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HomeMy WebLinkAbout030-1055-90-000 r ST. CROIX COUNTY ZONING DEP AS BUILT SANITARY REP r� Owner J© A4N SS , RENO Property Address City /State ST S 1?1,v Legal Description:' Lot Block Subdivision/CSM # � °���- ' /4 1 /4, Sec. , T go N -RAW, Town of �5 jo s`Orf � 6O-4oT SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer Size ST/PC/ / � Setback from: House 1 - S Well S5 PAL 1 0 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: St ,VA6& Width 3' Length �� ` Number of Trenches Setback from: House -7o Well SG ' P/L ys" Vent to fresh air intake 130 ' ELEVATIONS Description of benchmark '5�O /a 8 owdf p<£ Elevation i00 oo' Description of alternate benchmark Elevation Building Sewer �l� - 41' ST/HT Inlet ,2. ss ST Outlet PC Inlet _ PC Bottom 4 9. 1/1 ' Header/Manifold Top of ST/PC Manhole Cover Distribution Lines (4) Teo ( ) Bottom of System p4-) 93, Final Grade () Date of installation V/ Permit tuber State plan number c Plumber's signature r ! �` License number 4 L2 Date / 1 Inspector Complete plot plan � NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW Q,� rY 0 b E kk 'AJ A1- go . /2S' GQAVirY o /? �,�v. GJi�S� - Lcr..�8o p /oDt7�(Ppp CO/tL� ♦ �' &7?VN1N(. WALL SEpfJt Jerz — 4 1 Sq 35 P& a M � �S.cE+E ✓ff v rrrf y -.;Q 55' �F /LT/��'raP— S/.G1�tu /N/JLP 4 ZAA4 - /Ty /heDG< 77'E�UC/%S �rt 1v vkms ea► CAM or E.AcNTuucpi �oDeSEDLJZ(c N o S G. INDICATE NO TH ARRO) � ' I Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division Count y:ST. CROIX INSPECTION REPORT ` GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Personal information you provice may be used for secondary purposes [Privacy L aN, s.15.04 (1)(m)]. FgP3i8 HoIdj6 pe& RUTH EEOY EU013 Town of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description: Parcel T — 1 %.© 0 1 1 cN. 0 r Lsk TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic W -W C&m 00 Benchmark [fzQ GYM lM Dosi ng �, 3 M f3. S Aeration Bldg. Sewer Holding <D/At Inlet TANK SETBACK INFORMATION TANK TO P/ L WELL BLDG. Ventto ROAD D4- I n l et Air Intake Septic > fao 4c- r NA Dt Bottom d !S o r Dosing « (( 2 2 NA Header / Man. �` `� 9 3 3� Aeration NA Dist. Pipe E 7. . 3o tj / ° -(* ?3.G8 Holding Bot. System E rn. PUMP/ SIPHON INFORMATION Final Grade 7. c Manufacturer D ec e ;GPM C � S. J.� Model Number (,,p 37 TDH Lift a&,18 Friction 4 System TDH fi Forcemain Length �O Dia. Z `' Dist. To well SOIL ABSORPTION SYSTEM 3 7 1 6a,-tJ&, ( (Zug, eA c4 RENCH Width f Len i No f renches PIT No. Of Pits Inside Dia. Liquid Depth DIME N TS DI MENSION S SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manyfa� INFORMATION Type Of CHAMBER r INum : System: J' .,2� 7 Sa 7 S OR UNIT 'C_ bl ku - - �a DISTRIBUTION SYSTEM ,.c,% (4) 3 ti'- 8: 61 � S,� Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Ip. Lengtf Dia. Length ia. Spacing / #--t SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over (/ n Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center (O Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) G't•t(_ C p� ( - o, 3 LOCATION: ST. JOSEPH 23.30.19.199A1 1472 78TH STREET - OT 7 At 40? f' wit 1 3 p n„ +"- .. �r -s 4a _ 11 Plan revision required? ❑ Yes ;( No - S I ' 6 Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert. No ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: T. 3 _9 . »�. a ��, . �„ �. e � V —P f [ E s � t a E 1 —1 tkr r �. 4_14­111 7 if: �j 1-4 1 —1 1 t a E E , d til e w m »,m E e P } [ L 8 E ( € - t , "- h? I ,� 7 j a � e E I ' � q .