HomeMy WebLinkAbout040-1244-20-000 County Sanitary Permit Application ST.CROIX COUNTY WISCONSIN
In accord with Chapert 12 St.Croix County Sanitary Ordinance PLANNING&ZONING DEPARTMENT
Personal information you provide may be used for secondary purposes ST.CROIX COUNTY GOVERNMENT CENTER
adfte le [Privacy S 1 ] 1101 Carmichael Road
o t- Hudson,WI 54016-7710
t'. '� (715)386-4680 Fax(715)386-4686
Attach complete plan forjh&_%wt^^ A l9aper not less than 8-1/2 x 11 inches in size.
G�rp%n y Sanitary Permit# ❑ Check if revision to previous application 'l
ll� 7 ��— �� ,° 11�ts fl�'Uv
I. Applicati at -Please Print all Information Location:
Property Ow me Sl. 7c,
/ 1/4 P`✓ 1/4,Sec
/Z i L 4 SGT'�d yl/1 T 29 N, R -Fa(e�r
Property Owner's Mailing Address Lot Number Block Number
2.Z 12 � � e /?�44e. /
City,State Zip Code Phone Numer Subdivision Name or CSM Number
it Type of Building: (check one) Mity []Village Town of
1 or 2 Family Dwelling-No.of Bedrooms: f /- Gw`
❑ Public/Commercial(describe use): ;?i ���
❑ State-owned hz �-11Neare t Road
II.Type of Permit: (Check only one box on line A. Check box on line B if applicable) r/- 27.9cf
PaW l lax Number s)
A) 1.0 Repair 2 3.❑Non-plumbing 4.❑Rejuvenation Dye /?y�_P p vV
Sanitation
B) Permit Number Date I ued
State Sanitary Permit was previously issued 39S/Qj 3 /;z 60�
IV.Type of POWT System: (Check all that apply)
Z'Non-pressurized In-ground ❑ Mound? 24 in.suitable soil ❑ Mound<_24 in.suitable soil ❑ Mound A+0
❑ Sand Filter ❑ Constructed Wetland ❑ Peat Filter ❑ Drip Line
❑ Pressurized In-ground ❑ Holding Tank ❑ Single Pass ❑ Other
❑ At-grade ❑ Aerobic Treatment Unit ❑ Recirculating
V.Dispersal/Treatment Area Information: �/u � a L- - [" F!/ L f% /��� � `� C�•
1.Design Flow(gpd) 2.Dispersal Area 3.Dispersal Area 4.Soil Application Rate 5.Percolation Rate 6.Sys evation 7.Final Grade
Required f P ? Gals./day/ ft. Min./inch Elevation
V V q
VI. Tank Information Capai y in Gallons o al #of Manufacturer Prefab Site Con- Steel Fiber- Plastic
New Existing Gallons Tanks Concrete structed glass
Tanks Tanks
❑ ❑ ❑
❑ ❑ ❑ ❑ ❑
VII.Responsibility Statement
I,the undersigned,assume responsibility for repair/reconnenction/rejuvenation/installation of non-plumbing for the POWTS shown on the attached plans. A
license is not required for terralift repair or the installation of non-plumbing sanitation system.
Plumb is Name(print) Plumber's ig ature(no stamps): MP/MPRS No. Business Phone Number
Plumber's Address(Street,City,State,Zip Code)
VIII.County Use Only
— // Disapproved Sanitary Permit Fee Date IsJ�ued Issuing Agent ignat; re( st ps)
p/Approved Owner Given Initial Adverse ` �= / ^/��I2��
ttt!///!
Determination
IX.Conditions of Approval/Reasons for Disapproval: ( / - /h 2-Ur' Za✓ L' 7
SYSTEM OWNER: LJ J)✓-, /!'// �j�'a f��%
(
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1.Septic tank,effluent filter and �� ? �� .� ��1-7 11
dispersal cell must
as per management t plan provided by plumber.
2.All setback requirements must be maintained i ,1j �� ' �?� 4 2
as per applicable code/ordinances.
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Document Number Document Title
1002402
St. Croix County BETH PABST
REGISTER OF DEEDS
Occupancy Affidavit ST. CROIX CO., WI
RECEIVED FOR RECORD
(� & J 10/fl2/2014 2:32 PM
(�/ �t i� ,3Gjh �L,/f� EXEMPT#:
T Name — (Owner) Typed or printed RE PAGES:FEE:
being duly sworn , states, under oath, that: PAGES:: I
He/she is the owner/part owner of the following parcel of land located in St.
Croix County, Wisconsin, recorded in Document Number 1002089 at the St.
