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HomeMy WebLinkAbout020-1015-50-300 gi c ~ ; 3 ~ ~p ~ ~ 3 ^~ I ~ o a ~ w O m I N i N ~ fD ~ N (D c O y < ~ (D p~j f ~D fn '. I N°o ~ ~ o I _ I ~ cn z D ~ ~ ,tea, m ~o D ~' a I c o. W ~ o ~ I 3 O c 0 I ` ~ I ~ D ° ° ai o o w w ~v~~. ~ c ~ ~ to 41 y ~ Q v v v ~ ¢ (D d ~ ~ .- y I N I ~ ~ 3 n, ~ A a ~ rn Z •• O C W Z =i 7 p O I ~^' ~ o v v ~ m ~ c m N N ~ ~ C N c ~ ~ a w m ..% I a 3 ~ ~ o ' I ~ ^, D o C I ~ a I I ~ ~ I a :» I .~, z I I g A a a ~ o ' - c m o a I I I I ~ y I I O 7 °o ~ 3 m o 3 ~ 3 ff A 'O N ~ A _ -• o a IV Q NO ~ ~ ~ O cc ~ o~~ ~ ° ~~o y o c 3 " ~ .. o w y ~i A f0 A A ? ~ ~ ~ ,O. A ~Z ~ m ~ N z ~ ~ m ~ A d m FBI ~3 O a T • 0 ~~` ~• `i ~ fi y `v~ A `~ ti ti N O O A ti ~0 V f0 ~ ~°,, b 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)I. Permit Holder's Name: City Village X Township Powers, Steven & Kimberl Hudson Townshi CST BM Elev: Insp. BM Elev: BM Description: ~ L' u. ~~Z '~ 5 'T J v u TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic L `.,~,z ~ ~ s /~ il~ Dosing r-. ^,,! ~ ~ U ~ Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~- ~.~ ` ~ ~ /~ 1 Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand M Model Numbe TDH Lift rictio s System Head TDH Ft Force m Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM county: St. Croix Sanitary Permit No: 430208 0 State Plan ID No: Parcel Tax No: 020-1015-50-300 Section/Town/Range/Map No: 12.29.19.69030 ELEVATION DATA STATION BS HI FS ELEV. Benchmark Alt. BM ~ ~ . ~~ 3-l.~ g7-3~ Bldg. Sewer ~ ~ , SUHt Inlet S. ~ ?1.z3 SbHt Outlet 9 ~~ 9L~~ gh Dt Inlet Dt Bottom ~ Header/Man. ja .~`1 q, /G'. ~ ~ Dist. Pipe ~ ^t ~+ '~ f d • " l! • `~ ~- Bot.System445-} ~ tt~z~ ~"j,~,9 Final Grade St Cover BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ ` ( Z ~ _ ~.. SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufa rer: INFORMATION CHAMBER OR ~c%t~ ~~~ ~ ~'• S Type Of System: • ~~ ~ "L~ ~ r 3 L 0 7 ~ .`_"~. UNIT ~ Model Number: .~ a c a H u c r. J r . ! L+lr4 ~ DISTRIBUTION SYSTEM c~ u¢-.rt-/oh s . 2"= eh . ,K,>'~..t.t ,tit it Header/Manifold rt ~ Distribution x Hole Size x Hole Spacing Vent to Air Intake ~ ! ` Length ' ~ ~-1 Dia t Pipe(s) ._._.__,.__..._ Length Dia Spacing --____ ~-`"'~"` .'''_ // /`~ (L! SOIL COVER x Pressure Systems Onlv xx Mound Or At-Grade Systems Only Depth Over 2 'xC B d/T h C t ~ 3 Depth Over d/T B h Ed '~"" xx Depth of il xx Seeded/Sodded xx Mulched renc en er , e renc e ges ,~.__._ Topso i J yes [;-1 No J Yes [~ No c~ u f 4 COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: f f / ~ / ci3 Inspection #2: / / ~`-tw f Location: 1012 Arctic Trail Hudson, WI 54016 (NE 1/4 SE 1/4 12 T29N R19W) NA Lot 3 Parcel No: 12.29.19.69030 t 1.) Alt BM Description = $~ e ~v~ haw ~ t~ S~ S'1}Q ti`.. 