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HomeMy WebLinkAbout040-1109-90-000 a rrco) o `0 o - 3 c d ~1 c ! 3 3 cD co a A~ m A ^ r: (n g 3 Z o Oo n 1 O• 7 d 3 3 f; N rt A d `BOG PO 90 p 0-4 C) 00 n~ C7 Q Z n 0 N O rti F1• rt t~] -4 c m =r A 0 CD (D N CL 7 O O m ~p 0 CD (D r d r{ W 7 3 o W c c7l P O O W Gi Ci 3 H = ° ~ o r• 0 F- 9V o m M (D m v (n CD D a cD ro y y a N o 2 0 00 C co c N O H H 3 t. o o j b Q. n W ~ m aoo OD n p c ~I n O N rn 0) co) !T a N a o O O 3 Y H rt p T .Q .Z1, rt CD O _C ~l D) ;L cr (D 90 d O m a H H v~ m d_ y o 0. o t.) X CD 0) ON 00 C3 3 N Z = d Ul CL O ~o r\'~ Z O hh Z co z N O I CD 0 H Cti 0 O D a oO rt m • U) p 10 ` CD X07 Qq ~ c N N (D N 1 W CD a rt 0. CD -q cn o O A Z n m n 3 N ONo 10 CL d OD Z O Cf) p 3 v ~ w w I a 3 o - I m c oz a I x I a. I b I ~ o• k-, N I °c v, A o m O4 b ~ cfl O ~ o~o o ~ ~ a Parcel 040-1109-90-000 12/21/2005 09:45 AM PAGE 1 OF 1 Alt. Parcel 28.28.19.4428 040 - TOWN OF TROY 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 MARIJANE(LE) TRUST CERNOHOUS CO - oDA O DIANEMARIJANE(LE) TRUST %DADO DIANE 354 INDIGO TR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 531 CTY RD MM SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 0.600 Plat: N/A-NOT AVAILABLE SEC 28 T28N R19W PT SW SW BEGIN SE COR Block/Condo Bldg: SW SW;TH NLY 30 FT TO HWY MM R/W; TH WLY 140 FT; TH NLY 185 FT;TH ELY 140 FT; TH Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) SLY 185 FT TO 30 FT N OF POB 28-28N-19W SW SW I Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1133/638 QC 07/23/1997 1133/637 QC 07/23/1997 742/386 07/23/1997 647/120 2005 SUMMARY Bill Fair Market Value: Assessed with: 102865 111,000 Valuations: Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.600 20,000 86,800 106,800 NO Totals for 2005: General Property 0.600 20,000 86,800 106,800 Woodland 0.000 0 0 Totals for 2004: General Property 0.600 20,000 86,800 106,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 313 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 040-1109-90-000 12/21/2005 08:41 AM PAGE 1 OF 1 Alt. Parcel 28.28.19.442B 040 - TOWN OF TROY 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 MARIJANE LE CERNOHOUS O - C ERNOHOUS, MARIJANE(LE) TRUST %DADO DIANE TRUST CJ C - /oDADO DIANE 354 INDIGO TR + ~Q RIVER FALLS WI 54022 I u Districts: SC =School S p\-'$- I Property Address(es): Primary Type Dist # Description " 531 CTY RD MM / SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 0.600 Plat: N/A-NOT AVAILABLE SEC 28 T28N R19W PT SW SW BEGIN SE COR Block/Condo Bldg: SW SW;TH NLY 30 FT TO HWY MM R/W; TH WLY 140 FT; TH NLY 185 FT;TH ELY 140 FT; TH Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) SLY 185 FT TO 30 FT N OF POB 28-28N-19W SW SW Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1133/638 QC 07/23/1997 1133/637 QC 07/23/1997 742/386 07/23/1997 647/120 2005 SUMMARY Bill Fair Market Value: Assessed with: 102865 111,000 Valuations: Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.600 20,000 86,800 106,800 NO Totals for 2005: General Property 0.600 20,000 86,800 106,800 Woodland 0.000 0 0 Totals for 2004: General Property 0.600 20,000 86,800 106,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 313 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 i Form- S T C - 104 ~ sR AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP r~ SEC. T _;~Z N-R W ADDRESS ST. CROIX COUNTY, WISCONSIN ~~~r JG t i r SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I•ZHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ©t. (11 / m 3a `,U /,ooU .simoo/ II D 71 6 3 9/ f i INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used hQ Elevation of vertical reference point: D Proposed slope at site: / SEPTIC TANK: Manufacturer: GJvFfCS Liquid Capacity: / n Number of rings used: D Tank manhole cover elevation: 99 of Tank Inlet Elevation: g/~ ,-Z Tank Outlet Elevation: Number of feet from nearest Road: Front,0 Side0 Rear, O ~75_ r feet From nearest property line Front 10 Side 10 Rear,O ? So feet Number of feet from: well > /j 0 building: i (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDR ~s - 