIFIE CFRS e =~~tures $yrr =,Is ,rr0 t tj1 TO THE C IOp I 0 to t' start of any i STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT w St. Croix County OWNER/BUYER f t/SD~i o ROUTE/BOX NUMBER Fire Number 0 - d CT CITY/STATE /JSd /t~ ' j 66)(S ZIP 5-40 ( 4P C' PROPERTY LOCATION:'.S4_~) k, Si_k, Section 23 T 2~N, R Iq W, Town of-' (j-LQ St. Croix County, Subdivision fC~J~I)Dw5 Lot number _Z! . 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 um er. What you put into the system can affect t e'.unctionhe-septic tank as a treat- ment-stage in the waste disposal system. St. Croix County residents may be eligible to recieve a grant for a maximum of 60% of the cost.of replacement of a failing system, whLE 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 'sys'tems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a mater 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. H I/WE, the undersigned have read the above requirements and agree 0 to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Depart- ment of Natural Resources, Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration.date. SIGNED DATE `L U St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 386-4680 Sign, date and return to the above address. r r' L~ ill A« I ~ j at f~~ 3S/=c ax' 8 ' i DAVE FOGERTY PLUMBING Ucensed Perk Tester & Plumber #3233 #3289 133 ' Fooggerty Heights Road ROSERTS, WISCONSIN 54023 Phone 749-36 17s ~~sa7 //7•~a- rya/r i 3B p~ /=~h e ~f~/'l / L~Q(.c~ G~ S ~AG( 4SS N!s-rY / ~ D /SCIPst'/tt~y L16, d 74 /0, IL ~3 PAGE OF PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS VENT CAP 1"C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING JUNCTION BOX MANHOLE COVER 25' FROM DOOR, WIMCOW OR FRESH i2"MID. I AIR INTAKE GRADE 1 I `I"MIN.` I CONDUIT - - 18"MI \ k X11 IAII_.F:T PROVIDE I N.AIRYIGHT 4SEAL I I 1 ~ ~ / APPROVEC JOINT A I I I APPROVED JOINTS J~C,I. PIPE. I III W/C.I. PIPE EXTENDIAI(• 3' I II ALARM EXTENDING 3' .)NTO SOLID Scl B i ONTO SOLID SOIL I ON C •I I . 1 PUMP ~ OFF D CONCRETE BLOCK RISER EXIT PER'M11TED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL SPEC.IFICATIOAJS rIC AND ~TANKS MANUFACTURER: NUMBER OF DOSES: Z PER DA-4 TANK 51ZE : GALLONS DOSE VOLUME 1 ALARM MANUFACTURER' INCLUDING SACKFLOW: GALLONS MODEL NUMBER: CAPACITIES: A=--~7 INCNES OR GALLONS SWITCH TtIPE: B z INCHES OR GALLONS PUMP MANUFACTURER: C--LLINCHES OR aza GALLONS MODEL NUMBER: rio'97 D~ Z INCHES OR GALLONS SWITCH TYPE: NOTE: PUMP AND ALARM ARE TO BE PUMP DISCHAA&rE RATE GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERELICE B$1'1WEEN PUMP OFF AND DISTRIBUTJON PIPE.. Af FEET + MINIMUM NETWORK SUPPLY PR'E.`SSURE . . . . . . . . . . . e.