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HomeMy WebLinkAbout040-1064-10-110 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER r P.- t? Owe . ADDRESS 7 s yam/ ~ SUBDIVISION / CSMJ LOT - SECTION. N-R_W, Town of 7f-0,V I (o- ZS. µDiE I O ST_ CROIX COUNTY, WIS S N PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ..w Y R $ cA I INDICATE NORTH ARROW r Provide setback and el ation '/eof ymation on reverse of this form- Provide o7 dimensions to mseptic tanl: manhole cover. i BENCHMARK: ~~c~~y Opp ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING-.TANK INFORMATION Manufacturer: t0a"A'^- Liquid Capacity: Setback from: Well House Other Pump: Manufacturer Model# Size Float seperation Gallons/.cycle: Alarm Location - SOIL ABSORPTION SYSTEM Width: Length U Number of AA)F -0 lamqki-m a O J Distance & Direction to nearest prop. line: p $ Setback from: well: House o?70~ Other 5 7 ' e}o P 5 he,d ELEVATIONS Building Sewer ST Inlet; d 3 ST outlet 105,_7 PC inlet Or PC bottom Pump Off Header/Manifold $5, 1P Bottom of system 5q, S Existing Grade nl Final grade 7f 7 DATE OF INSTALLATION: -7 PLUMBER ON JOB: LICENSE NUMBER: / S7 INSPECTOR: 3/93:jt ■ County: 8.19.240WVATE SEWAGE SYSTEM Labor and Human Relations INSPECTION REPORT Safety and Buildings Division (ATTACH TO PERMIT) sanitary r it . GENERAL INFORMATION Permit Holder's Name: ❑ City ❑ Village R Town of: State Plan o.: ]4 'PT. rp V ST BM lev.: Insp. BM Elev.: escription: X Parcel Tax No.: BM D 1 1141 A-3 1364=3 0=3 3 0 TANK INFORMATION ELEVATION DATA A9300291 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 6~ 0 1"fo Dosing Aeration Bldg. Sewer Holding St/ Ht Inlet / .L)JT TANK SETBACK INFORMATION St/ Ht Outlet /Q TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic /Graf NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System 5114/5/ PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft oss Head Forcemain Length Dia. Dist. To Well A@ O PTION SYSTEM BED / TRENCH Adth L 0A Qdo. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth ~iJ DIMENSIONS / DIMEN I N LEACHING Manufacturer: SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM INFORMATION TypeO CHAMBER Mode Number: System: S f ~7 OR UNIT DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length _ Dia. Length Dia. Spacing J 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.) Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: R 17DILHR SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05, Wis. Adm. Code °....,...,~,e. sf 1 & ro STATE S NI .-Attach complete plans (to the county copy only) for the system, on paper not less than ,`ee%C~(kky 8% x 11 inches in size. ❑ ch if revision to p evious application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPE TY O NER PROPERTY LOCATION /UF_ % NCF'/4, S T.Zk, N, R or) W PROPERTY OWN R'S II LING ADDR LOT # BLOCK # eJ J t. Av< -5 /VA-1 CITY, STATE 'M - 15Z~ DE PHONE NUMBER SUBDIVISION AAMEO CSM NUMBER CITY 7 NEAREST ROAD 0 7 II. TYPE F B ILDING: (Check one) ❑ State Owned ❑ VILLAGE ~-t,.p ❑ Public 41 or 2 Fam. Dwelling of bedrooms''3 PAR L 111. BUILDING USE: (If building type is public, check all that apply) f ~0 A- j y® - 106 y /0- 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 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. 15 New 2.0 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 LJ 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 12. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE CO REQUIRED sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch)ELEVATION 7-/ 70Z 0 7~ O . Go 9145 Feet S'7. Feet VII. TANK CAPACITY Site in allons Total # of Manufacturer's Name WE:] Con- Steel Fiber- Plastic Exper. i~__~1/07711 I I INFORMATION New istin Gallons Tanks structed glass App. Tanks Tanks Septic Tank or Holdin Tank -e A om .e Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plu er's Name (Pri Plumber's Signal re: Stamp III/MPRSW No.: Business Phone Number: OA 0%r a AXIS J.5~3 ?lS d 516 S/..3 7 Plumber's Address (Street, City, State, Zip Code): r_~ 9'~9 / .--2' sya ALA.Hz Aku~ IL~~CQXd tAl IX. OUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sa ' ry Permit Fee (Includes Groundwater a e Issue Issuing A ent lure o Sta ) Approved ❑ Owner Given Initial Surcharge Fee) Adverse Determination M-00 77 X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: I8 (formerly Pib-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 rE.nev of a by new criteria in the Wisconsin Administrative Code will be applicable. 3. All :revisions to ti;i permit must be approved by the permit ;issuing authority. 4. Changes in ownir rship or plumber requires a Sanitary P ryi€` Transfer/P -i~:- a< Forn; ($F?) 6' aC) ::o be subfh itted to the .oijnty prior to installation. 5. Onsite sew,_,~ge systems mustr'be proper y maintained. The is tank(s) m<:st be pur :~)edt I.y~ +~lacenced ' pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your fodal code a'dr'r` nis-rator orthe• 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 ;ax numb.4r(s) of where the system is to be Msta~led: II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Fernily DwEiling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Cheek only one in line A. Complete line B if permit is for tank replacement, : eco inection, or repair. V. Type of system. Check appropriate box depending cn system type. VI. Absorption system information. Provide all information request-;! in #1-7 VII. Tank inrorination. Foil in the capacity ()f eve -,ry new and/or exi°i; f,_-1k., !ist the total g81 yii,, nur ber of tanks arid rnarlufacturer's name. lrhdi(;, o prefab or site consbur.-: and tank material. Conic'ct~ !cr all septic, pumf /s';,.;=:,n and holding tanks fo this system. Check ° x.. mental approval only if <3nk received experin,en1`; 'p a&jL ct approval from d: li VIII Respons,bility statement. Installing plurr h-r is to fill in name, o number with approp6pie f} a ix (e.g. MP, etc.), address and phone number. Plumber must sign appiic-d on form. IX. County/ Department Use Only. X. County/Dep;s.rtrnent Use Only. Complete plans and spef~ifir:ations not sr ta11er than 131,/'2 x 11 In .4 m„st be Sub Pted + thr, co, rtry. The p'anS must ;,wh.;de the, foilu:v.ng: A) plo! !-jn, drawr to scale or r~ ;io :OIT1pletE' Cis ,i 4 1 of holding tark(sj, septic tank:=;) or other t,a?nnent tan<s; buiidir _i wells; tv ,:r: `latE, service; streams and iakes, pump or siphon tarikz, Aistribution boxes, • ?!?ion ~y,c1-•r,}. ~ -0 System areas; and 4ht?'.ocatlon of the burk~'<ig B) ho,Jzontal „i..' cal ~IE'V 1€^ ?fF3 r.,r `-S; C) complete specifications for pumps and controls; dose volume r.-. ,Vation differences fl ; ;(-n is 3s; pump performance curve; pump model and pump manufacturer; D) cross section of the soil a.123orption system if. required by the county; E) soil test data on a 11b form; and F) all''sizing information.: GROUNDWATER SURCHARGE 1983 W'iscoinsin Act 410 included the creation M SUrcl;arges (fee:;) fo a number of regulated practices whic`i can effect groundwal-r- -The monies collected thi s;n these surcha g.,-. t rs, 4,0 f--,r monitoring gro.i clviai;'; water contamination invp.s0-.-i64,n.s and establisr;c 7' a;ardards:, SBD-6398 (R.11/88) E r I I1 r 1 , r , v 1 I I I , 1 1 s I , , I i I ! ~ 1 I ( _ i - 1 , 1 ' y 401 1 i 1 1 1 Y I 1 i i r , • IL f t ` ti i , ~ 1 ~ I 1 I t- . ~ i 1 ` ' y I ( 1 , r , I , r . 