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030-1080-80-120
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I ' C a 0c) L N C Y > 4 O Cl) i c m - c ~L i E a> Y m aL o rn o.o~ E-0 v In cu U) _ d~ E N m z m c =a p. m -p a~ M U. p m CO N N 1 U w .C E o 0 c Q cc O U co V I co QN Z £ rn Z m y oo°~ CL OD N F- U) C O O O Z fA F- ~ N Z c E u 'O N M N m y U) 0 CL - o a) Q O N Zco Z N Z rn d 0> N N E 0 N Mly Z\ a C yl C a ( c N y ` 9 p ~ o o a a z 000 • CL CL CL a N s a o 0 ul J U = m m z° D ° ° - o o E _lz CO co a L U) O v ~ Q Z ro C d r~ _ 3 yr c ~l Y O~ O 'O E CO co o o F- ~ c c a o 0) c> Ci 0. a~ a~ 7 (n N Y2 Z a) ..Oe o M_ 0~ E~ ~ t c) a) >a) m CO CO ~ • O O N U) > M O Z n H Z U) rr E a~ xt a L a T • eC CL N U of y C r"a w' E i 7 aJ A U a O U) U s Id" gig 1/" ;24' 7 o / Cam, , _a - / - u~ L =D ~ gn lvi G/'7~~ "Aft o ~980 i~r190~ *f Of ID .d tj i 1/~ PLC'.!' • 7v 1' Cr. c~ TIFIEta UFeINEY ~ Located in the SW1/4 of the SW 1/4 of Section 28, T30N, R19W, Town of St. Joseph, St. Croix County, Wisconsin. UN_PLAT_TED LANDS Surveyed for: Darrel Wert, S 00'09'28"E 373,797 Rt. 1, Park Lane East line of the SW 1/4 of Hudson, Wi. -the SW 1/4 of Section 28 54016 APPROVED a 4.4 v, a L Q 0 a m 198G SCALE IN FEET 1"c 1501 NOV U 6 0 11 loo 0 100 250 -S1. CROIX COUr11 Y m o a m N W CO~PKHCNSIVE PARKS PLANt" J G) N w SV4hZONING COMMIT;U z W W Id U ct1 U n1 iu in I I r-1 ¢ a ¢ o L` 4i .ri 4i n u N.0 O Q\ O t` w W¢ I t I m o FW- 4J - +3 00 C; M N cr\ Ic Co X! Bearings referenced to M b0~ bn / m o the South line of the a • a: • a J a SW 1/4 of Section 28 Q b0rs. Iw , ~141.,~ re t- Z0 N ^ho 0 l0 r ~'ti O~'C7 v ~l N W O ,Qr`~1{3it~itJf0/✓~ U~ H r~ of of<~ CiC~1\(Sl✓~.+o~, ao c.. Q Cl- v `b W M•IN4 \0 F-I Co V11 JAMES E. RUSCH V V) m 0I 1,-i 1 S-1376 a 01 C c Hudson,` w Z nl W a Q1 _j 0 J1 J O w........r•• ~a~4u N ~ ~ / tr 0 g0~ 0a' •~Mi Q o / ` ~oQ~ y o, ' c^~~1 W) n~ 3 ~p M o G1N ~ / O r 0 h NI S 00.47' _574,28 a ~ 'c . L 1 rC18 IJ ~I.' Q~ 286.64 ~p r V v~ Q3 M p fV o 0 O Q/ U td v o/ O N U C 0 wJ "i ILt•i y " O 4.1 Q 4.1 0 m I w l 0 00 O 0, 1 i ` I r. 7"'• U) .s: 1 p V\ C ~ 011' 0' ~22"F o L-4 ' ~ u 'OQDu bA i O 0 C4 - z a \ o l= r I cn \ . Uj ` Z Q4 o+,~ Q+ rd 'I o\ Y (14 W V cc La to 0 1'p v o n ~O U r+ U \ ad's ° N C C. .tb, `Ln z I F-1 v 7 I ` 1+:~ (yam N 'v 'V CQ C14 Q CO 14 7.1 1700.00' 33g.4t3 /099[ o E~1 .3~ V N GJ' 47'37"W 53.31 ~``rs ~ W 1/4 (°orner M West line of the S1~'~' 1 f of Section 28 u a CJ - R.EQEElD LflPL.A'rTE(7 )._ANQS COD:! Y ECTION CORNER ^ 4__ 0 1" ROUND IKON Plpk POUND 0 I" X 24" ROUND IgGN PIPE VIFIGHING I.GD I.OS•/ 1 INEM Fl. T qt3~ ° 49S Voluble 6 Pale 1735 i N.cmNN. conw•r~ ~ Stock No. 26273 FIV=D FEB 2 61993 L` 5 1 49550`7 o JAR~Sto ~i Deeds SL Croix CO.. W1 CERTIFIED SURVEY MAP Located in the SW j of the SW ' of Section 28 (also referred to as Government Lot 3) T30N, R19W, Town of St. Joseph, St. Croix County, Wisconsin. Surveyed for: Darrel Wert Surveyor's note: This Certified 10712 E. Apache Trail J1 Survey Map is prepared to correct Apache Junction, Az. 85220 and replace that Certified Survey Map previously recorded in Vol. L E G E N D is on SHEEP 2 PAGE 2 6, Page 1735, St. Croix County Register of Deeds Office. NORTH LINE OF THE SW 1/4 OF THE SW I S 89 ° 21'32" E 720.12 381.38' 262.67' 76.07' n D ( LOT 4 m ,T'... NOTE: LOT 4 IS Z •"tj'r~~ SHOWN HEREON PER fi -9 THE SURVEYOR'S UNDER- rn STANDING OF A VERBAL -I REQUEST BY THE TOWN 2/07/`)3 °a cp BEBOARD TO ACH LOTS WHICHHWAS Q ar PURCHASED BY THE a y; 4 TOWN IN 1965. W1/4 CORNER z a' co SECTION 28 0 Wo N e w ;vz a o rn rn w W = co nrn QF a o zz rrn m ~ o 0 v 0 to 47 m r n w RC n mmZ w N D U m m LOT 1 y3s k .i -4 rn G) X M i 2ef P. G/ cN Z ~RCCORQ S 7,30/3/9 y /965 ~ ` .4*0 O Rol o -4- - a (1) qS .9 >e LOT 2 g, f 0 o o~ co A MAGNETICI M m ; Uf N) Z rn O w ~ Water Ljne as of 7/18/1986 C Oi f12 O - >2o3 0 VOL. 2%p, 493 -srsi',4 2 - L ? 