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HomeMy WebLinkAbout008-1018-10-450 Wiscons+n 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 [I Village Town of: State PI ANDERSON, ROBERT J. X CST BM Elev.: , Insp. BM Elev.: BM Description: Parcel T C TANK INFORMATION ELEVATION DATA Z TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic i f..5~ ~trl e , ® Benchmark CCU( Dosing 161,3 71 Aeration Bldg. Sewer 7 s' (~S Holding St/A Inlet 916,5,E TANK SETBACK INFORMATION St/ Outlet 3 v TANK TO P / L WELL BLDG. Ventto ROAD Dt Inlet 95, 7~ Air Intake Septic l NA Dt Bottom Dosing 3 r NA / Man.- lax 31 Aeration A Dist. Pipe S0/ Holding-- Bot. System 8 Z/ a 3. PUMP tSTKDN INFORMATION Final Grade Manufacturer Demand 3, /110. Model Number GPM TDH Lift b t Friction System TDH Ft q~ Forcemain Length Dia." Dist.ToWell OIL ABSORPTION SYSTEM BED/TRENCH Width i Length i No. Of Trenches PIT No. Of Pits Inside Dia. Depth 141 DIMEN I N DIMENSION ll SYSTEM TO P/L BLDG WELL LAKE/STREAM LEAC M acturer. SETBACK CHAMB INFORMATION TypeO z~ Model Number: System: IT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) „ x Hole Size x Hole Spacing Vent To Air Intake Length D a Length 54/L, Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only 4ry Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched r Bed /Trench Center Bed /Trench Edges Topsoil C] Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: EAU GALL 28. 90B,NW,,SE,LOT 2,55TH AVE ; ..r/,~CeG~uceP~eC/r / - may" 01, ~~~a Y ~ ~ c_4 Z l f:: = S 70 ~U7 i n u., f r i r; ~Gt /U 3 ~7D. Plan revision required? ❑ Yes No Use other side for additional information. I- SBD-6710(R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: _z~ 32- D SANITARY PERMIT APPLICATION COUNTY ILHR In accord with ILHR 83.05, Wis. Adm. Code :3~i c STATE SANITABi Y PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 9- ( Y9 i5 .;I~ 8'f2 x 11 inches in size. ❑ Check if revision to previous application -See reverse side for instructions for completing this application. STATE PI AN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION /JIZPI,, .5,C- S 4~ TZ?, N, R /e/ Jg (or PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER 11/16/ -P~qc 11213 ; u GCt 11. TYPE OF BUILDING: (Check one) ❑ State Owned VILLAGE LLILLAGE NEAREST ROA I ~/p ~s7 ~ve ❑ Public ~ 1 or 2 Fam. Dwelling-# of bedrooms -1 PARCEL TANUMBE ( ) Ill. BUILDING USE: (If building type is public, check all that apply) ~Z-j - ~~l © - ~o - O OO 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 40 Church/School 8 ❑ Mobile Home Park 120 Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 130 Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ,In 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 El Specify Type 41 El 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 12. 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 50 -3 74 2 g . 