HomeMy WebLinkAbout006-1010-20-100
0
Q
.r. 0
ri O
O 0.' O
C
C
O O
N a
!n I
U
~ 3 I
t (V
m
~ I
a Z
c
m
N
LL p0 N
c co
O -D
°
E Q ~
U
O M
_I a
~ I
I
z ~ ~ y I
(L co
!
Ul) F-
0
o z d C: 0
o w -
o
m z
CD z
N H j E_ M
` N O 7
N
~ Q) O C
~ O
d ~ Q O
C IS U
o O Z M Z
N Lo Z
N
H E 0
a~ m y
IL d w ` co C Cn
n v O
CL
a~ G D N
0 f0 _
y~ U
Z co H H
O O O z °
m
• ►v i 3 a a a N
a_ I L I
n
n o N aNi
to J U o rn rn
co r lf)
i N N N O O
O N
E c,
W m CL
06 'O m a)
Lt) R3
W 3 U
p N N
at o 0 E c o° E
O W
O p (0 U O O O D
" O Lo C O C N d
04 lr r*-~ 30 O N E N N N
C O H cn C O O M N
N
CL CO
t[y~,) E M CD .0 a -
= 00 O U! F- N O N Z M9 U)
O M O p N p E U
O rte.. ~I.
.r
eC
at a `m a
3
• ~ a d y c
E y C 3
t A t) a O in Ci .
6
Parcel 006-1010-20-100 02/23/2007 10:25 AM
PAGE 1 OF 1
Alt. Parcel 05.31.16.75A-10 006 - TOWN OF CYLON
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
03/26/2004 00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
BRENT T WIRTH O - WIRTH, BRENT T
EMILY IGNATIEV C -IGNATIEV, EMILY
2301 HWY 46
DEER PARK WI 54007
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 2301 HWY 46
SC 0119 AMERY
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 5.350 Plat: 4719-CSM 18-4719
SEC 5 T31 N R1 6W PT SW SW BEING CSM Block/Condo Bldg: LOT 01
18-4719 LOT 1 (5.350AC)
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
05-31N-16W SW SW
Notes: Parcel History:
Date Doc # Vol/Page Type
05/24/2004 763640 2579/153 WD
03/26/2004 757811 18/4719 CSM
2007 SUMMARY Bill Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 07/26/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.350 12,000 90,000 102,000 NO
AGRICULTURAL G4 3.000 500 0 500 NO
Totals for 2007:
General Property 5.350 12,500 90,000 102,500
Woodland 0.000 0 0
Totals for 2006:
General Property 5.350 12,500 90,000 102,500
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
4k. i g9' 7f . TY R. /
D00 1
2 T13 5.2484 Z -6 04
2
2 F' ..CLEAR LAKF- = 3' 2 4- s¢ L 7 6 1 1
a RE VO 18 PAGE 4719
~/~'••-•''EyOQ KAT HCEER H. ALSH
SnC+uL,G suAY~ REGISTER OF DEEDS
amnn ST. CRO I X CO., W1
s~0'ERTIFIED SURVEY MAP 03%26/200R02E30PK
Located in part of the Southwest Quarter of the Southwest Quarter of CERTIFIED SURVEY MAP
Section 5, Township 31 North. Range 16 West, Town of Cylon, St. Croix REC FEE: 13.00
County, Wisconsin. COPY FEE: 3.00
Prepared for and at the request of: PAGES: 2
Owner.
James Thompson
2301 State High woy "48"
Deer Park. WI 54007
Drafted by. Howard H. Horrid III
WEST % CORNER BEARINGS ARE REFERENCED TO THE SOUTH LINE OF THE
SEC. 5-31-16 SW 1/4 OF SECTION 5. TOWNSHIP 31 N., RANGE 16 W.
Zo (FOUND SURVEY MARK NA 10 WHICH IS ASSUMED TO BEAR S89-16.33"E.
