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oco k 0) o tv e V��;�_ s . _ I � i # § � X � � $ F o ° m F e 2 - C E J # « \ g ® - CA) A R i F f 7\ ; { k # 8 ° ƒ ( E E k g § � a © ( / § £ F� §� 7 \ $ 7 ? � CD $� � 0 SS\ nr■ o c ƒ � k z 0 0 $' - � ( 0 0 0 -; c ƒ % § % CD (- § 7 E CA ■ CO) q 0 $ 7 ` . � 0 & ,..� � e E .. 0 2 j Z .. ƒ 0 I20 m } 2 ` \ \ § \ m � � � { CD (6 ƒ k # z \ R .. � ƒ � ■ � © E § z § � g ± k . % 0 \ , n \ / CL � 7 z R � t . � k � \ � k � � � / @ \ I � 0 « m § CD o k Wisconsir? Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division Count y St. Croix INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitar o.. Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). Permit Holder's Name: ❑ City []Village ❑ T n of: State Plan ID No.: Wahlquist, Bill Rush River Township CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 028- 1001 -80 -100 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St /Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANKTO P/L WELL BLDG. Air to i ntake ROAD Dt Inlet Air Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand St cover Model Number GPM TDH Lift Friction System TDH Ft oss h ead Forcemain Length Dia_ Dist. To well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSION SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING manufacturer: INFORMATION Type O CHAMBER Model Number: System: OR UNIT DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing 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 E] Yes ❑ No []Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: / ! Inspection #2: ! ! Location: 589 200th Street, Baldwin, WI 54002 (NW 1/4 NW 1/4 1 T28N R17W) - 0128176B -Lot 1 1.) Alt BM Description= 2.) Bldg sewer length= - amount of cover = Plan revision required? ❑ Yes ❑ No Use other side for additional information. 1 F1 I I I SBD -6710 (R.3197) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH j SANITARY PERMIT NUMBER: A- .. F � E � � c a . " y i 4 i e. . .... t ".�.,�.n..;?„�T.. .��n.� ..�a...e.,�.. ....�..a�,....» . �.. m.,,.....,....® �.,. �..... m....— �.....,...�...,..,�mw»»�..�.»' - a....�..,„m...�-- �s....:. - � .�,...�,mP..,.,..„�..�.,. 9 .. - � I � $ € t ? 3 W.w c i ZE g O" Safety and Buildings Division Vis�onsin SANITARY PERM ION 2 01 W. Washington Avenue In accord with ILH '�, C P O Box 73 Department of Commerce Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for stem` no county than 8 v ���y CCllll i x 11 inches in size. 5t • See reverse side for instructions for completing thi W lica State Sanitary Permit Number Personal information you provide may be used for secondary purpos ST cl;tax ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. 6 1NTV Q,> State Plan I.D. Number ZON L APPLICATION INFORMATION - PLEASE PRINT FOR Property � Ow�terNam / 8 t� tion Q or W �� �� ,6 ,rte / (!l / S � T � U , N, R .1 70 ( Property Owner's Mailing Address Lot Number / Block Number" n _: � ZGt� ,V J � f City, State Zip Code Phone Number Subdivision Name or M Number G 3883 Lt7i'tti Lam:. 5y00�i ( 7w �w-1 337 GZ`'d /�' !