3 IV/ l491 Feet X0 -3 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 strutted Septic Tank or Holdin Tank /'00-o /Oc-10 61 0 e- e- Lift Pump Tank/Si hon Chamber 00 O ac o VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsits sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) MP/MPRSW No.: Business Phone Number: 8 zS -3.37 Plumber's Address (Street, City, State, Zip Code): IX. COUNTY/DEPARTMENT-USE ONLY Disapproved Sanitary rmit as (Intl as Groundwater Date Issued uing A Y[IaLUI~ S ge Fee) Approved ❑ Ow ner Given Initial Adverse Determination uV X. CONDITIONS OF APPROVALIREASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) 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 (>BD 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. 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; wets; water maids/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 referenre 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) SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations October 12, 1994 2226 Rose Street La Crosse WI 54603 BOLDTS PLUMBING 820 MAIN ST BALDWIN WI 54002 RE: PLAN S94-41337 FEE RECEIVED: 360.00 ANDERSON, ROBERT NW,SE,6,28,16W TOWN OF EAU GALLE COUNTY OF ST CROIX MOUND SYSTEM The Department has reviewed the above-referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based on chapter 145, Wisconsin Statutes, and chapters ILHR 83 and 84, Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter ILHR 82 or in chapters ILHR 50-64, Wisconsin Administrative Code. This plan submittal approval will expire two years from the approval date, or if a sanitary permit is obtained, plan approval will expire on the day the initial sanitary permit expires. The licensed plumber responsible for this installation shall keep one set of plans with the Department's stamp of approval at the construction site. The installer shall notify the appropriate inspector when inspections can be made. All permits required by the city, village, township or county shall be obtained prior to installation. Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Sincerely, Dennis Sorenson Plan Reviewer Section of Private Sewage (608) 785-9336 SBD-6423 IR. 9U91! obi V , lr7o ler-,ro r- Page / Of S94-41337 Cross Section Of A Mound Using A Trench For.The Absorption Area a hiodit)n Sand Fill .~I ° F 6" Topsoil 3 E D Trench Of 2" - 22" Aggregate, Plowed Layer 6" Below Pipe, Covered With D /-O Ft. Straw, Marsh Hay Or Synthetic Fabric E ./Z_ Ft. G .p Ft. F • 75 Ft. H f,-T Ft. -Plan 10ew pf '`mound Us,ing`A Trench For The Absorption Area s Force Main Disibti"on Pipe Went Markers Observation Pipe t%a A o - W B K \Trench Of 2" - 22" Aggregate I L i A `t. I Ft. K /O Ft. W 2Z, 1,c Ft. B /og Ft. J 7-6 Ft. L /Z g Ft. License Signed: Z ~4 /~i~C~oc~`- Number: /1P 45~GZ9 Date: /O- - - 9'V Distribution Pipe Detail For Two Lateral Network S94o4133'7 Holes Located On Bottom Alk,r 7,ale. Are Equally Spaced PVC Force 3ain H. X X PVC Distribution Pipe P P X * Last Hole Should Be Next To End Cap Qr Alr? P_ Ft. Hole Diameter Inch X Inches Lateral Diameter Inch(es) Y 2-Inches Force Main Diameter 2 Inches x `y~i # Of Holes/Pipe 1 1 az. s Invert Elevation Of Laterals Y`Ft. 2.7(D3f" M,N. Signed: License Number: Z9 Date: /D - 7 - 91 PAGE" •3 GF PUMP CHAMBER CROSS SECTI01.1 AND SPECIFICATIONS VENT CAP S 9 410413 3 7 y"C.I. VENT PIPE T WEATHER PROOF APPROVED LOCKING _f r-T 25' FROM DOOR, JUNCTION BOX MANHOLE COVER WINDOW OR FRESH I2"MIU. AIR INTAKE GRADE I y"MIN. I ~ 18"hCIAI. CONDUIT 18"MIN. INLET -.PRQVIDE I - AIRTIGHT SEAL II v I