HomeMy WebLinkAbout040-1157-95-100
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
556384 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: I
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: City Village X Township Parcel Tax No:
Benedict, Core D. & Am K. Troy, Town of 040-1157-95-100
CS BM EI v: Insp. BM Elev: BM Description: , Sectionlrown/Range/Map No:
C'2, ! cl a 13 d, 6a --24.28.20.615F
TANK INFO MA ION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
W ('o ~k ~2 F e
4 A
Septic Benchmark to ~~~~r cyL, ~
Dosing U✓ I Alt. BM l
Aeration Bldg. Sewer r
1, 30 Iq
Holding St/Ht Inlet
Ind b . , s
TANK SETBACK INFORMATION SUHt Outlet
TANK TO P/L WELL BLDG. Pent ir Intake ROAD Dt Inlet
Septic I >l r Dt Bottom /
Dosing > ~C Header/Man.
Aeration Cs-R+t 0 35- C~
Hold' Bot. System .15-0
ft.`r 9.O
Final Grade
PUMP/SIPHON INFORMATION ~re ~t ~~►"~~r /
Manufacturer Demand S Cover
M
Model Number
TDH Lift Fr n Loss System Head TDH Ft
Forcemai Length Dia.
SOIL ABSORPTION SYSTEM o2 3 a-,.,,~ e 4 e kLtA
BEDITRENCH Width Length No. Of Trenches, P T !PENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 3 r C12 p.1
SETBACK SYSTEM TO P/L DG W L LAKE/STREAM LEACHING Manyfacturer,
INFORMATION CHAMBER OR
Type Of System- Q ~tov >I0UI UNIT Mode Numbtr: rnLUs
ii~g___►►,,ll l L~L
DISTRIBUTION SYSTEM
HeaderlM nifold Distribution x Hole Size x Hole Spacing Vent to Air Intake
Pipe(s) ,
Length Dia is Spacing le
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 BedR'rench Edges Topsoil FE-1 Yes ❑ No ]0 Yes ❑ No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: L 13 Inspection #2:
Location: 216 Plainview Drive River Falls, WI 54022 (SW 1/4 SW 1/4 228N R20 Croix _Ri e t Parcel No- 24. , 615F
1 ~ Sa S 5, QJ01~lJaa
1.) Alt BM Description - y l r r
2.) Bldg sewer length = ^ 95-0 J ! ':,,'C
- amount of cover = C fx- VU~ S
3) .,ALA
Plan revision Required? ❑ Yes ❑ No
Use other side for additional information. `
Date Insepctors Signature Cert. No.
SBD-6710 (R.3l97)
,~JDOal✓
t
3
~ ,mow { Y~~ ~a
~'Q' ~ ~sJ>i liY
a 2 1~
COmmeree.wE Safety and Buildings Division County
■ ■ ~yy 201 W. Washington Ave. P.O. Box 7162 is-
1I 1 Madison, WI 53707-71 eY"O X
Departmerrt of Com Q Sanitary Permit Number (to be filled in by Co.)
San' }'•551438
foim the State Transaction tuber
In accordance with s. Comm. 83.2I(2), Wis. Code, mit submission othis
unit is required prior to obtaining a sent appropriate Bove enta
submitted to the De ~ Permit. Note: Application forms for state-owned POWT
partment of Commerce. Personal information you provide may be used for seconds .e Projeet Address (if different than mailing address)
oses in accordance with the Privac Law, s. 15.04 1 m , Slats, rY
1. Application Information - Please Print All Information r,, n
Property Owner's Name V t`e K~ PA
~
Parcel # U~
Propetty Owner's siting Address
~ `/S t04a..`..•v U>`e.Z.7 ,TJr.- , `try Property Location
City, State Govt. Lot •
~~Jr
Zip Code Phone Number
R,Y Y a //S Zj ` -'/Oa Z $W 5W Section 2 Y
II. Type of Building (check all that a 'Y a2 F ~Q(circle onn
~y PP OL Lot # T N; R E
Ru 1 or 2 Family Dwelling - Number of Bedrooms tom, 217 6 Subdivision Name
M W.._ Blo
Public/Commercial -Describe Use Gb
0 City of
0 State Owned - Describe Use SM Number
4 n ~❑y Village of
J ~:a~- w /5 f"15 +-!(o Cs j7 Jr~ J~ Townof~//
III. Type of Permit:
A (Check my one box on line A. Complete line B if applicable)
.
New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
B• ❑ Permit Renewal
❑ Permit Revision 0 Change of Plumber 0 Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration
Owner
IV- T e of POWTS S stem/Com onent/Device: Check all that a 1
id Non-Pressurized In-Ground 0 Pressurized In-Ground D At-Grade 0 Mound > 24 in. of suitable soil 0 Mound < 24 in. of suitable soil
❑ Holding Tank ❑ Other Dispersal Component (explain)
V. is ersaUTrea nt Area Information; ~ Pretreatment Device (explain) /-Z 7 .57 Design Flow (gpd) Design Soil Application Rate( gpd j G~~ Q
Required Dispersal Area Pro ed s /
y~ ~ ( ste levation
a&o
d/
VI. Tank Info Capacity to Total # of Manufacturer
Gallons Gallons Units
New Tanks Existing Tanks nn
d C y U ~ ~ ~ ~
c~1 l'o ~i, U y
Septic or Holding Tank 6Z U y m w C
Dosing Chamber •C~ ` ~J,`~ r b
VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS own on the attached plans.
