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010-1089-50-150
0 f 3 m o d ~1 o CD N m A7 (D eD 3 ~ ~ 1 0 m o v to 0 ° to c m rn o • D o CD o w m o 9 *4 N C m^ Z d` y Cn CD O n~ lA\ CD co 00 N CD fy to CA ' a O co 0 co (A r~O 1 C> 0 C7 CD CJl C CD ~ 0 j 3 O ~ 7 p! O N O O 0 ~1 '~1a'' C/1 G] Cri N CCD N lY CD CD Cal CL (D O L=J c CD N IW CD 0 a! I~ QQ i Z O V v! rt= w o ODco co OD~ c~rcn rr y cn Cn o a r Q H $ H o 0 0 0• ca c N W N~; o D o ar M v v r j 7 CD CD N' W r o tr 00 sv tD co ~►1 GJ I N CD O II-~ a w " co 00 W Z N c N 07 D D o to' O o' CD m 00 m • ~ O W trJ m 77 O V"\ z~ I a 3 v z CD CA C 0 0) A f5 N t r P3 o W m w rn O (D 0 c 3 ~ ~ c m rn yZ CD I w 0 D CD a 0 d C v T CD _ c Z C a (n 0 m a p n x 0) A v 0 ~ C I I „t°v o 0 a 0 A CD A C++ a'C9 a O O CD 0- Parcel 010-1089-50-150 10/02/2006 03:57 PM PAGE 1 OF 1 Alt. Parcel 36.30.16.541 B-10 010 - TOWN OF EMERALD 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 BRIAN A & MARLENE J HURTGEN O - HURTGEN, BRIAN A & MARLENE J 1242 CTY RD D GLENWOOD CITY WI 54013 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 1242 CTY RD D SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 7.410 Plat: 3639-CSM 13/3639 SEC 36 T30N R16W PT NE SE BEING LOT 1 Block/Condo Bldg: LOT 1 CSM 13/3639 7.411AC FKA 010-1089-50(5416 & INC COM SE COR SD CSM; TH N 83'W Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 417.59FT TO POB; TH COM N 83'W 36-30N-16W NE SE 367.53FT;TH S 00 DEG W 25.91 FT; TH S 88' E 366.16FT TO POB (0.019AC) Notes: Parcel History: Date Doc # Vol/Page Type 10/24/2000 632337 1553/227 WD 10/24/2000 632334 1553/221 WD 07/23/1997 429/76 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/19/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 7.410 35,000 66,400 101,400 NO Totals for 2006: General Property 7.410 35,000 66,400 101,400 Woodland 0.000 0 0 Totals for 2005: General Property 7.410 35,000 66,400 101,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 12/04/1998 Batch 546 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 EMERALD T30N7R.16 W 47 S O SEE PAGE 59 S SEE PAGf 6o 7 C So m .Posse// E y 0 h'enderson • or/¢ ~e O f E/ic k~son u~i Gi//en cTa.nes tti!Cio e.s;~~{' Zi ~a /Nebsf z, eiux ~ y y /z/ vy /°s. efux C u F • Ql~ 3 2 K'/LLOW ~Cy y v z 1 4 3 z 1 ~y\ Z67 Pat .c 4 3 \ •z ttl~ i YZ10 /°adde •Hendcrson Lo ~eF z4.8 Ke/-..~atfi 0 y J 4 3 7s {Erickson v Cji//en eSa/mon ~ 0 Q /~9a~a/'ef N!e¢ffl '~'TJ 4 -s G C s s e n s az 7 a s N a 39/ R •~Cj~p F Why .2.79 ~0 Kevin e, b l 7 g ~r E a o F~ /P 6.1 tl 9 /s46 W.//et>< 'w~ ~9 l l ~5'h.i-/eyy \ F%%a~ W •a'Da /ena b0 X\ W~iScinei- z7z ock Names IJen~/s Q l ~.i+v "'Aa - Frans l~ Ci a ~Doros tl f7do/Ph K /s to £cNama a 0 e1e~•sen % 0 a'VO \ 0 0 4-0.7 Bo M N~ oa ce tl 3 ~ rends ~ ~ '0 ~ 0 • • \ /2 = eU /Q~ftl /6° /6o Q ] 0 00\~ /TO M 0.~ - CTRmes•f • 3G.7 • • • , Q. h Ca /<T A ci/ •-/Q W • Vahn c5 \ d 3 f Neal'-7' She!-m°n q Kah/ C C Louisa p0~ J V k E U ccn Mc/6 friary F 70 .C \`w^ W 3niak 'y J d p b~ /2o Kah/e Merwin i AVE. .Y 3 Kakh°efer /.Q ~g 79 j ~Q) a ~ ~ U 40 ~l¢ L • /9B zoo Kczhr • tl.~~ y tl n U x V(~~x C V • / N/c C7ee Deb~2 J /sa ON 9 ° \ w Uw~° P ~Q/~P U/eC/f \ w n ('f V UFn ~ /e z47 /GO 17av/d F • d~ o /moo I ~.eo~n.e `l` Lawrie R cn/°s Dennns -D "/d S C'ie:ne.-f ~ 0 uarn er g f.3 ie •~Tamas b ~ Ba . Q 4a G/en Si' Dor.cS cSfe: c% f Do.~a/d m.. ' , 0 efz1J E/anon, ~r irohn o ° f Sharon crcnd s 8o zss (f~~` /tee. JJorofhy °p .e ~ De MQr 72.3/ 7P 4B afu 0 of ~ ~M /3az fie W /55 •ji/e /ss~ /56 ~ ah~ .Cl2nes 4Janet ~ 60TH so 9 • Bo N/oNamar ,ye 7z~4- /No/a Kenn t/i I>. < 'C D¢ Q' 1 Gt! r - -AVE. .V . et¢/ 7 ,Tu/.e C ~ w l Norman Ci. f fJ n/B •KtH *o 0 sP ee.-s o~ 0 u tlO fray cSfeine/-J` /A.. /a. //9 /bo i6o Va Layterman f S'u.san /GO l oy~e. Fran.E K/aft oTy A' fu~c z sys K/ati 2 ~w pJ y~ Yan- zoo G~ 188 .0 J O Rans wa/te/- • h ~ l Th macs /yJau ice F Ems/.a W tl ~ :4 0 -fo sse//iLcs ~ . Q \ 0 Ma/ ney /7¢ awe//¢ % u b C 0 W ~vdm /zo jj \~00 ~CCx //e..e 290 V~ DuoneHi// zs P :nse \ v M E R Q a Q 3~ l //442 > 5~ a o" O ~°jq Ed va d M G c 7Ys /Na/sh % 1/.ew Timothy W (V • ' • .S ° , 7Z 7/ /.35 • HcrG , l ic. ¢ !tea/Brla U' 5oc%e es V ° K • • • 80 • 79 y ~1't, 40 P711 yenned _ G C D ,P /h M y•~ aeo ve\ o 0 rJ-uri'ow 8o Y F ~.oMlu'y tl\ C C/e¢r VeW .B W tl tl e~n.s Lo teNma/7 tn~~~ m y Aeres 4La.Ubh.>e W ci C ^ , y zoo la 80 Inc. d V Larson . h a ~7 el e ,gc//ows W 0 fill dy 400 h C l ° M 35 2L eJnfsch Wr Da--d E J'// 4 l~ Wef / ¢L Cl yl N Wa ~tl q 8O B° O Bo 4o Fe•d/-fck.~ C~`~OW or,a/d F, u tl t ~ EoLv f Aso 21?. ~nj Q .9o.~f ~v eae M/e.s ~7 C/ear cSchn:t3/er tl. j\ • 'y~ 4 av a/sh Kennedy ® Vew Acres, l C b \ 145 oy F arv o 140TH 40 80 2B0 Snc. /60 0 vC V y a en f S- ass- ~th mh•n • • ~ . Q~1 e/ e/h e/% O ann E~w- • i4"O q X379 /oo D f iTOmes r go %l Y.J R~G//ol'dj /ed •AVE. anti Marf~ Jhne// ~ w\V a Eo a. Onann M.k/ ~o U .~y _C\,p .C ~ Pofricf.7/e_a Obe~h e 177 /bo ~Eene wai h C a ~mo y d V ~7 Fecy 4 mar aei/ /6a zao \J~l Rr. Ur ~tl`E N o A aF a~~ Bruce E • \ 12 4 0 41 VI •8 cU `Q~ y'°~, 1s9s N Nadeauay aayy /zo N27cy (SPao • 0 u2Yi%e L Widen t' //e/ \ tl a p D y ~Q~,s P 79ZS 0 /32 X9 /zo wF ~ yy Franc/s F Jyce h'Eny (J)oanne E• .eeuben Oa e°, s •/ber 17anfe w 4 C tl~ Per :Y a% Hortgeo Forces. ls 2, rcon V tl oi% s • ..Ye ~ fToJc ce °v v 0 tl 3 o C 0 3 0 ~ ar /¢o .c37/ TH Bo Q~ yo Mi/,~ei'~ of v~ ~ 3 caz/ U ~i s~ L 2/5 ~ n . o'C A tcc • ' v f~W ZW, Nao'eau asp ~'C tl \ /%:~e Cli. 2~ • • AVE 40 l C~ \ do fWa.