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HomeMy WebLinkAbout032-1064-70-100 \ + � k § % \ g m / \ \ � m � $ � G � A � ƒ � \ � § & a % z 2 3 \\ � f � $ ® � Lu i_ § k ®) J . / \ a m % 2 / $ / E 2 I m f cc ' c W � Cl) C \ q . e z m z f q .. 4 = 2 q E m ~ ® � 4) = � k 1 @ j o k ) ) « E < § ' I U U) k i j � z N > � R \ k \ � � k � •� � a a a U) � k k k ƒ O> - - _ \ a 3 2 � § � k / ƒ / ) 2 0 w � & E c 6 ; ) $ c a £ 8 ~ R � f ; a & 2 C c - R k C § k \ 2 % E E f } ® - § � ) k o ) A CL� ® � � 4) £ » ® & ' : c a § k 0 a 2 o & v ' Parcel #: 032-1064-70-100 12/12/2006 05:11 PM PAGE 1 OF 1 Alt.Parcel#: 24.31.19.321 D 032-TOWN OF SOMERSET Current XJ 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 ARTHUR&MARCIA D CHRISTENSEN O-CHRISTENSEN,ARTHUR&MARCIA D 744 205TH AVE SOMERSET WI 54025 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description *744 205TH AVE SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 3.614 Plat: N/A-NOT AVAILABLE SEC 24 T31 N R1 9W SW NE 3.614 ACRES THAT Block/Condo Bldg: /2032 LOCATED IN SW N NCLUDES Tract(s): (Sec-Twn-Rng 401/4 1601/4) 24-31 N-1 9W Notes: Parcel History: Date Doc# Vol/Page Type 09/30/1998 588069 1361/297 WD 07/23/1997 841/258 07/23/1997 07/23/1997 830/01 2006 SUMMARY Bill#: Fair Market Value: Asse 145504 212,300 Valuations: Last Changed: 07/23/2003 Description Class Acres Land mprove` Total State Reason RESIDENTIAL G1 3.614 51,000 110,000 161,000 NO Totals for 2006: General Property 3.614 51,000 110,000 161,000 Woodland 0.000 0 0 Totals for 2005: General Property 3.614 51,000 110,000 161,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 213 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER �Qjj /�/ W,4T7E,r�TOWNSHIP -S /,',SET SEC. T N-RLj W PT ADDRESS / h ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of II- HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM a Iz 71,- L IV 0 /6ne &.4L S,7, a �Q ixxsz 5& 0,4C t?(?gp G TE 4(16- INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used L?AS : 5LZa /riVC&aa, ✓"�s� Elevation of vertical reference point: 1040, a Proposed slope at site: X t SEPTIC TANK: Manufacturer: Liquid Capacity: 164 &AL Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: lift&D 9?1 �D Number of feet from nearest Road.: Front,O Side, Rear, O .200 feet From nearest property line . ' Front,OSide,�Rear,0 62 ' feet Number of feet from: well 3o , building: / (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE O 1 PUMP CHAMBER Manufacturer: Liquid Capacity: Pump del: Pump/Siphon Manufacturer: � ` Size Elevation o let: Bottom of tank eleva Pump off switch eleva n: Gall per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest roperty line. Front, O Side, O Rear,0 Ft. N er of feet from well: Number of feet from building: nclude distances on plot plan). SOIL ABSORPTION SYSTEM Bed: fleli Trench: Width: /g` Length:__ Number of Lines: a2 Area Built:. ,2 41 Fill depth to top of pipe: X9 'le Number of feet from nearest property line: Front, O Side, Rear,O Pt . '_ Number of feet from well: Number of feet from building: 5 (Include distances on plot plan). SEEPAGE PIT ize: Number of pits: Diameter: Liqui epth: Bottom of seepage pit elevation: Area Built: Has either a drop box or distribution box O>beenn on an of the above soil ab.sorbtion sytems? (Check on HOLDING TANK Manufacturer: Ca Number of rings used: Elev io of bottom of tank: Elevation of inlet: Number of feet from ne at property line: Front, Side, O Rear, OFt. umber of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector• Dated: �� �� '° Plumber on job: ` License Number: p � 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDING LABOR&HUMAN RELATIONS DIVISION P.O.BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES&APPLICATION MADISON,WI 53707 State Plan I.D.Number: SE 4,NE 4i S24,T31N-R19W Mk� CONVENTIONAL ❑ ALTERATIVE (if assigned) Town of Somerset ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound DER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Robert Waters Route 2, Somerset, WI 54025 S 3v Eg r is-em, BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REP.PT.ELEV.: CST REF.PT.ELEV.: -Tag OF S.T . tn�tPEc`I`>rtJN )eIS,- CIA-(P lot , l3� jcicb.pb Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Donavin Schmitt 3205 St. Croix 119475 SEPTIC TANK MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER I PROVIDED: PROVIDED: W�EkS pOCD Q�. 