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HomeMy WebLinkAbout012-1024-20-000,cousin Department of Commerce PRIVATE SEWAGE SYSTEM safety and Building Division ~~ INSPECTION REPORT GENERAL INFORMATION (ATTACH TC~PERMIT) Personal infonnation you provide may be used for secondary purposes fPrivacv Law. s.15.04 (1)(mll. .TYPE MANUFACTURER CAPACITY Septic ~ ~ ^ro,~ `.~"~LXX Trr Aeration Holding -~t~~ / „ ~ ~-'~U f L+.- 1 AIMS JC 1 t3Al;K INFUKMAI IUN TANK TO P/ WELL r-- BLDG. Vent to Air Intake ROAD Septic Dosing ~ ~' Aeration Holding PUMP/SIPHON INFORMATION ~a'llls',('u'k,. Manufacturer Demand GPM Model Number TDH Lift Friction Lo System Head TDH Ft Forcemain Lengt Dia. Dist. to well 501E ABSORPTION SYSTEM ' ZS ~ BED/TRENCH Width ~/ Length 4/ .Of Trenches DIMENSIONS ~ 4 J SETBACK SYSTEM TO 7 P/ LD WE INFORMATION Type f System: ~ ,~~ ~~~ - t IBUTION SYSTEM P' Nl Header/ anifgld Distribution /'/~ Pipe(s) rC ~ I`~"f ~ J ngth Dia Length `'~~~ Dia Spacing SOIL COVER x Pressure Systems Only County. St. Croix Sanitary Permit No: 479286 0 State Plan ID No: Parcel Tax No: 012-1024-20-000 Section/Town/Range/Map No: 09.30.17.129A STATION BS HI FS ELEV. Benchmark /-'l I 3 •oS~ o~ I a~• o Alt. BM -- e4U•Q/t -18 ' r- ~' ~ b- t 3 Bldg.. Sewer ~~ oK-- - b ~t5.3 ~ St/ t Inle~, "1 ~. ~ St/ t O~ utlet^ ~ .os ~ .~ -v D-~s go 6 ~~- . ~ q 3. y~ Dt m 2- .. `7 3• ? (( Dist. Pipe 4 s 13, Z~ B .System Final Gra e 1 ~,/ - (j 3~$ St ~~ ~+ ~3 (~.~ ~ ~o. ~~ '~a Z Inside Dia. ILiquid Depth LAKE/STREAM ACHIN Manufa~t r ~ _ CHAMB OR ~ lalll IT Model Number. ~~. x Hole Siz~_ x Hole Spacin~ Vent to Air Int. ~' rz Mnund Or At.Gradw Svstpmc Anly n _ ~~ ~ . i Depth Over ~ y / " Depth Over xx Depth of xx Seeded/Sodded xx ulched Bed/Trench Center 1/ - Bed/Trench Edges Topsoil ~ Yes ~ `~ No ~. '' Yes No L'_~ L'zLN COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / Location: 1735 170th Ave~n^ue/N~e~nv-~R~i»chmond, WI 54017 (N 1/2 NW 1/4 9 T30N R/17W) NA Lot ~Q 1 Parcel No: 09.30.19 ~~ ~~ f ,. 1.) Alt BM Description = s `' W ~Ut`~ ~J ~ ~(~ ~$ ~~ ~l,Gt,~~/~.yJ f~ ~~ 7 2.) Bldg sewer length =~~(t /~ ~~ J ` I~~~ -amount of cover = T ~j'~ g7 Plan revision Required? I.•] Yes ~o L~~~ /~' n j ., Use other side for additional information. _G-_ ~_ iV~J ~__ _____ _ __ __ __J I ~06 ~ ~I Date Insepctor's ignat re Cert. No. SBD-6710 (R.3/97) 'ermit Holder's Name: City Village X Township Demullin , Gre Erin Prairie, Town of :ST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELE ION DATA /~' ~ 1 ~~ a ~ l roi ` 201 n~ t "'r'u`m ~ °''~ Sanit ry Permit Number (to be filled in by CoJ ~~ isconsin ~ (6 3 ~ ~. ~ m ~ q 2 ~~ Department of Commerce state Ian I. .Number Sanitary Permit Applicati JUt~ ~ ~~ 1jd In accord with Comm 83.21, Wis. Adm. Code, personal informati you provide ;C7 , ~) ' Proj Address (if different than mailing address) may be used for socondary purposes Privacy Law, s15.04( xm) S ~ ~~,;F;,•, )I? 1. Application Information -Please Print All Information Parcel # Lot # Block # Property Owner's Name © ^,~~ a Q~}~ Property Location Property Owner's Mailing Address ~~ ~ l y./~ '/., Section ~_ ;. ~ ~ Z~ Code Phone Number / l 7 / q City, State `~.~!