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HomeMy WebLinkAbout020-1004-10-001 n Cl) O 3 m n C r~ c d O ro w (o (70 m a y -0 n a c 'U 3 A 1 (ID A7 O (n O O C-) y O p O A~ C V N °C 7' 3 CD 7 n. N O i..i N Q W N Z n N CJI O O .7 N W( 7 (D O K ? O O O W O D UT N N o- 7 O Q v A O O -0 7 N F = O C~ O N C 7 p O m C7 ° cn m 0 c N N (n W D N C D ~ C> (Q N Q W 7\ C) w N) O i O CD 0 O W ~ CD (D 2 % ~1 ((n A A C rn O» !r • 7 ~ 07 z O O O ( _4~ 0 V1 N f/) o O D ° 0U vvv~, o O _ (D (D - N L O p O (D - i O' 0) N A D N z ° C Z z 7 D O Q ° ?o (D f m ~ 7 (n 1~7 c I~ C N (D W <p d. l 3 7 z D 1 cp O ~ Q A Z n n n A Z = o (n N C° V 03 D M M CD z 0 3 z z 0 CD z 0 0 7 Q N) D (C CD ° N - O , n T W Co O_ C cD 3 z a ° C 7 CD m cc C CL O ICl)(D cn A ~ CD ~ N ~ N O S O - O N O C -0 C~ O A O N co r p Q O O O L ti Parcel 0: 020-1004-10-001 01/20/2005 12:24 PM PAGE 1 OF 1 Alt. Parcel 07.29.19.7H 020 - TOWN OF HUDSON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner DUNN, MICHAEL W MICHAEL W DUNN 313 CASPERSON DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 313 CASPERSON DR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.410 Plat: N/A-NOT AVAILABLE SEC 7 T29N R19W 3.41 AC SW SW THAT PART Block/Condo Bldg: OF LOT 1 OF CSM 5/1442 ASSESS WITH P161 D AND P7C Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 07-29N-17W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 691/468 2004 SUMMARY Bill Fair Market Value: Assessed with: 47606 256,100 Valuations: Last Changed: 10/26/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.410 48,500 149,600 198,100 NO Totals for 2004: General Property 3.410 48,500 149,600 198,100 Woodland 0.000 0 0 Totals for 2003: General Property 3.410 48,500 149,600 198,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 201 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 001-WATER SPECIAL ASSESSMENT 0.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 Parcel 020-1003-80-000 01/20/2005 12:24 PM PAGE 1 OF 1 Alt. Parcel 07.29.19.7C 020 - TOWN OF HUDSON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner DUNN, MICHAEL W MICHAEL W DUNN 313 CASPERSON DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 0.660 Plat: N/A-NOT AVAILABLE SEC 07 T29N R19W .66A PT SW SW S OF RD Block/Condo Bldg: EXC W 706FT & EXC 7E AND EXC 3.41AC TO CSM 5/1442 ASSESS WITH P161 D & P7C Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 07-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 700/207 2004 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/19/1993 Description Class Acres Land Improve Total State Reason Totals for 2004: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2003: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount 001-WATER SPECIAL ASSESSMENT 0.00 Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel'#: 020-1038-85-000 01/20/2005 12:19 PM PAGE 1 OF 1 Alt. Parcel 18.29.19.161 D 020 - TOWN OF HUDSON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): Current Owner MICHAEL W DUNN DUNN, MICHAEL W 313 CASPERSON DR 154016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 2611 SCH D OF HUDSON SP 1700 WITC Lo-~ f Legal Description: Acres: 2.000 Plat: N/A-NOT AVAILABLE SEC 18 T29N R1 9W 2AC NW NW THAT PART OF Block/Condo Bldg: LOT 1 OF CSM 5/1442 694/468 ALSO THAT- IN 07 ASSESS WIT P7C 7HTract(s): (Sec-Twn-Rng 40 1/4 1601/4) 18-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 694/468 2004 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/19/1993 Description Class Acres Land Improve Total State Reason Totals for 2004: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2003: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount 001-WATER SPECIAL ASSESSMENT 0.00 Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 n N 0 o d f 0 (D 3 o 3 0) CD t 3 0 cp CD 0 65! 