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n ■ o ■ n c \ � § � ¢ ) � co� � CD a - 7 � )_% g Q ƒ / k / } ƒ § - r 0 3� m 2 C = :3 ) . ¥ � CD CO \}) / [ § 2 a - � @ g � ° / E @ z > . E e > � \ CD C a E a o CD / / / E� n 0 ® . ® ° 2 & rr & �- ; \ " ' -u -0 -u A \ f § ƒ § § § \ \ 7 M 7 \' \ 0 J 2 m \ \ ¥ / \ . � z .. I s \\_0 \ Q 7 � Z5* { \ I \ C 9} CD E E ƒ of g z 2 , I w ■ o e cn o k m / \ k .. § ; w / / N) / \ k m o X e G \ Z f % aa�0 c =ra CD CD /3 2.o n . o,,n5 =G l�gCD =° , ! CD <-- z a . _o § k CD CD ® ® ƒ�ƒ# . CD t cn C L ¥ \[(2mE w E \/ G E /� \q7 ƒ \ i@@§ _ /�7Efm 0)CD \ a2 mo= \ CD /f h 0 � CD § § . f o ( 0 CL �2 department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Building Division , INSPECTION REPORT Sanitary Permit No: 43 537 _NERAL INFORMATION (ATTArr1 TO FtKMIT) State Plan ID No: ersonal 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: Bo#:, ��YI�GLI�. Somerset Township CST BM Elev: Insp. BM Ele BM Description: Secti n/Town /Range/ p No: X 00 . O No Yo S/ 6ac or s 12.30.19. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic � / Benchmark I / V v 18 k - DDOV Si S U js. /0 D- c� Dosing �,i gidg I !D(, ?- Aeration Bldg. Sewer Holding St/Ht Inlet S 3� TANK SETBACK INFORMATION S `too St/HtOutlet ,37- Q 9 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet I Septic p Dt Bottom 3 � — Dosing Header /Man. / o d�• Z - Aeration Dis . M Holding Bot. System O Z. 4, N,13 .2 c, PUMP /SIPHON INFORMATION� Final Grade a 9� - 0 Manufacturer Demand St Cover �rA i11 GPM DyIA cJ S , D� CjD• 3 Model Number ��X = 3 i TDH Lift Friction Los System Head TDH Ft Forcema' Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM u „ks 1a BED/TRENCH Width . No. Of Trlen-cehes” R PIT DIMENSI No. Of Pits Inside Di Liquid Depth DIMENSIONS Q f , "t , 6,W 7 SETBACK SYSTEM TO Q P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION / / O CHAMBER OR Cl Type Of System: '7500/ UNIT Model Number: ri" Cmw44v7d 0 0 � �0 DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size \ / x Hole SP�ciJ� 9 Vent "'X e fo Pipes) X X Length Di - Lth Dia Spacin / \ _X_ SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only S Depth Over Depth Over /127 xx Depth f xx Seeded /Sodded ulched Bed/Trench Center `' 1� 2 � Bed/Trench Edges 3� 11 Topsoil ( Yes L] No Yes No COMMENTS' clude cod discre ncies, persons present, etc. Inspection #1:� � /_l Y ��li I i Location: I Somerset, WI 4025 SW 4 W 1/4 12 T30N R19W) Lakesi Es a Lot 2 P arcel No: 12.30.19. 1.) Alt BM Description = -� [obi G Cvy e_1 o 2.) Bldg sewer length = i C / t✓ OY I r� C,p I SfU V k� - - amount of cover = 1 Xf �� J l�lV 3) blo.��s Z h ate_ 6��1 - Plan revision Required? Yes No sty other side for additional informat ' n. I �11t ! — __�J �. _ _ 6710 (R.3/97) Date Insepctor s Signature Cert. No. , 7 T H r :r �; n O N O O w -_I .I 0 IV t �EOy; • .r O X O y n K m CD cC 111 J ° J to m 0 3 c � m ° A� O I Q y 0 0 = C �1 cn zD D `� a a, C N C w O N co O O rl O co w 0 $ Z m O O O v, C ' r) r CIO) CA N � x 0 v T o v N m m N an Si p m CD 7 M O O 0 N 0 3 (p N C c N 3 0 Q N N �p = 3 3 ° m cr c p z m Q ! O W N W M � o a z O Z w E I CD C A 0 Co C S a CO d A m Q C o " p Q00'° ° G �3 v 2. 0' O y n :3 "O f 0 (D fa m W < o a i I C=D, w:c m m M 7 dCOLD (p j 0 ? Ul < • < N m 6 ° T 7 :1 *3. °mm a N N o'O M O �Q_ m a ° C ID 2 c �. N• �. c m ! A o 1 O Cn m . m 0 N = c 00 0 ?` Q mo 00 ti 0 0 yaN °o o m w A _. 0 m A �0 <n O o m `, a F Sa and Tidings Division County 201 W 1 jshingt n Ave., Pb. Box 7082 YDep !Ttment A Madison, 53707 - 7082 Sanitary Permit Number (to be filled in by Co. (608 261 -6546 S 3 �L o 7 .- State Plan I.D Number r'init A � n N . PIS /� In accord w Comm $3.2 1, Arts. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, sl5.04(1 xm) Project Address (if different than mailing address) (0 0 fi s 1 I. Application Information - Please Print All Information 2 83,,J Property Owner's Name •f ? . � o Parcel # # 2- Block # -rlg' 1146-Ni t , ) //V Property Owner's Mailing Address P L52t 1 / �" 5 T' 5 SW /� City, it,SState [ I �/ Zip Code �j Phone Number �� �/a '/ti Section ✓! /� L(, 1 &t, / 't,# • �SQ d L 3 o Q (circle one) 11. Type of Building (check all that apply) T N; R ter W �t- �Qfti Yrw1 3 Subdivision Name CSM Number or 2 Family Dwelling - Number of Bedrooms ❑ Publit:lCommercial -'Describe kA Xa S! ©� 6s r� T ibe Use ,d,� ? �?eJ 11 State Owned - Describe Use `�� �S ❑City_❑vis ge 1>5tt ownship of III. Type of Permit: (Check only one box on line A. Complete Hue B if applicable) A. /hbIew Sy yst ❑Replacement System ❑ TreatrMnt/HokGng Tank Replacement Only ❑Other Modification to Existing System B Li revious Permit Number and Date Rued ❑ Permit Renewal Permit Revision ❑ Change of Permit Transfer to New O 53 � No V • Before Expiration Plumber Owner Op N. Type of POWTS S tem: Check all that appl o(Non - Pressurized In -Ground ❑ Mound ? 