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Parcel 016-1061-30-100 03/09/2006 09:00 AM
PAGE 1 OF 1
Alt. Parcel 29.30.15.427B 016 - TOWN OF GLENWOOD
Current L I 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 - WINK, MARK L & SHARON J
MARK L & SHARON J WINK
2855 CTY RD G
GLENWOOD CITY WI 54013
Districts: SC = School SP = Special Property Address(es): • = Primary
Type Dist # Description " 2855 CTY RD G
SC 2198 GLENWOOD CITY
SP 1700 WITC
Legal Description: Acres: 4.610 Plat: N/A-NOT AVAILABLE
SEC 29 T30N R15W PT NW NE BEING LOT 1 OF Block/Condo Bldg:
CSM 10/2765 4.61 ACRES
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
29-30N-15W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1082/635 WD
2005 SUMMARY Bill Fair Market Value: Assessed with:
89539 218,800
Valuations: Last Changed: 10/06/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 4.610 17,500 166,900 184,400 NO
Totals for 2005:
General Property 4.610 17,500 166,900 184,400
Woodland 0.000 0 0
Totals for 2004:
General Property 4.610 17,500 166,900 184,400
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 211
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 C? `~~-~sy^G
ADDRESS ~Gf 3 .2 ~O~
SUBDIVISION / CSM# 04- /O 2 C> LOT #
SECTION_2y _T2e N-R W, Town of 6~,Ze/V LvOOd
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
44
1
1
o~
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK: re /r e )?lf N f e' s7G eG l~/V ee / D S, lee
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: 4 I'Lose,? Liquid Capacity: /off ~~ao
Setback from: Well 10/ House Other
Pump: Manufacturer lli d i~ Model# _5'Ae/,2,,5'Size
Float seperation Gallons/cycle: 1-3-3
Alarm Location
-tee
.SOIL ABSORPTION SYSTEM l
Width: Length Number of trenches /
Distance & Direction to nearest prop. line: 3p ` o O[,17~-
Setback from: well: House Other
ELEVATIONS
Building Sewer D Z ST Inlet: 6 ST outlet
PC inlet PC bottom__v - Pump Off 7
Header/ ` 1 old Bottom of system
Existing Grade ! Final grade y ,
DATE OF INSTALLATION:
PLUMBER ON JOB: LICENSE NUMBER: /y
INSPECTOR:
4:7 4~1
3/93:jt
Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County:
Labor and Human Relations ST. CROIX
Safety and Buildings Division INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.:
Pe UJ ura tlio.lriV,ff- _mdkARLES ❑ City ❑ Village IR Town of: State JIM No.:
SMl tt r t; 7 7a
alAnwinind CST BM Elev.: Insp. BM Elev BM Description: Parcel Tax No.: /l -
v yt
/~r can r ~S (ts ,
A94 Q1 50
TANK INFORMATION ELEVATION DATA 7 5 e(ev, e5.~
TYPE MANUFACTURER CAPACITY STATION BS HI ELEV.
Septic -P 3R/ CLy,e a off Benchmark 3 ' l(
Dosing
c. r3. 0, /os 3S
Aeration- Bldg. Sewer 3. w 1.41 Holding St/ Inlet 6,V
TANK SETBACK INFORMATION St/ Outlet
TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic >laj ;4,4 NA Dt Bo~ta 2: Z 7S
Dosing 11 NA Header / Man.
Aeration Dist. Pipe S' 9,
s, sz
Holding Bot. System
PUMP /N INFORMATION Final Grade
Manufacturer's Demand N 3'
Model Number c~ z) GPM
I Loss Friction Syesterr~ . TDH Ft
TDH Lift
Forcemain Length 4(_-2.7 Dia.,2' Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 7 7 DIMEN
SETBACK SYSTEM TO P/L BLDG WELL LAKE/ STREAM HING Manufacturer: INFORMATION Type Of /(.P,,r CHAMBE i
W / OR UNIT
System: d X
.51.
