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020-1165-20-000
w k Q 0 ) I 2 \ 41 k -i m $]/ 22 § $ §R [ ) 4t-1 \ § � ] K \ U. 0 �yf CL -C 0 J u a.w , Cl) a z B \ 0 - L « 2 } / � a ■ � .2 Z 0 § \ k \ ) CCU, § } a 3 2 § k 2 « z co _ E j ; \ n 2 / 'D N © _ ■ S % ' k # a � « E 2 \ @_ 2{ �K K K CO t > 2 2 a & A ' \ � \ q \ 0 \ \ ƒ ' § § � £ o ; C) C) 2 � � f w 0 k E / / E ) £ \ } \ ƒ § k § -� ■¢ - k }\ c a I § $0.4 §§ � o _ I � m - \ z _ w � k � f % § I , a E / 0 v f § e c , o a l �; o k v ® r NiJC•% .� f_ �. _ L .as.K. T XOMMERCIAL TESTING LABORATORY, INC. 514 lVain Street, P.O. Box 526 Colfax, Wisconsin 54730 715 - 962 - 3121 800 -962 - 5227 ST. CROIX ZONING REPORT NO.1 02107/01 PAGE 1 ST, CROIX COUNTY REPORT DATE! 3/01/90 COURTHOUSE DATE RECEIVED*# 2/27/90 C91 HUDSON, WI 54016 ATTN1 THOMAS C. NELSON OI RS Joel. Kuenzii 2 LOCATIONS 1076 Cottenwood, Hudson / COLLECTOR*# St. Croix Zoning SOURCE OF SAMPLE! Basement Faucet COLIFORM*# 0 /100 mt INTERPRETATION! Bacteriologically SAFE NITRATE-141 2 ppm Under 10 ppm is safe for human consumption. Con form Bacteria/100 ml. Nitrate-Nitrogen, mg/L LAB TECHNICIAN'# Pam Gaye WI Approved Lab Not 19 �.\MOEYEIIpE�f < Means "LESS THAN" Detectable Level Approved by! �� ® PROFESSIONAL LABORATORY SERVICES SINCE 1952 ST. CROIX COUNTY ZONING OFFICE 9 6 St . Croix County Courthouse 911 4th Street Hudson, WI 54016 Telephone - ( 715 ) 386-4680 The St . Croix County Zoning Office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals . Completion of this form is essential so that the property can be located . Please provide the following information, enclose appropriate fee made payable to St . Croix County Zoning Office, and mail , along with form to the above address . Testing will be done as soon as possible after fee and form are received . WATER TESTING----------------------------FEE : $ 25 . 00 0 0 (For nitrates and coliform bacteria ) WATER TESTING FEE : $127 . 00 (For VOC ' S ) SEPTIC SYSTEM INSPECTION--------------- --FEE : $25 . 00 ( Determines if system is properly functioning at time of inspection ) o Property owner ' s name n I Property owner ' s address ZO 17 Legal Description 1/4 of the 1/4 of Section , T N-R Town of Lot Number Subdivision Nam FIRE NUMBER 1Q LOCK BOX NUMBER Color of house _Realty sign y house? Ll f so, list firm: PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP, i .e, COP OF PLAT BO , WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh . If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted . WINTER TESTING: Many times water lines are turned off , or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained . ' Firm or individual requesti services : " Telephone Number REPORT TO BE SENT TO: 02 ,E Closing dat _-M KZA_ Signature J . Parcel #: 020-1165-20-000 12/17/2004 08:40 AM PAGE 1 OF 1 Alt.Parcel M 12.29.20.1000-1002 020-TOWN OF HUDSON Current OX ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): *=Current Owner *BENNETT, LOWELL A&SONDA L LOWELL A&SONDA L BENNETT 1076 COTTONWOOD DR HUDSON WI 54016 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description * 1076 COTTONWOOD DR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 1.001 Plat: 1929-EDGEWOOD ESTATES SEC 12 T29N R20W EDGEWOOD ESTATES LOTS Block/Condo Bldg: LOT 70 70, 71, &72 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 12-29N-20W Notes: Parcel History: Date Doc# Vol/Page Type 03/28/2000 620249 1498/288 WD 07/23/1997 1047/457 WD 07/23/1997 865/391 07/23/1997 844/432 more... 2004 SUMMARY Bill M Fair Market Value: Assessed with: 49042 206,800 Valuations: Last Changed: 10/26/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.001 32,000 128,000 160,000 NO Totals for 2004: General Property 1.001 32,000 128,000 160,0000 Woodland 0.000 0 Totals for 2003: General Property 1.001 32,000 128,000 160,0000 Woodland 0.000 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 145 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Cha 0 00 Delinquent Cha 0 00 Total 27.00 a� - �3 ~ ST. CROIX COUNTY - ,�, WISCONSIN '. ZONING OFFICE G �ir r' ST.CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON,WI 54016 (715) 386-4680 SEPTIC INSPECTION. / WATER TEST REQUEST FORM Specify desired test(s) & remit appropriate fee with application. Outside water lines are often turned off during winter months, making access. to the home necessary. Please make arrangements with this office to insure a time when entry can be gained. ❑ Water (VOC's) $185 . 00 ( Septic $25. 00 1% Water (Nitrate & Bacteria) $35. 