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HomeMy WebLinkAbout026-1001-50-100 § 0 Q ¢ c 2 � c Lo Cc 0-2 $ n } �z § . A /k � $ Jt \ . k\ � * §f 2 n E2 zaEa § SEW 0 k ] ƒm < == 0 � � \ B 2 0 � z 2 / % : a ■ § § z k 2 \ • t U) k 7 E { N . \ ) 2 ) -� a. ƒ t Q } cok \ . z \ 7 7 � . � ƒ : 3 E � ■ § � § 0 k IL ) % Z } / k k )} j o 0 0 0 ) - k ; E a a a \ IL ; 0) 0)2 j � § § E 2 � f § § a 2 � ® ® _ ° E � 7 � \ 2 ' = 02 J ƒ / § % f § g E \ C) c SIE � § / 0 o � bk kk § - a 2 2 ® § 3 ƒ : I ] 0 z / k \ � ® � 2 % § ( 0 CL � co E ) $ B co� J v a 0 v � DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR AFETY&BUILDINGS LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.OtBOX 7969 UREAU OF PLUMBING MADISON,Vyl 53707 SW, NW, 1, 30, 18W iiCONVENTIONAL E]ALTERNATIVE State Plan I.D.Number: Elf assigned) Town of Richmond El Holding Tank El In-Ground Pressure El Mound NA A. NAME OF PERMIT HOLDER: DDRESS OF PERMIT HOLDER: INSPECT( N T A Mark Emerson Rt. 1, New Richmond, WI 54017 11/2/89 16:30 Hrs. BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN. REF.PT.ELEV.: CST REF.PT.ELEV.. Same as CST Top of SE lot corner stake. 100.00' 100.00' Name of Plumber: PMPRSW No C . Sanitary Permit Number: Calvin Powers Jr. RS 1563 St. Croix 128665 SEPTIC TANK/H � I�: MANUFACTURER: LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: Powers Concrete Products (PCP) 1000 gal 101.31' 100.96' AYES ONO ❑YES )1NO BEDDING: VENT DIA.: VENT MATT HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH Yi ALARM FEET FROM. LINE , 1 AIR INLET. 1 4 CI NA 47 2/ 26 NA ❑YES NO DYES ❑NO NEAREST DOSING CHAMBER: MANUFACTURER BEDDING: IL1111111)CAPACITY PUMP MODEL jP11"P,SIPII1IN MANIII ACTIIREH WARN ING LABEL LOCKING COVER PROVIDED: PROVIDED. ❑YES ❑NO ❑YES ❑NO []YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUN#BI=R 4'F PNOPEHiY WELL BUILDING VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) ❑YES ❑NO NEAREST—10 SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing F Ncitl( IDIAMI TEII 110ATI HIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease until FORCE the soil is dry enough to continue.) MAIN'' CONVENTIONAL SYSTEM: System Elevation 99.00' ED/ WIDTH LENGTH NO OF lIISiN PIP( SPACIN(V COVEN '.INSIDE OIA -PITS LIQUID THENCHFS MATERIAL' DEPTH tfW1ItS�tONS . , 12' 105' NA 6.0' Syntheti . PIT NA NA NA GRAVEL DEPTH FILL DEPTH DI STII PIPF UISTH PIPE DISTR PIPE MATERIAL NO DISTR -NUMB R,t3F PROPERTY WELL BUILDING: VENT TO FRESH BELOW PIPES ABOVE COVER EIFV INLFI ELEV LNU PIPES LINE AIRINL T: 0.82' 2.80' 100.26 100.16' ASTM 2729 2 FEET FROM 15' 2/ 45' S5� NEAREST MOUND SYSTEM: 3/ 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. ❑YES ONO SOIL COVER TEXTURE JPI HMANI N I M HKI IIS OBSEHVATIONWILLS 1:1 YES ❑NO _❑YES NO DEPTH OVER TRENCH BED DEPTH OVER TRENCH HEU 111PI111 TOPS()IL SODDED SEEDED MULCHED CENTER EDGES ❑YES. ❑NO ❑YES ❑NO DYES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: _ BEbI 13NCH -:WIDTH LENGTH NRENCHE& LATE HAL SPACING GRAVEL DEPTH HE LOW VIPI FILL DEPTH ABOVE COVER XMENS1010s, k MANIFOLD PUMP MANIFOLD DISTR.PIPE M UISTH ID ISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING 'ELEV.. ELEV. DIA. ELEV. PIPES DIA E'LEVATtEN ANO t I jk k ION HOLE SIZE HOLE SPACING DRILLED COHHECI LY N FID COVER MATERIAL VERTICAL LIF T CORRESPONDS TO APPROVED 'INFORII� PLANS DYES ❑NO DYES El NO COMMENTS. PERMANENT MARKERS: OBSERVATION WELLS. NUMStWOF PROPERTY WELL: BUILDING: ❑YES 1:1 NO ❑YES El NO NEAREST Notes: 1/ Septic tank sides backfilled. Could not inspect bedding. 2/ Well not yet installed. Well must be >_ 25' from the septic tank and: 50' from absorption field. 