HomeMy WebLinkAbout026-1119-11-000 ST. CROIX COUNTY ZONING DEPARTMENT
AS BUILT SANITARY REPORT
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Legal Description: l f,, cQ��i•��c
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Lot l Block Subdivision/CSM # � 0
�L 1 /4 �= ' /4, Sec. ,TAN -R, W, Town of ch i . ��C PIN # 11
SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION:
Tank manufacturer "�egTpi.� Size ST/PC/ �cryJ/ Setback from: House Well VW-9 P/L Z
Pump manufacturer Model
Alarm location
(HOLDING TANKS ONLY)
Setbacks: Service road Vent to fresh air intake Water Line
Meter location
Alarm location
SOIL ABSORPTION SYSTEM
Type of system: Ii Width 3 Length Number of Trenches
Setback from: House Well IiLl �- P/L '16'' Vent to fresh air intake //Z
ELEVATIONS
Description of benchmark c� � J" ` - Elevation 4
Description of alternate be nchm Elevation • L
Building Sewer, -tea?, `- ST/HT Inlet 4�2' , �� ST Outlet 9557,' PC Inlet
PC Bottom Header/Manifold ° , Top of ST/PC Manhole Cover • 9�
Distributio Li nes )
Bottom of System
Final Grade
Date of installation �' f'Pl J Permit number 3gcJ State plan number
Plumber's signature �'.�.���" ��i��— — License number Date
Inspector ol� C
Complete plot plan �
NOTICE: Please provide the following:
• A plan view sketch showing everything within 100 feet of the system.
• Two horizontal reference points to center of septic tank manhole cover.
• Show alternate benchmark, if applicable.
PLAN VIEW
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INDICATE NORTH ARROW
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count
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)]. 344644
Permit Holder's Name: I ❑ City ❑ Village Z] Town of: State Plan ID No.:
DERRICK, Richard RICHMOND
CST BM Elev.; Insp. BM Elev.: BM Description: Parcel Tax No.:
/— /aJ %b (�� 026-1119-11-000
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Ic �/jn: �b�eq ��� . �O1ll� Benchrrie k �,
Dosing
Aeratio . Sewer 70 /v i 3
Holding /14t Inlet 3 /00- E.
TANK SETBACK INFORMATION t/ t Outlet /a' 9g•
TANKTO P/L WELL BLDG. Air to
i ntake ROAD Dt Inlet
ir
Ic A NA Dt Bottom
Dosing NA Header/ Man. 6 . D
Aerati NA Dist. Pipe & .Z S
Holding Bot. System 7.
PUMP / SIPHON INFORMATION Final Grade 2, /O /. V
Manufacturer D and e,{
Model Number GPM
TDH Lift Friction System H TDH Ft
Forcemain L th . Dist.Towell
SOIL ABSORPTION SYSTEM
BEDeME Width S' Length Gv No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIM S L I DIMENSION
SETBACK
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEAC G Manufacturer:
INFORMATION Type O 1 CHAMBE
er:
Syste :o>•dr,� �� J Ar R UNIT
DISTRIBUTION SYSTEM
Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
1 Lam'`
Length 3�5 Dia. � Length C!O Dia. - r � Spacing A 7
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
FBed Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched
ench C enter Bed /Trench Edges Topsoil — T.[] Yes ❑ No ❑Yes E] No
COMMENTS: (Include code discrepancies, persons present, etc.)
RICHMOND 22.30.18.,SE,NE 1279 146TH AVENUE — PO MDWS LOT 11
O 4 �y y /�j q , A (�, (a M - la 0 It -fl A VJ G�-t� � A
Jam` lot f
!rp'
Plan revision required? ❑ Yes ❑ No a � r
Use other side for additional information.
SBD -6710 (R.3/97) Date spector's Signature
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
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A sconsin Safety and Buildings Division
SANITARY PERMIT APPLICATION 2 1 B Washington Avenue
Department of Commerce In accord with tLHR 83.05, Wis. Adm. Code Madison, WI 53707 -7302
10
• Attach complete plans (to the county copy only) for the system, o u
than 8112 x 11 inches in size. SSG Yo
• See reverse side for instructions for completing this applicatio REEI�/ED Sta Ma at n
ry Permit Number
�
Personal information you provide may be u iN r s econdary purposes � "- - vision to previous applic [Privacy Law, s. 15.04 (1) (m)]. /// Y�L. rl r Che If
1 .1? 1g . Number
I. APPLI ATI N INFORMA -LEASE PRINT ALL INF" ^ MAT Rplx
Property Owner Name % i. Pr ti
y „r rr•• 1i�[ " "' ilk; S T , N, R E (or V
Property Owner's Mailing Address L j -- �, Block Number
City, State Zip Code Phone Number Subdivision Pame or CSM Number
II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ !t Nearest Road
❑ Village ,,�
Public 1 or 2 Family Dwelling - No. of bedrooms Town of 'c!r /kG Y h
III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 22.
