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HomeMy WebLinkAbout020-1393-17-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division ti INSPECTION REPORT GENERAL INFORMATION (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 Zietlow, Ter Hudson Townshi ;ST BM Elev: Insp. BM Elev: BM Description: SANK INFORMATION ELE TION DATA TYPE MANUFACTURER CAPACITY Septic Dos' Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ ,~ S i Z 3 -- Dosing Aeration Holding PUMP/SIPHON INFORMATION M ufacturer - " Model Number TDH Lift Friction Loss Sys Forcemain Length Dia. Di: SOIL ABSORPTION SYSTEM BEDITRENCH Width ~ Leng,~ DIMENSIONS b0 ~, SETBACK SYSTEM TO INFORMATION Type Of System: DISTRIBUTION SYSTEM to 3 OR Header/Manifold Distributi9S x Hole Size x Hole Spacing Vent to Air Intake ri Length Dia_ Q Pipe(s) iC~ ~ ~ Length IoG~zs Dia ~ Spacing_~ 73S ~ SOIL COVER Y Drascura Svslams Anly YY Mnund Or At-Grade Systems OniV Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes ~ No ~ Yes ~ No COMMENTS: (include code discrepencies, persons present, etc.) Inspection #1: ~ 2 /~lfj~ Inspection #2: / / Location: 865 Charlie Ryan Road Hudson, WI~'54016~(SW 1/4 SE 1/412 T29N R119W) Moonbeam Ri '~/ Parcel No: 12.29.19.710 1.) Alt BM Description =~ 0 ~ ~dr,~e Si{ ~,~t~zk` ~ l ~ w~'I a ~ ''"'~~ / .~ - / // C,, 2.) Bldg sewer length = l3 / ,~ 5~ 5'/i~..~ C~f~a,{t~ ~OU/sied ~wt~ ~~(/ ~'~~`*~~ f mount of cover = 7 ~' ~CScr'~`« 50% ~S. / 3.) 4h se~U~`~. p ~~~s ;ks ~~t/~ia~ r;~. ~'~ ~/~,~ ~dcc~; ~,.,. ~,,.a,,.~c~ > S~ C 0 Pla~ evislo egwred? ~ ~ Ye ~ N~ Use other side for additional information. ~ ~ i G Date Insepctor's Si tune Cert. No. SBD-6710 (R.3/97) county: St. Croix Sanitary Permit No: 399514 State Plan ID No: Parcel Tax No: 0 to - a9- t9 ~ ~3Sv STATION BS HI FS ELEV. Benchmark Z /o/ ~ ~G Alt. BM ~~ Bldg. Sewer Z St/ t Inlet ~i• O ~~S S Ht Outlet v 9S, 3 Dt Inlet Dt Bottom Header/Man. ,SS 93-0 Dist. Pipe ~ ~i ~ •~°97 .~ y92-brT 2. Bot. System L ~ ~ - ~ 0 /i,3o o~ 9/. !Z ,3Z~J(7 Final Grade ~ ~, io ~ ~ y $"Z .3 St Cover ~ 3.~Z t ~? sd PIT Ia roerd r `.,~~..~...... 3a~ary u+,d ~+ulc;~r,~s~'.s;c~ '.._T~ .~ % ~~o ~` ~ :A ~ . Wtihiastoa Avu. , Y.C~ 8qx 7162 '~ ~! ` i~Kadisea~ WT !3'f(YT - ?.6'1 ~+ ' l~Al~ N~3raba Perna~t App~cstio~ ~~qs'/ ~ wlt. ter. Cede, ~ y~ P3QVid~ ~ ~ t~oic rt' ~v~iots v ,~I(S teal ~ D. M ~ ~r ~z.Z~.19._7~ eb+ v~+ e>F~ %2rr~q. ~~efi r~ i ~- ~~:'l~~ ~,~ s~i w~~-~~~ .II, "tyke Ot ~ ~W?b'~ ~' a ~ tl~- n l e>r Z PYeiiy • ltlwMt d tiu ..,,,., ~.sc~'~`~"""""' ....~._.~... I Q 4yb1~OtOtAleeM1 • De1~We VM ~,~ ~Sl~ Q diLp tywtl~ltk i II~Itk ~. Tj~ ~~'~t~ ~Cb~t o~l~r au bay on iw w c~u i liew i Q ~ 3 L3 p~iso 8. C1 Clete u ' ~ ' stw~ ~~~ ~I,~Nntt -~aew~+rd utrWaavted t:C3 wed ~s ~ Ai1~IMd qq~ bt "~ ~ou~'rsric ~~~ i~^~C? f i ~~~~ r s ~i Hmesbor ~ GWooe ~'t'~aict wr ' - ~ ~Gy l G .~ _ . of ~ 6 G Additdon ~ 3- r ~~~~.i~~ 17 !~ land Flitatr !9 0 Casstrosstl wetlsad ~ 7 ss~~. tau st Q a~ ~. ~ ~ to ~ a ' /o N% 1- ~ ~~a ~- ~ Y.s° eltHon tys~m v>r i FuGr~ eded (tflis.tSli4yd .Fq• - ~~ ~levatf~n Q~r ~ ~ ~ ~7~ 7l ,~tietucs: ~, o,"r"~ C;oeentt Co~+xad ~ 3gsa<s es e y - w ~- bP, ~~D'~ G~iJ ~~~~ ! G~ ~r~F7 ~'t ~ q t+Ml C / C owea ports b~ 1~eN • ~,~ s° °~l o p ~ 7~s -~i~~ i'~ o w ~ S~ !~ .r ~ 5 6 ~l ~ o ,n ~ h. _~'~'1//////~1~ y C /' ~ rTC ~ .w~h c~S~J ~ ~rcnr S ~~ r wbsar~ ~~~-v' ; ,C~c e.