Loading...
HomeMy WebLinkAbout020-1445-05-000cn ~ ~ ~ ~~ z v~3 g v ~~ Z ~ ~ y m o Ol ~- N 3 ~ y O ~ m ~' ~ a1 m ~ 01 ''~ N ~ ~ y ~ 9 m y o 3c m < ~ .n.. n o • c ~ ~ ~ c ~o ~ a N N ~ j o d A Q Gf N y 7 d ' 3 O H O O O 7 Q O 7 O w n O O 7 O O V C W C V C O ~ C O O ~ ~ cn Z cn Z cn Z D cn Z cn z cn Z D m co D co D co D y m cQ D~ D co D y n a a ~ a a o ~ ~ ~ . r. O O ~ i O O O ! . O O O O O O Z Z a ~ o- O O O O ~ O N ~ ( d D /1 ( D ( A ~ D y N y D f f f D f ( a L 3 L ~• L 3 a L 3 L 3 L 3 z z 0 0 O N O ~ ~ N O ~ ~g S ~ ~ ~ _. ~g _ • ~ w a ~ ~ ~ w a W ~. 3 rn rn Z O_ 0- ~p ~ N Z O_ v N ~ N ~1 O ~f O j N j N 3 3 fD (D m v > > 0 -„ 0 -„ a o> ~ ~-ov av a -o o •vu,m~.vm m <~ m v m~ o y aQ o a, __o o m m `G CON 0 ~ 7 7 C fD Q O r N m a d O ~ A O O• ~ ~ p ~ ~ t0l~ O O ~ N F ~.oO3~Do N W 7 ,y-. y ~ W ~ ~ O. by c~D c O ~ N y~ p W fD O ~ O N ~ 7 00 y N ~ (n N a ~ ~• y O O cD N o 3 ~ oo x '~ 'p y ry" N w iU y j ~ O O N -'•~ 0 m 0 0 0 ~ °o °o °o o- a v ~ ~v-o av t0 O 'O ~. O O O N `G y O. y 3~v~ °- a?-~o oo-oNm mcu a m ~ c~•D.~a m 3 ~ y ao- o y -o'o m N K fON O'p7? C fD Z m oa n ai w aa~• m ~ ?O O,~ fD O~(p 7 y 7 < O O O ,0.. O O C "~ O O.~ ~ n ~Wf~D O O ~ O ~ N y S O W N O ~ ; N ~ 7a OD ~O ~~ (~D a O .O ? y N ~p W N ~ O7 ~ y O ~ O O 7 ~ .-r N ~ r 0 m 0 0 0 ~ °o o° °o o. n N O c d. ~ ~ e~ ~ .2'v~ ~ 3 3 ;: °. o ~ o0 N ~ ~, i of 7 i C a a 00°0 A c~`O O p~ A A c a O O O ? ~~~~ N N N ~ v v o D1 ~ ~ ,dy, tl! .. C ao Z ~ o ~ i ~ C N ~~~ ., ~. ;~ _: a ~~ D o' C a W ~ a 3 Z m a ~ m c 7 a 3~n d ~1 c ~ O tp ~ ~~ .r `1 ~ ~ ~ O ~ ~ ~. y N ICI ~_ R ~ ~ ~~y R 'O G C 0 N rt ~ ~• 3 ~ ~, cn cnf c 0 y y A Z n i ~ K A Z O •• ~ i Z ~ ~ I~~~~ A 21 III N ~ m ~ I ~ I i i 1 A 0 O ti N O ~4 ti b •°p .:. o°o ~ ~ ~ a Cn ~ ~ ~ T. ~ Z fn -'g ~ '0 T. ~ Z ~, ai N N E N O ~ N N N C N O • S""D N O ~' ~ f"D ~ (D a TZ 7 (D N O ,y, ~ O ~ N n ro < c ~ ~ D G7 o c ~ ~p ? ~ O ~ Q- ~ o ~ v No °- 3 0 ~ v o c m c v c O c A ~ ~ 3 ? ~ cnZCnz cnZD ~ cnZCnZ u~ZD m ~a D m" D co D N ~ co' D co D ~n D N ~ a oa o. (W c a o. o, W O O O O O O Z Z ~ ao o~ ao ~ ° ao 00 0o v_ ~' c °c °c c ~' °c Oc c ~ m m m~ ° m m m~ ~ N N N ~ N N N N CAD N f~D f~~D f~~D a ~ 3 3 a 3 3 0 0 7 (WJ1 ~ CwJ1 Q ~ _~ (~D _7 N f0 (~ O C O C W W ~ ~ W ~. a rn 3 a rn ~ m ~ z Q ~ z v O_ ~p y O_ ~p N --_+i O ~i O W y d N 7 N ~ N fD (D 3 3 m m < < m d 0 0 ~ 7 O O a v -+ ~vv nd fp y n d ~ vv ad ~ D °°-v o'o •pNm~vm r. O~'C~{n(DOmm r. a m ~ c°.• D~~ m' 3 ~• ~ ~ m ,~a m 3 N aQ -O N _o o m m nQ o'~P = o'o co a~ ~ coN ~ ~~? c m coy ~ ~? c m Z ~D pVn N N m nQ~• m ~D an ~n m ana~'• m ~ A O O, ~ (~ O N 7 N ~ A O O. ~', (D O fD j N ~ N~ ~ O~~ (D O CD fN~DI p O~ 3 N. C ~ ~ N 3 7 .N-~ ~ ~ ~ O7 3 ON-. 7 O '00 ~ n Oz W Q 7 O "O OC O ~s W f~D 0 N c -' N = p c o m ~°'v_insp~ 20 m ~ m_ins»~ ~ y N O o W O `3 ~ y p o W O ~ ~ O . ~ N f ~ O . ~ N ~ a ~ O~~a n ~ - y~o N•. ~ (3p ~ n W ~N. A (3p N. n W •O A N fD d -O N N N M N •~ N C y Na N c O X 0 0 ~ O 0 0 7 ~ .. N 7 N N N O O O ~ O 0 0 0:. o g o~ c ~ ~ ~ ~ ~ ~ ^~ o~~'. N 7C f 3 d o ~ n 3 ~o ~o w 2 N IV O ~ ~ co f N c ~ ~ ~ eo a a J O OD A t ~0 p p 3 0 ~ ~v~~ °' 000' ~ c N N ~ ~ ~ v v o _ ~ °' _ ti ~ _ N 3 d .'. .. C 07 Z v' y y N ( D j ~ C n ~. -~ N a 'D ~ D o _ ~ ~ A z n n j A (? j ~ ~ a 3 °o :' 3 tl! Z A m c a CZ -I < ~ z .p ~ ~ ~ m ~ A d A~ i~` ~ ^ ~' \ 1 0 ~ ~• C o ~1 \ 1 A~ C N ~~yy,~,~ • "V O Q 0 a ti OO O ti pp ;r 1p ,~ W ~1a v, a a ~ Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTAC~%TO PtRMIT) 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 Bast, Kernon Hudson Townshi CST BM Elev: Insp. BM Elev: BM Description: TANK IN FORMATION TYPE MANUFACTURER CAPACITY Septic Dosing _ Aeration --. __ Holding ~ c /-, .f C t ~ ~ ~ ,. TANK SETBACK INFORMATION ' TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ ~~ ~ ;~> r1 ; ~ I Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number l ____------- ----- - - -`" TDH Lift ~.- riction Loss System Head TDH Ft Forcemaln Length Dia. Dist. to wets SOIL ABSORPTION SYSTEM county: St. Croix Sanitary Permit 453452 0 State Plan ID No: Parcel Ta o: ./ - ~/Yt fi(~iv~ ~} SectionlTown/Range/Map No: 11.29.19. ELEVATION DATA STATION BS HI FS ELEV. Benchmark I' `i 5 ~~ / `i'i % ~ -mar= Alt. BM s~,c% c, ~rr- Q t.l ~ Bldg. Sewer ~ \ ~ v ~; .