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014-1038-20-100 (2)
n N ~ e d ~ ~ m m i ,< ~o ~ I ~ 3 ~ ~: O O O OD T CJ3 N O ( A O j A ~ N ~ C v Z Q ,~ :R N !~ ~ Q ~ W O Cn N C N i y N N N N O- . ~ ( N O 0 'D i p ~ i m ~ c ° '~ 3 N 3 i C ~ r ~ fD N ~ N O C~ W S ~~ C ~ ~ ~ O ~ ~ I O N (D _ O s ~ ~ ~ (D N ~ ~ D) ~~ O O l i ~ -~N ~~~ ~ ~ O fO ~ fA fA fA ,p , ? ~ ~~ ~vvo ~ ~ ~ w N v ~` N ~' N y i ~ ~ I O .~- ~ o ~ o O D a N C O' O ~ N O N N o c m i d ~. ~ ~ C O N fD ~p .- -_.. I ~ a m m ~ a ~ ~i ~ a ~ ~ ~ °'~j,, °c o N ~ CD ~~ N o C 3 _. ~ a 7 ~ N O ~. O = -oa w cn ~~ ~ A a ~ o r; o •• 3 N Z fD W ~ -~D~(~~o -~ D om<o~m~~ o. ~- p d O y ~~ O ~ 7 d ? ~ n ~~ C 7 T ~ O N (D 7 d C 3 - S ~ ~ N a W v, n O ~~~° `° N m o 7 + O )( y 7 ~ ~-. O T W C , ~y~. o N 7 ~ ~ =~ f N n' `v W O t ~ m S O 7 X O~' ~ _ 6~ o ~ Jo ~A~ ~. ( / O O . C O, O y m 0 O \ ~ ~ N O ~ ~ ~ ~ \\ N W D C N ` O a O Vi f 0 3 fl- N OS ~ N ~ii- "K'" N N ~ ~ N ~ n N 7 (p S S O O N ~ O O_ ~ O 7 5 CD ~~rthh~ ~ O O m Q O S` O ~- Z 0 O N 7 a Z 0 _~ O w n Z 0 n N O ~ ~ N N `G f/ t? N O ;~ ~ 67 p w j ~ N O ~ (D cs 7 ~ ~3 ~ ~ ~? ~ W C< O C'z Z O N ~ c, a T 0 . ~ m O 7 O 3 ;D m C (D m N N ~O Q (D O L C. ~' O. 7 ~ ~p d O ~p ~ N S N ~ (D Z m ~ m a o ? O CD j N O p t!i O fD ~ N ~ N CO a d ~` t0 d ~ N fD n Q (D N 7 ~^. N N O O _~ O S O O ~ O q n ~ N N (n ~ (D Q. ~ O O O ~ O m g N _ .~. O O N ~ 0{ G Q o N ~'' ~ ~ o > d ~ ~ .'. m ' > n ~ ~ 3 m v v ' I m ~ m , 3 ^~ .~ ~c O Ui T T O OOi c O (D ~ A N 7c to ~ O o~ ~ ~, °' ~ O O O j N N p O N i O W .~ 0 ~ O N N C (fl m o- N ', ' a s ; j O ~ ~', N CO ~ ', N N ~ 0 0 ~ ~, N ~ O C a ~ ~ ~ ~ ', ~ of t~A N cn o ' G ! ° ~ Z D v ov °' ; , m ~ a m ~~ w 3 N d _ ~ ~ 7 ~ Z ~ Z D = ~ ~ _ v ~ O ~p N y p C nj ~ a A 3 ~° ' Z A o i ~ c ~ A I -+ ~ n ' : o ~ a N i . p z ~ 7 W ~ C W OD O. -, ~ Z 3 A _~ 3 ~. m Z ~ "' N ~ ~ m A W I N I ' ~ ! T C 7 a d ~. ~S ee R 0 "~ O • ~`'~~ ~• O h . H F ~~ ti ti O a J w b yq r:, .. V Q ti Parcel #: 014-1038-20-100 o7/12i2oo7 05:12 PM PAGE10F1 Alt. Parcel #: 18.31.15.2746 014 -TOWN OF FOREST 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 - FOUKS, BRUCE J & BECKY L BRUCE J & BECKY L FOUKS 2659 220TH AVE DEER PARK WI 54007 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description ` 2659 220TH AVE SC 1127 CLEAR LAKE SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 1.820 Plat: N/A-NOT AVAILABLE SEC 18 T31 N R15W PT NW NE BEING LOT 1 Block/Condo Bldg: CSM 11/3186 1.82AC Tract(s): (Sec-Twn-Rng 401/4 1601/4) 18-31 N-15W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1217/442 WD MARY Bill #: Fair Market Value: Assessed with: 2007 SUM 0 Valuations: Last Changed: 10/18/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.820 12,000 82,800 94,800 NO Totals for 2007: General Property 1.820 12,000 82,800 94,800 Woodland 0.000 0 0 Totals for 2006: General Property 1.820 12,000 82,800 94,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 113 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM SaSety and Building Division INSPECTION REPORT I:~ENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purp ses [Privacy LaU~, s.15.04 (1)(rn)]. Permit Holder's Name: City Village X Township Fouks. Bruce Forest, Town of ICST BM Ele~ ~ (Insp. B~EI~ IBM Descrip ion: ~ ~/ ~ 9 ~ ~,~. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic / ~p Dosing ~ d GGte~G~ Aeration ~/ ~,~.cvy~ . Holding TANK SETBACK INFORMATION TANK TO ~ W~ BLDG. Vent to "r Intake ROAD Septic ` ~+ ~ ,r/_ r.~o Dosing ~ ~ 1 Aeration Holding PI IMP/SIPHnN INFORMATION ,. I / Manufacturer Demand GPM Model Number ~~ ~/~ Z~ TDH Lift Fric~ion~Lo~s System e d TD ~ ~ Ft Forcemam Length Dia. Dis tom "i" C'4 111" d'K2C('fi7V'gif°IN CVSTFM ~-f~L _1 _1,-Y ~ / /1 / /~n !/ 1/ county: St. Croix Sanitary Permit No: 506231 0 State Plan ID No: Parcel Tax No: 014-1038-20-100 Section/Town/Range/Map No: 18.31.15.274B , STATION BS HI 1=S ~ ELEV. Bench ark / ~/ 25 /, /03 ~ / Alt. BM 'T~ °f ,2S /ob,~ BldgySa~e~n ~ ~ 3 -- , L [ ' - SUHt Outlet f Dt Inlet ~~ Dt Bottom/" . ~» 'Q ~ rn ~ _ Header/Man. ~ti Di$t,~ipe ll $. $~ to ~ Bot. S_ yam S~.e~ Z 3 •5 // , b f Final grade ~I ~~ 2. 