� P amM � e I m E . ,..,,. fi e.. _.,. ... L E� , � s 1 .A E € madam �se _ 77 L 14 J: ��j q- . . . . . . I � r J .. �e e ---- ... kv_ 3 s x e V is con si n Safety and Buildings Division SANITARY PERMIT APPLICATION 20 E. Washington Ave. Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 -7969 • 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. D • See reverse side for instructions for completing this application State Sanitary Permit Number The information you provide may be used by other government agency programs ❑ Check if revision to p" revious 6pplication [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATI N Prop r " ty Owner Name Property Location r. �r �,ua 1/4,S T2� ,N,R E(o W Property Owner's Mailing Address Lot Number Block Number .Il City, State Zip Code Phone Number Subdivision Name or CSM Number 11. TYPE OF BUILDING: (check one) ❑ State Owned Cit Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms --. I— sa Town of /S Q� III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo :% ? -/o .. - J 9 0 7CJ lT� 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. §fl 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 CM Seepage Trench 22 ❑ In- Ground Pressure 42 E] Pit Privy 13 E] Seepage Pit (3) IF 3 r "75' 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATIO 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.) (GalsJday /sq. ft.) (Min. /inch) Elevation CSC? - a I V L — �,� Feet 90'c7 n Feet VII Capacity TANK in g allo ns Total # Of Prefab. Site Fiber- Exper INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Existin structed Tanks Tanks eptic Tank nk p 4 - ® ❑ ❑ ❑ ❑ ❑ I Pump Tank amber ) ' ❑ I ❑ I ❑ I ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Pluum�ber's Name: (Print) Plumber's Si nature: (No Stamps) MP /MPRSW No.: Business Phone Number: Plumbe ' Address (Street, City, State, Zip Code): IX. COUNTY / DEPARTMENT USE OIQLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate I ssued Issuing ent Signature (No Stamps) A roved Surcharge Fee) pp ❑ Owner Given Initial oZ�s / Adverse Determination X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: SBD -6390 (R 11/96) 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 hoiding 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_ i -1 f - - S�Z iN — 3 &,O eoaws -16 • 4. Z 9 1. V r .?3, C'$ o If 2� SoEc��.vQEPs oR o? q "4HEs wrrl+ i� SIDcGiINO�s .CbNt. � �IiC Pt.or cnoss secTwN PLANS ZAIPPA bno'. EKCAYATMA ING PWMMMIa UNIT ... O'e"0 6 WEu- Pn m f�,�•s hKe iso'�,4c,E ��Si twcc. pT -�rkj r< /Lirrlr/ AW , oScl�II�wNSNi o !7 CiQ v �x L c�.�li' i I' C4K J�.+��ilf /tr P/tRaP %kL``k� S y°s /gale �rtPK - S p,K� �•� P ea . �P , -- _ - -- - - - -- 9a so-- Q y "SpQ 35 Al� ��T�P�t7bR" S1otw tn� app P FF,14AA ) r xo�s - S.�.rz_lw -1p MrAAil s AlG — � // S � ,, , cN�,lo P✓c I as 75 s � IV E --as7' Jtoi°6 -- ' • �°Doos�Q _ s z ,�� E Y 77 �5 19CMA Y IEvJ � � e '� V f.�Vt �B56P�IhT /O�J i�i�� 810NED: -- A oRovFo VENT LAo UC ENB E: L t/f>o�Pf a•? S'7 DATE: // • a �/ • S� - MaTmq BY: 129VP FN,sa �P�►�E I CST 3y g t:� ?o fi N �SN {a4,hOE Side View T EA, - H Bo Tro. �Eq so. c Ttsr End View X 15 ° JL ` I I. 34' / ° AGE I 'SIoEC -) Al OAR A)rGN oL"'APActrv' MoOEL. f -WW IZI to-ill 00 0 0 k C16 0 v 3 O I QC Rlr . . Z � I � ? 4 0 i W Q w A- V 5 a W V F � a o- w i t r h Vl Goulds Submersible Effluent Pump 3885 41 APPLICATIONS • Overload protection must smooth operation. Silicon can be operated continuously Y ''Specifically designed for the be provided in starter unit. bronze impeller available as without damage. • Shaft: threaded, 400 series an option. following uses: ■ Bearings: Upper and �•<Homes stainless steel. ■ Casing: Cast iron volute lower heavy duty ball bearing +: Farms •Bearings: ball bearings type for maximum efficiency. construction. railer courts upper and lower. 