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KATHLEEN H. WALSH
STATE BAR OF WISCONSIN FORM 2 - 1999 REGISTER OF DEEDS
Document Number
WARRANTY DEED ST. CROIX CO.. WI
RECEIVED FOR RECORD
This Deed, made between Joseph E. Simon and Judy A. Simon, 06/27/2003 09:39AN
husband and wife,
WARRANTY DEED
EXENPI ii
Grantor, and Charles W. Cooper and Dixie Lee M. Shaw Cooper, REC FEE: 11.00
husband and wife, TRANS FEE: 717.00
COPY FEE:
CC FEE:
PAGES: 1
Grantee.
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 attach addendum):
Recording Area
That part of NW 1/4 NW 1/4 Sec. 29- T3IN -R17W described as follows: Name and Return Address
Lot 1 of Certified Survey Map recorded in Volume 15 of Certified Survey Estreen & Ogland
Maps, page 4183, as Document No. 657676, St. Croix County, Wisconsin.
304 Locust Street
Hudson, WI 54016
036- 1068 -50 -100
Parcel Identification Number (PIN)
This is homestead property.
(is) IF XOO
Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any.
Dated this 2 day of June 2003
C
+ + Jose Sim n
« « dy A. imon
AUTHENTICATION ACKNOWLEDGMENT
Signatures) Joseph E. Simon and Judy A. Simon, husband and STATE OF WISCONSIN )
wife, ) ss•
County )
authenticated lis f June 2003
Personally came before me this day of
the above named
« Kristina Ogland
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.)
THIS INSTRUMENT WAS DRAFTED BY «
Attorney Kristina Ogland Notary Public, State of Wisconsin
Hudson, WI 54016 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 company. Fond du Lac. WI
STATE BAR OF WISCONSIN 800-655-, 021
WARRANTY DEED FORM No. 2- 1999
LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02
REAL ESTATE TOWN OF STANTON
COMPUTER NUMBER 036- 1068 -50 -100 Parcel Number 29.31.17.442C -10
OWNER NAME: First JOSEPH K & JUDY A Last SIMON
PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment
1519 200TH AVE
SECTION 29 TOWN 31N RANGE 17W '/4160 NW '/440 NW
Line Description Line Description
TOTAL ACREAGE 4.000 PLAT CSM 15/4183 036/01 LOT01 BLK
01 SEC 29 T31 N R1 7W PT NW NW 15
02 BEING CSM 15/4183 LOT 1 16
03 4.00AC 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, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit
i
LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02
REAL ESTATE TOWN OF STANTON
COMPUTER NUMBER 036- 1068 -40 -000 Parcel Number 29.31.17.442B
OWNER NAME: First RETIRED NUMBER Last SIMON
PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment
SECTION 29 TOWN 31N RANGE 17W 1 /4160 NW 1 /440 NW
Line Description Line Description
TOTAL ACREAGE 4.000 PLAT LOT BLK
01 SEC 29 T31 N RI 7W 4A N 15
02 417.42'OF E 417.42'OF NW 16
03 NW NKA T CSM 15/41 RA 7
04 18
05 19
O6 20
07 21
08 22
09 23
10 24
11 25
12 26
13 27
14 28
F1- General, 174 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit
�� O�- �N-1t. � N 0310 /069_ a� 106 �/�la 7_ / D
o `� i a 657676
l'L' �� f - 1669 - ��-107� KATHLEEN H. WALSH qqZ e _1 b
Low eSm lS��183 REGISTER OF DEEDS
/� �Q 3G) ST. CROIX CO. WI
`)` "` oZ /" ( `s " D fit, - p f g _ s v _ � RECEIVED FOR REURD 'Y yZ � -
Li, -i'-a c a a-� b yr P J
CERTIFIED SURVf MAC' -�° °14: PM
Rangel7 Town oNStanton, StaCrofx County,oWisconsiQuarter of Sec Township ORD kFEE: 13.00
�.��``� gCO1y ' PAGES: 2
Prepared for and at the request of: "o` 4 ,,,.,,,`�I4f �G�
OWNER:
Joseph K. and Judy A. Simon • TY n.