-r y-.vL SUHt Inlet ~5 ~~~ 3~> St/Ht Outlet ~,,, ti> ~ ~ ~ 7 Dt Inlet ~~,. Dt Bottom ~_ Header/Man. ~ ? ~~, ~ ~,. c~ i Dist. Pipe r~ ~ . ~ Z 9 '3 `~ ~,~ <% ~~ `~ .3 ~ Bot. System ^.~ 9 . ~ 6 ci '2 . 3 r ci 2 . 3 `? Final Grade ` . Y .'3~- 9 7 . ~~ St Cover `~ ~~ BED/TRENCH Width ngth No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ' ~ ~ ~'- 'l SETBACK SYSTEM TO --- P/ -~' BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION .___--_ OR CHA E 1''~ '~ ' Type Of System: r'~. ;~ 1.' :.,r--~ , r~~ •.-~L~~~ ~ ..k- lL' N c' '- ;...~ ~ '~ uN T , Model Number: r.. ltd C~ ~ ~ ' J DISTRIBUTION SYSTEM ~-- / -/r.~.._ ~- L'.-- Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake ~~ GG Length Z _- ~ Dia ~ ipe s _.... Length Dia Spacing -~-----_ . `~--_ ~ ._ `7 SOIL COVER x Pressure Systems Onlv xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded roc Mulched Bed/Trench Center Bed/Trench Edges '- Topsoil --- Yes No ~, ~ Yes ~ No S~`' t~' I`1= a~` ~r~ COMMENTS: (Inc-ude code~encies, persons present, etc.) Inspection #1: ~c 1 ..r l c ~ t Inspection #2: / / -1,41 Location: 755 Wild Turkey Tr l~rrkiTewr~+(NW 1/4 SE 1/4 11 T29N R19W) Sunset Hills Lot 5 Parcel No: 11.29.19. 1.) Alt BM Description = > `v ~ - <`~"-'~ ciz~:. ~ '3~ ~ w ~,-/ i~ ~..~~~ ,Y~/ ,~, ! cti nrj3,~- .z i., si.~ ~s% e~ ~ ~~G~-LE_ 2.) Bldg sewer lengtfai ~ - _~?~l / ~ `~ ~~ r< 3 -,_.--{~.CL-~~i' ~ /~~' c~~; c'dc%~-•~ ? ~ )~-., ~/~ (~- : !f <~~~;~/'~~~ ~-~-~ e•~N~ ire; r ~e,- ~~~ -amount of~over = ~ ~ ' 1 Plan revision Required? ~ `i Yes No i ~ Use other side for additional informati n. i. ~ Date ~ Insepctor's Signature , Cert. No. SBD-6710 (R.3/97) } . ~ n A :n v -- S ~ ~ f , s ~ , ~ f~%, ~ ~. . ~ ~kl ,~ S ~ ~l ~. cvi ncl e rs~ ~~ 'mil ~~~ 1iT~,c~ / ~-~ S ~~`' ~~ .m~.e, der.. ... -_ ---- ~ l.. ~~~yv..~.._.._.._..__... y ~l~c~ t-. ~'v'F~~,_r` ~N~h ma~~c 3I ~~~~ P V. ~ ~ ~ ~ ~.I~~- - oo~ o~~ ~ Nu~lllllllllllllnlll ~~ lU~ ~ u ~- ~._. ~~ ~,~~~ a, so' ~~ Aluu Zb~~ ~ti~~-~R ~(\ a,~ p~~~~~~' 3x 87- S ~ ~' ~ ~~~` rs' b I ~ ~~b ! e~ ~~ `~ ~s ~ ~-~ ~QN~~r~p~l~ T~~ ~~ -~~~ ~~t ~ fi~k~ ~~a" ~ bin. ~I-~v- 4g.~1 II g~-as ... _Y'_.. ..._ ... _.... ... _ 11) ~~/~~~/IAII,~ ./I~~~ ..i'r'e . /// j q ~~ s ~-~ s _~-~ -s ,N 9•~~~r ~~ _~• N ~ ~ r d h Safety artd Buildings Division County ~ 201 W. Washington Ave.. P.O. Box 71G2 ~,~~a~ns,~ De artmant of Commerce Madison. WI 53707 - 71 2 (608)266-31s1 ~~(~ 5snitar Permit Numtxr (ta Mied fa Ce.) ~/ ~ ~~ .. Sanitary Permit Application ~4~_ Stae Plan LU. Num r In accord with Comm 83.2l, Wia. Adm. Code, persorol Information you pmvkle may be used for secondary purposes Privacy Law, a Project Address (if d ffererN Bran maYhtg addrtaa) I. AppNcatfen Intorettation - Phrase Print Aii Istformation ~ tt, ~~ Property Owner's N ~ S E P 1 2 0 0 4 ~ P. d N ~~~, ,~ , ~ ~ Lot ~I Block I %~(,(~~- P Owner's M ail Address • 'd / ~ ZONING OFFICE ' Property Location T (~ Oa ~ / City. S to Zip Code Phone Nutnlxr " " _ " ~~ •~-~=u •~t~ ~ .$~ ~ Q (circk ) 1 II. Type of Buildlag (check all that apply) ~~ ~, 2~ T o ~ N; R,1~E W ~1 ' r 1 or 2 Famlly Dwdling -Number of Bedrooms L Subdivisk-n Name CSI1~( Piurttber ^ Public/Commercial -Describe Uae ~' Se ~ (S n'~'K~ ) ^ State Owrrai - Deacrilx Uae _ 02 J~J,fT. CG-Z (~ ('~L~-'+'1~~/1/.1~~0~',{~-- (jC:ity_I..lviUage ~(1'i'owrahip of SD~ III. Type of Petnndtt (Ch eck on1Y one box on Bne A. Complete Itne B if appUcahle) A' New System ~-; ^ R eplacement System ^ TresmtenUHolding Tank Replacement Only ^ Other Modification to Bxisting System B, ^ Permit Retrewal Permit Revision ^ Change of ^ Permit Tranefer to New List Previous Permit Number and Dale 1»tted &fae Expiration Plumber Owner ` yS3~~a g~ rv. T of POW'I'S S an: Check all that a i ) Non -Preprtrized In-0rourd ^ Mound > 24 in. of suitable soil U Mound < 24 in. of suitable soil U At-Grade U Shtgk Pass Satd FNlar ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter U Aerobic Treatmem Unit U Recirculating Sand Filter ^ Retircula S Media Filter chin Chsmber ^ Dri Line ^ G (ex lai ~ V• reatmast Area Wor tlon: Z O S S Design Blow (gpd) Desiga Soq Ag{ication Rate( Q Dispersal A~ ~equir ~7 Pr System evatiat I / U U r j 3 ~ 1 lQ g ! ~ 3 ~"" ~ 2 ,~ VI. Tank Info Capacity in Tota Number Msnufacturer Prefab Site S1CC1 r-A,ar Piastk Gallons Gallora of Units Cortcrete Constructed Ghw / New 6alating Tanks Tanlu Sepek Itoidily Tank Aerabk Treument UnN S ~ ~ _ ~~ Dwbtg Chamber VII. R Wlit Stattxnettt- I, the undet~igped, asetltne rbpot~bilttY for hutaUation of the POWTS ahovrn on the attached P1 Na ttx Prim) Piu r'a SI lure MP/MFRS Number Buaitteas Phatre Number /. p Phtmber's Addre as (Street. City. State. Zip C ) v ~ _ '~"C l . VIll twttt /De at Uae Oal Approved ^ Dlts-pproved Sanitary Permit Fee (includes Groundwater Date Issued Isa A Si ) Surcharge Pee) ~ ~ ~/U ~ ~ ^ / ~ O Owtter Given Reason for Denial iX. Coatgtlona of Approrttl/Rtmaona for Disapproval ~t~c.Q [~J (~~i ,M ~ ~~~ ~2hfl-i'ctGC~L ~• L r " l `~ ~ ~ ~ ~ ~ j~ SYSTEM eptic tank, effluent filter and ~(' 3,SZ ~ ~'~ ~ ~ ~Z ,r'~=~L",/t•~G~~L ~jQ~~ e " dispersal cell must all be servic ii5ed ~{ - Ct Dry- do 3 ~' ~ ~ 3 . ~` " r ~~ l d b t id l b an prov e y p er. as per managemen p um livable code/ordinances. Altaeil eomdere daw. te. 16. ~............~.. r__ .._ SHD-6398 (R. 01/03) ----•. ---• -•-- ••, •.......... ,.-yam. ...n .va m.w .vs E .. 111C0lt 111 tIL! ~/ Si f '/Y~'1 Wisconsin Department of Commerce Division of Safely and Buildings SOIL EVALUATION REPORT in accordance with Comm 85, Wis. Adm. Code 1835 Page 1 of 3 A.C.E. Soil & Site Evaluations ~ County Attach complete site plan on paper not less than 8'/ x 11 inches in size. Plan ust St. include, but not limited to: vertical and horizontal reference point (BM), directi and location and distance to t slo dimemsion rth arrow l , ~~r] ~i r~s ffdd'~~ Parcel I.D. pe, sca , percen e or s, no Pending Pleas __ ,, '°-~~~ Rev' Date Personal informafan yai provid$ may be ~ (Privac Lew, s. 15.04 (1} (m)). _ ~J Property Owners Property Location Kernon Bast r' '' 'i ~ ~ n ~ Govt. Lot NW 1/4 SE 1/4 S 11 T 29 N R 19 W Property Owner's Mailing Addres Lot # Block # Subd. Name or CSM# 948 LaBarge Road ( ~ ~ .~~)!, ~ ~~„'~', ~ " 5 Plat Of Sunset Hills City s ~ ~~Number J City _J Village t/ Town Nearest Road Hudson ~ WI 54016 715-386-7775 Hudson 755 Wild Turkey Trail 1~ New Construction Use: ~, Residential /Number of bedrooms 4 Code derived design flow rate J Replacement ~ Public or commercial -Describe: Parent material Glacial outwash Flood plain elevation, if applicable General comments and recommendations: Install two trenches at 93.25' using 28 leaching chambers. 600 na GPD Boring # ~ Boring ~~ ~ -~ Pit Ground Surtace elev. 98.16 ft ./ . Depth to limting factor ~98~~ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP Dlft~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-12 10yr32 none sil 2fsbk ds cs 2fm 0.6 0.8 2 12-20 10yr4/4 none sil 2fsbk dsh a 2f,1 m 0.6 0.8 3 20-32 10yr5/4 f2f 7.5yr5l8 sil 1 msbk mfr aw 2f 0.4 0.6 4 32-3 7.5yr4/6 none Is Osg dl gw 2f 0.7 1.6 5 39-98 10yr5/6 none s & gr Osg dl - - 0.7 1.6 Redox. concentrations identified in H#3 are tad in lower 6" - 8" of horizon and are due to greater matric potential of silts over underlying Is. 85.30(3)(a)3 applied to discount rdox. concentrations. Comm. a Boring # .J Boring /~ Pit Ground Surtace elev. 97.76 ft. Depth to limiting factor '93~~ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-7 10yr32 none sil 2fsbk ds cs 2fm 0.6 0.8 2 7-12 10yr4/4 none sil 2fsbk dsh cs 2f 0.6 0.8 3 12-19 10yr5l4 none sil 1msbk mfr aw 1f 0.4 0.6 4 19-28 7.5yr4/6 none Is Osg dl gw - 0.7 1.6 5 28-63 10yr5l6 none s & gr Osg dl gs - 0.7 1.6 6 63-93 10yr6/4 ne s & gr Osg dl - - 0.7 1.6 * Effluent #1 = BOD ~+ 30 <_ 220 mg/L d TSS >30 < mg/L ffluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signat e: CST Number James K. Thompson 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane. Osceola. WI 54020 8/192004 715-248-7767 Property Owner Kemon Bast Parcel ID # Pending Page 2 of 3 Boring # ~ Boring ; , /~ Pit Ground Surtace elev. ~ ~ 98.32 ft. Depth to limting factor >99" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 "Eff#2 1 0-12 10yr3/2 none sil 2fsbk ds a 2fm 0.6 1.0 2 12-29 10yr4/4 none sil 2fsbk dsh a 2f,1m 0.6 1.0 3 29-39 10yr4/6 none sil 1 msbk mfr gw 2f 0.4 0.6 4 39-51 10yr5/4 m2d 7.5yr5/8 sil 1 msbk mfr aw 2f 0.4 0.6 5 51-99? 