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rJ SAFETY & BUILDINGS DIVISION
201 E. Washington Avenue
P.O. Box 7969
~~EI!! Madison, Wisconsin 53707
VIsconsin
Tommy G. Thompson, Governor
Department of Commerce William J. McCoshen, Secretary
~l G JFRCE
-Dftvey
August 6, 1997
Mr. David Fogerty
Dave Fogerty Plumbing
Fogerty Heights Road
Roberts, WI 54023
Petition No. G97-02195-P
Dear Mr.Fogerty:
Re: Wally Milbrath Residence
Sun Ridge, Lot 1
Hudson/St. Croix County, WI
Your petition for variance of s. ILHR 82.30 (11)(c) l.b. of the Wisconsin Uniform
Plumbing Code has been reviewed.
The variance requested was to install a building sewer from a house to a septic tank
less than 18" below finished grade.
All of your statements and supporting arguments included with your petition were
considered.
Since your request was similar to other petitions which have been approved by the
department, it was processed based on the precedence established by these previous
petitions (e.g. G88-02584-P).
YOUR PETITION WAS CONDITIONALLY APPROVED. THE CONDITIONS OF APPROVAL ARE:
1. An approved insulated pipe shall be installed that has the insulating
properties that would protect this line from freezing.
This approval is granted with the understanding that all of the petitioner's
statements included on the variance application form and any other documents
submitted to the department will be carried out. This variance is specific to the
subject petition and cannot be used for any additional modifications. If you have
any questions, feel free to contact me.
C 1n rely,
, , J - Z--1-
Dan Kraft
Plan Examiner
Section of General Plumbing,
Fire Sprinkler and Licensing
Bureau of Integrated Services
(608) 266-8075
DK:0749C
CC: KEN PERTZBORN
S13D-5524 (R.07196)
> Ir
STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER GUj C(/ &dR ~7#
ADDRESS 70 7 -f~`.
kAX
SUBDIVISION / CSM# a22 L14 LOT # S~
SECTION-.53/ T_-7 N-R_1
W, Town of 17~L~.~~-tom
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WIT ZQ-,100 FEET OF SYSTEM
7 /719
0
s-GrRv,E'Y `Zo1~.
G-
~o
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
i t
BENCHMARK: v 8 E
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: Liquid Capacity:
Setback from: Well /U/YI House ~f Other
Pump: Manufacturer Model# Size
Float seperation yc e:
Alarm Location
SOIL ABSORPTION SYSTEM
Width: C~ Length ~ ZF Number of trenches Z
Distance & Direction to nearest prop. line: T •Sd r sv
Setback from: well: A4Y House z y " Other
YF_Cpo
~v _,Wa/t0VtLEVAT IONS
u lding Sewer ST Inlet: ST outlet: y'9 O~
PC inlet PC bottom Pump Off
F7v f,( ff/
Header/Manifold W-.>- ?,7,o Bottom of systeff,"-f_. ,for"
Existing Grade Final grade ~l! 7
DATE OF INSTALLATION:
PLUMBER ON JOB:
LICENSE NUMBER: Z~
INSPECTOR:
3/93:jt
WiEcdnsin 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 284182
Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.:
MILBRATH, WALLY HUDSON
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
~6d , 6v, JW LlI' 5a-,-f el a -5 /j,/
TANK INFORMATION ELEVATION DATA A9600444 2-1131X
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic l~~'r°,. 6 l/( Benchmark 3,77
Dosin vPar
Aeration Bldg. Sewer 3
Holding St/ Ht Inlet
TAN SETBACK INFORMATION St/ Ht Outlet ,G r
TANKTO P/L WELL BLDG. Vent to ROAD Dt Inlet
Air Intake
Septic NA Dt Bottom
Dosing NA HeadertitW-
Aerati Dist. Pipe (01~ yC
olding Bot. System S' Q~
PUMP/ SIPHON INFORMATION Final Grade /
77
Manufacturer Demand 3,aZ! /C6 7S
Model um
TDH Li Friction System
oss Head
Forcemain Length Dia. f Dist. To well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width I Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 6 DIME
acturer:
SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACH
INFORMATION Type Op~,t -6.51 u) ORAMIT Mode Number:
System: i e7
DISTRIBUTION SYSTEM
Headers r~ Distribution Pipe(s) C/ it x Hole Size x Hole Spacing Vent To Air Intake
Length r Dia- LengtlaV/ Dia. T Spacing ` -x "I
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Syste
Depth Over Depth Over xx Depth Of eeded /Sodded xx Mulched
Bed/ Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: HUDSON.24.29.19W. SE. NE, HWY 12
Y./J~ <)?„etas ^t ,
r!'-
GAL
A4 MY Tl~
f P an raev'ils lon qulredi ❑ Yes ❑ No /
Use other side for additional information. / 4t Al
1 [2 1 SBD-6710 (R 05/91) 1 to Inspector's Signatur Cert No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
Safety and Buildings Division
v~iLrin 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 8 112 x 11 inches in size.
