HomeMy WebLinkAbout040-1298-20-100 AS BUILT SANITARY SYSTEM REPORT
;,INNER •
.0. ADDRE S , TOWNSHIP SEC. TVN, R~W
ST. CROIX CO Y, WISCON IN.
:UBDIVISION LOT LOT SIZE
PLAN VIEW
-Distances & dimensions meet requirements of H62.20
S YTHING WITHIN 100 FEET OF SYSTEM
/ e
PTIC TANK(S) DoC~ MFGR. CONCRETE P" STEEL
NO. of rings on cover- Depth DRY WELL
TENCHES NO. of width length area
:D no. of lines widt/length ~
_Fa
area-
depth to top of pipe
;:r GREGATE
:RK RATE AREA REQUIRED AREA AS BUILT
'sciaimer: The inspection of this system by St. Croix County does not imply complete
mpliance with State Administrative Codes. There are other areas that it is not possible
inspect at this point of construction. St. Croix County assumes no liability for
'stem operation. However, if failure is noted the County will make every effort to
termine cause of failure.
:EASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
~I CTOR
DATEDPLUMBER ON JO
LICENSE NUMBER
V f
REPORT OF INSPECTION- INDIVIDUAL SLAGE DISPOSAL SYS?EN
Sanitary Pernit
• State Septic 7f/
'6ALL*•,��` TOWNSHIP
• St. roi County
SEPTIC TA H( 5 S -- T
Size gallons . 'lumber of Compartments
Distance From: Well ft. 12% or t greater slope �1.
f, Building ' / ft. Wetlands ft
J4k fighwater ft.
DISP ..SALYSTE:2 Tile Field tr or Seepage Pit(s)
Distance F orn: Well d� / ft. 12 or greater slop 14ft
/ AV
Building 2 ( ft. Wetlands f.-,
FIELD L Highwater /0(t.
Total length of lines /0 6/ ft. of lines . Length of
each line Sc.( ft. Distance between lines ft. Width of the
trench / . Lft. Total absorption area /` sq. ft. Depth
of rock below tile L 2- in. Depth of rock over tile Z-- in. Cover
over .rock , Depth of tile below grade `fi n. Slope of
trench ---__in per 100 ft. Depth to Bedrock //(kt. Depth to
around water / //ft.
•
"ITS
Number of pits . Out d jameter ft. Depth below inlet
ft. Gravel around :. : `yes w. .Total absorption area
sq. ft.
Square feet of seepage trench bottom area required
Cquare feet of see _ pa. are required
Inspected by
Approved - Date 197 .
Rejected , Date 197 ,
EH 115
WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
• DIVISION OF HEALTH,BUREAU OF ENVIRONMENTAL HEALTH
` P.O. BOX 309
MADISON,WISCONSIN 53701
REPORT ON SOIL BORINGS AND PERCOLATION TESTS
ci
LOCATION: 1/4, 1/4,Section 3 ,T N, R 9-E(er4 W,Township or-4.A icipo4i#t -1 k'L�`1
Lot No. , Block No. County a T .Q t.j lhC
Subdivision Name
Owner's Name: \mil L-L 6A R c--=r 1"
Mailing Address:'-'- / EJ -'t 3 j Iu] . YCYL
TYPE OF OCCUPANCY: Residence X No.of Bedrooms 3 Other
EFFLUENT DISPOSAL SYSTEM: NEW X / ADDITION REPLACEMENT
DATES OBSERVATIONS MADE: SOIL BORINGS 4// 1 /'7 El PERCOLATION TESTS //J 72I7 e'
SOIL MAP SHEET __ J «'J SOIL TYPE 1I)L---, '".A.--)
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 AFTER INTERVAL
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN
P- 1 3L al L rs,`7;1311 sit 3n 1, 3 ?6, kjC) 10 11 l /4 / /4, 9
P— Z 3 , BILrs,R; B ),J M l�nStR;8nlsa Z:6 tin 3 i 'lg 1 "% / " 3
P- 3 3L ,3iL ,—;i Ths,/,/ ,; 015 8i Dht<s,3 Z.t, ,u!_1) 3 3/y Sly 31y Y
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER,INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES
NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED)
B_ ! -71-- I -)AJ E. 7 ---/Z. R)I— �5,., .F3h Si 1,Zt>;T3h Si,6 ; a Is. is_i 3n 5 fiG►-1 2s ,
Z, ,, 91 19 ; ►/ 7 , y 15 , // 22
B 3 ( 1
" F; 'f ZZ ; '' 5 ; ,i 8 ; 02.9
B- S n f- r( 13 ; u I'3 a I, S - it '33
7Z )3613E 7 `72. I, n ; ,I )6 ; ,, 6 ; if 6 i- 'I 3
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. OS t1--T'R .JCHES — 615 r'' 13E'D Indicate scale
or distances. Give horizontal and vertical reference points. Indicate slope.
