HomeMy WebLinkAbout006-1056-30-000l - - ~ .
S't. Croix County Zoning
Monday, October 18, 2004 a12:34:27 PM
Detail Sanitary Information Page 1 of l
Computer #: 006-1056-30-000 Sub/Plat: 40 acres Section: 25
Parcel #: 25.31.16.386 Lot: TN/RNG: T31 N R16W
Municipality: Cylon Township CSM: 1/41/4: NE 1/4 SE 1/4
Owner: Shimon, Ron 1946 U. S. Hwy 63 Emerald, WI 54013
State Permit: 463111 Issued: 10/14/2004 POWTS Dispersal: Non-Pressurized In-ground Permit: Replacement
County Permit: 0 Installed: 10/18/2004 POWTS Detail: Bio Diffuser (11") (PSA) Bedrooms: 4 WI Fund:
POWTS Pretreatment: Unknown
Notes
Inspector As Built Plumber Other Requirements Additional Notes Money Owed
Pam Quinn NA Bird, Shaun This is a replacement for an undetermined $0.00
Signed Off: Yes system -old tank will be abandoned per Comm
83.33
This is an ag parcel that has an additional living
quarters not connected to the house or apparently
to its septic system The apartment is in an
outbuilding/garage. Size and type of the POWTS
servicing this dwelling is unknown.
Maintenance
Scheduled Pump Date Pumped 1st Notification 2nd Notification 3rd Notification
10/18/2007
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
Safely and Buridi=i~ Division
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
'ermit Holders Name: City Village X Township
Shimon, Ron C Ion Townshi
:ST BM Elev: Insp. BM Elev: 13 Description: n
~ 0a ~ v /Du • U GU~ C~ /~~~
TANK INFORMATION ELE ATION DATA
County: St. CPOIX
Sanitary Permit No:
463111 0
State Plan ID No:
Parcel Tax No:
006-1056-30-000
SectionlTown/RangeJMap No:
25.31.16.386
TYPE MANUFACTURER CAPACITY
Septic
~zoU
Dosing ~ ~ „~
„
Aeration
Holding
TANK SETBACK INFORMATION
TANK TO ^' P L
N WELL BLDG. Vent to Air Intake ROAD
Septic (DD ~ ~ ~~ ~ ~l o ~ ~ o l
Dosing /
d
Aeration
Holding
PUMP/SIPHON INFORMATION L~ ~.(-~~-
Manufacturer ~demand
M
SOIL ABSORPTION SYSTEM
STATION BS HI FS ELEV.
Benchmark
Dg2
~to-~t
~~ o
Alt. BM
Bldg. S wer ~ ~ / 6~
SUHt Inlet / s
. ~-
/o S- 7
SUHt Outlet
S S
/b
Dt Inlet
~---
Dt Bottom ~--
Header/Man. / ~-
~2zi ~
°~
I
~ 2 • ~
~ '
Dis . pe Z ~ 3 •'7~
Bot. System [ [ 3 , ~ ~'~ - (
Final Grade "
St Cover 3/r/ ~~~ /~-
PJ'K S
L
~~ /~O
BED/TRENCH
DIMENSIONS Width ~
1
~ Length
( No. Of Trenches _
Z PIT DIM ONS No. Of Pits Inside Dia. Liquid Depth
_
J, ' ~J
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREA LEACHING anufa :bD~ ~~~~~'
INFORMATION CHAMBER OR
T e Of System: ~ O J \ ~ Z
U r
UNIT
Model Number.
~ 2~ O
STRI UTION SYSTEM
/~t/-~-~`2K~ - 7
Header
ength Dia DiPtr(bjtion~ L r `~„ y,s ~ r
Pies 1 ~lQ~`
Length Dia_ Spacing x Hole Siz~ x Hole S~ng Vent 2rl~ke
=v'
?_--
o~
SOIL COVER Y Pracm~ra Rvctamc [lnly YY Mnnnd CIr At-Grade Systems Only ~
Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched
Bed/Trench Center Bed(Trench Edges Topsoil
0 Yes ~ No
~ Yes ~ No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~~ /~~/6
Location: 1946 U. S. H 63 Emerald WI 54013 NE 1/4 SE 1/4 25 T31N R16W 40 acres Ldt "-
1 J AIt BM Description = `~' ~ 2' ~ ) ~~ t7',~U.~t~
2.) Bldg sewer length =
- amount of cover = " Q~, n ` /~i ~ f ~r ~-~~ .~
r'"' .7
Plan revision Required? ~ Yes `° No /O ~~
Use other side for additional information. t/7~~
Date Insepctor's Sign ure
SBD-6710 (R.3/97)
Inspection #2: / /
Parcel No: 25.31.16.386
I/h,
~G (~~
~~~ - ~3 33
~-_l ~ I
Cert. No.
