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CERTIFIED SURVEY MAP
LOCATED IN THE NW1 /4 OF THE NW1 /4 AND THE SW1 /4 OF THE NW1 /4 OF SECTION 28,
T28N, R18W, TOWN OF KINNICKINNIC, FT. CROIX COUNTY, WISCONSIN .19f
i1
NW CORNER n~.
SECTION 28 Fr~~~ r'
w T28N, R18W co
NOV 1.21
'
o In U N P L A T T E Q L A N D S JAIAES 0' CONNELL ~
-r POINT OF - - - - - - g.gtetar of baa(IO
to fn I fih Croix Govnt
BEGINNING Wit in 6
o I S89019129"E 1321. 80' 1288.79' 7-
O i 33.01' 644.7 9' 644.00'
M LOT 3 w
r 3.40A.+ 148,238 S.F.± o _
y
e+ I X00 *3.54A.+ 154,143 S.F.± LOT 4
in cv t' o
N800571w~ 0 0 6.00 Acres± w I
J I ^ 525, 80, Ln M Z N 261,266 S.F.± _ Ul)
tc r p
I tO 55 9. Z
31''~ rn I
80 °57' V'J 547, g - - -.et 'I~RJ 1 p ° z I
D • s 5 ~ 4. 7 61 to Q
0; q~ Tic ` ~ r J
zI 1 LOT 2
QI I two 1 S88°47'20"W i
3.96A.+ 172,580 S.F.± 570.07' D
M M *4.21A.+ 183,440 S.F.± w
rn
1z1 00 704.63' 36• Mgr 2
wl S88°47'20"W 671 63' _ I F- I
M
o w U N P-L-A T T E_ Q
I-- IO 430. 63' 241, 00' n
i0 33r LOT 1 w o L A N_D S I J
I I
¢IZ~Z 4.09A.+ 177, 957 S.F.± t- Ln N I e' i
~I-II ~ ~ -4 *4.29A.± 186,827 S.F.± 8 o O3 ! Z
N N ~ 7 N 4 I
~Iw
Ul) l 33' 435.63' 18'9.C'0' 5-------------}
S88047'20"W 624.63` 6 8d 8d
1616' I - 657. 63' _ PART OF LOT 3
NORTH LINE OF LOT 3
LOT CERTIFIED SURVEY MAP
_5_
W1 /4 CORNER RECOi1..DED IN_V_0_.-2-P AG_E34
SECTION 28 -
T28N, R18W
LEGEND
U 0 1"x24" IkJON PIPE, SET, WEIGHING 1.689/1-INEAL FOOT.
Z
z 0 1" IRON PIPE, FOUND.
w 0 1 1/4" IRON PIPE, FOUND.
m
0 EXISTING' FENCE.
LIUJ * AREA INCLUDING LIBERTY ROAD RIGHT-OF-WAY.
N OWNER AND SUBDIVIDER
This instrument drafted by
Q Herbert D. Cudd Michael Ogden
905 Falcon Drive I( NJ
River Falls, WI 54022
APPROVED
SCALE IN FEET 0 51984
ST. CROW COUNTY
0' 200' 40 0' 00MPR5NEN3IVE PARKS PIANNINO
AND ZOA4NO COMMITTEE
Volumie Tare 14,87
4 9
CERTIFIED SURVEY MAP
j LOCATED IN THE NW1./4 OF THE NW1/4 OF SECTION 28, T28N, R18W, TO
KINNICKINNIC, ST. CROIX COUNTY, WISCONSIN y1,
_NW CORNER
SECTION 28
w -T28N, R18W 9 FILED
7 c:)
^ MAR 041993► t
0 UNPLATTED LANDS 7 JAMES O'CONNELL
'c:0, 00 - - - - - - - - Register of Deeds
POINT OF St. Croix Co., Y~I
BEGINNING
S-V U9-2!E_ S89o19'29"E 644.00' N
LOT 3 677.80' ~ o LOT 7 461.94' 182.06
.M.
2.003 Ac+ L -O 4
w-
VOL, u' 87,248 M.
- - 0 7,248 S.F.+ -
0
P 1487 0 Ln 3• YOL, 5-
~ 0Q#3_9Z7Q7 N3200 2 N X014$7 7 7 M
51.55? 30„E Z Q o
r- I
o f p -I LOT 6 co !