-s- FEET + 'D FEET OF FORCE MAIN X ~YOFLFRICTION FACTOR.. , / FEET TOTAL~L~-_.F OyNAMIC. HEAD = FEET Id, I INTERNAL DIMENSIONS OF TANK: LENGTH ;WIDTH -~;LIQUID DEPTH SIGNED: LICENSE DUMBER: 3 1d , DATE: -il~- FAM DOCUMENT NO. STATE BAB OF WISCONSIN FORM 11 - OU THIS sPACC aeeC11V90 Pon WCO1101166 DATA LAND CONTRACT Iadlrldael and Cerwrete 18 $tssee 18 I►INAN.ED AND OTH R NON--CONSUMLR ACT TRANBACTION81 REGIS'WS ONCE ti h Contract, by and between - Ree ~~se& IC Cil~nn Mixon-~ k s Glenn A. Waxon and Y 19.q1.1.8 n «QR 3 v 590 Mixon i,{k a - Vyc~l le M, --Waxon as to -(«Vendor" of M t> -~~more) and..... Thomas...w....-kJ=zca 8.30 A a ;i ("Purchaser", whether one or tense). ApylKelOr1~ + 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 rents6 profits, fixtures and other appurtenant interests (all called the "Property"). it............... .cif.A,...CiCJ7li.x.............................. County, State of Wiwnsin: nCTUPH TO ~,>r w•. - i t a 1'vl Lots 22 and 23, Plat of High Meadows II in the Town of Hudson/ together with the private V, roadway as shown on said Plot. Tax Parcel No. 1 rf iT~As'1 ' ~ 0 S not This ..i...s homestead property. (is) (is not) Purchaser agrees to purchase the Property and to pay to Vendor at Plac t...Y.andor..Air.gw.to............ the sum of $.....25.WGL..0n in the following manner: (a) A,.RQQ...Q4......................... at the execution of this Contract; and (b) the balance of $ 22.,.50.0..20 together with interest from date hereof on the balance outstanding front time to time at the rate of.......... 1.OX per cent per annum until paid in full, as follows: { Commencing the Twenty-sixth (26th) day of April and on Twenty-sixth day of each and every month thereafter, equal monthly installments of principal and interest in the amount of $232.00. Provided, however, the entire outstanding balance shall be paid in full on or before the.......~6th....... day of 19...;3.9. ( the maturity date). Following any default in payment, interest shall accrue at the rate of 19.. % per annum on the entire amount in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, trt• entire principal balance). Purchaser, unless excused by Vendor, agrees to pay monthly to Vendor amounts sufficient to pay reasonabiy antici- pated annual taxes, special assessments, fire and retluired ins urance premiums when due. To the, xtent received by Vendor. Vendor agrees to apply pa)•naents 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 bah•.nce at the rate specified and then to principal. Any amount may be prepaid without premium or fee upon principal at any time !fllFxxxxxxx_xxxxxjcpxxxxx 1bwx+salxbexno>RwKa7eaa10c ~ )ssi;bbstlt )plmBtB~ssbBOC talk fiscator~t x + 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 sued c:c=r accruing interest from month to month shall be treated ss unpaid principal) is less than the amount that said indebtedness woald have been had the monthly 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: none. P ' Y Purchaser al;rees to pay the cost of future title evidence. If title evidr nce is in the form of an ab_-tract, it shall be retained by Vendor until the full purchase price is paid. Purchaser shall be entitled to take possession of the Property ot: day of e I os i ng ly -Cr." Out One. LAND CONTRACT--ladhldeal and ATATF. n.