HomeMy WebLinkAbout018-2021-20-000 Wisconsini)epartmentofCommerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and`Building Division
INSPECTION REPORT Sanitary Permit No:
514987 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)].
Permit Holder's Name: I City Village X Township Parcel Tax No:
Hammond Hills Estates, LLC Hammond, Town of 018 - 2021 -20 -000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No:
65 08.29.17.1301
TANK INFORMATION f ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
9.+
Septic l), X7 3 I 53 Benchmark 5 91 5 Q -7
Vf /6 Alt. BM 7� ( / J
o a IF �ooa.� � a �.
Aeration Bldg.lSewer `` W T
7•� 00.
Holding SUHt Inlet
b Av '97-3
TANK SETBACK INFORMATION St/Ht Outlet y q
TANK TO �P /L WELL BLDG. Vent to Air Intake ROAD Dt Inlet T
Septic Z7 T Dt Bottom
Dosing /U Header /Man. y b g[�
Aeration Dist. Pipe !•,
Holding Bot. System '
Final Grade
PUMP /SIPHON INFORMATION 3 • , J
Manufacturer Dem and St Cover Z • 91 5
Model Number 7'
T, s. X3.5
TDH Lift Friction Loss System d H Ft j S . 4 . 83 ./
Forcemain Length ia. Dist. to Well
SOIL ABSORPTION SYSTEM T.P. $. `1 1 7 . T - .5
BED /TRENCH Width / Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS '? � �G :Y. — --
SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer
INFORMATION CHAMBER OR L Val
Typ Of System: A UNIT
7 `7 a � J t— Model Number: / J
1 AA
DISTRIBUTION SYSTEM D� f-/ t! c j' 5
Header /Manifo4 ot IDistribution ole x H Size x Hole Spacing Vent to Ai ntak
5 Pipe(s) \ ` ` 3
Length Dia Length Dia Spacing ` 1
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulc d
Bed/Trench Center Bed/Trench Edges \ Topsoil
5 Yes 0 No es E] No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / /
Location: 1024 166th Street Hammo , W�� 15 1 SE 1/4 8 T29N R17W) Hammond Hills Estates Lot 20 Parcel No: 08.29.17.1301
!b D ( ^^�d ver PC6. 1
1.) Alt BM Description
2.) Bldg sewer length
- amount of cover - D t
lD fZ. O 6 O sue. 6 n a �.�.a:+•. d L.. 1ST
Plan revision Required? ❑ Yes No ��' �Q /
Use other side for additional information. OO fi!
SBD -6710 (R.3/97) Date
'T 7 gnature Cert. No.
P .A
, Safety and Buildings Division County ` `)
201 W. Washin J�
t (lu sco n s i n Madison 531 nary Permit Number (to be filled in by Co.)
e parkneritofCornmer�oe 5 I e 13
Sanitary Permit Applicati n SEP
2008 S eTransactionN r
In accordance with s. Comm 83.21(2), Wis. Adm. Code, submission of this form the appropriate governmental t
unit is required prior to obtaining a sanitary permit. Note: Application fo for IMTI]1 W
submitted to the Department of Commerce. Personal information you provi may ;liver
purpo in accordance with the Privacy Law, s. 15. 1 m , Stets. `
I. Application Information — Please Print All Information
Property Owner's Naroe P
Pro 's Wading "C✓ L� �+ P<°pe�. L ocuion 13 1>1" 3
C, Govt. Lot
City, State 1 Zip Code Phone Number r (Cm �/ '' /s, Section
� le on
s I TN; RE
II. ype of Building (check a1 that apply) Lot #
D Subdivision Name
1 or 2 Family Dwelling - Number of Bedrooms <
Syr pty� Block # Q
❑ Public/Commercial - Describe Use ❑ City of
CSM Number ❑ Village of —
❑ State Owned - Describe Use
w Z3�i' Z t�A own of �-
III. Type o rmi k only one box on line A. Complete line B if applicable)
A' New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
List Previous Permit Number and Date Issued
B. ❑ Permit Renewal 11 Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New
Before Expiration Owner
IV. Type of POWTS System/Component/Device: Check an that appl
Non - Pressurized In -Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitablb soil
❑ Holding Tank ❑ the0 r Dispersal Component (explain) ❑ Pretreatme t Device (explai
rs n)
V. Dis al/Trea ent Area Information:
Design Flow (gpd) Design Soil Applicat A te(gpdsf) Dis al Area Required ( Dispe Proposed r Eleyati
J am--- 6
VI. Tank Info Capacity in Total # of Manufacturer
Gallons Gallons Units c _
New Tanks Existing Tanks 0,
dl m y W V Q+
Septic or Holi mg ank
Dosing Chamber
VII. Responsibility Statement - I, the undersigned, assume responsibility for its a of the POWTS shown on the attached plans.