00 (Visual inspection) Owner: Daure LyTHr- Requested by: Address: IG7& dayyom wooll AR.. Address: V6 1`44- 61. WL City & State: 14004 Wt City & St. {} Zip Code: 5#461L Zip Code: �y0/� Telephone N4: ( "115) nS 1 Telephone N4: ( ) 49 ie- S�7 EWoao Property address (Fire N2 & Street) : 10'110 C:0'rT0NW0&b Location: SE ; , MF_ + , Sec. , T N, R W, Town of AuDSebt St. Croix Co. , WI. Tax ID N2 Parcel ID NQ - I�J r lx �'0W N Lock Box Combo: / House color: Realty firm:C't=�rnlQu a-1 5-= Water sample tap location: TO BE COMPLETED BY PROPERTY OWNER *PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF IS FORM* Is the dwelling currently occupied? Gj Yes ❑ No If vacant, date last occupied: Septic system installed by: Year.: 989 Septic tank last serviced by. rt-n.16 — Date: Previous Owner's Name(s) : 61#11,0aQ- 6s09*6- n.o 1 Have any f the following been observed? �� n ❑Y N� Slow drainage from house. C,EGE�v�U ❑Y Mq Sewage Back-up into dwelling. i� r ❑Y 91N Sewage discharge to ground surface, oC� 1 19 3 road ditch or body of water. ❑Y 91' Slow drainage from the dwelling. ScAu F�cE ❑Y Foul odors. zOtstNOO �� Other comments relative to system operation: I certify that the above information is complete and true to the best of my knowledge. I OWNERS SIGNATURE:Va � � DATE:' o r h6 AAG /v_ C I OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION t I N 5�� �''rT14 CH E V TO BE COMPLETED BY ,INSPEQTION- AGENCY System design &/:or permit on file? ❑Yes ONo Soil series per SCS Soil Survey: sheet # Type of soil absorption system: Below grd OAt-Grd OMound Approx. size ' X Z' Gravity ❑Dose ❑Pressurized - GTFt.2 )(Bed OTrench ODry Well Molding Tank ❑Outfall pipe OBSERVED DEFICIENCIES ❑Other ❑Unknown Septic tank Setbacks: OHouse Jo OWell.25_ ❑Prop. Iinel S ❑Other Dose tank Setbacks: OHouse Jft' 11Well.5FiP OProp. line ❑Other ❑Locking cover ❑Warning label ❑Pump/Floats ❑Alarm ❑Elec. wiring Soil Absorption System Setbacks: OHouse TO ❑Well_ ❑Prop. line -s ❑Other OPonding: rg ❑Discharge: �a General comments: INSPECTORS SKETCH OF SYSTEM LOCATION N 01 1 Inspector Title r is ch 10 1� n ro =•;� y� •i ( , ,`•• Ire t ` cin, CIO i � , '•� std' � • ?a og:lv if 4 1 1 ' , 1 copy October 18, 1993 Andrea Kary Century 21 Premier 706 19th Street Hudson, WI 54016 An inspection of the septic system on the property of David Leuthe, located at 1076 Cottonwood Drive, Hudson, was conducted on October 18, 1993 . At the same time a water sample was obtained for testing. The results of that testing will be sent to you as soon as we receive them back from the laboratory. At the time of inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. Should you have any questions, please contact this office. Sincerely, Thomas C. Nelson Zoning Administrator mij a COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715 - 962 - 3121 800 - 962 - 5227 FAX - 715 - 962 -,4030 ST. CROIX COUNTY GOWRNMENT REPORT N0,*# 51264/01 PAGE I CENTER REPORT DATE! 10/25/93 1101 CARMICHAEL ROAD DATE f'tECEIVED*# 10/20/93 HUDSON, WI 54016 ATTN*# THOMAS C. NELSON OWNER** David Leuthe LOCATIOW 1076 Cottonwood Dr., Hudson COLLECTOR' Thomas Nelson DATE COLLECTED*# 10-13°93 TIME COLLECTED: 1100am SOURCE OF SAMPLE*# Kitchen faucet DATE ANALYZED210-20-93 TIME ANALYZEE42.00pm COLIFORM,MFCC*# 0 /100 ml INTERPRETATION, Bacteriologically SAFE NITRATE—N*# 4 ppm Above 10 ppm exceeds the recommended Public Drinking Water Standard. Cotiform Bacteria/100 ml Nitrate—Nitrogen, mg/L LAB TECHNICIAN: Pam Wne DF.1 DEPENDENT o=.- �A WI Approved Lab No. 19 I > d 5A i Means "LESS THAN" Detectable Level Approved by*# PROFESSIONAL LABORATORY SERVICES SINCE 1952 Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT SHIP SEC, .I^, �/ T T —.--- OWNER � e-Woo CROIX COUNTY, WISCONSIN 0 2� x/09' ADDRESS LOT SIZE SUBDIVISION PLAN VIEW Distances and dimensions to meet requirements of ILHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM NUS y I DICATE NORTH ARROW �1 Describe the vertical reference p oint used Proposed slope at site: 6o BENCHMARK: Prop o int: lr Elevation of vertical reference p ��� --- Liquid Capacity: SEPTIC TANK: Manufacturer: G✓ Number of rings used: _ Tank manhole cover elevation: Tank Outlet Elevation: �d � Tank Inlet Elevation: o Side Rear, O Number of feet from nearest Road.: Front, line : Front,O Side,&ear,O From nearest p ro P er-ty `�rence well �above ' building:Number of feet from: lot place)( 2 reE RE�E SIt (Include this information of thp PUMP CHAMBER Manufacturer; PUMP Model: Liquid Capacity: Pump/Siphon Manufacturer: Elevation of inlet: Bottom Pump Size i_ Pump off switch elevation; of tank elevation: Alarm Manufacturer: Gallons per cycle: Number of Alarm Switch Type; feet from nearest property line: O Front, Side, O Rear,0 Number of feet from well: Ft' Number of feet from building; (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width: Length; Fill de Number of Lines: pth to top of pipe: „ Area Built: Number of feet from nearest property line: Front, Number of feet from well: O Side, Rear,Opt , Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size; Number of pits; Liquid depth: Diameter: Bottom of seepage pit elevation; Area Built: Has either a drop box O or distribution box been absorbtion sytems? O used on an y of the above (Check one), HOLDING TANK soil Manufacturer: Capacity; Number of rings used; Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line; Front, O Number of feet from well: Side, O Rear, O Ft. Number of feet from building: Number of feet from nearest road: *.'m Manufacturer: Inspector: �eey Plumber on ,job: License Number: 5e4' DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS 1,ABOR &INUMAIVRELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX�7969 BUREAU OF PLUMBING MADISON,WI 53707 SF%,NEi, 12, 29, 20W XXI CONVENTIONAL ❑ALTERNATIVE IS,,,,Pgned)D Number: Town vj Hud�Son ❑Holding Tank ❑ In-Ground Pressure El Mound Lai 71 Bd ewvvd B.6t. NAME OF PERMIT HOLDER: AODR ESS OF PERMIT HOLDER: INSPECTION DATE B 9 H Veve o men- (Otc,i.n B "a vus ad) 910 St. aoix S N. Hud�san GII 54 2G (9'�`�' BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF.PT.ELEV.