•y Job 17 Y~d~.,ci ~au-.n ~,`o.~ P ~~ ~% ~~ ~u~ .r/ ®~ ~,~~~l~~~J - ~' f ~_ ~~ ~~~Ta,~eFsfcel p~/~~' ° ~ ~ ~kl 2 ,~~'(f` vet` Sub /~dQ-~" ~3 cti, i<i Z~ lo% -c ~~44 ~~ qs.L 9t, e a . 'c,~a~, ~• Yv 6crs, ~~ T~Q~ -~ B% ~ ,~'S~o ~G; ~ S7 C ~-~V ~0~~ 7 rnl'~ -(J ~<<-sn ~~ Gt~~J ~~CeG~ /©l~J ./~ 6 !" ft~~i-e~~~.-rJ ,t5 h/~` ~t~~~~ ~ ~'~/vCP 49G~~ _~ Sub /5~aa-~d. ~_ _ -----_ O rv ~ l ~ ~ c~~ ~ x ~o~. 2~~ ~~ X o0 J v _;~ ./ ~ ,r~ 1` p~~'.v, '` i 7-~ .. °ya ~ BB /~ ~lSs ~~ r `" ~- ~ ~ ~2 ~ ~' - ~_ ~ s 1 ~ T~. w o z~ 2 . ~., L s { a ~" ,, ~ ~, ly 9 , , ~ v cj Z. y ~ 'r f/ ` ° /a~ ~ `~'~• +~_ i ~ ~/ ~. ` ~ is fso ' ~' ~Y i Private ®nsite 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- ~~~ea ~. c..~*~.,, nnsinn Sneciflcations . w...~... ..,........ ___. Sanitary Permit Number ,,.. _.- - - ---- Number of Bedrooms Design Flow -Peak (gpd) Estimated Flow - Avers a {gpd) Septic Tank Ca aei (gal) G Soil Abso tion Component Size (ftz) T pe of Wastewater Domestic ~..r.e.. ~. c,,:s ea~....,a:.,~ t~.,.,,n~nant .Limps of Reliable Operation ~ ovsv i.. vvn rvv... p...... . ~~...r.....~.._ ---- Septic Tank Com orient - Soil Absorption Cam anent Design Flow -Peak ( d) Maximum Influent Particle Size (in) 3 1!8 Maximum BODE {m L) Maximum TSS { fL) 220 150 T~hl® ~• M~in4ananc~ ~clledule Se tic Tank ~~ . inspect and/or service once eve 3 years Outlet Filter Ins ect once a year and clean at feast once every 3 years Soil Absorption Component Inspect once eve 3 years Se tic Tan The septic tank shall be maintained by an indevidual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shalt 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 Pcrtabie Restrooms). The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet fitter 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 Sai~ Aasorption Component r ~itsr Is equipped with an alarm, the filter shoal b+a serviced If the alarm +s activated ~ntinuousiy. intermittent filteer alarms may indlc~te surge haws or en Impending cont3rtuous 8larm. The septic tank shall have its contents romovsd when the volume of scam end aiudgs to the tank ext~eds 113 the liqukt volume of the tank. 9f the contents of the tank ero net removed at the tarns of en sstsess~ctt, maintenance peroo+nnei >s#-all advise the owner of when the next service needs to be performed to maintain less than maximum scum and stodge accumulation in the tank. Manhole risers, etx~ss risers and covers should be inspected far water tightness and soundness. Access openings used for service and muressment shall be gated watertight upon the completion of service. Any opening deemed unsound, defective, or sub)ect to faiiuro must be replaced.., Exposed. access openings greeter than ~-inches in di$meter snail be s8curgd by an effective icn;icing device to prevent acddentai or unauthorized entry into the tank. No one should •nMr a septic or other fnainwnt or holdMg tank for array rwsvn rvi#hawt belt~r !n t-ull corrrQllarncs with GiSNA starnatarndar for •tttsrtr~ a s;or~llrHd apsax. Tin ~tmoephrn erlthln the aRarptlc or other trwtrrwnt of hcrdaling< tank may oonbrln /tthN ~asos, and roaa:ua of ar person frrom ~h+t Inhrlor of the btnJr may ba dlaMlat+lt of lmpoaalbhr. Tank abandonment shelf bm to accordance with Comm 93.33. Viits. Adm. Cede when the tonic 18 na longer used as a PCWT8 componentC, The soil absorption cornpanent