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Parcel 042-1086-30-000 10/03/2005 09:45 AM
PAGE IOF 1
Alt. Parcel 31.29.18.482B 042 - TOWN OF WARREN
Current Xi ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
JEFFERY W & JODY A OLSON O - OLSON, JEFFERY W & JODY A
652 93RD ST
ROBERTS WI 54023
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 652 93RD ST
SC 2422 ST CROIX CENTRAL
SP 1700 WITC
Legal Description: Acres: 6.017 Plat: N/A-NOT AVAILABLE
SEC 31 T29N R18W PT SW NW LOT 1 CSM Block/Condo Bldg:
1/221 (6AC) & PARC DESC IN QC-1436/469
(0.017AC Tract(s): (Sec-Twn-Rng 401/4 1601/4)
31-29N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/09/1999 606546 1440/521 QC
06/23/1999 605556 1436/469 QC
07/23/1997 1098/415 WD
07/23/1997 1098/414 X9
2005 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/22/2001
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 6.017 51,500 155,400 206,900 NO
Totals for 2005:
General Property 6.017 51,500 155,400 206,900
Woodland 0.000 0 0
Totals for 2004:
General Property 6.017 51,500 155,400 206,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: 12/04/1998 Batch 523
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP
SECTION_,/-T--e-N-R-a
ADDRESS ds)- 91-~ ST. CROIX COUNTY, WISCONSIN
A(e 5 w_L 6" w- -j \'SUBDIVISION LOT--=-LOT SIZE
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
Gv
2 I
Q
BM P40 le Art1
S
WINDICATE NORTH ARROW
BENCHMARK:Elevation and description: /crdB ./we eam i
SEPTIC TANK:Manufacturer: Liquid Cap.
Rings useu: Manhole cover alev: ---Final grade aiev:
Tank inlet elev.: - Tank outlet elev.:
No. of feet from nearest road:Front ; Side ,-Rear --F't.
From nearest prop. line:Front , Side , Rear -Ft-.
No. of feet from: Well , Building:
(Include this information in the above plot plan)
(2 reference dimensions to septic tank)
SEE REVERSE SIDE
G~:uG
~ew l/
a
PUMP CHAMBER
Manufacturer: Li uid Capacity:
Pump Model: Pu /Siphon Man fact.: Pump Size
Elevation of inlet: otto of tank elevation
Pump on elev.:- Pump off a Gallons/cycle:-
Alarm: Man.: witch T Location
Distance from nearest pr p. line: Front-, Side-, Rear_Ft.
Distance from: Well Building
SOIL ABSORPTION SYSTEM
Bed: c/ Trench: Seepage Pit:
Width: 42- Length d Number of Lines: Z Area Built 7j-
Exist. Grade Elev. Proposed Final Grade Elev.
Fill depth to top of pipe:
No. feet from nearest prop. ling:Front , Side , Rear ✓ Ft.,
No. feet from well: Sb No. feet from building> J-6
HOLDING TANK
Manufacturer: Capacity:
No. of rings used: Elevati n of ttom tank:
Elevation of inlet:
No. feet from nearest prop. line* r t , Side , Rear Ft.
No. feet from: Well bui ding , nearest road
Alarm Manufacturer:
INSPECTOR:
DATE: 1- PLUMBER ON JOB:
LICENSE NUMBER:
6/90:cj
IaCC94iTW1trr W0s41 . 29.18. 40li P,A 'MACE SYSTEM rL. .,y:
Labor and Human Relations INSPECTION REPORT
Safety and Buildings Division ST. CROIX
'GENERAL INFORMATION (ATTACH TO PERMIT) SanitaryPermitNo.:
186550
Permit Holder's Name: ❑ City ❑ Village [Town of: State Plan ID No.:
TV-, DENNTS WARREN
CST BM Ele~vj.: Insp. BM Elev.: BM =e"015 ionParcel Tax No.:
a 042-1086-30-000
TANK INFORMATION ELEVATION DATA A9300007 0~ q_3
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Cc Benchmark d ,~10
Dosipg--
Aeration Bldg. Sewer
Holding M St/ Ht Inlet
TANK SETBACK INFORMATION St/ Hf Outlet
Vent
TANK TO P/ L WELL BLDG. Air Ito ntake ROAD Dt Inlet
Septic k_ NA Dt Bottom
Dosing NA Headerla-
Aeration Dist. Pipe
%SU e2, 9~
Holding- Bot. System a Da
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand
Model Number GPM
TDH Lift Friction em TDH Ft
Forcemain._ Dia. Dist. To Well
SOIL ABSORPTION SYSTEM
BED /TRENCH Width Length / No. Of Trenches N §Inside ia. Liquid Depth
DIMENSIONS DIMENSIONS
SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACHING ctur
SETBACK
INFORMATION Type O >re r CHA umber:
!/6 '>!So 1,4- OR UNIT
Syst em: J, 3r_ >1.-161
DISTRIBUTION SYSTEM
Header Distribution Pipe(s) / . x Hole Size x Hole Spacing Vent To Air Intake
~ to
Length _I Dia. Length ~aZ Dia. ~ Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over c~ Depth Over C, xx Depth Of W- eeded / Sodded xx Mulched
Bed / ter ~S 4 r Bed LkrVk-MEdges 7 Topsoil ❑ Yes E] No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
LO ATION: WARREN 31.29.18.482B,SW,NW, 93RD 7
Plan revision required? ❑ Yes Q-0-0-
Use other side for additional information. zz 1 WN I
SBD-6710 (R 05/91) Date Inspector's Signat a Cert. No.
