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HomeMy WebLinkAbout032-1046-50-000 Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 — S t - L4 N VIsemisin Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in y Co.) Department of Commerce (6M) 266-3151 Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.21. Wis. Adm. Code, persorml information you provide " — nay be used for secondary purposes Privacy Law, sl5.04(1Xm) Project Address (if di f t ding address) L Application Information - Please Print All Information ����� PPh Owner's Na the Parcel p Lot ps Bloc Owner's 9 ailing Address Location L O 77M S4, SWA .Section City, State Zip Code A~' Nirreber w to ` MID t lko '3 T (circle ) n. Type of Bui (check all that apply) T „ N; R'B$ W �" Subdivision Name (�,,,,� GS M Number 1 or 2 Family Dwelling - Number of Bedrooms "•'" '"I f ❑ PubiictCommercial - Describe Use ❑ State - Describe Use ❑City_❑ "Ilag ownship of M�Q✓ r M. Type of Permit: (Check only m e box on ' A. C plete lithe B if applicable) A ' New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. El Permit Renewal ❑ Perm t Revision ❑ Change of 11 Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. T of POWTS stem: (Check all that apply) Non - Pressurized In Grou El Mound > 24 in. of suitable soil El Mound < 24 in. of suitable soil El At-Grade ❑ Single Pass Said Filter ❑ constructed Wetland ❑ Pressurized In- Ground ❑ Hotding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Chem ❑Drip Lire Gravel -less P' 11 Otbe r (explain) Leaching V. PtTn4ff M"ent Area Information: S Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dis Area Proposed (sf) System ElevatioTFibetPlastic o� VI. T k Info Capacity in Tonal Number Manufacturer Prefab Site Steel Gallons Gallons of Units Concrete Constructed New Existing Tanks Tanks Septic o Holding Tank I � J Aerobic Treatment Unit Dosing Chamber VII. Respmisibili Stateuaent 1, the unduvigaed, ass u� fen of the POWTS shown on the attached plans. Plumber's Na {Pn ) Plumber , Si gnature W� C� ' ) RS tuber Business Phone Number Plumber's Addre ss (Street, City, State, Zip Code) vm. use Onl Approved Disapproved Sanitary Permit Fee (includes Groundwater Da Issued ssuing Agent i tur tamps) Surcharge Fee) ❑ Owner Given Reason for Denial IX. Conditions of Approval/Reasons for Disapproval l d f &YL+ %'k7 YSTEM OWNER: / �yGryt,ti+� ,It..- 1 is is tank, effluent filter and T{ c�sT dispersal cell must all be serviced /maintained tdA� as per management plan provided by plumber. O C'��� 2. All setback requirements must be maintained M ITI ,( d �lr� 1 �f f�' as per applicable code /ordinances. "4r ► C4eck- ateaat cosapl�e Anus � �� � sln_� t' lo't 'C''lQ �. • A Srnac,��z SW �� sw �� i Io T 3 Ov 1Q 1 F Aq 3 3 f Lo cr v. Qc,.Q. ur�r�l.� ►'11 --�—� 7' y/ " 1 f h is al' Q r 3 - I'r-Q-V'4' C7 � oZ S<c�.ors E ��/ g S. l Q M 1 t oo" As 8` f," cy L . a l 1.� be 6� S acr es ��� s rt D y ��- s 'Y"�`'f' LO T CO / g / r 0) 0 / � � ■ � � k 2 r � T � � e 2 E E& ®� $# G Q N. 3 ® k 2 § e - � 9 [ � @ i \ j \ ! > / ■ ¢ \ & C/) z I 0 k \ : E /j \ E t j 0 §$. z § ( i 0 A \ �. 0 0 0 \ Oro { a §2/ 7 > § \ J 7 m i. » / - ED \ E E 4 § @ \ c z CD ° / C / � \ ¢ 5 ( § % m E E } 2 E f § N / -q CO) a m CD / [ / E , R R § Lo . D m m \ / z ¥ _ @ m k e c $ / 2 $ � %�EI0 C6 , § � 3 [ ,r i }f n/ z o= A =rc �CD £_� ; 6 E 0 , k; ° M. z ? � 2fo I«(0 cn = (D fn� z § \ =2ƒz ¥ CD\ CL \ � ■ � o ; � \ _o �$ PIC3 Aq 3 3 I �c� 4v� lAt,..o. �r�rtr1 h1S ODO ct -t s ,oy 74-- —7 04 a►r. - n"o ►� t� , ,.� c o, $nn Ci, tV�IV� Drt ue. ice! �a At L, ar 5 6/00 S Qcrey Al Dr la -Q- Lo • 1� v1 Ci r•e �..� � W�cc r` 4 VI �. EZ1203H Tl.w� rwenfWwiw =is iw wtt `wvt . i� !w wvw . f 2 4 v .ww, ..+.. .w..xa ►• t 4.625 .. Wv V, ••: tat Cue. = 18.8 rr++�� ' - )4 o z - 36" 12- 1/2 DIA (tYP ) Void Cmxfi'x m A MVaft glaea at 57.4% -At- !i! JR EL O.D. afa` ppr - 4,625 incurs 54de.rail {Z s aew,l7s) ,, f$ d in !t � t 2* = 3 It vol_ p_ ti._ Q.0 of ""Wer cylinder �,OCs R S asch� Bottom Tout Sait m f twterhec A vQ,d wlt in atilt mac of sutra t? t def ' r 2. a a • ¢—tom -. 1 1 ?J t2S 3.CE. 12 a 3.14 14 S • �_ 374 R 422 t}} t' tl.>a. ofaut3gfs C3iHAticrd t2 > �afd uwpestuE m p ct linden « : ` i. t q PraJected TrrnteA A rss tt2atrfl •Slag q®1 fe S +dcwrtt Nci&ht - 12 in 2_00 Sq.Ft. Vat,! s 1 •plurm a, Ew, a, sn b+cxwern cytira z 3tef y � J( S 1+ BotFO„s 3 3fi 9 3.00 Sq.Ft. f2ir,th s2 p f l l i;ai l ( `0.2iS R• p ! fJJ tOlwried Tretrca Area ' v at S 88 Old SWpl. urttc at putsttir hatturet ors ¢ t!? pf volt► vtttttfftr bcawren c tt t t 1 Total void vat Y "def3t 0 IS _ tt ttdt; J u"M 0. 117 - 0.422 + Q_'90; . 