HomeMy WebLinkAbout040-1191-20-000 ry o Q) °
oCD
o�
°
cb
w �
c
� I
a
N i cc I
q
^+ O
c
� 7 I
r� O
v I
O a°i
I
� I
[. o`
y I
� v I
z o
LL o a
-0 O
I
v 0)
Z y
04 fn = O
Lij
IL m
N H !n
o
O Z a c 0 I
y Z o
to F- c z
O C) M
` 7
N CL ry,
N �
C O
Q Z H Z w
N
Z
� I
W E N
N CL cc
c
N W d `f U O
x O G rC ra a ai
o 3 3
U N a =
0
•� :s 0 0 0 Z
ti
4p a a a
vi= N
i
—
L
a
I
o N co 00 20 O
to J U � rn rn Z
tt- "O
E
_ U
N
O O O
9 N O O O
m Q Z U) co
m o
o o a w c
°o
r el ` v E
a
co ° 0 O 7 O O Cl O O c c U H
N c E_ tn O
N _
b � T tOn ao C) N Z 'a c � O
• 0 CN O Z O Z N H Z E Cn
O N H
a
- d
— I
\ €
.m
o a a
a `
• CL m
rr`Iwwv E ` c c
Parcel #: 040-1191-20-000 10/19/2006 05:18
PAGE 1 OF F 1 1
Alt.Parcel#: 24.28.20.848 040-TOWN OF TROY
Current I X,
ST. CROIX COUNTY,WISCONSIN
Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type
00 0
Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner
O-DAHLBY, STEVEN J
STEVEN J DAHLBY
242 PLAINVIEW DR
RIVER FALLS WI 54022
Districts: SC=School SP=Special Property Address(es): "=Primary
Type Dist# Description '242 PLAINVIEW DR
SC 4893 RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 1.100 Plat: 0234-CROIXRIDGE
SEC 24 T28N R20W PLAT OF CROIXRIDGE LOT Block/Condo Bldg: LOT 02
2
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
24-28N-20W
Notes: Parcel History:
Date Doc# Vol/Page Type
06/16/1999 605067 1434/500 WD
07/23/1997 823/380
07/23/1997 719/538
2006 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/21/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.100 60,500 272,300 332,800 NO
Totals for 2006:
General Property 1.100 60,500 272,300 332,800
Woodland 0.000 0 0
Totals for 2005:
General Property 1.100 60,500 272,300 332,800
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch#: 140
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges 00
Total 0.00 0.00
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS
LABOR Si HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
1MA MADISON, I BUREAU OF PLUMBING
MADISON,WI 53707
SF!, SA-,S24,T28N-R20W UCONVENTIONAL ❑ALTERNATIVE State Plan l.D.Number:
Town o ThUy ❑Holding Tank ❑ In-Ground Pressure ❑Mound (If assigned)
Ptainview Dt ive
NAME OF PERMIT HOLDER: JADDRESS OF PERMIT HOLDER: INSPECTION DATE:
Tim Nizzen 523 &Achche.6x, Raven Fattz,, W1 54022
BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF.PT.ELEV..
Name of Plumber: MP/MPRSW No County Sanitary Permit Number:
CaAt P. He,u6e 3378 St. Ct oix 112823
SEPTIC TANK/HOLDING TANK:
MANUFACTURER'. LIQUID CAPACITY. TANK INLET ELEV. TANK OUTLET ELEV_ WARNING ILABEL LOCKING COVER
PROVIDED'. PROVIDED'
DYE S — No DYES ❑NO
BEDDING: VENT OIA.: VENT MATI HIGH WATER Ni1MBER OF ROAD: PROPERTY WELL'. BUILDING:JVENT TO FRESH
ALARM FEET FROM LINE: AIR INLET'.
