Loading...
HomeMy WebLinkAbout032-2025-80-000 a o p o p pva ~%i bq O c 0. o N O O ryj N Q x N y a`> rn c 0 ~C 0 N ~ 0 I L.. L 'LY V1 O O Z L I C - O LL C O 0 O I Q O v Z N ai Z j O O L Z y y h Im- Z Id m O 2 c v o N v N H N c E 7 a _~V N W 4) L • "Nib U) L O N Q p O Z co z N Y L N CD CL O Q w r W d N c p In a IL a c Z > H F H U=L v 3 3 o N N m a a a IE N (n co m fA J U O) O2 } c ~l > o Q O 04 00 In N ~ ~ N N co 4) '70 ~ O O co N C p c N c c O O O O OU (n y y co ~ Q Q. V N M y c O O C N O E C~ N 1- F- c~ c! cn y?,' O O (n III LL O ZnO w r ~ d N £ a a r A U IL 2 0 rn 00 C-7 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER d~~S/i~ S' r ADDRESS 71 SUBDIVISION CSM LOT SECTION. 7 T-- 3,N-R_2~? W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM sa INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING..TANK INFORMATION Manufacturer: Liquid Capacity: Setback from: Well _ House y other_ Pump: Manufacturer Model# Size Float seperation Gallons/cycle: Alarm Location :SOIL ABSORPTION SYSTEM Width: J~ Length Number of trenches Distance & Direction to nearest prop. line: h2ES t / Setback from: well: Housed 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: LICENSE NUMBER: INSPECTOR: 3/93:jt Lt,~pa,Ql~¢y 7.30.19. FATE SEWAGE SYSTEM County: Labor anz: Human Relations INSPECTION REPORT Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) sanitary ermit 0.9;IX Permit Holder's Name: ❑ City ❑ Village X Town of: State Plan I o.: ROMERS-PIP lF. Insp. BM Elev.: BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA A9300284 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark s Gt/ s ~~,C, Zc~J o .G8 Dosing - rfo Aeration Bldg. Sewer 1?, Z2 Holding St/ Inlet 3 F2 ~TC~• " TANK SETBACK INFORMATION St/ Outlet ' //a, TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic 7~ r 3.~ y~- NA Dt Bottom D sing NA HeaderttVah. , Aeration Dist. Pipe 71 & I 960,5_9 Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manu r Demand ~e. ko ' 4e'8 Model Number GPM % a TDH Lift Friction em TDH Ft oss ea Forcemain Len th Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width j Length f No. Of Trenches PIT No. its Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS SYSTEM TO P/L BLD WELL LAKE/STREAM LEACHING manufacturer: SETBACK INFORMATION Type Of CHAMB Moe er. System: i6( d OR UNIT DISTRIBUTION SYSTEM Header/ Me4oifeb!! Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length 7 Dia. Spacing Jct~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over rl. 7Bed th O ve(,,' xx Depth Of xx Seded / Sodded ulched- I I / /Trench Edges'. Topsoil o [I Yes E] No Bed / Trenchr COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: OMERSET 7.30 19.56 613 ° t.:, j ~~t~ ,k`~, ~.1✓6.~! rr ~-t..4:...E&~i~ T~J ~ ~ ~rd".