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042-1098-50-100 (2)
St. Croix County Planning and Zoning Tuesday, Ju/y 31, 2007ut /0:43:09AM 'Page ° r Detail Sanitary Information Computer #: 042-1098-50-100 Sub/Plat: NA Section: 35 Parcel #: 35.29.18.544A Lot: 2 TNIRNG: T29N R18W Municipality: Warren, Town of CSM: Vol. 09 Pg. 2578 114 114: NE 114 NW 1/4 __._. _ ._.._... Owner: Warnken, Steven 1349 70th Ave. Roberts, WI 54023 State Permit: 199965 Issued: 12/21/1993 POINTS Dispersal: Non -Pressurized In -ground Permit: Replacement County Permit: 0 Installed: 12/09/1994 POINTS Detail: Trench - Seepage Bedrooms: 4 Wl Fund: POINTS Pretreatment: NA N otes Issuerllns ector As Built Mary Jenkins Yes Jim Thompson °_ Off, Yes Maintenance Scheduled Pub Date Pumped 12/9/1997 4/18/2005 4/ 18/2008 Plumber Other Re uirements Schumaker, William 1 st Notification 2nd Notification 3rd Notification Additional Notes Money awed file in 1993 - was in 1994 files due to installation $0.00 date. Bob Ulbricht did a 1992 soil report that indicated a mound system was needed for this house, tested area west of existing drywell S T C - 104 AS BUILT SANITARY SYSTEM REPORT ADDRESS 11?A0 SUBDIVISION cSM# LOT V SECTION T N-R W, Town of_ ST. CROIX COUNTY, WISCONSIN F'rovi-de setback, and elevation Information on reverse of tills form. FIT-Ovide 2 dimensions to center of- so ptic Lank m(-InhcAe covel_- 13ENCH1' ARK: ALTERNATE BM: SEPTIC TANK PUMP CHAMBER HOLDING TANK INFORMATION Manufacturer: 471 e 57 Liquid Capacity: 4,�7e, Setback from: We 11 11 o u S e Vic) nt-1-)Pr Pump: Manufacturer Model Size Float separation- 0- C:;-2 Gallons/cycle:- Alar-m Location widtli: Length SOIL ABSORPTION SYSTEM Number of trenches Distance & Direction to nearest prop. line-, �Q ' ���,� �JL Setback from: welj:/e16> House Other ELEVATIONS Building Sewer ST Inlet, ST outlet PC inlet PC bottom Pump Off Header/Manifold_ Bottom of system Existing Grade Final grade DATE 01' INSTALLATION : PLUfIBER ON JOB: LICENSE NUMBEIR: I NS PECTOR: 3 / 9 -3 : j t- *2918WfNE �A7sTnW1� rt VW F-K%I�y5, *—PRI UT I 9N1,MF S Y ST E M • Labor and Human Relations INSPECTION REPORT Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) .Is Permit Holder's Name: 0 City E] Village IR Town of ARNKEN,S VEN WARR1RH CST BM Elev.:'Insp. BM Elev.: BM Description: L TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic Dosi ng Aeration-- -- Holdl., TANK SETBACK INFORMATION TAN KTO P / L WELL B LDG. Vent to Air Intake ROAD Septic NA Dosing > NA Aeration---'---"-- _mop, — ------ NA L PUIVIPINFORMATION Manufacturer Model Number ?P� ZZ 7�6"G PI%01 Friction System - TDH Ft TDH Lift LQss_ Head ?�A I Forcemain Length Dia. c2- Dist. ToWell->.,750" SOIL ABSORPTION SYSTEM BED/TRENCH Width J Length No, Of Trenches DIMENSIONS L.- 1 90 County: ST, CROIX Sanitary Permit No--. 199965--- State Plan ID No.: Parcel Tax No.: 2 Q-42-1298-50-1 00 A9 3 0 0 3 6 8 STATION BS HI �S ELEV. Benchmark Bldg. Sewer I-P St/Inlet 7 9el y� St IX Outlet C�S' Dt Inlet 57 Dt Bottom A01 Header—e&fi4_ Dist. Pipe Bot. System Final Grade /10 zo PIT No, Of Pits DIMENSIONS nside Dia a ct u re r: SYSTEM TO P / L BLDG WELL LAKE 1 STREAM LtIA; k SETBACK CHAMBE7� modZTT*w4ter�. INFORMATION Typeof I �Wf k7e14;1_' OR U,,wlr -L.-SYSteM: X, 1.30 L DISTRIBUTION SYSTEM Liqupd Depth Header / Manlfo)d Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air In -take, gth Di L � Dia ena. Spacin g /C:12 v L,ength/ a SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Only Depth Over Depth Over 0, xx Depth Of .,A�eeclecl/Sodded xx u ched to/ Trench Center %jrU Trench Edges c�f - 36 Topsoil E] Yes E] No E] Yes n No COMMENTS: (include code discrepancies, persons present, etc. ��Ac LOCATION: WARRENe35o29,18WONEINW170TH AVE. Plan revision required? El Yes Na 7 Use other side for additional information. /0: to) I, A04 SBD-6710 (R 05/91) Date Inspector's Signaturl Cert No nu,c,-4 1 a ADDITIONAL COMMENTS AND SKETCH , 4 , uoqlptx�v � I SANITARY PERMIT APPLICATION T( 'D ILHR In accord with IL`HR 83.05, Wis. Adm. Code COUN-1 := a ■17 1CLAffT=%kLM STATE SANITARY PERMIT # —Attach complete plans (to the county copy only) for the system, on paper not less than 81/2x 11 inches in size. ❑ Check if revisio to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER I. APPLICANT INFORMATION — PLEASE PRINT ALL INFORMATION. PROPERTY OWNER Ct.• PROPERTY LOCATION N, R Z'Z: E (or 114,v4d 1/42S 03 PROPERTY {OWNER'S MAILING ADDRESS LOT # BLOCK # ;!0 „rll j4loe , ofl 91;Z I CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER :?.7 .,e s9 72, 22Z ,L� 4 CITY NEAREST ROAD (Check one ;7e 11. TYPE OF BUILDING: State Owned VILLAGE: TQUN OE: MEMO" I %.f r-I&A/ E]Public Ell or 2 Fam. Dwelling-# of bedrooms PARCEL TAX NUMBER(S) 111111. BUILDING USE: If building type is public, check all, that apply) 1 El Apt/Condo 2 0 Assembly Hall 6 0 Medical Facility/Nursing Home 10 ❑+Outdoor Recreational Facility 3 0 Campground 7 El Merchandise: Sales/Repairs 11 El Restaurant/Bar/Dining 4 El Church/School 8 1:1 Mobile Home Park 12 0 Service Station/Car Wash 5 0 Hotel/Motel 9 El Office/Factory 13 El Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1.E1 New 2. 