33 /36 6049"e m Gi LOT ~3 t0 ao LOT i S~2 aegis>,©` 1, r_0 m O LOT 2 0 C?DT Oa39 l 4.2 , DETA2 . 426 446;60' P, 368 J 852.28 / 1967 wJ POINT OF BEGMISIMa N 89°33'20" W 967.31' 95. Water line as of 1992 rv_SW CORNER UNPLATTED LAND$ $ I/4 CORNER SECj10A1 28 _ _ H 89°33'20" W' ♦~2562,14' SECTION 28 SOUTH LINE OF THE SW 1/4 OF SECTI N 28 • T 30N, R19W VOLUME 9 PAGE 2596 THIS INSTRUMENT DRAFTED BY JAMES E. RUSCH -SHEET 1 PAGE L OF 2 SHEETS e mp ~ n o r*% P + er r; ( I I F lJV V1 LA N Y~ iZ J\j m N V ~ ~ 11 Tb kCw It" in ail Q o r ` x 7r N o o ` >r -v Imo- - p # A N , ~ N ~ ~ T: A t1 00 1 * O N d - - - - - - 1, ~~T 3 ~ o 'F aZ 7om -t r- D I ~ O` ~ W von . /c,,* 61 q US TMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS -INDUSTRY' C DIVISION N LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX 7969 HUMAN RELATIONS N WI 3707 (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: TOWNSHIP LOT NO.: BLK. NO.: SUBDIVISION NAME: SW '/4 s4 V44 -Z% /no N/R 19 E (or) W 03,e P 1 c5M Yoe 6 173s COUNTY: OWNER'S Wdyff9&- *ME: MAILIN ADDRESS: Si-CeoiX '75AIvk ,«LCR USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DES RIPTION: ROFILE NS: LA N TESTS: ❑Residence uN~ OrNew ❑Replace 7 440 Mpy 4,n~ MAYts RATING: S- Site suitable for system Ua Site unsuitable forsystem ~ 6 4Z ~p ~z 1 CN f N-FIL 0STI~U . MO NS.OU IN-G US RE: SYSTEM-IQu -1 E] DING u • RECQMO^EV iO'vg M:(fPtional) lai If Percolation Tests are NOT required DESIGN L.IdRATE: If any portion of the tested area is in the under s. ILHR 83.0915)Ib), indicate: SS ' Floodplain r,, , indicate Floodplain elevation: v PROFILE DESCRIPTIONS c BORING TOTAL PTH T GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH la ELEVATION OBSERVED HE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) - EST. B' a8$ O N lr S-ZS A LsCrs 14"&LL 3 z' S L Z o',$ ~a~G l'1!ar B- 2 10,41 /nz ZJ £ > /U• Al ~i "BATS 3z1R*wS1 l -7 '&oMS1~c 3 r?eNMsloe B-A • -i Az 9 s• Z9 No }7.4"Z g''e ► s n'69S As 48 -'8.el/ M 5 B- Z > lt4Z ,6ccTs /~"'8 NS.c. 7z"Rn1~lS-~42 89'~f3eNMS~~2 B- S Z 3 Z-I +v1 > 7.33 Q,, « ,seis, "RnMs-~'uk S6"'BRNMS~~2 B- D~C PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER I=913 AFTERS WELLING INTERVAL-MIN. PERIOD 1 PERIOD -77- PERIOD 3 PER INCH P- 1 Z•7.6 oNK 41 •40 > > y < 3 P_ 7- 7.4o 0 > P- 3 .70 0 40 Z > > L P- P jrL AT1 F A~ ~ L P. PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. ascribe 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 an the direction and percent of land slope. SYSTEM ELEVATION a/.7U _ _ µ ~ C tY L! + p St~oP A f~~ 4_ I _ To 1 s~j o►u r - - _ s~ 2 c' 1 ' ill -3~'~ (I I as- - I : . E _ col ' s Z I f ii 3 Z: i I, the undersigned, hereby certify that the soil tests reported on this form were made by 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. NAM (print : TESTS WERE COMPLETED AQVt~Y ,c ON: ~G14w5a JOINN S1nt JUkVE//N(, MaY 14 /990 ADDRESS: CERTIFICACON NUMBER: P ONE NIJMBOE (ptional): O7 SEco N, 5T fluLl.