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020-1171-40-000
Q o I °o I 11 p 6% a c 1 c 0 o I ~ I c N I In I 0 w O CL C 'w I o c c M t! Q O N O I m C C ry ~ °'mo I I d V C m O N I a MEy cc N X O C I N' W O a F 'a z N o o m I c z ti c '0.0- 0 ~ m c C N N N LL 3 LO CL I s y E $ v m c I Q M I I v (D 1 ° rn z E I z H z o E i 4.; o z- ~'`ao E O 1 rn- d d 1 a`+ d N H U) I a m I a m I oz:r 'D .0 tY ~ ~ I v I dzv I ° w I w U F C o E v ID f0 m W faU I m ai c CL v O ° 0 g Z m I Z Z D ::I I I U i d I m c p I CO l6 y I m E N O ` m CL 30 I u~i y d V a~ l o y `.g m Y c C 0 a a 1 S D O a a E wo ~mwm ~ E I 3 ~L `c `~W w yooo =ooo z a 7 a a a 1~ a a a U p ° y co U) i m O B' m 1 co 0~- N 8 0 Cl) N W o o I E to N M .Cri N d-N fA I 'p d Q1 Q z (A ~ p (D (D p a I N M C I 00 N O CD 0) :3 r- V v o 00) o a) CO C ° w I L ol 40 's ° y E n '00 U c a°i •O o 0 2 p z j2 epN- C Z fn V a I a`r a I € a • a m 'u I d a 1L; a rr~~ 0 m 0 1 3 ~ O c 19v ~1 A 10 CL ~ovic01- COMMERCIAL TESTING LABORATORY, INC. ' 5t4 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715-962-3121 800 - 962 - 5227 FAX-715-962-4030 ST. CROIX ZONING REPORT NO,: 34011/01 RAGE 1 j ST. CROIX COUNTY REPORT DATE. 12/18/92 COURTHOUSE DATE RECEIVEW 12/15/92 HUDSON, WI 54016 ATTN; THOMAS C, NELSON OWNER: C14cPhefres. LOCATION: 340 Edgewood Dr., Hudson COLLECTOR: M. Jenkins DATE COLLECTED: 12-14-92 TIME COLLECTED: 320pm SOURCE OF SAMPLE: Outside faucet DATE ANALYZED:12-15--92 TIME ANALYZED:2:00pm COLIFORM: 0 /100 ml INTERPRETATION'# Bacteriologically SAFE NITRATE-N: < 1 ppm Above 10 ppm exceeds the recommended Public Drinking Water Standard. Coliform Bacteria/100 ml Nitrate-Nitrogen, mg/L 9 10 !j o l~ a Q~ 9~. LAB TECHNICIAN: Pam bane OF.\NDEVFNpFNj : 1 L WI Approved Lab No: 19 t yA < Means "LESS THAN" Detectable Level Approved by: PROFESSIONAL LABORATORY SERVICES SINCE 1952 ST. CROIX COUNTY ZONING OFFICE St. Croix County Courthouse 911 4th Street Hudson, WI 54016 Telephone - (715)386-4680 he St. Croix County Zoning Office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals. Completion of thia form 1a essential %Q that -tb-q 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: $ 35.00 (For nitrates and coliform bacteria) FEE• $185.00 WATER TESTING . (For VOC'S) SEPTIC SYSTEM INSPECTION FEE:. $25.00 (Determines if system-,is properly functio in at ..time of inspection) PROPERTY OWNER'S NAME: c PROP. ADDRESS: / ✓ CITY Legal Des rip ion /4 of the 1/4 of Section N R Town of Lot Number/29!~,,4Subdivision: 0w- FIRE DER LOCK BOX NUMBER 1r Color of house - Realty sign by, house? If so, list firm: PLEASE INCLUDE :IF AT ALL POSSIBLE, A ,i.e,COPY OF PLAT BOOR, 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 reques ng,se vice Telephone Number REPORT TO BE SENT TO -77 CLOSING DATE: ~ Signature ST. CROIX COUNTY y WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE Y 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 December 15, 1992 Anchorbank 302 Bay St. Chippewa Falls, WI 54729 To Whom It May Concern: An inspection of the septic system on the property of Eugene W. McPhetres, located at 340 Edgewood Dr., Hudson, WI was conducted on Dec. 14, 1992. At the same time a water sample was obtained for testing. The results of that testing will be sent to you as soon as we receive them back from the laboratory. At the time of inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. Should you have any questions, please contact his office. Sincerely, fi f 1~1 Mary J. Jenkins Assistant Zoning Administrator cj a f ST. CROIX COUNTY ZONING OFFICE St. Croix County Courthouse 911 4th Street Hudson, WI 54016 Telephone - (715)386-4680 The St. Croix County Zoning Office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals. coMpletion of this form is essential so that the property can be located. Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning Office, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received. WATER TESTING----------------------------FEE: $ 25.00 (For nitrates and coliform bacteria) WATER TESTING FEE: $175.00 (For VOC'S) SEPTIC SYSTEM INSPECTION-----------------FEE: $25.00 (Determines if system is properly functioni g at time of inspection) Property owner's name C Property owner's address Legal Descripti 1/4 of the /4 of Section T N Town of Lot Number/,ZZ_Subdivi s ion Name FIRE NUMBER y LOCK BOX NUMB LNUMBER _ Color of house Realty sign by house? If so, list firm: PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. if this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual requestin services: Telephone Number " REPORT ��BF,OCT TO: "" Closing dat Signature COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 it 715 - 962 - 3121 800 - 962 - 5227 ST. CROIX ZONING REPORT ND.S 34686/01 PAGE I ST. CROIX COUNTY REPORT DATES 10/09/89 COURTHOUSE DATE RECEIVED: 10/05/89 HUDSON, WI 54016 ATTNS THOMAS C. NELSON OWNER! Eugene McPheters D LOCATIONS 3 r., Hudson COLLECTORS Eugene McPheters SOURCE OF SAMPLES Spigot on basement tank COLIFORMS * /100 ml INTERPRETATIONS Bacteriologically SAFE NITRATE-NS { 1 ppm Under 10 ppm is safe for human consumption. *CONFLUENT GROWTH, Non Coliform COLIFORM + NITRATE LAB TECHNICIANS Pam Gane WI Approved Lab No. 19 �.\NOEPEVa. C _ t Means "LESS THAN" DetectabLe LeveL Approved by'* 4T ® PROFESSIONAL LABORATORY SERVICES SINCE 1952 L Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER PI 4 ~ TOWNSHIP SEC. T L5~ N-R~W ADDRESS z ST. CROIX COUNTY, WISCONSIN SUBDIVISION u:-~~y" G I_ LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I•LHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM G&J'-' 06 z5 30 i I i - i q INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used ~ b,o Elevation of vertical reference point: Proposed slope at site: SEPTIC TANK: Manufacturer: 0-a- _ Liquid Capacity: `dam Number of rings used: t Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: ` Number of feet from nearest Road: Front 10 Side,O Rear , % ~ feet . From nearest property line Front,OSidenRear,0 O?