Loading...
HomeMy WebLinkAbout004-1029-90-100 C o H p vy I as (D ~ 0. 0 M ~ I ~ I d I t\° I ~ I ~ I I 'C ~ I U I CO I z° ` C y 3 co d LL C2 U Q ~ co a3i Z E I Z = o v 00 z r a 0) M FN- U) o o zv' e} O fn F- r ' N Z E ' ~ M i 0 I .,y s o ca O I', z z O o N Z r_ A) 4) E E O N N m N m ar m ~i ° 06 a w w c C LO y y d v°, O Co O a a) m N E y E C UO) O O O Z o •►.a a a a m co 0 to .~i U rn rn z *`rl T _o `n a) o 7 C) o E N c C°~ ° a CY) a) N ~ N Q Q M O O U y C O _ a) o a E O O O am U C y U CL ° O O 06 a) O O r \ O N 3 E d N N v c° o F- Y _M L r C ° T a a) o F- " a0 04 i.r pC' s N N 00 Q y O E U O U Y N O Z N z -7 (n I cn d a xt a a w ~`I~,0 a V c I' c 2 S STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER G VES ADDRESS j997 SUBDIVISION / CSM LOT ~ SECTIONL,43_T 6 N-R fS'W, Town of • X COUNTY, SIN PLAN. VIEW . SHOW EVERYTHING WITHIN 100 FE OF YSTEM T0~ ~ l.~Ir ~(x-7'.O e ® I wY loco ~trc 7So G~~ ~l0' f ~ C 11-Y "a"~ A H ARROW ide setback and elevation information on reverse of this form. rovide 2 dimensions to center of septic tank manhole cover. qy~ 'BENCHMARK: ALTERNATE BM: ~ :SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION /Ub~ s7 Manufacturer: / /'C C Liquid Capacity: Setback from: Well House 3(0`> Other ~87i Pump: Manufacturer_ :Modell * Size_ Float seperation 9~11 Gallons/cycle: f ~q 3 Alarm Location &WAA SOIL ABSORPTION SYSTEM /Vl e Width: Length Number of trenches de`s Distance & Direction to nearest prop. line: $ Setback from: well:House_ Other ELEVATIONS Building Sewer z,2 ST Inlet: s 8 8 ST outlet: PC inlet-_ PC bottom Pump Off Header/Manifold M13 Bottom of system .57 Existing Grade (r,~ Final grade DATE OF INSTALLATION: le- PLUMBER ON JOB: Z LICENSE NUMBERC.✓o~~~ c INSPECTOR: T s1n 3/93:jt Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM • Safety and Buildings Division CounttT . CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitar2it1NS.: Personal information you provice may be used for secondary purposes [Privacy L , s.15.04 (1)(m)). Alf ZIZ l~LL1,Y Ho ft_S Na~3e: ~rAijyY❑ Village ❑ Town of: State Plan ID No.: K I ( j V CST BM Elev.: Insp. BM Elev.: BM Description: Parcel TyoI a-:1029-90-000 TANK INFORMATION ELEVATION DATA A9700224 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic r% Benchmark 91 Dosing -7, t~/ Aera 'on Bldg. Sewer Ho St/ICI1Inlet /~/7 TANK SETBACK INFORMATION St/IWOutlet taTANK TO P/ L WELL BLDG. Ai Intake ROAD Dt Inlet Septic 311 I~A NA Dt Bottom ~3' ~~9 0. ya Dosing ) ~L 1' NA Fj / Man. & Aeration NA Dist. Pipe Holding Bot. System -77 oe PUMP / INFORMATION Final Grade Manufacturer Demand X1,77' ,y. Model Number GPM I Loss Friction System TDH ,g,q7Ft TDH Lift ~ H Forcemain Length q01 Dia.' Dist. To Well I' SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. th DIMENSIONS DIMENSIONS SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING i INFORMATION Type O CH R Moe Number: System: M -L R 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 /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) -)(,AS (Q,t.~.,'l /~P %r LOCATION: CADY 13.28.15.201,SW,NW 3219 CTY RD N. / C) ~ A Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R.3/97) Date Inspector's Signature Cert. No ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: Safety and Buildings Division SANITARY PERMIT APPLICATION Bureau of Building Water Systems 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O- Box 7969 Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. ST CROIX ~ • See reverse side for instructions for completing this application State Sanitary Permit Number The information you provide may be used by other government agency programs E] Check if revision ttoo preev3us application [Privacy Law, s- 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION S97-40349 Property