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HomeMy WebLinkAbout020-1365-08-000o o N ~V ti C O O N O ti 4, a h • ~ O N .~ *~ •~ ~0 V ~`i~i _1 C: O 'u lr O C L~ c~ A '6 C 7 LL 3 r~ ~ ~ y rn ~ ' '' z ;,; E z = ° ~ ~ j' E o ~ z ~ , d d ,f, N W a m .- ~ z ; c O C7 2 d' -o c . ~ ~ ~ Y ~ U1 Z F- ~ r' O ~ U p c _ ~ .D U N N L _m !, ~ ~ _ i y ~ O d iv O 4- Q ' Z ~ Z N o , , ~ ~ I ~ ~ ' ~ N ~ d (6 ~ H +~' r. d a ~, ~ o o a` ~ Q~ 00 ~. N ~ f.. H F- I' = O O O ;~ ~, a a a a ~' ~ .o g J ~ to o ~ N U ! a~ '~ 0 0 0 0 J N N M Q~ o ~ o O I I U C 'O N ~ d ~ W ~ ~ 0 ~ ~ N N C 0 m O ~ 3 ~ N H ~ - ~ ~ r- c y O CJ r O of N ~ ~ '. U ~ M o ~ _ a m o ` ~ a , s6 ~I ' d a a ; ,. G i ~ ~ C ~ ~ ' ~ 3 v a ~'' O in v I ~ °~ I ~ I ~ I I O C N ~ ~ C ~ 9N I c o` I ~ `~ I N ~ r O ~ _~ N G ~ O .~ +_ Z N C - Y ~ ~ O N .O ~ (0 'CS p, «0 Q Q'`°O I I I I I I o I U w N O c Z y I E ~ ~ M ~ C ~ ~ ~ ~ w E z I >~ > N N Y a E °- I 7 U ~ U d ~ ' Z ~ ~ I ~~ I Q ~ } I Z ~ m I ~`~ I .= oo ~, E m ~ ~' ~ I ~ i3S ~ ~ I of ~ ~ ~ ~ •:~s 2' o °o C N N iu N ~ ~ - ~ ~ ~ .-- ~ a`s c c ~ ti n l _~ m Y Y to I I I I I /* ~ ' `~sconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings-Division INSPECTION REPORT GENERAL INFORMATION tAT'TACH TO PERMIT) Personal inforrnafion you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: ^ City ^ Villa a Town of: 'C Collova Builders, Hud9son Township CSnnT BM Elev.: Insp. BM Elev.: BM Description: y ~ 2 ~~ ,N d~5~' so ~ ' r. uv .ur~nu wT~~ra~ ~1 weTl[1N r~d~TO ~ r.r.r. ~r...........-........ TYPE MANUFACTURER CAPACITY Septic ~~ f O~ Dosing Aeration Holding TANK SETBACK INFORMATION TANKTO P/L WELL BLDG. vent to Air Intake ROAD Septic ~ ~' ~ ~I 2'{ I ~" NA Dosing NA Aeration NA Holdin PUMP % SIPHON INFORMATION .. Manufactur r Demand Model Number GPM TDH Lift Lrid System TD Ft Forcemai Length Dia. H Dist. To well c•~u w o~AtsnT1AIU tV~TC11A /~ . \ A I _ 1 Count SYf. Croix Sanitary Permit NO.: 383971 State Plan ID No.: _~ Parcel Tax No.: 020-1365-08-000 STATION S HI FS ELEV. Benchmark ~ , ~a °(~.5"'i7 ~ Alt. BM ~.~. IoZ.o;r BIdg.Sewer ~•~,5 9~.oSi St/ Ht Inlet g • (~ Qb•'~t~ 1 St / Ht Outlet 8 '~ 96.38 ~ Dt Inlet Dt Bottom - Header /Man. yam- ~•.. ~ kS~ Dist. Pipe '~~ q5 •90 / Bot. System la• 3S YS ~ ~Jtif• Final Grade ~I •y S ~'. 8S ~ over 3•~Z ~o(.18f ........ r..- .. .. ~.- .... ---- L}+~o~v+y a c..v'~. i th Li uid De THE h Length , N Of Trenches Wid PIT No.Of Pits p q a. Inside D IMEN I N e ~~~ oZ IM N I N Manu adurer: SYSTEM TO P / L BLDG WELL LAKE /STREAM LEACHING ( . - rjco~..,.~4Cs/ SETBACK CHAMBER r: N INFORMATION Type O ~ st l ~ ~ S r ~O~ ~ 52 1 S ~ ~ ~~ OR UNIT um e M~ a - C ~-~ em: ..~u y v.J ....vv ..v.. ~ .... ~ Header / Mani old U ... ` - - Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake y S3 i Lengtl~e~ Dia. ~ Len Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At•Grade Systems only Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ^ Yes ^ No ^ Yes ^ No COMMENTS: (Include code discrepancies, persons present, et .sec lon 1: / /ol Inspection #2: -°t-- / 0~'l9l0/~ Location: 649 Laurie Lane, Hudson, WI 54016 (NE 1/4 NW 1/4 15 T29 R19W) - 1529192168 Riverpark Meadows -Lot 8 ~~~ C~~ ~4,wer) 1.) Alt BM Description = "~ ~°µ'^d~A'~~`'` 2.) Bldg sewer length = L~~S~~ -amount of cover = cf~ «,~ , ek Pt • ~ ~O~F ~ ~r 3) ~~ ' Plan revision required? ^ Yes ~ No t ~! Use other side for additional information. 