APPROVED JOINT A I (I ( APPROVED JOIIJTS W/C.T. PIPE I III W/C.S. PIPE EXTENDING 3' I II ALARM EXTENDING 3' OWTO SOLID SOIL B I 11 ONTO SOLID SOIL ` I 1 t_ ON x ti 'L'.NrYY I ELEV. 9o'$'FT ' q i• --j PUMP OFF CONCRETE BLOCK RISER EXIT PERMITTED ONLY IF TANK MAIJUFACTURE.R HAS SUCH APPROVAL SEPTIC r SPECIFI'CATIOkIS DOSE TANKS MAUUFACTURER: WMBER OF DOSES: -PER DA-4 TANK SIZE:- /Doo GALLONS DOSE VOLUME INCLUDING BACKFLOW: GALLONS ALARM MANUFACTURER: MODEL NUMBER: A9 CAPACITIES: A= INCHES OR 605. GALLOAIS SWITCH TYPE: //~J'1~.^GUry B= ~Zp IIJCHESOR-37-7 CALLOUS PUMP MANUFACTURI<R: rTou //A/ C = 9 INCHES OR 0'Z- GALLO►JS MODEL NUMBER: WL~O 3 L IS P'" D- INCHES OR z2G'YyGALLONS SWITCH TYPE: 7Ve e- e-- e- U 4-P,p0- NOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE 7 22bGpM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE 5ETWEEN PUMP OFF AND DISTRIBUTION PIPE.. ~L- FEET + MINIMUM NETWORK SUPPLY PRESSURE . , , , • , • • • FEET + SO FEET OF FORCE MAIN X Z'~ F/pp rtFRICTIOU FACTOR. FEET TOTAL OyNAMIC. HEAD = FEET INTERNAL DIMENSION: OF TANK: LENGTH 7 ;WIDTH 7 ;LIQUID DEPTH 51GNED: ~`-~Ot~~ LICEti1SE NUMBER: MP~6 Z9 DATE: ~~7~ J Submersible Effluent Performance Curves Pumps o.~ y ~ S94-4133 90 MODEL 3885 25 80 SIZE 3/4" Solids c WE15F1 70 S 20 WE10H J A 60 -WE07H 15 50 WEOSH 40 10 30 WE03M 20 WE03L 5 [ I I I I I T- N N 10 0 0 0 10 20 40 50 60 70 80 90 100 110 120 GPM L i 0 10 20 30 m'/h CAPACITY @OGOULDS PUMPS, INC. SMEIZA FALLS PEW YoW I N8 METERS FEET 120 MODEL 3885 35 110 WE15HH 30 SIZE 1/4" Solids 100 90 25 I i Q 70 W X 20 J FQ- 60 0 P- 50 WE05HH 15 40 10 20 5 10 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM 0 10 20 30 m'/h CAPACITY 01985 Goulds Pumps, Inc. Effective July, 1985 X3885 . V;I L h K in accord with ILHR 83.05, Wis. Adm. Code , COUNTY r w tjachaoornRota site plan on paper not less than 8 1/2 x 11 inchet.in sf=e.'Plan must include but ' ~►"o>'~ , snot Gr Red to vertical and horizontal reference point (13".,& ott~ard G: - f slope PARCELED. 9 ' dmoniloned. north arrow, and location and distance to nears AP j' 4. 4 ale 3 or 3 " REVIEWED iCAhT:INFORMATION-PLEASE PRINT ALL INfO MA?ION`-- DATE 1s R PROPERTYLOCATION O ` y's ✓L.i " GOV. LOT t// s' U1,S T 2 , N.R j~ ( W _PROPEAT OWNEIVS MAIL.IdG 11!)ORES LOT BL stmo.m CSM s - CITY. STATE 7 /J/ ZIP CODE PHONE NUMBER []CITY DVIIUIGE OWN NEAREST R~AD livi >ti S' dU (7/5) SS- ~Q New Construction Use Residential I Number of bedrooms _ j J Replacement ( J Public or commercial describe Code derived daily flow 50 gpd Recommended design loading rate • Z bed, gpd/ft2_L~trench. gpd ? Absorption area required bed, (t2 37 - ~ Maximum design loading rate bed. gpdnl2 trench, gpd!!t2 Recommended Infiltration surface elevation o ' it (as referred to site plan benchmark) Additional design / site considerations Parent material S.' Flood plain elevation, if applicable ~y9 It S =Suitable system OONIIE!(IIONAL MOUND 1fGR0l>r10PRESSURE AT~WDE SYSTEM r" FILL HOLONG TAW U= Unsuitable r« rem ❑ S U S❑ U O S U ❑ S U ❑ s'NU ❑ S'~KU SOIL DESCRIPTION REPORT Boring # Horiz Depth Dominant Color Mottles Structure GPD/ft Texture Consistence 8orxidary Roots in. Munsell Qu. Sz. Cent Color Gr. Sz. Sh. Bed Tnend- W _ t j a-'7 /,0 Y9 '7r Al si" MsIS M~r C uD 2 Z 7-18 75'y)e Y Al, ne- Sin ~mSb /h~r- c. ~21 ,3 Ground 3 / -Zy r'j.