Plum s Name (Print) Plumber's Signature MP/MPRS Number Business Phone N her
4 - z Z 2
Plumber's Address (Street, City, Sta ip Code)
/� o
VIII. Coun /De artment Use Onl
Permit Fee Date I ued Issuin gent Signature
roved =Vv,
��
❑ n Reason Denial U
IX. Condit sons for Disapproval A ��
1. Septic tank, iMuent rifler and 1 L
dispersal cell must all be an'-es'/ m*01111kted
as per management plan provided by pklmber.
2. All selback req erhenIS mtlsj be k►faiited C ► t C 44 j40 s
ua r be system and submit to the County only on pa not ten than a U2 I I cutlass In size
SBD -6398 (R. 01/07) Valid thru 01/09
L
Q T PLAN
PROJECT'8eveF*148 I&f;ges LLC ADDRESS P.O.Box 179 New Richmond Wi 54017
NW 1/4 SE 1 /4s 8 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE 9/12/08 BEDROOM 3
CONVENTIONAL )00( IN -G U D PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 933 # of chambers 46
IL BENCHMARK V.R.P Top of Survey Iron ASSUME ELEVATION 100' Filter BEST Filter
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
Well is to meet all SYSTEM ELEVATION 84.6/83.9 5' below qrade
setbacks required by
WDNR Plans Designed Using Scale is 1" = 40'
Conventional Powts
Manual Version 2.0 unless otherwise
108' P. L. B.M. Vent noted
>6 „ Quick4 Standard -W
of Cover Leaching Chamber
with 20.0 ft2 of Area
5.8ft ^2 /pair of end caps
4' Long
12"
34" Grade at System Elevation
168' Property Line �d
Pro 3
Bedroom AL
Zd� House
Vents
30'
B -
5'
455' Property Line
6
2 -3' X 94' Cells with >3' spacing
10% Slope
100'
166th St
C
20'
T PLAN
PROJECT s LLC ADDRESS P.O.Box 179 New Richmond Wi 54017
NW 1/4 SE 1/4S 8 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE 9/12/08 BEDROOM 3
CONVENTIONAL XXX IN -G U D PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 933 # of chambers 46
BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100° Filter BEST Filter
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
Well is to meet all SYSTEM ELEVATION 84.6/83.9 5' below qrade
setbacks required by
WDNR Plans Designed Using Scale is 1" = 40'
Conventional Powts
* Manual Version 2.0 unless otherwise
108' P.L. B.M. Vent noted
>6 „ Quick4 Standard -W
of Cover Leaching Chamber
with 20.0 ft2 of Area
4' Long
12" 5.8ft ^2 /pair of end caps
34" Grade at System Elevation
168' Property Line
Pro 3
Bedroom
House
Vents
30'
B -3 ST
B -2 O 5' 25'
20' 30'
455' Property Line 60'
2 -3' X 94' Cells with >3' spacing
10% Slope
B -1
100'
166th St
20'
c
' f
Wisftm Department of Commerce SOIL EVALUATION REPORT ge of
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code r
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel J.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information. Revie b pate
Personal information you provide may be used for Law. . 15.04 (1) (m)).
