HomeMy WebLinkAbout020-1357-18-000,~ ,
ST. CROIX COUNTY ZONING DEPARTMENT
~ ' ~ w AS BUII.,T SANTrARY REPORT
Owner ~/f~~/~o?•E ~u5 4T'GI ~r~
Property Address 8y% (.y rt- L 0 2 o f~' ~? ~ ~Q~
City/State ~t,~)S o,~J c,~ , . ~y~ iG
Legal Description:
Lot /g Block _ Subdivision/CSM # EV~7PG
~t _ '/a ~ '/a, Sec. ~, T~,N-R/~1 W, Town of _
o,J Pnv # ~a ~ -~ 3$~ - ~ g - ~'~
SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION:
Tank manufacturer t'•J'iLSE~ Size ST/PC/~"'~ / Setback from: House `7' Well ~o ~ P/I, 35~
Pump manufacturer -- Model
Alarm location ~-
(HOLDING TANKS ONLY)
Setbacks: Service road Vent to fresh air intake Water Line
Meter location
Alarm location
SOIL ABSORPTION SYSTEM:
~'r ~ T~.t ~ ~~
Type of system:~R~~- ~ Width 3 Length ~~ ~`~ ~~ Number of Trenches ~
Setback from: House 33` Well 73' P2 ~ 7,~ Vent to fresh air intake ~/.?
ELEVATIONS:
Description of benchmark / ~ ~ !t o ~ P ~~ ''~ ~ ~ ~ ~ rt ~`~'`'~ Elevation / oo •~'
Description of alternate benchmark ~,.~, s rl ~ oc? ~ vw e ~ ~~ v ~~ Elevation o ~ • '
Building Sewer / ~ ~ ~3 ~ ST/HT Inlet / y 3 • ~~ ~ ST Outlet ~ y 3 •yS ~ PC Inlet
PC Bottom ~- Header/Manifold ~7• ~~ ~ Top of ST/PC Manhole Cover / ~ ~ - ~~
Distribution Lines (p')
~'9. r7a
(B) 9~~ ~ ~ ~ ( )
Bottom of System (!~)°~ •'~~ ~ (~) ~ n~ ?$ ~ ( )
Final Grade
O 'a3 . Sy
Date of installation ! Y /O~ Permit number ~ ~~ ~ 2 ~ State plan number
Plumber's signature G 'cense number ~~ ~~ ~~ Date /~~ ~
Inspector ~~~.
Co~lete plot plan ~
nl ~STr¢ TF4
R
4 ' 4
NOTICE: Please provide the following:
• A plan view sketch showing everything within 100 feet of the system.
• Two horizontal reference points to center of septic tank manhole cover.
• Show alternate benchmark, if applicable.
PLAN VIEW
~dgrN 04u0~+r~i.c~s
~N~/ LT2 rtraP ' ~' O~W t ~u QC>? I ~-/GN
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X73' lv..x~PL~~i
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~ t~v.: l c7 /. ~ 96'
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a
w1SO0"~" ° °f CO"~`~r`"e PRIVATE SEWAGE SYSTEM
Safety and 8tll~algs Uivisktn
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Personal irNormation you provide maybe used for secondary purposes (Privacy Law. s.15.04 (1)(m)j.
PUMP /SIPHON INFORMATION
Permit H r s Name: ^ City ^ Vi lage ^Mown o
usdigian, Theodore Hudson Township
T BM E v.; Insp. BM E ev.: BM Description:
r/
(7 ~',,
TYPE MANUFACTURER CAPACITY
Septic !~Q Q
Dosln
Aeration
Holdi
TANK 1NFUKMAIIVN
TANK SETBACK INFORMATION
TANK TO P / L WELL SLOG. vent to
Airlntake ROAD
Septic 3 i ~ ~ ~ .- NA
Dosing NA
Aeration N
Ing
urer Demand
Model Number
TDH Friction TDH Ft
rcemain Length Dla. Dirt. To We
SOIL. Ag.SORPTION SYSTEM i ~ / ~
ELEVATION DATA
ounty:
St. Croix
Sanitary Permit No.:
384120
State Plan 10 No.:
Parce Taz No.:
020-1357-18-000
STATION BS HI FS ELEV.
Benchmark ~p (~ l~
Alt. BM 2 ,
Bldg. Sewer ~ ,
/ Ht Inlet
St Ht Outlet , j 0 ,
Header/ Man. ~
Dist. Pipe
~~ !bo
, ` 1Dl704
, a
eot. System ~~ ~ ~ L ' T
Final Grade •/G 103, 5
St cover
'~
, 5
Z
i
BED / ENC Width , Len tfi No. Of Trenches a ryplT No.Of Pits Iraide Dia. Liquid Depth
b ~~~ ~- I E I N
SYSTEM TO P / L BLDG WELL LAKE /STREAM L IN Man dui r:
SETBACK ~
INFORMATION Type ~
/
O H ER e Num r:
s`
System: J Z 3 ~
nISTRIRI ITION SYSTEM
Header / Mani old Distribution Pipe(s) x Hole Size x Hole Spacing o Air Intake
T
Vent
~
length ~ / Oia. ~ I Length ~Dia. ~_ Spacing __~' _ ( ~(.~ ~ ~ /~ I ~
/
7 Z~
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: Y /~/d/ Inspection #2: / /
Location: 849 Waldroff Farm Rd., Hudson, WI 54016 (NW 1/4 SW 1/4 23 T29N R19W) - 2329192092 Evergreen Estates II
-Lot 18 ,~- I
1.) Alt BM Description = ~~ DLtI ~S~F Trt+~-0l~ior~
2.) Bldg sewer length = f Z'
-amount of cover = 7 3
'' ~~ ~~-- ~ r`~
Plan ~~'visl~req"tlirBd? ~Q Yes ~ No
Use other side for additional information. b ~
Oat Inspect 's Si ature Cert. No.
S80-6710 (R.3/9~
~ 8 .I~~~FF ~, Sanitary Permit Application Safety & Buildings Division
~ In accord with Comm 83.21, N'is. Adm. Code 201 W. Washington Ave.
~ rr
`~ See reverse side for instructions for completing this application PO Box 7302
S`~R~~n Personal information you provide may be used for secondan• purposes Madison. W[ 53707-730.^
Department of Commerce
[Privacy Law, s. I5.04(])(m)j (Submit completed form to county if r•
state ovine:
Attach com lete tans (to the county co ~ only) for the svsterrt, on ~a er not less than 8-1/2 x 1 I inches in size.
County ~~ / x
~ State Sanit ry Pe~ t Number O Check if revision to previous`application State Plan 1. D. Number
~
I. A lication Information -Please Print all Information t .- Location:
Property Owner Name Property Location
„. ~r I/ I/4, S T ,N, E or
Property Owner's Mailing Address - Lot Number Block Number
City, State Zip Code Phone Number- Subdivision Name or CS~4 Number
II Type of Building: (check one) ~ CitY
® 1 or 2 Family Dwelling - No. of Bedrooms:~ D Village
_
^ Public/Commercial (describe use): ®Town of
^ State-owned
III Type of Perr.^.it: (Check only one bex on line A. Check box on line B if applicable) Nearest Road _
p) I. ®New System 2. ^ Replacement 3. ^ Replacement of 4. ^ Addition to Parcel Tax Number(s)
S stem Tank Onl Existin S siem v~p - -
$)
^ A Sanita Permit was reviousl issued Permit Number Date Issued
~j . ~~ . l g . oZ D
IV. Type of POWT System: (Check all that apply)
® Non-pressurized In-ground . ~ Mound ^ Sand F!Iter ^ Constructed Wetland
^ Pressurized In-ground ^ Holding Tank ^ Single Pass ^ Drip Line
^ At-grade ^ Aerobic Treatment Unit O Recirculating ^ Other:
-~ / -
Dis ersaUTreatment Area In ormation:
1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. stem Elevation \
~ 7. Final Grade
Required Proposed Rate (Gals.ldaylsq. R.) (Min.finch) ~
~. ~$" ~~owe/) Elevation
.~7S,P .F7 3~7 ~ . FT• /•o`Z p
/ 90a ~s V / ~~.~ S4
VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic
Information Gallons Gallons Tanks Con- Con- glass
New Existing Crete structed
Tanks Tanks
~ ^ O ^ ^
^ ^ ^ ^ D
VII Responsibility Statement
I, the undersi .ed, assume res onsibili fcr installation of the POWTS shown on the attached !ans.
Plumber's Name (print) Plumber's Signature (no stamps): /
M
PRS No.
f~4P r
be
Business Phone Num
/t ~/~ gq
e
~
n
o[oC. /~ oo
~~
- d0-
Plumb s Address (Street, City, State, Zip Code)
r - T s'
VIII County/Department Use Only
^ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued nt Signature (No stamps)
Issut
Approved ^ Owner Given Initial Adverse Surc~rg
ee~
e
F .~ ~
Determination a
~
a
2
,~ 6
/
IX. Conditions of Appro~v~a~,l/,/,Reasons for Disapp val: ~ ~~~ ~,~~- ~.. (,d, ~. Q3Z_ o' a,o
~ ~ .~.,,~,~, n ~,-P, .,~,~.~ •~ (~Ie~ I~._ c~atad~ ~µA~w,~a,~,QQ a,, ~,,. ~a+~u.c~.u~s treco+~t
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SBD-6398 (R. 07/00)
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L1PPA 8800. EXG-YATWrf!# INC
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Wisconsin Department of Commerce SOIL AND SITE EVALUATION ~ 3
~ivision of Safety and Buildings Page of
Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code
~~..~_ . -
Attach complete site plan on paper not less than 8 1/2 x 11 inches in ~dc,'~P~rf must Coun
include, but not limited to: vertical and horizontal reference point (; direction ar~,, - \` ~? ~~ ~~
percent slope, scale or dimensions, north arrow, and location and,tiis~~D(ce to ~~ee~~ss t~p~. ~:' Peicel LD. #
_. >> ~~L1=~ si C v~ ~
r .f
APPLICANT INFORMATION -Please print all inf rpa~t~oh r i ~~:: n~~~ R v'' wed by Date
Personal information you provide may be used for secondary purposes (PriNiae~r-' _Law, s. 15.Q~4-I(1~X 2 ~ p (o ~O 1
Prope~j, Owner l ~ r-~ -`"maw lion"~.~'~' Q p
!"1 r.. )>``~ /~ 11)~ ~~ nl~ ~ C.3 ~~:~',.?•~. Z ion of ~ ~~'', 1/4 ~1~1/4,S Z~ T Z ! ,N,R ~ / E (or) W
Property Owner's Mailing Address ~ ~, •-~~ ~o k Subd. Name or CSM#
~Zw~cu ~ '~~ ~~l~~QG ~~~~ i~ST ~ S
City State Zip Code Phone Number ^ City Village ~ Town Nearest Road pp
.TrJ~..,vv~.e. I /~?..~.I I~6s/ >f%.76-69/6 ~U~~ IWAc.I~Qo~~~~t-11~
New Construction Use: Residential /Number of bedrooms ~ Addition to existiny building
^ Replacement Public or commercial -Describe:
Code derived daily flow Xs. O gpd Recommended design loading rate ~ ~~ bed, gpd/ft2~trench, gpd/ft2
Absorption area required bed, ft2 3~ trench, ft2 Maximum design loading rate ~.~ bed, gpolft2~trench, gpdfft2
Recommended infiltration surface elevation(s)li~ ~ ~~ ~ ft (as referred to site plan benchmark)
Additional design/site considerations
Parent material ~ ~-bC~AL OU7L•~AS-1' Flood plain elevation, if applicable 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 REPORT ~ 5w
Boring #
Ground
I v.
~~ft.
Depth to
limiting
factor
} 12 in.
Boring #
7
Ground
10~~9 ft.
Depth to
limiting
factor
~ //~ in.
Horizon Depth Dominant Color Mottles T
t Structure istence
C
n Bounda Roots GPD/ft2
in. Muns
ell Qu. Sz. Cont. Color ure
ex Gr. Sz. Sh. o
s ry Bed ,Trench
) J
b 4 - S,~ ~ sbK ~ ~' GS - .~~~ .3
S ~~ ~' Q ___. ~ ~ i?~1'1 ~ C ~ ,7 '~
-~ y 4 ~ ~- ,~~ 1 -- .~ ;
Remarks:
6, t3-3d Y~ 4 3 -- S ~ ~ n~ Sbk rr, r c.~-.~ 1 ~
7 d- - S 4 ~vi5 rn c. ~•-~
0- / Y~24 3 ~--~ SG !~5 ,m ,~ b,
--- -
-1- 98~
x.-3.0 loa~ $ ,
Remarks:
:STN me (Please P int) n ure Telephone No.
~A~~~v JOUNSb~ ~s~ 40~b
4 ess D e CST Number
d $~ ! u~a> ~~a~ 3 Z Z~ Z2Z7S 7
PROPERTY OWNER A~~`A,vn~.~ ~~~ SOIL DESCRIPTION REPORT
PARCEL I.D.#
Boring #
Ground
elev
ia~.~ ft.
Depth to
limiting
fac~or
Ill in.
Boring #
9
Ground
elev.
/~~ ft.
Depth to
limiting
fact r
7~~ in.
Boring #
/~i
Ground
~~ft.
~+r ~ i
' Page. of
Horizon Depth Dominant Color Mottles
Textur Structure
Consist
nce
Bounda
Roots 2
in. Munsell Qu. Sz. Cont. Color e Gr. Sz. Sh. e ry Bed ,Trench
/~
f-1 -I Z /by~ 3 ~ ~ L f M Sb~: n, r' ~ w N'1 0,~ 5~
JL.(~ ~ t/~~ 4 -' SAC. 1 ,~r~sb~ i-., r Gw I ,Z ; ,3
1q-~ 7,SY~2 4 4 - SG rh ~ rn ~ ~^' -- ~ o.~S
~ ~-~ >dv2 4 -- ~ rns -~ - ~ o
~6 `~°'(o
Remarks:
a 12 ~ - ~- ~ b~ r ~w ,4 ' ,~
~av~2 4- 4 - s~L ,~, sb~ r}, r L~ 1 ,z ~0.3
(~ -~ x-124 4 _ 5- s~ ' mSbK ,'', r Cw ~' ,Z 'd .3
8s (Z ~ S~ S ~ .. Q.7 ;®.Ts
,~- 9ip• iS
S 2.2 ~ . L.
Remarks:
Horizon Depth Dominant Color Mottles T
t Structure n
C
i
t B
d R
t GPD/tt2
in. Munsell Qu. Sz. Cont. Color ex
ure Gr. Sz. Sh. o
ence
s
s oun
ary oo
s Bed ~ Trench
-t( /bye .--- L 1 ~ s K yr, r Cw I ~ SJ
-3~ dYi2 -' ~' L /n-SbK )'I~ r Gw -' 0.2 ~0.3
C 1 ,Sx,Q 4 ~ SC rn5 im I eS _ D~7 'a
Depth to
limiting
factor
~ !2~ in.
Boring #
Ground
elev.
ft.
Depth to 1~
limiting
factor
Remarks:
-'n' Remarks:
SBD-8330 (R.9/98)
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Private Onsite Wastewater Treatment System Management Plan
Septic Tank And Gravity In-Ground Soil Absorption Component
Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment
System (POWYS) shall include information and procedures for maintaining the system within
the parameters of Comm 83 and 84, and the conditions of approval by the department, agent,
or governmental unit. -The approved plans and permits for system are on file at the county
zoning or health department.
This. management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground
Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD-
Table 1: System Design Specifications
Sanitary Permit Number $ IZc~
Number of Bedrooms 3
Design Flow -Peak (gpd) S"~
Estimated Flow -Average (gpd) tJ~
Septic Tank Capacity (gal) tsut~
Soil Absorption Component Size (ft2} $- z ~
Type of Wastewater D mestic
Table 2: Soil Absorption Component -Limits of Reliable Operation
Septic Tank Component .Soil Absor tion Component
Design Flow -Peak (gpd) t5t.70 Z - as r~s
Maximum Influent Particle Size (in) 118
Maximum BODS (mg/L) 220
Maximum TSS (mg/L) 150
~~ 1
~2y
0
Tab le 3: Maintenance Schedule
Septic Tank Inspect and/or service once every 3 years
Outlet Filter Inspect once a year and clean at least once every 3 years
Soil Absorption Component Inspect once every 3 years
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks
under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with
NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease
Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable
Restrooms).
The operating condition of the se t' and outlet filter shall be assessed at least
once every 3 years by inspection. Th outlet f r shall be cleaned as necessary to ensure
proper operation. The filter cartridge shou d not be removed unless provisions are made to
retain solids in the tank that may slough off the filter when removed from its enclosure. If the
:~
Management Plan for a Septic Tank and Soil Absorption Component
filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously.
Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The
septic tank shall have its contents removed when the volume of scum and sludge in the tank
exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the
time of an assessment, maintenance personnel shall advise the owner of when the next service
needs to be performed to maintain less than maximum scum and sludge accumulation in the
tank.
Manhole risers, access risers and covers should be inspected for water tightness and
soundness. Access openings used for service and assessment shall be sealed watertight upon
the completion of service. Any opening deemed unsound, defective, or subject to failure must
be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by
an effective locking device to prevent accidental or unauthorized entry into the tank.
No one should enter a septic or other treatment or holding tank for
any reason without being in full compliance wifh OSHA standards for
entering a confined space. The atmosphere within the septic or other
treatment of holding tank may contain lethal gases, and rescue of a
person from the interior of the tank may be difficult or impossible.
Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the
tank is no longer used as a POWTS component.
Soil Absorption Component
The soil absorption component serving this structure is designed to accept domestic
wastewater from a residential facility. The limits of operation of this component are shown in
Table 2.
The longevity of a soil absorption component depends greatly on proper and timely
maintenance, and system use within or below the limits of reliable operation. Good water
conservation practices by all occupants and the installation of water conserving plumbing
fixtures are key factors in extending the useful life of this component.
The soil absorption component's operation must be assessed by inspection at feast
once every three years. The inspection shall include recording the levels of ponding, if any, in
the observation pipes, and a visual inspection for any evidence of surface seepage or discharge
from the component. On steeply sloping sites, areas of erosion should be identified and
reported to the owner for repair. The surface discharge of domestic wastewater or sewage
from the system is prohibited and considered a human health hazard.
Traffic around or over the soil absorption component should be avoided particularly
during winter months. The compaction or removal of snow cover over the component may lead
to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or
impossible to repair until weather conditions improve. In general, soil compaction over this
component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to
more intense, and earlier, organic clogging of the soil.
2
.
ST CRQIX CUUN'x'Y
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Ow:- ~er/Buy ty
tom: i~ Aa.,~: s 129v ~/~r~ l/ ~ic ~, S~•f~ f /wad ; ~I~I,N .S`s-o BZ
(Verifecation required from Planuia:g lhpartrrtent for new construcuon)~ -
Cit}~ State :~~DV~ I.t// Parcel Identification Number .DaD --/3S7-f moo
LEA: -AY. Dlr:;~~c~ 1T0:~ •
Prat: qty I.~:xrc;..~on /VW s/,, Sot/ s/,, Sec. 23 . T~N-Yt~W, Town a£ a
Sub c !~i~yisio i E~/~ r Yc eta ~s';-u~-~ s ~ Lot # ~_- .
~~
Cer:;ltled ~,;us~~~.ey Map #,~ . Vohune .Page #
War~t~tty~l?ksl::d # ~.,~(, U~,9 .Volume /S,/ .Page # 7/
Spo: ~ house C wl ,yes ~nc Lot Tines identifiable ~1 yes ^ no
~krEM ,~1t~:~~I~ivAt°dCE
lmpi~a>~ ~i ~ r,~se sad maxateaaace of yom septic system could t~esnlt in its prematsue failure to handle wastes. Proper m~SncC
consi:~ of p~~stiFi;:,sg out the septic tatilc every three yeas or soon, if needed by s licensed pumper. What'you. put:inoo: t'rre`:trystetn
ean:i~cet the ;f tn:~:tina of the septic tank as a treatment stage in the waste disposal systeas.
3~e ~ Pi ~7: eaty ovv~r. sgiees to submit to St. Croix ?.oniug Deparimeat a cettf' tcatioa fawn„ signed by the .o'.~ea.° 'an,d by. a
magic rplumb~:r .j~ tmoeymaug;mnber restrietedplumber or a licensedpumpervaifying that (1) the on-site ~vastewat'erdispo:~t;system
is in'.~rogp[ O`?e Ca ;ing COnd1t1C'•Q andlOT (x) after iasperfion and pumping (if IICCe65ary), the septa tank is less than L!3 £oll ~r~`~sl~ge.
IJwe : ~~e un~~ .i;~~iouedhave ra=.d the above tegaicea~ents and agtx to maintain the private sewage disposal sysban v~ritjL tbr~.::;~aadards
set fS;tti, herE:u+,; o~s set by the :Dtpartihent of Commerce and~thC Department of Natural Resources, State of Wlscodsin. GFrt.~iCatioa
statist ;that yrab • t:;;ptie system 'bas been maintained must be compieeed and ieturmsd to the St_ Croix County 7•onia~ Qffitc~?i4Yt6in 30
days. ef.the t~rec: ;dear expitati:om date. ~7
SIGN ,AT[JRl~ ~ (~f~ .APPi,ICAP DATE
I {wl~), c:~:~.:tify that aU statements on this foam are true to the best of my (our) knowledge. I (we) am (are) ffie a~zz_:es(s) of
the k~ operty tle::~.l ibed above, byyirdss of a warranty deed recorded in Register of Deeds Office.
~ oL l / ~
I(3I~'!4TUR~ (bl? .APPI:IC DATE '
*""' `_~'; Aay; it} Ec~ :rrtation that is mis-represented may result in the sanitary permit being revoked by the Zoning Depacirnej~i. «ss.::
•' I>> .Inds w~itip i.Gls appiica'!:ion: 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
-;
60 39~d tid9t' LS LS ~St 666L/9Z/L0
• + "
' STATE BAR OF-WISCONSIN PQRM 2 - 1998
WnRI~AN"1'Y UIiGU
urxn~~~enlydun~uFl~ Y0L 1571P~~~ ~~
'Phis I.)cecE, rr,adebctwern --Kennon J. Bast and Donalda
_~ _ .S{zeer-Bast_ ---._ .. _ - .....__-
__ __._ .. _. Grantor.
-.,
+nnl TheOdpze O., OUSdig7.di1. , a married person
_ ~ _
--._._. ......_... ...._ - _ Grantee.
Crai don, lul a ~~alunble cunslderallun, conveys and warrants to Gr:ndr:c the (bllowiug
described rt~af esi,tr In ._ ~__CT'O1X __-„__. County, State of Wisconsin:
Lot 1 tat of Evergreen Estates II, Town
Hudson, St. Croix County, Wisconsin
66029
Y~RTNLEEM H. WRLSH
kEGISTER OF DEEDS
ST. CkDIX CD., WI
RECEIVED F(Dt RECORD
12-23-2000 10:00 AM
NARRANTY DEED
E%EMPT N
CERT CDPY FEE:
COPY FEE:
TRANSFER FEE: 179.70
RECORDING FEE: 10.00
PAGES: 1
'. F{„~.r.-..~di~.lll lu e~
Name and HBIUrn Atldress
Fay /~ Va,1(~,:..` 13a..µ_ k
i..
020-1357-iR-000 ;i
Parcel Idenal¢alton Number (PIN(
This 15 nOt homestead property.
((s) (is not) ,,
~~
Dated ur;< _-.-.22th-_ day ~f ~~cemhe~_
-- )
___ _ -- -- ,- - ----- (SEAL ? QQD-_.. i;
i(l r9 ,c-...c e4.r_ ', ,,
~;~•=L,--~Q~r ._._ (srAL)
$.ern~c n.-J._-,Bast_____-
---
• Donalda J. Speer-Bast I'
- ii
(SEAL)
AU7'IIEN'-'ICATION
Slgnalwr(s) . _ --- ~-~ ~ ---- .
authentiurlc<7 this __,,. -___ clay u(-__....~-, __
ACKNOWLEDGMENT
(SEAL)
State of Wlsconsitt, l
ss.
~__ Saint C'roi x County JJ11
Personally came before me this 2 7th day of
_, DecEamttc r .___, 2000 ,the above named
_ _.Kernon~__B~ and Donalda J.
' .peer- ast
Tll'LE: AILiMBER .i I'A'I li BAR OP WISCONSIN ___. __ -__ to
({( not, .-.--___...-_________._. the known to be the person S who executed the foregoing
authul ized by §iUfi.OG, Wis. Slats.) Instrument and acknowledge Lire same.
fH1S INSTRUMLNI' WnS DRAFTEll BY _ ;~:
__.. _ Kernon_ J....~ast~---------.. --- -~-- i
Notary Public. State o~'Jisconsin
My commission is permanent. (E( not. state expiration dale ~
(SiHnahuc. m.ry Im urUtcnticated or acknowledged. Both arc not _______ G~J ° i IQ~`-• _^)
nccessnr.y)
iiVotary Pubtic
•N.r~„•..m p~~ „~~. nr;~a~y; t. .~~~~•rap~u~uv uov r,r iyp•.r..r p,en«I tH~io.. m~rr rlF O+~~n c. Stag OE WI$con$i17
tt'n1IRAFlI'Y i~l!1!U Sl'A'tE EiAH UP Nl~ol~7iJara J. Burk® Wiscauin Legal Bl;vik Co.. loc.
FORM Nn. 2 -9~79'A~'~ ~;~,,.,.,ro.. w»
Exuoplions Ir, warranties:
/D
.7.s 7 3i ..3? ~r.~-'~i.3i 3~ ~~ ~i '~ .~ t3 .~ 1., A,~.+ 3 .i , ~3.
/ /~
// .~•/.
IN PA}iT ?~~' TSB 1N~f//4 OF T~IB S~f/4 AND i1V P.L~T OF T:Y_3 S7f/4 ~F TNT N71/~ Q
ON 23, TxB,~T, JRf~^~, ?`03'~N OF ~UDSfle$, ST. CRflI~ COUNTY, rFISCfl~K~'IN; SSINC L13T 2 // ~Z"'" ,`
~I:~J SU:tI~'Y 1~P Ra~'COt4D~'D IN YDLU~YE f3, P.~GF 353 AT T~~' S?: CRflIX COU'~TY / ~/ /
OF DBR3S' OF4PICF. PREPARED FOR: // ~./, //
Lt)CATION SIfETCN
KERNCN J. BAST / ~' //
DONALDA J. SPEE,R-BAST SECTION 23 / ~.'
948 LABARGE RD.
HUDSON, SN 54016
:ARLES ARE i0 dE ?UCED SUCH tHAT n+E iNSTAiLA nON w0UL0
STAwE, OR C;.~'.`n:CT syON u_CNG ANY lOT VNE OR STREET UNE.
A SURvEY SisKE tlY ANYONE .S A 'AOIA nON Oi' SEC npa 2]6.34
E5. UIIU TY EASEVEN TS AS -'ERE'N SE7 :CF TN AaE FOR 177E USE CF
R'VAiE PU%JC UT~:+ DES HANNG THE aIGNi TO SER~.E rNE AREA.
vN TIIS LAP (PLA T1 I$ A,8.EC1 TO STATE, COUN ~Y, ANO TONNSNIP
01lAilONS (~.E., AE ILANOS, VRaNI'V LOT SZE. ACCESS TO PARCEL, ETC. j,
M OF4ELW~NG ANY PARCEL Of UANO CONTACT *HE ST. CAgX CCUN TY
]PRC]aiA~ TOW4 90ARp c~ AONCE.
EVERGREEN ESTATES
i
LOT i6 I
--------
I
<589~48'34'E)
589'461'06"E 890.'
3.8c'
_-_ 824.77'
18
2.532 ACRES
110,293 SQ, FT. rt~i
T29N, Rf91I
LoT _f_4
~! M'!a
t CO / Q' ' /
/ 'c .'
/
T
,~
., DOUGLIS J. d /
/ /
/
~
,
* ~ r4s 7t /
~
'
/
'' /
!' NUS // ~.: /
/ Q : /
/
/ / ~/: /
P ~ /
~
/
~'/t/qY / ~ /
8..4..L s/shy / /
400.95' ~
~~
NORTH LINE OF THE NVI/4 pi THE SVt/4 ~ 3'
U'1(
17 ~ "''
of
~(
2504 ACRES
109,079 ACRES I,
3 ~ /~'1
~, , -. 1
a ~
1 ~ jSO ~ ~
~, i ~• ~ , r
' ' ~~ ~
/ ,
~, .., .. ... , ~ , so.
I ... ........ ~ ..... /-~ /
~\`/'~~,Tj' . •\,, 143.x2 / / Q //
/ - TIT' -`87-o-6'Z,;_E__ __ _- ~
SO'
1
' f
r
m•
~i1„: 66 ~: ~I
`~ ~. ~
~
`~ / ~ 143,42'
~
/ /
'
/ /
~~ /' ..i .. .............. . ...
/ ~
~
/
O ~
~ / / .~' (
/
~
1 ~ / ~~
/' ~
z~Z
~~ SA'
PO.~'3.vTS
'~ ~~ .. ~
.- 2.500 ACRES
, (
~
' ~
~° z 1 ~ 108,906 SD. Fr,
\
~ •:~`
` (~L
o ~' ~~ oa•
~
~ 2.504 ACRES w
:Q~ \
o
7`~ ~
~t ~ o 109,054 SQ. FT. NL
_ ~ ~ :
0
~1 ° C
t o
~ a,
6
'w 13?7.53'
PLATTE) LANDS
~ ~
~ RADIUS }
?PINT I
/~
l R` 80' I
l TEMPpRARY CUI.-DE-SAC EASEMENT
~ n
is N / Tp HE REMpvED UPON
u'N
~' m /
/ EXTENSIpN pF ROAD
i° ~~ 609.20'
387.82' 221.38'
t<yLRVE CATA
NUMBER LUT NUMBER RADIUS CENTRAL ANGLE CHGRD BEARING CNL8t0 LENGTH
Q 167.00' 92.39'43" 546.33'43.3"V ~ 211.68'
® 233.80' 92.54.28" 546.25'23"v 337.77
t7 273.00' 21V9'?6" 582'18'34"V 83.33'
18 233.00' 379d'48" S32'44'47"V 17464'
19 23300' 33.46'14" 516'57'16"V 13').33'
/ /
~ ~
~ /
r
I i
I (
I I
1 ~S
1 j S 6• T~9
~ I ~9.
~ i . SS6~ j& F
6600' 40)16-. s?1
-+- ~ ---- ~ --~J----
(
QI~
33' ~ 33'
o
_
^i"'
12
4' +/-
' .
~ ZI
I
~ ,
~
i
~3
r`
W cU
ftl o
(U o
o t,~
°o `~ 5
fA ~
a
b
l u
4~
~~
O~
j'
8. a' +/-
ARC LENGTN TANGENTS
270.08' 500.1]'34^v N87.06.23'w
37782' N87.06'23"V S00'JO'SP'E
86.04' N8TC623"V S7l'4+'ll"V
134.43' S71'44•it'•v $33'43'23'•v
177.73' 533'45'23"V 500.00^.i"E
~ x,~clsr~n~s ozTrtca
JI', CAOLY ~Q 9/q 7''t
!i~ e~i~a! fa R.wd
d '- t
V~S ~o~C 3l 'L~~~g10
~~jj NW CORNER
SECTION 2J
• .. .
® ALUNINUw CCUN 1~ iEOnON C(MNER
wO.vuwENr :ounD IIO
C.ITB'n
~ I' IRON PIPE FOUND p
Or ,S yj~C'~
O 7' :( 30' IRON PIPE SET {i(',HING 0,~ CB'RT
1.85 LHS. PEP uNE AR FCOi n y~G, j~~~,.
NOTE: ALL OTHER lOt rCpNE~7S
wONUwEN TED WM I' z 2A'
IRON P'PE NEIGHING I.IJ U35.
PER uNEM FOOT
' ~ ~ ~ ~ ~ RDAOWAT SETH 4Ct( LINE (A$ SMOwN)
t2. ,NOE UnUTY EASENENi UTILITY EASENEM 7$
NO POLE CR BURIEC
~ ^ DISTUKH ANY SURh
~+
~ . THE OI~n;RHANCE
~ -'"""` ~'~ PROPOSED ORI~£ CF 'MSCCN54 STA fI
~ ~! ~ - vUHUC BODIES ANO
~
_
~
~ "'
K~
'~ ~
STORw WA IER 4ETEN90N AREA
EACH PARCEL SHOW
lA wS
RULES AND P
'~ ~ •
~
~ NIGH wA 1ER LINE ELfvA nDN ,
9EFCRE PURCHAyN(
~ W ~ ~ ZONING OFFICE ANO
I ~.+ W NO1E A GRADING 'HAT wWLO AI TER THE CAPAG TT
;iT -+~ W CF ME STDRw wA TER RETEN n(IN AAEA
~ IS PRg1181TED
~ A
$z I r<
'.
~ ~ ~
NOTE B
~
BUI(DINGS ARE PROHIBITED WITHIN
n1E STORM wA TER AETENnaN nREA
z
y °~
~ ~
PRE~AOUSLY AEG~DED OATH
1
a ~ ~ Ex15nNC FENCEUNE 1
L0~' 9 ~
•
l C._S
.M_.__ IN 1
1
I o
$ '
N _
V:
PG.
1fL _ 3234 1
., _
_ 1
589'A8'O6"E 397_85_
I /~
4i
( ° -
I
c.s. o
LOT 1
CERTIFIED _SURVEY_ MAP
VOL. >3, FIG. 3536
-----------------------
N85'20'00'^E 390,16'
H I
~ V ~ ~ M.W.I. ~ 42x.30
w q ~
W ~I '
.q I
L-- -------~
------- 33.00'
3
LOT 1 I
C. S_A!_. IN I iv C0
z
cu, rno.~co
20
2.910 ACRES
126,776 SQ. FT.
SCAtE w FEET T' 60'
~~
1.9-
2.389 ACRES
t0a,tl66 SQ. FT.
VMtisconsin Department of Industry, •
labor and Human Relations
~ Division of Safetv & Buildings
SOIL AND SITE EVALUATION REPORT
_..~ ...:ate ii i in nn nc ~11I:.. A..I r.. n....l..
Page 1 of 3
~„ ~.,.,,,,....,.,, ," „ . ~.,.., .,... , ..........,..., COUNTY
but
Plan must include
lan on
a
er not less than 8 1/2 x 11 inches in size
Attach com
lete site St. Croix
,
p
p
.
p
p
not limited to vertical and horizontal reference point Ire~tirna.~nd % of slope, scale or PARCEL I.D. #
n ~sti rbald,\
dimensioned, north arrow, and location and dist ~s~ 020-1020-90
r
APPLICANT INFORMATION-PLEASE ~ AL IN~RMAT14, REVIEWED BY DATE
PROPERTY OWNER: ~~.,/
• OPERTY LOCATION
'i
Kernon J. Bast '-1` ,/~(f GbVT. LoT ~ v4 ~ va,S 23 T 2g ,N,R lg F (or) W
PROPERTY OWNER':S MAILING ADDRESS c 7~' ST - ~09 ':
~ L T # BLOCK # SUBD. NAME OR CSM #
948 LaBAr e Rd.
~'X 8 na Ever reen Estates II
HEI~i '.
CITY, STATE ZIP COD ~ CITY ^VtLLAGE 1fcJfOWN NEAREST ROAD
~
Hudson, WI. 54016 S' •~1$ X75-''~•.., •' Hudson Waldroff i:~tt. Rd
,,.,
~ ] New Construction Use [x] Residential / Nu o tl<ob 4 [ ]Addition to existing building
j ]Replacement [ ] Public or commercial describe
Code derived daily flow 600 gpd Recommended design loading rate .7 bed, gpd/ft2 •8 trench, gpd/ft2
Absorption area required 858 bed, ft2 750 trench, ft2 Maximum design loading rate . 7 bed, gpd/ft2 •8 trench, gpd/ft2
Recommended infiltration surface elevation(s) 99.00 ft (as referred to site plan benchmark)
Additional design /site considerations trenches spaced to code 3.50' below grade
Parent material pitted outwash plain Flood plain elevation, if applicable na ft
S =Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U =Unsuitable for s stem ®S ^ U ®S ^ U ~E7 S ^ U ^ S ®U [~ S ^ U ^ S ~l U
SOIL DESCRIPTION REPORT
Boring #
:::.
Ground
elev.
lOn _ ~ ft.
Depth to
limiting
factor
+ '~
Boring #
... .::..........:::
2
Ground
elev.
100.2 ft.
Depth to
limiting
factor
+84"
Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots GPD/ft
Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed Treridt
1 -12 10yr3/3 none 1 2msbk mfr gw 2f .5 ( .6
2 12-33 lOry4/4 none sil 2msbk mfr gw 2f .5 .6
3 33-84 7.5yr4/4 none cos Osg ml na na .7 .8
Remarks:
1 0-15 10yr3/3 none 1 2msbk mfr gw 2f .5 .6
2 15-38 10yr4/4 none sil 2msbk mfr gw if .5 .6
3 38-84 7.5yr4/4 none cos Osg ml na na .7 .8
1
Remarks:
CST Name:--Please Print G L. Steel Phone: 715-246-6200
Address: 1554 200 ve. New Ric and WI 54017
Signature: ~ ^~/ ~ Date: 6-17-99 CST Number: m02298
PROPERTY OWNER Kernon Bast SOIL DESCRIPTION REPORT ~ Page? of3 ~
PARCEL I.D. # 020-1020-90
Boring #
~€ 3
Ground
elev.
101.7 ft.
Depth to
limiting
factor
+84"
Boring #
4
Ground
elev.
102.8 ft.
Depth to
limiting
factor
~~
Boring #
5
Ground
elev.
102.5ft.
Depth to
limiting
factor
+84"
Boring #
..................
4ii
Ground
elev.
ft.
Depth to
limiting
factor
Horizon Depth Dominant Color Mottles Texture Structure Consistence Bax>dary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
1 0-14 10yr3/3 none 1 2msbk mfr gw 2c .5 .6
2 14-29 10yr4/4 none sil 2msbk mfr gw 2m .5 .6
3 29-39 7.5yr4/4 c2d 7.5yr5/6 sil 2msbk mfr gw 2f .5 .6
4 39-84 7.5yr4/4 none cos Osg ml na na .7 ; .8
Remarks:
1 0-10 10yr3/3 none 1 2msbk mfr cs 2c .5 .6
2 10-23 10yr5/4 none sil 2msbk mfr gw 2m .5 .6
3 23-30 10yr5/4 2d 7.5yr5/6 sil 2msbk mfr gw 2f .5 .6
4 30-84 7.5yr4/6 none cos sOg mvfr na na .7 .8
Remarks:
1 0-16 10yr3/3 none 1 2msbk mfr cs 2c .5 i.6
2 16-36 10yr4/4 none sil 2msbk mfr gw 2f .5 ~.6
3 36-84 7.5yr4/4 none co Osg mvfr na na .7 `.8
Remarks:
Remarks:
STEEL'S SOIL SERVICE
Gary L. Steel Kernon J. Bast
CSTM2298 NW4SW4 S23-T29N-R19W
MPRSW-3254 town of Hudsen
lot #18-Evergreen Estates II
N
1"=40'
BM.= top of 1" steel pipe C el. 100.00'
Alt. BM.= nail in pine tree ~ el. 99.30'
1554 200th Ave.
New Richmond, WI 54017
(715) 246-6200
"1
C1~
Iv
Gary L. Steel
6-17-99