\H OF R'IRCU`-MV '.t'.. L•crr. Hied t,a..• (`grpta\Y YUItN Vo. 11 - IYB2 :.liw.... N.. er MIL SWPAPU in it va onto on When dutaxes and assexsmerts levied on the Property or upon Vendor's interest demand receipts showing such payment. Purchaser shall keep the impprovements on the Property insured against loss or damage occasioned by fire, ex- ded coverage peril and such ~ other hasards as Vendor may require, without co-insurance, through insurers approved b Vendor, In the sum of $ ......17,(-R...--._.._.., but Vendor shall not require coverage in an amount more thaO 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 i ff all po icies covering the Property *hall be deposited with Vendor. f•ui cl.ser shall promptly give notice of was to companies and Vendor. Unless Purchaser and Vendor otherwise agree in writing, insurance proceeds shall be tapplled to restoration or repair of the Property damaged, provided the Vendor deems the restoration or repair to Ie 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 tree from liens superior to the lien of this Contract, and to ewmplY with aU laws, ordinances and regulations affecting the Property. _ Ven f0HY dor agrees that in case the purchase price with interest and other moneys shall be fully paid and all c.nditions Ver.dor 'pi two `y LhDcedt fee simpl" ofnthe P~perty flsoe sand clear of all fie us and encumbrances, deliver e:cent MY lium or encumbrances created by the act or default of Purchaser, and except: _ R~RJgAlAllxai.~..~'f?fixf.~G. ~Q.QfE...l~f~d..rights•-of-way.•oF ret:ord.....if any.. . P1lrehaser 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 days following the specified due date or th) in the event of a default in performance of any other obligation of Purchaser which continues fur i. period of days ollowing written notice thereof by Vendor (delivered personally or mailed by certified mail), Leer, ti,e entire outstanding bulanc•e ;ender this contract shall become immediately due and payable in full, at Vendor's option and w,tmat n..tice iwhich Purchaser i.ereby waives), and Vendor shall also have the following rights and rvniedies u!. cct tc, ar_. i,alitatior,= provided by la., r in addition to those provided bylaw or in equity: (i) Vendor muy, at his „ ,t:,.i., t er n. i r... t e tt,.