/ir � I ll. TYPE OF B IN : (check one) ❑ State Owned ° c Nearest oa� Public 1 or 2 Famil Dwelling - No. of bedrooms ° own OF a-5 J t ve, III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) / tea` 6, /-3 1 ❑ Apartment/ Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 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 ap Iic A) 1. ❑ New 2. ❑ Replacement 3, ❑ Replacement of reconnection of 5. E] Repair of an tem -------- ________ System ...... Tank Only____________ Existing 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 &Keepage Bed 21 []Mound 30 ❑ Specify Type 41 []Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 15. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) -7 r� Elevation 7 �1 1 . I C10:55 Z, / re l Feet /O/ Feet Capacity VII TANK in g allons Total # Of Prefab. Site Fiber- Exper- INFORMATION g Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Existin strutted Tanks Tanks Septic Tank or Holding Tank /000 ❑ 1 ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber T7 ❑ ❑ ❑ ❑ I ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) I Plumber's Signature: (No Stamps) MP /MPRSW No.: Business Phone Number: Q l so r� ., cS7. Aft z zo 53 71s -4F — ..3 78 Plumber's Address (Street, City, State, Zip Code): IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved SayKary Permit Fee (Includes Groundwater ate ssue Issuing Agent Signature (No Stamps) fQApproved El Owner Given Initial l ;7- 5 CD Surcharge Fee) -S�, tl Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: BD- 39 ( / 7) DIS 5 ION: Original to ounty, ne copy T : fety & Buildings Division, Owner, Plumber INSTRUCTIONS t 1. A sanitary permit is valid for two (2) years ': �T 4p `M ` 2. Your sanitary permit maybe renewed bef6re the expiratiomdate,kaidat a time of renewal any new criteria in the Wisconsin Administrative Code will be applicalli, 3. All revisions to this permit must be app pved by the issuin"' y'thority. 4. Changes in ownership or plumber requires a PermitTiaRsfer / Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever 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 must include: I. 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 into fill in name, License number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete 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. free Inc P rop. props r"ne ✓t►+� c ` • /ot S•Eo.ki 5e� b�4 - F�^,o�uoosed ol s. �� �o�.7rn . � •�O t4_" .�/ ' ,6 zcm� :$4,% E)r i.S�i /, GL� �ee.P. �6r.�Grs Gr f 5eotrc .,1f: T bt d ;sconn�cfee[•F�r�r► k s[reeonnected •doProPose.d 36a1�..q. ryes ;domce- eosi — , 7:�+ /e�� bt reo /aee� re 6;Aeriat drlvecvay � 4*S�. q/ p�/.e. �1r'oP05� 3 b,�,d,rcx�rn /O,Z t Lv Q N.Q.M. jfr2 e cam, ASSu,,, 4d e(ec = /co•CO.' 5•T. in/e elev" = M.9 ' ex• syst. eltt,-- - ?7 Cx. vade Q o /. of f d rd UEPAR�10FNTC)F IN DUST11 Y, - REPORT ON SOIL WRINGS AND - SAM & BIM r)IIjCS LABOR AND DIVISION P.O. Rux 736 HUMAN RELArIONS PERCOLATION TESTS (115) MADISON, WI 5 9 (H63.0901 & Chnliter 145.0401 [L11' I I7WJ lu ;r-i NPATTT _ Rwi;h R.Ivex /T25 NA771t St Croix Jeff Wah1quist j595 200th_ St., Baldwin, wi 54002 GATES 011090VATIONG MADS 7 EGI:6tW= n/a CN8; Ist-MMUEATMNT il 1sklitatop -29-9( 6 7 O 17 RATIt!qL for system U- Site kir4uluble for sv, - lr@m EM.; uf L L I- SYST MN7 A K; F9ECON1I%jPkjTO — SY14rF S [39 IS ❑u DS9 I S corAviritional an a '?lam at Irmo I 1,16dar .H6],01XSj(Ij, jodir"W Class z I Is In Fialitdplain, indicato Floodplpin cli!vution! n/al der-imal PROFILE DESCRIPTIONS page 78 PIA C_ lisp 0! -I�S;W i0% t AT51R � tlt L WITH IMICKNIW. 