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HomeMy WebLinkAbout020-1302-10-000 ST. CROIX COUNTY TONING DEPARTMENT AS BUILT SANI'T'ARY REPORT Owner t� V t ► �oW rz-,r- h Address City /State h } C- ' Legal Description: 1 l Lot Z6 Block Subdivision/CSM # 4\n r^ Sec. a'7 , T a 9 N -RAW, Town of o N PIN # z -7. z9 SEPTIC TANK — DOSE CHAMBER — HOLDING TANK INFORMATION: Tank manufacturer e e y j bbb ' 1� Size ST/PC Setback from: House � � WeIi fi P/L S U + Pump manufacturer Model -- Alarm location - (HOLDING TANKS ONLY) Setbacks: Service road Vent to fre n e Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM: Type of system: arc h ok 1 Width 3 Len Number a of Trenches Setback from: House 3 Well 5 a -1- P/I, a t Vent t S o fresh au' intake � ELEVATIONS Description of benchmark _ a� ���>v � r . p" Elevation I UV . d Description of alternate benchmark Elevation Building Sewer ST/HT Inlet 4 U . a ST Outlet- r� U a PC Inlet PC Bottom Header/Manifold . U �p • Top of ST/PC Manhole Cover 1 Distribution Lines Bottom of System (K) U ( a l b ( ) Final Grade ( ) `� �i S U ( Date of installation ()bPermit number State plan number Plumber's signature Cv -- _ J License number �a� O� Date Inspector O �1 5o N k- ,-�ifip x Complcte plot plan 1' w 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 s 3 u7S 1.tuo g,�) op Ya' INDICATE NORTH ARROW F " Wisconsin Department Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division INSPECTION REPORT ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Pe rsonal information you p rovice may be used for secondary purposes [Privacy w, s.15.04 (1)(m)]. 324609 Mi4b V 1N tt i & BRENDA wab El village Town of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description::UIJ ON Parcel Tax No.: �& 6 D / 020- 1302 -10 -000 /V or ✓ TANK INFORMATION ELEVATION DATA A9800498 TYPE MANUFACTURER CAPACITY 1 4 TATION BS HI FS ELEV. Septic f' B L nchmark 6v Dosi Y Aeration Bldg. Sewer Holding �Ht Inlet Q Z 90 Z3' TANK SETBACK INFORMATION Ht Outlet o, o 0 Z 1 L01 TANK TO P/ L WELL BLDG. ven take ROAD D Septic > 0� Q' / NA Dm Dosing Header / Man. 04, . EHI tion NA Dist. Pipe in Bot. System cTl .y 8Z./ PUMP/ SIPHON INFORMATION Final Grade Manufacturer mand Z f Model ber G TDH Lift L ction System TDH t Forcemain Length Dia. Fi Dist. Tow �- SOIL AS;QPRTION SYSTEM I Z ckl 6e#— BED N Width - Len h � No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIM Z DIMENSION SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Ma fa ure SETBACK CHAMBER rS INFORMATION Sy 7Z / 7 0�/ � OR UNIT Mode N Number: r Q DISTRIBUTION SYSTEM Header/Manifold U Distribution Pipe(s) / / x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length S Dia. A LA Spacing AI /V 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.) L HUDSON 27.29.19,SE,NE 758 ORIOLE LAND — HUMBIRD HILLS LOT 26 1 / / / h to,,,r- y GeaCPt� �g o•• gCS:p� TL yG u Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. Safety and Buildings Division Wi sconsin S ANITARY PERMIT APPLICATION Zoo E. as 