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BEARINGS ARE REFERENCED TO THE WEST m
UNE OF THE NW1/4 OF SECTION 23,
ASSUMED TO BEAR SOO'53'11 "E
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SHEET 2 OF 3 SHEETS
Vol 19 Page 4873
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VOL 19 PAGE 4873
KATALEEN H.
REGISTER OF DEEDS
ST. CROIX CO. NI
RECEIVED FOR RECORD
^1 11/03/2004 01:30PN
FA c APPROV
o N ST. CROIX CO CERTIFIED SURVEY MAP
TY REC FEE:
15.00
r and P; m~~ ~t~e~
tTl PlanninotonAna COPY FEE: 4.00
c Z Z904 r' PAGES : 3
T NOV U 3=
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S.. O f+l If not recorded within *hall z
be
approval date ~'d
nult and BEARINGS ARE REFERENCED TO THE
' UN PLATTED LANDS WEST UNE OF THE NWI/4 OF SECTION
ao _ _ _ _ _ _ _ _ - -
II - - - - 23, ASSUMED TO BEAR SOO'53'11"E
SOO'5S "E 2653.76'
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SHEET 1 OF 3 ../SHEETS
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Vol 19 Page 4873
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Wisconsin Department of Industry, SOIL AND
Labor and Human Relations _ FtyAtUATION Page of
Division of Safety and Buildings in accordance h ;,MCHR 83.09, Wis\.A74m. Code
Attach complete site plan on paper not less than 8 1 /2 x 11 inches ' Plan fr►b~t.`.; 4 ' i. Cout#y
l /s
include, but not limited to: vertical and horizontal reference point ( direction and 5-I ` N
percent slope, scale or dimensions, north arrow, and location and ce,lggrei~t wad, 1° p feel I.D. #
APPLICANT INFORMATION - Please print all in 1 5 _U0
• t fl.C,C~k-'l ICS Rev* ed by , Date
Personal information you provide may be used for secondary purposes (Privacy w .04 (1) (m)). ' 11' f~l w"~~
14 V 2Qb
Property Owner Or p ry dc
•::rp ' r" t 1/4 ~j W 1/4,S a 3 T 3D N,R E (or5
Property Owner's Mailing Address Lot # Block# Subd. Name or CSM#
•3 / 9 ~
City State Zi Code Phone Number ❑ City ❑ Village ® Town Nearest Road
So ert ~'r t 5 yoAS IS >~47-3 3 ~~s r+ S•
W& RA
El New Construction Use: ® Residential / Number of bedrooms Addition to existing building
❑ Replacement ❑ Public or commercial - Describe:
Code derived daily flow 3 c y gpd Recommended design loading rate . , bed, gpd/ft2 _1? trench, gpd/ff2
Absorption area required y ;14A. bed, ft2 3 7 S trench, ft2 Maximum design loading rate bed, d/f
Q gp g trench, gpd/ft2
Recommended infiltration surface elevation(s) 1 S . SO ft (as referred to site plan benchmark)
Additional design/site considerations
Parent material G 14 C i Cy L.. "t- t,5 -A s, ~ Flood plain elevation, if applicable ft
Fu = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank
= Unsuitable for system ® s ❑ U ~I S❑ u [S' S❑ u 59 S❑ U ❑ S (g li El S 59 U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2
in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots
Bed Trench
V/
SL F r MFr
W-3 7.5 YR N/3 L 5 - n'„ L Gw WF
Ground 3 3D-$ 7, 5`fRy/y S
lev. f rt l C W, g
eft. y 7-7. s 7R L. .
Depth to
limiting
factor
-So in.
Remarks:
Boring #
A-e 0-9 0--w-A IF
Ground
elev.
ft. '
Depth to
limiting
factor
in. Remarks:
CST Name (Pleases Print) Signat re Telephone No.
a - S
T Q r k -)),5
Address Date CST Number
a.
-7 Le DQ-"' S". -tet, r 4,11 i It 145, - - cif 01
6 VD-1 6
SOIL DESCRIPTION REPORT
PROPERTY OWNER Page of
PARCEL I.D.#
8
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots G~Djft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
Ground
elev.
ft.
Depth to
limiting
factor
in.
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.
ft.
