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HomeMy WebLinkAbout020-1353-32-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division Countt. Croix INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitac$mi6No.: Personal information you provice may be used for secondary purposes [Privacy Law, i (1)(m)]. Permit Holder's Name: 1 ❑ City ❑ V wn of• State Plan ID No.: Woodward, Richard u T I ° ownship CST BM Elev.:- Insp. BM Elev.: BM Description: Parcel 6 LU -1 'j 53 -32 -000 100,0 100.x N e.t rb = CSC 1 ,,i TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Sep Benchmark r � Alt. .i M Y. S I 96- f ' Dosing Aeration !' -J Bldg. Sewer /.4 ( 12- 6 1 ' Holding _ / St/ Ht Inlet ! 5 ct - 4 ( ' TANK SETBACK INFOR ION St/ Ht Outlet 7. 9 ( ° fl.W{' TANK TO P/ L WELL BLDG. Air Ventto Intake - - ROAD Dt Inlet 7 ,-------- -V Septic '> () ? ' ' NA Dt Bottom �r - ---- -- Dosing v NA Header O � l �.4 10.SZ S /041 ( .56D Aeration NA Dist. Pipe Holding Bot. System N 12, ID .../ 5 $�• Is PUMP / SIPHON INFORMATION Final Grade 5(o '15".(QS r St cover Manufac rer Demand --4 6 Model Nu * - r / ' L PM TDH Lift n ric.. • System TDH Ft i Fi • Forcemain en gth II MIll Dist. To A - SOIL B5ORPTION SYSTEM RES / ENCH Width ' Length No( Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 11. q I ( � DIMENSIONS LEACHING Manufacturer: 4. SETBACK SYSTEM TO P/ L BLDG WELL LAKE /STREAM CHAMBER ` ` `�e` " "��'� INFORMATION Type Of c ` 1 odel Number: System: .1 OR UNIT DISTRIBUTION SYSTEM (23r 6o 4-to LiCi -') S ) - Header / yanifold t ,, Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length e,12-- Dia. l engt Di ac 7 D SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over 1 xx Depth Of xx Seeded / Sodded xx Mulched Bed / Trench Center Bed / Trench Edges I Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: 01/ (1/01 Inspection #2: / / Location: 668 Louise Lane, Hudson, WI 54016 (NE 1/4 NW 1/4 36 T29N R19W) - 3629192032 Cottonwood Ridge - Lot 32 1.) Alt BM Description = Sw c,ovh¢Tl - -- i � a' f LI 2.) Bldg sewer length = e • D o nt o -amf cover =/ $ 4' C e Cri er, _ , � ►( bJ o f a e Islsid re or additional inform at No Use other side f TI or aiat on. O ( �3 OI Z Co SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: i , , . m,�e® ... �� ®: ®... } .. ame ,...,,t ,. s F f I t ry t p, i 4 i , 3 Y .,,. .... 1 a L : i � ? ..n.m»�; - r 1 _ ill ali "111111p111 • I fJL I € f.,_ : t ail ..._ , ,_ 1 , , „ ._ maires 1,....,_ , .... , , , a , I . , , : , maii _ I imomEm as RR II EMIR t it __ .: i � i a •111 NI 1 _.4 , :: MEN [ .._. [ _. + ____ t _ h _ l _f, „ . 4 I _ I , - I - 1 -- 1--- 1 , , , , t 1 1 j I .„,� ��_.. �� f ,, s . „„„..„. , „. , , i ,,,i,_ .....,,.. W,.W._. .. .... ..,,., ..W�, .. .» .,, i „,,,,,,,,,,_ _ _ , „,,, 1 .,.“..._[....±_ i _ ' ...,......._ L.....4_,..1... 1 i s � • gym- H msd -, . 1 + , ' , j I , , , , , : , , , , , , , , , , g I a , , , , , , i , , , I L 1 I ! 9 I 1 1 i f 1 i ._, i _.. 1 1 , , i 1 . 