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HomeMy WebLinkAbout040-1285-10-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No INSPECTION REPORT 399410 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: Miller, Sam I Troy Township 040- 1285 -10 -000 CST BM Elev: r Insp. BM Elev: BM Description: &D .0 f M 'l1r,.., r - TANK INFORMATION U ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark t h -1 � � e,�se� 2t7O 1 �e 3.30 ya 3,3a Dosing Alt. BM e -� r Aeration Bldg. Sewer Holding St/Ht Inlet �3• S} 1 TANK SETBACK INFORMATION St/Ht Outlet 0 . 3 7 Q Z. Qe. TANK TO P/L WELL /LDP Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. • l t' Aeration Dist. Pipe • Ca. (O r Holding got. System Z •�� t ' O Z. �•91b Final Grade f�. p � 30f PUMP /SIPHON INFORMATION Manufacturer Demand St Cover S, GPM Model Num Z ;em System Head H Ft Length Dia. Dist. to well SOIL SORPTION SYSTEM() S Width Length No. O Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS -5 r 13, �' P.�► Z SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEACHING M ufact er, c INFORMATION Type Of Sy tey m: ( �S `- CHA UN OR Model N mber: 7 DISTRIBUTION SYSTEM 40 " �- Header /Manifold) it Dist ' ution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s �J 1 Length Dia 1 + Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of T77e�odded x Mulched Bed/Trench Center Bed/Trench Edges Topsoil ❑ Yes ❑ NIT ❑ Yes ❑ No COMMENTS (Include code discrepencies, persons present, etc.) Inspection Inspection #2: / Location: 499 Bauer Road Hudson, WI 54 (NE 1/4 NW 1/4 9 T28N R19W) The Orchard Lot 27 Par I No: 001.2 1615 1. Alt BM Description =/+ �'�^ _" _ � i � , ' ` 6 C 2.) Bldg sewer length - amount of cover = a 3 � e1v12 A • (� w P n revision Required? M Yes Use other side for additional information. Date Insepctor's Signature Cert. N SBD -6710 (R.3/97) Sanitary Permit Application Safety & Buildings Division In accord with Comm ^ - Wis,.Adm. Code 201 W. Washington Ave. Nvisconsin See reverse side for ins ops o cornplegrrg. his application PO Box 7302 Madison, WI 53707 -7302 Personal information you W;; {ide,tfray'bd usedrfor sec dary purposes Department of Commerce p ',v w, s. I5. 1 m (Submit completed forth to county if not 6' O )) state owned. Attach complete fans to the coun /c onl stem, on a ¢r n t less than 8 -I /2 x 11 inches in size. Count Star i ermit um r \ k if rc previous ppllcation State Plan 1. D. Number � l I. Application Information - Please Print all Info ma ion r Location: Property Owner Name � / Property Location /�7 / LL l—✓�— ` If .ti - /ILI /4/t'w1 /4,S T��N,It o W Property pwnees Mailing Address Lot Number Block Number City, State Zip Code r Subdivision Name or CSM Number b Z r. 9 T HF, O2 H AIe ❑ City II. Type of Building: (check one) Z<► A "� a g ❑ Village X 1 or 2 Family Dwelling - No. of Bedrooms: 7, 7 (T s Q N Town of 1 T QQ y ❑ Public/Commercial (describe use ):_ , S ❑ State -Owned - T s Nearest I>ioaa e - p RA 1�0� Parcel Tax Number(s) 41 / III. T e of Permit: (Checkpnly one box on line A. Check box on line B if applicable) 5 °� ' I 6. ❑Addition to A) 