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HomeMy WebLinkAbout020-1240-70-000 o � j2 \ g e a § � 0 ■ , o / 0\/ � © a6 � 2 520 � \\ 0 � t 222 4 D �) � / b00 o E >2 ) z § oc . ee® 3- k � kk§ 7pe8E , n , § / § IL i . / \ z � 2 / . . , to « cn k 7 ƒ E � 1 e ® N ¥ a \ } / § { 7 z ) \ / c ., z / 0 k R � }E 2 � j / C § $ 0 § k S§ 2 3 k k k f � EL « 0 " o a 2 a IL 2 2 _ _ 2 j q } § § z � � \ k \ \ 2 S S « =k a j .6 I / R .� 2 � 2 # a ' M s7 . . CE, LG§ @ B{ § } $ 0 \ © k z k 2 § ] k 2 © E ` ' § & 2 S o z a » ( 2 ' ika § ƒ J a a jo & J • Parcel #: 020-1240-70-000 12/15/2004 08:36 AM PAGE 1 OF 1 Alt. Parcel M 21.29.19.1248 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 * GLENS&FLORENCE A LABEAU LABEAU, GLEN S&FLORENCE A 508 JACOBS LADDER CIR HUDSON WI 54016 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description *508 JACOBS LADDER CIR SC 2611 SCH D OF HUDSON SP 1700 W ITC Legal Description: Acres: 2.609 Plat: 2135-JACOBS LANDING 2ND ADDITION SEC 21 T29N R19W NW1/4 OF SW1/4&SW1/4 Block/Condo Bldg: LOT 26 OF NW1/4 LOT 26 JACOBS LANDING SECOND ADDITION Tract(s): (Sec-Twn-Rng 401/4 1601/4) 21-29N-19W Notes: Parcel History: Date Doc# Vol/Page Type 07/28/2003 732177 2332/400 WD 912/605 849/97 2004 SUMMARY Bill#: Fair Market Value: Assessed with: 49288 266,400 Valuations: Last Changed: 10/29/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.609 33,100 173,000 206,100 NO Totals for 2004: General Property 2.609 33,100 173,000 206,100 Woodland 0.000 0 0 Totals for 2003: General Property 2.609 33,100 173,000 206,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 220 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 ST. CROIX COUNTY ZONING OFFICE L St . Croix County Courthouse v 911 4th Street Hudson, WI 54016 J �Y Telephone - ( 715 ) 386-4680 The St . Croix County Zoning Office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals . Completion of this form is essential so that the property can be located . Please provide the following information, enclose appropriate fee made payable to St . Croix County Zoning Office, and mail, along with form to the above address . Testing will be done as soon as possible after fee and form are received . WATER TESTING----------------------------FEE: $ 25. 00 as-. o 0 (For nitrates and coliform bacteria) WATER TESTING FEE: $127 . 00 (For VOC' S ) a� O SEPTIC SYSTEM INSPECTION-----------------FEE: $25. 00 ( Determines if system is properly functioning at time of inspection ) Property owner ' s name --ff Property owner ' s address SO co DS Legal Description 1/4 of the 1/4 of Section _Z.C7 , T N-R Town of ky�lN" Lot Number ?-(,o Subdivision Name .7ata65, FIRE NUMBER SO g VSV4E -� -drl�h LOCK BOX NUMBER Color of house Cay0A.Tuu" Realty sign by house? l. eSIf so, list firm: bt t )& 'Q� AUT`� PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP, i .e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted . WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained . Firm or individual requesting services : Lsi 0a4' Telephone Number S S It REPORT TO BE SENT TO: `z- &YVJJ &WAL T Closing date Signature 1 e r _ _ COkdERCIAL TESTING LABORATORY, INC. k. 5f4 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715 - 962 - 3121 800 - 962 - 5227 . . .. i� ST. CROIX ZONING REPORT NO.