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036-1017-60-100
a o 2 $ 2 $ \ 0 CD K 4 C a ) 0 ts § Go % f 2 � E 0 c ; i E Cl. �7 / v �� � � k \ fE \) 2) 2 §i 2 ) » kk/ z (ƒf � . 2 ) E 2 e &b2 3 0 c ` 3 }f \ § ) \ 0E§ co �� / \ E E � . 0 � / a m a m co CO § k z « 2 2 ) a ® J ® § ® \ o z 2 7 ■ e ƒ K / K \ . m . . % [ \ [ ) e -m a. / $ ) / \ z ca z z co z .. z 2 t c = 2 04 'a \ i k ^ . $ ® � ■ I E § ■ E 0 ) .0 % o k ) k $ 9 \ z � k � 7 � � k � z � / � k k � / / � •W Ip 2 2 a 5 2 a 2 � cc ! t ■ : » » _ _ 2 ] 2 £ k ƒ z £ § § z k § R 6 k § E 6 2 � i / \ § 2 § § ¥ 2 E � q / @ k / r a � � % ■ 2 2 . < 2 a » m o % — < z m � 7 § 2 / § \ % 2A b 2 2 = = k Co M_ o o k § 'o 0 § 9 k $ d k ] / § ■ \ § % » ■ \ 2 f 2 R , 7 § R o o a m § ) a z § t 2 § o o 5 ' > I o z 2 = R > o z / R z ■ « � � ■ � ' » � � » � J 2 ■ E � .. B C B 2 0 � ) k a ; k % & 2 � 2 A 2 0 U) 00 pp— Parcel #: 036-1017-60-100 01/10i2007 04:23 PM PAGE 1 OF 1 Alt.Parcel#: 08.31.17.115B 036-TOWN OF STANTON ST. CROIX COUNTY,WISCONSIN Current X_'; 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-VOLKERT, BRIAN W BRIAN W VOLKERT 1560 220TH AVE NEW RICHMOND WI 54017 Districts: SC=School SP=Special Property Address(es): "=Primary Type Dist# Description " 1560 220TH AVE SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 1.540 Plat: N/A-NOT AVAILABLE SEC 8 T31N R17W 1.54AC PT SW1/4 SE1/4 Block/Condo Bldg: LOT 1 C.S.M.7/2068 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 08-31 N-1 7W Notes: Parcel History: Date Doc# Vol/Page Type 04/12/2005 792066 2782/443 QC 04/12/2005 792066 2782/443 QC 07/23/1997 833/56 2006 SUMMARY Bill#: Fair Market Value: Assessed with: 166443 233,900 Valuations: Last Changed: 05/05/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.540 17,000 179,900 196,900 NO Totals for 2006: General Property 1.540 17,000 179,900 196,9000 Woodland 0.000 0 Totals for 2005: General Property 1.540 17,000 179,900 196,9000 Woodland 0.000 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 222 Specials: User Special Code Category Amount Special Assessments Special Charges 00 Delinquent Charges 00 Total 0.00 Parcel #: 036-1017-60-000 01/10/2007 04:22 PM PAGE 1 OF 1 Alt.Parcel#: 8.31.17.115 036-TOWN OF STANTON 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 BRENT A VOLKERT O-VOLKERT, BRENT A 1508 220TH AVE NEW RICHMOND WI 54017 Districts: SC=School SP=Special Property Address(es): '=Primary Type Dist# Description SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 38.460 Plat: N/A-NOT AVAILABLE SEC 8 T31 N R1 7W 38.46 AC SW SE Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 08-31 N-1 7W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 1164/75 WD 07/23/1997 1164/74 TI 07/23/1997 414/590 2006 SUMMARY Bill#: Fair Market Value: Assessed with: 166442 Use Value Assessment Valuations: Last Changed: 05/26/2004 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 31.000 4,600 0 4,600 NO UNDEVELOPED G5 7.460 3,700 0 3,700 NO Totals for 2006: General Property 38.460 8,300 0 8,300 Woodland 0.000 0 0 Totals for 2005: General Property 38.460 8,300 0 8,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M 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&BUILDING LABOR&HUMAN RELATIONS DIVISION P.O.BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES&APPLICATION MADISON SGl ,S�4 S 8,T31 N-R 17G1 State at s gned) 'Number Town v� Stanton ® CONVENTIONAL ❑ ALTERATIVE CU Iding Tank ❑ In-Ground Pressure ❑ Mound NAME OF P RMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: L o na)td V a 1 BENCHMARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM LAN: REF.PT.ELEV.: CST REF.PT.ELEV: Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: 119375 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPAEFEE TANK INLET ELEV: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ❑NO L:]YES ❑NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER ER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM: FROM LINE: AIR INLET: ❑YES ❑NO ❑YES ❑NO EST—► DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: 1PUMPMODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT LE FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF) ❑YES ❑NO NEAREST—I► SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER MATERIAL AND MARKING: or excavation. (If soil can be rolled into a wire,construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH: LENGTH: NO.OF DISTR.PIPE SPACING: COVER INSIDE DIA.: #PITS: LIQUID BED/TRENCH TRENCHES: MATERIAL: PIT DEPTH: DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO.DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV.INLET: ELEV.END: PIPES: FEET FROM