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• Wisconsin Department of Commerce
Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count y
INSPECTION REPORT St. Croix
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No
Personal information you provice may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)]. 353348
Permit Holder's Name: ❑ City ❑ Village ❑ jown of: State Plan ID No.:
Star Prairie Townshi
CST B Elev.; Insp. BM Elev.: BM Description: Parcel Tax No.:
" CJ
i s O 038 - 1184 -40 -000
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI I FS ELEV_
Septic r - �U o o Benchmark 3 �Z (03 - �� /C) C)
- Alt. BM
Aeration Bldg. Sewer
Holding St /Ht Inlet 41&/1
TANK SETBACK INFORMATION St/ Ht Outlet
TANK TO P / L WELL BLDG. Air I ntake ROAD
Air
Septic >5_0 N o NA
Header/Man. I- T .d
Aeration S, ,. -- r NA Dist. Pipe - r 2 - s
Holding Bot. System 9Z
3
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand St cover 7 9� 2
Model Number G
TDH Lift F ' to S stem TDH
Forc Length Dia. ell
e
SOIL ABSORPTION SYSTEM q
r
BED /0 1ENCR Width � Length No. O!Penches PIT No. Of Pits Inside Dia. Liquid Depth
DIME 3 Z DIMENSION
SYSTEM TO P / L BLDG WELL LAKE /STREAM LE G Man facturer:
SETBACK CHA BE
INFORMATION Type Of 7 r n o el Numbe r:
System: u Z� N(( C�
DISTRIBUTION SYSTEM
Header/Manifold /+ Distribution Pipe(s) / x Hole Size x Hole Spacing Vent To Air Intake
Length � Dia. Length S 2 S Dia. - Spacing - `7 ?-3-1
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 ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.) Inspect on #1: 3 /3 / /oe Inspection #2:
Location: 2114 Cook Drive, Star P airie, WI 54026 (SE 1/4 NW 1/4 21 T31N R18W) - 21.31.18.931 Circle "C" -Lot 14
1.) Alt BM Description = 74,-A 7" r .� `" �� r fo �a�°►/ i d C k r
2. Bldg sewer length = ! m '
� ) g g S y S E6h- y�,,,� 1 '�, t AA ctv tor. A" ��/' !4 el
�7 ' - amount of cover / = (g 2 °
J> tN�(���✓ fkSfG�ff(d( �l-s�� dl /`'i��� I / �:C�iG� --.
>-v / Ibt 4 Alt
Plan revision required? ❑ Yes ❑ No
Use other side for additional information.
SBD -6710 (R.3/97) Date Inspector's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH '
SANITARY PERMIT NUMBER:
Iq
I
ST. CROIX COUNTY ZONING DEPARTMENT
AS BUILT SANITARY REPORT
r
Owner
Property Address 21/ c /
City /State S' Y
Legal Description:
Lot _ q Block ~- Subdivision/CSM #
5 F_ t /4 &LUV4, Sec. j_, T�,N -3/N Town of 6 f �u�PIN # 10 "39, - l ILI —
SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION:
Tank manufacturer Size ST/PC IOW/ Setback from: House JL Well — P/L �O
Pump manufacturer Model
Alarm location
(HOLDING TANKS ONLY)
Setbacks: Service road Vent to fresh air intake Water Line
Meter location
Alarm location
SOIL ABSORPTION SYSTEM
Type of system: 1-{ /0 - ,5-J&- Width 3 Length �� Number of Trenches
Setback from: House - d - 7 Well -- P/L .3 Vent to fresh air intake
ELEVATIONS
Description of benchmark Elevation //O D
Description of alternate benchmark Elevation —�-��
Building Sewer r ST/HT Inlet ST Outlet & 5 PC Inlet
PC Bottom Header/Manifold Top of ST/PC Manhole Cover 7
Distribution Lines
Bottom of System
Final Grade ( ) O ( )
Date of installation /.3 / ermit number .3 jC33 Y U State plan number
Plumber's signature A L't License number , d - ?Date 3 /3/ l60
Inspector �a�--
Complete plot plan
h
NOTICE Please provide the following:
• A plan view sketch showing everything within 100 feet of the system.
• 1 reference points to center of septic tank manhole cover.
Two horizontal T o p P
• Show alternate benchmark, if applicable.