~© feet Number of feet from: well 7~ , building: 1 (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE 1 PUMP CHAMBER Manufacturer: y Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: i Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear, Q Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width: Length:_ Number of Lines:~ Area Built: Fill depth to top of pipe: Number of feet from nearest property line: Front, Q;Side, O Rear, OFt Number of feet from well: Number of feet from building: a ~f (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 box0 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, OFt. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: © Inspector: Dated: / Plumber on job: 66 G' License Number: 3/84:mj f Parcel 020-1171-40-000 12/17/2004 08:54 AM PAGE 1 OF 1 Alt. Parcel M 7.29.19.1069 020 - TOWN OF HUDSON Current 1XI ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): Current Owner JAMES E & DEBRA K MCPHETRES MCPHETRES, JAMES E & DEBRA K 340 EDGEWOOD DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 340 EDGEWOOD DR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 1.190 Plat: 1932-EDGEWOOD ESTATES III SEC 7 T29N R19W LOTS 108 & 109 EDGEWOOD Block/Condo Bldg: LOT 108 ESTATES III Tract(s): (Sec-Twn-Rng 401/4 1601/4) 07-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 06/03/2002 680543 1902/181 WD 11/19/2001 662467 1765/508 TI 07/23/1997 807/208 04/26/1988 436625 808/635 WD 2004 SUMMARY Bill M Fair Market Value: Assessed with: 49110 307,000 Valuations: Last Changed: 10/29/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.190 29,500 208,000 237,500 NO Totals for 2004: General Property 1.190 29,500 208,000 237,500 Woodland 0.000 0 0 Totals for 2003: General Property 1.190 29,500 208,000 237,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 218 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 SAFETY & BUILDING DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR DIVISION Lp,BOR & WUMAN RELATIONS ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION P.O. BOX 7969 State Plan I.D. Number: MADISON, WI 53707 (If assigned) SE41NW'4fS7,T29N-R19W [CONVENTIONAL ❑ ALTERATIVE Town of Hudson ing Tank El In-Ground Pressure ❑ Mound ADDRESS OF PERMIT HOLDER: INSPE TI ATE: L I 805 Kirmickirmic Street, Hudson, WI 54 16 REF. PT. ELEV.: CST REF. PT. ELEV.: Eugene 14cPheters BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: _Name of Plumber: MP/MPRSW No.: County: Rogert Thm 3224 St. Croix 119463 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: RWARNING OVIDEDLABEL PROVIDED:OVER ❑ YES ❑ NO ❑ YES ❑ NO ROAD: PROPERTY WELL: BUILDING: VENTTOFRESH BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF LINE: AIR INLET: ALARM: FEET FROM ❑ YES ❑ NO ❑ YES ❑ NO NEAREST DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: ROVID DLABEL pROVIDED:OV ❑ YES ❑ NO ❑ YES ❑ NO DYES ❑ NO PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VSER i LOFRESH GALLONS PER CYCLE: FEET FROM LINE: (DIFFERENCE BETWEEN ❑ YES ❑ NO NEAREST -1111- PUMP ON AND OFF LENGTH: DIAMETER: MATERIAL AND MARKING: SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: &INSIDE DIA.: # PITS: LIQUID WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER DEPTH: BED/TRENCH TRENCHES: MATERIAL: PDIMENSIONS MBER OPERTY WELBUI LDI: GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: P OESISTR NU E: BELOW PIPES: ABOVE COVER: ELEV. INLET: ELEV. END: FEET FRO REST MOUND SYSTEM: 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. PERMANENT MARKERS: OBSERVATION WELLS; SOIL COVER TEXTURE: ❑ YES ❑ NO ❑ YES ❑ NO DEPTH OVER TRENCH/BED DEPTH OV::: SEEDED: MULCHED: BED DEPTHS OF TOPSOIL: SODDED: H/ CENTER: EDGES: ❑ YES El NO ❑ YES ❑ NO ❑ YES ❑ NO : PRESSURIZED DISTRIBUTION SYSTEM: WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVtEPE FILL DEPTH ❑ABOVEYES COVER ❑ NO BED/TRENCH DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MSTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: DIAELEV.: ELEV.: ELEV.: ELEVATION AND DISTRIBUTION INFORMATION VERTICAL LIFT CORRESPONDS TO HOLE SIZE: HOLE SPACINGDRILLED CORRECTLY: APPROVED PLANS ❑ YES ❑ NO PERMANENT MARKERS OBSERVATION BER OF PERTY WELL: BUILDING: COMMENTS: T FROM ❑ YES ❑ NO ❑ YES NO NEAREST LINE: S Iris i Retain in county file for audit. Sketch System on SIGNATURE: TITLE: Reverse Side. Zoning Administrator SBD-6710 (R. 06/88) Z SANITARY PERMIT APPLICATION aD,&HR COUNTY In accord with ILHR 83.05, Wis. Adm. Code /I R-6` X STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 9V&3 8% x 11 inches in size. ❑ Check 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 OWNER / PROPERTY LOCA~ION AI C sl2i s !F- '/4 ~Gv'/a, S T Zl1', N, R /C1Dr) BLOCK # PROPERTY c NER'S MAILING ADDRESS, LOT # N A iCoe- lWl? C CITE, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER _ 9y r16` ?/S 3 ~ _ vacs 11~ NEAREST ROAD II. TYPE OF BUILDING: (Check one) ❑ State Owned VILLAGE ~ PM MN QF: -e Public ~R1 or 2 Fam. Dwelling- # of bedrooms _2 PARCEL TAX NUMB R ) 111. BUILDING USE: (If building type is public, check all that apply) 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. L&.I New 2. ❑ Replacement 3. ❑ Replacement of 4.0 Reconnection of 5.E] 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 10 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. 17. EFINAL LEVATION GRADE REQUIRED (sq. ft.) PROPO??SED (sq. ft.) '(Gals/day/sq. ft.) (Min./inch) f Y~6 40 J r7CJ 3 C> V -3 Feet (7 7. Feet VII. TANK CAPACITY Prefab. Site Fiber- Exper. in allons Total # of Manufacturer's Name Concrete Con- Steel glass Plastic App INFORMATION New istin Gallons Tanks structed Tanks Tanks Septic Tank or Holdin Tank f~ J3 Lift Pump Tank/Si hon Chamber I F-1 VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. MP/MI?BS1l hIo.: Business Phone Number: Plumber's Name (Print): Plumber's Signature: (No Stamps) - 32- z -71S 7i z 32.1 PI er' Ad s (Street, City, S te, Zip Code):' boo W <S Y2, - 7 IX. COUNTY/DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee (Includes Groundwater [ate ssue ssuing Agent Si ❑ gnature (NS Surcharge Fee) `\,l Approved El OwnerGiven Initial W Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber 1 INSTRUCTIONS r / I 