/1~~5~~/" ' ~ ~ C9 ~.j' O~ (a 6~J~0 _ /-circle (•~ ~ 1 T~ N; Kam- ` I. Type of Building (check all that apply) ^ 1 or 2 Family Dwelling - Number of Bedrooms 3g ~ t ~ ^ PublidCommercial -Describe Use ~it),_^Vipa~e~Co ship of ^ State Owned -Describe Use ~ ~` III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New System ^ Replacement System ^ TreatmenUHolding Tank Replacement Only ^ Otlter Modification to Existing System List Previous Permit Number and Date Issued B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New Plumber Owner Before Expiration IV. T of POWTS S stem: Check all that a I ^ > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ on -Pressurized In-Ground ^ Mound _ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain) V. Dis ersa(/Treatment Area Information: s Dis rsal Area Required sf) Dispersal Area Proposed (sf) System filev~tisp~ 7-~, _~ Design Flow (gpd) ign So Application Rate(gpd f) Pe `~ r y ~ 3' .r~ B~ / ~ol Number Manufacturer \ Prefab rte Steel Fiber Plastic Vl. Tank Info C paciry in ~~~~~ .~,. Ipp ~(~~ Concrete Constructed Glass Gallons Gallons of Units • New Existing ~~ d' ~j d Tanks Tanks Scptic or Holding Tank Aerobic Treatment Uni[ Dosing Chairdx:r VII. Responsibility Statement- I, the undersigned, assume responsibility for itvip/MPRS NumbePO~S shown on the B to nhesdPhone Number Plumber's Name (Print) Plumber's S' lure ~ _ plu ddress (Str t, iry, State, tp Code) ~ ~ ~, OE.~ Sanitary Permit F includes Groundwater Date Issued ssuing Agent Signature (No Stamps VIII. Count a artment Use Onl Approved ^ ~ Surcharge Fee) ~'f) - ~ Q~ ^ en Reason fo nial //"` `` ~.-~ .p-/~ ) (~ ~~ IX. Conditions f Ap ro al ~) /~- ~~ ~ ~ j try (sJCQJ(, o-~~ SYSTEM OWNER: J /~ n~n ~ ~~`j ~G~o i °~ 1 Septic tank, effluent filter and ~ t~[~ O° dispersal cell must all be s®rviced /maintained ~~ ,r„S -(~, ,~,~3~~ ~S i ~Ge , C~ as per management plan provided by plumber. a ~~ ~ S ~~~ 2. All setback requirements must be maintained y~,e•.•~ ~ ~~'-'~~ ~ as per applicable code/ordinances. (w~ J'e-t^'~ - 3$±~w,¢_ Athch eompkte plam (to the County only) for the system n paper, not las tl'an Sl x 11 inchesiQnosi~u I'- r s ~~, c~-~ Ise ~`^^~ SBD-6398 (R. 01/03) ~~ ~-P`~~°'^'~~ ~ -rte, ~~L au~+~, o.,~ o~ . ~ S (xv rv~ tp,t.r,,t„~ ~~ o~.~.Qas PLOT PLAN PROJECT Grea Demullina ADDRESS 1691 Hv 64 Newrichmoond Wi. 54017 N1/2 i/a NW 1/as 9 /T 30 N/R 17 w • Erin Prairie couNTY ST. CROIX MFRS Byron Bird Jr. 220527 6-29-05 BEDROOM 4 DATE CONVENTIONAL XXXX At de CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 &260 gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ~ LOAD RATE .4 ABSORPTION AREA 1500 # of chambers 49 ,BENCHMARK v.R.P. Base of steel fence post ASSUME ELEVATION 100° ^ BOREHOLE O WELL ~ g R p same as BM r--- > 12" of Vent SYSTEM ELEVATION T-1=89 T-2=88.5 T-3=88.0 Bio Diffuser with 31.1 ft^2 per chamber > 100' to PL Long 34" Elevation PLOT PLAN PROJECT Grea Demullina ADDRESS 1691 Hv 64 Newrichmoond Wi. 54017 N1/2 1/a NW 1/as 9 /T 30 N/R 17 w Erin Prairie couNTY ST. CROIX MPRS Byron Bird Jr. 220527 6-29-05 BEDROOM 4 DATE CONVENTIONAL XXXX At fie CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 &260 gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE 0 LOAD RATE •4 ABSORPTION AREA 1500 # of chambers 49 ,BENCHMARK V.R.P. Base of steel fence post ASSUME ELEVATION 100' ^ BOREHOLE O WELL *g,R,p, same as BM ~- Vent SYSTEM ELEVATION T-1=89 T-2=88.5 T-3=88.0 >12" of Bio Diffuser with Cove 31.1 ft^2 per chamber 6" 6' Long 34" Elevation Garage 4 Bed hou 25' st s 150' Fence Line 2~ lr~ ~ le ~ ~ 3) ~`k ' g~ r -. ~ ., 120' , ~~~~' ~ ~~ ~~ ~~ _.