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STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER
ADDRESS G lC ~/J <<./'
SUBDIVISION / CSM# LOT #
c~~2
7
SECTION T N-R W, Town of
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
n
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
a
BENCHMARK: ALTERNATE BM:
EPTIC'TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: ~Liquid Capacity:
i
Setback from: Well House y-e~ Other 7 -z = z ~ ~
Pump: Manufacturer Model# Size
Float seperation Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
Width: Length Number of trenches
Distance & Direction to nearest prop. line:l
Setback from: well Ho se ~c Other
1
ELEVATIONS
Building Sewer ST Inlet: 5~,575-/ ST outlet: S f
PC inlet PC bottom Pump Off
Header/Manifold Bottom of system;
Existing Grade /Final grade/
DATE OF INSTALLATION: ~Z"-'`
PLUMBER ON JOB:
LICENSE NUMBER: -7
f'
INSPECTOR:
3/93:jt
Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County:
Labor andOumanRerations INSPECTION REPORT ST. CROIX
s Safety and Buildings Division
(ATTACH TO PERMIT) Sanitary Permit No-:
GENERAL INFORMATION 268634
Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.:
ANDERSON, BRIAN STANTON
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
TANK INFORMATION ELEVATION DATA A9600333
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark /00-/
L 100
Dosing
Aeration Bldg. Sewer *3'
b0~ ~~S
Holding St/Ht Inlet q 7
5~ ,
TANK SETBACK INFORMATION St/ Ht Outlet
TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic >_d0 , g 6 NA Dt Bottom
Dosing NA Header / Man.
Aeration NA Dist. Pipe 'r)„ Ua 9g ~6
Holding Bot. System
PUMP/ SIPHON INFORMATION Final Grade - q y $
Manufacturer Demand
Model Number GPM
TDH Lift Friction Sysatem TDH Ft
oss -1
Forcemain Length Dia. FFii Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Lengthg / No. Off Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS DIMENSIONS
LEACHING Manufacturer:
SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM
INFORMATION Type Of CHAMBER Model Numer:
System: _A ' 3 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
Bed /Trench Center Bed/ Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: STANTON.35.31.17W, SW, NW, STANTON
3AJ
a l io X1,1 Ctk ~i C1 1
Plan revision required? ❑ Yes [~No
Use other side for additional information. 0 7 6 L
SBD-6710 (R 05/91) Date sp ct 's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
y
SANITARY PERMIT NUMBER: t
a
"u~ oyso Safety and Buildings Division
v~`nn SANITARY PERMIT APPLICATION Bureau of Building Water Systems
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. , G►
• See reverse side for instructions for completing this application State nitary Permit Number
The information you provide may be used by other government agency programs ❑ Check if revision to previous application
(Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number
1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION
Property n 1 Name ` Pro4er t Location
N, R /'E (or)
197 ~
a h /1 /mar d
Prop y Owner's Mailin ddres Lot Number~_ Block Number
31 cc r ~ c.~ - -7----
I ate s Zip Code Phone Number Subdivision Name or CSM Number
11. TYPE F BUILDING: (check on E] State Owned ❑CE] CiVIl tyage Nearest Road
X7~
❑ Public 1 or 2 Family Dwelling - No. of bedrooms ~
Town of / v
III. 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. 9 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- Final Grade
Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation
,0~~rv 1 '6j=- , Feet Feet
VII. TANK Capacity
in Total # of Prefab. Site Fiber- Exper-
INFORMATION gallons Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
New Existing strutted
Tanks Tanks J
Septic Tank or Holding Tank pZd"~/ / C ;La ❑ ❑ ❑ ❑ ❑
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' nature: (No Stamps) MP/MPRSW No.: Business Phone Number:
4~~-Av` "I -
PI is Address (Street, City, State, Zip Code):
IX. COUNTY/ DEPARTMENT USE ONLY
Issuing Agent Signature (No Stamps)
❑ Disapproved Sa tary Permit Fee (Includes Groundwater Date Issued I-(i/
)(Approved E] Owner Given Initial -64 4/; Surcharge Fee) ~
Adverse Determination
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: U VC/
SHE)-6398 (R. 05/94) DISTRIBUTION: original to Counly" One copy To: Safety & Buildings Divi ion, Owner, Plumber
INSTRUCTIONS
Y
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit maybe 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 lie>nsed-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 isto 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-dim inensions, 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 ar d 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.