2.) Bldg sewer length = .Y- ~ ~~~ - amount of cover = (•'. S - ~ ~ .5> Use otheris de foruadditional informs • ~, ! No ; -`' ~ _ IU~I' - ~~ -_- --- -J 'I - t /r,~/ /~1-~~I SBD-6710 (R.3/97) Date Insepctor's Signature L !~e,CCert. No. O ~ 2 ~-~L.~'T1 G 'T2t°e-l L, Safety ~c Buildings Division 201 W hi W t A `~ Sanitary Permit Applica Dirt . ng on as ve. po Box 7302 SCOIfS~If In accord with Comm 83.21, Wis. Adm. Code Madison, WI 53707-7302 Department°of Commaroe Personal information you provide may be used for secondary purposes (Submit completed form to County if not [Privacy Law, s. 15.04(I)(nt)J state owned. Attach co late lens to the c unt co onl for the s rem on a r not less than 8-I/2 x I 1 inches in size. County 5-~- ~ State Sanitary 't Number -a...L]~Gheck if revision to previo pphc n Stale Plan I. D. Number ~ rv o 0 l+ A lication Information -Please Print all Informatl n '~' ~ Location: Property Owner Name Properly Location Property Owner's Mailing Address i Lot Number Block Number f .. City, State Zip Code Phone Nnrr~6er-.r._ ~,.~ SulsdiMiaie CSM Number `` '~ ~~ le~-~ A O 7/.~ ~cy/~'"~7 298 ~ V. / O II Type of Building: (check one) ~y ~ s .N.~ nuS, ^ City ~! 1 or 2 Family Dwelling - No. of Bedrooms: ~ ^ village '1` a Public/Commercial (describe use): / ovn, of ~ l] State-owned ' III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest Road //q/~ 22,,,.~ A) I. New System 2. ^ Replacement 3. ^ Replacement of 4. ^ Addition to Parcel Tax Number s) S rem Tank Onl Exislin S stem - ~ Q' B) Permit Number Dete Issued ^ A Sani Permit was reviousl issued IV. Type of POWT System: (Check all that apply) Non-pressurized In-ground ^ Mound ^ Sand Filter ^ Constructed Wetland ^ Pressurized In-ground ^ llolding'fank O Single Pass ^ Drip Line O At-grade ^ Aerobic'freatment Unit ^ Recirculating ^ Other: V Dla ersaUTreatment Area Information: ~- (~ 1. Design Flow (gpd) 2. DispenalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. ystem Elevation 7. Final Dade Required Proposed Rate (Gals./day/sq. It.) (Min./inch) Ele lion VI Tank Capacity in Total N of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crate structed Tanks Tanks .r _ __ _ ^ - - ^ ^ ^ ^ o ^ ^ o VII Responsibility Statement. 1 the ttndersi ned assume res onsibilit for installation of the POWTS shown on the attached lens. Plumber's Name nt) Plumber's Signs (no ttatnpsr ~ MP/MPRS No. Business Phone Number ~ e ~- J~ ~~~~~ -3~ ' Plumb e r s Address (Street, City, State, Zip Code) ~ j Lf ~ ~ ~ ~ ~/ VIII County/Depart ant Use Only .Approved O Disapproved ^ Owner Given initial Adverse Sanitary Permit Fee (Includes Groundwater Surehivge Fee) Date Issued Issuin Ageq~ Signature (No stamps) , ` ~ 2~ ~ '~~' ~ . DetErmination . Q~uti . 