>. Wisconsin Department of Commerce SOI EVALUATION RE Division of Safety and Buildings in accordance with C m 85, l~.~d~. ~ocl~l(?r. Attach complete site plan on paper not less than 8 1/2 x 11 inch sin ss~~ dpi )IV-I-, include, but not limited to: vertical and horizontal reference point BM),'d' percent slope, scale or dimensions, north arrow, and location an ' Please print all information/~~~ ~ ~`r6 Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) ( )). P~rtY ~~ .- Property Location l~ d ~ O ~~ Page of 1. d/oZ -' l ~ ~-OC C~ -,?9~ red by Date 1^ e~ ~~ ~ ~ f'j GovL Lot ~ 1/4 x/!(/1/4 S T O N R l E Property Owner's Mailing A~ ~ Lot # Block # Subd. Name or CSM# Cfty / S tZip Phone Number ^ C' ^ village Town Nearest Road c> i vI~ 5 ~ t/ 6 6 ~' New Construction Use: l~Residential / Number of bedrooms Code derived design flow rate. jz ~`'~ GPD ^ Replacement ^ Public or comm rtaal -Des be: __ _ Parent material _~/ a- L o `~ ~ ~w~!!~ Flood Plain elevation if applicable ~,~~ ft. General conrrtents and recommendations: ~ ~„ _ / .p y O - ~ J -~ ~ ~~ # ~ Boring ~ ^ pit Ground surface elev. ~~~ .7 ft. Depth to limiting factor 7 °f~ in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~" ~ ~ y ~ - •~ Z, --~ p' ^ Pit Ground surface elev. --~ ft. Depth to limiting factor ~ ,~l_ ~,. ~~ ~~ ~ Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ftr in. Munsep Qu. Sz. Cont. Cdor Gr. Sz. Sh. ff#1 'Etf#2 6 •'~ e'¢ /~+'~ So ~• r~ ~~ ~ ~ 36_ ~Z~ cmuunc ~ ~ = ovu ~ su ~ [[u nxyu ana t xy >~ < 150 mglL ' Effluent #2 = BOD < 3p r~L and TSS < 30 rrtg/L CST Name (Please ) Signature ~ CST Ntrrtber ~^~ to Evaluation Conducted Telephone Number (o Property Owner ~r { ` ~~7K //~~ Parcel ID # Page Boring ~ Boring # ^ pit Ground surface elev. / . s. Depth to limiting factor ~ in. Sal ication Rate Horizon Depth Dominant Caor Redox Description Texture Structure Consistence Boundary Roots GP DlfP in. Munsell Qu. Sz. Cont. Caor Gr. Sz. Sh. 'Eff#1 `Eff#2 K~ R~ - ~c. /l Bonng # ^ ~~ ^ pit Ground surface elev. ft. Depth to limiting factor in. Sal ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIff in. Munsell Qu. Sz. Cont. Caor Gr. Sz. Sh. 'Eff#1 'Etf#2 ~~ # ^ Bonng ^ Pit Ground surface elev. ft. Depth to limiting factor in. Sod icatron Rate Horizon Depth Dominant Color Redox Desrxiption. Texture Stnx~ure Consistence Boundary Roots GP D/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Efr#1 'Eff#2 ' Effkient #1 = BODa > 30 < 220 mglL and TSS >30 <_ 150 mglL ' EftluueM #2 = BODs < 30 mglL and TSS < 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. sso-saw(rtsroo) Soil Test Plot Plan Project Name Greg Demulling Byron ird 3r. Address ` 1691 by 64 NewRichmond Wi. 54017 CS #220527 Lot Subdivision