PLAN VIEW
�o
O
INDICATE NORTH ARROW
Safety and Buildings Division
SANITARY PERMIT APPLICATION 201 W. Washington Avenue
V sconsin P 0 Box 7162
Department of Commerce In accord with Comm 83.05, Wis. Adm. Code Madison, WI 53707 -7162
• Attach complete plans (to the county copy only) for the system, on paper not less County T
than 8 1/2 x 11 inches in size.
• See reverse side for instructions for completing this application State Sanitary permit Number
35 33`f?
Personal information you provide may be used for secondary purposes ❑Check if revision to previous application
(Privacy Law, s. 15.04 (1) (m)).
State Plan Review Transaction Number
I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION�
Property Owner Name . Property Location
E 1/4 /VWIL S o� T 3 r N, R/ f3 or4Z
Property Owner's Mailing AddresC7 Lot Number Block Number
Cit , State i Zip Code Phone Number Subdivision N me or CSM Number
p 7 (715 ) 7 Of-
11. F I ING: (check one) ❑ State Owned It Nearest Road
Public 1 or 2 Family Dwelling - No. of bedrooms 3 0 Tow OF
III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) g.. ,� Y q
1 ❑ Apartment/ Condo OR 1. ; (• ($ •)
2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash
5 ❑ Hotel / Motel 9 ❑ Office/ Factory 13 ❑ Other: specify
IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable)
A) 1. 1K New 2 ❑ Replacement 3. [3 Replacementof 4_ ❑ Reconnection of 5_ E] Repair of an
System ________ System Tank Only System - -------- - Existing System
B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non - Pressurized Distribution Pressurized Distribution Experimental Other
11 []Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 OLSeepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy
13 ❑ Seepage Pit 43 ❑ Vault Privy
14 ❑ System -In -Fill - A - 3A $
VI. ABSORPTION SYSTEM INFORMATION:
1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. S to lev. 7. Final Grade
I SQ Required (sq. ft.) Proposed (sq. ft.) (Galsday /sq. ft.) (Min. /inch) o Elevation
Feet — Feet
VII. TANK Capaut in allo Total # of Prefab. Site Fiber- Exper.
INFORMATION g Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App
New Existing strutted
Tanks Tanks
Septic Tank or Holding Tank /QQQ " Q ❑ ❑ ❑ 1 ❑ ❑
Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ 1 ❑ 1 ❑ ❑
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name: (Print) Plumber' nat e: (No S s) PRSW No.: Business Phone Number:
Q n urn
Plumber's ddless (Street, Cit e, Zip Cod ): Qa
IX. COUNTY/ DEPARTMENT USE ONLY
❑ Disapproved 5 itary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No Stamps)
Approved ❑ Owner Given Initial Surcharge Fee)
Adverse Determination -S 3 2�D0
X. CONDITI NS OF APPROVA R / REASONS F DISAPPROVAL:
C.119 , `4 s
SBD- 398 (R.12/99) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years.
S
2. Your sanitary pertnit maybe renewed before the expiration date, and at a time of renewal any new criteria in the
Wisconsin Administrative Code will be applicable.
3. All revisions to this permit must be approved by the permit issuing authority.
4- Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD -6399) to be submitted to the
county prior to installation '
5. Onsite sewage systems must be, p rope rly` `maintained. The septic tank(s) must be pumped by a licensed plJmper whenever
necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsitt sewage system, contact your local code administrator or the State of
Wisconsin, Safety and Buildings Division, 608 - 266-3151.`, , µ'
IV be complete and accurate this san'itar`y permit application must include:
I. Property owner'spame andmaiG,ng address. Provide the legal description and parcel tax number(s) of where the
system is to be ins&Ied. -
II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling.
III. Building use. If building type is public, check all appropriate boxes that apply.
IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair.
V. Type of system. Check appropriate box depending on system type.
VI. Absorption system information. Provide all information requested for numbers 1 through 7.
VII. Tank. information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and
manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and
holding tanks for this system. Check experimental approval only if tanks received experimental product approval from
DILHR.
VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.),
address and phone number. Plumber must sign application form.
IX. County/ Department Use Only,
X. County/ Department Use Only.
Complete pla6' and'specifications not smaller than 8 1/2 x 11 inches must ,be submitted to.the county. The plans,must
include the foltba ifi id; A) plot plan, drawn to state o'Fwith complete dimensions, location-of holding tank(s), septic
tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon
tanks, distribution boxes; soil absorption systems; replacement system areas; and the location of the building served;
B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume;
elevation differences; friction.loss; pump patformapWcurve pump model and pump manufacturer; D) cross section
of the soil absorption system. .if'required bythe minty; F) soil test data -on a 1 15 form; anb F) all sizing information.
