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Home My WebLink About002-1012-50-000 o to O 3 y o m v1 ~ CD 3. ~ 3 H, CD o v (D c CD m rn ^ 3 U.~ y 2 2 N Z cn cN3 'U W CD oo cC • c~ y N N cn O N N O~ N N N ~I c3D 3 O O N N N (D (O l^l CL CL z 03 N O co N O O W G3 Q Q O 0 O o p C N (D C7 < = W 'O cn O = O O 7 N 1 O C N J N a Q, CD R, m a lA co~D rn w ' rTrl~ O N) CO p~ ci N OOO W :E O C N o o cn a 0 V 0• c: Co. -D °0 3 ry, Q c to cn to n~ m ~i `so W~ v v v N O G N Ro !r 7 fD - C O Of L9 tV 3 7 ~ N fZ ~ N o O D D I W ~ a CD CD -4 U) Z p Z m O W ~a n p z 0 i0= I ~ ~ O W -0 a z 0 3 C z O) 3 m N CD A W p~ 0 (D S C D 3 0 (1) CL CD d Q Q C 7 7 X T oZ a m m =N s o N y CL m ~ CL o m CL ~ m a 7 m O ~ =r N O O O O O , a (O A N O b N (D OAq V = A O o b C) CL 6 Parcel 002-1012-50-000 09/2512006 12:02 PM PAGE 1 OF 1 Alt. Parcel M 06.29.16.83B 002 - TOWN OF BALDWIN 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 O - HUEHN, DEANNA D DEANNA D HUEHN 1157 HWY 63 BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description 1157 HWY 63 SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 15.500 Plat: N/A-NOT AVAILABLE SEC 6 T29N R16W SW NE EXC E 800 FT, TOWN Block/Condo Bldg: BALDWIN Tract(s): (Sec-Twn-Rng 401/4 1601/4) 06-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 07/27/2005 801570 2852/216 WD 07/23/1997 1086/288 WD 07/23/1997 758/65 07/23/1997 739/138 more... 2006 SUMMARY Bill M Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 05/19/2005 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 5.000 500 0 500 NO AGRICULTURAL FOREST G5M 8.500 1,500 0 1,500 NO OTHER G7 2.000 4,000 80,300 84,300 NO Totals for 2006: General Property 15.500 6,000 80,300 86,3000 Woodland 0.000 0 Totals for 2005: General Property 15.500 6,000 80,300 86,3000 Woodland 0.000 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch M 510 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges 00 Total 0.00 0.00 Parcel 002-1012-30-200 09/25/2006 12:01 PM PAGE 1 OF 1 Alt. Parcel M 06.29.16.82E 002 - TOWN OF BALDWIN Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 04/03/2006 00 5 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner GRANT B FLEISCHAUER O - FLEISCHAUER, GRANT B 1157 HWY 63 BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 8.000 Plat: 5015-CSM 20-5015 SEC 6 T29N R16W 28 A IN NW NE NIA CSM Block/Condo Bldg: LOT 01 20-5015 LOT 1 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 06-29N-16W NW NE Notes: Parcel History: Date Doc # Vol/Page Type 07/27/2005 801570 2852/216 WD 07/08/2005 799831 20/5015 CSM 07/23/1997 1086/288 WD 07/23/1997 758/65 more... 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 04/03/2006 Description Class Acres Land Improve Total State Reason Totals for 2006: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 BA L DW I N SEE PAGE 47 T 29 N. 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O/ser7 fZ_ c.~omes 4 Ry .~¢/e ~ s ~Poyc~ L Q ~ /oo S 9/f~C 9s .0 1r ~cz ~ W d s stu ye/e zzo f m 3 e?