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s , • Form - S T *C - 104 .
i
AS BUILT SANITARY SY8TEM*REPORT
• • . TOWN8gIP + > 7 SEC. T~Z~7 N-R 0
_ ADDRESS ST.:CROIX COUNTY0 WISCONSIN
a,. •ti
+ SUSDIOI8I0lf LOT LOT SIZE
PLAN VIEW +L
Distances sad dimensions to sleet requirements of IIAA S3'
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
}
ntor r-.-
fit. .
seq
-or I of So
10
A e.
t. 40f t '.4
s .,.t
,
• " _ ,~.!•;u~ • INDICATE NORTH ARRow
•EMCIQfARKs Describe the vertical reference point used
Elevation of vertical reterefice•points
Proposed elope at sites
SEPTIC TANKS Manufacturers- ~
gvLd Capacitys
' `'•-s"Numbef of rin;s useds
.;_Tank manhole cover elevations
Tank Inlet Elevations
Tank outlet Slevatlort ,
Number of teat from nearest Roads Front,OSideo feet
Rear,
®
• .From nearest, property line s • Front toSide0Rear,~
teat
bar of feet irons well • • L °ldings
`c a this information of _the above pl: gin) ( 2« efe:-
u~r~"dimensfons to septic tank)
i.: ~ ' . 'fink' . t
PUHP CHANEER
Manufacturer:_ Liquid Capacity: .
Pump Models Pump/Siphon Manufacturers Pump•Sise
Elevation of Inlet: Bottom of tank elevation:
Pump off switch elevations Gallons per cycles
Alarm Manufacturer: Alarm Switch Types
•Number of feet from nearest property linif. Fronto 0SLdso O Rearo 0
'Number of teat from wells
Number of teat from buildings
• (Include distances•on plot plan). .
SOIL ABSORPTION•SYSTEH rt:
Bdd s' • Trench s
Width: Lengths ..-Number 'of Lines: Area Bunts
Fill depth to to cf pipe: • . '
Number of feet f om nearest property linet Frpnt, 0 Sides 0 Reargo tt
~Number,of feat from wells 941
am. f. ; . .
' N 'bar of teat from building:
(Include di Lances on plot plan). '
SEEPAGE PIT
Sizes Number of puss Diameters
Liquid depths Bottom of seepage pit elevations
Area Built:
t
Has either a drop box O or distribution box O been used on any of the above soil
abeorbtion sytems? (C eck one).
HOLDING TANK
Manufacturers Capacity:
Number Wirings %lsads• Elevation of bottom of tanks
• Elevation of inlets
Number of feet from.nearest property lines Frontq O Side$ O Rear,, OFt.
Number of feet from wells
Number of feet from buildings
Number of feet trom.nearest road:
I Alarm Manufaeturer t '
f
t fd Inspectovs,
Dated:
Plumber ,on job#.
j License Numbers
3/84:ioj . ~r
is
AR 000 Ll,_~
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING
LABOR & HUMAN RELATIONS DIVISION
P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION
MADISON W 537 7 State Plan I.D. Number:
NW4,NW,S~ec.27,T30-R18 CONVENTIONAL ❑ ALTERATIVE (If assigned)
Town of Richmond ~t 2
1 0th Me. Ho ding Tank ❑ In-Ground Pressure ❑ Mound
NAME OF PEROLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE:
James McCart ANA~Tew Richmond WI 54017 /v PO
BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: ST REF. PT. ELEV.:
i
r
644 ACS . ~_Iwo s~dc &U
Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number:
Calvin Powers Jr. 156 St. cro-kx 28
;iIl
SEPTIC TANK/FWEB0 Q~+I4NK:
LABE[ MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: W G : LOCKING OVE~t6.