1519 200th Avenue DODGE
New Richmond. WI 54017 .Z 4 - _ S -'2484 ?
Drafted by. Ty R. Dodge = (';LEAK LAKC,
NORWKEST CORNER �� /I .• '
SECnAN 29 - 31 - 17 UNP�i�T1ED LANDS ` %,,��itf� " " "��y0���� NORTH 1/4 CORNER
(FOUND ALUMINUA/ NORTH UN£ O!F T1YE NW 1/4 �������i:,����� �u� �������`���` • FCn0N 29 -31 -17
COUNTY MONUMEN9 - _ (FOUND 1 /RAN P/ E)
_,. - S89'5710 E 2631.55 - - -- ,� -
�'� R = ?96.25 _ _ 2_0077 _A V ENUE_ `����
- 29 — — — — — S89'57'10 "E 1119.52' ��
�S89'57'10'�'� ` - - - -- ; ---- NCAT -r iDZ - -- — = - -- ���
196.25 .�+ 702.41 w 417.42 'A
o' I -- S89'57'10 "E 1119.83' -- N o nC - -off
I Z ° ° ....... .. °, W 40
o a
g -- ....J ...... ........ .................
.........._ .�
o C C , �' ; NOTE• FOUND 1" IRON PIPE w f alw w v p
v7 2 is �/� r l IS N00'07'23 "W 0.39' FROM w oo •
u: �� I i COMPUTED RIGHT -OF -WAY m 'L N
1 os �' i� -4 I o ; N pnc b£HT ^?
0o I LOT 1
� Ir � I N � N
t0 I I � t0
;' S89'57'10 "E 417.42 , w�"
m I n 10 °•� iz
v m
N L4 �l ��-� D '�
N89 57'10 "WJ -- � � LOT 2 ° W T I
100.17' I ° t �f N w oo j
i TOTAL AREA: �� o� Io
Ic o I 872,045 SQ. FT. �► C w iD
iz - z
20.02 ACRES I
N C AREA EXC. R -O -W: ic
w t� a 848,870 SQ. FT.
�o 19.49 ACRES 2
WEST 1/4 GARNER �Z ORD /NARY N/GH WA 1FR MARK AS DETL�RM /N£D
(FOUND - 114' 17 (n BY ST. CRO /X COUNTY ZONING DEPARTMENT
(FOUND OD) iN ELEVA nON.• 990.03
IRAN RERAD) so 0
TOP OF IRON PIPE w TOP OF IRON PIPE
ELEVATION: J- �t.'�- ELEVATION:
997.16 /_T� / 993.94 t
_ _ _ _ �� 271.53' f 756.93' `�
.�� ,Ilk : N8956'56 "W 1028.46'
�!!k �� R =S89*5835 E I
�Il k A NORTH L /NE OF TH£ S 1/2 OF 7HE S 1/2
�` OF THE NW 1/4 OF THE NW 1/4
CORNER FALLS IN \ VNEILAJILIL LMM2 _ , .. '"
POND, NOT SET. NOTE: FOUND U.S.. � Ix' .J; )-N �3
`� MONUMENT S08'17`3'V1h`t -1h ia.�;i +T'ti'
NOTE: The parcels shown on this map ore subject to State, County and
4.02' FROM 9E.Tr4'P! IRON "PIPE . ,: `, r ' "`
Township laws, rules and regulations (i.e. wetlands, minimum lot size, access SEP 2 8 OO i
to parcel, etc.). Before purchasing or developing any parcel, contact the St.
Croix County Zoning Office and the appropriate Town Board for advice.
l F� If not Iocun�.:::; a: ur: ,it• c!:,r:. i r
rUV3I Cale ?I)�?fu 'al yhu l l;d
Section Corner Monument n:,n <a,,,.� • , r . �
0 of Record L O T 1
Set 1" x 24" Iron Pipe weighing TOTAL AREA:
1.13 pounds per linear foot 174,226 SQ. FT.
4.00 ACRES
O Found 1" Iron Pipe AREA EXC. R -O -W:
R- Recorded As 160,451 SO. FT.
