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HomeMy WebLinkAbout020-1304-70-000 n- C) ° II Cr 0 O C n N I I' I n ~ I i ~ I y ~ I I 'o I z U. cc I ~ I Cl) 3 O Z G z v C 'a I CL co C,4 UJ 0 c 0 v z d o c r d Z 0 7N O C fA F- r- O N Z c ~ -o N M ca a) N O • a U) o ¢ o a°i ¢ w q z co z - N " z to y -°c I N m m Y N ~~l ( O ;j a) V O G a. r+ c O An 75 0 O a p N O LO b f1 O F- H F- = N O- ~ Z V 0 0 0 0 O 7 O L N vi U ~ rn rn > N Cl) rr; ~z _0 o o p ° ° a N COI O_ L N y O) ~ =O 7 w N C ~ y N C O W C r\ R °i c O 2 c c E W 1- O p 0~ co c p p U\ n l G M o LO .o O O 0 ~ N M N H F- N rti ° N j M N E E U • yam„' O c- 2 N 04 ~ U) q ~ I t~ ( m a j m a IL 0 C4 CL `1v E i C C 7 r r A U a O to V PPF- CONTINUE FROM PREVIOUS PAGE 001 TNI-COUNTY 511111 AHON INC. Mi. Paul SelmlY'er . _ . 10(6 Mound 1)i. Iludscm, Wl, 5401t) DeAl Mi sobotler, An inspection vrilic scptlc system at you, ICsidclicc of 100 Mound alt. Hudson, Vvl was conducted on 9/13/0V. This septic system is made up of a septic tank and bed type drain iirid At this time tl,c xptiu system appeals w Uc tttnctiorttrt&- 1 his opinion was based ui: a sui face utspection of the septic system. This surface inspection Was limited to checktns the tiller pipC LV 0IC septic tank, checking the Wet baffle in the septic tank, checking the liquid level of t he septic uu&, which was at Utc normal level. This helps us aetermline it the exit pipe is cleat mcl n the drain field is able to absorb water lust enough. The inspection pipe at the end ofthe drain feld was cl,ccl col w we if any waist is ponding In the dratntleld bea. It itteasuied about lwelvr nwht;;: in the pipe. Phis could be an indication that although the field is absorbing all the houschp)10 t►.e, the soil under the field could be starting to plug, causing some Water to pond in the bed A-; noted this inspcsctiuat pipe is aL the citd of lowest point of Me held, this is a gravity teed system, ineanmip, that the far end could pond up first, leaving the rest of the bed for later use. it does appear that all the wutc, k;aving the septic tank Is absorbing into the round, tfleatiin~ the arainticicl is functioning. It should be understood that a septic system is like-any other part of a home, eventually tlic drainlield will weal out and need to be replaced, but it is impossible to detemime exactly whuii that will happe;rt. 'trio iushcctivu did out Involve any CxCavatine, oi' chemical atlaalySiS. l'1iCrr[ore, it is undci stuud and agreed that there remains the possibility of hidden defect: in the system which are not discoverable by a surface inspection. Tri-County makes no guarantee or representation its to the a4se of condition vt'thc septic systriti. 'i'ii-County Sanitation inc., makes no guarantee as to the continued proper tunctioniiip, or upcratiull vl'tht sefitic system alter the date of this ical estate ttansaiclion, 'I'd-County Sanitation recommends tri~t the septic system be pumped every two years, t hat bacteria be added whoa) maintainutg your septic stem, that a garbage disposal not be insiatic.6"it there is art existing disposal that it be used as little , and that powered laundry snaps acid othei nun-blodegradable materials not be run through the septic systein. 