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Parcel 030-2019-50-000 02/22/2005 09:55 AM
PAGE 1 OF 1
Alt. Parcel 1.29.20.425C 030 - TOWN OF SAINT JOSEPH
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): * = Current Owner
LARKINS, RODNEY J & JUDY
RODNEY J & JUDY LARKINS
229 RIVER CREST DR
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ` 229 RIVER CREST DR
SC 2611 SCH D OF HUDSON i 1
SP 1700 WITC 1 7
Legal Description: Acres: 4.790 Plat: N/A-NOT AVAILABLE
SEC 1 T29N R20W PT GL 1 LOT 2 OF CSM Block/Condo Bldg:
5/1356 ALSO EASEMENTS RECORDED IN 654/55
& 655/62 & 1124/028 & 1/6TH INT IN ROAD Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
01-29N-20W
Q,~ C9 L_o- l C~~ 513 s~ _
DI-Hfstory-_
Doc # Vol/Page Type
~v C~ 1 567246 1271/493 WD
O2~ 0 997
9/1997 873/308
l 7 yZ 9/1997 834/409 more...
t Value: Assessed with:
.L Q-l~cc'1.v -S 600
Last Changed: 07/09/2004
( ~ ~J - d Improve Total State Reason
0 361,300 614,500 NO
r
X-4
- ~ 10 361,300 614,500
0 0
10 279,400 501,800
(~D 0 0
)ate: Batch M 145
j /'9 'Q~- Category Amount
Special Charges Delinquent Charges
~j/jd 0.00 0.00
--Immmlmpplr
pp"w
COMMERCIAL TESTING LABORATORY, INC.
514 Main Street, P.O. Box 526
Colfax, Wisconsin 54730 M CA: v ~tj
715-962-3121
800 - 962 - 5227
ST. CROIX L'OUNTY R O i Dili
COURTHOUSE DATi" RFCETVVf♦
JULISON. 4!I X4,01
AT i N.
~~EF: i tnae s
:sURCE OF SAMPLE2 {~itthe~;
ri..IFORM! 0 !100 m(
NTERPRETATIONI Batter;n9+~u 1 ,
' TRATE-Nt I P~
.i#orr11 saL tef i a/i`
trate-~Ii+rf)aAT.« n !
OF"I'DEPENpFH .
l
2~ (9m
O P
V D
y
d~~'b,.'?yam
PROFESSIONAL LABORATORY SERVICES SINCE 1952
06/13/90 15:09 W159.62 4030 COMM. TEST LAB S.C. CO CRTHOUSE 0 002
COMMERCIAL TESTING LABORATORY, INC.
514 Main Street, P.O. Box 526 c - stj
Colfax, Wisconsin 54730 ~
715-962-3121
800 - 962 - 5227 .
REF-ORT NO .1 06131/01 PAGE
5T. CFOIX ZO!lIltiz REPORT BATE: 6113190
3T. CTK E DATE WCEIVEDi 6/12_/90
COl1f2T4f0U,,~
Aim. WI 54016
ATTNt TMMAS C. NEL.SW
Oy} Michael Curran
LOCATION1. 229 River Crest Dr.. Hudson
COLLECTOR! D. Thomson
soL*cF OF > ul. Kitchen fauce+
0OL,IFORM*, 0 1100 m L
INTERPRETATIONi Bacteriologically SAFE
NITRATE-N+ C 1 PPm
under 10 PPS is safe for human comwwtion-
CoLiform Bacteria/100 ml
ltitrate-Nitrogenr e9r~
i
t
LAB TECMICIAN: Pam Gane
WI Approved Lab No. 19
C means "LESS THAW" Betec+ab le Level Approved by
PROFESSIONAL LABORATORY SERVICES SINCE 1952
m
54--96
ST. CROIX COUNTY ZONING OFFICE
St. Croix County Courthouse
911 4th Street
Hudson, WI 54016
Telephone - (715)386-4680
The St. Croix County Zoning office offers the service of septic
and water inspections to Lending Institutions, Realty Firms, and
private individuals.
