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HomeMy WebLinkAbout020-1345-50-000 ST. CROIX COUNTY ZONING DEPART �.. RECEIVED AS BUILT SANITARY REPORT 1 �, Owner Si/r7/ /1 Z_ z_ .cx. -= JUN 29 1999 Property Address - 7o9 :j tk- k -E k D Q U k tOy City /State 9 t ? L S �! LIU 1 �Mlr�'�� c� � Legal Description: Lot Block Subdivision/CS r- •S T 0 S G VA /4 Q!j� t /4, Sec. I I , T Z .N -RL &town of ��1�1�;� o N PIN # .. SO •Goo SEPTIC TANK . DOSE CHAMBER -- IIOLDING TANK INFORMATION: � r Tank manufacturer GCJ. /S le. Size ST/PC o�U/ Setback from: House Z!E Well ( P/L 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: LIE 6 C h Width Len Number of Trenches Setback from: House ,3 4 . Well 7 y , P/L q • Vent to fresh air intake ELEVATIONS Description of benchmark / P < T ,; u,1 C O F E - 1.7 /V1 � Elevation Description of alternate be nchmark S I L l o 6 W11 L K -fad tdO a F / . 3 0 �0 3 Elevation Building Sewer Al . ST/HT Inlet S , `�= !0 ST Outlet -) PC Inlet PC Bottom Header/Manifold 7 y ` 1 0 4 Top of ST/PC Manhole Cover 3 Z = $ Distribution Lines () �r S �� () t - 7 Bottom of System( ) / d Z 401.5 ( ) / Final Grade () : 1 � � ( ) . ' .S = Date of installation /Z ( /C1 lpermit number �J_SSI t 3 State plan number Plumber's signature 21 L kl � License number Z Z �D Date Inspector Complete plot plan �+ NOTICE Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW ti 2 U ti �� IV •y�, �/7 t p�wElL 36 " M ,� / NSTP A.LE O Il k 7 �, G i i y9 1 TIZ� N e 44 E- 5 q - c �t�M 6E c 14 �► L q � A g, ( n, jt 1 To+' of I" Gm7" STr41rF ( A r 5 u) e- aA A/C 2 E/, Z/00,.00 INDICATE NORTH ARROW Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count y INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permi IX 338 913 Personal information you provice may be used for secondary purposes [Privacy La s.15.04 (1)(m)]. Per m H Id Namg: El Cit p Villa e Town of: State Plan ID No.: L , AM � CST BM Elev.:. Insp. BM Elev.: BM Description: Parcel Tax No.: 100 Ov _5 k) 020 - 1345 -50 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY T TION BS HI FS ELEV. Septic Lje ee pOC) B chmark L EW fSd COU Dosing C 2 Aeration Bldg. Sewer Hol g dt)Ht Inlet TANK SETBACK INFORMATION Ht Outlet , L TANK TO P/ L WELL BLDG. Ventto ROAD ' A st AiDk�Sake Septic l �( Z f / NA m Dosing NA Header / Man. Aeration NA Dist. Pipe FT - l v, Holding Bot. System 1 - T P. ?© L PUMP/ SIPHON INFORMATION Final Grade r f5 jp Manufacturer Demand -2 0. Model Number GPM TDH Lift Friction System TDH Ft Forcemain Length Dia. Ff Dist. To Well SOIL ABSORPTION SYSTEM �w BED/ ENC Width Lengt t No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIME :h < I Z — DIMENSION SYSTEM TO P / L BLDG WELL LAKE / STREAM LE Manuf t rer: SETBACK AMB INFORMATION Type O ' V /� �f p del Number: System: ' OR UNIT DISTRIBUTION SYSTEM cof 5 Header/Manifold it Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length��z Dia. � Spacing Aj A) if 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 E] Yes E] No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: HUDSON 11.29.19.1855,SW,SW 709 PACKER DR — HOMESTEAD LOT 5 01, (S.g bJ� 1 :;2w< r Zz rl Plan revision required? ❑ Yes [:]No Use