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HomeMy WebLinkAbout022-1064-80-100 o cn o 3 v n d O r1 3 r► O O n .0 ~ N A C/) p N N O O N j N N °C O• N N y a n W N C W Z O m` N T go O M 1 Qp CD U>> = j a a) O N a O N?. W Co = CD CD =A a o 3 0 C) O N N co Gf C7I O !r w (n < D a oN N C m c a m W a c _ O o o C CC) co ~z :5 Z co to 0 r- 0 4 m 3 y p !r z O O O Ili !r o n ~D E -q z 0 , N N (n N O D _ cT T 0 o N O O ~ (CD W N m 7 0 y CD N N v Z N a D CD N o CD CD (n v y CD N c W a 3 Z (D N A Z ID A z a I a. Z N N CD M 00 G Z 3 m z CD A W `G D) O D a m a sv n o y (n T 3 c Z a 0 co N N I a 'I y A CD i d m t O A O I ~ v I 3 c ON o p D b m O w c o ~ 0 b I o ~ 0 Form- S T C - 104 AS BUILT SANITARY SYSTEM REPORT I I OWNER GAY= Q'e- WKk*V' TOWNSHIP KTNr13C. K's W1~3 C. SEC. Z.'Z T ,5 N-R 1r:> W ADDRESS lal'1 14140 Gter,, - ST. CROIX COUNTY, WISCONSIN PC2g4x, 4UA , "C- SUBDIVISION k/ LOT N LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of II,HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM . It - t 3' 14OuSC p P IJ1D►~ L ~ ~ C~'~~-- I ~0 INDICA4 NORTH ARROW BENCHMARK: Describe the vertical reference point used N~lCll.N Q Elevation of vertical reference point: lto,rac:~ Proposed slope at site: 34?'o SEPTIC TANK: Manufacturer: i1 ct)CYL-, Liquid Capacity: JOL30 <-,AKA.-o),J Number of rings used: 3 Tank manhole cover elevation: ql..541 Tank Inlet Elevation: '13,62, Tank Outlet Elevation: Rz_ &Z- i Number of feet from nearest Road: Front, Side 0 Rear, OL 1lkD - feet From nearest property line Front, 0Side 10Rear,O 6\16,- /661 feet Number of feet from: well O. . .!')c , building: 3 (Include this information of the above plot plan)( 2reference dimensions to septic tank) CFF DFVRRRR RTnP PUMP CHAMBER a Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, 0 Rear, © Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: X- 3 Width: 5 Length: SCS- 0" Number of Lines: I iL 14Area Built: 25c~zr tC--W n Fill depth to top of pipe: 1~ Number of feet from nearest property line: Front, Side, Rear, Pt.JVeQ- AW' 0 Number of feet from well: Oy£a.. 106-6" Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion syterns. (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, O Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: Plumber on job: License Number: R P ~Q 7 7~ 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR,& HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.11:BOX 7969 BUREAU OF PLUMBING MADISON, WI 5$707 NW4,SV4,S22,T28N-R18W EXCONVENTIONAL ❑ALTERNATIVE State Plan l.D.Number: (lf assigned) . Town of Kinnickinnic El Holding Tank F-1 In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: IN PECT N ATE: Jeff Crandall 617 High Ridge Rd, River Falls, WI 5402 9 -4 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.: Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Thomas H. Cody 6593 St. Croix 92561 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER ` c PROVIDED: PROVIDED 19YES ❑NO ❑YES O BEDDING: VENT DIA.: VENT MATL.: JHIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM FEET FROM LINE: 1 AIR INLET. ❑YES ~O C-= ❑YES10 NEAREST' ~'I DOSING CHAMBER: MANUFACTURER: 71N-G L IQUIDCAPACITYPUMP MODELPUMP/SIPHON MANUFACTURERWARNING LABEL JLOCKING cov ER PROVDED: PROVIDED: ES ❑NO ❑YES ❑NO ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL BUILDING. VENTTO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) ❑YES ❑NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH: LENGTH. NO.OF DISTR. PIPE SPACING. COVER INSIDE DIA. Jt PITS LIQUID BED/TRENCH THE NCHES MATERIAL: PIT DEPTH DIMENSIONS t~ 3 (P` + GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. 