n 0 / PROVIDED: PROVIDED: '5•
pve v5 C! P"d (0, 33 /Olv. YES ❑ NO D YES NO
B DDING: VEtJ* DIA.: V&W MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT Tt) FRESH
r~,Q, rr G,d, ALARM: FEET FROM LINE: / AIR INLET,
❑ YES NO ❑ YES NO NEAREST 17 r 5-t 3(v
DOSING CHAMBER:
MANUFACTURER: BEDDING: LIQUI APACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
❑ YES ❑ NO ❑ YES -1 NO ❑ YES ❑ NO
R OF PROPERTY WELL: BUILDING: VENT LE FRESH
GALLONS PER CYCLE: PUMP AND CONTROLS OPERA NUM2ST
(DIFFERENCE BETWEEN EET ROM LINE: AIR INLET:
PUMP ON AND OFF ❑ YES NO N 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: MATERIAL: PIT DEPTH:
DIMENSIONS /a,/ J 6,1 GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. 151PE DISTR. PJ~ppE~,M~A TE RIP L: N . D TR. NUMBER OF PROPERTY WELL: BUILDING:
VENT TO FRESH
BELOW PIPES: ABOVE COVER: ELEV. INLET: ELEV. END: jol"14,r~"•~x-S•f/pHrG PIPES: FEET FROM LINE: I AIR INLET: /
'9.2 1011-94 OV 63 nC 5T/AI - a NEAREST --411- o~ 9o
MOUND SYSTE 83~
Mound site plo perpen ICUIar 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:
ELEVATION AND ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.:
DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO
INFORMATION APPROVED PLANS
❑ YES ❑ NO ❑ YES ❑ NO
PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING:
COMMENTS: FEET FROM LINE:
❑ YES ❑ NO ❑ YES ❑ NO NEAREST---*
etai in county file for audit.
Sketch System on
Reverse Side. SIGNAT RE: TITLE:
SBD-6710 (R. 06/88)
SANITARY PERMIT APPLICATION
DILHR In accord with ILHR 83.05, Wis. Adm. Code Cou
TATE SANITARY PERMIT
#
-Attach complete plans (to the county copy only) for the system, on paper not less than ❑ `
8% x 11 inches in size. Chec if revision to previous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROPERTY WNER PROPERTY LOCATION
T , N, R V(Or)R
PROP 'PTY /OWNER'S AILING ADDRESS LOT # BLOCK #
X _Y Z4~
CI , S AT ZIP CODE PHONE NUMBER SUBDIV ION NAME OR C NUMBER
II. TYPE OF BUILDING: (Check one) ❑ State Owned ❑ VILLAGE /e NEAREST ~h
❑ Public 01 or 2 Fam. Dwelling- # of bedrooms PA ELTA MB /
74
111. BUILDING USE: If building a is public, check all that apply) 1 ❑ Apt/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
30 Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. [9 New 2. ❑ 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. nPEoF SYSTEM: Check onl one
( v )
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 (2 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 ( q~)%) (Gals/day/sq. ft.) (Min./inch) ELEVATION
Feet Feet
VII. TANK CAPACITY Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION New xistin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
Septic Tank or Hold! n Tank DO s
Lift Pump Tank/Si hon Chamber F-1 R El L1
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plu is ame (Pri Plumber's Signature: (No S ps) MP/MPRSW No.: Business Phone Number:
J~ 3
Plumb Addr ss (St et, City, State Code):
IX. O TY/DEPARTME T USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater jDatelssued Issuing gent Signature (No Sta ps
Xpproved ❑ Owner Given Initial surcharge Fee)
10 Adverse Determination t
X. CONDITIONS OF APPROVALIREASONS FOR DISAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new
criteria in the Wisconsin Administrative Code will be applicable.
3. All revisions to this permit must be approved by the permit issuing authority.
4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be.
submitted to the county prior to installation.
5. Onsite sewage systems must'be properly maintained. The septic tank(s) must be pumped by a licensed
pumper whenever necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code administrator or the
State of Wisconsin, Safety & Buildings Division, 608-266-3815.
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'f 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; vvells; water mains/water service;
,
streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system
areas; and the location of the building served; B) horizontal and vertical elevation reference points;
C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump
performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if
required by the county; E) soil test data on a.115 form; and F) all sizing information.
GROUNDWATER SURCHARGE
1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of
regulated practices which can effect groundwater.
The monies collected through these surcharges are used for monitoring groundwater, ground-
water contamination investigations and establishment cf standards.