- l outrart aril rights, title and interest in the Property and recov-r the Pro,,erty bacx tr.ro.gr, strict forecwsure with any equity of redemption to be conditioned upon Purchaser's full payment of tLe ii-vurt o,.:-:andinu balance, witr: interv<i thereon iron, the date of default at the rate in effect on such date and other amount. uuc hereunder i in whictievent:JI wwwrits nreviousl M by Purchaser shall be forefeited as liquidated damages for failurt• to ;vliill this Conlii,c•t ;,nd as r(titu: for the perty if purchaser fails to redeem); or (ii) Vendor mac sue for l erfornianve of ti•is Cw..rac•t a, compel immediate and full payment of the entire outstanding balance, with inter. <t thereon at 'fit rate in effect on tr.v date of default and other amounts due hereunder, in which event the Property be curt-iced at Judicial saie and Purchaser shall be liable for any deficiency; or (iii) Vendor may sue at lair- for ti:e entire :'.per d purchase price or any portion thereof; or Ov) Vendor may declare thist Contract at an end and re•rnw.t• r i `;.traetasac•loud on title in a lu:et-title action if the equitable interest of Purchaser is insignificant: and Ivi Vendor nia~ F :vc Purchaser ejected from p• session of the Property ano have a receiver appointed to cullect anc r pru..L> the penueney of :,ny action under (ii), 00 or (iv) above. Notwithstanding any oral „r written sta:e1,.er,;s .r action.; of Vendor, an e!ection of any of the (foregoing remedies shall only be binding upon ender if aid %vr., r parsued in litigation and all cust:; and expenses Including reasonable attorneys fees of Vendor incurred to ei,for•ce any i. needy ;.vrv r,der t whether abated or nit) 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, inuding homestead interest, to coilect the rents, issues, and profits of the Property during the pendency of such action, anu such rente, issues, and profits when so collected stall 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 w•ayi without 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 s(At* as security for an indehtedn.ss of Purchaser. In the event of any such transfer, sale or conveyance without \'t ndr,r's written cr,nsent, the entire .utstnm+ir,: balance payable under this Contract shall become immediatelydue and payable in full, at Vendors ortior, tcithout I.•ai:•e Vendor shall make all payments wi en due under an%- mortirage outstanding, against the Property on tht date of this Contract (except for any mortgage granted by Purchaser) or errs err ar•.• r.;,r. :P, ii-d thcrchy. pro%idea Purchaser makes timely payment of the amounts then due under this Contract. Purchaser ni make and such payments directly v the Mortgagee if Vendor fails to do so and all payments so made by Purchaser shat] he considered p.,Nnicr:tf made r• this Contract. Vendor may waive any default without waiving any other subscgncnt ur prior dcfa.:lt of Purchaser. All terries of this Contract shall he hindine upon and inure to the benefits of the heirs, legal representatives, suceessors 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 day of March 14 90 • .