1 ❑ Apartment/ Condo 6 ' G
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. j, New 2. ❑ Replacement 3. ❑ Replacement of 4 ❑ Reconnection of 5. ❑ Repair of an
System ________ System __________ ___ Tank Only__ Existing System ________ Existing System
B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non- Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 []Holding Tank
12 g,Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy
13 ❑ Seepage Pit 43 ❑ Vault Privy 7 ���
14E] System-ln-Fill 5 / 'L
VI. ABSORPTION SYSTEM FORMATION:
1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade
Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft_) (Min. /inch) Elevation
y6 T +%W 7Q ,e/� 7 Feet f Feet
Capacit
VII. TANK in Ca allo s
g Total # of Prefab. Site Fiber- Exper.
INFORMATION Gallons Tanks Manufacturers Name Concrete Con- steel glass Plastic App
New Existin structed
Tanks Tanks
S tic k o g Tank // �' �,I+�C�IA,t� ❑ ❑ 1:1 El ED a
lift mp Tank /Siphon Chamber ❑ 1:1 ❑ 1 ❑ 1 ❑
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite se age system shown on the attached plans.
Plumber's Name: (Print) Plumber's Signature: Stamps) MP/ PRSW No.: Business Phone Number:
Xue l ,A 2'' 9d i • 3 F� :3IR /
lumber's Address (Street, City, State, Zip Cod /
� G�, G
IX. COUNTY/ DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate Issued Issui g Ag t S natu (No Stamps)
S/Approved ❑ a,(� Surcharge Fee)
Owner Given Initial <
Adverse Determination I
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
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.
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 isto 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 tothe 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.
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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. 026- 1119 -11 -000
VI ED BY ATE
APPLICANT INFORMATION- PLEASE �4�1 n RMATION RE
PROPERTY OWNER: PROPERTY LOCATION
Pat Collova ^ ^` ".„ GOVT. LOT SE 1/4 NE 1 /4,S 22 T 30 N,R 18 iE (or) W
PROPERTY OWNERS MAILING ADDR 8S ; , ` LOT # BLOCK # SUBD. NQMF OR r�M #
705 Cty. Rd. "E" `'`^ � 11 na Pon view eadows
CITY, STATE P CODE SRO NI.} BER ❑CITY [:]VILLAGE MOWN NEAREST ROAD
Hudson, WI. 54016 7,5 597T Richmond 146th. ST.
(X] New Construction Use [ ]d tubli4roommercial-
d'al / NunffkV bed s [ ] Addition to existing building
[ ] Replacement [ ] ri 8s
Code derived daily flow 450 gpd Z ecommended design loading rate .7 bed, gpd /ft - 8 trench, gpd /ft
Absorption area required 643 bed, ft 563 trench, ft Maximum design loading rate • 7 bed, gpd /ft - 8 trench, gpd /ft
Recommended infiltration surface elevation(s) 96.90 ft (as referred to site plan benchmark)
Additional design /site considerations na
Parent material outwash Flood plain elevation, if applicable na ft
S = Suitable for system CONVENTIONAL I MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem I CAS ❑ U 4K7 S ❑ U 1�7 S ❑ U ® S ❑ U F1 S ❑ U ❑ S ® U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft
..................
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
.................
..................
.................
1 0 -10 10yr3/3 none 1 2msbk mfr gw 2f .5 .6
..... 2 0 -28 10yr4 /4 none sicl 2msbk mfr gw if .4 .5
Ground 3 8 -108 7.5yr4/6 none ms sOg ml na na .7 .8
elev.
10 ft.
Depth to
tO
limiting
factor
+10 8"
Remarks:
Boring #
1 -14 10yr3 /3 none 1 2msb mfr cs 2f .5 .6
' 2 2 4 -36 10yr4/4 none sicl 2msbk mfr 9w if .4 .5
3 6 -96 10yr4 /6 none is Osg mvfr na na .7 .89
Ground
elev.