•
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I,the undersigned,hereby certify that the soil tests reported on this form were made by me in accord with the procedures
and methods specified in the Wisconsin Administrative Code,and that the data recorded and location of test holes are correct
to the best of my knowledge and belief.
Name (print) 1" ..R`1 \l.)' \.,.. I-0.C ti 2E-T2 Certification No. 5��
Address l-? ,L;7 Z EU-1 Stuc)Te?), to I .. ¶T 'JJ
Name of installer if known
CST Signature CtLb bL. -1:1 u'2—
COPY A—LOCAL AUTHORITY d
•
PLB 6 7 Lr�l � " State and County State Permit #
i, Permit Application County Permit,#C�
for Private Domestic Sewage Systems County
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
13La L9I t--;/B. LOCATION: _/4 4, Y4, Section r , T I, R /CjE (or) W Lot# City
Subdivision Name, nearest road, lake or landmark Blk# Village
--tear±6s-1" ,' , Township lik,"
C. PE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family j,..---*---' Duplex No. of Bedrooms \ No. of Persons
D. TYPE OF APPLIANCES: Dishwasher YES jam-NO Food Waste Grinder YES i..--.1q6- # of Bathrooms
Automatic Washer �qS NO Other (specify)
E. SEPTIC TANK CAPACITY `Pe (7 Total gallons No. of tanks /
*Holding tank capacity Total gallons No. of tanks
New Installation Addition Replacement Prefab Concrete
*Poured in Place _Steel Other (specify)
F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) q 2)5 3) T Total Absorb Area s�if sq. ft.
/ /
New 6
Addition Replacement *Fill System /s-
Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches
Seepage Bed: Length „r 'Width / 71 Depth Tile Depth , s/ No. of Lines
Seepage Pit: Inside diameter Liquid Dept Tile Size '4+«
Percent slope of land .5 7r Distance from critical slope -----
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 oil Tester,
NAME a, b. , L�Li �,/ C.S.T. # 1 and other information
obtained from caner/builder). �} � �r
Plumber's Signature ,- P/MPRSW# �`�t. 7 Phone # , � ". ,r' €jl
Plumber's Address +C , , 1
PLIFVWr a Provide sketch below of system (include dir�jction of slope and all distances in accord with
/lk
/i
.
.
........."
Do Not Write in Space,Below - FOR DEPARTMENT USE ONLY /
Date of Application vPaid: /Is / date) "!-�/, 7 ?0 Issuing Agent Name e �A �F'-'�
Inspection Yes�. No Valid# Date Rec'd
1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
state (pink copy) 4. plumber (canary copy)
Revised Date 6/1/76
t ' GLOVER GLEN LOT V / / N
00
N LINE ADJUSTMENTS °ao�°-3 �,'�"��� ,\�
i TOWN OF TROYY WI ������ '' �,����� �•�� 6 ST. CROIX COUNTY,
,' $' ' o ' 2.003 ACRES
8 `�o �,r°�F`� °ooLEGEND
- 4.618 ACRES \ 6'' tZ0 1 1/4" x 24"
x ♦ �o 0 IRON PIPE
0
�, E ��- WEIGHING
�5°00 0 /- / 1 .68#/LINEAR
LET 2 • N 21449,�' FOOT, SET.
I / • IRON/PI'PE, FOUND
( 1coS 2.358 ACRES N OTHERWISE NOTED) .
'N /
W
REVISED BUILDING SETBACK
1 o LINE, 25' (UNLESS
1.0 o. �, o OTHERWISE NOTED) .
0 o S 6 '►�
° 8 4),\ ° NOTE. ALL IRON
o 'o 11 PIPE (FOUND OR
��r�_\ F 2��`' 0 2.032 ACRES SET) ARE
z N 77°3�, 0� w _ 2•3p. DIMENSIONED AS
OUTSIDE DIAMETER.
3078/'' —
127 7T,
� � \ 77
N \__�6 50.00 ti
`r 1 S 75° ,
SCALE: 1 100' -r1 8j 451,7', E I,") co- 7. 57,� , ORAINFIEM�TE
r 2.299 ACRES , ,n s LOCATION
►.o REVISED Co co , :\ 0
3 5p- : ......
: 4
NN__— -- 43, 08 ' E • �A
\ • N 139.660 •, , \/ . 9d'%9,
••\ z 0 _ . /�
\off\
-x � �co ° ,SEPTIC O
\\�\ ��E./ TAW
10GS�E /
\- \ 'co 50' '/SI /. o
o �
\4\-�L\ (Ati\ 2 WELL �1� 0 U-'
\ \�1" -/• /0�3.105 ACRES/ o
\ OSy\ Nx"V REVISED `S0- S89°04' 24"W•r.,
\ \ �c D 0/ �o Fq L N>/ N // / / 01 355'
/ _
n OCT 2 8 2002 \ CP; \ 9� 12 01, /
N \ \0/, /� tx /, ° 2. REVISED• 02 ES
- \\ , \�
/
v /OGDEN ENGINEERING CO. \ \ .Jo- �5.
