HomeMy WebLinkAbout032-2185-28-000 Wi,scongin, DepartmentofCommerce PRIVATE SEWAGE SYSTEM County: St. Croix
`Safely and' Building Division
INSPECTION REPORT Sanitary Permit No:
506371 �
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:
Sorenson, Myron & Jenice I Somerset, Town of 032 - 2185 -28 -000
CST BM Elev: Insp. SM Elev: BM Description: p Section/Town /Range /Map No:
g m I G 5 — ( 12.31.19.1575
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER F, ` CAPACITY STATION BS HI FS ELEV.
Septic ' r it � t 1L5O Benchmark �. ! /ay.�l tat
C . � cc �•
QO �d� 'JZiJ
Alt. BM C^;1� G O ,3.�
Aeration Bldg. Sewer
y 3 5 9cy• e1
Holding St/Ht Inlet
5.42 4 17,7Y
TANK SETBACK INFORMATION St/Ht Outlet G • aZ 57� 3
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt inlet
0
Septic / , r� ' $ O g Dt Bottom �
/V
Dosing } Header/Man. Q . 'T �. 71
Aeration Dist. Pipe g 31 -/ y, 91
Holding Bot. System 7
9.�5 <q?1
5 3
PUMP /SIPHON INFORMATION Final Grade q, 0
Manufacturer GPM nd St Cover \ ; ` .. 3. gq e S$
Model tuber a�[' Ca�C 9 t 163.31(0 Z; ( / V Z �{
a
TDH ift Friction Loss System H Ft
Forcemain Len ia. Dist. to Well
SOIL ABSORPTION SYSTEM
BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 3 G6 Z, ,("e�" '�_ _" `\
SETBACK SYSTEM TO 7 P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer
INFORMATION CHAMBER OR �:•
Type f System. rr� rf Z� �� / /t /' UNIT Model Number:
,bN OIL WS O A. V
DISTRIBUTION SYSTEM $a,,}�►,, 5 } = ig "�°��
Header /Manifold IDistribution x Hole Size x Hole Spacing Vent to Air ntat - 1-.
Pipe(s)
l ength_j� ' L Dia Length Dia Spacing \ C
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only E"`•
Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched
Bed/Trench Center ` Bed/Trench Edges Topsoil �}� �e No Yes No
COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / / Inspection #2: / /
Location: 2247 - 71st Street S merset, W 54025 (NW 1/4 SW 1/4 12 T31N R19W) Wild Turkey Retreat II Lot 28 Parcel No: 12.31.19.1575
1.) Alt BM Description = / C i/�� �f �..dG� 6 V"
2.) Bldg sewer length
- amount of cover
Plan revision Required? Ni Yes No l 1 , 49 J
Use other side for additional information. t
Date Cert. No.
SBD -6710 (R.3/97}
r
corrwnercoii, Safety and Buildings Division county
W. Washington Ave. , P.O. Box 7162 v
sj, v-- Madison, WI 53707 -7162 itnryPermit ber� (to be 81 in by Co.)