1 . Fa: III i all Ma ti (e(f ) Lou_ ;s ue L. Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application Per PO Box 7302 NY4sconsin Personal information you provide may be used for secondary purposes p Madison, WI 53707 - 7302 Department of Commerce (Submit completed form to if not [Privacy Law, s. 15.04(1)(m)] ( t com p county state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size. County 77 State Sanitary Permit Number ❑ Check if revision to previous application State Plan I. D. Number S l ,x 3 8%3 <P/0 I. Application Information - Please Print all Information /'( \.. ,C ' j ocation: Property Owner Name �11 y � � / erty Location Pro e'( O iit nevi A9.t f�Siv "�c'i'G r- ? f�� 4 � 1 /4, , ( °r yf Owne s Mailing Address ^ r L. C;'* L. i1 tikber Block Number o GP a" .----.-/Va. ..6 ,.,44), ' ff rs City, S l 9 C J s i � � 1- Zip Code Phone e t r 200 S u t ' on Name or CSM Number C�Otx �^ �G�� �i / COUNTY T �� �l Gtr ( ZC II. Type of Building: (check one) ,, . v ." c y h 1 or 2 Family Dwelling - No. of Bedrooms : //it ' e tr - p fa i s y _ _ -1`7 )Tillage ❑ Public /Commercial (describe use):_ , j . _ ,__. - , �' Town of ❑ State -Owned / Nearest Road , // 7 Parc T umb III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) 36 , 2. 7. 19. Z o 32 A) 1. 0 New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System B) 1 Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) ISI Non - pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: 3 0 c „ 4. ,,, A t � 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area So Applic 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation 49D v i fie/) -/ '/ ✓ . 7 j,. '' /V, '9l s ✓ 9-S ; /s VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks / _ .0 ❑ ❑ ❑ ❑ sP h c ..?/'4:5 — 1:-2‘/5 / Gl e, -,eS ❑ ❑ ❑ ❑ ❑ / ,f" /47 /k,P VIII. Responsibility Statement I, the unde signed, assume responsibility for installa '.n of the 'OWTS sho wn on thP atta 4 plans. Plumber's e (print) i Plumber' Sig 4 ps MP/M ' No Business Phone Number a _ �J h r - - — S .-- ss Plumber's Address (Street, City, State, Zip C: le) <, 7 ?gyp )4- l srtz o1 i4 r /. �'` IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) Approved ❑ Owner Given Initial Adverse Surcharge Fee Determination 2 Z , ao h./9/ zodo - – pt, ..<:" ...."-44 X. Conditions of Approval /Reasons for / re Disapproval: / 0 A.F.',j„„,f- o- p esreectio— 0 O. re co, / ' r Gha t i.- rCTtKfi`er� 1 2 1 "Iln;+rar r.- bu ;(di ti9 elevafior. be `I9 /. °e. 9 3) S -1, etre& .4i 4, Gtr f• a e . /eye 4.ppr a a:l / pr,e der o{ Bo / I.J /4r "1'e Ia MR.•„_4ctcKC'd7Serviced t i NtQ c f p �� �c k / re rs reGdtitMtr. 5, c S(1r - ( c t��UW to bt CliVer �e Ciway 4o µ-' 4�rS7CM. SBD -6398 (R. 07/00) y ....► 1 �� ' , l � -J O X k") v - 3 V u 7 ,v .X � ,n r o \ tk .-`, ; ta /''' k‘ I �r , T _ / It ' k o t n 1 �� I �� )s \ , N I , , 4 y Ni4 N Ak ■4 .,) ( A N \ -. ,, o 19 / /I \ \ \ E)C ' L 1 ;! � \ \ \ i \ \T REA #, �'" 1 i N / / \ \ T 9 9 \0 \ • - \\ / �� o \, \\ \ \\ \ \ \ \ \\ p \ \ \,\1 \ \ \ - I R / // \ \ \\ \ \ \ l \ - " � // / /,? \ \ \ \ \ \ X10 0 8 8 1 I / i3A J \ : \ \ \ \ 9 9� .