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Home My WebLink About038-1044-80-000 r. 0 f c M o T d # ° \ 1 _ o ~ F) 0 ch o o o w m i v w i 3 00 Lo 90 fl_ N CD N ppj ~ CD pp c 3 m p n v. oo rO~r ^ N p. O N O CD CO CD Co R \ 1 c° °n c CD CD . p ° iv O 3 ao o ° (r N IN/1 7 O O l~~l C N O !V to D o n m CD ~j (p N a n c N co c O W (ZD ° co °o°o C N (D a m co n n r w CL CA ° cr rt td 0) 0) 0 P. O m Z OOO m ~N1 H 00 w ~ a o co o w 00 G c VJ f~lJ f~/J m ((D ON H W 9 G G ID - Z' N Q am -0 :Ej 90 93 V , 0 A o m s j (D N 3 a 3 N v a ' O (D :3 rr oo `i °S zD w o O 00 0 O a 00 "fti C7, :3 CD CD C, CD cn j ryZ~ m F-3 w O ° a w r QQ n 3 ° (D Z Z Z Z Ch by I trJ I O ~ p ? O rh c`l n A z o 00 cn s ° H. (D 0 I'd rt 10 Q r+ IN I z - n H. lz~ W M O a 3 ~d C-4 O Z Fl- mI N ~ ~ (D 3 CO (D ° 0 FD o a 3 3 a (D T n, v c o z ' < N p ° n, m a~ v m I ° 3 o I am CD c o, o .d ?o ° I o ~ ~ o C) CL f ' o C7 Co ~ -0 0 m O c D 3 3 ~ ~ ~ o .c+ (D CD co W r: C- 0 III O Al (n O 4) OD CD C1` --1 CD y W m o ~l C 3 7 O N w A O ZZ CL 7c N p' IV N -4 Q 'w ? n go C) C1 {CD C O~ ~ to ~ D m a a- i, m cn CD a v CD W _ ' p d y 3 O o ao o I o -4 CD jo o N tQ L N Cp0 (D N .O-r C lr Q D 3 0 0 0 0 ? fl:• O O O I° a0 zz (yr1 o N y CO) m D (D cr "a N°o o N A rn n s1 m y - N 3 N 5 a rT ~i Z N o Z -I Z cn Q D 'm O P~ O 0'-a° =r m v) Cn !~1 CD m c rye c CC n w co a = p A Z A Z O v a A G 3 0 W m a~ CL " z 3 °o z U) m g z f w I rn n 4 o m m c y Z O. m _ N n' O Z m y O C n CD y D C/) ti ti 00 N W a v m e ~ N ti Parcel 038-1064-20-000 05/10/2006 08:40 AM • PAGE 1 OF 1 Alt. Parcel 16.31.18.277A 038 - TOWN OF STAR PRAIRIE Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner DAVID M & BARBARA J SPRINGER O - SPRINGER, DAVID M & BARBARA J 1073 220TH AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 1073 220TH AVE SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 16.470 Plat: N/A-NOT AVAILABLE SEC 16 T31N RI 8W E1/2 NW NE EXC CSM Block/Condo Bldg: 8/2384 (3.53AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 16-31N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 897/224 07/23/1997 832/548 07/23/1997 806/582 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/13/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 37,000 173,000 210,000 NO UNDEVELOPED G5 13.470 33,700 0 33,700 NO Totals for 2006: General Property 16.470 70,700 173,000 243,700 Woodland 0.000 0 0 Totals for 2005: General Property 16.470 70,700 173,000 243,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 135 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 038-1064-20-100 05/10/2006 08:40 AM ' PAGE 1 OF 1 Alt. Parcel 16.31.18.277A10 038 - TOWN OF STAR PRAIRIE Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner DAVID M & BARBARA J SPRINGER O - SPRINGER, DAVID M & BARBARA J 1073 220TH AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1073 220TH AVE SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 3.530 Plat: N/A-NOT AVAILABLE SEC 16 T31N R1 8W PT NW NE BEING LOT 1 Block/Condo Bldg: CSM 8/2384 3.53ACRES Tract(s): (Sec-Twn-Rng 401/4. 1601/4) 16-31 N-1 8W Notes: Parcel History: Date Doc # Vol/Page Type 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/13/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.530 39,700 22,000 61,700 NO Totals for 2006: General Property 3.530 39,700 22,000 61,700 Woodland 0.000 0 0 Totals for 2005: General Property 3.530 39,700 22,000 61,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 038-1044-80-000 05/10/2006 08:28 AM PAGE 1 OF 1 Alt. Parcel 11.31.18.195D 038 - TOWN OF STAR PRAIRIE Current [X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - SPRINGER, DAVID M & BARBARA