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Parcel 030-1096-40-000 03/23/2005 04:06
PAGE 10F 1
Alt. Parcel M 32.30.19.352B 030 - TOWN OF SAINT JOSEPH
Current !X' ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): -Current Owner
" PALMER, GEORGE S & JOANNA L
GEORGE S & JOANNA L PALMER
1223 ROLLING HILLS TR
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 1223 ROLLING HILLS TR
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 15.000 Plat: N/A-NOT AVAILABLE
SEC 32 T30N R19W NE SE LOT 1 OF CSM Block/Condo Bldg:
3/900
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
32-30N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1003/18, WD
2004 SUMMARY Bill Fair Market Value: Assessed with:
5619 396,100
Valuations: Last Changed: 07/08/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.000 66,000 195,100 261,100 NO
PRODUCTIVE FORST LAND G6 12.000 128,600 0 128,600 NO
Totals for 2004: ~
General Property 15.000 194,600 195,100 389,700
Woodland 0.000 0 0
Totals for 2003:
General Property 15.000 117,800 162,900 280,700
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M 141
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER tied t 2
ADDRESS /2 Z -3 /l QL >,.~r llz~Z S
u~ Son/ 5 y0,1
SUBDIVISION / CSMf AZA LOT
SECTION .3,2_T 30 N-R. /?-W, Town of )'J rbStt; e -
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
-~~e 7R~N~~~S
PG
i
I
#Ouse
5eALC =~o ;aov s;T, wa(
84
I DICATI; r4OR`I'11 r~r.r:ol,
Provide setback and elevation information on reverse of this foie'
Provide 2 dimensions to center of septic tank manhole <'0ve1
B E N C HRA R K: O~ S J ®t /~~_QV Fkow r ap
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: W )cS Liquid Capacity: U00
Setback from: Well 0 0 House 41 Other
Pump: Manufacturer Modelg? Size
i
Float seperation 19 " Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
Width: Length 15- Number of trenches 3
Distance & Direction to nearest prop. line: Z AST ~6p y'
Setback from: well: 60 ~ House `/,Z Other
ELEVATIONS
Building Sewer ST Inlet. ST outlet
PC inlet 43:~ PC bottom gf, '7 Pump Off
Header/Manifold, Bottom of system
Existing Grade y7 ,S Final grade
DATE: OF INSTALLATIO -
PLUfIBER ON JOB:
LICENSE NUMBER: 31 Cj S'
INSPECTOR:
3/93: )C
Wiscorisin Department of Industry, PRIVATE SEWAGE SYSTEM County:ST. CROIX
Labor arad Human Relations INSPECTION REPORT
Safety and Buildings Division
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.:
PePrAbift's N mRGE ❑ City ❑ Village Town of: State Plan o.:
i
ST - JOSEPH
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
A~l "d-J, ,d- I A950018165
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark 3 S1~'
Dosing
Aeration- Bldg. Sewer
Holding St/ /),(t Inlet
TANK SETBACK INFORMATION St/)Ot Outlet
Vent
TANK TO P/ L WELL BLDG. Air Ito ROAD Dt Inlet
ntake IJ~3~ `~~,XZ'
Septic NA Dt Bottom i~,33 9/ j~~
Dosing NA Header fftp.
Aeration Dist. Pipe
Holdi Bot. System ry 9~ 4!5~3
PUMP / StPTNFORMATION Final Grade
Manufacturer 91,
Model Number = GPM
DH6,0 Ft
T D H Lift ? Loss Head 14~yste
Forcemain Length Dia. Dist.Towek,0
SOIL ABSORPTION SYSTEM
BED/TRENCH Width LengtF~ No. O fqrenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS ~__DIMEN I
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACH`II-~- Manufactur
SETBACK CHAMBER
INFORMATION Type O k el RU-ber.
