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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
c r INSPECTION REPORT Sanitary Permit No:
430680 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
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 Parcel Tax No:
Caldwell, Carrie Hudson Township 020-1411-11-000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No:
/00.d) PhAio Doers, 13.29.19.2581
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
e, 240 a.0 0 102.00 o d
Dosing Alt. BM 40 q• /
Aeration Bldg. Sewer -7:7 IN-3
Holding St/Ht Inlet •B3 93- I
TANK SETBACK INFORMATION St/Ht Outlet • 0 R2
TANK TO P/L WELL Vent to Air Intake ROAD Dt Inlet L _
Septic S :BLDG.
Dt Bottom
P0/ &0
Dosing Header/Man. V2, Aera
tion Dist. Pipe Holding Bot. System PUMP/SIPHON INFORMATION Final Grade S"Cl /1o-o
Manufacturer Qjwand St Cover/
Model Number
TDH Lift Friction Los ystem Head TDH Ft
Forcem Dia. Dist. to well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width/ Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 1 9-7 1
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: Qi
INFORMATION Type System: a~~ n CHAMBER OR Model Number: Y~ n
DISTRIBUTION SYSTEM ` QL
Hit Distribution X Hole Size x Hole Spacing Vent to Air Intake
Mfr Pipe(s)
h_~ Dia Leng is pacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over ~ / Depth Over xx Depth of xx Seeded/Sodded xx Mulched
Bed/Trench Center cz Bed/Trench Edges cfa r, Topsoil -
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection /
Location: 807 Hillside Trail Hudson, WI 54016 (NW 1/4 SW; 1/4 113 TT29N RQ199W)) Alexander Meadows Lot 11 Parcel No: 13.29.19.2581
1.) Alt BM Description
2.) Bldg sewer length
- amount of cover = q.f *4G y.& g ~ r
1 - s~ ~ 4.7 -'20,44",l "'err'
1
P n revision
Use n Required? Yes No
r side for addi nal information. -
SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No.
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Safety and Buildings Division County
~Vlrsconsrn 0 201 W. Washington Ave., P.O. Box 7082
Madison, WI 53707 - 7082 Sanita ermit Number (to be filled in by Co.)
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Department of Commerce (608)261-6546 30 6O
State Plan I.D. Number
Sanitary Permit Application
In accord with Comm 83.21, Wis. Adm. Code, personal onna
maybe used for secondary purposes Privacy La , sl5.ai ED Project Address (if different than mailing address)
1. Application Information - Please Print All Information V/
FEB (b 2004
PName Parcel # Lot # Block # Id', -7 OEEICE pi~)b
_ ST. CROIX COUNTY'
Property Owner's Mailing Address Property Location
City, State Zip Code Phone Number VIL) Section
(circle
T,~ N; R~E o C ,
II. Type of Idin check all that apply) 5
ffi1 or 2 Family Dwelling - Number of Bedrooms S
Z:)Pr-,e Name
❑ Public/Commercial - Describe Use
❑ State Owned - Describe Use 2) 3'X ❑City ❑V age 79Township of
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A' New System 11 Replacement System
❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Plumber Owner
IV. Type of POWTS System: Check all that apply)
V 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 Filter ❑
Recirculating Synthetic Media Filter ❑ Leaching Chamber Drip Line ❑ Gravel-less Pipe ❑ r (explai )
V. Dis ersaUTreatment Area Information:
Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) Syste levation
17
i~
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New Existing
Tanks Tanks
Septic or Holding Tank
Aerobic Treatment Unit
Dosing Chambcr
VII. Responsibility Statement- I, the undersigned, ssume responsibility for installation of the POWTS shown on the attached plans.
