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HomeMy WebLinkAbout022-1010-50-100 J r O !D I A O rr. O ' m o o C) p~j 3 N O o O A N - • s CD 7 CD m CO n0 OND > rte' ^ n p z n A CD x o 1 C.J 3 OCi 90 o K U) 0) CD CD ' Q m ° ~v cn 3 y H 7 o p (D CCD N C (D D L a z V v, W C: CD 3 CL CD `D w o~ 'm -4 -4 CD 3 w Z T z O O 0 O 0 . ~ TI G N z cn CO) cc 7-1 D) CD ~-3 Q O O I CD a a H T, ~ 1 -4 co C Z Q o Z W OZ o. O D CD N M ~ C CD S. C fD ((C w n m Z (D tD CO) A ? o N C A Z O v a O z -I P oo~ m00 r z 0 3 a c " m w H z CD A W ~ Q O a t O N T CD o CD m U) 7 N C N ' O I A CL O A N o CL O l< CL 60 3 m m Q k-j ur O N qb x w o CD A G.y b9 0 ~ a C) L V COMMERCIAL TESTING LABORATORY, INC. 5141VIain Street, P.O. Box 526 'Colfax, Wisconsin 54730 7`15-962-3121 800 - 962 - 5227 ST. CROIX ZONING REPORT NO.! 30575/01 PAGE 1 ST. CROIX COUNTY REPORT DATES 10/12/92 COURTHOUSE DATE RECEIVED! 10/08/92 HUDSON, WI 54016 ATTNS THOMAS C. NELSON OWNER!! Robert Jolocoeur LOCATION! 5 Hudson COLLECTOR! M. Jenkins DATE COLLECTED! 10-06-92 TIME COLLECTED! 101*00am SOURCE OF SAMPLE: Kitchen faucet DATE ANALYZED' 10-08-92 TIME ANAL:YZED4424400pm COLIFORM*4 0 /100 at INTERPRETATION! Bacteriologically SAFE NITRATE-NS 5 ppm move 10 ppm exceeds the recommended Public Drinking Water Standard. Conform Bacteria/100 ml 9 10 Nitrate-Nitrogen, mg/L oy co xp 'L C0 .7 S /C<I\ z LAB TECHNICIANS Pam Gana J WI Approved Lab No. 19 j < Mans "LESS THAN" Detectable Level Approved by. ~ aa- ~o Y 5~ _,oo 61t' aCA , -1 c ri~u /1 t1di /alb- t~~o°`~ 44 J _ U8/ 0/1' 10: 0 0715 3136 4828 S. C. CO Cli'I'llOl.iSl: ` f~UU. ST. CROIX COUNTY ZONING OFFICE -5-AA".Q" St. Croix County Courthouse -°9''' Ste` 911 4th Street y -Hudson, WI 54016 'Io c~ t ,P~r ti9 2J 1u kN~ S~ Telephone - s M (715)386-4680 The St. Croix County Zoning office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals. Completion DI this f grm ja essential &Q that =q pO eR rty can DA located. Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning Office, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received.. WATER TESTING---------------- --------FEE: $ 35.00' (For nitrates and coliform bacteria) WATER TESTING FEE: $185.00 (For VOCIS) SEPTIC SYSTEM INSPECTION-----------------FEE: $25.00 (Determines if system is properly functioning a time of inspection) PROPERTY OWNER f S NAME: l 6 e. y t LJ 0' / C ©t- u e - 141 5 Gj PROP. ADDRESS: sky/!h e, Di-ivc, CITY gUd-50h Legal De~~~Fri tiJ? n .x,_,,_1/4 of the 1/4 of Section _ , T N-R. - Town of C..IYIVpt7~1C,tLtL►t~ Lot Number ~Subdivis10n ~Z Em SZJ-/~ FIRE NUMBER .5.3 41 CS =z a~~ l a 4. 61 E Color of house C' vv;- Realty sign by hoouse? 6 If so, list firm: PLEASE INCLUDE, IF AT ALL POSSIBLE, A KAP,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual requesting services:_._ Owl- / ks f-wft, Telephone Number G 3 REPORT TO BE SENT TO: u t-C, CLOSING DATE: Signature k ST. CROIX COUNTY p4t~'F~y' WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE ` 911 FOURTH STREET 0 HUDSON, WI 54016 (715) 386-4680 W October 6, 1992 Sandy Lowry Lowry Real Estate 1201 Mayer Rd. Hudson, WI 54016 Dear Ms. Lowry: An inspection of the septic system on the property of Robert Jolicoeur located at 534 Skyline Dr., Hudson, WI was conducted on Oct. 6, 1992. At the same time a water sample was obtained for testing. The results of that testing will be sent to you as soon as we receive them from the laboratory. At the time of inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. Sincerely, / T.-Jenkins Mary Assistant Zoning Administrator cj '1 r Fit ED 00,16"1987 w c~ 431175 GOWN x00886 CMX o er, CERTIFIED SURVEY MAP R7rr OBERT V. JOLICOEUR AND CHRISTEL JOLiCOEUR Y (Part of the Northeast 1/4 of the Southeast 1/4 and the South- I east 1/4 of the Southeast 1/4 of Section 4, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wis. \UNPLArTED LANDS ii w 3 3MO m V A/ wee 1W - \ Q: „589142'29" 66,3A O Indicates 1" x 24" iron pipe weighing 1.13 lbs./lin. ft. \ a LOT / - (y ; set. \ , 4.192 ACRES { v I J Q 3 3 3 I761 75182,383 SO. FT. 1 h w' 3 ' m w I o OWNER'S ADDRESS : o ° n O i' SHED ~0 R I Q4 Route 1, Highway "65" 3, cc W h 0 7 ^O 4 N82•/g'09" DWELL iNG Roberts, V I W WI 54023 . . • • p W 574.38 I ~ O b O p p x 2 N 2 2 2 ' RUINS BARN Dated: September 23, 1987 n I. OLD FOUNDA7/0 a. Q MARSH I;] m 3 3 3 ls~ 76' O y' 66' J~s AVOW i a n ^O h I ti RU/NS BARN 33'I om m 31 ~N L';2 33 V) o►iew „a • • d N m 14. 