ee -
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
; H SANITARY PERMIT APPLICATION oouN
Ll A In accord with ILHR 83.05, Wis. Adm. Code
=I= STATE SANITARY PERMI
-Attach complete plans (to the county copy only) for the system, on paper not less than ~~Q
575--0
8% x 11 inches in size. ❑ ch cc f revis on to previous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PR RTY OWNER PROPERTY LOCATION
a--vz w '/a w'/a, S T,Z , N, R ly, E (or)
v
1PhOPERTY OWNER'S ILIN A RESS Lor# BLOCK #
Cl , S ATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
i'L Gr/ 023
II. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD
❑ Stat@ OWft@d O ILLAGE ; ?„,r{
❑ Public [K or 2 Fam. Dwelling-# of bedrooms -3- PARCEL TAX N M ER )
III. BUILDING USE: (If building type is public, check all that apply) O, /O
1 ❑ Apt/Condo 7
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. ❑ New 2. ❑ Replacement 3. ❑ Replacement of 4. M Reconnection of 5. ® Repair of an
System System Tank Only Existing System Existing System
B) [JA Sanitary Permit was previously issued. Permit # - Date Issued 7-2-
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 O,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) 75^ r!I1Cl- 4L ELEVATION
D 7z o 7 Z D 45 15- 9-'• Feet 9 S Feet
VII. TANK CAPACITY Prefab. Site Fiber- Exper.
in gallons Total # of Manufacturer's Name Con- Steel glass Plastic App
INFORMATION New istin Gallons Tanks Concrete structed
Tanks Tanks
Se tic Tank or Holding Tank
Lift Pump Tank/Si hon Chamber
Vlll. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sews system shown on the attached plans.
PI ber's Name (Print): Plu s Si nature) PRSW No.: Business Phone Number:
,:p V7
A 7"
vl, D erTl r 2-
Plu er's Address (Street, City, te, Z ode):
gAp7prc N /DEPARTMENT USE ONLY
❑ Disapproved San' ary Permit Fee (Includes Groundwater a e slue uing Age t Signatu o Sta s
~SurchargeFee)
vedEl Owner Given initial /r/"~
Adverse Determination
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Pib-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS
j
1. A sanitar
y 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
_1)submitted to the county prior to installation.
5. Onsite sewage systems must`be properly maintain_dd. The septic tank(s) must be pumpedby~aJicensed `
pumper-whenever necessary, usually-every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code 'administratdr or.the {
State of Wisconsin, Safety & Buildings Division, 608-2663815.,.
To be complete, and accurate this, sanOt q 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.
Ill. 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.
Vlll. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g.
MP, etc.), address and phone number. Plumber must sign application form.
IX. County/Department Use Only.
X. County/Department Use Only.
Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The
plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of
holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service;
streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system
areas; and the location of the building served; B) horizontal and vertical elevation reference points;
C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump
performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if
_ required by the county; E) soil test data on a t:15 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.-qoltected through,,these•-surcharges are use0jor mopitori.ngf groundwater, ;ground ~V s
v)a1er-bontamination investigationsa`nd establishment of standards.