Completion of this form is essential so that the property can be
located.
Please provide the following information, enclose appropriate
fee made payable to St. Croix County Zoning Office, and mail,
along with form to the above address. Testing will be done as
soon as possible after fee and form are received. z
WATER TESTING----------------------------FEE: $ 25.00 X
(For nitrates and coliform bacteria)
WATER TESTING FEE: $175.00
(For VOC'S)
SEPTIC SYSTEM INSPECTION-----------------FEE: $25.00 X
(Determines if system is properly functioning at time of
inspection)
Property owner's name Michael J. & Tanna Curran
Property owner's address 229 Rivercrest Dr- Hudson
Legal Description 1/4 of the 1/4 of Section T 29 N-R
Lot Number 2_Subdivision Name -
Town of St_.ln eph
P1 OF I
GOVT LOT 1 T4
FIRE NUMBER LOCK BOX NUMBER HER
Color of house cedar Realty sign by house? If so, list firm:
EDINA REALTY - Roger Hetchler
PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP,i.e,COPY OF PLAT BOOK,
WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET.
Testing of residential water requires a sample that is fresh. If
the home is vacant, and has been so for some time, the water line
must be purged by running the water for several hours before the
test can be conducted.
WINTER TESTING: Many times water lines are turned off, or sill
cocks are turned off, making access to the home necessary. If
this is the case, please make proper arrangements with this
office to ensure time when entry may be gained.
Firm or individual requesting services: Homestead Mortgage Corp
Telephone Number 612-338-4663
REPORT TO BE SENT TO: HMG - 511 S- 11 h Avenue-Suite 401 Mph- MN 55415-
(FAX-612-338-1611) Visa Pratt nr Rnh Sheets (Copy also to Ldji a Realty-)
Closing date 6113190
Signature >2,
7,2&9 e:57Z -W3
-Pdo a i Recit
Edina Realty,.. 'N,
Property Info. Sheet
Hudson QffiCe ADDRESS _ 229 Rivercrest Dr-
700 Second Street `
Hudson, Wisconsin 54016
(715) 386-8236 y
r✓ n Nf $339,000
PRICE- -
€s 1 t
Hudson
CITY/TOWN
r yt tif,
ra A ? , " DISTRICT
a Gay. ~t, . n 20 _
t
.+irlMr~ ti
A ~ art V
LOT SIZE/ACRES---- 4.79 Ac.
xs' f1
'.~w,: yx'~, {~*•t[x F~ X11 H.QI~ k;'; ; A 3• ~
•
~ + t
Room ns:
Dimensio
X
ADDITIONAL SALES HELPS: Dramatic soft contemporary on the
DR; 1 X 14
e a new lift access to FR X
ME. 42 X 14 . ^
DI 2 8 O g t Jn mature-tr z F; 1. x 1-;
0 M
a 150TH {I-\•Y : .l, X 15.5
f- - ---,~ks overlooking the
s '1.t> X 14
I~Pe1113_i~Lindaws R MD1-E-.
35 64 --00001
/f a ._22 23 24
1142ND AVE.
i o
MILETOr z F, ry F
I RDfs i ~ ~ r
E o y~F•yF V 3
Et7F1'dr m
4U T
PETER30N ST. IS6111 F
o F I AVE. n 25
~,,W b o I 26I .r. ROGER E. HETCHLER
~A\ z WTN AVE t Edina Ey Bus. 715 386-8236
I Reap/ Metro 612 436-7072
c~ NC , Home Office 715 386-8196
STN
38
RIVERVIEW
* ACRES 700 SECOND STREET • HUDSON, WISCONSIN 54016
♦ b R0. _ RED PINE
Vr \ i% TR. j REALTORS • MLS
1 ® MLS 1Q
s~ti ♦ R M
P M O~ !