0~ Zaa3 IX. Conditions of Approval lReas ons [or llis approvalt ' ' n L ~~ O-~ tan ~ . • ~ .. _ --~ U ~' ~- .~ iron ~ ~ ~ ,) ~~~ 1 Ave ~~ c,~ nsc: ~ ~~~ y.U... ... _ ---.___.___._.---.......---- _...._ .L`~ ~''~ ~ .r, ~~o~o~ S s~~ 9~.c~ W i°~ ,~ ~ .. . , . ~ L~ ~ . ~ / /`~ ~'I v t I'/~ ~.~ «ikl _5 ~~ ~l ~ cvi nc[e rs - _ --~-~-L- - .------... _...___ ..._ _ -- - -~1 .~. _.... _.._..__ _.___. - ~.~.~.~ ~ _ .~:~..r~ ..._. _...._.. _.._. N._~l_ _ ~ _ .. _. _ : m. _. ~u u.m.~..e~ del.''. .. _.__._._.,..._._.---....-----._ ._. .._ . , . .t~~ i IoD ~' ~KoN ~~tv- 9a-~s W i~ i) _ _ A/,IIIAe~I ~A~~~,/A ,i'ce'. ~a~o gel S ~ w(p-o~ ~'~ i BeN ~~ 1'-Wa~t~: T ~ ~RbN loft S~'a Ke Pssun~~ =F-~v=1~~,0 Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page 1 of 3 ~, t0ivision of Safety and Buildings in accord with Comm 83.05, W is. Adm. Code A.C.E. Soil & Site Evaluations Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix percent slope, scale or dimelnsions, north arrow, and ,end distance to nearest road. Parcel I.D.# ' ' '~~ 020-1016-50-000 ID#12.29.19.~.(.SIG APPLICANT INFORMATION - PI 12 ` iil ir~fdrnl~tion. Reviewed By Date Personal information you provide may be us dory pu es (Privacy Li~, s. 15.04 (1) (m)). Property Owner ~ ~ ~ ~~ ElV ~ ~ Property Location Lot NE i/4 SE 1/4 S 12 T 29 N,R 19 W ovt ~ Richard & Sharon Helm en . Property Owners Mailing Address _ .... 1 ~ Ef 000 -- I"" Block # Subd. Name or CSM# Lot # P.O.Box 1112 sT rp©l~ 3 Pro osed CSM P - 8G21p~yrnber - ~ e City Stat Co~ ^ City ^ VillageTown Nearest Road ~ y,, Hudson WI b`"'f'1g7 ~ Hudson ~ Arctic Trail Off 100Th Ave. ~ I e ~ rooms 3 ^Addiiion to existing building ^ New Construction Use: ^ Replacement ^ Public describe Code Derived daily flow 450 gpd Recommended design loading rate 0 bed, gpdfftz .5 trench, gpolft2 Absorption area required bed, ft~ 900 trench, ftz Maximum design loading rate 0 bed, gpolft2 .5 trench, gpolft2 Recommended infiltration surface elevafion(s) 90.0. ft (as referred to site plan benchmark) Additional design /site considerations Install trenches using high capacity infiltrators. Parent material Glacial outwash Flood lain elevation, if a livable na ft S=Suitable for System Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U=Unsuitable for system ®S ^ U ~ S ^ u ~~.. ~~~ ~ S ^ U ~~•~~•w~• wrw ^ S ^ U A!'fT ^ S ~ U ^ S ® U Boring# 1 Ground elev 94.90 ft Depth to limiting factor >gg• 2 th De Dominant Color Mottles Structure d B Roots GPDIft~ Horizon p in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consisten oun ary Bed ;Trench 1 0-10 10yr3/2 None sl 2msbk mfr as 2f,1m - 0.5 2 10-21 10yr4/4 None sl 2msbk mfr cs lfm - 0.5 3 21-32 7.Syr4/4 None scl 2msbk mfi cw if - 0.4 4 32-43 7.Syr4/6 None is lcsbk mvfr cw if - 0.7 5 43-88 7.Syr4/6 None s Osg ml gw - - '~ 0.7 6 88-99 IOyrS/4 ' None