� \ \ \ • f \ ' 0 ...".:',.: - ''' i ( 7 p \ ` A , > 0.T.:' . -. .:.:..r..4 -- l i r z \ .. / /P/ / ) ) 1 9 . 7 - ___----- lk z / . / / / _ VETO 9.00 - 1--- .._ 1 r / // � ,�� \ // ,- — 1 � i tI A // / / / / _ i ( /( X / / // / T, 1 ,07 ., �o x�Q.& A &. F / / \ \ � \ ,\9 . � - \ ( IX 1 y � � -- � \ \ �-- I • \ ' * \ i ----sE /A- ,_____ . _____ is S 1 \ . _ et \\ 1,. \ \ \-- v \ \ )3)\ N\ . \ .,- - ----- NI \ \I \ \ \ � \ 1 \ \ � �— / —� \\\ \ \ \ \ l, \\ \\ \i/ • -------"- 1 4 '\ \ \ \\ \ \ \� \��� '- \ \\ \ \ \\` , ) - _ � 1 ■ Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 2 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County �� Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 6 -WO ..-./ 3.173 _ .3-? DDS' Please print all information. R wed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 5-6, �^� 1 �Z� /L �d Property Owner Property Location ) 4 1_ i Govt. Lot 114 1/4 S T 9 N R/9 E (o& 1 70e .... /_44K/2 roperty Owner's Mailing Address Lot # Block # Subd. Name or CSM# ty Sta1�e Z C o d e Phone Number ❑ 7 ❑ Village ® Town Nearest Road 1 is X2 /1 1 ( ) snA✓ 1 �p 4.41-- , 14 New Construction User) Residential / Number of bedrooms Code derived design flow rate QQ GPD ❑ Replacement 0 Public or commercial - Describe: _— .� Parent material pu,4,1d:s,/ Flood Plain elevation if applicable A// V _ ft. General comments _ and recommendations: - ..5154...: ,' 8 ° , 15 — Boring # 0 Boring , P Ground surface elev.. 4 S� ft. Depth to limiting factor 1 11.-.V in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fl= in. Munsell Qu. Sz. Cont. Color Gr ��Sz. Sh. "Eff#1 "Eff#2 IMPMBEPZMIIIIIMMIIIMMBSIPNMIMIMIMIIDE PIIEIIEMIII -- MMINEMIIIIWAIIIMIIIMIIIMIENNIIPAIIIPAIIIIIIIII: IIPIIIIMBIIFNPAMIMIIIIIIIIIOEIIIIEIIIIIIIPJVAIIIEIPIIEPIIIMIENMNI MIIPILIEIEIWAIIMWAIIIIIIIIIMLMIII .l: ' /2(0 �y Boring # 0 Boring c� ® Pit Ground surface elev. 9 R ft. Depth to limiting factor` /S5 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. C nt. Color Gr. Sz. Sh. "Eff#1 "Eff#2 ■ (9- /.3• 72) X iv .•s/ -gym al .,y Is .3 a. ..'S . 9 /?-_3‘. /9 to's- 1 ✓ s./ ,-,11.5.a � sJ i .3c . $', , Q 2 3, -7 -i • jj X /G .1; / .� +s�� n/sA ( i n. .'S`✓ _4 *(1-k r� .v,1 .2i 4,.. .. / — /1 , '7./ /- < ,({- e I', /..f /OW ,, / � „ • Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L " Effluent = BOD < 30 mg/L and TSS < 30 mg/L CST Name ' ease • ) Signatur CST Number Add : i 704 a Evaluation Conducted Telephone Number Property Owner ),,/,4t;e,___42,5,(aulked9 Parcel ID # Page of 0 Boring # ❑Boring ....., pit Ground surface elev. / )2/ 0) ft. Depth to limiting factor a ' in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. nt. Color Gr. Sz. Sh. •Eff#1 'Eff#2 1 n - • /4 e-.7/ N is 4.--- ..5-1 / as Sii. , 7- /, ...? - .. . ., ✓ ,7 - t_ — - d'9.i. IL( o�" Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 i Boring # ❑ Boring . ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDIff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 • • Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L 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 -8777. SBD-8330 (8.6/00) (\,1 ,, \ ?r9 71.9.,i,t9, ./1 _____________ —s\c 7 cltr‘ _________________ 1 vat- ( ., / ,‘s \,. ‘. — J 'zt ,,- �c � G� t\ \o Nto te ^ 1 $ I— / / \ '4)1 / . 6'; o c ' 1 � \ M V - N ul \ ..., i . N, , N\N 14 ' 4 viv 4 - .1 ,, %g , s 42 --_, vP •:)'..._. Q , 72 rpm IN - c\, c.., , i 0 N Wisconsin Department of Commerce SOIL AND -SI E EVALUATION Division of Safety and Buildings l r.. Page of .3 Bureau of Integrated Services in accords With's. ILHR 8 .09, Wis. Adm. Code • County Attach complete site plan on paper not less than 8 1/2 x 11 in hes,hn j d"Yr "r)i, ot t? include, but not limited to: vertical and horizontal reference 'nt`(BM), direction and ' .` SA CrUI yt percent slope, scale or dimensions, north arrow, and locatio and distqnsp.to pearest, road. parcel I.D. # sT CROIX APPLICANT INFORMATION - Please print all i lormationcouNTy / ' Reviewed �, by c�(/l Date Personal information you provide may be used for secondary purposes (Anvacy- Lav7R.�1N. jjF(lir} \ i '° / �t�� I ?i /91'7 Property Owner 1_ y Property Locat ( P..01.a c 3611`4 - - - 4 - . ' et t. :f:.ot A) -' 1/4 %o 1/4,S 36 T? c ,N,R t o) E (or)J Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# , •- .5 Avs:.N- uv. -e - Cr. 3/ C ft6r)woc1Ci a,dsv City State Zip Code Phone Number City ❑ Ville � Town Nearest Road Village k/Ck- l 1> k i 940 I (`115) gq Hudson 1 ('0ff0,.,,, a s - • l-New Construction Use: 1Y / Number of bedrooms 3-" Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow (S OO gpd Recommended design loading rate • 7 bed, gpd /ft • trench, gpd /ft Absorption area required g5i bed, ft 150 trench, ft Maximum design loading rate • 7 bed, gpd /ft • $ trench, gpd /ft Recommended infiltration surface elevation(s) 9 /.S ft (as referred to site plan benchmark) Additional design /site considerations ,i9-Z-, f • 9 7 . ( Q Parent material a (IQ 1T Flood plain elevation, if applicable /Age- 998. 0 -99e:fi? S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system 0 S ❑ U 1 s ❑ u '❑ s U © S ❑ u ❑ s © u ❑ S © U SOIL DESCRIPTION REPORT Boring # Horizon De Dominant Color Mottles Structure GPD /ft g Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench L 1 0 (0•11( 3IZ " SL 1 m. Vri - FY - CS 1 C - - H , 5 2 - 2.-mq 11N)./r. 4 149 `— MS C) _ m 1 C.S 14 -c- s 1;- K Ground elev. 9440 ft. • Depth to - limiting factor min. Remarks: Boring # I 6 -1 ( l(Jyr 3IZ SL 1mS5 mfr C 5 1 G • LI : .5 14-9F( iv `{�(� — mS (1S3 m C.S ivf- . 1 $' Ground elev. ro ft. Depth to ,,g, , limiting w b� factr o g in. Remarks: CST Name (Please Print) Signature Telephone No. Ada 5c . 61' ' 7/5) 2'f 7_'406 e Address Date CST Number do der` 54. L I 5nrner e-4, wt 59 o2s `/ -ice - 9 . 