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HomeMy WebLinkAbout038-1015-80-000 r t -0 (D CD 3 # C r X = rt o rn -1 o CL p °a y w w w C m = 3 w m m a a v Q 0 ' o . o CD CD w C6 W s? o co !i o o A~ N CD O C (D (p a Q O Cp W •P CL O o o n C ono o 00 Z77 Lry a CO 2 !i o0 o Z y r = 3 ^ ? p o 0 o. m ~ n g g s m I3 N N~ a 0 o Z CD p p D m < N Ln 7 3 A (D Fr C? CO I 7 V CIl p D D o _a I CD ~ v • CD I C ~ A_ m [_rnY 3 CD .j Z CD 0 A 0' m o W Ca 0 3 Z p - p y CD I N a m X c o°N a 3 CD CID m m o a po > > m c l ~ o a a ~ co N I (D S I CD A N (h I 5 W N ~ c S _ O O O q CD A I b O O CD dC b C) Q r V ti Parcel 038-1015-80-000 09/12/2006 09:31 AM PAGE 1 OF 1 Alt. Parcel 3.31.18.43B 038 - TOWN OF STAR PRAIRIE 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 VALENTINE P & BEVERLY E JACKELEN O - JACKELEN, VALENTINE P & BEVERLY E 1144 CTY RD H NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ` 1144 CTY RD H SC 3962 NEW RICHMOND SP 1700 WITC SP 8055 CEDAR LAKE/N R Legal Description: Acres: 0.810 Plat: N/A-NOT AVAILABLE SEC 3 T31N R18W.81A IN GI-4 LOT 2 OF CSM Block/Condo Bldg: IN VOL IV PAGE 995 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 03-31N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 986/276 WD 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/12/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.810 196,500 132,300 328,800 NO Totals for 2006: General Property 0.810 196,500 132,300 328,800 Woodland 0.000 0 0 Totals for 2005: General Property 0.810 196,500 132,300 328,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 125 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ST. CROI X COUNTY t^ s ~rM W I S C O N S I N t►ii`t tr ZONING OFFICE 196-2239 At~;ri ! ttt_ ~M Post 0666ise B o x 227 it Hammond, WI 54015 O W N E R P U M P E R A G R E E M E N T PLEASE BE ADVISED, Fha.t un.t.i.t you axe again no.t.i6.ied, I w.i.t.t contcac-t with -'/r`rL-,E- To kNE. o'FS-' Y" o6 1J~ cif er.cfl."c.nib Wi.deons.in, (Pumpers), box the puxpose o6 xemov.ing a.t.t waste 6xom the ban.i..tany system to be .toeated on the pxopex.ty and 6u.tuxe home site .tocaxed in St. Cxo.ix County, W.is cons.in, Township o6 1'~xlvc'14 being in the oi the -5 L 14 o6 Sec. T. j / N.-R.-L±Lw. (Ox mou 6u.t.£y descx.ibed as 6ottows:) p gc-e T 5"S- 45 bocut,,F-4r o, 3~ 93 aE~N< e oc~~or'~ iN Vuk Y,il P19er' or C<~~~!'e/~~EN7 ,(oo ~SEf , SFr.rt'~N 1-4-,'cG3~~ T~,c~tlStl~P `fr>i~rY~ONF~~1~ 14 0K7-I-1 ~Hn/cie F ~C~NTFr~C! WEST Dazed this It day o6 (OWNER) State o6 Wisconsin) 4,6 County 06 St. Cxo.cx ) Pexson.na.teya tk* ppeaned be6oxe me this is ' day 06 i94i . the above named ~''~<<Tv td G c~~ Sari to a own to oche penbon who executed the 6onego~ng ins.txument and aeknowtedged .the same. SANK OP NEW PIT( 'Y, 'OND rr°t /he-t, k-, New Richmond VVis 4017 o any. uubtte, St. Cno.ix County, W1 My Comm. (.is pexmant) (Expi4e6) I, Charles W. Nutzmann hexe.inbegoxe 4e6exxed to as Pumpex, loin in the above agxeemen# to the extent that I have a con.txac.t with Ownex as above stated. ~rf (PUMP ) c e AS BUILT SANITARY SYSTEM REPORT . r{E'R1..z , 7; , TOWNSHIP1-V >xi~ SEC. 0. ADDRESS TR W ST. CROIX COUNTY, WISCONSIN. '3DIVISION LOT LOT SIZE PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM - -T - Al 4 ,7 ~ 1 Indicate ~ ! . North Arrow SCALE ?TIC TAICK(S)`_ MFGR.-~/~~ CONCRETE STEEL N0. or rings on cover_'_ Dept-h, ; t DA WELL 't•E:NCHES NO. of width length area .i no. of lines width length area depth to top of pipe AGREGATE 'To ;W RATE AREA REQUIRED AREA AS BUILT liwlaimer: The inspection of this system by St. Croix County does not imply complete .a,~Pliance with State Administrative Codes. There are other areas that it is not possible 60 inspect at this point of construction. St. Croix County assumes no liability for ,Stem operation. However, if failure is noted the County will make every effort to .i,ercine cause of failure. ,,EASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYST 'INSPECTOR 0 '4 DATED PLUM IBER ON JOB i LICENSE NUKBER 1 . REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM Sani taAy PeAmti /G / State Se.p-ttic,:R 93 NAME Towns hi . p St. Cko x County Loca,ttionSe 7tion~Lot # Subd-~ vi6 ion SEPTIC TANK Size gatfon~s Numbers o6 eompaAtment, Di6tanee 6AOm: Weft Buifding- _120 6tope High.wateA PUMPING CHAMBER Slc.ze_ ga toms Pump Manu(jaefiuneA Mode. Numben_____ HOLDING TANK Size 0 _gattons NumbeA oo CompaAtment5 P u m p e A _ A Z a A-m S y x e. m D.i Ata n c e (JA Om: Gl ef f-I ~ - - Buitd.tng.