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Parcel #: 012-1021-20-100 09/28/2005 11:06 AM
PAGE 1 OF 1
Alt.Parcel#: 08.30.17.109B 012-TOWN OF ERIN PRAIRIE
Current [X11 ST. CROIX COUNTY,WISCONSIN
Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type
09/28/2004 00 4
Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner
O-SWETLIK, RETIRED JOHNSON
RETIRED JOHNSON SWETLIK
Districts: SC=School SP=Special Property Address(es): *=Primary
Type Dist# Description ' 1672 170TH ST
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 17.000 Plat: N/A-NOT AVAILABLE
SEC 8 T30N R17W NE NE PART OF NE NE Block/Condo Bldg:
LYING SOUTH AND EAST OF WILLOW RIVER
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
08-30N-17W
Notes: Parcel History:
Date Doc# Vol/Page Type
04/29/2004 7601998 2560/065 WD
09/17/1998 587294 1358/040 QC
07/23/1997 790/619
2005 SUMMARY Bill#: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 03/29/2005
Description Class Acres Land Improve Total State Reason
Totals for 2005:
General Property 0.000 0 0 0
Woodland 0.000 0 0
I
Lottery Credit: Claim Count: 0 Certification Date: Batch#:
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
MAR 1 9 19%
506f S ST.CROIX COUNTY
CERTIFIED SURVEY MAP
8URYEYOR' RECORD
Located in Part of the Northeast Quarter of the Northeast Quarter Section 20, Township 30 North,
Range 17 West, Town of Erin Prairie, St. Croix County, Wisconsin.
of W1,9-C,
O
Prepared for and at the request of jQ DOUGLASJ. �a
Henry & Judi Brockpahler ZAHLER
1672 -- 170th Street
New Richmond, WI 54017 HUDSON,
WIS.
OWNER: Arnold J. Brockpahler Estate fqj�
o sUFN�
Drafted by: James M. Brault
UNPLATTED LANDS I = w l
NE CORNER SEC. 20 1 I W
NORTH LINE OF THE NE 1VE2166.00-
& OF C.T.H. "G" r'
--- N 89'02'00" E 2631.07'--- 33.00'-0_W LINE- N 89'02'00"
C.T.H. G,,-
_ . . _ . . _ . . _ . . ��- . . _ . . _ . . Q - -
� o
---- 2365.07 ---- — I/ �°� I V---- ---- \ �
NORTH 1/4 CORNER SEC. 20
\\ 45.00' N 89'02'00" E I
i "
LINE
R-O-W
p O W
= �I
GH DRIVEWAY LD M" Zf of
LEGEND rn� r°
CD S TBAC I io JI
Count Section Corner Monument �I _I.L6 T. _�_. _ . AREA..... i.. 0 0 1 of
County of 3 81,395 sq.ft. o Z I I
of Record. Checked from found �I $ 1.87 acres o (n— I I
witnesses & ties. Aluminum Monument 41 -- o w JI
" L0I m N WELL AREA EXCLUDING R—O—W cV °O M z
• Set 1-1/4 x 24" Iron Pipe weighing Joi =o o I 69,425 sq.ft. i `oo m of
a minimum of 1.13 pounds per >i cn I H s 1.59 acres I M r
linear foot. "Z I V)
o
• Set 1" x 24" Iron Pipe weighing i 1
AREA
a minimum of 1.13 pounds per
Kok
linear foot. �\ ; a�.„,i Old .j..lo7`l,vt, �� UtC'�Y��
UW l
( ) RECORDED BEARING
266.00' S 89'02'00" W
(EAST) i I
VOL.894 PG.493 I j
i
EAST LINE OF THE NE 1/4 — --L;j
Y
CO
GRAPHIC SCALE
r�
0 25 50 100 150 200 ND ':•1 `i a
I ,
I ,
1 inIN FEET'
ch = 100 ft. ''(XX C,,A 'ANT"�l i
Plamlir
BEARINGS ARE REFERENCED TO THE EAST LINE OF THE
NE 1/4 OF SECTION 20 TOWNSHIP 30 N., RANGE 17 W. Parks Comr -ittee
WHICH IS ASSUMED TO BEAR S 01'16'39" E EAST 1/4 CORNER SEC. 20
30 days of
NOTE: The parcels shown on this map is subject to State, County fir _
laws, rules and regulations ( i.e. wetlands, minimum lot size, acce�s�^ytSa✓p1ag,(�e) bs
etc.). Before purchasing or developing any parcel, contact the St. Crgi�ga Cou,, ty
Zoning Office and the appropriate Town Board for advice.
