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022-1062-50-000
Wisconsih Departmen'� of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Euilding Division INSPECTION REPORT Sanitary Permit No: 514965 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: Parkinson, Dudley Kinnickinnic, Town of 022 - 1062 -50 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: g � � CS 21.28.18.P336A TANK INFORMATION D, ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Ex; a-: �. _ 17-06 °• ( - 5 D0. b /QD bO -5. � 5 AI D. t �r•..., b , `� 5. Z5 Aerakion Bldg. Sewer �� I 5z5 ►� ti — Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. VVent to Air Intake ROAD BHrdter CC W.c� •8l s S • S eptic r �D / 7 X66 15 5 �� Dt Bottom Q 5 .1 l S r 7 Dosing T '7 /66 G a Header /Man. T 23 93 , a l z. Aeration V 1 Dist. Pipe 1 7- 2 3 I 3.I . qZ Holding Bot. System Z15 V . *2.. PUMP /SIPHON INFORMATION Final Grade 5.37 Z $ Manufacturer Demand St Cover / � GPM 5 �� 11.ti C.4 Q r 0 9 C/ ' 5 Model N er C f Z. 1 t � •5 TDH ift Friction Loss System He H Ft o , C(Zl ( O Forcemain 1 1_�� 1 Dist. to Well 7 F 1 SOIL ABSORPTION SYSTEM BED /TRENCH Width Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS $•6 - 3 f le 1— _ SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer:�� INFORMATION T e f System: L / c CHAMBER OR .1•n.� l YP bJ�lJe4�70 / >166 A' � UNIT Model Number: DISTRIBUTION SYSTEM �,+— Z6 t f ZO = (W?!S Header /Manifold,/ / J Distribution x Hole Size x Hole Spacing Vent to Air I ake S 44 Pipe(s) � \ 1 Z Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only S Depth Over Depth Over xx Depth of Seeded /Sodded xx Mulched Bed /Trench Center 3-1 Bed/Trench Edges Topsoil � r Yes � No Yes No COMMENTS: (Include code discrepencies, persons pr present, etc.) Inspection #1: / / Inspection #2: / / Location: 1185 River Drive River Falls, WI 54022 (SE 1/4 SE 1/4 211 T28 R18W) NA Lot 1 Parcel No: 21.28.18.P336A 1.) Alt BM Description = �` C OJC _ � S Ow J• GO JA.&— 2.) Bldg sewer length = • r v l _ - amount of cover = t n�• ` Maw�no Plan revision Required? ❑ Yes o [•, a�l r C��� Use other side for additional information. _► SBD -6710 (R.3/97) Date Insepctor's Sig ture Cart. No. * ry :.; s'S; va -,u.q, ta�rrr: r +.�a�e� -a .,; a _,: :�.. ^• .txy. sa€ w'S`YZ , •'w- w� ,,;ts +c +k M: s. tic, g - pit s o . Ica 't corrtrtmer'ce..vvi,gcry Safety and Buildings Division County L lepar a 201 W. Washington Ave., P. Box 7162 JQ' �p 1I KII sco n s i n Madison, WI 537 2 Sanitary Permit Number (to be filled in by Co.) t of Comnuwcee $141 -) ( j Sanitary Permit Application State Transaclion Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the aXused mme I rA unit is required prior to obtaining a sanitary permit. Note: Application forms for s Project Address (if differen tan mailing address) submitted to the Department of Commerce. Personal information you provide may eco p urposes in acco rdance with the Privacy Law, s. 15.04(l )(m), S n t I. Application Information - Please Pri I r a tion REG EIVED 1 t Je— Property Owner's Name f Parcel # r&I } i s0 Property Owner's NAa1I1 Ad�css � AU G Property Location � ^ � a to �� ` 7 N J i o c Govt. Lot City, State / t Zip Co ZO r S y, y., Section - k l er )w-Ps L ^ ` (circle on 11. Type of Building (check all that apply) Lot # -d1 L I or 2 Family Dwelling - Number of Bed oms rvtst (� on Name �e fara Block # ❑ Public /Commercial - Describe Use ❑ City of ❑ State Owned -- Describe Use T CS1/M Number ❑ Village of r Town of le%L'WiL � - III. Type of Permit: (Check o ly one box on line A. Complete line B if