HomeMy WebLinkAbout032-2022-20-450 (2).41A/-202,3-01K
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���� I U
our Sanitary Permit
Ch 1 t. Croix Pounty Sanitary Ordinance
ST. CROIX COUNTY WISCONSIN
COMMUNITY DEVELOPMENT DEPARTMENT
ry
1 ST. C R O N Y.
In rd er
�ers In lion pole may be used for secondary purposes
ST. CROIX COUNTY GOVERNMENT CENTER
i y rssrn
1bL7
w. S. 15.04(1)(m)j
2�,�'�d
1101 Carmichael Road
Hudson, WI 54016-7710
0
.7i1/ v
(715)386 4680 Fax (715)245 4250
St. roix c, nr
Attach complete plans for the system on paper not less than 8-1/2 x 11 inches in size.
7111111 "Illy
nitary Permit # ❑ Check if revision to previous application
frN-ZoZ3—ors.
I. Application Information - Please Print all Information
Location:
Property Owner Name
^ 114 1/4, Sec
T N, R E (or
Property Owner's Malling Address
Lot Number
Block Number
City, State
Zip Code
Phone Number
Subdivision Name or CSM Nu ber
TXpe o Building: check one)City
No. Bedrooms: /
❑ Vflage ($Town of
f3 1 or 2 Family Dwelling - of
N J�
❑ Public/Commercial (describe use):
Nearest Road
❑ State-owned
1. ype o ermit he only one box online heck box onl ne d applica e)
Parcel Tax Number(s)
1.❑ Repair 2. Reconnection 30 Non -plumbing 4.0 Rejuvenation
A) Sanitation
C -31:1?��
Permit Number
Date Issued
BL LState Sanitary Permit was previously issued 3
IV. Type of POWT System: (Check all that apply)
Non pressurized In -ground ❑ Mound >_ 24 in. suitable soil ❑ Mound 5 24 in. suitable sal ❑ Mound A+0
❑ Sand Filter ❑ Constructed Wetland ❑ Peat Filter ❑ Drip Line
❑ Pressurized In -ground ❑ Holding Tank ❑ Single Pass ❑Other
❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating
V. DispersaUTreatment Area Information:
1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Sal Application Rate 5. Percolation Rate 6. System Elevation 7. Final Grade
Required Proposed (Gals. /day/sq.ft.) (Min./inch)) - Elevation
^/
D / / ,� /v/� / I _
VI. Tank Information Capacity in Gallons Total ror Man acturer Prefab bite Con Steel Fiber- Plastic
glass
New Existing Gallons Tanks Concrete structed
Tanks Tanks
❑ ❑ ❑ ❑
— >
❑ ❑ ❑ ❑
VII. Responsibility Statement
1, the undersigned, assume responsibility for repair/rec onnectionlrej nationCinstallation of non -plumbing for the POWTS shown on the attached plans. A
license is not requir9d for term3lift repair or the installation of non-pWnbjng sanitation mtern.
Plum Name rin "'
Plumbers Signet to ): /
MP/MPRS No.
Business Phone Number
I
Plumbers Add (Street, G, S Zip
"I -I
Vill. County Use Only
Disapproved Sanita Permit Fee Date Issued Issuing Agent Signatu (No stamps)
Approved Ow�Jlnifiadl Adverse �T D 2�2��3 `Dete �(
IX. Conditions of Approval/Reasons for Disapproval: 3\ A` S� �
SYSTEM OWNER:�lYl
Septic filter dispersal
tank, effluent and cell
must be serviced I maintained as per s
management plan provided by plumber. /�
All setback requirements must be maintained oc
Reve3lptr app icadie code r ordinances.
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF EXISTING SEPTIC TANK(S)
This is to certify that I have inspected the existing septic and/or dose tank
presently serving the following residence:
Street address) �,3t . ? �y �T located
( g c
at: _ 1/4, '/4, Section _, To _N, Range W
Town of , St. Croix County Wisconsin.
Upon inspection, I certify that I have found the tank(s), to the best of my
knowledge, will conform to the requirements of SPS. 384.25, and it (they)
appear(s) to be functioning properly.
Most recent date of inspection or service
Did flow back occur from absorption system? Yes No
(if no, skip next line.)
