HomeMy WebLinkAbout008-1053-95-200St. Croix County Planning and Zoning
Monday, November 03, 2008 at 4:21:24 P:L1
Detail Sanitary Information Page 1 oft
Computer #: 008-1053-95-200 Sub/Plat: NA Section: 18
Parcel #: 18.28.16.2690 Lot: 2 TN/RNG: T28N R18W
Municipality: Eau Galle, Town of CSM: Vol. 13 Pg. 3733 1/4 1/4: NW 1/4 NW 1/4
Owner: Cernohous, Vince 2113 County Road N Baldwin, WI 54002
State Permit: 363919 Issued: 06/30/2000 POWTS Dispersal: Mound Permit: New
County Permit: 0 Installed: 08/17/2000 POWTS Detail: NA Bedrooms: 3 WI Fund: No
POWTS Pretreatment: NA
Notes
Issuer/Inspector As Built Plumber Other Requirements Additional Notes Maney Owed
Kevin Grabau >4/1/00 -Not Required Timm, Roger $0.00
Kevin Grabau ~~',iur~e~! ~tf: Yes
MaBntenariCt' Notification
Scheduled Pump Date Pumped Notification
8/17/2003 6/6/2005 04/01/2005
6/6/2008
'Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
Safety and Buildings Division
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (11(m)1_
Permit Holder's Name: ^ City ^ Village ^ Tdluvn of:
Cernohous, Vince Eau Galle Township
CST BM Elev.: Insp. BM Elev.: BM Description:
TANK INFORMATION
TYPE MANUFACTURER CAPACITY
Septic 0~ (o
Dosing ~
Aeration
Holding
TANK SETBACK INFORMAT~(I l~T
TANK TO P/ L WELL BLDG. vent to
Air Intake ROAD
Septic ~'~.S-~ ~5 ' ---. NA
Dosing ~ ~''S ` `' ~ 12 S ~ NA
Aeration NA
Holding
PUI~AP /SIPHON INFORMATION
v ELEVATION DATA
(8. ~: ~~, a~~c.
STATION BS HI FS ELEV_
Benchmark ~ o
o3.Sp
~.~
Alt. BM ~ (, Zf- (S ` //~ a g
Bldg. Sewer
St/Ht Inlet ~..3 ~-~ `' `>*(Q./~
St/ Ht Outlet ` ------~
-
Dt Inlet ~
~
Dt Bottom ~ p , ~ p ~ ~ ` Qd - ~. '
Header/Man. tf-, loL ~~~~r 9g,~g
Dist. Pipe ~ , ~ S r~ ~ `19.3
Bot. System rj ; ~ ~~4 ~~ q ~, ~ -
Final Grade
St cover '~ O ' 9 g- .Sb
TRENC Width r Length _ , No. Of ~Frenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMEN I N ~ 95 DIM N 1
SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING a '
SETBACK
CHA r
N
M
b
INFORMATION TypeO ~~I~r ~ ~ NIT .
um
o a
e
System: /
DISTRIBUTION SYSTEM ~-s~l
Header / M nifold 4
~ Distribution Pipe(s) r ( u
r x Hole Size
/ 4
~ x Hole Spacing
t~ Vent To Air Intake
_-'
length Dia- Length ~J Dia. 2 Spacing ,
`f' ~
Q
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.) ~ ~ r "`V~"' ~~
Ins,~ection #1: ~ /(}/ 15'Dlnspection #2: -~- f-,
Location: 2113 County Road N, Baldwin, WI 54002 (NW 1/4 NW 1/4 18 T28N R18W) - 182816269~CLot 2
~ .~ ~
1.) Alt BM Description ='~~ ~~~,~~,u,~n~-a,~ t ~..C ~l.J wave-l~^~/ (~ . `I `~
2.) Bldg sewer length = .~. ((S,o' ~{' S Q~l- ,t,S
-amount of cover = ~ ~ ~ ,~~ ~F-w-~'^n°'____~Cr-,,,~
3.) contour = l 1 _ r ~ 8 ~ ~S
Plan revision required? ^ Yes ~ No ~ ~ ~~
Use other side for additional information. °~ I~ ~ ~ (S
SBD-6710 (R,3/97)
Date Inspector's Signat
County:
St. Croix
Sanitary Permit No.:
363919
State Plan ID No.:
3ZI 8~ . T-Y„tis . ro ~
P cel Tax No.: OZ
008-1053-95 9~
Cert. No.
SOIL Ali RPTION SYSTEM
• ~~isconsin
Department of Commerce
~ ~~3 CT~-i1I
SANITARY PERMIT G'~4'~IQN
In accord with ILHR 83. m. CCode
Safety and Buildings Division
201 W. Washington Avenue
P O Box 7302
Madison, WI 53707-7302
• Attach complete plans (to the county copy only) for the ~ , onless county
/t
than 8 v2 x 11 inches insize. - (~
Sf.
• See reverse side for instructions for completing this app ~ ion Jib w s ~ ? ~ stet Sanitary Permit Numbe
Personal information you provide may be used for secondary purposes ~~~€Y
fi eck if revision to previous applica I
n ~/{/~p
(Privacy Law, s. 15.04 (1) {mj]. (
vVl I ~ ~C/ 6' ZCStrMN(~K~~" ~
S to Plan LD. Number
I. APPLI ATION INFORMATION -PLEASE PRINT ALL TI `~'~ /D = 3•Z.~ ~
Property0 neL.Name
c L n
t/a
S i8 T Zg
4(or)
R (~
N
,
,
,
,
Property Owner's Mailing Address Lot Number Block Numb '
// Z
City St a
l
' Zip Code Phone Number Subdivision Name or CSM Number
~
'
tc
at v z ( > /Z 3 / 13 /
373 3
C
II. F B I DING: (check one) ^ State Owned ^ !t~ Nearest Road
Public 1 or 2 Famil Dwellin - No. of bedrooms -3 ^ VII age
Town of Ccl.~ ~9~,Q.LG ~
C~ A/
umber(s)
k all that apply) Parcel Tax N
III. ,BUILDING USE: (If building type is public, chec
11
p
~ ~• 01 ~ • ~ ~ ~ ~ ~ ~$ ' /y53 " 9S
1 ^ Apartment /tondo
2 ^ Assembly Hall 6 ^ Medical Facility/ Nursing Ho a 10 ^ Outdoor Recreational Facility
3 ^ Campground 7 ^ Merchandise:Sales/Repairs 11 ^ Restaurant/Bar/Dining
4 ^ Church /School 8 ^ Mobile Homepark 12 ^ Service Station /Car Wash
5 ^ Hotel /Motel 9 ^ Office /Factory 13 ^ Other: specify
IV. TYPE OF PERMIT: (Check only one box on line A. Check box Online B, if applicable]
A) 1 _ ~ New 2. ^ Replacement 3. ^ Replacement of 4. ^ Reconnection of 5. ^ Repair of an
______System ________System_~ __TankOnl~r______________ Existing System ________ Existin~S~stem
B) ^ A Sanitary Permit was previously issued. Permit Number Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ^ Seepage Bed 21 ~ Mound 3 ^ Specify Type 41 ^ Holding Tank.
