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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
Safety and Buildings Division INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Parcnnat information you arovlce may lie used for secondary purposes [Privacy Law, s.15.04 (1)(m)J.
Permit Holder's Name: ^ City ^ Village Town of:
C~~~Y a~r~ 1 ~ k~.l erc.~ ~~~~
CST BM Elev.; Insp. BM Elev.: BM Description: _
TONK INFORMATION ~~ ~~~ ~ ELEVATION DAl
TYPE MANUFACTURER CAPACITY
Septic ~~{ ~I~ , ~~ /•
Dosing ~ C~(Lrjl~
Holding
TANK SETBACK INFORMATION
TANK TO P/ L WELL BLDG. vent to
Air Intake ROAD
Septic }- o2~P.~~ _.. NA
Dosing ~ (~ ~~ K NA
Aeration ~) 0 T-rw t S u.9 ~ NA
Holding 3'~3 ~c
PUMP /SIPHON INFORMATION
Manufacturer Demand
Model Number GPM
TDH Lift Lriction System TDH Ft
Forcemain Length Dia. I-f Dist.ToWelt
~~~~ wneAO~Tlnwt ~V~TC11A
County:
~ : Cry
Sanitary Permit No.:'
J~~ Vii'
State Ptan ID No.:
/P--a~~r~~c~~el Tax No~.1:
STATION BS HI FS ELEV.
Benchmark r ~ ~ I y• D d D. Ulm
~ of -~~~ ` ~ CB ~~ ~•
Bldg. Sewer S:~jQ 8.30
S / Ht Inlet .y0 ~~: $~
S / Ht Outlet (p.~~ cf .S0
Dt Inlet
Dt Bottom
Header /Man. ~,(p0 (p. (o O
Dist. Pipe
9gy~1''
Bo .~gstern ~
~ r r. 3 9r yr
p
Final Grade •(pa ~/ , 6p
~- ,~ a.y~ o . ~ o
2..r1d c~•l y
s ~~ I , a. b f ~n
7k1QCIY~I LL(~~ l~f lW~~~
th
id De
Li
BED /TRENCH width ~ Len th No. q~Trenches
d~ PIT
DtMEN 1 N No. Of Pits qu
p
Inside Dia.
DIM N 1 N -J LEACHING Manu adurer:
SYSTEM TO P / L BLDG WELL LAKE /STREAM
SETBACK CHAMBER
INFORMATION Type O ` /
V
t
S
1~
Sc~' t
~ ~
~ t~
OR UNIT- Mo a Num er:
em:
ys ,-.
r~~e~Tnt~t tTtAAI ~V~TC11A / ~ 1 n ~~ 1 ~ r 1 ~ ~ ~ n ~_l.c D/V-!t k, (JI l 1(' EL ~/ (Jl I `~
v~r ..~.rv..v.. ~. ~. ~
Header /Manifold t~
~
~ .-. ~ V - V J
Distn ution Pipe{s) ~
acin
S ~., --_
x Hole Size -
x Hole Spacing
Vent To Air Intake
Dia.
Length~ g
p
length a.
enn ~nvFR ,. araeeure Systems Only xx Mound Or At-Grade Systems Only
~
Depth Over ~ Depth Over xx Depth Of xx Seeded /Sodded xx Mulched
~
.
Bed ren enter ~ ~L y Bed /Trench Edges Topsoil ^ Yes ^ No ^ Yes ^ No
c ~ - r- r ti ~~ ~,.. ~-.1
COM ENTS ~ Includ code dis repancies, persons present, etc. /
}~,~~ ~ .s-~,,~ 1 ~.bo~t- ~ / ~f s sleet
b ~`t~rR y
~l~asw~ed~ c~r~~ `w ~d in ~ 1 ~ ~~
~y. ~ o~ . S s~rnC.UtxS n~.8o~ ~~~ ~ ~
S hem I`~ (6 y, ~~) ~ S~ is ~-
~p~ ~~Z~.'~li'~ ~ 131
Plan revision required? ^ Yes No ~ ~- ~~
Use other side for additional informa ion. ~3
Date Inspector's Signature Cert. No.
SBD-6710 (R.3/97)
~i
0
commerce.uvi.gav Safety and u tugs County
~ ~~
~ ~ 201 W. Washington Ave., P.O. Box 7162 ~D )
/'-/'- ~ ~ ~
V
V
^ ^ Madison, W 153707-7162 by Co.)