// i C W. o~ C • • <TQmas f W.°T Nom. ntl~~ ~.cv ' Thomas Coro/e o zo 9~ u o y p 0 h eG R 4a p 6 r dy d Meye /io 0 DO ¢/d e or s Genes 0 w, l 3 Th o WRY 5`O V G D / J 9 ne ~V nk U F Edwin, meson f 20 h y zoo ~`Y tle /eo 60- Keane ~'ar3 //o Co// :s tl KEVin as v w,/i a /92. B oii s . x Qw $ a 3 0 /ao sets s x °vzOrup v a Cam q~ ~y~ Posand¢/ Mor on c / ffen Y`a u ~ (U n V~ 0 /zo 0 tl 20 0~ ~ •f Susan d n \ 0 S u o Ed Qa d bona/ /bo y Ed u ~ o .5 ~ V1Q ~ _ _ d2 f3/-.a.~ £ f D ckm¢rr IMar/ene V~ De<7on9 y 0 `0 //sen_ ~U~ h'l cSi~~~~ \I Moron £PV°//a 1/1 N ndah R F Clrro/ d et x 'N .tye~ DD ' .s 4° f2•~ - cSabo/ l 'yOP~ s, zoo a cp eta/ /so /eo ©/9&s/?o /-d a/o P b/sue r c . _ SEE PAG • Y3 c51t Croix Countyw.ts. 12N WOLLACK POLLED HURTGEN TRUCKING, HEREFORD FARM INC. Ed & Donna Wollack and Family Route 1 - P.O. Box 73 (715) 265-4966 Woodville, Wisconsin yh • ~r 4-H Route 1, Box 253 (715) 698-2001 a famfl affair Glenwood City, Wisconsin 54013 Registered Polled Herefords Y Breeding Stock For Sale Springfield Section 17 • Form S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER :1R-1'('-f1? W1,1,-1qC12 TOWNSHIP SEC. T 30 N-R ICS W ADDRESS {~'f f ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of 11HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM F lice .a YO, ;✓C GJC3 y 7: e l y /n~ an ~rc Zy _ INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used 1 0 e Elevation of vertical reference point: /00 °O '^`~e we Proposed slope at site: SEPTIC TANK: Manufacturer: Li id Capacity: Number of rings used: Tan a hol /c ver elevation: Tank Inlet Elevation: Tai tle vation: Number of feet from nearest Road. on ,O Side o Rear, O feet From nearest property line Front,O Side10 Rear, 0 feet Number of feet from: well , building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Si n nu turer: Pump Size Elevation of inlet: Ott o tank elevation: Pump off switch elevation: Ga ions per cycle: Alarm Manufacturer: Al rm 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: Trench Width: Lengt u ber of Lines: Area Built: Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, O Rear, 0It. Number of feet from well: Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Number o pits. Diameter: Liquid depth: of o of a age 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: lees 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, ~Ft.17LO Number of feet from well: d / Number of feet from building: ~O i Number of feet from nearest road: 0 Alarm Manufacturer : Inspector: Plumber on job: =0Q re Dated: License Number: 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR LABOR & HUMAN RELATIONS P.O. BOX 7969 PRIVATE SEWAGE SYSTEMS SAFETY & BUILDINGS MADISON, WI 53707 DIVISION BUREAU OF PLUMBING ❑CONVENTIONAL XX ALTERNATIVE ~ State Plan LD. Number: IU Holding Tank ❑ In-Ground Pressure ❑ Mound (If.-fined) 8503629 NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: Brian Hurtgen R. R. 1 NSPECTION DATE BENCH MARK (Perman ent reference point) DESCRIBE IF DIFFERENT FROM PLAN, , Glenwood City, WI 54013 U ~d NE SE, Section 36, T30N-R16W, Town of Emerald REF. PT. ELEV.:: CST REF II ELEV Name of Plumber. MP/MPRSW No.. Cou my Dale E. Hudon Sanitary Permit Number: 6629 St. Croix 69634 SEPTIC TANK/HOLDING TANK: MANUFACTUR ER. jJ LID ID CAPACITY TANK INLE~LEV. TANK OUTLET ELEV WARNING LABEL 6•'" I~ / LOCKING COVER 9(j t" PROVIDEDPROVIDEDBEDDINGVENT MAT[ WAER / ?YES ❑NO ALARM NUMBER OF RogD: PROPERrv YES ❑NO ❑YES ❑NO FEET FROM WELL BUILDING JVENTTOFRESH LINE, ❑YES ❑NO NEAREST AIR INLET. DOSING CHAMBER: MANUFACTURER BEDDING. LIQUID CAPAC17y PUMP MODEL PUMP; SIPHON MA NUF AC 7UREH WARNING LABEL LOCKING COVER YES ❑NO PROVIDED PROVIDED: GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL ❑ YES ❑ NO ❑ YES (DIFFERENCE BETWEEN NUMBER OF t'HOPEHTV WELL ❑NO PUMP ON AND OFF) LINE BUILOING I VENT TO FRESH FEET FROM AIR INLET: SOIL ABSORPTION SYSTEM. Check the soil moisture at th ❑eYdepthES of plowin❑ NO NEAREST or excavation. (If soil can be rolled into a wire, construction shall cease unt the soil i il FORCE ulnnaE rLlt ntgTFHInL AND MARKIN s dry enough to continue.) MAIN CONVENTIONAL SYSTEM: BED/TRENCH WIDTH LENGTH No OF UISTH PIPE SPA(;INC; COVER DIMENSIONS HeNCHES MATERIAL. NsIUL Dln .PITS IT LIQUID '~N d EL DEPT Ii DEPTH. BELOW PIPES FILL DEPTH LIST It . PIPF UISTH PIPE DISTR PIPE MATERIAL ABOVE COVER Et EV INLE r E L E V LNU NO DISTR NUMBER OF PROPERTY PIPES WELL BUILDING: VENT TO FRESH FEET FROM LINE AIR INLET: MOUND SYSTEM: -N - EAR EST-----j,_ - Mound site plowed perpendicular to slope and furrows thrown upslope: Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM 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 PEHMANI NI MAHKE HS OBSERVATION WE LL S DEPTH OVER TRENCH BED DEPTH OVER TRENCH HEU ❑YES ❑NO ❑YES CENTER EDGES DEPTH OF70PSQIL SODDED ED ❑NO SEEDED MULCH PRESSURIZED