~ry y y /won e S/'. 2 S, /rj Y a • elev. ,4 Z.5wl 11 Z -yZ ~7, 5YR y `f Nan e, s ~ r m s rn vi'Y Q Lo . 7 • $ to 5 21Z /0,i~5f~ Dep limiting factor Remark's: - Boring # r cw Z f -z 1,3 41or 1.~, S ~v a w / 7 8 Ground 3 S-2 10'VR s~ I .n s rn -2 .3 9.69fL , 3~ loY~ 4 c2o1 7-AYR ~8 -5c s~ mv~r CU) - Z I.3 Depth l0 5 3-' -37 _1o YK y c 2 P 7.5 S g C_ Z c s n~~ , y . 5 limiting (actor Remarks: DGS. DIV. CST Name:-Please Piw+l-~ C? • f~' c tGYSOY'~ Phone: c r 715 -GSA 37 d Address: ~1 o 7 Q,~- 57e-. Sgnaly. Dale: CST Number: iiorizo Depth pominanl-Cofor Mottles Structure Consistence ' Gf/I Boring _ Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh.. GOLIX ry Roots Bed Trr~n . yy 7 Y '7 /ion - elev. c,: ' 7,sY Y ~•y, s6 v~'~. A,J ? = .g Depth to 5 3~ ` , limiting factor y 5 i>-J 3= 15Y sjg c~ 2 c s 6 nn~, y Remarks: Boring # 13 Ground - - elev. Depth to fimiling factor Remarks: Boring # f Ground elev. K Depth to limiting factor Remark: Boring # Ground elev. ft. Depth to limiting factor --r Remarks: STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER ~0 be,-~~ V ~~G~~ DSO MAILING ADDRESS 2c> 5`O Ave . PROPERTY ADDRESS (location of septic system) Please obtain from the Planning Dept. CITY/STATE ]20 /~v,'r~ lA"2' Z_ PROPERTY LOCATION 1/4, 52~J 1/4, Section ~ T N-R_Z,~ _W TOWN OF 0o Ile ST. CROIX COUNTY, WI SUBDIVISION h~X , LOT NUMBER /L//_~ CERTIFIED SURVEY MAP , VOLUME 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 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: P - DATE: ~n - - 9 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 Zeo be ,r-~ V/ , 1- o /L Location of property 1/4 51--1/4, Section 6 , T Z 9 N-RW Township, 60 f Mailing address 20 -elQ Address of site ~rP I a~P'w ~h S5'a6~ Subdivision name Lot no. ,V.4 Other homes on property. Yes L/ No Previous owner of property j 79~ ►r' Sa Y'~ Total size of property /O~ e5 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 L,/No Volume 2--q9 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 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. q5O 72S , 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 /o-'7- 9y Date of Signature Date of Signature FORM NO. 985-A FILED N O V 1981 1.14fS O' CONK=IC R*911ftf of Dood>f / , ~ APPROVE0 CERTIFIED -SURVEY MAP s' ' OCT 3 0 1981 00 sz' e~Q'x CJst -_Y P..Il3Y_S TL44ni4Y4 UNPLATTED LANDS OWNED BY OTHERS 001001yp,,Is AYJO ate: w~L'i ~oAarvsf7~°cE ,``,p'~10 Go N'S~ ~V 638.36' I b O O 17' 17' EAST LINE SW 1/4 NE 1/4 ♦o .1~®° " LOT SUIR '4-V 8371022 SO. FT. (INCLUDING Ro ~OQti04® 18.5 AC.! & 805,121 S0. FT. SCALE I"=300 (NOT INCLUDING ROAD) x I O 0 100 200 300 400 UNPLATTED , REUBEN DOORNINK a RT. I ° N T WOODVILLE, WI N w I - M 0_ SET 3/4" X 30" ROUND IRON ROD -co WEIGHING 1.502 LB./L.F. X =M (D (Lot l is not a o N buildable lot until ° UNPLATTED -00 BRG. REF TO THE SOUTH LINE OF THE °c a suitable percula- NE 1/4 OF SEC.6,T28N,R16W. o tion test can be k ASSUMED BRG. S 88°00' 38"E. k obtained) X TOWN ROAD SOUTH LINE SW I/4 2" IRON PIPE BADGER TRAIL NE 1/4 WITH AL. CAP . . . . L 51.06' 15.34' 1 •73' - 49.09' S 88000'38"E 1317.41' 635' S88°00'38~E - - _ - _ - 1368.31' 7` -588°00'38"E 2" IRON PIPE 12.90 -680.35'_ 131741' WITH AL. CAP -637.06 Di0U, T, 16.95 E I/4 CO ~-EXISTING BUILDING 1 _ 2" IRON 17 GARDEN C PIPE WI-1 Ki LOT AL. CAP LOT 3 0 4at;600 SO. FT. _ 811,133 SQ. FT. (INCLUDING ROAD R.O.W.) (INCLUDING ROAD) p co x 18.36 ACRES= 8799,934 SO. FT. (NOT C~ w UNPLATTED INCLUDING ROAD R.O.W.) -9.81 AC.