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ST. CROIX COUNTY
f WISCONSIN
- ZONING OFFICE
r ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
- Hudson, WI 54016-7710
(715) 386-4680
SEPTIC INSPECTION / WATER TEST REQUEST FORM
Please specify desired test(s) & remit appropriate fee with
application. Outside water lines are often turned off during
winter months, making access to the home necessary. Please make
arrangements with this office to insure that entry can be gained.
❑ Water (VOC's) $185.00 O ❑ Septic $50.00
Ll Water (Nitrate & Bacteria) 45.00% 0 Nitrate & Bacteria
I,' Water (Lead Concentration) 21.00 retest $15.00
Owner: \th I Requested by: LA&,.. "
Address: A Address:
_Sawucia Sa_ZI ZIP
Telephone NQ: ('113) X,y1 40(,; Telephone W: ( )
Property address (Fire If & Street) : 1
Location: S1x ik S1J, t: Sec:..JS , T .2 ! N, R W, Torn o ct ~
Realty firm: Lock Box Combo: Closing Date:
0~5z- /070- zoo ;?5L /7, 54167C_,Z0
TO BE COMPLETED BY PROPERTY OWNER
PROVIDE A 'SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORMS
Water sample tap location: `~Atl:c
Is the dwelling currently occupied? Yes 0 No
If vacant, date last occupied:
Age of septic system: ~~-aw,%&
Septic tank last pumped by: Date:
Previous Owner's Name(s):
Have any of the following been observed?
❑Y ON Slow drainage from house.
OY ON Sewage Back-up into dwelling.
❑Y ON Sewage discharge to ground surface or road ditch.
❑Y ON Foul odors.
Other comments relative to system operation:
I certify that the above information is complete and true to the
best of my knowledge.
OWNERS SIGNATURE: , DATE: ,q ffl%
1/94
OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION
tN ~
Moos`
° w~~ ~ ~,lc~ay
TO BE COMPLETED BY INSPECTION AGENCY
System design &/or permit on file? ❑Yes ONo
Soil series per SCS Soil Survey: sheet #
Type of soil absorption system: OBelow grd ❑At-Grd OMound
Approx. size 'X OGravity ❑Dose ❑Pressurized
Ft.2 OBed OTrench ❑Dry Well
❑Holding Tank ❑outfall pipe
OBSERVED DEFICIENCIES OOther OUnknown
Septic tank
Setbacks: ❑House ❑Well OProp. line OOther
Dose tank
Setbacks: OHouse ❑Well. OProp. line OOther
OLocking cover . OWarning label OPump/Floats
OAlarm OElec. wiring
Soil Absorption Svstem
Setbacks: ❑House ❑Well OProp. line 00ther
OPonding: ODischarge:
General comments:
INSPECTORS SKETCH OF SYSTEM LOCATION
N
Inspector _
Title
ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
r r r r r r■ No ST. CROIX COUNTY GOVERNMENT CENTER
rn. 1101 Carmichael Road
Hudson, WI 54016-7710
(715) 386-4680
March 30, 1998
Robert G. Urman
716 191st Avenue
Somerset, WI 54025
RE: Water Test Results
Dear Mr. Urman:
Enclosed are the original water test results from Commercial Testing Laboratory for a water sample
that was taken at your property on March 23, 1998.
If you have any questions regarding this, please call our office at (715) 386-4680.
Sincerely,
r`
Rod Eslinger
Assistant Zoning Administrator
Enclosure
sm
1-=
COMMERCIAL TESTING LABORATORY, INC.
514 Main Street, P.O. Box 526
Colfax, Wisconsin 54730
715-962-3121
800-962-5227
FAX - 715-962-4030
I
ST. CROIX COUNTY ZONING OFFICE REPORT NO, 59761/01 PAGE 1
ST.CROIX CTY GOV.CTR REPORT DATE: 3/26/96
1101 CARMICHAEL ROAD DATE RECEIVED: 3/24/98
HUDSON, WI 54016
ATTNS JIM THOMPSON
OWNERS Robert Gurman
LOCATIONS 716 191st Ave., Somerset
COLLECTORS R. Esiinger
DATE COLLECTED: 3-23-98
TIME COLLECTEDS 9210am
SOURCE OF SAMPLES Outside faucet
DATE ANALYZED23-24-9$
TIME ANALYZED: 2:00pm
COLIFORM,MFCCS 0 /100 mi
INTERPRETATION'* Bacteriologically SAFE
NITRATE-NS 2.4 ppm
Above 10 ppm exceeds the recommended Public
Drinking Water Standard.