DISTRIBUTION SYSTEM -
Header 1 Ma ool Distribution Pipe(s) x Hole 5 zex Hole S acing Vent To Air Intake
Length ia. Length Dia. Sparing I ~ ` S
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over f, Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched
i
f~llrench Center 8~?Trench Edges Topsoil Cn [~1G~5~❑ No j}- of n No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: Glenwood-29.30.15W, NW, NE, County Road G
Qp lS, oj. - 3 • Z r Q~ So" d •
a /v
d 97
Plan revision r qulred? ❑ Yes o
Use other side for additional information. .~--1,91
SBD-6710 (R /91) Da a Inspector's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH ,
SANITARY PERMIT NUMBER:
k
ILHR SANITARY PERMIT APPLICATION
In accord with ILHR 83.05, Wis. Adm. Code COUNTY 5~7' 4f 8,0
STATE SANITA MIT
-Attach complete plans (to the county copy only) for the system, on paper not less than ,9 0DIp
8% x 11 inches in size. ❑ Check If revision to previous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER /
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. S 9` O b
PROPERTY OWNER PROPERTY LOCATION
,Chh L° C l/ 414V 114A,4' '/4, S T , N, R /,f Aillor) W
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
/9&.? t- Sf
CITY, STATE ZIP CODE PHONE NUMB/E~R- SUBDIVISION NAME OR CSM NUMBER
II. TYPE OF BUILDING: (Check one) ❑ State Owned VILLLLAGE NEAREST ROAD
e7 47, L TAX NUMBER(S)
❑ Public Ill 1 or 2 Fam. Dwelling-# of bedrooms
III. BUILDING USE: (If building type is public, check all that apply)
1 ❑ Apt/Condo / O
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)1.14 New 2. ❑ Replacement 3. ❑ Replacement of 4.0 Reconnection of 5.0 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 [X 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./inch) ELEVATION
,.77v2 Feet Feet
7- ;1 &1 Fb0
VII. TANK CAPACITY Site
in allons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper.
INFORMATION New istin Gallons Tanks Concrete glass App.
Tanks Tanks structed
Septic Tank or Holdin Tank X
Lift Pump Tank/Si hon Chamber. !2
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Print): Plumber's Signature: (No Stamps) MP/ Business Phone Number:
/ z A
Plumber's Address (Street, City, State, Zip Code):
IX. COUNTY/DEPARTMENT USE ONLY
V❑ Disapproved San~ry Permit Fee (Includes Groundwater Date issued issuing Agent Signature (No Stamps)
Approved ❑ Owner Given Initial Surcharge Fee)
Adverse Determination 1 ,4&
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: UUC/
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 (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, 6,08-266-3815.
To be complete and accurate this sanitary permit application must include:
1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of
where the system is to be installed.
II. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling.
III. Building use. If building type is Public, check all appropriate boxes that apply.
IV. Type of permit. Check only one 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 comple=te dimensions, location of
holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service;
streams and takes; pump or siphon tanks; distribution boxes; soil absorptior, 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; frict on 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)
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W- Page / Of ZZ
Straw, Marsh Noy, Or
Synthetic Covering
Distribution Pipe
Medium Sand
G
Topsoil - F
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%
w; J
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lied Of t 2 t Main flowed
-2 (Force
Loer
~~~,,ONS Aggregate From Pump y
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NON N~ D 40
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aF of G~, Cross Section Of A Mound System Using F ,
o o~vptr3~
A Bed For The Absorption Areo ;
G p_
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Signed: f t.
i t
License Number;
Date:
Gb,,t:rvotion
A lit t
• \ Force Main
W - r.-_ - From Pump
r
1
Distribution Bed Of i - 2'2
Pipe Aggregate
1
Observation Pipe Permanent Morhers
Pion View Of Mound Using A Bed For The Absorption Area
S9-20x96
Page ;z u3iooi
Perforated Pipe Detoil `
/0
End View
~Pe foro I e d
/ - -
Er". Cop r VC P-pe
Holes Locoted On Hollon,,
Are Equolly Spaced
'c-Fn R C iwt p i N
j'L'G _ • ~Y~YrM
conditio
"Wall,
T Y, LOGIR
IJILMNO,
• DEPT. Of ►ND F AFETY N • .
` DIV1 - -
0SOF
N: a f±P \ pie
t? e)
Inches
i
Ilnl(. Na-eter Inch
Lateral IriCII
License NUMI)Pr: -Z90 Manifold Inches
Gate: Force Main Inches.
of holes/pipe
Invert Elevation of Laterals Ft.
