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HomeMy WebLinkAbout020-1048-20-200 C o c °o y O o ~ I ~ I M 0. 0 ~ I r~ li Y p w I a ~ I N ri o -o l co w o c ° 0 x I Z N 3 t6 N I LL C L O co ' Q N 3 co z y w w E z c C z co,4 H z I' a m o O Z c w O u, - tu 2 c o W F- cu Z III c E o v in a) co N O a~ m I U) C i. C C O U O o z F- z N z I LO d m E Y N co M a. O. ate.. w O CO H m a~ o o G G a a o N (0 E t+~~y Z N> F) F- F- F- Ov w N 'IT ►~i 0 0 0 d z° • rtvw I~ a a a I w~„ a c 4.; 0 G N N to `D N N J L) rn rn } 2 7 7- m o Q N co a) 0) E O N O O m 9? Q O o N H O O O c) N C O R C7 c co ° a) o 0 rn o oN p * 0 E a ~ Q d 0) o r N V L ~ ~ (an ~ E c (D Lo aj L" e c) c t m cy .o LO N o F c C) co :3 04 t -5 N 2 N O N z- U) • Lw O w w E cl #t M a a ' w • Q d V d y C3 C 4/ E i c % 3 w 7 3: 0 A s rAPR1 1.,91 ECONNEII 8391 4lgterof/+~Dew CERTIFIED SURVEY MAP Located in part of NE4 of the NEh and in part of the SEh of the NE4, all in section 20, T29N, R19W, Town of Hudson, St. Croix County, vvv Wisconsin; including Certified Survey Map recorded in Volume 3, Page 725. ° M NE Corner of & NORTH WESTERN RAILROAD Section '20 _ CHICAGO o 0 0 O O o d °x N84°06' 08"E 245.64' I vIV 0 ~ T d s • 1 66' o H ~ b o W Shad 07 u o CD C N O O L C 4- .H I LOT I o L ti ° N ° 128,720 Sq. 'Ft. CU - L 1 A 2.95 Acres a, m C W 0 0°, ~t a i L z rn .v en 1 W m I d m Garage r " House H v O1 0 1 Ln W ? ( C rHj r M o° c C i OWNER o • a I n Z i I Thomas :P. Rose N q a1 to 0~ W CD v 262 E. Cove Road J I 1~" r A N= Hudson, WI 54016 a a~ I = y M L I zi o -o ~ 1 HI st• II 1 7 4. Lo 191 o~ i. - N8402212011E °v i o a AI 0 0 330 381 .JO • C M Q V I • _ n ~ f•i 117 1 Jo t Driveway Easement _ LEGEND W ~ Z. .r *,Z of 19 County Section Monument- o°+ I I Existing Shed Aluminum Cap Found J (To Be Removed) ° o LOT 2 2" Iron Pipe Found M co 0 1( co • 1" Iron Pipe Found z 93,169 1 Sq~.. N ~ ipa I 2.14 Agree3 \ 0 111 x 2411 Iron Pipe Set, N weighing 1.68 lbs. per L linear foot. " fir' er; Y lot 36 U 1 l &A ~`r" ~M---if EY' c$•~inti~h7G.nruil i ne 12 - Parcel #:'020-1048-20-050 02/02/2005 PAG0E OF I1 Alt. Parcel 20.29.19.185G-05 020 - TOWN OF HUDSON Current X. I ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): Current Owner * JENKINSON, MELISSA MELISSA JENKINSON 881 DORWIN RD HUDSON WI 54016 C~Al Districts: SC = School SP = Special Property Address(es): Prim Type Dist # Description * 881 DORWIN RD V' SC 2611 SCH D OF HUDSON c SP 1700 WITC t0~~, "4 ~ Legal Description: Acres: 0.000 Plat: 0394-CSM 08/2350 SEC 20 T29N R19W PT E1/2 NE1/4 LOT 1 CSM Block/Condo Bldg: LOT 1 3/725 NOW KNOWN AS LOT 1 OF CSM 8/2350(2.95AC) EXC PT TO HWY (0.068AC) Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 20-29N-19W NE Notes: Parcel History: Date Doc # Vol/Page Type 01/09/2003 705160 2105/150 WD 02/06/2001 638080 1583/532 WD 01/06/1999 595154 1393/229 WD 07/23/1997 1019/380 WD more 2004 SUMMARY Bill Fair Market Value: Assessed with: 47978 183,000 Valuations: Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.882 34,400 107,200 141,600 NO Totals for 2004: General Property 2.882 34,400 107,200 141,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 001-WATER SPECIAL ASSESSMENT 0.