s Osg ml - - - 0.7 Remarks: ------- ! _ , 1 0-7 10yr4/3 ~ None sl ~ 2msbk mfr as 2f,lm - 0.5 2 7-17 10yr4/4 None sl 2msbk mfr cs lfm - ~ 0.5 3 17-26 10yr5/6 None is Osg ml cw if - 0.7 4 26-52 10yr4/6 None s Osg ml cw - - 0.7 5 52-80 10yr6/4 None s Osg ml gw - - 0.7 6 80-105 10yr5/4 None s Osg ml - - - ~ 0.7 X02- °`~ Q. 0 Ground elev o~ ~ ~ e Depth to limiting factor >105" Remarks: CST Name (Please Print) Signat re: / Telephone No. James K. Thompson • 715-248-7767 Address A.C.E. Soil & Site Evaluations Date CST Number Ref # 340 Paulson Lake Lane, Osceola, 54020 7/20/00 3602 1268 ._ PROPERTY OWNER; Richard & Sharon Hjelmgrren ipARCEI_LD.# 020-1016-50-0OOID#12.29.19.72E 3 Ground elev 94.33 ft Depth to limiting factor >g7• 4 Ground elev 95.82 ft SOIL DESCRIPTION REPORT ,ZSe Page 2 of 3 A (:_R_ Snil & Site Evaluations Depth Dominant Color Mottles Structure i t B nda Roots ~~ Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. ence ns s ou ry Bed ~ Trench 1 0-15 10yr3/2 None sl 2msbk mfr as 2f,lm - 0.5 2 15-23 10yr4/3 None sl 2msbk mfr cs lfin - 0.5 3 23-38 7.Syr4/4 None scl 2msbk mfi cw if - ~ 0.4 4 38-50 7.Syr4/6 None is lcsbk mvfr cw if - ~ 0.7 5 50-83 10yr4/6 None s Osg ml gw - - ~ 0.7 6 83-97 10yr5/4 None s Osg ml - - - 0.7 Sri'•9(~ 4- Remarks: 1 0-7 10yr4/3 None sl 2msbk mfr as 2f,lm - ~ 0.5 2 7-17 10yr4/4 None sl 2msbk mfr cs lfin - 0.5 3 17-26 10yr5/6 None is Osg ml cw if - ~ 0.7 4 26-52 10yr4/6 None s Osg ml cw - - ~ 0.7 5 52-80 10yr6/4 None s Osg ml gw - - ~ 0.7 6 80-105 10yr5/4 None s Osg ml - - - 0.7 Depth to limiting factor > 105" 5 Ground etev 96.06 ft Depth to limiting factor > 106" Ground elev Remarks: 1 0-8 10yr3/2 None sl 2msbk mfr as 2f,lm - 0.5 2 8-16 10yr4/3 None sl 2msbk mfr cs lfm - 0.5 3 16-24 7.Syr4/4 None scl 2msbk mfi cw if - ~ 0.4 4 24-40 7.Syr4/6 None is lcsbk mvfi' cw if - ~ 0.7 5 40-78 10yr4/6 None s Osg ml gw - - ~ 0.7 6 78-106 10yr5/4 None s Osg ml - - - ~ 0.7 KemarKS: Depth to limiting factor /a~ 3 ~D~o~o~os~d eSr,? nEs ~ 5 . /?, T. 29x1., S-~ . e.,-t~;,t C,o., ~,.~ ~. p~. 3 of'3 ~Sca/t . ~ =~ S/o' ^ ,5o.l4bse~~l~on f?~t as ^ 2 % S~gPe~e~iP ~~~ ~~ B I ^A sic ~.~/qoe ~'~Q ~ ~ ~ e Q ~~c '~ -, eP ^ 62 ACE• d.A1. ~ Top c~':~o~ ziBSB' enchwlw~• Top off'%i Hof 3~//e. Ass u~.ce.d ¢IeU . ioD.GY~., 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 oZd Number of Bedrooms Design Flow -.Peak ( pd) Ott Estimated Flow -Average (gpd) Septic Tank Capacity ( al) V Soil Absorption .Component Size (ftZ) a Type of Wastewater Domestic Table 2: Soil Absorption Component -Limits of Reliable Operation Septic Tank Component Soii Absorption Com one t Desi n Flow -Peak ( pd) zP,o 2.12 Maximum Influent Particle Size (in) ~ $ 1/8 Maximum BODE (mg/L) a, tj 220 Maximum TSS (mg/L) I S U 150 Table 3: Maintenance Schedule Se