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HomeMy WebLinkAbout020-1372-09-000'FWisconsin 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 Law, s.15.04 (1)(m)]. Permit Holder's Name: ^ City ^ Village ^ T~uvn of: Miller, Sam Hudson Township CST BMElev.:- Insp. BM Elev.: BM Description: tsp O ~ ~9 . c7 T B~~-1 '/ a TANK INFORMATION LEVATION DATA TYPE MANUFACTURER CAPACITY Septic ~,~ ~z-SO Dosing Aeration Holdin TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. vent to Air Intake ROAD Septic ~~p r 3 I ' NA Dosing NA Aeration NA Holdin PUMP /SIPHON INFORMATION Manufa r Model Number TDH Lift Lriction Syste TDH F cemain Length Dia. Ff Dist. To wen SOIL ABSORPTION SYSTEIVr~ZI ~-~ ~, , , _ l~ ~ County: St. Croix Sanitary Permit No.: 363930 State Plan ID No.: Parcel Tax No.: D~~ 132-09~b STATION BS HI FS ELEV. Ben . ~-0 0~..~-p eD •D ~ / 7 . Q • ~'d O3. o' Bldg. Sewer St / Ht Inlet '~.~ 3 3 q~. 33' st/Ht outlet x.63 q}.off' Dt Inlet `~ --- Dt Bottom Header /Man. ~~ ~S q~,~-5-' Dist. Pipe ~ , d 4G: ~ ~~ Bot. System `l ` Zv o- `lS.b-~ `~ .sa Fin Grade S'sp r .~,p' S'~Carue.~ ~, •~~ 9 Z' GPM Ft GCB RENO Width ~ Len th r N . Qf enches PIT No. Of Pits Inside Dia. Liquid Depth DIME ~ L DIMEN I N SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manuacturer: SETBACK INFORMATION TypeO t ~ CHAMBER Mo el Nu ~ r: System: ~ ~ ~-' OR UNIT ,b DISTRIBUTION SYSTEM ~i-{o ~t ~~t`l~.a- Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake u Length ~P~. Dia. ~ 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.) Inspection #1: t~/lo / opInsnection #Z: / / Location: 541 Raider Driv~ Hu gn WI ~4016~~S 1/4 SW 1/4 21 T29N R19W -Raider Estates -Lot 9 1.) Alt BM Description = `tee ?D~`~ '~~Ar-~°''t-• ) 2.) Bldg sewer length = ~j l • O -amount of cover = ~ '3(~ ~ tee./ Plan revision required? ^ Yes ~ No Use other side for additional infor atlon. pg (( tsp ~~ SBD-6710 (R.3/97) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: 3 ~~ ~ i ~~~ _~ _~ Y i ' `•ISCO/1S%n SANITARY PE TION Department of Commerce In accord wi .05, is. Ad e~ • Attach complete plans (to the county copy only) than 8 t/2 x 11 inches in size. • See reverse side for instructions for completing Personal information you provide may be used for secondary. [Privacy Law, s. 15.04 (1) (m)]. Ike sy~l~~.~per Ppll~i `D <-ZQO~ ~~-t4ti ~ Safety and Buildings Division 201 W. Washington Avenue POBox7162 Madison, WI 53707-7162 State Sanitary Permit Numbed 363 ~3 D ^ Check if revision to previous application State Plan Review Transaction Number I. APPLI ATION INFORMATION -PLEA E PRI F R Prope Owner N e ~ ~ t ~L.L..F-i`Z ~ ~ y Location /a ~/a, S ~ ~ T Z.y , N, R /'9' E (or Pr ~ Owr Maili dress ~F' Lot Number Block Number .i' Ci tat~sO e. '' Zipy~o ~~ ~ i3~~ ;u2m,~~ Su di ision Name or C~ Numbgr~~ IL P ILDING: (check one) ^ State Owned ~ It~ ^ Vil age Nearest Road ~1v t ~ ~ Public 1 or 2 Famil Dwellin - No. of bedrooms Town of C~ Q ~ ~ +~ eck all that apply) Parcel Tax Number(s) h III. BUILDI