1Z OS O~ , ~° Date Inspector s Signat Cert No. SBD-6710 (R.3/97) ~. ~9 ~ `"~ ~,.,Pcl,l.,R..l ~ L,A--~E .JLe ~ ~ ~ ~ ~ Safety 8c Buildings Division 20l W. Washington Ave ,~ Ssnita Permit A lltrAtlOn rY Pp In acaxd with Comm 83 Adt» Code 21 Wis Po sox 7302 n . , . . Madssan, W 153747-734 DePSrtmertt o! Commoroo Personal ipfotrtntttion you provide may be used for sa;ondary putpos~ (Submit completed form to county if not ~PtivaCy Lew, s. 15.04(!xm)] stye owacd.i Attach f ete area to the cou cal for the on 8 .112 x 1 I inches is sizo. Cotaitt• State Pestnit Number Cheek if revision t a icstto~ St~ta Wan !. D. Number !. A ' ation laforteattios - P lease Pristt all information ^~~~ ` - ~ Property ckvuerNanto ' l...r..~'v!~ .~ ~ .owtian ~ - ,` l e y ~ ~ !t4 ~' ~a s ~>v. u~~~2 ate Fraperty Owner's Mailing Addrals .. :' .ot Nucri Rlook Number ~6,J Co ,~vL yr c~z,;;x' ~ State Ci t y , !ap Code C3 (?F~F, -~ Phone )3 _ ~.;N Z iem 1Vsu~c err C'iM IVumbec / /~ ~ y /Q ~~J ~ li Type oP Building (trherJc ose) ` ~~,.`:1 ~',:,; .. ,, °;" 3 ~ ~ D l a 2 Family Dwelling w No. of &>drooms: ~ ~ O PttbliclGamta~cial(describe ttse): Tnwrt of O Ssattrowned cc d o.tJ Qi Type of Permit: (cheek only one box on line A. check box an line B if applicable} Ne.ernt ~~ QL SLY ~ ° ~ ~/ ~ / L Q• p) l . ~tew System 2. D Repituemeat 3. ^ Replacetneat of 4. D Addition to Paet~ti'Cax 1Numhar(:) _ Sastcm Talc Dal Exi S O 0-- / ~ ~ 60© $~ Pt:rrrtit Number Date Issrted '" D A Sanitan• Pessnit was viousl issued 7 a • 'i`Yi~ of PowT Syatt~: (C4ocic a!l that. ariPh') ~ l . Naa-prmswtizod in-grwurd D Maud CI Sand Filter C] Construcood Worland Pressurircd Ia-gcamd CI Holding Tank D Single Pass D Drip Line D At-grade ^ Aerobic Traattnent Unit D Itocirat>Rtiag D (3ther: ~/e102 S".`~~- .' .~~r a eye e.t~ S l v' ''~v V D" raUTtreatment Atrea Infbrmatioa: !. Design FSu<+• (gpd} Z. r. itey uit d 3~-S+~ 3. f7iapersaf~ Area ~}-~'Z) R'opu aed ( 3 1. Soil Applicsti~ Rate (C!a>g.lday/aq. R.) 5. PereoiatianRab Mlia. lss l d + ) 6. Sywem Iilevatiun 'J3 ~ 9 7. Fowl (;rode 7 e„atiarc / / l^~ ~ , ~j ~ / / ' / / ' ~ - / ~ VI Ta»i t Capacity in Total ~ of Manttfat~er Prefab Site Stoei Fiber Plastic lnfotnsation G+d~ Gallons Tanks Can- Con- glass New Existing csete structed Tanks Tanks p~ n / D C~ ^ D D D D D D Vll Responsibility Statement t the ttatsutrte for itrt:taUatioa of the PDWTS sho the attacbad Pltmtheda Name (lsrvtt) Plttmber'a Signature no riarttps): 3 No. 13twines~t I'Jwne Ttumber ~a G~ u.m.r~fe~s~ - ~~7 ~l Dr lS •- 3~r~ - 3(~ Z Plumber's Ad3axa (Street. L'ity, S ts k. Zap Code) /y/ /, A Vlll Colwsty/Department Use Only D Aaapproved Sanitary Permit ree (Includes Cirota>,iixatar Date laatmd I Agent .'signature (Nu ststrtps} ~$(,Appmved Q Owaar Given Ittitial Adverse Dtgexminadort s e Fee} Qp ~S- r-- 3 ~' YX. Candldons of Apprnvd /Reasons [or Diapprovai: ~- S•.