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020-1269-10-000
~~o~ ~y0 ~ I ~ ~ ~ I ~ ~ ~ I ~ ~ A 3 ~ 3 I I I I 3 I s 3 :* I ~: o I O W .Ty L ~ I ((mm~~ L z O C q O ~ CD ? D) j y O y 3 y ~ lD n ~ p ~ O fOf ~ N ~ ~ y p O ~ N C ~ a ~ p O O N N = ~ C C~9 d - ~' ~ (D a CD CT A 3 ~ I ~ y w l ~ w I ~ -.I I J Vi Z D V1 Cp O. o=i ~ m c/? ~ D ~ ~ ~ I ~ ~ N c[a D a ~ cca rn m I IW I lW I W °' I °< I 3 °' Om~ I °' O p W~ ~ m p N~ ~ ~ ~ ~ ~ ~ r ~ ~ I p °~ I N o p I O ~ fD ~ N I W =I ~ . = I I o O O O p > Z O O O gg gg gg gg v c ~ y~ `z I ~ v c 7. N N N~ I o~ ~ ~ ~ ~ ~ ~ ? N ~ ~ G A N A p C D ~ ~ ~o a, I a ~ ~ a, ~' 3 m I ~ 3 ~ I o N .. a ~ y I •• I o •• I N I a ~ ~' O x ~ ~ ~ O ~ ~~ O ? O N ~ ~ ~ (D ~ Cn ? O 7 (7 ~ 0 ? N ~ COD ~ ' 0 N I ~ ~ ~. I j m ~' ~. I ~ I ~' v N a I o ~' ~ N a I W ° ~ ~ ~ I ~ ~ I cd - z ~ I ~ ~ ~ y O ~ ~ y ~ O y c, I ~ m v a I I I > > I W ~ I W ~ a ~ I a ~ I o :' I o ^' I I ~ I I N ~ ~ I ~° I C ° v I W I ~ I ~ I a ~ I 2N a ~ I ~~ a ~= v 0 ~ C " ~ O C 7 O G N O N c ~ '~ O fy C ~ 111 o a I m,m a a I m o ' N < ~ y o I ~ N y o . I I N o I ~ I c ~, I a J I I io v I a ~ I I ~• I I I ~ I I I o I a m I I I m l I v V o ~ N i ~ ~ O O O `D I m I co I o f I o~ I o I °o % I o° % I $ a o ~' O ~ ~ ~ ~ ° ...1 ~ __ ° N ° 1 N W W '' N fNll = ~ ~' '' co ao'' a ~' F rn.°a~ A j ~ i C d O O O O ~ ~~~~ ~ v o ° ~ 0'1 d w N A ~ ~ o ~c a ~ (D y N y ~ ~. CND n O c 7 a CWD N a 3 o :~ !~ Z f W c a 3~~ d ~ c ~ c ~ n ~ '30 ,~~. ~^A ~ ~ ~ ... ` 1 ~ ~ ~ O _ , N ~ ~. C (1 IV Q ICI O ~ ~ R N n ~_ yy~ O ~ Y F N O O O ~ O ~ ? O ~ -p O d 3 K Q ~~ .. < W ~ p N ~ ~ ~ m d w a V ~ 0 W n a a -a rn A Z N .a ~ '% A `Z,' 3 (n ~ N Z ~ ~ A H A b m ti °o A A Op ao w ~o ti ~ Parcel #: 020-1269-10-000 12/15/2004 08:41 AM PAGE 1 OF 1 Alt. Parcel #: 21.29.19.1325 020 -TOWN OF HUDSON Current OX ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): ` =Current Owner *HAGAMAN, BRIAN BRIAN HAGAMAN 837 HARBOR VIEW RD HUDSON WI 54016 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description * 837 HARBOR VIEW RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.167 Plat: 2137-JACOBS LANDING THIRD ADDITION SEC 21 T29N R19W PT NW NW & SW NW Block/Condo Bldg: LOT 32 2.167AC LOT 32 JACOBS LANDING THIRD ADDITION N/WA LOT 32 OF CSM 8/2370 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 21-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 09/01 /2004 773178 2647/501 QC 08/13/2003 735299 2361/196 WD 906/354 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 49366 242,000 Valuations: Last Changed: 10/29/2001 Descriptian Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.167 30,900 156,300 187,200 NO Totals far 2004: General Property 2.167 30,900 156,300 187,200 Woodland 0.000 0 0 Totals far 2003: General Property 2.167 30,900 156,300 187,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 114 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 ~ . FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER Sa. ~, /Yt; l ~~~ TOWNSHIP ~~~~ a .+ - SECTION Z ~T~N-R,~~ ADDRESS ~,o~t ~ Z g z ST. CROIX COUNTY, WISCONSIN -~~ SUBDIVISION-JQ~o ~ < L~ ,~ ~~ 4 t LOT 3 z LOT SIZE Z - lG7 ~C PLAN VIEW ~ 33 fl= I ao.o~ BSNCfDlARK: Elevation and descriptioLn~: "Tn ~ g~ ?~~d/ Vd~ 16rt Alternate benchmark ~ `Lg 1 e P ~7 ~~-~-~~~-~^ ~{~~ SLPTiC TANK:Manufacturer: ~,~~; s~~ Liquid Cap. ao ~ Rings used:~Manhole cover el®v:Final grade elevs //,tea Tank inlet elev.: 1. 5 +~ Tank outlet elev.: 1 z ~~iZ- No. of feet from nearest road: Front_ ~, Side , Rear Ft. SHOW NVERYTHING WITHIN 100 FEET OF SYSTEM P:Jl~ C~i~l~ER - Manufacturer:~~ Liquid Ca acct • P y• Pump Model:_p~p/Siphon Manufact.: Pump Size Elevation of inlet:,_~Bottom of tank elevation Pump on elev.:_pump off elev.:`Gallons/cycle: alarm: Man.: _Switch Type: Location Distance from nearest prop. line: Front , Side, Rear Ft -- • _._ Distance from: Well Building SOIL SORPTION 3YSTEl~ Bed: Co-. v ~':o ~d Trench: '" seepage pit: ` -=--_._ width: 1__ ~ ___Length 3 ~~ Number of Lines: _~J~rea Built G_Sr ~ •r- Exist. Grade Elev. Proposed Firial Grade Elev. Fill depth to top of pipe:_~~ No. feet Prom nearest prop. line:Front Side ' _~ , Rear `Ft. / S No. fe,~t from well: 9 -s No. feet Prom building S~ HOLDING TANK Manufacturer:__ ~~~ Capacity: No. of rings used:__Elevation of bottom tank: Elevation of inlet: - No. feet from nearest prop. line:Front ~, Side _, Rea iFt._ No. feet from: Welh_, building ~ ~ ._____, nearest road alarm Manufacturers INSPECTOR: DATE: PLUMBER ON JOB:_~~ f yl~_ ~~~ ~~ ~ LICENSE NUMBER: 6/90:cj * • ~~ ~ ~~T~ & BUILDING DEPAFiTMcNT OF INDUSTRY, INSPECTION REPORT FOR LABOR & HUMAN RELATIONS DIVISION ~PprypO;~rrytBOX 7y9}W6y9 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES ~ APPLICATION JVY=q O~VV-4j3~eC21,T29-R19 SfatsgnedD.Number: Town o f Hudson, L 3 CONVENTIONAL ^ ALTERATIVE „ , ~ I-~f'.,7rlinn Tank ^ In-C~rnund Pressure ^ Mound 11Q L LJ V 1 V 1 V YY 1\ll • NAME OF PERMIT HOLDER: - ADDRESS OF PERMIT HOLDER: INSPECTION DATE: ~ ~ ~ ~/. Sam Miller Box 282 H d on WI ~/~~ 9/ BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: E REF. PT. ELEV.: CST REF. PT. LEV. O / , ~ ~ /?'`j /~ ~ ~ ~t-~ - ~ L -ry -. X1'!3-.'l"~c rv.. ~ S. ~ / = T~ ~ // Il ~ V~ . V Name of Plumber: MP/MPRSW No . County: Sanitary Permit Number: Dou Strohbeen 5432 St. C SEPTIC TANK ~ a.n earl 9 = D, 'J/ ,5~~ MANUFACTURER: LIQUID CAP TY: //~~ TANK INLET ELE .: TANK OUTLET ELEV.: ~~Q / WARNING LABEL PROVIDED: LOCKING COVE PROVIDED: / BEDDING: ~M~ DIA.: C ~ ~E~T MATL.: C: ~ HIGH WATER RM NUMBER OF ROAD: PROPERTY LINE f WELL: ( BUILDING: J VENT TO FRESH AIRINL T: ^ YES O . . ., ~ • • ' S ~ ALA : ^ YES O FEET FROM NEAREST ~~ ~Io ~~• ~ ~ ~~ MANUFACTURER: BEDDING: LIOUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ^ YES ^ NO ^ YES ^ NO GALLONS PER CYCLE: PUMP AND CONTROLS AL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF ^ YES ^ NO ~ SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: AMETER: MATERIAL AND MARKING: or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue.) i+~uvruTr~u w r w~r~u. c 1_ c-1 ~ - -- - v WIDTH: LENGTH: , . O OF v DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID BED/TRENCH ~ / . TRENCHES: ~ ~ MATERIAL: PIT DEPTH: i DIMENSIONS ~ ~ ~ OG-r"' GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. IPE DISTR. PIPE MATERIAL: NO I TR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: // ABOV VER: ELEV. INLET: / ELEV. END: / ,/~~ Qom(' !eJ//C',~ PIPES: FEET FROM LINE: / ~ / r`{ / AIR INLET: _/ ~ ~~S I ~l0 ~ d ~ ~ NEAREST ~~~ .5 7`~ o MOUND SYSTEM: ,y3" ' Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW YES NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ^ YES ^ NO ^ YES ^ NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOP SODDED: SEEDED: MULCHED: CENTER: EDGES: ^ YES ^ NO ^ YES ^ NO ^ YES ^ NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL TH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP ELEV.: ELEV.: ELEVATION AND DISTRIBUTION HOLE SIZE: HOLE: INFORMATION COMMENTS: DIANIFOLD I E EV.: PIPE MANIFOLD MATERIAL:I PIPES: ^ YES ^ NO "MARKERS: OBSERVATION WELLS: ^ YES ^ NO ^ YES ^ NO Sketch System on Reverse Side. SBD-6710 (R. 06/88) PIPE I DISTRIBUTION PIPE MATERIAL NUMBER OF PHUT FEET FROM LINE: NEAREST .~.~.~. CAII-IITAQV DCiQf\AIT ADDI IIf'_eT1AN In accord with ILHR 83.05, Wis. Adm. Code ~.~^".,,..a COUN /~~~ STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than ~~ QQ ~ 834 x 11 inches in size. ecK'if revision to previous application ^ G -See reverse Slde fOr Ir1StrUCtIOr1S fOf COmpl@ting thlS appllCatlOn. STATE PLAN I.D. NUMBER I. APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION. PROPERTY OWNER ~.. ROPERTY LOCATION S0. ~'.l,C~/ st~u'/aNW'/a,S~/ T•2`~,N,R /`~ E(o W 'S MAILING ADDRESS PROPERTY OWNER LOT # BLOCK # //~~ ~e ~ 2yZ Z- CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER w ~. s o ~. W'~ o / 3~S ~ Z-7 ,Tee c o ~ s l.Jn.. ~ ; K II. TYPE OF BUILDING: (Check One CITY ~ NEAREST ROAD nn ) ^ State Owned VILLAGE ~ ~ ~~ Sa to /{4r bo.