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter 0 Constructed Wetland ❑ Pressurized In -Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter Leaching Chan Drip Line Grave less Pipe ❑ Other (explain) 4 ea[ yva V. Dispersal/Treatment Area Inf rmation: a4l Y C Design Flow (gpd) Design Soil Application Rate(gpds Dispersal Area eouired (sf) Dispersal Area Pr ed (s System Elevation A . Q X15 0 •7 & y3 & y l�(� y . o VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plasti Gallons Gallons of Units Concrete Constructed Glass New I Existing T.h Tanks ES 7Z Septic or Holding Tank I Cp,U .P Aerobic Treatment Unit losing Charnber VII. Responsibility Statement- I, the undersigned, assume responsibiutyjor installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plu tier's Si re •MP/MPRS Number Business Phone Number ZZ . Zl _(3 R t c(4 zzcQ3� S 715.77. YY Plumber's Address (Street, City, State, Zip Code) VIII. un rtment Use Onl pproved _ ❑Disapproved Sanitary Permit Fee includes Groundwater D issued ing Ag t Si cure tamps) Surcharge Foe) cro ❑ Owner Given Reason for Denial IX Ir Conditions of Approval/Reasons for Dig pn al avyu t/ o� 0� � 2 3— �► ta.Q �L2`r�h " �S�!tl� -� o� �l Q.cc�- a - e,��.t r i -` '� � ` N�Q �71.�,�..e-t'i► -�- , t' I C L �vh -eo • �t�,�.��t., v�wt,�. �-1 TEM OWNS Attae e* as paper sat less than 81/2 x 1 dacha In size dispersal cell must all be serviced / maintained SBD -6398 (R. 08/02) as t Ian by plumber. 2. All setback requirements must be main tained - as per applicable code /ordinances. i t l I 1 ' M Rue 2 .> WO �H Ae /�0 • 4vies,i5iP CoNf,I 3�� t3A - .s p ne r4A-- f R$ a T A P of B A1 POOR s ell I yon ,6 3 SZ 5 y$TEM S y S nE �_ y+'� O 61S POWT SYSTEM SHALL INCORPORATE PER COMM. Q Z 83.44(2)c A PROPER ZABEL IJ' It FILTER MODEL # 4-100 TDp o f 3 �y - ,� f< � p - CO 1.34 p IILBRICHT & ASSOCIATES CO. 281210th Ave. • Spring Valley, WI 54767 Reg. Designers of Engineering Systems 715- 772 -3442 Private Sewage Consultants PROJECT INDEX W PLAN ID # AJ11 — DATE � l�O �NER 7' �J4 6jf1 U SdA) HONE u7 P ��.Z ' yo • 7� ADDRESS l se'Z- �l 113 tk S / • s/ / :11494 J e. /y . 5-so0o Z.. LEGAL DESCRIPTION Z. 1 TOWN OF S DTI. S�C•�1 JET' .6;eol COUNTY CSTM +�• ?� /`J/?IC"11 2 S LOCAL AUTHORITY/ SUPERVISION Z p,Jj X3 &_ ��,/ PROJECT DESCRIPTION: r� Rae o �,v� „ i 4a, do f3 49"dl -t 1w I;e Y r09 .3 iWif. tf. y Ulbricht & Associates Private Sewage Consultants 2812 10th Ave. Spring Valley, WI 54767 ORIGINAL Pg.l INFILTRATOR SIZING WORKSHEET P9.2 SYSTEM PLOT PLAN P9.3 CROSS SECTION OF SYSTEM, WITH ELEVATIONS. Pg . 4 if $1 n it if of Pg.5 OWNER MANAGEMENT PLANS & ZABEL FILTER SPECS P9.6 (OPTIONAL) CROSS SECTION AND SPECS FOR DOSING TANK. PG.7 (OPTIONAL) PUMP PERFORMANCE SPECS. The attached plans and specifications are based on "In- Ground Absorption Component Manual For Private Onsite Wastewater Treatment Systems." (Version 2.0) SBD- 1075- P(NO1 /01. i kA b AS Q - tD z a � b � V m ° g m ce N m cp z ?d 'k CA3 kA w o 7 - 2_ ' FIX 140p co,) AE iapo • FRCO A.16jile / • Rg TO ALUM U poop 8� IK 5/j/ rr / / ' yo/ 0 3 O1 / sYs r�M sys rE•y 1 2 • o j "17 -- 0 -- i ilS POWT SYSTEM SHALL INCORPORATE PER COMM. 83.44(2)c A PROPER ZABEL FILTER MODEL # 4 0 100 Il TDp of 3 /y -. ep' row ocs p i 5- r'hNr.G v to 'po � � � 5 o 54(. ir 3151W ,t �f A/I ire ��• l fir. ,f,�/°,�U � j, �,� 7 ow _ .Lli�v. �2 '' ►�� t tifr� OVER: See Reverse Side for Vent/ Observation Pipe Details. OWNER'S MAINTAINCE OF•SEPTIC SYSTEM POWTS (landowner) is reponsi.ble for proper operation and maintenance of this system. Regular periodic inspections and servicing is necessary for the safe healthy operation of.this system. The owner is required by code to submit all necessary, maintenance /inspection reports to the controlling,authorities. SPECIFIC CONTACT AGENTS *,Governmental authority/ inspectors: ge ZlIe Z 0A1 * Licensed installer, responsible for providing an operation/.,,,t maintenance "Users" manual: �7`' ? 7A • 3yI/a_ T A41V5 2 * Licensed serv&ce / inspection agent other than installer: 'TiP r 6 �S,qV,, ,+7 u 3 0 *. Electrician, for pump, electric controls, wiring units: IMPORTANT OWNER MAINTENANCE RE UIREMENTS 1• Winter traffic (sleddin shove3ring, etc.) across the area shall not be _permitted, or frost can /will penetrate into the cell, freezing -up the system. winter. (a Discontinuos use in the lead to fre eze u trip, resulting -in no water use) can also ups. 2 . Water conservation needs to be exercised! Or system can be hydrolicall y overloaded and destroyed. This sw4em was designed for a maximum wastewater flow of t� 7 v gals. daily. 3• POWTS are not designed to accomodate wastes from a arba disposal unit, or any other unnatural sources of waste', 9e. Any introduction of such waste materials will overload and destroy this system. 4. If a power outage occurs, or a pump fails, it may result in a temporary overload of effluent being pumped into the cell, which may adversely impact the cell (leakhge). It is recommended that a licensed pumper empty the dosing tank, allowing the pump to return to dosing the correct amounts. Consult your installer immediately for advice. 