¢ e his S : 4a so She ~/97z ~c~o~ r¢~ 6 's>S c> R~ v >9>F ✓ SEE PAGE 2/ OX G' oir C'ou~y ~."r _ Qr FARMERS Proudly Serves ,You And Offers These Services FERTILIZER: BULK AND BAGGED - TRUCK OR TRACTOR SPREAD BULK FEED - GRINDING - MIXING CHEMICALS - CUSTOM WEED SPRAYING - COMPLETE LINE OF HOMIX FEEDS - SEED CLEANING & TREATING GARDEN TRACTORS - SNO TRAVELERS - CAMPING EQUIPMENT PHONE: 684-3371 BALDWIN, WISCONSIN V If,/ TOWNSHIP ~c~ EC. A _ u~t~ _ T~ I, R C_W 'S ST. CROIX COLTNTY, WISCON IN. TON LOT LOT SIZE 0 -S T ` PLAN VIEW / Distances & dimensions to meet requirements of II62.20 57 j/+ SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM e rk r :'TIC TANK(S)- _ MFGR. CONCRETE STEEL fr NQ. of rings on ccoover Depth DRY WELL _ 'NCHES NO. of_ width length area no. of lines_ width length area f{c) a+-~~tii iV il+~i of Pj-~,; ( a~i <..F/(+Cf GATE RATE AREA RF'QUIP.ED ~ AF.EA AS BUILT .claimer: The inspection of this system by St. Croix County does not imply col to i v. pliance with State Administrative Codes. There are other areas that it is not possible inspect at this point: oi: construction. St. Croix County assumes no liability for tem operation. However, if failure is noted the County will make every effort to _erridne cause of failure„ ]ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTE11. °INSPECTOI c 7t DATED~~ ~ _ PLUrffiEIt ON JOB LICENSE. NUMBER REPORT OF INSPECTION - INDIVIVUAL SEWAGE SYSTEM Santi.tany Poimit/z OL., State- septic~Rcg NAME Tow n,5 h~ p St. C,,Lol('-x County Location__l ec ion La # _ Subdi,viS Lan SEPTIC TANK Size Grp 0 _-ga2eons Numbeh of eompantment6 D-i.5tane.e. {,nom: We.e.e- cc) Buitding ' 120 3fope. H,i_ghwateA PUMPING CHAMBER S.i.ze~ ga.et on,5 Pump Maru{,ae~unen Modek Numbeh- HOLDING TANK Stize~ gaffon6 Numbers o6 Compan.tments Pumpe n. - - Atanm S y4 te.m--!,,. - i2o htope_- - H,i.ghwateA ABSORPTION SITE Bed Tkeneh. Dti!ttanee nom: WeP-fButi2ding_ 120 /s cope Highwaten ABSORPTION SITE DIMENSIONS qutined area .t Width o{, tAenc-h_ le Length o(j each eine p-th o{, xock betow tiU in Numbers oo _ p,th o{, hock oven tife in To,ta,e teng.th o{, UnU/sq6 pth o 6 tite below gn.ade tin t S Di~anee between ,`ktne6_-~-~ eope a(n.eneh in. pen 100 6t i Totae absorption an.ea ~t T pe o6 Coven: Papers, on 6ttLaw " PIT DIMENSIONS Numb e-4 o( pi is navet a,, ound pith yes -no - f Outstide diameterc__ t epth below in.Cet (It Tota~ ab,5orLpt4'on arse Area nequined {,t INSPECTED-8V TITLE APPROVED t DATE 190 REJECTED DATE 198 REASON FOR REJECTION REPORT ON INSPECTION OF SANITARY PERMIT # (1) Name and Address of Permit Holder Person/Persons at Site (2 )Date of Inspection ame, ress, icen a No. o ns a ing Plumber Time of nspection J6 P >577 - 3 NSTALL, ION -CONSISTS p ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber ❑ Seepage Pit ❑ Seepage Bed Holding Tank ❑ Fill System (4) BENCHMARK: (Permanent reference Point) Describe: Elevation of vertical reference point: Slope at site: (5)MATERIAL AND DEPTH OF SEWER: , J (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: nufacturer o g ons ;ela ; construction j depth to the cover ft; If septic tank is being used are baffles removed? YES ❑ NO; ft from residence;_ jg7 d ft from well; ft from property line. Type of warning device ~t Is the warning device installed? ❑ YES ❑ N0; Wired? ❑ YES NO; Locking device on cover? Z 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 TRENCH: 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? 