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HomeMy WebLinkAbout006-1013-70-000 o M O tl b O N N O T ccc0 72 C N e~ N f6 O Z C C C LL O Y 3 ~ ~ I Q U 3 ro I ~ o i-- Z y W E En c Z W a m cc c') U) 0 o Z Z N ems- (D o c E o 2 h w o a (v I ~ ~ c I •ti d L O `0 O Z co z z N m co- N r N W 0 0 o a ' bip Z~>° m o z • wI is a a a y ~a a g a cn v fA J U y rn rn Z ~ 2 0 0 N 00 00 E ~ O m CD C d U Q co co U) W ~l O o N w c 0 O c~ d= o a"i c c°n u o ~r o c O c = C) a o \ rn € a c N o C O 75 00 0-4 6 cl .2 • O o U CO N O Z N Z -f 4r U) y cO IL Sit a `a a - 'v m • as y c A v a t O N U s r ` Parcel 006-1013-70-000 02/27/2006 04:41 PM PAGE 1 OF 1 Alt. Parcel 06.31.16.96H 006 - TOWN OF CYLON Current [Xj ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - BEEBE, BURTON L & DARLENE F BURTON L & DARLENE F BEEBE 2084 CTY RD H DEER PARK WI 54007 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 2084 CTY RD H SC 0119 AMERY SP 1700 WITC Legal Description: Acres: 3.000 Plat: N/A-NOT AVAILABLE SEC 6 T31 N RI 6W PT SE SE BEING LOT 1 OF Block/Condo Bldg: CSM 10/2769 3 ACRES Tract(s): (Sec-Twn-Rng 401/4 1601/4) 06-31N-16W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1086/158 WD 2005 SUMMARY Bill Fair Market Value: Assessed with: 143 176,000 Valuations: Last Changed: 09/08/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 15,000 138,300 153,300 NO Totals for 2005: General Property 3.000 15,000 138,300 153,300 Woodland 0.000 0 0 Totals for 2004: General Property 3.000 15,000 138,300 153,300 Woodland 0.000 0 0 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 STC - 104 / AS BUILT SANITARY SYSTEM REPORT OWNER l) A Q /Y° rL~~ ADDRESS SUBDIVISION / CSM# ~V 1 LOT # SECTION _T N-R7g~ Town of / z ON ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM X?"15 t0 cps V LO ° X (fox rT 26D 3 ~ 3 1e `l INDICATE NORTH ARROW C d 60WR l~ n^ 1,1',4 Ad Provide setback and elevation information on reverse o i Provide 2 dimensions to center of septic tank manhole cover. ~ r BENCHMARK: ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer- So eZ-lf'5 Liquid Capacity: Setback from: Well 'P (L-House Other Pump: Manufacturer Model#-/Y,/,'~- Size Float seperation Ly C) dallons/cycle: Alarm Location / ` SOIL ABSORPTION SYSTEM Width: Length Number of trenches Distance & Direction to nearest prop. line: V/ 7, Setback from: well:_ /6 House Other ELEVATIONS Building Sewer ST Inlet. ST outlet PC inlet PC bottom Pump Off a Header/Manifold Bottom of system D,✓~ P Existing Grade Final grade: DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: 424 INSPECTOR: 3/93:jt ,Wisconsin Department of Industry, County: Labor and Human Relations PRIVATE SEWAGE SYSTEM ST. CROIX Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Permit Holder's Name: ❑ City Village Town of: State Plan .:14 BEEBE, BURTON CST BMElev/:, Insp. /60 - BM Elev.: BM Description: Parcel Tax o. 6F TANK INFORMATION ELEVATION DATA 9 ~g TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic s C ~d Benchmark a Dosing-- 7,V Aeration Bldg. Sewer 7.6511 19A - 7 Holding St/ Inlet TANK SETBACK INFORMATION St/~4 Outlet S TANKTO P/L WELL BLDG. ventto ROAD Dt Inlet Air Intake Septic 30 NA Dt Bottom Dosing NA Header.- ell 91(o Aeration NA Dist. Pipe ~r Holding Bot. System 4S PUMP/ SIPHON INFORMATION Fi Ae?