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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, C DIVISION
LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX N W 53707
HUMAN RELATIONS
(H63.09(1) & Chapter 145.045)
LOCATION: SECTION: OWNSHIP UNICIIPPAALITY: LOT NO.:BLK. NO.: S/UBDIVISION NAME: F
'/,V 4 /T !N/R/` (or `e- r~ _ f.f b ~uh C II,L/d t~-.~
COUNTY: WNE 'S BU AM : A :
lc 4, / /o ~ji 5'-` ~w ~,~~•~~_~1 uJ,c SAC°/7
USE DATES OBSERVATIONS MADE 6 Au75
NO. BEDRMS.: COMMERCIAL DESCRI PROFILE DESCRIPTIONS: PERCOLATION TESTS:
Residence 3 PTION:
ONew ❑Replace
RATING: S= Site suitable for system U- Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUNDPRESSUR_ : S STEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional)
S ❑US DU ❑U ❑ S ❑ S ®U e o
If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the
under s.H63.09(5)(b), indicat G
e: ~ o Floodplain, indicate Floodplain elevation:
/5P 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 O SERVED (SEE ABBRV. ON BACK.)
B- d! va. d cn
13-
13- 7og ,7 7.:Z
B-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER IWO"E5 AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH
P- , a,
P
I
PP
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.
SYSTEM ELEVATION
~ t
V?JA
let
C -
;d
1-- 111 i
_I __.i T N
1
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i ( Cif`
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AV
I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and od .specifi~d(i t the WiW'an
Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. 3
NAME (print : TESTS WERE COMPLETED ON:
r17 n /11 dl J31
-
ADDRESS: CERTIFICAT N NUMBER: PHONE NUMBER (optional):
G ~o t3 41 7 Z 1,?
CST SIGN TU E:
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 02/82) - OVER -
i
STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER L Q ~,b
ADDRESS ~ j(' 0r>Z,
! ~Yo
SUBDIVISION / CSM# LOT #
SECTION_,,?A T ~N-R JILW, Town of
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVER ING WITHIN 100 FEET OF
SYSTEM
J
f
M~
r
1
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK: ALTERNATE BM:
SEP IC TANK PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: Liquid Capacity:
Setback from: Well
Q~eouse ~ Other ~
14, lop
Pump: Manufacturer Model# Size
Float seperation Gallons/cycle:--
Alarm Location
` SOIL ABSORPTION SYSTEM
width: b Length ~Q Number of trenches
Distance & Direction to nearest prop, line: Jam/
Setback from: well: Q ouse Other
ELEVATIONS
/ice
Building Sewer ST Inlet. ST outlet
PC inlet PC bottom Pump Off
Header/Manifold Bottom of system Existing Grade i- Final grade
DATE OF INSTALLATION:
'~~f
PLUMBER ON JOB:
I
LICENSE NUMBER:
INSPECTOR:
3/93:jt
I
III
WistonsinOepartmentofindustry, PRIVATE SEWAGE SYSTEM County:
LaborandHumanRelations INSPECTION REPORT ST. CROIX
Safety and Buildings Division
(ATTACH TO PERMIT) Sanitary Permit No.:
GENERAL INFORMATION
Permit Holder's Name: ❑ City ❑ Village aTown of: State Pla o.:
ROETTGER, RICK x
04- prairie
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
O: d /J -Q Q.c1 ...J
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic , r Benchmark
Dosing 0,2 ao
Aeration Bldg. Sewer
Holding St / Ht Inlet
TANK SETBACK INFORMATION St/ Ht Outlet g 3
Vent
TANK TO P/ L WELL BLDG. AirIto ntake ROAD Dt Inlet
Air
Septic NA Dt Bottom
Dosing NA Header/Man. Of 17_2 Ll'
Aeration NA Dist. Pipe 01 '
Holding Bot. System 3~ .D I
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand '
iri mss, b. a y /Ub ,
Model Number GPM
TDH Lift Friction System TDH Ft
Loss Forcemain Length Dia. I f Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Tr nches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS D' DIMENSIONS
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
SETBACK
INFORMATION Type Of IlUe-d CHAMBER Moe Number:
System: 'lQp~ 'SU .r) ,4 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: Star Prairie.28.31.18W, SE, NW, Lot 2, 104th street
G'?
