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HomeMy WebLinkAbout020-1346-80-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 538828 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Owen, Gary Hudson, Town of 020 - 1346 -80 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: &A , 451 11.29.19.1868 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic r Benchmark Dosing 196c) AIt,�BM J 3 Aeration Bldg. Se er 5 Holding t- St/Ht Inlet r � TANK SETBACK INFORMATION St/Ht Outlet 17 3 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 7,7 77 , 2.. Septic -7 f46 7Z �` Dt Bottom I' . Dosing y / � � , /� Header /Man. q / 7 • , Aeration Dist. Pipe C Holding Bot. System r J . , �� Z Final Grade PUMP /SIPHON INFORMATION J. t 161, Manufacturer Z o6Ll�. Demand � TDH L St Cer / 3, 3 /0 1 . Model Number S • � 53 Frictio Ls /V System H TDH Ft � os Z> 71 Forcemain Lengtth I Dia. Z / Dist.towell� • �� 5 SOIL ABSORPTION §YS TEM t BED/TRENCH Width Length No. Of Trenches _' PIT DIMENSIONS No. Of Pits Inside Dia. Liquid th DIMENSIONS Z i (etC� SETBACK SYSTEM TO I P/L EDP WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR (� Type f t , /7 ` UNIT Model Number: A DISTRIBUTION SYSTEM 7 .01 - /Q Header/Manifol� / Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia ` Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Dept oh f xx Seeded /Sodded xx Mulcheh Bed/Trench Center �J • Bed/Trench Edges Topsoil \\ `es ® No Yes H No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 732 Packer Dri Hudso WI 54 16 (SE 1/4 SW 114 11 T29N R19W) Homestead Lot 18 Parcel No: 11.29.19.1868 1.) Alt BM Description =J I �J'�'�' 2.) Bldg sewer length = - amount of cover Plan revision Required? ❑Yes ion. o � I � � �� ✓' � 'v!_` �' Use other side for additional informa SBD -6710 (R.3/97) Date Insepctor' Signat Cert. No. Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT sanitary Permit No: 538828 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Owen, Gary Hudson, Town of 020 - 1346 -80 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: 11.29.19.1868 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TFH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM id Depth BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liqu DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipes) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes No � Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 732 Packer Drive Hudson, WI 54016 (SE 1/4 SW 1/4 11 T29N R19W) Homestead Lot 18 Parcel No: 11.29.19.1868 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? ® Yes 0 No Use other side for additional information. Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) -`� &;/ JIVF ,t commerce .Wi.gov Safety and Buildings Division County i c 201 W. Washington Ave., P.O. Box 7162 St Croix Madison, WI 5 Sanitary Permit Number (to be filled in by Co.) part 'g" >t �� ��v7 e 3 O U �R OF F ICE State Transaction Number ry ermit Application In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate ggmmental � unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POW are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary ��� �qt.r n C U � p urposes in accordance with the Privacy Law, s. 15.04(1)(m), Slats. J4e 1. Application Informs 'on — Please Print All Information Property Owner's Name / Parcel # Gary Owen 020 - 1346 -80 -000 Property Owner's Mailing Address Property Location / 732 Packer Drive b (p City, State Zip Code Phone Number Govt. Lot 11 Hudson WI 54016 612 - 328 -5766 '' /a, '/4, Section (circle one) II. Type of Building (check all that apply) T 29N; R 19W X 1 or 2 Family Dwelling —Number of Bedrooms 3 Subdivision Name 18 ock # Homestead 1998 ❑ Public /Commercial — Describe Use e'C�.r''�P`. ❑ City of ❑ State Owned — Describe Use CSM Number ❑Village of Z q , 4� X Town of Hudson III. Type of Permit: (Check only ne box on 11ne A. Complete line B if applicable) A. New System XRe lacement System Other Modification to Existing System (explain) p Y ❑ Treatment/Holding Tank Replacement Only B• ❑Permit Renewal ❑Permit Revision 11 Change of Plumber [I Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner 3 _ 3 0 0 Z / IV. Type of POWTS System /Component/Device: Check all that appi X Non- Pressurized In- Grou ❑ Pressurized In- Ground At -Grade Mound > 24 in. of suitable soil Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treatment Area Information: U S Orv, Design Flow (gp Design Soil App lic on Rate(gpdst) Dispersal Area Required (sf) Dispersal Area oposed (sf) System Elevation # 199.2' 450 .5 900 900 #2 98.9' VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units o New Tanks Existing Tanks c U y t1/ o «= a. U Septic or Holdin Tank 1000 1000 1 Weiser X Dosin Chamber 800 800 1 Skaw Pre -Cast X VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP /MPRS Number Business Phone Number Thomas D Gustum 227618 1- 715- 658 -1344 Plumber's Address (Street, City, State, Zip Code) N13450 937' Street New Auburn WI, 54757 VIII. County/ e artment Use Onl .Approved � Me r Permit Fee Date I sued Issuing nt Signature Given Re r Denial $ g�Zy�� // IX. Conditfeasons for Disapproval 1 Septic tank, effluent fiRmr and dispersal cell must all be services / maintained as per management plan provided by plumber. 2. All sefbacktrequirements must be maintained as code / ordinances. Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x 11 inches in size SBD -6398 (R. 01/07) Valid thru 01/09 Trench #1 o Tech # LEGEND ■ = Soil Borings With Backhoe BM1 = ELEV. 100.9 -top of existing septic cover- also HRP + BM 2 = ELEV. 100.7 -top of door sill at basement door- also HRP I It B30, SCALE 1" = 40' 100. mai + en o 131 $ N� from iq old Soil test Property line g rstem er Drive Gary Owen 723 Packer Drive Hudson, WI, 54016 Town of Hudson Homestead 1998 Lot 18 Sec 11 T29NRl9W Page 4 of 5 Chambers Page 1 of 5 Cover Page Project Name: Gary Owen 450 GPD Conventional Owner's Name Gary Owen Owners Address 732 Packer Drive Hudson WI 54016 Legal Description y4 _ Y. Sec 11 T 2 9 N RF R 1-97 W Township Hudson County Saint Croix Subdivision Homestead 1998 Lot# 18 ParcelID# 020 - 1346 -80 -000 Table of Contents Pg- 1 Coverpage 2 Calculations and Drawings 3 Management and Contingency Plan 4 Plot Map 5 Lift Station Information total # of pages: 5 Designer Name: Thomas Gustum License #: 227618 Date: 8/18/2011 Ph. #: 715 - 658 -134 Signature: t, dam�&� If Design Methods Used "IN- GROUND SOIL ABSORPTION COMPONENT MANUAL FOR PRIVATE ONSITE WASTEWATER TREATMENT SYSTEMS" (Version 1.0) SBD- 10705 -P (R.6/99) Chambers Page 2 of 5 Calculations and Drawings Site Conditions Infiltration Elevations Site Type:' Private � Trench #1 Trench #2 Trench #3 %Slope 7 % Contour Elev: 101.20 100.901 0.00 Ft # of Bedrooms 