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HomeMy WebLinkAbout012-1060-90-000 a) 0 140 cm co � � \� � c 0 E E CL o cc CL cc 0 o a) -r- to CD V z 7s 0 0- C 0 E cc c) a F- LLJ E z 0 z Go 0 LL, C14 0 co 0 z E CD ® -5 a) I"D 0 0 0 m 0) z z co CNI \ / g $ IL 0 E < 75 1 U) V) U) z > Wb 0 FL J) 0 0 0 z CL CL IL 0 E E m CO CO z 0 M CD CD Go E IL Z) o I / ta 0 ?. 4 0 s a I 4) EL 0 (D CN F- (D c c CL C, a 0 0 -0 Q 1 C5 r i U) 0 (n M co 1- z z 2 ■ ci a. a) a) c a) co 0* C4 cl E E r, 00 0 cn 0 U) cl, w LL 0) 0 z F- CL L: IL AL 9 cL. .2 r E 0 m r IL S U) SO Parcel #: 012-1060-90-000 10/17/2006 01:19 PM PAGE 1 OF 1 Alt. Parcel#: 28.30.17.420C 012-TOWN OF ERIN PRAIRIE Current X ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner TERRY J&JUDITH M THOMPSON O-THOMPSON,TERRY J&JUDITH M 1360 CTY RD T HAMMOND WI 54015 Districts: SC=School SP=Special Property Address(es): '=Primary Type Dist# Description 1360 CTY RD T SC 2422 ST CROIX CENTRAL SP 1700 W ITC Legal Description: Acres: 8.060 Plat: N/A-NOT AVAILABLE SEC 28 T30N R17W 8.06 AC SE NE LOT 1 OF Block/Condo Bldg: CSM V 4/1108 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 28-30N-17W Notes: Parcel History: Date Doc# Vol/Page Type 09/21/1998 587355 1358/188 WD 07/23/1997 788/611 2006 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 11/07/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 8.060 65,200 168,300 233,500 NO Totals for 2006: General Property 8.060 65,200 168,300 233,500 Woodland 0.000 0 0 Totals for 2005: General Property 8.060 65,200 168,300 233,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 201 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 CERTIFIED SURVEY MAP FOREST AUSTRUM Dart of the Southeast 1/4,of the Northeast 1/4 of Section 28, Township 30 North, Range } West, Town of Erin Prairie, St, Croix County, Wisconsin. o indicates 10 iron pipe weighing 1 .13 lbs/ft. set. GO 0 % 0 .I O i poi 0 1 1 -3C0 0 0 0� . �. . o O f 'N NEC T a - ss 4 0 10� I N 0, 0 6. o� 0 e� � 0% o I 01 Iwo s ems'oAle 'so:E- s',d-*--5-.-6- S C'A L E i ,� ,'�"�CSC? 7•- C • S.G D liSCR I?r I ON: That certain parcel of land located in the Southeast 1/4 of the Northeast 1/4 of Section Township 30 North, Range 17 West, Town of Erin Prairie, St. Croix'County', Wisconsin, morn fully described as follows; Commencing at the East 1/4 corner of said Section 28, the POINT OF BJGINNING of the parer to be herein described; thence N 00° 00' 00" E (assumed bearing) 667.05' along the East line of the Northeast 1/I of said Section 28; thence N 89* 02' 50" W 521.47' ; thence S 00° 11 ' 26" E 667.05' ; thence s 89° 02' 50" E 525.25' along the East West 1/4 lYne of said Section 28 to the POINT OF BEGINNING, containing 8.06 acres, more or less, being subject to easement over the I'asterly 33' thereof for C.T.H."T"purposes. Nog11111111111111/1/f1l,�,,/ �d' JAMES L. `' o MURPHY S 1 0 4 2 �C• RIVER FALLS, ;'C WIF.C. .� State of Wisconsin) County of Pierce) 1, James L. Murphy, Registered Land Surveyor, do hereby certify that by direction of the Owners Forest Austrum, I have surveyed and divided the lands shown hereon in accordance with official records, Chapter 236 of Wisconsin Statutes and the Ordinances of St; Croix County; and that the above map and description are a true and correct representation thereof. Dated: 23 July 1980 W Vol. Page 'ham i Certif ed Survey Maps James L. Murphy : t. Croix County, Wisconsin Ufitegistered Land Surveyor ' Form - STC - 104 AS BUILT SANITARY SYSTEM REPORT ' T OWNER TOWNSHIP SEC. 2 & U N-R / 7 W ADDRESS L2• 'I 2 3 ST. CROIX COUNTY, WISCONSIN IL SUBDIVISION LOT 6) [ d LOT SIZE c�j'r�ivtS PLAN VIEW Distances and dimensions to meet requirements of I•LHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM u.SG cry 1 is SG 10'oo Vic+(. I ✓ Sep4 C r y� I I INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: /y o ` Proposed slope at site: °moo SEPTIC TANK: Manufacturer: (,� �� Liquid Capacity: Number of rings used: 0 Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front,®Side Rear, O /2.5 feet From nearest- property line Front,®Side,0Rear,O 12.3 feet Number of feet from: well E_, building: /6- (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE t f PUMP CHAMBER ' Manufacturer: Liquid Capacity: Pump Model: P Siphon Manufacturer: Pump Size , Elevation of inlet: Bottom of tank elevation: Pump off switch a vation: Gallons per cycle: Alarm Manuf urer: Alarm Switch Type: Number f feet from nearest property line: Front, O Side, O Rear,© Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: V z-zj Width: ,� Length: Number of Lines: Z_ Area Built: .,� C1h Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side,Rear,0 Ft., Number of feet from well: _72 Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Num of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Bui . Has eith a drop box O or distribution box O been used on any of the above soil abso tion sytems? (Check one). LDING TANK Manufacturer: Capacity: XElevation of bottom of tank: nearest property line: Front, O Side, O Rear, OFt.ber of feet from well: of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector• Dated: -�� Plumber on job: License Number: T 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 SE14,NE�4,S28,T30N—R17W 'RCONVENTIONAL 1:1 ALTERNATIVE State Plan l.D.Numb er: (It assigned) Town of Hammond ❑Holding Tank ❑ In-Ground Pressure ❑Mound CTY Road T NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DAVE— Charles Frawley Route 1, Box 123, Hammond, W1 54015 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: Gary L. Steel 3254 St. Croix 99066 SEPTIC TANK/HOLDING TANK: MANUFACTURER: JLIQUIII CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PRO IDED: PROVIDED: WU�►�J � � `u�)'09 Qgt1� ES ONO OYES )9NO BEDDING: VENT DIA_ I VENT MATL-. HIGH WATER NUMBER OF ROAD: PROPERTY WEL L BUILDING: VENT TO FRESH LINE: AIR INLET: _ ALARM FEET FROM /1 DYES 9O EYES 0 NEAREST DOSING CHAMBER: MANUFACTURER: BEDDING. LIQUID CAPACITY. JPUIAI MODEL. PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: OYES ONO I DYES ONO OYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER:OF PROPERTY J.ELL BUILDING FVENT TO FRESH (DIFFERENCE BETWEEN FEEL'FROM LINE AIR INLET: PUMP ON AND OFF) OYES ONO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL 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: WIDTH: LENGTH. N DISTR.PIPE SPACING. COVER INSIDE DIA.. #PITS: JLIQUID BED/TRENCH TRENCHES \ MATERIAL' PIT DEPTH vImlEllillslts 50 _ GRAVEL DEPTH FILL DEPTH DISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO. STR NUMBER OF PROPERTY WELL �BUILDINGJVIENT TO FRESH BELOW PI PES. ABOVE COVER. ELEV.INLET ELEV.END. PIPES LINE. AIR INLET. ^� MEET FROM "'? �--1 S i'}' IUEARES'T X05 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- meets the criteria for medium sand. TIONS MEASURED. ❑YES F-1 NO SOIL COVER ITEXTURE MANENT MARKERS PER OBSERVATION WELLS DYES 1:1 NO DYES ONO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. SODDED. SEEDED- MULCHED. CENTER JEDGES OYES 1:1 NO DYES ONO OYES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BEDfTFI1NICl� WIDTH LENGTH LATERAL SPACING: GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER TRENCHES: . DtME �fONS i "MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFO LO MATERIAL: NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING. I"I IELIEVATION'1,AND.i ELEV.. ELEV.: DIA.. ELEV.. PIPES: DIA.: jN0M ATION i HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED 1�1FM18)UTION PLANS OYES ❑NO ❑YES NO COMMENTS: 1 PERMANENT MARKERS: OBSERVATION WELLS: NI} BE,R I�F 'PROPERTY WELL: BUILDING: r0 FEET FROM LINE: O OYES 1:1 NO ❑YES ❑NO NEARES"f• O p' 5 D Sketch System on Retain in county file for audit. Reverse Side. �T. E: TITLE: Zoning Administrator DILHR SBD 6710 (R.01/82) i D!L R SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05,Wis.Adm.Code STATE SANITARY PERMIT# 9 -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 [ONO PROPERTY OWNER PROPERTY LOCATION AM '/4, SOP28 T30 N, R 17 f (or) W PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME R.R.4#1, Box 123 n/a n/a n/a CITY,STATE ZIP CODE PHONE NUMBER 71 CITY NEAREST ROAD,LAKE OR LANDMARK He-mond, Wi. 54015 715 796-5421 1❑ VILLAGE: Hamanond Co. Rd. ##T 11. TYPE OF BUILDING OR USE SERVED: ' 4:)l Number of Bedrooms if 1 or 2 Family 3 OR ❑ Public(Specify): III. PURPOSE OF APPLICATION: (Check only one in##1. Check##2,3 or 4,if applicable) 1. a. ❑ New b.N 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. 