13 Civil Engineers & Land Surveyors �O \. I, ,/
113 W. Walnut St., River Fals, WI 54022 '� N i
it (715) 425-7631 ':`i t�`'' `4 '-� i
o �' \ ; /
` \\ Q
v '' FEi gi!kiS \ • \ �< 71
DATE: 10-21 -02 sr-sc.04 �, 0
R^!Fn 1..1i 0 g, \ C)
01 -2543 ;4443/
`;;'1 {_- \'');3, 66i PAGE 2 OF 2
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:*rsconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of Z
Labor and Human Relations
Division of Safety&Buildings in accord with ILHR 83.05, VVis.Adm. Code
COUNTY
S.T. eel'x
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but
not limited to vertical and horizontal reference point(BM),direction and%of slope,scale or PARCEL I.D.it
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
,f-a//1- 4-5 T I • ' GOVT.LOT.7/.;_-. 1/4 -/,Z-_ 1/4,S/ T - ,N,R 0 E(oitY0
PROPERTY OWNER':S MAILING ADDRESS LOT# BLOCK S S BD-NAME OR CSM
t,5-7 73f}.uifie/f-- / 1 P4,,PT of 7 .-w
CITY,STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE &' a NEAREST ROAD
/-fVpSOAi 4,/ Syo'Co (7/5-) 3,06-6O52_ r 00y -/o/.2 ' sT^T/o..J
[ ) New Construction Use [, ) Residential/Number of bedrooms [ I Addition to existing building
j I Replacement [ ) Public or commercial describe
Code derived daily flow 'OU gpd Recommended design loading rate / ' bed,gpd/ft2 'e trench,gpd/ft2
Absorption area required 857 bed,ft2 /s 0 trench,ft2 Maximum design loading rate 7 bed,gpd/ft2 `1 trench,gpd/ft2
Recommended infiltration surface elevation(s) .5-ge- P - • 2 ft (as referred to site plan benchmark)
Additional design/site considerations - 711e-ucl6-5 ow 54..e 4,,I i. 24/2 (36 K D/S7A7,4O7fo...d
Parent material SCS el.- G ve4--A4A'J7 - )''77 , Flood plain elevation,if applicable y f- ft
o[TT S
S=Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN ALL HOLDING TANK
U=Unsuitableforsystem ❑S ❑U ❑S ❑U ❑S ❑U ❑S DU ❑S CI ❑S GU
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Structure GPD/ft2
Boring# Horizon Texture Consistence Barry Roots
in. Mansell Qu.Sz.Cont Color Gr. Sz. Sh. Bed Trerxfl
1j�:}t;'Hj�{y:;.• 4 O_7 /0 V y/2_ 5/� 2f, shot 44.1 fR 5 2-7(-- , ; , ,
Ground C, /7-2,S' 75 ye 3/y' - /S O,-f, VE v-fa r5 • 7 .8
9 elev.0 ft. Cz 1f-yo /o W /( . _ 0, C, s� , ..32 -- ,?
Deott1 to , •
limiting �- —
fa>cfD „ •
Remarks:
Boring #
�. 4 a- /o V' Viz /c,-3 r_, 2,f s6/ '41-/,P 0s -
i 1 /3 6-/g /0 y, y/'( /o4i I,-f, sht- r74 ,. s - . S .a
2- /i yr /0 //e 5/6. 1 i // 7; s*,- /pv, .'T/' 4 S 'up N p
Ground
elev. e .?e?_j / /D yg �/� ______- d,C1 s, �►-e 7 i
Depth to
limiting
facto „ —
7 Remarks: _
,S T i�aiite— 8as i-rint if�a,(1 /'T Li//6"/?/?T Phone: �/� 3��o ' /�S
ddress: 4,55 G /,t)6.7.e A,iy • f�GPfe-J 'J/S. ✓.. ,ei a„ CSTAy Z'/ Z.
Signature: � 2 Date: /O_//- 3 CST Number:
--/ RECEPIFD
> ORIGINAL
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I DUGUME-NT #348813
I
VOLU_ME_602 ' BARRETT
?AGE 406 33.288 ACRES
)OCUMENT 360381 1,450,035 S.F.
- - - - - - INCLUDING TOWN ROAD
I RIGHT-OF-WAY
32.733 ACRES
I + 1,425,865 S.F.
