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parcel 020-1065-70-200 01/12/2005 04:41 PM
PAGE 1 OF 1
Alt. Parcel 24.29.19.251A-20 020 - TOWN OF HUDSON
Current ❑ ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): * = Current Owner
* MARTIN, PAUL M & ANITA L
PAUL M & ANITA L MARTIN
813 HWY 12
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 813 HWY 12
SC 2611 SCH D OF HUDSON
SP 1700 W ITC
Legal Description: Acres: 5.830 Plat: N/A-NOT AVAILABLE
SEC 24 T29N R19W PT NW NW BEING LOT 1 Block/Condo Bldg:
CSM 9/2470 2.83 ACRES ALSO A PARCEL
BEING PT OF LOT 26 SUNRIDGE DESC AS COM Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
W1/4 COR SEC 24; TH N 0 DEG 1259.47' ALG 24-29N-19W
W LN SD NW1/4 TO POB; TH CONT N 0 DEG W
212.77' ALG W LN S R/O/W HWY 12; TH N 82
more...
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 961/32
07/23/1997 956/136
07/23/1997 950/619
2004 SUMMARY Bill Fair Market Value: Assessed with:
48156 304,000
Valuations' Last Changed: 04/29/2002
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.830 63,600 171,600 235,200 NO
Totals for 2004:
General Property 5.830 63,600 171,600 235,200
Woodland 0.000 0 0
Totals for 2003:
General Property 5.830 63,600 171,600 235,200
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 107
Specials:
User Special Code Category Amount
018-RECYCLING SPECIAL ASSESSMENT 27.00
Special Assessments Special Charges Delinquent Charges
Total 27.00 0.00 0.00
FORM NO. 985-A
"vo
481840
CERTIFIED SURVEY MAP
X11 / 4 C'0,R N;` ,
.!'SECT1Z7'12 f,~.. W
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SCALE IN FEET
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00 0
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LATTED LAN DS o z
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_ S• HIGH "
c U.
T-OF-WAY LINE E S84°55' 42 W
RIGH N$405514211 1361.49'
o N 83°20' 421E 729.42' 1 G 494.99 30°~ Point of Beginnin'
LOT 13 3 0°55 , .
~a,o1~~ X60'
-~N7g°09'2411 E' N82° '201,w_ D 1902.83 Acres
199.11' 299. 11~ N86°59,16'W 71g3• 14~ B N p L A T T E p H
U
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L rFp LAN
A N p
1- C .~.I
CENTERLINE OF FORMER U.S. HIGHWAY
SW-NW TABLE OF INTERIOR ANGLES
A 22000112" E' 175° 35' 04"
B 164057'23" F 18°29'54" LEGEND
C 164057123" G 178025100" COUNTY SECTION CORNER
D 175035104" MONUMENT.
0 1"x24" IRON PIPE SET,
WEIGHING 1.68#/LINEAL FOOT.
CURVE DATA TABLE ASSUMED
CURVE RADIUS CHORD CHORD CENTRAL TANGENT BEARING
LEERS STAR-M DISTANCE A LE BEARI
B-C 372.07' S770.58'0711W 193.14' 30005'14" N86059'16"Vy'
D-E 1942.53' N82034'2011W 299.11' 8049'52" N78.°091 4.;'W
This instrument drafted by James T. Swanson. -T,
Vol. 9 Page 2470
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SUNRIDGE
NW 1/4, IN THE NE 1/4 OF THE NW 1/4, AND IN THE SE 1/4 OF THE NW 1/4 OF SECTION 24, T2
9Y OTHERS
D- LANDS---OWNED _ _ _ - - _ -
UNPLATTE .
r - -
0 34!w
- RECORDED AS S8509. ig
S 83.52 iopW
304.74'
I I in
204. 11 0 I EXISTING DRIVEWAY
EXISTING DRIVEWAY - O O t _ lv~
9~g •82 ~ ~i r ~ m
tU _ HOUSE 3
2 .ajti i w \ O
• ,~~9 • SETBACK LINE 1 I c ~ _ o
M~' t t o °o at
.26 0 1 0 27 Z,
° 1 1 ° SHED 2.012 AC. 00 a
00 87,653 Sq. Ft.
