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HomeMy WebLinkAbout042-1017-70-150 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 561089 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)J. Permit Holder's Name: City Village X Township Parcel Tax No: Garden, Karen & Steven Warren, Town of 042-1017-70-150 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: Cc ~ o ow, &07.29.18.104C15 TANK INFORMATION EL VATION ATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Ibl-71 Septic- Tom- 3 Benchmark O~ Ong ,-l Alt. BM Aeration d 4 Bldg. Sewer Holding St/Ht Inlet $ CU, 615 q. 9 ~L TANK SETBACK INFORMATION St/Ht Outlet cf. 11 TANK TO PIA WELL BLDG. Vent Air Intake ROAD Dt Inlet Septic / Dt Bottom 766 (09 4/8 Dosing Header/Man. Aeration Dist. Pipe _ < 9 Holding Bot. System Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Nu 00 TDH Friction Loss System Hea TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO . /L4 BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION - 4%, A d4 CHAMBER OR Type Of System: % A UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x essure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Ov xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ® Yes g No ❑ Yes Ful No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: / / Location: 947 107th Ave. Roberts, WI 54023 (E 1/2 NW 1/4 7 T29N R1 8W) /NBA Lot 1 / Parcel No: 07.29.18.104C15 1.) Alt BM Description 2.) Bldg sewer length = f r , - amount of cover = ` 4 1N ,~a t'~•~c~.. S4L Cal o vi Plan revision Required? F-3~ Yes No ~ to Use other side for additional information. ate Insepcto s" ignat Cert. No. Dr4 SBD-6710 (R.3/97) v, CP- o - OD_ - W 1 D J ~ a _ N a - 4 O =ev°:. Safety and Buildings Division county 201 W. Washington Ave., P.O. Box 7162 SanitaryPermit Number (to be filed in by Co.) t ,S P : K V NiD Madison, WI 53707-7162 1Or'"` ~ / Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental untt itted to Proje Address (if different than mailing address) is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS arMY. the Department of Safety and Professional Servies. Personal information you provide may be used oy purposes in accordance with the Privacy Law, s. 15.04 1 (m , Stats. 1. Application Information - Please Print All Information _pazcel # Property Owner's Name N k RR /V GRRQ N (34Z-1-17-70 -~,5Property Location Property Owner's Mailing Address Tj Vp 9q7 /a7 A tJ~ ' Govt. Lot S 'City, State Zip Code Phone Number /1l E. At 0 Section 7_ R Y K (circle one ob~.a1F'S ~ 2~0 - 7 T 1 q N; R Eor U. Type of Building (check all that apply) Lot # Subdivision Name s O'I"or 2 Family Dwelling - Number of Bedrooms oC. Block ❑ Public/Commercial - Describe Use U ov ❑ City of CSM Number ❑ Village of ❑ State Owned -Describe Use Q 1 / y l 3 Town of L3 XIA>-,., III. Type of Permit: (Check only one box on line A. Complete line B if app ica '1 5 A ❑ Other Modification to Existing System (explain) ❑ New System ❑ Replacement System ~ Treatment/Holding Tank Replacement Only List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New Before Expiration Owner 1-715 Y 3 IV. Type of POWTS System/Component/Device: Check all that apply) 1Z Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade El Mo d ? 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) 1°2 / k 5 Z ❑ Pretreatment Device (explain) V. Dis ersaUTreatment Area Information: - "YVL - c 4- Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Require sf) Dispersal Area Proposed (sf)- System Emcn~, VI. Tank Info Capacity in Total W -0-f Manufacturer N Gallons Gallons Units Q U ew Tanks Exitig Tanks o Septic or Holding Tank / O o o / O a p W l4 -dam' Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Signature MP/MPRS Number Business Phone Number Plumber's Name (Print) xZ 1Lo -71 s-Z" 33-7 2 O ALL 2 WE C A V X t_L-E L anti Plumber's Address (Street, City, State, Zip Code)) cl 6'7 A A", 3L VIII oun /Denfirtment Use Only Permit Fee Date Issued ing A~ent Signature Approved El Disapproved $ Ott 41i El Owner Given Reason for Denial ix, (om s~~ffAA oval/Reasons for Disapproval lK 4'1 N-,,- I I ii OWN 1. Septic tank, effluent filter and ~ dispersal cell must bg serviced / maintained ` A , elk -y as per management plan provided by plumber. 