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349009 ST cROIX Cot) Ty
~L SURVEYOR'S RECORD
S
CERTIFIED SURVEY MAP
OERTIFIED SURVEY
I, Arthur L. Wegerer, registered land surveyor, hereby
certify: That in full compliance with the provisions of
Chapter 236.34 of the Wisconsin Statutes and the provisions
of the St. Croix County Subdivision Ordinance and under the
direction of George Gies, owner of said land, I have surveyed,
divided, and mapped said parcel of land, that such plat
correctly represents,,all exterior boundaries and the
subdivision of the land surveyed; and that this land is
located in the NE k of the SW k of Section 20,T29N,R19W,
Town of Hudson, St. Croix County, Wisconsin, To-wit:
Commencing at the Northeast corner of said Section,
thence N 89°4514$" W along the North line of the NE ~ of
said Section 1331.361; thence S 0°0$tl4" W 4287.211; thence
N 89°22100" W 2104.541; thence N 0038100e! E 330.001 to the
point of beginning. Thence N 89022100" W 544•$21 to the
West line of the NE-SW, thence N 0°05113" W along said line
4$0.041; thence S 89°22100" E 550.86t; thence S 0038100" W
480.001 to the point of beginning.
Said parcel contains 6.037 acees and is subject to
roadway easement over the Easterly 331 there of.
-
Dated this 4th day of 0c~pbax4l977.
vE~ SC 0 NS, Arthur L. Wegerer
AppRO Wis. R.L.S. No.S-963
• S Dittloff Engineering co.
v p Aga f ARTHUR L. .River Falls, Wis.
~pl = r WEGERER = 5402 ,0
~G\y;,,ZtKN1N4 y S-963 Jg0\~~to%
p,
ST. C901X P15 PtA ELLSWORTH ; O'`' 0,4
~MQRE O NG COMM eE , WIS. \Sl~\~ PQQV
0 OFDP~ \~r S
CENTERLINE ROAD I,,SURV~~O%gQtO~Ptk0, 0"'
fit 0, 'io-
S 89° 22'00°E 550.86' 1 s16' I N 00\\O\\4~0'Tb
e9c 517.86 90D
Cy 734 /g NORTH LINE OF SECTION 20
a o
p 0 0 LOT i Oli N 89045'48"W
R. N 3.027 ACRES ai o
OD 1331.36
w S 89°22'00"E 547.84' ~I
z NE CORNER
0 3 514.84 SECTION 20,
Kt iv ,J~ pl $1 T29N,R 19W
Z ~ MI o
O a LOT 2 ol,' v CENTERLINE
cn N TOWN ROAD
W Z 3.010 ACRES I OD
04
3 op' ~ 511.8 2' 90,6 ( V
N 890 22'00"W 544.82' I
i6SI
• I"IRON PIPE FOUND
8 O I "X 24"IRON PIPE WEIGHIN
SCALE IN FEET M M 1.13 LBS./LIN.FT.
O M '
0 2Cld 400 Z
-...,d. N 89022'00'W
2104.54' 1
Lv..L4 an
Volume 3 ,Wage 6044
Parcel 020-1050-10-000 01/10/2005 07:48 AM
PAGE 1 OF 1
Alt. Parcel 20.29.19.193A1 020 - TOWN OF HUDSON
Current ❑X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): Current Owner
* MILLER, JEFFREY J
JEFFREY J MILLER
834 NORTHVIEW DR N
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ` 834 NORTHVIEW DR
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 3.020 Plat: N/A-NOT AVAILABLE
SEC 20 T29N R19W NE SW LOT 1 CERT SURVEY Block/Condo Bldg:
MAP IN VOL III PAGE 604 ORD
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
20-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1097/612 WD
07/23/1997 850/59
2004 SUMMARY Bill Fair Market Value: Assessed with:
47997 279,200
Valuations: Last Changed: 10/29/2001
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.020 46,100 169,900 216,000 NO
Totals for 2004:
General Property 3.020 46,100 169,900 216,000
Woodland 0.000 0 0
Totals for 2003:
General Property 3.020 46,100 169,900 216,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 134
Specials:
User Special Code Category Amount
018-RECYCLING SPECIAL ASSESSMENT 27.00
001-WATER SPECIAL ASSESSMENT 0.00
Special Assessments Special Charges Delinquent Charges
Total 27.00 0.00 0.00
A~ A
Form-STC- 104
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP 5;~ fJ SEC. e_ T & W
ADDRESS ST. CROIX COUNTY, WISCONSIN
gq
SUBDIVISION LOT LOT SIZE T tx r
PLAN VIEW
Distances and dimensions to meet requirements of II-HR 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
:fiwa .