10yr5/6 none s & gr Osg dl - - 0.7 1.6 3'l ~.. y . ~s' r 7i. ~ `' 6 Redox. concentrations identified in H#4 are due to greater matric potential of silts over underlying sandy soil. Comm. (3)(a)3 applied to discount redox. concentrations. Boring # J Boring /~ Pit Ground Surface elev. 100.26 ft. Depth to limiting factor 42" in. Soil Appliption Rate Horizon Depth Dominant Color Redox Descripiion Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 "Eff#2 1 0-18 10yr3/2 none sil 2fsbk ds cs 2fm 0.6 1.0 2 18-42 10yr4/4 none sil 2fsbk dsh a 2f,1 m 0.6 1.0 3 42-84 10yr5/4 m2d 7.5yr5/8 sil 1 msbk mfr gw 2f 0.4 0.6 4 84-96 7.5yr4/6 none Is 1 msbk ~ mfr aw 2f 0.4 0.6 i ~-+ ~ H ^ Boring # ~ Boring Pit Ground Surtace elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Effluent #1 = BOD ~ 30 < 220 mg/L and TSS >30 < 150 mg/L "Effluent #2 = BODS<30 mg/L and TSS <30 mg/L 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. jJ~~tsa~u4~~ir ~~= ~lC~k EiO~'7 i ~ ~r ca ~ 4~/ r1~, !J, S ~z~t'c r , ~~G.i/G; /~= f~O ~e~•' ~~~35 7'7`. P ~ p~o5<.( 6kt Id,'n~ S~~ • io5 69' ~ vv, a~ `c~r+ `w~ ~ '~~ 8 -~ ~' 99.0, ~• ~ i ~ ~~ / ~ ~ ' i ~ ~ ." ( ~ /' r 3 i, ~ ~ z a S~aQ° ~ ~ Z ~e~ = /tx~. ctn.' ` , '1 i'~. L._% i /U' _, u,,~:y, -~~.~,• I ~,` I 9~3.0~ 1 i i ~ ~';2'~d .~: 91 =' ~ ~3 ~o ~ / , ~~ sy.s~a~ ,a~~~ ~2 ~ ~ n QSL , ~ fg"'~ ~' a ~ K ~ ~ D;5 i ~ ,_ ,' ~t~r3.ryt.~ To,~~f~ ~r,'~ ;d~ ~9.: _,' Safety and Buildings Division County t j ~ ~ ~ ~ 201 W. Washington Ave., P.O. Box 7162 U ~scons~n Madison, WI t-3707 -.7162 Sanitary P rmit Number (to be fil in by C .) Department of Commerce (~8) 266-3151 3 $' Sanitary Permit Application State Plan I.D. Number ', In accord with Comm 83.21, Wis. Adm. Code, personal information you provide may be used for secondazy purposes Privacy Law, s15.04(I)(m) roject Address 'different than mailing address) I. Application Information -Please Print All Information - _ ..., `~.,5~ j~l(,' l u ~~~ Property Owner's Na me ~ Parcel N Lot k Block J! eR ~ G Property Owner's ~ fling Address _ ~ ~ ~- 4~ ~ P r ovation i, t 2 W ~ 4;~ ' City State Zi d C V r k,Section _ 5 _ , p o e s ~ ' ho I utit2t<er Ub p ~ ~ b) d t (circle one) ~ ~ II. Type of Building (check all that apply) ~ p,~-S tn~ _ T N; R E or W ! ~ r ®- I or 2 Family Dwelling -Number of Bedrooms Subdivision Name CSM Number ^ Public/Commercial -Describe Use SSA ~.l f.Q I' j ^ State Ow - r' Use ~.- ^City ^Village ©Township TI SO N III. Type ermit: Check only ne n li a A. Co ete line B if applicab ) A' 'New System ^ Replacement Syste ^ Treatmen olding Tank Repla ment Only ^ Oth f t is tem B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit ransfer to New List Pr u tuber and Date Issued Before Expiration Plumber Owner IV. T of POWTS S stem: (Check all that a 1) b tY (`~~Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil ^ Mou 24 in. of suitable soil ~ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ P t F r ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ vel-less Pipe ^ Other (explain) V. Dis rsal/Treatment Area Information: Design Flow (gpd) C Design Soil Application Rate(gpdsF) ` Dispersal Area equired (sf) ispersal Area Proposed (sf) ` ` System Elevation X3 5 ~ Q 00 . 