Plumber's Name (Print) Plumber's Signature
PRS Number Business Phone Number
aOP 7 Y9'd
Plummber's,AAddress (Street City, St/a~te,
145 .5G- O` ~ c6FlnrQ~ J~ Q~~v
VI Dun /De artment Use Onl
Approved Disappro Per.Gm~it Fee Date I ed Issuing ent Signature
O easonforDent $ / 75• co ~I /1Z_
IX. CondiifgggMeasons for Disapproval
1. Septic tank, effluent filter and
dispersal cell. must all be servh:ee / maintaLted
as per management plan provided by plumber.
2. AN *914)ack requirements must be Mign aindd
per RRI~4* code / ardirtar~--
Attach m complete plans for the system and submit to the County only on paper not less than is in x 11 inches in size
SBD-6398 (R. 02/09)
i
CONVENTIONAL COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name:
Owner's Name:
Owner's Address:
Legal Description:
Township:
County:
Subdivision Name:
Lot Number.
Parcel ID Number:
Page 1 Index and title
Page 2 Plot Plan
Page 3 System Sizing & Cross-Section
Page 4 Filter Specs
Page 5 Maintenance Information
Page 6 Management Plan
Page 7 St. Croix Cty Septic Tank Maintenance Form
Page 8 Warranty Deed
Page 9 CSM or Plat
Attachments: Soil Test & House Plans
Designer/Plumber. License Number.
Date: Phone Number
Signature ,
Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01).
Page 1
'V
s
~ rcAb-
embus- ~ py ~'U
~ G9-e.ll
i
Soil Absorption System Cross Section
4° Schedule 40 Final Grade
PVC Vent Pipe
Nth Vent Cap ft
Leaching
Chamber
System Elevation
3 R it ft
Soil AbSommion System Plan VI@W
ft
~Y ft
I
ft Leaching Trench 1
Chambers
4" Die.
Trench 2 Header
Vent Or Observation Pipe I
Trench 3
Leaching Chafter SpecificsMons,
Manufacturer And Model
EEISARating
as sq ft per chamber Soil Applica~5ate 7 gpolsq ft
d Design Flow x Soil A placation Rate EISA
Chambers
3 rows of !5- -Pla chambers each.
Rage of
i
i
POWTS OWNIER'S MANUAL, A MANAGEMENT PLAN Page of
FILE INFORMATION
Owner Fker ECIFICATIONS
Permit # - Capacity ~~S C7 al ❑ NA
Manufacturer ❑ NA
DESIGN PARAMETERS Manufacturer❑ NA
Number of Bedrooms
❑ NA er Model Number of Public Facility Units ❑ NA
NA Capacity g a'0 al ❑ NA
Estimated flow {average}
4 0 al7cla PUMP Tank Manufacturer
Design flow (peak), (Estimated x 1.5} ~eG V, ❑ NA
C) C} ai/da Pump Manufacturer ❑ NA
Soil Application Rate _
Standard Influent Effluent Quallt , ,/ft Pump Model O NA
Y Mot ayerage pretreatment Unit
Fats, Oil & Grease (FOG) 530 mg/L 13 NA
Biochemical P Sand/Gravel Filter ❑ Peat Filter
Oxygen Demand (BOD6) 6220 m41L P NA ❑ Mechanical Aeration ❑ Wetland
_ Total Suspended Solids (TSS) 5150 mgIL 0 Pretreated Effluent Quality Monthly average Qispersal Cell(s)
Biochemical Oxygen Demand (gpp,,) 530 mg/l, ❑ NA
0 In„Ground Igravity) ❑ In-Ground (pressurized}
Total Suspended Solids (TSS) 530 mg/l Q NA At-Grade
Fecal Coliform (geometric mean) 510" cfu/100ml ❑ Mound
' 0 Drip-Line GI Other:
Maximum Effluent Particle Size Y. in dia. Ptha►~' -
Other: NA O NA
NA
D NA
`Vaiues typical for dornestic wastewater and septic tank efflyent. Other;-
❑ NA
MAINTENANCE SCHEDULE
Service Event
Service Frequency
Inspect condition of tank(s) ❑ month(s)
At least once every: (Maximum 3 years) ❑ NA
Pump out contents of tank(s) year(s)
When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA
Inspect dispersal cell(s) ❑ month s)
_ At least once every; (Maximum 3 years) ❑ NA
Clean effluent filter ~ Year(s)
At least once every: O month(s)
_ ~ yearls} C] NA
Inspect pump, pump controls & alarm ❑ mar(s) l
At least once every: ❑
❑ NA
Flush laterals and pressure test year(s)
At least once every: ❑ month{s}
Other. _ ❑ year{s} ❑ NA
At least once every: - 13 month(s)
Otner: ❑ year(s) ❑ NA
❑ NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by. an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank
inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any beck up or ponding of effluent on the ground surface.