Coliform Bacteria/100 ml
Nitrate-Nitrogen, mg/L
LAB TECHNICIANS Pam Gane
WI Approved Lab No. 19 RESULTS:
PHONE(::
CALLER:
- - -
< Means "LESS THAN" Detectable Level Approved by:
03126!98 THIT 16:24 FAX 1 715 962 4030 COMM. TEST LAB IM 001
COMMERCIAL TESTING LABORATORY, INC.
514 Main Street, P.O. Box 526
Colfax. Wisconsin 54730
715-962-3121
800-962-5227
FAX - 715-962-4030
ST. CROIX COUNTY ZONING OFFICE REPORT NO.: 59761/01,
ST.CROIX CTY GOV.CYR PAGE 1
1141 CARFfICHAEL ROAR REPORT DATE: 3/26/93
DATE RECEIVED; 3/24198
HUDSON, WI 54416
ATTN: JIM THOMPSON
OWNER: Robert Gurman
LOCATION: 716 191st Aver Somerset
COLLECTOR: R. ESLinger
DATE COLLECTED; 3-.43-96
TIME COLLECTEDD: 9:10am
SOURCE OF SAWLE: Outside faucet
DATE. ANALYZED!3-24-98
THE ANALYZED: 2:00pm
COLIFORN,MFCC; 0 /100 mi
INTERPRETATION; Bacteriologically SAFE
NITRATE-N: 2.4 Ppm
Above 10 PPM exceeds the recommended Public
Drinking Water Standard.
CoLiform Bacteria/100 ML
Nitrate-Nitrogen} mg/L
LAB TECHNICIAN: Fan Sane
WI Approved Lab No. 19
RESULTS;
FAX'D (>3
PHONED ON:
CALLER:
< Means "LESS THAN" Detectable LeveL Approved by:
I
FAX
ST. CROIX COUNTY ZONING OFFICE
1101 Carmichael Road
Hudson, WI 54016
(715) 386-4680
DATE:
TO: Fax Number. ~-7q R
Name: PW
FROM: Fax Number. (1 3864686
Name: y a ~-Gf-
Number of Pages Including Cover Sheet:
IF COMPLETE AND LEGIBLE INFORMATION IF NOT RECEIVED, PLEASE
CONTACT:
V AA
NAME:
TELEPHONE NUMBER:
u
STC - 10 4 AS BUILT SANITARY SYSTEM
OWNER_ 1,49
ADDRESS 5-S r1/i
SUBDIVISION / CSM# _ t j-7 %4C f' LOT # fv
SECTION o75 T ?l N-R/f W, Town of -sgrh ee.57er
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
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INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK: SQim~t~,~ ¢M 5
ALTERNATE BM: a p a _1+, ° d gv
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: Liquid Capacity:
Setback from: Well House / Other
Pump: Manufacturer Model# Size
Float seperation Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
Width: 15- Length ~S- Number of trenches vZ
Distance & Direction to nearest prop, line:.
from: well :House _57d'.,i-- Other
ELEVATIONS
Building Sewer ST Inlet. ST outlet
PC inlet PC bottom Pump Off
Header/Manifold Bottom of system
Existing Grade Final grade
DATE OF INSTALLATION:
PLUMBER ON JOB:y
LICENSE NUMBER:
INSPECTOR:
3/93:jt
I Wiscown 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 Hol er's N ❑ City ❑ Village Town of: State Plan D o.:
URMAIT, R~%'~,RT
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
Sd,O0 oS/Z-c Q_
TANK INFORMATION ELEVATION DATA /d
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic CG Benchmark 5!o_2~
Dosi n3, 0
Aeration Bldg. Sewer G. 3y 27 62 '
Holding St/ ID4, inlet 97 9/~'
TANK SETBACK INFORMATION St/,kol outlet e? 7, -24
TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic >160 7-7 30 7 NA Dt Bottom
Dosin NA Header/- s~
Aeration NA Dist. Pipe
Holding Bot. System 7.06
' 95l Sl/'
PUMP/ SIPHON INFORMATION Final Grade
Ma Demand
Model Number GPM
TDH Lift Frict' S stem TDH Ft
Head I
Force In Length Dia. Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width , Lengt No. Of enches PIT Pits Inside Dia. Liquid Depth
DIMENSIONS DIMEN I N
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Ma r
SETBACK CHAMB
INFORMATION Type Of //~~uConuf , -Model Number:
IT
System: t_(-,?_,c46
DISTRIBUTION SYSTEM
Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing e
Length Dia. `i Length Dia. Spacing /a2
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade e
Depth Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched
Bed /Trench Center Bed /Trench Edges Topsoil E] Yes C] No [E:1 Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.) r s~ ✓r-'
LOCATION: Somerset.25.31 1W, SW, SW, Lot 6, Highway 35
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Plan revision required? ❑ Yes [-l~lo
Use other side for additional information.
