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BALDWIN SPORTS CENTER Town of Baldwin
Wally Shef land
Baldwin, WI 54002
Form Sent 1-24-85 Returned 2-7-85
Action Taken: Pumped 2-6-85
Date of Card 8-26-85
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Parcel 002-1076-95-000 09/22/2006 05:25 PM
PAGE 1 OF 1
Alt. Parcel 30.29.16.451 E 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 - SHEFLAND, WALLACE E TRUST
WALLACE E TRUST SHEFLAND
730 FLORENCE ST
BALDWIN WI 54002
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 730 FLORENCE ST
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
Legal Description: Acres: 1.990 Plat: N/A-NOT AVAILABLE
SEC 30 T29N R16W IN N 1/2 SE 1/4 COM SE Block/Condo Bldg:
COR SEC 30. TH N 1379.15 FT TO CL HWY
12, N 77 DEG W 1198 FT TO POB N 217.8 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
FT, N 77 DEG W 400 FT, S 217.8 FT, S 77 30-29N-16W
DEG E ON CL 400 FT TO POB
(EZ-U-1109/274)
Notes: Parcel History:
Date Doc # Vol/Page Type
01/23/2006 816991 EZ-U
05/15/2002 679047 1891/55 QC
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 11/02/1999
Description Class Acres Land Improve Total State Reason
COMMERCIAL G2 1.990 15,700 96,600 112,300 NO
Totals for 2006:
General Property 1.990 15,700 96,600 112,300
Woodland 0.000 0 0
Totals for 2005:
General Property 1.990 15,700 96,600 112,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: 04/17/2001 Batch PRGRM
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
AS BUILT SANITARY SYSTEM REPORT,
OWNER' TOWNSHIP SEC .3T''2 -RW
ADDRESS ST. CROIX COUNTY, WISCON,5IN ; ,
SUBDIVISION LOT L0 SIZES
PLAN VIEW
Distances and dimensions to meet requirements of H63 y
- E$YTHING WITHIN 100 FEET OF SYSTEM
tt
y Is
i
i
-1
F-T-t-
I di a e otth Arrow
12
SC L
BENCHMARK: (Permanent reference Point) Describe:
Elevation of vertical reference point: Slope at site:
SEPTIC TANK: Manufacturer: Liquid Capacity:
Number of rings on cover : Tan manhole cover elevation: _
Tank Inlet Elevation: Tank Outlet Elevation:
PUMP CHAMBER
Manufacturer: Number of gallons
Number of gal. pump set or a cyc -e gallons; total capacity of
distribution lines gallon: size o pump head;
gallon per minute horsepower brand name of pump
and model number ;
Type of warning device
HOLDING TANK: Manufacturer >r's Number of gallons,'(;~(:W)
Elevation of manhole cover
Type of warning device _
SEEPAGE PIT SIZE: Number o pits eet iameter _
feet liquid dept seepage pit in e-t pipe-elevation
bottom of seepage pit elevation feet.
SEEPAGE BED SIZE: number of lines width lefigth the depth
SEEPAGE TRENCH: width length
PERCOLATION RATE REA REQUIRED AREA AS BUILT
INSPECTOR
DATED `K) --/D - W/ PLUMBER ON JOB
LICENSE NUMBER____fb-e
REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM
Sanytany Pen,Mit /jcr
w
ZX State Septic 2 X_
NAM &4T,-nlhip C,, o.i"x County
Locattion Sw S Sect on_Q Lot # Su -bd, v ,('.6,tavi
SEPTIC TANK
S,i.ze gat Z ona NudeA eompantmentls
F
Distance ~)Aom: We f BuZ2ding 12% Mope
Highwaten.
PUMPING CHAMBER
SLze. ,4," gaE'tonls Numbe,.
OW W, 00- Go~
HOLDING TANK
Size" _gaf on Numbers o{y Campan#ments
P u m p e. h-- A Q a A m S y e. m
DtiStance (),7om: We2~ Buti~dting__-- 2% s.Q_ope.