Depth to
limiting
factor
in. Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
in. Remarks:
SBDW-8330 (R. 08/95)
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Parcel 030-1057-60-000 02/24/2005 05:09 PM
PAGE 1 OF 1
Alt. Parcel 23.30.19.201 E 030 - TOWN OF SAINT JOSEPH
Current XI ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): * = Current Owner
* EIRING, JOHN & DONNA J
JOHN & DONNA J EIRING
1477 N BAY RD
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 1477 N BAY RD
SC 5432 SCH D OF SOMERSET
SP 8040 BASS LAKE REHAB DIST
SP 1700 WITC
Legal Description: Acres: 18.870 Plat: N/A-NOT AVAILABLE
SEC 23 T30N R1 9W GL 5 LOT 4 OF CSM 3/861 Block/Condo Bldg:
ALSO PT GL 5 COM W 1/4 COR OF SEC 23;TH
N 00 DEG W 1327.03;TH S 89 DEG E Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
1317.39';TH N 26 DEG W 365.52' POB;TH N 23-30N-19W
41 DEG W 348.70';TH NELY ALG ROW 68.03'
TO W LN OF LOTS 3 & 4 CSM 3/861;TH S 41
more...
Notes: Parcel History:
Date Doc # Vol/Page Type
04/11/2000 621036 1501/576 WD
07/23/1997 712/524
2004 SUMMARY Bill Fair Market Value: Assessed with:
5213 552,200
Valuations: Last Changed: 07/08/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.000 301,000 175,700 476,700 NO
PRODUCTIVE FORST LANC G6 15.870 66,600 0 66,600 NO
Totals for 2004:
General Property 18.870 367,600 175,700 543,300
Woodland 0.000 0 0
Totals for 2003:
General Property 18.870 198,400 141,200 339,600
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 108
Specials:
User Special Code Category Amount
040-OTHER ASSM'T SPECIAL ASSESSMENT 740.28
Special Assessments Special Charges Delinquent Charges
Total 740.28 0.00 0.00
r.
AS'BUILT SANITARY SYSTEM REPORT
OWNER. J, A~ TOWNSHIP IT, clop SEC C. T_N-R_W
ADDRESS ST. CROIX COUNTY, WISCONSIN.
SUBDIVISION LOT LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of H63
THING WITHIN 100 FEET OF SYSTEM
r~
-7 Fe7 V-1
d
Tie T ti
ALldi
a e o th Arrow LZI~
1- .4 ILI
i
BENCHMARK: (Permanent reference Point) Describe: 7dp v/= ,BL04C. Fot`~u~~TiaM
Elevation of vertical reference oint:
p /®C? ~-00 Slope at site: Q
SEPTIC TANK: Manufacturer:Liquid Capacity: Mon
Number of rings on cover : / Tank manhole cover elevation:
Tank Inlet. Elevation: yam- Tank Outlet Elevation: PUMP CHAMBER.
Manufacturer: Number of gallons
Number of gal. pump set or a cycle_ gallons; total capacity o
distribution lines gallon: size o pump head;
gallon per minute horsepower ran name of pump
and-model-number
Type of warning device
HOLDING TANK: Manufacturer Number of gallons
7-2-~/
REPORT OF INSPECTION - INDIVIDUAL SLWAGL SYSTEM
San.i. t.avi if 1'e~+m4t
State Septic
tv A' A4 I
,JejnG Town.6
p. St. Cho i x Cuun.#y
I I cr fi c,vr G.r ~S.e.0t-i.ov Lot N Sub divis i-can
~.-STd l.Tl"'
t'1'T l TANK
ti c zc' Nu.mben o6 eompantments
Ui'~tavrce 6nom: weft 8uitding _12s ~SEupe
H ig h w a t e. n
PUMPING CHAMBER
S.i ze gatton4 . Pump Manu6detun.e.4 Modef Numbe.n.
HOLDING TANK - -
S4, ze_______ gallons Numbers. o6 Compantme.nts
Pclmpen A,Qan.m, Sy4tem
U.i.e tanc e 640,m ,a wetf Buitding_ 1,2% .6 tope -
Highwate.n
ALiSORPTION SITE
Ill ~ taP!ov 6A..um: Weef Bui Pdi.~e~~- 12% ekupe
. .
Hl('ghwate)i
AIt.`ORPTION SITE DIMENSIONS
Width o6 tne.nch____-_.1- _-_6t Re.qu.i.ne.d an. e. a.
%Length o6 each tines _.6t Depth o6 nock bePow t<.fe. /,7-- (YI
Nii mbeit o6 fi-nes
Depth a6 hack avers t.%('e ~ I.vl
t o tak Length o6 line.6 _At Depth, o6 tit e be. ow gnade i n
Dt.atance between. finee -
G At ~Zope. 06 thenchin. pe.il 100 At
Total abaohption anea ~J 6.t Type o6 Coven: Pape.n fi~ca
i'11 DIMENSIONS
Numbers 06 pit's
Gnavel' a.naun"d I:>4'te ye.h n.•
01, to i de' (1 amete.n -6t Depth befow
l o tak abeonpti n anew 6t..