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: V Trench: Width: /z Lenth: Number of Lines: 2 Area Built: Fill depth to top of pipe: 2 8 Number of feet from nearest property line: Front, O Side, O Rear,0 Ft. 8 Number of feet from well: > MoD Number of feet from building: y0, (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 8 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O..ROX 7,0969 BUREAU OF PLUMBING %NDISON, WI 53707 LCONVENTIONAL ❑ALTERNATIVE State Plan l.D.Number: El Holding Tank ❑ In-Ground Pressure ❑ Mound Ilt assigned) - A- ]z NAME OF PERMIT HOLDER: JADDRESS OF PERMIT HOLDER: INSPECTIO GATE: Marijane Cernohous Rt. 3, Box 48, River Falls, WI 54022 ,D-f BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.. S1/2 of the SW 1/4 of Section 28, T28N-R19W, Town of Troy Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: David Fogerty 3289 St. Croix 88402 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV. TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER v v v SS P OVI ED: PROVIDED: 7, / ES ❑NO ❑YES O BEDDING: VENT DIA.: VENT MAT L.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: IVENTTO FRESH ALARM'. LINE, AIR INLET : IFEET FR ❑YES NO ❑YES NO NEARESTOM 7S f ~_!~4) i DOSING CHAMBER: J~ MANUFACTURER'. 7INGLIQUID CAPACITYPUMP MODELJPUMP/SIPHON MANUFACTURER. WARNING LABELOCKING COVER PROVIDED: ROVIDEDYES ❑NO ❑YES ❑NO ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: /11- NUMBER OF PROPERTY WELL BUILDING'. JVENT TO FRESH (DIFFERENCE BETWEEN V FEET FROM uNE AIR INLET. PUMP ON AND OFF) ❑YES ❑N ' VVV( 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 J INSIDE DIA. #PITS LIQUID BED/TRENCH TRENCHES 1~ M ERIAL: PIT DEPTH DIMENSIONS / 2 /-1 I V 1 GRAVEL DEPTH FILL DEPTH DISTR. PIPF DISTR. PIPE DISTR. PIPE MATERIAL: NO. D R. NUMBER OF PROPERTY WELL BUILDING. VENT TO FRESH BELOW PIP 1 t ABOVE COVER: ELEV. INLET ELEV. END'. PIPES FEET FROM LINE: AI RINLET Z j 7 2- 7 29 a2 NEAREST► V 20V U q 0 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- ❑YES ❑NO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEXTURE PERMANENT MARKERS JOBSERVATION WELLS DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED ❑ YES ❑ NO ❑YES ❑NO CENTER DEPTH OF TOPSOIL. SODDED SEEDED MULCHED. E OGES ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH TRENCHES: 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 ELEVATION AND ELEV.. ELEV.: DIA.. ELEV.: PIPES DA: DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS. ❑YES ❑NO ❑YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING FEET FROM LINE: ( ❑YES ❑NO ❑YES ❑N( NEAREST D o . 05 40 10 Sketch System on Reta0in au tty file for audit. Reverse Side. SIGNATURE: TITLE. DILHR SBD 6710 (R. 01/82) DILHR SANITARY PERMIT APPLICATION COU T C I H In accord with ILHR 83.05, Wis. Adm. Code STAT S ITARY PERMIT # l~"A10 Z -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 ❑ NO PROPERTY OWNER PROPERTY LOCATION L446 I~ cmw,"2 5 I-- J. S T , N, R E (o PROP T OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME CITY, STATE ZIP CODE PHONE NUMBER CITY NEAREST ROAD, LAKE OR LANDMARK F-I VILLAGE : 77 L, 6. I-A /&r vz- ) 9006 EY"TOWN OR 64/ 11. TYPE OF BUILDING OR USE SERVED: , C'~0"/l Number of Bedrooms if 1 or 2 Family OR/40416- R ❑ Public (Specify): III. PURPOSE OF APPLICATION: (Check only one in #1. Check # 2,3 or 4, if applicable) 1. a. 1:1 New b. U 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 morethan 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. L~Conventional b. ❑ Alternative C. ❑ Experimental 2. a. ❑ System- b. ❑ Holding C. ❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound I. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. R See a e Bed b. ❑ Seepage Trench c. E1 See a e 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): t .1 Feet Private EP'J'oint ❑ Public VI. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank VW I El" / ❑ ❑ 1-1 ❑ ❑ Lift Pump Tank/Si hon Chamber 7_1 _ ❑ ❑ El ❑ 1:1 VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name (Print): Plumber' nature: (No Stamps) 4AWMPRSW No.: Business Phone Number: 404 Plum ber's Add s (St et, City, State, Zip Code): Name of D er: 71 10. SOIL TE INFORMATION ertified Soi ~terSTName C CST # Z CST's ADDRESS (S et, i , State, Zip Code) Phone Number: 7 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved S itary Permit Fee Groundwater Date issuing Agent Signature (N Stamps) Approved ❑ Owner Given Initial / S charge Fee n Adverse Determination ! 