H4"ghwateh
ABSORPTION SITE
Bed Tn.eneh
D~,6tanee from: (Uetf- ~d~.n`{------- 12 / for
Highwatet
ABSORPTION SITE DIMENSIONS
Width o6 t,' e.neh ~t RequiAed area 6t
Length o6 each tine ~t Dee th o6 hock below t,i:fe_ tin
ti -
Numben o6 Xines `Depth o~ cock ove,tt tile. in
t. s
Adill
Totat te.ngth obi tines % Depth a6 ti e betow ghade tin
Distance between tines -{It s" Stope o{ tneneh tin. pen 100 At >
Total absorption area Type. o(j Coven: Paper. oic. st4aw
I
PIT DIMENSIONS
Numbers oo pits-- ~G4ave_,~ around pith ye,5 no
Outside diamete.tt Depth below intet 6t
Total absorption area 6t
Area nequ,4Aed It
'INSPECTED - TITLE
10,
APPROVED DATE 19 8
REJECTED DATE 198
REASON FOR REJECTION
RE RT ON INSPECTION OF SANITARY PERMIT #~s
(1) Name and Address of Per it Holder Person/Persons at Site (2 )Date of Inspection
;z_ Zell
Time of Inspection
Name, s, Lic
Addy4O o o installing plumber
3 INSTALLA ION CONSISTS OF: ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber
❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System
BEN ermanent reference Mint 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 ❑ N0; ft from residence;
ft from well; ft from property line. Type of warning device
Is the warning device installed? ❑ YES ❑ N0; 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 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? ❑ YES ❑ NO
(13) Has system been installed in floodway? ❑ YES ❑ NO Floodplain? ❑ YES ❑ NO
DILHR-SBD-6095 N.05/80
Signature of Inspector:
State and County State Permit # } ~I
PLB a-w Permit Application County Per #
for Private Domestic Sewage Systems County
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
~~g~~~c cJreJ o ~~f% nl Cie B. LOCATION: '/4 S Section T MN, R,~6 16 (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
Township glra
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 cc Total gallons No. of tanks 6AI
Prefab concrete _ X~ ` 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.
NewX,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 ❑ 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,, t
NAME -=-V e- tYL p c~r C.S.T. # and other information
obtained from fcJ ? ~v (owner/builder).
Plumber's Signature MP/MPRSW# Mf' 36T Phone #Z/-5-- 610 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. 99
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Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY
Date of Application Fees Paid: State. County Date - -
Permit Issued/Rejected (date) Issuing Agent Name
Inspection Yes , No State Valid# Date Recd
1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (pink copy) 4, plumber (canary copy)
Revised Date 7/1 /78
E / , 115 Rev. 9/78
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATION:'/4,, Section, ~ ,T21\1,131" (or) W, Township or N
Lot No. , Block No. County
ubdivision a e
Owner's/Buyers Name: RL.~I ~Ji p~;p 4-
Mailing Address: FZ c/ ~~~J ~t
TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL X
EFFLUENT DISPOSAL SYSTEM: NEW --X REPLACEMENT ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS 7 ^ / - Y6 PERCOLATION TESTS
SOIL MAP SHEET 7e NAME OF SOIL MAP UNIT R14A 1~?,L
~
PERCOLATION TESTS
PEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES
NUM- CHARACTER OF SOIL SINCE HOLE HOLE AFTE INTERVAL RATE
BER INCHES THICKNESS IN INCHES 1STWETTED SWELLING INMINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/ IN
/
P- l to 3 " eiLA o2! y V es
g
P- .2 3 g„ (1 V
r~ ~r
P_ 3,l7 ft .~l/ to
P- i
P- rJ e R o
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
B_ -2
if
y
B- U y $
B- 4 [r Ii A;Z r'
B- J
B-
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PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas.
Indicate number of square feet of absorption area needed for
Give horizontal and vertical reference points. Indicate slope.
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1, 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.
~
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N
ame (print) fie- q Certification No.
Address C, (,J i ,.j [
Name of installer if known e -,e- Cr ® L
Copy A - Local Acthority CST Signature --I- J
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AGRELMEr:
day of , 19 by
This agreement, made and entered on this
P ddss
and between the Township of
V'EERE.P. S: 1-n application has been made for a sanitation system on the
t following described property:
ViEEREAS: Septic tank drainage does not meet the minimum standards of the
ordinance of St. Croix County and state codes. -R
yE EEREAS: The owner agrees to install a holding tank for septic tank purposes
purposes.
NC.VT', THEREFORE: For and in consideration of the issuance by the Town-
ship of r 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 pumping charge in the sum of $
IT IS UNDEnSTOOD that this agreement shall be binding on the owners,
their heirs and assigns.
IN VITNESS %VEEli,EOF, the parties have hereunto set their hands and seals
the day and year first above written.