A~tea nequine. At
19 A
74,
EH 115 Rev. 9/78 ~ t •r~~ , ~ ~Q ~ 7~t s t`s o~~
REPORT ON SOIL BORINGS PE~COE I I T Per TA06&' am rl~~ Zdf-
WISCONSIN DEPARTMENT OF TKJ" S CES 70
P.O. BOX 309, MADI ISCO~ a / t_ An ~y Q
An
OFFICE T T -C A f Ow
? C- WAS
LOCATIO Sections,l,~T-?-C2 T-?-C2 (or QTo Mu 'ci tyi~' e ~s ~i
Lot No. , Block No. CV-06;t a unty 'rA a6doe`,'
` i rvlsion ame
Owner's/Buyers Name: s
Mailing Address: B .S cS'
TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW--X REPLACEMENTALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS_ ~l -1 PERCOLATION TESTS
SOIL MAP SHEET NAME OF SOIL MAP UNITS_en C.2L-
PERCOLATION TESTS
TEST NUM- DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
INCHES THICKNESS IN INCHES SINCE HOLE LE AFTE INTERVAL
BER 1ST WETTED SWELLING IN MINUTES PERIOD I PERIOD 2 PERIOD 3 MIN//IN
P At/~+~~ ra C 3 t L ' /
P- .a Q n C Y O
P--; 010re- z AID 3 3 -3
P-
P-
P-
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,
NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK
OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES
B tf 7 1" v t. S r 'O's *J &JAZAeo 4r
B " ct L~Lp.ttt~ '7 - if _y C9 `t 'A, ed -k jj~g Act
B- -3 a 7 ti ;Py'-
B-
B-
B-
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of.suitable areas.
Indicate number of square feet of absorption area needed for building type and Dorapancy~ G d In irate scale or distances.
Give horizontal and vertical reference
points. Indicate slope. t`~e~
TA s
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PL13 67 State and County State Permit #
`s Permit Application County Permit #
for Private Domestic Sewage Systems County
"DENOTE STATE APPROVA O BRED
Date App ova Received t equired State Plan I.D. #
A. OW R F T Y Mailing Address: a/
B. LOCATI N: Section ~U, TYO, N, R ' E (or) Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
S7ou1 Township
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) Variance
Single family X Duplex No. of Bedrooms No. of Persons
D. SEPTIC TANK CAPACITY &4W Total gallons No. of tanks /
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete X Poured-in-Place Steel Fiberglass Other (specify)
New Installation A( Replacement
Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify)
E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate Total Absorb Area sq. ft.
New X Replacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width. Depth Tile depth (top)_ No. of Trenches
Seepage Bed: A Length .36 WidthZ_Depth Tile depth (top)~_No. of Lines
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land Distance from critical slope
WATER SUPPLY: Private ® Joint ❑ Community El Municipal ❑
Owners name as listed on EH 115 if other than present owner:
I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared
by the Certified Soil Tester,
NAME _ j2E--,dZAej S C~/~/ST®p~.~~►~~ C.S.T. # ,5_,55 -/3 197 and other information
obtained from --0a- ner uilde0.
Plumber's Signature MPR Phone #715- 6_517-4
Plumber's Address
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca-
tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors
property. If well has not been drilled please indicate.
I
n T"
i
.F AIf f r.
l
PLIB 6 7 State and County State Permit # --16 617 7'
Permit Application County Perm
for Private Domestic Sewage Systems County
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A--Q,WNER OF PROPERTY Mailing Address:
B. LOCATION: ,MU/%, Section T_Jd N, R-& E (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
7677- Township ~S%~70SEit1f/
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) .Variance
Single family _X Duplex No. of Bedrooms 3 No. of Persons
D. SEPTIC TANK CAPACITY loot) Total gallons No. of tanks
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete X_ Poured-in-Place Steel Fiberglass Other (specify)
New Installation X' Replacement
Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify)
E. EFFLUENT DISPOSAL SYSTEM: Percolation Ra " Total Absorb Area sq. ft.
New--X-Replacement Alternate (Specify)
Seepage Trench: No. of i eal Ft. Width,-Depth Tile depth (to~p)No. of Trenches
Seepage Bed:. ~ _Length _Width De th
p r_Tile depth (top)-~4No. of Linec
Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits
Percent slope of land_ EZ Distance from critical slope
WATER SUPPLY: Private A Joint ❑ Community ❑ Municipal ❑
Owners name as listed on EH 115 if other than present owner:
I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared
by the Certified Soil Tester,
NAME At) aeA r 1. /CIt r C.S.T. # 5:3--di,Z ZE-21 nd other information
obtained from-
Plumber 's r).
Signature M PRS -.?2d~ Phone
Plumber's Address r
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca-
tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors
property. If well has not been drilled please indicate.