2. All setback requirements must be maintained lens for the system and submit to the County only on paper not less than 8 1/2 x 11 ' es in size SBD-6398 (R. 11/11) CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Owner's Name: / Owner's Address: ?q-7 /o-7 1R A>~. Legal Description: _ Township: County: Subdivision Name: Lot Number: Parcel ID Number: Page 1 Index and title Page 2 Plot Plan N R. Page 3 System Sizing & Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans IV. 14, Designer/Plumber:License Number: L O Date: , 3 t - t Phone Number 7! t - 71`I - 3 3 ZZ Signature Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01). Page 1 1 y J ~ v w N CP- - co N t - -0 i a 0 eA Z---~ W !n 1 atJ O w FILTER CARTRIDGE INSTRUCTIONS 4 16 _9/!0 sr. 2008 Installation STEP 1 Dry fit the filter case onto the end of the outlet pipe to ensure it is centered under the access opening. If not, then either insert more pipe into the tank through the outlet or solvent weld (glue) additional pipe onto the outlet pipe.' STEP 2 While the case is still dry fitted on the outlet pipe, measure the length of 3/4-inch pipe needed to brace the filter to the tank end wall if utilizing the optional supplemental side support. If side support method is not utilized, proceed to step four. STEP 3 For installations utilizing the optional supplemental side support: solvent weld the 3/4-inch pipe onto the filter case. If side support method is not utilized, proceed to step four. STEP 4 Solvent weld the filter case onto the outlet pipe. Insert the filter cartridge into the case, pressing down until the filter locks into the bottom of the case. STEP 5 If a VRS switch is utilized: insert into the filter and lock by turning clockwise 901. Maintenance 1. The effluent filter should be cleaned every time the septic tank is °~i serviced. 2. Open the outlet access opening to inspect the tank and filter. 3. Pump the septic tank completely, making sure to remove the sludge r layer on the bottom of the tank and not just the scum and effluent. " 4. Once the effluent level has been lowered below the invert of the outlet pipe, firmly pull up on the filter handle to dislodge the cartridge from the case. 5. Slide the cartridge up and out of the case for cleaning. 6. If a VRS switch connected to an alarm is present, the switch should be removed by turning counterclockwise 900 and cleaned w with water only. 7. While holding the cartridge on its side (large flat surface facing down) over the access opening, rinse off the cartridge with water 2 only, making sure all septage material is rinsed back into the tank. W 8. If VRS switch is utilized, replace by inserting into filter and k turning clockwise 900. 9. Insert the filter cartridge back into the case, pressing down until' the filter locks into the bottom of the case. 10. Replace and secure the access opening on the tank. BEAR ONSITE- FILTER CARTRIDGE - FIVE-YEAR LIMITED WARRANTY Bear Onsite filter cartridges are warranted to be free of defects in material and workmanship for five (5) years from the date of consumer purchase. BEAR ONSITET" Filter Case -Lifetime Limited Warranty Bear Onsite warrants the filter case wig be free of defects in material and workmanship during normal use for the period of time the original purchaser owns the product. If a defect is found in normal use, Bear Onsite will, at its election, repair, provide a replacement