HomeMy WebLinkAbout022-1054-80-075 \ � 2 \ �
$ 0
�
f U) �
} ) �
# ® o
CD
E
2 iR
o
C D 0
\
$ } 22
2 ®�(
) \ 7
E )tom
) � �
« E �
C2 w E
. �
to ) J �
_ § § IL rn
B z
t $ J \ D
q w = e Q
. D M 2
! \ / D
. �
D
Q zEz
. 7 $ i
C ■ `
/ q § CL k \
§ _ / g k m k #
°
-� k \ a a a .7
§ & ƒ y
$ v ) k § /
z ) § f ® ° k /
$ c e g\ E q $
f . � CO CL
_ 2 4 A \ a
■
B
5 2 G k ~@ E
It e & -- & 7 E m
§§ G« « ƒ� t u� 8 8 8 8
m 0 ` _ Q g g g
a } / ® E § ( = z § § § I
& \ k \ ) § )
'� ) 2} j R o )£ k
�
J$ m i k C
, / \ - � #
E ' § k a §
/ 3 a \ 3 $ 3
r
-Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Y'
Safety and Buildings Division Count St. Croix
• INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT) SanitaryImwo.:
Personal information you provice may be used for secondary purposes [Privacy Law, S. 15.04 (1)(m)]. �ll1l� 7
Permit Holder Name: ❑ City ❑ Vi o w OWriSh State Plan ID No.:
Larson, Todd K
— Z66 CST BM Elev. - - Insp. BM Elev.: BM Description: Parcel T�tt No
1055 -10 -000
/do 1 40 o Gl
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Z Benchmark rU l0
• __ _� t. O �
Aeration Bldg. Sewer b . 3 2
Holding 59 Ht Inlet �,�� �0
TANK SETBACK INFORMATION (01-It Outlet YZ 1 �, 3 6
TANKTO P/L WELL BLDG. Ventto ROAD
Air Intake
Septic -� 30� �2 �219b 7260' NA 111 -Beffeffl
" "- NA Header/ Man.
L
Aeration - Dist. Pipe , Zc
t .o /. o°
Holding Bot. System o
PUMP / SIPHON INFORMATION Final Grade
MamLt acturer Demand St cover
Model Number G 0 _ m
TDH Lift / Friction SY TDH Ft Q Z P. 2-1 _ 121 . 3y 2 3,12
L oss ead Forc ain I Length Dia. H Dist. To
SOIL AB ORPTION SYSTEM - 2 v
BED / Width Le gth No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIM 3 Z Z DIMENSION
SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACIMUG Manu tu,er: o /
INFORMATION Type O .�- // / AMBE Mof el Number:
System: U 2 o" O Jt
'94 r
DISTRIBUTION SYSTEM
Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length ¢/D Dia. Y r � Length QS r Dia. � Spacing � / �Q
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched
Bed /Trench Center Bed/ Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #l: 4 11Z1 161 Inspection #2•
Location: 220 Highway 65N, River Falls, WI 54022 (SW 1/4 SE 1/4 19 T28N R18W) - 1928183 A -Lot 1 /
1.) Alt BM Description = Pj;o door Sd y) ��� � S�e� (� > r / tw_ o c 1fAr
2.) Bldg sewer length = 2 -1,Sr " `
- amount of cover = -7 Y a `, - ) ' r"'L �'� c' "r�✓ Cli�ee,- f
5"e
Plan revision required? (:]Yes 0 No
Use other side for additional information. W W11- ri
SBD -6710 (R.3/97) Date Inspector's nature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER: .
t
� 7
5 1
z �
i
i
I
N Q
" ",, 6 �. a
I
Sanitary Permit Application Safety &Buildings Division
In accord with Comm 83.21. Wis. Adm. Code 201 W. Washington Ave.
I See reverse side for instructions for completing this application PO Box 7302
�� seonsin Personal information you provide may be used for secondary purposes Madison. WI 53707 - 7302
Department of Commerce
[[Privacy Law. s. 15.04(I)(m7); ,— (Submit completed form to county if not
1 i? 4 ' state owned.)