TWS SHE- 04~ • 2
EHw Rev. 9/78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS /ai9GEs
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATION: ,T 3° N,R I E (or) W, Township or Municipality s, C/1?O ~ ' lg
Section 13
~p~T S~,gD%visic~ "
Of laQUT LD~~ County
Lot No.~, Block No. u 'vision Name
Owner's/Buyers Name: 70 tf A.)
Mailing Address: '
TYPE OF OCCUPANCY:. Residence X No. of Bedrooms COMMERCIAL
x OTHER
ALTERNATE SYSTEM
EFFLUENT DISPOSAL SYSTEM: NEW -)(REPLACEMENT
PERCOLATION TESTS
d 0 J
DATES OBSERVATIONS MADE' IL BORINGS ~y /N TESTS
SOIL MAP SHEET. S~f NAME OF SOIL MAP UNIT 7
PERCOLATION TESTS
HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
TEST DOH CHARACTER SOIL SINCE HOLE HOLE AFTE INTERVAL PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
NUM INCHES THICKNESS IN I NCHES 1ST WETTED SWELLING IN MINUTES
BER ~1 3 3
P- p ''RN-G ~oAM 1, A1_0
P- 2 h~Q• bR• SA'VP Z
P-
1P IffAJ
SOIL BORING TESTS
DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,
TEST TOTAL DEPTH TEXTURE, MOTTLING AND DEPTH TO BEDROCK
NUMBER INCHES OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES
72 " 7'• G 'QN , OrfH 7'"l~iNE 014 SwD I~"~S O " /E,~.
B- if
6,t7c
.1<rED SAND w % ofe DEW s yJr cp, S.
B- 72- /1lo~V~ 71. -4m. LOAM 7NE0• Of .SAA;W R
Y- RIAAADT d) (:)Je.
B- 11,4 _fA A.)D
3 ?!a - Sl "~,NF~-• /a
100" A16A)£ 12111646yf-~4 .1 1 a51 ~s
B-
i, .~N ,SAID w B- BOWDS Odw. /S
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan t~~ocatiand square eetsof suitable areas..
Indicate number of square feet of absorption area needed for building type and occupancy or distances
Give horizontal and vertical reference points. Indicate slope. U)I
e
CIO)
P&H
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EH~_114 Rev. 9/78 7-1413 5,1716- 1046.
c-
REPORT ON SOIL BORINGS AND PERCOLATION TESTS Z 1~6E
Tri3_ WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES s
P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATION: ~~'/4, Section 13 ,T DN,RLy E (or) W, Township or Municipality
Lot No. Block No. 6007• L01 # :!;700F • County
Sy/31~ s7' «'D~X
Owner's/Buyers Name: JO HA.) E / ko iAJ 6- u Ivislon Name
Mailing Address: ~l a t!o DDS %ll cQ . /FooPN5 Uill_q_
TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL \
EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM (o
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS
SOIL MAP SHEET NAME OF SOIL MAP UNIT
PERCOLATION TESTS
TEST DEPTH HOURS WATER IN TEST TIME i
NUM- CHARACTER OF SOIL DROP IN WAT E iet_ I 6ME SINCE HO RATE
INCHES THICKNESS IN INCHES LE BOLE AFTE INTERVAL
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
P-
P-
P-
LsTe .3
P-
P-
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,
NUMBER INCHES OBSERVED ESTIMATED HIGHEST TEXTURE, MOTTLING AND DEPTH TO BEDROCK
IF OBSERVED IN INCHES
B- -7 iV aNE > 7 2- 2 ~-G Y, SL 49,0 At X? " AAA
B- cu 71, 4e.
=Q AoAM .
B- NOME > I '1~e2e (3N LOAW 3 "oR. f,9No Lo,fM
B-
B- 12„ AT 1h,4 , Sr►,vD
o15
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas.
Indicate number of square feet of absorption area needed for building type and occupancy Indicate scale or distances.
Give horizontal and vertical reference points. Indicate slope.
