HomeMy WebLinkAbout026-1041-20-000 ST. CROIX COUNTY ZONING DEPARTMENT
AS BUILT SANITARY REPORT
Owner S r yr
Property Address
City /State / 3 9 �
Legal Description:
Lot _ I Block Subdivision/CSM #
/I :%' /a NL? t /4, Sec., TAN -RW, Town of PIN # B- l (�yl -z�O - J
SEPTIC TANK -- DOSE CHAMBER -- MOLDING TANK INFORMATION:
i
Tank manufacturer L IIP - S eiv Size ST/PC Setback from: House j 7— Well P!L
Pump manufacturer ---- -- Model
Alarm location
(HOLDING TANKS ONL
Setbacks: Service road Vent to fresh air intake Water Line
Meter location
Alarm location
SOIL ABSORP ON SYSTEM:
Type of system: 7nQLg.rs Width - Length 7S Number of Trenches
Setback from: House JFf - Well W4 P/L'la _ Vent to fresh air intake /6-
ELEVATIONS
Description of benchmark/ J A ) G) h �.+� Elevation �
Description of alternate benchmark -- awW hWak, Elevation
Building Sewer °� ST/HT Inlet ?9, �- ST Outlet 9 k, 5 PC Inlet
PC Bottom �� Header/Manifold 9 7, Y3 Top of ST/PC Manhole Cover
Distribution Lines () 9 7 , S0
Bottom of System (1) / S
Final Grade
Date of installation 111-01f7 Permit number .?S311 S State plan number
Plumber's si nature License number a a OS 3 7 Date >/l
Inspector
Complete plot plan w
I
J _ j
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.
0*1 �
D PLAN VIEW
�5
INDIC TE NORTH ARRO
• Wiscons [)apartment of Commerce PRIVATE SEWAGE SYSTEM C ounty:
'Safety and Buildings Division
INSPECTION REPORT St. Croix
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.:
Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 353195
Permit Holder's Name: ❑ City ❑ Village ❑ of: State Plan ID No.:
Qm C-lenn Town of Richmo
S ev.: Insp. BM Elev.: r BM Description- Parcel Tax No.:
rsOta oo. 0 a
AVII, -
TANK INFORMATION ELE ATI N DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmar /"=
Dosing Alt. BM 6� C 1. XL
c
Aeration Bldg. Sewer �
Holding St/ Ht Inlet
TANK SETBACK INFORMATION St /Ht Outlet
TANK TO P/ L WELL BLDG. Air i to ntake ROAD
Air
Septic >SO r — NA
Dosing NA Header /Man. -7,8G
Aeration NA Dist. Pipe q 7,
Holding Bot. System 'S• `f2- �o , V
PUMP/ SIPHON INFORMATION Final Grade rorL 100.0
Manufactu Bp
Model Number GPM
TDH Lift L on Sys TDH Ft
Forcemain Length Dia. H Dist. To well
SOIL ABSORPTION SYSTE I
-BEB TRENCH Len th Width No. f T nches PIT No. Of Pits Inside Dia: Liquid Depth
DIMENSTUKrS ZL DIMENSION
SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manu tur S,
INFORMATION Type Of t CHAMBER Mo Number*
System: 0 i ID OR UNIT `
DISTRIBUTION SYSTEM
Header / nifoId U Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
r
Length / Dia. L ia. s pacing qp
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 discrepancies, persons present, etc.) Inspection #1: t / /3a /9q W.