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 6 1101 than 8 1/2 x 11 inches in size. • See reverse side for instructions for completing this application State Sanita Permit Number The information you provide may be used by other government agency programs [I Check if revisonto res'appiication [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION Pr rty Owner y ame Property Location Llj_ OUJL N - 1 /4 A; 1 /4, S a T , N, R f E (or Pr erty Owner' Mailing Add res� Lot Number Block Number City S to Zip ;d Ph ne ;um Su ivision Name or C Number Nd .J II. F B ILDING: (check one) ❑ State Owned It Nearest Road r y p S 4❑ VII age Public a or 2 Family Dwelling - No. of bedrooms liff Town OF III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo O 0 _ 5 0 --- 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/ Factory 13 ❑ Other: specify IV. TYPE OF PERMIT (Check only one box on line A. Check box on line B, if applicable) A) 1. New 2. ❑ Replacement 3. ❑ Replacement of 4. E] Reconnection of 5. ❑ Repair of an _____System Tank Only______________ Exi ________ Existing System -------- sn� ------ ----- -- ----------- — --- ---------- B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) fns' /��afer- ��/L �p "�� uvi�Y" 31 • S Non - Pressurized Distribution Pressurized Distribution Experiments Other CIncrtrvlb 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ff Seepage Trench 22 ❑ In- Ground Pressure , 42 ❑ Pit Privy 13 ❑ Seepage Pit ° 3 X 7� 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 15. Perc. Rate 6. S stem Qev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/ y /sq. ft.) (Mi . /inch) 6,UU El iOR 00 r� 0 NP 80.OU L -Feet Feet VII. TANK Capacit in g allo ns g Total # Of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con Steel glass Plastic App New Existing structed Tanks Tanks Septic Tank T ( ) 1Q00 �e ❑ ❑ ❑ 1 ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ 1 ❑ 1 ❑ 1 ❑ 1 ❑ 1 ❑ VI11. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's rint) Plumber's Signature: (No Sta ps) MP /MPRSW No.: Business Phone Number: Plumber's Address (S eet, City, State, Zi f Code): IX. COUNTY/ DLIPARTMENT USE ONLY ❑ Disapproved ' Sanitary Permit Fee (Includes Groundwater D ate Issued Issuing Agent Signature (No Stamps) ]Approved []owner Given Initial �� Do �SurchargeFee) 1 1 6 Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- (Rtt DISTIUBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber LEO A M Mr r4i - �IV\� 1 0 J��I *Oat cofzw�- p -25- �` • a - i r�N�l� f 3x�S Tt f� •lovvi Oeeji fpf , ►fig,�,tov - s fjZ • `1 35' I v � � CD a� c I c � c a� o o oc 2 co c Ci Ec o m x to v; > +•- c U E in n ® ca N E N _ EE'5c x mM LU � c � to > 3t C IT Cc N O O Q C O Q R1 p ++ E_ 'Ow 13 M 0 p to U Q c � �� U � �:� o �oo�� x t �lu)o 0 . 2! w LC °� t Wisconsin "mDep ommerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Saf ildings in accord with Comm 83.05, Wis. Adm. Code Enviro nmental By Design Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D.# APPLICANT INFORMATION - Please print all information. Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Reviewed Date Property Owner Property Location Howard, Kevin Govt. Lot SE 1/4 NE 1/4 S 27 T 29 N,R 10 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 26 Humbird Hills City State Zip Code PhoneNumber City Village ®Town Nearest Road Hudson WI Hudson I Oriole ® New Construction Use: Z Residential / Number of bedrooms 3 ❑Addition to existing building F - I Replacement [:] Public or commercial describe Code Derived daily flow 450 gpd Recommended design loading rate 5 bed, gpd/fl! .8 trench, gpolfF Absorption area required 900 bed, ft' 562 trench, ft Maximum design loading rate .5 bed, gpd/fF .8 tr ench, gpd/ft? Recommended infiltration surface elevation(s) 84'& 80'2 trenches ft (as referred to site plan benchmar Additional design / site consideration If a bed is used the loading rate must be .5 at an elevation of 81.60' Parent - material Loess over outwash sands 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 ® S El ® S ❑ U ® S ❑ U ❑ S ® U ❑ S ®U ❑ S ® U SOIL DESCRIPTION REPORT g Horizon Depth Dominant Color Mottles Structure GPD/(P in Munsell Qu. Sz. Cont Color Texture Gr. Sz. Sh. Consistence Roots Bed ! Trench 1 1 0 -9 10yr2 /1 - sil 2msbk mfr cs 2f .5 .6 2 9 -40 10yr3/4 - sil 2msbk mfr cs if .5 .6 Ground 3 40 -90 7.5yr4/6 - s Osg ml - - 7 ? 8 elev 83.46 ft Depth to limiting This bore hole is an addition to a soil test that was done on 10/23/94 by Robert Ulbricht so as to meet the set back requirements from the residence. factor >90 Remarks: 2 1 0 -22 1Oyr2 /1 - sil 2msbk mfr as 2f .5 i .6 2 22 -110 10yr5 /8 - s Osg ml cs - .7 i .8 Ground elev 87.10 ft Depth to limiting This boring was conducted just adjacent to the boring #2 that was conducted by Robert Ulbricht on 10/23/94. profile was conducted to a deeper factor >110 Remarks: This boring was conducted just adjacent to the boring #2 that was conducted by Robert Ulbricht on 10/23/94. profile was conducted to a deem denth so as to tiv for a bed system which is onl Bible if a .5 loading rate is used. CST Name (Please Print) Signature: f � Telephone No. Thomas C. Nelson 715- 246 -2454 Address Environmental By Desi Date CST Number Ref # 1432 120th Street, New Richmond, WI 54017 10/5/98 227387 48 ANIL PROPERTYOWNER: Howard, Kevin SOIL DESCRIPTION REPORT ® Page 2 of 3 PARCEL I.D.# Environmental By Desi Horizon Depth Dominant Color Mottles Texture Structure onsistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench 3 1 0 -12 10yr2 /1 - sil 2msbk mfr as 2f .5 i .6 2 12 -24 IOyr3 /4 - sI lmsbk mfr as - .5 .6 Ground elev 3 24 -112 7.5yr4/6 - s Osg ml - - .7 .8 87.70 It Depth to limiting This bore hole is just adjacent to a bore hole #4 that was conducted by Robert Ulbricht on 10/23/94. The boring was repeated so factor as to obtain possible depths for a bed system. If this is done a loading rate of .5 must be used. X112 Remarks: Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: ENVY ;ONMENTRL BY D E51GN 1432 t20"'j TRE17, NEW RICHMOND, MSCONSIN 7 1 i -246 i i !