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Parcel #: 012-1010-70-050 02/16/2007 02:13 PM
PAGE 1OF1
Alt. Parcel#: 03.30.17.40A-10 012-TOWN OF ERIN PRAIRIE
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
O- ELKIN, JOHN A&VICKIE L
JOHN A&VICKIE L ELKIN
1753 CTY RD T
NEW RICHMOND WI 54017
Districts: SC=School SP=Special Property Address(es): '=Primary
Type Dist# Description 1753 CTY RD T
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE
SEC 03 T30N R17W PT NW NE SW NE, SE NW, Block/Condo Bldg:
NE NW; COM W COR SEC 3; S 88' E
2302.36FT TH N 00' E 211.06FT TO POB; TH Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
CONT N 00' E 1431.14FT;TH S 85' E 03-30N-17W NW NE
504.08FT; TH N 81' E 328.75FT; TH S 42'
E 204.83 FT; TH S 65' E 225.58FT; TH N
more
Notes: Parcel History:
Date Doc# Vol/Page Type
03/27/2003 714844 2185/187 AFF
03/27/2003 714843 2185/186 QC
02/26/1999 598427 1406/263 CORDE
12/05/1997 569282 1280/148 WD
more
2007 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 11/07/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 9.200 69,800 323,200 393,000 NO
UNDEVELOPED G5 26.000 41,600 0 41,600 NO
Totals for 2007:
General Property 35.200 111,400 323,200 434,600
Woodland 0.000 0 0
Totals for 2006:
General Property 35.200 111,400 323,200 434,600
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: 12/04/1998 Batch#:
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS
LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P.O.BOX 7969 BUREAU OF PLUMBING
MADISON,WI 53707
SEi, W4, S3,T30N-R17W `CONVENTIONAL El ALTERNATIVE UfassPi"I.D.Number:
Town o4 EA in PAai,,t :,e ❑Holding Tank El In-Ground Pressure ❑Mound
Counta Road T /� [
NAME OavidT vaon gRoute 3, New Richmond, WI 54017 INSPF�T`ON QATE_:I� ` O
BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN. 33 REF.PT.ELEV.: 11 CST REF.PT.ELEV..
MP
Name of Plumber: /MPRSW No.: County: Sanitary Permit Number:
Garay L. STeet2 3254 St. Croix 112705
SEPTIC TANK/HOLDING TANK:
MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV_ WARNING LABEL LOCKING COVER
PROVIDED PROVIDED
52 ,-;_ l 4 AES ONO DYES iPQNO
BEDDING: VENT DIA.. VENT MATL. JHIGH WATER NUMBER OF ROAD: PROPERTY WELL. BUILDING. VENT TO FRESH 14 ALARM FEET FROM a Ei3
JAIIINLET
EYES NO `12 : YES ❑NO NEAREST
DOSING CHAMBER:
MANUFACTURER 71NGS LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER ACTIIRER WARNING LABEL LOCKING COVER
ROVID D: PROVIDED:
YE ❑NO ❑Y ❑ OYES ONO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PR OPE V W LL BUILDING VENT TO FRESH
IDIFFERENCE BETWEEN FEET FROM LINE AIR INLET
PUMP ON AND OFF) 1:1 YES FIND NEAREST
SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing I LENGTH IDIAME TE A A Q M RKING
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:
WIDTH: LENGTH. NO.OF DISTR.PIPE SPACING. COVER INSIDE DIA -PITS LIQUID
BED/TRENCH `^ TRENCHES t + MATERIAL: PIT DEPr I
DIMENSIONS N Q f,
GRAVEL DEPTH FILL DEPTH UISTH.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: 97NEAR____NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH
BEL W PIPES ABOVE SOVER. ELEV.INLET ELEV.END, FEET FROM NE AIR INLET
f 3. nl ,, ��� EST ► 3 Q �� 15S
M OUND 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 ONO meets the criteria for medium sand. TIONS MEASURED.
OIL COVER ITE XTURE PERMANENT MAHKERS 013SEHVATION WELLS
❑YES El El YES NO
DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED
CENTER EDGES.