7 4 4 r r C ~ r PAGE OF CrUSS Jec~lun br !~i ~ef~ SySTe~ i~ 0.r 1 ~~.q rte. y 7/ [-V~r f617~~ Fresh Air InIals And Observallon PIP$ evowe11 ~Vh SSy2/ Approved Vent Cap / Minimum 12" Above Final Grade 20- 42" Above Pipe -4" Cast Iron To Final Grade Vent Pipe Mash Hay Or Synthetic Covering Mtn. 2" Aggregale Over Pipe 018rlbullon - Tee Pipe 0 0 0 0 t 6" Aagr4PI o Perforated Pipe Below Beneath Pipe -Coupling Terminating At Bottom Of System ~7r l P~pPose~ ~1~~1.1gr~.~a< SOIL FILL DISTRIBUTIOt.I PIPE APPRJVED S4MTNETIC COVER OR 9" OF STRAW r OF A6GREGME OR MARSH NAy -CD j1~/ a le OF%2-21 ° 12 AGGREGATE 8 ELEV. OF FEET-~ DISTR191JT10W PIPE TO BE AT LEAST e!>?-Z INCHES BELOW/ ORIGIIJAL GRADE AW) AT LEASTM INCHES BUT 'MO MORE THAM 42 IAICNES BELOW FINAL GRADE MAXIMUM DEPTH OF EXCAVATIOP FKoM M&WAi CRAOR WILL BE INCHES MIKIMUM 9SF" OF FACAVATION fRoM 04 IGIMAL ~R~40€ WILL BE - INCHES SIGNED: cjd6:== LIGEUSE AJUMBER: DATE: ND SAFETY & B I VISION DEPARTMENT OF REPORT Ott LDINGS INDUSTRY„ LABOR AND P.O. BOX 7989 • PERCO r } " MADISON, W1 53707 HIIMAf~ RELATIONS IILHF3x83.08}.~., f N OWNSNIP4 PAt[T,,Xq0-g' j, OT NO d0LK_ ~t U • EOCXTION, SECTION' % Nx 1/4 le /Vf E (,do T.-;1? ]M , A . I L , 11, C $ USE _ DATZS ONIRVA IONS MADE r :gyp , ~lewRepletxz 4,41 RATING: go Site, suitable for system Um She unsuitable for system ~y I•-~ R M NOED YSTEM:(optional) s ou oS IDU Q'S ou osUr DsF,INuw ,.FNS/ - If Percolation Tests ore NOT requirod DESIGN any portion_of the tested area is in the under s. ILHR 63.09(6) 1b1, indicete: Floodplatm Ind [cat* Fioodplaln elevation: PROFILE QESCRIPTIONS BORING TOTAL Has CHARACTER OF SOIL,WITH TRICKNESS, ELEVATION NUMBER EPTH IN, Tg 010 _K IF SER D EE AB RV. ON BACKAN EPTH f/ for. P 1. -Al g. g-j's Ott IZA, WS., B- s s r Nnt~ ~ 9d w .s' . i' ~ t 10_ 't B. 1/7 PT, z /I) e a t' PEKIDLATIOWTESTS,, TEST NUMBER NCHES AFTERSWELLING ' INTTEST ERVA6-MIN. PER INCH , of P- 3 PLAN: Show locations of percot lion tests, soil borings and the dimenelons of suitable soil aieas: Indicate eale o noes. Describe whet are the hori- zontal and vertical elevation reference ints and show their location on the plot plan. Show the surface elevation ll borlleps and the direction and percent of nd slope. SY EM LEVATION fy s~ ' ~ a /f~r/ov~~_ . ~ _ ~ 1 . r~- ~ ~ ~ tee s.. ~"a t RNs ?gro,e P%oer POS i;_~ fi~ ~ ~{~s•L I.....i...... I ~ ► 11 7 l~IOUlV . `Mi 3 Ariof Wool 7tl I C yz" or- J4 ai i~ e, : /1 i lei 1 a /7! as y+ is;' y~ ITV1 _M tf:NN ra', I 77 Nell 10 fPl",4' Ht o i.cr~t N 1 D 1 i z j':kR 1~ r ~ ~ ,y~.i". ',.F t ~'ts•ara . ~ r ~iYU~ r 1,40Ilnd~nipnet~; hare~ll cFgif}.~that the soil tests :form were made ay, melin aeeord,'with the,proced nd methods specified In the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct tozthe best of my knowledge and A print TESTS N. "DAVE FOOERTY► AUMi31hl~. ADDRESS- t33~w , ( r, CERT.FIC TON NUMBER: P NUMBER(opttons b lf4023'' ~ _ DISTRIBUTIONS Original and oni Copy t 1 21LHP$8D43$5(R AQ!p APPLICATION FOR SANITARY PERMIT STC-100 phis application form is to be completed in full and signdd by the owner(s) of the iroperty being developed. Any inadequacies will only result in delays of the permit Issuance. Should this development be intended for resale by owner/contractor, ("spec house"), then a second form should be retained and completed when the property is Bold and submitted to this office with the appropUste deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property AEL /~~/ffi2c Location of Property Is E k, Section /(o , T N-R` W Township 222 Mailing Address 97 / itM/hm-~ S 13LIO CDM 1 N 7-0 sJ , /vl ~j Address of MO x-OVC~ ' ~uDSoN~ Gut S~OIlo 8ubdiiiiion Name Lot Number Previous owner of property S ~.?E-_-rZ MAri N Total Sisa of Parcel ~O AC 4- beta Parcel was Created 41 - / q - g 9 Are all corners and lot lines identifiable? X Yes No to this property being developed for resale (epee house) t Yes No Volume and Page number as recorded with the Register of Deeds. INCLUDE V1111 THIS APPLICATION THE FOLLOWING: 'A Weriantl Deed which Includes a Document number, volume and page number, and the Seal of the Reg,ieter of Deeds. In addition, a certified survey,.if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ence` to a Certified Survey Hap, the Certified Survey Hap shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERU PICATION 1 11001 cet.LL$y that dU bt0ementh on VUA 60hm Me hue to the bat o6 my (out) hncwCedges gat 1 (wet am (dAe1 the oauneA(e 06 the phopeAty de cAibed in this .tnAoNmdUon 6okm, by v,ill.tue 06 a WdAAdnty deed kecoaded in the 06 jec o6 the County Reg•tAten o6 Deede OA Ooeumen.t No. -'90 3L/9 ; and that 1 Iwe) p)tesentty can tJ+e p4opoeed site 60k the savage dispve system (o)t i (W el have obtdt"ed an #-dAc+ent, to kun w•i_th thr. above dei c tbed pnopehty, oh the eorutnucUon o6 ad id ayatemp and the name has been duty keeonded .Cn the 016tee o6 .the County Reg.te.teA o6 Vetd+, D No. q90 3,/9 1. SI OY R SIGNATURE OF CO-OWNER (IF APPLICABLE) q,z72~- g flATt Qtr-ifh SZ7- 17:C ",LClK :!AL:ITMNA:2C Sr.. C:v it Cauac'r QWNL• :L! 3tS'tEZ kkc- /"l yl'~a MOUTI/90° VUIMBF_:: (0/9 (IL ,-r2- ~ Ftrs "lumber (O/Ov C I'L't l STA i A LO SO l-I ZIP S 7 d l P^+?P~:t:'t L=LTION:`__`s. Section "own of -7; ~-O y St. Croix Caunc7, Subdivts ion M La c number 0( 7)0 0 improper use Xad maineanance of your sapctc syscam could result i its pramacure failure cc handles wascas. Proper maincanance con- s is cs ad pumping out Cho Also c is tank aver, three years or sooner, i= aeeded. ':y a Lic=zsed 3eo=c ca_ our. tihac you put Laco cite syscam can at ac= rho tunceiun oc Cho Aepcic tank as a C=eac- nteae seage la Che3 'Jasad d+yposal spseam. St. Croix Caunc7 residancs may ba aligtbia cc cacti-To a grant for a max=Mum of bdz ur Cho case ur replacement of a Eai:.iag syscam, which jaz La overatian prior co July L. L978. Sc. Croix Councy accepted :h-4s program La ttuscusc of L980, wf,ch ghee requiramenc cha owners of a, l ae•d svss agree to keep chol-Z systems properly maiacaiaed. T:te prooer_7 owner ag__es CO submit co Sc. C:ol: C-Junc7 Zanias; a carti_icae_on Eorm. sj-gmad by Cho owner and by a mas.ear plumber, lour-teyman plumber. rasc:iccad pLumber or a Licsnsed pumper ver_- f7tag Chat (L) Cho on-site wascawacar disposal syscam Ls.La prone ooeraclasg coedic'_on and (Z) ad': ar Laspec:Lon• and pump sag..' (L= aec essar7), =hersepcie tank is Less Chan L/3 lull of sludge and scs Car=i:tcacion fora sill be sane agora-.4-Macal7 30 days pear cc three year expiration. L/7Z. the undersigned. haTo read Cho above requirements and agra cc mai :main cats prtvaca savage disposal syscam :n accordance tic. Cho standards sac forth; herein, as sac by Cate Wisconsin Depart- mane of lacsraL lasources. Carci==cscion lore must be eompiaead and rac:s_zed co Cho Sc. C_o_x CaunC7 Zoning 01=ice wichia 3'0' day oc the three rear expi:~cton dace. IAT? Sc. C-v:: Counc'? ,.an;. Vf::cs P.U. Hameno~a . 340L.; Y a 44 `+8 9V P `yy CSRTZF IED r'`> SURVEY rt;, - MAP ` LOCATED IN THE NE1/4 OF THE NE1/4<AND THE SEl/4 OF THE,NE114 OF SECTION 16, T28N, R19W AND THE SW1/4 OF THE NW1/4 OF SECTION 15, T28N, R19W, TOWN OF TROY, ST. CROIX COUNTY, WISCONSIN: *14►N.E. CORNER SECTION 16 OWNER T28N,;R19W ALBERT P.J. HANSEN Sl°58'14"W 523'CTH,FF HUDSON, WI. 54016 UNPLATTED LANDS 327.87'; S89°00'33"E 600.00' 4-POINT OF BEGINNING LOT 1 E. LINE OF NE1/4 876,536 S.F. • -20,122 AC. c LEGEND INCLUDING ROAD ° ST. CROIX COUNTY SECTION CORNER yl RIGHT-OF'-WAY MONUMENT,'FOUND. ^ 871,479 S.F. 20.006 AC. 0 1"x24" IRON PIPE, WEIGHING EXCLUDING ROAD yi 1068#/LI'NEAL"FOOT, SET. W 1 i RIGHT-OF-WAY i W-06117"4) PREVIOUSLY RECORDED AS. al ~ FILED APRl 4 Mq $ cl, O _ SCALE IN FEET / ~~c9o 0'..:. -300' 600' TGBo 0 0 061,E H ra ~1T~ y►J ?00, s,~T1, r 4 t s ~0. 