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HomeMy WebLinkAbout040-1033-10-000 o . p v M ~ ~ I RY 0 ~ Cn I o ~ o x I N LO ~ t I C N d I O ~ o"i c N U 0 O a-:2 N ~ a Y~ I o w Cj z o LL 0 N O m N U °o 0 I 3 ~ I a CD Z w 00 I Z d I m 00 U) a m I o z C: a~i Z ° c m f- m o a I '0 0) I `r+U .N CL ~ I v°'i N o 0 o I •~l d L t •N .U O N C : o N I O o < Z H Z Z Z C> y N ' LO 4) 0 E N _O E ;w N O O CL It CL M d - 2 O C) L d w 1 c o a E z r-- >o (n U) (n :E 3 ~~vv o cn 0 0 0 n F- 0 -0 a (L a FL = 3 c) N `U G) N 0 to J U 0 rn rn } I 'V o a I 04 > Y E o CL _0 ai -o m a~i rn o v~ m Q ~ o I O O H C O i+ O Q 4- N U C C 7 n O' O O ❑ 0 w v0, U 0- aOj p ` w ch O (p C O O C 00 00 I Ci -CID S -C V 1 O~ aa) y N F" H C N cy=~,i O • O O N O Z N (n `D a #t a L a w • cet a d u m y c r'~1 E 0 C c 10 S T C - 10 4 r{ AS BUILT SANITARY SYSTEM REPORT g ,f k} 4% j;r'. . 1-k OWNER ADDRESS ~a ~ SUBDIVISION / CSM# 367,1 al /O,* LOT # 7 SECTION rI T Z* N-R /'7 W, Town of Tra ST. CROIX COUNTY, WISCONSIN 14 PLAN VIEW ' SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM - f o p o i l ya ~ & 3 - fo 1-1w S 5 k4-- 6 p p -f i~a c,~AtS ~j X • 03 ~ I 2~' • Y 12, C011*6' h N INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tangy; manhole cover. M BENCHMARK: / ~ t S e Gd/ GJI~c,• ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer. kJeek _I C. A Liquid Capacity: 1~-n Setback from: Well yo ' House Other Pump: Manufacturer 44 Model# Size Float seperation Gallons/cycle: Alarm Location -:SOIL ABSORPTION SYSTEM Width: j Length 75 Number of trenches Z Distance & Direction to nearest prop. line: Setback from: well: 63 House aG 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: /~fJ°l~SZ INSPECTOR: r"~Yal.ia►1, 3/93:jt I Wisconsin 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 Permit Holder's Name: ❑ City ❑ Village p Town of: State Pla RODEWALD, DEAN x CST BM Elev.: Insp. BM Elev.: BM Description: ~Z LL Parcel Tax No.: 6 1O(~. ~ C~cz ne Q.S /`2.~ 14 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic S C~ Benchmark Dosing Aeration Bldg. Sewer H St/ ,Jelnlet v~~ /d 5 Q TANK SETBACK INFORMATION St/ Outlet 5 atz"' JpSI TANK TO P/ L WELL BLDG. Aeintake ROAD Dt Inlet Septic A NA Dt Bottom 4 y- ~o~F3s~ r Dosing NA Header- S G' Aeration N Dist. Pipe 5/p/ o ding Bot. System 'U~~ ~a5 PUMP/ SIPHON INFORMATION Final Grade u acturer errand° Model Number G M TDH Lift Friction System Ft Loss ead Forcemain Length Dia. Fi Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length , No. Of Trenches PIT No. Of Pits Inside Dia. id Depth DIMENSIONS 75 Z DIMEN I SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACH anu acturer: SETBACK INFORMATION Type of BIER Model Numer: System: ! h 9F a / OR UNIT DISTRIBUTION SYSTEM Header / mefflfe'd / Distribution Pipe(s) Hole Size o e Spacing nt To Air Intake Length / Dia Length ~ Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or -Gra stems Only Depth Over Depth Over „ xx Depth xx Seede ded xx Mulched -Trench Center 3 - ry bedN-Trench Edges 3s1 Topsoil" ❑ Yes ❑ No Yes No COMMENTS: (Include code discrepancies, persons present, etc.).k/4s (3c~; ~4 LOCATION: Troy.7.28.19W, SE, SE, Lo 7, Cedar View Plan revision required? ❑ Yes 13-140 Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signat re Cert. No. 1 ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: - I SANITARY PERMIT APPLICATION Safety and Buildings Division Bureau of Building Water Systems 201 E. Washington Ave. 