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HomeMy WebLinkAbout040-1253-50-000 0 0 0 'I 3 v n C7 C d ( M ' C N s A Z &T z o w n -� o t �1 • O CD Ln N Q 3 m m w M o r m CD = o w Cl 9 0 W t*J c CD n 7c O) Q y 3 a o rn go C) �+ mO D m -0 m c� w I� 3 z. rn � N V ( N C. �p N C p p Off. n C CO) CD N O O N co CD f a o M a O O O N 3 N N fA o I Ln C) jCr v v = ° o ? CD ( D y G CD m a CD d CD (D o n Q � �, N z a z z D = 0 o v o ZY v o ter N CD C c =r CD w Co C1 a N j Z O w• O .p Z n O N n v CL p 7 0 e _ CD A C •� � Z 3 N Z g CD W � I D N a Q a m o a CD co o N D n O v, a s 3 4 = I V 0 � N �ti CD a o li o o b Rk o CD oR o En O v c.n o `' a 's Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code Environmental By Design Attach complete site plan on paper not less than 8'/z x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix _ percent slope, scale or dimensions, north arro ; and location and distance to nearest road. parcel I. D.# APPLICANT INFORMATION - P ase print p0hformat►ort Personal information you provide may be used )or secondary pttrbp¢;{pyry Law 104 (1) (m)). Reviewed By Date Property Owner ' < < Pr�perty Location Continental Develo meet k _, Go` . Lot - NW 1/4 NW 1/4 S 19 T 28 N,R 19 W Property Owner's Mailing Address 'i•; l # Block # Subd. Name or CSM# 12301 Central Avenue NE, Suit 230 ' 85 - Troy Village Second Addition City State ZI God ,e. PhoneNumber .< City ❑ Village Town Nearest Road Minneapolis MN Troy Birkdale Court Z New Construction Use: N Residential /lit Mm er of bedrooms 4 UAddition to existing building ❑ Replacement E] Public or commercial describe Code Derived daily flow 600 gpd Recommended design loading rate .7 bed, gpdtftz .8 trench, gpdff Absorption area required 857 bed, ftz 750 trench, ftz Maximum design loading rate .7 bed, gpd/fF .8 tr ench, gpd/ftiz Recommended infiltration surface elevation(s) By Designer ft (as referred to site plan benchmar Additional design / site consideration Parent material loess Over Glacial Outwash Flood plain elevation, if ap2licable NA ft S= Suitable for system Conventional Mound In - Ground Pressure AT - Grade System in Fill Holding Tank U= Unsuitable for system ®S ❑ U ® S ❑ U ❑ S [] U I ® S 1:1 U ❑ S ® U ❑ S ® U SOIL DESCRIPTION REPORT goring# Horizon Depth Dominant Color Mottles Structure GPD/ft in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Bed Trench 1 1 0 -13 10yr2 /1 - sl 2msbk mfr cw 2f . 5 .6 2 13 -25 10yr4/4 - sl 2msbk mfr cw 1f .5 .6 Ground 3 25 - 49 7.5yr4/4 - s osg ml cw - .7 .8 elev 100.6 ft 4 49 -105 7.5yr5/4 I - s osg ml - .7 .8 Depth to limiting factor >105" Remarks: Z 1 0 -16 10yr2/ 1 - sl 2msbk mfr cw 2f .5 .6 2 16 -32 10yr4 /4 - sl 2msbk mfr cw if .5 .6 Ground 3 32 -56 7.5yr4/4 - gs osg ml cw - .7 .8 elev 99.2 ft 4 56 -100 7.5yr5/4 - s osg ml - - 7 .8 Depth to limiting factor >100 Remarks: CST Name (Please Print) Signatu Telephone No. Thomas C. Nelson 715- 246 -2454 Address Environmental By Design Date CST Number Ref # 1432 120th Street, New Richmond, Wl 54017 1/30/98 MO2605 12 E BY DE51 1432 120`" STREET, NEW RICHMOND, WISCONSIN 715 -246 -2454 PROJECT NAME TROY VILLAGE 2nd ADDITION DESCRIPTION: Nj/, NW /, SECTION 19 „T 28 N, R19W TOWNSHIP: TROY COUNTY: ST.CROIX LOT: 8S