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HomeMy WebLinkAbout026-1051-90-000 nb ZPzi nyO lEmo d `r1 ® o m m o o f o 0 I ) r0r = A D m y 0 faillik N Z N n7 W H m 3 �_ AD rill) o m 5 7.: '� O o a cn UU a w m ='N a c N -a o o ... CO ~ H _4, a o w 4 o. . . ^.1 1 fD In o m co 1 m o O (D q i� c) ° 3 ° 5 N m i = oo C !� a' O .. c o o p �+ O, rtt m CA) ..� D a , �O i co La w W C. o N v � °� 3 C igt : i CO (D Pi H E i -< co co m , AI 1 n n O r\" co co co y » 6 1-1 5 I .. 5 hb o o N N N * co O 3. C/ O CYQ 0 O O o g m • a G 01 CD s. PI 5 Cn H O• I _so 0 In 0 0 I 3 3 °� - rn o a 0 N v =...z O Z w z D n O m O m m m c•••• 0 t►1 N CD w - CQ N' C CD Cp w m a. Z cn 0 co CD ,p Z M -' - Z O I m a - O a 1 0 W o °° I a - Z A X I o ,o z co 1 H m _. A w D a _a o c T w C ■ O Q- F N I z I et A. A CO Q a C N N O 1 O O V A l. I oo Fi I o 0 . y Parcel #: 026-1051-90-000 02/20/2007 03:24 PM PAGE 1 OF 1 Alt. Parcel#: 18.30.18.268B 026-TOWN OF RICHMOND Current X ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type p pp 00 0 Tax Address: Owner(s): 0=Current Owner, C=Current Co-Owner 0-LIEND, KATHERINE KATHERINE LIEND 909 160TH AVE NEW RICHMOND WI 54017 Districts: SC=School SP= Special Property Address(es): *=Primary Type Dist# Description *909 160TH AVE SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 2.250 Plat: N/A-NOT AVAILABLE SEC 18 T3ON R18W 2.25A IN NW NW COM CL Block/Condo Bldg: TN RD 313' E OF NW COR NW 1/4THS313' E 313' N 313'TH W 313'TO POB 516/1 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 18-30N-18W Notes: Parcel History: Date Doc# Vol/Page Type 05/04/2004 761549 2564/205 WD 02/19/2003 710388 2147/369 QC 02/07/2003 708677 2134/147 SC AF 01/24/2003 706995 2120/182 QC more... 2007 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/19/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.250 41,900 120,200 162,100 NO Totals for 2007: General Property 2.250 41,900 120,200 162,100 Woodland 0.000 0 0 Totals for 2006: • General Property 2.250 41,900 120,200 162,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 120 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 PUMP CHAMBER ' Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear,Q Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: ,' Trench: Width: a Length: 9O' Number of Lines: - Area Built: Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, O Rear,®ht ., Number of feet from well: /ZS- Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one) . HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, OFt. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: - Plumber on job: 6/L "12,..e.dijet License Number: /5-4. 3/84:mj I Form - ST C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER Edit er., d,./ /._? ..:TOLSN��Itp.. � SEC. �� ;.T.-_?"5 ADDRESS 1,el ST. CROIX, TY, WISCONSIN ;'444Q? A)-I.VQ/ 7 SUBDIVISION LOT LOT Stfig PLAN VIEW Distances and dimensions to meet requirements of ILIR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM wk.i4 oat?' r 66, („‘ 4 SG;44IF. INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used ;//iJ Elevation of vertical reference point: /4/),0' Proposed slope at site: jy SEPTIC TANK: Manufacturer: � I iquid Capacity: Number of rings used: Tank manhole cover elevation: "/ c ' 7 Tank Inlet Elevation: , ' Tank Outlet Elevation: 99.8 Number of feet from nearest Road: Front,O Side,®Rear, O feet From nearest property line : Front,OSide,ORear,co J35-- feet Number of feet from: well gc- , building: 7 (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE DEPARTMENT'OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P'O.BOX 3969 BUREAU OF PLUMBING MADISON,WI 53707 NWT, NW%, S18,T3ON—R18W ikCONVENTIONAL II ALTERNATIVE sltfae.?IonIIiD.Number. Town of Richmond ❑Holding Tank ❑ In-Ground Pressure ❑Mound HWY 64 7000)7 NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER INSP C 10 DATE: Steve Krampert Route 3, New Richmond, WI 54017 aq- g7 9, 3 C) BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN. REF.PT.ELEV.' CST REF.PT.ELEV of Plumber. MP/MPRSW No County: Sanitary Permit Number: Calvin Powers 1563 St. Croix 96032 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY TANK INLET ELEV TANK OUTLET ELEV.. ARNING LABEL LOCKING COVER WARNING PROVIDED. PO(A)QM 1000 100. 