5. Neglect of the vegetative cover erosion preventive) can lead to failuree1 Compaction or heavy insulation & traffic also can destroy t he system. It IS NECESSARY TO REGULARLY WATER THE VEGETATION OVER A SYSTEM!! Effluent in the system beneath IS NOT sufficient alone tO maintain a gra 6. Periodic inspections by the owner, or his agents necessary. Inspection pipes and is into the system: on the mound basal tareaVe been incorporated inspection pipes), cleanou (effluent level t terminals pals o als, at each _ n the pressurized l ti la terals P for flushing and cleani Out- - The filter s i the s in d la ground cover /manhole). Onl tanks (via a locked above Person should be pe rforminy licensed properly quali6ied & severe oafet g this work which involves health System's treatmentscell shallcalso befregularrind n the y y. 1� [SO4 @gw O(Y{ co bOdo 90 ° 1 P®° — 9 Z�9 I 215.29 NOO°1325'W 1321.08 � 560.2T 1 . 2 1292.10 I I fa Iii f N o � IPI r3 A 1 1@ y R, -4 �n W I , f ev « �r�l ° y m ' r m > - z I y m o Q � V � w m4� Y Ul 1 m W Avav . pS'BOE NL60.LZ.00fV 32.99 . . . m > m . ' X 01 1 `o ® V ^ Q W N O ® r C / N w so g ru o c / w� �Q / E 24o 'i tD . CJ NOT49- -239.99 0 V Qp �� C5 m 1 N ® V y v CA v � V �' RAINgrE � D � �� TO 25 Yq HL 28.61 NW*40 201.80 173.19' jI 71N N I co I I 800 ° 4552`E 387.3T 0% i 33 9m N p�.+ 0 1 03 v A � � o I I . 1 I Z C R� I o C A Not °st'Og+E 49773 5E IO 214.73' ICS Z 181.11' 283627 m 318.N2' NOO ° 45 , 52'W 385.13' T I�E' T`E5 7 oF a�Pi yi,�� Soi TE . � i so,v �a � -?z •+� �' f -- .: � 3 Wisconsin Department of Convener SOIL �VAL' UATION REPORT Paw of Division of Safety and Build=1 `; .� aoorr'leriCe4 Comm 85, Wis. Adm. Code County 57- GR O 1',X -- Attach complete site plan on not less than 81/2,x I I inches ,i In size. Plan must Include. but not limited to: verb and tuafitpntal►point ), direction and Pacei I.D. 03 a S • o �1' Percent slope. scale or rflmensfons, eta ` noe to nearest road. Please print a►► infonnadon. Date Persond kdbMwb— You ProvWenay be used for sewm1M purposes OW4aw Law, s. 15.04 (1) (m)). Propertyowner Mfg v Sd tJ Propertytvca �► � 1 f U 50,U /ttz S GovL Lot 5 t 1/4 1/4 S 12— T 30 N R / f der) W Props Owner's Mailing bd. Name Lot # Block # Su or CSW / 3 ST • 2. 1,,4kE51,PE city State Zip Code Phone Number �Z ❑ ❑ Village R3 Town Nearest Road 5fi / /wA�.� /'Y 5 - ( ) SDMER 5-a - f — /&0 &t- New Corstruction Ilse: Residential / Number of bedroom Code derived design flow rate Fr o - - GPD ❑ Replacement ❑ � Public or commercial - Describe: _ Parent material ���L2U1 Flood Plain elevation if applicable VI-4— tL General comments and reownrimuWalions: . /Wlf 7 - 4 LE' f0 2 AN (,3 3P. 0 0 4 j) WA) 0EA) 4A)7. f Q, (.c� • ! .S' . 73 �.S F /-1 Boring # ❑ gg Pit Ground surface elev. R Depth to linatirg factor in. Soft Applicalion Rate Nowt Depth Dori lcwt Cola Red= Desor"on Texbxe Struc tme Consistence Bokxxfary Roots GPM tn. MUnselt Q L Sz Cont. Color Gr. SL Sh. 'Etf#1 'Eff#2 / �• �d �' y� L / shy s cs �- . � Z -. s M ----- .s i 2- fshk r►rt cs 0 7 .S %1 1 5 , IV rw S 0 . S 7 /. 6 7 S ® # Pit B � ' Ground surface eiev. �• ft. i Depth to i W*V factor . ` y in. SW Applicatim Rate Horizon Depth Dominant Color Redox Description Texbae SMx*re Consistence Boundary Roots GPDM In. Mansell Qu. SL Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 / o• l /o YW 1 — - L / Shy C4> – y 6 s s 51& zf S n�-� • C 3 /0 Y s _ o . Z Ace !Z) ' - eA h Elhu W #1= BOD > M < 220 mg& and MS >W < 150 ng& ' Effluent #2 = BOD < and TSS < W ";k CST Name (Please F*Q ct' z Z 4 3 Address Date Evaluation 5ndrx6ed Teiephone (.barber Ulbr & Associates L- - 7 - 7/5 77 3 Private Sewage Consultants 2812 10th Ave. Spring Valley, WI 54767 A I ORIGINAL 1 4 D A) L Property t Parcel ID # G/7Fti � , 3 © Boring # Boring g6 Pit Ground surface elev. • ft Depth to WnMV factor / O in. Horizon Depth Rate Depth Dominant Redox Description Texture St uct re Consistence Boundary Roots GPDMF in. Munsell Qu. Sz- Cont. Color Gr. Sz Sh. •ES#1 •Eft#2 Y 1 L ifs s 1, Me 7-5* -5 IL -r CS — 7 S JQ- za VA? S F Boririg # ❑ Boring ❑ Pit Ground surface elev. it. Depth to fiffft j factor in. Rate Sol Appkabon Horizon Depth Dominant Color Redox Description Texture Structure Consistence Roots GPD AT In. Murnsssel flu. Sz. Cont Color Gr. Sz. Sh. *#1 •E Boring F # ❑ �s round surface elev. ft ❑Pit G /Depth to Urnift lactor in. f todzon Sol Rate Depth Dornlrwd Redact Dt tion. T Structure Consistence Boundary . Roots GPO ff in. Munseff Qu. Sz. Cont. Color Gr. Sz Sh. •Ef#1 `Etf#2 ` Effluent #1 = BM, > 30 < 220 nruglL TSS >30 150 mglL • Effluent #2 = BOD < 30 mglt and TSS _< 30 mglt The Department 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- 264 -8777. aeo- s�w�.6,no� 2 � U- r tSJ-iN ' fjM 8 AW A 7" v • w,�tK vs�1 � 0,0 . A; �Go � 3 w L � r TD of 3ry �� go' - m ST CROIX COUN'T'Y SEPTIC "TANK MAINTENANCE AGREEMENT AND r- OWNERS1ItP CERTIFICATION FORM Owner /Buyer IM A ySoV r: Z'. M%4GNUSo lk'A Mailing Address 1 5 0 :2- // //3 5 7 - . S7 tl 7 o y,v . s 5 e Z Property Address . (Verification required from Planning Department for new construction) City /Stan' Parcel Identification Number ^ ' yF r LEGAL. DESCRIP'T'ION Properly Location 54) Y +, k ' /,, Sec. , T ` 30 N -R If W, Town of 50 Azi SX Subdivision _ �A`i X -FlVe 65 r,q- 7~'4!srS , Lot a ?