0 Conventional b. ❑Alternative c. ❑ Experimental 2. a. ❑System- b. ❑ Holding c.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. ❑ Seepage Bed b. 0 Seepage Trench c. ❑ See Page 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): 30 900 900 94.93 Feet [3Private ❑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 structed App Tanks Tanks 1.I Septic Tank or Holding Tank 1000 1 Weeks ❑ ❑ Lift Pump Tank/Siphon Chamber -- — ❑ ❑ VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private wage system shown on the attached plans. Plumber's Name(Print): Plumber' ignature: N to ) /MPRSW No.: Business Phone Number: Gary L. Steel 3254 715 246-6200 Plumber's Address(Street,City,State,Zip e): Name of Designer: 988 N. Shore Dr. New Ric hm d, Wi. 54017 Vlll. SOIL TEST INFORMATION Certified Soil Tester(CST)Name CST# Gary L. Steel 2298 CST's ADDRESS(Street,City,State,Zip Code) Phone Number: 988 N. Shore Dr. , New Richmond, Wi. 54017 715 246-6200 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) Ex Approved ❑ Owner Given Initial qP S charge Fee c_�/,��! Adverse Determination a�/< <�/ ���'� ���� � X. COMMENTS/REASONS FOR DISAPPROVAL: Plc,, &Wl',J b j h-laj T, T-eh k 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 4 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 owners 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'./s 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 atBlr.-- included the creation of surcharges (fees) for a number of regulated practices which Wisco Er3r5 can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried reasur,.i' 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. 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 his application form is to be completed in full and signed by the owner(s) of the roperty 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 _3t �� h;, Section v2 , T.3dA/ N-RXI-7 W Township R/,Ll PRt? Ir- bailing Address ,,�� i A x 12 Address of Site Subdivision Name Lot Number Previous Owner of Property Z__f:�ST Total Size of Parcel 9,•i) (0 Date Parcel was Created in / _ Are all corners and lot lines identifiable? c/' Yes No Is this property being developed for resale (spec house) ? Yes No C�C �� --- Volume and Page Number as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warrantq 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. PROPERTV OWNER CERTIFICATION I We) co-Ati•6y that att etatementh on this onm ake tAue to the but o6 my (ouk) knowtedge; that I (we) am fake) -the ownek(e 1 o6 the pnopehty deJscAi•bed in .thiA in6olmation 6onm, by vclitue o6 a wahliarity dee�rceeonded in the 066ice o6 the Cocut.tyy Re_giA teA o6 Deeds ah Document No. ; and that I (We) pne�sent.ty avn tJte pnoposed site bon the eewage dihpoe eye em (ore I (we) have obtained an easerrcn.t, to hun with the above dei vt,ibed p)topertty, bon the eonhtAuction o6 said s ye.tm, and the same hat been duty n.eeonded .in the 066.tce o6 the County Reg,i.e,ten o6 Veedd, as Doewne►t No. SIGNATURE OP OWNER rte' SIGNATURE OF CO-0 (IF APPLICABLE) 7f 7 DATE SIGNED DATES NED r .. rE DOCUMENT NO. WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA STATE BAR OF WISCONSIN FORM 2-1982 42:3383 REGISTERS OFFICE ST. CROIX CO., W IS. Forest R. Ostrum a/k/a Forrest R. Ostrum Recd. for Record this 21st ............................................. ---•-•---._.....--•---------•.......------•-•---•--------•--•----•. a/k/a F.R. Ostrum and Elizabeth 0strum day of Aug. A.D. 1987, .....a/k/a__El i_zabeth..Mr....Ostrum................................................ 8:30 A ...-•-----•-----•--•-••--------•..............••----------•---------•-•-••--•--...._..........._._..._.__.._..... conveys and warrants to Charles J_._ Frawley Janice _ 77 p -•--....... _ _.... ...- -••------------•---------- •---••--•••-•---------•-------------------•--•--..........----•----•-----------.......--•---••-•-----............ r ...•............................................................................................................. RETURN TO ...................................................