3 Infiltration Elev: 99.20 98.901 0.00 Ft Depth to limiting factor 60 in Limiting Factor Elev: 1 J6,20 95.90 ,y N/A Zone: 00 3.00 Soil Application Rate: 0.5 gal /ft ^2 /day Treatment and Dispersal Z N/A Effluent Quality'! Eff #1 . r� Cover Material Required: t� 0 0 N/A In Design Flow: 450 gal /day Finished Grade Over Cell: 101.20 100.90 N/A Max BOD 220 mg /I Max TSS 150 mg /I Distribution Cell Septic Ta Choose chamber type Ez Flow 3 x to cell Septic Tank Manufacturer: Skaw # of Trenche Septic Volume Chosen: 1000 Laying Length: 10.00 Ft / Effluent Filter Selected: simtec 100 EISA Determined Area: 50.0 Ft2 Note: Access opening of sufficient size to be provided to allow removal of filter. Opening Open Bottom Area: 35.30 Ft2 to terminate at or above grade. Chamber Height: 12 Inches Required Infiltrative Area: 900.0 Ft2 Actual Infiltration Area 900 Ft2 Total # of Chambers: 18 Total Cell Length: 180.0 Ft Cross Section of Septic Tank Cross Section of Cell 12" Min Grade p 18" Min Barrier Paper y All joints to be water tight D3034 or Effluent Sch40 Filter Pipe Flow Channe r 3" Bedding Under Tank Plan View of Typical Cell ------------------- — — — — — — — — — — — Barrier Paper ------ ------ XL Page 3 of 5 In- Ground System Management Plan pursuant to Comm 83.54 W. A. C. Owner's Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make periodic inspections of the components, checking for surface discharge, treated effluent levels, etc. The owner or owner's agent is required to submit necessary maintenance reports to the appropriate jurisdiction and /or the department. Septic Tank: Septic tank(s) are to be inspected routinely and maintained by department approved individuals when necessary in accordance with their approvals. The use of chemical /biological "treatments" is not required or recommended. If such additives are used, make sure they are approved by Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & cleaned as necessary, with provisions to keep solids from passing the septic during removal. No more than 1/3 of the usable tank volume may be occupied by sludge /scum. 3 year inspection: If tank has greater than 1/3 volume sludge, tank contents must be emptied and disposed of in accordance with NR 113 Wisconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank, then the owner must be notified of when pumping should be done as to not exceed 1/3 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. Absorbtion Cell The absorbtion component must remain free of ponded surface water prior to pump operation. If 4 inches or more water level is detected in the observation pipes, the owner must be notified of possible /failure. The designed daily flow capabilities of the component should never be exceeded. Trees and any other deep rooted vegetation should never be planted, or allowed to grow anywhere on the component. Activities OTHER than mowing /maintenance (i.e. excessive walking, pets, vehicles, etc...) could compress the component and reduce it's absorbtion capabilities and /or possibly cause it to freeze in winter conditions. Performance Monitoring: Performance monitoring must be done at least once every three years following the installation or at the time of a problem, complaint, or failure. Contingency Plan: If the septic tank or other components therein (including floats, alarms, etc) become defective, the defective tank or component must be replaced immediately to ensure that the system can operate as designed. If the absorbtion component cannot accept wastewater or ponds wastewater to the surface, the component must be repaired or replaced in it's current location by removing the clogged bacterial mat, aggregate /leaching chamber cell, and distribution piping within the cell and replacing failing components in order to return system to proper working order as required. If repair is not feasible, a new system is to be constructed in a designated replacement area Lift Station Information & Calculations Page 5 of 5 Total Dynamic Head Calcs. Discharge Rate: 20 gpm Forcemain Length 100 ft Forcemain Diameter[ Friction Loss from Forcemain 0.916 Vertical Lift 7.00 ft U �, Total Dynamic Head (TDH)j 7.92 1 ft I J Dosage Volume Calcs. Does forcemain drain back to tank ?C� ( J Dose: 60 gal Forcemain Volurnel 9.60 gal Total Dosagej 69.60 gal Tank Informa Tank Manufacturer awPrrecast Inches Gallons Tank Capacity 800 gal A= 30.1 577.0 Tank Gallons per Inch Water Level 19.18 gal /in B= 2.0 38.4 Bottom of Tank Elevation 80 ft C= 3.6 69.6 Pump Manufacturer /Model Little Giant D= 6.0 115.1 9EH Total= 41.71 800.0 Pump Curve Pump Tank Diagram FLOW– LITERS /HOUR 0 1000 2000 3000 Elect. per Comm 30 to 16.28 and Vthtertight Lacking Cover NEC 300 4 inch �WSth Wamin Label Finished w Z 5 Minim , 20 W I E a 5 I Altemat- a L ocall Filter 10 w x 2.5 Forcemain D 0 A 444 Tr1T V f — V An Hole 0 20 40 60 80 or Anti- B Little Giant FLOW– GALLONS /MINUTE Siphon 9EH PUMP PERFORMANCE CURVE Device C 115V 60HZ D Selected pump requires a minimum operating rating of: 7.916 feet of head pressure at 20 GPM J vgfsaj 7b11 Free 88S-999-3290 Qjftv 231 - 5 82 - 1020 1455 I.,examar Drive, Boyriu City, M1 49712 Fax 231-582-7324 L- simtrcJ1@fivawuy.NEr Web INSTALLATION SERVICE INSTRUCTIONS INSTALLATION: When installing an STF-1 00, screw filter into discharge port of any pump that has a 2' National Pipe Thread. Pumps with a smaller discharge port may be adapted to fit. When installing an STF-1 OW a tailpiece and male adapter will need to be added to the inlet end of the filter to the desired height and a 2* union will need to be added to the outlet end of the filter. Always install the filters in a position where they can be easily serviced. **Always use caution when starting threads to avoid cross threading". Plumb force main into the 2" sch 80 PVC union. "We recommend that the union remain together during gluing to insure that glue or cleaner does not ruin O-ring or sealing surface**. SERVICE: Service of filter screen is dependent on usage as every system is unique, For most residential systems we recommend inspecting the filter within the first year to determine the necessary service intervals for the filter. In high volume systems we recommend inspection within the first 6 months to determine necessary service intervals for the filter. Once the service interval is determined it should be consistent unless something changes in the system. Always inspect the filter screen for any damage or corrosion and replace if necessary. if our -STF-101 service alarm switch has been installed and adjusted properly it will alarm when the filter requires service. It should be serviced no less than when periodic pumping of the septic tank and pump chamber is performed. Servicing will be more frequent if using any one of our optional filter socks (600 micron, 160-190 micron, and 100 micron), Check your local health department for septic system servicing recommendations. If the screen becomes clogged before the periodic pumping requirements, a high level alarm or light will indicate the need for service. If system is equipped with a "pump on light' that stays on longer than normal, this also may indicate a need to service filter. To service filter screen, unscrew the 4" cap. Pull filter screen from canister and wash out thoroughly in appropriate location with proper protection, In some cases an additional filter screen allows quicker service allowing the dirty filter to be washed later at the shop, Note-: tiffi W be . 