(SEAL) iSEAL, Glenn Waxon a/k/s Glenn A. Thomas W. Hanson we on.... (SEAL) 1.1:At.r .Vycella Waxon a/k/a Vycelle M. Waxon AUTHENTICATION ACKNOWLEDGMENT Signature(s) Glenn Waxon a/k/a STATE -.A %llacuN: i:\ ` Glenn A. Waxon, Vycelle Waxon ss. •8/1C/a--VYCe,l1$ trt~ Waxorr-,..Thomas the - ---day of.- March ISO. } , • ,,:r :a~ rf y...~''t G J=Z .l J.'c:C: iv a ti,r 1, is e nar.;cu • Kristine Ogland Lundeen `b TITLE: MEMBER STATE BAR OF 11-ISCONSIN ~ (If not. . authorized by 706.66. Wis. Stats.) to me 1.n,,tcn to be t .r. ul.,, cxt:uted the THIS I%STRUMENT WAS r;RAFTEn L-Y _Q Kristine Ogland Lundeen Attorney at- Law..- ~ R'is~ (~ign.tttin may be an:'t n!it:,r,,f .•r r .,t 1, , 1! :,re not rovvssazy.i LAND CONTRACT - IadiYHad and (orponte - sate nor 4 w•i.r..e.ea. F.P. N.. 11 - 14e: 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 L✓ oil) Location of property S~ 1/4 S 1/4, Section 2- 3 , T2-0 N-R I W Township ~1Z1 Q~d Mailing address Address of site 'fir Subdivision name 144-0 ow S Lot number Previous owner of property (.P l14, &k/ IN ed Total size of parcel S/t Z 7 <~C~S Date parcel was created 7 CY Are all corners and lot lines identifiable? Yes _N0 Is this property being developed for resale (spec house)? Y Yes No Volume 29~2b.and Page Number 4,1 ;23 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, eed rec$rded in the Office of the County Register of Deeds as Document No. ~•YJ ; 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 beery/ u r rded in the Office the Cq 'nty Register of Deeds, as Document No.-t'~ ) . Signature of Owner Signature of Co-Owner (If Applicable) F lG ~X Date of Si nature Date of Signature r y~ `~~,•sr ~,Y',r:,. v.".k; y''±i~ a r!mi{~irdw /~~•3'K'~i"'`7~~.. dy i"2 My'w~4.T~~ Aa~ ~~i , . ~A i~~, s x a~'r" . ~ fir'.. ♦T ~'s 'v`:k r. f j• 1 ~"•','tl,a. +T ,M`+^~¢ r^R•t ~('~l l:;'`.- ySF' J F 4' . Y ) .rl s,. 4 ..1. 1i }";.e+> rr''l". "}~.'°7`% tr ~'~!`~kC,l ^J',-~`!~.CY-rrtxt, ►,.t.~'P?. '~y'., 77 ,~''~+`..~sl:,.,.f ,may. ~~rl'"-`,{. - ae .~f 1 ,.'.L 1 •'4'7<;..:,c. Jr ~ Yl "ia: F,~ t H- tti •t. '!f~. ~`t ^.:R ~i pia •:r 4... t' y1.~,0 C• ~ t : 47", "r, ^i`v^" _ y` 1 1 n ,~'i~p~.4; r ' 4{ jai. ~'l : " t 1;~ "r'S 'L; , i'.'U. 'r ' ~a • ':JY r 1 `s '/l : ~ ` t { 7k. +!r:',~""J ,-t '`e~tr;S~. ~Lr:ii .v b(4 ''i"... ~ .q 5' , LT .4 i. v ~ , t . c.~ • ."S a e, ,r7r~` r - - , °4 r( ' 7 ' e S .+'!j. ",M'. C , ~'>:t._ , tB.cAj,? ;Y+ ~,r!p['~~ "~~'ip J, .ff~~ q ..'YY. 5.{ 1;74, J. t .Y~.'t . ,-.~.~.r •'ti ~ ,i(!1.,.-A'F', 1 i ~'L'_.. 1:{ r'f~ .J~i. .~E ~.7;1. 'r ~•y. na! ,,P .:rr~„ . , t, , t f k-..a„. ~ .1r~+~~ . y.1, 'q 'h`i.' JL wt" -t' ° v ~ 1 r. ~ "f ~V . 6 r - :5~~ ' {'q' Jf..A' ♦ J - - „ .-S.' .A r I S ;:'j,: Y: .1 .,Yip •.'V r~ ~ ~4 +I JJ t..`4, p~.~.:w.+,.~-P'`°•i~?-"1:-s,.."''."i`..."',...^r.-r*,.~.,!~!......