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Parcel 030-1018-20-000 04/15/2005 03:31 PM
PAGE 1 OF 1
Alt. Parcel 05.29.19.76C 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
MURAWSKI, ROGER P & DEBRA K
ROGER P & DEBRA K MURAWSKI
462 RIVER RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 462 RIVER RD
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 3.000 Plat: N/A-NOT AVAILABLE
SEC 5 T29N R1 9W SW NE LOT 1 CSM 2/586 Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
05-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 775/46
2004 SUMMARY Bill Fair Market Value: Assessed with:
4852 197,400
Valuations: Last Changed: 07/07/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.000 75,500 118,700 194,200 NO
Totals for 2004:
General Property 3.000 75,500 118,700 194,200
Woodland 0.000 0 0
Totals for 2003:
General Property 3.000 44,300 91,400 135,700
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 305
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Wisconsin Department of Industry,
PLB-1; INSPECTION REPORT Labor & Human Relations
Safety & Buildings Division
Bureau of Plumbing, Platting & Fire Protection
Name of-Premises Date an No.
Street city oun y Sanitary Permit
Master Plumber Firm Name dress
Journeyman Plumber Address -A TcT Owner ress
-
~ . _ A ~a,- _ . _ , . ~
iscusse with Signature
( )See Attached.
DILHR-SBD-6192(N.09/80) Signature o is um ing up. On-Site Waste Specialist
White-Inspector Yellow-Local Inspector Pink-Plumber or Responsible Party Green-Owner
' AS BUILT SANITARY SYSTEM REPORT
OWNER- -a---, 'T'OWNSHIP SEC Tx"-/N -R-~~ W
ADDRESS 00 AO ST. CROIX COUNTY, WISCONSIN.
SUBDIVISION LOT LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of H63
SHOW EVERYTHING WITHIN 1.00 FEET OF SYSTEM
i
~1
li
I di at N r h rr w
BENCHMARK: (Permanent reference Point) Describe:
Elevation of vertical reference point: ,did -Slope at site: .5~;
SEPTIC TANK: Manufacturer:
IF~ Liquid Capacity:
Number of rings on cover f e
Wank manhole cover levation:Zd(
Tank ln1et i?1cv,itTon - I',i;il< FJutl_et T? le v-1 tion:~~
PUMP CHAM.BE1v1
Manufacturer: _ Nui7~ber oL gallons
Number of.,gal. pump set for a cycle- gallons; Total capacity of
distrib ion lines -gallon: size of pump head;
gall per minute horsepower ;brand name of pump
a model number ;
ype of warning device
HOLDING TAB' Manufacturer-- Number of gallons
F.lev ion of manhole cover--
pe of warning device
SEEPAGE PI.T--SIZE; Number of pits feet diameter
fe liquid depth seepage pit inlet pipe-elevation
ottom seepage pit elevation feet.
SEEP,' BED SIZE: number of lines width length tile depth
f~c~'r~~c~i - ~C, / cFi!G✓ ~L~d ~ ,L''~ Y~.-.-.. ; /G d ~v 7 . i
SEEPAGE TRENCH: width_ length
PERCOLAT CON RATE _ _ AREA REQUIRED_- AREA AS BUILT
INSPECTOR
DATED 1 E-• s/ PLUMBER ON JOB
LICENSE NUMBER
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR
LABOR & HUMAN RELATIONS
P.O. BOX 7969 PRIVATE SEWAGE SYSTEMS SAFETY & BUILDINGS
MADISON, WI 51',707 DIVISION
BUREAU OF PLUMBING
CONVENTIONAL ❑ALTERNATIVE
❑ Holdin State Plan I.D. Number
l
9 Tank ❑ In-Ground Pressure ❑ Mound Ufassigned
NAME OF PERMIT HOLDER:
I ADDRESS OF PERMIT HOLDER:
Roger MUhaWS(2 ( 58 W. INSPECTION DATE
BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN Cook Ace , , S Pau. , MN
SW NE, Section 5, T29N-R19W, Town o6 St, Joaeph REF. PT. ELEV. CST REF PT ELEV
Name ,f Plumber
MP/MPRSW No. ount
Gany St e e l 3 2 5 4 C ,tary Permit Number
S y Cnoix San
43661
SEPTIC TANK/HOLDING TANK:
MANUFACTURER.
~f1 LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV WARNING LABEL
! LL - LOCKING COVER
BeoD NG: vEVVVNr C ol lJ M ~ p D (D ) ' 1 P O DED. PROVIDED.