part or product, or make appropriate adjustment. Damage to a product caused by accident, misuse, or abuse is not covered by this warranty. Improper care or malfunctions resulting from units not installed, operated, or maintained in accordance with instructions provided will void the warranty. Proof of purchase (original sales receipt) must be provided to Bear onsite with all warranty claims. Bear Onsite is not responsible for labor charges, removal charges, installation,or other incidental or consequential costs. In no event shall the liability of Bear Onsite exceed the purchase price of the product, w' ivbeAk6ns~tk~,+c f87~ LF (65:P-4 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 5' of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity /000 al ❑ NA Permit # Septic Tank Manufacturer L3 I n n e ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units Ild NA Pump Tank Capacity gal ONA Estimated flow (average) ~o o gal/day Pump Tank Manufacturer I(NA Design flow (peak), (Estimated x 1.5) o n gal/day Pump Manufacturer NA Soil Application Rate gal/day/ft2 Pump Model &r NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit P( NA Fats, Oil & Grease (FOG) :530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD5) :_220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) :5150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ,Q_ ~7 NA Biochemical Oxygen Demand (BODS) :_30 mg/L 19 In-Ground (gravity) M In-Ground (pressunz~ed~►` Total Suspended Solids (TSS) :_30 mg/L KNA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) 510° cfu/100ml ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size Y. in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA 6( year(s) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA IS year(s) Clean effluent filter At least once every: ❑ month(s) ❑ NA J 04 year(s) Insect pump controls & alarm At least once ever ❑ month(s)( NA P pump, y' ❑ year(s) Flush laterals and pressure test At least once every: ❑ month(s) ❑ year(s) 0( NA Other: At least once every' ❑ month(s) Iff NA ❑ year(s) 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 tank(s) 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 (Y3) 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 :_12 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 (4/01) START UP AND OPERATION Page (0 of For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) 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 POWTS MAINTAINER Name t'~ ' Name Phone '1 (t5-- '7 Q 3 3 ,7,, Phone -71 s, -74f - SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name ~l E Name ~ej, Phone 7 IS - 77 Phone 7!S - ~ $ - cQ 6, e n This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer /O J D_ Mailing Address Property Address (Verification required from Planning & Zoning Department for new construction.) - City/State Parcel Identification Number Q ` cq - 1 O ? - 70 LEGAL DESCRIPTION Property Location n16 '/4 , Nt-~ `/4 , Sec. 7 , T .19 N R / 8 W, Town of L>~ SE Kw Subdivision Plat: , Lot # Certified Survey Map # 95-11 Yy , Volume , Page # Warranty Deed # 9 3 -7 ~2 9/ (before 2007)Volume , Page # Spec house yes Kno Lot lines identifiable )(yes ii no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department 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/or (2) after inspection and pumping (if necessary), the septic tank is less than 1 /3 full of sludge. 1/we, 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 Planning & Zoning Department within 30 days of the three year expiration date. 