-. Name of Plumber: MP/MPRSW No Cnu Sanitary Permit Number: Witt%am Schamaken 6382 S nty. c&oix 1112774 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY. TANK INLET ELEV. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER n /\ PROVIDED PROVIDED �i CX)� 03 4 I ,� U [�ES ❑NO DYES NO BEDDING: VENT DIA.: VENT MATT HIGH WATER NUMBER QF ROAD: PROPERTY WELL. BUILDING. VENT TO FRESH ALARM LINE AIR INLET: ❑YES NO G EYES O INEARESTM DOSING CHAMBER: MANUFACTURER. BEDDING. LIQUID CAPACI TV PUMP MODE E. PUMP;SI PHON MANUF ACTUREFi WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: DYES ❑NO ❑YES ❑NO DYES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NMBE(�,dF >PHOPEHTY WELL BUILDING IVENTTOFRE:5H (DIFFERENCE BETWEEN FEET FROM NE AIR INLET PUMP ON AND OFF) ❑YES ❑NO NEAREST 30 SOIL ABSORPTION SYSTEM.Check thesoil moistureat thedepth of plowin g IIN(;TH JOIAMF TEH IMATE RIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease until FORGE MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH LENGTH NO OF DISTR PIPE SPACING, COVER INSIDE OIA -PITS LIQUID BEO/TRENCH THENCHFS I Mn7ER1AL PIT DEPTH: DIMENSIONS I I ' GRAVEL DEPTH FILL DEPTH kl'SEIVI PIPF UISTH PIPE DISTR.PIPE MATERIAL NO DI,. + NUMBER OF PROPERTY WELL BUILDING: VENT TO FRESH BELOW PIPES ABOVE COVER .INLI T ELL EEVV ENO F�^^� PIP FEET FROM LINE r AIR INLET. �� 9 tLt l IF�D d� Cam° NEAREST'-�-- ( �' MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. DYES El NO SOIL COVER TEXTURE PEHMANI NT MARKFHS ORSEHVATION WELLS ❑YES ❑NO DYES ONO DEPTH OVER TRENCH BED DEPTH OVER TRENCH RED D OF TOPSOIL SO UOFI) SEE UFO MULCHED CENTER EDGES [:1 YES, ONO ❑YES 11 NO [--]YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: +.WIDTH. LENGTH NO.OF LATERAL t DEPTH HE LOW PIPE- FILL DEPTH ABOVE COVER BEDJYRENCH TRENCHES DIMENSIONS I MANIFOLD PUMP MANIFOLD DISTR.PIPMATERIAL Nn UISTH DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING ELEV.. ELEV. DIA. ELEV. PIPES DIA.. ELEVATti�NAND DISTRIBUTION' HOLE SIZE HOLE SPACING CHILLED COHHECT LY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION PLANS ❑YES ❑YES ❑NO COMMENTS: PERMANENT MARKERS: ELLS. .OI=- "" L NE ERTY WELLBUILDING❑YES ❑N ES ❑Nf#ET. ( Sket ch System on j Retain in county file for audit. Reverse Side. J SIGNATURE. TITLE'. DILHRSBD6710 (R.01/82) Zoning Admcnizttatan SANITARY PERMIT APPLICATION. cot, TY ?J ,, � �' DiLHR In accord with ILHR 83.05,Wis.Adm.Code 'I� "1 STATE SANITARY PERMIT# a �/ 77V —Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER 8%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 ❑ NO PROPERTY OWNER PROPERTY LOCATION et` o� +t�/ E '/4 �''/4, S /2 T 0p, N, R 4 E (or) PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME CITY,STATE ZIP CODE PHONE NUMBER F CITY NEAREST ROAD,LAKE OR LANDMARK �^ VILLAGE TOWN II. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family OR ❑ Public(Specify): III. PURPOSE OF APPLICATION: (Check only one in##1. Check##2,3 or 4,if applicable) 1. a. R.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. bdConventional 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. &eepage Bed b. ❑seepage Trench c. ❑ See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): p� 0.--:3F �l 0 7° S� Feet UaPrivate ❑Joint ❑ Public A VI. TANK CAP CITY Site in gallons Total ##of Manufacturer's Name Prefab. Con- Steel Fiber- plastic Exper. INFORMATION New xisting Gallons Tanks Concrete structed glass App. Tanks I Tanks Septic Tank or Holding Tank Lift Pump Tank/Si hon 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 Stamps) PRSW No.: Business Phone Number: Plumber's Address(Street,City,State,Zip Code): N�amee f Designer: g � !4rA 'W–.0 4 •C �'✓d[ /, (mot/ ^G Lr tiL VIII. SOIL TEST INFORMATION Certified Soil Tester(CST)Name CST## 7,014,3a v 4J CT's ADDRE (Street,City,State,Zip Code) Phone Number: %— t T l IX. COUNTY/DEPARTMENT USE ONLY y� F7 Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) JR1 Approved ❑ Owner Given Initial Sucharge Fee 17� W � Adverse Determination 5 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 Sarm ary 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; 111. Purpose of application: Check only one in ##1. Complete##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in##1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. Responsibility statement: Installing plumber is to fill in name, license number with appropriate prefix (e.g.. MP, etc.), address and phone number. Plumber must sign application form. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8% 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 laver. 