~ V% c w /"CC ^ Public ~ 1 or 2 Fam. Dwelling~# of bedrooms-3 A L T N E ) Dao _ /a ~p ~~ {~~ III. BUILDING USE: (If building type is public, check all that apply) 13 Z S 1 ^ Apt/Condo 2 ^ Assembly Hall 6 ^ Medical Facility/Nursing Home 10 ^ Outdoor Recreational Facility 3 ^ Campground 7 ^ Merchandise: Sales/Repairs 11 ^ RestauranUBar/Dining 4 ^ Church/School 8 ^ Mobile Home Park 12 ^ Service Station/Car Wash 5 ^ Hotel/Motel 9 ^ Office/Factory 13 ^ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ®New 2. ^ Replacement 3. ^ Replacement of 4. ^ Reconnection of 5. ^ Repair of an System System Tank Only Existing System Existing System B) ^ A Sanitary Permit was previously issued. Permit # - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ®Seepage Bed 21 ^ Mound 30 ^ Specify Type 41 ^ Holding Tank 12 ^Seepage Trench 22 ^ In-Ground 42 ^ Pit Privy 13 ^Seepage Pit Pressure 43 ^ Vault Privy 14 ^ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. tt.) PROPOSED (sq. tt.) (Gals/day/sq. ft.) (Min./inch) ~ ELEVATION ~ „¢~p ~ ~ $~ ~i y ~ ~. 7 Z ~ 3 g y DU Feet $ ). 2 O Feet VII. TANK CAPACITY in allons Total # of rer's Name f ct M Prefab. Site Con- Steel Fiber- Plastic Exper. INFORMATION New istin Gallons Tanks a u anu oncret glass App Tanks Tanks structed Se tic Tank or Holdin Tank 000 (,~/¢ ; S , ~ lift Pum Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumb 's Srgnature: (No Stamps MP/MPRSW No.: Z s'~ Business Phone Number: ~©c,~ Srt~a~ #~Qa.r, ~ ~~ z.9E~7 3 z 3 3 Plumbe Address (Street, City, State, Zip Code): ~ It ~ " cl~ c ~. W ~ 7 IX. COUNTY/DEPARTMENT USE ONLY Approved ^ Disapproved ^ Owner Given Initial Sanitary Permit Fee (Includes Groundwater / ll~_ Surcharge Fee) a e ssue - ~~ Issuing gent Signature (No Stamps) Adve a Determi tin Z ' X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD~398 (formerly PIb~87) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety 8 Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in #1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the tots! gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this systE;m. Check experiments! approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8%z x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; welts; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; ~jose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) 11PPLICIITION FOR SIiNITMY PSRMI7' STC-100 Thf~ application torn !s to be completed in tali and signed by th• Ornt><<i~ of the. property being developed. 11ny inadequacies wilt only result In delays of the peta~ft issuance. ~9hould thfe development be intended tot resale by owner/contcactoc,tspec house), then a second Eot~n should be setalned and completed when the propesty !s sold and submitted to this Diller vllh the appropriate aeea•cecocdlnq.•-•-•••-•----•--_-- Ovnet of property ~ %~~ - Locatlon of property .~GrJ 1/~ ~1/~, Section .~./ T~•R~ Tevnehip ion Malil/n4 addteer ~~ '~ ~-~ Z- - -- ~Lt4 d a o v~ (.~.cT S~ D l t,i - Jlddceae of site .~a/ dg~ ~~~. ~oad` ~~ # L fobdlolelon name Sa~~ o ~ 5 ~-*A,rt 4/~~n ~ . Lot nusibes ~Z Previous owner of pcopeety , V ~ n i.~ /1~, ff~a 5~,~ Total slse of parcel ~* ~ ~7 i4-G_ . Oate pstcel was created . 3' Z Z' $X J-se ail corneae and lot ilnea idantftlablet =Yes ~ o Ia thla property be-ny developed for seaai• Caper housel7 ~ .,,.Yts ~ o Voluwe 8~and Page Nu~nbes r z as seeosded wllh the Reglstes of eves. INCLUDE WITH THIS 11pPLIC1-TION TIIB FOLLOwiNCt A wJ11lRJVITY Di:1ZD which includes a DOCUf1eNT NUMBaR, VOLUMi< 1W0 PJ10t NUf111<R, and the 81:11L OF THi R8028TBR OI DBBDB. In addition, a cettlEied survey, It available, would ba helpEul so as to avoid delays of the reviewing process. tE the deed dasctlptlon teterences to a CaitlEled Survey Map, the Cestltled fnsvey Map shall also be requited. PROPERTY OWNER CSRTIFICJITION itYel cectlEy that all statements on khis Eorm ase tsue to the best of wy tout) knoviedge~ that I twe) am tare) the ownerts) of the property described In this lntoe~natlon toctn, by virtue of a wasranty deed recorded in the Ottlee et the County Reglatet of Deeds as Document No. •y 3 Sy/7 j and that i twel presently own the proposed site Eot the sewage dlaposal syate~n tot t tve) have obtained an easement, ,to sun with the above descslbed ptoptrty, tot t:he conatcuetlon of sold systen+, and the same has been duly secosded !n the Ottle~ et ~ County Reglstec~ ~E Deeds, ss Document No. _~/3Syi7 1. r+c`r.uti+r+) t tvo WARRANTY DEED tars sr~~.[ wt Stnvtn rorr wttnwl,rau u~u STATE IIAR OF' Wltit:ONS{~I FQItJt 'L-:982 ~~ ;~~~ ' :. '~~i>tsc S OFFICE REGISTER . ST. CROIX Cc~., Wi Virl;lnta M. Manson, a single woman Recd for Record M~a ~2 ~~~ !~r`r!~`••~ :ul.l ++,.rr:rnt.• t++ Sam E. Miller, a slnf;le man « 8:00 A M RNMMr raf Oa~i the (otl,ra•i:+C dew•rihed real est ate in St. CCVIx • rx, r•.,,N .f) Ntatc u! 1\'r.con+in: < ,.ura), ~' Tax I'nrcel No:..:...:... ................. West Half (W'~) of the Southwest Quarter (SW't) r+I ticction Twenty-one (ll), Township Twenty-nine (29) North, R:utl;e Nineteen (19) West, St. Croix County, Wisconsin except that cart South of the public lttghway and except Lots 5, 6, 7, and 8 of Certified Survey Map n Vol. 6, Page 1747, Doc. No. 419479. That part of the West Half (W'~) of the Northwest Quarter (NW'a) of Section Twenty-one (21), 'fownsltip Twenty-nine (29) Nortlt, Range Nineteen (19) West, St. Croix County, Wisconsin lyiny~ South of the ril;ht of way of the Chicago, St. Paul, Minneapolis and thnaha Railway Crnnpany. I;~F This iS nOt hnnrt•elrwd prnPr•rt;:. #ak 1 in not ) F:,rr•c•1•~i:rr, tr• wnrrantie.: easem%nts of record and projective covenants and restrictions of record, if any. a , Sr Ihltrd this ,/ ~ t:'88 r.'F:AI,r • V.i ri;inla M. Manson t~F:AL- I~F,ALI AUTHENTICATION SiRnature(a) ...... .... authcnticaled tlria .... da}• of - 1!1 . . TITL!•:: ~iF,M1ii{F,R STATE, (tAI{ f1F R'1~(Y1NS1\ (If nnl. authorized by ~ i0r,q~, Wia. Stntr.) ACKNpW LEDUMENT STATE; OF \CISCUA'SIN + .S~<~u~ ~ ss. ('ounh. I'rr~onall} rnn+c lreforc me thin t'' ` da~• of rnlA .L t" IJ 88 the :droee namwl Virginia M. Manson f n ne• 6 non n to he l he Per; nn ~clur rsrvutcd the T.r. forecein • frunu•nt anrJ ni'knoa'Ie4¢e tiro aunu•. i INSTRUMC NT WAS DR AFTCO nY Lois, A. Murray, .Neywoodt_.Cari ~ Plurray ~• , P.O. ~ lsox 219 r~~w~-t~.•. Nudslm, WI... ~4Ol6 f~ /SiPnntun•~ nrne he nuthcnticnlcd or nrknrnc ~'"t"" uAlir ~•' ,], hrr n ler \ !,;,,p 1 t/ (~• •" ('Hunt}~. \l.. nt nreea.:.r•.• + l::rrl. Itolh h• t',..u.ri. 11 t2.L1_% !~. DEPA1iT.MENTOF REPORT ON SOIL BORINGS AND SAFETY&BUILDINGS INDUS?'RY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS (ILHR 83.09(1) & Chapter 145) LOCATION: SW ~/ NW ~/ SECTION: z~ /Tz9 N/R!9 E to W TOWNSHIP /~wesor/ LOT NO.: 3 2 BLK. NO.: - Stt~~BDIVISIO NAME: J~eco NCI COUNTY: S C2 OWNER'S BUYER'S NAME: ~ ~ ~ MAILING ADDR S: tr 11 1 , ',v W ~ ~o ~ C Q~ I'~1U>~s ~ T t,l x r~ d p oa o rvv. ocvnrvia. vv rvnvi~n~.ir~~ vco~.n~r ~ ~vw. Residence - ~~K `.r-- New ^Replace Sot ~s $optZ ~4 5f7I 5or ~y /~cDz RATIfU(.e S= Cite suitable 4or system ll= Site unsuitable for system A. Fl • via i t~ vesatnvfa ~ wrva msaut PROFIL DE RI IONS: R A N ~ 2~ 9' / 29~~r ~kN a>ep-T ~-t.AT O®~T^~ . MQIjfV~. ^~ IN-GR~ND-P~ URE: SYSTEM-IN^-FILL HOLDING TA K: RECD N ENDED SYSTE M :(opti nal) ~ ` If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s. ILHR 83.0915)(b), indicate: Ct,.iQ'.