Plu b Na (P ' t M's Si n re MP/MPRS Number Business Phone Number
P m Address ( treddet, City, te, Zip C )
VIII. County/Department Use Onl
Approved ❑ Disapproved Sanitary Permit Fee includes Groundwater Date Issued Issuing gent Signature tamps)
Surcharge Fee) 11
❑ Owner Given Reason for Denial 2. SO_ o lX~~ ZXAA,\
IX. Conditions of Approval/Reasons for Disapproval
SYSTEM OWNER: W
1 Septic tank, effluent filter and ) rj (Z Ig 2-
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 complete plans (to the County only) for the system on paper not less than 91/2 x 11 inches In size
SBD-6398 (R. 08/02)
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1049
Wisconsin Department of Commerce SOIL EVALUATION REPORT page 1 of 3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel Soil Service
Attach complete site plan on paper not less than 8Y: x 11 inches in size. Plan must County St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. 6 2-0 ~eC` dmg -Q60
Please print all intionrration. R By Date
Personal information you provide may be used to ag purposes (Privacy Law, s. 15.04 (1) (m)). 3 2'
LaCasse Development , Inc. GovNW 1 /4 SW 19 S 13 T 29 N R 19 W
Property Owner LFft=- Pr Location
Property Owner's Mailing Address 2002 Lot Block # Subd. Name or CSM#
573 Cty Rd " A" 1 na Alexander Meadows
City State Zip )LINTY City Village Town Nearest Road
Hudson WI 54 X05 Hudson Alexander Rd.
✓New Construction Use: it Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
Replacement Public or commercial - Describe:
Parent material Glacial Drift Flood plain elevation, if applicable na
General comments
and recommendations: system elevation 93.80 ft, trenches spaced and depth to code 5.00 ft below grade t/
Boring # Boring
✓t Pit Ground Surface elev. 98.80 ft. Depth to limiting factor 96 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/112
*Eff#1 *Eff#2
1 0-4 10yr3/2 none sit 2msbk mfr cs 1f .5 .8
2 4-22 10yr4/4 none scl 2msbk mfr gw na .4 .6
3 22-38 7.5yr4/4 none sl 1 csbk mvfr cs na .4 .6
4 38-96 7.5yr/6 none ms ml ml na na 7) 1.2
P Boring # Boring
Pit Ground Surface elev. 98.80 ft. Depth to limiting factor 96 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1fl2
*Eff#1 "Eff#2
1 0-11 10yr3/2 none sil 2msbk mfr gw 1 f .5 .8
2 11-31 10yr4/4 none sicl 2msbk mfr gw na .4 .6
3 31-48 7.5yr4/4 none sl 2msbk mfr cs na .5 .9
4 8-96 7.5yr/6 none ms ml ml na na 1.2
* Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOO5 S.30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signature- CST Number
David J. Steel I 248956
Address Steel Soil Service Date Evaluation Conducted Telephone Number
1564 CR GG, New Richmond, WI 54017 8/1/2002 175-246-5085
Property Owner LaCasse Development , Inc. Parcel ID # pending Page 2 of 3
3] Boring # Boring
Pit Ground Surface elev. 97.50 ft. Depth to limiting factor 96 in. Sod Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
*Eff#1 *Eff#2
1 0-11 10yr3/2 none sil 2msbk mfr gw 1f .5 .8
2 11-24 10yr4/4 none sicl 2msbk mfr gw na .4 .6
3 24-40 7.5yr4/4 none sl 1 csbk mfr cs na .4 .6
4 40-96 7.5yr/6 none ms ml ml na na .7 1.2
4 ] Boring # Boring
Pit Ground Surface elev. 96.90 ft. Depth to limiting factor 96 in. Sod Application Rate
F
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
*Eff#1 *Eff#2
1 0-9 10yr3/2 none sil 2msbk mfr cs 1f .5 .8
2 9-18 10yr4/4 none sicl 2msbk mfr gw na .4 .6
3 18-30 10yr4/4 none Scl 2msbk mfr gw na .4 .6
4 30-42 7.5yr4/4 none sl 1 csbk mvfr cs na _4 .6
5 42-96 7.5yr4/6 none ml osg ml na na .7 1.2
❑ Boring # Boring
Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
*Eff#1 *Eff#2
* Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 <30 mg/L and TSS <JO mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
Page 3 of 3
STEEL'S SOIL SERVICE
David I Steel 1564 Cty Rd GG
CST-POWTSM LaCasse Dev., lnc. New Richmond, WI 54017
Lic. # 248956 NWl/4,SWl/4,S13,T29,R19W (715) 246-6200
Town of Hudson, St. Croix Co. (715) 246-5085
Alexander Meadows, Lot 11
This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for
your use. The location of the test may or may not be as shown as permanent lot lines were not
N established at the time the test was conducted.
