HomeMy WebLinkAbout020-1315-40-000
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_1 A 0 IL 10 ai c0
VA,sconV SOIL AND SITE EVALUATION REPORT of 3
l.ith-r and Human Relations
Division of Safety n Buildings in accord with ILHR 83.05, Wis. Adm. Code CO• { pix
P R I.D
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but s~
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or 4p& 11 q
dimensioned, north arrow, and location and distance to nearest road. R ED BY DATE,' a
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION
PROPERTY LOCATION ' ,
PROPERTY OWNER: GOVT. LOT SW 1/4 NW 1/4,S !R T 2 K (or) W
John Rauchnot LOT # BLOCK # SUBD. NAME OR CSM a
PROPERTY OWNERS MAILING ADDRESS 14 na St. Croix Estates
527 Co. Rd. #W
CITY, STATE ZIP CODE PHONE NUMBER C]CITY VILLAGEudson )TOWN NEAREST Crosby ROAD Dr.
Hudson, WI. 54016 (715)386-3052
3 Addition to existing building
Fde ruction Use [x] Residenti al Number of bedrooms
nt Public or commercial describe
trench, gpdm2
50 Recommended design loading rate .5 bed, gP~2 • 6
aily flow 9Pd 5 bed, gPd~ft2 •6 trench, 9P~
Absorption area required 900 bed, ft2 750 trench, 9 Maximum design loading rate .
95.30 ft (as referred to site plan benchmark)
Recommended infiltration surface elevation(s)
Additional design I site considerations alt. site= 95.05' system el. na ft
stream terrace Flood plain elevation, if applicable
Parent material
CONVENTIONAL U MOUND o O U IN-GROUND S p U EssuaE ®S °0 U I O S ®U HOLDING 13UK
S =Suitable for system
U =Unsuitable for s stem CBS OSOIL DESCRIPTION REPORT GpD/ft
Depth Dominant Color Mottles Texture Structure Consistence lBouridary Roots Bed Trertdl
Boring # Horizon in Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
m .5 .6
0-11 10yr3/2 none 1 2msbk r 2f
2 11-29 10yr4/4 none sicl lfsbk mfr 9W if .2 .3
Y1?
Ground 3 29-82 7.5yr4/6 none S Osg ml na na .7 .8
elev.
98.55 ft.
Depth to
limiting
factor
211
Remarks:
1 2msbk mfr gw 2f .5 ':.6
Boring # 1 0-10 10yr3/3 none
2 2 10-28 10yr4/4 none sicl 2msbk mfr gw If .4 :.5
x
none f s Osg mvfr na na .5 .6
3 28-82 7.5yr4/6
Ground
elev.
98.95 ft.
Depth to
limiting
factor
+82"
Remarks: phone;
715-246-6200
C.STNama:-Please Print Gary L. Steel
ress: 1554 2001;. Ave., New Flicbmond, WI. 54017 fTNtxnbor
Dab: cstm 02298
Sipnauxe:
PROPERTY OWNER John Rauchnot
SOIL DESCRIPTION REPORT
PARCEL I.O. # Pend ina Page ? of
Boring # Horizon Depth I Dominant Color Mottles Structure G PD/ft
in. Munsell TQU- Sz. Cont. Color I Texture I I Consistence ~BWXJWY I Roots
Gr. Sz. Sh. Bed iTrench
1 0-10 10yr3/3 none
3 1 2msbk mfr 2f .5 .6
2 10-20 10yr4/4 none sicl lfsbk mfr
gw if .2 ! .3
Ground 3 0-32 10yr5/4 none
sil M na gw na np .2
elev.
4 2-84 7.5 r4 6
98.8 ft. Y / none fs Osg mvfr na na .5 .6
Depth to
limiting
factor
+84"
Remarks:
Boring #
1 -12 10yr3/3 none 1 2msbk mfr
gw 2f .5 .6
4 2 12-25 10yr4/4 none sicl lms bk mfr
gw If .2 .3
3 5-80 7.5yr4/6 none Co S Os
Ground g ml na na .7 .8
elev.
97.8 ft.
Depth to
limiting
factor
+80"
Remarks:
Boring #
1 0-9 10yr3/3 none 1 2msbk mfr gw 2f .5 .6
5 2 9-24 10yr4/4 none
sicl 2msbk mfr 9w if .2 .3
Ground 3 24-31 7.5yr4/4 none sl 2mgr mvfr
gw na .5 .6
elev. 4 31-80 7.5yr4/6 none
97.3 ft. fs Osg mvfr na na .5 .6
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(R.05/92)
STEEL'S SOIL SERVICE
Gary L. Steel John Rauchnot 1554 200th Ave.