. • ..4L Denotes Wetland 3.68 ACRES
- • .. - Building Setback Line (100' from Right of Way)
(75' from Navigable Waters)
JOB # 99157
,� Prepared by. 200 0 200 N� •�•�.�
J E OConsul�ngGroup, Ina GRAPHIC SCALE
Phone No. (715) 246 -4319 SCALE IN FEET: 1 inch = 200 feet
Fax No. (715) 246 -3830 BEARINGS ARE REFERENCED TO THE NORTH LINE OF THE
P.O. B x 325 NW 1/4 OF SECTION 29, TOWNSHIP 31 N., RANGE 17 W.
New R WI 54017 WHICH IS ASSUMED TO BEAR S89'57'10 "E.
Sheet 1 of 2
Vol.15 Page 4183
' Wisconsin Department of Commerce
Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count t. C roix
", INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT) Sanita ryg�Bgquo.:
Personal information you provice may be used for secondary purposes (Privacy Law,X.15.04 (1)(m)].
%WVWidj&Vame: ❑ City ❑ v sta ltalt nship State Plan ID No.:
s
CST BM Eiev.: tnsp. BM Elev.: BM Description: Parcel �esj: 40-000
M .0 r O� .
TANK INFORMATION ELEVATION DATA 0 3& 1 - 5D — / 00 , y
yZC —
TYPE MANUFACTURER CAPACITY STATION BS HI FS EL V.
Septic -,S� �25'O Benchmark `, 3'b ,j 10D.0 A BM
Dosi ng
Aeration Bldg. Sewer `
Holding St /Ht Inlet .$a O . $a
TANK SETBACK INFORMATION St / Ht Outlet �{ p . Sa
TANK TO P / L WELL BLDG. vent to Air Intake ROAD Dt Inlet
Septic > lap f ' 28 f NA Dt Bottom
Dosing NA Header / Man.
Aeration NA Dist. Pipe, qZ '
- , < I
Holding Bot. System 4 7 .2 v g4.Ilb
PUMP / SIPHON INFORMATION 5 .q I cm. 4, 8 ANdOMIRMI
Manu cturer De nd �-(- � , Z , o 04.38
Model N ber GP
TDH Li Friction System TDH F
L oss R
Forc main Length Dia. Dist. To
SOIL ABSORPTION SYSTEM
8EB TRENCH Width Length No.O Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMEN I D6 •ZS 3 DIMENSION
SYSTEM TO P / L BLDG WELL LAKE / STREAM EACHING I - r r r: ` n _
SETBACK CHAMBER MOW
INFORMATION Type Of
Z� Z f OR UNIT M el Number:
System: hrJ -1- .� "
DISTRIBUTION SYSTEM
Header l,0( anifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length Ae�— Dia
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched
Bed / Trench Center Bed / Trench Edges Topsoil InS ectio # Yes I ❑/ No I ea # No
L LOMMENTS: (Include code discrepancies, persons present, etc.) M'"5
Location: 1519 200th Avenue, New Richmond, WI 54017 (NW 1/4 NW 1/4 29 T31N R17W) -
1.) Alt BM Description = U16e 5T• w�o•w � �'� `
2.) Bldg sewer length = ^- 3o
r -amount of cove = tB `, - too q 30
3) ��� A- Iw r lk 4 '1 2 q . -Z'0
Plan revision required? ❑ Yes X No
Use other side for additional infornfation. I t[ eB o �
SBD-671 0 (R.3197) Date Inspector's Signature Cert No
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to ao" wHb CMM 53.21, Wis, Aden. Code: 201 W. WsdlhOm Ave.
SC n soa nvern sw fa br ao the awkstioa PO Baal 7302
Rareetisat Pe ncom w&aostion rou
pal r pmpoeres Wl 53707 -7302
_ (Ptivary Law ) ( torso to county jf not
� ` =` r uses uaraad.
as a IT it iba ea
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I. Apo kation - Iafbmausat - "U" Priat an Intormatio rn WL.0 Location:
O«aar tfleue � n �. •_ �7 trorseios
` b - MA, / dJ Nu: t/4 N w 114 T 3 � It � w
1519 - a06 UL-4
City,. So" t3
� C]ode •. ;f'� Nmeba � 9u�bd�ri�ina Nma or t�Mt 1
iCJ1VV. O
1
IL TYJN o f Bondin .