8 14 ACRES tt O O O i e N 645,311 SO. F7 ~y~ 2 2 2 2 I f z WATERCOURSE $7. Ch00I MUM \`1 I W CpNOM04VE PARS PLANN1Ngf i 1 I \ AMD ZONING COMMI77ES v 1 i. a k)~ M~ a oil co N V h) N 0 Q O O O O `IIS~ O I Q 2 O Q \ 2 1 al m Z W h m It v _j M \ 3 2 .II O O Q to cj N ^ ~ - W N M N \ ¢ 0 II h, on q to b thD b \ , 0 I I Q ~ C3 pV1a~ 4. \ oo I ~I i°.3 Q nnht g b to to Z N N W 00 In tq ~ to ~ m m ~ M to tj O I` N to II ~ 1. NMN I Uj 2 3 3 3 \ N ~ ~ W ~ n hh 3 ~ I Qa Q nj tp O N \ SCALE 300' O O N M h 3 N I 0 /50' 300' 430' 600' 730' O n Q: • • • • O O m ~p 0 O V' to 2 i 2 z `,~~1\Illllifq~'` \ o c IRA N „ gCONSZ *0 \ a LAURENC 0 Zo = =M.w 713 M CP E FALL ,kI 4 I SE COR. SEC. 4, T2BN, R/BW, WISC.••, • @ 01 9 /COUNTY SURVEYOR'S MON.) r, 6 ~ 8• 1 LANQ 4 N •~'EffIf11151~~, ~'tao, ys, Laurence W. Murphy Re istered Land Surveyor N9o•OO'oo"W S LINE SE //4 VOL. 7 Page 1901 S 114 COR. SEC. 4, T28N, RIB W, Certified Survey maps tI"IRON PIPE FOUND) St. Croix County, Wisconsin SHEE r / OF 2 PUMP CHAMBER Manufacturer: 41111e Clb~ Liquid Capacity: DD Pump Model: p{ pump/Siphon Manufacturer: Pump Size, Elevation of inlet: /D 5! Bottom of tank elevation: ~o/•~ Pump off switch elevation:._ /c /•Z Gallons per cycle: ,770 Alarm Manufacturer: JL 4.401 Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear, 0 Ft.>Aaep Number of feet from well: i Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width: Z Length: 57. Number of Lines: Area Built Fill depth to top of pipe: ?V of Number of feet from nearest property line': Front, O Side, 0 Rear,0 7 t.7 !Od Number of feet from well: 4,4 Number of feet from building: 40,;f (Include distances on plot plan). . nr /aC-3 SEEPAGE PIT X06 v~wt ~o s. vd 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: 7 Plumber on job: License Number: 311 3/84:mj f ANdOL r Form - STC - 10 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP SEC. T gy L~ W ADDRESS ~T Z ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of IIHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ~f s. r. 0 A . yS Sb' INDICATE NORTH ARROW "'U"r BENCHMARK: Describe the vertical reference point used °/c Elevation of vertical reference point: G~~D Proposed slope at site: : SEPTIC TANK: Manufacturer: e~e,,,e k Liquid Capacity: Q®' y~ Number of rings used: Tank manhole cover elevation: //o,3 Tank Inlet Elevation: S,L Tank Outlet Elevation: i Number of feet from nearest Road: Front,O Side 0 Rear, > /A~q feet • From nearest-property line • Front,OSide10Rear,Ov JDd feet Number of feet from: well /v building: /S (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE r _ 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 NE'-,,, SE-4,, S4, T28N-R18W K&CONVENTIONAL ❑ALTERNATIVE State Plan I.D.Numb er: (if assigned) Town of Warren El Holding Tank ❑ In-Ground Pressure ❑ Mound HWY 65 NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Robert Jolicoeur Route 2, Roberts, WI 54023 C)_ -0 3 v BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: JCST REF. IT. ELEV.: Name of Plumber: MP/MPRSW No.. County: Sanitary Permit Number: Dave Fogerty 3233 St. Croix 99094 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY. TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER W l.C1 -3 ib(~Q oy 50. PROVIDED: PROVDED. ~ 05 18 ~ YES ❑ NO ❑YES NO BEDDING: VENT DIA.: VENT MATL. HIGH WATER NUMBER OF ROAD: PROPERTY =EL BUILDING: VENT TO FRESH ALARM: LINE: AIR INIT. l FEET FROM 10 0 ► I~ IV ❑YES NO I ❑YES NO NEAREST DOSING CHAMBER: MANUFACTURER. BEDDING: LIQUID CAPACITY. PUMP S MODEL PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER W n 'pD_ P OV DED: PROV OED: ❑YES NO YES ❑NO YES ❑NO GALLONS PER CYCLE: PUMP....