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HomeMy WebLinkAbout020-1087-60-100 o 4 0 ~ ~i ° I M ~ 69, o ~ I o c N y N ~ I o I I U I d I i x ~c I z3 i LL g I c 3 ~ y ~ E Q ~ I m i c co I T E w o z rn N a m I M W O z c d z :t c U) E E N N 7 p~//1 c N CO) a w H o Q z co z N !i l0 d CL a C C a o w z O co N N U) WSJ z fta ooo a~ 4i CL m m a 3 ~JV l ~rnrn ~ I C,4 N a) co V U) N d Q lQ C'. ca •'4 ~l H H rV °6 OD y C _ CS p O ~ n O O C ) C M Q T\ y a b6 ( c I a o c d o ~Q O M 2 m- 0 z `n H J V un d a of a °1 I L: CL 0 CL 0 U) FORM - STC 04 AS BUILT SANITARY SYSTEM REPORT OWNER , E! TOWNSHIP W sL)tN SECTION TZ7 N-R _pW ADDRESS_ ST. CROIX COUNTY, WISCONSIN r SUBDIVISION L0TLOT SIZE T PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 1 t ( t I ~ j 1 h i INDICATE NORTH ARROW r/ CS, BENCILMARK:Elevation and description:_"f~,~ ac Alternate benchmark SEPTIC TANK:lianufacturer:=~~cs~~ s Liquid Cap. _c.c~~ Rings used: ~ ~,Manhole cover ee-l-ev: a ryi C nal grade elev: 9b/ Tank inlet elev.: Tank outlet elev.: No. of feet from nearest road:Front~, Side , Rear Ft. 1C*' -t- From nearest prop. line:Front Side , Rear Ft. IJNc No. of feet from: Well-2-0'Z' , Building: P-V (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE I PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufact.: Pump Size Elevation of inlet: Bottom of tank elevation Pump on elev.: Pump off elev.: Gallons/cycle: Alarm: Man.: Switch Type: Location Distance from nearest prop. line: Front_, Side_,_,-, Rear-Ft. Distance from: Well Building SOIL ABSORPTION SYSTEM Bed: Trench: Seepage Pit: Width: 2W Length 490" ,Number of Lines: Lk Area Built Exist. Grade Elev. 47j!+ Z`f Proposed Final Grade Elev. 90 Fill depth to top of pipe: `I-Z`t Ho. feet from nearest prop. line: Front XI Side , Rear Ft.~7a~ Ho. feet from well:<W) No. feet from building ! HOLDING TANK Manufacturer: Capacity: No. of rings used: Elevation of bottom tank: Elevation of inlet: No. feet from nearest prop. line:Front , Side , Rear Ft. No. feet from: Well , building , nearest road Alarm Manufacturer: INSPECTOR: 1., DATE: ZLIC PLUMBER ON JOB: I 4K ~ 5~ ~~f L-w-- 1 LICENSE NUMBER: AA FjCS fr 5 L (2- 6/90:cj i J~'_ DO." ~ p -14 ~'PS3~ i2 /ti4 G IUJD A, RM wu.if @ N cvsv u- cy + 4 4 7 I I; JD z4-` pC C~-, d ` dr:k~ -sla d I o r - ctd o~-~ drys Zr c Sllz 4 e-, 3; % V e 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 DISO WI 3707 State Plan I.D. Number: SW'4 , N 4 Spec . 33 , T29-R19 CONVENTIONAL ❑ ALTERATIVE (If assigned) Town of Hudson El S Holding Tank El In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTI DATE: 1 /;/1 Dan Bauer 8 S a e Line Rd Hudson WI ~ ~ ~„f +r BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM AN: RUJ. PT. VIE V.: CST REF. PT. EL 4 j~ _n ••J -~Y Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: ijohn Sykora III 212 W" U / St. Croix 128854 SEPTIC TANK/HOLDING TANK: ` " c~ Ggr V1 1 TLET ELEV.: WARNING LABEL LOCKING COVER MANUFACTURER: LIQUID CAPACITY: TANK INL EL ±2Z, PROVIDED: PROVIDED: lC o~ YES ❑ NO ❑ YES BEDDING: 7F.N+DIA.: aiWT MATL.: HIGH WATER UMBER OF ROPROPERTY WELL: BUILD_LUQ~ VENT TO FRESH tk 62, C.U. ry C ,d. /I I ALARM: FEET FROM LINE: AIR IN ET > F-1 YES NO ❑ YES NO NEAREST-~ R: DOSIN CHAMBE MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: [01 YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: ii PUMP ON AND OFF ❑ YES ❑ NO NEAREST 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 into a wire, construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS LIQUID BED/TRENCH / ( TRENCHES: / RIAL: T EPTH: DIMENSIONS V,P Gt/' GRAVEL DEPTH FILL DEP H DISTR. PIPE DISTR. PIPE DISTR. P PE M ERIAL: NOD TR. NUMBER OF PROPERTY WELL: ILDING: VENT TO FRESH BELOW PIPES: ABOVE C ELEV. INLEj: ELE . EN : I f PIPE FEET FROM LINE: Ali INLET r 3 / - $ yea...