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HomeMy WebLinkAbout030-2010-20-000 o NO' c 0', z d �1 ID n d 0 0 o ° rn c o 03 o v 0 o o `< O• co c N a °' 3 g v, y �' a 3 0 °' v m is N ° O La f7D• n OD C CD `�' a l O n 0 A� O M c c° �. c cc o o Cn Z D �a (n < D a m to D y a m c? N �' ° 1 a IW n W ° co c i a N N — w CD co to 0 r ca A A c y 00 -4 Q N Q lr CA ° 3 N 7 i Z 00071 N 000! '' � • Z g lV gg cn G w Z v � N� a s N N N a D 7. 3 0 v v CD 0 A 7 0 to 3 N <, A Ul 7 a Z Z D, o D m o Q 7 ° a 7 v �' 0 m o - m y � • ° 0 � ° 7 C N CD N C C a a 3 n 7 a 3 7 (p (D 7 p O N 3 C C iG g 7 N a A 0 0 cn "� W 4 CCD C A m W ? 3 a X ° e ! m co w H Z CD CD A w C) I m I d 3 TI Q _a m a � o c o cn y I 3 CD I I I I I A I I � lv N a I ry o o ° b CD ° oro r�0 .e0 w ° ° °° Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division -- INSPECTION REPORT Sanitary Permit No: 463129 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Kubler, Mark St. Joseph Township 030 - 2010 -20 -000 CST BM Elev: Insp. BM Elev: BM Description: ( � Section/Town /Range /Map No: 9q •17 1 1+ 77 I J �1 � z- (_S T 34.30.19.387C TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic t Benchmark 8esflTtJ� Alt. BM Aeration Bldg. Sewer N Holding St/Ht Inlet SUHt Outlet TANK SETBACK INFORMATION - .31 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet \ Septic Dt Bottom \ Dosing t � Header /Man. °% l , M Aeration Dist. Pipe Holding Bot. System ` q . 3 'ZZ 7 O Tz_ YS VS •S PUMP /SIPHON INFORMATION Final Grade _ qq ,[f S Manufacturer Demand St Cover GPM -7 -7 Model N er TA erg TDH Lift Friction Loss System TDH Ft \�-.. ir. 7 .71 � . ? 1 ' Forcemain J L - ra. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length / No. Of Trenche PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS l Z 1 !` l� --- SETBACK SYSTEM TO P/L jBLDG IWELL LAKE /STREAM LEACHING Manufacturer:._ --(� \ INFORMATION CHAMBER OR Type Of System: / / ! UNIT L ����i ;�� n ZL[ , S� , I n Model Number: c•� N fT 1 � DISTRIBUTION SYSTEM �� Header /Manifold il Distribution x Hole Size x Hole Sparing Vent t Air Intake cY % Pipe(s) NI-1 ��_�� Length t� Dia Length Dia Spacing t SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Z Depth Over j xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Ed es Topsoil Z • g Yes No Yes E No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 1219 Cty. Rd. I Hudson, WI 54016 (SE 1/4 SE 1/4 34 T30N R19W) NA Lot 3 Parcel No: 34.30.19.387C 1.) Alt BM Description = S �5 �- Ae. A- 1 L / J 2.) Bldg sewer length = 1 -amount of cover = Xt ti 1 r� 15�, cv vim, C EA Plan revision Required? Yes No L` l� A_�Use other side for additional information. V Date Insepctor ignatur Cert. No. SBD -6710 (R.3/97) c Safety and Buildings Division County 5+ C �Q r x N 201 W. Washington Ave., P.O. Box 7162 �scons�n Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce ( 266 -3151 / � 3 Sanitary State Plan I.D. Number In accord with Comm 83.21, A A, may be used for secondary purposes Prt P (}4(1)(m) Project Address if different than mailing address) 1 U.4 4 1. Application Information - Please Print All eUU4 p30 — a 2� /o — moo —GYM operty0wtler's N me t ZONIN uUU Parcel y Lot 1Y Block # Property Owner's Ma�iling Address �� Property Location a 1 2 /1 ` / o • I? D. h ��i 'A, s� u,Section City, State //,, •• Zip Code Phone Numbeerr- �t # a(circle one VVSa,N [�(J �. S / o /cp 5 y ' Cho 3 2-- T 3 V N, R or W H. Type of Building (check all that apply) X X t CSM Number , or 2 Family Dwelling - Number of Bedrooms ` �0_ /� El Public /Commercial - Describe Use 3 ? S 7 ? 3 , ` ❑ State Owned - Describe Use fit (14R 1 , W K7 ❑City_ ❑Village WTownship of - . 70e M. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System J&placemerrt System ❑ Treatment(Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑Permit Renewal ❑Permit Revision 11 Change of ❑ Permit Transfer Previous Permit Number and Date Issued Transfer to New d r Before Expiration Plumber Owner IV. Type of POWTS System: (Check all that apply) on - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized VLz:hB nd ❑ Holding Tank El Peat Filter L1 Aerobic Treatment Unit ❑ Recirculating Sated Filter El Recirculating Synthetic Media Filter - 13 Drip ne ❑ Grav 1 1 Other (explain) V. Dispersal/Treatment Area Informaho . Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal At& Required (so ea Proposed (sf) System Elevation � .7 (0 y .&. 6y Pi.o VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel -Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit Dosing Chamber _ VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Na true (Print) Plumber's Si cure - "P/MPRS Number Business Phone Number R. - U 1,(3R i d %7_ ZZ. 4 3 r7 l S' - 7 7;L Plumbe2 7 s'(Street, City, State, Zip Code) ��� /� �✓ / T / 5 q 7 VIII. tmt /De arhnent Use O nly pproved El Disapproved Sanitary Permit Fee (includes Groundwater Date Issued suing A t S1 Stamps) Surcharge Fee) � � � /t7 / O � ❑ Owner Given Reason for Denial . Conditions of ApprovaMeasons for Disapproval �1 / d��Z G�2 Q/1 �C SYSTEM OWNER: ent filter and dispersal cell must all be serviced /maintained as per management plan provided by plumber 2. Ali setback requirements must be maintained �� as per applicable code /ordinances: Q '' Attach complete plans (to the County only) for the system on paper not W6 than 81/2 a 11 inches in size L 7 /�� /L o ` coo C l ei r '� Y l ! t Q 1 tl ,v m CIA O h i kn I lk r q � 3 .7 SO Cr = QO V N) CD A � o ` 4 Co N m O� M n H D e n 0 -0 S -4 Q t � � u} O � nn -o 1 / m K � O nU) 0 a: Lo O m 9 C �, Q mKr- ULBRICHT & ASSOCIATES CO. 2812 1 Oth Ave. • Spring Valley, WI 54767 Reg. Designers of Engineering Systems 715- 772 -3442 Private sewage Consultants I PROJECT INDEX 1 � PLAN ID 4//�-- DATE ©G7'�• �7 " O 4 1 OWNER rV K 4113 J.C& PHONE - 7 ' 57 7 ' 000 .32 ADDRESS /2,/f /�!� . .� a ,�(> ItJ/ S'YD �o LEGAL DESCRI PTION G07�" ,3� C5,A9 . �Uf S �� . jgy,5 6 , t5'�. s • 3 ''- 7' /l'/ TOWN OF .5 T= J ey4e /`4 COUNTY LOCAL AUTHORITY/ SUPERVISION $ - r. PROJECT DESCRIPTION: . /41 7 6— 5 YS 2�e� / 4S, %V .DO WW & J ! Tf 6-- 4 OL:2.C.. Wbuar + GINAL Ulbri th & Associates 2812 .1 Oth A ge Consultants Sprina Valley, Wl 54767 A41 S -4� P9.1 INFILTRATOR SIZING 0 . 0 P9.2 SYSTEM PLOT PLAN NORKSHEET '� ` ` I P9.3 CROSS SECTION OF SYSTEM W P9.4 it �� n , ITH ELEVATIONS. P9•5 OWNER MANAGEMENT PLANS & ZABEL FILTER SPECS P9.6 (OPTIONAL) CROSS SECTION AND SPECS FOR DOSING TANK. PG -7 (OPTIONAL) PUMP PERFORMANCE SPECS. I The attached Absor p and specifications are ption Component Manual For Private based on It SYstems.,, (Version 2.0) SBD- 1075 Wastewater Treatment 5 P(NOI /01. I N M z °o ~• coca ° f coo A6 I /;---O= 7ko� r C � J ' / • o / l " "1j„ �Y J Q � r 4 0 `' rq CIO k �° 3SO A) .� °a N c .o go v �D CD d o O �� 0 M O I r a �. m S, Q { �l 2 'm 0 1 4 T< T ` 1 C\ �m 'Mm 7Z lk m C O O 0 O �o� W WK> mf r 4 � � d �A, d Z CL .A. z z? _ < to cr m m z ,A � � Q O r Its ..� Auf / _ o w !l olt� l ► l .Z. t t J t N G1. Y �t Q 0 Er k tt CIS q D FT y � 3 ao D > � d z -nm2 -+ rw0 m�o� Ox ,� D,� • 00 oo v (� y m Q 1 �0mm U m °v :o C �� Nncn Mfr a i S-f Nl� 1 41' RI 04 ivspc ffOA-o� ►(r 11 w /d>fi;�7XIf7 ede , F 7-eg T�� y - r ` rev Aj Iff S• � sq..� , ,tifiv. y gd OVER: See Reverse Side for Vent/ Observation Pipe Details. OWN ERIs MAINTAINCE OF SEPTIC SYSTEM POUTS (landowner) is reponsible for. ro e maintenance of this system, Re ular P P r operation and servicing is necessary for thg Periodic inspections and system. T e safe healthy operation of, this he owner is required by code to submit all necessary maintenance /inspection reports to the on i Y g SPECIFIC CONTACT .AGENTS Governmental authority/ inspectors: ZOA-)!,v _ ��s • 3 8� - y� * Licensed installer maintenance responsible for providing an o Users manual: peration/ '* Licensed serv&ce / inspection agent other than installer: 3 Co 2/3 0 Electrician, for pump, electric control wiring units: IMPORTANT OWNER MAINTENANCE RE UIREMENT 1. S Winter traffic'(sleading, shovelfiu area shall not be:permitted g' etc.