V
a
a
4'
4
INDICATE NORTH ARROW
BENCHMARK: Describe the vertical reference point used ,z it ce S /FA,
/ S-
Elevation of vertical reference point: JdL~ Proposed slope at site: jj
SEPTIC TANK: Manufacturer: `KJ e Liquid Capacity: 4'1~ 0 cl)
Number of rings used:_ Tank manhole cover elevation:
Tank Inlet Elevation: Tank Outlet Elevation:
Number of feet from nearest Road.: Front,® Side0 Rear, O O t/ e/`,1760 Ui feet
..From nearest-property line . Front,OSide,Rear,O c ( feet
Number of feet from: well 41"6~ building: /
(Include this information of the above plot plan)( 2 reference dimension's to septic tank)
PUMP CHAMBER
Manufacturer: Liquid Capacity:
Pump Model: Pump/Siphon Manufacturer: P
Pump Size
Elevation of inlet: Bottom of tank elevation:
Pump off switch elevation: Gallons per cycle:
Alarm Manufacturer: Alarm Switch Type:
Number of feet from nearest property line: Front, O Side, O Rear, Q Ft.
Number of feet from well:
Number of feet from building:
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed: X Trench:
Width: Length: -?e_ Number of Lines: 5' Area Built:
Fill depth to top of pipe:
Number of feet from nearest property line: Front, O Side, Q Rear,0 Pt.~~ G.
Number of feet from well:
Number of feet from building:
(Include distances on plot plan).
SEEPAGE,PIT
Size: Number of pits: Diameter:
Liquid depth: Bottom of seepage pit elevation:
Area Built:
Has either a drop box 0 or distribution box O been used on any of the above soil
absorbtion sytems? (Check one).
HOLDING TANK
Manufacturer: Capacity:
Number of rings used: Elevation of bottom of tank:
Elevation of inlet:
Number of feet from nearest property line: Front, O Side, O Rear, O Ft.
Number of feet from well:
Number of feet from building:
Number of feet from nearest road:
Alarm Manufacturer:
Inspector Oh /)/I 1- 111 (4-t4
Dated: ~ f~ plumber on job:
License Number: ~/j ? o~ ~Z.
3/84:mj
;DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
LABOR &`HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P.O. BOX 7969 BUREAU OF PLUMBING
MADISON, WI 53707
NE, SW, 20, 29, lOW CONVENTIONAL ❑ALTERNATIVE State lan
Town of Hudson ❑ Holding Tank El In-Ground Pressure El Mound
Lot 1
NAME OF PERMIT HOLDER: DDRESS OF PERMIT HOLDER: INSPECTION DATE:
Jeff Bratha 7Hudson, WI 54016 (d 30-947 .9,w
BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELEV..
11 gy-) - 'i, p0, O
Name of Plumber: MP/MPRSW No.: County Sanitary Permit Number:
William Schumaker 6382 St. Croix 128640
SEPTIC TANK/HOLDING TANK:
MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL JLOCKING COVER
~Oo ~~'~P
S ENO PR❑IYES NO
BEDDING: VENT DIA.: I J VENT MAT L.. HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH
L r ALARM FEET FROM ~OV Llv_E c AIR INLET:
DYES NO / ,I J► EYES ZNO NEAREST
DOSING CHAMBER:
MANUFACTURER. BEDDING: LIQUID CAPACITY PUMP MO EL. PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
DYES ENO DYES ENO OYES ENO
GALLONS PER CYCLE: PUMP AND CON SRO SOP noNAL: NUMBER OF PROPERTY WELL BUILDING JVENTTOFRESH
(DIFFERENCE BETWEEN FEET FROM LINE AIR INLET:
PUMP ON AND OFF) Y NO NEAREST
SOIL ABSORPTION SYSTEM. Check the soil moisture at th ep h o pl wing H [:FTER MATERIAL AND MARKING
or excavation. (If soil can be rolled into a wire, constructi n h II c as until FORCE
the soil is dry enough to continue.) MAIN
CONVENTIONAL SYSTEM:
WIDTH. LENGTH. 1\10 01` DISTR. PIPE SPACING. COVER INSIDE DIA.. #PITS: LIQUID
BED/TRENCH ,y TREK ES M TERIAL PIT DEPT j
DIMENSIONS
GRAVEL DEPTH FILL EPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL. NO. DI R. NUMBER OF PR OPERTV WELL: BUILDING: VENT TO FRESH