'N' Replacement 3. El Replacement of System System Tank Only B) A Sanitary Permit was previously issued. Permit # V. TYPE OF SYSTEM: (Check only one) Non -Pressurized Distribution 11 El Seepage Bed 12 RL Seepage Trench 13 F] Seepage Pit 14 El System -in -Fill Pressurized Distribution 21 El Mound 22 El In -Ground Pressure 4. ❑Reconnection of Existing System , Date Issued Experimental 30 ❑Specify Type 5, [:] Repair of an Existing System Other 41 ❑Holding Tank 42 ❑Pit Privy 43 ❑Vault Privy V1. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA REQUIRED (sq. ft.) 3. ABSORP. AREA PROPOSED (sq. ft.) 4. LOADING RATE (Gals/day/sq. ft.) 5. PERC. RATE 6. (Min./inch) fS% SYSTEM ELEV. 7. FINAL GRADE _F-L W 4ATION vy, too,"Op /02eo0 Feet Feet V111. TANK INFORMATION CAPACITY in gallons New Existing Total Gallons # of Tanks Manufacturer's Name Prefab. Concrete Site Con- Steel Fiber- glass Plastic xper. App. Tanks Tanks strutted Septic or Holding Tank 416) FX F1 I F-1 1 0 1:1 0 _Tank Lift Pump Tank/Siphon Chamber 7 1!511 El Lj VIII. 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) MP PRSW No.. Business Phone Number: _Tckk All le, Plumber's Address (Street, City, State, Zip Code): IX. COUNTY/DEPARTMENT USE ONLY E] Disapproved Sanitary Permit Fee (includes Groundwater Date I ued/ issuing Agent Signature issuing Agent Signature MWARI RApproved F-1 owner Given initial 4�2^ Surcharge Fee) 1 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 valid for two (2) years. r 2. Your sanitary permit may be renewed before the expiration date, and at the tirne of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit roust be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer./Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. onsite sewage systems must be properly maintained. The septic tank(s) must be pump6d by -a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. ll. Type of building being served. Check only one and complete ## of bedrooms if 1 or 2 Family Dwelling. Ill. 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 B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use only. X. County/Department Use only. Complete plans and specifications not smaller than 8'/ x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tanks), septic tank(s) or other treatment tanks; building sewers; wells; water mains, water service, streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. e GROUNDWATER SURCHAR E 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies coIected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. S B D-6398 (R. 11/88) T, le� 0 w sY r� Y`�� ba 0 7-4 vj PAGE - OF "Li C.I. VEfsJT PIPE 2.5' FROM- 000R, WlNJCGW OR FRESH AIR INTAKE 15" /"i I �' APFP.D',/Er- J01N71 W/ C. 1, Pr P F. c X7, I m c I ki PUMP CHAMBER CROSS SECT10KI AKJD SPECIFICATIOUS ..,,�VEIQT CAP WEATHER PROOF APPROVED LOC-KiNCo JUUCTIOKI BOX MXKIHOLE: COVER CFRA DE � Ie"MIS. CONDUIT _xl xr PROVIDE -- AIRTIGHT SEAL A APPROVED -iolNJT-co w/c.l. pipE ALARM C)N�7o SOLID SOIL. C) Ki c OFF A C0�4CRETIZ 5�OCK, RISER EXIT PERLMI-MEE) GlkJL� IF TAUK MAlJUFAC7LJRZR HAS SUCH APPRCVAL 5 PC C IF I CATIOUS SEPTIC ANID J)O5E- TAKIKS MAQUFACTLJ;LF-R' MUMBER OF DOSES: P E R DAd TA�K "'JIZC GALLOkJ S DOSE VOLUME ALARM MAWUFACTURrLR.6 ��� ��3Y � �'•:��IMCLUDiMG 15ACKFL-OW: GALLONS tw A60 MODF-L klUMBER: CAPACITIES: A= IMC-HES ORIW GALLOWS • SWITCH TYPE; r. >/ c- B IMC.HES OR 3i' - GA'-LQKJ5 PUMP MAMUFACTURER: IIJCIHES OR Zl!LZ2GAE-L0Q5 MODEL DUMBER. D INIC HES OR GALLONS 5 w i -r C H -r y p E: A;7 e 4t:]Q MOTE: PUMP A M D ALARM ARE TO BL PUMP DISCHARGE KATE G PtA IN5TALLF.0 0IQ SEPARATE CIRCUITS VERTICAL DIFFEFEMU Bt�YWzcu PUMP OFF AMD D15TRtBUTIOM PIPE., FEET + MIUIMUM NJETWORK SUPPLY PRESSURE fbabbilegba FEET + T FEET OF FORCE MAN X Fx10 0 FT.FRICTIOU FACTOR FEET Ambal �T t TOTAL 0�QkMIC- HEAD FEET 1UTERMAL DIMEWSMKli OF TAUK: LEKIGTH ;WIDTH .,;LIQUID DEPTH LZ�6 0- 7 5 1 G Q E D: LICF-QSE WUMBER1 IDATE;/-/e 80 160 240 FLOW PER MINUTE TOTAL DYNAMIC HEAD/FLOW PER MINUTE ETFLUFMT AND DEWATERMC CAPACITY HEAD UNFTStMIN FEET METERS GAL LTRS 5 1.52 56 212 10 3.05 46 174 15 4.57 35 133 20 6.10 15 57 Lode Valve 23-75' - 1 12 - 11112 NPT 2 35/16 CONSULT FACTORY FOR SPECIAL APPLICATIONS * Electrical alternators,, for duplex systems, are available e Mercury float switches are available for controlling and supplied with an alarm. single and three phase systems. * Mechanical alternators, for duplex systems, are avail- * Double piggyback mercury float switches are available able with or without alarm switches. for variable level long cycle controls. Standard All Models - Weight 33 lbs. - 1/2HP 97 Saks control Selec*m 1140d01 volts-ft Mode Amps Sim R!!X Dupkx M97 115 1 Auto 12.0 1 or 1 &7 N97 115 1 Non 12-0 2or2 & 6 3cK4&5 097 230 1 Auto 6.0 1 or 1 & 7 E97 230 1 NM 6-0 2or2 & 6 3or4&5 SELECTION GUIDE 1. Integral float operated 2 pole nuxAwical switch, no external control required_ 2. Single piggyback wide angle mercury float switch or double piggyback mercury float switch- Refer to FL010477. 