-IcOJECT NAME HUMBIRD HILLS LOT 26, PAGE 3 DESCRIPTION SE V4 SW 4, SECTION 27 T --2% N, R _____ 19 TOWNSHIP Hudsoll COUNTY St. Croix. Wisconsin ` D - Trto C-� e_ Cv j J10" �� r �rc nc�`, �f�Jc..l»n o, 00 1 SCALE I " -40' Torn Nelson BM 1. Top of 2" iron pipe. NW lot cortior 100' 22­ BM 2. Base of tree marked with yellow ribbon 96.70' Wisconsin Department III usby, SOIL AND SIT A LU ATION REPORT Page of - Labor and Human Rela Division of safety & Bui ldings in accord with .05; Wis: Adm. Code. • -� COU Attach complete site plan on paper not less than 81/2 x 11 inches in ' e ud� t ARCEL I.D. # not limited to vertical and horizontal reference point (BM), direction and , dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION BY DATE PROPERTY OWNER: 11111- 1011QD /filf L�9• O PROPERTY LOCATION �/ L /'//0 ,v - GL , Ar.P,y y GOVT. LOT $� 1 /4 N 1 /4,S � 7 T 29 ,N,R /,f E (or) W PROPERTY OWNER':S MAILING ADDRESS r2i8 f iO,v£? �/�J LOT s BLOCK • SUBD. NAME OR CSM e 336 Iwleog�Ts ST t� y� 2-60 }{UMBi RD H l'05 �Ptins� Z CITY, STATE ZIP CODE PHONE NUMBER CITY 011I[9G - E BrOWN NEAREST ROAD uG �1N• 55 /0/ (Grz) 222-5SS5 •f upSofj 4V New Construction Use ( kiesidential / Number of bedrooms - "I - [ j Addition to existing building (� Replacement [) Public or commercial describe ySd - / 2 trench, gpd4t Code derived daily flow � gpd Recommended design loading rate bed, gpddlft Absorption area required _; b ed, ft2 7�d trench, ft Maximum design loading rate � bed, gpd/ft ' � trench, 9P" Recommended infiltration surface elevation(s) sEC Q • 3 tt (as referred to site plan benchmark Additional design/ site considerations 2/SE 'E kV 72 S o4, c y o ✓ S /off w' (� Parent material s �E vsE F lood plain e if appI Gable �� ft S =Suitable for system CONV L MOUND IN f W40 U PRESSURE A DE SYSTEM ML HOLDING TANK U= Unsuitable for system 11 U S w SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Boundl3y Roots GPD /ft Boring # Horizon in Munseli Qu. Sz. Cont Color Gr. Sz. Sh. Bed Toxh -'7 4e7zv f// Q S ►.� N l d ,Q 1 �� S �� cS � 7 •� L /F 3 -7 S- YID' y/y Ground 3 9 /o YAP , s_ D , S �� 7 elev. r!!, 2 6 it Depth to limiting factor 7 Remarks: Boring # 3 2 3 -YO /o 1 Ground elev. 8 7• ! v ft. Depth to ay limiting fac tor —�� Remarks: / rddress: o�) W T Name: Please Print ? o Q E R T 4 L� P t � CGt T-• Phone: 7155 . 3 S O' Nf_ i t_ '� UV.S S �o gnature: Date: CST Number: ORIGINAL 1 • h ' PROPERTY OWNER SOIL DESCRIPTION REPORT Page of 3 PARCEL I.D. se Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft Boring # Horizon In. Munsell Qu. Sz. Gor!t Color Gr. Sz. Sh. Bed jTrench 3j l - z9 / s,/ , ,4c Ground elev. Depth to limiting factor Remarks: Boring # l O— 2, /O yiP Z�/ — - i �D'`/idif�T 'I Q s —' Ajp N z A y o �/ S/ Z �s�✓,� �,,,,�f nor S ��F ; S . Ground S �S e � r elev. g7 ( ft. ; Depth to limiting factor > G Remarks: Boring # ... i N 4, SC L d� � S , 7 Ground D /6/ elev. Depth to = limiting factor Remarks: Boring # i Ground elev. tt. Depth to limiting factor Remarks: con *moo D ^rinm