V. E ND r PIPES: LINE v AIR INLET.
BELO PIPES,, ABOV COVER. ELE NLE ELE
~~jjpp.~ 3 FEET FROM
uIV)`
NEAREST-----P--
MOUND SYSTEM:
Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM
and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA-
meets the criteria for medium sand. TIONS MEASURED.
DYES ENO
SOIL COVER TEXTURE 4:] ANENT MARKERS: OBSERVATION WELLS.
DYES ENO DYES ENO
DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED UEPTH OF TOPSOIL. SEEDEDMULCHEDCENTER EDGESENO DYES ONO DYES ENO
PRESSURIZED DISTRIBUTION SYSTEM:
WIDTH LENGTH. NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER:
BED/TRENCH TRENCHES:
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING:
ELEV.. ELEV.. DIA.. ELEV.: PIPES: DIA.:
ELEVATION AND
DISTRIBUTION
HOLE SIZE HOLE SPACING. DRILLED CORRECTLY. COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO APPROVED
INFORMATION PLANS.
DYES ENO DYES ENO
COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PRIOEERTY WELL: BUILDING:
FEET FROM
1",y DYES NO OYES ENO NEAREST
I
rJl~ 4- Q
Sketch System on Retain in county file for audit.
Reverse Side.
SIGNATURE. TITLE:
n~j k -L DILHR SBD6710 (R. 01/82) oning Administrator
D' SANITARY PERMIT APPLICATION
DILHR In accord with ILHR 83.05, Wis. Adm. Code couN % Q ~
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than 2 R6 V 0
8% x 11 inches in size. ❑ Check if revision to previous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROPERTY OWNER PROPERTY LOCATION
I A. C. A %a, Sae T Ac?, N, R /9 E (o W
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
r' S~7 0! L
CITY, STATE / ZIP CODE PHONE NUMBER SUBDIVISION NAAM~E OR CSM UUMBE'R/
II. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD
❑ State Owned VILLAGE
❑ Public Z 1 or 2 Fam. Dwelling-# of bedrooms-2 P R LT . UMBER() II ~ d
III. BUILDING USE. (If building type is public, check all that apply) n ko- tv S( W
1 ❑ Apt/Condo
2 r-1 Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 El Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. F1 New 2. ❑ Replacement 3. ❑ Replacement of 4.0 Reconnection of 5. ❑ Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental / Other
11 ® Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank"--
12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
14 ❑ System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE
L/ REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION
Z/ 9- Feet Feet
VII. TANK CAPACITY Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION New P-xisting Gallons Tanks Manufacturer's Name Concrete structed Con- Steel glass Plastic App
Septic Tank or Holdin Tank Tanks Tanks !/O d
Lift Pump Tank/Si hon Chamber Ej r_1 El I F-1 r_1 Fj
Vlll. RESPONSIBILITY STATEMENT
1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Print): Plumber's Signature: (No S mps) M /MPRSW No.: Business Phone Number.
W; c h?tit,~B1~ r o~
Plumber's Address (Street, City, State, Zip Code):
IX. COUNTY/DEPARTMENT USE ONLY
Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No Stamps)
Approved ❑ Owner Given initial 4 - Surcharge Fee)
/ ((PPii~~ t
Adverse Determination
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS '
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new
criteria in the Wisconsin Administrative Code will be applicable.
3. All revisions to this permit must be approved by the permit issuing authority.
4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be
submitted to the county prior to installation.