7 $S ~ ZO . ~ L VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Uni 4 0 ~ Concrete Constructed Glass New Existing a ~I 1 /; Tanks Tanks ptic r Holding Tank _„ '1 1 /\ of l4 V Aerobic Treatment~llnit D amber VII. Rt'sponslbility Statement- I, the undersigned, assume r' ponsibility for Installation of the POWTS sh non the attached plans. Plumber's Na me (Print) s' ~ ~ Pl bet's i gna a MP/MPRS Number Business Phone Number ' ~ M t/- ~ ~ a a~ q b 11 S -:~ $ , off, v Plumber's Addre ss (Street, City, State, Zip C e) 11 / j ~ ~ ~ ~ ~ ~ ~ ~ ~ V ~ . U 3Uu ! VIII. Count /De ent Use Onl pproved ^ Disapproved Sanitary Permit Fee (i eludes Groundwater Date Issued I ui g Agent Signature No Stamps) ^ Owner Given Reason for Denial Surcharge Fee) ~~' ` ~ ~ ~ IX. Conditions of Approval/Reasons for Disapproval ~` ~ a!..k~~6v~ SYSTEM OWNER J : ,p~ 1 Septic tank, effluent filter and ~ ~ ~Q, ~ei0.xlt+~R1~ t-6"'""p,~. ~"`~"""`` ~I ~ . dispersal cell must al! ~ serviced / maintaiint:irl ~ r as per management plan provided b l ~ 3 = ~ ~K~ tr~ ~ 3~f ~ t b C St y p - . .-- + - um er. 2. All setback requirements must be maintained as per applicable code/ordinances. ~> ~~~ .,~ ~ ~ ~ , t .+..aw wminere p~aos tm me t;ouhq omy) tar me system qp pallet no'l~, than UIiL x t fn es in size ~ ~ 1 /- SBD-6398 (R. 01/03) _TL;~,,,J- t,7,~lV/~~y._ yA„".-,u. J~p"`l~T`_ ~` .2, •\ aiJ ~e ENO ~ ~{~ sfi su Ns.~ ~~-1 ~ s ~~~ ~ 5 -_ _- ~ i M Isa.~ rneQ~(~ aaag~~P _ 3~ Ali ~~p ~S ~I (3marck ~ (3J /~ t[ / ~ a,~i'~ ~° o~ `~a~ ° ,Z, 5~~~1 ~, y ~bRa a ~ 1u0, ~ dwt l ~ lal, u ~ep~'ic 1~ou ~, wlA~~b- ~f l~h o i #/-~ a~ X 2 ')a Sett 1 ~; t £l..y=)Ob r~ CpP i~p'l~ U h'1 ?xa~ ~ let ~= ~~,U~ ~~q~.s~ ~e~N~i~ ~~s~ .~ i rv, ~ rneP~~ ~ ~l~ll aaa9~`P SUNS i s ~..~ ~ C, ~ ~ ~~ _ _ ~ __ _ _ ---~_ _ _ __ _ -- _ ~ _ ~-------------~----ern 7 ~6~ ~ ~p~ ----- ~ S ". '~ o~ ,~a~ ~ a' o pro - ~ ,~ ec~ ~I~ ~ QebROUl., dWc~~ f ~~o a~ ~ #ma~ 1 Ia ~~~~: iv~ ~ (~p'l~ U r'1) ,, ~n4 L~ C ~Qj ~~ ~~,U~ L~~~s~ .. .. ~ ~ ,f Jr ,kV ~i b~ [UU4 ~DOf sT. c~oix couNr~ ~ S iL ~1iAt.UATiON REPORT ` ~~ ~nniia,~fi[1FFLCE ~~a3 ..... w. ,.~_ .,,...~ .,~ ccmpiete site pt~ an paper not ~ the a ,a x » ~ sire. ~ 5T LiPo~ K. sae. liuc not ~cr io: v ana rrorizoreai rererenoe point {~). direction arts ,~~.~,.~~~~. a~ 1.0. 020 • is/3.70 • a~ Please print sil information. ~ oat t~etsaml kKamaHea Y~ v~ mey tie used torsaooiWSry papops (Priwer taw, s.1S.0~ (1) (n~. ~ j . O P ~ /~N ~~L Ef ~ " `' c Govt. Lat 1/4 sG 1!4 S // T -2~ N R !~ ~{off V{l P DY p a L.t! • Tft'rt~•yE t.ot # .S t'~o~c ~t s~ r>ame a cs~ SvN SC T`~ ff ~! S ~UOS~~ State ~ code Number ~i/. s yo~G t 7/f~ 381.9QOs CJ C+(Y ^ ®.Town Nearest Road ~o,u ?,~~vEy !-~ . ,~ ~" ~ use: ~ Resider~t / Number of bedroorrrs code derived design Aow rate d "' O a ~ ^ Replacement ^ Pt+b6c or oorrrreeraal - uesatbe: _ Pa~ntme~t~~f~]~ DST"/yl3.S.~+ FloocsWatne~evaUon#app~ceWe ~ ft. oommer~ • ~4~QFq- Ti`s rE'O iS sui Ti9•,aGE F~/2 ftN ~' /~ovvD f. . ~e ~ ~~ sur~ee)~+. 9~ ~. oeptt, to ~rn~, ta~or•, j O fir. sot Rate Morison OepM~ DaNnarrt Redoer Desoriptfon Te>dune Strrx~~re Caresistenoe ®ou~ary Roots ~. (~i. Sz. Hord. Color Cir. Sz ~-. '131f11 'E~2 / o- ~ io y/~ ~ /fsh,~ ~ fR w 3 -~ . y . ~ Z l~ • Z /o Y S S/L / sl/c ~~ ~S . Z . 3 3 a •S ~~sy,~s S D. s ~ c - ~. ~9Y.a6 0 ~ ~ Gtottnd surf~e elev. s8 9~ Depth b 6rrprrr~ factor ' ~~ in ~ . . ,~ so>I tiafaott Geplh Dormant Redoes Tex(ae Consistence Root G ~ in. Qu. Sz Coat. caor r~ sr. Sh. '~, y ' L ~ 7• S V ~-- I.2.. ~~~ • ~' .-8' • l~krerrt #9 ~ Soo > ~ < 22o nolL and TSS >3a <,s o,Y,a~ a7 = ~ < ~ .tea ,.~ r~ ~ ~ ~a_ . csr R ~ 7~!-JSRi c1~7_' csr Date E-~reon conduced Telephone NunGer ' /I/6 l/. 30 • d2 oa 715.7 gat • 3 ~lY2_ o.:.._~_ Associates • •~~ace; sewage Consultants 2812 10th Ave. SPt1R9 Valley, Wi 54767 r-- ~ ~ _ ~ . ~.._. -~ a,,. CS ~ S ~crt~ - -.d-- I . _. ,..... __l._ I _ 1 A ~ . ,~~Qi~t'itI /'~'~ lrz eg~,,i O Z d -! 6! 3. 70 • d~ .. ~~7WfiBf v P?lOP.I ~ ~ ~ Q ~ ~ ~ • ~° ~ Qr 3 Eiad~ [ Dam Tex~[e Cooe 8our~a~y R~oQa (F ~.. cam. c~o~. c3r. sz sn. ~ 'E~ Cl ~-~ ~. rya, ~ ~. ~ ~ soi ~ ~ ~ ~ _ ~~ ~. €+ ~n fac6or ~• ~ Gr. ~z. Sh ~ • ~t = Bobs > 3U_< 22b and t~ss >30 _< t9D mgt ~z = ea°6=3tt mgt. and TSS -` 3o mgR. i ~. --~- 0 ~~ ~~ \ y~ © L/ U. N ._.. _- "..__~ L o ~" ~#- S .y...- o ~ 5 v~v~Y°R 5 ', Gd T ~ ~ ~3 ~ Q s 7 °~B o { ~~~ _-- SC,q /.2 . / " ~ZD • - j,~il~C~Go~l ~ ~ ~~ 7" S 990 . ~ • ~?.. .