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POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pavu
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner Septic Tank Capacity, gal ❑ NA
Permit #
450 (01(7)01 Septic Tank•Manufaoturelr , r~; ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer O NA
Number of Bedrooms O NA Effluent Filter Model U ro"
Number of Public Facility Units ANA Pump Tank Capacity al Z NA
Estimated flow (average) gal/day Pump Tank Manufacturer Z NA
Design flow (peak), (Estimated x 1.5) al/day Pump Manufacturer ~14 NA
Soil Application Rate _ gal/day/ft' Pump Model Z~ NA
Standard Influent/Effluent Quality Monthly average' Pretreatment Unit O NA
Fats, Oil & Grease (FOG) 530 mg/L 0 Sand/Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BOD6) ,5220 mg/L O NA O Mechanical Aeration O Watland
Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection O Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) O NA
Biochemical Oxygen Demand (BOD6) 530 mg/L dIn-Ground (gravity) O In-Ground (pressurizedl
Total Suspended Solids (TSS) 530 mg/L D NA O At-Grade D Mound
Fecal Coliform (geometric mean) 510° cfu/100m1 O Drip-Line 0 Other;
Maximum Effluent Particle Size Yo in dia. O NA Other D NA
Other: O NA Other: D NA
"Values typical for domestic wastewater and septic tank effluent. Other: D NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every: month(s (Maxi(num 3 years) DNA
EK ear(sl
Pump out contents of tank(s) When combined sludge and scum equals one-third (Ys) of tank volume O N/,_
Inspect dispersal cell(s) At least once every: O month(s) (Maximum 3 years) j f i!
Year(s)
Clean effluent filter At least once every: ❑ month(s) ear(s) O Ni;
Inspect pump, pump controls & alarm At least once every: O month(s) -ZLNA
O ear(s)
Flush laterals and pressure test At least once every: O month(s) O _C&NA
year(s)
Other: At least once every: O month(s) n NA
❑ ear(s)
Other. O NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank
inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, Identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface.
The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding
of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-third (Y,) or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and disposed of In accordance with chapter NR 113,
Wisconsin Administrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretroatn,ur t
units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
GMW (4/01)
START UP AND OPERATION Page 42-_ of
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals
that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents
of the tank(s) removed by a Septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface,
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewatt. mil tae
discharged to the dispersal cell(s) In one large dose, overloading the cell(s) and may result In the backup or surface discharge o1
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist In manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the rea
within 15 feet down slope of any mound or at-grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the lilu n(;
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; tat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides;, meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the syste : is
properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servioing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space tilled .-ith
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code n,; :;nt
replacement system:
1 A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
\ system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area Nill
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems r, .st
comply with the rules in effect at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances ie PC) FS
technology a holding tank may be installed as a last resort to replace the failed POWTS.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and ;te
evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding ; AK
may be installed as a last resort to replace the failed POWTS.
❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at ne
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
< <WARNING> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RE60UE 0 A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALL POWTS MAINTAINER
Name
Name r~
2,- Ll
Phone Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Name
Phone Phone
This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.6411), (2) & (3), Wisconsin AdmlMsustive Code.
02FEB. 3.20043: 2:32PM1538COTTAGE GROVE ELEM LALAbA;t 07141 UM MUM= NO.290 P. 1/1
S't' CaOIX COUNTY
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canalatq vrptilttillue not ilia aeplla wil; oVaty three yapta or moutler, if t►oatled by •a Iloanscil palNpot•. What you pttt Into, the sysictt
call affect Ilia runctlall of the gorilla (ollk as it tlaatiltaol place Ili Ilia wpatl: 1111potnl ayptanl.
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staling tlw your 6Efitio syalolrl has 11161% 111a1ntt1111ad usual bo Cbm1110104 and telmlied Ia Ilia St, Crollt County Zoning Ci[Eioe wlthia 3.
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STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN N. WALSH
REGISTER OF DEEDS
WARRANTY DEED ST. C
Document Number ROIR
CO.. WI
RECEIVED FOR RECORD
This Deed, made between L.aCasse Development. Inc. 09/12/2003 10:30AM
Grantor,
and Carrie E. Caldwell and Mich el A. Grant WARRANTY DEED
n enants Grantee. EXEMPT ;
Grantor, for a valuable consideration, conveys and warrants to Grantee REC FEE: 11.00
the following described real estate in t. Croix County, State of Wisconsin TRANS FEE: 212.70
:ne' space is needed, please attach addendum): COPY FEE:
Plat of Alexande Meadows in the Town of Hudson, St. Croix CC FEE:
5 PAGES: 1
Wisconsin.