rd of carninmrse
Sanitary Permit Application . StatcTransaction Number
Ia accordance with s. Comm. 83.21(2), Wis. Aden. Coda, submission of this form to the appropriate go vernmental
unit is required prior to obtaining a sanitary permit. Note: Application forms for statc-owned POW15 are Project (if different than► mailing address)
submitted to the Department of Comme= Personal information you provide may be used for
p in accordance with the Privacy Law. a. 15. I m Stds
I. A lica#psi leformation- Please Print All Information +-- 4 d a
Property Owner's Name Parcel #
S �� 07 Dad -a s - _oo�
Property s Mailing Address y Location
V ST. CROIX C ;GUNTY Govt .Lot _ 1 v
City, State zip coda Phone Number A) J v.,� l J y,, section A
G O o- - Lot# T' —N' R�
IL Type of Bniltbng check all that apply)
Subdivision mama
- * or Family - Dwelling- Numlur of Bedrooms _. - _ - - ---- -
Block #
0 PubliclCommercial - Deschbe se 13 City of
CSM Number 0 Village of
lNon-pressurized ate Awned- J' l�Ci
Town Of _ m4,C�9Q�
oniv one x on line A. Corn ete line B if a
System 0 Rgdwement syman 0 TreannewHoidmg Tank Replacement Only 0 Other Modification to Fxiting System (explain)
0 Permit Renewal 0 Permit Revision 0 Change of Plumber 0 Permit Transfer to New List Previous Permit Number and Date Issued
BeforeFapiration owner /`� /'r
a MWn tear/Co onenOnevim: Check aH at a br- Ground 0 1�xsurized In- Ground 0 At- Grad / e >_ 24 of suitable soi M Z�l iu. of rabic Wil
oiling Tank 0 Other Dispersal component (explain EZ �` � ' �Drs reatmeat Area Information:
Design Flow WXO Desiga Soil Application Rate(gpdsf) Dispersal AreaiCft rod (id) Dispersal Area Propoaod (tO system ! I
t l C l gs r
'
VL Tank Info Capacity in Total # of Manufacturer
Gallons Gallons Units n go
New Tanks liaisting7aaks _ U m o w 0.
Septic or okling Tank ' Woc )s
- Uoaiag -_ -
VII. Ramonsibillty Statement I, the undersigned, assn ty for ioshilation of me POWTS a the attached plans.
ri 's Nam (Print) Si true Business Ph.. Number
. a
7�s a 6 913
Phrrtber s Address (sweet, City. S� ip Cade) fo q
'j
ZPPM Me nt Use Onl
ved ❑Disapproved Permit Fee Date I Issuing Agent
$ y 1 - 7
0 Owner Given Reason for Denial Ki
I;f 6iTfti/iGiW*B$provaUReasons for Disapproval _ (r(IG i r1l/�i -►
1 Septic tank, effluent filter and,
dispersal cell must all be serviced / maintained
as per management plan provided by plumber.
2. All setback requirements must be maintained
as for the system W sabU& to the Coawy o M y on paper not im than a Us: 1r hwbn to she
SBD -6398 (R. 01107) Valid thru 01109
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Post -it® Fax Note 7671 Date # of
pages
From
A 's _7 P o� S u ru yy C El 1 �M t� 10� Sri Co. /Dept. Co.
tfi f3n1 _ TH �f�rt z �� �Ca Phone # Phone #
Fax # Fax #
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EZ1203H
vvvvvvv : :i .. :•,•: '• v4vvv vv
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V
vv ..y .. Ov ♦
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24
Bottom
36
Vaicl Volume Soil Interface Are � jg & fig Ft
_ F
Void Coefficient in Aggregate given at 57.4 %. Sidewali (2 Sidewalls) 2 v 18.$4in = 3.14
O.B. of 4' pipe = 4.625 inches 12in IR
2.00
Void volume per linear ft. = 3.14 • 23125in ffr = 0.117 W Bottom
12ip l ft )'
O.D. pfcenterrylinder =tt.5 inches Total Soil Interface Area 5.14 SQ.
Void volume in aggregate of center cylind = 3.14 • 6.25in ( t25ia
y ( (12ur/ft, - 3.14.1 12inlft J }�- 574 =.422 ft'
O.D. of outside cylinders - 12 inches ll Projected Trench Area
Void volume in outside eyfindcrs - 2.3.1 q� 6m 574-.901 ft' Sidewall Height - 12 in. '2 - 2.00 Sq.Ft.
`t tint ft)
Bottom = 36 in. = 3.00 Sq.Ft.
Void volume at bottom between cylinders 24i, bin 3.1 J 6in
�[2ur /ft 12in /fi� - � 12ZIft) =0215 fN Projected Trench Area a S.00 Sq.Ft
Void volume at outside bottom comers (1 /2 of void volume between cylinder) 0115 / 2 — 0.108 tt
Total void volume - 0.117 + 0.422 + 0.901 + 0.215 w 0.109 = 1.763 cubic ft / ft
Gallons per ft - 1.763 X 7.48 - 13.2 ealions per linear ft.