serving this structuro is designed to accept domestic wastewater from a residarnttai facility. The limits of operation of this component aro ahnwn in Table 2. The longevity of a 8011 absorption component depends greedy an proper and timely maintortertc~, and system use within or below the iimi~ of rolieble aperetion, Oood water cattservatian practices by >~l ac~ctapents artid the instailetian t~f water conserving plumbing fixtures ors key factors fn extending the useful life of this cornpanent. The soil absorption componentas operation must be assessed by insQereon at least once every three yeera. The Inspection shall include recx:rding the levels of pondirtg- if any, In the observetior± pipet, and a visusi inspection for any evidence at surface seepage or discharge from the compan~rnt. On steeply slopir~ sites, areas of erosion should be identified and reporter! to titan owner far repair. The surtacs discharge of domestic wastewater ar sewage from the aystam fa prohlbitud and canariderod ar human h+~alth t~aterd, Traffic around ar aver the soli absorption component should be avoided pacticulariy during winter months, The compaction or removal of snow cover aver the component may iesd to hydraulic failure by freezing. This type of fa<iiuro is usually temporary, but is difficult or lmpassibte to repair until weather conditions improve. In general, Boll compaction aver this ~rnponent wail reduce diffusion of oxygen into the soil and dispersal cell, i~vhich may Seed to more intense, and earlier, organic clogging of the soil. Management Plan for s Septic Tank and Soii Absorption Component plantings o4 deep-rested trees and shruDa directly over s~f within ten taMt of the cornponertt should be avoided since root intrusion into the component may obstrud wastewater flow. Contingency Plan In the event of system failure, a new system could be lnitalted in an alternate ~. With the installatkm of a diverter valve, the existing system could also be reused after a period of t! -roe to four ye~ra, it is the property owners responsibility to maintain the aitemate eras Erse from any planting of trees, shrubs, etc. in case aF failure of the original system, the aftemaw area wiif bs needed. if any trees, shrubs, etc. have been planted on the alternate area, they wiif have to be removed at property ovvnera e~xpenee, if aitemate ens is deatroyd, there are other altemstivs systems that a;, be used, in which, scold result in added expense to the property owner. Any tank abandonment shall bs done in accxardance with Wisc.. Cotle 83.33. Any questions regarding this Dods, please canted your local Zoning Offloe or contact the lnstsiiing plumber. ,~ . , Wisconsin Department of Commerce SOIL EVALUATION REPORT Page ~ of~ Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code p v County St, C IC 0 ~ 7~ Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. D , percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ` ~ h t h Please print all information. Re 'wed by Date T Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~ ~ ~ ~ O ~r arty Owner Property Location QQ ~r C C" ~ r Govt. Lot S W 1/451/4 S I p~ T a 7 N R 1 9 E property Owner's Mailing Aeddress Lot # Block # Subd. Name or CSM# , 5 CO R ~ 1 mOah ~~~h, ~. s+ r io-1 amity State Zip Code Phone Number ^ City ^ Village ~ Town Near Road ~ F o F ~ ~ d +~ tat :S'lo1 (7 ) a 9 Y• 3 ~ YS ~ .. F, (-~ v So Pro o sew RS .dE (~ New Construction Use: C~ Residential / Number of bedrooms ~_ Code derived design flow rate y5 b GPD ^ Replacement ^ Public or commercial -Describe: Parent material ~~~~ ~ O ~•'~`~w ~E. ~ t~ Flood Plain elevation if applicable ft. General comments -f-~ U ~ ..