-Orv 1A ~3 66~1J 00~~ 99 000 CST SI ATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) - OVER - L_ bEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING LABOR W HUMAN RELATIONS DIVISION P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION DISON WI 53707 SW, SW4f Sec. 28,T30-R19 Sfa sgned) Number: Town of St. JOseph t 1❑ CONVENTIONAL El ALTERATIVE Parch Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: Cx DRESS OF PERMIT HOLDER: INSPECTION DATE: Sam Miller 282 on, H I 54016 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.: Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Doug r 2 Croix St. SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑ YES ❑ NO ❑ YES ❑ NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL BUILDING: VENT TO FRESH ALARM: FEET FROM LINE: AIR INLET: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST—* DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVDED: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF ❑ YES ❑ NO NEAREST---* SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: MATERIAL AND MARKING: or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: BED/TRENCH WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID TRENCHES: MATERIAL: PIT DEPTH: DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV. INLET: ELEV. END: PIPES: FEET FROM LINE: AIR INLET: NEAREST` MOUND SYSTEM: Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ❑ YES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ❑ YES ❑ NO ❑ YES ❑ NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH: NO. OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEVATION AND ELEV.: ELEV.: DIA.: ELEV.: PIPES: DA.: DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑ YES ❑ NO ❑ YES ❑ NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST-* Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE: TITLE: SBD-6710 (R. 06/88) 7fflLHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUN 1 ca:l mmmomomm - Y STATE SANITARY PERMIT -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ I~J 8'f x 11 inches in size. c I vision to pr vious application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION : S cv % S cv'/a, S ZS T3 o , N, R /91 E (otrW) PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # ,e, X-*- 291 2.- t CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER ~A oA~ S o/C, 38f- 2-a C-5. M. vof f~4 1-733' 11. TYPE OF BUILDING: Check one CITY NEAREST ROAD ( ) State Owned ❑ VILLAGE : ig TOWN OF: L S JO q.re_k I4JGm ~ea ❑ Public ®1 or 2 Fam. Dwelling-# of bedrooms L AX NUMBER(S) / _aL III. BUILDING USE: (If building type is public, check all that apply) aqo 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 40 Church/School 80 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. 14 New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ 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 ❑ SpecifyType 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 ,4:5-0 t o (S O„ 7 2 <f Z 70 Feet y $d 'Feet VII. TANK CAPACITY Site in allons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New istin Gallons Tanks Concrete structed glass App. Tanks Tanks I _T7_ F1 1 11 F] I F] Septic Tank or Hold! n Tank X opGo ° S~ Lift Pump Tank/Siphon Chamber Vlll. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Sta s MP/MPRSW No.: Business Phone Number:2 Plumber's Address (Street, City, State, ZI Code): _ - IX. COUNTY/DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued ISSuin Agent Signature (No Stamps) Approved E3 Owner Given Initial / Surcharge Fee) ~7- Adverse Determination 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 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% 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 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) • APPLICATION FOR SANITARY PERMIT STC-100 This application form is to be completed in full and signed by the owner(s) of the property being developed, Any Inadequacies will only result in delays of the permit Issuance. -Should this development be intended tot resale by owner/contcactoc,(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. Ownec of property •:Za_/w,7 Location of property S x_1/4, Rectlon ?8' T 3_M-Rf9n Township 51 Sfl s'M jeA Naaliing address .140 zo 8Z_ z'~ aj -r sy~ Address of alto 2%eck 14.40- n&+ subdivision name C. -S, Any ka,/ 0, 7,t Lot number Previous owner of property r rm \!mv~'" Total size of parcel S 914,9 4ege-g e Date parcel was created Ace all corners and lot lines Identiflable? as No Is this property being developed lot resale (apec house)?=Yes o Yoluws=-3 and Page Number as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLONINCt A WARRANTY DIND which Includes a DOCUMENT NUMBER, VOLUMR AND PAOR NUMaRR, and the SEAL OF THE REGISTER OF DEEDS. In addition, a testified survey, It available, would be helpful so as to avoid delays of the reviewing process. It the deed descrlptlon tolerances to a CetctIlled Survey Map, the Cattliled Survey Map $hall also be required. PROPERTY OWNER CERTIFICATION live) certify that all statements on this form are true to the best of my (out) knowledge; that I (we) am (ate) the owner(s) of the Property described In this Information form, by virtue of a warrant deed recorded In the office of the County Register of Deeds as Document No. 9 7 zat7 ; and that I (Ye) presently own the proposed alto for the sewage disposal system (Or i (we) have obtained an easement, to tun with the above described property, tot the conettuetlon of sold system, and the same has been duly recorded In the office Of the County Req~lj}r of Deedsr as Document No. "-7x_o-7 algnatuce of Owner Signature of Co-Owner (If Applleabiel Date of Signature Date of Signature t4 v YV`rV!'rl Grua ~O.r i doom 451.-PA" E474 WAnn" iTA7i OM W1iCONBIN • FOIth1 0. A ~lE 71 ~ ~ tHU ~MAtx kX0[RYtrD'FOaI IItiCOHDINO DATA 'ITS 1 1NTYJn& Yufade by BI' M i -J, Wert RtC18TE~iS, OFFICE ...._..w. ss. CROIX Co.. wis. _ Reed for Record this-_2W„ ' .f grantor. w of ...................e~ ...S~cr4. ~..w._.._..........County, Wisconsin, Ciey of.... 414 -----A. D. 1969 hereby toav s and warrants to...P.~4rr~_.~'ia.: A ey _ St.... ,34.... , M St. Croix County, Wisconsin for the sum of = - - Qne~ dollar (1,002„and other ,good, and ,valuable,.,, R~rURN TO Zr- conscTeratonr......_......_...._....._......_........_....__......_.._._...._.._.. ✓✓~',c/ ~4.. the ,following tract of land tor...