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FORM - STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER k1x& \7AbIC TOWNSHIP !7A. 5C4\
SECTION T-30 A9-W
ADDRESS ST. CROIX COUNTY, WISCONSIN
Huosom U1 SC CSI
SUBDIVISION LOTLOT SIZE I-
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
i
li~ G l2c)~>M
6 D
INDICATE NORTH ARROW
BENCHMARK:Elevation and description: IDU.O ~N4Ie T(~o1~
Alternate benchmark
qp-
SEPTIC TANK:Manufacturer: l )eAs Liquid Cap. 000 I.
Rings used:-3-Manhole cover elev:M.veinal grade elev: 0
Tank inlet elev.: 100-A -Tank outlet elev.: 9 T98
No. of feet from nearest road: Front , Side , Rear Ft. V r X
From nearest prop. line:Front , Side , Rear Ft. 10~
No. of feet from: Well d rl~ Building:
(Include this information in the above plot plan)
(2 reference dimensions to septic tank)
SEE REVERSE SIDE
PUMP CHAMBER
Manufacturer: Liquid Capacity:
Pump Model: Pump/Siphon Manufact.: Pump Size
Elevation of inlet: Bottom of tank elevation
Pump on elev.: Pump off elev.: Gallons/cycle:
Alarm: Man.: Switch Type: Location
Distance from nearest prop. line: Front_, Side, Rear Ft.
Distance from: Well Building
Shot oo'4U 105.14 HeAOeR 97.74
SOIL ABSORPTION SYSTEM 146• 3 ENO 97-S8
Bed: Trench: Seepage Pit:
Width: Length 6 Number of Lines: 2) Area Built-4
Exist. Grade Elev. 101,QProposed Final Grade Elev. Q - d
/
Fill depth to top of pipe: 4 a 11
No. feet from nearest prop. line:Front Side , Rear''< Ft.3 )
No. feet from well: 10 N No. feet from building
HOLDING TANK
Manufacturer: Capacity:
No. of rings used: Elevation of bottom tank:
Elevation of inlet:
No. feet from nearest prop. line:Front Side Rear Ft.
No. feet from: Well building nearest road
Alarm Manufacturer:
INSPECTOR:
DATE: O PLUMBER ON JOB:-
LICENSE NUMBER:- M 3 q M
6/90:cj
1"1a0C)C)aa0
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING
LABOR & HUMAN RELATIONS DIVISION
P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION
DI WI 3707 State Plan I.D. Number:
N . ,4,Shec.33,T30-R19 (If assigned)
Town o of St. Joseph CONVENTIONAL ❑ ALTERATIVE
52nd St. ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound
NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE:
Kent Gabl 412 Birchwood Courts, Whi Bear
BENCH MARK (Permanent re rence point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. EL CST HER PT. ELE
Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number:
Jim Bomneester 404 5 oix 128817
SEPTIC TANK/ Cover= of
\ti MANUFACTURER: LIQUID CAPACITY: ITANKINL TANK OUTL WARNING LABEL LOCKING COV;R~'
r PROVIDED: PROVIDED:
s 6 ~ S GG~ wC lei / 9?, 9 41 YES ❑ NO ❑ YES NO
VE+FT DI A.: ve"T MATL.: HIGH WATER UMBER OF ROAD: PROPERTY WELL: BUILDING: I VENT Tt) FRESH
r AIR INLET:
i
ALARM LINE: to
h• C.O. tr C,O, : FEET FROM
❑ YES NO CoC ❑ YES NO NEAREST -411'
MANUFACTURER: BEDDING: ACITY: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO
GALI)RIC PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDIN VENT TO FRESH
(DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET:
PUMP ON AND OFF ❑ YES ❑ NO REST
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LEN DKING:
or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN
the soil is dry enough to continue.
CONVENTIONAL SYSTEM /O. ' 5 S{4-m ELeU,
WIDTH: LE NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID
BED/TRENCH , TRENCHES: / MATERIAL: DEPTH:
DIMENSIONS -:36
GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATE IAL: O I TR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH 8 FEET FROM BELOW PIPES:
ABOVE COVER: ELEV. INLET ELEV. END: - V0 PI S: LINE: I AIR INLET:
(oil 7. 5 ' ...XXXAlllll NEAREST Z LSD 7b /
MOUND SYSTEM: Y I.3
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
EDEDMULCHED:
SE
DEPTH OVER ENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: 7OD
CENTER: EDGES:
ES ❑ NO ❑ YES El NO ❑ YES ❑ NO
PRESSURIZED DISTRIBUTION SYSTEM:
BED/TRENCH WIDTH: LENGTH: TRENCHESNO.OF LATERA PACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER.