19YA _(-�Iojca conclition , s 1110,;C40.4 to rornove: 49 .p too t in.Wwa :i.gree- br war orlm— w 0. filter is rM (n water d��r;ths ,cap, I-e pre a0'(Sips a- st6b16 tp.mperatuhY and i6m.. ovin.g.th, a o.ap*ffF-. hot be,.&prob em. If the system is equipped with our Service Alarm Switch, the filter screen does not need service until the Service Alarm Switch activates a light or audio alarm, We still recommend that the filter be inspected. once a year for damage or corrosion, NOTE: The total dynamic head loss of the system must be increased by 0.5 feet of head to overcome friction loss through the filter. SERVICE ALARM SWITCH The alarm switch is available in three pressure ranges, low head, medium head, and high head. Installation is simple, on SIM/TECH FILTER systems, remove plug from base of filter chamber and connect tube fitting. Next, run the tube up into the tank riser and connect to service alarm switch, The alarm switch is fastened to the side of the riser via the nylon strap provided. Run alarm wire to alarm box. The service alarm switch can be wired with its own alarm or with the high water alarm. Pressure adjustment is made by removing the end plug, and inserting the 7132 alien, Clockwise increases pressure. One turn equals approximately 3 PSI. The low head alarm switch comes factory preset at 8 PSI and is completely field adjustable within it's range (3 to 24 PSI), We recommend the use of a ball valve when using an alarm switch. Once you have installed the filter and alarin switch, the ball valve can be closed off to simulate a plugged filter so that you can make sum the alarm switch is working correctly. *** OUR LID/SCREEN REMOVAL WRENCH. Our wrench holds filter lid firmly and hooks screen for easy removal and installation. Made of PVC plastic. Installation Service Instructions.doc r 1 l�� j• i t a I..• The Sirn/TeL* filtEr vuft xr5 unrquo design and mountki' mkffi unmatched porkwmaneg capabAffieL The r*ar see- & a t9pe 347 sftiraksg stgoffl Koh y062 &SMoter hS, * is 3' inches in dAwmifffisr and 10 h7cheS JOW Nd j a jM_q2 square !inch open ergs Thk br9w Open area altovi& the 'bolter to P'aSL5 ORS aftcos per minims at .10. UM 1 tur"� •his thesis fivW a parflaky cJbq ' scr* kiwp the SqS " d n prVLGJV- p"XkW assess ' ' 'eff j ormir T5S. lev* s. kgej*g ,fir .pmssurized s9stem rectioning -at 1' fiffiamnCUL ringineem and s1'gnol:5 now have - the- abide to co ftuar d . to a Systgr ms Wo jurwgon as daskn now mid in the futur& I lbr, m:,, och Mer can b6 End' Grp bcth resldEn and c a, Rows .gym .ta X11 "911 ?rl �� Ind 0OW rate W . SUCEa�: f I e4 or,21 PSI ; Ej ; ., WWWw r iMtoQh 111 �'i W h Illl�j v 5P .90, ST. CROIX CO UNT' ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZA'T'ION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and /or dose tank presently serving the following residence: (Street ad dress)-2.1 -.. Re 1pn, Dr-- located at: 5E _ %4, ,SV ` /a, Section / J , Town N, Range W, Town of in , St. Croix County Wisconsin. Upon inspection, I certify that I have .fotuid the tank(s), to the best of my knowledge, will conform to the requirements of Comm. 84.25, and it (they) appear(s) to be :functioning properly. Most recent date of inspection or service 71 71 C Did flow back occur from absorption system? Yes No (if no, skip next line.) Approximate volume or length of time: ` gallons minutes Tank Capacity: - p Construction: Prefab Co ete 9 Steel Other Manufacturer (if known): acs c, Age of Tank (if known): .'?�_� s Permit number (if known) :32$ a Licensed Plumber Signature) (Print Name) z2.1c� (Title) (License Number) MP/MPRS (Date) Form to be completed by licensed plumber (Dept of Commerce Chapter 5 and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 0/2008 UNOFFICIAL COPY I ; x'758135 U 2 6 6 7 P 2 19 KATHLEEN H. NALSH STATE BAR OF WISCONSIN FORM 3 - 1999 REGISTER OF DEEDS Document Number QUIT CLAIM DEED ST. GROIN CO., MI RECEIVED FOR RECORD This Deed, made between Gary D Owen, a married person 10/81/2884 12:30PM Grantor, QUIT CLAIM DEED and Gary D. Owen and Kristine M. Owen, husband and wife EXEMPT # ON Grantee. Grantor quit claims to Grantee the following described real estate in REC FEE: 13.00 TRANS FEE: St. Croix County, State of Wisconsin (if more space is needed, please attach COPY FEE: addendum): CC FEE: See Attached Exhibit "A ". PAGES: 2 Recording Area Name and Return Address First National Bank PO Box 89 NeW Richmond, WI 54017 020-1346 -80 Together with all appurtenant rights, title and interests. Parcel Identification Number (PIN) This is homestead property. Dated this � day of August , 2004 (is) (is not) Gary D. Owen AUTHENTICATION ACKNOWLEDGMENT Signatures) —_^ _ STATE OF _W isconsin ) _-- - - - - -- .. ) ss. St. Croi ) authenticated this day of _ Personally came before me this 24th day of : Ra � September , 2004 the above named Gary D. Owen, * TITLE: MEMBER STATE BAR OF WISCONSIN (If not, _ _ to me known to be the person(s) who executed t}� oing ' authorized by § 706.06, Wis. Stats.) instrument and acknowledged the same. ,,�O T.4 THIS INSTRUMENT WAS DRAFTED BY • L �+ . ,, *i Attorne Kristina Ogland * Er ic M. ZbStrud ', �/BL% Hu dson, W 5401 Notary Public, State of V1 SCOIlsiri My Commission is permanent. (If not, state expirattdN> fffltt►Ii��` (Signatures may be authenticated or acknowledged. Both are not necessary.) 