12 ^ Seepage Trench 22 ^ In-Ground Pressure ~/ ~ r 42 ^ Pit Privy
7- x ~s ~~'`'~~
V
13 ^ Seepage Pit t
43 ^
ault Privy
14 ^ System-In-Fill ~(p
VI. ABSORPTION EM INFORMATION:
1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Pert. Rate 6. System Elev. 7. Final Grade
`/~~ Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ~ Elevation
T ;! /3 , j 3 7, 7S Feet i , !p Feet
VII. TANK
INFORMATION Ca aclt
in allons
g
TOtdl
# Of
k
Manufacturer s Name
Prefab.
Site
con-
l
st
Fiber-
Plastic
Exper.
N
E
i
ti Gallons Tan
s concrete ee glass App
ew x
s
n strutted
Tanks Tanks
Septic Tank or Holding Tank
r%GV
-~
LUOD
~ /
G.Jj~y(/ ~qp
^
^
^
^
^
Lift Pump Tank/Siphon Chamber - / ~ ^ ^ ^ ^ ^
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plum is Name: (Pri ) Plumber's Signature: ( o Stamps) MP/ PRN`SW No.: Business Phone Number:
7~5 - ? 72 ~ 3Z
Plum is Address (Street, City, State, Zip Code):
~
2 a~o ~ 1~ t
t b o a
IX. COUNTY/ DEPARTMENT USE ONLY
^ Disapproved Sanitary Permit Fee (Includes Groundwater ate ssue Issuin Agent Signature (No Stamps)
~4pproved ^OwnerGiventnitial ~r ~ Surcharge Fee)
S ~~ii~~
30
`
Adverse Determination v~v
X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL:
SBD- 639E (R.11/97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber
N STRUCTLON S ~ ..
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the
Wisconsin Adr>nl~i'str.~ti~e Code will be applicable.
3. All revisions to this permit must be approved by the permit issuing authority.
4. Changes i'rt ownership or plumb+er,requires aSanitary Permit Transfer /Renewal Form (SBD-6399) to be submitted to the
county priorto installation
5. Onsite sewage systems must be property 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 and Buildings Division, 608-266-3151..
To be complete and accurate this sanitary permit application must include:
L 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. .
II1. Building use. If building type is public, check atl appropriate boxes that apply.
IV. Type of permit. Check only one on 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 for numbers 1 through 7.
VII. Tank information. Fill in the capacity of every new/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.
V111. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.),
address and phone number, 'Plumber mus#°sign application form. -
IX. County! Department Use Only.
X. County /Department Use Only.
Complete plans and specifications not smaller than 81/2 x 11 inches must be submitted to the county. The plans must
include the foifowing: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic
tank(s) or other treatment#anks; 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 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 contamination investigations
and establishment of standards.
..
I: .
~ ~
~scons~n
Department of Commerce
Safety and Buildings
PO BOX 7162
MADISON WI 53707-7162
TDD #: (608) 264-8777
www. commerce.state.wi. us
Tommy G. Thompson, Governor
Brenda J. Blanchard, Secretary
June 11, 2000
OUST ID No.226524
ROGER L TIMM
3128 20TH AVE
WILSON WI 54027
ATTN.• POWTS INSPECTOR
ZONING OFFICE
ST CROIX COUNTY SPIA
1101 CARMICHAEL RD
HUDSON WI 54016
RE: CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 06/11/2002 Identification Numbers
Transaction ID No. 321898
Site ID No. 193752
SITE• Please refer to both identification numbers;
Site ID: 193752, VINCENT CERNOHOUS above, in all correspondence with the agency.
ST CROIX County, Town of EAU GALLE; 2113 CTH N, EAU GALLE 54028
NW1/4, NW1/4, S18, T28N, R16W
FOR:
Object Type: POWT System Regulated Object ID No.: 667497
MOUND /DWELLING 450 GPD
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in
chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements.
The following conditions shall be met during construction or installation and prior to occupancy or use:
A copy of the approved plans, specifications and this letter shall be on-site during construction and open to
inspection by authorized representatives of the Department, which may include local inspectors. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction/installation/operation.
Inquiries concerning this correspondence maybe made to me at the telephone number listed below, or at the address
on this letterhead.
- "1
Sincerely, ~ ~ ~ -~
i -~.-_',
i
ROBERT KANTER , POWTS PLAN REVIEWER
Integrated Services
(608)261-7735 , 8:OOAM - 4:30PM, MON-FRI
RKANTER@COMMERCE. STATE. W LUS
DATE RECEIVED 06/05/2000
FEE REQUIRED $ 180.00
FEE RECEIVED $ 180.00
BALANCE DUE $ 0.00
WiSMART code: 7633
~C
Cona
,API
DE~itRT I
ulvrs~cN o sa
~~ lZ_.,
SEE GORF
ca VINCENT CERNOHOUS
Vincent Cernohous -Mound
Transaction #
Location: Lot 2, Everson CSM
NW 1/4, NW 1/4, Sec. 18, T 28 N, R 16 W
Town: Eau Galle
County: St. Croix
Date: June 5, 2000
Owner: Vincent Cernohous
Address: 1160 Florence, PO Box 771
Baldwin, WI 54002
Plumber: Roger Timm
Signature: ~
License # MPRS 226524
Attachments:
page 1: cover
2: calculations
3: plot plan
4: system cross section
5: plan view, lateral detail
6: pump tank exit detail
7: pump curve
6748-Plan Review Application
SBD 8330
;VI/. T.S.