5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed
pumper whenever necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code administrator or the
State of Wisconsin, Safety & Buildings Division, 608-266-3815.
To be complete and accurate this sanitary permit application must include:
1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of
where the system is to be installed.
II. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling.
III. Building use. If building type is Public, check all appropriate boxes that apply.
IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or
repair.
V. Type of system. Check appropriate box depending on system type.
VI. Absorption system information. Provide all information requested in ##1-7.
VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of
tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all
septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received
experimental product approval from DILHR.
VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g.
MP, etc.), address and phone number. Plumber must sign application form.
IX. County/Department Use Only.
X. County/Department Use Only.
Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The
plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of
holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service;
streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system
areas; and the location of the building served; B) horizontal and vertical elevation reference points;
C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump
performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if
required by the county; E) soil tgst data on a 115 form; and F) all sizing information.
GROUNDWATER SURCHARGE
1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of
regulated practices which can effect groundwater.
The monies collected through these surcharges are used for monitoring groundwater, ground-
water contamination investigations and establishment of standards.
SBD-6398 (R.11/88)
APPLLCATION FOR SANITARY PERMIT
$TC - 100
This application form is to be completed in full and signed by the owner(s) of the
property being developed. Any inadequacies will only result in delays of the permit
Issuance. Should this developtaent bo intended for resale by owner/contractor.("spec
house"), then a second form should be retained and completed when-the property is
sold and submitted to this office with the appropriate deed recording.."
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Owner of Property
l,ocaE i.ou of Property section. T N - R .G... W
•lowlishlp
Ma i 1 iris; Address d t 4
Subdivision Name C
t.ot Number
Prvvious t.lwner of Property W!
Total. Size of Parcel
Dat.c Parcel was Created 2~ G
Arm all corners and lot lines identifiable? you No
15 Ellis property being developed for resale (spec house) ? Yes Nu
Volume and Page Number 4s-:recorded with the Register of Deeds
INCLUDE WITH THIS APPLICATION-OUR OF TUB FOLLOWING.
1. Warranty Deed
2. Land Contract
3. Other recordings filed with the Register of Deeds Office
In addition, a certified survey. if available. would be helpful so as to avoid delays
of the reviewing process. It the deed description references to a Certified Survey
Map, the the Certified Survey leap shall also be required.
PROPERTY OWNER CERTIFICATION
I (we) ee-ta' y that W Atatewente on thaie o+u au thus to the beet a6 89 (our)
knawl'edge: t I (we) am (au) the a1*wA1~~ of Ae =pto deAc A ed .tn tMA
~.n6onma ion 6unm, by vi4tue o` a wRJt~, ^4 deed ~ he 066.cc9 01 the
Cuunty Regislteh of Deed6 aA DoeuwAt No. ; and that I (WO
Ianeaently own .the pnapoaed a.t,tg ¢oh the ott d"Po`s+ ~4VAzem Ian 1 IwWt) have
obtained an eaeemenrt, to hun wUh the above 446keb4d P40PM4r ban the
conneuuction o6 eai.d ayetem, a,ad the 64m hob been 64 neeonded in the Mice
o6 Vie County Reg.iaate , of Deeds, ab DaCmoftt 'No.