Croix County Register of Deeds Office: Recording Area
A parcel of land located in the SE'/ of the NW '/ of Section 19, T28N, Name and Return Address
R 19 W, Town of Troy, St. Croix County, Wisconsin, being duly described `RTciia" ,Sap4g44st
as follows (include lot no. and subdivision/CSM or detailed legal 2v-)140)
description):
Lot 1, Plat of Troy Village in the Town of Troy, St. Croix County, Wisconsin 040-1244-10-000
Parcel Identification Number(PIN)
As owner of the above described property, I acknowledge that the private onsite wastewater treatment system
(POWTS)serving this residence is sized for a 2_5 bedroom home or a design flow of 371.7 gpd. Design wastewater
flow(DWF) is calculated assuming 150 gal./day for 2 individuals/bedroom. A maximum of five(5)occupants are
permitted based on the DWF; there are currently_occupants living in this residence. Therefore the POWTS serving
this residence is code-compliant at this time. However, I understand that if the number of finished bedrooms or the
number of occupants exceeds the DWF, the POWTS may be subject to premature failure and/or will need to be
modified to accommodate the increased wastewater flows and/or contaminant loads. I also acknowledge that I will
make this information available to any future parties interested in purchasing this property.
Dated this /S� day of
* �.z• . f oy.ot, .S4�.o�t;it�
A ,HENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN )
)ss.
authenticated this day f St.Croix County. )
Y P rsonally came before me this_�day of ,
ZD 1 the above named
'� 'vin0,i,r!'! s �dra���.l- r.►-- �bla.rnyi
*
ac.A^Q( I)l!4
TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s)who executed oing
(If not, instrument and cknoxvle WA'dSaM: Komro
authorized by§706.06,Wis.Stats.) HHN��TT110caiT�i�iAtuaRttllY PUBLIC
THIS INSTRUMENT WAS DRAFTED BY:
Pamela Quinn. Land Use Specialist STATE OF WISCONSIN
Community Development Department
I ro
Notary Public,State of Wisconsin
(Signatures may be authenticated or acknowledged. Both are not My Commis ion is permanent. If not,state expiration date:
necessary.) Date: a�7 1 I LP
"THIS PAGE IS PART OF THIS LEGAL DOCUMENT—DO NOT REMOVE"
This information must be completed by submitter: document title.name&return address.and PIN(if required). Other information such as the granting
clauses,legal description,etc.maybe placed on this first page of the document or maybe placed on additional pages of the document.Note: Use of a cover
page adds one page to your document and to the recording fee. Wisconsin Statutes,59.43.
ST.CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
J OWNERSHIP CERTIFICATION FORM
Owner/Buyer L�,�2�J 9- �I Alec ,l nl 4?r/%�
Mailing Address
Property Address
(Verification required from Planning&Zoning Department for new construction.)
City/State Parcel Identification Number/-0T l /;LZA T a 1(
�N, J vt✓���-T-1-CT-1-C)LEGAL DESCRIPTION CA 0 Ls4
—
Property Location 15C i/a, 4VVY4, Sec.-'T 1-D Ai RiftW,Town of
Subdivision O F i2c)'� yl llc�E Lot#�.
Certified Survey Map/# Volume ,Page#
Warranty Deed# ! �� 2-® � / , Volume , Page#
Spec louse yes no Lot lines idelitillabregno
SYSTEM MAINUNANCE AND Q MER CERTIFICATION
Improper use and maintenance of yaw septic system could result is its premature failure to handle wastes. Proper
inaintenanoe consists ofpumping out flue septic tank every three years or sooner,ifnwded,by a licensed pumper. What you put into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance
responsibilities are specified in§Comm.83.52(1)and in Chapter 12-St Croix County Sanitary Ordinance.
The property owner agrees to submit to St Croix County Planuzing&Zoning Department a certification forth,signed by the
ovvuar 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 andior(2)after inspection and pumping(if necessary),the septic tank is
less than 113 full of sludge.
Uwe,the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the
staisdards set forth,herein,as set by the Department of Commerce and the Department of Natural Resources,State of Wisconsin.
Certification stating that Sour iieptic system has been maintained must be completed and returned to the St.Croix County Planning&
Zoning Department within 30 days of the three year expiration date.
Uwe certify that all statements on this form are true to the best of my/our knowledge. I/we amlare the owners)of the
property described above,by vkMe of a warranty deed recorded in Register of Deeds Office.
Number of bedrooms 3
C-
SIGNAVM OF APPLICANT(S) DATE
'Any information that is misrepresented may result in the sanitary permit being revoked by the Planning&Zoning Department.**'�
include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed
(REV.08105)
START UP AND OPERATION Page ?, of
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals
that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents
of the tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at-grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or.must be taken, to provide a code compliant
reTsystem.ent system:
A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS
,,/ technology a holding tank may be installed as a last resort to replace the failed POWTS.
1`r/lb T
aluati
be e ai e �ZD!-1i�37i�� �Dl�/�/$1�✓ �NS`TR(!G?1pank
❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
<<WARNING> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTAALLER` POWTS MAINTAINER
Name Cv�1J Sid C LU t3//V '- Name
Phone �0 Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name /
Name Name s'T' CQ) ( 0VN 20AIIXJ
Phone Phone -71S- 3W(I"— (A��
This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code.