~tionally
QVEp
F COM ERCE
f ETY A gU~
.ESPONDENCE
page 1 of 7
System Calculations
~
One family residence bedrooms
Loading rate ~'3~ gallons/sq ft per day
Depth to ground water ~~ ~ " in
Depth to bedrock ~ ('~ in
Cross slope ~' ~
Force main length ~~ ft of ~ in
Manifold/header length µ~` ft of in
Drainback Z'~ gallons
,l~
1~/w~ 4-t ~
9'~ ~ `~( z
Lateral length
@ ( ft of
in
~ ~
2~
Lateral elevation ' ft (bottom of pipe)
Lateral hole size ~i4' in @ ~~'`~ in ( S'O ft) spacing
C F~w~ ~f~O , ~
holes/lateral, holes total
Lateral volume ~'Z'~ gallons
~
Total lateral discharge rate 2Z.'t'~ gpm @ Z'"~ ft head
Elevation difference ~'`~ ft
Friction loss
~'~~' i
ft @ ~'~ gpm
Total dynamic head ~ ~~~°~° ft
Pump/si~on ~Z" gpm @ ~'t'~ ft of head
Manufacturer C''~"'~~~ 3a~'~ Model # 1'~~ ~
,
~~~
Dose volume gallons
Lift/si~ion tank ~' ~''°'" `~ ~ ~'"° ~'"~ gallons
Septic tank ~` , ~`~" gallons
~`~
Measurement pump on & off in
1~''~
Height alarm from tank bottom in
393.(°
Reserve capacity gallons
Z
~
calcs page
of
PLOT PLAN
SCALE 1"= `IO '
O•`Z-mi
-- '.
~ s~.~ ~,
Page 3 of ~-
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~_ BAFFLES
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SEPTIC E
OOSC '
,.., ; ..l ...
SpEGiFI•GATI~IJ$
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t ~~~
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wESTNERPaooF
~n JUNCTION
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T^~.1~c5 MA-JUFACTURC.R: IJUMECR OF OOSCS: PEK Day
TAIJK SIZC : ~ o-cr'0 - fact-p taAL,LOAJS DOSC VOLUME + ~~
ALARf+'\ P1MlUiACTtJitCR: S3 ~~ ~"'T~`~ (hJCLU01NCa OAGKVLOW~ GA~~ONS
P'\ODCL 1JU/~~CR: `o' \ N w CAPACITIES: A = 3;~; WCKCS UK Sq1.~ WLLOUS
aWITGN TyP[: ~~'O~"` B c ~` I/,i~MLS Oq~ GALIOUS
PUMP MAWUFA~.TURCR: C o w..hES OK Gwl.~ou5
MG; EL WUMDCR: 3~~1 L=Pv ¢ D~ ~' int.,HES OK }O'~Z GAtLGu:,
SWi RCN T?JP[: w.4~ra,~.v ~' uDTE: PUMP A1JD ALl.KN~ ARC TJ BC
MIh11MUM OISCNARGC RATE_..~_G/M INSTALLED 01J SC.V~.KATE CIKCu~t~
VERTICAL 0-rFE1l[IJCQ DCTW[CU PUI1P OFD M!D OI~TRIpUT10AJ PIPE.. ~'~ FEET
Z"~
+ MIAJ,IFIUM IUCTWOitK SUPPLY PRfziURE .. .. FLCT
T,/
+ ,~ F:: ET OF FORC[ MAIIJ X (_. ~ F/oo ~xiRICTIGU iACTOR. ~~\ ~° FEET ~ Z~ ~y-.
= TOTAL DyUAMIC Nf AO = ~ O'~°~° FEET
~.
1~9 ~$
• S 1
gg `1
'1
IlJTERAlA1. DIMEAISIOAJi
01 TAAJK: LEAI6TN ;WIDTH
; LIQUID DEPTH
PAu~ 6 ~F ~
--1
1
GOULDS
~,~
Pump Specifications
'/3 H P
Up to 40 GPM
Discharge size 1'/+" NPT
Solids:'/a" maximum
Motor
Single phase: 115V
Materials of Construction
Brass/thermoplastic
Features and Benefits
•Top suction eliminates
impeller clogging.
• Corrosion resistant
construction.
• Float actuated switch.
METERS FEET
~ 25
0 6 zo
= 5
v 15
~+
> 3 70
O
2
5
o~ 0
MODEL DVP03
~~_.
~ s ~n is sn 2s so as ao u.s.~
2 4 6 8 TO nPAir
CAPACITY
All Models are designed for continuous o~
METERS FEET ~
,o !T-
- - MODEL: 3871
9 00 I
25
_ -~
o - --- ~-- ,- -~
~ 6 zo ~
_ ~ _-~- ;-- -t
5 ~--_ i
i a t5 O. ~ _r ~ EPOS
0
a 3
2 -- EP04
5
i
0 00 i0 20 70 40 50
0 2 4 6 B 10 12 m~M
Pump Specifications lea nd Benefits
'ha and'/z HP • EPOg impeller- semi-open design
Up to 60 GPM with pump out vanes to protect
Maximum head to 32' mechanical seal.
Discharge size 1'/~"NPT • EP05 impeller -enclosed design
Solids:'/+" maximum for improved performance.
Motor • Rugged glass-filled thermoplastic
All motors feature ball casing and base design provides
bearing construction. superior strength and corrosion
Single phase: 115V resistance.
Materials of Construction • Cast iron motor housing for
efficient heat transfer, strength,
Cast iron
Thermoplastic and durability.
Stainless steel • Corrosion resistant threaded
stainless steel shaft.
• Available fu. automatic and
manual operation.
• CSA listed models available.
ition and feature stainless e.
steel hardwar
~ o
°
~
Wisconsin Department of Industry,
tahbrand Human Relations
Divisioll.pf Safety 8 Bu~ ~ 'GEC!!