SUBDIVISION: TROY VILLAGE 2” d ADDITION 1, ly l �,c►2 es � b �t v C 2 SCALE 1"=40' Tom Nelson BM i Line post ground surface elev. 100' cstmo2605 BM 2 SW corner post at ground level elev.93.10 H O 6a a o°ic W N 4 0 0 o I N I r I I 0 I Z 44) c Z w � � c LL o Q m !' I to Z S O >> 0 O N > d m H Z io O Z v rna 4) c m U � O N (mil co C • (D O O C) c a O R m o o U 0 o Z E Z O Z o N I C 0 N _ lC N O v N a 'm a' T 0 0 0 a LO H H H co • �► N i o a O a a O N : o 0 N J U v ° o ° o ` N N O m N N .� 0 O O N N (O Q E N CO O O 0 d N N .�. w c I N aS o v _ E O CO L C7 ; N N lC6 N N C� �2 O LL o O N N I� r CD ~ N C y Gl -00 . C d f0 to • o ° H U m p Z Z Y g in � d IL E ` _1 A oa.z 0U)0 STC - 104 AS ' BUILT SANITARY SY$ REP �ErV 0 OWNER 1000 r ADDRESS , `�ou►vry _vn,lyGprICE C1> 9 SUBDIVISION / CSM -rxoY � �' ' LOT s SECTION P T 2 9. N -R ( W, Town of �iT LO X ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM OR INDICATE NORTH ARROW Provide setback and elevation 'Information on reverse of this -form. Provide 2 dimensions to center of septic tank manhole cover- G O 7' BENCHMARK: ��� U / �O�• c I ALTERNATE BM: C ST 1 S y it 5kt ( ( 2)SEPTIC TANK / PUMP CHAMBER / HOLDING ..TANK INFORMATION \ \\ � - C _ ► - /�� . Manufacturer: Liquid Capacity: N Setback from: Well House 5 Other To Pump: Manufacturer /_ Model# Size Float seperation Gallons /cycle: Alarm Location :SOIL ABSORPTION SYSTEM 5Ee 3 Width: 3 Length P1 T' r(A ) J Number of trenches Distance & Direction to nearest ro line: > _35 ' P. P• Setback from: well: � A_ House Other e SSE �Go �01,4A' _ELEVATIONS Building Sewer ST Inlet: ST outlet. / PC inlet PC bottom Pump Off Alice/ old 1 Bottom of system Existing Grade Final grade DATE OF INSTALLATION: Z `� d7k � PLUMBER ON JOB: P-Q 1v E-1� r u L LICENSE NUMBER: 2 �'�e S INSPECTOR• n7FVI�A) 3/93:jt � O � Z o o O N y o C ^ kA P wN LA LA °o rn ('N NJ Z � o g °o $ x o N I'' Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Buildings Division 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)]. 363896 Permit Holder's Name: ❑ City ❑ Village ❑ jown of: State Plan ID No.: a an Frank & Ch I vnn Troy Townshi CST BM Elev.; Insp. BM Elev.: BM D tion: Parcel Tax No.: / 6 • �' Cs��3w� 2 �� _a 040- 1253 -50 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 3.6 r Alt. BM 7` n R !rY Aeration — Bldg. Sewer Holding St/ Ht Inlet 1 6 9' TANK SETBACK INFORMATION St/ Ht Outlet l3.3<{ R6 •c(,� Ventto TANK TO P/ L WELL BLDG. Air Intake ROAD B f 3. Septic > 50 X5.5 '— NA =ST a 13, $lo - 2Z r Dosing 5 p zt'o. 5' NA Header / Man. Aeration NA Dist. Pipe �� �3 , go a`I•£o; al Holding Bot. System s PUMP / SIPHON INFORMATION Final Grade Manufac r Dema d St cover i Model Number GPM 8 • 9 ©fo ' TDH Lift Fri estem TDH Ft (( tk (d� �•�°� Flo • oD Forcema Length Dia. Dist. eu �, T q SOIL AB PTION SYSTEMC3o),4,,,,,,,(. . 