HomeMy WebLinkAbout020-1388-07-000Wisconsin Dt:partrr~nt of Commerce PRIVATE SEWAGE SYSTEM
Safety,and Buildii4g Division
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)J.
Permit Holder's Name: City Village X Township
Schreiner, Ron Hudson Townshi
CST BM Eley~~e Insp. BM Elev: BM Description:
CC// c
TANK INFORMATION LEVATION DATA
TYPE MANUFACTURER CAPACITY
Septic
2.
Dosing
Aeration
Hol ' g
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD
Septic ~, ~ S 7 ~ ~s ~ .~ 3 ~ ! ~___.~_
Dosing
Aeration
Holdin
PUMP/SIPHON INFORMATION
Number
Loss
to
PM
R[~II ~RSnRPTInN SYSTEM / ., . 4 / ~ _ _ i
GO10~" St. Croix
Sanitary Permit No:
395278
State Plan ID No:
Parcel Tax No:
020-1388-07-000
STATION BS HI FS ELEV.
Benchmark
t ~r
O
Alt. BM
Bldg. Sewer ~ ~
SUHt Inlet A Z y p.
Q ~~s Z ~
St/Ht Outlet A
Dt Bott
Header/Man. ~ 3 ~ (~q Yv
Di~t.IPipe
~ µ L S
~-(?3` 140
~ ~L
Bot. System ~L G.asy~ - p~. ~
,i
Final Grade
d ~'~
-. S
9 3 . s3'
St Cover ~, ~
.~, S
~ .?. pp
df,
~ / 0, ;,o Q.~. ,~
BED/TRENCH
DIMENSIONS Width
S / Length
~ Z ~ ~ o. f Trenches
3 PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
SETBACK
INFORMATION SYSTEM TO P!L BLDG WELL LAKE/STREAM LANG
M R OR Manufa rer•
Type Of System: ,~, ~/ ~~~ r
,.- •~-~~ /
- NIT Model fjlumber:
r
DISTRIBUTION SYSTEM
Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake
Length Dia ~~ Pipe(s) i / ~
Length / z. r Dia / Spacing ~ (A
~/ j
SOIL OVER v Dreecurw Svc4ams rlnly YY Mnund Or At-Grade Systems Only
Depth Over Depth Over xx Depth of xx SeededlSodded xx Mulched
Bed/Trench Genter Bed/Trench Edges Topsoil ~ Yes ~ No ~ Yes ~ No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~_/ ~S/ G~ Inspection #2: / /,
~h
a~
~r
Location: 795 McCutcheon Road Hudson, WI 54016 (SE 1/4 NE 1/4 14T~2~9N R~,1(9_WI() Field Haven Lot Parcel No: 14.29.19.2381
1.) Alt BM Description = Y'~GO"u~W '~~~'~ ~r~UCkJay
2.) Bldg sewer length = ~ ~ S.~ ~_i'~ 1~ rt4y..S ~-o t,.~, St~:~ y
- amount of cover = ~FtaNi~ cry '~ ~U (k,,(f f Gtet, V.e~t/~.
3~~o~sc,/._~~~7L!`~• ~ s ,t,~`,/ i,1 la•) ~i~w~cr s~4~ G~.wt.~ rs t<< rig. . ~ sa~~s-
Pla~n reblsTdfY}~~qui~~' ~ '~'es No "'- ~
Use other side for additional information. 2'' ~
Dat Insepctor's ature Cert. No.
SBD-6710 (R.3/97)
7
~_~ ~' I r1 ~7~1
t' SafetyBUildings Divis~ County S'
C
x 7162
201 w
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WI 53x107 -
162
Madison Site Address
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De artment of Commerce lK
Sanitary Permit Applieatio~ Sanitary Permit Number
-...
In accord with Comm 83.21. Wis. Adm. Code. personal infoupafiop yox pravi~e
~
^ Chock if Revision ~ ` `~
ma bo used for ses Pri Law 1;1. ~
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I. Appliesion Formation -Please Prhtt All Information State Plan I.D. Number
1
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Property Owner's Nauw ~=-- i ~~ ~~:~ Parcel Number
Property'. ^'s Address <. ~1,, S l ~ • h
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~ Property Locaaon
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City, State Zip Code umber c.~ Lot Number Block Number
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CSM
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II. Type of Bwtlding (check all that apply)
/ l~Ciry
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~~~~ ~ ~ ~ ,~
~l or 2 Faatily Dwelling - Number of Bedrooms V „~~d!'ex._:~1frriCJ~.... Village
^ Public/Commercial -Describe use '~Townshi
^ State owned Nearest ~'~
III. Type of Permit: (Check only one bax on Ihte A (mmrmbering scheme for internal tree). Complete line B if appUcabie)
A' 1 ^ New 2 3 ^ Replacement of 6 ^ Addition to For County use Qa~j - / --
stem -'Tank Onl Bxis ~ stem ~ . a
B. ^ Check if Sanitary Permit Previously Issued Ptrmit Number Date Issued
3Y. Type of Permit: (Check all that apply)(twmuberiag scheme is for internal use) 2,., 3 ~X b ar ~ ~
7
~.