J DAVID M & BARBARA J SPRINGER 1073 220TH AVE P -NET 54017 Districts: SC =School SP =Special Prope s es): Primary Type Dist # Description 1073 220TH AVE G CY1~~ D ! " ~f f SC 3962 NEW RICHMOND SP 1700 WITC ~ cry Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE SEC 11 T31N R18W PT NW NE COM SW COR N Block/Condo Bldg: 72 DEG E 826.32 FT TO POB N 71 DEG E 79 FT NLY ON C HWY 312 FT W 118 FT TO E BK Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) CEDAR CRK SLY ON CRK TO POB ASSESS WITH 11-31N-18W P195M Notes: Parcel History: Date Doc # Vol/Page Type 07/2311997 874/589 07/23/1997 863/330 07/23/1997 723/576 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/13/2004 Description Class Acres Land Improve Total State Reason COMMERCIAL G2 0.000 41,300 104,700 146,000 NO Totals for 2006: General Property 0.000 41,300 104,700 146,000 Woodland 0.000 0 0 Totals for 2005: General Property 0.000 41,300 104,700 146,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 • Marcel 038-1045-70-000 05/10/2006 08:30 AM PAGE 1OF1 Alt. Parcel 11.31.18.195M 038 - TOWN OF STAR PRAIRIE Current ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - SPRINGER, DAVID M & BARBARA J DAVID M & BARBARA J SPRINGER 1073 220TH AVE NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE SEC 11 T31 N R18W PT OF NW NE AS Block/Condo Bldg: DESCRIBED IN VOL 608 PAGE 329 ASSESSED WITH P195D Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 11-31N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 874/589 07/23/1997 863/330 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/23/1989 Description Class Acres Land Improve Total State Reason Totals for 2006: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2005: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 f'r,oww.- Form -STC- 104 AS BUILT SANITARY SYSTEM REPORT OWNER ,edct r ~~-.~G f„Ze~TOWNSHIP CJ C( r ~,z,~ SEC. _ T 3/ N-R1-C W ADDRESS j&v20o,~e2J ST. CROIX COUNTY, WISCONSIN e~~t2~~l~/Jid~c~ w~c J` rfo~7 6 7 SUBDIVISION LOT LOT SIZE ~j ~ el, PLAN VIEW c' Distances and dimensions to meet requirements of I•IHR 83 0 CPU, SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM I l / i eo 1 S ~ !O _ j~_ ~ W \i W ill & , q, r 1 L9 k -L INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used j~e®ls~cc/ Elevation of vertical reference point: ~O Proposed slope at site: 5-_ SEPTIC TANK: Manufacturer: We e ~S Liquid Capacity: f laeo - d d Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front,O Side,W Rear, O j 4 p feet From nearest property line Front,OSide,(D Rear,0 1o20 feet Number of feet from: well ~5'0 building: /0 (Include this information of the above plot plan)( 2 reference dimensions to septic tank) CFF VVIT ACTT CT11F . 1 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: 3G Len$th: Number of Lines: Area Built: 1X102 f Fill depth to top of pipe: fj Number of feet from nearest property line: Front, O Side ,(D Rear, It Number of feet from well: -O Number of feet from building: .3 (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: Plumber on job: License Number :®~T ~~f ~S 3/84:mj OF INDUSTRY, INSPECTION REPORT FOR ' SAFETY & BUILDINGS AN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION J9 BUREAU OF PLUMBING WI 53707 ®CONVENTIONAL El ALTERNATIVE Slate Plan l.D. N-1,11 W ass$604187 . ❑ Holding Tank El In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER. INSPECTION DATE Rt. 2 Bx 79 New Richmond Wi. 54017 8/12/86 4:00 P.M. Cedar Creek Inn BENCH MARK (Permanent reterence pouul DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REf PT. ELEV NW4 NE4 Section 11 T31N R18W Town of Star Prairie N.urn•n( Plumber. MP/MPRSW