2" NPT discharge adaptable ■power Cable: Severe du • Power cord: 20 foot tY Motels standard length (optional for slide rail systems. rated, oil and water resistant. Schools lengths available). ■ Mechanical Seal: SILICON Epoxy seal on motor end Hospitals CARBIDE VS. SILICON Industry Single phase: provides secondary moisture •'% and'' HP –16/3 SJTO CARBIDE sealing faces. barrier in case of outer jacket 4 Effluent systems Stainless steel metal parts, damage and to prevent oil ' 7. prong pjug o r 230 V three BUNA -N elastomers. wicking. SPECIFICATIONS • 3 /4 -1'/2 HP –14/3 STO with ■Shaft: Corrosion - resistant ■ 0 -ring: Assures positive ;Pump ' ` bare leads. stainless steel. Threaded sealing against contaminants • I.Solids handling capabilities: Three phase: design. Locknut on three and oil leakage. maximum. •'/2 -1 % HP –14/4 STO phase models to guard :Discharge size: 2" NPT. with bare leads. On CSA against component damage AGENCY LISTINGS ,Capacities:,up to 128 GPM, listed models – 20 foot on accidental reverse rotation. , Total heads: up to 123 feet length SJTW and STW ■ Motor: Fully submerged in SP Canadian Standards Assmiation } sTD11 are standard. high -grade turbine oil for i •' echanical,seal: silicon lubrication and efficient heat U� Underwriters Laboratories cArbI e- rotary,seat/silicon FEATURES transfer. carbide•stationary seat, 300 ■Designed for Continuous eries stainless steel metal •Impeller: Cast iron, semi- BUNA -N elastomers. open, non -clog with pump- Operation: Pump ratings are R.rts�. out vanes for mechanical seal within the motor manufacturer's emperature: recommended working limits,'. 1QF (40 °C) continuous - protection. Balanced for g 40��(60°C)intermittent. , METERS FEET asteners :300 series 90 r WglesS Steel. _ _ SERIES: 3885 F ap�abJe,of running dry 25 ao SIZE: 3/4' SOLIDS Ut�lamage to E? ._ -► SGPM - - RPM: vARious pOgents. zo ''N 20 E1 ' N 5 FT A glephase: _ s - nkA EWj V; 200 V; 230 V, 15 50 — - 1-1 6 N�,150 RPM;' /z HP, _ _. _.. _ ...:.._._ ..__..... :... __. _._.. _.. .__.. _.. 5 =V,60 Hz, 3500 RPM; 0 40 E 'HR 1'12 HP, 230/, a - 0 10 Hz, 3500 RPM. 30 rn ., ilL overload with - t1atlq;reset. 2 �Insulation.. 5 - - skv ephase 10 . HP. 200/230/ 01 0 - — Hz, 3500 RPM. 0 10 20 ` 30 U 40 50 60 70 ao so 100 110 120 130GPM lass 6 insulation. ' 0 10 20 30 M CAPACITY 99 GouIds Pumps, Inc. 00017A Effective Maya 1995 11 83885 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 - Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but �IR4t 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. Q- /[75S -90 000 APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION R IEWED•BY DA E PROPERTY OWNER PROPERTY LO ATION J N") + OWNER- r N r'1 U�5 GOVT. LOT - 1/4 114,SZ3 T 3© ,N.R �� E (or) W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # S BD. N CSM # �r oCv� ar ,, 7 �t Y ?4J/ CITY, STAN ZIP CODE PHONE NUMBER ❑CITY OVILLAGE OTOWN NEAREST ROAD (Off New Construction Use [ad Residential / Number of bedrooms 3 (J Addition to existing building I J Replacement ( J Public or commercial describe Code derived daily flow a gpd Recommended design loading rate Q bed, gpd/ft trench, gpd/ft to Absorption area required bed, ff? "ss v . trench, fit Maximum design loading rate 5 - bed , gpd /ft ' Vench, gpd/ft Recommended infiltration surface elevations) J-'_ 9s It (as. referred to site plan benchmark) Additional design /site oonsiderafths Parent material Flood plain elevation, if applicable e1 f'- ft S - Suitable for system �Q NVENTIONAL MOUND _ IN•C�ROUND PR ESSUf�t -• AT GRADE S�,STI:M IN FILL HOLDING TANK U =Unsuitable for system S O U -� S❑ U S❑ U —" ❑ S• r U - S❑ U ❑ S au SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourxlary I Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trends g, r 7 - 2� i Y�2 f; 3 �, Z r► a �K >h f r s I - � p Ground. 