40 pC~ U -(?-?6 X. COMMENTS/REASONS FOR DISAPPROVAL: _!V-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT" APPLICATION 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,! the permit issuing authority. A new permit maybe needed if there is a change in your building plans, system' location, estimated wastewater flow (nu'mbe'r 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 instakation; 5. Private, sewage systems must be properly maintained. The septic tank(s)•should be primped by a licensed pumper whenever neebssary, -usually-every 2 to 3::.years; 6. If you have questions concerning your private sewag4 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; 11. Type of building or use served: If public ; 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; 111. 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 talks; 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, 1964, 1983, Wisconsin Act 410 was signed into law. This legislation is more !t- ' commonly known as the groundwater protection law. This change in statutes was the result of ever2'years of steady negotiation and public debate. The groundwater bill '-,Grbund)vat6r included the creation of surcharges (fees) for a number of regulated practices which Wiscor, ln,S can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried Measure 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. The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Departry)'ent of Natural Resources. These funds are used for monitoring ground- t grater, groundwater contamination investigations and establishment of standards. Groundwater, - iCs worth protecting. SBD-6398 (R.03/86) I • APPLICATION FOR SANITARY PERMIT i 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 2 i N ~&pfid a 5 Location of PropertySection , T N-R W 69, _77-f -73L -S e Township y N • W, /.Ll c rry~ A I 'T ;-7, 0,/V 14 W. Mailing Address fit 18 o x it $ -1 V jt~- P A l c. 5 W o -p- ,Z Address of Site - R 13 o v 7 f ~\Vgt2 ~~4~1-5 1.U t• S..o Subdivision Name Lot Number Previous Owner of Property j 7' 1,"!F Total Size of Parcel p Date Parcel was Created ly 3 S 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 I (we) eeAti.6y that att statements on this 6ohm ace tAue to the bust o6 my (oun) knowledge; that I (we) am (ane) the owne&[6) o6 the ptopehty deg cA bed in thin in6mmatl on 6onm, by vil tue o6 a waiAanty deed %econded in the 066 ice o6 the County Registen ob Deeddas Document NoX /oj 00 ; and that I (We) pnesent'vy own the pupozed ~6 to Son the sewage du os_ z yz em (oh I (we) have obtained an easement, to nun with the above desn bed pnopehty, bon the eon6t ucti,on o6 said zyetem, and the dame has been dut necmded in the 046ice o6 the County RegisteA o6 Deeds, as Document No, 2 ) • IJa , e eJ 91-r,91941 SIGNAT OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED ST. CR.OIX CO., WIC, BOa{ - -54PAGE420 R-#,c'd. for Record this 4th '417286 ~w',~Y O Sept-A.D. 1986 N16 EASEMENT AGREEMENT t 8' 10 A y t 1 lev d D®®d~ THIS AGREEMENT , made and entered in this day 2 of September, 1986, by and between Charles F. Pearson and Donna 3 Pearson, hereinafter referred to as the Pearsons, and Maryjane 4 Cernohous, hereinafter referred to as Cernohous. 5 RECITALS 6 1)The Pearsons are the current title fee holders of 7 property adjacent to that owned by Cernohous. 8 2) The septic system on the property owned by Cernohou 9 is defective, and has to be replaced , with the only possible 10 location being on the adjacent Pearson real estate. 11 12 NOW, THEREFORE, in consideration of the mutual 13 covenants hereinafter set forth, and other good and valuable 14 consideration, the receipt and sufficiency whereof are hereby 15 acknowledged, it is hereby mutually agreed as follows: 16 1) The Pearsons hereby grant to Cernohous the right to 17 enter upon the hereinafter described land of the undersigned, 18 and to place, construct, operate, repair, maintain, relocate 19 and replace thereon a septic system which meets with the 20 approval of the appropriate governmental agencies of St.Croix 21 County, Wisconsin. 