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HomeMy WebLinkAbout002-1072-30-050 \ o -0 f � % j & . % ) c e 0 m \ � m _ §/ 1 t3 £« � Co � {° � ] ¥ ® _ B0 / � C a) _0 ) ) \ \ 2 ) &B k § t $ 5/ n 4 E z 1 ( 2 m § / a ■ E \ z :!t i 2 ) • z 2 ®e } ® ± E 2 \ ° } 7 (D / � k ) k ] t U') & ƒ : 0. 0 c 1 . a \ § 3 a .0 § \ k } � 0 2 2 2 CL § 4 & ) $ L) m CO CO ° . \ \ \ \ D / E E © § 2 § % $ # ƒ @ = / a ; CN , a / \ ; o ) E _ O a CY) # \ 2 ( S J_ § CY) ` ^ / � ) / k 5 @ g a j m \ § @ \ z a 2 / , a co / \ j \ / 0 z $ ] / \ � ® � � I � — , _ % , - a > E ) ' k a § / JIL $ 3 , � 727346 MAR 2 2 2004 VOL 17 PAGE 4551 t KATR= H. VIEW S;.CF?TX COMITY REGISTER OF DEEDS SURIrEypWS RECORD ST. CROIX CO. MI RECEIVED FOR hECORD 06/26/2003 M 15AK CERTIFIED SURVEY KAP CERTIFIED SURVEY MAP PAGFO;CRi2x COUNTY Gerry and Bonnie Veenendall plannim xon{nn and Parks Committee Located in part of the Northwest %4 of the Northeast '/4 and Southwest '/4 JUN 2 6 2003 of the Northeast ',4 of Section 29, Township 29 North, Range 16 West, Town of Baldwin, St. Croix County, Wisconsin. it trot wed '"30 dayS 01 WPWW do* "be Twin� OWNERS ADDRESS 227180TH AVENUE UMPLQ T TED LAtVDS BALDWIN, WI 54002 A' S87°37"WE 2618.66' -nT H=AUENUE S 87°37"56 E i 609.33'` — 817-3 „ 7 �-NOR NEV4 —' M .•33.87" 394.71' Y — — r—.--'`� _ S87�3r56" ` , NORTH 114 CORNER �' ' 05� 34.79'•: M 1309.33- SECTION29.T29 N,R 16 W 394.75' 305.31'" o° ��COUNTY����1 ^ -S 87°33'27"E 7Q0.46'- Cp•� NORTHEAST CORNER SECTION 29. •,_ SETBACK LINE _ _ " T 29 N.R 16 W 0� c SEPTIC I NTSENN Z{ AREA ENTERUNE J� r- TING?OS CEN7ERLW ! DRIVEWAY SOTHAVENUE Lu' in �/ W� to OWELUIVG (/ 1-111 ATTACHED V N Z GARAGE� � WELL LOT 2 SHALL NOT BE FURTHER �! ❑SHED SUBI) IDED NY THE FUTURE, UNLESS APPROVED BY THE LOT 1 LOT 2 1 ST.ERVIS COUNTY BOARD OF CONTAINS 871,244 SQ.FT. CONTAINS 217,800 SQ.FT- OR- OR 20.001 AC. OR 5.000 AC. (857,803 SQ.FT.OR 19.692 AC. (207,265 SQ.FT OR c6• EXCLUDING ROAD RIGHT OF WAY) 4.758 AC.EXCLUDING � ROAD RIGHT OF WAY) N �� �--2.5't BEAR1IWS ARE REFERENCED o I 30529' TO THE NORTH LINE OF THE �. N 87°37'56"W NORTHEAST 114 OF N y SECTION 21,T29 N, ` R 11 W,ASSUKED AS Z� --- S 87°3731°E OHWM ESTABLISHED BY + THE ST.CROV COUNTY /_• tti SCALENNFEET 1.2'", I ZONING DEPARTMENT � J _ ON 52303 60 6 160 260 44 P Z, LEGEND s� ER` M W. INDICATES 1-114*O.D.z 18'IRON r / ANY PROPOSED ACCESS ACROSS PIPE SET(MIN.WT.-1.13 LB-I.F.) /,• / A NAVIGABLE DRAINAGEWAY MAY SECTION CORNER MONUMENT REQUIRE PERMITS FROM THE ST. (AS NOTED) CROW COWN ZONING DEPARTMENT o =! AND THE DEPARTMENT OF NATURAL z N —■-- INDICATES FENCELINE RESOURCES. SOUTH LINE NWI*NEW NORTH LINE SWI 4-IVE& w 0, • ."7! LAUR •• ' W. ~ W MURPHY ��;•° DENVILLE,� K N 87'2.947°W 700.1 Tr p wl A0 DATED: s •° •. .••'�4 MARCH 17,2003 a� u,tvo sv REVISED: j� �! JUNE 19,2003 THIS INSTRUMENT DRAFTED BY JERALD L.LARSON , SHEET 1 OF 2 Vol.17 Pg. 4551 ~ f I ©�" PIaVt PIUM , h S O � g�t ► p�t4t ND DEpA�-AMEN -MIT �-n Poe Gar. She CQ.sf l d0.oc) NB cf}ovy\ of Nou sc_ D rw e. �tK,-- Po le Nose 5 keck ✓ProPose� �o�cQ�h�jTan� �s. Y agsrrf !r I -ro et VCNI flvdc, 17�J4 COLO 7 G�cX Ig 's e j h j 0104 1 HOLDING TANK CROSS-SECTION AND SPECIFICATIONS Approved Approved Locking: Vent Cap Weather Proof Manhole Cover Junction Box with Warning Label 4 C.I. 12 Min Vent Pipe 4" Min Final Grade�'�, Approved Joint 18" Min Water Tight Seal - — High Water Alarm Switch _ APpr ved C In Pip/ e uw� �cY of �rI M1� Extending 3' Onto �_ Va� a� l 17 7„X Soli Soil��QNS Gunj �SP►F A a�NG� Flo 917, 3" of Q c- v�) Uv e r� cuh. SPECIFICATIONS TANK Manufacturer: M I� LA)P.S� h f r ecxxs f Tank Size• ,2 6C)p Gallons ALARM Manufacturer: �,S C�ec.'