Attach eom fete plans (to the county copy only) for the. " •dh a er n s th 8 - 1/2 x 11 inches in size.
County / State Sanitary PermiLNumber ❑ Cheek i ision to p)? , State Plan 1. D. Number
1. Application Information - Please Print all Information ' '' t.ocation:
Property Owner Name _.. a Property Location
` J
1/4 ,6�1/4, S ,N, or
Property Owner's Mailing Address /Lot Number Block Number
117 e*7 4Z
j
City, State Zip Code Phone NL bjr' _.- - \ Subdivision Name 6LCShjjumber
II Type of Building: (check one) ❑ City Mi
- 1 or 2 Family Dwelling - No. of Bed rooms: 1/ Pvt ❑Village
• Public /Commercial (describe use): Town f
• State -owned R J�wl i
1 Type of Permit: (Check only one box on litre A. Check box on line B if applicable) Nearest oqd
A) 1 1. ❑ New System 2. Replacement 3. ❑ Replacement of 4. ❑ Addition to Parcel ax N er(s)
System Tank Only Existing System : — -U00
B) Permit Number Bate 1"tied I� 3
❑ A Sanitary Permit was previously issued I °/• a
IV Type of POWT System: (Check all that apply)
n- 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 Dis ersal/I'reatment Area Information: S' - P'rl L,0 f
1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade
Require P Pr r� 7ateals./day/s Elevation
A.) (Min. /inch) � �'d ; fi e �-
VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic
Information Gallons Gallons Tanks Con- Con- glass
New Existing crete structed
Tanks Tanks
Z62;�
L
VII Responsibility Statement
I, the undersigned, assume responsibility for install n ofithe shown on the attached plans.
Plumber's re (print) Plumber's g r (nos mps): MP/MPRS No. ! Business Phone Number
Plumber's Address (Street, City, State, Zip e)
VIII County/Department Use Only
❑ Disapproved Sanitary Permit Fee (Includes Groundwater D72 ed 1 ent Signature (No stamps)
proved ❑ Owner Given Initial Adverse Surcharge Fee)
YAp d�
Determination `l 16
IX. Conditions of Approval /Reasons for Disappro _- "/
Sfr� �tw �e (� c•. .., ,rf /o c w �. .C� vH - h"K, �{��itd S �e
No �td:,h�►,. w� wtR <to.,,, �t (of pek DoT sit "
SBD -6398 (R. 07/00)
PLOT PLAN
PROJECT Todd larson ADDRESs 220 Hwv 65 N River FaIIs Wi 54022
SW 1 SE 1 / 4S 19 /T 2 / 18 w TOWN Kinnickinnic COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE /31/00 BEDROOM 4
CONVENTIONAL XXX IN- PRE SURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE
1260 LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .9 ABSORPTION AREA 688 # of chambers 40
BENCHMARK V.R.P. Top of White Stake with Orange
ASSUME ELEVATION 100 Filter Zabel A -100
❑ BOREHOLE O WELL *H.R.P. Same aS Benchmark
SYSTEM ELEVATION 91.9
Alt. BM Top of White Stake @ 100.6'
300' Property Line
15' Alm Pro 4
Bedroom
15' House
B.M. 100'
15' S0'
96' B -2 60' 60' B -1 200' ,
Vents 125'
95' 75'
6% Vents
Slope B -3
94' D W 10' Existing
House
0' to be torn
2 -3' X 125' Cells down
with >3' Spacing
Site does not
have a well,
but a cistern
a�
Vent
> 12" Sidewinder High
of Cover Capacity Leaching
Chamber
° 16"
6' Long
3415 Grade at System Elevation
Highway 65
Wisconsin Department of Commerce SOIL EVALUATION REPORT
Division of safety and Buildings Page of,�
in accordance with Comm 8s, wis. Adm. Code County
Attach complete site plan on paper not less than 8 1/2 x 11 Inches in size. Plan must �/ Ie-
Include, but not limited to: vertical and horizontal reference point (BM), diredlon and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D.