4 g � 36 vrZ Depth to 3 /D /iQ ¢� limiting f ct 7f .`I Remarks: ... Boring # ....... .. • . • •, M r 16. �- 3 - -' _ 5; Z. q b n��l�r l d.E .Ground 8-z 6 y iq 4A -- 5;L Z q�k mY� 5 I d l ay - _e fL $ i 0'1/ R.� 5 C, 1�� s .7 Q Depth to limiting ` 7 fat Z Remarks: CST Name:-;-Please Print Phone: II>�`y ,� , . LO A ddress: AS � �....... Sgnaturi Date: / / CST Number :sq 7 PRO PEMYOWNER US SOIL DESCRIPTION REPORT Page? of 3 J PARCEL I.D. # 6 3�0 ' IOS — d Depth Dominant Color Mottles _ Structure - GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont —i Color Texture Gr. Sz. Sh. Consistence' Barx�ry Roots r tenth / b }�' r 3 5 a L l wr s vn 2m t5-37 1&, Z0,91.k n� s o.L Ground 9 it ► Ids S s(4 m l _ s o .6 Depth to limiting factor Remarks: Boring # 1 6-13 /dy _ I m sbx A - q , 5 Z 0. S q' 327 r c, $ E �rh .6 / o. 3 v� �o 5 Ground Z7-4 dYP14 6 14 rm G �9 M Ar e S ,S €O 9 ft /0`/2 4 ,� SG fvt CS _ ,7 ' a FS Depth to S limiting fa for Remarks: - - Boring # Ground `3 1dS `/- R d 5 ri+ b /ti► Y �r.. C S 5 0.� ele � ft Depth to $ 4 _ W'S S� O•�0,6 limiting ` f 7� Remarks: Boring # 13 Ground elev. ft Depth to _ limiting factor Remarks: SBD- 8330(R.05/92) i � I _ r PaWLk PaL F«x \ I 66 - - sz i �a Olb` 7 1 N \ 4 V a , r 93 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Ruth S. Huss Mailing Address 722 Linwood Avenue, Saint Paul, MN ` 55105 / S172 Property Address 14XX 78th Street, New Richmond, WI 54017 (Verification required from Planning Department for new construction) City/State New Richmond, WI Parcel Identification Number 2 3 ';� D , Li . i qg A LEGAL DESCRIPTION / 0 -Oc:�' Property Location Part ,9f �Goov�o esc 23 . T 30 N -R 1 g W, Town of St. Joseph Subdivision , Lot # Certified Survey Map # ?,�Z ;? , Volume .I : ,Page # Warranty Deed # SFj 9 , Volume , Page # �yr6 Spec house ❑ yes U no Lot lines identifiable U 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. 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 Zoning Office within 30 the three year expiration date. I Am ef lc l y 9 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 erty described above, by virtue of a warranty deed recorded in Register of Deeds Office. I ARS. 612D 0/ 1,0219.9 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 r �vo 581950 ��L'1` ?:1 1 oirF 4 56 WARRANTY DEED DOCUMENT NO. REGISTER'S OFFICE ST. CRGIX CIO., WI This Deed made between MARY P. LUTHY JUN 29 1998 Grantor and RUTH S. HUSS, Grantee, 9:30 A M Witnesseth, That the said Grantor conveys to Ro lsfor of Deeds Grantee the following described real estate in St. Croix County, State of Wisconsin: Part of Government Lot 3 and 4 of Section 23 -30 -19 described as follows: From the Northeast comer of said Section 23 go west along the north line of said Section 23 a distance of 1220.5 feet; thence due south a distance of 773. 