- Certified Survey Map 9 , Volume , Page # Wnrranty Deed # ?3 C O ! 4P S , Volume 2 3 8 5 Page # 3 0 - Spec Douse A yes Cl no Lot lines identifiable yes O no ���� ���� a SYS'T'EM MAINTENANCE n.cl�1 ��loY Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintena consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the sysl 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 b master plumber, journeyman plumber, restricted plumber or it licensed pumper verifying that (1) the on -site wastewaterdisposal syst is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludl i /we, the undersigned have read the above recprirements and agree to maintain the private sewage disposal system with the standa set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certifncat stating that your septic. ystem has been maintained must be completed and returned to the St. Croix County ning Office wi in days of he three year expiration dat RAW SIONATURI✓ or rPLiCANr DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) *m (are) the o t(s) the p petty described above, by vin of a warranty deed recorded in Register of Deeds Office. OU _JA SIG DATE NATURE . APPLICANT * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * ** ** Include wlth tills appiteation: 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 X3 69 3 5 Vni 2t'38 P.", 1 )3 8 \. STATE BAR OF WISCONSIN Pt )RM 2 - 1999 KATHLEEN H. MALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX Co. MII This Deed, made between Jef S. Boardman and Karen RECEIVED FOR RECORD Boar h a nd wife, _ 08/22/2003 09:00AM - _.---- -_ - -_- WARRANTY DEED — — -�� — EXEMPT # Grantor. and T1 Magnuson Ent. Inc. — ._._.- ---- _ —__ -- -__ REC FEE: 15.00 - - -- .._ -- - _.. - -- - - - TRANS FEE: 930.00 _ - -- - - - - — COPY FEE: CC FEE: Grantee. _ PAGES: 3 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix _ County, State of Wisconsin (if more space is needed, please att4ph addendum): Recording Area (See Attached Exhibit "A ") Name and Return Address t�q Z_ b 3 q-0 if 5 su OUo ct- 032-2 — Parcel Identification Number (PIN) This is homestead property. (is) M,ITt}Q Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of ,tu — 2003 Jerfr S. Boardman * . Karen Boardman AU�THE�NTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) ) ss. St. Croix County ) authenticated this day of 7.(/1 ` - - " -- - Personally came before me this day of June 2003 the above named Jeffrey S. Boardman and Karen Boardman, husband and w ife, TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing - instrument and acknowledged the same. authorized by § 706 .06, Wis, Stats.) 1*14IS INSTRUMENT WAS DRAFTED BY - -- - - Attorney Kristina Ogland _ j ' C.{�(pC( - - -- - -- Notary Public, State of Wisconsin h { udso WI 5016 - My Commission is permanent. (If not, state expiration date: (Signatures map be authenticated or acknowledged. Both are not necessary.) ' Namcs of persons signing in any capacity must be typed or printed below their signature. lntormata Professonals company. Foro dulac w: STATE BAR OF WISCONSIN Poo - 655 -2021 WARRANTY UEY ;U FORM No. 2 • 1999 �a T Z �I VOL 2385 PA-LA84 EXHIBIT "A" Legal Description File No. 3 - 42642 Lot 1 of Certified Survey Map filed in Vol. 10, Page 295 of Certified Survey Maps as Document No. 530892 except: Part of SE' /, of SE '/, of Section 11- 30 -1#, being a part of Lot 1 of Certified Survey Map in Vol. "10 ", page 2951, described as follows: Commencing at the SE corner of Section 11 thence N 89 04" W, along the South line of the SE' /, also being the South line of Certified Survey Map recorded in Vol. 11 10 11 , page 2951, at the St. Croix County Register of Deeds Office, 1323.86 feet to the SW corner of Lot-2 of Certified Survey Map; thence N 00 27' 15" E, along the West line of said Lot 2, 660.00 feet to the NW corner of said Lot 2 also being the point of beginning; thence continuing NOW 27 E, along the West fine of Lot 1 of said Certified Survey Map, 658.31 feet to the NW corner of said Lot 1; thence S 89° 38' 43" E, along the North tine of said Lot 1, 660.00 feet; thence S 00° 27' 15" W, 661.12 feet to the NE corner of Lot 2; thence N 89 24' 04" W, along the North line of said Lot 2, 660.00 feet to the point of beginning. Also except Easement granted to Dairyland Power Cooperative as shown in Vol. 1404, Page 297 Document No. 597998 described as being 40 feet on each side of the following centerline: Beginning at a point on the East line of a parcel of land located in the SE % -SE %, Section 11, T 30 N, R 19 W, and further described as Lot 1 of Certified Survey Map filed July 5, 1995 as Document Number 530892 In Volume 10 on Page 2951, said point being approximately 16.12 feet North of the Southeast corner of said Lot 2; thence In a Westerly direction a distance of approximately 663.86 feet to a point on the East line of Lot 2 of Certified Survey Map filed July 5, 1995 as Document Number 