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HomeMy WebLinkAbout042-1087-50-200 •Wisconsin p epartment of Commerce PRI ATE SEWAGE SYSTEM y: Safety and Buildings Division Count INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit IX Personal information you provice may be used for secondary purposes [Privacy La s.15.04 (1)(m)]. 3388 Per Ndln HARVEY El City_C1 lla�c e Town of: State Plan ID No.: rpitliul�l�h CST BM Elev.: MA Insp. BM Elev.: BM Description: WA Parcel Tax No.: 3 �► g 042- 1087 -50 -200 TANK INFORMATION EL ATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic I'LL �� � B n:hm Dosing � (j Aeration Bldg. Sewer Holding St /Ht Inlet C) .3o 88.93' TAN ETBACK INFORMATION St/ Ht Outle tto ANK TO P/ L WELL BLDG. Aeintake ROAD Dt inlet Septic ? 5-0 ' ` NA Dt Bottom -� r Dosing NA Header / Man. g . Aeration NA Dist. Pi p e I0•o0 Hol Bot. System PUMP/ SIPHON INFORMATION Final Grade %. Manufacturer Demand Model Number GPM TDH Lift F ' on m TDH Ft Force n Length Dia. Dist. To Well IL ABSORPTION SYSTEM b CIL NCH Width / Len th No Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMEN I 3 Z- 50 02 DIMENSION N SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Marwf� tu rep _ 5c SETBACK CHAMBER ZIP INFORMATION Type Of r , Model Number- System: > Sb 32 - OR UNIT L; DISTRIBUTION SYSTEM Header/ nifold u Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. — T ength Dia. acing ____ 3.2 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.) LOCATION: WARREN 31.29.18.486A- 20,SW,SW b-&-Z"93RD_ST-R£ET - LOT 7 q, 0 4 R� = 17- N/ 2 OD - Plan revision required? ❑ Yes W No Use other side for additional information. 441� SBD -6710 (R.3/97) Date Inspector's Signature Cert. No • � 1 Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Washington Ave. lVisconsin See reverse side for instructions for completing this application PO Box 7302 Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Commerce (Submit completed form to county if not [Privacy Law, s. 15.04(1)(m _z` state owned. Attach complete plans to the county copy only) fort oh p a ef nit 1eX than 8 -1/2 x 11 inches in size. County State Sanitary Permit Number X C e�l`i sion to plevio n State Plan I. D. Number I. Application Information - Please Print all Information 'j `-/ Location: Property Owner Names i Property Location /p C GL (d e _. SCJ 1146 14, T. ,N, RA o W Property Owner's Mailing Address — I $ I C qp Lot Number Block Number City, State Zip Code Number �.1 t , . Subdivision Name or CSM Number II. Type of Building: (check one) ❑ City ❑ 1 or 2 Family Dwelling - No. of Bedrooms : ❑ Village J$,Town of describe use ❑ Public/Commercial ( ) _ ❑ State -Owned lVa- *-4-, J 3 X (o 2­ 5 0 // S Nearest Road 6 5,�4 - W, - d _- '/ GhQ �i e6 Y S Parcel Tax Number(s) III. Type of Permit: Check only one box on line A. Check box on line B if applicable A) 1. X New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System B) Permit Number Date Issued A Sanitary Permit was previously issued 3 T " 2 IV. Type of POWT System: (Check all that apply) 1 Non-pressurized In- ground ❑Mound ❑ Sand Filter ❑ Constructed Wetland • Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line • At-grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: - °0 