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HomeMy WebLinkAbout032-2081-80-000 ` 0 u 7 \ \ \ � (5 $ 2E \\ [ A « ° Ecu { 0 gp7 % � 0. ) $ ]) 222 $ 00 f -�� . t § = i ƒ � o Cc >{ ) e /7� Q) 00- 00 \ E 2 \2} /k ] ® # moo ±let } \ k� f\\0= 7 E\ {2/ 0 ,=a \ � \ 2 0\ka &2 8 � § $ } co c : 2 � k � zt § / ) { Q e ® \ k CD / / � -� / } z m z } c 2 < % E ] ~ f ° ■ § e 3 # CL CL 0 In ) k \ \ ` § \ § / / \ . ; 0 0 0 0 lz § a a a EL U k \ § \ \ z 0 � :� _ § g � "Walk) 0 2 e c = o & o o . § § . \ \ _ * ' m 2 c � / § F § a2 ° / � 2 k 0 / ° e E §S I § \ = CO§\ \ ) \ § k \ \ � 2 E § � � � _ . \ $ k 2 % \ E f \ a S ) E _ • g /A 6 0 z $ I / ■ 2 2 � a E © � k � k / J a 2 0 k v kt _ G i - '• I _ I I I I � .e - I I `I!, �' �; , I � , ' I � � �/a 'fi`� I• ! { 114 I , t I I � 4 1 � I I I I , I , , I I ) ` 1 � I I , 4 I I 1 i t i ' I r I '•.Lvl, ,' sI t , 4 k r �1 I � x i 1 , r- , t i J� 1 PRA U1IK oeo Awl- PA I t 1 I , I , I � I I I f I � I ! i ' , ff , { � I , i I I I I - ! r I f I I I i t ! I � I I - , �� li - ,✓, ! � I I } f I r r , I I I r , i I ! I I 1 i 'i - 1 I r I r _ r ! I i f III I ' { I , { !� _ I I I I 4j r I I , I Ir I r I I i r � I � 1 t I C t , { ! r- 1 ' 1 I f l ! r I f it _ I r _.- I - t Form - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER hlj L /1 1 til hl TOWNSHIP SEC- ` T _D(j N-R_ Z0W ADDRESS �)� .3c��C J'y G ST. CROIX COUNTY, WISCONSIN SUBDIVISION VjN 4?jjVl LOT �lJ�� LOT SIZE ,LOT lit ­94,a-) PLAN VIEW Distances and dimensions to meet requirements of I•Z,IIR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 7,4 11 Y. X/5 T/Av!� 4 I_E 5 VV) e6/ao. !� � I I - ;1'I'X3h INDICATE NORTH ARROW �cp BENCHMARK: Describe the vertical reference point used a Elevation of vertical reference point: %(}["�, ' Proposed slope at site: _ SEPTIC TANK: Manufacturer: C-X1_5 jr//y,4,_ Liquid Capacity: /" CIS-' Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front,Q Side,o Rear, O feet From nearest property line Front,OSide,QRear,O f©CJ feet Number of feet from: well building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) Willi SEE REVERSE SIDE DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX 7969 BUREAU OF PLUMBING MADISON7XVI 5370-P NW%,SW%,S14,T30N-R20W VCONVENTIONAL 1:1 ALTERNATIVE Sltate Plan ID.Number: Town d� Some met El Holding Tank El In-Ground Pressure El Mound Lot 18 Twin S in b NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECT( DATE: Paul Debnyn Route 1, Sax 346, St. Joseph, WI 54082 BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN. REF.PT.ELEV.: CST REF,PT.ELEV.. Name of Plumber: IMP/MPRSW Ncr JE77T;� S anitary Permit NumberDonavan Schmitt 3205 . C)Loix 112810 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 OIA.: VENT MATT HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING. JVENTTOFRESH ALARM FEET FROM LINE. AIR INLET. DYES ONO ❑YES ❑NO NEAREST DOSING CHAMBER: MANUFACTURER. BEDDING. LIQUID CnPACl7Y POMP 1111171E jP11VP,1lPHON MANUF ACTHHEH WARNING LABEL LOCKING COVER PROVIDED- PROVIDED: ❑YES ❑NO OYES ❑NO OYES ONO GALLONS PER CYCLE: 7ND CONTROLS OPERATIONAL NUMBER OF PH OPEHTV WELL BUILDING IVENTTOFRESH' (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET. PUMP ON AND OFF) OYES ❑NO NEAREST-� SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing I IENnTH JI)i AMC TE It 111ATIRIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: r ^.WIDTH L IN1,111., pISTH PIPE SPACI NiI COVER ;INSIDE UTA mPITS LIQUID BEDyTRENCH TH NCS iMATLRIAL PIT DEPTH. DIMENSIONS L 3 GRAVEL DEPTH FILL DEPTH I'E)l!SEV . AL NO DISTH NUMBER QF PROPERTY WELL. BUILDING. VENT TO FRESH BELOW PIPES ABOVE COVER .INLE f ELEV END PIPES !LINE AIR INLET: I FEET FROM — L_ NEAREST— 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 ONO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEXTURE PI HMANE NT MAHKfRS OBSERVATION WELLS 1:1 YES ❑N _OYES NO DEPTH OV ER TRENCH BED DEPTH OVFN TRENCH HEU OFPTH OF TOPSOIL S(IOOFO IS11DID JMEJYES ULCHED CENTER EDGES 1:1 YES 1:1 NO DYES 1:1 NO 1-1 NO PRESSURIZED DISTRIBUTION SYSTEM: BEDITRENCII WIDTH JILINGTH TREONCHES LATE HAL SPACING JGRAVIL DEPTH BE LOW PIPE- FILL DEPTH ABOVE COVER DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL NO DISTR DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING I'.ELEV.'