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HomeMy WebLinkAbout030-1015-40-004 � o (Do M ti O cz h I o � 1 V N C .L-r ' ca a c m U) ti u) cc m m°°° o� in rNL e z f0 a) c p-a>in o N3: m LL O O N U 3 0 y to C 'O L a3 N <1 a : M O Z H O) Z ; O E Z a m v H U) 0 c o z p z � c Z o o H r c _ E Q' m M N a •� a L 0 1I c O O z H Z N z y c N r r+ N r0 L 4. 0 O �l U a l0 w N C �i tc6 to ',. M d N - O v ° co 0 0 a ° > d Z o Z •N 3: aaa a O o o N o a°'o 'o N U = rn 0, o .p M °' rV m ° w O E cl O o aa) N a p d Q LO a d o 0 1V O ° C H C O C7 U CD c0� LL H c V d. 0 t i (gyp L .0 N N ZZ V w � °� N U M 00 ° ca O N p U • O O U) 2 .- O Z c 1- U) O � I V� d (L 3 a CL • a m :0 a) c E ` c ' c w 1 1 �1 A 0 a 2 O N v Parcel #: 030-1015-40-004 03/17/2005 09:35 AM PAGE 1 OF 1 Alt. Parcel#: 04.29.19.64F 030-TOWN OF SAINT JOSEPH 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 SCOTT W&ELIZABETH M JENSEN "JENSEN, SCOTT W&ELIZABETH M 506 RIVER RD HUDSON WI 54016 Districts: SC=School SP=Special Property Address(es): `=Primary Type Dist# Description "506 RIVER RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.000 Plat: N/A-NOT AVAILABLE SEC 4 T29N R19W SW NW LOT 8 CSM 5/1477 Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 04-29N-19W Notes: Parcel History: Date Doc# Vol/Page Type 12/27/2001 666533 1801/488 WD 09/02/1998 586280 1353/588 WD 07/23/1997 858/495 07/23/1997 843/470 2004 SUMMARY Bill M Fair Market Value: Assessed with: 4820 221,000 Valuations: Last Changed: 07/07/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 75,500 141,900 217,400 NO Totals for 2004: General Property 3.000 75,500 141,900 217,400 Woodland 0.000 0 0 Totals for 2003: General Property 3.000 44,300 117,100 161,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 222 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 A/ ,. CERTIFIED SURVEY MAP LOCATED IN PART OF THE SW 1/4 OF THE NW 1/4 OF SECTION 4, T29N, R19W, TOWN OF ST. JOSEPH, ST. CROIX COUNTY, WISCONSIN. � OWNER LEGEND WILLIAM G MARILYN FEYEREISE.N G 1" x 24" IRON PIPE WEIGHING 1.68 LBS/ RT. 2, BOX 250 LINEAR FOOT, SET. BLUEBIRD DRIVE HUDSON, WI. 54016 CURVE DATA TABLE CURVE LOT CENTRAL RADIUS CURVE CHORD CHORD NO. NO. ANGLE LENGTH LENGTH LENGTH BEARING 1-2 68023'01" 224.35' 267.77' 252.15' S34 18'29.5"E 5 27021'45" 107.14' 106.13' S13 047'51.5"E 6 23008'30" 90.61' 90.00' S39002159"E 7 17052'46" 70.01 69.73' S59033'37"E 3-4 74 030100" 151.11' 192.78' 182.93' S31015'00"E 5-6 45010146" 231.20' 180.87' 177.62' S16 035123"E 7 27043'14" 111.86' 110.77' S07 051'37"E ROAD 17027'32" 70.45' 70.18' 530027'00"E 7-8 68°23'01" 158.35' 188.99' 177.97' S34 0 18'29.5"E 9-10 74030'00" 217.11' 279.77' 262.83' S31015'00"E NW CORNER 11-12 45010'46" 165.20' 130.27' 126.92' S16035'23 11E SECTION 4 CO. MON. N N proposed CSM1_ I I C z S89013104 11E I o o N 458.151 0 IZI 14 S0000615911E X" 0 7 88.47' z L4 LOT 5 )1 n 130,680 sq.ft. ` N89°53'O1"E �j d 3.00 acres � 66.00' � o 0 4>i S68030-00"E 56.07' 003 o Sti3 FFFT iwLOT 6 ! 