SBD-6398 (R.11/88)
APPLICATION FOR SANITARY PERMIT
STC - 100
This application form is to be completed in full and signed by the owner(s) of the
property being developed. Any inadequacies will only result in delays of the permit
issuance. Should this development be intended for resale by owner/contractor, ("spec
house"), then a second Corm should be retained and completed when the property is
sold and submitted to this office with the appropriate deed recording.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Owner of Property _V_1C_4_Vo.P,6 4012 "t42~z
Location of Property ~A.W k, Section 2_1 , T-300 N-R i b - W
Township VA CAV~.A 0N 0
Mailing Address 2o,. E
1Gw [A 1,+A tA0 a 0 , kl 1 5 4011
Address of Site PaLxm +
q5_**" P-AC. 4LA 0 140 \A4 54a 1-1
Subdivision base 6,5r>1
Lot Number t~
• Previous Owner of property j1.1~ 'i 47 N~
Total Size of Parcel 2. 87(0-+?.ES
Date Parcel was Created O
Are all corners and lot lines identifiable X Yes No
to this property being developed for resale (spec house) Z Yes No
Volume llc7 and Page Number 29"8 as recorded with the Register of Deeds..
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A Warranty Deed which includes G .Document number, volume and,2age number, and the
Seal of the Register of Deeds. In addition, a certified survey, if available, would be
helpful so as to avoid delays of the reviewing process. If the deed description refer-
ences to a Certified Survey Map, the Certified Survey Map shall also be required.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
PROPERTY OWNER CERTIFICATION
i Iwo) co-A-a6y that aCt statemenu oil tlws ohm ahe tAue. to the best o6 my (OWL)
hlicwtedge; that 1 (w¢) am (aA¢) the owneAkl 06,the pnopeJt.ty deAcAi.bed in tUA
t"401mat.ion 6ohm, by v.iA~tue 06 a wafAcanty deed n.eeoAded in the 06 ice o6 the
Celina RegiAteA o6 Deedsas Document No. 2~60a94 ; and that I (We) pneAentty
Mn tl,¢ phopoa¢d e Lt¢ bon the ~se<uage dvspo3 dya em (o)t 1 (we) have obtained an
easement, to h.un with the above deAcAibed p&opehty, 6o& the eondtnucti.on 06 said
ayatvn, and the same has been duty kecoAded .tn the 066.tee o6 .the County Regi6teh. o6
Deeda, as Voeume_nt mo. 28o9g 4 1.
GNATURE Of OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE)
5-150 : q0
DATE SIGNED DATE SIGNED
LAND CONTRACT-Insurance Clause. STATE O W SIN-FORM No. 33 N. C. YILLCP CO.. NILWAUKII
i
VOL
This Article of Agreement,
Made and concluded this 6th day of July A. D., 19 65 ,
by and between John F. Stephens and Anna Stephens. husband- and wife - - - parti e s of the first part,
and.____RicllazAli ~ Hopkins- and-Wanda._D. fiokinshusband and_wfe
parties-of the second part.
WITNESSETH : FIRST, That the said pard e S _of the second part hereby agree-and bind th em s e 1 ve s_'__ t}7 e i r
___-__-legal representatives, to pay, or cause to be paid, to the said part I e s of the first part, __the, r
heirs or assigns, the sum of _ Eighty-f ive__Hundred- (9P8-00.00)---- Dollars,
in the manner following: Two Thousand ---------(x2000_._00)---- _-Dollars,
at the ensoaling and delivery hereof: Balance_payahle _>1000 _00_._per_-yea_r_ including interest
at 5% on the unpaid balance, first payment November 15th, 1966, the parties
having the privilege of paying greater sums on the principle on any pay-
ment date.
The said payments to be made to the part ies-of the first part, at._-____ New j ichmond, _
Wisconsin
and the same being intended to apply, when fully completed as the purchase money for the following tract,.piece or parcel
of land, situated in the. County of _ St. Crol_X and State of Wisconsin, to-wit:
West one Half of Northwest Quarter (WZ of NW;) of Section 27, Township
30 North, i4ange 18 West, St. Croix County, Wisconsin.
It is agreed by and between the parties hereto that the parties of the
second part will build a pole shed type building on said property, but
said building will remain the property of the parties of the second part
as Chattel Property and will not become a part of the-real estate and any
loan on said building will be a Chattel Mortgage.
All A. S. C.payments for the year of 1965 payable to the parties of the
first part.
