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STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER
ADDRESS
~.N,re ~ T .S S
SUBDIVISION / CSM#
LOT ~
SECTION G T_2LN_R Z W, Town of xog,;~,~
d S/- Tr+
ST. CROIX COUNTY, WISCONSIN
PLAN VIER
S EVERY RING WITHIN 100 FEET OF SYSTEM
~,~Nk~`
N", pp~
O.i r
f
A +
C 1
N-I
Wit..
k j
IND] CATS tdORT,i AJRPO~d
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole coves
I
BENCHMARK:
ALTERNATE BM:
S b Na
SEPTIC TANKPUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: Liquid Capacity: J
r
Setback from: Well O , House Other
Pump: Manufacturer Model# Size
Float seperation Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
Width: Length Number of trenches
Distance & Direction to nearest prop. line:
Setback from: well:_ House_Y~T_ Other
ELEVATIONS
Building Sewer ST Inlet. ST outlet
PC inlet
PC bottom Pump Off
Header/Manifold Bottom of system
Existing Grade Final grade
DATE OF INSTALLATION: _-GJ
PLUMBER ON JOB: /A JAC
LICENSE NUMBER:
INSPECTOR:
3/93:jt
BENCHMARK:
ALTERNATE BM:
SEPTIC TANKPUMP CHAMBER / HOLDING TANK INFORMATION J
ManufacturerLiquid Capacity:
Setback from: Well &O, House Other
Pump: Manufacturer Model# Size
Float seperation Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
Width: Length Number of trenches
Distance & Direction to nearest prop. line:
Setback from: well:- H.ouse~_ Other
ELEVATIONS
Building Sewer ST Inlet. ST outlet
PC inlet PC bottom Pump Off
Header/Manifold Bottom of system
Existing Grade Final grade
DATE OF INSTALLATION:
PLUMBER ON JOB: - ~
LICENSE NUMBER:
INSPECTOR: t
3/93:jt
Wiscons*4 Department of Industry, PRIVATE SEWAGE SYSTEM County:
Labor and Human Relations INSPECTION REPORT ST. CROIX
• Safety and Buildings Division
(ATTACH TO PERMIT) Sanitary Permit No.:
GENERAL INFORMATION
Pelr]1it gf's N3~rIe~ID ❑ City ❑ Village Town of: State Plan o.:
Alp CST BM Elev.: UAA Insp. BM Elev.: Desch on: Parcel Tax No.:
TANK INFORMATION ELEVATION DATA s~ S
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
Dosi t L{ _ ~J - /Gd ~Qd
Aeration Bldg. Sewer S. O~ 90, 33
H
91 -
9 St/,W Inlet 17' TANK SETBACK INFORMATION St/X Outlet
TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic 3 3 NA Dt Bottom
4=441
A Header-! 071 , (Ql0
Dosin
Aeration NA Dist. Pipe :5
(}7'~ 77~ /
g But. System
Holdin
PUMP/ SIPHON INFORMATION rade " 3, 50~ ~o?, 013
Manufac mand
Model Number TDH Lift F ' Ion System Force Length Dia. ZM
- SOIL ABSORPTION SYSTEM
BED/TRENCH Width , Lengt No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS °2~ DIMEN I N
SETBACK Manufacturer:
SYSTEM TO P/L BLDG LAKE/STREAM LEACHING
WELL
INFORMATION Type O /(mot' ! 3 CHAMBER Model Number:
System:Lvo: kd -/O Ld OR UNIT
DISTRIBUTION SYSTEM
Header / Manifold Distribution Pipe(s) „ x Hole Size x Hole Spacing Vent To Air Intake
i
Length Dia Length SZ i 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.29.3,1.18W, NE, NE, L04,-,2, 198th Avenue _
O / (1~f.3'°, ,~7. c. y..n Q r c i~ rte ",e '
r l
~ 1 tom' !il c~~, . • _~-r ~.C. 'a i
Plan revision required? ❑ Yes &*o
Use other side for additional information. ~p
Cert. No.