6 Z 6,P � ,4,1 .gt� -r BAD TRENCH width r eng N . O Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIME I N 3 5�'v �k `( DIMEN I NS SETBACK SYSTEM TO P/L BLDG WELL LAKE STREAM LEACHING �uf�tuc, ref: I � � Md INFORMATION Type O 1 � � / OR UNIT CHAMBER ` • Model Number: , rr System: ter^^'` DISTRIBUTION SYSTEM Header/Mani old Distribution Pipe x Hole Size x Hole Spacing Vent To Air Intake Lengt4 \' Dia th Dia. ang > 15 SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over 7Bd th Over xx Depth Of xx Seeded !Sodded xx Mulched Bed /Trench Center /Tr ench Edges Topsoil ❑Yes ❑ No E] Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1:JuvfzZ? #2: — t - 1 — Location: 322 Birkdale�urt, Hudson W 540 6 1/4 NW 1/4 19 T28N R19W) - 19.28.19.1336 Troy Village - Lot 85 1.) Alt BM Description =1 2.) Bldg sewer length= -amount of cover t1tito Plan revision r red? Yes No Use other side for additional information_ OS Si SBD -6710 (R.3/97) e� ` s n�pecto 's a re Cert. No. s Tom' 1fo4)ea:r : 32-z I3i/Pk 9 �- CT 1Y v9 �Sf eal - Vvs Vi sco�sin Safety a nd Buildings Division SANITARY PERMIT APPLIC TION 201 Box Washington Avenue Department of Commerce In accord with Comm r83* Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the s less County C� than 8112 x 11 inches in size. a Stat 'sanitar Permit Number • y See reverse side for Instructions for completing this apple Personal information you provide may be used for secondary purposes i Ch#c if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. 5 w� i �� , ,t`�' Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL' R Property Owner ert Nam P o �j �J INK Q�nr�C r✓LI /�/e Cf !' ilk p y L I T29 , N, R /f E (or W Pr Owner's Owner's Maili� Address Block < //,� L Block Number City, / � Aw Zip Z `hone umber Su� ivi �N i5r II. TYPE F LDING: (check one) E] State Owned a'i' y 'J !, Nearest Road �,jn� 5 lage 131*P4?(e_ Public 1 or 2 Famil Dwellin - No. of bedrooms wn OF 111 BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo o - 12-53-s41 -Oz7v 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 9New 2 ❑ Replacement 3. ❑ Replacement of 4 ❑ Reconnection of 5. ❑ Repair of an ...... Syrstem ________ System Tank Only_ Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) i CfjPitG�'T�/ S /O�w /NDf ,Z�1{�L 77f4 - MWS Non - Pressurized Distributi Pressurized Distribution Experimental Other 11 E] Seepage Bed 21 E] Mound 30 E] Specify Type 1 C] Holding Tank 12 Seepage Trench 22 ❑ In- Ground Pressure d 42 E] Pit Privy 13] Seepage Pit 5Q•'Ff� B ,3 d �C�S /i'` �JI r S TpTi4 -G 43 ❑Vault Privy 14 ❑ System -In -Fill � �• L�; 3 f 3 VI. ABSORPTION SYSTEM INFORMATION: �f5,6 " ' Sly, 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade 7�o Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min. /inch) Elevation 3 8 ! Jj 8 p / Feet s• S Feet TANK Cap acit Site VII. I NFORMATION in allo Total # of Manufacturer's Name Prefab. Con- steel Fiber- Exper. New Gallons Tanks Concrete structed glass Plastic App Tanks Tanks 9we 5 T ed Septic Tank or Holding Tank 10V 750 1 -1 5- 0 Z 1 A6 ,- *5 Er ❑ ❑ ❑ ❑ ❑ L ❑ 1 ❑ ❑ ❑ ❑ ❑ Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Sign ture: (No Stamps) 4OP /MPRSW No.: Business Phone Number: R.0 845V 1 1 7 /5 - 3 X - 8/eS Plumber's Address (Street, City, State, Zip Code): IX. COUNTY/ DEPARTMENT USE ONLY [:]Disapproved nitary Permit Fee (Includes Groundwater ate Issue Issuing Agent Signature (No Stamps) Approved ❑ Surcharge Fee) Owner Given Initial � Adverse Determination 5Z7>'9() X. COND TIONS OF APPROVAL / REASONS FOR D APPROVAL: SBD -6398 (R. 4/99) (ry e-(J DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary perrrits, validfor two (2) years. 