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HomeMy WebLinkAbout042-1057-20-800 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: $t. CfOIX Safety and Building Division INSPECTION REPORT Sanitary Permit No: 574321 0 GENERAL INFORMATION (ATTAC H TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Dalton, Steven M. I Warren, Town of 042-1057-20-800 CST BM Elev: Insp.BM Elev: BM Description: ; SeCtionlTown/Range/Map No: 0 u i C 20.29.18.319A80 TANK INFORMATION ELEVATION DATA / t TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic k'au Bencr;mark p� p 0 0 6 C /2� - Dosing Alt. BM s 2q, d. 7 73.1 Aeration Bldg.Sewer Holding UHt Inle / '/7 c3� Ht Outlet IO/ Q j�' c TANK SETBACK INFOR ATION (D TANK TO P/L. WELL BLDG. Vent to Air Intake ROAD Dt Inlet 3/ �tlL rZ Z Dt Bottom Septic ! Dosing Header/Man. 41' ` Aeration Di st. e 7 JA Holding Both S_ys , �I L/ OIL Final Grade c- r/ PUMP/SIPHON INFORMATION �' S 'w, 5-, Manufacturer // Demand Sf Cgvle- Model GPM r ► Number {tlGtvt t0 - TDH Lift Friction Loss t Head TDH Ft Forcemain Length 4 Dia. Dist. Weu SOIL ABSORPTION SYSTEM C.Qr -f BED/TRENCH Width ; Length' 7 No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS r �-^-' SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM ACHI Ma urn, L AMBER R INFORMATION Ty Of System: /� i I uba Model Number: PISJCI RIBUTION SYSTEM ��!z,Gi �- Hea /Manifold C - istribution tH:ole Size x Hole Spacing ent Air Intake Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center 3 � 1 I Bed(rrench Edges Topsoil Yes F No [ Yes 'j No COMMENTS: (Intl/ufde code discrepencies,persons present,etc.) Inspection#1: / / Inspection#2: Location: 88"Q 8 0 r Ave.Roberts,WI 54023(SW 1/4 SE 1/4 20 T29N R18W) NA Lot 8 Parcel No: 20.29.18.319A80 1.)Alt BM Description= �'`�`�` �"� ��'c�� C;.Mti✓ 2.)Bldg sewer length= �' / ♦C�'L��'ty�"2+0 �I'Y1. �1 M4) 610'L / -amount of cover= U T � _ -- g l Plari quired. I 6'/1 se other side for additional information. o L—.-J � ww111 t o Cert.No. Date Insepctors Signature SBD6710(R.3/9 / �� � V; I o � � Ilk, 4 �-- S �1 l O A v ;l z �2 � o�rra �oT � Safety and Buildings Division County 201 W.Washington Ave., P.O. Box 7162 Sanitary Permit Number(to be filled in by Co.) Mad i '��0�7� _-7q 32 / State Transaction-Kum ber �,� (-,�o ermit Application N � In accordance with� 2),Wis.Adm.Code,submission of this form to the appropriate governmental unit is required prio�o fining a sanitary permit. Note:Application forms for state-owned POWTS are submitted to Project Address(if different than m ling address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary Q r purp oses in accordance with the Privacy Law,s.15.04(1)(m),Slats. O I I. Application Information—Please Print All Information Property Owner's Name L Pazcel# S L1�E' D.7/44 O q Z —1,9 Jr-7 0 d d Property Owner's Mailing Address Property Location _ C 30 B/2-,,v f- Govt.Lot ' City,State Zip Code Phone Number ' , , �y1/ /<, S� /,, Section L 0 ,5"e�' JA, S�Uzs (circle one) Z`� II.Type of Building(check all that apply) Lot# T N; R/45 E or W or 2 Family Dwelling-Number of Bedrooms r3 Subdivision Name Ok aD �aJSa_ ock# IvUT ❑Public/Commercial-Describe Use 101 4� ❑City of ❑State Owned-Describe Use CSM Number El Village of a o � F / -Town of LA_-JetA- -t.4.! V. III.Type of Permi : (Check only one box on line A. Complete line B if applicable) A. New System y El Replacement System ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System(explain) B. ❑Permit Renewal ❑Permit Revision ❑Change of Plumber ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV.Type of POWTS System/Component/Device: Check all that apply) -Pressurized hi-Ground ❑Pressurized In-Ground ❑ t-Grade ❑Moun >24 in.of suitable