other side for additional information. Z'S jcq SBD -6710 (R.3/97) Date Inspector's Si ature Cert. No ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: E i ° I 3 9 t e 3 E s 4 i s } € F { e E m � j s 3 , 6 > > 3 € e y .. , m „ E E 3 8 t i b e F fi i i € s A i F F € E A e E j e a t Safety and Buildings Division Nvisconsin SANITARY PERMIT APPLICATION 2 1 Box Washington Avenue Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8112 x 11 inches in size. ((o • See reverse side for instructions for completing this application State Sni Wary It Number Personal information you provide may be used for secondary purposes ❑ Check if revision to pr evious application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATION Property Owner N rfl Property Location (�„ 0 /a t /a, S t T Z , N, R E fodD Prope y Owyer's Mailing Address Lot Number Block Number .S/ City, State Zip C de Pho Number Subdivision Name or CSM Number O) ® f" E y' l� 111. TYPE F BUILDING: (check one) ❑ State Owned V E] Cit Pea rest Road r1 Public 1 or 2 Family Dwelling - No. of bed . room - v o w a n OF V O A T )R L VL III BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) )1 . - 2— 1 9 . 18'SS 1 ❑ Apartment/ Condo ZO " 3 -50 — OOio 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 online B, if applicable) A) 1 [rNew 2 ❑ Replacement 3_ ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System_ - __ 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) . Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 Seepage Trench LT. AL$ 22 ❑ In- Ground Pressure i 42 ❑ Pit Privy 13 Seepage Pit l91 1 N FI L�tkC%K X3 ����0• 43 ❑ Vault Privy _ 14 ❑System -In-Fill C 8E i1 e. VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation Sd t j %p3 l Feet 7. Feet VII. TANK Capacit in allo Total # of r Exper. Prefab. Site Fiber- INFORMATION g Gallons Tanks Manufacturer's Name Concrete con- Steel glass Plastic App New Existin structed Tanks Tank Septic Tank I S +�. ❑ 1:1 ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ 1 0101 ❑ ❑ 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) Plumbe 's Signature (No St s) AP RSW 4 .� OV Business Phone Number: MIFtL 0 10 PI m ber's Address (Street, City, State, Zip Code): O no t4 J tiYT ir toogD pso M W I S b I to IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate ssue Issuing Age t Signature (No Stamps) [Approved E] Owner Given Initial �,/ Surcharge Fee) � Adverse Determination l0D � , X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (8.11/97) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber s c INSTRUCTIONS 1. A sanitary permit is valid for 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 questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608 - 266 -3151. 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. IILti,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 9 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 plans and specifications not smaller than 81/2 x 11 inches must be submitted to 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 mainstwater 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 performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) 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. • SAM wt ILL£rL HaVA9 3TE *0 4j.o ' 0 5 PN ck.ER. pp-I VC- T-AX 0 - oz o- 1 3Y s- S -e on, SYs "K E 1. = l ' .YeAI 1 / "= / o ' rk ` Z Z T 4 �O►q f FA IT E 3.IM. "rDP of F M 1 � c E = c ca C l? Q, E N L y x m p r co _0 N p, c o o 0 o N o co a E a co O C p O N F - c0 a U N _ O .0 O j a` x M m O is p Op =. V a » c O ' t O ?