** 08987/01 PAGE 1 ST. CROIX COUNTY REPORT DATE: 8/07/91 ` COURTHOUSE DATE RECEIVED# 8/06/91 HUDSON, WI 54016 ATTN# THOMAS C. NELSON OWNER'. DV ( , LOCATION# 508 Jacobs Ladder Circle, Hudson COLLECTOR# M. Jenkins SOURCE OF SAMPLE# Outside faucet COLIFORM# 0 /100 ml INTERPRETATION# Bacteriologically SAFE NITRATE—N# 7 ppm Above 10 ppm exceeds the recommended Public Drinking Water Standard. Conform Bacteria/100 ml Nitrate—Nitrogen, mg/L r 'F4 LAB TECHNICIAN# Pam Gane 4a WI Approved Lab No. 19 0 V •> 4 C Means "LESS THAN" Detectable Level Approved by; ® PROFESSIONAL LABORATORY SERVICES SINCE 1952 - - ST. CROIX COUNTY WISCONSIN h "x ZONING OFFICE ST.CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON,WI 54016 - (715)386-4680 Aug. 5, 1991 Doreen White 1st Nation Bank/Hudson Box 187 Hudson, WI 54016 Dear Ms. White: An inspection of the septic system on the property located at 508 Jacobs Ladder Circle, Hudson, WI was conducted on Aug. 5, 1991. At the same time a water sample was obtained for testing. The results of that testing will be sent to you as soon as we receive them back from the laboratory. At the time of inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis . Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years . Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. 'n ejk)ns P Ma Assistant Zoning Administrator cj Form - S T C "' 104 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP /.[¢S SEC. T N-R ADDRESS '2.. ST. CROIX COUNTY, WISCONSIN /d sa�, LA)T-- ACS(D/b b Lo- -7boU0 SUBDIVISION X05 S Lcc� LOT Z,6 LOT SIZE 7­9 �G(r y —T PLAN VIEW Distances and dimensions to meet requirements of I,14%'`+B3 j i SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM sc a �Q its/ x 14 d ? cy 0 i \ r �S v INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used ��2c ,'D Q,S,(Pj �„�,�,✓ J. Elevation of vertical reference point: / .00 Proposed slope at site: 3_/iv SEPTIC TANK: Manufacturer: -his r✓ Liquid Capacity: 5-, Number of rings used: G�_ Tank manhole cover elevation: 3_G 7 j, Vy Tank Inlet Elevation:5•0S-/�Tank Outlet Elevation: �_ 35�;- 9k. Z Number of feet from nearest Road.: Front,wSide 0 Rear, O ,/Q feet From nearest property line ',Front 10 Side 10 Rear,0 feet Number of feet from: well �, building: Z-7 (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE G , PUMP CHAMBER : Liquid Capacity: Manufacturer: q p y IV Pump Model: Pump/Siphon Manufacturer: 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,0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: I� Width: Ler y`th: Number of Lines: 3 Area Built: 73(0 f Fill depth to top of pipe: 46 " Number of feet from nearest property line: Front, O Side, ( Rear,0 Pt .� Number of feet from well: 9 Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Numbs ' of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one; . HOLDING TANK Manufacturer: Ilk Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from near.e-,t property line: Front, O Side, 0 Rear, 0Ft. Number of feet from well: Number of f.eQt from building: Number of feet fi-om nearest road: Alarm Manufacturer: Inspector: Dated: Plumber on job• License Number: 3/84:mj �DEPA'TENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDING LABOR&HUMAN RELATIONS DIVISION P.O.BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES&APPLICATION MADISON,WI 53707 State Plan I.D.Number: W4,9A4,S21,T29N-R194J I CONVENTIONAL ❑ ALTERATIVE (If assigned) Town of Hudson ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound EQUE E R: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Sam Miller Box 282 Hudson WI 540--16 BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF.PT.ELEV.: Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Doug Strohbeen 5432 St. Croix 119498 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ❑NO ❑YES ❑NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM: FEET FROM LINE: AIR INLET: ❑YES ❑NO ❑YES ❑NO NEAREST� DOSING CHAMBER: MANUFACTURER: I BEDDING: LIQUID CAPACITY: P PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ❑NO ❑YES ❑NO [--]YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF) ❑YES ❑NO NEAREST--111111- SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: MATERIAL