DISTRIBUTION SYSTEM: ❑YES. ❑NO ❑YES ENO ❑YES ❑NO BED/TRENCH WIDTH LENGTH NO OF LATEHAL SPACING GHAVEL DEPTH HE LOW PIPE DIMENSIONS TRENCHES FILL DEPTH ABOVE COVER MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL NO UISTH DISTR. PIPE ELEVATION AND ELEV ELEV DIA ELEv DISTRIBUTION PIPE MATERIAL & MARKING PIPES DIA DISTRIBUTION INFORMATION HOLE SIZE HOLESPACwG DRILLED COHRECT Lv COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED ❑ YES PLANS COMMENTS: PERMANENT MARKERS: ❑ OBSERVATION ❑YES ❑NO OBSERVATION WELLS NUMBER OF PROPERTY WELL: BUILDING: ❑YES ❑NO FEET FROM LINE: ❑YES ❑NO NEAREST Sketch System on Reverse Side. In in county file for audit. SIGNAT ]TTIFT LE: r )ILHR SBD 6710 (R. 01/82) MMMMMMIN V, Lumcoriv APPLICATION FOR SANITARY PERMIT DILHR (PLB 67) COUNTY oePRATynEnT Of 7~ 1nousTRyLR8OPr.HUM7 04ELAT1on4 UNIFORM SANITARY PERMIT -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'hx 11 inches in size. • -See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNER MAILING ADDRESS R r ; Q _ey" PROPERTY LOCATION , 1/45 1/4. S TEWN, R /Z I (or W TOWN OF LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAF T F#OAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER ;1 . try TYPE OF BUILDING OR USE SERVED 1 or 2 Family Number of Bedrooms: -3 ❑ Public (Specify): THIS PERMIT IS FOR A: X New System ❑ Tank Replacement ❑ Repair Replacement Soil Absorption System ❑ Revision ❑ Privy El Alternate System El Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. Seepage Bed ❑ Seepage Trench ❑ Seepage Pit Holding Tank System-In-Fill ❑ In-Ground Pressure ❑ Vdlllt 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 So)-Conditions. Total" of Prefab. Site Gallons Tanks Concrete Constructed Steel Fiberglass Plastic 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 Pr ab. Site Gallons Tanks C Crete Constructed Steel Fiberglass Plastic Septic Tank Capacity L Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): '411f AIX 11114 ; 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): Signaturw,") MP/MPRSW No.: Phone Number: 141 Plumber's Address: Name of Designer: COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent. Fee: Date: r ( ❑ Disapproved • g~ 3 - S ❑ Owner Given Initial 6 J Approved Adverse Determination Reason for Disapproval: Alternate course(s) of Action Available: DIL.HR-SBD-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber , w ,.W,.._ ~.w..w _ { E i Q ~ I 4 t , DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (1151 P.O. BOX 7969 HUMAN RELATIONS MADISON, WI 53707 (H63.0911) & Chapter 145.045), LOCATION- SECTION:: TOWNSHIP/M.WNIGI.~orCtTY' OT NO.: BLK. NO.: SUBDIVISION NAME: TYiC~H~~I~ (or COUNTY: OWNER'S BUYER'S NAME: MAIL[ G ADDRESS: USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMER IAL DESCRIPTION: Ip~ P LED S~ELATION TESTS: Residence / lq~NewReplace I , RATING: S= Site suitable for system U= Site unsuitable for system ONVENTIONA MOUND: IN-GROUNIf-PRESSURE: S STEM-IN-11LLHOLDING TANK: RECOMMENDED SYSTEM: (optional) CIS 2u DsM ❑SCU QS BU ~S(]u If Percolation Tests are NOT required DESIGN RATE: FFloodplain, an y portion of the tested area is in the under s,H63.09(5)1b), indicate:Aq indicate Floodplain elevation: A/ PROFILE DESCRIPTIONS BORING TOTA ELEVATION D PTH TO ROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKN SS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH tom, OBSERVED EST. HI HE T TO BEDROCK IF OBSERVED'ISEE ABBRV. ON BACK.) R- 711120t, of D G' 4)eI' Hof of B-2 X.Tal - T /+7~ B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. p RI p t PE IOD 2 PETTOZ7 PER INCH P_ P- P P 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 elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION E g j i t . , , $ i TN .....E . t , E t 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 Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): /n L CST SIGH URf: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) OVER - ~r E a ,4 f F c0 i w J IWO ' r, c~ ~ C 1 ~ ~ { ST. CROIX COUNTY a WISCONSIN ZONING OFFICE t...x 1 796-2239 (HAMMOND) ;i 425-8363 (RIVER FALLS) HAMMOND, WI 54015 June 24, 1985 Division of Safety and Building Bureau of Plumbing P. 0. Box 7969 Madison, WI 53707 Dear Sirs: The St. Croix County Board of Adjustment granted approval of a special exception use, Holding Tank, for Brian Hurtgen on May 28, 1985. An on site investigation has been done verifying the soils were suitable to a depth of 14 inches. This site should be suitable for a holding tank. Should you have any question regarding this subject, please feel free to contact this office. Sincerely, Thomas C. Nelson Assistant Zoning Administrator mj ID DILHR PLAN APPROVAL BSafety an Buildings ureau ofPlumbing Division ° m P.O Box 7%9 General Plumbing Plans Madison, WI 53707 . Private Sewage Plans Telephone: (608)266-3815 OFFICE USE ONLY Plan Identification Na. 13 "S ~i•~A-..- _ _.