1. ew 2. Replacement 3. ❑ Replacement of 4. Existing System S stem S stem Tank Only Date Issued Permit Number B) ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) 3d �'1 a t �� ❑ Sand Filter ❑ Constructed Wetland Non- pressurized In- ground 4 XAe_ ❑ Mound ❑Sin le Pass ❑ Drip Line ❑ Pressurized In- ground ❑ l Iolding Tank g ❑ At- rade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) L. Dispersal Area TF a 4. Soil Application 5. Percolation }tale 6. System Elevation Elevation G rade Required ��� Rate (Gals! /sq. fiJ (MinJinch) t i 0 S b a . /.2 q /. Dd 9 G VII. T ank Capacity in Total # of Manufacturer Pre! ,b Site Steel Fiber- Plastic Gallons Gallons Tanks Con- Con- gl Information crete strutted New Existing Tanks Tanks ❑ ❑ ❑ ❑ ff I � VIII. Responsibility Statement 1, the undersi� res onsibility for installation of the POWTS shown on the attached pla pusinc Phone Number 1'lumbcr's Si nature no s M11P/hiPRS No + �� ' 961F Plumtxr's ­ Na {print) ( ) f. � r — 3 B A L rt�l ( � �� t7 Z S � cp Plumhcrs Address (Street, City, State, Zip Code) � D b 7 a T 1X. County /Department Use Only Santa Permit Fee (Includes Groundwater Date Issued ng Agent Si t (No stamps) Approved ❑ Disapproved n' _ ❑ Owncr Given Initial Adverse Sur rarge , n Determination LL'�' L� X. Conditions of Approval /Reasons for Disapproval: I appro; al: ltt tS S r� �I IT r ct L.PIA ac 3 t i 1 a s r� u r� i i r W E Z CA I, a a s lot 1 � k 'q (- Ir / 0 t,T �peN- S ca t a s ,r� 1399 Wisconsin Department of Commerce SOIL EVALUATION REPORT page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Sal & Site Evaluations Aktach complete site plat on paper not less than 8% x 11 inches in size. Plan must County St. Crobc include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. 040- 1039- 60 -000,1D#9.28.19.132 p /ease pfigt eN infotmatfon. D Personal nformadon You provideinycbq used for (Privecy L.dw, s. 15.04 (1) M). . 2 I Property Owner Y Property Location Miller, Sam , � G ovt. Lot NE 1M NW 19 S 9 T 28 N R 1 W Property Owner's Mailing Add re s �� h ip !Lot # 1 Bkx lc # Subd. Name or CSW P.O. Box 151 ���� N� 21 I Plat Of Miller's Orchard City 6*,,Zp Code umreer , , f J City Village ✓ Town Nearest Road Hudson Wf , -; 40afi (71 Troy Bauer Road t New Construction Use Res of bedrooms 4 Code derived design flow rate 600 GPD Replarernent _j Public or commercial - Describe. Parent material Glacial outwash Flood plain elevation, if applicable na General comments and recornirneind0tions: Recommend installing 2 trenches at Tx 90.625', using 29 high capacity BioDiffuser infiltrator chambers at system elev. = 91.00'. Boring # II' Pit Ground surface elev. 97.18 ft. Depth to iimfing factor >129" in. Soli Application Rate Horizon Depth Dominant Color Redox Description Texture Structure I Consistence Boundary Roots PD Eff#1 1 0-8 1Oyr2/1 none sl 2fsbk mvfr gs 21' 0.5 0.9 1 2 8 -16 1Oyr3/3 none - sl -- - 2fs bk mvfr cs 1f 0.5 0.9 a� - 3 16 -25 1Oyr4 /3 none sl 2msbk mfr cs 0.5 0.9 4 25 -34 7.5yr4/6 none Is O ml gs - 0.7 1.2 5 34 -76 10yr5/6 none s _Osg ml cs - 0.7 _ 1.2 6 76 -100 10yr5/4 none s Osg ml