❑YES ❑NO ❑YES ❑NO NEAREST
DOSING CHAMBER:
MANUFACTURER BEDDING'. JLIOUtD CAPACI rV PUMP MODE L. JPOMP SIPHON MANUF ACTUHEH WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
DYES ONO DYES ONO 10YES ONO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERTY WELL BUILDING JVENTTOFRESH
(DIFFERENCE BETWEEN FEET FRLINE AIR INLET:
PUMP ON AND OFF) EYES ❑NO N
SOIL A BSORPTION SYSTEM.Check the soil moisture at the depth of plowing IL I N(,TH IDIAMF TEH MATERIAL AND MARKING
or excavation. (If soil can be rolled into a wire,construction shall cease until FORGE
the soil is dry enough to continue.) MAIN
CONVENTIONAL SYSTEM:
BED/TRENCH ENCH WIDTH LENGTH IN O.OF UISIR PIPE SPA(.IN(I COVER INSI UE.DIA =PITS LIQUID
THE NCHFS MATERIAL'. PIT DEPTH.
DIMENSIONS
GRAVEL DEPTH FILL DEPTH DISTR PIPE DISTH PIPE DISTR.PIPE MATERIAL NO DISTfi NUMBER QF t;PH OPERTV WELL BUILDING. VENT TO:FR:ESH BELOW PIPES ABOVE COVER EI FV.INLF 1 ELEV END PIPES LINE AIR INLE
FEET FROM
NEAREST---1►
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-
❑YES ONO meets the criteria for medium sand. TIONS MEASURED.
SOIL COVER TEXTURE III HMANI NI MAHKI HS SEH VATION WELLS
_ ❑YES ❑NO 1:1 YES ONO
DEPTH OVER TRENCH BED DEPTH OVFH TRENCH BED DEPTH OFTOPSOIL SOUDFD 5 ""I':] MULCHED
CENTER EDGES
E:1 YES. 1:1 NO YES 1:1 NO ❑YES El NO
PRESS URIZED DISTRIBUTION SYSTEM:
BED/TRENCFI WIDTH LENGTH TRENCHES LATEHAL SPACING JGRAVIL DEPTH BE LOW PIPF FILL DEPTH ABOVE COVER
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MAT EHIAL NO DISTH DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING
ELEV.. ELEV. DIA. ELEV. PIPES DI A..
ELEVATION AND
DISTRIBUTION
INFORMATION HOLE SIZE HOLE SPACING DRILLED COHHEGT LV COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED
PLANS
1:1 YES ONO El YES ONO
COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS. NUMBER OF PROPERTY WELL: BUILDING:
FEET FROM, LINE.
❑YES ❑NO ❑YES ❑NO NEAREST
ate.
Y"//
2 �1 Pklli v 10
Sketch System on Retain in county file for audit.
Reverse Side.
SIGNATURE. TITLE:
DILHR SBD 6710 (R.01/82)
Zoning Administt tcn
®ILHR SANITARY PERMIT APPLICATION CO (2 RQ/x
In accord with ILHR 83.05,Wis.Adm.Code
STATE SA RY P�RMIT#
—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 El YES L'� NO
PROPERTY OWNER PROPERTY LOCATION
i5sEw 5t % 5I,J '/4,S a1 T , N, R E(or
PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME
V rery e4�� 12 �LY� C ro'i qud 4
CITY,STATE ZIP CODE PHONE NUMBER CITY NEAREST ROAD,LIAKE OR LANDMARK 9
i ver .5 VILLAGE: ^� C/ �dQ)w r-
�
gi !u l C 461-�-
II. TYPE OF BUILDING OR USE SERVED:
Number of Bedrooms if 1 or 2 Family 4 1311 rts OR ❑ Public(Specify):
III. PURPOSE OF APPLICATION: (Check only one in##1. Check##2,3 or 4,if applicable)
1. a. LN 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. X Conventional b. ❑Alternative C. ❑ Experimental
2. a. ❑System- b. ❑ Holding c.❑ Pit Privy d. ❑ Vault Privy e.❑ Mound f. ❑ IGP
In-Fill Tan k
V. ABSORPTION SYSTEM INFORMATION: (Check one)
1. a. ❑ 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): 4t 1,
C��6 G��U Feet Private ❑Joint ❑ Public
VI. TANK CAPACITY Site
in allons Total ##of Prefab. Fiber- Exper.