The dispersal cell(s) shall be visually inspected to check the effluont levels in the observation pipes and to check for an
ponding
of effluent on the ground surface. The ponding of eftlyent on the ground .surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any ta
19,
nk equals one-third (Y3) or more of the tank volume, the entire
contents of the tank shall be removed by a Septage ~ervicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment
units, and any servicing at intervals of 512 months, @hall be performed by a certified POWYS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
START UP AND OPERATION Page of
-
For new construction, prior to use of the PQWTS chebk treatment tankfai for the presence of painting products or other chemicals
that may impede the treatment process and/or darnape the dispersal celi(s). If high concentrations are detected have the contents
of the tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the Infiltrative surface.
During power outages pump tanks may fill above normal highwrater levels, When power is restored the excess wastewater will be
discharged to the dispersal cell(s) in one large dose, overloading the collls) and may result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or PQWTS Maintainer to assist in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive of park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at-grade soil absorption area,
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
PQWTS: antibiotics; baby wipes; cigarette butts; aorl0orns; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meet scraps; medications; oil;
painting products; pesticides; sanitary napkins; tare pone,, and water aoftener brine.
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the fallowing steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chapter Comm 83,33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed anal properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and rernov$d or their covers removed and the void space filled with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the PQWTS fails and cannot be repaired the follovvinp measures have been, or must be taken, to provide a code compliant
replacement system:
❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed etructure, lot lines and wells. Failure to protect the replacement area will
result In the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
❑ A suitable replacement area is not available due to setback andlor soil limitations. Barring advances in POWTS
technology a holding tank may be installed as a last resort to replace the failed PQWTS.
The site as not an evaluated to identify a suitable replacement area. Upon failure of the PQWTS a soil and site
tV evaluation be performed to locate a suitable rr placam .ent area. If no replacement area is available a holding tank
may bulls s a last resort to replace the failed PQWTS.
❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
< < WARNING > >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER AN1' CiRdUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICUd T OR IMPOSSIBLE.
ADDITIONAL COMMENTS
PO,WTS INSTALLER W Ell' I TAINER
Name t A C-~1a r(1` +t., Name
L Phone -7 / - 3 g
~ a i Phon®
SEPTAQE SERVICING OPERATOR (PUMPER) 404 RE# V4ATORY AUTHORITY
Name game e-/bt
Phone Phone
This document was drafted in compliance with chapter Comm 8122(2, lb1(1)Id)&lll and 83.54(11, (2) & (3), Wisconsin Administrative Code.
ST. CROIX COUNTY
SEPTIC TANK MA NTENA:NCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
(hutier/Buyer .T._.--
Nh.ailing Address 2?32 /1/IQ,~'NJ~J~~SI/)E l J,~r`J S D~ 2
Property Address
(VQriiiaatiott required froill Planting & Zoning &;p=en t for new construction.)
(:",itylState t/(=7` . ltJ'T Parcel IdentiEcation 1\rlunbez y~ 9 S"/ D
_9 y,
LE `AI, DE QR_1 ION
Property Location SLR 'l4 , , Sec. a T d____ N - ,9,6lW, Town of
Subdivision Lot #
Certified Survey Map # M(7 Volume Page #
Wariranty Deed # , Page # .
Spec house yes no Lot lutes identifiable ye no
SYSTE NTENANCE OWN R C1rR . AT ON
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 systern can affect the function of the septic tank its a treatmut stage in the, waste disposal system. Owner maintenance
responsibilities are specified in, 6Conmt 83.52(t) and in Chapter 12 w St. Croix'C:ounty Sanitary Ordinance.
The property owner agrees to rtubmit to St. Croix County Planning & Zoning Department a certification forth, signed by the
owner and by a master plumber, journeyman plutribe.r, restricted plumber or a licensed pumper verifying that (1) the m-site
wastewater disposal systern is in proper operating condition and/or (2) after inspection and pumping (i£ necessary), the septic tank is
kiss than 1/3 full of sludge.
Uwe, the undersigned have read the above requiretnents and agree to maintain the private sewage disposal system with the
stsndards set. (orth, herein, as set by the Department of Comaxwee 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 Planning
liming Department within 30 days of the three year expiration date.
1/we certify that all statements on tlr'. forth are nee to the best of my/our knowledge. 1/we an/am the ovvtter(s) of the
property described above, by virtue of a anty deed recorded in Register of Deeds Office.
Numb of be "on
X lO 1-3 / Z
OF AP . CANT(S) ~ . DATE
***Any information that is misrepresented may result in the sanitary permit being revolted by the Planning & Zoning pc artnxnt.