EPS Aggregate
Trench System
EZ1203H EZ flow
Rin4- lndustriol Group
65 indusvtr•ial Park Rd.
Oakland. TN .18060
SCALE FU NAME: EZ120.V4,1 SHEET: t of 1 11 -27 - 01
1
Wisconsin Dep a rtment of Commerce �QIL EVALUATION REPORT Page of
pa
Division of Safety and Buildings
►n aFcordance with Com , s 1 f,ode minty 44.
n `
Attach complete site plan on pa / ` h 14 x13rinches Ir( size. Plan - m // t O '�
include. but not limited to: vertical and horizontal reference poinT(BV), direction and Parcel I.D. `] Z� Date
1 S-, >
percent slope, scale or dimensions, north arrow, and location and distance to nearest ro e 'wed by V O" v"
Please print all information.
Personal information you provide may be used for secondary purposes (Privacy Law, S. 15.04 (1) (m)). V a. ' S
P Property Location
riY Govt. Lot 4,; 1 /4J u./ 1 / S T-3/ N fR4 E (o Ow
Proper r s Mailing Address Lot #-p Block # CS D `L O � c�
City State Zip Code Phone Number ❑ City ❑ Nearest Roa + /l:E
New Construction Us Residential / Number of bedrooms Code derived design flow rate GPD
❑ Replacement ❑ Public or cofnmerciai - Describe: - - - - - -- -
Parent material sa4,;a�.7 Z Flood Plain elevation if applicable ��� ft.
General comments l � y /,/[ i /
and recommendations: S�� e �c.�� �C/.3}'�.J / l /
Boring c�c� 2 /
Boling # Pit Ground surface elev. 1 !) J ft. Depth to limiting factor / in. I Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2
6- 3
i,
IL
B(xi # Boling
pit Ground surface elev. � -� ft . Depth to limiting factor i Soil App lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
0 �,� o 3 I r Z-
s c j ,
9� 3a
� G
• Effluent #1 = BOD > 30 220 mmgA- and TSS >30 150 ' Effluent #2 = BOD < 30 mg/L and TSS <_ 30 mg/L
S. CST Number
CST Name (Please Print)
Bird Plumbing, Inc. Shaun Bird 226900
Date Evaluation Conducted Telephone Number
Address
1008 192nd Ave, New Richmond, WI 5401 715- 246 -4516
4 ,
Property Owner ID # Page of
a Ong # Boring
Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDNf?
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
3/ s
❑Boring # Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Appl ication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
i
Boring # Boring Ground surface elev. ft. Depth to limiting factor M •
❑ Pit Soil Application Rate
Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots •E GPD �ff#2
in. Munsell Qu, Sz. Cont. Color Gr. Sz. Sh.
• Effluent #1 = BOD > 30 < 220 mg1L and TSS >30 < 150 mglL ` Effluent #2 = BOD 130 mgll. and TSS _< 30 M91L
i
� 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.
SOD4330 (RAW)
Soil Test Plot Plan
Project Name P.C. Collova Birds. Inc. Shaun ' d
Address P.O. Box 489
Somerset Wi 54025 CS #226900
Lot 2 8 Subdivision Wild Turkey Retreat II Date 11/18/04
N W 1/4 S W 1/4S 1 2 T 31 N /R19 W Township Somerset
Boring 0 Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of Survey Iron = g ,,,,.
System Elevation 94.3/94.1 *HRpSame as Benchmark
Alternate Benchmark Top of 1/2" pipe
Scale is 1" = 40'
99'
Property unless otherwise
Line noted
B. . M.
1t.BM.
I
S
B -1 B -2
20' 90'
30'
F150' 1% Slope
Please note: Lot lines were not
45' adequately staked at the time of
testing. Installer must verify all lot
lines and setbacks before installation!