m z " 01
W HOUSE z 303.00' w
N 90'0 '00"W
' 160.35 142.65 Q,
26 SHED N 90°00' 00" E J1
o j54i
285 X14-5~. -~L F ED Ill Z
O O
:D _ LANDS_ o O
IEVELOPER_ SHED o
BARN o
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N 90'00'00"E 394.00'
UNPLATTED LANDS
ONE By DEVELOPER
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
'INDUSTRY', I 1 C DIVISION
LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX N WI 53707
HUMAN RELATIONS
(ILHR 83.09(1) & Chapter 145)
LO~~ Ny~,/ SEC
IQJN: ~~(o T ®H Li~'i~; LOTNO.:BLK-NO.: SUBDIVISION NAME:
7-1
COU T O R'S UYER'SINfAME: MAILING ADDRESS:
rol/ •
USE DATES O SE ATIONS MADE
NO. BEDRMS.: COMMERC L DESCRIPTION: PROFI D AN PERCOL I TESTS:
W esidence ew ❑Replace Z-
RATING: S= Site suitable for system U= Site unsuitable for system
ONV NTIAL: M D: ❑u IN-G~D-P URE: SYSTEM-IN-FILL HOLDING T_ ANK: RECOMM~ DED~SYg%EM:(optional)
M ou los I DU S2N_ If Percolation Tests are NOT required DESIGN RATE
If any portion of the tested area is in the
under s. ILHR 83.09(5)(b), indicate: 4 S Floodplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS
BORING TOTALI'f DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH ELEVATION OBSERVED EST... HIGHESTSS TO BBED6ROCK IF OBSERVED7((SEE ABBRV.OtN BACK.)
/ TV/ / 3, as
Sir B- Z , 72 / /,03 S3 ~Z ' 7 41 7 lSn~ 2, •S Sgfr~ . 5V $n S
33
B- 7,33 v d,9,. ) 9, 33 F& 'Opt J, 4
/ •9241r4 7~d-► •7S 0 454 , j..S
B- P,, 0 A ~ 7 X 10, S8' > 7
011 3. S8 6„ 7s 414 s
B-
PERCOLATION TESTS
TEST DEPT WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER I S AFTERS LLING INTERVAL-MIN. PER D 1 PERIOD2 PERIOD PER INCH
P_/ 5; P 2 G 3
P- Z S Z 6 < 3 , 0E P-3 v <3
P_ (0 Z 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.
"/7,
SYSTEM ELEVATION
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i I, 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 ER OMPLETED ON:
C4 t44
A DRESS: ~ f CER IFI AT N NUMBER: PHONE LIMPER (optional):
D r.J 3S Al Ste. ~d 6
CST SIGNAT E•
f.
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R• 10/83) - OVER -
s
` TIONS FOR CO11111P .ETINC= F, 115 - SBO - 61
To be a cr;'T 1° -~,e soil te, Oft M US,
1. Comp x
2. The use set i iy indicate v. this is F residence or commercial project,,
3. MAXIMU'. ° !--droorns or c£ ial use planned;
4. Is this a nt iysterll;
Via. Comply ,,,g boxe,.. TE IS SUITABLE FOR A € OLDING TANK ONLY IF ALL
LI 3ASED ON SOIL CONDITIONS;
OTHER
6, PL_ re for vvriting profile descriptions and cc). r; plot plan;
7, y locating your test locations, D,'awig is rar~2er~red. A
sf
S. I,°, and, , elevation reference poiw. are clearly a permanent;
9. Cc `e boxes a-1 o dates, names, addresses, flood plain data, pf, t exemp-
t€c
1Q. If tree rch as flood plain, elevanor~) does not apply, place N.A. in the box;
11. Sign thu t _.I = lace your cur rant address ant: your certification number;
12. Mike leg, conies and distribute, as roquiied. ALL SOIL TESTS MUST RE FILED WITH THE
LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION.
ABBR VIATIOI S FOR CERTIFIED SOIL TESTERS
Soil Separates and Textures Other Symbols ~
st_ Stone (over 10") 3 Bedrock
cols - Cobble (3 - 10") SS - Sandstone
gr Gi< 4 (under 3") LS - Lin
s HG W H ig; rnr
Perc - Perco tio 't
rr r:d W Well
fs Bicig
d
sl In < t
L
R! I ;k
Gy Gray
c a y - YeIIoz,I,
scl - L=aarrr R Red
ic1 1,;,, Lc;arn rrrot - lot=Ies
Sc - ar1CI'g' Irry ?1i - 'with
sir !~-qty Clay fff - few, firre, teirtt
cc common,
P,, 11) In Many, C"e
d - distinct:
p promineni
WL High water level,
s -rt salt textures surface water
to disposal BM - Bench Marls
VRP Vertical Refeience Point
J
TO THE OWNER:
This soil test report is the first step in securing a sanitary permit. The county orthe 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.