314 ELEVAT ERV U* I, rfI F MIT"MURE, ANO IDEPTH mi [0 REDI]OPK Is QBS%F1VI!0 (SEE jl�BBRV, ON BACK.) 6-1 7.50 98.82 none >7.50 .83bl.1. 1,67bn.cl. 4 — - -00brI.l.6,&gr. 1.00bn.m.s. 2 7.59 98.24 none >7.59 .9 1.25bn.cl. 4.75bri.l.s.&Sr. .67bn.m,s, 0. 3 7.50 98-03 none >7.50 1,17bl.1. 1.33bin.C1. 4.25bn.1.El.&gr. .751in.m.s. 8 _4 7.1.7 97.64 'Dolls >7.17 .75bl.1. 1.50bii.c1. 2.50bn.1.9.&9r. 2.42bri..m-s. 8-5 7.83 98.36 none >7.83 -92bl.1. I..58bft.cl. 4.00bn.1,i%.&gr. 1.33 tin.m.s. PERCOLATION TESTS - IMPT, — I W -A TIER IN HOLE TES UA IN WATER LE Will. I 1147k_UTE9 t S ,,, LLN(3 !,!tat. M29% An- INTERVX41W. AMM= PER — (NO N see. PLO $I 0 racIalion tmts, sail b.,i,,V. and the dIffilmsiorts 0 u-110ble pail areas. hidiciw scalt, of v.switm Al'ol rte the 111r; z(o � "'ol 'v"tiPAII elevfitinn releranee powls and show their Infoiiall nn tma Viol V i s o . Shaw I t * ouffam alov! at *1 fl—I-19c avul tI•4 mr-ow It.1 Mope SYSTEM ELEVATION 94.39 .2 Aft tt aw Im 1114rie i ?N rus 0 J 'A thm Lrd' hardiv cattily that the tail tests Trf"rtcd nil This form —!r^ - 1) ,nni �v Idwith the proreduluffund limiljods srVOIlled 11• Ill'I M",I)FIxiti and iliac Ilia clillorneardwiland thalomijoij jile art, Cv,r(!tit w thIlhe" ot -Y W•—Jerlart and bellef. FFSTS .0 ?) C-Lry L. Steel PARr,J' i ;98 N . 21 7u l 71.5 - 24 0 - 7 n1rT 11jH-,)TICIN! Vilmiroll port. oar Py to Lt—I Antho'lly, I-,'* W-11Y Cl.,W! and atoll To.•v FORM - STC - 104 A5 BUILT SANITARY SYSTEM REPORT OWNER J�r=�C ja JI ��s.Y 0wSHIP SECTION - T _N -R _ W ADDRESS �,� 5` ea r �,,,_ CROIX COUNTY, WISCONSIN. A j SUBDIVISION LOT LOT SIZE FrAN VIEW SHOW EVERYTHING WITHIN 100 FEE'S OF SYSTEM A I � • INDICATE NORTH ARROW 8ENCl LMw:Slevation and descriptions & 4�j Alternate benchmark L SEPTIC TANS:Ma nulacturer: T . _' rn . ,7 �2�I, iquid cap. o = � Rings used; = Manhole cover elev: , Final grade elev: - 9,e� Tank inlet elev.t ank outlet elev.t .f No. of feet frog► nearest road:Front:_, Sid4, Rear,_Ft. Lt.y � From nearest prop. line:Fro t , Sides, Rear Ft. L& No. of loot iromt Well , Nuildingt 4a_� (Include this information in the above plot plan) (a reference dimensions to septic tank) 5$S REVERSE SIDE I M . Q W Z Q A ' u a i Lj- I 8 I s f �vd II s � ^ I I I I II II II II _ II II II o Z II = dl V II S � � CC II � II u _ I I II m 1 --------------------------- _ mas 11 I I I I Z O x _ S II _ II � u R I g O .- O 1 1 O f/l Nltl p7N•MY d API AA: a z� O$ O o� i ,D•,Dt 3 do 0 LL E us ° � DOepp Wav0 m �® mm E x s O E � r O ( 00 0 p, b F- f O O ST CROIX COUNTY SEPTIC TANK MAINTMANCE AGREEMENT OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address Sy' mop 6 a Property Address P p (Verification required from Planning Department for new construction) City/State ,Uctey�'� Parcel Identification Number _ 02 S" /PP/— 9O- oo p LEGAL DESCRIPTION Property Location '446) %<, /Ulf /<, Sec. , T2 h N -R W, Town of G�S / Ve y . Subdivision Lot # Certified Survey Map # &9'Z ��/ j Volume _ `� . Page # -3 Warranty Deed # �l /��.3 Volume . Page It Spec house ❑ yes 2/no Lot lines identifiable Q ❑ no SYSTEM MA MIMNANCE Improperme and