applicable) A. ❑ New System y 'Replacement System ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System (explain) B. ❑Permit Renewal ❑Permit Revision ❑Change of Pltunbeq6Owner List Previous Permit Number and Date Issued Permit Transfer to New Before Expiration IV. Type of POWTS System/Component/Device: (Check all that apply) X _No n -Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 i . uitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) pmreatment Device (explain) L V. Dis ersal/Treat ent Area Information: i y "f Est ) Y TC C I Design Flow (gpd) Design Soil Applicati Rate( g f) Dispe Area Req ' ed (sf) isp Sal A Pro ed (sf) S ste hleva o "7 J / VI. Tank Into Capacity in Total # of Manufacturer Gallons Gallons Units V New Tanks Existing Tanks a 0 X U in Septic or Holding Tank Jt> j vU �� 1 . Dosing Chamber , VII. Responsibility Statement- I, the undersigned, assurpe responsibility for installation f the P43WTS show a ched plans. Plut»I,e's Name (Print) / Plumb 's ignature MP/ PRS Numb Business Phone Nu ber r J Plumber's Address (Stet, City Z' Codye)� }� 16 y , L! P1 \ tr f V VIII. C unt /De artment Use Onl Approved ❑ roved Permit Fee Date sued Issuing Age ignature cJ G Z ❑ caner en Rea or Denial D IX. Condit�g�rg INF61fiN. easons for isapproval I �' 1. Septic tank, eft1utnt filter and 31 i�� ✓t? rilk dispersal cell must all be seryk4w / Mgb 2WW as per management plan provided byOkwd r. , Ye,, . 2. All setback•requiretnents must be n*k taihed W code / ortlira WO& Attach to complete plans for the system and submit o the County only on paper not less than 81/2 x I1 inches in size S oil s o F U� X10 Gof �e 017SBD )639 � 1d 01 /0� e_t St b"r 6 car I r + CL rV) C4, -)-c> - .4 e A Vol tf 7-prX cove, e l— /o )'e (& sh /et �. ��� F, � e.. l � $ 7 7 � P� h torto— J6.0 c S r aa- o 6 e- ECOPY ev s re A e li—N, Pl-�L coo 4 13 no Top ap v c 6,.z P i,,, )r-e e 140 - 0,7 q a. ) 1) Irex "O*e 4 We Zs - f 7 j o u t�- to P rt A RECEIVED Wisconsin Department of Co n mercq, U ���� SOIL EVAL ION REPOR Page of r Division of Safe and Buildin s M accordance with Gomm , Wi Adm. Code ST. RUI CO N Y County �� C'F , Attach complete site plan paper x 11 i es in si Pie ust include, but not limited to: int (BM), dir 'on d Parcel I.D. �^ \ percent slope, scale or dimensions, north arrow, and location and distance t ear road. O �1 Q6� - J ®� d Q t Please print all information. eviewed Da l Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 ) (m)). ` j 2 -2 /�&, Property Owner_ ,f �7 p�. Property Location G Dc'- � ` /e ! t3 f� t h > J d'i et 5 , 1/4 5E S,?/ T N R /6 W Property Owner's Mailing Address Lot # I Block # 40M. Pin to CSM# City / W S � ta / te Zip Code Phone Number ❑ City El Village Town Nearest Road [?;Ve. - C� IP I --4o t. QI^iye ❑ New Construction Use Residential / Number of bedrooms 4 Code derive / d / e sl flow �te � �6 ( GPD Replacement �❑ Pu c or com al AA Parent material F Plain elevation K applica General comments and recommendations: h s 1 d e C � G a q C �o t �► v 4e -drs�c� i o�� # a �C?w.'f� s,' �e � Cc; c C ca<n1.% � du ce rhsl` ft / a. �, f `rc? - f'p , o t k 0 I t= �.