~ ,o O H~ 5~ " T6p 6IC" ~- ~~ p~~- ~' /Dd~3Q~ . ~~~ - so~~ Ev~.uranoN ~o~zr... ~ ~ ~ 3 ol+~ o#s~-~,d spa in ~rrvrtsnro wON. f`........ nie .+' aw.., r...ts +~r~e she planar 81 ~ co~,ey 5T• G/PD(' !L ode. bcd aoc rata: s r r a~ t~.~leaa .~~~~. ~` w` o • iota . 70 • aaro Pi~se prfnt eN hatTan. P.~sawtarow+r a+~ov~~rsa+s.ewr c,arir tsot{~)N~L '~ ~ O D ~~ /~~LL~'/~ Lot i 5~ 1/4 S ~, T ~~ N R l~ ~(mj W P~OPertYOMmei'S 8 Address ~ 103 D Tf1'rV.vE •~ • Y # t~dc ~ Subct. tVerne a CSt-AA~ O~G' StlNSG'T ff-!/! S Gads F CE f{uO.Sa~, to/. Syo/G ~~ Cij/ ~id~ge ,Tam t~tearestiioad how 1.~N~y ~ . C~3 ~ ~ ~ r ~ otbedroans code domed a~igr- Aow ra6e 4 - Oa cep ©Pu6Gcccrconrraa~-pescrlbe: Rsrentms~~ bbj'ftJ1l Flood Plan etevadon #app~le ~ }t, ~ar-d~~or,~ • A~Ei} T£-S'7"E© iS Sv1Ti4•iQGE ~/p i¢~/ fit ~~Pov,~,D -----, _ Shc Ram ~. a,. sx ~. ~ ~ s~ sn. ~, r~z / o- ~ io yR /f5b~ ~ ~ fR w 3 f . y : ~ 3 a •~ ~~sy,2s S o. s ~ ~ ~. c• Q ~ ~. >~ {s~our~dsurtaoee(ev s8 9~ ~, , ~ ~,. sa RaOe +,o.Faa, t~ EtedooC TexLms cow eon„ Raota c /p ~ S ;2. f EIIMae1t #1 = 1300 > 30 _<Zd0 ~1'{gA.a1d TSS >30 ~ 15 Q mgA- ` E1Quant~2 =800 <30 t11g~t. a1d T5S < 301~tpiL . CST tdanle (Please P~ CSTNI~nbBr R© T Z11.~5~t'i ~!'T' Aad~ t3~ebe [v~k~on ca~dvaed elepiwne ~'~urtcrn & Associates t'rn-ate Sewage Consuitan#s 2si2 ~ otn AVe. SP~n9 Vaitey, W154767 ~ ~, ~~ r. , ;, , r Svvs~ f tail/S D2C~'!bf z~ 3 ~ ~ ~ ~ ~ ~ ~ ~ ~. ~ ~ cam. s~. cam. c c~.: s~ ~+. -ten l D • 2 (v /D ~/~ .__-____ L 1 f s,(~je il~h f 12 - ~ . Ca 3 •~` b is ~ ~ =-~- SiL / s h/~ ~ : - c5 - - • 2- ,. i ----- s . s . 7 `1S - . (,~ . _ M ~.~. c ~• ` i ~ ~ U v u ~ sce R~ iiat~i c ~ 1~ax~_ T, Carrs~erttae Ba~dax7t Roots ~+. cx~. sz c3ottc c~ sn. r §. ~~ ~ i~ t~lno~d t et~r. ~. ~ its. 3c~ Ft~e ttotsz~ti ~s Redrnc t Tie 91~x#sa fla~etm+ee y Roots t i its. Nkar~e~ Ckt Sz, fattf. fir. ~. ~+. 'E~i _ ~ _ ~ ~t = g()ps a ~_< ~ ir~ snd ~ X30 < i9E33 text ~ =£lt3F3s~ 3t? ttgti. ffixS•T'SS ~ 30 toQli. i ---~----e-..._____________-__..~~~____~__~.___.«.....•...._.:,te. ~,..~.n,...inwr ~f in.. .swr1~4A~iee ~n9E[ --~ 0 ,, ~~, -yam LD ~ ~ ~ ~ '~ i~o~ ~ f b L/ ~~ ~~ _~ -- __ ~_. ~- S _x~ o~ ~ - nor ~S ~ ~ ~.~... s ~Rv~Y°~~5 -F ° ~''~ ~ ~,,r /11 ~ Lk~ ~~~~ • ~ F~ 133 ~ 0 5 7~ . ,~ ~~ ~~ ., o f 9l~ ~.---- E a ~ P ~~ Ts 99. .._-- . ~ . 2. ~o ~ -~~ H~ Z 5~. T 6 p 6~- d Y '~ ~~ ! ~~ ~ ~ Dd~ 30' `` 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 Des ign Spe ificati ns Sanitary Permit Number Number of Bedrooms Design Flow -Peak (gpd) p p Estimated Flow -Average (gpd) Septic Tank Capacity (gal) Soil Absorption Component Size (ft2) U Type of Wastewater Domestic Table 2: Soil Absorption Component -Limits of Reliable Operation Septic Tank Co onent Soil Absorption Component Design Flow -Peak (gpd) U 'o (~tD $ U Maximum Influent Particle Size (in) ~ g 1/8 Maximum BOD5 (mg/L) ~~y 220 Maximum TSS (mg/L) (;~' 150 Tab le 3: Maintenance Schedule 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 necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids 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 1/3 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 enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be 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 far 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 Management Plan fora Septic Tank and Soil Absorption Component Plantings of deep-rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. When system fails, we will replace with another system at owner's expense. Alternate area must be left undisturbed. St Croix County Zoning Office 386-4680 Boumeester & Sons Excavating 386-9020 Tri-County Sanitation 386-2130 3 Q3f 13f 2001 16: 21 71-53858473 . _ _.... COPY CAT PAGE 01 6~T ~~tUHX ?UN't'9~ ~BPTiC 7C'AAIiG 1NIA.ii~i'i'BNAi~iG~ AG~~Mi~NT A1Vi7 OW~IBRS~iIF CBi~'i'iFiCATiON i:ORM ~~~ E'•''n~r~ ~~ -a /~Sa /G _ ~~./,/~ y .~ (Y 'tieNiou lkona Fls+nniss~ Uep~nsnlrsbc (as seas vannlruat' '~~~ 1~G~~~~n ~ ~ ,,._ Farcet xdeetid'toation Alattnbar ~D ~„~.