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HomeMy WebLinkAbout040-1097-30-000 m3 o t, 03 °� O °� o y c c a O O ti g c g o e rnmc � orn c N vN �'v vc a N cc 0 0 c c LO E y a�ni 0 xc> 0 o i C o � o E o n co f�0 CD is .0 0 D C y 0.- o I ,p E O...m.• @O. U l0 v y E N y O.T y N c Z o o °FO- c Z Q) (D ,r�: �i N LL o ff 0)c u o vaim ° c >� c 3 c y O o U` O O a •O Qa � co > y Q CO N > Z E E rn w 0 o Y z E Co a m a m N fN-• (n 0 c o Z v c v c v o 0 0 0 ! in N c' E z c' E O N O O N co CD Ra (OD CL •N O a N ( = cc- tN N v O ` n a < O O b o c c a . � o Z Z Z m Z O I N `t z Z NC14 r_ > c6 N a ��y1 E V N U i .. N Z' N ca V o , > a G d .0 n G D C $ ` a Q o to to to n a m w 2 N Z > H H H a N rr r a 2 oOOO Z l 00000 Z •N R 0o. n. a an. a v, o o rS; o o in ; o (A J U Q cm CO } Oj M W Z AV N N N O V V •.�' ,n m a m c a 'O m U O ! T 9 N O co M �` •p d Q } (17 lD Cl) � d Q Z U? f6 O ° O Cl) c > H e r.+ O E N O E O O M O OC "> ') 'e -2 G a W co CD O fn 0) c c a °0 Q Onj of p ' c Co m C 0 C N C N Z O) C LO V Y 07 FB N T O 2 E c L N M 0 0) L • O N I- m 0 Z N 2 2 'd' In 2 00 O Z y H- Z V - E L a a L: a • a m .2 '' d Y c d o c c o C ° C A Uaa � 0U) U 0 m0 F Parcel #: 040-1097-30-000 01/25/2006 04:58 PM PAGE10F1 Alt. Parcel#: 25.28.19.386E 040-TOWN OF TROY ST. CROIX COUNTY,WISCONSIN Current X_ Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner O-MOODY, ROBERT E TRUST ROBERT E TRUST MOODY 862 CTY RD MM RIVER FALLS WI 54022 Districts: SC=School SP=Special r erty Address ): *=Primary Type Dist# Description *862 RD MM SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH / Legal Description: Acres: 1.904 Plat: N/A-NOT AVAILABLE SEC 25 T28N R19W PT S1/2 NE1/4&PT N1/2 Block/Condo Bldg: SE1/4 BEING LOT 1 OF CSM 9/2526 1.904 ACRES Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 25-28N-19W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 965/613 WD 07/23/1997 771/98 07/23/1997 729/425 2005 SUMMARY Bill#: Fair Market Value: Assessed with: 102782 143,700 Valuations: Last Changed: 07/20/2004 Description Class Acres Land Improve Total State Reason COMMERCIAL G2 1.900 20,000 118,300 138,300 NO Totals for 2005: General Property 1.900 20,000 118,300 138,300 Woodland 0.000 0 Totals for 2004: General Property 1.900 20,000 118,300 138,300 Woodland 0.000 0 Lottery Credit: Claim Count: 0 Certification Date: Batch#: Specials: User Special Code Category Amount Special Assessments Special Charges 00 Delinquent Charges 00 Total 0.00 Parcel #: 040-1097-30-000 12/16/2005 12:39 PM PAGE 1 OF 1 Alt. Parcel#: 25.28.19.386E 040-TOWN OF TROY Current 'X' ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner ROBERT E TRUST MOODY O-MOODY, ROBERT E TRUST 862 CTY RD MM q a� RIVER FALLS WI 54022 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description SC 4893 SCH D OF RIVER FALLS ,( SP 0100 CHIP VALLEY VOTECH I I" al Description: �, Acres: 1.904 Plat: N/A-NOT AVAILABLE SEC 25 T28N R1 9W PT S1/2 NE1/4&PT N1/2 Block/Condo Bldg: SE1/4 BEING LOT 1 OF CSM'9/2526 1.904 ACRES Tract(s): (Sec-Twn-Rng 401/4 1601/4) 25-28N-19W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 965/613 WD 07/23/1997 771/98 07/23/1997 729/425 2005 SUMMARY Bill#: Fair Market Value: Assessed with: 102782 143,700 Valuations: Last Changed: 07/20/2004 Description Class Acres Land Improve Total State Reason COMMERCIAL G2 1.900 20,000 118,300 138,300 NO Totals for 2005: General Property 1.900 20,000 118,300 138,300 Woodland 0.000 0 0 Totals for 2004: General Property 1.900 20,000 118,300 138,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch#: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Alt 487273 �m STU -uw wi�,o ,• _ . �'ti�, z Part of the North 1/2 of the Southeast 1/4 and the South 1/2 yF r °°• of the Northeast 4 of Section 2S, Township 28 North, Range ° °3•° 19 West, Town of Troy, St.oix—County, Wisconsin. NE COR. SEC.25, es 4- T 2B N, R 18 W, �n-°4•� E1 14 COR. SEC.25, T 26N, R/9 W, MONNTYSURVEYOR'S, +_ �'• /COUNTY SURVEYOR'S MON.I �= UNPLA TIED LANDS •�, �S32• 14 'YJ"E 33/./3' R / S32•/9'E 33/./O'/ 'w O 4' Q Q Q Lori M Iy �I N BU/LO/NG O OI ~ 'u /.904 ACRES 00 -- —92, 926 SO.FT. - ~ � Q � O HIGHWAY SETBACK L/NE O QI � O lu ` : 4- � N .f2 . OB '/8 "W 331, 14' R/N 3P•/9'W 33/iJ011 O O O C)4 P yti ry\ 5_r—H_ „35 � StiQS o \ \yM VAR/ABLE W 10TH °'r• NW CDR. SEC.25, T20N, R /9 W, /COUN T Y SURVEYOR'S M O I C 1 1P - - Indicates fence �' Indicates l" iron pipe found. R() Indicates previously recorded data. Dated: August 14, 1992 This instrument drafted by Laurence W. Murphy 1 F1� �� UNPLA T TED LANDS LOT /LC. S.N_VOL . 51 I ` PAGE 1475 AUG 1 631992► ��•`��SC o N — — — — Z JAMES b'CONNELL 9 .••"'•"'•• S/ Register of Deeds ;'• � .