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 C than 8 112 x 11 inches in size. 5L • v ©1 • 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 it revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION Property Owner Name > Property Location 55 1/4 S £ 1/4, S T ZS3', N, R j k(or)(~) 4tQ6 Property Owner's Mailin Address, Lot Number Block Nunn r city, S ate Zip Code Phone NumJber Subdivis~i,pn Name or CSM Number 11. TYPE OF BUILDING: (check one) ❑ State Owned ❑ City Nearest Road ~ E] Village T j /e~ ❑ Public 1 or 2 Family Dwelling - No. of bedrooms Town of / -C-.) I/ 111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) D1/0 - 1433 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 12E] 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. IA New 2. ❑ Replacement 3. E] Replacement of 4_ E] Reconnection of 5. ❑ Repair of an ____System_________System_____________TankOnly______________ Existing System Existing System 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 11E] Seepage Bed 21 ❑ Mound 30E] Specify Type 41 ❑ Holding Tank 12,E Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 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 7:5,0 7 Feet %O Feet VII. TANK Capacity gallons Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Existing strutted Tanks Tanks , JJ Septic Tank or Holding Tank 6 44/Qe 1k ❑ ❑ ❑ ❑ ❑ 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. Plumb Name: (Print) Plumber's Signature: (No tamps) MP/MPRSW No_: Business Phone Number: 715'-772 -3 IV e .14111,11- Plumber' Address (Street, City, State, Zip Code): ~ Z IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved S itary Permit Fee (Includes Groundwater /ate Issued Issuing Ag nt S nature (N a ps) e. Surcharge Fee) c Approved I ❑ Owner Given Initial 9JYx M;90 / ~ Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-6398 (R. 05/94) DISTRIBUTION: Original to County, one copy To: Safety & Buildings Division, Owner, Plumber I INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe 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. 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 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. ll. 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 i. VII. Tank information. Fil! in the capacity of every new/or existing tank, list the total gallons nt,m oer of tanks and manufacturer's narr.e, indicate prefab or site constructed and tank material. Cc'-~iplete f -r ~ih septic, pump/siphon and holding tanks for this systern. Check experimental approval only if tanks receives experiment„I product approval from DLHR. VIII. Responsibility statement. Installing plumber is to fill in lame, license number kn,ith appropria`e :rrefix (e.g. NIP, etc.), address and phone number. Plumber must sign application form. IX. County / Department Use Only. X. County/ Department Use Only. C._.r.ole*t a < . ~ci ficat ~;rs nca smaler than 8 1;< x 1 1 inch ? _;;e s~;k,ittet) r}~:r:~;rty The plans must r<< ~i.f_`• ' _ I . i.:?i ll; Ai plot t 3n, Lirawn 20 SCale Or V/Ith COr 17iE"ti' . _r`S t±;' - ic~C '.IOr't )o ~C nC tank(s), septic t ;.;3nk a. f!ng sew'ers; wells, w_ C p.rmp or siphon ~7 3.I V1 ~f, sill <il3.