and
44~Non-Prtsaurized Ia-Ground 21~ Mound 4~ ~ Saud bitter 50 C~ Conshvcted WW
22 (] Pn:suuized In;-Ground 41 ~ Holding Tank 48 0 Single Pass 51 0 Drip Line 7D ~•~~ ~ u n 1'
> t ~E
45 ^ At-Grade 46 ~ Aerobic Treatnaem Urrit 49 ^ Racircula ' 30 ^ Other
V. D eIIt Area IIIfOCniat i011: f70 ~ ~ t 4 i e r
Design Flow (gpd) Dispcrstd Area
Retgured ~/~~~
W Dispersal Area
Pe+oposed~/`L ~
I `I. SoII Application
Rate(C:ala.mays+sq.~c~~~ Percolation
(Min.Jtnch) system ovation
8 / 8'(' ~ ~~~
~~ Final Glade
Elevation
'
'
~ ~ ~~~ , ~- 1 ~ 2 ~.~~ .o ~
9o.a ~a
VI. Tank Info Capacity in .Total Number Mam~tacturer Prefab Site Steel Fiber plastic
Gallons Gallons of Tanks Concrete Cotntntcted Glass
;~ Ta t S
~~v x
> ~ ~ ~ ~ ~ ~
VII. Statement- I, the , ter PnwTS shown oa the attached ghats.
Prlu~mber's Name (Ptiag) N Business Phone Number
Phmiber's Address (Street, City. S Code)
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P
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VIII. Coup /De t Use
ed ^ Disapproved ~ ~) Fee (includes titowdwater Date Issued Issuing A
gent Signahtte (No Stamps)
^ Owner Given Initial Adverse ~ ~.~, ~ n~ I r'1 ~ Z- (pl r
~ ~/~ .
Determination !~
/ ` !•L
I%. Conditions of ApprovaUReasons for Disapproval -- ~twrt, 1/`k. µZ ~ il't
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ntt~d-'aoariate riw (m ' ady) tor`thb s>~ oo rrer not tees ttms s7tZ: n ruches w s>xe
SBD-6398 (R. 45/01} ~~ ~
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11t=~sconsin Department of Commerce SOIL. VRLU~T QN REPORT Page ~ of
,,, ~~ Division of Safety and Buildings ~~~ i l ~•.`\
in accordance wi ~, Wis. ~ Ad
'~ ._
r~~u~ w~npie[e sue plan on paper not less than S 1/2 x 1 ' es ' i must '•.;•~' ''': ~ i `-~-~•) L
inGude, but not limited to: vertical and horizontal refere ce int (B and •''~
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percent slope, scale or dimensions, north arrow, and l .
and distance to ne
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er road:- parcel LD.
; ~ ~ - 13~' $'-07
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Please print all inform ~
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.. . Reviews b Date
Personal information you provide may be used for secondary ..
T
es (Privacy~3 ,. ~4 EY) (m));--~
9 /L O~
Property Owner
~ tot:atioh
~T~ SCl~1Z~1.r~1~-R ,
lr~.,.,~,: ~'~~ 1141V~1/4 S l~ T Z~ N R :~~ E(o W
Property Owner's Mailing Address '_~ 1 % ~} ~ '' 'Block # Subd. Name or CSM#
City State Zip Code Phone Number ^ City ^ Village (Town Nearest Road
~USO~ w1 S~(Ol b ~`1LS) Z~7 - 33 ~$ `~-lv~S01v ~ C CUTC~~~l )ZD
^ New Construction Use: ~ Residential /Number of bedrooms ~_ Code derived design flow rate ~ [~ f~ GPD
(~Repiacement ^ Public or commercial -Describe:
Parent material G t.{~-~l'Pf'L. Q V~'bV~~ }~ Flood Plain elevation if applicable 1V ~ ft.
