HomeMy WebLinkAbout020-1395-36-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
Safety and Building Division
INSPECTION REPORT
GENERAL INFORMQrTION~ (ATTACH TO PERMIT)
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
'ermit Holder's Name: City Village x Township
Manchester Homes Hudson Townshi
:ST BM Elev: Insp. BM E/l~ev~: BM Description:
SANK INF MATION ELEVATI DATA
TYPE MANUFACTURER CAPACITY
Septic
(,~,~1 S~
! 25~
Dosing
Aeration
Holding
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD
Septic t
~ sto ~
~ 1 °O /
0 „_~
Dosing
Aeration
Holding
PUMP/SIPHON INFORMATION
Loss System Head
Forcemain ILeyfgth IDIa.
SOIL ABSORPTION SYSTEM ~~ ~Q,,,,,,
BED/TRENCH Width Length No. Of
DIMENSIONS ~ ~ $~ ~ (
.Sa
i SETBACK SYSTEM TO P/L
INFORMATION
Type Of System: f
~ 1 t7p
county: St. Croix
Sanitary Permit No:
420613 0
State Plan ID No:
~~~~
Parcel Tax No:
020-1395-36-000
~M ~ ~S . ~ `~ ~V
STATION BS HI FS ELEV.
Benc ark
Alt.
•5S'
o .oS l
Bldg. Sewer ~ ~ •' ~~
St/Ht Inlet ~ G ~ 9 60,
St/Ht Outlet '7•~
'I
9~.og
Dt Inlet
Dt Bottom
Header/Man. ~f./~' 93•Y~~
Dist. Pipe 112 • ~ 3 ` O I
Bot. System 12.3
3. to q 2. ZS ~
t. ~
Final Grade
Ipw ~ .
at.•
St Cover ~/.~~ ~ • 2 t
Of Pits
./STREAM LEACHING
CHAMBER OR
_.~.~~ UNIT
Dia. [Liquid Depth
N~
DISTRIBUTION SYSTEM / W~'o ~.~ ('(L.)
Header/Manifold ~
~ Distribution
Pipes x Hole Size x Hole Spacing Vent to Air Intake
Length_''
' Dia Length Dia paang
SOIL COVER x Pressure Svstems Onlv xx Mound Or At-Grade Svstems Only
Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched
Bed/Trench Center Bed/Trench Edges Topsoil
Yes ~ No
~ Yes ~ No
9~
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1~~/~~3 Inspection #2: /
Location: 812 Highlander Trail Huds~oyn,-WI 540~16~(NW 1/4 SW 1/4 25 T29N R.19W) Scenic Hills Lot 36 Parcel No: 25.29.19.2430
1.) Alt BM Description = ~~ -'-~ ~"""~/~~~I~ `v"''K~.,`,,,, C-StJG"r-'''~AP) ~~) 5 ,~.~,1~Kt ~ ~ t
2.) Bldg sewer length = 3p //" 1 _`1°"^ ~ W tn~ C7 • ~~ i
-amount of cover = N
37 ~~. ~-~a~ .~'' ~ ~'(-tom. ~.
Plan revision Required? ~ Yes ~No 2 r
Use other side for additional information. ~ ~ 7 ~; _ _____~_ __, '_~
Da Insepctor's Signature Cert. No.
SBD-6710 (R.3/97)
Safety and Buildings Division County
~ ,r 201 W. Washington Ave., P.O. Boz 7162 SSG Yo G ~ •C.