__ 12% s tope HighwateA ABSORPTION SITE Bed_ TAench DiA ance ~j Aam tUeQ~- But ~d .n Hti g h w ate-A ABSORPTION SITE DIMENSIONS Width oo -tAeneh _ f.~ Requ-~.Aed aAea Length o (j e-aeh fine ),t D -pt - o6 no c k below tiL e. n NumbeA oo inels___ h. o6 Aock oven t.i_fe Total teng h. o{ E"n./s 6,t Depth o6 ti e below gAade. in Distance between S'ne6--- ~,t Sfope o6 tAench--- in. peA--100 6t < Totat ablsoAption. Aea ft Type- a6 CoveA: PapeA oA- IstAaw PIT DIMENSIONS NumbeA a{ pit.5 GA veQ. aAound pity yer no Outatide diameteA 6t De th. bekow infex --(I t Totat absoApt".on aAea 6,t, f AAea Aequt.Ae 6t L INSPECTED BY TITLE APPROVED DATE 19 8 REJECTED DATE 19 - REASON FOR REJECTION REPORT ON INSPECTION OF SANITARY PERMIT # 9 (1) Name and Address of Permit Holder Person/Persons at Site (2 )Date of Inspection GG7~t-. n Time of Inspection ame, re s, License installing Plumber 3 INSTALLAT ON CONSISTS OF: ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber ❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System BENCHMARK: (Permanent reference Point) Describe: Elevation of vertical reference point: Slope at site: (5)MATERIAL AND DEPTH OF SEWER: (6)SEPTIC TANK: Manufacturer: Liquid Capacity: Tank Inlet Elevation: Tank Outlet Elev: # ft to lot or property line: # ft to well: (7)DOSING TANK: Manufacturer: # of gallons: # of gallon pump set for a cycle gallons; total capactiy of distribution lines gallon; size of pump head; gallon per minute horsepower ; brand name of pump and model number Is the warning device installed? ❑ YES ❑ NO Wired? ❑ YES ❑ NO ; 8 HOLDING TANK: Manufacturer o gallons construction ; depth to the cover ft; If septic tank is being used are baffles removed? ❑ YES ❑ NO; ft from residence; ft from well; ft from property line. Type of warning device Is the warning device installed? ❑ YES ❑ NO; Wired? ❑ YES ❑ NO; Locking device on cover? ❑ YES ❑ NO; Diameter of vent and material ; Distance from building to vent (9) SEEPAGE PIT SIZE: # of pits; ft diameter; ft liquid depth; ft to residence; ft to well; ft to property line; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than seepage pit inlet pipe-elevation ft; bottom of seepage pit elevation ft. (10) SEEPAGE BED SIZE: ft width; ft length; tile depth; lineal feet tile; ft to residence; ft to well; ft to lot or property line; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes, water courses or drainage ditches Elevation of tank discharge line entering bed ft. 11 SEEPAGE TREN H: Total length of seepage trench ft; width ft; tile depth ft; ft to well; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes, water courses or drainage ditches; elevation of tank discharge line entering seepage trench ft. (12) Has system been installed in area indicated on EH 115? ❑ YES ❑ NO (13) Has system been installed in floodway? ❑ YES ❑ NO Floodplain? ❑ YES ❑ NO DILHR-8BD-6095 N.05/80 Signature of Inspector: EH 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH -P.O.-BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION: /h '/4, Section --I, T -31N, R! (or) W1 Township or Municipality =~i~S s~jn r~%G Lot No. , Block No. County tCe~ 11 ~ ~ Subdivision Name Owner's Name: /l e iii' 1272&-.»•'`xr Mailing Address: _ z'A' / , , ,Ih%F' TYPE OF OCCUPANCY: Residence No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS (PERCOLATION TESTS SOIL MAP SHEET SO] L TYPE --,4, PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WA 1 ER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN U hA 61', v, 2 4' ~,A P- P- SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) B- B- B- PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the locationand square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy. Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. r-A- II f G N I I~ I ~ ~ I ' i y j I M I~ ~ • 1 I I ~ t l 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 location of test holes are correct to the best of my knowledge and belief. 35 Name (print) 1 ' -j'-, i~ Certification No. S - Address - Name of installer if known r 1/x CST Signature COPY A-LOCAL A UT, ORITY Department of Industry, Labor & Human Relations Of Division of Safety & Bldgs. State Ot V~ 1SCOIISIII Bureau of Plumbing Platting & Fire Protection P.O. Box7969 Madison WI. 53707 Tel. 608-266-3815 IN ALL CORRESPONDENCE REFER TO PLAN 7 1 IDENTIFICATION NO. NAME OF PROJECT TYPE OF APPROVAL STREET AND NO. CITY OR TOWN COUNTY STATE ZIP OWNER Gentlemen: Examination of plumbing plans and specifications for the above-mentioned project has been completed. In accord with Chapter 145, Wisconsin Statutes and Wisconsin Administrative Code, the plumbing plans and specifications are approved contingent upon com- pliance with the stipulations indicated on the plans. Please review your code for the requirements of each code section noted. The architect, professional engineer, registered designer, owner or plumbing contractor shall keep at the construction site one set of plans bearing the stamp of approval of the department. In the event installation of the plumbing improvements or system has not commenced within two years from this date, this approval shall become void and new application shall be made for approval of these plans before work may commence. In granting this approval, the Division of Safety and Buildings does not hold itself liable for any defects in plans or specifications, plan omissions, examination and reserves the right to order changes or additions should conditions arise making this necessary. This approval is based on Wisconsin Administrative Code requirements. It shall be necessary to obtain and fulfill the permit require- ments of the city, village, township or county in which this installation is to be constructed. Failure to obtain local permits will auto- matically void this acceptance. Sincerely, James Sargent-Bureau Director PLANS REVIEWED BY: DATE: cc: DPS-OWS Owner PI Plumber DI LHR ounty H & R (2) DI LH R SB my (N, 06/80) Mfg. Rep. Bur. of Health Fac. & Services Rec. & Env. Services t State and County State Permit # ~ P~ L B 6 7 1 -4 - 41/ Permit Application County Permit #p for Private Domestic Sewage Systems County -44L d:IA icy *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: , B. LOCATION: /)L, % ` r Y4, Section N, Rl E (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family % Duplex No. of Bedrooms No. of Persons - D. SEPTIC TANK CAPACITY Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks / Prefab concrete Poured-in-Place Steel Fiberglass Other (specify) New Installation Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate Total Absorb Area sq. ft. New Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed: Length Width Depth Tile depth (top) No. of Lines Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land Distance from critical slope WATER SUPPLY: Private,4 Joint ❑ Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than present owner: I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Certified Soil Tester; NAME 4 L r C.S.T. # S 3z` and other information obtained from _ (owner/builder). Plumber's Signature M PRSW# Phone # Plumber's Address e 1. ; PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca- tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors property. If well has not been drilled please indicate. r i 3 t E _ S 1 E r Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY _ Date of Application 9- Fees Paid: Stated , c'Z} County Date Permit Issued/R 4@Qt-ed (date) Issuing Agent Name Inspection YesX_No State Valid# Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 -rate (pink copy) 4. plumber (canary copy) Revised Date 7/1/7$ i i r I Q Al U~ lk~ v v6 O~ i d 7 0 1 r V ' o r 1 Clf Kli 'ZI ~;f i This agreement, made and entered on this 6f "T►+day of 19j_;((,, by between the Township of,::~ Ty F P ddress `-,EEREp S: E n application has been made for a sanitation system on the foUowi.ng described property: Lr_ 4- t t VEEREAS: Septic tank drainage does not meet the minimum standards of the ordinance of St. 