I EXCLUDING TOWN ROAD
RIGHT-OF-WAY
I
EXISTING FENCE, TYPICAL
I \
I \ x
x DAPPROXIMATE 1 \
DRAINFIELD I x
LOCATION I ry'S
" I I \ POINT OF BEGINNING\
I SEPTIC TANK --~O I FOR UPDATED
l PoED I HOUSE I DESCRIPTION ~
SHED /
lx I I
_VOL UME_ 574_ x WELL I \
\ I
\ PA GE 432 I '
~ ~ I DOCUMENT X348814 ' •,"Y+
1
0
N 89004'24" E 2645.84'
(R-2645.31')
~ I I
ti R I I VOL UME 630 h
i PAGE 452 ESTLUND TO E
DOCUMENT 41371381 10
0.206 ACRES
tiJr,,s~ 1910.19
X0 i I - - - - - - - - -~3 3 8,986 S.F.
I I INCLUDING TOY
s° o ~J 6 I % RIGHT-OF-WA'
~~„0.193 ACRES
I ti o ~ 0 8,394 S.F. T^
• Parcel 040-1043-40-200 03i28i2006 07:57 AM
PAGE 1 OF 1
Alt. Parcel 09.28.19.143A-20 040 - TOWN OF TROY
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 - ESTLUND, PAULA J
PAULA J ESTLUND
393 N GLOVER RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description
SC 4893 SCH D OF RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 35.294 Plat: N/A-NOT AVAILABLE
SEC 9 T28N R19W SE SE EXC PT DESC IN VOL Block/Condo Bldg:
574 PAGE 430 ORD EXC AS DESC 2019/489
ALSO AS DESC 2019/491 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
09-28N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
03/10/2004 756244 2523/639 QC
10/22/2002 695280 2019/491 WD
07/23/1997 978/44 WD
2005 SUMMARY Bill Fair Market Value: Assessed with:
102344 64,100
Valuations: Last Changed: 07/19/2004
Description Class Acres Land Improve Total State Reason
UNDEVELOPED G5 35.294 61,700 0 61,700 NO
Totals for 2005:
General Property 35.294 61,700 0 61,700
Woodland 0.000 0 0
Totals for 2004:
General Property 35.294 61,700 0 61,700
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
SOIL AND REPORT Page of 3
Labor and Human Relations
-LUATION Di.ision
10 f Safety 8 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 C~~~
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. CS14
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION pld6 REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION v
~',gllLfj ~S T L Uti v GOVT. LOT s!c 1/4 S` 1/4,S 4 T a ,N,R • E (or) W
PROPEgTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUED. NAME OR CSM #
CPS 7 134t,7-A.04- ! .Al /e / o,-- y 7 a r-~e5
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE [gOWN NEAREST ROAD
vDso~v GtJ/S . (7ss13f4/1- ~aSL 7~ `9 e~lwl.47P S 7Tio,~
jX] New Construction Use[ ] Residential / Number of bedrooms 3 7t [ ] Addition to existing building
j ] Replacement [ ] Public or commercial describe
Code derived daily flow. gpd Recommended design loading rate /bed, gpd/ft2 trench, gpd/ft-
Absorption area required bed, ft2 trench, ft2 Maximum design loading rate bed, gpd/ft2, trench, gpd/ft2
Recommended infiltration surface elevation(s) -sue P 3 ft (as referred to site plan benchmark)
Additional design / site considerations 71-sE TiP~ S GV4 y a 1 APp/I doe .f~i s7' /,y ~G ✓ s v S/off' S'
Parent material 92- Flood plain elevation, if applicable ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U =Unsuitable fors stem ~ S O U ❑ S ®u El .1; 11 U [a S U ❑ S M U ❑ S RU
~,rr GF S/OS SOIL DESCRIPTION REPORT S~jtP5
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
`7Jrk....aX-2
:
l Z//
3:-77
ye z 3.~ sd,~ S cs ,s
k °
f /Lo Ad ye sd< es .2
Ground G ' 7S y~ 40 1 41 U f
88131 ft. Gla le
s/ S Dom, s
Depth to
limiting
factor_ _ PROV
Th!
t r a co ventiO 1 septic ys e
Remarks:
Boring #
2 y /o Yoe Y1 sib Asti Gs 21 -f
ys-
.y
s/y' 7
Ground
elev
Al",yy~ft.
Depth to GGk
limiting Q
fact
t
J
XTA
Remarks: `i
@A A
CST Name: Please Print ; Phone:
H ME ITE SEPTIC PLUMBIN 7~S"" 3~~ - cT ~~S
Address: 655 O'NEIL RD., HUDSON, WIS. 54016
Signature: VIS. MP STER PLUMBER LIC. NO. 3307 M.P.R.S. Date: CST Number:
p PROPERTY OWNER P~STGV.vj] SOIL DESCRIPTION REPORT Pagel or ;
Jf ~
PARCEL I.D. y7 <IS - 61dU7e ST
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
rM sir s 3-f ,5
Ground /3 30'~~ y/2 Sl~! - ~S ~i ~il° S / 7 .
elev. 3/
-4/0 40
Depth to
a~ limiting
i factor ,e
Remarks: _
Boring # Y/Z- S6yr ~S GS 3 f , S
X-N
lax
7/7
l; sb~< ,,..-rfX zf , 5-
Ground
,,,elev. ft.