❑YES ❑NO ❑YES ❑NO OYES ❑NO
PRESSURIZED DISTRIBUTION SYSTEM:
BED/TRENCH WIDTH LENGTH TRENCHES: LATERAL SPACING GRAVEL DEPTH BELOW PIPF FILL DEPTH ABOVE COVER
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR.PIPE M DISTR JD�STR PIPE DISTRIBUTION PIPE MATERIAL&MAHKING
ELEV.'. ELEV,: DIA.. ELEV.. PIPES DA.:
ELEVATION AND
DISTRIBUTION
INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED
PLANS
1:1 YES ONO OYES ONO
COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS. NUMBER OF PROPE RTV WELL BUILDING.
SFEET FROM LINE
r� ❑YES ❑NO ❑YES ❑NO NEAREST
"P3 17
Sketch System on Retain in county file for audit.
Reverse Side.
SIGNAT E. TITLE. �
DILHR SBD 6710(R.01/82) C Zo►u rag AdministAatot
r
Form - STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER ()(C TOWNSHIP SEC. 3 T 3U N-R W
ADDRESS ST. CROIX COUNTY, WISCONSIN
SUBDIVISION ; �- LOT LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of I•LHR 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
q'
t
f �
I \
s
-R
INDICATE NORTH ARROW
BENCHMARK: Describe the vertical reference point used — -
Elevation of vertical reference point: �(��` Proposed slope at site:
SEPTIC TANK: Manufacturer: Liquid Capacity:
loot)T,t!l.
Number of rings used: Tank manhole cover elevation: 1L G
Tank Inlet Elevation: 7 ` s Tank Outlet Elevation: 7 z S
Number of feet from nearest Road: Front,(Side 0 Rear, O feet
From nearest property line Front,0 Side,O Rear,O > feet
Number of feet from: well J1,4 building: �:zG} 1
(Include this information of above plot plan)( 2 reference dimensions to septic tank)
SEE REVERSE SIDE
1
PUMP CHAMBER
Manufacturer: Li acity:
Pump Model: Pum iphon Manufacturer: Pump Size
Elevation of inlet: Bottom of tank elevation:
Pump off switch a vation: Gallons per cycle:
Alarm Manufa urer: Alarm Switch Type:
Number o feet from nearest property line: Front, O Side, O Rear,Q Ft. ''
Number of feet from well:
Number of feet from building:
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed: Trench:
Q �
Width: � ' Lenith: — Number of Lines: Area Built: ^
�a
Fill depth to top of pipe:
i
Number of feet from nearest property line: Front, QSide, Rear,O Vt _
Number of feet from well: /X
T
Number of feet from building:
: c�
(Include distances on plot plan).
SEEPAGE PIT
Size: Number of pits: Diameter:
Liquid depth: Bot of seepage pit elevation:
Area Built:
Has either a drop box or distribution box O been used on any of the above soil
absorbtion sytem (Check one).
HOLDING T
Manufacturer: Ca y:
Number of rings used: E1 ation of bottom of tank:
Elevation of inlet:
Number of feet from nea st property line: Front, O Side, O Rear, O Ft.
ber of feet from well:
tuber of feet from building:
mber of feet from nearest road:
Ala anufacturer:
Inspector•
Dated: Z/ Plumber on job: <
License Number: d7 ld ZS fL
3/84:mj
SANITARY PERMIT APPLICATION COUNTY -
T DILHR St. Croix
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 STATE PLAN I.D.NUMBER
8'h x 11 inches in size.
—See reverse side for instructions for completing this application. PETITION
1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES D�NO
PROPERTY OWNER PROPERTY LOCATION
David Olson SE '/,NW %a, S 3 T30 , N, R 17 Xgor)W
PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME
R.R.0 m/a n/a n/a
CITY,STATE ZIP CODE PHONE NUMBER 7 CITY NEAREST ROAD,LAKE OR LANDMARK
New Richnmond Wi. 54017 1 (715 246-2236 o TILLAGE:Erin Prarie Co. Rd. ##T TOWN OF7
11. TYPE OF BUILDING OR USE SERVED:
Number of Bedrooms if 1 or 2 Family 3 OR ❑ Public(Specify):
Ill. PURPOSE OF APPLICATION: (Check only one in#1. Check##2,3 or 4,if applicable)
1. a. KI New b. ❑ 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. ❑ 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):
class 1 495 500 96.26
Feet NXI Private Ehoint Public
VI. TANK CAPACITY Site
in gallons Total ##of 's Name Prefab. Con- Steel Fiber- Plastic Exper.
Manufacturer
INFORMATION New xisting Gallons Tanks Concrete stCon- glass App.
Tanks Tanks
Septic Tank or Holding Tank X 1000 1 Weeks C.P. ❑
Lift Pump Tank/Siphon Chamber ---- ❑ ❑ ❑ ❑
VII. RESPONSIBILITY STATEMENT
1,the undersigned,assume responsibility for installati n of the private sewage system shown on the attached plans.
Plumber's Name(Print): Plumber's gnature:(N to s) XW/MPRSW No.: Business Phone Number:
Gary L. Steel i' 2 3254
715 46-6200
Plumber's Address(Street,City,State,Zip ): I Name of Designer:
988 N. Shore Dr. , New Richmon4, Wi. 54017
VIII. SOIL TEST INFORMATION
Certified Soil Tester(CST)Name CST#
Gary L. Steel 2298
CST's ADDRESS(Street,City,State,Zip Code) Ph umber:
0988 N. Shove Dr. , New Richmond, Wi. 54017 ��� 246-6200
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee I Groundwater Date Iss g Agent Signature(No Stamps)
Approved ❑ Owner Given Initial rcharge Fee o
Adverse Determination ,C�
X. COM NTS/REAS NS 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 W% 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
included the creation of surcharges (fees) for a number of regulated practices which Wisco iCt'S
e
can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried restore
is used in your building is returned to the groundwater through your soil absorption e
system or the disposal site used by your holding tank pumper.
0
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- f
water, groundwater contamination investigations and establishment of standards. Groundwater,
it's worth protecting.
SBD-6398(8.03/86)
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 B. David Olson
Location of Property SE k NW 1%, Section 3 , T 30 N-R 17 w
Township Erin Prarie
Nailing Address R.R.#3
New Richmond, Wi. 54017
Address of Site R.R.33
New Richmond, Wi. 54017
Subdivision Base - n/a
. Lot Number n/a
Previous Owner of Property Clarence 0. Polfus
Total Size of Parcel 80 acres
Date Parcel was Created 7-15-86
Are all corners and lot lines identifiable? x Yes No
Is this property being developed for resale (spec house) 1 Yes _ x _ No
Volume 747 and Page Number 339 as recorded with the Register of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A Warranty Deed which includes a Document number, volume and page number, and the
Seal of the Register of Deeds. In addition, a certified survey, if available, would be
helpful so as to avoid delays of the reviewing process. If the deed description refer-
' ences to a Certified Survey Map, the Certified Survey Map shall also be required.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
PROPERTY OWNER CERTIFICATION
i (Wo I co-Ati.6y that a.tt itatement6 on thus onm wce tJcue to the best o6 my (ouh)
hncwtedge; that I (we) am (OAe) .the ownen(�s� 06 .the phopeAty deAcAi.bed in thiA
.in6olmat.ion 6o&m, by viAtue o6 a waAAanty deed heconded in the 066.ice o6 the
Coruu.ty RegiAteh o6 Deeds ah Document No. 414621 ; and that I (We) pnesent.ty
avn flue pnoposrd 6jte 6oh the sewage disPOAaX system (oh I (we) have obtained an
ecuement to 'tun un •e w'
th the above dersau.bed phopeh.ty, bon the eona.thuc.ti.on o6 said
Aye•tv", and the same has been duty heconded .tn the 066.tce o6 the County Regi.e.teA o6
Oo�tpn
S ATURE Oh OWNE SIGNATURE OF CO-OWNER (IF APPLICABLE)
i
DATE SIGNED DATE SIGNED __
C% u
" DOCUMENT NO.
I TE BAR OF WISCONSIN FORM 1—1 THI6 SPACE RESERVED FOR RECORDING D �i
�S WARRANTY DEED DATA
►'
T
eoo 4 7PAGE'.33
This Deed, made between __ Clarence O. Polfu
..................•--- ASTERS OFFICE
-- .....•--•-- ST. CROIX QO
I ................•.............-•--...................