I_
PLOT PLAN
PROJECT Brian Anderson ADDREss 631 ParkView Dr. New Richmond Wi 54017
SW 1/4 NW 1/4S 35 /T 31 N/R 17 W TOWN Stanton COUNTYST.CROIX
` 8/27/96
MPRS BYRON BIRD JR. 3318 DATE BEDROOM
CONVENTIONAL XXX IN-GF , UND PRESSURE Z CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZEM®03allons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE.4 ABSORPTION AREA 1,~-4vo BED SIZE 18'X BENCHMARK V.R.P. Top of Metal Rod Red Ribbon ASSUME ELEVATION 100'
❑ BOREHOLE (DWELL *H.R.P. Same as Benchmark
VENT SYSTEM ELEVATION 97.5
12" GRADE
TYPAR COVERING
12" 3' 6'
. b SEVVTR K 18,
12'
200' Property :Line Property Line
36'
00
0
cn
B-5 40' B-2
f
Vent
4% 45' i
Slope /
Rep
-3
0'
-1 '1`B.M.
B-4 40' , 15'
T 5'
10'
Pro Driveway Pro 3
Bedroom
House
Wisconsin Department of Industry, SOIL AND SITE EVALUATION
Labouad Human Relations Page of
Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Adm. Code
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Par 1 4.,
U
APPLICANT INFORMATION - Please print all information. R ed ( l ate
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ; J U N 24 ',996 Cr, ~
Property Own r Property Location ST -Rc,
C( Govt. Lot 1 t r T E ( W
Property Owner's Mailing Address Lot # Block# Sub
CSM#
11~01 , 6 61
City to Zip Code Phone Number ❑ City ❑ Village Town Nearest Road
' _ o c h f~
New Construction Use: Residential / Number of bedrooms 5- Addition to existing building
Replacement Public or commercial - Describe:
Code derived daily flow Recommended design loading rate a bed, gpd/ft2 trench; gpd/ft2
Absorption area required bed, ft2 trench, ft2 Maximum desi loading rater bed, gpd/ft2~trench, gpd/ft2
J ft (as referred to site plan benchmark)
Recommended infiltration surface elevation(smr/
.
Additional design/site considerations
Parent material Flood plain elevation, if applicable ft
wool
for system Conv ntional Mound In-Ground Pressure AT-Grade System in Fill Holding ~Ta/nk
S = Suitable
U = Unsuitable for system S❑ U 'es ❑ U S❑ U 10S ❑ U ❑ S ) U ❑ S .Y~l U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
1 r ..3
Ground 3
jO a ft. '
/ Depth to
limiting
n.
Remarks:
Boring #
,.a
Ground
Depth to
limiting
A fac r
~n. Remarks:
CST N e (Please Print a Telephone No.
Address," Date CST Number
8' s a,20-96
j SOIL DESCRIPTION REPORT ter-
PROPERTY OWNER t2,, Page of
PARCEL I.D.#
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
9-
A IX4;.: 00 -
Ground y C/ ~l yJ
Ili. /fT
Depth to
limiting
y9
Remarks:
Boring #
:-_3
' N
Ground
Depth to
limiting
fa
Remarks:
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
Boring # %
5
Ground
tt.
9f V9
Depth to
limiting
fac r,.
in. Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
in.
Remarks:
SBDW-8330 (R. 08/95)
r
Soil Test Plot Plan
Project Name Brian Anderson Byro Bird Jr.
Address 631 Parkview Dr.
New Richmond Wi 54017 C M #3479
Lot Subdivision Pending Date 6/20/96
SW 1 /4 NW 1/4S35 T 31 N/R 17 W Township Stanton
R Boring ()Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of Metal Rod Red Ribbon
System Elevation 97.5/96.3 *HRpSame as Benchmark
200' Property Une 014 Property Line No.