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EFU 115 Rev. 9n6 ~iL~~ /0~6E of z
REPORT ON SOIL BORINGS AND PERCOLATION TESTS ~j¢6FS
T,e::r WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
~l P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATION:'/F'/.,/yW Section 23 T 2'0 N,R /9 E (or) W, Township or Municipality .-y T f 1~~
Lot No.6~131ock No. of 4p// 4f;#s rfpv/ SUBD~/!/T/oN 57~. ~'PO/
County 1
Subdivision Name _ -
Owner's/Buyers Name: TO #i/ A-1 A
Mailing Address: 00001 / D. ~U,f~/I~•'U//~~ /~`l.l~N.y~ . f
TYPE OF OCCUPANCY: Residence-)( No. of Bedrooms COMMERCIAL ` f12
W
EFFLUENT DISPOSAL SYSTEM: NEW X REPLACEMENT ALTERNATE SYSTE y~OTHi
DATES OBSERVATIONS MA SOIL BORINGS L~ 2± AM PERCOLATION TESTS
SOIL MAP SHEET~GS .3 NAME OF SOIL MAP UNIT C~C'L C i
PERCOLATION TESTS _
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTE INTERVAL MIN/IN
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
P- 14 &;E% S TuRr9TEL3 S7/e O 54,vD el-4 SCG
P- ,4_11ST If 7- GifiP %N!r- 1>E f ST E
P- 1 ./410 eL/N B%L 254,10L- 517
v/P TJo,v
P- Ex ~.v1~ Zvi iN 2 " of S~.P P_F . E 7' .v1~/N s'
P- M Evi,4TF / 'Z//V vi AEI, R -76 P- ~O/V 7/il-L ~i~ Nf/E S STE
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,
NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK
OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES
B- Z NONE 7 7,?_
B- 2 7L Np/VF > 72 ''~mnpSE/3~• /S 5'" ~O. S Sc 6!LW!1 7' " f
B- 3 72 NDNE Ar 2-Qm- S/ "LIAO.S/ 2 Ae' ScL w 0-&8 AfO7 r 16 B- 2y"A 54
B- '72- klET AT (p). " 1,- 1/2 Al 0-BN_,Y9)& Zp °
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas.
Indicate number of square feet of absorptio.. area needed for building type and occupancy No7' S~iTED {OAP Indicate scale or distances.
Give horizontal and vertical reference points. Indicate slope. NIS 4464 D~P~y%Nf/tt~
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REPORT ON SOIL BORINGS AND PERCOLATION TESTS n
5~ WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES Z /~6Ff
/ / P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATION: 444 Section ~3 ,T'3vN,RaE (or) W, Township or Municipality
Lot No.?~EBlock No. County 5y e'PG/)(
Subdivision Name
Owner's/Buyers Name: -Allw
Mailing Address: SEF AWE- J tJ~ ?tsT /1,fZ->} j#/
TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS
SOIL MAP SHEET NAME OF SOIL MAP UNIT ; r
PERCOLATION TESTS
TEST DEPTH HOURS WATER IN TEST TIME IN IAI E
NUM- CHARACTER OF SOIL SINCE HOLE HOLE AFTE INTERVAL RATE
BER INCHES THICKNESS IN INCHES IOD 1 ^ ERIC 3 MIN/IN
1ST WETTED SWELLING IN MINUTES
P G
P-
P-
P-
P-
P-
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,
NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK
OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES
B- jr 72 ~Z" 1S /2" V S/ 13 Z/ - S/ /7"SCZ w .f:f 11075
B- 0AWVA/ J 1:ffWCT -.alle Ole. /k0t3"
B-
B-
113-
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas.
Indicate number of square feet of absorption area needed for building type and occupancy Indicate scale or distances.
Give horizontal and vertical reference points. Indicate slope.
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EH 115`Rev. 9/78 -
REPORT ON SOIL BORINGS AND PERCOLATION TESTS lQ~G~c-f
~~r SlTF WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
Z P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATION: Section 2_3,T 30 N,R- E (or) W, Township or Municipality
Lot No. Block No. Z j- 7'OV7 Sy~A/U!S• aunty s7. 7-I 1
~kjbdivision Name
_ J'D11AI WAI e~-
Owner's/Buyers Name:
Mailing Address:
TYPE OF OCCUPANCY: Residence X No. of Bedrooms 3 COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW X REPLACEMENT ALTERNATE SYSTEM THEFT '
DATES OBSERVATIONS MAD IL BORINGS X1/91/ l90190 PERCOLATION TESTS
SOIL MAP SHEET SCS NAME OF SOIL MAP UNIT ~D C~Z C7flETF i -
PERCOLATION TESTS oralvL4-X
TEST DEPTH HOURS WATER IN TEST TIME
NUM- CHARACTER OF SOIL DROP IN WATER LEVEL, INCHES RATE
INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTE INTERVAL
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
P- / !),(gyp 04 72-e AT " AKrll' cT
P- List/ 5c l- v l~iY V /i /c/'
P- i E Ztl-7- usF 4 V 14:W
P-
P-
P-
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,
NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK
OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES
B- q/ONE 71 A lc 6 / 16"1-1-&, /s ",me
B-
B- /1 " e- w O - 6'y, 0,6r.
B- 2- 5zn IJAI, _f 1-01141 of All 2 2- *,CP, X441Z
B w G>1 / " 84Am2r o/` et4K plx.p 1
2 " s<< w ove - G-
B- e-.S PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas.
Indicate number of square feet of absorption area needed for building type and occupancy _7`liit !~`1i'ftLY.IT£' Indicate scale or distances.