} across the the cell, freezing or frost can /will winter . g up the system. Disco into useefn lead to freeze to (a eeze ups. -trip# resulting `in no water use eeze ups....._ can `also 2• Water conservation needs to be exerc' hydrolically overloaded and ised! Or system can be designed for a maximum wastewater o yed o ffs sys hem was . POUTS are SO gals. daily, not designed to accomodate wastes from a disposal unit, a o any other Any in troduction unnatural sources of garbage y this system. des troy of waste materials will overload and 4. If a power ot,ta in a temporary ge occurs, or a pump fails ` cell y overload of effluent bein it may result • which may adverse) 9 Pumped into the recommended that a licenSedm um the cell allowin (leakhge). It is g the pump to return to dosing the dosing Consult your installer immediatel for advice. amounts. 5 . Neglect of the erosion vegetative cover (the cells insulation preventive) can traffic lead REGULARL to & also can destro failure. Compaction or Y WATER THE VEGET heNsystem. It IS NECESSARY TOeavy t he 'YStem beneath IS NOT suffi cover. �ientA SyS'PEM!! Effluent in alone t maintain a 6• Periodic inspections b necessary- Inspection Piths Owner, or his a gent s , the s P and ports have been Incorporated ystems on the mound inspeCtion pipes} basal area (effluent level lateral r cleanout terminals on the at each tip - far fl Pressurized Out. The filter s ground ystetn in the tanks and cleaning the laterals cov er /manhol s (via a locked above &erson should be per €orminy a licensed properly ere safet g this work which 9ua116ied system's tre�tmentsks. Evidence of effluent involves health cell shall also be Ponding in the regularly inspected. y. F C:) Q D RECEIVED o Wisconsin Department of Commerce 0 C - P9 1 4 � U ION REPORT page / of 3 Division of Safety and Buildings in a nce with 85, ��. �r Ad .Code ST.MOIM�UNIY County 5 C (101 x Attach complete site plan on paper not less n 81/?jjD" N@WM a&. Plan ust include, but not fimited to: vertical and "1 '7111 d Parcel I.D. 0 . 2,0/0 • 20 , 00V percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all Information. R e b Date Personal information provide may be used for secondary purposes (Privacy Law, a. 15.04 (1) (m))_ r U U Property Owner Property Location M,4 P- K < �151L- 2 Govt. Lot S E 1/4 $ 1/4 S 2 T '� N R /0/ E (or)t& Property Owner's Mailing Address Lot # I Blocic I Subd. Name or CSKW 12-19 CO. i2 D 3 V0. 5, ' City State Zip Code Phone Number ❑ City ❑ Village ffTown Nearest Road uiJSON i i i ( ) 54q - V. S te - J G E S P H I C IO - QD ❑ New Construction Use: f Residential / Number of bedrooms Code derived design flow rate _ GIRD epiacement ❑ Public or commercial - Describe: _ -- Parent material SAAs V O V T 444 11 � Flood Plain elevation if applicable ft. General comments and recommendations: f�£ r,&:S7'je�-4? 1 -5 iN9,p490A)iD D. W•T. S . FTI Bor # Boring ® pit Ground surface elev. u Depth to limiting factor a S in. Soft Application Rate Horizon Depth Dominant Color Redox Description Texture Structures ;Consis Boundary Roots GPDM in. Munsefl Qu. Sz. Cont Color Gr. Sz. Sh. 'Efr#1 'Eff#2 0- 10YR /3 h C 5 v ol 10-26 i u YR 4 4 , - ip I I m ci s f i a w 1 3v-f 1 3 4-4,15VR M e 6t . I a W a of - 7 /, (0 '4 b _q 5 1b Me . (v les then IA Fuca Boring # ❑ Boring 1 I ® Pit Ground surface elev. �h 1 0 t. Depth to limiting factor in. Sod Appkation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsed Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 l Orb i0Y 31 - \(f . a �o -a /0 W4/10 - rr w V� 4 , co a3- R �� - s I - r f 1-7 /. 