W
Recording Area
Name and Return Address
020-1411-11-000
Parcel Identification Number (PIN)
This is not homestead property
(is) (is not)
Exceptions to warranties: Easements, restrictions and rights-of-way of record, if any.
Dated this 4~►'~~ day of September 2003
" _ ~ Richard W. LaCasse, President
- - - - - - - - - car W. LaCasse resident
AUTHENTICATION ACKNOW MENT
Signature(s) STATE OF (,U~ )
- - ) ss.
County
)
authenticated this _ day of - - - - -
Personally came before me this day of
,,`titittitlllSeptember - ` 2003 the above named
SK t:f rd W. LaCasse ,.c t ae_
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, _ Q to me~Itacvn to be the person(s) who executed the foregoing
authorized by § 706.06, Wis. Stats.) instrAmprEand acknowledged the same.
%
THIS INSTRUMENT WAS DRAFTED BY., ~A ' - e', - - -
Attorney Kristina Ogland
Hudson, WI $4016 tary Public State of f
My Commission is permanent. (If not, state expiration date:
(Signatures may be authenticated or acknowledged. Both are not necessary.) - - J~~ -
* Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co.. Fond du Lac, W1
SPATE BAR OF WISCONSIN 800-655-2021
WARRANTY DEED FORM No. 2 -1999
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SURVEYOR: PREPARED FOR: : ALEXANDER M E,
' DOI1ClA5 IAIILER LACASSE DEVELOPMENT. LINTY PLAT OF.
• •S&N LAND SURVEYING 573 CTY. ROAD "A' y
2920 ENLOE STREET HUDSON, VA 34016 f L I.._' y„r y~ .V j
HUDSON, WI 54016 OC D IN PART OF THE NW1/4 OF THE SWIM, PART OF THE NE1/4 O
OF E SEl/4 OF SECTION 13, T29N, R19W, TOWN OF HUDSON, ST.CI
CONSENT OF CORPORATE MORTOAO f 2002
I
THE RIVER BANK, A CORPORATION DULY ORGANIZED EXIS1klQ UNDER AND BY F~K___~_
VIRTUE of THE LAWS OF THE STATE OF WISCONSIN. TCACSFO OF(lw(* S~6;Oi gA~[~fi0 eeQHVAFK70P0F
DESCRIBED LAND DOES HEREBY CONSENT TO THE VNC, OOLRW
DEDICATION OF THE LAND DESCRIBED ON THIS PLAT.:i Mrpa:A,BtwTpNSauow
THE ABOVE CERTIFICATE OF LACASSE DEVELOPMENT N6. OWNER _
- VsaT-_----- mAs
N WITNESS WHEREOF. THE SAID RIVER BANK HAS CAUSED THESE PRESENTS 1•p BE f_______-___
SIGNED BY KEVIN BLINSMOK PRESIDENT AT . WISCONSIN. AND ITS
CORPORATE SEAL TO BE HEREUNTO AFTIXED THIS GAY • 1 • _
OF 20
' ' i! ~ ~aIWNVX
w THE PRESENCE OF:
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THE RIVER BANK LOT S
LOT 9 ZMACIES
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I 2.708 AD ES
KEVIN BUNSMON solve (117,71260Frj .a
PRESIDENT HOERIEIBAION LI0. 1130.0
AREA
STATE OF WISCONSIN ) SS
COUNTY OF SL CROIX) ) Srawam
PERSONALLY CAME BEFORE ME THIS GAY OF 20_. ,
KEVN BUNSMOK PRESIDENT OF THE ABOVE NAMED CORPORATION, TO ME KNOWN 10 ' J~ , • \ -I'
BE INC PERSON TRW EXECUTED THE FOREGOING INSTRUMENT, AND TO ME KNOWN TO 9S .I