tic Tank Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once eve 3 ears 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 sept' k and outlet filter shall be assessed at least once every 3 years by inspection. Th outlet filt shall be cleaned as necescary o ns~re proper operation. The filter cartridge shou 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. s 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 enterfng a confined space. The atmosphere within the septfc or other treatment of holding tank 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 wilt 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 S'1' CItUIX CUl1N'1'Y 5f+.1''I'IC 'TANK MAIN'TeNANC(? AGRI?!?MlsN~l' ANU OWNBItSltll' CERTI~ICA'i'ION I~ORM Mailing Address - 'aZ D ~ Property Address .~ (Verification required from Planning Ucparlment for new construction) $ (fY1. o_,. City/State ~/a~Sa ,J /,~~ Pnrcel Identification Number - Property Location y,, ~_ %,, Sec. ~_, '-'~N-R,~~W, 'i'own of Subdivision Certified Survey Mtrp # j° qs olumo ~ ` ,page # -`- Warranty Deed # .~,~91,1,~3 Volume _ o7~p ~' ,page # ~~/ Spy ~~ ~ y~ ~, °O Lot lines identifiable ~ yes O tto n .- ~'ep~ W° and maintenanceo[ your septic system could result in its premature failure to handle wastes. Proper maintenaooe ~ ~ °~ ~ ~ ~ every three years or sooner, i[ needed by a licewed pumper. wb.t you put into the fimetioa o[ the septic tank as • treatment stage in the waste disposal system. system ~tup ~iy owaet agrees to submit to St. Croix Zoning Departmeat a certiticatioo form, signed by the owner and by a j°w°°ym•npluupber~ rostrictedplumber or • licetued pumper verifying Wat (I) the on-site wutewater b In ptttper operating eoodition and/or (~)` S , ~ on and pumplog (if necessary), We septic tank is lea Wan sy~ ~~ ~tll~~sittdgo. The undersigned have tad the abov "~ .~~nd agree to mainlnin the private sewage disposal s~ ~~t-~in • ~- >taala, u set 1t)- Wa Da~ttment and the Department o[ Natural Resources, State of Wisooaaiti, Oecdtkstdoa stathtg ~t 3"~ ~ ayste,q ~ been ntainta~rred Dual be completed and returned to We St. Crota County Zoning Oplas withhs 30 days of the expinNon date. , R~ ;` ~~ ''.: ~~ ~i . ,,j~. O . SIONAT[JRS OP PLICANT ' ~.~ ~:. DATB ?,tiKa .. . WN~R CFR~rir>ar~+~~ . i ~~-'e) cetdty War all statemenb on. are true to We belt of my (our) knowledge, i (we) am (ate) the owner(s) of ,~i,~! We Pmpmty above b rue of a,rvfitcagty deed recorded in Register of Ueeds Oliice. '~.:. ~~ OP APPLICANT '. :~ ~ ~,.