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% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (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 form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 174 Owner of Property Location of Property ;L hC, Section TN-R W Township 7- 1 / Nailing Address Address of Site Subdivision Name .Lot Number Previous Amer of Property Total Size of Parcel - cj Date Parcel was Created i Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volumed and Page Number 35 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 refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION I We) ceAti.6y that a,tC statements on this otm an.e t ue to the beast o6 my (ouA) hnowtedge; that I (we) am (cute) the ownen(~s~ o6 the pnopenty de~sni.bed in .thiA .in6okmati.on 6oitm, by viAtue o6 a waAAanty, 4eed k C tded in the 066ice o6 the countyy Reg4Aten o6 VeedA a6 Vocument No. G/ +1 ; and that I (We) pkaentf.y own .the p4opo6ed site bon the sewage di6po6 by6 em (on I (we) have obtained an ¢.aeement, to nun with the above denscAiW pnopehty, bon the con6,tAucti.on o6 said ey6tem, and the same ha6 ¢e►i due hecohded to the 066.tce o6 the County RegiAten o6 Veed6, ab Vocmment No. SIGN 71_~2 ER SIGNATURE OFCO-OWNER (IF APPLICABLE) 2 20 15~ e DATE SIGNED DATE S GNED k a ~ y G: ; Own 4, 101% aQY • ..counts. ~ OWN" rr1 Tss POrcel MCroix. of Hudson, 5t wood Estates III, To%4n Edge. „.f Lots 208 and 109. visconsin- F r , 1• N $ j• . " Z,S not bw"t"d p"p"", fi..' and riSnts-of-way rd) restrictions t easements, , to r of record, if any • fi soy of .April .(SEAL) $ orngtad - Dennis ,3a • z (SEAL) R..-. - ,k 0W naln,n, ~ATIQ W13cONS1N w ACK atl)T)E~~~~ STATE OF ~r'a e a° Stad -».W • M"•`«$~ OTT► St., ~Ipix ....Coact! cam* Apra... 3f 88• Personally -mow ~~a r w•. . •.e r•} "mss . .~~~d .i - "TAD e• or 7 `llNa pIT MAC y i • ° rwll t~. r#+at >i y/ .].yG}l t~" MK \ ~r et y Public~nt. (tk IT ;e' JAY, commistion rnsy at *oft { Mph, below H G CA H ' a r ST C- 105 r" a H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z 7 OWNER/BUYER ROUTE/BOX NUMBER Fire Number CITY/STATE ZIP l/ I PROPERTY LOCATION: tv 4, /Y w Section, T N, R/W, Town of St. Croix County, Subdivision Lot number I Improper use and maintenance of your septic system could result in I its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, I if needed, by a licensed septic tank pumper. What you put into f the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to H three year expiration. £ I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with H the standards set forth, herein, as set by the Wisconsin Depart- '0 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. f~ SIGNED X22 9 2. DATE r2S St. Croix County Zoning Office P.O. Box 98 Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. IEPARTMFN Y F EPORT ON SOIL BORINGS AND SAFETY & B I NDU~TRY,, DIVISION ~ ABti AND R PERCOLATION TESTS (115) P.O. BOX 7969 )UMAN RELATI MADISON, WI 53707 (H63.09(1) & Chapter 145.0451 CATI N: SECT' OWNSHIP MU ICIPALI?Y: OT NO.; LK. NO.: SUBDIVISION NAME: SE t1wt/4 , TZR F for /Yt!?aS~nd /o~ 105 - [tiC7LG+1oC+2s C e COUNTY: W E ' YE 'S NAME: MAILING AD MESS: sSTCP.OtX i`sl4 LaP ,ENT INC Ck*ooe OJT Xt IZTN ;401 USE DATES OBSERVATIONS MADE i-- NO. BEDR COM AL TION: PROFILE 4 Residence I~N WSJ New m ReplaceC t{ ~4 / 9 X17 /V1 A ~c l r 19~ „J!f_s O K AC~~ ott_~ JS$ . J! tit ? t TIATING: S- Site suitable for system U- Site unsuitable for system CONV TI NAL: MQUND: IN- - -IN-FILL OLDING TA K: RECOMMENDED SYSTEM: optional) Z AL, U ComvL MTbu , S CCU CD S ❑U IS , tl L S Ill Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the =,4nder s,463.09(5)(b), indicate: (2L~tSS 3 Floodplain, indicate Floodplain elevation: ~Q PROFILE DESCRIPTIONS TOTAL H T R UND ATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH 'I HIl3 ELEVATION OBSERV D TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) - / '"ALCTS )Z"922 SL f2'` 6Pq< 1612 CoBCom ij:-S 14" AN MS gp' rfP,, M> eL 8A j 7"gwrs )7"$RNStL 14' &RNSL 4 C,e RhgkAI S . 's 97-01 IUia M > 9. 3'1~ G eN M, W K06 5 r~tct~s~o~ts 9 "IS <<rs /S' 9RN6Y 5, L /4"' 1QQ/V SL pl B- 3 /0.0% 9 s .2 t NoNLr /0.01 IS " 9 A V -M`• W P s- IN 1 - 4 8 67 qv,6? t40N1": > 8.67 8LLT<- M4" Ket,a 6Y <,,L '?,4" M S rY 6t ~ - //"gc~rs M3..Ber,IG,ySrL M8p g~N ~L k t X6.33 0.6~ No r > ,33 srs" 9 e F-M S t Ge r iEo b ~X PERCOLAnON TESTS C DEPTH WATER IN HOLE TEST TIME DROP WATER V H S RA MINUTES NUMBER Ii66WP& AFTERS ELLING INTERVAL-MIN. 1 _ _PInRIOD 2 PER INCH P 1~ S. 9 oN tc 98.9_ t' % v V P. z oa 6.00 3d ' ~ 7 P. 3 47 qe.4 0 1 V-7- VA Z4.0 P a 1 L+JT PLAN: Show locations of pereo) it rings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori xontaf and vertical elevation reference points and sho t location on the plot plan. Sho the surface elevation at all borings and the direction and percent of land slope. ~gWtNwl ARK 1 SPrKE INTRcC - l l_tyvt~T/U~ !(~.S SYSTEM ELEWION. ' 93,00 e P-3 , Lor 1p LoGnsr~N S+~TC..hI ES ~ P~ 1M rt~y ` LoT 107 4 p 1 v \ $-3 I ~ usT Lrnl~ ScAL~ ~ i / t 143.21 Td), 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures.an 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. AME print : TESTS WERE COMPLETED ON: Md,eCls /9S7 f1-~4QJC.Y l ~C~1In1SGhJ ~J~c-r-- '`-._~aRY~lrn.t~-• ~=J G.. _ ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): Ca 7 GCaN b w hJuDiGN 1 [ j4C)1 341A 3TS6'40k Ct L 4- CST I TUBE: DISTRIBUTION: (hutin:rl anel one cutey in t oc.d Authnuty, I'eoltt'elY t)wneer iernl Seed le%wl. Nf' S4?ll-t;a<r Ih; 1C~rf;'') OVER 6- - O ' C ff T O c G? 1°i ^tQ~i Z z^ N J D ~ ti I Z an t do ~y oc _ y V 134.19' MJ I v -4 8 0~1-'25' 41'W z ~ 'I O I 310.20' -4 ~ 1 S 01 25'41 W N ` V e; 143.21' r 8 01 25'41 W I» 4 I 1 o 4sn Q~ I I T I r -1 143.21' i7tp0' I - - S 01 a # 41 *"M 01 2541 w 203.21' 110.00' ~.~~.21 v IC! is r•~~ \ 1 A2' M E 2 0~' 02 1 \ 5 1 1 Io ~n =23, fn S e 3g•ge.