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HomeMy WebLinkAbout032-2015-95-300 00 0. I I h O I N i I O � C Lo c z x UO c 3 N Q I I Z y rn = O Z a m )-�s o o zv' ! c a 4)iza l p c a W N p ` co N c p � •Ai C a O O z z z N z ' E cc N c c o I LO E �^ z N W W �•J -x-3000 z •N ,. (D IL IL IL Lo .. Eti r rn rn M N N N N O O N ° 0 c a � 1p O a N ¢ io m O O C O L6 N H c C N = O co �O p _ V a O O � O a C 'O N N LO O) N p A O i Q li 0 r V _ C — z � p 4� ° r' � � � i ' y f0 O � i F�1 N M L f0 w d C N • M O j y 0 O C O l6 U yr O eh !n 3 O O z — z CO cl V cl € `m w a CL C 2 a `I�1 E c c N Parcel #: 032-2015-95-300 02/01/2005 08:43 AM PAGE 1 OF 1 Alt. Parcel M 4.30.19.527D 032-TOWN OF SOMERSET Current Xj ST.CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): "=Current Owner * DONALD A&DEBORAH A WISHARD WISHARD, DONALD A&DEBORAH A 1749 50TH ST SOMERSET WI 54025 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description " 1749 50TH ST SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 5.550 Plat: N/A-NOT AVAILABLE SEC 4 T30N R1 9W NW SW 5.55AC LOT 1 CSM Block/Condo Bldg: 7/1844 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 04-30N-19W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 783/556 2004 SUMMARY Bill#: Fair Market Value: Assessed with: 10690 245,300 Valuations: Last Changed: 07/24/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.550 60,700 147,300 208,000 NO Totals for 2004: General Property 5.550 60,700 147,300 208,000 Woodland 0.000 0 0 Totals for 2003: General Property 5.550 60,700 147,300 208,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 209 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Q 3S6 -1 Cn „ w m rl o O -3 'O O o a x w E c-3 fT1 N N Z h,• O N 7r 7 Z ti CD f O to W M o m —•� 0 J J m t o o rt n O LO 1 � + OD CO N T H O , N O J J E < M+ F. cD m -a fTl x LJ r �- Cn m < m ' S03 055'25"E `f' a c1� --,we 5t line of the SW4 -_ o � C C.)Y F•• -1 2 Cn �\ �/ Z N • m -+ -C d .-° Spth St. \ \tPO o p 3 :� >< Z C-. c m :I_- (t° o .p cn c c C m 6 �4, � .y N M o \ \\`Oel� po CNi CD n p N to m T p \ z Cn y S`0O \ c ME 1XI I 10 kS/ x N r I m �� C� S fS G/ �i � M � u u n u u n u D 0 a z z H 0 J CO C/) 004- m 2 C2 tO 4- N V OM = { O 1 7 r+0 W O 1� 1--• V O w r �>// EJ O O FO C:, H O' I'O (7D W I Cn CO N Z O C 7 I H - (n Cn O> N O - w m m N 1[11 C.71 .. � _ D1 ---1 I rt U1 W W W CO C7 N m CO = c O I CD m a 0- E f f C G`> O Cr M 1 f.-. - � m I OI CD O N C7 I C1 D N m H O o O -+ O N I J W O. C') CD Z rn I N r C7 CO D 7.. .'D r/� 1 11 11 II II II it II f DI O Cu I Q � 7 S I Cn Cn N N Cn N M C") H ~ I Cr) F tO OD N Cn w C= CD w CD I tO 1 0 0 V V O O 70 -7 O O N C yf Cn � Z I f11 N 4-- r OD W � N m 1--• CD = Ct Cn O 41 W - �• I fD W W W �_ D N t-• x C'7 tO Cr W V UY f J +E 8 S n CJp• O• Z N H x N C1Y CD 7 C') CO O t0 O O CT 0, O J C O UY OD I J rt CD 01 - I-O r• �< U'I N C.11 N Cr 1 d CD Cn CD N v Cn .-• T I tt E 0 w + + I fD N Ch CO CJY I d d CO d V I lO• O A N f) �• 1 1-• S J 7 N C CD D r I fv 8 fD N 1 J �• C•) (n CZ) Cn I 0- to O to I Cn -3 O I r J 1 O [D O I CD CO CD J D m H I0 3 UN x z I t1 0 C7 n 1 rT J �w si/ P c c 11< a 0 CD � � Irt rt I T Im r d cn o _ o rt 351.58' C NO3 °55'25' W APPR,0e''ED unplatted lands owned—by platter �; •: VJ '.•.• A 11 L n fZ L \ 1 1 rn m 4'. CD _„I,r,MMj Bearings are referenced to the west line of o' A1 0ritNG CUld1.'