USE: (If building type is public, c --t /~ ~ J ~' ~ ` ~~ ' ~~~ O~ ~ IO `~ - V ~ / 1 ^ Apartment /Condo v 2 ^ Assembly Hall 6 ^ Medical Facility/ Nursing Home 10 ^ Outdoor Recreational Facility 3 ^ Campground 7 ^ Merchandise:SalesfRepairs 11 ^ Restaurant/Bar/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 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~rstem ________System_____________TankOnly______________ Existing System ________ Existin~System 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 21 ^ Mound 30 ^ Specify Type 41 ^ Holding Tank 12 Seepage Trench ~ 4N 22 ^ In-Ground Pressure / ~ ~ 42 ^ Pit Privy ~ t ~ X X 7 ~ ~ ~ ~ Q /L 43 ^ Vault Privy , ^ Seepage Pit ,~(/ ( 13 (~-T~ 14 ^ System-In-Fill a ~'1~ ~f~'~/( ,~~ ~3/~ SQ ~ G VI. ABSORPTION SYS EM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5_ Perc. Rate 6. S stem Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) 9~s' (~~ Elevation G O 97 4 ~ ~ ©~ y L ' ~ .- Feet p LalOi ~ Feet • d . VII. TANK INFORMATION Ca acct in allons Total ll # of r Manufacturer s Name Prefab. Site l st Fiber- Plastic Exper. N E i i Ga ons Tanks concrete ee glass App ew x st n strutted T nks Tanks eptic Tan or Holding Tank ~ Z~ f ~ .S~ ^ ^ ^ ^ ^ Lift Pum Tank/Siphon 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) ~ Plumber's ignature: ( Sta ~ MP/MPRSW No.: ~ ~~~ ~ Business Phone Nul!mber: ~~ ~ ~~ ~ 1~ P umber's Address (Street, Cit ,State, Zip Code): 0 0 o~ ~Zor~- s o ~s ~ ~ S`4~ IX. COUNTY /DEPARTMENT USE ONLY ^ Disapproved sa~tary Permit Fee (1"dudes Groundwater ' Surcharge Fee) ate ssue Issui g Agent Sig tore (No Stamps) roved ,App ^ Owner Given Initial Adverse Determination ~, (Qj o~a5 ~ 6 ~D'~ X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: SBD-6398 (R.12/99) DISTRIBUTION: Original to County, One copy To: Safety a Buildings Division, Owner, f INSTaUCTlON~ ~, 1. A sanitary permit is valid for two (2) years. `; ' f 2. Your sanitacyperTnit may be renewed before thRexpiration date, aril at a time of renewal any new criteria in the Wisconsin Administrative Code will be apphicabie'~~ , 3. All revisions to this permit must be approved by the peril~if issuing authority. 4. Changes-in ownership or plumber requiresa Sanitary Permit Trans#er'/ Renewal Form (SBD-6399) to be submitted to the "~'' county prior to installation ~" ' ' ~. 5. Onsite sewage systems must be properly maintained' Thes2pt~ic 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: Property ovvner's name and mailing address. Provide, theiegal 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 phone number. Plumber must sign application form. IX_ Countyl Department Use Only. X. County /Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 1 1 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 areas; 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 i 983 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. ,~07 ~ ~1 $~/I ~~ LOS R pR1 /~ ~ ~ ~ - ~ a,,, - s r~ sT~wt ~ ~~ :. %S. S u~ 9 y. $~ L o ~d.1 Z~~a.3G ~ ~ .