111_T1. NUMBER OF PROPERTY WELL. BUILDING: INT TO FRESH BELOW PIPES ABOVE COVER: ELEV. INLET. ELEV. END: ^ PIPES. LLINNEE: A,RR IINN{LET. U~ NFEET EARESTO-- Fecr -Iii- too ~4 6 '1 r MOUND SYSTEM: Mound site plowed. perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- ❑ meets the criteria for medium sand. TIONS MEASURED. YES ❑NO OIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS ❑YES ❑NO ❑YES ❑NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER. EDGES: ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH TRENCHENO.OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER DIMENSIONS MANIFOLD PUMP MANIFOLD of STIR. PIPE JMANIFOLD MATERIAL: NO. DISTH JD:STRPIP DISTRIBUTION PIPE MATERIAL & MARKING ELEVELEVDIA.ELEV.PIPES DA.: ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS. ❑YES ❑NO ❑YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: O LI ❑ YES FEET FROM LINE: ❑ 1-1 NO YES ❑ NO NEAREST 1 l°1Jgo ~I5° 1 q~5 p Sketch System on 0,0 Retain in county file for audit. Reverse Side. d I ATURE. 71TLE: DILHR SBD 6710 (R. 01/82) Zoning Administrator INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION TO THE APPLICANT: 1. This sanitary permit is valid for two (2) years; 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable; 3. All revisions to this permit must be approved by the permit issuing authority. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation; 5. Private sewage systems must be properly maintainec'. The septic tank(s) should be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years; 6 If you have questions concerning your private sewage systern, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the-legal description where the system is to be installed; 11. Type of building or use served: if public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. Responsibility statement: Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8;12 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; dosing or pumping chambers; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form. GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was the result of over 2 years of steady negotiation and public debate. The groundwater bill Groundwater - included the creation of surcharges (fees) for a number of regulated practices which Wiscomin's can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried kreasure is used in your building is returned to the groundwater through your soil absorption ( system or the disposal site used by your holding tank pumper. The r.fonPes colle ;ted through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funcs are used for monitoring ground- water t~ , groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SDD-6398 (8.03/86) 4 DILHR SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05, Wis. Adm. Code 'sue- STATE SANITARY PERMIT # -Attach com `lete plans to the count co only) for the system, on paper not less than P ( Y PY STATE PLAN I.D. NUMBER 8% x 11 inches in size. -See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑ YES E] NO PROPERTY OWNER PROPERTY LOCATION - '/4 '/4, S T AR R E (or) W_ PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME CITY, STATE ZIP CODE PHONE NUMBER CITY NEAREST ROAD, LAKE OR LANDMARK O VILLAGE TOWN OF II. TYPE OF BUILDING OR USE SERVED: Q Number of Bedrooms if 1 or 2 Family OR ❑ Public (Specify): III. PURPOSE OF APPLICATION: (Check only one in P. Check # 2,3 or 4, if applicable) 1. a. ❑ New b. ❑ Replacement c. ❑ Replacement of d. E:1 Reconnection of e. ❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one-owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in #1, arid. o*, orre in 42) 1. a. ❑ Conventional b. ❑ Alternative c. ❑ Experimental 2. a. ❑ System- b. ❑ Holding c. ❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. ❑ Seepage Bed b. ❑ Seepage Trench c. ❑ See a e Pit 2. PERCOLATION RATE 3.. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED (Square Feet): El Private ❑ Jaint F] Public Feet CAPACITY VI. TANK Site in alloris ~ Total # of Manufacturer's Name Prefab. Con- Steel Frbew_ Plastic Exper. INFORMATION New istln Gallons Tanks Concrete stCon glass App. Tanks Tanks Septic Tank or Holding Tank Lift Pump Tank/Si hon Chamber ❑ VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) MP/MPRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code): Name of Designer: VIII. SOIL TEST INFORMATION Certified Soil Tester (CST) Name CST # CST's ADDRESS (Street, City, State, Zip Code) Phone Number: IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater Date Issuing Agent Signature (No Stamps) Approved ❑ Owner Given Initial Surcharge Fee EI. Zt Adverse Determination X. COMMENTS/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber I t APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, ("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property J_EFF 6C,41jb1-4t_L Location of Property Nit) k 15& 14, Section ~;;~2--?f -AT , T oej N-R~ W Township °/A~ ✓~/N/(/f ~;r Mailing Address khn1-1 f Aye v A LLM 6612-:1 10t Soo zz- Address of Site (,2Aj. ~0~~ Subdivision Name Lot Number Previous Owner of Property j,11 rr'tl 6A 6 S 67d Total Size of Parcel Date Parcel was Created 7 Are all corners and lot lines identifiable? Ye No Is this property being developed for resale (spec house) ? Yes A) J No r Volume and Page Number / 7& as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and page number, and the Seal of the Register of Deeds. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION I (We) ceAtijy that at t 6tatement/s on thus 6onm a>te ttule to the beast o6 my (*YAJ knowledge; that I (lxl am (ane) the ownesc4,6-' o6 the ptcopetr ty des cA bed in thi.6 .in4oAmation harm, by vi tue o4 a waA&anty deed uconded in the 044.ice o6 the County Register o6 Deeds as Document No. i/$ ; and that I YArr ptes entty own the ptopozed site jots the sewage diispoz .6ystem (otc I ' have obtained an easement, to nun with the above de.6cn ibed pt opeAty, 6otc the cowsttcuc ti.on ob said ,system, and the dame hays been duty ucotcded in the 046ice o4 the County Reg-usten ob Deeds, as Document No. SI A OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED . I C&iTl?I!s'D SUHVi•Y MAP HOWARD MADSHN Part of the Northwest 1/4 of the Southeast 1/4 of Section 22, Township 26 North, Range 16 West, Town of Kinnickinnic, St. Croix County,'Wisconsin. WI14 COR. SEC. 22, r28 N, R/BW, /IRON P/PE FOUND/ UNPLATT£D LANDS E//4 COR. sec. t?,Y28N, R/BW, - 6 66' (COUNTr SU.^,VEYOP,'S 4ON.i E/W I/I L/IyE 43' S00 46' 46"E 443.32 7T 9. BO' 163. 70' 43'1 NBB•46'4611W 1 1 /3/0.75' 1 y NO2•4I'00"E QI /9e./d' i i poi ! Q 35, lp, I h -4 - V 87•/9'00"W , 3 I lu I h Q ~ / 3. O O' I 4 4+ W LOT k I ti /5.00/ ACRES I I Q 653, 448 SO. Fl. ' ~ v QI „ NET : 13. 856 ACRES ' 45'1 1 ` 603, add SO. F7. t I p 1~ . U' ! Q I \ 1 \ 1 W N 2 J I Zj 1 W ! Y 2 2/4.33' 1 1 t ~ ~ I i Wh ' •J rc JI V I. 'D' m 765.01' 55' I J Q 4 N SO .3ti'38"W 843,30' 26' 1 ~ m m J N UNPLATT£D LANDS 0Indicates 1" x 241, irc)n pipe SCALE ROO' weighing 1.13 lbs./lin. ft. set. 0 50' /00' 200' 300' 400' 300' 6001 CURVE DATA CURVE CHORD SEAR/,VG CHORD ARC RAA/US CENTRAL ANGLE /ST TAN. BEAR 2N0 lAN. BEAR. Y - ! N 03.36'00"E 247.54' 24T.36 5673.68 O2. 