..........-
. Rec
..... __ ... Reco 18th
`j B � 'd. for rd this
and
ay.... �3lson and 'dud h =0 01sori Grantor, day of Jul
husband; and wife as' - ........_ ---__
]Olrit tenants,'-""""""
-.-........ ----------- of 8
.30 A
6
r ---------------------------------------<
- ---
t W,#1leSSeth; That the said Grantor, fo c Grantee,
of
� a
r a valuable consideration....._
AssqW
c
T VAYA to Grantee the following described real estate in ......-' r
yr.1x RETURN 70 —_
CoutltY,:;State of Wisconsin:
l
,Taz Parcel No
f. r < cfle;d description
Grantor; will not warrant title to an
-� is "south of the right-Of-way. y Property described which
y. of the SOO Line Railroad.
W '
r� Thul 18 not homestead p
(Ia'not). roperty.
Together with all and singular the hereditaments and And
grdntor appurtenances thereunto belonging;
warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances exce t .
P
and will,warrant and defend the same.
Dated this l ti l
.
�Ff .....
!.. -----•---•.... day of ...................July
.................................................. 19.86
X--
-----•--...... ••---(SEAL)
_...............
.... larence O .......................•----- .....(SEAL)
* Polfu
•......... .....••---....._.......-•--
-------------------------•--•(SEAL) ---•-
...........................•••-•-
* (SEAL)
x
.4r —
............................
AUTHENTICATION
7;fSI ($)' of :Clarence O. POlfus ACKNOWLEDGMENT
STATE
OF WISCONSIN
authenticated f '
this .flay of JU1 X. 6 -- ---- ---------County.
ss
Personally came before me this
" •.s,. - ..... .... .... ....... -----------------day of
.......................................... 19-------- the above named
. Norman
•...::.G. E -------------------•.........................................................
--
TITLE: MEMBER STATE BAR OF WISCONSIN ______
---------------
x xxxxxxxxxxxxxxxxxXXXXXXXXXX
�cxxxxxxX
to me known to be the person .............
foregoing instrument and acknowledge the s mecuted the
,
�P
pei$INSTRUMENT WAS DRAFTED BY
- AISKS t ' I�
..XQRMA.N
SCHUMACHER i
` H
eritage Drive ...... * .....................
1200;
-New'--R•i c 5401-7 ....._.
hmoTrd-;---inii-- .....---•..-------- ....................•--•-......................._.... _
Notary Public ........_
Signatures may be authenticated or acknowledged. Both My Commission is Count ,
are no necessary,) permanent. (if not, state expiration
date:' date: -
--------.. 19----.....)
*Names of persons sisaiaQ is any capacity should be typed or
' Printed below their str:aatures. _---`_"--_
WARRANTY DEED STATE BAB�..RF WISCONSIN
goon "T4 P AGE 340
A;1 '
The North Half of the Northeast Quarter (Ni of NE4) ; all that
part of the Southwest Quarter of the Northeast Quarter (SW4 of
NE4) lying Northerly of the railroad; the Northwest Quarter (NWT,) , .'
except the North 298 feet of the South 558 feet of the West 330` ;
feet thereof and except railroad right-of-way of record. All
in Section Three ( 3) , Township Thirty ( 30) North, Range Seventeen
( 17) West• 1r'„ ►}:.a}{11(q�!
Vendor reserves unto_himself and his successors and assigns .a � r� a
`porpetual •,non-oxelus.ive 'o'asoment :ovor the North Half of the`N
Quarter (N�
of NNk) of Section Throe (3) , Township Thirty (30)` '�tit �
Ar west over,,,the, road;as now laid,out'
tid �.eav°eI'+�A' anf a�ld� 80i► ,±MRP�►r,cdl� •loe �n' `�,eir andagcas"'to"�
N Eh�t South .ttelt of �tha;:;8owt oi►at ,,Qu�rtor S�j;,r,of SE );�,,qf Sectip
Ys xThirty-five- {3S) � ' .Township "Thirty ono '(31) North•, `Range Seven
,x
0 7) woat . `` Vendors -his '`successors and assigna reserves 'the``'n ���Y
' to 4I Ger this easement to the extent that it would extend from
a point on the proa®nt roadway immediately West of the Willow
Rivor directly North to said South Half of Southeast Quarter f„ f
(S of SCE) of Section Thirty-five ( 35 ) . �►ti.,., '.