2.2_ • I .50 °YES LINO DYES 12NO BEDDING: VENT D IA.. VENT MATL HIGH WATER NUMBER OF ROAD PROPERTY WELL BUILDING. VENT TO FRESH: ALARM. LI - Q ^ 7 AIR INLET. LIVES LINO C I ❑YES LINO NEAREST r I s �/ 1/r DOSING CHAMBER: MANUFACTURER: BEDDING LIQUID CAPACITY. PUMP MODEL. PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED PROVIDED OYES ONO OYES ONO DYES ONO GALLONS PER CYCLE: PUMP AND CONTROL P TIONAL NUMBER OF PROPERTY WELL. BUILDING VENT TO FRESH (DIFFERENCE BETWEEN FROM LINE AIR INLET PUMP ON AND OFF) DYES 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. NO.OF DISTR.PIPE SPACING. COVER INSIDE DIA.. *PITS' LIQUID `BED<'`REAR TRENCHES 1 MA ERIAL' PIT DEPTH: 30 GRAVEL DEPTH FILL DEPTH DISTR.PIPE TDISTR PIPE 1DISTR.PIPE MATERIAL. NO.DI R NUMBER OF PROPERTY WELL: BUILDING VENT TO FRESH BELOW PIPE ABOV CO ER. ELEV.INLET(ELEV.END. PIPES LINE AIR 1 L€ �t1 *) °►9.3t i g% .23 I 2.....7 2� NE EAREST S,p l S q7 �;�� NEAREST---s.- 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. DYES ❑NO SOIL COVER(TEXTURE PERMANENT MARKERS OBSERVATION WELLS DYES CI NO _OYES ONO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. SODDED. SEEDED. MULCHED. CENTER EDGES. DYES ❑NO OYES ONO DYES ONO . PRESSURIZED DISTRIBUTION SYSTEM: °. 1}i.i'iFNirH WIDTH. LENGTH. NREOFHES: LATERAL SPACING. GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER_ =: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL: NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING. �w ELE V.. ELEV.. DIA.. ELEV.: PIPES. DIA.: E`LEVA"t"ION AND NFOR TION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS OYES ❑NO C ❑Y ES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF OPERTY WELL: BUILDING: oa O� FEET FROM ❑NO DYES ONO NEAREST 00 Sketch System on - ..n in county file for audit. Reverse Side. ./— .,, SIGNATUR.0011P" TITLE DILHR SBD 6710(R.01/82) zoning Ac1mini Strptor APPLICATION FOR SANITARY PERMIT S T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, ("spec house") , then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of Property H-E-.VeN V-. Y-RokMc -T Location of Property .IOW 1 NW 1, Section , T -JO N - R W Township AC-4-IMoNO Mailing Address F 7141 c. + 't4ew \ltc-t4 M O N D Subdivision Name { 1./A Lot Number Rik Previous Owner of Property P y Uay 5C-+4 M►T • Total Size of Parcel S Pj k Date Parcel was Created Co - 14 - `b1 Are all corners and lot lines identifiable? )( Yes No Is this property being developed for resale (spec house) ? Yes )( No Volume —1451, and Page Number SG(G) as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed_,__ 2. Land Contract • 3. Other recordings filed with the Register of Deeds Office In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION 1 (We) eetti.tc y that at2 statements on this 4onm ate -tue to the beat o4 my (out) anow1 edge; that I (we) am (ate) the owneh.