1
Depth to
limiting
factor
+ 96
Remarks:
CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200
Address: 1554 200th. Ave. New RichmondjffI 54017
Signature: Date: 7 -24 - CST Number: mO2298
PROPERTY OWNER Patrick Collova SOIL DESCRIPTION REPORT Page 2 of 3
PARCEL I.D. # 026- 1119 -11 -000
R
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends
1 -12 10yr3 /3 none 1 2msbk mfr cs 2f .5 .6
2 2 -31 10yr4 /4 none sici 2msbk mfr gw if .4 .5
Ground 3 1 -90 10yr4 /6 none ms sOg mvfr na na .7 .8
elev.
1
Depth to
limiting
factor `tt)
+90
Remarks:
Boring #
1 -10 10yr3 /3 none 1 2smbk mfr 9w if .5 .6
>4 « 2 10 -36 10yr4 /4 none sicl 2msbk mfr 9w if .4 .5
3 36 -90 10yr4 /6 none ms Osg mvfr na na .7 .8
Ground
elev.
100.7 ft. --
Depth to --
limiting
factor
+90
Remarks:
Boring #
1 0 -11 10 yr3/3 none 1 2msbk mfr cs 2f .5 .6
`.,.5 2 11 -37 10yr4/4 none sicl 2msbk mfr gw if .4 .5
3 37 -90 10yr4 /6 none ms Osg mvfr na na
.7 ` .8
Ground
elev.
1
Depth to
limiting
factor
±9Q
Remarks:
Boring #
Ground
elev. j
ft.
Depth to
limiting
factor
Remarks:
SBD- 8330(8.05/92)
` STEEL'S SOIL SERVICE
Gary L. Steel Patrick Collova 1554 200th Ave.
CSTM2298 SE4NE4 S22- T30N -R18W New Richmond, WI 54017
MPRSW -3254 town of Richmond (715) 246 -6200
lot #11- Pondview Meadows
N
1
BM.= top of NW lot stake C el. 100.00
Alt. BM.= top of SW lot stake @ el. 101.50
e �
" �19
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N �v
Gary L. Steel
7 -24 -99
Wisconiin Department of Industry SOIL AND SITE E V A L U AT,.1 Page 1 of 3
Labor ana Human Relations ti
Division of Safety & Buildings in accord with ILHR 83.0 VVIs, Adm. Code
' COUNTY
Attach complete site plan on paper not less than 8 1/2 x 11 inches in siie..fYat i t
n mus i 1 r Croix
"
not limited to vertical and horizontal reference point (BM), direction anrj % of slo scale or
dimensioned, north arrow, and location and distance to nearest road. (�' ? k r 65 -50 -000
APPLICANT INFORMATION- PLEASE PRINT ALL INFORMA ! fON. > ^ a DATE
" C+t'
PROPERTY OWNER: I sPf30 LON
Richard Derrick G . LOT, S13.,.. - 1�
4 W
1 /4,S 22 T 30 N,R 18 Ejor)W
PROPERTY OWNERS MAILING ADDRESS L � LI11 -1 D. NAME OR CSM #
1310 H 65 11 na Pondview Meadow
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE [MOWN NEAREST ROAD
New Richmond, WI. 54017 (719 246 -5425 Richmond 146th. Ave.
[x] New Construction Use [ Residential / Number of bedrooms 4 [ ] Addition to existing building
[ ] Replacement [ ] Public or commercial describe
Code derived daily flow 600 gpd Recommended design loading rate _-np— bed, gpd /ft .2 trench, gpd /11
Absorption area required np bed, ft 500 trench, ft Maximum design loading rate np bed, gpd /ft .2 trench, gpd /ft
Recommended infiltration surface elevation(s) 99.75 It (as referred to site plan benchmark)
Additional design /site considerations system el. based on contour line of el. 98.75'
Parent material glacial drift Flood plain elevation, if applicable na ft
S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem ❑ S 5a I. S ❑ U ❑ S ® U EIS jE7 U EIS ®U ❑ S a u
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure Consistence Y Roots GPD /ft
Boring # Horizon in. Munsell Qu. Sz. Cont. Color G Sz. Sh. Bed Trench
..................
.................