mamtenanceofyoursepticsyrtemcoaldresalt in, its7ematu f Ruretohandlewastes Pmpermaintena= consists of pmmping out the septic tank every ibex years or sooner; if needed by at Iiceased pumper . What you pat into the system can affect the _ frm�ction of the septic tank as a treatment stage in the wade , TIC PrOPedY owner agree to submit to St. Croix Zoning Department a certification ion form, signed by the owner and by a P j]o=cYm;mPkmbc4 restactedpltmoberor a hcrosedprmrperverifymg that (1) tha on wastewaterdisposal system is in Proper oPCIRtg emndrtion and/or (2) after inspection and pumping.(if aoassary), the septic-tank is less than 113 fu11 of sludge. Uwe. the Undersigned have read the above requirements and agree to maintain t1u private sewage disposal system with the standards set fack herein, set by the Department of Commerce and the Department of Natural RcsourcM State of Wisconsin.. Certific ahon silting that Your septic system has been maintained must be completed and rearmed to the St. Croix .County Zoning Office within 30 days of year SIGNATURE OF APPLI o/ DATE OWNER. CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (arc) the owner(s) of 'bed bovc, b a ty deed recorded d in Register of Deeds Office. SIGNATU1tE 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 decd f nni the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed voi.1523P 44 625635 KATHLEEN H. WALSH REGISTER OF DEEDS Document Number WARRANTY EFn ST. CROIX CO., WI RECEIVED FOR RECORD Wahlquist Brothers, a partnership, conveys and warrants to 06 -30 -2000 9:00 AM Charles W. Wahlquist and Bonnie J. Wahlquist, husband WARRANTY DEED and wife, holding as survivorship marital property, the EXEMPT N following described real estate in St. Croix County State of CERT COPY FEE: COPY FEE: 2.00 Wisconsin: TRANSFER FEE: 5.10 RECORDING FEE: 10.00 PAGES: 1 Recording Area Name and Return Address Thomas A. McCormack 1020 10'" Avenue P.O. Box 2120 Baldwin, WI 54002 0a 1001-80 -000 (Parcel Identification Number) Part of the Northwest Quarter of the Northwest Quarter (NW % of NW %) of Section One (1), Township Twenty -eight (28) North, Range Seventeen (17) West, Town of Rush River, St. Croix County, Wisconsin, more particularly described as Lot 1 of Certified Survey Maps, dated March 31, 2000, filed 6 -29 -2000 , in Volume 14 of Certified Survey Maps, Page 3883 , as Document No. 625618 , Office of the Register of Deeds for St. Croix County, Wisconsin. Exception to warranties: all easements and restrictions of record. This is not homestead property. Dated thiso�day of SU *e 2000. Wahlquist Brothers by a' - 4uist *C arl . Wa Vui p�r , partne ell Robert L. Wahlquist, partner uist, partn - p AUTHENTICATION l Tl LL ACKNOWLEDGMENT Signature(s) �CL►KG3 R 6V O44U1 , STATE OF WISCONSIN ST. CROIX COUNTY Personally came before me this day of 2000 the above named Charles W. authenticated this o day of Wahlquist, Robert L. Wahlquist, Jeffrey C. Wahlquist to me known to be the person(s) who executed the foregoing in ent and kno ledge the same. signature n type or print name sig ure ty or print name - %1 TITLE: MEMBER STATE BAR OF WISCONSIN (If not, Notary Public St. Croix Coun�,V/isc4tsin. '� J+ authorized by §706.06, Wis. Stats.) M ommission