Depth to
limiting
factor N
i
' Remarks: _
Boring
3 Av s~ ~C S G ~ `F S
e -5'
7L P
13 /J;- C19
All,
Ground
elev.
ft.
{
l Depth to
limiting
factor „
Remarks: _
Boring #
siL
Ground -
elev.
Depth to -
limiting
factor -
Remarks:
'I SBD-8330(8.05/92)
f 4t t5
6
STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER
ADDRESS 39 Gl~v _
Mfg (X;Uh!YY`~'
t Z.
SUBDIVISION / CSM# N~ IJOT #
SECTION ! T 2' N-R W, Town of 71-400/
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
AO- S7`414
So 'Srites ,-yS 7-. 61171,4tef eld) alw-, 4-e.
iD
TttL 4:w
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
P0 tj-om S401,06- -Pf -7
BENCHMARK: 0
ALTERNATE BM:
cC.X(•ST/,v&--
SEPTIC TANK R / a T" SjU°•ION
Manufacturer: Liquid Capacity: ldzT~v CJ"~• '
Setback from: Well 6.3 'House Other
Pump: Manufacturer - Model# ze
Float seperation Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
Width:- 7 Length 7& Number of trenches
Distance & Direction to nearest prop. line: > .2,:1'0
Setback from: well: House Other
ELEVATIONS
? 9y,
Building Sewer ST Inlet: ST outlet: R
PC inlet PC bottom Pump Off
Header/Manifold Bottom of system
Existing Grade Final grade
DATE OF INSTALLATION: PLUMBER ON JOB:
LICENSE NUMBER: 330 7
INSPECTOR: lei,
S s • 4eI'X 1i1 w Jj
3/93:jt
i
1
1
74 Ape
0 2,
Ile
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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County:
Saftty and Buildings Division : CROIX
INSPECTION REPORT .
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.:
Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)j. 289495
feLIAM E R%P Village Town of: State Plan ID No.:
CST BM Elev.: Insp. BM Elev.: BM Description: RUy Parcel Tax No.:
040-1042-95-000
/D'Dzvrr e~ -
TANK INFORMATION E EVATION DATA A9700311
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
.O
Septic Benchmark /LSO- b / w:
Dosing
Aeration Bldg. Sewer
Holding T St/Ht Inlet
TANK SETBACK INFORMATION St/ Ht Outlet G. a Q
TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic >a 57 NA Dt Bottom
Dosing NA Header/Man.' y0 ib
,7. 2 57
Aeration NA Dist. Pipe q qy
Holding Bot. System l~ 9"'
PUMP/ SIPHON INFORMATION Final Grader -13" 2
,d 51
Manufacturer Demand 3.56
Model Number GPM 5
TDH Lift Fri Ion System TDH Ft
l mead
Forcemain Len th Dia. Dist. To Well
SOIL ABSORP ION SYSTEM
BED/TRENCH Width , Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS S ° DIMENSIONS
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
SETBACK CHAMBER
INFORMATION Type O Mode Number:
System: 'dog (o ` 0 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 u Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched
Bed /Trench Center r~ Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: TROY 09.28.19.142A,SW,SE 399 GLOVER ROAD
Plan revision required? ❑ Yes ❑'No
Use other side for additional information. /4 19L! 71 0/'7 k& L4, -11461 J 6
SBD-6710 (R.3/97) Date I is Signature Cert. No.
1 c c
ADDITIONAL COMMENTS AND SKETCH
l
SANITARY PERMIT NUMBER:
r
Safety and Buildings Division
SANITARY PERMIT APPLICATION 201 E. Washington Ave.
*Isconsin In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969
Department of Commerce Madison, WI 53707-7969
• Attach complete plans (to the county copy only) for the system, on paper not less County S,/
than 8 112 x 11 inches in size.