E R71
`~',~~K 2 ~o do 3.9 9 5 Ac. t ca
Sri I I LOI 2 l \ , ^ 17 4 , 015 S . F . ±
I I L - a' L'
N I I DRIVEWA~N\
` Y0L EASEMENT 437 o " 11 • w
I i 0 DZ727 SEE DETAIL \ 570.07 F~
0 1 00, LOI 5 ( ai
I~ I I t L,a,m, I z~ .
LDI - - - - BUILDING PG14$8
I L,a,m, 166'1 I LINE DK # 3927.
VOL 5 I
P 14$7 LEGEND
DOC 3_9Z7Q7 & ST. CROIX COUNTY SECTION CORNER MONUMENT, FOUND.
o O 1"x24" IRON PIPE,SET,WEIGHING 1.68#/LINEAL FOOT.
• 1" IRON,.PIPE, ' FOUND.
N --~H EXISTING FENCE. ~.j~
w
W DETAIL OF DRIVEWAY
W EASEMENT FOR LOT 6 & 7
' ►:.;i ~Z'Q
,N SCALE: 1"=1001
W1/4 CORNER LOI Z 0
-K---SECTION 28 W .:i i.. CROIX COLFNT`f
T2 8N , R 18 W arefiensive ptannim
z f2 Zoning and
o
w W c jjNF r, , S. Comnutteo
SCALE IN FEET LOT
if not•retarded
H j .'tin 30 days of
0' 200' 400' z 6 6' approval date
acs OWNER AND SUDIVIDER approval shag be
'WZLLYAM...J.. & JEAN S. DAVIDSMI & voad
THIS INSTRUMENT DRAFTED BY DARIN FLATER 1453 EMORY DRIVE, APT. 6
RIVER FALLS, WI 54022
CURVE DATA TABLE
CURVE LOT RADIUS ARC CHORD CHORD CENTRAL 1ST AND 2ND '
fib- N6: rZ= =GTH LENGTH BEARING ANGLE TANGENT BEARING
1-2 - 266.00'167.76'165.00' '26"W 36 '08" N21049122"W
N57057'30"W
6 266.00'81.43' 81.11' N30035'35"W 17032'22" N21049'22"W
N39021'44"W
7 266.00'86.33' 85.96' N48039'38"W 18035'46" N39021'44"W
N57057'30"W
PAGE 1 OF SHEET 1 OF 2 SHEETS VOLUME 9 PAGE 2597
61n MENTOF I&IS gTY & BU I LD IN
INDUSTRY, REPORT ON SOIL BORINGS AND SA DIVISI
LABOR AND PERCOLATION TESTS (115) CSN~ R~2~ MADIP.O. BOX 7
HUMAN RELATIONS
SON, WI 537
(H63.090) & Chapter 145.045)
LOCATION: SECTION: TOOW.NSHIP/ LOT NO.:BLK. NO.: SUBDIVISION NAME:
/b ,4 w4 2g /Tzg N/R/e for ~t ~/UN~G'/7 -170 /;1?
COUNTY: OWNER'S I3bWaR'3NAME: MAILING ADDRESS:
Sz, Cleo, x , E',eBE.G'T . t_ v ~J ✓E~P GA ur 4 2 Z
USE DATES OBSERVATIONS MADE
II~~_~ NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: 1PERCOLATION TESTS:
~wtesidence ? nl n ONew ❑Replace ~-7 ~ 8
RATING: S= Site suitable for system U= Site unsuitable for system /
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: -ECO✓MFVDE SR STEMnal
®S ❑U ®S ❑U IS ❑u ❑S M ❑S ~U E L
If Percolation Tests are NOT required DESIGN RATE:
/1 If any portion of the tested area is in the
under s,H63.09(5)(b), indicate el: '4.5.5' Floodplain, indicate Floodplain elevation: /
o7/ PROFILE DESCRIPTIONS
BOR G TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED EST. IGHEST TO BEDR CK IF OBSERVED (SEE ABBRV. ON BACK.)
B- 2 96 g9~ /too NE 96 z g, !~•-t.
s
4, Qom. ; 6 ~Q',r
/1I4N6 3
B- .3 9 7. 7
/daNE 30, .Qn ..~a /z
B- 4 90 ~9 fey
B-
PERCOLATION TESTS
TEST DEPTH, WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD PER INCH
P-
P-
P- L . O
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.
