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020-1033-80-000
O O N O ~ ~ m ~ (D CD 7 3 3 ~' ~~ ~ ro n n o cn Z D ~ D ~' ~ ~ ro ~ n O ^. Z O ~ Ib o G c ~ m ~ m m m O s m m C (D 3 (D N ~ X~ X 7 Q W </~~ N d W •+ - U1 r. ~~ fl.y o: ~ y (D N ~~ m 3 z (D ~ ~ O (D ~ N N ~ O p N ~ (D Q d ~ Q ~ O7 ~ ~ a ~ 0 m ~ a a d ~ N N O C7 °' O _ 3 a rn 0 m o ~ O ~ O ~- ncn 01 '~w c d 3 ~ ~ ~ ~ 3 r* ~- N ~ m -8 A'+ . • K ~ ~ ~ R C N ~ ~ G ^ ~ ~ ~_ ~ # A~ _ ~ ~ ~ C V N ~~jj ~-C ~ • W A ~ I n' N ~ H ~~ll O ~ ~ ~ , O ~ ~ ~ C i W ~ ~ ~ ~ ~ 1 ~ ~ o O ^~ N N T.' ~ O a O ~ ~ a ~ a ~, o ~ 1~.~ N ~ (~w °' N r ? ~ N ~ 0 ~1 c +, .. (V '. O O O ° I ~i N N N ~ N I I ~ ' O ~ O N cn ~ ~ N . .. ~ m d = ~ ~ ~ rn ~ o 3 d N - ~ ~ c m .. °- y N Z ~ Z c D - - o ~ v o ~ cu m ~ • !mil iU 7 fV (D m _a i ~' _ ~ -i fn A Z ~ a II~ a O 3 W ~ ~ ~ f!> --I ~ < ~ V a ~ -~ ~ ~_ Z I _ .+ a Z7 ~ C ~ < N ~ '~O ~ W pj n (D T C Q .. i III 'a, a~ ,_ '.. W N 0 I. c v ~ 'b ti I ~.n ~ N ~ y 5 c7 vip'', 3~v ~ r~ ~ ~ ~ ~ ~ ~ ~ ~ `~1 ~ c I ~ ~ d ~ ~ ^ ~ ~ 3 ~ " i ~ ~ ~ ~ C \ ~ ~+ r: •• as O ai O f ~ Cn CWD ' 0 C N N ~ • O N IV Q Y~1 m a y oN ~ ~~ w G ~ ~ O ~ ~ ~! a ~ ~ ° ~ t+~l ~ o ~ !a w~ x ~ o p ~ cn ZD D ~ ~ ~ j -a ao ~ I n. IW 'c~,' Q ~ y ~ ~ ~~ OZ N r ~ ~ ' ~ Or ~ ~ ~ . r 3 ~ I ° ~' ~• ~ 000 ~ i ~ ~ ~~yy , I o c ~ ~! ~ ,,~ ~ `~~1 N ~ '~'~ -7 ~ ~ ~ ~ ~ A ~ ~ Q 3 m ~ I 3 .. y N I D 0 c~ m o ~+ ~ ~ ~ N i t~1 ~ W'NG ~ ~+ N w~ ~ ~ 3 3 n, 3 J "'~ C 0 ? ~ A 2 eo ~ (~ ~ ~ j ~ M I ~ a A ~ ~ I ~ ~ in a .. I ~ J a A m Z N a .. ' ~ ? ~ ~ H ~ ~ I a w ~ I ~ I ~ a ~ a. ~ I K m ~ ~ ! c m o a I ~ °^ ~ I coo y ~ A I ~°- o n ~ ~ ~ ~ y N ~ ~ I, 4 ~ O ~ I N ~ p I O ~ A O I ~ W ~ _ ~ rQ O ~ l0 W O ~ C ~ ' ` O ~., i~ -~ ,• ~~'.~INRCIAL TESTING LABORATORY,. INC. -514 Main.Street, P.O. Box 526 .. Colfax, Wisconsin 54730 715-962-3121 800 -962 - 5227 . ~ , COLLECTOR: H. Jenkins SOURCE OF SA~'LE: Outssde faucet COLIFORM: 0 /140 rgt INTEt~'RETATION: Bacteriologically SAFE NITRATE'N: 5 PP® Above 10 ppe exceeds the recon~nended Public Dri~dcing Water Standard. ST. CPOIX ZONING REP~cT NO.: 14828/01 PAGE i ST. CRDIX COUNTY FEF'ORT DATE: 9!16!91 .COURTHOUSE DATE RECEIVED: 9/12/91 HUDSON, WI 54016 ATTN: THOMAS C. NELSON ~~-~~ 3 3- ~d-a zoo _. _~. OWNER: U.S. West Brokers/Sower ~ "7,.'2~. y6~ _. LOCATION: 984 Preis#er Lane, Hudson Colifora Bacteria/104 ml Nitrate-Nitrogen, mg/L 1 LAB TECHNICIAN: Fam Gave WI Approved Lab No."19 Qio~~~ \•ktt . ~ RECE-VED S~~ 1 ~ 191 N 4 COUNIY ZONINGOFFICE ; ~~`° `~ < iieans "LESS THAN" Detectable Level Approved by: PROFESSIONAL LABORATORY SERVICES SINCE 1952 C ~~ ., ,~ Telephone - (715)386-4680 The St. lCroix County Zoning Office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals. WATER TESTING-----------------"----"--'-FEE: (For nitrates and coliform bacteria) WATER TESTING FEE: (For VOC'S) SEPTIC SYSTEM INSPECTION-----------------FEE: (Determines if system is properly function inspection) Property owner's name 1~ S ~~5>'~ ~iPB6/f~5 .~ Completion of this form is essential so that the property can be_ located. Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning Office, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received.---~~ Property owner's address x ~U ? ~/~~C'T of Legal Descri tion ~1/4 of the Town of Lot Number t+Tn~ 1~7TT1(RF!7? ~~~ LOCK BOX NU ~,~ 1 i Color of house ~N rv:~ ~ ~ PLEASE INCLUDE;• IF WITH LOCATION SHOWN, Y ZONING OFFICE ~oix 911 y Courthouse Street Hu , WI 54016 $ 25.0 175.0 ~ c-a~ $25.00 1 time of ~`''`~ ~(o-8a~? i?l ~'S'1~'IZ L- /t/ X1/4 of Section ~~, T N-R Subdivision Name ,~D K Realty sign by house?~If so, list firm: ~~~TELS~~V ~v D D ~T ALL POSSIBLE, A MAP, i . e, COPY O~ ~LA~ $,OOA~,c»F~ AND A COPY OF THE LISTING SHEET. ~~ Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by runnin the Ovate for several hours before the test can be conduct . ~+- us f~ft~ ~~ ~~ Nr ~ ~~ ~ y WINTER ESTING: Many times Ova er lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained.~enni(-ems Olson Firm or individual requesting services•.~~11 3 1 , Telephone Number -- REPORT TO BE SENT TO • ~' a! ;cRTL~LSJ~Iu ~v7>17 . Closing date Signature ~ ,,,1 ~E NN ~ ~~ ~iZc 7 ~,... u ' ; ~ ri -- ~, c s~` ~~ ~~ ~~ ~~ 5 ~. ~~ N W i/4 - N W l/4 145 A r - ~ (~ 144 B /~ --`. ~ ~~ H ~a N{ !- ./~. ~.- ..yam ~ ,L>~ ~ ~ `~ R / 7a.8' 16fly' / _R"E ~ NE /ice ! lip b 144C ~.~~ ' ~ N // 6627' 144 n~~ /,~ ~ i I a,, ~ ~\ ~~ c145A / 1~4A ~P O ~ ~ ~i m \ eej, \\ ` / I N . . , ~`' r '- c ~~61 v . ~ ~ 1413 A i ' 'j' i ;, r oti. ~ 146 K ~~ ~ ~ ,, a ~/ 146E 147A ~ •; . ~ ! ~~ "~ -~ , ~~~~~ / / 2 . / 9S~, (~ n N / 1 4 6 6 256' ~~'/ y ~,3 ~ 1 V ~' // ~ i /• he 9 !J i ~ i -:-' 22.3 ~,;%~ 4`7, p~,~ ~ 146D 1 - 146E m I I t5 I ~ ~o. ' ~ 146E ~2 ~_~ w ~~4 ~ ~ I~ 'I I SEl/4-N i LOT I , 18 ~ ~ /~ I 147 l4 6 146 ~i~,• 2' / r I ~;., ~/ 529 ~ /' Lei G~~ , / ~ 146 I ~ ~ / \1~ e ' ~' y ~4 ~ . 1 '` ~ >46 C I ;; ~ 146 B I .,~ ' .ir NDTE: COMPLETE FIELD SU vEY ~ ~ !vEEDED TO •_ETEPMINE TAU DiMEN51~ ~ ~ ~ 6 PCSt7i0k5 OF AtL rARCE 5 I'V THE I / ~ // / ~ NN I/G EXCLUDING PARK VI w ESTATE B PAF,CELS 146N 8 14 TA 146 0 w V4 OR. __- ; - - E E~. 17 ~ ~~'~" .. "~.~ .~ Sept. 12, 1991 Jennifer Olson Century 21 706 19th St. Hudson, WI 54016 Dear Ms. Olson: ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, W154016 (715) 386-4680 An inspection of the septic system on the property of U.S. West/ Brooks/Sonner located at 980 Hudson, WI was conducted on Sept. 12, 1991. At the same time a water sample was obtained for testing. .The results of that testing will be sent to you as soon as we receive them back from the; laboratory. At the time of inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is 'the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. erely, ~ Mary J. Jenkins Assistant Zoning Administrator cj s~ '' s•' SERCO Laboratories 1931 West County Road C2. SL Paul. Minnesota 55113 Phone (612) 636-7173 FAX (612) 636-7178 LaE~vF~r'+TClnY s=-lriALYSIS FiEF'ORT' ItiO: 8L 84 1f1f_)~.J~ti +=msrQr~iai jesting Laboratory t 3 ~ z•a. i ~: _-t . Doi: ~ c ~E ~'ii~'itF BstP'I~ LE ~f?