10/02/05 ) Names of persons signing in any capacity must be typed or printed below their signature. Information Professiomals Co., Pond du Lac, wI STATE BAR OF WISCONSIN SM655 -2021 QUIT CLAIM DEED FORM No. 3 -1999 UNOFFICIAL COPY /D om STATE BAR OF WISCONSIN FORM 2 - 1982 60991 WARRANTY DEED KATHLEEN H. WALSH �? REGISTER OF DEEDS DOCUMENT NO. II 1451 PAGE 65 ST. CRdIX CO., WI _ RECEIVED FOR RECORD Sam E. Miller, 06-23 -1999 10 :00 AM WARRANTY DEED MC OPY FEE. M FEE- conveys and warrants to Gary D. Owen and Kris M. Owen, FEE: 529.80 husband and wife, as survivorship marital property, RECORDING FEE: 10.00 DACES: 1 i '.I 1 THIS SPACE 'RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS the following described real estate in St, Croix County, State of Wisconsin: First Federal Savings Bank 201 South Second Street i Hudson, Wisconsin 54016 I 020- 1346 -80 PARCEL IDENTIFICATION NUMBER Part of Lot 16, Plat of Homestead in the Town of Hudson, St. Croix County, Wisconsin described as follows: Beginning at the SEly corner of Lot 16 of the Plat of Homestead; thence N34 0 38'42 "E 138.00 feet along the Ely line of !' wi said Lot 16; thence S70 0 12 1 57 "W 219.62 feet to the Sly line of said Lot 16; thence S73 0 00'06"E 134.07 feet along said Sly line of Lot 16 to said SEly corner of Lot 16 and the point of beginning. Lot 18, Plat of Homestead in the Town of Hudson, St. Croix County, Wisconsin EXCEPT Beginning at the NW corner of Lot 18 of the Plat of Homestead; thence S73 0 00 158.75 feet along the North line of Lot 18 as shown on the Plat of Homestead; thence S70 0 12'58 "W 176.05 feet to the West line of said Lot 18 as shown on the Plat of Homestad; thence N07 0 26 1 27 "E 106.90 feet to said NW corner of Lot 18 and the point of beginning. This is not homestead property (is) (is not) Exception to warranties: Subject to easements, reservations and restrictions of record. Dated this ! day of Augunt A.D., 19 99 _. (SEAL) ` (SEAL) + SAM E. MILLER (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, ss. St. Croix Count authenticated this day of 19_ Personally came before me this day of Au ust 19 99 , the above named r "y Sam E. Miller TITLE: MEMBER STATE BAR OF WISCONSIN (If not, J+�' authorized by §706.06, Wis. Stars.) a o own to be the person who executed the foregoing s. i and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY ��ijF�f W �` E 1 STEPHE J. DUNLAP y�r�11tuluRttu n, Hudson, Wisconsin Notary b c, St. Croix County, Wis, (Signatures may be authenticated or acknowledged. Both are not My con ssion is permanent f not, state expiration date: necessary) — �( Names of persons signing in any capacity should be typed or printed below their signatures. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Ix. WARRANTY DEED Form No. 2 — 1982 mowaukea, Wis. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address 'J plc r, - (�y . t.� Property Address ,1 (Verification required from Planning & Zoning Department for new construction.) City /State A V'/1 Parcel Identification Number LEGAL DESCRIPTION Property Location 1 /4 , 1 / 4 , Sec. , T N R W, Town of Subdivision Plat: Lot # Certified Survey Map # , Volume , Page # Warranty Deed # (before 2007)Volume , Page # Spec house ❑ yes ❑ no Lot lines identifiable ❑ yes ❑ no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. 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 Planning & 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 wastewater disposal 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 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 the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. 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. Number of bedroom 3 O W CJ /J/ - - -- 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. 09/07) h N All VIscon REC S L EVALUATION REPORT #2541 in Department of Co merce in a ordance with Comm vip o Page 1 of 2 Division of Safety d Buik{ini ge, 2 L 11 Gustum Septic Service Attach complete site p non pp�� t n 8%2 x 1 inches in size. Plan must County include, but not limited o: vert�a14tr5AZ�lYrefere a point (BM), direction and St. Croix percent slope, scale o d�i4@�RfUFi, $drffMl�Id %QF"6ffo tion and distance to nearest road. Parcel I.D. Please print all information. 02 1346 -80 -000 Revi ed By Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Date Property Owner Property Location 0 Owen, Gary Govt. Lot n/a 1 , 1/4, S11, T29N, R1 9W Property Owner's Mailing Address Lot Block # FHomes tad N e or CSM# 732 Packer Drive 18 n/a 1998 City State Zip Code Phone Number City Village�>„ Town Nearest Road Hudson I WI 1 54016 1 612 - 328 - 5766 Hudson I Packer Drive ,LJ New Construction Use: 01 Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Ad Replacement N Public or commercial - Describe: Parent material outwash plains Flood plain elevation, if applicable n/a ft. General comments 2 acre parcel. Recommend system el. 98.9' and 9 \2' in two trench system. 61 from soil test dated 6-23 - and recommendations: 99. 2 Boring # Boring Pit Ground surface elev. 101.2 ft. Depth to limiting factor 70 in. Soil Application Rate Horizon Depth Dominant Color Redox Description I Texture Structure Consisten Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ce - Eff#1 "Eff#2 1 0 -5 10yr2 /2 none Sil 2mgr mvfr as 3f 0.6 0.8 2 5 -17 10yr3 /3 none Sil 2msbk mvfr Cw 1m 0.6 0.8 3 17 -29 10yr3/4 none sl 2msbk mvfr Cw 2m,ico 0.6 0.8 4 29 -39 10yr4/6 none sl 2msbk mvfr Cw 1m 0.6 1.0 5 39 -70 10yr5/6,4/4 none sl 2msbk mvfr Cw - 0.6 1.0 6 70 -80 10yr4 /6 c2 -3p 10yr8/2 7.5 r5 6 sl 2msbk mvfr - - 0.6 1.0 M r F 1 3 Boring # QV j Boring Pit Ground surface elev. 100.9 ft. Dep h toViting Vactor 60 in. ISoil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 •Eff#z 1 0 -5 10yr2 /2 none Sil 2mgr mvfr as 3f 0.6 0.8 2 5 -18 10yr3 /3 none Sil 2msbk mvfr Cw 1m 0.6 0.8 3 18 -25 10yr3/4 none Sil 2msbk mvfr Cw 1m 0.6 0.8 4 25 -38 10yr4 /4 none Sl 2msbk mvfr Cw im 0.6 1.0 5 38 -48 10yr4 /6 none sl 2msbk mvfr Cw - 0.6 1.0 6 48 -60 10yr4/4 none sl 2msbk mfr Cw - 0.6 1.0 7 60 -85 10yr4/6 c2 -3p 10yr8/2 Amg/L bk mvfr - - 0.6 1.0 7.5y 5/6 Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L CST Name (Please Print) Signature: CST Number Tom Gustum 227618 - Aa4�� Address Gustum Septic Service Date Evaluation Conducted Telephone Number N13450 937th St. New Auburn, WI 54757 7/29/2011 715 658 - 1344 SBD -8330 (R.07 /00) I � I a k I ca S ma a � � � 3� � 2 ■ a S g . % 0 O 2 § k a # 0 z & # q O / 2 I w w < on w w , i It ■ � � ` CNI r � � E @ C ' � e m contour _ . - -- - - -. �2 y Alm E \ \ �• $ ƒ \ � � $ E » 2 0a § > n ■ 0w @ f k� ■ CIL CL t § 2 04 , , , , , , , , , , , , a , x , � � I $ E , c U O � fA N O Z i O , N Z b (V W S g J , , J m w Q O J J [, U) W W i 11 II II v ^ ' 1 i , , N � m m , d ' C ' , i d � a e I a , , , 'a .�W�— m ,� O 101.2 Cor*Our ------------ _ 100.9' Contour , - - - - -- , m E io , rn .0 CD i , i i , i N C � i d i CL e CL m C , i d ' CL , a I CN RRF� 1 6 -T�701 ST. CROIX COUNTY ZONING DEP EN'P�E E AS BUILT SANITARY REPOR J Q 0 sr �x Owner Address ] 3 0 s City /State H y J�,L Q N W I 4/ (( y , Legal Description: Lot 17 Block ' Subdivision/CSM # 1-1o� :� T", 12 '/, f2L '/4 w Sec. Z�—, T22N -R i )' ' C, Town of M a D.5 o t' _ PIN # SEPTIC TANK -- `)DOSE CHAMBER -- HOLDING TANK INFORMATION Tank manufacturer �N a / /�. Size ST/PC /' Setback from: House ? 