'RYES ❑ NO (13) Has system been installed in floodway? ❑ YES P;UNO Floodplain? ❑ YES D;~rNO DILHR-SBD-6095 N.05/80 Signature of Inspector: r it P-LB. 6 7 State and County State Perm Permit Application County Permit # for Private Domestic Sewage Systems County ? *DENOTES STATE APPROVAL REQUIRED ` Date Approval Received from State if Required State Plan I.D. # ` L A. OWNER OF PROPERTY Mailing Address: T L (y rO' f B. LOCATION: C's '/a'/a, Section T_2yN, R ' E (or) W Lot# City IV IS -4- 1 Subdivision Name, nearest road, lake or landmark Blk# Village Township C. TYPE OF OCCUPANCY: *Commercial *Industrial Other (specify) *Variance Single family )C Duplex No. of Bedrooms No. of Persons D. SEPTIC TANK CAPACITY Total gallons No. of tanks HOLDING TANK CAPACITY j~yc;; e: Total gallons No. of tanks .4 Prefab concrete Poured-in-Place Steel Fiberglass Other (specify) New Installation Replacement A 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 „ t 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 diame r Liquid Depth No. of Seepage Pits Percent slope of land- ✓ Distance from itical slope ~G/ i t!/~~f /t! WATER SUPPLY: Private V1 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 c C.S.T. # S'' / Sr_ and other information obtained from CA A, (owner/builder). Plumber's Signature CrFj' Phone # MP/MPRSW# Z Plumber's Address 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. I . 3 e e_ _ e V 4 ' 3 ~ E e a eem..., sue. e f e m , 3 . r a E i y Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application X-G3 Fees Paid: State Co ty Date - ermit Issued/Rejected (date) Issuing Agent Name ction Yes No State Valid# Date Recd ty (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 ink copy) 4. plumber (canary copy) Revised Date 7/1/78 F H 1.15 Rew 9/78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION Section ,T` N,RE (or) ownship or Municipality f}-*- P Lot No. , Block No. County ~~--U-t-Y Cl n ubdivision ame Owner's/Buyers Name: Mailing Address: TYPE OF OCCUPANCY: Residence No. of Bedrooms t-;Z COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW REP`L`ACEMENT-X_ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS Z--< M4c j 2 PERCOLATION TESTS SOIL MAP SHEET_~ NAME OF SOIL MAP UNIT r~"e_QN S', It Hf.a~•~~,~I~~, _ PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P_ P- P P- P- P- SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES 1 r i _ n PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on t e plan the I cation a d square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupan ' O _ Indicate scale or distances. Give horizontal d vertical reference points. Indicate slope. eiA i low C _ f ,viz N e 77- t f 1, the undersi nd, hereby certify that the soil tests r ported on this form were made by me in accord with the pr ures and meth 's specified in the Wisconsin Administrative Code, and t at the~t~ta recorded and location of test holes are correct to the bes knowledge and belief. t V'I tV C1 Name (print) Certification No. Address 6 Name of installer if known ! L y A Local Authority CST Signature A 'I15 Rev. W78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 jCATION~1 Section ,T;;2?YN,RA-1 E (or) lpownship or Municipality 1 No. , Block No. County t! l r~~ Subdivision Name mer' Y s/Buyers Name: / iling Address:ZY K11,4: _1 ~ 'PE OF OCCUPANCY: Residence _?'C~_No. of Bedrooms COMMERCIAL FLUENT DISPOSAL SYSTEM: NEW REP`L/ACEMENT__ALTERNATE SYSTEM OTHER ,TES OBSERVATIONS MADE: SOIL BORINGS Z_x 111)4,1 M/~,1 PERCOLATION TESTS tL MAP SHEET_ V NAME OF SOIL MAP UNIT / ~,-e / S"•.e~ s' f ~'Kr PERCOLATION TESTS L ST HOUR$ WATER IN TEST TIME DROP IN WATER LEVEL, INCHES MM INCHES DEPTH CHARACTER SOIL SINCE HOLE HOLE AFTE INTERVAL RATE MIN/IN I H THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 9 SOIL BORING TESTS i EST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, vU.VIBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES n ' Tel i ~t" - /4 v E ✓ S J 7 / AN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on !Pe plan the l ca on a d square feet of suitable areas. licate number of square feet of absorption area needed for building type and occupan ) - Indicate scale or distances. ,ie horizontal d vertical reference points. Jndicate slope. i°e=A a rrY O v ®r~ , I 1 ` ' a S r s , i f i i . I I C Q I, the undersi nd, hereby certify that the soil tests r orted on this form were made by me in accord with the pr ures and methc{ds specified in the Wisconsin Administrative Code, and t at the 81eta recorded and location of test holes are correct to the best o my knowledge and belief. ~i.'I IJ~ / n N.arne (print) Certification No. Address Name of installer if known i Copy A -Local Authority CST Signature _ _ J EH 11Rev. 9/7$ ` REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 6 LOCATION: Ys,- Section-, -1\1,RrE (or) W, Township or Municipality County Lot No.-, Block No. u ivislon ame 7wner's/Buyers Name: Mailing Address:,_._ TYPE OF OCCUPANCY: Residence No, of Bedrooms COMMERCIAL AFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER )ATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS 301L MAP SHEET NAME OF SOIL MAP UNIT PERCOLATION TESTS TEST HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES NUM- DES CHARACTER SOIL SINCE HOLE HOLE AFTE INTERVAL RATE BER INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD t PERIOD 2 PERIOD 3 1411N/IN P- P- P- P- P- P_ SOIL BORING TESTS TEST TOTAL. DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, NUMBER INCHES OBSERVED ESTIMATED HIGHEST TEXTURE, MOTTLING AND DEPTH TO BEDROCK IF OBSERVED IN INCHES B-- 3- 3- 3- 3- 'LAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. ndicate number of square feet of absorption area needed for building type and occupancy ,Indicate scale or distances. 3ive horizontal and vertical reference points. Indicate slope, t i a/ r s fi i j:itk 4 { I } s-r #...?1)2 i s w~ C i 4......._ ...~._..4. _ y.~ I . 1 77- r I 4 E t 1 1 I, the undersigend, 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. Name (print) Certification No. Address .Name of installer if known Copy B -Bureau of Environmental Health, Division of Health CST Signature ~71 `sue ~JN ~a (~.~~a~ ~ ~ s :y \ 1 ~ L`--.. f l . i -T/i ~ r;~ h f 1 Department of Industry, Labor & Human Relations Division of Safety & Bldgs. State of Wisconsin isconsin Bureau of Plumbing Platting & Fire Protection P.O. Box7969 Madison WI. 53707 Tel. 608-266-3815 INALL CORRESPONDENCE U / ~ r v REFER TO PLAN /y IDENTIFICATION NO. lax ~o~~SSI 14 NAME OF PROJECT ~c~~~• N ~G~e..~ jam' TYPE OF APPROVAL STREET AND NO. CITY OR TOW COU Y STATE ZIP 14 OWNER -4 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: DP - WS Owner DI LHR Local PI Plumber H & R (2) oQRip•'- Mfg. Rep. Bur, of Health Fac. & Services DI LH<`R SBD-6099 (N. 06/80) Rec. & Env. Services JUL I AI _ o L~l~ , s e fe ~N tom--- es _ v r o c~- c o ve s oh goo -r V i` NNW tjoe, AtL A FORM 17-3509 ~~A4 2± e _ I' 11~11 lib C, o C I-Wo cc- & e o fie s o,, 4 A' 7,o N L /.7 4,0 4e c. ,irdOL IS r L, F 'tom ~ ~ L° t=• --A-U-LISI~IA' i FPRM 17-s09 Jul' Z Ll /Al" ItAlldy l~f r 1.2 v LEI 76 W,/y !I O :vt~ fQ S-CIO VE Y ' I L ~~~i rN R to p p1 +a~ 4od nnra 47.E°99_ AL- z I/ IA',l ZC'I,nri'y At 14 k/ UV r ho k-'Ire Jlj! ljbU bop! Z 10 0' A 4 al" W)v yN L i 14 7n e:e G` r'2 a ~t Department of Industry, Labor & Human Relations Division of Safety & Bldgs. ' State of 'Wisconsin Bureau of Plumbing Platting & Fire Protection P.O. Box7969 Madison WI. 53707 Tel. 608-266-3815 IN ALL CORRESPONDENCE REFER TO PLAN IDENTIFICATION NO. j 5 if)K c NAME OF PROJECT TYPE OF APPROVAL STREET AND NO. CITY OR TOWN OU , STATE ZIP J IC-1 Vi OWNER e~++ 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, 1_/1 , 4V James Sargent-Bureau Director PLANS REVIEWED BY: DATE: cc: DPS-OWS Owner DI LHR Local PI Plumber H & R (2) County Mfg. Rep. Bur. of Health Fac. & Services DILHR SBD-6099 (N. 06/80) Rec.& Env. Services Plb 100x02/78 Statc of Wisconsin Detach And Return Upper • DIVISON OF HEALTH Portion Of This Form With SECTION OF PLUMBING AND FIRE PROTECTION SYSTEMS Any Return Correspondence MAIL ADDRESS: P.O. BOX 309 MADISON, WISCONSIN 53701 608-266-3815 DATE: PROJECT: -1114, NEI/4, of Baldw' ix C' 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. ❑ No fee has been remitted. Plans submitted with no fees will be held in abeyance. ❑ Plans being returned. ❑ Additional information required. SEE BELOW. 1. Plan Submission ❑ 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. i This agreement, made and entered on this J (-,.,-H day of 19 8a, by and between the Township of &A1 40 Pddress V'EEREA S: In application has been made for a sanitation system on the t following described property: 4FEREAS: Septic tank drainage does not meet the minimum standards of the ordinance of St. Croix County and state codes. 'VihEREAS: The owner agrees to install a holding tank for septic tank purposes purposes. NOV, THEREFORE: For and in consideration of the issuance by the Town- Ship of 6,A LDt,,ra of a nermit for the above pre rises, the parties do hereby agree and bind themselves as follows: 1. Owner agrees that they will conform to all the rules and regulations pea raining to a holding. Lank system. They agree that anytime said township deems it necessary to pump out said tank, the owners shall have same pumped out in 24 hours, or township will have said work doneand charged to owners and place same on their tax bill as a special charge. 2. The Township reserves the right to assess a bond if they desire to cover any possible pumping charge in the sum of $ IT IS UNDERSTOOD that this agreement shall be binding on the owners, their heirs and assigns. IN V ITNESS WEEREOF, the parties have hereunto set their hands and seals the day and year first above written. Towns hip of _ by~ Developer or owner STATE OF V,IECONSIN) SS: COUNTY CF ST. CR.CIX) Subscribed and sworn to before me this / U,Nday of (JcT p 192C Notary Fublic, St. Croix County f AGRM IEPT A This A; reement made and entered on this . rNday of TU N~ Aig~& „ 19 8 o . by and bet0een the Twnshi p of &1 ~ County lfi scons °71. $'r. CRo1 X 1.11IEREAS• An application has been made for a Sanitation System on the+ I, r. ~ following described property: Section T_2_7 R_LL E or' `V Lot Block 11ame of Subdivision PHEREAS: Septic tank drainage does not meet the minimum standards of the Ordinance of Poll, County and State Administrative codes. !MEREAS: The owner agrees to install a holding tank for septic tank purposes. 