-CONTROLS OPERATIONAL. NUMBER OF PROPERTY WELL J BUILDING. VENT TO FRESH , AIR INLET: (DIFFERENCE BETWEEN J70 FEET FROM LINE An N PUMP ON AND OFF) YES ❑NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LNI J,11 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 NO. OF DISTR. PIPE SPACING. COVER INSIDE CIA.. #PITS. LIQUID BED/TRENCH TRENCHES: / MAT AL: PIT DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR.'P IPF DISTR. PIPE DISTR. PIPE MATERIAL: NO DISTR. NUMBER OF PROPE RTV WELL BUILDING: VENT TO FRESH BELOW PIPES. ABOVE COVER. ELEV. INIL ELEV. EN'0 PIP FEET FROM LI J. AIR INLET: 6 2 7 2 NEAREST MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. ❑YES ❑NO SOIL COVER TEXTURE: PERMANENT MARKERS: ]OBSERVATION WELLS. ❑YES ❑NO ❑YES ❑NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. SODDED. SEEDED: MULCHED. CENTER'. EDGES: ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH: LENGTH. NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPF FILL DEPTH ABOVE COVER: BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING. ELEV.. ELEV.. CIA.. ELEV.. PIPES. DIA.: ELEVATION AND DISTRIBUTION VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL PLANS: ❑YES ❑NO ❑YES ❑NO MBER OF PROPERTY WELLET FROM LINE: COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: 7NEAREST ❑YES ❑NO ❑YES ❑NO PA as~..t,c n o T d(A p(' 0 P Sketch System on etain in county file for audit. Reverse Side. E, TITLE: Zoning Administrator DILHR SBD 6710 IR.01/82) 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. AU revisions to this permit must be approved by ttte,permit issuing authority. A new permit.may be needed if there is a change in yobr building plans, system location, estimated wastewater flow (noniber 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 beprd~ erly maintained. The septic tank(s)•should be `pumped by a I'icensod• 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: 1. 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: Certifigd 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 81/2 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; •welis; water mains/water service; streams and lakes; dosing or pumping chambers; digtribution bones; soitabsorption"sye#ems; 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. ~-years of steady negotiation and public debate. The groundwater bill GrounclWater - included the creation of surcharges (tees) for a number o" regulated practices which Wisconsin's can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried 0easure 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.' _CJ The monies collecter through these surcharges are crediied tcj 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, s vYcrt : protecting. ':3D-6398 (8.03/86) SANITARY PERMIT APPLICATION COUNTY DI~HF~ In accord with ILHR 83.05, Wis. Adm. Code S77 D/ ~j' SAA.NITA YPERMIT# ~,,Q~ STA'7` C/ -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 XJ NO PROPERTY OWNER PROPERTY LOCATION '/4 f '/4, S 41 T N, R E (or PROPERTY OWNE AILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME L CITY CITY, STATE ZIP CODE PHONE NUMBER VILLAGE : NEAREST ROAD, LAKE OR LANDMARK s' 17,014)NN OF. ® w o 7 S 11. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family •3 OR ❑ Public (Specify): Ill. 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. U 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. IJa See a e Bed b. ❑ Seepage Trench C. ❑ Seepage 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): Feet S- s IIQ Private ❑ Joint ❑ Public O S. s VI. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed I Septic Tank or Holdin Tank Lift Pump Tank/Si hon Chamber fA& - 0 ❑ ❑ ❑ VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name (Print): Plumb bmw (No tamps) MP/MPRSW No.: Business Phone Number: 7-3 33 7 yYf 3 4-r4 Pluy is Addr s (Street, City, St a,*, Zip Code): Name of Designe w~ o ~3 Of 140 111111 01L T ST FO W AT10N /I Z Certi 'ed Soil Tester (CST) Name CST # ~.8 l s ADDRESS (Street, City, State, Zip Cod Phone Number: 24S-4 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved amtary Permit Fee Groundwater Date Issuing Agent Signature (No Stamps) Approved ❑ Owner Given Initial' 14rcharge Fee Adverse Determination X. CO MENTS/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber ~ 6s- DAVE FOQERTY PLUMBING Licensed Perk Tester 6 Plumber 03233 33289 Y, FoEEerty He~~httis Road ROSERTS, WISir ONSIN 5423 Bm PP I~ Phone 7494656 r I ~~6 6 7 7vq- 3~ 719lf7 i " i I p\ b I I I SS I i i i 7 - Sian` I 10' > SO I« d . ~~5- 1.~ PAGE OF PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS VENT CAP N"C.I. VENT PIPE 7 1 WEATHER PROOF APPROVED LOCKING JUNCTION BOX MANHOLE COVER 25' FROM DOOR, WINDOW OR FRESH 12"MIU. I AIR INTAKE GRADE I y° MIN. I JL 7,77m. CONDUIT IAJI FT PROVIDE I AIRTIGHT SEAL I I i I II v APPROVED JOINT A I III APPROVED .101NTS W/C.I. PIPE. I III W/C.2. PIPE fXTENDIA1f. 3' I II ALARM EXTENDING 3' ONTO SOLID SC;:. 9 I I ONTO SOLID SOIL I I ON C ( I PUMP-~ ' y OFF D CONCRETE BLOCK RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL SPECIFICATIONS SEPTIC AND DOS TANKS MANUFACTURER: NUMBER OF DOSES: PER I)A4 TAWK ;,IZE : Aoa GALLONS DOSE VOLUME ALARM MAIUFACTUKER' -Ag,, _ INCLUV!A!C. ZAC!' FLOW: :?73 GALLONS MODEL NUMBER: lVLd CAPACITIES: A=INCHES OR Aso GALLONS SWITCH TYPE: B c Z INCHES OR~ GALLONS PUMP MANUFACTURER: Zoe C 0 = / ~ INCHES OR _ GALLOWS MODEL NUMBER: 9 7 D n -2 INCHES OR 36 GALLONS SWITCH TYPE: NOTE: PUMP AND ALARM ARE TO bE PUMP DISCHAR4E RATE ~s GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFEREMCC Btr-?WCEN PUMP OFF AND DISTRIBUTION PIPE.. _1-5--_ FEET + MINIMUM NETWORK SUPPLY PRESSURTTEE~ . . . . . . . . . . . 2-5- FEET + o FEET OF FORCE MAIN X F/ooFr.FRICT1oN FACTOR..- FEET TOTAL DYNAMIC HEAD = s,G FEET INTERNAL RIMEIJSIONC OF TANK: LENGTH ;WIDTH ~y ;LIQUID DEPTH ys SIGNE LICEMSE NUMBER*. ~ L 3 DATE: S -117- ' e r a ict SI t 4 l I T Dti HE D/ L CAMLITY CURVE ui r~ TOTAL DYNAMIC NEADlCAPACITY PER MINUTE 1 30 EFFLUENT AND DEWATERING SERIES 53-55-57-59 97 137-139 163 165 j f M I LTRS i LTRS LTRS ,1 LTRS -i LTRS 28- 1.52 163 248 394 1231 231 EFFLUENT AND OEWATEFatldG 3.05 129 ' 216 300 231 231 ± 227 i 1 4.57 - 72 163 242 _1 227 {t227 : i 26 SEWAGE AND f3EWATE6i1PdG 6.10 104 ~9 136 223 1 , 7 62 9 30 216 223 \ 9.14 1 206 220 .,.24 \ J) 1219 - 172 206 15.24 125 191 1---- - \ ye 18.29 ~ J -57 161 22 21.34 114 - i 24.38 _ 4 53 MODEL MODEL Lock VE 1 s' 24,5' 2s s6' 87 1 - - E 20 163 165 TOTAL DYNAMIC NEADlCAPACITY PER MINUTE i} ` SEWAGE AND DEWATERING i SL,11ES 267 258 282 284 293 LTRS LTRS 4i.i LTRS LTRS C,A! I LTRS .'1 400 386 -i~ 492 J 681 18 ` ` F4 227 273 360 598 0 16 1 76 163 238 v%y 511 - 6.10 3 30 'i 125 11 401 \ 7.62 _ "d 288 _ 9.14 163 292 14- ` 10.67 60 227 12.19 - o 174 1 13.72 106 - r: I 12 ft 15.24 '1 26 35' vI'S3'45 MODEL Lock Valve: 18' 10 293 8 MODELS 137 139 6 rs ` MODEL 1 284 i 4 MODEL I MODEL a 268 I _ 282 I MODELS 2 - i 53, 55, MODEL MODEL 57,59 97 267 0 20 i 6 i 70 00 33 tQO i €0 ~f3t i•50 151 i60' 1 0 180 19G 0 4t~ LITERS 80 160 240 320 400 480 560 640 650 FLOW PER MINUTE 3280 Old Mlllors Lane Manufacturers of . L~ P.O. Box 16347 jgz`zl~ Louisville, Kentucky 40216 (502) 778-2731 ~111411ry PUMPS 5NCE' /939 f l INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 To be a complete and accurate soil test, your report must include: 1. Complete 1-~ ;,.1 description; 2. The us~ -r ust clearly indicate whether this is a residence or commercial project; 3. MAXIMUI i er of bedrooms or commercial use planned; 4. Is this a new c ement system; 6. Complete the su- T, / rating boxes- A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEM 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 LEGIBL_ -ram accurately locating your test locations. Drawing to scale is preferred. A e sheet