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. Number of bedrooms r130 SIGNAT OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) • .1 ` ~IIIIIIVIIIIIIIIIII~I IIIIIIIIII L8029656 State Bar of Wisconsin Form 3-2003 Tx:4020834 QUIT CLAIM DEED 937294 BETH PABST Document Number Document Name REGISTER OF DEEDS ST, CROIX CO., WI THIS DEED, made between Steven E. Garden, a single person 06/08/2011 2.58 PM EXEMPT*: 3 ("Grantor," whether one or more), REC FEE: 3 30.00 and Karen M. Garden, a single person PAGES' 3 ("Grantee," whether one or more). Grantor quit claims to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix Recording Area County, State of Wisconsin ("Property") (if more space is needed, please attach addendum : Name and Return Address Carol L. Law Law & DeMaio, S.C. 2215 Vine Street This deed is being corrected because the legal description was not a full description Hudson WI 54016 on the recorded Quit Claim Deed. See attached description. 042-1017-70-150 Parcel Identification Number (PIN) This is homestead property. THIS CONVEYANCE IS GIVEN PURSUANT TO DIVORCE JUDGMENT (is) (is not) GRANTED IN ST. CROIX COUNTY, WISCONSIN, CASE NO. 10 FA 205 Dated V(i V 6 %tL_c^' (SEAL) (SEAL) LZ ~ * Steven E. Garden (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) 0_t (r STATE OF WISCONSIN ) ss. authenticated on 2,e t 1 COUNTY ) * Lt *,,-0 l l4;4~ w. 6 1q4Z t4- I &1 0 11 Personally came before me on TITLE: MEMBER STATE BAR OF WISCONSIN the above-named (If not, authorized by Wis. Stat. § 706.06) to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. THIS INSTRUMENT DRAFTED BY: Carol L. Law-Law & DeMaio, S.C. 2215 Vine Street, Hudson, WI 54016 Notary Public, State of Wisconsin My Commission (is permanent) (expires: ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. A ©2MMODIFIC BAR O STHIS OON FORM SHOULD BE CLEARLY IDENTIFIED. N0.3-2003 QUIT CLAIM DEED • Type name below signatures. 1 of 3 'J 2 0 5 5 P 109 Warranty Deed - Francis to Garden - Description of land: A parcel of land located in the NE'/+ of the NW %4 of Section 7, T29N, R18W, Town of Warren, St. Croix County, Wisconsin, described as follows: Commencing at the N'/4 comer of Section 7; thence S43°01'38"W (assumed bearing referenced to the monumented N-S'/4 Section line of said Section, bearing assumed N00°03'09"W) 934.13' to the point of beginning of a lot described in a Certified Survey Map recorded in Vol. 6 of Certified Survey Maps, at Page 1658, as Document No. 412876 at the St. Croix co! Register of Deeds Office; thence SO0°09'46"W 338.01' along the West line of said lot described in said Certified Survey Map to the southwest corner thereof which is the point of beginning for the parcel herein to be described; thence N88°59' 1 FE 287.17' (passing through a 1" iron pipe at 253.28') to the centerline of an existing roadway easement; thence S14°10'58"E along the centerline of said roadway easement 295.48' to the North line of a roadway easement described in a Certified Survey Map dated January 8, 1980 :h+id..recorded-Jairuary 21,1980.in volume 4 of .Cerdfwd,Survey Maps at Page O13 as Document No. 362434; thence S89°02'41"W (recorded as S89°09'49"W) along the north line of said roadway easement described in said Certified Survey Map in Vol. 4 at Page 913 157.15' (passing through a 1" iron pipe at 33:90') to a V iron pipe on the easterly lot line of Lot 1 of said Certified Survey Map in Volume 4 at Page 913; thence N00°02'30"E (recorded as N00°09'38,"E) along the easterly lot line of said Lot 1, 59.00' to a 1" iron pipe which i3 also the Northeast corner of said Lot 1; thence S89101' 12"W (recorded as S89°09'49" NV) along the Northerly lot line of said Lot 1417.37' (recorded as. 417.42') to a 1" iron pipe which is also the Northwest corner of said Lot 1; thence N00°09'46"E 228.37' to a 1" iron pipe which is also the Southwest corner of a parcel described in a Warranty Deed dated September 15, 1997 and recorded October 22, 1998 in Vol. 1368, at Page 140, as Document No. 589582; thence N89°59' 15" B along the South line of the parcel described in said Warranty Deed