CSTM2298 WIWI S28-T29N-R19W New Richmond, WI 54017
MPRSW 3254 town of Hudson (715) 246-6200
lot #14-St. Croix Estates
I
N
1"=40'
BM.= top of 1" steel pipe @ el. 100'
Alt. BM.=nail in Juniper tree el. 104.2'
2
Irv \
Gary L. Steel
11-4-95
/VV
9 lQ
STC - 104 P
AS BUILT SANITARY SYSTEM REPORT
lR
Rc
OWNER c S 9 0;r7,
7 ~ y
~ sr ~,x ~
coukr e
ADDRESS
SlySUBDIVISION / CSM LOT #
SECTION T~ N-RW, Town of
ST. CROIX COUNTY, WISCONSIN 90 /fit
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
@v~e
49' G
6 ~
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tangy: manhole cover.
tr. ` f
BENCHMARK: ALTERNATE BM:~a~
SEPTIC TANK PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: Liquid Capacity: 7
Setback from: Well House Other
Pump: Manufacturer Model# Size
Float seperation Gallons/cycle:
Alarm Location
:SOIL ABSORPTION SYSTEM
Width: Length Number of trenches
Distance & Direction to nearest prop, line: Q
Setback from: well: House. _~3 _ Other
ELEVATIONS
Building Sewer / ST Inlet, / T, Z Z_ ST outlet
PC inlet PC bottom Pump Off
Header/Manifold Bottom of system 98,p7
Existing Grade Final grade
DATE OF INSTALLATION: -J
PLUMBER ON JOB:
v
LICENSE NUMBER:
INSPECTOR:
3/93:jt
Wisconsin Department of kndustry, PRIVATE SEWAGE SYSTEM County:
Labor and Human Relations INSPECTION REPORT ST. CROIX
Safety and'Buildings Division
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.:
Permi H ~Idder's Nam ❑ City ❑ Village Town of: State Plan o.:
S7 P, LARe1+Y
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
Dosing ~S f
Aeration Bldg. Sewer C? 3
Holding St/ Ht Inlet /o3.
TANK SETBACK INFORMATION St/ Ht Outlet 3 69 ~~3 yy
TANK TO P/ L WELL BLDG. Airi to ntake ROAD Dt Inlet
Ar I
Septic 'fib NA Dt Bottom
Dosing NA Header/ Man.
Aeration NA Dist. Pipe 7,)y 9~a.F
Holding Bot. System
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer - Demand
a.O Jo ~.oa
Model Number GPM
TDH Lift Friction System TDH Ft
oss Head
Forcemai n Length Dia. Dist. To Well -I F
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Tenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS DIMENSIONS
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
SETBACK
INFORMATION Type O CHAMBER r Model Number.
System:'- C?o 3 ~'7 OR UNIT
DISTRIBUTION SYSTEM
Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length Dia- Length Dia. Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched
No
Bed /Trench Center Bed/ Trench Edges Topsoil ❑ Yes E] No E] Yes El
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION. RUDSC)N- 28'. 29.. 29W, Sid, NW, CROSBY DRIVE
,
6, 7'j
Plan revision required? ❑ Yes No ~f
Use other side for additional information. 9 qo
SBD-6710 (R 05/91) Date nspector Signature Cert. No.
SANITARY PERMIT APPLICATION Bureau o oand ff Buil safety uildiinWater Systems
gWater ~ 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 812 x 11 inches in size.
• See reverse side for instructions for completing this application State Sanitary Permit Number
I*a qW
The information you provide may be used by other government agency programs E] 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
Prope y Owner Name Property Location
t 14 ] 1 /4, S T
, N, R fi/(or)e
74
Property O is Mailing A dre Lot Number Block Number
7
Cit , ate Zip Code Phone Number Subdivision am r CSM Number
II. T PE F WILDING" (check one) E] State Owned 0 ity Near t Road
❑ village
Public 1 or 2 Family Dwelling - No. of bedrooms 57 Town OF ZZ
III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s)
1 ❑ Apartment/Condo 07-20
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. Co 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 jI 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-FiII
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) , 97 Elevation
2 Feet Feet
VII. TANK Capacity
in gallons Total # of Prefab. Site Fiber- Plastic Exper.
INFORMATION Gallons Tanks Manufacturers Name Concrete stCon- Steel glass App-
New Existing Tanks Tanks
Septic Tank or Holding Tank ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility or i stallation he onsite sewage system shown on the attached plans.