30 0N05•//'00"E N02•41'00"E 4-3 N04.37'35"£ //2.46' //2.46 5/84.80 0/•06' 40" N04.04'/0"E N05•'00"E Dated: December 19, 1966 attt~~~n lPPR4VC', %•``~~~SCONSy~~,~ JAN U LAURENCE % M W MUqPHr~/ • C,) CUn,r: e PAWL-',rar14 N.RIVER ALLS,.: r ~ W sci..•. : t A 140 .•lb Vol. Page Certified Survey Maps Laurence W. Muri)hy St. Croix County, Wisconsin Registered Land Surveyor J sH+££r i OF2 CERTIFIED SURVEY MAP HOWARD MADS EN Part of the Northwest 1/4 of the Southeast 1/4 of. Section 22, Township 28 North, Range 18 West, Town, of Kiianickinnic, St. Croix County, Wisconsin. Description: That certain parcel of land located in the Northwest 1/4 of the Southeast 1/4 of Section 22, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin, more fully gescribed as follows; Commencing at the East 1/4 corner of said Section 22, thence N 88 4614611W (assumed bearing on the East/West 1/4 line of said Section 22) a distance of 1310.75' to the POINT OF BEGINNING, of the parcel to be herein described; thence S O1°52'21"W on the East line of the Ncrthwest 1/4 of the Southeast ;/4 of said Section 22, a distan~e of 776.101; thence N 88036'58"W 843.30'; thence N 01 52121"E 773.70'; thence S 88 46'46"E on the East/West 1/4 line of said Section 22, a distance of 843.32" to the POINT OF BEGINNING, containing 15.001 acres, being subject to easements of record and being subject to easement over Easterly portions of said parcel for C.T.H. "JJ" R.O.W. purposes more fully described as follows; Easement Description: Commencing at the East 1/4 corner of said Section 22, thence N 88°46'46"W 1310.75' to the POINT OP BEGINNING, of said easement; thence S O1°52'21"W 776.10'; thence N 88°36'58"W 78.25'; thence Norther;y on a curve concave to the Nast, having a radius of 5784.801, whose chord hears N 04 37'35"E 112.46'; thence N 05 11'0011F, 218.331; thence Northerly on.a curve concave to the We9t, having a radius of 5673 .8', whose chord bears N 03°56'00"E 247.541; thence N 87 19'00"W 15.00'; thence N 02 41100"E 198.181; thence S 88°46'46"E 63.52' to the POINT OF` BEGINNING. State of Wisconsin) County of Pierce) I, Laurence W. Murru.y, Registered Land Surveyor, do hereby certify that by direction of the Owner, Howard Madsen, I have surveyed and divided the lands shown hereon in accordance with official records, Chapter 236.34 of the Wisconsin Statutes and the Ordinances of St. Croix County; and that the map and description area true and correct representation thereof. Dated ; December 19, 1986 \S C O NS m = W MrtE : F LAURSC c~ Owner's Ad,irc:,s: Route 2 S ► N RI 6R~F + River Falls, WI 54022 w~. Q \ Laurence W. Murphy egis tered Land Surveyor APPROVED JAN 09 1987 Vol. Page CiCjiX c: •?UNlY Certified Survey Maps Co P.:,tirNMVE PAr.Kt, FuNMNa St. Croix County, Wisconsin ANC) z(JNrNC CoMWITU SHEET 2 OF2 DOCUMENT NO. ~I STATE BAR OF WISCONSIN FORM 3-1M THIS SPACE RESERVED FOR ARCOROIIj6 DATA .4 21 74a LAIM DEED . { l 5 _ ST, eRofx 0:, WI& IRON. for Record IMis 27th j, John H. Thompson, Jr., and Norma Jean Clay of Jan, aD 19 Thompson, husband and wife, _$7 it of quitclaims to Jef'f r_eranda_1l - I' James 0'C X A_..__C ' onne l l , - - - W 0.70 I DepLlt it the following described real estate in S_t_.___Cr_n1X........ County, I' State of Wisconsin: I I~ RETURN TO ! ! ~ ~ ✓G r ~-~V-~~s, ~i s Sf/e2 z i i II Tax Parcel No: Part of NW1/4 of SE1/4 of Section 22-28-18 described as follows: Lot One (1) of Certified Survey Map filed January 12, 1987, in Volume 6, Page 1770, Document No. 421311. 