229' Property Line Do-
i
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pa I of
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner Septic Tank Capacity al E NA
Pemtit # Septic Tank Manufacturer , P rs ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer D� ❑ NA
Number of Bedrooms ❑ NA Effluent Filter Model 1 ❑ NA
Number of Public Facility Units ❑ NA Pump Tank Capacity al ❑ A
Estimated flow (average) al/day Pump Tank Manufacturer NA
Design flow (peak), (Estimated x 1.5) Q al /da Pump Manufacturer NA
Soil Application Rate r 7 gal/day/ft' Pump Model NA
Standard Influent/Effluent Quality Monthly average' Pretreatment Unit NA
Fats, Oil & Grease IFOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS► 5150 mg /L ❑ Disinfection ❑ Other:
PreAmated- Efflueni_Quakv---- -_._ -- Pth rage s�essel ellls) - - -- -
G %
Biochemical Oxygen Demand (ROD 530 mg /L r��rin-Ground (gravity) - In- Ground (p r f
Total Suspended Solids (TSS) 530 mg /L t}� NA ❑ At-Grade ❑ Mound
Fecal Coliform (geometric mean) 510 cfu /100ml / \ ❑ Drip -Line ❑ Other:
Maximum Effluent Particle Size Y. in dia. ❑ NA Other: ❑ NA
Other: ❑ NA Other. ❑ NA
*Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) E3 NA
earls)
Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA
Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 y ews) ❑ NA
years) .
Clean effluent filter At least once every: r yeas sj b) . E3 NA
❑ month(s)
Inspect pump, pump controls & alarm At least once every: ❑ year(s) ❑ NA
Flush laterals and pressure test At least once every: ❑ month ❑ ye ar(s) ) ❑ NA
ye ar(s)
Other. ❑ month(s) 13 NA
At least once every ❑,year(s)
Other:
❑ NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer, POWTS Inspector; POWTS Maintainer, Septage Servicing Operator. Tank
inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface.
The dispersal call(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding
of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one -third IY or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All o h ices, including but not limit i of effluent filters, mechanical or pressurized components, pretreatment
units, nd any servicing at intervals of 512 months, s al a performed by a certified POWTS Maintainer.
A service r oca regulatory authority within 10 days of completion of any service event.
START UP AND OPERATION Page _,�,of
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals
that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents
of the tanks) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at -grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and /or is permanently taken out of service the - following steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin.Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pints shall be removed and properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems .must
comply with the rules in effect at that tune.
❑ A suitable replacement area is not available due to setback and /or soil limitations. Baring advances in POWTS
technology a holding tank may be installed as a last resort to replace the failed POWTS.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site
evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank
may be installed as a last resort to replace the failed POWTS.
❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative: surface. Reconstruct of su ch s must c ompl y _with the rules in effect at that time. .
< <WARNING> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name t Name
,ja in
Phone Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name i Name 5�_ ` h
Phone Phone (S 3g
This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &M and 83.Wl), (2) & (3), Wisconsin Administrative Code.
Sep PS 05 01:57p CRLVIN POWERS 715 - 246 -5135 p.1
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OVR- TMIIIP CERTIFICATION FORM
7
Owner/Buyer i ~ �11 <V
Mailing Address t4 �
Property Address
— (VeriVation required from Planning & Zoning Dcp rtmert for new coustcnc6m)
City /State &Ma'5G Z Parcel Identification Number ��� ` 2A i ' M`
LEGAL DESCRIPTION
Property Location '/. L C 2L/�/ 1/4 Sec. , T LN R� ®� Town of
Subdivision V V . �Z Lot #.
Certified Survey Map # , Volume Page #
Warranty Deed # Volume , Pa #
Spec house yes no Lot lines identifiable 0 no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper to and n amteugrice, of your septic system could result in its prenstvre failure to )Hindle wastes. Proper
I mamt MM= consists of pumpiug out the septic tank every throe yems or sooner, if heeded, 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. Owner maintenance
responsibilities are specified in § Comm. 83.52(1) and in Chapter 12 - St Croix County Sanitary Ordinance.
The property owner agrees to submit to St Croix County Planning & Zoning Department a certification fomk signed by the
owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying "t (1) the an-site
wastewater disposal system ism proper operating condition and/or (2) after inspection and primping (if nemwaty), the septic tank is
less than 1/3 full of sludge.