4 2 0 1
-11E,- ® 9 6
Page Of_
SEPTIC TANK & PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS
1 4" CI VENT PIPE 12" MIN. ABOVE GRADE & WEATHERPROOF
IRDI FROM DOOR, WINDOW OR JUNCTION BOX -APPROVED
. -FRE'SH AIR INTAKE
WITH CONDUIT MANHOLE COVER
FINISHED GRADE W/ PADLOCK &
- 4" CI RISER WARNING LABEL,
m._.4"- MIN.
1811 IN. MAX.
INLET
I -
WATER TIGHT SEALS GAS-
TIGHT \/APPROVED
A SEAL JOINTS WITH
APPROVED --i , ~ ALM APPROVED PIPE
PIPE 3' B I ON 3' ONTO
ONTO SOLID ' SOLID SOIL
,
SOIL C
PUMP OFF ELEV. Y-2-FT. I OFF RISER EXIT
D PERMITTED ONLY
3EM IF-TANK
MANUFACTURER
r
HAS APPROVAL
ROVED BEDDING UNDER TANK
!itiom
CONCRETE PAD
;4 & N13MA14 VeAT10NS
99 L „TRY, LABOR sulL01NGS
r4Y `~A ~ it C1 A~5Y~ p
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EgpONDLNGE
sEPrfc E-.j SPECIFICATIOAIS
DOSE i S~C R M6G} .3
TA.IKS MAAIUFACTURER: IJUMBER OF DOSES: PER DAy
TAWK SIZE r GALLONS DOSE VOLUME
ALARM MANUFACTURER: INCLUDING BACKFLOW: /'j y GALLOn 5
MODEL UUMBCR: H CAPACITIES: A=2,F_IAICHESOR GALLOki
SWITCH TYPE: ✓l Ld /i g = - IMCHES OR r GALLO'. S
PUMP MANUFACTURER: I/ ydr? 0,A11I/-1-1C C= _IMCHES OR uALLOQi
MODEL NUMBER: S ~-51 D= .IAIC14ES OR ~ - GALLOAIS
SWITCH TYPE: MOTE: PUMP AND ALARM ARE TO BE
MINIMUM DISCHARGE RATE GPM INSTALLED ON SEPARATE CIRCUITS
VERTICAL DIFFERENCE CETWELU PUMP OFF ARID DISTRIBUTIOUp1PE.. 0 FEET
+ MIMIMUM NETWORK SUPPLY PRESSURE . . . . . . . .i`. _ 2-5 FEET
+ _ FEET OF FORCE MAIN X L.-6 FT,/
~IOO FXFRiCTio1J FACTOR. ' FEET
TOTAL 09MAMIG HEAD FE"89 4 _ 2019 6
IUTERNAL. DIMEWSIONS OF TAUK: LENGTH > ;WIDTH - ;LIQUID DEPTH
SIGNED: LICLOSE UUMBER: M/'22 DATE:
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{ 5 F~
ODELq~ ,
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MAX. SOLIDS
'SPHERE a ERE:
z 114 AND;#~P
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FEATURES S~ BEM • For sump and effluent use • For sump and effluent use
5 • Automatic models available with • Automatic models available with
wide-angle piggyback float switch. diaphragm piggyback type switch
-
5 Also available• 1 /4 HP (SD25)_or 1 /3 HP (SD33),
+iO a~ • 1 /4 HP (SW25)in or 1 /3 manual HP (SW33), heavy-duty 115V oil illed motor
heavy-du-tyl tWoil ed motor e i verloa~d r t ion 1.
-
Co Ng with thermal ove oad rotection,! r ouon s
P~~ • Rugged`cast iron construction"t • ex 4 o astir
V~`a~{~ ~~aS • Non-clog vorte a oplastic 1 `
4 Y w
~V h t F. i•.
4-imp
eller sr a
, r Ong life lower ba I eanng r eev a Ong
~N 0 t>A` Sintered top sleeve bearing • vCa nand Gera
mic mechanical
Oc'G • Carbon/ceramic mech."shaft seal shaftseal
• 1-1 /2" NPT discharge • 1:-1/2 P. dik arge,.'
RE • 10' replaceable power cord. (20' • 10 replaceable'power cord -(20
optional} optional)
• hUL listed sumppump • UL ed:.~ m~pump
a~~, x
0,A /4 H .115V P. 10115.0
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00 10 20 1 -130 40 50 60. 0 10 201 30 40 50 60
s' r CAPA .S. G.P.M. CAPACRY-U.S. G.P.M.