= & m f cN 427,136 SO. FT -m f 0 fNOT INCLUDING 0 3 _ HOWARD BENGSTON m ROAD) 0 'M o R T. I w z o - - BALDWIN, WI tf) EAST LINE NW 1/4 SE I. o m CRYSTAL FERN 0 O RT. I U) z BALDWIN, WI. i U z I Y' i WEST LINE NW V4 SE 1/4 '53Q•T9 LINE SCHEDULE 80546 A- S888.0( 1340'25 00'38"E 64.00' 7°q9 51 E B- 300°19'51"W 14825 _ C- N88°00'38"W 132.00 r D- N00019'51" E 148.65' E- S88°0038'E 328.31 1-94 R.O.W. 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V3Hb of! WM04 DOXt1MENT NO. WARRANTY DEED THIS SPAC19 R:.aRvgu FOR RgCO STATE BAR OF WISCONSIN FORM s - im 11DIN0 DATA Ii 450705 ''~c~ - ~►e-_ REGISTER'S tai i CE i 3T, cROix co., m bed for Record i~ ~i Robert--s..-Anderson,...a... single ..man, AUG 181 I • I 10:00 A.M I ----i conveys and warrants to Aniderson--EXCdSIdt1I1 B-• --Inc.._, a * aphNr of Deed W~_;xcons.> a...coxpozataOrl.._located._at,..Bald~rin. ~ W?~_s~ozls_a.n.---------------------------- I' RETURN TO ' A WLi ~SCONSIN the following described real estate in . _ . _ t.__. C3;01X.._......Coanty, State of Wisconsin: Tax Parcel No: TURN THIS DEED OVER FOR DESCRIPTION OF REAL i ESTATE BEING CONVEYED. TWO WRETR'S FILED AS TO THIS DEED; ONE FOR I THE TOWN OF EAU GALLE AND ONE FOR THE TOWN i OF BALDWIN. i n ~I u rJ1.~ r c ,lei('' i ~i This IS __N.OT.___..... homestead property. (is) (is not) Exception to warranties: Dated this day of -Nay" ( zl.. 19..89,.. . . (SEAL) ' .RQbet...J~.. a _ (SEAL) a a AUTHENTICATION ACKNOWLEDGMENT Signature(s) -nf_..Rta.be_rt__Z-••-A.nde_I_snn-------- STATE OF WISCONSIN as. auth ca this _ . County. - --daY of---- 198-~ Personal! came before me this --._day of - - - - - • 19 the above named h Car ~L4'?~_119D.. T IT : MEMBER STATE BAR OF WISCONSIN (If no authorized b y ~ 706.06. Wia. State.) • to me known to be the person who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WA%DRAFTED BY .Zahn--.G_.._Np-s_tingen,.-.At_t Baldwin Wi.sconsin 54002 a . - (Signatures may be authenticated or acknowledged. Both MytaCommslsion is permanent a expi Wis. are not necessary.) . (If not, state xplratien date: 19- ) , *Names of oersons signing in any capacity should be tYDed ar printed below th-ir signaturm QWC[r1~~ STATE BAR OF WISCONSIN FORM No, 2 - 1982 Stock No. 13002 ;or WPM 'd 0 THE FOLLQWiNG DiS]&kIBED REAL ESTATE IN ST.' CROIX COUNTY, WX-SCONSIp: Beginning at.,a point in southerly limit of highway running east and west, 64 feeX west from NE corner of NW4 of SEh of Section 6-28-16; thence westLlri-jsouth line of said highway 8 rods, thence south 10 rods, thence east 8 rods, thence north 10 rods to place of beginning; also known as Qutlot 1 of Lot 2 of Certified Survey Map in Vol. "40, page 1123, Doc..pq. 374305. Part of NW% of SE4 of Section 6-28-16 described as follows: Lot 2 of Certified Survey Map filed November 5, 1981 in Vol. 4, page 1123. Part of NE% of SEk of Section 30-29-16 described as follows: Commenc- ing 