HomeMy WebLinkAbout020-1441-67-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
430245 0
GENERAL INFORMATION (ATTACH TO PERMIT State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. '..".........,.
Permit Holder's Name: City Village X Township Parcel Tax No:
Bast, Kernon Hudson Township
CST BM Elev: • S Insp. BM Elev: BM Description: Section/Town /Range/Map No:
'&• 2 ((00.05) 1CD•OS CSrBIM Tr 2 36.29.19.
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark (Z t
1.x.6( Sc-e___ 1 �l s. S8 )a9. o T
Dosing Alt. BM / `
is
t S l i �.tt/ , our Sj mtr, 1 q
S' 4°
Aeration Bldg. Sewer t ci.er
1.20
Holding St/Ht Inlet ror.10) 4/ 1" .$4 t
TANK SETBACK INFORMATION St/Ht Outlet J
/.30 0 c p• 4s /
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic 1 1 � � Dt Bottom
IP Sr 6/ 2. 0 „,....--- -...
Dosing Header /Man.
Aeration I Dist. Pipe 1.40
90.3s
Holding lBot. System
iv 1
l .10
PUMP /SIPHON INFORMATION Final Grade O
s • o 41.64 15.3r `
Manufacturer Demand St Cover
GPM (Ak ,Q 'i ■ • e )
Model umber 4
TDH (Lift Friction Loss 'System Head TDH Ft
Force ' Lengt Dia. Dist. to W
• IL ABSORPTION SYSTEM tLI) c ..... ,.., / y �
. idth ( Length ( No. gt Trenches I PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIME` • oT•S ern) (2)
SETBACK SYSTEM TO � P/L BLDG WELL LAKE /STREAM LEACHING I nufi tt r:� _,/ A A
INFORMATION CHAMBER OR .Z�.�/CQ�/
Type Of system: ' ' k ( c.) ! UNIT Model Number: ' z U
DISTRIBUTIO ; ,o_> M
'
ea - i istributior� x Hole Size x Hole Spacing Vent to Air Intake
•ipe(s) '� L- IJ s
Lengt Dia Length Dia Spacing -N. /� 4 5
SOIL OVER 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 L. No rfij Yes „JI No
COM N S: (Includ a discrepencies, persons present, etc.) Inspection #1: • IS 14 I nspection #2: --/-- T
Z S 4111 0
Location: 3 Wilcoxson Drive Hudso�y�W , 54 0 6 (NE 1/4 SW 1/4 36 9N R19W) ottonwood Ridge 1st Add Lot 3 Parcel No: 36.29.19.
1.) Alt BM Description = O'� '� '-' - 60 4f) ( CB"ST+'u•CM cEt
2.) Bldg sewer length = 21 4i `
- amount of cover = 36 4 10 C Ot ” � �
t
• 0, cr
, 1 ' al 4100 e t*: .6 At.t, 5) 6-46,recP.As Plan revision Required? Yes No (g 1,,� u I . 4 , : I
Use other side for additional information. �i�t , I
Date Signature — • : ;., ,k
SBD -6710 (R.3/97)
eil_iszqpctor's t M / te
G.�o -r •
,
Safety and Buildings Division County •
20I W. Washington Ave., P.O. Box 7082 5 T. (..e)--",-
NVI'sconsin on, WI 53707 - 7082 Sanitary Permit Number (to be filled in by Co.)