1 2 -53 • PROPERTY OWNER S U t SOIL DESCRIPTION REPORT Page 2 of J PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots r'PD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3 f O qt (O 3h- SL I m m c5 1 . -5 2- 1(0-97 �() y►- �1�� mS o mt CS Ivy - Ground elev. qs gOft. Depth to limiting f tff i�t 5 \.b �'1 in. Remarks: Boring # 1 01 l 0 y r 31 S 1 rnS >`r CS 1 5 3 4$ -13(, 10 y r LI j (v r Is 0S9 rn 1 c_S - , "1 : • �I Ground elev. 9S.20ft. Depth to limiting factor i Nein. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # 1 Hb 161r3)2_ SL m55 rr f, C S I ` ; , 5 5 Z 10-119 nyr`16 m cs9 . Ground elev. .5; SUft. Depth to limiting factor I t i ' Remarks: Boring # Ground elev. ft. Depth to limiting _ factor ' Remarks: SBD -8330 (R. 07/96) { : 1 )(2 c 3o4.3 5 u+ 3 Z et)4 -rcr Seals(`- 0 I na,l I i4"cir" ZpA. lol.eu. / h 4 f I "- " (frn /4 l.a.✓. UO. a ! O 5v,Siewk 9�, 5 3 c 4i -t. .-i . qz. !o 4, r.l- lti t., [— 1.4V 006A 7 .4 z : I as • • • — Br... I t 1 33 T 4. • et '1" • �Z • v I a v � r� (kg Oot 31 00 08:52a Jason Johnson 7153867992 fr p.2 . SUN. 01 -.�1N-80 ?:42 021 `,74 ,,, P. J silon John 7(531157392 Oct 2:r oo 06151a con y�„ n7 . 0412/426/16 ''S'HJ� ' "' T�'� ST CROJX COUnf ys',P'frf` 64N11.111:N NCE :'OkVCNit.T4 ,. pW N CRSI4 IP. ctA rfICAYtOffooRJ►f • Richard Woodward b Joan Mils wSCa on WI 54U16 -.-- -- HtidS . .... . 9311 Sac La/16 Malkin Addn±r 6Qi a ,pt 32 Col lonafood. Ri . vim , Prplst R�:t esx _:• - ,. M rrw canitrush LO�s ir. I m Pta Oep+ntec ... • trod a nern� iwrifieua«KaM+ T trccl ids„uf�c►aen NUrr7bee L +fYlSlawe -r-+, Siudxo�..�� - r :. ,..... �� ~- .... . nve1QV Ridry�` Let; , r � .� . �ttd7�tutan.';r Ctiir n+swp s'r i ,. wernnb Deed .. • ttt _ .. cs nc t i i ble di7 to Spa +vax y Imo! aces Idartta •, YS7i"H ... I � a 1 C .i �'r.•ntr WOK +�eS °a• sc!u a7uensc�pi4 s Ow Om (UIWCa,�?nd�Ma�, ctTiif� c . Ae! PIM ea a cry ti+;ee rear! or sonar. If .ceded br . twta.el! maniac/ ow WnNCte eiyarn7tRd e ttrrste of "OMF>KW, +� t3it a acel PM,NI 71!••I i4Pr ; einl atlY�ylK;��' t 7se o .rrta rd + 1:0!. t G rlN plpeas al srslurra: am/wt roa �4tve. !ra fool ,mbf �Iro"� LAmptAFi , :in11t1tlt1tt(Ifdsmrss ` d tpo maa., ,trnkKry' �^ Pruntrft l t: ii + � dplw^ � r eralrccacliQfusnAR .ua rcSiRk .lase II7 , • ii t11.a(ol!a! apenti4 ,>:1ti!ulursn a►N4r•*t ed•� +we l 1. " fe,n "d1 the atai0^+ u peye r tkLxGltsrrN e.ne tla+MtlitFr to mnru•.al4re ptl ew d+ NI ara • • • • . Nw 4 f he y«eaptxwtd +a rt ,.v, ruq be ..., ... 4 �A 7ht r . . vvla fM , ert ,W ., Imunr t rfcummcrl2 arW d sa Der - «c «r ai M+13wrs lts>{tSrkcb c ei /et farm hnclR a/ a. by tFC vetH , t„ ",tmMxu.l gntt 77110 aa, avr•.w rOt 1+[i4 lh �IOfR C.V ,.. , ... • r. �w+ ' !• dit+line 'yaw c.pmAiii ... ;;::•:;•••••: T::•;111 ., „ . 14* ., .. ; 4lQlfA'INRF 0f Aft . . ........:.. • ..., .. _ .,, .. .. ,.....• . , , >. ,.. ...... ... ..... so e jai' .1cdC , • ran i r rhra form ue uvc th tictt 0� {ikrl Rt74 e ' {"� t+ iMytly Ih•+ oil •Utrntc +' Ilrcco r,r/T':'dercrsaar a/r b7.r. +■' •aaotft•,e1!i �� , . • . eyedas t« R rf t W t 01 .