SBD-6710 (R 05191) Date ~~~~~Ins~pecto,'s~Siqntw~e Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
DILHR SANITARY PERMIT APPLICATION cou
u In accord with ILHR 83.05, Wis. Adm. Code
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than
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.
PROPERTY OWNER It ^H PROPERTY LOCATION
Gl %5$ld a, S T I, N, R E (or
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
/3 T Y/
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION IUA E OR CSM NUMBER d
y✓j /r CL/~
II. TYPE OF BUILDING: (Check one) El State Owned ❑ VILLLLAGE : NEA T ROAD
2.
❑ Public R1 or 2 Fam. Dwelling- # of bedrooms PARCEL TAX NUMBER(b)
III. BUILDING USE: (If building type is public, check all that apply) ~3~ 1 Q T~~ dyGyd)
1 ❑ Apt/Condo
20 Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 80 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. GCl~-New 2.E1 Replacement 3.E1 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 300 Specify Type 41 ❑ Holding Tank
12 09 Seepage Trench 22 ❑ In-Ground 420 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
ELEVATION
REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) 470
,06 ~qpw , Z- ri-Y Feet r f/ Feet
VII. TANK CAPACITY Site
INFORMATION in allons Total # of Manufacturer's Prefab. Fiber- Exper.
New istin Gallons Tanks Name Concrete Con- Steel glass Plastic App
Tans Tanks structed
Septic Tank or Holdin Tank
Lift Pump Tank/Si hon Chamber
VIII. RESPONSIBILITY STATEMENT
1, the undersigned, assume responsibility for installation of the onsite sewage system show on the attached plans.
Plumber's Name (Print): Plumber's Signature: (No Stamps) P PRSW No.: Business Phone Number:
Plumber's Address (Street, City, State, Zip Code):
S- -a
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sani Permit Fe (Includes Groundwater [7, e ssue ssung genr o mps)
.KW t Id
~o Surcharge Fee) pproved ❑ Owner Given Initial _ - 'j0 . y Adv a Determination `tt+ X. CONDITIONS OF APPROVAL/REASONS 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 renewul 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 (SBI~ 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-b" 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 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; wells; water mains/water service;
streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system
areas; and the location of the building served; B) horizontal and vertical elevation reference points;
C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump
performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if
required by the county; E) soil test data on a 115 form; and F) all sizing information.
GROUNDWATER SURCH;A
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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Wiscorisin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 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 8 1/2 x 11 inches in size. Plan must include, but C 0 1 4
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.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
GOVT. LOT 1/4 1/4 N,R f?e(or'
PROPERTY WNER':S MAILING ADDRESS LOT # BLOC K# SUUBDNAME Q~f M #
I 977-91
CI STAT ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE fETOWN NEAR R D
1
- - 3 -
kj New Construction Use.M Residential / Number of bedrooms Addition to existing building
j I Replacement [ I Public or commercial describe
Code derived daily flow gpd Recommended design loading rate bed, gpd/ft2 ~trench, gpd/ft2
Absorption area required bed, ft2_ trench, ft2 Maximum design loading rate _,t~_bed, gpd/ft2_,_,~;' trench, gpd/ft2
Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark)
Additional design / site considerations
Parent material AF_ ZS SaL2 Flood plain elevation, if applicable It
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem ® S ❑ U [AS ❑ U ®S ❑ U S ❑ U ❑ S F2 ❑ S OU
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Structure GPD/ft
Boring # Horizon in. Munsell Qu. Sz. nt Color Texture Gr. Sz. Sh. Consistence Baxdaly Roots Bed Trench
Ground -
elev.
ft.