0_2 3 - 0, Do = 3 1 t 7aa r„b,x h r ft � } Gatiuma per ft > 1.763 X 7.48 - t3 ? eatMuy �.7 tt�c a ft ! j a f SC EP j TrenCh9S�`egaie � EZ i 203H ysiesxi EZ R'9 Industrial Group 65 lndustriol Park Rd. f Oakland, TN 3806() FIkE ttMAT- a t2e,3►1..,.,1 s►tEEr; t o f 1 ,WicconsG Department of Commerce SOIL EVALUATION REPORT Page _� of _ Division of Safety and Buildings r in accordance with Comm 85, Wis. Adm. Code County 7 Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must ty t_. t include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all Infomation. viewed Dat Personal information you provide may tm used for secondary purposes (Privacy Law, S. 15.04 (1) (m)). Prop" Owner Property location Govt Lot 5Gt! 1l4 114 S (p T 3 N R r E (or Property Owner's Melling Address ar" # Subd. Name or CSM# YL State 73 Code Phone Number ❑ Villa e ENTown crest Road City P New Construction User Residential) Number of bedrooms _ _ Code derived design flow rate dQ GPD ❑ Replacement ❑ Public or commercial - Describe: __ Parent material !7 y� W 4 S _ —__ —__ ° Food ai 6 abb� pplicab /�/�( _ ___ ft• General comments sysf$j^ 2 d np gs,av tea... q y. _ _o ry and recommendations: AY 2 1 2 004 �U J� � F -il Boring # Boring Z ® Pit Ground surface elev. ft. Depth to limiting factor _ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 3 7 Y '- - S GS 1 cS ,` 1 Z u Si o EL , s. L u Boring # 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 GPD1W in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Efff«1 'Eff#2 L 5 'e �i CS 1 �l 4 55'&0 0 Cg 2 7. $ ✓ / SL ��h /c t Effluent #1 = BOD > 30 220 mg/L and TS5 >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) P Signature - CST Number SC. Y 2 Address Date Evaluation Conducted Telephone Nurfiber zifl ate' i �- L j , s ydz-5 5 71 �Ga 6z Q Property Owner ______—__—_—_.--- Parcel ID # - -_ -- - - - - -- Page __ -- �� [] Boring _ I I Boring # �/�0 ,l ft. Depth to limiting factor S�Z ._ in. 6Di nd surface elev. _ Soil lication Rate Horizon Redox Description Texture Structure Consistence boundary Roots 'EGPDIft'Eff#2 Qu. Sz. Cont Color Gr. Sz. Sh. ❑ ❑ Boring # Boring E] pi Ground.surface elev. - -_ ft. Depth to limiting factor in. SOIL A lioa6on Rate Horizon Depth Dominant Color Redox Dosc)iption Texturo Structure Consistence Boundary Roots GPDIft' in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eft#1 'Eff #2 ❑ Boring F-1 Boring # Ground surface elev. --- - - -_ -- ft. Depth to limiting factor _ —_ -- in. El Pit Soil A lication Rate Horizon Depth Dominant Color Redox Des(Aptiort Texture Structure Consistence j Boundary Roots GPD/ft� in. Munsell Qu. Sz. Cont Color Gr. Sz Sh. 'Eff#1 'Eff #2 Effluent #1 = BOD > 30 < 220 mg/1- and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mglL and TSS < 30 mg/L 'l he Department of Commerce is an equal op service provider and employer. If you .reed assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 -264 -8777. 5BD- 030(R.07100) PAGE_ OFj r LOT #_LEGAL DESCRIPTION X1 /4 5 1 /4,S j&T (, N,R, E(orj� SCALE: ELEVATION: BM I DESCRIPTION: Ila J� BM 2 ELEVATION . V it BM 2 DESCRIPTION: SYSTEM ELEVATION: SYSTEM TYPE: �o'n, 4"o "c" t 9� t SIGNATURE: DATE: ..5 - POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page .L of , sYSS" s Own C << kTw* nk MenuiecWrar 1 .e5`Q ❑ NA Permit Sopfic Cl Dow 0 NoWft vol. I CCKCI gill D sl^ S19111 PAPJWMUM Manufactdeer ❑ NA faimber of Bedrooms � ❑ NA ❑ Sapt�ic ❑ Dom 13 HoicrhQ Vol. gill Ntunbar of Public Fac ity Units ❑ NA Effluarit FIW Ma utacturw r4 H C 13 NA Eatknated (average) flow 3o c7 Effluans Finer Model Design (peak) flow = (Estimated x i.5) ,S� Pump Mwwfacturor ❑ NA Soil Application Rata pump Model Stadnd 1i g d/Efituent. Quality average` P(atreatywm Unit 0 NA Fats, on lk Grease {FOG) 530 mg/L 0 SendK3raval Flier ❑ Peet Filter Biodmnical Oxygen Demand (BOD 5220 mg/L ❑ NA ❑ Mechanical ical Aeration [7 Wetland Total Sus pended So lids lTSS) s1 5O mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly everne PE03 anufacturer siochexrdcal Oxygen Derniand (SOD,) 530 mgA. � Cefl(s) Q NA Total Suspended Solids (M) S30 mg/L ❑ NA in-Ground l�t © in- tirourd (Pressurized? Fecal Caflform lgoornetric meard S10 cfu/100ml At-Grade O Mound Maximum Effluent Particle Size Y. in die. ❑ NA ❑ Drip - Lima ❑ Other Oilier: ❑ NA ❑ NA •Vakm typical for dowa ttin; wastevrater and septic tank effluent. Other: ❑ NA MAf�i� lI,E Swvke Event SwWoe R el l nrarttltI) � 3 j ,, 91 ❑ NA Irapect � of tank(s) At West once every= - When combined sludge and scum equals one-third W of tank volume ❑ NA Purmp out contents of tenkts) When the high w#W alarm is activated Inspect dispersal cell(s) At least once every: rrte�et .1 (lYi:xbnuhrh 3 yeas) ❑ NA Mean effluent filter - At ko t once every: ❑ mrxtd 3ts1 ❑ NA ❑ rrmonih(a) ❑ NA Inspect purnp, punv controls & alarm At least once every. ❑ s) Rush laterals and pressure test At least once every: d YOWAS lal ❑ NA At least once e�raryz 0 month(s) C3 NA ❑ NA Inspections of tanks and dispersal calls shall be made by an individual carrying one of the following licenses or certifications: Master Plumber: Master Plumber Restricted Sauget; POWTS inspector; POWTS Maintaxmc: Sept Sw Operator (pumper). Tank inspections must include a visual irspectiorr of the tank(s) to identity any m or broken hardware, identify any cracks or Welts, measure the volume of combined sludge and scum and a dock for any back up or poncflng of effluent on the ground surface. The dtapasal cells► shall be vistuft kupwtod to check the effluent levels in the observation pipes and to check for any ponding of effkhent on the ground surface. The ponding of effluent on the ground surface may IndWate a failing condition and raqunres the wirnediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any treatment tank equals one -third (Y 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, Wismar► Administrative Gaels . All other services, including but not limited to the ser4k*v of effluent filters, madmnical or pressurized components, pretreatmen units, and any servicing at intervals of S7 2 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local rargutaiary authority within 10 days of completion of any service avant. GMW l21a3t START UP AND OPERATION Page r For new construction, prior to use of the POWTS check treatment tank for the presence of �pypV Products solvents or other he" the contents of ft tanks) removed Pia and/or damage the soil it to sa� caQ (s). ff high con�httadons we detsCtati �' a aervicing operator prior to use. System start up shall not occur when soil condidwo are f%san at the infiltro a surface. aurkhg extended power outages pump tanks may fN above normal hkAwater levels. When power is restored the excess wastewater will be discharged to the dual cents) in one larps dose and may overload tfnerrr 49d," of of iumM To avoid this situation he" the contents trf the pump tank removed by in the backup or awface t° g Power to the effluent ��e Servicing Operator prior t to restore P� ar cmmtact a Rumber or POWTS Maintainer to assist in mamusgy operating pip normal iavebn witign the pump tw*. drive witnbn rs feet down slope slope any s over tanks and ad am. q Park over. cx otherwise disturb or compact, the area of mound or at -- gadgrgds * a fledhr POWTS: or elimination of the following from the wastewater stream may improve the performance and prolong the Nfe of the foundation drain (Ournp "tibiotics; baby wipes; cigarette butts: condoms; cotton Wombs; degre:esers: dental !hoes; diapers„ disinfectants; fat; pelnithV Products, f ) dirge; , fn* and Vegetable pea ie: linger p gramme; her irides; mast : medications: oit Y ; tarnporo; and water softener brine. ABANDON When the POVvTS faits and/or is parr wwdy taken out of service the fob Property and safelY abandoned an compliance wipe dopier Comm 113.33. Mllseonsin Administ ti taken to a Code: insure that the system is a AN piping to tanks and pas shah be disconnected acid the abandoned pipe openings sealed. The manta of al tanks and pits shmN be removed and prepanfy disposed of by a Septa" Servicing Op era t or. • After pumping, all tanks and pits shoo be excavated and removed or their covers removed and the void span fined with r in son. gravel or armtheert solid rmetwial. CONTME NCY PLAN U the POWrS faits and cannot be repaired the fobwing rcne IWIt sYstern; saw" have been. or must be taken. to provide a code eompkant (' y°l A suitable ant area has been evaluated and may be udized for the location of a replacement soil ab / replacement area should be protected from disturbance and corrnpec"m and should not be ilti &IDW upon by MWred setbacks from e301prtp. and propo structiM let fires and wells. Failure to phrotaM the 190li cament mrse win rascrk in the need for a now soil and site evaluation to establish a auk" replaceme area. Replace nt me systems must comply with the rules in affect at that tune. ❑ A technology suitable replacement area is not available due to sadmick and/or son Wriftati the failed POWTS. a holding tank rpney be installed as a last raaont to Barring advances in POWTS been to � tuitatAe area. faittue f the PO a �:so:jjI to a asi t valtabla sg tank the f ❑ Mound and at -grade sotl absorption systems may be reconstructed in Place following removal of the biomat at the infiltrative surface- Reconstructions of such system must comply with the rules in effect at that time. < <WALMpING> > BEFfIC. MP t�t II�IdT IN MI S /OR FICIEiNT OXYG M. DO NOT eoTEifi A S . PUMP OT OR OT TREATME NT TA tN1C UND ANY LETtL TAtYCf3S DEATH MAY RF.SIN.7. RESCUE OF A FROM THE FOR OF A TANK MAY BE DST OR E. I POWTS NOTALLER POyd/TS MA/�ITAArER Phone �-s - [ Name SEPTAGE SERVICIG OPERATOR MUlY1 M LOCAL ItEGUILATORY AUTHORITY Nano C [ :nhorM t Phone ur vt Is I 'tor document was drafted C j( the staffs of f the Green t. aka. Marquette and Waumhars County Zoning and Sanitation * r ornet 83 . 