3. 164echanical alternator 1G-0072 or 10-0075- 4. See FL40712 for correct model of Ekwtrical Alternator, -E-Pak-. 5. Mercury sensor float switch 1G-0225 used as 3 control activator, specify duplex (3) or (4) float system. 6- Four (4) hole "i -Pak-. junction box. for watertight connection or wired -in simplex or 2 pump operation. 10-=. 7- Two (2) hole "J-Pak", for watertight connection or splice, 1 G-0003, CAUTION For information on additional Zoeller products refer to catalog on Combination All installation of controls, protecfion devices and wiring should be done by a Starter. FM(614-. Piggyback Mercury float Switches. FMO477: Electrical Alternator. qualified licensed efectriciam All electrical and safety codes should be followed FM-0486; Mechanic -at Alternator. FM0495: Alarm Package, FMO513-. and Sump/- including the most recent National Electric Code (NEC) and the Occupational Sewage Basins. FMO487- Safely and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. 3280 Old Millers Lane Manufacturers of ... o P. 0. Box 16347 -P Louisville, Kentucky 402161 rffA 'w P. (502) 778-2731e FAX (502) 774-3624 - 19,77 Al"'U'g '371*Cz vvlzog�ul IZJ11 I L/tIpal u I lul it V1 if luu:�uy' bUIL ANU SITE EVALUATION REPORT L-�'bor and Human Relations Page of 7 Division of Safety & Buildings in actor 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less th x 11 inches in n must include, but roe O/N not limited to vertical and horizontal referent tr,A-'(BM), trand' pe, scale or PARCEL I.D. # dimensioned, north arrow, and location and ranee' I ttQ',nea 0 11, -00 APPLICANT INFORMATION -PLEASE INT A F TION REVIEWED BY DATE PROPERTY OWNER: PERTY LOCATION �IzF- eeq 4,4gF r VT. LOT IiIZ- 1/4 AA0141S 3.5 T 2-7 N,R E PROPERTY OWNER'-� AILING ADDRESS �0 # BLOCK # SUBD. NAME OR CSM # 1454� 5'� 2 9 7 1 � 4 CU _ CITY, STATE 21P CODE PH UM E E]CITY []VILLAGE OTOWN NEAREST130AD 7-5 7WP New Construction Use X1 Residential 1 Number of bedrooms Addition to existing building J)Q Replacement Public or commercial describe Code derived daily flow -.01 gpd Recommended design loading rate bed, gpd/ft2 5 trench, gpd/ft2 ..-41 e1l Absorption arlea required .-"---bed, ft2 LO trench, ft2 lViaximum design loading rate bed, gpd/ft2 -5 _ P�9 -_ I trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Se�5 eC K, Additional design / site considerations�, Parent material 565 6;?F Y11A.,71*46-6 7- J Flood plain elevation, if applicable �f± ft S = Suitable for system CONVENTIONAL MOUND IN -GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for system El S EAU QS Elu OS EIIJ CR S El U ED S El U El S El U Now SOIL DESCRIPTION REPORT Ground elev. 19 ft. Depth to limiting fact„ > W. Boring # Ground elev. Depth to limiting factor Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Bolxday Roots GPD/ft2 Bed Tmrch fj L-00) - Y14e 313 41,q 4,i sd,� �,f�P cS 3-F- . 5- 4 V 13 -7 5 Y,e 51,6 s� o �, �,� ��,� Q S — . y -.� 6 - yo Isyle, 51P 0, 7ri 44,.2 .-- — , s . � /7%0e/-� G .500 7/-f 4 7 1're (0" 104:'A11V tip % � r9' -�.� Remarks: yle 31 R 21, 5 21 5,kt e 57 3 � 4/0 e, s�P 4y.F 2 � l of . � . S 70 7^ 5 r) 1 rem Remarks: ST Name: —Please Print HOMESITE SEPTIC PLUMBING CO, Phone: 3 21cp -5 655 ONEIL M., HUDSONf WIS, W16 ddress: ROBERT ULBRIGHT WIS. MASTR PLIUM. .2-0 '_1C_ - NO - 3307WAS, signature: MINN, WSTALLER & DEStGNER X, NO, 00663 Date: CST Number: PROPERTY OWNER SOIL DESCRIPTION REPORT PARCEL I.D. # 5- 7 Pagr. Ui y__ Boring # Ground elev. yE,'�7 ft. Depth to limiting factor > Boring # Ground elev. ft. Depth to limiting factor Ground elev. ft. Depth to limiting factor Ground elev. ft. Deptn to limiting factor Horizon Depth in. Dominant Color M..unsell Mottles Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Bounclary Roots., G P D/ft2 Bed 'ITrer& f� �- 1-�0 /�%/t' f1/f� oyliy 2 If 1 -5 6 k' -� 7,5 Yoe Mec 0., 2yf 'e7 5 -1'6;,u /�fil��' �r /P Tom" �F � ,j TIP e-Lr VAL pd- - 76-16-� - � s � rat- � ,P ,• Remarks: Remarks: Remarks: Remarks: SBD-8330(R.05/92) 130 740 lo RlAf 43 Off-` 0 Wei( -3 'y 94> -3 \S Xq er if This test sltg APPROVED for a conventlonBl septic sYstom sysTE-� �/�lrfiTio.�s �`�� �Eti� ys 3 0 1"'Ie;0 7-le ���T ,ov-yj� sT�rio,� is -ell 20 134 6 1rh 04E7 �O/ '715 HOMESITE SEPTIC PLUMBING CO. 855 O'NEIL RD., HUDSON, WIS. WIS ROBERTULBRIGHT WIS. MASTER PLUMBER UC. NO, '3307 M,P,R,S, MtNN. WSTALLEA & DESIGNER LIC, NO, OM 7,:: C C\jr CERTIFIED SURVEY MAP rn ' ` `�. �,-'° ',Located in Fart of the NWT of the NE a and in art of the NEB of the NWT f cc C. F o c� '� C' '. '�" �-` `n `r'Section 35, T29N, R18W, Town of Warren, St. Croix CountJ�,., .