'tS-q YES ❑NO F-1 YES X NO BEDDING: Vet f DIA.: VE11 MATL.: I HIGH WATER NU ER OF ROAD: PROPERT WELL: BUILDING:I VEN TO FRESH I x I�, ALARM: - FEET FROM LINE: 1 r AIR INLET: ❑YES ❑NO ,ill 960,114 ❑YES ❑NO NEAREST-11 z 2S "� 8 NR DOSING CHAMBER: MANUFACTURER: I BEDDING: LIQUID CAPACITY: P PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVDED: ❑YES El NO ❑YES ❑NO ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF) [:]YES ❑NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: I MATERIAL AND MARKING: or excavation. (If soil can be roiled into a wire,construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: Wis . EC., !v,(06 WIDTH: LENGTH: NO.OF DISTR.PIPE SPACING: COVER INSIDE DIA.: #PITS: LIQUID BED/TRENCH f TRENCHES: MATERIAL: DEPTH: DIMENSIONS 12—' SZ NA (o f W PIT GRAVEL DEPTH FILL DEPTH DISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO.DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV.INLET: ELEV.END: 1.7�,cr Pv C PIPES: FEET FROM LINE:i— / r AIR INLET: (orrf 3. 7 7(0z It Z NEAREST J 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. SOIL COVER j TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ❑YES ❑NO ❑YES ❑NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑Y ES ❑NO ❑YES ❑NO EYES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE I MANIFOLD MATERIAL: NO DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING: ELEVATION AND ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.: DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑YES ❑NO [:]YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE: ❑YES ❑NO ❑YES ❑NO NEAREST----♦ Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE TITLE: .-•�-- Zoning Administrator SBD-6710(R.06/88) I EDILHR SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05,Wis.Adm.Code STATE SANITARY PERMIT# –Attach complete plans(to the county copy only)for the system,on paper not less than /J 01,41 Nf5 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 I. APPLICANT INFORMATION–PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION PROPERTY OWNER'S MAILING ADDRESS LOT# BLOCK# CITY,STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER t CITY TEARES7ROAD II. TYPE OF BUILDING: (Check one) ❑State Owned VILLAGE; T V ❑ Public rm 1 or 2 Fam. Dwelling-#of bedrooms, R E N ) 111. BUILDING USE: (If building type is public,check all that apply) 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 11 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ service Cation/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 El Hotel/Motel 9 El Office/Factory 13 El Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1- 1� New 2. ❑ Replacement 3. ❑Tank cement of 4• ❑ Existing System 5 ❑ Existing System System System Y B) ❑ A Sanitary Permit was previously issued. Permit## — Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 30 El Specify Type 41 F-1 Holding Tank 11 N ❑Seepage Bed 21 ❑ Mound 42 Pit Privy 12 Seepage Trench 22 ❑ In-Ground 43 ❑ Vault Privy 13 ❑ Seepage Pit Pressure 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1.GALLONS PER DAY 2.ABSORP.AREA 3.ABSORP.AREA 4. LOADING RATE 5. M(Min./inch)E 6. SYSTEM ELEV. 7 ELEVATION GRADE REQUIRED(sq.ft.) PROPOSED(sq.ft.) (Gals/day/sq.ft.) ® r Feet I Feet VII. TANK CAPACITY Prefab. Site Fiber- Exper. in al Ions Total #of Manufacturer's Name Con- Steel lass Plastic App INFORMATION New istin Gallons Tanks oncrete structed g Tanks Tanks Septic Tank or Holdina Tank AM Lift Pump Tank/Siphon Chamber VIII. RESPONSIBILITY STATEMENT 1,the undersigned,assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name(Print): Plum is Signature:(No Stamps Me=SW No_1 Business Phone Number: 3- y P lumber's Ad ress( reet,Ci ,State, ip Code): f &y IX. COUNTY/DEPARTMENT USE ONLY 1�1ssuing Agent Signature(No S mps) Lj Disapproved Sanitary Permit Fee(includes Groundwater a Is issued Surcharge Fee) I� Approved ❑ Owner Given Initial 4 I qS•M A ve D termination] X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(formerly Pib-67)(R.11/88) DISTRIBUTION: Original to County,One Copy To:Safety&Buildings Division,Owner,Plumber 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 name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete#of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in#1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8'f x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers;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) t I I , I op { I i I eo d L'` I I I I , I I I I I I I ' i l I I I - I !