J
L~` ~ part tr ~tst~t • 29.19W %%~iUARiAiEM County:
Labor and Human Relations INSPECTION REPORT
Safety and Buildings Division
(ATTACH TO PERMIT) Sanitary Permit No-:
GENERAL INFORMATION
❑ City ❑ Village R Town of: State Plan ID No.:
Permit Holder's Name:
I HUDSON
v.: Insp. BM Elev.: BM Description: Parcel Tax No.:
,r
TANK INFORMATION ELEVATION DATA A9400035 //06/
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic S C Benchmark 1,9, od ' /mod, 66 ,
Dosing- 0. ?o ' ~ . 6~2 ~
Aeration Bldg. Sewer 0,9 3
Holding St/ Inlet $sr
TANK SETBACK INFORMATION St/ Outlet
TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic NA Dt Bottom
Dosin NA HeaderX;~ 20,5$
Aeration Dist. Pipe Apt,
Holdin Bot. System` 7, a/ Ga '77,03"
PUMP/ SIPHON INFORMATION Final Grade
Ma u ac Demand o ~ 7 9.2'
ti
\q~~ Model Number PM
DH Lift Friction t
1 Force main ength Did. Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width LengC~ tb r No. Of Trenches PIT No. Of Pits Inside Di Li Depth
DIMENSIONS DI
SETBACK anufacturer:
SYSTEM TO P/ L BLDG WELL LAKE / STREAM L
p MBER
INFORMATION Type Of 4 t,-.o Ca.✓ N
System: / v OR UNIT
DISTRIBUTION SYSTEM i3s
Header khLVW0Id Distribution Pipe(s)/ , x Hole Size x Hole Spacing Vent To Air Intake
v~ Length ~ Dia. 7 Length o~ Dia. Spacing ~o
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems On -
Depth Over Depth Over xx Depth Of xx Se odded xx mulched
Bed/IeEElEFrCente ! Bed/TTVxwtrEdges Topsoil Yes ❑ No E] Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: HUDSON.24.29.19W,NW,NW,LOT 1,HWY 12 rf~~s
~f2 aP?,,,4,,aA 7&17 CZ a4
Plan revision required? Yes EkNo pc
Use other side for additional information. `7~ J~p D
SBD-6710(R 05/91) Date Inspedor'sSignat re Cert. No.
SANITARY PERMIT APPLICATION
DILH In accord with ILHR 83.05, Wis. Adm. Code COUNTY
STATE SANITARY PERMIT #
-Attach complet plans (to the county copy only) for the system, on paper not less than
8% x 11 inches in size. ❑ Check if~slon tolpr vious application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROP OWNER PROPERTY LOCATION
W %4 014, S T,t q, N, R E (or
PR PERTY WNER'S MAILING AD RESS LOT # BLOCK #
s . l
CITY, STATE ZIP CODE PHONE NUMBER OR CSM NUMBER
0 6 (JA,) 7,or57 8 0
11. TYPE OF BUILDING: (Check one) CITY NEARE T ROAD
❑ State Owned VILLAGE : u~foh Z
❑ Public Z 1 or 2 Fam. Dwelling- # of bedrooms - PARCEL Nu
III. BUILDING USE: (If building type is public, check all that apply) ^ Z
1 ❑ Apt/Condo go 1,06 -7 Q
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1.0 New 2. ❑ 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 Z Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
14 ❑ System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE
REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION
J~ 2_4p Zo 97 L Feet Feet
VIII. TANK CAPACITY Site
in gallons 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 ~c S
Lift Pump Tank/Si hon Chamber E] =04 =01 0 1 0 0
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage "em shown on the attached plans.
ta
Plu is Name (Print): umber' ignature: (No Sm MP/MPRSW No.: Business Phone Number: 1-2, Z, :Z- I ( 7V:f)
u 's Address (Street, C , S te, Zi ode):
41
IX. COUNTY/DE ARTMENT U ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Agent Si nature (Ng&mps)
Approved 1 ❑ owner Given Initial ~/fj Surcharge Fee)
Adverse Determination 1 10
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Pib-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, 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.