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page ! of 2
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner j�, , /� V/ S T Septic Tank Capacity 12—00 gal ❑ NA
Permit —�U Septic Tank Manufacturer /��� El NA
DESIGN PARAMETERS 3 �� 3 Effluent Filter Manufacturer (/JCfxAJOUJ --- ❑ NA
Number of Bedrooms ❑ NA Effluent Filter Model V�� ❑ NA
Number of Public Facility Units F1D4V1TFN_A Pump Tank Capacity gal ❑ NA
Estimated flow (average) y�v gal/day Pump Tank Manufacturer ❑ NA
Design flow (peak), (Estimated x 1.5) �(�(� gal/day Pump Manufacturer ❑ NA
Soil Application Rate '2 Z gal/day/ftz Pump Model ❑ NA
Standard Influent/Effluent Quality Monthly average* Pretreatment Unit ❑ NA
Fats, Oil & Grease (FOG) :_30 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BOD5) :_220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) :5150 mg/L ❑ Disinfection ❑ Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BODS) 530 mg/L ❑ In-Ground (gravity) ❑ In-Ground (pressurized)
Total Suspended Solids (TSS) :530 mg/L 'b(NA ❑ At-Grade ❑ Mound
Fecal Coliform (geometric mean) :_10° cfu/100ml ❑ Drip-Line ❑ Other:
Maximum Effluent Particle Size Y. in di) ❑ NA Other: ❑ NA
Other: ❑ NA Other: ❑ NA
*Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every: ear()(s) (Maximum 3 years) ❑ NA
Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA 0 month
Inspect dispersal cell(s) At least once every: 3 dear(►(s) (Maximum 3 years) ❑ NA
Clean effluent filter At least once every: ❑ th(s) ❑ NA
ear(s)
Inspect pump, pump controls & alarm At least once every: ❑ month(s) NA
❑ year(s)
Flush laterals and pressure test At least once ever ❑ month ar(s) ) AA
Other: ❑ month(s) ❑ NA
At least once every: ❑ year(s)
Other: ❑ NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank
inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface.
The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding
of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-third (Y3) or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment
units, and any servicing at intervals of_<12 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
State Bar of Wisconsin Form 1-2003 8 Tx54211605
WARRANTY DEED - 1002089
BETH PABST
Document Number Document Name REGISTER OF DEEDS
ST. CROIX CO., WI
THIS DEED,made between Les J.Webster 09/25/2014 12:17 PM
EXEMPT#: 17
CGrantor,"whether one or more), . REC FEE: 30.00
and Richard Sandquist,and Sharon Sandquist,husband and wife PAGES: 1
("Grantee,"whether one or more).
Grantor,for a valuable consideration,conveys to Grantee the following described real LRec g Area
estate,together with the rents,profits,fixtures and other appurtenant interests,in
St.Croix County,State of Wisconsin("Property")(if more space is Return Address
needed,please attach addendum): D .SAN d u15Lot 1,Plat of Troy:Village in the Town of Troy,St.Croix County,Wisconsin (� (�-�v J2 bV � w►>� $5 1 y 1
This deed is in satisfaction of that Land Contract.dated March 1,2014 and recorded 040-124410-000
April 28,2014 as document 995268 in the office of the St..Croix County Register of Parcel Identification Number(PIN) .
Deeds
This is not homestead property.
(is)(is not)
Grantor warrants that the title to the Property is good,indefeasible in fee simple and free and clear of encumbrances except:
Easements and restrictions of record
Dated August 26,2014
(SEAL) (SEAL)
*Les J.W bst r
(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN JUDY L. DANNA
authenticated on St.Croix COUNTY OTARY PUBLIC
STATE OF WISCONSIN
t Personally came before me on August 26,2014 ,
the above-named Les J.Webster
TITLE:MEMBER STATE BAR OF WISCONSIN
(If not, to me known to be the person(s)who execuied the foregoing
authorized by Wis.Stat.§706:06) instrument and acknowledge a same.
THIS INSTRUMENT DRAFTED BY:
Les Webster Notary Public,State of Wisconsin I
Hudson,Wisconsin . My Commission(is permanent)(expires: J`/ ZoROf1101 )
(Signatures may be authenticated or acknowledged. Both are not necessary.)
NOTE:THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED.
WARRANTY DEED ®2003 STATE BAR OF WISCONSIN 'FORM NO.12003
•Type name below signatures.
