HomeMy WebLinkAbout020-1014-30-175,Wisconsin department of Commerce ~ PRIVATE SEWAGE SYSTEM
Safety and Building Division '
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
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
Beer, Dan Hudson Townshi
CST BM Elev: Insp. BM Elev: BM Description:
~. fa A-l~--. ~ ~5
SANK INFORMATION
TYPE MANUFACTURER CAPACITY
Septic
f.~1; -se.~.~ y ~
1 ZCX~
Dosing ~`
WV~
D
~:~ /
Holding
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD
Septic , ~~ ~~ ~ ~ ~ ~ ~ / ~_
Dosing ~OK
V ,~ ~ ~ ~ / / ~ ~
Aeration
Holding
PUMP/SIPHON INFORMATION /'-eY
Manufacturer errand
GPM
Model Number
zZ -e
TDH Lift Friction Loss Syst m (-lead TDH
fit
•~ ~ ~ ,
r
Forcemain Length o Dia.
j/ Dist. to well ~
~P~ Z ~
SOIL ABSORPTION SYSTEM
DISTRIBUTION SYSTEM
Header/Manifold i/
/ Distribution
Pipe(s) ~ ~
` x Hole Size x Hole Spacing
~ Vent to Air Intake ~
~Pi~~ ~ ~
Length ~® Dia / Length
Dia Spacing ~
SOIL COVER x Pressure Svstems Onlv xx Mound Or At-Grade Svstems Onlv ~v~.~S
Depth Over / Depth Over xx Depth of xx Seeded/Sodded xx Mulched
Bed/Trench Center ~ ~
! Bed/Trench Edges Topsoil
~
~ Yes ~ No L ,,
`° Yes ~ No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: //~/,
Location: 846 Moon Beam West Hudson, WI 54016 (SW 1/4 NE 1/4 12 T29N R19W) NA Lot `~ '
_ ~~ 11v.. Gay e~ ~ ~L./
1.) Alt BM Description - C~~I~ ~' ~,e~ O
2.) Bldg sewer length = !,~ ! ~ ,+ ~~~
- amount of cover = 1(~
f
'.aired? ~ ;Yes No ' ~ ' f ~a~i r
~r additional information. i ~Q _ ~_ __ _ _
,) Date Insepctor's S ture
ELEVATION DATA
County:
St. Croix
Sanitary Permit No:
4632 0
State Plan ID No:
Parcel Tax No:
,~d~~rW•~~~
Section/Town/Range/Map No:
12.29.19. f<J~
STATION HI FS ELEV.
Benchmark
7, 5
~o~. to
a ~ . /a
Alt. BM- , ~,r 5
(D ~,
Bldg. Sewer
SUHtlnlet ~ /~f ~D ~`~~
St/Ht Outlet
c:
9~s
~
3.~5
Dt Inlet _
Dt Bottom
~~},5
~~},~
,Z.
o . rS
Header/Man. ~y p.~ c
Dist. Pipe ` ~V ~ ~ I
Bot. System /~' --- ~^- r
~O
Final Grade ,rte
J ~Q'
G~
/ J
St Cover ~$ `
~j
Z 3 iaa ~~
Inspection #2: / /.
Parcel No: 12.29.19.
L
I v
Cert. No.
Safety and Buildings Division County
P.O. Box 7162
201 W. Washington Ave. CTO1X
$t
~ ~ , .
,~~~~~~~ Madison, WI 53707 - 7162 to be Shed in by Co.)
Sanitary
umber
(608) 266-3151 ~~ 3
~
Department of Commerce
Sanitary Permit Appl' Na Plan LD. Number
~~~'~'"`
Tn accord with Comm 83.21, Wis. Adm. Code, orrna
pets°°al t'"= ~., ..
~
~ Project Address (if differetrt than mailing address)
may be u dary purposes Privacy La , s 15.0
th
.: s,..