7 Well P/L `� Pump manufacturer Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake 1 551- Water Line _ Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: i- --44C / Width 3 / Length 75 Number of Trenches Z---- Setback from: House ! C g Well P/L - - 2.'. Vent to fresh air intake I Z I E LEVATIONS : ,617 W ik eu7 i "1"6 0 I �! �. k F6v Mrl 010 k � � Z 3 0 y Description of benchmark Elevation �© 0 ' Description of alternate benchmark KI P1 i l 10 T u— ` c . q Elevation 10 2 S " MANffa� Building Sewe0 - / 7 = � � t t ST/HT Inlet i V : " !: S `ST Outlet q 2: , q j / PC Inlet - PC Bottom Header/Manifold , S = 1414op of ST/PC Manhole Cover Distribution Lines 6 Bottom of System Final Grade i Lew 5!!�E 1 ►Q� Date of installation / 7/9 Permit number ='- I' State plan number Plumber's signatur t License number ` ,0 3(0 Date l lq Inspector � &MkA Complete plot plan �+ 1 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 aPP licable. PLAN VIEW © f w oo l( �t A F3iriZ Y R IL /N 74r't v I ty k ? 7S f t i t 4 INDICATE NORTH ARROW Wisco66in Department of Commerce PRIVATE SEWAGE SYSTEM Count Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No ST CRO X Personal information you provice may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)]. 338879 Permit Holder's Name: ❑ City ❑ Village ]C] Town of: State Plan ID No.: MILLER, SAM HUDSON CST BM Elev.:- Insp. BM Elev.: BM Description: Parcel Tax No.: 06 f 020 - 1346 -80 -000 TANK INFORMATION ELEVATION DATA A9900140 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ���� Benchmark 5", 7- pa, f Dosing -; Sy ICQ.6g Aeration Bldg. Sewer 7-1-1 Holding S�t W Inlet 7 - C. TANK SETBACK INFORMATION Q /+Ft Outlet TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet --� Air Intake Septic ;5_3 L / �? y NA Dt Bottom �.s z Dosing NA Header / Man. g SZ Q Aeration NA Dist. Pipe --- Holding Bot. System 2�-- PUMP/ SIPHON INFORMATION Final Grade 8 Z Manufact rer mand ( 3 o Model Number GPM DH Lift Fric stem TDH Ft Forcemain ngth Dia. Dist. To SOIL ABSORPTION SYSTEM l� 3 X 1.7 - 5 ��'►P.� aq REN Width Leng N Trenches PIT No. Of Pits Inside ia. Liquid Depth DIM N 1 DIMENSION SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING a4a 51r�c•�. INFORMATION Type Of u CHAMBER Model Number: System: CO'"V• 0�- `ng (l OR UNIT DISTRIBUTION SYSTEM Header/Mani N Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length .� Dia- Length —r Dia. Spacing ?S'a SOIL VER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS (Include code discrepancies, persons present, etc.) LOCATION: HUDSON 11.29.19.1860,SE,SW 732 PACKER DR — HOMESTEAD LOT 18 Plan revision required? ❑ Yes No Use other side for additional inforrdation. �' °� �"� SBD -6710 (R.3/97) Date Inspector's Signature Cert No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: Vn 3 e e L _....... ,„ .., i _._ ,t .. [ ............ —. —, } € s t _ E r ; ,.a j --- a. e ,. ..,.. _... ., w p e,. ,. ., .. ....a ...._ ... _ .. .,.. . . € 7 0- VI ° ,h a _ N. A s i 4 { g S 8 n i e e q E A ...m 1-14 -f _ .-. .-._ ....., me _ 7 L A d— E —. »...,. ..... N R .a... .. e.a.,.. .... ....... _ .:. _..,. _ . _ ..� i t .. .t .m .. ev mr. wmm .a..•. em �.aemmu E q } € 1.4 .m ..... �. E S� € I i ! 3 i 4 3 5 A e 1 494-4_4_41 All: s 1 € 4-4+4 4 . 41--f-TAK-4 i „... ( j 4 4 4 --, d A 9 V-2— T a E 3 b....., . .. �.. ..... ..�. .e_..�. �.. .... as . ..._e.. _.We m . ... .. ........... .. �. ........, ... ......... .. . .. e.,.,. .. .... . ._ ... .. ...... _.a.. . ....._... .....,..... ..,....,,,,. ., ._x 4 � 6 f � Safety and Buildings Division `./SCOnS� SANITARY PERMIT APPLICATION 201 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 8 1/2 x 11 inches in size. • See reverse side for instructions for completing State Sa this application Permit Number Personal information ou provide may be used for seconds p 1 3 2 18 7 41 . ous application Y P Y secondary purpo Check if revision to prev [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATION ProR?rty Owner Name _ Location t L ..-. Z je f F- 1/4 5 (j1 /4, S (( T 1 , N, R /9 E (ol(0 Property Ow fain Address lot Number Q Block Numb C ty, ! State I%ll Zip Code _ ;umber Subdivision Name or CSM Number (5 Z'749" _5 A D II. TYPE OF BUILDING: (check one) ❑ State Owned E] Cit Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms -3 0 Iow OF 14 0-SON ?ACk DO-1 r�E III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 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. ew 2 ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an ystem ________ 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 LE4CN 22 E] In-Ground Pressure 1 i 42 E] Pit Privy 13 Seepage Pit An /IViFI /_ T71G4 7'02 .Z X 3 Y 43 ❑ Va It Privy 14 ❑System -In -Fill L� 6 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 SCE Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation -5 , 1 60 - 3 - 76e 3 - 2 8 YS. 7 0 Feet l0 /-O Feet Capacit VII. TANK in ga llo n s Total # Of r Prefab. S Fiber- Plastic Exper. INFORMATION Gallons Tanks M anufacturer's Name Concrete Con- Steel glass App. New Existin structed Tanks Tanks ptic Tank Tlekling�etr X QQ(7 F ,S4 ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ 1 ❑ 1 ❑ 1 ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's ignature: (No Stamps) MP /MPRSW No.: Business Phone Number: < < ©E1-c.._ Z2 C. 38"� 0q Z Plumber'sAd s (Street, City, State Zip Code): 07 dre o utylA iQ ( PCe ROAP gi-)DW O W 5_ 11 f ,0,1 16 IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater ate I ssued IssuZg nature (No Stamps) [Approved []Owner Given Initial Surcharge Fee) L Adverse Determination lOv X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: I SBD- 6398 (R.11/97) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber 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. 11. Type of building being served. Check only one and complete # of.bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete 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 mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump 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. PAF- S L 07 k tX D 1 V E RF-vfsto►q To PiExmi & 33-3 79 i IS T E rig E / z 9 s g TA Y. 0 - 1 s - 4/,c bk n W F air ILI IIZ7 M /a r5- e ma r m J '. f�f TTS 11 1 0) o o �-rn CL C° CL . C CD C _ •� M -4 c 3 . aT T s 1 ( r Y �o v .rn 3 1 a " A o o" a .`. co q A p ?{ a. �'�•�• o XXXXX rn _ ��► .. /�' $ N m m 07 N y � ' 11� cx N \"V1 co =oO�c�r' o �:mo � w N Wa 2c�� c Oo x 3 w C D =— m o x �� = m O C m = _ C c cc CD C . M �' n l cr 0 CD CD N W (� N j y U N N CD 01 ca C.0 —M Ln ju ' � 1 CY) � x j Q .: CD C', `D S G O O 4consin' Departmentof Commerce SOIL AND SITE A4W Page 1 of 3 Division of Safety and Buildings in accord with Comm Q5; Wis: - A d - f A.C.E. Soil & Site Evaluations Attach complete site plan on paper not less than 8 /T x 11 inches in size. PI r � include, but riot limited to: vertical and horizontal reference point (BM), di R [� 9 St. Croix percent slope, scale or dimensions, north arrow, and location and distance t road. a I.D.