• See reverse side for instructions for completing this application State Sanitary Permit Number
28,7,q q5
The information you provide may be used by other government agency programs ❑ Check if revision to previous application
[Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number
1. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION I
Property Owner Name Property Location c h 1 G+
/rte/ / SW1/a 5`Ct/a, S / T N, R I l E (or
Property ] ner's Maili Address Lot Number Block Number
4az, -
City, State Zi Code Phone Num er S bdivision Name or CSM Number
. TYPE BUILDING: (check one) ❑ State Owned ❑ ity f/ Nearest Road
Public or 2 Family Dwellin - No. of bedrooms 3 ❑ vllwg of 7 00
III. BUILDING USE: '(If building type is public, check all that apply) Parcel Tax Number(s)
b yD • ~o4~Z • y.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: (Chec only one box on line A. Check box on line B, if applicable)
A) 1. ❑ New 2. Veplacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
------System--------System--- __TankOnly Existing System Ex_istingSyste-
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 ❑ Se page Bed 21 ❑ Mound . 30 ❑ Specify Type 41 ❑ Holding Tank
12 B-Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy
13 E] Seepage Pit E'a~ t 43 ❑ Vault Privy
t
14E] System-In-Fill 7/4 S s X_Z; 5-
VI. ABSORPTION SYSTEM INFORMATION: 7/•Z S F • 7,557
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.) (Gal ay/sq. ft.) (Min./inch) - Elevation
c~ ?1 7c/* Feet 1~3• ? Feet
VII. TANK Capacity Site
INFORMATION in gallons Gal ons Ta ks Manufacturer's Name Conc ete Con- Steel g ass Plastic Appr
New Exist in structed
Tanks Tanks / -
Septic Tank or Holding Tank tU t' K// E] El Lift Pump Tank /Siphon Chamber El 1 1:1 1:1 1:1
❑ 1 1:1
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name: (Print) Plumber's Signa ure: (No Stamp ft7rP1MPRSW No.: Business Phone Number:
~fl E7RT- 2Ilhv?ia/ 330 7!S• M6 ' JOIR5
Plumber's Ac dress (Street, City, State, Zip Cod a ) li A~~ . ~YO~ /
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Saniry Permit Fee (Includes Groundwater ate ssue Issuing Agent Signature (No Stamps)
Approved ❑ Owner Given Initial el Surcharge Fee)
Adverse Determination
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SBD-6398 (R.11/96) 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=3151.
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.
Ill. 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 into fill in name, license number with appropriate prefix (e.g. MP, etc.),
address and phone number. Plumber must sign application form.
1X. 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.
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Fresh Air Inlets And Observation Pipe
-rktiAaA- r Approved Vent Cap
Minimum 12".Above
Final Grade
1.`-11' G 7 7c J
36' '' Above Pipe — 4" Cast Iron
'to Final Grade Vent 'Pipe'
Synthetic Covering
Min. 2" Aggregate
Over Pipe
Distribution - Tee
pipe '-'-'•Q o 0 0 0 0
'I Aggregate o Perfbrated Pipe Below
Beneath Pipe Coupling Terminating At
~�� r �� Bottom Of System
s T v�
ys
v. 2,5
Gov)
p,t Fresh Air Inlets And Observation Pipe
rTh-• Approved Vent Cap
•
Minimum 12" Above
Final Grade
it To
3� Above Pipe 4" Cast Iron �3 75r
'ro Final Grade Vent Pipe
Synthetic Covering
• Min. 2" Aggregate
Over Pipe
Distribution ff Tee
Pipe —+ l 0 0 0 0 0
" Aggregate
:sys/ : Beneath Pipe o Perforated Pipe Below
o Coupling Terminating At
�Q• Z 5 Bottom Of System • •
Wisconsin Department of Industry, SOIL AND SITE EVALUATION / 3
Labor and Human Relations Page of
Division of safety and Buildings in accordance with s. ILHR 83.09, Wis.
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 J T' l
percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.#
oyo • %VI- • i'5--
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)).
I•
Property Owner ,, '� p Property Location
tZ'4fl • ✓ • $4./e R�T 7 Govt.Lot 54) 1/4 S E 1/4,S /P T 1 E9 ,N,R / E(orC)
Property Owner's Mailing Address Lot# Block# ubd.Name or CSM#
3ert Grov€.R 20 • A/41- VT of 30 kWS 1----
'City State Zip Code Phone Number / Nearest Road
�uDSo� 1• 15Ya(� I (715 )L( &219 ❑ city r a y g�6 7- T)I /61° "Z •
❑ New Construction Use: aKsidential/Number of bedrooms 3 Addition to existing building
[ieplacement ❑Public or commercial-Describe:
Code derived daily flow 7 gpd Recommended design loading rate ' bed,gpd/ft-
�� trench,gpd/ft2
Absorption area required bed,ft2 trench,ft2 Maximum design loading rate • 7 bed,gpd/ft2 trench,gpd/ft2
Recommended infiltration surface elevation(s) 5-Q-,2_ p C� . 3,, ft(as referred to site plan benchmark)
Additional design/site considerations SAP- �i,�'.S(� gel°I-4D
Parent material savvy O /7ZeI4-� /`Flood plain elevation,if applicable / ft
S = Suitable for system �Conventional �MMou/nd In-Groundun Pressure �AT�Gr de System in Fill Holding Tank
U = Unsuitable for system L:1 5 ❑ U L S ❑ u l�5 ❑ U L'J S ❑ u Ers-ill U ❑ s [4-tr
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
f 1 D- ' /oyie 3/3 — 5L /fshk' 444v f5 3f . y ; •s
/7C . z : • 3
Ground 3 ry'17 /e, lie n, G S bin f/t 41, G' S' .-- •• - 43
ff ). ft. 1. 27.92/o y, 5/ram — -5' 01, .d.Q . g_
Depth to — '
limiting ,
factor
?v in. '
Remarks:
Boring # I o-c, /o 0 3/3 — SL 1- sh,( Awfie � S 3 f 5
Z' z ' •/&/o ye riv �.L _if rsd,± 441 cs /7 . Z •3
3 (If'33' 7•s yie �� 4 . /M,f,� d 5 cs r .7 , •S
Ground it 33- !tY /ETA $/ S C9 SI_ e6( — C .9
elev.