{', Model Number: j Switch Type: • NUMBER OF BEDROOMS: OWNER'S NAM X: V .e� A� ADDRESS: � y ck, i ' LEGAL DESCRIPTION: NE a, SLUT' , Sec. T 2 V , R 6W TOWNSHIP/MUNICIPALITY: (jn[j C,j,v\ COUNTY: �-"f_ 0 R O l�( SIGNED: LICENSE NUMBER: DATE: 00 � i DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&HUMAN RELATIONS P.O.BOX 7969 PRIVATE SEWAGE SYSTEMS DIVISION MADISON,WI 53707 BUREAU OF PLUMBING NE%,Spl%,S16,T29N-R16W NKCONVENTIONAL El ALTERNATIVE IState Plan l.D.Number: Tower, o{ Batdwin 1:1 Holding Tank ❑ In-Ground Pressure El Mound (lf assigned) 235th S;c.eet. NAME OF PERMIT HOLDER: JADDRESS OF PERMIT HOLDER: INSPECTION DATE: Wayne VeenendaU Rowe 1, Ba idwin, W1 54002 BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF.PT.ELEV.: Name of Plumber: MP/MPRSW No.. Coumy: Sanitary Permit Number: Bennie He2gu on 3215 S�. Cna�x 112&32 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY; TANK INLET ELEV.: TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: DYES ONO DYES ONO' BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUM .ROAD: PROPER TV WELL: BUILDING: (VENT TO FRESH ALARM: E ,, LINE: AIR INLET: OYES ONO ❑YES 1:1 NO NE0RIE, DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY. JPUMP MODEL. PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ONO OYES ONO OYES E-1 NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL , PROPERTY WELL: IBUILDING. VENT TO FRESH (DIFFERENCE BETWEEN LINE AIR INLET. PUMP ON AND OFF) ❑YES ❑NO 11NARE. SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH IDIAMETER MATERIAL AND MARKwG or excavation. (If soil can be rolled into a wire,construction shall cease until the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH: LENGTH. NO.OF DISTR.PIPE SPACING. COVER INSIDE DIA.. #PITS. LIQUID TRENCH ES. MATERIAL: KTI DEPTH: GRAVEL DEPTH ; FILL DEPTH DISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO.DISTRiR PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES ABOVE COVER: ELEV.INLET.ELEV.END. PIPES �r �y�� `r.LINE: AIR INLET: E.ET"F"@@vN7rR 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- ❑YES NO meets the criteria for medium sand. TIONS MEASURED. ❑ SOIL COVER ITEXTURE PERMANENT MARKERS OBSERVATION WELLS DYES NO ❑YES NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. SODDED. SEEDED: MULCHED: CENTER. EDGES NO 1-1 YES ONO 1-1 YES ONO PRESSURIZED DISTRIBUTION SYSTEM: " � WIDTH: LENGTH: TRENCHES: LATERAL SPACING: GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER. �� TRENCHES: MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING: ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.: �A6 HOLE SIZE HOLE SPACING: DRILLED CORRECTLY. COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO APPROVED PLANS: F-1 YES NO ❑YES E NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: PROPERTY WELL: BUILDING: ""LINE: ❑YES 1:1 NO 1:1 YES E NO Sketch System on Retain in county file for audit. Reverse Side. TITLE: DILHR SBD 6710(R.01/82) [NATURE: Zoning Adm i,nio6 t c.aton DILHR SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05,Wis.Adm.Code St. Croixx STATE SANITARY PERMIT —Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN II..D.NUMBER 8%x 11 inches in size. S88-04026 —See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES ® NO PROPERTY OWNER PROPERTY LOCATION Wayne )/+¢0i0il/ Veenendall NE % SW '/4, S 16 T 29, N, R 16 V (or)W PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME Route 1 CITY,STATE ZIP CODE PHONE NUMBER CITY NEAREST ROAD,LAKE OR LANDMARK Baldwin WI 54002 715 684-21 M VILLAGE:Baldwin 235 th Street II. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family 3 OR ❑ Public(Specify): III. PURPOSE OF APPLICATION: (Check only one in#1. Check##2,3 or 4,if applicable) 1. a. ❑ New b.FX1 Replacement c. ❑ Replacement of d.❑ Reconnection of e.❑ 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. ❑Conventional b. ❑Alternative c. ❑ Experimental 2. a. ❑System- b. Q 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. ❑ See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 14. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): Feet ®Private ❑Joint ❑ Public V1. TANK CAPACITY Site in aa ons Total #of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks strutted Septic Tank or Holding Tank ❑El ❑ Lift Pump Tank/Siphon Chamber VII. 