[nclude with this application a rewarded warranty deed born the Regiater of Deeds Office and a copy of the certified survey trap if
reference is made in the warranty deed.
(R)FV. 08105)
w
VVisconsin Department of commerce SOIL EVALUATION REPORT Page I of 3
Division of Safety and Buildings
in~r~6-ewith Comm 85, VVis. Adm. Code
Counly' ST. CROIX
Attach complete site plan on paper nottless than 81/2 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 040 - 115 - #0(.
6 ~S
percent slope, scale or dimensions, north arrow, and locatiriirice to nearest road. l
Please print all informadon. "Jr.. a Data
mracy law, s.-04 (1) (m)).
Personal information you provide may be used for secondary p
%Ck-f In - I VA
Property Owner , Property Location ED 0
CHERYL SWANSON (Cory 13ene Govt. Lot SW 1/4 SW 1/4 S 24 T 28 N R 20 E (or) W
Property Owner's Mailing Address . pF Lot # Block # Subd. Name or CSM#
245 Plainview Drive 29 CSM Vol 7, Pg 1851
City State Zip Code Phone Number Vte ■ own Nearest Road v
River Falls, WI 54022 ( ) NIA 1my Plainview Drive
New Construction Use[q Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
® Replacemert ❑ Public or commercial - Describe:
Parent material sandy outwash Flood Plain elevation if applicable X-w ft.
General oon riertts Conventional In-ground trenches 0.7 loading rate
and recommendations:
Fil Boring # ® Boring
Q Pit Ground surface elev. 97.72 ft. Depth to limiting factor 115 in.
Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. *EW1 *Eff#2
1 0-6 10YR4/3 - 1 3f-ma&sbk ds cw 3vf-co 0.6 0.8
2 6-18 10YR4/4 - sl 2f-ma&sbk dsh cs 2vf-co 0.6 1.0
3 18-36 7.5YR4/6 f is Ifsbk ds cw 2vf-m 0.7 1.6
4 36-115 10YR3/6 cos OS ml 0.7 1.6
Horizon 3 has 1-5% gr.
~f
3579,
® Boring
❑ Boring # Pit Ground surface elev. 92.12 ft Depth to limiting factor 110 in.
Sot Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW
in. Munseli Qu. Sz. Conk. Color Gr. Sz. Sh. *EfWl *0111112
1 0-5 10YR4/3 - 1 3f-mabk ds cw 3vf-co 0.6 0.8
2 5-16 10YR414 - I 3fabk dsh cw 2vf-co 0.6 0.8
3 16-36 7.5YR4/6 - is Ifsbk ds cw 2vf-co 0.7 1.6
4 36-40 10YR414 - s Ogg dl cw 2vf-f 0.7 1.6
5 40-110 10YP-3/6 - cos Osg ml 0.7 1.6
* Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD 130 mg/L and TSS < 30 mg/L
CST Name (Please Print) - - S > CST Number
Mary Jo Huppert Hollister's Soil Testin & Desi gn) A&K~ 224832
Address Date Eva Conducted Telephone Number
W9875 690th Avenue, River Falls, WI 54022 07 - 17 - 12 (715) 426 - 1775
Property Owner SWANSON, Cheryl (Benedict, Cory) Parcel ID # 040 - 11579 - 5100 Page 2 of 3
a Boring # L1 Boring 97.82
• Ground surface elev. ft.
Pit Depth to limiting factor 120 in.
Sol Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDMF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Ef*l -Eff#2
1 0-5 1OYR4/3 1 3f-mabk ds cw 3vf-co 0.6 0.8
2 5-16 10YR4/4 1 2f-mabk dsh cw 2vf-co 0.6 0.8
3 16-39 7.5YR4/6
is Osg dl cw 2vf-m 0.7 1.6
4 39-50 10YR4/4 s Osg dl cw 1 vf-f 0.7 1.6
5 50-120 1OYR5/6 cos On ml 0.7 1.6
Boris # Boring
F-1 ppit Ground surface elev. ft. Depth to hniting factor in.
Sol Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Mursell Qu. Sz. Cont. Color Gr. Sz. Sh. -EM1 -Eff#2
❑ Boring # Boring
Pit Ground surface elev. ft. Depth to limiting factor in.