No.. co7, -y Sane tart' Perms( Number yron Bird Jr. 3318 St. Croix County 83826 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIOUILyC~P AC17yfr TANK INLET ELEV. TANK OUTLET ELEV WARNING LABEL LOCKING COVER O/V, (/CJ PROVIDED PROVIDED OYES ONO OYES DNO BEDDING. VENT DIA. VENT MAT L.. HIGH WATER NUMBER OF ROAD= PROPERTY WELL BUILDING VENT TO FHFSH JALARM LINE AIR INLET FEET FROM DYES ONO OYES ONO NEAREST DOSING CHAMBER: MANUFACTURER JBEDDING LIOUIO CAPACITY PUMP MODEL PUMP.SIPHON MANUF ACTUHEH WARNING LABEL LOCKING COVER PROVIDED. PROVIDED DYES ONO OYES ONO DYES [ENO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PROPI It tY bvf LL BOIL DIN(l VENT TO FNtsII FEET FROM LINE AIR INt F T (DIFFERENCE BETWEEN PUMP ON AND OFF) DYES ONO NEAREST 30 SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGTH DIAMI If rt %In TI HIAI AND MAHKIN(. or excavation. (If soil can be rolled into a wire, construction shall cease until FFORCE the soil is dry enough to continue.) AIN CONVENTIONAL SYSTEM: WIDTH LENGTH NO OF E71STR PIPE SPACING COVER JINSII)f IIIA ~PIIS I.IOUI(1 BED/TRENCH TRENCHES NIATEHIALt PIT TEPU( DIMENSIONS (,RAVEL DEPTH FILL. DEPTH 1~):'~,TH PIF UNo DISTH NUMBER OF PHOPERTY WELL BUILOIN(i VENT TO HI Srl I F I ELEV END PIPES FEET FROM LINE - AIH INLE T BF Lf)W PIPES AH()VE COVER "I I"It", 1 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. OYES DNO - SOIL COVER 7PXTIIHE PFHM nNf NI MnHKf IF(tlitif r+VnIIUN WI I I S _ OYES 0NO DYES _ LINO DEPTH OVER TRENCH HET DEPTH OVER TRENCH BED I/EPi11 f7F TOPSOI_L _ Sf 11)UF 11 SF-")"[):]YES , 1If U CENTEH EDGES OYES ONO NO OYES UNO PRESSURIZED DISTRIBUTION SYSTEM: NO.OF LATERAL SPACING GRAVEL Of P711 Hf LOW PIP( f It L DEPTH ABOVE COVE H WIDTH LENGTH BED/TRENCH TRENCHES DIMENSIONS MANIFOL D PUMP MANIFOL I) DISTR. PIPE JMANIC OLD MATERIAL NO OISTI+ I)ISTH PIPF OTSI (IHII I()N PIP( F1A 11 HIAI & MAHKINI, ELEV. ELEV. CIA ELEV. PIPES DIA. ELEVATION AND DISTRIBUTION INFORMATION ROLE SIZE HOLE SPACING DHFLLLU COHHECT I. Y COVFR MATERIAL Vf1+TI1( At I II 7 COHI-+FSPONUS TO APPHOVI U OYES ONO DYES DNO COMMENTS: PERMANENT MARKERS OBSERVATION WELLS. UMBER OF LINEERTV WELL BUILDING FEET FROM 17 ' S I OYES ONO DYES ONO NEAREST 217 J l 00 73 Sketch System on L Retain in county file fo&it-o Reverse Side. - SIGNATURE TITLE DILHR SBD 6710 (R.01/82) ..r. wlseansln APPLICATION FOR SANITARY PERMIT '~YDILHR Affik:__~C`OUNTY (PLB 67) UNIFORM SANITARY PERMIT # inDUSTTRY, LR LR OFBOR 6HUTRnRELRTIOnS g~~g G - - nOUS -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'/2x 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNER MAILING ADDRESS C e r .Z/7r~ a e~ c, PROPERTY LOCATION CITY: ~!"tylOl~ /4,S/ , T , N, R~ E (or vIL GF./''6t LOT NUMBER BLOCK NUMBER SUBDIVISION NAME AR EST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER 4c:? Ge j -7 TYPE OF BUILDING OR USE SERVED ❑ 1 or 2 Family Number of Bedrooms: Public (Specify): THIS PERMIT IS FOR A: ❑ New System ❑ Tank Replacement ❑ Repair Replacement Soil Absorption System ❑ Revision ❑ Privy 'LJ Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holdiny Tank System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued ❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer: IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): Z -5 141,70 . vZ ~9 Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber (Print): Signaturpl? r MP/MPRSW No.: Phone Number: 7 10151126 e) 72 'tc 1331-4 Plumb s d ress: Name of signer: O COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved 99 a -G (D ❑ Owner Given Initial Approved Adverse Determination s Reason for Disapproval: Alternate course(s) of Action Available: DILHR-SBD-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398 To be complete and accurate the permit application must include: 1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in a city, village or town); 2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.); 3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks. 4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of square feet to be installed; 5. Complete the section on water supply; 6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi- fication, place your license number in the space provided and sign the permit in the signature block; 7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the permit; 8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation. Failure to comply will void the sanitary permit. 9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable. 10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system, depth of the system, type of system. 11. All revisions to this permit must be approved by the permit issuing authority. 12. A complete plan including a plot plan, drawn to scale or with complete dimensions. 13. Horizontal and vertical elevation reference points that are permanent and clearly shown. 14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s) to system, building sewer and vent observation pipe(s). 15. The permit issuing agent may require a cross section drawing of the effluent disposal system. TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning your system, contact your local code administrator or the Bureau of Plumbing, DILHR, State of Wisconsin. G_ Q _i A- y Sri., LU %Izt~l ".i qc` r c, 0 ra CL R UJ O i 8604187 L J a~ N, 'fib pLU`N~g~NG ~3U~E~~ r+ PROJECT ~~d r C~"~c )Vf ADDRESS Ct -g ~ex z! jj~o l4)1y' 1/4/S JIIT31 N/R 9 'IN' TOWN ~ , /W.: G COUNTY 6,A Gro i!~ ~p BEDROOM_ CLASS PERC 4 517 CONVENTIONAL CONVENTIONAL LIFT_ MOUND_ HOLDING TANK- IN-GROUND PRESSURE_ -40 e SEPTIC TANK SIZE op ~rL TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ABSORPTION AREA CRATE BED SIZE ► 5 ` f t PLUMBER LISCENSE NO. 3 3;14 DATE 7-10 --g'~ ~L B,,M~~ me elevation 100' Location o Benchmark ea d e r(5o% Xe Q Borehole Q well a Per;c Hole System Elevation ~O• Z i 2, eENr r TYPAR COVERING 2" 2 2.. 4 C4 12 u ~ 3 6 Sewer Rock Yc~i:A iVv bJ T- 12 ft. 18 ft. 24 ft. ' 3 86041 8 7 01- - Rau +a J naffy :MAN 2ELAT-IONS I SA Aim - E MNREso c Arcs ~i ~l 0 Iff leC . ~T ri rn : G7 y CA 1 • Cf tR rn ~ ~ o ~-TM g Q1_ 3 b a a Z w J j .7Z Cf) c1 X cc c (n I ca) CA= i s L I lie 17 ►rIG BURF ~~~rng 1 .,t s a r"A CEO -cx ~ ~ I ,,~+l ter. ~ ~ I / \ f ; of Y~ ~ r i fie.. TZ RECEN ~p 'P►-UMR,~G BUREAU Pl b. 60 1 /78 PROJECT DETAIL DATA SHEET NAME OF BUSINESS LEGAL DESCRIPTION 11X /g 4.) OWNER 7 MAILING ADDRESS ~mX. ~y Gam, c1/ - Z I P .,'!r ARCHITECT, ENGINEER, ~rTr _ ADDRESS PLUMBER OR DESIGNER may, z-f Z I P TELEPHONE NUMBER 07-2' 1. Check appropriate building usage(s) and fill in the information requested opposite each usage listed. Please consult Section H 62.20. Existing building New building Addition ( } Apartments and condominiums . . . Number of bedrooms ( ) Assembly hall . . . . . . . . . . . Seating capacity ( ) Bar . . . . . . . . . Seating capacity 5~C2 # of meals served ( ) Bowling alley . Number of lanes ( ) With bar ( ) Campground and camping resorts . . . Number of sewered sites Number of unsewered sites Total number of sites ( ) Camps . . . . . . . . . . . . . ( ) Day use only Number of persons ( ) Catchbasin ( ) Day and night Number of persons ( ) Number . ( ) No kitchen Number of persons ( ) With kitchen Number of persons ( ) Dance