System: OR UNIT
DISTRIBUTION SYSTEM
Header / Manifold Distribution Pipe(s) Holes e Size x Hole Spaci To Air Intake
Length 1_1~ Dia. Length Y? / Dia. Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grad ystems Only
Depth Over „ Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched
rench Center ~ -3~ -Trench Edges o /-3 Topsoil E] Yes ❑ No ❑ Yes E] No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: T. JOSEPH.32.30.19, NE SE, ROLLING HILLS TRAIL
Plan revision required? ❑ Yes [c]~N'o• 8 O// ~ Q
Use other side for additional information.
SBD-6710(R 05/91) Date Inspector's Signature Cert. No
SANITARY PERMIT APPLICATION
t~•~~■7R
In accord with ILHR 83.05, Wis. Adm. Code COUNTY
;:V_-
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than a 3'
8% x 11 inches in size. El Check if 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.
PROPERTY OWNER PROPERTY LOCATION
A - C'/4 . C '/4, S 32 T 30, N, R E (o W
PROPERTY OWNER'S MAILING AP PRESS LOT # BLOCK #
01-1-Im - /LL lR.
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
C.16s yr 15-~1016 1('7jS 5Y - 525 3 4
11. TYPE OF BUILDING: Check one CITY NEAREST ROAD
( ) ❑ State Owned
Pr TOWN OF:,5 VILLAGE 1-t O;,t # (yUING- LC
❑ Public ~'N1 or 2 Fam. Dwelling-# of bedrooms _y_ PARCEL TAX NUMBER(S)
III. BUILDING USE: (if building type is public, check all that apply) 30 O 914 _ O
1 ❑ Apt/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 in line A. Check line B if applicable)
A) 1. El New 2. LN Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.0 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 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
REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION
600 0 ?,,,L0 r F , s Feet Feet
Vll. TANK CAPACITY in allons Total of Manufacturer's Name Prefab. ConSite- Steel
INFORMATION Fiber- Plastic Exper.
New istin Gallons Tanks Concrete structed glass App.
Tanks Tanks
Septic Tank or Holdin Tank o 09
I-FT
Lift Pump Tank/Si hon Chamber. VIII. RESPONSIBILITY STATEMENT
1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
WIN=
Plumber's Name (Print): Plu is Signature: (No S mp MP/ SW No.: Business Phone Number: 1-1
um er's Address (Street, City, State, Zip Cod6T
IX. COUNTYIDEPARTM NT USE ONLY
❑ Disapproved Sanity Permit Fee (Includes Groundwater ate ssue issuing Agent Signature (No Stamps)
Approved El Owner Given Initial /66 Surcharge FeeV )
Adverse Determination
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398(R.08/93) DISTRIBUTION: Original to County, One Copy To: Safety 8 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 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 & Buildings Division, 608-266-3815.
To be complete and accurate this sanitary permit application must include:
I. 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 in 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 in ##1-7.
VII. Tank information. Fill in the capacity of every new and/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% 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, ground-
water contamination investigations and establishment of standards.
SBD-6398 (R.11/88)
G- ~AG'E 9 7, s
Cov~i2
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V-0
.r
t / r
5 ~ s~ s
sysT~~ cL 9y6'
.X o
3 '
1~_3
5 NED P - _ _ ~ ~
600 F'c'
a,
izoo s.
L
1317 G--
Top slut-w.~~~c ray
rI?OA(r PooiZ L L• COO.D AWL=
/ACRES / S AcRE-S
c~lEGL
w y
I~ Au>/A16- FOR 1-3
G'eD • A L /`/E'2 .r(oq~vt= ll
)-3 SSG IlAztex (OI~CU T~P/ G~~So~ GlJ~~ Yo~6 Sorre~2 Se-T, t&
s~u~oS
/`%pl
• PAGE OF .
' PUMP _CHAMBER CROSS SECTION AMID SPECIFICATIONS
VENT CAP
4"C.Z. VENT PIPE WEATNEK PROOF APPROVED LOCKIIJCr
JIUJCTIOh1 BOX MANHOLE COVER
25' FROM DOOR, (Z•MIV.
••IINOOW OR FRESH
AIR INTAKE
GRADE I •1' Jr11N.
I t~
1e• Mlu. •
COWGUIT
10'P11N.