# 020 - 1346 -80 -000 APPLICANT INFORMATION,, � /ease pdntall informMa to , �� � y D Personal information you provide m y be used for secondary purpbsas (Privacy .04 (1) ( Cj Property Owner ' r tt Miller, Sam '�J oG�l, Lot SE W 1/4 S 11 T 29 N,R 19 W Property Owner's Mailing A dree�; Lo � Block # Name or CSM# Box 151 Trout Broo ad 18 , - --- Plat Of Homestead, Redone As CSM City c9 State jFpQV#APhoneNunr"j City Village ZTown Nearest Road Hudson e WI 715 769 Hudson Packer Drive ❑ New Construction �_' Residential] � of bedrooms 3 ❑Addition to existing building Z Replacement_ u Ik or 6o rcial describe Code Derived daily flow 450 gpd Recommended design loading rate •6 bed, gpd/ftz •7 trench, gpdffl Absorption area required 750 bed. 11 643 trench, ftz Maximum design loading rate .7 bed, gpdff •g trench, gpd/ft Recommended infiltration surface elevation(s) 95.40 ft (as referred to site plan benchmark) Additional design / site considerations Install trenches using high capacity infiltrators. Final grade must be reduced over system. Mound replacement area Parent material Outwash s & gr. Flood plain elevation, if appl NA ft S Suitable for system Conventional Mound In Ground Pressure AT - Grade System in Holding Tank U= Unsuitable for system NS E u N S❑ u ❑ S U ® S u ® 2MU 2 ❑ S u SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft' Boring# Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench 1 1 0 -24 10yr2 /1 None sl 2fcr mvfr as 2f,lmc 0.5 0.6 2 24 -38 10yr4 /4 None sl 2msbk mfr cs 2f& m 0.5 0.6 Ground 3 38 -55 7.5yr4/6 None sl 2msbk mfr aw if 0.5 0.6 elev 102.33 ft 4 55 -90 10yr5 /4 None s 0 sg ml gw - 0.7 0.8 Depth to 5 90 -136 IOyr6 /4 None s 0 sg ml - - 0.7 0.8 limiting factor >136" ,7 Remarks: Z 1 0 -14 10yr2 /1 None sl 2fcr mvfr as 2f,1mc 0.5 0.6 2 14 -22 10yr4 /4 None sl 2m sbk mfr cs 2f& m 0.5 0.6 Ground 3 22 -40 7.5yr4/6 None sl 2msbk mfr aw if 0.5 0.6 elev 103.93 ft 4 40 -87 10yr5 /4 f3p5yr5 /8 s 0 sg ml gw - 0.7 0.8 Depth to 5 87 -156 10yr6 /4 None s 0 sg ml - - 0.7 0.8 limiting Redox features found in sic inclusions of 10"- W' diameter. Redox features area result of the greater matric potential of finer soils and are not indicat' factor of roundwater saturation. >156" tt�• �;hS� Remarks: Silty ch inclusions com 5 -10% o horizon. S abso n area should be increased by >10% to compensate for itripeirmiability of the inc ions. CST Name (Please Print) Signatu Telephone No. James K. Thompson 715- 248 -7767 Address A.C.E. Soil & Site Evaluations Date CST Number Ref # 340 Paulson Lake Lane, Osceola, WI 54020 6/23/99 3602 1054 I ivlin-,r, S. SOIL DESCRIPTION REPORT Page 2 of 4 PARCEL LDS 020 -1346- 80-000 A.C.E. Soil &Site Evaluations Depth Dominant Color Mottles Structure GPDV Horizon in Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Co nsistence Boundary Roots Bed � Trench 3 1 0 -12 10yr2 /1 None sl 2fcr mvfr as 2f,1mc 0.5 i 0.6 2 12 -20 10yr4 /4 None sl 2msbk mfr cs 2f & m 0.5 0.6 Ground elev 3 20 -36 7.5yr4/6 None sl 2msbk mfr aw 1f 0.5 0.6 101.41 ft 4 36 -82 10yr5 /4 f3p5yr5 /8 s 0 sg ml gw - 0.7 0.8 Depth to limiting 5 82 -128 10yr6 /4 None s 0 sg ml - - 0.7 0.8 ' factor Redox features found in sic inclusions of 10"- 30" diariOer. Redox features are a result of the greater metric potential of finer soils and are not >128' indicative of groundwater saturation. . Remarks: Silty clay inclusions comprise 5 -10% of horizon. System absorption area should be increased by >10% to compensate for imoermiabilitv of e inclusions. Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: ,.. � � 3oF�3 5 cage : /:= Lki d wne / q • loco4xd lorbperty 56z*'e LL t,- \'- r�.o.6�rr isi �nca.�rrn: 7rou t,��coP(� 2d. Lod / 9' P/a,f e stead, SEpyso� Sec. II T.z9/l, �. /9 GJ; T . o d,", -.. ere-,r d rive v 3 btd�cQS� re 5 idenc t t off' Sfc66.eo! J�' v k3cn a� : T000f' 6 /oc�S'� «�a� aE u.� C.,eoact� /tdcC. iQssu.ntd ¢ltv� = iao.cn: p -2. Safety and Buildings Division `v = cw c - SANITARY PERMIT APPLICATION 201 W. Washington Avenue isconsin In accord with ILHR 83.05, Wis. Adm. Code P O Box 7302 Department of Commerce Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. orx • See reverse side for instructions for completing this application State Sanitary Permit Number P 9 pp you provide may be used for seconds 33 IBIS 7 Personal information Y p Y secondary purposes Check if revision to previous application (Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION Pro erty Owner Name roperty Location ( („ �.. >� -t i4'sj f.V 1/4, S T Zq , N, R E (cli Property Owner's Mailing Address Lot Number Block Number ... M- ity, State Zip Code Pho a Number S b ivision Name or CSM umber ® s 0 vii 11 . TYPE OF BUILDING: (check one) ❑ State Owned ❑ i lage t Nearest Road ill ❑ vl , / Public 1 or 2 Family Dwelling- No. of bedrooms a? Town v OF s Ac 9*IkF 6 III BUILDI USE: (If building type is public, check all that apply) reel Tax Number(s) ' 1. Q � � � ' � 1 [] Apartment / Condo d �� 3T / f w 0 0� 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 _ New - ___2. -- Replacement 3. E] Replacementof 4. E] Reconnection of 5 ❑ Repair of an _System __System_____. __ Tank Only______ ________ ystem Existing S ________ 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;M Seepage Trench Lpkiq 22 ❑ In- Ground Pressure ' 42 ❑ Pit Privy 14 ETSeepage Pit to f /OxAgrof ZX` XSL ► 43 ❑ Vault Privy 14 ❑ System -In -Fill -� �, ,S 40 V ABSORPTIO SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade O Required (sq. ft.) Proposed (sq. ft.) (Gals/da /sq. ft.) (Min. /inch) Elevation 4 2 ,, ft Illo Feet Feet VII. TANK Capacit in allo s Total # of Prefab. Site Fiber- Exper_ INFORMATION g Gallons Tanks Manufacturer's Name Concrete con- Steel glass Plastic App New Existin structed Tanks Tanks e n r�hFekliagiaak OO WE +C. ❑ ❑ ❑ ❑ 1 ❑ Lift Pump Tank /Siphon Chamber ❑ 1 ❑ 1 ❑ ❑ ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumb Signature: (No Stamps MP MPRSW No.: Busines Phone Number: Plumber's Address Street, City, State, Zip Code): 02-c MftWA"_ IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater D ate Issued Issuing Agent Signature (No Stamps) & ❑ Owner Given Initial Surcharge Fee) Adverse Determination� X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: >4 SBD- 6398 (R.11/97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber 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. Ill. 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. V11. 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 D1LHR. 