. ELEV. CIA. ELEV. PIPES DIA.. ELEVATION AN DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECT L COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS ❑YES NO ❑YES NO COMMENTS: PERMANENT MARKERS: JOBSERVATION WELLS. NUMBER OF PROPERTY JVVELL: BUILDING. FEET FROM LINE: /n 3 DYES ❑NO ❑YES ❑NO NEAR"EST ., lY Sty Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE. TITLE. Zoning Admi iztturton DILHR SBD 6710(R.01/82) PUMP CHAMBER Manuf turer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank vation: Pump off switch elevation: lons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nea t property line: nt, O Side, O Rear,0 Ft. umber of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: X, Trench: Width: ,,� y Length:35- Number of Lines:- Area Built: Fill depth to top of pipe: Uc- .4r,g 3 Number of feet from nearest property line: Front, O Side, Rear,0 P't . _ Number of feet from well: / i 3 Number of feet from building: 5 (Include distances on plot plan). t S PAGE PIT Si Number of pits: Diameter: i r Liquid pth: Bottom of seepage pit elevation: Area Built: Has either a drop box or distribution box been use on any of the above soil O absorbtion sytems? (Check e) . HOLDING TANK ` Manufacturer: pacity: Number of rings used: Ele ion of bottom of tank: Elevation of inlet: Number of feet from neares property line: Front, O Side, O Rear, 0Ft. Nu r of feet from well: N er of feet from building: N er of feet from nearest road: Ala anufacturer: Inspector.* Dated: � � ^_�� Plumber on job: License Number: 32 3/84:mj • DI I LHR SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05,Wis.Adm.Code r. L Po ' STATE SANITARY PERMIT# '1199,10 –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 L�1 NO PROPERTY OWNER PROPERTY LOCATION W1/45W1/4, S T & N, R L40 E (o W PROPERTY OWNER'S MAILIN6 ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME S CITY,STATE ZIP CODE PHONE NUMBER 7n CITY NEAREST ROAD,LAKE OR LANDMARK ❑ VILLAGE LX1 TOWN OF; TQ/_VAe-A_5 II. TYPE OF BUILDING OR USE SERVED: / / 0 0 — "' Number of Bedrooms if 1 or 2 Family `T OR ❑ Public(Specify): III. PURPOSE OF APPLICATION: (Check only one in#1. Check#2,3 or 4,if applicable) 1. a. El 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. N 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. N seepage 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): IG Q Feet IAJ Private ❑Joint ❑ Public VI. TANK CAPACITY Site in allons Total #of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank /Ico 14,06 Lift Pump Tank/Siphon Chamber ❑ ❑ VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system shown on attached plans. Plumber's Name(Print): Plu is Signature:(No Stamps) /MPRSW No.:3 Business Phone Number: s Plumber's Address(Street,City,State,Zip Code): Name of Designer: ` GfV 111. SOIL TEST INFORMATION Certified Soil Tester(CST)Name CST# 2 y 57_,ff_49,,L CST's ADDRES (Street,City,State,Zip Code) Phone Number: S' Al. IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) $Approved ❑ Owner Given Initial � S �ha�r}ge�Fee � _r- AdverseDetermination �"c�V'� 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 i, APPLICATION y 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 Iodation, estimated wastewater flow (number of Zed= - 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 wheneyer 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; Ill. 