6 Effluent #1 = BOD > 30 < 220 rng1L and TSS >30 150 mgA- ` Effluent = BOD < 30 < 30 mg& CST Name (Please Print) - - Signature - CST Number fJ 1 C- � / 59 - q Address Date Evaluation Telephone Number a illy ! 0" v2. 54 74 A u . a 5 r'^ a� � 15 - - - 10 - "M - 7D 5o& T i 7 w T /iv G— -sus ` /•S N C6Die Cdr 1;,4,0T ORIGINAL I I , Propert Owner u S / i E Parcel ID # Page of 3 1751 Borirg # ❑ Borkg - Q Pit Grand surface elev. �� 5 Depth to knbV Factor 91P k sa Pow Hortmrt Depth Don*wd Color Redwr Descrow Texture Structure Consistence Boundary hoots GPM in. Munsell Ou. Sz. Cont. Color Gr. Sz Sh. 'Eff#9 I 'E=2 D - �v CS 3yr 8 /+ IQ rz s/ 5 10 of 1 . F1 ❑ Pit Ground surfaoe eiev. R Depth to WOV factor !M Horizon Depth Don0nantCola Rsdox Descroon Texture Siruchre Consistence Boundary ; Roots . GPM in. MunsM Mr. Sz- Cant Color Gr. Sz. Sh. `del F Sam Cl ❑ Pit GMUW srrfae elev. R Depth /fbnWv factor in. Sol ftoication Rate Horbw WPM Dorrinard Color Redox Description. Teo" Conswence Boundary GPDJftT in. Munsell Mr. Sz. Cant_ COW Gr Sz Sh. soft o # Q t acrd aartaoe R Depth to rrtritirtg factor in. pit Shc Rate Haim No Dominant Description. Texture str cos w rm Boundary Roofs C~ in. MAIN" Coat. Color Gr Sz. Sh. 'Eff#1 � EMuent #1 = BOD > 30 < 220 mWL and TSS >30 150 mg& ' Effluent #2! BUD, 130 rnWL and TSS _< 30 mglL The Depariment of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608- 2644777. seo- a3jop�+oou P4 &i E 3 OF 3 WE LL 2 -V vz '55) BEDRe-301" t HOU5C 50.1 M *:v I TD P of F00f*S�)T10+� GOT -" o f 0-J EA5" =100 - C>O 18' 4b� IB M .b- a = q4 i7'7 "ToP oF' +ENT LCvL=L- = Yq.$® cavEr2 2 . so� BoR►N( -*t i �� xISTING� SYSTEM Go g yd ! o • --7 14 a t30 R N -1 4 3 3g. 10 r 3 (r. -q5T PRt7P 6 LI ry IA L L 0 TH GP- PR©P6 L 1 NC -5 REE A a: HEnl 50 FRaM �X f5 -T'IN4 / PRdPO5ELD SYSTEM. Uibricht & Associates Private Sewage Consultants 2812 10th Ave. Spring ValleY, WI 54767 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGRBEMENT AND OWNERSHIP CERTIFICATION FORM Owners ,, &E)Q- Mailing Address � 2 I � � • l�!/ • T � V �.� �.•J Gv /, S y D/ �i Property Address (Verification required from Planning Department for new construction) City/State Parcel Identification Number O3 O - )-v • 1-0 • M y LEG AL DESCRIPTI o / �6 oO's �-- s� S� 3� 3 3 properly Location %4, V4. Sec. . T N R W, Town of Subdivision . Lot # 3 Certified Survey Map # 3 / S 7 -7 3 . Volume s . Page # Warranty Deed # 1/ S Z s Volume 2 . Page # Spec house ❑ yes 0(no Lot lines identifiabIcA yes ❑ no ��M 1yZAINTENANCE Improper use and mamtenanceof your septic system could result in its premature failure to handle wastes. Propermaint consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you pu hem can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mas:Wplumber, Journeyman plumber, restricted plumber or a licensed pumper verifying drat (1) the on -site wastewaterdiRN"d system is in proper operating condition and/or (2) after inspection and pumping (if necessary). die septic tank is less than W fall of shulge,. Uwe, the undersigned have read the above requirements and agree to mamtaia the private sewage disposal system with the standards set forth, herein, as set by die Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system bas been maintained must be completed and returned to the St. Crone Comity Zoning Office within 30 days of am three expiration date. B F APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements an this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of die 'bed bove, by virtue of a warranty deed recorded in Register of Deeds Office. 