'phis pumpin14 estimate is based on air average family of four and can vary depending, on the age of childr%:n, work outside the home, and use of a garbage disposal. '1 heretote, the future acid prolonged Isle of this system is dcpwidciu on pi opei niaintcruance. By signing this inspection certificate, you waive arty claim against 1 ri-Courity Sanitation Inc., its employees or agents, now or in tic futuic, on account tit any damages allegedly s►ista med as a result of any 1hllure or other problems with the subject septic system, realimn$ that 'I'll. County Sanitation Inc., has performed a surface inspection on the sut>,ect system only. Please sign a copy of it" inspection certificate and return it to the above address. ~ti i cly, Srllui , Date 4;0111 moo V011 c~ ~ _1 ~t. 5 ~ mac... ~l 1 ~a Z.. `t ~ ~ r . i BOLDT s 17VL1J 1 1~ V L1J 1 "W,tall/ 1 PLUMBING & HEATING INC. "Serving You Over 45 Years" 820 Main Street Baldwin, WI 54002 (715) 684-3378 Fax (715) 684-3144 Date: 08/01/00 To Whom It May Concern: An on-site investigation of the septic system on the Paul Shafer property, located 1065 Mounds Drive South Hudson, WT was conducted on 08/01/00 At the time of the inspection, the sanitary system appeared to be functioning properly for the existing use (See exception x below). The inspection of this sewage disposal system was based upon a surface inspection of said system and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. Therefore, it is understood and agreed that there remains the possibility of hidden defects in the system which are not discoverable by a surface inspection and this inspection does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every two to three years. Therefore, the prolonged life of this system is totally dependent upon proper maintenance of the system and can very depending on the number of people living in the residence, the age of children, work outside the home, and use of garbage disposal. Should you have any questions regarding this subject, please feel free to contact this office. Sincerely, Dale E. Hudson Master Plumber/ Certified Soil Tester #220853 * SPECIAL NOTATIONS: System consits of septik tank and conventional drainfield. The drainfield has 30" tall observation pipe with vent cover. By measurement, thhdrainfield has 172" of water standing in it. This indicates that the system is beginning to fail. There is, however, no effluent, or grey water surfacing at this time, nor indications that there has been any surface discharge. The rubber expander seal is missing from the cover on the inspection riser for the septic tank and should be replaced. '~'z Ctic Gt~o2-- Zak C Michael McDonell 1070 Hunter Ridge Hudson, W154016 VV7 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER-SAM M /L L j~52 ADDRESS A30X '0~ Z$Z Iy~Sc) N W 1 ~yyir~ SUBDIVISION CSM#_ FANNEY t~1 E LOT # 10 SECTION Z T-L9 N-R~(W~ Town of N ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 13.M`Ti' MA coRNFk El. = 100.00 iVv r2T M t OT Z-/NE L"r # 9 '10 78 I I LoT (b -2 5-1 .per ~ Ali r a DRIVE WAY ~hRl~6E qs 8va f 4Y 12' I r' 70 WELD ~ ~ 1 Noss ~ ScAt9 rjy~- w i j #OTF: ELCT41C LINE INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: o? o-F lkoN ?IR,5 ff NW ~o~ ~oCNE/t 6/- ALTERNATE BM: %~~p~ ~~UL k FOv SEPTI / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: (~E ~ S or 2--_ Liquid Capacity: 6Q4~) 6xe, 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: 79176 Na2T fF Z-67- L/A(E Setback from: well: OD lel House Other ELEVATIONS Building Sewer - ST Inlet, / Z ' ST outlet i, PC inlet PC bottom Pump Off - Header/Manifold V 3 Bottom of system Existing Grade Final grade DATE OF INSTALLATION: PLUMBER ON JOB:4 LICENSE NUMBER: S-O 3Sf70 INSPECTOR: 3/93:jt e Wisconsin} Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Permit Holder's Name: ❑ City ❑ Village ❑ Town of: State PI MILLER, SAM X CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: d~ xe5b TANK INFORMATION ELEVATION DATA a7 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic jc~ o , r r Benchmark Dosing_ Aeration Bldg. Sewer I Hok+iT9g St / Inlet -77 . 