Depth to
limiting
factor
> 9('1
Remarks:
Boring #
r....
Ground - /
elev.
2La ft. J
Depth to /
limiting
factor
y9a
Remarks:
CST Name:-Please Print j Phone:
Address:
15, ZSIE
Signature: Date: CST Number:
~/_Lz 2"; L2 , - -
PROPERTY OWNER SOIL DESCRIPTION REPORT Pagq Zof ,
PARCEL I.D. # '
Depth Dominant Color Mottles Structure GPD/ft
Boring # Horizon in. Munsell Qu. Sz. 22nt. Color Texture Gr. Sz. Sh. Consistence Bourclary Roots Bed Trerxh
~a ..>:>:.:sg
NEI
Ground b
17
e-4ps 715-
elev.
b+Nas
Depth to
limiting
factor
Remarks:
Boring # VA-' -5 Z
Ground
elev. _ y
2v, ft.
Depth to
limiting
factor
Remarks:
Boring # 0/
}l,'iii•
42 ZC~-Z
Ground
elev
Mft.
Depth to
limiting
factor
1
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(8.05/92)
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CERTIFIED SURVEY MAP
Located in part of the South Half of the Southwest Quarter of Z
Section 25, Township 31 North, Range 19 West, Town of Somerset, atom
St. Croix County, Wisconsin. Bearings are referenced
Prepared for and at the request of: to the west line of the
Lindale Development Corporation SW; assumed to bear
964 192nd Avenue N00°40'07"E.
New Richmond, WI 54017
N00040'07"E 2640.37' - - - -
/ R/W N00023 24"E 66.00'- 0
. -1=66.00'- - \ D
WEST LINE OF THE SW 1/4
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VOLUME 10 PAGE 2775
DRAFTED BY. DJZ
CERTIFIED SURVEY MAP
I ated in part of the South Half of the Southwest Quarter of Z
'Section 25, Township 31 North= Range 19 West, Town of Somerset,
St. Croix County, Wisconsin. Bearings are referenced
Prepared for and'at the request of: to the west line of the
Lindale Development Corporation SWI assumed to bear
964 192nd Avenue N00040107"E.,
New Richmond, WI 54017
- N00040'07"E 2640.37 - - -
/ R/W N000 2324"E 24"E 66.00' , 66.00'
WEST LINE OF THE SW 1/4 D
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REC. AS NO. 30 E 62610' rt
uo a
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of 391.7!'
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Z 70o L EAST LINE OF THE SE 1/4 OF THE SW 1/4
ONz
LI
X
s CURVE DATA TABLE
a Curve Radius Central Arc Chord Chord
• ' Letter Length Angles Length Bearing Length Tangent Bearings
A - 8 167.00' 32'413'07" 95.37' H74'1B'33.5"E 94.07' S89'19153"E 1157'57100"E
C - D 233.00' 31'11122" 126.84' N73.32141"E 125.28' N57'57'00"E N89'08122"E
D - E 80.00' 39'03123" 54.53' N69'36141"E 53.48' N8900B'22"E N50005100"E
E - F 80.00' 109'16127" 152.58' 875016146.5"E 130.48' N50005100"E 820'38133"E
F - G 80.00' 38'04121" 53.16' SOI'36122"E 52.19' S20'38133"E 817'25149'W
G - H 80.00' 55'381$2" 77.70' 545'15115"W 74.68' 817'25149"W 873'04141"W
N - 1 80.00' 65'24149" 91.33' N74'12154.5"W 86.45' 573'04141"W N41'30130'W
1 - J 80.00' 63'02113' 88.02' N73'01136.5"W 83.64' N41'30'30"W 875'27117"W
J - K 167.00' 17'30'17" 51.02' 866'42108.5"W 50.82' S75027117"W 857.57100"W
L - M 233.00' 32'43007" 133.05' S74'10133.S"W 131.25' S57'571001W N89'19153"W
E - I 80.00' 268'24130' 374.77' S04'17115'W 114.70' N50'051000E N41'30130"W
SURVEYOR'S CERTIFICATE
I, Douglas J. tahler, Registered Wisconsin Land Surveyor, hereby certify that I have
surveyed, divided and mapped a part of the Southwest Quarter of the Southwest Quarter
end part of the Southeast Quarter of the Southwest Quarter, all in Section 25, Town-
ship 31 North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin; described
as follows;
Commencing at the Southwest Corner of said Section 25; thence along the west line of
said Southwest Quarter, North 00 degrees 40 minutes 07 seconds East a distance of
676.55 feet to the point of beginning of the parcel to be described# thence continuing
along said west line, North 00 degrees 40 minutes 07 seconds Zest a distance of 66.00
feats thence South 89 degrees 19 minutes 53 seconds East a distance of 199.39 feet to