,•
SOIL AND SITE EVALUATION REPORT
_J .. .al. 11 I In nn nr \IC.. AJ~ f1~J~
Page 1 of 3
C!)i ~h.~l%~~%~iv Qiy.. J~,ix,li~~-~ CoIJNTY
~'n.ccal ~ ~4 k.6~r~}.!~ •-~ ~r~ceC ~ -GQOus«.:~J~ Qsc...- ~~ ~° vx~.i%l
Attach complete site plan on paper rwt less thar~`~ 1/2 x 11 inches in siz Ian must i lude
but S`~-. C P~ UC
,
not limited to vertical and horizontal reference point (BM), direction and qa of sbpe, scale or PARCEL I.D. #
008- 1DS 3=95
dmensioned, north arrow, and location and distance to nearest road. •
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION R EWEDBY ~- DATE
r~ ,~
PROPERTY OWNER: PROPERTY LOCATION N 1 lL p ~ P2J1t-170h1I}{..
~,P(l\Jny ~ ~~~~ G6~GF:i~T ~ -- 1/4 1/4,S 1~ T ZS ,N,R l 6 E (or
PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
3~3s tit; tix~~ 6 3 Z - ~ opus ~ c s wt
CITY, STATE ZIP CODE PHONE NUMBER ^CITY ^VILLAGE ®fOWN NEAREST ROAD
n~.~wlly wl s -1 ooz (~t~ 68SF, X10 6 ~ G - ~,'~} • Iv •
[~ New Construction Use [~J Residenfial / Number of bedrooms y [ ]Addition to existing building
j J Replacement [ J Public or commeraal describe
Cade derived daily fbw loo. gpd Recommended design baling rate - bed, gpolft2 • ~ trench, gpolf~
Absorption area required SOS bed, ft2 50~ trench, ft2 Maximum design baling rate • 5 bed, gpd/ft2 • b trench, gptiAt2
Recommended infiltration surface elevation(s) `~~• 1 S ft (as referred to site plan benchmark).
Additional design I site considerafions r`'-oy~ w/ 5 `X1.OO' 'T~~NC~,}. wt- ~ tr~ufy lZ ° of StN~ f=~~.i. _
Parent material St t_`M oU~ Gt..+K.~M"t'~- `f1t-l Flood plain elevation, if applicable tV A ft
S = SUltable for System ~~~ MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FlLL t~IOLDNJG TANK
U = unsuitable for stem ^ S ®U f$~'S ^ U ^ S ®U ^ S ®U ^ S f~U ^ S U
SOIL DESCRIPTION REPORT
Boring #
•'it
I
Ground
elev.
a6.o~
Depth to
limiting
factor
3b~,
Boring #
Z
Ground
elev.
q~•S ft
Depth to
limiting
factor
30~
Horizon Depth Dominant Color Mottles Texture Structure ~~~~ Roots GPD/ft
in. Munsell Qu. Sz. Cons Color Gr. Sz. Sh. Y g~ rends
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Remarks: ,•_
Name:-Please Print Phone: ' ~~ 1 ~, , `
Arthur L. We erer 715-425- ..---~
gerer Soil Testing & Design Service-P.O. Box 74 River Fa11s,WI 54022• .
atwe: ~ ~~ ~j ,Gc ~ °l.-!0 - Z Date:. l- Z_? -~ ~ CST Ntxnl~er:
~ ~-~~> 1 ~~-. 220254
PROPERTY OWNER ~1~1Z Sore SOIL DESCRIPTION REPORT
PARCELLD.#__ C~C~P~-1053-°fS
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Page '?of 3 ~_
Horizon Depth
in. Dominant Color
Munsell Mottles
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PLOT PLAN
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G~c~~.'~ti~{ -~.- i-Z~-`~9 1400576
CST Signature ~ Date Signed Telephone No. CST #
Wisconsin Department oflndustry, SOIL AND SITE EVALUATION REPORT
Labor and Human Relations
Div'BioO of Safari ~ Buildings _:-, ..:,~, u ~ ~n nn nr ur w ~~ n_~_
Page 1 of 3
. .. ................-.......,..,.,, . ~...,..... .,.... COUNTY
Attach complete site plan on paper not less than 81/2 x 11 inches in size
Plan must include
twt ~ Ste- CP._()1,y~
.
,
not limited to vertical and horizontal reference point (BNh, direction and ~o of sbpe, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road. 008- ADS 3=9S.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVI DBY D TE
~ ~q
PROPERTY OWNER: PROPERTY LOCATION IJ 1 t L 0 != AY1) F~Rz-17 h-/}C.
~,4(1`lpy ~j ~1?~~ G9~T ~ -- 1/4 _ 1/4,S 15~ T ZS ,N,R 1 b E (or
PROPERTY OWNER':S MAILING ADDRESS LOT ~ BLOCK A SUBD. NAME OR CSM 0
CBs `r1ZG tix~l'Y 6 3 Z - ~ taus c s t^-f
CITY, STATE 2iP CODE PHONE NUMBER ^Cf1Y ^VILLAGE ®1'OWN NEAREST ROAD
n~t.Dw-ly kJ l s ~L cx~z (~ l~l 69St'- y v 6 ~ G c~ • tV
~ New Construction .Use (~ Residential / Numtter of bedrooms y [) Addition to existing bui~ng
[)Replacement [ [ Public or commeraal desaibe
Code derived daily flow boo gpd Recommended design loading rate - bed, glxilft2 ' ~ trench, 9P~
Absorption area required S~4 bed, ft2 Soo trench, ft2 Maximum design boding rate • S bed, gpolft2 ' b trench, gpolR2
Recommended infiltration surface elevation(s) °l'"t • "1 S ft (as referred to site plan t>ertchmark).