~j Floodplain, indicate Ftoodplain elevation: N ~~~, PROFILE DESCRIPTIONS BORING TOTAL D PTH TO GROUN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH'~tl. ELEVATION OBSERVED EST. HIGHE T TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 6- 2 ~ qz ~4.z4 n( ~ > $ .qZ. z " ~c s 3s"8 ,~ L N ~iS ~G re B- 3 i (.14Z 9o,I~ No > //.4Z 29• ACTS °:~eNS~ 6 "Qd a~ rl' B- ~ .b ~}2.~0 lVo > 9•~~l ~~" ~ SZ'e4~MS~fGle~c b ~3~'B~eN rhs B- ~ p,5p Q/.73 Nor~~ > a.SO 3" c-~s ~~y~QN[ ~' 4~ /ti-s~ z4">geu Ih5 6- ~~t,~l' PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER ~S AFTER SWELLING INTERVAL-MIN. PERIOD t PERIOD 2 P R PER INCH P_ Z 5.?..f) .Za 3 > Z > > ~ P_ ~, p •~~ > Z > > L P- P- EL.~14T 1J /lT P- PLOT PLAN: Show locations of colation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference ints and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. ,~ ~-___ ~-. TN ~S,F `._ SEPTIC TANK MAINTENANCE AGREEtiENT r St. Croix County ~ n OtJNER/BUYER ~.~ ~ ~ ; /~ c r ~ a ROUTE/BOX NUMBER ' ~~' '~'~' ? ~-•- .-Fire dumber •-~-"' ~ ... ~~ ZIP S i~®~G - n CITY/STATE ,l~4.~ s o m PROPERTY LOCATION :'.S'~_~•~~l~.~~ Section~•-• T~_N~ R ta. Town of H4~_ `, St. Croix county, Sub division~a,c.obt L,.d':as _~ Lot number~_ Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Prover maintenance con- sists of pumping out the septic tank every tf~ree years or sooner if needed, by a licens'ed' 's'e t•ic tank um er. What you put into the system can a ect t e .unct on o, t e•septic tank as a treat- ment~stage in the waste disposal system. . St. Croix Count residents•m~ be eligible to recieve a grant for a maximum of 60% of the cost.of replacement of a failing system whic was in operation prior to-July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new '~s~t'ems agree to keep their system properly maintained. The property owner agrees to. submit to St. Croix County Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or. .a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and •(2)•after inspection and pumping (if nec- essary), t-he sform°willkbessentsapproximately130fdayadpriordtoc~~ Certification three year 'expiration. I/WE, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Depart- menC of Natur~lo theoStCeCroixeCountyaZoningo0fficetwithinm30edays and returned of the three year expiration date. ~ SIGNE DATE 1 ~ ~ - q ~ - St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 386-4680 Sign, date and return to the above address. ~_ ' J G N 9 b- Q 1 o ~ A ~ 0 ti Y/~ 3Yc, 6 ~ . rn a od 1~~ u c ~+ ~ ~b W -ol') W P ~ D l . f, e o P a A ~ ~ `' o a _ ~ s ~rJ '~~ ,, P ~ ~ U ~ ~ 1 , e ~ ~ 4 ~ ~ ~, o O '''' ~ - y. n a. ~ ~ . ~ Q. ~ oa ,. ~ 1 ~ ~ O ~ l~ v 'per 0 ~' ,~ ;c i o ~; ~ w N I r I O~ ~ W W I W o S~ /~ r I _. ..D _' d- _ •- -~ ~ ~ 1Ti < rl a p N ~ ~ ' .~ _ ~ s ~o vim. 1 a E- r y _ ,` ~ \ M H _ ~ N < P ~ - - ~' C __ _---- --- - _ ~...~. O` ---~ - D ~~ w ,~ \ i ~~ ~r Iw ~~ ~ M /ey /~'~c 3yZ.aL ' ~/t/o S ~C ~ I m P - I~ F P ~, r w, 0 U n • R _, ~~ 1~ ~ n ,~ il ~~ 1 z l {~` ~ ~ ~ I; ~ ~ -~- ~i 1 , ( ~' 1 n r° O `i l I ~ O i O ~ I ' [T7 ~--~ I"r1 !( i ~ 'O m I 1 1 I I I ~ ~ W ~ ~ ! i 1 ! r D oa I I 1 U I I i '~ I ~ 4 1 i n ~ ~ ~ -o -~ ---~ ~_ +! rn ~ I 1I 1 O ~ 1 z '1~ i. 1 Iii Il ,,~ :~ h ~ "' ~ '~ ~ ° 4; !~! ' 0' .' I ' 1 -d 11 II 1 v~ 1 ~ ' m I 1 I I ~' m 1 ~ O ~ ~ ~ ClJ `~ i ~ 1 rn ~~ 1 1 0 ~.~.. ~~ ~ ~ ~ X O .. ~• ~ +~ ~' ~. t~1 ° o N- O n X ~ r J '"~ ~ `{ ~ ~ 0 ~ = Q -~ ~ ~ D i1 ~ C ;' ~ ,i, ~ ~ ~ z n :~ ~~ i ~ ~~ !ii I~ ~ I ry, fi ~ ~!! ~ m 'I ..Q ~iI 1 ~*: Ilt . I rn ~ d c.,.t ~ ''' ..A. l ~ ~ y ip ~~ ~~ ~ , ~I ~ f~l O ;, i W ~~ ~;~ ~!i ~ ,~~ s v _ N . h~ .._ ....--~' I r ~. -~ r .G. T _~.. r-- ~ ~ ~ ti O~ -- - ~- ~.n ~ ~.~ ~ ~"ViscGR in ~'epartment of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division ` INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. ~~- ~3 a~ 'ermit Holder's Name: City Village X Township Hesse, Bonnie Hudson Townshi ;ST BM Elev: Insp. BM Elev: BM Description: - / SANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic Dosing Aso Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ ~ 3 ~ -~ 3 ~ Dosing ± 3~, ~~~- Holding PUMP/SIPHON INFORMATION ~ScP t~.,, ,./...I Manufacturer Demand Q,~ GPM Model Number ~~ L O TDH Lift Friction Loss System Head TD Ft ~•qz .3~' x ~.3 Forcemain Length Dia. Dist. to Well ~, s ~ .. SOIL ABSORPTION SYSTEM c° ~~ St. Croix Sanitary Permit No: 399400 State Plan ID No: Parcel Tax No: 020-1269-10-000 STATION BS HI FS ELEV. Benchmark I.81 lol-~ vo '~ Ol~~le'r .5~; ~. ~~ 9y /!~ ~ab~~ ~r~t- ~. ~y 9y. o~ 4k{~ °1 8'00 r ~~ ~. 8'Z 3 - ~!' ` ' Q /~ VGII ~kr. V4Il~! "1 ~ / 7 A~ ~Z / Dt Inlet Dt Bottom Iz.~~ ~ ./y Header/Man. ~,, Z-~s q~- o~ Dist. Piperr (Gh [ / G 3 - Z 3 D 9'~• S~ Bot. System L z ~I.~,D s z '1 ~• i/ . s~ Final Grade x ~~~ St Cover BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ ' ~ / Z SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM G Manufacturer. INFORMATION HA OR S Type Of System: l~-20' , y~S , ~-3S ~ NIT Model Number: i DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake ,, Length Dia Pipe(s) , ~, // , Length~~~,s Dia ~ Spacing - !R , ~ ~ T ~S SOIL COVER x Pressure Systems Onlv 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:~~/ Z3 / o/ Inspection #2: / / Location: 837 Harbor View Lane Hudson, WI 54016 (SW 1/4 NW 1/4 21 T29N R19W) Jacobs Landing I Parcel No: 21.29.19.1325 1.) Alt BM Description = ~~ ~fc~~ vr~w ~~e~ur 'h5~q~~Pa1 2.)Bldgsewerlength= bur,e 'T'~ P~wm~~ '~ PPOVr`da G(.S-~u~({, ,® - amount of cover = ' `j0"S~`~ Plan revision Required? ~] Yes No Use other side for additional information. SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. b ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner ~T//` 1 ~ ~t~'~ti~ ~' /7~SSE- 3~~ • ~3S-O Address D ~/~'"~ City/State 1~ ^J G!j S D Legal Description: Lot ~ Block Subdivisions ~~~/i'~~ '/, . l~J '/<,(~ Sec. Lam, T 2~N-R/~W, Town of ~iUST7'~lr'"' Tank manufacturer Pump manufacturer Alarm location ~%ES ~~ Lr1Di`iit -- 11l ~, /Of'a Size ST/PC -~' Model ~` 5'. (~%Fl~ lU~Sv,~ PIN # oaD • i2.G; (HOLDING TANKS ONLY) Setbacks: Service road _ Meter location Alarm location Vent to fresh air intake Water Line SOIL ABSORPTION SYSTEM: ~~o •pi;~f'vt~° 7~-~Gtic c'P-~~S Type of system: Width ~ Length ~~ Number of Trenches Z Setback from: House 300 Well .ZOO P/L i~ • Vent to fresh air intake > SD ~ No• ELEVATIONS: Description of benchmark TOIL Df Description of alternate benchmazk ~ s.T. y" ~ s• v~-~T tvOo~ Si D%.v(~- ~/dam ~v%pD~LtJ /~.v Elevation Elevation 97 ~Z. SO Setback from: House 3s Weller ~ P/L ~ `~ Building Sewer ~ /~ ST/HT Inlet /V ST Outlet ~7 • ~Z ~ PC Inlet ~ 3' ~3 o PC Bottom a ~• y~ Header/Manifold ~~ f ` Top of ST/PC Manhole Cover _N~~' Distribution Lines Bottom of System O- ~ s-~ ~T Final Grade ( ) /~1~. p~.y~- 3~ ~ 4 ~~ Date of installation / / Permit number 3 ` ~ State plan number ~ ,~ ziG37S o . ~o Plumber's signature ~~~ ~~~G~,// License number Date ~ / ~>~~ Inspector Sd,IJ E.v /~G--~ Complete plot plan ~* rte. c ,~ e e r • !d -07~ . : ~~G~ ~ i~PL~~ ~ ~ n ~ . ~~ ~ -- 10 ~~~ ~ 3 i~~`'" s ~ --'`_- ~ Tor o f- .5, T, C ~~~P,, ~' o~Y 9°,~- o~,,,~r ~~D j/~~ .._ ~ y„ a~ ~ z ~ o ° ~ ~+ E~~ ~ ~ -use r~ SiDi;v~.. /~ ~l 7 S~ , ~ ~,~i5 Ti~~ --___ ~ ~. S,T~ ~~T~ ~~ l1 ~~ ~~ ~ ~~w y~ ~ ~ ,03 l ~-'~T~,~~g~ i~~ ~y ~ ~ ~ ~ ~'~ ~ w~~ ~-_ ~ -_- i ©~o ~ 01T~ ~ i pv~ ~ % a~~ ~ ~px3~ ~ ~ ~_ ~3 ~~ ~ i~T~T vi~f ~ /~v// ~~I/~ ' ° U,4/~ y~,So ~-------- :ti/,U~~ ~ QDX -" ~1 ~- 1r ~ SE j /N "off '` ~~ ~~ _-- /, y ~ ~i~ j1a,~ /os S ~ ~ ~7` a~ ~ v ~o~GQ- . {vS~~oS of ~~~ sysr~~ 9C~-G o ~ 9~,~U J ~- 3'X~ ~ --o - -------------~ -~ ~0, ~o T ~ i~~ Safety and Buildings Division 201 County pp L ~ !