the point of curvature of a 167.00 foot radius curve concave northerly whose central
angle measures 32 degrees 43 minutes 07 seconds and whose chord bears North 74 degrees
18 minutes 33.5 seconds East and measures 94.07 feets thence along the arc of said
curve, northeasterly 95.37 feet to the point of tangencys thence North 57 degrees 57
minutes 00 seconds East a distance of 312.00 Loots thence North 32 degrees 03 minutes
00 seconds West a distance of 451.21 feet to the north line of the South Half of said
Southwest Quarters thence along said lines South 88 degrees 47 minutes 47 seconds East
a distance of 2345.66 feet to the east line of said Southeast Quarter of the Southwest
Quarters thence along said line, South 01 degrees 25 minutes 44 seconds West a distance
of 702.14 feets thence along the north line of a Certified Survey Map recorded in
Volume 3, page 810 in the office of the St. Croix County Register of Deeds, North 87
degrees 07 minutes 41 seconds most a distance of 549.05 feet; thence along the west
line of said Certified survey Map, South 01 degrees 02 minutes 19 seconds Went a
distance of 641.01 feet to the south line of said Southwest Quarters thence along said
line, North 88 degrees 36 minutes 14 seconds West a distance of 66.00 foots thence
along the east line of a certified survey Map recorded in Volume 2, page 591 in said
Register of Deeds, North 00 degrees 56 minutes 19 seconds East a distance of 639.51
feet; thence along the north line of last said Certified Survey Map and the north line
of Certified Survey Map Volume 3, page 654 as recorded in said Register of Deeds,
North 88 degrees 55 minutes 59 seconds West a distance of 1110.03 feets thence along
the north line of Certified Survey gap volume 7, page 1938 as recorded in *aid Register
of Deeds, North 88 degrees 40 minutes 15 seconds West a distance of 258.76 feats
thence along the west line of last said Certified Survey Map, South 00 degrees 40 min-
utes 07 seconds West a distance of 77.99 feetl thence along the north line of Certified
Survey Map Volume 9, page 2436 as recorded in said Register of Deeds, North 73 degrees
33 minutes 52 seconds West a distance of 478.62 feet; thence continuing along said
north line, North 89 degrees 19 minutes 53 seconds West a distance of 199.39 feet to
the point of beginning. Containing 1,627,794 square feet (37.369 acres). subject to
right-of-way of State Trunk Highway '35" and Shady Lane and subject to all other
easements, restrictions and covenants of record.
I further certify that this Certified Survey Map is a correct representation to scale
of the exterior boundaries surveyed and described; that I have fully complied with
Chapter 236.34 of the Wisconsin Statutes and the Subdivision Ordinance of the County
same.
of Bt. Croix red t e Town of saaNSSet in surveying and mapping
A
Douglas J fah r R. .8. 2145 Dato
A 6 Z Land Surveying
F.O. Box 325 O IF
1y~s,
Now Richmond, WI 54017
Tel; 1715) 246-4319 0
~OUGCAS J. a
V 0%
^145
l ~~ts; ~.;;ON 1~
County General Notice
The parcel shown on this map is subject to State, County and Township laws, rules
ulations (i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchas-
As_ veloping any parcel, contact the St. Croix County Zoning Office and the appropri-
oard for advice.
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER A L, tArnnan
MAILING ADDRESS 3155 - g i l W cv~e r , tn►~ ssa~~
PROPERTY ADDRESS 1 1- rs'j-- S`yo as,
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE ni ) 1 S
PROPERTY LOCATION Sui 1/4, 1/4, Section -S_ , T_j N-R 1 q`W
TOWN OFD- ST. CROIX COUNTY, WI
SUBDIVISION n Q . 9e~ p,p YY~ orP r LOT NUMBER - to
CERTIFIED SURVEY MAP_ VOLUMEPAGE 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: ~"KaX~ I" I.