~_m.... Callons Per Dav 3 ; r - PRIORITY PLAN REVIEW ONLY Plan Review Petition For Modification Project Name Project Location - Street No. or Legal Description .1 lViC4 F-- Y c<7f-, t? (~n ,3 n , , N",/ xv County ❑ City ❑ Village Town of: J -~Z,20 " 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. ❑ FOR GENERAL PLUMBING PLANS: This approval will expire two years from the date approved below. If construction has not commenced before the expiration date, new plan approval must be obtained. FOR PRIVATE SEWAGE PLANS: J ` This approval will expire two years fro to approved below or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. Comments: By: James Sargent Bureau Director If Questions Plans Approved By: _ Date p oved Contact 11.1 7 cc: OWS El DPS El H&R & Rec. San. Section 3~1 ❑ Local PI ❑ Facilities Need Analysis Section ❑ UW-SSWMP ❑ Plumber ❑ Department of Agriculture DILHR-SBD-6099 (R. 01/84) ❑ Owner ❑ Other i N i is Q0` 1 ~ 1 R _ c ) ao w ~a n. .l rill. t Rol m r A a. m D a tp1 0 ~ l a► r c+ \ 4 cl*f O . G_ > C4 o Ao t ~ C s. a 10 x - i F L C ° ` G O O z av Ld VILA S r- _ -1 O r 15 d . 11 P N L n a~ ro L r ~ Z m a yam, VA ~d~ vv X W 0 Ns SID rn 00 CC) -n Q n owl m p o= E in .v A -i o cm cm r y '4, s r, m c+ r~ Z amp L ro vO cp o20 o~ Z nC ~u 0r.~ in v r > in p D A N q 1 0 1°~ O O r wX [ mx rp~ c m m n oV c p A oo u ? o t o in '3 < C in -i to ' 3~Vd Zo 4 Uf E ~w; -40 w rt m m r r% D a L n ' c-4 3 .4 0~ O o A A cr ~ Z -A r L ~u 'd - -4 n i Z N PO to 3 3 p F; t n roZ e ,p b t Z t JU r~ 0 C 0 030 d LIP (A 0 ~Cl z z~ p r+ 4L r ~D v~ C V 31 mtZ d t 0 FE =Nfu lk I < W Z 171 cZi~ -~o z~ n P 117 A0 < -O-Ni ~r~J CD m M fop - .n G, v pO p O0 Ap Z C M v w< rr P P U "b ,q Z ,o y U ]y r C C) rn 00 m r "o rD b-.t P. Arch p-i t ~.p 0 1 ZM0 y, C D u OLD a t+ in 0 p ~L p19 1 v2 -n Li pmQ p to f" y _ ` -i Er yo tr d r &C C M 1 i ~1 yy ' u a 1 o< A tI-V k o nso o 0 3 Z ' O z r 3-)Vj (A s. AGREETWE1\- T This agreement, made and entered on this J~ day of i-tuaf 19 ff5, by and between the Township of P ddress VEEREA S: F n' application has been made for a sanitation system on the following described property: VwERREAS: Septic tank drainage does not meet the minimum standards of the ordinance of St. Croix County and state codes. I&EEREAS: The owner agrees to install a holding tank for septic tank. purposes purpoges. NCV. ,THEREFORE: For and in consideration of the issuance by the Town- ship of t .l'Y tAlr~ of a permit for the above premises, the parties do hereby agree and bind themselves as follows: .1. Owner agrees that they will conform to all the rules and regulations pertaining to a holding tank system. They agree that anytime said township deems it necessary to pump out said tank, the owners shall have same pumped out in 24 hours, or township will have said work doneand charged to owners and place same on their tax bill as a special charge. 2. The Township reserves the right to assess a bond if they desire to cover any possible pumping charge in the sum of $ IT IS UNDERSTOOD that this agreement shall be binding on the owners, their heirs and assigns. IN Vi ITNESS WEEREOF, the parties have hereunto set their hands and seals the day and year first above written. Township of Y Developer 850,3629 or owner zl"s /-r STATE OF VJSCONSIN) ` COUNTY CF ST. CROX) SS: Subscribed and sworn to before me this. /f.;,, day of T' Croix County RECEIVED _ aUN 2 6 1985 PLUMBING BUREAU AGREEIViENT This agreement, made and entered on this day of cT r?e 1 9,95, by and between the Township of Address s VIZREAS: Sn'application has been made for a sanitation system on the e following described property: V~EEREAS; Septic tank drainage does not meet the minimum standards of the ordinance of St. Croix County and state codes. lU EFEAS The owner agrees to install a holding tank for septic tank purposes purpog es NCL;' TRBREFQRE For and in consideration of the issuance by the Town- ship of of a permit for the above premises, the parties do hereby agree and birnd themselves as follows: .1. Owner agrees that they will conform to all the rules and regulations pertaining to a holding tank system. They agree that anytime said township deems it necessary to pump out said tank, the owners shall have same pumped out in 24 hours, or township will have said work doneand charged to owners and place same on their tax bill as a special charge, 2. The Township reserves the right to assess a bond if they desire to cover any possible pumping charge in the sum of $ IT IS UNDERSTOOD that this agreement shall be binding on the owners, their heirs and assigns. IN V IT'NESS WEEREQF, the parties have hereunto set their hands and seals the day and year first above written. Township of & ~'k 8 5 0 3 6 2 9 by , .o ~l c.