Additional design /site considerations t~uvty~ w/ S `x W o' 1~zI~vC~, wtl fy t fyuty lZ" of SA-np ~k _
Parent material S l t-`tti/ ova 6~rtc.trt'c- '11 ~-l Flood plain elevation, 'rf applicable IV A ft
S = $Uitable for System ~~~- MOUND hFGROUND PRESSURE AT-GRADE SYSTEM IN FN.L tiOLDNG TANK
U =Unsuitable fOr slam ^ S ®U ($'$ ^ U ^ S (-~ U ^ $ ®U ^ $ I$'U ^ $ U
r
SOIL DESCRIPTION REPORT
Boring #
Ground
elev.
a6.on
Depth to
limiting
factor
3b''
Boring #
Z
Ground
elev.
q~•s n
Depth to
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Horizon Depth Dominant Color Mottles Texture Structure ~ Roots GPD/ft
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Remarks:
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Remarks: crw+
Name:-Please Print Arthur L. We erer Phone: 7 -42;5-0165 •~
gerer Soil Testing & Design Service-P.O. Box 74 River Fa `iatI 54n22~-
attue: ,~/ ~ . '' ' Date: CST Number:
C,(, t-ci~ol , J1.-~~.~,,,~,,~ 99--/0- Z 1-Z~ g9 220254
PROPERTY OWNER ~1~1Z SUrv SOIL DESCRIPTION REPORT
PARCEL I.D.# 1~qQ~-11753-°lS
Boring #
3
Ground
elev.
`IS•8 ft.
Depth to
limiting
fa3 5 ~~
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Page Zof 3 _I
.,,.,
Horizon Depth
in. Dominant Color
Munsell Mottles
Qu
Sz
Cunt Color Texture Structure
G
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S Consisbenoe Boundary Roots GPD/ft
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- . ~ PLOT PLAN ~ Page ~ of 3
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CST Signature Date Signed
99-LO-Z
(71~ ) 425-n7 ~s 1400576
Telephone No. CST #
4
7
Standard Erosion Control Plan
for 1 & 2 Family Dwelling Construction Sites
:~
Applicant:
Name Daytime telephone number
Street address, city, zip code
landowner: Ut rta..~. ~yn.v~vr.~-~ 71.~-6 ~~ X177
Name Daytime telephone number
Street address, city, zip code
LocatiOII of the but~ding site (complete SS appropriate):
fll~ ~k! quarter of Section / ~ .Town' ~ N., Range ~ ~l~t~
Lot 2' .Block ~/'e-~`Se~ ~ ~ /~ ~ l ~ ~ Z 3
Street address
Instructions:
1. Complete this plan by filling in requested information, marking (.~ appropriate boxes, and completing the site diagram.
2. In completing the site diagram, give consideration to potential erosion that may occur before, during, and after grading.
Water runoff patterns can change significantly as a site is reshaped.
3. Chapters ILHR 20 & 21 of the Wisconsin Uniform Dwelling Code, the DNR Wisconsin Constructwn Site Best Management
Handbook, and UW -Extension publication Erosion Control for Home Builders can be referred to for assistance in
completing this plan. The Wisconsin Uniform Dwelling Code and the Wisconsin Construction Site Best Management
Handbook are available through State of Wisconsin Document Sales, 608866-3358. Erosion Control for Nome Builders
(GW0001) can be ordered through Cooperative Extension Publications, 608/1b2-3346.
4. Submit this plan at the time of building permit apptication.
Chock (.~ appropriate bozos below, and complete the site diagram with necessary information:
b~c
•~`~ ~'~
s
CPm ~o~ Site CharaderisticS
~ North arrow, scale, and site boundary. Indicate and name adjacent streets or roadways.
^ ~ Location of existing drainageways, streams, rivers, lakes, wetlands or wells.
^ ~ Location of storm sewer inlets.
~ The gradient and direction of slopes before grading operations.
~ The gradient and direction of slopes aher final grading operations.
~ Location of existing and proposed buildings and paved areas.
^ ® Overland runoff (sheet flow) coming onto the site from adjacent areas.
Erosion Control ('radices
® ^ Location of temporary soil storage piles.
Note: Although not specijually required by Code, it is recommended that soil storage piles be placed
behind a sediment fence or more than 2S feet from arty downslope road or drainageway.
~ Location of gravel access drive(s).
Note: Recommended gravel drive design is 2 to 3 inch aggregate stone laid at least 7 feet wide and 6
inches thick Drives should extend from the roadway SO feet or to the house foundation (which
ever is less).
® ^ Location of sediment fences (filter fabric fence, straw bale fence) or vegetative strips that will prevent eroded
soil from leaving the site.
^ Q Location of sediment barriers around on-site storm sewer iNets.
^ Q Location of diversions.
Note: Although not specifically required by Code, it is recommended that concentrated flow
(drainageways) be diverted (re-directed) around disturbed areas. Overland runoff`' (sheet flow)
from adjacent areas greater than 10,000 sq. ft. should also be diverted around disturbed areas.
^ ~ Location of practices that will be applied to control erosion on steep slopes (greater than 12% grade).
Note: Such practices include maintaining existing vegetation, placement of additional sediment fences,
diversions, and re-vegetation 6y sodding or by seeding with use of erosion control mats.
p ^ Location of practices that will control erosion in areas of concentrated runoff flow.
Note: Unstabilized drainageways, ditches, diversions, and inlets should be protected from erosion through
use of such practices as in-channel fabric or straw bale barriers, erosion control mats, staked sock
and rock rip-rap. R'hen used a given in-channel barrier should not receive drainage from more
than two acres ojunpaved area, or one acre of paved area. In-channel practices should not be
installed in perennial streams.
^ ^ Location of other planned practices not already noted.
PLOT PLAN
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Indicate management strategy by checking (.f7 the appropriate box:
~~~ `~~~
q/~o~ Management Strategies
J~ ^ Temporary stabilization of disturbed areas.
Note: Although not specifically required by Code, it is recommended that disturbed areas and soil piles left
inactive for extended periods of time be stabilized by seeding (between April 1st and September 15th), or
by other cover, such as tarping or mulching.
~ Permanent stabilization of site by re-vegetation or other means as soon as possible.
(~ ^ Use of downspout and/or sump pump outlet extensions.
Note: Although not specifually required by Code, it is recommended that flow from downspouts and sump
pump outlets be routed to stable areas such as established sod or pavement.
~( ^ T~PP~ sediment during dewatering operations.
Note: Although not specifically required by Code, it is recommended that sediment-laden discharge water from
pumping operations be ponded behind a sediment barrier until most of the sediment settles out.
.~ Proper disposal of building material waste so that pollatants and debris are not catcied off-site.
l~. Maintenance of erosion control practices
Sediment will be removed fiom behind sediment fences and barriers before it reaches a depth
that is equal to half the barrier's height.