Approximate volume or length of time: gallons minutes
Tank Capacity:
Construction: Prefab Concrete Steel Other
Manufacturer (if known):
Age of Tank (if known): - -
Permit n er i�f^/known)
(Licensed Plumber Signature) (Print Name)
(Title) (License Number) MP/MPRS
(Date)
Form to be completed by licensed plumber (Dept of Safety and Professional
Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer
(NR 113 Wisconsin Administrative Code)
Rev. 2/2012
System PLOT PLAN
PROJECT Mike Thomas ADDRESS 1800 38th St. Somerset Wi 54025
NE 1/4 NE 1/4s 6 /T 30 N/R 19 WTOWN Somerset COUNTY ST. CROIX
SYSTEM ELEVATION 100.5/100.4/100.3 3.6' belov. DATE 3125121 BEDROOM 4
CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSI? TANK SIZE
HOLDING TANK SIZE LOAD. RATE .5 ABSORPTION AREA 1216 # of chambers 60
6 BENCHMARK V.R.i?. Top of SW lot stake ASSUME ELEVATION Ioo' Filter Lifetime Filter
❑ BOREHOLE O WELL *II.R.P. same as benchmark
r'CQ ply.
I '9'
176' v>
15' '
98, B Z
-a
16' !
134' i
174' 4
Scale l= 1 /4" = 10' �j /
ov M kij Se ' l �1Yr- �o%d+ bo,�, ,� l3 -Co 1
10 c„ 1 sus � 141
do 1'
K 1/`f � ► fit. c� s,, � ® l-t�s -}- c-►-�S �Q`j
-'�s f'l cJ r`+l
4cs4n., Fo U nJ 50:1s 4.
CO��j�S+ �cSC�r4d +h
ei'C js'b�
1%Slope red, 20' 15
. .
1,Bedroom
House
jL-
3-3' X 82' cells with >3' spacing
38th Si.
(16 b a Vents v
I � ent
98' B_5 QuiI S[andard
��� Leaching Chamber
52' of Cover with 20.0 ft2 of Area
All piping shall be ASTM SDR 30/34, within -5.6ft^2/pair of end caps
10' of tank, piping shall be ASTM F891 4' Long 12"
`B.M.* 34,>
Grade at System Elevation
523' Property Line
4
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
Safety and Budding Division
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
personal enfnrmatrnn you provide may be used for secondary purposes [Privacy Lave, s 15 na (1)(m)I
ermii Holder's Nar•e City Vtllag.i Township
Viike J. Thomas and AnnaMarie Thoma TOWN OF SOMERSET
ST BM Elev Insp. 8M Elev rM DescnptioM
TANK INFORMATION
TYPE
MANUFACTURE -i,,_,
CAPACITY
Septic
L,4t r
/ - S- U
°eM
t
r
Aeration
Holding
TANK -RFTRACK INFORMATION 1itaG r�-i�.k41V<1
TANK TO
P%`-
At[l I
RLDG,
4d
Vent to Air Intake
ROAD
Septa:
>
Dosing
Aeration
Holding
PUMP/SIPHON INFORMATION
Manufacturer Demand
M
Model umb r
TDH Li F ction Los Syster Head T DH t
Fore lain Length Dia Dist to Wel
SOIL ABSORPTION SYSTEM
tLtVA I IUN UA I A
county St. Croix
Sanitary Permit No
631290
State Plan ID No
Parcel Tax No
032-2022-20-450
Section/TowniRange/Map No
06.30.19.551 E-10
STATION
BS
HI
FS
ELEV.
Benchmark
-7 •
���,
�DV
Bldg Sewer
•�
/O�-
SVHt Inlet
_ Gt
CUJ
Gllf•
(•
SUHt Outlet
Q
V
Dt Inlet
Dt Bottom
Header./Man.
Dist. Pipe
C� /
Bot System
Final Grade
`17
7
OZ.
St Cover
f
2 .