� � � �,a y c F / Boring # �E] Ground surface elev, ft. Depth to limiting factor in. Soil Application Rate Horizon Dept minant Color Redox Description Texture Structure Consistence Boundary Roots GPD/(F in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh: `Eff#1 'Eff#2 J o- `l /C. �'�3 s s s q - �c o 0 - /.0 a ? - 0 0 i f! + f a C L(a G0 y s s o_.S /_0 _ ❑ Boring a / C 3) P Boring # q c b ® Pit Ground surface elev. / �• / ft. Depth to limiting factor >76 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 I *Eff#2 o -!S i�Y123 3 0s S .2 3 ' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Address Date Evaluation Conducted Telephone Number - 9 //7 / 615 7 S� 2. ?3 -343,3 Property Owner 'x �,�' L h r� f n S ' i ' Parcel ID # ( — Page of , j F3] Bodng # [].Boring �C�' �t Pit Ground surface elev. ! - f ft. Depth to limiting factor > 7 " in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color /� Gr. Sz. Sh. "Eff#1 *Eff#2 4 12 il 6�' C ❑ 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/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ ❑ Pit 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. 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CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certi th t I have inspected the septic tank presently serving the a �'%n S residence located at: S 1 �4,, 1 �4, Section, Town, N, Range Town of �w��; ; ,� � ! , St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of Comm. 84.25, and it (they) appear(s) to be functioning properly. Most recent date of service Did flow back occur from absorption system? Yes No (if no, skip next line.) Approximate volume or length of time: gallons minutes Capacity: Zkc Constructi n: Prefab Concrete Steel Other Manufacturer (if known): Age of Tank (if known): 9" � (Licensed Plumber Si tune) (Print Name) (Title) (License Number) MP /MPRS c ) / k� (Date) Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer D RJ LI 8 r&'36 Mailing Address /( E /l (6 er Or, Property Address i'� %� t' _' ; �j 2 Sz S' (Verification required from Planning & Zoning Department for new constructs n.) Ci /State c:v� (IL Parcel Identification Number '. LEGAL DESCRIPTION Property Location Sec. , T N R W, Town of , Subdivision J , Lot # Certified Survey Map # //�° , Volume , Page # r Warranty Deed # �� ? , Volume , Page # Spec house yes o` Lot lines identifiable yes; no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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 system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. 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. Number of bedrooms SIGNATURE OF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV, 08105) CERTIFIED SURVEY MAP ROBERT H. WEIGEL AND ESTHER D. WEIGEL Part of the Southeast 1/4 of the Southeast 1/4 of Section 21, Township 28 North, Range 18 West, Town of KinnickInnic, St. Croix County, Wisconsin. E 1�4 CDR. SEC. 21, r2e N, RIa W, / /" /NON P /PE FOUNO/ j L�T-f LOTS i LOT 3 C.S. A/- VOL. 4. OA 6E R as DOC 3632/3 I — r — — — m oe N LINE SE 1.14 SE/ A 4 66' YtNO AVE. /R /V--& OR/V;r/ 3 00 . 34'32 " / /05. /O'R/// 01.00'/ 73 I- 402 r5r' �� 369.3 3'x_ — 333. 0 3' o 369.34 v 04 9 F1 [ ED o wa x i BARN I L O T L 7.831 ACRES �. _'�•� V h =W 34/, 909 SO. FT. _ NET= 7.6/ /ACRES q SHED b 33/,124 50. Fr. 0 p N N n m OWFLt/iV6 O J O lu �'m LO T / $ 3 LO 3 IN . SNFO O O CA ~ O O / 003 ACRES q /5.370 ACRES N DO O 435,731 SO. p � O I 669, B S7 SO. FT. W POOL O -4 O i NET - /5. /20 ACRES C • NET= 9.781 ACRES N N 426, / 79 SO. FT. m a O II 658, 6/4 SO. Fr. O O O n -4 a o I N90.00'00 "W 406.71' � W Note: No further subdivision of Lot 1 or Lot 3 of this Certified Surve AP RgpVED Map is to be allowed. " NO' 11 1986 S1. i.X COUNTY 3 A"o Lo MG coft"Tm / * 7T2. 