INFORMATION New xi sting Gallons Tanks Manufacturer's Name Concrete stCon-d Steel glass Plastic App
Tanks Tanks
Septic Tank or Holding Tank 1200 1 ,�0�✓ � (��� vs ❑ El
Pump Tank/Siphon Chamber ❑
VII. RESPONSIBILITY STATEMENT
I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans.
Plumber's Name(Print): Plumber's Signature:(No Stamps) M MPRS o.: Business Phone Number:
Cry ► a'. 1�1<tg� .p,� r—� 3 S '7 �lS 425--PS �
Plumber's Address(Street,City,State,Zip Code): Na7-1.f Designer:
z Jv4 5. 1MtNX'W 5f (�c�c iull> s U7,v .vt IF AC,
VIII. SOIL TEST INFORMATION
Certified Soil Tester(CST)Name CST# 3 G b
O
CST's ADDRESS(Street,City,State,Zip Code) Phone Number:
ro- L 5 r/�K UaII (.v1-1
IX. COUNTY/DEPARTMENT USE ONLY
❑ proved Sanitary Permit Fee Groundwater ate Is ng Agent Signature(No Stamps)
f��Yr rcharge Fee
L�Approved Given Initial �I2C �6 / I(3_12r-
Adverse Determination
X. C MENTS/RE ONS FOR DISAPP VAL:
SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber
INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT ,
APPLICATION
TO THE APPLICANT:
1. This sanitary permit is valid for two (2) years;
2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new
criteria in the Wisconsin Administrative Code will be applicable;
3. All revisions to this permit must be approved by the permit issuing authority. A new permit may be needed
if there is a change in your building plans, system location, estimated wastewater flow (number of bed-
rooms, etc.), depth of system, or type of system;
4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be
submitted to the county prior to installation;
5. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed
pumper whenever necessary, usually every 2 to 3 years;
6. If you have questions concerning your private sewage system, contact your local code administrator or the
State of Wisconsin, Bureau of Plumbing, 608-266-3815.
To be complete and accurate this sanitary permit application must include:
I. Property owner's name and mailing address. Provide the legal description where the system is to be
installed;
II. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat
restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling;
III. Purpose of application: Check only one in ##1. Complete##2 if permit is for tank replacement, reconnection or
repair;
IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project
is in conjunction with University of Wisconsin;
V. Absorption system information: Provide all information requested in ##1-6;
VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed,
number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete
for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if
tanks received experimental product approval from DILHR;
VII. Responsibility statement: Installing plumber is to fill in name, license number with appropriate prefix (e.g.
MP, etc.), address and phone number. Plumber must sign application form. Fill in designer name if
applicable;
VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number.
IX. County/Department Use Only;
X. Comment area for use by county or resaon given when application is disapproved.
Complete plans and specifications not smaller than 8'h 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 stir
included the creation of surcharges (fees) for a number of regulated practices which Wisco M.
can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried reasurQ: a
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.
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)
i
APPLICATION FOR SANITARY PERMIT
STC - 100
This application form is to be completed leted in full and signed b
P g y 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
Location of Property L61 cl 4 ;x Y6:2: h;, Section Z y , T Z N-R 20 W
Township 7-1?v Y
Hailing Address Z 3 131 rC xC 9= t
�i ylc �� /� �i►i.Z ��/O L Z
Address of Site _ kal
Subdivision Name ro 1A r11( ell-
. Lot Number 2
Previous Owner of Property . 'le Ile- /yes 74
Total Size of Parcel r-cj
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 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
1 (We) ceAtt6y that att statements on thi-6 oAm arse trtue to the best o6 my (ouA)
knowledge; that I (we) am (aAe) the owneA(s f o6 the p4opelc ty des ch i.bed in this
in6o"ati.on 6oAm, by vi4tue o6 a waAAanty deed %ecoAded in the 066ice o6 the
County RegisteA o6 Deeds as Document No. ; and that I (We) ptesentfy
own the pAopos ed Aite bon the sewage, d i 6 pas s ys em (oA I (we) have obtained an
easement, to )1un with the above des ch i.bed ptoperc ty, 6oA the constAuc ti.on o6 said
eystem, and the same hu been duty >tecmded to the 066ice o6 the County Regi4teA o6
VeedA, ae Vocument No.