~y(a~,~„ 56,~,.~.dZ ~w;~.D ~ srd2tz- (ear, ~ cS~~s ~ w ~, t~.n. ~c l ~ .-~ ~s ~ o . ~~ ,~-Z ~ ~>us ~ bQQ . I~ ~s~~e>M,,~t- 6~ l ~-~ vw~ ,rr? - S ~~~.~,,~ ~ ~~ ~ ~~ t L h. a v ~ ~ ;~~ ~ ~ h O:. J Q- ~ ~ ,~ 4 3 a a r v N ^ f r •. 'Q `~ .;~ ° ~, n ,\ g ~ ~` h a ~'_ -. To: Bill Schumaker From: Jon Sonnentag Fax: 715-386-3121 Pages: 3 Phone: Date: 05/23/2001 Re: Elevation changes CC: ^ Urgent ^ For Review ^ Please Comment ^ Please Reply ^ Please Recycle • Comments: Here are some elevation changes that were made to a soil test by Adam Schumaker. Some mathical errors were made resulting in incorrect elevation differences between the benchmarks and borings - in most situations the elevations should be nearly the same since the BM's were at grade and close to the borings. You currently have a permit pulled for this lot, so please be sure to adjust your elevations accordingly. There are several other soil tests for River Park Meadows where this error was discovered. However, there are also several lots where the elevation between the BM's and borings correspond correctly. If you have any questions please give me a call. I • ~nsin Department of Commerce SOIL AND SITE EVALUATION I NOivision of Safety and Buildings Page of Bureau of Integrated Services in accordance with Comm 83 ~ Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must ' unty include, but not limited to: vertical and horizontal reference point (BM), direction and LrOi V percent slope, scale or dimensions, north arrow, and location and distance to nearest road. parcel I.D. # APPLICANT INFORMATION -Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location '. U~ ~~"C Govt. Lot S~ 1/4~~ 1/4,S j0 T Zct ,N,R ~ E (o 'W Property Owner's Mailing A ddress Lot # Block# Subd. Name or CSM# ~y 1 Q (} 1, ~ 5 City State Zip Code Phone Number g ® Town Nearest Road ^ City ^ Villa e 1-~ta r-~~bn I l~ 1 I SL1C~ 1 to I ~ 115 ~5~-1~i -S~i ~l N ~~c~~r~ I fez u r ~' ~ G ~ n,e (-New Construction Use: ©Residential / Number of bedrooms ~-~ Addition to existiny building ^ Replacement ^ Public or commercial -Describe: Code derived daily flow QC~ gpd Recommended design loading rate - ~ bed, gpd/ft2 - ~ trench, gpolft2 Absorption area required `~_bed, ft2 -75U - trench-ft2 Maximum design loading rate • 1 bed, gpd/ft2_trench, gpd/ft2 Recommended infiltration surface elevation(s) ,~cT'~• ~ ~ 1~3g9 ft (as referred to site plan benchmark) Additional design/site considerations _~ % 3 - I Parent material L)U-~LL1G~h Flood plain elevation, if applicable ~ ~ ft S = Suitable for system vvnvcnuvnq~ nivunu ur~aivunu rivaauio ni-~a~a~ac .~yaicn~ni~w ~iviuiny ionn u= unsuitable for system C~, s^ u ®s ^ u [~ s^ u p s^ u ^ s ~ u ^ s® u SOIL DESCRIPTION REPORT ~o...~ r~.n~Y'.6 ~ A~ -~ IUo,t~~2_`T~ Boring # I _~. Ground elev. fC~ ~l _ft. Depth to limiting fact 112 in. Boring # Ground elev. ~y$~t. Depth to limiting factor //iG in. Horizon Depth Dominant Color Mottles T t Structure Consistence Bounda Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color ex ure Gr. Sz. Sh. ry Bed ,Trench I o-13 U -- s. ~ ~bk ~s v~ . z ~ .3 3 yz~a~ ~o - ~,~, i ~ ~ - • 1 : - ~ i ~~ x s t Remarks: ~~ ` ~ - ` '~ ~~ ~ -l 1~ r3ll - `I (-'YYXr~~ +'Y'~r Li~'~i~. ~Yk`, '~~ Z ~ y .