3 _ ~ D t St Cover L~11- t-Q K > ~ r ~ -~ ro1~. ~ ~ I r ~ "T ~ I~'6 I'V` /~ 3 BEDITRENCH DIMENSIONS ',Nidth 3~ Lengt~ / No. Of Trees PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth i SETBACK SYSTEM TO P/L BLDG WEL L E/STREAM EACHING HAMBER O M ctur ~ ~-+U INFORMATION Ty Of Sy~ ~~ ~ / X70 ~ UNIT Model Number: /Q.l ~ I UTION SYSTEM Length Dia ~1 `PiIJetS) ~~ l I Dia Spai w ~„~.,... -- x Holex Hole Size~x Hole SpacinyHole Spacing .. ee.......~ n. A~_!_r~rlc Cvc}nmc C1nly S X59, l .~ ,SS ~~ r!~ f:.) PJr 110Ke vv.._ ..... ...... Depth Over ... ............ ..~.............y Depth Over __._ ---__~~_ xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center / Bed/Trench Edges Topsoil Yes _ No Yes ~~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:__-~/ l ~/~ Inspection #2: / / Location: 2659 220th A-ve. Deer('P~ark~-, WI 54007 (NW 1!4 NE 1/4 18 T31N R1~5W) >35 acres Lot 1 (~'~ Parcel No: 18.31.15~27y48 ~ ~~ _~ 1,) Alt BM Description = I ~ p `d~ v"^" ~~ ~ ~ ""~ l~'YI~JL-lam M `~ ~ Y,vll~ -~G -~ ~r1' ",/"-/OG~WIt/-~' 2.) Bldg sewer length = IJ I' p _. _ ~ G(Gt Gu~,y~~ IO~.-~ ~~~0 ~ `-s~~`~`' -amount of cover = ~~ u'T ~/Wl~ _ `~ ~~~, C~~ Plan revision Required'? es No ~ ~ Z /` ~~ II ~I ~ Use other side for additional information. v l \ Date Insepctor's Signa re Cert. No. SBD-6710 (R.3/97) • cotnmereewi.gov Safety and Buildings Division County ~ ~ t:a i2~ ` ~ 201 W. Washington Ave., P.O. Box 7162 ~w- /~ i~+li ~ ~ ~ Madi~a, WI 53707-7162 Sanitary Permit Number (to be filled in by Co.) ~ !]epartmerlt e+! Commerce 5 0 ~ Z Sanitary Permit Application tateTransactionNu In accordance with s. Comm. 83.21{2), Wis. Adm. Code, submission of this form to the appro unit is required prior to obtaining a sanitary permit Note: Application fortes for state-owned POWTS are ProjoctAddress(ifdifferrrttthaamailingaddress) submitted to the Deparimer-t of Commerce. Persorml information you provide may be used for secondary ~t+ A V u ses in accordance with the Priv Law s. 15. 1 m ,Stars. ~ ~ 5~ 2~U ~ . L A lication Information -Please Print All Information Property Owner's Name RECEIVEC? ~'~iUC,iz ~U~ K5 ~ °' inU ot4 -' lt~3gi " Properly Owner's Mail ing Address 1~41~i ~ 8 2007 ' -rt-t Property Location / , C ~G,C~ ~~, A~,.. . Go~Lot City, State V Zip Code ~. Phone Number ~'Q1~1~~~ 4 ~f ° ~_ yti Iv' z y., Section 1 eaJ (circleone ~~>r~ ArZt~ WZ 1 5 ~ J ~l ~ (check alt that a ildi f B II T ) 1 t -_- -_- _._ . . ng u ype o . PP Y Subdivision Name I or 2 Family Dwelling - Number of Bedroom s Q ~ Block CAS J 1' J~.-t~- ~' ^ PubliclCommercial -Describe Use ___ ran . b ,/ ^ City of . ^ State Owned -Describe Use CSM Number ----~, ^ Village of ~ Town of ~O~v ~T ~~~ ~ ~ ~ i 3~ III. T ype of Permit: (Check only one box o line A. Coropkte line B if applicable) A' ^ New System Replacement System ^ Treatmettt/Holding Tank Replacement Only ^ Other ModiHcatia- to Existing System (explain) B. ^ Permit Renewal ^ Permit Revision ^ Change of Plumber ^ Permit Traltsfer to New L>st °~ Permr~ ~ ~~ / (~ ~¢ ~ Before Expiration ~~ IV. T e of POWTS S stero/Com neat/Deviee: Check atl that a Non-Pressurized In-Ground ^ Pressurized In-Ground ^ At-Crt~e ^ Mound ? 24 in. ofsuitable soil ^ Mound < 24 in of suitable soil ^ Holding Tank ^ Other Dispersal Component (explain) ^ Prelreatrnent Device (explain) V. Dis ersal/TreatmentArca Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation + ~ Cif _ VI. Tank Info Capacity in Total # of Manufacturer 8 c ~ ~ Gallons t.,allons Units ~ I? U ~ ~ ` New Tanks Existing Tanks ~ o ~ 59t~ a ~ ~ ~ /Q>.~ /.~ /nJ Cl ~-U ~ V' /~ a. U in ~ r n w C7 ~ Septic or Holding Tank ~ L~CX7 .- 1 LY:)() I ~ KAt,J C ~ Dosing Chamber ~ VII. Responsibility Statertknt- i, the undersigned, assume respo ' ' itq for inatallation sf the POVV'I'S shown ea the attached plaes. Plumber's Name (Print) Plum r Signature MP RS Number Business Phone Number , Z2~5~4 -1~5 3"1-3uz~ ~ `~el~~~t a "i' . .. o:. Plumber's Address (Street, City, Stale, Zip Code) t 4•cq t3T" Av ~A'RP~DN i,~1 lz VIII. Coun /De artment Use Onl Approved isapproved Permit Fee ~~v Date I ued ~~~ 07 Issuing Signature ^ Own ' en Reason fo ial IX. Condi ' easons for Disapproval ~ J2I'~` ~ ' 1. Septic tank, effhunt faker and ' nn `~ ~•v rte, dispersal cetl must ail be services / mai ~ ~ ~ ~ 5 e,~ P~ ~ J C~ • as per frtallaQtltFlent plan provltied by plurnber. 