• See reverse side for instructions for completing this application State Sanitary Per it Number
The information you provide may be used by other government agency programs ❑ Che it a isiofl to~evious 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
~ 1 /4 1/4, S T , N, R E (or. 3P Property O ner's ailing Address Lot Number Block Number
jil-
City, State Zip Code Phone Number Subdivision Name or ar"4er
11. TYPE BUILDING: (check one) ❑ State Owned ❑ Nearest Road
❑ Village
Public 1 or 2 Family Dwelling - No. of bedrooms Town OF
111111. 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. [Z New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
-----System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy
13 ❑ Seepage Pit 43 ❑ Vault Privy
14 ❑ System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Finial Grade
Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation
3' 3 5~6 -7 .7 12 k-g Q Feet Feet
VII. TANK Ca aat
in altos Total # of Prefab. Site Fiber Exper.
INFORMATION g Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
New Existing structed
Tanks Tanks
Septic Tank or Holding Tank - /11 0 ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the nsite sewage system shown on the attached plans-
Plumber's Name: (Print) Plumber's Signature: (No Stamp MP/MPRSW No.: Businessss Phone Number:
I)Aclxz) L7 lu er's Address (Street, City, State, Zip de):
~-7 f° ,7;
IX. COUNTY /-DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (includes Groundwater ate ssu Issuing Agent Signature (No Stamps)
Approved El Owner Given Initial Surcharge Fee)
j~
I Adverse Determination (J
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SBD-6398 (R. 05/94) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the
Wisconsin Administrative Code will be applicable-
3. All revisions to this permit must be approved by the permit issuing authority.
4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD-6399) to besubmitted 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.
V11. 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 narne, 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 8 112 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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Dave Fogerty Plumbing
SEWER SYSTEMS & PERK TESTING
FOGERTY HEIGHTS ROAD ROBERTS, WISCONSIN 54023
(715) 749-3656
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LaWisco bor and Hum n Relations Industry, SOIL AND SITE EVALUATION REPORT Page - of 3
Division of Safely b Buildings in accord with ILHR 83.05,- Wis. Adm. Code
COUNTY
ST C,poi'X
Attach complete site plan on paper not less than R I n size. Plan must include, but
not limited to vertical and horizontal referenc a % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location an t rr - to nearest r
APPLICANT INFORMATION-PLEA. E PP''RINT~A_~L`1NF,04M REVIEWED BY DATE
PROPERTY OWNER: Q '`w ROPERTY LOCATION
c7i f'I 3 /4-1,f
/p y ~t!l $G s OVT. LOT SE 114 114,SZy T 29 N ,R /1l E (01 W~
PROPERTY OWNER':S MAILING ADDRESS LOT # T!"UBD. NAME OR CSM #
/'y/4 3R0 S r' 'r ,4' OdrE'
CITY, STATE ZIP CO 0 UMBER []CITY []VILLAGE OWN NEAREST ROAD
ff u p S o,J 6101, 5~! o v os c~ 13 -54-le V
(O'New Construction Use [p"esidential I Number o rooms 3 "r Addition to existing building
Replacement yS6 - [ ] Public or commercial describe
Code derived daily flow (,,o O gpd Recommended design loading rate -gybed, gpolft2 trench, gpd/ft2
Absorption area required 4_ bed, ft2 / 66D trench, ft2 Maximum design loading rate bed, gpolft2 • g trench, gpolft2
Recommended infiltration surface elevation(s) SA-f- P 3 ft (as referred to site plan benchmark)
Additional design / site considerations
Parent material 5c S S9 547-Tk,5 . Flood plain elevation, if applicable w Z+ ft
Arlo "IV
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem CAS ❑ U ❑ S ❑ U ❑ S ❑ U ❑ S ❑ U ❑ S ❑ U ❑ S 00
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Botxd3y Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed tench
- io I/le 31.7 -2 fsd~ F~ 'S
2. Si/ s~,t fie s f , s -G
Ground YA 7, s Yk '51
elev.