1 or 2 Fmily Da�f�No, of ) Bobeoa am ; _ 0 vmw
C] PubHdCbmnwmW owa of
O State -Owned fde ibe n �¢
I Road
III T Of PorWft an lice A. Cleak box on Use m it ble . /'?
Aj 1 . 4L S. o. to
Tads Bxisei
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IV. Typo of POWT Syxkm: (Cbmk an tiro apply)
O Mamd O sand FMW O Colimmad Wadaad
"[t re ad O H � Task Unit O Pm O Odwr
V. mat Area Information: 0 ,
t.
rwopowd iFa1a t= of ill I
L 27 & I 97, J ti>a l.s
VM I'aa1< Capadq► in Total * if otter Pads sae Sted Fhar nestie ,
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73 5�
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page _ of 3
` Division of Safety and Buildings
in accor�'ii i Cbrrfm 85v FAGS Adm. Code County
Attach complete site plan on paper not less t#ian x:1/2 x 11 1 ches in size. Plan must
St. Cr01 X
include, but not limited to: vertical and hori rtntal refer� c rnl� ), dirtictIM and Parcel I.D.
percent slope, scale or dimensions, north arrow; and Ids .z. - tl distance to;nerest road. 036-
Please print all ,information. iewed by Date
Personal information you provide may be use for secondWi purposes (Privacy LaW, s. 15.04 (1) (m)). 2 9 2mi
Property Owner 'F Property Location
law Joseph & Jud Simon Gc Govt: Lot NW 1/4 NW 1/4 S 29 31 N R 17 X (or) w
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
1519 200th. Ave, na na na
City State Zip Code Phone Umber• -• - - ❑ City ❑ Village [Town Nearest Road
New RichmoqdWI.1 54017 (715 )246 -5776 qtantnn I 20
❑ New Construction Use: 5d Residential / Number of bedrooms 3 Code derived design flow rate GPD
Q Replacement . El Public or commercial - Describe:
Parent material g 1 a r• i a 1 d - r i f t Flood Plain elevation if applicable ft• net
General comments
and recommendations:
trenches @ el. 97.10'
R Boring
Boring #
5 F1 pit Ground surface elev. 1 0 0 • 9 `rt. Depth to limiting factor + 9 � in.
Soil 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
1 0 -10 10 r3 3 no cs 2f .5 .8
2 10-21 10yr4/4 none sicl 2msbk mf
.6
3 2 -8 5yr4/4 none scl 2csbk mfr gw na .4
4 84 -9 7.5yr4 4 none scl 2msbk mvfr na na •4 .6
I
2 Boring # Boring
❑ Pit Ground surface elev. 1 01 • 1 Qt Depth to limiting factor +90 in.
Soil AP lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff
in. I Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 0 -10 10yr3/3 none L 2msbk mfr cs 2f 5
2 10-25 10yr4/4 none sicl 2msbk mfr CrW 1
3 5 5yr4/4 none scl 2msbk mfr aw n
4 5 -90 7.5yr4/ non scl 2msbk mvfr na na .4 6
' Effluent #1 = BOD > 30:5 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD 5 30 mg/L and TSS < 30 mg/L
Number ST
CST Name (Please Print) Signature C 02298
Gar L. Steel
Address Date Eva uation Conducted Telephone Number
1554 200th. Ave., New Richmond, WI. 54017 4 -27 -01 715- 246 -6200
Property Owner Joseph Simon Parcel ID # 036- 1068 -40 -000 Page 2 of 3
3 3] Boring # Boring
❑ Pit Ground surface elev. 1 0 0 . 7 O ft. Depth to limiting factor + 8 O in.
Soil � Appllcatlon Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 I `Eff#2
1 0 -10 10yr3/3 none L 2msbk mfr crw 2f
2 10-24 10yr4/4 none sicl 2msbk
3 24 -80 5yr4/4 none scl 2csbk mfr CFW na 4
4 80-90 10yr4/6 none .s M na na na 4
I
I '-f3• � 2
Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil A plication 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
Boring # ❑ Boring
F
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fg
in. I Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
I
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L
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.