2..AM silaick tequiren>ler><s tryst be mtth~airred _..._......w _..~..:... x.. r•.....w .,.1., ne .yes not lee tt.ae 8 1!t z 11 inches in sae SBD-6398 (R. 01/07) Valid thtu 01/09 `1'~ 6 ~~ s#ctn~ ~"o ~. ~1 a.d ~Q . 4 ~~~~ '`V `t 2 " SITE PLAN ~_ ~~ t~ c1 ~ BM Bench Mark EL 100.00 $;~r~ F l o~ of 1.~~4- 1CG• V ~2 13.:iTcJ: n Or `J:O~-3C; ~;~s~, C`tL~i•1Z o ~= srl~~ 5S. Sc~~~ IA~It 1i7CX)3H~~JKAv-~ WI Bv'~~ GF-~~ ~~a..i ~=2. i y , C . L t~ F l L 1 ~.,ia i ~~ 3~ ~~`~ ~ ~' Jta S=t 5~ LL i ~ Otto ~~.?~ 9~ ~i<< tca~.i ~~`. 2 / Dui. ,~o~- :, b?' -'" ~` ~ ~. - ~ ~4~'(J~ ~~ ~~ m r~ ~. ~;` L~/~J~` ~ _~~,, ~ Y"~ N°` ~ ~~ I~ III ~a•~ . SEPTIC TANK 6. PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS 4" CI VENT PIPE 12" MIN. ABOVE GRADE i; WEATHER PROOF >_ 25' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MANHOLE COVER W / PADLOCK ~ FINISHED GRADE ~______ ._. ~----WARNING LABEL - --- ~ _ _~~___ --~~___._--4 ~~ MIN . I WATER TIGHT SEALS A ppRcv~A ~i ar~ir~ APPROVED IPE 3' OAT'Pi OLID SOIL PUMP OFF ELEV . FT . l ~~ ~ ~~ :~ GAS- p TIGHT i %,~ SEAL ~ ~ ~~ ~ ~ ~- B i ~_ I C ~ ID 3" APPROVED BEDDING UNDER TANK ~~ APPROVED JOINTS W/ APPROVED PIPE 3' ONTO SOLID SOIL ~~ RISER EXIT PERMITTED ONL IF TANK MANUFACTURER HAS APPROVAL CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE TANK MANUFACTURER: SK~~ TANK SIZES: SEPTIC i%x:~y GAL. DOSE i~oa GAL. ALARM MANUFACTURER: ~~ -~~~; r: ~, MODEL NUMBER: ,~j SWITCH TYPE: m~-~-,a. NUMBER DOSES PER DAY : ~______ DOSE VOLUME INCLUDING. FLOWBACK: i ~j~ . Z GAL. CAPACITIES: A = '11..z. INCHES ~ _ _~34L' -6A~. B = 2 INCHES = L.~' GAL PUMP MANUFACTURER • (,~;,_.~~ C = c~ . "L INCHES = 15 8 ,'L,GAL . MODEL NUMBER: ~~/ SWITCH TYPE: rn~~r-. D = 3_ INCHES = ~ i ' .3 GAL. REQUIRED DISCHARGE RATE ~`~ PM PUMP >; ALARM WIRING AS PER ILHR 16.23 WAC VERTICAL DIFFERENCE BETWE PUMP OFF AND DISTRIBUTI ON PIPE ~ FEET + MINIMUM NETWORK SUPPLY PRESSURE -~-~.r FEET + 5 a FEET FORCEMAIN X ~.~° FT/100 FT. FRICTION FACTOR .-. FEET TOTAL DYNAMIC HEAD - FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH 5~-; WIDTH _(~,~ ; DIAMETER -- LIQUID DEPTH ~~ SIGNED: ~~ LICENSE NUMBER: ~,Z~Sb/I-- DATE: ~_ _ _~ ~~ r'~o a; v~ iCrk _ O O m W r a~-~~ c ~o~a~ R °i ~ ~a~- 0 3 ~~~~;~~~~ a o ~ j j~~ A A A ~ 0 ~ ~ T ~ ~ 3 C r To T A ~ ~ 0 3 ~ 1 a O ~,~ o ,3o Z 0 0 ~~3 m -' ~ o ~ ~ 3 d N ~~ I~ I d I N I N d D ^Z 1 Z •-~:: j. l H= L l~ ~t vavi:.. .. d~t• • • • o~+ a Q 2 ;L) O rno °' ~ d ~°+ ~ d' ~ _ r ~~~~~ s ~- = a ~.. _ _ ~ c ~ ~ ~ ~ a 1n a~ .. • • 'V • • ~ • • • • • • ~ ~~~ ~~ r f~D C~ O C N O C y f~D c=~ c=3 ~,~ ~,n;c~a-c~~c~ S~ ~~+ n ni O s QN (D rc ~ a • ~ ~ n io ^_' ~ v ~ -o •~a o a.~ Qn d ~ ~ fD ~~ d ~' O ~~ N~ N~ .Z- ~ ~ ~n ~ N C A ~ O O n ~ C O _ ~ ~ ~ Z ~ A T ~ N ~D v 7 • • • ~ • • • ~ • • • • • • • L1 ~~- j v ~ SxOn oo~o,v_+fD to X. ~ w N X ~ N K fD W > > O !0 tD O ~ ~ .. ~ c Ao .. ~ ~ c ~ ~ v0+ ~ o ~ o S v_,, ~ p~ ~ m is ~v 3'~° 5''=O•°p o _ ~ N ^ $, Q ~ ~ v `°- c ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ o v n O' o, m rno ~ 0 0 c s ~ ~ ^o .O ~o D _° ~ `° ~ o~ ~ d -° n -i n ~ m °' ~ d ~~ p ~ Jr ?~ ,^~.~ K !D n n D ~ f . av ~ ~a~ m ai .c in 1 ~ Q ~ Q~ ~ a N to o ~ v Q ~ , ao d a fD io ~ ~' ~ w n m -ai° za a~ 3 °' ° o fD ~ z ~ n ~ -'. ' ~ v, a~ ~ n~ n 1 C ~ m~ N N H~ O d N d .Q N ^ .G N s~~ ~ v,rnn~ ° n ~ a~ ~~m `- `~ , ,, ~ s a o a n N v T a o ~ ~ T 3 O O ~ ~ 'A H d m a. 3 D a ~ n T w w o ~ 3 ~ o Z ~ i G 0 ~ c m ~ N m -a 0 ~ ~ ~ ~ ~ J C ~' V~ O O ~ 2 j m d jp 6 ~ O N T A s O Z N 3 0 O C a T v 3 T Z N 0 Z N u C r v c ,3 V , • r/ • ~• ~, Y , C C ,~ V SITE PLAN 7 w~" ~;r __ BM Bench Mark EL 100.00 '~ ~ `' `"~" ~"J P ~ ~ ~ ~V B~ ~ ~ op of ~~~-~- ice, ~,; ~M 2 13Q ~T o nn O F S - D i ,x1 ti1;w , CoR-~i%iZ o ~= Stl ~~ ST . S ~~ i i C~ 1 i1-31t L UUC) a~ A ~. S !C A ~..7 S-i 5 -° Gf 1. I , Ct io I ~ ~54~ "r3 ~ ,~ , ~~ i~ ~, ~ ~ ~,,, SOIL EVALUATION REPORT Division of Safety and B . !l1dllL~""' 85 V4is AcLn Code Page ( of~ • ,,,~,,,,,M,..,~waep" dh Cornrn - Cotray ~ j ~',,P U ('\ gtt~tl complete sib plan on paper not less than 8 72 x 11 inches ~ s¢e. Plan must irnird to• vertical and twr¢orrtal neiererroe Point (8M), rreedion and Parcel I.D. / 6~4 T 3l N R ~5 ~W Stye ~ Code ST. OIX COON ~ ~ ®T~ Nearest Road ^ New Catstrudion use: Iii Residerlsa! ~ Nwrrber of bedrooms ~! Code derives design flolr- rate 4 ~,~ C~ GPD [~ Reerttt ^ Pubic or carrrrrercial - Descr~e: R Parent maw i~ ~~ ~{~-u r.