L Application Information t /!~I formation 1058 Moon Beam road
U' ;~ 7 ,
Property Owner's Name Parcel # Pending Lot # Block #
~ ,~_r.
Croix Homes Inc. B ~L '~_ ,~.i~ .,_ ~,~ ; r;, -: rom040-101430-OM~ 4 Na
~ T
Owner's Mailing Address - ... __ _.~ Property Location
707 Grandview Drive sw li., NE 'iti section 12
City, State Zip Code Phone Number
T 29 N; R 19 W
Hudson, WI 54016 (715 381-9896
II. Type of Building (check all that apply) mss- S w.,i
^ 1 or 2 Family Dwelling -Number of Bedrooms 4 ~1 ~ ~ ~ ~ 6 ~Z CSM Number
^ Public/Commercial -Describe Use CSM Vol. 18, P .4772
^ State Owned -Describe [Ise ^City ^Village ^Township of Hudson
lIL Type of Permit: (Check only one boa on line A. Complete line B if applicable)
`~' New System ^ Replacement System ^ TreatmentlHolding Tank Replacement Only ^ Other Modification to Existing System
B • ^ Permit Renewal ^ Pemtit Revision ^ Change of ^ Permit Transfer to New
List Previous Permit Number and Date Issued
Before Expiration Plumber Owner
IV. of POVVTS stem: Check all that a
Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^
Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment. Unit ^ Recirculating Sand Fitter ^
Recinulating Synthetic Media Filter aching Chamber ^ Line ^ Gravel-less Pipe ^ Other (explain)
V. l)hs ersaUTreatment Area Information: 6 ~ck 4" Infiltrator Chambers at 19.1 . ft. EISA/chamber = 878.60 . ft. EISA
Design Flow (gpd) Design Soil Application Rate(gpdst) Area Required (sf) Dispersal Area Proposed (sf) System Elevation
600 gpd 0.7 gpd sq. ft. 857.15 sq ft 92.50'
O.
VL Tank Info Capacity in Total Number Manufacturer ab Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New Existing
Tanks Tanks
Septic or Holding Tank 1,200 _ 1,200 1 Wieser Concrete Combo. X
Aerobic Treatment Unit
Doautg cbatnber 800 800 1 Wieser Concrete Combo. X
VIL ReSpOnsibility Statement- I, the mdersigned, responsibility for Installation of the POWTS shown on the attached plans.
Plumber's Name (Prtttt) Plumber' Si MPIMPRS Number Business Phone Number
Jce Stang MP #223475 (715) 684-5166
Plumber's Address (Street, City, State, Code)
P.O. Box 263, Woodville, WI 54028
VIIL Coun /De artment Use Onl
y
tKI Approved sa Sanitary Pernut Fee (includes Date Issued Signature o Stamps)
((( """ Groundw ure a Fee)
er Given Reason 'al z -' BV . Z 3
IX. Conditions pprov 1
SYSTEM OWNER:
1 Septic tank, effluent filter and
dispersal cell must all be serviced /maintained
as per management plan provided by plumber.
2. All setback requirements must be maintained
as per applicable code/ordinances.
Attach rnmplete plans (to the County only) for the system on paper not leas than 81/L z 11 inches in siu
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REG~iVE~
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Wisconsin Departmentof C me ~~'~ ~ S~iL EVALUATION REPORT Page of
O±vision of Safety and Buildin s _ _ ,,,.,, ,,,~ rrx !t~l
c~r~r+~ wnn ~.Nrnm aa, vols. r~arn. i,aae Can n C
Plan must
Attach com
lan o ess than 8 1/2 x 11 inches in size
lete site
.