~ t V, t . m t: r ~Z r, rlr," 111 , r -A ,~_a .p ~ ~ a y' I f •S - r l rY- ,~y 1 r ~ a- ~ r ~ p ~ t~ r ~ a ~ r r t '1 ~ do : . V;- y- f-~ t ,t• i ~ a: j7 r J `j~ / ,r' y - A' , l Nib ? a ~1 •is y ' •t r _ , ' ;t " `r 7 S ,a ' i~+ ! ~j. ~~'i~ f "a: Lt, t• .,~w I ~ `y f. K' ti,t Y„ 7~4't Fl."1 ~...'.l $'e' a .4. SS y. .'.'fc~ . •tt '.i. t j; , .I, r' / mot{. :.1•.. ! ~ ~ yr t''la& ~ 3 ':rK '',,t.tE°:;k ti f.. r iS;1° - - k t 7 '„f- 1- t 17r "e",mot V'~'7~.i .5'• Lt. {~i:'T F. :~_'"'1 ,i h ~~,'•ra'~. r- ' ~ _~J ~ ~ Tr , •-i'." t ` t.o. Vrd`=. .tit :r M ? 1•'r',!h ? ! $ ~rt y.M,{'al R-~: ~9Lt ~ E:1't'( - ~^..r.:. ' ,.3 r r'' s ,..N r :+lc w.y. xrv ti•f ,}{y-.~S~.S y~ ~!S , , ~2 r r t , s, .f ~ :,:'t' .'t' i! .9 . ~2Fn,~ .1^: r' } ~'Sr~"~`''1* lµS'~ ~C>;:~ •_'-..'...-.^.I•v.. tr.,rS' r , _ s . by . t t. , t ,'ti Y ~ i• 3'r':y ,r,' - { ~7 s%;~' ;41•" .'L:. J'g. , ~ k. fi;y YO.w.. aAf,o .,t'.,.,2 ti.. r . t '1, " y` r 'a~ e~"^. 2,'s?'.. +fi~t~ Y{,tt.,~C ~ .',~'r}'r 'i. I,;`•?'tY' 'etf, `V., ..tF k, • +.Gar - t' ~d t l,', 'R, l L3n-'a1`'<' ~41v f, t•'; ~t,. .t.w ti. rf . :4' 'f. i°~" sM, .!~'-L~tn {~S s-t.L`!~~4,•s4cyk~.:W y,~ rp i ti~ ;+1J. , S - A 1.~ .r C, f.. ~.;R.*.. r A r. •-l~~ Rar '=+.e A a~ r ~`9 i h s ' , ~ ,y - . ter.,. Jl,yr' } yp: L +i t~ 1"r ~ t+'`•' ~ t.~~" ~ ~ • f } l: ..Z.^ i': `-a.~ r `Aw, . y :;i _ 9' ,,,~•~'•,r' , it~'.r 1 ' ,~u'. A,"kc ...c ~ Fr ,L , a x ; - i' rI 5":;,~ 4. r t-, r rr r F, ,.:F~~" ...T t~ T"~•M1..'..f .1". yl, I11rt16 Yr. 1 't ~ _ F e it n :;tr ~ tf, °:,r it - ..\I , - r* { k f > 1 rX T, 1 'Yt _ 1h j~4,, 2 1. ~ ~l ; " ~ ' y r i , , j,~r' L r tr + w ~Q i ~a ~ `,r}, 4}~ 3)) t ~ Y jjj ~ j..., : C y''. F•]! ,;j t„ 41 -~cy" a r r`:9 '~"r 4'= fit' ' ;`Sj i'y"~t'~ ' S~ ' f ~::.ty'` 1 'R. a+' . i r. Y a ~ yr- y rl .1. t ' .u,~"" • ~ ~ ,{r " - Syr ~F,rt i'b •.,ey~{~: ~'A' h 1_ r" '_''r. .~~f: , a ~ , :,u "'~V 1. n , spa:{~, 4 ~ ~„~t' `'~L •~~•~i ~'`~i,t P t v 1 _ rl~ ,r,yF~,: r~6,'3,~9iRwwt 2•"`~`t 'A • a• ~i ~~p .ter ~.xS 1, r~~ ~ ^'s'y_ r _ ~ ,~~-4~ !R~'S ~ts ''~+~'~~,S,f R qf,- ~ - ~ A"~,V t ~~5• , h / J a~ (l. "u. M)t•~ 1.. ' ~e,~•"~Tf td1~ r t,,,{{%„~q '.L..1! I :i,a ~ .~,,•,k yet 1'. `r}"3 "^4, - ~ ~ 3 .1" ++':fra`+. - 'i ,ipl`~x~ k^ o ~fY, ;ii 'a<tf!y{ .!.-t 4.w. : t l,d 7 ~ t t'. . s r. ,H / -,j ti, r. 9 3 l'~2 , f'~,'.'~',. ~5~ PK: .;'r, :.,'ydE ~'tt _ +;•r• x ~ x °'v +r { ~ f `.a 4 i , «yM r i. ; ' } . ,r y f. ~ ~"4~: ` .dE'r. s4 a y M , Y ~ j ~,S~Y ''1iJ( >MI ~i.• r 3~iy' Y'Y ri t` r f b'. ,-i~3 -q'•~. d .n ` r;r . r, r .:i~~ ~ u ~ 'k,''" , - r• al 1 p X54' +tr. ;x, -i I R a: ~ rid,, ,y._ •~•,"G v'4-6+ ~ 4t"- f 'i, t - t:t 1\ f/ tv ;'r r yam. M i 1" t z'1 'J, 4 r}~ryi1^ . y ~ -'~i ~ ♦.~ry ; . jc., sy ,S Ct~. L ~ 4 w ,^~y~ 'ter .j ~ ~ t .r L .h•. Yr- r-` i... ;.r. 7v. f t' ~ 'r) , t,~M`~`f" L r - r _ 7+ ~ t l: Y N N~L• 7-l i(`!fY f.' ,b" ~ ~~y JI IIr. u , i 1 t" r 1 1 I r, a r ~ :.A * - i:~, .;j!•,' t `t:-t ,Jr ,?p ~ f >`,.:-V~~ a'1`y ~'~.dd~'~-f!