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 tamps) MP/MPRSW No.: Business Phone Number: Bennie Helgeson 3215 Mp 715 778-4425 Plumber's Address(Street,City,State,Zip Code): Name of Designer: Rt. 2, Spring Valley, WI 54767 Bennie Helgeson VIII. SOIL TEST INFORMATION Certified Soil Tester(CST)Name CST# Bennie Helgeson 3094 CST's ADDRESS(Street,City,State,Zip Code) Phone Number: Rt. 2, Spring Valley, WI 54767 715 778-4425 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) LAJ Approved ❑ Owner Given Initial ] t rcharge Fee Adverse Determination I -�U 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 } INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION 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: I. 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 81/2 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 Ground at8r— included the creation of surcharges (fees) for a number of regulated practices which disco irt'S o can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried reasure'. is used in your building is returned to the groundwater through your soil absorption u system or the disposal site used by your holding tank pumper. The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- t water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398(R.03/86) 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 I-A A - Location of Property A/E 14 _,IV 14, Section , T N-R�_ W Township Mailing Address -23J' 57- Address of Site Subdivision Name Lot Number Previous Owner of Property IDe�h'1 t Lee h-en Total Size of parcel `/ l Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes ✓' No Volume $' and Page Number 7 as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and pa&e 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 pro ess. If the deed description refer- ences to a Certified Survey Map, the Certified Sur I ey Map shall also be required. PROPERTY OWNER CERTIFICATION I (We) cettiby that att statements on this bonm cute true to the best ob my (out) knowledge; that I (we) am (ah.e) the owneA(s) o6 the pu petty dens CAibed in this inboAmation bonm, by virtue ob a ww anty deed neconded in the Obbice ob the County Registet ob Deeds as Document No. 2 yZ c,� ; and that I (We) pne�sentty own the pu po.e ed .6 to bon the �6 ewwag e d ins pos at .6 yam (on I (we) have obtained an easement, to nun with the above deschibed ptopetty, bon the construction ob .said .syztem, and the same has been duty %econded in the Obbice ob the County RegisteA ob Deeds, as Document No. ) . SIGNA URE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED --' N.C.MILLER CO.-NILWALKEE WARRANTY DEED.—To Husband and WIN as Joint Tenants FORM 399 Revised) 278265 November ......................... in the year ----------day of----------- - - - Th is Indenture, Made this________________r_-_ ----- - - - - - of our Lord, one thousand nine hundred and-sixty-four___________________between.-DeLmer_-Veenendall,•-_also-----_-- known as Delmar Veenendall2...and .Gertrude_Veenendsll_,._.hus baxld__and__wi.fe_,--•as-•jo.int--- tenants, Part.__ie_s__of the first part, and--------Wayne Veenendall and Ruth_Veenendatt________________________________ Baldwin Wisconsin--------------------------------------------------- husband and wife, as joint tenants, parties of the second part. ----of the first part, for and in consideration of the sum of Wltnesseth, That the said part... Hundred $16 500 00 --------------------- - --Dollars, -- ---------------- Sixteen Thousand Five---------- - them in hand paid by the said parties of the second part, the receipt whereof is hereby confessed and acknowledged, ha--ve-__given, granted, bargained, sold, remised, released, aliened, conveyed and confirmed, and by rant, bar gain, sell, remise, release, alien, convey and confirm unto the said parties of these presents do_-_.---_._-.give, g g the second part, as joint tenants, the following described real estate, situated in the County of...... t:...Qxw x----------- ---------------------------and State of Wisconsin, to-wit: North Half of the Southwest Quarter (N2 of SWµ) , North Half of the Northwest Quarter of the Southeast Quarter (N2 of NW-4 of SE-14) , West Half of the West Half of the Southwest Quarter of the Northeast Quarter (W2 of W2 of SW-14 of NE-14) and two (2) rods off the North side of the Southeast Quarter of the South- west Quarter (SE-, of SW-14) all in Section Sixteen (16) , Township Twenty-nine (29) North, of Range Sixteen (16) West, St. Croix County, Wisconsin. This deed is given in fulfillment and satisfaction of that certain land contract between the above parties, dated April 25, 1960. IM 11,11IN1111 1'_{Fy li ll' I I 1 li a i'. 