a -
Please print ail information. Re awed to
Personal informadon you P►Ovide may be used for secondary PurPoses (Privacy Law, s. 15.04 (1) (m)),
Property Owner
Property Location
Property Owner's Mai�g Address Govt Lot 1/4S 1/4 S T N R E (
Lot # I Mock # Subd. Name or CSW
„n WA Zip Code Phone Number ❑ City ❑ Village QTown Nearest Road
❑ New Conshx#on UseiWIResidential / Number of bedrooms Code derived d _
esign flow rate � �r7'/s GPD
eplacement Public or mercial - Describe:
Parent material Flood Plain elevation if pplirable - /1/ J ft,
General comments
and ►ecanmendation$;.�[��,/G,,� fG/ � ��� � � � �� r l —�-
// (oa
o Bodrig # r ❑ gyp so
ICt Pit Ground surface elev, Z Depth to limiting factor in.
Soil ApdIcatlon Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD
in. Munsell O.u. Sz. Cont. Color Gr. Sz. Sh. •Efr#1 •Eff#2
6 .-n e
Boring # ❑ Boring
Pit Ground surface elev. -:�/ft. Depth to limiting factor In. !*E ff#i Rabe
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDN In. Munsell Ou. Sz. Cont. Color Or. Sz. Sh. •Etf#2
Jl
I
" Effluent #1 = BCD > 30 <_ 220 ffKdL and TSS >30 i 150 • Effiuent 02 = BOD 130 mg/L and TSS = 30 mgfL
CST No Prk�t) J hi
Address
Date Evaluation Conducted Telephone Number
Prop" Owww Parcel ID # Page of
F -D] Boring # ❑ Boring
M Pit Ground surface elev��4 k Depth to limiting tactor --�= — in. soli App IM,ation Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW
in, Munsel Ou. Sz. Cont. Color Gr. Sz. Sh. • Eff#1 I 'Eff#2
CJ /L z . 07 . - .T
!�
a- la& s/ s' �v .
a ��
D Boring # ❑ Boring
❑ pit Ground surface elev. R. Depth to limiting factor In.
Soil Apiplicadon Rate
Horizon Depth Dominant Color Redox Desor#ion Texture Structure Consistence Boundary Roots GPD1YF
In. Munseli Ou. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2
D Boring # ° Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Sop AWNCOdon Rabe
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPON
In. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Effrf2
Effluent #1 = BOD, > 30 _< 220 rnglL and TSS 2 160 mg& • Eftkrerd #2 = SOD, 130 nV& and TSS 130 mg1L
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.
WD•3330 (R.6=)
Soil Test Plot Plan
Project Name Todd Larson Shaun.
Address 220 Hwy 65 N
River Falls Wi 54022 #226900
Lot Subdivision -- --- -- Date 10/31 /00
SW 1/4 SE 1/4S 19 T 28 N /13 W
Township iGnniddnnic
F1 Boring Q Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of White Stake with Orange Ribbon
System Elevation 91.9 *HRP Same as Benchmark
Alt. BM Top of White Stake @ 100.6'
300' Property Line
15' Alt Pro 4
Bedroom
15' * House
B.M.
15 50'
96' B -2 60' 60' B "1 200'
25'
95' 1 75'
6%
94' Slope B -3 DW 10' Existing
House
0' to be torn
down
Site does not
have a well,
but a cistern
a�
a
a�
a
0
0
M
Highway 65
�- 3 Cw -
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of
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 r LV
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. 0 z z -
Please print all information. Reviewed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner Property Location
,,` Govt. Lot 1/4 1/4 S T N R E (or) W
Property Owner's Mailing Address Lot # I Block # Subd. Name or CSM#
Z-2- D /� 6-�
City r
y State Zip Code Phone Number ❑ City C3 Village ❑ Town Nearest Road
7vr a &c Z I Sy62- Z I ( )
❑ New Construction Use: ❑ Residential / Number of bedrooms Code derived design flow rate GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material Flood Plain elevation if applicable ft.