~. 'r`~ . t ~ .-:~S ~ ~~ ~' ~ ~,, a~,, sue. ~ , r r~-x w, ~raW~ Qe ~v ~' Sub~iveeia~ ~ ' ~ ~ _. Lot # c~ L4et~crcy ~.~ ~ ~~ VQiu~ne // . Fage ~ '- ~ W~agr d #~ -~~.~ :.~.~~~_~...~...,,,., Vadtt~tte G~~(~......, Aa$e ~ 1 ,...., l~nac i Ci Yaa f~',~a L,ot liacas edanti~iable~' yce ©no drepoapar mio ~ nIt' yoat aP~ y,-edem cbuid nut in lu ~e~hua Ilsttuts to e.r+~eaa. Pnupei ~ ~ of oat t9se ink ove~y stmoa4 yaars- or , it' ae by # tiaans~od 1Nhtl you pal irk tw ryatrt- eon o~ot t9w IMrvt[aa of tM spsl4v talc u a #+!o e1o~e is~ tba esracN 1 systesan. Tom' 1tY aenax +~~ b t b 8t. t~oix paper a cettl~oatloa Ibtm, ripad by ~ owt!!4- ~rjr e ~ pt+ae~ar, easrhfelMl~smber qr a iiaeasadp~ ~oeit~tiu~t tba (t) l>sa sae-siar ~-~towratar yp- M ~ >~" ~ oeod~ltaa radvoP C~) . ~ aid (!t' Weaarreryh the wptia ttnic is lep ~a- •i~#~ii at Ywa„ ~ e Ya Insd ~Ip a ' ' ~ sf ~' set ~ ~--- - - „~ ~ to nealt~fa the ptirrta ra~e~a dinpaRel ~l~~~.t iJ11A0YQN~M' o~s1u 1'-.~~.~.~.~~a J~tt_~___^n_-----...__._ ~...- _-~rw_ .-~.~ ..r _. i ~ - ~~# ~ tell :~;,,~ . i:: lo~aatalr 1pa~*ti~aq- ase pus to e4e bat o[ ~- (wur) icuoo-te~o. 1('vej alu (~) fhe o~s~s~oos(t~ of w e v oi' a ra~tjr dead cacpt+~pd is Re~il~+e of Doer QiBcC. '" Aty- iafiuaat~ltocc ~ ~ m~ "~ ~ ie t6a tury ~qit bey xawdoud by the 1~oa~ awl, "*•'~ iM tiy/ =:t~A~i used iha ~a~feter cd' Lleedt ottiop a ~Y ~ dMMt ~iltied ra-ve~ mtq~ if ~ it wade M the a-etrasty daaa .~...~~ C z ~n ~YJ ~ ~ v~'~ h ~ 0 C •~~j' W ~ m ~'7+' ~ ~ '~ C~ m AY l7 . { N ~ ~ -( `~ ~ '" ~ ~ ~? ~ +r ~ ~ ~ ~ n ~ D v ~ ~ z m ~~ m-~ ~~~ ~~~ azn ~. C ry'~t ~~~ ~O" ~A~ OC~ ~m ~~ spa m~0 U1S71 nom ~~m i /~ W C ~ 'fl ~~m mo~ ~~zyz 71/ ~. m yy~~,, J ooz vsm o `" ~ ~°o m O ~n ~~~ ,,.- I i ~' 'r' ~J 2586 F' 216 STATE BAR OF WISCONSIN FARM t - 2000 Document Number WARRANTY DEED This Deed, made between Brian H. Raleigh and Michelle L. Raleigh, husband and wife, Grantor, and Kernon J. Bast and Donalda J. Speer-Bast, husband and _ wife, as survivorship marital property, Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (the "Property") (if more space is needed, please attach addendum): See attached Addendum A. /~ * Brian H. Raleis?h Together with all appurtenant rights, title and interests. Gi;t) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and &ee and clear of encumbrances except Dated this ~,(~ day of May 2004 * AUTHENTICATION Signature(s) authenticated this day of 1~- GheC~~ . c * ~}~pt2~C OOng1'~ TITLE: MEMBER STATE BAR OSC ONSIN (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Brent R Johnson Lommen Nelson Law Firm, Hudson, Wisconsin (Signatures may be authenticated or acknowledged. Both are not necessary.) ~Q~~~~~ * Michelle L. Raleig ACKNOWLEDGMENT STATE OF WISCONSI ST. CROIX Area 7645 1 4 KATHLEEN H. NALSH REGISTER OF DEEDS 51'. CROIX CO. , WI RECEIVED FOR RECORD 06/02/24 09:15AN MARRAN'CY DEED EXEMPT # A REG FEE: 13.00 ?RAIiS FEE: 1268.00 COPY FEE: CC FEE: PAGES: 2 Name and Return Address Edina Realty Title, Inc. 400 South Second Street Hudson, WI 54016 4 ~4Z~~~t9 020-1013-70-000;020-1013-60-000;020-1013-50.000 Parcel Identification Number (PIN) This is not homestead property. N ) ss. County ) Personally came before me this ~ ~ day of May 2004 the above named Brian H. Raleigh and Michelle L. Raleigh, husband and wife, to me known to be the person(s) who executed the foregoing insttumen d acknow edged the same. * Notary Public, State of WISCONSIN My Commission is permanent. (If not, state expiration date: ~~i * Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN INFO-PRO (800)855-2021 ewwv.infoproforms.com FORM No. 1 - 2000 tl 286 P 217 ADDENDUM A Tp ~VA~2~tA.NTY DEED PIN: 02Q-1013-7x000; 020-1013-b0-000; 020-1013-SQ-000 GRA~NTURS: BRIAN H. RALEIGH AND MICHELLE L. RALEIGH GRANTEES: I{ERNpN J. BAST AND DONALDA J. SPEER-BAST dal Description Located in part of the NW '/4 of the SE '/< of Section 11, T29N, R19W, Town of Hudson, St. Croix County, Wisconsin; including part of Lot 5 ofJoshua Hills recorded at the St. Croix County Register