m-, ` desired; ;s : your b and vertical elevation reference point are clearly shown, and are permanent; 9. f : all apps )pr boxes as to dates, names, addresses, flood plain data, percolation test exemp- ti appropriate; 10rtY on flood r' elevation) does not apply, place N.A. in the _ riate box; 11, t~)rrri and . ur CUrr- 6dciress and your certification number; 12, cop ;,id distribt as required. ALL SOIL TESTS MUST BE FILED WITH THE L ,UTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil " and T < Other Symbols sty ne over 10") BR - Bed-, coh - Cobble (3 - 10") SS - Sant' gr Gravel (under 3") LS - L" . - 1 HGW - High Idwater C -wand Pert, - I' ~ Rate - Wr Sand W ti. r Id Bldg Is Iy Sand Than si ly Loam L n ~l- Bn sil BI si -av - i Y 'VV - L~ trn R w t~ I tll sic - fif fovv, fine, faint e; - cc c« rnmon, coarse pi - l' min Many, edium d - d,stim ` p 1) HULL - Hi- veI Six gem r tares 'ter for liqu, ' disposal BM - B VRP V R~ ~.)cc Point .tHE0, ,.`y or °)e i tment may request ft r the private i DfPAhTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION ,LABOR,AND PERCOLATION TESTS 115 P.O. BOX 7969 HUMAN RELATIONS MADISON, WI 53707 (H63.09(1) & Chapter 145.045) LOCATION:,. SECTION: TOWNSHIP)QIdAH6FPA 11I LOT NO.: BLK. NO.: SUBDIVISION NAME: AAI'll cc N N '/4 Agy N/R /8 E ( COUNTY: OWNER'S MAILING ADDRESS: i' O13 USE D TES OBSERVATIONS MADE rmr~// NO. BEDRMS.: ICOMMERCIAL DESCRIPTION: .y PROFILE DESCRIPTIONS: PER OLATION TESTS: LYJResidence 3 [ J New ❑ Replace j / 7 RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE:SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) CAS ❑u RS ❑U CAS ❑u CC'S ❑U CAS ❑u X t,09~ _5A If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: z' Floodplain, indicate Floodplain elevation: C4" _ PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 0 7.3 d e O 3 S/ /fins 6 s. B- t j z 167, 8 s 117h 4's / if '3 1, !e fah . B- 77 p, > ox ' 77 3 ,7/' Tin S/ Y'13n s. „ s B- S 2 ' / s 7G,S' '13 B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PER D PER INCH S P- P_ z 3 s~~ ? " /6 1 " /L P- P P- S y ' i 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 i.~. x , 3 a € x 6 t , x x y ~ a .t t w... i _s,r IN - 41 E IV #7 rV17 x i x I x E i ~ € I x x 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): DAVE, FOGERTY KURONG TESTS WERE COMPLETED ON: LICelnsed perk Tester & Plumber ADDRESS: III= CERTIF T N NUMBER: PHONE NUMBER (optional): g N ROW R01 N=NSIN 54M Ptone 749-3656 SIGNATU DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. - DILHR-SBD-6395 (R. 02/82) OVER ff i/1S ~p ' N ~/~.2/~~ CAI c--7 ®~•~GK voce QGG3 b' DAVE FOGERTY PLUMBING Ucensed Perk Tester d Plumber #3233 03289 FWo~PWISCO hhNSIN 5502.3 ROBERT f•hone 74661 /DO - zz=N _ p- /Y /67 ' ~a/r _ 3o i 7.2 0 SZ ~L T I I 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/contract;g1Z,("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 ix Section T N - R W Township Mailing Address ,/e'~ 62 I j 67 Subdivision Name Lot Number Previous Owner of Property cL, ~ Total Size of Parcel S 411 Date Parcel was Created GfJrL a~ . /•S 7 3 Are all corners and lot lines identifiable? X Yes No Is this property being developed for resale (spec house) ? Yes No Volume w and Page Number t yz_ 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. PROPERTV OWNER CERTIFICATION I (We) ce4t%6y that att statements on this jotm ate tkue to the beat o6 my (out) knowledge; that I (we) am (ate) the owneAis ) o6 the ptopenty des ctibed in this .i,n6otmation 6otm, by viktu.e o6 a wahAanty deed tecotded in the 066ice of the County Register of Deeds as Document No.