� E N tti cu . cu ] > o 'Q)� i cm ti EO °= c°» � J) • • • • U4 Oil s CL a -, G 17j L W 1 N c N C ma T y rte;• � cr & Y v y 0 -$ Np -`• 3 $ a M cc a z cn W _ 0 . W � 3 0 L E ' N M • a N N x 9 • C m N Y 0 _ _0 � t.7 0 p 9 : c a�0 g tit .� U O O T L W� LLJ r a ca � � (L V Fn C - G j N Wisdansin 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 A.C.E. Soil &Site Evaluations Attach complete site plan on paper not less than 8'/ x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal ref( re t direction and St. Croix percent slope, scale or dimn esions, north arrow, aist�ncet o nearest road. Parcel I.D.# APPLICANT INFORMATION - PI 8le int all ' ormait(e o o- 3r/SS -C& . Reviewed By Date Personal information you provide may be used f ndary cy Law, 04 (1) (m)). Property Owner h .Pr perry Location Miller, Sam _ r ?,,°�, ° Lot SW 1/4 SW 1/4 S 11 T 29 N,R 19 W Property Owners Mailing Address ❑, l,p # Block # Subd. Name or CSM# 3 CF OX COIX 5 Plat Of Homestead Box 151 Trout Brook Road CouNTY City State ?W N"liloffow City E] Village ❑Town Nearest Road Hudson WI 5 �' S 386 - 1 ' Hudson Packer Drive ❑ New Construction ❑ Use: Resider edrooms 3 ❑Addition to existing building ❑ Replacement ❑ Public or commercial describe Cade Derived daily flow 450 gpd Recommended design loading rate -7 bed, gpd/ft .8 trench, gpolft Absorption area required 643 bed, ft 562 trench, ft Maximum design loading rate -7 bed, gpd/ft •8 trench, 9pdff Recommended infiltration surface elevation(s) 103.50' ft (as referred to site plan benchmark) Additional design / site considerations Install trenches using high capacity infiltrators. Parent material Outwash s & Flood plai n elevation, if a licable NA ft S= Suitable for system Conventional Mound In Ground Pressure AT - Grade System in Fill Holding Tank U= Unsuitable for system 2 ❑ u ® S❑ U ® S❑ U ® S❑ u ®S ❑ u [0:] s ® u SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft Borin Horizon Texture Gr. Sz. Sh. Consisten Boundary Roots 9# in. Munsell Qu. Sz. Cont. Color Bed Trench 1 1 0 -6 10YR3/2 None sl 2fcr mvfr as 2f 0.5 i 0.6 2 6 -14 10YR4/2 None is o sg ml cw if 0.7 0.8 Ground 3 14 -18 7.5YR5/6 None Is o sg ml cw if 0.7 0.8 elev 107.90ft 4 18 -129 10YR5/6 None s 0 s ml - - 0.7 0.8 Depth to limiting factor >129" Remarks: 2 1 0 -15 IOYR3 /2 None sl 2fcr mvfr as 2f 0.5 0.6 2 15 -22 10YR4 /2 None is o sg ml cw if 0.7 0.8 Ground 3 22 -36 7.5YR5/6 None 1s o sg ml cw if 0.7 0.8 elev 107.45 ft 4 36 -123 10YR5/6 None s o sg ml - - 0.7 0.8 Depth to limiting factor >123" Remarks: CST Name (Please Print) Signatur . Telephone No. James K Thompson yQ 715- 24 8 -7767 Address A.C.E. Soil & Site Evaludieffs - T Date CST Number Ref# 340 Paulson Lake Lane, Osceola, WI 54020 5/5/99 3602 1012 PROHiRTYOINNER: M iller, Sam SOIL DESCRIPTION REPORT 1012 Page 2 of 3 PARCEL LD.