OR. PP V
/O •
A SA ~
w9 URT
RIVEF '
rt CB
k Edina Realty..
ti
w
E R V l C E S/ ,
113 MLS 1~
Kitchen has cherry cabinets, Man corian counter top, beechwood
_N floor, 2 islands, sub-zero frig
and Thermado range.
Sr S
r¢c~SS° ± 4 w A_
~F.J root 9F 4~.'Y,gAw.~n.
4", nvu
ri~.iy~p. S 1~
xx pi~VYN~ ~ ' 4
z 'y
. r
Coated ceramic floor, soft silk
wall covering in entry. Curved
staircase.
r ~ f ~~99 3
r~
T7, q WIII
YY g~
ON
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2
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k ST. CROIX COUNTY
~`n ae^ WISCONSIN
h
ZONING OFFICE
N ST. CROIX COUNTY COURTHOUSE
911 FOURTH STREET • HUDSON, WI 54016
Y
(715) 386-4680
June 13, 1990
HMC Riley
511 S. 11th Ave., Suite 401
Minneapolis, MN 55415
Dear Sir:
An inspection of the septic system of the Michael Curran
property, located at 229 Rivercrest Dr., Town of St. Joseph was
conducted on June 12, 1990. At the same time I also obtained a
water sample for testing. The results of that test will be sent
to you as soon as we receive them back from the laboratory.
At the time of inspection, the sanitary system appeared to be
functioning properly. The inspection of this sewage disposal
system was based upon a surface inspection of said system, and
did not involve any excavating or chemical analysis.
Accordingly, there is the possibility of hidden defects in the
system not discoverable by this inspection. This does not in any
way warrant or guarantee the continued proper functioning or
operation of this system. It is recommended that the system
should be pumped once every three years. Therefore, the
prolonged life of this system is totally dependent upon proper
maintenance of the system.
Should you have any questions regarding this subject, please feel
free to contact this office.
Sincerely,
Mary J. Jenkins
Assistant Zoning Administrator
cj
Form- S T C - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP SEC. f T N-R W
ADDRESS ST. CROIX COUNTY, WISCONSIN
SUBDIVISION LOT LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of ILHR 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
r
~ a[~UI_SL
~I
t ~
F
INDICATE NORTH ARROW
BENCHMARK: Describe the vertical reference point used a
Elevation of vertical reference point: !t, Proposed slope at site:
SEPTIC TANK: Manufacturer: ; / ri Liquid Capacity:
Number of rings used: Tank manhole cover elevation:
Tank Inlet Elevation: =t~ F Tank Outlet Elevation:' !9 1
Number of feet from nearest Road: Front, Side feet
, Rear, O
From nearest property line : Front,0 Side,0 Rear, O feet
Number of feet from: well building: _ ''tea
(Include this information of the above plot plan)( 2 reference dimensions to septic tank)
SEE REVERSE SIDE
r*
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: Trench:
Width:. Length: Number of Lines: Area Built: ( {
Fill depth to top of pipe:
Number of feet from nearest property line: Front, O Side Rear,0 Ft. ll,:
Number of feet from well:
Number of feet from building:
(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, O Ft.
Number of feet from well:
Number of feet from building:
Number of feet from nearest road:
Alarm Manufacturer:
Inspector:
r.
Plumber on job:
Dated :
License Number:
3/84:mj
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR
LABOR & HUMAN RELATIONS SAFETY & BUILDINGS
P.O. Box 7969 PRIVATE SEWAGE SYSTEMS DIVISION
MADISON, WI 1:73707 BUREAU OF PLUMBING
< CONVENTIONAL ❑ALTERNATIVE State Plan LD. Numbec
Holding Tank El In-Ground Pressure ❑ Mound uraes;yned)
NAME OF PERMIT HOLDER'.