* 3 / 9 and that 1 (we) ptesent-ty own the proposed site Got the sewage posat system (ot I (we) have obtained an easement, to tun with the above desnibed ptopetty, Got the consttuctt:.on o6 said system, and the same has been dut tecotded in the 066ice o6 the County Regiztet of Deeds, as Document Nom 3 17 `j~ SIGNATURE 0 WNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED z rn _ H . a STC - 105 r H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z < y H OWNER/BUYER ROUTE/BOX NUMBER 2 Q j S 01 017 Fire Number4& 7/7/ CITY/STATE Z I P `'S L/D Z PROPERTY LOCATION: lyek, $F~k, Section TAN, RId' W, Town of „tiwvu,r~ St. Croix County, Subdivision Lot number - • 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 I! the system can affect the function of the septic tank as a treat- ment stage in the was•tte 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. Ho • E I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x 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 Ldm_'C~ IX DATE St. Croix County Zoning Office P.O. Box 98- Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. DOCUMENT NO. STATE BAR OF WISCONSIN- FORL BOOK ` 506 PA E 488 LAND CONTRACT-Individual and Corporate t ^ # - THIS SPACE RESERVED FOR RECORDING DATA 9 8{ RIeGISTERS U!^1=t:a CONTRACT, by and between Rupert E Duckert _ sr. CROlX co.. WIS. Rec'd for Record thiSAXift- herein called 1'en~~>~ yhhlher Une or Rime, and Robert V. Jolicoeur and Christel Jnlicnenr, husband_ A. and wife, as joint tenants herein called Purchaser, whether one or more,- WITNESSETH: That the Vendor, in consideration of the payments to be made and the U eg stet of rpe covenants snd'agreements by the Purchaser to be performed, as hereinafter set forth, .,hereby sells and agrees to convey unto the Purchaser, upon the prompt and full perform- RETURN TO once by the Purchaser of the covenants and agreements of this contract to be by the - Purchaser performed, the following described real estate in St. Croix .County, State of Wisconsin: Tax Key N This is not homestead property. All that part of West 22.5 acres of Northeast Quarter 3 of Southeast Quarter (NE 1/4 SE 1/4) and West 22.5 acres of Southeast Quarter of Southeast Quarter (SE 1/4 SE 1/4) of Section Four (4) and West 22.5 acres of Northeast Quarter :'of Northeast Quarter (NE 1/4 NE 1/4) of Section Nine (9), 4F all in Township 28 North, Range 18 West, lying Easterly of State Trunk Highway 65, Southerly of County Highway N and ,0~Westerly of the town road. , a - together with all buildings, improvements, fixtures and appurtenances, now or hereafter erected thereon, including all screen and storm doors and windows, attached mirrors, fixtures, shades,. attached floor covering, hot water heater, furnace, oil tank and light fixtures which shall be a part of the real estate. I The Purchaser, in consideration of the covenants and -agreements herein made by the Vendor, agrees -to purchase the above described premises, and to pay therefor to the Vendor at place of lega residence , the sum of -----Twenty Nine Thousand and no/100 ($29, 000. 00) Dollars, in manner following: s 7000. 00 at the execution hereof, the receipt whereof is hereby acknowledged, and the balance of $ 22r 000. 00 together with interest on such portions thereof as shall remain from time to time unpaid, at the rate * of eight per cent per annum, until paid in full, as follows: Said principal and U'16 at shall be payable in monthW installments of not less than s 200. 00 permonth, includ' intl?r beginning on the' first day of February 19 -74 provided the entire purchase money and interest shall be fully paid within fifteen years from the date hereof. Purchaser further agrees, unless excused by Vendor, to pay monthly payments sufficient reasonably to anticipate the payment of taxes, special assessments, fire and extended coverage premiums and such other insurance premiums as Vendor may ;squire, and Pur- chaser agrees to make such payments to the Vendor and hereby authorizes Vendor to apply the same in payment of such items. Said payments shall be applied first to interest on the unpaid balance at the-rate herein specified and then to principal. Any amount may be prepaid without premium or fee upon principal at, any time, and interest shall be _calculated at all times on the unpaid `balance on the daily