O~/G/NAG 96.3
SYSTEM ELEVATION AL r~-e~vArE- 9s : 3- Lam- ~E-,y.'r'> 7~ All
~ I
9~1 lb,
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OfjGar ye E _
S06/TN C/NE oc Gar ¢
I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin
Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
NAME (print)/: ~ + p TESTS WERE COMPLETED ON:
Y 1,41_7WA V. RG Q/S r O ~,EN ~iY ~.t/EE,Pi~Y Vo. 7 2 9 b'4-
ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional):
/ 3 .E'. EL /yl ~i'~ Y,E',P FALLS' G1/ ~ ~s'¢ ®z ,z S`S - Sg8 7/S- 42.3= 963J
CSST~SSIIGN T RE:
DISTRIBUTION: Original anri -e ropy to Local Auih.?rty, ?rope, ,v Owner an% Soil Tester. /d~ .!D g¢ ,~47D
1IL '494
S
N
9
INSTRUCTIONS FOR C~AIIAPLLTING FORM 115 - SBD - 6396
To be a cornplete 'accurate soil test, y report mast ir!clude:
1. Complete legal ~ 01;
2. The use secti early indicate wl, this is a r~ sidence or cornmergial roject;
3. MAXIMUi. t bedrooms or at use I ~.aed;
4. Is t lent system;
5. Cr ating boxes. IS SU_. 3LE FOR A JLY IF ALL.
.ULED OUT BASED ON SOIL CONDITIONS;
6. -I r thr: a ins shown here for writing profile descriptions a, :corny ~ plot plan;
I. 'A A LEGIBI ~n accurately locating your test locations. Dra to °rod. A
~e sheet a~ a3 desired;
sure you b,! k and vertical elevation reference point are cie `
p?ete all apt>l ( I -;es as to dates, names, addresses, flood plain p : col<atior, ~xernp-
oxopriat,'
nation plain, elevation; does not apply, place N.A. the approp-;-- box;
rn and pla - rrent address and your certification number;
copirxs distribute as required. ALL SOIL TESTS MUST BE Fit. TH THE
L _ ,-.UTHORITY WITHIN 30 DAYS OF COMPLETION.
ABBREVIATIONS FOR CERTIFIED SOIL TESTERS
tes and Textures Other Symbols
;vr~r 10") EAR Bedrock
1011) SS - S-
ier 3") LS L
- HGbU F `
Pere
VV
Bldg
l L
'I L Br!
4r= L31
Gy
y
H'kL
B I~.~
VRP
T(
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S TC - 10 4 IVE0
AS BUILT SANITARY SYSTEM REPORT
OWNER Atol (W S; L
ADDRESS 3.0 W
IL
SUBDIVISION / CSM# LOT #
SECTION _T_N-R~W, Town of~ r~w~c ~G~ w w~ e
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW 0w
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
vj-ttL
wy~ 53'
.j
v
r
y
q-
INDICATE NORTH RROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK: )ron .5"foAt. EL. too,oy
ALTERNATE BM: 1 o p CGM Gy 47"rt `J J®,.,, "jet F' of'. I
C_u~
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
0
Manufacturer: ~ to a
Ul,e,;.c. Liquid Capacity. v L o
Setback from: Well 5'> House 1S Other
Pump: Manufacturer Model#ME 4c,,+,c-ijSize
Float seperation Gallons/cycle: j2
Alarm Location aF~`n,.,f
SOIL ABSORPTION SYSTEM
Width:- I2 Length 6 U Number of trenches it
Distance & Direction to nearest prop. line: 3o
Setback from: well: 7a` House ZS* Other
TA 4 / G 2, S f ELEVATIONS
Building Sewer ST Inlet ST outlet y S,
PC inlet PC bottom I, ; 7 Pump Off 9 2, 5
0'.~, RIR 9f,
Header/Manifold 4 ( Bottom of system, d
Existing Grade J u l Final grade
DATE OF INSTALLATION:
PLUMBER ON JOB: e
LICENSE NUMBER:
~V~~ S 3 37 A
INSPECTOR:
3/93:jt
Wisconsin vpartment of Industry, PRIVATE SEWAGE SYSTEM County:
Laj~orandAumanRelations INSPECTION REPORT ST. CROIX
Sa ety and Buildings Division
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.:
Permit Holder's Name: ❑ City ❑ Village ❑ Town o : State PI
LUND BUILDERS X Tr 4 CST BM Elev.: Insp.9M Elev.: BM Description: p Parcel Tax No.:
opl" /o0• c5 t a ~tti/
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark '
Dosing '
/'00 Aeration Bldg. Sewer f'
Holding St/ Ht Inlet
/o.~ y 9 5
TANK SETBACK INFORMATION St/ Ht Outlet
Vent
TANKTO P/L WELL BLDG. AirIto ntake ROAD Dt Inlet g5- G'
Ar l0, $
Septic yas' .53• IT" 12- r NA Dt Bottom
Dosing >aS", 53' ry' 'a 3" NA Header/Man. 3 qq- I '
Aeration NA Dist. Pipe 7, y 5- FB.~s
Holding Bot. System 8 y - PUMP/ SIPHON INFORMATION Final Grade
5. r /0l,3 .
