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HomeMy WebLinkAbout040-1188-90-011 (2)Form- STC- 104 AS BUILT SANITARY SYSTEM REPORT OWNER (3reU OL k/ TOWNSHIP SEC T N-R W Jf ADDRESS SC3a� Reajrl ST. . CROIX COUNTY, WISCONSIN 71 � ' �NDZ oC r1 � �(' rl -- � f SUBDIVISIONCa k X I q -e AC tc$ LOT 71 LOT SIZE %� ,✓r f ' .. PLAN VIE14 Distances and dimensions to meet requirements of ILHR.83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 33 r56 gG BENCHMARK: Describe tl,,.e vertical reference point usedT) 0 V Elevation of vertical reference point: Zno. ()08 Proposed slope at site: cz SEPTIC TANK: Manufacturer: e k S Liquid Capacity:____L2_1 Number of rings used: Tank manhole cover elevation: T"-,nk Inlet Elevation: CfG ___ Tank Outlet Elevation: Number of feet from nearest Road: Front, OSide,;a/Rear,0 Feet From nearest property line: Front 10 Side,%&..JRear,0 Feet Number of feet' from: well L111 building: ZL TO: M6Y, TDAw',5 FROM: DATE:s--/ �7/ PAGES INCLUDING THIS PAGE: FAX FAX #: PHONE #: lions to septic tangy:) E.E REVERSE SIDE PUS. CHAMBER urer: Liquid Capacity: PUMP Model: Pump/Siphon Manufacturer: Pump Size PUMP Mc:el: Bottom of tank elevation: Elevation of inlet: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: ine: Front. Side, 0 Rear, 0 Ft.� 1 �.J Number of feet from nearest property Number of feet from, well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed. X Trench: Width: Length: () Number of Lines: Area Built: Fill depth to top of pipe: 3 nearest ro rt line: Front, Side, Rear. Ft. Number of feet from p Pe Y Number of feet f rom well: Number of feet from building: (Include distances on plot plan). SEEPAGE T Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box 0 or 'stribution box 0 been used on any of the above soil absorbtion systems? (Check one). HO TAN Man acturer: Capacity: Numbe of rings used: Elevation of bottan of tank: Elevation f inlet: ran nearest property 1 ine : 0 Front, Q Side, 0 Rear', Ft. Number of feet p � Y--- r of feet f ran well: Number o feet from building: Number of feet f nearest road: Alarm Manufacturer: Inspector: Plumber on the Job: Paul 5tejh_-eEA_ •711 q Y _3 DATED.License Number: 7 3/84:mj WA'�; pa rtTA9X I A§t?�S . 19 NW AYVAWIERAGR�94�ODRIDGE ' Lobar and Human Relations INSPECTION REPORT and Buildings Division (ATTACH TO PERMIT) INFORMATION Permit Halde�'s Name: ❑ City ❑ Village [R Town of: in TROY CST BM Elev.: lnsp_ BM Elev.: BM Description: rANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosi ng Aeration Holding TANK SETBACK INFORMATION TANK TO P 1 L WELL BLDG_ VeVeAirnt to Intake ROAD Septic , i° 4 � i NA Dosing NA Aeration NA Holding PUMP/SIPHON INFORMATION Manufacturer Demand Model Number GPM TD H Lift Fri cti on Head TD H Ft Loss Forcemain Length Dia_ Dist, To Well aunty: Sanitary Permit No_: State Plan ID No.: Parcel Tax No_: A9300126 STATION BS HI FS ELEV. Benchmark Bldg. Sewer St / Ht Inlet St / Ht outlet Dt Inlet -7R 5 01LJ, Dt Bottom Header / Man. M Dist_ Pipe" Bot. System 4 0 Final Grade SOIL ABSORPTION SYSTEM BED/TRENCH width Length No. Of Trenches PIT No- Of Pits Inside Dia- Liquid Depth DIMENSIONS - DIMENSIONS SETBACK SYSTEM TO P I L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Typeof •-' CHAMBER Model Number. rn < y S ste: ,4 � �� ID -7 0 �.!