GNATURB Qf,16WNER SIGNATURE OF CO-OWNER (IF APPLICABLE)
i0 0l�Y
7ATE SIGNED DATE SIGNED
i
REGISTERS OFFIGE
Steven M. Best and Paulette M. Best, husband and wife ST. CROIX CO., WIS.
- .
........ .........._------------.----- ------------ - . . ............. .... Wd. for Record this 23rd
-------------------------------- ------- - _
doy of Sept. A.D. 988
- .....___ 10:35.. . A. 1
Timotn E Nissen and Dian-a R-. Nf ssen,' _ ,
convt„ and ��.,rt:ints to _ ---. ., y -
husband and wife as marl tal property wi tYi _ri ghts_:of
survivorship �...,� _k I
--- - ------------------ R.ow�.► a c.. M
---------------------- -- - - -----
...-. -- -..---.-------------------------------------- ------- ... ----_ _ _. _.. ----------------- -- _ RETURN TO
II
F
..... ... .......... ...... ____-____ .------..--------.-. ..._._-_.--__.----...-_..-._ ---- _ _
i 1
_ ____ ----___-----_----_------_----------------_-----------------i- ---.. --------------------------
I�
St. Croix !
the following described real estate in ------ ---------------------------------_._ ._.County, 4
State of Wisconsin: I
Tax Parcel No: ..............................
A parcel of land situated in the South 2 of the Southwest 4 of Section 24,
Township 28 North, Range 20 West described as follows:
Lot 2, Plat of Croixridge, Town of Troy.
i
I
hh rq S 1 -R
F E
{j{1
F
Y
1
This --- __ homestead property.
-J S n-o-t-
(is) (is not) I
jl
Exception to warranties:
Easements and restrictions of record, if any.
Dated this -- -----21 St---------------------------- day of --- ---SeptembeY —
19.88 -• ;!
_... - ---------------------
(SEAL) !'/OF � ------------------ — (SEAL)
even--M,---Best----------
/
_(SEAL) �/ —...._ �_'_. . ------(SEAL)
_. -----
----------
'k Paulette M. Best
AUTHENTICATION ACKNOWLEDGMENT
Signature re
______________________ STATE OF WISCONSIN li
------------------------------------------------- St. Croix
ss. },
------------ -------- ----------------County. r
authenticated this ........day of___________________________ 19.._.__ Personally came before me this _ _�_:a __.day of
-------------------- 19__$$__ the above named j
Ste ven__M.,__B es t---and..P-a-ul_et_te_M,_--B-es.t,__-iii-s k
wife--------_------------- !
TITLE: MEMBER STATE BAR OF WISCONSIN a
(If not- -----------------------
--------------------------------
---- - --- - -
--- --- --
- -- - - -- -- -
authorized by § 706.06, Wis. Stats.) -- --- --- - - - - - - -----------------------------------•-
to me known to be the person S__________ who executed the
forehoing instrument and ac�jwwledge the same. r;
1� , ��''
� THIS INSTRUMENT WAS DRAFTED BY
William. J Radosevi ch, Attorne y --at Law - -- - ------------ -
b4
- - - --- - --- ---- ----_------_-------- Notary Public r �-----�,, a ~;
502 Second St. Hudson, WI 54016 _ ivT
County, is.
(Signatures may be authenticated or acknowledged. Both My Commission is ------ �tlt f not, state'• expiration
are not necessary.) ('
t
date: — U ;�"{t C _a 19-°��--•)
*Names of persons signing in any capacity should be typed or printed below their signatures,
WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin`Legal Illnnk Cu. t.
FORM No. 2— 1U92 nlJeaukea, wis.