Property Owner roperty Location
oe L.? i'r. n D 2W qO vt. Lot 114 1/4 S 8 T 2 f N R 1 E( W.
P rty Owner's Maft Address t I Block #
Name or M#
7 0, DEC ICY 12= --
CKY late Zip Code city ❑ Village Town N crest Rr
i
New Construction Used Residential / Number of bedrooms Code derived design flow rate GPD
❑ Replacement Q P is or commercial 'be:
- D cr
Parent material 42 �M [7, Flood Plain elevation if applicable ft.
General corrtmems . 5
and reoommendations:
System Type C Oli/lJ� System Elevation
51 Btxtng # Boring
Pit Ground surface of v. j ft. Depth to limiting factor ` in. n*Efftl
Appl ication Rate
Horhm Depth Dominant Redox Description Texture Structure Consistence Boundary Roots GPDM
In. Munsell CU. Sz. Cont. Color Gr. Sz. Sh. 'Eff#2
►�j '
l s— O
1
i ,
a Boring # [] Boring j
;9 Pit Ground surface elev. S ' ' ft. Depth to limiting factor ` in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr, Sz. Sh. •Eff#1 •Eff#2
4 ` � i bor 312 --- 1 0?• rY, P_ e 5
2 - / Y 'r-") LI mng 1,j l �y
lI
Effluent #1 a SOD 30 220 mg& and TSS >30 < 1 • Effluent #2 = SOD < 30 mg& and TSS < 30 mglL
CST game (Please Print) nature Cyr Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted Telephone Number
1008 192nd Ave, New Richmond, WI 5 17 715- 246 -4516
a�
Property Owner
Parcel ID # Page of
Boring #
[37 ❑ Boring
Pit Ground surface elev. °�L' ft. Depth to limiting factor �L (���n Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture St ucture Consistence Boundary Roots GPDlff
In. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. •Eff#1 `01#2
1 �r CS o�ml • g
t,� o
1
p �S/ C.l a? `a
1t9 y� F S n a-, n t
Boring # ❑ Borin
❑ Pit Ground surface elev. ft. Depth to limiting factor in. won Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. •E11#1 `Eff#2
Boft
El # Boring
❑ Pit Ground surface elev. ft. Depth to linAng factor in.
S Rate
Horizon Iepth Do ninant Color Redox Description. Texture Structure Consistence. Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Ef1#1 '81#2
Effluent #1 = BM > 30 < 220 mg& and TSS >30 1150 ffQ& ' Effluent #2 = SOD, <; 0 � and TSS 1 30 ffQ&
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need, material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608- 2648777.
serx.,wcR.aroo� .
r
Soil Test Plot Plan
Project Name Oevering Homes LLC Shaun
Address P.O. Box 179
New Richmond Wi 54017 CS' #226900
Lot 20 Subdivision Hammond Hills Estates Date 6/2/07
NW 1/4 SE 1/4S 8 T 29 N /R W Township Hammond
F1 Boring Q Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of Survey Iron @ NW of Lot 21
System Elevation 84.6/83.9 *HRpSameasBenchmark
Please note: survey was not
108' P.L. B.M. complete at the time of testing,
installer must check all setbacks
prior to installation.
Scale is 1" = 40'
unless otherwise
noted
168' Property Line
25' -3 10% Slope
B -2 20'
455' Property Line 0 90'
B -1 87
100'
166th St
20,
�• 69 UNPLATTED LANDS
255 50 ,
S 89'20'10" W 217.#' s
o BM .T.
TOP OF 3/4 PM �
ELEV- 1055.27'
18
LOT 21
6 S.F. ^�
Ac. ,� N 60. 83988 S.
S j) 1,93 Ac.