~ Y13,~~, r~P o{ 11~ u _ _, _ . ~...._._ ~pfg~trc '~~ ~ loa,~3 ~~ ~ v 2 ~ ~~ ~ / r, t ,~ r` ~~ ~o, ~ It, #~ J ~w ~_ . Elo~ s~ ~f-AEG Roan G~4ea6& I ~~ir5t ~SPl/7 ~ , ` 2S 4 -__..--.~¢ I ~,.,,, / 2 So E~/1 ~ , ~;T. ~ ys~. S ~ ' ~ ~ F1t7~,~NA7 ~" ~ (~ i~ k~~ ~ ----- - -- ---- a-~ ~- ~ ;~~~ ~. ~ .- j ~.~ IV ~ tl ~ S - 3 ~~c -r S ~'' ~' r x ~' .+•• ----- ' ~~ `~~ V ~ '~ ,O '~ ,y -~ ~' N q- ~ V ``~~ 1 V ~ ~ s v ~~` i ~ 1 Y~ ~ ~ m y J r• .: :. ~~ ~ .. ~ W: ;. Z -~ ,. L ~ • V W ~ ~. w0~= ~ C1~ U _~ ~ y. " ~. ~ 'CpC ~ ~ ~ c~ y 'a .+ (C L X t0 ~ N ~ ~ O ~~ cbM t~A .O ~ >`b to ,:, RI x N N 0- ~ ". ~ v~ r ~ ~ ! E m O R1 G ~ ON '~O ~ t`O~~` y ~ p 'O O O > a O) X Q . ~ t~~~~~ N 0 X ~ m ..~ ~~o~~~~~~:: ~ RS _ N> O O v Q _ J l{1 LL E O :r = V 'O ~ 'v, =cn3 . C a . °' ® ® ~, a ,~~ a ~ `~ ~ ~ b ,/~.,1 O ~ / 0 ~~ V ® O ~~ a m a V a a Uo © ~ d • [] ~ ~, ~ Z m~~ M gg W ~ 3 OLL ~ ~ ~ rn E • . .Q G p ~°^$ ~ ~ ~ ~ c V ~ t7 e a ,~ ~ .~ .. " G ~~ e s i~ ~; D~ ~i y ~~ ~~ ~~ ~~ ~~ ~~ R~ ~' ~~ ~~ ~1 ~~ M ~~ ~~ ~~ ~~ r ~-- ~° ~ Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code Page 1 of 3 A.C.E. Soil & Site Evaluations Attach complete site plan on paper not less than 8%2 x 11 inches in size. Plan must County include, but not limned to: vertical and horizont~ reference print (BM), direction and percent slope, scale or dimernsions, north arrow, and loci#ioa~-and~tance to nearest road. Parcel I D # "~ ~ °~ ~ ` ~ ~~ NFORMAT~N C ' r l . . 020-1056-10-000 LD.#21.29.19.209A APPLI ANT I - PIe ~Si Ya l i Normat Date VIBWed Personal informatlon you provide maybe used for d~s}i purp~~ (Privacy Law, s. 5.oa (1) (m)). ~ 0-2,~0 ~ Property Owner > _ ;..' ~ ~ ~:. ~., Prdperty Location Miller, Sam GovC; Lot SE 1/4 SW i/4 S 21 T 29 N,R 19 W Property Ownets Mailing Address ? ~ I' ` ' ~ ~=`'~ Lot Block # Subd. Name or CSM# ~,; r~y;~~,,,~.; P.O. Box 151 ' `9 PtatOfRaiderEstates City State ~p Code Phonetr - ^lCity ^ Ultage ^Town Nearest Road Hudson WI 540Y6 - 7~~ ~ 9~8ir~'~~~9 ~ Raider Drive ^ New Construction ^ Resid~npal /. Number of bedrooms 4 ^Addition to existing building Use: ^ Replacement ^ Public or corYlmereiatdescribe Code Derived daily flow 600 gpd Recommended design loading rate .7 bed, gpolftz .8 trench, gpolftz Absorption area required 857 bed, ft2 750 trench, its Maximum design loading rate .7 bed, gpd/fts .8 trench, 9p~ Recommended infiltration surface elevation(s) 95.5' upper trench, 94.5' lower. ft (as referred to site plan benchmark) Additional design I site Considerations ~~ ~~ trenches using high capacity infiltrators. Parent matefial Glacial outwash Flood Lain elevatron, if a icable NA ft S=Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U=Unsuitable for system ®S ^ u ^ S ^ u ~ s ^ u ®S ^ U ^ S ®U ^ S ® U SOIL DESCRIPTION KCPUK 1 Boring# 1 Ground elev U4 79 ft Depth to limiting factor >103" `2 Ground elev 99.67 ft Depth to limiting factor > 102' Depth Dominant Color Mottles Structure i t C nda t3 Roots GPD~ Horizon in. Munsell Qu. Sz. Cont Color Texture ~. $z. ~. en ons s ry ou ~ Trench 1 0-11 10yr3/2 None sl 2fsbk mvfr as 2f,lm 0.5 0.6 2 11-23 10yr4/3 None sl 2msbk mfr as Zi,lm 0.5 0.6 3 23-27 10yr4/4 None is Osg dl cs - 0.7 0.8 4 27-31 Syr4/6 None is Osg dl gs - 0.7 0.8 5 31-72 10yr6/4 None s Osg dl aw - 0.7 0.8 b 72-103 10yr6/4 , None s & gr. Osg dl - - 0.7 0.8 .