100 0 200 �w 130,680 sq.ft. c� o � � 11 aM� w 3.00 acres 1� LOT 7 1 tai o`ti �• 130,680 sq.ft. 4 io 3.00 acres s S06000,00"W N + 11 50..00' �i + +� �-4 + 192.00' 243.43' N89 013'04"W Oil N89013'04"W 435.43' 331.05' %+ + �� 66 foot ROAD + DEDICATED TO THE PUBLIC z o N W LOT 8 a z w OD 130,682 sq.ft. o � N �r 0 0 . res N L2 o ro osed CSM 300 ac , V = �O�° N r O 0 iv S88°39'47"E 35.45' ,,�;• ,� ,+� ew W 1/4 CORNER N89013'04"W 435.43' TOWN ROAD j� ALLEN C. SECTION 4 SOUTH LINE - NW 1/4 t NYHAGEN CO. MON. w v' DEDICATED TO THE PUBLIC S-1407 o V ; ` O 2nn2latted_lands oo HUDSON, VOL, `�a.s� THIS INSTRUMENT DRAFTED BY DOUGLAS ZAHLER JOB NO. 84-31 ��' Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER G OWNSHIP SEC. T N-R W ADDRESS q- OIX COUNTY, WISCONSIN SUBDIVISION gaNNOWCOT 0 LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I•MR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Q s. a3� INDICATE NORTH ARROW BENCHMARK: Describe th vertical reference Point used 401 f Elevation of vertical reference point. s/ ,�,pp/proposed slope at site: SEPTIC TANK: Manufacturer: L(/ps IJ C, /9A6uid Capacity: Number of rings used: Tank manhole cover elevation: '' � • Tank Inlet Elevation: Tank Outlet Elevation: s Number of feet ro nearest Road: Front 10 Side0 Rear, O Si / feet From nearest property line Front,0Side,eear,0 G feet Number of feet from: well _�—/ building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE A , PUMP CHAMBER Manufacturer: Liquid Capacity: " 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,© Ft•_,..__ Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM / Trench: Bed: v sS / Number of Lines: Area Built: S ..�---�- Width: L S ength: S S -.t 58 Li --�— Fill depth to top of pipe: G feet from nearest property line: Front, O Side, O Rear,E�? Number of / 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 O 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, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Ins r: Dated. Plumber on job: License Number: �g 3/84:mj DEPARTIt OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS & HUMAN RELATIONS P.O..O.BO X 7969' PRIVATE SEWAGE SYSTEMS DIVISION BO MADISON,WI 53707 BUREAU OF PLUMBING S�P4, PJE+11;,54, T29N-R11914 `M ONVENTIONAL El ALTERNATIVE Stata Plan l.D.Number ❑Holding Tank ❑ In-Ground Pressure ❑Mound (If assigned) Town of St. Joseph PERMIT HOLDER; ADDRESS OF PERMIT HOLDER INSPECTION DATE: Charles Hagen I Rt. 2, Box 1221, Hudson, TATI 54016 BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: .L REF.PT.ELEV.: CST REF.PL ELEV.: Name of Plumber: 7SW P/MPR No. County; Sanitary Permit Number: ae= 11e St- Croix 119511 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY. TANK INLET ELEV.: TANK OUTLET ELEV.: IWARNINGLABEL LOCKING COVER �j PROVIDED: PROVIDED L 1U ��0 11 (1. �8 ®.YES ONO DYES NO BEDDING: VENT DIA.: VENT MATL.. HIGH WATER NUMBER OI'` 'ROAD: PROPERTY WELL: BUILDING: (VENT TO FRESH �Q�� nn ALARM FEET FROM (� LINE` AIR INLET DYES PAN V� ❑YES NO INEAREST—­31t DOSING CHAMBER: MANUFACTURER. BE�ING LIQUID CAPACITY. PUMP MODEL. PUMP/SIPHON MAN UFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: NO OYES ❑NO ❑YES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERTY WELL. BU ILDING. VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM iNE AIR INLET PUMP ON AND OFF) DYES ❑NO i NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the de th of plowing LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease unt9 Ff)RCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: BED/TRENCH WIDTH +LENGTH NO.OF IDISTR PIPE SPACING COVER INSIDE DIA #PITS LIQUID I TR ENIES. � 1 MATERIAL: PIT DEPTH: C1!IMEMSiONS 1VAO\( GRAVEL DEPTH FILL DEPTPIPF DISTR.PIPE DISTR.PIPE MATERIAL: NO. TR NUMBE OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES ABOVE CONLET ELEV.END. PIPES LINE: AIR INLET' ab FEET Es°M ►o -1 (, 30 30 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- ❑YES ONO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER ITEXTURE PERMANENT MARKERS OBSERVATION WELLS. ❑YES 1:1 No 1DYES 0 N DEPTH OVER TRENCH;BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. SODDED SEEDED. MULCHED. ICENTER EDGES. DYES ❑NO ❑YES ONO DYES ONO PRESSURIZED DISTRIBUTION SYSTEM: BFwt31TR MCII WIDTH: LENGTH TRENCHES: LATERAL SPACING: GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL. NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING: ELEV.: ELEV.: DIA.. ELEV.. PIPES: DIA.: 1. VA I Ii3T ANt I'lIl .TRt#3UT1, ' ' HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO APPROVED I MA7I, PLANS: 1:1 YES ❑NO —]YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: AItIMSER OF- PROPERTY WELL: BUILDING: FE ' LINE: ❑YES ❑NO DYES 0 N INEIAVEMN XO -- S ketch System on Retain inlu�4y file for auditor�L 7 Reverse Side. SI TITLE: Zonin Administrator DILHR SBD 6710 (R.01/82) g T Nelson � - DILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05,Wis.Adm.Code COUNTY, STATE SANITARY PERMIT# -Attach complete plans(to the county copy only)for the system,on paper not less than // 4?�/ 3 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 I. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION At 1 UV t/a Aljj '/a,S T , N, R f E or PROPERTY TER'S MAILI G ADDR S LOT# BLOCK# ;:2. �a A /:;�z CITY,STATE I ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER WT '- ©� rS- - "7 W" 141 1 11. TYPE OF BUILDING- (Check one) ❑State Owned 0 VILLLLAGE NEA BROAD ❑ Public U 2 Fam.Dwelling-#of bedrooms a PARCEI TAX NUUMBBE ) III. BUILDING USE: (If building type is public,check all that apply) 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) LJ 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 ❑l opepage 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 REQ IRED(sq.ft.) PROPOSED(sq.ft.) (Gals/day/sq.ft.) (Min./inch) ELEVATION ��i� s6�. < s03Feet Feet VII. TANK CAPACPW in gallons Total #of Prefab. Ite Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name oncret Con- Steel glass Plastic App Tanks Tanks structed Se tic Tank or Holdino Tank moo / &J Lift Pump Tank/Si)hon Chamber VIII. 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 Stamps) MFQMPRSW No..