I/we, the undersigned have read the above requirements and agree to mauitain the private sewage disposal system with the
standards set forth, herein, as set by the Departrneut of Commerce and the Department of Natural Resources, State of Wisconsin.
Certification stating that your septic system has been wed most be completed and returned to the St. Crone County Plantnig &
Zoning Department within 30 days of the three year expiration date.
Ywe certify that all statememac on this form are true to the best of mylour knowledge. Uwe am/are ttte owner(s) of the
property
described above, by virtue of a warranty Bleed recorded in Register of Deeds Oflice.
Numb r of bedrooms
Aki 1Q� D
SIGNATURE Or APPLICANT(S) DATE
* ** Any information that is misrepresented may resort in the sanitary permit being revoked by the Planning & Zoning Department.
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed
(REV, 09/05)
r
II !lIIIIlIIIlIlIII!!IlIIlIIIlIIlI
* IIII f
State Bar of Wisconsin Form 2 -2003 $ 4 ? ��� 9
WARRANTY DEED 4
^*� XATHLEEN H. WALSH
Document Number Docurnertt Name REGISTER OF DEEDS
ST. CROIX CO., WI
RECEIVED FOR RECORD
THIS DEED, made between P. C. Collova Builde Inc., a Minnesota Corporation 032$/2007 02:OOPM
rs.
WARRANTY DEED
EXEMPT r
( "Grantor," whether one or more), REC FEE: 11.00
and Myron W. Sorenson and Jenice D. Sorenson, husband and wife TRANS FEE: 446.20
("Grantee," PAGES: {
whether one or more).
Recording Area
Grantor, for a valuable consideration, conveys and warrants to Grantee the following
described real estate, together with the rents, profits, fixtures and other appurtenant
interests, in St. Croix County, State of Wisconsin ("Property") (if more space yZ& EWM $ OgjaW LJl
is needed, please attach addendum): .0- X04 LoCust; SfteW
Lots 25 and ^ WAMMraftey Retreat IT in the Town of Somerset, SL Croix County,
Wisconsin NUdsOn, WI 54016
032 - 2185 -28- 000:032- 2185- 25-000
Parcel Identification Number (PIN)
This is not homestead property.
Exceptions to warranties: Easements, restrictions and rights -of-way of record, if any.
Dated / P. C. Collova Builders, Inc.
* (SEAL) (SEAL)
*By: Patric C. Collova, President
(SEAL) (SEAL)
* s
AUTHENTICATION ACKNOWLEDGMENT
Signatures) P. C. Collova Builders, Inc_
By: Patrick C. C lova Prey' ent STATE OF )
authenticated on G
ss.
COUNTY )
* i tins 021 a d Personally came before me on
TITLE: MEMBER 9TATE BAR OF WISCONSIN the above -named '
(If not, to me known to be the person(s) who executed the foregoing
authorized by Wis. Stat. § 706.06) instrument and acknowledged the same.
THIS INSTRUMENT DRAFTED BY:
Krisdna Odand Estreen & land Notary Public, State of
304 Locust Street. Hudson. WI 54016 My Commission (is permanent) (expire
(Sigaatures may be authenticated or acknowledged, Botb are not necessary.)
NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED.
WARRANTY DEED ® 2003 STATE BAR OF WISCONSIN
FORM NO. 2 -2003
Type name tx IOW Si gnatures.
INFO -PROTM Legal Forms OW_ 655 -2021 www.uffoDrororms.car
B.M. TOP OF 3/4 80 RADIUS
IRON PIN ELEVATION TEMPORARY
987.24' CUL -DE -SAC
EASEMENT, TO BE
W 1/4 CORNER OF SECTION 12, REMOVED uaoN
FOUND 3" ALUMINUM MONUMENT NORTH LINE OF THE NORTHWEST 1/4 OF THE SOUTHWEST 1/4 E ORTHE OU OF
— — — S 89'06'44" E 1339.17' ROADWAY
/ 361.86'
/ 360.26' �� 660 I
! — 722.12'— I / / I S 2 5 '5 '07"%V
/
r 91.47'
LOT 30 TOE
EASEMENT
F
\/
80' R AD IUS 131362 S0. FT. � V r / ' / - 9U.00' LOT 28 ,^ T
r 11B0.99a.00'
EASE , T 3.07 AG.
