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Parcel 038-1009-50-000 09x13.!2005 11:03 AM
Alt. Parcel 2.31.18.24E PAGE 1 OF 1
Current X 038 - TOWN OF STAR PRAIRIE
ST. C COUNTY, Date Historical Date Map # Sales Area Application # Permit # Permit TypeWISCONSIN
00 0
Tax Address: Owner(s): O = Current Owner. C = Current Co-Owner
KENT C & MARLENE K TRST REBECK 0 REBECK, KENT C & MARLENE K TRST
PO BOX 302
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 3962 NEW RICHMOND
SP 1700 WITC
SP 8055 CEDAR LAKE!N R
Legal Description: Acres: 0.000 Plat: N!A-NOT AVAILABLE
SEC 2 T31N R1 8W PT GL 3 COM 1335 FT E & Block/Condo Bldg:
876.25 FT N OF SW COR GI-3, TH S 4 DEG W
TO N LN HWY H, ELY ALG HWY TO E LN GL 3, Tract(s):
N TO CEDAR LK, W ALG LK TO PT OF INT (Sec-Twn Rng 40 114 160 1i4i
WITH LN N 4 DEG E FROM POB, TH S 4 DEG W 02 31 N-18W
323 FT MOL TO POB TO POB
Notes: Parcel History:
Date Doc # Vol/Page Type
01123,2001 637258 1578/193 WD
07!23/1997 424,1446
2005 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10112/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.000 124,200 224,100 348.300 NO
Totals for 2005:
General Property 0.000 124,200 224,100 348,300
Woodland 0.000 0 0
Totals for 2004:
General Property 0.000 124,200 224.100 348,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 516
Specials:
User Special Code Category Amount
Total Special Assessments Special Charges Delinquent Charges
0.00 0.00 0.00
Form - S 'I' C - lt5
'i AS BUILT SANITARY SYSTLM IZVIPOR'T
OWNER f. e.,r rtb ; % TOWNSHIP Sri • /-i c:.i z- SLR:. 1 _ T 7_ N-R 1 W
ADDRESS ST. CKOIX COUNTY, WISCONSIN
SUBDIVISION LOT ;c LOT SIZE
PLAN VIEW
Distances and dl[1Le11SiU11S to mutt requirements of H 63
SHOW EVEI?YTIJING WITHIN 100 FEET OF SYSTEM
A
pear
bu...~
l•J/- w;A' 1 IF,
F O
t
i
.iz.
io
+4 - INDICATE N RTH ARROW
BENCHMARK: Describe the vertical rofi-rrnce point u, fed T.--e z 7N- 5;
Elevation of vertical reference puinC : Proposed slope at site:
i
Sb.P'I'IC TANK: Manufacturer: L. Liquid Capacity:
Number of r:-ngs used: _ Tank manhole cover elevation: _
Tank Inlet Elevation: 'l'ank Outlet Elevation:
Numbs r of t( et from nec-rest k;,-t: Front,@Side10 Rear, O feet
From 1,earest pro,,erty line Front, Si(~ e,~Rear,O 6a feet
NUMbtr of fi:et from: well S" building: ,2c%_
(Include this information of (lip: above plot plan)( < reference dimensions to septic tank)
SEP: REVERSE SIDE
4
r
PUMP CHAMBER
Manufacturer: Liquid Capacity:
Pump Model: Pump/Siphon Manufacturer: Pump Size
Elevation of inlet: BULL-! Of tank u-Levatiuu:
Pump off switch elevation: Gallons per cycle:
Alarm Manufacturer: Alarm Switch Type:
Numbcr of feet from nearest property line: Front, 0 Side, O Rear, 0 Ft.
Numbcr of feet from well:
Number of feet from building:
(include dilstauces on plot plan).
SOIL ABSCRBTIUN SYSTEM
Bed: X Trench:
Width: .2 LengL11: ` Number of Lines: t/ Area Built: looo~
Fill depth to top of pipe:
Numbur of feet from nearest property line: Front, O Side, Rear, O Ft
Number of reet -`rom well ~Sf
Number Uf fuct rort building: y4'
(Include distances on plot plan).
SEEPAGE PIT
Size: Number of pits: Diameter:
Liquid depth: Bottom of seepage pit elevation:
Area BuilL:
Has either a drop box O or distribution box O be-ell used on any of the above: soil
ahsorbtion sytems? (Check one).