96, 0/ " TANK SETBACK INFORMATION St/ Outlet 4, ' TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic NA Dt Bottom r Dosing NA Header Aeration NA Dist. Pipe H g Bot. System 1/9 PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand y , Mode GPM TDH Lift on System TDH Ft Forcern Length Dia. H Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length i No. Of Trenches PI No. Of Pits Insid Liq Depth DIMENSION If / DIMEN INS_ - SYSTEM TO P/ L BLDG WELL LAKE / STREAM L Manufacturer: SETBACK INFORMATION Type Of J~Z-- CHAMBER Moe Number: System:, OR UNIT DISTRIBUTION SYSTEM Headerxd~ Distribution Pipe(s) r x Hole Size x Hole Spacin ent To Air Intake Length Dia. Length B 7 Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade ems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed / Uoad>-Center 3 7 - 102 Bed / ,,,a Edges 3 - off 'I Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: Hudson.11.29.19W, SE, NE, Lost 10, Mounds Dri e Plan revision required? ❑ Yes c[NNo / Use other side for additional information. O71 /-V I SBD-6710 (R 05/91) Date Inspector's Signatu Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: II ~•i : SANITARY PERMIT APPLICATION BureaSafetyu anofd Bildi uildiinng Water System- 201 gs ter 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 Co n than 8 112 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitar ermmiit Number The information you provide may be used by other government agency programs ❑ Check it revision to devious 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 5 M 11A /LL F- IL 1/4 41,F- 1/4,S T Z9' , N, R /q E (orlo Property Owner's Mailing Address Lot Number Block Number J3OXZyZY /0 City, State Zip Code Phone Number Subdivision Name or CSM Number 14UDSON w I Z 0 (Mp)Z769 TAN Y/ D9E II. TYPE F BUILDING: (check one) ❑ State Owned iI Nearest Road ❑ Public 1 or 2 Family Dwelling - No. of bedrooms 3 ° To, of O DS o MOVND S p,~lVE 111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) y-~ 1 ❑ Apartment / Condo 02-0- 13 o o 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/ Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. ® 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 1~0 Seepage Bed 210 Mound 30 ❑ Specify Type 410 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 q!5'0 lp 4( Z L O 7 5s-, 50 Feet 'F*, S Feet VII. TANK Ca in gallons Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existing strutted Tanks Tanks Septic Tank or Holding Tank x /00 0 1 LOCI,; S a, r ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No Sta s) MP/MPRSW No.: T usiness Phone Number: Plumber's Address (Street, City, State, Zip Code): V6 6R F-E M/,L Z L.¢/Y.E uvSoN W / SyD14 IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (IncluciesGroundwater ate Issued Issuing Agen ure (N Stamps) (App roved Surcharge fee) E] Owner Given Initial jllke',-4 Adverse Determination O 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 t 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 lime 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 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 lrcldinc. tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water se-vice, strew-ns i~ n 1 lakes; pump or siphon tanks, distribution boxes; soil absorption systems; replacement system area;; an<I