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 Groundt�r included the creation of surcharges (fees) for a number of regulated practices which Wisco 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 o 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- f water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398(R.03/86) • i APPLICATION FOR SANITARY Ply MIT STC - 100 i This application form is to be completed in full and signed by the owner(s) of tl►e property being developed. Any inadequacies will only result in delays of the permit Iss"auce. Shuuld this development be intended for resale by owner/contractor. ("spec house") . then a second forte should be retained and completed when the property is suld and submitted to title office with the appropriate deed recording.. - - - - - - - - - - - - T - - - - - --- - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property Lucat tun of Pruperty r_;4 Section , T N - RO W Tuwusi►ip Ma l l 1nb Address Subdivision Name Luc Number Previous Owner of Property n11 1�'614I '1'utal Size of Parcel jacre- + I/JLe Parcel was Created Are all corners and lot lines identifiable? Yes No 15 LhLs property being developed for resale (upec house) ? Lr _ You No Vulu►neS and Page Number yt/,�-, as recorded with tt►e Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Dead 1. Land Contract J. Other recordings filed with the Register of Deeds Office 1►► addition, a certified survey, if available, would be helpful so as to avoid delays 01 Lhe reviewing process. If the deed description references to a Certified Survey Map, the the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION i (We) eeAt i.6 y .tjta.t as 6 tateinentA on .thiA. 6o4m ane .tlu,te to .the beat 06 my (uuA) i:►luwYedge; butt I (we) am (ane) the ownen(a) o6 the rAopen.ty deb CA bed in t;U,e u+6vujaaun 6OAm, by viAtu.e 06 a wwvcanty deed neeon.ded in the 066.iee 06 .the Cuu►i t y Regi4 ten o6 Deeds as Document No. 39 d 1,26 ; and that I (we) rilensentxy own .the.pnopoaed -bite 6oA the aewaga poa aya.tem (un I (we) have ub.ta.ined an e.aaemen,t, to nun with the above de,6cAbed pkopenty, don .the eu►o-i.Auetion 06 aai.d 6y,6ten, and .the came ha.a been duty %eco4ded in the 066ice u6 the County Reg-i6 teA o6 Ueeda, as Document No. 39 ayao ) SIGNATURE OF OWNER SLGNATURE OF CU-OWNER (IF APPLICABLE) C✓ UA'1'L S L'U DATE SIGN)-.[) t DocuMQatr No.. - 11TATR BAR OF W1` WROIN FORM Il a IM t THIS "11iEa N an aeceanMa eAVA LAND CONTRACT 1041vied and colowale t„ (TO Si Usr.O FOR ALL TRANSACTIONS w11160= 0V= 2420 eraeN IN PINANCRD AND IN OIONS NON-CONSUfMSR �A�C�l�TRANSAOTIONS) PA4445 '' Its"106 OFFICE Cont raat, by surd betwcea ... 1?. ..lp:...l"1�41aY.t...il.. 41?3 ffi CllOil�Co.,Nli. JI�IQMAAIa.................................................................................................. Reed. for Rewrd This 1 i th _ _ ("Vendor". day of April A.D. 1934 Whether one or more) and.... .a..fi..11.,...RRY.4�.5?P.4n8i1 1... 11�.:.a........ a 11:30 A s M. ...................................................... ..............:........................... ............... ("Purchaser", whether one or more), ls and agrees to c Vender sells to Purchaser. upon the prompt and full per- bwar d 6 • formance of this contract by Purchaser,the following property,together with the rents,profl fixtures and other appurtenant interests (all called the"Property"), in............�t. Croix..........:...................... County, State of Wisceuin: aarua.(TiMLBEIO.', MmfaE f4 PORM P.O- BcK 321 Sh of NWk of Section 7, T29N, R19W, EXCEPT the Hudson WI 54016 South 30 rods thereof. All that part of the SEk of NEh of Section 12, Tax Parcel No................................... T29N, R20W. lying Easterly of State Trunk Highway "35", EXCEPT the South 32 rods thereof, and EXCEPT that part thereof lying Southerly and Westerly of the Southwesterly right-of-way tine of the easement described below. SUBJECT TO a non-exclusive easement for ingress and egress over a portion of the SEC of the NE1t of Section 12-29-20, Town of Hudson, more fully described as follows: Commencing at the East quart .r -corns r of said Section 12; thence N90e00"00"W 1, 332.81 feet to the Ely right-of-Way of S.T.H. "35"; thence N34e27120"E 637.14 feet along said Ely right-of-fray « property deeded to Arthur F. ins of the r of S.T.N. 35 to the Nly 1 p p Y Windolff and Mary Ann Windolff, as recorded in Vol. 519, page 25, Doc. No. 325163 6 in the Office of the St. Croix County Register of Deeds, being This �&_not.. .. . homestead property. DESCRIPTION ION CONTINUED D O N ADDS ND dMM zecis (is not tion , Vendlor's residence or her written Purchaser a rrtes to purchase the Property and to pay to Vendor at .............. , the,sum of 11.94.1M?00- --- -- in the following manner: (a) = Qr.QbO'b+...pz Or„�..AY1C.... at the execution of this Contract; and (b) the balance of $114,395.00-x................together with interest from date hereof on the balance outstnnding from time to time at the rate of.tea..