~ X ST' ~ ., W. Washington Ave., P.O. Box 7162 ' F r~seons~n Madison, WI 53707 - 7162 Site Address Department of Commerce .sCLLn-Q Sanitary Permit A lieatio Sanitary Permit Number pp In accord with Comm 83.21, Wis. Adm. Code, personal info tt11 u v ,e ~ i 1~ 1 ~ ~ ~ ~ ^ Check if Revisi ma be used for second sea Privac Law, 5. : m '• on I. Application Information -Please Print All Information ~:~~ ": ' `'~,~,,. 'l ~, ~ ~d rl ~ ~ r? State Plan I.D. Number N/i~' Property Owner's Name ` d ,/ /~ L L ,..... ; .-„ (sgj?!/ ?' /3 O~tlvi F /7~SSE r- ~- -~ ~ ~, Parcel Number old • /1 G f ` /D " G17'?> ?_ ~ Property Owner's Mailing Address ;;T c.;itfJtx !' ~ oZ pro petty Location /j d ct~t.xvt~ ,,, ~~,J d/C v/ ~~ ~ ; .- ,•. ZONAVG QFPICE r W S2I T Zy Sw ~ ~~~ ~~ City, State Zip Code \ ,.is8o a Number a~~; .__ . ~ N, R Lot Number ~ ~$lock Number 3 . ~ ~ // '' ~vOSO ~ W ~, s 7 ~ ~~ s C, d Subdivision Name ~ CSM Number ` hw/3s y 7o yG 3 II. Type of Bttilding (check all that apply) ~ ~ z 70 OCiry or 2 Family Dwelling -Number of Bedrooms ^Village ^ Public/Commercial -Describe Use ,... /~~ G 9 s's, J ^ Stat O d p , e wne Nearest Road /, ,I , ~~~~~~~ v ~f~W III. Type of Permit: (Check only one box on line A (ntunbering scheme for internal use). Co mplete line B if applicable) A' 1 ^ New 2 ~ Replacement System 3 ^ Replacement of 6 ^ Addition to For County use S stem Tank Onl Ezistin S stem B • ^ Check if Sanitary Permit Previously Issued permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) 44 Non -Pressurized In-Ground 21^ Mound 47 ^ Sand Filter 50 ^ Constructed Wetland 22 ^ Pressurized In-Ground 41 ^ Holding Tank 48 ^ Single Pass 51 ^ Drip Line 45 ^ At-Grade 46 ^ Aerobic Treatment Unit 49 ^ Recirculating 30 ^ Other (.~, 3 ~ X'(, t• ~ S~ V. Dis ersal/Treatment Area Information: (~ Design Flow (gpd) Dispersal Area Required Dispersal Area Proposed ~.7~ Soil Application Rate(Gals.lD s/Sq.Ft.) Percolation Rate (Min./Inch) System Elevation i Q i -~' Final Grade Elevation y~D 3?S ~ 7 S .7 ~,~ ~- / t r y's.o ~ ~ god, o VI. Tank Info Capacity in Gallons Total Gallons Number of Tanks Manufacturer Ptefab Concrete Site Constructed Steel Fiber Gl plastlC New Tanks Existing Tanks ~ ~ ~ / ass Septic or Holding Tank ~~ ~a~ ! ~~~ !-~ ~ ' Dosing Chamber "j ~•a J ~~O ! N I. VII. Responsibility Statement- I, We undersigned, asstmie respousstbtlity for butallatlon of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature ItRP/MPRS Number Business Phone Number RoC3~ERT ~~6~'i~T iZ~3 ~ S 7/S • 3 ~~ •~/~S ' Plumber s Address (Smet, City, State, Zip Code) lvS S O ~ N~t,`~ ~f~ ~ , f ~ ~so-J 1,~~. s yoi~ oun /De artment Use Onl proved ^ Disapproved S~~Y Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) - ^ O Gi wner ven Initial Adverse . ~~'~ /L '~y ~a ~ ~ ~~ Determination `7 l IIX. Conditions of ApprovaUReasorts For Disapproval 1. Effluent filter to be installed and maintained per manufacturer's recommendations. 2. All setbacks to system and residential structure must meet applicable code requirements Attach complete plans (to the eomh ony) rot the f~ftem on paper not leaf than 51/2:11 tncha Ia flze SBDy6398 (R. 05!01) u~.~r-t~c~-~~ & ~~s~-o~:~~ f ~~ co. a. ~. ' ~ 655 O'Neil Road • Fludson; WI 54016 ' • 715-386-8185 peg..Ues-gners o/ Engineering SJ~sfems FrivAfe Sewnge Co~rsv)larrls PROJECT INbEX PLAN I b # ~/~ DATE ~ y' d~ OWNER G,,~-jQy ~ ~O~/.t1i~ 7~~'S,3'L~ PHONE 34 ~ ~~3 s~ AbbRESS ~37 /f,~°~o,~ yiE~ ff~~So.~ 4~/..S'yo~~ L E GAL b E 5 C R I P'T I O N GOT 3 Z ~'~~ l3f L.~•.v~:`~ ~- ('S~y ~ ~ 7d~G3 - vo% ~ p~ . L 3 70 'TOWN OF !f vO.S0.,~ s'~ .~% X . -- COUNTY cs•t~M /~• ~/~it'iGlr j z- z.C[ 3 7 S' LOCAL A U'I' 11 O R I'I' Y ~ SUPERVISION .ST • ~/LQ% JC ~p,J [ ~ (~- ~'~k-~- . P'ROJEC'T bESCRIPTION: ~' y ~~ ~c s ~ s ~~~ . o /~ , s~,~ ,~ ,eP d-4,p C !~N-dG'~ ~ ii ,, , /~ /~ ~~„ S %v s, ~F G~ ~2tS ~~5~•v ~ S N Q.~i(, ~~.. , . o SSA' ff - ~v~/ U~f/~~ s~~ ~/ o ~. ~~ !' ~-~ , ~ ~ ~~,~~~ ~ r~ D ~. fie ~ ~ ~~ . t)-bricht & pssooiates gewa9e Consultants private eil Ftd~ H~• Wis. 5401/8 Qf • ~ ~ ~ z~3~ . ~/~ ~ ~ ~ ' Pg.l INFILTRATOR SIZING WORKSHEET PJ•Z SYSTEM PLOT PLAN Pg.3 CROSS SECTION OF SYSTEM, WITH ELEVATIONS. - P9.4 ~~ ~~ ., ._ T~ rn1 1 O \ ~' M ~ ~~ ., ~~e o . V ~~ b ``,. C .~ ~N O _ ~ .,m ~ ~. ~- r ° T 0 ~o b `~ r ~ 1 ~ ~~ o ;! ~ d C ~~ °c p ~ .~ ~~~~~ "~ ~ ~ o ~ ~ ~~ ~ ~ I ~ ,~ o '0 V ~.{, ~ ~l ~~ ~~ ~, -- :~ ~h h N of ~~ -~ ~. ~`i ..O C '~ to -~~1 Q C~ ~~ .~ 1 i,~. y w a ;~ ~ N ~` w x ~ ~y o ~,~~-- ~/ ~3 ~ -~ p = CD,~ -f~ v /? S _ _-r - -i i i 5 ~~~~" ~l 3 s~3` ~y. a~ 0 ~° o~.ca~"P ~w~ ~5~2 co iD~`'° ~ ~~ ~--., ~ ~ v T Gf T , Fi'LT~7P ~~ v~~ V~~ N~~ d"""_ . (~ z ` o P/c ~___ __~ i ~ ~ ' I T ~~ ~ i ~ ~ ~~.e l1 ' --- B~ ~ ~~ /~- ------_-~ ~ 1 0 Tv7~ ~,, o~ ~. P v ~ -v- N M ~~ ___ _._-- ~ -- 7r1" 1 ~D ~ 5 ~ ~ __. . _ _ h5 ---- _-_ ~~ 1 .- -- ~- - _ ~ - -- r 0 ~~ o ,o g~ ~T~ .. . ~~o~~ s ~ ~ ~~P A P. ~ ~ ~ ~ ~ w P ~9i°p~orr~l~ v~ti T c~ ~ l -~--- ~ P ~ ~ U.v ~.vS~J~c T/ov ~~ ./ ,~ ~ "Z._ ~/iv/ S If~E"D 1 ~~ 5c~. Ao -- JOI~• .Sl /.v L~~ZS 9 __ . 1,, - ______ _ c T~~ti ~ .~ - _ ~ ___..._~ ~' y /3oX y~•Sa ' - Cho ~`~~ S~ cTio~ ©~ T~'~`~v~s ~~~~ ~~ ii G- l/V ~i L 7~'~9- 7'O~'~ w ~~ 3~. ~ sQ~ Fr Tv T~9 L. p-~iL s ~-~ T~ati , . 1// ~ ~~ Z7, AP.~~ 1,. ,~ ~ ~~ ~9Pp~orr~l~ v~ti 7- cif U,v iusp~c T/ov ~~~ sc~. Qo '`L- ~~ C 9~~-~~_ T~~~ ~ ~ ,i .. ~9a y" s~ -~~ pvc. . VENT PIPE yG.o' ~~ ~1 /~~>D~ ~~E v~-~T/o ~ir~ ~-'"' 1 • ,~", D ~IEv~+n ~ti ~~. ~ INLET -.,---s- APPROVED JOINT 1J~ PIPE EXTENDING 3' OAITO SOLID SOIL, s~~ . ~¢o Pac ~q.9 ._,._ .. PLfMP CHAMBER CROSS SECTION AMID SPECIFICATIONS Pi4 E' `f of y___ ._ __._ ..._ vEN7 CAP , P~ PE WEATHER PROOF APPROVED LOCKING JUNCTION BOX ~MANw~ Gi~titN~N(~ //!/~E~ 12"Mlll. •~ GRADE coNDUIT-~ `'-- ~~~ ~~ Y" MIN. •,/~ .~ 18" MI N.. ~,.. PROVIDE i AIRTIGHT SEAL I I 1 I I I A INyIDNK I Ijl pA ~ ~(v ~ I ~p~ ~ O ` i i i ALARM B g ~ ~, ~ I , I APPROVED JOINT: W~ PIPE EXTEI.IDIAIG 3' ONTO SOLID SOIL s~.gvP ELEV, FT. ~ PUMP--~ --~ '/ i usE 3 0 I I , OFF D C •?' ~ ~lO,PE' eF ~k ~~pOI~~ ~ BLOCK S~1'.v~ ~fA V~ fio,J I . ivL ~ ~ E r-"2~-~' ~- RISER EXIT PERMI1i'ED OIJI_y IF YANK MANUFACTURER HAS SUCH APPROVAL. SEPTIC E SPEC.IFI•GATIOAIS DOSE r ,,gyp ~~c s~^ ~~G ~ ~• ~ TA AI KS MAIJUFACTURE:R : PER DAb IJUMBER OF DOSES: 1 ~ TANK SIZE: ALLOIJS G 7-So DOSE~VOLUME Z,5 ~? ;~ ALARM MANUFACTURER: d, ~ L.~~ ~9'LA~~'t• td IIJCLUDIklG BAGKFLOW: GALLONS MODEL NUMBER: ~' V' ~' ~ CAPACITIES: A= ~ INCHES OR ~ GALLOAIS 1 SWITCH TYPE: F~,~T GALLONS B . IIJCNES OR . / 2 © ~~ ~ ~2'~ GALI'OIJS J H S • PUMP MANUFACTURER: ` C~ ~j / [> ~ l Z ~ C E OR ~ C = ( II AICHES OR 2? ~ GALLO-JS ~ ' `~ O M DEL NUMBER: t D = I SWITCH TYPE: / p .,~ n ~/ j'' "~ ~S/ ~" `"~ ~1~~` IJOTE: PUMP AUD ALARM ARE TO BE ~ MINIMUM DISCHARGE RATE zd GPM ATE CIRCUITS INSTALLED OW SEPAR - L ~AN1~ S~>£C's ~~ VERTICAL DIFFERENCE BET WEEN PUMP OFF ANO DISTRIBUTIO FEET N PIPE.. -~ MINIMUM NETWORK SUPPLY PR ESSURE . .. .__._.._.___._.T~^~, . ~ FEEt EA~f^,. I Of' .Y{ P.~ a -}- ~ ~ FEET OF FORCE MAIN X ' 7 L F j tooirFRICTlON ~•'y FACTOR.. .FEET I ~-~Urf S /~~~' ` i = TOTAL DYNAMIC HEAD = ~~ EET ~~ INTERNAL bIMEN510NS OF TANK: LENGTH •~LIQUID DEPTH ;WIDTH ~ :i ~.vG~-r Tv ~~ sT~•",~ v i io.~ ~~'o ~ ~a X 9~ .So ~~ ./-' ... ~P~. S d~ S ZOELLER EFFLUENT PUMP MbDEL,'98 f totµDYMA4gNfM'tIOW-fl(In.tutf trhvftn ute ofw~ttw. , ' ~ q ` - 1~ eu~tettf tlNltUtitN ~ltf Mll[p• ill lttl• t0 ~ ~ 7! iri ~ /1 271 , 11 , ~ •.to f/ tro ~ •! leek Y•fr• ,~~: ~ she • .,'. • ( a s/e e n e 1 ~/Is t t/z-11 t/t NPI ,~, . 