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 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 Groundt8i-- included the creation of surcharges (fees) for a number of regulated practices which Wisco in$ can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried rf'&SISCB' a 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. o 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) APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signdd 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 /'//�1J L llV- "� 4 Z) & )' K f )�76x/I y/I/ Location of Property �V Section , T N-R W Township 5_10MOY14 _ Mailing Address feoJ o Address of Site 45-4 Me g fie V2 Subdivision Name — 1J)),.SaPQQJn 6_5 Lot Number DUSe o� s s/a ad Previous Amer of Property ,L�!/� �hr,� e ����,�/ , 9l Total Size of Parcel _ /j 075 , ' iy� �m��St-e Date Parcel was Created S Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume 7A 6 - jye e B8-11OU-s-e and Page Number as recorded with the Register of Deeds. 7a�- is- 5y�-^ yis sy< ,., 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 (tie) cutti.6y that att AtatemenU on tlti�s arum ane #hue to the but 06 my (ouit) hneurCedge; that I (we) am (cute) the owneA(�f 06 the phopenty dmcAi•bed in th,i,e .in6olmation 6o4m, by viAtue o6 a waAAanty deed kecoided in the 066.ice o6 the Co mtyy RegiAteA o6 Deeds as Document No, d6 �, and that I (We) pnehen.tty c�un ! e paoposed site bon the sewage di�sp0b by_s.tem. (on I (we) have obtained an ea.aement, to nun with the above demoscn,ibed pnopeAtq, 6oh the eonAtAucLion o6 eaid 6 y6 tem, and the carne ha.e been duty kecokded to the 066ice 06 the County Regiaten o6 Veed4, to Ooemen t No. ) . SIGNATURE Oh OWNER S GNATURE OF CO-OWNER (IF A LICASLE) 45;� � DAIE SIGNED DATE SIGNED .T, ,9 TV AAWMCMMIM-�IWN PsmebeeM►,low ib«waso aid fins»w ON � tl�smtlr 1Nls dirt l�6x.��wlr rM �� _ �`-r9 i 19s of the plat Of Mn Springs L_ 1ldtltl rflf isssle ft. Croix Cowty. Viscansin. - dx t1W rlslt an file in dw office of the Mosier ' 'ier f6t. Cre t Cowper* Viscassin in ioluos 3-,of raw API e 1�• "Ssbject to COVesants of IMCOrd and scenic "Wrsated to united States of Asortea and any otbe! { -ccvetaKs or restrictions, of record. Mt ,a a Fw. .... � � tK �.... � �).e beaemlead •+ ' R I f 110 me the 8te"ly and r pq M Vender at State»Dank 1if w lit -i ............•......... is do swasors (a) ....... ►; Ms K 11116 Gatsaet: and (b) the balance of;.. �i ate.......»......tall grlt' i�11 *e.6dmw asa ftndiag from tine to tine at the rata oL............. .U.............. ..... a 4, .5. 1966 51.125.00 Interest Wavember`3, 1967 $3.000.00 principal plus $1.125.00 Itttel<sltt u swoob, ;3. 19M $3,000.00 Principal plus $655.00 Interest s � 5,-1!964 53.000.00 Principal plus SS6S.00 Interese' lKovedwtr s, 1490 . $3.500.00 Principal plus $315.00 Interest *�s y>tM eebtamAK raison sND M Amid it trD es er bdore tM»».... »..«.... .... I asy detWM In pe rmeat. inter"t .bas aserue at the raw of_...�.»..% per some aft so (k '`bd ( a4m11 teltade witbemt linitatI'm ddhmpw t interest and. apsn accelwatba W bd"W�. " sduk ommud br Waisr,eases to pq asathy to Yom w aunmau sufficient to pee w NOW aMaeW asessssmwhk An and regmtred insurance preniuM wbM doe To the sorest rsra � P 11W­411111011F>M,rwrb to revs ebliaatione wine due. Sueh anwnts received by the Vendor tee '14 QlP .. mlftm d1A ibmrrson *W be depuAW into an seerow fund or trustee account. but abaD ni boo. 