5f(~A ltN OF OWNER $IGNATURE OF CO-OWNER (IF APPLICABLE)
DATE SIGNED DATE SIGNED
J
DOCUMENT No. WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA
i
•
STATE BAR OF WISCONSIN FORM 2-1982
451067 ~
REGISTERS OFFICE
ST. CROIX CO., WI
I? vzd..It.._. zatk al...and...Su_san ..R....B.ra_kha] Recd for Record
husband and wife as joint..tenants.,-..__"__.._.._____._-_. AUG3019®9
at 11:20 AM
I'i I• conveys and warrants to __Jeffrey•_D----Bt' tha-----and-----....-------------
__....._Vicki .S:ue..Remmerst...as-- jodn _tenants_--and-.----.- RegtVSterofDeeds',
nit.. r~S.x.tlxlfanfis~ ,_in._cQmmon,.. -
f
'
:I t RETURN ~ TO
thel, following j4psc4'd • estate- S....___CrOlX ---------------County,
State of Wyoefi
Y.. Tax Parcel No:
ast of iJEE iurvey 6X34 of Section 20-29-19 described as follows
'ILot 1 of Certif.' . Map filed May 31, 1978 in Volume "3'•, rage 604. I
;TOGETHER WITH and SUBJECT TO a 66 foot wide non-exclusive easement for
"ingress and egress and utilities in the E~ of SW^- of Section 20-29-19 i
,':described as follows: Commencing at the NE corner of Section 20• thence
,,N89045 '48"W along the N line of the NE4 of said Section, 1331.36 feet;
'!thence SO°08 141/W 4287.21 feet; thence N89°22 V7 2104.54 feet, thence
!N0038'E 810.0 feet to the NE corner of Lot 1 of Certified Survey Map in
Volume "3", Page 604 being the Place of Beginning of the Centerline of the
;66 foot wide easement, thence SO038 W along said Centerline 810.0 feet
".to the NE corner of a parcel of land in Volume 487 Page 156 being
b
ithe NW corner of a parcel in Volume 463 Page 365; thence SO 38'W along
~
the E line of parcels described in Volume 437.I Page 156 and Volume 465 ,
';Page 565, being also the W line of a parcel described in Volume "463", Page
811.6 feet to the Centerline of an existing Town Road (old U.S.H. "12")
and point of Termination.
l
is not
This homestead property. FED ~~~e
(is) (is not)
Exception to warranties:
" <
Subject to easements, reservations and restrictions of record. !l ~
i' Dated this 3.Qth-----------••--------------- day of -------------------August. 19..89..
' Ata; ----------------------•----------------(SEAL) - - - -----.(SEAL)
t
DAVID L. BRATHAL
- - - - -
-i
i ------------------•-•--•------••----•-----•-------•---•----(SEAL) --(SEAL)
SUSAN R. BRATHAL
- -
AUTHENTICATION ACKNOWLEDGMENT
David L. Brathal and
Signature(s) STATE OF WISCONSIN
Susan R. Brathal ss.
- -
----St ---St.---Croi county.
aut at this 0 U S
day of _._Q~._t i9_.89 Personally came before me this ________________day of
August----------------------1 19--II 9. the above named
" David L. Brathal and Susan R.
' TEPHEN DUNLAPrathal-, -
TITLE: MEMBER STATE BAR OF WISCONSIN
- -
to me known to be the person __q who executed the
foregoing instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY
STEPHEN J. DUNLAP
Hudson, Wisconsin
Notary Public St...... ro-ix----------- County, Wis.
(Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration
are not necessary.)
date- 19---------
*Names of persons signing in any capacity should be typed or printed below their signatures.
WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin LmRl Blank Cu. Inr.
FORM No. 2- 1982 Mihcaukee. Wis.
J
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ST C- 105 r
a
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SEPTIC TANK MAINTENANCE AGREEMENT o
St. Croix County z
W
a
H
rn
OWNER/BUYER Je /cam
ROUTE/BOX NUMBER rasa r/ Fire Number
CITY/STATE ZIP 0/4:
PROPERTY LOCATION: - , S'W !4, Section, T ¢ N, RZ'1-1_W,
Town of_A-&d_V-C'_"' St. Croix County,
Subdivision Lot number
I
Improper use and maintenance of your septic system could result in
its premature failure to handle wastes. Proper maintenance con-
sists of pumping out the septic tank every three years or sooner,
if needed, by a licensed septic tank pumper. What you put into i
the system can affect the function of the septic tank as a treat-
ment stage in the waste disposal system.
St. Croix.County residents may be eligible to receive a grant for
a maximum of 60% of the cost of replacement of a failing system,
which was in operation prior to July 1, 1978. St. Croix County
accepted this program in August of 1980, with the requirement that
owners of all new systems agree to keep their systems properly
maintained.
The property owner agrees to submit to St. Croix County Zoning a
certification form, signed by the owner and by a master plumber,
journeyman plumber, restricted plumber or a licensed pumper veri-
fying that (1) the on-site wastewater disposal system is in proper
operating condition and (2) after inspection and pumping (if nec-
essary), the septic 'tank is less than 1/3 full of sludge and scum.