1{ CONSULT ~ACTOHY ~Op SPECIAL APPLICATIONS ~ EMclrlce- ellertlator~, lot duplex eystema, are ev:tllAble and ° e~pplled wAh en alarm. Mercury (lost ewltchea are avaAable Itx conlroliing single and ~ Mec~l/hilcet eMernetore, Itir duplex eyelema, are ovellable with of ° D rye 1°ae systems. tl-lhtxtl Norm hvllt;hee. plggybeck mercury (foal ewAchea are avaHable l01 varlebls level bng cycle conlrole. 8landard alt models . Weigh) ~o lbe • _t/, f (•p, aELEC?ION oUIOE • . et tetlet- t• trlhetd fbal epertdsd ! pob rneehvtk:d •whch, fa exletrnl eonbol l•puh•d. Mode) Conlrel 9etactlon :' ~~ h.Plli0i01' b F~~~ ur~r IIoN •whch a double Pl~eyb•ek mneury, ~l y h--.~! •.~.PM 11od• Am • elm t•It M91 1 t 1 ulo t ~ ` ,_ bu lax e. Meehartleal ahetnala 10 OOIZ a t0 Awa, ' _~_ ' 0.6 ~y L ~ -, 1, Bee f Mo11t, la eorriet •-~1--. 114_____x_ ~_ _~, mod•1 d Ebc4kaf AM•rnata, •' 09, 2~0 1 11.ufo f ---t9i3.~i_ /. I~lereury prna Ilod •wgeh 100 r~ E•P•k"• f M !~0 t `~ / 1 a t e 7 - d"DMK W) a iq boat •pttettt , y ° •orwd tellvola .p•eN1' ~r a duplet epetatloR~~p~app~ ~ 0 f~ollrt•tttofl ftr wked~N •kn• t. we pl 11eM `~.P.k.•. kf wretllgtd eeM.......w ~ I~M11K1~~~j4,fa~ ! ~!4r McAnM IftN b wdea en r,,,.,u_..-- ~- - -- - ~~vw PER MINUT[ ~~ q p PAGE 6 REVERSE SIDE OWNER's MAINTAINCE OF SEPTIC SYSTEM ~~ ~ - ""' POWTS (landowner) is reponsible for proper operation and maintenance of this system. Regular periodic inspections and servicing is necessary for the safe healthy operation of this system. The owner fs required by code to submit all necessary maintenance/inspection reports to the controlling authorities. SPECIFIC CONTACT AGENTS * Governmental authority/ inspectors: S/ ("e/2oi X c~`/ * Licensed installer, responsible for providing maintenance "Users" manual: ~d~t<n~ ~~~,~.~1-- ~~~s Z ~ 3 ~ s 3 ~~ • ~if~s * Licensed service / inspection agent other tha; an operation/ Uibrlcht 8~ Associates Private 3ewapa Consultants 855 O'Neil Rd. u son, . z installer: * Electrician, for pump, electric controls, wiring units: IMPORTANT OWNER MAINTENANCE RE UIREMENTS 1. Winter traffic (sledding, shove ring, etc.) across the area shall not be permitted, or frost can/will penetrate into the cell, freezing up the system. Discontinuos use in the winter (a vacaction trip, resulting in no water use) can also lead to freeze ups. 2. Water conservation needs to be exercised! Or system can kre hydrolically overloaded and destroyed. This system was designed for a maximum wastewater flow of !'~v gals. daily. 3. POWTS are not designed to accomodate wastes from a garbage disposal unit, or any other unnatural sources of waste. Any introduction of such waste materials will overload and destroy this system. ~, 4. If a power outage occurs, or a pump fails, it may result in a temporary overload of effluent being pumped into the cell, which may adversely impact the cell (leakage). It is recommended that a licensed pumper empty the dosing tank, allowing the pump to return to dosing the correct amounts. Consult your installer immediately for advice. 5. Neglect of the vegetative cover (the cells insulation S. erosion preventive) can lead to failure.'Compaction or heavy traffic also can destroy t he system. It IS NECESSARY TO REGULARLY WATER THE VEGETATION OVER A SYS'PEM!! Effluent in the system beneath IS NOT sufficient alone t0 maintain a grass cover. r , ' Wisconsin Department of Commerce SOIL EVALUATION REPORT Page , of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County 5'~; ~'~o~ x. Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.b. 02~ _~Z (p `f • ~Q , p00 Please print all information. Reviewed b 7 Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ,9' ~g' /t Property Owner V v Property Location , l Q ~~ 1 ~ ~~ilf~/~ / / ~•S,S~ Govt. Lot ~~ 1/4 N~ Z~ T ~~ N R l/ 1/4 S f(or) W Property Owner's Mailing Address lot # Block # Subd. Name or CSM# 8 3 7 ffr9iP/,~o~ Ui~ic~ 3 Z csy 7o y~ 3 voi. ~ , P~. • X370 City State Zip Code Phone Number ^ City ^ Village own Nearest Road flvdSo,~ 4~/ syo~~ (7/5 )3~~ • J3S~ /f vDSo,v ~ ffA~P,aoip ~//L~ ^ New Construction User Residential / Number of bedrooms ~_ Code derived design flow rate So GPD ^ Replacement ^ Public or commercial -Describe: Parent material ~F..Ep LDFfs• t.~ Sf},~j~~/ Flood Plain elevation if applicable ft. General comments ~ p~~ ~i1 • and recommendations: d ~ ~ ,i~~~/~}tFi~tE,t~7- ~J'.E'Fr¢ ~il~ /~ ~f U~i~'F G/fT ~U.y /~ . Boring # U Boring ~!_ • ~ (~ ? ~~ ® Pit Ground surtace elev. W d H np~rh r~ r.,,ui.,., r~,.r,,. Horizon Depth i Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ft~ n. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Etl#2 ~ • y ~0 ~ Co .._. s: L ~~ ~ ~n f • 2 3 ~ s o 'l /~ Boring # ^ Boring CI /_ ~ 7 D ! 7 3 = ~/,j • ~ . n Pit Ground surfars~ elev. lY H ne..a .., r..s.:..,. ~__.__ ~- Horizon Depth i Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soii Appli GP cation Rate D/ft~ n. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 lab iu(rS ~ . 1~0 ~ S a- ~ ~ .~ zo,v l ~ - -~~ - --- ' - -- ~ • ~~ •• •y ~ unue~ n me - oVlJS ~ au mgit. ana i ~5 _< 30 mg/L CST Name (Please Print) Signature CST Number ~?o/3F~'T 2/~,6/1'lCGrT ~ ~ ~~ 2z !~ 3 7S ""'""'"'" Date Evaluation Conducted Telephone Number g.oc~teg z y. ~ oo ~ 7~s. 3~~ • ~~~s Pavata gewa~e ~ 855 o~neWis 54016 Hudso s Property Owner ~~~ S~ Parcel ID # ~ ~ ~ • /~ ~ ~~ /~ • Page of ^ Boring # ^ Boring 7d Pit Ground surface elev. ~~ it. Depth to limilina fartnr } ~~ s., Horizon Depth i Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ff2 l n. o• y Munsell /o yR .~/3 Qu. Sz. Cont. Color --. S~[.. Gr. Sz. Sh. a fs6,e s! w z f 'Eff#1 . s •Eff#2 . G 2 • L3 ~o YR .~ L. / f' ~ ~ti cs L ~ y .3 23 3 io ~ y ----, S c. a f s~6~ a°s ~s -- . s . ~ i a goring # ^ Boring 1 / ~ O ~T ... Pit Ground surface elev. ft_ np~tt, r~ r..,~i~.,., ,~..r.,. G Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/fl2 ~ In. ~'/9 Munsell ~o y,~ y~3 Du. Sz. Cont. Color SiC. Gr. Sz. Sh. ~ f ,e aC v~ cs i ,~ 'Eff#1 . ~- •Eff#2 . 3 ~ 3 • y ~ • ~o ~ ~s yr~ ~ ~ ~~~ s. ifs ~ o, s . ~ d,~ cs -- . z T • 3 ~. z ~• ~ ®Boring # ^ Boring ~Q Q " ~ Q Pit Ground surface elev. ff. Depth to limiting factor ~ ~~ in Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ff2 ~ fn. °'~5 Munsell ioY~P ~3 Qu. Sz. Cont. Color SiL Gr. Sz. Sh. ~ -FS6~ SSG, w ~ 7~ "Eff#1 . s 'Eff#2 . ~ 2 /s •3 /o ,t? ---- Sid ~fS v a s -- . z . 3 ~ y 'Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 =BODY < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider end 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. 580.8130 (R.6/00) s~y5~sr-~ T~-~-~~ -~-l.~v~r~a.-vs ~ ,9~~,~ may- ~s - ~~ ~~ ... ~~ ~~ o ,o ~E~,~~s ~2 /~_ ~~ D~ s o~"~y ~~~~ q~,5~ ,~ ,. ~3 .~z 5 ~~~ 0 s n~ ~~ ~~ , ~~~ o~ /~~ ~/ o, q~ so' '' Z vE~ ~ o~~ - ~ . s ys~ B n ~ ~ ro i2- o = /3~~~~o-P /~i'TS v = GD,~-fv v /? S 0 8~ ~ ._ ~~,~o 4 ~.D ~y .