~.. r D / -~^ t. ~ Ce,C ~ ~. ~ and rencommendations: ~ Cty •1. s S ~ s o~ ~ 5 ~ / I ~ ~{~G ~ .5 rC~ /'•' T'r; rnGlr T. I (93,~~') R~ ~at..t~t~i~w~". ?i3 C91,~.1 ~~ y' T. ~ 9a '~ Tr ~ (9o.gl Boring # ~ Boring ® Pit Ground surface elev. _93• ~ ~ ft. Depth to limiting factor /D bb in. Soil lication Rate i H th D D mi t Color tion Redox Descri Texture Structure Consistence Boundary Roots GP D/ff or zon ep in. o nan Munsell p Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 -I I pYQ3/a L 6~ -~fr GS ~F . 5 .4~ a to-! 7sy2sJy ~-.- aFS,~k. M r Cw I- • 5 .`d .3 /b 3 7.S~2yl~ ~~~ ate, k MFr ~~ ~~F . 5 , 9 34-y7 ?.S`-k~ -' l.. r C~ -- . c 5 `17-59 S`I2'-fy -----------y- S ~ dfSg~t.. wti fr ~ --' ~ S . ~ ~, -loo 5`I Q~J/ -----' ~ S f~F~~k r~ v ~~ ._ ____ ~ S . 9 Boring # ~ Boring ~ Q Pit Ground surface elev.._! ~~ ~ ~ ft. Depth t, ~~miting factor ~ d in. Soil ication Rate i th D l D i t C tion Redox Descri Texture Structure Consistence Boundary Rants GP D/ft? Hor zon ep in. nan o or om Munsell p Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 p- l aYQ~ ~ L d~ to m r q 5 ~;f . 5 . 'g ~ ~3y 7. sti~R.~ -- ~`'"i aMSbk- m ~r w t~ • S • 3 ,~y-yy 7, 5 YR ~/ - aFS~~. ~ ~_.._ qy,~ ~ 1 3~; sr t ._ 'Effluent #1 = BOD > 30 < 220 my/L and TSS >30 < 15U mgn. - tmuern ff _ ~~ ~~ ~~ . r.. ••~~ CST Name (Please Print) Signature INGOFft ~~ ~~7 a7~o~ ~ f7 ~ „~ h ~+ Date a)uation conducted ~' Telephone Number ~-P '~; s o ~~~ ~ ~ 7 Property Owner ~~ V C I~ 0 V~ r I~~ Parcel ID # _~n~ ' r^ Page ~ of Boring # ^ Bonng Pit Ground surface elev. ~ •g ~ ft. Depth to limiting factor I b Q in. Soil lication Rate Horizon Depth Dominant Cdor Redox Description Texture Structure Consistence Boundary Roots GP DIff in. Munsell Du. Sz. Cont. Cdor Gr. Sz. Sh. `Eff#1 'Eff#2 I a -7 a'I iR3 S L ~ F b r2 rh Fe.• q d F . 5 7 • d 7 .S'f Qy ~'""'""' cw`y r1' h~i3~1L r C W F , S- . I 3 y~3 ~ , S `+ y1 "_""~-..'' S L ~ FSb tc. vH ~~ ~~ / ~ F ~ 5 4~ 3 /oo SY~ yl --- .F-~t a FS b k - - - 5 ~.GS ^ Boring # ^ Boring ^ Pit Ground surface elev. __ ft. Depth to limiting factor in. Soil lication Rate tlorizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIft` in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 6 ~.~rr ~s A T V ~~ 1 N I .l'~ /A ^ ^ Boring d ~ "~ • - - ~~ -,~ - Boring # Ground surface elev. _ ft th o IimiGng factor m. ^ Pit Soil lication Rate ri H D th Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fF zon o ep in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 `Effluent #1 =BODE > 30 _< 220 mglL and TSS >30 < 150 mg/L '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. SBD-5730 (R.6/00) ', . P.C'. Co I lava.. ~: I~ e r~s ~l~C ~Q~~ 3 0-~ ~ Sw/~I~ SE'f~~ Sec.1~~ T~9N~ R19~ ~CM ~} ~. 5'~`a:r~ r Sc ~t. r t: (~' ya c s t vn a~ t 7 y b a~$ ACrL~ .~ m~ P i ..~'' a -`" ~. ~~~ -~ ,- (~~'~ '~~ P 3 ~ +~' t] bask-~no~ ~~~''S ~ ~ , ~'~ o'~ ~ L. 7 o L ~, c `~ ~ ~ Ra P oS ~ b ~'~,, ~ ~ f3v;1~-; a5 ` il. ...~ 's r ~ "`~.,s_ ~ ..,,, , --,~°"s~ ' Ste' L .~_ \,.~ f ~ -_ P ~ -~_..-.. ~. 