the locriar cf the building served; P) horizon Lai and vertical el.eva_ion reference points; CI complete specific<.t,a, for pump, a ontrols; dose volume; elevation c!ifferences, friction loss; pump performance -urve; pump modei anc frump man f,i:' :rer, D cross section of the soil absorption system if required by the county; L) soil test data on a 11'5 fonTl; an-; I ) dl sizing information- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges ('gees) for a number of regulated practice, which can effect groundwater The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. . J h 6I 'L 7~ ~/y/7 LOJ ~Sh~ Q` H 0 J Q v III ~ ~ ~ u t7 LU o s ~ N , Q w .9 z H DI M h VA ~d r I n v o- L14 / oCJ ~ v ~t l~' ~ C S k ~ M I O 1.it - J T 4 ~ - M \ co W Z Z at O t t- p O O J U ~t w 4 ~m A 77 W N ~ O W a 4 z 0 o~ C9 Y W _ QZ I- x O O O U D 1~ O 0 ° o x ~ CY) w i M AO Z F-- ~ O Pv~ , r C` P5 z N I a cu I I I 4 ~w I 0~ I I I O a ` 3 111 I DU I I ~ 4 z~ I I I _0 (V rL z W I e~ f c,"` © I I I CL I U I I a I 1.xJ r I I I I g~ . W o I I I IL p~: Q I a I I I 3 L9 I -01 I I ( W m I I I O W I i o~ I I w o> ~ 6~ ~ I a I I n I e I I ? r. I I I Jd I 10 I z ----------I I W rn M 4~. ~ arr.` e 3 Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page / of Labor and Human Relations Division c; Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but C-r cie6 o\ not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to " ~'re 1 APPLICANT INFORMATION-PLEASE PRINT $~1 R REVIEWED BY DATE /f PROPERTY OWNER: -Vk P Y LOCATION lyf /'1 t C C.CrR G j OT 5 L 1/4 N/~ 1/4,S / / T 7,9 ,N,R / g E (or) W PROPERTY OWNER':S MAILING ADDRESS `r p LO BLOCK # SUBD. NAME OR CSM TANti>`y i~ib4G CITY, STATE ZIP CODE ~P rf;; r ❑VIL GE OWN NEAREST ROAD Vy Tl I -j ofJ d^1N "y i-j r [0( New Construction Use Residential / Numbet ' oftledrooms [ ] Addition to existing building j ] Replacement [ ] Public or commercial deSWb4 + Code derived daily flow gpd Recommended design loading rate bed, gpd/ft2 trench, gpd/ft2 Absorption area required bed, ft2 trench, ft2 Maximum design loading rate bed, gpd/ft2 trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations Writ- u A7 10 u s e ~ Ta ~ aT /Q i°1~ Qo V A Parent material Flood plain elevation, if applicable ft S = Suitable for system CO IIVENTIONAL M UND IN ROUND PRESSURE AT-GRADE TEM IN FILL HOLDING K U= Unsuitable forsystem ( S0 U S❑ U S❑ U RS S❑ U ❑ U ❑ S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench o-10 16M 3 l - L Z n r. r- g, z4 7.syR,z 0 - L 2 r, 5bK A14 o. r; Ground 4 -6 oYA 414- S, rh S69 rwF. C S 0,2 03. ele 9 ft. 1-75 7. sY 4 ~ rh I C. S 7101 Depth to 'k- ! /a Xk 4 ~ n' limiting factor Remarks: Boring # o-lo DYR3I - rn r S ZMb.s" D.~ Eli Bi /6-3'3 6,ve 4 S , 1 n► S I d? 0.3 Ground D 4-14 S M C S 0 To elev. g 47-a4 /41/4° d 4 s o >M 8, JOL 7 ft. Depth to limiting > fac F Remarks: CST Name: Please Print Phone: Ot Address: J tJ ) U I Signature: Date:' / , 04 CST Number:p~ PROPERTYOWNER SAM MQ-1,00- SOIL DESCRIPTION REPORT Page -Z of PARCEL I.b. # L6-r /6 TAN j gy , m r Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourxby Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tw& A C 4 R ! L C-r M r s ZM O.4 d•S $ -~3 ~cyP, 4 4 L 1 M A,bfe s 0.4 a 3 Ground $z !-1 syr2 4 4 _ S M/ C elev. 94 ` ft. $ 9- l l0 4 3 s rn l 7 Depth to limiting factor -7 Remarks: Boring # L r j'11r iN Z YID 414 ia~ C 6:2 16. lr~'40 75V 's (3 V 07 -61 1 Ground goo o6ft. -~2 ~a y~ 4 rn 7A Depth to limiting factor Remarks: Boring # 4 el, c w Z fh 0.4 'S 01 $ l7 s c t 5~ c w z d. L.