1 1 111 N 1 1 1 t9 s � , lees v � N 11'IV /1 Will: Vt' 1 Yi�l 1 YYNI V.' 11` YNI Together with all and singular the hereditaments and appurtenances thereunto belonging or in any wise apper- s first taming; and all the estate, right, title, interest, claim or demand whatsoever, of the said partie ---_of the rst part, either in la.':or equity, either in possession or expectancy of,in and to the above bargained premises,and their heredita- ments and appurtenances. scribed, with the hereditainents and appurtenances, unto the To have and to hold the said premises as above de __ said parties of the second part, as joint tenants. Delmer Veenendall, also known as Delmar Veenendall, and ..Gertrude ---- And the said--------------------- --------------- --------------- - ------------------------------------- ------- --- -------------- ies Veenendall, husband and wife, as joint tenants, ------------------------------part------------of the first part, Veene - -.—--------I--------------------------- --- -----------—--------- .—.1------------- their ovenant, grant, bargain, and agree to and for.themselves, ------heirs, executors and administrators, do---------------..-.-c ------------------------------- with the said parties of the second part, and to and with the survivor of them, his or her heirs and assigns, that at they are------------well seized of the premises above the time of the ensealing and delivery of these presents-------- --- ---------- described, as of a good, sure, perfect, absolute and indefeasible estate of inheritance in the law, in fee simple, and thAt the same are free and clear from all incunibrances whatever.....----------- ------------------------------------------------------------------------------------- ......•............................................... --------------- --------------------------------------------------------------------------- ------------------------------------------------------------ -- -------- -------- -------------------------------------------------------- ----I................................................................. and that the above bargained premises in the quiet and peaceable possession of the said parties of the second part, as joint tenants, his or her heirs and assigns, against all and every person or persons lawfully claiming the whole or any part thereof---------the-y-----------will forever WARRANT AND DEFEND. In Witness Whereof, the said part-i-es—of the first part ha---v e-----hereunto set----------thqJr-----------hand----Sand seals....this--------------3 r-d-------------------day of-------------N-ov-embe-r---------- ------------ A. D., 19—-6---4 ---- Signed, Sealed and Delivered in Pre ce of Delmer Veenendall ....(SEAL) .. ................. Gertrude Veenendall A. A. Willink ------------------------------------------(SEAL) ---------------------------------------------(SEAL) ------------------------- STATE OF WISCONSIN, St. Croix .......................I..............................County. November 64 Personally came before me, this.-----------rd--------------------------day of----------------------------.............................A. D.. 19.......... (' d, Delmer Veenendall, also 'known as Delmar Veenendall, and -Gertru q ----------------------------------------------------------- .. ................ the above named------------------------------------------------s--------------- --------------------------- T 'V I., s joint tenants, d wife, a . ............................................................................. Veenendall, husband an .... ..... ------------------------------ - --------------------- -----------------I---------- -- ------------------- - to me known to be the persons.