~ ' Ste' 71 Ma rer Demand Model Number M TDH Lift Friction em TDH Ft Forcemain Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING manufacturer: SETBACK INFORMATION Type Of Z4-,-~ r v CHAMBER ~ r Model Number: am' ir --N System: OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length s) / Dia. Spacing V~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade S n Depth Ove „ Depth Over q xx Depth Of xx Seeded/ Sodded xx Mulched enter - S Bed/IEem:h ges 3~ - SV Topsoil ❑ Yes ❑ No E] Yes E] No Bed /4i vrb- 3; COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: CYLON.6,31,,16W SE,SE,LOT 1, CTH "HH" o - t/n ~~c(, U ~^Plan revi~iOn required? E] Yes1Vo se other side for additional information. -57~ SBD-6710 (R 05/91) Date Inspector's Signatur Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05, Wis. Adm. Code St., Croix N~F~Y PER I # -Attach complete plans (to the county copy only) for the system, on paper not less than STATES 8% x 11 inches in size. ❑ Check if revision to p evious application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION Burton Beebe SE SE N4, S 6 T 31 , N, R 16 E (or) W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # Box 56 1 N/A CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER De Park WI 54007 715 263-531 N/A II. TYPE OF BUILDING: (Check One) El State Owned ❑ VILLAGE : Cylori NEAREST ROAD" • CTH H ❑ Public ❑X l or 2 Fam. Dwelling-# of bedrooms ? PAR ELTAX NUMBER(S) III. BUILDING USE: (If building type is public, check all that apply) ©G (o _ 10 13 - 7 0 - 660 !O 0174)9 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. © New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ 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 ® Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 El Seepage Trench 22 El 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 300 REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) L TION 700 720 .42 10 90.58 9. E/ Feet Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank X 1000 1 Weeks Conc. Pr. Lift Pump Tank/Si hon Chamber El El El El I LI VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumb 's Signature: (No Stamps) MP/MPRSW No.: Business Phone Number: Byron R. Bird 1309 715 26878317 Plumber's Address (Street, 100 St. City, State, Zip Code): '(/Amery, WI 54001 1359 , IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date sue Issuing Ag t Sign S ps) Approved ❑ Owner Given Initial Surcharge Fee) 8 Adverse Determination D (J X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(R.08/93) 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 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. Ill. 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. Vill. 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. Ii 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) August 8, 1994 Lot #1, SE41 SE4, S 6, T 31 N, R 16 W BURTON BEEBE Township of Cylon St. Croix County WI Box 56 2 Bedrooms Deer Park, WI 54007 - 1 f o 8~ v C7~ 10~ 13 ('fe 2 R DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR- P.O. BOX HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 (ILHR 83.0911) & Chapter 145) LOCATION: SECTION: OWN /MUNICIPALITY: OT NO.:BLK. NO.: SUBDIVISION NAME: s r- s 6'/ /T 6 E to h [M'4 w COUNTY: / MAILING ADDRESS: USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: I LE DESCRIPTIONS: TS: Residence ❑Replace Il 7 §4 LUZ# -1 I RATING: S= Site suitable for system U= Site unsuitable for gt'grrj ONVENTIONAL: MOUND: IN-GROUND-PRESSUR "r YJVT E F,, OLDI K: RECOMMENDED SYSTEM: (optional) it" CAS DU PIS DU Ens❑U ill If Percolation Tests are NOT required DESIGN RATE.