HOLDING TANK
Manufacturer: Capacity:
Number of rings used: Elevation of boLLUlil of tank:
Elevation of inlet:
Number of feet from nearest property line: Front, O Side, O Rear, O Ft.
Number of feet from well:
Number of feet from building:
Number of feet from nearest road:
Alarm Manufacturer:
Inspector
Datud: 'Jb~ f s- Plumber on job:
License Number: /1"',
i~L~{:Ill
F-GPA RTrAFrJI ;iF ~t•~,-','~r
I AHUR &-Hrv1r1N REI INSPECTION REPORT FOR
A riOfdS SAFETY & BUILDINGS
P-0. BOX 7969 PRIVATE SEWAGE SYSTEMS
MADISON &WI b3701 DIVISION
BUREAU OF PLUMBING
i b-CONVENTIONAL _IALTERNATIVE s,aeP„ IO N.,,,,•„
Holding Tank r In-Ground Pressure
Mound
"v %IE OF PF11 \11T HOLDER - -
ADnrli 5 °F "ERN-1I I-C LDEH
Kent Rebeck NsFecil..!
319E Hafner CC. , Shoreview, !IN ~O 0
C•1 ttAFK 7Pei,r.an?nr •=1,•~e,:_... ~ -
UI_S!.BIPE F,' r :ERE VT FLIrrd FLa" - -
REF.PT CLEV CST RFI Pr ELEv
' SW, Sli T31N-R18W, Gov't. Lot#3,Sundvall Estates,Town of St.Prair e
Nam~•c1 PI. ,b..
ael Wilson sa~,•:L, f'
Hich NumEC,
6388 St. Croix 49449
SEPTIC TANK/HOLDING TANK: -
I+ A`i J~AC 71_IIILq _
I IiIU D CAP ACIT'r ANK II, LE7 ELEV t
ANK OI, TLFT I LEV 1NAFNING LABEL LOCKINI, 'ER
~%L.ZG7 ~/~771 •NiUVICED PRO !r
BEDDING VENT DIA - v VV ES I_J N
f ENT r.tarl HIC;H WA li. I E L_j NO
tLAH"• NUMBER OF HoAD FR,PERrr WELL "u`
}`vFNr ToFRFr.
!YES
NO FEET FROM
L_.JYES JNC NEAREST ~ Jj((l -•IRIVLEr
NG CH MBER:
FA,., 11 1
H DDING - /
ll'.II.IIU r, .IP:,("Ir" PJI.'P rA 1_IUEL " If~F;; - _
NAPhIYG LAU EL
PROVIDED PROVING COVEP
r~YES ❑NO PRnvn,Lu
cYPUPA,~wTHO_TOPFf,A-ornL YES ❑NO L -1 YES %T NO
FEHENCEBETWEEN NUMBIVC.P ON AND OFF) FEET F O AIR IvLFT
SOIL ABSORPTION SYSTEM. Check the soli molsturP at the e EISOf plowing NO NEAR T
nT excava*Lin. (If soil can be rolled Into a wire, construction shall cease until T~F O he soil Is dry enrnih to continue.)
CONVENTIONAL SYSTEM: AIN
BED/TRENCH vncry~ EN -r' Nc' or_ - - -
-~yS~J USTI -'PPE SF :.:EI`J., r„"IIJ LIf~
DIMENSIONS BENCHES "LF: I, uuulD
I `IPIT
yFAVI G UEPTH
L N I = F L. LISTI: P P -
LIST" 1 PF I F DSrH. PIPE MATE -1IAL r
AFiI?'F :-I,-eF E.. E, IvI _r ELF.G NUMBER OF : E,Tr .EEL-L Te;;IL~ING vEN-I:.la:
L - ,2 2. P FEET FROM AIR iNi
NEAREST------w ~
titOUND SYSTEM:
Mound site plowed perpendicular to slope
and furrows thrown upslope: Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM
mound systems to make certain that it I ON REVERSE
~IYES DNO meets the criteria for rnedium sand. SIDE. SHOW ELEVA
TIONS MEASURED.