• St.Croix Co.,WI , LAURENC � 20 W MU P \ r 3 : \ Vol. J►• ER ALLS,: 9`Page 2526 r WISC. ,•:�Q, Certified Survey Maps '� '9 . �Q St. Croix County, Wisconsin LAND•S �•�� rence W. Murphy Registered Land Surveyor SH££T / OF 2 ozlj sz fW 4872'73 CERTIFIED SURVEY MAP — S I FI-M waSELHorGr < y� ,y Part of the North 1/2 of the Southeast 1/4 and the South 1/2 yF. °°.o of the Northeast 114 of Section 2S, Township ?8 North, Range p �•° 19 West, Town of Troy, St. Croix County, Wisconsin. NE COR. SEC.25, pa r28 N, R /8 W, w 6'3 E//4 COR. SEC.25, T 28 N, R19 W, /COON rYSURVEYOR'S 4 • /CObNrY SURVEYOR'S MON., MON.1 w UNPLA TIED LANDS m �o s �S32• /4 '25"E 33/./3' R / S32•/9'E 33/./O'/ y e 4 C �I 0 LOT / p h 904 ACRES N W Z, 0 ._ __82, 926SO.Fr. - - J a H/GHWAY SETBACK LINE Q C ku ^ ' ` ^J O kj N h � J 4 k, ' M o - b N 32 . 08 '/8 "W 33/, 14 R/N 32•/9'W 35/,4"0'/ W ' y b � ti� h� M60 h 9�t to ti O ,,, �b O i b ti .s*,°JS�c 35 �9� r VAR/A8LE W/OrH NW CDR. SEC.25, r 28 N, °y •s•E, R 19 W, /COUN r SURVEYOR'S MON.) s� t -- - Indicates fence Indicates 11.' iron pipe found. F R0 Indicates previously recorded data. Dated: August 14, 1992 This instrument drafted by Laurence W. Murphy tl� CD - . � 1 l UNPLA TTED LANDS LOT /LC. S.M 5_VOL _, ROD a ``%%1111818 I PAGE 1475 AUG 1819 280- Z JAMES O'CONNELL 9 •''•""•" Register of Doe '••• SL Croix Co.,WI „ LAURENC•• = rn � W MU P � = ER LLS Vol. 9 Page 2526 Certified Survey Maps '�� '9�`• •"" .•c,JQ.,•,� St. Croix County, Wisconsin jflil� rence W. Murphy Registered Land Surveyor SHEET / Of 2 • cam, "� � i of F1LSO 3 004E400 JUN 0 4 1999 16 jahg 00 eds sT.CROP CERT EY MAP sRfCORD LOCATED IN PART OF OF THE NE 1/4, IN PART OF THE NE 1/4 OF THE SE 1/4 AND IN PART OF THE NW 1/4 OF THE SE 1/4 SECTION 25, T28N, R 19W, TOWN OF TROY, ST. CROIX COUNTY, WISCONSIN. N1/4 CORNER SECTION 25 NORTH LINE OF THE NE1/4 NE CORNER S 89.12'53" E S 89'12'53" E SECTION 25 1077.51' �\ 1574.38' \ �\ OWNER CHRIS KUSILEK N8618 1090TH \\ RIVER FALLS, WI 54022 \� G,.; \ 1" IRON PIPE FOUND � co G --' G; N62'S8'21"E, 0.43' `\\ OO cV g 1�'�1 O� FROM LOT CORNER • tips �c�O z wUw wo N �wVrn i tJv�OC� w w w S .O u- M LJ �°o \ 0 () �• ;<� cn z lop: 0 '9 a LLJ cn% MZN W/D °y \ 5$,$ SEPTIC 3r.. `\ WELL `• � � \` '•. GAF,`' F�• \ \ s � •.Ff P, Q• y \ •mss, �,\ 6g, 4) o� \ J \ 6�,\ i K100r�5p 1 �\ ' S LEGEND S; `\ I5��9 ALUMINUM COUNTY SECTION CORNER\ MONUMENT FOUND S� • 1" IRON PIPE FOUND O 1" X 24" IRON PIPE SET WEIGHING 1.68 LBS. PER LINEAR FOOT • • • • • • • 42' ROADWAY SETBACK LINE ` \0, �\ gip\,:-' • SCALE IN FEET 1 " = 100'`\ - \ \ 0 100 200 300 D.O.T. APPROVAL NUMBER 55-35-2882-1999 "CAUTION" — HIGHWAY SETBACK RESTRICTIONS PROHIBIT IMPROVEMENTS. SEE BACK OF THIS SHEET THIS INSTRUMENT DRAFTED BY MICHAEL ERICKSON JOB NO. 98-159 DATE: 6/03/99 Vol.13 Page 3658 DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX 7969 BUREAU OF PLUMBING .�ADISPN,W 1 53707 N2,SE�4,Sec.25, T28N-R19W UCONVENTIONAL El ALTERNATIVE State Plan l.D.Number : (If assigned) Town of Troy El Holding Tank El In-Ground Pressure ❑Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Steve Haselhorst 1437 Jefferson Ct. River Falls, WI 54022 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: Michael L. Hawkins 5926 St. Croix 1 88484 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: OYES ONO DYES ONO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD. L NE ERTY WELL: BUILDING: VENT TO FRESH ALARM: FEET FROM AIR INLET: ❑YES ❑NO ❑YES ❑NO NEAREST DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY. PUMP MODEL. PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ONO DYES ONO ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL 1BUILDING:IVENTTOF RESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) DYES 11 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 MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH: LENGTH. jN6._0_F____7D_1STR.PIPE SPACING. COVER ENEAREST- MOUND INSIDE DIA tt PITS LIQUID BED/TRENCH TRENCHES: MATERIAL: DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH UISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO.OISTR. F PROPERTY WELL: BUILDING: V NT TO FRESH BELOW PIPES: ABOVE COVER: ELEV.INLET.ELEV.END: PIPES. LINE: AIR INLET. 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 JOBSERVATION WELLS DYES ONO ❑YES NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. SODDED SEEDED MULCHED CENTER: EDGES. D YES ONO DYES ONO : YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH: LENGTH: NO.OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER. BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL. NO.DISTR. DISTR.PIPE OISTH18UilON PIPE MATERIAL&MARKING ELEV.: ELEV.. DIA.: ELEV.: PIPES DIA.: ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER ATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED M PLANS [11 YES El O DYES FIND COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING. FEET FROM LINE: ❑YES NO DYES 1:1 NO NEAREST Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE: TITLE. Zoning Administrator DILHR SBD 6710(R.01/82) Thomas C. Nelson 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 maintained. 