-,Orr`i1c11?'i' `t _Orr replaceme(, 3. r':e Ludding Served; i)oints, i:~ CrF.:Jss sect'-On n r <<_ounw; i=) sc.: inforr,iauon. GROUNDWATER SURCHARGE 1983 VVls,onsin Act 410 included the creation of surcharges (fees) for a number ` lated F racti vvnich can effect groundwater_ T ?e n or _te tnrJU jh these •>urcharges are used for monitoring ruur~t v~<~+.er ontaml; rati~:r investigations a,),J es} i lr l ier of sjandl'rds. JOB ~lJGC4fi. ~LlS~ LlJQI TIMM EXCAVATING z Route 1 Box 192 SHEET NO. OF WILSON, WISCONSIN 54027 CALCULATED BY 'e" DATE (715) 772-3214 (715) 386-5443 MPRS #3224 WI MPCA #696 MN CHECKED BY DATE SCALE D ..........>...........s .....................j.............. 1 ..e~, ~e f~ j. To.. .1s.k»+... a a C~......... ' . X3.0 !a~..... 'O r l' ...4i r I........ I I I V _i ; . . 'jam J lam/ !/'o~C_._ PRODUCT 205-1 Inc., Groton, Mass. 01471. To Order PHONE TOLL FREE 1.800-225.6380 : J JOB d11~-n ~O ~L~ Lc/o~ TIMM EXCAVATING SHEET NO. l OF Route 1 Box 192 WILSON, WISCONSIN 54027 CALCULATED BY `e10 DATE (715) 772-3214 (715) 386-5443 MPRS #3224 WI MPCA #696 MN CHECKED BY DATE SCALE . i j l . J y. , ! PRODUCT 205-1 Inc., Groton, Mass. 01471. To Order PHONE TOLL FREE 1-800-215-6380 tLaro and Hun Relation~asby' SOIL AND SITE EVALUATION REPORT Pape I of 3 Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but 57. cRory, not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. i dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION J t M WA H 2 E-&3 B R o c-k GOVT. LOT S,` 1 /4 SF 1/4,S -7 T 2 9 N,R E (or) W PROPERTY OWNER•:S MAILING ADDRESS LOT # BLOCK # sUBD. NAME OR CSM # yo sa. fot?K Ci.PclE- 7 cs.A pGbof1 CITY, STATE ZIP CODE PHONE NUMMBER QCITY QVILIAGE [BrOWN NEAREST ROAD ffvOSc.v Gl,/~• SyotC. (Ir5)3~f1-18~5 TRoy So. Foek 3>R . ( New Construction Use [ Residential / Number of bedrooms y Addition to exis&V building j J Replacement Public or commercial describe Code derived daily flow gpd Recommended design loading rate • 7 bed, gpd$ • ? trench, gPd*2 Absorption area required Y S P bed, 0 7 50 trench, ft2 Maximum design loading rate • 7 bed, gpolft2 • trench, gpol;t - Recommended infiltration surface elevation(s) _ S.~ h 4 • 3 ft (as referred to site plan benchmark) Additional design / site considerations Parent erial 5c5 73 Pi/ o j" Flood plain elevation, if applicable off- it S - Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYS r IN FLL HOLDING T U = Unsuitable for system '1 ❑ U I~ ❑ U Q_S_ ❑ U Ll-S ❑ U ~ [~'S o u ❑ ~ L SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed tench 0- /0 V 3/2- sh't S c5 i jc_ y • S Ground /d /e S/ S. S ~:2 1 • elev. Gd 7.0 ft Depth to limiting factor 7 Remarks: Boring # 0-3- /b 372- S~ /ti►n ~S C S Z f S Aff &,e 7/( 15*5 /1 5 Ell E Ground 2C l If `f ~•S l~ `//Co S• S ~1C C S r 7 It. NJ Depth to limiting factor .i Remarks: CST Nane:-Please Print ROr~E[2 1AL13R C 14T- Phone: 713': 3 S06 o6>1,? .15- Address: 5 5 O' Av i I p. H vpS o 4>/. S516iG CST.y 2 SIP2_ Signature: Date: CST Number: If ORIGINAL ilt$ t6st s~te,~PRavEo T for a ~nven s~e~ $yo i PROPEMYOWNER SOIL DESCRIPTION REPORT page .2 d PARCEL I.D. 0 Lo r i~' 7 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bw d3y Roots GPD/ft in. Munseil Qu. Sz. Cont Color Gr. Sz. Sh. Bed each 3 13, x-20 /o y 3/2 /7 SA& S lu f Y .5 Ground /32 o 3 /D /f '5A( fi ' G's S elev. It. 2 C- ?.2 7 5 ye Sir Depth to limiting factor~y,1 ry t Remarks: Boring # yie ~I O~P~r~t ~/G Si,/ 2 f S~i~ iw► f~~ ~S O 0-/o /0 13, o /oy,~ 3iZ s,/ l7-^5,.e /Ju ~.f s y s Ground 13i 30 /a rX y S, /7GS`J!< /M 7f i • S y . 55 elev. /3 - 3G 7• S Yid y G 5 ~~y, de C' S .R ZIL ~C to- o •5 y~ s• O, S 7' 9 Depth to limiting (actor Remarks: Boring # _ /oyiP L/t fsX*- /f r 1 st 4" Ground 13 ~'lo /Gl,e 1 /7-' 50- elev. f3 ~0-4 ~S al,(7 Z'5 7 , /07.7 IL' s O, s eS - 7 = , p Depth to 2 c' ~-36 75 M 14!k v limiting 2C2. yf 51 4v, V. factor Z-:~4- Remarks: Boring # M. i 'y i Ground € elev. ft. Depth to limiting factor Remarks: . eon oo~nio nclnn% wa.v ~ 3 a4 y* 'y.+i' 'so ~~Es ~t o sysre uh rI'oA3 5 103.0 I I Scare l yon I • _ /3~cKtia~ p/•rs ,voa d /o r 3 G.s' LoT-7 00 N 8,; 8z V 0 v. W I10 /3g /2L I /4j ~y so~t~ to T- . yon. sy, 0 ~3M s rap o~ sv,P~~yo/Ps AT s nor CoRN~p. ~/~v4r/o.✓ /oo•o 9 FALE® tp NOV'2 2 1994•• 5236'76 CG J ReglfOf~pe dsLL CERTIFIED SURVEY MAP /U JAMES AND GLORIA WAHRENBROCK Part of the Southeast 114 of the Southeast 114 and the Southwest 114 of the Southeast 114 of Section 7, Township 28 North, Range 19 West, Town of Troy, St. Croix County, Wisconsin. -r•--~-- Indicates fence. *Indicates 1" iron pipe found. O Indicates 1" x 24" iron pipe weighing 1.13 lbs./ 1eIndicates 2" iron pipe found. lin. ft. set. 2 NORTH L/NE OF SOUTH 112 SE 114 UNPLATTED LANDS W S "E //66.19' R/ 1/66.7/'/ J (66. J65. 28 ' - - - - O 734.88' I BOO. 9 / I S 0/ ' 00' 00 "E 73.76" h NO/•00,0AW,, I pI 75.66' @4 0 O ~ z 11661 7-go ~z v I TEMPORARY CUL -DE- SAC TO Be W iX 1 " ~I I O Q 2.480 ACRES REMOVED UPON ROAD EXTENSION O• / 3 I in 0 3 ~I ti o01 t„ ` i' t Op /08, 0/3 SO. FT. c JI 1SEE DETAIL FOR PLACEMENT p6 ` 0 1 I Q h, I O Q ;k k Q. Note: Unless the private Nh ~o i~ al 1 0 z l 3 driveway shown 5eomes a public i 3 s N e9. 2/'15"w 401, 43' by OC road Lot 6 must acce s ff South J v Fork Drive L 7~ 6 O 7 p0 ,L 0 7 8 0 Q O N 88 00 W 201,67 r` l o O~ 0 0 ' ° ° ,C /T, 355 ACRES B 0 1,2.351 ACRES 0 715, 996 S0. FT. r N W O tiry y 1 102,390 SO. FT. ^ 0 Q /5.8/8 ACRES EXC. 0 1 q / l>L .I ~ 1a1►1 O 66'W/OE ROAD EASEMEN I / iu N89 2/ '15 "W 482. 77' I p y 689,040 SO. FT. ' ~I a Q~e / I ►o 1 ~ ~ N o L1I Q' Z ~ I I O O~ ~I I I 1 N a1 Q1 N boy 1 66 PR/ VA TE D_R. VE. - h S L1 NE SEC114 2' N ? 1I WA~ EASEMENT '1 ~ ~ JI I O i I I 11 I b 712.52' /935.80' 3 OO d /O 1 " 0 I I I I S89•/5'56"E2648.3N O I 3 I I~ I 3 p N89•/8'35"W 205.33 SEC. 7, T28N, SE-- CO R, M 9 I 00 O I e 2 I O 66' ° q 1 h R/N B9• /5'56"W 205.46'1 R /9 W, / COUNTY MONUMENT/o ~I p^ I I p I N V I O O I oq NI m a °o LOT5 C.S.M. ~ Gr ° O I p " ~ I'I ? 4' VOL. 7i . 2 \ 292, all 16603 292. 92' y PAGE 1930 . v W k b N 89•/6'24"W 651, T.6' FORK DRIVE ti R/N 89.15' 56 "W W51.55') O ^ I I -T- h V W y LOT2 LOT 3 LOT 4 I Owner's Address: C.S. M. VOL. 7, PAGE /930 v 401 South Fork Circle y Hudson, WI 54016 h h h "Revised this 18th day of November, 1994." v R Q SCALE 1" r 200' 2 W Dated: April 11 4 Zz O O 50' /00.