OIL COVER TI -IME
FI IPaANFr.T Id AH•;-'. CS~. WFL._:-
I:'✓'..~EF r.!NCH aF~ cEPTH-, NL~IY I-'
F`IIER ' VFI+II=FCH R E ~ ES
DF:" O= r:;FVL_ NO _.YES LINO
FD'FS SIIUCFU JFFnf'.I -
LtULCHEG
YES LINO AYES UNO ❑YES CNO
PRESSURIZED DISTRIBUTION SYSTEM:
.YI 1111 ..(,T iA
•f
BED/TRENCH =F -TTeBn_ :~a (NG csRAV=1 cEPTHeEECnPIVF _
DIMENSIONS rfiLNCHEP FILL DFPn AeovE cOVrrl
ttAr,lrou, Pur.tP aravir
ELF'! ELEV '~LD i%iSTR PIPE MANVFOLG r'dA Tf IiIAL NO UISTII Cn$T~ PIPE O15 r1!13ur Fir, Vlr'E If nTEHIAI SNAP,K ING
ELEVATION AND =LE' PIPES
GIA
OISTRIBUl ION
INFORMATION "oI r slzF roI L SFr„ Irv,. I~R ED,.
nHRF. I LV C,^.vLH A7A 7ERiAt 1
V EHTIC 4. III I LC,FRESF:; N'I~. IU APP Ri)Vr J
FL-NS
COMMENTS: ~rWANENT,HARKLRS❑YES NO ❑YES ❑NO
7OCSERVATIIN WELLS. E PROP c"RTV WELL
NUMBR OF I 151)11 DI-46
I LJ YFS ❑ryU FEET FROM LINE 1
i~ ❑YES CNG' NEAREST~_ J
C:~f ~ ~E. ~L~L`: ~ti1 ~r11~i•Qit•Lc:~~ Vi.t~•~
Sketch System on
Reverse Side. county file for audit
slcNAnJ - ----IiIrLE -
i
DILHH SBD 6710 (H- 0" r'82'r
APPLICATION FOR SANITARY PERMIT
.''.DILHR e4 °TY
n-oc (FLB 67) UNIFORM SANITARY PERMfv1IT a`r
oecROTT'r
If IC]u ~T gflrlq! HIITR'14E1 RTinnZ
h~9~'y9
-Attach comiilete plans in accord s. H 63.05. Wis. Adm. Code for the system, on paper not less -,nan x 1 1 inches in size.
-See reverse side for instructlors for completing this application. PLEASE PRINT
PHOPFR rY OWNER MAILING ADDRESS
PROPER I Y LOCATION CITY:
V_ILLAG
Ivw 1/4x4% 1/4, S T.7-, N, R ) 9-E (0r)(0 IZZEUP
Slat P
LOT NUMBER BLOCK NUMBER SUBDIVISION NAME T AREST ROAD, OR LANDMARK STATE PLAN I.D. NUMBER
n -3 izAP S4n~/~ -T cej r-
v
TYPE OF BUILDING OR USE SERVED
i~ 1 or 2 Family Number o' Bedrooms: 3 Public (SpuuifO►
THIS PERMIT IS FOR A:
New Systern Tank Replacement L Repair
J Replacement Soil Absorption System - Revision L Privy
Alternate System Reconnection Petition for ,Modification
IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK.
Seep4yc Bed Seeaage Trench Seepage Pit _ Holding Tank
r~ System-In-Fill L In-Ground Pressure J Vault Privy Pit Privy
Existing, For V),'hich A Previous Permit Is On File, Permit ssued
❑ An Existing System That Has Been. Inspected And Is Compliant As Far As Soil Conditions.
Total #of Prefab. Site
Gallons ' urri Curc a e Corstructe 1 $ eel F rglass Plastic
Septic Tank Capacity
Lift Pumo Tank,Siohon Chamber ,rt
Holding Tank capacity y=; k
Manufact.irf- ~..i 'r . e -e -r e TS
IF THIS IS AN ALTERNATIVE SYSTEM C0111PLETE THIS BLOCK: - Mound (J In Ground Pressure
TotalcJ Pr dab. sit'.
Steel F'berglass Plastic
Gallons Tanti= Concrete Constructed
Septic I ank Capacity ,yr
Lift PumpiSiphon Chamber ei
%Ianufacturer: fy H
PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA 'uVATER SUPPLY:
W11111 es per inch): REQUIRED (Souare Feet;. PROPOSED (Srluare Feet}:
Ib 9 `1S 56 C' Private Joint ❑ Public
I, the undersigned, hereby assume responsibility for installation of the prlvate sewage system shown on the attached plans.