The said part i e sof the second part further agree,-that they -_--will pay, when due and payable, all taxes and
assessments which have been assessed or levied on the above described premises since the 1st day of January, A. D., 19 W-,
and also all such as may be hereafter assessed or levied thereon or upon the interest of said partigS- of the first part in said
premises; and also all taxes and assessments now or hereafter assessed or levied against any mortgage which may exist against
said premises or against the note-or the indebtedness secured by such mortgage or against the interest In said premises
of any party holding a mortgage against said premises durin4 the term of this contract, and promise _ and agree -that
the interest of the part! e 8 of the first part and the interest'of the part i e s of the second part in said real estate and the
interest of any party holding a mortgage against said real estate during the term of this contract, shall be assessed for taxation
and taxed together, without separate valuation as unincumaered real estate and shall be paid by the said part i e s of the
second part and the said part -1-@Lof the second part hereby waive- all rights of offsets or deductions because of the payment
of any such taxes and assessments, until the aforesaid purchase money shall be fully paid, in the manner above stated.
The part leS-of the second part further agree --that the said part i e s of the first part shall insure and keep insured
against loss or damage the building now on said premises and such as may hereafter be erected thereon during the life
of this contract in the sum of at least Dollars,
against loss or damage by fire
None
in the name of the part-i e -s-
of Elie first part as owner in fee, with clause in said policy that the said partlQ-B-of the second part hate-a land contract
Interest therein and the loss, if any, under such insurance shall be payable to the said part i e sof the first part to the extent
of their interest and the surplus, if any, to the said part lesof the second part, subject, however, to the rights
of mortgagees, if any, respecting such insurance; such policy or policies to be held by the said part i e g of the first part,
their heirs, legal representatives or assigns, as collateral to this contract; and the said parts Qg of
the second part shall pay the premium on such policy or policies when due, and in case of the failure or neglect of the said
part i e fi of the second part to pay such premiums when due, said partiPP of the first part, _ themselves -their
heirs, legal representatives or assigns may pay the same and oharge the cost thereof with interest thereon at the legal rate,
to the said partie8 of the second part, and the same shall be considered and taken to be an additional part of the con-
sideration of this contract.
The part iesof the second part further agree-to hold the said premises from the date hereof, as the tenant _
by sufferance of the said part i e 8 of the first part, subject to be removed as ' th4 it tenant1
holding ovdr, by process under the statute in such case made and provided, whenever default shall be made in the payment
of any of the installments of purchase money, interest, taxes, assessments or insurance premiums as above specified;
and also to keep the building-, fences and improvements omsaid premises in as good repair and condition as they now are,
except ordinary wear and decay, and not to do any act whatsoever which tends to depreciate the value of said premises.
SECOND, That the said part 3 e8 of the first part, hereby 'agree -and bindthelfteelyes, thei r
hei executors anadministrators, that in can the aforesaid sum of Eighty-Yj ye hundred=__---_-
t88500.00~ Dollars,
with the interest and other moneys shall be fully paid and'illl'the conditions herein provided shall be fully performed at the
r times and in the ILlariri®r above specified, ~ they on demand, thereafter-cause Lobe executed and ,
delivered to the said part An of the second part, or their - heirs or legal representatives, a good
and sufficient Warranty Deed, in foe simple, of the premises above described, free and clear of all legal liens and incum-
brances, except the taxes and assessments herein agreed to be paid by the partilH& of the second part, and except any liens or
incumbrances created by the act or default of the part ie8 of the second part, their heirs, legal
representatives or assigns -
THIRD, It is distinctly agreed and understood by and between the parties hereto, that if the said part i,&S of the second
part shall fail to make any of the payments of purchase money and interest above specified, at the times and in the manner
above specified, or fail to pay the taxes and assessments, or fail to insure and keep insured the premises herein as above stipu-
lated, or fail to pay any or all insurance premiums herein specified, or violate any other terms or conditions herein contained,
this agreement shall at the option of the said parti@.S-of the first part be henceforth utterly void without any notice what-
soever, and all payments thereon forfeited, subject to be revived and renewed only by the act of the partl e S of the first part,
or the mutual agreement of both parties; and whenever such default or violation shall occur, the part I e S of the second part
shall have no further right to collect rents from tenants, if any, of the said real estate, or any part thereof, but such rents
shall be collected by, and belong to the part_,88of the first part.
The said parka- of the second part further promise-and agree that in case of the commencement of an action
to foreclose this contract and also in case of the foreclosure thereof, they will pay in addition to the taxable
costs and expenses incurred, a reasonable sum of money as attorney's fees.