Ov 41
= LOT 20
77643 S.F.
N 1.78 Ac. !' "r
Cl)* 60
LOT 19
S D I
75560 S.F. @�
1.73 Ac.
<4 �, �
*US 6o °s �� �� /
N 6 O ,
�(b
CO
ti 140
O '80 : Ai
00 , o °p
alb
1,0T 25
:)T 9
3920 S.F. ,
1.83 Ac.
LOT 8 �.
p� Qj
.o � � � � �- •� •
79920 S.F. ps' Gj 0 v•
1.83 Ac.
0
LOT 26
j 66. , n..
819161
COUNTY PLAT OF S 89'2053 w 444.00_
a,I:f U
SD.Ef.' 'Sr: UO' ;4AOG 7.
HILLS
H L -J f A '1 YZIOI +W
3MY RAT
11 $18 .8g' UN --- --- II FA3 3:
Pei: I
1
-5
LOT LOT z, S 89700' w 217.02' r4`k
Jn
TAT ES 14 ib
wnv coot' LOT 16 55.�V
.^GATED IN PART OFTHENW 114 OF THE SE 114, THE SIN 14 OF THE SE '.5 a;. x n ¢':5 zt. i� i- 1 3
ry
94, THE NE IN OFiNE SW LA MIO11E�114 C5 TNESW tp OFSECUOA f>L. 10 11 , RN 99' >�
8, TM RITW,IOWNCF HAMMONO, AT. CROIK COINIY WISCONSIN. £ �t cr. la .. .; 4 5
k:. j 31 J y
^ LOT 18
�i LOT 21 a
DRAINAGE EASEMEN NOTE: v3 !,1 '} < h k v s s; �d' CY .''✓ 01
NO OWNER OR RESIDENT SHALL 00AN"INGWHICH WOULD INTERFERE WITH
OR CHANCE THE OPERATION OF THE APPROVED COMPREHENSIVE N ' DA.nt' �U alal I 1 �; w ✓:: Z
STOAMMATER MAMMENTPLANSEDIMENTPNDEROSiON CONTROLPLAN
FOR THIS FIAT TH INCLUDES BUT IS NOT LIMITED TO, BUILDING M
(7
OBSTRUCTING ALTERING, FILLING. EXCAVATING, OR PIANTINGNANY DRANA,GE a ?,� _.. �. >� LOT 20
EASEMENTS STORM WATER PONDS WATERDRAINAGE DITCHES: WATER .:M
RUNWAYS, WATER CULVERTS OR BERMS \ Ua' U c a� __ I' 'D
GENERAL NOTICE STATEMENT:
R s ,�
o
EACH PARCEL SHOWN ON- HIS MAP LFLAT)IS SUBJECT TO STATE: 9 S 9 A 39,BC ) 4" 22 q O YA
COUNTY, AND TOWN LAWS RULES AND REGULATIONS 9.E _ _; . i5 ..r. , C :, ./ 9 r', I \g
wETIAYBI MINIMUM LO'SME A.CGESS TO PARCa ETC.) BEFORE 1 - LOT 19 ' "v �TJ27
PURCNISNGORDE'VELOPNGMYLOTOF LAND, CONTACT THE ST. I, e r _......_ ,\ 1 - �p
CROIX COUNTY PLA1NINGA ZONING DEPARTMENTAND THE TOWN O ''
0 2,y 0
OFHAMMOND BOARD FOR ADVICE. ,, j �W Q
UTILITY EASEMENT NOTE: " °�� �' @ NG�eo 4 W ti LOT 23 A Ya\
NO POLE OR BURIED CABLES ARE TO BE PLACED SUCH THAT THE inm li WT 11 \) ` -a a w E x \ a
LOT ' LOT f �8 y
INSTALIATIONWOUDOISTURBANYSURVEYSTANEOROBSTRUCi �� 5 ER 0 Y(7 0 1