soil ❑Mound<24 in.of suitable soil ❑ Holding Tank ❑Other Dispersal Component(explain I ^ e r ent Device(explain) V.Dispersal/Treat ent Area Information: - £' 5" JC (,II j -f ;C'Jr C/ J Design Flow(gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required(sf) ispersal Area Propo ed(sf) System Elevation SU . -7 Ca Y7- 686 ✓ ill. ? — �0. VI.Tank Info Capacity in Total #of Manufacturer Gallons Gallons Units o v New Tanks Existing Tanks 420 & a` v Septic Holding Tank d d r 'T u w Dosing Chamber VII.Responsibility Statement- I,the undersigned,assume responsibility for installation of the POWTS shown on the attached plans. tuber's Name(Print Plumber's Signature /MPRS umber Business Phone Number $C k C 11 w `ti s L Z-7-877— P mbe's Address(Street,City,State,Zip Code) Ufa Z G`ucz ,SY8s3 VIII. oun /De artment Use Onl pproved ❑Disapproved Permit Fee Dat Issued I )8suing Agent SinapVe SYSTPM er Given Reason for Denial / ) !17 a V > .°�@Wr41k$oft "W/arsons for Disapproval& S/s- - �'�C L2 � _ . >/J dispersal cell must be_5erv_iced/maintained �C�C1/ as per management plan provided by plumber. V/ , 2.All setback requirements must be maintained 7 � C�`y�GLyv✓ fYt as per applicable cvle%dinays.d �� 9 �- 1()763- 2V , or pj Attach to complete plans for the system and submit to the Codnty only on pa er not 1 s than 8 1/2 x 11 inches in size SBD-6398(R. 11/11) CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Owner's Name: N -� 6 Owner's Address: 930 c�o/Wn LA, .3' Y6 Legal Description: _ 17Fc'. Z a Township: ._A�sN County: ��t,r: X_ Subdivision Name: Lot Number. Parcel ID Number: Page 1 Index and title Page 2 Plot Plan Page 3 System Sizing & Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat attachments: Soil Test& House Plans Designer/Plumber: dclealke `���K,°,�s License Number: Z Z L 877— Date: 7- zo Phone Number Signatu Designed purs a to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P(N.01/01). Page 1 h � v � to �� J 0 O w 3 P a z 2 � ' Soil Absorption System Cross Section 97.3 9� i ft 4"Schedule 40 Final Grade PVC Vent Pipe �j',2 .7 9l. With Vent Cap ft 7 s� Leaching 9 7 Chamber �— System Elevation ft ft Soil Absorption System Plan View l�8 ft 3 ft { r ft Vent Or Observation Pipe Leaching Trench 1 Chambers 4"Dia. Trench 2 Header Leaching Chamber Specifications Manufacturer And Model EISA Rating Za•© sq ft.per chamber Soil Application Rate 7 gpd/sq ft ` gpd Design Flow Q 7 Soil Application Rate =Z°°J EISA= ` .�'7` Chambers 2 rows of ✓7 chambers each. '} Page-3—of AM A ro = ' a AM O n ra ci o � N r3 r, r O a - c N r` 1 ra io rfl a'n r- m a rs J rg �• C• ;. n 4; n .ANN.. .gin ra X c--�'.."l,j'.•> to N G L ci cc CS ru J y� cm — l/'+J Ll � _ — — IS fk GI tz ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND _l. OWNERSHIP CERTIFICATION FORM Owner/Buyer C '2)W/To/­' Mailing Address !-3 CJ B"v£ A je; ,,,r r-1 Property Address t3 (Verification required from Planning&Zoning Department for new construction.) City/State b��efS, t/V Parcel Identification Number C> YL - 1,0J_-7 Z 0 — d v LEGAL DESCRIPTION Property LocatioF�� '/4 ,.�f '/4 , Sec.Zd T 9 N Rid W, Town of VV a,c,,tr�.✓ Subdivision Plat: , Lot# Certified Survey Map # & 57 I/G , Volume y , Page# 0-&0 3 Warranty Deed # 6 Y� � �7 V (before 2007)Volume /41 V­7 Page # 514 . Spec house yes no Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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 pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1)and in Chapter 12-St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning&Zoning Department 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/or(2) after inspection and purnping(if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth,herein,as set by the Department of Commerce and the Department of Natural Resources,State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St.Croix County Planning& Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s)of the property described above,by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms SIGNATURE OF APPLICANT(S) DATE I ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning&Zoning Department. *** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. I (REV.08/05) �G I Page 6 of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipe's; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sad itary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: -- --- piping to to tanks p -- - - - - --- P p p —9 sealed—.- =-- • All to tanks and its shall be disconnected-arid tfie abandoned-i a-o eritn s I • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. I • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon b1 required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area wiP. result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑. The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name 'S r L Name I Phone -71 _ g) _ 00 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name K I, &k, Name I J­f 6 ",-'X �I N•/� Phone 7/ J 5. -7, L` y y Z y Phone 7/ j -38�. - This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f)and 83.54(1), (2) &(3),Wisconsin Administrative Code. l POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner T £V � �dN Septic Tank Capacity 106 ,9 gal ❑ NA armit# cJ '�'1 Septic Tank Manufacturer 5."�,l L," ❑ NA DESIGN PARAMETERS !� Effluent Filter Manufacturer >^3 [ ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units -ET'�_A Pump Tank Capacity gal A Estimated flow (average) 'fJ_0 gal/day Pump Tank Manufacturer Aa-NA Design flow (peak), (Estimated x 1.5) (� j gal/day Pump Manufacturer -�nA Soil Application Rate gal/day/ft2 Pump Model a NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit ANA Fats, Oil & Grease (FOG) <_30 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODS) 5220 mg/L --E'1A ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) <_150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality_---_-- m Monthly.average Dispersal CeII(s) ❑ NA Biochemical Oxygen Demand (BOD,- 530 mg/L n-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L -Ei-NA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) :!004 cfu/100ml ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size Y8 in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA 'AINTENANCE SCHEDULE Service Event I Service Frequency Inspect condition of tank(s) At least once every: ❑ month( ) (Maximum 3 years) 11 NA Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA ❑ month(s) (Maximum 3 years) ❑ NA Inspect dispersal cell(s) At least once every: �ar(s) Clean effluent filter At least once every: ❑ month(s) ❑ NA / . j _EfTnr(s) Inspect pump, pump controls & alarm At least once every: ❑ m❑ yeaarr((ss)) ) A Flush laterals and pressure test At least once every: ❑ month(s) ❑ NA ❑ year(s) ❑ month(s) Other: At least once every: ❑ year(s) ❑ NA Other: ❑ NA I MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of:512 months, shall be performed by a certified POWTS Maintainer. I A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW(4/01) 1 M Kr i x. A. I ') Ju` 23�p14 y�s�ndnDeparhnentofCamr�rr,�ROIXCoVNTM Et :Ol! EVALUATION REPORT Page r of 3 Division of Safety and AuudlOtjAMUNS'(Y Dacc�anoe with Comm 85,Mu, Adm. Code, county D, x Attach complate site plan on paper not Maas than 8 112 x 11 Inches in eixa-Plan must Include,but not limited to:varUoal and horizontal reference point(BM),direction and Parcel 1,0. percent alopo,ovalo ordmondono,north arrow,and location w%d distance to near-1-;Ael c3 y Z Z O,j'7 "Z© Re b Da pleast�print all Pnkmatiai% Personal information you provide may be used for vow ury purpoese(Prlvsoy t-aw.a.15.04(1)(m)), W v 1^ 7i r PropartyOwner Property Loci,tlon �f L-f b a )4 L/J Govt.Lot V- '/Z S 914 S Z T Z N R �Lb E(or)W property owner's Malling Address Lot# BI,-AK tr s3llbd. ems cr Lx*A#5 Stets Zip Code Phone Number []City Village ($-Town Nearest Road NewCortWUatlon Uoa o r;Pn �17ealdentlbl 1 Number of bodroorrre� Dvdo d4.ivad doaign flow rata 0 Replacement Public or commeroial-Dea-c+ih& Parent material _ FWd Plain elevation if applkable n• General coritrnants .s� S 91 -7 and recommendations: -7 F Boring# r0rii�� Icing J� / tJ Pit Ground su►faceelev. �7 fk Depth to limiting factor }� Z�in. Soil Application Rafe Horizon Depth DanknmdCulur Rwjog De;&LrQtion Texture atruoturo Conactence Boundary Rootu GCt51tN in. Mans q 4u.Sz. Cont.Color Gr-Sz.Sh. •Eff#1 `Eff#2 02 z3 z A yl V /f t. S 1. >� L 2.5 YC�TIIV z- z •5 r 0 36 ❑Borlrrty# r 190ring Pit Ground su[facaelev. /�?• ft• Pena+ lirrsUn(J rector y I/ In. Soil Application Rate Herlaal Depth ]orrdnant Color Redox Description tion Texture 8borture Consistonce Boundary Roots GPDff •>=tf#ti F.fffka in. MurraF+s pu.3r- cunt Color Gr.1—Z:'.sh. o-03 QS / ' ? i e � /�- y" / sdk �f� aS Ill z a� c �= Y ✓ G? /. S 7.5 4 ;'IV 0:5 C' ? �• Z "Effluent#9=BOD >30 S 220 mgll.and TSS>30<_150 mgtL Effluent#2 BUD =30 rr(A and TSS j�30 rng/L CST (Please Pritt) Signature CST Number N Z7ZB�� a a w S Date Eratuatloll Conducted Telephone Number Address Z(Q y� T-7. k � GtJ, YC� 3 ^Z �Z / Hi- :4T RAA7,/R7/TA v * Property Owner Parcel 1D# page Doting# ❑ goring / 9 \/%s felt Ground surface elev.�ft Depth in lirruitin footer/ in. Sal A IicaGon Rafe Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDO in. Muneell Qu-Sz. Cont.Color or.Sz.tin. "EM 'EfTlf2 . 7 as -- . Z - 3 0 2 �j Ong# ❑ Boring It�r� ❑ Pit Ground sudaca elov ft. fkaplh to IhnlAna factor in. -i;O-dAppicallon Hate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/M in- Munsell Qu.Sz, Cont.Color (3r.Sz.Sh. *Eff#1 -Eff#2 ❑ Swing 6odne# Ground surface elev. ft. Depth to Umiting factor in. ❑ Pit Soil Appticaiiion Rate Horizon Depth Dominant Color Redox Des�rlptlon Texttre Structure Consistence Boundary Rog4s GPDffE in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *EfF#1 Mff#2 i i *Effluent#1 =BOD6>30 t 220 mol,and TSS>30=150 wQIL 'Effluent#2=BODO t 30 mglL and TSS 4 30 nVL The Department of Commerce is an equal opportunity service provider and empluyer. If you need assistance to ac ig$wrvices or need matarial in an alternate femrat,please contact the department at 608-2663151 or TTY 608-264-8777. seD-u330QL(;7/W) Z©/Z© 30bd XVA 9HIM7)Z A-10d 9VZ698VSTL 6b:51 8002/8Z/t0 * J1 C s - c C-1 C-A a r� °' CA L CL ,ate s_ rj- L to TA r� Z � \ 1647PAGE 516 �Z STATE BAR OF WISCONSIN FORM 2-1999 IS.-A 6ilEip–,W-dA WARRANTY DEED KATHLEEN O DE �H Document Number REGISTER OF DEEDS ST. CFiOIX CO. , WI This Deed,made between Archie Denucci and Ella Denucci,as RECEIVED FOR RECORD Trustees of the Archie Denucci and Ella Denucci Revocable Trust dated 05-29-2001 11:00 AM September 14,2000 WARRANTY DEED 11 IT Grantor, and Steven M.Dalton,a single person CERTPCOPY FEE: COPY FEE: TRANSFER FEE: RECORDING FEE: 12.00 PAGES: 2 Grantee. Grantor,for a valuable consideration,conveys to Grantee the following described real estate in St.Croix County, State of Wisconsin(if more space is needed,please attach addendum): Recording Area Name and Return Address SEE ATTACHED First Federal Savings Bank LaCrosse 201 So.Second Street Hudson,WI 54016 This deed is given in fulfillment of that certain Land Contract between the parties hereto dated December 12,2000,recorded December 18,2000 in Vol. 1568,page 213 as Doc.No. 635444 042-1057-20-000 Parcel identification Number(PIN) This is not homestead property. 144 (is not) Exceptions to warranties: Easements,restrictions and rights of way of record,if any. Dated this day of May 2001 • Archie Denucci Old.., r *Efla Denucci AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ss. S`f t a ►y_ _ County ) CL authenticated this day of •may Personally came before me this'"• day of May , 2a0 t 4;p named Archie Denucci and Ella Denucc 2• hie a • Denucci and Ella Denucci Rev bl us*date V*ber 14, 2000 TITLE:MEMBER STATE BAR OF WISCONSIN to me known to be the persons o.eeac•t the for0going (If not, instrument and acknowledged t �Aanq'tes -Q r authorized by§ 706.06,Wis.Stats.) THIS INSTRUMENT WAS DRAFTED BY ' I l.�J •�'•''• ..••$T• Attorney David J.Estreen Notary Pu ic,State of Wisconsin 304 Locust treet,Hudson,W 1 54016 My Commission is permanent.(If not,state expiration date: (Signatures may be authenticated or acknowledged.Both are not necessary.) r C Z Cad t ) •Names of persons signing in any capacity must be typed or printed below their signature. info mauon 7rofessionais co-psnr.Fond du Lec,wn STATE BAR OF WISCONSIN 800-655-2021 WARRANTY DEED FORM No.2-1999 I IlIIlI I I!L'' `'Il!IlII!IIlI Illl IIlill fill illl * b + 4 6 8 3 887488 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 01/28/2009 08:OOAM CERTIFIED SURVEY MAP VOL: 24 PAGE: 5603 CERTIFIED SURVEY MAP REC FEE: 15.00 LOCATED IN THE SW Y OF THE SE Y AND THE NW%4 OF THE SE Y4 COPY FEE: 2.00 OF SECTION 20,T29N, R18W,TOWN OF WARREN, ST. CROIX COUNTY,WISCONSIN, S89°04'58"W S89°04'58"W 3915.39' LEGEND WY CORNER OF SEC.20. -0--———:�—— T_—_j f- (ALUMINUM CAP FOUND) I "�l3, 1304.79' - INDICATES SECTION CORNER I m 9 W (AS NOTED) BEARINGS REFERENCED TO THE EAST- I • - INDICATES 1'IRON PIPE FOUND WESTy SECTION LINE OF SECTION 20. 1- 1-R O - INDICATES 1'X 18' (OUTSIDE DIAMETER) ASSUMED TO BEAR S89°04'58'W. -1 w v IRON RE-BAR WEIGHING 1.502 LBS/LIN.FT.SET I V; z 6 Cl ■ - INDICATES 'REBAR FOUND UNP���® I ° Y4 - INDICATES PROPOSED DRIVEWAY LOCATION LANDS ¢ N89°04'58"E 562.28' '---- W o OWNER!SUBDIVIDER STEVE DALTON To Be Dedicated tO t*Public o 816 106th STREET _ ROBERTS,WI 54023 F 12'Utility Easement --- ppmwteSbUth-!WM bF r 1489°04'58'E 496.25' --A ma Y 1 i i the NWY of the SEY w . m ® i ° cn m , _ _LOT 8_ — ' 87,120 SQUARE FEET L Approximate North line of (2.00 ACRES) � � � � 1 ' the SWYa of the SE Y4. o NBV04'58"E496Ar o I NE W THE DP04AGE FACILITY SHOWN ON LOT WILL BE I b IVR LOT. MAINTAINED BY THE OWNERS OF THE LOTS SHOWN HEREON AND m � 87,120 SQUARE FEET IN ACCORDANCE WITH THE ca ' j DRIVE (2.00 ACRES} PROVISIONS SET FORTH ON THE +— HOME OWNERS ASSOCIATION j AGREEMENT AS RECORDED IN I ' I DOCUMENT NO. N89'04'58'E 496.06' v + Sa � v A Utility Easement ao LOT 5.THE NET PROJECT AREA of ! ',i LOT 6 c L07 55,E)(CLWNC>THE 50'SETBACK •'. 15 � FROM PoGHT-0F-WAY,THE DRAINAGE `:_ `•:�`.� 87,120 SQUARE FEET EASEAENT AND A 1 S SIDE YARD , '` le selBAClc=33'038 SQUARE FEET ; _: \ I` _ypsE° (2.00 ACRES (076 `.`, d�E ) LOWEST BUILDING \ \ OPENING=993.35' 0 ELEVATION=1000.71' ELEVATION=995. ��?�...N /y \\vs N86°18'421E 449.41' 1884p t LOT5 1•N-Vd R HMOND I gal ;'4r- z \ 87,120 SQUARE FEET ; ;���• ,�� O \ (2.00 ACRES) :9 A ' LOWEST BUILDING t x ` OPENING=99335 — S67°40'40'W \ ' `\ _1-__ N_e2•azaa:E_soa0e-� 66.00' DrdrAV SB2°42'24"W 361.51 xl �\ ELEVATION=997.14' I VOL 17,Pa 44M V01- 17 mss.4•s�6 XI Scale in feet 1"=120' "1 1v�-M on V0ZL- 97 r�Cs. \, \ , �l 0 120 240 1 SHEET 1 OF 3 DF:AFTED BY: S.E.t. REOSED064WM 66 1 of 3 Vol 24 Pare 5603