Y
STATE BAR OF nneo00S[N FORM 2-1982
�
Steven
M. Best and Paulette M. 88st'� hU3bdnd and wife |� '~v /�-�
---- --. ----- ------ ---'. ---------'.---''
------------'----------------------------
��
----'----------.-----'------------------..
!
........................................ /. .
J �T�'� ' �E� �l���� �bd'D��h�'7<�''Ni���O, /
husband �D� wife marit�]----' '����'����f�'/��---' '� |
|( - 'r - �`-,-�^ ��__ |
SUrVlYOr�hi�.....................................
. --� -� -------
' -'--------' |
� i
| -----'-------------'-------------------' !�
i. |. i
: - ----- ------.-_.---.-�-_------.� --_.-_----
'
|
, ______________.____________------_-. | °"T,"° TO |
' -----._-------------_ ____.____. !/ !
� �| i!
---' -- ----------- ---------------- ------ - ����
the b�k,,ix� described ,:u estate in .....3t_.--Cr�_iX-'--------.Cvvnty,
� State of Wisconsin: �| �
Tax Parcel No: --'-----'------'-- ! �
i|
^
; A parcel of land situated i 1n the South � of the Southwest « of Section 24, |
�!
Township 28 North, RdOq2 20 West described OI follows: |
] |
| �
|
Lot 2, Plat Of [roixridge, Town Of TrOy.
/| |
. '
.�
�.
i! |
|! |!
|
' � !
i !
|' S
| � !
^ This -- .-n-o-1---- bnmascud property.
(is) (is not) !! |
. /
. �
Exception to warranties: ' |`
� |
Easements and restrictions of record, if any.
.`
om*| this ----------2]St----------------------------- day of ------�epte0be ........- ------- .........................
.
`|
----------------.------(8���) ���`��r��,�_---------'(aoA�.)
,
� ^ /
----------------_.-_--- �-------- -----
-' ---' - ------------------------------------ ........(oEAL) -/�.'�t �\~��+��---(oEaL)
~ -----'--------'--.--.---. ~ puVl�tte'�-,-B��t__ __� __ _� �.
�� � � '
'
/
,
AUTHENTICATION ACKNOWLEDGMENT
l
�
Signature(s) ------------------------------------------------------------ Sr�T� 0r �z3CO�G[�J 'i
.�
�� `
---'-------'------- 3t Croix / .
-'------'-''---'--------'--- ---'�-_-------.--' couu�r > i
-- .
authenticated this ----durof........................... 19--- Pc-s000D� c��obe�bne �c this --------duyof
_._________________________._ ----------- '- ----_'_~ 19-U.- the u�oroou�eo
Steven.ML'Res±'and Paulette-M^Best,-his U
U
__. ..... ........................ ........................... RETURN TO
... .... .... ... ...........---------_.._....... .. ...... ..... __. ....__ .................
_______________________________ _ _ ____ ______..------ .._-_-.----------......... .
the following described real estate in _-_St. Croix court.''----- —
---
State of Wisconsin:
Tax Parcel No: ..............................
A parcel of land situated in the South Z of the Southwest 4 of Section 24,
Township 28 North, Range 20 West described as follows:
Lot 2, Plat of Croixridge, Town of Troy.
i
i
I
�I it
This
-'---not........ homestead property.
(is) (is not)
i�
Exception to warranties:
Easements and restrictions of record, if any. .
i
Dated this -. -------21St--------------•-------•------- day of ----- September---- ..... .------........ — 19.88
....... ... ............................ --- ---------•• _(SEAL) �� E
---------•--.(SEAL)
........................ ------ -----------------•--- .............
.K e-ven--M.---Best---•--.. .--- -----• ---- ---------
------- -------- -------------(SEAL) l_--:.1.`... (SEAL)
* ................................................ . . Paulette M. Best
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN , !!
..........................-------------------------------•----••-••••----•--•--- St. Croix } SS.