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 informatiion 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 131/2 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; close 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,cQunty; E) soil. test data on a 115,form; and F) aN 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 coilected 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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DAVE FOGERTY PLURONG
Licensed Perk Tester & Plumber
#3233 #3289
Fogerty Hei6t►ts Road
R08ERTS, ,S9r4SiN 54023
Phone 749.3656
I
AND V TEVY
3
3 6
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STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER '
ADDRESS
uZ~ 4017
SUBDIVISION / CSM# !Zf/rYa LOT #
SECTION T~N-RW, Town ofT~/yc
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
3~ cu~ ~~I
/}Dlog
/Z X 60 7 /so b
~'vt G
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK: .t
ALTERNATE BM:
SEPTIC TANK PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: Ll/,~~K3 Liquid Capacity: 'rD
Setback from: Well House Other
Pump: Manufacturer Model# Size
Float seperation Gallons/cycle:
Alarm Location
:SOIL ABSORPTION SYSTEM
Width: 12 Length 60 Number of trenches 2
Distance & Direction to nearest prop. line: > LSD
Setback from: well: ke House_ 2 r Other
ELEVATIONS
Building Sewer ST Inlet .//..,o y ST outlet.
PC inlet PC bottom Pump Off
Header/Manifold Bottom of system 97.3 fn-w ~
Existing Grade Final grade
DATE OF INSTALLATION:
PLUMBER ON JOB:
LICENSE NUMBER: 3 ~9
INSPECTOR:
3/93:jt
. FORM NO. 985-A
' H.GMiI1.rCmpvry~ -
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48.840
CERTIFIED SURVEY MAP
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SCALE IN FEET
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U. S. INE S$4°55'42 W
OF-WAY L °55'42 E
CD RIGHT- G N$4 1361.49
o N83°020'42"E 729.42' 494.99' $ 9p.%93p```IJ point; Of Beginning
T 1
N7g° F E N82° ► 2 83 Acres X011% 56°5
1g09 2411W 4 20 W_ D 190. 11' C 1aS0 B E D
• I1' 299.11' o 14 A T
.s
UN N8659'16nW 193•
PLq U p5
N D S
ITx:
CENTERLINE OF FORMER U.S. HIGHWAY
A
SW-NW
TABLE OF INTERIOR ANGLES;' r'
A 22°00112" E 175°35104"
B 164°57'23" F 18°29'54" LEGEND
C 164057'23" G 178°25'00" COUNTY SECTION CORNER
D 175° 35' 04" MONUMENT.
0 1"x24" IRON PIPE SET,
WEIGHING 1.68#/LINEAL FOOT.
CURVE DATA TABLE ASSUMED
CURVE RADIUS CHORD CHORD CENTRAL TANGENT BEARING
LETTERS BEARING DISTANCE ANGLE BEARING
B-C 372.07' S77°58107"W 193.14' 30°05'14" N86°59'16rVa' 'M
D-E 1942.53' N82°3412011W 299.11' 8°49'52" N786024',W
1
This instrument drafted by James T. Swanson. '
Vol. 9 Page 2470
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DAVE FOGERTY PLuRaNG
Licensed Perk Tester & Plumber
#3233 #13289
Fogerty Heights Road
_ ROBERTS, WISCONSIN 54023
Phone 749-3656
II
y--i /
011
v rEw
I 31 ) 6 ( I aI
__/z-
~a ~DIVISION
LIBOR AND
OMAN RELATIONS \ / PERCOLATION TESTS (ll5l P.O. E30X 7969
(ILHR 83.09(1) & Chapter 145) MADISON, WI 53707
' ACA ION V4 S 10 9 y~ T ! tF1': LOT NO.:BLK. N_0_ SUBDIVISION NAME:
~Gti/Act T / /N/R ~!~(or soh
JUNTA O H'S/ UYER'S NAME: MAILING ADDRESS:
E DAT_4LJ- Is 0116
ES O SE ATIQNS MADE J
13, N0. 6EDRNIS.: COMMERCI L DESCRIPTION: PROFS -
D S R
p„s;d~ ,nce ~ew Replace ONS: F~rOI o
❑ Z~ ~ q^~`-'-''~ 00,
G,.: -,S- Site suitable for system U= Site unsuitable for system
~NVEa,' TIONALc - UNDP
"
J-PF0UND: IIV-GFjO URE: SYS
TEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional)
EIU 0S bul 0S F~ S Pst 6-re-k
El S
Percolation Tests are NOT required- DESIGN -
If any portion of the tested area is in the
n ~
der s. ILHR 83.0915) (b), indicate: Floodplain, indicate Floodplain elevation: I
_ PROFILE DESCRIPTIONS
)%1BFRf fOT, E DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITSI THICKNESS, COLt)R, TEXTURE, AN) DcPTt!