# A.C.E. Soil & Site Evaluations Depth Dominant Color Mottles Structure GPD/ft Horizon in Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. nsistence Boundary Roots Bed Trench 3 1 0 -6 10YR3 /2 None sl 2fcr mvfr as 2f 0.5 0.6 2 6 -14 10YR4/2 None Is o sg ml cw if 0.7 0.8 Ground elev 3 14 -20 7.5YR5/6 None Is o sg ml cw if 0.7 0.8 107.20 ft 4 20 -120 I OYR5 /6 None s o sg ml - - 0.7 0.8 Depth to limiting factor >120" Remarks: 4 1_ 0 -10 10YR3/2 None sl 2fcr mvfr as 2f 0.5 0.6 2 10 -30 IOYR4 /2 None is o sg ml cw if 0.7 0.8 Ground elev 3 30 -48 7.5YR5/6 None is o sg ml cw if 0.7 0.8 106.23ft 4 48 -124 10YR5/6 None s o sg ml - - 0.7 0.8 Depth to limiting factor OM sift inclusion observed at north end of pit wall edending from 10" to 44 ", fmd 7.5YR4/6 redox concentrations at interface of sift and sand due to >124" greater malric potential of sins and are not indicative ground water. Remarks: Pockets of o m silt should be disregarded as absorptio area if encounterded during system construction. System length should be mcrease to compensate or rsree areas. 5 F2 24-41 0 -24 10YR3/2 None sl 2fcr mvfr as 2f 0.5 0.6 10YR4/2 None is o sg ml cw if 0.7 0.8 Ground elev 3 41 -50 7.5YR5/6 None is o sg ml cw if 0.7 0.8 104.1 It 4 50 - 123 IOYR5 /6 None s o sg ml - - 0.7 0.8 Depth to limiting factor >1 Remarks: Ground elev Depth to limiting factor Remarks: I is l 4 a c s` Owner: py.3W3 '50-,, m Ltcr loc_0. -�ed A� °Par�'Y Sfa'{!ts �rsk� Q�coK�gl. ,Goca� d» �1 5i.JYjScJt'V, Sea. //, - r2 ?.Y 19 W. 7:t. o�h�•a/so>,, ■ -( iron . (`ebar: Elea z m sf O 8 -3 ■ e -z ■ I�ic�er genck : m or lob Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page I of 3 Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code 1'snvirouFnental By Desiga Attach complete site plan on paper not less than 8% 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 dimemsions, north arrow, and location and distance to nearest road. parcel I. D.# ., APPLICANT INFORMATION - P/ P;Vdt.':i# n atioA. Reviewed By Date Personal information you provide may be used \ siRCOi►aary purposes s. 15.04 (1) (m)). Property Owner ( RE r Property Location MILLER SAM ti Govt. Lot SW 1/4 SW 1/4 S 11 T 29 N,R 19 W Property Owner's Mailing Address i M Lot # Block # Subd. Name or CSM# TROMROOK RD 5 Homestead City Ste "''dip Code mber ®City ❑Village [:]Town Nearest Road Hudson Hudson McCutchen ® New Construction Use: id" - alb tt( o drooms 3 ❑Addition to existing building ❑ Replacement describe Code Derived daily flow 450 gpd Recommended design loading rate .7 bed, gpd/ft .8 trench, gpd/fF Absorption area required 643 bed, ftz 562 trench, ftz Maximum design loading rate .7 bed, gpolftz .8 tr ench, gpd/ff? Recommended infiltration surface elevations) 91.50' It (as referred to site plan benchmar Additional design / site consideration system area in the area of borings 2, 4, & 5 Parent material locss over glacial outwash sands Flood plain elevation, ff applicable na ft S= Suitable for system Conventional Mound In -Ground Pressure AT -Grade System in Fill Holding Tank U= Unsuitable for system ® S El ® S ❑ U ® S El ® S El U ❑ S ® U ❑ S ® U SOIL DESCRIPTION REPORT