-: D 7,~y 4/4 Ground 7 L>>/ro 4 s 1^n 1 S d,7 14 Depth to $4 / f Z4 O ►e 4 I~ I 7 O . limiting factor 7 ~Q.33 Remarks: Boring # h . Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) r7l Q~ D -0 z , 4 ~ ar a ; r N t ~ J - 1 7s pp N &Zpe 1 1 a VV? a Q-'~ O ~ \ I C7 • N _ l r PO wr YO rNr.Yrw■ .".Coc^^*rwr so0 r r 0. r V 0r- r Y»r wro 0,110. eo ~ go r~, me crow V,»~uoD s r coo Ik IG o ~ w v /l • N BEARINGS OK YI SECTION . [D TO THE WAR 7 j C O 4 • • V .A IV OK qI [RNMI 11 11. AeeDY[D TO O SEAS OoPs e6Te0'«w. MO»V w10 O O' ° $ nnO n~ all 9 Y 6 Y9 w i o q$ i UNPLATT'D LANDS _ WEST LINE DI THE 89M OF THE NEW. SECTION N N0(f03'2CI`E 12".73' 663.24* MIX We.N 200.76' ~ \ \ f Xll\ ~1' mND _ IICvYJIm O x oxq 10 V v ~3r \ p r A o tI f~ . t , CN, Q i r 1 ZSY 10. ON, 0 137.901- $ ~yF!• . 032D 179.17 \ ~t 'T EDICATED ro m'W {M. ' RlBUC - / A o 8~1_`._ ` aoA~_ MOUND --ROAD-SOUTH g \ m I Z NOO'«'20I2 M.SC 1 \ ~SL7 0 IrI It' CD m 8. !r ww. o o j o oa s- J pb~ I' o ~ O / T c0 p N N • Ito I1 N ~ In N {22.{6' q / p o yA 44 08 E 240.24 W I!~ W r r I IM rn - u IN y / ~I m i 1 r / D / es1.72' O q1• OD q u V s:7.»• (n 26{.33' / S00 03 20 W 481.72 110.00 171 Y 'O 1hv } 64j. I41 IO I 10 ,p f+ m v 03 f / / IN r I. r I-I \4,~'°Y O _ 0) KAI 0 W r o/Q92• / lop 20 I D yJ J F N009.'3{ •w e2{.{e' 5 'U~ BGC m 44 lplk~ Y N J to o r: I r n^ I a TI S N s h j' a~ I ° a~ i • S ' r It 76 N ~ N b• j.l S Iry m Z .C u 0 32 a I ~ w O ~ ~4• ~ ~ +4 it I ~ Iri i \ J / O ~ 0 8 ! \GY / Q `I2 3eTJ00 JJ / :0929 " 89 r 7AWIET uN1E D f m$ S m I y f 1 4 I I 0. 0 R ~ _ o _ j 4 RC,::~0.~~a8:rw: i•:iw si «i ~ «E~wMgse'~F'S t Z ]]ffff e~ nMrO ri," y~'a~ y~aaap/M[aa.aa[R7a 1OM TOow~ If T a ~ w w r • % ~ aa~i'eD'IaMCT'a" Aaa1N1Y TC aa• Ss :r~s~e•• °w ~.rw• E 94 :ara■r~.• eC a vu l pi e i :S rk urrPLASND •a..... a. M a. M .w, aar..a . I~ ~ 10•x_ , aoar•' E ~~r\ ~ E OR O O # 0 a F. 3F -I 6s0 "C3s0 -4 ~ E z O 179.17 : F -I- - - _ $ Z a - 1 ~ -4rn DEGCATED a THE PUBLIC N •a ~ rto --+t-MOUNDro-RDAD-~SOUT11- F D.:v \ $ a a\ 1 - nu C $ r- M k= a N ' ; IA i0 j r ' Eat 7 Lk) a 4 i f! \ r ~ 0 J -1 o 't1 r y' 1I. a - 4 13. G .a.w' FYI m ~ ua.a' SM 4s 00 E 2MA~ sr7~m / , os zo w +Br.az P It ;0 C-) raJ B ~ LA- 'K►F A0~ $r r '^Qai i8 0 rw z a: ~ ~ N a v 71 w i' g mt 44 J O m N A 1 d F _ s3 1 I I z ~ ~ s ' / 9y9 5 4 LANgs 1 a O • ro to 3 STC- 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNERIBUYER SAM M ILLFPC MAILING ADDRESS Bo)( I Z ?,-L- H U 1X50 N w PROPERTY ADDRESS IOtoS' MOUNDS DtIIIE- (location of septic system) Please obtain from the Planning Dept. CITY/STATE 4 WDSD N W ( S40I(~2 PROPERTY LOCATION 5 F_ 1/4, NE 1/4, Section Tc'~ 9 N-R TOWN OF Y V D 50A( ST. CROIX COUNTY, WI SUBDIVISION TA NN V R j D G E LOT NUMBER (O CERTIFIED SURVEY MAP -5-2'5-f f4 , VOLUME , PAGE 2-5- , LOT NUMBER /O 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 (I) 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. UWe, 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 SIGNF~D: ~19$- DATF~ St. Croix County Zoning Office Government Centcr 1101 Carmichael 1Zoad Iludson, AV'I 541110 1 i/93 • S T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/ contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of property S A M M ILLF OL- Location of property S E- 1/4 KIE- 1/4 , Section I 0 , T Z7 N-R / W Township Mail ing address B C X Z 8 L _ SaK\ wt $9b IS. Address of site _104.S MOUND S DIZIVF Subdivision name _TAN N r IZ~ D 6F Lot no. IO Other homes on property? Yes No Previous owner of property kA N D ALL 5j//Y,4 N Total size of property 7,5/ A L Total size of parcel