SBD -8330 (R.6100)
• STEEL'S SOIL SERVICE
Gary L. Steel 1554 200th Ave.
Joseph & Judy Simon
CSTM2298 NW S29 -T31 N -r1 7W New Richmond, WI 54017
(715) 246 -6200
MPRSW -3254 town of Stanton
4
✓( " = 40'
-top of 1" pvc pipe @ el. 100.00'
Alt. BM.= top of sw corner of concrete slab @ el. 103.60'
yn .
5 FW
Gary L. Steel
4 -27 -2001
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V. Va „a.0 ay." rnn I .J59 9HOtl ST CRC CO ZONING w ool �
Private pnsite Wastewater Treatment System Management Pis n'
Septic Tank And Gravity In- Ground Soil Absorption Component
Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment
System (POWYS) shah include Information and procedures for maintaining the system within
the p8rafneters of Comm 83 and 84, and the conditions of approval by the department, agent,
or governmental unit. The approved plans and permits for system are on file at the county
zoning or health department.
This management plan complies with Comm 83.54, Wis. Adm. Code, and the In - Ground
Soil
Absorption Component Manual for Private Onsike Wastewater Treatment Systems S8D-
10567 -P (116199).
Table 1: System Oes' n s
SaNtary Permit Number 2
Nlrnnber of Bedrooms
Design Flow - Peak ( )
Estimated Flow - Average ( O
Sep tic Tank Capacity ]AS
Soil Abmption Component Size S9
-I-Type of Wastewater Domestic
Table 2: Sal Absorption Co - Limits of Reliable Operation
Septic Tank Component Soft Absorplion Component
Desi gn Flow - Peak )
Maximum Influent Particle Size On 1/8
Maximum BOD ) 220
Maximum TSS ( ) 150
Table 3: Maintenance Schedule
Septic Tank Inspect and/or service once eveg 3 years
Outlet Filter - inspect once a mr and dean at least once every 3 years
Soil Absorption Component Inspect orate eymy 3 years
Smut Tank
The septic tank shad be maintained by an individual certified to service septic tanks
under s. 281.48. Slats. The contents of the septic tank shad be disposed of in accordance with
NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease
Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches. Privies. or Portable
Restrooms).
The operating condition of the and outlet filter shall be assessed at least
once every 3 years by insptctiort. T outlet fill as necessary to ensure
prope era
r op tion. The filter cartridge t be removed unless provisions are made to
retain muds the tank that may slough off the fitter when removed from its enclosure. If the
o5tovoi WED 10:27 FAX 715 388 4686 ST Ctt3 CO ZONING
Management Plan for a Septic Tank and Soil Absorption Component
fitter is equipped with an alarm, the Mter shag be serviced if the WOM is activated contirwou*-
Intermittent filter arms may indicate surge flu m or an impending continuous alarm. The
septic tern shag have its contents removed when the volume of scum entl sludge in the tank
exceeds 1J3 the liquid volume of the tank. if the contents of the tank era not removed at the
time of an assessment, maintenance personnel shag advise 00 owner Of when the next service
needs to be perfumed to maintain less than maximum scrum and sludge aodunufation in the
tank.
Manhole risers, access users and covers should be inspected for water tightness end
soundness. Access openings used for service and assessment shag be sealed watertight upon
the completion of service. Any opening deemed unsound. def Clive, or subject to tenure must
be replaced. Exposed scxwss otings greater them 8- dw3 in diameter shall be secured by
an effective bddng device to prevent accidental of unau entry into the tank.
No one should order a 560fic or ~ trwafrnwlt or hok tS hw* for
any remon wltlwW being in lilt compNon0f wiifb OSHA sombods for
wrtedng a com7ned space. The adnosp"M wWoln alit sapft or odor
b+6nwrt of ho"19 f nk nwy corer Nlhd gaam and rescue of a
person ltom Me ~Dr of We facer east be amt or knpossW&
Tank abandonment shall be in accordance with Comm $3.33, Wis. Adm. Code when the
tank is no longer used as a POWTS component.