goring# Horizon Depth Dominant Color Mottles Structure GPD/fl? in. Munseil Qu. Sz. Cont Color Texture Gr, Sz. Sh. Consistenc Boundary Roots Bed ; Trench l 1 0 -9 1Oyr2/1 - sil 2msbk mfr cw 2f .5 i .6 2 9 -12 7.5yr5/8 - sil 2msbk mfr cw if .5 .6 Ground 3 12 -35 7.5yr4/4 - s Osg ml cw - 7 8 elev 89.48 ft 4 35 -98 7.5yr4/4 - gs Osg ml Depth to limiting factor >98 Remarks: 2 1 0 -28 10yr2 /1 - sil 2msbk mcw 2f 5 6 2 28 -38 10yr5 /8 - sil 2msbk cw if .5 .6 Ground 3 38 -146 7.5yr4/6 - s Osg - - .7 .8 elev 94.8 ft Depth to limiting factor >146" Remarks: CST Name (Please Print) Signature:_ Telephone No. Thomas C. Nelson 715- 246 -2454 Address Environmental BY rgn Date CST Number Ref # 1432 120th Street, New Richmond, WI 54017 8/17/98 227387 74 PROPERTY OWNER: MILLER, SAM SOIL DESCRIPTION REPORT 74 Page 2 0 3 PARCEL I.D.# Environmental By Desi Horizon Depth Dominant Color Mottles Texture Structure onsistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ' Trench 3 1 0 -7 10yr2 /1 - sil 2msbk mfr Cw 2f .5 i .6 2 7 -14 7.5yr5/6 - s Osg ml Cw If .7 .8 Ground elev 3 14 -18 7.5yr4/6 - Cs Osg ml Cw if .7 .8 88.33 ft 4 18 -32 7.5yr4/6 - s Osg ml Cw - 7 i 8 I Depth to 5 32 -39 7.5yr5/8 - s Osg m1 Cw - 7 8 limiting factor 6 39 -96 7.5yr6/4 _ s Osg nd - - .7 .8 96 Remarks: 4 1 0 -9 10yt2/1 - sil 2msbk mfr Cw 2f .5 .6 2 9 -21 10yr5 /8 - sil 2msbk mfr Cw if .5 .6 Ground elev 3 21 -35 7.5yr5/6 - s Osg ml Cw - . 7 .8 ft 4 35 -98 7.5yr6/4 - s Osg ml - - .7 .8 Depth to limiting factor >98 't Remarks: ............... 5 1 0 -16 10yr2 /1 - sil 2msbk mfr Cw 2f .5 i .6 2 16 -27 10yr5 /8 - A 2msbk mfr Cw I f .5 6 Ground elev 3 27 -98 7.5yr6/6 - s Osg ml - - .7 8 96.26 ft Depth to limiting factor 988 Remarks: Ground elev Depth to fimiting factor Remarks: I I E BY D 1432 120`h STREET, NEW RICHMOND, WISCONSIN 715 - 246 -2454 PROJECT NAME HOMESTEAD 40 5 " PAGE 3 DESCRIPTION SW % SW Y, SECTION 11 T 29 N, R 19 W TOWNSHIP Hudson COUNTY St. Croix 3�-S 85 5� J Pt._ 0 41 � J r Q� 2A 0 SCALE 1" = y D awk/ i v _ Q F ? e #JCL) Tom Nelson k�' luv BM 1 . T I -c P 4 vra -e S � / CSTMO 2605 BM 2. ci ?, S ✓ lop 0� Spike T"c4J 1' ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer S m d Z E �L Mailing Address _d X # 1 ,:5- 1 Property Address V E (Verification required from Planning Department for new construction) City /State J4 V D.!SQ � W Parcel Identification Number 0 Z©- 3 5/S" 00 LEGAL DESCRIPTION Property Location S W '' /4, ' /a, Sec. �, T_?IN -R�W, Town of C/ O 'Subdivision h Dm �- .S U A b ,Lot # Certified Survey Map # 1 3 , Volume Page # Warranty Deed # �� Z 3 f , Volume , Page # Spec house yes ❑ no Lot lines identifiable I yes ❑ 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. 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 stating that your septic system has been maintained must be completed and returned to St. Croix County Zoning Office within 30 jp three year expiratio date. �-/( I sl6wtuu bt APKICANT DATE R AOOWNER 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 pr =e, irtue of a warranty deed recorded in Register of Deeds Office. I TUBE "PLICANT 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 • L ItIaI 11 �� I:i {{ t'tl -NSIN F FI }} 1N111– 1968 �• " "` "M.:o�:.