•{\,. j~~J~iU~ V/r ~Y~.: Plan revision required? ❑ Yes o Use other side for additional information. SBD-6710(R 05/91) Date Inspedor'sSignature Cert No. i 145 ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: i e i ' SANITARY PERMIT APPLICATION DILHR In accord with ILHR 83.05, Wis. Adm. Code CouN STA S I ARY P M # -Attach complete plans (to the county copy only) for the system, on paper not less than c1t E] w F71 8% x 11 inches in size. eck 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. PROPER OWNER PROPERTY LOCATION Y4 x' S T , N, fl (or PROPERTY OWNEF)'S M ING ADDRESS LOT # BLOCK # 9 44/d CI STATE / ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER T II. TYPE OF BUILDING: (Check one) ❑ State Owned VILLLLAGE NEAREST ROAD ❑ Public ~41 or 2 Fam. Dwelling- # of bedrooms L =N Q UM 6 Ill. BUILDING USE: (if building type is public, check all that apply) ~5 o e0ed 0 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 80 Mobile Home Park 120 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. M New 2. ❑ Replacement 3. ❑ Replacement of 4.E] Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ® Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-in-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION 7 Feet Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks strutted Se tic Tank or Holding Tank Lift Pump Tank/Si hon Chamber Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for install ion of the onsite wage system shown on the attached plans. Plumber' Name (Pr' t): lei Plum er' ign re- p MP/MPRSW No.: Business Phone Number: Plu ' A dress Street, City, S e, Zip Code):/ V, JA IX. LINTY/DE ARTMENT USE ONLY Disapproved Sani ry Permit Fee (includes Groundwater a e ssue Issuing gent Sig Lure (N Stamps Approved ❑ Owner Given Initial eh 00Surcharge Fee) p Adverse Determination U 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 renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by y-a licensed. pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all 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'/z 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; (Jose 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, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) 7-11 /14, 4W, 7 ' ~jyy,~,~,(5,@ ~ GL~,r S'~lta'J \JO'lnt,s°Sit` S.t~ T .~✓f! / S ~v G ~t y ~ l+fT~c'~dn~d i i 'lN D I i i I 1 1 PAGc 0► • Ct` SS~• S~cc~IOI~ o~ A ~t17. 3~~ Ca`y~s, d~. r~ / too 611 Ak wish AM 06641vouss Pipe Awtv" YOGI got ~ O.Iclw.rn ItlANr• i•, • . flail n 1 • -869411" • • j. , Coo 1000 It /IMI $f•I• Yom No , • 1 N - • 0 04 ;10 ,3e•1~ ' 71 T•• 6 . s•M•1k Pli• . • Pwlw•l•d Pipe Y•Iw • c"441 Tww ossel AI Wits 01 if~l•w • r P p 9. £~sJw~ IvI1 ~ OISTKIBUTiom PIPC =vf-., APPR0%If6 S`1Wpjr, TIC Cove `""-r1ATSRt~~ oF h4GRf6AI E OR 1" OF STFA1• OR MARsi+ ►'.Ay ELE OF' =•5^PES•T.