---who executed the foregoing instrument and ackno ed Z ...... A Drafted by Harold D. Olson, Atty. Notary Public,ltt---q-rPix.........County, Wis. My commissio-ft txpire%..6eqt..:.. (Section 59.51 (1) of the Wisconsin statutes provides that all instruments to be recorded shall have plainly printed or typewritten thereon the names of the grantors, grantees, witnesses and notary) 4-1 0 ;4 1 4i.9 v i3 2s 0 Cd r-4!In 0 CU U 0 �0 V rd 10 : 1--� I En ro LI.J U U) i M co Z L H: 0 44 0 Cd U 0 CIS I 00: M ro ro —1 0 [-4 Z 0 Q) (3) E-4 0 0i P: ce. �R; U 0 0 Ui(4 a) v ca 0 ai 1 > ro -o 4. 6 r� 0 co 0i > 0 CU 1. ro CO ai —0 41 HOLDING TANK SERVICING CONTRACT This Agreement is made and entered into this ' -2-day of �� 19&T, by and between Zd -V�ee hereinafter called the "owner" and hereinafter called the "pumper." We hereby acknowledge the installation of (a) holding tank(s) on the following described property: 1, The owner agrees to file a copy of this contract with the local governmental unit hereinafter called the "municipality", which has signed the pumping agreement required in ch. ILHR 83.18 (4) (b), Wis. Adm. Code and with the County of . 2. The owner agrees to have the holding tanks) serviced by the pumper and guarantees to permit the pumper to have access and to enter upon the property for the purpose of servicing the holding tank(s). The owner agrees to maintain the all weather access road or drive so that the pumper can service the holding tank(s) with the pumping equipment. The owner further agrees to pay the pumper for all charges incurred in servicing the holding tank(s) as mutually agreed upon by the owner and pumper. 3. The pumper agrees to submit to the municipality which has signed the pumping agreement required by s. ILHR 83.18 (4) (b), Wis. Adm. Code and to the county a report for the servicing of the holding tank(s) on a semiannual basis. The pumper further agrees to submit a report which shall include: a. The name and address of the person responsible for servicing the holding tank; b. The name of the owner of the holding tank; c. The location of the property on which the holding tank is installed; d. The sanitary permit number issued for the holding tank; e. The dates on which the holding tank was serviced; f. The volumes in gallons of the contents pumped from the holding tank for each servicing; g. The disposal sites to which the contents from the holding tank were delivered. 4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event of a change in this contract, the owner agrees to file a copy of any changes to this ser ice contract or a copy of a new service contract with the municipality and the County of 1� within ten (10) business days from the date of change to this service contract. SIGNATURE OF OWNER(S): SIGNATURE OF PUMPER (Include License Number): V X 7 7_3 State of Wisconsin )came before me this a day of A.D., 19 )to me known to be the person who executed the foregoing County of )instrument and acknowledged the same. Subscribed and sworn to before Me this P-*day of Notary My car mission exq�j�Notry Public State of%sconsin nssiea-€xpiFes Off'22-4 989 This instrument was drafted by the State of Wisconsin Department of Industry, Labor and Human Relations, Bureau of Plumbing. II 44 ,1.81 r. eon 8 ?AUK 17 3 HOLDING TANK AGREEMENT This Agreement is made and entered into this 6th day of September by and between the Township of Baldwin hereinafter called the "municipality" and ' Wayne Veenendall hereinafter called the "owner." We hereby acknowledge that application is being made for the installation of (a) . holding tank(s) on the following described property: NE—SW of Section 16-29-16 or that continued use of the existing premises requires that a holding tank be installed on the property for the purpose of proper containment of sewage. We also acknowledge that said property cannot now be served by a municipal sewer, any other type of private sewage system as permitted under ch. ILHR 83, Wis. Adm. Code, or ch. 145, Stats., and that the property does not contain an area of soil suitable for any other type of private sewage system as permitted by ch. ILHR 83, Wis. Adm. Code. Therefore, as an inducement to the County of Stw Croix to issue a sanitary permit for the above described premises, we hereby agree and bind ourselves as follows. 