PL T PLAN
PROJF,CT Ron,Shinon ADDRESS 1946 Hwv 63 Emerald Wi 54013
NE 1/4 SE 1/4S 25 /T 31 R W TOWN Cylon COUNTY ST.CROIX
BEDROOM
MPRS Shaun Bird 226900 DATE 10/14/04 4
CONVENTIONAL X)OC IN-GROUND ESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1250 LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1212 # of chambers 39
,BENCHMARK V.R.P. Top of wood corner post ASSUME ELEVATION 100' Fllter Zabel A-100
^BOREHOLE O WELL *H.R.P. Same as Benchmark
SYSTEM ELEVATION 95.7/96.1 /96.5 3.5' below grade
Altern a Bencl~mar To of Steel Fence Post with oran a ribbon @ 99.2'
c~ , A ~v~.
~M'~ ~'~v Cale is " = 4~ ~ Well is to meet all ~
Un eSS O eTW1Se setbacks required by
WDNR
noted
Vent
>6„ Standard Biodiffuser 1320'
of Cover Leaching Chamber Property
with 31.1 ft2 of Area Line
Well 11 "
Existing 4 6' Long
Bedroom 3 4„ Grade at System Elevation
10' House
25' 30' 150'
Ra
tank is to 33
Plans Designed Using 100' umped and buried a3•"
Conventional Powts .1,
Manual Version 2.0
N,,s~^°~'sT
c ~~~
80'
3-3' X 83' Cells with >3' Spacing
.~ B-2
30'
zo ~-~_
50' 30 B-1
10'
'~ 80'
_ Vents
B-3
7% Slope ~ AIt.B.M.
* 10'
B.M.
wy
Safety and Buildings Division
m 201 W. Washington Ave
P
O
Dox 7162 County I
~ ~
~
.,
.
.
SC'~~s,'~ Madison, WI 53707 - 7162
( ) 2 r
~ ~
san;~y Permit Number (to br filled in by Co.)
De artment of Commerce ~ 3 ~
Sanitary Permit Apph
`
~~ ~ ~'~ 1-D'" ,I
[n accord with Comm 83.21, Wis. Adm. Code. prasoaal inform o G.
V Iv
may be usod for seootrdary Purposes Privacy L.aw, s 15. lxm~ Add (f tii t than mailing address)
~
L Application Information -Please Print All Information ~ ~ \ ~--`~
VN~ ~ ~~'~~'
Property Ow~r~s Name /
`C~D ~/ cS NJ~ ~ S ZpN1NG OFF1 00 ~ - jD~~ -30 B1~17
Property Owner's Mailing Address
Propt:rtylocatron •310
City, State tip ode Phone Number ~ ~ ~ ~' Section ° ` '
l `S b~ o I
~~
~
II. a of Buildin
(check all W
r N;
g
T
g
a
aPP~7) /
~
,
1 or 2 Family Dwelling - Number of Bedrooms
-~1~1~C¢_~,
T/ Subdivision Name CSM Number
PublidCommercial - Describe O
star owaod - Descn~e use _ ~ ~-f . /~t/ ~~3 Dl.~ ./~e~~ • G
tY_ Pillage ownship of
III. Type of Permit: (Check o one boz online A. Complete line B if applicable)
A' New System lacement S
ysam
Treatrnent/Holdiag Tack Replaoemerrt only
Other Modification b Bxisting System
B • Permit Renewal Permit Revision Change of Permit Transfer b New List Previous Permit Number and Date Issned
Before F.upiration Plumber Owner / ;~,
V
IV. of POWTS S Check all that a I)
on -Pressurized Ut-Gt+ound Mound ~ 24 in. of suitable soil Mound < 24 in. of suitable soil At-Grade Single Pass Sand Ri(ter
Constructed Wetland Pressurized in.Ground Holding Tank Peat Filar Aerobic Treatment Unit Recirwlating Sand Fil
ar
" S 'c Media Filter Chamber Line Gravel-less
' a
(ex ) i ~ f ~`g>~/
V. D
rsal/Treattnent Area ormation: i ~
Design Prow (gpd) Design Soil Application Rate(gpds~ Area Required (st) Propoud (st) System S ~
O / ~ / I
~
~ QJ
? Q~
l
(
VI. Tank Lrfo Capacity in Total Number Maaofacturrx
Gallons Gattotu of Units ~
(
Prefab Site S Fiber Plastic
New Existing Concrete Coastrocted Glass
Tadca Tadrs