St.Croix County 1002089 Page 1 of 1
C P / County:
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM St. Croix
Safety alnd Building Division
INSPECTION REPORT Sanitary Permit No:
383853 0
�eNERAL 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:
Troy Development Cor oration I Troy Township 040- 1244 -20 -000
CST BM Elev: Insp. BM Elev: BM Description:
/ T
Co. 0 t M. o - =CST 6w1
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
2 qv
Septic Benchmark t k t
102 - q16 00.0
Dosing Alt. BM
Og
Aeration Bldg. Sewer S , t� 8.33 Qq 13 /
Holding St/Ht Inlet 1 1 2,
4
• �'�) 43
•zq
TANK SETBACK INFORMATION St/Ht Outlet t� z � 7 o qZ - }St
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic f ( �' t Dt Bottom
13 tv Dosing 4P/L_ Header /Man. l3 Z z 13. •fi
Aeration Dist. Pipe 13` ek' 335 (1 f r
Holding Bot. System ;.. I Z �� • O
Final Grade
PUMP /SIPHON INFORMATION �1• Z
Ma ufacturer Demand St Cover sut
GPM r
Model N er
TDH Li 541tion Loss System Head DH Ft
rcemain Length I DI Dist. to Well
SOIL ABSORPTION SYSTEM AlrW
BEDITRENCH Width Length t No. O Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS t 3 a
SETBACK SYSTEM TO P/L JBODG IWELL LAKE/STREAM LEACHING Manufact re
INFORMATION T e Of S stem: CHAMBER OR ER* YP Y � / n � / � UNIT Model Number.
FJ
DISTRIBUTION SYSTEM 7 ))p C P1 4
Header /Manifold t Distribution x Hole Size x Hole Spacing Vent to Air Intake
Pipes) 7 A 5 /
Length Dia Length cing 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
0 Yes ❑ No ❑ Yes [W No
COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: 0 4 1 /1Rj O�_ Inspection #2:
Location: 333 St. Annes Parkway Hudson, WI 5400 ((SE 1/4 NW 1/419 R19W) Tro Villa a Parcel No: 19.28.19.1244
1.) Alt BM Description
2.) Bldg sewer length
- amount of cover 6.4 Lk
Plan revision Required? ❑ Yes No
Use other side for additional information.
SBD -6710 (R.3/97) � 1� . ��� In � eoes sep Signature Cert. No.
C�-S
�7-3
3 3 3 S 7 A-ojiu6s Qp, . v wr4y Sanitary Permit Application Safety Buildings Division
In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Washington Ave.
See reverse side for instructions for completing this application PO Box 7302
VISConS l n Personal information you provide may be used for second purposes Madison, WI 53707 -7302
Department of Commerce p [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not
state owned.)
Attach complete plans (to the county copy only) for the system, on paper less than 8 -1/2 x 11 inches in size.
County State Sanitary Permit Number ❑ Check if revision r i u is State Plan I. D. Number
C ruet 39'3 5S3 -_
I. Application Information - Please Print all Information H AL�t tion:
Property Owner Name 1 ��� v / CQ y Location /d
P 9 ,0 I i P -- / 1 C L /4/1` ( �4, St 7 T 81 (or) W
Property er's Mailing Address - K -, 71 1 mber Bl ock Number
cRcqX
City, State Zip Code Phone / r ZONING OFFICE �Spb on Name o C Number
II. Type of Building: (check one) ( ❑ City
E 1 or 2 Family Dwelling - No. of Bedrooms: ❑ Village
Public /Commercial (describe use):_
Town of
❑ State - Owned - Arc - 1 \11-
Nearest 4a
Parcel Tax umbers)
� > 3 � x R3 - 7-s �� �s
III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) 167. 2 j of
A) 1. RWew 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to
System System Tank Only Existing System
$) Permit Number Date Issued
❑ A Sanitary Permit was previously issued
IV. Type of POWT System: (Check all that apply) . — in
❑ Non - pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland
❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line
❑ At -grade / � ❑ AerobicTea ent Unit ❑ Recirculating ❑ O �
u tJ`c
V. Dispersal/Treatment Area Information:
1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application. 5. Percolation Rate 6. System Elevation 7. Final Grade
Required Proposed R ( —./day/g — ft.) (Min. /inch) Elevation
0 0 9l-
VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic
Information Gallons Gallons Tanks Con- Con- glass
New Existing crete structed
Tanks Tanks
IIJ
❑ ❑ ❑ ❑ ❑
VIII. Responsibility Statement
I, the undersigned, ass responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (print) Plumber's Signature (no stamps): MP/MPRS No. Business Phone Number
Plumber's Address (Street, City, State, Z' Code)
w c/'
IX. County/Department Use Only
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps)
Approved ❑ Owner Given Initial Adverse Surcharge Fee)
Determination S. 3t7
X. Conditions of Approval /Reasons for Disapproval:
44a�t e r W-U. ZA-A
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CONTINENTAL DEU CORP TEL NO.757 -2532 Aug 12.>0 21 =15 P.02
. • � p a g e . I
w'mnsinoeeparunent Commerce SOIL AND SITE EVALUATION
olv a rid Saluty and Nu #dings in accord with Comm 83.05, WiS. A m- COde Eu%irorrmcrdal • lki
Attao complete site plan on paper not toss olan a % x 11 Indoes In size. Pion must County
krcdude, but not MrnhM [to: vcrtk:al ur,d imsize ntel referenc* poht (D". direction and
pe,cera slope. stele a r auaw, and location srwl rOsUnoe to n14r0at toad. pa,pd LO.x
APPLICANT INFORMATION - Please print all fnlormatlun. naih rr
r.norrA tnlornrAkin you vRMdfa nwr boo, ucM r on+ +diary prqT1140 (PrWar'y Uw. IL . _._.,.._._ .
