HomeMy WebLinkAbout032-2093-90-000
STC - 104°' q r*'~
AS BUILT SANITARY SYSTEM RE~(3Rr~.
o
OWNER-~~
ADDRESS
SUBDIVISION / CSM#---~?TX~~~~ LOT #
SECTION~T__?/N-R__& W, Town of
ST. CR,OIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
p
~jfd.cd✓b.f,~. /707 hl ~ 1~
yS '
i/C3Sci1'l,~
~ a
INDICATE NORTH ARROW
I
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
k
BENCHMARK:
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: l ,66~ Liquid Capacity:
Setback from: Well House Other
Pump: Manufacturer Model# Size
Float seperation Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
Width: A2 Length y_ Number of trenches
Distance & Direction to nearest prop. liner
Setback from: well:Z", - House- Other
ELEVATIONS
Building Sewer 7 ST Inlet: ST outlet
PC inlet PC bottom Pump Off
Header/Manifold ,S'''am Bottom of system
,r`avs - y5', 0 7
Existing Grade Final grade
DATE OF INSTALLATION:
PLUMBER) ON JOB:
LICENSE NUMBER:
INSPECTOR: ~ 422
3/93:jt
WisconfnDepartment of Industry, PRIVATE SEWAGE SYSTEM County:
Labor and Human Relations INSPECTION REPORT ST. CROIX
Safety and Buildings Division
(ATTACH TO PERMIT) Sanitary Permit No.:
GENERAL INFORMATION
Permit Holder's Name: ❑ City ❑ Village [Town of: State Plan ID No.:
PLOURDE, CHARLENE 1k _ _
CST BM Elev.: Insp. BM Elev.: 7BM Description: Parcel Tax No.
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS E -E
Septic Benchmark
Dosing
Aeration Bldg. Sewer
Holding St/ Ht Inlet
TANK SETBACK INFORMATION St/ Ht Outlet
TANK TO P/ L WELL BLDG. AirI to ntake ROAD Dt Inlet
Air I
Septic NA Dt Bottom
Dosing NA Header / Man.
Aeration NA Dist. Pipe
Holding Bot. System
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand
Model Number GPM
I Loss Friction System TDH Ft
TDH Lift
Forcemain Length Dia. Head
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 CHAMBER Mode Number:
System: OR UNIT
DISTRIBUTION SYSTEM
Header/ Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length Dia. Length Dia. Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched
Bed/ Trench Center Bed / Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: SOMERSET 24.31.19.913,SW,SE,LOT A,80TH
Plan revision required? ❑ Yes ❑ No
Use other side for additional information.
SBD-6710 (R 05/91) Date Inspector's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
SANITARY PERMIT APPLICATION
In accord with ILHR 83.05, Wis. Adm. Code COUNTY
ITEDILLHR .d,.,,..,,,,..,,..,,sue
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than a / 9
8% x 11 inches in size. ch revi onto previous 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
t/a '/a, T , N, R ~ (orffl
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
14 1
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME O SM NUMBER
t
II
. TYPE OF BUILDING: Check one CITY NEAREST ROAD
( ) ❑ State Owned VILLAGE -
❑ Public 10 1 or 2 Fam. Dwelling-# of bedrooms 2- AR • `
0610 ( )
Ill. BUILDING USE: (If building type is public, check all that apply) =P32.-Q0-q3 -yo
3 _ _
a() 93
90
1 ❑ Apt/Condo
2 El Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 70 Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 80 Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Off ice/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 4.0 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 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
140 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
Feet Feet
CAPACITY
VII. TANK Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION New lExisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks strutted
Septic Tank or Holding Tank
Lift Pump Tank/Si hon Chamber
Vlll. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for install ion of the onsite sewage system shown on the attached plans.
Plumber" Na (P • H: Plumbs 's ' n to No mpg) MP/MPRSW No.: Business Phone Number:
Pt r s Address (Street, City, State, Zip
r^
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved SantV Permit Fee (includes Groundwater ate Issued I uing Agent Signature (No Stamps)
Approved I ❑ Owner Given Initial 7 a v Surcharge Fee)
Adverse Determination
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety a 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 renew"d any new
criteria in the Wisconsin Administrative Code will be applicable.