�,�'�' OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air intake Length _ Dia. Length Dia. Spacing 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 1 Trench Edges Topsail a Yes a No ❑ Yes [] No COMMENTS: (Include code discrepancies, persons present, etc_) LOCATION: TROY 36.28.19 NW,NW LOT 71 EAST WOODRIDGE DRIVE C4 ;w , 7,. . Plan revision required? ❑ Yes ❑ No Use other side for additional information. � SBD-671 g (R 05/91) Date Inspector's Signature Cert No DILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code —Attach complete plans (to the county copy only) for the system, on paper not less than 81/2x 11 inches in size. —See reverse side for instructions for completing this application. I. APPLICANT INFORMATION — PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION D J S 3 0�1 ( Q K42 1/4A/ 1� 114v PROPERTY ni ER' MARLING ADDRESS LOT # COUNTY X STATE SANITARY PERMIT❑ # f Check if revision to previous application STATE PLAN I.D. NUMBER T �el N9 R /Y BLOCK # ..._. a C5 ---east UOocPO Cl,STATE ZIP CODE V PHONE NUMBER SUBDIVISION NAME CSM NUMBER F I �s ,5Y 71slO A -.0 A c v—e L 3 Vaa I F &919( 11. TYPE OF BUILDING: (Check one) ElStStB Owned NEAREST ROAD T FV10 V r E]Public CX1 or 2 Fam. Dwelling—# of bedrooms PARCEL TAX NUMBER(g) III. BUILDING USE: (if building type is public, check all that apply) 1 ❑ Apt/Condo I 2 El Assembly Hall 6 D Medical Facility/Nursing Home 30 campground 7 Omerchandise: Sales/Repairs 4 El Church/School 8 1:1 Mobile Home Park 5 El Hotel/Motel 90 Off ice/Factory IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. D4 New 2. EReplacement 3. EReplacement of System System Tank Only B) E]A Sanitary Permit was previously issued. Permit# V. TYPE OF SYSTEM: (Check only one) Non -Pressurized Distribution 11 Seepage Bed 12 Seepage Trench 13 ❑Seepage Pit 14 ❑System -In -Fill Pressurized Distribution 21 ❑Mound 22 El In -Ground Pressure C�a 0 -- I 18� C1 ta I I 10 ❑Outdoor Recreational Facility 11 El Restaurant/Bar/Dining 12 ❑Service Station/Car Wash 13 ❑Other: Specify 4. ❑Reconnection of Existing System Date Issued Experimental 30 ❑Specify Type 5. El Repair of an Existing System Other 41 ❑Holding Tank 42 ❑Pit Privy 43 ❑Vault Privy VI. ABSORPTION SYSTEM INFORMATION: I. AB VI. GALLONS PER DAY 11 L 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE . - I REQUIRED (sq. ft.) PROPOSED (sq. ft.) I (Gals/day/sq. ft.) (Min./inch) ELEVATION l 7 Feet Feet 0— 1 0 .: V VII T II. TANK CAPACITY in g lions Total # of Manufacturer's Name Prefab . Site Con- Steel Fiber- Plastic Exper. App. INFORMATION New Existing Gallons Tanks Concrete structed glass Tanks Tanks I SeDtic Tank or WQI,4-aa Tank kleAwt- Awo -0•e - p El Vill. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plu r s ig ture: (Notamps) MP/MPfFWMo-: Business Phone Number: P—a C Z., telkl Plumber's Address (Street, City, State, Zip Coder /V r W1 R. COUNTYMEPARTMENT USE ONLY F-1 Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued issuing Agent tampsr,"% E] Approved F-1 Owner Given Initial Surcharge Fee) dob Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1 A sanitary permit is walid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the t.'