I p NOTE: Outlot 1 is intended for rezoning to 200 a 200
W a&-residential and to be added to adjoining property in
Z Volume 531 page 360. Any other use ofOudot I must
I C { j comply with St. Croix County Subdivision and Zoning GRAPHIC SCALE
reguiations. SCALE IN FEET: 1 Inch - 200 feet
I S8 ' 18'50
tr ( 75.23' _ 7~ ~ NORTH LINE OF•~ T
f J THE SW 1/4 OF
THE SA(P16ROVED
70' S 89'18'50" E ST. CROIX COUNTY
296.23' W.q8EL4 NTY PiannkmZoNMandPorksCommitteel
0EEPi'°-L 5TL MAR 2 6 2004 ° q, 6~ g U
IiD .III- = PAGE 360 I
70'
uO OUTL OT 1'" O H If not recorded within 30 days of g p
1 I~" z O0 87,162 SQ. FT. OD w approval dabs "I be
1-4 CD C) N Z UNPL A T_ TED _L i4A0(C~
o a? 2.00 ACRES O M - - - - a. a~
'~IC~L4: p OF OWNER + v
I~ IIZ I~'^? = O ~ o~'a o
I III •I N S 89' 18'50 L E S 89' 18'50" E 674.00' I° a
I ~ i 288.75' ~ ~ I Sz: a 's 0
'X a
O: WEST L/NE OF THE SW11-4
°
Oo L OT2 I r V
ya a s
3 3
it: Co n N M TOTAL AREA: I y ° °
ao
I p IID loo LOT / 'y °o, 420,377 SQ. FT. ~ I p $ o P -
I~ EX ~ 1QD tFZ M l 9.65 ACRES I r ~ ig : g
II - m R1 v L' Z AREA EX. R.O.W.: I o o
-P I n C) _ = 410.510 SQ. FT. Q 10 0 o p-
2 - WARRANT 9.42 ACRES w I~ 3 N
A i` EED VOL 756 o v N m~ 5' n
g 2 = r \ PAGE 377 _ i 90 a o v
55' o
In N i~ 0 ryi/ R=EAST ^ w 3
NS 16'33"W_375.00' W o vK
70
N Iwo
CA CL
Z 1 ~In In to O >
p N r N p o
a I rn o I~IcIt'I ew C v~ °
No t w ° N ~il~ ~o°'o (A C) 01 $ rq Lo NO TH
_ - o I r*1 0 o
5~ - - N 89-16',33-
W
N 89' 163-W TF~L/NE . - - w i 546.98'
I 283.07' 16 33 W -
S89'16'33"E C•T.H_ _ H 299.00
1 64.02' S89'1 6'33 "E 2568.07' SOUTH 11'4 CORNER
JOB I WI05 SU158 U_NP_LA_T_TE_D_LANDS _ SEC. 5-31-16
Prepor d b LOT LEGEND (FOUND 2.5- /RO/V PIPE)
J~ Cor a&ng Glwp, /M / Section Corner Monument '
TOTAL AREA. of Record
Phone No. (715) 248-4319 233,155 SQ. FT. 0 Set 1" x 18" Iron Pipe weighing
Fax No. (715) 246-3830 5.35 ACRES 1.13 pounds per linear foot
P.O. Box 325
Building Setback Line (100' from Right of Way) _
New Richmond. WI 54017 223,600 SQ. FT. ,
Sheet 1 of 2 5.14 ACRES
Vol 18 Page 4719 400M
6%
STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER
ADDRESS
Flo 1, , 500 ?