gs - 0.7 1.2 7 100 -129 1Oyr6 /4 none s - Osg ml - - 0.7 0.8 o Boring # I Boring 01 Pit Ground surface elev. 96.69 it Depth to limiting factor > 132" in. Soil Application Rate Horizon Depth Dominant Cola Redox Description Texture Structure Consistence Boundary Roots GPM -Eff#1 1 0 -12 1Oyr2 /1 none sl 2fsbk mvfr gs 2f 0.5 0.9 2 12 -20 1Oyr3/2 none sl 2fsbk mvfr Cs 1f 0.5 0.9 (� 3 20 -36 1Oyr413 none sl 2msbk mfr Cs - 0.5 0.9 (� 4 36-41 1Oyr4/6 none Is Osg ml g s - 0.7 1.2 5 41-83 10yr5/6 none s Osg ml cs - 0.7 1.2 6 83 -132 1Oyr5 /4 none s Osg m - - 0.7 1.2 ' Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 1450 mg1L -PVSgt#2 = BOD <30 mg/L and TSS <,,30 mg/L CST Name (Please Print) Signal CST Number James K. Thompson �---_ 3602 Address A.C.E. Sal & Site Evaluations ate Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020 4/23/01 715- 248 -7767 /399 Properly p,,,,nar MIW, Sam Parcel ID # x-1 60-000, ID #9.28. 19.132 Page 2 of 3 D BWng# Boring V' Pit Ground Surface elev. 95.26 ft. Depth to luniting factor > 126" in. Soil Appkation Rate Horizon Depth Dominant Cola Redox Description Texture Structure Consistence Boundary Roots GPDIr " Eff#1 'Eff#2 1 0 -19 1Oyr2 /1 none SO 2fsbk m vfr as 2f 0.5 0.8 2 19 -27 1Oyr312 none sil 2fsbk mfr cs 1f,vf 0.5 0.8 3 27 -36 1Oyr4 /4 none sl 2msbk mfr as 1vf 0.5 0.9 4 36-47 1Oyr4/4 none Is Osg ml cs - 0.7 1.2 1ZI 5 47-87 1Oyr5/6 none s Osg ml gs = 0.7 1.2 6 87 -126 1Oyr5 /4 none s Osg ml 0.7 1.2 4 ] F Boring # Boring Y' Pit Ground Surface elev. 95.28 ft. Depth to limiting factor >121'-- in. Sod Application Rate Horizon Depth Dominant Cola Redox Description Texture Structure Consistence Boundary Roots 'Eff#1 'Eff#2 1 0 -23 1Oyr2 /1 none I 2fs mvfr as 2f 0.5 0.8 2 23 -31 1Oyr3/2 none so 2%bk mfr cs 1f,vf 0.5 0.8 3 31 -37 1Oyr4/3 none sl 2msbk mfr as 1vf 0.5 0.9 4 37-48 1Oyr5 /4 none Is O ml cs - 0.7 1.2 5 48-85 1Oyr5/6 none s Osg ml gs - 0.7 1.2 6 85 -121 1Oyr5/4 none s Osg ml - - 0.7 1.2 F - sI Bori # _j Boring JIM Pit Ground Surface slay 96.18 ft. Depth to limiting factor > 120" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots "Eff#1 "Eff#2 1 0 -11 1Oy /2 no ne sl 2fsbk mvfr gs 2f 0.5 0.9 2 11 -17 1Oyr4/3 none sl 2%bk mvfr cs 1f 0.5 0.9 3 17 -25 1Oyr4 /4 n one sl 2msbk mfr cs - 0.5 0.9 4 25 -31 7.5yr4/6 none Is Osg ml gs - 0.7 1.2 5 31 -52 1Oyr5 /6 none s Osg ml cs - 0.7 1.2 6 52 -120 1Oyr5/4 no s Osg ml - - 0.7 1.2 EfftueM #1= SM ? 30 < 220 mg& and TSS >30 < 150 mg& ' Effluent #2 = SM <30 mg& and TSS <-0 mg& 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. Orc4av - r Se.c. 9, Tn . off' 7 ■ 50� 1ir7ee 4 e- (;, o z� ,Za7 , r(a;l B n ch : 7 { 0 6 �jcb4/'. w000ten -ocenee Assumed ¢ICS _ /v0. E1ev: = /o3 .w ■ es d/ C o- C 4F ■ 17 a3 c ■ az 9S. o' cc -hour 97.0' Joint dri�ewq� easement 5 417 p t c H Ape Y) a�-N � ST al Bi oDiffuser• - • • 76" OD OO �f� OO OD DO DD OO OD OD OO OD OO �0 OO OD OO OD DO OD OO OD Chamber 00 0o OD DO OD DO OD DO DO Height 00 00 0[ 00 00 00 00 I 00 I ( 0 00 00 00 0o Qo o ao 00 A rse BioMuser sizes can - WMISland M -10 k" when (nslaled Wdh KOWY Wa Chamber OFW 496dod SOW Amu* Height req M*.140 k T119 End View 1 � at #o► H r 20 loads•' A of 18' of cover is 34° i r *quit ,%kr- M•29 toads. 