-,®s4r,iWisconsin. LL w � Cr ��� 1c , i ., , zr -;J� � OWNER Dorwe s Farms Inc.CC David Cowles CL Ed .. �s- '' � �• ' c UNPLATTED LANDS 1387 - 70th Ave .w Roberts, WI 54023 NJ Corner of 70TH AVENUE Section 35. �f North line of the NWi North line of the NEi N89033' 1211E N89033' 12 "E 343.931 M N89034' 42 "E 295 . 19' N8903414211E 2301.76' co `p 2321.30' N89°33'12"E 344.03' `''' r, N89°34'42"E 295.08' FA/ NW Corner of _ NE Corner of - Section 35. CD o Section 35. . o o m - M o coo - LEGEND 2 ,� iron pipe found. Ln s v Mf °�' 1" 4 iron pipe set, weighing -0 LOT 2 M Z1 0 0 �� _ HOUSE sHED �I 1.68 lbs./lin. ft. <I Go o �41 C� o ,; Cap - fenceline -4 a Qi BARN SHED LO Wi W1 :3: M ❑ GARAGE W Ni - building setback line, 1001. o 6 well 04; - Lot Areas L G 7 r� I tli Q I Ln L H�� p 5.80 Acres '� SCALE IN FEET v, a CD 252,448 Sq. Ft. Including R/W CD SHE© 0 0 50 100 200 SHED 5.31 Acres �' � 231,357 5q. Ft. Excluding RW / L O � m ..G CO m -w Z S89034'42"W 639.12' UNPLATTED LANDS This instrument drafted by Brett Bud . Job No. 92-47. SEPTIC TANK MAINTENANCE AGREEHENT st, era County OWNER BUYER Fire ilumb er .� � ROUTE / B 0 X N UMB r' It /X NOWUMMOM 2__ �?_ ZIP' CITY/STATE J�L F T N9 Section PROPERTY LOCATION: "e/�k t Town of St. Croix Countyt Subdivision Lot number SWW enance of vour septic system could result - in Improper use and maint 0 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's'ed' 's'ept'ic tank pumper _. What you put into the system can a ect the function ot tha-13eptic tank as a treat- ment - stage in the waste disposal system. St. Croix County residents"m be eligible to recieve a grant for a maximum of 60% of the coat .of replacement of a failing system, whi-c-h was in operation prior to-JulY 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of a__0 ll new agm ree to keep their systeproperly ' maintained* The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or..a licensed pumper veri- fying that C1) the on -site wastewater disposal system is in proper operating condition and .(2).after inspection and pumping (if nec- essary), 11-he 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. 1/WE, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as .set by the Wisconsin Depart- ment 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. SIGNED DATE 11,2 Z4� st. Croix County Zoning office 911 4th St. Hudson, WI 54016 386-4680 Sign, date and return to the above address* �J 0 S T C -- loo This application form is to be completed in full and signed y inadequacies the owner(s) of the property being developed. An 9 will only result in delays of the permit issuance. Should this development be intended for resale b owner contr his house) , then a second form should be retained � actor , (spec the property is sold and submitted d and completed when to this ,office with the appropriate deed recording. -�w�--------------------------------------------------ter---------.---war------ owner of �- .�_ property ..� � ,.� te-L%,.r Location of property.�1/4 1/4 , Section 3 5-` T a_ - N R r'' � W Township A4.7,9 L � Mailing address Address of site C Subdivision name Lot no. Other homes on property? yes -A'/ No Previous owner of property Total size of parcel Date parcel was created Are all corners and lot lines identifiable? ,' yes No Is this property being developed for (spec house)? Yes 'Y No Volume," � = and Page Number � 4 as recorded with of Deeds. -----� h the Register ----w"'----rr------- � -.0 r - - - - - - - ------------r-----------------.--------- INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER & THE SEAL OF THE REGISTER OF DEEDS, In addition a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Ma shall also be required. P PROPERTY OWNER. CERTIFICATION I(we) certify that all statements on this form are true to the best of my (our) knowledge that I the property described in (we) am (are) the owner(s)of this information form b Y Virtue of warranty Deeds deed recorded in ..:��� a the office of ' the County Register of as own the Document No. �_ proposed site .�:,� -r, u- and that I (we) presently the sewage g disposal system I for obtained the construction an easement of or (we) to run �w he above described property, for recorded said in the office of system, and the same has been duly County Register of deeds as Document No. C:��Z Zlf 5ignatur _Z f apgscant Co -applicant pplicant 112 Dat o ig ature Date of Si nature g DOCUMENT NO. WARRANTY DOElD THIS SPAct JR169Xr90 foal attco+eb'tta DATA STATE OF WISCONSIN - FORM 2 506875 'V 'OL'1040PAGE 06 S'TC �. 'I'his inder.tull•e Made this.___ .,.______.�_ .day October A. D 1 '93 bets+-cn�..._Dorwes� Farms., Inc.._ .._ .._...._...__._.., _. 