00' 4, 333.00' - � - t - NBB / "W //03.00' r S L /NE SE //4 SE COR. SEC. 2 I, T2BN, R le W,// "IRON IINPL A TTEO LANDS PIPE FOUND/ Dated: October 8, 1986 `,x0tBt4 III Boost,, O Indicates 1" x 24 iron pipe � x h c km Lu weighing 1.13 lbs. /lin. ft. set. Vol. _L__ Page 1740 w U Yf ae ` N Certified Survey Maps M C* 13 f _ St. Croix County, Wisconsin �f := - RIVER FALLS.. •�� o 2 200' 300 400 5 ,,9FDesANO�S�`,,'` : is o � N O Laurence W. Murphy t x Registered Land Surveyor SHEET / OF2 — f — FENC E 1 111111 VIII VIII VIII VIII VIII IIII 111111 IIII IIII $ 8 7 7 1 3 6 1 State Bar of Wisconsin Form 3 -2003 877136 QUIT CLAIM DEED KATHLEEN H. WALSH REGISTER OF DEEDS Document Numbcr Document Name ST CROIX CO., WI RECEIVED FOR RECORD 06/20/2008 10:45AM THIS DEED, made between Peggy D. Par kinson, a single woman QUIT CLAIM DEED �_ -- ---- EXEMPT t 811 REC FEE: 11.00 PAGES: 1 ( "Grantor," whether one or more), and Dudley C. P arkinson, a sing man -- _ ( "Grantee," whether one or more). -- — - r Grantor quit claims to Grantee the following described real estate, together with the rents, profits, f fixtures and other appurtenant interests, in St. Cro Recording Area County, State of Wisconsin ( "Property ") (if more space is needed, please attach addendum): Name and Return Address LOT ONE (1) OfCERTIFIED SURVEY MA1' IN VOLUME SIX (6) OF CERTI FIED WESTCONSIN CREDIT UNION SURVEY MAPS, PAGE 1740, AS DOCUMENT NUMBER 419164, FILED IN ST. CROIX ATTN: LOAN PROCESSING COUNTY REGISTER OF DEEDS OFFICE ON NOVEMBER 12, 1986, BEING PO BOX 308 LOCATED IN THE SOUTHEAST QUARTER OFTHE SOUTHEAST QUARTER (SE% 11 RIVER FALLS WI 54022 OF SE' /,) OF SECTION TWEN'T'Y ONE (21), TOWNSHIP TWENTY EIGHT (28) NORTH, RANGE EIGHTEEN (18) WEST, TOWN OF KINNICKINNIC. 022 - 1062 -50 -0 _ Subject to 22nd Avenut aka River Drive right of way. Parcel Identification Number (PIN) _ St. Croix County, Wisconsin. This is —_ homestead propcny. (is) () This deed is given pursuant to a divorce judgment. Wis. Stat. §77.25(81n) Dated --- -------- - _ . ..__� -____. __.- _.._.. - - - -- —___ -- (SEAL) k g gy D. Par tnson AUTHENTICATION ACKNOWLEDGMENT Signature(s) _ STATE, OF WISCONSIN ) authenticated on COUNTY ) Personally came before me on - .- •--- ______ __ ._ —_ -_ -' the above -named PS D TITLE: MEMBER STATE BAR OF WISCONSIN (If not, _ to me known to be the person(s) who executed the foregoing authorized by Wis. Stat. § 706.06) — instrument and acknowledged the same. THIS INSTRUMENT DRAFTED BY: �_.- -- Jost: h D. Boles - Attorne at Law eN►s t — - - -- . ------ .--- --- ____._.. _w� Y_____ —__. P W ISCONS IN River Fa[Is, WI 54022 -0138 -_ _ �-� , .M�c,+'$s (is peananent) (expires: ��•...qqqqqq i - (Signatures may be auth led' ► avlse It are not necessary.) NOTE: THIS IS A STANDARD FORAY. ANY A�017 O AV,, 11 (Olhl SHOULD RE CLEARLY IDENTIFIED. Qurr CLAIM DEF.D 020033TAtFBAR �,tYI 311 FORM NO. 3 Type name lubw signatures. �i wFO.PRO° L"s ram • (aooPS-2021 -ink"ams.0" 1 of t �•` CERTIFIED SURVEY MAP ROBERT H. WEIGEL AND ESTHER D. WEIGEL Part of the Southeast 1/4 of the Southeast 1/4 of Section 21, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin. Description: That certain parcel of land located in the Southeast 1/4 of the Southeast 1/4 of Section 21, Township 28 North, Range 18 West, Tcwn of Kinnickinnie, St. Croix County, Wisconsin, more fully described as follows; Commencing at the Southeast corner of said �ection 21, the POINT OF BEGINNING, of the m reel to be herein described; thence N 88 48 11 W on the South line of the Southeast 1/4 cf said Section 21, a gistance of 1105.00'; thence N 00 "E 1312.48' (recorded as 1320'); thence S 88 34'52 "E on the North line of the Southeast 1/4 of the Southeast 144 of said Section 21, a distance of 1105.10' (recorded as 1105.00'); thence S 00 00'00 "W (assumed bearing on the East line of the Southeast 