Proporty () - Properly 1-O0811orn
Govt. Lot SF. 114 NW 114 S 19 7 24 ., KR
Conti ,. W
Conti{te ntal Ocyclu{micnt `�- `
Subd Name ofCSMM
Property Ownoes Mailing 11ddn:ee Loll N ._ ' .
Trgr Village
12301 Central Avenue Nli, Suite 730 2
C_____......... stele Zp Cexlc, 1`rY,ncNumber ..1 C [_]
1: . St. Anne Parkway
M +new x�lis MN 55434
Y New Construction Residen
`'.� tial 1 Number of bedrooms a
�.� tlxcr. - - - ---- -- _
(� Replacement Pubic or commercial describe —
Code Derived daily Now ._ ..... -G( gPd Recommended design loading t a1e_?- . __bed. 9Pd ` -� . tem+. wdw
Absorption area required,... .857 .. b0d, 4' _ trench, IF MaxMnen design loading rate . ,7 ,_ bed. gpdAt' _�.K.. trench, gpd1R'
-- _ Q (as r &TW tb site plan beetchmar
Recomi, tided infiltration surfi .o elovalion(S) K .W' .. - - - -- _........
0" top sail lu tw t,ls" uu Rradcd area - - - --
Additional design 1 site considerations _.... _.- ____...._... _.. __ — --------- •--- -- --'
( ;I:tcial Uula-sxlr � Flood Girl A1ev a6on,lt IICabN ,.,_ NA � n
Parent material L v= O ver - _ _ . ; ..._.. - stets In l Hol4utg lank
ru n-UnstRable = Suitable for system
C:orrvrnC�nn:# M Ptbeaum
AT -Grade SY
ttx system _ l S l Ili _t i s C� U S t7 u T 9 [�] U [ "] S U I :{ S
Mound Ground U
SOIL DESC IPTION REPOR
GI'DIII'
DepU► Dominant Color Monks Sit nslsten Boundary Roots - -
Borinytt horizon in. hklnselt Qu. Sr.. Coal Comx Texlufe �1. lied ;Trench Jt
7.5y[6 /4 - -- - --
s �g m .. _. .. - -:-
Ground
- - - -- --- __— -
Depth to .. af o ..... ... - - -- - - --- - ._._..---•• - --.... ...._ .._..
limiting
lixt
>125'
Itema<ks; • w i t h barutsoft* 7..tyr4
•
1 0 -120 7.5y,(,/4' Tr - - - _ - --
2 ° �'� - --
- m
I 7 .
Ground
elev -_.... _........_ .. } - ...
I m"
factor -- - —
�020"
• lteudod with cs 7 ;Syr•1 /4 _...- _- ._..... .. •_. -
RerlraAcs. _ _ ......__.... �_._....._W. _.....
( n -- m
Na Telephone No.
CST No= •. cJ •- ___. -_ _
TNomss C. Nelson �•~
[?ale CST Number Ref P
Address Lnvironntartal tag L�csiBrr `' 31."9 227387 222
1432 120th Street, New Richol A. \Vl iW)7
CONTINENTAL DEV CORP TEL NO.757 -2532 Aug 12, >O 21 :16 P.03
PrtovER7y OWRER, o !;rwi AI IA vitivipnr_ - .. ,..._ . SOIL OESCRIP ON REPORT 1 Page ...? . of .. s. .
PARCELLD.I...
Depth I Dominant Color Mot11e8 Slnicturs 80Uhderr GP --
Horizon In. Munsoli Qu. Sz. Coral Color Te�IWr° Gr. SL Sh. Roots 8C0 ' Trenc
=:
1 0.1 It) 7.5yr614 - t OSS 7
...... 1 -.: ...
m
Ground ....... .
elev
90.70' 1l
l
Depth b 3 2 . �/ 4� • l _
factor W Top for to M MO SOW on M dq
- I 1111
Remarks'
•
«A_ 1 _ 0 -105 - 7.5yiO/4 I r . ' . '. .°
4 ....... _.__"'! _._ 8..
Ground
efar
t� ,
f 105 +......_......_...._. _.... _.__....__ _ ...__..