Give horizontal and vertical reference points. Indicate slope. ~4,eeJ} NOT ,s'G%fEO FO.Q ~'j~sc1PP7~/GLv -f Elm,
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Rev. 9/78 / Z-
4 REPORT ON SOIL BORINGS AND PERCOLATION TESTS / vv
S<'T~ # L WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES 2 f
t/o vr11W)AP P.O. BOX 309, MADISON, WISCONSIN 53701
LOCATION:NE XAL Section Z3 T e)N,R dE (or) W, Township or Municipality
Lot No. , Block No. County
Owner's/Buyers Name: ivision ame
Mailing Address: ~j ?EST >l/"fE L 4,
g4 24
Jam' ,PJ.
TYPE OF OCCUPANCY:. Residence No. of Bedrooms COMMERCIAL
To A-—
EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SY_' ~~r•s
DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TES
SOIL MAP SHEET NAME OF SOIL MAP UNIT
PERCOLATION TESTS
TEST NUM- DEPTH CHARACTER SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
SINCE HOLE BOLE AFTE INTERVAL
BER INCHES THICKNESS IN INCHES 1STWETTED SWELLING INMINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
P-
P-
P-
P-
P- EST S/'f~ L
P_
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,
NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK
OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES
B- NOME S/ 2/
B- SAND &"AW & dl, Q1°. S 4 "Cs w Z /"AA-ADS S<< ,
B- l2" ScL AtofllZI-o 6040- leafs .
B- SL "Lf'/3N )N_-j7 D V S
Z 51
B- i~vcf -G.PA /'~O s. SE~f396E .I r 66 .
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas.
Indicate number of square feet of absorption area needed for building type and occupancy Indicate scale or distances.
Give horizontal and vertical reference points. Indicate slope.
Ass 74.,<'
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W-1-A" WISCONSIN DEPARTMENT OF HEALTH & SOCIAL SERVICES
• Division of Health
` Section of Plumbing & Fire Protection Systems
ON-SITE WASTE DISPOSAL INSPECTION REPORT
Name of Premises
Stteet City County
Mister Plumb y,' n b!r, <
Address
Owner Address
❑ County Permits ❑ Appropriate State Permits
Type of Building: - ❑ Public Single Family orDuplcrk`
CHECK APPROPRIATE BOX FOR VIOLATION TYPE OF TREATMENT SYSTEM
❑ Building Sewer , Conventional Soil Absorption System
❑ Septic Tank ❑ Conventional System-in-fill
❑ Holding Tank ❑ Alternate Mound System
❑ Seepage Bed ❑ Holding Tank
❑ Seepage Trench ❑ Seepage Pit ❑ Experimental System
BRIEF, FACTUAL COMMENTS AND SKETCH:
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Wisconsin Department of Commerce
Safety and Buildings Division PRIVATE SEWAGE SYSTEM countyST. CROIX
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitar P
Personal information you provice maybe used for secondary Purposes [ PrivacY Lap, s.15.04 (1 )(m)1•
~rp~K j~
/
11 ier's~JARte- C~rtty ~J~14 Town of:
t(1 , VtllV '1 Ub-EYtt' State Plan ID No.:
CST BM Elev.: =sI;9I1'1'1 BM =Description: Parcel
I(35b11-;1057-60-000
TANK INFORMATION ELEVATION DATA A9700195
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
Dosing
Aeration Bldg. Sewer
Holding St/Ht Inlet
TANK SETBACK INFORMATION St/ Ht Outlet
Vent
TANK TO P/ L WELL BLDG. A
ir Ito ntake ROAD Dt Inlet
Air
Septic NA Dt Bottom
Dosing NA Header/ Man.
Aeration NA Dist. Pipe
Holding Bot. System
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand
Model Number GPM
TDH Lift Friction System TDH Ft
Forcemain Length Dia. hi Dist. To well
SOIL ABSORPTION SYSTEM
BED / TRENCjHWidth Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIM N I N DIMEN I N
SETBACK TO P/ L BLDG WELL LAKE / STREAM LEACHING Manu acturer:
INFORMATICHAMBER Mo el Num er:
OR UNIT
DISTRIBUTION SYSTEM
Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length Dia. Length Dia. Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched
Bed/ Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No
E03 Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: ST. JOSEPH 23.30.19.201E,NE,NW 1477 N. BAY ROAD
Plan revision required? ❑ Yes ❑ No
Use other side for additional information.
SBD-6710 (R.3197) Date Inspector's Signature Cert No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
SANITARY PERMIT APPLICATION - and Bureau Building Water Sng Water Systems
ureau o off Builystems
In accord with ILHR 83.05, Wis. Adm. Code 201 E. Washington Ave.