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CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * DUNN, MICHAEL W MICHAEL W DUNN 313 CASPERSON DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 313 CASPERSON DR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.410 Plat: N/A-NOT AVAILABLE SEC 7 T29N R1 9W 3.41 AC SW SW THAT PART Block/Condo Bldg: OF LOT 1 OF CSM 5/1442 ASSESS WITH P161 D AND P7C Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 07-29N-17W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 691/468 2004 SUMMARY Bill Fair Market Value: Assessed with: 47606 256,100 Valuations: Last Changed: 10/26/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.410 48,500 149,600 198,100 NO Totals for 2004: General Property 3.410 48,500 149,600 198,100 Woodland 0.000 0 0 Totals for 2003: General Property 3.410 48,500 149,600 198,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 201 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 001-WATER SPECIAL ASSESSMENT 0.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 Computer 020-1038-85-000 Parcel 18.29.19.161 D Municipality: Hudson, Town of Address: 313 Casperson Drive Hudson, WI 54016 0110612005 Dunn, Michael Pam Quinn This lot spans both Section 7 and 18, with the permit recorded on parcel #020-1004-10-001/.7H see permit #54985 Parcel 020-1038-85-000 01/07/2005 12:31 PM PAGE 1 OF 1 Alt. Parcel 18.29.19.161 D 020 - TOWN OF HUDSON Current [I ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): Current Owner " DUNN, MICHAEL W MICHAEL W DUNN 313 CASPERSON DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.000 Plat: N/A-NOT AVAILABLE SEC 18 T29N R19W 2AC NW NW THAT PART OF Block/Condo Bldg: LOT 1 OF CSM 5/1442 694/468 ALSO THAT PART DESC. IN 700/207 ASSESS WITH P71-1 & Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) P7C 18-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 694/468 2004 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/19/1993 Description Class Acres Land Improve Total State Reason Totals for 2004: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2003: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount 001-WATER SPECIAL ASSESSMENT 0.00 Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Form - S T C - _ 104 AS BUILT SANITARY SYSTEM REPORT OWNER 0`~` ~U~11 tJ TOWNSHIP I~IUJ2SdILI SEC. T N-R f f W ADDRESS ST. CROIX COUNTY, WISCONSIN ~f vDs~~l Gv~• s . R SUBDIVISION CS'y ~~1292 LOT LOT SIZE _,2 Go% s , r Yy ~ PLAN VIEW Distances and dimensions to meet requirements of ILRR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Vt2 T REF f'r• I-loki2. 