General comments
and recommendations:
F T] ❑ Boring rl
Boring # 3
Pit Ground surface elev. ft. Depth to limiting factor in.
Soil ication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff #2
�- v I/
s bo
Sy Zcsd�C ,s ,9
5L
oy
y 3 - O Z G c5 g
�7a ♦' w 0
A C r Se o e JIA r t`Ole
F-1 Boring # � Boring El Pit Ground surface elev. ft. Depth to limiting factor in.
Soil ication 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
• Effluent #1 = BOD > 30 1 220 mg/L and TSS >30 1 150 mg/L • Effluent #2 = BOO 1 30 mg/L and TSS 1 30 mg/L
CST Name (Please Print) Si nature CST Number
Jo So e'4' G6
Address Date Evaluation Conducted Telephone Number
/ Z o0
/0 3 0, r" - //: do a,�-
Property Owner _ Parcel ID # Page of
Ong # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Appli cetion 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
a Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Appli cetion 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
F-1 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
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.
SOD4330 QW00)
�I
s
.a
I Cr,
F
J � n
16 I
r
' � r ul Idi�ll k a�.
a'
I �
IG I II 6
4 s a
rr
Ilm
y p wu
1 I
u
s. I
i
I,
I�u I l
1
100 0 100 200 Feet
r'
Private Onsite Wastewater Treatment System Management Plan
Septic Tank And Gravity In- Ground Soil Absorption Component
Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment
System (POWTS) shall include information and procedures for maintaining the system within
the parameters of Comm 83 and 84, and the conditions of approval by the department, agent,
or governmental unit. The approved plans and permits for system are on file at the county
zoning or health department.
This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground
Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD-
10567 -P (R.6/99).
Table 1: System Design Specifications
Sanitary Permit Number 3
Number of Bedrooms
Design Flow - Peak (gpd)
Estimated Flow - Average (gpd) .
Septic Tank Capacity (gal) o1co0 6j
Soil Absorption Component Size (W) �f$
Type of Wastewater Domestic
Table 2: Soil Absorption Component - Limits of Reliable Operation
Septic Tank Component Soil Absorpti n Component
Design Flow - Peak (gpd) I&-( p
Maximum Influent Particle Size (in) V 1/8
Maximum BOD (mg /L) 220
Maximum TSS (mg /L) 150 777 ��
Table 3: Maintenance Schedule
Septic Tank Inspect and /or service once every 3 years
Outlet Filter Inspect once a year and clean at least once every 3 years
Soil Absorption Component Inspect once every 3 years
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks
under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with
NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease
Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable
Restrooms).
The operating condition of the septic tank and outlet filter shall be assessed at least
once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure
proper operation. The filter cartridge should not be removed unless provisions are made to
retain solids in the tank that may slough off the filter when removed from its enclosure. If the
Management Plan for a Septic Tank and Soil Absorption Component
filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously.
Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The
septic tank shall have its contents removed when the volume of scum and sludge in the tank
exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the
time of an assessment, maintenance personnel shall advise the owner of when the next service
needs to be performed to maintain less than maximum scum and sludge accumulation in the
tank.
Manhole risers, access risers and covers should be inspected for water tightness and
soundness. Access openings used for service and assessment shall be sealed watertight upon
the completion of service. Any opening deemed unsound, defective, or subject to failure must
be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by
an effective locking device to prevent accidental or unauthorized entry into the tank.
No one should enter a septic or other treatment or holding tank for
any reason without being in full compliance with OSHA standards for
entering a confined space. The atmosphere within the. septic or other
treatment of holding tank may contain lethal gases, and rescue of a
person from the interior of the tank maybe difficult or impossible.
Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the.
tank is no longer used as a POWTS component.
Soil Absorption Component
The soil absorption component serving this structure is designed to accept domestic
wastewater from a residential facility. The limits of operation of this component are shown in
Table 2.
The longevity of a soil absorption component depends greatly on proper and timely
maintenance and system use within or below the limits of reliable operation. Good water
conservation practices by all occupants and the installation of water conserving plumbing
fixtures are key factors in extending the useful life of this component.