r ° r i � 4 R 'h 0 2- ti 1 o 0 0 o / � r / S 6� \ z � s�ti G s � c� cUO In N IN N d s w W � E 1 C2 _o\o o ' 2m 4 s�o Q O . •y� E SEME Lip T y O 5p �I 2.53 ACRES \ \ s� \ n ` •� O � 0 SQ, Fi. / /PONDING bt g EASEMENTS c _ EL. = 964 �% 3 0 'LOT 27 \ 0o F / 2.14 RES 93 ,106 Q. FT. I PONbING 1EASE4ENT ? l�� EL z972 OOO S89 °06'22 "E o 298 46' o� s. > O p p Ic 1, s. o LOT � 2.23 ACRES ' o a 4N 97,078 SQ. Fh u' EASEMENT !f r N, N•87 0 52'18 "F zzn Wisconsin Department of Industry SOIL AND SITE EVALUATION 3 Page of Labor and Human Relations Division of Safety and Buildings in accordance with s. , ILHR 83.09, Wis. Attach complete site plan on paper not less than 8 1/2 x 11 inches in si t, rriust County Include, but not limited to: vertical and horizontal reference point (B ion an percent slope, scale or dimensions, north arrow, and location and ' to a to n"� part I I.D. # 020 • /302- /O APPLICANT INFORMATION - Please print all info "on.' `� "0,9 Reese ed by Date Personal information you provide may be used for secondary purposes (Pdva y s. 15.04*15 "01 X, `! � �(� 9 96 Property Owner �, kpon .�/� /�!� ; Govt. Lot 5 1'/4 /V�1 /4,S / T A �,N,R l 9 E (o W Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# - 33 - 2- )hl vwesvrlf s�" l�/oy ' ?:Co ffv�r i,+�� / / ; / /s �.� s1�o1Tia,� City /J State Zip Code Phone Number ,� K/ Nearest Road )2-2- 2 S SSS El city [_1 Villa a L�TOwn ET - New Construction Use: esidential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived dally flow gpd Recommended design loading rate gibed, gpd/ft • V trench, gpd/Ft Absorption area required bed, ft ` SO trench, ft 2 Maximum design loading rate ! bed, gpd /ft = trench, gpd/ t Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design /site considerations ���� /� �V of !�*wpl ;a 6 4`r Parent material ���1 © 1 Flood plain elevation, if applicable ft S = Suitable for system Conventional MS In- Ground Pressure AT-Grade System in Fill =�din U = Unsuitable for system S❑ U M S ❑ U XS ❑ U 9 S ❑ U SOIL DESCRIPTION REPORT Boring orizon Depth Dominant Color Mottles Structure GPDlft g # Consistence onsistence in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Boundary Roots Bed , Trench a, ' S l e j ,7g5;!? es )- 2 •Of lor� 54 /, m sl4l Awv7�El' es 7' s Ground 3 �y 7. S y/� yl s / e e ft. �o /� S��Q S C/ S Depth to limiting factor Q�In. `` Remarks: Boring # 1 0-// id f /e 2-13 SL /W C S' / • ` , • s 13 0 7. S, rR V6 45 45e ee .5 Ground 1 1 9 low � s Q ,5 oex 0 elev. /00•loS R Depth to limiting factor 7 in. Remarks: CST Name (Please Print) nature iSTelepJ2 : 7 eIO5 Address Date CST Number Nuumber Ulbricht & Associates Private Sewage Consultants 655 O'Neil Rd. Hudson, Wis. 54016 OR I GNAt, P �- `{ lj�. Gov 2 1 � SOIL DESCRIPTION REPORT 2 of 3 PROPERTY OWNER / / /�'. Page PARCEL LDI Gd?