131-1 w ~ r ' j/rgDE- I r I I 136f61- &tc EAGln fO~rUE~ j~ a EAR coRa~R ~P rV 0~'c~- ~jtTFRrf/ , off w `1 21) 0 wE(f INDICATE NORTH ARROW I ~ BENCHMARK: Describe the vertical reference point used y 7 ~l r Elevation of vertical reference point: Proposed slope at site: SEPTIC TANK: Manufacturer: W'5iFe/ ~OUGct]~Q L id Capacity Number of rings used: "2-" /d FT Tank manhole cover elevation: 106 Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front,0Side,o Rear, O feet From nearest property line Front, OSide, 0 Rear, 0 feet Number of feet from: well building: 1:2 (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER , Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of t elevation: Pump off switch elevation: R Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nea st property 3ne: Front, O Side, O Rear, 0 Ft. Number of feet from well \ Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM RR Bed: Trench: !a3 i Width: 13 Length: S L Number of Lines: -2- Area Built: Fill depth to top of pipe: ltlfX. ' y~ 0 ~£~Q 6/ '.v'!~7- S Number of feet from nearest property line: Front, O Side, O Rear, 0I?t.~ Number of feet from well: dUE2 /y (J FT . Number of feet from building: l1 3 F~ (Include distances on plot plan). SEEPAGE PIT Siz Number of pits: eter: Liquid depth: Bot of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevati of bottom of tank: Elevation of in e . Number of feet from neare property line: Side, O Rear, O Ft. -0 ber of feet from well: /Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: Plumber on job: HOMESITE SEPTIC PLUMBING CO. License Number: RI 30'NE" Rn Nu 54016 ROBERT ULBRICHT MS. MASTER PLUMBER LIC. NO. 3307 MR.R.S. MINN. INSTALLER & DESIGNER LIC. NO, 00663 3/84:mj QEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR &=HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 CONVENTIONAL ❑ALTERNATIVE Slat' Plan l.D.Numbe,. ( Holding Tank 1:1 In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION D TE Michael Dunn R. R. 2, Box 19A, Hudson, WI o if BENG#MrMAIRV,,,-SttaE-iotf,"I)RESCRIBE IF DIFFERENT FROM PLAN REF- PT. F(LEV. C REF. PT. ELEV.. 1iS EE 1WNW LLl 7, T29N-R19W, Town of Hudson f Na,ne of PI-be,. IMP/MPRSW No. County. Sanitary P-n Number: Robert Ulbricht 3307 St. Croix 54985 SEPTIC TANK/HOLDING TANK: MANUFACTURER. r QUID CAPACITY. TANK INLET ELEV. TANK OUTLET ELEV_ JWARNING LABEL LOCKING COVER P VIQ D PROVIDED. Cz~ f'I G ! Q(O, ~V4(P / 'YES ONO DYES ONO BEDDING: VENT DIA,: VENT MAIL.,. HIGH WATER INIUET MBER OF ADPROPERTY WELLBUILDINGVENT TO RESH ALARM FFROM ~ IA IR L OYES ONO EYES ONO NEAREST / V ` DOSING CHAMBER: MANUFACTURER BEDDING. JLIOUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED. PROVIDED. DYES ONO OYES ONO DYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERTY JWELL BUILDING; IVENTT7FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) DYES ONO NEAREST ~.l SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKINa or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH. LENGTH NO. OF DISTR. PIPE SPACINI; COVER JINSIDE DIA -PITS LIQUID BED/TRENCH TRENCHES MATERIAL PIT DEPTH DIMENSIONS j X CRAVFL DEPTH FILL DEPTH 11)ISTR. PIPE DISTR PIPE DISTR. PIPE MATERIAL. NO. DISTR NUMBER OF PROPERTY WELL: BUILDING. VENT TO FRESH BE LO PIPES / r-'/ ABOV C ER ELEV. INLET ELLEEV Ell) c, PIPES. FEET FROM LINE AIR INLET. I/ c1 /-5• 3 / Z 7 2 / NEAREST-- 12j f MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- DYES NO meets the criteria for medium sand. TIONS MEASURED. O SOIL COVER TEXTURE PERMANENT MARKERS JOBSERVATION WILLS DYES ONO DYES ONO DEPTH OVER TRENCH BED DEPTH OVER TRENCH BED DEPTH OF TOPSOIL SODDED SEEDED [DITCHED CENTER EDGES. DYES ONO DYES ONO DYES ONO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH LENGTH NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER. BED/TRENCH TRENCHES DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. NO DISTR. JDISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEV.. ELEV.. DIA. ELEV. PIPES DIA.'. ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS DYES ONO DYES ONO COMMENTS: PERMANENT MARKERS: JOBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE. o EYES ONO OYES ONO NEAREST- , 3. r Sketch System on ounty f le for audit. Peverse Side. SIGNATURE ; - w-- ~ TITLE 4R SBD 6710 (R. 01 /82) TION FOR SANITARY PERMIT E1[`,0US'77-, conci,,i APPLICA 0 1 L H R (PLB 67) COUNTY TR LRY,LR BO6HUTRrIRELRTIOUNIFO1RIM SANITARY PERMIT # -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8/2x 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROPERT OWNER MAILING ADDRESS /off /~vvS6,v ~v S . M "A EL ~()MAI p r . i. 13 6X PROPERTY LOCATION CITY: PhF1' of w VILLAGE: 1/4 N 1/4, S T L, N, R I E (or) W /7 UpSa STATE PLN I.D. NUMBER LOT NUMBER BLOCK NUMBER SUBDIVISION NAME 7NTEAREST ROAD, LAKE OR LANDMARK A J~t L Ua/ 5~ . lyLTTL L/V - - / CS/1 39 :~/f S7- TYPE OF BUILDING OR USE SERVED ? L1J 1 or 2 Family Number of Bedrooms: v Public (Specify): THIS PERMIT IS FOR A: New System ❑ Tank Replacement ❑ Repair Replacement Soil Absorption System ❑ Revision ❑ Privy Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holdiny Tank System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued ❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total # of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity /azrz) X Lift Pump Tank/Siphon Chamber Holding Tank capacity 14,44 Manufacturer: W~Ej~s Q E 1 M IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure Total # of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): 62- Private ❑ Joint ❑ Public I, the undersigned, he gW9EpTVe_W0W*t)6for installation of the private sewage system shown on the attached plans. Name of Plumber (Pri HIJUDN, MS. ature: ~~~~QQ RRPIMPRSW No.: Phone Number: ~j ROBERT LILBRICHT Z"`"~1 l .~3 O 7 (7M Plumber's Address MINN. INSTALLER & DESIGNER LIC. NO. 00663 Name of Designer: COUNTY/ DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved d ` ❑ Owner Given Initial X Approved Adverse Determination Reason for Disapproval: Alternate course(s) of Action Available: DILHR-SBD-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398 To be complete and accurate the permit application must include: 1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in a city, village or town); 2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.); 3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks. 4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of square feet to be installed; 5. Complete the section on water supply; 6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi- fication, place your license number in the space provided and sign the permit in the signature block; 7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the permit; 8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation. Failure to comply will void the sanitary permit. 9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable. 10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system, depth of the system, type of system. 11. All revisions to this permit must be approved by the permit issuing authority. 