Plan revision required? ❑ Yes O No
Use other side for additional information. Qv o e F5-i t `eL't t ' o't_. 11~,
SBD-6710 (R 05/91) Date spe or's ignature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER: ,
i
,
SANITARY PERMIT APPLICATION Busafereaty u oand Bu f Building System!
ding Water 201 E. Washington Ave.
t In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969
Madison, WI 53707-7969
• Attach complete plans (to the county copy only) for the system, on paper not less County
than 8 112 x 11 inches in size. GAO/
• See reverse side for instructions for completing this application State Sanitary Permit_Number
The information you provide may be used by other government agency programs ❑ Check if revision to (previous application
[Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number
1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION
Property O Nam P ope ocation
D Ile- r" v4, S T , N, R Af(047
491 Property O is Mailing Address 101 Lot Number Block Number
oZ C
City, t to t Zip Code Phone Number Subdivision Name or CSM N tuber
II. TYPE F BUILDING: (check one) ❑ State Owned ❑ City Nearest Road
1-1 Public 1 or 2 Family Dwelling - No. of bedrooms ° vown o /lethO
III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s)
1 ❑ Apartment/ Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash
5 ❑ Hotel/ Motel 9 ❑ Office/ Factory 13 ❑ Other: specify
IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable)
A) 1. New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
-
System -------System - Tank Only _ ___Existing System Existing -----m
B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 Seepage Bed 21 ❑ Mound 30E] Specify Type 41 ❑ Holding Tank
12❑ Seepage Trench 22 ❑ In-Ground Pressure 42 Pit Privy
13 ❑ Seepage Pit 43 ❑ Vault Privy
14E] 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
'L.V Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ~g► Elevation
An - Feet . Feet
K
VII. TANK Ca
in gallons Total # of Prefab. Site Fiber- Exper.
INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App
New Exist in structed
Tanks Tanks
Septic Tank or Holding Tank / ❑ ❑ ❑ ❑ ❑
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.
t (Prin Plumb gnatufe: (No ps) MP/MPRSW No.: Business Phone Number:
Street, City, State, ZCode):
Y / DEPARTMENT USE ONLY
❑ Disapproved Sapitary Permit Fee (includes Groundwater MDate Issued Is ng Agent Signatur (No Stamps)
~V(
Approved ❑Owner Given Initial Surcharge Fee)
-
Adverse Determination / U
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SOD-6398 (R. 05/94) 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 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. Onside 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 line B if permit is for tank replacement, reconnection, or repair.
V. Type of system. Check appropriate box depending on system type.
VI. Absorption system information. Provide all information requested for numbers 1 through 7.
VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and
manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and
holding tanks for this system. Check experimental approval only if tanks received experimental product approval from
DILHR.
VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.L ,
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 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
I
1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can
effect groundwater.
The monies collected through these surcharges are used for monitoring groundwater contamination investigations
and establishment of standards.
PLAN
PROJECT/ G ~c.cy- ADDRESSX/Oo7
N/R/.W TOWN ~k r~s_COUNTY
MPRS Byron Bird Jr. 3318 DATE
BEDROOM_3 CLASS PERC_,ZZ7 CONVENTIONAL IN-GROU PRESSURE
CONVENTIONAL LIFT_ MOUND HOLDING TANK
SEPTIC TANK SIZE LIFT TANK SIZE
DOSE TANK SIZE HOLDING TANK SIZE _
ABSORPTION AREA 1405<1-
PERC RATE--30 BED SIZE
k& Benchmark V.R.P. Assume Elevation 100'
Location of Benchmark
H.R.P._
❑ Borehole Q Well Scale _ Feet
0 Perc Hole System Elevation
Uent
12"'
Grndp
TYPAR COVERING
2
12" 3' 4 sO 3' Q 3~
Sewer Rock
6"
1.2' .