45 ~. -~ ~ ys ~,. ~^ ~ ~ ~i ` © "' ` ~ ~~ _ ~~. ,a -~---.`_ i ~`-_ t3 - ~ 3.q ~- ~ 3 93. ~g ' ~. t . ~ ~~ M~ _':•~ ' ~ ^, ~` i \ ^~ SV` ~'~~ ~1 ~f--~ ~ G uenv~ 3 y `~~ 4~ - 11JJ ~~ umrr t _ p ~~~ ~ ~ ++J! tl~ ~ ~ U 1tN11t ~~ .C C w s- ~~0 ~ aJdct ' ~ f(~ A~{ ' M a s / ~ , W ~ ~ ~ ~ ~~~ ~~~ ~ o ~ c ~ ~ ~~~ ~ ~ : 3~ ~ ~'~ ~v ~ ~ ~ r in _; .Q ~ ~E~o~ .,~ ~ V x : t`~i c~ r N ~ ~ ~,, C6 L~ y ~ C~ rn r" ~ ; C~ ~ dpi ~ ~ . C m Q ~ ~. ~ ''' C1 ` fi ~ Y ~ „ r . ~ y ` Oa,. "p ~ ~ ~ U Cn ~ ~. R1 y '~ '3 ~ 01 > c X J ~ ~ ~ r m ~ ~~ .rl+ i ~" ~ ~ ~ ~ K ~ ~ ~ - j~~.. A ~ 'O ~pt~ tn ~ t.~. Q Z N _ ~ ~ O` '~ M'J~, a. .. ~n to ~ ~~ i ;~ ~~ r ~ «°~ ,~ v ~ Y ~ + ~ ~ ~ ~ ~: z ~ 4 ~ H M ~ ~ ~ ~~ • , at M m ~ ~i a N °~ ~~ ~i ~ ai ~ ~ ~ ~ r g . ;.~~ St K g ~ a~ :; .x ~ ° e a~ i 3 -~ Mj 7 FROM P C COl_LOVA BLLRS ~ I NC PHONE N0. ~ 7:5 549 59 ~ 1 Feb. 01 2001 07: SAM P1 ST CROIX COUNTY ' SEPTIC TANK MAINTENANCE AGRELtviBNT AND OWI'IL~RSI~IIP CERTII~ICATIQN, FO(LYI Owe I .et' r- ~~l ~ ~.v ,~; l l ?~~o ~ n r~Buyer + c ~ _ ~ ~oo l.e ~ ~o~~ ?viailing Address ~~ ~ y'\ ~'~ , ~~, 1~ -~- ~ ~~ y / ~, Property Address O ~j ~ " _ ~,~ ~~ (Verification required front Planning Departtaent for new con:;.ruction) S'~j C' City/Stato~~ ~ --~ 'sec: Identffcatioct riumvcr Q'LO -f D (tp -p p .'O LEGAL AIt;~S CRII'TIOIV Prcpe:ty I.ocaticnS w_ :~,, ~ 'i;, Scc. ~ ~ ~~"I :~I-R~~,V, Tcw~I of a1(1 . Subdivision ~ ~ H.~• Lot ~ _~ CCt~ICt~ SL'3^It: %' :~113u i~ VbtLIY2C ~ :~n~3 ~~SrI'aII~ DCt:3 isE ~"' / ~~~~ VaiLmC < J ~Q 1~3~C Y ~ O SGfir I:OtISL' ^ YCS~t] T,.7ti:I.ir.. :~;~'fiilitaUlC~y'~ i~ il0 SYSTEM M.~P'ITEIYANC 3mr"~QZS •n.•e and maiateaac.c of your scYt~r. systCm Could t'~St1lt in tts FresaCare f3tltlre to i'aLd1C ~,~;tcs. i roger maintcaaccc ;assists otr pumping otrt the septic taaE every thaw years or szanar, it needed by a liczased Dut:tcer. ~4"hat you put into tie sysL-at csa affect the finsctiaa of :he septic talc as a Ya:steat stage is tlbe waste disposal system. Tie prepe:ty o~ruer aprecs to submit to 5t. Ctrois Zoning Degartmcst a certiticatioa form, ;igncd by tn- owt~ and by a ~rP~r-.i~y~p~bsr,:tstr'etcd plumber or a licensed our.~er vt•^ifyiag tlut (1} the on-site arastc-,vatcdiaposal systtm is is Proper operating cot:dition az±d/or (Z) aP.tr inspcctioa sad ~xuuping lif nc~.:.sa:,~), the septic tank ss lzss than ll3 fu11 of sludge. Ilwe, the ttat3crsitned have read the:bove :egtsirements sod ngr_c to asaintain tllc private sewage disposal system with the standards set forth. hetia, as set by ilu Depazi~-at of Coomerce and the Department of Natttt'al gesaurecs, State of Wisconsin. Certification slating that your septic :ystertt bas been maiutautcd attst be completed and returned to the St. Croix County Zanatg OfI•ica within 30 days of i-.x thrre year ex}sirstioc date. ~~~~ ~~~. 9~2~ o , Sf • •IVRE OF APPLIC.~NT LATE OWNER CERTIFICATION 1(vre) xrtify t4ui sIl statements as this form are tau to the ~cst of ny !cur) kaowlcdg~, ? (we) am (sre} the owner(s) o! the p described above, by virtue oC a warranty decd recorded in Register of DeaiLs Office. 