Septic or Holding Tank
Aerobic Tmlmeat Unit
Doaog Qwoba'
VII. Res 'bility Statement- I, the assume ility for hutatlatioa of the POW1s shown on the attached
~~ [fit) _ PI tgnatrrre MP/MpRS Numob]ei
!' Btuittess Phone Number
[
~ /
'
r
e ~,~-~'"G' -yJ~~
Plumber
s Add
ess (Str
et, City, State. T.rP )
~ ~ ~~ ~ ~~
VIII. /De artment Use Onl
Approved Disapproved Stitch ge ~; Fee fmcludes Growrdw~
s Date Issued Agent ro ~)
,/
ownert;riv
R
f
-- ~
~a 5~ `
o
w
eason
orDeaial
. ~~ o ,~
.~.. wuwa.v.u va ~aypa v.aurawiVns [or ursapproval ~ ~ _T ~. _~Z~/~!'h
~ ~3.~
.STEM OWNER: and `~
~ optic tank, effluent filter D~ ,1,_ _ / , , _ _ n /I ~ ~~~~~~ ~~ „ /~~~
dispersal cell must all be serviced / mai~n?d 7"'+''-K- l~-~X G'Ti
as per mane ement plan provided by plun'tber.
~'~Cfl-se ark requiremerits mu`sTb~marrrt~~ned
as »er apnlirabte codelordinances. ___.~ ~y;A ~ ~ ,~ ~~ ~~
Attach eomptete pleas
only) [or the system oa paper not kss than il/2 x 11 inches is rtze
~F./
~~~"t_
' PL T PLAN
~PRO.fFCT Ron,Shinon ADDRESS 1946 Hwv 63 Emerald Wi 54013
NE 1/4 SE 1/4S 25 /T 31 R W TOWN Cylon COUNTY ST.CROIX
MPRS Shaun Bird 226900 DATE10/14/04 BEDROOM 4
CONVENTIONAL )00C IN-GROUND ESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1250 LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1212 # of chambers 39
,BENCHMARK V.R.P. Top of wood corner post ASSUME ELEVATION 100° Filter Zabel A-100
^ BOREHOLE O WELL *H.R.P. Same as Benchmark
SYSTEM ELEVATION 95.7/96.1 /96.5 3.5' below grade
Alternate Benchmark Top of Steel Fence Post with orange ribbon @99.2'
Scale iS 1" = 4~' Well is to meet all
unless otherwise setbacks required by
WDNR
noted
QVent
Well
Existing 4
Bedroom
10' House
_ 25'_ _ 30' _
Plans Designed Using
Conventional Powts
Manual Version 2.0
>6"
of Cover
6' Long, jl l „
150'
Standard Biodiffuser 1320'
Leaching Chamber Property
with 31.1 ft2 of Area Line
at System Elevation
40' Old tank is to ~3
100' be pumped and_b,~ur~ive-~d a 3
ST
80'
3-3' X 83' Cells with >3' Spacing
B-2
wy
30'
50' 30' B-1
10
Vents
B-3
7% Slope A1t.B.M. L
B.M.
10'
Wisconsin Department of Commerce ~1 ~ SOIL EVALUATION REPORT Page ~ of 3
Division of Safety and Buildin~ ~, __....I lJ / _.
+~ acco a, vvis.
r~~^ C ~~
P
Attach com
lete site
lan on a
er not le s tha 1d}~h~i to size room. ~.ooe
n must
County
'~
p
p
p .
indude, but not limited to: ver5cal and ho ontal reference point (BM), dived nand Parcel I.D.
Q~
~ ~~
percent slope, scale or dimensions, north crow, and location n tqp nce t
~
~ ~~ nearest road. ~ f
p
Please print U
~~~ ~
11 in anon. eview Date
Personal iMortnation you provide may be used f r sewn >~~I~~~aw, s . 5.04 (1) (m)). ~b ~ Y
Property Owner
~
~ ~
f ZONIN perty Location
i
4 S
T
~'
~
N R ~ E
~ 0~
~ G ovt. Lot ~- 1 /
~
1 /4„ (o
Property er's Mailing ess Lot # Block # Subd. Name or CSM#
City to Zip Code Phone Number ^ City Village Town Neares Road
( ) lh~ ~
^ ew Construction Use: Residential /Number of bedrooms Code derived design flow rate ~ GPD
Replacement ^ Public o m 'al -Describe: ___--___ __-_ _`
Parent material Flood Plain elevation if applicable ~~~" ft.