SBD-6710 (R 05/91) Date Inspector's Signa we
SANITARY PERMIT APPLICATION
i:■+ COUNTY
v'■~■'■■~ In accord with ILHR 83.05, Wis. Adm. Code ~~z
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than ❑ as 3
8~i~t X 11 Inches in size. Check if revision 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
'/a '/4, S T , N, R (or&
PROPERTY OWNER'S MAILING ,AD RESS OT # BLOCK #
CI STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
I'dt -7 -
11. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD
❑ State Owned O VILLAGE :
❑ Public M 1 or 2 Fam. Dwelling-# of bedrooms PARCEL TAX NUMBER(
III. BUILDING USE: (If building type is public, check all that apply) /per
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.,0 New 2.E] Replacement 3. El Replacement of 4.E] Reconnection of 5. ❑ 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 M 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 ./i ch) ELEVATION
a/ ~
Feet Feet
VII. TANK CAPACITY Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION New xistin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
Septic Tank or Holdin Tank
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.
Plumber s Name (Print): Plumbe 's Si ature: ( o s ) MP/MPRSW No.: Business Phone Number:
2 9
lu ber' Ad ress (Street, City, State, Zip C e):
IX. COUNTY DEPARTMENT USE ONLY
X❑ Disapproved Sapary Permit Fee (Includes Groundwater Date Issued issuing ent Signa re (No S ps)
Approved ❑ Owner Given Initial Surcharge Fee)
Adverse Determination v
X. CONDITIONS OF APPROVALIREASONS FOR DISAPPROVAL:
SBD-6398(R.08/93) 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 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:
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.
111. 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)
/ ~~a soh 3
41,
is-~-
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a
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ds~ y<
Are s
"VII W~
.125 4
/4J
I
PAGE OF
CrUSS Sec~Iun C I ieO Syster
Fresh Air Inlels And Observation Pipe
APprovsd Vent Cap
Minlmum 12" Above
Final Grade
20- 42" Above Pipe -4" Cast Iron
To Final Grad• Vent Pipe
marsh May Or Synthetic Covering
min 2" A
over ggregale
Pipe
Olsrrlbullon - Tee
pips 0 0 0 0 0
6" Aggregate
ft
'a o Perforated Pipe Below
Bensat Pipe
0 -Coupling Terminating At
Bottom Of System
PrUPOSe~ t'tnkl qr~,~1<
~icJ•. ton
SOIL. FILL
DISTRIBUTIOI.I PIPE
APPROVED SJWPETIC COVER
tl - MATRRIAI- OR 9" OF STRAW
Z" OF AbGR EGA-IF. OR f jARSN MAy
(o>0F12-Z1/Z A G G R E GAT E
V-L E V. O F& .C FEET-_ e ~
DI-S-1-11IatUTIOU PIPE TU BE AT LEAST INCHES BELOW ORIGINAL GRADE
AtJ(J AT
LEAS720 INGHE- BUT 1.10 MORE THAN 42 RICHES BELOW FINAL GRADE.
MAXIMUM DEPTH OF FXCAVATIO►.➢ IF'gol'1 OKIGYJAI 6KAoF- WILL BE INCHES
MINIMUM ®Ef" of EACAVATION FROM. ciiR\I(,IW iL GRapf- WILL BE iNCNES
s IGUEO:
LICENSE. NUMBER:
a DATE:
Wisconsin Department of Industry, SOIL AND SITE E V A L U AT I O N REPORT Page of
Labor and Human Relations
Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
' COUNTY )
" .J
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 (BM), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPE TY OWNER: PROPERTY LOCATION
GOVT. LOT 1/4 1/4,S T N,R e(ora
PROP TY OWNER':S MAILING ADDRESS LOT # BLO K # SUED. NAME OR CSM #
CITY STATE ZIP CODE PHONE NUMBER ❑CITY ILLAGE ~f W NEAREST ROAD
New Construction Use [)CJ Residential / Number of bedrooms [ ] Addition to existing building
j ] Replacement [ ] Public or commercial describe
Code derived daily flow gpd Recommended design loading rate bed, gpd/ft2yS trench, gpd/ft2
Absorption area required "ZJ~2 bed, ft2 Z;~-? trench, ft2 Maximum design loading rate 1~bed, gpd/ft2_trench, gpd/ft2
Recommended infiltration surface elevation(s) &"5 It (as referred to site plan benchmark)
Additional design / site considerations
Parent material Z2 2!~'L o Flood plain elevation, if applicable _2~ ft
rU =Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
=Unsuitable fors stem ®S ❑U 1ZS ❑U S ❑ U 1?1 S❑ U ❑ S Ea U ❑ S U
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
Boring # Horizon in. Munsell Qu. Sz. Copt Color Gr. Sz. Sh. Bed Trepdi
7
Ground
elev.