~ RECEIVED Developer w , r owner , I I l~ 2 6 1985 STATE OF' WISCONSINJ` PLUMBING BUREAU SS: CpUNTY OF ST. CRS) Subscribed and sworn to befgre me this day of 1.r. -Y-- ct. Croix County' p 0 ST. ClOl X COUNTY W I SC Q N S 1 N q,tiiir'!tl ~I Z g N 1 N G OFF I CE 796-2239 Pao t 0 666-ce Box 227 Hammond, WI 54015 O W N E R F 0 M P E R AG Rg'FAIENT PLEASE. BE AVVr$ev, Tkat unt-if you aae again nott6~.ed, t will coact with 01 M,i.e ca .Ln, E Pu.PPO a , 604 the punpoa e O j x emovtng aLt wae.te pnam the ♦a u.t"y '6"ttm to be toca.tad an the pnope2.ty and `utuxe home e.ite towed in St. C'%O.x County, 044o.on.6in, Township o6 being in the 06 the 6L4 06 Sec., At-N (Oa wo ace 6 y d ea c bed a4 6 ottaws gated atk" /7 rp day o b 1 ~9 ~5 _ ( OWNER ) RECEIVED Stott a Wdcon,e~is1 ~62 ~ 44 Caux, y 06 S C a x ) $ e~ ® JUN 2 6 1985 PLUMBING PeaonnattyappeaAed Eae6o~.e one thxe /9TPday o6 tip= gS~ the above ncme4il/Z~.Ar> Q _ u JLTC-,c3'_'.,r ' 19 to me non to e p P9440" Who executed a ohego ng 4ne` nument and ackn¢wedged zkte game. d 4A ~t C, 1104-X Quit y, My Comm ('.a pe4Mant) (Exp e4l Notary Public = Stare o isconsin M Commission pares Mar, 16, 1986 • . he4e.Lnbe6on,e n.e6e4)t pen e4y to " ~um, o~x ~n x e a out agnQeme,nt Q t e ex.ten.t` that I OW kau~t4. contnac,with N4 a4 4bovt ta$ed. ` ~ (PUMPER I r ~T. 40011 COUNTY ,.4'1'y,. 101 SC 0 S N f ~J W i 'VW Z Q N 1 N G 4 F F 1 CE 796- 2 2 39 - 'f1 PoAt 06664ce Box 227 Hammond, N1 54015 0 M N E R PU'WPER A 0 R I F M E N T PLEASE BE ADVT$vV, 'rhaat antit' you ane, again no,t g i.ed, ? Witt conuget with "d~ z of NiacQPA", (Pumpen), io-t the pUnpaac 06 neimOving att W4ete 64om the 499itaut.y 06tem to be .tocated on the p4.o,pe)t.ty and Ju.take home e.i.te loe4t4td in $t. C40ix County, lwiAeonain TgWnahiP o6 ZQ~. buds in the L ~4 01 ;he ~ SL% obi Sec. (0; Pau d .tll 0eseUbed 44 60UPW4r 1 gated ' tk" '7 rp day, oJ ~S- . ( OWNER) 2 RECEIVED 4 $ JUN 2 6 1995 C014 44V 06 St. Cn.ol x 1 ' PLUMBING BUREAU y appeaAed begone we' PeR4uiKUaZC #h.ia /9rP day 94 Jo 1-(5 19 ,the: 00aue 4410, 0 . btz~A, Q UU eTC Qom,,' to OR .l-*l W►n .to the p A4o,a Who t, f.ca e e o t aino -W uOnt and atc40wtedged the same.. 0 4 kr, , . 40.cx oun y, My Goo I a pg-tvan:tl (Expi4ee I Notary Public = e o Wisconsin My Commissions • , he~etn;b~e6oae ottie'te4 too " NIIAM e4, 1986 join 4 4F tk- 'b e a vVe ag4eemen to the exw gn,t` that- 1' kgvt ae, r-o1tttar-t with l~►ne~ eta, abQV~t ~►~~eel. (PUMPERI Olt( j r N _ a ~ m G N :-i y y N N afD ;r .00 c0 o c o w w w Z G =r 3 c tp y 7r lG 0 i5. N m c= S a y CD O l' CD CO lVm O O m f p y CD Q A) 0 A- 0) CD O ODD w v CD m CL 0) (D w A - = ~D M CO n o (3D a c In y w 0 =r OwO(° o~ 3 0 0 C- c wM c 3 w ~ cl< Qm ao 3 6 ac ? N=~`~° w w v°, 0wy Oco0aCD3 °70° w~NC, v < 0 C N C o A O~ D t31 A A 0 yi CO " m oy~p vw- C O (D y CD - = ~ O A M C 'I CD 0 CA wC Err ° m c C7ya (DN.= CL ~w a c o f v y° uiyww_. C fl1 (D a CD _-7 (+J~ o aco w vrw n 8-0 0 , (a Y 1 7' ~D A !D1 y a0 0 or caw O RI 4= W a C O cD N M M aaar. cy-1 ~0w~m MA° atom `c mm-,3 N c0m oco o- ow~Amo a c a w o --gym c m s -CN 0 0. O IMF, y, m wa 0 < 3 s:.>. 0 1 O • PLAN APPROVAL Safety and Buildings Division 1 Bureau of Plumbing DILHR P.O Box 7%9 General Plumbing Plans Madison, WI 53707 Private Sewage Plans Telephone: (608)266-3815 OFFICE USE ONLY Ian Identification No. ' allons Per Day p ; ~ PRIORITY PLAN REVIEW ONLY Plan Review Petition For Modification Proyect Name ! J Project Location - Street No. or Legal Description - )K,y 7 ;,A ~ ~ r , {~y . County ! ❑ City ❑ Village j Z Town of:4/ ' C, The plumbing plans and specifications for this project have been reviewed for compliance with applicable code regwrem ts. 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. ❑ FOR GENERAL PLUMBING PLANS: This approval will expire two years from the date approved below. If construction has not commenced before the expiration date, new plan approval must be obtained. i FOR PRIVATE SEWAGE PLANS: This approval will expire two years fro ri the dd e approved below or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. Comments: By: James Sargent r Bureau Director If Questions Plans Approved By:% Date A p oved. Contact y `3 f If { cc: kOWS t ❑ DPS ❑ H&R & Rec. San. Section County § ❑ Local PI ❑ Facilities Need Analysis Section ❑ UW-SSWMP ❑ Plumber ❑ Department of Agriculture DILHR-SBD-6099 (R. 01/84) ❑ Owner ❑ Other SBD 6678.(R. 08/83) (Plb 100a) (Wis Slats. S. 145.02) g Detach And Return Upper STATE OF WISCONSIJD7 Portion Of This Form With h DIVISION OF SAFETY & BUILDINGS, I BUREAU OF PLUMBING Any Return Correspondence 201 E. WASHINGTON AVE. RM 141 11.1 . ' P.O. BOX 7969 MADISON, WI 53707 DATE: so8-266-3815 V611 - 07/24/85PROJECT: Hurt en, Brian - Residence ME SE * 3600,16W 6o1dt'S Pluoibing y Fn Emerald St, Croix WI 820 Main Street Baldwin, WI 54002 PLAN ID. # - - - DETACH HERE 85-03629 PROJECT NAME ~itirtctert Briars its ence - - - - PLAN is to acknowledge receipt Of your plans: and PLAN A"N ID. V. 85-0362a specifications for the above-indicated project. Preliminary review indicates the required fee is $ 30, 0fl . Plan accepted for review. Fee Received is $ 30 00 El Plans being returned. Underpayment- Please submit additional fee. Plans will be held in abeyance. Overpayment, Refund forthcoming. ❑ Additional information required. SEE BELOW. No fee has been remitted. Plans will be held in abeyance. I Plan Submission El Additional information shag be submitted in duplicate unless El Soil borinTand percolation test data on 115 completed specifically noted. by Certified Soil Tester. (1 copy) ❑ Plans not clear, le ible or El Petition` For Modification signed by county,.owner and 9 permanent. El All information submitted shall be signed, dated and sealed or notarized. (1 copy) stamped in accord with