22 12)1b)St } {fief!) and 83.5411). (2) 6 (3). Wisconsin Adn*f native Code. in oompksnw with I -SR ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT V - AND (` r OWNERSHIP CERTIFICATION FORM Owner/Buyer k na"Cl-) S Ir C - a r, ;-- Mailing Address 33 L IP Property Address _ .a I a-7 L+ (Verification requ from Planning Department for new construction) City /State Parcel Identification Number _03 — Y z J I'A LEGAL DESCRIPTION Property Location S W r /4, S W y,, Sec. T_3 LN -R __3W, Town of Subdivision , Lot # Certified Survey Map # dos alb Volume f , Page # Warranty Deed # 741,,65 o� Volume Page # Spec house ❑ yes 1 no Lot lines identifiable�8( 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 is 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 master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal 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 Zoning Office within 30 lays of the three year expiration date. 4'/o 31GNATUKE OF APPLICAN DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. 1 (we) am (arc) the owners) of he property described above, by virtue of a warranty deed recorded in Register of Deeds Office. 1`D1b SIG A OF APPLI DATE ' * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. •• *••' * Include with this application: a stamped warranty deed from the Register of Dccds office a copy of the certified survey map if reference is made in the warranty deed • ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer xo- C '10 r Mailing Address Property Address (Verification required from Planning Department for new construction _ c City /State Parcel Identification Numbe 0 8. - l � ( 3 O 10C a LEGAL DESC IP TION Property Location S4O y,, StJ /,, Sec. -AL T-31N -R NW, Town of Subdivision , Lot # s Certified Survey Map # Gas a b Volume j , Page # 'NJ I V7 Warranty Deed # _ 1 2/n i1 R Volume 7 Page # - 7. Spec house ❑ yes PQ no Lot Iines identifiable b?f yes ❑ no SYSTEM MAINTENANCE Improper use and maintenanceof 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 master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in Proper operating condition and/or (3) 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 Zoning Office within 30 Jays of the three year expiration date. 1 ? //0 /O 3IGNA i E OF APPLICAN DATE 2WNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of he property described above, by virtue of a warranty deed recorded in Register of Deeds Office. /or SIG A OF APPLICAN DATE Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. ••••'• 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 U 2599P 50? - 76F--, �e+5a STATE BAR OF WISCONSIN FOI�M 2 - 1999 KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO.. WI This Deed, made between Brendan Loran Germain RECEIVED FOR RECORD Grantor, 06/21 12004 10 : 00AN and Andrew J. Smaciarz WARRANTY DEED Grantee. EXIDVT f Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Cro County, State of REC FEE: 11.00 a is needed, lease attach addendum): TRANS FEE: 222.00 Wisconsin (if more � p COPY FEE: That part of SW 1 /4SW 'ASec. 16- T31N -R19W being a part of Lots 2 & 3 CC FEE: of Certified Survey Map recorded in Vol. 17, Page 4534 described as PAGES: 1 follows: Lot 5 of Certified Survey Map recorded in Vol. 18 of Certified Survey Maps, page 4767 as Doc. No. 765286. Together with easement for ingress and o ver d across the 66 foot og gr egress o ran c wide joint driveway as shown on subject Certified Survey Map Recording Area St. Croix County, Wisconsin. Name and Return Address KFt1STli \4A OGLAND ATTrC !'=—Y AT LAW uw/�J Part of: 032- 1046- 50-000 Parcel Identification Number (PIN) This is not homestead property (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this /lfi day of June ,2004 * * Brendan Loran Germain - - - -- - -- - -- — - — ------ --- - ---- - - -- - - - . -- — - -- -- -- -- - - — - -- AUTHENTICATION ACKNOWLEDGMENT Signature(s) Brendan Loren Germain STATE OF ) _ ) ss. County ) authenticated this l day of June - _ , 2004_ -- Personally came before me this _ _ day of 1 - - --- _Y the above named Kristine Ogland TITLE: MEMBER STATE BAR OF WISCONSIN -- ----------- ---- -- - - - - -- ___— — __ -- _ (If not, to me known to be the person(s) who executed the foregoing authorized by $ 706.06, Wis. Stats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY ` � — Attorney Kristina Ogland - Hudson, WI 54016 Notary Public, State of My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ) * Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co., Fond du Lac, Wl STATE BAR OF WISCONSIN 800-655 -2021 WARRANTY DEED FORM No. 2 -1999 76Z!S2l36 VOL__�$ PAGE4767 KAT EEII H. REGISTER OF DEEDS RECEIVED FOR kEI 06/08/2004 01:45PH CERTIFIED SURVEY NAP BEARINGS ARE REFERENCED TO THE REC FE s 33 WEST LINE OF THE SW1 /4 OF SECTION PAGES: 2 16 ASSUMED TO BEAR NOO - W , 9( - :r& - Vrz ar xv'TaNTz .L?I� ; 00•ZO Ll r 3 »sse »005 T6'OT6 M Sb.8£o00N eo ory .OL•eLS to zee KOIdYYYdiS gg'rlt j.