3. All revisions tc this permit must be approved by the permit issuing authority.
4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Forrri ISRi:. 6399) to be
submitted to the county prior to installation.
5. Onsite sewage systems must be properiy-maintained. The s ,,ttc; tank(s) mL:st be puirrped ty 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.
IL 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, =Sconnection, or
repair.
V. Type of system. Check appropriate box depending cn system type.
Vl. AhsorptP^n system information. Provide all information requested in #1-7.
Vil. Tank . i!r~i'r natlon. Fill in the capacity of every new andlor exist1rr; ',alk ,,st the total ~!iwil)er of
tanks ill nufacturer's name. It,dicate prefab or site constructed and tank 'Hate; ial. G on-j, :,tea for all
sept c t-,r ohon and holding tanks for this system. Check c-xf,erimentaI approval cn'' received
expEr ,t,,,4 i`)rGd0ct approval from DILHR.
Vill Respw)s+bility statement. Instailir'i!; piumber is to fill in name, hroose n •!nber with at)proiori,'..e prefix (e.g.
Mi', etc.), add, ss and phone number. Plumber must sign application form.
IX. County/Department Use Only.
X. County/Department Use Only.
Tarr; c _v,. ,perificatiol not sroaller than !31/2 x 11 inc es l be submitt`' 5 t.-, th,county. The
~~r+ r,-'FS1 the following. plot r.ian, drawn to scale ,~r with c-. ,s ,atior~ of
hoo i ,er++ tark('=) or ciner tntatment tanks; hu lding sewY t¢3r service;
;Prt?c#rs~c Anoi iako.c pli_rnp of SIpl1G'z tankn: diStrlbution boxes. Soy; ~vRt~il 1.<I,4 ._"'neotSyste,m
areas i _G JC.'-tlliSi o' the, bUfl? 4CY/y se wod 3) horizontal aria ,r rljoa
C) cornpic-te speci cations for pumps and controls; dose volume; elevat.,)r'= ; Terence; ; ft i':i~~ 11 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 SUrch:a. qes ! a4s) for t u of
regulated practices l",;ch cari affect groundwater.
!'~);1 .t. 7ft~ ai: iFar I .
The noonjes C,J , t p ,.a-G '?.ro=JCjh i'l,a SlriCflatt.t` <<., _ yot4 " M
water contamination irlvesii+gat,ons and estahlish# t {ar-jarc s.
"
SBD-6398 (R.11/88)
-5 5 ea 7: 31411 A- 'A d
ImZ
/ ` p Sc ~3 4621 9
p yO'
'W' 30
r
Per. c 0 r
`.roS~' ~~c~IU11 0~ ~~1
fifth. Ali wet$ "4 964611141104 Pipe
Awev4d Voss Cot
• Yw.ru•YataDiovo
91944,
to 4 a, 4* Coto 1164
"fits 041 2# freuylk C•••.~.•
` ~~M•1~ ♦1•• • I•rlw•Ied IIp• Y•qw
• ~"C•M11~~ Taw1••11•~ AI
• IWO* O1 6161•0
t
P, 9.