Date 6/29/2005 CountyST. CROIX N1 /21 /4 NW ~ /4 S 9 T 30 N/R17 W Townshi p ErinPrairie [] Boring (J Well PL Property Line# Alt. BM ,BM or VRP Assume Eievation i 00 ft.Base of Stee! fence Post Blue Flag System Elv T-1=89.0 T-2=88.5 T-3=88.0 H.R.P. Same as BM SCALE 1" = 40 ` Unless other wise Noted Garage ~` Driveway 4 Bed hou B3 150' 75' Fence Line 101 to PL 75' BM 120' 40' 100' to PL ~_ S' 2~ POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner !'YlK /~~ Permit # Z DESIGN PARAMETERS Number of Bedrooms ^ NA Number of Public Facility Units ^ NA Estimated flow (average) b~ gal/day Design flow Ipeakl, (Estimated x 1.5) p~ al/day Soil Application Rate gal/day/ft2 Standard Influent/Effluent Quality Monthly average* Fats, Oil & Grease IFOG) <_30 mg/L Biochemical Oxygen Demand (BODS) <_220 mg/L ^ NA Total Suspended Solids (TSS) <_150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand IBOD51 _<30 mg/L Total Suspended Solids (TSS) 530 mg/L ^ NA Fecal Coliform (geometric mean) 5104 cfu/100m1 Maximum Effluent Particle Size Y8 in dia. ^ NA Other: ^ NA *Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE Septic Tank Capacity ~.~ x O al ^ NA Septic Tank Manufacturer ~ ~ ~ h ^ NA Effluent Filter Manufacturer Z~ ~~ ^ NA Effluent Filter Model ^ NA Pump Tank Capacity al ^ NA Pump Tank Manufacturer ^ NA Pump Manufacturer ^ NA Pump Model ^ NA Pretreatment Unit ^ Sand/Gravel Filter ^ Mechanical Aeration ^ Disinfection ^ Peat Filter ^ Wetland ^ Other: ^ NA Dispersal Cellls) In-Ground (gravity) ^ At-Grade ^ Drip-Line ^ NA ^ In-Ground (pressurized) ^ Mound ^ Other: Other: ^ NA Other: ^ NA Other: ^ NA Service Event Service Frequency Inspect condition of tank(s) At least once every: ^monthls) (Maximum 3 years) ^yearls) ^ NA Pump out contents of tankls) When combined sludge and scum equals one-third IY3) of tank volume ^ NA Inspect dispersal ceI11s) At least once every: ~ yea~(s)ls) (Maximum 3 years) ^ NA Clean effluent filter At least once every: ^monthls) ^yearls) ^ NA Inspect pump, pump controls & alarm At least once every: ^ month(s) ^yearls) ^ NA Flush laterals and pressure test At least once every: ^ month(s) ^yearls) ^ NA Other: At least once every: ^monthls) ^ year(s) ^ NA Other: ^ 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 tankls) 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 back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent 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 tank equals one-third lY3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing 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, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW 14/01) Page ____ of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tankls) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s1. If high concentrations are detected have the contents of the tankls) 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 highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) 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 POWTS 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 or 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 POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following 