22 It is agreed by the parties herein that the easeme t 23 granted herein shall be perpetual in nature, and shall cover 24 the property described as follows: Part of the ,S12 of the SW$ of Section 28,Township 25 28,Range 19,described as follows:Beginning at a point 1,320 feet West of the South quarter corner of Section 28; thence in a due Northerly direction 30 feet to a point on the road right-of-way of County Trunk 'MM'; RODLI, BESKAR thence in a due Westerly direction 140 feet; thence in a & BOLES, S.C. Northerly direction 185 feet; thence in an Easterly Attorneys at Law 219 North Main Street River Falls, Wisconsin 54022 Bath( f 54PAGE 421 direction 140 feet,which is the point of beginning; + thence in a Northerly direction 20 feet; thence in a due Westerly direction 30 feet; thence in a due Southerly direction 20 feet; thence East 30 feet to the point of 1 beginning. Town of Troy, St. Croix County, Wisconsin. 2 3 IN WITNESS WHEREOF, We have hereunto set our hands and 4 seals on the day and year first above written. s a 45~ 7 Charles F. Pearson 9 Donna Pearson 10 C' 11 Marij a Cernohous 12 Iths ribed and sworn to before me 13 day of tember, 1986. 14 15o, A Beskar, Notary Public ,..State Sof. Wisconsin 1 „ AUI Lammission is Permanent • ern . 171, 18 19 20 21 22 23 24 25 This document drafted by: Leo A. Beskar, Attorney RODLI, BESKAR Rodli, Beskar & Boles, S.C. & BOLES, S.C. 219 North Main St. Attorneys at Law River Falls, WI 54022 219 North Main Street. River Falls, Wisconsin 54022 -2- H z cn _ H 9 STC - 105 r t r a SEPTIC TANK MAINTENANCE AGREEMENT H St. Croix County z d y~ 9 OWNER/BUYERM R^I c a NE ~11= R IV D #0 ROUTE/BOX NUMBER o-~c Fire Number3033 .CITY/STATE ZIP ~R' ?.l Ill • W . 'l r cry (,'Tx^~4. a 8) c ( 4 w PROPERTY LO ATION:5-1~, lL/a,✓ 14, Section IC T _N, R W, Town of , 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 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 E I/WE, the undersigned, have read the above requirements and agree En to maintain the private sewage disposal system in accordance with x the standards set forth, herein, as set by the Wisconsin Depart- d 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. a ~ SIGNED cy D ATE 5.s 7{G St. Croix County Zoning Office P.O. Box ga, Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND CC P.O. BOX 7969 HUMAN RELATIONS PERCOLATION TESTS (~1J) MADISON, WI 53707 (H63.09(1) & Chapter 1.45.045) LOCATION: SECTION: TOWNSHIP LOT NO.: BLK. NO.: SUBDIVISION NAME: 1/441/ .2 /T.7y H/R E (o Irv COUNTY: OW ER'S/BUYER'S NAME: MA ING ADDRESS: S~ "vy of USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: ER OLATION TESTS: I LJ Residence ❑ New Replace RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM:(optional) 13S ❑U [aS S DU CCU EDS ❑U r If Percolation Tests are NOT re uired DESIGN RATE: Q I If any portion of the tested area is in the under s.H63.09(5)(b), indicate: _ !i Floodplain, indicate Floodplain elevation: 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- B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD I PERIOD 2 PERIOD 3 PER INCH 7 L P- I Z -3 P- P- P-_ G 3 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 ~s Z d , k } E j , E f~ M M • y } } AN f I i , l E 3 e i i } 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 +ministrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. (print): TESTS WERE COMPLETED ON: P CERTIFICATION NUMBER: PHONE NUMBER (optionalF: 2 -z 3 3 s< CST SIGNATURE: %.AJ L Original and one copy to Local Authority, Property Owner and Soil Tester. i (R. 02/82) - OVER - r-- a ~ IPLET" "r-' cnra 115 - S BD - T r THE I ~ f %~1.• f t~ 1 ~ 1 ~i~- ~ I, i r ~ <yl ~ E ~ ~ I 'max \ tti Y M1 1 h ~ ~ C ~ ~ i i d r ~ ~ ~ ~ .y` w ~ + ` r ,~I .rl t ~'r, j l ' r i ~e~.._- I ~,z_m, I I y ! I , S ~ i ~ N\ 7 m n s M \ a ti r ~ o ,n St £ v s j 3 4 i h 40 i S o ~ n\- /t -Ai 31 s v ~ I -o o I s o ~ ~ n N~