SOIL IIL.L•'
MTKIDU?101.1 PIPE
APPRp`lr 6 S'juTl{CTIC COVc
2"OF INGGREOME r ATERI^l• OR 1' OF STRA
ELEV. O dr~;-L'/t AGGRCG^TL
F.~ FEILT,
015*rgl5u low Plrc.TV BC AT 4CJI><'( INCHES BELOW ORi&AWAI• •irAOE
AUU AT LCAiT;O IA9QHCL BUT 1.10 MORE THAN 42, 11JCiiC6 OCLOW /1NAt.. 61lAOC
N'MUM DEPTH OF E-ACAVAT100 FKoM OR16VVAL 69PA WILI• BE
I1JCNes
1'UNIM11 OEPn1 OF EACAVATION FJ OM4 03 14INgI. GRAPE WILL 6C _ INCHES
LIG[uSC WUM9CIt: jfi
Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page _'L of
Labor and Human Relations
Division of Safety & Buildings in accord with 'ILHR 83.05, Wis. Adm. Code
' COUNTY
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARC I.D. #
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
GOVT. LOT 114 114,S /T,?/ N,R E (or) W
PROPERTY OWNER':S MAILING A RESS LOT # BLO K # SUBD NAME OR CSM #
CITY. STATE ZIP CODE PHONE NUMBER CITY VILLAGE MOWN NEAREST R0~1D
t
Z7 -,ZZd !.~i
[XI New Construction Use [xJ Residential / Number of bedrooms 3 [ ] Addition to existing building
j ] Replacement [ j Public or commercial describe
Code derived daily flow ! "SD gpd Recommended design loading rate _lbed, gpd/ft2_trench, gpd/ft2
Absorption area required 96o_ bed, ft275'D trench, ft2 Maximum design loading rate _bed, gpd/0trench, gpd/ft2
Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark)
Additional design / site considerations
Parent material Z~I.-, Flood plain elevation, if applicable ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable for s stem ®S ❑ U JB S ❑ U ®S ❑ U Im ❑ U ❑ S ®U ❑ S ® U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bour>dar)r Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trend
Ground - .7 x
elev.
ft. /5/ - - '7 9
Depth to
limiting
factor
Remarks:
Boring #
Ground V
Iev.
ft.
Depth to Lld~_ ow 7
limiting -
factor 92"
_ 2
Remarks: 17
CST Name: Please Print Phone:
Address:
Signature: Date: CST Number:
VZ5
PROPERTY OWNER SOIL DESCRIPTION REPORT Page,-,? of
PARCEL I.D. # r
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourbay Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trerxh
4.;
Ground _
elev.
s ft. Q
_
Depth to V- 114 ills
limiting, 8
factor
?7G - -
Remarks:
Boring #
•::v:::x: l
>cz" 1
Ground
elev.
/qu_ ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground - j'
elev. A "
R,Lg- ft. - -
l ~
s s'
Depth to -
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(8.05/92)
7
JJX 's a- 's,
~.(ifl~'.E ~ CO 7S
(9„fx~.J6E
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER 011 (6 r r (MAEU NG ADDRESS /Nc c~ S c'
PROPERTY ADDRESS ?S y ~j
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE(` C S C-
PROPERTY LOCATION SE 1/4, SC 1/4, Section T 3 1 N-R__L~__W
TOWN OF %l if (ZS c
ST. CROIX COUNTY, WI
SUBDIVISION 4"Se YA 7U P_ LOT NUMBER
CERTIFIEDSURVEY 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:
DATE:
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
S T C - 100
This application form is to be completed in full and signed by the
owner(s) of the property being developed. Any inadequacies will
only result in delays of the permit issuance. Should this
development be intended for resale by owner/contractor, (spec
house), then a second form should be retained and completed when
the property is sold and submitted to this office with the
appropriate deed recording.
Owner of property)
Location of property L 1/4 -'~C 1/4, Section T 3 N-R - W
Township Mailing address_ , > >
Address of site /I// ll 1
Subdivision name lff~~~ G ceKE ~lS Lot no. C''v
Other homes on property? Yes X_No
Previous owner of property
Total size of property
Total size of parcel 12, . 3
Date parcel was created S ! '
Are all corners and lot lines identifiable? _ X Yes No
Is this property being developed for (spec house)? Yes No
Volume /!-V 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.
i
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. / 4 C /4 , 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
y
Date o Signature Date of Signature
x Ir•e r'oe w r.r:.as •,7 (,!-77•l.