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Appl icahon 5. Percolation Rate 6. System Elevation 7. Final Grade Requited Proposed Rate (GalsJday /sq. ft.) (Min. /inch) - Elevation z i �_67 SG3 S ?d z' .vim- a.Yr VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks ❑ a ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume res on bility for installation of the POWTS sho wDqp the attached plans. Plumber's / Name (print) Plumber's Signature (no stamps): /J RS No. Q Business Phones Number - 3, r �l ' G� /'! , j ^ w,•• -r k r mod/ �O I / T 7 � `� 3V a Plumber's Address (Street, City, State, Zip Code) d G d IX. County /Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signa (No stamps) )�_Approved ❑ Owner Given Initial Adverse Surcjjarge Fee) Determination 6 - LID $ zO X. Conditions of Approval /Reasons for Disapproval: (_ t­k[4 W -cam -e [ -� - j � t�►`c Q ►"L- w.0 rx r n e ee_ / /ar��+ ldf�ns J y� s 5 7- ✓ ' 100 --'' v • F/ rt s ODb�, U 0 , t� o y a s; � v�y1, �n uuparunein or commerce SOIL AND SITE EVALUATION Divi,. of Safety and Buildings Page ! of __ 3 Bureau df Services in accordance with s. ILHR 83.09, Wis. Adm" Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and S T C'f/o fC percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. it APPLICANT INFORMATION - Please print all inform Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location /';, , it . Govt. Lot j tom t/4 j��1 /4,S,3� T,� ,� ,N,R E (or Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# .7e5' - J vo a a y City State Zip Code Phone Number [] City ❑ Village (] Town Nearest Road I V 5 )spy 5 - 7 ti} Y ® New Construction Use: (Residential/ Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial • Describe: Code derived daily flow gpd Recommended design loading rate bed, gpolft? c _ C trench, gpd /ft Absorption area required _ bad, ft J �' trench, ft Maximum design loading rate r 7 bed, gpd/f1 gpd/ft Recommended infiltration surface elevation(s) �`'� 59 T `j ft (as referred to site plan benchmark) Additional design/sitkc Parent material .1c e a( L Z`iJeksh Flood plain elevation, If applicable ft S = Suitable for system Conventional Mound in-Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system 0 S❑ U RL s❑ U K S M u 1 0sou ❑ s z u ❑ s u SOIL DESCRIPTION REPORT Bonn # Horizon Depth Dominant Color Mottles Structure P /ft 9 Texture Consistence Boundary Roots ,e F in. Munseil Qu. Sz. Cont. Color Gr, Sz. Sh. Bed Trench �� � $ �� ,_ � -� y /d o? 02 S';l �y✓rxb � CS" 1� ° � ' ; � •S _ /a S(:�' S "` ,2 7,41 r C r S Ground �� le �- _ 5 — % J_ elev. Flafft. Depth to , limiting factor Remarks: Boring # I S,' fv" �� f �S 0=�0 � Pub Ground lev. Depth to limiting factor �,In. Remarks: CST Name (Please Print) Signature Telephone No. Address Date CST Number / ?d aj ` 41 I SOIL DESCRIPTION REPORT PROPERTY OWNER Cc 4 Page o- PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh, Bed Trench ., qN... R...c Ground Y X & — 5' c plev Depth to limiting factor €'3 Remarks: Boring # E - ��- ' 07 � Ground elev Win• Depth to limiting factor Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots D /ft2 in. Munsell Cu. Sz. Cont. Color Gr. Sz, Sh. Bed , Trench Boring # u 6& f �P��7r��rbr afr 1 l i s n�Gl� G F ,•�' '� Ground elev Depth to S" limiting `f8 e fa 1�_In• Remarks: Boring # ;i E, r F�tl AEx� " e 4 > C Ground slev. Depth to limiting factor ' Remarks: SBD -8330 (R. 07/96) 57 i✓� i v J 2 &4 r c V A l seonsin Safety and Buildings Division SANITARY PERMIT APPLICATION 201 B 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 1/1 x 11 inches in size. 5rc re / K • See reverse side for instructions for completing this application State Sanitary Permit Number y ou p rovide may be used for seconds J� W 4 Personal information y p y second purpos Check if revision to previous application (Privacy Law, s. 15.04 (1) (m)1. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION Property Owner Name Property Location /h e ! v S�1/a G>•J 1/4, S 3 ! T o 2q , N, R /,p E (or) VV Property Owner's Mailing Address Lot Number Block Number 90 //, WCYCS? — 7 City, State Zip Code `hone umber 5ubjii� siggName or CS�� ��� Q ri y�8 a ��/ 11. TYPE 0 z E BUILDING (check one) ❑ State Owned 0 cit Nearest Road ❑ Village Public 1 or 2 Family Dwelling - No. of bedrooms QL Town OF ,e,0 U III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 3t. 8. /8. Ono ., _� 1 ❑ Apartment/ Condo 041.2-- 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. [W New 2. ❑ Replacement 3_ ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an _ _ __System -------- ---- ------------- -------- --------- Tank Only Existing S - --- -- - - -- -- -_------ _ - -_ -__ ng yst Existing em ---- ^--- _ 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 V ABSORP SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate S. Perc. Rate E 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation �s� 510 3 5 c� ` Feet /D/. G Feet VII Capac +t . TANK in gallo Total # Of Prefab. Site Fiber- Exper. INFORMATION Manufacturers Name Con- Steel Plastic New Existing Gallons Tanks concrete strutted glass App. Tanks Tanks Septic Tank or Holding Tank Y+. ���Q cveSfeY.c/ ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑ V)ll. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No Stamps) P PRSW No.: Business Phone Number: �ill'a r � o 2a'J�9D lS - 86- l.� l Plumber's Address (Street, City, State, Zip Code): //724 Se�,1g,4eAg4 ` IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater a e ssue Issuing Agent Signature (No Stamps) V Approved []Owner Fee) Owner Given Initial �WJy �a Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11/97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber %(G !a G Cd % /Q VC2 53/ ` 2 y���C.J %6�J.dof� ✓arc L/ v� � s c C , v � V • a v d a � Loy v 17 Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of _3 uitq` a'nd Human Relations • Division of Safety & Buildings in aCCOfd with ILHR 83.05, Wis. Adm. Code COUNTY St. Croix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point t d % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and dista ' riE� �� DATE APPLICANT INFORMATION- PLEASE PIN" LL INFORM PROPERTY OWNER : OPERTY LOCATION Harvey Hielkema i " .. < `'` y ' VT. LOT SW 1/4 SW 1 /4,S31 T 29 N,R 18 )egor)W PROPERTY OWNERS MA!I.ING ADDRESS ��'. � T # BLOCK # SUBD. NAME OR CSM # 990 Hi llcrest . - `,� 7 na csm pending "111 1 CITY, STATE ZIP COD • RHON 'NUM r.k",. s CITY []VILLAGE Z]TOWN NEAREST ROAD Baldwin W' . 