- I — `, rt ol Xi RIGID lA S - - - — - - { r i I � j I , -- — /r_ �l Arlo r { s I I jU Tft/ic�r %0 o l< '<•1 � t. I I I I i uu I 1 i I ' I J � t I I i I i I : i l I I : _- I I � I � - � I � � I I � -1 i i;♦ I I i i II I I I : j - ' t- i ' I 1 I ,I 1 I I II t I I 1 f I � , I I r I i I I - I I } ' I I { i I _ l l I i l IL 1 t f I - - , ; _------- - - -Y-- T-1----T- Nj : - I I -7-1 , I t - 1 j DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY,. DIVISION DIVISION LABOR AND. PERCOLATION TESTS (115) P.O. BOX 7969 HUMAN RELATIONS MADISON,WI 53707 (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: NSHIP UNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: 1/a /T N/R E ( y-� .2 COUNTY: OWNER'S/BUYER'S NAME: ADDRESS: a c ]MAILING e -5 U E DATES OBSERVATIONS MADE NO.BED MS.:ICOMMERCIALDESCRIPTION: ' PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence KNew ❑Replace RATING:S=Site suitable for system U=Site unsuitable for system 7� r ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM:(optional) $ ❑U [XS ❑U ES ❑U EIS 25U I EIS ZU I 6 is 1 If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s. ILHR 83.09(5)(b),indicate: /U Floodplain,indicate Floodplain elevation: 1/0 JJJ PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- o p . 7/0�' G — D B- a 4 0-I-< B 0" o n S B- ��� PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER 1+441WS AFTERSWELLING INTERVAL-MIN. PE RIO 1 PERIOD-2 PERIOD 3 PER INCH P_ t 3 a ti 4-jr P_ ,< P- L P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. �filrl/y1 clef, Syl TEM ELEVATION 296 .610 > 20102 I '55 E le.,- joy . fir 'aal IN I off` _ _ 3� C� 5 aD , 1,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: v� t ADDRESS: CERTIFICATION NUMBER: IPHONE NUMBER(optional): �r CST SIGNAT DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) —OVER — r INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 5395 , To be a complete and accurate sail test,your report -rust include 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 3_ MAXIMUM number of bedrooms or commercial use planned; 4, is this a new or replacement system: S. Complete the Suitability rating boxes.A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON BOIL CONDITIONS; 6, PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A separate sheet may be used if desired; B. Make sure your benchmark and vertical elevation reference point are clearly shown,and are permanent; B. Complete 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 riot apply, place N.A.in the appropriate box; 11. Sign the form and place your current address and your certification number; 12. Make legible copies and distribute as required. ALL BOIL TESTS MUST BE FILED WITH THE LOCAL AUTH013ITY WITHIN 30 DAYS OF COMPLETION, ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures tither Symbols i st — Stone (over 10") BR Bedrock cob - Cobble (3- 10") SS — Sandstone gr — Gravel (under 3") LS - Limestone *s Ban€:f HGW — High Groundwater cs — Coarse Sand Perc — Percolation Rate coed s — Medium Sand W — Well fs - Fine Sand Bldg — Building Is — Loamy Sand > ..... Greater Than `sl -... Bandy Loam < — Less Than 'I — Loam Bn — Brown *sil Silt Loam BI -... Black Si Silt Gy — Gray cl — Clay Loam Y ...- Yellow scl .. Bandy Clay Loam R — Red sicl - Silty Clay Loam mot Mottles sc Bandy Ciay w/ with sic — Silty Clay fff -.... few, fine, faint *c Clay cc -- common, coarse pt — Feat rnrn Many, medium m Muck d distinct 1:a prominent HWL - High water level, Six s€:ail textures surface water fo;liquid waste disposal BM - Bench Mary VRP — Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department may request verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a permit. The sanitary permit must be obtained anti posted prior to the start of any construction. STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER 7,;,—,z qS 1A/14 Gf//�TTEi�S ROUTE/BOX NUMBER ���'T'� FIRE NO. CITY/STATE So�I��SFT, �y�SGD�✓- ZIP SE 5 W PROPERTY LOCATION: lyw 1/4 N� 1/4, Section , T-3/ N, R P? W, Town of 5oorg swL , St. Croix County, Subdivision AlX , Lot No. Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a LICENSED SEPTIC TANK PUMPER. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County Residents MAY be eligible to receive a grant for a MAXIMUM of $3000 of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of ALL NEW SYSTEMS agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Department of Natural Resources. Certification form must be completed and returned to the St.Croix County Zoning Office within 30 days of the three year expiration date. SIGNED Q q DATE `9$/ St. Croix County Zoning Office St. Croix County Courthouse 911 4th Street Hudson, WI 54016 (715) 386-4680 Sign, Date, and Return to above address APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, ("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of Property /�r�B�>ZT /✓ %a�7�9S/�.� /,��rTEi�S SE SuJ Location of Property Alkj It ,yE , Section 2`� , T 31 N-R19 W Township .S D/�9 'l�5,!�7 Mailing Address /7oz/TF Z Address of Site Subdivision Name N11 ,4 Lot Number Previous Amer of Property . Total Size of Parcel 1;132 ,gc1z�5 Date Parcel was Created S Z- .22%$ Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes AO No Volume 530 ' and Page Number 0/ 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 1 (We) cent i6y that att S tatement6 on th i.6 604m ace true to the best o6 my (oun) knowt.edg e; that 1 (we) am (ace) the owner(,6) o6 the p toper ty dens cA i.b ed in th,i d .in6o4mation 6o4m, by vi tue o6 a wavcanty deed neconded in the 066.ice o6 the County RegisteJr 06 Ueetfisaa Document No. ? y411 7S ; and that I (We) pnedentty own the proposed z to bon the 6 ewage di dpod a yd em (on I (we) have obtained an easement, to nun with the above deAcA bed pnopenty, bon the con-6tA u ctiqA o6 said d ydtem, and the dame had been duty neconded in the 066ice o6 the Co y Register o6 Veede, ad Document No. ) . A /,072-,"..r SIGNATURE OIL OWNER SIGNAT 0 0-0 F APPLICABLE) DATE SIGNED DATE S�dNED r Ii IC k)f 11 I5(',); I Pi 11:A1 11 - li,ri2 LAlvlD COl i 13ACT Individnnl u,d ur Drain r �t4 1.�5 I TO 00 S FINANCED FOR ALL D IN ,ACTIONS NON-CONSUMER OVER I, N 8L6,000 IS F1NANACT ANA S OTHER NON-CONSUMER - Air "I'}tANSA+;TIONSI _ fEGISTER'S OFFICE : i ST. CROIX CO., WI Contract, by and between - Lucil le Baillargeon Recd for Record .................................................. i ---------------------------------------------------------------------------------------------------------• --- ----- DEC 3 01988 . I whether one o>gmo-�eJ and-Robert N. l9atterS and ("Vendor", Ct Tomas ina - Natters 'Fiji d "'and""wife" "" a --------------- 8'30 A. M ------------------------------------1----------------------------------------------------------------' - --------------- V survivors marital eon r, .......................... or el ' - --------P- f Purchaser", whether one or more). "" Register of D&Ods 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,fixt res anA other appurtenant interests (all called the"Property"), in---------------- - 9t. Cr o i x - --------------------------- County, State of Wisconsin: RETURN TO 1t , See attached Schedule "A". I Tax Parcel No. ...................................... This land contract is executed to correct the description in that land contract between Vendor and Purchaser dated December 19 , 1988, I and recorded December 20, 1988, in Volume 830 on Page 01 as Document i No . 44-3966. ., II � II li ,I I II This 1s not ------ ..... homestead property. I ii (is) (is nut) I j Purchaser agrees to purchase the Property and to 1 ay to Vendor at _.._._._..__ ! }ice residence the sum of I $•- . x.. ----•----------•--•- in the followilr* manner: 3 S60 00 at the execution of this Contract; and (l,) the balance of 11 5�� I e ='- --- -•------, together with interest from date II hereof on the balance outstanding fraln time to time at the rate Of. --- (� until paid in full, as follows: per cent ;I •••• per annum Payments on intt,,rest and principal Jf $ 151 . 00 due on January 15 , 1989 I and due on the 15th day of each mon '.h thereafter for 1 months , at which time tiie entire amount ow ,is is due and payab) e . I i I I i -•--'.._ ( the maturity ,i:,te Provided, however, the en ) � outstanding bali,�,ce sl:.,il be Laid in full on or before tl:e.___.__.. Januarys �.�t�l. day of Following any default in payment, interest shall accrue nt the rate of_...