£0'9 .LZ "Z££ n rt _ n SAIVCr ,BYf KOlivur rzs YAlva ,04I O y °' 7b • • • r /LMS 3H1 �O r /LMS 3H1 �O 3NIl 1S3M , , , • • • g A p >IDVEI3S • • • . . � � >IDd813S C .Ni e3 � _ $i coo O : g C30 � 9 o G � �t chi 3 m y , e y P rn cn �:G$ �ZR a i� b L _ : p p _ Y4a• r 4 a ^ - 4 — n SOOSS'� O IC IN m y :�- 100' -+G ~ y ',—�� i. 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CROIX COUNTY, WISCONSIN. COPY FEE: PAGES: 2 PREPARED FOR: SURVEYOR: BREN GERMAIN THOMAS M. HEALY SCALE IN FEET 1" = 200' w 2121 40TH ST. S & N LAND SURVEYING, INC. Z F- SOMERSET, WI. 54025 2920 ENLOE STREET m o �2 z HUDSON, WI 54016 200 0 200 ¢ Hg WEST 1/4 COR. w - � m SEC. 16 T31 N, R19W C++ Lu o I d04 4 O[_C�o�o[titlo oa N W c -- - - - - - 39.68' MOdo 9 0 ,, o N S89 19 23 E 1311.14 476.38' 834.76' 66'-J ' 436.70' 9 3 09 0 NOR LINE OF THE SW 1/4 OF THE SW 1/4 I33 .. .. .. 3 ACRES — —127 46'— — 142,875 SC3:.fT:.INCLt�DIN��• S 130.693. S.Q:..FT; EXCLUD }N(,. LOT 2 LOT ::::: m ��� ` 24.088 ACRES S . ...., .. CONTI . .....NET ` Fn w 1,049,286 SO. FT. INCLUDING R/W v c:�.... ;...BUILDABLEAREA ... " S 23.500 ACRES n I ! :::; 2:7:t:ACRES '.' $ 1,023,676 SO. FT. EXCLUDING R/W ... m i 41. 55'....:..... 434:83' ............. F. m 1� m N N89 0 19'23 "W 476.38' CUR - 1 m 1 1 (A LENGTHS IN FEET) C9 I� CENTRAL CHORD CHORD ARC _ 1 R , NUMBER RADIUS ANGLE BEARING LENGTH LENGTH TANGENT IN TANGENT OUT y I I I IQ C1 10417.47 02 °07'55" S00o03A4.5"W 387.61 387.63 S01 °00'13 "E S01°0T42 W z ` I� °' I� Z C2 10417.47 01 S01 56'00.5 "W 292.78 292.79 S01 °07'42"W S02°44'19"W 0 y l o m C3 1041747 03 °44'32" S00 °52'03 "W 680 O I = O ..30 680.42 S01 °00'13 "E S02°44'19V -n N I N O I I Co -n C4 614.61 13 °48'41" SO4 °10'00.5 "E 147.80 148.16 S02°44'19"W S11 °04'22"E m 00 Ig N W s 00 .4 I m � '� i m APPROVED ST. CROIX COUNTY y 1� cO a .a I� I 1 1 • ' .. ............................... Plann;• - 7— .. 'rl! Pnrkg Committee -n O IQo o ...................... .. ............1.1.1..1.'."....' RI ; �• I n CONTIGUO`U JUN 0 4 2003 W m. BUILDABLE AREA........... W IGu� • ........... ............................... O i 1 ; • ;;; ; ; ;; ;;; ;;;;;;;,D aCAES :::; _ If not rec:oroea wili"11 30 days of a Imo° approval date approval shall be Ig (7 ............................... m!I! end void O O 1< S89 0 30'52 "E 1313.30' I@ IQ w 1275.15' I� I �33 38.15' 33 1 I� I II EXISTING DRIVEWAY I� GARAGE 13.271 ACRES ` N 578,090 SQ. FT. INCLUDING R/W a 11 A A � I LOT 1 p HOUSE- 12.965 ACRES ° 100 L� WELL 564,742 SO. FT. EXCLUDING R/W EPTIC - 1 S I I I 34.05' SOUTH LINE OF THE SW 1/4 OF THE SW 1/4 1280.34' _ 1 RIGHT -OF -WAY PER C.S.M. N89 °30'52 "W 1314.39' SW COR. SEC. 16 d4 OD C�ooG�lo OG� T31N, R19W -- �_�_ Q _`V'_o�a1NUo �� SOO Qdo _ 0 pCo ? - i LEGEND FOUND ALUMINUM COUNTY SECTION Tm -' � CORNER MONUMENT / / I DIAMETER BY 18" LONG IRON SET ill OUTSIDE 546 PIPE, WEIGH I NG 1.13 LBS. PER LINEAR FOOT 2 '�" HUDSON 0 FOUND 1" IRON PIPE r� ,9 WI OQ • • •. . ...... • • • 100' BUILDING SETBACK LINE ww v PROPOSED DRIVEWAY 'YO � THIS INSTRUM : WES ANDERSON +,250 DRIVEWAY SEPARATION JOB NO.6225 -01 DAT :10/16/2002 REVISED 1/27/03 SHEET 1 OF 2 SHEETS Vol. 17 Page 4534 n ■ 0 0 0 e , S £ § § ; ■ ^ . f }q \C k 7 2 j J # ■ «■ z— z o o m o. n, s; o ® m o r iI $mi §_] 2� CD \� P C ° / 3 ; C § \ § ; o E E 0) 8 [ @ > £ % § \ CL q S 0 o to ) w 2 7 "AM, z 0 0 0 \_ o -,-I § 2 C4 ca (0) )_ 7 � � r. \ • ; z / o \ / 0 f \ \ ƒ C. \ z 2 is _ ca / P ■ ? CD ' — ! � ■ a 0 z R 0 CL § q z j 2 CD n > C \ 0 » & ƒ \ k . U) j @ it ■ k \ � \ kj � \ \ � < / 69 0 � 22 r I , ' GENERAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR01 REAL ESTATE TOWN OF SOMERSET COMPUTER NUMBER 032 - 1046 -50 -050 Parcel Number 16.31.19.234A Claimed Date Re- certified / / Relate Number: OWNER NAME: First BRENDAN L Last GERMAIN CO -OWNER Mailing Address 2121 40TH ST City SOMERSET State WI Zip 54025 - Type Vol Page Doc # Rec.Date Type Vol Page Doc # Rec.Date HISTORY QC 2154/367 711193 02/26/2003 QC 1183/195 PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name- Type SD Apartment Post Office 2121 40TH ST School District: 4165 - SCH D OF OSCEOLA Special District: (1) 1700 - (2) - (3) - W ITC Plat Code: Last Changed on: 08/12/2003 Book Number: 1 SECTION 16 TOWN 31 N RANGE 19W %160 SW '/440 SW Map Number: 00 - Sales Area: Parcel Control 0 TAXABLE Number of Units: ZONING: Permit Number: Type: Bank Numbers : F4 -Prev, F5 -Next, F6- Legal, F7- Value, F8- History, F10 -Exit, F12 -More r LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF SOMERSET COMPUTER NUMBER 032 - 1046 -50 -050 Parcel Number 16.31.19.234A OWNER NAME: First BRENDAN L Last GERMAIN PROPERTY ADDRESS: Hse # 112 PD -- Street Name -- Type SD Apartment 2121 40TH ST SECTION 16 TOWN 31 N RANGE 19W '/4160 SW %40 SW Line Description Line Description TOTAL ACREAGE 13.271 PLAT CSM 17 -4534 032 -03 LOT01 BLK 01 SEC 16 T31 N R1 9W SW SW 15 02 LOT 1 CSM 17- 4534(13.271AC) 16 03 17 04 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1- General, 174 -Prev. Parcel, 175 -Next Parcel, F7- Valuations, F8- History, F10 -Exit VEIZI 032 — /OS/(a -.SO La * / VOL 17 PAGE 4534 /UEC�J l>3Z— /D</10 -50— /5'd ,23�/A;2o BEGISSTER OF DEEDS MAP CERTI ST. CROIX CO. wI RECEIVED FOR kE15AM CERTIFIED S URVE Y 2003 11: 5AM CERTIFIED SURVEY MAP LOCATED IN THE SW I/4 OF THE SW 1/4 OF SECTION 16, T31N, R19W, REC FEE: 13.00 TOWN OF SOMERSET, ST. CROIX COUNTY, WISCONSIN. COPY FEE: PAGES: 2 PREPARED FOR: SURVEYOR: in UVI BREN GERMAIN THOMAS M. HEALY SCALE IN FEET 1" = 200' z w 2121 40TH ST. S & N LAND SURVEYING, INC., SOMERSET, WI. 54025 2920 ENLOE STREET ILI HUDSON, WI 54016 Z WEST 1/4 COR. 200 0 200 U, o m SEC. 16 T31 N. R1 9W N w o 1 1@V 4 W _C�o�pGv]o_�[ vl LL u w w - w --2 cn 0 0 � `� 39.68' 476.38' S$9 0 19'23 "E 1311.14' 834.76' m o N 66' ' 436.70 - 9 3V ;2D NORTH LINE OF THE SW 1/4 OF THE SW 1/4 {33 3.280 ACRES — — 1271.46— — t42,875 SO . :.FT.:.INCL_UDINQ RliN ::. ° w c c am' Q.3Q 693. $,Qr.FT; EXCLUDING::: /, LOT 2 � 2 � 5 :. -�.... LOT:Z ... .:.:.:.:.::.:::.:.: 24.088 ACRES rn �3 �'� ' ' V CONTIGl10US NET w �` 1,049,286 SO. FT. INCLUDING R/W v I I w.: BU1k DABLE AREA' :'.'.' :'.' 23.500 ACRES m I :1::' ACRES'...::: :.':.'..: S 1,023,676 SO. FT. EXCLUDING R/W ! z 41.5$'. .: ............................. m , ........... 434:83'•' '• - I N N89 °19'23 "W 476.38' CURVE DATA TABLE I� m I W (ALL LENGTHS IN FEET) I� (P ' CENTRAL CHORD CHORD ARC I' ° I : m NUMBER RADIUS ANGLE BEARING LENGTH LENGTH TANGENT IN TANGENT OUT I c1] {� C1 10417.47 02 °07'55" S00 °03' 387.61 387.63 S01 °00'13 "E S01 °07'424 C: 44.5 ° I " z C2 10417.47 01 °36'37" S01 °56'00.5"W 292.78 292.79 S01 °0T42"W S02°44'1 9"W rrn y Z I= m C3 10417.47 03 °44'32" S00 °52'03"W 680.30 680.42 S01 °00'13 "E S02°44'19"W -n N I -n C4 614.61 13 °48'41" SO4 0 1900.5 "E 147.80 148.16 S02°44'19"W S11 °04'22"E 5� G 19 0 APPROVED � 44, io _ I m . . ST. CROIX COUNTY A i I all _ I I a Committee O IQ ................ ............................... JUN N 4 2003 m . .....:..:.:.:.:...CONTIGUOUS NET i IE, .. ................ ............................... i I� i .. It not rectoraeo wanin 30 (lays of a 0) I� ................ ............................... • I A ... • ........... ..... . ... . approval date approval shall be I o0 I Of � l nc,I� end void �_ I� I@ nnn Iw S89 0 30'52 "E 1313.30' 14 8.15' 1275.15' 12 I� 3 I� I �33 3 I o EXISTiNGr EWA�— O �- I�l ( GARAG n ® 13.271 ACRES I N 578,090 SO. FT. INCLUDING R/W A A LOT 7 HOUR' 12.965 ACRES 100' `� WELL 564,742 SO. FT. EXCLUDING R/W - I � 3 SEPTICD I � I C7 34.05' SOUTH LINE OF THE SW 1/4 OF THE SW 1/4 1280.34' _ RIGHT -OF -WAY PER C.S.M. N$9 ° 30'52 "W 1314.39' SW COR. SEC. 16 ' L OO U 2 W MoU�i_ . Oil T31 N, Al 9W I�M Oho _ 0 P-(@ o 7 _74 _ I MOdo 9 0 pro X74}_ ONS LEGEND FOUND ALUMINUM COUNTY SECTION T}� CORNER MONUMENT SET 1" OUTSIDE DIAMETER BY 18" LONG IRON Z546 PIPE, WEIGHING 1.13 LBS. PER LINEAR FOOT HUDSON, Q` • FOUND 1' IRON PIPE l i wl ................. 100' BUILDING SETBACK LINE -9 �O V� - -- PROPOSED DRIVEWAY THIS INSTRUM V : WES ANDERSON *250' DRIVEWAY SEPARATION JOB NO. 6225 -01 DA :10/16/2002 REVISED 1 /27/03 SHEET 1 OF 2 SHEETS Vol. 17 Page 4534 r ' - ., w t SOIL EVALUATION REPORT Page -- L o t 3 DNislon of Safety and Bupckrhgs . code accor dance witlt Conan 85, Wis. Aft , Counly S� Attach complete sire pion on paper not less than 8 U2 x 11 inches in Size. Man must � � wwk,de. but not limited jo, vertical and horizontal reference point (BM), direction and Parcel I.D. peresntstope, Scale or dimensions. north arrow, and tocmtion and die w nearest road. Elato Please Z P�ao+�d i+�(oimmion you prowls rotp used aor Lsn a 15.M (1) tmp Proport yOwner PropertyLocatim MAY 0 Govt Lot w 19 Sw 114 S T 3 1 N R 1 E (or) w pMpwty 0~s MAWAddrsso Subd, 1 7 S'3 Z I Z t Z Iv �, i ST. CROIX COUNTY �Y Stale ❑ c ly ❑ warea .So tv Lr 1 5 oZ S (7/ M New construction use: W Residenlial ) Number of bedrooms Code derived design now rase S U O cPD ❑ Replaeoment Q public or commercial - Describe: Parent maw ___. pv4-w u S h Flood P N cerWei aommems S cm el-et, . q?—.00 / V� 0� S and recommendati D� B ori ng l swing pit Grond surface eiev. q s - . q0 fL Depth to timkng factor L,�1.L_ in. B 6Y soil Rabe Depth D Red= Description Texturs Structure Consistence Boundary Roots GPDNt? in. Munson t]u. Sz Cont. Color Gr. Sz. Sh. *801 *002 I 10 3 — 5 rY�r C5 j Ib� — S Q� awl e 1 1. 