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. '
• See reverse side for instructions for completing this application Sta anitary Permit tlu
tuber
The information you provide may be used by other gov ment agency programs 01 r? [Privacy Law, s. 15.04 (1) (m)]. ❑ Check if revision to previous application
/ v • ~ay ~u • V V / ~i . State Plan I.D. Number
1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION
Property Owner Name Property Location
/1/4 ~v4, S T 3 O, N, R E (or) W
Prope y Owner's Mailing A ess Lot Number Block Number
/Y 7 4- I
City, State Zip Code Phone Number Subdivision Name or C M Number
II. TYPE F BUILDING: (check one) ❑ State Owned ❑ 'ty Nearest Road
Public 12 1 or 2 Family Dwelling - No. of bedrooms ❑ village
Town OF ~
Ill. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s)
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 TankOnly_----- _----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
2 Seepage Trench E] 30 ❑ Specify Type 41 E] Holding
1 Tank
El 22 ❑ In-Ground Pressure 42 ❑ Pit Privy
13 ❑ Seepage Pit 43 ❑ Vault Privy
14 ❑ System-In-Fill 4
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
~Z Q Feet , Feet
VII. TANK Capacity
INFORMATION in gallons Total # of Manufacturer's Name Prefab. Site Fiber- Ex per-
New Existin Gallons Tanks Concrete Con- Steel glass Plastic App
Tanks Tanks strutted
Septic Tank or Holding Tank
❑
Z= 16 44 &_-A 2 ❑ ❑ ❑ M_
Lift Pump Tank /Siphon Chamber El 1:1 El ❑ 11
0 =T- I -F _E1 1
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility r ins atio of the onsite sewage system shown on the attached plans.
Plumber's Name: (Print) Plu er' Si r . ( Stamps) MP/MPRSW No.: Business Phone Number:
Plumber's Address (S r et, City, State, Zip Code):
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date SSUe , Issuing Agent Si am S
Surcharge Fee)
pproved
❑ Owner Given Initial
Adverse Determination
X. CONDITIONS OF.APPROVAL / REASONS.FOR DISAPPROVAL:
SBO-6398 (R. 05/94) DISTRIBUTIO : Original to Counly. One copy To: Safety flrriHlings Division, Owner, Plumber
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit maybe 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 bythe 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.
S T C - loo
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.
,s
Location of property /4 _1/4, Section ~Ts3a N-R ! _W
_flAf Township ,j" T~ Mailing address
Address of site
Subdivision name Lot no.
Other homes on property? Yes__)( ~No
Previous owner of property
Total size of property ~3 ,p«
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 No
Volume :2ZA_ and Page Number !%;-z fZ 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. tlJ Z , and that I (we) presently
own the proposed site for th 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.
Signa re of Applicant Co-Applicant
s
Date f Signature Date of Signature
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER _ I ,I,na
MAILING ADDRESS
PROPERTY ADDRESS
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE ~/YL~rf' L✓~"
PROPERTY LOCATION 1/4, 1/4, Section a3 TAN-R~_W
TOWN OF 3~,7. Lrj P",kj ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMBER
CERTIFIED SURVEY / 6Z, VOLUME , PAGI~ LOTNU1vIBER
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 main 'ned must be completed and returned to the St. Croix
County Zoning Officer within 30 days of the three ex p' ' tion date.
c
SIG
DA S-1076
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF AN EXISTING SEPTIC TANK
This is to certify that I have inspected the septic tank presently serving
the residence located at: AIC: V4, &C
Sec._, TN, R~~W, Town of
St. Croix
County, Wisconsin. Upon inspection, I certify that I have found the tank and
baffles to be in good condition, and it appears to be functioning properly.
Last time serviced e g )
47
Did flow back occur from absorption system? Yes No
line. (if no, skip next
Approximate volume or length of time: ~d d gallons minutes
Capacity: ~P o
Construction: Prefab Concrete- Steel Other
Manufacturer (if known) : A1,,4
Age of Tank (if known) : ~ 4
(Si ature) (Name) Please Mint
(Title) (License Number)
(Date)
Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes) or
licensed disposer (NR 113 Wisconsin Administrative Code) ,
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
u-PTURM-er (applying for sanitary permit) Certification:
In accepting the above statement regarding existing septic tank condition, I
c(~Irtify that the tank, to the best of my knowledge, will conform to the
requirements of ILHR 83, Wis. Adm. Code (except for inspection opening over
outlet baffle).
