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Home My WebLink About036-1096-60-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village Township Iris Bierbrauer Trust TOWN OF STANTON CST BM Elev: Insp. BM Elev: BM Description: 1 DD w 6� Sidi n TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic D g ion Hoidin 5❑ TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic II r 7� t nce o` D i g A I i Holding PUMP/SIPHON INFORMATION Mzfi�facturer Demand GP Model Num r /1 T H Jft Frictio oss System dead H Ft rcemain ILIn!L Dia. Dist. to ell SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: 651300 State Plan ID No: Parcel Tax No: 036-1096-60-000 Section/Town/Range/Map No: 31.31.17.584 B . 585A STATION BS HI FS ELEV. Benchmark ►-i-��, a� Alt. BM Bldg. Sewer St/Ht Inlet St/Ht Outlet Dt Inlet Dt Bottom Header/Man. a 1�J5 Dist. Pipe Bot. System Final Grade 3 �lo St Cover BED/TRENCH Width Length No. Of Trenches PIT DIM ONS No. Of Pits Inside Dia. Liquid pth DIMENSIONS , SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: r INFORMATION CHAMBER OR UNIT Type Of System: 1 _6 25' '0 Model Number: I- DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake 11 Length Dia q Pipe(s) Length Spa in �, �.... SOIL COVER x Pressure Svstems Only xx Mound Or At -Grade Svstems Only Depth Over Depth Ov xx of xx Seeded/ ded xx Mulched Bed/Trench Center Bed/T nch Edg s opsoil No Yes ❑ o COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 1889 142ND ST 1.) Alt BM Description o-r . &D 5.1 44 �41-r C6V. fJ�a PIS gin' �s �,"!l dd. 2.) Bldg sewer length = 2&' I I J 1 one o� S 5}eM is �. � i� c1e�-� � �o'� o� �csCYijcd S�i� � 9 -amount of cover = y IOD' a&suiW � D-7 IDidiaq l�Lq�T i/(11 Plan revision Required? ❑Yes XNo �0 R 23 15- Lo'7 I II — Use other side for additional information. SBD-6710 (R.3/97) Date Insepctor's Si t ature Cert. No. I TWUSU-Y I CCS 0 IV IS] 011 4822 Madisoii Yocirds Wq Madison,, W1 53705 P.O. Box 7162 Madison. W1 53707-7162 Sanitary Permit Application -ni to the appropriate governmental unit i iss iol �i of th i s l'o i accordance with S I'S _183.21 1 (2), Wis. Adm, CtidQ Libn is, rquired prior to obwmmg a saniwry immit. Ali sac: Appicatic)n forms for state-owned ROWTS are embinitted to lic Departinent o f Safety and PrOfCSSiO 11,Gj "_Tt: Ply F -.S011J1 I oformatioi ou provide may he used (i!:�!,4coi ry 'M f 15.04( 1. )(in), Mats. I �,rposes in accord ajice �-vitli (lic Pviv;wy L� ?, /j f if 1. i%j-)plicd,ltion Information — Please Print All Information I i: I L, n y Own er's N anie Vroperty 0-viier's Mailing Addmss U/!L/ 2W its, State ZIP Code Phok''Num er . I 7- 11.Type ail" Builditig (check all that apply) � Lot # car2 1°arnflw y Dk�Numbe lhag - rofBedroon', 13 ublic/Comm,�,rcjal — Describe Use Ss:atc O-Mied -- Dcscribc Use r CSN-1 Nuinki, %-'%d uj I IL 1, C S qfz:rk�, .Lj Sanitary Permit Number (to be filled in by Co.) 451300 State Transaction Number Project Address (if different than inailing address) par"I # & 12 Property Locafi6n Govt- Lot 4 e , 22 � ect- n �41kl-Ao�f z -, s io 'r .......... N R I *� /. _11-or Subdivision Name O ity of Elillago of own of P,j6 /K I IL Tyj)e of POWTS Perm it: (Check either "New" or "'Replacement" and other apiflicable on line A. Cheek one box on line B. Coin pfete line it V 1 k I I I I I i e _n I I I i. I R. Ncl%- sytitLlli C lacement System Dothcr Moth Fi cat i oil to Ex i st i ng Sy stoni (ex pi a i n.) ElAdd 11, 1 onal I 1i ctreatment i i i ( (ex [)lain) Individual Site Design �.ti1f�ti � .1.