Vz-
1,6
/;2~
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, DIVISION
LABOR AN P.O. BOX 76
HUMAN RELATIONS PERCOLATION TESTS (115) MADISON WI 53707
(H63.090) & Chapter 145.045)
LOCATION: SECTION: SHIP UNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME:
/4a .24 /T~/N/R/~ 1.
r to r r 40"
COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS:
Gro ~ v, ~ fibsyt / /o f1r ~ w ~ c.1 n• o .z ~GIJ y , Szl ° / 7
USE DATES OBSERVATIONS MADE 6 --2676_
NO. BEDRMS.: COMMERCIAL DESCRIPTION: II~~rr PROFILE DESCRIPTIONS: 1PERCOLATION TESTS:
Residence ;9New ❑Replace ,~c~
-a , /Z
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUI)ID: IN-GROUND-a URE: SYSTEM-ILMIS DING®NK: RECOMMENDED SYSTEM: ms UU L~{gs ~c U Os U J
If Percolation Tests are NOT required DESIGN RATE:
I If any portion of the tested area is in the
under s.H63.09(5)(b), indicate: -J J Floodplain, indicate Floodplain elevation: ~Q
/7 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 O SERVED (SEE ABBRV. ON BACK.)
~o - 5/ya2 -GO
D ,5~'i,J 020
11
B- od ao. vv v
B-3 6 ~7-,z ',0'r
B-
B-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER IAiOPWS AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH
P- . P-
P- i_
P-, 3
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.
SYSTEM ELEVATION
Glar~cx
1-4
al o- 1-
,
I ac
T
10
011ZI-~ t '
6 r Api
c.._.... ,.___....3 _ ..........i_ ' '1 , ~r ! + f 1 ~'XAfy 39'sin
'C9 A-
I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and fh 3,~specified7Administrative Code, and that the
data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON:
r'0 n k11-1
ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional):
(/c G Ilk, r r Gtlo /
CST SIGN TU E:
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 02/82) - OVER -
- 1
INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395
To be, a )mplete and ac<,urate soil test, your report must include;
1. C( legal description;
2. TI- ~>ction must clearly indicate whether this is a residence or commercial project;
MUM numbi I bedrooms or commercial use planned;
4, iew or rep 'nt system;
5. C the suit.._ r-cing boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL
O' ' :R SYSTEM A RULED OUT BASED ON SOIL CONDITIONS;
0. PLEASE use th itions shown here for writing profile descriptions and completing the plot plan;
7, h A LEGIE liagrarn accurately locating your test locations. Drawing to scale is preferred. A
~e sh--.,. rod it d^'
are vor i'7ark an I elevation reference point are clearl, --own, and are permanent;
B C date boxes o dates, names, addresses, flood plain percolation test exemp-
t;:
10. ! ( ich as flood p' in, elevationi) does not apply, place N.A. in the approl to box;
1 I . :ace your cur. it Ar+dress and your certification number;
12 lies and distrit: 7 re(JUm-l. ALL SOIL TESTS MUST BE FIL, F' ITH THE
LC .`'A)THORITY WITHIN DAYS OF COMPLETION.
ABBREVIATIONS FOR CERTIFIED SOIL TESTERS
Soil Separates and Textures Other Symbols
st _ ne (over 10") BR - Bedrock
col, - C 4bi., (3 - 10") SS Sandstone
gr _,vel (under 3") LS - Limestone
d HGW - High Grou
C .nd Perc - Percol 'ion
f ..nd W - Woll
Bldg - Bu''
Is - Loamy Sand > GreaThan
sl - dy Loam Less Than
*I f , -n Bn Brown
sit - Loam BI - Black
si - It Gy - Gray
cl y Loarn Y Yellow
scl -:y Clay Loam R - Red
sicl - lay Loam mot - Mottles
r Clay - with
C'ay fever, fine, fai,it
c - common, coarse
pI t nrnr Many, rnediurn
m - M,rck d - distinct
p prominent
HWL High wa',,
rneral soil textures surface w;
:'^quid waste disx>osal BM - Bench M
VRP - Vertical F point
TO THE OWNER:
This soil test report is the first step in securing a sanitary permit. The county or the Department may rectuest
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 authority in order to
obtain a permit. The sanitary permit must be obtained and posted prior to the start of any construction.