540 , 4' 1 15 648- 0,` Warren Co. Rd. #N ]x] New Construction Use 3 ] ] Addition to existing building j ] Replacement ( ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate • 7 bed, gpd/ft .8 trench, gpolft Absorption area required 643 bed, ft2 563 trench, ft Maximum design loading rate • _ bed, gpd /ft • trench, gpd/ft Recommended infiltration surface elevation(s) 98.17 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material pitted glacial drift Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL II MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for system �S ❑ U 1 Ig O U la O U n ❑ U 0S ❑ S �gU 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. I Bed rer>d1 ..,1...... 1 0 -10 10 r3/2 none 1 2msbk mfr qw if .5 .6 2 10-32 10 r4/4 none sic lfsbk mfr qw if .2 .3 Ground elev. 101 ft. Depth to limiting factor Remarks: Boring # 1 0 -8 10 r 3/3 none s1 2msbk mfr w 1f .5:'• .6 2 8 -20 7.5 r 4/4 none is osg mvfr gw if 7 .8 Ground 3 2- r 4/6 none s i elev. 10 ft, ! Depth to limiting +8 Remarks: CST Name: — Please Print Gary L. Steel Phone: 715-246-6200 Address: 1554 200t AV6., New Richmond, Wi. 54017 Signature: Date: CST Number: I 6Z/A2�4 4 -26 -95 cstm 02298 PROPERTY OWNER H. Melkema SOIL DESCRIPTION REPORT Page of PARCEL I.D. # pending Boring# Horizon Depth Dominant Color j Mottles (Texture I Structure IConsistence ,�Roots GPD /ft in. Munsell f Ou. Sz. Cont. Color I Gr. Sz. Sh. � I Bed iTmrich 1 -9 10yr 3/2 none 1 2msbk i 2 -21 10yr 4/4 none sl lmsbk mfr gw If .4 .5 i Ground 3 21 -78 7.5yr 4/6 none is osg mvfr na na .7 1.8 elev. i 1 Depth to limiting factor +78" Remarks: Boring # 1 -11 10yr 3/2 none 1 2msbk mfr qw If .5 .6 4 `??`? 2 11 -28 10yr 4/4 none sicl lfsbk mfr q w if .2 .3 3 8 -78 7.5 r 4/6 none 1s osa I m f Ground 9 V763 ' Depth to limiting +g Remarks: Boring # 1 -10 10yr 3/3 none 1 2msbk mfr gw If .6 5 ` "` 2 10 -22 10yr 4/4 none scl 2msbk mfr gw If .4 .5 MEMO Ground 3 2 -76 7.5 r 4/6 none is os mvfr � 9 1. 66 f t. Depth to limiting factor +76" Remarks: Boring # Ground elev. ft. Depth to limiting I factor Remarks: SBD- 8330(R.05P92) PROPERTY OWNER H. Bielkema SOIL DESCRIPTION REPORT Paget of 3 PARCELMS pending Depth `Dominant Color Mottles (Texture l Structure Consistence Roots GPD /ft Boring # Horizon in I Munsell Qu. Sz. ConL Color Gr. Sz. Sh. Bed lTrench k mfr 1 -9 10yr 3/2 none 1 2ms. 2 -21 10yr 4/4 none sl lmsbk mfr gw if .4 .5 Ground 3 1 -78 7.5yr 4/6 none is osg mvfr na na .7 i.8 elev. 1 Depth to limiting factor + 7811 Remarks: Boring # 1 -11 10yr 3/2 none 1 2msbk mfr qw if .5: .6 4 '>' 2 11 - 10yr 4/4 none sicl lfsbk mfr Cf w if .2 .3 %k. A \�Ci'2i'Lt•: i:•i:•ii 3 6 8-78 7.5 r 4/6 none is osa mvfr na na Ground 9 r. 63 Depth to limiting +78 Remarks: Boring# 1 -10 10yr 3/3 none 1 2msbk mfr gw if .5 .6 5'. 2 0 -22 10yr 4/4 none scl 2msbk mfr w if .4 .5 `" ...., Ground 3 2 -76 7.5 r 4/6 none is os mvfr na nal .8 9 Depth to 6miang factor +76" Remarks: Boring # Ground elev. ft. Depth to anating factor Remarks: M- MO(R.05M) I STEEL'S SOIL SERVICE Gary L. Steel Harvey Hielkema 1554 200th Ave. CSTM2298 SW4SW4 S31- T29N - x 18W New Richmond, WI 54017 MPRSW 3254 town of Warren (715) 246 -6200 lot #7 N 1 =40' BM. =top ofNW lot stake C el. 100' 80 �' st ly P ' k-( 'I3 ' C Gary L. Steel 4 -26 -95 • .FIaM P C COLLOVA BLDRS, ?NC PHONE N0. : 715 549 5511 Apr. 14 ' %9 08:06RM P3 • ST