Breaks and gaps in sediment fences and barriers will be repaired immediately. Decomposing
straw bales will be replaced (typical bale life is three months).
All sediment that moves off-site due to construction activity will be cleaned up before the end
of the same workday.
All sediment that moves off-site due to stort:~ events will be cleaned up before the end of the
next workday.
Gravel access drives will be maintained throughout construction.
All installed erosion control practices will be maintained until the disturbed areas they
protect are stabilized.
A publication of the University of Wisconsin-Extension, Ron Struss, UWF.X Water Quality Education Specialist (12%92).
?his publication may be fretly duplicated Additional copies are available through the UWEX Environmental Resources Center,
216 Ag Hall, 1450 Linden Drive, Madison, Wl, 53706. 608/262-3652
EROSION CONTROL
FOR HOME BUILDERS
Erosion Is a Costly Problem
Eroding construction sites aze a leading cause of water
quality problems in Wisconsin. For every acre under con-
struction, about a dump truck and a half of soil washes
into a nearby lake or stream. Problems caused by this sedi-
ment include:
Local taxes--Cleaning up sediment in streets, sewers and
ditches adds extra costs to local government budgets.
Dredguig The expense of dredging sediment from lakes,
hazbors and navigation channels is a heavy burden for
taxpayers.
Lower property values-Neighboring property values are
damaged when a lake or stream fills with sediment.
Shallow azeas encourage weed growth and create boat-
ing hazards.
Poor fishing-Muddy water drives away fish like north-
ern pike that rely on sight to feed. As it settles, sediment
smothers gravel beds where fish like smallmouth bass find
food and lay their eggs.
Nuisance growth of weeds and algae-Sediment carries fer-
tilizers that fuel algae and weed growth.
Preventing Erosion Is Easy
Erosion control is important even for home sites of an
acre or less. The materials needed are easy to find and
relatively inexpensive-straw bales or silt fence, stakes,
gravel, plastic tubes, and grass seed.
Putting these materials to use is a straightforward pro-
cess. Only a few controls are needed on most sites:
• preserving existing trees and grass where possible to pre-
vent erosion;
• Silt fence or straw bales to trap sediment on the down-
slope sides of the lot;
• Soil piles located away from any roads or waterways;
• Gravel drive used by all vehicles to limit tracking of mud
onto streets;
• Qeanup of sediment carried off-site by vehicles or
storms;
•. Downspout extenders to prevent erosion from roof
'r runoff; and
• Revegetating the site as soon as possible.
By controlling erosion, home builders keep our streets
and waterways clean.
Erosion Con
For Hoi
STRAW BALE or SILT FENCE
• Put up before any other work is done.
• Install on downslope sides of site parallel to contour of
land.
• Extend ends upslope enough to allow water to pond
behind fence.
• Bury 8 inches of fabric in trench (see back page).
• Stake (2 stakes -per bale).
• Leave no gaps. Stuff straw between bales or overlap sec-
tions of silt fence.
• Inspect and repair once a week and after every %2 inch
rain. Remove sediment if deposits reach half the fence
height. Replace bales after 3 months.
• Maintain until a lawn is established.
SOIL PILES
• Locate away from any downslope street, driveway,
stream, lake, wetland, ditch or drainageway.
• Temporary seed such as annual rye or winter wheat is
recommended for topsoil piles.
GRAVEL DRIVE
• Install a single access drive using 2 to 3 inch aggregate.
• Lay stone 6 inches deep and at least 7 feet wide from
the foundation to the street (or 50 feet if less).
• Use t6 prevent tracking mud onto the road by all
vehicles
• Maintain throughout construction.
;, SEDIMENT CLEANUP
• By the end of each work day, sweep or scrape up soil
tracked onto the road.
• By the end of the next work day after a storm, clean
up the soil washed off-site.
SEWER INLET PROTECTION
• Protect on-site sewer inlets with straw bales, silt fences
or equivalent measures (see back page).
• Inspect,, repair and remove sediment deposits after every
storm.
SAMPLE EROSION
CONTROL PLAN
FOR 1 OR 2
FAMILY
DWELLINGS
i
I ~
[~- ~r
\- -
i `~
I \ 0
r
I ~
~ \
-~ ~ -_
TD /~ \~ \~
AREA TO BE TOPSOILED,
SEEDED AND MULCHED
BY OWNER AT THE HOUSE
COMPLETION OF I GARAGE
CONSTRUCTION ITD TC
~ ~~:
\ ~ ~ Y
TD ~ \~ ~ ~ x~ .~~'
Tc
RNV LINE r l ~;~
i--r~-a~-~-s--~ -_ _ _...
SOIL TYPE: SILTY CLAY
SLOPE: 3%
STREET NAME
DOWNSPOUT EXTENDERS
• Not required, but highly recommended.
! Install as soon as gutters and downspouts aze completed
to prevent erosion. from.roof runoff.
Route :water:;to a grassed .or paved, azea.
• Maintain`unttl a lawn is established. .
.. "~~ .,... > s, . ...
~~I practices
e Sites
EROSION
CONTROL PLAN
LEGEND
_ _ _ PROPERTY
LINE
N •
I EXISTING
_ _
~ DRAINAGE
-TOPSOIL
TD TEMPORARY
DIVERSION
DRAINAGE FINISHED
-
_
SWALE ' DRAINAGE
_ _ LIMITS OF
GRADING
^ . . sILT
FENCE
•~~ sTRAw
BALES
.;~~~ GRAVEL
CONSTRUCTION VEGETATION
'~ ENTRANCE~EXIT ®SPECiFICATION
AREA
TREE
PRESERVATION
STOCKPILED
' SOIL
SCALE:1"=40'
PROJECT LOCATION:
EXISTING CURB PROPERTY OWNER:
~,
AND GUTTER ANTICIPATED STARTING GATE:
CONTRACTOR:
ANTICIPATED COMPLETION DATE:
• PREPARED BY: DATE:
PRESERVING
EXISTING VEGETATION
• Wherever possible, preserve existing trees, shrubs, and
other vegetation.
• To prevent root damage, do not grade, place soil piles,
or park vehicles near trees mazked for preservation.