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 system, 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: Property owner's name and mailing address. Provide the legal description where the system is to tie installed; I!. 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; Ill. 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'/2 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 madel 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 Pars of stead negotiation and public debate. The groundwater bill y - Y 9 P 9 i`around Adter,.r. included the creation of surcharges (fees) for a number of regulated practices which wiscor�in'S can effect groundwater The surcharge took effect on .iu'y 1, 1984. All of the water that buried fasure is used ir, your building is returned t-- the groundwater through your soil absorption p system or the disposal site used by your holding tank pumper. 0 ' ,e ;r!or es :vll, c;te•: thr wgti these :jrc„arrges are credi':ed to the groundwater fund admirds tcrera by the Departfrient ;,f Natural F-,so�lrces. These funds are used for monitoring grou cl- t g o undwa er contamination in:estigations and establishment of standards. Ground�%a'�!, t s vvorth protecting DILHF'� SANITARY PERMIT APPLICATION COUNTY. In accord with ILHR 83.05,Wis.Adm. Code ; ` ` 0��� - ,�,...,. ;;;_ STATE SANITARY PERMIT'# S8 —Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER 8'%x 11 inches in size. ?do&033 —See reverse side for instructions for completing this application. PETITION I. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES ❑ NO PROPERTY OWNER ``/ PROPERTY LOCATION e%Q �S"11&/' 14_57 '/4, S S- T , N, R -E-f�W PROPERTY OWNER'S MAILING ADDRESS LOT N MBER BLOCK NUMBER SUBDIVISION NAME 2r,5anJ CITY,STATE ZIP CODE PHONE NUMBER . CITY NEAREST ROAD,LAKE OR LANDMARK s t w ED VILLAGE: -r,0 EX II. TYPE OF BUILDING OR USE SERVED: c Number of Bedrooms if 1 or 2 Family OR Public(Specify): FjvytNf ; 6�L` )?i C�t'G� 134Tb(tze III. PURPOSE OF APPLICATION: (Check only one in##1. Check##2,3 or 4,if applicable) 1. a. ❑ New b. ❑ Replacement c. ❑ Replacement of d. Reconnection of e.❑ Repair of an System System Septic Tank Only an Existing System Existing System i 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 and only one in##2) 1. a. XConventional 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): Feet XPrivate ❑Joint ❑ Public VI. TANK CAPACITY Site in aIIons Total ##of Prefab. Fiber- Exper. INFORMATION New xistin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank Lift Pump Tank/Siphon 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 St ) MP/lIdIMM No.: Business Phone Number: Lu+t .. , . vv, D, �zto 1 ( 71,ZT) 4pu-(o�77 Plumbers Address(Street,City,State,Zip Code): 11 Name of Designer: ' VIII. SOIL TEST INFORMATION Certed oil Tester(CST)Name CST# IT I <SS C)be 0 CS ADDRESS(Street,City,State,Zip Code) Phone Number: W [1),T\`�san � S71460P d p IX. COUNTY/D PARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) Approved ❑ Owner Given Initial S rcharge Fee �] Adverse Determination /4�) •66 n- `O -/t M C. X. COMMENTS/REASONS FOR DISAPPROVAL: I SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber i 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 Location of Property Section , T�N-R // W Township Mailing Address Address of Site w S' Subdivision Name . Lot Number Previous Owner of Property Total Size of Parcel Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume 1' Page Number 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. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - I PROPERTY OWNER CERTIFICATION i (We) eentti.6y that att statements on thin 604m cute thue to the best o6 my (oun) hnowtedge; that 1 (we) am (cute) the owneh(s) o6 the piopehty de cAi.bed in this .in6oAm ti,on boron, by viAtue 06 a waAAant deed heeonded in the 066.tce 06 the County Reg.iAteh. o6 Ueeds as Uoeument No. `, and that I (We) pneaentty own the pnopoaed site bon the sewage dlApozat system (on I (we) have obtained an easement, to nun with the above deeehi.bed pnopenty, bon the eonatnucti.on o6 said system, and the same has been duty %eco&ded in the 066.ice o6 the County Reg.i.ateh o6 Veedd, as Voea ment No. SIGNATURE 0I1 OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED ___.__. ._. - __ _ ..-_ _ ___ __ _ _ - h POCU M ENT NO. THIS SPACE RESERVED FOR RECORDING DATA WARRANTY DEED STATE BAR OF WISCONSIN FORM 2—1982 771 98 .. _..... _ 'RED. ISIERS OFFICE ST. CROIX CO., WISr _.Davi�1.-• -t--.3-� sk-�y-,--. ._xes�.de_ t_._Q ...�Joxth__liud�Qn,----• Reed. for Record this 6th Wisconsin �j -----•---..------•--•-----------••---------------- �y March A.D. 19.L7 i ........................... $-8:30 A conveys and warrants to -._-_••---•--___-____.- -------------•-------------...-----•-•-----•------•--------•-••----••----------•----•-------------•------•-------- geyEotw of Goa1� j •----------------••-----•-......