Dep Madis 608) 261 -6546 302
State Plan I.D. Number
Sanitary Permit Application
4
In accord with Comm 83.21, Wis. Adm. Code, personal information you provide
may be used for sego purposes Pri
Y secondary purpo viicy.Lawk.I S O4(lXm) Project Address (if different than mailing address)
I. Application Information - Please Print All Information Z o 64 LLOKS ay.) D R '
Property Owner's Name . Lot # BBlock #
Property Owner's Mailing Address 3 i 1 p- , /
Pro. • . ation
5 y d % ._.. _... _. Nt_. �,� . s0,., Section 3 , o
City, State 1 Zip Code / -S' p��O
Phone Number
l (/'t -/ - ,YO /C� / 4 I circle one)
apply) � � � AAA)
, 4 -/ II. Type of Building (check all that a T �N; R / E or W
4� S
tit
Q ) Subdivision N < .e CSM Number
1 or 2 Family Dwelling - Number of Bedrooms ! A pIL f ( � / /
❑ Public/Commercial - Describe Use \ r _gaol/'
f
❑State Owned - Describe Use ( t Z, 3 X �T 7 S IT 7� _r� ! t ❑City ❑Vil : ?To . ip of
ITI. Type of Permit: (Check only one box on line A. Comp ete ine B if applicable)
A. New System yst 0 Replacement System ❑ Treatment/Holding Tank Replacement Only 0 Other Modification to Existing System
B. ❑ Permit Renewal ❑Permit Revision List Previous Permit Number and Date Issued
❑ Change of ❑ Permit Transfer to N ew
Before Expiration Plumber Owner
IV. Type of POWTS System: (Check all that apply)
Non - Pressurized In -Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑
Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑
Recirculating Synthetic Media Filter 0 Leaching Chamber A Drip Li ❑ vel -less Pipe ❑ o . . exp
V. Dispersal/Treat nt Area Information: . 111 , , 0 ' -- "0,) " ['
Design Flow (gpd) Design Soil Application Rate(gpdsf) a'sersal Area Required (sf) o ispersal Area Proposed (sf) System Elevon
p
G od - 7 e ? 8 70 76
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New Existing
Tanks Tanks
Septic or Holding Tank /R — /025-6 / �� ,
Aerobic Treatment Unit 1
Dosing Chamber
VII. Responsibility Statement I, the undersigned, assume responsibility for in ta)lation of the POWTS shown on the attached plans.
Plumber's Name (Print) Plum. - s S' ?. ature P PRS Number Business Phone Number
I-3 h /V 107 12 M r', a 9D 35 ? 7is- ,268 -4 ?5
Plumber's Address (Street, City, State Zip Code)/ / zz- oc)
VIII. Coun ap rtment Use Only //
pproved 0 Sanitary Permit F includes Groundwater Date sued su' Agent Signatur tamps)
(((((( ���'��( Surcharge Fee) ��/ ,
❑ Owner Given Reason for Denial 2.0 ( C �! ' 0 03
Conditions of Approval/Reas s fof Disapproval ' ' : % Ilk ItaiAtk -04AAA;tiLj / I ‘ . ' . .4
Or _ i�► �LU�t, c,�Q y p,�a,,u, r l
s o/. � I
_k•- f vw ,4*- .
Attach compkte plans (to the County only) for the system on paper not less than 81/2 x 11 Inches la size
1 SBD -6398 (R. 08/02) r\
1- Pit -i ti, j,e
5 961 Dc) ilY 3
07,F a /1)-(--, i i ll_ ,o 1
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----.. 70 / ___019)00 ' (16 5V- %
. . , $ 114
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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page / of 3
Division of Safety and Buildings
in accordance with Comm 85. Wis. Adm. Code
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must
ST' 6/2 o/x- .
Include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D. 5 . /W6 w *-
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information. R ewed by ' Date
Personal tnforme on you provide may be us '. ewrnnAary purposes Privacy Law. s. 15.04 (1) (m)). Yee Or
Location 5.ij a
POwner
/(15/ ECtIVED 4,,C Lot .se 1/4 iOu4 S34 Tzy N R /7 s (or)W
Props Owner ' s Mailing Address Lot # tit/ Subd. Name or CSM# ppvp/,vf P /* r-- V 6 cry, , y . n/ .JAN, 0 9 2 003 ( Pte, w ca 4 /4s,e l5 } IiOW
City State Zip BOUNTY ❑ City ❑ Village J Town Nearest Road
,, YVP.SoA) l ov /. I SO/ 1( 1 9 4
Flua vp5o,) I My f /, Al .
&New Construction Use: 00 Residential / Number of bedrooms 3- y Code derived design flow rate '5'O — Co O GPO
❑ Replacement ❑ Public or commercial - Describe:
Parent material / / ) & 3 5 d 1's SAoI f/ ev "4 s 4.-- Flood Plain elevation if applicable N J , ft.
General comments
and recommendations: ' 4i6 TE - 5r2i) /5 SO iri43 /& fs , ) /.0 f CA 0 vAvD
C o o / / E , v T / o v A ' L Ad. co • i 5 . Z{S /.v 6- /3/o0/F - 4, -
. mss . s ft. 3 •
I / Boring # 0 8orhng /o o• 3 5. > S
® Pit Ground surface elev. ft. Depth to limiting factor / tn. Sol APPS Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
In. Munsel Qu. Sz. Cont. Color Gr. Sz. Sh. 'Elf #1 'Eff#2
/ o - // /oY/e 2 /2_ $IL. tfs ' 411 752 ;w 3 .F' . 2- ' . 3
z /9 • /o Y/1 3/y 61 z... /7 / 640 i . z. • 3
3 22.37 /or4 //y ---- -• SIG 2, h/ tit/' a. 5 — . s . 8
— 1 .
y ?7. sy ,aYR 5"/ 4,r_,2107 . 5 o, S ��. 7 Z
' I Z # ❑ Boring / oo .3 > 7
Pit Ground surface elev. ft. Depth to limiting factor in. I Sol 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 'Ef#/2
o -iz ioyg 3.72_ Sit. /7c5',e , w 3 . 2 •.
2 l.2 .23 IEPAEVA=IIIIIMIEIEIIWZII fro-752 cw 2 • Z • 3
3 2 3.3 , /0 2 sil.- MIMI 1- • a5 — . s • g
all /ol - s6/ --- ', /. S Ds 12- .7
• Effluent #1 = BOD > 30 < 220 mglL and TSS >30 < 150 mgll • Effluent #2 = BOO. < 30 mg&L and TSS < 30 mgt& •
CST Name PrM) Slgnetu a CST Wurltuer
o BERT Zf /,6/P/ Cti T / dal 2 2. C. 3 'T S
Address Date Evaluation Conducted Telephone Number
Ulbricht 8, Associates Dec • g- Z.0 o Z 7/5. 3 PG • VS' S
055 O'Neil Rd.
Hudson, Wis. 54010 . Av5
N � F
S oa0 • /b y• / C• a'�
se or MO o //09. • cart .
. iThip\c_sliAi\L
020.//0 go• COO
flubL to/co So o10 • //b y • �o • o� 2 3
Property Owner Parcel ID # Page of
❑ �rin9
I � # it Ground surface elev. �� o. 2 ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Desaiption Texture Structure Consistence Boundary Roots GPD/ W
In. I Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. . Eff #1 •Eft#2
/o R 3/3 L /-(5d,C _1w f . 9 .
2- 4
2 /9 ioN 3/ f siL. / fshe •►•l r die cw / � z. • 3
3 JO .36 /o J/' , 5/1- 2. - (she ,mot A C4) . i t . 5 S
9 30.38 /OW foe ___- -_ sL - Fs4e ,>~►fe '. 5 — . s • 7
s 3. i� /oyAY ,>o&.QJ. S. 6, 5j. 4)2- . 7 A Z
te ago • '
51/131
Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Sort Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f?
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2
I I Boring # ° Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
I Sod Application Rate
Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff
In. Munsed Qu. SL Cont. Color Gr. Sz. Sh. •Ef#1 'Ef#2
t
I I Boring # ° Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor
Sod Application Rate
Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff
In. Munsell _ Qu. Sz. Cont. Color Gr. Sz. -h. •Eff#1 'Eff#2
1 • •
Effluent #1 = BO; > 30 < 220 mg& : TSS >30 <150 mgll. • Effluent #2 = SOD. < 30 rng&L and TSS < 30 mgi,.
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.
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' suance of permits and designing
�e5 For issuance
Ulbricht & Associates
Registered private wastewater consultant and plumbers i
655 O'Neil Road
Hudson, WI 54016
715- 386 -8185 or 715-772-344
• So, Gd T 1--i.(4.,Q
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POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of 2
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner /36-, — Septic Tank Capacity /a c gal ❑ NA
Permit # 430 2 L(s - Septic Tank Manufacturer t ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA
Number of Bedrooms V ❑ NA Effluent Filter Model /0 0 ❑ NA
Number of Public Facility Units -JA Pump Tank Capacity gal p NA
Estimated flow (average) 7 I) 6 gal /day Pump Tank Manufacturer 1ZDNA
Design flow (peak), (Estimated x 1.5) 4 an gal /day Pump Manufacturer 'TINA
Soil Application Rate ? gal/day/ft2 Pump Model NA
Standard Influent /Effluent Quality Monthly average* Pretreatment UnitA
Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (B00 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BOD 530 mg /L ?,.In- Ground (gravity) ❑ In- Ground (pressurized)
Total Suspended Solids (TSS) 530 mg /L ❑ NA 0 At -Grade ❑ Mound
Fecal Coliform (geometric mean) 510 cfu /100mI ❑ Drip -Line ❑ Other:
Maximum Effluent Particle Size Y8 in dia. ❑ NA Other: `
Other: ❑ NA I Other: i
lblA
*Values typical for domestic wastewater and septic tank effluent. Other: ri A
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every: c)R 1:I month(s) (Maximum 3 years) ❑ NA
,(1 year(s)
Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA
o Z Inspect dispersal cell(s) At least once every: g mon( ,(s) (Maximum 3 years) ❑ NA
❑ month(s) ❑ NA
Clean effluent filter At least once every: /. ,,, year(s)
Inspect pump, pump controls & alarm At least once every: p month IA
Y �_
— • ❑ month(s) A
Flush laterals and pressure test At least once every: p years) r
Other: At least once eve ❑ month(s) ETNA
rY: ❑ year(s)
Other: NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank
inspections must include a visual inspection of the tank(s) to identi any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check f•r any back up or ponding of effluent on the ground surface.
The dispersal cell(s) shall be visually inspected to check the effluen levels in the observation pipes and to check for any ponding
of effluent on the ground surface. The ponding of effluent on the g ound surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tan equals one -third (Y or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing 0 • erator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All other services, including but not limited to the servicing of efflux t filters, mechanical or pressurized components, pretreatment
units, and any servicing at intervals of 512 months, shall be perfo ed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority ithin 10 days of completion of any service event.
Page Z of
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of paihting products or other chemicals
that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents
of the tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at -grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or, must be taken, to provide a code compliant
replacement system:
A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
O A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS
technology a holding tank may be installed as a last resort to replace the failed POWTS.
/f' alu a ' o • mg tank •
• . b. ', • • • ..■r r)FT1 a ai - • ' • ?g0(4I13 TPiEZ. rote way Co js gcicalo
D Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
< < WARNING > >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name /471 _ Name
Phone 7/ 5' -._ 6 y�l Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Name ST C20(</ (oved 20 f /&J
Phone Phone - 1/S - - 3 e _ 1.,ap go
This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code.
ST CROIX C • UNTY
, SEPTIC TANK MAINTEN CE AGREEMENT
AND
OWNERSHIP CERTIFI • ATION FORM
Owner/Buyer '�
Mailing Address '4- CD• ,e/v0 3-r/43/4,
Property Address
(Verification required from Planning Department for new constinction)
City/State ,4/ Parcel Identifica • on Number
LEGAL DESCRIPTION
Property Location / 1t- r /4, S '/4, Sec. 7i 4, T ' -R l W, Town of _2-- L .
Subdivision CO77 / • / � , Lot #
Certified Survey Map # , Vol «e , Page #
Warranty Deed # 7O 8 8 8 0 , Vol e (2/35 , Page # —
Spec house , yes ❑ no Lot lin= identifiablees ❑ no
SYSTEM MAINTENANCE
Improper use and maintenance of your septic system could re t in its premature failure to handle wastes. Proper maintenance
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the function of the septic tank as a treatment stage in the • . to disposal system.
The property owner agrees to submit to St. Croix Zoning i • .. an ent a certification form, signed by the owner and by a
master plumber, journeyman plumber, restricted plumber or a licensed p s verifying that (1) the on-site wastewater disposal system
is in proper operating condition and/or (2) after inspection and pump'' : (if necessary), the septic tank is less than 1/3 full of sludge.
I/we, the undersigned have read the above requirements and agree to • tain the private sewage disposal system with the standards
set forth, herein, as set by the Department of Commerce and the Dep • I ent of Natural Resources, State of Wisconsin. Certification
stating that your septic system has been maintained must be complet - s and returned to the St. Croix County Zoning Office within 30
days of the three year expiration date.