(lABZ....................... per cent per annum until paid in full, as follows: r before the first 0 000.00 each, lass accrued interest, on o Annual installmc�ts of $1 P and second anniversaries of this contract, and the entire balance, plus accrued interest, on or before the third anniversary of this Contract. See attached ADDENDUM for provisions for release of lots and application of payments thereto. Estimzted Real Estate Taxes for 1984, payable in 1985, have been prorated at closing; Purchaser shall thus pay the entire 1984 Taxes and subsequent years as due. Provided, however, the entire outstanding balance shall be paid in full on or before the.....23rd............. day of F1Ekbt"_=y........L.......... ...... 1987.... ( the maturity date). Following any default in payment, inter•,st shall accrue at the rate of... per annum on the entire amount in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance). I Purchaser,1UG619QGM3QGkPGJKF&0W agrees to pay Iwo 16CManrttal taxes,apt'cisl assessments,fire and required insurance premiums when due. t)QI(YY.X)mti ,mpp ;ar and furnish copies of receipts on VlendOrls written request. l'ayn,ents shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any moult ntay be prepaid without premium or fee upon principal at any time fn the event o! any prepa!•ment, this contract shall not be treated as in default with respect to payment so long as the ,mpnid balance of principal,and interest land in suci ense accruing interest from month to month shall be treated as unpr d principal) is less than the amount that said in(l,,htedness would have been had the monthly payments been made as first specified ni.eve; provided that monthly pn)-w-nts shall be continued in the event of credit of any proceeds of insurance or crmderlrnation, the condemned premises being thereafter excluded herefrom. Purchaser stntps that 11!trchaser is satisfied with the t.%, as shown by the title evidence submitted to Purchaser I •xandnation except: within six (6) months hereafter, Vendor shall record a certified copy the t1•-ath certificate of William F. K--irty, and release of inheritance tax liens in tmttrr of the Estate of William F. M-irty, to th(i satisfaction of Purchaser's attorney. Purchaser n rrccs to pay the cost of future title 1 videm,.. if title evidence is in the form of an abstract, it shall be retnined b} Vendor until tl•• fill purchase price ip pnid, lilt may have rk-w abstracts pry parm !'ur ns,r shall heent tl,dto t-4e t,,_a..i„n ..f the i'ruperl un tIK' CLIt.L2 ht'rc'Of. Xxxx il[ •Irt•.+ (tut lt• . LAND ('.u`IRA('tL ..� .. .1 and ST\rl It11t fit wlcl n\al\ tt'.� n•m l.rtal wank ro. Inc. I Corporate ►.Ill tl t1---1'1N7 Sbw.u4.•. Nir I VO!. 1!85 PkE 446 -Purchaser promises to ))ay when due ad taxes and assessments levied on the Property or upon Vendor's Interest In it and to deliver to Vendor on demand receipts showing such payment. Purchaser shall keep tine improvements on the Property insured against foss or damage occasioned by fin. ex- i "• tended coverage perils and such otbor, hazards as Vendor may require. without co-insurance, through insurers approved t It Vendor, in the sum of ifl(d: VaCaI1t laIY� :, but Vendor shall not requtn coverage In an amount men In the balance owed under this Contract Purchaser shall pay the insurance premiums when due. The policies shall contain the standard clause in favor of the Vendor's interest and, unless Vendor otherwise agrees in writing,the original of all policies covering the Property shall be deposited with Vendor. Purchaser shall romptly give notice of less to insurance companies and Vendor. Unless Purchaser and Vendor otherwise agree in writing. insurance proteeds shoji be applied to restoration or repair of the Property damaged, provided the Vendor deems the restoration or repair to be . economkally feasible. Purchaser covenants not to commit waste nor allow waste to be committed on the Property, to keep the Property In good tenantable condition and repair, to keep the Property free from liens superior to the lien of this Contract,and to comply with all laws, ordinances and regulations affecting the Property. Vendor r green that in case the purchase price with interest and other moneys shall be fully paid and all conditions shall be fully performed at the times and in the spanner above specified, Vendut will on demand, execute and deliver to the Purchaser, a Warranty Deed, in fee simple, of the Property, fr`e and clear of all liens and encumbrances, except resent) -revorded any liens or encumbrances etesce� by the act or default of Pu chaser and except: P . . .. y............ .......... .. .. easements as set worth in the le al description above^. _........... .............. ... ...................................................... ....... ... ....... ......... .... . .............. ... .....p.... ...................... .y.�.. .. .--r ....... . . ... See attacft� I.D�QJDCl1 for rovisions mx1if i the restrictions on transfer._show.. befow........ ........................... .......... ........... _.. Purchaser agrees that time is of the essence and (a) in the event of a default in the payment of any principal or interest which continues for a period of .30....days following the specified due date (.r (b) in the event of a default in performance of any other obligation of Purchaser which continues for it period of.30.. .. des}i :ollowing written notice thereof by Vendor (delivered personally or mailed by certified coati),then the entire outat:hnding balunce under this contract shall become immediately due and payable in full, at Vendor's option, and without notice (which Purchnser hereby waives),and Vendor shall also have the following rights and remedies (subject to any limitations provided by law) in addition to those Provided by law or in equity: (i) Vendor may, at his option. terminate this Contract and Purchaser's rights, title and interest in the Property and re•over the Property back V rough strict foreclosure +cith any a yuity of redemption to be conditioned upon i'urehaser•s full pa'rnhent of tit.. ,mire .urtding h:d:one, +.ith iracre�t the•e.•r!r'n+ the date of default at the rate ,n effect on such (late andotheratrou tits duc hereunder Onwhichevent all amounts previously paid by Purchaser shall be forefeited as liquidated darrares for failure t , fulfill this Contract and as rental for the Property if purchaser fails to redeem►; or (ii) Vendor may sue for specific perfornhancc of this Contract to compel Purchaser- immediate and full payment of the entire outstanding balunce, with interest thereon at the rate in effect on the date of default and other amounts due hereunder, in which event the Property hall he auctioned at judicial sale and Purchaser shall be liable for any deficiency; or (iii) Vendor may sue at law for the entire unpaid purchase price ur ur} portion 'on thereof; or (iv) Vendor may declare this Contract at an end anti remove this ttractasacloud on title in a •curet-tith action if the equitable interest of Purchaser is Insignificant; still (v) Vendor not} have Purchaser ejected fn 1•, i!``""n of the Property and have a receiver appointed to collect any rents, issues or profits during the pend+ney of :oi% :.cr ••n under (1), (I1) or (h) above.Notwithstanding any oral or written statements or action- of Vendhr, an cl• ' f un} of the foregoing remedies shall only be binding upon Vendor if :nut when purmoid in liti4ation and all (,•its n.,! .•),p,'u5cs including reasonable attorneys fees of Vendor incurred to enforeean}• romerd}' hereunder (whether ubut•.1 � 1.11 to the extent not prohibited by law and expenses of title evidence shall he added to rrincipal and paid by Pur.. :.•er, as in- curred, and shall be included in any judgment. Upon the commencement or during the pendency of any action of foreclosure of this Contract, Purchaser consents to the appointment of a receiver of the Property, including homestead interest,to collect the rents, issues,and profits of the Property during the pendency of such action, and such rents, issues. and profits when so collected shall be held and applied its the court shall direct. Purchaser shall not transfer, ell or convey any legal or crlense o interest in the Property Ib} u•s pricirt of any >R of Purchaser's rights under this Contract or by option,long-terra (case or in any other way) without the i+rior written * consent of Vendor unless either the outstanding balance payable under this Contract is first paid in full or the interest • Tit conveyed Is,&pledge or assignment of Purchaser's interest under this Contract sdrl} as seem itv for an indO t.dners of Purchaser. In the event of any such transfer, sale or conveyance withwit Vendor's written consent,the entire i'.:'AandinR IT * balance payabj+,under this Contract shall become immcdiatclydue and payable in full, at Vendor's option wit' notice. Vendor shall make all payments when due under nn+ mnrtgag' out!landing nrnin-t the Property .,1 t' lrltr 'f this Contract (except for any mortgage granted by Purchaser) or under nn}• note sreurv,l thereby, provi,l+tl purchaser makes timely payment of the amounts Cher due under this Contract. Porchn tier inn}• make any such a}•metav directly to the Mortgagee if Vendor fails to do so and all payments so made by Purchaser shall he r,n.idered payments mode nn this Contract. Vendor may waive any default without waiving any other sulp>vq tent or prn•r d(fault of Purchaser. All terms of this Contract shall he binding upon and inure to the benefits of the heirs. legal representatives, su"essors and assigns of Vendor and Purchaser. (If not an owner of the Property the spouse.of Vendor for a valuable consideration joins herein to release homestead rights In the subject Property and agrees ?o join in the execution of the deed to be made in fulfillment hereof.) Dated this 23rd _ ... day of February 19 84 B. b H. DLN'rI,nPMEM', DC- (Purchaser) e ) B .ht t J�u3 1•ti.e.c Jj Q.L (SEAL► Y= 7 <4 Anita P. Marty (Vendor) nail L. 3 jcYi'rtst.3ci, President And ,L(i, William L. llanale .0 ll, SecretY N`� • t ! 1 �c� AUTHBNTICATION ACKNOWLEDOMEN11, = • Signature( of Anita P. Marty a.single_... STATE OF WISCONSl` %,& ; . ... .. ............... r '��htbno t110t1faRt................... .. . . ST. CROIX puthen 'cat d,this 23 d y of ? `; ..�....., 1384 . l'or,nn:,llc came iheforc tnc this 23rd , day of IFehYU•lt�' 19 84 the nLaae namevi ............ D rlalcl E. II`ornstad, President, and . Wbert F. Wall William C. Han,lell, Secretory, r1f Said I ..... ration, uiio� acknirvledged that they I TiTI.E: !t1F::1111F.R STATE: BAR OF \ViSe'tiv`1'� Cp executed this instrtuwnt as such officers of slid Cgr{lx)t tion t��y its auuthorit ., Aryl authorized b}• a 06.06, Wis. Rats.) t rue. m..+n o a• n ,• r lu wf• rscrute the f Ttf i� rilctl:lnn;t ( arknAwkllNt• tidsnrne. T 4tS +NSJRt1I0E-4: WA", Char Tr:.t'a' William J. Gilbert, Atty. )I j,-Lm J. Gilhcr`tJ1 ! I GILBFRT, NlibM 6 POMT•.R (t. CTofx P.O. Box 321, Hudson W1-54011, r�i;nah;n : m:,� he autFenti.:ried or ackno+elydlyd. 17„1' N1` ' ni 11K\ QY]�CK�a�} + 1 ;awx 1 are not r cr .::Ir}.1 ?4XDCACti 1• -Non,.. ..r r., . ,inning In a .n i•�t..l 1.y C.7nrn."ixn is Permanent i i 1• r VOL �S A� 47 * i f R f� ADDENDUM Page A '' . CO..TINVATION OF PROPERTY DESCRIPTION! the Nly line of the South 32 rods of said SEh of NEk of Section 12-29-20= thence N90°00100"E along said Nly line of said Windolff property for 248649 feet to the centerline and Point of Beginning of said 60 foot wide easement, being described along said centerline as follows; thence N12 055100"W 199.43 feet; thence Nally on a curve concave to the SW, having a radius of 99.45 feet, whose chord bears N46 005100"W 108.82 feet; thence i N79.15120"W 111.50 feet, more or less, to the Ely right-of-way of S.T.H. "35" and the Point of Termination of said easement. (For the purposes of this description, all bearings are referenced r.o the East-West quarter-section line of Section 12-29-20, assumed N90°00100"W) . M.' SUBJECT TO recorded easements for electric and telephone lines. SUBDIVISION AND RELEASE OF LOTS: Vendor agrees that Purchaser may subdivide said Property, with all costs associated therewith to be paid by Purchaser, and that Vendor will join in execution of any plat(s) , certified survey map(s) and other instruments necessary for such subdivision, except that Vendor's interest shall not be subordinated to any indebtedness incurred by Purchaser. Purchaser may develop, improve and sell subdivided lots, with or without buildings being constructed thereon by Purchaser. Vendor agrees to release such lots upon sale thereof by Purchaser, by Vendor's ececution of Warranty Deeds thereto to Purchaser; Purchaser shall prepare and fur- nish at Purchaser's expense all such Warranty Deeds and the associated Real Estate Transfer Returns, except the final Warranty Deed and Transfer - Return conveying the remaining part of said Property which shall be at Vendor's expense. Upon such release and conveyance of lots, the value of each released lot shall, for calculation of the transfer fee, be determined by rounding off the acreage of the lot(s) released to the nearest even number and multiplying same by $1,500.00 per acre; the transfer fee shall be paid by Vendor. Upon conveyance of the remaining part of said Property, the balance of the transfer fee not paid upon lot releases shall then be paid by Vendor regardless of the acreage of such remaining part. r Upon Vendor's release of lot(s) as aforesaid, Purchaser shall have paid or shall then pay to Vendor an amount equal to 50% of the selling price paid to Purchaser for such lot(s) released; provided, however, that the $10,000.00 annual payments due on the first and second anniversaries of this Contract shall be deemed advance payment toward such release-payments, thus entitling Purchasers to release of lot(s) for tales up to $20,000.00 for each such annual payment, and Purchaser shall be obligated only to pay 50% of the selling prices that exceeds $20,000.00 aggregate with respect to such credit for each annual payment. All payments received shall be applied first to interest and -then to principal . The $10,000.00 down payment paid at the execution of this Contract shall not be applied to any release of lots, but instead shall be deemed to be advance payment toward Vendor's release and joinder in t)ie dedication of public roads and of any parkland or similar areas which Purchaser may be required to dedicate pursuant to the subdivisior, of said Property. It is the belief of the parties that such $10,000.00 down payment, applied to release and dedication of lands to the Town of Hudson for pubic use, is exempt from real estate transfer fee pursuant to Sec.. 77. 25(2) , Wis. Stats. , and that transfer fees will thus be due only upon ;84, 395.00, to be paid by Vendor as provided above. vot 685 rArc 448` Page B aforsaid method of calculating the amount to be paid Nothwithstanding the r a f to Vendor for release of lots, Purchaser shall be obligated to pay such n additional amount, if any, for lot releases to assure that the remaining ;. acreage not theretofore released as lots or dedicated to the public, if multiplied by $1,500.00 per acre, does not exceed the remaining balance r' due under this Contract. z The foregoing provisions shall be deemed to modify any conflicting term . this Contract which prohibits or restricts transfer or conveyance of aid Property, to the extent necessary to give full force and effect to the foregoing provisions. s c r 9 s� a 1 I i S .T C , 10 r y SEPTIC. TANK MAINTENA CE AC:KEEMENT o St , Cxpix ou►►4 y ` • f CJ ' Y WNEK/BUYEK l UUTE/BOX NUMBEK Fire Number _ _• CITY/ STATE _=! PKUPEKTY LUCATIUN : k. k, Section�� 1' 2`�_ .. N • Town of SL • Cru1x l:uu►►ty , Subdivision --1 Lo uumber .L7.