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR. PIPE MANI MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MA IAL & MARKING:
ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.:
ELEVATION AND
DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATER AL 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
C/ C
etain in county file for audit.
Sketch System on
Reverse Side. SIGNATU / TITLE: t n
SBD-6710 (R. 06/88) PLC
SANITARY PERMIT APPLICATION
OILHR In accord with ILHR 83.05, Wis. Adm. Code couNT5
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than ❑ ~i.UV 2vious 8% X 11 inches in size. application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROPERTY OWNER ~a PROPERTY LOCATION
je, N \j I f,'/4Si,Jl '/4, S T N, R E (or) W
PROPERTY OWNER' LING A DRESS y LOT # IV IQ BLOCU yA 0 (J. ly, STAT ZIP CODE PHONE 11 r ER SUBDIVISION N ME R CSM NUMBER
-oil 'ab
II. TYPE OF BUILDIN : (Check one) ❑ State Owned VILTMLAGE J7wc NEAREST R A
N OF - 1115
❑ Public CR1 or 2 Fam. Dwelling-# of bedrooms AR ,I
N NUMBER(S) 090- a 003-'7G-0Q
III. BUILDING USE: (If building type is public, check all that apply)
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. XNew 2.E] Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.0 Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
14 ❑ System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE
REQUI ED (sq. ft.) PR t OSED (sq. ft.) (GalsTi /sq. ft.) (Min /inch) 161.0 ELEVATION
~Sc~ I to J Feet Feet
VII. TANK CAPACITY Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete structed Con- Steel glass Plastic App
Tanks Tanks
Septic Tank or Holding Tank 0 et.
0 1 El
Lift Pump Tank/Si hon Chamber
VIII. 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 Stamps) MP/MPRSW No.: Business Phone Number:
IAmets -t - 31 Y lS 38 C- q 03
Plumber' Address (Street~C~ity, Stat Zip Code): , 1., VS 0
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (includes roun water a e Issued Issuing ent Signa No Sta
Surcharee)
F8~proved El Owner Given Initial / f~ /C C
Adverse Determination 7
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety s 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 yodrbnsite 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 tarks; 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; close volume; elevation differences; friction loss; pump
performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if
required Nay the abunty; E) foil test data on a 115 form; and F) all sjzing 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 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.
j ~ f As~+
Owner of property aAa1-E
Location of property 1/9 1/9, Section s , T 30 N-R_?W
Township 4Z% 9 a.~;:Y.Af
'
Mailing address 2 A (?A-"I
Address of'site
Subdivision name
Lot number / Nou. ZY• ~s7e rl "3 ~rGd 79a P•c'. ~?.rjSeS
Previous owner of property
Total size of parcel
Date parcel was created 'V00 s9 IS/,
Are all corners and lot lines identifiable? Yes No
Is this property being developed for resale (spec house)? Yes N0
Volume 8e and Page Number ?Y-e~xs recorded with the Register of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER, and
the SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if
available, would be helpful so as to avoid delays of the reviewing process. If
the deed description references to a Certified Survey Map, the Certified Survey
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 Document No. y6 '31 ; and that I (We)
presently own the proposed site for the sewage disposal system (or I (we) have
obtained an easement, to run with the above described property, for the
construction of said system, and the same has been duly recorded in the Office
of the County Register of Deeds, as Document No. '54631-1.4
Signature of Owner Signature of Co-Owner (If Applicable)
Date of Signature Date of Signature
~,is .
DOCUMENT NO. wARRANn D= THIS SPACC ASSMOVga ►OR 09CONDO040 DATA
STATE BAR OF WISCONSIN FORK 2-IM
463141 911p,,,
REGISTER'S OFF10-
ST. CROIX CO., WI
Bruce ..J...Bolles .aril Sharon.L.. Boll.ea...as. hi.s..w.le..... Recd for Record
and_in..her..own .right .
at J i 11 1990
11.20 M
conveys and warrants to Kent,-W. and..Teresa.K...Yorlc:~able T 1 20 A M
husband and wife,..as. survivorship..mar.ital..prope>rLy........ of Doe&
. AITUAN TO
. .