1/4 of said Section 21) a distance of 1308.14' (recorded as 1320 to the POINT OF BEGINNING, containing 33.232 acres, being subject to easement over- Northerly portions of said parcel as shown on this map for town road purposes and also being subject to easements of record. Dated: October 8, 1986 State of Wisconsin) County of Pierce) I, Laurence W. Murphy, Registered Land Surveyor, do hereby certify that by direction of the Owners, Robert H. Weigel and Esther D. Weigel, I have surveyed and divided the lands shown hereon in accordance with official records, Chapter 236.34 of the Wisconsin Statutes and the Ordinances of St. Croix County; and that this map and description are a true and correct representation thereof. `` ,,11 {llllafllj� LAUREN 'f '• M = W MUR • Y. i S 1 t N� Fp LAND C Laurence W. Murphy riste red Land Surveyor APPROVED Owner's Address: Route 2, River Falls, WI 54022 Nov 1 1 1986 ST. CRM C.OUNTV QPAiPftwffMrW PAWS ►lw�rvrrtp AND zo"Q COAU a Vol. 6 Page 1740 Certified Survey Maps St. Croix County, Wisconsin SHEET 2 OF2 ' - Parcel #: 022 - 1062 -50 -000 08/22/2008 09:54 AM PAGE 1 OF 1 Alt. Parcel #: 21.28.18.P336A 022 - TOWN OF KINNICKINNIC Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - PARKINSON, DUDLEY C DUDLEY C PARKINSON 1185 RIVER DR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description 1185 RIVER DR SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 15.378 Plat: 1740 -CSM 06 -1740 022/1986 SEC 21 T28N R18W SE SE 15.378AC LOT 1 Block/Condo Bldg: LOT 01 CSM 6/1740 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 21- 28N -18W SE SE Notes: Parcel History: Date Doc # Vol /Page Type 06/20/2008 877136 QC 05/20/1994 516855 1079/85 WD 10/01 /1987 430676 792/360 LC 11/12/1986 419164 6/1740 CSM more... 2008 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 08/07/2007 Description Class Acres Land Improve Total State Reason G1 11.378 140 000 153 100 293,100 NO RESIDENTIAL , AGRICULTURAL G4 4.000 500 0 500 NO Totals for 2008: General Property 15.378 140,500 153,100 293,600 Woodland 0.000 0 0 Totals for 2007: General Property 15.378 140,500 153,100 293,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 555 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 i g����� J #Tn c © � U � 0 o 0( o o q - i I E E ° § % c - ƒ E § - / ± § 7 7 CA / 2 § 8 C ' (D b 0 Q E § k % @ « > E § $ (n CL " $ E 9 w @ 9' Bw «: CL k2 / d k co m , g E T -n : T g E E "04. [ n I : c p k k k �1 { / -ft FY \ G D ~ 2 � f � � / g � 2 ( � � ƒ / /� "A- m C � m � f § 2 z ■ [ CL \ ■ T m § CL 'k2 coaECL 2 @ E E R * a 0 D \ \f \ � o CD �C tA � §«k # 5L x. ( § R � /K � (D 2 §oo Vim, \ co =r o � o §� \ 0 � ° § % � % ' Parcel #: 022 - 1062 -50 -000 01/04/2007 12:32 PM PAGE 1 OF 1 Alt. Parcel M 21.28.18.P336A 022 - TOWN OF KINNICKINNIC Current _Xj ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner DUDLEY C & PEGGY D PARKINSON O - PARKINSON, DUDLEY C & PEGGY D 1185 RIVER DR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): • = Primary Type Dist # Description " 1185 RIVER DR SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 15.378 Plat: N/A -NOT AVAILABLE SEC 21 T28N R18W SE SE 15.378AC LOT 1 Block/Condo Bldg: CSM 6/1740 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 21- 28N -18W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 1079/85 WD 07/23/1997 79 — L G• 07/23/1997 47/140 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 179188 295,900 Valuations: Last Changed: 08/10/2005 Description Class Acres Land improve Total State Reason RESIDENTIAL G1 15.378 120,000 153,100 273,100 NO I Totals