1 0 -12 10yr3 /3 none 1 2cpl mfr cs if ap .2
::::1:` 2 12 -32 10yr4 /4 none sicl lcpl mfr gw if np .2
Ground 3 32 -45 5yr4/4 none sl 2csbk mfr gw na .5 .6
9q elev. ft. 4 45 -75 5yr4/4 none scl M na na na np .2
Depth to
limiting
factor
45"
Remarks:
Boring #
1 0 -10 10yr3 /3 none 1 2fp1 mfr cs if np .2
2 2 10 -17 10yr4 /4 none sici lcsbk mfr gw if .2 .3
3 17 -42 7.5yr4/4 none sl lcsbk mfr gw na .4 .5
Ground
elev. 4 42 -80 5yr4/4 none scl lcsbk mfr' na na .2 .3
99.2
Depth to
limiting
factor
42"
Remarks:
CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200
Address: 1554 200th. &Sj New RichmQud, WI 54017
Signature: Date: 4 -22 -99 CST Number: m02298
PROPERTY OWNER Richard Derrick SOIL DESCRIPTION REPORT Page 2 -of 3'
PARCEL I.D. # 026- 2065 -50 -000
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
1 0 -12 10 r3/3 none 1 2c 1 mfr gw if np .2
................. 2 12 -24 10yr4 /4 none sicl 2cp1 mfr gw if np .2
Ground 3 24 -48 5yr4/4 none sl lcsbk mfr gw na .4 .5
elev.
4 48 -80 5yr4/4 none scl M na na na np .2
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft. —
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev. j
ft.
Depth to
limiting
factor
Remarks:
SBD- 8330(8.05/92)
STEEL'S SOIL SERVICE
Gary L. Steel Richard Derrick 1554 200th Ave.
CSTM2298 SEkNE4 S22- T30N -R18w New Richmond, WI 54017
MPRSW -3254 town of Richmond (715) 246 -6200
lot #11- PondView Meadows
This soil evaluation was conducted to satisfy a zoning requirement, it may or may
not be suitable for your use.
ZI
N
1 =40'
BM.= top of 1 pvc pipe by NE lot corner @ el. 100.00
Alt. BM.= top of SE lot stake C el. 105.50
5 q ; f6-
N
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P.2
a
Gary L. Steel
4 -22 -99
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
OwnerBuyer k r &f-4 K vj f rr n i UK
Mailing Address 6 /VFW
Property Address ; 2 '2
(Verification required from Planning Department for new construction)
City /State ,r/,c I X. --/, g-, e 4,- !/ Parcel Identification Number
LEGAL DESCRIPTION
Property Location S %., y., Sec, 5- , T () N - R W Town of
M
Subdivision 1D6 NOVI E tt..) I ' EA'80 t.")- Lot #
Certified Survey Map # Volume , Page #
Warranty Deed # 4y 3 C/ Volume �?'.5 , Page # 5-3
Spec houseXyes ❑ no Lot lines identifiable / P3yes ❑ no
SYSTEM MAINTENANCE
Improper use and maintenance of your septic system could result in its premature.failure to handle wastes. Proper maintenance
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the function of the septic tank as a treatment stage in the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge.
Itwe, 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 Zoning Office within 30
days of the three year expiration date.
LzJ
/f_ 3/99
SIGNA' F APPLICANT DATE
OWNER CEATMCATION
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 mperty d scri above, virtue of a warranty deed recorded in Register of Deeds Office.
l;Sl9T1
SIGNATURE 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
' 4 ! _ ► 131 fry r b, we by: ACA. PC RICA, "I VOL 952P 5, g
P, 1 of r
48399'7
LIMITED WARRANTY DEED
THIS INDENTURE, made this 21st day of May
19 92 , between AgriBank, FCB, formerly known as
REGISTER'S OFFICE Federal Land Bank of St. Paul
ST. CROIX CO ., M a federally chartered corporation, with a post office address of
:. Recrdfonccord 375 Jackson St.
St. Paul, MN 55101
MAY 2 9 1992 party of the first pan, and Loren D. Derrick, Rose H. Derrick
at M Richard L. Derrick, Joan L. Derrick, and Robert J
10:15 A. Derrick
V &"� whose post office address Is Route t14, Box 48, New Richmond
Register of Deeds WI 54017
party of the second part, (hereinafter referred to as party whether singular or
plural), WITNESSETH, that the said party of the first part, for and in
consideration of the sum of Fifty Five Thousand Eighty and
Recording lnfor ioa 00/100 . ......................... DOLLARS,
($ 55,080.00 ), to it paid by the said party of the second part, the receipt whereof is hereby acknowledged, does grant,
bargain, sell, and convey unto the said party of the second part, his /her /their heirs, successors and assigns forever, the following described real
estate, situated in the County of St. Croix and Slate of Wisconsin , ro -wit:
EJNE} except Lot 1 of CSM recorded in Volume 4, page 1144 of CSM of Register of Deeds.