AND MARKING: or excavation. (If soil can be rolled into a wire,construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: BED/TRENCH WIDTH: LENGTH: NO.OF DISTR.PIPE SPACING: COVER INSIDE DIA.: #PITS: LIQUID TRENCHES: MATERIAL: PIT DEPTH: DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO.DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV.INLET: ELEV.END: PIPES: FEET FROM LINE: AIR INLET: NEAREST MOUND SYSTEM: Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW [:]YES ❑NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ❑YES ❑NO ❑YES ❑NO DEPTH OVER TRENCH/BED D H/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL: NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING: ELEVATION AND ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.: DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑YES ❑NO ❑YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE: _ ❑YES ❑NO ❑YES ❑NO NEAREST r 7 S. Sketch System on � Retain in county file for audit. Reverse Side. SIGNATURE: TITLE: SBD-6710(R.06/88) Zoning Administrator SANITARY PERMIT APPLICATION couNTY �t =00--1 FR In accord with ILHR 83.05,Wis.Adm.Code X 1: STATE SANITARY PERMIT# -Attach complete plans(to the county copy only)for the system,on paper not less than // 9'Z147,1 ' 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 Sa,M N(,rl'/a Sw'/a, S Z TZg , N, R E(o W PROPERTY OWNER'S MAILING ADDRESS LOT# BLOCK#A119 CITY,STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER T_ 1.:S-Vo/6 39 4 27`9 Sar-ob s 'a II. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD ❑State Owned VILLAGE )A��SO h Sa c ob 5 �a n a-- ❑ Public �1 or 2 Fam. Dwelling-#of bedrooms 3- PAR EL AX NUM ER( ) III. BUILDING USE: (If building type is public,check all that apply) V O —.-7 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1.® New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ 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 [__1 Mound 30 1:1 SpecifyType 41 El Holding Tank 12 N 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 14. LOADING RATE 5. PERC.RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED(sq.ft.) PROPOSED(sq.ft.) (Gals/day/sq.ft.) (Min./inch) o , ELEVATION 141-115'6 141-115'6 7 Sq 'W Feet Od Feet VII. TANK CAPACITY Prefab. Site Fiber- Exper. in allons Total #of Manufacturer's Name Con Con- Steel glass Plastic App INFORMATION New istin Gallons Tanks structed Tanks Tanks Se tic Tank or Holdin Tank X C✓ Lift Pump Tank/Siphon Chamber VIII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name(Print): Plumber's Signature:(No Stamps) MP/MPRSW No.: Business Phone Number: st(6\1N 6QLAZ MP- S-1-3-2- ZY 2-33 Plumb is Address(Street,City,State,Zip Code): 3 %_ 'I- �, o IX. COUNTY/DEPARTMENT USE ONLY 1HOwnr Disapproved Sanitary Permit Fee(includes Groundwater a e Issued suing Agent Signature(No Stamps _ Surcharge Fee) 19 Approved Given Initial 'P1 to ,oU /,� Adverse Determination ``## �.3 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 `' t _ u i i 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: I. 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. s 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. Vlll. 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 test data on a 1-1-6 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) i l .f II APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. ------------------------------------------------------------------------------- Owner of property S�r� i'/i%//�r✓ Location of property LCD 1/9 1/4, Section Z / , T N-R /9 Township f1'ljze' Mailing address Address of site /./a�h4f /o.►rY :Ha �f - `Z6 Subdivision name .- /a ,D"a Lot number •��i >. Previous owner of property i r 17 Total size of parcel Date parcel was created ,12 a. Are all corners and lot lines identifiable? /r Yes No Is this property being developed for resale (spec house)?