3 t� Iv �V V" Z Borkhg # P Boring &Ww surface oleo. 9SP � ft D ept h 60 6r�hg TacOor � kr• Sol A Rate Horizon Depth. Dominant color . Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munson (lu. Sz. Cant Color Gr. Sz. Sh. •EW1 'Eff#2 _12 Zm�5 c .5 -(3 z IZ -3 (n O� c J I � l Z 3 • F�rlent 01- 80q j: 30 < 22D mglL and TSS >30 150 w4vt, • tJOuent a R2 =1300 <_ 30 mglL.mW TSS _< 30 Numb CST Name {Pisses_ Pr � �--- CST Numb Address Date Evaluation Conducted Telephone Number g' 03 - 1 h . Property e r mo r� Parcel ID # 0 - pow z Of a Baring # ®, Pit g &Wwmrbm elsv. L1 v R Depth 1D Nmiing bCIOr (`x0 in. Sol Rate pominantColor RedoxDescription Texture Sduckme Consistence Boundary Roots GPDffF Horizon Depth Gr. Sr- Sh. •E1�1 'EfNi2 in, tArareeN Ou. Sz. Copt Color 1 d -I 10 3�3 L Z C5 Ivy 5 S 41 A, El Boring # ❑ lto g _ Groard surface Wev. — R Depth to NmTn9 bCI0r in. Soft Rea ❑ Pit Horimn Depth Daratnent Color Redox Description Texture Sbuckme Cow Roots GPD11F in. munsell Ou. SL Coat Color Gr. SL Sh. 'EilAR1 F-I Boring # ❑ Swing Ground surface elev. R Depth to KwAft lector in. ❑ Pit Soi Rate Horiaon Depth Donrirant Redox Description T exture Structure Corrsistenoe Boundary 1 in. MI/teeii Qu. &- Cont. Cow Gr. Sz. Sh. *M1 •Etkl2 • E&mt #1 = SW 30 220 mg1L and TSS >30 <_ 150 mgiL • Eftm t 02 = BOD 30 mglt. and MS : s 30 mg& The Department of Commerce is an equal opportunity service pmvider and employer. If you need assistance to access services or need material m an alternate format, please contact the deparunent at 6M266 -3151 or TTY 608- 264 -8777. ss 41330Ca.oMor PAGE 3 OF NAME: LOT# 9 LEGAL DESCRIPTION:_1 /4_1/4,S T E(or)W SCALE: 1"= CALEVATION: BM 1 DESCRIPTION: /tar ' ( i' n �� P -fire e BM 2 ELEVATION: %00 • d BM 2 DESCRIPTION: f1a,'I ,' 10 • 7oublL ,Q, e _r te( SYSTEM ELEVATION: D 0 V anti l ' SYSTEM TYPE: (o1�Uv✓� +,`� na I `' �rd l ok f t t rl All �f z f ,: �' 95 ov v SIG ATURE: ,.... DATE: _. B 3^ 9y• r 7'6!5.c/36 VOL 8 PAGE4767 KATHLEEN ALSIU REGISTER OF DEEDS ST. CROIX CO. III RECEIVED FOR RECORD 06/08/2064 01 :45PH CERTIFIED SURVEY HAP BEARINGS ARE REFERENCED TO THE REC FEE: 13. 00 WEST LINE OF THE SW1 /4 OF SECTION COPY FEE: 3.00 16, ASSUMED TO BEAR N00'38'45 "W PAGESs 2 100'ZOLZ 3.9111.9£.00S Y 160'OYb 'C1 >.89'6£ n KOI.IYYYdSS .88'bZL j.£0'9 .LZ'Z££ � w Q SAma • 9Y8 NOl bYMY fJrS SAIMa . 090' ri .9 "£'i9 3..£ 1.00.1.0S � rn MM 3H1 �0 4 /1,MS 3H1 AO 3NIl 1S3M c ...... c7 .......... I • ......... • • • NOHH135 • i C fy ' y Z Q g 0O T O c� ° m�` c GS o m lv T m r.�iG a T z N v Cn D. m�� P N I��''jj r .�.. ao S N ' r 7C • I y N 1� x i � -P• pZp `� m Z r c0 m u m `100 G u,: O x 1 * b --� N �"$' z m �A y O N r cn 0007 8 m �v l i7f z F. o �j Iz n w In N ° cn 1 mO� µ c O X m tN_ ZZ Z££ 3.00.£b.00S gr4 yO Op W 'r m N O Ida I'Z boa Y7 y m c Oy \ I� ��\ w r 2 E"� 1� --j M 1 W T m � og m C= � A N > mg I j n o A z z 1� p, Fn N x r, n z m S t-rt z n -n C 2, ;fit; ? m ~ m z S = �z bILMS 3F41 /IMS�lij.yQ�Nt� 1$V3 ,{� rn .LS'906 3..9T.41tro00S SQi�i�'"I Q��.s,�l'Ld1�IfY I w * n 1 v 0-+z 1 O • 0xm;0s0 m�AOm v (� ° - n w fR m (n m �"� N O � C, C � ps S rn "'o jV Z 0 $ $z -IZ C.7 ?m��z Nm m--z� N 3� m v po m 0 * Z1 ?� C �n In o 9 z;! g oa D ST Z! 52iv �a � y l M r p < z d,m 0 m� 4T F mc"imr -- ,� m m G . Y+ zO m rt' zp my z� �Ot� z�o aa 0 y � om yam+ c �� ZmpM G7 A m j � m-< z `" O� vp A z m �' O N� ° x zb � z z z r z r" SHEET 1 OF 2 SHEETS Vol 18 Page 4767 032 - /00 -,50 -OSL" La t / 2 J � �t/EGJ ' 35/A -/ U VOL 17 PAGE 4534 /1JEC�J p3 Z- /D (Ao -SD — /50 z3 yA;ZO REGISTER OF DEEDS oT ST. CROIX CO. VI RECEIVED FOR SA kECORD Y MAP 06/04/2003 ii:i![ CERTIFIED SURVE 1:1 CERTIFIED SURVEY MAP LOCATED IN THE SW1 /4 OF THE SW1 /4 OF SECTION 16, T3 IN, R19W, REC FEE: 13.00 TOWN OF SOMERSET, ST. CROIX COUNTY, WISCONSIN. COPY FEE: PAGES: 2 PREPARED FOR: SURVEYOR: o BREN GERMAIN THOMAS M. HEALY SCALE IN FEET 11"= 200' 2121 40TH ST. S & N LAND SURVEYING, INC. 2920 ENLOE STREET � SOMERSET, WI. 54025 w Z g HUDSON, WI 54016 200 0 200 a g u� p WEST 1/4 COR. : w SEC. 16 T31 N, R19W ' w 0 d04 4 O� C�a@ofio ON W 9 °19'23 "E 1311.14' 834.79 66' ' 436.70' a 3 2D NORTH LINE OF THE SW 1/4 OF THE SW 1/4 i 133 — 3.280 ACRES 18 — — 1271.45— — t 42. 875 SCI:.fT INCLt1DIN9.R/VI( HwAr co . r I '.' .'.'.•.'.'.'.'.'. ... . . . '''''''• � LOT 2 C _ 1 i1 24.088 ACRES � m .:CONTIGUOU&N : w 1,049,286 SO. FT. INCLUDING R/W AREA:. ... $ 23.500 ACRES .... ....... ....... .. + 1,023,676 SO. FT. EXCLUDING R/W 1 � � 41'.55.'.'.'.1.•:'.•.'.•.' ..• - I .................434:83'.' :.•.'.'.':::.•.�.