747/
ATURE APPLICANT DATE
OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of
the property described above, by virtue of a warranty deed recorded Register of Deeds Office.
7aJ,1a3
GNA F APPLICANT DATE
*** * ** Any information that is mis- represented may result in the sa s'tary permit being revoked by the Zoning Department. * * * * **
** Include with this application: a stamped warranty deed from th• Register of Deeds office
a copy of the certified survey ma if reference is made in the warranty deed
•
J 2 1 3 5 P 3 5 5 "7 4?) 4E38
KATHLEEN H. MALSH
WARRANTY DE D REGISTER OF DEEDS
ST. CROIX Co., wI
Neil L. Wilcoxson and Mary J. Wilcoxson, atkl =
RECEIVED FOR RECORD
Mary Jo. Wilcoxson, husband and wife, convey- 02/07/2003 02:00PN
and warrants to Kernon J. Bast the followin• EXEMPT #
described real estate in St. Croix County, State o
Wisconsin: REC FEE: 11.00
TRANS FEE: 2880.
COPY FEE:
CERT COPY FEE:
PAGES: 1
Exception to warranties: all easements and restrictions of record
This is not homestead property.
Parcel Identification Number(s): 20- 1109 -40 -000; 20- 11 -9 -20 -010; 20-
1109 -10 -000; and 20- 11 -90 -55 -000
Name and �o s• t0:
A parcel of land located in part of the Southeast V. of the Edina ealty Title
Northwest 1/4 , part of the Southwest 1/4 of the Northwest 400 South 2nd Street
1/4 , part of the Northeast 1/4 of the Southwest1/4, and part Suite #115
of the Northwest 1/4 of the Southwest 1/4, all in Section 36, j s on, WI 54016
Township 29 North, Range 19 West, Town of Hudson, St. 1`)18r J
Croix County, Wisconsin described as follows:
Commencing at the South % corner of said Section 36; the ce North 00 degrees 10 minutes, 01 seconds West
along the north-south 1/4 line, 1634.77 feet to the Northeast orner of a parcel of land described in Volume 526,
page 259 at the St. Croix County Register of Deeds Office, being the point of beginning; thence continuing
North 00 degrees, 10 minutes, 01 seconds West along said orth - South ' /< line, 1977.22 feet to the South line of
the North 350 feet of said Southeast %4 of the Northwest 1/4; thence South 88 degrees, 49 minutes, 51 seconds
West, along said South line and the Westerly extension of -aid line, 1324.14 feet; thence South 00 degrees, 09
minutes, 43 seconds East 2,096.73 feet to the centerline of ounty Trunk Highway "N" being a point on
1,999.00 foot radius curve, concave southerly, whose central angle measures 03 degrees, 00 minutes, 19
seconds, whose chord bears South 80 degrees, 02 minutes, ► 1.5 seconds East and measures 104.84 feet; thence
Easterly, along the arc of said curve and centerline, 104.85 feet to the point of tangency; thence South 78
degrees, 32 minutes, 12 seconds East along said centerline, 712.54 feet to the West line of said parcel described
in Volume 526, Page 259, thence North 00 degrees, 10 ' utes, 01 seconds West along said West line 304.75
feet to the North line of said parcel; thence North 89 degre: s, 49 minutes, 59 seconds East along said North line
523.00 feet to the point of beginning, all in Section 36, To . hip 29 North, Range 19 West, St. Croix County,
Wisconsin.
tk
Dated this .,/ day of JC (i. , 2003.
N ....... A
f,7evig, lcoxson Mary J. Wi( • on \
ACKNOWLED MENT .<5;;;.2.4;
STATE OF WISCONSIN ) 1 P(/eiil4.
COUNTY OF ST. CROIX ) -tL- "p ref f l
Personally came before me this.` day of J(»7 ; 200c, the above . -med Neil L. WiIcox3of d Mary .
VA
Wilcoxson to me known to be the persons who executed th fo oin. instrume - acknowledge the 4mme A. * -r
�- PRESTON
Nota Public /p _� �, 2
My commission = xpires: � J, i W
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