-, Business Phone Number: Plumber Address(Street,City,State,Zip Code): IX. COUNTY/DEPARTL4FNT USE ONLY ❑ Disapproved Sanitary Permit Fee(Includes Groundwater Date Issued Issuing Agent Signature(No Stamps) Approved ❑ Owner Given Initial �C Surcharge Fee) Adverse Determi tin e� 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 r 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 1he 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. Il. 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 thelcounty; E) soil test 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) 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. ------------------------------------------------------------------------------- O Owner of property CAA LL&2-&j Q Location of property �1/4 1/9, Section �_, T y N-R�W Township �U.5 � q Mailing addressC) l Address of site 11��12 12L Subdivision name So Oce- Lot number Previous owner of property Total size of parcel Date parcel was created _ L� Are all corners and lot lines identifiable? Yes No X Is this Lrand being developed for resale (spec house)? es No Volume Page Number as recorded with the Register of Deeds. --------------------------------4---------------------------------------------- INCLUDE WITH THIS APPLICATION THE FOLLOWING: CJ 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 the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. ---------------------------------------------------------7---------------- --- 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 (ate) the owner(s) of the property described in this information form, b y ��virtue of a warrant d r o ed in the Office of the County Register of Deeds as Document No. ; 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 the Count Regi ter of Deeds, as Document No. ) . — P A-A AWL VI Signature of Owner Signature of Co-Owner (If Applicable) (' / ) L' ) V � ("/ I 1�) eq Date of Signature Date of Signa ure DbCjJMENT•NO. STATE BAR OF WISCONSIN FORM 2-1982 THIS SPACE RESERVED FOR RECORDING DATA ' 448 878 WARRANTY DEED vc'. A tl rA�l -- REGISTER'S OFFICE istt tDr- "A"ke kai;ee, (. "it a�. 4A- w ST. CROIX CO., WI Ct t[�l ��!/'1 l !ri G G ,t rl Recd for Record i:t t^cw+�•I-.:r^ JUN 1 6198 at O conveys and warrants to C t.�c -1 ` C: I-�r1.� �e. G�L1 A Cct��c)i ,�� y M �-R r1.�.K ►tvt 5�fn„t K ► we W t �-r �y rei v►'�" 'C'. r Register of Deeds RETURN TO the following described real estate in Sr C',-c' :x County, I State of Wisconsin: '+ I Tax Parcel No: 030•�t D)!J' —'70 CV (fir►,"�' o-� .� S �"� ti.3 ht V') `/ `�+ S e6i` to i ck:�t 5'�i 29 00�4• r iz.XkV? i'q ���s't� Tc.�-t 0A Si._(�skl� Sr Ctrs�;� Ct:t.L..� CUtS�c^,. ft�163 cl'� v�'C.ILL� �j/I V"LLlti�e PI Z S_1j boo 3'14 C/SJ �P `�GCJC:k +✓ tLc Ttw GJ Iw 1 I-t>t�Q d11F w t L N tip..-, S-i'�LG)oL�ti� r1W vkkot'C-�i iG1L.Liitlt CLLtbI' Lr G`���bt(1Ull�S FGF' 9 i 'LGO�I, t+u i A t"`�Cy'itVF[S u. Gii+tit ,(- 'yiL'Ci•;r'Lt VIi�S4rJGtNsQ w S(' r, i CL"V c ts�s ytl�c. `skit ��lv� IS ��Cf`�� iVvl C'��i.j i�lc tut rJ vrr S t�-Pt4:' CUL-uQ •��� c� This i ko-t homestead property. (is) (is not) 14 Exception to Warranties: 5�,,a-j•�� � Q�.,y��rtz,h�.5 � ��'PS�2V+•:.'k'tc�''�s'+ �t-c�.4Q �^�f StU"+<'��°l�K S �+`fir �`�.t�C;.