CROIX COUNTY SEPTIC TANK. MA,INTIRNANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Qwner(tuy®r 4,4& i 4 VA Mailing Address P. C. COLLOVA B UILDERS, INC. G 2 4 Property Address dt C 5) 549 -5977 County Rd_ E i (Verification required from Platuting Department for now construction) City/staie P=4 Yde zYtiftatttion Number X 1), 4 , 1 r �rAY �g�,r�oty sue+ s w Property Location _ 1., W, 'fa, Sec. I T�N -R 1 �- W: To wn o f WArtR 3 h SubdivWon CWdW Survey ll Rp # �� 9' G _ .. _ . Voitttnt: ! d _ _ . _. Page # z0fa iNaffsnty Died # Voltui9e Spec itotsse yes C] no Lot line idendSWe es fa no SYSIM kimppropts use and aooaiate�aaace: of your setptic syvD.:n could rasttlt in its premzatusefailute to ltaudIe wastes. Pmper mamsteaaraoe e oms�ls of purupke eat thin septic tank every three yeas or soma, it needed by a I'rou sed pumper. 'What you prat into the system can affvot the fam tk a of dw aepdo tank as a treatment stager in the waste disposal system. The property 6"10 ages to submit to St. Croix Zoning DqMtrucat a cestificatiact form, signed by the aw ar and by a maaterPlttmb=, jQ=Mey=anplutnbe:r, rrstnowdplumberor aliceasedp ngmverifying dw(I) ft on-site wastewater ftosal is in ptopar operating condition "Not (2) aftrr itaspecti®u and rAving (if necessary), the septic tame is Ica the 113 fun of sh*e. Ilwet, the undenipod have read dLe above tequhm mu and ague to tetaimhtin rite pt'ivatet sewage disposal system; Wi& the standards eat f+oartlt„ lain, as set by die Department of Commerce and then Depattateci: of N*Vjral Resatucaa, State of Wisconsin. Czar rmdon elating that yaw septic system bas been mainWAtd wig bo vouiplotod and mtutned to the SL Croix County zWW office wan 30 days o lbree yar expiration date. SIQNA F APk'UCANT DATE W RTIFfCA= I (we) eettdfy that all statements an this form, arc true. to the but of t„y (our) knowledge, I (we) aut, (ate) the oarnee,(s) of *0 property detscribed above, by virtue of a warr=Ay deed recorded in Register of Deeds Oft'tce. $ICiIVA F wp //6 5; D rr►rw Any information that it: mis- repremted may remelt in the sanitary p =At beitze mvdwd by the Zoning Department. *"•••: ** Include with this applieation: a stamped warranty died $+ern the Fm&tor of Deeds office a espy of the certified puvey trop if rafett ut is %A& in the warranty eked i DOCUMENT NO.�_ D� 552473 V OL VI 0 OVE 1 Dale foQerty, a /k /a Dole X. regerty. conveys and warrants to .array N. sialkesa the following described real estate in St. Croix County, State ST C + ivlx co.. va of Wisconsin. P&:d'oaRs J Nov 2- 1 1996 A parcel of land located in part of the Southwest Quarter of the 9 A. M Southwest Quarter (SW 1/4 SW 1/4) and in part of the Northwest Quarter � ' 1 of the Southwest Quarter (NW 1/4 SW 1/4). all in Section Thirty -One '1��f l..-. -�{ 4).4(1, (31), Township Twenty -Nine (29) North, Range Eighteen (18) Went, Town f?e ^_"crC)'e °: of Warren, St. Croix County, Wisconsin, further describe: as follows: Commencing at the SW corner of said Section 311 thence NSB'54'52'E. along the South 1 of said SW 1/4. 