Section, ILHR 83.08 (2) (a) Wisconsin El El Complete data relative d. anticipated use of building. Administrative'Code. El restriction required. (1 copy) Affidavit enclosed. El El Plot plan showing location of land -Condominium declaration. (t copy) parcel (distance from nearest road intersection, etc.), lot size and. all distances from IV. Holding Tanks private: sewage system to buildings, lot lines, well, water- course; swimming pools, water service ❑ 'Holding tank profile showing vent, manhole, alarm, vice road, etc: Show benchmark service Piping, all weather set and manufacturer if state approved. with-permanent Complete . construction details if site cQnsicucted. II. Pressure Distribution Systems (Mound or tnground Pressure) F1 Holding tank agreement signed by owner and local ❑ Application for Use of an Alternative System signed by owner unit of government (sample enclosed):. and notarized. (1 copy) ❑ Reason for installing. holding tank: Statement from ❑ ,County arized required. (1 county or soil boring and percolation test data on copy) ❑ Design calculations. 115 completed by CST, showing that a soil absorption system ❑ Soil boring and percolation test data on 115 completed by Certified Soil Tester. (1 copy) cannot be installed on the land parcel. ❑ Cross section of system. El Affidavit for all-weather service road (enclosed). ❑ Pipe lateral layout. ❑ Plan view of system. ❑ Verification fo Exception Status Form by county. (1 copy) V. 'using Information _ Calculations for total dynamic head and gallons 111. Private Sewage Systems pumped per cycle. El Ground slope with 2' contours in entire. area of oil absorption. ❑ Size, length and depth of force main. system extending 25' minimum on all sides. ❑ Detail and model of pump or automatic siphon, .including E3 :Location of area suitable for replacement system- provide soil : size, pump curves, drawdown, and average flow rate (GPM. data. ❑ Cross section of dosing tank showing pump(s) or siphon(s). ❑ Construction details of septic, holding or dose tank if site constructed, or tank manufacturer if state VI. 'Systems in Fill (Fill must be placed prior to plan submission.) approved. Total area filled (fill to extend 20' beyond edge ❑ Construction details' and cross section of soil absorption system.. -of french before side slopes 't56gln.). ❑ Depth and type of fill. ❑ Copy of signed onsite report by county or district staff. SSD 6678 (R. 08/83) (Plb 100a) (Wis Slats. S. 145.02) T't] Detach And Return Upper STATE OF WISCONSIN DILHR DIVISION OF SAFETY & BUILDINGS POr 1 .n-Offhis Form With BUREAU OF PLUMBING Arty Return Correspondence 201 E. WASHINGTON AVE. RM 141 P.O. BOX 7969 MADISON, W153707 DATE: cos-266-sas 07/08/85 n 8 PROJECT: Nurtgen, Brian - Residence 2 NE,SE,36,30,16W c Tn Emerald Boldt's Plumbing ~s St. Croix WI 820 ka'i n Street ; Baldwin, WI 54002 PLAN ID. # , 85-03629 - - - DETACH HERE PROJECT NAME Hurtgen, Brian - Residence - - 85-03629 - This is to acknowledge receipt of your plans and PLAN N ID. # specifications for the above-indicated project. Preliminary review indicates the required fee is $ 30.00 El Plan accepted for review: Fee Received is $ 30.00 ❑ Underpayment- Please submit additional fee. Plans will be held in abeyance. Plans being returned.' ❑ Overpayment - Refund forthcoming. Additional information required. SEE BELOW. ❑ No fee has been remitted. Plans will.be held in abeyance. 1. Plan Submission Additional information shall be submitted in duplicate unless E Soil boring and percolation test data on 115 completed specifically noted. by Certified Soil Tester. (1 copy)' ❑ Petition`For Modification signed by county, owner and ❑ Plans not clear, legible or permanent.' El All information submitted shall be signed, dated and sealed or notarized. (1 copy) stamped in accord .with Section ILHR 83.08 (2) (a) Wisconsin El Deed restriction El Deed data relative to anticipated use of building. Administrative Code. required. (1 copy) ❑ Affidavit enclosed. ❑ Condominium declaration. (1 c°,opy)' ❑ Plot plan showing location of land parcel (distance from nearest road intersection, etc.), lot size and all distances from IV. Holding Tanks private sewage system to buildings lot lines, well, water- course, wimmin ❑ Holding tank profile showing vent, manhole, alarm, g pools, water service piping, all weather ser and manufacturer if state approved. Complete vice road, etc. Show benchmark with permanent elevation. construction details if site constructed. II. Pressure Distribution Systems (Mound or Inground Pressure Holding tank agreement s~iced by owner and local unit of government (sample enclosed)S Application for Use of an Alternative System signed by owner ~e t from .G -and notarized: (1 copy) ❑ Reason #orinstaNing holding tank. Statement from County arized required. 1 co - county or soil boring and percolation test data on El onsite ( py) ❑ Design calculations. 