1. Owner agrees to conform to all applicable requirements of ch. ILHR 83, Wis. Adm. Code relating to holding tanks. If the owner fails to have the holding tank properly• serviced in response to orders issued by the municipality to prevent or abate a nuisance as described in ss. 146.13 and 146.14, Stats. and the municipality may enter upon the property and service the tank or cause to have the tank serviced and charge the owner by placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by s. 66.60, Stats. • I 2. Owner agrees to pay all charges and costs incurred by the municipality for inspectibn, pumping, hauling or otherwise servicing and maintaining the holding tank in such a manner as to prevent or abate any nuisance or health hazard caused by the holding tank. The municipality shall notify the owner 6f any costs which shall be paid by the owner within thirty (30) days from the date of notice! In the event the owner does not pay the costs within thirty (30) days, the owner hereby specifically agrees that all of the costs and charges may be placed on the tax roll as a special assessment for the abatement of a nuisance, and the tax shall be collected as provided by Wisconsin Statute. 3. The owner., except as provided by s. 146.20 (3) (d), Stats., agrees to contract with a person who is licensed under ch. NR113, Wis. Adm. Code to have the holding tank serviced and to file a copy of the contract or their registration with the municipality and with the. county. The owner further agrees to file a copy of any changes to the service contract or a copy of a new service contract with the municipality and the county within ten (10) business days from the date of change to the service contract. • aaaK 822 ?��E K 4. The owner agrees to contract with a person licensed under ch. NR11S, Wis. Adm.'Code who shall submit to the municipality and to the county a report in accord with s. ILHR 83.18 (4) (a) 2., Wis. Adm. Code for the servicing on a`semiannual basis. In the case of kregistration under s. 146.20 (3) (d) , Stats. , the owner shall submit the report to the municipality and the county. ` 5. This agreement will remain in effect only until ithe local governmental unit responsible for the regulation of private sewage systems certifies that the property is served by either a municipal sewer or a soil absorption system that complies with ch. ILHR 83., Wis. Adm. Code. In addition, this,. agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which will permit the existence of the certification to be determined by:reference to the property. 6. This agreement shall be binding upon the owner, the heirs of the owner and °v assignees of the owner: The owner shall file the agreement with the register of deeds which \ shall be recorded by the register of deeds in a manner which will permit the existence of the agreement to be determined by reference to the property whe a holding tank is installed. SIGNATURE OF OWNER(S): ^ SIGNATURE OF MUNICIPAL OFFICIAL (Include Title): L+: ttn �W• f`� '°�'�— t Ay > State of Wisconsin )came before me this 6 day of Sept: A.D., 19 88 , )to me known to be the person who executed the foregoing County�of St Croix )instrument and acknowledged the same. Su*Zibtd.an4 sw�ork to before !4 it h..qa' of Y $ept. 19 88 Notary My corypiission.exp,} .April 30, . 19 RECEIVED FOR RECORD 61h day of Septa A.D., 19 A_L, at 9"55 o'clock M. and recorded in Volume 822 of Reoor ;ist;er 72 & 78. of D eeds St. Croix County This instrument was drafted by the State of Wisconsin Department of Industry, Labor and Human Relations, Bureau of Plumbing. DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISON BOX I 53707 HUMAN RELATIONS (H63.0911)& Chapter 145.045) LOCATION: SECTION: OWNSHI MUNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: /�5 to /T N/R bE (or)W Q w COUNTY: OWNER'S Q�"+`z�n�-:+�.":��: MAILIN ADDRESS: t. C o e ! (C' ("\ CO-I..