.17IEG the SW-41 assumed to bear NO3°55'25"W. J �' F °N' Volume"Volume"i 7 Page 1844 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,0 Ft. _ Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: X Trench: Width: t{ Lenjth: . Number of Lines: _ Area Built: /2?6 Fill depth to top of pipe: 9(o Number of feet from nearest property line: Front, Side, O Rear,O Pt —0_ Number of feet from well: elo O Number of feet from building: a'� (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, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: (�; �2 Plumber on job: License Number: I 3/84:mj Form - STC - 104 ' AS BUILT SANITARY SYSTEM REPORT OWNER 06yja (� sA" TOWNSHIP k SEC. T ,50 N-R1�_W ADDRESSfSk a[,Z Sc, ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT �� LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I1HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM N S � Ca At- INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used 7 l Elevation of vertical reference point: Z0C) Proposed slope at site: Za SEPTIC TANK: Manufacturer: w��p-ps Liquid Capacity: 12-00 Number of rings used: __3 — Tank manhole cover elevation: Tank Inlet Elevation: fD(,111� Tank Outlet Elevation: Number of feet from nearest Road: Front, Side, Rear, O feet From nearest property line Front,&Side 10 Rear,0 feet Number of feet from: well (oo, , building: Z (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. QX.ZP69 rk ,. IF)��.. BUREAU OF PLUMBING MADISON,WI 53707 4— f4�r NW-14, SW4 [ , S4,T30N—R19W CONVENTIONAL El ALTERNATIVE State Plan 1.D.Number: Town of Somerset ❑Holding Tank 1:1 In-Ground Pressure El Mound (If ssigned) 55th Street NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DA E: Donald Wishard Box 262B, Somerset, WI 54025 4'19- 13 v BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT,ELEV.: CST REF.PL ELEV.. Name of Plumber. MP/MPRSW No County: Sanitary Permit Number: William Pfannes 6222 St. Croix 96060 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: ITANK,INLET ELEV.: TANK OUTLET ELEV. WARNING LABEL LOCKING COVER P O IDED PROVIDEDQ 10 ,Cf t� It51 V8 YES 1:1 NO DYES O BEDDING: VENT DIA.: VENT MATE_. HIGH WATER NUMBER OF ROAD: PROPERTY WELL BUILDING: VENT O FRESH ALARM'. FEET FROM LINE: JAIR INLET: ❑YES NO �_ ❑YES O NEAREST 1 0�) DOSING CHAMBER: MANUFACTURER: B I_IOUID CAPACITY. PUMP MODFL PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: E ONO ❑YES ON ❑YES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF 'PROPERTY WELL. BUILDING.JIENTTOFRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR wLET. PUMP ON AND OFF) Y ❑ ES NO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH JOIAMITER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease unt FORCE the soil is dry enough to continue.) MAIN' CONVENTIONAL SYSTEM: ws WIDTH. LENGTH. NO.OF DISTR.PIPE SPACING. COVER JINIIDE DIA. #PITS. LIQUID BED/TRENCH TRENCHES MATERIAL: DEPTH � S SIT �ktfVAEf�51{y1�►S , Z h -- � GRAVEL DEPTH FILL DEPTH DISTR I I I E DISTR.PIPE DISTR.PIPE MATERIAL NO. TR NUMBER OF PROPERTY WELL BUILDING: VENT TO FRESH BELOW PIPES ABOVE COVER. ELEV.INLET ELEV.END PIPES LINE: AIR INLET: a� too /-F a�a �' 4 BAREST 115© �r� a� 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 ❑NO SOIL COVER ITEXTURE PERMANENT MARKERS OBSERVATION WELLS 1:1 YES 1:1 NO DYES ONO DEPTH OVER TRENCHBED DEPTH OVER TRENCHBED DEPTH OF TOPSOIL. SODDED SEEDED- MULCHED. CENTER. EDGES. ❑YES ❑NO ❑YES ONO IEl YES 1:1 NO PRESSURIZED DISTRIBUTION SYSTEM: �y, WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER. BERITN H TRENCHES: IM6N 6NIS MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL: NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING: ` ELEV.: ELEV: DIA.. ELEV. PIPES. DIR.: EIEVATCIN A ° HOLE SIZE HOLE SPACING DRILLED CORRECT COVER MATERIAL. VERTICAL LIFT CORRESPONDS TO APPROVED YE O ❑YES ONO COMMENTS: PERMANENT MARKERS: BSERVATION WELLS: N BER%PROPERTY WELL: BUILDING: FEET FROLINE: YES NO ❑YES ❑NO NE�1R�S 1 79 Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE: TITLE: DI LHR SBD 6710 IR.01/821 Zoning Adminis r 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. Prcperty owner's name and mailing address. Provide the legal description where the system is to be installed; II. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. Responsibility statement: Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8'/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 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 .:titer-- 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 reps-U re' is used in your building is returned to the groundwater through your soil absorption o system or the disposal site used by your holding tank pumper. a The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- t r water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398(R.03/86) E:z�°° SA NITARY PERMIT APPLICATION COUNTY DILHR In accord with ILHR 83.05,Wis.Adm.Code^� STATE SANITARY PERMIT�# —Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER A 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 M NO PROPERTY OW PROPERTY LOCATION f Aj%S(,J%, S-// T,- , N, q Elora P OPERTY OWNER'S MAILING ADDRESS LOT NU BER BLOC UMBER SUBDIVISION N � Of'?,9TAIIE ZIP CODE PHONE NUMBER LJ CITY NEAREST ROAD, DMARK VILLAGE: C d J II. TYPE OF BUILDING OR USE SERVED: . 03J —of Q I CY- Number of Bedrooms if 1 or 2 Family OR ❑ Public(Specify): III. PURPOSE OF APPLICATION: (Check only one in##1. Check##2,3 or 4,if applicable) 1. a. yv New b. ❑ Replacement c. ❑ Replacement of d. ❑ Reconnection of e.❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit## Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in##1 and only one in##2) 1. a.x Conventional b. ❑Alternative C. ❑ Experimental 2. a. ❑System- b. ❑ Holding c.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a.J4 Seepage Bed b. ❑seepage Trench c. ❑See a e Pit 2. PER OLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): /� (� t0 9i Feet X Private ❑Joint ❑ Public CAPACITY VI. TANK in allons Total ##of Prefab. Site Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks I Tanks strutted Septic Tank or Holding Tank 1:1 El El 1:1 Lift Pump Tank/Siphon Chamber ❑ L] ❑ ❑ VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name(Print): I flu�mber's Signature:(No Stamps) MP/INtillill"Mo.: Business Phone Number: 7/ - Plumber's Address(Street,City,State,Zip Code): Name of Designer: 'r O VIII. SOIL TEST INFORMATION Certified Soil Tester(CST)Name '? CST## f CST—s ADDRESS(Street,Pity,State, ip Code) Phone Number: IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuin Agent Signature(No Stamps) Approved ❑ Owner Given Initial S hhargg�e Fete Q �/ Adverse Determination �� d�7 +V� A���" 1�+�'�N � X. COMMENTS/REASONS FOR DISAPPROVAL: G+PAZ 0 Qd b� �,-►cam C : f��c,C�-v�-.� SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber APPLICATION FOR SANITARY PERMIT STC - 100 is 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 001yAi_D_ L-1iIddlzJ Location of Property _ a _fit �` , Section _��, T__Zo N-R W TownshipMrQ2 . Mailing Address J?7- Z SE 7- &4..,i SC .S'Y•0 1-_ Address of Site 5 AA 1= Subdivision Name C(L' L 1 T-Z . Lot Number f Previous Owner of Property L?t j�C 2 L•/ fZ L I Total Size of Parcel A C:ZE C Date Parcel was Created h,�rtl Are all corners and lot lines identifiable? �-'� Yes No Is this property being developed for resale (spec house) ? Yes No Volume _ and Page Number /� �' as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and page number, and the Seal of the Register of Deeds. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION 1 (toe) cen tkN that ate A tatement�s on this 6onm ane thue to the but o6 my (oun) hnow.tedge; that 1 (we) am (ahe) the owne bs) 06 the phopeJcty de6n bed in .this in6o"ati.on 6onm, by viAtue o6 a waAAanty deed neconded in the 066.ice 06 the Count Reg-usxen o6 Veeds as Vocument No. ; and .that I (we) pne�sentty own .the pnoposed bite bon the .sewage di,sp" . byes em (on I (we) have obtained an easement, to nun with the above ded ch i.bed pnopen ty, bon the cond.thuc ti•on o6 daid system, and the same had been duo nQcondo_d i.n ILho, Oil e o n,( fho rn,,,,t„ nn,,:k t, * nt r • DOCUMENT NO. WARRANTY.. DEED THIS SPACE RESERVED FOR RECORDING DATA 4569 STATE BAR.OF WISCONSIN FORM 2-1982 VG. PAGE REGISTERS OFFICE ST. CROIX CO., WIS. Beverly M. Erlitz- -------------------------------------------------------------------•---....---------------------------- Rec,d. for Record tIIiS30th "---•-----------------------------------------------------------------------------•--....----•------.....:._..... y of Jun� ,ne AD. 198 ------------------------------------------------------.------..._...---.....-------------------------------------- 8 7 5 A -- Qt' 8: 1 conveys and warrants to ...Donald-_A.... ishard and } .......Debsarah..A.. Xisha>~cL,.__huskzaiad---and .�a.i.fa,_ ................. .......s u ry itarship._mazi.taJ..�z�gexty,----------------------------------- Deeds, ................................................................................................................. RETURN TO •. .............................................................................................................. the following described real estate in -----Et_._._CSOi X.....................County, State of Wisconsin: Tax Parcel No- ----------------------------- Lot 1 of Certified Survey Map dated November 18 , 1986 and filed with the � ''>i.i Register of Deeds office of St. Croix County on June 25, 1987 in Volume 7, Page 1844, as Document Number 427396 EE]i located in the Northwest Quarter of the Southwest Quarter ;(NW4 of SWh) in Section 4, Township 30 North, Range 19 West. This ..S not----- ho11}este4d.property. (is) (is not) Exception to warranties: Subject to easements, reservations and restrictions of record. /� '.. June Dated this ......... _4P ------------------ day of ---• -• --•-- •. ......... .........•---•. 1 ....87. (SEAL) .... ............... ..... ..... .` AL) ° ---------------------------------------- BEVERLY M. ERLITZ _ - (SEAL) •..................................(SEAL) s AUTHENTICATION,, ACKNOWLEDGMENT Signature(s) _ ._.. ... _...___..._ STATE OF WISCONSIN _ SS. .................-.............._.. --- ---- ------------------- ----=---------- -------- ._....--_.County. authenticated this 26 •....da y o June -_. 19:87 Personally came before me this ----------------day of --- ---------------------------------9 19-------- the above named - -------------- DUNLAP ------------------------------------------------------------------- ----------------------------------------- ---- ---- - - - - TITLE: MEMBER STATE BAR OF WISCONSIN ----------------------------------------------------------------------- -- ----- -- - ---- ---- -- - --------------------------------------------------------------- ................ to me known to be the person ............ who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY STEPHENJ. DUNLAP -----=-------------------------------------------------------------------------- -------------------------------------------------------------------------------- Hudson, Wisconsin ----------------------------------------•------------------------------------- ------------ --------------------------------- -------- -------- ----------- Notary Public --------------- County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent.(If not, state expiration are not necessary.) date: ....... 