p
p
indude, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information. Re ewed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 75.04 (1) {m)). ~ , Z.~
Property r Praperty location
~ i/ /~ Govt. L.ot ~ 1/4 X1/4 S ~ T N R / E (or W
Property Owner's Mai ing Addre Lot,# Block # Sutxt. Name
City State Zip Code Phone Number City ^ villag own Nearest Road
S ~/~ ( /J i 3,fi'~- BOG
New Construction Use• esidential / Number of bedrooms Code derived design flow rate ~
^ Replacement ^ Public or mmerdal -Describe: __,_______ __~
Parent material ~' - ~ ood Plain elevation if applicable n/
General corrunents ~ r--~
and recommendations: Sy.S~~- e ~'QiV r,..... ~ ,~ -~ ~~
s~ ,~~ d
_ ______.__
---
/ /JL
~ / GPD
___
ft.
p Boring ~
~ ~ /
Bon # ~ pit Ground surface ele ~~ ~ • ft. Depth to limiting factor ~'~b in. ,,dam - I
Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ff
in. Munsell Qu. Sz. Cont. Cdor Gr. Sz. Sh. 'Eff#1 'Eff#2
3 ~ ~ S ~ ~ J ~/~ l - ~ z,
~,-t qx .~
~~ # Boring f.~~
Pit Ground surface elev. ~' ft. Depth to limiting factor ~ in.
Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDr`fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
_5"Z~ S ~_' G ~~ ~ ~ 02 ' -3
~1' ~• o
' Effluent #1 = BOD > 30 < 220 mglL and TSS >30 < 1 'Effluent #2 = BOD < 30 mg/L and TSS < 30 mglL
CST NarrfQ (Please Print) lure CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted Telephone Number
1008 192nd Ave, New Richmond, Wl 54017 /~ /S~~ "~ 715-246-4516
. • ~:
1'
Property Owner
Parcel ID #
Page of
~~ # Q Boring /.
rC~J Pit Ground surface elev. ~ ~~ K" ft. Depth to IimiGng factor /~ in.
Soil ication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DlfI?
in. Munsetl Qu. Sz. Cont. Color Gr. Sz. Sh. `EfI#1 `Eff#2
~q
[0 1. 2_ 9 ~. 2_
n Boring # ~ Boring
.~
-Z
. ~-
l_J U Pit vrouna surface elev. n. unpin w unuuny iau~i n~.
Soil lication Rate
Horizon Depth Dominant Cdor Redox Descxpton Texture Structure Consistence Boundary Roots GP D/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Etf#1 `Eff#2
^ Boring # ^ Boring
^ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil ication Rate
Horizon Depth Dominant Cdor Redox Desaiption. Texture Structure Consistence Boundary Roots GP D/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2
`Effluent #1 = BODE > 30 < 220 mglL and TSS >30 < 150 mglL `Effluent #2 =GODS < 30 mglL 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.
seo-s~3o ~e.rrao>
~,
Project Name Dan Beer
Address 1119 Cty Rd A
• Hudson Wi 54016
Lot 4 Subdivision ------- Date
~ #226900
12/15/03
S W 1 /4 N E 1 !4S 12 T 29 N/R1 g W T h• Hudson
Boring 0 Welt PL Property Line
BM or VRP Assume Elevation 100 ft.
owns ip
County ST. CRO{X
Top of Stee{ Fence Post
System Elevation 93.0/92.5 *HRpSame as Benchmark
Alt. BM Top of Survey Iron ~a 97.1'
a~
..,
a
Q
0
N
~O
M
Soil Test Plot Plan
Shaun
Dose Tank Information Locking cover with warning
label and locking device and
sealed watertight
Electrical as per NEC 300 and ---
Comm 16.28 WAC ~ 4 in. min.
Disconnect
----~_
Tank component is properly vented '~1 f--- Aftemate outlet
location
Wieser WLP1200~80
Ga acit 800.64
Volume 22.24
Manufacturer
Gallons
gal/inch
A
B
C
D
Forcemain diameter
~ 2 in.
Dimension Inches Gallons
A 18.25 405.87
B 2.00 44.48
C 5.50 122.33
D 10.25 227.96
Total 36.00 800.64
tank.