Certification form will be sent approximately 30 days prior to
three year expiration.
0
I/WE, the undersigned,, have read the above requirements and agree Ln
to maintain the private sewage disposal system in accordance with x
H
the standards set forth, herein, as set by the Wisconsin Depart- w
ment of. Natural Resources. Certification form must be completed
and returned to the St. Croix County Zoning Office within 30 days
of the three year expiration date.
S I G N E D'-s
/
DATE -c2y-F
-T
St. Croix County Zoning Office
P.O. Box 98
Hammond, WI 54015
715-796-2239 or 715-425-8363
Sign, date and return to above address.
by WILDINGS
INDUSTRY, ~'#llwll` W~ M i►. NVi r1►~.w rtc. ~~rrt N DIVISION
P.O. BOX 7969
LAUCIR AND RERCOUTK)N TENS (115) MADISO
N WI 53707
HUMAN RELATIONS
{H63.090) & CltaPtttr 145.046)
LOCATION ItSN--~ - TOW,NSH1 dT NO. K. NWO). SUSDVIS~I NAM :
N ~i w 1/ zO IT Z9N~R tgItrr _/~'vo
MATT OW 41. U
-ST%tolX )Evf p.4TOAL
_ DATBB ONSERVATIONS MADE
Residence a New OReplace -Z~ ~ ~ . 2 1 T~
_
kw1 _
5r,)c.~ molt _ ~'pv~ '~.~a lam, e~ _ AKA-~•~
RATWO. 8* Site suitable for ayetent U= Site ur+sttit" for system C tI IAf >,T _ . _
tf percolation Tests are NOT retluired DESI RATEl If any portion of the tested area is in the
under s,1-183.00(Mb►, indicate: (./~'S.'CS Fioodplain, indicate Floodplain elevation: 1v A
PROFILE DESCRIPTIONS
BORINGrAL A(~-1 CHES G~FfAIiA T R OF SOIL WITH THICKNE5S, COLOR, TEXTURE, AND DEPTH
Nli'MBI R IMf ELEVATION TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.)
gl_53 t > 7S__ ~Ba,jcs t1~,~9" N s~cs~4Nok
_775 >7.7~ /d"~~t_-rs ila"IBQ.IC CI "&nrrsty~ St:''$rlNl~?-tS
e,4Z 90 .4 0 > ~/'$LLT'S Z/`QQn151L /9 SQNCS (.,-A SJ•~Ca1?NM-C.S
& Nprv~__.- X3.4 Z -
is. O 3.. 9U.a`~ Nt~t l; > ~i, $ b'`&cT5 /G>"~~Ni! S~gR.a C5~FG2 6/ p~RN h)-C`-
& S ~DOg 9q.Z3
PERCOLATION TESTS
WATER N HOL TEST TIM A MINUTES
NICER t H AFTE S LLIN INTERVAL-MIN. PER INCH
Q, c 91.SQ 3 >2
.
PLOTiaLAN: Show locations of percolation tests, soii borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori•
aontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope.
SYSTEM ELEVATION gb .9 v
4 ` p t 3Sr
rJ
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i
37 Tt v,
4
tN
46' - ' S i pall,
~~ptG4Mt't AA ~ - Z >i 1 Qp N i'i Ip l~ ----y""~
z"fkn*p A~ 1';traa~PL~
i L
1, the undersigned, hereby certify that the soil tests rely. rted on this form were made by me in accord with the procedures and methods specified in the Wisconsin
Administrative Code, and that the date recorded and the location of the tests are correct to the hest of my knowfwige and belief.
NAME print : TESTS WERE C!)MPLETED ON:
Z'Z /90
CERTIFICATION NUMBER: PHONE NUMBERlopiionat):
ADDRESS: 967 'SE<o-j~j
CST 51GN1iR[:'
DISTRIBUTION: Ot i!iinal en() rule copy to t oc,il Authoo it v, P'rr>fl- ly f i ~mv it', `;oral 1 ~ ~;1
'tlt,Hf~-Sf31~.r•..,.,~ rra r~, <r~t _ _ _ - -
w e, G - y SGd o a e ~rr.~ r3~ al Q % I eS fn
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