~ ~ Flood Plaer elevation ~ appicabie recomaiions: ~i ~~ v,r. nn >/ rJ ~ 3 5 ~v fZ.. ~ ~ f2.-~ n~GH ~5 ~L Z ~~~ ~ I~i~~.o rr.r~n Z-J:© ~A.-~,. , to ~ 1 . ~ ~. _, mdude, tart not percent slope, scale or dirrrrensions, north arrow. and bcation and distance to nearest road. Please print all inferniaBon. Personal &donnMion Y~ Wow ~Y be used for seeorWary PuP~ (Y ~• s. 15.04 {1) (m)). Properly owner •pj >~u c,~:. F'~ ~ ~~ RECEIVE ~onrt. era tJ ~. ~a s Properly Owners f1Aai~rg Address 2007 LOt ~ l~ Subd. Name or 2w ~ q 2'~ T~-l A f JUN 1 8 ~ ~ pg Ground surface elev. I i7 C7 ft. Depth ~ 9 ~~ L..1`;-- "'- Sore Rate d B Roofs t~ Dl~ Horizon Depth Dorrurmrrl Redax Description Texture SUudure Catisisfe~e ourr my 'EffiTi 'Ett~2 in Muttsei Clu. Sz. Cont. Color Gr. Sz Sh. ~ . p._ ~ -? cJ ,-, .~ 5 I I 2m5b K fYl tr 55 2 1.O `L 'l' l8 25 Sr 1 Zmc,,bk m~ t d~ I ~ r ~ , ~ v ~ ~ ~- '31-k'f~ i ~~~. 5 c~ s rn l --- - ~ . a ^ pg Ground surf~e elev. ,~ q , 4 tt. DePlh to im~rg faaor ~ 1 ('~- ~. ~ ^ ~ Hodzw) Deptlr i DomirraM f111tmsei n, I o - ~, 7.5~~. 3 Z 2 ~- t4 i©~r~4 3 t4-~ lu~';~5~~ • Efirrerrt ~k'I = 80 CST Name ( PrirrQ ~~ -~~ Redox DescriPtior- Texture Sttudure Corrsisferroe Borrnci Qu. Sz Cont. Color Gr. Sz Sh. -• 5 l) 2rn5bK M r 5 -• S ~ I Z~nc.~blC t Cll. 5 --- Sc~I ~.mabK ~''-5 .._. t ~ a s ~ ~~ I - ~ ~~ > ~ < 22o mglL and TSS >30 _< 150 (q-l~ i3~11~•./ ~a~~f~ t~l`~4Y~rZ Roots CaP D/lt= 'E1flf1 'EEtfl Z , tt • v ~ i.0 -- . 4 , (o -- • 1 i , t< ' e2 = BOD _< 30 mgll. and TSS _< 30 mgit. CST Numbef 22~5sa4 ~ Telephone Number .. ayt f~raperty Dwner ~c~ v << S Parce+ tD # Page 2 of 3 a~o ®Pit Grantd Surfcee elev. _ "1 ~ tt Depth to inul'm ~.~ i . _j K Ftorizort Depth Dortwtartt Redoot Description Textwe _ ShueWre ~____,_ Cor~sienoe ~_ _- Hdrrtdary Roofs Sol -- GP Rafe D~11F ~. tlAunaetl t]u. Sz Cord. Color Gr. Ss. Stt. ~1 .~ 1 U- ~ ~ 3L -° 5l j ZrnSb~ m r 5 Z'~ > !r I.O Z Z 'Z 1 t~ `i +~ 413 ---" 5 i l Zm Sb K t~ t CAS l • tp I , b 3 ~ ' IoY' 5 ~ ^- St,l Zw.Sbk t~1 C~.S ---- : ~{- e ^ ~'~ ~~ ^ air Ground surface elev. tt_ r~rt~ ~ ~,., t~....,. Ftorizort Depth Dorrtirlarit Redox Destxiptiort Te~d~D _ SZtucNre _ Cor>:~toe _.. Botrrtdary Roofs ~ ~ Rafe (3pD1~ in. BAwtsetl tau. Sz Cont. Cotor Gr. Sz. Sh. 'Eff~1 'EffR2 ~~ ~ ~ ^ Pit Graund surface etBV. ff. Deptit 1D tYrt~htg fBCtOr tt_ Horizon Depth Dorrt6tard Redotc Desrxiptiort Texttme Strtrdtse Cortoe Botatdary Rohs Soi ' f~sle in. fNh~il tau. Sz Carts. Color Gr. Sz. Sh. 'E1~1 'EtYR Efftuerd #11= BODs > 30 < 2Z0 mglt. and TSS >30 < 150 mgn. ` Effluent ff2 = t30D, < 30 mgll rind TSS ~ 30 ~ The Depattment of Commertix is an egos! opportunity service provides and employer. If you need assistance ro access scrvices or Heal. rrtatecial in an attemate format, please contact the departrnent at 608-266-3151 or TTY 608 264-877?. sao.umtRO•+Am ~k ~._ '_ _ • ~ _ Property Owner r` C~ ~3 tL S Parcel ID # Page 2 ~ :3 Boring #~n1 BOn~ . ~1 Pit Ground surface elev. t~_ it. Depth to 9 ~ 6r. Soil Rate Horizon De~tr Dom~rt Redox Desaiptiorr Texuun: Shudrse Ca~slenoe Boundary Roofs GP DAF . in. Mur>SeN Qu. Sz. Cont Color Gr. Sz. Siti:'; 'E~1 '~ U- ,~ ,Z3L -° ~r~ ~ri5b~. t1r1 ~r- ~`a '2~' .(~ 1,O Z -Z ii~~~ 4-13 ---, ~ ~ i Zrns~ K ~~ i (~.S 1 • ~ I -C~ 7 - 10~, ~~ ~ '_'_. ~Ji~l ~.w.~b~ i~'lSi 0..S -- `{- , (P b ~ D ~g ^ Pft Ground surface elev. fk. Depth ~ 1in~n9 factor in. Soa Rsle Horizon Depth Domirrsnt Redoor Desaipl'an Texture SMrchae Cons~e Boundary Rook in. 11AurrseR Qu. Sz. Cont. Color Gr. Sz. Sh. 