�0__-% per r,nnum on the entire amount ill dr salt (which shall il,clude, without limitation, delinque principal balant•e). ..t interest and, upon accelerati,n or maturity, the entire Purchaser, unless 1--cubed by V, _lor, agrees to pay monthly to Vendor <.,nr. is I pay putcd annual taxes, ,pe,ic l u=se; ux+nt , fire and require.,' in. uranc, premiums wlr, due.To it received b�'Vendor, l Vendor agrees to apply h,yn,ents to these obligations w'her. due. Such a,!iuuut A- ce.vLd by ILe Vendor for payment of taxes ss , : essments and insurance will be deposited into an escrow fund or tr.,stcx account, but shall not bear interest !I 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 ..,ithout 1„erniurn or f,c a un p pnr. ,pal at al.y C r'.C. after. Dec . 98 8 E` ka '��iX�t)CSi1Ck �i� �.c . 19 r In the event of any prepayment, V is contract shall not be treated as in default with respect to payment so long I 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 ind,ehtedness 'A'""I h;,ve been had the month,' made as first specified abr.ve; provided ti at monthly payme.rts shall be t., .till" d in tLv event of credit an epr been of insurance or condemnation, the condemned Y proceeds premises being thereafter ei.cluded hereirom. Purchaser states tht:t Purchaser is satisfied with the .itle as shown by the title evider ce submitted to Purchaser I� for examination except: i. '.v Exceptions f I I i Purchaser agrees tc 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. i Purchaser shall beu,titk;,l to take possession of the Pruperty on...--..I1-t•.i:-,..-�-;1 •ct u�t u,. . 119..88 ltll L SURVEYOR ' S CERTIFI TE '', I , Allen C. t' n, registered Wiscoi�: -_fi Land Surveyor, do hereby certify t hai by i he dl: on of Gary Bail.104� 'n, I have surveyed, des ribed and •; m�:p�uci th-, land ! ..ircel wh - l:, ije RrLgPre his Certi .. :, --•��- ;�qr _ I"t died Sig y Map; Thai. 1- he exterio : , ►. a ri.�,�fj�� - ,ed s des(-3 7% p-ar{-(�1 -)i land located in part of the SEa -f the NW; and in ;,a,.•;- of the tlQ I11- IPJE;, ,11 in Section 24, T31N, R19W, Town of Somerset, St. Croix ,• i �.consin ; further described as fol' ows : :FIm:�rir!cing at the E4 corner of said Section 24 ; thence N89018112"11, along he ( ,ast - west 1/4 line of said section, 2460 . 90 feet to the point of ' :,(,g . ,.ninc: of this description; thence continuing N89(-�18 ' 12"W, along said t�asi.-west- 114 line, 851 . 43 feet; thence N00009 ' 40"E, 466 . 52 feet; thence S89i1.8 ' 12"E, 851. 5 feet ; thence S00010 ' 16"W, 466 . 52 feet to the point of beginning . Above e'escribed parcel is subject to right-of-way for town Road ( 205th Avenue) and all easements of record. I also certify that this Certified Survey Map is a correct representation to scale of the exterior boundary surveyed and described; that I have ful : complied with the current provisions of Chapter 236 . 34 of the Wisconsin Statutes and the Land Subdivision Ordinance of the County of St. Croix in surveying and m•-�pping same , 171. 11 fir..• l '�Y • ,� Ifs _ l \/!,_... \�• '(_.1, n.I,C�yl ;i Al 1-n C. Nyh -qen v Date { NOTE: The ea5 -ment shown on the face of this mlp is a private roadway easement. Anv mainir^n:r'!ce casts of the private roadway, after it's anpro- al by the Zoning Adminisi.r; r as a sty ndard road, shall be shared prn-r:)t.a by !,hr, ,adjoining property owners. n l f? the pl ivate roadway be taken over by a mun i ip,,l i as a public road, main �,,�ts thereafter would be a public expense. )MEkT f40 BAR ,/t)i ' STATE B.A ' \`1.7t t.): �t V l�t)]cl�l 11 �1rJo2 (� 7MIb DY.-..t h'h i,r.M JG.! •UK • LJ/,.,1! G!-'A �I LAIiID C01 MACT .I • - Indi,idun) and ,np°ratn .j TU BE USED FOR ALL TRAM :ACTIONS WHI•:RF, OVER [` _ - ACT TRANSAh:T]ONSI _ t�EVISTER'S [�[����� v<26,000 IS FINANCED AND IN OTHER NON CONSUMER I - - OFFICE : � ST. CROIX CO., W1 Lucille Baillarreon l Contract, by and between ------------------------------------------------------------ Recd for Record ----- DEC 3 01988 -----•••---•----------------------------------------------------------------------------- ("Vendor", dt whether one o%mofiV and_Robert N. WatterS and 8:30 A. M Folnasina VVVatters wi " as - ---- t :?