'wino s—y 4 bow. 4 ". .g: . limn M ap p" Bret a interest on the unpaid balance at the rate specified aty:.tLen to ion principal any .r."X7 ...., siMirast`ace►,iw prapmii sritboat !r'�dmrm or foe u .frees at tine after....._Feb 1 W e esamt,Of MY psupaYment. this te contract shall not be treated as in default with respest,.to e� !M# seNK babnse of peLkipal,and interest (and in such ease accruing interest from month to=set ahal.f # {f4s 1111615 is kft tbmn the anwunt;M►t said indebtedness would have been had the no �at peoubd slow.tsow that monthly payneab shag be continued in the event of ea�liS"fit iewe+wM er � the etaasoned promlen.being thereafter esdadd berefron. Parchaesr is enWfied:Witt as title as shown by the tfW evidonee # v,uaderatands that f p ter= .. r �� uel pump located on Lot '18 is owned by,. rose„ otr itp succeaaor Luepke Oil Company and is not included in this sale. `} � 'r Pl1ealep ew fe Mp t4 sent of fltpire tiW:�msY�see. If title reideoce is fn the foret ee suet,it VkI f1 tM! ,�rebw�Mriee is MW s eb1�basAllititil to teiihenreNtia of.theraRerty en Naveeber .5. x 4s 9 # . q i�r anyC III-111111114 1 ilia. wnlrflt war a :r wade to be :lei rtt ter Mt or�Il�it d � .aow............ ... *. it Of As Aanna aM (a) in dw at.31L—am fitM�ia�t1s >taebaser sMiil os�liaaee tee', +1M fl/rM`Y�it at 14a GNIS U. irasrw tie ftetiewi.���sad �' a 1il «ri *U6"to)•cider aiy►.at bis In airs fee er tba-fho�erlr _ Yii ter is date aaibee� aw aAM M tarotoI d as liquidated raaneas for fallwlik'. 4 sadalta :ae lfiwalaadiR Mbaes► so for V" 01144> ..0`.«4 n''''or`''. is at m cad and is bnianiffeaat:and l.) Y oei ated b adMd aar nate. .ra►erai or wrktea atl)rM M upa Valor K and i)ftll K iairr rnd to We p any de oddenee sball be bM at any adieu at K�MtMa.aid, eoahom�laad or seavq any bwai er K b mow.loa�te*+a� baba�ea paraw under irrIsreat under " Co ;' .male ai e or weer an"w l I} "�MI� faaasifatdr due and �' I � d�ae aaiar an. w�orteap ilsd►r Purdyssr) or under Ow duo under this Contract. elf;ao and A paymwts as made by a r. ii l)t witiw! wamm ow oLMe ow— be"wdins pea,and faeau to sM lasabaaee. (It aft as owner of a i Mrnesbad riabb b tbo sa►iad ...................... rye of ...... .. " (SEAL) * • . ........ ........... lA . Ao ffiUM .• -- � --:-(SEAL) .... . .................. .............. .... • . .. . �,, AUTXX i VICATi01I ........ STATE O!' ..:. .. +*: a uiatben* ted this S ,aa, .............. �9f_.... ! xeC _�-�• -� — ............ Rr ItEIIYEE>!?!�'1` TE EAR 0*,MfIBC01VSIN lialltborisd by ¢ 488AA.Wif Stllti.) to me k to i"i f1ti 1i�Jt�# T.WAS 9MAIT[D BY & Wow � N. ........ 2- (!aY • ; .�aa�"'be tatiteRttq�tad ort"#eitnuwlydtei, Rtb � :'.-1. ,3 •,��_'�ys tae . .,., T? .,.. _ -•---:w - - - ,,,.,.. ,___.. Wisconsin Department o Revenue y-D CUM NT i NO.. STATE BAR OF WISCONSIN FORM 1-1982 i THIS SPACE RE ED FOR RECORDING DATA WARRANTY DEED 6 Pa61 . 68 a de between -------- ........ .......................... ----- ------------ this 8th Grantor N I -_-____ wa_rd__ e_l_________ Husband__and Wi fe ------ D °" A.D. 14 85 ---------•-- ---=- n and-_-_Paul A. De Briyn and Lorl Kaye De Briy_n,_ as_,�olnt --•..__ 1 Tenants -------------- ---- --------- -- --- —2.00 P -------------------------------------- - ------------------------- ---------- •-------------- Grantee Witnesseth, That the said Grantor, for a valuable consideration-_____ s RETURN TO conveys to Grantee the following described real estate in ....$t_.._C1°R]-X----- _-_.-__ _--- County, State of Wisconsin: I p Tax Parcel No: - -- -------------- Lot 17 and a strip of land in lot 16, 25 feet wide , adjacent to said lot 17 Twin Springs Addition to the Town of Somerset, St. Croix County, Wisconsin I I , i This 15 ------------ ------ homestead property. (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; i And--------------------------------------•------------ ' warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except- ----- -- - e ------------------ I and will warrant and defend the same. � II Dated this ------------------•----- day of ---------- ---•--------.---- 19 ......