3
wlscmm SOIL AND SITE EVALUATION REPORT Page/of 3
~-DILHR in accord with ILHR 83.05, Wis. Adm. Code
DFARMW R(OIE .IIBOR6614AWf19ANS COUNTY -
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but 57- X 71
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. 0 6 " /A/";2 O
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
Sl GOVT. LOT 1/4 I 1/4,S;! 3Q N,R IS-##) W
PROPERTY OWNER: 'S MAILING ADDRESS LOT # BLOCK # SUED. NAME OR CSM #
CITY, STATE ZIP CODE PHONE NUMBER []CITY VILLAGE (BfOWN NEAREST ROAD« i~
Crl w a a °.5' o (7iS-1 6S`- vv d Leo, d
JA New Construction Use Residential / Number of bedrooms 3 [ J Addition to existing building
[ J Replacement [ J Public or commercial describe
Code derived daily flow gpd Recommended design loading rate bed, gpd/ft2 trench, gpd/ft2
Absorption area required bed, ft2 3,;~5"trench, ft2 Maximum design loading rate bed, gpd/ft2 -trench, gpdA2
Recommended infiltration surface elevation(s) .3.1Z ft (as referred to site plan benchmark)
Additional design / site considerations Sfl Nd !,()ki cl e R b eel e / Alp 4N d SY Z2'_&A
Parent material G~ Gr i .a- L 7-1 L Flood plain elevation, if applicable ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE 7ATGRADE SYSTEM IN FILL HOLDING TANK
U= Unsuitable fors stem ❑ S [X U M S ❑ U ❑ S W U 14U ❑ S NU ®S ❑ U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence BOuldaty Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tnnch
Ground 7 r~f16 G' r
elev.
9s' ft.
Depth to
limiting
factor,
Remarks:
Boring #
lea 3 1.7-
e d, 6 4 2,+,d c MSS
Ground
elev.
5,2,krtl.
Depth to r
limiting
fact ~ ~
Remarks:
CST Name: Please Print P s- Phone:
6S=
ddress: ~2 .2 7O G-'4 eN W 4, I /v l SL D/
Signature: r r. Daie: /v /9 93 CST Number:
• PROPERTYOWNER SOIL DESCRIPTION REPORT Page _2 of
PARCELI.D.tf d I6 - /O~o2 -
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Botxxfvy Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trend
;2 4i A-Ai M Fj:' C~ A/ ~
Ground
elev.
9 _,.2
ft. '
Depth to
limiting
facto
i
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
t
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
' ' P~~'e o C 3
MIESER 1111BETE
RT. 2 (Hwy. 10) MAIDEN ROCK, WI 54750 • 715-647-2311 FAX 715-647-5181
,S'y< C Ro
_IV Sc e 4 /o "
9.88
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FILED
MAY 2 6 1994 ►
JAMES O'CONNELL O
Register of Deeds
JC1'7057 St. Croix Co., WI
CERTIFIED SURVEY MAP
LOCATED IN THE NW4 OF THE NE4 OF SECTION 29, T30N, R15W, TOWNSHIP OF
GLENWOOD, ST.CROIX COUNTY, WISCONSIN.
OWNED BY: Charles DeSmith
1' 'PROVED
9.iY 2 5 '94±
NOTE: BEARINGS ARE REFERENCED TO
THE NORTH LINE OF THE NE 1/4.
( COUNTY DATA), ~-;ROIX COUNTY
..:.:rahensiie Plannir
Zoning and
f<'-,ts Committee
U N P .L A T T E D L .A N D S ,vt recorded
o,= tnl-!mim 30 days of
_ -S1 N 1/4 CORNER OF SECTION 29. o .Awov ~~dyaptgel~a
S~ ( COUNTY MONUMENTFOUNO). n _ .(r OS~TIONgESTA"BCl';'REd 9
ut NORTH LINE OF THE NEI/4 FROM TIES). ►hT[>id
_ S 8605554"E 549.70
2 M N86055'54"w
C. T. H 111 G 11 b 209 .34 '
v v N
S86055'54"E 220.06' a
S 3 ° 04'0 6 S66°5554E 32 9.63'
N• O T-
4.50 ' '
N;
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0
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Z. o
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In
Q.
J M BUILDING SETBACK I in
w co
w o L 0 T I to o.