�L_ I
Remarks: _ __— ._.........._
7.5yi6/4' - ..._. _ }._ OSS _ _M!..... __._�..... .7 8
Ground
elm
916411
Depth to
fades ..._...._._._....
>t06
Remarks' . _ . ___..,_.__...._.... _.__...... ....,.._.._._....------ ..__.... ... .
1
Ground..._. _.•...._. ... ...... _._..... ........ ___ _. _..... . -• - - -• - - - --
elev •
Depth to
factor
_.wow
CONTINENTAL DEU CORP TEL NO.757 -2532 _ Aug 12, >O 21 :17 P.05
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0 0 T� .
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Top o` t E lu{ Cornet �'Qlt ha.,� 1 P 1
Io 4
dP �L Top of t >tJ 1 u� Cccrf Irong, I( t -
w��
.� 9
CONTINENTAL DEV CORP TEL NO.757 -2532 Aug 12, >O 21:16 P.04
��
ENVI ON M N THL BY DE
1.43? 12U" STREET, NEW RICHMOND, WISCONSIN
715.246.2454
PROJECT NAME TROY VILLAGE
DESCIUVI SW %, NW%, SE(. ON 28 „T 28N, R19W
TOWNSIRP: TROY COUNTY. ST.CROiX
L01. SUBDIVISION: TROY VILLAGE
lb
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$CAI-E 1 ^3V loin Nelson
BM 1 NE 1.0'I' corner lot. 2top of telephone ped elevation 100 cstmo2CO5
KM 2 Nw lot cc:ruer lot 2 elevation93.98
ST. CROIX COUNTY
WISCONSIN
G ✓4`� ZONING OFFICE
ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
Hudson, WI 54016 -7710
(715) 386 -4680
August 11, 1998
Wisconsin Department of Commerce
Plat Review
ATTN: Leroy Jansky
Box 8911
Madison, WI 53708 -8911
RE: Onsite soil verification, lots 1,2,4,5 and 19 of Troy Village Subdivision, Sec. 19, Town
of Troy, St. Croix County, Wisconsin
Dear Leroy:
I have reviewed the soil reports for lots 1,2,4,5 and 19 in Troy Village Subdivision, filed by
Tom Nelson, id #227387 and have verified the soils onsite on July 17 and July 30. My
findings have verified that the soil conditions as reported by Mr. Nelson are accurately
described. The soils at these sites are suitable for subsurface sewage disposal with a loading
rates of 0.7/0.8 GPD /sq.ft.
If you have any questions regarding this issue, please contact me at the number listed above.
Sincerel
f e, ��
Rod Eslinger
Assistant Zoning Administrator
cc: Tom Nelson
file
I I + LJ --
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rYtsce,7sa Daoatrn+nt SOIL AND SITE E VALJATION REPORT Page Lof_I
Lat»r and Human RefaWns
Diwsmn of Safety S 13W*ngs in accord with I LHR 83.05. Wis. Adm. Code
' COUNTY
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but ST CROIX
not limited to vertical and horizontal reference pant (8M), direction and % of slope, scale or PARCEL I.O. #
dimensioned. north arrow. and location and distance to Z
APPLICANT INFORMATION- PLEASE PRI ,� L A�1f�A/TG REVIEWED BY DATE
n
PROPERTY OWNER: RECEIVED PEATY LOCATION E 1/2S 24T 28 NR 20 W
TOM RUEMMELE & JOHN AND B � LE . LOT 114W 1/2S 19T 29 NR 19 -6(«) W
OR CSM
PROPERTY OWNER :S MAILING ADDRESS APP 13 1997 TROY V LLAGE #
260 COUNTY ROAD F
CITY, STATE ZIP CODE NE NUMASIMUA a6fY C3VILLAGE QrOWN I NEAREST ROAD
HUDSON 54016 ) Y .JES ZAtI
New ConstnJ= Use pC I Residential ! ( f Addition to existing building
j ] Replacement (1 Public or Comm
Cade derived daily flow 600 gPd Recommended design loading rate 0• ¢ bed. gpd/tt trench. gpd*
Absorption area required OO bed. ft trench, ft Maximum design loading rate bed. gpd/lt _ 01- 45. trench, gpolft
Recommended infiltration surface elevations) BY DESIGNER tt (as referred to site plan benchmark)
Additional design/ site considerations 7 NO 7
Parent matenal Zp ? /GL mvTw y Flood plain elevation, if applicable N/A It
S a Suitable for system I CONVENTIONAL I MOUND I MGROUND PRESSURE I T- GRADE U I Q I F U I HO HOLD I NG ,
U . Unsuitab for system ❑ S 9U WS ❑ U C3 li�U
SOIL DESCRIPTION REPORT
Horizon Depth Dominant Color I Mottles (Texture Structure Consistence tn
lBodely I Roots GPD /ft
in. Munsell au. Sz. Cont. Color Gr. Sz. Sh. Bed ITrench
Boring # A 0 -9 10YR 3/3 - -- sl 1 2msbk mfr as 2vf- 0.5 0.6
N328<`'` B1 9 -20 � IOYR 4/6 - -- sl Ilmsbk mfr cw lvf - 0.4 0.5
B21 20 -28 10YR 4/6 - -- sicl 2mabk mfr cw 1 1vf 1 0.4 0.5
Ground
elev. B22 28 -31 10YR 4/6 c2f 5YR 5/8 sicl 2mabk mfr gw lvf - -- - --
903. tt.