rate basis at 1/360 of the annual rate. ' In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long as the unpaid balance of principal, and interest (and in such case accr.uirlg.interpst.fcom.month to month shall be treated as unpaid principal) is less _ than the amount that said'urdebtedne`ss'w5-u'liiraTd"Beers"ITZl7!"fllg tlRfllfltlq"plYRrtr~trts~bexft made as'first specified-above; provided that monthly payments shall be continued in the event of credit of any proceeds of insurance or condemnation, the condemned premises - being thereafter excluded herefrom. - - 4C~lL Nnoabmd (MThe Vendor shall furnish the Purchaser thirty days prior to the date of ultimate closing, and the Purchaser shall accept as a - sufficient showing of title, either (1) a title insurance commitment for an owner's policy of title insurance in the sum of the purchase price, the Purchaser to be named as the assured, to be written by a title insurance company, and guaranteeing the Vendor's title in the condition called for by this agreement, or (2) a merchantable abstract showing the Vendor's title in the condition called for by this agreement. If an abstract is furnished, the Purchaser shall notify the Vendor, in writing, of any objections to title within ten (10) days after receipt of such abstract, and the Vendor shall then have a reasonable time within which to rectify the title or furnish a title policy as above described. - The Purchaser shall be entitled to take possession of said premises on December 21 1973 . In case possession is to be obtained by the Vendor, he shall have a reasonable time after such date in which to remove any occupant. The Purchaser shall be entitled to remain in possession as long as he performs all covenants and agreements herein mentioned on his part to be performed and no longer. ~a Kr_MWIVCarprry *tm r e-_n.. ~.rn veano one ..n - - o o .o .e-... ,d~o•..vim... ..nom>~.- -w i The Purchaser covenants and agrees as follows; I. TO JwV k1l'i-IIo llwi 14ila1111N I~r ~llh~lif'Ill fill IH>rhii lilif) 1144rti4pll+Rlhr lir~l~ III 1Iril:01 pt Ij+iRr•hh1f~ lit 1COVII 010,0#1.0 0#1111 rill lilt, frol estate described in this contract and to deliver to the Vendor receipts evideucing due payment thereof. 2. To keep said premises insured for fire and extended coverage. for at least the sum of $ fu11_insurable_Value to pay the premiums thereon when due, and to comply with coinsurance provisions, if any, in insurance companies approved by the Vendor with loss payable to the Vendor as interest may appear, and all policies covering said premises shall be deposited with and held by the Vendor. 3. To keep the premises in good condition and repair. ;h 4, To keep the premises free from liens superior to *the lien of this contract, or the rights of the Vendor in the premises. 5. Not to commit waste nor suffer waste to be committed. j 6. Not to do any act which shall impair the value thereof. _ Irt case any such taxes or assessments remain unpaid-after they become delinquent, or incase of failure to keep the premises--!;o insured; the-approved _ policies deposited; or the insurance premiums. paid,_ or to_keep the same in_gaod_condtion and repair, free from `I z liens and waste, the Vendor may cure such defaults, and all sums so paid shall immediately be repaid to the Vendor and shall, unless II L so repaid, be added to and deemed part of the purchase price, and bear interest at the rate aforesaid. The Vendor hereby agrees that in case the aforesaid purchase price with the interest and other moneys shall be fully paid and all the conditions herein provided shall be fully performed at the times and in the manner above specified, he will on demand, thereafter cause to be executed and delivered to the Purchaser, a good and sufficient Warranty Deed, in fee simple, of the premises above de- scribed, free and clear of all legal liens and encumbrances, except any liens or encumbrances created by the act or default of the