VISIONALMANY LOT LINE OR STREET LINE MDISTURBANCE 13 W 12 - � +.5 ,� I
OF ASURVEY STAKE BY ANYONE IS A VIOLATION OF SECTION 23532
WSCONSIN STAW.S. UNUTYEASEMENTS ASHERIENBE'T FORTH ° : w iT °
ARE FOR THE USE OF FUND BONES AND PRNAT.ERMUC o ._.' i �W /� LOT 24 .TI jk4 TAT6
UBLPIES HAVING A RIGHT TO SERVE THE AREA, o
g, I, LOT 1O
/° e i
m
C . y
NOTES: h;
_ i i I :., � o
: ra
FRONT SETBACI -T',UlrtrSSOTHERWISENOTECI CI
SIDE SETBACK = 123 CIS COMBINED) zW: u' =5
REAR SETBACK z 25 LOT 9 ` \ LOT 25 e •` . `,
WE1lANDiBACK =1tl > 0 iw<..i 5 ?I •� ix r [ r. 22 i
FROM SETBACKNEASLRED FROM ROW V U -i,. rii ih / a i
b 4 \ \
ALL BUILDINGS TO BE CONSTRUCTED IN PRO &M4YWTTH DRAINAGE c I / p - i /�,o - y a
ID 1500 vn G �. 7' 1 LOT 8
EASEMENTS HAVE A LOWEST BUILDING OPENING OR WINDOW b Co --
V(h 4
WELL ELEVATION NOT LESS THAN TW'OFEET ABOVE TIE• HIGH lu^ O �.. .y 9 P 3
i5 -
WATERREVATIDNSHa m i /� dT D n/ O LOT 26a4c/
m / r
.:.
p'111sma LOCATION MAP:
low r
a
NOTTO SCALE)
�'. LOT 6 p� °G5• i w _ �;
I SECTIOU T29N RI74N
W E r
ti's c�
N 1
MS' -- F � Y LOT 27 r �'
` i,om AVE Mk r c ! < LO ry
W I
��
032 -,v ( ® B v}a l ! c 2
•4W HE o k s D a• 9 �( '� � so H s J a r
o W J Jr
4ie _ 2G / ^^ LOT 28
�J
m mk _ 55 tre�+iii e�vx
ALL
BE4RINCSAAEAEFERENCCD ro 101ST
_ \ ✓ N 89'54 B IN 236,48
713ESOJiHLNEOFTHE SE.1140F 1 1__ —. y . 9
SECTIONS RAY RIM; ASSUMED tu"I sf>flB - '' /
C. 12 - - I2GE2 - vti>
TO BEAR B9'OI IZ'E.(ST CROL% \ ✓,`A' _\
Q N G9'4PI6 E \\ ID12
COUNTYCOOKCNATE SYSTEM) :. LOT 2
- PLAT LOCATION LOT 5 p +. D ' o D. 4 N /Z \� o
-'2
ZOF f. ,�.• �I 1 l 0. f..y5' cN
LEGEND: m q
- -- ✓
SP ROM SETBACK UNE
4 FOUND I1A'NON PN ^t' 1" - I, p i �>> •0
}d '
12 11LI YEASEMENT
fdNLESS OTHERWISE NOTED) SET 11.4'BY ITINON PIN WT. 4.172 T ,A WT A LOT J !I, LOT 2 LOT +1 LOT 29 • a
W 4 a'
c .0
6
DRAINAGE EASEMENT UNE
SET N'4' BY 18' )RIM' FIN WT.1 SD
LBSJFT. AT ALL OTHER LOT fi
-- FENCELWE
CORNERS
HIGH WATER ELEVATION
y PROPOSED DRIVEWAY LOCATION E7a
KI LOWEStBNLGNGOPa'1MG 1 °v I� i _ — T UI
PROPOSED JOINT DRiVEWAYLOCARCN . T ...- _..... - i — _. _.. _. ' � '
Tse,? o �•Tf Nf?