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 . Parcel 020-1048-20-200 02/02/2005 04:13 PM PAGE 1 OF 1 Alt. Parcel 20.29.19.185G-20 020 - TOWN OF HUDSON Current I X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * PETERSEN, ROBERT A & MARY K ROBERT A & MARY K PETERSEN 879 DORWIN RD HUDSON WI 54016 Districts: SC =School SP Property Address(es): * = Primary Type Dist # Description * 879 DORWIN RD SC 2611 SCH D OF HUDSO SP 1700 WITC lf/ l Q l c Legal Description: Ac s: 2.080 Plat: N/A-NOT AVAILABLE SEC 20 T29N R19W PT NE NE & PT S LOT Block/Condo Bldg: 2 CSM 8/2350 2.14 AC (ADD-L HISTORY 923/01) EXC AS DESC 2052/499 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 20-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 11/19/2002 699077 2052/499 WD 07/23/1997 2001 /305* WD 2004 SUMMARY Bill M Fair Market Value: Assessed with: 47979 249,000 Valuations: Last Changed: 06/06/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.080 30,400 162,200 192,600 NO Totals for 2004: General Property 2.080 30,400 162,200 192,600 Woodland 0.000 0 0 Totals for 2003: General Property 2.080 30,400 162,200 192,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 213 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 001-WATER SPECIAL ASSESSMENT 0.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 n 0 p 3-0 0 C r1 w (n Z O N- = N O n 0_> 3 Cn 0 O_ C O N • K) cp 0-4 CL CO CD _ n H tr ' y0 CO N 13 c 3 O p CO _ A n A. CD 0 w 00 O CO n y 3 0, p O (D 0 co ch COIF COO = V CO 7 y o - O O S"1 O .'7 CD c m N 0 CD cc a (ft -0 =3 CD c (D 3 CL a 0 co i rn c j co c° a Q) CO) C l~l g 3 T o oooS'i _ v CD C~ 0 N N N rn p N ~ D o 0 (D CEO, CD 3 d w N ~ a f o z D m o O o s s ti• C Cy CD ~O CD c N G tC C. W 3 CD Z CD Cb + (n a ° cn v O. ; o. Z -I N W T m CD 0 ~ Z O ? M O Z H z A m CO W N a c CD M C Ch - CT C x N m cO C= CO R I °7 o- 0 e A D ~C A n ~ M A o b _ CD v o O I 0 CD Parcel 020-1048-20-100 02114/2005 04:16 PAGE 1 OF 1 F 1 Alt. Parcel 20.29.19.185G-10 020 - TOWN OF HUDSON Current ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 2 Tax Address: Owner(s): * = Current Owner * PETERSEN, RETIRED RETIRED PETERSEN Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 879 DORWIN RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.140 Plat: N/A-NOT AVAILABLE SEC 20 T29N RI 9W PT NE NE & PT SE NE LOT Block/Condo Bldg: 2 CSM 8/2350 2.14 AC (ADD-L HISTORY 923/01) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 20-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 2001 /305* WD 07/23/1997 1223/499 WD 07/23/1997 1135/250 WD 07/23/1997 1035/82 LC 2004 SUMMARY This parcel will not get taxed. It exists soley Assessed with: for parcel history tracking purposes. Valuations: Last Changed: 03/07/2003 Description Class Acres Land Improve Total State Reason Totals for 2004: General Property 0.000 0 0 0 Woodland 0.000 0 Totals for 2003: General Property 0.000 0 0 0 Woodland 0.000 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 213 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 020-1048-20-200 02/14/2005 04:16 PM PAGE 7 OF 1 Alt. Parcel 20.29.19.185G-20 020 - TOWN OF HUDSON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * PETERSEN, ROBERT A & MARY K ROBERT A & MARY K PETERSEN 879 DORWIN RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 879 DORWIN RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.080 Plat: N/A-NOT AVAILABLE SEC 20 T29N R19W PT NE NE & PT SE NE LOT Block/Condo Bldg: 2 CSM 8/2350 2.14 AC (ADD-L HISTORY 923/01) EXC AS DESC 2052/499 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 20-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 11/19/2002 699077 2052/499 WD 07/23/1997 2001 /305* WD 2004 SUMMARY Bill M Fair Market Value: Assessed with: 47979 249,000 Valuations: Last Changed: 06/06/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.080 30,400 162,200 192,600 NO Totals for 2004: General Property 2.080 30,400 162,200 192,600 Woodland 0.000 0 0 Totals for 2003: General Property 2.080 30,400 162,200 192,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 213 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 001-WATER SPECIAL ASSESSMENT 0.