Pur- chaser, and except: " easements, reservations and restrictions of record. - 1 r r : The Purchaser hereby covenants and agrees that time shall be deemed to be of the essence of this contract and in case of default in the payment of any principal or interest when the same shall become due, or in the performance of any of the conditions, covenants, d ; or promises by the Purchaser herein to be kept'or performed, and such default shall continue for a period of 60 days, then the $.Vendormay, at his option, declare the contract at an end, all rights of the Purchaser under this agreement cancelled, and the amounts "paid by the Purchaser hereunder forfeited, the same to remain the Vendor's property as rental of said premises and as liquidated dam- ages for the failure completely to fulfill this agreement; and the Vendor shall forthwith and without notice have the right of re-entry; or, at'the option of the Vendor and without notice to the Purchaser, notice being hereby expressly waived, the whole amount of unpaid s principal shall be, deemed to have become due and payable; in case such option shall be exercised, the unpaid principal and interest a together with all sums which may be or have been paid by the Vendor as herein authorized with interest on such disbursements at the rate aforesaid shall be collectible in a suit at law, or by foreclosure of this contract in the same manner as if the whole of said unpaid principal had been due at the time when any such default occurred,:and the indebtedness shall embrace, with said unpaid principal and interest, all the sums so disbursed with interest as aforesaid. In case of legal proceedings; in enforcement of any remedy hereunder, whether abated or not, all expenses, including reasonable } attorney's fees, shall be added to the principal, become due as incurred, and in case of judgment shall be included therein. Upon the commencement or, duririg the pendency of any action. f foreclosure of this contract, the court may appoint a receiver of g the premises, including homestead interest, and may empower the receiver to collect the rents, issues, and profits . of said premises during the pendency of such action, and may order such rents, issues, and profits when so collected, to be held and applied as the court shall, from time to time, direct. _ All terms, conditions, covenants, warranties and promises herein shall be binding upon and inure to the benefit of the heirs, legal representatives., successors and assigns of the-vendor and the purchaseir: If not an owner) of the.property_the_ spouse.of the vendor for a valuable consideration joins herein to release homestead rights in the subject property' and agrees to join in the execution of the deed-to be made in fulfillment hereof. Executed at Roberts, Wisconsin this 27th day of December 19-13 . SIGNED AND SEALED IN PRESENCE OF - (SEAL) t Aupert E. Duckert (SEAL) Robert V. licoeur r . - ICI (SEAL) w Christel Coeur : (SEAL) T - AUTHENTICATION Signatures of authenticated this `day of -`.lg . _ , - - - - ( _ Title: Member State Bar of Wisconsin or Other Party Authorized under Sec. 706.06 viz. STATE OF WISCONSIN - - " St. Croix County. } as. Personally came before me, this 27th day of December 19 73 the above named Rupert E. Duckert and Robert V. Jolicoeur and Christel Jolicoeur, ' husband and wife, to me known to be the person f3 who executed the foregoing instrument and acknow ged the same. s_ Oil This instrument wsa drafted by •N O rq ••.70~ , Eldon A. Bader Charles E. White, Attorney at UVA Ve r ~s a, tit! • ~-_;Notary Public Pierce County, -1 t• 5-29-77 The use of witnesses is optional. .My Commission (Expires) ( A Names of Parsons aigning in any capacity should be type& or p'IIhte&i*low their signatures. a - _ A r i , i a . 4 ~ 4 r ~ s Y, 17 . G i a y a . . 4 . a . y - -ti f r i i t ; r { t , { 711 ' j S • , j ~ a } a 7 J ' alh { 13. 4 i YJ 1 r . _ t r '~I ^ , K t R S. Y -c s K ! .a - It- • i G C4j S > 1 , i ,