� _ 6 , / -1 y II& I -Si1 1 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 3 a. in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench CS af Z D .L 7,57 Y Ground elev. Depth to limiting factor 7 � i n. Remarks: Boring # 213 SG / 5 nM f,2 CS 2 f S Ground 0 vx ,S& a • ? '� ft. Depth to limiting factor m. 7 Remarks: Horizon Depth Dominant Color Mottles Structure GPD ft Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # l /o /o t//� I/ Cs Z •S 7SW R-10 Z5 op �• Ground ,S �— J ' e ky . Depth to limiting actor 7 �in. Remarks: Boring# Ground elev. ft. Depth to limiting factor in. Remarks: SBDW -8330 (R. 08/95) .= t S,T Q PI TO � zv - F P °S7- p poc i k k D v � X00 .. 33 �o / a ri PO 0 i G— Gy, 7"v 3 f — �� D X298 HUMBIRD HILLS SECOND ADDITION .00ATED IN PART OF THE NWI/4 OF THE NE 1/4, NE 1/4 OF THE NE 1/4, SE 1/4 OF THE NE 1/4, kND THE NEI /4 OF THE SEV4, ALL IN SECTION 27, T29N, R19W, TOWN OF HUDSON, N ;T. CROIX COUNTY, WISCONSIN. A_ N OWNED BY: HUMSYID LAW CORPORATION 1215 PIONEER OULIONO 1 �„m 336 NORTH ROSERT ST. St PAUL. YS1. 55101 -/m O ,., =2 CYO U ANC IAYG[YI IAYGEYt " o tEYG111 tt%Gfr ICARING 11UNIN6 N� • N y .s.4 721.69' 234.51' MS•i0'00 "[ YOS °!1'07.1 7 n I.S•t IS4.11' IS6.10' 1/S °50'00 "E 111 °55'25 "t ° "' �•t 77.113' 71.11' 111 °55115 [ 103.21'01 "( D or I.f"Y 131.21' 170.10 NOS °111'01 "t 152 ° 111 41 "r ^'T. t.S'r 169. N' It {.11 105 4 21107 "( 103 1 31'70 "Y 1.S•r 107.71' 705.69' NOS ° 77•)0 "Y 121 ° 115'15 "� 2 ' )•r 111!.05' 211.51' 1t1 °15'115 "Y 1117 LINE Cr N 'I.Sw 227.22' 127.7 {' 51!•69'19 "r 6957 °69'4 { "Y 1 '' '. I.S 3!!.00 312.69' 6971 °10 'f NSI °511'1! "r Net 41'63'w 471.3a •LS•t 97.01' 97.10' Y1)0I0'10( 924 7 . H•r 2S4.11' 269.11• 114 °01.4s.c :St ° S I'1I•Y .t. A E•I 345.110' 352.21 NSI 6969 °69'11 / "r , 7S•Y (15.21' t) {.0)' ,SI °51')7 "r 170 °51'11"• •� ` LOT 36 T 71.3•r 164. 24- 170 "r :17 o 2.11 ACRES • Q, .Cr 21.13' 21.17' Np ° 31'3t"r :If w f slssa east ,13-11 703.07 701.61' 319 5569569174 wt 75.00• 75.01' 5111 "[ .710 b� R 20. ! "t 731.15' 277.51' 910 SSI ° 57'31•[ :� �•'• �`.., % LOT 35 1►i 1 {x' 1 �' 111.5 "[ 231.11• 1151.7!' 9S1°S7'37 "t 537 °10'11 "r ��O� 4r ; ••< l•' a�a 11.5•! 692.111' fot.fT SSt °M'i6 "E SOS °21'01 "r / !� \. \ "•� 2 ` ' ` 5.11 ACRES � sl,Tel ao, st N St.S "t 220.00 !10.11' 95! •411•! / "[ S)1 °70'07 "E \ \ J �' • r I] "t 721.52' 711.21' fIt °70'01 "[ SO{ °511'07 "E \ \ 1 00•t 150.00• MAO 501 ° 19'07 "t II.S "Y 114.03' 111.07' 90S ° 29 . 03 "11 545 ° 50'00 "r ` ' ll•Y 141.50 111.0!' 531 °10'11 f73 °11!'51 "Y O •' . • EAASEVANT \ \ \ ,•' t t, 6 EL..56+ OT 26 \ •••., \ 0� \ I 2.53 ACRES �"� � ,, 't )N OF 971.23 .\\ ' ."1 110.'/ \ .4i�'p•1 \ \ • • / /POra4w \ LOT 34 g EA6EME� \ t 1 \ 2.02 ACRES 0 1 so. PT. _. I( \ " _ , S EL. • 564 \ i \ •. N i -I LOT 27 \\ S S �\ \ \ t IM / 3 2.14 ACRES • 1`0 ' 1, ' 1 1 '' 1 yy \ ` t SO.ft ,tASEw�,NT: \ t 359 Yt 1119.45' \ t 1 S 1494 2!30.9 •� i in I 1 1 t 160.75• (A 1 •ty4�tfla• 44e � i 4\ , I I 4S• .\ 4 I 1 I 2 � LOT 28 \ t sip» o FT. U (J jq i twtE [ NTY •• � 1 ' t LOT 33 A :.a ACRES Z �(_ •� �.�. 1 ? 07,365 1f : ' ? IU) N 7 1 7 ' I (J �' El. • Sp / j ' 7 I P WHO I I LOT 29 I 2.00 ACRES t 1 8 ,b 57, 15430. PL I= 1 69{11 . 39' 't 375'° UI 1 CHICKADEE-LANE �E�T SECTION 2. _� ' Net 35'42 230.01'- - I` 55 4 . 