� f�� ;}It Holdincy Taiik t7 In- round E DAt-Grade �MoUri d (Coll ventional) Bellorc [:] Revision 'ber�ransferewOwner hange Of PlUm to NneFIRewal List Previous Vcrinit Nuinllcr andExpiration IV. Dispersa 111reatm ent Area sa n d j an k i n io rin n,t I o n � Design Flow (gpd) k k�si�jn Sol Application Rate(igpil'i.A) Capacity in Tank Information Gallons New Tanks So Pt IC or H cil d I i i g Tank Dosing -Chamber M1 I an 4.l(S 1tiiurcd 0 ... `t)[Sprrsa] Area Pr X)scd (,J) sy stein El e Y al 101 7 73.2 Ti) [il # o 1, NI'Lil I Ll liar carer Gallons Unit-9 �:L J�e4Ne -�-�� =n Z � U V1 V) 7_1 I V, Resp,insibility Statet- 1, the undersigned, assume ibility for installatitifo ol'the POWTS shown on the attached plans. Fluill S S* u M P/M P R .5 Numbc r Business P11"'11c 1"1li b".r 11[kimber's Name �Jj P lit) re 5=m_ �Oelll FV PIL: -iber's d ss-(Street,'6'ty, -State, Pod Z it 1. Co ii n ty/ 1)epa rtni en t tJse Only d "d Pci in it Fee law 1,SSLICLI ],,suing AgBrit Signature l l l l�°� 1 ✓ �� 10 12, 17- .3 cas r C,ondilions t%l Approvt1FRc,,,,son,-, f0i- F.)_I'�11[)PW Ll SY� � S c t STEM OWNER: s -� �� cam. � �� 1. SeptiC tank, effluent filter and dispersal cdl % aw&4-e- olecL &5 - must be serviced / maintained as per gaLOD LIK --t A,4-*#tfe fi�f wj-UL+ 4Q_ 401— U_)-L 6— F x,.P& -S management plan provided by plumber. I tA % r 2, All setback requirements must be maintained _e CjG. Djq 2-3 7D as per applicable code / ordinances, Arl:[�Ik W C'01111}10tk� JIL111-1; For t1w systvin and submit to ow ('ounty only on Imper o(II less Than 9 112 % I I in -claw in size Q Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 sbird Qfrontiernet.net 1 of 5f 23 Subject: Septic Failure at 1889 142 nd St. To whom it may concern The septic at the above property has failed. The drywell is completely of water and has had a history of backup into the house. They have been pumping the tanks to get by. A new drainfield needs to be it Sincerely, Shaun Bird MPRS #226900 715-781-0653 if you have any questions )01xodo sign by apryse Title IMG-0004.pdf File Name IMG-0004.pdf Document ID fe3ab56caO5O4d84b97dd64e847fc7a1 Fingerprint a8cba4eed446e7O37a92ef4aee7e4168 Status Doci.irnent History Audit Trail ST, CROIX COUNTY CDD Document Created Document Created by Heather Potting (heather.potting@neurorelief.com) Oct 10 2023 Fingerprint 2ab7f 1 846f0f9b4c79aa21996da33e7a 05:4-7PM UTC Document Sent Document Sent to Sharon Potting (skpotting@gmail-com) Oct 10 2023 05:47PM UTC Document Viewed Document Viewed by Sharon Potting (skpotting@gmail.com) Oct 10 2023 IP: 184.97.4-8,219 05:50PM UTC Document Viewed Document Viewed by Sharon Potting (skpotting@)gmail.com) Oct 10 2023 IP: 64.246.133.6 05:51 PM UTC Document Signed by Sharon Potting (skpotting@gmail.com) IP: 184.97.48.219 Document Signed Oct 10 2023 05:51 PM UTC Document This document has been completed. Oct 10 2023 Completed Fingerprint: a8cba4.eed446e7037a92ef4aee7e4168 05:51 PM UTC Processed by xodo sign Sharon Potting 1889 142nd St. Now Richmond Wi 54017 715-417-2413 skpotting@gmail.com 10/9/23 Subject: Septic tank located under the deck IfiRM7181 To whom it may concern: I acknowledge that the septic tank is located under the middle of the deck. I agree if the deck was ever to be removed or replaced, that the septic tank would be filled in at that time. I know that the septic tank can not be filled in at this time. Sincerely, Sharon Potting Oct 10 2023 System PLOT PLAN PROJECT Iris Bierbrauer REV Trust ADDRESS 241 240th St Osceola WI. 54020 NW 1/4 NW 1 / 4 s 31 / T 31 N / R 17 W TOWN Stanton COUNTY ST. CROIX SYSTEM ELEVATION 93.01i92.$' 4.5' Below Grade 1015123 3 BEDROOM DATE CONVENTIONAL xxx CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 Gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 L6 BENCHMARK V.R.P. Bottom of Siding ASSUME ELEVATION 100' Filter Lifetime Finer ❑ BOREHOLE 0 WELL * H, R.P same as benchmark Seale = 1/4" = 10' Property Line f7.5' Quick4 Standard Leaching Chamber with 20.0 ft2 of Area 6.6ft^2lpair of end caps Dry well is to be pumped and collapsed Old septic tank will not be able to be collapsed due to being under deck Grade at System Elevation $ME COPY to * Y � gym, � ,.ar �•"`'. :,:: ,�... �r �, �• t •',r# '.M',P _ `�:" w � 4 yr,�ik',"'��".:!