530892 In Volume 10 on Page 2951, said point being approximately 22.10 feet North of the Southeast corner of said .Lot 2 and there terminating. Also except a parcel of land located in the SE % of the SE % of Section 11, T30N, R1 9W, Town of Somerset, St. Croix County, Wisconsin described as follows: Commencing at the E '/, corner of Section 11; thence S00° 27' 04 "E along the east line of the SE '/a of said Section, 1323.90 feet to the north of beginning; thence S89° 40' 13 "W, al ng s id north line 658.66 feet o th e ast line of line parcel of land recorded in Volume 1141, Page 571 at the St. Croix County Register of Deeds office; thence S00° 13' 35 "E along said east line, 120.00 feet to the south line of the north 120.00 feet of said SE' /. of the SE %; thence N89° 40' 13 "E, along said south line, 659.13 feet to said east line of the SE %; thence N00° 27'04"W, along said east line, 120.00 feet to the point of beginning. And: A parcel of land located in the SW '/. of the SW % of Section 12, Township 30 North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin; described as follows: Beginnin at the SW comer 9 of said Section; the � j » line o lin thence N 89 14 08 E along the south f the SW' ne of said section, 285.79 feet; thence N 00° 45' 52" W 165.47 feet; thence N 35° 15' 13" /W 0 0 5 �� J J T z _ � L E k �� 2 f g CD \ § ƒ 2 �\ / / § £ CL i : « 5 z E E n r@ o E ; § 0 (D ƒ Z T o o $ rr Oro k 1 3� 2 w 2 § 0 � v v - m aE�§ E � \ \ \ � } U ƒ � .. @ / @ \ � 9 @ CD ._ [ k k 3 n — i CD EI � w■ CA o , - & 7 \ z E R 2 I 2 / j3 � E § 2 rT k � .. z CA) $ / I ' U])k a =0ƒ }< om— 2z ( ■\ (Aa � (A CD ik� cyl/ \i& =r@ I K �m $ // . ,P \e \ CL ■ 0 (D t \ § 0n �2 LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF SOMERSET COMPUTER NUMBER 032 - 2045 -50 -025 Parcel Number 12.30.19.656A -20 OWNER NAME: First ELAINE G Last BOARDMAN PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment 822 1 60TH AVE SECTION 127 N 30N RANGE 19W '/4160 SW %40 SW Line Description Line Description TOTAL ACREAGE 38.515 PLAT LOT BLK 01 SEC 12 T30N R1 9W SW SW 15 345 16 03 EZ -UT- 1404/295 17 04 EZ -UT- 14121297 18 05 EZ -UT- 1625/179 19 06, EXC AS DESC 1991/537 20 0 L IN THE SE SE 1 \ 0FDEG ESC AS COM E1/4 COR 22 0 H S 00 DEG E 1323.90 23� 1 H S 89 DEG W 658.66' 24 1DEG E 120';TH N 89 25 1 9.13';TH N 00 DEG W 26 �/ 2 /& p 1 1 4 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit RECEIVED uuJ fety and BuildinVDivision ` m m 201 W Washington Ave., P.O. Box 70 2 • GRa[ 1L OIX CC UNTY adison, WI 53707 — 7082 SamVU Permit umber (to be filled in by Co.) De artment of C NVG OF ICE (608) 261 - 6546 x5 ?. • Sanitary Permit Application State Plan I.D. Number In accord with Comm 93.2 1, Wis. Adm. Code, personal information you provide /V//+ may be used for secondary purposes Privacy Law, s! 5.04(1 xm) Project Address (if different t 4ajd—s . I. Application Information — Please Print All Information IN 01 a • 2 b s - Property Owner's Name �� Parcel # Lot # I�E,)viN ng Address 5 ,+l T• T S. MA ,V Uso.t> Property Owner's Mailing s � 1 Properly Location CS►"'',�3 $LZ Cod '� � � ' GcJ /. s yot' �7 S St(J � 2 I Ip I City State Zip Code Phone Number Section �� "7 7� 5 z 7 S 3 6 30 �9 (circle one) T N; R . 1 13 orb II. Type of Building (check all tha pp y) Oo fy¢l S wti (tor 2 Family Dwelling - Number of B ms _ 4 Subdivision Name CSM Number ❑ Public/Commercial - Describe Use Gk , 9! ;,r 'r � s State Owned - Describe Use � ❑City �lage Jkownship of oe III. Type of Permit: (Check only one box on a C Complete line B of appli e) - A. New system yst ❑ Replacement System ❑ TreannentJHokGng Tan eplacement Only ❑Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ hange of Permit TransV7� Li st Previous Permit Number and Date Issued Before Expiration Plum Owner IV. Type of POWTS System: Check aA that appl Y -Son - Pressurized in -Ground ❑ Mound > 24 in. of suitable soil Mound < 24 in. of su' able soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized in- Ground 11 Holding Tan Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Ch rip Lin ❑ velAess ipe Oth (explain) t / V. Dis rsa.UTreatment Area Information: Design Flow (gPd) Design So il Application Rat Dispersal Area wired (st) Dis Proposed (sf) Syst Eleva 'oa 7 6# y 3 60 9� VI. Tank Info Capacity in Total Number M Vufacw Prefab Site Steel Fiber Plastic Gallons Gallon of Units Concrete Constructed Glass Existing Q"q / � Tanks Talcs �J Septic or Holding Tank S Aerobic Treatment Unit Dosing chamber 50 X- VII. Responsibility Statement- I, a undersigned, assume responsibility for installation of a POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Nu Business Phone Number -Pat Plumber's Address (Street, City late, Zip Code) VIII. Cots /De art t Use Onl Approved ❑ Di proved Sanitary Permit Fee includes Groundwater to Issued issuin t Signature o s) Surcharge Fee) ❑ Owner Given Reason for Denial 25 Z 1X. Conditions of Approval/Reasons for Disapproval 3) SYSTEM OWNER: 1 Septic tank, effluent filter and S dispersal cell must all be serviced / maintained as per management plan provided by plumber, 2. All setback requirements must be maintained as per applicable code /ordinances. . Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 lathes In size r - � w d � a Al \41ZI ry A-Z cl h k < m U� N O o W �o wWa \ W }CL 0� o � ` I LU Q`w 4 a C S < 0 Cc 0 p °'o N CC —F7 p -D CJ) U4 J ul z t - G 09 ` 7:3- _ i0 O � V to i 5 Ad M v LILBRIC14T & ASSOCIATES CO. -- 655 O'Neil Road - Hudson, Wi 54016 Regg•.Designers Of Figgin" System 715- 386 -8185 . /UEw Oltl Private Sewage CoMuNa►ns 0-r Pin of PIA7- APPR #uc,L- �� PROJECT INDEX Nov. 3 - '-eo 3 PLAN ID # DATE / D OWNER j 'l,4jVE - 13O}�j 0 f} i tJ / M f* PSO'y AS PHONE 7 /. '.2y4Q ' ✓�3d �P ADDRESS g2 Z /6,9 v, e . W & Aa,-I ly/• S y 0/ 7 LEGAL DESCRIPTION GAT h 2 - L/� �� %�� eST}fT�S ( 0, S w , 5,9 C• / 2. , R/rV 032 2.0 4 15 -So • o a S i ST. G�ar }� TOWN OF _ .�D�l�"RSET CS ) COUNTY C STM VARi6A t jt ZZCt 3 7 5 LOCAL AUTHORITY/ SUPERVISION 5 ' • aOIX G �� r' N cr — PROJECT DESCRIPTION: CD.v ST1 UG 7 A - ) �/ � : y . /�iffG,tJcf so c> �, 7 ffj e S� . ���,c9Diiv (- il/ -�.U'• �lrJ..v� S — `F t'- ©M � �A-r N t� l� 4��M �� 4 3 13 &i?i`l . 5 A - : - c // 5 . MP2s 4 %?08897 Z�443 R (C( j r Ulbricht & Associates Private Sewage Consultants 2812 10th Ave. Spring Valley, W1,54767 v ' LP 3 P9.1 INFILTRATOR SIZING WORKSHEET P9.2 SYSTEM PLOT PLAN P9.3 CROSS SECTION OF SYSTEM, WITH ELEVATIONS. Pg.4 is to to it n " P9.5 OWNER MANAGEMENT PLANS & ZABEL FILTER SPECS Pg.6 (OPTIONAL) CROSS SECTION AND SPECS FOR DOSING TANK. PG.7 (OPTIONAL) PUMP PERFORMANCE SPECS. The attached plans and specifications are based on "In- Ground Absorption Component Manual For Private Onsite Wastewater Treatment Systems. (Version 2.0) SBD- 1075- P(NOI /01. � o 0 Vs .71� N3 N -fit �� O 1 V o tti I1 V Vim/ C � 'tt Oz Z -i r ..- O� OO p Np rn > r D m " o m � M --� a m M K nox o C Y oe �, 9 0 � a tt Zt Gt' , 1A) 1 1 lo 3 Af /a/. l.Z 1ff I/ M jr CH yam• �'° 9��,�� t y5 0 OVER: See Reverse Side for Vent/ Observation Pipe Detaiis. �tE r��Gop i / � ' S 4o P W 17 & v`°GO p yExv 7 - el-,o To t o yfINSE�tJ ST REV Cv /:�G—, Aw. sSo�G (S /• 388 1&od 46& . 414 / Wisconsin Department of Commerce SOIL EVALUATION REPORT Page ! of 3 Division of Safety and Buildings In accordance with Comm 85, Wis. Adm. Code Caxr TI C. �C AO / x Attach complete site plan on paper not less than 8 112 x 11 inches In s `- /� Include, but not limited to: vertical and horizontal reference point (BM), IT .. i• SEF /�.� /a W percent slope, scale or dimensions, north arrow, and location and dista . Please print all Information. J a by Date Personal Information you provide may be used for secondary purposes (Privacy q . t Z Property Owner Prtjerty{ S /� 1A1; ,E JLFF) 30,4,e 1q*V L GovF m ` , �..� 4 S XA T N R /9 g (or) W Pty Owner's Mailing Address lot # Block # Subd. Name or CSM# Z Z /t!U0 +1- A U.0 • Z P W.P40G— mil �o�p P1,47 7 city N State Zip Code Phone Number ❑ City ❑ Village Ea Town Nearest Road Rfc"O Gv /. Syo17 ( 715 iyG •YM6 S4A4E - RJL= - 7 -- /Go >LI 4 New Construction Use Residential / Number of bedrooms 3 Code derived design flow rate Y 9�� �y GPD ❑ Replacement 11 ❑ Public or commercial - Describe: Parent material y �fJ�' /il �✓ Flood Plain elevation if applicable ' L� I —_ -- ft• General comments and recommendations: jP y¢ S v SVI PI* le / //(J /v % eO eoti v �,vr iQV .� 1�_D. • TS . — #� I'o d� S, D Borin > a Ground � # Pit surface elev. 7 Depth to limiting factor �U In. Soil icaillort Rate Horizon Depth Dominant Cot Redox Description Texture Structure Consistence Boundary RoI GPDff In. Munsel Qu. Sz. Cont Color Gr. Sz. Sh. - Etf#1 *E02 1 v -/o /,O ,2 G -S /f Asti •< < z 0•L V/?I/ SL ?w / 7C • y . 3 z . 2.S f — LS / • 1& /o y2 s/ 01 ' S �3n•�� f bb -`f Z Boring Boring Pit Ground surface elev. tt. Depth to limiting factor in. Soft Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF In. Munsel Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 - Eff#2 / /6 y/e y ---- -- z "CS / ,e 4 64V 2- 046 D• 2- 7Sl /1 GS 10 S / t ' Effluent #t = BOD > 30 < 220 mgtL and TSS >30 < 150 mg& ' Effluent #2 = Bop ,: < 30 mgA- acrd TSS < 30 mgll / C Name (Please Print) Sigma CST R 06ele 7 ,( Z Z 3 7 5 i Address Date Evaluation Conducted Telephone Nurttber Ulbricht & Associates - 7 IS • 77.X • 3 ` ?/Z 2812 10th Ave. o 2-- 20 q- • �o • " Spring Valley, WI 54767 �I p 3 415 41 g/se Sec. // Se /5,C ,,Sty. For issuance of permits and designing � • S Contact: Ulbricht & Associates S Z - 0 3 2 - 2 oYS S D o Z S�v /Sw Registered private wastewater consultant and plumbers yG,J �SGv S��• 12 - D32 - 2 ays_ yo. o z 2812 14th Ave. j jp Spring: Valley, WI 54767 r 715 -772 -3442 411401.5 40 ? S W /^/w -!�,gC. 30- o Z ° yd • A• �• i30�/10 �i�f -� Z 71 2— Page 3 Property Owner _ Parcel ID # Boring it ❑ Boring a 9-Pit surface elev. 7 R. Depth to limiting factor In e Horizon Depth Dominant Color Redox Description Texture Stnrch" Consistence Boundary Roots GPDff In. Munson Qu. Sz. Cont. Color Gr. Sz. Sh. '81#1 'Eff #2 V S d s Boring # E] Borin 11 pit Ground surface elev. R. Depth to Writing factor In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff In. Munsen Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eft#2 F] Ong # ❑ Boring ❑ Pit G surface elev. R. to Nrr>ibng factor i^' Soil Application Rate Horizon Depth Dominant Color Redox Description. To Stricture Consistence Boundary Roots GPDAF In. Munsell Qu. Sz. Cora Color Gr. Sz Sh. 