.Ine of rene'vmad any new' criteria in the VN11;sconSJn Administrative Code will be u. U 12, 0 a 'p .3. All revisions to this PETMJit' rn u s t be a p p r o v c.1 el r iffi it -,U tr I Z ­�-t'q i 4. Changes in ownership. Or P!L1mb,_n,,r* requires a Sa.r'.tary P e r M, 4.1y prior to 'nstal.lation �ubmiffed to the %,evva� e sy,,�I�crric� ��nust be. pre-.,perty pumper \�-,Ihenevor i ecessary, usually every 2 W yes -iistrator or the 6. 'on --oncerning your te sewrage sv-sitem t a t our lo(,P0 d admir ..If you have questl , s ur onsi y State of Wisconsin, Safety & Buildings DivIsion, 608-26, _38-i5. To be complete and accurate this sanitary permit,application must include: 1. Property owner's name and mailing address.. Provide the -legal description and parcel pax nurn'be'.-r(s) of where the system is to be installed. 11. Type of building being served. Check only one and complete # of bedrooms if I or 2 Farniiy Dwelhing. I.I.I. Building use. If building type is Public, check all appropriate boxes that, apply-, IV. Type of permit. Check only one in line A. Complete line 8 if permit is 1tor yank re-Jdacemeint, re.Coni-ir.-icticill, C)r repair. V. Type of system. Check appropriate box depending -on system, �%;Pe. VL P`sorpticl.- systern mforrlaf,,nn Provide ?W nfo!­r" vil. TanK inforn-lafigor, F tank.ci, and, anc h k S �W - I I r X a t, i j I A,� t 1 i� 1 .0 il V �,l I y A f,-4 i'� p,.", n s i v i I ty s, *w f�l m e q. i to i i i r PI t- I er, h IX. Use Only. X. 0 z. A. 4�a L', 4 f V IA %1 com u r4-js a, n d W i plete Perf:C)f:,rT:janc.,e curve- PUrnp rnodel and pump nn a i ui t a. c; t U f4 e- r of 0-�e required by the county; E-) s> o i I test data on a form; a n d F) a I I s zing i to r: 711ion. GROUNDWATER SURICH A RGE 1983 Wisic-lonsin Act 410 included the crez:-Jion of tc SBD-6398 (R.11/88) APPLICATION FOR SANITARY PERMIT • 9TCw100 This aAp llcatlon form Is to be completed in full and signed by the ovner(s) of the to err being developed. Any inadequacies V111 only result In dtlay= of a p Y � the petmit Issuance* •Should this development be Intended for resale br evnesrcontractat # t $Pee house)* then ■ second form should be retained and completed when the property is sold and submitted to this *Ulco with the approptlate deed recording. w�wrwr�.rwrwwrrw+rwrwrM�rwwrrwwwwwrrrrrrwww�rrrwrrrr�rwrrr�awrsrrArrMrrwrrrrrriiii�irAiiir�� o cv ett 8 r� L �Aq n Zt��Z 2 1v one = t p P Y Cx vpestrAI/�VL�/4,r eectlon3vLocatlon of prT 2�'?� 0 Tonne h i p p NaillnT address o0 Ct el 1 i 0 llder... of site Subdivision name Lot nubs Ftevlovs ovnec of pcoQesly. , 1114r1 4dIs 29,eclelogdf MTet.l .s:. et pasc.l � �/ �' /SO'= o�/';)!