� . a MJ xw► • i � M� uedl+• tirr•dAc iM,eerypewr+ »bs.+iR*e'+.flr.d L God ftitnt' y p11� u7s�eo .. „. :. d wonM d II�fi1Na'the ii �, l e a ves'i'J�ear,4wrar.. . .i , ; ..': ►• filed ..;sn'iR:s •�piiCsiWltS{ " 'Y uy fls.atlrtrcr map If tciemws is 1Pa01 me wany«tr deed a e Y> 717C GRkM. . TOTRL P. 01 STATE BAR OF WISCONSIN FORM 2 -- 1998 6318 WARRANTY DEED KATHLEEN H. WALSH 15Q REGISTER OF DEEDS Document r�1 O Number t PAC. ST. CROIX CO., WI RECEIVED FOR RECORD This Deed, made between RICHARD O. STOUT and JANET _STOUT—_ 10-16-2000 10:30 NM husband and wife, _ WARRANTY DEED _ Grantor, • EXEMPT M and RTCHARD C. WOODWARD and JOAN MrISTRT,F,WTC'Z, COPY F TRANSFER FEE: 179.70 RECORDING FEE: 10.00 PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following .. described real estate In St. Croix County. State of Wisconsin: ReCOrni.nq Area Lot 32, Plat of Cottonwood Ridge, Town of Name and Return Address Hudson, St. Croix County, Wisconsin. N -sC` c y /. /r �p n02 t- ca4lser) f t� � 5/0( 43e '30446 020- 1353 -32 -000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: easements, restrictions, rights -of -way and covenants of record. Dated this �� 9rd day of (lc t 2f100 / • P tJ JI J. S V1 •\�K►v�1 (SEAL) E A _-`' ^�" (SEAL) . Richard 0. Stout Janet P. Stout (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, ss. St. Croix County. authenticated this day of Personally carne before me this 3rd day of _ October ,2000 , the above named Richard 0. Stout and Janet P. Stout • TITLE: MEMBER STATE BAR OF WISCONSIN — ___ — to • (If not, me known to be thheh61#11Y PI B jcuted the foregoing authorized by 5706.06, Wis. Stets.) Instrument and &T AT WISCONSIN KERNON J. BAST THIS INSTRUMENT WAS DRAFTED BY - - - -- Janet P. Stout r � 1353 Awatukee Tr. • — Hudson, WI 54016 Notary 'ublic, State of consin My c•.mmissio is pe anent. (If not. state expiration date: (Signatures may be authenticated or acknowledged. Both are not _ _ �� .) necessary.) • Names of persons signing in any capacity must be typed or printed below their signature. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc. WARRANTY DEED FORM No. 2 - 1998 Milwaukee. Wis. • '� .1aI i 4 PAGE 601 Igo' AFFIDAVIT OF CORRECTION 3°'`' 634762 Document Number Document Title KATHLEEN H. WALSH REGISTER OF DEEDS ST.. CROIX CO., WI RECEIVED FOR RECORD I, Douglas J. Zahler, Registered Land Surveyor, S -2145, hereby 12- 05 -2400 11:00 AM certify: that the plat of Cottonwood Ridge recorded in Volume 7 of plats, Page 45, Document No. 603431, St. Croix County Register CORRECTIVE AFFIDAVIT EXEMPT N of Deeds, shows storm water retention areas on Lot 32; one labeled CERT COPY FEE: with a High Water Line Elevation of 992.7 and one labeled with a COPY FEE: 3.00 TRANSFER FEE: High Water Line Elevation of 988.0. That due to some additional RECORDING FEE: 12.00 2 grading on said Lot 32 said Storm Water Retention Areas are amended PAS = ' as