NOTE: This lot is being created under the Farm-
land Consolidation Ordinance.
A & E LAND SURVEYING
PHONE # (715) 246-4319
109 EAST 3RD STREET
P.O. BOX 325 Z PILED
NEW RICHMOND, WI 54017 A'fgR 1
JOB # 96002 �>HLEEN'. 1996
Sheet 1 of 2 � 1fo-0 edsSH �
Vol. 11 Page 3069
a
Parcel #: 012-1045-60-000 09/28/2005 09:49 AM
PAGE 1 OF 1
Alt. Parcel#: 20.30.17.301 B 012-TOWN OF ERIN PRAIRIE
Current [X(i 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-MOORE, PATRICIA M (LE)
PATRICIA M(LE)MOORE C-MOORE DANIEL J
MOORE DANIEL J
1697 CTY RD G
NEW RICHMOND WI 54017
Districts: SC=School SP=Special Property Address(es): '=Primary
Type Dist# Description ' 1697 CTY RD G
SC 3962 NEW RICHMOND �-
SP 1700 WITC
Legal Description: Acres: 1.870 Plat: N/A-NOT AVAILABLE
SEC 20 T30N R17W PT NE NE BEING LOT 1 Block/Condo Bldg:
CSM 11/3069 1.87AC
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
20-30N-17W NE NE
Notes: Parcel History:
Date Doc# Vol/Page Type
06/30/2000 625678 1523/170 LC
07/23/1997 1170/478 PR
2005 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 09/17/1998
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.870 7,900 83,300 91,200 NO
Totals for 2005:
General Property 1.870 7,900 83,300 91,200
Woodland 0.000 0 0
Totals for 2004:
General Property 1.870 7,900 83,300 91,200
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch#: 306
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Y
Form - S T C - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER V TOWNSHIP cL 11i°L� SEC. _ T N-R2LW
ADDRESS / ST. CROIX COUNTY, WISCONSIN
SUBDIVISION LOT / LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of I•1HR 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
i
G2
i
7o s�
a
�GISL
INDICATE NORTH ARROW
BENCHMARK: Describe the vertical reference point used
Elevation of vertical reference point: -/M0 Proposed slope at site: p
SEPTIC TANK: Manufacturer: ,S'Liquid Capacity:
Number of rings used: _ Tank manhole cover elevation:
Tank Inlet Elevation: Tank Outlet Elevation:
Number of feet from nearest Road: Front 10 Side,®Rear, O 3 a__ - feet
Mi
From nearest- property line Front 10 Side, Rear,O __T;2,- feet
Number of feet from: well /V __, building: S. 9
(Include this information of the above plot plan)( 2 reference dimensions to septic tank)
SEE REVERSE SIDE
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:
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed: Trench:
Width: Length: Number of Lines: or Area Built:
Fill depth to top of pipe: �Q
Number of feet from nearest property line: Front, `ON Side, O Rear,O Ft . �
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, O Ft.
Number of feet from well:
Number of feet from building:
Number of feet from nearest road:
Alarm Manufacturer:
Inspector:
Dated: Plumber on job: ;rl'
License Number:
3/84:mj
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS
LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
is P.O.BO"X 7969 , BUREAU OF PLUMBING
MADISON,WI 53707
NEk, NE%, S8,T30N-R17W CONVENTIONAL ❑ALTERNATIVE State Plan I.D.Numbec
Town of Erin Prairie 1:1 Holding Tank [:1 In-Ground Pressure El Mound If
Conv. New 170th Street
NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE:
Henry Brock abler Route 1 New Richmond WI 54017 // & —
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:
Calvin Powers Jr. I1563 St. Croix 99090
SEPTIC TANK/HOLDING TANK:
MANUFACTURER: LIQUID CAPACITY. TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
DYES ONO DYES ❑NO
BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMII•ER OF '..ROAD: PROPERTY WELL BUILDING: VENT TO FRESH
ALARM FEET FROM LINE: AIR INLET.
❑YES ONO ❑YES ONO NEAR987
DOSING CHAMBER:
MANUFACTURER. BEDDING: LIQUID CAPACITY PUMP MODEL. JILIMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
DYES ONO IDYES ONO ❑YES ONO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PROPERTY WELL-. BUILDING:JVENTTOFRESH
(DIFFERENCE BETWEEN FEET FROM LINE AIR INLET
PUMP ON AND OFF) DYES ❑NO NEAREST
SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKING
or excavation. (If soil can be rolled into a wire,construction shall cease until FORGE
the soil is dry enough to continue.)
MAIN
CONVENTIONAL SYSTEM:
WIDT���III LEff��TF�. NO.OF DISTR PIPE SPACING. COVER INSIUE DIA.. #PITS. LIQUID
SED/TRENCH I I ( ] r TRENCHES / , M.SERIAL: PIT DEPTH:
01MENSIONS
GRAVEL DEPTH FILL DEPTH DISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO. R NUMBER OF I PROPERTY WELL: BUILDING: V NT TO FRESH
BELOW PIPES. ABOV VER ELEV.INLET.ELEV.END: PIPES. LINE: AIR INLET:
�, I FEET FROM
Z NEAREST
MOUND SYSTEM:
Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM
and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA-
meets the criteria for medium sand. TIONS MEASURED.
DYES ONO
SOIL COVER TEXTURE JPERMANEIIT MARKERS OBSERVATION WELLS
❑YES 1:1 NO ❑YES 1:1 NO
DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. SODDED SEEDED. MULCHED.
CENTER. EDGES.
DYES El NO DYES 1:1 NO ❑YES NO
PRESSURIZED DISTRIBUTION SYSTEM:
WIDTH. LENGTH. NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER.
=.d;S IT-Ft CH TRENCHES:
131MEN$IONS
en n
MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERI L. NO S DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING:
ELEV.: ELEV.. DIA.. ELEV.: .:.w..j PIP E DIA.:
E���fATN�Al�i3 ,� )
I,NO RII3EITIof HOLE SIZE HOLE SPACING DRILLED CORRECTLY C ER MATE AL VERTICAL LIFT CORRESPONDS TO APPROVED
I IFflRMATION � PLANS
OYES ❑ DYES El NO
COMMENTS: 11PIERMANENT MARKERS: 0 WEL NUMBER OF PROPERTY WELL: BUILDING:
FEET FROM LINE:
❑YES 0 N 1-1 YES El NO INEAREST
/
Sketch System on Retain in county file for audit.
Reverse Side.
SIGNATURE: TITLE.
DILHR SBD 6710 (R.01/82) Zoning Administ
or
SANITARY PERMIT APPLICATION COUNTY ,v�j
ILHR In accord with ILHR 83.05,Wis.Adm. Code STATE SANI oERMX
� �
99?d go
—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
PRV OWNER PROPERTY LOCATION
�/4 �/4, S rg TF,6 N, R Z E (Or)W
PROP TY O ER'S MAILING DDRESS LOT NU ER BLOCK UMBER SUBDIVI N NAME
CIT ,STATE ZIP C DE PHONE NUMBER C Y NEAREST ROAD,LAKE OR LANDMARK
VILLAGE
Ajy 41 TOWN OF:
11. TYPE OF BUILDING OR USE SERVED: d`a—Ll_ l
Number of Bedrooms if 1 or 2 Family OR ❑ Public(Specify):
III. PURPOSE OF APPLICATION: (Check only one in##1. Check##2,3 or 4,if applicable)
1. a. X 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. WConventional 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. X 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):
'? Feet Private ❑Joint ❑ Public
VI. TANK CAPACITY Site
in gallons I Total ##of Prefab. Fiber- Exper.
INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
Septic Tank or Holding Tank ❑ I ❑
Lift Pump Tank/Siphon Chamber I ❑ 1 ❑ 1 ❑ I ❑ ❑ I ❑
VII. RESPONSIBILITY STATEMENT
I,the undersigned,assume responsibility for installation of the priv to sewage system shown on the attached plans.
#Plumber','s ame(Print): Plu er's Signat e: o Sta s) MP/MPRSW No.: Business Phone Number:
ddress( treet,City,State,Zip Code): Name of Designe .
Al
Vlll. SOIL TEST INFORMATION
Certifi So' Tester(C Name CST##
C s ADDRESS(Stre ,City,State Zip Code) Phone Number:
'l
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved itary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps)
Approved ❑ I S?Srcharge Owner Given Initial 1 'l Fee
o
Adverse Determination - vV 9r/(s?
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
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 owners name and mailing address. Provide the legal description where the system is to be
installed;
IL 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;
III. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement, reconnection or
repai r;
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 81/2 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 'aw. This legislation is more
commonly known as the groundwater protection law. This change in statutes was the
result of ove! 2 years of steady negotiation and public debate. The groundwater bill Ground titer-=
included the creation of surcharges (fees) for a number oi regulated practices which Wiscon ttws, a
can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried tieasure
is used ir! your building is returned t-• the groundwater through your soil absorption o
system or the disposal site used by your holding tank pumper.
The monies collected through these surcharges are credill:ed to the groundwater fund adminis-
tered by the Department of Natural R,-sources. These funds are used for rnonitoring g!oursd- t
water, groundwater contaminatic� in,estigations and estEblishment of standards GroundwatE!;
it's worth protecting.
`_;BCD-633$(6.03186)
APPLICATION FOR SANITARY PERMIT
STC - 100
his application form is to be completed in full and signed by the owner(s) of the
roperty 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 � u ,� 'C/ cl, �q , -
s r�-7rs
Location of Property 9AIZ 1% �_A& 1%, Section �,O N-R W
Township ,;
!failing Address
Address of Site
Subdivision Name
Lot Number
Previous Owner of Property -...''`�
Total Size of Parcel 7 CL C/ 113
Date Parcel was Created
Are all corners and lot lines identifiable? D Yes No
Is this property being developed for resale (spec house) ? Yes 74,
Volume �_ and Page Number 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 Nap, the Certified Survey Map shall also be required.
- - - - - - - - - - - - - - - - - .- - - - - - - - - - - - - -
PROPERTY OWNER CERTIFICATION
1 (WO cenV6y that ate etatements on th,i s okm a4e, .thue to the best 06 my (owe) {
hnowtedge; that 1 (we) am (ahe) .tile ownen(e1 06 the pnopehty de�sehi.bed in tUA
in6oimation 6o4m, by viAtue 06 a waAAanty eed kecoAded in the 066ice 06 the
County Reg.us ten o 6 Deede" Document No. ; and that I (We) pnee entty
avn the pnopoa¢d di,t¢ bon the -¢wage di�spoA Aye em (on I (we) have obtained an
eaaen+ent, to hun with the above del c abed pnopehty, 6orc the eonztnucLion o6 said
system, and the acne has been duty n.eeoaded .in the 066.tee o6 the County Reg-e.aten o6
Veede, ab Poeament No. ) ,
SIGMA 010 OWN&# SIGNATURE OF CO-OWNER (IF APPLICABLE)
-2
DATE SIGNED DATE SIGNED
DOCUMENT NO. WARRANTY DEEOi "". THIS SPACE RESERVED FOR RECORDING DATA
STATE BAR OF WISCONSIN FORM 2-198211 !,
430095
VoK, 790 FAU619
kEotsrEks orHcE
ST. CROIX CO., W IS.
Michael L. Peterson and Teresa D. Peterson 9,.ved. f" Record this 11th
hls wife as joint tenants d® of Sept• AD. 1987
-- .............•_...
.......................................... .................................. Y
--------- -------------•----..._..------------------------------------------------...--•---••-••-----------•-•.
�i 11:10 Md
-------- ------------•• -------------------•--•---- -----•-•---•--••------------•-... ----•-- - .
Henr Brock ahler and Judith
conveys and warrants to - y . --------- -----------------------------------------------
B.rQ.CkI?.ah.�.e r-,_..husbas� ?n.d..wif_�
DOW
,.-_as___survvoship tieapWar �
mari.ta. ..proerty_ i'
.................................................................................................................
.....------------......... ..•--...................................................................._._..... .... i'. RETURN TO BAKKE, NORMAN
--- ---- ---------- ------------------------------ --•-•--•-•-• .............................................. SCHUMACHER, S .C .
- -
- ------- -•-...--- ..... .. ........ .......... --_... _
the following described real estate in ....St.--_jCxA.iX.......................County,
State of Wisconsin:
Tax Parcel No: ..............................
�I �I
The Northeast Quarter of the Southeast Quarter of the Northeast Quarter
(NE4 of SE'-, of NE4) and that part of the Northeast Quarter of the North-
east Quarter (NE4 of NE4) lying South and East of the Willow River,
ALL in Section Eight (8) , Township Thirty (30) North, Range Seventeen
(17) West .
',-• 1 S not _ homestead property.
i uis i o t pro ert
(is) (is not)
Exception to warranties:
th Se t------------mbr. --- --- -• 19_-8-7-.
Dated thi ��------------------ day of .-_-- -p..
X
....... -----(SEAL) .........................(SEAL)
Mi h 1 1 Pete s n
y��!C �rL.JI...�._--- - ---•-----••----(SEAL) #---- . .....-•------•---•----------------------•--•- •--•---- ---.(SEAL)
•-- --------------------------- •-•-----•---•-- --
* Teresa D. Peterson
------------ ------------•------------------------------------•--• ........
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) Michael L. Peterson and STATE OF WISCONSIN
Teresa D. Peterson ss.
------ ---------
......................................County.
au d this .11 ay ofs ...... ........... 1931 Personally came before me this ................day of
.........................................., 19........ the above named
Thomas R. Schumacher
--------------------------------------------------------------------------------
-----------------•------------_------------------------------------ -----•-------------•------------------•-------
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, --------•---------------------------------•----------------- ----------------------•-•----•-------•------------•-----------•-•----•--•-------
authorized by § 706.06. Wis. State.) to me known to be the person ............ who executed the
foregoing instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY
BAKKE, NORMAN $ SCHUMACHER, S.C.
..-•--------•---------------•-----..._.......--------...--•---------......_..._..
New Richmond, W I 54017
--------------------•-----------------------------------------------------
Notary Public y,
• -- ._.._._.. - -- Count Wis.
(Signatures may be authenticated or acknowledged. Both My Commission is permdnent.(If not, state expiration
are not necessary.) date:
------------•-------•---•-------•---•-------------------• 19---------
*Names of persons signing in any capacity should be typed or printed below their signatures.
urarue.r I'hT.vl STATE BAR.rOF WISCONSIN C}nr(, mg, innm
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SEPTIC TANK MAINTENANCE AGREEMENT o
St . Croix County z
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OWNER/BUYER
ROUTE/BOX NUMBER Fire Number
CITY/STATE L_ Z I
PROPERTY LOCATION: AIC 14, AIZ Section , T 76 N , RZ_W,
Town of St . Croix County ,
Subdivision T� Lot number '//1 .
Improper use and maintenance of your septic system could result in
its premature failure to handle wastes . Proper maintenance con-
sists of pumping out the septic tank every three years or sooner ,
if needed , by a licensed septic tank pumper . What you put into
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. yo
I/WE, the undersigned , have read the above requirements and agree En
to maintain the private sewage disposal system in accordance with 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 withi 30 days
of the three year expiration date . I�
SIGNED(J-e�V
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 .
DEPAhTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS
INDUSTRY, - c DIVISION BOX 76
LABOR AND PERCOLATION TESTS (115) MADISON WI 53707
HUMAN RELATIONS
(H63.09(1)&Chapter 145.045)
LOCATION: SECTION: TOWNSHIP MU TY: LOT 0.:BLK. 0.: SUBDIV SION NAME:
I/ _e-/4 /T N/R d(or*
COUNTY: OWN NAME: MAI LING ADDR SS:
USE DATES OBSERVATIONS MADE
r cNO.BEDRMS.: COMMER IALDESCRIPTION: FI DESCRIPT NS: R OLATIONTESTS:Residence New ❑Replace Ilf—� y
I
RATING:S=Site suitable for system U=Site unsuitable for system _-
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDING ANK:R COMMEND SYST M:(optional)
OS ou Q s ❑u I s ❑u o s ®u a s ®u
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: J I Floodplain,indicate Floodplain elevation:
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH
NUMBER DEPTH Ug. ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.)
B- '991 A62 > 7
B- }
xz-
,�•!�•tds'�rgr
B-,�
B- 7 .3
B- 7 z y o- �s
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER R4Q41M AFTERSWELLING INTERVAL-MIN. PERIOD.1 PER IO 2 PERIOD 3 PER INCH
P 3 /
P-
-
P-
P- _
PLOT PLAN: Show locations of percolation tests, soil bA* ca ar>,9� imensions of suitable soil areas. Indicate scale or distances. Describe what are the hom
zontal and vertical elevation reference points and show t ?ioxi n the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope. e,47 Y
SYSTEM ELEVATION
3 (
1
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•
A.
i70`
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S 1
7 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 Wis bnsin
Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
NAME 2t): TESTS WERE COMPLETED ON:
aJ S l —
ADDR S: CERTIFICATION NUMBER: PHONE NUMBER(optional):
CST GN TURE
DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester.