~ 11~ _
PROVIDE I
. INLET ~ AIRTIGHT SEAL I I ( ~
I III v
41 i
APPROVED JOINT A ( I I ( APPROVED JOINTS
W/C.Z. PIPE I III W/C.I. PIPE
EXTENDING 3' I (I ALARM EXTENDING 3'
ONTO 601.10 %OI L I I ( ONTO SOLID soiL
s I I
I I ON
C 1 i
I
CLCV. FT. PUMP
OFF
0
CONCRETE BLOCK
3'• APPROVED
RISER EXIT PERMITTED OWLS IF TAWK MANLIFAGTURCR HAS SUCH AP'PROVAL' %&DOING
SEPTIC f SPEC,IFICATIOKIS
DOSE
TA N K MANUFACTURCR: NUMBER OF DOSES: PER DAU
L
TANK SIZE: GALLOWS DOSE VOLUME n
ALARM MANUFACTURER' L E(/i L ALA/?INCLNDINCs OACKFLOWW~: ~AC GALLONS
.Le• INCHES OR 300 GALLOWS
MODf:L NUMBER: CAPACITIES: A-
SWITCH TyPC: / , eim "k s/ g -.2INCMfi OR '31-_ G+LLOWS
PUMP MANUFACTURER. 2C L L L 6" 12 C INCHES OR -126 WALLOWS
MODEL NUMBER: ..(,A 0s-~-f--INCHES OR _.X.Li GALLOWS
SWITCH TYPE: 1/~2/I L/a C z MOTE: PUMP AND ALARM ARE TO BC
MINIMUM DISCHARGE RATE 30 GPM I~N,S~TALLED ON SEPARATE CIRCUITS
VERTICAL DIFFERENCE CETWEEN PUMP OFF AND.DISTRIBUTIOW PIPE.. L= FEET
t MII&JIMUM NETWORK SUPPLY PRESSURE . . . . . 2.5 FCET
♦ 570 FEET OF FORCE MAIN X .4 m FYoftFRICTION FACTOR.. FEET
TOTAL DYNAMIC HEAD =13,3 FEET
41
INTERNAL D LW510N~ OF TANK: LEWOTHIYA ;WIDTH do/ .;LIQUID DEPTH
OD
SIGI.IED: LICE, WSE WUM9ER: -
OF
5
W S94 -04 3 05
HEAD/ 2
11S
CAPACITY 211°
105
CURVE 30 100
95
26
9o
Y zs es
I I
EFFLUENT 24 MODEL
and 7S MODEL 169
1+
DEWATERING = 22 70 ,65
V 20 es'
Q
Z 1e 6055
i 16 So ODEL
0 163 MODEL
F- 14 IS All lee
12 40
3S-
10 MODEL
30 MODEL
137, 139,
18S
SEWAGE and 25
DEWATERING 6 20 MODEL
1s MODEL 161
-
4 7 •A
i° -
2 MODEL
L , S S3, SS, -
S7, 59
i 0
C GALLONS 10 20 30 40 S0 60 70 80 90 100 110
24 80
7S LITERS 0 80 160 240 320 400
` 22 FLOW PER MINUTE
I{ 7o
16 60_ - MODEL-
.291. SS
x 1e ~ .
v so
14 45 MODEL
294
L1 12 10_
J MODEL
35 293
O 10
~ MODEL '
f 284
0 2S - - ~ '
MODEL
0 20. 282
~ 1f
» Moon
zJ91-z"Aw O.
6 I 3280 Old Millers Lane
extoll 10 26 30 40, 90 00 70 06 190 100 1110 120 '130 140 46 180 tiro ISO 1110 P.O. Box 16347
I /
+ ' 9 1 I I- -i I LoulsN/!e, Kentucky 40216 1\
Us 0 w tee 1W 3" 400 480 on" 640 720 (502) 778-2731 1
FLOW PER MINUTE
6161'="163* -"165*" «185„°- "188"- "189" Sedes
(%2 HP) (%2 HP) (1 HP) (1 HP) (1 % HP) (2 HP)
• Automatic or Non-Automatic.