- t3/>3 NEAREST >166 MOUND SYSTEM: c.res C;,.,e 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 E] 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 ❑ YES ❑ NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: ❑ YES El NO ❑ YES El NO NEAREST RenI/county file for audit. Sketch System on Reverse Side. SIGNATU E: TITLE: SBD-6710 (R. 06/88) / SANITARY PERMIT APPLICATION DILHR In accord with ILHR 83.05, Wis. Adm. Code COUN f STATE SANITARY P RMIT -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ / ~i~ 8% x 11 inches in size. chec i re isi n to pre sous 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 Da LA J& CL 4 S u) Y4 #J()'/4, S T 29 , N, R! 4 E (O PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME ORCS ~ t. 5_ijo I to '3&474 yo~ 4- ca II. TYPE OF BUILDING: (Check one) 1:1 State Owned VILLAGE u N ACR ~ROA~D 4,e ' ❑ Public Itni 1 or 2 Fam. Dwelling- # of bedrooms !~2_ P R EL TAX NUMB R() 0 III. BUILDING USE: (If building type is public, check all that apply) -2 1P. CG °i 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. IM Replacement 3. ❑ Replacement of 4.0 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 N Seepage Bed 21 ❑ Mound 30 ❑ Specity 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 (s q. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION gs~ /89n 9 Z,0 -7 id , r,, 8 ' 8 "meet STS ~ 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 structed e tic an r Holdin Tank ZlaC~ - 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): Plumb 's Signature: No tamps) M MPRSW Business Phone Number: L P u er Address (S t, City, State, Zip Code): K 1r?_ vK 7S 1)0 4-A~ LAX- a4'7 2-t- I IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No Stamps) / PLC Approved El Owner Given Initial Surcharge Fee) I -f& I 1~~ *2~ Adverse Determination / `'j O1(/ X. CONDITIONS OF APPROVALIREASONS FOR DISAPPROVAL: SBD-6398 (formerly Pib-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, 6()5-266-3815. 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. 111. 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. V1. 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 834 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; (Jose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if requifed 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 (R.11/88) I APPLICATION FOR SANITARY PZRMIT 8TC-100 This application form Is to be completed in full and signed by the ovnez(s) of the property being developed. Any Inadequacies will only result In delays of the pirmit Issuance. -Should this development be intended got zesalt by owner/contractor,(spec house), than a second form should be retained and completed when the property Is sold and submitted to this office with the apptopciate deed recording. Owner of property ~a4A 0a u2af' Location of ptopazty W_1/1 x_1/4, Bectlon _S3- T .Il-R V Township ~4 ti,oSd ✓1 Walling address 4 ~ L~; Vj "drove of site Subdivision name_ 1A) Lot number Previous evnet of property Total also of parcel 13 i, a c y-e s Date parcel was created CL~ 9 Are all cognacs and lot lines identifiable? on __Jl0 Is this property being developed for resale tapec house)? as P0 Volume and Page Number 'q(?O as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION TIM FOLLOWING: A WARRANTY DEED vhich Includes a DOCUMENT NUMBER, VOLUME AND PAGZ NU>Ane and the BEAL OF THR REGISTER OF DEEDS. In addition, a cettlfled survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description teterences to a Cestifled survey Nap, the Cettlfied Survey Map shall also be