General comments
and recommendations:
~~) h'1>v! ~.1~ 3 e•~zrs ~
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6 l.v~ L O ~~ tT'S
o~ H~,G~ e-tq-~i~t~c-y s t,~,~w)~b~z L r~tt~wr~~s P~ ec~.
Qom >~1 of N~.g 70 ~L ~ L~sr 611c~ `~ S ~ 6 N-o~Z~zo ~ .
^ Boring # ^ Boring '~11V9 1"l,Pt~Clt"lu1"! bp" D~~ .
pit Ground surface elev. ~.b •~ ft. Depth to limiting factor 7 Ll~ in.
Soil Appfigtion Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#~ •Eff#2
~ O-1~ lo`1.TZ.3lz - Sly Z~ S~k ~.SY1 G+N Zf' • 5 •$
2. t~ -3 S to ~ ~z~16 -- s i 1 z~F-s1~~ s 1-t ~-S - . s . ~
3 3S-CIS ~ •S`ttz3~Y - S $ i;r o ~g d~,1 c-S - .~ ~_ i.
y ~S-11~ ~~ ~R X116 - S ~Gt• O s4 rA,l - .~ ~z
cot. a q
$5-~
^ Boring # ^ Boring
® pit Ground surface elev. ~ ~ . ~ ft. Depth to limiting factor ? 112 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2
~ o-t.s to~.2.3~z -, stS Zn1sb~ ~h c~ z.f .S -8
Z 1S 3q 1p~-j2316 -- S'i1 3~sbh s aw - •5 •a
3 3oj S 10 ~'! 2 3 ~ ~ -~ S 1 I 1'n'1 S ~ }
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h~ C°.g - • Z _ 3
Sy-11Z l~~t fZ ~!~ _ S ~ 61- ~O Sq cn
1
at. ~ - .-1 t..- Z
(9~ q, t0
~muent ~, = rsuus ~ su ~ ~u mgrs aria i ss Sao _< tsa mg/t_ • Emuent ~Z =Bobs < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Sig lure CST Number
Arthur L. tde;rerer ~ ~ ~ -~-y ~ 220254
Address [~ e g e r e r S o i l T e s t i n g & Design S e r v i c e Date Evacuation Conducted Telephone Number
421 d• %iain St. giver calls, t1I 54022- g_~y_o) 715-425-0165
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Property Owner S~~{-~Z--~'1..?~
ParceitD# ~~~ 1'3a~ -~,
... . `...:,..., .e
p;;,e . 7 ... 3
Boring # ^ Boring
® pit Ground surface elev. ~ 3 • s ft. Depth to Ifmiting factor ~ ~ ~ In.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft'
in. Munsell Qu. Sz. Cont. Color " Gr. Sz. Sh. •Eff#1 •Eff#2
0-9 iu~1,tZ~iz - sit Z~-'sb--L 1-~ GS L~ •S -8
^ Boring # ^ Boring
n ai- Ground surface elev. ft_ nar,r-, r~ i~r.,~ri~~ f~,.r.,~ ~..
Horizon
Depth
Dominant Color
.Redox Description
Texture ~~~~
Structure Consistence Boundary Roots Soil Application Rate
GPD/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'EtT#1 'Eff#2
~ S L 1. C`.U `~E C.o-~1, t/k IN ~sT'! ~ .
b ~~- v s S >v G D ~S rvtJT.
~,S L2 •` ~ O'er w L s T ~j kJ ~ ~ ~~
CJ ~" 2.,
^ 8oring # ^ Boring
^ Pit Ground surface elev. ft, Depth to limiting factor In. .
Soil Appligtion Rate
Horizon Depth Dominant Color Redox Description Texture Stnrcture Consistence Boundary Roots ~ GPD/ft2 -~-
in. MunseN Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'EfT#2
k
;.
1
'Effluent #1 =BODE > 30 < 220 mg/l and TSS >30 < 150 mg/L * Effluent #2 = BODa < 30 mg/L and TSS < 30 mglL
- 4
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608=264-8777.
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CST Signature
8 _~y_0 ~ 715-425-0165 220254 p l _Zp
Date Telephone T•do. CST T~do. Job PdO.
Property Owner S~~'~~'1J~,1Z
ParcellD# ~~~ 13~~ -o,
Paap ~ of
^ Boring # ^ Boring
3 ®Pit Ground surface elev. ~ 3 • S ft. Depth to limiting factor ~ ~ ~ in.