SUBDIVISION
c-/- CSM# LOT #
SECTION T ~N-R_16& Town of A 4,
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
0
~°y ~ ass
.p
CO
t
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
s
BENCHMARK: ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: Liquid Capacity:
30,,5- Other
Setback from: Well 77 House
Pump: Manufacturer Model# Size
Float seperation Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
Width: Length Number of trenches
Distance & Direction to nearest prop. line:
1 /
House Other
Setback from: well:
75-
,6A - J, 7'/ ELEVATIONS / l
Building Sewer 7, /a ST Inlet: ON 60 ST outlet: i
PC inlet PC bottom Pump Off i~
Header/Manifold ZjQ,00 ~ Bottom of system
Existing Grade Final grade
DATE OF INSTALLATION: '77
PLUMBER ON JOB:
LICENSE NUMBER:
INSPECTOR: J
3/93:jt
Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County:
Labor and Human Relations
INSPECTION REPORT ST. CROIX
Safety and Buildings Division
(ATTACH TO PERMIT) Sanitary Permit No.:
GENERAL INFORMATION 284316
Permit Holder's Name: ❑ City ❑ Village Town o : State Plan ID No.:
THOMPSON, JIM CYLON
CST BM El v.: , Insp. BM Elev.: , BM Description: Parcel Tax No.:
/GrJ ,1,11 ll- G) S~e /C 006-1010-20-000
TANK INFORMATION ELEVATION DATA .2A~
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic IA-) IL-6/s Cm Benchmark
Dosin X7,70
Aeration Bldg. Sewer 710 S! ~ ~
St/ Inlet
H 9 7(,&&
~
TANK SETBACK INFORMATION St/ APE Outlet
TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic ,7y' 71 30 A NA Dt Bottom
Dosin NA HeaderaWtzaL 6 Z X'
Aeration NA Dist. Pipe -77 ng Bot. System 1"Y' 9d r-(1
I I PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand s_ 7-
C r~
Model Num GPM
TDH Lift Friction stem TDH Ft
Forcemain Length Dia. Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width . Length3p / No. Of Trenches PIT Of Pits Inside Dia. Liquid Depth
DIMENSIONS D / DIMENSIONS
SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING urer:
SETBACK
INFORMATION Type O S&760. / CH R Model Num er:
System: (~eo1 37'~. cry RUNIT
DISTRIBUTION SYSTEM
Header I Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length _ 7 ~ Dia. T Length 3J~ Dia. Spacing
S~
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade S
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.)
,i 5A, SW, SW DEER PARK
LOCAIT.ION : CYLON 5.31.16.
Z~ eanC rF o ~C°-&Ca r 0~, e-, ec&0"
Q~
Plan revision required? ❑ Yes B -A-0
Use other side for additional information.
SBD-6710 (R 05/91) Date Inspector's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
i
Safety and Buildings Division
~~■~nr,. 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
6(0 than 8 112 x 11 inches in size. 1
• See reverseside for instructions for completing this application State Sanitary Permit Number
2 9~8 /6
The information you provide may be used by other government agency programs ❑ Check it revision to previous application
(Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number
1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION
Property Owner Name Property Location
SWV SW 1/4,S 5 T N, R I (p E (or)(9
Property ~Owner's Mng~A dr~~ Lot Number Block Number
City, c State J I R.J t Zi Code Phone Number Subdivision Name or CSM Number
u- Ua0 (715) -513
II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ City Nearest Road
❑ village
❑ 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 Numbertsl
1 ❑ Apartment/ Condo 00(0- 1010-
❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility
2
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. KReplacement 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 dLI i(3$ 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 5. Perc. Rate 6. System Elev. 7. Final Grade
Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation
5c a 0 C fj 4 qd • $ Feet q5 Feet
VII. TANK Ca
in a]loacitns Total # of r Prefab. Site Fiber- Exper
INFORMATION g Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App
New Existin strutted
Tanks Tanks
Septic Tank or Holding Tank f LDI ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name: (Print) Plum is Sig ure: (N St MP PRSW No.: Business Phone Number:
of `145 `1IS_ tQg GQ
Plumber's Ad ress Stree , City, State, Zip Code):
P,O. 86,x mi r
IX. COUNTY/ DEPARTMENT USE 'ONLY
j~~ ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Age t Signature (No St
Approved Surcharge Fee)
❑ Owner Given Initial
Adverse Determination
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SSD-6398 (R. 05/94)' DISTRIBUTION: Original to County, One copy To: Safety & Buildings Divi ion, 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.
II. 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.
VI. 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 with 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; E) 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.
3-
a y x 3 s` ~3~.
goo, g
Nzpl.