§ I Date parcel was created 11c• •11 corners and lot ilnes ldenllElablet �yen _� o to this ptopetty being developed lot renal* (spec house)? Yes o Yola end Page Number as recorded v1th the Register of Deedso rrr.rrrrr+�r+�rrrrwwwwrr rwr"wrr W rr�rrwwrrrwrrrrrrwrwwr�rrrirarrrrrwrrrrrrr�rrrrrrrrrw�rrra INCLUDE WITH THIS APPLICATION T112 POLLOWI NC 1 h VARRAXTY DASD ►rh I ch Includes a DOCVNHNT NUMB tR , V0LVX1t AND PAOt KVMBVal, and the SEAT. or THE R2OI8TKR or DREDB. In add 1 t long a tort 1 f ied sutvay, it available. Mould be helpful so as to avoid delays of the revl e►+ing process. t E the deed description tolerances to a Ceit1 l led survey Nap, the Coctlf led Surrey Nap shall also be required. ww�rrrrwMwMrrrrrrwwMMMrmr�rMao goMMMw onme" r►nwr�wrmgrwrrwrrrMrrr174rwrrrirrrrrrrrrrrrrro . PROPERTY OWNER CERTIFICATION I (VQ) carts fy that all statements on this form are true to the best of my (out) knowledge; that t (we) am (ate) the ownectsl of the ptoperty described In this Intotmation totm, by virtue of a warren t rdad in the Office of the county Regletet of Deeds as Document No. A%T1 and that�Y(Wel presently own the proposed rlto for the sewage disposal system lot tYei have obt■lned an easement# to ru n n with the above described property! [or the eonottuct l do of said system, and the same has been duty recorded in the office o �h County q I,Vt■ r of Deeds# as Document Me. f . s i9natuie 1-6f owner N RM I -----21tratilte v Cowftner 1 t 8 Applicable ) late at • ynalus• a T"? eif 47 2.., Date of Vignatus� SEPTIC TANK MAINTENANCE AGREEriENT � St. Croix County 014NER/BUYER -� ��O �'y �-• � � �l � L- C� lt�l /I ✓ J C./ � � �/ `�/j` w 0 ROUTS/BOX NUMBER ��O � -GX/06�✓ Vj Fire Number � ,(� d CITY/STATE Weil. ZIP � PROPERTY LOCATION:�k',A/4(k, Section T ;SINR /� W, Town of St. Croix County, Subdivision �/I IJLee i�G✓PS, Lot number_ Improper use and maintenance of your septic system could result in its premature failure to handle wastes.. Prover maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licen"sed—se tic tank er. ghat you put into the system can a ect the unction o tum e -septic tank as a treat- ment -stage in the waste disposal system. St. Croix County residents -may be eligible to r+ecieve a grant for a maximum of 6Olo of the cost . of replacement of a failing system, whic was in operation prior to July 1, 1978. St. Croix. County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix County Zoning, a certification form., signed by the owner and by a water plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on --site wastewater disposal system is in proper operating condition and .(2) . after inspection and pumping (if nec- essary) , the septic -.tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. H the undersigned have read the above requirements and agree ° to maintain the private sewage disposal system in accordance with 6 the standards set forth, herein, as set by the Wisconsin Depart- zr merit of Natural Resources. Certification form must be completed .�. and returned to the St. Croix County Zoning office within 30 days of the three year expiration date. R SIGNE DATE --e St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 386-4680 Sign, date and return to the above address. ..,w.r.:,3•a�. az7�i3°-is:4��!...rt�.fe: �+�- ;�+r�.,r ,., s.. ...... .,•.na.:.