• Place plastic mesh or snow fence barriers azound trees
to protect the azea below their branches.
REVEGETATION
Seed, sod or mulch baze soil as soon as possible.
SEEDING AND MULCHING
• Spread 4 to 6 inches of topsoil.
• Fertilize and lime if needed according to soil test (or
apply 10 lb. / 1000 sq. ft. of 10-10-10 fertilizer).
• Seed with an appropriate mix for the site (see table).
• Rake lightly to cover seed with I/a "of soil. Roll lightly.
• Mulch with. straw (70-90 lb. or one bale per 1000
sq. ft.). '
• Anchor mulch by punching into the soil, watering or
by using netting or other measures on steep slopes.
• Water gently every day or two to keep soil moist. Less
watering is needed once grass is 2 inches tall.
SODDING- .
• Spread 4 to 6 inches of topsoil.
• Fertilize and lime if needed acxording to soil test (or
apply 10 lb. / 1000 sq. ft. of 10-10-10 fertilizer).
• Lightly water the soil.
• Lay sod. Tamp or roll lightly.
• On slopes, lay sod starting at the bottom and work
towazd the top, overlapping like shingles on a roof. Peg
each piece down in several places.
• Initial watering should wet soi16 inches deep (or until
water stands 1 inch deep in a straight-sided container).
Then water lightly every day or two to keep soil moist .
but not saturated for 2 weeks. -~
If construction is completed after September 15, final ~_
seeding or sodding may be delayed. Temporary seed (such '
as rye or winter wheat) may be planEed until October 15.
Mulch or matting may be applied after. October 15, if ~ ~ ='
weather permits. Straw bale or silt fences must be mam-
tamed until final seeding or sodding is completed in spring
(by June 1). ~ }}~.~~,,;;,,tt
` •g.
~ ~;
Cautions Consider public salety when using inlet barriers. These barriers create ponding and mud deposits on
streets. Frequent maintenance is essential. After every storm, remove sediment deposits and repair
barriers. Repairs maybe needed several times a day during major storms.
Curb Inlet
Block & Gravel
Barrier
Note: Allows overflow to prevent
excess ponding.
Drop Inlet
Block & Gravel
Barrier
Note: Allows overflow only when water
reaches top of blocks. Adjust height to
prevent traffic hazards or damage to
structures.
Drop Inlet
Filter Fabric
Barrier
Note: Allows overflow only when water
reaches top of frame. Adjust height to
prevent traffic hazards or damage to
structures.
1. Place concrete blocks on their
sides around inlet.
2. Put a 2" x 4" wood stud through
outer holes of side blocks to
support front row of blocks.
3. Put wire mesh with half inch
openings on outside of blocks.
Cover mesh with filter fabric
extending fabric 12 inches onto
pavement.
4. Pile 1 to 3 inch washed gravel on
fabric to top of blocks.
1. Place concrete Mocks on their
sides around inlet. Adjust height of
barrier by stacking rows of various
sizes of block.
2. Put wire mesh with half inch
openings on outside of blocks.
Cover mesh with filter fabric
extending fabric 12 inches onto
pavement.
3. Pile 1 to 3 inch washed gravel
on fabric to top of blocks.
1. Build a frame of 2" x 4" wood
around inlet. Drive stakes into
ground at least 12 inches.
2. Dig an 8 inch deep trench
outside frame.
3. Attach wire mesh to frame
extending mesh 2 inches into
trench.
4. Attach filter fabric to frame
extending fabric at least 8 inches
into trench. Overlap joint to next
stake.
5. Backfill and compact soil in trench.
Figure 6-Curb Inlet Block
and Gravel Barrier
Curb inlet _
= _
_~. _
wre mesh ~ -~---• - - _...._. ~`=-
8 finer fabric Concrete block
Gravel filter
Runoff
water with Cvertl~ Filtered water
sediment
IM ..:;. ~ua~~
w ~-•.~•. ••~~
Sediment ~ w ''t
R~
tKre mesh 2' x 4' Curb inlet
~ filter fabric "~ stud
Figure 7-Drop Inlet Block
and Gravel Barrier
wre mesh Concrete block
3 filter fabric ~_~~.~--~
~-
Gravel fitter ~^ -•-~
Runott
water with ~e~ Wre mesh ~ fitter fabric
Filtered water
sediment
~,. ~
4.
_ ~
~ ~ ~ Orop inlet
Sediment with grate
li
tt
~~
maximum
minimum
Wre mesh 8 filter fabric
~-~o„erlap ends
`~ of fabric
C S between
~. ~ a a~ o a~ a ^r 2 stakes
-- -~. ._
Figure 8--Drop Inlet Filter
Fabric Barrier
~~~ .~ 2' x 4' wood frame
F i;•
:.~:'
Straw Bale
Fences
Figure 1-Cross Section
of Straw Bale Installation
Staked and Entrenched
Straw Bale
Binding Wire Compacted Soil to
or Twine / Prevent Piping
Filtered II II j Illf'I / Sediment Laden
Runoff ~ ,.,~I . N 1 ~~~!ll...LLL ~ Runofff
Source: Michigan Soil Erosion and
Segmentation Control Guidelxlol~ 1975.
Silt Fences
Figure 3-Cross Sections
of Trenches for Silt Fences
Fitter Fabric
a" r ~u III Ill
Jarencl; ~ ~ I r`•~II~~
F~Iter Fabric -+
I A : ~~?--r---
;-
Source: North Carolina Erosion and
Sediment Contro! Planning and Design
Manual, 1988.
Figure 2-How to Install a Straw Bale Fence
1. Excavate a 4" deep trench.
-r.,s ~~
~~P~."..
to"f w ~"
~f ~ Bale
Width
3. Anchor bales using two steel re-
bars or 2" x 2" wood stakes per
bale. Drive stakes into the ground
at least 8".
4"
I 4:,fi ,'
~ ~- J. .
'~-z
7 ~
--1~~ 1 ~
Figure 4-How to Install a Silt Fence
1. Excavate a 4" x 4" trench along
the contour.
~~~~
,~.
i _G
FIOW ~ 4"
~/j,
~~
Figure 5-How to Install a Gravel Entrance
%D .
Hard surface
road
Gravel Entrance
1. Install as soon as possible after
start of grading.