-► AGGRCGATC ~P ~~~C 7 1•.r OISTRIDU"'Ow Fort ATV ©E AT ~£A%T - IWCHE3 6CLOW ORWINA1. •~,~,,o~ ^UV AT. LCAS"~' ° ? H[L OUT 1.10 MORC THAN 41 IWCIiE$ NCI.OW rINAI. C►4AOC 1'WcUwlr► DEPTH OF EXCAVATION FXcM oK16w,\L 6XJwF. WILI. 5E IWCHCS 1'UK~t'1uM IDEPni OF EACAvATioN FP,0;0, (;Rnpf. W1t.L. 1sc •..L~G~,, INCHCS Ur-cusc Ila ; 9 'INDUSTRY, OF REPORT ON SOIL BORINGS A ~o & s oN LABOR AND fp ~ O. BOX. 7969 HUMAN BOR RELATIONS PERCOLATION TESTS 115 sFf'~ "~%~•ppA N, WI 53707 (H63.0911) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO. NO.: ISI N > 1/4 7 /T30N R 17 E (or) W S'or'►E~P.5CT_ J /~to~/rVl~ C41 ADI X OWNER'S/BUYER'S ~NAME- MAI J b /mil ~01V 97F LING ~/CO ADDRESS: .5_5 USE DATES OBSERVA DE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: E TON TESTS: Residence New ❑ Replace 57, ;1 - S'2-- f 82- RATING: S= Site suitable for system U= Site unsuitable for system AlwXY 1-1^ SA~~ S4- Atz ! u-,Le ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) / Q.Fr. Ris ❑U MS ❑U ~S ❑u ❑S U ❑S ®ll rovvt:v,,o n1_ We /axsa ~ If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: I Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) ji: 5 r" Go L ) " Si L. , 7!a " Mix fast ' 7hRZ B- /OR.fv ll, / $iL~ Ly,Q,t), 4e $•L B- 0040 /0% V6 O ~0 120",q/X.'O . S ! RV . sL 5-09.0 -Sc B- 209 /3a. S y/ w/ 6-R B- z6 6y, Mix. .m S 0J* 13m.4tuSe SL 09 B- 10.3PF 93 11 Au :6-Y- 5-•4 „6y iL 9" BIV, c&"T_C 5-1- wl rr , SL fat 0 34 RAJ,S B-~ 9Z oyl~Gf ~ y 9Z 6"AV-6y. VIC) 7 -L;r aN.s;L, q"OR.Sl 40WAR 1300P Qa. S SL to j or-A,4 ' ~0 PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER 53V 7-. AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH P_ 7,10 r P- P- Z 5.70 16 7 S~j 4.1 - Z_ P__ P- .50 6 P- PLOT PLAN: show locations of percolation tests, soil borings dno the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation 7att-all borings and the direction and percent of land slope. soj'T m of 13eD Exc.4vATloA) To ixe- 0~7 FT 13"oto 1x"r A06_,JC_. " SYSTEM ELEVATION PT gar el"4 rio v o c 9~ - 75_ Fr• F x _ ~ U D i i Q - AR-0-AX X077 r A7-1 142 ro r /3 3 k 77 Al il.<r r ~ k r L4~ Fr s i~A 5 TS • =E' S? E M ST fj x ~~Pac ;S T ~ . a E E y~ : j ~7 € 1/ r ' r rl 11 f! IEl E;+ . Z S I, the undersigned, hereby certify that the soil tests reported on this form were made b me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: ADORE S: CERTIFICATION NUMBER: PHONE NUM ER (optional): D uvso v ~~s syo~ _02Z Z 3(?6 j ate) Gam. Seta 211*Wi,--f7 / PaT SIGNATURE' `//rJ(/~. + le, 9 le- -3 DISTRiBUTKON Original a-A nns copy to Inca! Auth,-)rty, Property Owner an. Sail Tester. INSTRUCTIONS FOR COMPLETING F ILM 115 - SBD - 6395 ' To a complete accurate soil test, your mt: 1. 1 legal 2. Ti - me section it rly indicate this is ~,o nmercial project; 3. MAXIMUM dumb. 'ooms or corn use planr 4, Is this a new c, r- -it System; 5. Complete the sui ing boxes. A )SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEaIr RULED OUT -DON SOIL CONDIT - S; 6. PLEASE use t rtions sh_ >r vvriting profile de i is e nd completing the plot plan; Al`E A LE" B ''n G 10 atirIg your test locations. Drawing to scale is preferred. A ,TP Qheet if :..s.. st- your -ark < a reference poin, shown, and are permanent; rJ. lete all - )piiate boxes i dat names, addresses, floor i lata, percolation test exemp- if ap of 'o ir=for < flood plai'- n does not apply, x; 11. i le f(" i y )ur curre{7t 0, nd your certifica~":an 12, N=ike legit and distribute as I. ALL SOIL TES1: L F.