ft. - -
Depth to
limiting
factor
a 2`L
Remarks:
Boring #
A,
Ground
elev. - g
RZ:f ft.
Depth to
limiting
factor
Remarks:
CST Name:-Please Print Phone:
Address: 2
Signature: Date: CST Number:
PROPERTY OWNERZ21J,',2 4°a SOIL DESCRIPTION REPORT Page,=~?, 6f 3
PARCEL I.D. #
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourxiary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends
Ground
elev.
Q ft. -
Depth to
limiting
factor
Remarks:
Boring #
17
Ground
elev.
&gQ ft. `
Depth to
limiting
factor
Remarks:
Boring # 511
Ground
elev.
8&lZ ft :je- 9K) 42 e4~1~ 44
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(R.05/92)
PROPERTYOWNER SOIL DESCRIPTION REPORT Page,=~? of3'
PARCEL I.D. #
Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
(L(v2:''• :fie
ti~• h~i:
Ground 1/7-61 . "-J Z11 7 e?
elev.
-22Qft' -
Depth to
limiting
factor
Remarks:
Boring #
'2 Le- Z.4/,
Ground
elev. - -
Depth to
limiting
factor
Remarks:
Boring #
hS:
v Fv'nitii~:}
n 7 y
Ground
elev.
~Q ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(R.05/92)
l 7~6 ~SG!t~ 58~
\ i1 _
la,
325',/
~L Vic} )O lk
CERTIFIED SURVEY MAP
LOCATED IN THE NE V4 OF THE NE 1/4 Of Section 29, IMN, R18W, Town i
OF STAR PRAIRIE, ST, CROIX COUNTY, WISCONSIN.
/ LEGEND
BEARINGS ARE REFERENCED TO ST. CROIX CO. SECTION CORNER MONUMENT
THE EAST LINE OF THE' NE 1/4 9 FOUND 2" IRON PIPE
ASSUMED TO BEAR S00. 22'27"W.
NOO•I?'27"E O SET I" X 24" IRON PIPE WEIGHING 1.68LBS/LIN. FT.
SCALE I" - • 150'' • 41.97
D TQ
so p 150/ / A mN( UNPLATTED LANDS
as
mcnml~o
to ~ / I N .
m (4
<0 --628.73'--....-----
o ° - - N00° 12127"E 562.72 - - '
m d' 6.00 496.72 66jrn
r WEST LINE OF THE NE 1/4 OF THE NE 1/4 N~Z N 0A0 N WI
-i p row . r N z W
m m hl O w 0 - A Q i to I -4
n tD m p
D $ In
a 0 my O AO
A 0 -i m°D rn
Q in o
m m y y"n J m
m 0 m :4 = 1
031 m
BIB.