'Q'� Rod l Corporation duly organized and existing under and by _ i OCT ' virtue of the laws of the State of Wisconsin located at Roberts •• �� Wisconsin, party of the first part; and _Steven J . Wa_rnken and Judith M ._ 12 00 P • Warnken, husband and wife as suryiyorship_marital firoperty,, H ne is part_ i e s� of the second part. Wltnessrtn, That the said party of the first part, for and in considerationof the sum of —valuable consideration - _.r.to it ppid by the said part-.ie-& __ of the second part, the receipt whereof is hereby confessed and acknowledged, has given, granted, bargained, sold, remised, released, aliened, convry►ed and con firmed, and by these presents does give, grant, bargain, sell, remise, alien, convey, and corfirm unto; the said part._ie-S.________._ of the second Part,---.- the I ,....._._.__._._ heirs and assigns forever, the following described real estate, situated in the County of---. w --St. Croix State of Wisconsin, to -wit: Part of NW 1/4 of NE 1,/4 and Part of NE 1/4 of NW 1/4 of Section 35, Township 29 North, Range 18 West, St. Croix County, Wisconsin described as follows: Lot 2 of Certified Survey Map filed December 23, 1992 in Volume 9, Page 2578, as Documnet Number 493239. El (Ir NI9Qr.88ARY, CONTINVE DWORIMON ON REVERIIA SIDE) Together with all and singular the hereditaments and appurtenances thereunto belonging or in any wise appertaining; and all the estate, right, title, interest, claim or demand whatsoever, of the said party of the first part, either in law or equity, either in possession of expectancy of, in and to the above bargained premises, and their here.:itaments and appurtenances. To have and to hold the said premises as above described with the hereditaments and appurtenances, unto the said part. - of the second part, and tom ._lr ._..._... __._.. heirs and assigns FOREVER. And the wild Dorwe s Farms, Inc., party of the first part, for itself and its successors, does covenant, grant, bargain and agree to and with the said part_l-es of the second part, ,__ thi. .., heirs and assigns, that at the time of the ensealing and delivery of these presents it is well seized of the premises above described, as of it good, sure, perfect, absolute and indefeasible estate of inheritance im the taw, in fee simple, and that the same are free and clear from all encumbrances whatever,-_.___.aItLi...-Ca-eMP.Lt,=,P.� and that the above bargained premises in the quiet and peaceable possession of the said part ...... ieLa of the second part, their _ heirs, and assigns, against all and every person or persons lawfully claiming the whole or any part thereof, it will forever WARRANT and DEFEND. In Witness Whereof, the said _.._ Dorw_es Farms_Ine:_.e..__ party of the first part, has caused these presents to be signed -by ... .-.Qs .u. i _ Q ,ice` � D► --_s3n � �'Crat aX:y --, ._....Pre its President, and countersigned by__-__.M.... _ __.._.._.w.w___._.__. ___.._..._.---_.__, its Secretary, at .Hudson _ - ___....., Wisconsin, and its corporate seal to be hereunto affixed, this day of._ October __�_... ___w_.._._._... A. D., 14..9-3 --. SIGNED AND SEALED IN PREBMNCR or DORWES FARMS INC. _._-- -- -----------------! .»_---___... Corpamt• Name �a 4 President COUNTERSIGNED: David Cowles STATE OF WISCONSIN ss• 5t .. Croix County, Personally came before me, this__._.-...___ fith day of..._.A. D, ...._- ......... David --Cowles ..__...-_. ., President, and...___5 eta of the above named Corporation, to me known to be the persons who ex cured dregojgg.. nstrutnent, and to me known to be such President and Secretary of said Corporation, and acknowledged that they exec �he'foregving,Ynstrum t as u officers as the deed of said Corporation, by its authority, 14 THIS INSTRUMENT WAS DRAFTED BY NOTARY Notary* PI bUc, ~. t_- QrOi_}Kc u Wit. SEAL STEPHEN J. DUNLAP hty con ivniWon (expires it -- f - ---- _-.---. HudsQn, 'G isconsin '_ - (Section 59.31 (1) of the Wisconsin Statutes provides that all instruments to be r;tWF ed shall have 01aM y printed or typewritten thereat ' the names of the ;cantors, grantees, witnesses and notary. Section 19.513 similarly requires that ,the name aI the p ssan wbo. or Scmere. mental agency which, drafted such insbument, sball be granted, typewritten, stamO4 a wrlt't'm thereon in a 1e;i1We eeanner.) j 6GTE OF WIt3C"ONSIr W3geonals trtal Blank Co. Irte. WARRAIPPY DEM13 -- 1'IT Corporatton FORM No. ! Mil.taEee, Was, t„r. 9 September 9, 1992 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET 9 HUDSON, W1 54016 (715) 386-4680 An onsite soil investigation of the Dorwes Farm Inc. property, located in the NE1/4 of the NW1/4, Sec.35, T29N/ R18W, Town of Warren, St. Croix County, WI,, has been conducted with the assistance of Bob Ulbricht, CST# 24820 This onsite revealed suitable soil for onsite sewage disposal to a depth of 4811 while meeting the requirements of the A + 411 rule. This site should be suitable for a mound septic system having 1211 of sand fill or an At -Grade system. Should you have any questions, please feel free to contact this office. Sincqrely, mee;ls K. Thomps n Assistant Zoning AUinistrator -0 cc a file ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET 9 HUDSON, WI 54016 (715) 386-4680 September 9, 1992 