General corruner>ts ~'~1 Cj .-,
and recommendations. -Sy~~ ~ l~0 ! J ~ ~ ~ p( ~~ ~~ . ~
S `i13 Q l ~ ~Grr~~ Il. ~ ~3 ~ ,S ~/
Ong # ~Bonng / /
pit Ground surface elev. L ~`` ft. pepth to limiting fador ~ in.
Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2
~i
J
--~s r
..3 r
~--
~ I
s / r / / i C/ • V
9.Sr- ~3 ~^ ~--
-- '~ ---~
I_ / 1 Bortna # ~' BO"ng ~ fl / ~ ~ .~r/7
I~ ~ I ~~ Pit Ground surtace elev/ ~' ~ i ~' tt. ueptn to ummng racror / - -m.
Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Strudure Consistence Boundary Roots GPD/ff
in. Munselt Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2
..~ O~ .s~ ~ ~.s-~1
~~
~
~
' Effluent #1 = BOD > 30 < 220 mg1t. and TSS >30 < 150 'Effluent #2 = BOD < 30 mg/L and TS5 < 30 mg/L
CST Nartte (Please Print) Si CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evalu lion Con ucted Telephone Number
1008 192nd Ave, New Richmond, WI 54017 .- '~ 715-246-4516
Property Owner
Parcel ID #
Page of
~~ # ^ Boring
~t Ground surface elev. ~ ft. Depth to limiting factor ~~ in.
Soil ication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2
Q r--I ~ 3i ~ S ~ ~ ~'
Z .- ,-s v-- ~ .~b(~
3_/ i '~ S n'I il/1 l ~ ~ "~
^ Bonng # ^ Bonng
^ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIfP
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Etf#1 `Eff#2
Boring
Bonng # Ground surface elev. ft. Depth to limiting factor in.
^ Pit
Soil ication Rate
Horizon Depth Dominant Color Redox Desrxption. Texture Structure Consistence Boundary Roots GP DIfI=
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2
`Effluent #1 = BODE > 30 < 220 mglL and TSS >30 < 150 mglL `Effluent #2 = BODS < 30 mgll and TSS < 30 mglL
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
SBD-8330(8.6/00)
' - ~ Soil Test Plot Plan
Project Name Ron Shinon
Address 1946 Hwy 63
Emerald Wi 54013
i
Lot ------ Subdivision -------- Date
j7`M #226900
10/14/04
NE 1/4 SE 1/4S 25 T 31 N/R16 W Township Cylon
Boring Q Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of wood corner post
System Elevation 95.7/96.1/96.5 *HRpSame as Benchmark
Alternate Benchmark Top of Steel Fence Post with orange ribbon Cn? 99.2'
. COUN'T'Y -
• ' ' ST CROIX CE A~~ENigNT
SEPTIC ~T fi~I~EN~
. .. ". ~ - ~ ~ HIP CERTIFICATION FORM
. ~ pyirrTER-S
~ ~~ ill ~ D~~
/Bu er ~ .
Owner Y _ ~ / / . ~ / ~
~l~g Address ~= ~ '_"'`~.'~ _ .
. - ~"`~ Depa~cnt for new construction)
Prope~Y Address iced from Planning / ~b -- ' G9,~
(Verification requ f'
parcel Identification Number
~~^~~ ~
City/State ~ / , j~~
~~v ~ r n~SCRIpTION / w, Town o
~~ ~~ ~ 5e~ 2_ S T~,N- ~2-- ,~
o I.,ocati.oa~,~~:1~ 1~', r-=G-- ~`' Lot #
P~3` v
Subdivision ~ Page #
Volume ------ ,
Certified Survey Map # .. Page # SS~~~'
n ~ , 2 /~ .Volume
Warranty Deed # _~ [~ es [~ no
Lot ~~ i.dentifiable Y
ec house ~ Y~ ~!" "o e
Sp failure to .handle wastes. Proper mac
,~t~-~' tic system could result is i d be~~ ad ~fhat You put into the system
~ySTEM~ ceof Your~e ~~ or sooner, if necdc Y a livens . Pte'
off umPin& nut the septic tank every tmc waste disposal system.
nt stage is the s by ~ owner and by a
can affect ~ fuaction.of the septic teak ~ a trd Dopattmc cation form, iSn~ ewaterdisp m
on-site w~ osal systc
'~ a that {1) the .
owner agrees to submit to St. Croix ~'°~ r verifying yQ less thaw 113 full of sludge.
rasttietedp or a licensedp~Pe tic sank.'