requited. ---------------------------------------------------------7--------------------- PROPERTY OWNER CERTIFICATION ilve) cettlly that all statements on this form are true to the best of my (out) knowledge; that I (we) am (ate) the ownst(s) of the property described In lhfa lntoc.atlon form, by vlttue of a warranty deed recorded In the Office of the County Register of Deeds as Document No. x,45 /.3 3 1 and that I (Wa) presently own the proposed alto for the sewage disposal system (or 1 (we) have obtained an easement, to run with the above described ptoperty, lot the construction of sold system, and the same has been d}aly recorded In the office of a County Register of Deeds, as Document No. Slgnatu a of Owner Signature of co-Owner (if Applicable) /b7 12=4a' Data of 219naturs Dots of Signature +'ti t .jari .4 - Fyy71. r•. 4 sand ` ; t to mole). cvt s ur Oei, A. { . % Iwls a Ut" /b fi~., wil.0 ~,p~'7Called the -Pftpn,q'.), Y.(+. !~...r•.i1+•+Mw r.rar. .t. 'r. State Ot- wwmwn: h;}r Tax Parcel No. ' WE;Afctio>« 32 and' that t ?y S of U.' Kj9hwap` "12." W of Wisa~ans3n Sea e~ t ;I` df 'i►uills<,-"A%'Utuated ..in Township 2 ' w4rt'~ Lot. .-Of C$`'t i`3` e d S u rve y.,,Map recorded may. oeument -Nu tuber '43987, recorded w t~,a pa"Or e. - Y• loot) i H. M ~Q' ptlseAase the Progeny and to pay to Vendor at ..~'+44g.errp, 1uaw$~ f v9 . r e 4 diu III in the following manner: (a) $ ti "ana (b) 'thebalance of i6D 0y•d0.4 teresD '?~M/ oatetandl from tope to time at the, rate of t:en toiether with in t $60,''000,0:0 is to be paid on October 1 1 i _ pills lp~tC :is o' be applied: to principal. There is rlo 'Intex'e$ti oe n " d- the first y~►ar of "this contract. -2. Inte.r:er tio: ~t1 rt t . nCB ipal' balance shall be paid on tabor .31,. 3,- pcr Qctober 3 1992 the entire outstanc7inkr balance?'oprincipal d n~es seal l be paid in full. ~3 ~lKifexpKiQ~G~I fib ~F,X Keidr~ R.X X X ~t x X W en#,:istere;st''aha11 accrue at tha rate of _:.1 per unnuinan sh. ex , r a nt~e lMlndy,It$oat ►imitatton,,:$ttjny~nt ntrtzst ;.nd, u on a,cereratiun r v F? or maturity `f~he agflt~r' -to Reff' 11114 -77 fund me the uA anY titauncn at the rate specified and thrlte to ps$dctpa~, ' tA'11t14OYt premmm ' r. = aA principal, at,tny time after -DeQ 8- 9 ( ,a 77 1} , lot (I sweit case ..t i - vft"~~ bliss. event of el d- re k em. rC}►a!p fOhittit 6d 11it~ the.-title as shown the tit ibatr t + , by le ex'idence,l~nWitted to'P ! ~ ;D t 'i eatt' no p J', 1,; 1i~slat *m . t r ~z r . slidence is in the, form of ~ ~ Nt' Qr► Y `.R~* Proper*, be ~y} h 4 ti 4V 4, T to r" a 3•.'kl~ ".n r e. tl } t, .:r'} } 'w leape union a - looms e11. Pi4 49 A-Ss, too as iweri1.1 Showing 6606 paYmeot' aw b*"-b is oa an Property insured qgps~ low !4W donimp bit sesma tbawgM ,DNf~11°~ss~ t baewrrds as. Viesler way wuay reyuure, 'Abaltt W A.- A but Vendor shall goat regain. `eoi►ee b sa ataurt S at-$... d ha asra r11~11 ~i`;~Apttact. Pa% shall pay the insurance Pren+/ams s►M11 dMd. The ~cisli chose in frame of the Vender's interest and. unless Vendor otherwise agrees iu4. .the Property shah Do deposited with Vendor. Purchaser rh&H PromPUY OWO 40*e Of teas ay peliciw tpwarialilmy. m Vendor, , OM Pursbrar, and. Vendor otl rw" agree in writing, lnetlraose progopda moss # repair of the. Property damaged.' Provided the Veqdor doom the restoralleu ets•P60MT'~~ Y. p oovNlwwte riot to commit Amer allow waste to be eommittW on the Propertyi to beep of this die Property i'ree twm liens superior to lire lien an lowat affecting the Property. a l~NM ratM~ Yeller apeas in, earl the purchase prim with iatorest and other moneys shall be fully paid !sd ltil a Nr: AM M tt P`e at the times and in the manner above specified, Vetubr will an demand, egedtte