Township of 80,03-928
by f `
Developer
or owner
k
STATE OF V~ISCONSIN)
SS: ~trrrtrn►r~,~ -
COUNTY CF ST. CRS) ~,,•O NAD~''~r, `
Subscribed and sworn to be r ®1t~A Y P day of A11 C? S l~ 19
p ,PUBLIC
Notary Fublic, St. Croix
°o, of Wisp
Notary Public = State of Wisconsin •4,,,rir~o»r~r,
My Commission Expires Mar. 15, 1981._
~ kT ST. CROIX COUNTY
v
{ l :r ~ W I S C 0 N S I N
~v r E n z~'
7 9 6- 2 2 3 9
Z O N I N G O F F I C E
_+illi:Ill I4
Post 0156tics Box 227
r s =ti,' Hammond, WI 54015
0 W N E R
P U M P E R
A G R E E M E N T
PLEASE BE ADVISED, That unt.it you are again not. hied, I Witt
I
contract with C /4R S L I C true- 5,'S o 6 rc 4 LC/1V
Wisconsin, (Pumpers) , 6or the puxpos e o6 removing att waste 6rom the
Aan.itaxy system to be toeated on the property and 6utuxe home site
Located in St. Cxo.ix County, Wisconsin, Township o6
T
being in the % o6 the % of Sec. , T. N.-R. W.
(0& moAe. Gutty desex.ibed as 6ottows: )
Vated this / day o6S 19
'
(OWNER)
State o6 Wisconsin)
s s
~,~OuYi4# 06 St. Croix) IN ADDyappeared before me this day of 4l't6 `t S 19,)-'
v e named ~vr~~ s N c F 4 ,1 r 7 to me nown to b -et h e
w* ~on _ execute the 6orego.ing .t.nstrument and ack.nowiedged the same.
- w
01otaxy u "etc, t. t ix County, W
of Wisc.+`My Comm. (is pexmant) (ExpiAes ) J~1i1~2- t ltd I
I, C ►2 S C_ rvVe-sS , hexeinbebore xe6erred to as Pumper,
foie .in t e above agreement tot e extent that I have a contract with
Ownex as above stated.
~~-2 >L 4PUMPtR )
K
y
Department of Industry, Labor & Human Relations
S Division of Safety & Bldgs.
+ State of Wisconsin Bureau of Plumbing Platting & Fire Protection
P.O. Box7969
Madison WI. 53707
Tel. 608-266-3815
~ V
1
IN ALL CORRESPONDENCE
REFER TO PLAN
IDENTIFICATION NO. V~
NAME OF PROJECT
r ~
TYPE OF APPROVAL r0~ yR
STREET AND NO. Ly/ SFp /~F~ ~
CITY OR TOWN NTY STATE ZIP IpA~ 1g8
A-A
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, /
G~
James Sargent-Bureau Director
PLANS REVIEWED BY: DATE:
Owner DI LHR
cc: D
Local al PI PI Plumber H & R (2)
Mfg. Rep. Bur. of Health Fac. & Services
County Rec. & Env. Services
DI L H R S9D-6099 (N. 06/80)
Plb J00a12 78'
, State of Wisconsin
Detach'-And Return Upper DIVISON OF HEALTH
Portion Of This C 1 orm With SECTION OF PLUMBING
AND FIRE PROTECTION SYSTEMS
Any Return Correspondences MAIL ADDRESS: P.O. BOX 309
MADISON, WISCONSIN 53701
608-266-3815
DATE: PROJECT:
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
A ST. CROI X COUNTY
W I S C O N S I N
ca ~ 4.2 . f Lro~~,ri. GN
ZONING OFFICE 796-2239
~ . HAMMOND, WI 54015
fii•ii .
November 25, 1980
Chris Lickness
R.R. 1
Baldwin, WI 54002
Dear Sir:
Enclosed, please find the pumping report sheets which
include all the information needed by this office.
These reports should be sent to us once a month through
the first four months, as to get an idea of the usage,
and thereafter on a quarterly basis.
Thereafter, the township should also receive a copy of
these reports. Then on a yearly basis, the state
should receive the past year's pumping report informa-
tion.
Should you fail to submit this information, we will
request, of the owner, to contract with a new pumper.
In addition, periodic inspections by the county and
state will be made to determine the success of the
holding tank system.
Should you have any questions, please feel free to con-
tact this office.
Yours truly, ,
Thomas C. Nelson
TCN:sl
CC, Baldwin Sport Center