'EtBt1 'Ef>lr2 ^ ^ Pit Ground surface elev. ~R Depth b factor in. ~ Soi Rafe Horizon Deem Dominant Redox Description Texture SUtrcture Corrrce Baurd~r Roots . _ in. iNw>SeN t~rr. Sz Cont. Cobr Gr. Sz Sh. "EfiBt'1 ~ Eta #F1= B~, > 30 < 220 mglL and TSS >~ < 150 mgit. ' Eitliref>t ix2 = BOD, _< 30 mgll. and TSS _< 30 mgfl The Department of Commerce is an equal opportunity service provider and employer. if you need assistance to access services or need material in an siterrtate format, please contact the department at 608-266-3151 or TTY 608 264-8777. sew~aotRO~~ r SITE PLAN PROPERTY OWNER: PROPERTY LOCATION : ~ `'`l ~~- N ~ y~ ~`~`°°~' I f?' T 3 i r`~ ~1 ~~k~"~ TM A v 1~ U BM BENCHMARK:EL~~ i3 C~ ~ i a ~ 4 r l-~ ~ t.~. L~ BORE HOLES: ~l, ~, ~Uv ~~ t3~~ q~i,4 ~~ i+~ ~w i.vc.A ii i o n~ ,J~ ~ ~" ~~ SN~p ~~ Ron Friedell #226564 CONVENTIONAL INGROUND DISTRIBUTION DESIGN Residerdfal Appl'u:ation INDEX AND TITLE PAGE PROJECT NAME: ~y V ~ J OWNER'S NAME: ~ ,2u ~ ~~ i? K.`~ OWNERS ADDRESS: ,~~ 5~ ~~ ~rN a J~ . i~t;t;~ l~a~K I,JS ~4c~1 (`115 23U, - 22.4 LEGAL DESCRIPTION: a ~ ~ ~ ~ ~ -`~ ~ ~ •~ ~rJ ~ TOWNSHIP: T-~ ~s,~~- COUNTY: ~T !' ~.- ~ Y SUBDMSION NAME: LOT NUMBER: BLOCK NUMBER: __ PARCEL I.D. NUMBER: Page 1 Index and Title Page 2 Site Plan Page 3 System Crossection Page 4 Management Plan Page 5 Page 6 Designer. Rare FriedeA ~-_-`~ Licence Number: 226564 Date: .-. ~p~~y~_, Phone Number: (715) 637-3020 Designed Pursuant to the Cornentional Sotl Absarbtion Componerrt Manual for POWTS SBD-10567-P (R.6/99) SYSTEM SPECIFICATIONS In-ground Soil Absorption Compon/ent Component Manual # SL3t7-~ ~y5~~ ~' ~ 1 ~ . 4~ ~~C'i Project Name: ~ ~y K S Distribution Cell Type Aggregate ^ Non-Aggregate] Type of Non-Aggregate Component G 1-1 Fa m R X25 Manufacturer ~ ri 1 _~"rz~~Tbt~ Model C.~ U i GiC - 4-- Number of Bedrooms 3 Soil Application Rate (DLR) .f~ gpd/ftZ (Designed Loading Rate} Wastewater Quality Treated ^ Untreated Combined wastewater: Number of bedrooms 3 gal/day/bedroom x 1 0 Daily Wastewater Flow (DWF) _ ~ V Clear and graywater only: Number of bedrooms gal/day/bedroom x 90 Daily Wastewater Flow (DWF) _ Blackwater Number of bedrooms gal/day/bedroom x 60 Daily Wastewater Flow (DWF) _ Dispersal Area (Aggregate) - - ftZ (DWG (DLR) Dispersal Area (Non-Aggregate) EISA Rating 1 `~ ~ Lft2 System sizing = DWF _ DLR =EISA (. ,~c~ = . ro, } = C ~t " I = ~_ chambers (DVVF) (DLR) (EISA) Diverter valve ^yes ~no Manufacture Septic Tank Min. Septic Tank Vol. Req. 5U gal. Septic Tank Volume I~ gal. Manufacturer J~K A 1~ Effluent Filter Manufacturer ~ ~ ~j Model ~~ ~~ - I a Pump Tank Manufacturer Volume Model Distribution Component Distribution Box ^ Hydro-sputter ^ Other Manufacturer Cross section of distribution c~~l(s) ~s ,,~ ~- ,. ~~ t+ 'd r ~--i- .,, ,- T~, ~t4' r ~~ ~~: 4' 4' fi--I ~~I ~, o I +I 5 c.,' I P5 3 PROPERTY airiER ~~R~ C.G ~cx~ <<5 TO~iNSHIP ,-- t-o ~.~~ Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System {POWYS) shall indude information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD-10567-P (R.6/99). Twhlw , . c.,~m rtn~Gnn Snec~cations a.,~~ .. y .aav... v Sanita Permit Number -- --- -- - - Number of Bedrooms Desi n Flow -Peak d 4 `~ Estimated Flow - Avers a 3c:x~ Se tic Tank Ca aci al I~<~c.: Soil Abso lion Com onent Size ~x~~ T e of Wastewater Domestic T.. L. ~.. e. ~..:~ Aw~.,rr,+:nn f`mm~nnpt'tt . t. imits of Reliable Operation I QI./IG L• a7V~~ /"~VaIV. a.v. . vv... ~.----- -------- - - Se tic Tank Com Went Soil Abso lion Com Went Desi n Flow -Peak d 4 5v 4x~ Maximum Influent Partide Size in NA 1/8 Maximum BODS m L NA 220 Maximum TSS m /L NA 150 Maximum FOG NA 30 T~hle ~• IUl~inteananr_p Schedule Se tic Tank Ins ect and/or service once eve 3 ears Outlet Filter Should ins ect once a ear and dean once eve 3 ears Soil Abso lion Com onent Ins ect once eve 3 ears $eptl~ allk The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shalt be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The ou#let filter shall be deaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its endosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shalt have its contents removed when the volume of scum and sludge in the tank ~g Management Plan for a Septic Tank and Soil Absorption Component ~ , exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective loddng device to prevent acadental or unauthorized entry into the tank. No one should errter a septic or other treabnent or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the. Irrterior of the tank may be dtffcult or Impossible. Tank abandonment shah be in accordance with Comm 83.33, ws. Adm. Code when the tank is no longer used as a PpWTS component. Soil Absomtion Component The soil absorption component serving this structure is designed to accept domestic wastewater from a rBSidential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall indude recording the levels of ponding, if any, in - the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic dogging of the soil Plantings of deep-rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct __- -wastewater flov~c. _--_ Gorrtingeacy Plain : If System failure occurs and rep~.irs are not possible, a new system Site is to be located, and a new system is m be installed per comm. 83 Wis. Adm. Code. Management Plan for a Septic Tank and Soil Absorption Component e~cceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should eater a septic or other treatment or holding tank for any reason wi~out being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatme~ of holding tank may contain lethal gases, and rescue of a person. from the. interior of the tank may be d~cult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorotion Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and sys#em use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component The soil absorption component's :operation must be assessed by inspection at least once every three years. The inspection shall indude recording the levels of ponding, if any, in - the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snowcover over the component may lead to hydraulic fiailure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic dogging of the soil. Plantings of deep-rooted trees and shnabs directly over or within#en feet of the component should be avoided since root intrusion into the component may obstruct wastewaterflow. Coirtingency Plan : If Sy~m failure acxurs and repairs ar+e not passilile, anew system " Site is to be located, and a izerv system is to be installed per comm. $3 Wis. Adm. Code. s•r caotx covlvT-v SI.?I'7'IC TANK MAINT'P.NANCI? AGRBBMeN'I' AND OWNBRS[i[P CBRTIPICATION FORM Ownerll3uycr _ BRt~~.t~' ~~~y r~S Mailing Address Z(a ~ 1 ZZt~~`" ~y~ Properly Address JAr+~t/ (Verification required from Planning Department for new construction) City/State ~ ~~ iZ ~ I~AR iK 171 Parcel Identification Number ~~ ~' ~(73~'c~}- ~ 60 Property Location ~ t~ %,, ~z '/,, Sec. f 8 , T 3 I N•R~_W, Tovrn of ~yP_:~Si LCGAL DESCRIPTION (• ~7 ~{ ~ Subdivision _ Lot # Certlficd Su rvc Ma # 5 ~~ ~ ~~ ~ ~ ~ 3 ~ ~~ Y p .Volume .Page # Warranty Deed # _ ~ Sy oC ~ / Volume ~ 2~ ~ ~, Page # ~y ~ Spec house [] yes ~ no Lot lines identifiable ~ yes ^ no SYSTEM MAINTENANCE Improper use and maintenance oC your septic system could result in its prematuraf;ailure to handle wastes. Proper maintenance consists of porn ping out the septic tank every three years or sooner; if needed by a licensed pumper. What you put into the system can aII'ect the fi nctioa of the septic tank as a treatment stage in the waste disposal aystena. The pn-petty owner agrees to submit to St Croix Zoning Lkgartment a certification form, signed by the owner and by a masterplumber, journeymanpl~mber, restrictedplumber or a licensedpumperverifying that (!) the on-site wastewaterdisposal system is in proper open sting condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge.. Uwe, the unders igned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set tsy the Department of Commerce and the Department of Natural Resources, Start 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 ~ year expiration date. ~~ ~ ~ /a SIGNATURE O C APPLICANT DATE owrlER cEtiTiFICATION I (we) cctiify that all statements on this form arc true to the best of my (our) knowledge. I (we) am (are) tlu owner(s) of the property desr:tibed above, by virtue