- • . . S'T CROIX COUNTY SEP'T'IC 'TANK MAINTENANCE AGREEMENT AND OWNERSIiIP CERTIFICATION FORM ` ~ 3 ~'~ •135 Owner/Buyer ~~/ ~ ' /3 a~~%~ ~~ss~ . Mailing Address ~3~ ~~~~~ (/~~~ Property Address ~U~s~'`~ ~~' `~ ~D~~° ,. (Verification required from Planning Department for new construction) City/State Parcel Identification Number ~ ~'©~ ~~' ~ ~~ ~~ ~ ~~ LEGAL DESCRIPTION G L/ 0 Property Location ~~ '/,, N Y~, Sec. ~'~ , T 2 ( N-R ~~ W, Town of `TV~'S'J Subdivision fh~~S G~'y~l~~ , 3i~ ~D~!'l^ ,Lot # ~ ~' Certified Survey Map # y~~ y~ 3 ,Volume ~ ,Page # ~3 7a Warranty Deed # ~7~ ~O ~ 3 ,Volume yO~P ,Page # 3`ss Spec house O yes f~ no Lot lines identifiable ~ yes O no SYSTEM MAINTENANCE Improper use and 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 function 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 (I) the on-site wastewaterdisposalsyscem is in proper operating condition and/or (2) aRer inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, 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. Cert~cation • 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, r _~~-2c~t~0 J ~ '_y- J i SIGNATURE OF APPLICANT ~~~ i ._._ DATE OWNER CERTIFICATION I (we) certify that all statements on this form ate true to the best of my (our) knowledge. I (we) 9m (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNA'IURB OF APPLICANT b'~l a.i DATE ****** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ****** ** Include with lltls application: a stamped warranty deed from lire Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed INAL . ORIG ~ ~. Docuh+~"~T n:o. STATE BAtt (tF W}S('O'~S[N FORDS 1-1942 WARRANTY DE°.D 4'70683 von. ~~~ r'a~E~355 This Deed, made between .... Sam. E..-Miller,--a -si-wg-1~-----•• __ -- -- • - .. _..... .. .. _._.......- -- •-• - ...... -person - ..... _. _ - --- --- - - - .....--- -• Grantor, and .Gary. L. .Hesse and Bonnie 1.. Hesse,-husband-and-w-ife 9mriwrship L~irital Pmpaty. _ _..-....-- - .--.__ -.---..--- - _ .. ............. _...... -----..._ - - ......_.-- _., Grantee, W1trieSSP,th, 'Chat the said Grantor, for a valuable consiaeration -.- copse; s to Grantee the following described real estate in -St.--Croix - ---- - County-, State of R"isconain: Lot 32 of Certified Survey Map filed June 14, 1991 in Vol. 8, page 2.370, Doc. No. 470463, being part of Lots 32 and 33, Jacobs Landing Third Addition in the Town of Hudson, St. Croix County, Wisconsin. 7N19 9YA!'? TE9ERY.^D FOR ^'"CORDING DATA REGISTER'S OFFICt ST. CROIX CO., W I Recd for Record JUN 2 41991 ~ 8:/0~0 / A. M V C. Register of Oeeds RETI.RN TO Taa Parcel No: Cl ZO~~~" /O~v~ ~~~ ~ b__,9~0 -~~ This ......is.-not------- -- homestead property. ~) (is not) Toeether with all and singulac the hereditaments and appurten:.nces thereunto belonging; And -_ grantor,..Sam. E. Miller -- - - _ ...,.. ._.... ------ warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, covenants and restritions of record, if any, _._ June _ - - - -.... 19..g1 ~~l+iJ ~'._ .-...(.._ .._ --...-(SEAL) Sam E. Mill R and will warrant a,-,~i defend th^ same. Dated this .. -._ 2~ _----- ----------- --------- day of -..__. ___ _ __ _ _ -_ - ...___ - - --(SEAL) ___ - - ---_ .. ....-.(SEAL) __ -- - - -- _ --- - __ -(SEAL) AUTHENTICATION ACgNOWLEDGMSNT STAT^ OF WISCONSIN ' <g, S_ t__. Croix _ _ .County. Personally came before megthrs• _._.ilst..--.day of . ............June--------------- I9' 1----- the above named Sam E. Mi11'er to me known to he the person .__ - a-ho executed the foragnina inrtn!ment acd acknowledge the same. • _ l~rlen~- !''4 ):?etersrn- _ _ - - Nota~:~ Public _.- St.-Croix-- --- .-- __.Count}~, wis. ST~• ('nmmiscinn is permanent. (}f not. state exn`rati.;n Signature(s) -----------------•-----------------.........----•----••- authenticated this .___...-day of___.___._ ............... l9.___- TITLE: ~iF.'4IBER STATE BAR OF WIS~ONSIN.~ :" (If not- -- -- --- ------ -- -- - --- --- - -~= authorized by ~ 7O6AF, Wis. Mats.) ' ~' T!-IIS I:V STRUME~iT WAS OR4FTED HY I HE`f>;d00D & CARI • ` r' ~ ~ ~ i ~ - , / by Samuel R. Carl P.0: Box--229-;-Hudson-; il}I--•----5401(x- --. - -- ..+:. ~, ~ ~ 4~704e3 i'"~. ~.`Y,-~L~ ~ 1 Y ~`~~<~\ Fr~~~ `~ 3UN 141~gt ~ CERTIFIED SURVEY M,4 R Located in the SW 1 /4 of the NW 1 /4 of Section 21, T29N, R 1qW , Town of Hudson, St. Croix County, Wisconsin, being Lots 32 and 33 of Jacobs Landing 3rd Addition. Surveyed for: Sam Miller Construction and John L • a>:rl 5renda J. Atlagadanz Trout Brook Road Harborview Road Hudson, Wi. 54016 Hudson, W i. 54016 LEGEND .I p ~i i, N 89' 10'rjs"E I ~ FENCEIINE I x24 Iron pipe wei ing~ 1.68 lbs/ lin. ft. set g3. 1 1 245.86 • i" Iron pipe found 33' ! l0 Bearings ref- 1 I erenced to the • 2" Iron pipe found nfi / I Plat of 3acobs / ^ / I Landing Third / ~ j o"! ~ ®~- 7J 7J I Addition. Q~ W v) 89,850 Sq, Ft. I ~/ ' ~ (2.063 Acres) I OI ~ 1 I•n CURVE .DATA / ~'1 h I IN . n / rm" ~ O= 15'45'00" / Q ~ Im ~ R= 267.00' "' ap C= N 7 02'49"E 2 - i ~7 0l 73.16' ~ I W a A=73,40' / o~ S I s ~ MrNNhq / ~- - - 3S• - - O o~ .~`" G~NS~1~ I -/ 9s 6246 Me I ~ I HARVEY O. ~ ~ I I d r~-~ JOHNSON I I ~ al East line of 3-1899 I I I N zl the Wl/2 of HUDSON ~ I I ~~ the NW1/4 of W~ ~ I ti I ~®-(1" 32 I Section 21, T29N, R 19W . 4N~ • wl ~ d 94, 373 Sq. Ft. ~ ~I ~ ~ (2.167 Acres) I~ 13 ) o I ~ ~ IN m~ o ~ QI Z i Utility easement (10' wide) 9, F I S 89~ 10' i9"N1 342.02' ' FENCEI.iNE 33 133 I Lot 23 Jacobs Landin Second Addn ~ 1 I ----1 -- --- ~'----- ---- NOTE: Pursuant to St. Croix County Zoning Ordinance 18,05(A)(3) the sale of exchange of parcels between owners of adjoining parcels• • •Town and County approvals are not required. No new lots have been created. Thia is only a realignment of lot lines.. Both lots remain the same size as before. Ohly the lot line common to both lots has changed. SCALE IN F=EET I"= 100 0 100 200 300' This instrument drafted by VOLUh~ 8 PAGE 2370 4891666 L ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT y~ Owner ~T/!` ~ ~ /.~ ~'tl'(Ji•~ /jL~.SS~- .3dt/O • ~3-s~ Address 4 U~~w City/State ~ ~ ~ S D Legal Description: ~'~/r Lot ~ Block Subdivisivn~ ~ '/e , !~ '/a ~, Sec. Lam, T L~N-R/~W, Town of EIUSI'7~~ ~/E~~-~° Tank manufacturer Pump manufacturer20~!!~t' Alarm location /NS_,a~- 1V1UL` It ° llt ~, iota Size ST/PC -_'~ Model ~` _L (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake _ Water Line Meter location Alarm location SOIL ABSORPTION SYS'T'EM: Z Type of system: Width 3 Length ~8 Number of Trenches Setback from: House 100 Well r.U'? PIL 1~ , Vent to fresh air intake > S'0 _ ~ Na . ELEVATIONS: Description of benchtnark TD/" Of S.T • y Elevation Description of alternate benclunark IQo .N ~~~ o~ t~Oo1~ D~ _ Elevation 97 ~ s:ai,v~,-- (~/aav ~vlva~lc~ ~ /~ ST/HT Inlet /V ~ ST Outlet y 7 • ~Z , PC Inlet ~ 3' ~`3 '` Building Sewer C PC Bottom 8y~y~. Ileader/Manifold yQ • f! ,Top of ST/PC Manhole Cover N Distribution Lines () () () Bottom of System ( ) 5..~-~ / ~ r ~" ~~ ( Final Grade ( ) ( ) ( ) o~(.iy-~~ 4 ~~~ ~ ~ bate of installation / / Permit number 3 ! ~ State plan number zzG3 7S ° ~ `~ o Plumber's signature ~~~ ~G~'r// License number Date / _~~~ Inspector ~ ~d~NE~ %/f"~-' Complete plot pl ~%~i~ 'U~ So.~ PIN # D 20 ' /Z • lc7 -G L11~V 1H1\i1 ll~l~vau.~~~•~+i•• • SO Setback from: House ~s Well ~ P/L ~ 5 r~5'~~~G G~~ ~~a, P d ~ . a~ 0 wt ~~ V / ~o ~~~~siiv ~- I ~ -'~ ~~. 1 ~r o f s, T, ~ y„ c.l. a~ ~z ~ 13 o too ~., F dt ~ /~? • 2l~rt- c17 S~ ~ ~ ~,~/5 T/ . ~ s.7'- X3.03 0 7~ \~ ''-- ~ ,~£W, T~~ ~ I ~~ vµ~~~ w~~S 9~'S P~ ~~ i- ~, 7o TEL Gi{j ^', i~ ~. g,Sb ~l~G~fT ~_ /, ~/ O ~,~ jia,~ /os S ~ ~ ~"T ~ ~-~ A-~~ ~ ~~ o ~t~ ~ ~ Q ~ o• i o iQ I ~ J~ ~ ~p x3~ ~ q 3 - ~ ~ ~ ~ v~~f ~ ~ /~v// UA/V2 o ~ //,q/~ - - ---- SET i•~ "off '~ -i ~~ o~ ~- ~a~~ f~s~~s of D~~ Sysr~~ ~C~•G o ~P ~,~u' I- - °---- --- --- -----5---~ .~-- ii sleeDS - 1 ~ 0. ~D ~ Gi~~ .~ Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice may be used for secondary purposes [Privacy Lays, s.15.04 (1)(m)). PerrnEt~sl~p~ ~N Yri1 tiU~NIE ^ C~t~f7DSs_ Town of: IIU UU11VV CST B M Elev.: Insp. BM Elev.: BM Description: TANK IN FORMATION TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/ L WELL BLDG. vent to Airlntake ROAD Septic NA Dosing NA Aeration NA Holding PUMP /SIPHON INFORMATION Manufacturer Demand Model Number GPM TDH Lift Friction Syetem TDH Ft Forcemain Length Dia. H Dist. To Well SOIL ABSORPTION SYSTEM ELEVATION DATA County: Sanitary Permit No.: 338890 State Plan ID No.: Parcel Tax No.: 020-1269-10-OQO STATION BS HI FS ELEV. Benchmark Bldg. Sewer St/Ht Inlet St/ Ht Outlet Dt Inlet Dt Bottom Header /Man. Dist. Pipe Bot. System Final Grade BED /TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia.. Liquid Depth DIMEN I N DIMEN I N SYSTEM TO P / L BLDG WELL LAKE /STREAM LEACHING Manufacturer: SETBACK INFORMATION Type O CHAMBER Mo el Number: System: OR UNIT DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length 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, etc.) LOCATION: HUDSON 21.29.19. 