hall . . . . . . . Number of persons ( ) Dining hall . . . . . . . . . . . . Number of meals served daily ( ) Dog kennels . . . . . . . . . Number of enclosures ( ) Drive-in restaurant . . . . . . . . Inside seating capacity Car-service Number of car spaces ( ) Dump station . . . . . . . . . Number of dump stations ( ) Employees ( total of all shifts) Number of employees ( ) Hotel ( ) Motel ( ) Cottages . . . . Number of units with 2 persons per unit Number of units with 4 persons per unit ( ) Medical and dental office bldgs. Number of doctors, nurses, medical staff Number of office personnel Number of patients ( ) Mobile home parks . . . . . Number of sites ( ) Nursing homes . . . . . . . . . . . Number of beds ( ) Restaurant . . . . . . • • • • • • • Number of persons ( ) Toilets ( ) Showers . . • • . . . Seating capacity ( ) Dishwasher and/or disposal? ( ) 24-Hour service ( ) Retail store . . . . . . . . . . . . Total number of customers ( ) Schools . Number of classrooms 7 Meals ( ) Showers ( ) Self service laundry . . . . . . . . Total number of machines ( ) Service station . . . Number of cars served daily ( ) Swimming pool bathhouse . . . . . . Number of persons ( ) OTHER . . . (Specify) . . . . . . . COMPLETE OTHER SIDE r 2. Indicate whether the following facilities are present. Floor drain yes _ no Number of drains Food waste grinder yes no Dishwasher yes no Automatic clothes washer yes no Number of clothes washers 3. Septic tank capacity Holding tank capacity Septic or holding tank manufacturer Lel e G 4. SEEPAGE TRENCHES: total square feet width of trenches _ length of trenches depth number of trenches i SEEPAGE BEDS: total square feet width length of bed depth SEEPAGE PITS: total square feet outside diameter depth below inlet total depth from top to bottom of pit Signature of person completing form: FOR DEPARTMENTAL USE ONLY n - Address d Z i p Telephone Number Date eg~ 4a rv" set - T,~ so X q 0S o 1 X ;20 Iaao )fill el fro4 On, -ft) X a ✓ /0 s y ~t- RECEIVED J(JL 1 7 ,o, PLUMBING BUREAU State of Wisconsin ` Department of Industry, Labor and Human Relations PRIVATE SEWAGE PLAN APPROVAL SAFETY & BUILDINGS DIVISION Bureau of Plumbing 201 East Washington Avenue P.O. Box 7969 Madison, Wisconsin 53707 BYRON BIRD, JR. RE: Plan Number: 86-04187-S Gallons Per Day: 470 ROUTE 4, BOX 6 Date Approved: July 30, 1986 AMERY WI 54001 i Date Received: 7/17/86 Project Name: CEDAR CREEK INN BARB KUNZ Location: NW,NE,11,31,18W Town of STAR PRAIRIE County: ST CROIX The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped 'conditionally approved'. This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or, county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. This approval will expire two years from the date approved or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. The Bureau of Plumbing has reviewed these plans for private sewage system code requirements only. These plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50--64 of the Wisconsin Administrative code. This approval is for the following components only: 1 REPL CONVENTIOP 1. 