1349.62 feet to the SE corner of the SW 1/4 of the SW 1141 thencr 1 400 °51 along the East line of said SW 1/4 of the SW 1/4, 101' feet to the point of beginning of this description. thence contf. ag N00'51'28'W, along said East line of the SO 1/4 of the SW 1/4 and along the East line of said NW 1/4 of the SW 1/4, 1218.06 feet to the Sout." line of Certified Survey Map. Volume 6, Page 1580, as recorded in the Office of the St. Croix County . . . _ Register of Deeda; thence N89 "00'03'W. along said line, 912.76 feet to UMM AND RaTURY ADDRESS the East line of Certified Survey Map, volume 3, Page 723, as recorded in said Register of Deeds; thence 900'55'56'E along said line, 1531.43 Thomas A. McCormack feet to the centerline of C .T.B. 'N') thence S88 °29'50.8, along said 990 Hillerest St centerline, 336.70 feet to the See corner of Certified Survey Map, 4 0 0 2 Volume 6. Page 1571, as recorded in said Register of Deeds; thence Ba W N01'38'32'E, along the West line of said Certified Survey Map, 300.15 feet; thence N89'21 558.79 feet to the point of beginning. EXCEPT Lot Six (6) of that Certified Survey Map as rec :ded in the St. Croix County Register of Deeds Office in volume 10. Pages 2924, as Document Number 529260. Parcel Identification Number (PIN) This Warranty Deed is given in full and final satisfaction of that original Land Contract between the parties as dated April 1. 1995. FEE EXEWT This is not homestead property. Exception to wa�rantiesi Easements, restrictions and rights- of-way of record, if any. Dated this �� day of November: 1996. (SEAL) (SEAL) le (SEAL) (SEAL) AVESMIChTION AcKnowumaim Signature(s) of Dale E. Fogerty STATE OF WISCONSIN ) ) ss. COUNTY ) authen c ted this day of November, 996. Personally came before me this day of 19 the above named to me known to be the persons) who executed the foregoing instrument and acknowledge the sane. * Leo A. Beskar TITLES MEMBER STATE BAR OF WISCONSIN (If not, authorized by §706.06, Wis. Stats.) • — — — 2218 I28l20CM WAS DRAMED 2!; Notary Public County, xis. Lao A. Reskar, Attorney My conrrussion 1s — permanent. (If not, expiration date: RODLI, BESRAR, BOLES 6 KRUEGER, S.C. 219 North Main Street P.O. Box 138 River Falls, xI 54022 . •'�„�'' 11 � '.� FILED MAY 2 3 1995 ► 4 KATHLEEN H. WALSH 6 � low 529260 CERTIFIED SURVEY MAP HARVEY HIELKEMA Part of the Southwest 1/4 of the Southwest 1/4 and the Northwest 1/4 of the Southwest 114 of Section 31, Township 29 North, Range 18 West, Town of Warren, St. Croix County, Wisconsin. Owner's Address: C.S. C.IS VOL. P /390 Harvey Hielkema M. VOL.2 I PAGE 4 I I I Century 21 Premier Group — 1 1 1 990 Hillcrest EieldYV WI 54002 A- 6 D e R C) Rec :, I 80 .p /j— — t 1 b 0 Indicates 1" 50' 694.06' R(894.17') I iron pipe L — — — — S 89 00 "E 9 / 3. 74' R / 9 /2. 76'1 _ — 1 19.68' found. This instrument drafted by Laurence W. Murphy I e In � 3 di cates 1 'T x M V ' - _ � N 24' iron-pipe �,t� % � i I weighing 1.13 h , ��.���gGONS .,� I1 LOW AREA /i lbs. /lin.f+_.. N W 3 `�} •• . •'•.. • �400 , J % I o 3 set. o .� 40 I 2 +n k, o -° LAURENC — 1 c N q l z N „ 37 i ; � °„ � m s W M P � 0: Dated: 3 -?6 -1995 ;4 b L 3 W k Q M o S � �� x 2 RI ALLS,;?•,� ROAD SETBACK LINE LA1JO �% LOM14 ARIA allies$ v MAY 2 3 I � it Laurence W. Murphy Registered Land Surveyor 2 �►I o W N 89 • 28' 34 " N E 55T, 74 ° ;'I CROI COON i o h 335.49 � k ov:ptehensive h 122.zr � `` V a ° Zonisi and o o LOT 5 I a I h W Park, Comrnitter� _L 4 h 3.393 ACRES O IO .2" h a 166' 17.604 ACRES co /47, 798 $O. FT. I9 not rP+_i)I -d N I b b 4 3 N 766,843 SOFT, ° 3,234 ACRESEXC, ROAD R.O.W. within 30 days of 1 17.305 ACRES EXC. /4/, 760 SO, FT. approval date ROAD R. 0, W. M K 100' 1 � j ,O m 89 28' 34 "E 337. 