30'57' 1 Y g 371.52• .1 f 7 . .......................... f I 1v ' a I I LOT 32 LOT 30 i 10) • 2.00 ACRES r 7 2.01 ACRES , 97.049 30. st �. 57,152 $0. PT. __ _. Z z ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND �O CERTIFICATION FORM Owner/Buyer �`C. u i y�, C l� o wo r Mailing Address n,�gnv� e Wac e (� U & rrx CJj t 5 D L6 Property Address '"I 0 r 1 p I (L L G `� ` (Verification required from Planning Department for new construction) - 1 City /State �I Ud svn LV1 Parcel Identification Number © c *), p 13 d a, 10 LEGAL DESCRIPTION Properly Location c5E %., Y., Sec, N -R Z� W, Town of ��A) Subdivisi U ryl l� t t` U I t I T S S �e c p h K# Ad c r c Lot # _. . Certified Survey Map # Volume . Page # Warranty Deed # _ S S (00 O Volume ( 5 ,k . Page # Spec house j yes no Lot lines identifiable.)R(yes ❑. no SYSTEM ]WIAIN IENANCE Im p rO p eruseandmaintenan ceofyourseptiesystemeouldresaltinitspL ==tmfiguretobandlewastes.Ptq=vi aintm oe 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 do function of the septic tank a treatmat stage in the waste di gK=1_System, IU Property owner agrees to submit to St. Croix Zoning Department a certification form, signed by &e owner. and by a niastnrpluniber. iourneynianphmibc4 restrictedplumber or a hcensedpumperva ymg that (1) hue on_s to wastesvaterdisposal system is is 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 wed 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 of Natural Resources, urces; State of Wisconsin.. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoni Office within 30 days o the three year emuation da 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 descraW above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT DATE « « « « «« Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. « « «s «« «« 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 x , ♦ Y p lo .�i��v+r ;544 q o uCUMENT NO, WA Al - ft DEED ;I ' STATE BAR OF WISCONSIN FORM 2 - 19821 I ZE Humbird Land Corps "tion, a Minnesota Corporatiam ii ST. CROIX CO.. WI . .... C .ewe . -.. . _ ... AU it G 2 8 1998 j ;nnl wal 1 to Kevin E. Howard and Brenda 5_ Howard, M Husband and „wife - Net! : M of ONa .. ........ .. ..... ...... .. .................... /tCiUgN TO r , the following; described re:Il c9tate in ...... .$t.- Croix _.,__ ..County, ° State of Wiscunsin: - Tax Parcel No ii Lot 26, Humbird Hills Second Addition Town of Hudson, St. Croix County, Wiscon in T NSFER i Q "d y ` FEE N t t This is not homestead propertc. 04KX (is not) r. *s" 1•;sception to warranties: Easements, restrict znS and rights - of - way of record, if any t ((tt i t Dated this I ?1st day o` August _ _. - 19 - -98 HUMBIRD LAND CCRPORATION j+ _ (SEAL _.... 1 P ) i ' .... ....- - "by . r Austin J. Baillon, is President I .... . . . ` ti .. - ...._(SEAL) (S I r AUTHENTICATION ACKNOWLEDGMENT 4( li •nature s) STATE OF W�Hrd81kX YX MINNESOTA Si6 ( -- -- - ---- -. _ . I I ss. - - - - - -- -- - - - -- _.._.. RamsP f =y.. - ... - County. . I9_ I'crsouali cane before me this ....z1 st .....day of - qui.hemicated this ...