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 i STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER -S A M i L L X12 ADDRESS B O )C Z -p-7 JJD.S o N W yo r SUBDIVISION / CSM# `f W9 3 LOT # Z- SECTION d T oZq N-R W Town of (4 Of) vOn! ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ND R7 N ~ oT ~ i NE ~lo776~ 9 G,ELL Nor V6-r T!V5Z"~cl.~D S Ay. r i + b ~ ~IkaaE ~ ~ R I~ ;a,~Xgt' i f ~,~1 3 APPlzox ~ ~ or -4- L A INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. r BENCHMARK: -10 1~ D F- I oT Fl Rif i47- M. Or4LO445p-e or/ w 7. G S = / oa o d ALTERNATE BM: TO4P O h'ov S E ©oti '1 5 10 = l ©o • 9 5 T~~ o~ lot~c ON DWr tof/= a~'1o = /o q. I?s PTIC t}1d"/ PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: Liquid Capacity: /006 rg,qL. Setback from: Well 1 Zo House .S Other 3 y To %,e541r H Pump: Manufacturer Model# Size Float seperation Gallons/cycle: Alarm Location - SOIL ABSORPTION SYSTEM Width : S Length (o Number of trenches Z--- Distance & Direction to nearest prop• line: 4/ Z l p ,~l~T L. ,~7 L /,t/,c Setback from: well: House _7 _ Other T~j ,T O7)A17110ZE a ~~v~'s y•7 = l~z,~~ ELEVATIONS q~ Buildin Sewer , /I'? Q g ST Inlet: ST outlet: yZ S= 99PC inlet PC bottom PumOff -y off ~•~8= °JS`d Header/Manifold'?,'~S__~~1, Bottom of system Existing Grade -.3Z=1074!;:i-~'nal grade S 3 2 = 162,33 DATE OF INSTALLATION: PLUMBER ON JOB: `zi?? -7 LICENSE NUMBER: /~~iQS INSPECTOR: 3/93 : j t 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 268659 Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.: MILLER, SAM E. Hudson CST BM Elev.: Insp. BM Elev.: 7BMescription: Parcel Tax No.: C~s TANK INFORMATION ELEVATION DATA A960 362 ~G TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark S led. ~ i 7 Op~~ rrt . rv! , 0 .9s Dosirrg Aeration Bldg. Sewer Holdin St/ he Inlet 7J , ANK SETBACK INFORMATION St/1#f Outlet J. __26 TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic ~Clll / >2 I S~ NA Dt Bottom Dosin9 NA Header Mawt_ ' Aeration NA Dist. Pipe 9,!r.e7 r ing Bot. System 9 7 ? 7 PUMP/ SIPHON INFORMATION Final Grade lo-D, 33~ Manuf Demand 42~0 6Z_5- r Model Number GPM TDH Li Lriction System TDH Ft Forc-"in Length Dia. Fi Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length,,,O 7 No. Of Trenches PIT . No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS LEA nufacturer: SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM INFORMATION Type Of clew Cr,,,u~ r / AMBER Moe Number: OR UNIT System: ~r`0-nCRss 7~/7a DISTRIBUTION SYSTEM Header / Mamfatd_ Distribution Pipe(s) le Size x Hole S a nt To Air Intake ~ i` Length ~ Dia- Length ~ Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or A rade Systems On [Bed epth Over „ n Depth Over . xx Depth O xx Seeded /Sodded xx Mutche /Trench Center Bed /Trench EdgesO~ Topso E] Yes ❑ No E] Yes El No COMMENTS: (Include code discrepancies, persons present, etc.) ~LOCATIONoudson.20.29.19, NE, NE, Lot 2, Do/rwin Road Plan revision required? ❑ Yes L9-K-0 / Use other side for additional information. 9 p~ So-- SBD-6710 (R 05/91) Date Inspector's Signatur Cert No. ADDITIONAL COMMENTS AND SKETCH r= SANITARY PERMIT NUMBER: ' Safety and Buildings Division SANITARY PERMIT APPLICATION Bureau of Building Water System: 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County . than 81/2 x 11 inches in size. • See reverse side for instructions for completing this application State sanitary Peerr(miitt Numbeer 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 `//,6j /4/ICE 1/4, S 20 T Z 9 , N, R /9 E (orM) Property Owner's Mailing Address Lot Number Block Number Box Z tlf Z.- Z_ I..