%
SBD-6398 (R.11/88)
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Dave Fo gertY Plumbin
SEWER SYSTEMS & PERK TESTING
FOGERTY HEIGHTS ROAD ROBERTS, WISCONSIN 54023
(715) 749-3656
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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
• INDUSTRY, DIVISION
LABOR AND PERCOLATION TESTS (115) MADISON W 7969
HUMAN RELATIONS
(ILHR 83.09(1) & Chapter 145)
LOCATION: / SECTION: TOWNSHIP/ LOT NO.: BLK. NO, SUBDIVISION NAME:
T N/R E I. It OW R'S Btf'IR,S ;OZ A4 MAILING ADDRESS:
j-Z !dr Sft3
USE DATES OBSERVATIONS MADE
2//R NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DE CRIPTIONS: PERCOLATION TESTS:
LJReside-ce w Replace O 3 G
~ys~i~ • a
RATING: S= Site suitable for system U= Site unsuitable for system _71
r ONVENTiONAL: MOUND: r-114 IN-GRO]U.NND-PRESSURE: SYSTEcM-I(N~Fl-fLHOLDIIN`G TANK: RECOMMENDED SYSTEM: (optional)
~J DUDS 5,4 ROUJ OU DV LJV EIJ - '
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.)
,f
B- 1 .3 < .6 zvnw 59
/
B-
B- Z d y. . c r SA 7 r ' MIr .
B-
B-
B- d
PERCOLATION ESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATPER INCH ES
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 P R D
P- 1 z 3
P > r
P-
P-
P-
P-
PLOT PLAN: Show locations of percolation tests, soil borings and 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.
01
SYSTEM ELEVATION pi. v
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3
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I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the pr edures and methods specified in the Wisconsin
Administrative Code, and that the data recorded and tthhe,l; c_ a~o~rlp~the tests are correct to the best of my knowledge and belief.
DAVE FOGEM PLUME n(7
NAME (print): We 81' @ umber TESTS WERE COMPLETED ON:
#3233 X289
ADDRESS: R991 71461N Hewhts Road CER IFIIATION NUMBER: PHONE NUMBER (optional):
SHE=3656
CST SI ATURE:
e
r 11
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 10/83) -OVER -
,I TIONS FO COMPLET FORM 1 - SBA? -
To be, a c ,,curate s your report nl rst inclxade:
1. Complet I on;
2. The use clearly v.hether this is a residence of commercial project;
3, MAX - of bedic:w r commercial use planned;
4. Is th; '.erttertt
5. Complet t` ? s€ -y raC, A SITE IS SUITABLE FOR A HOLDING TANK ONLY I ALL
OTHER SYSTE . F= RUL BASED ON SOIL CONDITIONS;
6, PLEASE use the abbreviations sere for kvriting profile descriptions and completing the plot plan;
7, MAKE A LEGIBLE diagram a{cdtely locating your test locations. Drawing to scale is preferred. A
separate sleet may, be used if d(,. '-d;
8, Make sure your benchrtrark and vertical elevation reference point are clearly shown, and are permanent;
9. Complete all appropriate boxes as to dates, names, addresses, flood plain data, percolation test exemp-
tion, if appropriate;
10, If the information (such as flood plain, elevation) does not apply, place N.A. in the appropriate box;
11- Sign the dorm and place your current address and your certification number;
12. Make legible copies and distribute as req€.tiie€-l. ALL SOIL TESTS MUST B FILED WITH THE
LOCAL. AUTFIORITY WITHIN 30 DAYS OF COMPLETION.
ABBREVIATIONS FOR CERTIFIED SOIL TESTERS
Soil Separates and Textures Oth, . Symbols
st: Stone (over 10"? BR k
cola Cobble (3 - 10") one
gr .Graver f nder 3"} ~r"s Sane-! I :ii C
's Cc< 1, rc Pi..rcola`
€yred s IV9? 'and Well
fs F ;,)(I ` Build
is Loamy a-nd
`sl Sandy Liana L......
;
Loam BED - l3rosiI ;'';t Loam BI Black
CGy Gray
Clay Loam y - yeilrs~.•=<
scl - ;>.ndy Cray L.oarn R Red
sic! S:lty Clay Loam rnot - Mottles
$C - Santry Clay vv" v ith
sic - silty Clay fff- few, fine, faint
k
c -Clay c:c common, coarse
pt Peat m Many, medium
m Muck - distinct.
p protninent-
HWL High water level,
Six general : xtures surface water
for hquid ms', ispt3St11
_ Bench Mark
V liei tical R to , Point
TO THE OWNER;
This soil test report is the first step in securing a sanitary permit. The county or the Department may request
verification of this soil test in the field prior to pern- t ,nce;-A complete set of plans.tQr 4he private
sewage system and a permit application must be submitte r the appropriate local authori'tfin order to
obtain a permit. The sanitary permit must be obtained and posted prior to; fhe,start of any construction.
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF AN EXISTING SEPTIC TANK
This is to certify that I have inspected the septic tank presently
serving the residence located at:
SW 1/4, it ct, 1/4, Sec. 3,/, , T 49N, RAW Town of
Upon Inspection, I certify that I have found the
tank and baff'les`''to be in good condition, and it appears to be
functioning properly.