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 8 1/2 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 mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump 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 41.0 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. rh of , UU Ll pt, pd Ok 31 % c m A Ot r W CL _ J CS m rs m rn T °' � ! p 3 v . YC a CL a , 3C �o �i a w m r z0 � a a n gg o 0 m ' `. cr i A A ZA e n ®' �. a ) a a Ob. � N � 9 ^« co co ) N �! CD mac a oo x cn o U � (<D � r a ? Ul CD X CD cC N m 0 C. j s = n C vi O cr N v D C� ( 0 N O O =3Z 7 3 � CD i m . N (D 1 W N p 'O N CD N Ta 3 �0 a o 0 wU3 x A 1 co � 0) N CL CD O. O , N a c a ' 4 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'h 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 lion and distance to nearest road. Parcel I.Q.# APPLICANT INFORMATION - priht allin mation. Personal information you provide may be fa�l Purposes lP Law, s• ts•oa (t) (m))• Reviewed By Date Property Owner Property Location MILLER, SAM Govt. Lot SE 1/4 SW 1/4 S 11 T 29 N,R 19 W Property Owner's Mailing Address t" F' ) P "` ! E ru Lot # Block # Subd, Name or CSM# TROUTBROOK RD C r ,;;; /. 18 Homestead City \State Zip Co&)LPhbitie E] City E] Village ❑Town Nearest Road Hudson 'yVI Ica' i $K9 ; '' Hudson Labarge ❑ New Construction Use: 1 Sfdgnti l F� _4tth of bedrooms 3 ❑Addition to existing building ❑ Replacement ❑ Pu' ' - ercial describe Code Derived daily flow 450 gpd Recommended design loading rate .7 bed, gpd/ft .8 trench, gpdKF Absorption area required 643 bed, ft 0 trench, ft Maximum design loading rate .7 bed, gpd/ft .8 tr ench, gpd/ft Recommended infiltration surface elevation(s) 91.6 ft (as referred to site plan benchmar Additional design / site consideration This is additional bore data being added to a report conducted on 8/19/98 Parent material loess over outwash Flood plain elevation, ff applica ble 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 ❑ S ® U ❑ S ®U ❑ S ® U SOIL DESCRIPTION REPORT Horizon Depth Dominant Color Mottles Texture Structure Consistent Boundary Bounda Roots GPDIft2 Boring# in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench 1 1 0 -12 10yr2 /1 - sd 2msbk mfr cw 2f .5 .6 2 1240 1Oyr4 /4 - sil 2msbk mfr cw if .5 .6 Ground 3 40 -110 7.56/4 - s Osg ml - - 7 8 elev 97.47 ft Depth to limiting O factor >110 0 •�I Remarks: 2 1 0 -11 10yr2 /1 - sil 2msbk mfr cW 2f .5 .6 2 12 -39 10yr4 /4 - A 2msbk mfr cw if .5 ! .6 Ground 3 40 - 100 7.56/4 - s Osg ml - - 7 8 elev 94.8 ft Depth to limiting factor >1 001, �. Remarks: CST Name (Please Print) Signature; Telephone No. Thomas C. Nelson 715- 246 -2454 Address Enviromnental BY Design Date CST Number Ref# 1432 120th Street, New Richmond, WI 54017 9/17/98 227387 58 PROPERTY OWNER: 1vIILLER, SAM SOIL DESCRIPTION REPORT ® Page 2 of 3 PARCEL I.D.# Environmental By Design Horizon Depth Dominant Color Mottles Texture Structure onsistence Boundary Roots GPD/fl2 exure in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed ! Trench 3 1 0 -9 1Oyr2/1 - sil 2msbk mfr Cw .2f .5 .6 2 9 -94 7.5yr6/4 - s Osg 1w - - . 7 .8 Ground elev 96.02 ft Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: 0 B D 1��II 1�Jrllll NT L SIGN 1432 120 STREET, NEW RICHMOND, WISCONSIN 715- 246 -2454 PROJECT NAME HOMESTEAD 1T 10. PAGE 3 DESCRIPTION SE % SW %, SECTION 11 T 29 N, R 19 W TOWNSHIP Hudson COUNTY St. Croix Wisconsin SD 6 w Bill �c f � SCALE I"= 40 Tom Nelson BM 1. Base of tree with ribbon Elevation 100' 227387 BM 2. Base of tree with ribbon Elevation 100.67' Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page 1 of 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 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 dimen 9 sions, no cation and distance to nearest road. Paroel I.D.# s APPLICANT INFORMATI 1!? e`p 1 formation. Reviewed By Date Personal information you provide ma�/tia,uee$ for seam.*ry purpas�d(P • y Law, s. 15.04 (1) (m)). Property Owner .� L UM = Property Location MILLS SAM <> Govt. Lot SE 1/4 SW 1/4 S 11 T 29 N,R 19 W Property Owner's Mailing A Lot # Block # Subd. Name or CSM# TROUTBROOK RD ST CROX I i`' 18 Homestead City \"-Mate honeN ❑ City ❑ Village ®Town Nearest Road Hudson Z�7v1NG ��6-8 Hudson Labarge ® New Construction Use. id 'a� ber of bedrooms 3 ❑Addition to existing building ❑ Replacement commercial describe Code Derived daily flow 450 gpd Recommended design loading rate 1 — 2 bed, gpd/ft 2 trench, gpd/ft Absorption area required 3 7 S bed, fF 373 - trench, ft Maximum design loading rate /. 2 bed, gpd/f 2 / • Z tr ench, gpdA Recommended infiltration surface elevation(s) ft (as referred to site plan benchmar Additional design / site consideration Parent material loess over PJ acial outwash A 17 / <4 lJtIZ4 1 Flood plai n elevation, if a licable —IIA— ft S= Suitable for system Conventional Mound In -Ground Pressure AT -Grade System in Fill Holding Tank U= Unsuitable for system ❑ s K U S ® u El u ❑ S ®u EIS ®u ❑ S ® u SOIL DESCRIPTION REPORT Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPDW Boring# in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bad ? T 1 1 0 -16 10yr3//1 - sl lmsbk mvfr cw 2f .5 .6 2 16 -47 10yr4/4 - sl 1 msbk G Ground 3 17 _( �v s t� �rn �. C' (r elev tr- � 4z -1y Io\lr `� r SiI 1mS6k mF► C �J D '�S r — S w l y e th to # S' I 1 � 1 r– „� p I l� s limiting factor Remarks: 2 1 6-)(7 /� r- it .5 2 20-y 1 n yr 6 Ground 3 114J b elev r Y. 4 '79 -.48 /n r y/ l l Im f b 4" r C L A.) N Depth to 5 8'60 A7 limiting factor 6 1fH =V 7 7 fl Remarks: W7 MA77 l oft! luvrY. CST Name (Please Print) Signature: Telephone No. Thomas C. Nelson '�— 715- 246 -2454 Address Environmental By Design Date CST Number Ref# 1432 120th Street, New Richmond, WI 54017 8/19/98 227387 61 PROPERTY OWNER: MILLER, SAM SOIL DESCRIPTION REPORT s, Page 2 of PARCELI.D. # Environmental By Iksi Horizon Depth Dominant Color Mottles Texture Structure onsistence Boundary Roots GPDHts in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ; Trench 3 I s6�' My r C( 2 Ground 3 -. 7 o i C 1 S 1 /~► S K m v� r' elev �= 4 �� toy r lS r G S'I 1rnS6�rr C W �(/ Depth to 5 limiting factor 6 7 � 7 Remarks: 4 1 . 2 Ground elev 3 4 Depth to 5 ... limiting factor 6 7 Remarks: 5 1 . 2 Ground elev 3 4 Depth to 5 limiting factor 7 Remarks: Ground elev Depth to limiting factor Remarks: o B Y DE 51G N 1��II NM1�J�TflL 1432120 STREET, NEW RICHMOND, WISCONSIN 715- 246 -2454 PROJECT NAME H OMESTEAD lx PAGE 3 DESCRIPTION SE Y SW '/, SECTION 11 T 29 N, R 19 W TOWNSHIP { Hudson COUNTY St. Croix L 1� !