LINE: AIR INLET: NEAREST-♦ MOUND SYSTEM: Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ❑YES ❑NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER I TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ❑YES ❑NO ❑YES ❑NO DEPTH OVER TRENCH77 DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL:I NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING: ELEVATION AND ELEV: ELEV.: DIA.: ELEV.: PIPES: DA.: DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑YES ❑NO ❑YES ❑NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: ❑YES ❑NO -]YES ❑NO -----[FEET �I Retain in county file for audit. Sketch System on Reverse Side. SIGNATURE: TITLE: Zoning Admmin,istfcc�,tatc SBD-6710(R.06/88) {� SANITARY PERMIT APPLICATION CONY t� Z] UILH� In accord with ILHR 83.05,Wis.Adm.Code 119r— 1 STA/TEgSANITARY �r PECRM IT# / ! / �J —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 PROP RTY LOCATION �j Q A e '/5C '/4, S ST N, R (7 E (or GI PROPERTY OWNER'S MAILING ADDRESS LO NU BER I B O NUMBER SUBD VI I NAME CITY,3T�AT,� t�f C ZIP CODE PHONE NUMBER VILLAGE: NFA�iE IT�R AJ� LA LAX�O(�I( ii T 1Y I�+,"] I 1 Jr Th II. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family OR ❑ Public(Specify): t �) 111. PURPOSE OF APPLICATION: (Check only one in##1. Check##2,3 or 4,if applicable) 1. a. ❑ 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. CKConventional 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. 5<seepage Bed b. ❑Seepage Trench c. ❑seepage Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes p r inch): REQUIRED(Square Feet): I PROPOSED(Square Feet): Feet �Private ❑Joint ❑ Public I k VI. TANK CAPACITY Site in a aIons Total ##of Prefab. Fiber- Exper. INFORMATION New Existing Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tans structed Septic Tank or Holding Tank v t Lift Pump Tank/Siphon Chamber -4-00-1 ❑ 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) MP/MPRSW No.: Business Phone Number: Plumb 's Address(Stree City,State,Zi Code): Name of Designer: p� VIII. SOIL MST INFORMATION' Certified oil Te ter(CST)Name CST �� �. mss- (>)I CST's A DRESS(Street,Ci ,State Zi d ) Phone Number: Rt C�' �� p sa f '715 38� 1 gs IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issu g Agent Signature(No Stamp � rcharge Fee Approved El owner Given Initial /�v� ha /^ / /a�� Adverse Determination ` CJ (O ✓✓✓ lll��� C X. COMMENTS/REASONS FOR DISAPPROVAL: SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original tr nty,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 a//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 •Ground tifEaBr 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 reaSufQ: is used in your building is returned to the groundwater through your soil absorption system or the disposal site used by your holding tank pumper. a The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- t water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398(R.03/86) APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. `------------------------------------------------------------------------------- � Owner of property �j1 �1. � -0Cr Location of property 1/4 J 1/4, Section � , T .3 N-R j W Township -S7tC,i,y1 J-Z' Mailing address /` /C' Address of site Subdivision name ', Lot number Previous owner of property a Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Yes No Z A�iC Is this property being developed for resale (spec house)? Yes Ji✓c f No l�r, Volume 4A-7 and Page Number as recorded with the Register of Deeds. s ------------------------------------------------------------------------------- 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 references to a Certified Survey Map, the Certified Survey Map shall also be required. ---------------------------------------------------------7--------------------- PROPERTY OWNER CERTIFICATION I (We) certify that all statements on this form are true to the best of my (our) knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the Office of the County Register of Deeds as Document No. -3/ / o U ; and that I (We) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the same has been duly recorded in the Office of �h�e County Register of Deeds, as Document No. ) . Signature of Owner Signature of Co-Owner (If Applicable) /S � Dati of Signature Date of Signature 'F REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS .LATIONS PERCOLATION TESTS (115) DIVISION P.O. BOX 7969 (H63.09(1)& Chapter 145.045) MADISON,WI 53707 �A4 ,/ SECTIOIT 2/NCR E(o )W TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: JTY:. uvvNNt:H'S BUYER'S NAME: R S�q�To �T —� MAILIN ADDRESS: f O/X GEiVple O GI�ER T ter-/ STA �if'.