recorded in Vol. 1368 at Page 140 as Document No. 589582 214.25' to the point of beginning of this parcel- Together with and subject to a non-exclusive roadway access easement across the Easterly 33' of the above described parcel, and including non-exclusive roadway access easement rights across the 33' lying Easterly of and adjacent to the above described 33' roadway easement, and also non-exclusive access easement rights to those easements as recorded in Vol, 5, Page 1214, and Volume 4, Page 913, of Certified Survey Maps recorded at the St. Croix Co. Register of Deeds office, said easements intended to grant uninterrupted access to the Town.Poad which lies to Qhe.sogtheast of the above described parcel, across the roadway which'is now open and traveled, containing 130,044 square feet (2.99 acres), more or less, total, or 120,284 square feet (206 acres) more or less, exclusive of said roadway easement. I 2 of 3 1 U 2055P 110 The parcel shown on this document is being added to the parcel shown on the document recorded in Volume 607, at Page 506, as Document No. 362509 legally described as follows: Lot 1 of a Certified Survey Map dated January 8, 1980 and recorded January 21, 1980 in Volume 4 of Certified Survey Maps at Page 913 as Document No. 362434 in the office of the Register ofDeeds in St. Croix County, Wisconsin, said parcel being located in the NE'/4 of the NW % and the SE %4 of the NW K of Section 7, T 29 N, R 18 W, Town of Warren, St. Croix County, Wisconsin, to create one parcel, and this transaction is thereby exempt from Chapter 18 ofthe ST. s CROIX COUNTY LAND USE REGULATIONS pursuant to Section 19.05 (A)(3). This deed is exempt from the Wisconsin Transfer Tax per Wisconsin Statutes Sec. 77.25(8). r 3 of 3 !I l li { { 111.11111111111111111111 8-0 ' 4 9 8 0 6 Tx:4036789 951144 BETH PABST REGISTER OF DEEDS ° = p ■ • ST. CROIX CO., WI co zo 0 c y RECEIVED FOR RECORD n 02/21/2012 2:46 PM c r r g to r EXEMPT x: Z m A ° 171 REC FEE: 30.00 COPY FEE: 3.00 ~o z TZ°' z °o mzc C) ~n rn g~~ o z n K m 6 m o m ~(~~O mm TDC7 Z PAGES: 2 O O m 1-I z O m z v _ < ~ O G7 z m N m m UNPLATTED LANDS UNPLATTED LANDS o N00°29'1 WE 645.79' a z 327.00' 90.42' 228.37' I I ol^ Z IV ~ co m m- I!'lO jam' I~I ~ CL 0 Irp I zm o I~In ~3 co I I ~~g p i I Irn CD ^ N IC-3iy F~ 02 _ C r CE+ a' m' I m I In O I O m O o I ND W SR j p Ippln C C I m `c Z = cnz zcn I ~q ~I t i ? .4 m O= I O= I IG~I~ IO S w D I~ TC 1lr ~m I N m m i I~ N I~In zol m zo ' w V I~Icn w I. 02 cn t o A m m c Icn I~ i I~ O m 1 W Sao-1919w zaz.s3 I S00°29'7 9'W 282.63' ~ 0) 7 ID;~ N o I i ~p imlio 1 iN O I~ D I ~ I NN i iZll~ I .'64 T r. ■ N9A m N n Opp I m~QN--m~v ' ~COa n n co -o a -ml •a I III _ -0-0 0 d ~i z m cn ti w n o 5? I I I N a 9 co, 0 m co 2 m m w E. ? n I ` I\ L A n 0 'on 0 -n -n n N C ` Rm -p cc m z-t oz ° i o. o a M-* _ o m v z I C) N pz m I Z:t m 3630.75' ~w 616' . I ?u m z 0 z b. T I- S00°1 '59"W 1655.94' Cv C O 0 -n r- -4 S001 1 'p +4~ t ~ Z Z os~~ o O = m C NORTH-SOUTH 1/4 LINE _ ~<I ~ooofA oaf 0 ~-n m z xDl ~m=zC 9oz~ ~m~v o " Oz z N\ T m raw Z C n I cpoAn N O n < m c y I O 0 N m Z p C m BEARINGS ARE REFERENCED TO THE < w C C/3 NORTH-SOUTH 1/4 LINE OF SECTION 7 m = BEARING S00'1 5'59"W (ST. CROIX COUNTY < ? 2 m m COORDINATE SYSTEM), M U) w 1 of 2 Vol 25 Page 5836 Parcel 042-1017-70-100 09/26/2005 11:01 AM PAGE 1 OF 2 Alt. Parcel 07.29.18.104C-10 042 - TOWN OF WARREN 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 - GARDEN, STEVEN E & KAREN M STEVEN E & KAREN M GARDEN 947 107TH AVE ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 947 107TH AVE SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 6.990 Plat: N/A-NOT AVAILABLE SEC 7 T29N R18W PT E 1/2 NW 1/4, LOT 1 Block/Condo Bldg: OF CSM VOL 4 PAGE 913 ORD;ALSO COM N1/4 COR OF SEC 7;TH S 43 DEG W 934.13'TO Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) POB;TH S 00 DEG W 338.0170 POB;TH N 88 07-29N-18W DEG E 287.17;TH S 14 DEG E 295.48';TH S 89 DEG W 157.15;TH N00 DEG E 59';TH S 89 more Notes: Parcel History: Date Doc # Vol/Page Type 11/20/2002 699304 2055/108 WD 2005 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/22/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 6.990 55,000 141,900 196,900 NO Totals for 2005: General Property 6.990 55,000 141,900 196,900 Woodland 0.000 0 0 Totals for 2004: General Property 6.990 55,000 137,600 192,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 201 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 FILED ED IJA0, 980 11980 N CLftTTFIED SURVLY MAP GLaIN FRANC IS ` Part of the Northeast 1/4 of the Northwest 1/4 and the Southeast 1/4 of the Northwest 1/4 of Section 7, Township 29 North, Range 18 West, Town of Warren, St. Croix"County, Visconsin. ` o Indicates 1" x 2419 iron ppe-weigh- Svo'S0// ~E ing 1.13 lbs/ft. set. ~o o ;V I AGG /~Eq.P/iv6S 13E.r 7"O O V ~ ic/O.Q T•~•~ ~yEST //~c.. O~' SEC , ~ I -7 T Z - ig W ASS Q C o ~ N o o 0 o'T U' MOVED 0 Yoko Ol 0 p' W _ 16 1980 s ~ 01 4J COtitPReHen!siv.: AND ZONING CL..:..,:.cc ~ ~ o~ IJI ~S ^/0O° O~'~8 "E 4•/'7'42 . State of Wisconsin) Pierce County) I, James L. 'rurphy, Registered Land Surveyor, do hereby certify that by di ~gRt$ti1d~4Hlrp~A,, ~the Owner, Glenn Francis, I have surveyed and divided the lands shown her. eo 4~~~g/~ with official records, Chapter 236 of Wisconsin Statutes and the Ordinc,•b County, and that the above map and description are a true e and correct`-epr'eST* ~t n er if Dated: 8 January 1980 1 0 .w L Vol. ~t 1 a.g e 913 James L. Mur h p ' Certified Survey Pdl P Y aps i~egistered Land Surveyor St. Croix County, Uisconsin ~ (DESCRIPTION ON HEYERSL) LA I Vnlump. li pnao Ql ~ as GIn,.. I ~ O M 03 °rn I oa g `c (D O fV N LO a x C fV t m I O ~ w N I V (a d O N N a U 'a Z o LL C f0 N O 0).G 3 v Oo tV Q o 3 I y N I Z E o ~ Z 0 ~ I Z N I ~ 'd I N - a m h H w C y 6 t~ O 2 a c o v E o J~ N w ly N E N CL L N N o N N ` N c O Y a 0 Z m Z c v I M _ C - N I o c L N C d Y Z> O H H H p a ` 000 'N R I aan. a o o o V) m co co (D v~ V a CF) 0) m } a o o Q E N N Q O O 'O Ln '7 7 N e- N a n v °y y rn 0) co `mil • o ~ d Q ~ cn Q C H n _ rr c c o E O; 0 0 0 00 CD O U d a) a a CD C n ap F- C co C t0 v 7 r r N ar C ° of v> a~ o Z c N u C, Y~I Cp N C a+ 7 E L 12 1- 0 0 LL M z YO) E v a a 3 L: a A 0 a z o U) U i AS BUILT SANITARY SYSTEM REPORT r OWNER /^/-►~.'C® TOWNSHIP JAeer SEC.2 T,79N, R/,P W ADDRES r'zz z 77 ff,e d ST. CROIX COUNTY WISCONSIN. SUBDIVISION LOT LOT SIZE PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM I 7 E t I I I dicate North;Arrow SCALE : kC- SEPTIC TANK(S) / MFGR. CONCRETE STEEL c/ rings n cover Depth PUMPING CHAMBER SIZE PUMP MFGR. MODEL NO. GALLONS Per Cycle TRENCHES NO. of width length area BED NO. of lines 2 width 2 length .Z _area SCtY' depth to top of pipe NUMBER OF SEEPAGE PITS Outside diameter total pit area AGGREGATE 1Q-, ail f24p k PERK RATE AREA REQUIRED AREA AS BUILT G SL' Disclaimer: The inspection of this system by St. Croix County does not imply complete compliance with State Administrative Codes. There are other areas that it is not possible to inspect at this point of construction. St. Croix County assumes no liability for system operation. However, if failure is noted the County will make every effort to determine cause of fa' GREASES AND OILS SHOULD NOT BE DISPOSED THROUGH T T INSP _ DATED PLUMBER ON JOB LICENSE NUMBER Z REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM - San.itany Penm.it c / State Septic 171 NAME rownahip - ~f St. Croix County Locat.iox ction " SEPTIC TANK Size gattona. Number as Compantmenta Vi4tanee Fnom: Wett 4t. 12$ on greaten atope ~t Bu.i,td i.ng Wettande N.ighwaten a 6t. DISPOSAL SYSTEM D.i.atance from: Wett of 6t. • 12% on greaten atope 6x. i Bu.i.td.ing2?