---..day oi....- .. - -. y the above ii_ried �l .............. •...................... -- -- --- J 6oi .Ion President_ of y + • Hu .Conporati.on I,I TITLE: MEMBER STATE BAR OF WISCONSIN ... �{ (If not................. . ------------ - _.- ------ -- - ---- - .... ........ authorized by 5 706.06, W is. Stats.) to me 6no%vn to be the person ..... who executed the fore *utn;; instr unt a* t�, polyt +aa r A lg t s "!}+d'aan+e,•�^�^^^ a ' A THIS INSTRUMENT WAS DRAFTED BY i. 0��� •� (.G G • Humbi rd Cor oration )`J CC 1;%, i� •--• - 2 "' "" Paul ,A. Bai l lon i MI s rtiaw t N { ............ ......... ... IVot:u y f uhlic a o M I; (Signatures may be authenticated or acknowledged C.;r• NIY Commission is permanent.(If not, state expiration < ) are not necessary.) L•,t January 31 t •Pinmee nt per >nT .•irninR i n+y cn;mrty sh dd hn tYi i'.f ,� � J 'C1'Il• 1 7 +).1•• �a1.i7� T.m �'�•" �"'-' � / Is• r � Wt'U53'k: ,T3.Si' ` 'Oi'75!, 111 11.11• 11.30' 111.19'111•[ SIPt1•.Yf �! I 'os•„• \u'1t•1w 354.m 610.01• nP11•.S•t mhrvl•• A ` Z C '13.43. 6 uo'86•.1.5•� 613.86• 753.75• 061.33.01.3. nlhruw , / 9 •sv,v . AtP,I•a•r 013.11• ' ua:•� ►st•SI.01•0 61043.13•• •d ,{{ OT 36 •13.11• ISO, ISt.,I UO A61 .p,g ./r 2.11 ACRES ` Q -0 Q tl.oes sort j hl•11• uP.4ve•r MW 17.63• 461.31.1.•0 061*41-we + It •svor 130.11.43.54 303.01' 148.41• 111 ssr01vr•T +•, • ,P _ l; ht a• 1Mu• S.9 75.00• ISAP t41 . 380h1 1 : Q hr61• 861.61'10.3 ^t 111.75• 16133. s/abr4vt eslhrn ^t N •61',1• 341.31•tl.t•t 1111.61• 311.75• 151.31.31•t t33.14•It•. %;•; : \� �� to LOT 35 "a e0 s :.1 $:616111 34341 3 � � . 113 14:.61 s , 'b. t s 3.0013 t e,./ . t Ta so 3.t ' 3.61'61• 30.13.x3.11 04.44• 014.1.• 33)•61.113.11 30104.11.11 i "' ,G. j}. •11'00• 33.4.61.61.1 016.11• 011.41• 866130•11•t 204 a•aw3. 304.0'44.0 414.04• tse.30• SOP41•e•t SOS-29-63-9 3.41.33.• 30.01.30.1.3. 6111.0 >• 186.03. 1os•41111.0 34P30.00•r , .. � • •• 3.01'61• 386019.314 we.So• 10.11 111.1ovt•r 111.0.30.3. 6 1411000 �\,\ \, 6th *t • ` +' LOT X66_- o %l r "[11..,30 4.eS Aenu '` � � t \ � • • '• 3 I .VEAV AT El[VATICH Of 1171.1! ��.• 110 R�� • ; 9�/.; \• - •\ I //ONOea % LOT 34 $ / EASEIIE� `,� , • 1 2.02 ACRE, c �z 87.932 30.3.T. Iv Ss LOT 27 `� t 1 \ i IN si of A CRES t foN41NO T ; ssIt [t. sn '. 1 69*06'arg 4 .4 \ . 1` 1 NSete30't n sN� e 10 b• _ `I t uaaY 1 J s •�t9, • 11119 i s I � • I LOT 28 �t Jlt (a3 0 2.23 AcRts I(7 10 117401't to. rT. • i I 33' 133` 1 19 i EASE »t•� �- .. 1 ! LOT 33 kaut v.. �O^Lrvj pNDINO 1 � -- lam' EAUTAEN�' i II : ^ O� t 19 LOT 29 1 I 1 ; 0 0.00 ACRES i s t 1 tV '2 91,164 40. /T. If j Nt9•34' � �� ?:' A VI � 1 I CHICKADEE -LANE iC 1104 CORNER � u IC i T t ( /U9y9YY[ E70.71'- I 33,•34'03.^ 317. S � I I ! IY 4 LOT 30 1 ; 1 ' LOT 32 I 1.00 ACRES 1 I J 2.01 50. I1J1 D j tT,t, 9 40. IL 4),14= 60. /T. H f4N4.14 �% 1 1 La tq w Q F . �w1E.lE31T ,, � V X 9T tPi / i r A n LOT 31 86.02 Y i• 2.01 ACRES •� ' . + fir • 1.5" $0. 3.t » 6 CM/� V V.W ST6`2)gJ E �A SCALE IN FEET Soo w 0 too too s ct