�%P%E � S' SE l NO.BEDRMS:11(5)1Mfl5MER IAL DESCRIPTION: DATES OBSERVATIONS MADE WResidence ,l/� ❑Re lace ROFI O S: A NTESTS: �V �New p 1 13- RATING:S=Site suitable for system U-Site unsuitable for system S c S© /✓,Q VA0FG 4 ONVENTIONAL: MOUND: IESSURE: S= 1" O-LDINGTANK:REOMMENDED SYSTEM:loptional)®S ❑U S ❑U ®S ❑U U EIS KU jrov vE�Tipv.y If Percolation Tests are NOT required DESIGN��ppKATE f—s¢ under s.H63.09(5)(b),indicate: 7O cwt /�pR /�T If any p onion of the tested area is in the lain, indicate Floodplain elevation: %,V 34 CiM^L fT. Did1/VF/ELO PROFILE DESCRIPTIONS BORING TOTAL WATER-In Fr CHARACTER OF SOIL WITH THICKNESS OR,TEXTURE, AND DEPTH NUMBER DEPTH ELEVATION r-1- .1QUROUND>EST. GHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B-Z �0 ' 0 (9./y •�3 �� 13.o. s/E��o s o�l•'f 3 ' o �• 2 N k' C.s 7 ' AN vE C I.S'. ' B , 0 s, v v e s 3 ap �.s f 3 y �- �s o,� Qa. s/, . 75',&1. J; w,4�, 7.0•INA C wi sue, S Is oc s , B- DN soot(, t`.PF -tvA// - �4 s/.0 Ti4W SCL oC 1 cu; - Ho yLED iN FT= PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME UMBER INCHES AFTERSWELLING INTERVAL-MIN. DROP I LEVEL-INCHES RATE MINUTES PERI D 1 OD P- NG Z P R PER INCH s A Z P- Z S�hD. OT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- tal 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 land slope. /f e /e•'` STEM ELEVATION "a•��C s O �. 1 '3 OM i Aee _1 f I � � ItsG,ppss___ Ron yP' E �__., t r.. ♦ t � 111 � t t _ s77/Vi6f TE _ , U _ - This#Pst` is s A,pP ,_ pqV _��TEV 3 3 F,. ' anti ! ' , s. s i f cr�cony I ss tic Y E A) -j 50 ,2 q -�-�. - �- �_ crctP�rF�' l .R ( I s;1.p t�•...A_v&t . J __ l --i _ _. 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 inistrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. 'ROMESM TS�G OOH TESTS WERE COMPLETED ON: R MINNESOTA LICENSE NO.00663 CER FICATION NUMBER: PHO NUM R(o tional): US S^1=6L y�L 3 3 3,0MAL R.D.,HUDSON,W1 e%16. CST SIGNATURE: IBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. R-SBD-6395 (R.02/82) —OVER— s 3 i AUGri1L Nb:, fi -At 1 G k ,� ;plttf5�1YE3�` xr ID0600*" � l � � .TNtS 1rtri i' 1>7 , Merle by ,Williim.14lKert , 4-61kert,. hie wtfi,'. grantor' g.."of, X COW, Wisconsin, heroby.con�v 'a and warrants to arc . Volkert and Muriel J. Volkert hire wifa as o s nants grantee a—of St. CroiXoynfy;=Wiaciitlsin, for the sum of the following tract of land in . St.:. Croix Ctgdiyri5tat6l of Wisconsin:: The ?vast Half of South, East Quarter of Sectiin ; the West Half of, South Eaet .Quarter ..'and the South Half of.,"South West Quarter of Secti6n' 81 except 'tract described as commencing at the SV corner of Ithe s =59%; thence East 245` feet;- to>the place of beginning= thence North 147 feet; -thence-gast` 95 feet; thence- South 54 feet; thence Bast 137 feett thenc+e` South 93 feet; thence West 232 feet to point'of beginning= a1.1 ioiariship 31, Range 17; subject to easements of record and publicigh�tays. This deed is in completion of Land Contract ,dated January 30,1958, recorded in 113401page 73, Document No. ;.253527, °ae amended..by •.instrument dated June 22, 1965, recorded in 11414" page 590, Document No. 280794, in Register of Deeds for said St. Croix Counter.. t FEE EXEMPT IN WITNESS WHEREOF, this document has been sealed, executed and delivered this 4th day of Aucust: , A.D., 19 72 ............. ....' '�.fiam. r .,+. �.,*(SEAL) i[b�dX�d�d�CfdblCidiC7eLsltiCmSX 1 er .ru,,..,. .......... .. ..., ............. .... (SEAL) ... ,... :U.. ' (SEAL) ...,.. ....................................... (SEAL) STATE OF WISCONSIN Count of � SS' (�Qd�'!� }�t6iE4dif)4tltld6ti+CK1 �� Y Personally cam re me this day of 9 President, and Secretary, of the above named corporation,to me known�o c p and officers who executed the foregoing instrument and r acknowledged that they executed the-somas such officers as the sold corporation, by its authority. w � (NOTA RIAL ,...o..i....,....... .............. SEAL) SEAL) Notary Public,' Cou isconsin My Commissloft expires: STATE OF WISCONSIN ) County of i$t: Crpix. ) SS. (INDIVIDUAL ACKNOWLEDGMENT) ); . Personally came before me, this 4th day of :'Aug118t a -, 19 72 , the above named Wi l l a . rr.&P-r-E nel epaw*ti,a vn1ker_ r h s. wife, a ` to me known'to be the person &who executed the foregoing instrum nt Ackn W1 a scale.' `rte Received for for Record this 7th day of .. ... i4y!(, r��.............. AU=`+ A.D., 1,9 1Z_.....�..at .8 i3o ..�.err. .r�. 11.. o►clot (SEA'') Notary P biict .ig' CroiX County, Wisconsin t My Commissiotl e>ipiress ;E f -2.3 Register of Deeds ,,,,,,,► Deputy Register of Deeds •.