Manufacturer Demand S'JG„4v
Model Number GPM
r3-~8/ 9asa'
TDH Lift Friction System TDH Ft
Forcemai n Length Dia. Dist. To Well
Head
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSION 1a 60 / DIMENSIONS
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
SETBACK
INFORMATION Type O CHAMBER , Model Number:
System: 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: Kinnickinnic.28.28.18W, NW, NW, Lot 7, Pine Ridge Drive
Plan revision required? ❑ Yes ❑ No
Use other side for additional information. ( 95 'J , , /j/ (o
SBD-6710 (R 05/91) Date pector's Signature Cert. No
ADDITIONAL COMMENTS AND SKETCH #
SANITARY PERMIT NUMBER:
i
I
I
-ycl SS 70 0
SANITARY PERMIT APPLICATION
13ILHR In accord with ILHR 83.05, Wis. Adm. Code COUNTY
sw.n.~ns
6L ,
~eos.,wtue,~,~nwu~w.o~ , Cry
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than 1:1 3 4 fO
8% x 11 inches in size. Ch k i revision to previous application
--See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROPE TY OWNER PROPERTY LOCATION
U. 11S IJ Y4 ,N vj Y4, S 6 T~9 , N, R ~ (or) W
J
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
720 vKo 5-f' 7 VVA
"I` N
CZ STATE ZIP CODE PHONE NUMBER
SffKSM ER h 4 ~r
fi4"vtr f~_ (I1 54o-t 2 f(-7 15 42S-j136 OCST
-0 ITY
II. TYPE OF BUILDING: (Check one) ❑ State Owned D VILLAGE : REST ROAD
=NQF: k,w wre L 1r% \ R lej!to Pk.
❑ Public ~Q 1 or 2 Fam. Dwelling-# of bedrooms PARCEL TAX NUM R(
III. BUILDING USE: (If building type is public, check all that apply) 022- WO- 50 0"4
1 ❑ Apt/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
30 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 in line A. Check line B if applicable)
A) 1. In New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 511 Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit # - Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 X Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy
13 ❑ Seepage Pit Pressure 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
d REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION
-1 S 6 "7 2 0 '72 0 G ? 6 Feet 101 Feet
VII. TANK CAPACITY Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name oncret Con- Steel glass Plastic App.
Tanks Tanks structed
Septic Tank or 1000 1000 W i 6'e'i Co
Lift Pump Tank/Si hon 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 SignaattJure: (No Stamps) MP/ PRS o.: Y(7 siness Phone Number:
~tir( 4t1,~ i" 3 3 7 2 /S 425-a17
Plumber's Address (Street, City, State, Zip Code):
o4 2 WLcr.~, '.cr Fa t5
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (isurchesg roun water Date Issued suing Ag t Signat a (No S pw ee) Approved ❑ Owner Given Initial +Q t
Advers
e Determination I z& X.,~CONDITIO S OF APPROVAL/REASONS R DISAPPROVAL:
'Zoo.- C:YA4
Uv 9,Q?
SBD-6398 (formerly Plb-67) (R. 11/88) 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 the time cl renev,al 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: r, ownership or plumber requires a Sanitary Permit Transfer/Re-owal From (;;Et) 63E9) to be
sub,r[~ted to the county prior to installation.
5. On,-te sev:aye systems must be properly maintained. The v-pt;- tams-,) n -t 'he , C. lTenv^d
pumper whenever necessary, usually every 2 to 3 years.
6. If you have questions concernin.U,ouyonsite sewage system, contact your local co c air, nistrator or the
State of. sgoflsin, Safety `:t 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 it 1 or 2 Farn','y Dwelling.
III. Building use. If building type is Public, check all appropriate boxes that appl, .
IV. Type of permit. Check only one in line A. Complete line B if permit is for tanik replacement, reconnection, or
repair.