~ ~ o I F .w I -WI MPCA 696 MN JOB GAG. °.ot~ - I Ti m m SHEET NO. I OF Z 1 / 1„ 1 CALCULATED BY~e Of --r~Eft IN, DATE PleS 37~y ' Excavating Co. CHECKED BY _ DATE R I, Box 192, Wilson, WI 54027 SCALE 715-386-5443 R TIMM 716-772-3214 ~1 t?r~Yh ~e f 1 - T}/~► f S~'_ i-l1, 111J6 l fGG F'~ " (e 2 S, / r £L SyS~c+-.., 9.3.0 lop `o~ Ja`1~ / d M ~IZ~ i 44el 4~ Gam' Ca•~Pr ~L 160 J J J 1 ilal°~ e B3 l ~erK to 1 i a - I f ~.7jr s u.vlIM, 0rotoo. Wu. 01471 NNW Mc ,Q/j e on't lers PAGE Z OF Z C, rO S S S e e I o n O 4 r-t IJ a iJ S y 5 t e r~ Fresh Air Inlels And Observation Pipe ( Approvad Vent Cap Minimum 12" Above Final Grade i 20- 42' Above Pipe 4" Cost iron To Final Grad• Vent Pipe Marsh Hay Or Synthetic Covering Mln. 2" Aggregate Olatributlon - Teo Pipe 0 0 i OtAggragate ' 6Pertoralad Pipe BelowBe o Coupling Terminating At Bottom Of System PrUPI7SCD T teal 19rtid-c i SOIL FILL DISTKIBUT10".1 PIPE APPROVED S4MIETIC COVER 9 O ?."OFAGGREGA1F. OR MAKSN NA`JF STRAW 1e' OF 12 -P- AGGREGATE ELEV. OF 3 ~ ~ 3 3 DISTRIBUTION PIPE TO BE AT LEAST INCHES BELOW ORIGINAL GRADE AND AT LEAS-f20 INCHES BUT 1.10 MORE THAM H2 IKICHES BELOW FINIAL GRADE MAXIMUM DEPTH OF EXCAVAT100 FROM aRI&WAt WK. WILL BE ~ INCHES PUP(MM AGPr'tt OF EXCAVXTimN FROM C*161I AL GRAPE WILL BE ? INCHES r SIGAJED: ' LICEMSE WI ABER: I'Vey -~z2~ E II' DATE: Z va 0cn0 3- o tv c ? 3 ~ co~ 7! C T CD O ai O O C OJ N `C 7 N a N Q hl • (D (D H 00 v R M O NO O 50 - C I i ~ RR 1 N O O El co b ~Oy 3 N O mN =r N o A N a ° O D m a c o o N O co co O (DOD co N O CO) p OD = 3 Q • a Z c II O O O 0 =3 CA CA CA cp~ ty m ~ ~ ~ o Cc CD m rn g 3 ~ y 3 CD I - c z z = D D O 'o I i C I CD c CD G7 7 p z W I N I ~ ~ A G I C/) -4 w T m co a z C 3 a °o 3 ~ N z (D A O O d O ;w ca CD O N c oZ CL CD ~ O N N CL O O V) 26 a I ~ I b o I ~ o- O I ~ O w 1 N N CT O G_ A ti N ~a 69 O ~ O~ p ~ O yb o ~ 'v y Parcel 020-1171-40-000 12/13/2004 04:04 PM PAGE 1 OF 1 Alt. Parcel M 7.29.19.1069 020 - TOWN OF HUDSON Current ❑X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner JAMES E & DEBRA K MCPHETRES * MCPHETRES, JAMES E & DEBRA K 340 EDGEWOOD DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 340 EDGEWOOD DR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 1.190 Plat: 1932-EDGEWOOD ESTATES III SEC 7 T29N R1 9W LOTS 108 & 109 EDGEWOOD Block/Condo Bldg: LOT 108 ESTATES III Tract(s): (Sec-Twn-Rng 401/4 1601/4) 07-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 06/03/2002 680543 1902/181 WD 11/19/2001 662467 1765/508 TI 07/23/1997 807/208 04/26/1988 436625 808/635 WD 2004 SUMMARY Bill M Fair Market Value: Assessed with: 49110 307,000 Valuations: Last Changed: 10/29/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.190 29,500 208,000 237,500 NO Totals for 2004: General Property 1.190 29,500 208,000 237,500 Woodland 0.000 0 0 Totals for 2003: General Property 1.190 29,500 208,000 237,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 218 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 SAFETY & BUILDINGS DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR DIVISION ,LABOR%i HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS BUREAU OF PLUMBING P.O. BOX 7969 MADISON, W 153707 State Plan I.D. Number: SE~,NW1,S7,T29N-R19W UCONVENTIONAL DALTERNATIVE plasslgneal Town of Hudson D Holding Tank D In-Ground Pressure ❑ Mound Lot 10 - 09 Edgewood Estate III INSPECTION DATE'. NA -PERMIT HO DER: ADDRESS OF PERMIT HOLDER: B & H De el0Pment 910 St. Croix Hudson WI 54016 REF. PT. ELEV.: CST REf. PT ELEV. BENCH MARK IPer ent reference po,ntI DESCRIBE IF DIFFERENT FROM PLAN: W No. : County Sanitary Permit Number: Name of Plumber. MP/MPRS St. Croix 102867 William Schumaker 6382 SEPTIC TANK/HOLDING TANK: PROVIDED' MANUFACTURER. LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.. PROVIIDEDLABEL LOCKING COV DYES ❑NO DYES ONO HIGH WATER ROAD: PROPERTY WELL: BUILDING. (VENT TO F RESH BEDDING: VENT DIA.. VENT MATL.: NUMBER OF LINE. AIR INLET ALARM FEET FROM DYES DNO DYES ONO NEAREST DOSING CHAMBER: PUMP/S IPHON MANUFACTURER WARNING LABEL LOCKING COVER FIER BEDDING'. LIQUID CAPACITY PUMP MODEL pq OVIDED'. PROVIDED MANUfACTU D YES ❑ NO DYES ❑NO DYES ❑NO RESH PUMP AND CONTROLS OPERATIONAL. NUMBER OF PROPERTY WELL BUILDING AIR INLET GALLONS PER CYCLE: LINE (DIFFERENCE BETWEEN FEET FROM PUMP ON AND OFF) DYES ❑NO NEAREST LENGTH. DIAMETER MATE FRAIL AND MARKING SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: INSIDE CIA S PITS fA HLENGTH NOOF DISTRPIPE SPACING COVER PTH WIDT BED/TRENCH TRENCHEMATERIAL: PIT DIMENSIONS PR AVE L DEPTH FILL DPTH UISTH DISTR OPERTY WELL BUILDING T TO FRESH GREPIPE PIPE NO DISTR. NUM BER OF LINE INLET FROM BELOW PIPES ABOVE COVER. ELEV. INLET ELEV. END. PIPES FEET NEAEST R MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. DYES DNO P ERMANEN T MARKERS OBSEH V A T I ON WE LLS SOIL COVER TE x7URE DYES ❑NO DYES ONO SMULCREO DEPTH OVER TRENC H!BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED CENTER EDGESDYES DYES ❑N0 ❑NO PRESSURIZED DISTRIBUTION SYSTEM: FILL DEPTH ABOVE covEH jT0. -OF WIDTH LENGTH TRENCH ES LATERAL SPACING GRAVEL DEPTH BELOW PIPE. BED/TRENCH DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL NO DISTH DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEV.. CIA. ELEV.. PIPES CIA: ELEV. ELEVATION AND DISTRIBUTION COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY PLANS DYES DNO DYES ONO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS PROPERTY WELL BUILDING : NUMBE R OF LINE'. FEET FROM DYES ENO DYES ❑NO NEAR EST- Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE. TITLE + Zoning Administrator DILHR SBD 6710 (R. 01/82) SANITARY PERMIT APPLICATION COUNTY (~)DILHR In accord with ILHR 83.05, Wis. Adm. Code 5T STATE SANITARY PERMIT l0.1-) 001 69 -Attach complete plans (to the county copy only) for the system, on paper not less than STATE PLAN I.D. NUMBER 8'/z x 11 inches in size. -See reverse side for instructions for completing this application. rF TITION 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. R V ARIANCE 1:1 YES ~~j' [ NO PROPERTY OWNER PROPERTY LOCATION '/a ,41k)'/4, S 7 Ta 17, N, R /,P' E (or PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME .57 1"e' 54 /or -/~y z vva s T TY, STATE / ZIP CODE PHONE NUMBER 77 CITY : NEAREST ROAD, LAKE OR LANDMARK W S 01~ ~I S O VILLAGE : TOWN OF7 II. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family OR ❑ Public (Specify): 111. PURPOSE OF APPLICATION: (Check only one in ##1. Check 2,3 or 4, if applicable) 1. a. N New b. ❑ Replacement c. ❑ Replacement of d. ❑ Reconnection of e. E1 Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in ##1 and only one in ##2) 1. a. 91 Conventional b. ❑ Alternative C. ❑ Experimental 2. a. ❑ System- b. ❑ Holding C. ❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. Seepage Bed b. ❑ seepage Trench c. ❑ Seepage Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): ~l - ` d Feet Private ❑ Joint ❑ Public VI. TANK CAPACITY Site in allons Total of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New xisting Gallons Tanks Concrete structed glass App. Tanks Tanks Septic Tank or Holdin Tank o o* / - ::P- Lift Pump Tank/Si hon Chamber ❑ ❑ ❑ 79- V1111. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name (Print):// Plumber's Signature: (No Stamps) P PRSW No.: Business Phone Number: i Q G R t .t / Plumber's Address (Street, City, State, Zip Code): Name of Designer: VIII. SOIL TEST INFORMATION Certified Soil Tester (CST) Name CST e t7 ST's ADDRE Stre , City, State, Zip Code) Phone Number: IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater Date Issuing Agent Signature (No Stamps) 17 Approved Sffcharge Fee ❑ Owner Given Initial / ~ , l y~ - / L ~„Yv Adverse Determination L~ FLU coi X. COMMENTS/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber J INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION r , TO THE APPLICANT: 1. This 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. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 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. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years; 6. If you have questions concerning your private sewage system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 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 where the system is to be installed; II. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in ##1. Complete $#2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. 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. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8'/2 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; dosing or pumping chambers; 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. GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was the ? result of over 2 years of steady negotiation and public debate. The groundwater bill Groundwater included the creation of surcharges (tees) for a number of regulated practices which Wiscoritsin's can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried treasure is used in your building is returned to the groundwater through your soil absorption system or the disposal site used by your holding tank pumper. The monies collected throug , these surcharges are credited to the groundwater fund adminis- tered by ?he Department of Natural Resources. These funds are used for monitoring ground.- f , abater, groundwater contamination investigations and establishment of standards. Groundwatr=r, it's worth protecting. S S D-6398 1 R.03186) t APPLICATION FOR SANITARY P4liMIT STC - 100 This application forty is to be completed in full and signed by the owner(s) of the. property bring 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 title office with the appropriate deed recording.. - - - - - - - - - - - T - _ - - - - - - - - - - - - - - - - - - - - - - - - - - owner of Property Location of Property, .,(d k,. Section T ~7y N - R W Tuwe►ship ~J41-<6/v Ma 11 Lng Address wowI'ZA)4dd ri 64,, !>I~SoN S O/d w ir- - .--.-T-•--~ i _ 1 Subdivision Name 1.1?L(1,odc1 ~S t~eS Lut Number /D~l Previous Owner of Property Z49Zq &A1f~ Total Size of Parcel ~aCfe -f DaLe Parcel was Created ae lZer Are all corners and lot lines identifiable? ~C Yes No is Lille; property being developed for resale (spec house) 7 __,yZ__• Yes No vulwne and Page Number _ZV9. as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 1. Land Contract . 3. Other recordings filed with the Register of Deeds Office In addition, a certified survey, if available, would be helpful so as to avoid delays of Lhe reviewing process. If the deed description references to a Certified Survey map, the the Certified Survey Hap shall also be required. PROPERTY OWNER CERTIFICATION 1 (We) cen+ti.6y tJua,t aU etatemvaA on thjA. 604m ane true to the but o6 my (uuA) 0iowtedge; VL a t I (we) am lane) the owner (b i 06 the pnopen,ty dee en ibed in th4A c►►6u.,unation 6onm, by viAtue o6 a waauinty deed neconded in the.066ice o6 Vie Cuwity RegiAteA o6 Deede ae Document No. .1,9, aQ ; and that I (we) pa"e►►.tty own the.pnopoeed A to Jon the ee"ge poea ~6yeteM (on 1 (we) have ubta.ined an eabement, to nun With the above de cAi.bed p)LopeAty, 6o4 the eaiotAueti.an 06 said 6yatem, and the came hab been duly recorded in the 066.ice u6 the County Regi4ten o6 Deedd, ae Document No. 39aVan ) SIGNATURE OF CO-OWNER (IF APPLICABLE) SlCNA''U1tE OF OWNER T1 DATE SIGNED ~ DATE SiGNI?D L . Iti'1'. ~•~-~'l.r~r~•~.. ~ i •*ti. Est i h t .R~w~ ry 'f wr. ..rtes cantor VON aseMawe soft •s•w a. _r RN~~~ i47TPI' 4• •.r. t t " L Her '4 ••r t• '~~.♦♦wr ~ •r • 40 Remus offick t 1 i II ills Cam CCU., "M coo" _11th a<:'• t' ~~~~y~ 1 Rata for Reaxd Oft day of crii A.o. 194 1100 A , M. 5... " PlmehMe". % bow Mr ee awes). veaie aeA.' elel.e t . /aFtlarm to IN.,Iraa~ If" w P"N" MA Itis «lt- >btra~rtN ~1f 9 w somba p"Mor wseder with the 41Me~ra~r ii111eewMs (et1 etMsi the "rawer). _ bs..... OMM06 stew et wheettda d asruas .rGiIAH KD(~ i Pp~t sy of Mi~tt>r> rfeQ,Igt 70` R R19M, EXCEPT the P. 321 W1 54016 South go" A111 that part of the °Szk of Ugh of Section 12, Tan Fared Ma T29M, RWO Iy XaSberly of State Trunk Higt~il~hlY: So•uth 32 rods thereof, and -1 ~ lying Southerly and Masterly. 