'Croix County and state codes. %ELREAS: The owner agrees to install a holding tank for septic tank purposes purposes. NC.4T', TEEREFORE: For and in consideration of the issuance by -the Town- ship of .1-'4c 7;!g i P - 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 ;,gill 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 puznping charge in the sum of IT IS UNDERSTOOD that this agreement shall be binding on the owners, their heirs and assigns. IN V ITNESS WEERLOF, the parties have hereunto set their hands and seals the day and year first above written. r _ • Township of Developer, or oune~, S'K'ATE OF WISCONSIN) SS: COUNTY CF ST. CROX) - Subscribed and sworn to before me this 10th day of July 19 80. Notary iubli , St. Croix County Ruth A. Johnson Comm. Exp. 1/2/83 fir.. ~y ST. CROI X COUNTY y wISC0NSI N faar saa^ ' A Z O N I N G O F F I C E 796-2239 PoAt 0666ice Box 227 Hammond, WI 54015 O W N E R P U M P E R A G R E E M E N T PLEASE BE ADVISED, rhat unt.it you ate again noti6ied, I w.Ltt conttact with Calvin Powers 06 New Richmond s WiAconz i.n, (Pumpers), Got the putpoa e o6 Aemov.ing att waate Jtom the can-itaty bydtem to be toeated on the ptopetty and 6utute home site toeated in St. CAo.ix County, Wiz conzin, Townah.ip of Star Prairie part of Government Lot 4 being .in/the % o6 the % of Sec. T. (On moAe Gutty deset.ibed a.6 6ottowe: ) Lot 2 of Certified Survey Map (recording information not available at this time) Dated th.i.a day o6 ,.?uly 19_0 . s d (OWNER) __owa d J. Thom ".'n State o6 Wis conAin) (OWNER) 43 L cille Th mpsor._ County 06 St. Cno.ix ) Petaonnattyappeated bejote me .th.i.6 dac ha the above named Howard J. Thompson, Lucille Jul:980 pet.bon who execute t e 6otego.ing ~ nd ment~and acknowtedgedbthehbame. aty u -c.c Wit. Ctoi County, 7W My Comm. (.ia petmant) (Exp.itez) 1/2/83 T, Calvin Powers hete.inbe6ote xe4etted to as Pumper, join in .the above agAeement to t e extent that I have a contrast with Owner a.a above ata.ted. (PUMPER) Calvin Powers HOLDING TANK PUMPING REPORT Name oj Residence Addneez Te.tephone Legal: % o6 % of Section T N- RW Towna h.ip Date Pumped Amount Pumped Location S head Remanks -P um W.6 --S.iana.tu le_ Zoning 06j ice Use: Date Inapec•ted Cond.ition6 Found The above in6onma-t.i.on shah be sent to the St. Cno.ix County Zoning 066iee, PoAt 064iee Box 227, Hammond, Wl 54015 monthty by the Pumpers. The .in6onmation w,itt at that time be nev-iewed by the Zoning 06j ice and placed in a permanent 6iee. Random inspections w.itt atz o be made by the St. Croix County Zen.ing Ojj ice to .inbpect the zucces,s o6 the 6y.6tem at the above Location. ST. CNOI X COUNT( ~ r Y W I S C 0 N S I N " Z O N I N G O F F I C E 796- 2239 P.J. Box 227 - Hammond, WI 54015 HOLDING TANK PROCEDURES DUE TO THE MISUSE OF THE HOLDING TANK PROGRAM, THE ST. CROIX COUNTY COMPREHENSIVE PLANNING, ZONING, AND PARKS COMMITTEE ADOPTED ON OCTOBER 16, 1979, THE FOLLOWING PROCEDURES. THIS POLICY IS EFFECTIVE AS OF THAT DATE WITH THE INTENT TO BIND THE HOLDING TANK OWNER TO ITS INTENDED USE. i . Town.bh.ip Agneementi 2. OWneAlPumpen Contrcact 3. State Hotd.ing Tank Appnovat 4. $100 bee p Lu.5 tegutan /san.itany bees. The $100 1i6 intended to pay bot petiod.ic zite -in4pection/s and 0 j 4 ice tcev,iew6 5. Monthty Pumping Repott. The Monthly Pumping Repont w.itt be the tezponsib.iffty ob the pumpers. PIb 100a 12/78 r Detach And Return Upper State of Wisconsin DIVISON OF HEALTH Portion Of This Form With SECTION OF PLUMBING A AND FIRE PROTECTION SYSTEMS n y Return Correspondence Y MAIL ADDRESS: P.O. BOX 309 MADISON, WISCONSIN 53701 608-266-3815 DATE: PROJECT: ra PLAN ID. # DETACH HERE PROJECT NAME PLAN ID. # This is to acknowledge receipt of your plans and specifications for the above-indicated project. Preliminary review indicates the plan review fee required is $ ❑ Plan accepted for review. Fee received is $ Fee is being returned because of ❑ Overpayment ❑ Underpayment. Providing one of the two catagories above is checked, remit correct fee in one payment. El No fee has been remitted. Plans submitted with no fees will be held in abeyance. kN / d~ ~~CfF ' ~t t ❑ Plans being returned. ❑ Additional information required. SEE BELOW. 