2 -6 Y 0" F APPLICANT D & JLr/ « « « « «« be' revoked b the « « « « «« Any information that is rots - represented may result in the sanitary permit mg Y ?oniag Depa�� «« Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed ORIGINAL RECEIVED ST. CROIX COUNTY ZONING OFFICE u � 1 9, 2 2004 CERTIFICATION STATEMENT ST. CRUIX CUn�1 FOR UTILIZATION OF AN EXISTING SEPTIC TANK ZONIN (' n '7T 'r S This is to certify that I have inspected the septic tank presently serving the 14 1 1 1)� / residence located at: 51�' 1/4, /G 1/4, Sec. 3 , T3XN, R / W, Town of 57 70 S& -,P 4 Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced Did flow back occur from absorption system? -Yes No (if no, skip next line) Approximate volume or length of time: �� gallons minutes Capacity: Construction: Prefab Concrete Steel Other Manufacurer ( if known) : zoeex -5 - Age of Tank (if known): (Signature) (Name) Please Print (Title) (License Number) (Date) Form to be completed by licensers plumber (s.195.06, Wisconsin" `Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements of -83, Wis. Adm. Code (except for inspection opening over outlet baffle) . Nam q41 i C�l Signature _ MP /MPRS z Parcel #: 030 - 20.10 -20 -000 10/19/2004 01:39 PM PAGE 1 OF 1 Alt. Parcel #: 34.30.19.387C 030 - TOWN OF SAINT JOSEPH Current ❑X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): ' = Current Owner * MARK E & MARY C FARMER KUBLER KUBLER, MARK E & MARY C FARMER 1219 CTY RD I HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description ` 1219 CTY RD I SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.675 Plat: N/A -NOT AVAILABLE SEC 34 T30N R1 9W SE SE THAT PART OF LOT Block/Condo Bldg: 1 OF CSM 2/512 NOW KNOWN AS LOT 3 OF CSM 5/1455 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 34- 30N -19W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 721/111 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 318,900 Valuations: Last Changed: 07/09/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.680 128,300 175,100 303,400 NO Totals for 2004: General Property 3.680 128,300 175,100 303,400 Woodland 0.000 0 0 All 3.680 128,300 175,100 303,400 Totals for 2003: General Property 3.680 85,800 145,600 231,400 Woodland 0.000 0 0 Total 3.680 85,800 145,600 231,400 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 I� • �. DOCUMENT N O. STATE BAR OF WISCONSIN FORM 1 -1982 TNia spAct Rase"go fOR 1116CORO1Ne DATA *. WARRANTY DEED 7� 405254 V� 21PAGf This Deed, made between . .Gerald G • Line and- • .................. REGISTERS OfHCE K�►tiheXill_.>,�t..Line,..his wife. • -- ......... .... ST. CROIX CO., WIS. ........_... Reed. for Rewrd this 17th ..... ...................................... . ...................................................... , Grantor, Sept A.D. 19 and... Mar1C.Ze..Xubler.. and.. Mar y.. C.-- Earme- r =Kuhlez.__huahand...... day of ... and w ife..aa.. Joint.. tenants............................................................ 2:15P Me .........--••--••••------•--• .........................•--•-•.....•------•--•-•--•- •••- •-- ••••••-- •............... ..................................................... .. .......................•..... ......... Grantee, polo- pedg Witnesseth That the said Grantor, for a valuable consideration_..... ' ................. ... conveys to Grantee the following described real estate in .... St,. Croix..._._•.... HILT AN TO F ;''` `^�^•��` County, State of Wisconsin: � C.`a:...ca. • w Sy 7 o -1 �i A parcel of land in the Southeast Quarter of the Southeast /` ^�,, Quarter of Section 34, Township 30 North, Range 19 West, Tax Parcel No:v�d Di! � — Wo described as Lot 3 of the Certified Survey Map filed and recorded in the Office of the Register of Deeds for St. Croix County, Wisconsin, in Volume #5 of Certified Survey Maps, Page 1455, as Document #395773. 