•---...............-•---...•.........._.._........._...._..... .........................•_--..._.....--....--.--•--.--......-_........---•—_...•......._............._....._.... the following described,real„estate,in,� St Cr 01X...........County, I ecw+�,xt+"ak' .d`N.lY7k -. «Y-.-per ....... State of Wisconsin: Tax Parcel No: .............................. Part of Southeast Quarter of Northeast Quarter (SE4 of NE4) of Section Twenty-eight ( 28 ) , Township Thirty North (T30N) , Range Seventeen West (R17W) described as follows : Lot One ( 1 ) of Certified Survey Map filed September 24, 1981 in Volume "4" , Page 1108 . This Deed is given to satisfy that certain Land Contract between the parties dated October 15, 1981 , and recorded in the office of the Register of Deeds for St. Croix County, Wisconsin, on October 16, 1981 , in Volume 636 of Records, at Page 605, as Document No. 373939. "TAR FED . This ......5._210t.___.._... homestead property. XAM) (is not) Exception to warranties: Easements and restrictions of record, and except any liens or encumbrances created or suffered to be created by the acts and defaults of the. grantees, their heirs , successors(, or assigns. Dated this .. day of ...................................... A. :..._..., 1987.... j ..........--•------•---••••---••--------•-----•......................(SEAL) ......(SEAL) ;, * Forest R. Ostrum * ... ........................................................ •-•-•---------•••--•------••----..__....._..--•-------_...._ ................(SEAL) ..6% ...... - (SEAL) * Elizabeth Ostr .m AUTHENTICATION ACKNOWLEDGMENT Signature(s) ------------------------------------------------------------ STATE OF WISCONSIN ---- ---------..-----...........-•-........----•--••------•••......---•---- ._.._.._..St Croix Count+..` v authenticated this --------day 1 1 9-------------------------- 19..__.. Per onally c � before.me Ahis� Aiy-of ----------- to _, 19 1:}--th ab na3med . . ....................... . ..................... .. . . . ... . .. . Forest . Ostrum, ------------------------------------------ la .. '------------------------------------------------------------------------------ R. Ostrum, -a TITLE: MEMBER STATE BAR OF WISCONSIN Elizabeth Ostrum ___aka•*°'� --- ....... ........t a -` (If not- ------------------------------------------•----------------- Elizabeth M. Ostrum ------------------------- authorized by § 706.06, Wis. State.) to me known to be the person S---------- who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY Thomas A. McCormack --------- ------ ---9; --s---- -- - --------------- ---------------------- Baldwin, WI 54002 • -- ------- g�iqot,----------- ----•----•------ --------------------------- Notary Public - - - X----- tyr Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent.(If a expiration are not necessary.) � --_ ----_-•, 19_ .) date: F I *Names of persons signing in any capacity should be typed or printed below their signatures. KC diercompmv STATFORM of 2 ISO S2 SIN Stock No. 13002 M..!..«.WI-1a H z cn a r ' STC - 105 r 9 H SEPTIC TANK MAINTENANCE AGREEMENT o St . Croix County z t7 a H OWNER/BUYER GH9-X'1-C S > ..Ti9�c/'�!� �!►'.g����L , ROUTE/BOX NUMBER Z;r 4 /.z 3 Fire Number CITY/STATE f�y /yl �yic`�,t1� L�.sG, ZIPS l PROPERTY LOCATION : .�'f_ 14, Section T :30 N , R 1Z W, Town of �/�'iR,f �fi'rr'� '� 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 septic tank pumper. What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St . Croix. County residents m_ y be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1 , 1978 . St . Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained . The property owner agrees to submit to St . Croix County Zoning a certification form, signed by the owner and by a master plumber , journeyman plumber , restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping ( if nec- essary) , the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration . Ho I/WE, the undersigned, have read the above requirements and agree En to maintain the private sewage disposal system in accordance with 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 St . Croix County Zoning Office P. O. Box W Hammond , WI 54015 715-796-2239 or 715-425-8363 Sign , date and return to above address . DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTR DIVISION Y P.O. BOX 7969 LABOR ANY PERCOLATION TESTS (115) MADISON,WI 53707 HUMAN RELATIONS (H63.09(1)&Chapter 145.045) LOCATION: SECTION: TOWNSHIP/M {Il11 LOT NO.:BLK.NO.: SUBDIVISION NAME: SE '*E 1/4 28 /T30 N/1t7 1(or)W Erin Prarie n/a n/a n/a COUNTY: OWNER'S AME: MAILING ADDRESS: St. Croix Charles Frawley IR.R.