- it. Wet.tand.a Ft. • H ighwatex St. FIELD DIMENSIONS: Width o6' tnench-- =--6t. Depth o6 noek betow t.ite f Lin. c 1 Length o6 each tine 6t. Depth o6 rock oven t.ite 'Z- .in. v l/ Number- o6 ,t.i.nea L' Depth o6 t.ite below grade /S .in. T tat .den th o tined it. Sto e o tnench in en 100 6t. Di4tanee between t.inea t. Depth to bedrock b Totat abaonbt.ion aaea-~491 6t2 Depth to groundwater 6t. Requited area 6t2 Type of Coven: Pap on Straw PIT DIMENSIONS: Number o6 p.Lta avet around pity yea no Out6 ide d.iameten t Depth betow .intet it. 2 Totat abaonb =ax 6t z A Area h u.ined ~t2 R+ INSPECTED TITL . 1--711 APPROV , DATE ~G 197 REJECTED DATE 1971. ' P t B- 6 7 State and County State Permit # 00 Permit Application County Permi # / -3 for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # i A. OWNER OF PROPERTY Mailing Address: ,51 P-1111- ~~ct L~ 1 B. LOCATION: % 44-,~ Section _7 T, N, R E (or) Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township L~ cxiJ~t p ` C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) Variance Single family _t~-' Duplex No. of Bedrooms No. of Persons D. SEPTIC TANK CAPACITY f &w-7- Total gallons No. f tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete Poured-in-Place Steel Fiberglass Other (specify) New Installation Replacement Lift Pump Tank or Siphon Chamber - Total gallons Prefab concrete Poured-in-Place Other (Specify) E. EFFLU.EN/T DISPOSAL SYSTEM: Percolation Rate Total Absorb Area S sq. ft. New -Replacement Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed: e #2 -Length s;- Width 7 -2- ' Depth 3G Tile depth (top► ,r1o No. of Lines Z Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land 71% Distance from critical slope WATER SUPPLY: Private N Joint ❑ Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than present owner: ~ I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Cer Tied Soil T ster, NAME nr C.S.T. # and other information obtained from (owner/builder), Plumber's Signature MP/MPRSW# l d Phone # Plumber's Address PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca- tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors property. If well has not been drilled please indicate. I ; D PIP ID y e w..<. a n . a x mss. ate.. ~ z i i Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USEPNLY Date of Application Fees Paid: State J~O Q County -7Z D0 Date o? -~~-~Q Permit Issued/ (date) Issuing Agent Nam F C/ Inspection Yes r No State Valid# Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 7/1/78 . __-A Ab . r- I r t i . 9 I • 9 9 ~ 5 r ; ,t j, - _ -tom EH- 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS c LOCATION:,_5_E 4, " 'I, Section /^Z , Tom, R~'E (or) W, Township or Municipality Lot No. , Block No. e-2e.-'7 .17 t' / s County Ce- I Y f Subdivision Name Owner's Name: / s7 jej /J r' 1 c Mailing Address: Ife j" A- TYPE OF OCCUPANCY: Residence Li No. of Bedrooms 3 Other EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS /C' e o PERCOLATION TESTS 1 ",/C> SOIL MAP SHEET SOIL TYPES s" - S C PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 3 3 P 1~n 3 (o C / SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) B- PLAN VIEW (Locate percolation tests,soil bore holes and suitable sail areas.) Indicate on the plan the location and square feet of suitable ar as Indicate nu er of square feet o rption area needed for building type and occupancy. ate scale or distances. Give horizontal and vertical reference points. indicate slope. ®1'' 45L L r J ~'J t N r7l 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 location of test holes are correct to the best of my knowledge and belief. Name (print) G / t S Certification No. , _4L c,6 Address -A. 7 v, J 1 G jy / Name of installer if known CST Signature COPY A -LOCAL AUTHORITY