a" ds1;, st' of the Property. free and clear of all, liens and oweumtbrarlees, d~~ tote PareAeear. a 1~aesa'g1 Dwd, in f« oupie, Muni an ` eoyr, lA1M eP eMewit~eee ereste by the stet or default of Purchaser. sad tc P $ corded easem6nts,- build and use restrieliitkna~, .ac~nf.Ia3~::nlcdil~ianc~s~ re y~,~trictions„ot __acaess to sign and sightirles ~t~on i+ ~ixt.airtl9Y..... "n" . that; time is of the essence and (a) in the event of a default in the payment of `any principal os Panpaear 'etM r~ iwti~eest wAieM•eowtAtgss fora. period of .:.J54--days following the specified duo date[ or (b) is the airent of a delat~il -ef clay' elAw Abliption of P*reAWs which continues for a period of ..LO... days follow wti *an +t ..*War ( personally or mailed~r certified, mail),-then the entire outstanding balmice ■RORt 1 L lraltetn : due and payablo is fain at VeAdar'a gption and without notice (which Pa" Noaiwma 4" law have the toUowirtQ:i!ights atld remedies (subject to any. limifaeiom p„wside~iby &Ii►) Qk ;l + T by I&* or iii equity: (i) vendor muy, at his -ion , terminate " CoeAtract And t++ ` s wft~t at7 {a rite Proppeerty and tc0nvlr the Property back tnrough strict foreclosure interlst p. yig we n #I a ltPua pyrchayer full-payment of the entire outstanding balance. with edt/ehd ~j~i~tberstp to effect on such date and other amounts due hereunder(iawhich event as~i ts' rehaer lAel be'forefeited as Liquidated donage% for failure to fulfill this Contract at18 as ~ s parebaeer. (a* to redesm); or 09) Vendor may sue !)r r t. performance of dais %WAM t, +~r sad foil payelieaLef the engird outstanding balance, with mtcre st thereon at the rate It* ofd qtr! ' a olt~er atnou» to due hereunder, in which event the Property A.40 be auctioned at judieW a lE f.1'a hase ptiiCe;or an) ~k k.,~ lifori~t~ ~deficiency; •or (iii) Vendor stay sue at law f. r the tr,rirc input, pure or>(iv) Vettdor may derlarc t1 lc Contract at an end anti rer t tractasacloud odk O le Iii a lu ejeCtRW from Vie eq able interest of Purchaser is msignificani; and (v ► Vt 11dor rnal h eve Purebe ser P61 F *0 ';IaW Lave a r4ceiver a, tit ,t.ta•,1 to c.,llc,t un, rr r , r6 ..4 'auring the pendener of any "oa ,,,(b) or (iv) abuve.Notwiths";,nding any oraor writ,,;: r en tn,r ,r actions of Vendor, an elect" reaaedtes shall only he binding, upon V nu Y. if and, \t. r pursued ,n itt:nn and all costs sad e y aborneys feet 44 Vendor incurred to raft r,tin r, mt ly L,rcardcr (whether absted'or Mt) to tMk ~ r<y$h•', ''r~ C' r.vtdtnrr shall u,idc•d to pruu r, ,l and paid by Purchaser,« t riot pto6 bylaw and expenses c,f title etlrtwl, arid' shall be. included in say Jnlgn , nt. ISiPM`aiit eoinmentement or during the ,tendency of any art ,n or " ,r c.c , ore of the t:ontyaet, Ptttetiieel 40106io Of o receiver of the Property, including i , u .:td rt,tto ux:,•c t .he rents, !ssues, and tba ,wag the pendency of such action. atld :uch r,r n ;scar n.; bfits'wnen to coi]ected shall be held applied as court shall direct. ' purchaser short not transfer, sell or cons s ~r.} i,E it or ,.,..r,,1 rt t ti.(- Property (by aesigutmeat0le"I -W Pllreltaser's rights under this Contract or by upt.on, ,on{ -term , a: c r i any r tt , r tsa l a .thout the„prtos espta►t of Veltdyr unless either the u t rnding balance na able under th ,'anti u t i+ fir-t paid in full or th. , , 9i a OW pie or aasignmcnt n. !arc haler s nti r unary this t on, i, a a wcunty for an i ti • In thi event of any such.ira..s,rr, ale or c r~et net tt c a ,crittrn twtsent the entire o t: pder tbio Contract shall be,•omc !mmed ltely:dt a and ra\ v in full. at Wndor s option without 4t Vepgbr atlaA make all payments w•r, n due under ,n Mort •aln• uu s and r against the Property on the ate ~ this Contraet:(epicepf t p~_ ar u!