�'� � "x. �, �! '�s�•"i �'� �,. *5�,,. •`:"'. a flu . " ' .��.. .'�� a �w�*'. �^.. � . w r 1 wr , r �.T -' . m .. i 'T a 1 q t , � F 1 a , . �r r �A djFAOP .. wLA40 a.' 40 - _ .f " + r r • e a v. F �y f 1f, @ . „ ICI 11 .. • Y. lw AL 16 }� w!r t , Y ,n p: *aw y , b• _ r— ... y" y M ..., '"..' `.,*w w r s '1 • �` , , • IF • r ftm VIVO, .Y� d Y w �f r y . t + , , r �{a e F ,-Z41 I�^ ,p" n .100 # ti Vi h ° 1,t'�+ �1.AP Lk 71 w ,y 1 ' 6- F. s r y a ,1 w _ i uuw Y w ; J� +y,` w •M } 1 n a III %I or ■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■ Cover Page Shaun Bird Bird Plumbing Inc. 1432 120tb St. New Richmond Wi 54017 715-246-4515 Date: 10/05/2023 Owner: Iris Bierbrauer REV Trust Location II W1 l4 IOW 1l4 S 31 T31 I1, R 17W 1339 142nd St, Stanton Used: In -ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. chamber cross Sectiorv--x 4-5. Maintance and Conti 7. Filter Cross Section Signature License number #2259 nc Plan System PLOT PLAN PROJECT Iris Bierbrauer REV Trust ADDRESS 241 240th St Osceola WI. 54020 NW 1/4 NW 1 / 4 s 31 / T 31 N / R 17 W TOWN Stanton COUNTY ST. CROIX SYSTEM ELEVATION 93.01i92.$' 4.5' Below Grade 1015123 3 BEDROOM DATE CONVENTIONAL xxx CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 Gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 L6 BENCHMARK V.R.P. Bottom of Siding ASSUME ELEVATION 100' Filter Lifetime Finer ❑ BOREHOLE 0 WELL * H, R.P same as benchmark Seale = 1/4" = 10' Property Line Quick4 Standard Leaching Chamber with 20.0 ft2 of Area 6.6ft^2lpair of end caps Dry well is to be pumped and collapsed Old septic tank will not be able to be collapsed due to being under deck Grade at System Elevation $ME f7.5' Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber 6.6ftA 2 pair of end plates Typical Installation Vent � Grade j 4" 3' ��"30/34 Septic Tank _ To be > 1' above grade Finish grade elevation 97.5' Vent 5' Lon 1 " � S' Lon 1' Grade at System Elevation 36 Grade at System Elevation Spacing 5' 2-3' X 66' Cells Same on other end observation tubeNent At end of cell A B 18 chambers per cell System elevations: A 93. o' B 92.8' 0 4 Oic.5200 CID5e Cr)d 1460 loll SECTION 1761 164 ri 9-3759 9.4356 kf!,� W-4 Page ., Of START UP AND OPF-RATION I ding products or other chemicais thE-!t Fir n ew canstrucfion. - prior to use of the POVVT S ch eck t re atme rat tan k(s) for the p resence of pa! r n ts, of thf'-:l I ceII. If hincent gh combons are detected have the conte may impede the tvatment PrOcess and/or darnage the disperss tank( rem removed by a 56"e se System operator P Or tO use. System start up shall W occu r whoa s oil condifl ons are ftx)ze n at the infiltratlive au ower is restored the eXCeSS wastewater will bo p tanks may fill above normal highwater levels. When p luent. Duriing power Wtag�es PUM ovedoading the celi(s) and rnay resutt in the backup or surface discharge Of aft d1scharged to the dilspersial oell(s) in one large dose, restodng pm to the To avoid this sftua�on have the c6ntents of the pump tank removed by a SePtage Servicing Operator pr:or to I levels effluent pump or contact a Plumber or POVVTS Maintalner to as.s'st In manually operaiJing the pump oDntrols to restore no,rma w0hin the pump tank. not drive or ark over, or oiherwise disturb or compact, the area withIn Do not drive or paw Vehicies over tanks and dispersal cells. Do p 15 feet down slope of any mound or at -grade soil absorpton area. and prolong the Ift of the POWTO' owi thA foil ing tam the wastewater stream may improve the performance Pteduction or ellmin-ation of diapets; disinfectants-, fat'. foundation dre�n antiblofics; baby wipes, ciganade butW'zondoms,, coffin swabs: degreasers; dental floss painting produd*4k (sump pump) water, fruit and vegetable peelings; gasioline'; grease; herbicides', meat scraps' medications; oil; pesticides; sanitary n