•••.,• *IE grantor is a corporation, insert core. name I nd•complgte�byi <'jIgnetures of Pres. and Sec. and core. seal, if j any, If none,'so state. (Sec. 59.51(1)of the ts. rovides thdf �t natruments to be recorded shall have plainly I printed or typewritten thereon the names of t a*tor', to so *IGj-so$ and notary.) f ► :,�;•S� 91at�••o! Died warrbnty.( orp, or Indiv.) �'�i'%l .�'•a►; Win. Stats. 235 0 l 9TC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER L &rt, a rI ()r, Z� e/- ROUTE/BOX NUMBER .3 6 (?1`. ,r /11/ FIRE NO. R CITY/STATE �Qcy �(/L 04-11 14 � , ZIP PROPERTY LOCATION: 1/4 J�E 1/4, Section d , T 3 N, R 7 cl Town of S'f!2 -.,, ± 6 2- , St. Croix County, Subdivision /11g , Lot No. . Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a LICENSED SEPTIC TANK PUMPER. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County Residents MAY be eligible to receive a grant for a MAXIMUM of $3000 of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of ALL NEW SYSTEMS agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Department of Natural Resources. Certification form must be completed and returned to the St.Croix County Zoning Office within 30 days of the three year expiration date. S I GNE DATE St. Croix County Zoning Office St. Croix County Courthouse 911 4th Street Hudson, WI 54016 (715) 386-4680 Sign, Date, and Return to above address SAFETY&BUILDINGS DIVISION BUREAU OF PLUMBING XT I V E ISlate Plan LD.Number: AS BUILT SANITARY SYSTEM REPORT Mound I"as'9^�'I 7 OWNER TOWNSHIP INSPECTION DATE � y 3- 030 ADDRESS . ST. CROIX COUNTY, WISCONSIN REF.PT.ELEV. CSTREF.PT ELEV Sanitary Permit Number: 54934 .. WARNING LABEL LOCKI COV R SUBDIVISION LOT LOT SIZE PAOV�oED PROVI ED ONO TO FRESH • r PLAN VIEW Distances and dimensions to meet requirements of H 63 , SHOW EVERYTHING WITHIN 1-40 FEET OF SYSTEM wpn,rl 6` b6 •i ` ,fir 5 N s o 0 INDI ATE NORTH ARR BENCHMARK: Describe the vertical reference point used �- Elevation of vertical reference point: / Proposed slope at site: SEPTIC TANK: Manufacturer: Wg ( L„ �iquid Capacity: ®ad Number of rings used: _ Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front�ide10 Rear, O ,Zx 71 feet From nearest property line Front,6ide10 Rear,O / �! feet Number of feet from: well ' ` building: S _ (Include this information of the above plot plan) ( 2 reference dimensions to septic tank); a � � k k r: ► Liquid Capacity: Pump/Siphon Manufacturer: Pump Size .et: Bottom of tank elevation: a elevation: Gallons per cycle: _.-... .-cturer: Alarm Switch Type: Number of 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). 1 SOIL ABSORPTION SYSTEM Bed: Trench: Width: �J Length: ` Number of Lines:_ Area Built: Fill depth to top of pipe: !V 7 Number of feet from nearest property line: Front, �9`lde, &ear,0 Ft . Number of feet from well: '7 Number of feet from building: i 3 (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one) . HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, O Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: Plumber on job: License Number: 3/84:mj r ' 445237 .� CERTIFIED SURVEY MAP 00 Located in part of the SW; of the SE a of Section 8, T31N, R17W, Town of Stanton, St. Croix County, Wisconsin. NOTE: Creation of this lot is permitted under chapter Leonard & Burial VOlkert 17.14 (1) (b) of the St. Croix County Zoning Code. `.`. as of 10/01/86 which states: single family residential : e w ::i c hlo n d dwellings occupied by at least one person or member of q.faC[ri;`y;lv,ho earns a substantial part of his L livelihood from farm operation on F p the parcel, contributes work which °4;r'' �':,i.'..... �`;• 0.s bstant i a l I y needed in the r ,r farm operation or is a parent, child or spouse of the farm 8G ppe�ator, and structures accessory and secondary to such dwelling provided that not more than two •'t.,•�_ �!'s6ch dwel I ing units may be established with or without creation of separate LEGEND parcels, upon a tract of land which existed as a single tract or parcel of the effective St. Croix County Section Corner Monument date of this chapter. AREA INCLUDING ROAD 67,224 sq. ft.(1.54 ac.) 0 111 x 2411 iron pipe weighing 1.68 pounds per linear foot, set. AREA EXCLUDING ROAD unplatted lands owned by platter 61,412 sq. ft. (1.41 ac.) -------------------------------- WEST 208 . 62 ' I c Ic la 17 I� 000 I Iv W I rr O Bearings are referenced to ;a ; ° O the south line of the SE} i id assumed to bear EAST. I= gars a house I \ CL z° ° 'N FILED is° :� N • x 2 FEB 0 61989 I d D p� N I Cr I 1_ JJ Ap N I 9 JAMES O'CONNELI� Crok l N LOT 1 '\ N 1 � �''� I � N N N N SCALE I14 F EET co - v 100 50 0 100 _Co 90p- S890551 1411W 208 621 EAST 875 , 99 ' — — — — — � 1537.60, south line of the SE EAST . 