IN WITNESS WHEREOF, the said parties have hereunto set their hands and sea this 6th- day of
A. D., 19 6~.~
(SEAL)
Sgne and Seale in Presenc f ohn P_. ep n8
r. sir (SEAL)
-1 / - - E
- nna St`Lhen"s
Wm. W. Ward c.
Ni ~ti We o i~ _7i1~ _ --(SEAL)
- -
hard ns
Diane Beauvais and'a ll. Hopkins•~
STATE OF WISCONSIN,
St. Croix County. ss.
Personally came before me, this of__Jllly-, A. D., 19 _65-_,
the above named --Inhn F. Stephenet and Anns`St-ephens_,---hus-hand--and--w-iis-and__Richar&
to me kngwjA ,>;p,¢e the persons who executed the foregoing instrument nd ow gad lie s me. I
t - Notary Public, St. Croix County, Wis.
c~Ut3 L1 My Commission t 4?f is rermanentA
90;•;.x,_ ~ -
~(SSCt16►n ll7.,~t•ty~ of the Wisconsin Statutes provides that all instruments to be recorded shall have plainly printed or typewritten thereon the
names o/ that tttantoes, Wants", witnesses and notary).
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VOL 415 PAGEM
F
"S
~s
45
ST. CROIX COUNTY IABSTRACT COMPANY
HUDSON, WISCONSIN
I I
CONTINUATION OF ABSTRACT NO. 12,31
From the S th day of _ju1y_ 196 at I A 00 o'clock In the --AM.
of the land described as:
D w W of NW-1 4 of Section 27-30-18.
0~
Gp'~"~'pcc _ 46
N
John F. Stephens and Anna Land Contract,
Stephens, husband and wife, Con. $8500.
P Dated July 6, 1965,
-to Ack, July 6, 19659
Rec. July 26, 1965.
Richard W. Hopkins and In "415", page 248, #280994.
Wanda D. Hopkins, husband
and wife.
Wj of NWk of Section 27-30-18.
I;I
Recites: It is agreed by and between the parties hereto that
I the parties of the second part will build a pole shed type building
on said property, but said building will remain the property of the
parties of the second part as Chattel Property and will not become
part of the real estate and any loan on said building will be a Chat-
tel Mortgage. All A,,,S, B, payments for the year bf 1965 payable
~,rto) tihe , partlep' of.~the~ tiro t part. _ rk
47
II Richard W. Hopkins and Wanda Mortga e.
Hopkins, husband and wife and Con. 14,800.
each in his own individual Dated July 23, 1965.
capacity, Ack. July 23, 1965,
Rec. July 26, 1965 :00 •
-to- In "415"., page 250, 080995).
,1 First National Bank of New
i Richmond, a corporation.
j All right, title and interest of the mortgagors in and to the
Wj of NWu of Section 27-30-18, including all rights of the mortgagors
as purchasers under that certain Land Contract between John F. Ste-
phens and Anna C. Stepherne as vendors and i.chard W. Hopkins and
Wanda Hopkins, dated July 6, 1965 and recorded July 26, 1965 in the
Register of Deeds office of St. Croix, Wisconsin in "415", page 248
j Recites: It is further agreed and understood between the parts e
j hereto that this mortgage shall stand as security not only for the
j above mentioned note but also for any and all renewals, partial re-
newals, and extensions thereof, overdrafts and other indebtedness now
or hereafter owing said mortgagee by the morbgagors herein, or either
j or any of them, to the extent of $500.00 in addition to the note re-
ferred to herein. "1vlanda l). Hopkins")/
(Partially
(Partially Released, see No. 50).
,j
II
COUNTY ABSTRACT COMPANY
ST. CROIX CONTINUATION OF ABSTRACT
s
CERTIFIED SURVEY MAP
Located in the NW 1/4 of'the NW 1/4 of Section 27, T30N, R 18W , Town
of Richmond, St. Croix County, Wisconsin.