F apkins; tarnpons; and water softener bane. flY ABANDONMENT of service the follcrMng steps shall be taken to insure that the SysteM 1:5 PrOPe, When the POWTS fails andfor is permanenti-y taken out mi nistrabve God e - and saf&y abandoned in c;ompljance vvfth chapteri Comm 83.33, Wiscmsin Ad All pOng to tanks and pits shall be dC'Onnected and the abandoned pipe openiTigs sealed. The r-nritiant of all tanks and pvat and removed or theive its shall be removed and propertydiSPOS45d of by a Septage Servicing Operatof- removed and the void space -filled M S011. be ex car cors After pumping, all tanks and pits shall gravel or another Inert solid material. CONTINGENCY PLAN 4 he folloWng measures have been, or must be taken, to provide a c*de comPlit-O"t If the pOWTS falls and Gamot be repaid t re replacement system.- ublized for the location of a replacement SCirl absorpflon systelm. 0 A suitable reptacement area has been evaluated and may be The replacement area should be proteded from disturbance and compaction and should not be infringed upon by requirled sod structure, lot lines and wells. Failure to proted the replacement area will result in the neJed setbacks from existing and propo the le-ci in 'table replaoement area, Replaoement systems must comPlY with ru for a new soli and site evaluatlon to establish a suitable ffect at that time. liable due to setback andlor soil limdations. Barring advances In POWTS te&no1cgV a A sustable replacement area is not ava hbldtng Wk My installed as a last resort to reel a the failed P OV\r7S. so eva 11or The ante has not been evaluated to Idenfify a suitable replacement area. Upon failure of ft POWTS a soil and site lua, must be perfoffned to locate a suitable replacement area. if no replacement area is available a holding tank may be installed) al a last resort to replace the failed POWTS. Mound and at -grade soil absorption sterns may be reoonstructed In place folloWng removal of the biomat at the infiltrajivi surface, Reconstructions Of 5Lch systems must comply with the rule-9 in effect at that firne. <<WARNING>> ENT TANKS MAY CONTAIN LETHAL GASSES ANDIOR INSUFFICIENT OXYGEN. DO N01 SEPTIC, PUMP AND OTHER TREATM CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY PERSON FROM THE INTERIOR OF A TANK MAY BE D10FICULT OR IMPOSSIBLE ADDITIONAL comMENTS ------ POWTS INSTALLER a.2 Nme Phone Y71 POWTS MAINTAINER Na Phone LOCAL REGuLATORY AUTHORITY SEPTAGE SERVICING OPF-RATOR (P-WMFER) —It . q-,, I 6L Phone -j &M and 383,540), (2) & 0), Wsmns Adrn1n'Strat'_v`e CcAe Cx,timent wasdrpifced if, C<>nVjjaTj ,th C TNS 1-fi i i Ce W. 7. a pte F SPS 38 3,22 2) b ,A) FILE INFORMATION owner L P Fer;m K# nADA%AF=TFP.q MAINTENANCE SCHEDULE POWTS OWNER'S MANUAL & MANAGEMENT PLAN SYSTEM SPECIFICATIONS Septic Tank Capac-Lity Septic Teak Man u fact u re Effluent Filter Manufacturer Effluent Filter Model Service Event inspect oondition of tank(s) pump out contents of tans) Inspect dispersal ceil(s) Clean effluent filter Inspc-ct pump, pump wntrols & alarm Rush laterals and pressure test Other-, Moc. Pump Tank Gapac4 pump Tank Manufacturer pump Manufacturer Pump Model Pretreatment Unit C1 Sand/GMvel Filter C3 Mechanical Aeration C1 Disinfect.ion ManufaMrer Dispersal Gells) ri-ground (gravity) C1 At -grade Cl Ddi>4ine P.agp AROW.a.'Oe C1 Peat Filter El Wetland 11 Other C1 In -ground (['.')cessurized) E3 Mound D Other Values typical for domestic (non-commerd,,iT) wostewater and s,eptk,- tank effluent - Values typical for pretreatQd wastewater. Service Frequency -1 ye (Max,imuni At least once every months -ar(s) When combined sludge and scum equals c)ne-third (Y a of tank volume At ieast once every -,;&rnonths C] year(s) (Maximum 3 Yrs.) At least once every 7Wmonths C3 year . (s) At least once every. At least once every At, least once every At least once every ftmonths Ell YearN Lj "ON [I months 