Soii Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2
0-~ tb`1,t2_..~tz -- stl Z`~'sbiz ~"1 CS L•F •S -fi
^ Boring # ^ Boring
^ ,Pit Ground surface elev. ft. Depth to Ifmifing factor In.
Soil Application Rate
Horizon Depth Dominant Color ..Redox Description Texture Structure Consistence Boundary Roots GPD/ft~
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. «Etf#1 «Eff#2
~ S LL C`.U11.~ ~r"L L~ 6N X1^1 G
b ~. v ~ s ~ G o u/v 1s rvur«
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^ Boring # ^ Boring
^ Pit Ground surface elev. ft. Depth to limiting factor in.
Soii Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots r GPD/ftt
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. «Eff#1 •Eff#2
• Efnuent #1 = BODs > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODa < 30 mglL and TSS < 30 mglL
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or "
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608=264-$777.
SBD-8330 (R.N00)
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CST Signature Date
~ 715-425-0165 220254 _ ~p~ Zo6
Telephone Igo. CST X10. Job P70.
Private Onsite Wastewater Treatment System Management Plan
Septic Tank And Gravity In-Ground Soil Absorption Component
Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment
System (POWYS) shall include information and procedures for maintaining the system within
the parameters of Comm 83 and 84, and the conditions of approval by the department, agent,
or governmental unit. The approved plans and permits for system are on file at the county
zoning or health department.
This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground
Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD-
Table 1: System Design Specifications
Sanitary Permit Number So~-$'
Number of Bedrooms
Design Flow -Peak (gpd) D d
Estimated Flow -Average (gpd) ~
Septic Tank Capacity (gal) U!~
Soil Absorption Component Size (ft2) - (~
Type of Wastewater Domestic jC
Table 2: Soil Absorption Component -Limits of Reliable Operation
Septic Tank Component Soil Absorptio Component
Design Flow -Peak (gpd) Ia 6d~
Maximum Influent Particle Size (in) 1/8
Maximum BOD5 (mg/L) 220
Maximum TSS (mg/L) 150
Tab le 3: Maintenance Schedule
Septic Tank Inspect and/or service once every 3 years
Outlet Filter Inspect once a year and clean at least once every 3 years
Soil Absorption Component Inspect once every 3 years
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks
under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with
NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease
Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable
Restrooms).
The operating condition of the septic tank and outlet filter shall be assessed at least
once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure
proper operation. The filter cartridge should not be removed unless provisions are made to
retain solids in the tank that may slough off the filter when removed from its enclosure. If the
Management Plan for a Septic Tank and Soil Absorption Component
filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously.
Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The
septic tank shall have its contents removed when the volume of scum and sludge in the tank
exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the
time of an assessment, maintenance personnel shall advise the owner of when the next service
needs to be pertormed to maintain less than maximum scum and sludge accumulation in the
tank.
Manhole risers, access risers and covers should be inspected for water tightness and
soundness. Access openings used for service and assessment shall be sealed watertight upon
the completion of service. Any opening deemed unsound, defective, or subject to failure must
be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by
an effective {ocking device to prevent accidental or unauthorized entry into the tank.
No one should enter a septic or other treatment or holding tank for
any reason without being in full compliance with OSHA standards for
entering a confined space. The atmosphere. within the septic or other
treatment of holding tank may contain lethal gases, and rescue of a
person from fhe interior of the tank maybe difficult or impossible.
Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the
tank is no longer used as a POWTS component.
Soil Absorption Component
The soil absorption component serving this structure is designed to accept domestic
wastewater from a residential facility. The limits of operation of this component are shown in
Table 2.
The longevity of a soil absorption component depends greatly on proper and timely
maintenance, and system use within or below the limits of reliable operation. Good water
conservation practices by all occupants and the installation of water conserving plumbing
fixtures are key factors in extending the useful life of this component.
The soil absorption component's operation must be assessed by inspection at least
once every three years. The inspection shall include recording the levels of ponding, if any, in
the observation pipes, and a visual inspection for any evidence of surface seepage or discharge
from the component. On steeply sloping sites, areas of erosion should be identified and
reported to the owner for repair. The surface discharge of domestic wastewater or sewage
from the system is prohibited and considered a human health hazard.
Traffic around or aver the soil absorption component should be avoided particularly
during winter months. The compaction or removal of snow cover over the component may lead
to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or
impossible to repair until weather conditions improve. In general, soil compaction over this
component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to
more intense, and earlier, organic clogging of the soil.