Alarm Manuafacturer LevelArm
Alarm Model Number DLV ~-
Pump Manufacturer Goulds
Pump Model Number EP04
Pump Must Deliver 22.62 gpm at 9.19 ft TDH
Weep hole or anti-
siphon device
P~ ump off elevation ft)
88.85
D~ k elevation ft
88.00
Project: Croix Custom Homes Page 4 of 9
Submersible
Effluent Pump
~~
3871 EP04
EP05
APPLICATIONS
Specifically designed for the
following uses:
• Effluent systems
• Homes
• Farms
• Heavy duty sump
• Water transfer
• Dewatering
SPECIFICATIONS
• Solids handling capability:
1/•"maximum.
• Capacities: up to 60 GPM.
• Total heads: up to 31 feet.
• Discharge size:l'h" NPT.
• Mechanical seal: carbon-
rotary/ceramic-stationary,
BUNA-N elastomers.
• Temperature:
104°F (40°C) continuous
140°F (60°C) intermittent.
• Fasteners: 300 series
stainless steel.
• Capable of running
dry without damage to
components.
Motor:
•EP04 Single phase: 0.4 HP,
115 or 230 V, 60 Hz, 1550
RPM, built in overload with
automatic reset.
•EP05 Single phase: 0.5 HP,
115 V, 60 Hz, 1550 RPM,
built in overload with
automatic reset.
• Power cord: 10 foot
standard length,16/3
S1TOW with three prong
grounding plug. Optional 20
foot length, l 6/3 S1TW with
three prong grounding plug
(standard on EP05).
• Fully submerged in high
grade turbine oil for
lubrication and efficient
heat transfer.
Available for automatic and
manual operation. Auto-
matic models include
Mechanical Float Switch
assembled and preset at the
factory.
FEATURES
^EP04 Impeller. Thermoplas-
tic Semi-open design with
pump out vanes for mechanical
seal protection.
METERS FEE
10~-
a ~
W
x
v 6
z s
0
a 4
0
~ 3
2
1
0
^ EP05 Impeller. Thermoplas-
ticenclosed design for
improved performance.
^ Casing and Base: Rugged
thermoplastic design provides
superior strength and corrosion
resistance.
^ Motor Housing: Cast iron
for effident heat transfer,
strength, and durability.
^ Motor Cover: Thermoplastic
cover with integral handle and
float switch attachment points.
^ Power Cable: Severe duty
rated oil and water resistant.
^ Bearings: Upper and tower
heavy duty ball bearing
construction.
AGENCY LISTING
~' Canadian Standards Assodation
(CSA listed model numbers end
in "F" or "C".)
Goulds Pumps is 150 9001 Registered.
®2000 Goulds Pumps
Effective February, 2000
83871
0 2 4 6 8 10 12 m~/h
CAPACITY
Goulds Pumps
ITT Industries
u0 10 20 30 40 50 GPM
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Conventional Septic System Management Plan
Pursuant to Comm 83.54, Wis. Adm. Code
General
The conventional septic system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall be maintained
in accordance with component manual SBD-1056?-P (R.6/94). All local and/or state rules pertaining to system maintenance
and maintenance reporting shall be complied with.
Septic Tank
The operating condition of the septic tank and outlet filter shall be assessed at least once every two years by inspection. The
septic tank contents shall be removed when the sludge and scum in the tank exceed 1/3 the liquid volume of the tank. The
contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code, by an individual certified to
service septic tanks under s. 281.48, Stats. If the contents of the tank are not removed at the time of a biannual assessment,
maintenance personnel shall advise the owner of when service will be needed to maintain less than 1/3 scum and sludge
accumulation in the tank. 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 filter is equipped with an alarm, the filter shall be serviced if the alarm is activated. Septic tank
manholes 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 individual should ever enter the septic tank
as dangerous gases may be present that could cause death. Septic tank abandonment shall be in accordance with
Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. The addition of biological or
chemical additives to enhance septic tank performance is generally not required. If such products are used they shall be
approved for septic tank use by the Department of Commerce, Safety and Buildings Division.