3v
x lie _ VI
A
38,
C~v
Wisconsin ,Department of Industry, SOIL AND SITE EVALUATION
Labor and Human Relations Page L of
Divisidn of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Adm. Code
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County
include, but not limited to: vertical and horizontal reference point (BM), direction and S-11
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. #
o C) ~a /o/C9 C~
APPLICANT INFORMATION - Please print all information. Reviewed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner Property Location
ZL4etn Govt. Lot Ste, 1/44 1/4,S S'' T N,R E (or)IV
Property er's Mailing Addr s Lot # Block# Subd. Name or CSM#
9,361
City State Zip Code Phone Number ❑ City Village Town Nearest Road
❑ New Construction Use: ❑ Residential / Number of bedrooms 3 Addition to existing building
Replacement ❑ Public or commercial - Describe:
Code derived daily flow ' /S-O gpd Recommended design loading rate i bed, gpd/ft2_/~_trench, gpd/ft2
i
Absorption area required dd bed, ft2 - 0 trench, ft2 p Maximum design loading rate . S bed, gpd/ft2_jj6_trench, gpd/ft2
Recommended infiltration surface elevation(s) (as referred to site plan benchmark)
Additional design/site considerations / A 3 & &_'o
Parent material - dC.Cae•eL•C Flood plain elevation, if applicable ft
i
S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank
U = Unsuitable for system S ❑ U F9 S El U IiNlS 1:1 U El s 5-_u El S E+ U ❑ S {]-U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
l l x j ' v' S-// s: 14'Fs,~iC IS~itAeCW a m c- e , ,3
D- ef-3 S14 3/3 S, :1.0 57 1 1/1jes k MclorW c 3 Z ' - 3
Ground
lev to
r
L
Depth to
limiting P 1
factor
~OT_in. 8T
c
Remarks:
Boring #
z •y ~~r R 3f~ s, ~Cf lL'~S~/l ~61~ ;3
Ground
elev.
9Sa 3J ft. '
Depth to
limiting
factor
/OQ_in. Remarks:
CST Name (Please Print) Signature Telephone No.
404'hn Gt' v 7• s'= .26 r- GG a •7
Address Date CST Number
3? 2 1410 tk sr ti-ce ' 1411 S,go~o 3 • 9 7 3 Vo 9'
SOIL DESCRIPTION REPORT
PROPERTY OWNER1X601 02& `I Page of X
PARCEL I.D.#
Borin # Horizon Depth Dominant Color Mottles Structure 2
g Texture Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed . Trench
Ground %__t) 7 S St /r si, A 1
elev
Depth to
limiting
cfactor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
in.
Remarks:
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
Boring #
Ground
elev. ,
Depqto
limiting
factor
in. Remarks:
Boring #
Ground
elev.
ft '
Depth to
limiting
factor
in. Remarks:
SBDW-8330 (R., 08/95)
~ 67 Ion
'w Sr,. s,;'T31 N'414AW
sTt.Y► W, 8'
y~ A/5t
/
f4~
;L2 j :A!% 3 '
t
2~
8 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 (yl E- 7 C o
5 -Location of property5Ld 1/4'5-F-- 1/4, Section S
T 3( N-R /6 W
s w /y Townsh' Mailing address 3 C9 ( y~
Q ~ ~ l~ ~ ~ s~-I o a -7
Address of site S Q Q
Subdivision name Lot no.
Other homes on property? Yes ~C No
Previous owner of property
Total size of property
Total size of parcel
Date parcel was created
Are all corners and lot lines identifiable? k. Yes No
Is this property being developed for (spec house)? Yes No
Volume and Page Number I 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 office 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'"office of the County Register„ of Deeds as Document No.
ignature of Applicant
Co- pelican
Date 4 f Signature Date of Signature
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
~l U4 k o
OWNER/BUYER W
MAILING ADDRESS -ID 0 / 4 w Y 'lJ Ir VGL i.J l
PROPERTY ADDRESS 5~l Ov 7
(location of septic system,) Please obtain from the Planning Dept. -
CITY/STATE W t 5 y
SW a~ 5wey
PROPERTY LOCATION S tJ 1/4, S 1/4, Section , T 3( N-R W
TOWN OF C X a ►w ST. CROIX COUNTY, WI
e
SUBDIVISION LOT NUMBER
CERTIFIEDSURVEY MAP , VOLUME , PAGE , LOT NUMBER
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 thr/ee.. xpiration date.