Last time serviced_
Did flow back occur from absorption system? Yes No_ Z(if no, skip ,
next line)
Approximate volume or length of time: gallons minutes
Capacity:
Construction: Prefab Concrete 11 Steel other
Manufacurer (if known): Ag of Tank (if know ~-~7 2
(-Signature) (Name) Please Print
~1 ~ ~z 'y'?
(Title) (License Number)
(D te)
Form to be completed by licensed plumber (s.145.06, Wisconsin Statutes)
or Licensed Disposer (NR 113 Wisconsin Administrative Code)
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Plumber (applying for sanitary permit) Certification:
In accepting the above statement regarding existing septic tank
condition, I certify that the tank to the best of my knowledge will
conform to the requirements of ILHR-83, Wis. Adm. Code (except for
inspect n opening over outlet baffle).
I---
Name ~1
4 Signature 24g/MPRS Z~
5/88
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/ OUTER-
ADDRESS : FIRE NO:.
_
LOCATION: sw 1/41 ~cJ 1/4, SEC. T -9N-R_j2_W,
TOWN OF:_ ~U~crter c~ ST. - CROIX COUNTY
SUBDIVISION: LOT N0.
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.
I/WE, the undersigned have read the above requirements and agree
to maintain the private sewage disposal system-in accordance with
the standards set forth, herein, as set by the Wisconsin DNR.
Certification form must be completed and returned to the St.
Croix County Zoning Officer within 30 days of the three year
expiration date.
y SIGNED: `
DATE:_ St. Croix County Zoning Office
911 4th St.
Hudson, WI 54016
And Cudd a Sans MCI
1047 South Wasson Lane WI License No. MPRSW2739
River Falls, Wisconsin 54022
715-425-2049
January 22, 1993
RE: Dennis Fogerty
652 93rd Street
Roberts, WI 54023
TO WHOM IT MAY CONCERN:
This letter is to inform you that on January 22, 1993,
we pumped the septic tank on the property at 652 93rd
Street, Roberts, Wisconsin, which is owned by Dennis
Fogerty.
This is a 1000 gallon septic tank with fiberglass
baffles and it is in good condition.
If we can be of further service to you, please contact
us.
Sincerely,
PAUL CUDD & SONS, INC.
Paul R. Cudd
President
PRC:mly
STC-100
This application form is to be completed in full and signed by
the mmer(s) of the property being developed. Any inadequacies
will only result in delays of the
permit issuance. Should this
development be intended for resale by owner/contractor,(spec
house), then a second form should be retained and completed when
the property is sold and submitted to this office with the
appropriate deed recording.
Owner of property
Location of propertyse4 1/4 yy 1/4, Section 3 T _z P N-R E W
Township
Mailing address r~
Address of site
subdivision name
Lot no.
Other homes on property? yes f% No
Previous owner of property
Total size of parcel 4ctej/
Date parcel was created L41-7:5-
Are all corners and lot lines identifiable? r%
Yes No
Is this property being developed for (spec house)? Yes •LNo
Volume ,S~and Page Number Asy as recorded. with the Register
of Deeds .
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE
NUMBER & THE SEAL of THE I2EGIST]kR OF DEEDS.
certified survey, if ava.i ~lable• ~ would be helpful so as to avoid
delays of the reviewing process. If the deed description
references to a certified survey Map, the certified Survey Map
shall also be required.
PROPERTY OWNER CERTIFICATION
I(we) certify that all statements on this form are true to the
best of my (our) knowledge that I (we) am (are) the owner(s) of
the property described in this information form, by virtue of a
warranty deed recorded in the office of the County Register of
Deeds as D
own the o
obtained current No and that I p posed site for the sewage (we) presently
disposal
system or I (we)
aseme
nt,- to run the above described property, for
the con ruction of said system, and th
recorded 'n the same has b
e office of county Register of deeds as Doc
ument
Sign re of I ant
co-applicant
Date of signature Date of S gnature
'STATIt
- ' rICS SPACE R ttytj.
336306° 544 ►w~f 488
" REGISTERS
THIS DUD. __1Li11 = CIAPP1 Jr.:, Also known as ST. R4tx CO., WNS
Recd. ,
for R*Gwd Ihit4
day of Gc_ t SOLAA I
drstttw comys rs red arwrams to ._D_ 19 E.._ ZnWty.--sA41. Susan, Ann at i~?D
rsrtr, huthand_.and wife ae-.jaiat tenants,
ittir
Granter s
~i ftr a tralu" consideration RETURN TO _ .,~•1...•;`t.