------------------ ------------- __-------------------------------------------------------------------
GROt1NDWATER SPRCHARGE
1983 Wisconsin Act 49d'included the creation of Surcharges (fees) fora nrombef of regulated practices which can ' It '
effect groundwater. r =
The monies collected through these surcharges are used for monitoring groundwater contamination investigations
and establishment of standards.
PAGE,.'�_OF_,S_
NAME LOT# LEGAL DESCRIPTION S15 -/. /. S T N R or
� o I(tu,� � !'� s tiw . �.t ,3 (, . � SE � �
SCALE: 1 "= �QO
BM 1 ELEVATION �(� • V
BM 1 DESCRIPTION ' AtG R Pf,
BM 2 ELEVATION - I.7y
I
BM 2 DESCRIPTION 1 2 p. cA- • Prc. P j i2e.
SYSTEM ELEVATION 4 7 Y• OLO
ALTERNATE ELEVATION 9 q- 2-0
CONTOUR ELEVATION
No
4
�
1
� • Jo -- o0
DATE
SIGNATURE
,
Wisconsin Department of Commerce SOIL AND SITE EVALUATION
Division of Safety and Buildings Page of
Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code
Attach complete site plan on paper not less than 8 1/2 x 11 inches i !Size. Plan must "' County
include, but not limited to: vertical and horizontal reference point (OM), direction and 94, (f r i
percent slope, scale or dimensions, north arrow, and location and distance to nearest road., . Parcel I.D. #
APPLICANT INFORMATION - Please print all infort6tion. a r. R viewed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.Q4 (1) (m)) 3 2Z_.cwv
Property Owner Property Location
o, Govt <Lot _5. 1/4/(/W 1/4,S Z,l T?; f ,N,R f g E (or&V
Property Owner's Mailing Address Lot # Block# Subd. Name or CSM#
70,5__ al IeA 1q � 1 (2 L 0 _ I
City State Zip Code Phone Number Ci ty ❑ Village ® Town Nearest Road
❑
w \ Syo4(o (7,/,5 ).SW- 9 rc I Car, Or,
a New Construction Use: [4 Residential / Number of bedrooms 3 _ y Addition to existing building
❑ Replacement ❑ Public or commercial - Describe:
Code derived daily flow _ gpd Recommended design loading rate 7 bed, gpd/ft e — trench, gpd/ft
Absorption area required bed, ft 7-5 trench, ft Maximum design loading rate 7 bed, gpd/ft2
g g _1 r- trench, gpd/ft
Recommended infiltration surface elevation(s) yq, Z C) ft (as referred to site plan benchmark)
Additional design /site considerations • Z v A 1 - e_i l_ J
Parent material r) S h Flood plain elevation, if applicable 1_1� ft
S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank
U = Unsuitable for system 53 S ❑ U - 9S ❑ U [OS ❑ U I ®S ❑ U ❑ S ❑ S
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
-i t� i0 z SL l L l r
2 16 .21 / / L5 I rn54 n4 C_ S 8
Ground 3 2t -N$ / c J g
elev.
92 ,
Depth to
limiting L� ;
factor
// in. 33.6.6
Remarks:
Boring #
�z
1 0 -/ 16 yrz / mfr L C, L v'P 4 4
2 F 2 s - /d Y r N LS ! rnF►- c - _ - t 8
22-1/7 /U , '1140 COs rn G S
Ground
elev.
571-V ro
Depth to
limiting
factor
// - 7 in. Remarks:
CST Name (Please Print) Si a Telephone No.
Address Date CST Number
2 / C) - r,5 UPS - -C} 0
SOIL DESCRIPTION REPORT r
PROPERTY OWNER Page of
PARCEL I.D.#
Borin # Horizon Depth Dominant Color Mottles Structure 2
9 Texture Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
3 J a
- 24 l Vr 3 12 SL . 1 4 I .4 5
2
V-40 1 L5 /m rn�r c S — - ;• 3
Ground D -ltd w `f LDS 6sc, M) c 5
elev.
.6o ft.
Depth to Z
limiting
factor
IZV in.