The soil absorption component's operation must be assessed by inspection at least
once every three years. The inspection shall include recording the levels of ponding, if any, in
the observation pipes, and a visual inspection for any evidence of surface seepage or discharge
from the component. On steeply sloping sites, areas of erosion should be identified and
reported to the owner for repair. The surface discharge of domestic wastewater or sewage
from the system is prohibited and considered a human health hazard.
Traffic around or over the soil absorption component should be avoided particularly
during winter months. The compaction or removal of snow cover over the component may lead
to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or
impossible to repair until weather conditions improve. In general, soil compaction over this
component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to
more intense, and earlier, organic clogging of the soil.
2
- Management Plan for a Septic Tank and Soil Absorption Component
Plantings of deep- rooted trees and shrubs directly over or within ten feet of the
component should be avoided since root intrusion into the component may obstruct wastewater
flow.
3
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT`
AND
OWNERSHIP CERTIFICATION FORM
f
Owner/Buyer
Mailing Address 0 C>L d �P J
Property Address /�.c�r 1l C� <:�LZU a-
(Verification required from planning Department for new construction)
City/State Parcel Identification Number
LEGAL DESCRIPTION
Property Location Se c- '1 ' /,, Sec. LY--, T
j W, Town of rLJ
Subdivision Lot #
Certified Survey a # ,�-
Y P {✓ Volume . Page #
Warranty Deed Volume / — ' / /L- -� Page # �
I
Spec house O yes no Lot lines identifiable, s O no
SYSTEM MAiNTit: MCE
Improper use and maintenanx of your septic system couldresult 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 is the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system
is in proper operating condition and/or �2) after inspection and pumping (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 maintain the private sewage disposal system with the standards
set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification
stating that your septic sygezn has bees maintained must be completed and returned to the St. Croix County Zoning Office within 30
days of the throe year expiration date.
w 12-1 c3rO
SIGNATURE OF AJPPLIQkNT
BATE
OWNER GERM AMN
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 in Register of Deeds Office.
ril -I , �94�. n 01/0 1 / / 2- ts°
SIGNATURE CW APPLICANT DATE
« « « « *« Amy information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * **
** Include with this apPlicattion: a stamped warranty deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
i
`k 3 1r STA1L RAR OF wV �'R \1 2 - IUBt2
Q \VARRANIY 1)P.FD
L)OC M:.4T r.0 . :IL It i s ,
,- ?8
Nary Pat Elsen, Dale Johnson_,, Susan 5utheimv -r— _
acid Jean Moelter, an undivided one fuurt'n jiltere.st _ _ MAY 1 7
each _ - -- 9:30 A.
- Todd M._Larson, -a ngie peravn -- _
'mr�, MAI Harruu:'u 1
_ _ -_ - St. Croix -- -- C,�t ;�•. River F�i11s State Ban
Chef „I m,nv, ....<�; rata.: __ -- _ -- — Attn: Julie
�t..,e , t t'. rurvsitt i' 0 Box 89
River Falls WL 54022
T �FER _
FEE
Part of SW 1/4 of SE 1/4 of Section 19 -28 -18 lying West of State Trunk Highway "65”
EXCEPT the South 182 feet thereof.
Part of NW 1/4 of SE 1/4 of Section 19 -28 -18 lying West of State Trunk Highway "65" and
South of County Trunk Highway "SS" EXCEPT Lot 1 of Certified Survey `lap in Volume
page 237.
Y :.
4 ,
b
This _ is not homestead pronem
is not)
I, Exception to warrannes
easements, restrictions and rights of w.., of record, if .,:T.."
n
da of May .AD, ly 96•
Dated this _ Y BEA
--- - - - - -- - -- - -- - -- ti
U
(SEAL)
- - -- U �Q .