~----- City, State Zip Code DX) ne Number Subdivision Name orCSM Number 14 J SDR WI /o/4 z?4q e_ SM / C] ! VIIt(age Nearest Road II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ yv'~ oN DQ k~/ Public 1 or 2 Family Dwelling - No. of bedrooms Town of N III. ' BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) p 1 E] Apartment/ Condo / C7 -;;l'd /o 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 130 Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. N New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System___ Tank OnlyExisting System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 13'Q 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 S4-7. hod g 5%8 t Feet !0 ►i 77 Feet VII. TANK Capacit Site y gallonTotal # of Manufacturer's Name Prefab. Con- Steel Fiber- Exper. INFORMATION Gallons Tanks Concrete glass Plastic App New Existing structed Tanks Tanks Septic Tank or Holding Tank X (~o / 4A.) r ® ❑ ❑ ❑ 1:1 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) Plumber's Signature o Stamps) MP/MPRSW NO.: Business Phone Number: /,L'il N I do MEL L ~,eS-~35av 3 F09 Z_._ Plumber's Address (Street, City, State, Zip Code): IC?7d J/tITE~ keP&C E/uDsoN w~ ~s~o/6 IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved 5 itary Permit Fee (Includes Groundwater ate Issue Issuing Ag nt Signa Surcharge Fee) Approved E] Owner Given Initial /QC X/ 9/0 ,~9i9 ~-r Adverse Determination X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: SBD-6398 (R. 05/94) DISTRIBUTION: Qriginal to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1 _ A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. ll. 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. -0 0 J z O W Z V w W Y -qr d~ -a N - S `N rJ ..o ~ ~ - O ti GPG, < Z-- W a ~ o Q tij IV ` 0 Q- # J N L~-'Al 4 i 'J M G M M V1 U4 V J Q ~ J w VL W V, 19 0 ~4S% r-2 C7 b Q,; /Y /r,#Jy o Q m 1 z -b 0 1 b I ' m I I ~ I ~ I cry ; ~ ~ ~ ~ s ? n P, m Iv y Z © ,g A ~ r O i ~ I n _0 I I LA v I ' m I ' 411. 'U I z J Irk\ r J { O H m ZO F O r ' T C7 N O ' kA .v 0 fn LA DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR P.O. BOX HUMAN REDLATIONS PERCOLATION TESTS (11J) MADISON WI 53707 (ILHR 83.0911) & Chapter 145) LOCATION: SECTION: TOWNS HIP/J0U&N§,12)UffY: LOT NO.:BLK. NO.: SUBDIVISION NAME: PIE 1/4 NE 20 /T29 H/R194(or) W Hudson n/a n/a n/a COUNTY: OWNER'S AME: MAILING ADDRESS: St. Croix Tom Rose 262 E. Cove Rd., Hudson, Wi. 54016 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence 3 n/a New ❑Replace 112-6-90 12-6-90 RATING: S= Site suitable for system U= Site unsuitable for system ONVENTIONAL: MOUND: JIN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) ®S ❑U ®S ❑U E~iS ❑U ❑ S E3U S ®U conventional If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the n/a under s. ILHR 83.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: decimal' PROFILE DESCRIPTIONS page 58 SIB BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTFPM ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B-1 7.42 101.52 none >7.42 1.42bl.1. 1.50bn.sil. 4.50bn.c.s. B-2 7.09 101.52 none >7.09 .75bl.1. .42bn.sil. 5.92bn.c.s. B 3 7.09 101.83 none >7.09 1.42bl.1. 1.67bn.sil. 4.00bn.c.s. B 4 7.08 101.77 none >7.08 1.25bl.1. 1.58bn.sil. 4.25bn.c.s. B-5 7.09 101.85 none >7.09 1.17bl.1. 