of a warranty decd recorded in Register of Deeds O[[ice. S[GNATURfi O F APPLICANT ~~ DATE ''~'"'• Any inf mrtation that is nris-rcpresentedmay result in We sanitary permit being revoked by the Zoning Department. •••••' "• Include with this application: a stamped warranty decd [rom the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed w ~, ~ - . , ,, Permit Number l2F.Scheck Compliance Certificate checked By/Date Wisconsin Uniform Dwelling Code REScheck Software Version 3.6 Release 2 L)ata filename: K:\Modcodes\Heatloss\98000-98999198035.rck PROJECT TITLE: SN: 98035 COUNTY: St. Croix HEATING TYPE: Non-Electric WINDOW /WALL RATIO: O.12 DATE: 06/05/07 DATE OF PLANS: 3-21-OS PROJECT DESCRIPTION: Dealer: STEENBERG HOMES, INC. Customer: FOUKS DESIGNER/CONTRACTOR: Wick Building Systems, 1ne. 2301 E. 4th Street Marshfield, W I. 54449 PROJECT NOTES: 90 Plus Efficiency Humace Required 12" Exposed Foundation Walt RS Foundation Insulation On Entire Walt 12 Sq Ft OfFoundation Windows UDC COMPLIANCE: Passes Code-Allowed UA = 336 Your Home IJA = 31 1 7.4% Better Than Code (L'A) Gross Glazing Area or Cavity Cont. or Door Pe~,~eter g_Va1ue -Value ~ actor ~A Ceiling 1: Flat Ceiling or Scissor Truss 1531 SO.U U.U 39 Skylight 1: C)ther 16 0.500 8 Wall 1: Wood Frame, 16" o.c. 1472 17.4 0,0 80 Window 2: Above-Grade:Wood Frame:Double Pane with Low-E 78 0.290 23 Window 3: Above-G-ade:Wood Frame:Double Pane with Low-L 35 0.350 12 Window 4: Above-Grade:Wood Frame:Double Pane with Low-E 2 0.560 1 Door l: Solid 48 0.076 4 Door 2: Glass 44 0.350 15 Basement Wall is Solid Concrete or Masonry 1321 0.0 5.0 11.9 Wall height: 8,0' Depth below grade: 7.0' Insulation depth: 8.0' Window 1: Basement:Vinyl Frame:Single Pane 12 0.870 10 Furnace 1: Forced Hot Air, 90 AFUE COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to mcct the Wisconsin Uniform elling C e requirements in REScheck Version 3.6 Release 2 (formerly MECcheck) and to comply with the rnandat requi listed in the REScheck Inspection Checkli Builder/Designer c'~G Date Heating Equipment Sizing Summary General Information Outdoor Design Temperature: Conditioned Floor Area: Average Ceiling Height: Infiltration Rate: Equipment Oversizing Factor: Loads Summary Conductive Losses: Infiltration Losses: Oversiaing Factor Losses: -2S deg 3061 $2 8.4 $ 0.50 Normalized ACH 15.0 29610 Btu/hr 21984 Btu/hr 7739 Btu/hr Total Building Hating Load: 59333 Btu/hr _ 4 ti N V Z Z W o~ >Q> = J = J~~U WZ~~ ~'' wWW~ a u NU¢ '~ ~~ ~~ ~5~~~~ z _ ~ ~ ~ ~ i r G $~~~ i .._y MARSHFIELD A Product of Wick Building Systems, Inc. P.O. 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'I' STD ~' O 00 e--1 O Production No. 38572 HOME System - RPT_SalesOrder.rpt z 0 a U O J z w ~L z rD J a ~- z w ~~--~--i r--~ ^ , v./ F- O n a ~ O N W° r^~ _~ v J ~~ jrO~~ ~~ II ^ ~ 1~ ~ ~1.! F O ~ O r--+ rn a u~ 0 ~ Y r~q o ~ I 0 1 0 ~ I x ~ _ 1 O ~- tETAIL CUSTOMER ND BUILDER 'his is a SPECIAL DESIGN PRINT with nominal dimensions. Thl an is subject to additional engineering review and may require :hanges as a result. Local building codes may require some alterations to this plan. The addition of options may also require alterations. 'his plan cannot be confirmed or built until this copy is returned with the signature of both the customer and the builder. Signature :onfirms acceptance of this plan as presented. 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N (~ .~.Nf7 Y.r (7 t7N N.-. ..N ~ < } N O ~ .~. N(7 V N~0 (~fD U~° ti('1 <In ~OhmO+o .. N('l V Inman W Oro-+N('I C Inter W Oro rNf~<VI ~O I~mO~o.. Nf'1 v 2 .~ N N N N N N N N N N (7 ~ (7 (7 (' l (' 1 (`l (7 f 7 (7 V<< V' < Y R O V V I n I f J 11') V 1 I l] i ~ 7 H O O ~11 STATE E ~R OF WISCONSIN FORM 2 - 1982 ~ JJ` t •+ WA AN Y DEED . ` Y~11 ~~ 1 ~ PA~~ ~ •~~ DOCUMENT NO ~ ~ ._. _ ~, ~- ~T GFiC~„ CD., ti'.I Stanley S. Fouks, a single person, _ ~.d~tx~:mra -- - - __ . ~__ -. -~ - ~ JAN 9 1997 _-- Bruce~.~ou cs an ec~ ~- 1 tt 9:30 A• ;. conveys and warrants to - Fouks, husban an wide, as survivors i _ P---- "'~:.*t+l..-,. 