) bq. 8
4--7o / 4 w4 lc,b
BEDITRENCH
Widtl
_ength
No OI Trenches
DIMENSIONS
No Of Pds
Inside Dia
Liquid Depth
DIMENSIONS
1
7PIT
-3
---
.ZZZZZ===;-
SETBACK
SYSTEM TO Pr
BLDG
WELL
LAKEISTREAM
LEACHING
%Ianufaclurec.T-, / ) 1
t- �}y
INFORMATION
CHAMBER OR
UNIT
Type Of System >ZS
J
So
n f
V
Model Number:
f
o v( IK Dt n
uialrAiuWr.—vr.,r_r
HeadertMan!foic 1 t
JD�slnbution
Ppejs)
x Hole Size.
x Hole Spacing
Vent to Au Intake
L �A ►^4 �
L.,7-�-`��/
1 6 Dia
Length Dia Spacing
_i
Depth Over
..r.,....... ...,.�
Depth Over
.-...------ -- -
xx Depth of
- -
xx Seeded,Sodded
xx Mulched
BedfTrench Center
Bed,Trench Edges > f Z
Topsoil
Yes
No
COMMENTS: (Include code discrepencies, persons present. etc.) Inspection #1. Inspection z;2
Location: No Address Available
1.)Alt BMDescription =M.fj"e►�g1f�,P�ep!' J
2.) Bldg sewer length = �'
- amount of cover
-r kh LA 7 � '� - rod �— cow `}c -ka •
Plan revision Required? Yes X No / J t e Z 1 I Ob� L
Dat
Use other side for additional information ( i Cert No
Jlnse ctor's ign
S9D-6710 (R 3+97)_-
Y
pt�
ram'
FED-)
IE C, F91, nPn
OCT 21 . ! Safety and Buildings Division
2�2�
D 201 Vet. Washington Ave., P 0 Box 7162
S `` i Madison, WI 537�7-71
Cntrmunicy Deveio(n.entJ
County •�
_ L Sanitary Pcrmit Numbe: (to be filled in by Co j
Sanitary Permit Application -�""--
fn accordance with SI'S 383 21;?), Wis Adm Code, submissioo of this form to the appropriate governmental unit
is required pnor to oblaiaing a swittary permit Note Alinlicalion forms for'.ate-owned POW-TS arc submiaed to
the Department of Safety and Professional Scrvies Prrs ,nal information you provide may be used for secondary
oiirnnses in accordance with the Privacy Law, s 15 04(1 i(mr, Stirs.
n — Please Print All
Owners Name
Proper!), Owner's Marling Address
City, if3te�Zip Cede
I /
iI. ype of Rui{dis
ng (check all that apply) —
FamilyDwelling—Numbcro Bccroom_
t S1 —
Phone Number
Lot A
Block ;!
Transaction Number
Project Address (if different than marling address)
v Location
1� i/,, Section
/(6!Ic
T %�, N; R �--- E r
Subdivision Name
❑ PuMic/Conimeretal - Describe Use ` I ❑ cm. of
i t;SM Number Villarc of —_
State Owned -- Describe Use
— --- -- -
tmofl
�,_JlfTY_pe of Permit: (Check only one box on line A. Complete line B if applicable) —
__�__
'a ew System ❑Replacement System T ❑ Trcatrn olrl3oid:rig Tank Replacement ihtly r) Other i 7odificet,on to Existing System (explain) i
l.!ct Pfe47ni S Permit ;vumi•er and Date Issued
❑ Pennit Renewal emit Revision i ❑ Change of Plumber U Permit Transfer to New i
Aefore Expiration n"nC
[V vpe of POW rS Svstcm/Componcnt/Device. (Check all that apply)
on-Pressu zed Iri-Ground v Prms;i tied In -Ground ❑ At-Cirade t " Mouu:i> 24 �`sunabte I;ocl J NSound <241a stir ai le so�rtp J�
r� linlding Tank Offer Dispersal Component (plain)— C etreatment Device (explain) ✓-
4 -� - —_
V. DispersaUPreatment Area Information:
Design PI� 1)esien� oil Application Rat
I Dispersal Acc� �gmred (sfl L r petsal Area Proposed (st) System Fae/u t
a
VI. Tank Info Capacity in
C:allons
Tanks
-
Total- N of Manutactur
GallonsUnits 44
New Tanks existing
I c .. _
U i rn v
Septic w Holding Tank
�iiSing t.tlambti
VII• Responsibility StatemeAll, the undersigned, ass),
-
es onsibility for installation of the POWTS shown on the attached plans.
P r-- sName (Print) Plumb
_rw
S ure MP/MI'KS Number TBusiness PhoneN bcr -
t 1 - �-
Plumber's Address (Street, City: State, Zip Co.