4" Knockout 4 Universal End Cap Avcdlable Sizes ' 1191 14 High 16 High Length 76" 76" 76" Width 34" 34" 34" Height 11" 14" 16" v Invert 6.5 9 11.3 10 Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity in- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters 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 Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number Number of Bedrooms Design Flow - Peak (gpd) Estimated Flow - Average (gpd) cD CY Septic Tank Capacity (gal) R z S� Soil Absorption Component Size (ft 5 Type of Wastewater Domestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) (" C <' Maximum Influent Particle Size (in) 5 0_) 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall 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 se and outlet filter shall be assessed at least once every 3 years by inspection. Tkfe outlet filte shall be cleaned as necessary to ensure �" proper operation. The filter cartridge should not be removed i.anless provisions are made to - retain solids in the tank that rnay slough off the filter when removed from its enclosure. If the I _ Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. ins Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component 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 longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified 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. m Traffic around or over the soil absorption component should be avoided particularly Y during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or conditions improve. In general, soil compaction impossible to repair until weather p g action over this p ad to component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead more intense, and earlier, organic clogging of the soil. 2 • Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep- rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. p 41 - L� C' -����� � �✓D [J S � . r . 1 ZZ 7 3 f 7 /S" 3gb" �tP�a 3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION 0ORM OwnerBuyer Mailing Address 4Sax r Propetty Adams .4vC,2._ (Verification japired from Planning Department for new construction) City/Stt .H y 0 S C— w V Parcel Identification Number i t rr _ w_L DFSC=ON I /� Property Location '/•, GL / /•, Sec ._, T Z�? N -R Town of IZ D PAY , abdividon _�/'� �' D c h A ILA . Lot # � Cerdtled Survey Map # �$ 3 too , Volume Page # -5 _.� Warranty Dad # �� 3 7 �° . Volume S. Page # Spot house yes 0 no Lot lines identifiable yes 0 no Iun wqW use and maintenaaoeof "W septic system could result in its premature failure haadl was�o .. puProper system consists of pumping out the septic tank every three years or sooner, if needed b a licensed pumper. can aifg� 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 ma:terPlum1w• 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 sep tic tank is less than 1/3 fttll 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 statin 8 that your septic system has been maintained must be completed and returned to St. Croix County Zoning Office within 30 da f the three year ex irctio ICy�/ DATE TURE O#APPLICANT t knowledge. I we am are the �dwner(s) of .i ;•(we) certify that alt tements on this form are true to the best of my (our) B • ( ) (are) de bona rtue of a warranty deed recorded in Register of Deeds Office. i DATE ­W(M ATURS 6MPPLICANT 0.400• Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Deputment. 