Sanitary Permit Number (to be fi^l~led in
Depart
rrt ctf
Cotrtt~rese
me J
~Qr(~ ~~ ice"
Sanitary Permit App
' State Transact}on umber
rt
I n
Wis. Adm. Code, submission o
to accordance with s. Comm. 83.21(2) C~
this fo ~p~ria3~Dvemm ntal "
~
,'C
,
unit is required prior to obtaining a sanitary permit. Note: Applic lion forms for state-owned POWT are Project Address (if different than mailing address)
submitted to the Department of Commerce. Personal iptformation ou provide ma be used for seco ary
u ses in accordance with the Privac Law, s. 15.04(1 tm ,Slats. /7 7"
I. A lication Information -Please Print All Information 44.• ,
Propeny Owner's Name
ST. CROIX COUNTY Parcel #
Property Owner's Mailin Address Property Locati~ _ ./,~
~Yt/~~-
Govt. Lot
City, Stat
Zip Code
/
Phone Number l
i~ y., ~Y,, Section
cle on
~c~
/ !
~~ / ~b ~
r
T ~ 9 N~ R / J g~
-
Type of Building (check all that apply)
II Lot # -F-t-
C/
.
~ ~ Subdivision Name
__ __. _
1 or 2 Fam' y Dwe ing - Number of Bedroo
~ _
~~
'~
r '
i~
~ /
~ Block # .
iy D }
^ Public/Commercial -Describe Use ZL J 5 A ~ ^ City of
~ r `
/ ~"
^ Stat caned -Describe Use CSM Number ^ Village of _
~
~~ ~ \ I ~
~J l~__ i
own of
~
lli. Type o Permit: (Ghee only one bo on line ...Complete line B if applicable) ~'Yj o"Z.
"4'
y
S stem
^ Replacemen[ System
! ^ Treatmenr/Holding Tank Repiaceme my
^ Other Modification to Existing S stem (explain)
B. ^ Permit Renewal ^ Permit Revision ^ Change of Plumber ^ Permit Transfer to New
List Previous Permit Number and Date Issued
Before Expira[ion Owner
IV. T e of POW'TS S stem/Com onent/Device: (Check all that a 1
n. ofsuita le ^ of nd < 24 in. of suitable soil
24
^ Mound
i
an-Pressurized ]n-Ground ^ Pressurized !n-Grounzl ^ At- red
e
>~
,
j
/
_
~
/
^ Holding Tank ^ Other Dispersal Component (explain} /t ~ ~71'LG~I~'"' W / Pretreatment a [ce x ain
V. Dis ersal/Treatment Area Information: ~ ~
Design Flow (gpd)
~' Design Soil Application Rate(gpdsf)
~ Dispersal Area Required (sf) Dispersal Area Proposed (s
' System Elevati ~~ , /
~ '
y
S2~ - 7 ~ ~ ~
9 / J
VI. Tank Info Capacity in I Total # of Manufacturer
~
Gaiions Gailons Units
/
~
~ B
~
U °~
^
y .~
V
Ncw Tanks
~,,y,.
Exist T
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t//~~/r/~~ T/~
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~
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Septic or Holding Tank Q/'t
V `L
Dosing Chamber
VII. Responsibility Statement- 1, the undersigned, as a responsibility for installation of the POWTS shown on the attached plans.
Plumb is Name (Print) Plumb ignature MP/MPRS Number Business Phone Number
~ ~.Q,,,t,v,.c~, 2 2 6 i crU ~%r.-t~f~~- ~-
Plum/ber's. Address (Street, City, St te. Zip Code) (
~p
,
VIII. unt /De artment Use Onl
pproved ^ Disapproved ~ermit~ 0'U Date Issued I uing Age Si
^ Owner Given Reason for Denial ~
IX. Conditions of Approval/Reasons for Disapproval //1 ~~Z~ Q~ ~, ~_ ~~~ „ „/~~'~t~'1'~
~~ ~!' "'_
L
""""
SYSTEM OWNER
~% '
G
~
:
9 Septic tank, effluent filter and 07zCc
G~i~Gti~~l
dispersal cell must aA be s rvi ed /maintained -
as per management plan provided by plumber.
2.
p pp ~ ~ft iTh tb't't}fitplNte lil'd+i#t6irlli6#iJst nd s it ro the County only n .per not kss the tR~ s ir/Y !~'- '~~'~fW'~"
as era Ilcable co e~ordinances.