is permane pot, - Vat" a ira$oa cafe: Z r THIS INSTRUMENT WAS DRAFTED BY r v I Thomas A. McCormack *Names of persons signing in any q9#Acily,Aould%j0jV f Baldwin, WI 54002 printed below their signatures. ''Y;. Information Professionals Company Fond du Lac, Wisconsin 800.655 -2021 FILED L JUN 2 9 2000 ► t KA g ster of Deeds H 62$68 vj St. Croix Co., WI c� CER T IF I ED SURVEY MAP LOCA I N THE NW 1. OF THE NW 114 OF SECTION 1, T. 28N. , R. 17W., TOWN OF RUSH RIVER, ST. CROIX COUNTY, WISCONSIN. NORTHWEST CORNER SECTION 1 - FOUND ALUMINUM MONUMENT � PREPARED FOR: 3 BILL WAHL OU I S T Oi O tF OIv O i I BEARINGS REFERENCED TO THE y i WEST LINE OF THE NW 114 � I I UNPLATTED LANDS ASSUMED AS N oo° 00' oo" E. 1 33' 33' 361 \/ 1 N88 12' 57" E 331. 14' 0 33. 02 298. 12' / " �30 ± ? I 100' 0 LLu 1 SEPTIC VENT cri 1 W : I MOBILE HOME cj-:2' ' 04 b -_- DRIVE l 4: SHED Q 00 co J- U 1 N W LOT Q: ' • I N O I$ 2.7 ACRES ± k/ o I$ 2.33 ACRES TO M. L. I 101, 302 SO. FT. o I 2. 03 AC. TO M. L. EXC. R l / Q 88,606 SQ. FT. ' I � 30' "`((( I I S07 ' E � I 1 >-: 69. 98' 6 6' I ' o w M L N cn> I 33' 33' a° C - 0 1 100' S 19 08' 32" W n Z ; 41.14 WATER'S EDGE avf �;u I Z: Q ~' 33. 02 192. 3T 30'.t CL =r c' o I O : S88 ° 12' 57" W 225. 39' , v o I N: i 255' ± cr UNPL A LANDS I Cc) C O °' JAMES M. WEST QUARTER CORNER ` LEGEND = � SECTION I - FOUND i 1 Sim 3x4" IRON REBAR i O SET I" X 24" IRON PIPE WEIGHING 1. 13 LBS. PER LINEAR FOOT.,(' VA M. L . MEANDER LINE 1 " -80' JAMES M. WEBER S -1804 0 40 80 160 SHEET I OF 2 NELSEN -WEBER LAND 3RVEYING 99164A THIS INSTRUMENT DRAFTED BY JIM WEBER DATED Y�•cv • � -20 -� Vol. 14 Page 3883 i I xu,H �JW Q W n Ci M • N Z LI''H A O W�C N N WHw �a C.)LLA - � i�vi //��.-1cnu W CU F- =h_>_ tllCJ • W O W? W Q W h CA: O 9 W is Ca F- GC Ci V_ Ix CA DESCRIPTION A parcel of land located in the Northwest 1 /4 of the Northwest' /4 of Section 1, Township 28 North, Range 17 West, Town of Rush River, St. Croix County, Wisconsin, more fully described as follows: Commencing at the Northwest Corner of said Section 1; Thence South 00 °00'00" West, along the west line of said Northwest 1 /4, 464.22 feet to the POINT OF BEGINNING; Thence North 88 °12'57" East, 331.14 feet to a meander line along the Rush River; Thence South 26 °21'47" West, along said meander line, 88.75 feet; Thence South 17 °09'10" West, along said meander line, 209.52 feet; Thence South 07 °22'57" East, along said meander line, 69.98 feet; Thence South 19 °08'32" West, along said meander line, 41.14 feet; Thence South 88 °12'57" West, 225.39 feet to the west line of said Northwest 1 /4; Thence North 00 °00'00" East, along said west line, 384.70 feet to the point of beginning. TOGETHER WITH all lands lying between said meander line and the thread of the Rush River, being between the extension of the northerly and southerly lines of the lot as shown. Contains 2.7 acres, more or less. Subject to right -of -way for 200 Street as shown. Also subject to any and all additional easements, right -of -ways, or conveyances of record. SURVEYOR'S CERTIFICATE I, James M. Weber, registered land surveyor, hereby certify: That in full compliance with the provisions of Chapter 236.34 of the Wisconsin Statutes and the provisions of the St. Croix