Sol Application Rate
Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/FF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#l -Eff#2
• Effluent #1 = BODS > 30 < 220 rrg& and TSS >30 < 150 mg/L - Effluent #2 = BODE < 30 mg/L and TSS < 30 rng/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material m an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
SBD 8330rot (x.07/00)
A
Plot Plan for Site and Soil Evaluation Page 3 of 3
Property Owner 'vv u sg C ~ y
1"=40ft
Legal Description sw'/4 ~F f4 s~4 (except where noted)
7903, ao~.l PWE OF eRM Y R1 ArME MWA of L~ = Backhoe pit
TRDy ST_ Cpa Y coy, wk&CQ'esw . 11.460 Aegzs
North
a
all
04
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Parcel 040-1157-95-100 10/01/2012 08:05 AM
PAGE 1 OF 1
Alt. Parcel 24.28.20.615F 040 - TOWN OF TROY
Current ❑ ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O - SWANSON, CHERYL
CHERYL SWANSON
245 PLAINVIEW DR
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC SCH DIST RIVER FALLS
SP 01800 CHIP VALLEY VOTECH~ `7 ? / 1/im~)
Legal Description: Acres: 11.860 Plat: 1851-CSM 07-1851 040-87
SEC 24 T28N R20W LOT 29 CSM 7/1851 EXC Block/Condo Bldg: LOT 29
PT TO CSM 12/3350
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
24-28N-20W SW SW
Parcel History:
Notes:
Date Doc # Vol/Page Type
03/02/2011 933022 TI
07/28/1999 607623 1445/106 WD
07/23/1997 994/451 QC
07/23/1997 785/110
2012 SUMMARY Bill Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 11/09/2009
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 2.000 400 0 400 NO
AGRICULTURAL FOREST G5M 9.860 39,600 0 39,600 NO
Totals for 2012:
General Property 11.860 40,000 0 40,000
Woodland 0.000 0 0
Totals for 2011:
General Property 11.860 40,000 0 40,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
8 0 5 9 1 0 2
Tx;4043330
957414
STATE BAR OF WISCONSIN FORM I -2000 BETH PABST
WARRANTY DEED REGISTER OF DEEDS
Document Number
ST. CROIX CO., WI
THIS DEED, made between Cheryl K.. Swanson, Grantor, 05/31/2012 3:37 PM
and Corey D. Benedict pnd Amy K.~edict, husband and wife, as EXEMPT#: NA
survivorship marital property, Grantee. REC FEE: 30.00
TRANS FEE: 495.00
Grantor, for a valuable consideration, conveys to Grantee the following PAGES: 3
described real estate in St. Croix County, State of Wisconsin (the
"Property"):
Legal Description Attached
Recording Area
Name and Return Address:
Agstar
po o-" 360
WZ 54001,
Together with all appurtenant rights, title and interests. 040-1157-60.000; 040-1157-95-100; 040-1160-
40-000;040-1160-60-000
Parcel Identification Number (PIN)
This is not homestead property.
Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except
reservations, restrictions, and easements of record, if any, and public highways, zoning and building regulations.
Dated this ~5 day of May, 2012.
*Cheryl K. Swa on
* *
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN )
L5 ) Y COUNTY. ) ss.
authenticated this Personally came before me this ~S_ day of May,
2012 the above named Cheryl K. Swanson to me known to
x be the person(s) who executed the foregoing instrument and
TITLE: MEMBER STATE BAR OF WISCONSIN acknowledged the same.
(If not, ~ VICKY SPAETH
NO v pl IR1 II^
authorized by § 706.06, Wis. Stats.) IN
ST&TE: OF THIS INSTRUMENT WAS DRAFTED BY Notary Public, Slate of Wisconsin
m
anent. (If not, state expiration date:
My c CioZler,
3 )
Michael H. Forecki, Attorney
(Signatures may be authenticated or acknowledged. Both are not necessary.)
"Names of persons signing in any capacity must be typed or printed below their signature
WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1-2000
1 of 3
SWANSON TO BENEDICT
WARRANTY DEED
LEGAL DESCRIPTPION:
That certain parcel of land in the SWIA of the SW1/4 of Section 24, the NW1/4 of the NW1/4
and the SWIA of the NWI/4 of Section 25, all in T28N, R20W, Town of Troy, St. Croix County,
Wisconsin, including all of Lot 1 of Certified Survey Map recorded in Volume 7 of St. Croix
County Certified Survey Maps, Page 1852, part of Lot I of that Certified Survey Map recorded in
Volume 5 of St. Croix County Certified Survey Maps, Page 1207, and part of Lot 29 of that
Certified Survey Map recorded in Volume 7 of St. Croix County Certified Survey maps, Page
1851, more fully described as follows: Beginning at the Southwest corner of said Section 24, also
being the Southwest corner of Lot 29 of Certified Survey Map recorded in Volume 7 of St. Croix
County Certified Survey Maps, Page 1851; thence North 01 degree 31 minutes 13 seconds West
(assumed bearing on West line of the SWIA of said Section 24 and the West line of said Lot 29;
recorded as North 01 degrees 35 minutes 18 seconds West), 896.27 feet (recorded as 896.21 feet)
to the Northwest corner of said Lot 29 and the Southwest corner of that Certified Survey Map