2. Your sanitary permit may be 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 properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questiansconcerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608 - 26631 -51. - To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. 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 many facturer's name, indicate prefab or site constructed and.tan'k °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. V111. Responsibility statement., Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phon' `number.. Plumber must sign application.form. IX. County/ Department Use Only. X. County / Mepartmerr#, Use Only. Complete plans and specifications not smaller than 8.1/,2 x 11 inches rrj_ustbe submitted t9 the county. The plans must include the following: A) plot plan, drawn to scale or with 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; andffie location of the building served; B) horizontal and vertical elevation reference ; poihts; Q- 1 complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; Q) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. o p . tja" V ,6Y LOT ir 2g� � C r U) PS �E im Sip �s Y P�LA -f n ut 0 • TOP a F S0j?0eVvR' t46" E" ' 1 p r,Q o N LoTr q psGl� �� �+ s � p0.0 � • TPoy 13 P f' 3 t: P LOT P tAk 3 0 �b1 ��r� ew �e p % \vs 6 e q\% p .r.6 o wis 5 Lo s i•� �D���ss •' 3 2 . 2 - 13i��Dr��� c� . ��a� S yap Wisconsin Department of Industry SOIL AND SITE EVALUATION 3 Labor and Human Relations Page of Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County �?• G � a` , include, but not limited to: vertical and horizontal r rence point (BM), direction and percent slope, scale or dim ns; noft arrow, and location and distance to nearest road. Parcel I.D. # ayl� 3 APPLICANT INFORMATION - Please print all information. R i Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). - ZZr�Loat� ropertyOak� a t 6 dRY /� elf ph1v Govt. Lot Location .) 1/4 /JW1 /4,S // T ,N,R f'/ E(or)(@ Property Owner's Maili A dre s I G � �� • Lot # Block# Sub d. Name or CSM# �lG l Kp- 17-ROY CI State / State Zip Code Phone Number ��' Nearest Road � • .S Sa ((05/ ) siy E l ❑ villa e L7 To wn 13 1M ,9 4 1E C r New Construction Use: U Residential / Number of bedrooms �-- Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow 7✓ gpd Recommended design loading rate • 7 bed, gpd/ft �-- trench, gpd /ft Absorption area required _107 Z- bed, ft ! �j' 3 trench, ft Maximum design loading rate 7 bed, gpd /ft - � trench, gpdff1 Recommended infiltration surface elevation(s) •S�� 3 ft (as referred to site plan benchmark) Additional design /site considerations 14 / �' V Parent material 5/IND YY j - 40SN/ Flood plain elevation, if applicable S = Suitable for system Conventional Mound � In Grrou Pressure AT- Grade System in Fill Holding Tank U = Unsuitable for system [T S❑ u ❑ s l' � �' u H G U El S 1 U BS El U ❑ S 2 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 o 1 3/3 6%A- zf . 't • $ o A /o YA YIL( f00.11/ LS /te f i f G?. C — • ? ' - 8 Ground /d Y � S �-- /►.y� S . .S G� iC elev. 1 ft. Depth to limiting factor f6 Remarks: Boring # .g /o 313 1-5 bwt fA 1 4) .1 .? '.6 2. 