• 1/2 H. P., 115V, 230V, 200-208V, 1 Ph. or3 Ph., 460V. e••Ke °I
I IT M O+I lt•f n+t llrf OM ltrf OM llrf n+t Llrf n.l llif
3 Ph. s , s2 IN p1 61 23, a 23, a, ]22
• e, 2, 22, es 3n
os ,ooI ,„..0 „ 2211 ,ea
1 H.P., 11/7 H.P., 2 H.P., 230V, 200-208V, 1 Ph. or 3 I, 13 I
es 3n
Ph., 460V, 3 Ph. » e'a 02 310 a 223 M 22, es 322
SC 1225 A Ted ii ?w yr Pit 5. 0 223 as ,n
• Passes 3/4" solids (sphere). V all as 210 is 300 se 220 " 3.0 as 322
-0 2
• 1'/," NPT discharge standard.
so Is 2. re las 33 In ss se sa 29 ei3 210 s1
• e0 Ie» Is a .3, let 3e ,3e s, 210 0r 2s3
Float operated, submersible (NEMA 6) mech- ° 213. „ ,e „ 1p °i 210
anical switch. 2130 53 , .s Ire
w M 130
• Automatic reset thermal overload protection, 1 0° M'° 2, e2
Ph. only. lx. se 0* 13 es
• Durable cast iron construction. Canadian Standard,
Non-Automalic • 2" or 3" flange available. 4 U(, listed • Assoc. Approval
arsllable
I Model Pictured • 20 ft. UL listed neoprene cord and plug.
NOTE: No UL listing for 200-206V/1 Ph. pumps.
Mercury NOW switches are available for non-eutomelk models.
vnsconsuiuaparmiemoiuwusuy, SUIL ANU 511 t tVALUA I IUN HtPUK 1 rage 1 or 3
Labor and kviman Relations
Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
• COUNTY
St. Croix
Attach complete site plan on paper not less than 8 1 /2 x 11 inches in size. Plan must include, but
not limited to vertical and horizontal reference point jj it ion and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distangeq: d road. 030-1096-40
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
GOVT. LOT NE 1/4 SE 1/4,S32 T30 N,R 19 2(or)W
George & Joanna Pal' t
le*
PROPERTY OWNERS MAILING ADDRE ' r LOT # BLOCK # SUED. NAME OR CSM #
1223 Rolling Hills 1. na na na
CITY, STATE ZIP OE. PKONE []CITY []VILLAGE MOWN NEAREST ROAD
Hudson, WI. 54016 (715) 549 St. Joseph Rollin Hills Trl.
[ ] New Construction Use jx] Resident t)f s 4 [ ] Addition to existing building
j Replacement [ ] Public or commercial describe
Code derived daily flow 600 gpd Recommended design loading rate • 7 bed, gpd/ft2 • $ trench, gpd/ft2
Absorption area required 858 bed, ft2 750 trench, ft2 Maximum design loading rate • 7 bed, gpd/ t2 - 8 trench, gpdift2
Recommended infiltration surface elevation(s) 94.50 ft (as referred to site plan benchmark)
Additional design / site considerations na
Parent material outwash Flood plain elevation, if applicable na ft
S =Suitable for System CONVENTIONAL MOUND IN-GROUND PRESSURE AT GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem i ® S ❑ U ®S ❑ U ®S ❑ U ®S ❑ U ❑ S ®U ❑ S ® U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bound3y Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed rertdl
:kiXShK^lP4•C::::
1 0-9 10yr4/4 none sl fill mat ial cs 2f n n
2 9-14 10yr4/3 none sil lfsbk mfr gw if .2 .3
Ground 3 14-23 10yr4/6 none sil lfsbk mfr if .2
98.54 ft. 4 23-88 10yr4/4 none co s Osg ml a na .7 :.8
Depth to
limiting
factor
Remarks:
Boring #
1 0-8 10 r3/3 none 1 2msbk mfr 2
2 2 8-21 10yr4/4 none sil lfsbk mfr if .2 .3
3 21-82 7.5yr4/6 none co s Osg ml na na .7 .8
Ground
elev.