00 foileariag des"ibed real estate as __..$ta -rr~iY County, State of A'rs, mstn.
partial of land located in the Southwest Quarter
! Northwest Quarter of Section 31, Township 29 raz Ket •
RRe 18 West, described as Lot 1 in the This Is not hotseaead
ft~d /nrvey -Map filed in the office of the Register of Deeds for t '
catattyp `Misconsin, on March 9, 1976, in Volure 1, page 221, docwms►t.',
t#th a non-exclusive easement it;r an access toad 3 rods in widtL r
.'4ba t side of said parcel as shown, on said map.
ds" i1o~s not convey any interest in land in the Southeast Quarter oR
Awthvw* Quarter of said Section 31, and if any part of the above de+*
sat fift'`o r a wamednt lids in said Southeast Quarter of the Northwest
W-# -It is ;asa*pted tram this seed .
ftp Motor reastv" fee title to the 3 rod road shown on said map, and i~
*art. tbere0f lies in the Southeast Quarter of the Northwest Quarter 09,41
AU-Secti" i,31# to reserved so much of the land lying along the East
pp 6"A-Lot 1 as may be necessary to provide him with a S rod
. ly I" finkir"VIA th* douth'west Quarter of the Northwest Quarter of said -
r Section. 31.
_ T~p.NSFEB
Hudson,. Wisconsig--~`- 26th October
44i4 E:ecated st _ - r F$ tht. 19. ;
t.j
SIGNED AND SEALED IN PRESENCE OF
William Clapp, Jr.
T ~ -MAO
S
slptsttt.esor.._._Vil11j9L_C1app,..Jr•, also known as w. S. Clapp
sutbonticated this_- _ 161b dsy of October 76
John D. Heywood
• Y
' t STATE OF WISCONSIN t
Counts Personally came before m, this the above named.
to us known to he the perscrt w•hn rrty wv'i IN, 1"wr- :nt ,r,t•
This instrument was dratted by
John D. Heywood, Attorney at Law
godson, Wisconsin C0uat"
The use of Mtimessrs is op1;1•11A M, ` - f t,r•e.r lo-.' .x
*atses of persons Signing in any capacity sh,;uld Is, ♦prd or print, d hel.,w ihvit sitmatures
- t~
r
ST. CROIX COUNTY
t ~ WISCONSIN
a
.~00a_. ZONING OFFICE
a.
ST. CROIX COUNTY COURTHOUSE
911 FOURTH STREET 0 HUDSON, WI 54016
404
(715) 386-4680
EXISTING SEPTIC SYSTEM AFFIDAVIT
The existing septic system which serves the dwelling being added on
to must be inspected by a licensed soil tester for compliance with
high ground water and/or bedrock seperation requirements as set
forth in s. ILHR Chapter 83.10(2) WI. ADM. CODE. The results of
that inspection must be made available to this office. If the
existing septic system meets these minimum requirements, and is
,properly functioning, an addition may be added to the dwelling
without updating that system. This addition must not, however,
encroach upon the required septic system setbacks as setforth in s.
ILHR Chapter 83.10(1).
Property Owner(s)
Property Mailing Address:
Property Legal Description: LotiCSM/Subdivision
1/4, Sec. R.,,Z,~'_W. , Tn. of
I, as the owner of the above described property, hereby affirm that
the septic system serving this dwelling meets the above referenced
state private sewage system codes. I realize that this addition
may cause the existing septic system to become undersized for a
dwelling of the resulting size, and I will make this information
available to any future parties interested in purchasing this
property.
Notary Public
Subscribed and sworn to
before me on this d e:
Signed•
+
Q;4
Date:
My commission expires:
County Approval: a + j `frf Y
Date:
v
ST. CROIX COUNTY
~ryr WISCONSIN
,
.fi
ZONING OFFICE
ST. CROIX COUNTY COURTHOUSE
911 FOURTH STREET • HUDSON, WI 54016
(715) 386-4680
January 18, 1993
Division of Safety and Building
Bureau of Plumbing
P.O. Box 7969
Madison, WI 53707
To whom it may concern:
An onsite soil investigation of the Dennis Fogerty property,
located in the SW1/4 of the NW1/4, Sec.31, T29N, R18W, Town of
WarrenSt. Croix County, WI., has been conducted with the assistance
of Dave Fogerty, CST# 3233.
This onsite revealed suitable soil for onsite sewage disposal to a
depth of 82" while meeting the requirements of the A + 4" rule.
This site should be suitable for new construction utilizing a
conventional septic system.
Should you have any questions, please feel free to contact me at
this office.
Sincerely,
c
ames K. Thompson r
Assistant Zoning Administrator
cc: file