2 8 '12 7.5 YR yl v. LS /.1r, JA 2 /oYX5 S. Dt Y5. Ground elev. Depth to limiting 7 � fact r in. Remarks: CST Name (Please Print) � fA ` w A_ Signature 3 8& - 818 9— Address Date CST Number 7• a. 0VV 2 20 3'ZS Private Sewage Consultants 655 O'Neil Rd. Hudson, Wis. 54016 c � o� � 7• � 5115TH" —_ �n�P �� r r r - I 3 q , S p s I f " o ' 19 3 L Ito I ter" r r � c " r 5 " � r a Y � D ,cv (9� S T. 16 t r'`� --- I�e u t � g3 44 nuo • TO a F S ���tYo �'S d tit E" t f I o N 1-0 - �p g Troy j30 P&)� !� w i C I A 6-E"" s'c,4 G : / 3 0 • 13 4 ��G�o -e P r' '7!s Hj'�� 0,e44 aL DT I LOW - M to CA-PAN SOIL DESCRIPTION REPORT Z PROPERTY OWNER Page . of PARCEL 1.0.1 G 8 3 — / R O y Borin # Horizon Depth Dominant Color Mottles Structure 2 g Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench .i . s Vi2 ell GS /,s c — ' • 9 Ground . � S GS' elev. J�ft. o s S . 4 ;Q •S _1 Depth to limiting factor y �in. ZS• Z .� Z o t� Remarks: Boring # D•(o /O Oje /3 GS /ten 7 ZE ,Q G5• 2 f' ; .8 �.. L2- . ?. S Y9 /o s. D,s ,e •� '•8 Ground elev. 7 Depth to limiting factor m. 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 # fJ` /a Y'/,o 31 3 LS GS Z -F . 7: .8 /o R Yll, 6 S4 c -- • 7 $ Ground S ..- -- S D +O ev. • ; �ft. Depth to limiting • 8 , $a factor ' Remarks: Boring # Ground elev. ft. Depth to limiting factor in ' Remarks: SBDW -8330 (R. 08/95) I I rte! ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND 6�1 -- OWNERSHIP CERTIFICATION FORM Owner/Buyer X Mailing Address 11, ltcle 41 �ru /t/ Property Address 30- a 73; } ka `e C �- , 27- 9 (Verification required from Planning Department for new construction) City /State -- � ti Lf I:_ Parcel Identification Number y� ZS3 S D Orb f LEGAL DESCRIPTION Property Location Val 1 /4, � 1 / a, Sec. , T N -R W, Town of Subdivision TWo 1 13V ANF / , Lot # s Certified Survey Map # Page Warranty Deed # (o 3 , Volume / s / 0 , Page # s Spec house ❑ yes no Lot lines identifiable QKyes ❑ no • SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage 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/we. the undersigns have read the above requirements and agree to maintain the private sewage disposal system with the standards set fo ein, as et by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating o s tic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days o e ar expiration date. 5 /' SIGN OF APPLICANT DATE OWNER CATION I . that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the grope s riedabove, by virtue of a warranty deed recorded in Register of Deeds Office. S SIGNA F APPLICANT DATE J * * * * ** 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 - 62033 KATHLEEN H. WALSH STATE BAR OF WISCONSIN FORM 2 - 1998 REGISTER OF DEEDS WARRANTY DEED ST. CROIX CO., WI Document Number J1O PAG.. c 60 RECEIVED FOR RECORD � (. ; 05 -16 -2000 9:40 AN This Deed, made between WARRANTY DEED Troy Development Corporation, a Minnesot Cor -ion EXEMPT # ---- = - - - -- CERT COPY FEE: Grantor, COPY FEE: j and TRANSFER FEE: 449.70 RECORDING FEE: 10.00 Frank A. Capan, Jr. and Charlynn M. Capan, _ PAGES: 1 n usband and wife , Grantee. Grantor, for a valuable consideraton i, conveys and warrants to Grantee the following jI described real estate in St. Cro