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An onsite soil investigation of the Dorwes Farm Inc. property, located in the NE1/4 of the NW1/4, Sec.35, T29N, R18W, Town of Warren, St. Croix County, WI., has been conducted with the assistance of Bob Ulbricht, CST# 24820 This onsite revealed suitable soil for onsite sewage disposal to a depth of 4811 while meeting the requirements of the A + 411 rule. This site should be suitable for a mound septic system having 1211 of sand fill or an At -Grade system. Should you have any questions, please feel free to contact this office. ;s inceI rely, c re 2 me K4, Thomps n Assistant Zoning ACIpjmistrator cc: file Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of La6or and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code [COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but PARCEL I.D. # not limited towertical and horizontal reference point (BM), direction and % of slope, scale or dimensioned, north arrow, and location and distance to nearest road. N REVIEWED BY DATE APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION 4 PROPERTY OWNER: PROPERTY LOCATION Cy GOVT. LOT 1/4 1/4,S T INIR E (or) W PROPERTY P EE RTY OWNER -"S- MAILING Al) DRESS LOT # BLOCK# SUBD. NAME OR CSM # CITY, STATE ZIP CODE PHONE NUMBER []CITY OVILLAGE ZFOWN NEAREST ROAD � 7 New Construction Use residential / Number of bedrooms Addition to existing building 11-1114lacement I Public or commercial describe Code derived daily flow gpd Recommended design loading rate —bed, gpd/ft2 trench, gpd/ft2 Absorption area required bed, ft2 trench, ft2 Maximum design loading rate bed, gpd/ft' trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations Parent material 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 11� D-S El U I D-9 El U El' S El U El S E1U 0 S Ground elev. ft. Depth to limiting factor Boring # Ground elev. ft. Depth to limiting factor SOIL DESCRIPTION REPORT Horizon Depth i n. Dominant Color Munsell Mottles Chu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ft Bed Tmrch Remarks: Remarks: CST CST Name -.—Please Print Phone: ST N Address: ig Signature: Date. CST Number. PROPERTY OWNER SOIL DESCRIPTION REPORT Page r of., PARCEL I.D. # Boring # Ground elev. ft. Depth to limiting factor Boring # Ground elev. ft. Depth to limiting factor Boring # Ground elev. ft. Depth to limiting factor Boring # Ground elev. ft. Depth to limiting factor Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Root G P D/ft? Bed. r- Tmr& Remarks: Remarks: Remarks: Remarks: SBD-8330(R.05/92) Wisconsie r nt o Industry, ..abor and d Human Relations SOIL AND SiTE EVALUATION REPORT Page of -�' ,b"vvision of Safety & BuildiNs in accord with I LHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (13M), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road, z�7/v APPLICANT INFORMATION --PLEASE PRINT ALL INFORMATION Zlzzflrl"710,0c'� REVIEWED BY DATE PROPERTY OWNER: W$?wE-!; F:APM PROPERTY LOCATION 70 of 14C o, GOVT. LOT N,6-- 1/4 A-,)W 1/4,S 35 T 2- 7 N,R E (o I INj PROPERTY OWNER':S MAILING ADDRESS LOT BLOCK # I SUBD. NAME OR CSM # 11W7- d1c 2 3 7 3 7 .5 /f Che.�r CITY, STATE ZIP CODE PHONE NUMBER OCITY []VILLAGE 2OWN NEAREST)30AD 7��- Ji�?Cf�p 170 1T^ 00vjL4Z_ P06 =on Use Residential / Number of bedrooms Addition to existing building Replacement Public or commercial describe IV 511 IV dailyy flow gpd Recommended design loading rate bed, gpd/ft2 trench, gpd/ft2 Absorption area required bed, ft2 trench, ft2 Maximum design loading rate bed, gpd/ft2 trench, gpd/ft2 Recommended infiltration surface elevation(s) P.5 ft (as referred to site plan benchmarl� Additional design site coft*Qrations 0,0 Z_K 0�.4 e 000-90 &ouP 5-Y S 7`, r .0 WCTr 5147-Z, 51;� 7- Parent material 73'Flood plain elevation, if applicable 4L4= ft S = Suitable for system CONVENTIONAL MOUND IN -GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for system I El S 10 u MS Elu [Is IM U M S El U I C] S a U 1- 1:1 S OU Ground elev. �y i'1� ft. Depth to limiting factor Boring # .X ............... Ground elev. 73 ft. Depth to limiting factor Q Horizon Depth in. Dominant Color Munsell SOIL DESCRIPTION Mottles Qu. Sz. Cont. Color REPORT Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ft B e d Trend 14 y,.e 4ZZ2 t yb e 2. (7 B io-31 0, 21-f v� . � , G hl I've- 2. 3/-sy 7 .5 y�C 5/G oE-2-2 s� i, f sd� �P ��, Q.i � '. se2 I .0( � . 7 s' yl 51X 5cl u f 5 � vF,' ,_- �- , z � 3 Remarks: �`• TE �l� f TS � -� y " �'v/�" - fI%/ -� �3�4 ��hc� P. TS 0—d7 loyef j//z YW Yl�ee5- 5./ Z,f, sh/� JAe �S' �Li34r�) s Z� 2L)+ , ,S , � S ;7 34�9 INV 75 Y�e 516 +1 s�,� � �� � ,� � . y ° . s c " y� s� � Sy,� sip s ?;�-C yhh� ��� _- � � . s 51 vfl fhl oo Remarks: T Name -.