Jh,18FR DEPTH, ELEVATION OBSERVED EST. HIGHEST TO BEDROC-K IF OBSERVED (SEE AbBRV. ON BACK.)
'47W11 4,e74,1 12,
93j' v v, 91' 9, 33~ Srr , . 3 jam-,,, s F . 3 g
2 'ell
-1
PERCOLATION TESTS
TE-ST DEPTF WATER IN HOLE TEST TIME DROP IN WATER LEVEL-If1CHES '
E? ! S AFTERS LLING INTERVAL-MIN. -
! r, g~ PER D1 PERIOD2 - RATE:'•'Ihir
S~ P PER !N1,
z
T- _
OT PLAN: Show locations of
percolation fasts, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what aye th;: I.eri•
ital and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and perc::nt
and slope.
YSTE M ELEVATION
1~--
Q ~ Bow F~c sl 3
ti
o _
N
0, v jy 3G~.
I(z
-3 13
lit
•
1
The undersigned, hereby certify that the soil tests reported on this form were made by me in accord wits, the procedures and methods specified in the
Wisct:n;in
lministrative Code, and that the data recorded and the location of the tests are correct to the host of my knowledge and belief.
aVff (print)' -
~--jTE~S,~~R OMPLETED ON: -"r'•"-~
DRESS: CER~IFi,ATj NNUMBER: PHS~CNE Uh"iER(opic.;,;j
-5 4
-•--____.._.....-.._._.I
CST SIGNAT RE
!STRIBUTION: Original and one copy to Local Authority, Property Owner and Soil ".'estcr,
LHFi•SBD-6395 !R. 101•'83) - OVER -
v:
s" I
S T C - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER_ PA%AL. 1 "IA 0,1_1 N
ADDRESS 1.2 FIRE NUMBER
CITY/STATE H wAczz m l J ZIP_ Jy C) I b
PROPERTY LOCATION: 1/4,,4G 1/4, SECTION -r2F T 21 N-R W
TOWN OF ~Lc , St. Croix County,
SUBDIVISION ztt -e 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 a 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 Co. Zoning Officer within
30 days of the three year expiration da e.
Lr~L
SIGNED:
o7~o2aZ/9
DATE:
St. Croix co. Zoning Office
911 4th St.
Hudson, WI 54016
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 T+ t AL M 4f_T 1 Aj
Location of property_,JZ'~1/4,1/_u/ 1/4, Section T.19 N-Ry'W
Township ASOt'i
Mailing address
Address of site I~ G, +4w v\
Z
Subdivision name /!/ELI e Lot no.
other homes on property? yes No
Previous owner of property 7Bq D4
Z
Total size of parcel S M RCre.S
Date parcel-was created
r
Are all corners and lot lines identifiable? X_Yes No
Is this property being developed for (spec house)? Yes _K_No
Volume and Page Number g' as recorded with the Register
of Deeds.
II
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.- ~'P3 976, , 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 County Register
of deeds as Document
No. yX?
Signature of applicant Co-applicant
Date of Signature Date of Signature
DOCUMENT No. S :E BAR OF WISCONSIN FORM 1-.108 T, i Hence aescavEO roa aceoapl a owrw
! :OLRDEED
4834'76
REGISTER'S OFFICE
This Deed, made between ._..Char.les_T.....Herres_and-__-
III .D.Qra_-M.ae-.B-errl _husband_-and.----wifet_-as----------- j~ ST. CROIX CO., WI
I~
sur.viv-Qrship_mar_it.al-propert----------------- Reed for Record
and ]?aul_ ...i Grantor, I,I MAY 181992
M. Martin and Anita L Martin _ I
husband--and wife, as-survivorship marital
NI
CI
property - 10:20 A.
'I Grantee,
WitrieSSeth, That the said Grantor, for a valuable consideration lJ
Regislar of beads
conveys to Grantee the following described real estate in --S t..- Croi X-. aeruae ro
County, State of Wisconsin:
i
3 ~ Taa Parcel No:................... 7•
Part of NW 1/4 of NW 1/4 of Section 24, Township 29 North,
Range 19 West, St. Croix County, Wisconsin described as
follows: Lot 1 of Certified Survey map filed April 13, 1992
in Vol. 9, page 2470, Doc. No. 481840.
This is -not homestead property.
Thl (is not)
f" Together with all and singular the hereditaments and appurtenances thereunto belonging;
And Charles T. Berres and Dora Mae Berres
- - - -
warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances .l
and will warrant and defend the same.