-•-•--------...------..............I.--•---._... ..........•...................... -----------•--•----•----------------- ---•---•-----•---------••---------- ------------------------•-•-- I �,•Vr IAd/ 'p, rlA o4 it r ----- ---------________ ___ ___________ RETURN TO CE�V�l I� ---;- -- --------------------••--•--------...-----•-••---•--- - - 14. 7 I; ?.r?_ G.onsa.dex_at�ar� of --•-------- ..........................------------•-•--------•. �w�2f uS,wl. SYr�ty I ------------------------------------------.QX'07 ?� =_- -- - the following described real estate In ....S:tr.,_.. . ......................County, State of Wisconsin: Tag Parcel No: -------•-----•---------------- Part of the North Half (N2) of the Southeast Quarter (SE;) and part of the South Half (S2) of the Northeast Quarter (NEa) of Section twenty five I � li (25) , Township twenty eight (28) North, Range nineteen (19) West, described as follows : I Commencing at the Northwest corner of said Section 25 ; thence East on the North line of said Section 25 , 1086 . 5 feet to the centerline of State Trunk Highway "35" ; thence S52°49 ' E on said centerline 2095 . 3 feet; thence II S32019 ' E on said centerline 1368 . 75 feet; thence N57041' E 60. 0 feet to the Northeasterly line of said highway and the Place of Beginning; thence ;; N57041' E 250 . 08 feet; thence S32019 ' E parallel with said highway 331. 1 ifeet; thence S57041'W 250 . 08 feet to said Northeasterly line of said highway; thence N32°19 'W on said Northeasterly line 331. 1 feet to Place of Beginning. ! TFANS5 I $11f 0 FEE This __..iS..TlOt____.._-_. homestead property. (is) (is not) Exception to warranties: !!I (i i Dated this .... -----•....... day of -••------••-• --- IK r_ch 19._$.7... .__..._(SEAL) f j II ------•----------••---------------•-•-----•----- (SEAL) !I ------------------------ -------------------------- David H. Biskey ...................(SEAL) ------------------------------------------ --• (SEAL) AUTHENTICATION ACKNOWLEDGMENT I� Signature(s) STATE OF WISCONSIN ------------------------------------------------------------ SS. ---------------------------------- St Croix ---.County. authenticated this --------day of--------------------------- 19------ Personally came before me this _._3rd----•day of March -------- 19__8 7_ the above named •------------------------•----------------------------------------------------- David -H Biskey TITLE: MEMBER STATE BAR OF WISCONSIN L - (If not, -------•----------------•---------------------------------- ✓-' w ' authorized by § 706.06, Wis. Stats.) to me known to be the person ------------ wl�o e e fed foregoing instrument and acknowledge tom;sa THIS INSTRUMENT WAS DRAFTED BY C3 ritt William J. Gilbert -------------•------------------------------------ •-•-••......•-•••-•••• 1a Y'v� Vti• r>z►1SN I ?�� k� o 1 h ----------- --- <. ........................................................1 ecnt udo , ��I... 4 016 Notary Public ..........................................County;"Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent.(If not, state expiration " are not necessary.) till( \ l date: -•-•-------- 19--- ) *Names of persons signing in any capacity should be typed or printed below their signatures. 3: STATE BAR OF WISCONSIN c HCMi11er Conparry� - FORM No. 2— 1982 Stock No. 13002 H - a ST C - 105 r • a H SEPTIC TANK MAINTENANCE AGREEMENT o St . Croix County z d OWNER/BUYER l[ a %/ ! ' r� �i/-� CcS�< <<91" ROUTE/BOX NUMBER Rc2 f��• _�S,Jy Fire Number CITY/STATE �ev ;�/l �� Z I s �aZ PROPERTY LOCATION : _5Y _a, Section,, TN , R _W, Town of St . Croix County , Subdivision Lot number Improper use and maintenance of your septic system could result in its premature failure to handle wastes . Proper maintenance con- sists of pumping out the septic tank every three years or sooner , if needed , by a licensed septic tank pumper . What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St . Croix . County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1 , 1978 . St . Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained . The property owner agrees to submit to St . Croix County Zoning a certification form, signed by the owner and by a master plumber , journeyman plumber , restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping ( if nec- essary) , the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration . Ho E I/WE, the undersigned , have read the above requirements and agree to maintain the private sewage disposal system in accordance with x H the standards set forth , herein, as set by the Wisconsin Depart- v ment of Natural Resources . Certification form must be completed and returned to the St . Croix County Zoning Office within 30 days of the three year expiration date . SIGNED DATE St . Croix County g Zonin Office P. O. Box 98 Hammond , WI 54015 715-796-2239 or 715-425-8363 Sign , date and return to above address . EH 115 Rey.9/76 REPORT ON SOIL BORINGS AND PERCOLATION TESTS 8 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES �. 