VIII. CountvlDe artment Use Only_—_-
T Permit Fee Date Issued Isswn • Agrnt Signat c
Approved j llisa to S t
p Cason tal
— _i
IX. Conditions Approva
`
4
SY 'TEM ii'•�vN"._R 3 � ���%t5t�
1 e-plic lank 0flue-it filter and
L_1_
St:CeP WLISI i:i; Se' JI ed ''Stall"airel manaitc°went plan t)lcvidcd by phimber.2 '"" ' "' eR�' c o coirip top aces or the system and submit to the County o sper not less It 8 ir- z 11 iocha, in size
as per appac,a;lc ccn7eiC 1r inant�'rs.�5� �S 7� Lt $••I
3.
SBD-6348 (R. 1 i/l1)
LEFT ELEVATION 1 /8" = 1'-0"
U
Op
K
� 1pa�?a® s:>n. lsu d�ara lama �:nnrw Roar. alxmaA
ymcd to :x e.ma plws m >�ik e�a f!'t'a!x
� laae�,svng :o s yap�T- M�o:
.sN is sny ade Oo'alu .rt>Y rcC lc ns.}'.ad
hT a .._Nen, a�n nry� roa,rwfmn u" a,.,v Wx.n''Y
REAR ELEVATION 1/8"= 1'-0"
FRONT ELEVATION 1 /4" = V-0"
9-0' POURED CONC. FOUNDATION
9'.1 1/8" CEI`_ING ® MAIN LEVEL
FOR BIDDING ONLY
NOT FOR CONSTRUCTION 8
o
0
RIGHT ELEVATION 1/8" = I'-0-
#22-138 cra 1 1 !r
2 <x
N
N
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N
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0
m
c
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;,r;>a.r�aese m».a nr,anm roar. ai��d
N x 9rarnad tox [�aee Pia W �.ii a -a ab<�re.
_ na P.-wrq xoan rcserm� a gw. t-ae wro rN'o:
used la aM adc 4o-al urvc:.xs, way ret 4 a=zg:ed
ur�wpu.. am rry na'x �w/Irgn a-..xA n rY re+may.
..vt:le oxn wa[La uaxc-L ��-Ia rS ltanng Wx,n
MAIN LEVEL PLAN 1M' = P-On
9'-1 118- CEILING @ MAIN LEVEL
rUK DIUL)INU UINLI
NOT FOR CONSTRUCTION
VAL15 - 10'-1 1 /8" OFF CURB
#22-138 cu 13 (x
N
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^ c »\ 1800m nj7*efO ±«E-T, v 54025
�aaDrawing Eom.
WSRWO .b I �.
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334a
400
032-2022 20-600
551F-10
LOT3
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551E-10 f'
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551 B �b' 032-2022-10 060
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032-2022-20 350
ISCLAIMER: guaranteed
50 l 100 15oR
0
551D-10
DThis map is not
accurate,
be
urate, correct, current, or wmplete and
conclusions drawn are the responsibility of the
user.
Cam• x� i f`_. h 7 - _. ,
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,y cate, correct current, co " drtd • $.- i:'s �.a
+ tdribksTons drawn are theresponssi bl Cf#}i9
#. user.',
S RO` TY SANITARY SYSTEM OOffice Use Only
IF OWNERSHIPIADDRESS FORM o—w2l2o21
Community Development Department will utilize this information to provide the property owner with
information regarding operation and maintenance of your new or replacement sanitary system? This
information will be provided as part of our ongoing efforts to protect public health, your well, groundwater,
surface water, property values, and county resources. Once approved, this completed form and educational
information will be sent to you by email.
Owner/Buyer }; 1 (C� t 1 t tlt./ti�
Mailing Address
City/State/Zip — C �1 s.� 0., .{ (% �-- LA_/
Phone Number (required) — --s -� ^ ("7 C� j
Email Address
is
Parcel Identification Number_0 �� ` v 0
(found on the property tax bile
Property Location ;Al 1/4 , Sec. T C44 R/ W, Town of
Subdivision Plat Lot #.
Certified Survey Map st_
Volume _ / 1' Page # ` < ���
Warranty Deed # (before 2006)Volume Page #
Number of bedrooms ±���Spechou`SeOyesOno Lot lines identifiable4yes C] no
New Property Address IivD
(Verification of new address required from Community Development Department for new construction)
415 , z1
(Staff Initials) (Date)
This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications.