1 1Q
W~ ~J.0 ~,v A W W :p I
Qo w ° a 3 o w o~ O co I 3 a to la
re N. r~~i N N IC pay $~O 0H L.11 a~ CID Iz
N m Iz W m m Q y 0 m O f71 O 1-0
fD N I.0 w 10:1 O rn N p W (A If
R+ it m 71 8-4 y 1 I I ~ 11 ID
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C7 0. m m W Im
0 fTI 10
0. m : 1 N0OOI I. " to Ir
o N I i8:fl!" 3.81.78' ' til I D
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t y ao m
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aIi m r= 14-40 co N
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0 14
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L, (A y o m° p l
rh w bo I< I m I N o
10 i ri fmD N N• I
h l W 1
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14 z
c 86' 111 N00022'27"E 556.58' ' 0D C 1
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G O {Np 130.94' 425.64' I !4 r
fb rt W tr i x I V I A
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i
33' 133' I
REC. AS 12 o:as ° 240.42' ; 554.57' '
124 .16 1 318.91' 235.66' 66.01 620.58'
EAS LINE 0 NE I/4 S00°22 27 W 620'.58
m CENTE$LINE _
-4 (6 --10 z
Z 0 4 R D j 1001-1 -~TE3EFTT _ -0~
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30 P LU E. I C. S. M_ VOL. 4-, P G_ 1014 :0 ° m
z
z ;u N~ ESTATES I sheet 1 of 2 N~
THIS INSTRUMENT DRAFTED BY DOUGLAS 2AHLER.
I
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER DAJ m' C) ~2 . t; R 6 c 1-\ r
MAILING ADDRESS-_ •0. 9c-x_ 3L Ar, ncr w i c~ s SS~O S
PROPERTY ADDRESS ( ►q .jH u4 . SOME Z.S L_ r cv p, _
5~ ~ S
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE
PROPERTY LOCATION J_ 1/4, }\i 1/4, Section- 1 T-3 I N-R ) W
TOWN OF SI-110- RJZ ; fzi ST. CROIX COUNTY, WI
SUBDIVISION_ 4j N i, LOT NUMBER
CERTI PIEDSURVEY MAP _X~ VOLUME /Gy?, PAGE 3L LOT NUMBER `Z
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.
SIGNED:
DATE:
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
S T C - 100
This application form is to be completed in full'and signed by the
owner(s) of the property being developed. Any inadequacies will
only result in delays of the permit issuance. Should this
development be intended for resale by owner/contractor, (spec
house), then a second form should be retained and completed when
the property is sold and submitted to this office with the
appropriate deed recording.
Owner of property `AV' p 6„ f32ac
Location of property NE 1/4 N6 1/4, Section :X9 T31 N-R 1k W
Township S*I fVR ~il6t2 Mailing address
Address of site x x )y?' ry Avg --~ryO Z
Subdivision name IVO/J~ Lot no.
Other homes on property? Yes No
Previous owner of property Ct oq('ct.S }~tlr~, Si'?ZD
Total size of property f}r~ G 5
Total size of parcel $ Rcrza&
Date parcel was created Oct 3
Are all corners and lot lines identifiable? Yes No
Is this property being developed for (spec house)? Yes No
volume )0q 59' and Page Number S%E as recorded with the Register
of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE
NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a
certified survey, if available, would be helpful so as to avoid
delays of the reviewing process. If the deed description
references to a Certified Survey Map, the Certified Survey Map
shall also be required.
PROPERTY OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the
best of my (our) knowledge that I (we) am (are) the owner(s) of the
property described in this information form, by virtue of a
warranty deed recorded in the office of the County Register of
Deeds as Document No. S'O?3, "7°i , 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
'/-5 - q:5
Date of Signature Date of Signature
f
RM 1 -1982, !I THIS SPACE RESERVED FOR RECORDING DATA
DOCUMENT NO. !;,;STATE BAR OF WISCONS eED
r WARRANTY
st. l ~a~ix COFFICE
_ WI
R'ec'd for Record
This Deed, made between
Charles __H Borgstrom__ and.__Dolores___Borgstrom..a/k/~
Dolores S Bor-g --s--t---rom NOY~, 2 1993
I. ~ husband and wife
- a)
Gra ntor, I' 11 :00 AA
~I Grantor, i
p:--•------- ------g-------......................................
and-.---- Dav1:d..R._ Brat,__.a._.sin le_ erson
IM7 RspTq Des*
-
j'
I Grantee, j
Y
Witnesseth That the said Grantor, for a valuable conslderation------ t~iiTHWEST SAVINGS BAN
- -
;I -532 S, KNOWC€~ i
conveys to Grantee the following described real estate in St..___ Cr0-1X ~I MNEWRICHMONI),W1 SQ11`
County, State of Wisconsin: lI
i.