. -' -._ WETU:NU _ 24c5 1 ES
(F GkNUNi ASNOT NT )
va'IC_ - .. _. rC OO I G ( .__ ___
IFAS NOTED ' `s"' S 89'54 25 E 853.68' E'rz = , •y 13.0 < n •G4 ,' n -,
spy
BENCHMARK s B C2D' [ ' E 771.74' ' 'C.'
_ Bilk EOBY. AHFMXIA
aGlc' 100TH AVENGE N 89'9417 SHEET IOF2
5uc 4G n
r4 CCi NL' _.
S7 1s J'q
v sClL IIf U'>~E JNPJ A1L_i
`' SE.II',>h
S,,RvEY GAL. �IP�T' N- I _'a r P b ...
Maintenance and Contingency Plan for a Septic System
Maintenance Plan
1. Septic Tank is to be pumped once every 3 years.
2. Effluent filter is to be cleaned once a year Please note: a larger filter Is being installed in
order to extend the maintenance interval of the Miter.
3. Once every 3 years, cells are to be inspected via the Inspections pipes ids of
the Dells.
th ce agrees to limit greases, garbage, and water conditioner discharge IrW the sY's�-
4. 5. The owner agrees to save this plan.
6. Do not plant trees nor park nor drive over system.
7. Watershed is to be diverted away from system-
8. Discharge into system is not exceed those required as per Comm. 83
F y Plan
system_fails, determine cause of failure, use alternate area and ir>sWl new
sted replacement area.
Option #2. install system at a lower elevation, by removing chambers, removing biomat,
and install new system. elevation
option#�3. No adequate area is suitable for replacement area. and system
cannont be lowered. install holding tank as last resort.
3. Replace any other failing components as needed.
Plumber: Shaun Bird 715- 246 -4516
St. Croix County Zoning 715 - 386 -4680
Pumper Tom Mondor 715- 246 -5148
Shaun Bird #226900
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
ow=/]Buyer � v
Mailing Address -
levy J � ,
ss mrction.)
Property Addre (Vae,cla n required from Planning & Zoning Department for new cons VA
�s
City /State
Parcel Identification Number
LEGAL DESCRIPTYON
Pro Location �� 1 / , Sec. , TN Rw, Town of
Lot #
Subdivision
ed Survey Map # Volume , Page'#
Certified
W Deed #
so � , Volume _______ Page##
Spec house no L lines identifiab yC no
SYSTEM R7ATNTENAN AND O'oVNER CERTI ICATION
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
Im
tic tank every three years or sooner, if needed, by a licensed Pumper- 'hat you put into
maintenance consists of pumping out the septic
the system can affect the function of the septic tank as a t stage in the waste disposal system Owner maintenance
Chapter 12 - St. Croix County Sanitary Ordinance-
responsibilities arc specified in §Comm. 8352(1) and is Chap
to submit w 'St Croix County Planning & Zoning Department a certification :form, signed by the
The PmPu o °mom uunber, restricted plumber or a licensed Pun P r verifying that (1) the on -site
owner and by a master plumber, journeyman P l n and pumping (if necessary), the septic tank is
wastewater disposal system is in proper operating condition and/or {2) after inspectio
less than 1/3 full of sludge.
to maintain the private sewage disposal system with the
Uwe, the undersigned have read the above requirements and agree t of Natural Resources. State of wisoonsin
standards set forth, herein, as set by the Department of Commerce and the Departmen
Certification stating that your septic system has been maintained must be completed and returned to the St Croix County Planting &
Zoning Department within 30 days of the three year expiration date. Uwe am/ate the owner(s) of the
Uwe certify that all;tatements on this form are true to the best of myfourc knowledge.
property described above, by virtue o a warranty deed recorded in R of Deeds Office•- i q
�� � L �� /off
SIGNA �O�FAP�PLICA�NT(S) DATE
** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Deparoneni. #sa
h clude 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.