. .
the following described real estate in .........$t., .Cr.1\__.............. County.
State of Wisconsin:
Tax Parcel No:....Q3Qr20Q3n7.Q....
(See Attached)
FM
i
This . is not homestead property.
TK) (is not)
Exception to warranties: Existing highwavs, easenk-nts and ri flits of way of record.
Dated this day of October 19 t;(j
(SEAL) ISF'A1,
• Bruce J. Bol les
(SEAL) i~. l . ♦ f r 1
(SEA I.t
. . - _ . Sharon L. Wiles
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN
} se.
of tit. Croix County.
authenticated this da I
'
19 Personally came before me this day of
0L.U JL•r , 19 .t.3U. the above named
13:.uce .,1. Biullcs..and Slxiron„L. Ka111c!s.
•
hustktrxl. a1x1 hilt:
TITI.F,: MEMBER STATE BAR OF WISCONSIN
I i f not, , `
suthorizee by 1 704.06+, Wis. State.)
to me known to he the person i who fxvcuted the
foregoing instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY
Attorney..Dauid. 1 _..Esueen
621 2nd St., Ihxlson,_ T 54010
Notn•c Pnhlic St. Croix County, wit
(Signatures may be authenticated or acknowledged. Both Mc rttrnmiisainn is permanent. (If not, state exp';ratlnn
are not necessary.) date:
to
•Namas of bersons missing in any eaparlty should be typed or printed Mlom th- sitnatur..
thrwrFORK N OF - WISCONSIN
Sttrk No I "IM4I
ATTACHMENT TO WARRANTY DEED
Part of the FiSWZ of Sec. 33-T30N-11191AT, Town of St. Joseph, described as
follows:
Parcel A: Lot 1, Certified Survey Map, recorded November 29, 1978 in Vol. 3,
page 740 as Doc. No. 353565.
Parcel B: Commencing at the Southeasterly corner of the above described Lot
1; thence S42027'43"E, 149.94 feet, along, the Northeasterly right-of-way line
of a 66 foot private road easement; thence N12023'03"F., 509.4) feet; thence
N55048'00"W, 257.13 feet to the Northeasterly corner of said Lot 1; thence
S00°14'45"E, along the Easterly line of said Lot 1, 531.07 feet, to the point
of beginning.
Parcel C: A parcel consisting, of the Northeasterly half of a 66 foot private
road easement abutting the Southwesterly side of said l,ot 1, described as fol-
lows: Comtmencing, at the Southeasterly corner of said 1,ot 1; thence N42O27'43"
W, 66.40 feet along said Southwesterly side of said Lot 1 and Northeasterly
right-of-way line of said road easeme•it; thence N55048'00"W, 255,00 feet to
the Southwesterly corner of said Lot 1; thence S(X)014'45"F., 40.02 feet to the
centerline of said 66 foot private road easement; thence S550481(X)"F, 228.50
feet, along said centerline; thence S42127'43"E, 62.55 feet, along said cen-
terline; thence N47032117"E, 33.00 feet to the point of beginnin),,. A parcel
consisting of the Northeasterly half of a 66 foot private road eascnient abut-
ting the Southwesterly side of the parcel described as Parcel B above, de-
scribed as follows: Commencing at the Southeasterly corner of said hot l;
thence S47032'17"W, 33.00 feet to the centerline of said 66 foot private road
easement; thence S42027143"E, 142.48 feet along said centerline; thence N60°
16'11"E, 33.83 feet to the Northeasterly right-of-way line of said road ease-
ment and the Southeasterly corner of Parcel B descrilx~d above; thence N42°27'
43"W, 149.94 feet along the Southwesterly side of said Parcel N .ind the North-
easterly right-of-way line of said road easement to the point of heginninp.