—Please Print C,'NFIL RD., 1-10SON, WIS. 54016 Phone: 7j�5 = 3 � �' �� �s_` Aaaress, ,'%qs. W'77E.Fl PLUMBER LIC. NO, 3307 M.P.R.S. Signature'. �14. IRfSTALLF-H & DESIGNER NO. 00663 Date: CST Number: ht4 . PROPERTY OWNER PARCEL I.D. # SOIL DESCRIPTION REPORT Page 2, Qf v Boring # -g-- M'. Ground elev. e7-5,36 ft. Depth to limiting factor p - -!Y-i- Ground elev. ft. Depth to limiting factor Ground elev. f t. Depth to limiting factor Boring Ground elev. ft. - Depth to limiting factor Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots', GPD/ft2 B e d Trends /� o /3 �oY,� y 2-- � �, , s ,e �e S 2f • 5 , • p 31 lo �w -- rM 1(2� 13, 31- yo ;7,5 Y� Y(; ------- she d VA � w � - y s z1 7. 5 2- �7,k m 516 y re 51 2 Remarks: V L; Lf for a c nve n flonal Sept gy-sto Sp,e expinn3-tion Remarks: Remarks: Remarks: SBD--8330(R.05/92) PLOT PL/iN Top WE-s Fpioe,-i z A--XI57-1,06- %teyjoe- 45" 14'il-lf r10 A�� AA 0 0 3 f Ell f3tp�Gj, - 39 0 zf I A This t0-st site NOT AMSOVE-0 for a conventional SePtIc system" e x p e, 52- 6- c::5 legof rl 0 0 HOMESITE SEPTIC PLUMBING CO. &.r O'NEIL RD., HUDSON, WIS. 54016 E Lt uA 'n ok-)3 1.2 ROBEATULBRIGHT W16-MASTM PLUMBER LIC. NO. 3307 M.P.R.S. RECEIVED MINN. R4STALLER & DESIGNER LIC. NO. 00663 (32. 93, 5co 1 4 119,92 .5 3 00 ST C;RQIX couNTY ORIGINAL ZONINGoFFIC'E.. q -3, + 5YS TE�Al le &�/f 7-1.OAj �'�'K5 71-' u fif',�f>� �fv��-,+� ��'aj��s�� ,c3 �- !� � y 3 � y' yi sc n 0 4 ustry, ran 0 D d Human Relations SOIL AND SITE EVALUATION REPORT Dlvision of Safety & Buildings in accord with ILHR 83.05, WiS. Adm. Code Page of 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 (13M), direction and % of slope, scale or dimensioned,, north arrow, and location and distance to nearest road. z�/v 5'17-,6— APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION PROPERTY OWNER: �01?wes J=^em :rAjC. clo �'Ue Ce>WI95_S — 701y-1 �u� �a,�, PROPERTY OWNER':SAILING ADDRESS 13zl�? 70 yt-t- lf4l-z- (s: ram) 14fiq-X&;5 4 om4c-:- CITY, STATE ZIP CODE PHONE NUMBER ;e0,8&1e7-5 4-'IS 57%0 z3 � ors � �y9- 3y�� pwmw� ST eeo / 11 K PARCEL I.D. # REVIEWED BY DATE T,,A4 7-40--VlrVa 9-s- fZ PROPERTY LOCATION GOVT. LOT Ne— 1/4 NW 1/4.S 35 T 2- 7 PNJR 100 E( - 00i LOT # BLOCK # SUBD. NAME OR C.SM # 7 /FPS EICITY EIVILLAGE RITOWN NEARESTtROAD 1 70 V�N o?l [ ] New Construction Use [yj Residential / Number of bedrooms -3 Addition to existing building V1 Replacement I Public or cornmerciaJ describe Code derived daily how Ca gpd Recommended design loading rate bed, gpd/ft2 trench, gpdft2 Absorption area required -??-5_bed, ft2 3)5 trench,ft2 Maximum design loading rate bed, gpd/ft2 trench, gpd/ft2 Recommended infiltration surface elevabion(s) -5-'x�e- P-5 _3 ft (as referred to site plan benchmark Additional design site coRs*rafions Z_ tv rve .0090 Al Parent material _Zi 1�-7_ S&Pl-�f "75'Flood plain elevation, it applicabld we"77- $1�-7_4- - 57 S = Suitable for system U = Unsuitable f2Lsastem CONVENTIONAL El S [0 U MOUND IN -GROUND PRESSURE AT -GRADE SYSTEM IN FILL [Z S El U El S [M u IDS El U El S ED U HOLDING TANK EIS IRTu SOIL DESCRIPTION REPORT Boring # . Horizon Qepth in. Dominant Color Munsell Motties Chu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Bwxbry Roots G P D/f t2 Bed Try ....... L•: ,5 ' 2- + .......... r�- /0 YX 511 2 0 f 5h)t j- Ground Rz�_P5 hlve- l YK %I zAf-1j1.ov elev. ft. 75 Y40iIQ IOPe,-i.r 1//X n Vj C L. Depth to .0( 0-' limiting factor 5?'- icy/0 Yee 51Y U ■ Remarks: Jr' TAF- A14e_-7—,5 1� e_�1%04C IoDl Boring # 0- /00 //Z 2- az4 5w ti.'-':X ........ 13 V. 3e) /0 Y10e 2U+ % 40'��77■ Ground elev. ly 7,5 516 + d 3 ft. 5P 1 51 f sh& zoo( Al �y Depth to le limiting 7e) la 51 ��, � �'G� / � �/� _ .- factor Remarks: IT 1. CST Name. —Please Print j4jP00)6C tU O'NEIL RD.,'HUDSON, WIS. 54016 Phone: Address: 4- ROBERT UILBRIGHT VAG. MASTER PLUMBER LIC. NO. 3307 M.P.R.S. Signature: fi'U.T rRS rAELER & 0—SIGNER 11C. NO. 00663 Data: .2 CST Number: PROPERTY OWNER PARCEL I.D. # it r't A.X SOIL DESCRIPTION REPORT Page 2, of I I Boring # Ground elev. 5.36 ft. Depth to limit,ing factorI it -- 4q Boring # Ground elev. ft. Depth to limiting factor Boring # Ground elev. ft. Depth to limiting factor Boring I Ground elev. ft. Deptn to limiting factor Ho - rizon - Depth in. Dominant Color Munsell Motbes Chu. Sz. Cont Color Texture Structure re Gr. Sz. Sh. Consistence l3w-dary Roots T GPD/ft2 Bed Trench 42-13 2- -F 13-31 lo y�e �'lz 50// .2, rm , S"h e .2- U f- -S 31- 31- 0 7, 5 y� e 7 Sh re dvA 0, 3 - 1/7 7. S M 01f/ DS46 c.5' y Remarks: ow �W AID Remarks: Remarks: Remarks: PLOT F�L� �1 To P co E-S Fel oeAi s 4A&x,- CA 1, t5-- 30 03 '99 Sys 67 Y3. C, ELL UA rl 0)0.5 �, yy. yc ' fi, �3 95 3G ' rEz,-) 7e,) z57- 5YSTE� 7-1;0,j ZE po 3 f 01 ilr,044, 39 - 0 2 f HOMESFE SEPTiC PLUMBING CO. 6a O'NEIL RD., 'HUDSON, WIS. 54016 R013ERT UL13RIGHT 0 5 7---Fl! -: WIG. MASTER PLUMBER W. NO. 3307 M.P.RS. MtNN. WALLER & DESIGNER LIC. NO. 00663 yste-rT 34 j 21. • Oft . !:.