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 and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following 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 structure, 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 and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ^ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ^ 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 ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Name ~ i n Phone PAWTS MAINTAINER - ----- ---- Name ------------- ~ Phone 6 ~ ~.~ SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Phone Name t~i!^ o / ~ C Phone `_ ~~ This document was drafted in compliance with chapter Comm 83.22(211b11111d1&If) and 83.54111, 12- & (31, Wisconsin Administrative Code. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mailing Address Property Address c ~~ O ~ ~` S~°o / (Verification required from Planning Department for new City/State Parcel Identification Number „~~ ~ / D i.~ ~~ DD® LEGAL DESCRIPTION ~/ ,~ Property Location `' ~' %,;~~ '/., Sec. ~, T,~ON-R/_ZW, Town of _~.-~ ~ ~ ~ a ,r :-, ~ Subdivision -Lot # Certified Surve Ma # ~~~~~-- B~ Volume Pa e # y r ~ Warranty Deed # ~ g ~~ ~~ ,Volume ~j,~~5~ .Page # ~°Z _ Spec house ^ yes ~ no Lot lines identifiable,®" yes ^ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeymanplumber, restricted plumber or a licensedpumper verifying that (1) the on site wastewaterdisposal system is in proper operating condition and/or (2) a8er inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the- standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three ear expiratio date. 6 ~, SIGNA OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. / ~/~ SIGNA OF APPLICANT DATE *'`**** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed oa~uMENr NO. I` WARRANTY DEED tNl{ /-ACL R[![RVRD -OR R[COROINO DATA . ~ , STATE BAR OF WISC021SIN FORM 2 - i88f 484692 " - __ -- - ~ - __ von 9~~ ~a~t~21 __ --- ---- _ __ _ _ __ REGISTER' S OFFICE .-..8elen__ Demuling S~CROIXCOy VNI _.____••- .-•-.•. .... .....................•-----.....---.....---...... a Reed for Record ................................... I JUN 151992 conveys and warrants to .._.~XlrQAZ'y...A.....A£7UI13..~,~..~.Aq dZtG~ 10:35 A. M _. .............. .. _..lliane. -I...-.Demiil ling-.. husba..nd..and..Iai fe.. as .............. ....-marital._prapezt_y..-with..righta..af..sur.~civorship. Qr _ ......................•-•--...._....---.......---.....------..... ........ RegishraFDes~ ............. ....................... ...__. - - •---- .............•-••---....._._.._..._...--•--••-•--........ R[TURN TO - Northwest Federal .. . ...................................................... . _ ._.._.. t following described real estate in ..._..S.~.A ~( (ix:Q~ 532 3. Knowles Ave. .-. , „--____-••- ......_.County, State of Wisconsin: 7 Ta: Parcel No:._.._...-•_•-----_---__-- See attached description. ('Rftfi~'~ s /s_'7 SO This deed is given in full satisfaction of that certain land contract datiz~l April 1987 between the parties hereto and recorded Apfi~i 23, 1987 in Volume 776 at page 12 as Document No. 424800. ~~ •_--•-i_S not•-•_-•- homestead ro rt (is) (is not) P ~ Y• Exception to warranties: municipal and zoning ordinances, easements and restrictions of record and any lien created by act or omission of grantee. ~ tea. Dated this ...