`~: B~t~F°`E E~ES;:Ji~IrTlGtd: _!_.-_ Bromodichicromethane~ ugr'L Ere~=?o7orm, i?~~J~ From=-?etr~:ne,}~L?gJL iP~ethyl bromide: '_.~--~,[~rf tetraLh~ or3. (tee \ ~?gJL r e L Ff~Gr 1 Fi?4's E C1~LLECTED: ia9J 1 ~.ii 91 ; ~='9l 1 1 l~? 1 L}ATE FtEGE_~E£t: ~?~J1?r91 s.~~7LLECTcD H~' CL I El+~fT DEL I VE?=tED L Y : CL I El~~ '~NP1°LE TY*= E DR Y Nk: I NG ~-ATEt=i St. Croix Zoning Hudson, [~lI 54016 1 ~~i5t~ f ~. 8. West 1 ~~~~+ f; . ~. ~ , J t:i.tia ~- {ii~ , i - 1 ~ 1 ?=~lorc;et~:~:^e, ~?g/~ {Ethyl ~haoride~ <~a.y .~-~hioroe=hyi~fin'YI R~~-;fi?-s t_?g!~ °•.~:s4 Chiorc~lethane, ~?gJL CMeth;~l chloride) ~:C~.~ ir•=.'~~romoc~ l orornet'-1a~?e, ugJL <i:~, 4 ?,~-Dichloroben~ene, ugJL io-Dichlorobenzene~ _-!ti ct-:l oroben~ ene, ~?glL +~??-iii hl erobenz.ene~ i,4-iiichlorobenzene, uglL i~-i~ichiorobenzene5 Dichlo~'adi#luorol??ethane, ugJL 1,i-i~ichlor~ethane, ugfL f,?-L~ichlorc~ethane, ugfL tEthyl e?-?e di ct~?I o?•-i de? I,f-%ichloreathene, ugiL tra~±s-1,~-ui_hloroethene, uglL i,2-i-ic~lioro~rcipane, 1_+.gr'L Yis-i,-'-Di rhlor~?propene, ugfL <:ti.2 <c;.2 <~i. f «. 1 ~:i.5 tr:~ns-i , -'-ui chl oro~+ropene, ug/L :t~. ~ Methylene chloride, uglL <;S.D {Dichloromethane} t_ means "not detected at this Ievel", 1.~~ r 1 < t -1. C~ {Freon i2) ~:ti.5 CC1. 1 1 mg = 10C:Cs ug . Member ~•. J SERCO Laboratories ,1931 West County Road C2. St. Paul. Minnesota 55113 Phone (612) 636-7173 FAX (612) 636-7178 ~t ~E~GF:c=;~ Gi~:'r` ANA~Y~ 1 ~ ~(E~GFi T t~iG: E,aE%+ IC1fC~4f91 GEF:;~G ~ At'~~=•LE rvi, : 1 L~55i ;1 ~=i?"S~~i t i~-~~.t~I°TIG~tI; L#. S. MieSt i cx~~ ------ ---------------------------------- , i,~,.~:-Tetra.chloroet:~ane, ±1gfL -------- ~~'~.~ etrachicroethere, 'a9f~- ;:1.5 ~,,i-Trichloroethane, ~tgf` {G:t~, =: = i ,~-Trichl,~roethane, ugfL . t C}. 1 Trics~Ioro ~ Iuo rometh ane, ~+.gfL ir=reon fi) ;~ i.7 J r ~ t ~'Y'~i1~1 ch~.QriI..f t?a i1~fL i { 1.~/ ~en~e^e, ttpfL ; 1. ~.~ PACE :f 'lC7i;_ierie, 1_!yf~, 'i.l.il ?richloroethene, ugf~ ~:i).4 This sample's analytical results are below the ii. ;,. EF-A's SHWA Maxa~nl_tm i~ontami Want I evel o~ 1 f._,titf~i ~c+r those regtlested compounds which are aI 51- on the S~~vA ~"iG~ I i st. AIIanalvses were ; erformed 1_lsing EPA or ether accepted methodoioaie~. Samples that ;nay he o~ an environmentally hazareous nature will be r?-F•'_1."-nef~ tO yo(-d. +~ther s-asR~ i es wi ~. i be stored 1Or -':•°~ ~a1{S trOi~1 tii+? date o~ this repcTrt, then 1.iisposel] o~f 13y SERGG Lahoratorie=_-. `lease co^t-art me i* ether arrangetnents are needed. This report maf not oe rerroducec, e.:cept in its entirety, witt-lout prior written approval . rom SEr~GG Lah~~~-ato~-ies, r'ieport submitted by, .. ~~iane ~+. nderscn += r-o? ect Manager means "not detected at this level". 1 mg = IOC~~ ug. Member 09/27/91 13:11 '715 982 4030 COMM. TEST LAB ---~-- S. C. CO CRTHOUSE X1002 I •'p ~ i i i SERCC~ Labaratc~ries 193114Mt t`.G~d-tY Neaa CZ. SC. P.uf. hlifMlNQti 66 t 4'~ PPpM (61a 43671 t3 fA1i {94?a 4~7 tt0 i - L:;&L'tfi~ATCiRY ANgLYSi3 RE.=+~~T NO: ~1~~ ~'AtSE ~ ~. ~~24f92 Commercial ie~zinq Laboratory ~i4 Masn 5t. Bex 326 G©1fax. ~iI .;~I..O Attn: f}atnel a Gan^ SERCO SA~iPLG M4: Si~1'71~LE DE'3CkIPTIONs pNALYS15: -~rrr~..-----......++r~ swr-++~-~~.r-rr~rrrr-~-~~ Firtyt»ndichloram~thansr, uplL J4romof orm, uglL Bromometharrar, uq/L tt'lethyi bro~aide) Carbon t~trachlorida, ufl/t. Chloroben~ene, uglL Chloraethatn~, ug/L 2-Chloreyethyivinyl Chloroform, uglL t~thyl ~hlaride) ether, t~glL Chioromethane, uq/L (Methyl chloride) Di bratatachloromethdrse, ug1L 1 ~2-Di chlort5benzene~ uplL to-Di chi orobnr,~enr) i,~-Dfehlorobenzene, uplL {m-DiChldrobvnzen~3 1,4-Dichlorobenzene, uQ/L t p-Di swhl araber~~ ene) II~i eh I arpdi, f 1 uorotnethine ~ i~1~Dichloroethano~ ugt`L 1,2-DiChloroethar~e, uglL tEthyi tin^ df ehi orf dej i,i^-dlehloroethvne, uq/L *rana-I,2-DichiOrtiathene, i , Z-Diehl vrapropane, ~cplL C i s~ 1, w~-D i Ch 1 OI''Opl~'L'~p~l7l, . uglL tFrQtM 12) uQlL uplL trans-3,3-Dichlor~apropene, ugrL Methylene CM~oride~ uq/L t)17i it h 1 orQenethenr ) D~1~'E C~LtEC?ED ~ (i~/ 1 C-141; BATE RECEiVELt 09f17f91 COL~L~CTfiD BY CLIENT 1YEL T VEREb 8Y' t CL. I ENT ~S-+aMPLE TYPE ~ DRINICYNG I i ~176t~1 97~ai 3 ~ 8aK ken U'. $. i14q~ We6t X8.5 <t1.5 {1.0 «~~ to.2 <~.2 <s.~ «.a €4.4 «.4 ~a.4 :~.~ ~ 0.5 <4. S X0.6 Ka.6 ~G.4 <c~.4 {i.t7 <1.O <1^4 ~ 11.d ~i.~ X1.0 i4. "S X4.5 C: i <Q. i I X0.2 X0.2 ~a.1 <o. i {0. X <t?.1 <1.5 I ti.s . ~CO.~# +C4.9 ~.0 <5.d t~~}1'_1f~1 ~IATEr~ r ~' c ` SEFi.~C3 L~br~~~t~ri~s t/,l1WweCountrAaaaCT. St. Paw. a1u+n..ex.6b713 Plton•tA1~la.1B~71~s r~ucro,2~eaaane ~ :..:iBu~C{~iTL7R~'' tiNF~t.'r$IS ~~10RY nIC1: di.i~ ~:~!i~c i u9l~ qtr ~ Y a~rcC:t SaMF? E r14t i ~~b41 I ~ r ~': - S~MR± m 4E3CRSPTI~7Na 5akken U. ;. 1444. west r'~FfALYS g 5 1,1,2,2-Tetrachlarp4+~hanQ, up/L {{y,~ {4,3 Tetraeh 1 orflethane, yqi j„ ti 1.'.-" ~ 1. W i , i ; i-'i'rx chi oreet:hane, ug/l. ~c~. 8 4S. V i ~ 1,2-Tr3chloroethanat uql~ ~©. 1 ~c~. 1 Trichlorcrfluoro~eethane, ug/L sFwaen 333 t0.7 X0,7 Vi»yl chloride, ug/L ~l.d {1.U Benzene, ug/L <t.+~ X1.4 Ethyl benzenr, ug/!, ~' 1.4 ~ t . ~ Toluene, ug/L <1.~~ ~ ~i.v A12 artialyste:! were parfQrmQd .using BRA or" other accepted method©1Qgfea. 5aus~pl es that may k~a of an envi rvnmenta2l y hazaarctaus nature wi 1 i be retuned to yCu. tither safiplee wi 13 br storeact for 3G day: from the datb of this' report, then disposed pf by SERCO Laboratories. F~2,Qase contact me it other ,7,rrangemenCe sre naedecl. Yhis report may net be reproduced, except in its entirety, without prior written approval from SERCO Laboratories. Repertsubmitted by, liana 3, ~k-tlerson Pro14~t MatnaQer i t' meaner "not derteGCaed at this 1 anal " ! ! a9 ~ iG40 ug. Wisconsin D~+partment of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Breault, Ma Hudson, Tow of CST BM Elev: '~ o Insp. BM EIev:T BM Descriptiop; ~ - t( ' ( ~a S~ y , V ~ i TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~~~'/~ Dosing ~~~ Aeration 5 Holding TANK SETBACK INFORMATION TANK TO P_!L WELL .