9-4 00 ` ON N c N88050' 18"W " wo ° s G4183.39' y F-I ~ r \ e+1 GLOVER; ROAD - - L W1/4 CORNER- ,F + - - _ - SECTION 15 u - - - T28N, R19W CENTERLINEAND N88°50'18"W M r' E-W 1/4 SECTION LINE 153.26' UNPLATTED LANDS El/4 CORNER 4r SECTION 15 T28N, R19W This instrument"draftedby Francis H. Ogden. VOLUME PAGL 2084 fi'•fas ' yfx 4, S , .7, 3..• Ada t• f ice. " DESCRIPTION A parcel of land -located in stheAN 4 of \the #NE1'/.4 and the SE1/4 of the NE1/4 of Section 16, T28N, RJ.9Wan die 4 of the NWl/4 of Section 15, T28N, R19W, Town of TroySt Cro.x C Xzt Wisconsin, described as follows: Commencing at the NE . corner `ef`~sa d `56ection 161 thence S1°58' 14"W 327.87' along the- Eastk;ine of said NE1/4 of Section 16 to the point of beginning, thence "t,SL°;58'1`4";WnJ.354`.00' 'along said East line; thence S48°06'34"E 1496.67'; thence H88V'IVW 153.26' along the center- line of Glover Road and the E W:rl' 4 ss`ectiom,I- .ne;-of said Section 15; thence N48006134"W 2079.071, ~-'I,thenceps:N1°58~kt,1°4"E,t972.171; thence S89°00' 33"E 600.00' to the point of.beginning This parcel contains 876,536 Square,Feet, mor® or,.less, being 20.122 Acres, more or lessincluding,existing,Glover°Road right-of-way and 871,479 Square Feet, more or Iese;pbe ng'20.006`Acres, more or less, excluding Glover Road right-of -way.^~s 7"' Subject to easements of record. yV"`' k I hereby certify that the above des~cri tion and`ma P pare correct and that I have fully complied with the,provisions of Section 236.34 of the Wisconsin Statutes. r~ D ate: January Z 11, 1989. Franc s,;,H.,Ogder S.-88 Job No. 89-1787 Ogden;Engineering~Co. ~iq~::~~:►~r~,4~~ 113 W.z~.Walnut St~rekt""7 `*`s$1~~0C. C~Of~,.cw.~~i~~~+♦ River Falls, Wisconsin 54022 % 10 FRANCIS I-I. ~ s w w OWNER OGJcN ssa2 Albert P.J., Hansen RI VV? FALLS. 523 CTH FP 40 C '00"7A Wis. r O z Hudson, Wisconsin 54016 VOLUME 7 PAGE 2004 4 , i.. 4 fEn'i~vvWWj~d l .'i• Yw T i GM } `E }r 09/21/93 18:17 0716 381 4400, 9C CO REG/DE S 02 own 00CUMENT Ka. $T1TE PAR OF cozr'szrra~oa~°s ss~ v,a. W%" ....~«a DATA h r`: ,i' ~ i 1 L CantMCt, by sad WWI= ~ flCT B BIN lea D. F~wl 7721~ - wiisl one or trbare sa+d..... a c~8:3Q A. Yeador SeIIs and sera otiaesy toreAsw.,ayv~t h f,=,= of lids conusab by Pmub=w, tip bRawft S"PUty exu ';w'r ti r Of tr, tiara wad oHatr qP iabas4 [s1t eailsd tfsr "Ppb'7. rata, prp$ Comity. Sb 4'.1W sew: ; nRwar T~ _ 7 of . IDt ore (11 • of Ont#fUd in volt= Cerdf'ied Snwey N MMV E t 8g 37oLZZts ti' Tax Pared Na... { + affim c.t Jk 1989,j bedM l0Mte&IU.the`~ QWtAW Of MS ~ Qzrter a~ rg)• end ram ~ 0mrt;ar of the Wit; OlErbw tSft or. NEW z -of: sectim sUteea =d tba~,4 opt: the rest Quarter tsti~►a ' NWg) Of sectjm •Fitteea CT,53,`;a313xt bdp : (28) N*vt[i, FWP Nineteet (29) Went, weft to zvcft mtlm of ~ a~ 19, Omgba Fall=y Ccaggrq as act •~u tt , r ~ ~ ted3w vbl. " 42•r,, Pagft.144 as noaz No. 2Es77. t FLY Is mt bonus+ pr~z+ Tift CEO r dtt'ects As P20plof =a ea pa to Vudw so r' Vcnffw at the of tbfs Coates sad (b) ft betsaes 41 ; besrs~ as the b&~-GftftrAft ftM UM to tuna at Sirs rste oi' ~ asst 1+*r aaa~ =MM P" is fem. as foum'. C xovunbm, 3. JM~ sad c 3~ax th> Y o~ eac>z tiz~t awry anth b ter,, ~ munth7.y .YP~-3~nez, olt In its of $600.00, said pgMMts to be moo jclnt7s.,t6,amts 'cracma~n.sna{ the ftSt atsGW. ,s Hank of RI-Rer Fe.L32. 