~ .6~! S'6.6 Remarks: H#6 contains :itl% cobbles and stones. 1 0-15 10yr3/2 None sl 2fsbk mvfr as 2f,lm 0.5 0.6 2 15-28 10yr4/3 None sl 2msbk mfr as 2flm 0.5 I 0.6 3 28-36 10yr4/3 None gr.ls Osg dl cs - 0.7 0.8 4 36-40 Syr4/6 None is Osg dl gs - 0.7 0.8 5 40-102 10yr6/4 None s Osg dl - - 0.7 0.8 5-b. 0 4b . o Remarks: CST Name (Please Print) Sign re: Telephone No. James K. Thompson s--- 715-248-7767 Address AC.E. Soil 8c Site Evaluations Date CST Number Ref # 340 Paulson Lake Lane, Osceola, 54020 4f 19!00 3602 1203 PROP[=RTY OWNER: Miller Sam ,PARCEL I.D.# 020-1056-10-000 I.D.#21.29.19.209A 3 Ground elev 97.54 ft Depth to limiting factor >104" 4 Ground elev 93.93 ft SOIL DESCRIPTION REPORT ~zos Page 2 of 3 A (' F._ Cnil ~ Site Evaluations ~th Darlinant Color ~~ Shuc~ure s~ence Bounda Roots GPD~ Horizon in. MunseN Qu. Sz. Cont. Color Texture Gr. Sz. Sh. ry Bed ~ Tlench 1 0-8 10yr3/2 None sl 2fsbk mvfr as 2f,im 0.5 ~ 0.6 2 8-IS 10yr4/3 None gr. sl 2msbk mfr as 2f,lm 0.5 I 0.6 3 15-21 10yr4/3 None gr.ls Osg dl cs - 0.7 '~ 0.8 4 2K-~9!°I 10yr5/4 None s Osg dl gs - 0.7 0.8 5 69-104 10yr6/4 None s Osg dl - - 0.7 ~ 0.8 ~ 9y ~ g 3 b .ys ~a. y8 Kemancs: _ / _ ~ __ 1 0-18 10yr2l1 None sl 2fsbk mvfr as 2f,lm 0.5 ~ 0.6 2 18-30 10yr3/2 None sl 2msbk mfr as 2flm 0.5 0.6 3 30-42 10yr4/3 None is Osg dl cs - 0.7 ~ 0.8 4 42-53 10yr5/3 None is Osg dl gs - 0.7 0.8 5 53-104 10yr6/4 None s Osg dl - - 0.7 ~ 0.8 Depth to limiting factor >104" 5 Ground elev 93.68 ft Depth to limiting factor >101" Ground elev KemarKS: 1 0-8 10yr3/2 None sl 2fsbk mvfr as 2flm 0.5 ~ 0.6 2 8-15 10yr4/3 None gr. sl 2msbk mfr as 2f,lm 0.5 0.6 3 15-23 10yr4/3 None gr.ls Osg di cs - 0.7 ~ 0.8 4 23-58 10yr5/4 None s Osg di gs - 0.7 0.8 5 58-101 10yr6/4 None s & gr. Osg dl - - 0.7 ~ 0.8 KemarKS: ~~~ comatns cu-ro woutes ana swnes. - Depth to limiting factor 30{'3 r <..~n 2l ~/u-dSon, ~,J/, Sy0/~O ~c~C - cue - ~~ c ~-oca--~; o,-, ~ 9 ~/a ~ of ,'der ES S SEy~ 5 ~.J/-y, 5zc . z~, r• 1-911, P~'`l . U~/R S ~ ^ 50;1 Db~rYa~ ors P. b • /pca~ed P~o~• She A 1 Scale. / = s/o' .~ 6/ ~ Pr. many sys~e,~--, ~I S/c ~3 Qe~/ace.-r~enE 5y5~ i4r'ta ^ 6S To, =K sl9lso' ~z ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ..S ~"1 // - /~ l ~ ~-~ Mailing Address ~ ~ ~ ~ ~ Properly Address ~ ~ ~ ' ` ~ ~ ~ ~ f ~"` ~ ~ 1 V (Verification required from Planning Department for new construe 'on) r City/State ,~"'~ U .,(.) S +a ~ ~' ~ Parcel Identification Number LEGAL DESCRIPTION Property Location '/a, ~ ~I.~ '/., Sec. ~ T~N-R~Town of s ~ Subdivision ~~ (Q~~- ~~ ~ ,Lot # ~_. Certified Survey Map # L 2 SS~,/a , Volume ~ .Page # Warranty Deed # '~i0' ~"~ ~ ~ ~ .Volume ~ ~`~~ ,Page # ~ Spec house yes ^ no Lot lines identifiabl yes ^ no SYSTEM Iy'IAINTENANCE 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 masterplumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewaterdisposal 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 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 been maintained must be completed and returned to the St. Croix County Zoning Office within 30 f the three year expire ' date. -j2~j ~Q A F APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the operty des 'bed above, 'rtue of a warranty deed recorded in Register of Deeds Office. ~ ~ma ATURE OF APPLICANT 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 deed , -. I ''~ ~ - 1 y , I ~• q>e7 I1..~~ yN~~u.~ .. ~Q .` ~ ., •c tSL ~~LL-LP69 S tl*~ i 1 i ~ ~ l t ~ ~\ • ~ . ~ I \ e$ ~ r' \ \ !l T ~~ .r'' ~ 7, M ..., 0 7 ,~~ ~a~ ~ i I I I I;I I I I r •I ~I •I '~. ,'iii ~> ~i ~~y I ;n ~ s~~ ~. ICI I I~-{ I l l l l l l l k I ~ ~. ' O'?. I iRS~$ _ ~`~ Ri I<I ~jl I I I I I I _..~ ~ ., ~+ ~~ `~`~ L~~ ~> \ ~ a ^.$ 1 ~ ~ ~m d 1;~~v~ 1~~ilil=I~ II III, Y ° ~`, ~ I ~; ;> ;~' \ \~ I~.l If L; I I I ~ .~ a ~. ~ l I .a '~ L~ ~~ ~ 11'r ~ L ~ ~R I I i I '~ .r _ I 1, 9c,o=.n n : ~ ~ ; ~ ~ K ~ \ / ~ ~ ~H Cf9~j N VO \ I nN~C O I .~.~ ;~.. ~ _. ~...,+r rte'"' ~~ ~ '~ ~ \49 ~^'r~.+~£>N~~ ~ .PE ~ ~ ~ I ; ~ -? ~-rte; ,. 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'L 1 I II ; ~_ o ~~~ o 1 4 4 _r fTl I i~ ~ ~~ ~ ~ I u1 ~I i l li LOT ~ 1 ~ ~ I i \~ N ~ n r ~. 1~- z o i D , i I r ~ ,. } _ -tt oooc~" 1~1- ~ ` ---- ~'~ -r_- ~=~~ °. -2 /~rl I SPA ~c~i~ _ ~ '' ~ ~ ~~.,.,az_ I , .L _N~ N ~ ~~ D -----h---. `.- -., ~~ -- V 4 _- 1 ~ i ~/ a Yt lOl II i~ ~' ~ I ~ O Z O F _ ii~~ 9 t o •~ ~~IL- ~ I m ~ V ~i [ 101 M ~ ~Q 91 101 I O 2 ~ IR ,Aria X Q ~ / _ I Ci lCll N ~ y ~~y ~ ~~~[~ Nouvis o3ave sii~ I N ~ ~ IN~ $~3 I 2~LN ~ 44 ~9' o. ~ D R-I m ~ A R g ~~s ~ ~ ~~ zoA; A p Or; ~ ~ ~ ~ ~~ ~;~ ~ ~" ~ o m a ~ ~~~ ~ s ~ N ~w f~~pi~ N IN ~ N ~y m • 1 ,. i r I. ~ !~ ~i COi:lih~t:NT Nr'1. I '1Yhflrir.•iY L'E ~~ S'."%.Tr. BAR' F :~'; .:.. FO:S',f 2-108a ~ ~~~ 1 ~ 58 ~f,~E 6'S !, EXCEPT parcel conveyed to Donald F. Johnson in ':olurne 500, page 525; and EXCEPT parcel conveyed to De~ald R. Jordan in Volume 580, page 354; and EXCEPT parcel platted as we "s ~aryo Sta*_ior. in Volume 5 of Plats, page 89, as Document ;1478658, ALL in -'ction 21 (21j, Township Twenty-nine (29) North, Range Nineteen (19) Nest, Town of Hudson, St. Croix County, Wisconsin. i ! The East Half (E>?) of the Southwest Cuarter (5'w~) EXCEPT parcel Tax Ptrcel No: l~Q.~JD.$-i0 conveyed to Alfred L. EkDlad in ~otur„e 498 •~~~~~••~'~~ ~""•' page 484; and EXCEPT ~O ~OS•~ 6 ~ parcel conveyed to Leslie L. Swe^son in Volume 498 page 504• and 6 1 0 7 5 icA 1 FiLEEN! H. WALSH kEG1;TEk OF DEEDS ST. CkOIX CO., WI RECEIVED FOR RftORD 09-22-1999 ~!:)0 AM i1ARRANT7 DEED EXEAPT N CERT C(~C FEE: COF''f FEE: TRANSFER fEE: A17.50 RECORDING FEE: 10.00 PAGES: 1 ... ......................... .. ......... n[7U/1N T ~.........~ ......::.~:.........:~ .:.:..:..::....: .:.....:.:.:.~.. ~.. ::..::::._.:.:....~: fF~~ the following dcuribed rc:J estate in ......5.4,.,Crpix -,-,,,_,-.,County, -' .............. State of Wisconsin: Subject to unrecorded agreement sated October 12, 1991 by and between Donald R. Jordan, Cail Gordan, John A. Elbert and Eric J. Lundell regarding fut.:re lava transfers and roadway conveyances. Subject to covenants, conditions, ^estrictions end easements created by preliminary plat of 'hells Fargo Station First Addition. Subject to easements, restrict :^s, reservations, and r~;hts-of-way of record, if any Tllis is not >,.-..estead pro~er.~:_ ....................:...... (1k1Q (is nnt) t:xcchtimT h, warrnntics: 4s ^oted above f)alal this .. ..- .-20th --- ._...... ...... .. Jay ~: . .... _ ..............._.................. .. _. ( 'SAL) AUTHENTICATION TI'fLl:: SiG~i11L•'R S'P:ATE DAR'JF •.V1:'',•~~ .. i I f not .............................. nuthorized by S ?OG.OG. Wa.::r.s.) THIS IN STNI;MENT W,a~ ;~p,~F-E-, BY' HuTbird Land Corporate-~.:n (Sign¢ture3 may.-be auti:enti~a'_a .: acwnowlrcl,...- 'T ¢re not r. ~.. .ec ~. .. 1 ' August.... ........................ 19.99..... HUM81Rp LAND CORPORATION f (S L•'A L) 4y. ~~ ~~~~Zst .............. . Austin J. Baillon, Its President . ............................................ (SEAL) ACKNOWLEDGMENT STA:')J OF XXi~ld91f4$iXl MINNESOT ss. Ransey .County. f c rs~n.:i:y ,-.,nw b•_iorc me this ...20th.-....day of 't~.9ust ........................... . 1!':39.... the above nnmed Austin J. 9aillon~ President of `~.'.^~bi.rd .Lacd..Cncanratinn ........................... .............................. . :a n•.c known to i:e Ilse , erson .........-.. who u.ecutcd the iorchoic~; instrument ,nc ¢_c~.ww(ec:~a~tbe•X?3?aati+wl~,,.`•, , Phu) 'A.. 9~11.!c n _ - -t~ v r'OU,~TY .:t,,,, , blc Nashingtdn•'^• -:~.Y;erA-tv„°liM:' N '.S~• Jul ~l ,;on is ne.mnr.cnt ([f rot,,statc exl~,ration /D a' 1101 Carmichael Road Hudson, WI 54016 Phone: (715) 386-4680 Fax: (715)386-4686 Fax To: Tammi From: Shawna Moe Fax: 386-9281 Date: October 18, 2000 Phone: 381-5000 Pages: 2 Re: Septic Verification -Raider Est. Lot 9 CC: ^ Urgent x For Review ^ Please Comment ^ Please Reply ^ Please Recycle ~~ ,1~.Y" ,~~~ IIMII~I~N^ -- rrrri r.~. ' ~. October 18, 2000 First Federal Attn: Tammi 201 S. Second Street Hudson, WI 54016 ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 Fax (715) 386-4686 RE: Septic Inspection for Sam Miller located at 541 Raider Drive, Raider Estates (Lot 9), Hudson Township, St. Croix County, Wisconsin Dear Tammi: A septic inspection of the above referenced property was conducted on 08/11/2000. This property is located in the SE 1/4 SW 1/4 of Section 21, T29N R19W, Raider Estates (Lot 9), Hudson Township, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a four (4) bedroom home. If you have any questions regarding this, please contact our office at (715) 386-4680. Sincerely, Kevin Grabau Zoning staff /sm cc: file