1.42bn.sil. 4.50bn.c.s. BPERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 P R D PER INCH P_ 1 3.75 none 3 6 6 6 < p- 2 3.67 none 3 6 6 6 <3 P_ none 3 6 6 <3 P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION 98.10 ~67 f Sy Oc-'~les`~ ~a 1 1 "6 rky 3 E E TE ~ N FILED ~ ~ 81991 - PES O OONNELL pe91~~ Wt 468391L CERTIFIED SURVEY MAP - Located in part of NE4 of the NE4 and in part of the SE4 of the NE4, all in Section 20, T29N, R19W, Town of Hudson, St. Croix County, Wisconsin; including Certified Survey Map recorded in Volume 3, Page 725. _ c M NE Corner of WESTERN RAILROAD Section 20 u- CHICAGO & NORTH o o0 N 0M o O L0 c 1 N N84°061 0811E 245.64' _ N O d ~ N pp L i• 0 In :3 { I O ' O N 1 861 Y N A d w~ Shad c°v I o= I L c o - o i o 1 LOT 1 L -ij I ( 128,720 Sq. Ft. CD i M to 2.95 Acres N rn ~ J~ LO N • 1 c 4, 011 z v _ o d I A a~ L M M t` I m d-. 0 0°1 ❑ Garage _ .1 N House rn r- o i c Lnw a 1 0 41 rl °o o i OWNER C1. cn I'D ° t°a = 1 Thomas P. Rose a) 4- NI I Z 262 E. Cove Road -0 01 ko C 1 F+•11 W i Hudson, WI 54016 Z ro l A 1 J1 o N 3 d, ~ s '01 N '0 I +r zi C) H1 cr o w i lo+ 37 o a 1- N84°221201IE o aui Y 1 d M U7 a 1 rn 6 O OI I c M 330.381 0-- LW I _ _ Q U I r+ to n n1 Q . _ U) N N to to 0 O._^ o z I L Joint Driveway Easement LEGEND W z I Z 0 /GO County Section Monument- o°, I I Existing Shed Aluminum Cap Found o J (To Be Removed) o 0 211 Iron Pipe Found LOT 2 M co o co • 111 Iron Pipe Found Cl) 93,169 Sq. Ft. 0 111 x 2411 Iron Pipe Set, o 00 Z N 2.14 Acres weighing 1.68 lbs. per o L linear foot. Lot 36 . -*-.€x;;st-i=ng.,ciFenj;;e(ine Cif:• Y STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER 6.1 /l t l C MAILING ADDRESS BO.y -ryr 2 4 -X PROPERTY ADDRESS $ ) S d e.- w / 1 4e (location of septic system) Please obtain from the Planning Dept. CITY/STATE 11 U 0; D N uO ► yD / 6 G PROPERTY LOCATION 6/ 5 1/4, N~ 1/4, Section Z T N-R / TOWN OF 1 L ),D S D N ST. CROIX COUNTY, WI SUBDIVISION C 5 Al LOT NUMBER CERTIFIED SURVEY MAP q0 191 , VOLUME $ , PAGE 2 3 S, LOT NUMBER z-- 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: S~~ DATE: 9- 9 St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 S T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of property SA ~r► m 1 Lt-f-/L Location of property_A?4F 1141VE 1/4, Section Zo T 2:y N-R / W Township 4 0D 5 6 N Mailing address Z © X Address of site 'F 7,5-- 60 fe W /rI b, Subdivision name S 171 Lot no. Z- Other homes on property? Yes )l No Previous owner of property K EV / N ME D C N/ L L Total size of property 'L, 1 ~f '4 e- Total size of parcel Z' 1,! .4 4- Date parcel was created 7/ Z 3`j Are all corners and lot lines identifiable? *I Yes No Is this property being developed for (spec house) ? Yes No Volume 70O/ and Page Number 33 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. S4/ 9r 1l0 5- , 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. sy ~sos S' ture o Applicant Co-Applicant Z3--~(' Date of Signature Date of Signature A State Bar of Wisconsin Form 2 - 1982 5498WARRANTY DEED DOCUMENT NO. VOL 2001PACE`305 REGISTER'S OFFICE Kevin D. Medchill and Diane H. Medchill, ST. CROIX CO., WI f/k/a Diane H. Marcon, husband and wife, Rrod for Re=d S E P 2 3 1996 conveys and warrants to Sam E. Miller, a single at 8:00 A. M person, .....cs THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS the following described real estate in St. Croix County, State of Wisconsin: 020-1048-20-100 (Parcel Identification Number) I Part of NE 1/4 of NE 1/4 and Part of SE 1/4 of NE 1/4 of Section 20, Township 29 North, Range 19 West, St. Croix County, Wisconsin described as follows: Lot 2 of Certified Survey Map filed April 18, 1991 in Volume "8", Page 2350, as Document Number 468391. i i TRANSFER $ 2 °O I This is not homestead property. (is) (is not) Exception to warranties: Subject to easements, reservations and restrictions of record. Dated this 20th day of _ SePte_m r -'19 96 (SEAL) (SEAL) VIN D. MEDCHILL (SEAL) 91 V 2~ (SEAL) * * DIANE H. MEDCHILL f/k/a Diane H. Marcon AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN SS. St. Croix County.