New System: Include with this form a recorded warranty deed from the Register of Deeds Office and a copy of the certified
survey map if reference is made in the warranty deed.
Community Development Department - Land Use Division
715-386-4680 St Croix County Government Center 715-245-4250 Fax
cddCo)sccwi gov 1101 Carmichael Road, Hudson, WI 54016 wwwsccwi qov
21
a COD
S'? 3p20
Document Number Docutnen`jI&'.0t'4 gAi
ommunity
St. Croix C Cy
Accessory Structure Affidavit
�i?1i-/-+C-L 7j—
Name — (Owner) Typed or printed
being duly sworn , states, under oath, that:
He/she is the legal owner of the following parcel of land located in St.
Croix County, Wisconsin, recorded in Volume _ Page
Document NumbeQ /! � 3 St. Croix County Register of Deeds
Office, Recording Area
being: duly described as follows (include lot no. and subdivision/CSM or
detailed legal description): # 5 70 AE6>L7 /
r
II II III II IIIIIIIII
° 47Iful%
1140145
BETH PABST
REGISTER OF DEEDS
ST. CROIX CO., WI
RECEIVED FOR RECORD
09/29/2021 12:05 PM
tXEMPI n:
REC FEE 30.00
Name and Return Address
PAGES: 1
Parcel Idenufic66n Number (PIN)
o� 4 -v�0��0-��
As owner of the above described property, I acknowledge that there are two Private Onsite Wastewater Treatment
Systems (POWTS). One serves the existing principal dwelling and one will serve an accessory building on this
lot. This accessory building may not be used as a second residence on this parcel. I also acknowledge that I will
disclose this information and stipulation to any future parties interested in purchasing this property.
Dated this -,lQ day of
*
*
Signature(s)
�r
AUTIIENTICATION
authenticated this _ _ day of — __ __
TITLE MEMBER STJUE BAR OF WISCONSIN
(If not,
authorized by § 706 06, Wts Slats j
THIS INS I'RUMENT WAS DRAFTr.t) BY
+^
� to -A "l �J i rc-1
l
ACKNOWLEDGMENT
S PATE OF IVISLONSIN )
St- Croix County. ) „ .-
Personally came before me this day of -� )
C:� � the atwve n mcd
- ----- to me
known to be the person(s) who executed the foregoing instrument and
acknowledge the same.
LBETHTnRvJPu KOPF
STATE OF WS ONSILIC
z r
State Bar of Wisconsin Form 1-2003
WARRANTY DEED
Document No. Document Name
THIS DEED, made between
Diamond "D" Farms, Inc., a Wisconsin Corporation
("Grantor," whether one or more), and
Michael J Thomas and AnnMarie Thomas, married to each other
("Grantee," whether one or more).
Grantor, for a valuable consideration, conveys to Grantee the
following described real estate, together with the rents, profits,
fixtures and other appurtenant interests, in St. Croix County, State
of Wisconsin ("Property")(If more space is needed, please attach
addendum):
1121138
BETH PABST
REGISTER OF DEEDS
ST. CROIX CO., WI
RECEIVED FOR RECORD
01/15/2021 11:30 AM
EXEMPT#:
REC FEE 30.00
TRANS FEE 225.00
PAGES: 3
**The above recording information
verifies that this document has
been electronically recorded
& returned to the submitter
Recording Area
Name and Return Address:
Edina Reafty Title
6800 France Avenue South
Edina, MN 55435
032-2022-20-450
Parcel Identification Number (PIN)
This is not homestead property.
SEE EXHIBIT "A" ATTACHED HERETO AND MADE A PART HEREOF
Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of
encumbrances except:
(Signatures may be authenticated or acknowledged. Both are not necessary.)
NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED.
WARRANTY DEED 2003 STATE BAR OF WISCONSIN FORM NO. 1-2003
'Type name below signatures
St. Croix County 1121138 Page 1 of 3
_.„r�kg � LLB..,: PpM.xn �,�ewwpxgry+x xNvc�rne w. „fi; a n. pxWacev .—.