Mar at Elsen
an Suthe' e
- —
ISEAU _ s2 s (SEAL)
„ �`
• Dale Johns aka Dale E. Johnson ean - aka Jea A. Moelt a
9
AUTIIENTICATION ACKNOWLEDGMENT r"
..,,
Mar at Elsen, Dale Johnson, State o f Wisconsin. p i
" Signaiure(s) _ y t F
Susan Sutheimer ii Jean Moelter
Count}' i
31 )" � da f Ma y 19 96 Personally came txfore me this day of
R authrnticated tMsnn } fy__, the above named
CJ
� (ose h D. Boles -- - -- -- - _ -
TITLE MEMBER STATE BAR OF \47SCONSIN - -- —
(If not. - — - — - -- -
aut5on_ed by § 706 06, Wis. Scats.) to me 'Known to be the Person who executed the fotegomg
instrument and acknowledge :he same.
THIS INSTRUMENT WAS DRAFTED BY ;
Joseph D. Boles - Attorney at Law _ — --
River Fa lls, WI 54022 (715) 425 -7281 Notary Public, __ —_ _ Count \'is
(Signatures may be authenticated or acknowledged Both are not M commission is f%cur.an 19- date
ent (If not -state expir
, 19_ )
necessary)
t
• Name, o ary :apa.uv should be taped or rented bz_ .he�o ata:es • ,,assn _may earv Cn .�
STATE BAR OF AISCONSIN W a�. 'r,
WARRANTY DEED Form No. 2 - 1982
� D
0
E `IOR' s REC l l
,��� C p.. SU
IFIED SURVEY MAP
:bO - o' Todd Larson
/4 of the Southeast 1/4 a nd the Northwest 1/4 of thWisconsest 1/4, Section 19,
Located in the Southwest 1 Town of Kinnickinnic, St. Croix County, n
T28N,R18W,
NORTH OVARTERCORNER D.O.T. Approva`ll/ 55 -65- 2824'1999
SECTION 19, T 28 N, R /8 W (/IVPL ATTED �` (• ANDS
r f8ERNTSEN MONUMENT) 0,11
r { QWN�Q
B 0
A, 4 Aj �� Hig setback restrictions
I
FOUND I�' 1l�ON PIPF�� � �° y QZ.a �� �QO�• prohibi imprgvements.
se9.3s 20 w 3.IS M .r 2 �c� • `•'�ccp (See Sheet 31
FROM MON.SET I Q 0 .�S
N 9.37 23 E 566 73 70 •
2 �$
} 470.03
4 69.44' '33.00' " Q� :.• 5
, -
N 89.37 23 E 3 D /
d a� _
6.
( 010
/ C
Q %4
ev
04 A ,dry -k�
40 4, �TF
2/ .O N89.43 00 W D �� 6 'a.� �. �e7, �jp,��'QiV�•R� .4
N89•38'20 "E t'
0 1RffSa9.02'40fiE) N �LQ'T 3 D ,�U 7 s
E
5, AbrE tiT
8 I � h
; •/-/�''� /� � 4 •A�,'� �
O i/ �• J
LOT i 1 r
An erosion control plan 2 ��i %�, %, NOTE -
.�
� See Sheet for
will be required on a111 11 , el 9 �`t' fn ei dua/ lot areas.
Lots 2,3 and 4 68 , g2 / M
W �\\�\
m prior to N 100 *. ' �/ / A
a Co nstruction. • 0.1 C1
W
01 a d' �? y �� OWNERS ADDRESS
O L
s o•? 220 HWY. 65 N.
a �Q ��,j e4 �1 RIVER.FALLS, Wt.
Cal z
� 1 7 e Z s yb n ��• �/ r Q 300
Scale in Feet 1 =
r y J, o I
. ' 05
0 100 200 300 600
{ e Bearin s are referenced to the North-South
s ` 1 Quart f Section lin o Section assu 19,med
LE� GEN bearing NO 0 23 ' 41 " W
Indicates I" x 24 Iron Pipe Set
CAI ;• �� 0 (Min. Wt.-1. lb. /tin. ft.)