---------------County.
authenticated this ........day of........................... 19...... Personally came berore me this ................day of
e�?1eUl4e.r...................1 19._$$.. the above named H
Ste-ven__M....Best._anc•!_P.aul.et.te.M....B.es.t,.__hi_s
wAfP.
TITLE: MEAMER STATE BAR OF WISCONSIN
(If not, --•-------
authorizedb -------•-•••--•-------•--•----•---•--•----•-•--•---•-•-----------•--••--......--
y § 706.06, Wis. Stats.) to me known to be the person S.......... who executed the
foregoing instrument and acknowledge the same. I'
THIS INSTRUMENT WAS DRAFTED BY jI
William J. Radosevich, Attorney at Law
---------------- .............................................................502 Second St. , Hudson, WI 54016 * i�
......---•••........... .....• • Notary Public .------------------------- - -•-------County, Wis.
(Signatures may be authenticated or acknowledged. Both MY Commission is permanent.(If not, state expiration
are not necessary.) ;I
date: --- 19--------•)
.....---•------•-......
;i
*Names of rersnng siznins in any capacity shunld be typeri cr in•inU,d belrrn• their riRnatnrc ��
N
H
y
STC - 105 r
H
SEPTIC TANK MAINTENANCE AGREEMENT Mo
St . Croix County x
ry
OWNER/BUYER 7/ y,1,7 �Y ��i/��rfl /� �l�9SSc�ii/ rn
ROUTE/BOX NUMBER OT Z �ru/Xr�% ,,iy'-/ 111 Fire Number
CITY/STATE vti4 CS z I P S'yo2Z
PROPERTY LOCATION : Ste✓ , Section ZV , T Zd' N , R 20 W,
Town of %rU , St . Croix County ,
Subdivision C.-01Xr101 , Lot number .Z .
I
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 affe— cT t 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. H
0
r:
I/WE, the undersigned,, have read the above requirements and agree N
to maintain the private sewage disposal system in accordance with x
M
the standards set forth , herein, as set by the Wisconsin Depart- Iv
ment of Natural Resources . Certification form must be completed
and returned to the St . Croix County Zoning Offlrpe within 30 days
of the three year expiration date .
SICNED
DATE SCI /U
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 .
i
i
I
i
!
i
1
i
� 1
7 64e
)m aLi
/00 ..
i
CD A) _' CD
�
Q
Na D
UNPLATTEO LANDS OwNEO BT THE RATTER
�4�iM 4 w o-4 SdE 463.00'
Jd
0 f yA: i 4'Vol O
A. Al J C O J O M x O
� YWr •e# is: f• � t � o
� 5 iX ..
If
oo, aaa 1
pA b i i s� t ✓d \ artsNa O
` 4 Mt`•:ly' '�r. i 2 v
�. a r••Yr,- , •!a ro,',•• ra. 7 ,.ss"•y` �!,. .\ ..tr" M
0.33716
ssO.AS
w0•Jt 20•E = I f "a-02,16't •a w ,,�
:60J0 = ��=i 1x00
N fr O
�_ g. w o•02 291E ` ♦ 31 x
• "� ►W * I 6 •�� • « �~�f �
22!77
s z •a0. 8. �_ Jrfb, y + t• �f7•f
t tU • '• '1T :
260 00 a s r
^
°
IA Is.
0% Ilk
� \ M •
u / JJ,
at
r :;t � N � 5 •' •a•ara O�• 1 R � ww /�C f'�
s _ �• K bJ e J `•
- 260 J0 O — V 'r'�i. � s Oi+� b�•v GG �G �•,J.►. / ••
n !0 n
= w I 'x.)14 �• '!7.••• � _ �
.7 s
r. ,i �.-" s0� as 6t 1{000
tv
r i r NC° • �� 4:' N��if E
y. JJ• 2G9 f%•aN �' n��q
i L � s r• t<661 cd N °, v r 'n' � � `9 i
A
0
., w s 4•
1 ,� 1 J•N rrrl•H !•• i « Ilk
.e r • a ft
Fl r ttr i 1 :M .6K t ,L• 17500 62135
.60W 1a00 17s 0)
c
A H
uF
r—,--z
1�
-
y
r 7 H•7.rrr1••�,•r�{t d f { z+.—.r.•!�•.wwr. ap�o0 .s^7F'.�' �T7Tr"^+'^^• +r•.—sw:r+•.^^r r
'�.
x Y9Sx ..{}n a. 1 r r :� r t Sa3 t✓A t _ al
3 A F •� Frl 9 t i lJ ! t5'
p
�kk 3ti fx.''} }I;`..l r. a 4 s r {.: * t R'}• �.!! t{ r r A.. t s '.