Dated: 31st day of December, 2020
Diamond "D" Farms, Inc., a Wisconsin Corporation
BY: /- s
Dennis Fleischauer
President
AUTHENTICATION
Signature(s): Diamond "D" Farms, Inc., a Wisconsin
Corporation authenticated on
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not,
authorized by Wis. Stat. 706.06)
THIS INSTRUMENT DRAFTED BY:
Edina Realty Title, Inc.
Cheri Brown
400 South Second Street, Suite 130
Hudson, WI 54016
N0-T'-a-Y PUBLIC
ACKNOWLEDGMENT
STATE OF 1A/ I ?
COUNTY OF - L
Personally came before me this
-,27d vqz
the above, Dennis Fleischauer, President of
Diamond "D" Farms, Inc., a Wisconsin Corporation
to me known to be the person or persons who
executed the foregoing instrument and
acknowledged the same.
Cheri Brown
Notary Public, State of Wisconsin
My commission is permanent. (If not, state the
expiration date: 03/01/2023 )
(Signatures may be authenticated or acknowledged. Both are not necessary.)
NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. NO.
WARRANTY DEED 2003 STATE BAR OF WISCONSIN FORM
-2003
"Type name below signatures
St. Croix County 1121138 Page 2 of 3
EXHIBIT "A"
Lot 2 Certified Survey Map, Volume 12, Page 3400, recorded in the Office of the Register of Deeds for St. Croix
County, Wisconsin, as Document No. 570860, located in part of the Northeast Quarter of the Northeast Quarter
and in part of the Northwest Quarter of the Northeast Quarter of Section 6, Township 30 North, Range 19 West,
Town of Somerset, St. Croix County, Wisconsin
Less and except that part of said Lot 2 lying easterly and westerly of, within 40 feet at right angles to the following
described reference line:
Commencing at the NE comer of said Section.6; thence S02°21'23"W, along the east line of the NE 1/4 of said
section, 35.04 feet to the southerly line of the Wisconsin Central Ltd. Railroad (southerly line being 141 feet distant
southerly from the centerline of the existing railroad); thence N88°55'59"W, along said southerly line, 1133.35 feet
to the centerline of the town road (38th Street) and the beginning of said reference line; thence S24°37'40"W,
along said centerline, 893.60 feet to the point of curvature of a 764.49 foot radius curve, concave easterly, whose
central angle measures 39°25'56", whose chord bears SO4*54'42"W and measures 515.82 feet; thence southerly,
along the arc of said curve and said centerline, 526.14 feet to the point of tangency; thence S 14°48' 16"E, along
said centerline, 241.78 feet to the point of curvature of a 2292.01 foot radius curve, concave westerly, whose
central angle measures 17°48'52", whose chord bears S05*53'50"E and measures 709.77 feet; thence southerly,
along the arc of said curve and said centerline, 712.63 feet to the point of tangency; thence S03000'36"W, along
said centerline, 2181.17 feet to the end of said reference line.
(Signatures may be authenticated or acknowledged. Both are not necessary.)
NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED.
WARRANTY DEED 2003 STATE BAR OF WISCONSIN FORM NO. 1-2003
*Type name below signatures
St. Croix County 1121138 Page 3 of 3
�,,.� .,>. ..• ::: tngW J+rm`,�f ic,i�.tni yw.nx +he,4}twr ..�, ...;...s ;.:. m;wi.rvr n�ria �'t M: � � .:. r., .4�:.,�,..ry ... „<,...,..e�, .:.
EL-998
5170860 UAWRSNco
FILED
1
CERTIFIED SURVEY MAP
c'
N oy
JAN 0 7 1998 ►
a
w1TNLEEN
LOCATED IN PART OF THE NE1/4 OF THE NE1/4 AND
lstefoI.WAdN
Replsteroll a
Sl.croucCo.,VYI
9 AND PART OF THE NW1/4 OF THE NE1/4 OF SECTION
6, T30N, R19W, TOWN OF SOMERSET, ST. CROIX COUNTY,
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NE CORNER OF
WISCONSIN_ CENTRAL_ RAILROAD SECTION 6
N89'53'19"W 400.00' FENCE IS CORN —
FROM LOT CORNER
N In
FENCE IS 2,5'+/— h , " N89'53'19"W N89'S3'19'W ro
FROM LOT CORNER M o NOO'O6 41 E 2 7.45' I
M N 66.00 221.45.' / 1133.35'
• 36.00'
3 N � LOT 3 6�
(7r � ri L'co 00 S661g' S>! 99' I
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7g40"F SSB Spa\ N/�� Q N N
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LOT 1
N� o�q r
3sg7' _ 1 APPROVEU W
87'50'36"E 510.54' r� JAN 0 7 '97
/ �/ ����
S7. CRG;X CO:n"TY 4 CORNER OF
%,�� ! VW= Comprehone�+Fly"SUCTION 6
Zoning and
perks Commlttae
It not recorded LOT AREAS
17 g / wtch:n 30 dayll of
approval date AREA LOT I
approval shall be
+ DIAMOND 'D' FARMS
DENNIS FLEISCHAUER
6659 STILLWATER BLV
OAKDALE, MN 55128
null and void
3,154 ACRES INC. R/W
137,369 SO. FT.