y, 7& ft. y 3 - il~ 7,T ye e, 7
Depth to YR `1/ 5, S Gt ,Q C S - • 7 i
limiting
factor p - yp o //P S~ C'. j, $ _ • 7 ' •
Remarks:
Boring # :
Z, Z ly- yp ,o bK ew, f ►
Ground 3 y ' S Y/Y f/ s u f2 5 / •
ele
22 v. L1 f/~' CI 5 rt. Y/e - S O
f,
Depth to
limiting
factor
Remarks:
CST Name:-Please Print R o f3 ER T U LR R I*C L,7- Phone: 71S" 3 P6. 9/ 8S
Address:
Z Z - ~ 5 CSTi4i -z S/Q L
Signature: ~ 1 1 c.....e..e rnnaultAniB nma- rAT Ni mhor
PROPERTY OWNER J-1 3 N ~U 5 SOIL DESCRIPTION REPORT Page? of 3
PARCEL I.D. tt SU,vR iDG-,d5-
Boring # Horizon Depth Dominant Color Mottles Texture Structure Roots GPD/ft
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tnrch
Ground 3 VD - z17, S le v f 2 C 5
elev.
7. '2-& It.
Depth to
limiting }
factor Remarks:
Boring #
/ D "/o ~O 3 s 6, /r ~►N.f i2 S l 'F , Y j , 5
/0 - /6 /b yle 3 C- S 10 f
:Ground 3 / - z Z 7, ~ R s/ ~ f s b~ ~ f ~ 0.S" - • , S
elev. Y 12 - y 7, S yk ftq
- s ~.b►~ GQ C s 7 ! .
y 7~ rt.
Depth to
smiting (o So 10 y2 y/ C S O S d 7
factor
Remarks:
Boring #
/ o- y i0 /R 3 /-i S, / t f S b& A , f Y , S
2- 15 ✓°yie 3/ s/ ifsl~~ FR s i~~ , y =.s
Ground:: /s- 2 7,S t//2 emu f P- C- 5 ,
elev. 22 -q ja S/ S, O S - • 7
it.
Depth to '
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
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+b1 ~ N* . Y .+'r t 1 C~~ S ' ~ ~~`'t~. S`e r ~Y 1ti.a` r•+'Jti't+~f t .
t, < ti " j~~ ~t't~ '~~•y},~3•~~Aw~ra }t Mrt tf!p', t ~ 7 - ~
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Nand Y~ 1 64 .JUNI %IUht 1
10. LOCATED IN THE SE W4 OF iN
E NW 1/4, AND IN THE SW I/4 OF THE 'aE V4 OF SEC iroN
ALL-
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SURVEYOR'S C2Ri•IFICATE soft ro r,
CURVE DATA TABLE
Curve Lot Radius C"tral Chord Chord Arc r-p' s. T-)ent
I, Harvey G. Johnson. Registered Wisconsin IoM Surwyor, hereby certify No. Length Angle Length Bearing L-It.h & -s9 In lfaring
best of my professto.-.4 kelezf9e, ng and pellet: to the 1-2 50 167.00' 6a 46'00••
urderstardi 168.37' ST J7'00'V 177.12' 56'4~'00.1: SSf 00'(
That I lave surveyed, divided and zapped 81+st1 ]-l - 273.00' I54* T 32127" 213.52' 56'43'46.5'11 221.80' SS-r 70'00'11 90•J2'2t
%1 of the 44"1/t and in part of the SCI/1 of the n located in Part of the 4648 20' S 4077•'1)60" 8" 63.12' SW 11'25'V 63.S2'
SW1as W
R19W, 7~ of M/4. St. Crolz Cbtrh /4 of Section 24, T29N, " 5.89' Sir 15'32'7: .32'
02
fol 1 Tows: ly, Wisconsin, 'lore particularly described t6 17'00'10•' 75.62' S~17'S4'14 75 75.%'
5-6 51 167.00' S4'32'27" 153.04' 426.43'46.5"L 132.97' 9V Z'77-V N5r 00'0
Cbllmencing at the WI/1 corner of said Section 24; 7-8 233.00' 60'16100" 235.69' NBT ?7'00"E 24 .12' !6-r JO'00"E N6.46'00
pearl. referenced to the thence N89'27'J3"E (assured 53 " 4500.00" 167.00' LOT00'00'$'73.80' 1&r X-J0"r
'19 aloe nted Fast-West 1/4 section lire of said Section 24, Road 18'16'00" 75.98• Mr 37'00"6 75.32' s12'70.00'E
tearing N79627'33"EI along the East-West 1/4 section )!re of said Section 24, 9-10 51 80.00' 105.48'10" 127.62' 706'33'28"9 141.73' !PW Z7'33"C H16.20'3
13431 98' W tSoutheast corner of Lot 10 of the Plat of SuMidge, being also the 10-15 51 80.00' 70• 20'37"
Point
92.161 M7'.5"9 96.22' '20')]11 Nbf00'0
Beginning; [twee contlruing 110927'33"E 2586.54' along said East-West 12-53 51. 167.00' 45'00'00" 127.82' S70- )0M00"9 4)1.76' !7 [,6,70'00'7' S49'00.0
lire to the Southeast corder of the Stn /4 of the NET//; thence NO'IS'01"W 1320.97' 14-15 54 263.00' 47'15'00"
2)1.)4' S72.07'30'*t 238. i7' s4r 30'00"E Nor 45'01
Along the East line of mid SWI14 of the M/4 to the Northea st corner of said 16-17 S4 167.00' 7'00'58^ 20.44' Nr87.15129"E 20.45' -Far 8600"" S89. 14'0,
SWI/4 of the W14; thence 589.25'51'11 1028.22' along the North line of mid SIt4 18-19 54 80.00' 45'04'10"
of the NLI/4 to the Northeast corner of Lot 37 of the Plat of SunItidge / 19-20 - 80•x. ar29, 61.72' S76')2'OS'M 62.93' 5-17'>D'10-
50'34'09" SS?04'11
E )14.17' along the that !ire of mid lot 37 to the II; thenre 270* 08 1 20" 11).00' S16-00'00"E )77.18• S`9' N'10'1l N3r 01'11
line '0 Yo1rg Road; long the Eas 63.21' slang mid Right-the NNy therrly Right-of-Way 51 ~J4)o^ 111.64' ata'4"1 12.7.56' 9.11'10'11
of Umtoe N67-of- 66.00' to the Northeast corner of Lot 38 of said Plat of SurAidge II; thencee ST" 56 " ",21 10" 60.67' NSssr 2,42'4010E 62.21'
S7111'27"W 456.83' along the East lire to the Southeast comer of said Lot78; 57 57 b'46" 79.57' 112749'23"E 83.28'
th
theno@ ence N78'W 245.00' along the South line to the Southwest corner of said Lot 38; 58 " )1'04'10" 42.85' NI S'32'OS"W 43.38'
'these chord bad 7N2•J7'along ~ the arc thence of a 233.00' radius curve concave westerly 20-21 58 15'04'50" 61.32' NO-12'05"W 62.93' 313roG'1091 N1 4'M'OC
of Not 79 of cold Plat of ShnRt S8T 14'W 56.00' to the Southeast corner 22-23 s7 233.00' 14'00'00" 171.57' N96'00'ou"E 178.93' S72-='DO'E N64.00'OC rner line
W the Ssaid Plat co Su dge II; th"nce 1165'51'44'14 397.42' along the Southerly 21-25 59 167.00' !1'00'00" 125.12' S756.00'00'M 128.25' ;6P 90'Op'y M2.00'00
of mid Lot 39; thence S42'W 100.00' along the 25-27 59 233.00' 24.15'0D" 97.88' NW 07'30'V 98.62' Y72"70'00"W S83'45'00
Southeasterly line to the Southwesterly comer of lot 40 of said Plat of SnRldge II; 28-29 59 217.00' 4r 15'00" 177.39' K7r07'30"W 182.74' Stir 8'00'11 1148'00'00
theme S58•15'M 903.29'
Along the Southerly lire of Lots 41 through IS to the 30-31 59 80.00' 38'31'52" 52.86' Hfir 17'26E 53.87• IN2'70'09"E N50.34'52
northeast corner of lot 11 of mid Plat of Se; therms S15.27'3391 246.00' 35-32 - 80,00' 160.04'52" 157.59' !5.32626'•" 223.52' !6('34'52'" M7)0'00
along the East line of Tats 10 and 11 of said Plat of Shnitidge to the point of 60 80.00' 5737'00" 79.54' N50'46-22"E 73.24'
Beginning, containing 2,165,484 square feet, or 49.713 acres, more or less, and 61 " 3r 51'38" 43.91' Nb•02'O3"E 44.49'
being subject to all maenents, restrictions and covenants of rimed; that such 62 6V 36'14" 90.17' 1,145'11'53'14 95.79'
Plat is a correctly drawn representation, to scale, of all the exterior b.,daries 33-34 63 233.00' 15.00'00" 178.33' MO.30'00'M 18).00' s4B'O0'00'7/ 587.00'00
of the land surveyed and the salbdlvlslrn thereof ache;
That I have sods such Plat Addltionel curve, data [a cvpltatlorel phupones only:
the above described; and the direction of Creaalood Enterprises, Inc., owner of
17-35 Road 167.00' IT 14'02" 50.01' 580')7'01"+ 50.21' S89'11'02"E 572.00'00'
that I have fully ralpllrd with the current provisions of Chapter A-E 7 of the
Wisconsin Adainlstrative Code, Chapter 18 of the St. Croix Canty Land Use Regulations and napping,thhe smtl'w . n of Ekrdson Subdivision Regulations in surveying, dividing.
~j
t~ }po,_SaGONs/~ I
Harvey G Z HARVEY
R.L.S. No. 1899
Dated this 17th day of November, 1995 : JOHNSON 40
HL!,- ;ON
W6
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c+o.`a, i SE/1'IRffK•.F...~4 39
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TEMPORARY CUL-M-SAC To BE EXCLLGNG EASE.UI
AUTOMATICALLY wGTCD UPON
1381.98 / EXTENSION or K"
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SECTION 24 l1NAT iEO labs
T29N. R19W
STC-10.5
SEPTIC TANK MAIN I,INANCI?
St. Croix County
OWNER/I3UYF,R -
MA FLING ADDRESS 70'7 S'7. Q/. ~~T 1.. / r & egg:
PROPERTY ADDRESS XV/
(location of septic s /stern) Pleasc obtain from the Planning Dept.
CITY/STATE "AF 'f' w'/6
PROPERTY LOCATION 54~5 1/4, fle 1/4, Section N-R
TOWN OF ~ ~ - ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMBER 5/
CERTIFIED SURVEY 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.
St. Croix County Zoning Off-ice
Government Center
1101 Carmichael Road
Hudson, W1 54016 103
• 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 A.&%ryEZT 6
Location of property_1~~1/4 1/4, Section ,:d ,T;k9 N-R_/f_W
Township_lluDsCAJ Mailing address 7~~ ~'31:'p/ rL
A10-
Address of site
subdivision name Lot no. 57
Other homes on property? Yes_,.,~ No
Previous owner of property TZ4" ,msG,&
Total size of property
Total size of parcel
Date parcel was created
Are all corners and lot lines identifiable? i,/- Yes No
Is this property being developed for (spec house) ? Yes L.~No
Volume ,/Zof and Page Number 1-7e 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. = 2..,7 , 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.
7
Signature of Applicant Co-Applicant
- w~>
Date of Signature Date of Signature
YOt 1?01_ PAul-14 /0
L •
1
550227 WARRA:.Vr DEM
FIZOTtR 5 0,
Document Number: $T. CROV CO., V111
Re:'i bor FA=d
OCT i Tess
Return Address: Orea'wood Enterprises, Inc., 1416 Third Street, H-&,. WI 34016 8t 1:15
t P' 7j' 7&
~Jl
Fk21s'Vr of Deeds
Parc.0 I.D. Number: --.a
THIS DEED, made between Greenwood Enterpri ec, Lu, a Wiiscea corporation, Granter and Walter Milbrath and Carolyn
Malbrath, husband and wife as survivorship marital property, Grantee.
WITNESSETH, that the said Grantor, for a valuable consideratioe of one dollar and other good and valuable consideration conveys
to Grantee the following described real estate in St. Croix County, Stec of Wisconsin:
Lot 51, of the Plat of SunRidge III, (Sled in the Office of the Register of Deeds for St. Croix County, Wisconsin, on January 2, 1996
in Volume 6 of Plats, at Page 46, as Document Number 538046.
This is not homestead property.
Together with all and singular the heraditaments and appur enanc es t6emmto belonging: and Greenwood Enterprises, Inc. warrants
that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and reservations,
if any, of record and will warrant and defend the same.
Dated this 12-0 day of September, 1996. ~TPA NPF
GREENWOOD ENT'iRPRISES, INC. GREENWOOD ENTERPRISES, IN
By: By: '7E. Rusch, its president Mary R. h secretary _
AUTHENTICATION ACKNOWLEDGEMENT
Sigmture James E. Rusch, its president STATE OF WISCONSIN
autheRtie*ted th* day of September, 1996 )
ss.
_ ST. CROiX_ COUNTY )
Lois A. Murray Pe rs 3way cane before me this
TI'T'LE: MEMB~ STATE AR OF WISCONSIN dig of 1996 the
L narrkd l~i<vy R. Ruscb, its secretary
to be the pe who executfd the foregoing instrunxnt
THIS INSTRUMENT WAS DRAFTED BY: aed esan~
Lots A. Murray ,
Zil-, Estreen do Ogland
304 Locust Street No" Public, Slate of Wisoos! n /Y
cowwim-im P.O. Box '359 My expires 1/ ~ Hudson, WI 54016
Brenda Poulin
Notary Public
State (If Wisconsin
`