Dated this 14th---- . day of ----May-----------_.................. 13.92
----`---------------------------------(SEAL) -~-------._.--..(SEAL)
Charles T. Berres
-
t ! (SEAL) - - .-----(SEAL)
• . - - - - -Dora Mae -Berres
- - - -
i
l
F AUTHENTICATION ACKNOWLEDGMENT
Signature(s) Af--Charles--T,. STATE OF WISCONSIN 11`
and Dora Mae Berres I ss.
a
County.
' .
authenticated t -.1.4.day of. May.--.___...--._.., 13..92 Personally came before me this ................day of
! 0 the above named
i r._...........................
_k TITLE* EMBER STATE BAR OF WISCONSIN
.
authorized by § 706.06, Wis. Stats.) to me known to be the person who executed the
5'y foregoing instrument and acknowledge the same.
q
THIS INSTRUMENT WAS DRAFTED BY
x Kosa t Attorne Ale
- S - - y
Notary Public County, Wis. II
3 (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (Tf not, state expiration
are not necessary.)
7 date:
19__-_--_--
-N&- of peraone IBnlne In any cnpnc,ty should be typed or printed below their eienaturcc. ,
't WARRANTY DEED STATE BAR OF WISCONSIN Wi=--ft, I -l Wool, Co. Inc.
3. FORM No. I-1982 Alilwnokee. Wu.
r r•
81
A'
• DOCUMENT No. tTE BAR OF WISCONSIN FORM 1-1s._, T"is srwcE aesEavEO FOR aECOaow° °ATn
WARRANTY DEED
48n X55 V' L 956 , _f 4.36/
' Verl n E. Beno Arl n L. REGISTER'S OFFICE
This Deed, made between __.__.y............_.__....y, ......X...- ST.CROIXCO.,WI
Benoy, and Wayne A. Benoy, tenants--common r
A: Rec d for Record
- - - _
- - - I Grantor, JUN 2 21992
and-----Paul--M._-Martin -and- Anita-:,------_--- -Martin,
husband_and-wife as--survivorship.-marital at 10:20 A. M
property------------ .
- , Grantee,
Witnesseth, That the said Grantor, for a valuable consideration Register of Deeds
of..one,.AQ.llar---and--o ther_valuable_- consideration
t Croix aETpa"'°
i conveys to Grantee the following described real estate in . 5...
County, State of Wisconsin:
Tax Parcel No:
c
See description on back side.
FEE
r
p
7
i
Y
This i5 not homestead property.
(is) (is not)
Together with all and singular the hereditaments and appurtenances thereunto belonging;
. A. Beno-
And- ..Verlyn E. Benoy, Arlyn L. BenoY -and.WaYne
y- -
warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except
easements, covenants and restrictions of record,
and will warrant and defend the same.
Dated this __._.......lx~--..._.___._... day of 19... 9.~.
............._-----------_--------------------------.(SEAL) y.'c .(SEA],
Verlyn-E' Benoy n) Arl n L. -Benoy-----..-------
k: - - - ---...-(SEAL) L . f. -(SEA1.
Wa ne A Benoy .`l
- - -
AUTHENTICATION ACKNOWLEDGMENT
n
Signature(s) STATE OF WISCONSIN -
ss.
e. St. CYOiX _County.
s` authenticated this ...-....day of........... 19...... Personally came before me this -9 .
1992... the above nano.
;j Verly_n E.---Benoy, Arlyn----------------------------
and_Wa ne A. Beno
BenoY-
i. TITLE: MEMBER STATE BAR OF WISCONSIN
(If not-
g authorized by § 700.00, Wis. Stats) to me known to be the person . ' = ' who executed th
t I
} Nt/c foregoing instrument and acknowledgj')he same.
THIS INSTRUMENT WAS DRAFTED BV `Yo /moo/
Robert F. Wall , f/LGtLGJtC-~G~ - lll.<(
WALL--&--MILLRR--- F- ~aZARy j 2
0 522 Second Street §t. Croix
`tA G ' Nott y Public County, Wi.
- -
FIudson; WI 54016
13
(Signatures may be authenticated or,A n"4,;, p)`.?o `a M) Commission is permanent. (If not, state expirati,
are not necessary.) t ""V.. O`, date: 31-3! 19_9.6
0p W%S'
•Noa+es a persons s,gn,ng m any capacity should be tyVnl pV* ri.ted bd- their e,g,+atures.
WARRANTY DEED STATF. DAN OF WISCONSIN Wihwau-kLegnl monk Cn. 1-
FORM No. I-1982 Nl iee. Wu.
'S
5
F.
n'