• 200' 300' 400' 500' tttill, orrj4ti~,i Q rLAUR CE. • 'm •WM el -H = • S 13 z a•. This instrumept drafted by Laurence W. Murphy ER+~ALLS,,: WISC. Q ~ f,, u ~~9F SJ o o ~ ~ ~ s:• Iv LAN -0 0 o 7' ti o "C Q 411 soisfIs a+ L+~ n C7 fV Laurence W. Murphy CL ~y o Ixi M' egistered Land Surveyor a is cu C: r,• , .I ~ ~ ` iy• to C .a~ t11 t, C.' ' SHEET 1 OF 3 Vol. 10 Page 2845 N CERTIFIED SURVEY MAP JAMES AND GLORIA MAHRENBROCK Part of the Southeast 114 of the Southeast 114 and the Southwest 114 of the Southeast 114 of Section 7, Township 28 North, Range 19 West, Town of Troy, St. Croix County, Wisconsin. Description: That certain parcel of land located in the Southeast 114 of the Southeast 114 and the Southwest 114 of the Southeast 114 of Section 7, Township 28 North, Range 19 West, Town of Troy, St. Croix County, Wisconsin, more fully described as follows; Commencing at the South 114 corner of said Section 7, thence S 8901515611E (recorded bearing on the South line of the Southeast 114 of said Section 7) a distance of 712.521; thence N 01004140}1W 925.141 to the POINT OF BEGINNING, of the parcel to be herein described; thence continue N 01 o 0414011W 394.031; thence S 89 2111511E 1166.191 (recorded as 1166.711) on the North line of the South 1/2 of the Southeast 114 of said Section 7; thence S 0100215911E 779.021 (recorded as S 0100015111E); thence N 8901813511W 205.331 (recorded as N 89015156"W 205.461)• thence S 0004112511W 220.001 (recorded as S 00044104"W); thence N 8901612411W 651.761 (recorded as N 8901515611W 651.551); thence N 10032100T1W 611.22' (recorded as 610:001);'thence N 880111001W 201.671 to the POINT OF BEGINNING, containing 22.186 acres, being subject to those roadway easements as shown on this map and also being subject to easements of record. Note: The parcel shown on this map is subject to State, County and Township laws, rules and regulations (i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office and the appropriate Town Board for advice. State of Wisconsin County of Pierce) I, Laurence W. Murphy, Registered Land Surveyor, do hereby certify that by direction of the Owners, James and Gloria Wahrenbrock, I have surveyed and divided the lands shown hereon in accordance with official records, Chapter 236.34 of the Wisconsin Statutes and the Ordinances of St. Croix County and that this map and description are a true and correct representation thereof. ```,,11111 t 11/try,,, A/ s rLAUREN E 40 Dated: April 11, W MU Dated: m 1994 O 1 "Revised this 18th day of November. 1994.11 IVERFALLS,•:~,v" `t cirr of Huosoa i F••''. WISC. pp ~ oiti~il~titt►t~ APPROVED er ZZLJCDL`' Laurence W. Murphy //''~~•-Registered Land Sur~sY24'IC7;:: r i rc B D A reo SHEET 3 Of 3 f,~~;;; y.:•,~: Parks C;CSrirr if not Ce?~t1~ t....i ;Jt)proval Vol. 10 Page 2845 STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNERBUYER~~. MAILING ADDRESS I ~f,~ u r PROPERTY ADDRESS (location of septic system) Please obtain from the Plannin Dept. CITYISTATE ^ S~~ WT G llr~ C C S i PROPERTY LOCATION U4, J 1/4, , Section T N-R J_ L~ W TOWN OF Y u ST. CROIX COUNTY, WI Jol lr~,o~~b~l.5 SUBDTVLSION C.S'vyI ti~ 3~`7,~ LOT NUMBER CERTIFIED SURVEY MAP~a' ~(O VOLUME I , PAGEELOT NUMBER r 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 Rexpiration date. SIGNED: / l~ 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. 