V. Type of system. Check appropriate box depending on system type.
VI. Absorption system information. Provide all information requested in #1../
VII. Tank Information. Fill in the (:apat;ity of every new and/or existing tank, Ist 1 e tc, l = -,umber of
tanks and , ;anufacturer's name. Indicate prefab or site constructed and tank matori;:i Corn ?'ete :or all
septic, purr;p/siphon and holding tanks for this system. Check experimental ;>pprova; of i,' if i inks received
.)xperirniental product approval from DILHR.
Vlll. ~esponsibility statement. Installing plumber, is to fill in name, license nt.rnber with a-)prop-i tte prefix (e.g.
SAP, etc.), address and phone number. Plumber must sign application form.
IX. County/Department Use Only.
X. Country/Department Use Only.
Complete plans and specifications not smaller than 8'/2 x 11 inches mi; * b:. °;ubr^'t1-:,,f o th county. The
plans rnust include the following: :=k) plot plan, drawn to scale or with + os I(f P ; }r":; ~ation of
holding tank(s). set ti,. r= Cr other treatment tacks; building sewej -l 4v .;i~ r vate- service;
s=treams and lakes. piimp a+ siphon tanks; distrib-ition boxes; soil -roet1 system
;areas, and the iocatioi; of the building served; B) horizontal and vertico
C) complete specifications for pumps and controls; dose volume; elevation eren r 1r :ti: losis; pump
performance curve; pump model and pump manufacturer; D) cross section of the so!; absor)tion system if,
required by the county; E) soil test data on a 115 form; and F) all sizing information:
- - - - - - - - - - - - -
GROUNDWATERSURCHARGE
1983 Wisconsin Act 4110 included the creation of 3urcha.rges (fees) for a nijw'.-I-,r
re g'JI'ted i-trI-sct ces whic1-S care effect g7oundwater.
The monies co;!octe. , 1,hre-j9h <9sb£ s;:rchar, les ;1r4 f v. ;rC' ?r.
water t::~Jr!3'.1C11i s Tit7n !nvf-71, gcatfcrts and estahlishil-k ,12:^ sir
x ,
r
SBD-6398 R.11/88
Fresh Air Inlels And Observation Pipe
Approved Vent Cap - for
Minimum 12' Above
Final Grade
II~=E C
.IND eY _.~t. f~ Mt~R$
20- 42' Above Plpa - 4 Cost Iron
To Final Grade Vent Pipe
Synthetic u1ODistribution
Pipe lee
6
BI
00
98.0
X44
L a~ ~
J
g5
Go
4LTFfZ K4TF
a
A7 I ARV Pr, 11
. ~ P3 64
a'pvc (lih!1
To Ira"
1000 301 xP 1` V-01 E21100.0
0
4 pvo ~a~e t ff' 4b/
EKGepf t" "l
-e-4
Q i'S}Te ~s flaT
O ° hr~
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fo..w~ ,~.STCtI ~ob~s 1
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DEPARTME,NT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, DIVISION
LABOR AND PERCOLATION TESTS (115) MADISP.O. BOX 796
ON WI 3707
HUMAN RELATIONS
(ILHR 83.09(1) & Chapter 145)
LOCATION: SECTION: TOWNSHIP/Mt'NtetP€ l=+-Y: LOT NO.: BLK. NO.: SUBDIVISION NAME:
iL!.+~~~ ,I,/k' ~/a /T,~f N/R/~' E (.60
k"hn
OU T -OWNER, /BUYER'S NAME: MAILING ADDRESS: CS Ht,
I b<111 x ~1 Ac / s Yo
USE - If DATES OBSERVATIONS MADE
NO. BEDR COMMERCIAL DESCRIPTION: P< PROFILED S R IONS: ER OLA I ION TESTS:
Residence 3 'L1' New ❑Replace
RATING: S= Site suitable for system U= Site unsuitable for system
rffONV STIO~NAL: MOUND: ~ IN-GROUND-PRESSURE: TISTEM-IN-FILLHOLDING T~ :RECOMMENDED SYEM:( o tional)
LE~J EN EIS
Percolation Tests are NOT required D SIGN RATE: I If any portion of the tested area is in the
under s. ILHR 83.09(5)(b), indicate Floodplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B- M -f S
B- 1.2 IP /3" jr,
B- 3 o , s' of > ,p'/3 r . P' /s ,Hs
B- Fro IV/. Z D / 1 / , S' s < r
B-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH
P_ ( V2-
P_
P- L / /1 11^ t 3 ? ~ro s PJv r:7 . r c S~
P-
P- ,3 ` L 3 S"
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 ver ical elev tion 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,6P/, , AW 10
SYSTE ELEVATION _ va
7
i
0E
#,3 .4 tf io i
r/}~ 63" 6s ~L'q v l
~
e
Y
4.._~'
z ~
L~ r rec~ C loU O /
, . GMf fnri~!. .