Z, sy '4 C. Date parcel was created y-/ - g3 Are all corners and lot lines identifiable? X Yes No Is this property being developed for (spec house)? X Yes No Volume /0.3 / and Page Number ~ as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No. pDos-s- , and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of the County Register of Deeds as Document No. SoyB'S~ Signature of Applicant Co-Applicant Lf - ,1 S Date of Signature natP nf q i c,nar,,,-P e j t DOCUMENT NO. STATE BA F WISCON$I ORSI 1-198)i THIS WAC[ w[sltwVW ,Ow w[COwo,NO DATA ARRANTY D D { 5048s5 - io~ 103i►GE 456 -CISPER'S s This Deed, made between ~0..~1t9 r Randall W. S an and Patricia E. S nan, ---y-n-- - - y . "echxRecoo a husband and-wife - - -Grantor, SEP 1' 1993 and -Sam=-E. M~l-.:er......a_.s_3ngle...p-erson-------•----- ~t 10:45 - A - Grantee, I R-:+xe+ ~t Deem Witllesseth, That the said Grantor, f r a valuable consideration...... l-' Randall W. Synan and Patr~cia E. Synan conveys to Grantee the following described real estate in ---St CrO..X...._.... waruwN To County, State of Wisconsin: t i Tax Parcel :Jo------------------------------------ ,i The SE1/4 of NE1/4 of Section 11; the SW1/4 of NW1/4, the N1/2 of SW1/4, and the South 53 rods (874.5 feet) of the SE1/4 of NW1/4 except the East 74 feet thereof, all in Section 12; all in Township 29 North, Range 19 West, Town of Hudson, St. Croix County, Wisconsin. FEB, AND A parcel of land located in part of the NE1/4 of SE1/4 of Section 11, Township 29 North, Range 19 West, Town of Hudson, SL. Croix County, Wisconsin further described as follows: Commencing at the E1/4 corner of said Section 11; thence S89 3010011W, along the North line of the SE1/4 of said Section, 1212.32 feet to the point of :.eginning; thence continuing S89 30100"W, along said North line, 66.00 feet; thence SOO 28103"E, 500.00 feet; thence N89 30100"E, along the North line of Certified Survey Map filed in Vol. "3", Page 722, 38.08 feet; thence N00 11133"W, 150.00 feet; thence N03 58134"E, 351.07 feet to the point of beginning. This 1_4..AQ.t... homestead property. (is) (is not) Together with all and singular the hereditaments and appurtenances titereunto belonging; And..... Racllda .j__ W_,___Synan__and_-Patr,ici-a-. E-.-..Synan_..._- warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and rights-of-way of record, if any. and will warrant and defend the same. 3.. Dated this day of Aug.List-.................... 18.. G1LYtd'........-•,~r lt~'it!'~ (SEAL) ~GIQLLF.w - - -41- (SEAL) Randall W. Synan Patricia L. Synan t (SEAL) ----------•----•--••-----•----•-----••--•---------•-----••--•-------(SEAL) - - - tz AUTHENTICATION ACHNOWLEDOMSNT Signature(a) STATE OF WISCONSIN lc i es. : St. Croix County. 3 j authenticated this dsy of_.......................... 19------ Pe~sopally came before me ......day of August 119 the above named j . Randall W. Synan, atricia E. TITLE: MEMBER STATE BAR OF WISCONSIN Synan Arica yoy.~o+!+ 's (If not, ,,7,/~, it authorized by 4 706.08, Wis. State) to me known to be the person . $ Nawyzw e "going I il, nt ;and a n wle~e1{~~SCO THIS INSTRUMENT WAS DRAFTED BY r Kristina Ogland Alice Joy O;1ors Notary Public County, Wis. ' AtcoTmey--at--taW t. cralx on (Signatures may be authenticated or acknowledged. Both My Commission is permanent.f not, state exp ati7) are not necessary.) 1Q date- - - - •-f sNa Ies of persons signing in an capacity should be t1ped or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin 1,ee►1 Blank Co. Tue. FORM No. 1- 1982 blilaaukee, Wis.