1325,SW,NW 837 HARBOR VIEW ROAD IX Plan revision required? ^ Yes ^ No Use other side for additional information. SBD-6710 (R.3/97) Date Inspector's Signature Cert. No. Safety and Buildings Division ,- - SANITARY PERMIT APPLICATIQN 201 W. Washington Avenue `~scons~n In accord with ILHR 83.05 Wis. Adm. Code P O Box 7302 Department of Commerce Madison, WI 53707-7302 • Attach complete plans (to the county copy only) for the system, on paper not less County c~ C than 8 vi x 11 inches in size. ~' • /Q) • See reverse side for instructions for completing this application state sanitary Permit Number ~~ ~ Persona! information you provide may be used for secondary purposes on ^ Check if revision to previous appli [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLI ATI N INF RMATION -PLEASE PRINT ALL INF RMATI N Pr erty Owner Name ~ Property Location S T a , N, R / q E (or J1ia j~1ia lU ( „L , , Property Owner's Mailing Address Lot ~mZr Block Number ~ A2 ~ •'7D City State ~ Zip Code Phone Number Subdivision Name or CSM Number ; " son ~ ~ c, c > -, 1.~ ~ I1. TYP ILDING: (check one) ^ State Owned ~ !t Nearest Road Public 1 or 2 Famil Dwellin - No. of bedrooms ? ~ rowan OF c.~Sa'~ ie~ III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) /~~. 2q , ~q . 1.4j 2.~ o2c~ -/a~9 -/0 1 ^ Apartment /Condo 2 ^ Assembly Hall 6 ^ Medical Facility/ Nursing Home 10 ^ Outdoor Recreational Facility 3 ^ Campground ~ 7 ^ Merchandise:Sales/Repairs 11 ^ Restaurant/BarlDining 4 ^ Church /School 8 ^ Mobile Home Park 12 ^ Service Station /Car Wash 5 ^ Hotel /Motel 9 ^ Office /Factory 13 ^ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. ^ New 2. ~ Replacement 3. ^ Replacement of 4. ^ Reconnection of 5,~ Repair of an ______S~stem ________ System _____________ Tank Only______________ Existing System ________ Existm~S~stem B) ^ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11'~Seepage Bed ~~x~ 21 ^ Mound 30 ^ Specify Type 41 ^ Holding Tan)< 12 ^ Seepage Trench 22 [] In-Ground Pressure ~ 42 ~ Pit Privy ' t- 43 ^ Vault Privy 13 ^ Seepage Pit ' L,~ 14 ^ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Pert. Rate 6. System,Elev. 7. Final Grade r~ Required (sq. ft.) -Proposed ~sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation ~ a~ ~ ~ 7 l Feet ~ yG Feet S 7 ~ VII. TANK INFORMATION Ca aut in allot s g Total ll # Of T k Manufacturer s Name Prefab. S1te con- steel Fiber- l Plastic Exper. A ons Ga an s concrete g ass pp New Existin strutted Tanks T nks e tic T IQpO 11 I ^ ^ ^ ^ ^ Litt Pump Tank/Siphon Chamber ^ ^ ^ ^ ^ ^ VIIL RESPONSIBILITY STATEMENT I, the undersigned, assume responsi ilit for installation of the onsite sewage system shown on the attached plans. s Name: (Print) Si ytature: (No Stamps) #Mfe1t'1l~1alT: Business Phone Number: ~', 's o ~ 5 ~iS -aUG,. S73 Plumber's Address treet, City, State, Zip Code): ~ / ' Sao ~~~ IX. COUNTY /DEPARTMENT USE ONLY ^ Disapproved 5 itary Permit Fee 1'n`ludes ~rou"dwater ate ssue Issuing Age ignature (No Stamps) Approved ^ Owner Given Initial Surcharge fee) /2~~3D) !~ ~/ z ~7b CI Adverse Determination / ( X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: ~~`~ ~~ SBD- 639H (R.11I97) DISTRIBUTIpN: original to County. One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the. Wisconsin Administrative Code will be applicable- 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phonenumber. Plumber must sign application form. IX. County /Department Use Only. X. County /Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system area; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section. of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. . ~ GROUNDWATER SURCHARGE ~~~ ~"~~ 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the jJ~Q, ~c,,rP residence located at : ~~_/, ~~/~ Sec . ~L, T~_N, R ~ _W, Town of ~y,~ St . Croix County, Wisconsin. Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced 3~C~Q ' Did flow back occur from absorption system? Yes No (if no, skip next line. Approximate volume or length of time: ~~~ gallons minutes Capacity: / ~ Construction Prefab Concrete ~_ Steel Other Manufacturer (if known) : -~e~P~~Q~ Age of T nk (if known) /, ~ (Signa re (Name) Plead Print (Title) (License Number) y-1 ; -Gi ~ (Date) Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) , Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank, to the best of my knowledge, will conform to the requirements of ILHR 83, Wis. Adm. Code (except f inspection opening over outlet baffle) . Name ~'j~i-~~3 ~C,b~ Signature MP/MPRS (~~~ tnfls:n °t °~ °ortun~ SOIL AN Division of Safety and Buildin s . UATION ~ P ~ f ~ g Bureau of Integrated Services in accordan , . 1 :; , 1 '1a±1 m 83:09,- . .Adm. Code age ,.,,o ,..Q ' C fi y Attach complete efts plan on paper not less then 81/2 x 11 n include but not limited to: vertical end horizontal reference oi ( s. P ~~!~~ B ) dir o nd r. ,~ m 51' C ' , p n a ~ . v percent sbpe, scale or dimensions, north arrow, and location ~~iear~ast,ro~d P I.D. # ~~:.k. ~ O - ~ •ID . • ~. APPLICANT INFORMATION - P/eaas print all Jnf loq ~~~%Nrv r' ed by oats Personal information you provide may be used for secondary PurPo~s lP~ ~ •~ ~~(~.. ~: s. 1 b.04 l1~(~rr{j~~ ~ \ O P ro~~perty owner ~ RrgpertX 4 (( Q Vq`(' ~' Viz «~- ~ ~ 5 W 1/4 N W1/4,S a ~ T 2 ,N,R , ~ E ( PropeAy s MaUing Address Lot # Block# Subd. Name or CSM# ' 3 "~ ~ ? r r v ~ 3 a ~tuob La -~d~~• >n ~ o City State Zip Code Phone Number ^ City ^ Village ®Town Near Road WI 5y0lly (TI >38 - r 'e t.,~~~t-r,a ion ^ New Constructlon Use: ^ Residentlal / Number of bedrooms 3 Addition to existing building ^ Replacement ^ Pubiks or oommerolal - Deerxlbe: Code derived daily flow y~ gpd Recommended design loading rate ~• bed, gpd/ft2 - trench, gpd/ft2 Absorption area required - bed, n2 ~ trench, ft2 Maximum design loading rate ~ bed, 9P~ -" ~ 9p~ Recommended infiltration surface •elevatlon(s) _ 9 5 . ? ~ fc (as referred to site plan benchmark) Additional deslgNsite considerations e- yrL1 ~~ a'~" i f, try a ~ nn f7C r` Gt. ~ h ~i t ~ ~ ~ o w Q ~ ~ u ~t .1. ~i. e. 'T' f, O h Parent material ~ O t_ SS b ~ G V'` Qi ~ ~L ~ i C. ~ r'9 ~} ~ t.JQ 5 ~ Fltod plain elevatlon if applicable i< . , S Suitable for system Conventlonal Mound In-Ground Pressure AT-Grade System in Flll Holding Tank U = Unsuitable for system ^ S ^ U ^ S ^ U ^ S ^ U ^ S ^ U ^ S ^ U ^ S ^ U SOIL DESCRIPTION REPORT esonng ~ around elev., ft. ~~ limiting Horizon Depth Dominant Color ~~~ Texture Structure Consistence Boundar Roots GPD/ft2 in. Munsell ou. Sz. Cont. Color Gr. Sz. Sh. y Bed ,Trench ~ ~- i o ti Ira/ --~----~- ,5; L _ - ,5 ~ , ~ ~.~ ~ - , 60.70 ? ~ 5 "~ ~. y ~--- ' L _ ---. ' . S ' . ~ Remarks: ~ t . d `e hi S i n tr^ ~ r1 ~~- ~g -, ~~d ~., v n-t- i factor in. Remarks: _ CST Name (Please Print) ~1.. ~'~ h .~ Signature Telephorw Na Date CST Number a a ~, ;~ PROPERTY owNER SOIL DESCRIPTION REPORT PARCEL I.D.