1 NOTE: Please make an attempt to improve plan neatness and quality. The plan received was very cluttered which makes them very difficult to read and interpret. Such plans only make plan reveiw more difficult and may lead to delays in plan approval. Inquiries concerning this approval may be made by calling (608) 266-6952. Sincerely, 4LRO-Y JAN 2Y Bureau of Plumbing Safety and Buildings Division PPP024/0009w/ 7 cc: _li/~Private Sewage Consultant " County U WMP Plumbing Consultant _Owner umber Environmental Health DILHR-SBD-6423 (N. 04/81) v LA r m x x m CO) c S, 9 -S' w ?Oc 0 K'3 0 c v (D O ID O O r n 8(D N d (D S w ~o .C.Cy o c 0wwrA z S0 3 ~(n(o 0 0 A N D O (p N ((DD N -app w o ~o 1 ca -0 (D v 0 w (D =r C.)3a ol ID Co (o C,) 0 CD 0) 09 3 ~ :3 o ff 3° ~ L c w-» C w? c~ Q5 w c? 0 w w w (D o ~o a~ D (a = (c (D v CD 0 D c (D sr CD w o w c a o CL o~w w ~ C y QQ- 0 N (D N NON : a E So D G~ w(D m' j-+m' Z am0 3 (A Wa ~ D CA CL * =r 0 =r m CD?M FA w » CL a (a a c f vCDo myaAi~CD•' C 171 ~ a (D S ~ =a cr 0) _ 0 (D N w O (D (A caw ao f a ((n c 5 aN pi ? 171 3 w (D a - C CL a oc mo=r CD ,3 ` pA (G (/1 n (D O O~ 7 g r D* C -4 0 CL 0 O 0(a a c, c V s CL r- SD (D CD CD a g o 3 0o 0'°.3 'Vo c ~4 w 0 a (D 0 0 3 a 0 < p- CD CD 0 Cl\ c I State of Wisco sin ` Department of Industry,,Labor and Human Relations ",s... SAFETY & BUILDINGS DIVISION 1, AN, c -777-77 _ utA. t , c a f_ 1. 'j77~ 4.t)k,:3+ DILHR-SBD-6423 (N. 04/81) DEPARTfy1F.fNTaF 11 J . BORINGS AND SAF ETY & BU I LD I NGS INCt TRY, _REPORT V--- F DIVISION LABOR AND P.O. BOX 7969 HUMAN RELATIONS PERCOLATON TESTS 0) MADISON, WI 53707 (ILHR 83.09(1) & Chapter 145) IY NO.:BLK. NO.: SUBDIVISION NAME: ILOCATION: SECTI N:T 2 e T WNSHIP/ UNICIPAA~LITY: LOT 1,U ~ / !J NI RI A(0 5761 r- ~ COUNTY: OWN ER'S BUYER'S NAME: MAILING ADDR SS: r ! Gro~~ r 4-e - .s ~ek/ r 5G 6-Z/o/ USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMER IAL DESCRIPTION: 7ffUFI1_E- DESCRIPTIONS: ERCOLATION TESTS: / / ❑New ®Replace Residence ~Qr ff( acl(/ul G~o4i -°2 7 RATING: S= Site suitable for system U= Site unsuitable for system ONVENTIONAL: MOUND: lik--dAOUND-PRESSL)RE:rYSTEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM: (optional) ®s au os u s❑u as u ❑s u 1&20-- DESIGN RAT If Percolation Tests are NOT required If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: Q' PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED E IGHE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) rZls, S a44-~A sjr Syr B- S h'M 4e 1 • - . B- rs y6 ew -5 14 B- -1-17 14 ILI B- B- PERCOLATION TESTS 4TEST DEPTH WATER IN HOLE TEST TIME DROP I WATER LEVEL-INCHES RATE MINUTES INCHES AFTERSWELLING INTERVAL-MIN. P RI PER10 PER INCH 3 C. 4 G P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface eleva *on at all borings and the direction and percent of land slope. 8604187 SYST M ELEVATION y~• b Pc.' r C C:~~ yj'y im r h y P;,(,JPf ~o~t L l~la r ~r Ll LIfI1 5,~~ ) 6`1 b b u el, rS ~ TN (oP ~~X3 _,~wQ II ~ I(. ~ ~,f 0'30. 1r ~~t u. RECEIV I 61-f r v;` J U 1 7 OFD , PLUMBING BUREAU I, the undersigned, he by 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 (pr,i,nt): TESTS WERE COMPLETED ON: &zw 9, -J5" - -TJC ADORES. CERTIFICATION NUMBER: PHONE NUMBER (optional): L l OC,~ i44 7,417 7/5-, 2~ CST SIGNAT RE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Sail Tester. H x N H a STC - 105 r r a H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County x d a OWNER/BUYER C ej_a,- I~ Za n1 I?AI2CIP9A S. M ROUTE/BOX NUMBER Q + ? q Fire Number .CITY/STATE ~QE.J R!Ghr" n.J~ , l.J 1 ZIP PROPERTY LOCATION:_42~_dk, V'F__'k, Section H TN, R W, Town of tot~c rI e. , 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 pdt 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 (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. H 0 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- u ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNED DATE St. Croix County Zoning Office P.O. Box 98• Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. 