1623 feet Easterly as measured along the north right-of-way line of Chicago, St. Paul, Minneapolis and Omaha Railroad from the inter- section of said right-of-way and the north and south quarter line of Section 30-29-16, St. Croix County, Wisconsin; thence continuing east- erly along said right-of-way line a distance of 60.0 feet; thence north to the south line of State Trunk Highway 12; thence westerly along the south line of said highway a distance of 60.0 feet; thence south to point of beginning. That is the intent to convey the East 60 feet of that parcel of land described in that certain Warranty Deed from Oscar Berkseth and Celia Berkseth, his wife, to Robert Anderson, dated September 4, 1951 and recorded September 22, 1951 in Volume "307" of deeds, page 94, in the office of the Register of Deeds for St. Croix County, Wisconsin. Part of NEh of SE% of Section 30-29-16 described as follows: Commenc- ing 1,483 feet east of where the west line of the NWh of SEh of Sec- tion 30-29-16, St. Croix County, Wisconsin, intersects wit the North line of the right of way of the Chicago, St. Paul, Minneaptis-and Omaha Railroad Company; thence east along the North line of the said right of way 200 feet; thence North to the south line of the State Trunk Highway 12; thence in a westerly direction along the south line of said State Trunk/ Highway 12 to a point due North of place of begin- ning; thence South to place of beginning EXCEPT part to George H. VandeBerg in Vol. "307", page 626. Parcel 008-1018-10-450 12/02/2005 12:53 PM PAGE 1 OF 7 Alt. Parcel 06.28.16.90B-35 008 - TOWN OF EAU GALLE Current X'! 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 JOSEPH A ANDERSON O - ANDERSON, JOSEPH A 2143 55TH AVE BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 2143 55TH AVE SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 5.490 Plat: 4084-CSM 15/4084 008/01 SEC 6 T28N R16W PT NW SE CSM VOL 15/4084 Block/Condo Bldg: LOT 04 LOT 4 5.490+-AC FKA (906-30) 008-1018-10-450 & INC PT OUT LOT 2, THE Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) W 66FT 06-28N-16W NW SE Notes: Parcel History: Date Doc # Vol/Page Type 07/03/2001 650073 1672/619 AFF 2005 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/15/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.490 26,200 187,200 213,400 NO UNDEVELOPED G5 3.000 1,400 0 1,400 NO Totals for 2005: General Property 5.490 27,600 187,200 214,800 Woodland 0.000 0 0 Totals for 2004: General Property 5.490 27,600 187,200 214,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch M 513 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 In accord with ILH . • ' • v . ' • . ~ • v R 83.05. Wis. Adm. Code. Attach complete rile plan on a COUMY per not less not limited to vertical and horizontal reference an 8 1/2 x 11 inches In size. Plan must include, but te : pof dimensioned, north arrow, and location and direction and y. of slope. scale or FA-RC-EL 1.0. t APPLICANT INFORMATION- oad. PLEAT ALL IfiF f4'1~ ION REVIEWE08Y PROPERTY GINNER: DATE PROPERTY LOCATION PROPERTY CWNER S MAILIplG /100RES GOVT. LOT -114 S 114,S T el .2 A 7 ( W LOT t 6l ~ N.R y CITY, STATE SU80.NAME / CSM t C~IC~cc~in. zIPCOpE NU A OcIT~ Ufa N NEARESTAO ~g~{ - jN