Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
022-1054-80-100
*( consin Department of Commerce PRIVATE SEWAGE SYSTEM Count Safety and Buildings Division INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 363958 Permit Holder's Name: ❑ City ❑ Village ❑ lown of: State Plan ID No.: Kinnickinnic Townshi C 8M Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: / 1 l ao 1 4, a 0 Q j 022- 1054 -80 -100 TANK INFORMATION ELEVATION DATA 33H C. R d SS TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 20 Benchmark pa av Alt. BM Aeration Bldg. Sewer 3 Z r HoIdin t Ht Inlet " TANK SETBACK INFORMATION 9/ Ht Outlet Ventto TANK TO P/ L WELL BLDG. Air Intake ROAD Septic NA i Dosing NA Header/ Man. Z Aeration NA Dist. Pipe . Holdi Bot. System >z S ;;y PUMP/ SIPHON INFORMATION Final Grade X 3,le - -Manu facturer Dem d St cover - 5.0S — Model Number GP Friction stem TDH Li L e TDH F oss F iocemain Length Dia. D_,, . wen SOIL ABSORPTION SYSTEM BED / RENC Width Length No Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMEN DI SETBACK SYSTEM TO P/ L BLDG WELL LAKE /STREAM LEA ufacturer. INFORMATION Type O CHA R o umber: System: e tA Q UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipes) x Hole Size x Hole Spacing Vent To Air Intake Length �— Dia. Length 4- "' Dia. Sr Spacing 3.S - Z 3 Z 2 Z72 — SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over [ Bed th Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Infection #1: ,? l (a lba Inspection #2: Location: 234 Coun ty Road SS, River Falls WI 54022 (NW 1/4 SE 1/4 19 T28N R18W) - 192818302A10 -Lot 2 1.) Alt BM Description= 7a%o a 4,Hda7,-� L •, rock 2.) Bldg sewer length = (h ,f - amount of cover =rKur( kao l ld" o -r e e uev l� 3a t- d (t^ klf K/eG_- lz� 3 >trtr -C��5I 3) 30 0� efrlaed 4h4- e�_Xfead o� z Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: e i r I _ E _ 1 1 e _ � f r e j i r 3 s _ = _ c x a = a E E i i F e� h 4 F e e i _ fi *` Safety and Buildings Division V i sconsin SANITARY PERMIT AP TION 201 W. Washington Avenue P O Box 7162 In accord with Comm 83 a Madison, Department of Commerce , � so , WI 53707 -7162 • Attach complete plans (to the county copy only) for the ' o n�a W O N not s, County than 8 v2 x 11 inches in size. • See reverse side for instructions for completing this a Rion `` 2QQQ to Sanitary Permit Number 4 36 3 -1,5 Personal information you provide may be used for secondary purposes \�� Con, if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. O S�ut1 `GE to Plan Review Transaction Number I. APPLICATION INFORMATION - PLEASE PRINT 0 0 Property er e S e „p A 6 PT °p A, 5 ? "T Q , N, Re (o� Propert y O r' ili g Addr G (f � r Block Number Cit t e ' Zi P Number Subdivision Name or CSM Number A'. II. 7YPE Or (check one) ❑ State Owned ❑ !t 1 Nearest Road f!� Public 1 or 2 Family Dwelling 13 Village - No. of bedrooms Town OF lll t� Ft imic 111. BUILDIN USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 E] Apartment/ Condo 1q. 29. [' 7 $02,4 - 10 0 a 2- / L o 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ epairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1, N 2. ❑ Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an System ________System _ Tank Only Existing xisting System ________ Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 3 ❑ Specify Type 41 ❑ Holding Tank 12 Seepage Trench 22 In- Ground Pressure 42 ❑ Pit Privy 13 Seepage Pit -- 5;,�) 3� ❑ Vault Privy 14 [] System-In-Fill 3 13 L VI. ABSORPTIONS STEM INFORMATION: , 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Req il;p ( 1. ft.) Propose-id (s ft.) (Gals/day/ (Min. /in ) El v do �r Feet r Feet Capacit VII. TANK in Ca allons g Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Existing strutted Tanks Tanks Septic Tank or Holding Tank S r Pets ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ 1 ❑ 1 ❑ 1 ❑ ❑ VIII. RESPONSIBILITY STATEMENT 1, the undersigned, assume res onsibili f r installation of the onsite sews a tem shown on the attached plans. 9 p 9 P Plgmber's Name: (Print PI be Signature: (No ps) MP/ PRSW N Business Phone Number: eM h Plum r' gdd ss (Street, C' to ip C �: w [ t ( v- IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater D ate Issued Issuing Agent Signature (No Stamps) ' AApproved ❑ Owner Given Initial Surcharge Fee) © ` Adverse Determination�� X. CONDITIONS OF APPROVAL / REASO S FOR DISAPPROVAL: A .*S t ,E,r. ..ttie BD -639$ (R.12/99) DISTRIBUTION: Origirkfl to County, One copy To: Safety 6 Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. -4 2. Your sanitary perrnitmaybe renewed j5efore the e' x - ion date; and at a time of renewal any new criteria in the Wisconsin Administrative Code wilTbe apotViAble. - 3. All revisions to this permit must beiapproved byAhe..perniit issuing authority. 