115.compteted by CST, showing that a soil absorption system ❑ Soil boring andpercolation test data on 115 completed by Certified Soil Tester. (I copy) cannot beinstabed on the land parcel. ❑ Cross section of system. ❑ ` Affidavit for all=weatherservice road (enclosed). ❑ Pipe lateral layout. . ❑ Plan view of system..:. ❑ Verification fo Exception Status Form by county. (1 copy) V. Dosing Information Calculations for total dynamic head and gallons III. Private Sewage Systems pumped per cycle. El Ground slope with 2' contours. in entire area of soil absorption El Size, length and depth of force main. ❑ -Detail and model of pump or automatic siphon,.: including system extending 25' minimum on all sides. Location of area suitable for replacement system.-provide soil size, pump curves; drawdown, and average flow rate (GPM). data. ❑ Cross section of dosing tank showing pump(s) or siphon(s). ❑ Construction details of septic, holding or dose tank if site constructed, or tank manufacturer if state V1. Systems to Fill (Fill must be placed prior to plan submission:) approved. ❑ Total area filled (fill to extend 20' beyond edge Construction details and cross section of soil absorption system, of trench before side slopes begin.) ❑ Depth and type of fill. ❑ Copy of signed onsite report by county or district staff. t SBD 6~76~R. 09/83) (Plb 100a) (Wis Stats. S. 145.02) i STATE OF WISCONSIN DILHR Detach And Return Upper DIVISION OF SAFETY & BUILDINGS Portion Of This Form With BUREAU OF PLUMBING 201 E. WASHINGTON AVE. RM 141 A I1 feturn Correspondent 8 P.O. BOX 7969 MADISON, W153707 608-266-3815 DATE: , JUG ~F~~F PROJECT: 06/26/65 I4H~G,98S Hurt en, Brian Residence OFFj`f 2 1 NE,SE,36,30,16W Tn Emerald Boldt`s .Plumbing ® St.' Croix WI 820 Main Street i ,Baldwin, WI 54002 PLAN ID. # 85-03629 DETACH HERE PROJECT NAME Hurtgell, Brian Residence PLAN ID. # 85-03629 This is to acknowledge receipt of your plains and specifications for the above-indicated project. Preliminary review indicates the required fee is $_30.60 Fee Received is $ 30.00 Plan accepted for review. ❑ Underpayment - Please submit additional fee. Plans will be held in abeyance. Plans being returned. ❑ Overpayment -Refund forthcoming. Additional information required. SEE BELOW. ❑ No fee has been remitted. Plans will be held in abeyance. 1. Plan Submission ❑ Soil boring and percolation tesLdata on 115 completed ❑ Additional information' shall be submitted in duplicate unless by Certified Soil Tester. (1 copy) specifically noted. ❑ Petition For Modification signed by county, owner and ❑ Plans not clear, legible or permanent. notarized. (1 copy) ❑ All information submitted shall be signed, dated and sealed or ❑ Complete data relative to anticipated use of building. stamped in accord with Section ILHR 83.08 (2) (a) Wisconsin ❑ Deed restriction required. (1 copy) Administrative Code. Affidavit enclosed. ❑ Condominium declaration. (1 copy) ❑ Plot plan 'showing location of land parcel (distance from nearest road intersection, etc.), lot size and all distances from IV. Holding Tanks private sewage • system to buildings, lot lines, well, water- ❑ Holding tank profile showing vent; manhole, alarm, course, -swimming pools, water service piping, all weather ser- and manufacturer if stateapproved. Complete vice road, etc. Show benchmark with permanent elevation. construction details if site constructed. Holding tank agreement signed by owner and local - 11. Pressure Distribution Systems (Mound or inground Pressure) unit of government (sample enclosed4I'10t (3,_6'1 Z.l-:.. Application for Use of an Alternative System signed by owner ❑ Reason for installing holding tank. Statement from and notarized. (1 copy) county or soil boring and percolation test data on ❑ County onsite required. (1 copy) ❑ Design calculations. 115 completed by CST, showing that a soil absorption system ❑ Soil boring and percolation test data on 115 completed by cannot be installed on the land parcel Certified Soil Tester. (1 copy) ❑ Affidavit for all-weather service road (enclosed). ❑ Cross section of system. ❑ Pipe lateral layout. ❑ Plan view of system. V. Dosing Information ❑ Verification to Exception Status Form by county. (1 copy) ❑ Calculations for total dynamic head and gallons pumped per cycle. 111. Private Sewage Systems ❑ Size, length and depth of force main. ❑ Ground slope with 2' contours in entire area of soil absorption' ❑ Detail and model of pump or automatic siphon, including system extending 25' minimum on all sides. size, pump curves; drawdown, and average flow rate (GPM)., ❑ Location of area suitable for replacement system- provide soil ❑ Gross section of dosing tank showing pump(s) or siphon(s). data. r Construction details of septic, holding or dose tank if site VI. Systems in Fill (Fill must be placed prior to plan submission.) constructed, or tank manufacturer if state approved. ❑ Total area filled (fill to extend 20' beyond edge Construction details and cross section of soil absorptior►- of trench before side slopes begin.) system. ❑ Depth and type of till Copy of signed onsite report by county or district staff. . 