Depth to B3 31 -49 2.5Y. 6/4 m3d 5YR 5/8 sil lcabk mfi Iai Ilvf I - -- - --
limtUng C 9- 7 2 10YR 5/6 - -- s 7 OS - 9 ml - -- 1Vf - -- - --
fat 8
Remarks:
Bonng #
-14 OYR 3/2 - -- 1 2msbk (mfr Icw 2vf -fI 0.5 0.6
'329 ,' 1 14 - �OYR 4/3 - -- 1 2msbk mfr cw (2vf - fI 0.5 0.6
2 3 -31 OYR 4/6 - -- sl 2msbk mfr �w 1 2vf-f l 0.5 0.6
Ground
elev. 3 1 -41 kYR 5/6 f if 5YR 5/8 sicl 3mabk mfi Ici 1Vf I - -- ---
90 ft.
1 -72 OYR 5/6 flf 10YR 3/4 is Osg ml - -- of - -- - --
Depth to
limiting
factor
Remarks:
E m— leave Print .JAMES 0. FUU 011c (715) 425 -7831
000E14 ENGINEERING CO.. 113 WEST WALNUT ST., RIVER FALLS. WI 54022
Date: ¢ / 7 CS7"CSTM03988
PROPFRVOWNEP SOIL OESCAIPTION REPORT Page __Z_ at 3
PARCEL I.O. r
Depth Dominant Color I otlles ITexture I Structure lConsweritwiBourxivy GPDitt�
Boring # Horizon in, I Munsell Cu. Sz. Cont. Cobr Gr. Sz. Sh. i Bed ITrerrn
.. A II 0 -15 110YR 3/2 - -- sl 12msbk mfr Ri 2vf-d 0.51 0.6
t`
59:.,.-
B1 15 -24 10YR 4/4 1 2msbk mfr gw 2vf- 0.51 0.6
Ground B2 24 -30 10YR 4/6 - -- s1 2msbk mfr gw 2vf- 0.5 10.6
i
902 ft, B31 30 -37 10YR 5/6 - -- sicl 2mabk mfi cw 2vf- 0.4 0.5
10YR 7/2 2mabk mfi cw 2vf -
Depth to B32 37 -45 lOYR 5 / 6 m3d 5YR 5 8 - -- - --
limtrng 10YR 7/
tam C1 45 -68 10YR 6/6 m3d y r - -- - --
37"
i C2 68 -72 6YR 6I6 - -- fs Osg ml I -- 4 1vf
Remarks:
Boring #
w
Ground
elev.
ft.
Depth to
hrrabng
factor
Remarks:
Boring
Ground
elev.
Depth to
limning I !
factor
Remarks:
Boring # I
ti
i
Ground
Slay.
ft
Oeptfa ro
li mrbng
factor
Remarks: _
SBO�:totA.ot�
PAGE 3 OF 3
SITE PLAN
ST
BE,�/cifylge,L'� Ta �
SCALE: 1" = 40' GOT G oT /
Go 7'
8- 3z8
Lo7
NOTES: PROVIDE MINIMUM OF 1' SAND BETWEEN BOTTOM OF BED AND EXISTING GROUND.
MOUND TO BE A MINIMUM OF: 25' FROM DWELLING; 50' FROM WELL; 5' FROM LOT LINE.
/ OGDEN ENGINEERING CO.
JAME D- FILKINS, STM03988 Civil Engineers & Land Surveyors
113 W. Walnut St. River Falls, WI 54022
DAT .Z / � ,7 (715) 425 -7631
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 �j 3
Number of Bedrooms
Design Flow - Peak (gpd) o►o
Estimated Flow - Average (gpd)
Septic Tank Capacity (gal) 2 S�
Soil Absorption Component Size (ft) 2
Type of Wastewater Domestic
Table 2: Soil Absorption Component - Limits of Reliable Operation
Septic Tank Component Soil AbsoT tion Component
Design Flow - Peak (gpd) 12-5 S 2
Maximum Influent Particle Size (in) 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 nk and outlet filter shall be assessed at least
once every 3 years by inspection. Th out et filt Shall be cleaned as necessary to ens ure
pry ,o per-atiea. The filter cartridge shou not be removed unless provisions are made to
retain solids in the tank that may slough off the filter when removed from its enclosure. If the
L
` 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.