9 P.O. BOX 309,MADISON,WISCONSIN 53701 � (' l4 LOCATION:S� Y4, �E'/4,Section.�L_,T Z_N,R If E (or)&Township or Municipality Lot No. , Block No. County S{ �X RNs u bdiv ision Name Owner's/Buyers Name: ��<JE /3� t Mailing Address: TYPE OF OCCUPANCY: Residence No.of Bedrooms COMMERCIAL X EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE>. IL BORINGS N491" /PERCOLATION TESTS N0 V' to SOIL MAP SHEET SAS /� NAME OF SOIL MAP UNIT PERCOLATION TESTS / SO TEST CHARACTER OF SOIL DEPTH CHARACTER WATER IN TEST TIME DROP IN WATER LEVEL,INCHES RATE NUM_ SINCE HOLE HOLE AFTE INTERVAL MIN/IN BER INCHES „ THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P— p'' Lf P- Z P— S L " L¢. P— y G f U S SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER,INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE,MOTTLING AND DEPTH TO BEDROCK NUMBER INCHES OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES B- > P '%✓.S// 7'kf•44.51.1 �y"edAy /s 3 1„®.et-fla. U-4.s. B- z ,ti'oN,e' y„ s. r3"ci.A'j,s;/ „R�.sL ic" Zs 31” -f cs B— 3 "/3N S/l "10-BA). sil Wledm,4t LS X -�ti. A-4 S. B— > �' "/�u. Si/ "[f•$,j.Sil (,,,SZ " LS 36 52 44.13 B- 12„gv. / /o”Lf•/3a.L S"Lf-/3a-SL 7"'dQ►,1,%s"c- LS B- 1`/O " -J3110 nwej • -so—k PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicat2 on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy 61,� SG'•'rf' .Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. VAJ GA's . _SV/roW4 rel 40,0y, Spa 407-ry i a /�G/I�taS /V07 7Z) SCA/ i f I i 'leCU '•'17� 3 E t D1 T�.uc�s �,P�" !C jS�T f I I . i vicey rod /3M o PM f , PawQ 13, _11, 13-e to r 77 , JO W ' I 7Cn lie o�. r � , i�N . F y� y /?4 Y! ; J 1! 1% I f X r « sil 41C4 ! ,.� { ` f � ( l � � � •o�'.�Jtilh'-E!v.�, �} lys` !_ . i r i l i # �.tr r t��✓�; f I 0 /'�/d i. 71, �, e" SSE I E/ ;r4 ,oAo �- Ora I,the undersigend,hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code,and that the data recorded and location of test holes are correct to the best of my knowledge and belief. Name (print) >b ER 7- WhW l cy Certification No.B_':-6 1 Yet_ Address •3 ow his Name of installer if known SG V O'✓Of Copy A—Loea Authority CST Signature GG%G�i { r t� I L9 2 ° � D 3 2 v y L Q n • �1 ' a 0 °� 2 ° p2 CO CO 9- , La a N ° too r _ _ �! � ���., ._. _ .a.: «. �.. .5 � ..e.1' a ♦]_�'i,Y A�+I `.�i t�;� .. _ <, , 1 k MEN �` i R AS BUILT SANITARY SYSTEM REPORT S TOWNSHIP�I,� SEC ,,���-R W OWNER ! )A\I I K 7-- ADDRESS 1��{� T'R its i ST. CROIX COUNTY, WISCONSIN. � C SUBDIVISION 1 �w N 3.5 LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 TANG WITHIN 100 FEET OF SYSTEM t 1 I i a e d o th Arrow SC L _ rop e� wooer FA we PoST Ar 5E' BE CHMARK: (Permanent reference Point) Desc�ibe: Elevation of vertical reference point : � Slope at site :—e --o TANK: Manufacturer: : /Z S Liquid Capacity: / X00 ) Number. of rings on cover : / Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: PUMP CHAMBER Number of gallons Manufacturer: gallons ; capacity of Number of gal. pump' set or a cyc e_ g total head; distribution lines gallon: size o Pump gallon per minute horsepower ran name of pump and model number Type of warning device HOLDING TANK: Manufacturer Number of gallons Elevation of manhole cover Type of warning device um .er o p SEEPAGE PIT SIZE: its feet iameter__________ feet liquid depth seepage pit in et pipe-elevation bottom of seepage pit a evation feet . i SEEPAGE BED SIZE: number of lines width 1z! length _tile depth SEEPAGE TRENCH: width length PERCOLATION RATE REQUI D (61 BUILT INSPECTOR DATED PLUMBER ON J B LICENSE NUMBER _ REPORT OF INSPECTION - INDIVIDUAL SLWAGE SVSTLM S an.i..tan y P e nm.i..t oll _ State Septic jAME Town4hip St. ChU-i.X Cuun.ty o'cat.ion Sec onajrLo,t N Subd Z vi4ion tPTIC . TANK Size gatton4 Number o6 compantment4 Z ,iat.anee 640m:. Welt. Bu.itd.ing _12% atope H.ighwaten LIMPING CHAMBER Size 9aetona _ Pump Manu,6ae•tuu,% Mu det Numb en OLDING TANK Size gatton4. Numben o6 Compaktmente Pumpers Atau Syatem 'Catanee 640m: Wett_ Buitdtng 41ope_ Highwate4 8SORPT10ON SITE Bed Taeneh t e tan ee 6-tom: wetter Bu.itd.ing! f2% 4 tope ______,- Highwaten HSORPTION SITE DIMENSIONS .Width o 6 tn.eneh aZ. it Req u4 red anea Length o6 each. Une it Depth o6 Kock betow ,tite .cn Numbers A ' tines oZ Depth u6 nook oven .cite_ _— _ i.n TotaX Length u6 tinee �4 O 6t Depth u6 file betow grade_ _ _i.n 1%� D.iatance between eine,6 6t Stope u6 tn.eneh �i 441. pen 100 6t Z t u N, aLo u��N.tiun anea (o (e 0 6-t Type o6 Coven: Papeh on 4 thaw IT D_I MC_N_S I_O_NS- Numbers o - p,itA rti .,,.„ Ou.ta.idg diamete4 it Depth betow .intet At Totat abaohption anea it .A)Lea" %equ.iKed it NSPECTED• BV TITLE ' I1PROVED DATE .