* BOring # Ground elev. ft. Depth to limitlng factor in. Boring # Page.. ~ `' Horizon Depth Dominant Cobr Mottles Texture Structure Consistence Bounda Roots 2 in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. ry Bed ,Trench Remarks: Cuound elev. K Depth to limitng factor in. Boring # Ground elev. ft. Depth to limiting factor In. Boling # ,..:..,,F, . 4 .~ Ground Remarks: Horizon Depth Dominant Cobr Mottles Texture Structure Consistence Bourxia Roots in. MunseU Ou. Sz. Cont. Cobr Gr. Sz. Sh. ry Bed ,Trench Remarks: elev. ft. Depth b limiting factor in. Remarks:. SBD-8330 (R.9198) .-•ti.. _ Cjce,r'{ {- ~nn~~ G ricss ~' Sw'j~* bw'/y~ Sec. ~~~ -r a ~t~t ~ ~~? ~ f ~ ~ a ~ ~. .~'g jCa~~.: ~ s ~/ r o~~ ~ ~o A~r~~ ~ ~ lat tt ~ _ -~----a_ °~ Syf c ~, ay d~' ~ ~ a~~ ~ ~Y' 3 + ~ ~ G~r~yt n as b f ~~ v~ h µonSG. ~ J To P .~, st , "S sO 81'Y1 d~a:~:al~S V~~'{" P;P~ s ~pt;c ® w~-ils o t~N~ ~ ` ~bttw~ta,.eQ ~ bores o ,` ~,~; s+, <_ _ Q~r,n, n ~ao~lr31. ~ - s' ~6~ ;- -- ~ ,~ 1'- 9~'~ o o ~~ 1.. ®-t 3~ o t i o+ ; he.~ ~a g G a °~. ~ .......,.._ o~~ gel lao ~ ~tt'~~ckti~.~- ,fit (31 9 $. ~~ ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMBNT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer _ Mailing Address 7 C.~/ L ~ Property Address ~,~„ (Vcrificatioa required from Planning Department for new construction) City/State ,~ ~a/SO~ - ,, ~ ~' parcel Identification Number O Zl-~ -/~~ ~~~ 1L,EGAL DESCRIPTION Properly Location,~Z %., ~ „1 /~ Ste. ~~ TAN-R~W, Town of ,~1~,~~,., Subdivision _ •,~L~,~s ~,/,~,.,,,~ ~ ~~ Lot # ~. . Certil'ied 5arvey Map # Volume .Page # ,: . Warranty Deed # _ c l ~G,`'=a ~- I ~ ' I Volume ,y~'•~ Page # `/~^:~ Spec house ^ yes [,~ no Lot lines identifiable. t~' yes ^. no SYSTEIVi~~r!!!-I~NANCE - Qleraseaadmaiatenaaxofyoars~ios3'S~~ldresQltmitspre~atar~fa~uretohandlevvastes.Propermaimbwanoe O°t ~ ~~ tank ~v'ay three years or soak if acodod by x Yieeasedpirmpcz:. What you part into ffie system can affoct the function of the septic taalc-ss. a h ~ .ia ~e t~rasbe fiisposal_sysbem, ~ . mastar T~ PY~ owe agrees ~ to St. Qnmc 7.oning Deparbmemt a oaf fay, signed by tie ~ownoc and ~ a is in P7~y~aPlambes; resdictodpiuaibexor a Iioemodpumpertraifymg that (lj 6Le oa~arta arastewatp~dit~OSal system P~ oP~g condition and/or (2) after inspoction and pamping.Crf IIOO~Y). ~ septictxnk is less $aa 1/3 ~tull of sladge. . ~, ~ ~dccsignod havaread the above rogain and sgree to maintain tau private sewage disposal sYsbeaa wi$r ~th,e sandands tct foctir, . -as set by the Department of Comm,crce and the Dcpaztmcat of Nat~ual ~~g that Y~ optic system has been ~~: State of Wisconsin.. Cutifcatioa maintainod mast be completed and rchnnod to the St, t~+oix.Coimty Zoning OfFicx within 30 days of the tbnoe year expiration date. SIGNATt OF APP CANT OWNER CERTIFICATION I (we) °ertify that all statements on this form are hue to the best of my (our) knowledge, ~ PmI~Y d~'bod above, by virtue of a warranty decd r+eoorded in .Register of Deeds Office. SIGMA OF APPIi:It ;ANT / / DATE I (we) am (are) the owa«(s) of `-i / R~/ 9~ DATE s««««« Any information that is mis y ~$ -r'epraentcd may result in the sanitary Permit being revoked b the Zo ' ent. «««««« ss I(nclade with this applicatloa: a statapod warranty decd from the Register of Deeds office . a copy of the certified survey map if rtifbreace is made in the warranty decd DOCUhtEVT n;n. STATE BARUO1pF WI~Ci3~i8iN FORM 1-1993 4'~C~S~ va-_ ~~~ ra~t..~JJ This Deed, made between .... Sam E..-Miller,-.a si-ogle-- •-•- __..... ._------------- --- --- ----- -- -- -- -- -- --....----- ---.-....... - -- person- - -------------- ----.. - ---.......... ---- - ..._----•-- -..........-- - - ---....., Granter, and..-Gary-L..Hesse--and-Bonnie..L. Hesse,--husband-and w-i-fe-- 9aviwt~hi~ Marital Pmperty._-- - --~ -- -.......-'-- --- -- - --~- •---- - --- ----- ' . ........ .. . .. . Grantee Witnesseth, That the said Grantor, for a valuable consiceration_ ... conve.;;s to Grantee the following described real estate in -St.-Croix ----------- County, State o[ Wisconsin: Lot 32 of Certified Survey Map filed June 14, 1991 in Vol. 8, page 2370, Doc. No. 470463, being part of Lots 32 and 33, Jacobs Landing Third Addition in the Town of Hudson, St. Croix County, Wisconsin. 'Y'$~1N ~ b_2.~D ~ r~ TN'S S?/'E tEBERY^7 FOR R'_"CORD+NG DATA R;E~lSTFR'S OFFlC% ST. CRQlX CO., WI Reed for Record J~)N241991 at 8:/0~0/~~ A.~M~ V C Register of Deeds RETVAM TO Tar Parcel No- -----------------------------•----- This .. _is--npy.-------.. homestead property. ~) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And grantor,.-Sam- E. M.i11er.------- . - -._..._ _ __ ...._. warrants that the title is good, tndefeasibte in fee simple and free ~ r,d clear of encumbrances except easements, covenants and restritions of record, if any, and will warrant and defend the same. Dated this .- Il-.--~~ ..-.__ day of ...... - - - - - - _ _ _._ _ _ - _ (SEAL) --.June _ _ 19. g1 Sam E. Mille _. _ - - - -(SEAL) AUTIIENTICATIQN Signature(s) authenticated this -..---..day n' ........................... 19 TITL.F.: ~il?1tBF.R STATE BAR f1F W[`;rn~Sf~ .- - (if not. -..... - - _ _. - -- - _ - -..:y authnrire~l by ; 70R.f1fi, R'ig. St,~ts.) TNiS :V;TR'J ti•E`~T Was p. ,rT~p r,v HEYWOOD & CARI '' ` __ ..... by Samuel R. Carl P,O; Box 229, Hudson,- Wl --5401fr _._.. _ (SEAL ACgNOWLEDGMENT ST:1T^ OF ~VISCOtiSIN ss. St. Croix County. Fersonallc came before me tills .-..215t.._--.day of June _ _ qq1 ...--- . - _ --.... 19'--_--- the aho~•e named Sam E. Kil1'er to me !;+m:'n to h., ,•~ noFSOn _.--- :c!~n executed the far^1'~in in=tr.i~ r- a~.l ack+tnT~-ir~l~t~ .c:`e. r / ~ .. _. /~ ~.. G Marlene `9. Peterscri intr., 1',,F,;ic SL. Croix C++r.ntc. ~j•~c- . ,>< ~ . nc+t:ur,r•t, No i . WARRANTY DEED ::TATF: 1t.11i t)F' WFSI:()NSiN'F()lt~t '1-1982 •~w t J~~l<~t~ !,~ Viri;lttia M. Ilansun, n single woman rrm\r)w :,n.l n,.rrnnte to Sam E. Miller, A slnj;le man "s the fnUrrw•in¢ drw•rihrr! rral a+lute io ~tatr o! ~1',aconrin: rres sr•~•.c wcscwvtn roe wrc.~warau uwu REGISTER'S OFFICE ST. CROIX CO., Wf Recd for Record Ml~q ~Z ~96~ « 8:00,, AAAM f~ CSC Rtt/IMp ~/ Or,~ n, r,:r,y rn St. Cruix v~ Tnz Parcel No:..:....:. .................... West Half (W',) of the Southwest Quarter (SW'z) r.t Section Twenty-one (2l), Township Twenty-nine (29) Nurti,, Ran);e Nineteen Og) bleat, St. Croix County, Wisconsin except tltstt part Suuth of the ~~ublic highway and except Lota S, 6, 7, and 8 of Certified Survey Map n Vol. 6, Page 1747, Doc. No. 419479. . Ttt.•tt part of the West Half (W!~) of the NortFtwest Quarter (NW&) of Section Twenty-one (21), 'fownsitip Twenty-nine (29) Nortlt, Range Nineteen (19) West, St. Croix County, Wisconsin lyin); South of the ril;ht of way of the Chicago, St. Paul, Minneapolis and (hnaha Raflw.•ty Company. $.~~ -- n ~ ~~' Tbix is nOt hamr•rl,•+ul pnq.r•-t}•, >tbtk t iA not ) F:x"c•1••iur+ t•• wnrrnntic;,: easements of record and projective covenants and restrictions of record, if any. '" c~ ~ 4~ Ih,l+•d this t t~F:AI,, • V.i rl;inla M. Hanson . 1SF:AL1 ,~F.11.- AUTHENTICATION 5iRasture(s) ....... nuthrnliealed this .... day of •. . .. .. ................. .. ..... IA . . TITLE;; 11F.biRF,R STATE. RAIL ~)F R'ISt'htitilX (1 f nnt, wvthorizrd fiy ~ ~ur,,t,r,, Wia. State,) ••r'i INSTRUMENT WAS ORArTEO AY L4i~.A. lfurraY....iieywpod~..Cari b.Murray t'. U, ~ 6ox 229, Nud$sm, WI,., ~4p 16 iSiznntun•. may hr :rvthcnticalyd nr acknawlr,L•....t f:, nrr nni n...•..... ~... ACKNOWLEDUMENT STATE: OF WISCONSIN. aa. < ~v y~ f'ounty. 19•r~nnall}• cnmr Irc•fnrr m" .this . ''' ~ dny of M~ 'L 1"" . 1J $$ .the alrrn'r nam,til Virginia .M. Ranson • In mr Lnrn,'a In hr lho ia•rj.on a•hn r•xryntrd lhr f++n•crrin • ' tnrnu•nt nntj nilcnn+vledco thr cnmr. `:rdn• <• vAilr i0 ~~• e~.tl ~~ (i..+ i•nnntc. ~Ci..