SBD-6398 (R. Oi/07) Valid thtu 01/09 ,,iG~t~`~,`/,~' / I/ G~J/Xa"' '
PROJECT Gordon Keller
NE i/4 MN i/4S 15 /T
PLOT PLAN
ADDRESS 981 Ctv Rd A Hudson Wi 54016
N/R 19 W TOWN Hudson COUNTY ST. CROIX
r 5/29/07 5
MPRS Shaun Bi
rd 226900 a
DATE BEDROOM
CONVENTIONAL XXX IN-GROU PRESSURE CONVENTIONAL LIFT HOLDING TANK
SEPTIC TANK SIZE 1000/630 LIFT TANK SIZE DOSE TANK SIZE
MOUND
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 1091 # of chambe s 54
,BENCHMARK V.R.P. Top of spike? ASSUME ELEVATION 100° Filter BEST Filter
^BOREHOLE O WELL *x.R.P. Same as Benchmark
SYSTEM ELEVATION 94.8/94.4' 4.5' below grade
~ _ ~ 8' _ 12 _ 37' _ 574' pronertV line
/_
~-
B-3
2~
vents
B-1 ~ ~ 180'
1a,
L
2-3' X 110' 27 ~'~" ~'~
it >3' Spacing
// B-2 Vent
>6"
of Cover
12"
4' Long
34"
10'
Huffcutt Combo tank
25'
Pro 5
Bedroom
House
Plans Designed Using
Conventional Powts
Manual Version 2.0
229'
System is to
be installed
along the
contours
4% Slope ?
Rd A
Well is to meet all
setbacks required by
WDNR
M.
Quick4 Standard-W
Leaching Chamber
with 20.0 ft2 of Area
5.8ft^2/pair of end caps
at System Elevation
IV
~~~
Wisconsin Department of Comme OlL EVALUATION REPORT
Division of Safety and Buildings
in ar~aaee~ollTfComm 85, Wis. Adm. Code
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and p~ I.p.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information. Revie
Personal information you provide may be used for se ~ ;~y~(S~ 75.04 ( ) (m)).
Page 1 of 3
ST. CROIX
ZS` ~
Date
y~Z~o
GORDON & DANA KELL R vt. Lo ---- NE 1/4 NW 1/4 ~ 1 T 29 N R 19 E (or) W
Property OwnePs Mailing Address Lot # Block # Sutxi. N or CSM# ~ ~ 2 - y ~ q
981 C.T.H. A - -- (Pending) b 6
City State Zip Code Ph a Nu ity ~ Village Town Nearest Road
Hudson, WI 54016 ( 7 C.T.H. A
New Construction Use>~ Residential / Number of bedrooms 5 Code derived design flow rate 750 GPD
Replacement ~ Public or commerclal -Describe:
Parent material outwash plains Flood Plain elevation if applicable 1~A ft.
General comments Conventional In-ground trenches -- 0.71oading rate -- to be designed by installer after basement depth determined.
and recommendations:
of
puss;l~. 95.75 <3.5 halv,..~ ~~ frost)
1^ Boring # 0 Boring ~
Q pit Ground surface elev. 99.50 ft. Depth to liming factor 120 in.
Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2
1 0-8 10YR2/1 --- 1 lfgr mvfr cb 2vf-co 0.4 0.6
2 8-18 10YR2/1 ~ -- sl if-msbk mvfr cs lvf-m 0.4 0.7
3 18-30 7.SYR3/2 -- is lf--msbk mvfr cw lvf-m 0.7 1.6
4 30-41 7.SYR3/2 -- ~ lcos Osg ml cw lvf-f 0.7 1.6
5 41-120 7.SYR4/4 -- ~ cos Osg ml -- -- 0.7 1.6
(Backside of pit had a pocket of clay at 41- 51 ")
(Few cobs)
2 (J
Boring # Boring 99.40 J
116
Pit Ground surface elev. ft. Depth to limiting factor in.
Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 "Eff#2
1 0-10 10YR2/1 -- 1 2fgr mvfr cb 2vf-m 0.4 0.6
2 10-18 10YR3/2 -- sl lf--msbk mvfr cs lvf-co 0.4 0.7
3 18-36 10YR4/4 ~ -- sil 2fsbk mfr cs lvf-f 0.6 0.8
4 36-41 7.SYR4/4 -- / is Osg ml cs lvf-f 0.7 1.6
5 41-46 7.SYR3/4 -- ~ •~5 a cos Osg ml cs __ 0.7 1.6
6 46-87 7.SYR4/4 - " g~ cos Osg ml cs -- 0.7 1.6
7 87-116 10YR5/4 -- s Osg dl -- -- 0.7 1.6
* Effluent #1 = BOD > 30 < ?20 mg/L and TSS >30 < 150 mg/L ' Etfluent #2 = BOD < 30 rng/L and TSS < 30 mg/L
CST Name (Please Print) re CST Number
Ma Jo Hollister Hollister's Soil Testin & Desi n 224832
Address Date Evaluation Concluded Telephone Number
W9875 690th Avenue, River Falls, WI 54022 04 - O1 - 07 (715) 426 - 1775
Property Owner KELLER, Gordon Parcel ID #
(Pending)
2 3
Page of _
3 V Boring ,/
Baring # ^ Prt Ground surface elev. 99.25 ft. Depth to limiting fador 126 in.