Inspection #2•
Location: 1382 157th Avenue, w Ri h ond, WI (NE1 /4, NEIA, Section 14 T30N -R18W) - 14.30.18.199B
1.) Alt BM Description = Cep
2.) Bldg sewer length= �-
-amount of cover = > IT
Plan revision required? ❑''Yes No -
Use other side for additional information. 12- R 4 z ro
SBD -6710 (R.3/97) Date Inspector's Signature Cert. No
ADDITIONAL COMMENTS AND SKETCH "
SANITARY PERMIT NUMBER:
E € {
� i I
<n .._ i�
3
€ i
E
Y f
s
l
—
a
H
l
r
V is ' consin Safety and Buildings Division
SANITARY PERMIT APPLICATION 22010 B Washin Avenue
In accord with ILHR 83.05,
Department of Commerce ( , Madison, WI 53707 -7302
• Attach complete plans (to the county copy only) for the s r, on pager not les County
than 8 112 x 11 inches in size.
• See reverse side for instructions for completing this a Op ion tt - � 'Mate Sanitary Permit Number
Personal information you provide may be used for secondary purpose I �� 4 �] Check if revision to previous application
(Privacy Law, s. 15.04 (1) (m)].
sf�(1iX tate Plan I.D. Number
I. APPLICATION INFORMATION - PLEASE PRINT . ON
P o rty Ow r Name r yk a n
O`,: �t /4, 4,S T 3 ,N,R r
ropel�Owner's ailin 4d ress ri4i t eR Block Number -1
City, State Zip Code Phone Number Subdivision Name or CS Number
111. TYPE OF BUILDING: (check one) ❑ State Owned ❑ 't Nearest R04
❑ VII age 5 V
Public 1 or 2 Family Dwelling - No. of bedrooms -3 Town of
111. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) ' n b . Ib 10I0
1 ❑ Apartment/ Condo — — — 0d 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 online B, if applicable)
A) 1 _ New 2 E] Replacement 3. E] Replacement of 4 E] 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 22 ❑ In- Ground Pressure 42 ❑ Pit Privy
13 Seepage Pit 43 ❑ Vault Privy
14 ❑ System -In -Fill 3 x Te 1 6 ZM I CAM C 2 4 4LA8����
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) p Elevation
41 S I D 75 7 6 / Feet 1 9, Aj Feet
VII. TANK Capa Ity
in gallons Total # of site
INFORMATION Manufacturer's Name Prefab. Con- Steel Fiber- plastic App.
New Existing Gallons Tanks concrete structed glass App.
Tanksl Tanks
Septic Tank r1f � f,�0o t 'PAC ❑ 11 11 El El
Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑
VI11. RESPONSIBILITY STATEMENT
1, the undersigned, assume responsibility for ins Ilation of the onsite sewage system shown on the attached plans.
Plumber's Name: (Pr Plu er's Si atur : ( St ps) MP /MPRSW No.: Business Phone Number:
LLCLL h `Tr/ .0S3 7/5 - - 1.35
Plumber's Address (Street ity Stat Zip Code):
jr
. S' o
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate Issued Issuing Agent Signature (No Stamps)
j4 Approved []Owner Given Initial Surcharge Fee)
Adverse Determination
X. NDITI N F APPROVAL N DISAPPROVAL:
CO O S O OVAL / REASONS FOR DISAP O AL. p�
DISTRIBUTION: O to County. One co To: Saf & Ruildin s Division, Owner, Plumber
SdD- 63�a (R.11/97) � Y rr y �
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 pumperwhenever
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.
ll. 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 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 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.
Plo
CO' vi e r r�s�ro ,,,`, N E Y K V/ Z I c( T 30 N 12 tK Lo
SIV7
-x -rr �Q r� Cy�a. o '' o� ( 1y\b �e rS)
�(
--
D 3
' Wisconsin,Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3
Labor and Human Relations
Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. Croix
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION R IEW J BY DA E
PROPERTY OWNER: PROPERTY LOCATION
Glenn Fernstrom & Kathy Dilley GOVT. LOT NE 1/4 NE 114,S 14 T 30 N,R 18 *Jor) W
PROPERTY OWNERS MAILING ADDRESS LOT # I BLOCK # SUBD. NAME OR CSM #
369 W. 9th. apt. #4 na na csm
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE 00WN NEAREST ROAD
New Richmond, WI. 54017 (715 246 -7264 Richmond 157th. Ave.