+c*Y Dated this ' day of ct art A. (SEAL) (SEAL) M AAj0,I l.,vAz yCrZaI e2Eti1 (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN SS. St. Croix County. authenticated this day of 19 Personally came before me this 16th day of June ' 19 89 the above named William A, and Marilyn F Feyereisen ,��1111 ' Ii: ICI gI ' TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to Fe nown to be the person 8 wiFi,041putdcrthe/ authorized by§706.06,Wis. Stats.) to ego ng instrument and a oV3 he same. e. INSTRUMENT WAS DRAFTED BY _ •C /� t n /'� Y a (� (� ames O'Connell �':ti ��7! �Zii1G`tG4vtc+% V A.�,S 4u'J0 .5.' 0') „54Gll� Notary Public St': C�01�t 1 SGS�Q}tcfty,Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not;"St�lt�' expiration are not necessary.) date: April 23, 'Names of persons signing in any capacity should be typed or printed below their signatures. $B2 NTF 7774 WARRANTY DEED STATE BAR OF WISCONSIN Nelco Tax Forms,P.O.Box 10208,Green Bay,WI 54307-0208 Form No.2— 1982 STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER DYER Via. �� `—� 7A �� (� V� ROUTE/BOX NUMBER z �'J�x �,2 l FIRE NO. CITY/STATE _4�(ihSoN ZIP 6 PROPERTY LOCATION-S_1_11�_1/91/4, Section , T-) N, Rj_9__W, Town of S[�1 , St. Croix C unty, Subdivision 3 uI rA.JC� , Lot No. 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 , the undersigned, have read the above requirements and agree to maintain e 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. SIGNED DATE St. Croix County Zoning Office St. Croix County Courthouse 911 4th Street Hudson, WI 54016 (715) 386-4680 Sign, Date, and Return to above address F d .�•5:1: � �5 ., � •• C 4 LAV H MS °W CL 6QOROOM FAMILY-KIT 111.0x121.9 rl—F� 181.2XI01.3 olnlnG yL.�ej a 1160x101.9 a a Lin�srort L a/ w t4 aI 0 Entering the drive, which is at street a cL a level, gracious steps lead you to the LIvInG distinctive double front entrance doors 151.OXIGI.3 CL and vestibule which is located midway 12#-GRx10o°o IgOiGXKY-O between the ground floor and first floor - CL levels. Seven steps down takes you to a large 501.0 family area that offers the conveniences 1 F I RrT• FLOOR of a soda bar and lavatory. To the left, the garage has an abundance of storage space and the centrally located utility area concentrates all the plumb- STORAGE ST011AGE SOD HEAT A ing because it is directly beneath the LAV kitchen and bath facilities on floor _ LRunORY above. 101.8X1II.6 The exterior is picturesque because it has a colonial appearance that reflects GR4RGE FAMILY a modern feeling. Board-on-board sid- _ 22Ix22/.O 141XY.1.4 ing, brick veneer and colorful asphalt CL shingles are the principal materials. STOR VEST 1,400 sq.ft. rL 25,200 cu.ft. (includes garage) GROUnD•FLOOR 5.111 i � �z�s� �. ' x a � f•�`���,�&y�,�� r � a � �F�I� Y� Q�. v F�,'� �:�� m" IK a s ; 160,301 c,q.f t. /,{ _. 3.6' ,, - F:n` I !'.:I f f 3.00 130,G60 ..,1.1 t. 3`,8.52' 8.02' Ic"..';il iWAD CT) SOlcl'/' lf>"4l - ` A 66.00 - S68°42.'44"E C) 1 100 200 ' r LOTS j t- r w o Ell N 130,680 sq.ft. � � . WILl.liti•1 f: MMULYN F'EYE.W..i:"i..N t t Suc1 . 