44 :r , 3th 1 • dq ai : I's i howww tbt UWAAMMn s balsnes z6a bs gam bz to oa or bafoze • wry date)- , aflih. smoaae PoPawb>!e dee~nle is i~stassas sban &*xm it-6e rats oi.~.. P~ saaam as the - ' is aaflwatt c .taro taelodr► * t a fnt wr M *04 apvo soesLrat3o~s or =Mutv. the codke Pte, =IM by Yoodaq Ktes ta' p4 to VCI& • tQ JW "==NI satb 7 wM& dn` To tha egt=t by Psndor► + pau d amaal trim, speol4i ate. t'Jsa•aaa X00d d irroranee i vendor area to apply P bo Mss.d b4 the VWAW fm l of a 'and mae WS TM lgadbd sa ,esRo~aaad or.ts~tee`samaat. but ball not tsar isle i tsM16 , tff? an{paid bslatvr+ st tb! rate speoISsd,avd then Oo prla~psl. ltd 'i pa-M Ain ffkau be applied tit to hdcw* M sit =w be -Vts wftb or' fes;aPO*;griaazatiitilt , t pe"Glaw Mb a game" ml P& w { tz gay so IMM ! Ia. the suesof aas,DZowizaact• tide a ~~sbld w maath shin be ~ ~r ss tie MWM bsiaan of ~siaetp sad C 3stsaait amw' . _ µ ! A- --Rdft s; aapatd•p:dt~A+d),fs7~o ihmzs,tlm;sasa~.t>~' :;~ntaiored&a~! Parma ~ • math s: ~ spe~Sed ebarri . ; , at' or.t 4c~ed to P=jbMM ' tint pues..Q;is'a 3 . said MoY't t6 c7et 0=6 1, X9905 , x` 5,'>3990 43n : cIs ° 3 se Dom Pmabo= aka ip tiiy the o~aC a~ Saime.i3fk' 4TSdea~. TZ.Ctds,aridR 41 Iii. tiOaLt as iHiMfYr1 !1~ s~1I ' be rs0ftad by Paador aatsX t]lt` ' Pmt sltsIl be Mar*w ca 0M 09/21/93 _15:1$ $T15..381 4¢00 SC CO PEG/SEEDS _ A0 ' banes' D~Le~ to ps,T bra dwt tssos"ice; e~A~kr~d as ltya Proiw+'t7 os cpas Y~da t~c~l• . in It and 0 b4 danver t9 Peado s Pa xe ssvawia ~ P~ce~sser absII iereys tM aaiPtoy~rC~ ,.~tFiws`ar+blO cnvasvea pea-Ca ss~d i+ ra, ~a +a►,~w~a~ La I Vm h hm ttse s= aL t_ " ; V* g c TIM tllaa the slt~ati ' bahee When dam. o~d ~d~or t~ -P'axlnr~e~: ' tip esi at . a sta:a the at:adst 8 etaoae is avw Of du Pmdoes taticrTW P~tdOR• vtifetad" tau is Mri of all paudee egewiac the d" be:de v~it~d* tF WW i of ioaa'ts iasassosssatiaa aada 1 _m n~a 14*0 is t t~+a P:oper~. to kag the Ra «asatsbie data At OWN hm [ Raite,nor alfoer safledtakbe ooaiati~pd,"= m ft $Si~Iprt +fS+Mtrn== 81CSbISUp~eiOS ea Lbe !!sa Of Wid Coaa+e4- +aa to &MDIv vt& at *mw a:dtnsfsoee Wd seleis IKOCAUX,04 ftOpjL4- ± .r,; Peadvr ieaa tbs4 is asie tt p a%.TZM a print With, JA and otbar aaontYs sTw1i bs i11 Td asd nit 0114400 sbiII be Saly parlormed a; do tlmaa and is Lh~;asaa~a<sbotra~ ~9+odo~. RiQ. oR• a-ml-oa► swaais m" dait7as U ~ t:n~'ssser, s l~lsrraatp: Ih~ dos ~ ahaQiY~~d>t3e¢ aod~eleastof;.sII 11aet,aad spaWabtaoo~y s>agt " • • . qe usm II as C~ 100 T Yatcbaaeae aaraes t3at ewe s a~~oa . as~a c~) • aef utc !a the noma of am pbwp t as bftrMt Wbi* eoaU=W tioe a preiod of -ds7s fa8oari*' ► apeaitid dss tb} h tbs e+a~t v[ i detseri is . at ot7ie: eblipitkaatPOMIMar,-W tans far'*. sot 'dRta. ~rsltt~ aee* ceo~4eaaoss ` ddtearad paaaoaDy as mai~ei~~c~ss~d ut~?~tltaa, aP~ e~ eon bes=a iaaaadb"T dna r'.d paa►~Abls i, c tRbi~► use a r Waite:). and Peadvr AIR $f0 blew IW T) bt - addition bo et:aa. ~ ~ iseto~iaeq+itp a'9 r , i~7e ls. C'oa`t Md ?mss ~t r titiram is tila ~a t ~ ~s~txlgtet)ttste R: eq~q to be aaeditiaeeQapapt fq~ pa4~a+~!*a asi~orl6 arltb iotenrit ~e~ do data Of defaait at ft vide !a a iaC as aaab;ds~tamdoakbaramga tdgi R<d~tattlatalE #~as=~ w sbal be taaalleiLad aa4 ~x }~i ' ff P=w ftft tD • ~ VL Ab to .a.. . ftatadiate w d =1 pal attbe aod~md~ sb td14- m' 01{ lttr of ` . daliat! and. of sanaats dst►ktC+e•ta.t{~ ,absib btu E.~'aw end POtl~sse ' ' • • . - tbdC+10l: b7 (W Vendor dte'faxa ~~ol aeti a~ -~allT4el .06 two INSY iQtMO.R_ egaitAbie b>z+sbof,psrei:aaee~fs!XC1'C~.~,.~adetAi ~ Wo/ pOffMiiCf a •iY CpI~CR i1~~ r` 0 i, #0 ' L i•' ~ tbQ Ptopert~ ~ ba•*e s id"W "da PM- M. or ti* Apt saov.ertt as wsitaaa Y sa mult@ p of law of tbs Oinp; petd bR al0 ri4O 3 l1►i imc d ~h IaasT w iad~~ s~ia0ai~ie ~M[ ~ r ~bd 0~ 10 ssteat ant :Led Tste.