recorded in Volume 5 of St. Croix County Certified Survey Maps, Page 1323; thence, along the
North line of said Lot 29 and the South line of said Certified Survey Map recorded in Volume 5,
Page 1323, South 80 degrees 17 minutes 14 seconds East, 478.32 feet (recorded as South 80
degrees 22 minutes 30 seconds East, 478.01 feet); thence, continuing along said North line of Lot
29 and said South line of said Certified Survey Map recorded in Volume 5, Page 1323, North 84
degrees 36 minutes 37 seconds East (recorded as North 84 degrees 31 minutes 21 seconds East),
184.14 feet; thence, continuing along said North line of Lot 29 and it's Easterly extension, and
along said South line of that Certified Survey Map recorded in Volume 5, Page 1323, South 60
degrees 40 minutes 44 seconds East, 506.83 feet (recorded as South 60 degrees 46 minutes 00
seconds East and South 60 degrees 45 minutes 53 seconds East, 506.89 feet to the Southeast
corner of said Certified Survey Map recorded in Volume 5, Page 1323 and a point on the
Westerly right-of=Way line of Plainview Drive; thence Southeasterly along said Westerly right-
of-way line, a curved line, concave to the Northeast, having a radius of 266.00 feet, whose chord
bears South 21 degrees 23 minutes 31 seconds East, 303.07 feet to the most Northerly corner of
Lot l of that Certified Survey Map recorded in Volume 12 of St. Croix County Certified Survey
Maps, Page 3350; thence, along the Northerly boundary of said Lot 1, South 19 degrees 30
minutes 54 seconds West (recorded as South 19 degrees 28 minutes 27 seconds West), 64.47 feet;
thence, continuing along said Northerly boundary of Lot 1, North 89 degrees 52 minutes 15
seconds West (recorded as North 89 degrees 54 minutes 42 seconds West), 819.36 feet to the
Northwest corner of said Lot l; thence, along the West line of said Lot 1, South 01 degree 48
minutes 29 seconds East (recorded as South 01 degree 50 minutes 56 seconds East), 928.00 feet
to the Southwest corner thereof; thence, along the South line of said Lot 1, South 89 degrees 52
minutes 15 seconds East (recorded as South 89 degrees 54 minutes 42 seconds East), 64.64 feet;
thence South 03 degrees 56 minutes 39 seconds West, 632.88 feet to the Northeast corner of Lot
1 of that Certified Survey Map recorded in Volume 7 of St. Croix County Certified Survey Maps,
Page 1852; thence, along the Easterly line of said Lot 1 recorded in Volume 7, Page 1852, South
04 degrees 26 minutes 30 seconds West (recorded as South 04 degrees 21 minutes 52 seconds
West), 350.77 feet; thence, continuing along said Easterly line, South 12 degrees 25 minutes 00
seconds East (recorded as South 12 degrees 29 minutes 38 seconds East), 214.28 feet; thence,
continuing along said Easterly line, South 01 degree 16 minutes 58 seconds East (recorded as
South 01 degree 21 minutes 36 seconds East), 145.00 feet; thence, continuing along said Easterly
line, South 30 degrees 04 minutes 38 seconds West (recorded as South 30 degrees 00 minutes 00
2 of 3
seconds West), 185.00 feet; thence, continuing along said Easterly line, South 15 degrees 12
minutes 00 seconds West (recorded as South 15 degrees 07 minutes 22 seconds West), 199.35
feet; thence, continuing along said Easterly line, South 30 degrees 04 minutes 38 seconds West
(recorded South 30 degrees 00 minutes 00 seconds West), 180.00 feet; thence, continuing along
said Easterly line, South 01 degree 48 minutes 42 seconds East (recorded as South 01 degrees 53
minutes 20 seconds East), 100.00 feet to the Southeast corner of said Lot 1 and a point on the
South line of the NW1/4 of said Section 25; thence, along the South line of said Lot 1 and the
South line of said NW114, North 89 degrees 18 minutes 45 seconds West (recorded as North 89
degrees 23 minutes 13 seconds West), 100.00 feet to the West quarter corner of said Section 25
and the Southwest corner of said Lot 1; thence, along the West line of said Lot 1 and along the
West line of said NW I/4, North 01 degree 48 minutes 42 seconds West, 2628.05 feet (recorded as
North 01 degrees 53 minutes 20 seconds West and North 01 degrees 55 minutes 01 seconds West,
2626.08 feet to the Point of Beginning.
3of3
CERTIFIED SURVEY MAP
Located in the SW 1 /4 of the SW 1 /4 of Section 24, T28N, R20W, Town of
Troy, St. Croix County Wisconsin.
Surveyed for: Alex Kosa
WI/4 CORNER 325 Vine St.
Hudson Wi. 54016
CERTIFLEQ~$~I~y~Y-,MAe-
-LQL...4 _P1 2! FUND
JUL 131887
s 80 0 22 30 baw of 4 78 0I . ~E A ~4Deft
MIN84° 31' 21"E
yob _ 184.14 -00 I
ZI fee a 0op
J e0 F
of
WI
H1
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d
I
Z1 N
I ~N N
bA
LOT 29 Mo,
6007!25 SO. FT.
H 13.791 ACRES
T 3 y a1
X o ~1
g o1
U N `,'NIINI/~ jNI, zI' W
CSC O& I W
Z 0 0 °c
o oI X.