follows: the Storm Water Retention Area with a High Water Line Recording Area Elevation of 992.7 is eliminated; the Storm Water Retention Area Name and Return Address E rile n R cL with a High Water Line Elevation of 988.0 now has a High Water Line Dreamstructure q 4b ` ,P- c3 Elevation of 988.5. There shall also be a minimum building elevation PO Bo ` of 991.0 on said Lot 32. See Attached Exhibit A. on, WI 54016 LA 5t/01 Lot 32 Cottonwood Ridge 020 - 1353 -32 -000 Parcel Identification Number (PIN) Dated this 27th day of , 2000 , of Wise Douglas 1 Z. l'e ' .L.S. S -2145 y DOUGLAS J. s Z ZAHLER * S-2145 �_ HUDSON, State of Wisconsin ) +A_ WAS ss. S l St. Croix County ) " " "" Personally came before me this (`�, ( k%day of N‘ `_tv, , °,:'..; it.; , 2000, to me known to be the person who executed the foregoing instrume : ' • • : Cktio '` :; d the same. M Commission Expires \ . f. - _ t_, •. NOTAR Y PUBLIC •2 ST. CROIX COUNTY APPROVAL CERTIFICATE Approved for re recording by the St. Croix County Zoning Office g Y tY g Date ib1� y''4 2000 00 0 cx......_ S This instrument was drafted by Douglas J. Zahler, S &N Land Surveying, Inc., 2920 Enloe Steet, Hudson, WI 54016. This information must be completed by submitter: document title. name & return address, and (if required). Other information such as the granting clauses, legal description, etc. may be placed on this first page of the document or may be placed on additional pages of the document. Note; Use of this cover page adds one page to your document and $2.00 to the recording fee. Wisconsin Statutes, 59.43 (2m) WRDA 2/99 I / I /I l _ \ \ \E `` \ \ \ J) / \\ - \ RE \A # 2 1 \ \ \ J 9 .9 \ \ 1 \ / / I \ \saTT - 992 .. 0 \ • \ 1 / C \ . - 1`0 - A\ C \= .�9 \ F f___ / I ' T \\1X0 \ / / �\ ,\ 1 19 0, ' ' l IV � ,., / \\ \ ' \;i j �X 4_ /,,,, s� \ \ i N \X10 0 8 i . ) _.....,_ � / * 74,.. 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I ! ? 41ri.. , .. • 1 1 1. _ • .- • it4. — ■ ► — "�•• ' e fi ' / - • • t, �'' y , � rc:x. r ., •w „'t Y 1 . ► -�. • j t • •.i ,� • .. 1 w 11 �• � 119 Safi i 1 1 t 11 • As •, i f , vP • - c•...".. 4 ' H.W1. t 900.0 1 1 ' D 90 ^ 1 ; v ; ,• . .. � . 1 • w•.• r ( P.".......... .,, . f 1 2.088 ACM 1 I; I I j r i y p► ,534 '�Q'FT' , .. • S' f i • IEIiPORM1f CYU•OE - SAC CA�E11f NOTE 2..104 ACRES : ` i' 33 33 OA —OE —SAC TO 8E AMAX/ AX/ IJOON ROAO EX?ENSION 1 9 j 91.073 SQ.rT. i r' i " i •' - 1 1• i 1 1 . i : • i • • 9 t • • 1 •. ' • • • • 1 - „... -• • `, • • CE N TER f7 33. • t . '.....%le • . ilo , , •,_ t. 3 • .....".•"” t /1 �. ll l'.. 4.... . -"i/' i j t ..•�n�� j j ., I ' f � � r • . .•t 11 ` '"f .. 1 I • . • • 1 N y -• • ••• 1 t' ` t 11 , I . _.