for 2006: General Property 15.378 120,000 153,100 273,100 Woodland 0.000 0 0 I Totals for 2005: General Property 15.378 120,000 153,100 273,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 555 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 I �a�91s� 00 CERTIFIED SURVEY MAP - ROBERT II. WEIGEL AND ESTHER D. WEIGEL t Part of the Southeast 1/4 of the Southeast 1/4 of Section 21, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin. £ 1/4 COR.s£c.zl,r28N, R16 W, 1I "IRON PIPE FOUND) t V ( COT / I LT P I O I LOT S C. S. M. VOL. . 4 , _PA G E 9 S9, DOC. �i36S2IS 1 1- _ _ _ o N LINE SC 114 SE1 ,J4 66* 22ND AVE. /RIVER DRIV�I l I _7 588.34 `32 "C-,1105.101 11105.00 02, 73 L 4 ` 369.3 3 33.0 ' 402.73` 369.34 V p M 333.0 4 V 9 a N88 1` 13 "W N O 0 l m ^1 N N m 1` N Q " n 0 Co ' ' N BARN 4 a Of D� 2 � O 72 z a 0 ' 7-.83/ ACRES W 341, 963 S0, F7. Z NEr= 7.6/ /ACRES SHED 331,524 SO. FT. 0 n� N N n M I DWELL J \ p DWELLING W W Im LO T / 3 LO 3 Icy O SHED O O 0 O I� 15,378 ACRES M 0 O /0.003 ACRES O O 433,735 SO. Fr. p iQ 0 vl O 669,837 SO. FT, t� POOL O NEr= 9.784 ACRES N cq N£r a 15.120 ACRES 426,1 79 SO, Fr, 0 q 4. 00 658, 614 SO, Fr. p O/ O ° N v lt5 4 z (n -T qZ - o @ h al I N 90.00 `00 "W 406,7/ ` I +t I W Note: No further subdivision of Lot 1 or Lot 3 of this Certified Survey AP R`IED Map is to be allowed. N M NOW, 2 St. ::• ':)iX COUNTY 3' ComptzEH&4;1vt PARKS PLANNNO 772,00` 4 AND Zo LING CQALMI►Tf! 4 ' _ 333,00' S /NE SE1 /4 N68.4B�2 /'�W 1/05.00` /' _ SE COR. SEC. 21, r28N, R /BW, I /"IRON UNPL A TIED LANDS PIPE FOUND/ Dated: October 8, 1986 � % %` \ SC O NS '0,, O Indicates 1" x 24" o iron pipe �. ���' x h • weighing 1.13 lbs. /lin. ft. set. : ,o o W Vol. Page 17 = 1 9, PPfF44 ac �', Certified Survey Maps ? W.-6 „ W Q St. Croix County, Wisconsin �:.;RIVER FALLS,.-'-, W 3 W WisC. J Q �►' i m O SCALE 1 "= 200` ','' �,'� O• I.ANO .S ��� °`e W 2 0 O 30` 100' 200` 300' 400` 3n0' *�IRR1111tA6't m W m O I ? N O Laurence W. Murphy Q ��, Registered Land Surveyor SHEET / OF2 — f —FENC E | ----- ------------- - .;ER ^~^~~^^^^ �~^ ^�c�' -_*�__-' /Q}D�E S 3?. CD0I� COC��Y, �WISCO0SlN "'DIVISIO0 �O 3[%2 . PLAN VlEN /~ 0� SyV\ /' /-l//h / - �u Distances & dimension to meet r,quiromeuty of l|62.20/ , ' � / '�CDDS �O � width length SJJOT ?TIC TANK (S) AA�MWR. — CONCRETE - '��STFEL NO. of rings on cover Depth DRY WELL '' . � w area no. of lines width lenp;tli � area � 8£{ATE -K RATEC AREX REQUIRED AREA AS BUILT 'clalmer: The inspection of this system by St, Croix County does not 1mply complc�e �liauce with State Administrative Codes. There are other areas that it is not possible inspect at this point of conxtrucL St. Croix C000ty assumes no liability for cemnperutioo. However, if failure io on�ed �he Cnuoty will make every ei"iort to crmine cause of tailore. � ! &SES AND OILS SHOULD NOT DC DISPOSED 1JlRODCB THIS SYSTEM. ` V / � DATED PLUMBER ' LICENSE 0lMBE RI PORT Of . - INDIVIDUAL StWAGL SVSTEM 0 San.i ('a Vv l(m4 1 S .t: a t e. S v p t i. c� �� -- NAM( T &�,fAk St. 'Cn.cr�i x Cuuntc{ I_uvat.4 on +" Section Lot # _Subdivi,6ion SI_PTIC TANK -Si z ¢M ga,t,tone Numb oA eompa.n.tme.n:t6 Di 6&om: we.tt r 0 "J Building 120 6. ope. Highwaten PUMPING CHAM Si v _ ___Tga Pump Manu4acltun.e4 — Modet Numbers. H 0 I. D I N G TANK � -- -- - - - - -- . — - --- Ni _gaffon .6' Number o6 Compantmente Purnpe.n._ Atan.m Syetem Highwateh ABNORPTION SITE Li ed Tench U� A tance An.om: We.t.t Buitding 12 o b cope Highwate.n. A6SORPTION SI DIMENSIONS — — z W1 d th .o 4 tne.neh r ,`7 _ 6t Req u.i n.e.d an.ea �,� 1 Kt length o4 each tine f _6t