1!0!1, THEREFORE: For and in consideration of the issuance by the Township of _B 9 '-0 j of a Permit for the above premises, the parties do hereby agree and-h nd themselves as follows: 1. Owner agrees that they will conform to all rules and regulations pertaining to a holding tank system. They agree that anytime said Township deems it necessary to maintain this tank, the Owners shall have same maintained in 24 hours, or Township will have said work done and charged to owners and place same on their tax bill as a special charge. Pumping is included as normal maintenance. 2. The Township reserves the right to assess a bond if they desire to cover any possible r.iaintenance charge in the sum of IT IS UNDERSTOOD that this agreement shall be binding on the Owners, their heirs and assigns. Ii1!1ITHESS !!HEREOF; the parties have hereunto set their hands and seals the day and years first above written. SIGHED: Name of Tot-in Official Address SIGNED: fame of Owner or Developer Address /q . R . ray ~o~ S o gl--,OLUTAJ )/5C"j 5;.,1 Syoo z STATE OF l!ISC011SI11) ST. CAGIX) SS. COW ITY OF -Pt , Subscribed and sworn to before me this I7:Nday. of ,T;, N 19 ?G SIGHED ✓ J t _ ST. CRo►x Notary Public, Poll tounty., !!isconsin. Notary Public - State of Wisconsin l ly COmrl1 SS l on eXpi reS Mp CommIssion ExpiresNav: 1, Q1 AGREEi iEi'T JU L S 1 This J~reenent made and entered on this 19,„day of TA ,v by and between the To~lnship of &cDw~~ County J!isconsin. 5,.. CRoOX PHEREAS - An application has been made for a Sanitation System on the folloeling described property: a_ot Block ilame of Subdivision PHEREAS: Septic tank drainage does not meet the minimum standards of the Ordinance of Poll, County and State Administrative codes. !J1IEREAS: The ovlner agrees to install a holdling tangy: for septic tank purposes NO!% THEREFORE: For and in consideration of the issuance by the Township of 6 9 c.DL/i i Q of a Permit for the above premises, the parties do hereby agree and bind themselves as follo,ls: I. Oi,!ner agrees that they t•lill conform to all rules and regulations pertaining to a holding tank system. They agree that anytime said Township deems it necessary to maintain this tank, the Otiners shall have same maintained in 2A hours or Township r!i l l have said t,iork done and charged to oclners and place same on their tax bill as a special charC . Pumping is included as normal maintenance. 2. The Township reserves the right to assess a bond if they desire to cover any possible r,aintenance charge in the sum of IT IS UODERST00D that this agreement shall be binding on the O,•lners, their heirs and assigns. li! UITHESS 11HEREOF, the parties have hereunto set their hands and seals the day and years first above written. SIGiJED: Flame of Town Official Address SIGNED: i'ame of Owner or Developer Address A_, A6-x ~c w Syvcz STP,TE OF UISCOiJSI:J) ST. CA r7) X) SS: COUNTY OF -F, SubSCri bed and stlorn to before me this 13 j~tday of _1,,c 10 8 SIGIM. I ST• CRc X Notary Puvl i c, -Poik County, , '.!i scons i n . Hy comrli ss i on expi res M NY C mini lion Expires Nny 1; "")RI ST. CROI X COUNTY ~y W I S C O N S I N T"?f> f ' ,~r~~' ZONING OFFICE = 796-2239 (HAMMOND) 425-8363 (RIVER FALLS) `L HAMMOND, WI 54015 QUART E R L Y PUMP I N G REP O R T ST. CROIX COUNTY NAME: fl~~ /C A S 4 RETURN COMPLETED FORM TO: ADDRESS: 13 G X- ST. CROIX COUNTY ZONING OFFICE. P. 0. BOX 98 4 HAMMOND, WI 