f9• 75 ft. -
Depth to
limiting L
factor
1 b in. Remarks:
CST Name (Please Print) Signature Telephone No.
1 oBeRr viL&RI'cc.z-- 7`5 . 3ea • e/6s
Address Date CST Number
g' I- 3- C s rAi )-Ll,S)Z
Ulbricht&Associates
Private Sewage Consultants /
6555 O'NHudsoeil
ew sd.s4ots /(J f9 TL /téi... /:ia1 Sr(pt...7`i` _ a 7�'
OR\ GINAL 1,/,_,A s st
�'5 ,s/•7-4`Z7 /,-) Go� -- wit,//4ic T Say lS /
/i/4f- i. rn-me s VS Tc', .
04*/ • / 4ieXt SOIL DESCRIPTION REPORT '2- 3
PROPERTY OWNER Page of
PARCEL I.D.# 0 1/42 • /0412_ •
Boring # Horizon Depth Dominant Color Mottles Structure
Texture Consistence Boundary Roots G(DD/ft2
in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed ,Trench
5/3 5 sh4 4,,r6e s 3 .f •5
2- fs t$14-iie c / • 3
Ground
If.35 plygVce — z.5 / f/e As
elev.
3.3 ° ft- 35104 /e yi e . 5 0, Sg • -) : •
Depth to - — —
limiting
factor
7 to&in.
Remarks:
Boring # _ _
Ground
elev.
ft.
Depth to
limiting
factor
in.
Remarks:
Horizon Depth Dominant Color Mottles Structure GPD/92
Texture Consistence Boundary Roots
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)
y . L
Ahlr
t .
4
STC - 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 .n 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 • /� r /
Location of• property'Wl/4 sE" 1/4, Section / , TZ' N-R If W
Township f'
Mailing address•, 3 / 7 '`6t& M
asp,, to 1 5. . S q D c 9 .
Address of site S
Subdivision name (k44� AM/W/6
• Lot no. �4 l�
V
Other homes on property? yes No -
Previous owner of property itty/W — /4. /7ztn �
Total size of parcel 30 1
Date parcel vas created /414---
Are all corners and lot lines identifiable? Yes _____;2_ ,No
Is this property being developed for (spec house)? Yes No
Volume ill and Page Number Z3 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 & 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 o'_
Deeds as Document No. 55 `f 7 / 7 , and that I (we) ' presently
own the proposed site for the sewage disposal system or I (we)
obtained an easement, to run the aboie described property, for
the construction of said system, and the same has , been duly
recorded in the office of County Register of deeds as Document
No.
` 1 /l 2 p
\ 1( I ^
� _�_ ‘ � a
Signature of applicant C pplic
A
<-:). / ' / /_.:1 -----2
Date of Signature D 6 of Signature
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 4i • i9 ze7-%-
resldence locat,d dt;
54) 1/9, 5E- 1/91 Sec. Z
, T N R Owl Town of
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 ~I C,
Did flow back occur from absorption system? Yes * No
(if no, skip
Approximate volume or length of time: next line)
gallons minutes
capacity: /077D
Construction: Prefab Concrete Steel
Other
Manufacurer (if known) :
Age of Tank (if known): ~4pP(~a~C 1? y/~~t.($
(Signature) (Name) Please Print
~ ~i~il's 3 30 '7 '
(Title) (License Number)
(Date) Form to be completed b ORIGINAL
or Licensed Disposer (NR 113 Wisconsin Administrative Code)nsin Statutes)
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Plumber (applying for sanitary permit) Certification:
In accepting the above statement regarding existing septic tank
condition, I certify 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_ MP/MPRS 3
5/88
. ' . ~ p#T-off 36
s
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
~/1'►'t !-'+X1,,6 7`%
OWNER/BUYER n
MAILING ADDRESS - 3 6~jaC S yOl r,
PROPERTY ADDRESS -S_
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE C
PROPERTY LOCATION S~ 1/4, S'F, 1/4, Section ! T 2-$ N-R W
TOWN OF ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMBER 1-Y
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 three year expiration date.