'Etf#1 'Effif2 Boring # ❑ Boring Nt. C] pit Ground surface lev. R. Depth to gntitin9 factor Rate Horizon Depth Dominant Color x Description. Texture Structure Consistence Boundary Roots GPD/ff Gr. Sz. Sh. 'Eff#1 -002 In. Munsell Sz. Cont. Color • Effluent �1 = BOD > 30 < 22o nV& and TSS >30 1150 MII& f ' Elnuent 92 = BOD, < 30 mgll. and TSS <_ 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access sery ices or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 -264 -8777. sao- ono pe.doot I ' 4 a � � o � a � � y � s a � a o a 0 0 f o o -o a°i v► ST CROIX COUNTY ` SEPTIC TANK MAINTENANCE AGREEMENT AID . ' ' OWNERSHIP CERTIFICATION FORM Owner/Buyer A Gt J0S0 n; ��;� . J ✓�C z� L,� /�'(/� �O/9 %c�/I'l� � oft r A curesf Mailing Address [ i5 a I (� 3 S (� . =�'h' �l �✓ JL141 Property Address N�� Aal OA_�z2 PA (Verification required from Planning Department for new construction) 03 Z Zo y 2. City /State ) 1� 4A� t6A � Parcel Identification Number - - v 0 3 e��C'cs z. LEGAL DESCRIPTION A #/q &A x-cn/ 2 v3 Z _ �{� _ 40 - 2A%'> 30. a 4�0/ Pro Location 5A) %., 5 � %s, Sec. ` , T 3 O N -R /� W, Town of S40M Property Subdivision Lo 4 Z ZALE -51 b Lot # Certified Survey Map # , Volume , Page # a a�� Warranty Deed # 5 y [o `� °► 5 . Volume E Page # 5 I I Spec house ® yes ❑ no Lot lines identifiable 5b yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system 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 masterplumber, joumeymanplumber, restricted plumber or a licensedpumper verifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin, Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zo ning Office within 30 days of the three year expiration date. �i4z;(�e . Ao DATE 1 0 3 SIGNATURE OF APPLICANT OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. SEPTIC TAN & - PUM P CHAMB C SECTI AND SPECIFICATIONS F 4" CI VENT PIPE 12 MIN. ABOVE GRADE g .'WEATHER PROOF ? LO' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH INTAKE WITH CONDUIT MANHOLE C( 4D W/ PADLOC l' l J G WARNING L.E % E'�Tiav __4" MIN, it INLET r GAS- TIGHT1 r ' r SEAL 1 A •� APPROVED 5GD. 4 0 i 4 _ r ALM JOINTS W/ pVc. pipv PIPE 3' OA ;` fp SOLID ' �GV �•3 + O N SOLID SOI1 SOIL PUMP OFF ELEV . -7 FT. ? - 7 i OFF RISER I D O PERMITTED 1�5 (© IF TANK O .�Q IA MANUFACTUR 0 r__ 3" APPROVED BEDDING UNDER TANK HAS APPROV ii CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE �l�f 4 /+� _/ TANK MANUFACTURER: •d C+•� k NUMBER DOSES PER DAY: - TANK SIZES SEPTIC ��� GAL. DOSE VOLUME INCLUDING - DOSE 50 GAL. IS FLOWBACK: 130 GAL_ ALARM MANUFACTURER: L.Ptzet h1oW/y CAPACITIES: A = � g y Z INCHES =36 G MODEL NUMBER: . U • 1'. SWITCH TYPE: /oit -T^ B = 2 INCHES = 3 G PUMP - MANUFACTURER: 04o ll `- C = INCHES = /30 G MODEL NUMBER: +• / /,L C, SWITCH TYPE: p' G A T" D = f 2- INCHES = 115 G REQUIRED DISCHARGE RATE ZS GPM PUMP E ALARM WIRING AS PER ILHR 16.23 VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE . . 1 7 FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . . . . 4!• FEET + FEET FORCEMAIN X /�FT/100 FT. FRICTION FACTOR . . 1 FEET TOTAL DYNAMIC HEAD Zj?.41 FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH �?� WIDTH a 7 DIAMETER,_ ' G/� N LIQUID DEPTH 77 SIGNED: LICENSE NUMBER: DATE: THIS POWT SYSTEM SHALL P/c SPEC'S INCORPORATE PER COMM. 83.44(2)c A PROPER ZABEL �pic& I O f DE o FILTER MODEL # � •� Q � 16 a .5 J *X-r - SEPTIC TANK; per Comm.83.44 (2) (c) shall be equipped With an outlet attached approved filter device (Zabel fllter). Tank shall have an approved above ground locking manhole cover for regular (every 12 months or less) inspection & servicing by a l i censdd s ervi nP rnimrPr - 11/01/2003 01:45 7157491719 NORTHLAND SURVEYING PAGE 02 pOCUMFNT NO. 4T - ,Tl°: BAX OP WISC0 ?J91H FORM 6 -1983 + "•• •r��t Rc..wvte me wttoRwro o. +♦ -PERSONAL 0I11PRESENTATIVE'S DEED REGISTER'S OFFICE yai 11 -9QPA IltevrtrnrJOA Fxs IM, Q,. ......-- .. .................. ....... . . .... •--- ..................... -. JUL i_a 1996_ ..- -.. ....... . .... ..... .... .. .... . .. . .... . as Personal Representative of the estate of at 9 -30 AM ot+.r�. .meta_------ ....- ... ...... . ..... ..I ............... ......... ........ �ir,I..,. •i4 ��'4 .......... ........... ....... . ..........• .............. ...... "Decedent "). .............. for vaIusble con siderstlon conveys, without warranty, to ..,�.ZA1)lA...Cr.•--- - -••• BnArdman ............................................ .................... . ........,... Grantee � '$ 6 VAN DYK. 9. G. the following described real estate in _.. fo 0^ SS � ...-- ° ................ ..,. -Coen SC. ...CiSO.iK ..............