TOGETHER WITH a non-exclusive private road easement over it strip of land hf,
feet wide located in the S14; of said Section 33, heirq,, 33 feet on each side
of the following described centerline: Commencing at the Southwest corner of
said Sec. 33; thence West 57.61 feet along the South line of said Sec. 32:
thence North 628.97 feet; thence N87°55'(X)"F., 120.15 feet; thence N=+40 48'tF,
444.26 feet; thence N01041'00"E, 761.23 feet to a point on the centerline of
a town road !mown as Hillcrest Drive, which point is the bep'innirnp, of the
centerlim of the 66 foot non-exclusive private road easment descritx,d herein;
thence East 586.64 feet to the center of a 50 foot cul-de-sac; thence S45°u5'
54"E, 131.90 feet along the centerline of wi easement shoals on Certified Surk•ey
Map filed narch 8, 1976 in Vol. 1, page 218 as Doc. No. 331875; thence Sl2°
08'00"E, 195.10 feet; thence S55048'00"F i0►3.04 feat t- the !asterl~ side of
said Certified Survey Map in Vol. 1, page 218, a! the .-,otahea,tvi iv end of' the
easement shown thereon, which point lies SOO'14' 45"F, 40.02 feet of' the South-
westerly corner of Lot 1, Certified Sure Map filed Noy mhr 211, 1078 in Vol.
3, page 740 as Doc. No. 353565; thence S` F, thence 5420
27143"E, 205,03 feet to the end of the centerline of' the hh toot non-exclusive
private road easement described herein.
STC - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER '4~" A111 2 s4 94'3[C
ROUTE/BOX NUMBER FIRE NO.
CITY/STATE ZIP
PROPERTY LOCATION: 1/4 -S w 1/4, Section 33 , T 30 N, R W,
Town of S`i ->r , St. Croix County,
Subdivision , Lot No.
Improper use and maintenance of your septic system could result in its premature
failure to handle wastes. Proper maintenance consists of pumping out the septic
tank every three years or sooner, if needed, by a LICENSED SEPTIC TANK PAMPER.
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 for a MAXIMUM of
$3000 of the cost of 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
systems properly maintained.
The property owner agrees to submit to 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 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 Department of Natural Resources. Certification
form must be completed and returned to the St.Croix County Zoning Office within
30 days of the three year expiration date.
SIGNED
DATE
St. Croix County Zoning Office
St. Croix County Courthouse
911 4th Street
Hudson, WI 54016
(715) 386-4680
Sign, Date, and Return to above address
SAFETY
DEPARTMENT OF REPORT ON SOIL BORINGS AND &BUILDINGS
INDUSTRY, DIVISION
1. , LABOR AND P.O. BOX 7969
HUMAN RELATIONS PERCOLATION TESTS (115) : MADISON, W153707
j ; (1-163.090) & Chapter 145.0451
'
TOWNSHIP/Nowmaeft=: O. 8 : sUSDIVISION NAME:
NE %/4 SW4 33 %T 30N/11941-4 St. Jose n a n a n a
COUNTY: ADDRESS:
UYE R'S NAME: MAILING St. Croix Bruce Bollea 1549 Goodwiew Ave. N. Oakdale Minn. 5511
USE DATES OBSERVATIONS MADE
j ' ®Residence 3 n/a ®New ❑Replaca DESCRIPTION FERCOLATION
11-9-88 11-9-
4
RATING: S- Site suitable for system ' U- Site uroultable for system
ICONVINTIINAL: ND: O T NK: RECOMMENDED SYSTEM:loptional
s ❑U S ❑U ®S •DU IS []]S ®U ❑ S @U 1805 conventional
II Percolation Tests are NOT required DESIGN RATE: /
yj If any portion of the tested area is In the
under s.1-163.01)(5) (b), Indicate: n/a Floodplaln, Indicate Floodplain elevation: n S
decimal' r' PROFILE DESCRIPTIONS page 42 &D2 v
BORING R EPfH ELEVATION DEPTH TO ROUI O AT R-INCHES CHARACTER I CKN ,C R,TE T R AND DEPTH
V T BEDROCK IF OBSERVED SEE ABBRV. ON BACK)
B-;1 71.25 100.63 none >7.255 50bl.s.1. 2.08bn.l.s.&gr. 4.67bn.c.s.&gr.
B 2 7.74 100.61 none >7,74 .75bl.1. 2.08bn.ail. .58bn.l.s. 4.331in.c.s.W.
B_ 3 7.67 99.71 none >7.67 .715bl.1. .92bn.l.9.&gr. 6.00bn.c.s.&gr.
r M
• B. 4 6.75 96.29 none >6.75 .58bl.1. .75bn.sil. .50bn.l.s.&gr. 4.92bn.c.s.& .