-~'~/A .. ~\ i 1~fG ~~ . _ Remarks: CST Name (Please Print) Signatur Telephone No. Ac1a Sc.-4, ker _~ /S - 2 7 -fig Address Date CST Number ~-FO ~ Ceclc~r ~~ - ~`~' So me r~e+ ~ ~ 5 `f o Z //- S- 2 5 9 PROPERTY OWNER Ct U I ~ U lJ ~ SOIL DESCRIPTION REPORT PARCEL I.D.# Boring # ~~ Ground elev. ~! Yo rt. Depth to limiting factor LZ~in. Boring # c-~ Ground elev. r~tT, 47 ~ h. Depth to limiting factor /Zi in. Boring # Ground elev. ~~ ZUft. Depth to limiting factor Z~ in. Boring # Ground elev. ft. Depth to limiting factor '~ Page ~ of ~ ~,. Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed .Trench I o-3~ io 31 / _ 5~ I ~-~' c 1 v~ Z- 2 37-b l r yly "" S' Z k ,' L S • 5 3 b~-~ lV r yl -' m S D vyi ( cs - ~ ~ - 8 t*.o~. Remarks: 3 ~-IZ iv yl -- ins ~~ r ~.. s - . ~ ~ , g 8.`~ o`f. Remarks: Horizon Depth Dominant Color Mottles T t Structure Con istence Bound R t GPD/fit in. Munsel! Qu. Sz. Cont. Color ex ure Gr. Sz. Sh. s ary oo s Bed ,Trench b-ls l0 1 ~ - s; mQ.bE m~' ~ l v~' . Z ~ -3 Z ~s- i i yl s; I zn~~ m~'~' ~ S Remarks: in. Remarks: SBD-8330 (R.9/98) r_. _ _ .• ..i __ C)Jc~_ _-_ LOT. # D '~ SCALE 1 "_ ~U ~ / B.1 ELEV. `,. %(~1°f~ ~ DESCRIPTION- ~~ 6~ z"per R'De BM2 ELEV. %~/;~~ ~-- - DESCRIPTION- Fc>Q a~ z '`pv~o;~ SYSTEM ELEV. ~ 'fD y'3 ALT. ELEV. ~ ~3• CONTOUR EL• EV . VI v n-e LEGAL DESCRIPTION N' PAGE 3 OF 3 -Scv -/U - Z q -1g' W -.. ~ - _ _ ~ a~ ~~ Private ~nsite Wastewater Treatment System Management Plan Septic Tank And Gravity In-Ground Soii 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 $4, 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 tn-Ground Soii Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- T_~~_ ~. c.._~...., ne~~n., Cnra~ifications .. 1 AfllQ 1. v awn. vv.-.. i...r~~..--"-•---- Sanita Permit Number Number of Bedrooms Desi n Flow -Peak ( pd) Estimated Flow - Avera e ( pd} ov Septic Tank Ca aci (al) t5~10 Soii Abso tion Component Size (ft2) 3 Z ^ ~ Type of Wastewater Da estic ~_~~.. ~. @wil Ahl.~.•.,4Gnn ~.,mnnnant . i-units of Reliable Operation 1 ~YI~ 6. Vvu nwvv.M~.v. ...~...~.~..~..- ---- Septic Tank Component Soii Abso tion Com onent Desi n Flow -Peak ( pd) ca~fl ~ ~ - `~ ~ Maximum Influent Particle Size {in) 1~8 Maximum GODS (m !L) 220 Maximum TSS (m L) 150 Table 3• Maintenance Schedule .Q,~cs+, Se tic Tank Outlet Filter Inspect and/or service once eve 3 ears inspect once a ear and clean at least once eve 3 years Soil Absorption Component Inspect once eve 3 ears Segtic Tank. The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. 