Soil Absorption Cell
Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should
be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for
vegetative maintenance) over the system is not recommended. Soil compaction may hinder aeration of the infiltrative surface
within the system and will promote frost penetration during cold weather months. Cold weather installations (October-
February) dictate that the system be heavily mulched for frost protection.
Influent quality into the system may not exceed 220mg/L BODS, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not
exceed maximum design flow specified in the permit for the installation.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the
owner. Levels above 4 inches indicate an impending hydraulic failure requiring additional, more frequent monitoring.
Contingencv Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the
system in proper operating condition. Excessive ponding within the dispersal cell will be eliminated by removing
biologically clogged adsorption and dispersal media and replacing said components as deemed necessary or by installing a
new soil absorption cell to bring the system into proper operating condition.
Questions on the operation or maintenance of the system should be directed to installing plumber, Joe Stang at
(715) 684-5166, or the St. Croix County Zoning Department.
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FOR1~1
9tiv~tTerBuyer ~/ 0 ~,l' ~.cc_.S~i~'~'1 „/_~/~e S
Mailing Address 707/o+-+c~/l<~ ~/'i'ye~ ~u~c/Sar~~~j, S-~l~/~
Property Address /~Sg
(Verification required from Planning Department for new construction.)
City/State
LEGAL DESCRIPTION
Parcel Identification Number / ~ncJi~ ~~a»-+ O.Z~- /O/~ ~3~'~~
Property Location 5 ~ '/< , rJ CJ '/4 ,Sec. /.2. , T ~N R~_W, Town of !~`~SO'~
Subdivision
Lot # 5~
Certified Survey Map # ~Tbsf ~o~ ,Volume ~a ,Page # ~ 7 7•z
Warranty Deed # `~~~ /`3S ,Volume 7.z~3 ,Page # SGG
Spec house f~s 0 no Lot lines identifiable~s (] no
SYSTEM MAINTENANCE
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 County Zoning Department a certification form, signed by the owner and
by a master plrimber, 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 pumping (if necessary), the septic tank is less than I /3 full of
sludge.
Uwe, 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 oI~ Wisconsin.
Certification stating that your septic system has been maintained must be completed and returned to the St. Croix Comity Zoning
Department within 30 days o the three year expiration date. ,,,,
~_ ~/~/~~
SIGNATURE OF APPLICANT DAT
OWNER CERTIFICATION
Uwe certify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the
property described above, by irtue of a warranty deed recorded in Register of Deeds Office. '~'~ ~~, ~c.~
SIGNATURE OF APPLICANT DATE
****** My information that is misrepresented 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 and a copy of the certified survey map if
reference is made in the warranty deed.
AMENDED
DOCUMENT NO. I $'CATE BAR OF WISCONSIN FORM 15-1981 ~i r'"• •'•« "~'~"`'~o ,o" "cco"on"o o.r•
- ,~ n6~ ~$ ~ ~ ASSIGNMENT OF LAND CONTRACT II
~t++ i
tivo~ i2~P~~F5~fi ;~
_
The: Assignment recoi~ec~ iii Vol:y7ffI;`Fags"43,-"Document-" ~ RFG~S7ERS O~RCE
Y398057 is amended as read: ,~
i ST. CROIX CO. WIS.
Assignor, whether onr. or more, fora :valuable consideration, ass
trns i~ r
and conveys to ...Uxa:.~"..Hst~hJ.e>c..cad..P~a.;,)r..E.,-.He.~chler,,..- -,..- . ~I R~~d for Record ffiis 15tH
. hushand..and..wi_`e..aa-.point..tenants .................................._....... I'
, day of oct A. D. 1985
,
................................................._...... ....---............................................. ,i
,.