-'. f If any pgrtion of the tested area is in the under s. ILHR 83.0915)(b), indicate: pl9pdpIpi v indicate Floodplain elevation: .e_e 7- pR > D~IPTIONS` BORING TOTAL DEPTH TO ROUNDWAT dAAWq ARACTE :AF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH 11t. ELEVATION OBSERVED EST. Sfi TO BEDROCK IF OBSERVED ISEE ABBRV. ON BACK.) B- ~ , ~41b Wpb S/~ 7 g b 3 - S Ls 6- Li B- O~-•S,QC Ss- Z~(~a C C 0 U. 0' -2 C C 10 C) 0 B- PERCOLATION TESTS } TEST DEPTH WATER IN HOLE TEST TIME DR I WATER LEVEL-INCHES RATE MINUTES t NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH P- P- P- P-17 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. F o { g:l ~t 4 r z { 3 3 Prey E I Aj, a 3 I t /00 N 3 - ❑ 20 w P ac- 4 I~ l 3 r J, P~ P rc t E _ ' ~ X µR E E ~ r e;.- 1_1_ 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative 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: L ADDRESS: § fA/ CERTIFICATION NUMBER: PHONE NUMBER (optional): _C7 -7 CST SIGNATURE: / DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. HR•SBD-6395 (R. 10/83) - OVER - - - INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 To be a complete and accurate soil test, your report must include: 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 3. MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing scale is prefered. A separate sheet may be used if desired; 8. Make sure your benchmark and vertical elevation reference point are clearly shown, and are permanent; 9. Complete all apropriate boxes as to dates, names, addresses, flood plain data, percolation test exemption, if appropriate; 10. If the information (such as flood plain, elevation) does not apply, place N.A. in the appropriate box; 11. Sign the form and place your current address and yur certification number; 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st - Stone (over 10") BR - Bedrock cob - Cobble (3 - 10") SS - Standstone gr - Gravel (under 3") LS - Limestone 's - Sand HGW - High Groundwater cs - Coarse Sand Perc - Precolation Rate med s - Medium Sand W - Well fs - Fine Sand Bldg - Building Is- Loamy Sand > - Greater Than 'sl - Loamy Sand ~ - Less Than '1 - Loam Bn - Brown 'sil - Silt Loam BI - Black si - Slit Gy - Gray cl - Clay Loam Y - Yellow scl - Sandy Clay Loam R - Red sicl - Silty Clay Loam mot - Mottles sc - Sandy Clay w/ - with sic - Silty Clay fff few, fine, faint 'c - Clay cc - common, coarse pt - Peat mm - Many, Medium m - Muck d - distinct p - prominent HWL - High water level, surface water Six general soil textures BM - Bench Mark for liquid waste disposal VRP - Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department may request 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. r 44 517147 CERTIFIED SURVEY MAP Located in part of the Southeast Quarter of the Southeast Quarter of Section 6 Township 31 North, Range 16 west, Town of Cylon, St. Croix County, Wisconsin. Prepared for and at the direction of: Donald W. Krueger & Bernice T. Krueger Deer Park, WI 54007 LEGEND j APPROVED Public Land Corner - Aluminum monument found O Set 1" x 24" Iron Pipe weighing 1.68 LBS/ft. MAY 2 7;„•94] o ST. CROIX COUNTY mprehensive ptam* Zorilng and TT~~ 6y. O ks'Oommittee MRS ~,~pNNE~~' If ndt,rocorded N 9 ~p9e9skelotD 1 '*!thin 30'days(df % Oio~xOo spproval dells Bearings are referenced to the 9pproval-shaltbe south line of the Southeast Quarter -h na4R void assumed to bear S89°56'22"W. COUNTY GENERAL NOTICE Note: The parcel shown on this map is subject to State, County and Township laws, rules and regulations (i.e. wetl4nds, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office ar+d the appropriate Town Board for advice. I" a , SCALE - 100 50' o loo UNPLATTED LANDS I N89056'22"E 367.00' z 1(n la LOT 1 ° 1r. ' cn ID r a CD ~ Ir o? 130,737 square feet) JrIr Total Area > -4 3.00 acres ) LA I-+ ~m m N 116,503 square feet) m m 1~ 10 W 2.67 acres )Excluding R/W N 10 r N (.4 10 ID W CD Z 1 10 0) I N N CD O S00°03'38"E $ 17.00' SOUTH QUARTER CORNER O Ike SOUTHEAST CORNER SECTION 6 - 31.10 O 241.92' 1 S89056 '22"W SECTION E 12 731N. RIaw S89056'22 "W C. T. H. 1H ° / 1770.55' _ 0 462.00' cl~ S89056 22"W 367.00 - - - SOUTH LINE OF THE SOUTHEAST QUARTER - S89°56'22"W 2599.55' - - - - Drafted by: DJZ Vol. 10 Page 2769 s SURVEYOR'S CERTIFSCATE Z, Douglas J. Zahler, Registered Wisconsin Land Surveyor, hereby certify that I have surveyed and mapped a part of the Southeast Quarter of the Southeast Quarter of Section 6, Township 31 North, Range 16 West, Town of Cylon, St. Croix County, Wisconsin; described as follows: Commencing at the Southeast corner of said Section 6; thence along the south line of said Southeast Quarter, South 89 degrees 56 minutes 22 seconds West a q s id distance of 462.00 feet to the Point of Beginning; thence continuing along said line, South 89 degrees 56 minutes 22 seconds West a distance of 367.00 feet; thence Nor~h 00 degrees 58 minutes 17 seconds West a distance of 356.28 feet; thence North 89 degrees 56 minutes 22 seconds East a distance of 367.00 feet; distance of 356.28 feet to East a thence South 00 degrees 58 minutes 17 seconds Subject feet (3.00 acres). SubJ square the point of beginning. Containing 130,737 to right-of-way for County Trunk Highway "H" and subject to all other easements, restrictions and covenants of record. I also certify that this Certified Survey Map is a correct representation to scale of the exterior boundaries surveyed and described; that I have fully complied.with the provisions of Chapter-236.34 of the Wisconsin Statutes and the Subdivision Ordinance of the County of St. Croix and the Town of Cylon in surveying and mapping same. Paw Douglas (7. Z ler R.L.S. No. 2145 Date Ron Johnson Land Surveying P.O. Box 194 Amery, WI 54001 CF w1,90, Tel: (715) 268-2601 DOUGLAS I tiN y ZAHLER s * S-2145 HUDSON, W13 O~ Sua~ Vol. 10 Page 2769 rJ STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNERBUYER (n~ rJ a r ton L, O e 4e o hJ Da r l h e F► 8ee_L e MAILING ADDRESS 13®)( 5- Ne r Po,,-K, W1, PROPERTY ADDRESS (location of septic 'system) Please obtain from the Planning Dept. CITY/STATE Oeer LOCATION S L 1/4, S E 1/4, Section T 3 l N-R W TOWN OF C y ` Q il ST. CROIX COUNTY, WI SUBDIVISION / LOT NUMBER CERTIFIED SURVEY MAP 5 l 7 / 4 7, VOLUME /0, PAGE LOT NUMBER Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposai 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. 0, SIGNED: DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 STC - loo 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. D 4- Owner of property P Ur [ /i L , Bee b e p nc~ 00de ne r~ Bee -e Location of property S E 114S El/4, Section , T3/ N-R 16 W Township Cy on Mailing address box SG Oeer tLk h/, !5-4(06' Address of site ' w Subdivision name ~~Iyf /L/) _ Lot no. Other homes on property? Yes' No ~j Previous owner of property p Q /l W. K r- U r anGf Qernice. r, kr&,ye, Total size of property 3 C r f- S Total size of parcel 3S6, 2!? / X 30,01X 32 3 . ZT X 3(7 Date parcel was created A4 0 y Z7 17 ~ Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)? Yes < No Volume to and Page Number 2 - 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 / Y $ 13 , 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 a'~ , lqqq ? - q - Date of Signature Date of Sirinat11YP I DOCUMENT NO. STATE BAR OF WISCONSIN FORM 2-1082 THIS SPACE RESERVED FOR RECORDING DATA • WARRANTY DEED VOL1086PA,45 nnnald W, TCruegQr and Rernir•o T rrrneger., hnchand and ioea aeaoond wife._ as joint tenants JUL 8 1994 0i• 5 conveys and warrants to_ Burton L. Beebe and Darlene F. Beebe. husband and wife, as survivorship marital property t~ar~,x'b)`13~I1 I ETU TO MortRNwrest Savings Bank P.O. Box 46 the following described real estate in St. Croix County, I Amery, WI 54001 State of Wisconsin: Tax Parcel No: Part of the SE 1/4 of the SE1/4 of Section 6, Township 31 North, Range 16 West, Town of Cylon, St. Croix County, Wisconsin described as follows: Lot 1 of Certified Survey Map filed May 27, 1994 in Volume 10 of Certified Survey Maps, page 2769 as Document No. 517147. i i This is not homestead property. (is) (is not) Exception to Warranties: i i Dated this 30th day of June , 1994 I (SEAL) (SEAL) j Donald W. Krueger (SEAL) D D (SEAL) Bernice T. Krueger I AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ss. Polk County. authenticated this day of _19 Personally came before me this 30th day of I Junp '19 94 the above named Donald W. Krueger and Bernice T. Krieger TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the pers who ex led the authorized by § 706.06, Wis. Stats.) toe ng instrumen{and kn wle the as I THIS INSTRUMENT WAS DRAFTED BY Donald W. Krueger Jam". Ivey T Notary Pub PO 1 k STATE unty, Wis. (Signatures may be authenticated or acknowledged. Both My Commiss n s permanent. (If not, state expiration are not necessary,) date:- 1/28 , 19 96 Names of persons signing in any capably should be typed or printed below their signatures. S02 NTF 0021 WARRANTY DEED STATE BAR OF WISCONSIN Noted Tax Forms, P.O. Box 10208, Green Say, WI 54307-0208 Form No. 2 - 1982 i~l~ L~®~x~//DDG /4l2 1s ~4 ~d y~tv~OQ're!eL 1 pV6 /D/J M 9W H 517147 ~ CERTIFIED SURVEY MAP 9 Located in part of the Southeast Quarter of the Southeast Quarter of Section 6 , ~•7 Township 31 North, Range 16 West, Town of Cylon, St. Croix County, Wisconsin. Prepared for and at the direction of: Donald W. Krueger & Bernice T. Krueger Deer Park, WI 54007 X/ 8-v, LEGEND APPROVED Public Land Corner - Aluminum monument found O Set 1" x 24" Iron Pipe weighing 1.68 LBS/ft. MAY G A ZT-K 7 O ST. CROI•X COUNTY 8 Oompreih4insive Ptart * z0fto am l ove" Darks "Odmr(guee M ~X ,~~NNE~~' 'ff rOt 'fecarded N OJ INOS SS Ot otQ s~ 'Within 301fa ysedf S~,Ocolxf'0•' ~ ap~ovel~date Bearings are referenced to the C~ 10provaPshaltbe south line of the Southeast Quarter -h nc4-& void assumed to bear S89°56'22"W. COUNTY GENERAL NOTICE 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. " _ 100, 100 50' 0 loo UNPLATTED LANDS N89056'22"E 367.00' Q~ z(` cn 8 8 LOT I 0 ~r. Ul ID IZ (-n m Ir ~ 130,737 square feet)Tota Area 1r In Z4 3.00 acres 0 m 1n m ro 116,503 square feet) 1° w 2.67 acres )Exclu ing R/W N !0 Ir N ~ ~ Iy In W W - - 1Z - 0 _ - H1 CtHWAY_SQTBP~K. i. N ICA N O O) CO- 0 S000 03 38 ° E w o° 17.00 SOUTH QUARTER CORNER SOUTHEAST CORNER SECTION 6-31-10 O 241,92' I 8 05- 2?"W T3CIN10R16W S89056'22W 24.81 C. T. H. H" ° / 1770.55' - 462.00' S89°56 22 W 367.00' 'hip SOUTH LINE OF THE SOUTHEAST QUARTER - S890 56'22"W 2599.55 - - - - Drafted by: DJZ ` Vol. 10 Page 2769 s