3/ Instructed plumber to install second vent pipe at NE system corner because of the central manifold used and distribution pipe gradient both north and south. Sketch System on Retain in county file for audit. Reverse Side. SIG AT E. TITLE: DILHR SBD 6710(R.01/82) 1F1P_%v41r_- Sew4W_ IPNStnt rANT 1 f } 1 � n i 3_�p t -1 AP YG ? Si1�1 N W 1 3P, I0 _Taw►? 0(- kct+r-wr,�� � cr vf.-JT re BE ' S�,CP-0 I Y. I+PJ T`l O l 1o3,7i , _ woo 6At,, PcP ��._ 3 •wniCi'�� seprK 14 j i Thwk I ; lop OF MaNk4c%�E I . �- ID2. 7 1 i 3 , - r 1 I h C 0 WT oup-04cP, - s?P. 4F , r t_ i Aw^^ _ _ O XI*% , ,_. O 1�V � Rr\ 1 QILHR . I Leroy_jansky P.S.C: I. 13 E. Spruce Street Chippewa Falls, W1 54729 _ (715)- 723-8786 SANITARY PERMIT APPLICATION EDILHR In accord with ILHR 83.05,Wis.Adm.Code COUNTY STATE SANITARY PERMIT# –Attach complete plans(to the county copy only)for the system,on paper not less than ❑ 8%x 11 inches in size. C k i preoviswn tor us application —See reverse side for instructions for completing this application. STATE PLAN I.D.NUMBER I. APPLICANT INFORMATION–PLEASE PRINT ALL INFORMATION. PROP TY OWNER PROPERTY LOCATION AA ew '/a '/a,S , N, R It -Ejorkp PR77OWNER'S MAILING ADDRESS LOT# BLOCK# t, r_�, "/Z. CI ,STATE ZIP CODE PHONE NUMBER SUBDIVISI N NAME OR CSM NUMBER II. TYPE OF BUILDING: (Check one) CITY NEAREST R D El Owned VILLAGE: � ❑ Public 141 or 2 Fam.Dwelling-#of bedrooms 3 AR E TAX NUMBER(S ) ` /661 7� III. 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. M New 2. ❑ Replacement 3. El Replacement of 4. ❑ Reconnection of 5.❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit## — Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 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 �t —o R EQUIRED(sq.ft.) PROPOSED(sq.ft.) (Gals/day/sq.ft.) (Min./inch) ELEVATION Feet Feet VII. TANK CAPACITY Site in aallons Total #of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass App. App Tanks Tanks structed Septic Tank or Holdin Tank ' Lift Pump Tank/Siphon Chamber VIII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation the site sewage system shown on the attached plans. MP/MPRSW No.: Business Phone is me(Pri Plu s e Number: Plumbe 's Addr6siflStreet,C' te,Zip Co IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee(includes Groundwater ate i9sued ssuing Agent Signature(No Stamps) *Approved ❑ Owner Given Initial ) Q Q Surcharge Fee) Adverse Deter ination / X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(formerly Plb-67)(R.11/88) DISTRIBUTION: Original to County,One Copy To:Safety&Buildings Division,Owner,Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: I. Property owner's nafne and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. 11. 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 3TC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. ------------------------------------------------------------------------------- Owner of property � �u^� sy, �� s C-DL/ Location of property SC's 1/4 /AJ 1/4, Section �, T-510 N-R l LW Township Mailing address _ Address of site /&f_7 f—) it « ,Urn�G+ L C/� `rye � �7 Subdivision name A) ,A Lot number Previous owner of property Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house)? Yea No Volume and Page Number as recorded with the Register of Deeds. ------------------------------------------------------------------------------- INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which Includes a DOCUMENT NUMBER, VOLUME AND PAGE NUNBZR, and the SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. ------------------------------------------------------------------------------- PROPERTY