+ a „• This Deed, „,�d, batwee„ ;ona It L . i 11 ie and ;ot i R. t.il l ie, husband and r� Grawor, 10: 111 A. .,nl Sam L. `tiller, a sin-je person , Gr'u,trc, WitIlesSeth, That the aid llrautor, for a valuable cunslderat.url i pa: ,r.w ra t„ tir.ultee the fullowu w &s. r,bed real estate in S. t.. Croi (' ,unt %, State of R ua.nsln: See attached description. Tax 1 Seer( No: . .......... ..................... i TRA FEft EE i I I This is not homrst,•ad property. tlsl (Is Rot) To with all and singular the htredttaments and appurteu..rces .:ereuntu t, nging; And Ronald L. Willie and Naomi R. Billie „ arrant. tr.at the title is good, In.lefe, able in fet simple .in.d free at„1 clear ,r,” eneumbr:..i.es eacrpt easements, restrictions, and ri;hts -of -way of record, nd %i!l „ Hirt ant and dciend ti a crane. Dated thl, d:,y of `arch 11 y0 (SEAL) 4V V L• tt. ��L (SEAL) • Ronald L. Willie (J:.AL) ;'.00°s <� / . /_<G LCC (SEAL) Naomi R. Willie AUTHENTIC!1'TION ACKNOWLEDGMENT Stbmaturcls) _ _ _. STATE OF V iSCONSIN ss. .......... ...._._. _ . S t... Croix .. -. _. County. � authcnticat,d this _ day of _..., 19 .... Person:. y came bef•ie ne this .Sri .....day of � arch., 19 9U.- the :above named ftonald..L....wiIUe _ aud .... ......... • _ . __... ........ NaQmi.R ,...wi1.lie ............... . TITLE: J1FaiRER STATE R.%R i'�F WISCONSIN _.._...._.._.._.. _ .... (If not. _. _..... _. _ .. authorized by ; 7u1S.C N'n. Stat.,.) S wl,u executod the to me known t., lie the per�.al . furugoing instr .ment and.gyktlpwl the same. L, THIS 'I aTRUP.ILN. WAS C .! FJ NV • •k\ C. L. Gaylord,._ attorney _. ... —1 . / C? „tc► r r�. .lr River Falls, [vI 54022 _ �.,t.a . P::1 1, �$ �. 1- -rx Count % Wis. I I:.,t..r. L. ,, h,• u,t :, nh,.at. ,•r n „lc. : ,,•J R„th 1Ic Con my kinn is , �in ` I rnjp (I f rldt, ,tate expiration date: - „AFtkA%TI DEED ar •. L Vt nF I UkN1 ]•. 1 — IlEll �I,.a�e ►era Nu I parcel of land located in the SF -1 /4 of the :h' -1 /4 and in part of the SI;-1; of the Si: -1 4 of / Section ll h w c . Ve;t. loin of Hudson, being. further de= cribedas follows: Fr�nEE 19 be at the S -1/4 corner of said Section 11; thence h6t 29'G3"�;, along the South line of the SV -1/4 of said Section 11, 2376.39 feet; thence NO2 2& 1322.62 feet to the North lire Of the 5-112 of the S1: -1 /� of Section 11 tF.Er�E ��� °: "'�'� a I r .. said North line, 2445.4 fEEt to the North - 5cuth 1/4 line�ofsaid - Sectior, 11; thence S00 34'16 1 1;, along said North -South 1/4 line, 1325.6:, fEEt to the point of beg,innir . ParcEl contains 73.32 acres (3,193,674 Square feet) and record. subJECt to all ease-,Ents of Together with and subject to an easement for ingress and egress located in part of the EW -1/4 of the S1; -1/4 of Section 11 and in part of the SF -3/4 of the SE -1/4 of Section 10, all in Township 29 horth, RanrE 19 West, Town Of Hudson, being further described as follows: Corr: °:ericin�, at the 5 -1/4 corner of said Section 11; t? ice NE9 29'03 "6.', along the S ath line of the SV -1/4 of said Sec::_.. 