of Deeds Offtce; described as follows: Commencing at the S '/4 corner of said Section 11; thence North 00 degrees 33 minutes 37 seconds East,. along the west line of the SE'/4 of said Section 132S.b3 feet to the south line of the NW %4 of the SE '/n; thence South 89 degrees SS minutes SO seconds East, along said south line, 13.67 feet to the point of beginning; thence continuing South 89 degrees 55 minutes 50 seconds East, along said south line, 876.02 feet to the west line of Lot 1 of the proposed Plat of Sunset Hills; thence North 00 degrees 18 minutes 4S seconds East, along said west line, 347.77 feet to the north line of said Lot 1; thence South $9 degrees 27 minutes 39 seconds East, along said north line, 377.45 feet to the west line of a Town Road (Tanney Lane); thence North 00 degees 18 minutes 4S seconds East, along said west line, 33.00 feet; thence South 89 degrees 27 minutes 39 seconds East, along said west line, 19.14• feet; thence North 00 degrees 3S minutes 36 seconds East, along said west line, 33.00 feet to the south line of Lot 10 of said proposed plat; thence North 89 degrees 27 minutes 39 seconds West, along said south line and the south line of Lot 9 of said proposed plat; 434.50 feet to the west line of said Lot 9; thence North 00 degrees 36 minutes 12 seconds East, along said west line, 511.98 feet, thence North 01 degrees 19 minutes 09 seconds East 74.93 feet; thence North 89 degrees 44 minutes Sb sec;onds West 831.70 feet; thence South 00 degrees 54 minutes 40 seconds West 1003.59 feet to the point of beginning. Page 1 of 1 OWNERS 1030 T EY IANE 602 OLD M«ILLBpOgp BapB TANNEYLINE HUDSON. WI 51018 HUDSON. WI 51016 HUDSON. WI 51016 715366.D0p5 suRVE,roR EDWNI FIANU61 N°RTMUHO SuRVEnNG, wc. P.0. BGOC 11 Ro9ERTS, va 61021 PHONE 7/S71D•1716 FAX 715.7411719 ENGINEER HUNPHREy ENGINEEWNO ROGER HUMPHREy 115IAAIN STREET/ P.O.80X252 WOOOVILLE, YN 51026 N 1 I ~' _ I®~ ~' 9~°~1 V ~ I 1 1 2// ~f~l V 9f~f 1 ~ 1 ~ 1Q b~ 1 ~i~ o~ g' ~ ~ d~ R~ 7286 d8•d8SN 68/.16 $~ I ~<jj ~ ~ Lox a ty = 216 ACI~8 03.830 6Q Ff. 2 ~ ~~ 7i~ LOT 4 3.62 ACAEB I 1w,7n so. vr. ~~ I Lo.SMM' 0 a~ ~~ ~~ CURVE DATA TABLE LAUNDER lOT NUIRER RADIUS CENTRAL G/ORD CHORD ARC ANGLE SEARING CI LENGTH LENOTN TANGENT 17300 79'1x19• N1976.113•V 2lBES' 32..16• ND9'2799' 3 233m 37.5627• N70.2925sy 151.1t IS129' N69'27.39' TLOT 1 233D0 16.17'01• 1N3'22'10N 66yy 662 • . . 273-00 2 . ' ' N51 71'12•~ E2 25 29 16 N22.2Y2Yy fOP-00' 103E5• M33•N '087 167m ~~' NyN73•y M1.7C 233.16' N09•U~ C3 23am 35Y7'IS• 5279627s•E N316' 113:3' S1$•32'p5 G 167m 79'4x19• S19.36'113t 211D5- 232.31' so9•u ~~,~., o~~®~ ~~, LOT 7 ~~~~ 3.61 AGES ... ' .... . na7a 770. Fr. , Lf0 . SMNr .. w'~~', :: LOT B 731,D88 8¢ Fr. ~~ Lf0 ~ ~I{/Dt _. _. ~ ..... o ~ ,~ - ::: ,~v ~ ::::: J_~ ::: ....... :::: LOT ................................................................. ........................ ..... 6E g C s~' 3 Pr1c S'A ~ ~ ~ ~ 178x66 ¢Ff. ~ LOT 2 75:::::: :.:..w.:::::: :: d 2710ACRE8 € LOT'. . 77¢ ::::: ~ ::::: .. ~ : ~~. 7wa31 So. FT. g w ~ ......... ... g :: ............. µ.. .....::::: l]0. p1AD• s 6.aoAtxtl t70Ae0S0 ' ~ . . ......... ... 0 .. . 78132 ........... __~__ o...... ......... .... ~~~+~+yQ_rt~ ~ _______ ___ .. ..... ~ O \ \ 16.BT I 9'6S'Sp'E 1233.4T .... SG/IN IlA:OF 71E NM/IN OF 7Ri1N OF~EC17pN 1t \ n I \ "UU~`riJP%~ 9 I \ ~'~~ ~ • I \ ~°•?'~l ~ ~ G11OPCSlIG7~3 C~£4LQ4t~ I \ w~ I 90- ----- I \\ ~9 ~ ~ I \ I 1 I \ I \ I i T-~WS7RUMENTDRAFTEpBYMICHAELERICKSON SINCOgNER ~ _~--------1?L9C JOB N0.016 GATE 2.16-04 ~] sECT10N 11 / -• _ - \1 / /~ SHEEf10F2SHEETS / U l~uv - - COUNTY PLAT OF: LOCATED IN PART OF THE N SlJNSETEHI NDS OF SECTION 17 , T29N, R7 9W, TOWN OF HUDSON, ST. CROIX ! ALSO INCLUDING PART OF LOT 5 OF JOSHUA HILLS RECORDI COUNTY REGISTER OF DEEDS OFFICE. TEMPORARY CUL-DE-SAC DETAIL N7/1 G>ANER BECIgN 11 i' \ , / / \ ` f \ '` ~. i 1 LOT 7 qi~I °' ' LOTB`~ ~ ' ~,~ '~' ,~, I I ~ i 1~,~ ~ I ., ~~ ~ p' -~ ., -~-._ - - - - n •. -__ . 0 ~~Oi ..t LOT 6 ~ ~: 1 znACRES ~ ~ ~' M T16Q F ' , f. i 1 I