I ~v YES LINO
VENT MATL: HIGH WATER - OYES LINO
ALARM NUMBER OF ROAD: PROPERT WELL
❑YES LINO FEET FROM BUILDING: vENrroFRESH
DOSING CHAMBER: ❑YES LINO NEAREST ~AI`r -
MANUFACTURER BEDDING. LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER.
YES WARNING LABEL LOCKING COVER
❑
LINO PROVIDED PROVIDED:
GALLONS PER CYCLE: PUMPANOCONraoLSOPERATIONAL, ❑YES LINO ❑YES LINO
(DIFFERENCE BETWEEN NUMBER OF PROPER rv WELL BUILDING VENT r0FRESH
PUMP ON AND OFF) FEET FROM L-INE I AIR INLET
EAREST
SOIL ABSORPTION SYSTEM. Check the soil moisture at theLIdepEh of plowing LI NO NLENGTH
or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE DIAMETER MATERIAL AND MARKIN(,
the soil is dry enough to continue.)
CONVENTIONAL SYSTEM: MAIN
BED/TRENCH 111TH' LENGTH € NO OF
DISTR. PIPE SPACING COVER
DIMENSIONS 11 TRENCHES ~ MATERIAL: INSIDE DIA PIT =PITS
_ uoulo
GRAVEL DEPTH ! - DEPTH:
I FILL DEPTH BELOW P DI TH PIPE DISTR PIPE DISTR. PIPE MATERIAL.
IPE A B VE COVER ELEV. INLFT ELEV. END NO DISTR
) e r ; 1 /0 / PIPES NUMBER OF PROPERTY WELL: BUIL ING: VENT TO FRFSFI
? FEET FROM LINE } AIR INLET
MOUND SYSTEM: NEAREST--~ t Jet)-'
Mound site plowed perpendicular to slope
uPslope: and furrows thrown Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM
mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA-
❑YES LINO meets the criteria for medium sand. TIONS MEASURED.
SOIL COVER TExruRE
PE RMANENT MARKERS: OBSERVATION WELLS.
DEPTH OVER TRENCH'BED DEPTH OVER TRENCH 'BED ❑YES LINO ❑YES
CENTER EDGES. DEPTH OF TOPSOIL SODDED LINO
M ED
❑YES LINO r-,",YES LINO ❑YES LINO
PRESSURIZED DISTRIBUTION SYSTEM:
BED/TRENCH WIDTH LENGTH If 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
ELE V. PIPES
DISTRIBUTION CIA
INFORMATION HOLE SIZE HOLE SPACING. DRILLED CORRECTLY
COVER MATERIAL . VERTICAL LIFT CORRESPONDS TO APPROVED
PLANS
COMMENTS: PERMANENTMARKERS: YES LINO ❑YES
OBSERVATION WELLS: LINO
NUMBER OF PROP ERTV WELL BUILDING
❑ YES ❑ NO FEET FROM LINE
❑YES LINO NEAREST
Sketch System on
Reverse Side. to in county file for audit.
TITLE
DILHR SBD 6710 (R. 01/82)
w15con5in APPLICATION FOR SANITARY PERMIT
-
COUNTY
~ DILH (PLB 67)
oEaggTrnmEnr of
EPR TEnT Og6HUTgnqELFTIOnS 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'/zx 11 inches in size.
-See reverse side for instructions for completing this application. PLEASE PRINT
PROP$TEY OWNER
MAILING ADDRESS
PROPERTY LOCATION
'CfT-Y:
114fi _1/4, S , T-,~/, N, R / /E (or) W TOOF: c~.
LOT I MBER BLOCK NUMBER SUBDIVISION NAME
NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER
TYPE OF BUILDING OR USE SERVED
1 or 2 Family Number of Bedrooms.
Public (Specify):
THIS PERMIT IS FOR A:
New System ❑ Tank Replacement El Re air
Replacement Soil Absorption System p
Rep lac ❑ Privy
lternate System ❑ Revision
A ❑ Reconnection ❑ Petition for Modification
IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK.
❑ Seepage Bed Seepage Trench
System-In Fill ❑ Seepage Pit L] Holding Tank
❑ In-Ground Pressure ❑ Vault Privy L] Pit Privy
❑ Existing, For Which A Previous Permit Is On File, Permit #
❑ 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
J 4 C)
Lift Pump Tank/Siphon Chamber
Holding Tank capacity
Manufacturer:
IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure
Total #of Prefab. Site
Gallons Tanks Concrete Constructed Steel Fiberglass Plastic
Septic Tank Capacity
Lift Pump/Siphon Chamber
Manufacturer:
PERCOLATION RATE ABSORPTION AREA
(Minutes per inch): ABSORPTION AREA WATE:S
Y:
REQUIRED (Square Feet): PROPOSED (Square Feet):
t'a 'ci
❑ Joint ❑ Public
I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans.