County, State of Wisconsin: Lot 85 of the Plat of Troy Village 2nd I�e`O dint' area Addition in the Town of Troy, St. Croix County, Name and Return Address j Wisconsin. Frank and Charlynn Capan 1166 McKusick Road Lane i; Subject to Declarations of Covenants, Conditions and Stillwater, MN 55082 Restrictions for Troy Village, recorded Vol. 1241, Page 256, as Doc. No. 559964, and the Declaration of '! Golf Course Covenants, Conditions and Easements, recorded in Vol. 1241, Page 301, as Doc. No. 559969, 040 - 1253 -50 -000 all as appearing in the office of the Register of Deeds 19.28.19.1336 for St. Croix County, Wisconsin, and such other Parcel Identification Number (PIN) d easements, reservations, restrictions and reservations This is not homestead property. i of record, or in use, and obligations contained in the (is) (is not) �! Purchase Agreement for this lot. II � I i �i I Exceptions to warranties: I ; Dated this 8 th day of May 2000 I 4 SEAL) (SEAL) I'. !i Kathy M. Coo , Vice President Troy Development Corporation (SEAL) (SEAL) i; `` I # AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of M innesota ii tstbnsttr i Anoka County. jI authenticated this day of Perso al came before me this L day of the above named �i Kathy M. took, Vice President I'. TroyDwelopent Corporation i s _ ! TITLE: MEMBER STATE BAR OF WISCONSIN tO ii (If not, me known to be the person who executed the foregoing h instrument and acknowledge the same. f authorized by §706.06, Wis. Slats.) � THIS INSTRUMENT WAS DRAFTED BY I I TROY D PMENT CORPORATION N cy d Clift i! Notary Public -State of'Msm sin Anoka County, Minn. L My commission is permanent. (If not, state expiration date: ! (Signatures may be authenticated or acknowledged. Both are not _ January 31 2005 j necessary.) i' 'I I ' Names of persons signing In any capacity must be typed or printed below their signature. I STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc. 1! WARRANTY DEED FORM No. 2 - 1998 Milwaukee, Wis. .� NANCY L. CLIFF y NOTARY KftCr M*#iE9DU MY COMMISSION EXPIRES JANUARY 31, 2005 M . I W ig 3 � ��z I W ~� I U L - - - - - — — — — — — — — — 67 N\= I =3 TROY IVILLAGE 4 � 00 I Z N OUTLOT 4 I SCALE: 1" = 120' , 15' N 88 0 00' 00" E 348: N 88 0 00' 00" E 335 ' 82 43678 S.F. OUTLOT 11 6� °''� , k9'' Z 1. 003 ACRI 49095 S.F. 0 N a8 °pp' wilt 1.127 ACRES °0 326.21' 6 85 83 2758 S.F. 1.441 ACRES 44648 S.F _ �. �. _ 1.025 ACI o N 83 °oot a ro vs 314.19 40 •000,, �N .86 � 45993 S.F. _& g o 1.056 ACRES i 46761 o° o � 4 . 1.073 78° OS' C6 S 83 z ^ .16f ' BIRKDA E 87 9o' R =80' - 43732 S.F g 45.10 z 1.004 ACRES / N 8 °0c 88 pM iPP N o 43630 S.F. , o ° N 89 o C-4 h e 1.002 ACRES o "' z lot / � , ° o „u' 44278 S.F. O ff ° ?s s °� N 1.016 ACRES 108 E O 2 . N gp °00 � 91 A 46156 57 I ,- ;�� 1.060 Ai 58 ° �l a r � r � Y FROY BURNE VILLAGE TOWN OF TROY, ST. CROIX COUNTY, WISCONSIN _ ISOUTH COVE ROAD 1 I 81 - - 1.060 AC 6 6 4. , OUTLOT 1 ' 0 8 ' ' I ' 8 AC 1.127 AC 1ep`, 1.001 AC 0. 85 283 1 1 1.074 AC 44 1.1 AC. 1.025 AC 314.19' = 3 _ ,4,8 ........ 7.96 20. t9' 1.07 SCALE: 1 " = 400 _ 3 AC J 6 COST n 1.0' WALKPATH �1 77 WALKPATH 4 AC �� 1.055 AC 1.002 AC ^? 6 ° 1.063 1 1.022 t 1. 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