77AA .. I"T7U SIGNA7Y3RE OF APPLICANT DATE ~~•4~+ iIIfOtmEtiOA i11St ~ ~3S-rc r~ a.a.a• Any g _seated may result in the sanitary pet:stit bolas revoked by tttc Zonins Department. ~~ Include w3tL th{s appllealion: a stamped watrauty decd from rho Register of Deeds ot7lce a :spy of the carti.Red survey trap if reference is made in the watnnty decd ' ~ ~,),. ~~34P~~E244 STATE SAR OF WISCONSIN FORM 2 - 1999 Document Number + WARRANTY DEED This Deed, made between Daniel R. Beer and Kimberly A, Beer, husband and wife, ---" " _ - Grantor, and Terry A. Li^tlow and Jill E. Zietlow, husband and wife, - -- -- and Ronald R_ _Poole and_ Joyce Poole, hus)~an`~T- ------- wife,_ as_-Zint tenants -- - - - -_ ____ -- Grantee. ---- ---- -- - Grantor, for a valuable consideration, conveys to Grantee the following described real estate in _St. Croix __ __ County, State of Wisconsin (if more space is needed, please attach addendum}~ Lot 17. Moonbearn Ridge~n he Town of Hudson, SL Croix County, Wisconsin. 658575 Y,ATHLEEN H. WALSH FiFiiISTER OF DEEDS ST. CF(OIX CD., WI RECEIVED FINI RECORD i0-49-2001 9:30 AM YARRANTY DEED EkEMPT H CEkT COPY FEE: L'ORY FEE: TRANSFER FEE: 191.70 kECOkDINO FEE: 11.00 PAGES: 1 Recording Area rvame end Retum Address q((~1~~, ),'f~r, ~/1L i3~'1 e~ 7i"' ~ ~9~1~ 020-1016-00-000 Parcel Identification Number (PIN) This is not homestead property. Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. ~) (rs not) Dated this ~(.~.~ day of S~rlenrber ~'rG~4-s-(p2~v Zp01 -- - __._ __ --___ _ _ ----- - • Dat 'eI R. Beer -- _- -_- _ _ -- J -- - - - -- --- --- -- ---- - -- - - . + mberly A_._B AUTHENTICATION ACKNOW[.EDGME:VT^ Signature(s) Uaniel R. Beer aad Kimberly A. Beer, husband and STATE OF WISCONSIN wife, - __-------._-_. _ . _.- ---- -- ---- SS. ~~~7 --C.`>f-d-'~FPi'Y awhcnticated thi ~^ _ --...- County ) s day of Sa~uwClter 2001_ ~~~ Personally came before me this day of --- the above named ---- ' ~ Krishna Ogland _-_ __ -_ TITLE: MEMBER STA fE BAR OF WISCONSIN - (Ifnot, _ _ to me known to be the person(s) who executed the foregoing authorized by § 706.Ofi, Wis. Stats.) --- instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY + - --'- ----- - - Attorney Krishna Ogland ---- -_-_ .__ ~_ _._ Hudson, WI 54016 ----_- ----- -- -- Notary Public, State of Wisconsin '-- - -- _ ------ ----- ---- (Signatures may he authenticated ur acknowled d B h My Commission is permanent. (If not, state expiration date: ge . ot are not necessary.) __ I - - _ "Names of persons signing in any capacity must he typed or printed below their signature. ibw~roo a.ore,.wr~i: coo~~y, r«w a~ t.x wi . WARRANTY DEED STATE BAR OF WISCONSIN eoa655-m21 FORM No. 2 - IY99 // uucurnt;rir r+a. ~ .. rr'nrt~~tat ~r u~~o BTATE BAR OF WISCONSIN FOR)H f--aM' ~ Rai` =Te CROi~ ~ , '; .,,RaG~#'„-~,~...€>rcl„~;tart',,.I,,liet.ch,ler.t.,Husband.•.and...,._., ~d ~ ReQM~ Ihl~ 6th ...il.~,~.~ ................................................. ' ................................................. I ~ of 0_ ct_.,_A.D. 1966 i conreya..and.n•arranta to......Ai3X.l~e~..fia...v'1.1I~i..K,in;i7erly„A-.,.,•.,,~,,, I ~ I ....Ileer.,..husl,ar:d..and-.xtSTe.....a.a..r~.arlt~,7...rr.~.R~xL;i...... -. ....with..ri(_:hts..o.~..aurviv.crsh.lp ............................................ :~ s s' ................................................................................................................. i .............................. .................................... ............................................. I R[TURH t0 ' ... .... ...... .......................................................... ............ .. II the following described real estate fn fit. CC01X ........................County, ------ ------ .................... . 9tata of Wisconsin: Ta: Parcel No :.............................. SEE EX3fI$IT "A" r' ~. ~~.~ ~F=. This .~S...i1GT ............. homestead property. (Ia) (ia not) Exception to warranties: Subject to easer::ents. reservaticns E:IIC restx•icticr.~ cf t•eccrc:. Dated this ..~.t::~.TC) .................................. day of .......O~t452Y:. ..............-........................, 19... ~.~. ...........................(SEAL) ...Ch~'. .. .. .. ... .. .. .... ...(SEAL) • .................................................................. ..Roger....E.. He,,tc~hLle~r~....................... .....................................................................(SEAL) --..... ... ..`~. ~"''!~^................ISEAL) • Ma etchler AUTHENTICATION 9lgnatnte(a) anthentleated thb .-----..day of ........................... 19...... TITLE: MEMBER STATE BAR OF WISCONSIN (if tat . ............................................................ authorized by 4 708.08, Wle. StaG.) 7 INSTRUMENT,, //WAa DRAFTED aT (Signatures may be aathentlcated or acknowledged. Both are tat necessary.) ACHNOWLEDOMSNT 3TATE OF WISCONSIN aa. St. Croix -.-..-cellncy. Personally came before me this .. 3rd.......day of ----------October-.-• ............... 19.a6... the above named --........Rogar...~.-..He Bch l.~r...and ............................ .-........Mar.Y...1....Hetch~~r ....................................... to me known to be the person 5.......-... who ezectlted the foregoing Instrument and acknp ~1 a came. ,•. '-- my t;ommisslon date :.............. j •lriunae er~penorr dlninf Is •es erp[elb Should br bD~l or printed bdnw the!r dan•ture[. wALRAlR1f DIED STATE BAR 01 W19CONa1N -OR1i N~. a - 191! SCR Cr -_e .y.ceprlet-= wia. permm~p't.(SQn~, ~atc.~~~fiation c~..l/'~r~ sf~...'~J. ~~oassf~) .S1.A•'' w4eenaln Lord RIRnh l-o. Inc. Al il.venM•r, NV. "`•~e~z :• soon i 56RAGE 51 ; .,c.'V . EXHI3IT A The W} of the Sf•.}~ except the Esst 33 feet of the South 264 feet; and a parcel In the P.~ of the SE}, described es; Commencing at the Southeast corner of Section 12; thence West 462 feet; thence Norty 264 feet= thence West 582 feet Co a steel pest anti the Point of Beginning; thence Weat 276 feet to the West line • of said E~ of SE}; thence North 2,367.05 feet to the North line of said E of SE}; thence East along Bald North line 276 feet; thence South to the Point of Beginning; and the South 53 rods of the SW} of the NE} and the East 74 feet of. the South 5:f•roda of the SE} of the NW}. except the following described two parcelst L) Commencing at the Northwest corner of the SE) of Sec- tion 12; thence East 763.1 feet; thence South 1~98U feet; thence West 103.1 feet; thence Southwesterly to a point ' 165 feet East of the Southwest corner of the SF,} of said Section 12; thence West 165 feet; thence North 2.640 feet to the Point of Beginning, together with a non-exclusive . 