I .l r
Ha a a -az.,.. PUBLIC ht.;. i'R'- uoo•:; "Ine wn.e.
as oo
♦a. ua.M a cc d zmon d oo• ro o --U!"o.at~9.. _ STREET
•„I • °Op .,..e ea of . ° $ t oo VP r.a. or ere,~I oo - ee -
„'l.:oec ~8 tl7i r vs V, LE d
E 8' :yr a..ao i N 8 b S
te, fit" IT5.3oo n 141,000.. 11
2 3
`-'t~ t '•71 . ° n ~L I I t. r$ /30,33110!1. 133,951 sO. Ir 131,599.6/! 133,95r .p lr
.o t\I` ~+z•.oll _ ,T 1 i`. '~h •.y,Ay* i nC
y 1~7 z e r(
iP -0t, o~• ~tf ..,f
.t '\~~1' / f •'et•'+yr.+~. p If
+o +o
rsl.oo
a IBY 75os.r -L-_.. uo.
R(
G
A'
`\:x`11 ;d: ~:is a
APPROXIMATE HIGH WATER ELEV.-6600.a ,i0 1 r'Jrc" w
APPROXIMATE LOW WATER ELEV.•655.3 r~ ,0, + e er0.o
\ APPROXIMATE WATER ELEV16E0.0 \ .E.~~~r s♦♦
(APRIL, 19811 \ ~/}~!~{'•,X.I.r,S+s r;~1~,K, t 1 i
I~ ALL ELEV. ON U.S.G.S., MEAN SEA „v\, 1•^' .Rxn .Yr,, ~.Il.~"5,. -9,21 ~,g501
LEVEL DATUM :•1y„~y iv c.
7 ?
t \\\t ~ ! ~ ma9oow.N
+c+c
lei u1 i'\\t1`o. 'k•'IRI. Vti
I x ls..
/ °!I 1,x0.0 I~'ft!i•,~:< W I' 1a.h^11 ~ L ~ 8
8
♦ o
L_"___._...-_. 9..-. ..xt i., 159,600.0 I'
~V I I-9 T NO l -
rIo
\ ~ ~ I i v elRnF En uRVe M I .i/5 .000.1 ( 'III
v
oao -
,.M0.O~~R.
APPROXIMATE HIGH WATER ELEV.•660D 11\ 111 s1+°`°" erea0
APPROXIMATE LOW WATER ELEV. ♦855.3 li
APPROXIMATE WATER ELEV.-660.0 ` " It
(APRIL, 1961) I I y
MEAN
, ALL CLE V. ON US G-5
SEA LEVEL DATUM. '
1\ J \ 131,830 s0. rr +IC
TURTLE ♦?A`
xa~,l;,;.1Yl,l~. LAKE - - ----12- _
'1 a0... 000 I Ixi xl/a, x(IN,1RC. Re I.
e .G
' f`faY•' Js
o>! PRIVATE POND` ♦eo oo'
APPROXIMATE WATER EL L'V
y I 660.0 o.'as
(APRIL,1961) rj t+ ea.aCC w
OUTLOT /
y ~I r
4,z31,e50 .o r!
_ 8• ~M
152.021 cl
0<`9
RU bb' oRln♦uxc .!rx<e.aaasrUr
x I
U PAPS,; 'v,t
» 1
01
-I ~ rcir racol
.ee•oll.'. lrae.,
oocUMENT No. WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA
!STATE BAR OF WISCONSIN FORM 2-1982
01 1.06SPAGE 433
_RichardHanse__a_/k/_a_.Richard__-M_.___Hans_en,___and-__ ~ CO.,W1
-Jane--A_-__Hansen,---husband- and -wife------ ;'dry
- MAR 10 1994
conveys and warrants to _ .-..-.Char-lene_ .S-..._Plau.rd.e, ..a-.--..._..
..s.ingl.e -.per.s.o.n.,--------- I 11.:30A ~
RETURN TO
-
_ - -
the following described real estate in S-t....-.Grmlx---------------- County,
State of Wisconsin:
Tax Parcel No-
(See Attached Exhibit "A") a 70
FEE
This 1S__n0t _ homestead property.
XXY, (is not)
Exception to warranties: Easements, restrictions and rights-ofway
of record, if any.
1994..-.