'together with the benefits of the following restrictionson Lot 4 of said Certified Survey Map: The grantors hereby covenant and agree, for themselves and their successors in title, that they will not erect any structure on the South 110 feet of Said Lot #4 that will obstruct the view of Furger Lake from the house located on Lot #3. The Grantors also hereby covenant and agree, for themselves and their successors in title, that Grantees may remove (cut and trim) any vegetation that has a diameter at the soil level of less than six inches from the South 110 feet of said Lot #4 that obstructs the view of Furger Lake from the house located on Lot #3; provided they are in compliance with any laws or ordinances and remove all stumps, stubble, and brush that results from their clearing of vegetation. The benefits of these restrictions shall also extend to the Grantees' successors in title. This ...... is ................. homestead property. (is) ( - - 1 Together with all and singular the hereditaments and appurtenances thereunto belonging; FM And....Gerald_ G. Line_ and Katherine L._ Line,. his wife_________ ......... _ .............. __ . .............. ... warrant3cthat the title -is - good, indefeasible in fee simple and free and clear of ercunbrarrees 1¢mn& except subject to easements of record, if any , and will warrant and defend the same. Dated this � . day of .......September 1 9 85 ---...----•-•-•------•----••-----•--•--- (SEAL) c'L''tf .... (SEAL) �Z .......................••-•----.... ........--- .................... • ...Ger�aldd -G.- Line ......... ................. ....... ----•-•--------•------•-• .. ............................... .......(SEAL) EAL) • .............................. ................................... • . Katherine - L,... Line .....---- ................ AUTHENTICATION - ACKNOWLEDGMENT Signature(s) ............................................................ STATE OF WISCONSIN as. .....................................•----....---- .._..----- ............-- _..... St. Croix County. rrte�'' .._..... 19_...__ Personally came before me this ....(A ..: authenticated this ........ day of__________________ ...da y of -.. September .............. 19 - - -e5.. the above named --------------------------------------------------------- •--- •:_-------- - -• - -- - -.G rald__C. _ _i,ins._and..Ka>ihexine_.I,a..l �a... -•--------• ..............•----•---•........... ..._.......- •- •-- ••-- .......... .- . ............................................................. TITLE: MEMBER STATE BAR OF WISCONSIN (If not ............................................................. authorized by § 706.06. Wis. State.) to me known to be the person .9 .......... who executed the foregoing m ,,, e / n f t �n ckn edge the same. THIS INSTRUMENT WAS DRAFTED BY ` ; John D. Heywood, HEYWOOD, CARI & MURRAY ..... - .. °••••- ................... ............................................................ s P.O. Box 229, Hudson, WI 54016 ..............•--•---•------------• •--- • •-- ..........--- - - -_.. --...•............................................. . .............. Notary Public ....... 5;;. ..Croix- ................ County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) date: ......................................................... 19 ......... *Names of persons signing in any capacity should he typed or printed below their signatures. WARRANTT DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Co. Ine. FORM Ns. 1 -1993 Milwaukee. Wie. . F 395173 CERTIFIED SURVEY MAP 1 Located in the SE 1/4 of the SE 1/4 of Section 134, T 30N, R 19W FI i D Town of St. Joseph Surveyed for: Gerald Line S AUG 4 CENTERUNE R —t• a 00lN&L �TY. TRU HIGHW ^I Hudson, WI 31111111111111W d DMd8 o , 62.03 ' . LEGEND �'� NO 1921 3 z � 8. c COUNTY SECTION CORNER MONUMENT L 2 I S — — 32802,`°f'. — ; - • 1/4 "STEEL REINFORCING ROD FOUND °o O I X24 IRON PIPE WEIGHING 1.68LBS. /LIN. FT. SET g I A? FENCE SHORELINE 0 N p cld2 W / SCALE IN FEET I " =15d1 LOT 3 ; /� 0 2550 150 300 450 Ii. O /�:'" A BEARINGS REFERENCED TO THE MON EAST N La P. LINE OF THE SEI /4, ASSUMED NO 1306 E , ^�,�� m - tifie d D SCRIgTJON - Re- divis.i on f� t ot 1 of aq o Ce In , I r carve it, Vol 2 Pa ,e 51 A p arcel of land located in the S 1 /4 of