N EY G. * HI S 0 o
W
$ ~ m ~o
N - W n dl W o
i~ o f I 0:o
l M ~H
Ltj
49W
O WT
O m 1-
h
,...-POINT OF BEGINNING
680.03,
N 89 07 31 W
SW CORNER
T28NI N 24 SOUTH LINE OF THE SWI/4
S I/4 CORNER
-lINPI,9LT~Q LANQS SECTION 24
SCALE IN FEET 1" -ISO' LEGEND
0' 76 150, 300'
SECTION CORNER MONUMENT
3/4 "STEEL REBAR FOUND
0 1"X 24"ROUND IRON PIPE WEIGHING
1.68LOS./LIN.FT, SET.
Volume 7 Page 1$51
1851
Parcel 040-1157-60-000 10/01/2012 11:46 AM
PAGE 1 OF 1
Alt. Parcel M 24.28.20.615A 040 - TOWN OF TROY
Current ❑X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
0 - SWANSON, CHERYL
CHERYL SWANSON
245 PLAINVIEW DR
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 4893 SCH DIST RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 3.280 Plat: N/A-NOT AVAILABLE
SEC 24 T28N R20W SW SW EXC PLAT OF Block/Condo Bldg:
CROIXRIDGE & EXC CSM MAP VOL IV P 946 &
EXC CSM 7/1851 & EXC CSM 12/3350 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
24-28N-20W
Notes: Parcel History:
Date Doc # Vol/Page Type
03/02/2011 933022 TI
07/28/1999 607623 1445/106 WD
07/23/1997 994/453 QC
07/23/1997 826/532
2012 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 11/09/2009
Description Class Acres Land Improve Total State Reason
UNDEVELOPED G5 2.280 38,900 0 38,900 NO
PRODUCTIVE FORST LANDS G6 1.000 10,000 0 10,000 NO
Totals for 2012:
General Property 3.280 48,900 0 48,900
Woodland 0.000 0 0
Totals for 2011:
General Property 3.280 48,900 0 48,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
i
qp ~2~C1 ~ . ,
CERTIFIED SURVEY MAP
Located in the SW 1/4 of the SW 1/4 of Section 24, T28N, RZOW, Town of
Troy, St. Croix County Wisconsin.
Surveyed for: Alex Kosa
WI/4 CORNER 325 Vine St.
Hudson W i . 54016
CERTIFLED_SURV9 - MAe-
__[Of 4 -PAGE 946 FILED
JUL13 1987
Awn a
S 800 bomw of boo*
22 • 30 4E
4 78.0/ ,
N840 3121
"E sb'Oo
184.14 F
Q I /~G 6 0 .r
a 1 .6,0 ~ I
01 ( 1
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6007125 SQ. FT.
3
N 13.791 ACRES vi z1
0
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POINT OF BEGINNING 680.53'
N 89 17'3 1 W
SW CORNER
SECTION 24 SOUTH LINE OF THE SW I/4 :::7
T28N, R2OW S I/4 CORNER
_lJ _E[. ITTER LANDS SECTION 24
SCALE IN FEET I" = 150' LEGEND
0' 75' 150' 300' SECTION CORNER MONUMENT
r` 3/4 " STEEL REBAR FOUND
1"X 24" ROUND IRON PIPE WEIGHING
0 16BLBS./LIN. FT. SET.
At
Volume 7 Page 1051+
1851
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CERTIFIED SURVEY MAP '*V_~ V
7 LOCATED IN THE SWI/4 OF THE SWI/4 OF SECTION 24, T28N, R20W, TOWN OF TROY, ST. CROIX CdUNTY, WIS.
UNPLATTED_ L,ANDS_ i
e
°r• N 8902016"W 926.91' (NsoeiW G"w R.) 21000 NORTH LINE OFT_HESW1/4OFTHE SWV4
i 500.00' `
= n ,C a 426.9( POINT OF BEGINNING
mA IZ e N
OA 1-0 U) 8
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n rn = N 81°38'5711 u
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0 49 ~ O $
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Or, 46 Sao 143.311'
r ST. CROIX COUNTY
°22~30"E ea °14, ~s~es• b UrCO 0 COKIPREIIENSIVE PARKS PLANNING
478 .01
ZONING COMA! G
4.
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L.E G E N °tis rO r/ I ybg
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SCALE IN FEET I 200 (R) PREVIOUSLY RECORDED AS. N 15°55'53"E
- SECTION CORNER MONUMENTa 55.4.2' .
1 • 2"IRON PIPE FOUND
0 1001 20d 30d 500 • I"IRON PIPE FOUND 1'%4'
I
I
O 1 "J( 24" IRON PIPE WEIGHING 1.68 LBS./LIMFT~ SET
DESCRIPTION
A parcel of land lgcated in the. SW1/4 of the, SW1/4•o£ Section 24, T28N, R20W,
Town of Troy, St, Croix County, Wisconsin, described as follows: Beginning at
the NW corner of Outlot 1 of Croixridge; thence N89°20'16"W 926.91' along the
North line of said SW 1/4 of the SW 1 /4 to the West line of said SW 1 /4; thence
S1035118"E 437.91' along said West line; thence S800 22130"E 478.01); thence
N84031121"E 184.141; thence S60045153"E 506.89' to the Westerly right-of-way
line of Plainview Drive; thence Northerly 12.481 along said Westerly line on a
266.00' radius curve concave Easterly whose chord bears N14035116"E 12.481;.
thence N15o55153"E 55.42' along said Westerly, line; thence Nb0045'53"W 151.91(
along the Southwesterly find of said Outlot 1; thence N29001'33'"W 151.451 along
said Southwesterly line; thence N0040136"E 464..9'9' along the Westerly line of Isaid
Outlot I to the point of beginning, containing 481158 sq. ft. (111;046 acres), and
being subj-ect,to all easemetlts of record.