4 feet; thence S5 °59'Ea distance of328.46feet Tax Parcel No. 030 - 1055 -90 to point of beginning for parcel to be herein conveyed; thence S5 °59'E RETURN T0: ROBERT MUDGE, ATTY. a distance of 328.46 feet; thence S 86 ° 00'W a distance of 314 feet, 110 Second Street, Hudson WI 54016 more or less, to the east shore of Bass Lake; thence northerly along said i shore to a point due west of the point of beginning a distance of 350 feet, more or less; thence due East a distance of 350 feet to point of beginning, the above parcel containing 3.0 acres, more or less and subject to easements of record, together with an easement appurtenant for ingress and egress over the existing road abutting said land on the E and extending Nly to the town road as now opened and traveled, being Lot 7 of Certified Map filed May 18, 1998 in Vol. 12, page 3451, Doc. No. 579329. This is not homestead property. i Together with all and singular the hereditaments and appurtenances thereunto belonging; i And Grantor warrants that the title is good, indefeasible in fee simple and free and clear of. encumbrances, and will warrant and defend same. Dated this `2 day of June, 1998 T AN oFER FEE maju !. (SEAL) Mary P. Luthy STATE OF PENNSYLVANIA /11 N _ `� T G o M t COUNTY )SS Personally came before me this 0 4 " — y of June, 1998, the above / named Mary P. Luthy, to me known to be the person who executed the foregoing instrument and acknowledged the same. Notary Pu&c_�l 'Sf M Commission ex ir@s � '}'` -; THIS INSTRUMENT DRAFTED BY: NOTA13Ir L SF-Al `~ Robert W. Mudge, Attorney VIRGINIA M. NE L�,' f�Iotary Pttbpc S - MUDGE, PORTER, LUNDEEN & SEGUIN S.C. East Norriton I Wp Lk!' ery ry' M 110 Second Street, P.O. Box 469 ,_ Commission Expiid� : 8.. �. Hudson, Wisconsin 54016 COPY 1 cc FILED 19 1 7 9 �� MAY 1 8 1996 go F' MM pegister of Deeds H EN CERTIF V Y MAP LOCATED IN PART OF COVE ' OTS 3 AND 4, SECTION 23, T30N, R 19W, TOWN OF ST. JOSEPH, ST. CROIX COUNTY, WISCONSIN AS DESCRIBED IN VOLUME 522, PACE 139A; AND IN VOLUME 522, PACE 139B. SCALE IN FEET 1" = 100' NORTH LINE OF SECTION 23 100 0 100 200 N89'41'40 "W NE COR. NW COR. �— SEC. 23 SEC. 23 4054.06' 1217.42' OWNER 3 (WEST 1220.5') JOHN & RUTH HUSS o o r- E1315 FIRST NATIONAL BANK BUILDING ^'') a o 332 MINNESOTA STREET F4 D ST. PAUL, MN 55101 ON N sl T��CZ V MARY LUTHY 8 ` .. PARCEL - �o (N83'27'11 34 3.5') ' VOL. 895, PC. 253 S83 -13' ,0981 � EXISTING DRIVE I - - - - - - - - - - - - - - 1 - 4 .92'— 2' 1 86.57 - - - - -- Ln 1 4 0 . O • ■ I N 1 N Z \ O SEPTIC 1 i c � v O jr s i? N D I m Co x z C 9 �_ 1 O ED N O : 3 z f 9 ` m C o G O (� O N s O Z Z \C11 z z v -< � m LOT 6 W 0 \\� J m ;u z O v o 0 O 0 r-U O �^ Z z 2.T70 ACRES U' 0 m m Z O v \ \`�, ` 94;507 SQ. FT. Q0 m y vZ ;u V) O Z m m v n w O I o ° A °z D 100.92' 141.48' fTl Z ? 0 U, 4' +/- S89'40'00 "E 242.40' m ti m ? (WEST 350' + / -) m ;u T) z = Cn m 0 o . Z o c O 3�-I Z X yam O m 00 U) : III J p EA 0 �► (A D W I " O C) 6 LOT 7 rn o <� b o ` 1.819 ACRES -v; - D i x 79,256 SO. FT. Ln m o x N r ri C - c ON3 I o % ` .o l< ~ Z OI c a 00: (O �� o W * a O I I ° ` Z w Cn to N f OD Of z 7 faD VI EXISTING DRIVE y O_ W w 0 w ENCROACHES 0 :2 10 Q w w Z m 69.59' 162.98' 1 C1 �' �✓ ° a I o S87'20'50 "W 232.57 �'�� a o � ° 8 (S86'00'W 314' + /--) 4 � ��D PARCEL IN 1 mf QwN - -- I x w = (n N w m I-- Q 3 : v 0 VOL. 556, PC. 27 r VOL. 12 PAGE 3451 SURVEYOR'S CERTIFICATE I Douglas J. Zahler, Registered Wi f sconsin Land Surveyor, hereby 9 y e eby certify that by the direction of John Huss, I have surveyed, divided and mapped a part of Government Lot 3 and part of Government Lot 4 of Section 23, T30N, R19W, Town of St. Joseph, St. Croix County, Wisconsin; being those parcels described in Volume 522, Page 139A and Volume 522, Page 139B in the office of the St. Croix County Register of Deeds; described as follows: Commencing at the Northeast corner of Section 23; thence, N89 "W, along the north line