DILHR-SBD-6395 (R.02/82) —OVER —
4 1 ♦ • f I
INSTRUCTIONS FOR COMPLETING FORM 115 - SR13 - 6395
To be a complete and accurate soil test,your report must include:
1. Complete legal description;
2. The use section must clearly indicate whether this is a residence or commercial project;
1 MAXIMUM number of bedrooms or commercial use planned;
4. Is this a new or replacement system;
5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL
OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS;
Pi. PLEASE Use the abbreviations shown here For writing profile descriptions and completing the plot plan;
7. MAKE A LEGIBLE diagram accurately loeatinll your test: locations. Drawing to scale is preferred. A
separate sheer may be used if desired;
8. Make sure your I_ie€-rchniark and vertical elevation reference point are clearly shown,and are permanent;
S. Complete all appropi rate boxes as to dates, narries,addresses, flood plain data, percolation test exemp-
tion, if appropriate;
10. If the inforrna,ion (sr)ch as flood Main,elevation}does riot apply, place N.A. in the appropriate box;
11. tiipn the form wid place your current address and your certification numla..r;
12. Make legible copies and distribute as required.'. ALL SOIL TESTS MUST BE FILED VVITH THE
LOCAL AUTHORITY lr°CrITHIN 30 DAYS OF COMPLETION.
ABBREVIATIONS FOR CERTIFIED SOIL TESTERS �
Sail Separates an(] Textures Other Symbols
st _.. Sic'no Iotier 10") BR Bedi-ock
coin - Cobble f3- 10") SS - Sandstone
.1i - Gravel (under 3") LS — Limestone
"s — Satin HGtN — High Groundwater
CS crrai ar: sand Pet(; P ;o!ation Rate
mere s Miedium S,i nd Al .._. s,,, li
Is Lf)arny Sand -- Gieater Than
°sl . . Sandy Loam _. Less.Thai~
- i..oarn Bn ,_ Bro i
Sdi Loam BI .. Black
cI _. Clay Loam Y Yellow
SCf Sandy Clay Loam R ._.. Red
sic I — Silty Uay Loa;-n mot - Mottles
Sandy, `°lay
S�, - Say >_. Wi vv;t9t
sic — Sa`ty Clay f I f -- fdtti hn'e' faint
-._ t- co nrnor? coarsf.
Ini-n — Mony, foedtllill
1,11,,ck d - distinct
P — proininent -
HWL — High water level,
Six yeneralsoiltextures surface grater
for hgkiid waste disposal BM — Bench Mark
VRP - Vertical Reference Point
TO THE OWNER:
This soil test report is the first step in securing a sanitary permit. The county or the Department may request
verification of this soil test in the field prior W permit. issuance. A complete set of plans for the private
sewi,ge system and a perrnh. application must be submitted to the appropriate local authority in order to
obtain a permit. The s<arEtary perry?it must be obtained and posted prior to the start of any Construction.
e17
S-417
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PAGE OF
CroSS II� (l Q Q j lrl 4JC1� 'sy51c'n'1
Fr*ch Air Well; And Obcsrvotl0n Pipe
(� Approved Vent Cap
Minimum 12"Above
[� final Grade
's';�9�7
20-42'Above Pips —4"Cost Iron
To Final Grade Vent Pips
Marsh May Or Synthetic Covering
Min 2"Aggregate
j Over Pipe
1 Distribution
I Pips —k 0 0 0 0 0 —Tee
6"Aggregate
Beneath Pip e
roo Perforated Pips Below
—Coupling Terminating At
Bottom OI System
PON0- D f ine_I gre.�l< \
SOIL FILL
DISTRIBUTIWA PIPE
APPROVED $40THETIC COVER
° MATERIAt- OR 9" OF STRAW
Q"OF AGGR EGAIE � -CD W // OR MARS" 1-AA,y
(o OF 12-2t/2 AGGREGATE
1CLEV. OF_�' FEET—...
? � r
DISTRIgSTIOW PIPE TO BE AT LEAST =3 INCHES BELOW ORIGIMAL GRADE
AIJU AT LEASTIO INCHES BUT AIO MORE THAKI 4Z IAICNES BELOW FINAL GP.ADE
MXIMUM DEPTH OF EYKAVATtowi FROM oKiboju 6RADE WILL BE IAICHES
MINIMUM OFF" OF EACAVATOOM FROM CA141WAL 6RADf- WILL BE INCHES
SIGMEO: —Ozz:12J
LIC-LUSE UWABER: ���•��
DATE L= I