~S~O
~Sj~ Madison, WI 53707 - 7162 Site Address
I
De artm~nt of Commerce O ~ j ~ grz Y
Sanitary Permit Application ~`'~'' P~"t ~ !3
In accord with Comm 83.21, Wis. Adm. Cade, personal information you provide
^ Check if Revision
ma be used for seco ses Privac Law, s15. 1 m
I. Application Information -Please Print All Information State Plan I.D. Number
Property O
ner's Name
~
~d~,~~~, Parcel Number
~
`~ ~
w
~/~/ ~j ( ,^j/
Property Owner's Mailing Address Property Location ~~~
!o~ 2 ~Q ~S`firLlsJc~~t°.4 CG~R /X~ 02, ~ `~'k: S ~ T _ N. R 1'
City, State Zip Code Ph ber Lot Number Block Number
X
Y
O~~CE
gT_ CROI bdivision Na
CSM N
b
ZpNING m
um
er
I~' jam/
SI .~ GIQ7 ~ ~ ~~ a ~2 ! //~
e~ G'4.l/ L G r ~4s
II. Type of Building (check all that apply) a-~s ~ °~'" ^Ciry
or 2 Family Dwelling -Number of Bedrooms ^Viilage
^ Public/Commercial -Describe Use wnship ~• n
^ Statc Owned t ~ Nearest Road
2 3 ~ £s'~-sv
o
III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line if applicable)
A' 1 New 2 ^ Replacement System 3 ^ Replacement of 6 ^ Addition to For County use.
stem ~ Tank Onl Existin S stem
B. ^ Check if Sanitary Pemut Previously Issued Permit Number Date Issued
lV. Type of Permit: (Check ail that apply)(numbering scheme is for internaLus ~•-(Dy •
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 3 0 ^ Other
,
V. Dis ersal/Treatment Area Informat ion: ~'7`a ,~ r/' G ,e Y
Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System E anon Final Grade
Required Proposed ~. Rate(Gals./Days/Sq.Ft.) (Min./Inch) Elevation
/!~
7~5! ~~ ~f ~~ ~~
/~~ ~~ ~ ~ I '~ ~~
VI. Tank Info Capacity in .Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Tanks Concrete Constructed Glass
New Existing
Tanks Tanks
Septic or Holding Tank ~ _
i ~~ e ~/
Dosing Chamber
VII. Responsibility Statement- I, the undersigned, assume responsibility for tton of the POWTS shown on the attached plans.
Plumber's Name (Print) Plumber's Signature MP PRS Number Business Phone Number
1l,`~~ .~~~'a,s-.~s e~ ~ ~ a2a ~ ~ 7/.~' ~~~'r-3/mil
Plumber's Address (Street, Ciry, State, Zip Code)
1 r 1~
~
J
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~ ~
~
o.~
~
-
VIII. Coun /De artment Use Onl
Approved ^ Disapproved Sanitary Permit Fee (includes Groinwater Date Issued Is ing nt Signature (No Stamps)
^ Owner Given Initial Adverse . Surcharge F )
`' ~ C ~,
`~
~
~a/ 2
'`'I'~
Determination !
~~ /~
IX. Contlitio °~ of A~provaUReasons for isapproval~ ~ ~
~~
yy~p~^ ~ f~'V'~. ~ G~
~
_„_ j g~ttaQc6Qcompl 7) 1 tncna7tfS~
{,(AQf'S 1 ~ ~~'S'
SBD-6398 (R. OS/Ol)
l7?~..~es u,~ ~~ ~-U L _ ~ 6 7`` ~3G Sc ~ti~ _L ~ 'lls' ~~ls~,~
2 `"
~~
~~ ~
2 ~ ..,
~~~
~~~~
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Wisconsin Department of Commerce ~ - SOIL EVALUATION REPORT Page l of
Division of Safety and Buioings
to aocoroance wrm wmm esa, wis. rwm. woe
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Attach complete sibs plan on paper not less than
inducts, but not limited to: vertical and horizonta) reference point (BM), deection and parcel I.D.. .
to nearest road.
percent slope, scale or dimensions, north arrow, and oc
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Please print all info
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Persortai tnforrnatlon you provi
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Property Owner ~ ~ - C t ~_ P Location
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l 1145w 1/4 S Z S T Z `T' N R/ E (ot~p-D
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property Owners Maiflng Address ~ot c,,i Block # Subd. Name or CSMIf
.
s cRO;x
CO ~ Z .O 5~ i ~ ~ t,uc~. ~'` ~.
S e
Cily State Zp Code ~~ING OFFIC ~ ~~ ~ Town Nearest Road
E
~STi' I l w«.~r ~,~. ~'s-a Viz. t ~'`~Y:~~ - zy/ v s 'n a°
®New ConsUuction Ilse: ® Residential - Number of Code derived design now rate ~S~ ~~ 0 4 GPD
^ Replacement Q Public or oommerdal -. Descnbe:
Parent material O U f caJrZ..s (~ Flood Plain elevation iF applicable ~/~- R
General canments S ~ S ~ rri e. l c J0.+,b ~ - -I-o P qy. Sv /~, r. -`•'' 9~/ .o 0
and recommendations: ~ ~ ~ e, I .~J al, ~-.`o r~. - ~b~ 4 S'• p d Go w -e ,~ 9' 3 SO
Boring # ^ Boring
Pit Ground surface elev. - ~d R Depth b limiting factor l 1 t~ in.
Sod ication Rate
horizon Depth Dominant Color Redox Description Texture Structure Consistienoe Boundary Roots GP DffF
.
in. Munsefl Qu. Sz. Coat Coor Gr. Sz. Sh. 'EtT#1 'Efflf2
i d-lo lu 1 -- 5~ k V`(TfT ~5 1 v L' . 5 -~7
2 ~ p- I to _ -~ VYiS DS l `- `' . -1 ~ - Z
®Pit Ground surface elev. ~ 7 Z ~ ft. Depth to limiting factor. I I A in.
~~ # ^ ~~
Sod Rats
Horizon Depth Dominant Coor Redox Description Texture Structure Consistence Boundary Roots CiP D/fP
in. Munsell Du. Sz. Cont Coor tic Sz Sh. _ 'Eff#7 'EtT#2
i a -1Z ( 31z. - - ~ l 2 cs 1 ~-~' . 5 . 8'
Z -z - 3ti I ~y ~ y =-~ Sid Z~ma
GS
'-
~ ~l
- ~
3 ~--I g I ~ y -- S D s l -- ~ . --~ 1, 2
93•sa~
_____---
.'r .
' Effiuerrt #1 = BdD_ ~ 30 < 220 and TSS >30 < 1 50 mall. ' Effluent #2 = BOD. < 30 mglL and TSS < 30 mglL
CST Name (Please Print) ~~~ ~~~~ ~~`` store CST Number
~~YVt ~~- Iti~J ~~i'-~ 2. r' ~~ ~~ ~S ~~~~
Address Date Evaluation Conducted Telephone Ntxnber
21(3 ~~' ~-~, „~~a m~ev~-~~~.. (~J ( 5~/0 Z5 G - /-c~/ 7~ s -~Y7- ~o b £~
Property Owner 1a.y' k~ l I Parcel ID # Page z of----~-
^ Boring
3 Bonng # ®Pit Ground surface elev. ~ S~ ft. Deptn~to limiting facmr I /b in• Soil ication Rate
Horizon Depth Dominant Color Redox Description Texture Sdvchire Consistence Boundary Roots GPD/it<
in. Munseil Qu. Sz. Cont Colo[ Gr. Sz Sh: "E~'I *Ef(#2
~ 6_~ y Si l Zrr~ 1C ~r c s I v -~ . 5 . g
~-
~~ # ^ Boring
^ Pit Ground surface elev. ft. Depth to limiting factor in. Sod ication Rate
Horizon Depth Dominant Color Redox Description Texture Struc~xe Consistence Boundary Roots GPD/il?
in. Munsell ~ Qu. Sz. Cont. Cobr Gr. Sz Sh. 'Eff#1 *Eff#2
Bonng # ^ Bonng
^ Pit Ground surface elev. fl. .Depth to limiting factor in.
Soil tion Rate
Horizon th
De Dominant Cob Redox Descr~tion Texture Structure Consisfienoe Boundary Roots GP D/fi?
p
in. Munsetl Qu. Sz. Cont. Cobr Gr. Sz. Sh. 'Eff#1 *EfF#2
"Effluent #1 = BODE > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODs < 30 mglL and TSS <_ 30 mglL
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-87TT.
ssas3aotx.mroo~
PAGE ~ OF~_
NAME ~ Y` K.e.r I I LOT# _3 ~ LEGAL DESCRIPTION N~ '/4 sr.,'/4,S z5T Z ~f ,N,R 19 E (or) Q __
SCALE: 1 "= y 0 1
BM 1 ELEVATION /O O • y
BM 1 DESCRIl'TION~~ a •~ I~+11 ~ " .-o, ~
BM 2 ELEVATION_ 9b'. ~ Su. Z ~
BM 2 DESCRIPTION -{a ,o a~ I a f h g~ /-/,-a b, 1C ~
SYSTEM ELEVATION ~o p q ~' So how ~ r' 4 y ° ° -- t --
ALTERNATE ELEVATION4op 9G/.oo LoweJ' ¢3•So
CONTOUR ELEVATION q~ . So . R g. s ~
6r"Z 8~
• ~
,2
^
~ 6-i
^
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Private Clnsite Wastewater Treatment System Management Plan
Septic Tank And i~lravlty In-Ground So!! Absorption Component
Pursuant to Comm 88.54 Wis. Adm. Cade each Private Onslte Wastewater Treatment
System (POWYS) shall indude informat#on and procedures for ma#r~talning the system within
the parameters of Comm 83 and 84, and the cond#tlons of approval by the department, agent,
or govemmentai unit. The approved puns and permits for system are an file at the county
zoning ar healm department
This rr~anagement plan complies with Comm 83.54, Wis. Adm. Code, and the in-Ground
Soli Absorption Component Manual for Private Onsit® Wastewater Treatment Systems SBD-
Table 1; System Design 8peatficatlons
San Permit Number
Number of Bedrooms
Deaf n Flow -Peak d
Esdmated Flaw - Ave d
Se c Tank Ca acs ai ZS'n
Soi! Abso flora Com Went Size ft
T of Wastewater Domestic
..
Table ~: 8oii Abso flora ~`om onent -Limits of Reliable 0 eration
Se tic Tank Component Soil Aba n Com o n
Des n Fiow -Peak a.
Maximum influent Particle Size in 1I8
Maximum BOO i. 220
Maximum TSS L 15t?
Table 8: Maintenance Schululs
S tic Tank Ens ct and/or service once eve 3 rs
Outlet FIlter ins ect once a ear and clean at least once eve 3 ears
Sall Abs tiara Cam onent ins ct once eve 3 ears
The septic tank shall be maintained by an individual certified to service septic tanks
under s. 281.48, Stets. The consents of the septic tank shall be disposed of In acoardance with
NR 113, Wis. Adm. Cade (Servicing Septic ar Holding Tanks, Pumping Chambers, Grease
lnterreptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable
Restroams}.
The operating condi5an of the s and out#et filter she## be assessed at least
once every 3 y$ers by inspection, T outlet filter hall be cleaned a~a necessary to ensures
p era flora. The filter cartr#dge s e removed unless to
retain solids in the tank that may slough off the filter when removed from its endosure. if the
Management P;Brt fpr a Septic Ta^k Ord Sol: Ai,~sorpt;on Compp~ent
.,.,....
!titer E+s e4utpped With an alarm, the filter shelf be tervicad ;t the Alarm ie sat:vsted cantir~uaus~y.
intermit'tent ftltrr aiarttta may t~ldtoate aurpe ~iowa or an impendtng continuous afarrxr. Tire
eeptia tank shat! have its aar+tente romoved when the volume of scum and sludge to the tank
exceeds 'tl3 the iiquld volume of the tank, tt the oontantt of the tank are nct romovsd st the
time of an aseeasment, fllair3tenanCe peraonnel shall advise the owner o! when the next servsce
needa to be peMomted to malntaln less than maximum scum and sludge eccumutation !n the
tank.
Manhole Mears, encase ri'ers and oovers should be inspected for water !lahtneae and
soundness. Acaesa openin$a used for service and assessment sh=1t be sealed waterttgt~t upon
the completion o! eervtq~. Any apenin~ deemed unsound, defaettve, ar subject to tailors must
be retained. , ~xpased acoase openings greater than 8-inches to diameter sha11 be secured by
an ettecdve loddrtg device io prevent aoatdental or unauth~ixed entry into the leek.
,.
No one ahouhl en~rt • sa~ptic ar other bwbnent ar hafdin~ tank ~-r
any naaon wlthesrt !o lull earnpltwnoe rrrl#~ OSHA derda txor
enreu~tt~ ~r corM-ned +cpaoe. The ~tsbna~phen tin the aeptla or otl-er
bt11lb~t of !~ terttt 1~ty et0lt~Rtn ti~ha/ q~e+~ and moue of e
~ the lnterrar of a,• a~ my ~. ~~ o~ lmpaatbie.
..
Tank nbarrdonn~urt ahsii be in naaordsnoe with Comm x3,33, iMs, Adm. Code when the
tank is no kanger used as a POW1"8 component,
't'ire so!! abaarption component serving this atsucture is designed to accept domestta
wsstawster from a reatdenttat tracitlty. The Nmits of opsratbn of thbt oamponent are sl~owr #>'?
Table Z,
'rhe bngevity of s sol! absarptton oornponent depends great#y an proper and limey
maintenanas, and system use within or betaw the itmtt# of roitable operation, Gcad water
canservatton practices by al! occupant: and the irrataitatiorr of water conserving plumbing
fixtures are key hcton irr ext!-ndtng the useful life ofthis component,
The soil atnorpttan oompanent's operatbn must be assessed by Inspecttan at least
ona~ every three yearn, The ir~pet~tion strait Include recording the teYets of pond~tg, K` sny, In
the observation Rlpes, end a visual Inepeaion tar any evidence of iurfarre seepage or d~sGharge
tron'- ~ ~~~ Cn reply:iopina eJ1ei, arena at erasion should be Identltled and
repdrtecJ is the owner for ropslr. The suAaas discharge o! dornsstta wastewater or aewags
from the system is prohibited and considered a human health hasard.
Tt~rffiC around or over the soil absarpt3on component atrould be avoided particularly
during winter months, The compaction or rernavai of maw covet over the aompanent Tray lead
to hydraulic faiiu» by freezing, This type of failure irj utu*ISy tem~rary, beat k dttticsrit or
imposslbie to ropair unfit weather oandWans improve. in general, soil. compaction over thin
axnponent will educe dlifusion of oxygen into the soil and dispersal oeri, whfah may teed to
moro intense, and ea~fier, organic clogging of the soil,
T
Manapamant ptan for a Septic Tank Md SOII Absorption Component
Piantirpe of deep~rocKed tnae and shrubs directly owr of within ten hit of the component
should be avalded Nnoe root intn~ion into the component may aisstr~ct arati~wtter tom.
Contlnq~noy Plan
In the swrrt of system failure, a nsw system could be installed in an alUrnah area. 1Mth the
installation of a diverter valve, the exiatinp ayatem could also be nut~ed after a period of three to
lour year:.
(t is the property owns respor~slbilky to maintain tM aitemsu area fi'N from any plantlnp of
tree, shrubs, eta. to cae olfailure of the original system, the aiterrrate area wi# be nadad. It
arty tnsss, shrubs, etc, have been planted on the a~temate arsr, they v+rlli have 1o be removed at
p+roper'tI+ ovvrters e~xpertsa
tf aiterrtaM area is dsetrotnd, there an other aitarmative systsms that can ba used, in which,
oouid result in added expettM t0 the properly ter,
Any tank abandonment shall be done i„ acacrdanoe with wlsc. Gods 83,33. Any questions
rripardtr~tp thhl cxlde, plsasa eaztact your +oaai Jonlna OfFita} or eontact the Irtstaltinp plumber.
c~ v..rr, a1~a,.~,. ~ ~, r~. er, b t tv ~ ~ ~ ~ 5~ 3 a t~ , 3 i ,~ t
FR1~M 5oi.ua+akor Ptumbinq fAX N0. :7153863221 FIOU. 21 2@t32 0T~31FM P2
~~- r~.,~,-~- sr cROix cocrrrrrt
~ SEPTJC '~,A,NIC MItTNr~ANGE ~-GRB~'
_ OWNERSHIP C$RTY~CATION FO~CM
y ~~ ~ ~~
pw>aex~Buya _~,v . fi_ e ~ Te ~i~'
MtiWng Address
'J~l
S/ r~L l~~ G G,' ~G~cc l/Q- liG~ / ~ l
Propatty Address
{YctiBaatboo toqui~ed
PlanaiII~ t)eparq»eat far new
~-3p ~_
t3U~
(~ty/Stste P~x~ Ydentifcatfan l~urnt~r o2~ -i3~s~ 3~ . Z~F3a
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property Locatfan~, %., ~'/•. Sec. ~ T~N.R,,[¢ -W, Town of f~`~~l~o,~/
Subdivision s~ ,d~'G r~/` ~~s .._.~.......~ ~ ~ ~.
tkrdBed 9ntrny Mep #
wttrrent~- naa ~ (a~4'6o ~ , voiuma !66 ~- pie ~ .~.
Spec hc~q,'Pjyes O uo
Lot dines idontifrablc J~yes O ao
taopsupe~ use sad noaiatso.nceaE your eegt~ t~nreem eontd cesals is rte p~+t~ failarata l~dlt+ttraetas. Arapermaiatemssice
oaawsts of ptmapisu osat ~ ~]~ tank ~'tla~se t~ ar soneeG !i treededtsy a lioa~ p~P~• 1st Ym pus into the sy+wcern
an sRect the ttanctton of ibe igftk tsatc as s areamsent samba is tbo w~srte diems ~a+•
't`be penpatty arnsi s4tses eo s~ f4 Sti t~OCrix 2rooia~ pepattaoaat ^ erataEeo~laa fob tiY tiro ri~raiar aad by a
sata~rptuatbar.3e'su~ tr~ieeedplamberara lioen.ed~sepe'r~ll~8~-t(i) the oasite,vt~e,rtardtsposat ogre0oat
is to per o~eea4rag c~difsaa aadJor (Z) after 3nspreti~oa aad t~t~i (u txes~b ti`b a~ taak u Lees tbaa 113 ertt od siud~o.
~. ~ >mQaott~ bava seed the shave requiromeots sad to taadattiu the pel~M w+Wa~e dot ~m °1ith t5e staadards
sst harsh„ ltetssi4 as sat b7- ~ ~ of Gb~aesoe sad the Dapartmeatt nt'I~aaaral RrsouQ+cea. Ststc aZ Wl.+ooa++a. t~eetilfaagva
ctsliee that spsteai mast bs ~~ aced rt;tusaed 1o the S't. t~irr CaunsY 7.oaiae, t]tilse widsia 30
~~ ~p iratiot- datR:
L._. N 4 7"
f~M. aA7't3 '
.. i (.ro fy tbtt alt ~tatesxots as t4is fans arc true ro fire boss of tsry (out lmowkd~e. I (wee) am (ste) the owrAet(=) ~
~r y' ~ }'~ w died tecord~e4 #,a Rt~~ of beads Ocoee.
(~'~-
S[GNA CA DATlE
...... fed nra resals is the saai t beiuC mvotixd by tha Zodaa ~, , t'...
. N,y iat~storr t~ ~ ~-~ r ~ p~
•"' Taetnde wlt6 this ~peptfoa; a rrtaaped wsexsslti- flood f'~ the R °~ ~ ~ ~ ~~ty d~eod
a Dopy of the aa~iit+d ~'9 msp
t•d t~SZS-ZSE-iS9 ~~IZd q~lI Q8Zs60 ZO ZZ now
•~' ~l)G?PAG_ 289
uocum m N mb r IL
l,,Ja r r k,ti / !7cc~
6486p4
KATHLEEN H. WALSH
REGlSTEF OF DEEDS
Si. L'F'OIX. CO., WI
kECEIVED FOR kECOkD
Dt-.9-200? :2:45 P!'
WAkF.ANTY DEEG
EiiEMF~T tl
CERT COPY FEE:
COPY FEE:
T.RAHSFEk FEE: 9900.04
kECOkDIhG FEE: 11, DG
PHGES: 3
Rxording Aces
Name and Reim Addr~
~:,.d ~T, 71z, Ire .
i9o0 5 Ivcr L...k~ ;~
`~ ~~ ~ MN .SS/I Z
02~ - 1(7bq ~ ~O - oo v
Parcd Idm4&aCOa Nmnber (pIM
CJ~ <J -- ! 0764' - DSO - J U p
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(~ zo - io7o - vo - ~.,~,
o2v - ro7o -/o -c~c~
U2cv - )o~~
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"THIS PAGE IS PART OF THIS LEGAL
D6COI~PcNT - DO NOT BEHOVE"
7Lir iaCorwtioa awq ba co~letod by wbmiasz: doccmwrr Ocfe
ar rhs ~rravf^! cfarrta, k dercrf ~~+ mm~c & rcnrrn addrrcrr onJ PfN ~/rc4'ar~1. Odkr inJornradon rvch
f~ paan, uc. may be pfaccd on dur JGr1 port o/ nc~ lacuncru or
Q.>c+ar~c `~ / rc: Utc of rho cw~cr poac addr one WCc ra Yow r^~' bs placcd on _ • ,... , paSr~ pJ do
- Cocwnar aid j2.(b ro do rrconL.,. r.. ~ cavvin Sraoacr~ J9.Sf7. F'RDA 7iP6
;' 1
DOCUMENT NO.
_ wnwt.tNTr nr•.hn
. ' yli .} [?C ~PA(,t~~ 6iATE OF WISCnN 61N-FORM 9
lUU TRin nYAC[ REaEnvtO FOR R{~paO NU DAr•
THIS 11VI)E^7'I'URE, \fadc by.fliC'Hr'skp N. P;i1RtiON and JEAN M.
PEnRSCN, __._.. _ .............
7ust~anc _ ................_...........
...... and wife,
County, R'isconsin,
hp cry cons cs al:,i su ,i'lrs [ ~ :.~\fiR PiGI: ir~Q~ X:a lNl a
........................
:~]o trig on .... ~;rt1'1CggC runtre ... of
. _ __ . Co(:n y ~i/iblYttt ~cr the sum of
t;ne ~>1]ar Ica ro Itp.(~' Cq) z d r,t--~~t ;dou ar,d valuable Er~n.~ p-c :.ti,~~ ',flt
CgrStd(,ratt~.~ _ __ r lc:'!u ;~c c• ~.,(~~, (t:l(r i(<-1
the following crtt of lay ,r,. ~ C_cot,c _ _ _ rc t ' JitJv~.~l/`
_ County, >"S i/ Z
_.
Wisconsin: Al ~..c[ to NortnwPat Quacler ;NWa) >.nd North 11a1E (N~) of the Southwest
~'uatt~r (SW~;) of erection Twency-Flue (25), Township 'Twenty-Nine (29) North, Range
Nineteen (19) west, St. Croix County, Wisconsin, except Lr~t One o[ Certified Survey
'•t~p Eiied :rune 29, 1994, recorded in Volume 10, Page 2782, St. Croix County Register
':>r :~('ecis, as f)oc:ul^ent No. 518444.
See Attached Exhibit A
Parcel identification Number
1ni~ i; no[ hcmcs~eau property
In \~imess Whereof the said grantor. S.. haYS...... hereunto sct........_the tr_ ...... }sands... and seals.... this
....._. _.._ day oL..."'~aY_ ...... ........... A. U., X~(.2Q01
a`IUN F.U ANU at:A [. ~'G fN PR EHF:NCL t>F' ...................... ...................................................... _....,(S&1I.)
. ....... .... .. .... ..- .... .1 ~t:11.)
nt
PLAR.,(...
._..... I .. .I'i;-ALA
St.~tG of s1G%Fs~~rlrSr4,L~ - -- - -- -. - ..
wa ~ln(rtrin t
_ ~ .....~.. -....Co(:a(y. T'crsnnally carne before me tlns i ~'~`. day ot..-~~'.~.. _. _, A. D., Y~>Y 2Q01
the above named Rid-({~~ N. 1?E./~RSC)N and J'.:i\N tA. Pt,f,RSUN, husband and wife,
_.......
- __...._
to me know^ tv pc (hc hcrsuar.... ssho rsrr utrd the I~rrcE;ninF I:r,t:umcat anJ arknowlcd ~cd tilc sJ:r. r.
-~' - ~
..~ .~. ~.^.~ti ... q/wNlvVVw~i ......
7M16 INBTR UMEN'r WAS DRAFTED qY '.# LAII f?.Y T•!'QU~• IAII~r
Rtct'.,~r 1 ~~atrrt •1, n 81 - - ~
,TAUV 'Volar Pubt~c, ~( 'a r?fr.1r1 be - M,NtJESOTA
8E3C :i1h1 ": M~-nc.c ;y. ( r {(1 L4 r.e~ Y ~.~+4 ~ _ __._ Count}', ~~.'IS.
fb C,, n c.prea an. 31 2W5
t~Wrk3t~~ -tl(--k~jl~E.~,-t`}iL~~~~11-:.73fi Aly~ronvntsslnn (n( n
the nan 79.f1 (11 ~^the Wisr nns~n 4st arcs {•~~ viJcs rust .I inu:v:nen(s t~ her ~rJeJ shall have pl ei my pri nteJ ur rypc.rinrn thereon
cal lhM yrs N, yranttts, w,lnc~se: anJ n~taty. $e:li~tn >Y. 111 son:larlr rr<yuilea Ilisl the nam o! th< pe:s whe, ~ r Rov
r :~~tal'ragen.y hi;h.tdral:eJ will inrri,rn.e ., rl i.~:l ',~ nr~nte,l, 1`~I•r.. rirten, Nurl J .,r mitten thereon<in • IeK~Lie m. n<r,l r:n
W ARRnN'l,l' L)F. F'll 51•.~"t•)r Q[• ~a/(S(;ONSIN Wlacone5n 1LeCnI hlnnk C~,ntnnny
!~rI I:~Af '. n. 7 Mllwnuk0e, wln. (Job a:ly 11 1
~~~~ 1(if~2PA~~: ?91
EtiHIBI"I' A
Parcel Identification Numbers
030-1069-70-000
03U-1069-SU-000
U30-1069-90-000
030-(Oi0-00-000
03ii-1070-10-000
u3U-! 0"%U-30-UOU
20' DRAINAGE I '
EASEMENT 10' EACH
I I
SIDE OF LOT` E I I °?2,t8,~E 38629'
' . N79
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J H.W.L. = 1024.0 ~
L53 ~2 ~
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H.W.L. = 1027.0
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j 98,418 SQ FT
__
20' DRAINAGE . I ,
v 2
259 ACRES
EASEMENT 10' EACH . .
SIDE OF LOT LINE I
35 I I -
y 87
121 SQ FT
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~ 2.000 ACRES
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I Ns7°o7'SS"E a68.08
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93,959 SCE FT
• ~ NI 2.157 ACRES
N89°59'05"E 295.80'
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