B. 5 6.75 96.64 none >6.75., .58bl.1. 1.00bn.l.s.&gr. 5.17bn.c.s.&gr.
B, ,
I ~
` -9 decimal' PERCOLATION TESTS
DEPTH. WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES
MINUTES
NUMBER 1 AFTER SWELL IN INTERVAL-MIN. PERINCH P -PERIOD RATE P•1 3.90 none <3 6 6 <3
P. 3.92 none 3 6 6 6 <3
{ P• none
3 6
6 <3
{ ;I P•.
P-
P-
I
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate sale or distances. Describe what are the hori-
sontal and venial 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. .
96.71
SYSTEM ELEVATION
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%
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tit
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tE.T.-
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1, 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,
I } A print : TESTS R COMPLETED ON:
> Gary L. Steel 11-9-88
ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER opt nal
988 N. Shore Dr. New Richmond Wi. 5401
T SIG R
f.
S DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tenor.
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CROSS SECTION
Approved Vent Cap II
'•r • Minimum 12" Above Oro/
Final Graii~_.____~
A" Cast Iron
Above Pipe Vent Pipe
To Final Grade
Marsh Hay Or Synthetic Covering
Min. 2" Aggr.eg"O _
Over Pipe
Distributio~~ ► Tee
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a Aggregate ~Q Perforated Pipe Below
• 7 Beneath Pipe << -Coupling Terminating T
Hottom of System
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a N LAIND SURVEYING
.
HUDSON , WISCONSIN 54016
(715) 386-2007 '
' I
Name Thomas Seim, Rt. 2, Hudson, Wi. 54016
Address
~i
Description A parcel of land located in the SW 1 /4 of
Section 33, T30N, R19W, Town of St. Joseph, St. Croix ~I
County, Wisconsin, further described as follows: j
:I
Commencing at the SW corner of said Section 33; thence
last, 1285.00 feet; thence N 000-14'-45" W, 1356.63 feet;
thence S 550-48-x•-00" .E, 255.00 feet; thence
S 420-271-43" E, 66.40 feet to the point of
beginning of this description; thence continuing I
S 420-271-43" E, 149.94 feet; thence N 120=231-03"E, ;
509.00 feet; thence N 550-48'-00" W, 257.13 feet; 4,
.hence S 000-141-45" E, 531.07 feet to the point sse I
of beginning. Bearings referenced N 000-221-08" W,.. ?s 9e'
along the West line of the SW 1/4 of said'Sec. 33.' ,°0•0
I'
W
p~ 0 2.00 ACRES o
0
40
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EAST F
1285.00'
S.W. _COR: SEC.- 33
ST. CROIX CO. MO
State of Wisconsin 0 IRON STAKES DRIVEN
County of ST. CROIX ) ss. SCALE OF MAP - I INCH = loo' Feet O IRON STAKES FOUND
, GENE C. SHAFFER , registered Wisconsin Land Surveyor,do hereby certify that
~n OCTOBER 4th 19_Zfi_, I surveyed the above described and mopped property according to
the official records and that the accompanying mop is a correctly dimensioned representation to scale of the boundaries,thot
,FS buildings and improvements lie wholly within the bpundary„~Ines, and that no encroachments by adjoining owners appear
tram said survey. .1AVa Y• f~
Map No. 78 -63
CIJUDSWN Drawn By R. M. w. •.t
4L 0 10
ilN4 SU R`I~'►~~~
nn_E_197~ CERTIFIED SURVEY MAP atcft4 ~
SW 1/4 - SEC. 33, T 30 N , R 19 W
REPLAT OF C.S.M. 2-432
APPROVED
AP?COVAL CF ►ii~J .\t:it:.ri: sUsu~YiSIGI
NUV 17 973 DO::S NIT f:. A.+ APB ; UV,",L FU.
BUILD:PIG SITE OR SEP11C SY. TLiM.
q ST. ciom, REFER TO
,jG
UNPLATTED
sso LANDS
ul, O
BEARINGS ARE REFERENCED cm !sa ss O
TO THE WEST LINE OF THE r •00•
SW 1/4, SEC. 33
C,.' _ ( REC. AS N 000- 221- 08" W) 30
sso
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O SQ
N /O' 100' 50' 25' 0' 100
~ Py
SCALE
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LEGEND
C.S.M. 0 M In
1' 218 Z o -1" X 24" IRON PIPE SET
LOT I WEIGHING 1.68 LBS./LIN. I
w
3.00 ACRES FOUND 1" IRON PIPE
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LANDS
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3 I~\`9jc°i~Tc° oaf O. N S > GENE C.