OWNER CERTIFICATION I(We) certify that all statements on this form are true to the best of my (out) knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty dyer r co ed in the Office of the County Register of Deeds as Document No. ��// ; and that I (We) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of Bald system, and the same has 'been duly recorded in the Office of the C unt Register of Deeds, as Documen o. 1 . � -•e G Signature of Owner gnature of Co-owner (If Applicable) Date of Signature Date of Signature • rR� �,.i PAGOORM THIS SPACE RESERVED FOR RECORDING DATA DOCUMENT No. STATE BAR 0 WI7CON it-1982 4,50 80 LAND CONTRACT `� Individnal and Corporate (TO BE USED FOR ALL TRANSACTIONS WHERE OVER $26,000 IS FINANCED AND IN OTHER NON-CONSUMER REGISTERS Tt°'S OFFICE ACT TRANSAOTIONS)_____ _ ST. CROIX CO., W1 Co tr et by and between __Paul 0. Swenby, Robert E. Recd for Record ` Ahlin t___Iatirn G. Pederson 89 - - -- - -- ------------------------------------------------------ AtWO1��19 ---------- ---------- -------- ------------------------------------------------------------- ("Vendor i! at whether one o mo e) a d__.. r)t,.' �__ BS,SOI)__�Xl _.J?X17..�?.g-. :4 •. ! 8:30 A. N� Emerson., and and wi e (� ------------- -- ------------------------------------------------------ j ------------------------------------------------•--------- ("Purchaser", whether one or more). ReginelOfDeede Vendor sells and agrees to convey to Purchaser, upon the prompt and full per- formance of this contract by Purchaser, the following property,together with the rents,profits,fixtures and other appurtenant interests (all called the"Property"), i� -:-- in............ ................................... County, State of Wisconsin: iRETURN TO Part of SW' of NW4 of Section 1-30-1$ Box21Y,S described as follows: Lot 2 of Certified I! NE,19 RICHMOND, �'.'ISCONSIN Survey Map filed August 22, 19$$ in Volume "7" Tax Parcel No. .026. 1001 50_1.00, .. .... .... .............. .. . Page 2014. This ........15..NOT...... homestead property. LigjL (is not) Purchaser agrees to purchase the Property and to pay to Vendor at .A9W..Ri dhPIQ the sum of $--------- �.4 sL50_0.,.QQ------------------------- in the following manner: (a) $.:_.1_f.QrJQ• ......................... at the execution of this Contract; and (b) the balance of $..._.13-15.QQ.s.Q. ...... ....... together with interest from date hereof on the balance outstanding from time to time at the rate of.ten__ 1 )______________ _____ per cent per annum until paid in full, as follows: Twenty Seven Hundred Dollars. ($2700.00) on February 15th, 1990 and annually thereafter in like sum until principal and interest are paid in full. Provided, however, the entire outstanding balance shall be paid in full on or before the-------12th......... day of 1 1 9.... ----------------- 19-_94. ( the maturity date). Following any default in payment, interest shall accrue at the rate of._ten_.% per annum on the entire amount in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance). Purchaser, unless excused by Vendor, agrees to pay monthly to Vendor amounts sufficient to pay reasonably antici- pated annual taxes, special assessments, fire and required insurance premiums when due.To the extent received by Vendor, Vendor agrees to apply payments to these obligations when due. Such amounts received by the Vendor for payment of taxes, assessments and insurance will be deposited into an escrow fund or trustee account, but shall not bear interest unless otherwise required by law. Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any amount may be prepaid without premium or fee upon principal at any time after---JulY--- st........ 19..8.9_ =X XfXeKeXXff,XeXIXoX-*)WX4 WXI[1 NXXXXW 9t'jl'X In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long as the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be treated as unpaid principal) is less than the amount that said indebtedness would have been had the monthly payments been made as first specified above; provided that monthly payments shall be continued in the event of credit of any proceeds of insurance or condemnation, the condemned premises being thereafter excluded herefrom. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except: NO EXCEPTIONS Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall be retained by Vendor until the full purchase price is paid. Purchaser shall be entitled to take possession of the Property on...........June..15.th........................ 19. 9... *Crow Out One. LAND CONTRACT—Individual and STATE BAR'0F WISCONSIN Wisconsin Legal Blank Co. Inc. Corporate FORM No. 11—1982 Milwaukee, W is. J .o.,, „ •n - n j..W—r J4&" ••u -w•s—o u,uUJU.) 11U. lunplAlput—13vHJNO3 QNV'1 •SJan11)u JIB ilaN3 Molaq paluud ao pod,1; L%I pinotls .4pLdL•J XT L' ul :tulu:fls suosaad yo sawaN. --------61 e,-6/16-Z fL--SaaTdxa :mac / /.. (Aarssa3au IOU adv f13E1 ]� 6X3 iSC7 C ;6pfiuotssturtuoo slq glog pa2palmouzl3s ao papa11uag1ns aq Arut saan3Llidls) stm.' unon --. ;-;- XT ... otlgnd Aa>;3oK ...............................T ---- __ LZO�S zsNOOS iv, QNOIdHOIh I�uN V W 1 7 ._.`1471s s-C ll V l_.._._.-----R +)Y .`0 A9 431AV214 SVM 1N3wn81.SN1 SIHl ;:l>`.18wgs aq4 -:mou l .. aao; otll,p }toaxa oqm -----•—W,:4 uosp -au: o; •. °•° CoMS •stm '90.90L § Sg paztaog4ns ` . Squa .......................0 T"d NISNoosim do uva dsdss 2I�g7 aw :arIZIs 4�- -------- ----------------------------------------- $ - u� - ,�M�uo :z2tlz ' :1itzuu ..uc5s,zaiii --:S x,zeff -----------------------------------•-------------------•------------------------ pautgu eAoge aql -W-61 '..................................--_...._ ;o Sep- stgl aut aao;aq atugo Slleuosaaa ------6T ----;o Sep-------- stgl paleotluaglnu u�s-r •SJunoo... 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'aapunaaaq anp slunom, aaglo pur Zlnr;ap ;0 alep aq1 uo 13a;;a ut 94ea aq1 Js uoaaag3 Isaaa4m gltm 'aouetsq 2utpuelslno aatlua 3111;o ZuatuSrd Itn;pug alglpatutu! laduzo3 03 loea?uoo stgl ;o aoueulao;aad of;toads ao; ans Setu aopuaA (i1) ao !(utaapaa 01 si!r; aasegmnd ;t Slaadoad aql ao; lsluaJ on pus l3raluoo stgl IIt3In; of eanlls; ao; sa2rtuup palrptnb11 6`s papa;aao; aq 1ILgs aasLgaand Sq lnrd Slsnoteaad slunou le Ilsluanag3tgmut)aapunaaaganpslunotueaaglopuualrp gans uo 13a;;a ut a1La atil ZL 11nr;ap ;o algp aq1 tuoa;uoaaagl Isaaalut gltm 'aaurlrq butpuslslno aatlua aq1 ;o ZuatuAud IIn; s,aasrgoand uodn pauoljlpuo3 aq of uotldumpat ;o SZtnba Aug g11m 9ansol3aao; pi psi g2noagl �13rq Slaadoad agl 13n033a pus Slaadoad aq1 u1 153331111 pur. 31111 `6`111213 s,aasugaand pug J3saluoo sttll alsuttuael 'uotldo stq is 'Seto aopuaA (t) :SZlnba u! to mr1,Sq papinoad 36`0111 01 u011lppL ut (mel Sq papinoad suo11sj!1UtI Sur 01 J3afgns) satpatuaa pus 6`111213 2utmo11o; aq1 0erq oslu Ilggs aopuaA pug '(sanlem Sgaiaq aasegoand gatgm) a3lJou 3noglrm pug uotldo s,aopuaA lB 'lin; ut alquArd pun anp Slavipauttut auto3aq Ilggs javaluoa stgl aapun aousleq 2utpuslslno gal;ua at14 uagl'(putu pat;!4a90 Sq pal!rtu Jo Sllruosaad pa19n113p) aopuaA Sq;0333111 oa1lo uaJta 2utollo; gAvp -- 9--;o poaad u ao; sanuluo gtm aasggand 