33 foot wide right-of-way easement from this parcel to the Town Road. 2) A pparcel of land located in the SW} of the SE} and the SEt of the SE} of Section 12, more fully described as follows: Commencing at the South quarter corner of said Section 12; thence South 89°56'43" East (assumed bearings referenced to the•roonumented East line of said . SE}, bearing North 0°05'01" East), 165.00 feet along the South line of•said SE} (previously recorded as East), to the i'oint of B_d{n~~in~; th~ncP cnntjnlr~ng Snath R9°Sf+'41" East, 1,071.32 feet aluug said line; thence Eastr•rly~ 20,78 feet along the Northerly right-of-way line of an existing Town Road on a 603.00 foot radius curve concave Southerly whose chord bents North 80°33'37" East. 20.78 feet; thence North 81°32'~ ^t. 46.72 feet along said right-of-way line; thence Nord, 253.55 feet along the Easterly right-of-way line cf a proposed town road; thenr_c Surrth 89°57'16" East ~previ.ously recorded as F.ast), 301.06 feet; thence North 0°02'46" East, 475.00 feet; thence North 62°15' West, 838.00 feet; thence South 16°08'29" East. 499.45 feet; thence North 88°32'38" West, 343.31 feet; thence South 36°55'27" West 821.47 feet to the Poirrt of Beginning. Together with a non-exclusive easement for ingress and egress over the drive and cal de sac as presently laid out and traveled. located id exception (2) above; and also an easement for ingress and egress over a parcel deacribed as follows: Commencing at the South quarter corner of Section 12; thence South 89°56'43" East, 165 feet along the South line of said SE}; thence North 36°55'27" East. 821.47 feet= thence South 88°32'38" East. 343.31 feet; thence South 16°08'29" East, 147.56 feet to the Point of Beginning; thence North 16°08'29" Weat, 147.56 feet; thence North 88°32'38" West, 75 feet; thence South 16°08'29" East to the cal de sac above deacribed; thence Northeasterly along the curve of the cal de sac to the Point of Beginning. All that part of Lot 4 of the Certified Survey Map filed and recorded in the Office of the Register of Deeds for. St, Croix County, Wisconsin on'May 8, 1984 in Yolume "5"~ Page 1417 Docu- ment No, 393111. which lies North of the centerline of the 66 foot roadway easement as shown on said Map, Together w)th an easement to use the 66 foot roadway easement shown on said Certified Survey Map as an access road and for utility lines located so as not to interfere with its use as a road. Sec, 12-T29N-R19W, . _ ~J~ ~I ~~. I ~I p I I g~ a OI ~i 1 ~~ L1 _J EAb~w1tN I Vh/ I . i oa I I 0 ~ N ~_ ~: EASEMENT FOR TEMPORAI - - ~ i - -~ LOT 21 LOT 2O I ~ CUL-DE-SAC RECORDED It` I VOLUME ~ i h 2.50 ACRES ~ 2.50 ACRES ~ 'r PAGE O I G, I W (108,929 SQ. FT.) ~ (108,899 SO. FT.) I ~; Q; ao ~ I M~n]P~44[~C a i air I O~UIC~DD o ~`I G I OOI Z - ~ I s6.oa 2N~raa~E 357.0 • ~ \ .CENTER OF .l ~ ~ •CUL-DE-SAC ,'~~~\~ MINIMUM BUILDING I~ / / ~ ~~ RADIUS TEMPOI ~ ~~ / , /• CUL-DE-SAC EASEI ~~ \ ELEV = 934.3 ~ ~ \ ~ / ~ ~~ / ~ i. W.L. = 932.3 ~~ ~ / G6 . ~ LO'1 .• , ~ ~ 2.50 ~ `~ ~ ~ ~ 3• \~\ - . - `~.~T . 5i. ~ ~' Gh / .. (108,900 S89°57'29'E 258.01' ~ -N89°57'29'W 631.34'-- c~•~ ~ ~ , . J ROAD- I 1- ~ --rte / ~ . ~ . ~~ S89°57'29"E 617.71 L2 L17 ~ , ~~ . i.i I.. N y ~a, ~'L~ BENCH MARK: TOP __ _ `~~. I ~ ~ "' `$z OF 3/4' IRON REROD, -~ JIMUM BUILDING I ~ i~ oi~ ~` ~, ELEVATION 826.72 LOT 17 -s,, :LEV = 925.5 I m ~ - I Im DI (108,886 SQ. FT.) i I ~z~~ ~~ I ~~ ml LI '~ I ~ u9 ' ~~~ ~, (135 i7'29'E 447.35' ' ~ • ~. ~ ---- 168.78' ~ ~i' v /' I w H.W.L. = 923.5 ~ r / I~ , ~~ °C ~ ~r~ m j~ ., $ w ~. I ., ~, _ -- ~ I ~ LOT 14 ~,, ~~ I ~ 2.50 ACRES d04 ~ ~ ILDING ~ i (108,939 SQ. FT.) ~ ------- ~~ 5.5 I 24' ~ ~ `~ ~ I ~ / 1 ~ ~ MINIMUM BUILDING ~ ELEV =925.5 ~ ~ d~~ ~