*+Y+r+®rr. ++L�w. wrr xr... NO � ul SOIL AND SITE EVALUATION REPORT 04VISiOA cat S;AfUry & SWIC0GS in accord with ILHR 83-05, Wis. A&n. Coda FOOLU N-TY St. Croix Attach coniplatj:�Ia plan on papar not lass than 8 112 x 11 inches in <2o. Plan mini inclWd4j, but PARCEL I.D. W1 Ilnnitad to vaniicW and horizontal ralarconce point (BM), dria6c6on and %o of :�lopijj scald or dimensioned, north arrow, and loc"on and di:uanca to nf3x6st road. APPLICANT INFO R 41ATION-PLEASE PRINT ALL INFORMATION REVIEViEl) EY 0A T E A PROPERTY OWNER: PROPERTY LOCATION C,"reg 12QIivka GOVT. LOT NW -_ -_ IA NW V4,S 36 T 28 ji.R 19 PROPERTY OWNER':S WJUNG ADDRESS LOT # BLOCK I E suso. t"OR CShi 8 120 South Pearl 71 1 -- ]oak Ridge Acres CITY, STATE ZP CODE PMONE Nu'tA@Efl @0j0CPxx= 006N NEAREST A04 River Falls, WI 54022 (715)425-8008 Trov I Count y Road MM New Construction Use (XI Residential / Number 01 Dexwms -3- A 00i ion to ejuis 0,Iljjlg Replacement ] Public of commercial describe 2 Code derived CIZuly Ilow 6QO gpd RecominanoW design loading rate5 gAa6 uexno gpo o2 Absorption area icquilm 200'01:d, ftL)'- 1r 000 luencn. ft2 NUximum design loading iaie .7 ptq:d. opwn2 .8 _Vench, 9P1111" RexwunanaW ififill,tatiOn SU(IaCe Clavabon(s) 92.4 q (as referred 10 $+LQ PW wranafk) AC10160nal aesigii l site considerations additional rock will have to be used. Parent maw" FloW plain eleiat;w, d appLcaola NZA_ S 0 E F4.L CONvENWNAL MOUND iN - Gli0i�t%D ME:;6uhE AT-Q z Sultaole lot systeln 1 1 [2 2 Ou 0 S ED U 0 S 2 u u- unsullziolo lot S 21 S CC) u 2S Ou S ou S stem I up� SOIL DESCRIPTION REPORT Boring Giound ellv- 91 it. DPth to L1111bing Ixtut Boring if Ground 96,8611. Depth to 1016no luclo( Horizon Da to In. Dominant Color munsell Nlomi�ls QLi. Sz. Cont. Color Texture SuuCLu10 of. SZ. Sn. Cyr ,swnce 5axuq Roots OL!u ,110J, j - Q-1 4 - MI 1 Q None sil 2 M P1 Mf i as 1 f .5 6 2 14-41 2.5YR 5/0 (2P.5YR 5/8 sicl 1 f sbk mf r as NP _NP 3 41-52 10YR 3Z4 r 1 f I.") sil 1 f sbk mfr as D4P NP 4 52-61 10YR 6/4 — None S gr 0 M sg 7 M1 as T­ .7 e8 5 51 -110 10YR 6Z4 None s gr 0 m scL M1 7 .8 Remarks: Sy2tem DeL21h Nin 7011_j3Qttm_. _Wet ;.-.#--4 & 5 Dry -Qf lsay!2r � 2 VeEL 1 1-20 10YR 3Z2 sit 2 m sbk mfi as 1f .5 6 -2 20-39 -,.None 10YR 4/2 None sil 1 f sbk mfe as 1f _*2 3 3 39-51 10YR 3/4 None sit 1 f sbk mfr as 2 3 4 51-63 10YR 6/4 None s qr 0 M sg .7 5 63-113 10YR 6/4 None s qr _0'M sg Ml 7 *8 ' ;wry �� � �� � . Remarks: '40 V%JT Nwiw—P1,ua.,*o Piwit -2dul Q,J,-Steiner N8Z3.Q Hiqhway-§�_L_River Falls WI 54022 Pnorw: N (715)", 425-5544 WEAW. Ml-ly 25, 1993 '3074 j Gr 011vka SOIL DEO%CRIPTION FIEPORT PROPERTY OMER _9E� �P� PARCEL I.D. I r ) lm7 Depth Dominant Color TexturLl Structure Sz. Sn. Bouraq Roots .............. 6L:0 Boring on FHorizon in. Munsell Qu. SZ. C�OAL Color 1 0-12 1 OYr 2 2 27 7 on 1 f sbk mf r as 1 f 2 .3 3 2 12-51 1 OYR 4/2 None s 51-65 1 OYR 3/4 None s i l f sbk mf r as '+ .2 .3- Ground3 4 65-80 1 OyR 6/4 None s 0 M s Mi as 7 98 f Depth to 5 80-13 1 OYR 6 4 None Boring 4 Ground elev. 95, 37 it. Depth to 411ilting Boring 4 5 clouflj ak%v- 95 IL factor Boring - 6 Ground e1j;v. 96 IL Depth to Remarks: 1 -10 1 OyR 2 2 NoneSiT 1 f 2 0-53 1 OyR 4/2 None sil 1 f sbk mf r as .2 3 :)3-62 1 OYR 3/4 None --------- sil 1 f sbka Mf s 3 4 2-67 10 YR 6/4 -,-.