97.6 ft.
Depth to
limiting
factor
+82"
I
Remarks:
CST Name:-Please Print Phone:
Gary L. Steel 71 _
Address: 1554 200th. Ave., New Richmond, WI. 54017
Signature: Date: 11-3-94 cstm 02298 umber:
J
PROPERIYOWNER C.&.T. Palmer SOIL DESCRIPTION REPORT Page of
PARCEL I.D. x 030-1096-40
Boring # Depth Dominant Color Mottles Texture Structure Consistence Barry Roots GPD/ft
[Horizon in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed ITmr&
3 - 2m r mfr if .5 .6
N&! 2 2-20 10yr4/4 none sil lfsbk mfr gw if .2 .3
Ground 3 0-26 7.5yr4/4 none sl lmsbk mfr gw na .4 .5
elev. i
97.5ft. 4 6-82 7.5yr4/6 none co s Osg ml na na .7 .8
Depth to
limiting
factor
+82"
Remarks:
Boring #
Ground
elev.
ft
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev. j
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(R.05/92)
STEEL'S SOIL SERVICE
Gary L. Steel elorge Palme 1554 200th Ave.
CSTM2298 IGE ZSe'z S32 -T ON-RAW New Richmond, WI 54017
MPRSW 3254 town of St. Joseph (715) 246-6200
1
N
1"=40' r"$;
BM.= top of sidewalk by front door at el. 100'
lot 15 acres
fl
-20
l flu '
`P r ~ l
0 1-'2
vlcle~ 6, ion 1
Z,
I
i
~r
Gary L. steel
11-3-94
CERTI FI EU SURVEY MAP
\.EI/4-SEI/4-SEC. 32, T3.ON~ R19W
yr~
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14
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EAST LINE OF THE SE 1/4 S 000-5 T=05-W
600.00, N P
SHEET 2 OF 2
t 1
35025'
CERTIFIED SURVEY
1 ? N. W. I/.4 - S. E.I/4- SEC. 32, T
REPLAT OF VOL. 27 PAGE 51
RUC F~ w CERTIFIED SURVEY MAPS, S
JA41
P,
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y,~~• o
It, 01 19 ?8
*#41#p
L '
I 6 6' I
I I S 88-37-57 E 653.26'
-26.58'
I 6 26.68'
I T 190o 653.26.'
f NI ~
I °I LOT- I
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SEC. 32 SHAFFER
• S-1325 1
HUDSON
•OL. I PAGE 636 1~NO SU
ZRTIFIED SURVEY MAPS sw
T. CROIX COUNTY, WI. Volume 3
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF AN EXISTING SEPTIC TANK
This is to certify that I have inspected the septic tank presently
serving the 6r4SE A AA4-1-le12 residence located at:
1/4, 1/4, Sec. 3a~ T .3U N R
_Zj W, Town of
5 I/r7w sz:ro Upon inspection, I certify that I have found the
tank and baffles to be in good condition, and it appears to be
functioning properly.
Last time serviced_ A10(j, / p2
Did flow back occur from absorption system? Yes No (if no, skip
next line)
Approximate volume or length of time: gallons minutes
Capacity:
Construction: Prefab Concrete Steel Other
Manufacurer (if known):
Age Tank (if known
(Signature) (Name) Please Print
/Yf 1 7.24)5-
(Title) (License Number)
(Date)
Form to be completed by licensed plumber (s.145.06, Wisconsin Statutes)
or Licensed Disposer (NR 113 Wisconsin Administrative Code)
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Plumber (applying for sanitary permit) Certification:
In accepting the above statement regarding existing septic tanE
condition, I certify that the tank to the best of my knowledge wil.
conform to the requirements of ILHR-83, Wis. Adm. Code (except for
inspection opening over outlet baffle)
Name' Q~fJ1A(__ lt/7i/ 7r Signature MP PR 3%~dS
5/88
STC- 10S
SEPTIC TANK MAINTENANCE AGREEMENT
P,4, Croix County
OWNER/BUYER Ca f M
AELING ADDRESS
PROPERTY ADDRESS f, ► t
(location of septic system) P se obtain from the Planning Dept.