~ 8:30 A AA.
i
...............................................................................................'. (..Assignee
whether one or more) the (Vendor's XdCl4XYc~](i?'oY"L~Cinterest in a Land Contract
dated the......~4.th .............day of............Mdy..........:.... 19:.85..., executed by ! Mb'Ar s,t oedr
Roger..E...Hetchler..and .Mary..L..llerchl.er.,..his..irife ...............
as Vendor to """"" TO
Daniel. R...Reer ................................................................................... .: ~~~*,,(~ pa,c~ cz..~ Nfs,,v~,y~„
-•-• .......................................................................................... as Purchaser *as modified by the Amendment
on lands in ............81:...GxQiX ..........................County, State of Wisconsin, recorded in the Office of the
together with (the indEbtednesa therein referred to and) all the interest of the Fegister of Deeds for 331d Cotmty
Assignor is the Land Contract and the lands described therein, which Land Con- in Vol. 702, Page 12, Document
tract r o •ded in the Office of a Register of Deeds of said County, on
~ay ~t~ ...................... 19........, as Document Number..3.1.06.69...., in Ii398359.
~~ 628 (Records) ~(3~
(Vol.) ................................ of (Mottg's on (Page) .._...552-*---....---•-.....
The Assignor covenants that there llv~owing and unpaid on said Land Contract, the sum of ...~ .................... .
...Thizty--~~,xE..IhQUSar11i..T~r4..kluA.d.Ced.--(as.. o.f._ No_yember...26:--1984) ......................................Dollars,
and also interest at ._..S~.X...(6~-~........ per cent per annum from August,-15•,---1984
that Assignor is the owner of the above described interest in the Land Contract and has^ood right to assign the same,
and that the condition of the title of Assignor's interest is the same as at the time of receding Lhe Land Contract.
' Y Except for Assignment hereby amended.
mid'
)6}~fa~EDfl(~C. X
`~tQ9@~f4
PARAGRAPHS APPLYING IF TBIS IS AN ASSIGNMENT OF VENDOR'S INTEREST: (Strike either 1. or 2)
1. This is a complete assignment of the Vendor's interests in the above described Land Contract. The Purchaser
under the Land Contract is instructed to make all further payments to Assignee upon receipt of a copy of Lhis docu-
ment,=Cl'~#C
This
Dated this
..._ ..........................................._.._.__..(SEAL)
_._...._ ................._............................(SEAL)
ACITHENTICATION
Signature(s) -:of both assignors
authenticated t is :. 7.•~?day of...-October 19.85..
~ John Heywood
TITLE: ME~~IBER STATE BAR OF WISCCNSIN
(If n.~t, .. .....................................................- ---
author~zed by § 708.06, Wis. Stets.)
T~fiS IN3TFUMENT :Y45 OR4FTEq 6Y
John D. Heywoodt HEYWOOD, CARI & HURRAY
........................
P.O. Sox 229, Hudson, Wi 5401b
(S;Knahlres may he authenticated or acknowledged. Bnth
are not necessary.)
is not
(is not) -
7€h
homestead property.
........... day o[
October
__. _._ .................. 1x..85...
• Roger E.. tc r ... ...................
~'. , ....................(SEAL)
~.
. t xy Hetchler
ACKNOW LEDOMENT
STATE OF WISCOi':SIN
ss.
....- •--• ............................County.
Personally came before me this ................day of
......................•--•---..........-., 19........ the above named
to me known to be the person ............ who executed the
foregoing instrument and acknowledge the same.
Notary Public ........................_ _...........County, Wis.
My Commission is permanent. ([f not, state e~tpiration
._ .0 1
~.
CERTIFIED SURVEY MAP
LOCATED IN PART OF THE SW1/4 OF THE NE1/4 AND IN PART OF THE SE1/4 OF THE NW1/4
OF SECTION 12, T29N, R19W, TOWN OF HUDSON, ST. CROIX COUNTY, WISCONSIN.