-''i BLDG. Vent to Air Intake ROAD Septic \ Jv~ / ~ ~ Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number ~~0~ TDH Lift Friction Loss System H a TDH Ft Forcemain Le~tly- / Dia. „ Dis . to Well SOIL ABSORPTION SYSTEM // f- // „~ / 1--- County: St. Croix Sanitary Permit No: 506150 0 State Plan ID No: Parcel Tax No: 020-1033-80-000 SectionlTown/Range/Map No: 17.29.19.146M ELEVATION DATA STATION BS HI FS ELEV. Benchmark~m ~ ~ ` ~ /D -~ • ~,~ ~ Alt~pd ~ ~ RIr1~Ra~,ver ~ - St/H Inlet //~ ~ 9o.~sr SUHt Outlet ~-U ~- „r.--- Dt Inlet ~- fi Dt Bottom /,~,~,~ ~~' ~/ p D ~• Head r/Man." ~a ¢ + . S Bot. System Z„ ~ ~~ ~ ~ ~ ~~ Final Grade ~~ +/~ ?,~` .'7 St Cover - ~ ~ .~ ,/'1,t,.~.QJL , ~~ = S • Z- v BED/TRENCH Width ~ ength No. f Trenches PIT DIMENSIO No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ ~ L~((j,f. 7'7 7 C7 3 SETBACK SYSTEM TO P/ B DG WEL LAKE/STREA LEACHING Ma u a turer: INFORMATION CHAMBER OR / Type Of stem: ~ ~ ' / ~ ~ _ ', ~~ /~ UNIT Model Number: i ~ . DISTRIBUTION SYSTEM ~ ~~ Heade an' I Length Dia Distribution ~ Pipe(s) Lp~ !l ~ ~ Length /'~ Dia Spacing ~ x Hole Size _- x Hole Sing /~ Vent Air Intake 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 discrepencies, persons present, etc.) Inspection #1:~/~/~~ Inspection #2: / / Location: 980 Priester Lane Hudson, WI 540f _16-(SW 1/4 NW 1/4 17 T29N R19W) metes & bounds Lot ~ ~ Parcel No: 17.29.19.146M 1.) Alt BM Description = (~ ~ ~ r~'~ „~" ~jO ~s'7e~~~~-/,i~+/f~~ ~!'i'LF+wf ~'/LGtOV~/~-":. , ' 2.) Bidg sewer length = ZS ~ ~s~~~~',~~-71 iG e~x.K+i .Tv ~t.0~. LZ~G't'~tt~ - amount of cover = ~ ~ ~ ~ " Use otherlside foruadditional information. No ~, ~_ ~`~_! ~ ~ ___--- _ _____ __ __ ___ . _.L1~~r_~il_'4. 2~_-_ _.. _ S~__` i_J SBD-6710 (R.3/97) Date Insepctor's Sig ture Cert. No. commerce.wi.gov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 ~ i scons i n Madison. WI 53707-7162 Sanita led in b_v Co ) Department of Commerce RECEIVED (o ~ Sanitary Permit Application State Transaction Number 007 2 3 2 Wis. Adm. Code. submission of thi orm t e ap pria ernment I In accordance with s. Comm. 83.21(2) , unit is required prior to obtaining a sanitary permit Note: Applicati rm s OWTS a Project Address (if different than ai ng address) submitted to the Department of Commerce. Personal information yo may be used for seconda ~ CROIX COUNTY u ses in accordance with the Privacy Law, s. 15.04(1)(m). Stats. ST. L A lication Information -Please Print :111 Information 1 Property Owner's Name arcel # Property Ow er's Mailing Address ~~~ ZjA Propem~ Location / -' L~ /r//r' k/ iC{~~/ J/I~f/ Gti B , Govt. Lot City, State Zip Code Phone mbcr ~ y; ~~ 4~. Section ~~~ ^~~ DZ T (circle ontl T ,Z~N: R~~Eor(~ 11. 'T'ype of building (check all that apply) of # ~or2t~amilvDwelling-Number of Bedrooms ,3 ~ '-'~ Subdivision Name Block # ~- ^ Public/Commercial -Describe Use ~- ^ City of ^ d ib um L+ '~'T1 Village of ^ State Owne -Descr e Use _ ~'~ ~ , ~, L_f f o.cn of ~G/f~f~ ~Y7 0 III. Type of Permit: (Check only one box on line :~. Complete Tine B if applicable) i :~. ^ New System replacement SYStetn ^ '1'reatmendHolding funk Replacement Only ^ Other Modification to Fsistine S~~s[em logplain) B. ^ Permit Renewal ^ Permit Revision ^ Change of Plumber >> ^ I ~nnit'frtnster to New List Previous Permit Number and Date Issued Betbre fi~piration O~rner p ~/~ ~ ~ ~ ~ ~0 1 IY 'I'vpe of POWTS System/Component/Device• (Check all that apply) uitahle soil '-t i n o fs > M Non-Pressurized In-Ground ^ Pressurized In-Ground ^ At-Grade ^ o~d ^ Mormd <_d in. ofsuitablz ,oil ~ , ,,~ ~ ~ ,~- / / ~ i ^ fielding Tank ^ Other Dispersal Component (esplai ~ ~//l/`~'tif~~7ftretreatment D ice (explain) ~ . Dis ersal/Trcatment :area Information: ' ~ Design Flow (gpd) Design Soil Application Ratesgpdst) Dispersal Area Reyuirad tsf Dispersal Ar ea Prop :cd (si ~ S~~stem L.1 cation G 3 ~/ / 3• .~ ~'I. ank Intit Capacity in Total # of Manufactu rer Gallons Gallons Units r - o ~ ., ~I New Tanks Esistine Tanks ~ ~ ~ u ~ ~ - - - cs 3- ~ r~ ~ ~.:~ f n f _ Septic oiryfekh~i'at5~ -~- ~ ~ ~ ~K / Dosing Chamber ~_ ~ / I i li I'll. Responsibility Statement- I, the undersigned, assume responsibility for inshdlation o'[he PO«'TS shown on the attached plans. Plumber's Name (Print) Plumber's S~ ~ tore Mali'/MPRS Number ~ Business Phone Number i Plumbers Address (Street City, State. Zip Co ~ 7 GLj"N /T,c~ o r r W.t ~~ ' ~~111. Co ~/De artment Use Onlv pproved ^ Disapproved hermit f=ee Date sued Is' me Agent Sie tre ~~~~ /~ ~~~~ ~ ^ Owner Given Reason for Denial ~ D S `~~ IX. Conditions of:~pproval/Reasons for Disapproval ~ ,~jGz,~„ /f,~.~ /)i/~J".~`~-/ ~~ SYSTEM OWNER: ~i „' ~~'W ""1` ~ ~ ,,/d 1 Septic tank, effluent filter and ~~ . ~ 3.3.3 (,vat' da/ j dispersal cell must all be serviced /maintained as per management plan provided by plumber. as per applicable`~t~P~f`~If`I~fi~~~ r°r `ne s's`em n"~ s°n"'i` `° `ne c°°"h °"'" °" pAper nut less than 8 tlz x t t inches in size SBD-6398 (R. 01/07) Valid thru 01/09 W~L/~duT t ~~1 i~~~ ~~~ y i3.~~,~k~ r ~-=3/ 7 f~~~ ~''-yon .\ ,~ u = 8~ ~ ~m~. v f srw~~ s-~-v~-~~ /~ ~ Q = ,r3or«~ ~j~,,..~ y et/ ' ? C'~G1~ C:e.~ c ~«s .~ ~.~- 6S' ~ Lo.J g3. S ~ E~- ~I syrj~ l ~~~~ Q~ e~~~~~ /9./ ~ ~~- ~a'4 ~~o E~ N~~ ~°,.° m-w N V i~ ~#~ ~~ s° ~ °'v N ~ 0 U ~1 ~/ H ~U ,---~ ~ N U '~ 3 ~ CC3 4-+ OO ~ ~ ry1 U N TO V ~l ` n 3 a ~ ~ ~ - Q~ a o- c~d m O ~^L U f ~ ~ ~ t ly, G. n .a (t~~,! O ~ ~ ~ w o u - ~o _~ :_ .... -~ - . ~ a ~ - - _ ~ -_ ~ - y- { _ -` • ••~ ~ _ ~ - i~ v L _ • _ - y .:_,; . _ Q ~-o } ~: 'm.o .-}~ "µ._ .-7~t . ' -~'~.' i ~-~ ~ ~ - - ~ ` ~ ~ __ L -~ q_ ~- - d ~ i • -°~ - -. .; \i' - :- t _~_. -- sa- ~_- _ M~ iit - 1 ~t* -~_~ ~ i `: S S ~ -.`~. f ~;~ ~U ~ -. m _. ` ~ - - n~~ aQi i;~ - -- - ~ ~ t ~ i .