Soil igtion Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fi?
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-4 10YR2/2 -- 1 1 fTn' mvfr cb 2vf-m 0.4 0.6
2 4-9 10YR2/2 __ 1 2f mvfr as lvf-m 0.6 1.0
3 9-16 10YR3/2 -- sil lfpr mfr as lvf-m 0.4c 0.6
4 16-28 10YR4/4 -- sil 2fsbk mfr as lvf-m 0.6 0.8
g 28-40 7.SYR2.5/3 -- ~ ~ r cos Osg ml cs lvf-m 0.7 1.6
6 40-48 7.SYR3/4 - t cos Osg ml cs -- 0.7 1.6
7 48-126 7.SYR4/4 -- s Osg ml -- -- 0.7 1.6
^ Boring # ~J Boring
Pit Ground surface elev. ft. Depth to limiting fador in.
Soil ication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/f1?
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
(Few cobs & stones.)
^ Boring # Bonng
Pit Ground surface elev. ft. Depth to limiting fador in.
Soil Iication Rate
Horizon Depth Dominant Color Redox Description Texture Strudure Consistence Boundary Roots GP D/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
* Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
SBD-8330Test (R.07/00)
W
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98:30'
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37'
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574.2'
X X
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- _ ~ ~ Site Location:
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207.56'
3 9°38'43"W 263.67' zo
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PLOT PLAN
PROJECT Gordon Keller ADDRESS 981 Ctv Rd A Hudson Wi 54016
NE 1/4 NW i/4S 15 /T N/R 19 W TOWN Hudson COUNTY ST.CROIX
~'' 5/29/07 5
MPRS Shaun Bird 226900 DATE BEDROOM
CONVENTIONAL XXXX IN-GROU PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE i 000/630 LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE •7 ABSORPTION AREA 1091 # of chambe s 54
,BENCHMARK V.R.P. Top of spike? ASSUME ELEVATION 100' Filter BEST Filter
^ BOREHOLE O WELL *H.R.P. Same as Benchmark
SYSTEM ELEVATION 94.8/94.4' 4.5' below grade
12' 37' 574' property line
123'
/_I
~t--
1`
M
Plans Designed Using
Conventional Powts
Manual Version 2.0
229'
System is to
be installed
along the
contours
4°Io Slope ?
B-3
vents
~ B-1 ~ ~ 180'
l too
L
10'
Huffcutt Combo tank
25
Pro 5
Bedroom
House
Rd A
Well is to meet all
setbacks required by
WDNR
2-3' X 110' Z 7 ~' ~~
it >3' Spacing
B-2 Vent
>6„ Quick4 Standard-W
of Cover Leaching Chamber
with 20.0 ft2 of Area
12" 5.8ft^2/pair of end caps
4' Long
Grade at System Elevation
M.
OwnerBuyer
it
ST. CROIX COUNTY
SEPTICTANK MAINTENANCE AGREEMENT
AND
OW(NER.SI~IP CERTIFICATION FORM
Mailing Address
Property Address
City/State
~ ~1 R 5
(Verification required from Planning &
LEGAL DESCRIPTION
Properly Location ~ 1/4 , _~ 1/4 ,
Subdivision
Certified Survey Map #
for new
Parcel Identification Number ~ Z d' /~Z Jam' ~d ''
i t~ I j
Sec. ~, T 2 / N R 1 Vt/, Town of l~~~s-~~
~e~ ~~~
Lot # _~_~_,,.
Volume Z' Z' ,Page # ~~
` /D`f~ P e#3D Z
Warranty Deed # `--~~3a _, Volume ag
Spec house ~ i no Lot Imes identifiable yes no
L--~ _iL_
SYSTEM MAINTENANCE AND O'S~VNER CERTIFICATION
improper use and maintenance of your:,' septic system could result in its premature failure to handle wastes. Proper
maintenance consists of pumping our the septic~tank every three years or sooner, if needed, by a licensed pumper. What. you put into
the system can affect the function of the septic as a treatment stage in the waste disposal system Owner maintenance
responsibilities are specified in §Comm. 83.52( )and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit t~ St. Croix County Planning & Zoning Department a certification form, signed by the
owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (I) the on-site
wastewater disposal system is in proper operati~-g condition and/or {2) after inspection and pumping (if necessary), the septic tank is
less than i/3 full of sludge. j
T/we, the undersigned have read the ab}~ve requirements and agree to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Dep t of Commerce and the Department of Natural Resources, State of Wisconsin.
Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning &
Zoning Department within 30 days of the three year expiration date.
Uwe certify that all statements on this ~orm are true to the best of my/our knowledge. Uwe am/are the owner(s) of the
property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
of bedrooms
DATE
***Any information that is misrepresented mayj result in the sanitary permit being revoked by the Planning ~ Zoning Department. ***
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed.
(REV. 48/05)
Maintenance and Contingency Plan for a Septic System
Maintenance Plan
1. Septic Tank is to be pumped once every 3 years.
2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in
order to extend the maintenance interval of the filter.
3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of
the cells.
4.Owner agrees to limit greases, garbage, and water conditioner discharge into the system.
5. The owner agrees to save this plan.
6. Do not plant trees nor park nor drive over system.
7. Watershed is to be diverted away from system.
8. Discharge into system is not exceed those required as per Comm. 83
Co cy Plan
Option # . If system fails, determine cause of failure, use alternate area and install new
sy em in tested replacement area.
Option #2. Install system at a lower elevation, by removing chambers, removing biomat,
and install new system.
Option#3. No adequate area is suitable for replacement area, and system elevation
cannont be lowered. Install holding tank as last resort.
3. Replace any other failing components as needed.
Plumber: Shaun Bird 715-246-4516
St. Croix County Zoning 715-386-4680
Pumper Tom Mondor 715-246-5148
Shaun Bird #226900
Parcel #: 020-1025-90-100 05/31/2007 01:00 PM
PAGE10F1
Alt. Parcel #: 15.29.19.111A 020 -TOWN OF HUDSON
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 -KELLER, GORDON J
GORDON J KELLER
981 CTY RD A
HUDSON WI 54016
Districts: SC =School SP =Special Property Address(es): ' =Primary
Type Dist # Description "` 981 CTY RD A
SC 2611 HUDSON
SP 1700 WITC
Legal Descriptions Acres: 20.000 Plat: N/A-NOT AVAILABLE
SEC 15 T29N R19W PT NE NW BEING LOT 1 OF BlocklCondo Bldg:
CSM 10/2701 20 ACRES
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
15-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1047/302 WD
2007 SUMMARY Bill #: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/25/2005
Description Class Acres Land Improve Total State Reason
UNDEVELOPED G5 19.000 56,800 0 56,800 NO
OTHER G7 1.000 30,600 115,000 145,600 NO
Totals for 2007:
General Property 20.000 87,400 115,000 202,400
Woodland 0.000 0 0
Totals for 2006:
General Property 20.000 87,400 115,000 202,400
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch #: 126
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Tota I 0.00 0.00 0.00
O d f
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3T. CRO1X COUNTY
gUFiVEYOR'S RECOi~
CERTIFIES SURVEY MAP
LOCATED IN PART OF THE NE'1/4 OF THE NW1/4
OF SECTION 15, T29N, R7 9W, TOWN OF HUDSON,
ST. CROIX COUNTY, WISCONSIN; BEING LOT 7 OF'
CERTIFIED SURVEY MAP RECORDED IN VOLUME
1 O, PAGE 2701.
OWNER
GORDON 8~ DANA KELLER
961 COUNTY ROAD "A"
NW CORNER HUp30{,{, yy{ 54016
SECTION 15
~S 89°44'50"W _
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SURVEYOR
EDWIN C FLANUM
NORTHLAND SURVEYING. INC.