4. Changes in ownership or plumber regru�es a'Sani Perm 'Trapsfer / Renewal Form (SBD - 6399) to be submitted to the county prior to installation r , 5. Onsitie sewage systems must be properly raided These ptic tank(s) must be pumped by a licensed pumperwh never necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608 =266 -3151. To be complete and accurate this sanitary permit application ust include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. r, IX. County/ Department Use Only. ` X. County / Department Use Only. Comp'ete plans and specifications not smaller than 81/2 x 11 inches must be submitted -to the county. The plans must include the following: A) plot plan, drawn-to scale or with complete dimensions, location of holding tank(s), septic tank(s)' or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form, and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation•of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. v g - /� a Pot�w� t ,S��V1� bp.0 �lo` 3 �,l�oG� �� (y�� 03�` � �� • a rx k X AND to ijlll,�k 7 fTTT - fl r � I c7 4 a r r •:a e y �y .f - f' F �•Ci+Y y r y PUS' 1 -1:11 Pa'ba 9 e : . _ _ c � � •s 4 § :<,�r 7 r a _`� :'t,�; "_.. -- -�''- M'�` - � 'r - i= - � -- f .r•,���,�' r �. a t• , a t M w r , ! J E 44 1 4 0 � +reN ellrs x w d 4� r 3 ��hr S 3 Alm bY, > so f )h S s. B g3 �° `�o�-a ► � f �a :?4 1, F; P 1 r� 3 f ed.�� V� Ti IS a' f ll / - f4W C cr c � ►n 5 ��� b Icy s ► ' ��101,vd`� p�GJ�i� 03� bY, B rw, fable �, r�� st4 �ro ee 0 lr � a P O j °�o �- via � 6 2 - EP 8. �s �� Tso,� Abu a. eve r� n S .VI D IJ4� 03 () �� y �c10 IAJr� f eAo ��U, 9S.S b�. ti rb dab e F evr ee "PUS Oa G rat 3 Ts I I Combination Sep -ta- c; Tank and PUMP CHAMBER CROSS SECTIOU. ARID SPECIFICATIOUS ' PAGE OF - VEUT CAP WEATHER PKOOIF JUUCTIOIJ 80X M'C.I. VENT PIPC APPROVED LOCKING 10' FROM DOOR. MAIJHOLE COVER k.- :jINDOW OR FRESH wARIJ1W6 1.P.6EC.. AL IEITAKE lr tj I " � � le•MIU. J8 "JKIAl. ---- ---- -- 4 "tuSPeM01a PIPe 11, - - - -- PROVIDE I - - - -- IW LE T 7AIRT(GHT SEAL. B APPROVED JOIruT A I APPROVED JOIIJT: W /C.T. PIPEaR Tank construction I ill W /C.=. PIPE we shall comply with i I y ALARM ILHR 833.15 and 83.20 d j i I Ow r 1 ELLV FT PUMP -1 . _ -J OFF O COAJC LETE 9LOCK 3" APPRovE RISER EXIT PLF MI - WED OIJL!J IF TAIJK 1AWLIFACTUREK HAS SUCH APPROVAL 1B E W IN46 BE•DD t NG SEPTIC F 5PECIFICAT10KIS DOSE I`�1tOwt�Sly p �t'3 T WUMgER OF DOSES: 3 • �O TI.IJK MAL► UFACTURCR: PER DAy TAWK SIZE: CALLOUS D05E VOLUME r ALARM MA►JUFACTURI<R: S • . `rZ-QcTi SYSTID IMCI- UDIME, BACKIFLOW: b 8.4 GALLONS MODEL DUMBER: CAPACITIES: A= IAJC14E50R LI20.0 GALLOIJS SWITCH TYPE: IUCHES`'OR G(LLOIJS PUMP MAMUFACTURCR: C- � IAICHES OR «'y CALLOUS MODEL MUMBER: 3821 �y� 0- S INCHES OR \: GALLOUL SWITCH TYPE: ZC_lJR �( JJOTE: PU MP AND ALARM AR TO 5C • D MIIJIMUM DISCHARGE RATE 3q. b GPM INSTALLED OAI SEPARATE CIRCUITS l VERTICAL DIFFEICENCE OETWEEIJ PUMP OFF AJJD.DISTRIBUTIow PIPE.. 1 / 7 FEET + M IIJ IMUM METWORK SUPPLY PRESSURE . . , . . .. . . . . ,� S O FE.!`T + FEET OF FORCE MAIM X `x F 0o FLFKICTIOU FALTOR FEET -- TOTAL OtIMMIC. HEAD = a ' I FEET Pump chamber DIAMETER - I IIJTERIJAI DIME.NSIOAI� OF TAAIK: LEAJGTH - .W IDTH . *LIQUID DEPTH BOTTOM AREA - 231= GAL /INCH AS PER MANUFACTURER = - GAL /INCH I Goulds Submersible Effluent Pump 3871 EPO4 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- • Homes components. Available for automatic and tic cover with integral handle • Farms Motor: manual operation. Automatic and float switch attachment • Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical points. • Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, built in overload with preset at the factory. rated oil and water resistant. automatic reset. ■ Bearings: Upper and lower SPECIFICATIONS • EP05 Single phase: 0.5 HP, FEATURES heavy duty ball bearing 115 V, 60 Hz, 1550 RPM, Pump: EPO4 built in overload with ■ EPO4 Impeller: Thermo- construction. • Solids handling capability: automatic reset. plastic Semi -open design 3 /4" maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. 0- Canadian Standards Association • Total heads: up to 24 feet. with three prong grounding E EP05 Impeller: Thermo- • Discharge size: 1 NPT. plug. Optional 20 foot (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in " or "AC.) rotary/ceramic- stationary, three prong grounding plug improved performance. " BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10- - • Capable of running dry without damage to 9 - 30 components. _ Pump: EP05 s — -- — - -- Solids handling capability: c 25 %" maximum. a 7- — W • Capacities: up to 60 GPM. s 20 • Total heads: up to 31 feet. • Discharge size: 1 NPT. z 5 - -- • Mechanical seal: carbon- 0 15 rotary/ceramic- stationary, 4 I BUNA -N elastomers. o - -- • Temperature: ~ 3 10 104 °F (40 °C) continuous 140 °F (60 °C) intermittent. 2 -�— -- 1 5 0 00 1 - 10 20 30 40 50 GPM L L L 0 2 4 6 8 10 12 m °/h CAPACITY Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of Labor•and Human Relations Div' * n of safety s Buildings in accord with ILHR 83.05, Wis. Adm. Code ' UNTY 6e, 09 sT . cA -k3kX s on a er no ess an / x 11 i es in size. Plan must in ude, but not limited to vertical and horizontal reference t n and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and dis �� ,a�e ro JOS 80 REYIEWED BY DATE APPLICANT INFORMATION - PLEAS NTALL INFOR PROPERTY OWNER: AROPERTYI ATION tiW 114 S\�i 1/4,S 1 9T Z$ ,N,R 1j) (or PROPERTY OWNER':S MAILING ADDRESSI- L T # BLOCK # SUBD. NAME OR CSM # 2.Z.p SZ'K'1 % 65 — �a�ost?t� cs►�1 CITY, STATE ZIP CODE PHONE IVIJ,tp(B R CITY E]VILLAGE WOWN NEAREST ROAD 7- lU et �G r Jrv1 C�rc 11� 111J 1 C L°`111 S S K New Construction Use { Residenti Addition to existing building [ J de Replacement [ J Public or commerq Code derived daily flow 1 SO gpd Recommended design loading rate — bed, gpd/ft S trench, gp0 Absorption area required �`3� S bed, ft 1 Sot) trench, ft Maximum design loading rate _ y _ bed, gpd$ S trench, gpd/ft Recommended infiltration surface elevation(s) ot S • S ft (as referred to site plan benchmar Additional design / site considerations S lEe ti16M '1� )Au Sl C'nJ tG(r 3 Parent material Lo e5 S oy )Oxz 0 %S4 Flood plain elevation, if applicable N A ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE I AT -GRADE SYSTEM IN FILL I HOLDING TANK U = Unsuitable fors stem IBS ❑ U R S ❑ U ®,S ❑ U (R S ❑ U ❑ S IRU [IS RU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bcurxiary Roots GPD /fit in. Munsell Ctu. Sz. Cont Color Gr. Sz. Sh. Bed ITrench .<: ) 0 - S tbti►i_ Z[ Z sl Z'F s b�T -5i:,N,•tii4V'.4 ::: Gam. S _3z Lb Litz- Ground 3 3Z -S3 �.s�tlz �1� — s� a1 s �sbk �l C •�f elev. ca- — 5 ft. S3 -6Z lwlfL, S/b Depth to S b? -Sn IW- iR S m b F1 — ,1 4 s • S limiting facta�py V_ .3! 1 �t w Remarks: Boring # s11 z S b . wt ti^ cLA.) -S - L -s§ �3 - Z8 lo`LfZ 311, SO Zht Sb1z wl�t- CJJ S l ' ` >. ,, . y 1 , S Ground elev. y ft 1 Depth to limiting fac e CS T Name: Please Print Arthur L. We erer Phone: 715- 425-0165 ! ress: egerer Soil Testing & Design Service -P.O. Box 74 River Falls,WI 54022 Signature: 99 , S Z Date: 3- .Z_q el CST Number220254 • .r PROPERTY OWNER SOIL DESCRIPTION REPORT Page ?'of 3 PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. �:� ,•••:� ; .� Bed ITtrich 3 c z -(z_ ................. z �► - Z� tu`'t2 �l(. 51� Zvn s�1-c wt`�1� Ctv � , S • � Ground 3 Z) -sb - S`1fZ 31Y C-S�k m V�` L S _ •�( . S elev. Il - ft. `1P We �S o 1oiV l- ,y •S Depth to limiting f > & VU Remarks: _ Boring # fix. y Ground 3 "b3 S vv 3/y S � � CSb1� lvt V �h e S • `( • S elev. \.f 63-70 \ R S! 6 — °l -� ft. S a Wlv .5 Depth to i limiting i factor i Remarks: Boring # I 0 -Q1 W�t2. 7-L 'L l O `f fz 31 6 1 S) 1 Zyn S 6t yr1 I- S S 3 Z -SLIP- 3/y s� �� rnv e_S - .�l ?.S Ground elev. y b6 � lu`1►z S/6 ��si c��, p y) — ,y .S ft. Depth to limiting factor s Re a s: Boring # Ground elev. ft. Depth to limiting factor Remarks: rnn oonnin )r n— PLOT PLAN Page 3 of 3 • SCALE 1"=L40 ' q- CTVA S S � 98.S '01,j Nf17L ✓ 16 rYBouE GROVn� t►v 8M { - -. Lp[) •p' p�1 111P OF' 3 A T'PrL . ~ stop 1 S)cvj AoJr f 3 �X 3" ` QLWW tZ.p.w.�os7 J f a " .3. X11 �E 3.Z t,v slyl u- 3 71u� 0-ttt-33 , L'`VCA S X I d0` t-1yv G h11Tti R GG fZL _. Gt2 A 3' x t o o' L0 , 06 w t� V-" G 4 Ct�'Pti1�l IY s t � N�1 «v p J�!R TU %Z kT L(�!* ST Z-5 ` Fiz o" `T1Z-�) C..tZS , k ��% _ Lor LWES Tp 3E f�T ULts r S' Fiz_jM 1 f1Z ►fit N`S . 1 q9_ sz ( 715 ) 475 -0165 14 00576 CST Signature Date Signed Telephone No. CST # Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page \ of Labor and Human Relations Division of Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8112 x 11 inches in size. Plan must include, but ST C��JC not limited to vertical and horizontal reference int BM direction and % of slope, scale or PARCEL I.D. # Po ( ). P e dimensioned, north arrow, and location and distance to nearest road. o Z Z_) APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REV DBY ATE ii PROPERTY OWNER: PROPERTY LOCATION GBVq. LOT- 114 114,S 19 T Z$ ,N,R lb E (a PROPERTY OWNER':S MAILING ADDRESS • LOT # I BLOCK # SLIGO. NAME OR CSM # ZZp ZV � Q,%M CITY, STATE ZIP CODE PHONE NUMBER []CITY ❑VILLAGE RrOWN NEAREST ROAD , f �,t.0 �, F x.1-3, W I Stu �.Z(1LS) 4ZS � 66 � � ►Jtv� Cam! 1.1�J1 C L` -`�1 S S New Construction Use [ Residential I Number of bedrooms S ( ] Additign to existing building [ j Replacement [ j Public or commercial describe Code derived daily flow 1 Sz gpd Recommended design loading rate — bed, gpdfft S trench, gpolft Absorption area required W'� S bed, ft 1 Sot) trench, ft Maximum design loading rate bed, 9 S trench, gpd/ft Recommended infiltration surface elevation(s) q S • S It (as referred to site plan benchmark) Additional design/ site considerations S NEe N CTty lb �- 3 Parent material U e5 S oy V!R SP��`i WJV-yP%Sl•] Flood plain elevation, if applicable N A It S = Suitable for system CONVENTIONAL I MOUND IN GROUND PRESSURE AT-GRADE SYSTEM IN RLL HOLDING TANK U = Unsuitable for s stem cgs ❑ U u s ❑ U IR ❑ U [R S ❑ U ❑ S [R U EIS RU SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon in. Munsell Ou. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Bed Toxh U 0 -1 1r3y2 Z/Z Z � 5 b� >h Z tS - 3Z lbLitZ Ground 3 3Z_S3 �•S`fR -'�1y — S, Q�S ��Sbk `MV'�1^ CiJ •4 •� elev. ` c n , S ft L-( S3 -6Z 10 `t R. S /✓o Depth to S b z-So If) ` -tvL limiting facto o � �'�S Ctu / u 8°s 3 0>- 3 C '�, Remarks: Boring # sit Z Fsb2 w►'�l- �v — - =; INS 1, Z € Z V) -28 1o4 tz 3P. — sib Zvi sbk 3 zg -6a S'ftz y ' s s _ ,y S Ground elev. 14 j It bo - t��2 61t; �S c�� Yrty - — •� . -S Depth to 1 limiting factor , Remarks: � S CST Name: — Please Print Pine Arthur L. We erer 715 425 -0165 egerer Soil Testing & Design Service - P.O. Box 74 River Falls,WI 54022 Sgnatue: / Date: 2 r CST Number: c-41 A ll L � - 71.� 9'9 3 -S j c ii 220254 PROPERTY OWNER t SOIL DESCRIPTION REPORT Page ?"of 3 PARCEL I.D. # 0 l 1 3 Sv - QED Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft $ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Treridt `v�;: .w< Z 1.1 -Z7 ll� ` 2 �� (. � S t 1 Z wt S 1pk Y✓1 `F 1� C.uv � � S - � Ground 3 Z1 -S$ 1 .S Y R 3Vy — S� ��S 1 C S�k mV e.S _ •�{ •S elev. 9 b-O ft. Io +`4 •s Depth to limiting fac or i > i i Remarks: Boring # qS Ground 3 S � wtv H �S +( elev. \4 63 �o oti S16 a �- rt. Y . Depth to limiting factor 7 d' Remarks: Boring # i 0— k's Lbtiz_ zCZ SU� 1 .3 L O ` IL. 3!s I Zvn S Ground - 3 - S K R 3/y S1 C S btk l," U 'Ff^ C,- - , ,I i 's elev. e ft. `� 66 �u ti2 s� i, �� q i's Depth to limiting factor . > - ) 1 4 1 Remarks: Boring # k wruas'�w� t Ground ' elev. ft. Depth to limiting factor Remarks: cnn ao�nin nr n� PLOT PLAN Page 3 of 3 SCALE 1 "= L4O ' S BM�Z -�L, 9B.So�v NPp� ib'' r7BouE 6¢_au� try 8Ml�) - �'Z-, IOq.O 011 SUP OF 3 �tt�. Q na R.O.W. Ltutz to q -4 a. I �l'� s.► eLq� 5 B .3 I I 1 hJ �'�'\ PCL- A 1•�'c� IS I Zp I Q SwU.. �!tkS , kav�CH S' x ! D0 Lk" kJ IT ri R f catZ �Tl S, cl� 3'x100' L1316 w� mG1+ P II StDN��n - R t1v� St TX3 % AVT LLVR ST Z's ` Fl " `T7LQVQ C L , Futi� l.or LwE s M aE p�T lk�tsT S' F Lo" 'MeNj . aq_ sz ( 715 ) 425-01 14 00570 CST Signature Date Signed Telephone No. CST # _ Standard Erosion Control Plan for 1 & 2 Family Dwelling Construction Sites �Acj4or4'utg thapXers It. 2q & 21 of the Wisconsin .. Um[fotm lvvelltng Code, a sc�tlxOSit�n e4ntrpl plan tees ta submitted and approved prior to ifie issuance of i�widing permits for X 8c 2 family dwelling units to th05 arisdtc�ttottS There the tl e�rz�$ ion contr+ 1 pr4vistahA 0f the Use Dwelling 4�4de are aforcedi fit$ ; ><:sStaridarcrasion I' -NO rttvYded to assist in ritIt :liis`t: ttUetnent ;.::.... :.::.::;:..: P. g.;:.:;::.;:.;,.;: . .... ... .......... g ns :;... .rs.have auth txty to r uest erastan rontroi rtteasares..az ........... apeCtficw.... required by Codewhen ttch eastr*esardeemed necessary to meet the Code'sor�rali performance standard . of keeptn sari art site. ` onstructlonv .ro errs fh t. disturb mz..re tltaa 5 acres, or ire art of a development t1taY dtsC iilis miare Zhan 5 :...::: :...:.....::... ar e: <: it: otn : ?ahe: >:iS- Onln.. ?! :::::<cces :ace >'alsd.;::r... utced .,.tc� > a. < :oonstrueuan sitetQnGn meter dtsch 5.... Prcn.<.;:;,.:::.::..;:;;:.;:.< ;. >:.:::.; .:.::::::::. : >::::::De . arLmcn�f ;:f.l?Tataral:Rexc�urces >::<:: >= : >:<: >::;::::;:: Applicant: 1 V f—n s e � Name l Daytime telephone number Street address, city, zip code Landowner. Name Daytime telephone number Street address, city, zip code Location of the building site (complete as appropriate): quarter of Section Town N., Range E. Lot ��` Block O S 9 Street address Instructions: 1. Complete this plan by filling in requested information, marking (.0 appropriate boxes, and completing the site diagram. 2. In completing the site diagram, give consideration to potential erosion that may occur before, during, and after grading. Water runoff patterns can change significantly as a site is reshaped. 3. Chapters II.HR 20 & 21 of the Wisconsin Uniform Dwelling Code, the DNR Wisconsin Construction Site Best Management Handbook, and UW - Extension publication Erosion Control for Home Builders can be referred to for assistance in completing this plan. The Wisconsin Uniform Dwelling Code and the Wisconsiti _Construction Site Best Management H andbook are available through State of Wisconsin Document Sales 3358. Erosion Control H , 608R6G- or Home Builders f g (GW0001) can be ordered through Cooperative Extension Publications, 608/262 -3346. 4. Submit this plan at the time of building permit application. I - Cbodc (.*) appropriate boxes below, and complete the site diagram with necessary information: bUP s CP °� Site Characteristics North arrow, scale, and site boundary. Indicate and name adjacent streets or roadways. ❑ 411- Location of existing drainageways, streams, rivers, lakes, wetlands or wells. ❑t Location of storm sewer inlets. d The gradient and direction of slopes before grading operations. 