• 0 S11°04'22 E I� N N89 °19'2 6.38' DAT h"�'�1.F ----- -- - ---- -_ _ -- 1 9 ' (ALL LENGTHS IN FEET) I� m I I� ce CENTRAL CHORD CHORD ARC I _ NUMBER RADIUS ANGLE BEARING LENGTH LENGTH TANGENT IN TANGENT OUT a I N C Ct 10417.47 02°OT55" SOO °03'44.5"W 387.61 387.63 S01 °00'13 "E S01°07'42"W z a Z A z C2 10417.47 01 °36'37" S01°5500.5"W 2 292.79 S01°0T42"W S02°44'19"W m y Ip °i I= m C3 10417.47 03 °44'32" S00 °52'O3"W 680.30 680.42 S01*W13 "E S02 T O1 C IN C4 614.61 13 °48'41" SO4 °10'00.5 "E 147 4'19"W .80 148.16 S02°4 M i I APPROVED *4 1@) - I I m . ......... ............................... ST. CROIX COUNTY p1 I A ..:•:•:•:':•:•:•:.•:':•:':'.':•:•;•;';•;':•;•:•,•:•.•, •,':•:......• ...... :...... . :.:. Plane 7. ^; ,, ,r.� Parke Committee 0 lO ......:::':'::::::':'::::':: :::::':::'::':'::':::::'::::::: .1 U N 0 4 2003 m Ig I I ( (C� CONTIGUOUS ET::;::::::: J I i .'.�'.•.'.•.•.'.•.•.•.......'.' •N.'.'.'••••• ••• •• . m .............. 13UILDABL1? ARC..'..'........'.'.'. ` W 1 ul W I ..;......'.'.'....' ... ............................... . Iq j I I II : . ...... :.:.......:...............•i4CR 5 ... if not recArded wuiln 3U days of a IQ° I� • :'.:'.':.'.'.'.'..'..'.:..:..::::..'.. ..'.'.'.'..'.'.'.....'.'.'..... approval shall be I o0 1 > G approval date app I� Hutt c+ntl vgid �� �j C C7 ( o ... ..............................: ' . S89 0 30'52 "E 1313.30' I� 1275.15' 1� 1� 38.15' I 1 I33 33 � I� E�N I v GARAGE 13.271 ACRES 578,090 SO. FT. INCLUDING R/W A LOT 1 p HOUSE 12.965 ACRES ° & WELL 564,742 SO. FT. EXCLUDING R/W SEPTIC 34.05' SOUTH LINE OF THE SW 1/4 OF THE SW 1/4 1280.34' _ RIGHT -OF -WAY PER C.S.M. N89 ° 30'52 " W 1314.39' SW COR. SEC. 16 n/,� M I C►�0413_Oo__� C?o�o[o Oa T31N, R19W d04 9 _Oo_� C� o�olMlo �1J�1 I �n n n n c,7 Odo _ O P@. MOM � ---- - - - - -- - C N ` 4 � LEGE FOUND ALUMINUM COUNTY SECTION CORNER MONUMENT T�';O ( /`�/p3 O SET 1' OUTSIDE DIAMETER BY 1 LONG IRON I 1.13 LBS. PER LINEAR FOOT HUD PIPE WEIG HI NG �� 2 • FOUND 1" IRON PIPE Q r 9 WI �O ................. 10Y BUILDING SETBACK LINE AAII ,-- PROPOSED DRIVEWAY THIS INSTRUM : WES ANDERSON 1250' DRIVEWAY SEPARATION JOB NO. 6225 -01 DA :10/16/2002 REVISED: 1/27 SHEET 1 OF 2 SHEETS l Vol. 17 Page 4534 Wisconsin Department of Commerce Count Safety and Building Division PRIVATE SEWAGE SYSTEM St. Croix I INSPECTION REPORT Sanitary Permit No: 453480 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan to 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 Smaciarz, Andrew I Somerset Townshi CST BM Elev: Insp. M E ev: I BM Description: Section(rownlRan lMap No: ( no, �� ✓ � �D �� ✓ti- (1.�Qa F o TANK INFORMATION tLEVATIO14 bATA TYPE MANUFACTURER CAPACITY ATION� BS HI FS_ ELEV. Septic O Benchmark J ° Dosing Alt. BM �S - 7 - 6 e ,S57 /oG JD Aeration Bldg. Sewer 3 /0 3 . 6 Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outle /o . 2 / 0 TANK TO P// WELL BLDG. yen�c to Airlutake ROAD Dt Inlet Septic \ ) ) � � I ( Dt Bottom Dosing / b Heade a Aeration _ Dist. U `? I Holding Bot. S stem PUMP /SIPHON INFORMATION Final Grade��/ c Manufacturer Demand St Cover / GPM v 3 �3 /03'r/ Model Num er e_- G lei TDH Lift Friction Lo System TDH Ft Forcemain Le Dia. Dist. to Well s /0 ,3z C4 Z ,/ S -ABSORPTION SYSTEM evi- S BED/TRENCH W J No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WE LAKE /STREAM LEACHING Manufact ryJ i G � _ _ / INFORMATION CHAMBER OR C IiUG� Typ f System: _! UNIT Model Number: I�UTION SYSTEM Header/ nifold Distribution x Hole Size x Hole S cing Vent to it Intake t 2 Pipes) l/ ��r t��Yi l A 4 �� 6 U r Length 1 D ia �i Length h Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only �� Depth Over / Depth Over xx Depth of xx Seeded/Sodded 1 xx Mulched Bed/Trench Center ' (a N .�N Bed/Trench Edges Topsoil �/ tttTTT"' 0 Yes [] No Yes [� No COMMENTS (Include code discrepencies, persons present, e Inspection #1: le / 12 Inspection #2: d v y Location: 2127 40th Street Somers WI 54025 (SW 1 C4SE 1 6 T31N R19W) NA Lot 5 _ Parcel No: 16.31.19.234A10 t, 1.) Alt BM Description a/ v � ��/t�/t`' 3 ���' �� 2.) Bldg sewer length = Ll pr ,{ / ei v 7 UUU� Q 2 /� � : a, R( cl,62— �f - amount of cover = } �,� Plan revision Required ?] Yes No I l Use other side for additional information. -- Date Insepctor Si nature Cert. No. SBD -6710 (R.3/97) _<1, Mai 25 04 03:41p Dave Bracht /Jack Harrison 1 - 715 - 247 -4880 05/23/04 SUN 16:54 FAX 715 386 4686 p0 4 l 13j004 i PAGE_ NAME: (,.err r LOTN_!5_LEGAL DESCRIPTION• '' I/4 SCALE: 1 "_ gnI ELEVATION: _ /Qv 10 : t BM t OESCRIPTfON: BM 2 ELEVATION: 1,9d. C; BM 2 DESCRIPTION: SYSTEM ELEVATiOW 9S Od 4 I C SYSTEM TYPE: r�l1 rc n Et� u f V (f A. w i a'► " _ Z 9 ° BA4 .3 �G� SIGNATURE: D E: U GC tj �� J VOL 18 PAGE4767 KATHGEEK H. REGISTER OF DEEDS R WORD 06/08/2004 01:45PH CERTIFIED SURVEY HAP BEARINGS ARE REFERENCED TO THE REC FEE % 13.90 WEST LINE OF THE SWIM OF SECTION CAGESFEES 3.09 18. 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