2
Management Plan for a Septic Tank and Soil Absorption Component
Plantings of deep-rooted trees and shrubs directly over or within ten feet of the
component should be avoided since root intrusion into the component may obstruct wastewater
flow.
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ST CROIX COUNT'X
SL'PTIC TANK MA(NTL~NANCB AG[LL~eMeNT
wnu uy
Mailing Address
Propexty Address
AND
OWNBRSNIP CP.ILTIFiCATION FORM
~.
(Verification ttquutd from Planing Depat4nent foe aew coastzuction)
t~ityfStatc ` ~ ~~ S ~h a 1 f Parrs[ Ideuiific~tion Number
x.EGAL U~SCI~
Property 'oa ~~ ~...~~%, Soa ~,
Subdivision
T._.Z_ri ~_1:,Lw. Town of
Lot # ~~.
~`t;tfifad Stuvey Map # Voltrmc .Rage !#
war>;~aty D~a ~ 6 ~ ~6 '1 ~ Volume ~~ ~ 1 ~C/ .
Page # r
Spe~.bovso ^ Yes ~ no Lot Imes ideatifablc ~ yes []. no
SYST~VI:iI~tA'II~l'1',~~y~.'N(;gr, -
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oosai~ts ofpaa~g aat rile ~~~cy>uroc P~~c~ta~oaet~o I~evrufcs.ProQetmaiaticoam~oe
sari:ffott.~eoa~oftlye ~ori00°~ifa~dodby~ri~oeasodp~ ~yp¢p~.m~botbesps~
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Ttae.ProP~S"~~nesto mba~tto St ~~~ signori bpffieoaraaeaidliy:
P~ or:
~'~`410~` ~ Chit theon~owba
uiapavpcr'~P~:adlor(7jafta~~~n°Y~.~s~~kss$aa1l3#~~'sludga.
. ~- ~ Inrne~d the abome nogoirca~ and agme ~ ~iatiro pavitc sevrage ditlosat system t~ Qre sCaadat+ds
~~'~"~~~'~~~mmanc~ndQreDtof'I~Calg,~so,m~o~;ScateofWssoonsia~ Qatificahca
~~u~csystCmbas'6ocaiaaia~~tbeeompictodta~d~+cGnon~odt~otlyeStQvncCowityZ~iagOtroe~34
dayr•of A~e _tbc~x year ~ia~ dafe.
~ / 3/~
SIGNA'P[lRB OF APPI,IC,AIdT DATE
. I (arc) oafiily'y that all stataaogts oa this fa~,u rte tmc to the 6«t of my (onaj kaoartodgo. I (arcj aat (arcj the owner(s) of
~ ProF~Y abom~, by tnr~c of a
r waaa,a~tjr flood tncordod is ILcgistcc of Doody Office.,
SIGNtiTt3R$ OF ~IPPIICANT e 1 3 i~ l
DATE
s«~«sa ~ infocmatioa that is this
'r~Y test in tho sanitary pcrmi~t bang t+evolccd by the Zoniag Dcpact~uart. •"' • •
ss Xadatdc ~rlth thtc app[icaUon: a sha~od ~~, flood from tluc R~egistcr of Roods otYicc
a Dopy of true ocrtiCcd carvcY maA if ocfacaoc is made is the vramanty dcod
~ P. - ~'
><~~ 1691PA~E :_
tiTA'I'C DAR OF WISCONSIN FORM 1 - 1999
Document Numher WARRANTY DEF,D
Tl{is Deed, made between I,aCasse Development, Inc.
Grantor, and Ron -Schreiner and 1Cim Liend husband and wife
Grautec.
Grantor, far a valuable consideration, conveys to Grantee the
following described real estate in St. Croix County,
State oC Wisconsin (if mare space is needed, please attach addendum):
"fhe Bast Half of the Southeast Quarter of the Northeast Quarter (E1/2 ofS)r
I/4 ofNl3 1/A), Section 14,'fownship 29 North, Range l9 West, Town of
Flurlson.
RETURN TO: TITLE ONE
706 19TH STREET SOUTH
HUDSON, W! 54016
oza loza-~o-ooo
Parcel Identification Number (PIN)
Together with all appurtenant rights, title and interests. This is not homestead property.
Grantor wan ants that the title to the Property is good, indefeasible in fee simple and free and(clear of encumbrances except
easements, restrictions and rights-oC-way otrecord, if any.
Dated this~21_5~ day of July 200]
L.aCasse Develgyut nt, h .