12. A complete plan including a plot plan, drawn to scale or with complete dimensions. 13. Horizontal and vertical elevation reference points that are permanent and clearly shown. 14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s) to system, building sewer and vent observation pipe(s). 15. The permit issuing agent may require a cross section drawing of the effluent disposal system. TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning your system, contact your local code administrator or the Bureau of Plumbing, DILHR, State of Wisconsin. APPLICATION FOR SANITARY PERMIT S `1' C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractgr,("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - r Owner of Property r Location of Property )"bo 14 ' Section, T N - R 2 W Township Mailing Address `ter y Subdivision Name Lot Number `"I 1 T C Previous Owner of Property f( Total Size of Parcel J ~u~ Y S Date Parcel was Created ~j aJ- t T Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume and Page Number y as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract 3. Other recordings filed with the Register of Deeds Office In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the the Certified Survey Map shall also be required. PROPERTy OWNER CERTIFICATION I (We) eeAti6y that a.PX statementz on ,this Konm ate t ue to the bat o6 my (out) knowledge; that I (we) am (ate,) the owners (,s) o6 the pnopehty dacAibe.d in .this in6onmati.on;6onm, by vZAtue ob a wa4Aa),ity deed necmded in tjte 066ice o6 the County Reg-i teA o4 Deeds ass Document No. 3q s-6 O ; and that I (we) p4mentYy oRn the proposed zite ion the sewage izpo~ system (on I (we) have ob-ta-fined an easement, to nun u;tith the above de~senibed pnopeAty, ion the cony ftuctiox o6 said system, and the same has been duf y recorded in the 046.i.ce o6 the Couw y Regi/sten o6 Deeds, a6 Document No. ,2 SIGNATURE (iF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED C) I-a rrl C~7 L 1 12 C).) Cr, O 1-~ _ U c C) U1 (~Q4 i" /~'r ti W (-n N > «A C) (7 I- F-4 HF r :j hJ CO C, Ut C7 O ::2: " C W vi 4 ~I IJ --1 / G~ L~ ti7 L F~ n (z) a~ n L' CD Iv 1, d I- / / C> - p X, ur CD C ~D G7 C~7 U) p C7 ^y ~n cn 10 w J u7 (7 d C cn -11 Ili to C) -I p y - I tr t~J a 10 U~ w H 1 / Un IFJ o j' ` CD I C) CO i I ~ / O Y -iJ `^'i~ I n L•J l' v tY] O Cn 13~~1i~I JGS RLru.; CL,L TO ','OZ T' , i CD C', n Q G O N. Jr, > N C) U1 1- § F-' (A r rn y c7 s t-h (D C) r. nGHLo (D n, L-1 rt (n 21, (n -n .1; ry In F... L-4 CD rl G (D r C7~ ti•;. ~o H v ri C c G7 { rr. " "1 0 !n f*1 I~ • CTS C; r tAwl v rn n +t r-• 1 t• ~A" L y H ri ` S '1 C - 105 r Y Sl?PT LC TANK MAINTENANCE ACREEMENT o :;t. Croix County c~ U W N 1': It / !S U, 1' i•: k _ _.i ~CL~~_~..._ - ~ t-- ~J_CtiCJiZ.~_ . _ `r' f~ Fire Number i ROUTE/ BOX NUMBER _____~L q'✓7- - C: 1 'I' Y / L n'1' 1': - - #uQ d!C ~fJ , s I. P P.4 6- P r PA)K4r o F s 4> 'ly 5j~(f, PRHPEHTY Ll)CAI'it)N: 'a, ~UcL in 18-., 1, aZ_J_ N, It Town of /9 St. Croix County, Subdivi.sion , Lot "umber_ L_- I Impr"pur use and ma inLunaucc of Your SvpL ic system druid result in its prumature laiture to haudLe wasCuo. I'ropcr maintenance con- ~ sihLn of pumpinq Out the septic Lank evcry threes yours or :sooner, ii nuedud, by a Licensed :,cl Li.c t:auk humpoi. What you put into the system can a l v L the I sucL iun of the ncpt ie tank as a treat- utent Stage In the waste disposal system. St. Croix County rusi_denls may be uligible to receive a grant fur a maximum of bOZ of the cost of rupLacuwent of a hailing, system, which was in operaLiOn prior to July 1, 19/li. St. Croix County acceplud this program iu August of 1985, with Chu ruquirewent that owucrs of ati new s Vjymy ""rue to kung uhcir systems properly ma inLa iuud.l. The property owner .tgrucs L" Submit to KL. Croix County 7.ouing a curtificalion I"rm, sirnud by the owuur and by a waster plumber, journeyman plumber, rcnLrit tud plumber or .s licensed pumper veri- fying, that (1) the on-situ wastewater dispostaL system is in proper operating condition and (2) aitur inspccLiou and pumping (i1 ucc- essary), the acpLi.c Cant: is less than 1_/3 lull o sludge and scum. CurLiflCaLlo" Corm will he -.,eat approximately 30 days prior to three year expiration. o I/WE, Lire undersigned, havy read the above requirements and agree to maintain Lhe private sewage disposal.-stem in accordance with H the standards, rset forth, herein, as set by Lhe Wisconsin Depart- w went of Natural Rusuurcus. CUMMcatiou form must he i umpl_Med and returned to Lire SC. Croix County Zoning 00kge: wiLhi.u 30 days of the three year expiraLio" date. SIGNED DATE / St. Croix Cuuttty Zoning Ol I ice P.U. Box 58. itammc Ltd , W L 54 0 l 5 715-196-2239 or 715-425-4363 Sign, datu and return to above address. F n z ~ m ao - cD w ? cn cn "3 O Q cn w 't 0' O m o O - N (D V C (D 7r n 0 O O :E Cl. co =r =r w , _N DO Z =r 3 c co co o 7 0-ft C 0 -0 CD CD 0 "0 CD I C: CD CD D o n O CD M co m 0 0 CD ° CD w w 00 0, U) w `0 -1 CD W CD w w 0' C A M o' CO n cno3a- o_°COCOw c = w o a ~o w r- 0T 0 .<c_C-.-nN Ei•ZC° c~v3:~ 0) -4 CD N O (O 0 a CA > j•~0 A00 (D C ~ n < Q- N Q CD Cn U) > CD N O 0 0 O c w"0 ~0aCD0w O CD O ~ cr 0 C 0 F) CD --I N cn w m cD w co Z w ~'?w w0 Z ~MCD CDCD0M' CD q (a M CD =r Q. CD 0 3 N~CD o ~ 0~ R1 ,..oa ,mow?rwo (A CD CD nCL 0' CL ca g ~A v; w CL c n~ CD C M v 3 CCD •vM ~ w = ~ M 10 CD N? 0a CD ? C~ ic CD jw CL CD C-D o o ca CA w M 0 N w o.o* incr-aM0 m w o w m M CL aaCL .0. CL (D 5- C-n 0- co M J' 3 as g ca O M O N 0 CD O CL 0;. M C co O w C D -I cD c CD S c 3 0 0 3 • M:> a 0' a o 0 O a < z 0 0 w DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY',' DIVISION LABOR UMAAND4 PERCOLATION TESTS (115) P.O. BOX 7969 HUMAN RE(.r•,,TIONS MADISON, WI 53707 (H63.09(1) & Chapter 145.045) LOCATIQN: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.: BLK. NO.: SUBDI ISION NAME: S,6 1/ 7 /Txy N/111? E(o H~DSofJ / c.S. /'~/c) C-- COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: S-{ •Giot•X -GUilgeR CifsPD "j-ad 1/0/3 40- A/1e7_1-C_ J;'1 S~i//u1~TE,p *IW- STOPL USE DATES OBSERVATIONS MADE 7NO. BEDRMS.: COMMERCIAL DESCR=XNew P OFILE DESCRIPTIONS: PERCOLATION TENS: l XResidence ? V A ❑Replace I ~D, ' O -AO-3 ~y~ r RATING: S= Site suitable for system U= Site unsuitable for system ~~~J O CONVENTIONAL: =MgOUNjD:I - OUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) © S ❑U ©S ❑U ❑ S xZU ❑ S DU TEFP 10CV0V `.oTioaAL- 13'EJ3 oA.) L/. SF E- volt ~f` E/acJ [under Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: /.V DeCiM4) ~-f PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-IN ~T• CHARACTER OF SOIL WITH THICK ESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) i ,3"j)" F- au, S/) 1,17 ' a. S/, 1123- ' OA C-S . B- / 13.0 /0 ~ 50 - > 13. d , .,sy'P4. Q). S/ 1.'