Dated this ! day of -------------------MSrC
t
---------(SEAL) - -------(SEAL)
;A. !t? t IT
___Richa____-_-.___n,_-_a k~a Richard M
H ---(SEAL) - X--- ----.(SEAL)
J e Hansen
-
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) Richard Hansen a~k(a STATE OF WISCONSIN it
Richard M. Hansen, Jane A. Hansen ss.
I •
(See Attached Exhibit "A") 0
~ D
FEE
This is_-nOt------ homestead property.
XXX (is not)
Exception to warranties: Easements, restrictions and rights-ofway
of record, if any.
March 1994
Dated this - - day of - - - - l-- - - - - - - - - - - - - - - - - - -
J a t7
- -
--(SEAL) - - - (SEAL)
* __Richar__-__----.-__-n~_-a . k/a_Richard M
H n.
- - ----(SEAL) X v- - (SEAL)
* ---J--- e-- A._ Hansen--
AUTHENTICATION ACKNOWLEDGMENT
Signature (s) RichardHans _en_,___a/k/a_ STATE OF WISCONSIN
Richard M. Hansen, Jane A. Hansen ss.
County.
-
authenticated thisAl/'-day of March--_-- 1994_ Personally came before me this ________________day of
1 19-------- the above named
- -
* Kr s t ins-_ Ogland
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not-
by § 706.06, Wis. Stats.) to me known to be the person who executed the
foregoing instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY
Krstina- Ogland------------------------------------
Attorney -_at --LSW Notary Public -----------------------------------------County, Wis.
-
(Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration
are not necessary.) date: 19---------
*Names of persons signing in any capacity should be typed or printed below their signatures.
I
Wisconsin Legal Blank o., nc.
WARRANTY DEED STATE BAR OF WISCONSIN
FORM No. 2 - 1982 Milwaukee, Wisconsin
j
' _pasE 434
Exhibit "A"
A parcel of land located in part of the SE1/4 of the SE1/4 and
part of the SW1/4 of the SE1/4 of Section 24 and part of the
NE1/4 of the NE1/4 and part of the NW1/4 of the NE1/4 of Section
25, all in T31N, R19W, Town of Somerset, St. Croix County,
Wisconsin; being part of Outlot 1 of Hansen's Turtle Lake Hills
First Addition; further described as follows:
Beginning at the SE corner of said Outlot 1; thence N8800811811W,
along the South line of said outlot, 1266.31 feet; thence
N0501311811W, along the West line of said outlot, 1258.45 feet;
thence N8901714211E, along the North line of said outlot, 196.00
feet to the beginning of a meander line; thence S55012'18"E,
along said meander line, 500.00 feet; thence N6600812511E, along
said meander line, 264.96 feet; thence N3804313511W, along said
meander line, 280.00 feet; thence N0604714111E, along said meander
line, 223.51 feet; thence N4604310911W, along said meander line,
188.78 feet; thence N1404411311W, along said meander line, 394.18
feet; thence N2801915211W, along said meander line, 207.55 feet;
thence N60 47 0211W, along said meander line 405.60 feet, ; thence
N2503210811E, along said meander line, 36.03 feet to the end of
said meander line; thence S8705012211E, 1299.20 feet to the East
line of said outlot; thence S0105212411W, along the East line of
said outlot, 435.84 feet; thence S0702413311E, along the East line
of said outlot, 1177.04 feet; thence S8800613511E, along the North
line of said outlot, 380.00 feet to the Westerly right-of-way of
the town road (80th Street); thence S0105312511W, along said
right-of-way, 66.00 feet; thence N8800613511W, along the South
line of said outlot, 380.00 feet to the point of curvature of a
473.00-foot radius curve, concave northerly, whose central angle
measures 2500512611, whose chord bears N75033'5211W and measures
205.48 feet; thence westerly along the arc of said curve and the
south line of said outlot, 207.13 feet; thence 521609138"E, along
the East line of said outlot, 375.14 feet; thence S01053'25"W,
along the East line of said outlot, 466.69 feet to the point of
beainninci. Including all land lying between above described
meander line and the water's edge of Turtle Lake between the
extension of a line bearing N8901714211E from said beginning of
meander line and the extension of a line bearing N8705012211W from
said end of meander line.