- 7.: iTH THE LOCAL AU 'T Y WITHIN 30 C ~PLETION_ ~ VIATIONS ITI FI ED SOI L TESTERS Ti Mures •n `kals - 3") Cal t t~ i TO THE O r~ r Lit: rp' Mi+v+ Ur $ 1 715 246 7079 RE/MAX P02 INL KtFUK I UN SUIL WKIN(ib AIVIr,1 ' ' " IVISO"IS110 ~ N LABOR AND x.15 ~sF' /~~r ar X 7 ` PERCOLATION TESTS 707 HUMAN RELATIONS (H63,09{7) 81 Chapeer 146,0481 t I~rfIO OM11 153707 LOCATION: I- SECTION: r TOWNSHIPWUNICIPALITY: + NC.: C+7N k7-H?ti ~CJf~`~A •r fit' '14 /T3v N/R i? E tor, w -5,014trA T ' tiyf 177 " Xrcrf7C7c~1'ff1€s X / is Sole 87:~ ,.r~i7~7~10/. /.P. • ~ ~ v ~ t4•`~ _ DATES 08SERVATIONSMknE r RetiMMlV NNaw 1 +AepfaCa I~/-,~ ^ d i: P`_ J 1 SC4 & r9M y w.-pub- tz~tir'RS ~ RATING: C• sit. rull.tol. ,er .y.um V• C+U 0116.1t.61. }ar .YN.m + Sig iai) •~e'ruti{'.x ~-fl,J, ~/J. t N MUUN t IN tln+66ft N-FILL 40LDIN 7 NK:RECOMMFNOF.DSYSTFM:(nnl,on;,Tj (pr%j ~p S ❑u []U$ 0 ®U ~art'ulroc~i n 4z X.~ If Percolation 7µu ue NOT requ!rvrl 10 NRYEII aAy p4r1;Gn 01 Mrt tHHd aN6 It +8 IhY- ~~rahr ..f460.0416+bt, Indie.ia: / 111111 fiwJyloir, inJi.ute ~+wJrla+.. rria,ri~or rFS1;.iPil,i= f.lE$,:KIt+1'IONS QOHINC OrA4 + -1 fl UNDWA'rEfl•I CHEb A 6~t "1 VTrNICKiE6F, COLOR, i•F.xTrVri C+•n~~ l1+TIi IDEA ~t PT+I IN. ELEVATION y T TQ-aE0g0L K IF 00 ERVEO (SEE ADDAV.ON RACK) > y II,~.,Tr, Z7~• A1, se 76 „ Anil ti.I..e da' 7,>u.Q • 5 ?~it'• o 0o s 4 -o ! B• ~l+r V6 F i• I ,Ov,4 11'r &I'am-ow SL kJ,;~(,, R~ .,20"Arr o 5 Q.) , s` (5-0 9'. -sa o, D• J ~ r~ 61 fAj SL -,64, 99. xG fab''au`6 s,•L. bN /3a, s;6 04 $4 w/ 6-,f • 6y-! 13. 16A.3Ff ;;I-ire,- > 93- ~r• w.6 y. s4 ,..~y. rL 9 - au. Mitre 4- 4r;• Aj '44, 00 0 '1) > 92 III, rr 13AO SIB, 7 44- $-Q . s;L, rr ° o,P. s~ o-~ " 04.. ge,~ PERCOLATION TESTS TUT PRQ PTH WAIlIt IN I,UIr 'i 1:51 IIMt P IN WATER LEVEL •IN 11 u I,AT INVTLS NUMBER ,Ilr; j~ AFTER SWe L.IN INTERVAL-MIN. P'H INCH 7,10 P. P. 111,07 Pt, AN: *I,.- I...du,,. .o,l (bunrpt .,)u Ire <r n4Mi9n1 }f I.Jitants en11 anent IMtllr•nin anal nr nstarnmr Oulurlint whelk lie Ili? hy-1. .natal aril verlic/l alevetlpn ,afseance points and show their location on the plot plan. Shuw the $.frece elevation at all Uannps an,.[ In- -,%d I"ONIOng of1erKI WWII, $orror4 of 9--D --Ye 41A7; A-) rig 44''- y.J f,~` 40/aeN Uf;p T'.Ia~F SYSTEM ELEVATION P7-• nr !ruRTior~ aF 9,57 ; iffer• -h Aos r' -wow- 4"Cao , i Gi ..,~..1x zr o s , r~ y ~ Fr• '~~'ora 7tsT t~~,g.. , rf 6 ..1 A' Z l 7~,~a s ~ WrLL- 1.l t~s~ 4~ X Y~PC :S%TEf 0 74-37-1W+ r:,,4 SEprre• 7A,,,e , PI a' yr'.•as, Izo Fr R~/~,Roki~,Rrrc/ r~l ~x~c-l~ IN I, the Vntltutipnatf, busby certify that the toll tees roloo.led oei ihlt form wars mado b~ me in accord with the PrOPirdwas noo nipV•ods itweih«ei a the Wi.,:e I Administ•aliv. Cud.. ii,d that the aura feaoraed and the locallon of thv tests am ;o,re,t to the best al illy Y.noviletipa untl b,dl.,f T65TS44 i7C-CC7MPlF.TC0p'~" AUDHh ~ _ EftTIf1CA'I'ION NUA17fCV2• PIIQNt~NUMHiat;nr,linr,.,li lie rt'.'r.ar.I~+^.V• hr.q, I . ••av tr I., dthlf,:•/.?ror!