This Warranty Deed is given in satisfaction of that Land Contract
dated May 1 ,;1985, and recorded in the St. Croix County Register
of Deeds office on May 3, 1985 , in Volume 711 of Records on Page
374 as Document No. 401707.
t-+
Ln
H
' a
STC - 105 r
a
H
SEPTIC TANK MAINTENANCE AGREEMENT o
St . Croix County z
d
a
H
OWNER/RMMR DalTid lsor r�
ROUTE/BOX NUMBER R R #3 Fire Number
CITY/STATE New Richmond, Wi 54017 ZIP
PROPERTY LOCATION : SE 14, NW Section 3 T 30 N , R 17 W,
Town of Erin Prarie St . Croix County ,
Subdivision n/a Lot number n,.
Improper use and maintenance of your septic system could result in
its premature failure to handle wastes . Proper maintenance con-
sists of pumping out the septic tank every three years or sooner ,
if needed , by a licensed septic tank pumper . What you put into
the system can affect the function of the septic tank as a treat-
ment stage in the waste disposal system.
St . Croix . County residents m_ y be eligible to receive a grant for
a maximum of 60% of the cost of replacement of a failing system,
which was in operation prior to July 1 , 1978 . St . Croix County
accepted this program in August of 1980, with the requirement that
owners of all new systems agree to keep their systems properly
maintained .
The property owner agrees to submit to St . Croix County Zoning a
certification form, signed by the owner and by a master plumber ,
journeyman plumber , restricted plumber or a licensed pumper veri-
fying that (1) the on-site wastewater disposal system is in proper
operating condition and (2) after inspection and pumping (if nec-
essary) , the septic 'tank is less than 1/3 full of sludge and scum.
Certification form will be sent approximately 30 days prior to
three year expiration. Ho
E
I/WE, the undersigned , have read the above requirements and agree N
to maintain the private sewage disposal system in accordance with x
H
the standards set forth, herein, as set by the Wisconsin Depart- b
ment of Natural Resources . Certification form must be completed
and returned to the St . Croix County Zoni fice within 30 days
of the three year expiration date .
SIGNED
DATE_
St . Croix County Zoning Office
P . O. Box 98-
Hammond, WI 54015
715-796-2239 or 715-425-8363
Sign , date and return to above address .
RT OF REPORT ON SOIL BORINGS AND SAFETY&BUILDINGS
INDU
INDl7STR Y,, G DIVISION
LABOR HUMAN NDLATIONS PERCOLATION TESTS (115) MADISON WI 53707
(H63.09(1)&Chapter 145.045)
LOCATION: SECTION: ITOWNSH IP/ tTY: LOT NO.:BLK.NO.: SUBDIVISION NAME:
SE 1/4M 3 /T 30 N/R1726or)W Erin Prarie I n/a n/a i n/a
COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS:
St. Croix B.David Olson R.R.#3 New Richmond Wi. 54017
USE DATES OBSERVATIONS MADE
®Residence NO.BEDRMS.: COMMERCIAL DESCRIPO ew Replace PROFILE DESCRIPTIONS: PERCOLATION TESTS:
3 n/a
6-8-88 n/a
RATING:S=Site suitable for system U=Site unsuitable for system
ONVENTIONAL: MOUND: IN-GROUND-PRESSURE:SYSTEM-IN-FILL HOLDING TANK:RECOMMENDED SYSTEM:(optional)
®S ❑U S ❑U S ❑U ❑S ]o U ❑S CCU conventional
If Percolation Tests are NOT required DESIGN RATE:
Q If any portion of the tested area is in the
under s.H63.09(5)(b),indicate: class 1 Floodplain,indicate Floodplain elevation: n/a
decimal' PROFILE DESCRIPTIONS page 29 AOB
BORINGI TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH
NUMBER DEPTH%, ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.)