—None S r 0 m sq mi as 8 5 7-130 1 OyR 6/4 None S gr 0 M --- Sg M1 7 Remarks: Mf f 0 - 13 rR 1 ON 2/2 None o if NP NP 2 13-60 1 OyR 2/2 f 2D sicl 1 f sbk mf r as 0 M f i _N 3 60-120 10 M 3 P P)OL J� L6 71 0 0 Tor.) 1 SyS` c � �� c �j '� 1 ►;�,t 17�, � 642, ji / ?,-I# SOIL AND SITE EVALUATION REPORT Dora on al Salary �u�wrx�s in accord wiUi ILHR 83-05,1 Wis. ACM. C00a COUNTY Mach complatio :�Io plan on papar not w4s than a w*20 x i i irochios in:s�zu- Plan rnuw inclwdj. b�ot St. Croix mi finii4od to vorticW and horizontal foioior�co point (6hi), drfjcton and % of ;wopj4 *"1W or PARCEL I.D. A cjjm6ns.janijd, north arrow, and location act" to na;a -:it load. APPLICANT INFO UATIO N-P LEASE PRINT ALL INFORMATION FLEvi EviED 6 Y DnTc PROPERTY OViNER: PROPERTY LOCATiON ea GOVT. LOT NW V-4 NW V4,S 36 T 28 XR 19 W.Xxlv.� _�10E.- 7 _2cLjiyka LOT 4 8L00(.1 SUED. WV42 OR C-SM I PF HT1(OWNER':S IvWUNG ADDRESS 71 Oak Ridge Acres 120 South Pearl CiTY, STATE ZiP CODE PnONE Nulii8EA aofai tir�ST River ]Falls, WI 54022 (715)425-8008 Oounty Road MM - - Troy WMEMMEMEMMOMM-_ - New comuctioti Use JXJ ResiOaniiW / NwMWI 01 D�XO=S _. ,_ C Aar tian ews�ng C visd.ng .� j R�:Plaar:ment C) PU011C Of Ccwlc" aescri� code dafivtv. da;ly 110W F 600 gpd dL-sign loading tal,61 5 tea* 0ArL2 .6 uncna qpWl 2 1) .8 Vencn' -qu 6- 1 000 Vencn' ft2 Ntaximwm je�gn joaaiN talA,., 7 Absorption area iL 4L-ld 1 r 200 ft 191�wmffianjw infiivacn Su(=' efivatiQr)(S) 92.4 (as lelerlea to S W Ptah toaranaf�) Additional daSiqll / site WnSidCM6011S .ddiLjDnal rggk will have to be used. Parent N/A tt MOM S z Swale lot System CC)fivUJCNi�L hiodtto CAQwtv 0 ME "-'uRE ik T - C� L;% 0 E SY0W vq f" rK;4�41wi u z unsullaole 101 system 0 u 2 S Clu [2 S 0 U 2 s Ou 0 S ® u Ds Ou SOIL DESCRIPTION REPORT Boring N Giound 6v. , 91 IL Q�Ptn to LaIlLing 1; clur Boring 0 ti Ground CIL-V. 96.86 it, Depth to limiting lactar Honzofl Depul Dominant Color WOW" Texture suUCLUw C"sw= Boa-c:q R o o i s B�L) 11L1,J, in. lunsell Qu. Sz. Cont. C010r Sz. Sn. ]12 None sil 2 M P1 Mf i as 1 f .5 .6 2 14-41 2.5YR 5Z0 p 5/8 1 sicl 1 f sbk mf r as NP NP 3 41-52 10YR 314 l f 1 sil 1 f sbk mfr as NP NP 4 52-61 10YR 6/4 None S qr 0 M Sg Mi as 4,7 •8 5 51 -110 10YR 614 None s 0 M sq -.7 .8 Remarks: __ _qyatem DepthL__ Min 7Q" 13QLtQW Qf I _#2 YeEy Wet.L #._4 & 5 1 1-20 1 OYR 3 2 None sil 2 m sbk Mf i as 1 f 5 6 2 20-39 10YR 4/2 None sil 1 f sbk mf e as 1 f .2 3 3 39-51 10YR 3Z4 None sil 1 f sbk mf r as 3 4 51-631 10YR 6/4 None s cjr 0 M sg M. as 7 .8 5 63-113 10YR 6/4 None s gr 0' M Sg 7 8 Remarks: Pa N8 C.j I .....,3teiner L12. Highway 62; River Falls ;P WI 54022 "o A 0 ; rA A .. %I. _�S` — 1991 3074 '2Le�LPolivk-a SOIL DESCRIPT10a flEPORT PROPEM MiEfl PARCEL I.D. i Boring 11 3 .16. "4f J, Ground 98 Remarks: -- Lori -- I ? I n 10xrIx 2 2 None 2 0-53 10YR 4/2 None Sil 1 f sbk mf r S as i f .2 3 4 1 OyR 3/4 Na 1 f sbk m sil fr Sil Lif... as 3 Duna' 4 2-67 1 OYR 6/4 None S SE 0 m M-1 S cl as .7 95. 