- o USE DATES OBSERVATIONS MADE �c NO.BEDRMS.: COMMERCIAL DESCRIPTION: �-��// PROFILE DESCRIPTIONS: PERCOLATION TESTS:- J I­NeResidence /� ❑New NrKeplace C/ e RATING:S=Site suitable for system U=Site unsuitable for system G b D �a��� a.3o r ON�VENTI©AL: MOUND:� IN-GROUND-P�RE: SYSTEM-IN-FILL OLDI G TANK:,RECOMMENDED SYSTEM:(optional) If Percolation Tests are NOT required DESIGN RATE: If an portion of the tested area is in the under s.H63.09(5)(b),indicate: /A I Floodplain,indicate Floodplain elevation: N PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-LAIRS CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER DEPTH W, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) s B r 3,p' gb.7s ©�n 1,67 •s; e �► S�� , s' 51- �, f 81 SiIts ./'1.+ Sh lo . 3'a" Ss;l *roo.1. - B- B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PERIOD2 PERIOD 3 PERINCH P- P- P- P-_ P- P- _ PLOT PLAN: Show locations of percolation test , soil borings and the dimensions of su table soil area . Indicate scale or distances. Describe what are the hori- zontal and vertical elevation r ference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. &rr% -pok .. ca- `/ - r/O SYSTEM ELEVATION n on car. k ® F. 0. CHcs i l F e � - rxSC , t*a it O i 3 t ► ; j _- t A if 7-i xr j C' Flt C t3 B y � r � I } � h .. .�. +.- _ �- __v i _ 3 L mt_ Q Q �/ U , I,the undersigned, hereby certify that the s test repor d on this form!!!„Lavac{_by me in accord with the pro edur s d methods specified in t e Wisconsin Administrative Code,and that the data reAded d the cation of the aro4 eorrect{o t Te est of my knowledge and bel f. NAME(pri ): * TESTS WERE COMPLETED ON: ADDRESS. ERTIFI AT ON NUMBER: PHONE NUMBER(optional): lyl P t oq S T S I G N ATU RE: S7 CRC)j, COUNTY ZONINGOFFICE: DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) `-. OVER — _J INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 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; 3. MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement systern; b. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locatiag your test locations. Draining to scale is preferred. A separate sheet may be used if desired; 8. Make sure your benchmark and vertical elevation reference point are clearly shown,and are permanent; 9 Complete ail appropriate boxes as to elates, 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 distribcrte as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION, ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st Sto€acs, (over 10") BR — Bedrock cola _ Cobble (3- 10") SS — Sandstone gr Gravel (under 3") LS — Limestone % — Sand HGW High Groundwater cs — Coarse Sand Perc - Percolation Rate reed s Medium Sand W -- We 11 fs _ Fine Sand Bldg BUiIdingl Is Loamy Sand j -. Greater Than si — Sandy Loam _ Less Than { -- Loam Bn — Brown 'sii - Silt Loarn BI - Black si — Silt a Gy — Gray gel — Clay Loam Y Yellow scl Sandy Clay Loam R — Red sicl - Silty Clay Loam mot - Mottles sc -- Sandy Clay w vvith sic — Silty Clay fff — few, fins, faint c Clay cc -. common,coarse pt — feat inrn — Many, medium rri — Muck d - distinct p — prominent HWL — Nigh water level, Six general soil textures surface water for liquid rtvaste disposal BM — Bench Mark VRP -- Vertical Reference Point 'TO THE OWNED: i his soil test report is the first step in SeWrinct e sanitary permit. The county or the Department may request ve rifieation of this soil test in thr= field prior :zr permit issuance. A cornplete set of pl<sns for the private ,rwacte system, and a !"wrinit application must be suoniitted to the appropriate local authority= iri order to obulin d llerrnit. 1-11e sami ai y permit must he ubtaincri and poster# prior to the start of<Ioy cc>rasiruction. k ST. CROIX COUNTY WISCONSIN ZONING OFFICE { ,? ST.CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON,WI 54016 MAILA (715) 386-4680 September 9, 1988 Divi,sion ob Satiety and Bu,ieding Bu iau o6 Ptumbing P.O. Box 7969 Mad,uson, Wl 53707 Dean Si,%: An on z to invezt gati,on bon the Wayne Veenenda22, .located at the NF4 o6 the SW4 o6 Section 16, T29N-R16W, Town o6 Wdvin, St. Croix County, teveated zmitabte doitz at a depth o4 1.4 jeet, beCow which .ae"onabte high ground water was noted. I This 6 to shoutd be suitab.te bon amound bydtem. Shoutd you have any que,6tionz, pte"e beet 6,tee to contact .thi6 o6jice. Sinceaety, Thoma3 C. Ne zon Zoning Admin iz t a ton TCN/jAz