EASEMEN 105 T. (� m
T, TO BE
REMOVED
UPON O !
tYcSTERLY N ` "T
EXTENSION OF !n LOT 29
ROADWAY N 131754 SQ. FT./ / ' v !! /
a 3.02 AC. \ /! Cy� N 89'21'04" W 599.04' ISD
— — — — — _ z / r � / 279.20' 319.84'
i 56733'00 / / 4J /
86.54'
TO CENTER '
EASEMENT B.M. TOP OF 3/4
IRON PIN ELEVATION
-S 89 57'58" W - — - - _ ti / / 998.04'
° 193.98' 1 n AVFN H \' `1 \ \ 1 t� ' v ,' / m 0
N 89'57'58" E -- - >_ _ UE C6� \ / .5`� /`l� ' / 1345 SO.7FT. ,°o LOT
�= 131068 S0. O.
FT. N
Q. 3.08 AC. � 3.00 AC.
S 3 B.M. TOP OF 3/4
> IRON PIN ELEVATION
(n Z — — — — _' -- \ 997.77'
u
�Z o z 0 O 63 "2� / N 83 ' 2 0'23" W 535.03' o
'7i
D �°, O "xT . "o-ow — _ _ — — y
—i N = N LOT 31 00
I
1 i I
m f m � 37273 S0. FT. I \ LOT 26
I C7 N N 3.15 AC. / I
r - c % �MbNt 1 1 131230 S0. FT. 89'33'57" W
so - 4, B.M. TOP OF 3/4 ( \ \ 3.07 AC. •Pi
D A = O IRON 47 IN ELEVATION / a 'yG Y \ / - \ ' i 108.33' c ITI
Z 9.90'
In
�� `�• • C8 ..rte - S 89'3357 E
6
y
\ N
/ c / LOT 32
140495 SO. FT. \ /
z
/ 3.22 AC.
I.i
LOT 35 LOT 36
130965 SO. FT. 130921 SO. FT. J
2ao LOT 33 �, 3.00 AC. J 3.00 AC.
130918 SO. FT. N LOT 34 ;
3.00 AC. °j 130834 SO. FT. 0
2
100 AC. 0
428.08' 455.12' 220.69'
236.06'
z N 89 06'44" W 1339.95
0
o UNPLATTED LANDS
PD
N PD
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1L �L .., ..L.._
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r d. S
l5h
lum % J-A)A 6 k
R+�i�rdQris
UNPLATTED LANDS
80' RADIUS
J TEMPORARY
CUL —DE —SAC
EASEMENT, TO BE t
REMOVED UPON
OF THE NORTHWEST 1/4 OF THE SOUTHWEST 1 / 4 NORTHERLY !
EXTENSION OF
S 89'06'44 E 1339.17 ROADWAY
26' 1 �!
960 55;.05'
J / f S25'57'07 "W /
J ' TO ENTER OF
EASEMENT
LOT
J `so sea � 310 SQ. FT. o
/ �r> 3.00 AC.
n
N 89'21'04" W 599.04'
279.20' 319.84'
/ V2 I
{ I I
1 FL / rn
� Tf • i / —a.m. '. nP OF `3 CO
/ i cne csinr El E VA �
,� LOT 27 o J LOT 25
ti q 134502 SQ. FT. 131068 SQ. FT. 4b. Ln
„��o (Yoh• 3.08 AC. 3.00 AC.
B.M. TOP OF 3/4"
IRON PIN ELEVATION
997.77'
N 83 ' 2 0'23" W
0
\ 535.03
\ LOT 26 f 0 \
131230 SQ. FT. / io
3.01 AC. / _ _ — — — -N 89'33'57" W
108.33' m