`, s i ~1 ~. S~ ij ~ i 'd i-~ b ' VJ .~ ~ ® :~-j-_ a-~ _: 11 ~_ - -. 1 - -~ _ -_ - a ~ - , -'~ ~ - i `1 --.. ~_ _ ~~ - ~~ - - - \ i , I ~ r - ------_'_-F O n n n o i~ a~ ~ ~ ~ ~ f ~ 1 ~ Q} .--r ~, i' ~, ~ f ~i ' ~ ~ N ~ ~~ ~ 0 ~ H N 00 .sr O w m -~ 3 b O. U f"+ c~ b U O U a~ O .i,,, .~ ~r N a~ O S a ti ~99. ~ ~~ i~ ' n w,~.~xm~r ~~i ir~o 3 J3~~ »-~ ffay.~ fP ~ l ~ /1~~.~y i3~a~k~ r ~js/ 7 ~ sc,~L~ r~'`r'O~ ~ ~ r- Q 3- ~ ~~~ ~~,,~ . a ~ ~o~~~ _W ~ w~LL ~ . ,et ~.o~~v T,~.vks ~a•rr~ srl I ~ ~LGS .' ~- ~~ ~ Lm.J~ ! q3, ~ '~_ tysT~"' Combination Tank Component Cross Section Approved Manhole Covers With Warning Labels and Locking Device / 4" Min_ Above Final Grade 4" Sch. 40 Vent > or = to 12" Above Final Grade Weather Proof Junction Box Electric per NEC 300 & COIvgvl. 16.28 WAC Inlet Approved Effluent Filter < or = to 1/8" BafIli~ Particle Size A ~r ®D~/~Bo L ~ B C Tank Mfr. ~~x~ /Z D Alternate Outlet Location W/Approved 4" Sleeve _ Force Main Diam. _ " deep Hole or Anti Siphon Device Pump Off Elev. Dose Tank Elev. i Vertical Difference Between Pump Off and Distribution Pipe = Minimum Required Supply Pressure ...................................... _ -- ?~ FT. of Force Main x3.o3 Friction Factor/100FT.... _ .~ Total Dynamic Head .................... _ ~', 7 Number of Doses ... _ ~ Per Day Gal. Per Day/ #of Doses = So Gal. Volume of Backflow .................................................................... _ .~ Gat. Total Dose Volume ..................................................................... = i S' ,~ Gal. Pump Tank Capacity ~~ Gallons Pump Tank Volune /~/,2. Gal/Inch Pump Mfr. ro ~. L~ Pump Model v Minimum Discharg Rate = GPM Dimensions Inches Gallons A ~ _ 3Lo. v C ~~~~~ D -~- ~r.~.~6 • ~ Alarm Mfr. S ~ j,`~p~ Alarm Model -,L j~~/ h~ Total= 2 2,f ~D Bed Tank per COMM. 83.45(5) yi ~ ~ ~`~ Anchor Tank as necessary to negate buoyant forces per COMM. 83.43(8)(g). ~~#~~~ 30 MODEL: 3871 25 - 20 15 EP05~ ~a 5 EP04 00 1 0 2 0 3 0 40 5 0 US.GPM 0 2 4 6 8 10 12 rtr~/iv ~ CAPACITY ,' 0 Pump Specifications `/~o and'l2 HP Up to 60 GPM Maximum head to 32' Discharge size 1'/Z' NPT Solids: 3/4" maximum Motor All motors feature ball bearing construction. Single phase:115V Materials of Construction Cast iron Thermoplastic Stainless steel Features and Benefits • EP04 impeller- semi-open design with pump out vanes to protect mechanical seal. • EP05 impeller -enclosed design for improved pertormance. • Rugged,glass-filled thermoplastic casing and base design provides superior strength and corrosion resistance. • Cast iron motor housing for efficient heat transfer, strength, and durability. • Corrosion resistant threaded stainless steel shaft. • Available for automatic and manual operation. • CSA fisted models available. ration and feature stainless steel hardware. WiscorrsinDepartmentofCommerce SOIL EVALUATION REPORT Division Of Safety and Buildings in ~rnnrrl~nro uri-h (:nmm Ar, Wic Aram r'rvla 1780 page 1 of 3 A.C.E. Soil & Site Evaluations County Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference point {BM), direction and Parcel I D percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. . . 020-1033-80-000 P/ease print all infionnation. R gy D e Personal information you Laa, s. 15.04 (1) (m)). ~ ~' 2b Property Owner Property Location Peter & Vicki Bear Govt. Lot SW 1/4 NW 1/4 S 17 T 29 N R 19 W Properly Owner's Mailing Add p, ~ ~ ~ `~ ~ Lot # Block # Subd. Name ar CSM# 980 Priester Lane City to ~ ber ~ City J Vllage 1/ Tovm N~rest Road NU Q P Hudson ~ - Hudson Priester Lane 1 ~~ 2 S"~' q~~' ~~ ;:J New Construction Use: ~ Residential / Number of bedrooms 3 Code derived design flow rate 450 jJ/ Replacement ~ Public or commercial -Describe: Parent material Glacial outwash Flood plain elevation, if applicable na General comments and recommendations: Dosing required to reach system area. Install two trenches at elev. 93.50' using 22 leaching chambers. GPD Boring # ~ Boring 1I Pit Ground Surface elev. 98.10 ft. Depth to limiting factor ~98p in• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roois GP D/ftT in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-4 10yr32 none I fill na na as 2fmc na na 2 4-7 7.5yr4/6 none s fill na na as 2fmc na na 3 7-14 10yr32 none sl 2fsbk mvfr cs 2fm,1 c 0.6 1.0 4 14-36 10yr4/3 none Ifs 0 sg mvfr cs 2fm,1c 0.5 1.0 5 36-50 7.5yr4/6 none gr Is 0 sg ml cs 1f 0.7 1.6 6 50-98 10yr5l6 none gr s 0 sg dl - - 0.7 1.6 a Boring # ~ Boring Pit Ground Surface elev. 98.25 ft. Depth to limiting factor ~ 102" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roois GP D/tt2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-14 10yr4/3 none Ifs fill na na as 2fmc na na 2 14-18 10yr32 none sl 2fsbk mvfr gw 2fmc 0.6 1.0 3 18-36 10yr32 none Ifs 0 sg ml cw 1fmc 0.5 1.0 4 36-52 7.5yr4/6 none gr Is 0 sg ml cw 1fm 0.7 1.6 5 52-102 10yr5/6 none gr s 0 sg ml - - 0.7 1.6 ~t * Effluent #1 = BOD ~ 30 <_ mglL and TS >30 < 150 mg/L * Effluent #2 = BOD <30 mg/L and TSS <30 mg/l. CST Name (Please Print) Signature. CST Number James K. Thompson ~_ 3602 Address A.C.E. Sal 8 Site Evalu Date Evaluation Conducted Telephone Number 340 Paulson Lake La . Osceola. WI 54020 4/122004 715-248-7767 • Property Owr-er Peter & YK[b Bear /Ro Parcel lD # 020-1033-80-000 Page 2 of 3 Boring # ~ Boring ' /~ f Pit Ground Surface elev. 98.00 ft. Depth to IimRing factor >99" in. mil Application Rate Horizon Depth Dominant Color Redox Descr~tion Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 1 0-17 10yr4/3 none Ifs fill na na as 2fmc na na 2 17-21 10yr32 none sl 2fsbk mvfr gw 2fmc 0.6 1.0 3 21-32 10yr3/2 none Ifs 0 sg ml cw 1fmc 0.5 1.0 4 32-48 7.5yr4/6 none gr Is 0 sg ml cw 1fm 0.7 1.6 5 48-99 10yr5/6 none gr s 0 sg ml - - 0.7 1.6 ^ Boring # ~ Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 ^ Boring # ~ Boring PK Ground Surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD $> 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. ~~ ' ~ ~~~ox~dc ~e4 ~~; ~ ~ec~:L f' we.l~ _ op of ~rl c~s;~: 9~7r' ~' ~_ ~ ~ad¢• ~ ` ~= 99.0 r' .r \ti W i x, Q ~ ~, x, ~ 'r . y~i ~%i 0 ~i fsee5 I ~i bru.S ~ ~L i I r /( 3,5'wn¢,a/ Q/eve _ v/G~ I,~.