0MV. 08105)
1 111111111111111111111 11111 11111 Illl 111111 lilt 1111
* 8 5 0 4 11 8 2
State Bar of Wisconsin Form 1 -2003 $"0418
WARRANTY DEED KATHLEEN H. WALSH
REGISTER OF DEEDS
Document Number Document Name ST. CROIX CO., WI RECEIVED FOR RECORD
05/11/2007 03:15PH
THIS DEED, made between WARRANTY DEED
EXE
D &B Equipment, LLC A Wisconsin Limited Liability Company
( "Grantor," whether one or more), REC FE s
13.00
and TRANS FEE: 1333.20
_Hammond Hills Estates Development LLC PAGES 2
( "Grantee," whether one or more).
Grantor, for a valuable consideration, conveys to Grantee the following described real Recording Area
estate, together with the rents, profits, fixtures and other appurtenant interests, in
County, State of Wisconsin ( "Property") (if more space is Name and Return Address
needed, please attach addendum):
Assured Title, LLC
See Attached Is 10 Crest View Drive, ##1B
Hudson, WI 54016
PINS: art of the following p arcels
P gP
018 - 1016 -50 -000; 018 - 1017 -00 -000; 018- 1017 -30 -000;
018 - 1017 -40 -000; 018 - 1017 -50 -000; 018 - 1017 -50 -001 Parcel IdentifiicationNumber (PIN)
This IS NOT homestead property.
(is) (is not)
Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except:
Roadways, Easements, Restrictions, and Rights of Way of Record
Dated 01
-
g (SEAL �tQ cl �� (SEAL)
* Ronald C. Bonte, Member * Steven M. Dalton, Member
(SEAL (SEAL)
AUTH ` ACKNOWLEDGMENT
Signature(s) � �
STATE OF WISCONSIN )
* ) ss.
authenticated on •� St. Croix COUNTY )
PUBLIC ?
s Personally came before me on YJ1 - 7'
TITLE: MEMBER STA the above -named Ronald C. Bonte and Steven M. Dalton as
the Members of D ui m L
(If not, t me ow be ke per (s) wh executed the foregoing
authorized by Wis. Stat. § 706.06) in trument ac o ledg d the e.
THIS INSTRUMENT DRAFTED BY:
Richard K.Y. Lau - Redmon Law Chartered
2217 Vine St., Ste. 204 — Hudson, WI 54016 Notary Public, State o isconsin
My Commission (is perm (expires: d �)
(Signatures maybe authenticated or acknowledged. Both are not necessary.)
NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED.
WARRANTY DEED C 2003 STATE BAR OF ISC NSIN
W O FORM NO. 1-2003
* Type name below signatures.
1 of 2
Property Description:
A parcel of land located in part of the Northwest Quarter of the Southeast
Quarter (NWI/4 of SEI/), the Southwest Quarter of the Southeast Quarter
(SW' /4 of SE' /4), the Northeast Quarter of the Southwest Quarter (NE'/ of
SWI/4 and the Southeast Quarter of the Southwest Quarter (SE /4 of SWIA),
Section 8, Township 29 North, Range 17 West, all in the Town of
Hammond, St. Croix County, Wisconsin, and more particularly described as
follows:
Commencing at the Southeast corner of said Section 8; thence on an
assumed bearing of S.89 °04' 17 "W., along the South line of the SEI /4 of said
Section, a distance of 1830.54 feet to the point of beginning of the land to be
described;
thence N.01 °42'49 "E., a distance of 5 72. 10 feet;
thence N.29 °05'43 "E., a distance of 549.73 feet;
thence N.68 1 22'03 "E., a distance of 144.43 feet;
thence N.21 *37'57"W., a distance of 510.00 feet;
thence S.68 1 22'03 "W., a distance of 100.55 feet;
thence Southwesterly, a distance of 200.76 feet, along a tangential curve,
concave to the Southeast, having a delta of 18 0 10'20 ", a radius of 633.00 feet
and a chord bearing of S.59° 16'53 "W.;
thence N.49 0 49'36 "W., not tangent to said curve, a distance of 333.73 feet;
thence S.89 °20' 10 "W., a distance of 217.62 feet;
thence N.73 °12'01 "W., a distance of 516.69 feet;
thence N.89 0 20'53 "W., a distance of 444.00 feet;
thence S.00 0 39'07 "E., a distance of 1808.96 feet to the South line of said
SE I /4 of$WI/4;
thence S.89 1 54'26 "E., along said South line, a distance of 653.68 feet to the
South I /4 corner of said section;
thence N.89 °04' 17 "E., along said South line of the SEI /4, a distance of
771.74 feet to the point of beginning.