- - -'- Survivorship m a r l t--l p n o n("purchaser", whether one or More). Reglster of Deeds - ------------ 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,fixtt res an other appurtenant interests (all called the"Property"), ' t. r O 1 X County, State of Wisconsin:in................... • t. u --•----- -- RETURN TO I See attached Schedule "A". If Tax Parcel No_ __________________________________ �j ]'his land contract is executed to correct the description in that �I land contract between Vendor and Purchaser dated December 19 , 1988 , and recorded December 20 , 1988 , in Volume 830 on Page 01 as Document No . 44.3966 . l �f Ij �I I� This ----.1-5--not ..- .- hon;estead property. (is) (is not) Purchaser agrees to purchase the Property and inttl�:ay to ndmann er: (aher ... 5��_residence ��Ce•--••"--- ---'-r i the surn of $.�_S.,11 Q :.�)------•-- _ . _- ! ) $ i; at t};e execution of this Contract; and (t,) the balance of >i-.1 1 : 5(�0 • O 0 , together with interest from date �I ],ere,)f on the balance outstanding fron. time to time at the rate Of............................... .-••....... ...... ....... per cent per annum Ij i; until paid in full, as follows: ii Payments on int.•rest and principal )f $ 1Sl . 00 due on January 15 , 1989 !! I� and due on the I St.h d��y of each moncli thereafter for 12 months , j ;it which time the t n t i rc am�)tlnt OW L rl t? IS dice and payable . Ii Piuvided, hw'l'evcr, the en�i)ie out,itandinb balr,;,ce s}:all be ]laid in full on or before tl.e..__._._.�_�Z�1_ day of i! j tanllary U ._._ �i •-•----•-•--• - b ............ paJ•ment interest shall ace I ly-__.._.. the ma urrt date). . Followin• an • default in �ue at the rate- of .-_�.Q- °,b per .annum on the entire amount in d. !'.cult 0%hich s}:all i):clude, without lintrt..t)un, dclln(juc..t interest and, upon accelerati, n or maturity, the entire i1 ,incipal balance). i Purchaser, unless egeused by Vt .lor, agrees to h-y n..inthly to Vendor arn" 'ts suffici- it to pay reasonably antici- pattd annual taat:, ,ptri;1 a-c—Dent:-, fire i;nd require!: in. uranc, hrr•miurns wig. due Tc, tl eatel;, received by Vendor, Ij Vendor ujrees 41 al,Oy paJ-nuents to ti,e=e obligations whey: due. ;;uch a):,uunts 1-eivid by :r.e Vendor for payment of tax-a_`., Ps meats and irsurance will be leposited into an escrow fund or tr„tee account, but shall not bear interest unless otherwise required bJ law. Payment, shall be applied first to interest on the uu;)aid balance at the rate specified and then to principal. Any unwur;t n,ay be prepaid ::ithout ),er,)iuni or fee ❑�un Dec . 19 88 I r prlt ipal at ar.y tin,c after... t k�i :tAX \�fw?tjkri• P.3(r�l k�� :tai �tA#V.4ixj;i.� AMNYtx_hAXX In the event of anJ prepayment tl is contract shall not be treated as in default with respect to payment so long as the unpaid balance of principal, and )„terest (and in such case accruin- interest from month to month shall be treated as unpaid principal) is less than the amount that said ind•!btedness woLld have been bad the monthly I.ayurents been made as first specified ah ve; prov dcd ti.ut monthly payn.e.rts shall be L, .Ling,d in tl;c event of credit of any proceeds of insurance or condemnation, the condemned premises being thereaitLr excluded hereirom. Purchaser states th:.t Purchaser is satisfied with the ,itle as shown by the title evider ce submitted to Purchaser ,j fur examination except: No Exceptions (! 1, I i Purchaser agrees tc pay the cost of future title evidt nce. If title evidence is in the form of an ubstract, it shall be retained by Vendor until the full purchase price is paid. j I urt•},atse - r steal. be untitl ,. u1 to take pusaessiun of the I.uperty on.......I). .C..._-�.�.........- 19 8g �I L I'll rc} • Fri it :ud to . wh .i!Ir all t ryes aura a<,.,• ,,.,nt vin„ drliver '� ndcr en dr_ �d receipt+ a'tn;NIT! , s,-rcl. p tynl rn the Prnpe,rty' u; upon Furrhaaer �' ell kr •p ti:e imprn meets on the Pro crt in-nr„! against Ipss or dams tended coverage p,,-ils and such other hazards as Vendor nay requ :,, without co-insurance, through asins occasioned approv el by Vendor, in the sum of g none than the '. ••... -..------- ., but Vendor shall not require coverage in an amount more balance owed under this Contract. Purchaser contain the standard clau,e in favor of the Vendor's Lrt^re+tlandtyunfless�,endor otherwise agrees in writing, the original of all premiums v,-hen due.