~ _---~ QXif~jnq reSici''encG d~~veway ~- ¢Xisfl I~.J i, ~ s.7 , 98 • 0 81 ~ ez:sE~~~aaqq ~ drYt,~lf~s I ~ ~ 1 j ~ ~ .b~ ~ Q w ~ ~ ~/ Q~3 Pates r' ~ ~ /~.ne ~~, by/ dk~K pa.d ty'¢.eS ~ bruS~ .9 ~ mil Q/a/ua ~on~E • E/ev(~ E:o.~ ~nd~~~d~.a-F'trecs ~ ~ $ca /e ~ / `= ~O ~ / Kote: 1'to ~PPrQC~'~.b /e 5 /o~OQ ~l,!'o c,~~ / SySteM alert M Ede /a-~,'o» 5 -Gid,at s.T : 98.6.3' - Top o4' S.T ~b/e : 98 ~ ' -ESE. ekv: at xV~-c.~a,,,~ o ~. tit : 90.50,' -Grade o/trb~+~Idrnq Scw~:99.od: p~ , 3 0~-~ ~~t• 1 tl; 1 AlV1t 1V1AllV~l'.LNANt;L{ ALi1ZL{L{MENT AND OWNERSHIP CERTIFICATION FORM Owner/$~er _ ~liS~,~y QiC.~.r~ arLT Mailing Address ~l.Z.z t~.rl~l~~/ L~ ~~w .~rc~ixsri~ .ovz- ~-'rb-/7 Property Address (Verification required from Planning 8c City/State LEGAL DESCRIPTION for new construction.) Parcel Identification Number m„Z a ... /m33 -dro _~p Property LocationSw i/4 , ~~'/4 ,Sec.../ ~ , T ~~N RAW, Town of ___~Lupf~yy Subdivision _ ~ / Lot # --' . Certified Survey Map # `~~~ ~e7~Zf/1?G~/y ,Volume ,Page # Warranty Deed # ~y~ ~ Volume ,Page # Spec house yes Lot lines identifiable ® no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Irr~roPer use and maintenance of your septic system could resuh in its premabu~e failure to handle wastes. Proper maintenance consists of pumping oar the septic hank every three years or sconce, if heeded, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in tbe waste disposal system Owner maintenance responsibilities are specified in §Comm 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman pfimbar, restricfied plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper apeiatimg condition ardor (2) aver inspection and pumping (if nary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin, Certification stating that your septic system has bees maintained must be corx~leted and retuned to titre St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form 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. Number of bedrooms 3 ~~,~.s,~ ~,~ SIGN OF APPLICANT(S) ~ DATE ***.Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Departmeril. *** Include with this application a recorded warranty deed from the Register of Deeds Offitce and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) a Y~' T pLE dNFOIgIIlAl70N *V~ues types for domes-dc w and septic ~ errwie~x. MAIN ~ u~uaw..c ~••• •~••••••.~ Service Fieque~l/ Serw~ Event ^ morrthlsi n 3 years) d NA Inspect condition of tank(s) At least once every= ~ s) 1Mtren sludge and scum eq~ one-tired {~ of tank voN~ne DNA pump out contents of tank{~ D {s) 3 yam) ^ NA ect dispersal cdlls} Ins At iea~st once every: 3 . p D mottdt{s} .D NA L. Clean effluent filter ~ ~ At least once every: ' . ~ s) D month{s} -p,NA ~ Inspect pump, P~ control & alarm At least once every: D year{s} - ^ monthts} ~ NA Flush- laterals and Pressure test At least once every: O year(s) , D rrrorrthls) _ j'1 NA Amer:- At least once e+renr- D year(s) Q.NA VM~•• #ANN7'E10ANCE dNSTRUCTIONS one of the fodowin9 uses or cations: Inspections of tanks and d- cads shad be made by an ind-nridual carryirs 9 Maintainer: Saptage OP'~'ator. T~k Master Plumber: Master Plumber Restricted Sewer; POWYS )nypector% POWTSor broken hardware. iderrtifY any cracks or leaks, inspections must incGde a visual itspection of the tanklsl to identify arry rrrrss kg g ,~ effhre<rt on the ground surface. measure the vokrme of combined sludge and scum and to check for in the observation pipes and to dteck for any ponding The dispersal cedlsl shad be vistr~h- Inspected to check the effluent may ~~ a fang condiibn and requires the of effluent on the grolwNf surface- The P~~ of effhlent on the ground immediate notrlicatwn of the local regulatory auttority_ When the combined accumulation of sludge and scum in any tank equals d rrs~sed}ofr~ ~ Ada ace w~h ~ p ~ej~13, contents of the tank shad be removed by a Septage Servicing Operator Wisconsin Administrative Code. ed components. Pretreatment All other services, mcludklg but not limited to the servicing of efflo~~t fikers, ~~SP . units, and any servicing at intervals of S12 months, shah be pert _ - of any service event. A service report shad be provided to the k-caf regulatory authority with°r 1 O days of completion • 1'VYY ~ a7 VYV~YGR v .r.r+..ai.~....aa ....-....--....-------- - -- -- •' -T"- .~ati'f UP AND OPBilok'><ION of painting products a other chemicals For new consmiction: prior ~ use of the POWTS dteck treatment tankls} for the presence that may impede the ueatrnent Process andlor damage the dispersal ~f sl. ff h~ a ~ detected have the contents of the rankle! removed by a septage servicing operator pnor to use. System start up shalt not occur when sal conditions are frozen aR the mfikrative su wer ~ restored the excess wastewater will be During power outages Pump tanks may fN above normal ~ When po to the dispersal cell(s) ~ ono ~ dose. overbad'mg the cell(s) and may result in the backup or surface discharge of d-~scharged of the pump tank r~noved by a Septage ~vicin9 pear to restoring effluent. To avoid this srtuatiat ha+re the contents the pump controls to power to the effluent pump or contact a Plc or POWTS Maintamer m ~~ ~ manuagt- o restore normal levels within the pump tank. Do not drive or park vesicles over tangy arxi dmpersal cells' Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade sail absorption ~~' the performance and prolong the life of the Reduction or elimination of the foNowrng from the wastewater stream may ewe dental floss: d'~apers; disinfectants; fat; POWTS: antibiotics: baby wipes: cigarette butts: condoms: cotton swabs; degreasers: medicatwns; oil; foundation drain (sump pump) wat+~; fruit and vegetable