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.
Traffic around or over the soil absorption component should be avoided particularly
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
impossible to repair until weather conditions improve. In general, soil compaction over this
component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to
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.
i
I
3
r -
• ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer / Vo �4 AeU eIWE 11 7f ng tQf % O'7
Mailing Address l U / . Qil uC y�r[�t s t • /U �, �r�� �/LQi� MIV �S �
Property Address
(Verification required from Planning Department for n nstnrction)
City/State Y(41, /- F)15d -" Si h Parcel Identification Number
LEGAL DESCRI
Property Location J lam= %a, - Lj `'� Vi, See.. ( T N -RIT—W, Town of
Subdivision 2;� UV V it LqZ . Lot #
Certified Survey Map # , Volume _ #
Warranty Deed # ��5� 3 , Volume Page #
Spec house 0 yes ❑ no Lot lines identifiable ff yes ❑ no
SYSTEM MAINTENANCE
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maint enan ce
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
mastorphunber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdiSIM -1 system
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 15 full of sludge.
I/wa, 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 Commence 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.
SIGNATURE OF 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 above, by virtue of a warranty deed recorded in Register of Deeds Office.
7
SIGNATURE OF APPLICANT DATE
«s• « «« Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.
•« Include with this application: a stamped waranty deed from the Register of Deeds office
a copy of the certified survey map if refe nice is made in the warranty deed
Sr x HAR Of 'iIS0)NSIN FORM I - 1432
5599&3 WARRANTY DEED
Dmument No. VJL 1241
J
This Deed, made between ko H.%�A 4
John
___ Ur maj
J . RuSmmelC and Barbara A. Ruernmele-AlisIL if_drhQ MAY, 2 7 897
Ruernmelk and Nell L . _RuerlmcLe—kils
__,Grantor.
fcd 3:15 , FM
Grantee,
Witnesseth, That the said Grantor, for a valuable consideration % AML NND at n IL% WURI SS
conveys to Grantee the following described real estate in — St. Croix Co unty _
County, State of Wisconsin:
(rarcel Identifiat n 1 4,n-bef)
Lots I through 45, Lots 47 through 65 and Lots 68 through 70 of the I'tat of Troy Village, St. Croix County. Wisconsin and that
portion ofoutlot 8 of the Plat of Troy Village described on Exhibit A attached hereto,
and AI _ ER
Outlots I and 3 tn the Plat of Troy Village, St. Croix County, Wisconsin
A portion of the above described propert) is homestead property of the Grantors, John I Ruerrimcle and Bart aira.x tzuemmelc
(is) I" not)
Together with all and singular the heTeditaments and app%menances thereunto Wonting.
And
_
—
warrants that the title ii good, indefeasible in fee simple and fir and clear of encumlirariccs except
c asements, covenants, restrictions and highway rights of way of record
and w01 %% arrant and defend the same.
0 7 19
day of 7
Dated this
r (
ISEAL 1 SEAL) • A!aR L,__
�)ohn J R mel Th.
----Nell , L. Ruemmele
• Barbara &.
AUTHENTICATION ACKNOWLEDGMENT
,
J'?41 FREE 55)
EXHIBIT A
A parcel of lard located in the SE -1/4 of the SW -1;4, the NE -1/4 of the SW-1 /4 and the N`N-
1/4 of the SW -1/4 of Section 19, T28N, R19W, Town of Troy, St. Croix County, Wisconsin,
described as follows: Commencing at the South 1/4 corner of said Section 19;
thence
N00o19'39 "E (assumed bearings referenced to the North -South 1/4 Section line of said Section
19 which bears N 0019'39 "E ) 1305.22' along said North -South 1/4 Section line; thence
'
N89 31'29 "W 660.36' to the point of beginning; thence N89 o 31 29 " W 637... 6' along the
North line of Lot 4, Certified Survey Map, Volume 4, Page 993, Document No. 366634;
thence SOO*04'41 "E 298.00' along the West line of said Lot 4; thence N89-33'26 "W 24.04';
thence Northerly 211.84' along a 1533.00' radius curve concave Westerly whose chord bears
N0026'28 "E 241.58'; thence Northwesterly 176.98' along a 433.00' radius curve concave
Southwesterly
WIIOSe
chord bears
1147' 14 'W 175.75'; thence 589. 31'29 "E 678.56'. thence
SOOol4'07 "W 114.75' to the point of beginning. This parcel contains 1.808 acres, more or
less, being 78,756 square feet, more or less. Subject to easements of record.
The parcel shown on this document is being added to the parcel shown on the document
recorded in Vol. 4, Pagc 993, Doc. No. 366634, described as Lot 4, Certified Survey Map, to
create one parcel, and this transaction is thereby exempt from Chapter 18 of the St. Croix
County Land Use Regulations pursuant to Section 18.05(A)(3).
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