~;rr Owns, 41.4 S,h1 ifilar rt~m Ne~ISOA, zvn,',Ir~ ,~lvf6r;.1 s ~ .•,.>;~.ra:,~-, < ct,s:'~ /)u Ps nOfnP~o( ~i]~PrrKt,~F,~ILISSX LfPNVPr;~%c~~a,/ Pw~'t'' 33008' 330087 . ~ 9~ IO co Noy a 1975 ~ 000*444 CERTIFIED SURVEY MAP ~ I, Arthur L. Wegerer, registered land surveyor, hereby certify: That in full compliance with the provisions of Chapter 236.34 of the J Wisconsin Statutes and under the direction of Ferris S. Mahmood, owner of said land, I have surveyed, divided, and mapped said parcel of land, that such plat correctly represents all exterior boundaries and the subdivision of the land surveyed; and that this land is located in the NE4 of the NE4 ::jbf Section 7 and the NW4 of the NW4 of Section 8, all in T 30 N, R 19 W, Town of Somerset, St.Croix k, . County, Wisconsin, to-wit. Commencing at the Northwest corner of Section 8; thence w N 87°39100" F along the Section Line 836-30t; thence S 02°211001t E 35$•001I • thence S g$°15145" W 3$6.671; thence S 06°3$'5511 E 641.261 to the point of beginning; thence continuing S 06°3$t 551t E " 32$.$71; thence S 87°5714011 W 509.2$1; thence S $$°5$14511 W $6$.651; thence N 03°41t00" W 569.2$1; thence S $404$'5511 E 790.761; thence S 57°001 1511 E 273-39t; thence s 82°0$1151' E 163-74'; thence N 79057 t 20" E 200.001 to the point of beginning. Subject to a 661 wide easement road as shown. C Dated this 2nd. day of October, 1975. Arthur L. Wegereif87°39-00"E \$c0/VS/' Wis. R.L.S. No. S-963 836.30 W CORNER SEC. 8-30-19 So2°21"E f ARTHUR L. : 358.00 C WEGERER ; r S-953 } ELLSWORTH ` WIS. Iro 'C ROAD ,♦'y S88 ° 15' 45"w • ...S 84° •♦♦:,SUR\6~~•~' 386.67 48 55 E ' ~•9y„.,..&%•: S06°3d5 'E 356.00 ' `5~4 .>c 641.26 350.85 33 434.76 11,20 .00 c~ S'F 426.59 A ss„ 9.24 39,, „E•••,,, . S82008:14PE N7°-P57 cri M 3g 163.74, Zpp, , . LO •a~ ;n ° 176.30 ~Z 2p3 2,y►' N vi I in 00 too tO 0 3.941 ACRES 5.087 ACRES U+ 0 3 to OD o 5.116 ACRES O z 269.83 437.32 16.5 509.28' S87 ° 5?'40~ W 509.28 S 88058'45-- W 868.65 e SOUTH LINE OF NE 1/4 OF y NE 1/4 OF SECTION 7 SOUTH LINE OF NW 1/4 OF NW 1/4 OF SECTION 8 6 = 1" X 24" IRON PIPE WEIGHING 1.13 LBS./LINEAL FOOT APPROVED ST. CROIX COUNTY COMPREHENSIve PARKS PLANNINr. ORTH AND ZONIM, COMMfr(EE SCALE--I° 1 Volume 1 page 192 (1st of 2) 5117176 VIOS31YNIW ONV NISN03SIM ONIAH3S (Z JO Pu?) Z61 OBBd T GUMTOA ??1li1"irY0D Jl',,Noz dN`d -l.iY~ ~tin~yvl~ OPiitiNdld Sx~dd ,~tS1:3i~321dW0~ XIM:) '1S r 1,1, G3AOBddV *SIM HIHOMS113 £96-S nziTZAM = '1 LfiHlbd N.0 p~gT.zosap Buzaq dT.z~.s opTr~l +99 eqq jo OUTT.zaqua0 auk Jo puce aTfl osTle Butaq pleog uMOy 2ju-rgsTxa ue jo OUTT,za~ua0 OT4 014 ,9L* 75ZT 9uTT,z94ua0 pees BuOTe M aa55.S-t7n'719 N 90u9u,4 46C'£LZ auTT.z94u90 pTes BuOTe M u5TsOOoL5 N 93uaT4 : S47L•C9T auTTaa4ua0 pies BuOTe M 1151&FOoZ$ N 9OU9114 ! aF9•z~z OUTT.zajua0 ptes 2uo-[e M siOZ a L5o6L S 90u944 : s 56'ORT 9uTT.z94u90 pTes 2uoTe m u5t&650A9 S aouagi ! a9$•5OZ 9uTT,z91u90 pees 3uOTe M aa5Ta6Zo9T S 93u9gl !