W: w ` 0 4.OOAC.EXCLUDING ROADR.O.W. W*
O 6 ( 174,424 SO.FT.) 3
4,6 C. ACRES TO SECTION LINE M F'.
Q' (2-00,641 S0. FT.) O Q.
d' I- o rn
M IL
0
a
Z
3, Z 0 Z M Z.
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N86°55 54 W 549.70
W
_ M
0 o UNPLATTED LANDS
as En
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rn
M
2
S 1/4 CORNER OF SECTION 29.
I COUNTY MONUMENT FOUND).
Flo
c. JAMES M. $
WEBER
S 1804
O ° SET I "K 24" IRON PIPE WEIGHING 1.13 LBS. SPRING VALLEY
PER LINEAR FOOT. f% WIS.
SCALE I = 100 00
_ oe®eae~
0 50 100 200' JAMES M. WEBER S-1804
DATED
SHEET I OF 2
94-53 THIS INSTRUMENT DRAFTED BY JIM WEBER 1
VOLUME 10 PAGE 2765
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SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County ~
w
MIOR
OWNER/
o
y `3
ROUTE/BOX NUMBE Fire Number :3
CITY/ STATE i✓LLf~'C'd ClY' i ZIP~Lfd/ r
PROPERTY LOCATION:'.'Li/A/ k, 4 k, Section TAN, R W,
Town of iV Lv~ ~d St. Croix County,
Subdivision Lot number.
Improper use and maintenance of your septic system could result in
its premature failure to handle wastes.- Prover maintenance con-
sists of pumping out the septic tank every three years or sooner,
if needed, by a licens'ed' 's'e t'ic tank um per. What you put into
the system can affect t e unction o, t e septic tank as a treat-
ment-stage in the waste disposal system.
St. Croix County residents-mom be eligible to recieve a grant for
a maximum of 60% of the cost.of replacement of a failing system,
whit 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 'sys'tems agree to keep their system properly
maintained.
The property owner agrees to.submit to St. Croix County Zoning a
certification form, signed by the owner and by a mater plumber,
journeyman plumber, restricted plumber or..a licensed pumper veri-
fying that (1) the on-site wastewater disposal system is in proper
nec-
operating condition and(rthaninspection
fullnofpumping
sludge and scum.
essary), the septic.tank is less
Certification form will be sent approximately 30 days prior to
three year-expiration.
0
I/WE, the undersigned have read the above requirements and agree 0
to maintain the private sewage disposal system in accordance with
the standards set forth, herein, asset by the Wisconsin Depart-
ted
ment of Natural CerCountytificaZoningtion
and returned to
of the three year expiration date.
SIGNED A
DATE vue Q~
St. Croix County Zoning Office
911 4th St.
Hudson, WI 54016
386-4680
Sign, date and return to the above address.
STC-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 C '
Location of property !Li 1/4 N 1/4, Section v2/ , T2e N-R /.3-W
Township
Mailing address /_?11.7 C~-
r r
Address of site
Subdivision name Lot no.
Other homes on property? yes-__y No
Previous owner of property
Total size of parcel
Date parcel was created q,~ 7
Are all corners and lot lines identifiable? Yes x No
Is this property being developed for (spec house)? Yes No
volume,and Page Number ~D 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 & 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._9/-7, 7// , and that I (we)
own the proposed site for the sewage disposal system orr I e(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 County Register of deeds as Document
No._37d
X
signaturAO!!f ap~licant r
Co-a 1 cant
PP
-aCe~
Date of Signature Date of signature
DOCUMENT NO. STATE BAR OF WISCONSIN - FORM 2
V4t 644 7t nE 601 WARRANTY DEED
376911 THIS SPACE RESERVED FOR RECORDING DATA
Phillip C. Rassbach, also known as Phillip KEGIST6RS OFFICE
Rassbach and Ella D. Rassbach, as his wife ST. CROIX CO., WI&
and in her own right Rend, for Record Ibis 1st
conveys and warrants to Chart°s J. DeSmith and day of AD ril A.D. 19JJ2
P
of 2:00
Joan L._ DeSmith, husband and wife
•
dvSra of Deeds
RETURN TO
Federal Land Bank Assn.
the following described real estate in St. Croix County, Hwy. 35 N.
State of Wisconsin: River Falls, WI 54022
i
W~NElxr
Tax Key No.