DATE:
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
S T C - 100
This PP to be completed in full and signed by the
_ c o a liadn form is
• 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 o~ex-~" a+•~a n L llcbnsAc ~
Location of property '5W 1/4 SLJ 1/4, Section _T N-R W
Township ~OQrMS•.~'- Mailing address
C::L tkwn b D V I l N S~~ c~
Address of site
Subdivision name -►1Q- ~Qc7C'~D~~Ct Lot no.
Other homes on property? Yes,L ----No
Previous owner of property j.,; n A
Total size of property ,,Q 1'7 Aft
Total size of parcel,
Date parcel was created lt'
Are all corners and lot lines identifiable? Yes No
Is this property being develope ~f)or (spec house)? Yes _~No
Volume JC)go and Page Number j 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. 51 Ms-l , 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.
A-i\Signature of Applicant Co-Ap iDate of gnature Da e o Signature
r
i THIS SPACE R[S[RVLD FOR RSCORDIHO DATA
D=U MENT NO. ISTATE BAR OF WISCONSIN FORM 1-1982
` WARRANTY DEED i
I
,5~18~82 VOL .~.0.8fiPa,E617
- - - - _ - 7REGISTER'S OFFICE
This Deed, made between ..Linda7.e..Devp-lopment..CC)rporati n, OIXCO., WI
d lbr Record
Grantor, 14 1994
and... Robrer.t.. G.... Ilrman. and . P_enny_..L ....tlrman,.. husband. "and..........
30
w 3 : Q.
~ ...ii:e..as..survivorship.-mar ital..properLy at M
i
~i Grantee, Register of Deeds
Witnesseth, That the said Grantor, for a valuable consideration......
RETURN TO ~conveys to Grantee the following described real estate in ..S-t..--Croix..............
County, State of Wisconsin: jl
Part of the South Half (S 1/2) of the Southwest Quarter
Tax Parcel No:..._--
II (SW 1/4) of Section 25, 'Township 31 North, Range 19 West,
I Town of Somerset, St. Croix County, Wisconsin described as
follows: Lot 6 of the Certified Survey Map filed June 17, 1994 p
in Volume 10 of Certified Survey Maps, Page 2775 as Document 1.
No. 517968.
I
j'
I'
• i
This is not homestead property.
(i8) (is not)
Together with all and singular the hereditaments and appurtenances thereunto belonging;
And.
warrants that the title is good, indefeasible in fee simple and. free and clear of encumbrances except
Easements, covenants and restrictions of record, if any.
and will warrant and defend the same.
Dated this ........................1.'? day of JLlly-............................................... , 1994.....
Lindale Development Corporation
.....................................................................(SEAL)BY (SEAL)
~.,..l..~-~.,t.l....*..L.n..a R.__Eh rs,, its President...
.......(SEAL) B GL.i`c•...... .........................(SEAL)
*
AUTHENTICATION ACKNOWLEDGMENT
Signature a STATE OF WISCONSIN
ss.
ST. CROIX }
-•----------------July ounty. }
authenticated this ........day of 19...... Personally came before me h4's ......1 ....day of
" 19........ the above named
Linda
le Develo me Cor oration b
............P............
__Y
Linda R. Ehlers, its President- and Dale A.
TITLE: MEMBER STATE BAR OF WISCONSIN Schafer, its SecretarX
(If not,
authorized by § 706.06, Wis. Stats.) off• - r -
to in own to be the 4son att , exicuted the I
for go g instrume3it d Wl a the same.
THIS INSTRUMENT WAS DRAFTED BY
flOS -
Heywood &Cari S:C by__Samuel R. Cari
P.O. Box 229, Hudson WI 54016 Jim EMU=
Notary Public St....E'roi........; :,,,r; _County, Wis.
(Signatures may be authenticated or acknowledged. Both My Com ission is permanent. (if fi , state expiration
are not necessary.)
date: ~ 19.7)
*Names of persona signing in any capacity should be typed or printed below their signatures.
.v.oo RTATF. IIAn !1F wigrn?4RIN w•:-•...,... i.. t...._I n1...4 r.. 1...