0 year(s) NA [I months El year(s) NA El months El year(s) 01NA MAINTENANCE INSTRUCTIO14S cells shall be made by an Individual carrying one of the fol[owing lioenses or Inspedons of tanks and, dispersal c,ertificabons: Master Plumber Master Plumer Restricted Sewer, POWTS Ins, pector ,. poVVTS MaIntainer, Septage mint Include a visual Inspection of the tank(s) to identify any missing or broken Servicing Operator. Tank inspectiOnS hardware, identify any cracks of leaks , measure the volurne of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cells) shall be visually inspected to check the effluent levels ipes and to check for any riding of effluent on the ground surface. The pond ing of effluent on th el in the observabon p 0- 1-� 1cation of the local regulatory -RLJth')1 ground surface may indicate a failing rendition and requires the Immediate no6f ior, ()f sludge and scum in any tank equals one-third (Y3) or more of the t{'iri+. VOILIR)" When ttie oombined aocumulati ,.rj.h d", entire conterits of the tank shall be rerTinved by ;i Septage Servicing operator and disposed of in -accordLjr-i,'c, i L 113, Wisconsin Administrative Code nt copofients, and any T'he servicing of"efflueni fitters. rnech�inlcal or pressudzed POWTS components, pretreattme m other maintenance or monitoring at Aervats of 12 months or less shall be performed by a ccLrtjfjeci POWTS Maintainer- servireport shall be rev id to the local regulatory authority within 10 days of completion of any service event. A cp p START UP AND OPE-:RATION of painting products or attler For construction, [)rlor to jjse of the POWTS check 1,matment tank(s) fir the presence. e� ttic treatment process andlor damage the dispersal celi(s)- If tligli concentra- fions are (temicals w3t may irn;-Fcd I i d have the wrtei 7ts c)f vie tank(s) removed by a septag eservicng operator prior to use. S-1-P CIZ01 '�IuNTY SANITARY SYSTEM File Office Use only s� OWNERSHIP/ADDRESS FORM Created 212021 Community Development Department will utilize this information to provide the property owner with information regarding operation and maintonance of your new or replacement sanitary system! This inform atioti M1 be provided as part of our ongoing efforts to protect public healthr y0LJr VVP-11, qro�indwater, surface water, property Vall.,10s, arid county resources. Once approved, this completed form and educational information viill be sent to you by email. If you would like to view your, issued sanitary permit online, you can do so by using the Property Files Scanned weblink,, '"GIVITJ § 14 ON -031riffica yk- 0 vj n e r/ B u y e r t5 j I e�6 2L 04 Z M -a i I j n g Adfiress 62? < 01LJ/Statc/zip�2z- Lcio�—' Phone Number (required) Email Address (required) Pa rcel I d entificatl o n Number ZZ (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Locatip v,'/L-�/ Sec. T 3/N W, Town of SUbdivision Plat: Lot it Certif ie U rvey um Map Vole- Page e CVN--,, #Ipw� - C9V be- C- I 1� 3io�- pagty Deed(before 2006)Volume Number of bedrooms Spec house 0 yeso�o Lot lines fdentifiabl�yes 13 no N ew Property ACIL d re s (Staff initials) OFFICE USE ON Y V (Verification of nevy address required from Omrntjnity Development Department for r� (Dated construction] Th I's fo rm tr u s t b e s u b 1'111 tted wi th a II Pri vo to 0 i� s i te Kla ter Tr -ea tm en t Eys seta (P 0 W TS) ( ipp � 1"ca ti 0 1) S. New System: Include with this form a recorcled warranty deecJ from the Reylster of Deeds Office and a copy of the certified . Nr 0, I'Vey rr, ap if reference is mode ire the wo rra n ty deed_ Commurilty Dr.)ve1Q[)r-i-,.et)t Department — Land Use Division 715-386-4680 St. Croix County Government Center Cdd@5CcWi,QQV 1101 Carfiiichael Road, Hudson, W1 54016 71-`)-245-4250 Fax 15=9401=110 all DECEDENT'S NAME 1R MGM= D��FE OF DEATH September 20, 2022 DECEDENT'S ADDRESS AT DATE OF DEATH CITY ST ZI -P 1889 142 d Street THE INTEREST CFTHE DECEDENT IN THE PROPERTY LEGALLY DESCRIBED HEREIN IS TERMINATED PURSUANT TO THE FOLLOWING WISCON51N STATUTE AND TRANSFERRED A5 PROVIDED BY STATUTES: 0 867.045 — real pr'-1periy in which the de.