of said Section 23, 1217.42 feet; thence, S00 "W 781.30 feet to the point of' beginning; thence S05 "E 657.58 feet; thence S87 "W 232.57 feet to a point being 8 feet more or less from the water's edge of Bass Lake being the beginning of a meander line along said lake; thence N07 "W, along said meander line, 341.90 feet to a point being 4 feet more or less from the water's edge of said lake; thence N15 "W, along said meander line, 377.32 feet to a point being 20 feet more or less from the water's edge of said lake being the end of said meander line; thence S83 "E 314.92 feet to the point of beginning. Including all lands lying between the above described meander line and the water's edge of Bass Lake lying between the extension of a line bearing S87 "W from said beginning of meander line and the extension of a line bearing N83 "W from said end of meander line. Above described parcel contains 3.989 acres (173,763 Sq. Ft.) excluding lands lying between said meander line and water's edge. Subject to an easement for ingress and egress over the existing traveled private road and subject to all other easements, restrictions and covenants of record. I also certify that this Certified Survey Map is a correctly dimensioned representation to scale of the exterior boundary surveyed and described; that I have fully complied with the provisions of Chapter 236.34 of the Wisconsin Statutes and the Land Subdivision Ordinance of the County of St. Croix and the Town of St. Joseph in surveying and mapping same. Douglas J. Zahler Registered Land Surveyor S & N Land Surveying ~. ";` ►:'� �'�! �i� 212 Walnut St. ' Hudson, WI 54016 Each parcel shown on this map (plat) is subject to State, County and Township laws, rules and regulations (i.e., wetlands, minimum lot size, access to parcel, etc.) . Before purchasing or developing any parcel contact the St. Croix County Zoning Office and appropriate Town Board for advice. VOL. 12 PAGE 3451 � I FINDINGS, CONCLUSIONS, AND DECISION OF THE ZONING BOARD OF ADJUSTMENT ST. CROIX COUNTY, WISCONSIN Case: 38 -98 Complete Application Received: July 14, 1998 Hearing Notice Publication: Weeks of August 10 and 17, 1998 Hearing Date: August 27, 1998 FINDINGS OF FACT AND CONCLUSIONS OF LAW Having heard all the testimony, considered the entire record herein, and conducted an on -site inspection, the Board finds the following facts: 1. Ruth Huss is the applicant and owner of the property which is the subject of the application and located in Government Lot 3 and 4 in Section 23, T30N -R19W, Town of St. Joseph, St. Croix County, Wisconsin. 2. The applicant on July 14, 1998, filed with the Zoning Office an application for a special exception request for restrictions on filling and grading in a Shoreland District. 3. The agent for the applicant is Gary Zappa of Zappa Brothers, whose address is 715 6th Street, North Hudson, WI 54016. 4. The subject property is currently a vacant woodland. 5. Special Exception request is for a permit for restrictions on filling and grading in a Shoreland District under Section 17.29(2)(c)1. A special exception is required where there is any filling or grading in a Shoreland District on slopes greater than 20 %. 6. The following exhibits were presented: Exhibit 1: Application for filling and grading Exhibit 2: Staff report Exhibit 3: Copy of site plan and topographic map showing slopes and ordinary high water mark of Bass Lake Exhibit 4: Erosion Control Plan - Thompson went over this plan with the Board and pointed out retaining wall Exhibit 5: Structural design of retaining wall Exhibit 6: Copy of letter from Eunice Post to Ruth Huss Exhibit 7: Certified Survey Map of Lot 7 Exhibit 8: Copy of designs by the architect 7. The new structure will be a guest house. 