The Prop lumber, lumber ing (if necessary) the sep
mastcrplumber, jousaeyn~aap ~ 2 a~ inspection sad pump s em with the staadar~
~ ~ Pia opting condition sadl (~ rain the private sewage dispo~ Y~
eats ~ agree to main Resources, State of Wisconsin. ~ificatioa
d have read the above ~~crce sad the Dep~eat of Natuzal pffice within 30
Uwe, the uadezsig~ the Dot of Comm letcd sad returned to the St. Croix CouutY ~~
set forth. herein, as set by ea maintained must be comp
stating that Y~ septic system has be ~~
e y gyp' 'oa date. / U`1
~ ~ DATE
~~
Sy(}NA"TtJRE APPLICANT
our) knowledge. I (we) am (arc) the owner(s) of
OWIWER ~•Eg~ICATION foraz are true to the best of my {
I (wet cam' ~ovclb~~e of a w~tY ~sd ncozded in Register of Deeds Office. -7
~ p perty described Y ~7`o~i
ro DATE
OF APPLICANT peratit being nvokedby the Zoning Department. #'~f«` ,
SIGNATURB
:assts pa information that is mis-raPros~~~y result in the saaitazY
y deed from the Register of Deeds office deed
1-estion: a stamped warranty ~p if reference is made m ~~ warranty
ss IpClude with this aPP ~ a copy of the certified survey .
Maintenance and Contingency Plan for a Septic System
Maintenance Plan
1. Septic Tank is to be pumped once every 3 years.
2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in
order to extend the maintenance interval of the filter.
3. Once every 3 years, cells are tv be inspected via the inspections pipes at the ends of
the cells.
4.Owner agrees to limit greases, garbage, and water conditioner discharge into the system. ~
5. The owner agrees to save this plan.
6. Do not plant trees nor park nor drive over system.
7. Watershed is to be diverted away from system.
8. Discharge into system is rrot exceed those required as per Comm. 83
ncy Plan
JJ~ system fails, determine cause of failure, use ~ 9rnate area and install new
tested replacement area:
Install system at a lower elevation, by removing chambers, removing biomat,
new system.
No adequate area is suitable for replacement area, and system elevation
lowered. Install holding tank as last resort. ~ S,d-c' Y-~
3. Replace any other failing components as needed.
Plumber: Shaun Bird 715-246-4516
St. Croix County Zoning 715-386-4680
Pumper Tom Mondor 715-246-5148
Shaun Bird #226900
Parcel #; 006-1056-3U-~~0 10/14/2004 03:33 PM
• PAGE 1 OF 1
Alt. Parcel #: 25.31.16.386 006 -TOWN OF CYLON
Current ^X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units
00 0
Tax Address: Owner(s): * =Current Owner
* SHIMON, RONALD J &CATHLEEN F
RONALD J & CATHLEEN F SHIMON
1946 HWY 63
EMERALD WI 54013
Districts: SC =School SP =Special Property Address(es): * =Primary
Type Dist # Description * 1946 HWY 63
SC 1127 CLEAR LAKE
SP 1700 WITC
Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE
SEC 25 T31 N R16W 40A NE SE EXC HWY R/W Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
25-31 N-16W
Notes: Parcel History:
Date Doc # Vol/Page Type
09/03/2002 689136 1966/552 W D
9AAd CI 111AIUARV Bill #: Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 09/08/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 15,000 229,000 244,000 NO
COMMERCIAL G2 0.500 3,500 56,100 59,600 NO
AGRICULTURAL G4 26.500 4,000 0 4,000 NO
UNDEVELOPED G5 1.000 100 0 100 NO
PRODUCTIVE FORST LANC G6 10.000 20,000 0 20,000 NO
Totals for 2004:
General Property 40.000 42,600 285,100 327,700
Woodland 0.000 0 0
All 40.000 42,600 285,100 327,700
Totals for 2003:
General Property 40.000 16,900 233,000 249,900
Woodland 0.000 0 0
Total 40.000 16,900 233,000 249,900
Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch #: 512
Specials:
User Special Code
Category
Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
~. ~ ,
Ij STATE BARIOF WI ~ ONSIN FORM 2 - 1999
Document Number WARRANTY.DEED
This Deed, made between Ned A. Hahn and Becky Hahn,
husband and wife, __ _ _._ _._______
Grantor, and Ronald J. Shitnon and Cathleen F. Shimon, husband
_.__
and wife,
Grantee.