0 ;o uo13r2ttgo 33110 Aug ;o a3ugtuao;aad ut llne;ap a;o Juana aql ut (q) ao alep anp pat;toads aql tut mollo; sAsp--•--b g- ;o potaad 8 ao; sanu1luoo gotgm Zsaaalut ao lgdtoutad Aug ;o JuaWvd aql ut Jing;ap s ;0 Juana eq1 ut (g) pug a3uassa aq1 ;o 6`t atoll Zsg1 6`333211 Jaseg3Jnd ----------------------------------------------------------------------------•---- ------------- ----------------------------------------- ------------------------------------------------------------------•---•--- ------------------------------------------------- - ------------------------------------------------------- :Jdaoxa pun 'aasutloand ;o Jlne;ap ao Zae aql Sq paleaa0 saoueagtunoua ao suatl Sus Jdaoxa 'saougagtunaue pug suail IIe ;o agala pus aaa; 'Slaadoad aql ;o 'aidmis aa; ut 'pea(I Slugaag?A s 'aasggaand aq of aamlep pug alma" 'pugutap uo Iltm aopuaA 'pagtaads aeogg aauuutu 9111 ut pug 6`011111 aql le patuao;aad Slln; aq hugs 91101 400 IIg pus pled Slln; aq Ilsgs sSauotu aaglo pun Zsaa0lut gltm aotad asegoand agJ 36`6`3 uc ZegJ 990J2e aopuaA •Slaadoad aq1 2u11a9ge suolIvIn2aa pun 6`aous11tpao 'smei Ile 11J!m Sldtuoa of Pug 'Josaluop stgl ;o uatl aql of aomadns suatl uzoJ; aaa; Slaadoad aqJ da9�l 0J 'Jteda.1 pus uotl!Puoo alg1RlusU01 pool U1 Slaadoad aql dawl 01 'Slaadoad aql uo pal4tut1uo3 aq 01 016`rm mo11e Jou alsem lttut11o3 01 loo sJuru3no3 aasggaand algtssa; Slluoituouoaa aq of atedaa ao uotlgaolsaJ 3111 suzaap aopuaA 041 paptnotd 'pa2etzzgp Slaadoad aq1 ;o .nsdaa Jo uolZgaolsaa of paT1dde aq uses spaaaoad a3usansul 2utltam ut aaa2s astmaagl0 aopuaA pug Jasrg3Jnd ssalun aopuaA pur s30ISD-1 '4 a3Iddu a t a} s6`o1 ;o a3t4ou an12 Sllduzoad Ilegs aasggaand •aopuaA 114tm paltsodap aq ly,-gs dlaadoad aq1 2utaano3 sat3tiod [Is ;o igut2lao 3111 '4u11um ut 6`33326` astmaaulo aopuaA ssalun 'pug Jsaaalut s,aepu9A ayJ ;o Jung; ul asnrl3 parpugls 3114 utr.JUOD Ilggs samilod eqy -anp uagm stuntuzaad aougansur aq1 And Ilsgs aatigg3and 13rJJuoo s1y1 aapun pamo a3uglrq ayl ugyl 9aouz JunoUZe us ut 92VIOA00 aainbaJ loo Ilsgs aopuaA "f[El1 aTQL.ztlSli �L�.I---$ do tuns ayl u! '.10110A Sq paeoaddr saaansut g2noagl 19aueansut-oa Jnogltm 'aamboa Setu aopuaA 6`g spaezeti Jag10 qons pun sI!aad a2gaano� papual -xa 'aJg Sq pauotssazo a2eump so ssol 4suiu2s poansut Slaadoad agl uo sluatuaeoadutt aq1 daa)i tlslls aasggaand •ZuawAed gons Sutmogs s1dt930a puetuap uo JopuaA 01 a9n11ap of puL J1 ut 198104111 9,JOpu9A uodn ao SJJadoad aqJ Uo pateai sluatuosasse pug soxeJ i1g anp uagm And of saslutoad Jassg3and STC - 105 SEPTIC TANK MAINTENANCE St. Croix AGREEMENT County OWNER/BUYER ROUTE/BOX NUMBER CITY/STATE n,e FIRE N0. PROPERTY LOCATION: ZIP -3�-_ C� ��iLl/9 Section _ T r/ Town of Subdivision St. Croix County, Improper /�r,� P per use and maintenance Of Lot No. -_- failure to handle Your sap tank wastes. tic system could every three years Proper maintenance consists of Pumping in its What you Or sooner, if needed, Pumping out the septic treatment state into the system can affect by a LICENSED SEPTIC TANK pseptic 9 in the waste disposal the function of the DER• St. posal system. septic tank se as a Croix County Residents MAY $3000 of the cost of be eligible prior to July 1, 19f replacement of a failing receive a grant for a MAXI 1980, with the re St. Croix Count g system, which was MIlM of systems Properly 9uirement that owners Of accepted this program in operation Y maintained. ALL NEV SYSTEMS a August of agree to keep their The property owner form, signed b agrees to submit to St. restricted y the Owner and b Croix County Zoning a certification Inspection and Pumping system Pumper verif in Journeyman plumber, pum in is in proper operating Y g that (1) the sludge and scum. P g (if necessary), the Sptic to condition °n-site three Certification form will septic tank is and (3 after year expiration. be sent less than 1/3 full of approximately 30 days prior to th�"E, the undersigned, private sewn have read the above re herein, as set 9e disposal system in accordance and agree form by the Wisconsin p with the standards must be completed and Department of Natural 30 days of the returned to the Resources. forth, three year ex St•Croix Count Certification piration date. Y Zoning Office within SIGNED St. Croix Count ATE St. Croix y Zoning Office County Courthouse 911 9th Street Hudson, WI 54016 (715) 386-4680 Sign, Date, and Return to above address 4 p bEVARrMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISQN W5370 HUMAN RELATIONS (1-163.0911)&Chapter 145.045) LOCATION: SECTION: TOWNS P/MUNICIPALITY: LOT NO.:BLK.N .: SUBDIVI ON NAME: /�/a /U N/R $E(0 02 COUNT : OW R'S BUYER'S NAME: Al NQ ADDRESS: USE DATES OBSERVATIONS KADE NO.BEDRMS.:ICOMMERCI DESCRIPTION• PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence 1 1 ©New ❑Replace RATING:S=Site suitable for system U=Site unsuitable for system ONVENTIONAL: MOUND: IN-GROUND PRESSURE:rYSTEM-IN-Fl L LHOLDING TANK:RECOMMENDED SYSTEM:(op D S ❑U 2 S ❑U ®S ❑U ❑S �U [:]S ®U ��c • If Percolation Tests are NOT require DESIG RATE: If any portion of the tested area is in the under s.H63.09(5)Ibl,indicate: S Floodplain,indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER DEPTH W. ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) B- 7 7 — B- - -/ ' / B- > /,IRIS &Aads r,&Ic/s'- B-,51 s- - B- PERCOLATION TESTS dC TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER IRQ14ES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD FF=R PER INCH P I G / i P-2 P i! P-_ P- P- _ /� PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indic le oY dista s. Describe what are the hori zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevatio t all borings and the irectiof�nd per�c�ent of land slope. _ — to fleNE SYSTEM ELEVATION a 36' tN 4 14 E C � 1 A� ( ti 1 q_ � s I _ L Ci ( { 1,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures aand etho Is spec fie Lithe 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( nt): TESTS WERE COMPLETED ON: \ (� (3Q bRE CERTIFICATION NUMBER: PHONE NUMBER(optional): 4& CST�S�E1NA E: I ,N: Original and one copy to Local Authority,Property Owner and Soil Tester. e5 (R.02/82) —OVER — L INSTRUCTIONS FOR COMPLETING FORM 115 - SRD - 6395 To be a complete and accurate soil test, your report must include: 1. Complete legal description; 2, The use section must clearly indicate whether this is a residence or commercial project; 1 MAXIMUM number of bedrooms or commercial use planned; 4. is this a new or replacement system; 5. Complete the suitability rating boxes. A SITE 1,3 SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE'RULED OUT BASED ON SOIL CONDITIONS; � 0. PLEASE use the aiabreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A separate sheet may be used if desired; 8. Make sure your benchmark and vertical elevation tiff>rence point are clearly shown,and are permanent; 3. Cornpiele all appropriate boxes as to dates, names,addresses, flood plain data, percolation test exemp- tion, if appropriate; 10, If the information (such as flood plain, elevation)does not apply, place N,A. in the appropriate box; 11. Sign the form and place your current address and your certification number; 12, 1)i<e lagii.3le copies