&U-06t 9uTT.z94u90 pTes 2uoTP M aa517a64io*l£ S aouegi !pagT.zosap Butaq dTals ap-Nm a99 aqq jo auTT.zaqueo eqq jo ButuuTBaq 9qj osTe BuTaq oes-cep-TnO snTpP,z SOOT eqj jo i9queo auj Off, &W61TS n517&617o17C N 90u9u1 ! aC5•T17Z S uOTS< Oo 7Z S 90u9T44 : BOO*~5>; S aa00r<TZoZO S 93uaT4 ! a0C'9C~ 3o a3ue4sTp le ~ uOTIOOS JO au-VI gIJON auk, BuoTle S aa00a6~.L~ N 9Ou9g4 !L u0T439S 90 .zau,zoo IsPaT;lJON auq Ole 2=uammoO :sMOTTOJ sle pagT.zosap .zagganj 2utaq OuTsuoosTM "AlunoO xTo.zO•IS 149sjamos jo uMOy `M 6T H `N 0C y uT TTP u0T409S JO ~MN 9ql JO ~MN aul purr L uOTIOGS JO ESN aril 3O ESN auk. uT p94eOOT sesodand peo.t ,zoj oes-cep-Tno snTple.1 +OOT,;e pule puleT jo dT,z,.s apTM a99 y PL-0-9 TO u0T'1c1TJ3G9C1 5L6T `C .zeg0130 179-5L ,3S poom-qL-W elijad L8£6-01p (SLL) ZZObS 'IM 1119=1 JaAla "IS uleyy 'N 9LZ £L90-4£8 (SLL) LOLVS 'IM 'enel0 ne3 •eny welsaM £06t NOIS30 ON10line • 0N1A3/ 8ns ONVI 0 EJNIU33NION3 '11A10 r ICuodwoo 6u1j;90u16u9 110111!p State of Wisconsin County of St. Croix I hereby certify that this Instrument Is a full; true and correct copy of the document on file and of record In my office and has been compared by me. Attest CICTORF.R 1 ~ 19~_ .TAM_F.S 0' GONNEL.L. James O'Connell Register of Deeds DEPUTY DEPARTMENT OF REPORT ON SOIL BORINGS A ~Y & BUtOINGS INDUSTRY, p ' DIVISION LABOR 0. BOX 76 HUMAN REDLATIONS PERCOLATION TESTS (115 sFj NA N, WI 53707 Al' (H63.09(1) & Chapter 145.045) 10 LOCATION: vl~ SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.: NQ.: ISY N S~ V/ 7 /T 3o N/R 19 E (or) W J►~//U(~ G L COU TY: OWNER'S BUYER'S NAME: /I MAILING ADDRESS: Of X h a rh iS d A SOAv 197F K9 U0/S 14U-e . NRVA_11*NfWA_USE BSDE NO. BEDRMS.: COMMER AL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence N d _ New ❑ Replace, 1 Stub s°r~.IVT~IS dU~~ 1W T l SCj ,.10" RATING: S= Site suitable for system U= Site unsuitable for system ."Y~ ~L~ ✓ s/9~.~ S4- T M%X "i-e CONVENTIONAL:' MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FI L OLDING TANK: RECOMMENDED SYSTEM: (optional) / IV•Fr, S ❑u N1 S u ]S ❑u ❑S uL H❑S ®u O,v,P£IAd hIt (fie 41 X,3 ~ If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the `CJ under s.H63.09(5)(b), indicate: I Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. IG E TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- ~ /od. 21tr > "117 3,0170) t1 L C6U4 ~4~1J sL s~ ~c ~ f N • L, 13 „ G-/. N. $•iL~ B- Z 0~ /0 yG 1 r > o so".k;X. o s. ,BN, sL sore y ,p,1 S~ ~,a; Pac,~efs RN .~Q . B- 3 Aa.1ZI 1, Zo% . B- 3 99 ~6 F ~ > P'' av -6 . si 8-- . "04. 51 w/ y'~ Mix • N s 509, N. SL a 9 ICI' 24- > rr" au-6,Y- s:'4 „Gy ;L 9 11 Bm' ~r-e 5'Z_ to/ B- j~ /oa . 