NW }NE#
All in Section 22, T30N, RI8W.
ly 4 c�
' m , )ti. �.
. 'r`�......n.ov� EXEMPT
subject to all existing casements and rights of way; also subject to all taxes on said premises for the year 19 92 and following years; also
subject to all unpaid parts and installments of special assessments on said premises which have fallen due, or will fall due hereafter.
EXCLUDING therefrom and excepting and reserving to said party of the first part all mineral and royalty rights, interests, estates and titles
heretofore reserved or excepted of record by The Federal Land Bank of Saint Paul prior to January 22, 1986, if any, with such easements for
ingress, egress and use of surface as may be incidental or necessary to use of such rights. The foregoing exclusion, exception and reservation
shall include, but not be limited to, all oil, gas, hydrocarbons, coal and other minerals of whatsoever nature lying in or under the above -
described lands and all royalty interests as to oil, gas and other minerals produced and saved therefrom. It is expressly understood that the said
party of the first part will make no warranty as to the extent of its ownership of minerals, or as to Its title thereto.
TOGETHER with all and singular the hereditaments and appurtenances thereunto belonging or in any wise appertaining; and all estate, right,
title, interest, claim or demand whatsoever, of the said party of the first part, either in law or equity, either in possession or expectancy of, in
and to the above bargained premises, and their hereditaments and appurtenances.
TO HAVE AND TO HOLD the said premises as above described, with the hereditaments and appurtenances unto the said party of the
second part, and to his/her /their heirs, successors and assigns FOREVER.
AND THE SAID party of the first part, for Itself and its successors, does covenant, grant, bargain and agree to and with the said party of
the second part, his /her /their heirs, successors and assigns, against all and every person or persons lawfully claiming lite whole or any part
thereof, by, through or under said party of the first pan, and none other, it will forever WARRANT and DEFEND.
('Ae 2 012 •., V P.I 1 h U L U_1 0
IN WITNESS WHEREOF, the said party of The first part, has caused these presents to be executed in its corporate name the day and year
first above written.
WITNESSESS:
AgriBank, FCB
}DI�CBZ�CRA[A.
By: _
Je j h ne z Regional Vice Presid
(N —) mI
of Farm Credit Services of Northwest
Wisconsin, FLCA
Acting as Attorney -in -fact for Farm Credit Bank of St. Paul.
or:
By:
(N.—) (n,le)
STATE OF Wisconsin
1 ss.
COUNTY OF St. Croix J
The foregoing instrument was acknowledged before nit on (date) May 21, 1992
by (,lame) . Jerry Lehnertz (title) Regional Vice President
o f ..*P '4Yltf"Olr dit Services of Northwest Wisconsin, FLCA
or Ja 11 behalf of Farm Credit Bank of St. Paul.
nna ti
Notsr� N O t. Croix County, Wi s consin My commission expires 4-9 19 95
STATE OF
ss.
COUNTY OF
The foregoing instrument was acknowledged before me on (date)
by (name) (tide)
Of
on behalf of said corporation,
Notary Public, County, My commission expires 19
I;
This instrument was drafted byt• ;
Farm Credit Services of Northwest Wisconsin, FLCA n
R. A nderson, P.O. Box 199 �)
R iver Falls. WI 54022 C�
r •.
ST. CROIX COUNTY
WISCONSIN
" 1 z ZONING OFFICE
p p p g p p p p p ST. CROIX COUNTY GOVERNMENT CENTER
"' ■" 1101 Carmichael Road
Hudson, WI 54016 -7710
(715) 386 -4680
November 29, 1999
P.C. Collova Builders
Attn: Pat Collova
705 County Trunk E
Hudson, WI 54016
RE: Septic Inspection for Richard Derrick located at 1279 146"' Avenue,
Lot 11 of Pondview Meadows, Town of Richmond, St. Croix County,
Wisconsin
Dear Mr. Collova:
A septic inspection of the above referenced property was conducted on September 29,
1999. This property is located in the SE% of the NE% of Section 22,730N -R18W, Lot 11
of Pondview Meadows, 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,
lu ���
Kevin Grabau
Zoning Technician
T