Owner Name Property Location KELLY KERR SW 1 /4 NW 1/4,5 13 T28 r N, R 15 15100 W Property Owner's Mailing Address Lot Number Block Number N/A 304 HANSON STREET N/A CitWEIVILLE WI 2154028 ( Phone ju3056 Subdivision NN17Aor CSM Number II. TYPE F BUILDING: (check one) ❑ State Owned ❑ City Nearest Road village CADY C.T.H. N E] Public 1 or 2 Family Dwelling - No. of bedrooms Town OF III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 004-1029-90 1 ❑ Apartment /Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel /Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. ❑ New 2. ❑ Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5_ ❑ Repair of an ____System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate S. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation 450 900 900 .5 N/A 97.5 Feet 99.8 Feet VII_ TANK Capacity INFORMATION in gallons Total # of Prefab. Site Fiber- Plastic Exper. Gallons Tanks Manufacturer's Name Concrete Con- Steel glass App. New Exist in strutted Tanks Tanks Septic Tank or Holding Tank 1000 1000 1 MIDWESTERN PRECAS ® ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber 750 750 1 MIDWESTERN PRECAS ® ❑ ❑ ❑ ❑ VI11. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plu r s Signature: (No amps) A220292 P/MPRSW No.: Business Phone Number: BENNIE HELGESON \ 715/772-3278 Plumber's Address (Street, City, State, Zip Code): 141U01770x91/(N4 W1229 770TH AVENUE,. SPRING VALLEY WI 54767 IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sa ary Permit Fee (Includes Groundwater Date Issue Issuing A nt Si nature( o a s) ft!* pproved ❑OwnerGiveninitial • Surcharge Fee) 7/6 -71Y7 Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-6398 (R. DS/94) DISTRIBUTION: original to County. One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must 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 pumped 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 and Buildings Division, 608-266-3815. 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 tax number(s) of where the system is to be installed. IL Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on 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. Vt. Absorption system information. Provide all information requested for numbers 1 through 7_ VII. Tank information. Fill in the capacity of every new/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 1/2'x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or vvith complete dimensions, location of holding tank(s), 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; 1.) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Commerce May 13, 1997 2226 Rose Street. La. Crosse WI 54603 HELGESON EXCAVATING W1229 770 AVE SPRING VALLEY WI 54767 RE: PLAN S97-40349 FEE RECEIVED: 180.00 KERR, KELLY SW,NW,13,28,15W TOWN OF CADY COUNTY OF ST CROIX MOUND SYSTEM The Department has reviewed the above-referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based on chapter 145, Wisconsin Statutes, and chapters Comm 83 and 84, Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter Comm 82 or in chapters ILHR 50-64, Wisconsin Administrative Code. This plan submittal approval will expire two years from the approval date, or if a sanitary permit is obtained, plan approval will expire on the day the initial sanitary permit expires. The licensed plumber responsible for this installation shall keep one set of plans with the Department's stamp of approval at the construction site. The installer shall notify the appropriate inspector when inspections can be made. All permits required by the city, village, township or county shall be obtained prior to installation. Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Si&.n ly, M. Swi viewer Section of Private Sewage (608) 785-9348 SBD-7907 MA I/96) INDEX SHEET AFbFi V,F O NO - SAFETY ~ ~ 1,g9) PROPERTY OWNER KELLY KERR 04 UGS Olt, PROJECT NAME: KELLY KERR PROJECT LOCATION: SW 1/4, NW 1/4, S 13, T 28, N, R, 15 W MUNICIPALITY: TOWNSHIP OF CADY COUNTY: ST CROIX CONTENTS Page 1: Plot Plan Page 2: Cross Section & Plan View Page 3: Pipe Detail Page 4: Pump Chamber Cross Section & Specifications Page 5: Pump Model & Size Name: Bennie Helgeson Signe Address: W1229 770Th &S"ff e rin 7 Sp .Date: May 1, 1997 Credentmber: 2 GG 5~~ N ~ (T Cly ~ ~ 0 NW W LA C7J o 00 61- °o Q T M ~ s A r O A ~ A nq ' ~ n F Page c~ Of 5 Cross Section Of A Mound Using A Trench For The Absorption Area lelev. 99 g -Tq aeral 9 ~3 AS1 1yl L'jFiI1;_,:,_ Medium Sand .~1 F o so v 9..5 E D p " Plowed Layer Trench Of h" - ; 21" Aggregate, 6" Below Pipe, Covered. With Reu.96.s 0 Ft Straw, Marsh Hay Or Synthetic Fabric E Ft. 0 ~ Ft. F H 1, S Ft. Plan View Of Mound Using A Trench For The Absorption Area Force Main ~ Distribution Pipe ~ P rmanentlAarkers Observation Pipe W B K r \Trench Of I? - W Aggregate . I L A Ft. K 0..2 Ft. W 7 Ft. B 75 Ft. J 7,7 Ft. L q Ft. 4 License Signed: -Number: Date: - • Aker 7~.G= ~ O`•- S P~R.F-oF2f~Tt=-b Pt PE G "x'.41 L t-?V~ PIPE ~ o~Z1J5TALl (>`C~MA1JEt.lT MA~'~"~"~ LihTL-RAL AT EtJD OF En CIA -Mu-WD tA?. Q ZioLES LOCA m-0 Ohl 3JT7U t1 AM% eWQA\-LY SPF+::tz . t / pV C .~,--'FpRCE "how 11y FRAM Pu h P "pvC ' 1-ATE~AL3 P1._AC-F- LhS"f liOL~ N ~>t? 1O E'UD CAP "D~STRI $uT701.1: PIPE .1.A4 D U~'= - PS FT. x 3 G .N, Oti= 1}OLE.Vpi PE o p of v4~+Ls -C u FROM TIEE W j-rH SU CCZSb)AJ G HDLe:S T..3~O "11J f U I.S . Ll~csT t-to~E 'f0 13E ~EXl' TD -17+E ON3D C ArP- ~C.Whr-r . ,l r& 4619- / PAr.r c,F .5 PUh%P CHAMBER CROcc AMU 'PECIFICAIIU~!.c: VENT GAP 4`C.I. \'E%!T PIPE . ROVED LOCA:''•i(, WEATHERPROOF APc JUNCTION 90X MA►JHOLE COVET. ~ 25' =ROM DOOR, WINDOW OR FRESH 12"MIU. AIR INTAKE I GRADE I 4" MI A:. ~ COWDUIT Q-'- WAIN. PROVIDE ( INLET AIRTIGHT SEAL I I ( I I I APPROVED JOINT A I I I I APFROVED JOINTS W/C.2. PIPE I I I W/,-. 1. PIPE EXTENDINb 3' I III ALARM EX7E►JDIAIG 3- OWTO SOLID SOIL I II OAN70 SOLID SOIL e I I I I ON . c I I i ELEV. q/ FT. PUMP OFF 0 CONCRETE BLOCK RISER EXIT PERMITI•ED OWLtl IF TAWK M~IJUFAGTURER HAS SUCH APPROVAL /OGn Gd/ SEPTIC E SPEC IF I•GATIOAIS 11 7- 44L DOSE I ' TAUKS MANUFACTURER: Mi~tileST Prh PkeCa!`1~ IJUMBE,IFt QF DOSES: PER DAy Fla "o ts.~c T• 7y TAIJK SIZE: D°Se- 7S'D GALLONS DOSE VOLUME ALARM MAUUFACTURER' S rI•tLTYO ~yc y's INCL DI B ~`FL 3~7S~ GALLONS 18,75' d~41 MODEL 1JUMBER: Nw CAPACITIES: A=_ _INCHES OR .-.2~_`-~~/0 GALLOWS SWITCH TYPE' Pyr t1 o.. ~IOtf. B= IMCHES OR q -CALLOUS PUMP MANUFACTURER: ~s c~ Co _ INCHES OR GALLOUS MODEL NUMBER: - D-./-3-:Z INCHES OR 5GALLOIJS SWITCH TYPE: ;~)b m-erCLclrc-. ~Ia@l MOTE: PUMP AUD ALARM ARE TO DE MINIMUM DISCHARGE RATE Q a INSTALLED ON SEPARATE CIRCUITS GPM VERTICAL DIFFEREAICE BETWEEIJ PUMP OFF AND DISTRII5UTIOM PIPE.. FEET + MIrJIMUM NETWORK SUPPLS PRESSURE. . . . . . . 2.5 FEET + _5- FEET OF FORCE MAIN X ~ F/Ioo rT.FRICTION FACTOR.. • ~S FEET TOTAL 0131JAMIC. HEAD = S- FEET ~ /i ~ N yd .V IIJTERNAL. DIMEIJSION` OF TAUK: •I•LE*.j&TH ;WIDTH ~.Z.L.-;~-IQUID DEPTH SIGrJED: \ LICEMSF I.JUMBER:? _ DATE: 00011 l' r Submersible •ble MODEL: 387 SOLID SIZE: 3/4 ID RPM: 1550 Effluent Pump HP: 0.4 METERS FEET ---r 25 7 w g 20 2 5 Z 15 • J O 3 10 2 • 5 0 Op 10 20 30 40 50 GPM g 10 12 m'/h 0 2 4 6 CAPACITY C, GOULD UM ~NC8 ON< /e October, 1988 F INTEO IN U.SA. i STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OV{ NER/BUYER. KELLY KERR MAILING ADDRESS 304 HANSON STREET, WOODVILLE WI 54028 PROPERTY ADDRESS cD I 4-'-t Ie (location of septic sys m) Please obtain from the Planning Dept. CITY/STATE PROPERTY LOCATION SW 114, NW 1/4, Section 13 T 28 N-R 15 W TOWN OF CADY ST. CROIX COUNTY, WI SUBDIVISION N/A LOT