•...... ti' 201 S. Knowles Avenue J �✓a' state of Wysoonsin (heretnsftst' called the "Pt operty"): New_ Richmond, Wt 54017 t' r ( 032 204 - 8 0 ; The Nortt.eaat Quarter of the Southeast Quarter (NEE SE}). ,section El even (11), Township Thirty (30) North, Range TaxPartet:' Q 32 .2045 -50 and l Nineteen (19) West. The Northwest Quarter of the Southwest Quarts! +NWi Sri }). Section Twelve (12). Township Thirty (30) Narth. Range Nineteen (19) Weat.�'( The Sout Mast sites o t • ter (Sit; sits) • Section T (12) . y�' rty (39) North. Ran est. West Half of the Northeast Quarter of the Southwest Quarter E C NEB the e r T h re e ad West- one (1) Oast s Section T r l/r1 . y (3). Township Thirty (30) north, Range Eighteen (18) � � C Six (6) rods of the South Eleven (11) rods 5 of North Sixty -reins (69) r Oda and the West 7 of the East Ralf of the Northeast Quarter of the Southwest Quarter (E� NE} SW(). Section Three (3). Township Thirty (30) North. Range Eighteen (18) Vast' v � 2 - Z l C f 5 - ?, e> 1 Personal Representative by this deed Boas convey to Grantee 611 of the estate and interest in the prope bthe *a Decedent bad Immediately Prior to Dccedeet's death, and all o j the estate and interest in the p roper t y rty* Personal Reprefeo has since aCgU;T}{. 6 / - day or ------- j i I (NAL) Elaine G. Boardman 1 P.....a Yrn.••atu.. AVT1R1lbl ?IOATt�lt AV CHOWLUDO STATI~ Og WISCONSIN Sign6ture(e) -- R1) 1�AR._ �fw_. �A l9.Lf)A4�ll.- ----- •----- -...., ss. ._............... y. ``-- day of Ia .Y Pare'+naily ca+ate before MY this authent - ---....----•--• ica this day, at.....! - -- - - - -• – the abow named .......... . ....I...... ............................... - ---... ).h Tres- .. .. ... -- Randrik W. Van Dyk ........... ..........• °........ • ........... TrMg: KEMBER STATE PAR 01 W)$CON9iN If not .. ........... ( - -•• ----- ^ --... . . who e�wutsd the anthorired by f 106.06, Wye. 9tata.) to me III to UY the person -.- ..•---•' the !area. fereaoing instrument and acknowledge 1 1 ' TM4# iNaTAUMENT WAY nRAMTeO YT .- DYK. S.C. it1!3NSTIIA b VAN . ` •20x• "�3out:fi ICncs+�eA• Afiul ------- ------ • - .. .. ....... 'County. Wis. N. a { Naw.•RiChn4nd, - - 7 111;. 5 4U1 7 . ................... ........... . •- ry co mm i ss ion is permamn...(If ne t. o,. state explr.ti (Si�ature may be authenticated or acknowiedaed. Both .... n .......... t0,.......•) are not ncctssary) date: ... ...... ........ r I/ j� / � - �`. I / /Iii . %�.: iii . �/ / / / /� /� //! •i •• I / /� /� . I,/ ® // /.Iii / /ice •i �o /I //I � I/, � /// �'•��i Sri ��� � ♦ / /I/ e� • i Y "in...::a a •i II . � f I1 ;! !1 • LOT � CSM 1N M W VOL. 14, PG, 2949 • p w&LG ST. CROIX COUNTY ZONING DEPARTME T RFCF_ Fr___ AS BUILT SANITARY REPORT �• /f�CrN vso,� 1{7�i�1,e s jUN Owner r, 0 2004 Legal Description: Lot Z Block Subdivision/C&M -& '/• SA2 '/, 5 Sec. JZ , T, N-114 Town of S — / � �C PIN # 4 2 • .10 y ' S 0 SEPTIC TANK -- DOSE CIIAMBEIt -- HOLDING TANK INFORMATION: Gc9iSE� /61 W • 13 /V P > 2,5 Tank manufacturer 4 0 Size ST/PC / Setback from: House Well P/L _ Pump manufacturer Model Alarm location (ItOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SO ABSORI' I' SYS'T'EM: Type of system: Width Length Number of Trenches 'Z.. Setback from: House Well ,L,/ . P/L 2 ,S Vent to fresh air intake > ELEVATIONS _ � p -F- O P OP Rte, w l i� • o Descri of benchmark �'I�OV � l�O� S Elevation r Description of alternate benclunark _TO/a Or ,4W ,2(/" �0A. Elevatio /,u Le" 1-- -" Building ewer , g S'I'/fI'I' Inlet �l 7. 3 S ST Outlet � 7 ' 0 7 PC Inlet PC Bottom Ileader /Manifold Top of ST/PC Manhole Cover Distribution Lines () s r� " V i�G () r �i'� A) Bottom of System () () ( ) Final Grade ( ) ) ( ) Date Anstallation 3 Pernut number State plan number Plumber's signature License number 2ZGo31 S Date Inspector 4FAI Rke , Corviete plot plot ' S Ulbricht & Associates Private Sewage Consultants 2812 14th Ave. Spring Valley, W154767 vvA- RA G � / y p Y _ so AJA ;1� 'got sS THIS POWT SYSTEM SHALL I INCORPORATE PER COMM. 83.44(2)c A PROPER ZABEL i FILTER MODEL# I sill / = s ° pop s� ,s �O"C'15 7- of r o le � V 3 dal- 3 'a Ulbricht & Associates �q Private Sewage Consultants p 2812 10th Ave. Spring Valley, Wi 54767 �/l` 1� - �'Z� , - 3YVZ / r �7 I1 � f3- m/' ' 01 Al 1' T- op s!g //s /t 61 3 ` r u $ . L.© - f " S r ' t LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF SOMERSET COMPUTER NUMBER 032 - 2043 -10 -200 Parcel Number 11.30.19.645A -20 OWNER NAME: First Last TI MAGNUSON ENT INC PROPERTY S W ee 9 1/9 F20 --Skaet Name Type SD Apartment 812 160TH AVE SECTION 11 /440 Line Description Line Description TOTAL ACREAGE 18.360 PLAT LOT BLK 01 SEC 11 T30N R1 9W PT SE SE 15 02 BEING LOT 1 CSM 10/2951 16 03 EXC AS DESC IN 1141/571 17 04 EZ -UT- 1404/297 18 s 05 EZ -UT- 1412/299 19 S 06 ALSO A PARCEL IN THE SW SW 20 07 SEC 12 BEG SW COR SD SEC;TH 21 I 08 89 DEG E 285.79';TH N 00 DEG 22 09 W 165.47';TH N 35 DEG W 23 10 101.43 ;TH N 58 DEG W 219.64 24 11 FT;TH NO2 DEG W 315.02';TH S 25 12 87 DEG W 28.05';TH S 00 DEG 26 13 E 679.12'POB 27 14 EXC AS DESC 1991/540 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit