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HomeMy WebLinkAbout020-1073-40-100 `r ~ o I a+ 0 3 C) v 0 `fl h 0. w n I N O~ ~ I C ~ I N C Z LL c o I 3 I M I 3 w z E rn = o z ~ ~ v I m N~ ~ a m I N I- Z Op E L7 U O Z c w Z o c o ~ F- r N z I c m m `h d) I! ~ aoi m I c N •~V CL u _ c ol Z F`- Z 0 ° 0 N _ Z t~1~ N t6 E Y N (L to 0 CL co O y d N c p 0 0 or a E N zN> I~3 n.2 ZNI z o I CL 0. IL Vi a 0 o ) N to J U > c } ~ I ti 'IOa v o o L I V m a d Q z in io t Ci w Z y y 00 p p Y! C O" C E o O c3 c r°n vd~ c rn o c E Cl) CD CD W 6- a) ~.r O N d N H C N 0 O N 00 L • N= co O O Z N Z-=i 'd U) j L: a m .2 d • ca E v~ c) / ~1 A c~ (L I 0 Parcel 020-1073-40-100 05119/2006 04:58 PM PAGE 1 OF 1 Alt. Parcel 26.29.19.291A 020 - TOWN OF HUDSON Current F_X_1 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 - MITICH, KENNETH & TRACEY ANN KENNETH & TRACEY ANN MITICH 730 N MEADOW DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 730 N MEADOW DR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.020 Plat: N/A-NOT AVAILABLE SEC 26 T29N R19W PT NW SE BEING LOT 2 OF Block/Condo Bldg: CSM 9/2420 2.02 AC Tract(s): (Sec-Twn-Rng 401/4 1601/4) 26-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 04/03/2006 821899 WD 07/23/1997 1216/088 WD 07/23/1997 1184/595 WD 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.020 75,100 212,100 287,200 NO Totals for 2006: General Property 2.020 75,100 212,100 287,200 Woodland 0.000 0 Totals for 2005: General Property 2.020 75,100 212,100 287,200 Woodland 0.000 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 133 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges 00 Total 0.00 0.00 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION P.O. BOX 796 LABOR AND PERCOLATION TESTS (115) MADISON WI 3707 HUMAN RELATIONS (ILHR 83.090) & Chapter 145) LOCATION: SECTION: TOWNSHIP,MAt~ 1: OT NO.:BIK NO.YH UBDIVISI N NA E: FE 41/ 5E 1/ 2& /T29 N/R 0 E (or) H U t'~So►.) i&fF MEA.Dows_= COUNTY: MAILING ADDRESS: S-F.C'RO(X Cv/9X©.) 7Z 6P coda Ty ` Z)- A , N U Soo 4J I S SV6 USE ~Z2 S DATES OBSERVATIONS MADE NO. BEDRMS : COMMERCIAL DESCRIPTION: Residence r~ Replace I JU~f= 14 l5 1911 JU0 i S 3 IG 3 DR /I/, ,Y~I,New I g 4 1 5C 13URk11A Rdr 4)~kk07-,k /D,kH RATING: S= Site suitable for system U= Site unsuitable for system • CONVENTIONAL: MOUNcD: IN-GROUND-PRESSURE: SYSTEM-IN-FIILL OLDING TANK: RECOMMENDED SYSTEM:(optional) MS O S ❑v Z 3S ❑U ❑ S OU ❑ S EU Tc,>e Oc kis co i 'f'- D r2op ~O X ~i $T~i /t T- L) f F E-T- 6t6U-^T',0a5 OAJ 5/0 f-.,. If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: G r4SS =F I Floodplain, cate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL P H T R UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST. HET TO BEDROCK IF OBSERVED ISEE ABBRV. ON BACK.) /D y 3/2 P/aw-4A ; 12- 20"10 yl2 416 /oAti, 2,w sbA' e ; B- I Zp /O/, Cot p > !ZO 20 I2p • /o yR 5,/g .a. cs Gq u , ~ - ' / o {'iP 3/Z /C',4 -1, 40 how 4d1 ; y-ice„/O f,~p .5,1 2 ti., .r'6&' B.Z l(5 4. Is-, -y - VA 4V6 9.e 3 it o ID2,ip ~o > 1/O a'~Sb~,y~~i2;~P jio ~0 foie%B ~o~y~ o- S.s: g. /O SIC, fr'A_) e 5 / f Je tM U f 2 0-12" /o yR 3/2 o+A1 p/oweD ; 12-i0" i°fyR f G z sdF B- ~ 12-0 Ito > lZD 6" "e; LD-yp° /00 s/C. S/) O fA 4)% 1)5- yo" 1.2o _T W 1"It' 70 / f ~jif',, rw, Uf,2 ~ / " ,Qq,Ups 7`U 3 " /3A vDS B- cwfo /o.}Af iOyfa 2 ; -fop" /oyc G s , B_5 101.4 Q 'Lb 118 0-P IA, M.L4A , w,'dG_ poc,<'e7 s cG ~o y e s/a Y .4, {~ERCo~AT~o~ Eft<lb'tT~o.vS PERCOLATION TESTS EST DEPTH . WATER IN HOLE TEST TIME DROP I WATER LEVEL-INCHES RAT MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. p RIOD 1 -PERIOD 2 PERIOD 3 PER INCH P_ I K - 1'-6 /0/.(" < Z Ce 4 Y3 2 s Y.3 P- 3 10 - co 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. L C)U)E ST 71E'f-u~~t - 9 7 2 SYSTEM ELEVATION., i i tN ~i ( r I ~'PLC~T~ PL~41J M J Mop--ti- LOT r a 15 I I r y PY ~ O 4 of a St~lc : / 30 135 v~ q v w pEpc ~dc~tTioNS I J u . ~ 'Y- Pz I J I 33 132- Aw, U'.r".0 407sY : /DO *el S D . nil i s Q/zy z. ,z a~ b 1991 a.. v J, too ,?~/H a~eae I " l Si, q I ~ ~ ` ~-I,arlrFir:3 $~;2G ~~•U~/rte FY,~/.v S,~ ~ Mq ; . . I F ~,Yy'1 ~y ~+~~+f~~~~J IV V ~a /G +yt~~ r GIn f\ .,'1 !y s~vYljl~„~~~i~,~~'. .,i:lY ~ k'. ~ r•I-f•{if I. ~e~~ir~r~,, ~v '~.c.. a~'~ r..: ? Y 'i , 1 c .e,{h.yyYi1 (5 f< •jtP^ry~ '%7 P` t I,~ t~ '.!.yV~FS 1 _ NIAJ 9 + r• it y z t.. ~'Y .al~r nvYi 7.s31~S 't'r""4 i 8;, t ;:~r•'r r~( A 9ehiy*''etr~e~r"fie, .q~t be'd~ro ~'he 'bast-West'. lil~te of SOttior 26, '.assumed to b'ear cc m c?" x! t:,.+ e; N8o3T~22!IW. rn o ►rt o H 4~T 2 !,1991 x CROIX000NTY Unplatted Lands "r ►~1 'CO qPREHOIAVB'PARMKANNJjVC3 v N o West line of the SE} 'of Section 26 S000181.2411E 1058.201 N000181249' 858.201 i I. CA I f i dw. c H Ir m Nff+O o n ko 0 a cn:p v ' -4 a Fr t'h PI g iNN v ' oz a $ i o: r: r• v co+ - ia o s N ,r f r z rlnr , w J !~wa+, 01:: • .ft a O o ro ;I 66 ~r't,lux-y.• r r } hFOO,." 'M ,~r y+rkM .rl 1 l:75'w ,l Mkt lriYi r~y.+• rr r rn: , r i , -0'. y ~JU, i7 "r 4~ 3 Y •ry. ri.l v y, j~. t r r ';Y ! r kOf 1 ,Y 4YJ i,lf~r~ ~y01 ~~L"i n'~ 'k' y! ryartrj~'~rt+~F.~~l ~~!}~'£j f rr~`_c!f'klt~DO 4i ii Qy y i , s ,s y Jy~k O . OW ark V~Jr f i'i' a'.) t~^: +'S 1 N~~ £~;'d 1113t~ +j•4V! al' '`~if~•k,h + as~~n.sr t~ (~i• s , l r..• ' I..t.''V ' . , o o. I I~ f `C u oN ow. rt~ 7~• ~ i++ co ha m 3 1.11 ■.S`:/~! ~rl v~',M •r~,'. n.'.' _ ,'I~,•~ w H ` i) ~'mt}~ # n, S, ) w ';i r yrl f~7~ kJ" p~ wk4 A A rf t4. 0 ny W I C s r' .i e a e a ~.yr !a 4V .HI .,y1 ~W r t1' 7 r1• :3 O. LJ N rt ! rt wm Cw °L~ a Ftit, r. H N k, r 1 d CA ir to ch co 0 ,~P• G • N N - -aa ~y • s : O to : A O. Z b. i ; r + ~ i' ~ ~ ~7t+r` c,' a aY'`.a• r. w; y N ~ fi ~r ' t t ! ! 1P~Gq {rJ.~ ~~n,,.~t,d ~ ~ '4~f a~ji ~ '~r'•' a• ? y • Fr F A? } rn t! Unplatted Lands °f r I f. 3 r'1'~++ r , 1, •f',' ~,~{r J ,n + p~' 1,. a ~.r~r~'irt e kk St~1l~~r8~a1i1 3~4. 5Q( ry+ :.s7 tool, .s~. e« s ~E.'~ ,r M~ 1 .a~ p 5y~ V J~a 1+. ~1') 'ice'. l•t (17'~t/fd 4A- 1i~SA5 er y0 1 V. N. 4 h1 t' nQ 6.O~j J~0Q r.~. N , to , t N. . ° Y • ~ G , ra•. r i ° ` ~p t ~1h1~;~t~{ t' G i t s ~r~ka~ jr~1t~ L; , ay js n~ :u ° pro t , 1 / Yt ~y I?~ 1 ~lt\t•S rn'" i.i MRi4 r , 7,T,y s ~~Y k•a' kQ. is , ft;t~'t•+ +Dt a~ r r r t'~} 1, . b4: e r + y-~r. i• , al nY •W x,; 1•' ~p~, ',~y'y}~. ,s"!;10'' 6 i ~ii~ti `I:. t N~ t L r,.. 1rij1 p O; / _ LEI cc co N tNJa STC - .10 4 AS BUILT SANITARY SYSTEM REPORT OWNER 5,+M M/ [ LE/Z_ ADDRESS BA X JO Z $ 7~ ~J(~"man! I Sy0/(o SUBDIVISION / CSM1 6 q Al E,4 ocq S LOT Z_ C SM SECTION_ Z~ T _-_>1 N_R /5 W Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ~ 2D SGkL~ I/y sSS I Q i ~ ~,~V► 15 upTE : A5 bE q-I ~'yG ~ ~ ~ ~ ~ ~ I VHF cC nlof yET 7A(<YJ I C ~oUSE t I 3' I i f I W ysa 3 - moo i~ ---"~1~- - - - - - - A I So L,7/a < d7 L - - i-NS-1 _ ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to cent-or or BENCHMARK: 'P pF !"l2oW AT ALTERNATE BM: To p F (0 Gk- LV14LK_ OU7T Zz i SEPTIC TANK / UMP CHAMBER / HOLDING TANK INFORMATION rer: W E / S cT Liquid Capacity: lDaO (,AL-. Setback from: Well !5 ~ House l Other ~7 r ~aL~x2 M a~Sr l Pump: Manufacturer Model Size Float seperation Gallons/cycle: ~ Alarm Location :SOIL ABSORPTION SYSTEM Width:. S ~ Length 7 S Number of trenches Z. Distance & Direction to nearest prop. lire: 20. 7.0 A<02,TN Setback from: well: a3~' House r3,1" 3 other 741 &1 Al o ~'I A- N N-oL t= a /QLIV ELEVATIONS Building Sewer- ST Inlet. (0'1,18 ST outlet x,65'. 10 3 83 PC inlet PC bottom f ~N. _ ~H El~vN Pump Off Header/Manifold 3 P w i uB0 t' u of s stem ~o~N ~y' 97,F1~. w ~ iy,g3: 9. Existing Grade 10.2 5' IoZ4,/3 71x1' Final grade )o. 2 S~ . /0 2 4/3 DATE OF INSTALLATION: c n \ PLUMBER ON JOB: ` Y LICENSE NUMBER: G' - 3S0 Q INSPECTOR: 3/93:jt Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division Sanitary Permit No.: ' GENERAL INFORMATION (ATTACH TO PERMIT) 268646 Permit Holder's Name: HL1tDSONllage Town of: State Plan ID No.: MILLER, SAM CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: &C , 162)r os TANK INFORMATION ELEVATION DATA//.30 A965g. TYPE MANUFACTURER CAPACITY S TATION BS 01 Septic a. e s-er Benchmark Dos13. , 5 Aeration Bldg. Sewer Holding St/ Inlet C~•~ TA SETBACK INFORMATION St/,~4 Outlet TANKTO P/L WELL BLDG. ventto ROAD Dt Inlet Air Intake Septic NA Dt Bottom Dosing NA Header 121m- p~a3, 13,% EHd tionDist. Pipe in Bot. System /y B0 97.8"77 PUMP/ SIPHON INFORMATION Final Grade Manufacturer errand Ex, 0,6' S'T~ odel Number GPM TDH Lift loss System TDH Ft lie Forc ain Length Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width 5 , Length s No. Of Trenches IMEN 1 No. Of Pits Insi Liqu Depth DIMEN I N D fact r SYSTEM TO P/ L BLDG WELL LAKE/STREAM LE HING SETBACK CHAMBER Moe Number: INFORMATION Type O A0' V: ' OR UNIT 11, jo System: -L/'e, I DISTRIBUTION SYSTEM Header/ r Distribution Pipe(s) x Hole Size x Hole Spacing vent To Air Intake Length Dia Length Z Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Gr ys Depth Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched Bed /Trench Center Bed / Trench Edges Topsoil E] Yes No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: HUDSON.26.29.19W, NW, SE, NORTH MEADOW DR. a ~ Plan revision required? ❑ Yes Q/N o Use other side for additional information. 7 / SBD-6710 (R 05/91) Date Inspector's Sign, ure Cert No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: 5 Safety and Buildings Division SANITARY PERMIT APPLICATION Bureau of Building Water Systems V ~L■'■■'t 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 j than 8 1/2 x 11 inches in size. g ` State Sanitary Perm t Num • See reverse side for instructions for completing this application goprevious The information you provide may be used by other government agency programs ❑ Check it revisioapplication [Privacy Law, s. 15.04 (1) (m)). State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION Property Owner Name Property Location q -4- C~/4S~ 1/4, S Z{, T Z N, RI/ E (r W Property Owner's Mailing Address Lot Number z Block Number R C> K Zip Code Phone Number Subdivision Name or CSM Number S City, State tj/ 1 (_!>n) Z 7 ec o 4 0 4(j ~ o A. y II. TYPE F BUILDING: (check one) ❑ State Owned LT it Nearest Road illage tJv S~~ Public 1 or 2 Family Dwelling - No. of bedrooms own III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) D Zo-/C7-~_ y 1 ❑ Apartment/ Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 E] Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/Bar/Dining 4 E] Church /School 8 E] Mobile Home Park 12 E] Service Station/ Car Wash 5 ❑ Hotel / Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF P RMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1 ew 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System --System--- ---------Tank Only Existing Existing System ExlstingSystem 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 F1 In-Ground Pressure 42 E] Pit Privy 43 E] Vault Privy 13 E] Seepage Pit 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. Final Grade 1 -7 Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Cgg.o 04 ; C, o Elevation sU Z U SO - 7, ~Z r,o../Feet Feet VII. TANK Capacity Site Fiber- Exper. INFORMATION in gallons Galleons Ta ks Manufacturer's Name Conc ete Con- Steel glass Plastic App New Existin strutted Tanks Tanks Septic Tank or Holding Tank ~tJC~ U I- S 4E7,e- El El E] E] Lift Pump Tank /Siphon Chamber LJ L_! VIII. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Signature: (No S mps) MP/MPRSW No.: Bu mess Phone Number: Plumber's Name: (Print) gj Z' Plumber's Address (Street, City, State, Zip Code): SB )0 ? O 11W)I k v E /C-0 /yU 0 C'.) IX. C UNTY / DEPARTMENT USE ONLY (Includes Groundwater ate ssue Issuing Ag t Sig a Disapproved San ary Permit Fee / ❑ ~ surcharge Fee) Approved ❑ Owner Given Initial Adverse Determination U GCS 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 be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 112 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. 4 ' ~ cSir~ ~ ~/752.`~O SysTErK El.. N~~N_ LBT Z Cscn-t S'~t~0o~ Low= 97,~z.~ o E -o s- S~ ZOO W£ v T 6 Y~ L E iC L L ~R~Lr?6IC NousE J' }41tpFt '72EMC~/ F gS~~oO j~ ti Lou) T!' E A/c H F l q~, 6L F? /A kl IF A(r $S h r LID yes t ~ r x B - -z ! I Ro Al /}-T N/E ,107 <o~ NE l~. 6AsT coT !i~/E too NoALTFF AkF-4r)c7w L2lV4 m k.A m r I O I I ~ a . ~ i n as t~l -p 00 O z co z I a I ' r 41 v I ~ ~ N I N` L-A u Z I 1 y I m p ~ I a s 'C b ~ µ m 90 0 i ~ o O ~=o N C ~ z ,M ~ ~ rn LA z tp Nov JA4fEp 19910. S"off J; 475290 SL V A Lv-j w. ti .re rri f . 0 APP w~ r ttq ^ 7 s/ r ~b QOt~v~~ Bearings, are ref•erenced to the f't CD 1/4 line of Section 26, assumed..e bear x C6 ,mc,. o O CT 2 2 1991 N89°371224. cc 0 H oNi o .rt+. o z ST Cr7OIXCOUNTY Unplatted Lands NJ ~J COM", HENSN6 pARKS PLAW%gN0 N o t+i AND ZONING COMMRTEE y West line of the SE} of Section 26 S0001812411E 1058.201 c 200.001 N000181244 858.201 i° z x v c~ rt N co N to to 1 7 N 0 7 O 1"11 O O N t0 ti .P w 1 C 1 3 I O N n (J1 0 O v Irt m a Z .7 Zia m y o lv icd rtr x o 7d • 10 .0 41 (D M 4' -3 1 I aE I 1 0 o rt Id O ;....75 rn I ► f+. I (Recorded :'bo off: o 1661 O O PC W 214.741) ° M tfi:A1 t 214.86 lot 200.061 I S00~18113E 414.66.1 ° _ c r G `~"N 4t•', rte; rh n- } wrfr z N00 co 18,1311W 412.121 o o co rt Of xis ,V v 1 I I - I O O O m m 00 r.: N co 0 1 0 00 ;P1 I O' I rt . t'7 n C) Cn N• O :M,. ~ t-o I 3 11 -11 -M -3 N -5. N Q M c N o c o 'c y H I m I = ° m :3 0 ''az -n -n ' ..~C to. (t xZ pmi d ..q o o o rt rt 0 m a' c r" I o 'Pyx„'r 5y,, 1 ^r. . 'O Q,' 'C r0 ft O ~ V C I O O I N t GS ~r ' c W C P1 . ("1• M.~{ N UI 1 N . 0 O t J I» rh 1 rr 1rt ~l - t a y. a y. f} Ice • '17 C 1'C ~ 1 d O VI N Of N 1 a I r E a Cn i ~ ;A ' uo 0 1 to U1 0 N) 41 co co 0 Ln O 4.1 Unplatted:Lands °f Cu M CD C1. 0 y X - r ~W w s r ` 501 d N I u,''- 3308 501 '7 7 k 4':..{ P. .p 66:'Opltx~ 't N : F+ 'T1 ' F•1 '7 . f0'f .7 . , •1 fi m . ~O ,i^';7 ~ r. m 'T7 ° ry.. 1J r..u tp_ :O t9 t9 >'.C. ...i'r w tx y' /y• N d: Oft to ! Co 'O • t.~~ W 0 1 OD (m 41 1 r S T C - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER 5 ~'Y1 n' /G L ADDRESS_,~ C 3x = e i } FIRE NUMBER CITY/STATE ;f. J a_ ZIP_ S y~~~ PROPERTY LOCATION :/V44_) 1/4,5-1- 1/4 , SECTION Z G , T N-R- TOWN OF_9UDS4 N ' , St. Croix County, SUBDIVISION 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 a 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 og';'-replacement of a failing system, which was in operation prior, my 1, 1978. St. Croix County accepted this program in At~tst 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 Zoni a certification 'form, signed by the owner and by a mater plumSer, 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/Ile, 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 Co. Zoning officer within 30 days of the three year expiration date. 0 SIGNED' DATE: I Z - .6, St. Croix co. Zoning Office 911 4th St. Hudson, WI 54016 i a 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 S f'I rn7 h7 / L L E!Z,_ Location of property~ccJ 1/4 Sf- 1/4, Section oZro ,T-~a9 N-R / W Township 14u D .S ON Mailing address 14- J D S o rk k-)J ► Address of site -7 2,n Vait7h° Subdivision name 6~jepll Lot no. - Z-Other homes on property? Yes $e No Previous owner of property a4 00 Al A/ Total size of property Z, col AC Total size of parcel Z o I ~f C Date parcel was created Co - 1 - Are all corners and lot lines identifiable? X Yes No Is this property being developed for (spec house) ? - ' Yes No Volume 6 and Page Number Z /ZC 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. ~j ~S Z q O 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. "_~~&17 -4 ature of Applicant Co-Applicant 9-/Z-9~ Date of Signature Date of Signature WARRANTY DEED 9 Document Number HEG►STERSOFFICE ST. CROIX CTY., W1 Wd 1a Fw,ad x ju4, 1 T 1996 Retum Address at 10:00 A. M Aeg,ster of Deeds Parcel I.D. Number 020-1073-40-100 z ot Glenn Waxon, a/Wa Glenn A. Wax on, andVycella ~ r~ ,descnbedn r h I cbaad a ❑d5t.+f Ce,roix vCoun qa State warrants G to Sam E. Miller, a single person, the follo Wisconsin: fi Part of NW'I/4 of SEIA Tad part of NEIA of SEI 4 of section 26. Township 29 North, Range 19 West, St. Croix County, Wisconsin, described as follows: Lot 2 of Certified Survey Map tiled November 1, 1991. in Vol. "9", Page 2420, Doc. No. 475290. T Ai~ER a This is not homestead property. .r Exception to warranties: Easements, restrictions and rights-of-way of FeF&d, if any. Dated this Y day of June, 1996. (SEAL) ~i (SEAL) _ ' on Vycella M. Waxon Glenn Waxoe, a/k/a lenn A. Waxon ACKNOWLEDGMENT STATE OF WISCONSIN ) //11) ss COUNTY ) day of r-~- 1996, the above named Glenn - Personally came before me this Cella NL W' on, husband and wife, to me known to be the Waxon, , Glenn A. Waxon, and y perso } W' tV uted the foregoing instrument and acknowledge the same. t p. li y ' L'~ Y, County, WI mi Storic,Wcpires /1Z M OF w.. . THIS 1NS'~l 6MENT WAS DRAFTED BY: Attorney Kristina Ogland Hudson, WI 54016 1