~ . ~f: "~ ~ ~.. '~' DATB ''•""• Aay information that is mis-represeit~Dd~uy~1esult in the sanitary permit being revoked by the Zoning Depatttavat. +••`+« •• ittclade Mth tots ippllcallon: a sta ' , 11~ff~''t~~t~~, ti :~• • ml~•~tr~gRy deed liom the Register of Deeds otiice a copy of the eerll0ed survey rnsp I[ reference is made in Ilre warranty deed Lot N 3 'J 2 3 0 7 P 3 0 1 ' 7 29433 DOCUMENT NUMBER WARRANTY DEED HATHLEEN H. IiALSH REGISTER OF DEEDS Richard C. Hielmgren and Susan M. Hielmgren, husband and wife, individually ST. CROIX C0.. wI and each in their own right, Grantors, - RECEIVED FOR RECORD conveys and warrants to Steven M. Powers and Kimberly K. Powers, husband 07/09/2003 01:45PM and wife as survivorshiu marital nrouerty MARRANTY DEED the following described real estate in St. Croix County; State of Wisconsin: E%EMPT ~ Lot of a Certified Survey Map dated August 18, 2000 and filed September 14, REC FEE: 11.00 TRANS FEE: 215. 70 2000, in the office of the Register of Deeds for St. Croix County, Wisconsin, in EE: P pj, a Fourteen (14) of Certified Survey Maps, at Page 3949, as Document No. ~C CC FEE _ 29895 being located in part of the Northeast one-quarter of the Sout east PAGES: 1 one-quarter (NE '/, of the SE '/,), and in part of the Southeast one-quarter of the Southeast one-quarter (SE '/, of the SE '/4), of Section Twelve (12), Township Twenty-Nine North (T29N), Range Nineteen West (R19W), in the Town of Hudson, St. Croix County, W1sCOI1Sm. THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS: Grantors reserve, for the benefit of Lot 4, a right of ingress and egress, over the Easterly 345 feet of the "Existing Drive" that is on Lot 3, as shown on said Certified Survey Map. GWIN LAW FIRM, S.C. 430 Second Street Hudson, WI, 54016-1510 This is not homestead property. (is) (is not) 020-1015-50-300 PARCEL I.D. NUMBER OR G.I.S. Exception to warranties: TOGETHER WITH AND SUBJECT TO any other easements, covenants, reservations or restrictions of record, if any, but this shall not be deemed to extend any such other recorded encumbrances beyond the term established by law therefor. Dated this 8th day of July , A.D., (Seal) (Seal) AUTHENTICATION Signature(s) Richard C. Hielmgren and Susan M. Hielmgren authenti ed is th day of Jules, 2003. - * Huh win TITLE M BER STATE BAR OF WISCONSIN (If not, authorized by §706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY: Attu. Hugh H. Groin, GWIN LAW FIRM. S.C. 430 Second Street. Hudson. WI. 54016 (Signatures may be authenticated or ACKNOWLEDGMENT STATE OF WISCONSIN COUNTY Personally came before me this day of , 20 ,the above- named (Seal) (Seal) to me known to be the persons who executed the foregoing instrument and acknowledge the same. Notary Public, County, WI. My commission is permanent (if not, state, expiration date: , 20 * Susan M. Hielmgren ~ ~, N ` I ~ FILED Z ~ ~ ~nu~lx.wfasH 3 ~~ ~ CERTIFIED SURVEY MAP E^CATED IN PART ^F THE NEl/4 ^F THE SEl/4 AND IN PART ^F THE SE1/4 OF THE SE1/4 ^F SECTION 12, T29N, R19W, TOWN DF HUDSDN, ST, CR^IX C^UNTY, WISC^NSIN, ^WNERS RICHARD do SUSAN HJELMGREN P.O. BOX 1112 HUDSON, WI 54016 0! ~I I OI I y~ ~~ o I W I OI ~ ' C~' ~; o~~~ nna~yy I I ~I I V I I ~, a 1 ! 