!Roil AD220 tlen GaerfoOlNrl
The soil absorption component serving this structure is designed to accept domestic
wastewater from a residential facility. The limits of operation of this component are shown in
Table 2.
The WnW41ty of a soil absorption component depends greedy on Proper and tlmely
maintenance, and system use within or below the limits of reliable operation, good water
oorxesrvation practices by all occupants and the installation of water conserving 00
fixtures are key factors in exteMing the useful We of this component.
The soil absorption components operation must be assessed by inspection at least
once every three years. The inspection shag include recordimp the levels of ponding, if any, in
the observeftn pipes, and a visual inspection for any evidence of surface seepage or discharge
from the component. On steeply sbping sites, areas of erosion should be identltled and
reported to the owner for repair. The surface discharge of domestic wastewater or sewage
from the system is prohibited and considered a human health hazard.
Traffic around or over the sod absorption component should be avoided particularly
during winter months. The compaction or removal of snow cover over the component may lead
to hydraulic fatim by freezing. This type of failure I s usually terry. but is difficult or
impossible to repair until weather conditions improve. in general. soil compaction over this
component will reduce diftusicn of oxygen into the son and dispersal cell, which may lead to
more intense, and earlier, organic clogging of the sal.
2
• • M Plan for a Septic Tank and SON AbsorPtion CIDMPWW(
plantings of deep-=Wd tMOS OW ShnJbS ft war or WWM ton bet of the
.mpmont should be avoided Ided S i r " ( W in i the mnponent n-Ay obstru &sIe
flow.
�T- U?,OIA 2 iii J = 586-4660
plumber - Calvin Powers - '246-7135
Replacement site will be that jail tested area by
C3T (0
heplacement site must be le undi.3tarbed, Dr
management/ contingency plan must be modified
and filed with the zoning office, outlining the
steps to be taken in event of septic system failure.
3
May 21 ,01 12:04p CRLVIn POWERS 715 - 246 -5135 p.2
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer
Mailing Address �Sl �-' ��S /4t f( &4j /� /C.hMon Q, Lij
Property Address
(Verification required from Planning Department for new construction)
/0 -000
City /State RLA /7 �� Parcel Identification Number T `�
LEGAL DESCRIPTION
Property Location , th y,, '" " F /,, Sec. , T ILN - Rjj — W, Town of
Subdivision Lot #
Certified Survey Map # , Volume , Page #
Warranty Deed �� ��-- Volume `�� Page OC
Spec house O yes jz no Lot lines identifiable yes 0 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 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.
I/wc, 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
da s of the three year expiration date.
r NATLgFOF APPLICANT DATE
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 owner(s) of
the property described ab ve, by virtue of a warranty deed recorded in Register of Deeds Office.
D
NATWE OF APPLICANT 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 decd
05/21/01 MON 1:21 FAX 7,15 98¢_4,6$7 EGISTE OF DEEDS 2
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I nc 177 & Jacobsen Blanche &, Mary County 43.87 James & Mary Magnus W
A May Alice 85.06 Avsen Johnson 43.76 Johnson ^' w arner
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Rcmnkk 154.55 Ziegler 238.16 r William AOd1ey etal
236.44 sterwa
2 `s 6354 83.65 Dunbar 167.%
Boche ' ar �" 3 g ettaal 84.08 84.14
Richard M heel
Bo etal Robert Jr & O M ke
G r egory RH KalMnrc M ha l cF
s Ra 12096 Lc i "n` William q°derson
STAR a0� 40 &Joyce Boche " el' "h . CC K e ` Leo r117.6 Lola
R, -n A 'I" &Margot Hammes PRAIRIE T ° 40 & L ona - Paul 0 a.4 B Mae a Manski & ��` 239.13 & Hammes Lawrenm
Fouks H 40.67 r SporMlli _ea u'_ 189.% R° 76.91
Howard
1: J C. Y _ 160 {.