ADDRESS OF PERMIT
James Mc Phail INSPECTIoN DATE
R. R. 2, Hudson, WI 54016 `')r_ /1►
(Pe
BENCH MARK rmanentreference point) DESCRIBE IF DIFFERENT FROM PLAN: o
NW NW, Section 1, T29N-R20W, Town of St.Joseph,Lot#2, Landry Sub. REF. PT. ELEV. DST REF PT ELEV
Name. of Plumber -
JIPIMPRSW No. County.
Donavin Schmitt 3205 sanitary Permit Number
St. Croix 64865
SEPTIC TANK/HOLDING TANK:
MANUFACTURER.
LIQUID CAPACITY TA K INLET ELF
AN
OUTLET ELE V..
~{1(f /jV / /j > WARNING LABEL
ED: LOCKINGC V PH ' PROVIfSED
BEDDING: VENT DIA.. VENT MATL. HILGAHR WATER ( 77 / ( Cl YES ❑ NO NO
NUMBER OF ROAD:
C..- f ^ AM PROPERTY WELL: BUILDIN VENT TO FRESH
❑YES O ( FEET FROM C LINEn ll AIR wLEr
❑YES ❑NO NEAREST > d ~S tJ
DOSING CH MBER:
MANUFACTURER BEDDING. LIQUID CAPAC ITV PUMP MODEL
PUMP/SIPHON MANUFACTURER
WARNING LABEL LOCKING COVER
❑YES LINO PROVIDED: PROVIDED.
GALLONS PER CYCLE: PuMPAND CONTROLS OPERATIONAL ❑YES LINO ❑YES LINO
(DIFFERENCE BETWEEN NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH
PUMP ON AND OFF) FEET FROM LINE I AIR INLET
SOIL ABSORPTION SYSTEM. Check the soil moisture at thEYEhof plowinONO NEAREST
or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE DIAMETER MATERIAL AND MARKING
the soil is dry enough to continue.) MAIN
CONVENTIONAL SYSTEM:
BED/TRENCH WIDTH LENGTH. No. OF DISTR. PIPE SPACING COVER
DIMENSIONS F ~ < n TRENCHES M "IAL PIT INSIDE CIA v TS LIQUID
J L DEPTH
GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL.
BELOW PIPES/` ABOVE COV R ELEV. INLF NZ . NUMBER OF WELL BUILDING'. VENT 70 FRESH
f Q ELEV. EZ PIPES; PROPERTY
/I FEET FROM LINE AIR INLET
NEAREST--i.
MOUND SYSTEM:
Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM
and furrows thrown upslope:
mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA-
❑YES LINO meets the criteria for medium sand. TIONS MEASURED.
SOIL COVER TEXTURE
PERMANENT MARKERS. OBSERVATION WELLS
DEPTH OVER rRENCH.6ED DEPTH OVER -TRENCH BEE' ❑YES LINO ❑YES LINO
CENTER EDGES. DEPTH OF TOPSOIL . SODDED SEEDED
MULCHED
❑ LIYES LINO
PRESSURIZED DISTRIBUTION SYSTEM: YES NO ❑ YES LINO ❑
BED/TRENCH WIDTH LENGTH NO.OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE
DIMENSIONS TRENCHES FILL DEPTH ABOVE COVER
MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING
ELEVATION AND ELEV ELEV CIA FLEV PIPES
DIA.:
DISTRIBUTION
INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY
COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED
PLANS
COMMENTS: PERMANENT MARKERS E YES ❑ NO ❑ YES ❑ NO
OBSERVATION WELLS: NUMBER OF PROPERTY WELL BUILDING.
7 ❑YES LINO FEET FROM LINE'
❑YES NO NEAREST
b
Sketch System on
Reverse Side. Retain in county file for audit.
SIGNAT i.., TITLE:
DILHR SBD 6710 (R. 01/82) --Z.
- wlsconsln APPLICATION FOR SANITARY PERMIT
~ DILH
~7 OEPgq'777~EnT OF R1@
(PLB 67) COUNTY
- InOUSTPV,LRBOg6HOmgnqELPITIOnS 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'/2x 11 inches in size.