P.O. BOX 14
ROBERTS. WI 54023
r
w~
NORTH LINE OF THE NW1/4 ~- S89°44'50"W 1320.93'
LOT 2 0 ~
2.81 ACRES INC. R/W U z
122,395 SOFT. ~ ~p
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j - LEGEND ---------
Qi ~ ALUMINUM COUNTY SECTION X X EXISTING FENCELINE
~ i a~ CORNER MONUMENT FOUND
o I ~ • • • • • • • • 50' ROADWAY SETBACK LINE
~`~ ~ 1 5/16" O.O. IRON PIPE FOUND
1 1
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a~ ~~
Q; ~i Q 3/4" X 18" IRON REBAR SET WEIGHING
~ i ~ 1.50 LBS. PER LINEAR FOOT
O I
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Jb~150. OR7-34EN DATE 03-29 p7 KEVIN REED
~ SEPTIC VENT
® WELL
~ SOIL TEST
1 lliill III' ""'''111111111 Illll 111! llllll illl 11i1
851 X37
KATHLEEN H, WALSH
REGISTER OF DEEDS
ST. CROIX CO., WI
RECEIVED FOR RECORD
05/24/2007 11:OOAM
CERTIFIED SURVEY MAP
VOL: 22 PAGE: 5399
RFC FEE: 13.00
COPY FEE: 3.00
PAGES: 2
N1/4 CORNER
SECTION 15
5.0'
L~04
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NOTE: 1 5/16' O.D.
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S77°32'09"E 0.59'
FROM SET 3/4"
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( 3 PREVIOUSLY RECORDED DATA
SCALE 1111 FEET 7" = 200'
SHEET ~ OF 2 SHEETS 2O0 0 200
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DOCUMENT NO. ATE BA~t O! IIfI8CON8IM FOitlt 1-1lM
w~~r-~rt~r oao
saes3o ;~;~ 1047-~~ ~r~
This Deed, made Detwwa .Slitta.~...lcataa~..----• .....................
.....a..Mido~e..aad..siagle. tioeun ..............................•--._.......----............
....-....~i~lo: "S: - Cif'l<r-----~-~ .............................................. .aranto:,
ssd ............. ... .......................................................................................
..................................................................................................~ Graatssr
Witriesseth, Th.t th. saki Grantor, fer • •alnabh can.ider.tioer....--
5£""-Cio fi
conveys b Grantee the followtns described real esbb (a ....:............................
County, State of Wiseonsin:
Part of the Northeast quarter of Lhe Northwest
quarter of Section 1S, Township 29 North,
Range 19 hest, described ass
nxs wes esse~vao roe ^seeeo~MO a-rs
~~+~s or~~c~
~~
a Nos°a'~~
~~ 80iX~ta7 '~aiN1. ~ pF M~
Ta: Paral No:..».......»...._..» .............
Lot 1 of the Certified Survey Map tiled and recorded in
the office of the Register of Deeds on October 22, 1993 is Vol.
10, Page 2701, Document Na. 507728.
$ 30 o
E~ ~.
This _... is not-------• homestad property.
(!s) (ia not) ----
TeRethsr with all and einyular the heredibmenb and apparbnanas thsreanb belonetny:
And..._..~th_ C. Latner
warrants thex the title is sood, indefeasible to fie eimph and free and clear of encumbranep ezcept
eziatiag highways and eaeemeata of record.
snd wW warrant and defer tM same.
Dated this .--•----•-----._....,i/..~ .............. day of ......_.._......._............., 1l.. 93..
........ ....................................•---......._.............(BEAL) ......_. --.....(SEAL)
Ruth C. [atner
--• .................................................... (SEAL) _..1~-......Le._.. ~!_'r'~+.t_....~~_..d''e A(SEAL)
~ .................................................................. ~ .....YI.!fA. ............._-.
~IITS>•7(TICw?201f
Sl~-tan(s) ------»-------------------»--------.»....»...........--
anthee+Hested this .»»---day af:.---»--.._...»...».... If....--
TITLE: l[E1IBElt STATE HAR OF WISCONSIN
t~-M i 7osue. ~-ii. stiti.)' ....................
~CSltOwL>1D~i1[E1f?
STATE OF WISCONSIN
ss.
.....»»..».---»._....----».»_»Coaaty.
~. Fiesonaliy,~eame heroes ae ~ »~..._»...dq of
t. mw kaowa to bs the persoa
lasteoaesnt ad aeki
rule ~NSruuwa+r wns oawFr[o w
. HR1~xaaQ..h.-~i.._~.i*.._,__Dj-__,IAbs._A..»ASsd
....~.~Ot.._~tos..?.?.9.,..J~a....~_ 5441.4...»........... Neb:, Pobde -
(3tenatores may bs ssthentieatsd os adcaowledsed. Both iry Cnm~isias
are sot neeeseary.) dab- --------------
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CERTIFiECi SVRVEY MAP
LOCATED IN PART OF THE NEB/4 OF THE NW7/4
OF SECTION 15, T29N, R19W, TOWN OF HUDSON,
ST. CRO1X COUNTY, WISCONSIN; BEING LOT 1 OF'
CERTIFIED SURVEY MAP RECORDED IN VOLUME
1 O, PAGE 270 ~ .
OWNER
GORDON 8 DANA KELLER
981 COUNTY ROAD "A"
NW CORNER HUDSON. WI 54016
SECTION 15
~ S89°44'S0"W
'
1320.93
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7as.6o4 so.Fr.