1. Plan Submission 7 > ❑ Additional information shall be submitted in triplicate unless specifically noted. ❑ Plans not clear, legible or permanent. ❑ All information submitted shall be signed, sealed or stamped in accord with Section H 62.25(2)(a) Wisconsin Administrative Code. ❑ Affidavit enclosed. II. Alternate sewage Disposal Systems (Mound Systems) ❑ PLB 108 (Application for use of an alternate system). ❑ County onsite required (1 copy). ❑ Design calculations for pressurized distribution Cross section of mound. F-1 Pipe lateral layout. 'I Plan view of alternate. I II. Private Sewage Disposal Systems ❑ Ground slope with 2' contours in entire area of soil absorption system extending 25' on all sides. ❑ Elevation of permanent reference point (benchmark). ❑ Location of area suitable for replacement system - provide soil test data. Plot plan showing lot size and all lateral distances from sewage disposal ,-stem or holding tank t,, b!dgs, lot lines, well, watercourse, e, - ❑ Construction detail of septic, holding or lift pump tank if site constructed or tank manufacturer if precast. ❑ Construction detail and cross-section of soil absorption system. ❑ Soil boring and percolation test on EH 115 completed by certified soil tester (1 copy). ❑ Complete data relative to anticipated use of bldg. ❑ 3 copies of PLB 60 enclosed. ❑ Deed restriction required (1 copy). IV. Holding Tanks Profile of holding tank. Holding tank agreement signed by owner and local unit of government (sartnple enclosed). Reason far instali.ng holding tank soil test or statement from county (1 copy). V. Lift PI-IZIp L Calculations for total lift pump discharge, dead and gallons pumped per cycle. ❑ Size, length & depth of force main. Detail & model of pump or automatic siphons including size, pump curves, dr ,r v:,n ar _ Pf x:, f! Pr v1. _ Cross section of lift pump tank showing pump(s) or siphan(s, VI. Systems In Fill (Fill must be placed prior to plan submission) ❑ Total area filled (fill to extend 20' beyond edge of trench before ~,'de slops ?,~~;in? L l Depth and type of fill. u Copy of onsite repart by county or di-strict plurnbing ;wpe;-visor r-j __J Le: cth of time fail has been ;r! o+af-c, lb- HOLDING TANK AGREEMENT This Agreement, made and entered into this dayherelna ter ' €ca ed of 5- L 19_mac'~.by and between the N~ Tl~ hereinafter an `L s tj H C/~t i N C+' V ca led the owner permit on the WHEREAS, application has been made for a building following described property, to wit: or domes- t said property is not located in suchaa mannionsystemeforr a by a a municipal sewer system or on hsite soil epremises requires that a holding tic sewage, and continued roeext t€©xthe purpose of-proper disposal of tank be installed on the p P y domestic sewage. NOW, THEREFORE, in consideration and tas an ank pinduce enttto the Town of ~Fu_'__ to issue a holding iUed remises, tie Owners hereby agree and bind ourselves as follows: descr P 1. Owners agree that they will conform to all the rules and rigu lations of the Plumbing Code in the building of their septic system the holding tank. They agree that anyHealth tOfficer deemscitecdMrND time eluding through the County Plumbing Inspector or Town necessary to pump out said holding tank, the Owners`sh~all have same fz pumped out in twenty-four (24) hours, or t0fl-t-I agree t at will have said work done s ecdiachchar~e same Thec further ag ace same Oers t ranted on their tax bi 1 as and County of St. Croix g ~c'Hrc~n'y on their property above he Town of1~ n ec t, ~m~ and haul, if the right , t an reasonabler time , to ins described, a at any y . necessary, from the said holding tank.,cJv`c~,~ 2. That all charges and costs incurred by the Town of Hr' for inspection, pumping, hauling or otherwTeventrorcabatenanyanuisanceg said holding tank in such a manner as to prevent such or )aid health hazard caused by such holdinghallknotily bhe Owners ®hea0wne°fs. The Town of Aj~ ~k' 12 icH Me N p da s from ate cost which s a e pai y Owners within thirty a (said cost within may ent that Owners shall no p thirty (30) days, Owners hereby specifically agree that all of said special assessment costs e and and in chargethes event be placed on the tax roll as a for the abatement of nuisance, and said tashall be collected as pro- vided by Statute of the State of Wisconsin. 