--edent was a joint tenant, had a vendof"s or mortgagee's interest, or had a life estate. R 867.11415 - property of a decedent specified in a marital property agreement, survivorship marital property; a third party confirmation; or a nonprobate transfer on death as described in 705.10(1) or 70S.15. 1163907 BETH PABST REGISTER OF DEEDS EST. CROIX CO., WI RECEIVED FOR RECORD 02/14/2023 08:51 AM EXEMPT#: .11M REC FEE 30.00 PAGES: 5 "The above recording information verifies that this document has been electronically recorded & returned to the subn)itler Recard�fng Area Name and Renim Address: Rernington Law Office�, LLC 126 S. Knowles A, %' -enue New Richrriond, W1 54017 DOCUMENT LINDER WHICH DECEDENTS INTEREST IN THE PROPERTY IS NOW TERMINATED — Capy(ieS) of which ls/are attached: 036 -1 0961-60-coo Rcir-orded Document No. 899860 'Volume Page P�ir�* Identific2ticnNumber: L Deed W Transfer on Death 0 Land Contract. 0 Mortgage SEND TAX STATEMENT TO; Other Unrecorded Document. Sharon Potting ED Mj-vItal Pri�pr---,tyAgreernew. 0 Other L-r 01 240th Street Osceola, Wl 54020 L) ESCRIPTION OF THE PROPERTY TRANSFERRED (check all that apply); iR REAL PROPERTY - legal description as set f0-th in the attached referenced and previous;y recorded document E, REAL PROPERTY - current legal de 5----1 ptiop ;f different than the f aregoing document 0 NON -REAL PROPERTY — property identified in the attached document, including. digital property, bank accounts and 5escur-ities Name(s) and address of owner(s) of th,- propi-r-ty immediately after the decedent's death; attach addittonal names,.&, addresse-s if more than one owner. Iris E. Bierbrauer Revocable Living Trust dated July 7, 21D09 Shar-on Potting, trustee 2-41 240th Street, Osceola, W1 154020 Interest of the signer of {this document in the property: [J joi,t ~ermnt 0 rerva4)der person if a life estate L2 rn:artu0agee 0 land contract vendor 0 decedent's spouse 0 beneficiary of a marital property agreement R beneficlary of a transfer under- 70.5.10(1) or 705.15 1i other: DECLARATION: To the best of undersigned's knowledge and belief, the undersigned der-lares that this docurnerit is true, accurate, complete and in conformity with the provislons and 111Rations of the Wisconsin Statutes - DATE, DECLARANT SIGN TURF AC K N 0I.VLE, D G MENT STATE OF WISCON!:31N x COUNTY OF DRINT NAME: Sharon Lofting, trustee 11, JYJ�)q swbq�:ribed and t sworn to be -fare me om, k•elL46al.r.4 31 by ile 3 a h:v� nar-nFd person(,0 who exr--c-uted tl-1f5 documL-nt and Signature of Notar,� or other a t k rio w te d 11 Q S pi THIS DOCUMENT WAS DRAFTED BY; person authoraed, to adminis-Ler of an ca".1h (as per 706.OG, 706.07) Leah E. Boeve. # 1081407 ;P) 6 t X4 ary Publ"Ic, State of TItle: notpublic My Commission his r ey.rq PIOL U THIS IS A STANDARD FORM, ANY M ODIFICATI DNS TO TH 15 FORM SHOULD HE CLEARLY IDENTIFIED. T'-'RI`-JI%A710N OF 06r,!--00-CN7'5 Ir,.77-,RES7 - Wisca-sin R.eg cf Association Fora" H7-110 arc 70ID-I10. Apprave-AR %C--eds SIL, Croix CountV 1163907 Page 'I of 5 TRANSFER ON MATH I)EED This deed shall constitute a non probate transfer on death, made by Iris E. Blerbrauer, a single person ("Grantors ) tf) Sh-aron Potting, Vault Christian Blerbrauer and Donna Doreen HS to-ti-ti�stees Iris E. Bierbnjiuer Revocable Liviner Trust dated July 7, 2009 for the purpose of GI-C,1631g, a transfer on death provision affccting the following described real estate in St. Crt)ix Coujit- y, State of Wisconsin- 'rhe South 44 feet of Lot 8, and North 44 feet of Lot 9, Plat of Westview in the 1'own of Stanton. This directive is not a conveyancc. The Grantor intends 'her this dml to