Plumbe s Na : (Pr' t' Plumb r' Igna r . (N ~taps) MP/MPRSW No.: Business Phone Number.
S
I mber's Address (Sleet, ity, St , Zi Code): `
IX. COUNTY33/ APARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (includes Groundwater ate Issued Issuing A ent Si nature (N to ps)
Approved ❑ Owner Given Initial Surcharge Fee)
A 1;eo
111 Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SOD-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 Dv4elling.
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 l,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 experiment, 17! 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.
A110 s Eec~C~J ~ ir1~ 9'6J
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-
wrio'nsir,Departmentoflndustry, SOIL AND SITE EVALUATION REPORT Page of
La*r andlih,,uman Relations
Division of~afety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY - _."l -j mom. Croix
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but • t s
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PA -13 5-Cf7.'`;'.
dimensioned, north arrow, and location and distance to nearest road. ED B DATE
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION
PROPERTY OWNER: PROPERTY LOCATION
19
GOVT. LOT SW 1/4 NW 1 T
Neal Krz aniak
PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME
14 na St. Croi gates -
11736 177th. St.
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY nVILLAGE N _
Crosby Dr.
Lakeville, MN. 55044 (612 898-2566
3 [ ]Addition to existing building
[x] New Construction Use [x] Residential I Number of bedrooms
[ ] Replacement [ ] Public or commercial describe 2
450 Recommended design loading rate • 5 bed, gpd/ft2 •6 trench, gpd/ft
Code derived daily flow 9Pd /ft2. • 6 trench, gpolft2
Absorption area required 900 bed, ft2 750 trench, ft2 Maximum design loading rate • 5 bed, gPd
Recommended infiltration surface elevation(s) 98.97 ft (as referred to site plan benchmark)
Additional design / site considerations na
Flood plain elevation, if applicable na ft
Parent material outwash
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE ATE- S DE❑ U SYSTEM S IN ULL HOOLS NGETAtNJK
U =Unsuitable for s stem ®S ❑ U ®S ❑ U ®S ❑U
SOIL DESCRIPTION REPORT
GPD/ft
Depth Dominant Color Mottles Texture Structure Consistence BRoots Bed Trench
Boring # Horizon in Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
i 2msbk mfr gw 2f .5 .6
1 -15 10yr3 2 none
•4 1.5
1 2 5-31. 7.5ry3/4 none sicl 2msbk mfr cs if
Ground 3 1-84 7.5ry4/4 none sl 2mgr mvfr na na .5 .6
nd
elev.
102.37 ft.
Depth to
limiting
factor
+84"
Remarks:
Boring # 1 1 -12 10yr2/2 none 2msbk mfr gw 2f .5 .6
sicl 2msbk mfr gw if
2 2-25 10yr4/4 none
mvfr na na .7 .8
3 5-98 7.5yr4/6 none is Osg Ground
elev.
104.07 ft.
Depth to
limiting
f+~ti"
Remarks:
CST Name: Please Print Gary L. Steel Phone: 715-246-6200
ddress: 1554 200th. Ave., New R' ond, WI. 54017 TjNumber-
Date: 3-23-96 c02298
Signature.
PROPERTyOWNER Neal Krzyaniak SOIL DESCRIPTION REPORT
PARCEL I.D. # 020-1315-40 Page ofj
- J
Boring # MOM t F15-30 Depth Dominant Color Mottles Structure
G PD
D/tt
Bax>dary Roots
in. Munsell Qu. Sz. Cont Color Texture Gr. Sz. Sh. Consistence Bed Trench
3 0-15 10yr2/2 none 2msbk mfr
. 5 .6
h` 10yr5/4 none 2f
sic M
na gw if np .2
Ground 3 30-82 7.5ry4/6 none sl 2msbk
el v. mvfr na na .5 .6
1027 ft.
Depth to
limiting
t~r
Remarks: LLJ
2msbk mfr gw
2f .5 .6
Boring # My7-y5r none
4none sic lfsbk mfr
gw if .2 .3
none sl 2mgr mvfr na
Ground na .5 .6
elev.
104.OOft.
Depth to
limiting
factor
+9811
Remarks:
Boring #
~vri 1 0-14 10yr2/2 none
2msbk
mfr gw 2m E.2 .6
5€ 2 14-34 10yr4/4 none sic lfsbk mfr
gw If .3
3 34-82 7.5ry4/6 none sl 2msbk mfr na
Ground na .5 •'.6
elev.
101.97ft.