54015 715-796-2239 or 715-425-8363 TOWNSHIP: (j A D w - PLEASE PROVIDE__TH-E FOLLOWING- INFORMATION ACCOMPANIED BYCRECEIPTS FROM YOUR PUMPER:--, NAME OF PUMPER: yG~Z, S' 4 <r C /T '2 LOCATION OF DISPOSAL SITE: NUMBER OF PERSONS LIVING IN RESIDENCE: USE: YEAR ROUND _ SEASONAL (CHECK ONE) OCTOBER NOVEMBER DECEMBER DATE VOL. PUMPED DATE VOL. PUMPED DATE VOL. PUMPED THIS REPORT MUST BE RETURNED NO LATER THAN JANUARY 31, 1986. OWNERS SIGNATURE mj :12-83 k ST. CROI X COUNTY W I SC O N S I N amt. ~C}~~ r ZONING OFFICE 0~~~ 796-2239 (HAMMOND) 425-8363 (RIVER FALLS) _ HAMMOND, WI 54015 ' QUARTERLY PUMPING REPORT ST. C R 0 1 X COUNTY NAME _A r,, -5 RETURN COMPLETED FORM TO: ADDRESS X5-1Q ST. CROIX COUNTY ZONING OFFICE P.O. SOX 98 / HAMMOND, WI 54015 715-796-2239 m 715-425-8363 TOWNSHIP PLEASE PROVIDE THE FOLLOWING INFORMATION ACCOMPANIED BY RECEIPTS FROM YOUR PUMPER: NAME OF PUMPER: LOCATION OF DISPOSAL SITE: ( /.2,P ..r td % ~LIV &1 ~1 NUMBER OF PERSONS LIVING IN RESIDENCE: USE: YEAR ROUND SEASONAL (CHECK ONE) APRIL MAY JUNE DATE VOL. PUMPED DATE VOL. PUMPED DATE VOL. PUMPED > 2 ® o THIS REPORT MUST BE RETURNED NO LATER THAN JULY 30, 1985 OWNERS SIGNATURE CL ST. CROI X COUNTY Y4 err ; WI SC O N S I N ZONING OFFICE z. Bfic~y~'yC ~9~. 796-2239 (HAMMOND) c - ,;=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. C R 0 1 X COUNTY NAME A// e ~v r n.a s Z RETURN COMPLETED FORM TO: ADDRESS 0,x '2 ST. CROIX COUNTY ZONING OFFICE P.O. BOX 98 5,9 HAMMOND, WI 54015 115-796-2239 an 715-425-8363 TOWNSHIP %3,4 << PLEASE PROVIDE THE FOLLOWING INFORMATION ACCOMPANIED BY RECEIPTS FROM YOUR PUMPER: NAME OF PUMPER: C hi,g S- ke S LOCATION OF DISPOSAL SITE: NUMBER OF PERSONS LIVING IN RESIDENCE: / USE: YEAR ROUND & SEASONAL (CHECK ONE) JANUARY FEBRUARY MARCH DATE VOL. PUMPED DATE VOL. PUMPED DATE VOL. PUMPED THIS REPORT MUST BE RETURNED NO LATER THAN MAY 15, 1985. OWNERS SIGNATURE a_le- ' a.. _ ST. CROI X COUNTY WI SC O N S I N At ZONING OFFICE ?d ,796-2239 (HAMMOND) 425-8363 (R I V E R F A L LS) 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 NAME: RETURN COMPLETED FORM TO: ADDRESS: JAG' ,r s / / c ST. CROIX COUNTY ZONING OFFICE. P. 0. BOX 98 g%/~~,~~~ y✓,`S HAMMOND, WI 54015 715-796-2239 or 715-425-8363 TOWNSHIP: PLEASE PROVIDE THE FOLLOWING INFORMATION ACCOMPANIED BY RECEIPTS FROM YOUR PUMPER: NAME OF PUMPER: LOCATION OF DISPOSAL SITE: G NUMBER OF PERSONS LIVING IN RESIDENCE: USE: YEAR ROUND L, SEASONAL (CHECK ONE) OCTOBER NOVEMBER DECEMBER DATE VOL. PUMPED DATE VOL,-PUMPED DATE VOL. PUMPED THIS REPORT MUST BE RETURNED NO LATER THAN JANUARY 31, 1985. OWNERS SIGNATURE; mj : 12-83 T. CROI X COUNTY YY~ }y,~ oo~, 4 WI SC 0 N S I N x •s: r y . A~,,~~ ;L-~~i~`~~: , iL~ - ID 'leggy O,cF749 1 ZONING OFFICE Y F ` r r.<; 796-2239 (HAMMOND) 'z tom,, 425-8363 (RIVER FALLS) HAMMOND, WI 54015 U A R T E RLYPUMPING REPORT G---- ST. C R 0 1 X COUNTY NAME f l f" N f x /15 RETURN COMPLETED FORM TO: ADDRESS ST. CROIX COUNTY ZONING OFFICE P.O. BOX 98 b 'A /I~ ~HAMMOND, WI 54015 715-796-2239 on 715-425-8363 TOWNSHIP PLEASE PROVIDE THE FOLLOWING INFORMATION ACCOMPANIED BY RECEIPTS FROM YOUR PUMPER: NAME OF PUMPER: LOCATION OF DISPOSAL SITE: ; F .y c 5 e NUMBER OF PERSONS LIVING IN RESIDENCE: j USE: YEAR ROUND VSEASONAL (CHECK ONE) JULY AUGUST SEPTEMBER DATE VOL.PUMPED DATE VOL.PUMPED DATE VOL.PUMPED THIS REPORT MUST BE RETURNED NO LATER THAN OCTOBER 15, 1984. OWNERS SIGNATURE