- r to c ,r(,,! erehy, provided Puret►pset °nr any rho t axe ed by a wallas tbasly payment of ,e amounts tt-,n due under t : Cant , r. Furct er ma n r an v ~ucil. payments dt oitg#yee if Vendor .`ails to do .o ••rd all rat: me .t:.o made ?hal! be con, ?eyed paymenta~ i to tT .Y/ndoe may waive any default witl.out vtaivinu ar,} I t , r *ui ! t r:nr dt fault of Purchaser. r *R A"me of this Contract shall be binding upon and it.are to the he netlts of the heirs, legal re recto A anti of Vendor and Purchaser. (If not an owner of the Property the spouso of Vaidot';ors exit t,• d ]tereit to release homestead rir-h t ijp "yhe sableect Pa oaeft apd%agr s to o join n9t~°+apt .~ey~+}O~y Old T . : to be main in fnlfl nt hereof.l Via" 10 ~z 'A L y _ ~ i e 1 "t= as *r. a CATION ACKNOWL$Dt,3UENT: r+ v` y AUTIItENTI h Signs }+s(s} .ITATi: 01 N:;CU.'~si` . n, oc'ur',S authetuttcated tills da\; p , s I~ y u k bl r„♦ Y , }1!lE~. r~-• t'C. ave a ~F{'iJcL~~ W1 )NSI\ TATF' r, s S BAR OF not drize~ Iy}' § : t7F.~F R itf.r fi t „i t., m e i nr s ; , to i'tt iic of r . 4h,fd~wr rra6e{tC~it*~u'•„1 _ S. C T itl;- kN4SI FMML 1 WAS 1`,,t,> F Batt .c.., ` r,s 3 t Y.' Lt t t cn.. r,r,`3, ° , rn t n' t5Z>t3ratuZt ; ma} he irathrrrt ,ir r't:$:rr, w h Z i . 1{Y i,1 tttr 4th n rjt r, ~,a s~4 f pt It1(c ' ~'r s 'd ?T 5~ jaY• k y k _ ~ ~ ! b F .C- ~ -a `may„' d'?. a'4 e n +°z 40, rt.h)t'.Ls?~n r'easr'i g ~a w z .X AaDDRADt11►4 TO T - V*wdw area to release the Mestsrly 33 acres of ttie tX x rsceipt of a per` Pa> of $75,000 00. Pts~ebaaer tontr" up" desl+i tM Pa.'o be rwd, 11ha 1 mvey #A We 44PUM etra easterly boundaty that tins in a WOW wwill~~ ~ . of~iAl d tis d H~ , ry t of Way for WArmite 94 to St~tgdine Road or to Ow b y er'af in Voturne 9 at Pace 1925 in the St. Goix Cewrty offift. this land onted M---- s r 3 = 1. Vendor agrees to release other parcels subject to Ip a payment of $6560.00 for each acre to be released. ft~ Princi* e"m describing the parcel to be released. MIS ~ ~ at Ms " a survey ~ , aesrle•°` r property to be transferred under this paragraph shall be a minimum Of fWi have resulted in special "or odber 60 tM in+rovennent: by that such liens *A., Pr9Pe11Y held sewr,ty by vendoc► Purchaser agrees ~ t , to' the. yr woes security interest in the property. : Purchase r agrees to pay attorney:fees not to exceed $100.00 for the draftittlt ny parcel less than 25 acres in dead and transfer tax return for the release of a , provided for in paragraphs 1 and I above. q, pyrchasac agrees to forward to vendor at address noted abaft # tece<Pt ay ; of real estate taxes within ten (10) days of the date upon which sesch UM bteoe p due and payable. conditiop. 5. • purchaser agrees that he is purchasing property in an as-is" inspect ffWr.IM his successors, heirs or assigns agrees he has had ample opPurhunit specifically to o in inhsspec waives aa6 and is relying exclusively on his inspection of the property and releases any claim which he may have against vendor relating to the condiUenh at property. 6. Upon a default in any provision contained an this land control Veados ~ i that Vendor shall have all of the rights and remedies proYideei Purchaser agree inequity, including but not limited to those described lin the attached I imited to $200,000. occluslae a deficiency judgment against purchaser shall be lime fees. and expenses and exclusive of attorney • S %i Y; STC - 105 p SEPTIC TANK MAINTENANCE AGREEMENT ~ St. Croix County OWNE BUYER ~ccrc e-~ Fes'' ROUTE/BOX NUMBER Fire Number 0 v t rt CITY/ STATE ZIP G k ~ l j M PROPERTY LOCATION: QJ(A) k, Section S- T. ?