• The policies shall Policies covering t !e ndoperty shat] be deP, itrd v th Vendor. Purch tsr•r shall P"Ol"fitly give notice of loss to ins applied a companies and Vendor. Un'eis Purchaser and Vendor otl ter«is e agr, in writing, insurance proceeds shall c applied tot restoration r repair of t' e Prol" •tv dan•al;H, provid!d the �'• r,•.i„r deems the restoration or repair to be economically feasible. Purchaser covenant; not to corm: 't waste r,,r allow xaste to be committed on the Property, to keep the Property in Food tenantable laws, on and repair, to keep the Prnpe rt. free from liens s,tperior to tf:,• lien of this Contract, and to comply with all lawn, ordinances and reg,tlat:: ns affect nl; tite Property. Vendor agrees that in case the purchase price with iriteri st and otl:• r moneys shall he full'.' paid and all conditions shall be fully performed -it the times ar•I in the manner at ove specified, Vendor will on demand, ozr. clte and deliver to the Purchaser, a Warrnr y Deed, in fr= mpie, of the P orc-'v, fr^e n-±d clear of a!I !ion and encur hand d z, ,r any liens or encumhr ; creat,d by ,Ste a.t 1er . ' t am or r _ a tl. ' f Pur,ha•-cr, ! d r•xr••I,t: 11 t eXce”t- 1 nil ............. -- Purcha h : e ,cr agrees t �,t tiurc is of s ---" ...... .--•-""- e�,encr and (a) in the event of a default in the oayment of any Principe] or interest which continues for a per iod of _E-(I data (ollowin� ti'• s „••' 1 t I c.rfied clue dace or (b) in the event of a default in per[orma,•ce of any other phligation of ' ,irchaser wl!i(l, cenrin thereof b:• Vendor (deliveled pe,Fzv,,gll r i :�s fur a rio•1 of.__-:SO_ d � follow;., :.titre :, a 1• I b tii, 1 .,a t, the•r; '. , cr••Irr •utstandint b.danee Ian der this cnnrtraet shnv beano immediately due and Pa min Nll at Vet: lot s opt;r,n a,ici wiLhr�rt notice (which Purchaser hereby waives), and Vendor shall also hate th flowing rights at ( rr•medic; (s�rbjer•t any limit;,tions provide I by law) in addition to those Provided by l.t:. r in t Vendor n' .y, at his option, ter< unate thi: Contract an,i Purchaser's rifzhts, title and interest in th, )Pet ( 1 r , P ,d re• r the 1 operty bacl through ,trict fore•losure with any equity of redemption to he conr.i. or ed ul,• n 1 u> er's paymer` of the entire outst:cr, ling balance, with interest thereon Crpnf the date of default at the rate in effect sucl• '.eand othcramcuntsdue hereu" ' r(in which vent all-,mount.,;is previously paid by Purchaser shall be forefeited ;• yui,' ,I damar« : for failure to hlluil this Cont act and as rental for t1 , Property if Purchaser fail; of tedenti 00 `."ender may sue for specific performance of this Contract to conij-1 efau lia and full mount t of tt e entirr 'standing halance, with interest !hereon at the rate in effect on the late of default and other amounts chte h,rounder in which e,. nt th • Property shall he auctioned at judicial sale and Purelvi-vr shall he liable for any deficiency; or (iii) Vendor may -ue ;,t. 1:tw• fill" the entire unpaid purchase price or any portion thereof; or (iv) Vendor n,•ty declare this Contract at : n en aIml rcmove this Contracta,aclr ud on title in a quiet-title action if the equitable intc rest of Purchaser is insignificant and (v) Vendor may have Purchaser ejected from Possession of the Property and have arecciver appointed to ,•nllect an, rents, issues or Profits during the ender (i), (ii) or (iv) rlhove.Notwithstandin- , pendency- of any action >f the foregoing remedies shall only be binding upon Vendo.-I if ardrwhr ilt pursued rin actions of lit teat o t andrlall coatsland expet><ey including reasonable attorneys la - fees of Vendor incurred to c,force an} remedy hereunder (whether abated or +wt) to the extent not Prohibited by l;nv and expenses of titlr evidence shall he added to principal and Paid by Parcha:er, as curred, and shall be inclu•led in any judgment. in- Upon the cnmmeneernent or during the pendency of any action of foree_I, ;tire of this Contract, Purchaser consents to the appnintm"_at of a r,ceiver of the Property, including homestead interest, to coll,•et tl a rents, issi-s, and profits of the Property during the Pendency of such action, and such r•,---r,f issues, an,l profits when so collected hall be held and applied as the court shall direct. Purchaser shall not transfer, sell or convey any Iegar