/r2 ' ,V. S, ,O' 130 . S , B- Z 12.0 10.2• yd ~fO- / . 0 TAN C s . 5- ~ s. Q ' TfIN v ~ c. s•. B-J 13. /o% 52X,,-- 713. 1 3-17 -11-~4 s SAM .a,u c s S. /L, D I ✓0D•75 ) •S'~ (3u. L 7f',C~u. .75-' L/ div. S1, •33 B / IL 'O ' 4,U CS .Q IIn.O S. r Npy~/ED FINE $G B_ yp' 7~ti C S . A C 14, © q i B .5 a J~ ~ 1 7 > • `/.z Ak Av. S/ 3 13N , Ytrr 5- -'74,) &J. .17'iA,v IS 3. OR' 17,4 • s /0 ' Z/. 64 PERCOLATION TESTS F40E_ SC Md~S , TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER IN f7, AFTERSWELLING INTERVAL-MIN. PERIOD1 PERIOD2n PERIOD3 PERINCH P- U s i v C'S /fa,P 2ou S P- /D •/I Z '7 'P le 4 N E~P /N /ESS P- J L c P_ 7,62 P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. Sv oQDE,P %O S•.-7" 134v 136 noM /,v SA•uD MORj20AJ - SYSTEM ELEVATION 130_"" Of 1321 V6IV'r710N 54411 1~P- q'~ s .A1 SArCi AZ- _:7_1V0, 7,_40 r y0TF" 7"d -'_v TvP,'C` a 4~,v iP / 110 s7111e . ? Cau,~ S,4,uPS AXIS _ A T ~ U,4Tio vs o u TLl i S S%,~~ S7b 2e DAM SA,JDY cl- Abg i zo is Ex I•s T' AS .b ~1S 7 Q Y~ (f- 0--A- ~ (300E- 3 . Si-rE- A ITrje,4'T16A) IS NfCeSSA0_1 rp16k IN 34h11,kT (eN . SEE- S k'e 5~ Lto fLjtV/1Tre,S = fQ,?j.O c`~rsrray `1Qn~E _ I " r /euog d~^ Y' X0 0 a E~ 1OA :5'A) P fi-AC E at,T~RED _ - _ - PO {9.n' JA L- - - lFt/AT~ onJ TO S } _Tf SDi~N O~~ (oT _DQAIaA(rE" ' CR O S S S ccrl J~ Di-Ir,G w~f( p¢ rd1 APE~g~~G -T o ~ErftrA) I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: ITOMFSTn Tr_snxr. CC). AP,e;~ 3 f ADDRESS: T-ANEAPPREPVFF) A i CERTLFICATION NUMBER: PH E NUMBER optional): i ESOTA ,_'.r-~--:, S-E NO.03563 S s= o L yy Z M ? MCONSIN-M i Z T N, SE No. - 4r 2 CST SIGNATURE: RT. 3, O'NEIL RD., HUDSON, WI 54016 DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) OVER ~ d KoeS AW GUN LA, Is'F't a n"S= tr .;8i f~Y 5 t5t compote rr., t.WoF<<:'v' t at:hq kJU" A Qi@ i E €5 SUITABLE : F_ R w3 . 7 Mr 1 . F f-. RUL ''1 ._d !:4 AFiF-,D t i € S011- PLEASE ~ ~ Lao 10- =.fi,W c.V7ti7 a "ShO • We h.3t w6.1% M OAK "W:, MAKE F"-t € E ,.=H ?.(;P.li;t am" WA 4F,;:3tit':7 j013r t..<i 9. ;Ot:r7 Ft 0-0wq iw I.,, w.. =:i. -:j? tx p sky' x 0 ell=,>€md: W L OM rnwhrn, v ~ t ti%.a! pF )i"! a sleady shoon , mKi r., perntar" t , , ,Ippl .p) <4'w t':3C);ti s as to an et namt,,, aCk't ...::.i. Mod O n Cpw, , €..,e'']'"f:odwicin ow e, n 11 f. . n is ;r,. €r Nuch as Hood no,l,, Y?t 4a,ion) Lines not app! v, ,J1.'k, in the> eppiopl~ia'te it, " t,E :i d ;One `yr,€_v 4;F,m m t"F`.€ as alit yf(nw ,°.f lTK€Co Rtel. twr eq 'j'Fo-L "01i ` [ flaw! tf e It:.€ , ws1i, Sand 1-461V _ 40, C-' , I'm Gx-o Bl °K-1 ownv Son! Ell a e, - xy t R - FIN t u='L. rlu 9' Mar flit poor ty Es t= fiEal y is"Cul'I avt'~f;uay - t. ai soil tr3„i in ateo mod PAM :0 Pmx~ :WNW, A ;(i"l, tr M , Of roq- ihr love" nt c.F e'li tin l '-wm y i lde 't<o };q$r' ; ~t Steel' ==t fir'€ t r ona l(";3 t€on, 'RE R,T.om SOIL 13ORIN&S PERCOLATION TESTS IIS PLor PL.AN PRo3'Ecr r. D ~oTl ~v,/6o~ 04s k; /~P. 3 Sc4dq;o,,-- I HOMESITE TESTING CO. n'r- 3, O'NEIL ROAD BOB U11,11'1C, kiuuit:>N, WIS.,, 54016 e 5 r az yg,~ PROPOSED HojSE MU5' LiV z" Fr. ®,c Mc~~ F~Po~a .~t~ TEST' .9,P~`•4S. PROPOSED tt Eu Mvsr mF ,Sp Fr. o,~ tioRE f~Poti 41,4 T£sr- ',0ee,45. =EXIST/.U LI~EL,G PE,ec /oC~Ti®,!!f = 1114,VP 409'CPED of s4ovi'L /j,vES ya,eit . 131►1 V£PrieA4 ,F'EFEPCA)e- - C/;O r- T Q ~'c~,~sZ C?4A4tl- /-)o s T- ~s f coLUQr-. 7 S,'~- E GE N D elEVhrid v OA 11"'r /00. 