6 220th AVENUE Si corner ------------ SE corner Section 8-31-17 � Section 8 unplatted lands owned; by others this instrument was drafted by Douglas Zahler job no. 88-48 Vol. 7 Page 2068 1 m® FEB Q 6 1999 :,t. CROiX(_'OUMY 'L:U'MPI211 E10,S1VC PAWS 0;, ANN) O'•" AS BUILT SANITARY SYSTEM REPORT OWNER ; TOWNSHIP ADDRESS CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H 63 SHOW EVERYTHING WITHIN 1-00 FEET OF SYSTEM 7 '33r 77' mow/ 5 Jq Q w Al INDI ATE NORTH ARR BENCHMARK: Describe the vertical reference point used - iC�' / AU-1 Elevation of vertical reference point: / Proposed slope at site: SEPTIC TANK: Manufacturer: / o CA.n6h4 &.iquid Capacity: /g2egoak V Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front�ide 0 Rear, O -71 feet From nearest property line Front,6Side10 Rear,0 feet Number of feet from: well -- �-� building: : (Include this information of the above plot plan) ( 2 reference dimensions to septic tan' SFF. RFVFRSF STDF r Liquid Capacity: Pump/Siphon Manufacturer: Pump Size et: Bottom of tank elevation: elevation: Gallons per cycle: turer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear,0 Ft. Number of feet from well: ``"` Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width: Length: Number of Lines:_ _ Area Built : $ Fill depth to top of pipe: �T Number of feet from nearest property line: Front, aS"ide, &ear,O Ft . Number of feet from well: — 17"Y '�=! Number of feet from building: l (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, O Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: Plumber on job: License Number: 3/84:mj 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 L&�-y-yONVENTIONAL ❑ALTERNATIVE I State Plan I.D.Number: ' El Holding Tank El In-Ground Pressure ❑Mound (lf assigned) NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER INSPECTION DATE: Lenond Vo.2kW R. R. 3, New Richmond, W1 0'3—FY 3�3e30 BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN. REF.PT.ELEV.: CST REF,PT,ELEV.: Sw% SE%, Section 8, T31N-R17w, Town o5 Stanton Name of Plumber: MP/MPRSW No County Sanitary Permit Number: Henry NechviUe 3258 Ist. Croix 54934 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIOUID CAPACITY: TANK INLET ELEV.. TANK OUTLET ELEV.: WARNING LABEL LOCK: COV R /� P OV ED: PRO VI ED L U O v j ,.�Z YES El NO ❑NO BEDDING: VENT DIA.: VENT MAT L.. HIGH WATER I4IMBER QF ROAD: PROPERTY WELL: BUILDING: IVE TO FRESH ALARMEET FROM ^ LI�yE AIR INLET: ❑YES ❑NO ❑YES ❑NO EAREST G/ 2 I y DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY. PUMP MODEL. PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ❑NO DYES 1:1 NO 1:1 YES ❑NO GALLONS PER CYCLE: P UMP AND CONTROLS OPERATIONE1NSAREST__j NUMSER OF PROPERTY WELL. BU ILDING.I V ENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET: PUMP ON AND OFF) 1:1 YES ❑SOIL ABSORP TION SYSTEM.Check the soil moistureat the de th of lowin LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease until the soil is dry enough to continue.) CONVENTIONAL SYSTEM: Icy'�rr �y WIDTH LENGTH. JNOOF DISTR.PIPE SPACING: COV R INSIDE CIA.. #PITS: LIQUID TRENCHES M�AL: PIT --- DEPTH: GRAVEL DEPTH FILL DEPTH ID ISTR.PIPE DISTR.PIPE DISTR. E MATERIAL: NO,DI` BE, QE PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES. ABA C VER. ELEV.INLET.ELEV EN PIPES. AIR INLET: MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA- ❑YES NO meets the criteria for medium sand. TIONS MEASURED. ❑ SOIL COVER ITEXTURE PERMANENT MARKERS JOBSERVATION WELLS 1:1 YES 11 NO ❑YES ONO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOI L. SODDED SEEDED. MULCHED. CENTER. EDGES. 1:1 YES 1:1 NO DYES ONO ❑YES 1:1 NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: n� •Ir MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL: NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING: +tyG�£,A ��•� �ELE V.. ELEV.. DIA.. ELEV.' PIPES. DIA.: HOLE SIZE HOLE SPACING. DRILLED CORRECTLY. COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO APPROVED _ T111 .vd PLANS: ❑YES NO ❑YES NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: N.UMI EA, °,.