Grantor, for a valuable consideration, conveys to Grantee the
following described real estate in St. Croix County,
State of Wisconsin (if more space is needed, please attach addendum):
Recording Area
6 8 9 1 3 6
KATHLEEN H. WALSH
REGISTER OF DEEDS
ST. CROIX CO., MI
RECEIVED FOR RECORD
09-03-2002 11:25 ATI
iJpRRANFY GEED
t%EMPT it
REC FEE: 13.0@
TRANS FEE: 990.00
COPY FEE:
CERT COPY FEE:
PAGES: 2
(See attached Exhibit "A"} Name and Return Address
006-1059-30-Q00
Parcel Identification Number (PIN)
DOT TANS 233 Ctatnt~lianCe Approval This is ___ homestead property.
No. 55-63-3565-2002 i (isl ~ai00
Exceptions to warranties: Easements, restrictions and rights-of-way of record, if any.
Dated this 3d~._ day of _ August __ 2002
~ • Ned A. Hahn _ _ ___ .
---....
--
-~ _., _
~ + Becky Hahn
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) Ned A. Hahn and Becky Hahn, hustrand and wife, STATE OF WISCONSIN )
- ) 55.
7 ~~ __ _` ____._.._ County )
authenticated i ~ _.day of _ August 2002 Personally came before me this _ _ day of
_ _ _ , _ ___ the above Warned
. Kristine Ogland
TITLE: MEMBER STATE BAR OF WISCONSIN to ine known to be the person(s) who executed the foregoing
(If not, _ _ _ ._ _ instrument and acknowledged the same.
authorized by ~ 706.06, Wis. Stets.) _
THl5 INSTRUMENT WAS DRAFTED BY + _ ___._______ ___._--_.._ _.
Attorney Kristine Ogland _ _ _ __ Notary Public, State of Wisconsin
Hudson, I 54016 My Commission is permanent. (If not, state expiration date:
(Signawres may be authenticated or acknowledged. Both are not necessary.) __ ...._ __ _ .-- -- • ~)
• Names of ersons si Win in an ca stir must bet ed or rimed below their si nature. ~Man„n~lon Prom:.iw,•u comc.er• Gores eu uK, m
P S 8 Y P Y YP P 8 eoaass-mt~
WARRANTY DEED STATE BAR OF WISCONSIN
FORM No. Z - 1999
1~
• -,
EXHIBIT "A"
NEi/4 SEi/4, Sec. 25-T31N-R16W, St. Croix County, Wisconsin.
The property is hereby restricted so that no owner, possessor, user, licensee, or other person may
have any right of direct vehicular ingress from or egress to any highway lying within the right-of--way
of USH 63; it is expressly intended that this restriction constitute a restriction for the benefit of the
public as provided in s. 236.293, Stats., and shall be enforceable by the department or its assigns.
Any access shall be allowed only by special exception. Any access allowed by special exception
shall be confirmed and granted only through the driveway permitting process and all permits are
revocable.
The Department of Transportation has granted a Special Exception to Trans 233 for the
existing driveway access with the condition it serve a single residential use only. Additional
land divisions, change in land use, or future highway pro,~ect(s) may require a road
intersection or relocation of the driveway to an alternative road of the discretion of the
department.
The highway setback line shall be at a distance of 50 feet from the right-of--way line. No
improvements or structures are allowed between the right-of--way line and the highway setback line.
Improvements and structures included, but aze not limited to, signs, parking areas, driveways, wells,
septic systems, drainage facilities, buildings and retaining walls. It is expressly intended that this
restriction is for the benefit of the public as provided in section 23b.293, Wisconsin Statutes, and
shall be enforceable by the Department of Transportation or its assigns- Contact the Wisconsin
Department of Transportation for more information. The phone number may be obtained by
contacting the County Highway Department.
The lots of this land division may experience noise of levels exceeding levels in s. Trans 405.04,
Table 1. These levels are based on federal standards. The department of transportation is not
responsible for abating noise from existing state trunk highways or connecting highways, in the
absence of any increase by the department of the highway's through-lane capacity.