0 To ~n~( GN ' P -'~bb FT U~¢TE- 4MV L I Ta GU 4VD A r1 i ~f C Q. s uR DiUl S16A) I zo . %C:1 a ~ t 35 1<1N0 ~z A /1 ~p a o , Nj, i3Y 3o v ,J,~ ' /2oR0W~~ ~ n U1 ~ ai 0 A~ O n n O C,G~G CJ ` Cn a n a a ~~j ` r H o ern H V ~0 ro ' m co CC) co OD 0 U-V CD 0 V 'b W T ~ 1~~ 1~0 Z'7 °O`L to J ~ O Un C) 1 y ~0 r W w • c~,yti ~ . ~ ` ~i ~ r r~ d F-I N O 7J G Ul ;~a7 T~ d 0co~ -j ry t- R s~" a re r ~w C~ co P n :R: r :z7 cn r o t-~ rn co H Hnoz) o `o C7 N Co Z1 Cn 2: - O - (n U7 N a r O N to O x ' c-' O \ ] O r:~' .T C 3 C H n ~ '1 w ~ocn /C) nz t-I .0 / Qo ICS ri5 ~ ~ ~ i ~ I F~ W C j O~ l\ o o z n I V / rt Im G:) n / C~ O d FT1 I (n cn V) c+ n 0 C N y m ct L Al U1 a d O 3 O / BEARINGS REFERENCED TO THE NORTH LINE ' CL OF 'IHE NU 1/4 OF SECTION 18 ASSU1'11r;D TO o n K ° 0 7 BEAR N88057' 03"E. o 0 n C 7 S C / n (7 H / O Li =J C) V..1 H b a~ V r CA E- • a_ ~ ~ J W ~ ~ 1` C. Q ° rn o t'' Gn C!1 ~3 CD v i n V , M l~Mrn~ O t) n.ja~ i17 O O I I` d r C' j 7 V • to z t=~ • H ' J O 6 a ~ .9:, ON co C rTl n va SURVEYOR'S CERTEPICATE T; Allen C. 6yhagen, a registered Land Surveyor; hprr5y certify thac b;I the Cirection of Wilber Casppr-son,- 1 have surveyed; dasc,_ i_bU and mapped the land parcel which is represented by this CctQfim Survoy Maq. that ;:he exterior boundary (;f the land parcel surveyU ara mapped is desccihe as follows: A parcel of land located in part of the Ni; 1/4 of Sc ct. Ton 18 any, part: of the Sit 1/4 of Section 7, all in `1'29:x ; "19',; : Town of ` uc son , An. CruA County; Wisconsin; further Q scribed follows: Commencing at the NW corner of said Section 13' thenco =05 / ' 03"F, alone! the no.rt line of said NN 1/4 of Section 18, 381.10 feet :_o i_cs intersection with the centerline of a 66 food: prlvaLe road said point being the point of beginr:_ng of this descriprion7 thence 521005'37"L, along said center- line, 103.30 feet; i_henc2 SK905240 E; 438.45 feet.; cncocu N00 37 0]. r,- 43.76 feet to the can =er.I ine, of a 66 foot private root:: thence «53001' S7 "U: along sLid center-line, 166.10 f eec; thence 643047' S7"W, along said centeMne, 156 90 eat; thence U63016'57"W, along said centerline, 411.70 feet to the inte.rsec -i-on of the centerlines of the two private roads; thence 521005' 37"1 , along sa'.c centerLine• 309.42 feet t, tha point of beginning. Above described parcel is subject to U 6 foot private rovc= cass went- on the westerly side and a 66 foot private _road easement on the northeasterly side and all ocher e_sements of record. That this Certifier Survey Map is a correct representation of the exterior boundary surveyed and described; that I have fully complied with the current provisions of Chapter_ 236.34 Wisconsin Revised Statutes, and the Land Subdivision Ordinance of the. County of St. Croix in surveying and mapping same. This map is hereby approved by the Town Board of Hudson.. Date Town Clerk This map is hereby approved by the Village of North Hudson. - ' Date Alllage Clerk Y~~:~. tea rid{ j ei n 4-07 ca NOTE* The roadway shown on this map is a private roadway. Any maintenance costs of the private roadway, after its approval by the Zoning Administrator as a standard road, shall be shared pro-rata by the adjoining property owners. Should the private rcadway be taken over by a municipality as a public road., maintenance costs thereafter could be a public expense. l'