--------•-- .say or ................Tune....-----....... ............. is 92 -----------------------•--....-......--.-.--•---....----.......-.. (SEAL). -•-------------•-•---....---------•----•---•--.....-... (SEAL) AIITHI3NTICATION Signature(s) ..._ autheatisated this .-_--___day ~--:`__. ~: ..............~ 19...... TITLE: li[E'ISBER STATE BAR OF WISCONSIN (Ii not-------------------------------• sothorized by ¢ 708.08. Wis. State.) ..............••----- -THIS INSTRUMHNT WAg DRAFTED BY ~_,_Judith .A.--.Remington _ REMINGTOIJ LAh OFFICES •• ~~~'---'"-'"' S 4Q1.7_-------•-•_--.... (5:gnatrres may be authenticated or s,knowlodged. Both are not necessary,) a!t'saa~ °~ Dersoas d[aia4 to aar uD4it, should ba tread or rlated below th~•i D r siQnaturea. v /~ ............... .. .. ....... _ .... (SEAL) .. Helen Demulliny ---• ... ............................................................(SEAL) ACHNOWL13DdMENT STATE OF WISCONSIN ST CROIX as. ...------- '- • .......................County. - .~ Personally came before me this . ~ s~-...day of June "-- .............•----------------....--------• 18__92. tha stave maned -_,_-Helen Demulling _ to me known to be the person ____,._---.- who ezecuted the foregoing i d novel ame. Notary Pnhlia ------ ST C R Qi x ......County, Wis. --. _... ~y Commi=sion i permanent. (If not, state ezpirntion date: -----...._~. ~. ~.!_g ._.._. 19_~~) ea~B A DAI N t`fl~l .IR . - t -+ ' ~.. - ~ ~ , 9c~5 PA;:E ~2? i That part of the N 1/2 of the NW 1/4 of Section 9, Township 30 North, Range I7 West, St. Croix County, Wisconsin lying South and East of the Town Road Except Lot i or Certified Survey Map filed Septembe*_- 10, 1986 in VoI. 6 of Certified Survey Maps, page 1703, Doc. No. 416813, and EXCEPT commencing at the Southwest corner of the NW 1/4 of NW 1/4 of said Section 9; thence East along the South line or said NW 1/4 of NW 1/4, 8 distance of ].3.00 chains; thence North at right angles, a ~3istance of 6.70 chains to the center of the Town Road; thence Southwesterly .-;long the centerline o! said. Town Roa3, a distancs of 12.00 chains, mare or less, to a point. on the 'Test line of N'~1 1/4 of the NW 1/4, which i~ 4.50 chains North of -the point of beginning; thence South along the West line of said NW 1/4 oP NW 1/4, 4.50 chains to the point of beginning. Part of NW 1/4 0_* NW 1~4 of SE.:,~~.on 9, Township 30 North, Range i7 west, St. Croix, County, Wisconsin; being ,~ rt of Certified Survey Map recorded in Vol.. 8, page 23.43 described as follows; Commencing at the W 1/4 corner of said Section 9; thence N00°36'34"W along the West line of the N'A I/4 ~f said Section, 2324.79 feet to the Southwest corner of said Certified Survey Map; thence continuing N00°36'3 "W along said West line 3.49 feet; thence N87°18'09"E 704.15 feet; th nce N88°1228"E 93.76 feet to the point of beginning; thence continuing Nt38°12'28"E 60.00 feet; thence N02°2204"W along the East line of said Cart iiied Survey