lake advantage of qec. 705.15 of is. Stats, fain8 nlated statutes, wbich collectively permits trtansfcr of real estate upon the death of Grantor if) a 11011-testa[nulltlry and Tlon-prob;it,. fashion. The Grantor intend this deeL` (o lc�-incd a "transfer �on death" and "'payable on dcl-iflh" convqa,,)-,-,c such that Grantor retains full inanagement and in feeM.T11 ple during the rest of Urafflur's life. This includes the right to sell and convey said real property in anv inatincr or rescind this trRnsfer on death designation- This decd is revocable and niay he changed by Grantor at any three. Upon the death of Grantor, this real ek4tate iviniediately pass and vest in the named co -trustees, �,'u i will receive title subject to all ucumbrances or liens or record wi the death of -Grantor, I ifli�l �I II fll�l i�fl18111i 6Illl IIII ll�l1� 899860 BIN PABST REGISTER OF DEEDS Si. CROIX M, I'll RECEIVEO FOR RECORD 07/10/2009 11-.20AM TRANSFER ON DEATH DEED EXEITT I ION RAC FEE: 11,00 ptiGES: I —K, �i i i i e am, I R (- #, , j rn Add rVIS S, jIlihill A. RUM irigian Law Offices, LLC I '- 6 S. Knowles Avemue Nm Rlchmwid, W1 54017 PIN: 036-1096'-60-000 This is h-nmestcad property. Nothing contained in this, docimwnt shall prevent Grantor ficni C011VO ing or enc-unibcrina this Y C�y l ted by , t. aw r oftoin exercising any right real estate for any ptirpose =d in any manner 1ipplicabl allc)wcd 1)y applicable law rtgarding this real A LAs Insttlument shall not be an encumbrance upon fl:is real estate:, If this instrwnent is ill coifflict instrunient -iigned by Gnintcir prior to dale h...reof, then SLCh prior instrument shall be M)Sic:O.A.Cdj iiull and void and the provisions of this instrtiment I sa�dl control the disposition of Grantor's inierest, it any, in this real estate upon the death of Gnlnto�r,. This document is exempt FT(im fce and retuni Linder secs, 77,21(l) and 77-25(10rn) his, Mats, fi II])UT-,')0-SCS Of M11 St[: I]-',M �fei—�La-,,,cs because it is not a f�onvqancc, Dated this. fit' day c)f July, 2009. A L'THE NTIC ATI ON S ign awr authrzriticat,M ibis _ day of 2009. 4 1r 1%11E liitR STA"VE BAR OF WISCONSIN ITI I �' YN'ST R UM ENT %VA S I)RAMT D F3 Y: JudIth A. lea' miiigt(m P1016706 26 S. Kri ms I e Avell Ue w I � i C I I I ri 1) 11 k I U 154 (117 'Ye"Uplic-rie (71-)) 246-3422 Allor-my for G'I'Mitur (sigrtwurcs rnaybc RLIffiCriLiCalEd 0 F Ri;kno)w1cdPcJ KnlEve :1-L11 fl:CCSNBey. ) of 1, -- rums 11pli ng iE imy capaci!-, J be 1y-Oed ur p'i Ln I ci b6i W dICLE 3 i r)1&1LjJ C N, [RI S L. 1flLk13RA1,./'1-;jK A ('KNOW 1, E 1) G;M V.iNN.I. STATE 0Y V-1S CON S IN ) ST. CK(JX C�)UIN14Y I'mormlly came Lcfcirc mr, this 7L" d4. fi up"VIC shove rmmr-d Iris F, Rlubmurr, a,single be Tim puson who mccKited ttic 1"ol -nek n ow ledge lite same. -Y Ir 4i (,J h3bilC, Sta(C- Of WkW05iri- r 1% 1 ion is Pumancin. Nuitc mpiraliell date: St. Croix County 1163907 Page 4 of 5 JUL 15 7OD9 Ile Wisconsin D epa irtmen 10( Safety a n d P ro f e ssion a I Services Page -of Division of Industry Servides T Nil SOIL EVALUATION REPORT C , 1 In accordance with SPS 385, is, Adm. Code COurltY SI.Croix Attach complete site plan on paper not less than 8 112 x 11 inches 'in size. Plan must include, -1 . ........... but not limited to, vertical and harizontall reference point (113M), direction and percent slope, Parcel 1. D, scale or dimensions, north arrow, and location and distance to nearest road. 036-1096-60-000 Please print all information. Revie ed by Date I Personai information you provide may be used for seconds iry purposes (Privacy Law, S. 15-04(1)(m)) [ D/10 Property Owner Property Location F.1 Iris Bierbrauer Rev Trust Govt, Lot N'W N W /* s 31 T 31 N R 17 E (or) 'W 73- Propc�rty Owner's Mailing Address Site Address or CSM and Lot #: 241 '240th St. 1889 142nd St, C i l y State Zip Code Number City 0 Village IN Town Nearest Road Osceola Wi 54020 IStanton 142nd St. 0 New Construction Use- F Resi.dantial lNurn berof bedrooms 3 Code ded ved des Ig n fl ow rate GPD, Replacement D Public or commercial — D scribe, Flood Plan elevation if applicableN/A ft. Parent material.0utwash c,-*e- Gerier�l cornments and recommendations: System Type:Conventional S '�'D USog Boring rin # 97.