Narr•e o' Plumber iPrintl Signature: MPRSW No.: Phore Number:
6 3 5~ (7iS' L~ 6 -nr_aS' I -7
P umbers Add'ess: NzirTll_` of Desigmwr-
COUNTY/DEPARTMENT USE ONLY TF
Signature of Issu ng Agent f rlr Datr Disapproved
LT _ Owner Given initial
Approved Adverse Determination
Reason for Disapprova
Alternate courselsi of Action Available:
D'I HR SBD-6398 (R. 5i821 DISTRIBUTION: Original to County, One Copy To, tiuleau o' Plumbing, Owner, P umber
INSTRUCTIONS FOR COMPLETING T; HIS PERMIT APPLICATION, PLB 67 - SBD 6398
To be complete and accurate the permit application must include-
1. Property ovwner's name and cnmplete 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 seal 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
sr:uare feet to be installed;
5. Complete the section on water supply;
6. PRINT the came of the master plumber or master plumber restricted --ho will install the system, circle the appropriate license classi-
tication, place your license number in, the space provided and sign the permit in :he 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 o' nwnership or plumber requires a Sanitary Permit Transfer Form (67-T! to be submitted to the county prior to installation.
to cui ply will void the sanitary permit.
9. This : e rmit rray he renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable.
10. A nevv permit will be needed if there s a chanyc in, estimated wastewater flow, i•number of bedrooms, etc.), locat on of the system,
depth of the SyStr rn, type of system.
11. All rev's 0115 to th's p rrnit roust hi' al;h u.e,. by th-~ pr.rmit isAliny wthniit4'.
12. cnr•,pl?t~ plan nclur inc a plot plan, drawn to scale o- Lavith complete dimensions.
13. Hcr,zontal and vertical elevation reference uoina that are perrnanerit a•rd clearly shown.
14. Pipit,(; detail includ my pipe size, separatinc distances, distances hetween beds if appropriate, tank locations, effluent line f-om tank((;)
to system, b-ild ny sewer and vent 0b,ervation pipe(,;.
15. The p~rrnil,ssuin- ay-gin: nrry r~.crrie ;i cr;~„ ;~~c:irn dra~,;inq ref thr_'f=luent r isl%u':al stem.
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.
APPLICATION FOR SANITARY PERMIT
5 T C - 100
1111.8 applicaLion Iorm is to be completed in full and 8ignud by Llie owner(s) of the
propurty being developed. Any inadequacies will only result in delay,-5 of the permit
issuance. Should this development be intended for resale by owner /ContractgV,("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.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Owituc of PrupcrLy
f~LV~cC3 Locution of Property /hLi'; a l~ -14W
, Section C. T ~ I N ft -
l' T awn. ~ill) ~y P~Cx11 ,
Mailing Address 15 0 2, ~~cV~l~-C'i
~)2-
Subdivision Name 17-
Lot Nuwber
Previous Owner of Property ~ti'174 iA:) PC t; o4-
Total Size of Parcel
Date Parcel was Created 6
Arc all corners and lot lines identifiable?_- Yes No
is tins property being dcvelupr--d for resale (spec house) ? Yes No
Volume and Yag` Number as recorded with the Register of Deeds
INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOW1141;:
1. Warranty Deed
2. Land Contract
3. Other recordings filed with the Register of Deeds Office
In addition, a certified survey, if available, would be helpful so as to avoid delays
of the reviewing process. If the deed description refurences to a Certified Survey Map, the the Certified Survey Map shall also be required.
PROPERTY OWNER CERTIFICATION
I (Wcj ee tijy that aLU .5-tati✓rnenta on "thtib `omen ane th.ue to n the b,1-5t o6 Iny ,1e'rL-L)
knowtedge; .td.at I (we) am (ane) the. vwneic f b) 06 .tile pnopULty deac,ubed in th.i,5 in6o.unatiun (orun, by viAtue oo a wa4Aavtty deed teeo/Lded in
the 060.iee u p the
County Reyt44err o6 Deeds as Doewnent No. '29 y 2 Z, and that I (we)
pneeen-tiy own .tyre proposed s.c-te bun the 6eioage pusar :5y6tein (on I (we) have
obtained an e as elnen t, to hun with the above des eAibed pnope i ty, 6a"7 the
corwt4uction o6 said 4y6tem, and the same has been duty teeonded in .the 066iee
u' the Coun4 Rep' t o4 Deeds, a6 Document No. - )
S1' A CRF,_OElt SICNA U ()-U NER (IF APPLICABLE)
DATE SIGNED DATE SIGNED
H. U. RUSE Registered Land Surl,eyor
CRestwood 348.38 211 So. Maple St. Ellsworth, Wis.