`'~ t,~ r- ?/~yi~~~n i v' 4 • la' ! r' trl i 1. fY ~ ' ! ~)r.~ k ; 't ~3 •Y • .•A' . /y r I y ~.CC, ~ f :S.yT: i?" •'b~t'~1: ~'~7~ ~•,t, wvT.- :a i `t,.; 7 •r. , r3 jt , f ,~~t ,rv_, ~ y ~j~~:~` i.. `.7 _ ti• 1, .y":~~ 7 Yr r• r~✓ t ,.{t ~'t♦ i .Yjs;.' fi C ;x.. (tea»tr!. il..tle,- )dr .f$'>a.- 'V} `'_4"YT• S:- ,r -+',:N~~ i' tt i1. t%+~t"~• 4,y ~.".w,'~~ MP~ c7 ~ ri„'~ ~r ,4~;:' ~ Y1 ~„"t,ti. '3,;'; #.°Z_ yf. :~`:F~ xy. .?n. ,,rr~'''1d r r°.a r .,~r~. 't w a ~ t 3 ; ~ '++~y'•1,~,~7v :n~vr?' , q."K y.,,-.4 - tr ,x, `~rc" w , t f fir' ,r',.~r „ _ :t,.: g.. _~,~r~: f~ ..+t Se' x , r 'rpY~";R~. AY r ' ~ :a y . I ' S 7: t 1„.T' Lr ~ Y' ~~lK,I t... f, s. 'i. •+ri i, ,py _ I>r , r RV.,k' •f-:. t ar - Fa , F...,.,. xt r . -'.'Vf.`i`' ~.Y e '.A~ .'1, t l ~ A` •'1:. ,~r_L1.. a•. i. 1, f I .,1 C."' ~ 'i:_ - .Wt' _ .1 " ~ k~r?.ii: f;~,p?T, ~,r: f ,i ~r,,t .K^, t'r :Y t r ly. 'l;;i . y _ .:~'~3`~it P'!: r.~. ~•X ~ 'i~ q,. 'f 1, a` }.Y• n `,1 'n: 'it ?Y\ i'..rti' yg..,,. ~r.~i' i •;tr. 7 1 { . J ~ Y '~v ' ~ 1' i tV . t - r, L~ - ' L.; i 7~'' .,:l+i^• a ~5,.. x 1:tir ..r i. $ ~ +c ~~+r •y;' SS !i'u~;~.~i, > ,,t~~-'.v ,-i. rc ai';i~" `~,.S w!?, •i". ,~.„,~.-•4-. 7.,,, .-~•j ..fir. .L~,~•t.~ r ,it~ 9 •r,- r` vt ~n it -L ti.. * , "y. 1. ,..SW: w~7 .yy.i+. ti.. `.YYt• .i f,. r 1... Yt 1 r • 3 r i s *Ra. 't',.r,;. :,a. ~'+'1 1' A' , 'C 4~M1. .eV ~ ?~r~t •1'c Na, S'. !af C'v r M. :,t•>,/.~ -rk~.~r:rt ,r t ~Ja ti's, E a,i_ d~ T ',q h. 1' ,~w~ 'q~ N "~,e>,~'"'l%?.:'C fO tf~;; •a.'~;~'' i-,a . ~~e;. f' `4f 'k.'Y ~ .x - ~ ;/y- ~ . .R ,'.yR,rJ~.,. .r{/{..r_Y. Yr,..: y•~ t7 .yq'1 [d r'e ~ a e~,, _ 4 ~ ~~e,L„„t~,1 '~,tK t,r •a- ~~'h. r iw;i•, "ai.' F ,i '%,J~. r, v c ~ S ~ ' R~ ,x: ak•i 'r r ~ ~ ,:,,r ,tp4 ~t~ t ¢ r t'~' ! ~ ti! , ,t,r',,' y ^`i• .l ` L 1 :'.~S .i10'.~j}. t 'r;("' ' ^1- /~~.y?f} ~ y.,F `.✓Y•~ R .r ~ ~,A dN A'T} '?`f! .}.,1`'h~ lyp~',4::S O.y, L ii^p(`+j~~~•T/'"pl` 41~r~S. / .l :.l 4, : ( ~f ~'?k. ':^l.y~> FP .'.,S tM ' r I~ 'Y !1'~ 4:" S.~.Y..,.~r "ki' 4 ~ • V ~ 4 A y ~ {V~ ~k ,S r.. ~ ~ yt. F- .:1~~~ '`•t"+: V i t ":2 s.. w k G . 4R ~ .c r'.f V wt~ ~1~, a.r mss:' .t H . ~S•e;`~'• ~ 1n',y 5+~5 ~t ~ ~Y ~ .•~.,a 't7 i~- _ q ~ .,,~~y' ,v Jt r . Prf~. r.. ..'X ,t t.Sw .t!' ,'t' 1~:.'. ,"+'L t, a1•- W'i 1. •fp: :A, ~ Y-''~ 'Lfi~. ,ru' tr•. r, ~ •r~' r' r A:atk-. .h 'rt. •r. -4~~~r ~~:.r ~ ~ . - r a ~ ..i L~~ °n,,. ftla4>. ti *x',~..> ,.r_,.; g, r~r'. .r .'.{A'.. ~ . l,. ):4': r F.y'. .y:: ,^.,b;p! r't .1 "l r' d: .y!7;,,. tC . •t '-F i.,i t` s '.Aw_F. .2.:. _ ~ ' 3: : vt t ,y • i(:,: ~J' ..6~iT, • _.'4,, , :'S - `r~>aK ,i- •t.~<s ,K 'b ~ - r'-r'•'r,!:, i~ •R.. •'r -zr' r?' ~:t,•F _ceD.! J~,,r r t i. 'c.. 1 - . s f t :~i "Y'~.l t? - D~'h •k.,- ? r 'r"~' i 4•! Y s. .k `,k.^ . "Q't"i ^.'Y Y 't- R!. r~ ;ti~~• rfy .r~"°.. 1.4;C' r 7 f r ,Rn . ,7a w y ' t., ' v ~ . •i-, ,s.,, - , '-7,,f,•V....7 ~ a ~i;:.,. ~r i ~ F e};.