74' b 4 h 2 ,approval shah by i 733, 793 so. Fr. 534,40' 1 23.34 hi nuN 1G void I 1 3 N O LO T 6 i I h I 50 ROAD SETBACK ° O 0 X1 I LINE ; ° 3.393 ACRES I O O W I • Yj /47, 79B S0. FT. N 3.248 ACRES EXC. ROAD R.O. W.1 H 'o -4 14 /, 470 50. FT. 1 I lu i 337. 24. �4� + 354.1 n 333.300' J I I I i N89 . 28 1 54 "E 911,93' 1 ` I Q 3 i I S 89 "W 337,74' R/S 89. 'L O T T 333_03' R/3133.60'1 ZI 2 %- - I N X 723 ACRES . h :t - 24.7/' , O �( I !N,162, SO. Fr. 4� N h3.429 ACRES EXC, O +1C S M C.S M. O ROAD R. O. W. M 3 a V OL. V O L . 6 r 1 i I M % 3 �, PAGE 1571 VOL 6, P AGE o tu Od49,334SO.Fr. _� - -.°+ \M__ —_ 3 �;tu /00' o a M /662 m N y a 1 0 S 88 • 20' 38 "E 33 Mi O � �. BB' C. h O O 2 t + o N "W 338.09' /N "W338.70'1 SW COR. SEC. 3I, T29N, O O ` v 2 Q y R /BW, /2 " /RONP /P£ 1 j 1 U A r rED FOUNDI C.S. V OL. 7 PAGE /939 I LANDS SCALE 1 " = 200' 025'30' 100' 200' 300' 400' 300' I N 88' 42' 04 "E 2664.83' R I N 88'34'32 "E 1 2661.211 SHEET 1 OF 2 Vol. 10 Page 2924 1101 Carmichael Road Hudson, WI 54016 Phone: (715) 386-4680 St. Croix County Fax: (715) 386 -4686 Zoning Department Fax To: Laurie Collova From: Shawna Moe Fax: 549 -5911 Date: September 25, 2000 Phone: 549 -5977 Pages: 2 Re: Septic verification CC: ❑ Urgent x For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle *Comments: ST. CROIX COUNTY WISCONSIN ZONING OFFICE NPNN IN 0 rrrri' ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 Fax (715) 386 -4686 September 25, 2000 P.C. Collova Attn: Laurie Collova 705 County Trunk E Hudson, WI 54016 RE: Septic Inspection for Harvey Hielkema located at 619 91st Street, CSM Vol. 10 Pg. 2924 (Lot 7), Warren Township, St. Croix County, Wisconsin Dear Laurie: A septic inspection of the above referenced property was conducted on 08/24/2000. This property is located in the SW 1/4 SW 1/4 of Section 31, T29N R18W, CSM Vol. 10 Pg. 2924 (Lot 7), Warren Township, 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 staff /sm cc: file Parcel #: 042 - 1087 -50 -200 09/26/2005 10:19 AM PAGE 1 OF 1 Alt. Parcel #: 31.28.18.486A -20 042 - TOWN OF WARREN Current X! ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner DANIEL J & KATHRYN L O'BRIEN O - O'BRIEN, DANIEL J & KATHRYN L 619 91ST ST HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): • = Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 3.723 Plat: N/A -NOT AVAILABLE SEC 31 T29N R18W PT SW SW BEING LOT 7 Block/Condo Bldg: CSM 10/2924 3.723 ACRES Tract(s): (Sec- Twn -Rng 401/4 1601/4) 31- 28N -18W Notes: Parcel History: Date Doc # Vol /Page Type 11/16/2000 633863 1560/194 WD 11/16/2000 633862 1560/193 WD 11/21/1996 552473 1210/117 WD 1188/388 QC 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 11/20/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.723 44,700 145,000 189,700 NO Totals for 2005: General Property 3.723 44,700 145,000 189,700 Woodland 0.000 0 0 Totals for 2004: General Property 3.723 44,700 145,000 189,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 524 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00