5 fz i t ..i.A4 t'i• t < t4' .1 it s:5a7"4�'"E C!�.AJ
L - , • h xTx
"3
rfi il, ,3 M t r e•ri r ,r 3 +�r4.yL'f t h k
s � •!• f �r t�r ,9 n {g 1 4 �r� a�rf t N"r v ). s C.k•I[} ��W t y '4 t r
4 :1 A 4:. 3.; six d-:' ? yf F.y to t�,i..zt "�� :�r T'4 NY �tN.t ru �{ {.r(uy :G 1 a i.Y'K A e r� ! •l yrfr :fl;
�y�f•, ik ,:l 4 1 t x!? t s.H r ,,i'} r F r t :3 a t +.�.{ l�,.
'�.�s'a]] t-Rl
At f rT.,.4 �4 ( •k .ti(�a .5."i�.!! +a5 f •••�•5, 9 'r•Y f Y-.'R 5': 'y I! y 4 s�+1 Y � Jr S.i i��a.CV:�E rAt�.. .��•i la'�`�� !3a. +•rr .
e
y.`,r 7 ,:;�'i} � '9w ,. ,J �:A 7 tm4r���f: !a+! f r i� c f tF•. A 'r}�x.�. � :a. 3 e ! fi � r-:tr•,L M� a R I ,� e _.5 a:.
-$;":.:�•v } ,,:�!.9 :1.•}7 s'! w: fi.5 tnr r•',d ,f<t. .rti y;.x� T r Iy,P l,ti�S4.,tt 'k. h,,:�yiR. .tits.:1A '.Ipgx 1. tF �iY: as• IFS :..n.{rt *�
V
�4a.�I:;a t 4t:�:4� l�.a.. 5 .yi i it.7�•-� I t!!k..:/r !T^F J;. 1 t.S. ,.gk R :.'� � P... { r �15�;� �1 ) ; f { r M1.wci .;y..�•� 7.(�i +'t�a )7 :,'l D t,.
x�5. •� '.7_ r.., 4f r 1'+ t t ..�:^)t it a !'.1!'.ix�f !-trt a a �*ir Y:eF ,,)ft:j. l�y�nA X ! • �.� �t r:': -+..ray + r"�r ��,...:fl y, r °t .. ' r � "aI
�r7:., •4:.�s � + tIr s rJ t.:r; r `�,.f !9,�x14 ,11/t 4 t!i�tvA7' ry .+x A �,(Fl;1 f y n'fd s,fin i4 :•F 1 r�..J.•:'j t , f-. t Y } F l�t�!�t ri f' 7•- y .
5 •7 �•7 1 .a s r ! .T `[4 :P, � L r r a S! t a f
t „' � r ., -�« w ,�.!c F S '' � FF +: r- i }f .r ti sc r F .{r r �, ir•Nt
'ARTMENT OF REPORT ON SOME WINGS AND SAFETY & B DIVISION E
±USjRY, a
OR AND PERCOLATION TESTS (115) P.O. BOX 7969 - I
MADISON,WI 53707
AN�R E LATI ONS _
(1-163.090)& Chapter 145.045)
A SECTION: TOWNSHIPHNt)NtCiP*t-FTC: LOT NO.:BLK.NO.: SUBDIVISION AME: -
ff �� /D%N/RD3 E (o W � � Croy RId
RUNTY: OWN R'SeBv ER'S NAME: MA te` �A-ODR SS: �� � .t��sQ� - \ ` , 5�,y no _
,[l� DATES OBSERVATIONS MADE J►
NO.BEDRMS.: COMM R A DESCRIPTION: ,-,/ PROF DESCRIPTIONS: ON TESTS:
Residence /�/A 2New ❑Replace.