• qti .'h , ~a~„ 'n..!f. "'t~ "ft,.'~.;,r f'`V' z"s?'. r ~":y v ' ' ~ . ` a ~ . 4 + . r..~~.. A , t • v i~ L ,p< e'r,:1 ~ tJx h C `:~,yy ; ~ ~ p ~L ,,,,,t•~.,l:r J - `h~` "b+•a> 'v =:1( ,R ~ d,~''~,:-s s.<`' `LV' max,-. :?F~'^ 1, R, *x", 1* ~':.:'Y,~ r ta..i>'3i - .t~. sy. ,rF,f- t ,'r„~•.. 'z+. :.a '~r r~4-.r'.t:'"t~ An. r ~t ~p~ ' n: .7r h .i k: 'i~r f : t . ~ f Y ~ ~ t ~ ,1' 2 . r T.y B J : Y 1 Y t r~wyf f. ~:..aj A, ' v rt't.. ~ }"15N, - ''i• ~$e tJ~..,~., 'HS`. '-"c''• ;„f ,~4`,t,~'.; d:++."rY}~ 4> t,- -r .42 fir. it ,.u.' ~•~;Aa b. I f' •rt! a'4'9:. -~S a"l ,.A` _ •e,.' r. e .S - +~i'~.tt' '.P '.r-t ~'n0r 1 ~~i. ,'[,..I':~.~~ It^.. 'iR• k S -C .h-' t1 t d t ,•.^4. '.dN titC- ~-k -•c„ I• +Y r•. .S• ? r t . ,U. - f l';c a' 1.. : S t.. I 7a,t ~ ,r t '::"`,CA' v. .•fM1e , ~ %r r:. L.. t :•:c~i° „r ,yy..T. 'r ~ .4Y' fY'h•.:r:'., ,y r,< r`1', .r • t `•y-'~. ,l~ ~'t y,~r ...C"Y S :~r •?7 *e. '~'.4 ~s,, r'.. : . y ~ ~ ' • .rfs .i': Y a, '6` -ie : i . ~ "r;~: ;r ~ fi ;J 1 -s,,yk;.. ;i : w~ r'. a t, ~ -I 7- :7 . ! w .a :v,- ~ SA' r,, ~C +.i... v?. , 4'`, .ary ,~th".• '~k.4. v j ;,{r ~:tF.. b.',i -.tr i e • a. s 2y,~; rY ~ a' t ~t: -t 's , .4.~_~.. r ~-;,.,<.•a.,r .x 3••i~h~t-~,~, ti ~r..~+" "v, f~'" _r'!-, at'k ~~,e tit ~~,k~ a, o t `r '.t.. -"a ~"r4 Z ri r"S 1f 1, .l ~ ,r~, rt: r t5'~ 7 `at, t -J .vl t~ c a P ,t' ::.d%' iy,. 9, d'y. ~Y ! t ti'•. \u 4._ r ,.'.~1 .r;~• t ,~dYr-. ~ r :~`.,,k,'' -tti `c, - .7 N,~'f° hF'ry ',~t~L Y"s+39; is is yr a` :r;. y'y.~"ka,,i';F>k_.z V A •f~ t` 3 .14 ,~yi.~ p C 'P } ,,,,,,7 f ♦p1 ,."fir k•<. P,. `y I , 9K +ir'S.•w 4. .'JF , ~ f `s. Il S. . A ~~r' t' ~l :-r/.t` ~ ^ •'f.`. `Ii •g~ mow cJ,-T» ~"4-, - . :-k,~s. t' ~j~m,;s r.,.C;, '`.'~y~' ;''r1 'ba d ~ • v~~- "`t"x ti. < ''i~ t1, rt. .I. TS•t .,'s.,~ 2' irS.1'„~^t>j, t°' - o, M.-~,., I,.s . a .k ,r? . `x, , it `%i °.r • r '"rfd. ~ rr 4. - `~ht ' Yr y~, ,~„d~; hy' r e ;.a,y. :."rt.: w, `w a ~u, 7, d f 1'''._'.Y. , a.. •4~ {Y.. -a',1', .stir`:. E'-:s. "r r• •+F~v,.:",/ k r.~ i Q''~, I J /S. .f. v,}.'4'~ n-LTyr .G r.'-~ - ~ ;a r4" {y • r y f f .w, .,~-rot•: F' ; Y. +`f,,.' "7.. ,,5,t ~ ~.~.L y y..- ~f .y Z"• _ '~S', y: ,p,. f ~ k :%ry. ;a t}1 .r: '.Y a.rf ~h `YF ~2'~•\'9',. ',t' t t Y .L, _ -t+, k :1'f..: .:h .i~•:! '.r,ti ,;a.t 'r f4' t1. ~r L-~1 "l" R. %Y +7 ..F :7;' f ,L 1._ ':.,s. _y ~::.a: ,t?:~,~: Y k 3.~ + .n...~. •R s -lP..~-• ~~~rp :.i;~.•n ~5p'~'~1' tea: .,f _ ~ a~ ,r, > J ~t ( ' 7 r.. K. ,g, ~,ar``. :~'r '>•r', f 't - ':''4J , 't: - U,. " ~ a. %g xI' e.i .F. ` ~.y,, S£ 1 ~ .ni at ~s. 1 ~ "';'F; ir.: ~s' `st .,.1 y:'. }}.r~ o-'T'r as arr r f ~ t -.y ;1 rl, t•AL• ~ ~ ~prty~' ~,v' .uk .L~ I Cr'., ,..~`g i'L..t~• 'ir ~t>f`.:~~ r -~rL'/I I ~ n.t"i fl~f, rF d?+a*'i,b~:,h~!{'P" 1 G r~}a~i x} ~ f - , r ''s'` 'l •r r. ,f~ it L r 4~'Y 4i a. P ,'e y (~j h'Y R a i`. r ~ti w k -.7 'Y n !.w. x L i•; 1 ~ 5S'~:~'~'+L?` ,~rx ('~,ray~... -