peel'mgs; gasoline: grease; herb~crdes; meat scraps: painting products; Pesticides; sanity napkins; tampons; and water softener brine. - ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • Alt piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. of by a Septage Servicing Operator. . • The contents of all tanks and p-tts shall be removed and properly disposed . ~ -- After pumping, all tanks and pits shaft be excavated and removed or their covers removed and the void space filled with - soil, gravel or another inert solid material. CON7'INQENCY PLAN if the POWTS fails and cannot be repaired the following measures have been, or. must be taken, to provide acode-comp iaM replacement system: . _ ^ A suitable reptatt erg has been evacuated and may be u~ for the location of a r~laoem~t soil absorption syst~n. The replacement area should be protected from d~burbance and cow and should not be infringed upon by stnrctcrre, cot tines and welts. fame to Prareck the ~ area will required setbacks from egg and proposed area. ~ systems must result in the need for a new sog and site evaluatan to estaf>risfi a ~ comply with the rotes in effect at that time. ^_ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS tachnotogy a holding tank may be installed as a last resort to replace the failed POWTS. ~. The site has not been evaluated to identify a suitable replacement area. Ups failu t o~ ~ ~~ ~ a hold-mg tank evatuafwn must be performed to locate a suitable replac~nent area- If no replacemen -. may be installed as a last resort to replace the failed POWTS. ^ Mound and at-grade soil absorption systems may be reconstructed in Place following removal of the biomat ~at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. - < <WAINIING> > gappR MSU' O)(y(,`>gll.-DO NOT SEPTIC. PUMP AND OTHER TREATMB~T TANKS MAY CONTANI LEiHA1. GABS DEJr-TH MAY I~SUI.T. RESCUE OF A • ~ A~ T~ MtNT~OR OF A TMiK MAY t3E ~OffFICULT OR HNPOSSIBLE- , - #221180 _- ~ c POWTS INSTALLER ~~ v Name c Phone °7j.~_ ~`,3 49' - ~~ 1JJ v~v-7~+w+ POW7'S MAWTANIBi - - Name - - Phone SEPTAGE SERVICW6 OPERATOR tPUM~1 .... LOCAL -T~' Auk tv~ ~ f~t)C ~0.1.,~~3zY Name _ _ p,~ Phone Phone ~~ ~ a V - - e ~. Triis document was drafted in compliance with ahaPt~ Comm 83.22t211W1111d1&(fl and 83.5'1111, 121 & 13L 1Ner~tsin A ~~ Document Number I SPECIAL WARRANTY DEED NAME AND RETURN ADDRESS: Mary Breault 980 Priester Lane Hudson, wI 54016 TAX PARCEL NO.: 020-1033-$0-000 This Deed, made between Homesales Inc. ("Grantor', and Mary Breault ("Grantee'. Grantor, for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisrnnsin ("Property': 8 4 ~ 2a ~ C2>t KATHLEEN H. wALSH REGISTER OF DEEDS ST. GROIX CO., MI RECEIVED FOR RECORD 03/23/20N? 10:10Ali MARRAHTY DEEI> EXERT N REC FEE: 11.00 TRANS FEE: 525.00 COPY FEE: Cr FEE: PAGES: 1 // This is not FiolnesteBd propertrty. ~ZO - lU'~ 3 - go-flao PART OF THE NW 1/4 OF SECTION 17, TOWNSHIP 29 NORTH, RANGE 19 WEST, TOWN OF HUDSON, ST. CROIX COUNTY, WISCONSIN, DESCRIBED AS FOLLOWS: FROM THE SW CORNER OF SAID NW 1/4 GO DUE EAST A DISTANCE OF 1056.9 FEET; THENCE DUE NORTH A DISTANCE OF 739.2 FEET; THENCE NORTH 43 DEGREES 34' EAST, A DISTANCE OF 370.8 FEET TO THE POINT OF BEGINNING FOR PARCEL TO BE DESCRIBED HEREIN; THENCE NORTH 53 DEGREES 34' WEST, A DISTANCE OF 186.5 FEET; THENCE NORTH Ol DEGREE 04' WEST, A DISTANCE OF 294.8 FEET; THENCE DUE EAST A DISTANCE OF 197.3 FEET; THENCE SOUTH O1 DEGREE 04' EAST A DISTANCE OF 354.6 FEET; THENCE SOUTH 43 DEGREES 34' WEST A~ DISTANCE OF 70.2 FEET TO THE POINT OF BEGINNING. TOGETHER WITH EASEMENT FOR INGRESS AND EGRESS AS DESCRIBED IN GRANT OF EASEMENT RECORDED IN VOLUME 648, PAGE 103, A5 DOCUMENT NO. 378192 AND IN GRANT OF EASEMENT RECORDED IN VOLUME 601, PAGE 493, AS DOCUMENT NO. 360034. GRANTOR WARRANTS TITLE AGAINST THE LAWFUL CLAIMS ARISING BY, THROUGH OR UNDER GRANTOR ONLY, BUT NOT FURTHER OR OTHERWISE Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except municipal and zoning ordinances and agreements entered under them, recorded easements for the distribution of utility and municipal services, recorded building and use restrictions and covenants, and general taxes levied in the year of closing. Dated this March 16, 2007. Homesales Inc. By ~ s2!c.~ C._ r i AUTHENTICATION ACKNOWLEDGEMENT Signature(s) State of ~~"axc.~ County of ~ a\\ ~ authenticated this March 16, 2007. Personally came before me on U.u~e.e- the above _..__ __ ____.____ _ named s~,a V - _ ~„~~~~+1 to me known Printed Name: to be the person(s) who executed the foregoing instrument and acknowledged the same. TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by 706.06, Wis. Stats.) n ax 1~~ Notary Public: Notary County/State: / Commission Expires: THIS INSTRUMENT DRAFTED BY: a ADRIq R. BRFNNAN Attorney Gerald T. Warzyn s ~, ~ _ Notary Public. State of Texas ~~:z My Commission Expires '~,~, State Bar No. 1016508 F~~„.~~' Fsbrucrry 20, 2011 ~~ "~n~';~°` r""~ IL (Signatures may be authenticated or acknowledged. Both are not necessary.) File Number: 222408 wi~consin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division + ~ INSPECTION REPORT FGENERAL INFORMATION (ATTAC~rt TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Bear, Peter & Vicki Hudson Townshi CST BM Elev: Insp. BM Elev: BM Description: TANK IN FOR ION TYPE ANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL B Vent to Air Intake uosing Aeration PUMP/SIPHON INFORMATION Manufacturer Model Number Ft SOIL ABSORPTION BEDiTRENCH Width DIMENSIONS SETBACK SYSTEM INFORMATION Type Of Sys DISTRIBUTION S W el I BLDG (WELL ELEVATION DATA STATION Outlet Bottom Grade county: St. Croix Sanitary Permit No: 453420 0 State Plan ID No 020-1 80-000 town/Range/Map No: 17.29.1 146M HI FS ELEYa lo. Of Pits Inside Dia. LEACHING Manufacturer. CHAMBER OR UNIT Model Number. Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVEF~ x Pressure Systems Only xx Mound Or At-Grade Stems Only Depth Over Depth Over xx Depth of xx See /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes ~ No ,,;~ ~ Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 980 Priester Lane Hudson, WI 54016 (SW 1/4 NW 1/4 17 T29N R19W) NA Lot Parcel No: 17.29.19.146M 1.) Alt BM Description = 2.) Bldg sewer length = -amount of cover = Plan revision Required? _ l Yes ~ No r I ~' Use other side for additional information. ~ ~___ l j SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. ID'S ~ 11 ~ie~~ .yr o.-t ~7~ Safety and Buildings Division Co ty ~ ' ~ 201 W. Washington Ave., P.U. Box 7162 ~scons~n Madison, WI 53707 - 7162 Sanitary ermit Number (to >>e fille in by Co.) De artment of Commerce (608) 266'3151 Sanitary Permit Application State Plan LA. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, s15.04(1)(m) n_ Project Address (if different than mailing address) I. Application Information -Please Print All Info 7 r~ ~ ~ <~;/ I"' S"` 4 Q Pr rty Owner's Na me € Parc 1 y Lot At k X r Property Owner's ailing Address s 2 Property Location ~ ~ City State Zi C k • r~ 'I 'S n / l , p ode Phone Number ~ [ /~I p !~~ '~.1~~ I,,~ t7 circle e) ~ II. Type of Building ( ck all that apply) T ; R E ot ,~1 or 2 Family Dwelling - tuber of Bedrooms ~ ubdivision N e CSM Number ^ Public/Commercial - Describ se ~- __ _ _ _ ^ State Owned -Describe Use 2 ~. ~ ~ _ I 1 'Village owruhip of ~~~~IJJ ZZ H - III. Type of Permit: (Check only a box on line A. Complete ne B if ble} ~ O ~ - ~p , ~ yv( '4' ^ New System ~Replacem System ^ TreatmenU old'ng Tan Re ent O ^ O Modification to Existing System B. ^ Permit Renewal ^ Permit Revisio ^ Change ^ Pe it Tran r t ew tst Previous Permit Number and Date Issued Before Expiration Plumber Own 1V. T of POWTS S stem: (Check all that a 1 ) Non -Pressurized In-Ground ^ Mound > 24 in. o 'table soil U Mound < t ' suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ F ing Tank U Peat ter L.i Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter Leaching Chamber ^ Drip Line .' Gravel-less Pipe ^ Other (explain) V. Dis rsallTreatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispe Are ' equired (sf) Dispersal Area Proposed (sf) System Elevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Uni ( ~}_ !oa Concrete Constructed Glass N E ew xisting Tanks Tanks Septic or Nolding Tank ~ / ~ ~ O Aerobic Treatment Unil Dosing Chamber ~~ VII. Responsibility Statement- I, the tmdersi ,assume rPsponsibilily for installation a POWTS shown on the attached plans. Plumber's Na Print) .r Plumber' nature MP/MPRS Num Business Phone Number ' ^ ~ U ~ I ~U ~ L/C~/ Plumber's Addre ss (Street, City, State, Zip e) U' D ~ ~ ~~c~~o~ "~ ~~U1 VIII. Count /De ent Use Approved ^ Disapprov Sanitary Permit Fee (includes Groundwater Date Issu ssu' g Agent Sign re (No Stamps) ^ Owner en Reason for Denial Surcharge Fee) ~'-' IX. Conditions of Approval/Reasons for Disapproval 3~C-~Gt`S '~ ~ a~c~ ~7 a ~`•. ~~l SYSTEM OWNER: 1 Septic tank, effluent filter and 4d ~ wt , . 33 ~ -~ , dispersal cell must all be serviced /maintained --- ~~ as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances. ~•..~.. wmp~e~e y~ans lro me county omy) for the system on paper nM less than SUl x 1t inches in size SBD-6398 (R. 01!03) .. I- : , t~ w / t~ ~'l v t~ 1 r/~ j_, «~k~ ~ ~S ,~ ~C ~. cvi ncl ~ rs~ I p~eNch htoR~, l1°~~ O~j J l b~ N~ / ~ ~ 1-ev - ~ UD . 0 ~--- T~p o~ W< ' caslNS ~ ~~cl S~1rv5 ~pri,~ ~kv~ 99.'? 3 ~~2uo~~ o~ N?I,,J-boo ypi Sc '1~.. wlpla~ ~~~-~~ P~~+~ - BoU 5yl P~M~ t~ok~~ o ~~,~ W~y `~~~ ~Onc-t 1tioiN as' ~k„~', ~~ D~~l1s P~-`'~p~e.Jd' T~ I~P~ ,..~,- P'~ u ~~ ~~or, ~S l~a~ ~:l~s 93-so ... _Y'_....._ ... _.. . I,p,IIA.I '~iI ~~ .~ ~` AA~ C .N ' ~ ~, ~ .s _~• .3 v~ S ZO x h M ~ ~"" r . ! , X1...1 (rte / f~ ~/v t" / r/i ~, «~kl ~ _S ~~~ ~ u~~n~.le rs~ . ~~,~ ~.~ ~...~?'`G ~s~:_.._~~~...._....--- ~~M_ L- .... _ :'n:~_ ~~u.m~.~ der.. .. . ~~ _-~Z'___.... ~e..~~~ .La..,t~ _. ._... ~c,~~1sc: ~ ~~~yU...~. _____.... _ ~ . r ReH~~ ht~Rk Q~'~o-., d~ S-b1 N~ f ~ 1-ev = BUD. ~ __ r---~ Tip ~~ ccs, N ~ o .- ~~cl S~4rv~ lJD9~...,~ 3 ~~ ~~~ ~~ NSW-l~o~ ypi s~ '~~ w I p)ov ~'~ -~ ~ ~~~ - S00 ~~1 ~~M~ C~~~~~ o T~ s ~. ~2~t 5~ ~~ ~~ I7R111~ l,.l n~ ~a" ~orcc,~ hoiN as' ~k- ~~"~ -~~ ~~j,-~~Is- P~Mp~J~- ~; -~~~ a -T ~ k ~~,_7~ -N / ~p ~~~~iS -',.-- ~~am ~ L~w~.~s 9 ~- sa ... _T-.. ....... _......pp ... ~~,,~ ~~ ,,,~~ ..II // / ~ ~~ T/ C 01 .~ ~~ ~ ~ ~ .s So g x '~ K • ~ ~a ~ r 82 PRIVATE SEWAGE SYSTEMS - II PAGE Of ti~~C.l. vE41T PIPE ~' 44 r RCM DOOR, '.r ~CC'+J CR FRESH AIR ;F;TAKE i B"."1I IJ. \ 11.1LE T1 APPROVED JO!AIT/ ~+'; C... PIPE CXTENDIAIG ?' Q~.1T0 SOLID SCIL ELEV. FT. PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS Iz'Mlu. A e C D VEA)T CAP WEATHER PROOF JuuCTIOAI Box GRADE I I COAIDUIT ~-- APPROVED LOCK4NG MA-JHOIE COVER \~~ ,~ `~\\ PROVIDE ~ AIRTIGHT SEAL ~ I I 4 I I J PUMP -~ (~ ~ l C0IJCRETE BLOCK y' MIR.I. 1 ~ ~ i8"MIU. ~----- - - - I II ~ f V APPROVED .:OIAiTS I ~ ~.,//C.I. vIPE I (~ ALARM EXTELIOtUG 3~ I I ~ ' v O-J I UNTO SOLID SOIL OfF RISER EXIT PE P.P11TfED G-JLy IF TAUK MAAJUFACTURER HAS SUCH APPROVAL SPEC.IFICATIOAJS SEPTIC E LOSE J FA T RE ' ~ I~1<e~S 1JUMBER OF DOSES: PER DAy . At. U C U TArUKS I R TANK _!ZE : Q UUy - GALlOA15 OOSE 'JOLUME I~~ ' ~eVQI ,/~~ib1L~ ItUCLUDiAIG BACKFLOW: - GAIIOtiS 1 1 F URER: ALARM_ MAIJUFACT any , / INCNES OR ~~U'~ GALLCUS J L PACITIES: A= ~ ~ MODEL I.IUMBER: ._ _ _ ^ V CA l I ~ WLL0~5 S OR ~ SWITCH TYPE: !tiCNE - 8= ~` c I Q ~]~~ ~ ;,A_~0r.J5 J L._'~1CNE5 OR 1 ~' ` `~' C =- PUMP NlA1JUFACTURER: w ~ ~~/ ~ ~ LL GAll0A15 IAtCNES :R = ~~ `10CEL 1JUMBER: A D -~.- _ SWITCH TYPE: ~.( _ NOTE' PUMP A1JD ALARM ARE TO DE ~ i ~ ~ Q ~~ INSTALLED ON SEPARATE CIRCUITS MIAIIMUM DISCHARGE RATE~IY-GPM . FEET VERTICAL DIFrERENCE CETWEEAI PUMP OcP AUO DISTRIBUTION PIPE. + M11,11MUM NETWORK SUPPLY P'R~E(S\S~L+RE 2.5 FEET F FRICTIOW fACTOR._ ~orr. ~."