AND, Lot 11, Block 11211, Hansen's Turtle Lake Hills First Addition
in the Town of Somerset.
DOCUMENT NO. STATE BAR OP WISCONG N; FARM 2-1982 THIS SPACE RESERVED FOR RECORDING DATA
521274 WARRANTY DEED
VOL 108BP1sF117 REGISTER'S OFFICE
,y1 _ a~ t~ 11, a cROUC co., W!
- - Reed for Record
JUL 11 1994
_ hens and 3:15 P.M
~ • 1.-
conveys and warrants to ,_cnae l ` to
oni t- Y • LeLhens, 'nusb2nd ..nd. Wife,
lMe~l~rdOMd~
RETURN TO
the following described real estate in t • , County, I
State of Wisconsin:
Tax Parcel No:
=F nd the
-arcel- of land located in .)-'rrt of the Se } C) J_ the se F-
.J f µ 7I 111 ~0 1, LCiL µ J' -I -!-7.On '~,I.i ~rn d. in LL Y~,'~`_ Tri' -jt - Ja.
` r'cu OJ: Gi~~: + 11•, L1' µ
j
C-Li ,on 25, ; 1 1_ in 1`31N, i?1_n. , to':'.'1 0 01:1'::'7.'S t, t . C:. i.... ou-n,r,
,fit
_:Con _lri; )e in- ,.r-I; o f ,1 ] ' 1 tlot 1-. of th an . . r, - u...
I
T 2, n t n
? -tn, f uthPr c;.,,Uc:ct.~e a_,
:J'~1~5 '25rr , along
P.t "the !;i._, corner o-1 eCti on 25; thence
c 7.i_nn of -the NETT& of Section 25; 1.11.74 ^c; t; thence
,\r7057,r-5'",;9 ealon tine south 1- _7.. of lot 1.2 of is 1!7:2.15 feet
_l_-_ Y
the -ooint of be inn.-i_ri., thence continuin;° V~7° 57' i5n ,Jai fir. 51 feet
o_s1t 3.. ee :ore of le. s - ror: l'1e t~.ate - e o: , urt e lea ,.e
l :''1^ 'DC'.: !-ni1]_11;r O:f r!1E _t Ci ::Y' 7_'1_i1' ; tl'lenc `r j ° L1 l ' ff ;l , D-1.01,
1.n^ , X 55 5j ^ae t to r pint 5 -``f?,--t '"'s`ir, ; o l s!. "('?..oS a
'ri c:r'g a; 1rianc ? iVrl_) 1~°!I/~'S~'f1 , °.~.in"T '.1,.7 cut
oj_ -Le
If. r.'[i,1ll,-. 52 V .-..V J. ~ -
5 11 -
e 1A e 7L:; tL1 c111i A~J_''~ _ t J r.lon}ry' s,-,.id
`r f et'.t to oint 1.2 i c:=t r,1or o 1 roi;; said
Y' J e L:.-j- !.-1; in- the end of said m on6i er liYlrf -{hericc S840 07'2j11.:
^Q .I. feet; thence S7L!-7' 5" 7-03 , e - 6):,o 55'1-,rf•y, 77 • 36
5 feet; zenc ,7: 5_.~ r11 ~'f n / -i- 1 r,. 1!,011,^
This homestead property.
(is not)
Exception to Warranties: ''EU`11,:1~S, 'e_",~1.Gt7 On
w AL
Dated this day of- " 19 ~Ll
Y l7 ~yi
(SEAL) ^h~.rlh cp' i ,1 1 - (SEAL)
(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN
9_4_/'' ss.
County.
authenticated this day of 19 Per ovally came before me th's day of
19 the above named
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, to me known to be the person who executed the
authorized by § 706.06, Wis. Scats.) foregoing instrument and acknowledge thijNeRITRR
THIS INSTRUMENT WAS DRAFTED BY JUAN
t
Not r Public - County, Wis.