-See reverse side for instructions for completing this application. PLEASE PRINT
vu C MAILING ADDRESS
ON ® t
ITY:
, S NR
E (or
20 CWD
OCK NUMBER SUBDIVISION NAME OWN 'r
T ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER
L, i .
99
TYPE OF BUILDING OR USE SERVED
1 or 2 Family Number of Bedrooms:
❑ Public (Specify):
THIS PERMIT IS FOR A:
New System ❑ Tank Replacement
Replacement Soil Absorption System ❑ Repair
❑ Revision ❑ Privy
❑ Alternate System
Reconnection ❑ Petition for Modification
IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK.
Seepage Bed E] Seepage Trench
System-In - Fill ❑ Seepage Pit El Holding Tank
❑ In-Ground Pressure ❑ Vault Privy E] Pit Privy
El Existing, For Which A Previous Permit Is On File, Permit #
E-1 An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions, issued
Total #of Prefab. Site
Gallons Tanks Concrete Constructed Steel Fiberglass Plastic
Septic Tank Capacity
Lift Pump Tank/Siphon Chamber
Holding Tank capacity
Manufacturer:C~ `
IF THI ATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound
❑ In-Ground Pressur
Total #of Prefab.
a nks Constructed Steel Fiberglass Plastic
Septic Tank Capacity
Lift Pump/Siphon Chamber
Ma
PERCOLATION RATE ABSORPTION AREA
(Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square R Feet):
WA~T~ER~SUPPLY:
6 ~ IE° Private ❑ Joint ❑ Public
I, the undersigned, hereby assume responsibility for installation of the private sewa e system shown on the attached plans.
Name of Plumber (Print): Signatur
Phone Number:
77
Plumber's Address: a Iy~
a Name of Designer:
~N
COUNTY/DEPARTMENT USE ONLY
Signature of Issuing Agent:
Fee: Date:
~\j~ ^ Disapproved
tA1, o a l" 411 1_1L - ~9i Owner Given Initial
Reason for Disapproval: Approved Adverse Determination
Alternate course(s) of Action Available:
DILHR-SBD-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber
INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398
To be complete and accurate the permit application must include:
1 . Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in
a city, village or town);
2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant,
etc.) ;
3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks.
4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of
square feet to be installed;
5. Complete the section on water supply;
6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi-
fication, place your license number in the space provided and sign the permit in the signature block;
7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the
permit;
8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation.
Failure to comply will void the sanitary permit.
9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable.
10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system,
depth of the system, type of system.
11. All revisions to this permit must be approved by the permit issuing authority.
12. A complete plan including a plot plan, drawn to scale or with complete dimensions.
13. Horizontal and vertical elevation reference points that are permanent and clearly shown.
14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s)
to system, building sewer and vent observation pipe(s).
15. The permit issuing agent may require a cross section drawing of the effluent disposal system.
TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems
must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning
your system, contact your local code administrator or the Bureau of Plumbing, DILHR, State of Wisconsin.
1
APPLICATION FOR SANITARY PERMIT
S T C - 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
Location of Property Section T
N - R W
Township T
J
Mailing Address
Subdivision Name
Lot Number
Previous Owner of Property 1 /1 A
Total Size of Parcel LL U-:2
Date Parcel was Created ei- c ;
Are all corners and lot lines identifiable?
Yes No
Is this property being developed for resale (spec house) ? Yes
No
Volume ZL and Page Number
_ as recorded with the Register of Deeds
INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING:
-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 references to a Certified Survey
Map, the the Certified Survey Map shall also be required.