1 OO I pQ I 1 I ~7 ! 1 I C5! I I ~I ~~ W I ~~ I I o I Qp I I I OI ~I~I ol~i~~ d~9;~ ~; ~ i ~ i Q ~ APPROVED ~; sr.cROlxcouNTy rnirg Zoning and Packs Con MATCH LII SEE SHEET ; 5T29" d ~ ~ ~ _ ~ N M ~ N LOT 4 w 6.114 ACRES o N 266,319 SO. FT. O m w Z g z ~~ ~~7~ ~° L51 I a ~I a ! o ! ! I t ~~ ~I ~I D ~! ~I L' JI ~I OI ~I I !°o l nnnnnnl ~i ~1 I U! OI ~I ~I ~i ~i Oi LwJ a• n l ! N89°38'11 "E 231.22' HOUSE & GARAGE HE ® EXI 71j`1G SEPTIC DRIVE 66' SEP 14 2000 ~ ~If not roco-ded within 30 days of ~7 approval date approval shalt be a, T~ullandvoM OO' ~ ~ • d, ~ ~~\ ~~o~~ ~~~ ~ \/ /n~__ / ``~v~ ~/ / ~~ ~ / `\ ~~~ ' z ~ ~° ,~ , 3/4' REBAR FOUND ~ ~ S86°52'O6'W, 7.85' ~, .- l FROM SET CORNER. m ~o a ---~- _. ^ n• 459. f 3' • ~~ 72' ~ 320.pq. ~ ' ~ S7g° ~ E ?98.7G p~ ~N~ • szs,48, • • LOT 2 ; `~i 3.643 ACRES 158,681 SO. FT. Should Lot 2 access from the existing access for Lot 3, the access would be required to . be upgraded to County road Standards. _ • .. LOT 1 3.643 ACRES 158,707 SO. FT. PROPOSED DRIVE ~~ h N W Z ; xo~ ~ N O N N I 0 tL 01 ~I OI 17A~ $`(V ?WQ: W-~W I o; W v m Who a~ `~ ~ ~~~ I N Z 0! ~ < m w v ` D' OI ~7I ~ G51 ~! w i ~! ~j! ~~ o D ~ nn~ nn ~I UI I OI ~I ~ OIO ~g~~~~~ ~ , di ° i I ~ ~! CI I ~I ~~ O! I I I , ~I n~pp LJI I I ~t I~! I I ~ Q a; al 1 ° 0 ;I I ~° i I I I a I ~°i{{G~~'~~i(~7I J! ~I Qp I nJ_~I ~I nLn5f11 al ~1 nnnl LL~1Ri//I OI ul ~I OI ~I ~I I ~; ~; o; a; oo; o o' ~' ' ~ i oaj Q. L.a'GQ I al s~ tea, d, 1 W k' 1' IRON PIPE FOUND 589°59'05"W 516.25' ' ~ < S16°28'OS'E, 10.39' ~ FROM SET CORNER. ~ 4 ~ LL,QO - - I-------- Z ~ 60~0~1o M aOdo_~ 9~, pC~a X39 9 ~ _ ------------ --------- ~~ .,~ "~~I1pOTF1_A_~ ~-~ .-~ zZ ~ -f`' ~ ~- SCALE IN FEET 1" = 200' _~-- Nm ~~ 200 0 200 400 ow: w~s~ O,y DOUGLAS J. ZAHLER ss14s HUDSON, 11Vt8. " l.J~ SHEET 1 OF 2 SHEETS Vo1.14 Page 3949 5URVEYUR'S CERTIFICATE 1, Douglas J. Zafiler, Registered Wisconsin Land Surveyor, hereby certify tl-at by the direction of Richard Hjelmgrert, I have surveyed, divided and mapped a part of the NE'/• of the SE'/~ and a part of the SE'/, of the SE '/< of Section 12, T29N, R19W, 't'own of Hudson, St. Croix County, Wisconsin; described as follows: Commencing at the E '/, corner of said Section 12; thence N89°57'29"W, along the east-west '/• line, 758.98 feet to the westerly line of a parcel of land recorded in Volume 656, Page 548 at the St. Croix County Register of Deeds Office; thence S00°00'00"E, along said westerly line, 1316.16 feet to the southerly line of last said parcel; thence N89°38' 1 t"E, along said southerly line, 231.22 feet to the west line of a town road; thence