(Signatures may be authenticated or acknowledged. Both My ommis 'on is perman t. (If not, state expirati n
are not necessary.)
date: 19
Names of persons signing in any capacity should be typed or printed below their signatures. SB2 NTF 0021
WARRANTY DEED STATE BAR OF WISCONSIN Nelco Tax Forms. P 0 Box 10208, Green Bay, WI 54307-0208
t YOL,- ,()J ~ a oU95
4
VOL IMBPa3l, 1~
4~1"I .'~c6 "So 380.28 feet to the east line of sai( 0utlo t 1,
ii?r ~ lf' ltd t~~ E along said easy; line, 62.67 feet -to the joint of
b c. .•71'Q'1 b'"flb+tf
Ii1ClLidlri~, al 1"1 and. lying between the above doscribect n1,^ naer line and
the t.rC"-e 's edg 't'urtle Lake bet,,'veen the e-tension of a line
~f from from said beginning of meander line .znd the
e71tej-6c6~ jj6j a In
bearing lI8 , 0 2 from s~).id en:.. of meander line.
I '07 511',7
Above descrij- - - n_,=cel contains 1'x.66 11cres (46'~,367 Sql:!=0 feet) not
including lands lyi_n- bets.^,;een described meander line anc_ the ;~Tater's
T dli.i r),ir cel is subj C-t -to all ;:'i? Yl"tS O)f record
3c T ?arcel_ Lo be Jeeded to a. ~o1_nu1` o'•:,ner
''1\T0"te: Charlene Plourde grants easement of e_cist .n,,~ drivcv;ay -as now
traveled.
J
the cel shown on -this documen- is being ai'('ed to the narce:l
Shn-)-n on the. document recor. r?ed in Vol. 10U, Page 139; Jcument
"I). 51-7672, described as liot 12, Block 2, Hansen's `purtl.e la.ke
:tills ,,!.-st la.ddition, in the To~,r of Somerset, St. Croi,_ County,
`tdi_sconsin, Croix County Register of Deeds Office, tD create one parcel,
and this transaction is -thereby exempt from Chapter 18 of -the
St. croix County Land Use Regulations pursuant to Section 1.8.05 (A) (3).
A
SEP 1 2 1994
2:50 Pr
52127 5 VOL 1095Pa,1606
This affidavit should be recorded by Michael Stephens for the
existing parcel being added to:
{ Si. C OQ::: CJ., WI
AFFIDAVIT P30'd for rjCQrd
State of Wisconsin ) SEP 12 1994
) ss. 2:50 Pat q .
County of St. Croix ) (
r ,"s .St'Cr of Dees
Your affiant, being duly sworn, states under oa - .
1. He/she is the owner/part owner of the following
parcel of land located in St. Croix County, Wisconsin,
recorded in Volume 1082, Page 139, Document No. 517672,
St. Croix County Register of Deed's Office:
Lot 12, Block 2, Hansen's Turtle Lake Hills First
Addition, in the Town of Somerset, St. Croix County,
Wisconsin.
2. The above parcel has had added to it the following
described parcel recorded in Volume 1086, Page 317,
Document 518872, St. Croix County Register of Deed's
Office, resulting in a single parcel:
A parcel of land located in part of the SE 1/4 of the SE
1/4 and the SW 1/4 of the SE 1/4 of Section 24, and in
part of the NE 1/4 of the NE 1/4 of Section 25, all in
T31N-R19W, Town of Somerset, St. Croix County Wisconsin;
being part of Outlot 1 of the plat of Hansen's Turtle
Lake Hills First Addition; further described as follows:
Commencing at the NE corner of Section 25; thence
S01°53'25"W, along the east line of the NE 1/4 of said
Section 25, 111.74 feet; thence N87°57'05"W, along the
south line of lot 12 of said plat, 472.15 feet to the
point of beginning; thence continuing N87°57'05"W, 644.51
feet to a point 30 feet more or less from the water's
edge of Turtle Lake being the beginning of a meander
line; thence N38°44'12"W, along said meander line, 155.55
to point 25 feet more or less from said water's edge;
thence N06°46'53"E, along said meander line, 223.46 feet
to a point 36 feet more or less from said water's edge;
thence N46°42'35"W, along said meander line, 188.75 feet
to a point 28 feet more or less from said water's edge;
thence N14°41'53"W, along said meander line, 305.82 feet
..r
VOL 1095PA F007
to a point 12 feet more or less from said water's edge
being the end of said meander line; thence S84°07'25"E,
77.36 feet; thence S54e1911E, 58.46 feet; thence
S34°42'17"E, 102.56 feet; thence S69°44'03"E 380.28 feet
to the ease line of said Outlot 1; thence S07°24'33"E,
along said ease line, 462.67 feet to the point of
beginning;
Including all lands lying between the above described
meander line and the water's edge of Turtle Lake between
the extension of a line bearing N87e57'05"W from said
beginning of meander line and the extension of a line
bearing N84e07'251W from said end of meander line.