3. That a quarterly pumping report shall be submitted by the Owner or his agent to the local government and the county which shall state the Owner's name, location of the property on which the holding tank is located, the pumper's name, the dates, volumes pumped and the disposal site. An annual pumping report or the fourth quarter report including a summary of the pumping history of the previous year shall be submitted to the Department by the governmental unit responsible, per s. 145.01 (15) Stats. 4. Owners further agree that in the event that municipal sewers shall be installed so as to make the premises available to such municipal sewer service they will pay all special assessments levied against the premises as the property share of costs of the installation of such san- itary sewer and shall not assert any claim as to lack of benefit or reasonableness as to the installation of municipal sewers by reason of the fact that the Owners have been permitted to install a holding tank, and that upon municipal sewer service becoming available, Owners will abandon use of the said holding tank and connect the premises to the municipal sewer. 5. This agreement shall be binding upon the Owner, their heirs and assignees and run with the deed. WITNESS our hands and seals this /l day of Z(_,,L- TOWN OF N]V cv e~j c N o.•; oij b 014NERS 't" by , a (4~ ~c eY by STATE OF WISCONSIN Personally. came before me this `J day of above named 19S the Owner s ,'--~to me ~ known to be the persons.who executed the foregoing instrument and acknowledged the same. THIS INSTRUMENT NOTARY PUBLIC DRAFTED BY: My commission expires:- z - .NOTE : As specified in H63.18 (4 A) Wisconsin Administrative Code this document is to be recorded with the deed, located at the County Register of Deeds. At the time of Sanitary Permit Application, a co agreement, with the recording dates and number should be submittedlto .this office. n f -a d Lj 'y HOLDING TANK SERVICING CONTRACT This Agreement is and entered into this day of 19 by and been. hereinafter called the "owner" and hereinafter called the "pumper." We hereby acknowledge the installation of (a) holding tank(s) on the following described property: 1. The owner agrees to file a copy of this contract with the local governmental unit hereinafter called the "municipality", which has signed the pumping agreement required in ch. ILHR 83.18 (4) (b), Wis. Adm. Code and with the County of 2. The owner agrees to have the holding tank(s) serviced by the pumper and guarantees to permit the pumper to have access and to enter upon the property for the purpose of servicing the holding tank(s). The owner agrees to maintain the all weather access road or drive so that the pumper can service the holding tank(s) with the pumping equipment. The owner further agrees to pay the pumper for all charges incurred in servicing the holding tank(s) as mutually agreed upon by the owner and pumper. 3. The pumper agrees to submit to the municipality which has signed the pumping agreement required by s. ILHR 83.18 (4) (b), Wis. Adm. Code and to the county a report for the servicing of the holding tank(s) on a semiannual basis. The pumper further agrees to submit a report which shall include: a. The name and address of the person responsible for servicing the holding tank; b. The name of the owner of the holding tank; c. The location of the property on which the holding tank is installed; d. The sanitary permit number issued for the holding tank; e. The dates on which the holding tank was serviced; f. The volumes in gallons of the contents pumped from the holding tank for each servicing; g. The disposal sites to which the contents from the holding tank were delivered. 