[x] New Construction Use Residential / Number of bedrooms 3 [ ] Addition to existing building
I ] Replacement j ] Public or commercial describe
Code derived daily flow 450 gpd Recommended design loading rate 5 bed, gpd /ft - 6 trench, gpd /ft
Absorption area required 9 0 0 bed, ft 750 trench, ft Maximum design loading rate • 5 bed, gpd /ft • trench, gpd /ft
Recommended infiltration surface elevation(s) orig area=96. 5-alt. 97. 5 5t (as referred to site plan benchmark)
Additional design / site considerations na
Parent material glacial drift Flood plain elevation, if applicable na It
S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable for system i0 S ❑ U R] S El CA S El ®S ❑ U ❑ S ®U El ® U
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure Consistence Y Roots GPD /ft
Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends
1 0 -8 10yr4 /3 none 1 2msbk mfr gw 2m .5 .6
2 8 -21 7.5yr4/4 none sic 2msbk mfr gw if .4 .5
Ground 3 21 -46 7.5yr4/4 none sl 2msbk mfr gw if .5 .6
elft 4 46 -86 7.5yr4/4 none lfs Osg mvfr na na .5 .6
Depth to
limiting
factor sr.
7
Remarks:
Boring #
1 0 -12 10yr3 /3 none 1 2msbk mfr gw 2c .5 .6
}..2..._ €< 2 12 -26 10yr4/4 none sici 2msbk mfr gw 2m .4 .5
3 26 -84 7.5yr4/6 none lfs Osg mvfr n .5 .6
Ground
elev.
9 9.9 ft. \
C
/V
Depth to , J�f f
limiting f
factor g
+84 11 b /X
Remarks:
CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 E
Address: 1554 200th. Ave. -New Richmon4 W 54017
Signature: Date: 7 -1 -99 CST Number: m02298
PROPERTY OWNER G. Fernstrom SOIL DESCRIPTION REPORT Page 2 ", of 3' r
PARCEL I.D. #
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Baxbary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
' 1 -8 10yr3 /3 none 1 2msbk mfr gw 2f .5 .6
2 -24 10yr4 /4 none sicl 2msbk mfr gw if .4 .5
Ground 3 124-88 7.5yr4/6 none lfs Osg mvfr na na .5 .6
elev.
10 ft.
Depth to
limiting
factor
+ 88 11
Remarks:
Boring #
1 -9 10yr3 /3 none 1 2msbk mfr gw 2m .5 .6
€'<'4 2 9 -24 10yr4 /4 none sicl 2msbk mfr gw if .4 .5
3 24 -52 5yr4./4 none sl 2msbk mfr gw na .5 .6
Ground
elev. 4 52 -88 7.5yr4/6 none lfs Osg mvfr na na .5 .6
101. Ct.
Depth to -
limiting
facttor
+88"
Remarks:
Boring #
1 0 -9 10yr3 /3 none 1 2msbk mfr gw 2m .5 .6
5 2 9 -18 lOyr4 /4 none sicl 2msbk mfr gw if .4 .5
3 18 -88 7.5yr4/6 none sl 2msbk mvfr na na
.5 .6
Ground
elev.
1 01.8 ft.
Depth to
limiting
factor
Remarks:
Boring #
13
Ground
elev. j
ft.
Depth to
limiting
factor
Remarks:
SBD- 8330(R.05/92)
STEEL'S SOIL SERVICE
Gary L. Steel Glenn Fernstrom & K. Dilley 1554 200th Ave.