SURVEYOR: PREPARED FOR:
DOUGLAS J. ZAHLER DANIEL & KIMBERLY BEER
5 8 N LAND SURVEYING, INC. 1119 C.T.H. "A`
2920 ENLOE STREET HUDSON, WI 54016
HUDSON, WI 54018
765'9~w2
VOL 18 PAGE 4772
REGISTER OF DEEDS
S?. CROIX CU. NI
RECEIVED FOR ~2ECORD
e6ii6i20a4 08:00Al1
CERTIFIED SURVEY MAP
REC FEE: 15.00
COPY FEE: 4.00
PAGES: 3
DRAINAGE EASEMENT 'A' LINE TABLE DRAINAGE DRAINAGE
# DIRECTION DIST. # DIRECTION DIST. EASEMENT 'B" EASEMENT "C"
At 575°40'56"E 37.4T L13 N41°30'44"W 166.28' LINE TABLE LINE TABLE
A2 S56°25'22"E 79.98' L14 S19°O1'47"W 24.41' # DIRECTION DIST. # DIRECTION DIST
A3 N88°32'42'E 62.82' L15 S50°35'52"W 30.88' B1 N89°46'24"E 30.00' C7 N89°46'24"E 30.00'
A4 N05`22'S4"W 52.76' L16 S76°30'55"W 30.76' 82 N00°13'31"W 88.10' C2 SOO°13'31"E 102.62'
AS N89°48'3T'E 159.08' L17 N83°35'37"W 35.20' 83 NBB°02'25"E 44.62' C3 S24°59'25`E 56.17'
L6 S17°1T18"E 71.22' L18 N26°41'OS"W 117.4T B4 N08°00'O6"E 81.90' C4 S09°35'48"YI/ 64.25'
L7 ~ S19°01'47"W 44.83' L19 S88°32'42"W 68.32' 8"W 82.32'
B5
N
4°
5
6
'
3
3 C5 S52°Q4'26"W 53.81'
7
1 0 5
i7
n
pN
pa
va
~
]
0
~ CB N00°13'31wN 249.84'
L9 "E
500
°09'5 257.50' L21 S41°58'39"1N 56.48' 268.66'
+so0na3~
°
"
' ' "
°
' ' CR01X QQUNTV
wT
L10 N00
57
09
W
°
` 32.53 1.22 S56
02
W
20
`
°
' ~~Ir~
46.31
' .
In9 ~~ and Parka C°mmktse
BENCH MARK: TOP L11 W
N32
13'15 18.84' L23 W
N00
13
31 152.89
OF 1" IRON PIPE, L72 NOO°09'S7'W 222.82' JUN 1 5 2004
ELEVATION 945.9 U NPLATTED LANDS
' ---
-- ----------------------------- -
S89°46'37"W 438.3 ~yy~
'--It not rycor~ed w+thln 3W ha11 of LEGEND
aFpofevil d~f~ • ta! FOUND ALUMINUM COU
NTY
A r1, 31 85' A5 118.53' Holt a SECTION CORNER MONUMENT
' L""... r~+' ~ ~ ~A ~ VVV77 FOUND 1" OUTSIDE
~ O 1 i H W L = ~ A-~- H.W.L. = DRAINAGE ~ DIAMETER IRON PIPE
944.30 _
.~ ~ 946.50 P~j "'~ n EASEMENT
~ ". Q"~ , SET 1 `OUTSIDE DIAMETER BY
C71 ' ~~2 ~/ DRAINAGE~-v ~ A" O 18" LONG IRON PIPE, WEIGHING
N + Cn ~ P^"~ EASEMENT "A" \~ ~' \ ' ~'` 1.13 LBS. PER LINEAR FOOT
ROADWAY SETBACK LINE