80 &Marg ret Douglas kK.in warren RM 7o Ralph H 3
Krueger & Jean irle Irle 80 Noel Gary ,
80 w 105' 34.5 & &Marguerite T
Hansen L Olson Arlene 40 Gerald
80 Elmer USA Fish & Laura C Steven &Hat�eve�
15 240 Mk
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Dittman 160 105 &Iruaufe Izo Derrick
Ralph 76.31 Daniel t g0 � � Crow
Crisdhome 40
1 Casey •
Farm Inc 160 �� �� 4 a David +
80 160 o ,,, Maxon 118.15 39.77 I 2
0 158 Brent 158.46 '''t Donald c Y 71.03 440.08
Volkert• WIDNR Dubois ° zi 37.81 297.93
66 i R Donald
Melvin R 8s� C &L 20 cal, wu r.cx tss Kellen 60
&Marjorie Y m j.. Anderson A f.3 Ra ymond
Volkert 204.33 y "� ",k " 793 7°25 Crai Duane &Kenneth
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At.. Ga Blan g Ailts a 36.E ceases 120
168.83 Y, &Arlene seeven Steven Erlitz 239.19 g $ 40 &Marlys
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cc Keith ` 86.33 154.6 F 120
ase sl.a iw�e ass .e "''' o&� Larson rt••
rlerai Brshep Richard June Anee 1 Willis 190 , f Kevin ��. & Robert Brabec 2 Hogheem mss' Savadge & Kathleen d
Leo & Margot RR t6
O vi ola Merlin Kunze Derrick & Brabec 79.43 , lin Hammes Howar M 20
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46.87 S Family Trust ''. xg Robert Jarchow . . > .fan., & Cheryl
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s Frank 160 Frank & Steven Hallee Johnston • 259
p Janirn,V- Walter w al. s so
&loyce Peterson 78.5 o & .ny 1 s NP 4)
V Im.,l - &Rita � h $ f Mary 1 Gary David to . r. bill, rn a wn, Ralph - , Dons Andersen a Kevin & Arlene
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& Sette N , 156.49 Trustees
sv.7s 76.84 t 160 y Swenson ,
a n 70 115 80 110 40 Raymond 156.22
Fritz Roger oc Chdsdhome 3 r L
& Allen 5.3 v Lavon a David & 2
Frid Faros nc Babarn A c 184.01 Y 120 William Richard Ga ry,
}' Vehrs Fuller Gay Kenneth
Reuben Gary Knrmm eoS 40 Wickenhauser &Lori Gleason Arlene
65 207 & Marion a snannnn 3 Frank & Grace O'Shea Krampert °
0 6 r,g c "� steel p McNamara 160 Scott & Bonnie & Steven x
0 3s 99R Johnston 240 Halletm
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4 120 `246 97 269,84 10 a c 160.43 McNamara a Bethke
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&Helen kA 24Q e I Jr 80 _ $ 178.02 r
se h .1 a 1 & Barbara & Emma Rosemary
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z' = `z 80 - a Kiumm & Clea Lamers 3 Karl 2
oa 64 a r v E f _ Daleon 157 . N I & )ma s `o x Ra
Richard °Ga F Krampert 3 K "
& Linda `y" &A N David 1
NEW 720 Pederson &Nancy as 145.93 Michael 64 t
Cook & Julie 80 ° James 3 3 ,
70.3 HMI D 50 79-55 Waldroff Richard Mark & Arliss 160 ;M' 4
cnades G ro 120 Q,s 165.64 &Robert Dalton 80 Cody T " James & Clea oaten 3s `I
Polfus &u &Mnwkin 237 285.01 Derrick 80 158.16 `'`�.0 Dalton 202.92
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36'16 160 GOOSE w1 r,9- Traiser 152 „ F. `m 120 40 s
" Pond Co 240 v 80 Charles 120 ? "
1400 See Page 46 lsoo lc Polfus
1500 See Page 48 16o0 1900 2000
F
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EGGEN Woodville Insurance Agency, Inc,
"One Stop Shopping" - '
Agents: Dennis Mathison-
Quality Meats & Produce Rebecca Luecke
In Store Bakery }
Noon Hot Deli INSURANCE - INVESTMENTS d
684 -3316 (715) 698 -2244
641 830 Tenth Avenue - Baldwin, WI 54002
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