'i I ✓tt i FXE)AW- -i~ I II II li II This homestead property. , X( (is not) ij I) d this 16t-h. - day of ....J.an.uar.y..... 19.8.7 I 1 ~ ~ ~ it (In SEAL) (SEAL) , John H. Thomp , Jr d t?( s~L.~ SEAL) (SEAL) * Norma:.-Jean. _Thompso_n j' j li AUTHENTICATION ACKNOWLEDGMENT i Signature (s) John--_H . Th o mp s o n x__ J r_!___,_,,,,_ . STATE OF. WISCONSIN and_ Norma-Jean_•ThomP-son...... ss• County. authenticated this 160ilay of..... January_-.•_, 1987-- Personallcame before me this ________________day of r 19-------- the above named john W.Davison l )*//ILlE__M_E_MBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) to me known to be the person who executed the foregoing instrument and acknowledge the same. i j ! THIS INSTRUMENT WAS DRAFTED BY ._Jo_hn---W...__D-a.vIsenON---&---V1A..U. _111..W.-Wad..ri1;t.,.-54022 Notary Public County, Wis. (Signatures may he authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necescutry.) date: y j 19----•-•-•) QUIT CLATAQ DEED ST%TV BAR OF WISCONSIN Wi-icnnsin Legal Blank Cn. Inc.. VORht No 3__.198' T4ilwf%111< e- win. b 57,174 NT NO. STATE -BAR- OF WISCONSIN FORM 1 - 1M THIS *PACE Rn[RV9O FOR *CCORDING DATA WARRANTY DEED Q 100( WA ST. C`f?f~IX CO., W1S, 134 27th {i iaet'd. fir `-c->rd this do This Deed, made between ._.AdQlg___J .__al?d__H_a___•---_--_ I Y of tan. A.D. 19 87 G.,-.. MadS.en..-Faml1X Truk.t._by-_Hower_o __E .-_Madsen q•3 n n M. ~ ...and...Garda.-M.,.,_MadaeJ1i.... Trust.e.e !i I~ James O'Connell , Grantor, and.Jef_frey.._A.---Crandall...................................................... i Deputy: Grantee, Witnesseth, That the said Grantor, for a valuable consideration...... TURN TO ~~~Ti✓ . . conveys to Grantee the following described real estate in -_-..S.t_._-_Cr-Qi.X....... RE County, State of Wisconsin: /Zf S'o/YIAiN ~,,er ~r4llr Cd~s ss%z _ Lot One (1), Volume'8 , Certified Survey Maps, pagel770, being a part of the NW 34- Tax Parcel No: of the SE4 of Section 22, Township 28 North, Range 18 West, Town of Kinnickinnic. i Subject to easements of record. I i (This deed is given in partial satisfaction of that Land Contract recorded in Book 521, Pages 123-124, as Doc. No. 326052, Register of Deeds' office, St. Croix County, Wisconsin.) , VINI JF(r 1 FEE l This _..._is...n.ot......... homestead property. j: (is) (is not) i Together with all and singular the hereditaments and appurtenances thereunto belonging; And------- Hovard..E_~...Ma_dse-n---and. .G_a>;da-M.....Mads.en............................................................. warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements and rights of way of record i and will warrant and defend the same. Dated this cr .fh day of . J_anuaxy................... 19..8.7.. i (SEAL) ......(SEAL) * • -.H.o ard...E.,...Made.en..................,.._..... . • (SEAL) t~.. GL~wvl/.--(SEAL) I * * .....G.._rd ..-M~...Madsen.....--• AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ,I .Count e authenticated this day of___________________________ 19 Personally came before me of -•-----Janu.... 1 19._ e abo named • ----Howard---E-'--•Madsen--a• ..d~-•M..... Madsen trustees.. d lh J' • _ TITLE: MEMBER STATE BAR OF WISCONSIN and Hazel G. Madsen c3i~[rlily Trust (If not, authorized by § 706.06, Wis. Stats.) to me known to be the person who executed the foregoing in ent a ~d~ckno a the same. THIS INSTRUMENT WAS DRAFTED BY C. L. Gaylord, Attorney --------~--,-vti•---- C~cx7~ River Falls, WI 54022 Notary Public County, Wis. (Signatures may he authenticated or acknowledged. Both My Commission is permanent. (if not, state expiration are not necessary.) date: --••-----.._._~.