-----------'---- - ~~it/--'_
- ` by ~ It's
°~4'S
+ -
5tgnaturc(s)
AU"CHENTICA'fION
authenticated this _ day of~
ACKNOWLEDGI4IENT
ST'AI"I'll OF ~JJ.~ Scr~ S v` )
S-~. erUlyC County ~ ss.
Personally came before me this ~- day of
July , _2001 the above named
LaCasse Development, loc.
'fI1'LG: MEMBER STATE BAR OF WISCONSIN _
(lf not, to me known to be the person(s) who esecuted~~le,,Coregoiug
authorized by § 70C>.0(, Wis. Stats.) instnu ~ri~ d ackn ,wled at
,ES J.• ~
THIS INST'RUMEN'T WAS DRAFTED BY ,r
Attorney Krishna Ogland, ••S
Iludsun,lYi !- Notary Public, Slalc of ; %.td1' c
My Commission is pern anent. t~~
(Signatures may be authenticated or acknowledged. Both are not necessary.) _ a . ~ i~, ti
v
Naives utpersnns signing in any capacity must be typed or printed below their signature. kdorrratwn yore •'
ppN~'ARRAN'{;'1Y pEEU STATF,bAROFWI5CON51N ~`aaQY.4~pvw~.wt
SODS ~~(7 FORM Nn. I - 1999 •F. ~r •a~-csssnt
~-~~y a~~~~ ~ w~a 1~ ~~~~~ ~ ~-~~~ r'~ ~ s
r G.o~`'~~ ~~,~ Deed oh`~i~P
652677
i'.ATNLEEN H. WALSH
kFGISTEk OF DEEDS
Si. CfiUIX CD., WI
RECEIVED FOk kECOkD
08-O1-2D01 1:30 PM
AAkkANTY DEED
EY.EMPT II
CEkT COPY FEE;
COPY FEE:
ikANSFEk fEE: 574.40
kECOkDING FEE: 10.40 ;;~
PAGES: 1
. J
4
Recording Arca
Natne and Return Address
-H
AV
E
N
NE COR. ~ I (~i I
SE1 /4 OF THE NE1 /4 OF SECTION 7 4, SEC. 14 ~~1 ~ ~~ ~
-DSON, ST. CROIX COUNTY, WISCONSIN Q I~ I
dlal
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dodo ~ 09 G~LaEC~ ~~7~~ s r ~, I ~ I
I Eiji
~,(p 4 ~ I d04 6 NORTH UNE OF THE ~ O
_-- _ _L ---- SE1/40FTHENEt/4 I~I
.ON ROAD 9,35'21 "W 658.59'
w
°E ~ - w
~~ w
N89°46'06"E 499.48' w
Fj' `~ y \ DRAINAGE EASEMENT j ~
~ ~ H.W.L. = 932.00 i ~
\ C6 `\\ 100' M
,\ '
~ EXISTING 2
\ • • ~~~j`QQ`~~~~`~ Ta~gg .. _ .. DRIVE
~~ \ ~ ~ PClf~I61N~AREA..- _..-.._.._ ._. ..-..-.. _..
\ ~~~° \~\ ~0~' \ EXISTING h
sew \ ~~i5` y~ '•\ HOUSE ~
~~ ~i9cS`j,\ ~ ~~= \••\ 2.829 ACRES
W 123,228 SQ FT
~ \ ~ \ ~ ~ MINIMUM FIRST FLOOR ~~~(~~ 8
IEf~,T \ ~~ tJ ELEVATION OF 936.40 WiY~
\ \\ ~~ ~ ~ c~ \ ~~2°~ ESHEDG
~vATER \ \ ~ •\ -~ \ S S8' N89°44'43°W 191.42'
G AREA . ~ C5 \ ~\
\\ 2 \
\~ ~ ~ 1
.~
\ 1 ;` ,~, ~ ~ EXISTING
` ` I i SHED
I II 33' 33' I 3~±
~ I I I EXISTING
0 ~ o N -I i CONCRETE
~ ~t ~ ~ ~ EX STING STRUCTURES t~ ~
~''~ N I TO BE REMOVED ~ N I
'_~~~rn ~ I
~'E 264.41 ` I ~ N~ N I ~ g ~ Q I [~ I
~ I" y c' I ~ 2.219 ACRES I LwJ I
I I" I~ j ~ 96,659 SQ FT b~ ~I~ I
I h I
~ ~ r I S89°27'54"W 327.17' ri l 101
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