4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event of a change in this contract, the owner agrees to file a copy of any changes to this service contract or a copy of a new service contract with the municipality and the County of rj C c` } within ten (10) business days from the date of change to this service contract. SIGNATURE OF OWNER(S) : SIGNATURE OF PUMPER (Include License Number): State of Wisconsin )came before me this 18t1day of Feb. A.D., 19 86 )to me known to be the person who executed the foregoing County of St. Croix )instrument and acknowledged the same. Subscribed and sworn to before Me this.J b-+.W.ay of r'ebruary 19 86 otary Carol A. De You my commission expires Sept. 4; 1988 i This instrument was drafted by the State of Wisconsin Department of Industry, Labor and Human Relations, Bureau of Plumbing. 12, WILSON'S MARINE ,s , 71 i ~ L 7/z , / (J v JIV7 D G" r. Rt. 2, Box 96 New Richmond WI 54017 715-248-7285 COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 olfax, Wisconsin 54730 4:1:A:w 16. 715-962-3121 800 - 962 - 5227 G FAX - 715 - 962 - 4030 ;OURTHOUSE tiA? F;~CF f , _ lei J TION! CTOk! COLLECTED'# COLLECTED! 2:301- CE OF SAW[ r C. ANALYZED ANALYZED, RPRETATION! Dacter i o le,; PPM Ve 10 PPM c is rr , ~ ~ T 41 Q' , p F~F/kJ07 tic ~ry_, OF`EIOEGENOFNI, z` roved Lab No. 19 9 aloe f. J S \ O J y ~a ~ a c5: ~ Cst, T '.1~ F - t'4'E". i^Fi?E: t SJ ~Y • dJ,kS PROFESSIONAL LABORATORY SERVICES SINCE 1952 -ql ST. CROIX COUNTY ZONING OFFICE 911 4th Street Hudson, WI 54016 Telephone - (715)386-4680 St. Croix Co. Zoning office offers the service of septic and water inspection to Lending Institution, 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 CO. ZONING, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received. WATER TESTING FEE:$ 35.00 X (For nitrates and coliform bacteria) WATER TESTING FEE:$ 185. 0o (VOC'S) SEPTIC SYSTEM INSPECTION FEE:$ 25.00_ PROPERTY OWNERS NAME: Ronald and Nancy Wilson PROPERTY OWNERS ADDRESS: 1144 Co Rd H CITY: New Richmond, WI Legal Description NE 1/4, Sec.. , T N-R W, Town of Star Prairie Lot o. 2 Subdivision CSM 4 995 FIRE NO. 1144 CH BOX NO." none Color of house cedar Realty sign? Y Firm: Edina ea y PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP, i.e.,. COPY OF PLAT BOOK, SMITH 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: Roger Hetchler Telephone No. 386-8236 REPORT TO BE SENT TO: Roder Hetchler Edina Realty, Inc. 700 2nd Street, Hudson, WI 54016 CLOSING DATE: 11/2//92 Signature - - . C rr "dina Realty INC. Property Info. Sheet ADDRESS 1144 Co. Rd. H d A ' k aI } r PRICE $ 139,900 I CITY/TOWN New Richmond, 4+ rt,~ DISTRICT _ a 3~ mwr nlxru r7sy ?x, aMru.wm ^ u"7 P. g = ~ 5 r"^,~nl 4 i ~ J ~ N~` kF~, ''1NW `~.•Ki I ; ~f F I~u --Ak µl~ • 81 A LOT SIZE/ACRES 3 r N {t:' ~ x,44 rX.ri'~1 ~ i a 4x u liL..n:4a.i..c a;ysl.eww ADDITIONAL SALES HELPS: COMMERCIAL ZONING ON THIS PROPERTY ON SOUTH END OF CEDAR LAKE. IDEAL OPPORTUNITY TO HAVE HOME AND BUSINESS IN AN IDEAL LOCATION. CEDAR LAKE OFFERS WALLEYE NORTHERN, SUNFISH AND CRAPPY. GREAT FISHING!! 139.900 II MTROCMS' +II "A'I11S' 1.111 WI' Imo] f-l nts f] Tl:~cru; ZN: N,DRISS: 1144 Co. R(I 11 CI"l'Y New Richmond ZIP: 54017 COUNTY: St. Croix I:I' SZ: .61 A UISI': 8 SC1 100LS/ ELFM: N Richmond MID: N Richmond ILIGII: N. Richmond I'M.: St. prid et's LPCAL: Part. of Govt Lot 4, Lot 2 DSM 4 pcI 995 -.Star Prairie Twp. S1YLI?: Rambler F IE11IOft: Rat/poard YPAR BUILT: 7'A; fS: " 2894 YIt: .L9 91 SQ FI' MAIN LEVEL: 1344 'lYICAL I'1N PT: R00b DIMENSIONS L W. I-. LIZ: 1 / X ]-7. 