HUMMER N/A CERTIFIED SURVEY MAP LJr 1 H VOLUME lc9~48 PAGE 1-19 LOTNUMMER Jr~ Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which 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 Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/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 DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: DATE: 0-2 .7 St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 S T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/ contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of property KELLY KERR Location of property SW 1/4 NW 1/4, Section 13 T 28 N-R 15 W Township CADY Mailing address 304 HANSON STREET WOODVILLE WI 54028 Address of site 15a19 04-u.. Q6 ltpj-- Subdivision name Lot no. Other homes on property? Yes "C' No Previous owner of property f ~E1N 5 boecLR eQ-1Q c Total size of property 0.C Total size of parcel Date parcel was created to -aLo - Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house) ? 1e Yes No volume 1694& and Page Number 1-19 as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND 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 Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the ffice of the County Register of Deeds as Document No. and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the offic of the County Register of Deeds as Document No. Signa re o Applicant Co- pplicant 3c'7> - 9 7 (o • W - 9 7 Date of Sianature Date of Sianatiirp STATE BAR OF WISCONSIN FORM 1 - 1982 5G4 WARRANTY DEED DOCUMENT NO. VOL 12-48 Po 11 9 I{EGISMS Q M"ri ~ . SF, 010M M. Va. This Deed, made between Allen L. Kerr and Dorothv L. Kerr, his wife JUN 2 6 1997, 12:30 P. Grantor, and Kelly A. Kerr and Rebecca A. Kerr, husband and wife as survivorship marital property Register of Deeds Grantee, Witnesseth, That the said Grantor, for a valuable co • conveys to Grantee the following described real estate in St. Croix THIS SPACE RESERVED FOR RECORDING DATA County State of Wisconsin: NAME AND RETURN ADDRESS All that part of the Southwest Quarter of the mad( ~ .Northwest Quarter (SWJ •of NWJ) of Section Thirteen (13), Township Twenty-eight (28) North, Range Fifteen (15) West, lying South of County Highway "N", Town of.Cady, St. Croix County, part of 004-1029-90 Wisconsin. PARCEL IDENTIFICATION NUMBER T %FER This is not homestead property. (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And Grantors warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except. Easements; Township and Zoning Ordinances; Recorded Building and Use Restrictions; Covenants and Real Estate Taxes levied in year of closing. and will warrant and defend the same. Dated this o~.5 day of June 19 97 (SEAL) (SEAL) ' . Allen L. Kerr (SEAL) (SEAL) Dorothy L. Kerr AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, County J s .4 Parcel 004-1029-90-100 03i27i2007 03:06 PAGE 1 OF 1 F 1 Alt. Parcel 13.28.15.201A 004 - TOWN OF CADY Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 T r s: Owner(s): O = Current Owner, C = Current Co-Owner O - KERR, KELLY A & REBECCA A KELLY A & EBECCA A KERR YRDN WILSON WI 54027 Districts: SC = School SP = Special roperty Address(es): Primary Type Dist # Description " 3219 CTY RD N SC 5586 SPRING VALLEY SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 10.900 Plat: N/A-NOT AVAILABLE SEC 13 T28N R1 5W PT SW NW S OF COUNTY RD Block/Condo Bldg: N EZ-U-1255/316 & 1257/433 425/446 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 13-28N-15W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 425/446 2007 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 09/07/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 28,000 155,600 183,600 NO AGRICULTURAL G4 6.900 1,100 0 1,100 NO UNDEVELOPED G5 2.000 1,300 0 1,300 NO Totals for 2007: General