SIGNE)7
DATE: 7
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
O!~t 7 h'7 L ~1 A^~~nI~1 brATE V*,H OP WtSCCVSIN FORM
,,,,1 WARRANTY DEED
REGISTERS OFFICE
_ ST. CROIX CO. WIS.
Clara Thompson,,a single ~
person, Reed. for Record this_26th
- daY Sept /1. D. 19 'T8
~unve.s an:4 wnrrnn~+ to - O} U A~. M.
_ -
Jamey ir,. Thompson: and .Zs.the-r Thompson,
husband and wife. as joint_tenants._
R~plt of eed,
- _ - - Union State dank
the foi:owing d~~crihed real estate in St. Croix Deer Pa; tk
...........County,
State of Wiseomin:
The South Half of the Southwest Quarter (S11 SW%) Tax Key No...
and the Southwest Quarter of the Southeast Quarter
(SWk SE14), Section 5, Township 31 North, Range 16 West, except
the following described parcels in the Southwest Quarter of the
Southwest Quarter (SW% SW~)e
TRRNSFER
1. Lot 1 of Ceiti.fied Survey ,tap recorded in Volume 2 of CS~t on. s ~
page 391, a current No. 340901 in the office of the Register of
Deeds-for St. Croix County, Wisconsin; FEE
2. West 418 feet of the North 209 -ft~eet of the Southwest Quarter of
the Southwest Quarter (SW'54 S04): •Section 5, Township 31 North,
Range 16 West; and'
3. Commencing at the Southwest corner of said Section 5; thence East along South
line of Section 5, 480.09 feet; thence North 33.0 feet to North right of way
line of C.T.H. "x", and the point of beginning for the parcel to be described;
thence North 208 feet 8 inches; thence West at right angles. 208 feet 8 inches;
thence South at right angles, 208 feet 8 inches; thence East at right angles,
208 feet 8 inches to the point of beginning.
Subject to right of way of St. Croix County Highway "H"Wand State Highway
46. SEE REVERSE SIDE HEREOF
T`-k i3 not - homestead property.
(i") (is nnt)
Exrvp'ion to warranties'>-~
Subject only to municipal and zoning ordinances and r.ocorded easements
and restrictions of record, if any,
Dated this 23 September ` ° 78
day- of - - 19- -
(SEAL) ' ~CL..~ c~SL ~L. (SEAL)
. Clara Thom aon
- p--------•-----.---
--(SEAL)
P~T~~ea
NOTARY
AUTHENTICATION ACKNOWLEDGME
~,w
Signatures authenticated this day of STATE OF WISCONSIN
1s........ yJ► PUBLIC
St. Croix (ss. "~j~g~~,
County.
Personally came before me, this 23 `
. September_,1974he above named
TITLE: MEMBER STATE BAR OF WISCONSIN Clara-:Tbompson,._a..single•-person_.._______.___
(lt loot . - .
authorized by § 706.06, Wis. Stats.)
---------------p...I..
CWAYNA, bi~f t~ , E~ S, AGUSrI~ 6 WILLIAMS w me known to be the er. w~ho executed the
a n n__. ni . , :,,regmin(; ir~trament and ael nocv~ $1'-~ _ame.
V
This deed is given in satisfaction of a land contract dated October 29.,
1977 and recorded in Volume 564, page 278 as Instrument No. 344590 in
the office of the Register of Deeds in and for St. Croix County, Wis-
consin, which land contract amended another land'contract dated June 1,
1973 and recorded in Volume 498, page 519 as Instrument No. 316544 in
the office of the Register of Deeds in and for St. Croix County, Wisconsin.
1