#l, Box 123, Hammond, Wi. 54015 USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILEDESCRIPTIONS: PERCOLATION TESTS: ®Residence 3 n/a ❑New Replace 8-3-87 8-7-87 RATING:S=Site suitable for system U=Site unsuitable for system r ONVENTIONAL: MOUND: IN-GROUND-PRESSURE:ISEIS YSTEM-IN-FILLHOLDING TANK:RECOMMENDED SYSTEM:(optional) S ❑U 0 S U ]S ❑U ©U ❑S I u conventional If Percolation Tests are NOT required DESIGN RATE: I 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 decimal' PROFILE DESCRIPTIONS page 45 JEA BORINGI TOTA DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH NUMBER IDEPTH ELEVATION OBSERVED EST.Hl T TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- 1 7.76 98.78 none >6.76 .17bl.1. .92bn.sil. 1.50bn.s.l. 1.50bn.s.si.2.67c.gr. B_ 2 7.59 98.44 none >7.59 1.25bl.1. .67bn.sil. 3.00bn.s.1. .50bn.s.sil. 2.17bn.c.s.& r. B_ . 3 7.42 9743 none >7,42 00bl.l. .75bn.sil. 2.50bn.s.l. 1.67bn.c.s.&gr. 1.50 .cob. B- B- 6- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD I PERIOD 2 -RERIOEF PER INCH P_ 1 3.85 none 30 14 1 1 30 p none P_ none 3u 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 94.93 0. [ ^ E 1 E y ( I l[� lop,-I I g t , 1 t E ' € ' EI( `! ; r i I t € 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 8-24-87 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): 988 N. Shore Dr. New Richmond Wi. 54017 2298 15-24 -6200 CST SIGNAT DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) —OVER — • s, 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; 3. MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement system; 5. 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; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A separate sheet may be used if desired; 8. Make sure your benchmark and vertical elevation reference point are clearly shown,and are permanent; 9. Complete all appropriate boxes as to dates, names,addresses, flood plain data, percolation test exemp- tion, if appropriate; 10. If the information (such as flood plain, elevation)does not apply, place N.A. in the appropriate box; 11, Sign the form and place your current address and your certification number; 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 Soil Separates and Textures Other Symbols st — Stone (over 10") BR — Bedrock col; Cobble (3- 10") SS — Sandstone gr — Gravel (under 3") LS — Limestone *s — Sand HGW — High Groundwater cs Coarse Sand Perc Percolation Rate med s Medium Sand W — Well I's --- Fine Sand Bldg — Building Is — Loamy Sand > — Greater Than +sl — Sandy Loam < — Less Than *1 Loam Bn — Brown .sil Silt Loarra BI - Black si — Silt Gy — Gray *cl -- Clay Loam Y -- Yellow sc.l — Sandy Clay Loam R — Red sicl — Silty Clay Loam mot — Mottles so Sandy Clay wi - with sic — Silty Clay fff - few, fine, faint *c — Clay cc — common, coarse pi -- Peat mm — Many, medium m — Muck d — distinct p — prominent HWL — High water level, Six general soil textures surface water for litILlid waste disposal BM — Bench Mark VRP - Vertical Reference Point f , TO THE OWNER: iER: h;s staid (est rel.ort is the first step in securing a sanitary permit. The county or the Department may recluest a .rificat r r;l ,his Soil Pest ;n the field prior to pe3rtait: issuaance. A complete set of plans for the private va€le ,stern €'C! a tnerrnit application must tae suhmitted to the appropriate, local authority in order to -edit=a x^r,r it. ThC sanitary oerrrait must he obtained and posted prior to the start of any construction. Il _► Charles Frawley SEG NE'. S28-T30N-R17W Erin PraRIE, TOWNSHIP V 4 (o' Lf 202 ( VVVA N � l i �c 9� (�It a—voQ— Gary L. Steel 988 N. Shore Dr. New Richmond, Wi. MPRSW 3254