� (OOOV ti 0i kD�rr%nl ff- AA,3-inoQ-szn--inn 03/22/2006 08:23 AM PAGE I OF 1 Alt. Parcel #: 35.29-18.544A 042 - TOWN OF WARREN Current X ST. CROIX COUNTY, WISCONSIN Cr"bation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co -Owner 0 - ALBRECHT, SUSAN SUSAN ALBRECHT C - JASPERSON, DARIN K DARIN K JASPERSON,ET AL C - TRINASTIC, MARK A 1349 70TH ROBERTS Wl 54023 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 1349 70TH AVE SC 2422 ST CROIX CENTRAL SID 1700 WITC Legal Description: Acres: 5.800 Plat: N/A -NOT AVAILABLE SEC 35 T29N R18W PT NE NW & NW NE BEING Block/Condo Bldg: LOT 2 CSM 9/2578 5.80 AC Tracts): (Sec-Twn-Rng 40 1/4 160 1/4) 35-29N-1 8W Notes: Parcel History: Date Doc # Vol/Page Type 06/22/2005 798384 2828/202 WD 11 /21 /1997 568834 1278/209 WD 11/21/1997 568833 1278/208 QC 07/23/1997 1040/06 WD 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 79818 2487800 Valuations: Last Changed: 10/23/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.800 50,900 150,100 201,000 NO Totals for 2005: General Property 5.800 50,900 150,100 201,000 Woodland 0.000 0 0 Totals for 2004: General Property 5.800 50,900 150,100 201,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: I Certification Date: Batch #: 112 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 �Pnrr-nll ii nA'3-i noQ-rn-nnn 03/22/2006 08:22 AM PAGE 1 OF 1 Alt. Parcel #: 35-29.18.544 042 - TOWN OF WARREN Current X ST. CROIX COUNTY, WISCONSIN Cfeation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co -Owner DORWES FARMS INC 0 - DORWES FARMS INC 1387 70TH AVE ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SID 1700 WITC Legal Description: Acres: 26.020 Plat: N/A -NOT AVAILABLE SEC 35 T29N R1 8W 40AC NE NW EXC PT TO Block/Condo Bldg: CSM 9/2578 & EXC PT TO CSM 11/3149 Tracts): (Sec-Twn-Rng 40 1/4 160 1/4) EZ-U-1 532/38 35-29N-1 8W Notes: Parcel History: Date Doc # Vol/Page Type 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 79817 Use Value Assessment Valuations: Last Changed: 07/14/2003 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 26.020 3,500 0 31500 NO Totals for 2005: General Property 26.020 3,500 0 3,500 Woodland 0.000 0 0 Totals for 2004: General Property 26.020 3,500 0 3,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 COMMERCIAL TESTING LABORATORY, INC. &14 MqT6,n Street, P.O. Box 526 Colfax, Wisconsin 54730 715 - 962! 3121 800j 962 - 5227 ST* CROIX ZONING ST* CROIX COUNTY CWRTHOUSE HUDSON* WI ATTN'#' THWAS C 4 NELSON CoLiform Bactee- ia/100 ml Nitrate-Nitrogent mq1L REPGRT NO # 4 # 29375/01 PAGE' REPORT DATE: 9/16/92 DATE RECEIVED** 9/16/92 via ........... ,,jj OWNER# Dor Wes Farms Inc,* D. Cowles LOCATION# 1349 70th Ave+t Roberts 4 COLLECTOR4 M,# Jenkifts DATE COLLECTED'. 9-15-92 TIME COLLECTED4# 2#20pm SOURCE OF SAMPLE*# Kitchen faucet DATE ANALYZED*69-16-92 TIME ANALYZED*#2'#'00Pm COLIFORM'#' 0 /too M1 INTERPRETATION'+ Bacteriolcog icatly SAFE NITRATE-N*4 40 ppm Above A10 ppg) exceeds the recommended PubLic Drinkting Water Standard+ LAB TECHNICIAN'# Pam Gatte WI Approved Lab No4 19 � hears "LESS 'MAN" Detectab Le Level 91 1110, Al Approved by'+ d� �-ate 2� � ��-�� ST, CROIX COUNTY ZONING OFFICE St. Croix County Courthouse 911 4th Street Hudson, WI 54016 Telephone - (715)336-4680 rV 11 St. Croix County Zoning Office offers the service of septic and water inspections to Lending Institutions Realty Firms, and private individuals. pletion of is -- pp e,rtv e located. i-a arm --- §!sgentiai aa t tbQ - c an b— Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning office, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received.., WATER TESTING-- --__-_-___-r__----_-------_FEE: $ 35,00 (For nitrates and coliform. bacteria) WATER TESTING FEE: $185,00 (For VCCfS) SEPTIC SYSTEM INSPECTION ----------------- FEE: $25,00 (Determines if system is properly functioning at .,time of inspection) e%� PROPERTY OWNER'S NAME:c4- ,Ot�twet;, D PROP, ADDRESS:- 2 t) f4v e CITY Legal Description 1/4 of the 1/4 of Section N-RI-9-4) Town of Lot Humber --Subdivision: FIRE NUMBER LOC n 0 1 at /'� Color of housedloe 'Realty sign by house?jnj:� If so, list firnVpy-r� PLEASE INCLUDE,, IF AT ALL POSSIBLE , A NAB' J,e,C0PY OF PLAT BOOKr WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. if the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary, if this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or 'individual requesting services:%Dci� �i V i2� Cr� 41J L-Cz Telephone Number 7 14 '7 S REPORT TO BED SENT TO : Co " (e-c, t Lo'-ULN' bA,3 CLOSING DAT Signature ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET 0 HUDSON, WI 54016 (715) 386-4680 Sept. 16, 1992 David Cowle Dorwes Farms, Inc. 1349 - 70th Ave. Roberts, WI 54023 Dear Mr. Cowle: An inspection of the septic system on the property of Dorwes Farms Inc., located at 1349 - 70th Ave., Roberts, WI was conducted on Sept. 15, 1992. At the same time a water sample was obtained for testing. The results of that testing will be sent to you as soon as you receive them from the laboratory. At the time of inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. silqcerely, W. Mary J. Jenkins Assistant Zoning Administrator a NOTE: System is being replaced