Map 486.62 feet; thence S67°24'07"W along the Northerly line of said Certified Survey Map 128.07 feet; thence S08°38'39"E 281.72 feet; thence S12°39'48"W 164.34 feet tto the point of beginning. ~• ~~~J~ ~ CCs'-v-v~ ~_ ~--~ 7 9 9 0 6 6 VOL 20 PAGE 5008 REGI OF' DEEDS ST. CROIX CO. MI RECEIVED FOR ~tECORD 06/30/2005 04:15PK CERTIFIED SURVEY KAP REC FEE: 13.00 CERTIFIED SURVEY INIAP PAGES: 2 LOCATED IN THE NEi/4 OF THE NW1/4 OF SECTION 9, T30N, R17W, TOWN OF ERIN PRAIRIE, ST. CROIX COUNTY, WISCONSIN. OWNER / SUBDIVIDER BEARDJGS REFERENCED TO THE G DEMULLING NORTH-SOUTH i/4 SECTION LINE ~ 1741 170TH AVENUE OF SECTION 9, ASSUMED 7o NEW RICA, WI. 54017 BEAR S00°43'46'E. -INDICATES SECTION CORDER -N- c As NorED ) ~~ --~ - INDICATES i- x 19•' c DursiDE DIAMETER) D7DM1 PIPE WEIGHING THIS LOT BEING CREATED UNDER THE 1.13 LBS. PER LIMEAR FT. SET. FARM-Alp IOATION PROVISION AND ~~ - ~~TES FENCE IS CONSISIT KITH SECTION 17.14 ( 1 ) ST. CROIX ZONING ORDINAMCE NORTH L OF THE NWi/4 N1/d CORNER, SECTION 9 U~ypLp,TfED LAND FaAr PIrIO~N i' NN CORNER. SECTION 9 ]E NOT TANGENT ( ALUMIMrI CAP FOUND ) -_------------------ 7°34'03"E - - _ -- NB7°34'03'E 262.12' ~o _ ~/ ~f- ~~ ~~ CURVE 2 \ SETBACK LIME FROM R -NAY ~ ~ Sr (3i0I~ CONY SOD' BUILDING / %; '' ~ i V ~~ ~~ ~~~ ~ LO 1 ~ ~ Z. ~ ~ sHEO 175,721 _FEET ~ ~ ~ ~ ~ ~ ~ ~ ^ INGi~dl04 RIGHT-OF~ MAY ~ ~~'ttt~ ~ I ~ 163:7~g SOiUARE FEET ~ UDING RIGHT-OF-WAV ~ I ooG ~ I KENNEL ~ \ ~7't ~ I \~ .. 1' 977°~~~ ,~W ~~ ~°.-1 ~~ ~ ,~ S1/4 CORNER, ION 9 ( i' IRON PIPE FOIk~CI SEE CL14VE IAF TIQN TIE SHEET FOR MORE 1~PF0. ) CLaiVE i (a,pyE 2 y RADIUS- ]510.00' RADIUS- 1477.00' CIiO~ 171~62~~ - CFi0F~~286~ o7•ie° ` (`' /VS, NBi 03'07'E NB3°04'iB'E y ARC TANGENTS 1 71' ARC LENG~N~2B6.70' * ~ •• IN- N77°47'39'E IN- N77°30'39"E ~ G ~ G our- NB4°iB35•E our- NBB°37'57'E s NEW Rte( MONO t tiO '••..w• yOQ' ~ SURV~ ~ GRAPHIC SCALE i"=100' PREPAREneY: S(A4VFYIAAC~ N1AC 1286 GTJi. 'E' 0 100 200 300 ~FVN • ~' X17 PHONE (716) 2/6.7629 THIS DVSTHIlENT DRAFTED BY: _,10$EpH W. GRMBERG 5-2295 JOB NO. 06017 ~ 1 OF 2 Vol 20 Page 5008 St. Croix County Map Output Page Page 1 of 1 St. Croix Count Ma in SWlHSW7H SE1H-SW1H ~ ~~~~ ~ j ~ 5 ~~ .~ CJ 5 4 ,~,~' ~ ~ ~~ i ~°~ . ~ - - .~ , ,_ _- -- 1 : ~~ ~ f MN 1 H-MN 1 H ' ~ ~ 1H-NW iH t~M/1H-PE 1H g ;. .'~, Lan 3~j~ l ' E r i ~.~F,i ~ ~.. ~ „ --"'` csa! rota: z3as ~...~, Lan LaTT d ~:( .. j~. ;. 9 s X ~QI ~~ 1 I /1//NA ` ~` ~ ~ ~ ~: Lan SW714NW1H SEIHNWIH ~ ~~~ SW1HdJE1H g °' - 2iI . / ~~ 1, t. Croix County Planning Department 1101 Carmichael Road LeBe!nd riaiiaclp al 6 aaslda k s 3L'd'""'°^~ ~ oer~ye d ~~~X Mss ~ ~~' Hudson, WI 54016 ~ Phone: (715) 386-4674 Rona O Ra~ra~ed DISCLAIMER :The information contained on this map is advisory. Map Orai rage Streams accuracy is limited by the quality of the public records from which it was na... prepared. It is not intended as a substitute for an accurate field survey, nrrrena! Mean AERIAL PHOTOS :Aerial photography is date-sensitive. Features that exist hkmnl Ikn! ^J3 rCanf "'bk' presently in the County may not be present in the photos. http://72.21.230.178/servlet/com. esri. esrimap.Esrimap? ServiceName=StCroixOV&Client... 6/30/2005