AL U INUM/COUNTY SECTION CORNER
3.000 ACRES EXC. R/W
B MO MENT FOUND
130,700 SQ. FT.
D • V 'IRON PIPE FOUND
AEA LOT 2
1' X 24' IRON PIPE -'WEIGHING
0
1.68 LHS. PER LINER FOOT
3.181 ACRES INC. R/W
• • 100' ROADWAY SETBACK LINE
138,57E SQ. F7,
. . .
3,000 ACRES EXC. R/W
EXISTING DRIVE
130,701 SO. FT.
—•--- EXISTING FENCELINE
AREA LOT 3
3.238 ACRES INC. R/W
141,030 SO, FT.
3,000 ACRES EXC. R/W
THIS INSTRUMENT DRAFTED BY MICHAEL ERRICKSON JOB NO, 97-136 130,704 SQ. FT,
VOLUME 12 PAGE 3400
L
Safety and Buildings Division Co
la 201 I ff W�ashing% Ave., P.O. Box 7162 Sanitary Permit Number (to be filled to by Co }
Madison, 537 -71
Z � � State Transaction Number
-s .itap-tapApplication
in accordance with SP5 3gZ1s`z), Wu Palm Code. su3 ;usstca of this form to the appropriate govermnental unit
I is required pnAr to obtaining a sanitary pttnvc Note A,,yh=on forrms for state-owned POwZ'S are subtnitrrd to Proles: Address :,if afferent than rnahme aadress,
the Departmelit of Safety and Professional Senses Pers:•nal utform2uon you provide may be used for secondary
purposes in accordance with the Privacy Lau, s..5.041' 1 Km;, St:.ts J
j L Application Information - Please Print All Information`�'�
Property Owtte's Tame Parcel # f
Property Owner's Matting Address
�ror�
Gvt- Lot
crty, State Lip Cede Phone 1`rmrber N�- ,. � r/. Secuon tC3 I
iiilllj o r ' ' C L'� ' S `1C2� �% , tr<k � I
i' Type of Building (check all that apply) lot ; T3 N. R E R'
�2 Family Dwelling - Number of 13ecroomS _ I � — Subdivision Name
Block #
PrbadCoararercial - Describe Use _ -
_Cmof
Stan Owved - Describe Use ('aM NUrn'r Viliaee Of
001UF X i IZ- 7,46) i
III. Tvpe of Permit: (Check only one box on line A. Complete line B if applicable)
A stem Re lacttnrnt S
p System L Tt�mtenc yoldrng Tani: Rcplacement Only Other Modification to Extsnng System (o p;amj
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to *:ew List Previous Perrin Numbs and Date Issued
Before Expiration Owner
IV. Tune of P0A` TS Svstem/Comnonent/Device: (Check all that annly) 1,0 r, uy G k- CJi1� .M .tee
gjhiQ_n-Prmmctzcd ln-Groun� S Pressurtzed In -Ground J At -Grad: ❑ Mouo3 > 24 tit, of suitable soil ':_ i Mound < 24 in. of suitable sod
-1 u t.r:. R -4 11 r,,...,.,... , re. t 1-1 0.......--.
i V. Dis rsaVireatment Area Information.
