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HomeMy WebLinkAbout040-1206-30-000 2 ) 2 � \ / 0 _ 2 \ § � � $ � ? \§ � � k � k / � ƒ � � \ D � i ; \ � 0 } 0 ) , J / � « $ i § E 10 / 7 I § ) z « c \ 5 ce G $ 7 2 7 / E 2 k 0 co o .0 ) k k ) 2 2 § / k f ~ \ ICL § � \ c ' R 2 .2 a k c @ k k '04- j ' 2 a a a • IL � r . 2 / k k v 2 coo \ _ D §\ \ \ § 0 / . a $ J ƒ f a ¢ ' r ■ ) � � . . m C. . � & Eco C? .2 6 ' o £ ® � 9 H \ A / m72E 0 - k $ / / / o ) 2 2 A � ® � % k % a � 2 » ! E _ k a § / 3 m 2 io U) 0 . � I ppl- Parcel #: 040-1206-30-000 02/07/2007 02:51 PM PAGE IOF1 Alt. Parcel#: 16.28.19.967 040-TOWN OF TROY Current X ST.CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner O-ROE, MICHAEL&DIANN R MICHAEL&DIANN R ROE 378 SOUTHERN PACIFIC RD HUDSON WI 54016 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description *378 SOUTHERN PACIF RD SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 2.250 Plat: 1993-GLOVER STATION SEC 16 T28N R19W 2.25A GLOVER STATION Block/Condo Bldg: LOT 13 LOT 13 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 16-28N-19W Notes: Parcel History: Date Doc# Vol/Page Type 05/17/2006 825484 WD 07/06/2001 650348 1675/90 WD 07/23/1997 1147/160 QC 07/23/1997 896/90 more 2007 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/22/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.250 90,000 247,800 337,800 NO Totals for 2007: General Property 2.250 90,000 247,800 337,800 Woodland 0.000 0 0 Totals for 2006: General Property 2.250 90,000 247,800 337,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 111 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST.CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON,WI 54016 (715)386-4680 Feb. 18, 1991 James Straining • �9. 61:7� 378 Southern Pacific Rd. Hudson, WI 54016 Dear Mr. Straining: An inspection of the septic system on the property of James A. Straining, 378 Southern Pacific Rd. Hudson, WI was conducted on Feb. 18, 1991. At the same time a water sample was obtained for testing. The results of that testing will be sent to you as soon an 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 operations of this system. It is recommended that the system should be pumped once every three years . Therefore , the prolonged life of this system is totally dependent upon proper maintenance of the system. Should you have any questions, feel free to contact me at this office. Sincerely, Mary J. Jenkins Assistant Zoning Administrator cj ST. CROIX COUNTY ZONING OFFICE St. Croix County Courthouse 911 4th Street Hudson, WI 54016 1� 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 (For nitrates and coliform bacteria) — WATER TESTING FEE: $175.00 (For VOC'S) 2 ----------------FEE: 25.00 SEPTIC SYSTEM INSPECTION- $ Determines if system is properly functioning at time of inspection) Property owner's name Property owner's address P Y 1 4 of Section , T N-R l� Legal Descri t'on 1 4 of the / g Town of Lot Number 5� Subdivision Name � ,►� FIRE TKRER 4/- -1 7f Color of house Realty sign by house? If so, list firm: 06V� ?-/ 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: Telephone Number REPORT TO BE SENT TO J Closing date Signature r I t: Cer*J * 42 1 IM -BERTELSEN-CUDD 10 nth Steel South ..sin. Wisconsin 54010 6i2) 43E 433 d t .. w K-4928 A Country Dream Add< 378 Southern Pacific Road L Experience country living in this CitY Hudson I Fire # Dist Ol fabulous coutempory cape cod home '/< '/e Sec I Twsp Troy Icty St Croix beautifully situated on a very Ext Cedar JYr Blt 1988 Ht Propue I Style 2 stoEr private wooded��acres. Lot Sae SMFL 2 Tax Yr .39 2 .25 _; 8 2 $3830.39 Charming 4 bedrooms', 3k baths, a 2 L C I D JApprox Rm Size 34 # Baths WT Sch Hudson story livingroom with skylight, LR 1 X1 I 17x15'5 MB BB PARS St Pat's brick fireplace and overlooking DR 1 W1 I 12'6x10 M Dwshr Disp. Mtg Bal. loft/sitting room. Spacious center Kit 1 W1 1 1311 U12 [ I Reki R&0 Mt T island kitchen w/ breakfast area fi FR L X 24'5x193 DQ WS R 0 Avg Ht $ 64.00 wood floor. Main floor laundry, MB 2 X 16'4x11' C. Wtr I C. Swr. Av Util $ 120.00 master bedroom-bath suite and 4 BR 2 X 1112x15 Well Septic Poss Date T.B.D. season porch. BR 2 X 12'2x11' Frplcs pQ C. Ai Bsmt Full walkout BR L X1 1518 101 Gar A GDO A Deck []j Patio Enjoy nature at its best on the (2J Rec Rm[7q Ldr UFFI [ J Y ( J N ( J UKN cedar deck off of the dining and Le Ij isclos a Lot 13 Glov �`t miners rM living area. i oc�eramic"hMs' T.1 + •s M. Mt concrete patio. � us S/B/C 2.4 Lister Tim ashman Ph 425-6367 PRICE: 178,900 Briar Century 21 Bertelsen Cudd 1# 230 Ph 386-8207 Directions: I-94, Exit 13, Hwy 35S to River Falls. Turn :.right on Glover Road, turn right onto Borth Glover Road, left on Omaha, then left on S. Pacific Road. Information is considered accurate but we accept no liability for error. 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A 0 EL 06 E 0 02 c 0 a CLO.Y.4) 0 = '-'- '6-a 0 E Z 0 X� .6 x cc .9 c.2`c X* 2,4 E OC z CL 0 0 , 0 -60 U,r cc Z tx� 1 - 0 r- Or C) 014 2 c 0 C,e C:s 0 6 ki -J.20 .5.2-"15 q'-_L._0 c Z w I e O� O�cm 0 r Do E 0 0 0 c 0 410 E d. 2 0 10 ii:2 :2 0 w c Q).2 4, ;ia .c > on 0 E--6 E M r z 0 a::2 Z2 Cl goo 1 4) .2 0 o 4) CL C-0 C c 00 9cc amomi�, Q. MOCZ0220 c 20 0 C. 0 E 622 Eo 2 *6 C 3t 3: 0 w-to 0 0 Form - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER Sply TOWNSHIP n SEC. T 0 N-R�W ADDRESS ST. CROIX COUNTY, WISCONSIN LOT LOT SIZE SUBDIVISION Gloyerz S )at �� 13 PLAN VIEW Distances and dimensions to meet requirements of I•LHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 18x3b BED qi = t 3' 1 as, aye Dee 3 �eDRoOh'� Home © _ 100� � INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Our. C'k lJ �k tow-C k Elevation of vertical reference point: 100-0 Proposed slope at site: � SEPTIC TANK: Manufacturer: GJe e k 5 Liquid Capacity: 10 U U q p Number of rings used: I Tl. Tank manhole cover elevation: 9 V.11 Tank Inlet Elevation: 91, Tank Outlet Elevation: Number of feet from nearest Road: Front,®Side, Rear, O_ a feet From nearest property line Front,0 Side 10D Rear,O Q feet Number of feet from: well �O, , building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE 1 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,0 Ft. Number of feet from well: Number of feet from building: �1 (Include distances on plot plan). 5k,+. 3! 100-31 SOIL ABSORPTION YSTEM 100 0 d _ �N O g$•(9 �• i 9 10 0.3-1 13VO Bed: Trench: QeD Width: 1 Lenjth:-3(2 Number of Lines: 3 Area Built:- Fill depth to top of pipe: a 0- 1 �! Number of feet from nearest property line: Front,t O Side, O Rear,Opt . �J , Number of feet from well: 9S Number of feet from building: V1 (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, OFt. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: - VU Dated: �p ' �U Plumber on job: •c ° ' License Number: ,-Tf 11 J U -3 l L3 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}W 1 53707 kW,4,NW1,4,S16,T28N—R19W 97CONVENTIONAL 1:1 ALTERNATIVE State PlanI.D.Number: Town of Troy ❑Holding Tank ❑ In-Ground Pressure E:1 Mound Lot 13 Glover Station NAME OF PERMIT HOLDER: JADDRESS OF PERMIT HOLDER INSPECTION DATE, Carl E. Thompson 458 Burlington Road, St. Paul, MN 55119 ('0 -)� -,9 F, B NCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN. ` n REF.PT.ELEV.: CST REF.PT.ELEV.- ajName of Plumber: t-P61 PRSW No Coumy. Sanitary Perron Number, Richard Hopkins 1059 St. Croix 106070 SEPTIC TANK/HOLDING TANK: MANUF CTURER'. LIQUID CAPACITY. TANK INLET ELEV. TANK OUTLET ELEV WARNING LABEL LOCKING COVER 1 Q / P DED PROVIDED: �rLkS O qla I '• � J YES ONO ❑YES NO BEDDING. VENT DIA.. VENT MATT HIGH WATER NUMBER OF ROAD. PROPERTY W : BUILDING: VENT TO FRESH /� �� ALARM FEET FROM / LINE AIR INLET 14 : YES NO I� G ❑YES ❑NO NBJREST SO / DOSING CHAMBER: MANUFACTURER. BEDDING'. LIQUID CAPACITY "MP MODEL 1PUMP,SIPHON MANUI ACT(IHE12 WARNING LABEL LOCKING COVER PROVIDED: PROVIDED. 1-1 YES ONO OYES ONO DYES ONO GALLONS PER CYCLE: u j AND CONTROLS OPERATIONAL NUMBER OF PHOPFHTV WELL BUILDING JVENTTOFRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) OYES []NO NEAREST SOIL ABSORPTION SYSTEM.Check the/o oist re at'the depth of plowing N(,TI+ uinnaF rEH afATEHInE AND MARKING or excavation. (If soil can be rolled into w cc struction shall cease until FORGE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH LENGTH NO.OF DISTR PIPE SPA(,IN(i COVEN INSIDE DIA -PITS LIQUID BET]/TF ENCH 4 3( TRENC s rFHIAL. PIT DEP DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR.PIPE UISTH PIPE DISTR PIPE MATERIAL NO 7H NUMBER OF P PERTY WELL. BUILDING. VENT TO FRESH BE WPIPES ABOVE COVER EI EV INLEE ELE V.ENU PIPES LIN / AIR INLET: ►� ao-H , '38.3I 06. � a9 3 NEARES°L'---P �� �s �v _ 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. ❑YES NO SOIL COVER TEXTURE PFHMnNENT MAHKFHS :TEFIVATIONWILLS ❑YES ❑NO ❑YES I--]NO DEPTH OVER TRENCH BED DEPTH OVER TRENCH BED DEPTH OF TOPSOIL SOODFD SEEUFD IMULCHED CENTER EDGES ❑YES. ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LENGTH NO.OF LATEHAL SPACING IGHAVIL DEPTH BELOW PIPE- FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES: DIMENSION MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL NO UISTH DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING ELEVATION AND. ELEV.'. ELEV. DIA. ELEV. PIPES DIA.. DISTRIBUTION MA HOLE SIZE HOLE SPACING DRILLED COHHECI LV COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION PLANS ❑YES NO OYES ONO COMMENTS: PERMANENT MARKERS OBSERVATION WELLS. NUMEER OF PROPERTY WELL: BUILDING: FEET'FR(,?M LINE: ❑YES ❑NO ❑YES ❑NO NEAREST 0 . ..-._ } Ig'b- X Y2_ 9g Sketch System on —9 `S� Retain in county file for audit. Reverse Side. -=" — !b� SI ATDRE TI7LE Zoning Administrator DILHR SBD 6710 (R.01/82) ' '(' ILHR SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05,Wis.Adm.Code STATE SANITARY PERMIT## —Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER 8%x 11 inches in size. -See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES ®NO PRO RTY OWNER PROPERTY LOCATION o saaJ Nal %/u0j '/4, S / T,130, N, R /f E (or)V PROPERTY OWNER'S MAILING DDRES LOT NUMBER BLOCK NUMBER SUBDIVISION NAME 13 O CITY,STATE ZIP CODE PHONE NUMBER CITY NEAREST AD,LAKE O ANDMARK Aauj'I ;f ❑ VILLAGE 38 II. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family -3 OR ❑ Public(Specify): 2 111. PURPOSE OF APPLICATION: (Check only one in##1. Check##2,3 or 4,if applicable) 1. a. ® New b. ❑ Replacement c. ❑ Replacement of d. ❑ Reconnection of e.❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit## Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in##1 and only one in##2) 1. a. R Conventional b. ❑Alternative C. ❑ Experimental 2. a. ❑System- b. ❑ Holding c.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. ® Seepage Bed b. ❑Seepage Trench c. ❑ See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): 3 1; 8 , 07 Feet ®Private ❑Joint ❑ Public VI. TANK CAPACITY Site in gallons Total ##of Prefab. Fiber- Exper. INFORMATION New xistin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank — S Lift Pump Tank/Siphon Chamber ❑ 10 ❑ VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name(Print): Plumber's Signature:(No Stamps) MP/MPRSW No.: Business Phone Number: /5 -90.7 O PIu er's Address(Stree,City, te,Zip Cod Name of Designer: Alegi U d r VIII. SOIL TEST INFORMATION Certified Soil Tester(CST)Name CST## CST's ADDRESS(Street,City,State,Zip Cod ) Phone Number:XL 116101A] 0 bo,.61 534616 - IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sa ry Permit Fee Groundwater Date Issuing Agent Signature(No Stamps) Approved ❑ Owner Given Initial 126 urcharge Fee ' Adverse Determination ` X. COMMENTS/REASONS FOR DISAPPROVAL: SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber i INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION TO THE APPLICANT: 1. This 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. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 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. Private sewage systems must be properly maintained.The septic tank(s) should be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years; 6. If you have questions concerning your private sewage system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 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 where the system is to be installed; II. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; Ill. Purpose of application: Check only one in ##1. Complete##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. 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. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. 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; dosing or pumping chambers; 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. GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was the result of over 2 years of steady negotiation and public debate. The groundwater bill Ground included the creation of surcharges (fees) for a number of regulated practices which Wisco tlI'S can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried rlSt1F8 a is used in your building is returned to the groundwater through your soil absorption o system or the disposal site used by your holding tank pumper. a The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- t water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398(R.03/86) 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 ��J"/' j�i Jai l( <7, 1: Location of property Jb ,j 1/4 1/ /9, Section T N-R�7W i Township l-c% Mailing address _441-S-S{ j3 e, j-/_j k,c, c 1� Address of site ��`7`�cYp h � 1 f 'c G, Subdivision name Lot number /- Previous owner of property S c_.�� c, Total size of parcel Date parcel was created 12 Are all cor ers and lot lines identifiable? _Yes No Is this operty being developed fo resale (spec house)? _Yes No Volum AP -7 and Page Number 3 3as 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 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. /�3 G G ; 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 County Register of Deeds, as Document No. Signature of Owner Signature of Co-Owner (If Applicable) l Date of Signature V Date of Signature • _. -- DOCUMENT No. STATE BAR OF WISCONSIN FORM 1-19821 THIS SPACE RESERVED FOR RECORDING DATA I' WARRANTY DEED 4-US _ � �bbt � ➢� rAt��� I KfGISTER �I S OFFICE � This Deed, made between C. ... Bye and ST. MIX CO. - - By -- WI& Dennis R.---Schultz, as tenants in commons itec'd. for Record this 1_lth ------------•------•- ----------------------_---•----••---_- ------------------------ ........... - day of AP_ r_ 1._1_....A.D. 19 --------------------------------------------------------------------------------------------------, Grantor, and Carl: _.. r1DInpsQ>ae-: of 9:30 - --------•-•---------------------------------•----------•--------------------------------------------------------- ,James O'Connell --------_------------------------------------------------------- -----------------••--------•- j ------ ---- Grantee, I Witnesseth, That the said Grantor, for a valuable consideration__--_- ---- ----- -------------------------------------------------------------------- St CroiX ;I RETURN TO C. M. Bye conveys to Grantee the following described real estate in ._._.._e__________________________ County, State of Wisconsin P. 0 Box 167 River_Falls. WI 54022 Tax Parcel No- ------------------------- i I I 'I Lot #13, Glover Station Subdivision, located in the NWT and NE14 of Section 16, Township 28 North, Range 19 West, Town of Troy, St. Croix County, Wisconsin. I l I-RANSf FEE Ij is not This _.___.._____ _ ___ _______ homestead property. X (is not) +j Ii Together with all and singular the hereditaments and appurtenances thereunto belonging; I And. grantors is ----------------------------------------------------------- --------•-----------------------•-------------•----•------•-- warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except for easements, covenants, and restrictions of record, i it and will warrant and defend the same. 11th j Datedthis -------------- day of ---------- ---Ap rll-------------------------------------------- 19.88.--• --------------------- ------------------------------------------(SEAL) - •- ----------------------(SEAL) II * ---------------------- ----------------- C. M. Bye ------------------------------------------------------------------ . l7 1�..-----------------------------------------•--------------------------(SEAL) �i -------•---...__..._(SEAL) * Dennis R. Schultz AUTHENTICATION ACKNOWLEDGMENT �1 Signature(s) __________________________________ ......................... STATE OF WISCONSIN i! ------------•----------------------------------------------------------- ------- St. Croix ss. i _ ___.__County. � authenticated this ________day of___________________________ 19------ Personally came before me this __11th day of ....April----------------------------- 19...8.8._ the above named �! ---------------•-----------------_.....---------------------------------........ *--------------------- ----------------------------------------------- -------- -- G.--M._-B-y.e---------.....--•-------...------------------------------. TITLE: MEMBER STATE BAR OF WISCONSIN Dej$_ ,_--Schultz__________________________________________ (If not- ----------------------------------------------------- I ------------------•----------- - authorized by § 706.06, Wis. Stats.) i to me known to be the person .a......... who executed the foregoing instrument and acknowl ge the same. THIS INSTRUMENT WAS DRAFTED BY C. M. Bye, Attorney at Law -----------------_-- --------------------- * Dianne L. Crosby P_ _0.__Box__167-,-_River Falls. W1 54022 -- - -------------------- ---- ----------------------•--------- Notary Public __.St.-_Croix___ --_ _--County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) jl date: ---------------N9yember---6---------------------• *Names of persons signing in any capacity should be typed or printed below their signatures. i! i� it H.C.Miller Company iYl STATE BAR OF WISCONSIN ® FORM No. 1-1982 Stock No. 13001 L_ P _ GL STAT I N { is xF " 9ECM SIT2KFwK r t OV TROY,sr COUNTY.VASOONSIN 4 iL x f R 'a t +-+ "LSD OL SOLIA-. `�' ry3.�N y s� �—�,---_-- � i-- SOLD' e�• �, OL SOr t � �•r� �3A st OLD SOL �rp�` e ULD� n # 114 s �wJ"�at A `�+ r t, SOI. ►�'-� SOLD ya M. Ys ( ^ rSs a) Sr tf xL�xSrr+t; aya a G � titre. a�smr Cb o,xe a '�i�,rre�u i aaYa �� s � ,,,.a.n.ew�r� ;'tom��at � �ej��w� c•. 4 "`te`.`. �:.� Y� ,>v s i �. ' rte, i *�i�et r -+�F.ewz• � f"na 9- r''ftt �,, a t+iJit+'rA""yK, sY '*..¢ �+ak '� �� : k - .dai aulkt- lgj�jlil SO + t!a } r MrMr 11!�ff'�� u •�wia w rr �nuL�'^4`�r � �:s r x r , s aw'�"'.riir� �"r.': �`:. ��•. r�wrt.w.^,r+.r.+wrr• , k �y yy22 • R i Andersen' SALES REPRESENTATIVE Wilk, STEVE SHEROD 439-5150 Vi,dom-patio Doom Come home to quality. Come home to Andersen. DATE JOB F t r i i 1 - I ' IT � --] f _�— _l i i 1 , j 4---"1—_— I , i i , i _ F _� ANbERSEN° P 1 S1 IEL 'WI1�1D0 S PATIO{DO R& OR COMNIER [A F& NS TUTIOI}tAL USi STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER ROUTE/BOX NUMBER ,// f t ► CJs�� s, j`� FIRE NO. CITY/STATE i�� ��I �Y ZIP�`��//� PROPERTY LOCATION: 41/4 /4, Section �*� , T .?_ N, R _W, Town ofi^ca / , St. Croix County, Subdivision C Y -� �' Lot No. J 3 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. SIGNEDZ�4,:::� \ 7� DATE oc Acj 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 I DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, G DIVISION LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS (H63.09(1)& Chapter 145.045) LOCATION: SECTION:I TOWNS HIP/MiefP*ttrY: LOT NO.:BLK.NO.: SUBDIIVISION NA1ME:MI COUNTY: WNER'S BUYER'S NAME: SS' ro;� ]MAILINGADDR 9g w/aw r 1- l��t�, USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAX DESCRIPTION: rte- PROFI DE TIONS: R ATI NTESTS: P�� A) I.�New ❑Replace RATING:S=Site suitable for system U=Site unsuitable for system CONVEcNTIONAL:IMOUND:c IN-GROUND-PRESSURE: SYSTEQM-IN-FILL HOLDING TANK:RECOMMENDED SY�^S�TEAjI:(optional) 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 Floodplain,indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH NUMBER DEPTH JX. ELEVATION OBSERVED EST.HIGHES TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) Y jjjs 7S'/j�fSY� .�3%s!/�r, 3,1'7'Qi,s'djr,./)Q�4 S, B- / 1 �$' 1. 3 1`r- B- Z �3, �I.2,Dg, 7 � 3,91' r B- 3 �'�3. /�.LS 31� .5"de sA!f�"� B- / �`I yl' > 7,v d 1 B-J 7.33 $�,73'/ `J,'73/ i,7s ,Z. 3'dy�f, 3,z5 '�n CAIC", A .> i B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER IMe"n AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PER PERI PER INCH P_ / 33 2- 6 ` < 3 P_ y, s$` Z. 6 G 3 P_ 3 ."$ V L <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/ i 7 z h9 I _ " ; /s �z fi tLbs` G►nar ! T ; N IE (41-W let ! 0 S 13 5,4e'5 pea 1 , �3 b yPj �- r �1 I t ! ! I _ I,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 E COMPLETED ON: ADDRESS: `` � CERTI ICATI N NUMBER: PHONE NUMBER(optional): 80, SI��i G6/t. S yo iZ3 7 CST SI AT Z� kk_q DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) —OVER— P. Q 67 P OTA N R 0 S ,' 5EC1+ I �� I�I P ( OJECT PLUMS .. 'N AM N: AM M E -K� -�PKA Aiop�\)N5 t,� L 0 C AT 0 N L. I.0 E NI S E :- 7"T Y P T LO IMF `70 00-,>/ 30 o 33 Sd C' 01; , ()Y 0 Q' 8) 30' ��, N 15 �90�tK �SFOrA SQ + " SReeN"t""FeNce.host wlyellda Ta� Lots Aa�w--tA to T -s 'Tkt Wtffi AgARIL Mog-k Sites 130k- fhA� FRESH 1, INLETS AND OBSERVAT100 PI-PE C1,\0SS SECTION • C�— Approved Vent Cap 9/-'7 Y Minimum 12" Above r, Final Gr ya MAX 4" Cast Iron Above Pipe Vent Pipe To Final Grade- Marsh Hay Or Synthetic Covering Min. .2" Aggregl-t( ,-) Over Pipe Distribut Tee Pipe Aggregate Perforated Pipe Below 21.Z 5 Beneath Pipe —Coupling Terminating At Bottom of System