SIGNED:
DATE:
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
V VOL PACE fi 't.
4
STATE BAR OF WISCONSIN FORM - i#E=
554717 WARRANTY DEED
DOCUMENT NO '
This Deed, made between
1 JAN 2 2 1997
E r T i1 9:00 A. and
Map:,.. ~ L..
Witnesseth, Thu the said Grantor, for a valuable cortsidetan ,5 `
THIS SPACE Rc SERVEG GOA RECORDING DATA
T C KoS-
AME AND RFr'-MR-
conveys to Grantee the following described real estate in -S
County, State of Wisconsin: 1- Y`e-+
3f~ c~/.•er Roo d
f - !
z
A parcel of land located in the sht or ~VCSo~ Glx' sy0/"
the 5E4ad the SS1. ofthe SEi of Sec. 9 and in 'k"0* ~r
all in the T28N, R19~►, Town of Troy,
of Sec 16, further described as follows:
County, , '~Jisconsin, being thence 1 x°59'55" W along the South 1
~sencing at the Southeast corner of Section 9; N 76°51'40• W 328.7741
line of said Section 1496.14' to the point of beginning; thence thence N 47°59'22' W &"W4 f<
thence 3 2-W38" it 342.40' to the centerline of a town Woad; T
the
said center line 86.161; thence N 20W138" 4 1522.02' LO e Sh2000038" 844-771;
the ne of the SWt of S4; thence S 88°55'25" E along said forty line 745.76'; ~ thonc • thence S 56°33'40" 4 218-~ to the point of begianitt6.
tlte>nee S 2S°5(%'34" W 3g3.451,
Contains 21.00 acres of land subject to town roan right-of-may. Subject to easements for i the width of ~ 6 f~b 3de ro Yd alon those two provisions of boundaries
and of subject parcel that bear S 29 52841978 between the parties shall survive the
&tat* Sale Agreement of February , :s.
execution of this contract and are ratified and affirmed as 28 aid7r padetwesa tie pzrtios y
The provisions of the Real Estate Sale Agreeserf, of Febroart ee of this does _
relating to the construction and mainterta of tomca ~dve the executi ument and the deed contemplated hereundeF'['rara hereby lsR~ t,
This 65 Xdf-homestead property. n~
(is) (is not) N
Together with all and singular the hereditaments and appurtenances d wm.:.,to belonging. 1
And
warrants that the title is good, indefeasible in fee simple and free and clear OF r- mbran.es except ,t
s T AbiSFER , .
and will warrant and defend the same.
/3nua 1 L__
[)aced this ` day of -
(SEAL)
t
O Al
Q Pt • L>` b\) (SEA'-)
(SEAL) +
i
ACKNOWLEDGMENT
AUTHENTICATION
State of Wisconsin,
ss _ i
Signature(s)
County.. _
authenticated this day of ftrupipally came before the this ~ ✓ day of
19__ 197, the abfne named 3
d rk Ccl
t
TITLE MEMBER STATE BAR OF WISCONSIN
(if not, who executed the foregoing.
authorized by $706.06, Wis. Seats) W toe imcwn to be the person and•aeknowfedgl the same s 4
u 709370
MAY 1 4 20Q4 VOL 17 PAGE 4460
KATHLM H. VIM-
REGISTER OF DEEDS
S.. CROiX COUNTY ST. CROIX CO. NI
RECEIVED FOR hECORD
SURVEYOR'S IiEWCRD 02/12/2003 03:30PK
REE:
OPYFFEE: 13.00
CERTIFIED SURVEY MAP C
LOCATED IN THE SW 1/4 OF THE SE 1/4 OF SECTION 9 AND THE PAGES: 2
NW 1/4 OF THE NE 1/4 OF SECTION 16, ALL IN T28N, R19W, TOWN
OF TROY, ST. CROIX COUNTY, WISCONSIN, BEING ALL OF LOTS 1,2,3, OUTLOT 1
AND 7 OF THE PLAT OF GLOVER GLEN.
\G,~~ti - - - - -
00 ~ O 1 q?A
i
I 'EcXj-S 1NG 69' W D~ :RjC'AC%
_9
8 )SEAS LOT 1 P)TAr L N
6
I -------I
M II °oo' p0'o E -d' SCALE IN FEET
N 15
4g , /
144 'to
~ - LOT 14* NOT N I N~ (PAGE 2)E #3.'i\ `r 0 75 150 300
I
I 2.358 ACRES
102,749 S.F.'
0
I G~ o
o
^ \pZ-t
I LOT 2 i o - ?`gyp' £ ! co 8 >>e3p,p„ 6 ~G' o W
C! o
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