PLAT OF SURVEY Nov. 10, 1965
OF PROPERTY OF Sundvall Estate 80' parcel on East side
described as follows: A parcel of land located in Gov't. Lot No. 3, Section 2, T31N, R18W, Town
of Star Prairie, St. Croix Co., Wis., more fully described as follows:
Commencing at a pipe on the East line of said Gov't. Lot # 3, said pipe being 44'
from high water line of Cedar Lake and the point of beginning for parcel to be con -
veyed; thence S 40 20' W along the East line of said Gov't. Lot 3 a distance of 297'
to an iron pipe; thence N 850 40' W a distance of 80' to an iron pipe; thence
N 40 20' E a distance of 323' to an iron pipe set 27' from high water mark of Cedar
Lake; thence S 670 40' E a distance of 84.12' to the point of beginning.
Said parcel containing .57 acres.
i
I
I ell
i 1
l3
a.
th ~ ~ ^ a 3
t h ~ `aT
i
CERTIFICATE OF SURVE( C1
I hereby certify that on 194-41 zurveyed E* property
described above and that the above pear, is carrec rE p:'c s_^tation ot,said survey S. ale: 1 inch ` /0 a feet.
- - - ~pf - - / a--Indicates Iron Monument,
„ V1,L U.) I
The Purchaser hereby covenants and agrees that time stall be .iectned to be of the essence of this contract and in case ui iefat.it
in the payment of any principal or interest when the same shall become due, or in the performance of any of the conditions, covenants. or promises by the Purchaser herein to be
kept or performcd, and such default shall continue fur a period of sixty (60) d"tys, then the
Vendor may, at his option, declare the contract it an end, all rights of the Purchaser under this agreemrnt canceilr•d, and the amounts
paid by the Purchaser hereunder forfeited, the same to remain the Vendor's property as rental of said premises and as liquidated damages for the failure completely
to fulfill this agreement: and the Vendor shall forthwith and without notice have the right of
re-entry; or, at the option of the Vendor and without notice to the Purchaser, notice being herebyy expressly waived, the whole amount of unpaid principal shall be deemed to have
become due and payable; in case such option shall be exercised, the unpaid principal and
interest together with all sums which may be or have been paid by the Vendor as lie-rein authorized with interest on such disbursements at the rate aforesaid shall be collectible
in a suit at law, or by foreclosure of this contract in the same manner as if the whole of said
unpaid principal had been due at the time when any such default occurred, and the indebtedness shall embrace, with said unpaid
principal and interest, all the sums sd disbursed with Interest as aforesaid. In case of legal proceedings in enforcement of any remedy hereunder, whether abated or not, all expenses,
including reasonable
attorney's fees, shall be added to the principal, become due as incurred, and in case of judgment shall be included therein.
Upon the commencement or during the pendency of any action of foreclosure of this contract, the court may appoint a receiver of the premises, including homestead interest, and
may empower the receiver to collect the rents, issues, and probes of said premises
during the pendency of such action, and may order such rents, issues, and profits when so collected, to be held and applied as the court shall, from time to time, direct.
All terms, conditions, covenants, warranties and promises herein shall be binding upon and inure to the benefit of the *heirs,
legal representatives, successors, and assigns of the Vendor and the Purchaser; the wife of the Vendor for a valuable consideration, joins herein to bar her dower and homestead
rights and agrees to join in the execution of the reed to be made i`-fulfillrnea.. hereof.
IN WITNESS WHEREOF, this land contract has been executed and delivered this -_-_l_7......~.d ay of.... 4!21 kJ 19A1_-
SIGNED AND SEALED IN PRESENCE OF
/ Q .0 A; / ~_t~ --(SEAL)
Vincent A. McCo
H_ Gordon TA or
t s........ ce.:_L1'..~ lane A. McCo -
C1 al rp W Sri art
-------.............(SEAL) for Rebeck
nt C.•
Claire O'Brien -._...._......_J_(SEAL}
-_Marleni, Rebeck MINNESOTA INDIVID AI. ACKNOW'LEDGrti1ENT
STATE OF W39COMM, l
County of
Personally came before me this L..! 1-7--: -day 19_.$1._.., the abo", -
named -..YinceiLt..A.-.McCcty...$rid_.rane._A_._McCay,.-.buaband._and..wife;.........-........__._.-._...__-__.._
__....-_......,K~at_ C.._ Rebeck_ and .Marlene _Rebeck ..husbd awife; -
to me known to be the persons who executed the foregoing instrument and acknowledged the same.