23 +6.3q fEFt; thence NO2 26 1256.54 feet to the point of bf thence continuing NO2�26'06 "6; 66.06 feet to the North li"t of the S -1/2 of the SW -1/4 of said Section 11; thence Nb� 35'00 "Wo along the Forth line of the S -1/2 of the St,' -1/4 of said Section 11, 179.28 feet to Pe NE corner of the SE -1/4 of the SE -1/4 of Section 10; thence N59 41'39 "W, along the North line of the SE -1/4 of the SE -1/4 of said Section 10, 1318.24 feet to the Wes line of the SE -1/4 of the SE -1/4 of said Section 10; thence S00 25'39 "M', along said West line, 66.00 feet; thence S69 41'39"f, on a line being 66 feet distant Southerly and parallel to the North line of the SE -1/4 of the SE -1/4 of said Section 10, 1I16.32 feet to the E line of said SE -1/4 of the SE -1/4; thence 569 "E; or. a line bEinc 66 feet distant Southerly and parallel to the North line of the of the SW-1/4 of said Section 11, 162.54 feet to tEC oint of beginnint. Parcel contains 2.27 acres (95,9 6 Square FEEt� aPrl 15 sut')ect to Iight -wad' for town road S d sut�jEct to all easeTsnts of record. ( coif F.eac) an m: f nrE•ari' i l lu.M' 11.6'1' 17111'46 N.U' w..aw IN#1'N61 W #)'11 r 1 M.N' IS"11'I3' I 18.1, 34 19 61.0• IU.N' 41/•11'1.1 141#1'11'1 • 21.11 / 111.1' 47 I 41.46' li tU 46.46' 46.]1' WhJ'84 721 : 21.11 t/1 US.N' 41 I w.0' U•ss'u' 1Sf ltl.u' 1N.U• 144 U44wo)•1 1 1I).H' 11 I ?11.1' 11.61'11 RI•M'48 U1.51' 14mv Ns•U'U'l 146 S 41).46' 15/1176 I 111.0' 36%'U Qsh7•U.Sq 146.71' 161.02' 311•U'114 Sril•117/•1 ! •••• 1 111.1' 67 i 1 711.' Mn'u1 0f•11'sims um N.N' stU•U'H'1 167.4'11'1 • • 1 431m 11#1'46 I 28.0' 61 IIIh2M-1 -1 ULU' U1.11' IN•N'IS'1 31111'U't 2 513./ {' 4/H's1' i - 331.11 9% W #l'U.S U.N' U.H' 16744 X121'22•/ 23•1'17' I _ 111.11 31#1'4 ffi120'Uq 81.11' u7.u' aftonel 310#1'11,[ )I•)1 1 1f1.11' 21°1'31' F 711,11 IMN a4h1'u.sq U7.41' 111.1' 0NN'Nq Nlk14f4 �' If -1S 1 113.11' 11 I: 151.11 0#1.11 SUIU M1.H' UI.M' MA4 UO31 4 •'111.11' nowu/ sworn urw U.71' 8.12' MI#/'U'1 sll/lS'N'/ I .'7p,IM 2a u'i/ 111#1'u.1 Ulm 511.1' 847#6'16'1 91 : N' Ufll'u s26h7'2s.6 112.71' 19.11' 111.51'1461 114 M o , ��� �� 6 � # 3 0 I 711.1' 4#1'611 u 8q 11{' 24 5.11' 81.26' 114.41'11 11{ 3 !'31'1 � UNPLATTED ! ANDS IIaTM LOC OF THE 6Vt 0r THE As 489 2448.54' 1170.00' 1.00 461 M' 410.0 1 ( • 110..64' 7 �'�>; 0 8 0% 1 z,b I / I 'S'q am" ft I L34 .01.6 rl L73 • I IO2, ton a 116.1 °y ;14 { M.7708 $0. FT) 1 ® 1 2.21 K 1 8 411 (2•9 Y y 1 497.007 w •11 �'' 1114, C da y. 1. f4 s, •a. �� , to 1a 401.1 641 .CKf ®y �� ` ^ j • �1• ,' ,. A� w.4= 40. /T. 106.161 64 rT � � +► {� /' � 414 aL h \N.,. �� •� / � �i Q2� ♦� •t.r N •• 1 , i 'K, a.s• 1 i / �r • • U 621 / 13 , • . • ,. • / / \ � ` 1 lM wu 1 M ^T 624 Lb ACK1 t Wi01 / 94466 am FT. �y a 33' 2x 4040 `, 61 / I �� 1 1 Q4.290 >a ., \ I \� 1 I I / 6!'61 •r• 4p>s({/ I , Ilto / ► o / �` 12 0 `, .� 616 \•// � .,» qrT LS 1 ,► \ _ 4 so X276.0111 N / _ I m, , ILI 9� 116.606 7o R i I /so am 904 Ow" sa,T ` � � •n IF S� �. iii � ►d'� - g � l � `� _ -- 1�1 fi - � •o \ l \ \ 7 � 1 � 1 o - N s : • � -DRIVE i 1 .0 >: 3 As 237 ACRES - - - - - u "�• ' 1 ifoc s s .A K 11�A46 10. R r t.OGA1 1 `' 7 -66.06 =FT I • A 6A26 v \• ^ / Le �A2 1 !' 107. 42' 1111 t• I / �µ. 601J7H LINE or THE 11•V4 1189'29'03 "w 2378.39' UNPLATTED LANDS LOCATION SKETCH �'