36'
00
0
B-5 40 B-2
4% 45'
Slope
Rep Pri A
-3
0'
B-4 40' 15'
5'
Pro Driveway Pro 3
Bedroom
House
Wisconsin. Department of Industry, SOIL AND SITE EVALUATION
Labor and Human Relations . Page of
Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Adm. Code
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County
include, but not limited to: vertical and horizontal reference point (BM), direction and S C!'''D
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. #
a
APPLICANT INFORMATION:.- Please print all information. Reviewed lif Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Own r Property Location
C Govt. Lot 1/4 ~/4,S T3~ N,R E ( W
Property Owner's Mailing Address Lot # Block# Subd. Name or CSM#
City to Zip Code Phone Number ❑ City ❑ Village Town Nearest Road
O ( ~ o a f~
r 16 Llowz& I
New Construction Use: Residential / Number of bedrooms _ Addition to existing building
Replacement mPublic or commercial - Describe:
Code derived daily flow - - Recommended design loading rate bed, gpd/ft2 trench; gpd/ft2
Absorption area required Zzzf. bed, ft2 trench, ft2 Maximum desigp. loading rate bed, gpd/f12/ 5 trench, gpd/ft2
Recommended infiltration surface elevation(s) 7X, h:C .j ft (as referred to site plan benchmark)
Additional design/site considerations
Parent material Flood plain elevation, if applicable _ft
Conv ntional Mound TI n Ground Pressure AT-Grade System in Fill Holding Tank
S = Suitable for system
U = Unsuitable for system S ❑ U ~s ❑ u s ❑ u 0s El u El s O u El S XU
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2
9 Texture Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
G
17
^ 3
Opp- CIZ
Ground h2k 0 q 'T
1
AIft.
Depth to
limiting
Remarks:
Boring # ,
lov-512,
y. 1 .
Ground
Depth to
limiting
fa r
4n. Remarks:
CST N e (Please Print a Telephone No.
Addres Date 6- CST Number
SOIL DESCRIPTION REPORT
PROPERTY OWNER XQ ~ Page 'of '
PARCEL I.D.
Boring # Horizon Depth Dominant Color Mottles Texture Structure 2
Consistence Boundary Roots
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
A&7YZ,
01
10,
Ground 10
Depth to
limiting
0a
Remarks:
Boring # ~
40
Ground
Ae~ n
Depth to
limiting
fa
'W
Remarks:
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench
-Boring # 0-
.a..
77 412~
Ground
9 v ft.
Depth to
limiting
fac r
Remarks:
Boring #
Ground
elev.
_--ft.
Depth to
limiting
factor
in. Remarks:
SBDW-8330 (R. 08/95)
- Soil Test Plot Plan
Project Name Brian Anderson Byro Bird Jr.
Address 631 Parkview Dr.
New Richmond Wi 54017 C M #3479
Lot Subdivision Pending Date 6/20/96
SW 1/4 NW 1/4S35 T 31 N/R 17 W Township Stanton
R Boring ()Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of Metal Rod Red Ribbon
System Elevation 97.5/96.3 *HRPSame as Benchmark
200' Property Property
36'
00
0
B-5 40' B-2
4% 45'
Slope
Rep A Pri A
-3
-1 *B M.
B-4 4 15'
5'
Pro Driveway Pro 3
Bedroom
House
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
/I
0WNER/BUYER r'tGh Mar 4. 4nJersoh
mAuxgG ADDRESS 631 R rWeL 3 Dr %ve, 1~nz ?..t k 01 -L(b 17
PROPERTY ADDRESS
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE New 2"C~wond I~iSCov~sih
PROPERTY LOCATION 50 1/4, t-)W 1/4, Section 3S , T-L _N-1k _1W
TOWN OF SACkrNk Ord ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMBER
CERTIFIED SURVEY MAP VOLUME _JJ, PAGE 3 I y 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 600/9 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 Ze; iratio
SIGNED: 2 Q
DATE: J~(
St. Croix County Zoning Office
Government Center
1101 Carm ichael Road
Hudson, WI 54016 11/93
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 Mat .4 4-en4r,
Location of property 5W •1/4_ W'1/4, Section, 3S,T ,N-R_ l'1 W
Township annr61& Mailing address
Address of site X1C
Subdivision name Lot no.
other homes on property? Yes-- . No
Previous owner of property (,V ss' G
Total size of property 3. "'-!s
Total size of parcel ns
Date parcel was created 30 ~1`S~
Are all corners and.lot lines identifiable? X Yes No
Is this property being developed for (spec house)? Yes _%_No
volume ,f 3;W and Page Number ~J as recorded with the Register
of Deeds.
INCLUDE WITH HIS'APPLICATION THE FOLLOWING:
A WARRANTY.DEED which cludes a DOCUMENT NUMBER, VOLUME AND PAGE
NUMBER AND THE SEAL 0 THE REGISTER OF DEEDS. In addition, a
certified survey, if a ailable, would be helpful so as to avoid
delays of the revie ng process. If the deed description
references to a Certi ed Survey Map, the Certified Survey Map
shall also be required
PROP RTY.OWNER CERTIFICATION
I (we) certify that a statements on this form are true to the
best of my (our) knowle ge that I (we) am (are) the owner(s) of the
property described i this information form, by virtue of a'.
warranty deed recorde ins office of.the County Register of
Deeds as Document No.' 5 44 y and that I (we) presently
own the proposed site for he sewage disposal system or I (we)
obtained an easement, run the above described property, for the
construction of said.s tem, and the same has been duly recorded in
the office of the my Register of Deeds as Document No.