19.........) *Names of persons signing in any capacity,should be typed or prir✓d below their signatures. STATE BAR OF WISCONSIN KC.Miliarcompow FORM No. 2— 1982 Stock No. 13002 a­.-MY....M .. H N H a ST C - 105 r � 9 . N SEPTIC TANK MAINTENANCE AGREEMENT o St . Croix County z r OWNER/BUYER DliAIA L O A LA-1115NAIZO M ROUTE/BOX NUMBER 9r �A- 6)( Fire Number CITY/STATE <QjMr g-SF_ T w cSG Z IP �z/D .S' 1 PROPERTY LO CAT ION :jj(6� 14, _�W 14, Section_L T ' ;F3 N , R /I W, J Town of S'ohp--125 _ 71 St . Croix County , Subdivision F-4L17­2 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 waste disposal system. St . Croix . County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1 , 1978 . St . Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained . The property owner agrees to submit to St . Croix County Zoning a certification form, signed by the owner and by a master plumber , journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping ( if nec- essary) , the septic 'tank is less, than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration . ti 0 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- 0 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 , 0, Z :ti _ DATE J'- 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 . DEPARTMENTOF REPORT ON, SOIL! BORINGS .AND SAFETY& BUILDINGS INDUSTRY, DIVISION HABOR AND n PERCOLATION. :TESTS (1151 P.O. BOX 7969 ,'HUMAN RELATIONS \ / MADISON,WI 53707 M63.0.6.(10,&Chapter 145.045) LOCA ION: SECTION: TOWNSHIP/ Q Y: LOT NO.:BLK.NO.: SUBDIVISION NAME: �/4 /T H/ (or)W merse In/a n a n a COUNTY: 0 NER'S AME: MA LIN ADDRESS: St. Croix Donald Wishard Box 262B, Somerset, Wi. 54025 USE DATES OBSERVATIONS MADE NQBEDRMS..ICOMMERCIAL ES R PTIONt ��;0 DESCRIPTIONS: ES S: ®Residence 4 n/a ]New OReplace 4-$-$7 n/a I•- r RATING:S-Site suitable for system U-Site unsuitable for system r ONVENTI NA : MOUND: U R S STEM-N-FILL HOLDING TANK:RECOMMENDED SYSTEM:(optional)S U ®S OU �S ❑U O S U ❑S flU 54x24 seepage bed. If Percolation Tests are NOT required DESIG RATE: If any portion of the tested area is in the under s.H63.09(5)(b),indicate: Class 2 I-Floodplain,indicate Floodplain elevation: n/a PROFILE DESCRIPTIONS page 26 GOB BORING TOTAL PTH T GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR TEXTURE,AND DEPTH NUMBER DEPTH ELEVATION gSERVED ES IGH TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) B-'1 7.08 103.12 none >7.08 .50b1.l. 2.50bn.1.s. .50bn.s.1. 3.58bn.s.1. B. 2 6.75 102.99 none >6.75 .75bn.s.1. 6.00bn.l.s. B_ 3 11.17 105.92 none >11.17 Ml.l. 2.50bn.s.1. 3.00bn.1.s. .50bn.s.1. 2.92. bn.m.s. .50bn.l.s. 1.00bn.ms. b.m.#2 B- 4 7.25 : 100.00 none >7.25 . .42bl.s.1. 1.00bn.s.l. 5.83bn.l.s. b.m.#2 B" 5 6.58 100.11 none >6.58 .50bn.s.1. 3.58bn.l.s. .50bn.s.1. 2.00b .l.s.' b.m.#2 B- 4 5.00 .67bn.s.1. 4.33 bn.l.s. .92bn.mot.s.sil. .92bn.m s. PERCOLATION TESTS EST DEPTH, WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES D RAPER IINU ES NUMBER INCHES AFTERSWELLING -INTERVAL-MIN. — P- P- P- P- see P. J P. PLOT PLAN: Show locations of percolation tests, soil borings and the d),mansions 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 99.49 a�J I'll's _ L-1 i r -+— r10 ; '7/i 7- _ �A I I L ICZ:. J 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. SAME(print): TESTS WERE COMPLETED ON: ary L. St el 4-8-87 ADDRESS: CERTIFICATION NUMBER: PHONE NUMB ER.(optionalF 448 N. %ho Dr. New Richmond- Wi 54017 71 S-9-46-6700 ' % CSTSIGNA - - DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. 01LHR-SBD-6395(R.02182) -OVER- , . � i � - _ : ,.� �. �; _ ;_ • �°.,� . .. 1 y 1 � ♦ e 1 t � r ..� Acni �7 gin e � I ca eolecl, Sl000a S7 BSS o '' . . .