i
' G' K ~O✓i N
,
e ~ m
fa~u SI v G+( lltf !vu•r /trbe
I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin
Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
NAME (print): DAVE r TESTS WERE COMPLETED ON:
• Perk Tester & Plumber ri
Licenad ADDRESS: CERTIF ATIO NUMBER:
F rty He is Road PHONE NUMBER (optional):
NSIN 5023
Ph~„~ CST SIG E:
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 10/83) - OVER -
INSTRUCTIONS FOR COMPLETING FORM 195 - SBO - 6396
To be a c= curate soil test, your report must include:
1. Complete,
2. The use section y indicate i ' ,i this is a residence or commercial project;
3, MAXIMUM nurn' as or coy ial use planned;
4. Is this a new € _ .,.at s, teaar;
5. Complete the sui rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL
OTHER SY TE ;E RULED OUT P DON SOIL CONDITIONS;
6, PLEASE use iae _ ~Jations shown he sr ,,iriting profile descriptions and completing the plot plan;
. MAKE A LE gram accurately locating your test locations. [drawing to scale is preferred. A
separate shee rnr u: =d if desired;
s. hake sure your b in,ark and vertical elevation reference point are clearly shown, and are permanent;
9. Complete all appropriate boxes as to dates, names, addresses, flood plain data, percolation rest exemp-
tion, if appropriate;
10, If tho information (such as flood plain, elevation) does not apply, place N,A. in the aiapropriate box;
11. Sign the form and place your current address and your certification number;
12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE
LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION.
ABBREVIATIONS FOR CERTIFIE 3 SOIL TESTERS
.parates and Textures Other Symbols
- Stour- {over 10"? BR Bedrock
cob f~'able (3 - 10") SS - S ndstone
gr 4'' (under 3") LS Linrestt,
"s IlGW High C:< ...,~ac.r
cs Sand Pere Percolat" n Rate
m d s ra Sand W Well
Bldg F ail . az;
Grey, r i ndn
a < Less T an
E3a Brovyn
BI Black
Gy Gray,
Y - Yello=""
sc, - y Cray Loarn R Red
sic' Clay Loam rraot - Mottles
sc - S::.,c;y Clay with
sic - silty Clay fff - few, fire, faint
~c (.-,c common, coarse
pt peat corn - Many, mediurn
in Muck d distinct
p - prominent
[AWL High water lev=l,
Six general Soil textures surface water
for liquid waste disposal BM - Bench Mark
VRP Vertical Referem F t
TO THE OWNER:
This soil test report is the first step in securing a sanitary permit. The county or the Department may request
verification of this soil test in the field prior to permit issuance. A complete set of plans for the private
sewage system and a permit application must be submitted to the appropriate local a,L-Io, :y in order to
obtain a permit. The sanitary permit must be obtained and posted prior tq the start pi a,y. "construction.
1-
ri. e
114
405'703
CERTIFIED SURVEY MAP
LOCA'T'ED IN TILE NWL/4 OF '1'1113 NW1/4 OF SC'CTJON 28, T28N, R18W, TO
KINNICKINNIC, S'T'. CROIX COUN'T'Y, WISCONSIN
N
W CORNER FILED
SECTION 20
'T'28N, R18W 9 FILED
MAR 0 4199133 t UNFLATTEU LANDS JAMES O'CONNFI.L
o °D - - Y - - - - - Rl gwor of UOOd1
I (f) Ln POINT OF ;Q SL Croix Co., VYI
BEGINNING I
SID'U9' 29"E_ ~ _______j0 FSQ9OT e
- -S89°19' 29"E 644.00'
Of 3 677.80'
3- LOT '74611V ~0 182.06'
13- 0 2.003 Ac. 1
, W
OL o 0 07,248 S.F.1. 1 .5.
UL. 5
I 1111$
C) v,
I OCfl39Z7U7''~ ~11$I - o
`i
i~ N32°02 to ~`F' 0_039V.07
51 5 5, 3 0 F, ,1 y
LOT 6
o ( 1 ~Z G~ o
2 ho ~p 3. 9 9 5 Ac A
I
to I' I U v~? n/ \ ti 17 4 , 015 S.F.!