� r
Dent Flow (gFtd)
Dataa Soil .Application dsfi
I Dispersal f,-ca Required ;sf, i Dispersal A a7f)(s
System Eleyauo
V1. Tank Info
I Lawny in
Gallows
Taal
Crailens
# of Manufacture(s
Units
New'ania
'
-
Sepw or Eioldmp Tank
I d S
Ibswg Chamber
r-m
1
Plumber's Name (Pnrtt) Pl Signature MP!.WRS ?tiurnber Buctnes; Phone
-1.. -� t 2 26�,1�
City,
2—
Approved Disapproved PC-= Fe: i Date sued ssurn_o . Agent awe
�5Z5. oy 5 z
❑ Owner Given Reason for Denial o :
t#@W1blE.4provaVReasopsfor Disapproval 3 MvS-}- ,;�nj So r1S 3 (7�� IOvJ S�/S v,
kept tank h 1 •,t fi ter -tnc /
�ir,+arrl e y l t'�f
&t pergal c „, �j
BSjiCtfl» al nlrn ra rlt
1Fi l.)a'iiiatiQ7�J-%LS7�!`Kr ^4115 ��v1Vc S�/I77✓7 /��[/Yi
na -04
2-Ail setback
• ,itr. tlt',c Gode'or tlut<jc�rPS. � n-w�e r� rim ta.t r-O /` O� jY Cf- i
$ �f ai i attach to wmp4a plans for the system and submit to the County only on paper norim t4i A 1.1 11 inc.h� m sue
5) J2e f �4t tl�crl �re> 04-L15-4 & lo✓`��se!`v�eFJ' .
SBD-6398 (R. 11111)
A
�3
a
`1 /5pdrt7e>w1
couNry No. 631290
STATE SANITARY PERMIT
/boo 38+1% Sit
C��lvs��nL r �
OWNER
PLUMBER5�ru+h 19i4
TOWN OF
SEC & _,
AND/OR LO
Llc. #ZZG yec
T om_ N9 R E40
T Z BLOCK ---
ow
SUBDIVISION
CHAPTER 145.135 (2) W'ISCONSIN STATUTES
(a) The purpose of the sanitary permit is to allow installation
of the private sewage system described in the permit.
(b) The approval of the sanitary permit is based on regulations
in force on the date of approval.
(c) The sanitary permit is valid and may be renewed for a
specified period.
(d) Changed regulations will not impair the validity of a
sanitary permit.
(e) Renewal of the sanitary permit will be based on regulations
in force at the time renewal is sought, and that changed
regulations may impede renewal.
(f) The sanitary permit is transferable.
History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314
Note: If you wish to renew the permit, or transfer ownership of
the permit, please contact the county authority.
AUTHORIZED ISSUING OFFICER -DATE AUS
THIS PERMIT EXPIRES N W 2, NLESS RENEWED BEFORE THAT DATA
POST iN PLAIN VIEW
VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION
SBD-06499 (R. 10/11)
.`"
ST, CROIX COUNTY-NoZos3-o�v
SANITAI?YPERMI
OWNER
LIL
PLUMBERN�MO• NNE. LIC. #
TOWN OF ��LC'r� LOCATED
REPAIR ❑
RECbNNECTION K
NON -PLUMBING ❑
SANITATION
REJUVENATION ❑
(a) The pNpose of the sanitary permrls to allow repair, reconnection,
rejuvenation, or installation of non -plumbing sanitation as described in the
application for permit.
Zz�i263�.
SEC T N;R�W
AND/OR LOT 2,_ BLOCK
VM `37"" S161(00 _SUBDIVISION
The approval of the santlary permit Is based on regulations In force on
date of Issue.
(c) The sanitary permit Is valid for 2 years from original date of issuance and
may be renewed for similar periods thereafter. Application for renewal shall be
made through the county and shall comply with regulations In effect at the
time.
(d) Changed regulations will not Impair the validity of a sanitary permit until
the time of renewal.
(e) Renewal of the sanitary permit will be based on regulations In force at
the time renewal Is sought. Changed regulations may impede renewal.
(f) The sanitary permit is transferable. A sanitary permit transfer shall be
Dbtained from the St. Croix County Zoning Department.
' If you wish to renew the permit, or transfer ownership of the permit,
Tease contact the St. Croix County Zoning Department.
AUTHORIZED ISSUING OFFICER - DATE
THIS PERMIT EXPIRES Z UNLESS RENEWED BEFORE THAT DATE
TWO YE RS FROM RIGINAL DATE O ISSUANCE
POST.IN PLAIN VIEW
VISIBLE FROM THE ROAD FRONTING THE LOT
DURING CONSTRUCTION