CSTM2298 NE4NE4 S14- T30N -R18W New Richmond, WI 54017
MPRSW -3254 town of Richmond (715) 246 -6200
N
1 =40'
BM.= top of 1" pvc p ipe @ el. 100.00%
Alt. BM.= top of 1 pvc pipe C el. 100.40' '
-I o —% <
I f � 4- slae
Gary L. Steel
7 -1 -99
i
4
C
O <
N
7
_ N s
C a)
p
5E ca — "s
w : °
tJ
- C M
5; cd OC X CO uj
Q �, O` C U .0
fl O tom- co
a> E *'
1� �X N m
co .c U co T
?D co —: v�
o R, oc
q 9 ��o c` vo
,q N as �cd
O U O c
N w
O j,N Z (1)
0 "Q O= U d
8 C
a) = U 0 co
cd -p cd c
U
U � � C: -C C = � 0) .c
to CL . . . .
m �
N
° E
® U
O N E
Q o ��
N
L.� CO x0 ..
ap � q�
VJ W
^ O ^
l co a
.nom E co
UL W c °
.0 co % n „ i
N
a
" c �
' J
V1
�fi
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
i OWNERSHIP CERTIFICATION FORM
Owner/Buyer h rte' "4't1yy�'
Mailing Address W9 W 4 ZJ N4f 019, eh Lzr
Property Address
U
. erification required from Planning Department for new construction) 94" el
City /State Parcel Identification Number f>,.� — I041 '010 —01 .
LEGAL DESCRIPTION
Property Location PJ'�� ' /,, N� ' /a, Sec. T ZN -R W, Town of
Subdivision , Lot #
Certified Survey Map # (n , Volume � Page # T�
Warranty Deed , Volume , Page #
Spec house ❑ yes no Lot lines identifiable 9( 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 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.
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 hat our septic stem has been maintained m
g Y must be completed a re
P Y p and turned to the St. Croix County Zoning Office within 30
days of the three year expiration date.
ID l/ l Q
SIGNATURE OF APPLICANT DATE
OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of
the property described a ve, by virtue of a warranty deed recorded in Register of Deeds Office.
e4le 3es� 0
SIG ATURE OF APPLICANT 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
VUL 1`3(JUl Abt JLt-)j
STATE BAR OF WISCONSIN FORM 2 - 1998 612 750
KATHLEEN H. WALSH
Document Number WARRANTY DEED REGISTER OF DEEDS
ST. CROIX CO., WI
This Deed, made between Edna F. Fernstrom, a single person, Grantor, RECEIVED FOR RECORD
and Glenn A. Fernstrom, Grantee. 10 -26 -1999 12:15 PM
Grantor, for a valuable consideration, grants and conveys to Grantee the WARRANTY DEED
following described real estate in St. CroixCounty, State of Wisconsin: EXEMPT # 8
CERT COPY FEE:
COPY FEE: 2.00
TRANSFER FEE:
RECORDING FEE: 10.00
PAGES: 1
Recording Area
and Return A,dl#sss
Joseph P.
5
39 S ow venue
xRichmond, WI 5 ^—a
67 `e
Parcel Identification N (PIN)
This is nC +-
homestead pro
(is)
V cl -I3 Q 3 � Yo e,
Lot 1, Certified Survey Map, St. Croix County filed September 29, 1999 as document number 611222, being a part of the
Northeast Quarter of Section 14, Township 30 North, Range 18 West, Town of Richmond.
Exception to warranties: Easements and reservations of record.
Dated this 9 day of , 1999.
V 7
Edna F. Fernstrom
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN )
ST. CROIX COUNTY )
authenticated this _ day of /p, Personally came before me this day of
S-� — , 1999 the above named Edna F. Fernstrom, to me
known to be the person(s) who executed the foregoing instrument
and acknowledge the same.