�� 02 19 't. JECTED DATE 19 is I ASON FOR REJECTION and Count State Permit # State a y PLB 6 7 Permit Application County Permit # • for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: D�v /� Ey 90 y so,�,��-,� s �D. v�so,� ��s . B. LOCATION: S '/4 Nom'/4, Section Z�, T.�L N, RY�? E (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township C. TYPE OF OCCUPANCY: *Commercial_ *Industrial *Other (specify) Variance Single family Duplex No. of Bedrooms No. of Persons_ �Oy-CR_ M4 hf/E #Q' I E 5AAA 4 D. SEPTIC TANK CAPACITY /oVt Total gallons No. of tanks f HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete- - Poured-in-Place Steel Fiberglass Other (specify) New Installation Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other(Specify) E. EFFLUENJ DISPOSAL SYSTEM: Percolation Rate :E-Z-1 Total Absorb Area New Jr Replacement Alternate (Specify) Seepage Trench: No.of Lineal Ft. Width Depth Tile depth (top) No.of Trenches Seepage Bed:— X Length S idth /Z Depth 5elk*� Tile depth (top)_3sQ, No.of Lines Z Seepage Pit: Inside diameter Liquid Depth No.of Seepage Pits Percent slope of land 2A;P6 y T2 Distance from critical slope /yOit1E WATER SUPPLY: Private X Joint❑ Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than present owner: I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Certified Soil Tester, NAME / Ah�iC�T �1hZ/C 47 C.S.T. # n :dL 70L and other information obtained from (f (owner/builder). Plumber's Signature MP/MPRSW# Phone # Plumber's Address Z 2 WoeOWL L' f✓ PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20.Well loca- tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors property. If well has not been drilled please indicate. E E E , r a.....—e Q. .....e„ mom« '._ .., y..,...,., e........ e .mow.,. ..... W. t i E t 't f t ¢� 3 Y^ i F m r r E E � E E 3 3 e x 3 L x k j r 3 Do Not Write in Spac B ow FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application 2 Fees Paid: State.-�—County � Date Permit Issued/FveMcted (date) 40 Issuing Agent Name inspection Yes State Valid# Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON,WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 7/1/78 EH115 Rev.9/78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS 8 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES A 9 P.O. BOX 309,MADISON,WISCONSIN 53701 rO VRFCEj� 5!k/ + !(/E+ 2 2� jj44 r Township or Municipality T�0 Ovj3 LOCATION. /a, /a,Section�,T_N,Rl..[_E (0 1(� P Lot No. , Block No. County S{ /n Owner's/Buyers Name: �,4ve- Subdivision Name Mailing Address: TYPE OF OCCUPANCY: Residence No.of Bedrooms COMMERCIAL X NOhi�E E SA��S �� EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT-ALTERNATE ALTERNATE SYSTEM OTHHER DATES OBSERVATIONS MADE>. IL BORINGS NPv' /?O o PERCOLATION TESTS NOV- 49 l< O SOIL MAP SHEET Scs // NAME OF SOIL MAP UNIT ZZ" f AVID s;f,vvy SO4 -srlffu.-�_ PERCOLATION TESTS TEST HOURS WATER IN TEST TIME DROP IN WATER LEVEL,INCHES RATE NUM- DEPTH CHARACTER OF SOIL SINCE HOLE HOLE AFTE INTERVAL INCHES a THICKNESS IN INCHES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN BER 1ST WETTED SWELLING IN MINUTES P- / D Av. 1;/ 7 ..L�, %�v. L 13"P P- P- L p /l"� . t// /0 '"L�/v. L /oG •/s+r - Z & .3 P- S L "edwxg Lf,. n/ L f P— a r" O IP SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER,INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE,MOTTLING AND DEPTH TO BEDROCK NUMBER INCHES OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES / yS 3/"®21 . * B- .9 NOUE / W / S . L - B- L /V DNE y" l3"0-AAA.5d 144 SL 1G" LS Z)_ .0 CS B— aP N•S/I "L!•BN. Sil j5- GS -2Q. 0.;4. S. N B- ? "Am. Ll, G"SL /" 36 B- yLo�-JL_ ? 2"Sj• Z /O"L/% .5 13,J•SL , 7"4a'11 fl-� L S PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) IndicatB on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy 44S SQ• 0- ,Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. ?yLGra HMV,,, /30 _y..So� z E s M T N� ze, r17F F z cS. T 4 _m ._ _ d - _. w s3 s N I �� � „ ,.,. ......s j X 3 _ O i!�/r } m I,the undersigend,hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code,and that the data recorded and location of test holes are correct to the best of my knowledge and belief. �j Name (print) fobE47- �/"��i Ch� Certification No.-4-1-:-6 1 W2_ Address Xt.3 &P,04 f_44W .Name of installer if known S ' �XG U ti s CST Signature Copy A—Local Authority 13772 REPORT ON INSPECTION OF SANITARY PERMIT # (1) Name and Address of Permit Holder Person/Persons at Site (2)Date of Inspection c. ame, Aaaress is se o. o ns a Ong p um er Time of Inspection ,/ LaadA If ZA? 3 INSTALLATIO ON S ❑ Septic Tank ❑ Seepage Trench [:]Dosing Chamber []Seepage Pit ❑ Seepa a Bed ❑ Holding Tank ❑Fill System ermanen re erence Point) Describe: Elevation of vertical reference point: Slope at site: (5)MATERIAL AND DEPTH OF SEWER: (6)SEPTIC TANK: Manufacturer: Liquid Capacity: Tank Inlet Elevation: Tank Outlet Elev: # ft to lot or property line: # ft to well (7)DOSING TANK: Manufacturer: # of gallons : # of gallon pump set for a cycle gallons ; total capactiy of distribution lines gallon; size of pump head; gallon per minute ; horsepower ; brand name of pump and model number Is the warning device installed? [:)YES ❑NO Wired? [:]YES ❑NO 8 HOLDING TANK: Manufacturer of gallons ; construction depth to the cover ft; If septic tank is being used are baffles removed? YES ❑ NO; ft from residence; ft from well ; ft from property line. Type of warning device Is the warning device installed? ❑ YES ❑NO; Wired? ❑YES []NO; Locking device on cover? []YES ❑ NO; Diameter of vent and material ; Distance from building to vent (9) SEEPAGE PIT SIZE: # of pits; ft diameter; ft liquid depth; ft to residence; ft to well ; ft to property line; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than seepage pit inlet pipe-elevation ft; bottom of seepage pit elevation ft. (10) SEEPAGE BED SIZE: ft width; ft length; tile depth; lineal feet tile; ft to residence; ft to well ; ft to lot or property line; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes, water courses or drainage ditches Elevation of tank discharge line entering bed ft. 11 SEEPAGE H: Total length of seepage trench ft; width ft; tile depth ft; ft to well ; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes, water courses or drainage ditches; elevation of tank discharge line entering seepage trench ft. (12) Has system been installed in area indicated on EH 115? [—]YES ❑ NO (13) Has system been installed in floodway? []YES ❑NO Floodplain? []YES ❑ NO DILHR-SBD-6095 N.05/80 Signature of Inspector: Y A. ` _ Y Department of industry, Labor&Human Relations State.-Of Division of Safety : & Bldgs • State of p 'WisgonsiA Bureau of Plumbing Platting& Fire Protection P.O. Box7969 - Madison W1.53707 Tel. 608-266-3815 IN ALL CORRESPONDENCE REFER TO PLAN f IDENTIFICATION NO. NAME OF PROJECT �r n TYPE OF APPROVAL ' STREET RECEIVED AND NO. _ _ r. ,; r' i ' �t .{ )' DEC 20 1980 CITY OR TOWN COU STATE ZIP ZONING V C R. r '1 l 6' OFFICa9 OWNER C� Gentlemen: Examination of plumbing plans and specifications for the above-mentioned project has been completed. In accord with Chapter 145, Wisconsin Statutes and Wisconsin Administrative Code, the plumbing plans and specifications are approved contingent upon com- pliance with the stipulations indicated on the plans. Please review your code for the requirements of each code section noted. The architect, professional engineer, registered designer, owner or plumbing contractor shall keep at the construction site one set of plans bearing the stamp of approval of the department. In the event installation of the plumbing improvements or system has not commenced within two years from this date,this approval shall become void and new application shall be made for approval of these plans before work may commence. In granting this approval;the Division of Safety and Buildings does not hold itself liable for any defects in plans or specifications,plan omissions,examination and reserves the right to'order changes or additions should conditions arise making this necessary. This approval is based on Wisconsin Administrative Code requirements. It shall be necessary to obtain and fulfill the permit require- ments of the city, village, township or county in which this installation is to be constructed. Failure to obtain local permits will auto- matically void this acceptance. Sincerely, James Sargent-Bureau Dire or PLANS REVIEWED BY: a DATE: �y cc: Owner DI LHR Local a 11 - Lcal l P P1I Plumber H&R (2) County `�s Mfg.Rep. Bur.of Health Fac.&Services ~ Rec.&Env.Services DILHR SEED-6099(N.06/80) 14'4- IN 0 3 � N H w _ o �°\ - - - - - - - ?E /2 2 H I E- .331 -�► i r7 411 I L IN 7&6( 0 r Q t4r\ izil 0 z,G"= N �` tj Q E �o Qh o � e C� k ~o tiZ L� 2 P a _ h j • • k a f 4 2 f � { of VIP It fi x• -.q` ,- a o. K, r 1. ¢I h� 'i :'�R'.is'�� tax � � r ' r , I' y� 7 C ' i �} � ,�, .s: a 7 r f �„ #+a ;3'x3 y,� W'''���6Y.`,M tv s y'�A$ _� •a'r ,�,` �+ � � ! �ti r a » 'k ed•' r ,- ex's ., I i, :�� § : r f 4�,s ,xu: I .iS e AT •_ '�� !� . 212. t nor,* w o r Oro R. y�k,i' Ail r t r y t �� s• �` t�+��� r• �j�an k .rT` �3+� .�FYS"��9 a:, t��v �� aw�i + Nix, �ppt�µ4 mat infio,*io• L.. cnatrcn aca� cds, ! J9 ( '34l1d8Yit'enekktfad rt y '' 1 g-b.1Y��,` }�ipgi�#y�: e$ .twa..Fr r 14�;.}'� �I x 5 xS : ,S, i $'' _•`f { I J * ff44'�{. l 'f^FLt1i'�ti+ii.®'lIw oat or onsfte°,fit fy -T ,Sewal" oso (St s +W.�9, i ik .- M e,•. '4f .1Y 34 •? t �7 r } 1: .OWmnd akbpe'with 2'a n000�"+► #i af"I,vf op" 00 sVaem 9*t }f 2-W Eeva#ion oftnenn# e# i rk { i a t acatiom4f area suitab ofaw-poppw lot'► ► i ` #.1�► �.> . �' " a#n. 'SIte constru Mr s rk : 7 p ' E3opie rs 3 u } � 4VrttnteM{ Ple 8► "EQ 51 KIM Tr e "t3o> t a r 1 #oK tpW#fr PMMOd*arge,head and fil es.pt raped p+#i€ a a : p� f farce_ . " i cuves 1,,devNdow. n and iw sl S nck PUMP r Ift .