PROPERTY OWNER CERTIFICATION
I (We) eent%Sy that att 6 tatemen.ts on .thi,a 6on.m ah.e tAue to the best o6 my
hnowtedge; that 1 (we) am (aAe) the owneh(6) o6 the pnopenty duc ibed inthiz )
in6o4mati,on Soh.m, by vi tue o6 a wa4.anty deed teco4ded in the 066.ice o6 the
County Reg-c,s-teA o6 Deeds as Document No. -IVL C L, ) ; and that I (we)
pee s entCy own the p.4o pos ed 6-c to Son the sewage pod 6 y.6 tem (on I (we) have
obtained an easement, to h.un with the above deseh.%bed pnopenty, Son the
const ueti,on os 6aid 6ys-tem, and the Game has been duty h.eeohded in the 066.iee
o6 the County Regi4 teh o4 Deeds, as Document No.
C L L / L
i SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE)
DATE SIGNED DATE SIGNED
H
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ST C- 105 a
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SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County o
z
OWNER/BUYER
C=]
ROUTE/BOX NUMBER
- • Fire Number
CITY/STATE-f~_GzC;~y~7~ 'LIP : /(F>
z
PROPERTY LOCATION: yl
Section 'f N, K ~C-) W~
Town of.~ `T St. Croix County,
Subdivision Lot number
Improper use and maintenance of your septic system could result
I
j
its premature failure to handle wastes. Proper maintenance con -in
sists of pumping out the septic tank every three years or sooner,
if needed, by a licensed septic tank pumper. What you pt into
the system can affe e function of the septic tank asua 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.
y
0
57.
I/WE, the undersigned, have read the above requirements and agree
to maintain the private sewage disposal system in accordance with ac
the standards set forth, herein, as set by the Wisconsin Depart- ny
H
ment of Natural Resources. Certification form must be completed
and returned to the St. Croix County Zoning Office within,
of the three year expiration date. O d;ys
SIGNED', -
DATE
St. Croix County Zoning Office
P.O. Box 98
Hammond, WI 54015
715-796-2239 or 715-425-8363
Sign, date and return to above address.
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INDUSTRY
DEPARTMENT OF SAFETY & BUILDINGS
REPORT ON SOIL BORINGS AND
LABOR HUMANAND,
DIVISION
PERCOLATION TESTS
P.O. BOX 7969
(115)
(H63.09(1) & Chapter 145.045) MADISON, WI 53707
LOCTY SECTION:
i /T~~l/~ (or) W TONSHIPLSBDSION NAME:
COUI
; OW ER'S/BUYER'S NAME:
ALING DDRESS:
USE ; t,>✓
C, k
NO. BEDRMS.: COMMERCIAL DESCRIPTION: E I 5~814
DATES OBSERVATIONS MADE
Residence PROFILE DESCRIPTIONS: PERCOLATIO
{ New E01 Replace TESTS
N :
•3-f'
51
RATING: S= Site suitable for system U= Site unsuitable for system R U NS []U
CONVEccNTIONAL. MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional)
If Percolation Tests are NOT required DESIGN RA TE: J
j~
under s.H63.09(5)(b), indicate: If any portion of the tested area is in the
Floodplain, indicate Floodplain elevation:
on:
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH Z'i
NUMBER IN ELEVATION HICKNESS, COLOR,~OAND OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED ISEE ABBRV. ON BAC6a /V0 A)
O
B- 5B lad .51, ~ 7 06
B- z - 1 as X33
B- 3
,9z- j~ B
7 3
B-
`Q~Simp~ PERCOLATION TESTS
TEST DEPTH WATER IN HOLE
NUMBER '{TE AFTERSWELLING INTTEST ERVAL-MIN. E NC H
DROP IN WATER LEVL-IES
P_ 3 PERIOD 1 PERIOD 2 RATE MINUTES
PERIOD 3 PER INCH
,7 QU A)0
P- 3
7
P_
41-
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-
of land slope.
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
SYSTEM ELEVATION] '
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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 C he
Jministrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. J\~
`
Wisconsin
4ME (print)) :
/ TESTS WERE COMPLETED ON:
CERTIFICATION NUMBER:
CDR PHONE NUMBER (optional):
CST SIGNA I YR
;TRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
_HR-SBD-6395 (R. 02/82)
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