8. Gary Zappa, Zappa Brothers, will be doing the excavating and explained that filling and grading needs to be done at this site in order to construct the garage. There will also need to be some work done on the bank. 9. The structure will be above grade and there will be a very minimal chance of any erosion. 10. There also needs to be a permit from the Department of Natural Resources for this project. Eunice Post, of the DNR, will review the application and then it will be put out to public notice for 30 days. 11. The Town of St. Joseph has postponed a decision until their September meeting. 12. The Board of Adjustment finds that this special exception application conforms with the requirements for granting a special exception under 17.29(2)(c)1. 13. Special Exception permits may be terminated under Section 17.70(7)(d) of the St. Croix County Zoning Ordinance if the conditions of the decision are not met. DECISION On the basis of the above Findings of Fact, Conclusions of Law, and the record herein, the Board approved the applicant's request for a special exception permit for Restrictions on Filling and Grading in a Shoreland District and has been approved on the following vote: R. Peterson Yes N. Golz Yes B. Wert Yes D. King Yes Chairperson Speer Yes with the following conditions: 1) Applicant to obtain all appropriate permits and approvals from the Wisconsin Department of Natural Resources and approval from the Town of St. Joseph before construction can begin. 2) Follow plans as presented 3) Notify Zoning Office prior to commencing project and when project is completed. 2 4 " i APPEAL RIGHTS Any person aggrieved by this decision may file an appeal in St. Croix County circuit court within 30 days after the filing date shown below, pursuant to sec. 59.694(l 0), Wisconsin Statutes. St. Croix County assumes no responsibility for action taken in reliance on this decision prior to the expiration of the appeal period. St. Croix County does not certify that the identity of all persons legally entitled to notice of the Board of Adjustment proceedings which resulted in this decision was provided to the County. If an appeal is taken of this decision, it is the responsibility of the appellant to submit at his /her expense a transcript of the Board of Adjustment proceedings to the circuit court, which is available from Northwestern Court Reporters, Hudson, Wisconsin. It is the responsibility of the Board of Adjustment to submit its record (file) of this matter to the circuit court. ZONING BOARD OF ADJUSTMENT Signed Chairperson Attest Zoning Director/ Specialist Dated: 09/22/98 Filed: 09/22/98 3 ST. CROIX COUNTY WISCONSIN ZONING OFFICE p I von,, A N w ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386 -4680 i September 23, 1998 File Ref: 38 -98 Ruth S. Huss 722 Linwood Ave. St. Paul,MN 55015 Re: Board of Adjustment Decision Dear Ms. Huss: The St. Croix County Board of Adjustment has reviewed your request for a special exception for restrictions on filling and grading in a Shoreland District and has approved this application with conditions. The enclosed document is the formal decision regarding your application. Should you have any questions or concerns, please do not hesitate in contacting me. Sincerely, James K. Thompson Zoning Specialist dm Enclosure cc: Marie Schmit - Town of St. Joseph Gary Zappa Eunice Post - Department of Natural Resources