~._..._.... _ County, - _ - - i1 Wisconsin : i The Southeast quarter of the Northeast quarter (SEJNE}) of Section 32 and the Southeast quarter of the Southeast quarter (SEJSEJ) of Section 32 and the West half of the Northwest quarter (W}NWI) of Section 33 and the West half of the South- west quarter (WJSWJ) of Section 33, and that part of the Southwest quarter of the Southwest quarter (SWJSWJ) of Section 28, lying south and west of that body of water called Perch Lake, except part conveyed to Arthur T. Kerrick and Agnes Kerrick by deed recorded in Volume 265, page 493, and subject to the buyers interests in those land contracts entered into by the grantor and grantee (and his wife, Beverly A. Wert) with Theodore L. Mackmiller and with Kenneth D. Wert and wife, all in Township 30 North, Range 19 West. In ita Whereof, the said grantor....- ha s.._. hereunto set........... heT...... hctnnd....... and seal...... this ' day of.......»_.., UVL0 _ A. D., 19 9 . • 11.w ......(ss~t) SIGNZ AND SUALMD IN rAY=NCM OS RI-Clin M_ T_ WALIrt ..(SEAL) Jf .....................................(SEAL) Marlys oUmeester (SEAL) ...S to of Wi aslnc 7Aay of.........441*........., A. D., 19.69 t~ .ro X ,,,,,County, } Personally came before me, this.. the above named ........lBle_Alit...f~.I«..!@&r......... _ to me known to be the person...... whoiit+e~~llie .foregoing instr t aiyd10,a ow ad the same. liz, ! . xu h Gwin THIY INBTRUMRNT WAB DRAFTED B i~ ~ J ~y • V NOTARY: r kOtA Public . ...............1t........rO1X..._...........County, Wis. Hugh: F Gwin Permanent m aussion 0 ....R.........._......... (Section 39.31 (1) of the W4cotuln i~We! ~ilg~rrjdea that all inatrtrme 1} al tomi helarlrrecordedtequirca ahall that hire plainly printed or typewritten thereon (Section the name of the grantors, granteer, efats ahdtnotary. Section 59 the time of the person who of govern- agency which, drafted such 1 •igtlall be printed eyPP~~uttea, stomped or written thereon In a legible manna.) WARRANTY DEED ESTATE d2 WISCONSIN ~9„~;ntiee Legal . g("i b eP+s XVRM No. t S T C - 10 5 SEPTIC TANK MAINTENANCE AGREEMENT ~ St. Croix County ~ P3 OWNER/ BUYER a aft _ ROUTE /BOX NUMBE Fire Number :3 R Q,t z- g z--- ty ZIP M CITY/ 'STATE zak_ G 2-- SectionZ~ W PROPERTY LOCATION: T JON, R / Town of-S7 .TbSWiek_____, St. Croix County, Subdivisionc s. M. Kl(-.-P-le,17 Lot number Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Prover maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed .se tic tank pumper. What you put into the system can affect the function o t e septic tank as a treat- ment stage in the waste disposal system. St. Croix County residents may be eligible to recieve a grant for a maximum of 60% of the cost.of replacement of a failing system, whz.c 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 s stems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and .(2).after inspection and pumping (if nec- essary), the septic.tank is less than 1/3 full of sludge and scum. Certification form 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 Depart- ted ment of Natural Resources. Certificatioinfor must be co 30edays and returned to the St. Croix County Zon g Office within of the three year expiration date. SIGN DATE St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 386-4680 Sign, date and return to the above address. r I I z , I ~3 < j I I I x~ ~ i I I L I I -p i 1 I I ~ O ~ I I p I m ; z I I n I I rbn I ~ m I I I I' 1 W 02 I I I I p I I I i r j I I I 1 j j l M l r*1 i I I I I m I I n I 0 ~ I Z j I ~m I z p 1 I I p r I I I vm i I 1 I 'v a I o I ~ j w j '0 1 I I ~ I I I Z W N -Pa m I 0 as I m I ' ® Z "Ar a s ~j ~o Fri p ~ O ~9 X E m V =o ~ r z m -o b m p c 46 z rn 4, m p L :a v% IA r r% -fl A Xj P J TV ~ o P~