Property 10.900 30,400 155,600 186,000 Woodland 0.000 0 0 Totals for 2006: General Property 10.900 30,400 155,600 186,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch 511 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 004-1029-90-000 03/27/2007 03:06 PM • PAGE 1 OF 1 Alt. Parcel 13.28.15.201 004 - TOWN OF CADY Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - KERR, ALLEN L & DOROTHY ALLEN L & DOROTHY KERR 3204 CTY RD N WILSON WI 54027 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 3204 CTY RD N SC 5586 SPRING VALLEY SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 29.100 Plat: N/A-NOT AVAILABLE SEC 13 T28N R15W SW NW EXC S OF COUNTY Block/Condo Bldg: RD N 425/446 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 13-28N-15W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 425/446 2007 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 04/17/2006 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 25.100 1,600 0 1,600 NO UNDEVELOPED G5 2.000 200 0 200 NO OTHER G7 2.000 24,000 86,000 110,000 NO Totals for 2007: General Property 29.100 25,800 86,000 111,800 Woodland 0.000 0 0 Totals for 2006: General Property 29.100 25,800 86,000 111,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch 511 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 -Vki-,censin Department of Industry, SOIL AND SITE EVALUATION REPORT Page _ of Labor 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 ST-` CPO l not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. U© 4 - /6 ? ` 17D APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: / / PROPERTY LOCATION l1 _ /1 e-! f I- GOVT. LOT jW 1/4 fJW14,S 13T N,R rJ E (or W PROPERTY OWNE ':S MAILI G ADDRESS LOT BLOC # SUED. NAME OR CSM # 6 14 ~zv~ oc2 r e e~ CITYtSTA~,E 'i ZIP CODE PHONE NUMBER OCITY VILLAGE [OTO NEAREST ROAD ,r [ New Construction Use [ Residential / Number of bedrooms [ j Addition to existing building I ] Replacement [ ] Public or commercial describe Code derived daily flow gpd Recommended design loading rate 4~ bed, gpd/ft2 • S trench, gpd/ft2 Absorption area required bed, ft2 gL~'0 trench, ft2 Maximum design loading rate , bed, gpd/ft2 s S__ trench, gpd/ft2 Recommended infiltration surface elevation(s) '7 7 97 5544a ok f~,- 4 ft (as referred to site plan benchmark) Additional design / site considerations Cast" y k 7 = 7S 7 J Parent material ZZZ Flood plain elevation, if applicable A_IeW ft S = Suitable for system CONVENTIONAL MMOU'Ne IN-GROUNLD P52SSURE AT-GRADE / SYSTEM IN F HOLD NG TAN U = Unsuitable fors stem ❑ S 9 U L9"S ❑ U ❑ S En ❑ S U E3 S SOIL DESCRIPTION REPORT Boring # Horizon _ Depth Dominant Color Mottles Texture Structure Consistence Bounday Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Ground / o J S rn ~k Y • S__ elev. a _ ft. --3C~ ` cU-) S rv3 _ Depth to L I b -7- ~ NP limiting factor a7, F-F Remarks: Boring # I Lj !b-l(" o S Itil u 1 1. S Ground 4,1 elev. , j 0 C a~ b' I v eft. REC Depth to limiting factor Remarks: CST Name:-Please Print Phone: ~S Le7'VI 1~ ~ o w Address: W D 9 !2 70 _11~ U i•~ Q C' (/L/~/ 7bl -7 Signature: Date: / y, CST,?Tke : U PROPERTY OWNER SOIL DESCRIPTION REPORT Page PARCEL I.D.# CGa Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Barbary Roots GPD/ft +C[v in. Munsell Gu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench y % l a~ s Ground 2 -5-3 / c5 y Y 1'C e elev. 7ft. Depth to limiting factor j Remarks: Boring # 3 / o I S 10 k Ylii i~ Q. j Nom. 44 A4 OL Ground elev. - ft. Depth to limiting factor aa' Remarks: Boring # 3 I Ground 3 5 3 ° v ~ r V /U elev. ft. Depth to limiting factor " Remarks: Boring # MO. : Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) i n tiC T_ IZI CA C7J o -C - t7 (O _ cic C ~ ~ i ol~ 7 p S ~w i S s "IT rt `r ~ ^ I 0 f^^~ Q~ I Ca s ~ z d j