1rJ m � 3.00 acres 71 , Ir f l FtS L aHC? `> ° (n om HUDSON, W1 54016 �afs c~ Is N88 42'44"V! � 307.05'- o o 396 2 � GS o 0 I a rn �d + to vi f� �"" 1.1-CLND 41 :� ►; 1 (90 2 Z91i L 7 7 2 I LO1 1 I" )k-)N 1>TPE FOUND. i 13U,6tlb I J o i I>f)n' 1'!t'.'•: sc .i-t.. I. fn v Ic, ] .(,t) 1.!s: jI.IN. FT. SET. 3,(!0 F,Ct'F•S O I� u, to I(n •GS - _., � 6ti F001' 1?U?,I) U1.1+'CAT' 1) TO THE PI111),IC l0IT' 4 130 680 s ft. r 3.00 acres t`n� •• .•i-� ,.:•.. R !..10 Q, /ALLEN C. , r, 458.15' ___ �?• �, t ,'.'n LOT 5 i , 88.471 130,6130 sq. t. N89.4 01"G l� �s / i . _ �d 3.00 acres ' `Va-__, ,` �� 66.00'. �> �(). _ LOT 12 SfoCi ' - E ^ 5 r o (r Q� �► ►� ;. OT f `u S o , sq. t. �. �r3.00 acres LOT 11 L4 LOT 7 ; i - 1 o U�/� 130,+- 0 s .ft. 2 vri,312 sq.ft. I q 2 ' 2: - to 3.'3.00 ;.cres 2 :5�t0 L• �(JI I�flQ00 v q l 0 1'1 2. 0 24.x3 + G .43' 1:8•+ 13'04 4� J.4 3' :)31 .0 it. O r'} ': f.t .l 1 0. 111 16900 oY 'Z 21 � Co 1 v 30,( tiZ sq.ft. of LO) too .a l� o 1�0 3t 00 t ( a ., :'(j; l C!lilJ LIi;:? - NilI 1/!, •, _ 1 l,.n,.. � i I. , V� - o�. tAbq r �`11 .�•��� 3�o e oa '� 1 -� D CP A R TM 0% )F SA ETV&L DI' IMDL.;,;rr, REPORT ON SLIP BORINGS AND LA'WR AND P.O. PLRCOLA'riON TESTS (115) MADISON D I S 0 NBWOX 5 3HLfiA-, RELATIONS :71 71" (H63.09(1)&Chapter 145.045) LOCAT ON- -:CTION: T('-WNSHI DIVISION NA ME I "A"4-4PAU-T-Y f I '5 to '/'4 Ilis /T21 N/R j%E(,,)W 'PIA7 OVA COUNTY: PW S NAME' USE DATES 013SERVATIONS MADE NO.BED13MS.:1COM-M-7MAL DESCRIPTI It MOM LE DESCRIPTIO99J. PrMWATION TESTS: Residence 2- e LOA, L 2 I RATING:S-Site suitable for system U-Site unsuitable for system CONVENTIONAL: MOL 3ROUN06PRESSUR.FTYSTE U 0S-IN-FILL 0 DINC MENDED SYSTEM:(optional) 0 FA ms , f Percolation Tests are NOT required RATE: If any portion of the tested area is in the if s.H63.09(5)(b),-r, =dIcate: Floodplain,indicate Floodplain elevation: - - A4 PROFILF DESCRIPTIONS RE HJQ R TER-INCHES T,'H_A_WAU'ffR_0TT01L OATIA ',;KNESS,COLOR TEXTURE,AND DEPTH SERVJDQUIIDIW. FZTMBERtqG2pp4_W. ELEV'ATION HIGHESI- TO BEDROCK IF OBSERVED(SEF AB9RV.ON BACkT) �7 /7 B- 3 - 64 lu Al, 1, 17 2- jVr B- 23 AA20 9 13-y 0 PERCOLATION TESTS j,,,=jjDE;;PT;H_ WATER TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES RoplienIES AFTER SWELLING INTERVAL-MIN. PERIOD 3 PER INC4 _ K 2ERIOD I PERIOD2 P_ 1 1019 -4- 1 P- 7- 1—.,1�-_t- — Ab/VA: 1 -3 < LP. 3 1 a as 106 +3_ P- PLOT PLAN: Show locations of p,.--cowkAr. tests, soil borings and the dimensions of suitable sod are_?s. Indicate%cale o; distances. Describe what are the.hori- zontal and vertical elevation reference poin 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 7 k' g. 4 t A" 4_ t N T 4-- T III A- i F- J­ F t -El 1,the undersigned,hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administratiuv Code,and that the data recorded and the location of the tens.are correct to the best of my knowledge and belief. E tprinti.,--j TE,'.TS WERE COMPLETED ON: IADDRE SqS: CERTIFICATION NUMBER: PHONE NUMBER(optional): � DISTRIBUTION:Original anc;one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBO-6395 (R.02/82) OVER- At A by �IrCAVAI t/�.�1 Saa wx s�a�G Ui7B y„ SO "FA 1 PuA S3 t � � I.J✓i I1� �I r a I t 1 JV _ f