_ K Yes No Volume (/ and Page Number 6 as recorded with the Register er of Deeds. ------------------------------------------------------------------------------- INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER VOLUME AND PAGE NUMBER and the SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available would be helpful so as to avoid delays of the reviewing process. If � P Y 9 P the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I(We) certify that all statements on this form are true to the best of my (our) knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the Office of the County Register of Deeds as Document No. 513 -1--1117* ; and that I (We) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the same has been duly recorded in the Office of t County Reqjji ter of Deeds, as Document No. 4/3 Sy/7 ) . Signature of Owner Signature of Co-Owner (If Applicable) 4 - 2 - �?? - Date of Signature Date of Signature i DOCUMENT NO. WARRANTY DEED THIS of ACg ALsinvao VIM 09CO1101100 OAfA STATE BAR OF WISCONSIN FORM q—iftl! I� OFFICE�R'� OFFICE '. . ,I1 • 435417 M twx coot WI bed for Record Virzinia.M.. Manson, a single woman... . ........ ........... . . .. ... .. . . ... . ... . ... .. ............. � ........... ... ..... .. . . ......... . ..... .. .... ........ .. .... 8:00 A QA .. .. ...... . ..... . ...................... eA conveys and wflrrants to . $Am..E. Mille r...a..aingle roan... ....... ... . d �, ... ......... . .. . ...................... (iMow of ONE . . . .. ......... ... ... ........ ........... ............ �. .... . .... .... . ... ..... .. .. ......... . .... ....... .. .. . ........ .. . .. ............... .... AETURN To . .......... ..... . ..... ... ........ . the following described real estate in ......St...Cro. .. .... x ... ty ...............Coun , .. ... .. State of Wisconsin: TaxParcel No:.............................. West Half (W11) of the Southwest Quarter (SW's) of Section Twenty-one (21), Township Twenty-nine (29) North, Range Nineteen (19) West, St. Croix County, Wisconsin except that part South of the public highway and except Lots 5, 6, 7, and 8 of Certified Survey Map in Vol. 6, Page 1747, Doc4 No. 419479. That part of the West Half (WIj) of the Northwest Quarter (NWj) of Section Twenty-one (21), Township Twenty-nine (29) North, Range Nineteen (19) West, St. Croix County, Wisconsin lying South of the right of way of the Chicago, St. Paul, Minneapolis and Omaha Railway Company. • SFf:K� 0 EEE This . is not.. ....... homestead property. Mink (is not) Exception tip warranties: easements of record and protective covenants and restrictions of record, if any. Dated this . °1 %1r 1 day of . .m A 0-C , 19.88 . .. . . ........... . . .. . ASEAL) --c. (SEAL) . .............. ......... .......... ................... . . ... • .V1rg1n1a.M...Hanson ... ... . .. .. ... . ....... ... . .. ....... . .... . .(SEAL) .(SEAW ....... .... . . . ... • AUTHENTICATION ACKNOWLEDGMENT Signature(s) ............................................................ STATE OF WISCONSIN r a$. ................................................................................ (( County. ....... . k./t!y�I1............ authenticated this .......day of........................... 19...... Personally• came before me this ...°... ........day of ........MPt.ft L................. 19.08... the above named ................................................................................ Vir inia M. Hanson •............. .....!..................................................... ................................................................................ TITLE: MEMBER STATE BAR OF WISCONSIN ......................................................................... ...... (If not. .................... ... ....... . . . .. .. . ........................................ authorised by 4 706.06, Wis. State.) to me known to he the person ...... .... who executed the foregont and aA� owledge the same. THIS INSTRUMENT WAS DRAFTED BY V1 ...... . . .... .. ... .. .. .... 119t.R.A,..ltr((Y.A..Heywood,,,Cari. .................. lotn p "�y'. (i. "'. County, Wia. (Signatures may be authenticated or acknowledged. Both My f1b ��IC�l�ld4lent.(If not. state expiration are not necessary.) date: : . 19.0 /. . ..) "Manes of cremes sinning in any espaeity sMmld be yped..r .r1nVA b.-low Ih•ir rlanat.:n•.. WARIMNTT DEED STATE BAR OF WISCONSIN O'Mmn.ln L.wnl I11%0. 1•... to.- FORM Ile E— I7%2 �Id....•Mt+, tt'1•. STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER S^r /y1i���✓ ROUTE/BOX NUMBER &,,r f 2 Jr Z-- FIRE NO. ---- CITY/STATE ,�ri./,,� i� 4a/ ZIP Z4e.;14 PROPERTY LOCATION: *4�,1 1/4 JA./ 1/4, Section 2/ , T-2 9 N, R /f W Town of /�4g�Sort , St. Croix County, Subdivision J�a�s 1�Hti' , Lot No. Z� Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a LICENSED SEPTIC TANK PUMPER. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County Residents MAY be eligible to receive a grant for a MAXIMUM of $3000 of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of ALL NEW SYSTEMS agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Department of Natural Resources. Certification form must be completed and returned to the St.Croix County Zoning Office within 30 days of the three year expiration date. SIGN DATE St. Croix County Zoning Office St. Croix County Courthouse 911 4th Street Hudson, WI 54016 a (715) 386-4680 Sign, Date, and Return to above address DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS DIVISION INDUSTRY, P.U. BOX 7969 LABOR AND PERCOLATION TESTS (115) MADISON,WI 53107 HUMAN RELATIONS (H63,090)& Chapter 145.045) TOWNSHIP/�: OT LK.NO.: SUBDIVISION NAME:r4 L j t/4 w1/4 2 TZ9 N/R/9 E �+�c.c� dh•".+NG COUNTY: E MA L A D SS: ST C`t?0 is 'SAM M► LEA DATES OBSERVATIONS MADE USE NO.DEDRM C ERCIAL DESCRIPf ION: UrRasidenct INK New ❑Replace 7 Ay 3/ /9�9 JuNL RA7•W a:So Sfta suitable for system W its unsuitable for system f`', N. NIUMIS ILNG TANK:=NVL'Vt SYSTEM:(optional) QWS u Soul S oU MS U 10bjA� if P ercolation Tests are NOT required DESIOG N RATE: If any portion of the tested area is in the under s.1,163.09(6)(b),indieatas C L ►4SS Floodplain,indicate Floodplain elevation: N A &G-1 T PROFILE DESCRIPTIONS ATER INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH ELE�VATI`ON TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) Q �•�',# 4 ^(�(t-,j MS B- Z $.6,7 x}9.53 ®Ner �$LLt= ae r,4' 2�NM,S El- ji 91.0!5 KetiC r 1'�J 2 ^61,cr, t• 7'•l..Qwtt- J�j"• t''!.e'~^•?tiC.h� 66,8 0,4 & O` 9710 Nonlc� > 4•t78 x7 � 11S LTEQ+v /�'k'Rr�'- 1R h rtl�- �R El- � .q'Z 9 f:J(� > 9.9� 23 GccT Bar�L 2� g.,,,c�f�,� 4a" t�+t., 6- — — PERCOLATION TESTS WATER HOLE TEST TIME WATER V E RATE MINUTES AFTERS WELLING INTERVAL-MIN. p ff1 PER INCH r 3 36 NON g600 z > } > P-' Z•' S, o NOW is 191. 3 > > >2 < ►.n 9.t0 > >2. > 4 /tI OY Pt A#4-. Show locations of percolation tests, soil borings.and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- lX" end 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 W4$lops. SYSTEM ELEVATION LAN OT tN I T I,tM urtlWdgrted,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 At h*0shative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. nt : TESTS WERE COMPLFTED ON: It Y J04N%6Q 4PU%1.11�v')VL' hJ6 INC — - CERTIFICATION NUMBER b C PHONE NUMBER(optional): ptional): ? 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