Name-of Plumber (Print): , Signature.
J)
i
MPIMPRSW No.: Phone Number
Plumber's A ress: -t- r
Name of Designer:
I
COUNTY/DEPARTMENT USE ONLY
Signature oAgent:
Date:
❑
Disapproved
(~C 7
%./~~%i./ ~=r ❑ Owner Given Initial
Reason for Disapproval: ( x~ Approved Adverse Determination
Alternate coursels) 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.
o r w - S T C 10 0
Owner of Property_ krqe V, f~
Location of Property L; ~ =c, Section-
/U E N R 1~ 1 w
Township
F' LC, T ) f
~•a rYl~rn ,n o it
VIJ
M
ailin8 Address ac{ (A f
Subdivision Name
Lot Number
Previous Owner of Property_ 4jL Total Size of Parcel
Date Parcel Was Created
Are all corners identifiable?
Y e s No
Include with thin d) lvication one of the following:
.Certified Survey Map
.Deed
.Land Contract, or
.Other Legal Document which describes the property
PROPERTY OWNER CERTIFICATION
a
((~e)certify that a
kr(owled-54atements on this form are true to the best of my ur)
41e; that I ((Ve) am (are) the owner(s) of the property described in this
information form, by virtue of a warranty deed recorded in the Office of the
County Register of Deeds as Document No. _ 1
presently own the proposed site for the sewage disposal system and that I t of ave
bbtained an casement, to run with the above described property, for he
construction of said system, and the same has been duly recorded in the Office
of the County Register of Deeds, as Uoeument No.
1.
4~ruoE OF
O~WIILR SIGNATURE OF CO-0WNER (IF AppLICAEfLE)
c
DATE SIGNED
DATE SIGNED
WTSCONSIN REAL ESTATE TRANSFER RETURN
- Wisconsin Department of Revenue
GRANTOR
GRANTEE:
f(feme - D. HillAtt IIIA sad LlettT A, 41Ut ame fl~r 1 1ir1 i De1~rr,11 1w.....s.,Y
Social Security Number Social Security Number I I I
Full Address - New address if property transferred was residence Full Address
638 St. Croix Stre" worth 58 W"t C"k met
Hmdaoa, Wiecaleeft 54016 St. Pant, eta 31117
Is grantor related to grantee? Relationship includes, Name and address to which tax bills should be sent
marriage, blood relative, partner, lessee-lessor, co-
owner, parent corporation or joint owner. Q Yes ❑ No
Grantor is 50 {ndividual ❑ Partnership ❑ Corporation ❑ Other
Telephone: Grantor,(. Telephone: Grantee ( ) -
PART I - PROPERTY TRANSFERRED
Check proper box and enter name of municipality and county Street address of property transferred Include road name and/or fire number.
❑ City ❑ Village ® Town of: at. Jesep)]e
County of: St. CMIX
Legal Description (Fill in complete legal description in space below or if metes and bounds description attach 3 copies of it as shown on the instrument of
conveyance. df certified survey map number is used in description list town, range, section and acres.)
Lot No. Block No. Plat Name
Town Range Section
Parcel Number _
Part of t>lsal 9* of the XWetheast k of Soetiea 5-29-19, Togo of at. Josalrbi 4"G rium ass
Lot 1 of the Certified Sur"y Map Mod and recorded in the Office of the Register of DoWe
-
PART 11 PHYSICAL DESCRIPTION AND INTENDED USE
~~~y~- s•'* ~a~
1. Kind of Property b. Residential Units, if any 2. Principal Intended Use 3. Land Area and Type Estimated
a.] Land Only [I One Family a. Residential d. [A Agricultural a. Lot size x ❑
❑ New Construction ❑ 2 and 3 units b. ❑ Commercial e.
❑ Recreational b. A Total Acres
❑ Building Previously Used ❑ 4 or more units c. ❑ Industrial f. ❑ Other (Explain) 1. Tillable Acres
❑ ySol~ar Design C. ❑ Rental 2. W.T,cres
❑'Earlth Sheltered Home
❑ Condominium 3' F`~~~~
Ft:-of Wataf rrimtage ❑
PART III - TRANSFER (Answer as many as apply)
1.0
satisfaction of land contract - What was tote date of the o land contract?