\ ~V
DRIVEW7 9'\
N I Sul , . ,
~ EASEMENT o ~ ..W E I
w SEE DE'T'AIL H
6Vil-13-9Z /U / , 570.07 it
1 1 ( i i 150i LUI 5 ( z
(n
0
CZA l
I '~I
N I' - - - - - -t DULLULNG 1OL 5
. UI - SF1'I3ACk 11$8
I 1 166 ( LINE 39Z7Q$
UL. I
I LEGEND
K ""V/ & ST. CROIX COUN'T'Y SECTION CORNER MONUMENT, FOUND.
t- 0 1"x24" IRON PIPE, SET,WEIGIIING 1.68113/LINEAL FOO'L'.
r' 1" IRON. PIPE, FOUND.
E N N EXISTING FENCE. APPROVED
3W DE'T'AIL OF DRIVEWAY
EASEMENT FOR LO'T' 6 & 7
~r4 SCALE : I"=100'
W1/4 CORNER "0
LO Z o~~
on V <;t. CnQlx COMITY
-SECTION 20~ Y~•' ~~p
T28N, 1110W --po ,p ti0 -.•rr.lNeh4nslve nlannn.(
~)O S%
) Znt,kvl AtKT
" .n \F O, rc.. Cotnr~,illr,v
,
~aPri4l d~ f 04 o
N SCALE IN FEET _ `wc7 Off, LOT G 11 ~l recottlr►d
oz v,*11-+1 30 days of
020 ' H 6 6' eantovel dalo
OWNER AND SUDIVIDER eIptoval shallbo
WILLIAM J.-& JEAN S. DAVIDS I d1 void
'T'HIS INSTRUMENT DRAF'T'ED BY DARIN FLATER 1453 EMORY DRIVE, AP'T'. 6
RIVER FALLS, WI 54022
CURVE DATA TABLE
CURVE LOT RADIUS ARC CHORD CHORD CENTRAL 1ST AND 2ND
irra-. N?3-. I;EA;Tll V'711G'rn LEITUTII UARIE NG_ ANGLE •TANGENT BEARING
1-2 - 266.00' t'G7 76' 165. UO'P3~~ J' 26"1•I 36"08'00" NTM§' 2l'W
N57°57'30"W
6 266.00'01.43' 81.11' N30°35'35"W 17°32'22" N21°49'22"W
N39°21'44"w
7 266.00'06.33' 85.96' N48°39138"w 18°35'46" N39°21'44"W
N57°57'30"W
PAGE I OF SHEET I OF' 2 SHEE'T'S VOLUME 9 I'nrf 2597
t
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
owNERiBuYER LyN lbks ---r JC 414; 4 DEN +5
MAILING ADDRESS % etZ i 4 1) S w ; SYa Z Z
PROPERTY ADDRESS lpi o ~t . ~?Z . ~ ~ e2 t s+ I t S w o 2Z
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE
PROPERTY LOCATION N v-) 1/4, _NUJ 1/4, Section Q~3 TO 8 N-RW
TOWN OF Q; C- K ' G, ST. CROI K COUNTY, WI
SUBDIVISION-_. P; Nr= R. D6 BIZ . LOT NUMBER 7
y~S7o3 Q 'x597
CERTIFIED SURVEY MAP' , VOLUME`, PAGE, LOT NUMBER
Improper use and maintenance of your septic system could result in its premature failure to handle
wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed
by licensed septic tank pumper. What you put into the system can affect the function of the septic tank
as a treatment stage in the waste disposal system.
St. Croix County residents may be eligible to receive a grant for a maximum of 60%. of the cost
of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County
accepted this program in August of 1980, with the requirement that owners of all new systems agree to
keep their system properly maintained.
The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner
and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1)
the on-site wastewater disposal system is in proper operating condition and (2) after inspection and
pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum.
I/We, the undersigned have read the above requirements and agree to maintain the private sewage
disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR.
Certification stating that your septic has been maintained must be completed and returned to the St. Croix
County Zoning Officer within 30 days of the three year expiration date.
DATE:
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
S T C - 100
j
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.
-----------------------XA1 AARR4;0 +b&N;S~' 14i'/!
owner of property L)PJZ) ORS C
Location of property dvJ _l/4~j,) 1/4, 5 ction aS ,T_a -R_Z8W
Township ;c►L;Q~ N; ~ Mailing address 7o2p & .41A;N ,
LJeVL iAi/4; w% :SYD22
Address of site //!o? J?"m ~k; ZI&O P-PA11S
Subdivision name C.AMPW. 2,A3. X597 Lot no. 7
Other homes on property? Yes_p-~' No
Previous owner of property
Total size of property 00 C0,6 7
r.