NI/4 CORNER
SECTION 27
_ =tzj30N.R18W
UNPLATTED LANDS
EAST LINE OF THE NW 1/4 OF THE NW 1/4
° "
S014-77.68 E 05 S 00.18'02"E 434.97'
- '0-~ 399.87' ,
1%12-0 7 FENCE
in
D 1 1 11i~d
z 1 1 IIa
II
lOl I(® LOT I
194192 Sq. Ft. (4..458 A)',
z I Including R -O -W 19
= I 179024 Sq. Ft. (4, 11 Ac) W
111 0
I Excluding R -O -W v
10
LL
No
Z I In y NO a
x W ..,WIN ~
Io
0 1 e o I no
z I v PI 33.69' 0
00,18,010E 471.04' to
I i I^ m 437.35' N UNPLATTED -LANDS _
II/// 1 to I ai
v Ip LOT 2
r~ 123101 Sq. Ft. (2.826 Ac)
1 ~5 Including R -O -W
WI I I 114743 Sq. Ft. (2634 Ac) 0
Excluding R -O -W a
-°In I b
c°1u of
O0 a 1 00
461.89' Owned b y:
Wil COO 133. 1 N 00' 18'02"W 495.00' Richard Hopkins
i'I C11 I
UNPLATTED LANDS Route 4
I
W1 1
I a~ New Richmond, Wi.
oI f ~ w : I BEARINGS REFERENCED TO THE 54017
zl II i~ WEST LINE OF THE NW I/4 .
JI FII N I ASSUMED S O° 17'00"E.
11OIN I
of Oil 0~
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I ~-I II z 1
I
Zi 3! 33'1
\ SCALE IN FEET 1" = 150,
~I Q1I
I 1\
1\ 1~ 1\ 15O' 75' O75150' 300'
\ \ e=3001456 LEGEND-_
` R = 375.00'
\ CHORD= 226.67 ST. CROIX COUNTY SECTION
N67°17'30 "E CORNER MONUMENT
\ \ \ L = 230.67'
O 1"X 24" ROUND IRON PIPE WEIGHING
\ \ 1.68 LBS./LIN. FT. SET.
\ °s\ \ W 1/4 CORNER
~y ~0- - - SECTION 27
NW CORNER 1E0.I ST~i€ET _ _ M II
SEC. 27 -
S 0° 17 00' E 348.70 rn 2294.33
I 2643.03
WEST LINE OF THE 490-1686
NW I /4 DRAFTED BY JWG
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SEPTIC TANK MAINTENANCE AGREEMENT
Sr_. Croix County
OWNER/BUYER ~IC~►AQ-1~ ~PY.-tNS~,Q►MeS I~'`~-R~/
ROUTE/BOY NUMBER PCP%A-fE 5X le> I Fire Number
.CITY/STATE ~ W PAC-4 "Otlb, WI ZIP S4v~'1
PnOPERTY LOC.ATION:- Nw NkArt, section 2`7 , T N, R ~4b W,
Town of PCA4MON-D , St. Croix County,
Subdivision L S M Lot number Z •
Improper use Xnd maintenance of your septic system could result in
its premature failure to handle wastes. Proper maintenance con-
sists of pumping out the septic tank every three years or sooner,
if needed, by a licensed septic tank pumper. What you put into
the system can affect the Eunction of the septic tank as a treat-
ment stage in the waste disposal system.
St. Croix County residents may be eligible to receive a grant for
a maximum of 60% of the cost of replacement of a failing system,
which was in operation prior to July 1, L978. St. Croix County
accepted this program in August of 1980, with the requirement that
owners of all new systems agree to keep their systems properly
maintained.
The property owner agrees to submit to St. Croix County Zoning a
certification form, signed by the owner and by a master plumber,
journeyman plumber, restricted plumber or a licensed pumper veri-
fying that (1) the on-site wastewater disposal system is in proper
operating condition and (2) after inspection and pumping (if nec-
essary), the septic tank is less than 1/3 full of sludge and scum.
Certification form will be sent approximately 30 days prior to
three year expiration.
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-
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.