0MtM"z*rly*, right-of-nay line SOi.TSC? easawnt tos ingress and egress over a portion of the or.: Uft:-'cf- Section 12-29-20, Town of Hudson, more fully described "'42ame"' Cawmwo uq at the East quarter-oorner of said Section 121 VIONWO, M900000'0014M 1,332.81 feet to the Ely right-of-way of B.? H. '3S"t-''WM~e ,1014s37r2a'49 637.14 feet along said Ely right-of-way of S.T.H. •3$i tp,, tAt• Nly.' lens of the property deeded to Arthur F. windolff and Xmry;Ann' Mindkollff, as recorded in Vol. 519, page 25, Doc. No. 325163 in-this-09fice of the St. Croix County Register of Deeds, being •n, fie _ axft_...:, r DESC11UP'>!, ION1 COUTINUED ON ADDENDU" list rfi oat. ` dIMC}Inn-+ twit wthaes as Pn/ereV MW M pap to Vttsder at Vendor' fit residence or bar uri.tten ' E1 a no of i. h the following Mainers (a) s. ~.Q PY'~.. at the execution of this Cetdtraet; MW (b) Uw balanee of tli.84095.QQ'..........."'~..:. together with intor"t from data ba r04 atil pelt is .as floe cote et.LaeJJl.dlA.i1....................... a per ant per annum fir W1 installments of $10,000.00 each, plus accrued interest, on or before the first and second anniversaries of this Oontract, and the entire balance, plus accrued interest, on or before the third anniversary of this (contract. See attached ACCENDUM for provisions for release of lots and application of payment thereto. Estimated Peal Estate Taxes for 1984, payable in 1985, have been prorated at closing; Purchaser shall thus pay the entire 1984 Taxes and subsequent years as due. Provided, however, the entire outstanding balance shall be paid in full on or before the 23rd day of F'P1X%bMY • 1987.... ( the maturity date). Full-ing any default in payment, interest shr!l accrue at the rate of ...W.. % per atuwm un the entire amount in dvfuult twh.ch shall include, without limitation, delinquent intetcat and, upon acceleration or maturity, the entire p,-rnu{,.il balaneel• Purci.aser, apamem agrees to pay ~annual taxes, special asesasments, fire and required insurance premiums when due. - and furnish copies of r+eoeipts on Vendor's written request. Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any -linour.t m.y be prepaid without premium or tee upon principal at any time In the event of any prepayment, this contract shall not be treated a+ in default with respect to payment so long the .u,psid balance of principal, and interest land in suct case accruing Interest frorn month to month inall lw treatea u .ntnn+d prmcii,all ►s Ins than the amount that said indebtedness would have been had the monthly payments been !+de as ^r.t specified al.ove; prodded that monthly paynwrits shall be continued in the event of credit of any proceeds n•!:rat.c.• or condemt!,tion• the condemned promisee being thereafter excluded herefrom. I'us,I,,.er +rrteilhat l',Irchwer is satisfied with the t.tte as shown by the title evidence subm;tted to Purchaser f,,r -,n. t,atl,.n exrept: Within six (6) months ht:toafter, Vendor shrill record 3 CkTtlfied tx71ry ,f t1rl.:.dth t;e rt i f lc atj_- of Wi 11 i<vn F. hlrlrty, and release of intr. ritance tax I iens in of th- EaAtt- rIf Wi 11 i.tm F'. Kirty, to tho satisfaction of Purchaser's attortxy. t, t t., • . •,f • rent n ;.~.r I•t.. I` titr r~`I•, . :a tt - r•.t :it, r0 .,rt, !t rl'al: • , 1". rt..l .L• r , t 1.• r p.r I. ilt~ i1tt ..1 1' 111•. n• • fP ! 1'•t` trY~ 1 s Atrsbaasr M pnI w~st1,i. . - I=~. ,►•t' f• ~ tls , , r K ..A dlllw bt .w. . pwdmwor d" how do me" eaverep Jawk and Vendor, to eta 4 tv. tha ww dkb aom§b 1M 01111101111111`4 tenter ~g tlsltlr Of an olwas at .neritts nflsll be be cep 11s, w et dle MNrq ne.V.d • - t eewwM.W feasible, b we > q t to be awwamd 40 ft i-- IOM retWMs% spsr ` D swept w" all I"% adlsasas as>1 aflrstls/ (y reposRP. I10 ptiMa W" Ibloeat sold setae witty 40 r vesdsr sews q)at r no the stag be tuft psrlermw si its tiw = la /M ussser shoos MPMMA VeVsr M the Purchaser, a Naerasy D84 r to sslkW% d do arty, free ash snot ar 1fw~~ ~b yt e,,, K d and @woPt ~ any lines or rsen~ents• as stitiaoE; d; tar:'Ri w gii :aio~le!!'Si::tlr ';fa!Sot+. ~Purehassir agsess.tfta Ones, is of • ad.(a)+fs tls crest d a dsbult r Ibs>►sParsslt tit g■P tlg~Mr Internet wbkb Manatees bra /cried of MPs tmewlas the "WifM dos &%a Alf ib,iM w.."411s deft* Is e soon terlnrrataaee of any etbei d1lih a~lon of tureheser which aontbwr for arW d.+~.i.. ditsi ewNrara M=W Y eMroef by Vendor (delivered personally w trnetilsd b eertified avail). tbsa the esAlweoarfaMlefas shall bosoms immediately due and payable In fog, at Vendor's option tad witbwt awtice ( Ptarebsee b waives), and Vender shelf also have the following rights and remedies (sntbiJect is any MsiMAisaa prorYsd addition to those ~-_d, by bra, er in equity: (1) Vendor may. at his dye, torsaisate Ws Csaaeoet end MosMsw~s vent al) sAN1' d riot" title wed Q;Z b tM Property and recover the Proper" Mic tln+sdt mum sr with htwMSt elisr+en from redemption to he conditioned apes Purchaser's full payment *(the entire tspreviwty tW date of default at the rate is effect on such datetadothsranwwtedi whiebel Mussels paid by Parehsor shag be ferefeited v Ilgnitlated damage* for fagare 11 faltli bdarts Contrast and • rental for the Property It purchaser tails to rodeem) ; or 00 Vendor may some for specific performance of ebb Csub vmt to eempsl imawdlato and fall payment of the entire outstanding below. with interest thereon at the rate is deed an as deb at default and otter amounts due hereunder, in which event the Property ahall be aoetiond at Judield nab anal Purebwr shall be liable for any deckle acy; or (iii) Vendor may sue at law for the entire unpaid pure"se prk+e or may thereof; or (IT) vendor may declare -this Contract at an ead and remove this Coutrootasadead M Win is a action it the "pit" interest of Purchaser Is Insignificant; and (v) Vender may have Purcba r I* W from posewia► of the Proand bare a receiver s~~ ted to collect say rents, issues or profits during the partMri" of any action, under 1). (Ii or (iv► above. Netwitlutaading any oral or written statements or active of Vender an eMetion of any of the foregoing rtmedbs shag only be binding upon Vendor if and when Variant, in litigatlea amd air casts and ompansee Including ress finable e-WW 'rt tw of Vendorrlmcurred to onto rceany remedy betemder (whdber absbd or not) to the extent not prohibited by law and expatsm of title evidence shall be added to pri"ipal and,.paH by Purchaser, as ia- currod. sad shag be bieJudW to any Judgment. Upon the wnenomwtt or