the SE 1 /4 P) C+ h P 0, w -I HOME r „ of Section 34, T30N, R 19W, Town of St. Joseph, rn o • I- 5 St. Croix County, Wisconsin, described as follows: � is us a �� z Commencing at the SE corner of said Section 34; r., � 0 z thence N0 "E (assumed bearing referenced to acs i r, CD CD 1 � the Certified Survey Map recorded in Volume 2, page I� w e 236.89' w i i 512, St. Croix County Register of Deeds) 982.56' C+ 0 w C+ I< 0 D � S0 1 21 E - rn al the East line of said Section 34;to_P.O.B.;thence 1. o � g I Z m Io S89 "W 1328.00 thence N0 "W 328.03' w � W Ir along the West line of said SE 1 /4 of the SE 1/4; �. co LOT 4 w I> thence N89 17 1331.09' along the North line rA o I� o I j ( o �N of said SE 1 /4 of the SE 1 /4; thence SO.o 13'06 "W 327.72' p _ 0 along the monumented East line of said SE 1 /4 to the 0 point of beginning, containing 435,925 square feet or • c g5' 10.01 acres, more or less, including County Trunk Nag 33 .15 Highway "I" right -of -way and lakebed of Furger'x� C+ 0, lake (5.9 acres, more or less excluding said 'right- -- �5 "�4 o of -way and excluding said lakebed. R a ' (D _ w t �� 32 j�e• I, James E. Rusch, registered Wisconsin Land Sur- °D- veyor, hereby certify that I have surveyed and mapped CD m 22' the above described property; that such plat is a true a �' I •tea and correct representation of the exterior boundaries m CD of the land surveyed; and that I have fully complied r c0 with the provisions of Chapter 236.34 of the Wiscon- on ; M sin Statutes, the St. Croix County Subdivision Ordi- 'r1 M nance, and the Town of St. Joseph Subdivision Ordi- o 0 r nance to the best of my professional knowledge, � r standing a �elief. �' �• "' 4w Affidavit in mes E. Rusch Vol 741 Page 107 isconsin Land Surveyor 51376 Doc #4 421 Second Street I � Hudson, Wisconsin 54016 °v0 December 1, 1983 `��IIppNI� 982 56' Point Of Beginning a., ``��/BB ♦� 302.72 EI /4 CORNER : dI NO 0 13'06 "E 327.72' f JAMES E . SE CORNER R T ECTtON 34 UNPLATTED LANDS w APPROVED = S- 1376 H _ 30N, R 19 W - - - - - - cD w ` Hudson, f jr .. N S ML t ♦� ♦ AU 22 198 4 B •�.. ».... O Volume 5 Page 1455 S . A tt CO0; 'tY +:NSIY't OAKS VW414ING ./ � /- wr1i� EANlt�ii • OOrwfrwl>«� THIS INSTRIIMFNT nRAFTFn RY �V`rl'r� - � 4 Y � __- 483 -559 7 i c I i I I 1 e I 1 1 T 90•ed aamTOA i 0£6'2 T£9LZI 99Z'9 IZSZLZ Z££'9 IZ89LZ 090'£ 96Z££I SL£'£ £OOL{VT SL9'£ rvOT09T £ saaoV laal amen g saaoV laal amen S saaoV laal aaen S •oN jo-I pagax-el pule enn - ;o A enn -lo -4g ill a ButpnTo;xa •eaay 2uipnToxa 'eaay -ea.zv T L s'eaaV 3o-I ;o aTq xaaTo unno 1. a�eQ •gdasor •49 Io umoL ago to pa-eog unnoy age. Aq panoadd•e Agaaag st d-euz sign, Parcel #: 030 - 2010 -20 -000 03/24/2006 08:58 AM PAGE 1 OF 1 Alt. Parcel #: 34.30.19.387C 030 - TOWN OF SAINT JOSEPH Current U ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Ma # Sales Area Application # Permit # Permit Map pp Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current CO-Owner O - KUBLER, MARK E & MARY C FARMER MARK E & MARY C FARMER KUBLER 1219 CTY RD I HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description " 1219 CTY RD I SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.675 Plat: N/A -NOT AVAILABLE SEC 34 T30N R19W SE SE THAT PART OF LOT Block/Condo Bldg: 1 OF CSM 2/512 NOW KNOWN AS LOT 3 OF CSM 5/1455 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 34- 30N -19W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 721/111 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 84170 333,600 Valuations: Last Changed: 07/09/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.680 128,300 175,100 303,400 NO Totals for 2005: General Property 3.680 128,300 175,100 303,400 Woodland 0.000 0 0 Totals for 2004: General Property 3.680 128,300 175,100 303,400 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 go * AS BUILT SANITARY SYSTEM REPORT. OWNER (�- �,(� L /� E L /NE= , TOWNSHIP