anti distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY VVI T HIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates acid Textures Other Symbols st — Stont" (over 10") BR — Bedrock cols - Cobble (3- 10") SS — Sandstone gr Gta,uel #un(k�i 3") LS - Limestone s — Sand HGW — High Groundvvater cs C r a ; sal-d n,, . Fart; - . rrolation Rate rrc:d ; ,_ ,diur r •`,.trit3 W — C, ;,'l rr `s F r r; S,n Bldg I?L;iitlint, t� I #- s� ands Sanfl > Greater Than -s - . aE-r �q y T n ... .:....ten-..:. .,.. s Silt G _. Gray c.l - Clay Loarn Y __ Yello v scl -- Sandy Clay Loam R — Red sicl — Silty Clay Loarn mot: - Mottles sc Sani:!y Clay w! — srr tlI sic - Silty Clay f f I few, tine, faint Cl - Clay cc: - ct,rntc r coarse, turn Many, medium m Vilm-"k d -- distinct p - prorninent HWL — High water level, " Six_general soil textures surface water fos {iqu d waste disposal BM — Bench Mark VRP — Vertical Reference Point TO THE OWNER: : This soil rest report is the first step in securing a sanitary permit. The county orthe Department i-nay request verification of this soil test in the field prior to permit: issuance. A complete sot of plans for the private ses--'age system and a permit application must be submitted to the appropriate local authority in order to o'blain a p,,rmit. The sanitary permit must be obtained and posted prior to the start of any CCMStruCtlt:)n, �l ; 34 tilt J,4 4 10 -7--t I I i I I I I I I , _ - ------------ - - - - 1 1 -4 I -- - - - - -- - - - i i --J__--------- _ I I r I I - : Fr --- - - - - - - - - I - - -- - '-- I , I I I I - � I I I I I I I ; I I 1 I � I PAGE OF . � 11 C.rvSS Szc � IOn o � � Zito SvSTen-) Froth Air Inlol•An^And Obr,orvollon Pipe r i��Approvsd Vent Cop Minimum 12"Above final Grade 20-42"Above Pipp _4"Cast Iron To final Grade Vent Plpa Marsh Her Or SymMtk Coveriny min 2"Ayyreyole - Orer Plpa Dletrlbvllon ' Pipe 0 0 0 —Too - b"Apyrapole Benealb Pipe o Perforated Pipe Belo. o —Covpinp Twminariny At Bottom Of Sy►lem Prp�o�e D T'Ine-' �fwc'I< �lev•.� ion / �//�j SOIL FILL OISTRIBUTIOLI PIPE APPROVED SIWPETIC COVER Z w OF 6G EGATE � OR 9� OF STRAW A R o OR MARSH HAJ ./ /, <e�0F�r2 -a% AGGREGATE ELEV. OF FEET-- b .•�\�%;� i DIST1115UT1OW PIPE TO BE AT LEAST INCHES BELOW ORIGIMAL GRADE AQU AT LEAST t0 INCHES BUT AIO MORE THAM tit INCHES BELOW FINAL GRADE rMIMUM MrH OF EXCAVAT160 FROM 0KI&WAL 6KADa WILL BE _ INCHES MINIMUM ®EPrN OF E'XCAVATIOM FKOM OlkIGIbAL (3Kgp€ WILL BE INCHES � I SIGIJEO: ti LICEUSE AJUMBER: DATE : Parcel #: 026-1001-50-100 12/12/2005 03:04 PM PAGE 1 OF 1 Alt. Parcel#: 1.30.18.7D 026-TOWN OF RICHMOND Current X'', ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner JEFFREY L&LISA A MILLER O-MILLER,JEFFREY L&LISA A 1749 140TH ST NEW RICHMOND WI 54017 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description * 1749 140TH ST SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 1.820 Plat: N/A-NOT AVAILABLE SEC 1 T30N R18W SW NW 1.82AC LOT 2 CSM Block/Condo Bldg: 7/2014 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 01-30N-18W Notes: Parcel History: Date Doc# Vol/Page Type 09/06/2001 656055 1715/54 WD 07/23/1997 860/389 07/23/1997 847/316 2005 SUMMARY Bill#: Fair Market Value: Assessed with: 95288 260,100 Valuations: Last Changed: 06/19/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.820 38,300 184,800 223,100 NO Totals for 2005: General Property 1.820 38,300 184,800 223,100 Woodland 0.000 0 0 Totals for 2004: General Property 1.820 38,300 184,800 223,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 222 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00