BE SUCH PRESIDENT OF SAID CORPORATION AND ACKNOWLEDGED THAT THEY \
EXECUTED ITIE FORGONC INSTRUMENT AS SUCH OFFICER AS THE DEED OF SAID \ i ' • • • • • • I •L si
CORPORATION BY ITS AUTHORITY. ;v LOT 10 2JI54 ACRES
01LaaSMFI74 01s
LID. - Sm
NOTARY PUBLIC WISCONSIN • I I
MY COMMISSION EXPIRES ' 1 + I
i
a
CORPORATE OWNER'S CERTIFICATE OF DEDICATION
LACASSE DEVELOPMENT INC., A CORPORATION DULY ORGANIZED AND EXISTING UNDER ,
AND BY VIRTUE OF THE LAWS OF THE STATE OF WISCONSIN, AS OWINER DOES
HEREBY CERTIFY THAT SAID CORPORATION CAUSED THE LAND DESCRIBED ON THIS • LOT 1:
PLAT To BE SURVEYED. DIVIDED. MAPPED AND DEDICATED AS REPRESENTED ON THIS ZMACRES
PLAT. LACASSE DEVELOPMENT INC. DOES FURTHER CERTIFY THAT THIS PLAT b c LOT 11 1 M46700-FT
REQUIRED BY 5236.10 OR 5238.12 TO BE SUBMITTED TO THE FOLLOWNG FOR Z s.00sACRES LILO.-NQ
APPROVAL OR OBACTION: TOWN OF HUDSON, ST. CROIX COUNTY PLANNING, ZONING, n G.M OJ
AND PARKS COMMITTEE. atmeff
N WITNESS WHEREOF. THE SAID LACASSE DEVELOPMENT INC.. HAS CAUSED THESE v
APRESENTS TO BE SIGNED BY RICHARD LACASSE R / LOTH
THIS DAY OF 2002 D21,DMSQ.FTa
N THE PRESENCE OF. 1 71MN HOME
~ LOT 8FQ
LACASSE DEVELOPMENT INC. ` INOR7N , ; 11 WATER FIE
INATERREMN" N i
AREA 0
RICHARD LACASSE• PRESIDENT STATE OF WISCONSIN) I
ST. CROIX COUNTY)Ss.
PERSONALLY CAME BEFORE ME THIS AY OF 2002• RICHARD ACsi did
LACASSE, PRESIDENT OF THE ABOVE NAMED CORPORATION, TO ME KNOWN TO BE °l ~p06 .X
THE OFFICER WIO EXECUTED THE FOREGOING INSTRUMENT. AND TO ME KNOWN TO ' 7•- £ Y`
BE SUCH PRESIDENT OF SAID CORPORAMK AND ACKNOWLEDGED THAT HE 'i R StTtn.
EXECUTED THE FOREGOING INSTRUMENT AS SUCH OFFICER AS THE OECD OF SAID
, py VI
CORPORATION BY ITS AUTHORITY. K gg
3 {''n
NOTARY PUBLIC. ~ ' {,j6 Q'L 8d ~ J
MY COMMISSION EXPIRES
ST. CRODE COUNTY PLANNING, ZONING AND PARKS /
COMMITTEE RESOLUTION
RESOLVED. THAT THE PLAT OF ALEXANDER MEADOWS N THE TOWN OF HUDSON, I /
LACASSE OEVLOPMENT NC., OWINER 1S HEREBY APPROVED BY THE ST. CROIX COUNTY
PLANMNQ ZONING AND PARKS COMMITTEE
/ TOWN BOARD RESOLUTION
ART JENSEN. DATE
CHAIRMAN / RESOLVED. THAT THE PLAT OF ALEXANDER MEADOWS IN THE TOWN OF F
-IX LACASSE DEVELOPMENT INC.. OMNER is HEREBY APPROVED BY THE TOO
STEVE FISHER DATE /
ZON WC DIRECTOR
/ JEFFREY JOHNSON OATS
1 HEREBY CERTIFY THAT THE FOREGOING 5 A COPY OF A RESOLUTION ADOPTED BY CHAIRMAN
THE ST. CROIX COUNTY PLANNNC. ZONING AND PARKS COMMITTEE.
1 (HEREBY CERTIFY THAT THE FOREGOING IS A COPY OF A
RESOLUTION ADOPTED BY THE TOWN BOARD OF THE TOWN OF HUDSON.
SUE E. NELSON, DATE
COUNTY CLERK
W AA CDR.
AIM W
RITA HORNE DATE
CLERK
SHEET I OF 2 SHEETS
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