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Form - STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER , (� TOWNSHIP .s 1 Z-et01-t SEC. T _�L_N-R �2 W
ADDRESS I ST. CROIX COUNTY, WISCONSIN
SUBDIVISION Llq�' i LOT / LOT SIZE w�
PLAN VIEW
Distances and dimensions to meet requirements of 11148 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
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IND CAE NORTH ARROW
BENCHMARK: Describe the vertical reference oint used ! f C
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Elevation of vertical reference point: pC Proposed slope at site:
SEPTIC TANK: Manufacturer: lam'• "/j Liquid Capacity: 1601
Number of rings used: / Tank manhole cover elevation: Y , a
Tank Inlet _Elevation: !V j; >%Tank Outlet Elevation:
Number of feet from nearest- Road.: Front 10 Side,O Rear, i feet
' .From --nearest-property line Front 10 Side 1 ORear,0 �J
feet
Number of feet from: well " , building:
(Include this information of the above plot plan)( 2 reference dimensions to septic tank)
SEE REVERSE SIDE
% T:
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, Q Rear,0 Ft.
Number of feet from well:
Number of feet from building:
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed: Trench: '
Width: Length: S�� Number of Lines: Area Built: .5c'd y
Fill depth to top of pipe: T d 11
Number of feet from nearest property line: Front, O Side, O Rear,O
Number of feet from well:
Number of feet from building: Z�
(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 Q 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:
b
Inspector•
Dated: L6 - ,g0 Plumber on job:
I
License Number:
3/84:mj
A 900 0&7
DEPARTMENT 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:
SE 4,SE 4,Sec. 32 ,T30-R19 (If assigned)
CONVENTIONAL El
�gwn Std °r '�s�epl� Holding Tank ❑ In-Ground Pressure ❑ Mound
NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE:
Hary Zajac R Brook Wood Dr. Hudson W15491.6 / -d6-90 11*676
BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF.PT.ELEV.:
/Ott, v
Namt of PI ber: MPRSW County: Sanitary Permit Number:
Roger Timm 3224 St . Croix 128684
SEPTIC TANK/HOLDING TANK:
N F TURER: LIOUID CAPACI15: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER
jjr f� n �/ q/� ,/ PROVID : PROVIDED:
�V o 19 ( "� 1 l� 7 ES ❑NO ❑YES O
BEDDING: VENT IA.: VENT MATL.: HIGH WATER NUMBER OF AD: d PROPERTY ELL: BUIL ING: VENT TO FRESH
11 ALARM: FEET FROM V LI ' U (� IR INLET:
❑YES AO ❑YES O NEAREST ' " s Y
DOSING CHAMBER:
MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER
PROVIDED. PROVIDED:
❑YES ❑NO ❑YES ❑NO ❑YES ❑NO
GALLONS PER CYCLE: P MP N C OLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH
(DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET:
PUMP ON AND OFF) ❑ ES ❑NO NEAREST---00-
SOIL ABSORPTION SYSTEM. Check the soil mois r at a depth of plowing FORCE LENGTH: DIAMETER: MATERIAL AND MARKING:
or excavation. (If soil can be rolled into a wire,cc ucti n shall cease until MAIN
the soil is dry enough to continue.)
CONVENTIONAL SYSTEM:
WIDTH: LENGTH: NO.OF DISTR.PIPE SPACING: COVER INSIDE DIA.: #PITS: LIQUID
BED/TRENCH 1 TREN RIAL: PIT DEPTH
DIMENSIONS
GRAVEL DEPTH FILL DEPTH DISTR.PIPE DISTR.PI E DISTR.PIPE ATERIAL: NO. R. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRE H
BELOW PIPES: AB �OVER: LV,I LET: ELEV.E /� �p PIPE : FEET FROM LINE: AIR INLET:
S (•/l• 1 NEAREST�♦
MO ND 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 I TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS;
❑YES ❑NO ❑YES ❑NO
DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/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:
ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.:
ELEVATION AND
DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO
INFORMATION APPROVED PLANS
❑YES ❑NO ❑YES ❑NO
PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING:
COMMENTS: FEET FROM LINE
[--]YES ❑NO ❑YES ❑NO NEAREST—*
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Sketch System on Retain in county file for audit.
Reverse Side. y� n, /� SIGNATURE TITLE:
' `
SBD-6710(R.06/88) I` �
D�LHR 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 ❑ /
8%x 11 inches in size. Chet if ivisok//evious 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
S',E Y4 5'x Y4,S :541 T ?e, N, R 1 (or)
PROPER Q ER'S MA NG ADDR SS LOT# BLOCK#
CITY STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
II. TYPE OF BUILDING: (Check one) CITY NEARES ROAD
YN OF:
❑State Owned VILLAGE sf'°
❑ Public )P/11 or 2 Fam.Dwelling—#of bedrooms 5 AR ELTAX NUM ER( )
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)
A) 1. New 2. ❑ Replacement 3. El 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 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 Seepage Trench 22 El In-Ground 42 1:1 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) ELEVATION
Sr'O 4440,rc? Feet Vag Feet
VII. TANK CAPACITY Site
in allons Total #of Prefab. Fiber- Expp.
New INFORMATION N istin Gallons Tanks Manufacturer's Name Conc rete Con- Steel glass Plastic App
Tanks Tanks strutted
Se tic Tank or Holdina Tank
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:( Stamps) MP/MPR Business Phone Number:
6RIV ✓ Jo�r1^_1 4,4v- 1-714 77Z- 301
Plumber' Address(Street,City,S 4 te,Zip Code): ,
r ��3 /� 6 i
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee(Includes Groundwater a e ssue Iss ing Agent Signature(No Stamps)
Surcharge Fee)
Approved ❑ Owner Given Initial r / d d J� /f
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 8 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:
I. Property owner's name and mailing address. Provide the legal description and parcel tax numlier(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 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)
3
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f
APPLICATION FOR SANITARY PERMIT
STC - 100
his application form is to be completed in full and signdd by the owner(s) of the
roperty being developed. Any inadequacies will only result in delays of the permit
seuence. Should this development be intended for resale by owner/contractor, ("spec
ouse"), then a second form should be retained and completed when the property is
old and submitted to this office with the appropriate deed recording.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
er of Property
Location of Property k S 1�, Section , T_ 36 N-R /% p
Township �b .2 L1 A
Nailing Address " J R f0v 710J d f-
Address of Site
Subdivision Name —C'�X1`1__
Lot Number Z
Previous Amer of Property QlctJ��i �r� �
Total Size of Parcel
Date Parcel was Created 77
Are all corners and lot lines identifiable? Yes No
Is this property being developed for resale (spec house) ? Yes No
Volume _ and Page Number - 3f,L- as recorded with the Register 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 the deed description refer-
ences to a Certified Survey Map, the Certified Survey Map shall also be required.
PROPERTY OWNER CERTIFICATION
i (lvo) cVt.ti.6y that att atatement�s on thus OAM ane tJCue to the bust o6 my (own.)
hncwtedge: that i (we) am (ahe) the ownenk 06 the phopehty deAcAi.bed in tit a
.inAolmdtion 6o", by viA-tue o6 a waAAanty deed Aeeohded in the 066.ice o6 the
Ceitn,ty Regihteh o6 Deeds ail Voeument No. °��� ; and that I (we) pheaenttty
eon tJ+e 0oposed 6i.te bon .tile 'selvage dils_0A _ 'a"ys a—m (on I (we) have obtained an
easement, to nun with .the above deAcAl-bed pnopeAty, 6o& the eonatAucti.on o6 aai.d
e yetcmv and the same haA been duty Aecohded Xn the 066.tee o6 the County Reg•i,a•ten o6
Oeede, ae Doewnen,t No. )
SIGNATURE Of ER SIGNATURE OF CO-OWNER (IF APPLICABLE)
n�TV etnvrn •
DATE SIGNED
i
DESCRIPTION
A parcel of land located 'in the SE 1/4 of the SE 1/4 of Section 34, T 30 N, v
R 19 W, Town of St. Joseph, St. Croix County, Wisconsin, described as follows:
The N 1/2 of said SE 1/4 of the SE 1/4, subject to existing highway right-of-way
across the West 33' thereof and across the East 17' of the West 50' of the North
609' thereof, as recorded in Volume 320, page 597, more fully described as
follows: Commencing at the SE corner of said Section 34; _thence N 00 1 ' "
(assumed bearing-referenced to the monumented East line-of said SE 1
bear
N 00 13' 06" E, assumed bearing) along said East line 655.44' to the point of
beginning; thence S 890 15' 43" W 1324.90' along the South line of said N 1/2
of the SE 1/4 of the SE 1/4; thence N 00 19' 21" W 656.06' along the West line
of said SE 1/4 of the SE 1/4; thence N 890 17' 32" E 1344.34' along the North _
line of said SL•' 1/4 of the SE 1/4; thence S 00 13- '6611-w 655.44• along said.
East line of the SE 1/4 to the point of beginning.-
I. James E. Rusch, registered Wisconsin land surveyor, do hereby certify that I
have surveyed and mapped the above described property; that such plat is a true
and correct representation of the exterior boundaries of the land surveyed; and
that I have fully complied with the provisions of Chapter 236.34 of the Wisconsin f
Statutes and the Subdivision Ordinance of St. Croix County to the best of my
professional knowledge, understanding and belief. ,
.
•RR I:"Ri
James E. Rusch
Wisconsin Land
rve Y or S-1376 =�! d•D
Stevens Engine rs, Inc.
1407 Coulee Road ' Jr^,f>!ES C.
Hudson, Wisconsin 54016 RU �C.�
S-1376 '
°e Fiver F,:i.s, j
1
Surveyed For: Gerald E. Line, Owner , �i� lJ1s' r• •'L,;
4257 Highland Drive pv < Ma..+��•�' �0' w
St. Paul Minnesota 55112 Ief NM SUR`��
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�u •r+.• % 191L 79-1180/918 -- ---- t'
PAY TO THE �
ORDER �
OF ci Q C _
DOLLARS
,
STATE
.IV CBANK
Q I0N J HUDSON
WISCON�SIINy(54016
`-
1
01:09 L8 L L8001: 209 290611' s
:ould not 1
_.... �,.... ... 6�..... ,... ..��.... ...,.........,�,.�..a1 and field f
location of property-lines.
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STC - 105 r
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SEPTIC TANK MAINTENANCE AGREEMENT Ho
St . Croix County z
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OWNER/BUYER G' u
ROUTE/BOX NUMBER Fire Number
CITY/STATE ZIP
PROPERTY LOCATION: S £ Z, 5� 34, Section , T 3C> N , R W,
Town of , St . Croix County ,
Subdivision /Ufa Lot number IZ4
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 , I
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
E
I/WE, the undersigned , have read the above requirements and agree N
to makntain the private sewage disposal system in accordance with x
H
the standards set forth , herein, as set by the Wisconsin Depart- v
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 .
SIGNED✓ v 1
DATE
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 .
DEPARTMENT 01" ', REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
iIID"S7RY, DIVISION
LABOR AND HUMAN RELATIONS PERCOLATION BOX 7969
.TESTS (115) P.O.MADISON,WI 53707
(H63.09(1) & Chapter 145.045)
LOCATION: SECTION: - .�(or OWNSHIP UNICIPALITY: ILOTN :BLK SUB DIVISION NAME
-- 33-�`// - 1 - - �e �+---=-- ---... - - - _ ._ ------------- -
COU TY: OWNE 'S BUYER'S NAME: MAILI ADDRESS:
USE I DATES OBSERVATIONS MADE
NO.BEDRMS.: COMMER I L DES RIPTION: PROFI D IONS: RCOLYIOYTE S TS:
esidence XNew ❑Replace.
RATING:S=Site suitable for system U-Site unsuitable for system `r 1
C �T❑� . OND:❑� IN-GROUND-PRESSURE:_ �� . S[:]S.IN-FILL HOLDING TANK:'' .1 . 6 /Iopt�onal),�
�11�=�'',(J` , S S. 1B.�dU1
If Percolation Tests are NOT required DESIGN RATE: If any'portion of the tested area is in the
under s.H63.09(5)(b),indicate: .<3 lFloodplain,indicate Floodplain elevation:
PROFILE DESCRIPTIONS
BORING TOTALr DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,TEXTURE, AND DEPTH
NUMBER DEPTH*}, LEVATION OBSERVED EST. IGHES TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.)
B , y f DyIG 7 ' Q' d. , `.��9 V,y2 r
B- y > 7 ' � y'
331
B_ 3
B- 7, l5 02.9 7,73 -Qis �.z`sah�, : ah s, 9-1-
B-5 9.7 /0 . A, > 9,7" g3'Olsl //,7Bh 1, 7,7'B�, s r
B-
PERCOLATION TESTS
TEST DEPTH t I-WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER R# 'FiL'S AFTE SWELLING INTERVAL-MIN. P RI D 1 P RI D 2 PERIOD PER INCH
P- % 5 3 Siy -5 < 3
P. q,f,a 3 6 6 6 3
P- , 3 /
P_
P-
P_
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
zontal 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 R
�% 'P z C��bar;l/�C•� a{J /M. nL PW W,�J, /�d.D I - - ---
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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
Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
NAME(print): TESTS WE FE CO PLETED ON:
ADDRESS: CERTI ICATI N NUMBER: PHONE NUMBER(optional):
I �A S� �, GJ: 0/4 s 1,0 6 3 7 3rz s,o3
CST SI N TU
a�
DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester.
DILI-IR-SBD-6395 (R.02182) —OVER —
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��� VOL 18 PAGE 4783
APR 6 KAT ATHL:EEII H. -----
S. CROIXUCO SEMI
4 L RECEIVED FOR RECORD
07/07/2004 04:15PK
� CERTIFIED SURVEY MAP
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Vol 18 Page 4783
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SURD. -
344993
CERTIFIED SURVEY MAP
FILR®
NoV 251977
JAWS •!C014M.LL E I/4 CORNER
bWlW at Deed's SET 3/4" IRON BAR, 24'LON'
Qto1x County, �W / OVER 20d SPIKE
Wluonein FOUND AT FENCE POST
CD
UNPLATTED LANDS o
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SW CORNER
SE CORNER
SECTION 34
T30N, R19W
SCALE IN FEET
200' 1001 0' 100' 200'
LEGEND (I"= 2001 1�
County Monument - Berntsen Cap APPROVFn
0 #6 round steel reinforcing rod, 1/4" diameter x 24" )
weighing 1.502 lbs./lineal foot set. 2 3 ����
ST• CRQ�-
-�E—-%I Fence Cow aFHF ,e P *W
APPRON aru 2�G C��
Section or 1/4 section line_, DOES NOTOFTHISMINORSUBD TTa,
BULL MEAN I�'1SION
Shore line; VG S{t� ORS SEPTIC
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FJ?�TA''H62 2a S1�S
• 1" iron pipe found
• 2" iron pipe found
This instrument was drafted by Scott B. Lohman
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