1� The gradient and direction of slopes after final grading operations. / Location of existing and proposed buildings and paved areas. ❑ 0 Overland runoff (sheet flow) coming onto the site from adjacent areas. Erosion Control Practices ❑ Location of temporary soil storage piles. Note: Although not specifically required by Code, it is recommended that soil storage piles be placed behind a sediment fence or more than 25 feet from any downslope road or drainageway. Location of gravet access drive(s). Note: Recommended gravel drive design is 2 to 3 inch aggregate stone laid at least 7 feet wide and 6 inches thick Drives should extend from the roadway S0 feet or to the house foundation (which ever is less). P ❑ Location of sediment fences (filter fabric fence, straw bale fence) or vegetative strips that will prevent eroded soil from leaving the site. ❑ 53" Location of sediment barriers around on -site storm sewer inlets. ❑ 'P' Location of diversions. Note: Although not specifically required by Code, it is recommended that concentrated flow ( drainageways) be diverted (re- directed) around disturbed areas. Overland runoff (sheet flow) from adjacent areas greater than 10,000 sq. ft. should also be diverted around disturbed areas. ❑ Location of practices that will be applied to control erosion on steep slopes (greater than 12% grade). Note: Such practices include maintaining existing vegetation, placement of additional sediment fences, diversions, and re- vegetation by sodding or by seeding with use of erosion control mats. ❑ Location of practices that will control erosion in areas of concentrated runoff flow. Note. Unstabilaed drainageways, ditches, diversions, and inlets should be protected from erosion through use of such practices as in- channel fabric or straw bale barriers, erosion control mats, staked sod and rock rip -rap. When used a given in- channel barrier should not receive drainage from more than two acres of unpaved area, or one acre of paved area. In- channel practices should not be installed in perennial streams. ❑ a Location of other planned practices not already noted. -Site Diagram - Note: Any base map of useable scale can be substituted for this sheet. Site Diagram Legend Please indicate north direction PROPERTY SILT LINE FENCE by completing the arrow. - �� EXISTING STRAW ' DRAINAGE SALES TD TEMPORARY 1*= GRAVEL I DIVERSION T FINISHED TREE l � -�� DRAINAGE PRESERVATION I LIMITS OF STOCKPILED GRADING TOPSOIL VEGETATION 0 SPECIFICATION Scale AREA 1 inch = feet Indicate management strategy by checking (,0 the appropriate box: Management Stratceics ❑ ❑ Temporary stabilization of disturbed areas. Note: Although not specifically required by Code, it is recommended that disturbed areas and soil piles left inactive for extended periods of time be stabilized by seeding (between April 1st and September 15th), or by other cover, such as tarping or mulching. ❑ Permanent stabilization of site by re- vegetation or other means as soon as possible. ❑ ❑ Use of downspout and/or sump pump outlet extensions. Note: Although not specifically required by Code, it is recommended that flow from downspouts and sump pump outlets be routed to stable areas such as established sod or pavement. ❑ ❑ Trapping sediment during dewatering operations. Note: Although not specifically required by Code, it is recommended that sediment -laden is water from pumping operations be ponded behind a sediment barrier until most of the sediment settles out. ❑ Proper disposal of building material waste so that pollutants and debris are not carried off -site. ❑ Maintenance of erosion control practices. • Sediment will be removed from behind sediment fences and barriers before it reaches a depth that is equal to half the barrier's height. • Breaks and gaps in sediment fences and barriers will be repaired immediately. Decomposing straw bales will be replaced (typical bale life is three months). • All sediment that moves off -site due to construction activity will be cleaned up before the end of the same workday. • All sediment that moves off-site due to storm events will be cleaned up before the end of the next workday. • Gravel access drives will be maintained throughout construction. • All installed erosion control practices will be maintained until the disturbed areas they protect are stabilized. ..... ; Y f�ereby certify that l .understand the construction site erosion control prom of the Wisconsin 17nifotm; Dv�rel Code, aad ttiati'1 accept responsibility' for carryiag out the: above erosioncoiitroi plan as pproved by' the enforcement a thority. cure of a franc .. Da Stlna PP ..: A publication of the University of Wisconsin - Extension, Ron Struss, UWEX Water Quality Education Specialist (12192). This publication may be freely duplicated Additional copies are available through the UWEX Environmental Resources Center, 216 Ag Hall, 1450 Linden Drive, Madison, Wl, 53 706 6081262 -3652 EROSIO CONTROL FOR HOME BUILDERS Preventing Erosion Is Easy Erosion control is important even for home sites of an acre or less. The materials needed are easy to find and relatively inexpensive —straw bales or silt fence, stakes, gravel, plastic tubes, and grass seed. Putting these materials to use is a straightforward pro - cess. Only a few controls are needed on most sites: • Preserving existing trees and grass where possible to pre - } vent