0000•• nty deed ftom the •• Include with this application: a cpy the cert fied survey map R made in the warranty deed .p STATE BAR OF WISCONSIN FORM 7 - 1998 632796 TRUSTEE'S DEED KATHLEEN H. WALSH REGISTER OF DEEDS vui 1555PAGE323 ST. CROIX CO., WI _..... DANIEL S. SOLBERG AND KARLA J. SOLBERG RECEIOEI FOR IECORI 11-01-2000 8130 AN TRUSTEES 10 as Trusteed EXEII•T 1 SOL BERG DANIEL S. KARLA J. SOLBERG REVOCABLE CERT COPY FEE: CORY FEES _ TRANSFER FEES 2110.30 RECORIII6 FEES 10.01 for a valuable considerstlon conveys without warranty to PAGES' 1 SV E. MILLER, A SINGLE PERSON Racpoep Area the following described real estate In County. ; eltd ReItrIl Address State of Wisconsin: SAM MILLER P.O. BOX 151 PART OF.THE NWk OF THE NWk AND THE SWk OF THE NWk AND THE HUDSON. WI 54016 NEk OF THE N* AND THE NWk OF THE NE AND THE NWk OF THE SWk OF SECTION 9, TOWNSHIP 28 NORTH, RANGE 19 WEST, TOWN OF TROY, ST. CROIX COUNTY, WISCONSIN AND MORE PARTICULARLY.-­­­­ DESCRIBED AS FOLLOWS: BEGINNING AT THE NORTHWEST CORNER OF 040 - 1038 -60 040 - 1039 -60 -000 SAID SECTION 9, THENCE 500 "E ALONG THE WEST LINE OF 040 - 1039- 70 -finn SAIDNA 2626.30 FEET TO THE WEST QUARTER CORNER OF SAID Prod Iatlueation NI,nIDM (tea SECTION 9; THENCE S00'45 "E ALONG THE WEST LINE SWk OF SAID SECTION 9 150.31 FEET: THENCE S56'24'38 "E 70.00 FEET: THENCE N59 11 E 850.85 FEET THENCE ON AN ARC OF A CURVE TO THE RIGHT 102.10 FEET AND WHOSE RADIUS IS 403.00 FEET AND CHORD BEARS N07 "W 101.78 'FEET; THENCE NOO'21'49 "E 569.05 FEET; THENCE S88'45'38 "W 250.00 FEET; THENCE N00'SO'54 "W 350.92FEET; THENCE S88'57'07 "W 512.29 FEET; THENCE NOO'50'54" 100.00 FEET; THENCE N88 "E 250.31 FEET; THENCE NO3'10'51 "E 202.31 FEET; THENCE N32'19'49 "W 95.25 FEET; THENCE NO2'24'54 "E 136.96 FEET; THENCE S87'34'25 "E 198.63 FEET; THENCE SO1'54'33 "W 149.41 FEET; THENCE N89'46'50 "E 148.76 FEET; THENCE S2'27'16 "W 256.95 FEET; THENCE N88'37'07 "E 1065.55 FEET; THENCE N89'12'30 "E 325.61 FEET; THENCE S00'47'30 "E 10.00 FEET; THENCE N89'12'30 "E 554.46 FEET; THENCE NO1'23'32 "E 587.22 FEET; THENCE N55 "E 651.90 FEET; THENCE N38 "W 413.25 FEET; THENCE S89'31'02 "W 142.03 FEET TO THE NORTH QUARTER CORNER OF SAID SECTION 9; THENCE 589'12'35 "W ALONG THE NORTH LINE OF THE NWk OF SAID SECTION 9, 2666.45 FEET TO THE POINT OF BEGINNING, SAID PARCEL CONTAINS 96.52 ACRES AND IS SUBJECT TO ANY EASEMENTS OR RESTRICTIONS OF RECORD. :I I Dated this ay of OCT OBER 2000 L�z &o. I DANIEL S. SOLBER KARLA J. SOLBERG yow Than - i AUTHENTICATION ACKNOWLEDGM1 NT SwraW Q State of Wisconsin, C01 u �P�tpt>Ally nmt brae n,e tau: ay of is authenticated this day o f the above named TITLE: MEMBER STATE BAR