_7 R I~W, Town of ' Lk h 5 LA St. Croix County, Subdivision J1~/ Lot number Improper use and maintenance of your septic system could result in its premature failure to handle wastes.- Prover maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a ;licensed 'septic tank pum2er. What you put into the system can of ect the runction o the 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, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix 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 to maintain the private sewage disposal system in accordance with the standards set forth herein, as set by the Wisconsin Depart- :r w tural Resources. Certification form must be completed went of Na b and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNED DATE St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 386-4680 Sign, date and return to the above address. HTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS "INDUSTRY' , DIVISION LABOR AND P.O. BOX 7969 HUMAN RELATIONS PERCOLATION TESTS (115) MADISON, WI 53707 (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: er%,[TOWNSHIP EMMA11 CIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME: S~J/ N 0/ ~J? N/R/9E(or ~ n11~ 9/ COUNTY: Q INGAD DRESS: s L~11't~ ( ~H a ^ ~1KQ a ~Scltti w/~ ~iol~ USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE DESCRIPTIONS: ER CATION TESTS: Residence / _ nl ❑New Replace Il y,/`YL ~'70 L . RATING: S= Site suitable for system U= Site unsuitable for system ONVENTIONAL: MOUND: IN-GROUND•PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SY TEM:(optional) ES ❑U ®S ❑U 91 S ❑U ❑ S NU ❑ S ®U CaKd cs b 24 K90 If Percolation Tests are NOT required DESIGN RATE: -rte If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: CLceCS ?L Floodplain, indicate Floodplain elevation: ~J PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED ST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) e/ g 97`g`` 9(~ d"_ Ia~` ~r ~r~-~,1aN- S~, ~~3►~- qe ~ ,rg~ e- - 2 v, I 947 4 B s-t ±A 9 0 16 B-3 IIIaK~ 13- 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 PER PER INCH P- P-A e, P_ e'1` I ~t 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 gam,`, I I ; , I Ia , M f a _7-- - i ~ _ ~ ( ; - ~j l p of ~ i I I ,l tT I @A roe, I E 3 f i # ILA ! ' i t c ~ I I I ! + E , 11 bK qrl eM : _ r ---rte 7 1 1) &4 4- 64 I^ I, the undersigned, hereby certify t-h-af'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: P.S (z 00 ADDRESS: ~Ij CERTIFICATION NUMBER: PHONE NUMBER (optional): 2 ~o (~l s ~2 z-7 CST S NATU 1 DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) - OVER - y INSTRUCTIONS FOR COMPLETING FORM 115 - SOD - 6395 To be a complete and accurate soil test, your report must include: 1. Complete legal description; 2. The use suction must clearly indicate whether this is a residence or commercial project; 3. MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing scale is prefered. A separate sheet may be used if desired; 8. Make sure your benchmark and vertical elevation reference point are clearly shown, and are permanent; 9. Complete all apropriate boxes as to dates, names, addresses, flood plain data, percolation test exemption, if appropriate; 10. If the information (such as flood plain, elevation) does not apply, place N.A. in the appropriate box; 11. Sign the form and place your current address and yur certification number; 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols at - Stone (over 10") BR - Bedrock cob - Cobble (3 - 10") SS - Standstone gr - Gravel (under 3") LS - Limestone 's - Sand HGW - High Groundwater cs - Coarse Sand Perc - Precolation Rate med s - Medium Sand W - Well is - Fine Sand Bldg - Building Is- Loamy Sand > - Greater Than 'sl - Loamy Sand < - Less Than '1 - Loam Bn - Brown 'sil - Silt Loam BI - Black si - Slit Gy - Gray cl - Clay Loam Y - Yellow scl - Sandy Clay Loam R - Red sicl - Silty Clay Loam mot - Mottles sc - Sandy Clay w/ - with sic - Silty Clay fff - few, fine, faint 'c - Clay cc - common, coarse pt - Peat mm - Many, Medium m - Muck d - distinct p - prominent HWL - High water level, surface water Six general soil textures BM - Bench Mark for liquid waste disposal VRP - Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department may request ! verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a permit. The sanitary permit must be obtained and posted prior to the start of any construction. I l r w o ~ o 3 0 C) 64 c c M Oq O 0. O y I O C d O G M N ~ O w U G ! r o X r N C N C d cco c ~ 3 c m o LL C C O N C 6 N N C'i a U a LLI c6 ~p rn o Z o Z cv ! d C\j a m M F W O 2 d cc ftJ F- e- ~ 4:' c E _0 N O c C N O N Q p Z co Z ` r - ° E a a (L N m _ L 7 N N L N C ! O N fn fn ~c d N z > = 0 0 0 c T •w o a a a ► a r ra ~ ! c o 0 *ti. ~ N } Vi -i U ~ rn rn m 00 ~ '1 ~ O N c0 N '6 N C 0 C yyQ NO 'C O C Q (1) U •r M (0 N _0 E p o= O c a) O O O co O Z H ^y O N c CO v7 E • y' O Cl) U m d N F L ~YI ✓i d 'f6 ~ a ~ ai a a CL (D A U a I' O N U • _1 w E _ 3 w ST. CROIX COUNTY ZONING OFFICE AC St. Croix County Courthouse 911 4th Street Hudson, WI 54016 ID 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 (For nitrates and coliform bacteria)FEE: $127.00 WATER TESTING (For VOC'S) SEPTIC SYSTEM INSPECTION-----------------FEE: $25.00 (Determines if system is properly functioning at time of inspection) It . Property owner's name_\. ~vn Cu yF S Property owner's address Legal DescVif t'on 1/4 of the X1/4 of Section T Aq N-R lCf Town of <n Lot Number Subdivision Name FIRE NUMBER y e LOCK BOX NUMBER Color of house Ve / OU._Realty sign by house? eS If so, list firm: PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual requesting services: Q7L ~~osg~n Telephone Number 3$-& cif /a2 3~ / J 1~ REPORT TO BE SENT T0: Closing dat Q Signature PART N UD S O N T. 2 9 N- R.19 W. 27 EAST I i SEE PAGE 4/ i /FFAV/LLOW ~ + y Ce 1-- 1 h.-f nc. PON S • ~FRcd 41 a rvnrre 'in cr m~hre A 40 seer ~s @7/Jaa// f 67 9 RIVER /9f.4 Mend ' c er5 a` %dh Jy/!a/7 VC~ S TATE PARK. t 'Kirks iesoe ea n .IS~p 0f O/nen . b:i es R C c ! scrrfctis r • 74, e, / ///iG / f i// e n shi: • ej.35 «.adA,;::• '90 t©s as AYE ~.::::::5 J Ruth T s/Jev @2✓ {E/~/xre ~a S b i~4 Katnen Brown .S'z Va//ey . +P Jot z9 a . • Gir/ MYA cull offal Q • L /e R r ; . : Scout Ca/~os, • /7.E4! .R!ws e` Inc. .610 h v C' /sB is N 'S"a~a`L•.rs~~::_ Ke~f tt a ado tl n craco6 54Be Bak n Uorin/da a'::: /of S9 e y 5 70 Chaeles -r c on • cnerJ, fi dares ~`4t • A /sag amts CJa r ~ ~guJe! h~ m.>.f /4.99 YV.rrres Mixes U C. 8 N• std V 3 a, a ~ ~ 'Off y Y ~ v s ~ ar N r ~ .c w ~ y Ly/e ro : ~a/e ^•e z !~e//yn BenaJr . u N y /3aer- n92s o fIsabisi/ /7o. a/ a ~t07 • ~ L 14 4 .,y' ,d airi ~ enn e•th Land Bank 20 ::::FOX;:;::::;;; Gen~an~ N b W OF~I 40 7S Roherux ojSi Pau/ rir Y .n4 J . h 7Y~~ Q .sx pill M 4 xsfix r! z M.. o Kss ek/3/ry~- cTn a w' y~ xya ~ :w.e.d.',. : Tftl 4- p o ~ V IC/ srn tas All •e RG I- ,Jl53 9.54 S • t Ivells .4 • /9ernard s Po%n 'av i i y Ivel fCiniJe Remand /Gp o.'i KinrrCaJ C s • MCI. /G~Corp. e x437 C 4 S~ :::Lew.a „~µA' c r ~ ' ~ I [/S Fis 6 tl ~ of acr~t~s; ; . ~ am rd ~Kiraey 2a,m Wi/d/ 5Q ~ . ...aa ~'e • . Ke/y eo ` n/G.LCcv . p. jv9C O g+ L es 7.os J6 /2 n e Dorothy S~ ei V 9 .srr a..ct's L72/B r9fjro/fo; efa/ Wi//iarrn /'~~s ~ N 9is Cia~P q p T v a Spy.. !j 4 ro -.ln. , a ~ reo/xnt e • ue- ~o ~ /48.43 ~ .BaJ-6 3 • ~ h a Leo ryge / ~ Sy.BRiEG ~ Ci¢/be 9 ~V N C~ h 3 LW6Hwi~ / W/Gam N Sin • ag : ; :..11s➢.ej~ r $ Arhb T ®/9BBRo rlorv nc: SEE PAGE /S rorx ou..ty,W.. a WORKING We Keep the Spots RIVER VALLEY ABSTRACT TOGS, ER & TITLE, INC. 220 LOCUST STREET • • ^n„~Mn • • ,r HUDSON, WISCONSIN 54016 ' VGiw~G PHONE: (715) 386-7772 4-4 When You Care Enough To Send ROGER D. BEVERS Your Very Best "Hudson's On Location Dry ABSTRACTS • TITLE INSURANCE • CLOSINGS Cleaner For 40 Years" ►-""d IT HAPPFN 1 MAK t ~ ST. CROIX COUNTY WISCONSIN ZONING OFFICE x ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 October 26, 1989 Pat Kossan 700 2ed St. Hudson, WI 54016 Dear Ms. Kossan: An on site investigation of the septic system on the property of James Hayes of the NW 1/4 of Section 33, T29N-R19W , Town of Hudson was conducted.on October 25, 1989. At the same time I also obtained a water sample and subitted it to the laboratory for testing. The results of that testing will be sent to you as soon as we recieve them back from the laboratory. At the time of the inspection, the sanitary system appeared to be functioning properly for the existing use. 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 is totally dependent upon proper maintenance of this system. Should you have any questions regarding this subject, please feel free to contact this office. Sincerely, Mary Je ki s Asst. Zoning Administrator TCN:cj 9 7i5 962 4030 COMM. TEST LAB. 10/30x$9 COMMERCIAL TESTING LABORATORY, INC. 514 Mein Street, P.O. Box 526 Colfax, Wisconsin 54730 715-962-3121 800.962.5227 O ST. CROIX ZONING REPORT NO, 35460/01 PAGE i ST. CROIX COUNTY REPORT RATE! 10/30/89 COURTHOUSE HATE RECEIVED! 10/26/89 HUDSON, WI 54016 ATTNt THOMAS C. NELSOii OWNER; Janes Hayes LOCATION! 498 Stageline Rd., Hudson COLLECTOR! St. Croix Zoning SOURCE OF SWtPLE; Kitchen faucet COLIRRM1 0 1100 at INTERPRETATION! AacteriologicallY SAFE NITRATE-N; 2 pps Under 10 pps is safe for huren consupption. COLIFORM + NITRATE I LAB TECHNICIAN; Pas Gans WI Approved Lab No. 19 < Means "LESS THAN" Detectatle Level Approved by; e PROFESSIONAL LABORATORY SERVICES SINCE 1952 PRircel 020-1087-60-100 12/28/2009 11:51 AM PAGE 1OF 1 t. Parcel 32.29.19.370C 020 - TOWN OF HUDSON 'urrent X 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 O - BAUER, DANIEL R DANIEL R BAUER 947 QUARRY RD RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 498 STAGELINE RD SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 10.020 Plat: N/A-NOT AVAILABLE SEC 32 T29N R19W E1/2 NE1/4 10.02ACRES Block/Condo Bldg: THAT PART OF LOT 1 CSM 7/1925 LOCATED IN E1/2 NE1/4 INC P391B ANNEXED 2000 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 32-29N-19W NE Notes: Parcel History: Date Doc # Vol/Page Type 10/25/2000 632394 1553/402 ANNEX 07/23/1997 855/492 2009 SUMMARY Bill Fair Market Value: Assessed with: 0 020-1097-40-100 Valuations: Last Changed: 01/18/2001 Description Class Acres Land Improve Total State Reason Totals for 2009: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2008: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch 150 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ltit;C ti•• 41 r ti; . yt i rt Z96L 30NIS S30lAU3S kkjOlddOBd-1 1`dNOISS33Olid > € L,cq paaoaddy banal algepsa ad „NtlHi 55316, sueayl ~'ONIdiON~1 61 'oN qel PanO.Addy IM au" fed INdIMNH331 01 3.LVHiIN + WJWIIM •u0 o nsw uefny i0; a;es s1 odd OT .10Pu{y odd z M-31MIN 3, Al l e3+.6o101 aaPeg INOI1d13HcWiNI 1f OOT/ 0 Iw)jojI" m }acne; u843MI 13idWS 30 3:1M 6u l uoZ X1013 •4 321Q133T10'J uospn" 4•pa au!la6e* Bbd INOI V301 saAeH safer #a m N05'13t! •3 s*m Min 9TOts IM `NO9al1H 390000 6B/9Z/OT :aMI3331 31bt1 AJNff03 XI0W '15 68/0£/OT 131tli1 12lO33y 91lINOZ XI033 '15 T 39tld TO/09i5£ I'01! 1a0d35 LZZ9 - Z9e- 009 LZL6-Z06 -9LL OSIM `xIelloO S uleW bl9 ' 3WYIlO~