(a ) o4 the pnopenxy dens ct bed in .thus Lnconmati,on 4onm, by v,vttie os a wantavtty deed neeonded in the O44.iee o4 the County Regis-en. o4 Deeds ao Document No. 42'1t, 0 ; and that I (we) pnesen.2y own the pnopo4ed site 4on the sewage diipasa.2 -sye-tem (on 1 (we; have obtained an easement, to nun with the above deb eh ibed pnopetty, 4on the eonst ruction oti said system, and the same hays been duty neeonded in the O44-ice o4 the County Regi ten o4 Deeds, ab Document No. 42-1 o O ) . -Sta4v F• _ , I■1- - SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF •PLICABLE) DATE SIGNED DATE SIGNED • 9 Je• STC - 105 9 , SEPTIC TANK MAINTENANCE AGREEMENT �+ St . Croix County x a 9 OWNER/BUYER �Er1 /Lv� R7r cn ROUTE/BOX NUMBER Si b LI 4114 917 Fire Number CITY/STATE 4w fitCh-40410 Nt0 , 'f ZIP S4-a 11 PROPERTY LOCATION : q■N 14, 1W/ 44, Section 1 g , T O N , R W, Town of 12-1C4+ r.4o00 , 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 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 (I) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping ( if. nec- essary) , the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. 0 • E I/WE, the undersigned , have read .the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth , herein , as set by the Wisconsin 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 52'VPrW R DATE 0-240 -g7 St . Croix County. Zoning Office x. P.O. Box 98 Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign , date and return to above address . • • . . • 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 ate 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 infrirroation (such as flood plain,elevation) does not apply, place N.A.in the appropriate box; 1 1. Sign the form arid 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 cob Cobble (3 - 10") SS - Sandstone gr - Gravel (under 3") LS --- Limestone `s - Sand HESS' - High Groundo/ear Cottivse Sand Per;, -- Percolation Rate reed s Mar:turn S:rlrl tr' Nell <ti Hut Sand EtkAg �,iilrlirlct --- Loamy Sand j ._ Greater Than - Sandy Loam < __ Lass Than I earn S. - Prrnvvri Sin Loa=d 13i [linc h si -- S;it Gv --- Gray -_ Clay Loam Y yellow sd �-- Sa log Clay loam F{ Rrad sicl - Silty C!ay Loam mot -- Mottles a: arid, C ay wi (fads t - c }I Clay cat lire;- alt Pratt man - tvl env, nr , le a -- \i c. ri _ U rtiltct • — )rurn ievr11. Hylt+L - High water ,Six (tenttral sroJ texi,nrr's AM surface warn '- t liquid waste disposal AM -_. Bench tt,elriCI VRP _ Vet Reference Point TO THE OWNER: Gass soil test epert is the 'H st step in securing a sanitary period. The county or the Departmnerit may request vrtadicalaon of this St? I test in the field prior to prirmil issuance. A complete set of plans for the private sewair e,'si.eum and a permit cpipticat,on must he snhrn,tied !C) the notaor hate local attdtrmr1 ty in OrdeI- to obtain < < -rntiis I h se (tar y` permit must be smote irseil amt porafed to o E.-Cr�t�., start .; army'construction. 1 r DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTRY, DIVISION LABOR ANb ' • PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS (H63.09(1)&Chapter 145.045) LOCATION: SECTION: TOW HIP/MUNICIPALITY: *LOT NO.:BLK. SUBDIVISION NAME: aJ 1/ ;�A m /T?©H/R/4 i (orb,` V ,e2A/ ,941 All( /1/ AY�U U T Y: OWNER'S/BUYER'S NAME: MAILING ADDRESS: / USE DATES OBSERVATIONS MADE NO,BEDRMS: COMMERCIA DESCRIPTION: PROFILE DESI RIPTIONS: PERCOLATION TESTS: E'Residence :3 _ j/ ❑Replace New place ._--5-- }�1_ tq 7 .1 f3 AP7 RATING:S=Site suitable for system U=Site unsuitable for system :i ...3 j, . Aim., -. s- �i,i c. - CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: S STE -I - ILLHOLDI G T•NK:RECOMM DE SYSTEM:(optiona 1 S ❑U ES ❑U , I1 S ❑U ❑S CCU CIS NU doad ��,.,,A/ 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: A/ 64 ,-? Floodplain,indicate Floodplain elevation: y// PROFILE DESCRIPTIONS �v cpC efr BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH ELEVATION NUMBER DEPTH tn. OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) ein4e, > ,.. a. ir - /J _ it' -i Al P. L I, c _ . B- I 1111111MI a s ' -/:g : _ : Ae, - MEMM • 0 a !Ma . .. -4... .... -= .,. - • „ ••'. 