2 of 2
v.-i 1509 FAGi 477 KATHLEEN H. WALSH
Document Number QUIT CLAIM DEED REGISTER OF DEEDS
ST. CROIX CO,, WI
RECEIVED FOR RECORD
05 -10 -2000 9:30 AN
THOMAS H. SMITH, Grantor, quit claims to THE THOMAS H. QUIT CLAIM DEED
SMITH REVOCABLE LIVING TRUST, Grantee, EXEMPT ' 0 FEE: 16
CERT COPY FEE:
the following described real estate in St. Croix County, State of TRANSFER FEE:
Wisconsin:
RECOR FEE: 10.00
An undivided one -third (1/3) interest in:
Southeast Quarter of Northeast Quarter of Section 33, Township 30
North, Range 19 West, except the land shown in the Certified Return to:
Survey Map recorded in Vol. 4, Page 929. D. Peter Seguin
Mudge, Porter, Lundeen & Seguin, S.C.
Southwest Quarter of Northeast Quarter of Section 33, Township 1 10 Second Street, PO Box 469
30 North, Range 19 West, except that part conveyed to Richard Hudson, WI 54016
and Rosalie Ostendorf, recorded in Vol. 408, Page 220 and except
the part conveyed to Jerome Anderson and Phyllis J. Anderson, Tax ID # 030 - 2005 -80 -000;
recorded in Vol. 536, Page 153, and except that part conveyed to 030 - 2005 -40 -000;
Ervin J. Schauer and M. LaRae Schauer, recorded in Vol. 449, 030 - 2004 -95 -000;
Page 426. 030 - 1099 -50 -000;
030 - 1099 -90 -000.
North Half of Southeast Quarter of Section 33, Township 30 North,
— Range 19 West, except the part deeded to Ervin J. and M. LaRae Schauer, recorded in Vol. 449, Page 426, and
except that part conveyed to Floyd E. and Marie M. Nestrud, recorded in Vol. 441, Page 59, and that part
conveyed to Donald L. and Loretta E. Kooiman, recorded in Vol. 457, Page 269, and except the Plat of Oak
Knoll.
Southeast Quarter of Southeast Quarter of Section 33, Township 30 North, Range 19 West, except the East 20
acres and except the Plat of Oak Knoll.
All recording references are to the records in the Office of the Register of Deeds for St. Croix County,
Wisconsin.
This is homestead property.
Dated this 3 ,-4 day of , 2000.
(SEAL)
Thomas H. Smith
AUTHENTICATION ACKNOWLEDGMENT
Signature of Thomas H. Smith authenticated this STATE OF WISCONSIN )
day of 2000. )ss
—T � COUNTY OF ST. CROIX )
Personally came before me this day of
TITLE: MEMBE9 STA BAR OF WISCONSIN 2000, the above named
Thomas H. Smith, to me know to be the person who executed
authorized by §706.06, Wis. Stats. the foregoing instrument and acknowledged the same.
THIS INSTRUMENT DRAFTED BY:
D. Peter Seguin, Attorney
Mudge, Porter, Lundeen & Seguin, S.C. Notary Public, State of Wisconsin
1 10 Second Street, PO Box 469 My Commission (expires):
Hudson, WI 54016
(signatures may be authenticated or acknowledged. Both are not necessary.)
•Na orperaana signing in aoy capecny Should be t or printed below moor aignswre , QUIT CLAIM DEED
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