Part of NE 1/4 of NE i/4 of Section 29, Township 31 North, Range 18
ii West, St. Croix County, Wisconsin, described as follows: Lot 2 of i
Certified Survey Map filed April 9, 1993 in Vol. 9, Page 2607, Doc. j
No. 497224.
i~
AND a parcel of located in part of the SE 1/4 of the NE 1/4 of Section
29, Township 31 North, Range 18 West, Town of Star Prairie, St. Croix
County, Wisconsin, described as follows:
Beginning at the SE corner of Lot 2'of Certified Survey Map, Vol. 9,
Page 2607 as recorded in the Office of the St. Croix County Register
of Deeds; thence along the south end of said Lot 2, also being the
ij north line of said SE 1/4 of the NE 1/4, N 89.19106"W 325.16 feet
to the SW corner of said Lot 2; thence on a line bearing S00.12'27"W
j to the thread of the Apple River; thence Easterly along said thread
of the Apple River to a point which bears S00.17127"W from the point of
beginning; thence N00.1712711E to the point of beginning.
j
N
is not
This homestead property. ,s?! 7
(is) (is no,
r rr~
EL-2
Together with all and singular the hereditaments and appurtenances thereunto belonging;
And....... easements,___restrietions___and__right_S-Of-way--Of__reCOrd,____if___any.
warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except (j
k easements, restrictions and rights-of-way of record, if any. ii
!
I
I
! and will warrant and defend the same.
! Dated this O day of ..November 19.93
,00
--.._(SEAL) (SEAL)
li~
! Charles H. Borgstrom * Dolores Borgstr m a/k/a
-
Dolores S. Borgstrom
(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
S ature(s) Charles H. Borgstrom, STATE OF
i WISCONSIN
Dolores Borgstrom a/k/a Dolores Sg
County.
authenticated this 0 November 93 '
.day of___________________________ 19______ Personally came before me this day of
19---- the above named
Kristi a Ogland
*
-
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not- authorized by § 706.06, Wis. Stats.) to me known to be the person who executed the
foregoing instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY
Kristina Ogland
A-ttorriey at Law------------------------------
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.
46
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Y Parcel 038-1114-10-250 03/31/2005 09:23 AM
PAGE 1 OF 1
Alt. Parcel 29.31.18.483C-20 038 - TOWN OF STAR PRAIRIE
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
* BRACHT, DAVID R
DAVID R BRACHT
985 198TH ST ( e~
SOMERSET WI 54025 ~j~
Districts: SC = School SP = Special Property Address(es): ]=mary,\~ Type
Dist # Description SC 5432 SCH D OF SOMERSET SP 1700 WITC LID ALk 7
r
Legal Description: Acres: 2.740 Plat: 1255-CSM 15/4073
SEC 29 T31N R18W E1/2 NE1/4 FORMERLY PT Block/Condo Bldg: LOT 6
A:
F LOT 2 CSM 9/2607 NKA LOT 6
O
15/4073 (EZ-U-1145144 Tract(s): (Sec-Twn-Rng 40 1/4 1601/4)
29-31N-18W NE
Notes: Parcel History:
Date Doc # Vol/Page Type
07/16/2004 768970 2617/614 QC
07/23/1997 1048/368 WD
2004 SUMMARY Bill M Fair Market Value: Assessed with:
30559 320,400
Valuations: Last Changed: 10/14/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.740 108,000 226,600 334,600 NO
Totals for 2004:
General Property 2.740 108,000 226,600 334,600
Woodland 0.000 0 0
Totals for 2003:
General Property 2.740 56,200 187,000 243,200
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M 568
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
9
5
ic 2041 >o
Ap w MAY 14 2001 G43G24
~C ob~~0"'M y~
CER bAIMUSUBNEY MAP
OWNER
~ o UJ LOCATED IN THE NE1A OF THE NE1/4 AND PART OF DAVE BRACHT
O O N 985 198TH AVE.