LING:S-Site suitable for system U-Site unsuitable for system
NVE
DU
IMOUND:L JS EA IIN-GROUND-PR QSQu RE: S0S S N2 I,L H 0 JG TU V ' Tv'_L,chcDED S rel epX 13� l rte.` F�'Na _
o . f1 !a�'
ercolation Tests are NOT required DESIGN RATE:n/d If any portion of the tested area is in the /� , - 1
der s.H63.09(5)(b),indicate: /Y/I Floodplain,indicate Floodplain elevation: A/,A (�
PR FILE DESCRIPTIONS -
tRING TOTAL DEPTH T 0 GR UNDWATER-IiNC# S CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH
IMBER DEPTHjo,, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.)
.4.1 h L .y n M5
81 SL TS 4.0' 8n I F '5
3
�
, .
1,8'
't . J S� S. L
i
K B ,. Ts 5SL 1.0 3h,S5" f
erg ti
Q. 3
' E
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES )
JMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD ,515 3 PE I C t
f
-
i
f
)T 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
and slope. Tr-c r� h 4 3. 6Y tZe p�ac.rnev\�- ,l�rca; Trcw�. G 17-0. 3:3
(STEM ELEVATION -rr8 qa .33 _
13
,t'►;C- -D-��-- .'✓ — ccl.st'ru�-�X �:i1 :lr ItlSr �_.. ._i...-- �--C ---v c o� 01
p
q �
f3,,-1 F f
N
' 1 1 i _ � 041 Fe
.
C Cot% d ax 1. ACAI�._. S�.fc
.he 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
ministrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
%ME(print): TESTS WERE COMPLETED ON:
L 0 _ /7 Z -ee
)DRESS, CERTIFICATION NUMBER: PHONE NUMBER(optional):
o� 30'7 77.5-'y4aS"
CST SIGNA RE:
r
.,�TRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester.
tLHR•SBD-6395 (R.02/82) OVER -
L
R
fUNT
r-nfft% n 1 1/+c% A 1►1 SAF TY& BOIL INGS i
r �
- - -- — -- -
e
— _ p0
P
CD
LA lo
Cl
et
1
3 _ '
^ ^ — I/-A...r7 +! :.tea_-o -- 3
If Vk
reigned,hereby certify that the soil tests reported on this form were made by ma in accord with the Procedures and methods specified in the Wisconsin I
live Code,and that the data recorded and the location of the tests are correct to the best of my knowledge end belief,
TFSTS WFpF rn",, FTFn nN
l
APPROVED vFNj CAp
V�P 3" F&NCE POST_ _N W C6J NER
MAX 42" COvE R _
APY40v Ea SYiv-M5r I G )=4 1591 0 F L 07 WITH 09,419 G E Rt BOOM
E f f
D S G N FD 8�' CARL 1,1� SE
4" PERFORATEP piPE -
MIN G" W,4$NED .¢GB
EL, 92,33
-0T 2 CROIX RJDGE
bM TOP 3 FEpCEPOST
w►9N oRAN&E ({,BQoN
SsU C EL. loo.co' 3FENcE POSE
M� 110R'7N P oPef-rY LTNf� HRP- SELIpI�
" 7 RF1scN� 2
P2
83 .�
REQLac�MFHt, 82
III
GaR.t6E 1200 GAL ' k
I $E Ptl.L '
TANK
PLAIN � �pRoPosE9 s
v i lrti/ NOOSE 6'1
�oAD
?(ZoPo5FDp M
1 w CL�
i
` w
PI07' PLAN �!_. 92.33 1 _ ��'R•ok �'-�`
\\ TREneNdZ 1- ''c
SCALE i" qo' FL Q1.63
\� CRoS SECPrTON uj
iC
I
i
i
Souig pizoPERTY LINE