Y
STC-105
SEPTIC TANIfTENANCE AGREEMENT
St. Croix County
f 21,,p OVVNER/BUYER
MAILING ADDRESS
PROPERTY ADDRESS
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE%/~ GLr G/l S~ c~/ 7
G s2 R W
PROPERTY LOCATION ~ 1/4, !<1/4, Section T~~ N- ,
TOWN OF ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMBER
CERTIFIED SURVEY MAP *11~VOLUME PAGE , LOT NUMBER
Improper use and maintenance ofd-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,..
StN ED:
DATE: > ! ~l f 9 S
St. Croix County Zoning Office '
Government Center
1101 Carmichael Road
Hudson, WI 54016<` 11/93
This application form is to be completed in full and signed by the
owner(s) of the property being developed. Any inadequacies will
only result in delays of the permit issuance. Should this
development be intended for resale by owner/contractor, (spec
house), then a second form should be retained and completed when
the property is sold and submitted to this office with the
appropriate deed recording.
owner of property X C x- ~fJeJT'~ .r
Location of property =1/41/4, Section N-R.2 W
Township = rk Mailing address
4 /D 7sy
site
Address of
Subdivision name :~C /.e- Lot no.
Other homes on property? Yes_.Z__No
Previous owner of property (::~;i4 .E
Total size of property ~Q~ X.~ •
Total size of parcel Date parcel was created
Are all corners and lot lines identifiable? x _Yes No
Is this property being developed for (spec house)? Yes No
Volume 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 THg. 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 sments on this form are true ',-o 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. *_,f:-046 l 6 . , 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.
Signature of Applicant Co-Applicant
1/Aq s
Date of Signature Date of Signature
FILF'10
OCT 161992► 4
O JAMES O'CONNELL S
Registsr of Deeds
490116 6 SL Crok Co., W1
CERTIFIED SURVEY MAP -4
LOCATED IN THE SEI
OF THE NW,'- AND THE NEI OF THE SWI OF SECTION 28, T31N, R18W,
4 4 4
TOWN OF STAR PRAIRIE, ST. CROIX COUNTY, WISCONSIN.
OWNED BY: SURVEYED BY: SCALE: III = 200'
Charles Borgstrom A & E Land Surveying
1951 104th St. P.O. Box 325 200 loo 0 2,00
New Richmond, Wi. 54017 New Richmond, Wi. 54017
LEGEND
• 1" Iron Pipe Found
0 Set 1" x 24" Iron Pipe weighing 1.68 LBS per linear foot.
S51°4P 56 E
-70.21 _S64014'01"E
\ \ 120.86' N1/4 CORNER
00 i- N SECTION 28. T31N, R18W
N _N25045'59"E A~ ALUMINUM CAP IN CONCRETE
cF 17.00'
Irn _N72°,45'07"E TF
10 IN Im z tW0 O sFT q \~\00
~ RAINAi .ry1YA c
IN ~ o w / ~N g _ \ S3404T'35'E
o - A 0 N -
ID LOT I -4k LOT 2 127.46
1-i 0 )0 y -
o ~ \ z
, N
ZZ-4> Im'^ O M ' Jm
O O = N 1 V) \
O M m to
_ 3 S880 47'00" W S 88° 47' 00"W
N
(n a o -4 445.00 2 505.71 I _
'z
Acom-------~ EAST WEST N~° I/4 LINE_ _ I o
rn LOT 4 N~~ LOT 3 4.