-� 100 Epill. Ground surface eiev, ft- Depth to limiting factor in. / elev-ft- SoilApplication Rate Hob on Depth I 1-i Dominant Color Munsell Redox Description Qu. Az. Cont- Color Texture Structure Gr. Sz- Sh. Consistence Boundary Roots GPD/Ft-' "Efil"41 OEff#2 1 0-10 1 Oyr3/2 none L 2mar mfr CS 2m .8 2 10-42 1 1 0yr5/4 none, C1 2!i�abk mfr gw 1 f A .6 3 (12-100 1 Oyr4/6 none S 0:5g M1 n/a n/a 3 1.6 0 :1 (Z aK%9— - I C Co Boring # F]Boring 96.8 100 Kpit Ground surface elev. f 1, Depth to limiting factor in. I elev. ft. Soil Application Rate horizon Depth In Dominant Color Munsell Redox Description Qu- A,4. Cono. Color Texture St ru ctu re Gr, Sz. Sh, C ons Is tence . ................... . Boundary Roots GPO/Ft' *Eff#1 "Eff#2 1 0-9 1 0Yr3/2 none L 2mgr 2rnabk rnf r CS 2 m 1 f .6 A .8 .6 2 9-41 1 Oyr5/4 none C1 rnf r gw 3 41-100 1 Oyr4/6 n o n ca S Osg M11 n/a Wc-i .7 1.6 CST Name (Please Print) Shaun Bird Address Da valuation can. K-- 1432 120th St. New Ric�hmond W! 54017/ 10--`5,23 CST Number 226900 Telephone Number 715-246-4516 • Effluent 92 = BOD. -5 30 mg1l. and TSS � 30 mg/L SBD-8330 fR042'21) Boring # Page of ["] Boring 97.4 100 ® Pit Ground surface elev. ft. Depth to limiting factor in.1 elev. ft. Snit Annl icat inn Rate Horizon Depth In. Dominant Color Munsell Redox Description Gnu. Az. Cont. Color Texture Structure Consistence Boundary Gr. Sz. Sh. Roots GPD/Ftz *Eff#1 *Eff#Z 1 0-1 g 1 gyr3f2 none L 2mgr mfr CS 2m .6 .8 2 1 g-38 1 gyr514 none C1 2mabk mfr gw 1 f .4 .6 3 38-1 gg 1 gyr4/6 none S gsg m! nla nla .7 1.6 5�62 Boring # Boring ["] pit Ground surface elev. ft. Depth to limiting factor in.1 elev. ft. Snit Annlicatinn Rate Horizon Depth In. Dominant Color Munsell Redox Description Gnu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIFt2 *Eff#1 *Eff#Z Boring # C7 Boring El Pit Ground surface elev. ft. Depth to limiting factor in.1 elev. ft. Snit Annlicatinn Rate Horizon Depth In. Dominant Color Munsell Redox Description Gnu. Az. Cont. Color Texture Structure Gr, Sz. Sh. Consistence Boundary Roots GPDIFt' *Eff#1 *Eff#Z * Effluent #1 = BCD > 30 5 220 mgtL and TSS > 30 5150 mg1L * Effluent #Z = BOD, 5 30 mg/L and TSS 5 30 mg/L Soil Test Plot Plan Project Name iris oienDrauer hr- v gust N' /1,J B it Address 241 240th St Osceola Wi 54020 ..-,,C-�STM #226900 Lot 8/9 Subdivisi I on Westview Date 10/5/23 NW 1/4 NW 1/4S 31 T 31 N/R1 7 W Township Stanton L Boring 0 Well P1, Properhr 1,,.ille County ST. CROIX IL BM or VRP Assume Elevation 100 ft. Bottom of Siding System Elevation 93-0792.8' *HRpSam e as Benchmark Scale - 1/4" = 10' IN 97.5 1 NY kk } - --------- O"\ s • hit ZI JI 0 N � Wtj o i o n As owners we hereby • owners possessor user o �— ..o have aright ol direct State Truck HJLgkway No* that, this restriction ah the the benefit. of the V Wisconsin Statutest and W sconsin Stale Highway � 0 A t. CQorx OWNERRBPA�2 P.�J Tusk AV I oil L 1 Uff-'r M -13h 9, R L I # 2Yd 6 0 2a..2 '""WN "O""'F 4�;�umlV sr-ju AND/ S su-no . . . ..... . ................................... . ........... ..... . .. AUTHORIZED ISSUING OFFICER ........... No.SOS! 3..00 t06')( CHAPTER 145.135 (2) WISCONSIN 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 �� YP Y 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: 1f you wish to renew the permit, or transfer ownership of # ca authority. t e erm�t lease contact he uu h permit, P tY DATE ° /10 /2z23 IF T "SS RIEN", W", " """'RIE THAI, D"I'Alor'Ej �Mll ... . .. ... ..:. W U Inj r-j rj" -"r-jYU WAVOK&MILA Ww..� NL SBD-06499 (RI 1/20)