S00°00'11"W, along said west line, 1042.83 feet to the north line of Certified Survey Map recorded in Volume l 1, Page 3112 at above said office; thence S89°59'05"W, along said north Iine, 516.25 feet to the easterly line of a parcel of land recorded in Volume 756, Page 50 at above said office; thence N00°01'09"E, along said easterly line, 2357.87 feet to said east -west '/• line; thence S89°57'29"E, along said east -west'/, line, 284.30 feet to the point of beginning. Parcel contains 20.94 Acres (912, l49 Sq. Ft.). Above described parcel is subject to all easements, restrictions and covenants of record. I also certify that this Certified Survey Map is a corcect representation to scale of the exterior boundary surveyed and described; that I leave fully complied with the provisions of Chapter 236.34 of the Wisconsin Statutes and the Land Subdivision Ordinance of the County of St. Croix and the Town of Hudson in surveying and mapping same. Op WJSC ~~ Oy DOUGU45 J. S~ Douglas J. Zahler, RLS 2145 ZpHLER 5-2145 S & N Land Surveying HUDSON, 212 Walnut Street Wrs• Hudson, WI 540 i 6 8'~-d° Each Parcel shown nn this map is subject to State, County and Township laws, rules and regulations (i.e., wetlands, minimum lot size, access to parcel, etc. ). Before purchasing or developing any parcel contact the St. Croix County Zoning Of'Gce and the Town of Hudson for advice. ~,~ Vol. t 4 Page 3949 ~..~ /"~ n SCAM JW3 IC ~ °o 6 ern 3Q ~ ~ ~ O LL W=~~~ ~~~~~ERTIFIED SURVEY MAP ~W~ ~ ~ ~~~~1 PART DF THE NE1/4 DF THE SEl/4 AND IN '~~~' PART OF THE SE1/4 ^F THE SE1/4 ^F SECTI^N 12, T29N, R19W, TDWN DF HUDSON, ST, CR^IX C^UNTY, WISCONSIN. ^WNERS RICHARD Ec SUSAN HJELMGREN P.O. BOX 1112 HUDSON, WI 54016 LEGEND N wZ; FTOO~N U O~~ oLLOI '~°z 2 W W Z W J W ~~O t~'~ ~ ~ Z I f~/f ~F- Q LD W ~ N89°5T29"W 80.79' W 1/4 CORNER SECTION 12 ALUMINUM COUNTY SECTION CORNER MONUMENT FOUND ~ 1" IRON PIPE FOUND 0 1" X 24" IRON PIPE SET WEIGHING 1.13 LBS. PER LINEAR F00T • 50' ROADWAY SETBACK -+-r-~ EXISTING FENCELINE • SEPTIC SITE MGIp6G~ r~ii'CD dG1Gv1D~ ----------------------- DOMIn 11:1C~D aS? 04[n1C~G°3~ ---------------------- ~ EAST - WEST 1/4 LINE E7/4 CORNER Sao°s~~~o"F gad any _ Ne9°sr2s'w ~ n SECTION 12 758.98' v V a QI ~J~1 ~ nn G51 0l VI ~I 41Q°i~i~iV~(/ Vvl ~ ~ ll~I ~I I OI ~~ QI ~I ~1 0o I ~I ~ I p I ~~'SI 1 lllrrrr I ~j ~j ~~ (~j O~ I I C~I I I ~ l L1J C~ ~ ~1 L~J~ Oi nn IM I ~I VI I L~1 al a; 61 ' s ~, ~ LOT 3 °F w~S~ 7.540 ACRES 328,441 SO. FT, o ~ ~~ y~ y DOUGLAS J ~ . * 2;AHLES ~ 7' , • HUDSON, J 29 5 ~ ~ Q° I n^nl I QI I Oi n I ~I ~n l~l C°XfAiJJ I I vl o I It~I L"7j 6 ~ IY~ ~~ o lOl ~I~I ~ibiOOl I ° ~ pQ~ I o;oi~~ I ~ ~ ~I ~7 I I ~; I OI o I I ~I I QI D ~ a' SHEET 2 ^F 2 SHEETS MATCH LINE U ~'I8 SCALE IN FEET 1" = 200' 200 0 200 400 Vol. 7 4 Page 3949