B- 1 6.75 100.33 none >6.75 1.00bl.l. 1.00bn.s.l. 4.75bn.c.s.&gr.
B- 2 7.08 100.05 none >7.08 1.08bl.1. 1.00bn.s.l. 5.00bn.c.s.&gr.
B- 3 7.17 99.76 none >7.17 .50bl.1. 2.17bn.l.s. 4.50bn.c.s.&gr.
B- 4 6.75 98.44 none >6.75 .75bl.1. 3.00bn.c.s.&gr. 3.00bn.s.l.
B- 5 7.08 98.10 none >7,08 .67bl.1. 1.08bn.s.sil. 2.67bn.c.s.&gr. .58bn.s.1.
B-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERT D 1 PERIOD PERIOD 3 PER INCH
P-
P-
P- see desim rate
P-_
P-
P-
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope.
SYSTEM ELEVATION 96.26- ,8. �1 Ql
j
3
� ' i 2
_
x �
r
:
f
� v r°-° .�_. _ t .. _
i
I,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:
Gary L. Steel 6-8-88
ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional):
988 N 7 -2 -6200
CST S I G N ATW E:
4//
DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester.
DILHR-SBD-6395 (R.02/82) —OVER —
i
INSTRUCTIONS FOR COMPLETING; FORM 115 - SBD - 6596
`1-o be a complete and accurate soil test,your r0f)01-t must inclu€:le,
1. Complete legal description;
3. 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 systems;
5� Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL
OTHER .SYSTEMS ARE RULED OUT BASEL) ON SOIL CONDITIONS;
Cs. 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 Wray be used if desired;
£3. "yPake sure yocir benchmark and vertical elevation reference point are clearly shown,and are permanent;
0_ Complete all appropriate boxes as to dates,names,addresses,flood plain data, percolation test exemp-
tion,i'f appropriate;
10 If the inform=ation (such as flood plain, elevation)does riot apply, plane N.A.in the appropriate box;
11. sign the form and place your current address and your certification number;
13= Make legible copies and distribute as requirecL ALL SOIL TESTS MUST BE FILED vViTH THE
LOCAL AUTHORITY VVITHIN 30 DAYS OF COMPLETION.
ABBREVIATIONS FOR CERTIFIED SOIL TESTERS
:foil Separates and Textures Other Symbols
st - Stone: (over 10") BR Bedrock
cola - gobble (3- 10") SS - Sandstone
r - Gravel (under 3") LS Limestone;
�s -- sand HGUV - Nigh Caroundwater
cs Coarse Sand Perc P etcolation Rate
r7led s - Medium Sand W thrall
Is Fine Sand BIdq - BrAdding
is - Loamy Sand > Greater Than
sl - Sandy Loam < - Less Than
'I -- Loan) Bn Brown
s i i - Silt Loam BI - BL-1rk
si - Silt G - Gray
cl - Clay Loam Y - YoIlow
scl - Sandy Clay Loam R ;fed
sicl - Silty Clay Loam mot Mottles
sc. ... Sandy Clay W11 l:Vial
sic Silty Clay fit few, fine,faint
`c - Clay cc comma , coar -e
p! - Peat j m - Many, mediurn
ria Muck d distinct
la - prominent
HVV L Nigh water level,
Six general soil textures surlace water
for liquid vvaste disposal BM - Beach Mark
VRP - Vertical Referencu, Point
TO THE OWNER:
Tllr s sr„s test report, is tho first s[cf7 in securing a sanitary raermit.Taa county or the Ciepa;trn3��nt may regciest
ve!dicarim, of this soil test ire the field prior to per mi1 is4ira;a e. A csrnraietir et of for the private
sk"""valge system, and a Permit application must he iubii(S€t.od to tJw appropriaw, local a€ llor4y in order to
t, bt ain a perrnit. the>• sanitary (}+'rrnit MLIi $: be €0) aind ed an'd I )Steil r➢3"ior to the, 'tart of ar y{{,ns?:ruCtion.
David Olson
SE4NW4 S3T3ONR17W
• Erin Prarie, township 3 ��
FI
pild
03.
s
Gary L. Steel
988 N. Shore Dt.
New Richmond, Wi. 54017
MPRSW 3254
7-12-88