7 B- PERCOLATION TESTS ,IBCi TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER I-Ne44€S AFTER SWELLING INTERVAL-MIN. PERTlV/l PERIO 2 PERIO 3 PER INCH P- I 3:1/ 1huE .- )% /J /4- 0 P -9 y A/OA/S 36 l �� . f I /7 �..i,s .* s - Ai,.;,,,_ . t2 I / /_/ 1 � I P-_ *- 2ee EL JF D'- A ' E'A'4v,pi r'1 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 ;7*. / d ____7;• `,n' ,_ 44)4 L(. , 1 _ X _ _- I 1 11 11 7 1 , i `3` : i . 1,„... _ ___ _1_1 ._ ...1:___i____.,_ t F __.., '.GAG /� ? ( I I = t j j ll 11 , 7 _ I TN- I � a_ - _ .. . ._ t ( 3 __ .._.... S(. _ _ -- t _ 1 ' t 4is ij, ' t 1( - � I t 7 = 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 rint) TESTS WERE COMPLETED ON: d/A1 J v) c iit" S.- /.q r � AD R CERTIFICATION NUMBER: PHONE NUMBER(optional): -.3 IL,..) e,6 ,9 ,Y" ,.s- /7 ,s7s=s.?1 7�s-Q4-87.?S.' CST N TUR 4 DISTRIBUTION: Original and one copy to Local Authority,Propel Iy Owner and Soil Tester. . DILHR-SED-6395 l- 32/82 — OVER — t - I cue_ k ra», pri • At P' at v. • •FR. .N icA 4 vs S t0141 IL)(.6 J X42 h 720 Rae y y k« d 041112-4 m f50 /.sue A %b'-T, C-‘- re). Y/ It 5 Ci e'''' e'-' 's icy' �. / � � / r�� II Wri." ..NN45):d\v):,) 10/„//, A/Qi✓!M C Q r.4 Q r 4S0Sth ,/ `. • 4 r.;`11 , 4 V fr rt& id‘413 . - S /'e ve._ W rc¢ Ot 1 .. PAGE OF rivtJu,)p U ., c. Ion o 1 et J Sten C-7.,,,/ rsS zE //� 13 � Sy Stern 1110 Fresh Alr Wile And Observation Pipe 1 An.. Approved Vent Cap Minimum 12"Above T -` Final Grade , 20-42"Above Pipe �_ _4"Cost Iron To Final Grade Vent Pipe— Marsh Hoy Or Synthetic Covering Min. 2"Aggregate Over Pipe I-1-- Distribution pips ""—S 0 0 0 0 0 _Tee i 6"Aggregate Beneath Pip• o, Perforated Pip. Below `o —Coupling Terminating Al Bottom Of System ' /D ,G%Z PrOpOSe D Pin.-1 c rACt • / Otto.--V ton ���\\,� III SOIL FILL `'''' DISTKIBUTIOf.1 PIPE APPROVED VAI HETIC COVER !�:`%:; +t _ °= MATERIAL- OR. 9'' OF STRAW 2"OFAMGREGAlE -� . %6 OR AARSN HAU L° oF,'/2 _ _�. tLEV. of /g EET - ,t44:-..:,...11 iv; _ /�%� DISTRIB'UTIOM PIPE TO BE AT LEAST 27 INCHES BELOW ORIGINAL GRADE AMU AT LEAST2O INCHES BUT MO MORE THAN H2_ INCHES BELOW FINAL GRADE titillMUM ®EPn►1 of EXcAVATio0 FRoM ORS&P .L 6RAD€ WILL BE le �' yuNi W ®Erni of E'XCAvAnow rRoM o�It,m 1 L GRAD. WILL BE 3r1 ._< N! SIGNED: � PO Cr -- LICENSE HUMBER: /; 4 DATE : S 73 f/ 110 i. T STATE BAR OF WISCONSIN FORM 1-1$5$ TNIC SPACE RIKRVID PDR UJOQIOING aiT14/ PQGUMENT NO. s row • WARRANTY DEED I, � 782 Gi 2PAcE RE STERS OFFICE M �,: _`..�==- — ---7,- — ST. CROIX • �11/IS, is'it" f+,., r Deed, Gale Susan Schmit This y J S t made between 1 6t SX h ��oi'd a einglg ...fin doy —.-.._ of-- .,A.t 1987 , Grantor, ' 4.55 P � sod Stevan..L...K aiupgrt..and...Dehorah KrampertI b9.0t+ 4 ms .4 f@r..AO 41,4 if/ / aurviY4T'ihiR. T.4t4 R.T.9PiTtY .....,. . -^ , Grantee, " ' Jip$$E1 That the said Grantor, for a valuable consideration One dollar encl, o g�FYalual l•e..gt ..........ti4i3 , .. y, ... . .}.,...T... R[TURN TO F, . 49111/,Y$to Grnilt .t1*tR1l0Wii dtssr estate is at•.••GxQ�.x Eric "J. Lunde/11, Box 157 c H County, State of Wise vein; New Richmond', Wisconsin 54017 1 ► Tax Parcel No ,*» ....,±,.�,..,,,,,,, �,..: a The Eaat'.313 feet of the Weat. 626 feet of the North .313 feet of.the Nw of the NW)t of. Section 18-30-18. Subject to recorded easements, reservations, and rights of dray. xs Tv:tie . . , . � r* �d d �,. 