- PROPERTY WELL: JBUILDING: F,ER� LINE: ❑YES 1:1 NO 1:1 YES ❑NO 41tEAiI:$T 6e c5t k,,k 0' Sketch System on -- mir snunty file for audit. Reverse Side. ATU TITLE: D I L H R S B D 6710 (R.01/82) F consin APPLICATION FOR SANITARY PERMIT D'LH� OUNTY (PLB 67) UNIFORM SANITARY PERMIT RRTMEnT OF USTRV,LRBOR&HUTRn RELRTlOnS L L/� 7th —Attach complete plans in accord with s. H 63.05,Wis. Adm. Code for the system,on paper not less than 8'/2x 11 inches in size. —See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNE MAILING ADDRESS ,E�j/C�/I h Ile/ =r _3 LCD c PROPERTY LOCATION CITY: 1/45 1/4, S t' , T31 N, R E (or IQ I TOWN0 S r fly L0.T N,UBER BMBER S NEAREST ROAD, LAKE OR LA DMARK STATE PLAN I.D. NUMBER/4? &(j fF tCD _�j TYPE OF BUILDING OR USE SERVED A 2 Family Number of Bedrooms: El Public (Specify): THIS PEJtMIT IS FOR A: New System El Replacement ❑ Repair ❑ Replacement Soil Absorption System El Revision ❑ Privy El Alternate System [] Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. _, [� Seepaye Bed ❑ Seepage Trench U Seepage Pit ❑ Holding Tank System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued ❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity c E Lift Pump Tank/Siphon Chamber Holding Tank capacity _ Manufacturer: ��.� e7 IF THIS IS AN ALTERNATIVE SYSTEM CO LE YE THIS BLACK: ❑ Mound ❑ In-Ground Pressure S Total #of Prefab. Site Steel Fiberglass Plastic Gallons anks Concrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Min tes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): �/2'm,,,,P fin• rivate ❑ Joint ❑ Public I,the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber (Print): Signature: MP PRS o.: Phone Number: ` '` 3 7�9�-��� fJ Plumbe 's A ress: i Name of Designer: - XF COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved ❑ Owner Given Initial Approved Adverse Determination Reason for Disapproval: Alternate course(s)of Action Available: DILHR-SBO-6398 (R.5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing,Owner,Plumber INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398 To be complete and accurate the permit application must include: 1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in a city, village or town); 2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment,30 seat restaurant, etc.); 3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks. 4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of square feet to be installed; 5. Complete the section on water supply; 6. PRINT the name of the master plumber or master plumber restricted who will install the system,circle the appropriate license classi- fication, place your license number in the space provided and sign the permit in the signature block; 7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the permit; 8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation. Failure to comply will void the sanitary permit. 9. This permit may be renewed,and at the time of renewal any new criteria in the Wis.Adm. Code will be applicable. 10. A new permit will be needed if there is a change in,estimated wastewater flow, (number of bedrooms,etc.), location of the system, depth of the system, type of system. 11. All revisions to this permit must be approved by the permit issuing authority. 12. A complete plan including a plot plan,drawn to scale or with complete dimensions. 13. Horizontal and vertical elevation reference points that are permanent and clearly shown. 14. Piping detail including pipe size, separating distances,distances between beds if appropriate,tank locations,effluent line from tank(s) to system, building sewer and vent observation pipe(s). 15. The permit issuing agent may require a cross section drawing of the effluent disposal system. TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit.Private sewage systems must be properly maintained.Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years.If you have questions concerning your system,contact your local code administrator or the Bureau of Plumbing,DILHR,State of Wisconsin. 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 f 15 PA(6�t' d LO Location of Property S GLf 4 S L , Section ,` T 3 N - R 1_ W Township T A Al 7- // Mailing Address Subdivision Name `— — Lot Number Previous Owner of Property Total Size of Parcel Date Parcel was Created Are all corners and lot lines identifiable? ✓ Yes No Is this property being developed for resale (spec house) ? Yes /-�No Volume and Page Number as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract 3. Other recordings filed with the Register of Deeds Office In addition, a certified survey, if available, would be helpful so as to avoid delays of the 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) eeAti6y that aU .5tatement6 on thi,6 4o&m aAe tAue to the best ob my (ouA) knowledge; t4at I (we) am (ane) the owner.(a) o4 the pno peh ty deb c4ibed in thi-s in6o4mation 4o4m, by viA tue o4 a wak&anty deed neconded in the 04jice o6 the County Regizten of Deeds ab Document No. / b and that 1 (we) pnaentty own the pnapoeed site Jon the aewage dispo.6at System (on I (we) have ,obtained an eatibement, to &u.n with the above desc& bed pupenty, ion the conbtnuction io6 6aid 6ystem, and the same hays been duty neconded in the 066ice of the County Regi6teA o4 Deeds, ah Document No. ) . SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED 311660 BOOK 487 PA,E388 DRAWN HY:Louis G. Nagler, (DOCUMENT NO.: VOL. & PAGE. Attorney THIS INDENTURE, Made by William Volkert and Bertha Volkert, his wife, grantor_S_of st- Crinix .—County, Wisconsin, hereby conveys and warrants to Leonard E. Volkert and Muriel J. Volkert his wife as___jqipLt tenants,__ grantee of St. Croix County, Wisconsin, for the sum of $1 .00 --.-.d other va-11-i-a-ble unensi—at-inn the following tract of land in St. Croix .County, State of Wisconsin: The East Half of South East Quarter of Section 7; the West Half of South East Quarter, and the South Half of South West Quarter of Section 8, exce t tract described as commencing at the SW' corner of the S o $Wh; thence East 245 feet to the place of beginning; thence Nortli '147 feet; thence East 95feet;'�thence South- 54 feet; thence East 137 feet; thence South 93 feet; thence West 232 feet to point of beginning; all in Township 31, Range 171 subject to easements of record and public highways. This deed is in ompletion of Land Contract dated January 30,1958, recorded in 113484C) page 73,, Document Nol,'',,253527, as amended by instrument dated June 22, 1965, recorded in "414" page 590, Docur�ent No. 280794 , in Register of Deeds for said St. Croix County. FEE IN WITNESS WHEREOF, this document has been sealed, executed and delivered th7'S 4th day of t A.D., 19 7-2— ..'. *(SEAL). ........ i .............I... .......... .............................................................................................. .................................................................................... (SEAL) _jger 4� t .g ��........I... . . =. .. ........ (SEAL) .................................................................................... (SEAL) STATE OF WISCONSIN County Personally ca�re me this day of -- 19 , , President, and Secretary, of the above named corporation,to me known C p andofficers who executed the foregoing instrument and acknowledged that they exec utecL.t he-s L�t e as such officers as the f said corporation, by its authority. (NOTARIAL SEAL) SEAL) Notary Public, Cou isconsin My Commission expires: STATE OF WISCONSIN SS. (INDIVIDUAL ACKNOWLEDGMENT) County of -,at. Crc)!.x Personally came before me, this 4th —day of August ' 19 72 the above named P-rt and Bertha- t. his wife, to me known to be the person_S_ who executed the foregoing instrum nit ac;n. �e same.llr�;n. w Received for Record this 7th day of .... ...... . .............. A1290t -A.D., 19 72 at 8:30 (SEAL) o'cloc 4- Y."f Notary P blic, St. Croix County, Wisconsin Aa� A - My Commission expires: 2--? Register of Deeds Deputy Register of Deeds sl If grantor is a corporation, insert corp. name ice_ q mpl*te*W i signatures of Pres. and Sec. and corp. seal, if any. If none,so state. (Sec. 59.51(1) of the ts vides thdi It knstruments to be recorded shall have plainly )f printed or typewritten thereon the names o t to ranters, wiGisses and notary.) Deed Warrant (Corp. or Indiv.) F Wis.Deed, M26 9, MEN ' H r STC - 105 y t ti SEPTIC TANK MAINTENANCE AGREEMENT o St . Croix County 0 L y OWNER/BUYER ���( Un 1l1 E kt ROUTE/BOX NUMBER ]�� {- _ Fire Number CITY/ STATE ��0�i� ►Cr�QfIC �i� �Y15il1 _'LIP `7yC)�� PROPERTY LOCATION : SE _'4, Section____, T34 _N , R 1_W , Town of N Tam St . Croix County , Subdivision Lot number 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 seLtic 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 ma 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 stems agree to keep their symtems properly maintained _ The property owner agrees to :>uc,,..; r to St - ^. uix 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 . ti 0 I/WE , the undersigned , have read the above requirements and agree to maintain the private sewage disposal system in accordance with x H the standards set forth , herein , as set by the Wisconsin Depart- � meat 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 . _ DATE St . Croix County Zoning Office P . O . Box 913 Hammond , Wa 54015 715-796-2239 or 715-425-8363 Sign , date and return tc, above address . f,5n r a''s Jx 4 t '`'; r . ., .:tr Yom`t J f t'. �t r y d i n R q -.. a¢ r .oY ..'�'a t°>L 'r ''G f� ^.wl x " 'i �+e �'� r�' sYx '.v y+ f'+.c - •1 r ,l +!r c 4 ' '" ''x '`a•k +r.. r °x� f }i�, r h at'r`` r 1.'n'3'''� Y w e::r:`7- d• err'' �� f 1:. 