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C.S.M. SHA 3 1 0 00"r t
5-1325 `
I - 2 18 HUDSON
CD. S.
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EAST THIS INSTRUMENT DRAFTED BY
R.M.W.
1285.00' ' 78.-63
S.W. COR. SEC. 33
ST. CROIX CO. MON.
vuL. 3 o ;
_JL
CEtiTIFILll SURVa MAPS Volume 3 Pal-o ?1r0 '
Imo. Q1p__. n:Jf1TV n.•, r .
ti
' l DOCUMENT NO. w~~TMTHIS wACa aPawso FoaecoROlMO aA1A
STATIC BAIL OF WISCONSIN FORK =-I M
' '-`463141 SVC'. , ` PA61 REGISTERS OFFICE
_
ST. CROIX CO., WI
Bruce..J....Bolles. .and Sharon L.. Bolles.-.as his.-Wife Recd for Record
11 190
and.. in.ber..own..right_...
_ . _ or
11:20 A.M
conveys and warrants to Kent. ..W..-Gable. and-Teree-sae K...XUA.C. ble
.husband and wife' ..as. survivorship .Marital..Propet:L
MONNr M 0euds
119TVNN TO
i
.1 .
'F .
the following described real estate in . .....$t., .Cr01\ ........County,
State of Wisconsin:
Tax Parcel No:....00::20U3-70....
1
i
(See Attached)
f
s
Sk
FM
This - As not. , homestead property.
*S) (is not)
Exception to warranties: Existing highways, easenMints tend ri i j,,Ls of wa% r(Tcord.
f 19
Dated this .............day of October till
(SEAL) y/ /1.e (t (SEAL
Bruce J. B9 11rS
(SEAL) IL x t ' (SEAL
• • Sliarcui L. Bulles
AUTHZNTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN
St. Croix County.
authenticated this .------.day of 19..... Personally came before me this dad of
0L.L4A)L-r , 19 tlU . the above named
1i~ L:e J. bulluti. and Sharan,J,.. 1ba~1L:S.
' tlusbalX1. and wilt
TITLE: MEMBER STATE BAR OF WISCONSIN
li?not,................. _
authorized by 1706.06. Wis. State.) to me known to be the person 3: Wko f*ecuted the
foregoing instrument and acknowledge the same. `
THIS INSTRUMENT WAS DRAFTED BY
Attorney..Dauid., I _ES treen............ _ ,
621 2nd St. Hudson WI 54016
) ...............7 Not:,-e fuhlir (:I rountc, W1,
(Signatures, msy be authenticated or acknowledged. Both Mc 1 wvimis.;om is permanent (if not, state exp.ration
are not necessary.) date- 19 1
oNeaa of Passes sieatae is any capacity should b• typed or printed below inr,r assns to rc.
8TAT9 BAR of WISCONSIN Stock No. 13004
WORM NP. t - Nat
Parcel 030-2003-70-000 02/13/2007 12:12
PAGE 10F 1
Alt. Parcel 33.30.19.3648 030 - TOWN OF SAINT JOSEPH
Current X 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
O - ANDERSON, KELLY MARIE
KELLY MARIE ANDERSON
536 BIRCH LN
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 536 BIRCH LA
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 5.000 Plat: N/A-NOT AVAILABLE
SEC 33 T30N R19W NE SW LOT 1 OF CSM Block/Condo Bldg:
2/432 AS REPLATTED BY CSM 3/740 & IN VOL
587 PAGE 231 AMENDED P 233 ALSO BEG. Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
SETLY COR LOT 1 S 42 DEG E 149.94' ALG 33-30N-19W
NETLY R/W LINE 66' PRIVATE ROAD
EASEMENT, N 12 DEG E 509', N 55 DEG W
more...
Notes: Parcel History:
Date Doc # Vol/Page Type
01 /31 /2005 786188 2739/609 QC
03/13/2002 673397 1853/50 WD
07/23/1997 1129/48 QC
07/23/1997 883/404 more...
2007 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/08/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.000 108,600 263,200 371,800 NO
Totals for 2007:
General Property 5.000 108,600 263,200 371,800
Woodland 0.000 0 0
Totals for 2006:
General Property 5.000 108,600 263,200 371,800
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 119
Specials:
User Special Code Category Amount
I~
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00