{ b & fi � - s. -u _ ate. gbr�>2-�'I��`e�s..'rt' _a.2usx5��a _t.,.w,.a,t,.. . .. ,.✓s_ 'm .� .,. .. ,:.''� _y fi.:t'_��"�` 4'�.� .�.�i_aii Parcel #: 040-1097-30-000 02/06/2006 11:29 AM PAGE 1 OF 1 Alt. Parcel#: 25.28.19.386E 040-TOWN OF TROY Current X ST.CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner O-MOODY, ROBERT E TRUST ROBERT E TR Y 862 CTY RD MM RIVER FALLS WI 54022 Districts: SC=School SP=Special Prope (es): '=Primary Type Dist# Description 862 CTY RD MM SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH ( 3 3� Legal Description: Acres: 1.904 Plat: N/A-NOT AVAILABLE 9 p SEC 25 T28N R19W PT S1/2 NE1/4&PT N1/2 Block/Condo Bldg: SE1/4 BEING LOT 1 OF CSM 9/2526 1.904 ACRES Tract(s): (Sec-Twn-Rng 401/4 1601/4) 25-28N-19W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 965/613 WD 07/23/1997 771/98 07/23/1997 729/425 2005 SUMMARY Bill M Fair Market Value: Assessed with: 102782 143,700 Valuations: Last Changed: 07/20/2004 Description Class Acres Land Improve Total State Reason COMMERCIAL G2 1.900 20,000 118,300 138,300 NO Totals for 2005: General Property 1.900 20,000 118,300 138,300 Woodland 0.000 0 0 Totals for 2004: General Property 1.900 20,000 118,300 138,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch#: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 i 487273 i CM 1111-3. SURVEY MAP `�'tllP1J St FI-M water Part of the North 1/2 of the Southeast 1/4 and the South 1/2 ye'. ti°°.° of the Northeast 114 of Section 2S, Township ?8 North, Range +� �'•° 19 West, Town of Troy, St. Croix County, Wisconsin. NE COR. SEC.25, p m T28N, R /8W, 4A a3 E 114COR. SEC.23, r28N, R19W, /COUNTY SURVEYOR'S ?• /COUNTY SURVEYOR'S MON.) MON'' 4 w UNPLA TTED LANDS m *S32. 14 '2?'IF 33/./3' R / S32•/9'E 33/./O'/ Cn 2I a aU/L°/NC „ W t4i�Ifu /.904 ACRES N o -- --e2. 928so.Fr. - - — Q a / HIGHWAY SETBACK LINE NE I N �I 1 Zj h o - b N 32 . 08 '/8 "W .'l3/. 14 R/N 32•/9'W 331i%09 W ' 1 O W 7 � Z �00 ti� 60. w 11 �� W 2 �� l yF B4. 1/ l�, 9 4 L S. T. H. �� °°• 'yQ o c� c 4- P�y �h r VAR/ABLE W/OTH NW COR, SEC.28, r 28 N, y yF R /9 W, /COUN T Y SURVEYOR'S MON.1 —1 Indicates fence 0 Indicates 11.' iron pipe found. R() Indicates previously recorded data. Dated: August 14, 1992 This instrument drafted by Laurence W. Murphy 1 �,^ UNPLA T TED LANDS LO � T / C. S.M_VOL . 5, F . 6 uu�„a� I L PAGE 1475 AUG 131992• CONS� — — — ?, JAMES O'CONNELL Register of Deeds ° St Croix Co.,WI ' LAURENC m W MU P ;�•' ER ALLS,; ,� Vol. 9 Page 2526 '•• WISC. Q Certified Survey Maps 9Fp• ••• ..••SJ ,��� St. Croix County, Wisconsin i ,AND,`,•` rence W. Murphy Registered Land Surveyor SHEET / OF 2 3 of G04400 ,Da "AT,CRDI CERT � _ EY MAP SRECORD LOCATED IN PART OF T OF THE NE 1/4, IN PART OF THE NE 1/4 OF THE SE 1/4 AND IN PART OF THE NW 1/4 OF THE SE 1/4 SECTION 25, T28N, R 19W, TOWN OF TROY, ST. CROIX COUNTY, WISCONSIN. N1/4 CORNER SECTION 25 NORTH LINE OF THE NE1/4 NE CORNER S 89'12'53" E S 89'12'53" E SECTION 25 —� ti 1077.51' �\ 1574.38' \ \\ OWNER \\ CHRIS KUSILEK \ N8618 1090TH �\ RIVER FALLS, WI 54022 r11 cy) \ 1" IRON PIPE FOUND 00 . \\\ � G N62'58'21"E, 0.43' FROM LOT CORNER z `L =U w o� rn w o0 ~J zwN LLI F W F Qww �� ,O z-�V)i \� <9� w o tri m z N VARIABLE WIDTH SEPTIC \0� O �. WELL G � 15D p p \ KN 5 LEGEND ALUMINUM COUNTY SECTION CORNER\ MONUMENT FOUND ) S • 1" IRON PIPE FOUND 1" X 24" IRON PIPE SET WEIGHING 1.68 LBS. PER LINEAR FOOT �\� N • • • • • • • 42' ROADWAY SETBACK LINE \ \ \'��,•,�' SCALE IN FEET 1 " = 100'`\ \ \ 0 100 200 300 D.O.T. APPROVAL NUMBER 55-35-2882-1999 "CAUTION" — HIGHWAY SETBACK RESTRICTIONS PROHIBIT IMPROVEMENTS. SEE BACK OF THIS SHEET THIS INSTRUMENT DRAFTED BY MICHAEL ERICKSON JOB NO. 98-159 DATE: 6/03/99 Vol.13 Page 3658 Parcel #: 040-1097-50-000 02/06/2006 11:12 AM PAGE 1 OF 2 Alt. Parcel#: 25.28.19.386G 040-TOWN OF TROY Current X ST.CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner O-KUSILEK, CHRIS&DIANA CHRIS& DIANA KUSILEK N8618 1090TH ST RIVER FALLS WI 54022 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 1.508 Plat: 3658-CSM 13/3658 SEC 25 T28N R19W PT SW NE,NE SE&NW SE Block/Condo Bldg: LOT 3 BEING LOT 3 CSM 13/3658 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 25-28N-19W Notes: Parcel History: Date Doc# Vol/Page Type 06/26/2000 625342 1521/457 WD 05/26/2000 623680 1513/577 QC 11/26/1997 569095 1279/309 LC 07/23/1997 825/408 more 2005 SUMMARY Bill#: Fair Market Value: Assessed with: 102784 584,600 Valuations: Last Changed: 11/06/2002 Description Class Acres Land Improve Total State Reason COMMERCIAL G2 1.508 40,000 522,700 562,700 NO Totals for 2005: General Property 1.508 40,000 522,700 562,700 Woodland 0.000 0 0 Totals for 2004: '1 General Property 1.508 40,000 522,700 562,7000 Woodland 0.000 0 Lottery Credit: Claim Count: 0 Certification Date: 12/04/1998 Batch M P GRIVII Specials: ,� User Special Code Catego _ )-O (Amount 1 4� . -- Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00