Depth ii6 Hoch beY_ow ti. e N i4mbv n o 6 . t in, ee — - - - - -� Depth o6 Aoc.h oven tkee � in fot - (4' ee.ng.t o6 ki.n • � {�t Dc a(� t�.Pv be('aw g �` <n D -i 5 fiance between e4n(",6 Se o Vue.nch - -__ IYl v'I 100 1 "f(aC a1)_Oo11 tan area �!J -- - At Typv (16 Coven: Papvn (In A11 aW/ � P11 u1 MlNSIONS Numbvn 06 Pi.tb. It- e.G- ' ; % .t b yea nu OutSicle di.ame�en. h e -Law inPe.t (�t To ta abeon.ption an.ea . j A jc ,q u,c he. d _ r' fi 4� AI'I'K U DATE 19 9 Il JC('7LD � - -- < DA TL 1 f x Rl ANON 1=CR REJECTION _Z// 0 1 9 I I / Sf 37. i 115 fl r" i PLB 67 State and County State Permit # �`� /a 0 Permit Application County Permit for Private Domestic Sewage Systems County �� *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY ( Mailing Address: � — i ' Ra6er+ 0,211t\ � 't 2 �i Ve - y rc I IS W B. LOCATION: % %, Section �, T 18 N, R J 4P (or) W Lot# City --- Subdivision Name, nearest road, lake or landmark Blk# Village Towns K .nni� tnr C. TYPE OF OCCUPANCY: *Com er 'al *Industrial *Other (specify) Variance Single family Duplex_ No. of Bedrooms No. of Persons D. SEPTIC TANK CAPACITY ? Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks '— Prefab concrete Poured -in -Place Steel Fiberglass Other (specify) New Installation Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured -in -Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: ercolation Rate Total Absorb Area sq. ft. (01.5 Re-%, New Replacement Alternate (Specify) D Seepage Trench: No of meal Ft. Width Depth Tile depth (top No. of Trenches Seepage Bed:_L_LengthWidth I A Depth 4 1 ad• Tile depth (top :5 0 ' No. of Line 74 Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land L �& Distance from critical slope nO n - S- WATER SUPPLY: PrivateX Joint ❑ Community ❑ Municipal ❑ Owners name as listed on EH 115 if other t pre owner: r I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH -115 prepared by the Certifi Soil Tester, C` NAME — — J ko—r,5 ft C.S.T. # J> '� �i � S and other information obtained from (owner /builder).� Plumber's Signature 2 ! — Phone / PRSW# w �, Plumber's Address PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca- tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors property. If well has not been drilled please indicate. , F , i i F E �,. - i _ _..�_ .�..A �. _ r r I F , F � p i E � 1 F j , , t € � ' s I i Do Not Write in Space to FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application & 0 Fes Paid: State County .1 Date IP Permit Issued /Rejected (date) Issuing A ent Name •�— Inspection Ye No State Valid# Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 7/1/78 J INDUS REPORT ON SOIL BORINGS AND SAFETY &BUILDINGS DIVISION LABOR AND P.O. BOX 7969 HUMAN RELATIONS PERCOLATION TESTS 115) MADISON, WI 53707 LOCATION: SECTION: TOWNSHIP /MUNICIPALITY: L NAME: St 1 / St 1 / z I /Tj- F l<, k,'no�C' C N dt'a I O WNER'S/ ' 90 ' b YW 6N 4 � MAI LIIj�i ?D SS: — 1 1 15 USE l DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: ESFR PTIONS: PERCOLATION TESTS: IlResidence F-1 New Replace I A Q , &t � 3 ! G A9 RATING: S= Site suitable for system U= Site unONAL: suitable for system `+ 6c 1 � 1 1 � 11 S DU ON ENTI MOUND: IN- GROUND- PRESSURE:S STEM -IN -FILCH ANK: NGTRECOMMENDEDSYST M:(option I) S ❑U S ❑U D S MU S E U c_'5 n om, If Percolation Tests are NOT required DESIGN RATE: SY M ^ If any portion of the lot is in the under s.H63.09(5)(b), indicate: -- "� I Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GR UNDWATER- INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. O L N 1 BACK B- 77, n c ri c - 7 61L I & -34 Lit,sl B - so 95.3), t I Aso o -12- 51 L I1 - 44 Q3mS1 46 -59 T B- 93. 