(SEAL) j ----•--------------------------------------------•---------•---------(SEAL) Edward R. p j - -- ----------- --- --------------------------------------------------------•-----------(SEAL) --- - ----------(SEAL) * ------------------ ------------------------------------------ oyce K aspel AUTHENTICATION ACKNOWLEDGMENT Signature(s) it STATE OF WISCONSIN ------ _County. authenticated this --------day of------------------------ __, 19...... �) / P son II came before me this __._�_L._._ y ii da of -� ..._..------� 10 �t 1"y, named --------------------------------------- -----------------•------------- _ .. ., TITLE: MEMBER STATE BAR OF WISCONSIN . V. unot, ed............................................................706. -------- --- -*.......... ;-'C_ foregoing instrument and ac ow authorized by § ?06.06, Wis. StatsJ to me known to he the crs �_ o exec ed e THIS INSTRUMENT WAS DRAFTED , � i off•• ••'•�a D BY ►� Notary Public ____________________ County, Wis. (Signatures may he authenticated or acknowledged. Both If not, state expiration g Y g My Commission___ i�_ge6i �' ' are not necessary.) MN�LD date NOteFy-pub0043 .0f-VV190orah__- .., 13 ) --- - - --- -— ----- - My=C,orrxnroWon E ee -Names of persons signing in any capacity should be typed or printed below their signatures. WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Leval Blank Co. Inc. FORM No. I—1982 Mil w:. H « z cn , H _ a « ST C - 105 r a _ H SEPTIC TANK MAINTENANCE AGREEMENT Ho St . Croix County z d OWNER/BUYER Paz k T A,�l ROUTE/BOX NUMBER AgtU / 0 Fire Number CITY/STATE a p )S�o��i n ZIP SW 9 PROPERTY LOCATION : 14, S I-J !4, Section, , T <1 N , R SOW, Town of 6e►r(?Y , St . Croix County , � Q Subdivision , Lot number �� ' ,915C 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 may 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. 0 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- ro ment of Natural Resources . Certification form must be completed and returned to the St . Croix County Zoning Office within 30 days of the three year expiration date . SIGNED DATE 9S St . Croix County Zoning Office P . O. Box 98 Hammond, WI 54015 715-796-2239 or 715-425-8363 �jc„� ��,r,•,{� Sign , date and return to above address . . ©INDUSTRY, OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDDUST yy DIVISION LABOR�HTJ ANA EDLA,IC'.NS PERCOLATION TESTS (11 ) MADISON WI 53707 (H63.09(1) & Chapter 145.045) LOL'ATION: SECTION: TOWNS HIP/MLXW[IKMXXXY: LOT NO.:BIJ NO]SUBDIVISION NAME: NW �/4CW 1/4 14 /T30 N/Reox6o W1 Somerset I n/a n/a `n"n Springs COUNTY: OWNER'S 'S NAME: MAILING ADDRESS: St. Croix Paul Debriyn R.R.#I, box 346, St. Joseph, Wi. 54082 USE DATES OBSERVATIONS MADE NO.BEDRMS.:ICOMMERCIAL DESCRIPTION: PROFI DESCRIPTIONS:1PERCOLATION T ESTS: esidence 3 n/a ❑New Replace 3-2-88 3-2-88 RATING:S=Site suitable for system U=Site unsuitable for system CONVEN 6] TIONAL: MOUND: IN_-GROUND PRESSURE: N-FILL OLDING TANK: RECOMMENDED SYSTEM:(optional) S ❑U ZIS Is ❑u ISYSTEM-1 H❑S�u ❑S ®U 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: n/a Floodplain, indicate Floodplain elevation: n/a PROFILE DESCRIPTIONS page 33 WhB BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTFMM, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B-1 6.83 99.47 none >6.83 .58bl.1. 5.00bn.m.s. 1.25bn.c.s. at limerock B-2 6.83 99.32 none >6.83 .33bl.1. 1.25bn.s.l. 1.25bn.m.s. 4.00bn.c.s. B-3 8.08 100.22 none >8.08 .58bl.1. 2.00bn.cob. gr. 5.50bn.c.s. B- B t: PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH P_ 1 3.15 none 3 6 6 <3 P_ 2 none o 6 6 <3 P_ none 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 96.32 4 F i .. �� �� �� 1 {d_ d l Y , TN } ( I II I 1 I _ — o L... .a _ l 1 _ I _ _ _ _ i L 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 3-2-88 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): 938 N. Shore Dr. , New Richmond, Wi. 54017 2298 1&15- 6-6200 CST SIGNAT • t/ \ DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. DII._HR-S'>D-(',?95 (R.