avN p .A
O ~ 38.86'•; • ` 'f
z m'n S88°47'00"W
M
y m
Co 1C 375.00 S31059'16" W 1
M 1Z 301.60' /.9' ,i
n 204.87 305.13'
y y v I-p gI S88047' 00" W 865.52' as 1.02'
Jr- yl i NE CORNER! OT
0 7
o -I /
m~ RED PINE ESTATES /ss N
Io zI LOT 6 i LOT 7 LOT 3 0
I A I I m
ID m n I S 1/4 CORNER
IZ caI SECTION 28
E T31N, R18W
10 51 3" X 6' IRON PIPE
I(n
Radius Central Angle Arc Length Chord Bearing Chord Length
curve 1 600.01' 12°27'05" 130.391 S58°00'28.5"E 130.14'
curve 2 total 388.28' 43°00'52" 291.50' S85°44'27"E 284.70'
Lot 1 388.28' 25°17'18" 171.37' S76°52'40"E 169.99'
Lot 2 388.28' 17°43'34" 120.13' N81°36'54"E 119.65'
curve 3 253.ti4' 72°27'18" 320.75' S71°01'14"E 299.80'
curve 4 total `1i'';•''11 66°46'51" 244.46' S01°24'09.5"E 230:,:j(I
Lot 2 74' 15°01' 02" 54.97' S27°17' 04"E 54.82'
Lot 3 209.74' 51°45' 49" 189.49' S06°06' 21.5"W 183.11'
i'r6ilillfiif/b/
Tangent Bearings Curve 1 S51°46' 56"E S64°14' 01"E SGoN
Tangent Bearings Curve 2 S64°14' 01"E N72°45' 07"E 4-
Tangent sl~B~~z S`/~y~i'
Tangent Bearings Curve 3 N72°45'07"E S34°47'35"E
Tangent Bearings Curve 4 S34 47135"E S31°59'16"W RONALD F.
Y JO SON •
Area of Lot 1 - 138,130 Sq. ft. (3.17 acres) Ar, ^Y.
Area of Lot 2 - 107,902 S ft. (2.48 acres)
Area of Lot 3 - 98,371 Sq. ft. (2.26 acres) w a t°~ ,.10
Area of Lot 4 - 163,184 Sq. ft. (3.75 acres) BUR'
-2- Ile C
VOLUME 9 PAGE 255 ra a '''s,;x, ->gi~+xAt
This instrument was drafted by Douglas Zahler VOLUII 5
~ Y
7
State Bar of Wisconsin Form 2 - 1982
WARRANTY DEED
~M REGIST'ER'S OFFICE
DOCUMENT NO. VOL 1148PAGE 496
ST CROIX CO., WI
Redd for Record
Charles B. Borgstrom and Kathleen A. Borgstrom, NOV 1 0 1995
us an an wire,
at 11:30 A. M
conveys and warrants to Ricky Roettger Register of Deeds
THIS SPACE RESERVED FOR RECORDING DATA
NAME AND RETURN ADDRESS
the following described real estate in t. Croix
County, State of Wisconsin:
T At~aSFER (Parcel Identification Number)
Part of SE1/4 of NW1/4 of Section 28, Township 31 North, Range 18 West, St. Croix
County, Wisconsin, described as follows: Lot 2 of Certified Survey Map filed
October 16, 1992, in Vol. "9", Page 2554, Doc. No. 490116.
This is not homestead property.
M (is not)
Exception to warranties: Easements, restrictions and rights-of-way of record, if any.
Dated this J~ day of November
(SEAL) EAL)
Charles B. Borgstrom t K thleen A. Borgstrom
(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN
ss.
St. Croix County.
authenticated this day of 19 Personally came before me this day of
November , 19-95 the above named
Charles B Borgstrom and Kathleen A
Burgs rom, husband and wife, _
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not,
authorized by §706.06, Wis. Stats.) to me known to be the persons who executed the
f re o' g instrume nd acknow e e the same.
THIS INSTRUMENT WAS DRAFTED BY I S
Kristina Ogland Notary public
Attorney at Law Notary Public ounty, Wis.
(Signatures may be authenticated or acknowledged. Both are not My commission is permanent. (If not, state expiration date:
necessary.) ~7- -'19 $x.)
*Names of persons signing in any capacity should be typed or printed below their signatures. ` J
WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc.
FORM No. 2 - 1982 Milwaukee. Wis.