6' nature of Applican Co-Applicant
Date.of signature .Date of Signature
$48'743
o
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00
E 0
M 8 ~2 Z :
VI w Bearings are referenced to the 0 r
~~~~D west line of the NA of Section 35, fh a
AUG 2 7 1996 P 1 assumed to bear N00°00'00"E.
M
M KATHLEEN H. WALSH r
°o ^ 9 Register of Deeds
St. CtoixCO•-Wl 2 rt pi
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Z to ~r,
CA IE CA
W dr N W Tc ('I'
o rh
o ' ° UNPL471 TED LANDS o -1 n
180 TH STREET 0
West line of the NWk A;.
N00°00'00"E N00°00'00"E 330.00' N00°00'00"E 0 I-h
990.00' 1329.43' 0
m m
m ~ rt
_ c - - •°o _ w - ~t
w_ ~C fD
N00°00'00"E 330.00' E E
N• w-
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M O ,t A Cr o O i A C
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0 • SO0°00'00"W 330.00' " F r
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a x 3 M UNPLATTED LANDS rt
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SURVEYOR'S CERTIFICATE
I, Allen C. Nyhagen, registered Wisconsin Land Surveyor, hereby certify
that by the direction of James ahd'Arliss Cody,-I have surveyed, mapped
and described the land parcel which is represented by this Certified
Survey Map; tha.t the exterior boundary of the•land parcel surveyed and
mapped is described as follows:
A parcel of land.located in part of the NW1/4*of the NW1/4 and in part
of the SW1/4 of the NW1/4, all in Section 35, T31N, R17W, Town of
Stanton, St. Croix County, Wisconsin; further described as follows:
Commencing at the W1/4 Corner of said Section 35; thence N000001.00"B,
along the west line of the NW1/4 of said section, 990.00 feet to the
point of beginning; thence continuing N0000010011E, along said west
line, 330.00 feet; thence N900001000B, 480.00 feet; thence S00000'00"W,
330.00 feet; thence S-.900001 00"W, 480.00 feet to- the ooint of beginning.
Described parcel contains 3.64 Acres (158,400 Sq. Ft.).
Above described parcel is subject to right-of-way for Town Road (180th
Street) and all easements of record.
I, also certify that this Certified Survey Map is a correct
representation to scale of the exterior boundary surveyed and
described; that I have fully complied with -the current provisions of
Chapter 236.34 of the Wisconsin. Statutes and the Land Subdivision
Ordinance of the County of St. Croix in surveying and mapping same.
Each parcel shown on this map (plat) is subject to State, County and
Township laws, rules and regulations (i.e., wetlands, minimum lot size,
access to parcel, ,etc.). Before purchasing or developing any parcel
contact the St. Croix County Zoning Office and appropriate Town Board
for advice.
548950 VOL 1198 PACE T9
DOCUMENT NO. STATE BAR OF WISCONSIN FORM 3-1982 THIS SPACE RESERVED
QUIT CLAIM DEED FOR RECORDING DATA
REGISTER'S OFFICE
James A. Cody and Arliss Cody, husband and wife quit claims ST. CROIX CO., WI
Redd to Record
to Brian W. Anderson and Mary L. Anderson, husband and wife
survivorship marital property, the following described real estate AUG 3 0 1996
in St. Croix County, State of Wisconsin: at 2 : 30 P.m
pa &W d Deeds
REMINGTON LAW OFFICES
126 S. KNOWLES AVE.
New Riclunond, WI 54017
Tux Parcel No: Part of 036-1090-80
A parcel of land located in part of the Northwest Quarter of the Northwest Quarter and in part of the
Southwest Quarter of Northwest Quarter all in Section 35, Township 31 North, Range 17 West
described as follows: Lot One of Certified Survey Map filed August 27, 1996 in the Register of Deeds
Office in Volume 11 of Certified Survey Maps at page 3148 as Document No. 548743.
#EX MPT
This is homestead property.
Dated this 30 `day of August, 1996.
(SEAL) (SEAL)
* *J S A. CODY
(SEAL) (SEAL)
* *ARLISS CODY
ACKNOWLEDGMENT
STATE OF WISCONSIN )
) ss.
St. Croix County. )