OF WISCONSIN V to . (If riot. me known to be the person L who executed the foregoing authorind by $708.06. WIS. SUM) trument and acknowledge the THIS INSTRUMENT WAS DRAFTED BY 1 H EYWOOD& CARL S.C. 204 LOCUST STREET i _ S"am. of WISCOA HUDSON, WI 54016 Notary Public. State of Wisconsin My commisslon Is rm I peanent. (If I. state expiration ate: dp (Signatures may be authenticated or acknowled. Both era not �-- ( � ) necessary) • tl,mr of pa m ,IO "m ry cwKAy mum be typoe or prw4od b* m ,Iry ei#,Au . . STATR BAR OF WISCONSIN w"mrn atom ow* ce . tm TRUSTEE'S 06E0 FORM No. 7 - Im ra.e.Ar. we I A LO / g wy R� \ 4ti ,^ NAlt ; 1 y _ .�. 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(l. ^'• N.B. 2.71 AC./ v` C. rl I i N w N.B. 11810j � sq. ft. i O I y OC L < j ,n Uj 63.34' I�tYip it 5 3931'3 "E 1O ,� JOINT DRIVEWAY V 00 I i 33.00' u n.sr s s ...... E 1T W ` / w 66' EA 2 .� �\ v _ -- - --��33. S 6 '04'25" W // / / / / // // 44f 't 33.00 t � • I / 1 `, /tip' S 6 QQ %/ / / "LOT 19 / y 3 139 238119 Sq. Ft. \ 3.20 Ac Ft. . A �\ \ �\ 5.47 Ac. r F ' a �r \ N.B. 1.75 AC. \ \ t TEMPORARY CUL-DE-SAC N.B. 76420 sq. ft. \\ V1 EASEMENT (REMOVE UPON NORTHERI EXTENSION OF Lr J� 1 NIP ROAD) N.B. 2�ia Avg \ o = 908.00 0 , a G \ N.B. 1 104219 sq, ft. 4� _ S E9'43'28 W Q it. J > N 67. 46 .''1 7' 24 w " \� ° ,15586 '= LOT 17 \\ \ L. Tv`ei Ft. 13 _ 6 \ t 2.65 c. f } �1 Sq. Ft. A a 5 N.B. 11111.23 AC. IE DRAINAGE -49 AC. 2.62 AC. O N.B. 53r89 sq. ft. }3R I II E '° x11 914 sq. ft. o�) p I —� of �J- B� f • - ' ' m e oeauTEO TO I 1$ lu 517.28' N 8703'12' E DETAIL A •. ' " THE Kftx N+oa O 2u.65' NOT TO SCALE 414_66' J N xxzeY u - -- - I LOT 16 - - — - — - — - — - - —J rn f 111953 Sq. F to.0o' o 2.57 A�./ w 292.00' 33 N.B. ".44 AC. ELEVATON " 33' I N.B. '09 AC 11 . 46 a I IJOIN -� N.B. 47 87 s . it.l iD H M a' L T14 Sts.7B• HIGHWAYSETEIACK N Z I MIN. FILL S 7917 >t 109006 Sq. Ft. I ELEVATION - J 34• E Z AS PER WISCONSIN ADMINISTRATIVE CODE TRANS 233 NO IMPROVEMENTS OR t. 2.50 AC. ° °- ­Ow a =�' / STRUCTURES ARE ALLOWED BETWEEN THE RIGHT -OF -WAY AND THE SETBACK V 1 1 1 VIN. FINISHED N w I ♦ I + FLOOR ( N LINE IMPROVEMENTS INCLUDE BUT ARE NOT LIMITED TO SIGNS, PARKING LOTS, ' wi i N DRAINAGE •N � I N N w � � PARALLEL DRIVEWAYS. WELLS, SEPTIC SYSTEMS, DRAINAGE FACILITIES. ETC.. IT y N.B. 106220 sq. ft. I m I I a 910.00 LOT 15 00 BEING EXPRESSLY INTENDED THAT THESE RESTRICTIONS SHALL CONSTITUTE A j y L I I N 1,o I ; L0 RESTRICTION FOR THE BENEFIT OF THE PUBLIC ACCORDING TO SEC. 236.293 WISCONSIN STATUTES AND SHALL BE ENFORCEABLE BY THE DEPARTMENT OF i 3 N TRANSPORTATION. CONTACT THE WISCONSIN DEPARTMENT OF TRANSPORTATION + e 137900 Sq. Ft. / a. 1 3.17 AC. / / / DISTRICT OFFICE FOR INFORMATION. THE PHONE NUMBER MAYBE OBTAINED BY SEE DETAIL A I i / CONTACTING YOUR COUNTY HIGHWAY DEPARTMENT. N.B. 1.01 AC. 292..0' I I I N.B. 43901 sq, ft. -- - - - - - - - - - - - -- 493.90' N 8912'30" E o r - 325.61' N89'12'30 "E _ — — — _ — — — — — — — a 554.46' N89'12 30 E 0 COUNTY HIGHWAY FF m ----------- ----- - - - - -- P 10.00 S00'47'30 "E � I I I I I I DRAFTED BY. JASON PALWNER SHEET 1 OF 3