Name Signature A 01 .41 MP/MPRS
FORM NO. 985-A
„GMi~IHCmpYq~
00 f 1n
FILED
ERTIFIED S U•R V E Y MAP to Jm" CONKEII
R~p4fq of Duds ti
C
86 C'iolx
GOVT LOT 5 , SEC 23, T30 N 7 R 19W s'
UNPLATTED - LAND S66°-13'-23°1N
S 89°-41'-40" E N 73.62 16
S 89°- 41'- 40" E 748.69' SEC. 23 NE \
N.W. COR. 1317.87'
SEC. 23 ~o
I"LP. FD. 0260 u'~, 20-04'_571'
,oS380-10LY'w
114.12 /
LANG
LOT I
UNPLATTE~ _ _ - 4.3 CRES
.'L
o:~ho,2,L_66 O~.Ob
SIB 618.26,
/ 218°-2 "56 S 8 9°- 41'- 40" E \'b* S 88°-13'- 14M-W 5
189°-41-40W 96' ----174.61L•--
106.30' i N51°-55'-24"E 511.
6' \ 67.25'
'RIVATE Mb is I451°-55=24"E
EASE-
MENT `v4,~
M, n; Fes,, LOT 2 5 ss
0
V.- cv o ti 3.0 ACRES 0 3p
o, co
-Z' V6 V:
2 _ is
O
159°-26'-56" M
~ S89°-41'-40"E B A S S
° 55 6.6 2' 13.35' co - -
o~ ) cv N03°-59'-07"E 115 /
93.20', 3
.o - ® °_15'-58 =
_0157 N~ LAKE
CD LOT 3 01
1 3.0 ACRES o'
01570-15-59 co Oz
%
---o~ f 6rO 'L A`~~ S 890-41'-40" E%,00.x
498.55' O~ O S6.3°--03` 4 7 E
Fib 120.81'
6'PRIVATE ``°'O Asa, O' . \
:ASEMENT FROM
:.T. H . "i TO
:UL -DE -SAC F~~\ ~O LOT 4 6 S32°-45'-09°E
S9 3.0 ACRES 109.44'
K
PRIVATE ` o` T00 S19°-30'-50"E
EASEMENT 6~O \43' '/0,~ 50.38'
~o--- 65'!
1
LEGEND 88.52 N 89°- 41'- 40" W 505.74' \
I"X24"IRON PIPE SET _UNPLATTED LAND
WT. L68 LBS./LIN. FT.
tt-----1"X30"IRON PIPE SET
L -;Ft
1U le e►ncs aa•s+wn re11 aeeeaal 410110
w WO
MATS BAS OF WISCONSIN FORK I-1M• 9'4
COMA
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A4 ~ . ~.Wi~l• ••31Wi, •~I1Gl •~.~Ilie~.w iamdft 2
~!R`..Dili)#
w
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IT. ...i..... .
t
...w.....
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t
ar idkwhw d~escribod seal estate in St...c~1 IZ...................coonw,
Statie of Wissonsin. f
Tas Pared Not
c-
Pert CC GovezuMt Lot s5` of Section 23-30-19 described as folL alat lift 4 of
Cwdffed Swwy Jbp filed September 6, 1979, in Vbltms 030, page 861. TOGMM I41'fft
ty - as esa®ent as described in said certified Survey Map.
b MUS L~ GMM IN SAtl'iSP1yLTIaN AM OoNPZMMON OF TIM c EMM LAID =R&M IMI
M AMW PAMES MW MY 10, 1980 AMID IUD IN THS W733 OF 7 MMSM Or
D PaR Sr. (VIX a)UM, WISCOl jN cm MAY 12, 1980, IN VOL. 611, PAM 504, AS MC. ,
10. 364144.
53X.0
FF•~
This iS Ot . homestead property.
(is) (is n Z1ot)
restriCt~Cns d riots-Of Y
of
i~cergtjoa to wamnties: ftsementso reservations, an
1s any.
x
Hated this 21St-
- day of may.................................................. )!..sags
.....t%% ~ .M'.9m!!:c...••--•-.(SEAL) ►ri0 M ~!,4i. .dwe!e....(SEAL)
Richard O. Stout Maude H. Stout a/k/a Maud H. Stout
by--fficKaa-•0:•-stout;- fier
C ...............(SEAL) Attnrney!Aa-Pact........................ (SEAL)
•
AUTSnNT>ICATION ACSNOW LUDd1[sNT
Sipatoea(s) .C.~l P. STATB OF WISCONSIN
Sto Ma!d- H.
S 0 - n -F•~~ H St. Croix as.
..............Conatp.
a lp. 5 Personally came before no this ................day of
! MY 120..._ the above named
• Rir~aaxxl.Sl.. S.t1~tt_t~uQ~1.Jr3~0Yat.P....3t~QtttR.
• Ro t N.. Mudge.. ie►ifs.r7u.klu.it.._,St.QUt.~llklr7i.klau!d.H..~tout
TITLE: YEYBEB STATE BA$ 0! WIS IN
•
i
to me known to be the person who executed the l
foregoing instrument and acknowledge the same.