2. Use 2 to 3 inch aggregate stone.
3. Drive must be at least 7 feet wide
and 50 feet long or the distance to
the foundation, whichever is less.
4. Replace as needed to maintain
6 inch depth.
6" minimum
depth
2. Place bales in trench with bind-
ings around sides away from the
ground. Leave no gaps between
bales.
t.. Y^'a.' 7i`%.;• , .tax
B l l a .l«i•
_ 7
pt.
4. Backfili and compact the
excavated soil.
_ ~,
. / -ii~Y"~j ~ r .
~- ..,. ~ ~ I-.
t~ Y
/_ t
' ~.~
2. Stake the silt fence on downslope
side of trench. Extend 8" of
fabric into the trench.
50' or distance
pp~to,_~foundation
R~S~ '
...... ~'. ~7' : '=: t i.'w'~:r4
- {,~,~ c { ~ t S d
~'>
cYy . .
4. Backfill and compact the
excavated soil.
3. When joints are necessary, over-
lapends for the distance between
two stakes.
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
OwnerBuyer +~ ] r1Ce~' Ler~uJ
Mailing Address / l In d l216 r,~.,~c~c
Property Address
~ 113 c
110
(Verification required tom Planning Department for new
City/State ~~'~.~c%..~ ~ Gl~_ parcel Identification Number C~~ - L4S3 - ~5- a ( ~
LEGAL DESCRIPTION
Property Location lrJlef '/4, /JI,J '/4, Sec. _/~ , T_~l N-R ~<o W, Town of ~~ ~ ~ / /P
Subdivision Lot # ~_.
Certified Survey Map # ~Ci! z 3 ,Volume ~ 3 ,Page #
Warranty Deed # ~~5r5 3 ~ ,Volume ~ 5 Z Z ,Page # ~_.
Spec house ^ yes ~ no
Lot lines identifiable ~ yes ^ no
SYSTEM MAINTENANCE
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 pumper. What you put into the system
can affect the function of the septic tank as a treatment stage is the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
master plumber, journeyman plumber, restrictedplumber or alicensed pumper verifying that (1) the on-site wastewater disposal system
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge.
Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards
set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification
stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30
days of the three yeaz expiration date.
J
~/ ~
SI NATURE OF APPLICANT DATE
OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of
the property describ above, by v' a of a warranty deed recorded in Register of Deeds Office.
'~ d' laal do
S NATURE OF APPLICANT DATE
****** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ******
** Include with this application: a stamped warranty deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
/UI
~~1..1522PAG~38'7
umber ~ .WARRANTY DEED
Randy Everson conveys and warrants to Vincent A.
Cernohous and Carolyn D. Cernohous, husband and wife,
holding as survivorship marital property, the following
described real estate in St. Croix County, State of
Wisconsin:
6-2553E>.
Y.ATHLEEN H. WALSH
REGISTER OF DEEDS
ST. CROIX CO., WI
RECEIVED FOR RECORD
06-'c8-2400 11:15 AM
WARRANTY DEED
EXEMPT I!
CERT COPY FEE:
COPY FEE:
TRANSFER FEE: 78.00
RECORDING FEE: 10.00
PAGES: 1
Name and Retum Address
Thomas A. McCormack
1020 10"' Ave.
Baldwin, WI 54002
008-1053-95; 008-1053-50
(Parcel Identificafion Number)
Part of the North Half of the Fractional Northwest Quarter (N '/ of Frl. NW '/4) and in the
Northwest Quarter of the Northeast Quarter (NW '/4 of NE '/4), all in Section Eighteen (18),
Township Twenty-eight (28) North, Range Sixteen (16) West, Town of Eau Galle, St. Croix
County, Wisconsin, more particularly described as Lot Two (2) of Certified Survey Map filed
September 28, 1999, in Volume 13 of Certified Survey Maps, Page 3733, Document No.
611123, office of the Register of Deeds for St. Croix County, Wisconsin.
Subject to terms and conditions of Farmland Preservation Agreement with State of Wisconsin
dated November 20, 1982, and recorded December 6, 1982, in Volume 656 of Records, at
Page 197, as Document No. 381480.
Exception to warranties: all easements and restrictions of record.
/Y• is
a
y so~:~
FI~.ED
SEP,~,2{~~8 1999 -
IOW'^d~ V
~ ~`~~'~ ~. ~ X11123
CERT l F l ED SURVEY MAP
LOCATED 1N THE NORTH 1~2 OF THE FRACTIONAL NW li4 AND IN THE NW li4 OF THE NE 1i4,
ALL IN SECTION 18. T.28N., R.18W,, TOWN OF EAU GALLE, ST. CROIX COUNTY, WISCONSIN
:n
..UNPLATTED.,t,ANDS. ~Z'~I
- _ ~ MEST L INE OF THE NW li4 _ _ ~ _~
N00. 17' 49' W 2640. 78__63
U., S.. H. ~_ N00' I S' OT' W 4 11. 70'
379. 48'~
HIGHWAY 32.24
n y~ SETBACK L f NE _ ~" ~ q l I m
gyy .........~~~~.......... m m o
~~~ a •"' yyyD ~ Tlo al`~1'w
~mm G~ ~X~m -~ /00' I~W~ ~
3 131 G'~ ~~~~// ml TI
2111n ~ '1~'1 C
"g ~ ~ ~I e'I
~~ 383.37' ;28.40'
SOO.2B' 28"E 41 1.77' I
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w ~yB ~ ' ( C~
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~T. CROIX COUNTY ~
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7.011111p and Party J a
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SEP 2 8 1999 ~ Noo•28'ie•w 4II''ii' ul
~ 397. 78'
If not nooMad wAlflln 30 days of ~ ~ o
apP~al daM approval a11aY
nui and void t» ~"
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NORTHEAST CORNER 13 ~ w
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SECTION !8 -FOUND
~!
COUNTY AlONUMENT a
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98302A THIS INSTRUAE N7 ORAFTEp 8Y JIM M£BER
SHEET ! OF 3
Vol. l3 Page 3733
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JAMES M. MEBER 5-1804
NELSEN-aFBER LAND SURVEYING
DATED (wh'. ~.1~ c'1'\~