43 019 BOOK 801 PA4E630 THIS SPACE RESERVED FOR RECORDING DATA CANCELLATION OF A HOLDING TANK AGREEMENT REGISTER'S OFFICE ST. CROIX CO., WI As the sanitary permit issuing agent in the county Reed for Record Jan. 27, 1988 stated below, I hereby certify that the following at 1_0:00 A M described property is now under a new Holding Tank Register of De,;ds Maintenance and Service Contract that complies with Tow-, 0a'Ieff- ILHR 83.18 (4), Wis. Adm. Code. RETURN TO: In.addition, I understand that execution and recording of this document cancels a holding tank agreement between the T dui Dec T M1 t^~ l A and 1r %An that was recorded on the 13+V da of y 19in volume paged (o as document number Witness my hand and seal this 9 (+V\ day of Ck 19 County of St. Croix by Thomas C. Nelson, Zoning Administrator Owner(s) Name(s) (Print) i Owner(s) Signature(s) i Subscribed and sworn to before me on this date: ' otar Public y My Commission; ' ' $ I. 1 i J i NOTE: This document to be recorded in the Tract Index at the office of Reg , . ist`,?*~ deeds. 3 0 0 PooY ra4~631 Document No. This space reserved for recording data HOLDING TANK AGREEMENT REGISYER'S OFFICE Agreement Date This agreement is made between the ST. CROIX CO.v W1 County or Local Governmental Unit Holding Tank(s) Owner(s) - Redd fcw Ro001'id OWE 0 1-" ~ Jan. 27, 1988 4V ern n Q i* 10:00 AM Celled Municipality below) We acknowledge that application is being made for the installation of (a) holding tank(s) on the following property, (Provide legal land description:) RegbW of Deeds S C 3.6 _0 O Al ya_ N S d' .~I Q Return To - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - or that continued use of the existing premises requires that a holding tank be installed on the property for the purpose of proper containment of sewage. Also, the property cannot now be served by a municipal sewer, or any other type of private sewage system as permitted under Ch. ILHR 83, Wis. Adm. Code, or Ch. 145, Slats. As an inducement to the County of S C hd' l to issue a sanitary permit for the above described property, we agree to the following: ' 1. Owner agrees to conform to all applicable requirements of Ch. ILHR 83, Wis. Adm. Code relating to holding tanks. If the owner fails to have the holding tank properly serviced in response to orders issued by the municipality to prevent or abate a nuisance as described in ss. 146.13 and 146.14, Slats. the municipality may enter upon the property and service the tank or cause to have the tank serviced and charge the owner by placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by s. 66.60, Slats. 2. Owner agrees to pay all charges and costs incurred by the municipality for inspection, pumping, hauling or otherwise servicing and maintaining the holding tank in such a manner as to prevent or abate any nuisance or health hazard caused by the holding tank. The municipality shall notify the owner of any costs which shall be paid by the owner within thirty (30) days from the date of notice. In the event the owner does not pay the costs within thirty (30) days, the owner specifically agrees that all of the costs and charges may be placed on the tax roll as a special assess- ment for the abatement of a nuisance, and the tax shall be collected as provided by law. `3. The owner, except as provided by s. 146.20 (30) (d), Stats., agrees to contract with a person who is licensed under Ch. NR 113, Wis. Adm. Code to have the holding tank serviced and to file a copy of the contract or the owner's registration with the municipality and with the county. The owner further agrees to file a copy of any changes to the service contract or a copy of a new service contract with the municipality and the county within ten (10) business days from the date of change to the service contract. 4. The owner agrees to contract with a person licensed under Ch. NR 113, Wis. Adm. Code who shall submit to the municipality and to the county a report in accord with s. ILHR 83.18 (4) (a) 2., Wis. Adm. Code for the servicing on a semiannual basis. In the case of registration under s. 146.20 (3) (d), Slats., the owner shall submit the report to the municipality and the county. 5. This agreement will remain in effect only until the local governmental unit responsible for the regulation of private sewage systems certifies that the property is served by either a municipal sewer or a soil absorption system that complies with Ch. ILHR 83, Wis. Adm. Code. In addition, this agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which will permit the existence of the certification to be determined by reference to the property. 6. This agreement shall be binding upon the owner, the heirs of the owner and assignees of the owner. The owner shall submit the agreement to the register of deeds and the agreement shall be recorded by the register of deeds in a manner which will permit the existence of the agreement to be determined by reference to the property where the holding tank is installed. Owner(s) Name(s) (Print) Owner(s) Signature(s) J. 4 ,5t4fril2,an~0~fore me on this date: • l t 0- Municipal Official Name (Print) Municipal Official Signature f e- Q_ 1 44 uni ipal Official tle. t_ (Print) Chi C ' / ~il7l.~ + ® _ 7 \ V SBD-6123 (R. 10/85) This instrument was drafted by the State of Wisconsin Department of Industry, Labor and Human Relations, Bureau of Plumbing.