Remarks:
Boring #
1 q /Z 54- lrneahk rn� C S . ;•
3 y - IZI iU yr `tl (o Cos 6SCA rh / C. S
Ground
elev.
q +0 ft.
Depth to
limiting
factor
I Z in.
Remarks:
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
Boring # I Q —I(o lU 3/Z _' / a mpr LS
5 , 2 )6 -2q I6 r y jq
3 24 -1 — & ye 1- 11tD Co S I C S — 1
Ground
elev. Q
9 / I I
Depth to
limiting
factor
Ir 5 in. Remarks:
Boring #
13
Ground
elev.
ft.
Depth to
limiting
factor
in.
Remarks:
SBD -8330 (R.9/98)
PAGE,OF,_S_
NAME 00 ( r LOT# LEGAL DESCRIPTION Sr '�aWl,,S7 T 3 (,N,R t SE (orlso
SCALE: I"=
/ BM I ELEVATIO �(
v BM I DESCRIPTION Jp0 ct I r OyG (�� ��
' 2 ELEVATION �• ��
✓ BM 2 DESCRIPTION 4
` ELEVATION T Y' 0
ALTERNATE ELEVATION q"! . Z�
CONTOUR ELEVATION /LI /ICI -.
c. L
e o n Z '
' t35 0 3
Q
SIGNATURE DATE
l
� ��
VVisconsin Department of Commerce
Division of SAfety and Buildings Page _ of
Bureau of Integrated Services rdance with 'sa -4LHR 83.09, Wis. Adm. Code
Attach complete site plan on paper not less th X11 ' Plan must County
include, but not limited to: vertical and horizo ference poin 3 , irection and
percent slope, scale or dimensions, north arr d I p� and distance to nears road.
M 1r 7 sR Parcel I.D. #
APPLICANT INFORMATION - Plea i "nt all l ion. Reviewed by Date
Personal information you provide may be used for se co r' {" s. 15.04 `) (m)).
Pro p e rty op rty Ow r > � � -._ Property Location
i 14-4L _ - Govt. Lot s E 1/4 - 1/4,S T N,R O
Property Owner's Mailing Address Lot # Block Su . Name or SM# I A, 2�
City Stat Zip Code Phone Number ❑C ity ❑Villa ® Town Nearest Road
I L I
New Construction Use: CgResidentiai / Number of bedrooms --� Addition to existing building
❑ Replacement ❑ Public or commercial - Describe:
Code derived daily flow - ��-�} `- gpd Recommended design loading rate bed, gpd/ft -,g - trench, gpd/ft
Absorption area required 3 bed, ft 5 C� trench, 2 g g bed, gpd/ft trench, gpd1ft
-L--- Maximum design loading rate
Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark)
Additional design /site considerations
Parent material d. 4 1 , Flood plain elevation, if applicable ft
S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank
U = Unsuitable for system M s ❑ U 13S 11 u ®S ❑ U as ❑ u I ❑ s o u ❑ s o u
SOIL DESCRIPTION REPORT
Boring Horizon Depth Dominant Color Mottles Structure GPD/ft
9 Texture Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
s 10 1 Arl .S
Ground -S S
elev.
Depth to
limiting
factor
Remarks:
Boring #
y . ..... /7�2
z �v
�-
Ground gz
elev.
S ft.
Depth to
limiting
facto
Re marks:
CST Nam (Pleas j ) S' e� Telephone No.
Address Date CST Number
I
•
Dominant Color Slr�re
MMOA
M MA
MM
Dominant Color
Mu I
MM
MM
. ' s,� �. -,1/W � �� a 1 �T.�IJ✓- �C /� �.,/�G.� -S o f �.
3e .
G GO
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer John N. Heintz / P. C. Collova Builders, Inc.
Mailing Address 905 County Road H, New Richmond, WI 54017
Property Address 2114 Cook Drive, Somerset, WI 54025
(Verification required from Planning Department for new construction)
City/State S t a r Prai WI Parcel Identification Number _0315 - 9
LEGAL DESCRIPTION
Property Location SE %,, NW 1 /., S 21 , T 31 N -R 18 W, Town of Star Prairie
Subdivision Circle C Lot # 14
Certified Survey Map # Volume , Page #
Warranty Deed # 5 5 0 5 21 Volume 12 0 2 , Page # 234
Spec house 13 yes ❑ no Lot lines identifiable ® yes ❑ no
SYSTEM MARMNANCE
Improper use and maintenance of your septic system could result in its premature - failure to handle wastes. Proper maintenance
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the function of the septic tank as a treatment stage in the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
masterplumber, journeyman plumber, restrictedplumberor 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.
Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards
se, forth, herein, as set by the Depariment 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
days of the three year expiration date.
X 3 00
SI TURE OF APPLICANT DATE
OWNER CEATMCATION
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 above, by virtue of a warranty deed recorded in Register of Deeds Office.
x 3 1 -4 1 0o
f'IATURE 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 deed
Slate Dar of Wisconsin Form 2 -- 1982
�50 v�JL WARRANTY DEEG
�1 _ CEG!JTt
DOCUMENT NO. VOL / PA`E�.�� ST. GRO: x Co., V11
James Barnett, a married man
t 10:00 A.
( conveys and warrants to "---John N. Heintz and Patricia J.
Heintz, husband and wife as survivorship marital
QroQerty _ _ — - - - -- - -
71115 SPACE nE SERVED rOn nECOD DING DAtA -
NAME AND RE 4 -- - -- - - - - r N ADDR
REINSTRA & VAN DYK, S.C.
II - -" -- _ - ---- - - - -__ - 201 South Knowles Avenue
the following described real estate In St_._ Croix I New Richmond, Wisconsin 54017
County, State of Wisconsin: I ,
038- 1088 -30 ;_ 038- 1088- 80;___ ;I
(Parcel Identification Number) 038 - 1089 -30 I'
and 038- 1089 -30 -110
I;
SEE ATTACHED SHEET
I� TRAM §FER
FEE
i
�6
1
This---is - not-- _._ -.__ homestead property.
(is) (is not) -
Exception to warranties: Subject to all easements, restrictions and covenants of record.
Dated this _ 2nd October 96
- - -_ - __ - -- - - -- day of _ _ - _ _ - -- -- - - -- _ _ - - - -- - • 19.
Ii i
l
I�
�" - - -- - _ (SEAL) _ _ - - -- .. - -- - _ (SEAL)
I �I
Y Barnett
-- -__ (SEAL) - - - -- - -- (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
i
i, Signature(s) JamesBarnett STATE OF WISCONSIN
ss.
County.
Huth cn)ic Icd this 2 nd day of October 19 96 Personalli came before Inc this __ __ day of
19 the above named
Hendrik W. Van Dyk _ ._---
TITLE: MEMBER STA'T'E IIAR OF WISCONSIN
(If not.
authorized by §706.06, Wis. Sots.) to me known to he the person who executed the
li _
foregoing instrument and acknowledge the same. -
�, THIS INSTRUMENT WAS DRAFTED BY
REINSTRA & VAN DYK, S.C. - --
- 201 Knowles Avenue
New Richmond, Wisconsin 54017
_ Notary Public County, Wis.
(Signatures may be authenticated or acknowledged. Both are not My commission is permanent. (If not, slate expiration dale:
necessary.) 19 )
•Nama•. a( pereon..ip.ing in ane e:q +aa'i1v .buulJ Ir ryprJ nr prinlcJ bete++ Their ciFnnlnrea.
WARRANTI DEEO STATE BAR 01' WISCONSIN W1sronsin t,q.�l Rlank Cn_ Inc.
FOR %I Nn. 2 — 19RZ Milwaukee. Wis.
ST. CROIX COUNTY
� WISCONSIN
ZONING OFFICE
N N N N N N N■ ����� ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
Hudson, WI 54016 -7710
(715) 386 -4680 Fax (715) 386 -4686
August 30, 2000
P.C. Collova Builders
Laurie Collova
705 County Trunk E
Hudson, WI 54016
RE: Septic Inspection for John Heintz located at 2114 Cook Drive, Circle "C"
(Lot 14), Star Prairie Township, St. Croix County, Wisconsin
Dear Ms. Collova:
A septic inspection of the above referenced property was conducted on 03/31/2000. This
property is located in the SE 1/4 NW 1/4 of Section 21, T31 R1 8W, Circle "C (Lot 14),
Star Prairie Township, St. Croix County, Wisconsin. At the time of the inspection, this
septic system was found to be code compliant for a three (3) bedroom home.
If you have any questions regarding this, please contact our office at (715) 386 -4680.
Sincerel
Jon Sonnentag
Zoning staff
/sm
cc: file