I, James E. Rusch, Registered Wisconsin Land. Surveyor, hereby certify that I
have surveyed and mapped the above described property; that such plat is a. true and
correct representation of the exterior boundaries of the .land surveyed; and that I
have fully complied with the provisions of Chapter 236.34 of the. Wisconsin Statutes,
the Town of Troy Subdivision Ordinance, and the St. Croix County Subdivision
Or 'nance to 7th f my fessidnal knowledge, understanding and belief.
T a-1 E. Rusch'
W consin. Land Surveyor S-1376 Surveyed for: Corina Jorgenson
4 Second Street
Hudson7" Wisconsin 54016
~ ~
This map is e eby approved by the To oard of the own of Troy. ~~tNNIgII~j~
~yGO/115+
D to own GI VIP
JAMES E.
RsU-iS~eH
:r
483-468 o
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Volume K Page 1323
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565437 - 7 1997
~v~ o~ Eco o 11 FILED
Z)tp 1 6 1997
Z CERTIFIED SURVEY MAP KATHLEEN H.WALSH
F LOCATED IN PART OF THE SW1 4 OF THE SW> 4 0 RegislerofDeeds
SL Croix Co., WI
NF= UJ N SECTION 24, AND PART OF THE NW 1 /4 OF THE NW 1 /4 h•
OF SECTION 25, ALL IN T28N, R20W, TOWN OF TROY, ST.
-J
OP CROIX COUNTY, WISCONSIN, ALSO BEING A PART OF LOT 1 0 co
w~ C.S.M. VOL. 5, PG. 1207 & LOT 29 OF C.S.M. VOL. 7, PG. 1851.
z;i
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WIT
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a
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w m OWNER
"ors
~ F- o Bernard N. Ashbach h D9
w UtR 47 Plainview Drive ~•7 R',P;1_.j;Ft i'..
°Q .Y ierFalls, WI 54022 awW r..'
S 2.
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mZN C.S.M. S w 1 y
I U N P LA TTE D_ LA N D___
VOL. 7
LQt__ 1.4_
PG. 1851
, N 19'28' 27"E\ \
I -
64.47' PLAINVLEW_DRIVE
S89'54 42 E 819.36 %~2 -r- -
PROPOSED CroixRidge
n i -e
Pole i DRIVE-• A
Shed Q ,CV I
ro Co Lot _ 24 1 Lot 23
i W Sv N of
Z fij - i S89'54'42"E
I 1 1348.33'
S89'54'42"E 1145.21' North line o 1 . 4 c .25 i~
RECORDED AS N89'57'31"W SO~Fi (in o t1he--SW1 e 2 89'54'42 if E ~
T r~ l~ N1/4 Corner
TNW Corner L l / 202.92 m Section 25
ection 25 i-- w S1 4 Corner
SW Corner e- ° p in Section 24
Section 24 ° O (V
16.80 Acres z c0 ~l
0 F o6
V)
0 00 j Garage a- 7 S ¢ O z Qf
(V I U (n o N
(3) 00 LLJ co ~ 3) S ~
w;
\ ~.~EXISTING DRIVE_
4113 z QI
0 Shedd House 4
N89'54 4 -JI
~i 0 Deck w 281.38' 182 40
1 ~I
z -C7)
61~~ Lo
ar
o N UNPLATTEDLANDS S S 00,
m VV '
AM Q
N89 54'42"W 457.00' 16 «9
i:.lw~„1.._.:
UNPLATTED LANDS
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iI~TlN3 i~t31#11#71ft#3l'9
LEGEND
ALUMINUM COUNTY SECTION CORNER 1t 13r~i 1>~r•,.c~lcfr►(i
MONUMENT FOUND aitttihIM!""'!dtq%or
2" IRON PIPE FOUND x,^~R1r~vcaC:t#Illiaia
1" X 24" IRON PIPE SET WEIGHING rnaili:nrx vend'
1.68 LBS. PER LINEAR FOOT
. • • • • • • • • 100 ROADWAY SETBACK LINE SCALE IN FEET 1" = 200'
o 2" X 30" IRON PIPE SET WEIGHING 100 044;w 100 200 300
3.65 LBS. PER LINEAR FOOT
(j Well ,
® Septic Vent
THIS INSTRUMENT DRAFTED BY Michael J. Erickson _JOB No. 97-79
Vol 12 Page 3350