~{j
CITY/STATE
PROPERTY LOCATION 1/4,_ 1/4, Section, T N-R_ j V4'
TOWN OF . J, jr) f'y✓~4't /u ~ ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMBER
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.
V\kle, 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: ~t
DATEi
St Croix County Zoning Office
Governmcnt Center
1101 Carmichael Road
liudson. \VI S4016
S T C - 100
This ap 1!~fatho. tion form is to be completed in full and signed by the
owner (s property bo i my :fwol oped . `luny i rmdediaac. i c . will
only r salt in delays of the permit issuance. Should this
develop ent be intended for resale by owner/ contractor, (spec
house), then a second form should be retained and completed when
the p~operty is sold and submitted to this office with the
appropriate deed recording.
-r•-7-r--------------------------------
<
Ownerd ;operty J d Irn e_ r
Location ~ property 1/4 Sr 1/4, Section I T30 N-R_J_lq_-W
Township / Mailing address i
7 5' , 6- 7,F
Address of site i r~~ ~a '~J ~9gatr[
Subdivision name Lot no.
Other homes on property? Yes_ _No
Previ.6 his pw Ozer of property ry r 1 v- a e f
Total size of property A L(~
Total gize of parcel 4 c,~~ b f
Date parcel was created a0 jg
Are all ,corners and lot lines identifiable% _2c-Yes No
Is this, property being developed for (spec house)? Yes _,K No
volume14, nd I';ry4~ lvrrmbor 2 r11=t rig(, wdod w i t-1► flirt Rocj i nt-.r~r.
of Dee'ds:'
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
referepces, to a certified Sur-ey Map, the Certified Survey Map
shall also be required.
~PROPERTY OWNER CERTIFICATION
I (we)~ certify that all statements on tni.s form are true to the
best of my,.(our) knowledge that I (we) am ?area the owner(s) of the
propertyM described in this information' foram, by virtue of a
warranty,i deed recorded in the office of the. County Register of
Deeds,, as Document No. 1$ 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.
Date of Signature Date of ignature
THIS $PACa ntatnvcv rv.. -
,JCVMEIVT NO. STATE BAR OF WISCONSIN FORM 2-198
WARRANTY DEED
497583 VOL so IMI 2.0
R GISTIrR'S OFFICE
Geor e E . Williams and Katherine F . Williams husband ST. CROIX CO., WI
and wife Rsc'd for Record
APR 16 1993
conveys and warrants to George S Palmer and Joanna L. Palmer. 3:5.5 P. W
husband and wife as survivorship marital property,:
bdrOEDeeds • '
RETURN TO
the following described real estate In St. Croix County,
State of Wisconsin: A parcel of land located in the NE ,1-6f :.the
SE _k of Section 32,. T30N, R19W, described as Lot 1 of a Tax Parcel No:
Certified Survey Map filed.in the Office Of the Register of Deeds for St. Croix Count
Wisconsin, in Vol. 3, Page 900, as Document 361930.
TOGETHER WITH a non-exclusive easement for ingress and egress from Rolling Hills Trai
(a public Town Road) to the above described Lot 1, and further described as follows:
A 66 foot wide Private Road Easement located in the NW 4 of the SE ~4 and the NE 14 of
the SE k all in Section 32, T30N, R19W, Town of St. Joseph, St.. Croix county, Wiscons' ,
also being part of Lot 4 of Certified Survey Map volume 3, page 636, and further
recorded on Sheet 2 of a Certified Survey Map filed in the Office of the Register of
Deeds for St. Croix County, Wisconsin, in Vol. 3, Page 900, as Document 361930, also
partially shown and described on the Survey Map, recorded in Vol. 809, Page 399 as
Document number 436856; said easement being 33 feet distant as measured at right
angles on each side of the following described centerline: Commencing at the S 1
Corner of said Section 32s thence N01036'15"E along the west line of said SE 14,
1319.71 feet; thence S88 40122"E 389.34 feet to a point where the South line of said
Lot 4 intersects the northerly right-of-way of the Town Road; thence N74008'27W
33.25 feet to a point on said northerly right-of-way and the point of beginning of
this centerline description; thence N08050139"E 29.69 feet; thence N01 31'17"E
169.03 feet; thence S87014'31"E 328.91 feet; thence N31030'00"E 332.77 feet; thenc
N53009'28"E 359.63 feet; thence N45°40'28"E 207'62'-feet; thence N67o17'00"E 264.34
feet to the West line of said Lot 1 of said Certified Survey Map.