4 4 This , is no . homestead property. (4) (II not? t . Together with all and singular the`bereditaments and appurtenances thereunto belonging; ' And Gayle Susan Scl mit i warrants that the title is goody, indefeasible in tee simple and free and clear of encumbrances except a;, •no exceptions .. end will warrant sad defend the same. . Dated .,�..,.. day of June • ,. , 1 :B7,., . (SEAL) 6 (SEAL) ��' .Gay le Susan Schmit • (SEAL) (SERI•) • • AUTB*NTICATION ACKNOWLEDGMENT Signatures) GayeSusat) Schmit STATE OF WISCONSIN ...,,.; ss. .,,. . ....,.. County. authe cated°this l •• y 'e ..., 19..J1. Personally came before me this day of 10_ __ the above named • Eric . Lundell F TITLE: MEMBER 8 ATE BAR OF WISCONSIN 1 .. (If not, authorised by 1 706.05, Wis. Stags.) to me known to be the person who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED CV Eric J. Lundell, Box 157 ...... • New Richmond, Wisconsin 54017 Notary Public County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent.(If not, state expiration AN not necessary) date: • 19 ) *Name of pewees signing la any ss es* should lie typed or printed below their signatures. aZATH BAR 01 w1sCONatN NAMMMOREPORta r011id ape i—yin Stock No, 13001 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.gl..- 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 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; 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 ana#.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 afar included the creation of surcharges (fees) for a number of regulated practices which Wisco can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried reasure is ysed in your building is returned to the groundwater through your soil absorption system or the disposal site'used by your holding tank pumper. The monies collected through these surcharges are credited to the groundwater fund adminis- ® '� �'"R tered by the Department of Natural Resources. These funds are used for monitoring ground- water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398(R.03/86) SANITARY PERMIT APPLICATION CouNTY 01-H9 In accord with ILHR 83.05,Wis.Adm. Code ` - CRO/ x "' ... .�,,o., STATE SANITARY PERMIT# -Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUM ER 8%x 11 inches in size. -See reverse side for instructions for completing this application. PETITION I. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES I NO PROPERTY OWNER PROPERTY LOCATION � J14 %, S 1' T� , N, R (or)W PROPERTY OWNER'S MAILING rnDDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME R R. N (cMm r - AVA A/P NCR CITY,STATE ZIP CODE PHONE NUMBER ❑ CITY : NEAREST ROAD,LAKE OR LANDMARK L T. $ro/7 ( 7(s_ )a54 E TQWNOF: i ?Id gi,nv 6 y II. TYPE OF BUILDING OR USE SERVED: pia° Ad- Oal&--,VS/- 9 OV O 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. IX 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. Xi 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. IX Seepage 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): a 9413 `rs .7bo s '709 Feet .®Private ❑Joint ❑ Public VI. TANK CAPACITY Site in gallons Total ##of Manufacturer's Name Prefab. Fiber- Plastic Exper. Con- Steel INFORMATION New Existing Gallons Tanks Concrete glass App. Tanks Tanks strutted Septic Tank or Holding Tank //kel /O'8D / P9 rs ' L_I ❑ ❑ ❑ ❑ ❑ Lift 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 Nam Print): PI ber's Signa o Stamps) IoOMPRSW No.: Business Phone Number: Plumber's Address(Street,City,State,Zip Code• Name of Designer: Yk3 K oq7 AJILt t) /C4mAn Cil (34:: 0'7 gift VIII. SOIL TEST INFORMATION Certified Soil Tester(CSTMame CST# eat.,, w erg s3/ CST's ADDRESS(Street,City,State,Zip Code) Phone { Number: r f 3 a o Sf AIL) ,L A I JJ- S �df) ( >/S" ) o?I.''-S/.3S IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater Date Issuing Agent Signature(No Stamps) Approved ❑ Owner Given Initial S charge Fee Adverse Determination X. COMMENTS/RE ONS FOR DISAPPROVAL: ii) cu, e �e_c.. 8 b 1\Wwla s e is 6`', SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber