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HomeMy WebLinkAbout020-1380-38-000 Cn ~ ~ N ( (7 S (D < CD G V) S_ C\t C`I ~ s1 ~ 3 N ~ _ O _ ~ O ~ ~ ~ ~ ~ ~, N N SZ 6 Q N O A C C C n O O N m D v ~ ~ c ro m ~ I~ O ~~ 0 3 ~ ~ m m x m O m CC C (D 3 GD N ~ N N C ~ p O ~ ~` d 'p d '-. N ~ j ,.. N ~ N 7 O o c_ ~_ y N ~ ~ v v n N ~ O N O V N ~ C ~ ~ a N fD a 0 m ~ O O S,~ O 2` O Q- o d f _ ~ ~ ~ ~ ~ ~. M ~ ~ ~ ~ ~ ~ ~ 1 ~ ~ ~ '" ~ # ~ _ ~ ~ I o w W ~ = ~ o N ,~ 1 1 A N C a N 0 „" 1 rn ~ W ~ A N ? 0 0 .. . C~ + ~ '~ N ^S 1 v ~ ~ w ~ ~ '~ ~ O' ~ .P O A7 1 ~ rn ? O O O ° ~ C 1 m ~ ° ~ 1 ' . a - = m a .. -°o ~ 0 y I C )7 ~ N N ~ o rn m 1 0 0 m 1 1 0 0 2 N o a n ~ , ~ , ~ ~ ~ o ~ _ ~ ' I ~ ~ ~ ~ owo p ~~y+, N ~ 3 v O O o ~ 1 :~ ~ ~ _ Q1 ~ , m m , ~ m m , m '~ d a 1 ~ ~ 1 3 D .. a a Z 07 Z D o 3 , O ~ c 1 w , N ~ N i i -~ N (D .~ ~- ~ ~ ~ ~ fn ~ D ~ ~ ~ n . a A ~ ~ Z -~ -~ W .D ~ ~ '~ Q ~ ~ Z Q ~ A 1J <~< C ~CC < N Z ~ ~ A A G T C 3 a s 0 Q IC O N O O .d A ~o w o' q a ~ '~ A ;~ ... y Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL'IfNFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 'ermit Holder's Name: City Village X Township Miller, Sam Hudson Townshi :ST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~5 ZS>7 Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. vent to Air Intake ROAD Septic ~ `!~ f ~ ~Dt 23 r Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand M Model N ber TDH Lift ' tion Loss System Head TDH Ft Forcemai Length SOIL ABSORPTION SYSTEM ~,-,$') c~.lsez/~ County: St. CrOiX Sanitary Permit No: 384144 0 State Plan ID No: Parcel Tax No: 020-1380-38-000 /..t~• rq, a34y ELEVATION DATA STATION BS HI FS ELEV. Benchmark O,~ f 1~•~ J~.o~ Alt. BM ~ ~ 3'~ I~~S-. / 111`1 Bldg. Sewer SUHt Inlet (a 5.30 ~9~ Its. SUHt Outlet Aa• S , 90 10~-,69 f Dt Inlet Dt Bottom Header/Man. d 13 q~ ID`S g8.9`f ~ Dist. Pipe 19• 9 Bot. System ~, D ~z Final Grade St Cover D 2. o III•'~9f BE RE Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIM NSIONS 3 ~ ~'3,}SJ C2 SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR g 1 o D) ~ k Type Of Sx stem: / / UNIT Model Number: l~"~J . '~ !06 ~ t ao -~ DISTRIBUTION SYSTEM Header/Manifold « Distribution x Hole Size x Hole Spacing Vent to Air Intake ~ th ~S i L ipe(s) ~ i ~ eng D a L Dia Spacing SOIL COVER x Pressure Systems Onlv xx Mound Or At-Grade Systems Onlv Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil 0 Yes 0 No ~ Yes 0 No ~ ~i COMMENTS: (Include code discrepencies, persons present, etc.) I~cnection #~1: D5~/ / a / ~ I Inspection #2: Location: 704 Old Hopkins Place Hudson, WI 54016 (NW 1/4 SW 1/4 11 T29N R1yW) Homestead=1st Adaiiion Lot'38 Par :11.29.19.2364 _ /~' mss{-~w~.a st d1~ I`'`~° /'- - 1.)Alt BM Description = S ~ ~ ~ ~ ~~-~~e~C ~" ~ r~St~ ~s ^~Q `},V~~pt, 2.) Bldg sewer length = ~ti„tu,Q,~Q Gyo,~ytr4.q,,,~„ ~~ ~ i'~, 19' (,cE1'au _` -amount of cover = /~~ g~ ~ I,~,• 2cF r. -• ~, Plan revision Required? Yes ~ No '0 (~ ~ ~, 2~~! e~ ther side~for~d'`ti_o~I inf1ormat~'[~n. ~ r T ~J/~~~-)b_~ S~'E.3/97~"oC `tom. tOGOtJ6~ 9^'~ ( gy. ., .,,. /Aeao ~t~re WA , 6 rt° r" ~ ~~ pV( ~,~ (~ PLJ~C.E Sanitary Permit Application ', Safety & Buildings Division 201 W. Washington Ave. In accord with Comm 83.21, Wis. Adm. Code PO Box 7302 f See reverse side for instructions for rompleting this application Madison, WI 53707-7302 n rseons Department of Commerce Personal information you provide may be used for secondary purposes s. 15.04(1)(m)J (privacy Law (Submit completed form to county if not , state owned. ' Attach com f ete fans to the;'coun co onl fo o, t m r not less than 8 -1/2 x I t inches in size. Ranh, State Sanitary Permit bcr Clr ~ , application State Plan 1. D. Number A lication Information -Please Print all informatign.., 'Y~ I Location: . Property Ovmer Name y ~~ N c, ~ I /. ' ' ~ p Property Location )~ E or N S' T ~/4~ "r'I/4 1 `L~ ~~ _ ._• ~ , , , ` ~ property Ownet"s Mailing Address `'~ Sp ~R ~ ar w Lot Number Block Number 3 ~X o x~< s/ fta , 2 l • `, P r Zip Code City, State Subdivisio nSNa/me or CSM Number T ~ dQ '' `` 5~ IMF ~ ~ S ~ ~ ~~ ~~ ~ ~~ ~ ~ ./ ~G~ ~ S . II. Type of Building: (check one) ~ ^ City ^ village ^ l or 2 Family Dwelling - No. of Bedrooms : Town of ^ public/Commercial (describe use):_ ~ / ' 3 X 9 3.7 S 7~ N G ~- // O ^ State-Owned est Rod /dC~ OL ~ ~ / ~ 7 F~ 2 -~ [", Parse T Num s _ O U d III. T e of Permit: Check onl one box on line A. Check box on line B if a licable 5 6. ^ Addition to A) 1. New 2. ^ Replacement 3. ^ Replacement of 4. Existin S stem S stem S stem Tank Onl Date Issued Permit Number B) ^ A Sanita Permit was reviousl issued IV. Type of POWT System: (Check all that apply) ^ Mound ^ Sand Filter ^ Constructed Wetlan d ^ Non-pressurized [n-ground ~ ^ Holding Tank ^ Single Pass ^ Drip Line ^ Pressurized In-ground ^ Aerobic Treatment Unit d ^ Recirculatin ^ Other: e ^ At- ri V. Dis crsal/Treatmcnt Arca Information: pesign [low (gpd) 2. Dispersal Arca 3. Dispersal Arca 4. Soil Application 1 5. Percolation Rate 6. System Elevation Eleva onmd , Regairrd i roposed ,~ Rate (GalsJday/sq. RJ ' ' (MinJinch) -' / 9' 9'S ao -~~~.~ MoD S ~~~ 'o a~ - 3,00 . S tic Pl Tank VII Capacity in Total # of Manu acturer Pre? ~b Site C Steel Fiber g as . ion forntat I Gallons Gallons 'l'inks Cor.- l on- tructed . u Ncw Existing e cre s Tanks Tanks ____ r-, n n n "sue T/G Z~ b~L /ooA Fj L VIII. Responsibility Statement _ 1, the undersigned, assume res~ Plumber's Name~(print) P!umtx rs .4d~lress (Street, City, State, Z /Z four installation of the POWTS shown on the atattyached tans. l~ ^ ~ ^ o l ^ I ^ G `~i6 9 Z 1X. CountylDepartment Use Only Sanita P~imit tee (Includ<s Groundwater Dale Issued Is uing Agent Signature (No stamps) ^ Disapproved n' ~Approvcd ^ OwnerGiven Initial Adverse Surct~~2S'~ ~ ~' Dctcnnination ^ X. Conditions of Approval /Reasons for D;isa~pr~oval: ` h_ ',S~ ~'~5-~-'S 5~+~-- ~~ _ S,s~xs ~ c~ ~ ,~ S H /y1 /yJ /L ~ E ~ y ~ •rrE 5 7f,~1 U / ST ~lQ,v / % /~N ~ ~ '~' .3 ~ -70 ~/ r ~/~ ft00°~~lV s ~~,4G~' Sy S?~-yy-~ ,~ /, ~ `~ 3 , 00 , ~~i~. ST t t 3 ~~! ~i ` £r /OD.O~ ~ L p N o P ,~ i rat S ~ L ~9c F T 13 nr, i' z. p ~ 1. = wl ~ ~~- `c~S '~~ .~ i 3g . ~ ~~' i L cT 3 ~ Z,~~ ~4~ z-TrefNc~l~ ~ ~'x 9 3,7~ S- Hrf ltilCSE~) a r~1~ d row...., r ~r y ~ .~/r A ~/ - a y ~~, i 3' \ / ~/ 3' a ~ ~. a Y 1 ,nJ~ Y \ r, S ~ m ~> /L C ~ ~. h' ~ n~~ 5 Tf,~I p / ST ~ ~lov ~ Tia/~ ~O r'# 3 b~ v ~\ `' ~I ~ (. = W1 ~ iv~h ~~ /~~ `~~ ~~ ~' ~, ~~i~, ST /V~E L~ ~-~ ~ ~ 55/ f (-t o •/ 5 a- - I `/-1~f"D ,boo n ! ~.~~{<~ l a5~ Y3L ~ ! L cT 3 ~ Z,~ 3 o4c I S- fHr1YY!(3E~L5 EAcH T2EN~H ,. ~ f ~ ~ , ~,. ~ ~, ,, ~ ~ ~;~' o ' ~ ,~`` ~~'~ j 3 ~ ~ ~ ~~ r3 - S ~ ~ti U +r ~~ i a JD 1 l Y .~ ' Wisconsin Department of Commerce ' Division of Safety and Buildings SOIL EVALUATION REPORT in ~rnnrvi~nro wiFh (`nrnm R5 WIC Ar1m r:(][tP 1304 Page 1 _of-3_ A.C.E. Sal & Site Evaluations - Courrty Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference nand Parcel I D percent slope, scale or dimemsions, north snow, and I n 4is nce to ~.-- -- est road. ~ . . 020-1012-40 ID# 11.29.19.546 Please print all inf ~ ; ~ ~~ gy Date Personal informatbn you provide may be used tors puryos . 15.04 (})"(m~j. ~Q 1 Property Owner .~ ~ Propert~r ~ ion Miller, Sam ~ - ~ tit. Lpt-- NW 1/4 SW 1/4 S it T 29 N R 19 W Property Owner's Mailing Address ~, ~ ~ # `~' Block # Subd. Name or CSM# P.O. Box 151 - ST cgoix 38~, 1st Addition To Plat tDf Homestead City State Zip C ePl4Ndl+E1, OFRC ' ..~j(Y ~ village Town Nearest Road ~ Hudson WI 54016 ~•~ (7~5 , 86-2769 . - ~ ~ • -~ Hudson Packer Drive ' ~ t i ! . ~ /~ New Construction lJse: ii+ Residential / NumbeTrof~~ 4 Code derived design flow rate 600 GPo ,J Replacement ~ Publ'~c ar commercial -Describe: Parent material Glacial outWdsh Flood plain elevation, 'rf applicable nd General comments and recanmendations: Increase trench length if silt inclusion is found at system elev. while installing system. ^ _J Boring ~ Bonng # / Pit 71 > 135" in ~ ft. Ground Surface elev. 98. Depth to . limiting factor Soil Application Rate Horizon Depth Dominant Color Redox Description Texture. Structure Consistence Boundary Roots GP Dlft2 1 0-20 10yr4/2 none sl 2msbk ds as 2f 0.5 0.9 2 20-36 10yr4/4 none Is imsbk ds cs if 0.7 1.2 3 36-52 10yr4/4 none s Osg dl cs - 0.7 1.2 4 52-93 10yr5/4 none s Osg dl gs - 0.7 1 5 93-135 10yr6/4 none s Osg dl - - 0.7 1.2 -~- , a t ir$•~- ~o~{-~- Boring # ~ Boring Pit Ground Surface elev. 97.89 ft. ~~ Depth to limiting factor > in. Soil Application Rate Haizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIft' 1 0-32 10yr2/1 none sl 2msbk ds as 2f 0.5 0.9 2 32-62 10yr5/6 none s Osg dl cs if 0.7 ~•~ 3 62-87 10yr4/4 none Is Om dsh cs - 0.5 0.7 4 87-128 10yr5/4 none s Osg dl gs - 0.7 1.2 •6~ * Effluent #1 = BOD ~ 30 < 220 mg/L and TSS 30 < 150 mg/L ffluent #2 = BODS <30 mglL and TSS < 30 mg/L CST Name (Please Print) Sig ure: CST Number James K. Thom son 5---- 3602 Address A.C.E. Soil & Site Evaluatioru Date Evaluation Conducted Telephone Number Osceola, WI 54020 9/19/00 715-248-7767 property Owner Miller, Sam Parcel ID # 020-1012-40 ID# 11.29.19.548 Page 2 of 3 ^ $ Boring Boring # Pit Ground Surface elev. 97.24 ft. Depth to limiting factor > 135" in. Sal application Rate D i t Ca tion R Descri d Texture Structure Consistence Boundary Raots : Horizon Depth or om nan ox p e *Eff#1 *Eff#2 1 0-10 10yr4/2 none sl 2msbk ds as 2f,imc 0.5 0.9 2 10-28 10yr5/4 none sil 2fsbk dsh cs 2fm,ic 0.5 0.8 3 28-34 10yr4/4 none is lmsbk ds cs ifm 0.7 1.2 4 34-91 10yr5/6 none s Osg dl gs - 0.7 1. 5 91-135 10yr6/4 none s Osg dl - - 0.7 1.2 ~'a~ -- So~~8~8,,$$ Boring # ~ Boring ~ Pit Ground Surface elev. 95.84 ft. Depth to limiting factor > 126" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 1 0-20 10yr3/3 none Is lcsbk ds gs 2f,im 0.5 0.9 2 20-33 10yr4/4 none S < < 2fsbk ds cw if 0.5 0.8 3 33-38 7.5yr4/4 none Is Osg dl aw if 0.7 1.2 4 38-84 10yr5/4 none s Osg dl gs - 0.7 1.2 5 84-126 10yr6/4 none s Osg dl - - 0.7 1.2 Boring # --~ Boring - Pit Ground Surface elev. 96.08 ft. Depth to limiting factor > 13$" in. Soil Application Rate H i D th D i nt C l Redox Descri tion Texture Structure Consistence Boundary Roots or zon ep om na o or p *Eff#1 *Eff#2 1 0-16 10yr3/2 none sl 2msbk ds as 2f 0.5 0.9 2 16-32 10yr4/4 none Is imsbk ds cs lfm 0.7 1.2 3 32-95 10yr5/4 none s Osg dl cs - 0.7 1.2 4 95-138 10yr6/4 none s Osg dl gs - 0.7 1.2 Silt inclusion found in NW comer of soil pit extending from 32" - 62"x40" in width. Do not include silt inclusions as absorption area is found at system elev. while installing system. Increase trench length to compensate for any excluded area. * Effluent #1 = BOD 5> 30 < 220 mg(L and TSS >30 < 150 mglL * Effluent #2 = BODS < 30 mg/L and TSS < 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. .~ {~. 3~{3 ^ Soi l ~.SC!'d4~i'on P. ~ ~ E/eda.~io~ /of 380{~~ / ~.4dor. fo ,yK.dso~, .Sf. Cro y c'm. , ~i M 82 ^ ^ 3y 6 S, ^ 7~oof',2"inn /oi`S'6aJ~. 2 I ed; :. ioo. G~: To/oo~',2 "inn/off 5~~ on r.~.-.nor-_ /..i tv) _ E~~[~`: ~O. 8( ^ ^ $5 o ut~ S.di o+~' P. o. u9.' f~P~.~ ~laC~ ~~ ~P~~''~/,30 ~/ S~f'i~a` ~'I ~~~~2-- ~-f~Yr,~ sT~~~ ~oT~ 38 ~o y ot~ ~~K~xs 3o-~ffA~/Yl~~-~s Ta'T~L, ~~~~~~f~ T~~"~ . S y~7"~ ti, ,93, as ' Y $ if 1CCttlol"1S~ /y1 BioD~f fuse p~ _~~~ .- ;~ ~zSv 3 T ,~1~[~ ... ..* Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWYS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- Table 1: System Design Specifications Sanitary Permit Number 3~`{ (`} Number of Bedrooms Design Flow -Peak (gpd) Estimated Flow -Average (gpd) t7D Septic Tank Capacity (gal) Soil Absorption Component Size (ft~) Z ~~ Type of Wastewater omestic Table 2: Soil Absorption Component -Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow -Peak (gpd) ~ Z - ~.s Maximum Influent Particle Size (in) 1/8 Maximum BODS (mg/L) 220 Maximum TSS (mg/L) 150 GYM 0 Tab le 3: Maintenance Scheau~e Septic Tank Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessa to ensure proper operation. The filter cartridge should not be removed unless provisions are made to re am so it ds in the tank that may slough off the filter when removed from its enclosure. If the . ° Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 113 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enfer a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for enfering a confined space. The atmosphere within the septic or other treatmenf of holding fank may contain lethal gases, and rescue of a person from the interior of the tank maybe difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer -S ~ m ~ / ~ L~ Mailing Address ~ © ~C ~ -s ~ Property Address _ ~ ~ ~ ~ L ~ l-~ o P ,(C iN S ~ L ~ G~ - ~ (Verification required from Planning Department for new construction) f"1" City/State /-/ v n 5 o N w 1 Parcel Identification Number i.F.rAL DESCRIPTION Property LocationN ~ `/+, ~ ~ '/+, Sec. ~ ~ . T 2-~N-R / ~ ~ ,Town of ~/y.® S~' I~ . ~bdivision ~a~~ STF~ ~ ~ S ~ %~f» ,Lot # ~_• Certified Survey Map # ~.3 -7 ZS `1 ,Volume Page # ~ Warranty Deed # ~ Z 2 ~ -Z 3 , Voltune ~ D L ,Page # ~ Spec house/, yes ^ no Lot lines identifiable yes ^ no cV~TEM l1~IAINTENANCE 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. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeymanplumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requiremtnts and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Cornmerce and the Department of Natural Resources, State of W isconsin. Certification stating that yotu septic system has been maintained must be completed and returned to~the St. Croix County Zoning Office within 30 days of the three year expiration