during the peadenc • of suet action of foreclosure of Slide- Dwant*. lead oer leonseate to 00 the propperty bring the a Involves pof the Propert o sea aeion, andusuet ream issues. and pre toe' Mis~esueiebd sw be MM "d applied as the court *hall direct. Purchaser shall net transfer. sell or convey any legal or Nuitable interest is the Property (by assigament of any e m of Hrebasor's rights under " Contract or by option. long-term lea" or Ee •wt • come=& of Vonder umh=,rtltsr lbs ootstsndis~ balsme* lay * conveyed is a pledge or mien me It of Purchaser'. intrr7llt under this Contract sole)i as aceurit> for an indebtedness of e Purchaser. In the ewant of any such transfer, sale or convey anet without Vendors written consent. the entire outstanding Of balance payable under 64 Contract shall become Immediatelydue and payable in Mr at Venders optba without notice. e 'it , shva l ma;i* 43 pavtrcrte as•:n out under ww nt:.r'trair a'=-s'-axn!aiB sl = °Mlfe-.7 on !ho dst.+ of this Contract (except for say mortgage granted by Purchaser) or under any nets secured tboreby. provided Purchaser melees timely PA t of tie amounts then due under thin C,ontrart. f'urehaasr asap anakst say even ~oyaento directly to the Nortimm tt Vendor falls, to de w and all tray mentF eo made by Purchaser eball be cnusidetwl ;a;m ruts made on this Contract. Vendor may waive any default without waiving any other *uba nuent or prior default of Purchaser. All terns of this Contract shall be bbdimg upon and inure to tlw bemsflto of the beirs legal ropr+ taeiw• succomers and aosips of Vendor and Purchaser. (If not an owner of the PropsrtP the spouoe efr Veedsr Ter a ratable em elderstien Jobs beeirin to release homestead rights in the cobject Property and agrees to join Is the eseestion of the deed to be made to f loah ent Itereof•1 hated thla 23rd day of Febnj IY Ice 64 B. b IY:'VMnPMW, IIVC. (PurCtlaser) lw~.(... rt. !1 ~t~ Lr- (SEAL) BY: G/ (SEAL) Anita P. Marty (Vendor) d 8 . President (SEAL) And: ~~'•A;• I William C. HarMll. Secrre 'a `s J AUTHXNTICATION ACSNOWLIifD01L1iN 0 Signaturets) of Anita P. Marty, a sirmlle STATE OF WISCONSIN 2 N wOttt2!nr _ _ ST. CROIX Count,. ~ '•relve suthruZicrttd this 231d day of rY. , 1884 I'eraontJly came Wfurr me this 2 day of TU31 awned l :b 1984 the above, sal y ol:rtstad, DonaldE V:;esidertt, ana . ; ~ ' : . B j • . . Robert F. Wall William C. liatwe~l, ..t they itilxi vli~wl . TITi.F:• 141F: IFa( STATE BAR OF tt IS OSIN Corporation, hdz:XW=l . exc .vted chi"s' ihi taatent As iikh' of'f~~'iyycers :wt~•77n:7J hV r 1OI..u7:, Wks. tIAH.) of la Mr- gtioN its llMverutlA~theand 177 mr Hawn e f,lr~,tni ~•~1y1,1umtly anM ta'kAtil~ thqf *ent• •'7 N1•. 1•N 1111 1 II % tan 111:on .1. Gillt,rt, At t t . inillialn J. Jbcrt (;ii1,l:Kl•, ,%nax"E b ivi?3^:I' Croix RCi.. aloe: Pnhi;r • Counts. , ` P.V. 14,)x 321, IIu7L:7•tl Wl 3 et, A,.,•7:t !..1 I,r7•ah•h7v1 1174! M% 1'77tnnu•rion 1+ ;7ent.+.r;1- I' 7 J. GAM N 3:3'. t'~ ~ppt 1 NUN= . :!r!e o` Ill. 1. hey Cosr.us;.xn 1 a If7 1 is Perrnanenr 1 ~••h 7 n~ I~An deal U• 1 N.•r•w.lw, r•.~ N•. 11- Iq: _ ■ - W,14 Page a CONTINOATION OF PROPERTY DRSCRIPTIONn the Ply line of the loath 32 rods of said Rik of Nth of /eetim W29-208 tbence M9000010002 along said Nly line.of said Mindolff'prppesl- ibr 249.69 feet to the oenterline and Point of •eginning of I&WA id tma aide easement, being described along said centerline as folloves thence M12.55000OW 199.43 feeti Views Neely on a curve concave to the M. having a radius of 99.45 feet, whose chord bears U4600S'00ON 108.12 fish thence N790151200W 111.S0 feet, more or less, to the Xly right-mot-40Y of B.T.M. 035" and the Point of Termination of said eesesient. (For ,the ~lYrpONa of'this description, all bearings sire referenced to the ]tatAftst quarter-section line of Section 12-29-20, assumed N90.001000N). SUBJECT TO recorded easements for e.ectric and telephone lines..' SUBDIVISION AND.RELEASE Or LOTS: Vendor agrees that Purchaser may subdivide said Property, with all oosts associated therewith to be paid by Purchaser, and that Vendor will join in execution of any plat(s), certified survey map(s) and other instruments necessary.for such subdivision, except that Vendor's interest shall not be subordinated to any indebtedness incurred by Purchaser.. Purchaser may develop, improve and sell subdivided.lot*#`-,rith or without buildings being constructed thereon by Purchaser. Vendor agraw to release such lots upon sale thereof by Purchaser, by Vendor's OeScution of Warranty Deeds thereto to Purchaser; Purchaser shall prepare and fur- nish at Purchaser's expense all such Warranty Deeds and the associated Real Estate Transfer Returns, except the ! Return conveying the remaining part of said Property wfiLch shall be at Vendor's expense. -Upon such release and conveyanos,olf,i+-°the value of each released lot shall, for calculation of the trassKt3r'-:use, be dote.-A:«ed by rounding off the acreage of the let(s) released to he :eeerest even number and multiplying same by $1,500.00 per aerei the transfer fee shall be paid by Vendor. Upon conveyance of the remaining part of.said Property, the balance of the transfer fee not paid upon lot releases shall then be paid by Vendor regardless of the acreage of such remaining,part. Upon Vendor's release of lot(s) as aforesaid,,.Purcbaser shall have paid or shall then pay to Vendor an amount equal to 500 of the selling price paid to Purchaser for such lot(s) released; provided, however,.that the $10,000.00 annual payments due on the first and second anniversaries-of this Contract shall be deemed advance payment toward such release-payments, thus entitling Purchasers to release of lot(s) for sales up to $20,000,00 for each such annual payment, and Purchaser shall be obligated only.to pay 501 of the selling prices that exceeds $20,000.00 aggregate with respect to such credit for each annual payment. All payments received shall be,applied first to interest and then to principal. The $10,000.00 down payment paid at the execution of this Contract shall not be applied to any release of lots, .but instead shall be deemed to be