erosion; Silt fence or straw bales to trap sediment on the down - slope sides of the lot; By controlling erosion, home builders keep our streets ' Soil Piles located away from any roads or waterways; and waterways clean. • Gravel drive used by all vehicles to limit tracking of mud onto streets; Erosion Is a Costly Problem � construction sites are a leading cause of water 0 Cleanup of sediment carried off -site by vehicles or Eroding storms; quality problems in Wisconsin. For every acre under con- struction, about a dump truck and a half of soil washes • Downspout extenders to prevent erosion from roof into a nearby lake or stream. Problems caused by this sedi- runoff; and ment include: • Revegetating the site as soon as possible. Local taxes -- Cleaning up sediment in streets, sewers and ditches adds extra costs to local government budgets. Dredging —The expense of dredging sediment from lakes, harbors and navigation channels is a heavy burden for taxpayers. Lower property values — Neighboring property values area damaged when a lake or stream fills with sediment. Shallow areas encourage weed y g growth and create boat- Y b a .{ -�-: ing hazards. o Poor fishing —Muddy water drives away fish like north - ern pike that rely on sight to feed. As it settles, sediment smothers gravel beds where fish like smallmouth bass find i food and lay their eggs. �t^[r Nuisance growth of weeds and algae — Sediment carries fer- tilizers that fuel algae and weed growth. Erosion Con For Hot STRAW BALE or SILT FENCE • Put up before any other work is done. • Install on downslope sides of site parallel to contour of land. • Extend ends upslope enough to allow water to pond behind fence. SAMPLE EROSION I • Bury 8 inches of fabric in trench (see back page) CONTROL PLAN I \ • Stake (2 stakes per bale) FOR 1 OR 2 ®\ • Leave no gaps. Stuff straw between bales or overlap sec- FA GS i tions of silt fence. \ • Inspect and repair once a week and after every %z inch rain. Remove sediment if deposits reach half the fence i �\ height. Replace bales after 3 months. \ O • Maintain until a lawn is established. \ SOIL PILES \ • Locate away from any downslope street, driveway, i stream, lake, wetland, ditch or drainageway AREA TO BE TOPSOILED • Temporary seed such as annual rye or winter wheat is SEEDED AND MULCHED recommended for topsoil piles BY OWNER AT THE ' HOUSE GARAGE COMPLETION OF CONSTRUCTION STD Tl GRAVEL DRIVE • Install a single access drive using 2 to 3 inch aggregate. \` •Lay stone 6 inches deep and at least 7 feet wide from the foundation to the street (or 50 feet if less). D • Use to prevent tracking mud onto the road by all — — _ _ _ TL' vehicles. R/W LI NE • Maintain throughout construction., SEDIMENT CLEANUP SOIL TYPE: SILTY CLAY STREET NAME • By the end of each work day, sweep or scrape up soil SLOPE: 3% tracked onto the road. • By the end of the next work day after a storm, clean up the soil washed off -site. SEWER INLET PROTECTION g' a • Protect on -site sewer inlets with straw bales, silt fences 1 or equivalent measures (see back page). • Inspect, repair and remove sediment deposits after every storm. s u r o ` m DOWNSPOUT EXTENDERS ace an • Not required, but highly recommended. ° • Install as soon as gutters and .downspouts are completed n o to prevent erosion from.ioof runoff. i e Route : water -;Eo a grassed .or "paved, area. a a `- • Maintain until a lawn is e i O I Pract e Sites PRESERVING EXISTING VEGETATION • Wherever possible, preserve existing trees, shrubs, and other vegetation. EROSION • To prevent root damage, do not grade, place soil piles, CONTROL PLAN or park vehicles near trees marked for preservation. LEGEND . Place plastic mesh or snow fence barriers around trees PROPERTY to protect the area below their branches. N LINE _ _ • EXISTING — TOPSOIL DRAINAGE T REVEGETATION D TEMPORARY DIVERSION Seed, sod or mulch bare soil as soon as possible. _ DRAINAGE FINISHED SWALE —�� DRAINAGE LIMITS OF SEEDING AND MULCHING GRADING • Spread 4 to 6 inches of topsoil. SILT • Fertilize and lime if needed according to soil test (or FENCE apply 10lb./1000 sq. ft. of 10 -10-10 fertilizer). `—'—• STRA • Seed with an appropriate mix for the site (see table). GRAVEL • Rake lightly to cover seed with I /4 "of soil. Roll lightly. VEGETATION • Mulch with straw (70-90 lb. or one bale per 1000 CONSTRUCTION ® SPECIFICATION sq. ft.). ENTRANCE/EXIT AREA • Anchor mulch by punching into the soil, watering or TREE by using netting or other measures on steep slopes. PRESERVATION . Water gently every day or two to keep soil moist. Less STOCKPILED watering is needed once grass is 2 inches tall. SOIL SCALE: i " =40` PROJECT LOCATION: SODDING' EXISTING CURB PROPERTY OWNER: • Spread 4 to 6 inches of topsoil. AND GUTTER ANTICIPATED STARTING DATE: • Fertilize 'and lime if needed according to soil test (or CONTRACTOR: ANTICIPATED COMPLETION DATE: apply 10 lb. /10W sq. ft of 10 -10 -10 fertilizer). PREPARED BY: DATE: • Lightly water the soil. • Lay sod. Tamp or roll lightly. • On