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, . ' C
authorized by §706.06, Wis. Slats.) • °.••�•. °•
Notary Public, State of Wisconsin
THIS INSTRUMENT WAS DRAFTED BY My Co is permanent. (I nr�ip st>�P &fie:
Joseph P. Earley, Attorney l f /
New Richmond, WI 54017
�•' B Li C o t
(Signatures may be authenticated or acknowledged. Both are not ' '
-` e �
necessary.) • '••...a "
*Names of persons signing in any capacity should be typed or printed below their signatures
WARRANTY DEED STATE BAR OF WISCONSIN
FORM M. 2 - 1998
k9onnabon Professionals Company Fond du Lac, Wisconsin 800.655-2021
STATE BAR OF WISCONSIN FORM 2 - 1998
Document Number WARRANTY DEED
This Deed, made between Edna F. Fernstrom, a single person, Grantor,
and Glenn A. Fernstrom, Grantee.
Grantor, for a valuable consideration, grants and conveys to Grantee the
following described real estate in St. CroixCounty, State of Wisconsin:
Recording Area
Name and Return Address
Joseph P. Earley
539 South Knowles Avenue
New Richmond, WI 54017
Parcel Identification Number (PIN)
This is
homestead property.
(is)
Lot 1, Certified Survey Map, St. Croix County filed September 29, 1999 as document number 11222, being a part of the
Northeast Quarter of Section 14, Township 30 North, Range 18 West, Town of Richmond.
V
301
IM
Exception to warranties: Easements and reservations of record.
Dated this Yday of , 1999.
Edna F. Fernstrom
AUTHENTICATION ACKNOWLEDGMENT
Signatures) STATE OF WISCONSIN )
ST. CROIX COUNTY )
authenticated this _ day o f Personally came before me this day of
ott_ 1999 the above named Edna F. Fernstrom, to me
known to be the person(s) who executed the foregoing instrument
and acknowledge the same.
TITLE: MEMBER STATE BAR OF WISCONSIN �•'>
(1f not,
authorized by §706.06, Wis. Slats.) "'• ° " " " °'�
Notary Public, State of Wisconsin `'y . , t - '� A ° 4; � �`' �
THIS INSTRUMENT WAS DRAFTED BY My Co is permanent. manent. (1 !?�p l,: stal'� batpB�a�i date:
Joseph P. Earley, Attorney !1=l o?DD� �� ; • 1
New Richmond, W154017 "
° 0
L-
(Signatures may be authenticated or acknowledged. Both are not ?` • . ... • +' �; r
necessary.) �� , ; (' ",•
*Names of pcisom signing in any capacity should be typed or printed below (heir sigrounts
WARRANTY BEER STATE BAR OF WISCONSIN
FORM Na 2 -1"3
kdorma•on Professionals Company Fond du Lac. Wisconsin 800855 -2021
3 3 3
Q Certified Survey Map
Edna F. Fernstrom
a�Q:t;Q�
+� o
o ° k � o N Part of the Northeast 1/4 ofthe Northeast 1/4 of Section 1=4, Township. 30
o ` North Range 18 West Town of Richmond St. Croix County Wisconsin.
qp lu tz b U . M
V t . in N h G1 Owne s Addregs:
1388 157Th Ave.
a a in e New Richnwrid, Wt 54417
W a .
Q Q ' lu This instrument drafted by Laurence W. Murphy
� M N ab ►� M N
OJ �� o- o� UNPLATTED L
l 40TH
E L /NE NE // Mb NOO.4 " W 2 R/N00.38 0 7 "W 2625. /2' �262j•08'1 O
M
VV_ Q b 233,22' of 94.80'
/3/2.43'
982.4/' M M IL 330.0?' f ro' O
219.07 ' 73.02'
3
$ 00.47'59 "ET91.09' O
m x ro m o
R .I N
Uj
2 y
W 1 N 1 q
ox
'
y 4 N N in
N -•.� My I 0 °j I �I IN 2 W W n V W 0 0
Z Q: y V � Q. O
I Z J L O O O
OQ:
V C �A, I � ^ C I f► h O �� V� � n .