'fi't f~i~ah marital pr~e~, - `"`'~`"Oto"a" MrS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS the fol-cw~ng dcscnbed rral estate m St • Croix county, Bert D. Petersen Attorney at Law state of Wisconsin: P.O. Box 117 Clear Lake, WI 54005 014-1038-20 PARCEL ~OENTiFICATION NUMBER Lot 1 of Certified Survey Map recorded in Volume 11 of Certified Survey Maps at page 3186 as Document No. 552675, being located in part of the NWT of NEB, Section 18-31-15, St. Croix County, Wisconsin. Grantor snail be entitled to tt~e non-e.cclusive use of existing driveway located ad scent to the Westerly aouna~ryoofttee abovoe NE 4, des y to prove E acct's y raptor. This Section 18-31-15, St. Croix Count Wisconsin owned b g right to the use of the existing driggveway for access shall terminate upon the sa~eo e~totheTherrightrtoytheauser ff theedriveway sha lealso benefited p p Y ro ert has not terminate upon the death of grantor if the benefited p p Y been previously transferred by grantor. This ____~.a~__115~ t __ ttntnestead properly. (~) (is not) Exception to warranties: Municipal and zoning ordinances of record and recorded easements, restrictions and reservations. December , A.D., t~ 96 Dated this 30th day of ~~,cf~` ~ /'p-t.~~?i (SEAL) • Stanley S Fouks (SEAL) (SEAL) (SEAL) AUTHENTICAT'ON Signature(~I_ of Stanl°° S Fouks authenti is ~ Lh da ~ C er , t9 9 66 • Bert D Petersen TITL[: MEMBER STATE BAR OF W15CONSlN (!( not, authorized by 9706.06, Ws. Su'=.) ACKNOWLEDGMENT State of Wisconsin, ss. County. Personally came before me this _----- day of . tq ,the above named to me known to be the perwn who executed the foregoing instrument and ackr:owled~c the same. THIS :NSfRUMENT WAS DRAFTED BY Bert D Petersen, Attorney at Law - WI S4OOS _ County, Wis. clear Lake . Notary Pt:bhc. -- (Si-;natures stay be authenticated ur acknowledged. Berth are not hty cpmmrsiu:! is p:rmanent. i1f not, state expirl~on dat): necrssary.) • tiames of p.~r..,ns signing :n any cap:xny should bq .I ped or panted i~ ~w then irgnawres. :;~~,~ ~~y gyyyc Co . tr,c. STATE BAR OF ~VISCOti51r+ Mr,~vauhee. ws W'AP°.An TY UFFD Form No. 2 - 1982 _~ c 5526'75 CERTIFIED SURVEY MAP ~05 ~ a / - r/~- Located in Part of the Northwest Quarter of the Northeast Quarter of Section 18, Township 31 North, Range 15 West, Town of Forest, St. Croix County, Wisconsin. Prepared for and at the request of: OWNER: Stanley S. Fouka 2661 220th Avenue Deer Park, WI 54007 Drafted by. Ty R. Dodge UNPLATTED LANDS ~,, i~ i~ ~ I 243.76' --T~ ,,,- {~-1~.._.._.._ .. ~~ ~. -~, NORTH 1/4 CORNER, ~ M SECTION 18 (FOUND 1/2" ROD) /_~ 1/~ O~ I UNPLATTED LANDS ' 3 ,,~~c. OF W I SCOy ~~ ~Q' DOUGLAS J. ~',. ~ EXISTING TOTAL AREA: 1.82 Acres 79, 505 Sq. Ft AREA EXCLUD/NG R.O. W.; 1.63 Acres 70, 904 Sq. Ft JOB #96152 Prepared, by. A & E LAND SURVEYING Phone No. (715) 246-4319 P.O. Box 325 109 East 3rd Street New Richmond, WI 54017 Sheet 1 of 2 ~ ~ ~L~~~. ~ \OV 2 T 1996 ~PeglsteNot DeedsH BEARINGS ARE REFERENCED TO THE NORTH LINE OF THE NE 1/4 OF SECTION 18 TOWNSHIP 31 N., RANGE 15 W. WHICH IS ASSUMED TO BEAR S89'40'36"E County Section Corner Monument of Record • Set 1" x 24" Iron Pipe weighing a minimum of 1.13 pounds per linear foot. - S 89'40'36" E 2668.07'------- NORTH LINE OF THE NE 1/4 AND -`.\ CENTERLINE 220TH AVE. ~~ - ~ - S 89'40'36" E 262.58' --~ _,2_1_61.73' _-~,~ ,~~~fh A v~ 33.00'~;~ __ ___ ~ __ ~N 89"40'36" W 258.69' NORTHEAST CORNER, SECTION 18 LOT ~ (ALUMINUM CAP MONUMENT) (V 100' BUILDING ~ SETBACK LINE N o ! ~ Q' J ~ ~ ti N w ,rfi rysl~"' ~ . _ ~ ~;~~ ~ ~ `~ UNPLATTED LANDS~~ ~.--CENTERLINE ~ N ff~fQ,~- _ \ DRIVEWAY ~ _ Q (~ \ HOUSE N ,V•" _ ~"'~ A~1~~iOVi.. SEPTIC O ~,_ 12't~ ~">>': ~' ?':~~S H E D:a. UNPLATTED LANDS ~,~ j ~,~, 3.5'f N 0 TH ~) 19QV L q _'~ 1 ST . CROIX COU~i1'''( ~OfT1(ra'@llenSlVQ rFaT~J1iY ZOntrl~ anti Parks Camniitt~ tf not recorld~ti within 30 days~df approva) d~#e 9~rr©val shalttc~ nail ~ vnirt 100 0 100 GRAPHIC SCALE SCALE IN FEET: 1 inch ~ 100 feet NOTE: The parcel shown on this map is subject to State, County and Township laws, rules and regulations (i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office and the appropriate Town Board for advice. VOL. 11 Page 3186 r~ M ,as H