3P ho- . S' /L W44-1 o s -0 ~O 13ai. S s-~ 9Z oyY~f > 92 ~'QAV-6Y. ~ , 7 „ 44 ail. 5; w/r,Z t'it A9 PERCOLATION TESTS TEST DEPTH. WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER W :T AFTER SWELLING INTERVAL-MIN. P I D 1 P RI D PERIOD PER INCH 'A7- 00 P_ , *O , P- P- 5.70 16 , Z-- P-- P- .50 6 P_ PLOT PLAN: show locations of percolation tests, soil borings'ano the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. Qorjo m o~ 134P exc.4 Arlm) To 41E- S FT ~/ow lf~r. EF SYSTEM ELEVATION PT 07- e1E-v4r10.) of 9575 Fr• , A 1A i I lea "T. 7 ro -te W71 i 13 , I d'9 1T of N~uS~ GCE r 3 ' ..i ' i As F Ar 1 217 al ' - I - r~....._I_....._... .S T 1 5 - - lee 1j ~4 E E S Z I, the undersigned, hereby certify that the soil tests reported on this form were made b me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print : TESTS WERE COMPLETED ON: kob,,01- Zl/,6~Pi chT 9- - z_ A D ,~•('~D 01U ✓~y~/ CERTIFICATION O NUMBER: PHONE NUMB~R.(optional): NE/L S S Z/ f2-3 6 e CS IGNATURE• DISTRIBUTION: Original an•i nna copy to Local Authority, Property Owner and Soil Tester. DILHR-SED-6395 iP, _ C?~iEF - II Y 100?PAGE 516 DOCUMENT No. WARRAN.T'Y DEED JTNIS SPACE RE'ERWO . RECORDING DATA 7OR STATE BAR OF WISCONSIN FORM 2-49'7535 ~hEGISTER'S OFFICE Gary...J. Chi.33t-Qpherson..and...I~~.nsia. g- ST.CROD(CO.,W1 .---------Cori-~tophers~n hu ita- s~_..aDA--W; f e Reed for Record APR 16 1993 `8:30 A. u~ conveys and warraiits to -_...Thomas--M-.---Faf.i.ns-ki---and------------------ AMY.-M_•. Ka-dow -Faf-i-nski-,•--husban-d--a-nd--w•i-fe RqIetneeds ~ . RETURN TO the the following described real estate in -St St----Cxolx County, State of Wisconsin: Tax Parcel No: A Parcel of land located in the NE1/4 of NE1/4 of Section 7, Township 30 North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin more fully described as follows: Lot 1 of Certified Survey Map filed November 4, 1975 in Vol. 11111, Page 192, Doc. No. 330087, as amended by an Affidavit filed May 17, 1976 in Vol. "53711, Page 207, Doc. No. 332994, all in the Office of the Register of Deeds in St. Croix County, Wisconsin together with the right of ingress and egress over the roadway described in the above Certified Survey Map. Subject to utility and roadway easements and Protective Covenants of record. I'RA NSF $ S41.30 FEE This j*_s--not...... homestead property. (is) (is not) Exception to warranties: easements, restrictions and rights-of-way ('~p of record, if any. Dated this day of ----....April 19......... (SEAL) f Z41. , ary J. Christopherson Linda A. Christop erson I ----------------------•----•-----•--•------------------------------.(SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature (a) ._....Car_y..J--..C!ir1.stnpheraon., STATE OF WISCONSIN Linda A: Christopherson ~a& )A C/ County. authenticated Ithiis ---t-fday of..--_~ri-l......... 19-3 Personally before me this day of the i 19 the above named Kristina gland TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by 1 706.06, Wis. Stats.) to me known to be the person who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY Kristina 0gland Attorney at Law Notary Public Cowl.-ty, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) date: 19.