W y I I tn _�__ I hl =
JI J W % %
Z' N O
Z S 00.47'59 "EI 330.02'
257.66 ,
J _j ~ 72.36' 218.316' C 39.3 '
\ I H
m I Z 2 9 0. 72'
b
Q QI '� Dated: August 6, 1999
fn r
02 4 � O 1 a� N 3 O
W
V
tu T4
Ix
to b ® I o 2
CL 4 1 i I 6 I
"LAU CE
S00 .47'59 "E 330,02'
�o o =m ' PHY C)
-- 289.68' i I 40.34' + 1713 y
Z I N I ER FALLS.;
N WISC. .�
W x
I us
• 4, ' L A
w J
of
2 Q 188.98' R I 141.0 4
W 00
vi �? N00•47'S9 "W 330.02'
v �o UNP LANDS
SHM 1 OF 2
r 0810/99 TUE 14:13 FAX 715 483 3238 FALLS_Ui41ES X006
ARTCRAFT
A Product of Wick Bui Systems, Inca P� +IaduCtion No. 2T460
P.O. Box 530 • Marshfie Wi 54449 - (715 )••387 -2551 Last Page
Attach Print On this Page: 07!22!1999
o e s Q
e
art GwQ s yE {,i,`''t;';i' "•�,� �� ?5;�;' %
U.
• j'.' i67ry i. , J ) eY
,4i •. y:" :;ti; ,, I;,;i,r,4�„ x,,,!44,' "ii'' >:;�,)i:i �•�:''• •'y�: 0
Al
o CD -•-!•' CL
rf
GL
+Z ' O• r
a C ll 2
RC
0 I'L I 1
4
o =
x O
u 1 I C Y
? 1
o Y
CO U
• .. e � 011
a2 \
4�
X
kZ
J
Ttla�[�j [90SL 0!�'!aT /RZl 96'Po Q� 6E /Ct /OT
I '
• r
X
TO Q
CL
w a l La j Cl) La
Q. J AT 1 4 u �, ti /.
j
2 '3 a
it a p
:n ' J w
t�� M nd �Go
' W
i. •• ~ ^�, d "'.ice
IMP
.1Z
�6 o
zo
� r
m�
� w
CL
cc IV
i � v
y ? 1 W
W o m
w • N 1
1 J I.w
w .
�Ld
�,�. d U
a , •= 1- T iK
UJI
d
iv 6 e.
•
d �
' 4
P
a H `�d��
1 11
® X
♦ ♦ W
H1QE/t•JW N
U, .4 -�
ALUM
12 2!t]! U3nON7b a � ' I CJ
ILI F �ljaa
' r, S Q r
T @ /iF " ZL15g 9pei;l0 Et - @i `665x S£6$ L8£ 9TL S 62 - rdS MMIMi Wo2ld
Tn(n ��TNOH 5'T'T`',3 SC7.0 ERr 9% XVA W OT nHI 66 /tT /OT
1101 Cannichael Road
Hudson, WI 54016
Phone: (715) 386 -4680 St. Croix County
Fax: (715) 386-4686 Zoning Department
Fmc
To: Kathy Dilley From: Shawna Moe
Fax: 246 -2084 Date: December 9, 1999
Phone: Pages: 2
Re: Septic Inspection Report CC:
❑ Urgent x For Review ❑ Please Comment ❑ Please RePly ❑ Please Recycle
*Comments:
ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
N N N N p N N N■ ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
Hudson, WI 54016-7710
(715) 386 -4680
December 9, 1999
Kathy Dilley and Glenn Fernstrom
1382157 Avenue
New Richmond, WI 54016
RE: Septic Inspection for Glenn Fernstrom located at 1382157 Avenue,
Town of Richmond, St. Croix County, Wisconsin
Dear Ms. Dilley and Mr. Fernstrom:
A septic inspection of the above referenced property was conducted on November 30,
1999. This property is located in the NE'/ of the NE'/ of Section 14, T30N -R18W, Town
of Richmond, 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,
w K 6u�w
Kevin Grabau
Zoning Technician
/sm