•• i ',1 owA , Wisconsin Department of Commerce SOIL AND SITE EVALUATION / 3 -Division of Safety and Buildings Page of Bureau of Integrated Service in accordance , - .. :309, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 Inc ®sic st a Pia just ' \ C ounty include, but not limited to: vertical and horizontal reference •,, int ( v1), di ' r)d ,Cl, e, VO i )C percent slope, scale or dimensions, north arrow, and locatio 'AN distanc to neart;ls ,}oad Parcel I.D. # I r. r r + APPLICANT INFORMATION - Please print akinformation. -` I Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, ;ci, {0) (m)). , Property Owner 1" srigy Locatio \ G ovt..Lgt'', .€ 1/4 1/4 ,S T Z , N,R E (or fit '- (',ttno�UvS �/ 3Co `� /1 Property Owner's Mailing Address � \./ r :3 +Ldt # '" lock# Subd. Name or CSM# % 5 +I' v / � '1G r l . iv (° Le . ,U , 'Z" co/y-04 woo CQ le ' dge_ City State Zip Code Phone Number ❑ City ❑ Village Fl Town Nearest Rod( Plyr'►'t(1 141 v1 1.55 I ( U / 2-) 55 7- Jo1l 1- i-(,4 A I N //e ry j C r- 4( [l New Construction Use: ® Residential / Number of bedrooms 3 - -. Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow (o 0 gpd Recommended design loading rate • L c bed, gpd/ft trench, gpd/ft Absorption area required i9 0 bed, ft /7 0 trench, ft 2 Maximum design loading rate • [ ./ bed, gpd/ft e S trench, gpd/ft Recommended infiltration surface elevation(s) '7,g 0 0 ft (as referred to site plan benchmark) Additional design /site considerations C A.11:1 r C.14, Q7. � Parent material 0 cry ' $ t/ Flood plain elevation, if applicable ter/ / ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S ®u 171 s u ❑ s 7u ❑ s Igt u ❑ s 0 U ❑ s® u SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft fAtIEM 9 in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed , Trench 1 o -g io — wls c)sB Yr\ 1 c S I -� 7 ; X Z g -Z$ IOYr3/ Z- S L /vrubt /0_4'r c_5 I /. - y S" Ground 3 -4.0 /Oy✓Y& / /r Syr '1/3 Sir lmabL ✓n-(f c s : elev. Depth to limiting factor 2% in. Remarks: Boring # 1 0 - // /014 yy3 A$ O S n't / C S l .7: •g ar a „ /oy✓3 /z ,z_ l,n4/' I - P ^ ( -- - Y /10-C- y ; S Ground elev. . j) art ft. , Depth to limiting ' factor 2.1 in. Remarks: CST Name (Please Print) Si�gn:..: Telephone No. Date CST Number A•dress 4 7 2 //3 5 S v 7 Z/7/ .r � /O S ----- -- 2/-0 0 „IS-30 PROPERTY OWNER C e r' ‘ { `` 3 SOIL DESCRIPTION REPORT ' s Page of PARCEL I.D.# ! ' . ,� Boring # Horizon Depth Dominant Color Mottles Structure G D /ft Texture Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 3 1 3v co /3 -- /15 ©sue en- - cc Lc 7 .., Z 30 roy /Z -- S R_ r c 5 1 o- . S' Ground 3 3Y `/l /O f'' - 74 - / 'J /'r c 5 $� 906 ft. Depth to limiting factor 34C in. Remarks: Boring # Lori Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # ss 34x i Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to • limiting _ factor 'n ' Remarks: SBD -8330 (R.9/98) r t i PAGE _3 OF 3 > > !-�e� 4 , or NAME aryl 5 LOT# 52-LEGAL DESCRIPTION / / S T ,N,R E ( ) W a , SCALE: 1 "= (UCH BM 1 ELEVATION /X) BM 1 DESCRIPTION A k: ( t n ! y 'fop (k 4- I BM 2 ELEVATION (00 • O x BM 2 DESCRIPTION n ; ( iN ZO 1301-ei c r SYSTEM ELEVATION f 00 ALTERNATE ELEVATION ./( CONTOUR ELEVATION y 7' O v I \1 I � rr� I(',L c_ �A \ 0 4 • az (3+ SIGNATURE DATE G / - Z/ c)