�N � 4 All o � 7 �w � 1nPG O�ereS 'a 1 ow n cy SCALE I" _ Z/0 Tom Nelson BM 1. n �- Lot Ca 2 n 4-r 0 d u j �� o , r � P , p CSTMO 2605 BM 2. -,-r-te j n �� 9 �, 3 y ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address Property Address 6 ra l V �- (Verification required from Planning Department for new construction) City /State 14 V DSO ti� L01 Parcel Identification Number e- ze ` 5/G ' X4 ` d o v LEGAL DESCRIPTION Property Location '/4, -5 U) 1 /4, Sec. T � 7 N -R/ 9 W Town of 1J M E, S T.C_ ' 4 a Lot # ,Subdivision 14 � Certified Survey Map # 3 , Volume , Page # a Warranty Deed # 1-4 1 3 �_ ,Volume Page # Spec house yes ❑ no Lot lines identifiable yes ❑ no S YSTEM NAN E 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 wastewater disposal 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 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 days of the three year expiration date. q C l IGNATURE OF%PPLlCXNT ATE OWNER CERTIFICATION <.: d'(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 th optifty. above by virtue of a warranty deed recorded in Register of Deeds Office. N RI/ 9 ATURE PLYC NT 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 _ I' \'1 . is 1i: ;i t )(� WA 'CLY DEFR i This Deed .-d, u, twet•„ J ll,l l c i. t h e and \ao,)i R. l,il l ie, nu;b;lnd :iiid 10: 16 A .,n,l �aln C. `tiller, a single i:ecs4a , Grant.•„ t %'itllesSeth, That ire ,cd I ;raator, for a valuable cunsld cr,.t.ur, ,•o lc,, < t, t;rentee the !'ulluwll ti der, nhed real estate in 5.t • C r o ix OIL! - TJ C ,u,:t�. State of R ISCt.r18111: See attached description. Tax t areal No: . _ . ........... ................. TRANSFER This is not honiest...d property. (Is) its lint) Tog; tixr with all and st n,;.11ar the hertilaaments and appurter,..t:ces rrunto L. - -. nt;ing; And Ronald L. Millie and Nao; R. Millie ,arrant, tr,at the title is gu..J, Ir;.,efr —Ib:t in tee ,unP;e AIA free ..r.,, ,...,. cn.unlhi;,.,,e; e.xeeut easements, c'2striction5, and ri- hts -of -way of re,:ocd, :,nd w:!1 „art ant and defend U r -:one. h yu dated tnl, ;� d.ly „f late t� tSEALr t «.c�r L t•L �_CcL 1SEAI.r • Ronald L. 'Willie IS:.ALI c °� «�. / w /.FLLcC. ISEALr . Naomi R. Millie AUTHENTIC r10N ACKNOWLEDGMENT S,gnar.rel ) STATE OF V 1-�CONSIN ) ss. ....__..... ._....._._.. _ . ... .. ..... .... �.t. Croix ...- . County. i , auth.ntie:u.d tbiz da o` _.. 19.... Pere came bef,.re me ` t ' his . -;. .....day of _- _......... _.`Larch -, Ig 7V.. the above named ..Ronald..h...�yil lie _ and. — .. .. . • ........................... TITLE: IIENIRER STATE It -llt F R'ISICUNSIN .. ... .... ... (I f nut, _ .. authorized by ; ;ud.(, i, 11 St..L -.) . to me known t.: i,e the per „n .S. w'i:u execut , td the furs wing insti .iiwnt and 4 the same. THIS IJ iv '•.\ C. L. Gaylord, attorney River Fa115, U''l _ )4U22 _ N•,t:, , 1'.J-.i A ✓ Countc, Wis. I r . }• ho . �r ., ,.a"wi..,•e , l 11 :i: %i l'umuu -tine, t5 riot, .t:;te expiration ,.,It I)t 111•,'U \.IN A parce of lano located in the SE - 1 /4 of the Sh -1/4 and in part Of tt:e S6: -1;4 of the SV -1/4 of Section 11, We,t Township 29 Korth, Fr�nEe 19 . 7o�n of Hudscn, being further descrited as foilows: betanning at the S -1/4 corner of said Section 11; thence 2 89 29 'U 3 "i+, along the South line of the Sk - 1/4 of said Section 11, 9 feet; thence K02 ?E 06 b, 1322.62 feet, to the Korth lire Of LhE 5 - 1/2 Of the SW - 1/� of Section 11; iF.EL'E S6 0_�����'�j c1GL said Korth line, 2446.:, fEEt to the lurth -South 1/4 line of said Section 11; thence SOU 34'16 "1;, alone said Korth -South 1/4 ling, 1325.65 feet to the point of beginnint. Parcel contains 73.32 acres (3,193,674 Square Feet) and subj record. ect 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 SW -1/4 of Section 11 and in part of the St -;/4 of the SE -1/4 of Section 10, all in Township 29 Kurth, RantE 19 West, Town of Hudson, being, further described as foltOWS: COU:^:ericinZ at the 5 -1/4 corner of said Section 11; ti- ice AE9 29 ' 0 3 "W, along the S uth line of the SV -1/4 of said 2376.3q feet; thence NO2 26106116: 1256.54 feet to the point of bcg.inning; thence continuing KG2'26'U6 "w, 66.06 feet to the Korth lint of the S -112 of the SW -1/4 of said Section 11; thence KbJ 35'S0 along the Korth line of the S -1/2 of the SW -1/4 of said Section 11, 179.28 feet to the NE corner of the SE -1/4 of the SE -1/4 of Secti.,n 10; thence K99 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 Wesa line of the SE -1/4 of the S£ -1/4 of said Section 10; thence SOO 25'39 "h', along said West line, 66.00 feet; thence S69 "E, on a line being 66 feet distant Southerly and parallel to the Korth linE of the SE -1/4 of the SE -1/4 of said Section 10, 1316.32 feet to the E line of said SE -1/4 of the SE -1/4; thence S69 "E; or. a line bEinz 66 feet distant Southerly and parallel to the Korth line Of the of the SW -1/4 of said Section 11, 162.54 feet to tEL oint of heginnint. Parcel contains 2.27 acres (95,9..6 cquE6re FeEt� and is sutiect to right-of-way for town road d suLJEct to all eaSC-.Me (`coif F.oaCj an nts of record. ":- foreari- - !F ' I 10 1064 1.11 ' NNII'N'1 II.II' I NI.11'll'I l.li' LJIVPLATTED LANDS "O13TH LINE OF THE 21/2 OF THE SWV4 ® M 2448.54' :� 327.:: 220.00' EI Cos • 8 s 2 � uaol �^ M 20 ��y� / ♦ / UO Ames : K311 212. R 3 146,038 .4 FT �` 42.04 sAC, o.►r ) / ( AC.) DO (141,259 I�: � 54 FT.) Q ' ��• .. $i Boo) ♦ \ ' ' •-7 e -16 , 304 A011[f I 1 016 AC S 1133.41• SOFT) ` r t 3 �P / '02• '�'� 199071 e� op . +9j,, 19 \1 1T Y V 2. IMA 4 2 18 ? � $ of ,00 RCIIIES / 22 q. R (7.339 3 r / -./ ; ` .•- O •1j 2A7 ACRES f JI O - w wi 24127 50 -FT. flu u 11.96 AC.) N p� 105,202 31-1v J 33' a. U - -- { _. ao.ao' 7qf / 1 -- - 3)4.20' 9N•24• . 722.03' P _ 3 0 / �`�. G/ GIS OICATEO ., PACKE 3 Ix - - C!'E H) Te f .00� - 20. W C7 409.94 a / 1 � _ - �9 ' K4 J b ° I N2 ' Ri ll "'° 7- 23 /14 GI6 ' II N3 J I � 1 / • ' • J. 2.39 4CNL3 26 $ ,�' ll 2� 8 24 )03.509 2o. FL r 1 3,115 ACRES / ,� I 2.97 ACRES L30 ACHES 0. J III 6» SK 4R 527 SQ. a,. , 1A6.676 SQ. FT/1.64 N12 104.290 So, R. Iq .0 31 14A22) I = 919 OJ T 66.01 KM , t2 . — 1171.01 SO 299.49' 4 1 VS t— Lo O: EL N89'29'03'W 2378.39' SOVTH UN[ OF T1( swi RCLAD Sw N B,'�1?r� \ \ o s,� '' �\ - - - - -- PROPOSE" P_AT OF GkASS R,9NG: ST. CROIX COUNTY WISCONSIN ZONING OFFICE p p n a n n s n■ ST. CROIX COUNTY GOVERNMENT CENTER _ + " ■ +� 1101 Carmichael Road Hudson, WI 54016 -7710 - (715) 386 -4680 August 18, 1999 First Federal Attn: Jae Olson 201 S. 2 nd Street Hudson, WI 54016 RE: Septic Inspection for Sam Miller located at 732 Packer Drive, Homestead Addition, Lot 18, Town of Hudson, St. Croix County, Wisconsin Dear Ms. Olson: A septic inspection of the above referenced property was conducted on July 9, 1999. This property is in the SE' /4 of the SW' /4 of Section 11, T29N -R1 9W, Homestead Addition, Lot 18, Town of Hudson, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a three (3) bedroom home. If you have any questions regarding this, please contact our office at (715) 386 -4680. Sincerely, Kevin Grabau Zoning Technician /sm