or ryuitaf,le interest in the Property (by assignment of any of Purchaser's rights unde-- this Contract or by option, long term 1--e or in any other way) without the prior y ritten consent of Vendor unless ether the outstanding halance Pa}able under this Cv�itrnct is first paid in full or the interest conveyed is a pledge e or ass -nment of Purcha<er's interest under this Contrac4 nle[y as security for an indebtedness of Purchaser. In the evert of any srrch transfer, sale or convey ance without Vendor', a--itten corn ent, the entire outstanding balance payable under this Conrr t shall become immediate"v dale and payable i.t full, at Venrtnr's option zyithout notice. Vendor shall make :dl Payments when dote under an: r., ,r±g,n,e cutr.irt:ding against th• Property on the date of this Cntract (ercePt fo a::y mortgage gr�,nteci by Pureh:tse, 1 or under any note secured 11, reb makes timely payment of t' ,r amounts then (file ,odor this (', ntInet. Purchase: ,^ay make an•. ;ucl��pFyments directly cto the Mortgagee if Vendor fails to do so att.l all nayments sc made h} Furch r shall be con:iderecl payments made on this Contract. Vendor may waive my default without waiving any ot'�er subsequent or prior default of Purchaser. All terms of this / mtract shall h­ binding upon and inure to 'he benefits of the h• irs, legal representatives, successors and assigns of ndor and F 7 baser. (If not an owner of t!te Property the spous - of Vendor for a valnable consideration joins herein I release homy stead rights in the subject Property and agrees to ivin in the execution of the deed to be made in fulfllm-rit hereof.) Dated this --._. ` day of_..._ necelliber 88 --- . • ------- 19.. -- i r`7 - �G . ' (SEAL) :..<'...._ l -_. _---- ------ ---(SEAL) Lucille Baillar � ' ' -------------- g-=°R • Robert N. }Vattern ---- ----- (SEAL) „1 r - -;`- '777 " +✓-- -------(SEAL) ------ . Tomasina 13. 11atters ----- ----------------------- ----- -•--•••-- ......... AUTHENTICATION ACKNOWLEDGMENT Signatures) ............................................................ STATE OF WISCONSIN -------•-------------------------- ------ ------ ---- ST. CROIX ss. authenticated this --------day of................. a 19 . •--•- - ------ ---------------County, 7W Personall came before me this ._ ------day of Deceml er -.•--- ---- 1sg$ ]Z_ �lr ---­---------------------- Lucille Bail1argeon , Obert PK Watters and Tomasina B. Natters TITLE: MEMBER STATE BAR OF WISCONSIN ------- (If not ....-----•---••-------.. authorized b------- ----�;------•-------i^---------•------------- Y $ 706.0!r, Wis. Sta,,...) -•--•-------------- -------------•----•--•---------_.._......-- to m- known to he the person S.......... Wt"aOWat the foregoing in tru7nt and ackno:rled�s�� m�{� �1* THIS INSTRUMENT WAS DRAFTED BY r/ B,l kke , Normand •z`, x-- `'-;�'S'��'•^ .......... Schumacher , S. C. ---------• --- .r . •--•••...__. ---------- 2 0 }e 1 t 1 e I �.ve Srl:fJ�✓ P. ( : � elv Ri 54017 c moo-c--�---w-1 ------. •------ - --- - - ....,�.---•---------- Notary Public S t . ( x (Signatures may be authen'' rr Y cated or ackno-aledged. Both "`y ('omrrir.r m is ernulnent. y • re n„t necec�an•. d: : <�1 j r ! i�I) Le 1 l,r nfipn S N 7 N C/f r n S ��'• O t7' \ o a Bearings are referenced to the M m East — Nest 1/4 Line of Section 24, X -* assumed to bear N89°18112"N. — ° M N A co C ' p N �O X N 7 +n CL cn ....O rt T M �e cn -M _ N N tp V 0 T 0 (" - - 'mil ►+ H ►.. n 7 I s_ A v rt rt w m n Co A 0• ►-'• rt m Unplatted Lands CD H 331331 1 cn_ Cn A a N N• r?00009 ' 40"E 466. 52 ' Ln A .0 CA 0 - A A A ro f. 3 00' 433.52' �.. �• w fi Cr rt z z 0 Fh o t Q •+ 1O7 IVI �� too •-3 ro -3 Nrt N I Hi r - A m /o A lD �' CT I:L; N N O d :E: (D $' r n V X n Co r r fn Co Of A N 1--• A N .0.-• C=) rn a C N C 0 a� N N Co E rj ° N• 4 o, <� O Fh I n G FT F F O cn (D T7 Co O —( 1 9 rt 0 z ►-/ (D r - 33.00' N N M S - (D N C= 433.521_ `+ rt, � - �I d by ;a a cn NOOo09'40"E 466.52' \ C �, i a M P. �7 oo N it M rt '•� b G W... w o _ rn °fd Nm � 1N 0 rt D � N ►.. r— i,. k O C N C A A C4 0 (D North — South 1 4 � � o / line of Section 24 ',j" F'• O .: 433.521 H M (n HI ' Private 7L - S5'0010 ' 16"W d :+ rt m O rt 33.001 Roadway Easement o � "j N 433.52' ' en o w P. 466.52 ' o �.,� 6 1 N < I U A o aC' ISmall Tract f` Co a ,`,y3CtPt�p� � N ` • • a� � �� • t r i.