6 - I'QUIPMIiNr / MLSC M C .ItCERIC: Y DR: J.0 X 11.2 C. W1'R: M C OVEN: Y Icr: 11 X 12.5 - C. SIJR: M V IJOII[i: Y WC.I.L: FR: Y QI S11 1t: SEPTIC: y M13: 11 X 14 M C D I S P • t11(2: 9 X 13 M C - \ ISR3: Ws ['ATIO: y A/C: CASMI'. BIJ6: CAR: 26 x 20 A CEO: rl:['LC: FOSS FATE: I IPAT: I•A/Propane 180' frontage on CEDAR LAKE, boat landing, ' aluminum boats, 4 motors docks, bait house, commercial zoning. Public landing on south endo of lake. 2+ bedroom rambler homw w/2 baths, double garage, patio s beautiful view. LISPIJL Roger I[Ctchler ['I III 386-8196 - L,ISrI]I: ER 213 (3/84) S/13/C 2.8 ISrlcr: EUINA Rl•'A1 TY, Inc.. III 26600 1910NIi 715- 386-8230, 612- 416-7072 - (MAKE m 9~ oO~J-`t ~ SUCH i - 3:U1 1573 _ MENTS `yi b JU )r v fl a R 0 C N d Q Cf) .j~2' N CJ ' ~1 i3 -J b LL- .19 7 1 a a • q s DIRECT T. 31 N.- R.18 W. POLKA COUNTY 65 f cent~~ V CEDAR L. i - i L4 0 o , J I 71 HUN suit [rv• p ~l ta. /o. .I r ~ V, vv,! c sua) f)h/,C_fS I.ILSlYI q 0 ) ~ b ./a $~,41' .,ay/I ~ E c 4 VCl J i //7 /)l, cJ Nc~/r, a F C/uyf ,/f6cet ~'1unG~ 2 e/a/ C14( t/n ~ ~i Y/Ael/ J: ` ~ L4/JCr/ ST. CROIX COUNTY T~~x~UJ WISCONSIN ZONING OFFICE 7 ST. CROIX COUNTY COURTHOUSE S- 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 December 2, 1992 Roger Hetchler Edina Realty 700 - 2nd St. Hudson, WI 54016 Dear Mr. Hetchler: An inspection of the septic system on the property of Ronald & Nancy Wilson, located at 1144 Co. Rd. H, New Richmond, WI was conducted on Dec. 1, 1992. At the same time a water sample was obtained for testing. The results of that testing 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 may be dependent upon proper maintenance of the system. Sincerely, 10 / , v w Mary 3enlins Assistant Zoning Administrator cj Y ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 December 3, 1992 Roger Hetchler: Edina Realty 700 - 2nd St. Hudson, WI 54016 Dear Mr. Hetchler: An inspection of the septic system on the property of Ronald & Nancy Wilson, located at 1144 Co. Rd. H, New Richmond, WI was conducted on Dec. 1, 1992. At the same time a water sample was obtained for testing. The results of that testing 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. The Wilson property was approved for a holding tank septic system because the soil and site conditions on the property are unsuitable for onsite disposal and treatment of septic tank effluent. Holding tanks are designed to contain sewage so it can be hauled away and disposed of at a sewage treatment plant or other approved site. The state legislature indicated the holding tanks agreement and servicing contract as part of the permit process to insure the proper disposal of holding tank wastes. The owner shall be responsible for the submittal of a semiannual report for the servicing of the holding tank to the St. Croix County Zoning Office. The agreement conveys the responsibility of maintenance to future owners and any changes to the service contract or copy of a new service contract shall be filed within 10 business days from the date of change to the service contract. I have enclosed copies of both the agreement and the servicing contract. Should you have any questions, please contact his office. Sincerely, Mary J. Jenkins Assistant Zoning Administrator cj (~j"/~ ~j~/:',, G,/' URA ^'y , U 02 d~~ °7?''I,G2.f,~►t...~.z. r ~n~. a fi QQ F d ST. CROI X COUNTY WI SC O N S I N ZONING OFFICE I ' P9 19, r - r® j,~ 796-2239 (HAMMOND) , 425-8363 (RIVER FALLS) HAMMOND, WI 54015 Q U A R T E R L Y P U M P I N G R E P O R T ST. CROIX COUNTY t NAME:- ADDRESS: C - 1 4- RETURN COMPLETED FORM TO: % ST. CROIX COUNTY ZONING OFFICE, P. 0. BOX 98 l J ,ti; D HAMMOND, WI 54015 715-796-2239 or 715-425-8363 TOWNSHIP:' PLEASE PROVIDE TION ACCOMPANIED BY RECEIPTS FROM YOUR PUMPER: NAME OF PUMPER: 0_.~E I ~F -51-/~l LOCATION OF DISPOSAL SITE: ji al b - U ~i ~ NUMBER OF PERSONS LIVING IN RESIDENCE: USE: YEAR ROUND SEASONAL (CHECK ONE) OCTOBER NOVEMBER DECEMBER DATE VOL. PTM ED DATE VOL. PUMPED DATE VOL. PUMPED -22 I-Al THIS REPORT MUST BE RETURNED NO LATER THAN JANUARY 31, 1986. OWNERS SIGNATURE mj :12-83 A VIM s,. 72 a~ ~s~' - wh ~ fps ► ~ . . CERTIFIED SEPTIC SERVICES 6212 ry RT. 1, BOX 124-1 - SOMERSET, VII UM - JIM MELVIN 115-247-3788 CUSTOMER'S ORDER NO. DEPT. DATE 3n• " i - NAME ` ' - ADDRESS SOLD ■Y CASH C.O.D. CHAR GC ON ACCT. MDSEFeTD. /AID OUT DESCRIPTION 4 4 ' ms=s:... y,'. 5 7 O K 10 12 m. 13 ys^. 14 15 g~(v 16 17 18 RECD BY F*gfOW. ► KEEP THIS SLIP 5H 320 FOR REFERENCE