�� improper use, end maintenance of your septic byst .•,u could result in I its premature failure to handle wastes - Proper wuintu►►unce c011' sibts ut pumping out the septic tank every tl1r.•u years or buuu�•r . I it ncuded , by a lic(,tnved se tic tank 2umpur . Wh.,t yt)u put i►►► u the system can affect the function o'f• t w sUPtic t:►►►k as a tr. .►t- ment sta6e in the waste disposal aystem. St . Croix County residents may be eligible to receive a grant tur a w.,xiu►um of 60% of Cho cost of replacement of a faili►►g syetew, - _. .�t . which was in operation prlv Croix Cu,►►►ty i with the requirewe►►t Lhit accepted this program in August' of 19tiU, owners of all new systems agree to keep their systems properly maintalaed. � M !,• 'I•he prupurty owner agrees to subu►iL to St . Croix County zoning u certification form. signed by the owner end by a pUML er ptuwl,er . journeyman plumber , restricted plumber or �na[eu►1'l�1pin proper tying Lilac (1) the on-pit�p wastewater disposal Y operating condition and (2) after inspection and puu►pi„g ( it l►ec - essary) , the septic 'tank is lees than 1/3 full of ayrior LO ulll. CerLiflcatiun form will be sent approximately 30 Jays p p .i three year expiration, 1/WE, the undersigned, have read the above requirements and agree CA to maintain the private sewage disposal system 1►► accordance with v Wisconsin Depart- the standards set forth, herein, as set by the mplt - ment of Natural Resources. Certification form talthin30edayy and returned to the St . ' Croix Coun;y Zoning 0ffi.Ge 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 . LDINGS DEPARTMENT OF . REPORT ON SOIL BORINGS AND SAr^-F- ETY &R DIVIISION INDUS G j LAB K AND PERCOLATION TESTS (115) MADISON WI 53707 9 HUMAN RELATIONS (1-163.090)& Chapter 145.045) ATI ;:,4 SECTION: �TOWNSHIP UN ICIPALITY: OT NO.:BLK.NO.: SUBDIVISION NA E:'SIr- / / IZ Z9N/R7--04(or) U�so 71 - E&4Ew0o6 Es'rlq = COUNTY: WNER' BUYER'S NAME: p MAI LING ADDRESS: Si CQoI R100N --TAA I5c�P.s USE _ DATES OBSERVATIONS MADE r I TESTS NO.B DRMS,: CO R A O RIPT10 : � V�L)S� �� At� I Residence �N� �-- L�INew ❑Replace / oP-, AL-,I� qg Sous ONCE - G�NAM A RATING:S�Site suitable for system U-Site unsuitable for system ONV S 4.._l MOU D:❑U-TIN-GROUND-PRESSURE:S ❑� S rars I❑U L EIS G_ U . ON M ENDED SYSTEM: 6N716N 14L(optionakr h If Percolation Tests are NOT required DES/I�GN RATE: I If any portion of the tested area is in the n under s.H63.09(5)(bl,indicate: l LqS� / Floodplain,indicate Floodplain elevation: NIv PROFILE DESCRIPTIONS BORING TOTAL 12EPlij TQ R UDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH NUMBER EPTH ELEVATION OBSERV N O T.HIGH TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK. A B- ! .Al 44 .7-) > g 4Z 7 g` LT s 99� 8ik•J mS *Cwt B- Z Ip,6-7 �i� .v4 > /o,67 9`91-Cr"' 3!" k'4 S,t �SkA 1R4t>v ✓hS44* B- 3 SY, 93.Z I r4ONC > 8•S6 14"I9LLT-S 23 BQ�IS�t V4-e 66p81 ' Sf�re B- 9,T.3 y3.S4 No�1<r ?9.�3 �I,'BL�T-`> aZ�BRtiSIt Wp' Ru04-- B- S 6.o�S 90.3 1�on1� >6 ,oFS /S BLLts I'2."'k2 SIC 4* B- c�f- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER L V RATE MINUTES NUMBER IAtMS' AFTER SWELLING INTERVAL-MIN. p I PER INCH P. TA a 96-90 > Z > < P. Z 93.30 3 > > 2 t 3 P- 1"Jopid 19-S-40 P RC- 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 ints 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 "Pe P� E 160.vo 16, i coA -T ,Gl tN '-)CA Lt. � 7 fl °P3 t� �L17) 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the pr cedures anti methorls specified irr 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 sprint : TESTS WERE COMPLETED ON: /-J Q_qL`< ON Njl bN eUSIL14 ' UUk\1L, 'IY\/C, Au4Us-T 5 ADDR S� S:— CERTIFICATION NUMBER: IPHONE NUMB ER(opt ional): �,2 CST SIG i URE: y` 1?ISTRIBt1TION: Ohupnid nntl niio colty m I oval Aulhot sty,INotrcity Owarn imd Soil Teslm. U ''R-SBD-6395 (R.02(82) OVER - fd -e u v'r 70 OA ovzo ^� l 0 y "yhs� o. REGISTER'S OFFICE ST. CROIX CO., W1 A F F I D A V I T Reed for Record 411r, 2910 STATE OF WISCONSIN at 11 :30 A M SS ST. C.ROIX COUNTY Register of Deeds I, Harvey G. Johnson, Registered Wisconsin Land Surveyor, hereby depose and say: That I have surveyed and platted Pdgewood Estates, located in the SE1/4 of the NE1/4 of Section 12, T29N, R20W, and in the SW1/4 of the NWI/4 of Section 7, T29N, R19W, Town of Hudson, St. Croix County, Wisconsin; That there is a proposed on-site liquid waste disposal system intended for, and a percolation test completed on Lots 70 and 71of said plat; That said system in intended to serve a home intended to be built on Lot 70 of said plat; And that I make this affidavit to inform all future purchasers of said Lots. 70, 71, and 72 of the possible existence of said system. Subscribed and sworn to before me thi lT day of August, 1988. 1 yoXr STEWS FF E Nota Public, State of Wisconsin My commission expires . 3i � � ord 8 This instrument drafted byt M Harvey G. Johnson