-- FEET + ~ ~ EET OF FORGE MAIW X {~ II l( ~ FEcT TOTAL DyfJAMIC HEAP = 7T5~ ~ I l} EPTH ~ ~ ~ IR]TEGZNAL CIMEIJStoti15 _ ;LIQUIO D ;WIDTH Jf Ta1,IK: LENGTH Slc;r~E C: ~' ~~a 9o`f _ DATE: "1 ~u ~~/ _ LICENSE IJUMB.R: _ 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 4 Number of Bedrooms Design Flow -Peak (gpd) S Estimated Flow -Average (gpd) 3 0 Septic Tank Capacity (gal) p~ v Soil Absorption Component Size (ft2) (o $~{ (p 2 . !' Type of Wastewater Domestic Table 2: Soil Absorption Component -Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow -Peak (gpd) b , 2 ~ ;h Maximum Influent Particle Size (in) ~ ~ 1/8 Maximum BODS (mglL) asp 220 Maximum TSS (mg/L) , S v 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 u let filte shall be cleaned as necessary to ensure proper operation. The filter cartridge shou no a 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 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 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 the 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 over 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 fora 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. When system fails, we will replace with another system at owner's expense. Alternate area must be left undisturbed. St Croix County Zoning Office 386-4680 Boumeester & Sons Excavating 386-9020 Tri-County Sanitation 386-2130 3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWh1ERSHIP CERTIFICATION FORM OwnerBuyer ~ ~P ~ ~- ~ ~ ~ ~ ~P,Q, j` Mailing Address ~~D ~/'~~P_,~,teel" //i./'7 P Property Address ~~(~ ~/' /~~ ~•~P~' /ct,/'1 ~ ~~Q c7 D ~ LV-~ (Verification required from Planning Department for new construction) City/State ~~Sn~ L~J~ Parcel Identification Number Gb7O - /~~~ - -GY~o (.1 '~ m LEGAL,. DESCRIPTION Property Location ,~]~, '/,, ,~, '/., Sec. ~~, T,~N-R,1,~W, Town of ~~~a~l~-tom ~bdivision .Lot # Certified Survey Map # '~- ;Volume .Page # • Warranty peed # 'S~~J'~~.~~ : .Volume o ~ _, Page # 4~ Spec house O yes (~no Lot lines identifiable ~ yes O no { 'r: SYSTEM NANCE~ Improper use sad maintenance of your septic system could result in its premature failure to handle wastes, Proper"maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the fuactio~n of the septic tank as a treatment stage in the waste disposal system. The property owner agrees,to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the oa-:ire wastewaterdiaposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requiremtnts sad agree to maintain the private sewage disposal system with the standards ttt forth, herein, as set bythe Department 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 Zoning Office within 30 days of the three year expiration date. SIGNATURE OF APPLICANT DATE . • ~rDWNER CERTIFICATION ~ . ••i~ :i'(we) certify that alt statements on this form are trot to the best of my (our) knowledge. I (we) am (are) the owner(s) of the roptrty,.described above, b virtue of a warranty deed recorded in Register of Deeds Office. •~ ~ SIGNATURE 01; ' PLICANT ~ DATE ••'••• Any information that is miS-represented may result in the sanitary permit being revoked by the Zoning Department. •••'•• •• Include with this application: a stamped warranty deed from the Register of Deeds office ~a copy of the certified survey map if reference is made in the warranty decd oo^Ut~IErIT r:9. STATE: Ii:~R (1F WISCUNSIN FpR~i 1-i992 iN~+ s..~c PCS[PY(O roP ,ccono~no o,T~ • WARRANTY DEED 4'5232 Y•': ~~t1t~uE sd2 ~ia~l..; ~_.,•: S ~ -_ This Deed made between ... ReC`d for Record KEVIN J. SOMM~RS AND EMILY Jf BROOKS, HUSBAND AND WIFE, A HOMES'CEAD PROPERTY _ ,~~ ; j• ~ ;J 1JJ ' _ Grantor, /+alt 12:00 P. M :rn.l Pater D_ Rear and Victoria- M. fi~ar, r C~ /~ ~~nn husband and wile, surv;vorsilip marital ,•(f'""1'" ~~~''^^~t~C R^rJist~/ of pna+s ProPertY .. _.- Crouare, Wltil£SSetrl, That the said Granttr, for a valuTable considcra::un ~•unc~;s to Gr:rntce the fol'.owing described roal estate in (',nr;;h:, irate of Nr'i~sconsin: Tax f arret Vo: ---- -•_-----------•------- ----- PAR"I' OF TIIE NW 1/4 01' SECTION 17, TOWNSHIP 29 NORTIi, RANGE l9 WEST, ST. CKOIX COUNTY, WISCONSIN DESCRIBED AS ~'01.1.OWS: PRt)M11 TIIE SOUTIiWEST CORNER OF SAID NW 1!4 GO DtIE EAST A DISTANCE OF 1056.9 FEET; 'TIlENCE 7UE NORTIi A DISTANCE OF 739.2 FEE"T; THENCE N43 UEGREFS 34' E A DIS'T'ANCE OF 370.8. FEET TO TIIE P(11NI' OF BEGINNING FOR PARCEL I'O BE UFSCRIBED IIF,REIN; -I'IIF:NCE N 53 DEGREES 34' W A UISTANCF. OF 186.5 FEE-T; I-IlENCE N 1 DEGREE 04' W A DIS"TANCE OM' 244.8 FEE"f; "TIIF:NCE DUE F:AS'F A DISTANCE OF 197.3 F;.E-P; THENCE SI DEGREE 04'E: A DISTANCE. OF 354.6 F'EE"T; "THENCE S43 DEGREES 34' 1V A DLS"i'ANCE OF 70.2 F'EE"f TO TIIE. POINT OF BEGINNING. -I'OGETIiER WI'I'1! AN EASt:M1tENT FOR ACCESS TO T11E ABOVE llFSCRIBED PROPERTY OVER AND ACROSS T11E EYISTING ROAD NOW OPENED AND -TRAVELED WES-TERLY TO CONNECT "TO -THE ECIS"TING TOWN ROAD. 1- ~' ~, ~e~~ ~ rc~~ ~~ ___- ,~ 1 3b~o.o ~ 'This I$ humestcad pr~.:,••rtc (isl f:3 net) Ta,;ether with as ar ? ;iar fire he • ~ ~.m••rt ~ ;4 ;r*, . -,es ,.~ ~..!a heh; ~;;ri Kevln J. ommers and E'mi Ly Jo crooks ~:,.r_i•.t, that t„e t~.t1e i~ Kc>~°d, .t.-ii~;c,lc,f;, in .e • !n;ple anal [rce :.. ...'sr ~t: r -~~::nhru:~te, except :~n;, ~..i;l ~.c;,rrant :url ~1•_.~-.:d tre >snn•. _ /_ / /+ KEfV1N S1JtiL~1ERS r-. EMILY JO BK~OKS°~ (SF:YIIJ ~ ~ (SEAL AUTFIENTICATION ,~CKNOW,LEDGMENT ~ r' .~ ~i;-•tature(a) ___ -.--.--- ---- ST.1TF. OF ~ti ' ~: .. authenticated thi; lac b`- 13 ~ be;or~ the t .~ "`. -- :at' - t' t tail' rutT:e t; ~ .... .. r` /, /> r i /i ` U ~ -. 13 -the aho^e named __ _. ' . _. _. .. _ __- _ _ E;°tILY JO BROOKS TITLE: ~.lr~tr.>•:p :;•r.~T>:: e_al: r,F~ lr<<<•:;~::~r~; i1r ..red b'. ~~tt;.ihi, ~t ~t::,_.) .. ~~' . t., ,,:e '. ~, i .~-, ,,n n c•xrr ttcd :}e "• -• fnm•, ,. _ ...-'; ;rr r.t .~ .••kno«'le~l>;e tr'r s;itr.c. 146E .. ~, ~~,°`~' , 146H F i~ 146M ~J~~ 147A 6 / ~/ ,~G , ~ '~ ~ ~ 4~~ 146E ~~~~~ 1 ~l ~`