I •
Indicates 1" Iron Pipe Found
Indicates Fence
At /� v! (R- j Recorded as
W j i00, ♦ Proposed Driveway Location ,11111111x1
{� 0%, tiI
• / O Soil Boring rye/
a: / V V ��
LA Ono
h // �' " (• W RPHY c
Dated June 17, 1999 m
3. Revised Sept. 17, 1999 + +; 1713 = >
40 it 8 Revised Oct. 5, 1999 ' N RIVER FALLS,
y s a e * � J ar F9 WISC.
$02-4 APPROVED , 4 LAND
• •
\ ���a I•so ST. CROIXCOUNTY ee j1j1s1 /a ss `
\ Planning Zoning and Parks Committee
SOUTH OUT2BA ER CORNER
EC. 19,N,R /B
S �y
/8ERNTSEN MONUMENTI FEB Q 9 2000
SHEET 1 OF
nt Drafted by Mark W. Peavey It not recorded within 30 da O V01.14 Page 3806
This lnsirume approval date appro ...•
w .. ., .., . r. �,.. r.++...• r. ri+. ys, o-Y :,'r.h+..'.+s.w;ur�•1}�l�N�` .: . ..... .. .. .... .••s!•.r•^^•'.Krr•'nrn+•'r..'.. ..,,.. .,.. ,,, ..
ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
....r ST. CROIX COUNTY GOVERNMENT CENTER
�rrrrrrr■ --
1101 Carmichael Road
+..'
Hudson, W154016 -7710
s (715) 386 -4680 Fax (715) 386 -4686
November 14, 2000
Todd Larson
220 STH 65
River Falls, WI 54022
RE: Replacement Structure
Dear Mr. Larson:
Per our conversation on November 7 1 understand that you are seeking approval
to continue to reside in your existing residence while you construct a new single
family residence on your parcel.
According to a signed statement dated November 8, 2000 you indicated that you
are constructing a new single family home to replace the existing residence. You
also indicated that you will remove the existing residence by June of 2001.
Pursuant to section 17.15 (1) d., you allowed one single - family residence per
parcel. The sanitary permit for the new residence was issued on November 7th,
with the following condition: The existing residence must be removed immediately
upon completion of the new residence. Therefore, you are allowed to live in the
existing residence while you construct your replacement residence and remove it
once the new residence is completed.
If you have any questions concerning this, please call our office at (715) 386 -4680.
Sincerely,
Rod Eslinger
Zoning Specialist
Cc: Town of Kinnickinnic, Carol Hoopman, Clerk
Government Center
1101 Carmichael Road
Hudson, WI 54016 St. Croix County
715 - 386 -4680 phone Zoning Department
715 - 386 -4686 fax
Fcnx
To: Ca Hoopman From: Rod Esling
Fax: i25 1 0488 Pages: 1
Phone: 425 -2796 Date: 11/14/00
Re: Larson property CC:
❑ Urgent x For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle
Call if you have questions.
,-�, r� ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
`.
IBM r r r r r „„ ST. CROIX COUNTY GOVERNMENT CENTER
- - -- 1101 Carmichael Road
Hudson, WI 54016 -7710
-- - ! —� (715) 386 -4680 Fax (715) 386 -4686
November 14, 2000
Todd Larson
220 STH 65
River Falls, WI 54022
RE: Replacement Structure
Dear Mr. Larson:
Per our conversation on November 7 1 understand that you are seeking approval
to continue to reside in your existing residence while you construct a new single
family residence on your parcel.
According to a signed statement dated November 8, 2000 you indicated that you
are constructing a new single family home to replace the existing residence. You
also indicated that you will remove the existing residence by June of 2001.
Pursuant to section 17.15 (1) d., you allowed one single - family residence per
parcel. The sanitary permit for the new residence was issued on November 7th,
with the following condition: The existing residence must be removed immediately
upon completion of the new residence. Therefore, you are allowed to live in the
existing residence while you construct your replacement residence and remove it
once the new residence is completed.
If you have any questions concerning this, please call our office at (715) 386 -4680.
Sincerely,
Rod Eslinger
Zoning Specialist
- Town of Kinnickinnic, Carol Hoopman, Clerk