slopes, lay sod starting at the bottom and work toward the top, overlapping like shingles on a roof. Peg each piece down in several places. • Initial watering should wet soil 6 inches deep (or until water stands 1 inch deep in a straight -sided container). Then water lightly every day or two to keep soil moist _ but not saturated for 2 weeks. If construction is completed after September 15, final seeding or sodding may be delayed. Temporary seed (such as rye or winter wheat) may be planted until October 15. y Mulch or matting may be applied after. October 15, if _ weather permits. Straw bale or silt fences must be main- tamed until final seeding or sodding is completed in spring ;. (by June 1). I "Ic i �,:�YZ Sewer 11n et Protect � � ►,.e. as '1�.'�' ; �> c � r ,':!: C autions Consider public safety when using inlet barriers. These barriers create ponding and mud deposits on streets. Frequent maintenance is essential. After every storm, remove sediment deposits and repair barriers. Repairs may be needed several times a day during major storms. Curb Inlet 1. Place concrete blocks on their Figure 6 —Curb Inlet Block sides around inlet. and Gravel Barrier Block & Gravel 2. Put a 2" x 4" wood stud through curb inlet Barrier outer holes of side blocks to support front row of blocks. 3. Put wire mesh with half inch openings on outside of blocks. Wire mesh F - �-=— Cover mesh with filter fabric & fitter fabric Gravel lifter Concrete block extending fabric 12 inches onto Runoff pavement. water with overflow FiHered water sediment 4. Pile 1 to 3 inch washed gravel on fabric to top of blocks.` * >f► Sediment ' •. R Note: Allows overflow to prevent Wire mesh 2" x 4" Curb inlet excess ponding. & filter fabric wood stud Drop Inlet 1. Place concrete blocks on their Figure 7 —Drop Inlet Block sides around inlet. Adjust height of and Gravel Barrier Block & Gravel barrier by stacking rows of various Wire mesh Concrete flock sizes of block. & fitter fabric _.• = - Barrier - 2. Put wire mesh with half inch openings on outside of blocks. Cover mesh with filter fabric — extending fabric 12 inches onto pavement. Gravel lifter 3. Pile 1 to 3 inch washed gravel water with Overflow Wire mesh & r w ater f abric Filtered w Note: Allows overflow only whon water on fabric to top of blocks. sediment reaches top of blocks. Adjust height to prevent traffic hazards or damage to :. . Drop inlet structures. Sediment with grate Drop Inlet 1. Build a frame of 2" x 4" wood Figure 8 —Drop Inlet Filter around inlet. Drive stakes into Fabric Barrier Filter Fabric ground at least 12 inches. 2" x 4" wood frame Barrier 2. Dig an 8 inch deep trench _ outside frame. `- 24" max imum 3. Attach wire mesh to frame ll it extending mesh 2 inches into 12" minimum A I ii 11 trench. t„ !, 4. Attach filter fabric to frame Wire mesh & filter fabric extending fabric at least 8 inches into trench. Overlap joint to next OvedV ends of fabric stake. S between Note: Allows overflow only when water 1 2 stakes reaches top of frame. Adjust height to 5. Backfill and compact soil in trench. prevent traffic hazards or damage to structures. - 4' k, Co a: o sed E os o Co tro s i , Straw Bale Figure 2 —How to Install a Straw Bale Fence Fences 1. Excavate a 4" deep trench. 2. Place bales in trench with bind- ings around sides away from the ground. Leave no gaps between Figure 1 —Cross Section ""� bales. of Straw Bale Installation low Bale f i . -:..,. y I• ill Width 41 �• - ; n i Staked and Entrenched Binding Wire straw sale 3. Anchor bales usin g two steel re- ry � �i /- -ma ' ' Compacted Soil to -�� /�� t or Twine I I ' III Prevent Piping bars or 2" x 2" wood stakes per Fihered Ill 1 III I Sediment Laden bale. Drive stakes into the ground 4. Backfill and compact the Runoff * III I II I Runoff at least 8". excavated soil. A t l '' � a I � �� 1 1 Y•. Source: Michigan Soil Erosion and ����� =— . � � ' � • r Sedimentation Control Guidebook 1975. Silt Fences Figure 4 —How to Install a Silt Fence 1. Excavate a 4" x 4" trench along 2. Stake the silt fence on downslope Figure 3 —Cross Sections the contour. f bric into the trench. 8" of of Trenches for Silt Fences Filter Fabric i r A I Flow a " � U - I� - -- W ' III — Flow Jt . 3. When oints are necessar over- ench V tr `�i I� 1 ry, IIIf =. � - lap ends for the distance between 4. Backfill and compact the two stakes. excavated soil. Filter Fabric ---► � I III � .'1: ;�• -r --- Source: North Carolina Erosion and 1 Sediment Control Planning and Design Flow Flow Manual, 1988. Gravel Entrance 1. Install as soon as possible after Figure 5 —How to Install a Gravel Entrance start of grading. � O 2. Use 2 to 3 inch aggregate stone. Hard surface road 3. Drive must be at least 7 feet wide so' or distance to foundation and 50 feet long or the distance to the foundation, whichever is less. 6" minimum depth 4. Replace as needed to maintain 6 inch depth. F ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Bu er k 01 S� Y Mailing Address � �6� � Property Address (Verification