Above described parcel contains 10.66 acres (464,367
square feet) not including lands lying between described
meander line and the water's edge of Turtle Lake. Parcel
is subject to all easements of record.
3. The addition is a transfer exempt from Chapter 18 of
the St. Croix County Land Use Regulations pursuant to
Section 18.05 (A)(3).
4. The purpose of this affidavit is to notify the public
of the addition and the resulting parcel.
Subscribed and sworn to before me this o~ day of
e y 1994.
U
Notary Public, State of Wisconsin My commission expires: j/- 77
This instrument was drafted by:
. . fd E(S~~s.~ ~E E. ryF ~
to 0
• H
O"p, 0/ em
rJ ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
a H u a if N if a{
mean
- ST. CROIX COUNTY GOVERNMENT CENTER
~
a 1101 Carmichael Road
Hudson, WI 540 1 6-77 1 0
- (715) 386-4680
August 10, 1994
Charlene S. Plourde
2006 - 80th Street
Somerset, W 54025
Dear Ms. Plourde:
It has come to the attention of this office that on July 11, 1994,
you conveyed 10.66 acres by warranty deed recorded in Vol 1086, Pg.
317. The property is described as part of Outlot 1, plat of
Hansen's Turtle Lake Hills, First Addition. A note on the deed
states that it is being conveyed to an adjoining land owner,
Michael W. Stephens.
St. Croix County Land Use Regulations, Chapter 18.05(A) (3) provides
for the sale or exchange of parcels of land between owners of
abutting property if additional lots are not thereby created and
the parcels resulting are not reduced below the minimum survey
standards or minimum lot sizes required by the Chapter or other
applicable laws or regulations, and where an affidavit is recorded
tying the parcel to the certified survey map of the original lot.
Accordingly, please provide this office with copies of the recorded
affidavits resulting in a single parcel, and documentation that any
remainder is above the 35 acre mapping requirement. If this can be
shown, the transaction will be noted as exempt from Chapter 18
requirements. If not, the remainder will become an illegal parcel,
and in order to correct this, a certified survey map must be
created, and presented for township and county approval.
Should you have any questions, please contact me.
Sincerely
Mary J. Jenkins
Assistant Zoning Administrator
cc: Clerk, Town of Somerset 91-V-16
Michael Stephens
File
S & N Land Surveying
HUDSON, WISCONSIN 54016
(715) 386.2007
BILL TO:
Charlene Plourde
1245 Old Mill Rd.
New Richmond, WI 54017
DATE INVOICE
5/5/99 9405
DESCRIPTION AMOUNT
Survey parcels of land located in part of the SE 1/4 of the SE 1/4 and the SW 1/4 of 2,318.00
the SE 1/4 of
Section 24 and in part of the NE 1/4 of the NE 1/4 of Section 25, all in T31N, R16W,
Town of
Somerset, St. Croix County, Wisconsin; being part of Outlot 1 of the plat of Hansen
's Turtle Lake
Hills First Addition.
Location of Section corners for the plat of Hansen's Turtle Lake.
Location of existing iron property corners on Outlot 1 of Hansen's Turtle Lake, both
North and
South of parcels.
Location of angle points for Lot corners.
Compute Lots, Stake Lot corners, drawing and legal descriptions.
TOTAL 2,318.00
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