New Construction Use SS Res1dettilial NurtltTdra j j Replacement ( I Public or comtn ibe Cade derived dally now 50 9Pd . Absorption area required ~ • 1123% Recommended design loadurg rate Z bed, gpd/ft2Lj _tr~. gP~ Recommended Infiltration surface elevations trench" design loading rate O _bed, 9PdV trench. gpd/(!2 Additional design / site considerations ft (as referred to site plan benchmark) Parent material S,' f y a r~•„ r. applicable It - 11 Flood plain elevation, S = Suitable for system aN~+GWIONAL MOUN U= Unsuitable fa s (em ❑ S ,pj U t o 0 U SSURE AT-GRADE ~1 S ❑ U O El S U SYSTEM IN FLL HOCOWG TANK SOIL DESCRIPTION REPORT ❑ S ~ U ~ S ~U Boring # Horiz Depth Dominant Color Mopes in. Munseil CbntCobr Texture Structure Gr. Sz. Bayday Roots GPD/ft ° ~ W 47n e Bed Tra-d . 7 -IS 75-Y, • Z , 3 Ground / -Zy ~j , ~rYR. -y y , ~m S b f r^ C Z.~' • Z i ,3 elev. /won e S/ Z. t5lfft. 77, YR IV,, Depth litriling to -7 •9 factor ~S ~8 SG/ Remarks: i Boring # 2- z1- 15 *2, J Ground I5 10 `/~,c /yl ✓ w / rr • 7 8 scl ~,,~r • Z •3 96~G'9ft. Ae!~ y,e ' Qd 7.5yR m s s m s~ mv~'Y • 5 = Depth to 35'3'_7 _ IO )Z-n- C 2 P 7, 5 5 / c w Z I 3 limiting 8 C 2 c s !actor _ _ • • 5 Remarks: , CST Name:-Please Print Address: 6'z - Phone: 7is-S -3379 057'17 S~ nature c~ /~'~c c~ I'yL Uale: 7 -Z CST Number: 7 9y' - Structure Roots GPDl1 1 -Depth Dominant Color Mottles Texture Consistence Boixiary Bed Tray Boring # Horizo in Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. f O- /DY 5` r~- Si s6t::~ r Ct,J 2 F 'Z "3 2-17 A10 Y? Ground 5 Y, ~e4 elev. ' 30-36 7,.5,y I/ - cz-' W5 ~~r• a~ 5 YR~ >t Sc > n7 5 6 ~nv~r G Cc) '2 '3 3~1 ~Yle~d c2'7:5 Depth to WON ~ sIg G/ In~~ • y facto 30 Remarks: Boring # Ground elev. Depth to limiting factor Remarks: Boring # Ground elev. Depth to bmifing factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: FORM NO. 985-A ' MCMn •rCamrU® Zee, FI ,v -9Cz LED ~'7y NOV 5 1981 JAAES O' 1 CONHELL Off! pspt+tor of Do&drt Q~ WNW* V APPROVED CERTIFIED SURVEY MAP s OCT 3 01981 Ss, c4tom t:sL'--TN Nn.P,t;s :v> 1'x~r.5 rL~n1>skyti UNPLATTED LANDS OWNED BY OTHERS Alt•'10 Y+~. lt~fi Ct'~M►?tY1TCE2 ,~,~~fffflfrw;►h~! S 87 ° 47'24!'E 638.36 X a 17' 17' ~rO, X LOT I X EAST LINE SW I/4 NE I/4 V 837,022 SO. FT. (INCLUDING RO son$~ 18.5 AC.= & 805,121 S0. FT. k (NOT INCLUDING ROAD) SCALE I"=300' I I_ 0 100 200 300 400 UNPLATTED ,v REUBEN DOORNINK I M RT. I N - - WOODVILLE, WI (D W O - SET 3/4' X 30" ROUND IRON ROD x _00 - WEIGHING 1.502 LB./L.F. 3 V X N o (Lot 1 is not a 0 r4.) 0 buildable lot until Z UNPLATTED BRG. REF. TO THE SOUTH LINE OF THE 0~ a suitable percula- NE 1/4 OF SEC. 6,T28N,R16W. o tion test can be k ASSUMED BRG S 88°00 38"E. obtained) X~ ~ I x k TOWN ROAD SOUTH LINE SW 1/4 2" IRON PIPE . ' ' ' ' ' ' . ' I I NE 1/4 WITH AL. CAP BADGER TRAIL x , I 51.06' 15.34' 16.35' 1 '75, 49.09' S88000 38"E S 88000'38"E _ 1317.41 1368.31 _ -S 88°00'38"E 2" IRON PIPE 112.90' is -680.35:_ 131741' WITH AL. CAP 637.06' D OUTLOT 8 16.95 -EXISTINr, BUILDING I E 1114 CDR 17' GARDSU 0 2" IRON PIPE WITI- X LOT 2 AL. CAP LOT 3 m 435,600 SO. FT. > 435, 811,133 SQ. FT. (INCLUDING ROAD R.O.W.) (INCLUDING ROAD) p m 18.36 ACRES= 15799,934 SO. FT. (NOT OD W UNPLATTED INCLUDING ROAD R.O.W.) O 9.81 AC.t a 00) ~ a 427,136 SO.FT.1- a~ (NOT INCLUDING 0 3 HOWARD BENGSTON 0) ROAD) oO 0 o RT. I w z BALDWIN, WI ~n EAST LINE NW 1/4 SEI/4 0 o CRYSTAL FERN J 0 0 RT. I cn z BALDWIN,WI WEST LINE NW 1/4 SE 1/4 534.79 LINE SCHEDULE 1 1340 25 r 805•g6 A- S88000'38"E 64.00' N78°495CE B- SOO°19,51"W 148.25' C- N88000'38"W 132.00 ' _ fr D- N00°19'51" E 148.65' E- S88000'38"E 328.31 1-94 R.O.W. F- S88000'38"E 132.00' UNPLATTED Vol. 4 Page 1123 3 Ml~ ~ . FORM N0.90.Y' A ' ~FtGfYllNar 26273 p G C p 645468 nn i q&, W-1 UU - 200, a~ & ~ sr. cROlx 6 , SURVEYOR'S RECORD CERTIFIED SURVEY MAP NO. 4084 v VOLUME 15 , PAGE 4084 LOT 2, CERTIFIED SURVEY MAP NO. 1123, VOLUME 4, PAGE 1123, LOCATED IN THE NORTHWEST 1/4 OF THE SOUTHEAST 1/4, SECTION 6, TOWNSHIP 28 NORTH, RANGE 16 'PEST, TOWN OF EAU GALLS, ST. CROIX COUNTY, WISCONSIN PREPARED FOR LEGEND C'O~ ANDERSON EXCAVATING GOVERNMENT CORNER (AS NOTED) DOWD M. 120 USH 12 E BALDWIN, N 54002 • FOUND 3/4" STEEL REBAR g~ O SET, 3/4"X24" STEEL REBAR M~NOMONIE, ; a DRAFTED BY: WEIGHING 1.502 LBS. DONALD M. CLARK PER LINEAL FOOT. 1''.~~• WI RECORDED AS I ~b z oO'••••••'~i y{~ y~ ~ .v ~~~0 rOO UNPLAT_TED LANDS NORTH LINE OF NW-SE PT. OF BEG. 58800'_38"E_Y55TH AVE. A/ ir> in NW COR. NE-SE N88'07'32"W r- - S88'07'32"E S88'07'32"E 2634.82' 793.12' 8 F-56-58. 32328.32' NW coR. OF SE 1/4 M3• w- 1317.41' SEC.6, T28N, R16W uj ' m to / g' 64.00' FND. ALUM. CAP r 3 rn 00' SETBACK LINE r ~f 2 N 87"56'58• W EAST 1/4 CORNER - SEC.6, T28N, R16W w w 2 g 0' FND. 3/4' REBAR C'j / (S88'00'38E) M G y M OUTLOT-2 S88-07'32} Z I.- 00 to 196,227 SQ. FT. w 3 s N `O ~ (4.50±ACRES) 2 w 0) N ~ CO o c tI ?"f W w 189,950 SQ. FT, LESS RW'3o 00 I 0 z (4.36±ACRES) LESS Ri m ai t « / z o o w ?60 411 2 0 o e~e4~ w ti~ 00 Zi SA,1rG, H 1 3~. S 80'47'56' W 3 :3 g w wq yS m s 3go w 183.37' iv o n c . u n'1'C SEP 3 3 -`0 r. w 85 « a 00 00 Nq y AC I,~ m ao 0 ao 0 3 r og +s z 3 04 C14 ,~ryTS y M O v m° ° o °z Z° LOT 4 0 3- o oH3 N N 00 p En' 239,324 SQ. FT. N (n S $ o, IF o (5,49tACRES) ® ~l j/ 0 0. F, :6 "o 2P .01 oco °d w a SETBA U''E` MA4 0 50' o ~j o c q- m m~m w NO ACSSS _ g34M.2 y o n~ I S71i 42 59*W(S7a 49"5A*w) 5 E 0 -cc Z. C c A PROD-- f 1 94 1z E « -5.5 00 E c o Zonino and POarks Committee u « ' c_ 0c fi .2 = 3: MAY 14 2001 SCALE:1 "=200' ° N I~ ; 0 o z a o E if not recorded within 30 days of 0• 100' 200 400' approval date approval shall be null and void CEDAR CORPORATION DOT NUMBER 55-94-3085-2000 ONO 604 WILSON AVENUE MENOMONIE, vN 54751 (715) 235-9081 Vol. 15 Page 4084 SHEET 1 OF 2 8 94 4'f 337 Owncr ; - I 1Y•~% ,..s o rL Mf'Q L9 rI ~i : SyQDZ CsT 3y l3 tea- fi_9,y ,~l - ~oz.s4 5~~. G B2 330 fi 63- 96-69' O Pe s,fi 7gN Rl6w Nw % SE'% y ~ ca~E DJ C.T ~d1` 'MCc~t~eaau.~tt T sgle';-ic is ~ { /1Z r M`Z~' ? LiM. ZZ r et b/Ne 3 Bd.-,•,, 3°1. d B/ T.NsTA4L w1T11 I F.~~,6 c^.f- SA~uyy~~CQ((y~1'~ Sl~srtn. a~~ FL.Fcva, kut 4E2 (~Ai►~7~~~ .6~lfe, No. 01 D V f a et pl, t , S'S 4 ve- Oc,~nCr Il obi r/ A1' P ~ s o rL 64 L9 ~4/c/u,,, • 7 j 14-4 SS~GIdz csT- 3y/3 ~a- 7-9y B.M. Ql - ~oz .s4 S~~ . ~ 132 330 96-69~ O Pe- c /o/ 7gAl Rl6c~ A1wry sr% ]33 30' .31f /l z 33// o /`l Peer • ti o M ` BzZ P%~ e PQ; v f C of ~C ~ ZZ Tee LIge 3 Edo-on. 31. u' 1 1`9A r& PQ f~ slue, No, LA D Grave- pl, Ave-