required from Planning Department for new construction) SQL G City /Stat E-11 lt1 r A/I Parcel Identification Number LEGAL DESCRIPTION Property Location � � 1/45 Z' `` /4, Sec- A. T �� N -R�W, Town of Subdivision , Lot # Certified Survey Map It A Y , Volume Page # 3 Warranty Deed # Volume , Page # Spec house ❑ yes ❑ no Lot lines identifiable V yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result 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 waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeyman plumber, restrictedplumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal 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 system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days f the three year expiration date. ' /7 0 SIGNATURE OF 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 pro rty described above, by virtue of a warranty deed recorded in Register of Deeds Office. ,( 3 / IGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.****** ** Include with this application: 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 ' voi.1525PAGE 216 626137 STATE BAR OF WISCONSIN FORM 2 - 1999 WALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX CO., WI This Deed, made between Todd M. Larson RECEIVED FOR RECORD 07 -10 -2000 1:25 PM WARRANTY DEED Grantor, and Robert Engesether and Beverly Engesether, husband EXEMPT # CERT COPY FEE: and wife, aka Robert C En$esether and Beverly ;,T_ COPY FEE: Engesether TRANSFER FEE: 158.70 RECORDING FEE: 10.00 PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Lot Two (2) of Certified Survey Map in Volume Fourteen (14) of Certified Name and Return Address Survey Maps, Page 3806, as Document Number 618150, filed in St. Croix ST CFtTX V&W Wis SERVICES. W. County Register of Deeds office on February 9, 2000, being located in the PO BOX 750 109 N. IAAUI St Southwest Quarter of the Southeast Quarter (SW 1/4 of SEI /4) and the RIVER FMAA1.Wl 54022 Northwest Quarter of the Southeast Quarter (NW 1/4 of SEI /4), Section 60 - D w Nineteen (19), Township Twenty-eight (28) North, Range Eighteen (18) West, Town of Kinnickinnic, St. Croix County, Wisconsin. 022 - 1054 -80 -00 Parcel Identification Number (PIN) This _ is not homestead property. CK) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of July 2000 "'-J t A * * Todd M. Larson AUTHENTICATION ACKNOWLEDGMENT Signature(s) Todd M. Larson STATE OF WISCONSIN ) ) ss. County ) authenticated this day of July 2000 Personally came before me this day of k�� the above named * Kristina Ogland TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Ogland Notary Public, State of Wisconsin Hudson, WI 54016 My Commission is permanent. (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. Information Professionals company. Fond d - u sss c, WI STATE BAR OF WISCONSIN WARRANTY DEED FORM No. 2 - 1999 y p lk i � tP 1� 1 5 0 0, CERTIFIED SURVEY MAP Todd Larson Located in the Southwest 1/4 of the Southeast 1/4 and the Northwest 1/4 of the Southeast 1/4, Section 19, T 28 N, R 18 W, Town of Kinnic•kinnic, St. Croix County, Wisconsin NORTH OUARTER CORNER SECT /ON(9, RIO W D.O.T. Approval# 55 -65- 2924 -1999 1 (BERNTSEN MONUMENT) UNPLATTED Al 1 I id o mo (�',� LANDS 1 QWN�D BY to '2 Q�� CAUTION "^ FOU ND e 6'20 "w 3.16 Var5B2at' ` ��J,� o Highway etback restrictions SET FROM 80077 23 E 566.73 1 T2� SOoyF'QS (See Shoot p 3 gvements. T j 470.03' 6.70' - a y o m 30/• 469.44' 33 "0 96 C� N 89 °3723 "E 3 y - � 0 4^� OBaI W �► . .. .. .: 566/4 , 0 ��N)c0 Nm p v pN a n �4 O Q-�/ O_ N �p..� �l 6 0 a, 2 'so O Q� 1 ro 4 ry V ? 2/ .O ' � 6 /5.0 6 A .a : p hi f y /s N89 °38'20 "E NB-9 1 W J ��,��`b "'o SOS° /0 1V O .�`�TF 90 (R=S89 02'40 "E� 3 01 e 21ok _ LOT 3 ;�' O M �• / C1 . LOT � o . An erosion control plan isf� Will be required on 11 � � NOTE - Ole, 9 s See Sheet 3 for ? ; Lots 2,3 and 4 .'�2'g2 �� ;��� �, individual /of areas. ., m prior to SC o a construction. 00 ; ��a� �� y 0 -k LQ L W a' � o• OWNERS ADDRESS m Q� a 220 HWY. 65 N. O m O tiJ Q /I 4 / �z eqR y� �/ � RIVER FALLS, Wt. r/ � ���/ Scale in Feet I"= 300 pop o ( r O 50 100 200 300 600 Bearings are referenced to the North -South ���' --r� o LEGEND Quarter Sectionline of Section 19,assumed (n ) ' �\ bearing N0l o 23'41 W. QI / �ti Indicates 1 x 24 Iron Pipe Set • � (Min. Wt. - 1.1316. /lint ft.) / r • Indicates I" Iron Pipe Found of � ' N 0 / �� - -- — Indicates Fence ' . V (R= ) Recorded as �i l oot . / h • Proposed Driveway Location 0 soil Boring ,fAIt101110.11.4 004 `,, Vol to io do • �° �7 '�, •• 001 Qi Doted June 17, 1999 m W RPHY I . I / Revised Sept. 17, 1999 z O • Revised Oct. 5 ' 1999 1713 * &. • s ' 1 CA RIVER FALLS, T F - WI .... Q .• era, = $02.47'00 "W APPROVED •........••'SJ • LANG •• N 1.60 .. ST. CROIX COUNTY i � SOUTH GUAR ER CORNER Planning Zoning and Parks Committee SEC. 19, r28 N, R /B W (BERNTSEN MONUMENT) F E B 0 9 ZOQEO is Instrument Drafted by Mark W. Peavey SHEET I OF 3 If not recorded within 30 days of approval date approval shall be Vol 14 Page 3806 null and void