SICNED
DATE 5 - ~Jc7 ' ~c7
St. Croix County Zoning Office
P.U. Sox 2'?7
Hammond, WI 54015
715-796-2239
S1
i.,gn, dar.,- -inct recnr.n r7o :thuve address.
r
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFE 1 6t B DNISION
A60 ~
LABOR AND T'tn AND PERCOLATION TESTS (115) P.O. BOX 7969
HtiIMAN RELATIONS MADISON, WI 53707
(H63.09(1) & Chapter 145.045)
Q~ TOWNSHIP/MUNICIPALITY: LOT NO.: BLK. NO.: SUBDIVVII/SION NAME--
OC'A-TIO SECTION-
NW ~4 7 /Vvn/R/O (o0 W R. 7T 0j<%
COUNTY: OW R'S YER'S NAME: IMAILING ADDRESS:
S ,
Sf• G o I 1 c Ct r 1 V\ S I~ n t,J R c Yrw "Cc l
USE DATES OBSERVATIONS MADE
NO. BEDRMS : COMMERCIAL DES R PTIO I PROFILE S: JPER LATION STS:
)IResidence _ KNew ❑Replace It d _.10 _
RATING: S- Site suitable for system U- Site unsuitable for system 1 ~1 9 Lk rk~
ONVENT N L: MOUND: IN-GROUND ESSUR_ : S STEM-IN-FILLHOLDING NK: RECOMMENDED SYSTEM (optional)
$ U S ❑U EMS U I El S EM El S [X
e tfon J
If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the
under s.1-163.0915)(b), indicate: pI I
Floodplain, indicate Floodplain elevation: tilA
L ASS
~G PROFILE DESCRIPTIONS
BORING IOTA 7TH GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTFi1N' ELEVATION VED ES . TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
10-2110 I,e , ai s ~ off,- /tsi8y►s/, ,1,s -a.s8.t y~ rt~ ~
B-
B- 7 /04,~On'` 7 7 " t9-' 761 -I. s ~►s/~ l,S~-a, l 8-ti S/ ~r
- 17 61 7-
B-3 , s~,~,p ~5 9~
0~ . A) 0 r.e > 7 0-719 *
B- /ll ,Y-5 one 7 47 0'/0 ►31s1~ s 7 8n Ise- ~
Bf rvon 79' 0-,7 al s/ , -a,i t s td
B-
Q PERCOLATION TESTS
TEST DEP WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER I11144e5' AFTERSWELLING INTERVAL-MIN, PERIOD I P RI D PER INCH
P_ I U
P_ o[ O D
P- D
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 ELEVATI • ~s
t 51
- -
z, ,ri - - - - _
tf -bl a - - - - y __7 171~
N
_ l-_ i - - - - -
I
410 ° -~?$7 Sa CC ^`4
/ anc
nd methods specified in t e isconsin
I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the o pro dunes1
Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
NAME 1 4) ' TESTS WERE COMPLETED ON:
/vIt1 W ~/vw-vrS /0 A9 - V g
nlc:t
ADDRES : CERTIFICATION NUMBER: PHONE NUMBER (optional):
6.5 --.53 7 1s
CST SI NATURE:
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 IR. 02/82) - OVER -
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_ PAGE OF
Cr~SS S~c~IOn o~ A 3x17 SySt~~
F/daA Ali Inldli, And ODiayvollon Plpd
~f/ri~ S / nr~ C:~I^-- Approvld Vent Cap
Mlnlmwa 12' Above
Final Crode
20- ♦2' Above Pipe _ 4' Call Iron
To final Orodo Venl Pipe
margin may of Symeelk Covering
"rn 2" Aggrsgale
Over Pipe
0Ie1r10u110n t
Plpa a o o - Toa
2 9 6' k$4 pipe a Perlordled Pipe 0019V
la
o -Coupling Terollnoling Al
Balloon 01 Syblun
Pau o1 e D Pin.-I 5 c1t
SOIL FILL
DISTRIBUTIOM PIPE
APPROVED $y►JPETIC COVER
` '14ATER14 OR 9" OF STRAW
2" OF hGG9EGAlE OR MARSH HAi
~ ','~'P (o 0 P1z-21/z AGGREGATE ~P
DISTRI5UTIOW PIPE TO BE AT LEAST WCHES BELOW ORIGIMAL GRADE
AQU AT LEAST LO IUCHES BUT KIO MORC THP," 42. INCHES BELOW FINAL GRADE
MAXIMUM DEPTH OF EXCAVATIO0 FROM OK16V AL 6KOR WILL BE -161 IMCHES
nNinuM OfT rtl OF EACAVATIOW f ~O/A 0,161"AL GRAPE WILL BE _ 0 1NJCHEL S
SIG/JEO:
LICEWSE DUMBER: J
DATE: 110