E~SE'4NW„
All in Sec. 29-T30N-R15W.
FEB
Thisi_S nOt homestead property.
ft (is not)
Excepflon to warranties: Existing highways, easements, rights of way and
restrictions of record.
r Il
Dated this day of /47' + 1g $ 2
.I
'I
i
(SEAL) /.-Tue~ :o f zu--d✓
c (SEAL) .
Phillip C. jassbach
(SEAL) ~ dY (SEAL)
• Ella D. Rassbach
• a
AUTHENTICATION ACKNOWLEDGEMENT
Signatures authenticated this day of STATE OF WISCONSIN j
19 SS. t
County.
Personally came before me, this day of
/I1'► I~ _ 19 TEL
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, the above named
authorized by § 706.06, Wis. Slats.) Phillip C. Rassbach, also known as
This instrument was drafted by Phillip-Rassbach and Ella D.
Rassbach, husband and wife
Attorney David J. Estreen
619 Second St., Hudson, WI to me known to be the person -5-- who.e4 4d foe foregoing in-
strument and acknowledged the same.
I (Signatures may be authenticated or acknowledged. Both are not t
necessary.)
Notary Public County, Wis.
'Names of persons vgning in any capacity must be typed or printed below IfnSS pat es
iv 1f , `t. (,?lily Commission is permanent. !If not, state expiration date:
Notary Public - of qi& - • 19 - - )
Commission :.x.; res
WARRANTY DEED - STATE BAR OF WISCONSIN. FROM NO 2 - 1977 August 15, 1982 - Stock No. 13002
7 - N ~1
F+1 C O
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a,
N D MASTER loc'.
BATH m Tv J
'AD O c y
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iz-
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UTILITY °D
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25
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FILED 7`1,~~oal/ 60
~
D/G /
MAY 2 ' 1994 a-
JAMES O'CONNELL O
Register of Deeds
517057 ti St. Croix Co., W►
1 N
CERTIFIED SURVEY MAP
LOCATED IN THE NWk OF THE NE4 OF SECTION 29, T30N, R15W, TOWNSHIP OF
GLENWOOD, ST.CROIX COUNTY, WISCONSIN.
OWNED BY: Charles DeSmith
ROVED
`aff 2 5 '94!
NOTE: BEARINGS ARE REFERENCED TO
THE NORTH LINE OF THE NE 1/4.
( C O U N T Y DATA). '_:rcOIX COUNTY
ahensive Plannit
Zoning and
57_'t's Committee
"--at recorded
U. N P .L A T T .E D L .A N D S ~wv,!11QI30 days of
F' - - sumovaldate
N 1/4 CORNER OF SECTION 29. - NE CORNE'~~} ~ 9.
S ( COUNTY MONUMENT FOUND). ( POSITION ES4B~~
(n NORTH LINE OFTHE NE114 FROM TIES). '7.'snid
_ S86°55 54 E 549.70 N86-°55'5W
to t C. T. H 11 II o 2090.34 .
0
c
v 01
a °i
S86055'54"E 220.06 a _ _
586° 5'54"E 329.63'
S3 °04'06"W
V). p 4.5 0
0 0 OO Q.
Z• ,n - - op zQ' 0 J.
.I to BUILDING SETBACK to
L L ..T
W: w w 0 4.OOAC.EXCLUDING ROADR.O.W. ~S ~ W.
I'- 2 O ( 174,42t SO.FT.)
F-• ro 4,6C, ACRES TO SECTION LINE
Q' 0: ( 2.00 , 6 4 1 SO. FT.) p Q'
J.
J. w p a)
d.. a: p a .
z a Z z.
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N66°55 54 W 549. 70
w
M
a U N P LATTED LANDS
o
rn o
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o V
M
2
S 1/4 CORNER OF SECTION 29.
( COUNTY MONUMENT FOUND),
c: ► JAMES tel. a'
dVEOCA
S- 1804
SPRING VALLEY
0 a SET I "X 24" IRON PIPE WEIGHING 1.131-13S. k
PER LINEAR FOOT. G WIS. /'Q7 +
0009
SCALE I 100' C
3 U k
0 50' 100' 200' JAMES M. WEBER S-1804 x
DATED
SHEET I OF 2 R`~,'~ s t~ qy
94-53 THIS INSTRUMENT DRAFTED BY JIM WEBER
VOLUME 10 PAGE 2765