__-__-..) Names of persons siSnina in any capacity should be typed oe printed below their signatures. WARRANTY DEED STATE BAR OF WISCONSIN Wisc^nsin Legal Blank Co.. Inc. FC,RM No. 2 - 1982 Milwaukee. Wisconsin 5 State of Wisconsin County of St. Croix I hereby certify that this instrument is a full; true and correct copy of the document on file and of record in my office and has been compared by me. Attest OCTOBER 1 ,1g 93 JAMES O'CONNELL James O'Connell Register of Deeds DEPUTY 3a ()a0000 SEPTIC TANK MAINTENANCE AGREMDKIJ St. Croix County OWNER BUYER ADDRESS: St* FIRE NO: 3 jr /~vq LOCATION: NF 1/4, .0VC0 1/4, ShlJ_ T Z._N-R W, TOWN OF: Al~7'ZSET ST. •CROIX COUNTY SUBDIVISION: LOT NO. / Improper use and maintenance of your septic system could result in its premature failure to, handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system: St. Croix County residents may be eligible to receive a grant to help with the cost of the 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 the St. Croix County Zoning a certification form, signed by the owner and by a master 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. Certification from will be sent approximately 30 days prior to three year expiration. I11aE, 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 form must be completed and returned to the St. Croix County Zoning officer within 30 days of the three year expiration date. SIGNED DATE : O St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 STC -loo This a1)plication form is to be completed in full and signed by the o~:!ner(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 t1l I, e o ert pz-P y is sold and submitted to this office with the appropriate deed recording. ow n er of property _ MY • KpA70 Mr-1 U 9 / ,~~At /~l• ~jq-~j~l~~ Location of propertyjAVLO.' 1/4 ALF-1/4, Section T_6 _N-R19 W ' Township -TERSE Hailing address ~ $4011 e I KO APAOQ -OKA-ALwj . 5;17 Ala IsV rs- aZ Address of site __XgX I G /llk AV4- S10AIA4 rS'.4-4 4WX Subdivision name Lot no. f. other homes on property? yes- No Previous owner of property Awry J• 4N&4 L/Kg/4 A• Cyr/SLv~ rs4m Total size of parcel 3r 1 a(. " Date parcel was created Are all corners and lot lines identifiable? _ x Yes No Is thic proliaty~being developed f 2x, s ea house)?! Yes No Volume tAnd Page Number ~p as ecorded.with the Register 114CLUDE WITH THIS APPLICATION THE FOLLOWING: A WARIU ITY DLED which includes a DOCURENT NUMBER, VOLUME AND PAGE. NUt! sEAL OF THE It.EGISTLR 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 Hap shall also be required. PROPERTY OWNER CERTIFICATION I(wc) certify that all statements on this form are true to the hest 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 . Nieoffice of the County Register of -a 44 5 3 5, Deeds as Document No, and that I (we) presently own the proposed site -or the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the sams hae been duly recorded in the office of County Register of deeds as Document 27 0 . 4,~ F1 i TheEu of p-11 Cant o ap cant f 3 Date of signature Date of s gnat