16.06 ACRES EXC. R/W
sss.as2 so.Fr.
SOUTH LINE OF THE NE7/4 OF THE NW7/4 ., .
• - • • -~- • • - • • • •IV89°49'23"~ 91056' • (IV89°59'02"E)~ 6.8 ±-
5.0' `t 757.43__
SURVEYOR
EDWIN C FLANUM
NORTHLAND SURVEYING. INC.
P.O. BOX 14
ROBERTS. WI 54023
' _~ I ~ MCCUTCHEON ROAD ~N6s°saaa"E~
O; ------------------------
~~ ~~ ( I I MMI.~[~G14~'[~D L~GQf~ID~
°; ~; 1 j ~ LEGEND
Qi ~ ALUMINUM COUNTY SECTION X X EXISTING FENCELINE
~ ~ I CQRNEfi MONUMENT FOUND
C~ ~ d~ - • • - • - - • 50' ROADWAY SETBACK LINE
~i ~q ~i 1 5/16" O.D. IRON PIPE FOUND
~' 1 LWJI ~ 1" O.O. IRON PIPE FOUND
~ ~~
Q j ~j ~ 3/4" X 18" IRON REBAR SET WEIGHING
~ I d' 1.50 LBS. PER LINEAR FOOT
I I
~I
~I
Jb~150. 07 34 EN DATE 03-29 p7 KEVIN REED
w~
Nt/4 CORNER
SECTION 15
NORTH LINE OF THE NW114 ~ S89°44'S0'W 1320.93' ~ ~
~O N
LOT2 W~
2.81 ACRES INC. RNU
z
122,395 SOFT.
w¢O
2.00 ACRES EXC. R/W ~ S
87.120 SOFT.
(~O4 6 ~ ~G30~I(~I~pQG?C3 lvt7L LaDO_Mn_I~ i ~ ~ ~
i zX
(S89°54'44"W) ~ m ~ / ~ ~
i ~ S 89°45' 7 4"W 968.00' ~~ ~
~'~~" '! 338.68
s7a ~s' S.0'
;x x x x x 9129a'
1
•I N
~ x,04 9
:" ~
;:G,tl° ~Gj1 C~IOdNJ~1C~ 4J OQ [?Ls1C~G ~? c709
m SEPTIC VENT
® WELL
~ SOLI TEST
851237
KATHLEEN H. WALSH
REGISTER OF DEEDS
ST. CROIX CQ., WI
RECEIVED FOR RECORD
05/24/2007 11:OOAM
CERTIFIED SURVEY MAP
VOL: 22 PAGE: 5399
REC EEE: 13.00
COPY FEE: 3.00
PAGES: 2
[~05~ g
0
0
O
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~ -------
0
g; i
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•'' L~a4 9 9
NOTE: 15/16' O.D.
IRON PIPE FOUND
S77°32'O9"E 0.59'
FROM SET 3/4"
-~ -
`~~.~~SCOIys~~, =.
~ EDWIN C. ~
_ 1=ulvuM _ /,,,~
3-2487 ~ AA~'-
AMERY, ///_
l9~wlscoNSIN ~~ ~' ~ ~
~ ti-~ ~ ~ 0
~~'~~ 3UFt~1~y~1~ qs~
l ~~
( ) PREVIOUSLY RECORDED DATA
SCALE IN FEET 1 ` = 200'
SHEET 1 OP 2 SHEETS Zoo 0 200
.,.,
~~
CERTIFIES SVRVEY MAP
LOCATED 1N PART OF THE NE1 /4 OF THE NW1 /4 OF SECTION 15, T29N,
R19W, TOWN OF HUDSON, ST. CROIX COUNTY, WISCONSIN; BEING LOT 1
OF CERTIFIED SURVEY MAP RECORDED IN VOLUME 7 O, PAGE 2701 .