o co N THE SE-1/4 OF THE NE1/4 OF SECTION 29, T31 N, R18W, SOMERSET, WI 54025
W o o TOWN OF STAR PRAIRIE, ST. CROIX COUNTY,
Cl - m WISCONSIN. ALSO BEING LOT 2 OF CERTIFIED SURVEY
w w M MAP IN VOLUME 9, PAGE 2607. NE CORNER
ir= O SECTION 29
W LL r) p~4 0IF @@umuau dodom ` n A
LL r) W r- 0) OD
0
C7ZCD \ NN N
N O
J
Q O (O
(S88°57'53"E 389.53 N88 59'19"W co
o- co -N - - N88°59'19"W 389.32' 60 . '
e, 188.18' 3 -
6- 0
00
L6 (9
(D S SO 66.00' 39.11' 1 pGCES O~ME G ' _ rn
- - - ~
2.t8 U
N88059' 9"W R= 80
161 9'
i
't , ~ A
LOT 5 ~0j ` 0g o
N 1.500 ACRES M 1Z
65,340 SO FT
` C\j EXC. EASEMENT cOn ~ ~ 0 ~ c~
(p 1.286 ACRES j i ~Q LI ` r
1 ~f ~ 55,997 SO FT CO n W
11 r
W
BENCH MARK i i W 0
f N O 1"IRON PIPE i N W u-
EV.875.68 1 N W
° O
r N88°32'00"W 168.84' 1 r
c Z Z
0 W
/ LOT 6 O
Y z
TO MEANDER LINE O
O 2.740 ACRES EXISTIN SEPTIC
ro 119,374 SO FT HOUSE
® r
LO cr)
co
N TO O.H.W.M. WELL - Co
3.17 ACRES
138,176 SO FT+\-
75' SETBACK , . •\NE ~,179+\ N N
FROM HIGH - /M,p,O. I'S ER !1a~ 3t3 201 ag3 Op _ o
r °NN
WATER MARK i i 05 1,160 3 \N E\'v" 0
N? 1t8~13 \~OOID'P SOUTH LINE OF THE
- --E1/40FTHENEI/4
r~ E1/4 CORNER
p pQ ' J SECTION 29
THREAD OF RIVER LEGEND
ALUMINUM COUNTY SECTION CORNER
MAMS Dp o MONUMENT FOUND
ST. CROIX COUNTY 1" IRON PIPE FOUND
Planning Zoning and Parks Committee
O 1"X 24' IRON PIPE SET WEIGHING
APR 2 5 2001 1. 13 LBS. PER LINEAR FOOT
- - ' - ' - 50' ROADWAY SETBACK LINE
If not recorded within 30 days of (N88055'23"E 254.87) PREVIOUSLY RECORDED MEASUREMENT
Sgt;m sl~tJ,be 100. • 2" IRON PIPE FOUND
1 O.H.W.M. ORDINARY HIGH WATER MARK AS VERIFIED
100 0 iia 100 BY ST. CROIX COUNTY ZONING OFFICE
ELEV. 860.50
DRAFTED BY: KEVIN REED JOB NO. 00-94 DATE: 12/22/00 REVISED 2/22/01
Vol. 15 Page 4073
I
I
ST. CROIX COUNTY
WISCONSIN
- ZONING OFFICE
r x r x x r x r .orni ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
` - Hudson, WI 54016-7710
(715) 386-4680
June 27, 1995
Hartman Homes
P.O. Box 326
Somerset, Wisconsin 54025
ATTN: Becky
RE: Septic Inspection for Property Located at
985 198th Avenue, Somerset, Wisconsin
Dear Becky:
An inspection of the septic system for the above address was
conducted on June 15, 1995. This property is located in the NE, of
the NE; of Section 29, T31N-R18W, Lot 2, Town of Star Prairie, St.
Croix County, Wisconsin. At the time of the inspection, this
septic system was found to be code compliant for a three (3)
bedroom home. Should you have any questions, please do not
hesitate in contacting our office.
incer ly,
e .7T h pson- ~
Assistant Zoning Administrator
St. Croix County, Wisconsin
mz
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