1 1 7 7(P 0 -1I� StL 1�- 40Lt'bn S� 40 -74 w S B -1 84 9 31 d 1 7 81 0-14 B11.. B- +- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL - INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL -MIN. PE RIOD I PERT 2 PERIOD PER INCH P_ no rl P 2- P- P- 1 4 $ / P- P- PLAN VIEW: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slop. SYSTEM / ELEVATION s E 4 � E Z �b� n .? e� _. .. C? 100 � � JC 41 r 014 _. 1� 01-ts > I01 I ..'-e4' - 0t s, ------- 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures methods specified in the Wisconsin Admimistrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (pri TESTS WER COM7 ETED ON: I h 0 ow, ��Is� . 4, 1.9 1 ADDRESS: CERTIFICATION UMBER: PHONE NUMBER optional): �IJC�' F►13 5s — �� - 4x s- 74� CST S I DISTRIBUTION: Original -Local Authority, 2nd page- Bureau of Plumbing, 3rd page - Property Owner, 4th page -Soil Tester. DILHR -SBD -6395 (N. 03/81) r � � • r _ J a �rp r , r' r co AL _c, i p 10 y I �O P w f ^ q C -r 7" 4h q P � • 4* V r c #J • Y � P .1• �C r SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer f d['AA �6h Mailing Address �< �� er Ur'. Property Address e - Ci , (Verification required from Planning & Zoning Department for new constructi n.) City /State f( I Parcel Identification Numbe LEGAL DESCRIPTION s Property Location '/: , '/4 , Sec. , T 2LN R_,g_W, Town of r f Subdivision , Lot # Certified Survey Map # U , Volume , Page # Warranty Deed # % �/ �! , Volume , Page # Spec house yes no Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in §Comm 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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 system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. 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. Num of be o SI ATURE OF APPLICANTS) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) 41:91 CERTIFIED SURVEY MAP ROBEt2T H. WEIGEL AND ESTHER D. WEIGEL Part of the Southeast 1/4 of the Southeast 1/4 of Section 21, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin. E 1/4 CON. SEC. 2/, T2BN, R/B W, / /" /RON P /PE FOUNO! LOT / I LOT- I I L_O_ T S VOL t 4. PAGE 9Sp DOC 3632/3 I —�- -- — �— - -- m I N /NE' SE 1/4 SE 1, BB / ZZNO AVE. /R/ VER OR /VIr l ' 500.34 'J2 "E / /OS. /O'R / //01.00 1/ _ L 402.71' �� J6 4r __ 333.0 r -- '� �► N88 1' 13 "W //05./J' 333.04 � 8 N h N N o W � h w a2 ys86 BARN p ='• 0/ i LO 2 �r, L 7-93. ACRES h =W 34/, 901 SO. F7. Z NET= 7.6 / /ACRES q SHED 331,324 50. FT. 0 OWELC 1N6 2 3 CI `' ( m / v OWELL/NB 3 LO 3 z N LO T SN£O ° O ° 111 O IN /1.378 ACRES /0.003 ACRES R W 431.731 SO, FT. ° i•.I ° I 'F60,007 SO. FT. NET= 1 1. /?O ACRES N W POOL O ET= 9.704 ACRES �I / O 426, / 79 SD. FT. m q 610, 6/4 SO. F7. O � O 2 � � � a f O I � N 9O.00'OO "W 406, 7/ ' T I � i W Note: No further subdivision of Lot 1 or Lot 3 of this Certified Surve APV� Map is to be allowed. M N 0 11 1986 5[. :);X COUNTY J' Comip,a H&S Ve 1AIK PLAM"We 4' AND IO 40 COAUMTM 4 ' 7T2. 00' 333.00' S L / NE SE //4 // 01. 00' /' SE COR. SEC. 2/, TYBN, 0 I W,// "IRON /�NPL A TTEO GANOS RIPE FOUNOi Dated: October 8, 1986 ``,`a%aG�Oari� a O Indicates 1" x 24" iron pipe ���`5......... �/�y0 i h weighing 1.13 lbs. /lin. ft. set. �'f ?� o c w Vol. 1740 z' L.AU NC L W qp(i ac Certified Survey Maps ,-,E; 4713 St. Croix County, Wisconsin RIVER FALLS.: �w m W 3 = . SCALE /"- 200' I '•, � L aKO S .•�'� o ° O 10' /00' ?00' 300' 400' /00 5 0 1 , q W W 0 Laurence W. Murphy Q x Registered Land Surveyor SHEE T / OF 2 — f — FENt E