OWNER SURVEYOR
GORDON S DANA KELLER EDWIN C FLANUM
981 COUNTY ROAD "A" NORTHLAND SURVEYING, INC.
HUDSON, WI 54016 P.O. BOX 14
ROBERTS, WI 54023
SURVEYOR'S CERTIFICATE
I, Edwin C. Flanum, Registered Wisconsin Land Surveyor, hereby certify that by the direction of Gordon and Dana
Keller I have surveyed, mapped and described the parcel of land which is represented by this Certified Survey Map;
that the exterior boundary of the parcel of land surveyed and mapped is described as follows:
A parcel of land located in part of the NE1/4 of the NW1/4 of Section 15, T29N, R19W, Town of Hudson, St. Croix
County, Wisconsin; being Lot 1 of Certifed Survey Map Recorded in Volume 10, Page 2701; described as follows:
Commencing at the N1/4 Corner of said Section 15; thence S89°44'50"W, along the north line of the NW1/4 of said
section, 1320.93 feet to the west line of the NE1/4 of the NW1/4 of said section; thence S00°11'49"E, along said west
line, 420.93 feet to the north line of Lot i of Certifed Survey Map Recorded in Volume 10, Page 2701 recorded at the
St. Croix County Register of Deeds Office also being the point of beginning; thence continuing SOO°11'49"E, along
said west line, 900.00 feet to the south fine of the NE1/4 of the NW1/4 of said section; thence N89°45'14"E, along said
south line, 968.00 feet to the east line of said Lot 1; thence N00°11'49"W, along said east line, 900.00 feel to said
north line of said Lot 1; thence S89°45'14"W, along said north line, 968.00 feet to the point of beginning. Described
parcel contains 20.00 acres (871,200 Sq. Ft.).
Parcel is subject to town road (McCutcheon Road) right-of-way, county road (C.T.H. "A") right-of-way and all other
easements, restrictions, and covenants of record.
i, also certify that this Certified Survey Map is a correct representation to scale of the exterior boundary surveyed and
described: that I have fully complied with the current provisions of Chapter 236.34 of the Wisconsin Statutes, the
Land Subdivision Ordinance of the County of St. Croix, and the Subdivision Ordinance of the Town of Hudson, in
surveying and mapping same.
APPROVED .•~'` coiv ''~•
s'r. cweouc co11*RY ~•~y1~s ... S~,~%
MAY 2 4 2007
If not recuttW wip>;n ~ Oays of
COUNTYa~~~IF~ATE
STATE OF WISCONSIN)SS
COUNTY OF ST. CROIX)
_~ . EDWIN C.
i FLANUM
>i S-2487 ~ = ~ 0~
~ AMEFiY,
~9~WISCONSINiOQ- ~ ~/
~~/////,J(~~'/ L
,,,~suR~~,.~ ~.
I, Cheryl Slind, being the duly elected, qualified and acting Treasurer of St. Croix County, do hereby certify that the
records in my office show no unredeemed tax sales and no unpaid taxes or special assessments as of
:Z 3r ~ la ecting the land included in this Certified Survey Map.
Che Slind, Date
County Treasurer
Each parcel shown on this map (plat) is subject to State, County and Township laws, rules and regulations (i.e.,
wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel contact the St. Croix
County Zoning Office and the Town of Hudson
P N~ 20-1025-90-100
P 18{~5.29.19.111A
SHEET 2 OF 2 SHEETS
Parcel #: 020-1025-90-100
07/16/2007 11:46 AM
PAGE 1 OF 1
Alt. Parcel #: 15.29.19.111A 020 -TOWN F HUDSON
Current ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
05/24/2007 00 0
Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner
O -KELLER, CORDON J
CORDON J KELLER
981 CTY RD A
HUDSON WI 54016
Districts: SC =School SP =Special Property Address(es): ' =Primary
Type Dist # Description ' 981 CTY RD A
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 20.000 Plat: N/A-NOT AVAILABLE
SEC 15 T29N R19W PT NE NW BEING LOT 1 OF Block/Condo Bldg:
CSM 10/2701 20 ACRES
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
15-29N-19W
Notes: Parcel History:
RETIRED 2008--NEW CSM 22-5399 TAKES ALL Date Doc # Vol/Page Type
NEW LOT 2 PCL 020-1025-90-200 (111A-1) &
LOT 3 PCL 020-1025-90-300 (111A-2) 05/24/2007 851237 22/5399 CSM
07/23/1997 1047/302 WD
2007 SUMMARY Bill #: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 06/05/2007
Description Class Acres Land Improve Total State Reason
UNDEVELOPED G5 19.000 56,800 0 56,800 NO
OTHER G7 1.000 30,600 116,500 147,100 NO 05
Totals for 2007:
General Property 20.000 87,400 116,500 203,900
Woodland 0.000 0 0
Totals for 2006:
General Property 20.000 87,400 115,000 202,400
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch #: 126
Specials:
User Special Code
Category
Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00