~fd; ktwsye~avcw~~~ MOPM as 4~ upon the or tm the appefta eat of a: rtatttz r! eo;iealt fem . - p~ p! OP to awffidl~ of Much , t t prods wha4 710 ih~ bi applie$ as % tint sun kli . ' ~ ~ ?~`~x p~Y t~ kx~~ ; r'~ - • - , Pasdtaear'ab~II nat i so ar w1r, Pew te of r: eadar tbi: CAOOtiaa! ar - eosaea! of P nde4t sizbss t ~r p ~f ~ - Q= of , to- 03 is ac~ os i eaeas~.aaderot Colt as P 3a the eIrt ai eaP sq~k aaF' ea~aeatta eslhe . . mmdQ tbda Caotesistbaoema. .+adas's aptiaa r►it3osti aoties*. Z Yabalt name sQ TA►7 °=a aPG, lbf ?[opesss oa tdfa dste of this CoalraeL Eesxpt lnr sat mossaap trd `p'as+dssf4) ar Imia"d *012 fir" ' Valoe tiaod? acf tba ~anoeae cei~e ti►b ttib aa~ direeitT La t~ vklv~ if Poadw Me to da is saa W. VV✓t.& 7r sue, o~ oe;paio~~# Od Pardafset Yeadwr MW "doe aas drtdaatb baaa34cr !Le - AU te!M o! grim, c attest ohm-be ~ sad francs Lo'tlAe sad of Psaamt sad. Ym ~ sat sn vwx~r a! lt+t ~ spode al P~mdeor jodas~a'bsdwo At d r fs:ffia 4a jds is ffit aswalfea ad em tQ La grade 1tr btssOt.1 r F k r ;i ; , Dated arts ism Pm?3a'E • AVTXXNTICATZ03F + 'ACW rQWAi~ni~~aa►~r ' i fky,~ it t ~d`ak dime{e) A~ ~'it<'ffiE:ONSIrT~ ~ • ~ r„ '~7{I~~~ eta j ~j~R~R . • Ilk- of' xzdwaUbd~d *fz -41W at T=:3MURM Srw= BAS 08 WMONStrF aatad by ¢ g06At Wi& sods ' irbd miabd tbs ' ' THM Iflfiiit UG" WM Ohm ■rf. i Sam" w0d AttC=T8t'-F$K Wl~ r> ~ OOt: ~eearg) " a. map ~•~~1••, ~..~,'i~ •j' ~mO V.i~l ~1 ~17: e.':.~ ,ambCm>m n• _ ! .,-.a.,r;,~ ~S y. ~ ~ {ri I ~•Irr! y~ ~~iV►-+t,ir ' C7 IT. •T...1,, arc : :-7 :rJ 3 ! L!t r fn HII F, mm n; M I t r-1 t . 57 r sr :+7 m 4I t rr ti J ' 772 cu 0) At r`^d'i.zO p . 4 .r 10 T3 ,f .i I t f ~ t~ ~ 1'i ~ 1 i vQ SF p F E C, 3r 1, 4r"d J 4 Y ~yrJ.U~ t 1 ~1 r PU- rN iCJxrCyP~+f r-P rQ T. CO L' .3 -P. f !j 33 mx-+0 ell r <1 n ~m ,r ! c v Oo w m rn IS o -4 m -4 O D. j x N ~ ~I ~ ~N' ° F ~ w E n 1 ~ ~ ( ty 4 -4• •J 1 p~jg2 ( IS34NV6 11V 03UV310 SVH m03HO imNn (31'IVA LON)1d13O3W j. 900 HIIWS •0 -8 09T9 1;99 ZT90 9T :ZT 864Zi60 -7 q V f/ I 7471 I~ DEPARTMENT OF REPORT ON SOIL 13ORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LA80R AND PERCOLATION! TESTS (115) MADISOP.O. BOX N WI 53707 HUMAN RELATIONS (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: OWNSHIP/Mb4ftt ITY: LOT NO.:BLK. NO.: SUBDIVISION NAME: ~c 1/a F 1/ /6 /Ttf N/R/ E (o T ro I COUNTY: OWNER'S _ MAILING ADDRESS: / lie /z P USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: R OLATION TESTS: LJResidence 3 E3*lew ❑Replace ILI RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED YSTEM:(optional) ES ❑U ❑ S [DU CC'S ❑U ❑ S CCU ❑ S CCU 4" - X Gm ' If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: 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. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) i B- /DO e'. G C > Od 7 r/-? r w /,8~T3 L1 t r B- L j p~. P NMI ' I ~r f/ r w do ' Est B- 3 5 N nt e- > lj s w c Alf ec c 5! arr B- I/Sr P7, IVA < ?2, 7' s w c l 1 r w e 13- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES 1 NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 P R PER INCH 3 P_ e- P P- 2 S 1 7 rr la 11 i P- P- 3 .3 P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or ~tances. Describe what are the ho zontal and vertical elevation reference oints and show their location on the plot plan. Show the surface elevation all borings and the direction and perce of nd slope. dy a4 SY EM LE"TION P 6;10 - F ~ ~ r?, Gk_sc a gcerr° ~e rc y ~jo~~~~ /62~__°pf6 r~.