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/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 C ~cs ~ f c RA k d,49 CA 00 Location of Property n) l,) ~14, Section N-R W Township r C- ' Mailing Address Qo,r 7 Address of Site Subdivision Name Lot Number Previous' Owner of Property - e Jo cs 1- ~l Total Size of Parcel 9L0 Date' Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes X No Volume F and Page Number 3a? 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 I (We) ceAti.by that att statements on this bonm ane tAue to the best ob my (ouA) knowledge; that I (we) am (are) the owner (.s) o6 the pnopeAty dens ch i,bed in this i.nboAma ion bonm, by vittue ob a wa~vcanty deed teco&ded in the Obbi.ce ob the County Register ob Deeds as Document No. ,36x79 ; and that I (we) pnezentty own the pro pob ed site ban the sewage di s poz system (on I (we) have obtained an easement, to nun with the above de~scA bed picopehty, bon the construction ob said system, and the same hays been duty recorded in the Obbi.ce ob the County Reg-usteA ob Deeds, as Document No. SIGNATURE OF O~NER SIGNATURE OF CO-OWNER (IF APPLICABLE) Lzo~ /~n DATE SIGNED DATE SIGNED VOL ADDENDUM TO LAND CONTRACT THIS ADDENDUM is made with reference to that certain Land Contract between John M. Nutzmann and Eleanore Nutzmann, husband and wife as joint tenants, VENDOR, and Robert J. Kunz and Mary C. Kunz, husband and wife as joint tenants, and Kunz's Apple River Chalet, Inc., a Wisconsin Corporation, PURCHASER, dated February 13, 1980, a copy of which is attached hereto and incor- porated herein by reference: 1. Interests conveyed under this land contract are as follows: a. to Robert J. Kunz and Mary C. Kunz, husband and wife as joint tenants, the real estate conveyed herein and the building located thereon. b. to Kunz's Apple River Chalet, Inc., the covenant not to compete, and the following personal property and fixtures: 40 foot bar and back bar, 2 keg taps, 2 drain boards, 8 foot cooler, 12 foot x 12 foot walk-in, 4 ring up cash register, refrigerator, 2 chest type freezers, 1 pop cooler, scale, meat slicer, window air conditioner, color television, 45 chairs, 6 booths, 18 bar stools, a 2 pizza ovens, ice cuber, 8 foot x 10 foot walk-in, coffee urns, tables, roof air condi- tioner, and all miscellaneous glasses, dishes, and utensils necessary for the operation of the business. 2. The purchase price shall be allocated as follows: a. Land $ 11100.00 b. Building $ 66,000.00 C. Personal Property and Fixtures $ 41,900.00 d. Covenant Not to Compete $ 11000.00 $110,000.00 3. PURCHASER agrees that all payments due and owing under this land contract, including the down payment, shall be paid to the First National Bank, 109 East Second Street, New Richmond, Wisconsin. Said payments to be applied to the outstanding mortgage dated May 19, 1978, recorded May 22, 1978, in Volume "575", page 345, as document no. 348752. 4. PURCHASER agrees there will be no assignment of this Contract during the duration of said Contract, without the written permission of the VENDOR. 5,. SELLER further agrees that for consideration received, they will not, either individually, as a shareholder or employee of a corporation, or as a member or employee of any partnership, engage in the business of owning or operating an on and/or off sale liquor establishment, nor shall they have any financial interest in such an establishment other than the one now being sold,within a radius of ten (10) miles from the location of said establishment, in the Town of Star Prairie, St. Croix County, Wisconsin, for a period of five (5) years from the date of this Contract. 6. SELLER to provide snowplowing for property conveyed at at reasonable rates for the 1979-1980 winter season.