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. ff the ~~ ~ ~ Management Plan for a Septic Tank and Soii 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 performed 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 locking 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 OSNA standards for entering a confined space. The afmosphere within the septic or other #r+eafmant of holding tank may contain lethal gases, and rescue of a person from the interior of the tank maybe dJffrcult 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 Com off. Went The soli 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 great{y on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by ail 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 over the sail 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 aver this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to mare 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 of within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. Contingency Plan In the event of system failure, a new system could be installed in an altemate area. With the installation of a diverter valve, the existing system could also be reused after a period of three to four years. It is the property owners responsibility to maintain the altemate area free from any planting of trees, shrubs, etc. In case of failure of the original system, the altemate area wil! be needed. If any trees, shrubs, etc. have been planted on the alternate area, they will have to be removed at property owners expense. If altemate area is destroyed, there are other alternative systems that can be used, in which, could result in added expense to the property owner. Any tank abandonment shall be done in accordance with Wisc. Code 83.33. Any questions regarding this cads, please contact your local Zoning Office or contact the installing plumber. G., ; ~I,tw~. ~~uN,~,~ = ~S ~ 3~ - 3 X21 -~ S'I' CItOIX COUNTY SPI'1'1C 'f ANIC MAIi~~"I'I?NANCL AGItLI?tv1[?N'I' ANU OWNI?RSII[P CI~R1'IPICATION rORM Owner/l3uycr - tJ, ~ . ~ (~ oVA Q ~ ~~ rt S -~nJ ~ Mailing Address -7t~~ nv . ~ ~ . ~' /~v'Su,v ~V L .5 ~-~~ 1(v Property Address hq~(! ~ (Verification required from Planning Department for new conslmction) City/St~tc _~t/~SV/~/' ~'~~ I'arccl Idcnliftcalion Nuutbcr T,r(:AI. 1)rSCRIP"PION I'roperiy [_ocation ~E '/,, /~VV~ 1/,, Scc. ~ 'I~~1~-R~W, '1'otvn of d.TQ Su~divisia,t f'(I !!E/' Cct'lificd SutYCy 11'I~p Ir! Volume Lol fit' ~_. Pa~c # '~irtll'1'Aply nCC(I # ~~ ~ ~~" I , Volwuc ~ 4~ rage I~ -¢-S~. Spec Itousc Q yes~i~o Lol lints idcnlifiaLl~cs Q no SYSTrM R7AINTI!,NANC>J Inlpropcr use and ulainlcnanccof your scplic systctn could resull lu ifs prculature failure to handle wastes. Proper maiulenar cotuists of pumping out the scplic lanl: every duce years or sooner, if tteedcd by a licensed pumper. What you put into the systc eau affect the function of the acplic tank as a lreatnrcnt stage iu the waste disposal system. 'ILe property owner al;rccs to submit to Sl. Croix Zoning Dcpallnunt a cclliGcnlion fonu, signed by the owner and b} nlaslerplunlber, jounlcyruau pluulber, restricted plumber or a liccnscd pumper verifying Ihat (1) the on-site waslcwalerdisposal syslc is in proper operating condition alul/or (2) aQcr inspection and pumping (if necessary), tl-c scplic lank is Icss than I/3 foil of sludg Uwc, Illc undersigned have read tl-c about rcquircuuuts and agree to nlainlain the private sewage disposal system witl- the slandai set forth, herein, as set by the Department of Commerce and the Deparinlent of Natural Resources, State of Wisconsin. Certi(jcati staling that your acplic systctn has been mahllaiucd must be completed and rclunud to the St. Croix County Zoning Office willlin day t Ic t i year expirali n date. ~~ ~~ NATTJRI? Or APPI.