date. ~~ ~ per/ Zq O / A OF APPLICANT DATE '. •=:OWNER CERTIFICATION '~i; i'(we) certify that ali statements on this form are true to the best of my (our) knowledge the aptt'ty,.de9cribed above b virtue of a warranty deed recorded in Register of Deeds Office. GNATiJRE PI.YCANT I (we) am (are) the owner(s) o. Z/7.v/ DATE ****** Any information thay~is mi5-represented may result in the sanitary permit being revoked by the Zoning Department. ***** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed •, STATE BAR OF WISC((~~ON~~S{~I••N FORMo2 - 1998 t f WyR~J~JUPAGE~S~ pocunprn tWxnMr Mark D. Roaencranz and This Deed, made between _-. - -- -- Christirta Rosencranz, husband and wife, - Grantor. and _S~n E' Mueller, a sanyle person, _ - - _ - _ __-_-_-__-_-_~-_--- -- - -J Grantee. Grantor, for a valuable corrsideratlon. conveys and warrants to Grantee the following described real estate In St. Croix ~ Crxmty. State of Wlsconsln: /~,~' • 622 1 23 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO.r WI RECEIVED fOR RECDRD 05-O1-E000 10:00 RM YARRAMTY DEED EXEMPT N CERT COPY SEE: COPY FEE: TRAIISFER FEE: 900.00 RECORD]N6 FEE: 10.00 DADES: 1 Name 8nd HelWn Address First Federal Savings Bank I,aCrosse-Madison 201 South Second Street Hudson, Wisconsin 54016 020-1010-~0; 020-1012-90: and 020-1012-10 Parcel Idenlibcelgn Number IP1N1 This is -homestead property. (Is) (is not) Part of the NE 1/4 of SE 1/4 of Section 10 and Part of the N 1/2 of SW 1/4 of Section 11, ALL in Township 29 North, Range 19 West, St. Croix County, Wisconsin described as follows: Commenciny at the SE corner of the NW 1/4 of SE 1/4 of said Section lot thence East 2739 feet; Lhence North 610.5 feet; thence West 1419 feett thence South 544.5 feet; thence West 1320 feet; thence South 66 feet to the point of beginning. Exteptlorts to warranties: Subject to easements, reservations and restrictions of record. Dated this a ~ "day of April 200/0 (SEAL) //t~__~/'~I L~ ~ (SEAL) • RK D. ROSENCRAP (SEAL) / (SEAL) CHRISTINA ROSENCRANZ AUTIiENTICATION ACKNOWLEDGMENT Signature(s) Slate of Wlsconsln, as. J St. Croix Cou authentkated lhls day of Personally carne before me this daY or Aril 2000 ,the above named Mark D. Rosencranz and _ Christina Rosencranz, ..aMINJIta.. TITLE: MEMBER STATE 8AR OF W]SCI (If not. authorized by §706.06. Wts. Stars.) THIS INSTRUMENT WAS DRAFTED ~4~~~Pt.S.', t SGN~,~ r'- STEPHEN J. DUN LAP ~'>< Hudson, Wisconsin (Signa[ures may be authenticated or acknowledged. Both are ndt necessary) - _ l0 me kn wn to be the person s ho executed the foregoing tnst nt nd acknowledge the r • Notary Public. Bute of Wisconsin My commission Is permanent. (If not, state explratlon date: • ---•) Nanws rN pntoro aignMa in any up•cay mutt M typed « printed below rhea srRnturr*. yyis~,~ ~~ qa,y, Co., IrIC. STATE BAR OF WISCONSIN ~rwarAw W1f WARRANTY DEED FORM No. 2 - 199a Hd"ME STEAD IS'~AODITIDN DOC~L372r9 Voc.S ~~~E 3i NEST 1/t CORNER SECl10N 11 1.29N.-R.19r. tr 4.1!?li!??~4.4•ANRS ayOllµUllL/ couN SB9'43'OS"E 1315.40 EAST-WEST 1/4 LINE Of SECTION 11 ' - - - 4:1.2s 144.27 ~Y~~ 1 -- I e2s.17' -- I ~1 ~~ 1 I vl• _ _ ~ lOT 36 LOT 35 1 13 c~ •s ~ 939~i7 a4• I1 \ \ 115 ,® 90Jii sg ll ~ oyg ~ (a _ ~ a ~ - ~ \ ~~= d5 \ N $0902' a ~J!•T~p \ ~ ;~ . / ~ / uT a ORi ~ \ ,:, LOT 37 2.31 AC. ~ / ~ _ / ~ ~ / ~ ~ ~ 1 / ' /, ~ \ - -- ZuZ 100562 sV. Il / / ~ / j ~ 1 ~ / ~/~ 1 ~ 1 ~ \ / / i ~ p~E. ~~~~. ay '~ rrr~~~ , ~ ~ l ~ ~3/3.T' ~ 1 LOT ]0 ~ ~ _ 1 2.33 Ac. ~ _~ n / 1101344 aq. 11 / i in (M/ {.r// e / ~ ~ ` ~ LOT _ ~i t= ;~ ~ j T F' b~ :-~:. ~~ ~ E / ~ + LOT 31 ~ ~ LOT 32 N ~ r .. 2.33 Ae. ~/~, ~ 101312 10. Il < / ~. •~^ 93602 aq. Il .~ 2.Ot Ae. ~ 87460 W. Il '~ r'~ ~ ~ ~ ~ y, ~ y ~ s~~ ~ ~'' ~J r,, !.~ * p '~" ~ 1 / ~ / I ~~ B9 5'43'E ~ ~ ~ ' ~ • .22 - ~ - - ' ~ 43.n' . ~.--..rr.. ^ _ ....- ~ ( •~, ay 'b ~ LOT 29 79 Ac 2 • " ~ i \\, NMTN'! ~ ' ' ~,d$r ' . . « 4.)~' 121520 a0. Il OLO MOPKINS ~' u \ '77•E 1]1.00' ~ \ \\ ~~ yes" x~ la' ~~' `t0 NanY14'[ 2w n ~; •33ti4t To.oY \ _, \ ~ ~ . - _ - --fib, \ t 1 ` -- nsr ~ \ \\ '-~ li ula~lY ti~ usEYENr ' ' OR AINACE EASEMENT as " a - \ \ \ NWE - 901.00 ,n N aNl1'U'r f21aT ` ~~ \ \ \ , s "tea . ; PA t \ ~ ~ 0 O \ 1 • Ul 20' 011ANACE [ASCY[Nl OT 6 1 ~ \ \ O Ckf /Oj ~ ORAINACE ~'ASEMENF ~ ~ R OR/ ~ y ~ ~ \ i ~ ~ g4,7Y ~ ' _ v W ~ D J i 3 ~ HWE r 901.00 s~ /1~, 1~~ . \ ~ lM'4ri ~.ay ~ ~s ss \ ~ ~ ~ '~ ~ ~ ~7 3 \ ~: \ `~ ~, ~ ? z I~ lOT 39 62 Ac. 2 LOT 40 R ^„ 2.27 Ac. rZ LOT 41 11 Ae. 2 \ \ ~~ \ \ ~ ~ \ 1 . ~ 114244 9Q. Il 98956 aQ• It ; . 91673 sG. Il ~ ~; 33' 1\S 11 1 I- /~S l0 1 o ,o I~; ix; i R s s - BENCH YARr i0- OE 3/4' NON 1w OY CLEVALp1 r 944 1 1 ~ I . Ulf Yi09 OAtuY y I ~ I~ ~ I g , ~ ' -- 7w,4r 190,3f' u4.9r Y •1 ' a o0' e0U7H , • .`IW 1/4 - eW 1/4 01 e[CTION 11 Ne9'n43•W iN 7.e3 • w 1 39 I ~ i33 3 \ fOlINO YONWENi AS N01E0 91 CORNER ~ SW CORN[11 NW 1/1 a THE sr lp t'RM~SIEAR.t~R4l?IAN I I ~ I 129N, a9w ~ go t ~ o ,„~ ~ I ~ i /OMRIENI & ~ I I W I \ < I \ ~ ~ ~ a' / . n. r \ ~ r ~ r _ f 39] [ASr 1/4 CORNCR S[C. 11, i24W, R19W 3' AlUWM1Y CpRItT yONY11ENT 509Y3'OS'E 3930.10' l0T 34 ~ 3.21 Ac. « '~' 1~~39AA935 a0• Il H W~ ~ ~ r ~~ Nls~`yp0'L LOT 33 ~ 2.06 Ac. 6/9^579 aa. 11 s W ~ ~ N 1 '*~! OCNCN YMII 10P Of 1927 IISOS OAIW ~~ ~ 4 ~ ' ~ 4i vrv~~ ~' 1.~ SB9'JS•43'E <I ~~ 99.00' - 197.7!' - DoT 2e n • 2.94 Ac. R 128127 aa. It (~ $ Z ~ O b I'30'OSY 504.10' 1 3 vl r ~fG vooi LOT 27 4.20 Ac. 182.946 sa. 11 (~,S h O / \ SOT .4. NSk!~SIE:'R_rAQ!?!4N / ~ ~ ~E / \ / IOT. 1!