5 7-1301 1 OyR 6/4 None s gr 0 m S9 .7 71 8 Depth to Boring CIO" 95 Dcp� to Remarks: 1 0-13 1 L OYR 2 2 None - if HP NP f 2D sicl 1 f sbk mf r as 2 13-60 1 OYR 2/2 mf 3 60 -12 0, 1 O)OR 212 M3P Sicl -0 ................ . Boring N 1 OyR 2/2 None S i 2 m mf r as if 0-10 sit m sbk mfr as 1 f 2 3 6 2 10-51 10yR 4/2 None ..... . 3 51-63 1 OyR 3 4 None- sit 1 m sbk mfr as 82 .3 Clowid 1 4 63-7C 1 DYR 6/4 --- None s (gr 0 M sg ml as 7 96 IL S 0 m ml 7 5 7o-130 1 OyR 6/4 None DOM 10 A. ------ Ploy 1)lon LoJ/ t �d a� 83 RC�(r�<e n•�t I V arx�c Dr* �uewny �Ob �y /IOUc: O aWG�I � O 92, ya , No �01e�3�4� M(F7�'0 GNr ec�ory ��o�6V �Ca (p � 51zv173 4)ht� r . . I . a , . , ' . i, - -"o 2 v R. 1 S' I . I DC-CUMENT NO RUN 1LOX61 STATE BAR OF VVISCONSIN FORM 2-1982 WARRANTY DEED VOL 101- PAGE 309 Rolling Hills Devel a Wisconsin corporation, aka Rollin llqs Develo ments Incorporatedaka Rollin Hills Deyeloyaea Corp cony-ays and wa.,rants to Gre oiri,i( L.--Polivka and LuVnn--J—. Polivkat.--husband and wife as survivorshi marital ry ertv THIS SPACE RESERVED FOR FIECCIRDiNG ,ATA REGISTER'S OFFICE ST. CROIX CO., M Rec'd far Record J U N 3 1993 at M Regjster of Deeds RETURN TO R j!r cz t FAn 124 S. ST- Ou 22- 7 x Ql�"02 � 1 the following described real estate in crniCounty, L' State of Wisconsin: Tax Parcel No. Lot 71, Oak Ridge Acres in the Town of Troy and art of Lot 70 of the Plat of Oak Ridge Acres, located in Section 36, T28N, R19W, Town of Troy, described as follows: Beginning at the SE corner of said Lot 70; thence NO0 07'E 9.00' along the East line of said Lot 70; thence Northwesterly 23-56 ' 0 on 'a 15.00" radius curve 1 ; consave Southwesterly whose chord bears N44 53W 21-21thenceI N89 53'W 120-00'; thence Southwesterly 23.59 on a 15radius curve copcave Southeasterly whose chord bears S45 07'W 21.21"; the8ce SO'07'W 9.00' along the West line of said Lot 70; thence S89 53'E 150.00' to the point of beginning. This is not homestead property. (is) (is not) Exception to Warranties: easements, restrictions, and rights -of -way of record, if any. Dated this 27th day of May '19-9-3 fRO L L G LLS D V ITT, INC. (SEAL) -(SEAL) -Richard N. Fox, President (SEAL) SEAL) J. Frances Fax, Secretary_ AUTHENTICATION chard N. Fox Signatur ig nal ur chard N. Fox J F ces Fox )aut ticated this '19 Lauri J. Gaylord 0 TITLE- MEMBER STATE BAR OF VVISC NSIN (It not, authorized by § 706,06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY G-aV-10rd. AttnrnPv River Falls_, W1 54022 (Signatures may be authenticated or acknowledged Both are n o t necessary -) ACKNOWLEDGMENT STATE OF WISCONSIN SS. County. Personally came before me this cay of * 19— the above named to me known to be the person who executed the foregoing instrument and acknowledge the same. Notary Public-- Counly, Wis. My Commission is permanent. (if not, stale expiration date-- .19--) 'Names of person5 signing inany capac-ly shou:0 be typea or printed bejoyv their signatures STATE BAR OF WiSCONSIN WARRANTY DEED Fenn No 2 — 1982 bf74f P41 P' UW T 11 Neko Tax Forms, P.Q.130A 102208, Gr000 Bay, YA 54301.0208 m y �T4 N< *rV 7//3� 103 /-Z-:t AIkjAO