,~'~ ~ LOT 1 `AT7 ~5\` "9~ Zb
I"'r ~ O ~ 2.485 ACRES A~6 P q S; t"'I (50' FROM RIGHT-0F•WAY)
Z ~, ~ (108,252 SO. FT.) ti ~~+~ ~ ~i ~ . FOUND 2" OUTSIDE
~~.yy °~ ~ LBO =948.90 ~i ~ ~ ~' ~ DIAMETER IRON PIPE
~ i V 8s ~ ~ LOT 2 ~ ~; "- _ EXISTING FENCE
H.W.L. _~ ~i
i 12' WIDE UTILITY EASEMENT
~ ~ ~ ~ ~ 6.9 ~ ~ ~ 2.434 ACRES , ~1 ~ ~-- PROPOSED DRIVEWAY
n ~ ~ (106,044 SO. FT.) ~~ r'"' ~ ~ m
~ IO / LBO a 946.30
~''"'~ 10 '`DRAINAGE al y p3; Z `f0~~ 4~~~ N
t""' ~'~ -°+ W ....EASEMENT "B N~ `D . ~ aJ ,y`, N `t GZ7
1 ;~ .Wi N89°48'24"E 1... , ~ (n ~~j,\ ~~~ ~ ~ a
L - 83:09' ~ ~ . , 02 oti G1 m - m
'VIOONBEAM~ ~--s1 4--~; ~~,s~;~~~.•.... I• ~~~ 5p~ ,,f~=' °'' ~
WEST ~ _' C~L._~ ~ MOC~/V8~"~~1 ~c2w,~•y~i > /~ i , ~ ~" Om z:
' y , T ``
" .. .} C'7 .............. ~~'~
I O J H.W.L = ~3~
}T
~
d 1 ~ 944.20 -~ ..~$,
~ t-r r ~~
DRAINAGE
,' __.___
' ~ ~
EASEMEN ~ ~
tr7 LOT 4
(""' ' ~ _
~-~
g
3.252 ACRES
Q G
gZ (141,855 SO. FT.)
, J
LBO a 946.20
' ~ BENCH MARK: TOP
"
' ~ OF 1
IR N PIPE,
'
' Y4
ELEVA
T
~P;~47.8
2596.1 T 77 ( 459.02' (N89°5T28'Mn
G0 ~ ~, ~:
~ ~~ ~ ~ ~ o`
/ ~O ~
'
~.
cf~
~ `
~ ~ O 0
''
~
~
0~ o,'.
Q
~ ~ j
',~ m N m 1
~= 1r'~1
1
\
~'
Q ~ LOT 3 L
1'
~
~ ~i ~
I '
~
2.419 ACRES
~ ~`~ ~
`
~
CD
s ~
, (105,370 SO. FT.) •Q
;
~
~ ~ N ~V '
c~ 616' cYi.w E1/4 CDR.
33' 33' ~ `4 ` SEC. t2
68 0' 312.16' 1890.68' '~
`
'"-7
W1/4 CDR. ILO ~ N89°46'37"E 37.1 EAST-WEST 1/a LINE
SEC. 1z ~----------PLAT_OF "~azswE --}, X04--~' MOONBEAM_RIDGg_
NOTE: ~;o ;z~ LCOT_13 '.
NO OWNER OR RESIDENT SHALL DO ANYTHING WHICH WOULD i ~ i W
INTERFERE WITH OR CHANGE THE OPERATION OF THE APPROVED ~ i~
TH 5 PLATETHIS ININCLUDES BUT S NOT L M~EO TO BU LI D NO UPON, ~ '~ ~ SCALE f N FEET 1" = 150'
OBSTRUCTING. ALTERING, FILLING OR EXCAVATING, OR PLANTING IN
ANY POND EASEMENTS. WATER DRAINAGE DITCHES. WATER 7 50 0 ~ 50
RUNWAYS, WATER CULVERTS, BERMS OR GRASS SEEDINGS. ,
THIS INSTRUMENT DRAFTED 8Y: WILLIAM KANE
JOB NO. 6134-02 DATE: 01/06/04 REVISED: 06/11/04 SHEET 1 OF 3 SHEETS
Vol 18 Page 4772