Depth to
limiting
factor
+82"
Remarks:
Boring #
k4:{ 'A..:..
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(8.05/92)
STEEL'S SOIL SERVICE
Gary L. Steel 1554 200th Ave.
CSTM2298 Neal Krzyaniak New Richmond, WI 54017
MPRSW 3254 WIWI S28-T29N-R19W (715) 246-6200
town of Hudson
lot #14-St. Croix Estates
N
1"=40'
BM.= nail in Ash tree C el. 100'
Alt. BM.= nail in ash tree C 105'
l~
i
3
~9C
4VC -n
1V
r
3 g rn
Gary L. Steel
3-23-96
.
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER ~ O rr 4 _M0 V_y Jo t< m p
MAILING ADDRESS 5'7'7 ba k ~r , uGI S ayi LZ I
y~ !z _ C'✓~~b~y fir,
PROPERTY ADDRESS x-14 # 14- e ri) X. T-S+ac c5 9ttdSM , w
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE 4-_tJ S cy, , 54o/4_,,
PROPERTY LOCATION ' S- (c) 1/4, J 1/4, Section g , T 6Z `1 N-R ` W
TOWN OF ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMBER 14
CERTEFIEDSURVEY 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
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.
-
~"Y1a evy►
Owner of property rrei
Location of property S 1/4~) U) 1/4, Section ~ rg N-R W
Township /y-c~G( Mailing address
4T27 6a ,r. /~MoYsa), (fJ 1 5-21016
~ 5-21
7 y C_ 6« JA-, ~ z Sm W ! 8/-
Address of site _
Subdivision name /Fs& /-S Lot no.
Other homes on property? Yes__X_No
Previous owner of property Nee- ( i~rZ.aa n ~cz
Total size of property
Total size of parcel
Date parcel was created
Are all corners and lot lines identifiable? Yes No
Is this property being developed for (spec house)? Yes _ _No
Volume and Page Number 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. , 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.
Signa ure of APPcant Co- pli a
`
r' 11a, 13
Date of Signature Date of Signature
VOL ~'78 PAP 321
DOCUMENT NO. STATE BAR OF WISCONSTIRM 2-1982 THIS SPACE RESERVED FOR RECORDING DATA
543819 WARRANTY DEED
Bri eland Development Company, a Minnesota corporation REGISTERS OFFICE
ST. CROIX CTY., WI
Roe'd for Record
conveyrs and warrants to LM MAY 1-6 1996
Lar y K. Stump an Mary o Stump at 11•15 A. A/1
us an an`d wi e
Register of Deeds
RETURN TO
the following described real estate in St. Croix County, State of Wisconsin
TAX PARACEL NO.-~G~
Lot 14 , St. Croix Estates in the Town of Hudson, St. Croix County, Wisconsin.
This is not homestead property.
(is) (is not)
Exceptions to Warranties:
Dated this 8th day of MU 19 96
(SEAL) (SEAL)
* * N 1 Kr i i
(SEAL) (SEAL)
* *
AUTHENTICATION ACKNOWLEDGMENT
Signatures authenticated this day of STATE OF MINNESOTA
19 Dakota County
Personally came before me, this l_day of
* MU_ 1996 the above named
TITLE: MEMBER STATE BAR OF WISCONSIN Neal Krzyzaniak
(If not,
authorized by 706.06, Wis. Stats.)
This instrument was drafted by
to me known to be the person who executed the
Bridgeland Development Company foregoing instrument and acknowl the same.
17799 Kenwood Tr. # 265.Lakeville. MN 55044
(Signatures may be authenticated or acknowledged. *Darla J. Bauer
ST. CROIX COUNTY
WISCONSIN
ti
ZONING OFFICE
N M Y N ■ p ■ ■INO ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
OIN -,_,s x = Hudson, WI 54016-7710
(715) 386-4680
October 7, 1996
Attention: Becky
Hartman Homes
P.O. Box 326
Somerset, Wisconsin 54025
Re: Septic Inspection for Property Located at 773 Crosby
Drive Street, Hudson, Wisconsin
Dear Becky:
An inspection of the septic system installed to serve the above
described residence was conducted on July 30, 1996. This property
is located in the SW-44 of the NW, of Section 28, T29N-R19W, Town of
Hudson, St. Croix County, Wisconsin.
At the time of the installation, this septic system was found to be
code compliant for a three (3) bedroom home.
If you have any questions with regard to the above, please do not
hesitate in contacting our office.
Sincerely,
'
Mary J kins
Assistant Zoning Administrator
pe