J° T, j � SEC . T N, R W P.O. ADDRESS j,�T,2 , ST. CROIX COUNTY, WISCONSIN. H u�s�N ld1L ` � yon -r SUBDIVISION LOT LOT SIZE PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM /V V �usi� SEPTIC TANK(S) MFGR._ CONCRETE_ STEEL N0. of rings on cover 7 _ Depth 1/1 DRY WELL TRENCHES NO. of width length area BED no. of line width 1`L length are y_ depth to top of pipe !K" AGGREGATE 0 ;� ~ LU)i 1622 PERK RATE AREA REQUIRED AREA AS BUILT Disclaimer: The inspection of this system by St. Croix County does not imply complete compliance with State Administrative Codes. There are other areas that it is not possible to inspect at this point of construction. St. Croix County assumes no liability for system operation. However, if failure is noted the County will make every effort to determine cause of failure. GREASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. �c - INSPEC DATED ,- f�- PLUMBER ON JOB - LICENSE NUMBER • RV-PORT OF ITISPECTI ON- - INDIVIDUAL SEWAGE DISPOSAL SYSTEM Sanitary Permit State • S otic — li& r s�1E _ T01•INSHIP t, ro unty SEPTIC TA' ?K . `�� c�z .�xze � � gallons. "lumber of Compartments - Distance From: ''dell ft. 12% or greater slope ft. r Building / _ ft, Wetlands ft Ilighwater ft. DISPOSAL SYSTEM Tile Field or Seepage Pit(s) Distance From: Well ��%� ft. 12% or greater slope ft Building a ft. Wetlands f FIELD J ' Highwater ft. . Total le gth of lines ft. ! of lines 2 Length of each line - ft. Distance between lines C ft. Width of the trench _ ft. Total absorption area sq. ft. Depth of rock below tile _2 in, Depth of rock over tile in.. Cover over.rock, L Depth of tile below grade in. Slope of trench i per 1OG ft. Depth t Bedrock ft. Depth to bound water ft, Number of oits �. Outside diameter , ft. Depth below inlet ft. Gravel around pit: dyes no. Total absorption area sq. ft. Square feet of seepage trench bottom area required `:quars feet of seep nit re - required _ Inspected by' Title Approve Date 197 Rejected. Date 197 J i r ( y x c ! g l 3, � W N l x4 Sk4Sfa' L F 1 4r+'g� *:a�} °'P'A, I ,., a Out Wt Mae Y t g' Y i $J + I �t� � � v , A M k , i ( 5 m 4 Pi MS T• F°. 5 q 1 Ax n t 1 4 ^J1M � t v � , F `a.„iil+b,`'.;,+.q.•, I IR i i 8 I '1 O N ; a t) �� 1 ., .s � •rL a �i*t �.��r a,'' , I is spy M t r r•r Ati 01, 1 W ft ,_, . ;�:.. State and County State Permit # PLB Permit Application County Permit # for Private Domestic Sewage Systems County • �.. r©lx *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: B. LOCATION: Y '4, tect ion T , N, R E (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township 2, C. TYPE OF OCCUPANCY: Commercial * Industrial * Other (specify) —- * Varian e Single family _1,� Duplex No. of Bedrooms No. of Persons_ D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder_YES # of Bathrooms Automatic Washer YES NO Other (specify) E. SEPTIC TANK CAPACITY Total gallons No. of tanks *Holding tank capacity Total gallons No. of tanks New Installation Addition_ Replacement, Prefab Concrete *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2): 3) Total Absorb Area sq. ft. New��Addition Replacement *Fill System Seepage Trench: No. Lin. Feet Width gqepth Tile D��h No. of Trenches Seepage Bed: Length — Depth�Tile Depth No. of Lines )Z 0 i IF Seepage Pit: Inside diameter Liquid Depth Tile Size 1 2 1 Percent slope of land Distance from critical slope 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 Cert' 'ed Soil Test NAME C.S.T. # _��nd other information obtained fr (owner /builder). �+ Plumber's ignature P /MPRSW# ; % Z 1 Phone # W. r Plumber's Address PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). r �C oe Do Not Write in Space Below FOR DEPARTMENT USE ONLY DO Date of Application 1`'245 7/ 7 Fees Paid: State 4 County D Permit Issued /RX (date) — Issuing Agent Name i/" ' !/ �) Inspection Yes 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 6/1/76