1 Owner of property Location of property S 1/4 `S 51/14 , Se ion N-R W Township --A rf0i Mailing addressbjxv-u,e") Or. Address of site( ' , rem Subdivision name Sr►'1 X23 'o no. Other homes on property? Yes No Previous owner of property JcLtme s 4 G (0Y~U -'edAr 2l"\ bryck, Total size of property ;t°Ll~ gCre~ Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house) ? Yes No Volume [0 and Page Number a'~W 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 t e office f the County Register of Deeds as Document No. ~ 34and 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. Ga 341 ignature of Applicant Co-Applicant f-I(J-Z5' ll~0- Date of Signature Date of Signature F• oocuMENT NO. WARRANTY D® THIS SPACE RESE•VCD.OR RECORDING DATA STATE EAR OF WISCONSIN FOAM 2-1982 526236 Vor1~?~a~~ S~ - REGISTER'S 0; FICE - SE CR0 - CO, Vvl James- B.--Wahrenbrock and Gloria M. Wahrenbrock,-_ - ReedtorRecord - - husband and-wife holding as survivorship marital _ .f FEB 2. 1995 property....- 8t 9.45 A.h ) - - - - - _ ii conveys and warrants to .I)eag_A,- Rodewald•and-Lori J_- Rodewald, ;j yy f husband and.wife, as-survivorship marital--property 71 RofD(eeJ as 1 wer : • . - - - - - - _ - i; - RETn RN TO _ - - - - - - - - - . - the following described r^-al estate in __...-St.--CioiX------------ County. State of Wisconsin: fi t.' Te; /Z~ Tax Parcel No_ r I LOT SEVEN (7) OF CERTIFIED SURVEY ';l4AP IN. VOLUME TEN (10) OF CERTIFIED SURVEY MAPS, PAGE 2845, AS DOCUMENT NUMBER 523676, FILED I IN ST. CROIX COUNTY REGISTER OF DEEMS_OFFICE ON NOVEMBER 22, 1994, BEING PART OF THE SOUTHEAST QUARTEit OF THE SOUTHEAST QUARTER (SE 1/4 OF SE 1/4) AND THE SOUTHWEST QaRrr -.OF THE SOUTHEAST QUARTER (SW 1/4 OF SE 1/4) OF SECTION SEVEN :[r:_WNSHIP_TWENTY SIGHT (28) NORTH, RANGE NINETEEN (19) WEST, O-TROY` FEE mot. I I - x,..!<.-, ..~.-r-.n.~},~zs may,. is not This . homestead property. (is) (is not) 4 Exception to warranties: easements and restrietiona of reco d~ including Declarations II Establishing Restrictive Covenants. - 1 Dated this ---------•---•-~D- - day of Febraatry 119.95'.. qd4we (SEAL) -(SEAL) James....Yahr-en rock............. II o ,_.~~r ! - -----..(SEAL) SEAL) - Gloria M Wahrenbrock i . TION { - ACKNOWLEDGMENT II AUTHENTICATION II Signature(s) STATE OF WISCONSIN ~I _ ss. L - - - .......County. authenticated this day of Fgb_r_4arY-------- 1995 _ onally came before me this __-_-o~Q.... day of Furnary-.................. 19__95__ the above named ; • @Al)4 l TITLE: MEMBER STATE BAR OF WISCONSIN (If not. _ . authorized by § 706.06, Wis. Stats.) to s known to be the person --a who executed the figgasng na+ru a nd acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY II Keith•Rodlf,__Attorne--_at Law River.Falls. WI 54022 ! County, Wis. (Signatures may be authenticated or acknowledged. Both 3ff7r tf not, state expiration are not necessary.) 199 !Names of venom signing in any capacity should be typed or printed bet.- Ears af-don"ztVES. WARRANTY DEED STATIC BAR Or -D^s'^ Legal Blank Co.. Inc. 1 FORK Na a- "n R4hrauhee- `N.s_-nsin k