[CAl~"I' ~ /Z /~ nn~'c oWrlrR Cr1i~rlrrCA~~r•I~l_v I (we) certify that all stalcnteuls on this fotYU arc true to the best of my (our) l:rlowlcdgc. the cscribcd above, by virtue of a warlanly decd tcconlcd in Rct;istcr of Dccds Office. ~` /J GNAIUR[? Or AI'PI:ICAN'1' //___ 1 (\YC) Alll (al'C) 1lIC O1YI1C1(S) ~` /2~j v I DAT'[: +++++~' Any Infortnalion that is ulis-represented may resull In Illc sanitary pcmlit being revoked by the Zoning Deparhnent. ++" +* Include with flits applicallon: a stamped warranty decd fiotn lllc Register of Dccds office u copy of the certified survey map if rcfcrcncc is made in tl-e warranty decd ~ - - •+~~~ v ., . y !. l.. 1 .~ V .. J V a V V V V L L a,-• ~.• V V V l 1 L 11 V • .^ ~i I STATE D.iR OF \VISCONSIN FORM 2 - 1983 YJAitypRAh((~jTY DEED DOCUMENT N0. 'Cl t. 1'J ~%1Pr1GC Q U~ ~3~r1ar jorie Nalernee, Frances August and Paul K9tner rts tenants l.n cumtnan a/k/a fr~ncia _ August cunvr;a and wasranta tc P.~. Co_ ova 8u core, Inc., a . Wlsi:onsin Cnrporaticn - 64626'7' KATHLEEN N. uALSN kEGISTER 0p DEEDS ST, CkOIX CO.~ UE RECE[VE- FDR AECORD 01-06-1994 9: ]0 AM YARRAIITY DEFD EXFfDf tl CERi COPY FEE: CORY fEEs TRGhiSFER FEf2 1310.10 kECORD11,10 fEE: 12.00 PAGE9: 2 n to a•~ce nos enoe o roaCareonrnro ~on~r`~' thclollnwinddcsn~ilxd:uleeuu~.n t. ro x Cuunty, L~J'1V~t ~ J, 457RELi'V Sla:e of Vii;ccnsin. 304 ~.. ~)CUST . • ~. SE 1/4 Sb; ]/4 Sec. 10-T29N-Rl9W excepting therefrom Lot 1 ~iUDS~PI, W~ 540.') of Certified Su_vay CIaF recorded in Vol.7 of Certified Survey llapa, page 2089 as Doc. No. 447309, also excepting 02U-1010-20 the railrcad right of rk1). U20=1024-9U• o2a-In25-9(] 11E 1/4 NW LJ4 SeC. 15-T2411-R19W excepting tharel'rcm Lot lpencaa>4nnNC~i'~clvnuueen of L'ertified Survey Map recorded In Vol. lU of Lertified Survey Mapc, page 2701 as Doc. vo. SC7728. t(1: L/4 NE 1/4 Sac. 15-T29N-R19W Tlria is nor hrxncac.dpropcrty. --Ik?-- fbnuU Ex:cptlon to a•asnnties: ~r t IrdrlgKie 'alernee ~1Nr~ •'• ••:i++' r' ~; • ~~• • a, •, , '11 n r X4 ~!, +aaasst AUTHENT1CATlO N ACKNOWLtDGh1ENT I Sigau•ams)_ ' State of 1~{~~•~on SEL' ATTICHBD,t - ~ 1 t:Al[IDIT A" sc. ~ ----- King ~ Couray amhcuUated this Jay of , :9__ Tersaaat:y came bcfure me tlds 2fi th _ day of tj June 19 99 _.tl'~eabovenamal 1' __ . fITL.: ~1Eh1BER:TAT@ B.9R OF W15CJNSIN i prancaa uguct j (If nut, _ ~ awhorizcd by 1706.06,'rYis. Stau.) _ __ tome 4.nuwn to he person_ who es:rtaatul the furegoit g ' ~ InSI 1 of f n WlCdgc Saf G. T.-)19 I'v-aiRU)A f.Nr 190.5 DRAFTEfi PV Hevuood 6 Ct)ri, 9.C, b Walter '.lodynaky • 204 LoCUeC St., P.O, llt:x 125 H1 son, (~lI 540 15 -- Kln __ NoUrypublic. K _ Countg~Jlb,- ~:A (Sidra:c:<s nwy ba au;Leallcaced m scknow,edded. 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