1 a L1 b .5,
Total size of parcel _ a Oo 3 ACf~GS ~.~3? ZYF~ -S•
Date parcel was created
Are all corners and lot lines identifiable? _Iff:~Yes No
Is this property being developed for house) ? Yes ✓/No
Volume and Page Number - Oec
c corded 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. 5049 aDI , 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.
L v ~c'S /JC
Signat re of Applicant Co-Applicant
S- / -25
Date of Signature Date of Signature
i
I
•
DOCUMENT No. STATE BAR OF WISCONSIN FORM 1-1982 THIS SPACE RESERVED FOR RECORDING DATA
0 61 09 vot. VIRRANTYAGE 164 DEED
f r,
This Deed, made between Chris_topher._A.-_Haroldson_and_.
qecord
-Kathleen_A_--Haroldson,__husband- -and -wife __as _Bur_vivox_ship
marital--property---- SEP 2 .7 1993
Grantor,
and---- Iio._Lund-Euildexs,__.Inc...... -Wisconsin--Corporation.....--- 4 %tt 2:00 P. p,
}
Grantee
Witnesseth, That the said Grantor, for a valuable consideration......
One- _dollar--and- _other- _good__and_-valuable __considerati.on__RETURN TO
conveys to Grantee the following described real estate in St___CrQZX__-____-__-.
County, State of Wisconsin:
LOT SEVEN (7) OF CERTIFIED SURVEY MAP IN VOLUME NINE (9) Tax Parcel No:
OF CERTIFIED SURVEY MAPS, PAGE 2597, AS DOCUMENT NUMBER
495703, FILED IN THE ST. CROIX COUNTY REGISTER OF DEEDS
OFFICE ON MARCH 4, 1993, BEING LOCATED IN THE NORTHWEST
QUARTER OF THE NORTHWEST QUARTER (NW, of NW,) OF SECTION
TWENTY-EIGHT (28), TOWNSHIP TWENTY-EIGHT (28) NORTH, RANGE
EIGHTEEN (18) WEST, TOWN OF KINNICKINNIC, FORMERLY BEING)
PART OF LOT FOUR (4) OF CERTIFIED SURVEY MAP IN VOLUME
FIVE (5) OF CERTIFIED SURVEY MAPS, PAGE 1487, AS DOCUMENT
NUMBER 397707.
Together with and subject to a single driveway between
Lots 6 and 7 as shown on said Certified Survey Map.
St. Croix County, Wisconsin.
This ig__nQt--------- homestead property.
kX) (is not)
Together with all and singular the hereditaments and appurtenances thereunto belonging;
And --g- ntors
r--a-------------------------------------------?------------------- -
warranta that the title is good, indefeasible in fee simple and free and clear of encumbrances except
easements, restrictions, reservations and covenants if any of record and highway
rights-of-way.
and will warrant and defend the same.
Dated this 2,9- day of SePtemb 19-91-
71-1 -
- - ------(SEAL) s1---Q?-^-------•-•------_-(SEAL)
- * Chr: stapher_ A--_ Haro_ dson------------------
(SEAL)
-(SEAL) - - -
* * Kathleen__A.-_Haroldson----------
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN
ss.
Pierce County.
authenticated this ________day of___________________________ 19 Personally came before me this d--__-day of
eptember 19.93... the-aboveta;Amed
Ohri5tQpbar A.._HarQ1d09nar)d:I, I k IShI A~.
H.a roldBo1x r._
TITLE: MEMBER STATE BAR OF WISCONSIN
r
(If not, -----------_..:_'•y a'
authorized by § 706.06, Wis. Stats.) to me know a the person _ S wfY' $eeU the
foregoing i ru k
THIS INSTRUh1ENT WAS DRAFTED BY
Edward _ F_,__ Vlack,
DAVISON -VLACK---------------
*---Edward -T.__ylack------------------•-------- =
20D__E.__F1m_txee_t_,__Ryer__Falls_,__WI__54022 Notary Public ------------------------------------------County, Wis.
(Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration
are not necessary.) date: , 19--""---'')
*Names of persons signing in any capacity should be typed or printed below their signatures.
WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Co. Inc.
FORM No. 1-1982 Milwaukee, Wis.