<< Ile a , F vr~i Uf cGrao~ , _ 7th o _Y t6 E s / d At N' = r ~ U~wa~ p c : 4<v ~b %P et SyS~~tt-r ado e-t ' I,/tTiP Cfridersignecj, here0 cer lfy hat the soil tests r Kor is form were made by me in accord with the proced a nd 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 b Xi p,D ~S'PY v I (C /"a O l~ NAME (print): TESTS WERE COMPLET N: DAVE FOGERTY PLUM81N%-: ADDRESS: Ueensed r ester um er CERTIFICATION NUMBER: PRQX~ NUMBER (optional): //~~~~yy #3233 #3289 Fosertif Hemahts Road 41 S, WISCONSIN 54023 CST SIGNATURE: "BE Ph;ne 749-3656 ~ TRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. 'R-SBD-6395 (R. 10/83) - OVER - TI T e dH t III TO H j Parcel 040-1064-10-110 04/28/2005 02:38 PM PAGE 1 OF 1 Alt. Parcel M 16.28.19.240A10 040 - TOWN OF TROY Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * MYHRE, KARL D & PAULA E KARL D & PAULA E MYHRE 618 GLOVER RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 618 GLOVER RD SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 24.600 Plat: N/A-NOT AVAILABLE SEC 16 T28N R19W LOT 1 CSM 7/2084 BEING Block/Condo Bldg: PT OF NE1/4 NE1/4 & SE1/4 NE1/4 SEC 16 & SW1/4 NW1/4 SEC 15 ALSO A PARCEL DESC AS Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) BEG NE COR SEC 16; TH N 89 DEG W 600'; 16-28N-19W THS01 DEG W 327.94'; TH S 89 DEG E 600'; TH N 01 DEG 327.87' TO POB (LSAO) more... Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1066/485 WD 07/23/1997 1065/44 WD 07/23/1997 976/281 LC 07/23/1997 976/40 LC 2004 SUMMARY Bill Fair Market Value: Assessed with: 26628 467,600 Valuations: Last Changed: 07/20/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.000 71,500 362,700 434,200 NO UNDEVELOPED G5 19.600 34,300 0 34,300 NO Totals for 2004: General Property 24.600 105,800 362,700 468,500 Woodland 0.000 0 0 Totals for 2003: General Property 24.600 123,600 371,100 494,700 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 44fa9S CERTIFIED SURVEY MAP LOCATED IN THE NE1/4 OF THE NE1/4 AND THE SE1/4 OF THE. NE1/4 OF SECTION 16, T28N,' R19W AND THE SW1/4 OF THE NW1/4 OF SECTION 15, T28N, R19W, TOWN OF TROY, ST. CROIX COUNTY, WISCONSIN. ®IN.E. CORNER I SECTION 16 OWNER T28N, R19W ALBERT P.J. HANSEN S1°58'14"W 523 CTH FF UNPLATTED LANDS 327.87' HUDSON, WI. 54016 _ S89°00'33"E 600.00' 1 -POINT OF BEGINNING LOT 1 4--E. LINE OF NE1/4 876,536 S.F. o =20,122 AC. o LEGEND INCLUDING ROAD ST. CROIX COUNTY SECTION CORNER zl N RIGHT-OF-WAYS a1 rn 871,479 S.F. ^ MONUMENT, FOUND. =20.006 AC. O 1"x24" IRON PIPE, WEIGHING wl EXCLUDING ROAD NI 1.681/LINEAL FOOT, SET. E-41 RIGHT-OF-WAY A ¢I o ~I (N48°06'17"W) PREVIOUSLY RECORDED AS. a a I 041 ° .t ~I z en AI E- ~I z I F F►LEp Co ~I Z APR 141989, I \r+ G o°o ° a JAIN 'CONWL 9 %IS* of Deft u~ 00 Ln `%D SCALE IN FEET of 300' 600' 0, 00 H o 6 N~' \ ?S 9 0.- N U o N z \ N 06. r4 o w I ?q 1s~6\Z ~s f.Q s v~ z ul) W 96 u~ 16j, H~z ~.o E y - oo .o w w o V) r~ N88°50 `18"W NI 0 a z z \p 6 4183.39' z H, x I A SO r*.s M GLOVER ROAD W1/4 CORNER ~ R~~~ x.2 • r- - - - _ - ~Q SECTION 15 ~ j~ T28N, R19W CENTERLINE AND ° M cn E-W 1/4 SECTION LINE N15352618 W M UNPLATTED LANDS El/4 CORNER SECTION 15 This instrument drafted by Francis H. Ogden. T28N, R19W VOLUIIE 7 PAGE i 20811 i ~ y ST. CROIX COUNTY WISCONSIN 1-` k ZONING OFFICE M M N ■ ■rrri ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 January 26, 1994 Derrick Construction Attn: Mike Stephens P.O. A New Richmond, WI 54017 Dear Mr. Stephens: An inspection of the septic system for the Karl Myhre property in Document No. 490349, Vol. 976 at page 286, located in the NEh of the NE; of Section 12, T28N-R19W, Town of Troy, was conducted on November 15, 1993. At the time of the inspection this septic system was found to be code compliant for a three bedroom home. Should you have any questions, please feel free to contact this office. Sincerely, Thomas C. Nelson Zoning Administrator js I~