advance payment toward Vendor's release and joinder in the dedication of public roads and of any parkland or similar areas which Purchaser may be required to dedicate pursuant to the subdivision of said Property. It is the belief of the parties that such $10,000.00 down payment, applied to release and dedication of lands,to the Town of Iludson for public use, is exempt from real estate transfer tee pursuant to Sec. 77.25(2), Wis. Stats., and that transfer fees will thus be due only upon $84,395.00, to be paid by Vendor as provided above. i Nothwithstanding the aforsaid method of calculatiaq the amosat to be paid to Vendor for release of lots, rurchaser shall be obligated to pry such additional amount, if any, for lot releases to assure that the remaiaing acreage not theretofore released as lots or dedicated to the public, it multiplied by $1,500.00 per acre, does not wwood the remaiuiaq balance due under this Contract. The foregoing provisions shall be deemed to modify any conflicting term this contract which prohibits or restricts transfer or conveyance of aid Property, to the extent necessary to give lull force and effect to the foregoing provisions. ~4\ V L ' cn • y S T C ~ 10 r r SEPTIC TANK 014INT9NA CE AGREEMENT o St. Croix 940~y c i UWNEk/BUYEk 1,LY Z m ROUTE/BOX NUMBEit Gcla fi✓ ___Fire Number CITY/STATE /~1wO0N PkUPERTY LUCATION: J NAI 1:. Section___?__, T_-,q N, P Town of Zt'-sod St. Croix COU11ty, SubdiYlSloo ~~ould~~ G fi-Pf; Lot uumbe rZa:- J 1 Improper use,and maintonance of your septic System could result in its premature failure to handle wastes. Proper u►aic►tenance cun- sibtb ut pumping out the septic tank every thrvv yvira or bouner, I Lt needed, by a licensed sceptic tank 2uaMer. W11JL you put into the system can affect the function o'f- GJwe septic tank as a tr.vat- went stage in the waste disposal system. St. Croix County residents mu be eligible to receive a grant for a w.,ximum of 60% of the cost of replacement of a failing System. which was in operation pr"c -..-St. Croix County 7.z y occepted this program in August of 1980, with the requirewent that owners of all new systems agree to keep their systems properly maintained. r------ - The property owner agrees to eubatit to St. Croix Cuuuty Zoning a certification form, signed by Lite owner and by a muster plumber. journeyman plumber, restricted plumber or a licensed pumper veri- tying that (1) the on-pits wastewater disposal system is in proper operating condition and (2) after inspection and pumping (it 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 E I/WE, the undersigned, have read the above requirements and agree N to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Depart- 'v ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Offi.re within 30 days of the three year expiration date. SIGNED (Jf1~I DATE Z-8 St. Croix County Zoning Office P.O. Box - 98 Hammond, WI 54015 715-796-2239 or 715-425-6363 Sign, date and return to above address. SAFETY & BUILD DEPARTMENT OF REPORT ON SOIL BORINGS AND DIVIS INDUSTRY, c HUMAN REDLATIONS PERCOLATION TESTS `115) MADISOP.O. BOX N W 5370 (H63.09(1) & Chapter 145.045) LOCATION: SECTION: W ONSIIIP MUNICIPALITY: OT NO.:BLK. NO.: SUBDIVISION NAME: IS sE yW~/ TZQ N/R/4 (or a~.:•q ,o~.leg - C~c~r %AJO , . IS 0 COUNTY: OWNER' UY R'S NAME: MAILING ADDR SS: JTCQOt~' t/) DE L6AMENT INC. 910 Sr Cle0l), ST "kTN M) USE _ DATES OBSERVATIONS MADE NO. B P : COMM AL DESCRIPTION: POFILE DESCRIPTIONS: PERCOLATION TESTS: R Residence ()Aj ~3JNew ❑Replace MAkcri 14 19V MARC41 / SOILS dK A61Er L< >•+~1° lhCR`~ JS~'JELtrrrr !RATING: S- Site suitable for system U- Site unsuitable for system ,E ZU ;CONY N' AL: MOUND: IN-G - - TE -IN-FILL OLDING TA K:RECOMMENDED SYSTEM optional) oN S _ S ❑U ❑ S E] S U CowvrAjr/oj t AL, gel, c11 Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the junder s.H63.09(5) (1)), indicate: e,LA-s I Floodplain, indicate Floodplain elevation: A PROFILE DESCRIPTIONS ,BORING TOTAL EPTH T GR UNDWATER-INCHES C ARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTHI, ELEVATION OBSERVED EST. HE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- /~"gLITS IZ" ~R~ SL 17" {3RN~.s fGa r!OBCQm 1r•S n 96.-17 ~o/V€ S ~~•7~ 1A`1 (LI> M; CIO ~Lr1~.~'-r`i M t.r KD ~AN-1~ 7"$c ITS 17"UNStIL /4"IERNSL 466 SI` le&9k1/ S x 6- Z 9 33 9704 Na,,t e 1> 9. 3 ~ Irv it4'C66, r eN MS W r, S INCLUSIONS 4 `6LLTs lS" BQN6Y Si L /4' &N 'SL B- J 0.0% 9 S .21 NOnf~ 7 /6,01 Isy Q~7 -M S W <,e f C•~ b a ~13- 4 S-67 4'9 .69 A113 NC~ 67 b"6c.LT`:. /4"Rer.r6Y`,,L `iW'k4V MSIrtlie -cal, 13'/6*rg6ySrL /8' Rem ~L B- PERCOLATION S x,33 o.~G No 8"1 e- 1 > 8 33 -S" ~'-M s eSC 57 Co 6 s B- l c TESTS { TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RAT MINUTES NUMBER IAW#E6 AFTERS WELLING INTERVAL-MIN. PERIOD 1 P.ERI PER INCH P- J S. 9 Nth 98•$i _ / 0.0 P- Z .0a o 94.00 30 ' g 1' 67 , P- 3 5 47 4@-4 36 Z Z .0 E P- ?LOT 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. Sho the surface elevation at all borings and the direction and percent of land slope. 6NCKM ARIL SYSTEM ELEVATION -93.00 / ♦ P-3 LnT X06 Local*rbv S+t[TCNES / ~RIMIIA.y ' 4IU ~EJtd~tt: A ~z I x r i 4 Lo-r 107 N t-3 60 t N I ( i aT Lr~lt: sCALi -criA p J1F I = zo r 143.?I TO - - - ' P- I E~6Ewoo~ ~QryE i, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures an 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: ADDR SS: ~ 1 CERTIFICATION NUMBER: LHONE NUMBER (optional): 40-7 ~cs~4N S hluDCOr~1 ~ s4o 4~4 ~G-4okc} CST 1 TURE: DISTRIBUTION: `~Otnpnal amI tine copy to I ocal Autittitity, f'top,!tly Owner and ;roil Testes. nrl~.___n.r,:~gr, It, n?rn,~i 0\14711 IN I ^ N ^ N' C tA (p W , ' .&co ao a O s n' "i, °c4~~ Z y f d nq p VRS, do ~ a~ _ 0S' y O N 134. 19' S 01 25'41'W Z A m ~w n I I Cw 330.20' 5 01 25' 41"W ur+ fV~ ~ I 143.21' W S 01 25' di "N ~ . v I la 10 1 1 to Ila p U 1= r ~ o ~ IM ° I I i 143.21' QQ I - s 01 25.41'w 03 25 t1 W 203.21' 110.00' t I 318.21', Iv a~ t . ~ ~ ~ 6 O ~ I I y I ' 2~2 ,202, E 5 4S 0 I 1 to o } \ 12 38- I o w W ti w f ~ I ,:r t`y -R ~GtlGef~ i r-66~ ~70-C~)elojol?7 -tir f5 J~el a' i j 67 /0 6,-e Toss s e~~ 1 w i G r ~JS. G 'tea w