5. Othr
sfefrL+d ❑ Full [I Other (Explain below) 7. What'is the amount of mortgage assumed"
by grant. ? 8. Does the grantor retain any of the following rights: ❑ Life estate Ea
❑ sew*a- E] Other (explain below).
Oriat
PART IV `iC0 POTATION OF FEE OR STATEMENT OF EXEMPTION
1. Total value of REAL ESTATE transferred (purchase price, etc., Do not include personal property)
2. Value of personal property transferred but excluded from line 1 . $
3. Value of tax exempt property (solar, wind, waste treatment, mfg. M&E, other) included in line 1 $
4. TRANSFER EXEMPTION NUMBER if exempt for Reasons 1.13 (see instructions) . Sec. 77.25 ( 41111ds. 19C4
)
5. Fee - thirty cents per one hundred dollars of value (line 1 times .003) (Make check payable to Register of Deeds) $ `
PART V - CERTIFICATION
We declare under penalty of law, that this return (Including any accompanying schedule) has been examined by us and to the best of our knowledge and belief it
is true, correct and complete.
(Grantor understands that the transfer must be reported for Wisconsin Franchise or Income Tax purposes regardless of the Grantor's state of residence.)
Signature of Granto? r Agent Date Print or Type Agent's Name
SIGN
Signature of Grantee or Agent Date Print or Type Agent's Name
HERE 001.
Documen o. Vol. (Reel) Page (Image) Date Recorded Date and Kind of Conveyance
LEAVE
THIS Parcel Number
xDistritt A,*Wt Dist
AREA L L
BLANK 3 Use 4 Reiaet
19 fig 7RatioConsideration
E F B C D T T
In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long
as the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be treated
as unpaid principal) is less than the amount that said indebtedness would have been bad the monthly payments been
made as first specified above; provided that monthly payments shall be continued in the event of credit of any proceeds
of insurance or condemnation, the condemned premises being thereafter excluded herefrom.
Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser
for examination except: Providing all payments then owed have been paid in full, the vendors
will have the abstract of title recertified and submitted to the purchasers for
examination on their behalf some time prior to November 10, 1983. The abstract shall
show the title to be in the condition called for in this contract.
Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall
be retained by Vendor until the full purchase price is paid.
Purchaser shall be entitle to take possession of the Property on------ December--Is--____--_--_________________
-Cross Out One. (TO BE USED IN NON-CONSUMER ACT TRANSACTIONS)
LAND CONTRACT-Individual and STATE BAR OF WISCONSIN Wisconsin Legal Blank Co. Inc.
Corporate FORM No. It - 1977 Milwaukee, Wis. (.ioh 34819)
TMFNT'OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY,, DIVISION
LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969
HUMAN RELATIONS MADISON, WI 53707
(H63.09(1) & Chapter 145.045)
LOCATION: r~ SECTION: TOWNSHIP/MHfdfC}PAtITY: LOT NO.:BLK. NO.: SUBDIVISION NAME:
1/ #/4 5_ /T:;~N/R/'//'(or) W - -
CI~NT OAR`S/BUYER'S NAME: ' AILING ADDRESS:
liip* IIi
0 r X
USE
DATES OBSERVATIONS MADE
NO. BEDRMS.: COMMERCIAL DESCRIPTION: I~I PROFILE DESCRIPTIONS: PERCOLATION TESTS:
Residence y~New ❑Re lace
RATING: S= Site suitable for system U= Site unsuitable for system
CONNV(VENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDIN721
ECOMMENDED SYSTEM: (optional)
F_ - S []U =S ❑U S ❑U ❑S u ❑S If Percola
tion Tests are NOT required DESIGN RATE: [Floodplain, f an
y portion of the tested area is in the
under s.H63.09(51(bl, indcate: indicate Floodplain elevation:
/ "M' PROFILE DESCRIPTIONS
j)>¢>2I / 2
BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DOM._tN, OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.)
A_ / di n owe i
V
~L9 00
B-
/ iF >r yy~ r?)' PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER +AIEHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH
P?
P- Ij No
P-
3 "'VD T V s /
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
,
--Z
s.
i4p X/
•CJ ~ 3
s
• , s J z 2,
,
i
_ r-- _
,jE y 7e,yd _ ° . - I
,
I, the undersigned, hereby certify that the soil tests reported on this form were made by mein 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):
CST SIGNAIU .
LDISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
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