This ?5 homestead property.
(is) 0@ M94)
Exception to Warranties: easements, covenants and rights-of-way of record
Dated this -day of 19
•
(SEAL)
(SEAL) ~
• Katherine F. Williams
(SEAL) ' (SEAL)
George E Williams
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN
'S"f.C✓b~ X County,," ..151
authenticated this day of 19 P rsonajly came before ~rte.thFs•••~ day of
API T~i.9g _theat;fvramed
George E. Willi a' t1E) U,
TOGETHER WITH a non-exclusive easement for ingress and egress from Rolling Hills Trai
(a public Town Road) to the above described Lot 1, and further described as follows:
A A 66 foot wide Private Road Easement located in the NW k of the SE tL and the NE 4 of
the SE '4 all in Section 32, T30N, R19W, Town of St. Joseph, St.. Croix county, Wiscons ,
also being part of Lot 4 of Certified Survey Map volume 3, page 636, and further
recorded on Sheet 2 of a Certified Survey Map filed in the Office of the Register-.6f
Deeds for St. Croix County, Wisconsin, in Vol. 3, Page 900, as Document 361930; also
partially shown and described on the Survey Map, recorded in Vol.. 809, Page 399 as
Document number 436856; said easement being 33 feet distant as measured at right
angles on each side of the following described centerline: Commencing at the S '
Corner of said Section 32s thence N01036'15"E along the west line of said SE k,
1319.71 feet; thence S88 40'22"E 389.34 feet to a point where the South line of said
Lot 4 intersects the northerly right-of-way of the Town Road; thence N74008'27"W
33.25 feet to a_point on said northerly right-of-way and the point of beginning of
this centerline description; thence N08050139"E 29.69 feet; thence NO1 31'17"E
169.03 feet; thence S87014'31"E 328.91 feet; thence N31030'00"E 332.77 feet; thence
N53009'28"E 359.63 feet; thence N45o40'28"E-207.62-feet; thence N67017'00"E 264.34
feet to the West line of said Lot 1 of said Certified Survey Map.
This )5 homestead property.
(is) E+e•net•)
Exception to Warranties: easements, covenants and rights-of-way of record
Dated this 40 day of f t ~Y t I 19 a3
(SEAL) 2 (SEAL)
• Katherine F. Williams
' V r (SEAL) (SEAL)
George E Williams
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN
SS.
f 'Cr i i k County:'' "1 M
authenticated this day of , 19 P rsonally came befate methFs= day of
/fir I 1.9 the abode named
Geor a E. Wi liams ucl t)
Katherine . Wil iams-
i 4A
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, to m no n b t erson--:who(emigUted the
authorized by § 706.06, Wis. Stats.) fore Ing st a acknowledge fhe Amgi,;
THIS INSTRUMENT WAS DRAFTED BY
George E Williams
rs p
129 Quarry Road ow I, t
River Falls Wisconsin 54022 Notary Public C':~f. (youC k County, Wis.
(Signatures may be authenticated or acknowledged. Both My Commission Is permanent. ion
are not necessary.) date: 19
$B2 NTF 0021
'Names of persons signing in any capacity should be typed or printed below their signatures.
WARRANTY DEED STATE BAR OF WISCONSIN Nelco Tax Forms, P.O. Box 10208, Green Bay, WI 54307-0208
Form No.2 - 1982