H. GORDON TAYLOR H. Gordon Ta
HENNEPIN COUNTY Notary Public, Wis.
p1my MOTA VPUBLIC-YWtwE80TA - ylor commlttston QxWrq Nov 11, 1987 My commission .
COItPORATE ACKNOWLEDGMENT STATE OF WISCONSIN, l
- } as.
County of Personally came before me this.- day of _ 19.......
- _ _ - President and.._...-..._.._-.-_..._..-__-._......._---- Secretary,
Hof the above named corporation, to me known to be such persons and officers who executed the foregoing instrument and acknowledged that they executed the same as such officers,
by its authority, for the purposes therein contained.
Notary Public, County. Wis.
My commission expires
This instrument was drafted by t-GORD0N TAYLOR, ATTORNEY. 504 Midwest Plata Bldg. ,Mpls.-Mn.55402 .--•-••••--.-.--.-----.1
j (Section 59.51 (1) of the Wisconsin Statutes provides that all Instrumeons to be recorded shall have plainly printed or typewritten thcrFun the names of the grantors, grantees,
witnesses and nutary). .
!I ~ i •t nt ~ UR ~ ~ .l! moo,
in 0 3= i 1
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S1:N'1 iC IANb: ?r1AIN`1'ENANC.E A(;REEMENT r+
V
SL C1-0iX County
0
t h Y l L~ H
M
K0U7•E/BOX NUMBER Fire Number
l:l Cl'/ l:l'L1' r' L lP
11 kn11 LKIY LL)CATIuN -`4, SecCion C 1' D' N, It W,
'1'uwn of -_~_~\I~~1 a~ to- irf'~- Croix County, 1
SubdiVLSi.utt E'k l~_~~~~~I LuL number
I
III:(11UpuI Ilse itll:l .IIai[ILetla[II- )1 i)U1 tii'tl1 Iull i':)I1lIl I- i'tillIL I11
1L ti 1)rc:maLuIF e` Iailure t ) it IIt dlu wastes. I'r.,i: rr ill Ii -It L eit a LtC e con -
SiSLS o f punlp111g 0Ut the e1)tic tank evury three years or sooner,
if needed, by a licensed tic L! tack puuILer J It aL you puL i11 Lo
Lhe system can affect Lite fUtICLIUII of LI1 1)t il_ l.luk a 1 Lri'at_-
ment stake in the waste dispusal SySLem.
St C r u i x CL) UllLy residents maw be eligll)l IV 1 I':)11C I il'
a in axfIli uIli of 607, of the cost of rep[ it crluenL o1 a failing systew,
which was in upl_ration prior to July 1, 1978. St. Croix County
accepted this 1) rograIli in August of 1980, w i L h Chu Yc(IUireIII cuL Lh.1L
owners of it 11 new systems agree Lu keel) tht,•ir -i y: Loins I,rk)1)C L1)
wainLainr_d. The property owner agrees Lo Submit Lo SL . C: a tx (-)It111 ou 111 a
L_ertitication fUrIII, signed by the owner and by a master plumber,
journeyman plumber, restricted plumber or a 1i.ceIt sed pumper vuri
Lying tI I aL (1) the on-Site wastewater disposal System is ill PruI:L I
uperatinh CUit diLiUl1 and (2) it fIe_r inspection and 1) uIli piit l; (if nec -
essary), rhe_ septic tank is less than 1/3 Lull of sludge and scuu.
Certification form will be :ieut approximately 30 days prior Lu
rIt r e e year expiratiuu.
1/W1 the It ndvrsiFitvd, have read Llle above I-e1-1 UiruulerlL!j and agl:cc vim)
I maintaiu the private ,iewa};e disposal SySLuul ill accurdance Wit11
=4
H
Llie Standards Set forth, herein, as set by Lite Wisconsin Depart- ~o
meuL ul' NaLUral. Resources. CurtitiCatiun IUrnl must be cumpleted
and returned to Lite St. Croix CUUULy 'l.uning 011 ice wiLhiIt W days
of the three year expiralLOU date.
S I G N S
~C Croix CuuuLy lulling 01 l 1.:t,
I, o. liox 9&
Hauluload, W1 5Zt015
715-796-22 =',~i or 715-425-8363
Slgn, date and ret Llrn to rlb..vn l ldru',cr