`.l~ 18.1Q •Names of persons signing in any capacity should he typed or printed below their signatures. ~p STATE PAR OF WISCONSIN H.C.MnlerCompanvl ~ FORM No. I - 1982 Stock No. 13001 , Owner's name San. Permit No. " H63.05 PLOT PLAN Show: , Location of building served NR Dosing chamber Q Septic tank Vertical/horizontal. r feren$ce point Building sewer Q System elevation is Q go•49 3 go. I0 Q Effluent system Q Well Replacement system area NA Property lines w/in 50' of system Distribution boxes Scale O , or dimensioned NA Pump and controls: Mfr. & Model No. Vertical Lift Size Force Main Friction Loss T. D. H. Vol. Dist. Pipe Gal. per Min. Gal. per Cycle Place check mark in appropriate box, indicating item is shown on plot plan below: 41 y " CZ. 87 50' s5 /o b ' wLESLR Co>v e. S~C~ 1~FcRbt.- - - - - - - s ~ otzoP dues • 100.0` oU So' SPIfCC \N OAk~ o IOp'pF .r (7 g~ PZ;F32 \000 ~At1 0►.~ e - - - - - - -e w, es 86 t_trJE /I, IR00 Pipe VO OF 4° CZ ~ ~ g3 ~ ~ K o v SC Q wLTl.lr -I 11-7 l~D Cat 1')0!J ~ c.T• H . SSY - By the granting or approving of the above plan, or upon the event of a subsequent permit being issued, St.CroixCounty and theSt.CroixCounty Zoning Administrator, does not assume or hold itself liable for any defects in plans or specifications, plan omission, examination oversight, construction, or any damage that may result in or after 'nstallat'on. 3 T a 7~ P um r s signature/ icense o. a e r,.v• 3 t4 P V C 1=k.0n - r Sir T1C T~N`r y „CZ J V E lJT' p\PE V:S 1 E 5 c"R CAI. Ct2ETc ~SR~Dlx.Z S ' C~S:.~P 8'~~ES Z 2 1,z $OL\pW+~LL P1PE PE2FoRAYc_1: PIPE i I 50' - C R.~SS S ~T1 'y Cl- VENT PIPE w/ AS'PP.szivEb CAp N-L" APPR.OVE~ S-tiJTFi~T'iC R80UE 1=1~J~S1it"D CAVERIQG OR of ~fZA~E _ Sp)L F1LC. U1JC.01'\pAC~'D STRAW SEXIST~.1G D _ C J ' EL. o „lac ~L Cl FL. 90.1o GOF 1/2~i7c, Z~~Z! A6~RcGAT~ SELDW P1PE A1JD ~F _ PI:- RFOr~ATtD S'lPE `t9--- AGGh~c6A~E AHJVE p\PE _ 1 TTON ~F TREQc-,A - V ' ' Ili. _ 1 V ll CERTIFIED SURVEY MAP HOWARD MADSEN Part of the Northwest 1/4 of the Southeast 1/4 of Section 22, Township 28 North, Range .18 West, Town of Kinnickinnic, St. Croix County, Wisconsin. WI14 COR. SEC. 22, r28 N, R18W, /I"IRON PIPE FOUND, UNPLATTED LANDS E//4 CGR• SEC.22,T26N, R16W, 66' 4~3' /COUNTY SURVEYOR'S MON.) E/W LINE x 4- - f---_ S 86 • 46' 46 "E 8 43.32 ' 779.80' 163. I70' 45'I N88.46'46"W I 1 )3/0.75' 1 y N02.4/100"E I /96./8' I 1 QI I ~ I 70, . ti . I N Q V -4 ^ N87• /9'00"W Oi~ 3 h N O Q W LOT 15.001 ACRES '1a N 653,440 $0 . FT. H Q a Q b NET = 13.856 ACRES 45'1 _ -4 b JI • 603,588 SO. FT. ©o 7pr 3 ~ ~ I~ I Wb 4 = I o ~'?j I' I m N05•11'00"E I O W 2 18. 33' I I 2 tt, J 2 1 Q W H 1 I -i Q Q , ©0 m k % 3 I, ~0•l =m I I J Q Q 765.05' 'A 0175 ' I W I m = N Be •36' 56 11W 843. 30' 26' b N Q ti UNPLATTED LANDS 0Indicates 111 x 241, iron pipe SCALE I"= 200' weighing 1.13 lbs./lin. ft. set. O 50' /00' 200' 300' 400' 500' 600' CURVE DATA CURVE CHORD BEARING CHORD ARC RAD/US CENTRAL ANGLE /ST TAN. BEAR 2ND 7AN. BEAR. 2-1 N03.56'00"E 247.54' 247.56 5673.68 02.30 00' NO5•//'00"E N02-41' 00"E 4- 3 N04.37'35"E I 12.46' 112.46'15 78 4.80 0/' 06' 50 #04.04' /0 "E 103• `00"E ~ ~IIf1lttlp~h Dated: De 19, 1986 A% PPRt~ti~O.. \SCONs A- FILED cA JAN :LAURENCE% JAN1rniWSMU J'a PH ~987 " MAIM Of SMOB W r" PAS PL:°;naf N ::RIVER AI.LS,,. • (liA1"t':i ':..`u:k11eTIFs ♦ . A. IQ j "..'.l f WI$C. LAND Vol.- 6 Page 1770 Certified Survey Maps Laurence W. Murphy St. Croix County, Wisconsin Registered Land Surveyor ` SHEET / OF2