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BOX 7969 LABOR AND HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 53707 (H63.090)&Chapter 145.045) LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: S w 1/ '/ ? /T3/ N/R 17E (o )W STq,VTO A/ s' flG,.i C,��•�-r . COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: S1•C1 oix LE,v0i2 d v/i�ER T USE DATES OBSERVATIONS MADE rat NO.BEDRMS. COMMER IAL DESCRIPTION: PROFILED CRIPTIONS: PERCOLATION TESTS: UQResidence N+ New ❑Replace , �— I RATING:S=Site suitable for system U=Site unsuitable for system S C S0 "_V'e1-1V t,�� o CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK:RECOMMENDED SYSTEM:(optional) ®S ou RI S ❑u I S aU o S Ku o S au rd-vO.'r-OT/DV�tG 44� If Percolation Tests are NOT required DESIGN RATE:�r s �/.- I If any portion of the tested area is in the s.H63.09(5)(b),indicate: f0� Floodplain,indicate Floodplain elevation: j,) 3)tcfMhL fT, I�i�il�Vf��L� PROFILE DESCRIPTIONS BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-IN 'Cr. CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER DEPTH OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- 9'.0 � *0-- ' 90 s r,4N E,� iqs • B-2- D 0 (�•/y� ��-- > 43 'D,� AA) s/, /.o ' o�•H� .33 0 /r C•S v Cs B- ' �.s ' . 3 y ' ?�— > e .,f'ol- 4- si .,S �,�. sy w;o� . , 7o'P� r/ c w Idc.' s,N 5 I S o c c . DN soodk r►DE P,f -wA// - ,4 B- si'x T..4 S e L p C c e, - H o 11 /,v T fC1Pf -Q- FT- PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD PERT PER INCH P- Al v Arwee,24,LT 04,irl A P_ /,V P- P ef rwe P- Al Q L iV V ES. &" e4 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. 130 TTOM s'r f r��j S A&Z' Ak ,7, Q /e r r N ,�►i SYSTEM ELEVATION _ .. _ _ _. _ _--- __ 3., �. #0 p` �' I �° Sao __ �.n J i 1137 /0 t N IRO v s'Ei T 0 0 t --} i PROVfl ? t ir �SY 77 € Ij 1j (.... ITS ({•I- (( � _ 1 ..., I � 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(pnn .O1V1�ii7i iL y TESTS WERE COMPLETED ON: � ►7111V17v l3 — /f � ADDR CER FICATION NUMBER: IPHO NUM R(optional): MINNESOTA LICENSE NO.00663 SCONStN 0:24917 �,O'111E1L RDy HUDSON0 W10%16. H�( CST SIGNATURE: ` DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) —OVER — J INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 To be a complete and accurate soil test, your report must include: 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 1 MAXIMUM number of bedrooms or commercial use Manned; 4. Is this a new or replacement system; B. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; B. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locatifig your test locations. Drawing to scale is preferred, A separate sheet may be used if desired; B. Make sure your benchmark and vertical elevation reference point are clearly shown,and are permanent; . Complete all appropriate boxes as to dates,names,addresses, flood plain data, percolation test exemp- tion, if appropriate; 10. If the ir4for nation (such as flood plain,elevation)does riot apply, place N.A.in the appropt late box; 11. Sian the form and place your current address and your certification number; r 12. Make, legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Sail Separates and Textures Other Symbols st - Sione (over 10") BR -- Bedrock col: --- Cobble {3- 10") SS - Sandstone gr - Gravel (under 3") LS - Limestone s - Sand HGVV - Nigh Gr0UHdwater cs - Coarse Sand Perc Percolation Rate nitid s - Medium Santa W Well fs Fine, Sand Bldg ._ Building Is Loamy Sand > - Greater That) �sl - Sandy Loarn < Less Than 'I Loarn Bn - Brovin .sil - Silt Loarn BI - Black si - Silt Gy - Gray *cl - Clay Loam Y -- Yellow sc.i -- Sandy Clay Loarn R Red sicl - Silty Clay Loam mot - Mottles s€s ._ Sandy Clay vv'/ with sic - Silty Clay fif few,fine, faint • ye, Clay cc - common, coarse of _. Peat mrn Many, mediurn P1 Muck d - distinct p - prominent FItrVL - Hugh wat er-level, Six general soil textures ace water for liquid waste disposal BM - Bench Mark ARP - Vertical Reference Pint O THE OVVNR; j This soil test report is the first step it)securinq a sani':a f y permit. The county�� fm Tr t r lay request ver ification of this soil test in the field prior to prrinit issrranee. A complete set of play;, for the private swage system and a permit: application must. Le su',r)rnitted to the appropriate local autl ori�ty ill order to 7 k�t 3ir� a ernut. The sanitary t f ' tier rrit: must be olataarre ant. r ed pi for to he start of-any con uctiorr. - M ,8.t c S aPE 14 Q s s �b ///EI'0 S U 1'E f� 'if IF- < ViE:Art p - ;2 0 AOL-) S�"� -��"/°�r o.►ti �o�g� a f��0.k� o--..AQ �oc ye-7Ed� s'1"jra.uY •r-Sy N't�lst;C Go��'r;Nq S. o f .r S Teo T -1 x t� a-Hfi Al �s s 48 o G /`i o JE f �rep'°J® A•u E 7,5-0�.fton- TE -sop t e/ �7SCSA1ti'E