County Subdivision Ordinance and under the direction of Bill Wahlquist, owner, I have surveyed and mapped the above described parcel of land and that this map is a correct representation of the boundary thereof. NIIMflpjm Dated this day of r , 2000. C0JVq % JAMES M. MER James M. Weber S -1804 a NELSEN -WEBER LAND SURVEYING, INC. SMNG vu�" < W1 Q ,U NOTE: The parcel shown on this map is subject to State, County, and Town laws rules and regulations. (i.e. wetlands, minimum lot size, access to parcel, etc.) Before purchasing or developing any parcel, contact the St. Croix County Zoning Office and the appropriate Town Board for advice. 99164A This instrument drafted by Jim Weber SHEET 2 OF 2 Vol. 14 Page 3883 Parcel #: 028 - 1001 -80 -100 09/15/2006 09:32 AM PAGE 1 OF 1 Alt. Parcel #: 01.28.17.6B 028 - TOWN OF RUSH RIVER 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 CHARLES W & BONNIE J WAHLQUIST O - WAHLQUIST, CHARLES W & BONNIE J 589 200TH ST BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description " 589 200TH ST SC 0231 BALDWIN - WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 2.700 Plat: 3883 -CSM 14/3883 SEC 1 T28N R17W PT NW NW BEING CSM Block/Condo Bldg: LOT 1 14/3883 LOT 1 2.700AC Tract(s): (Sec- Twn -Rng 401/4 1601/4) 01- 28N -17W NW NW Notes: Parcel History: Date Doc # Vol /Page Type 09/15/2000 629903 1542/563 WD 06/30/2000 625635 1523/044 WD 07/23/1997 850/401 07/23/1997 829/521 more 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/30/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.700 26,800 221,400 248,200 NO Totals for 2006: General Property 2.700 26,800 221,400 248,200 Woodland 0.000 0 0 Totals for 2005: General Property 2.700 26,800 221,400 248,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 121 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 C� C FILED L JUN 2 9 2000 10 AUG 1 4 2000 MM H. WALSH Reg ister of Deeds q�s Reg • 618 a St .CroucCo.,WI ? ST. CROIX COUNTY U' CERTIFIED SURVEY MAP L OCA TED IN THE NW 1/4 OF THE NW 114 OF SECTION 1, T. 28N. , R. 17W., TOWN OF RUSH RIVER, S T. CRO I X COUNTY, WI SCONS IN. NORTHWEST CORNER SECTION 1 - FOUND PREPARED FOR: ALUMINUM MONUMENT 3 BILL WAHL OU I S T Ile s O N o i I BEARINGS REFERENCED TO THE WEST LINE OF THE NW 114 y ' ASSUMED AS NOO° 00' 00" E. a I I I UNPLATTED LANDS 6 6' ........... ............. / J l�,•' 361' a \/ w I 33 ' 33 �• N88 12 ' 57 " E 331. 14' 4• I 33. 02 0 � ° � ; 0+. I o /� ^h ? 1 100' \ I-SEPTIC VENT W MOBILE HOME, / Lu • WELL DRIV l I Z; d' SHED IM Lu I- I N w I W LOT I o° I$ 2. 7 ACRES + Z: I N p $ 2.33 ACRES TO M. L. Z; 101,302 SO. FT. ° I 2.03 AC. TO M. L. EXC. RiW 88, 606 SO. F T. ' 2 I I ( � I I �S07 0 22' S7 "E I >-: 69. 98' ' m d 6 6' < (D > 33' 33' R Q S 19 ° 08' 32" W c (D ( I 100' 41. 14 i WATER'S EDGE C , 30':t `ooh '�0 I O' H33.O 192.37' 1 S88 12' 57" W 225. 39' d o I N: .. UNPLATTED LANDS_' $ I / t oy`" G Ns, o' �= JAMES M. WEST QUARTER CORNER z LEGEND +� SECTION I - FOUND $' i 314' IRON REBAR i O SET 1 « X 24 « IRON PIPE WE 1 GH 1 NG � SPR �WILLEY, OQ 1. 13 LBS. PER LINEAR FOOT. .t M. L. • MEANDER L I NE���/O JAMES M. WEBER S -1804 0 40 80 160 SHEET I OF 2 NELSEN -WEBER LAND 5RVEYING 99164A THIS INSTRUMENT DRAFTED BY JIM WEBER DATED -3 Vol. 14 Page 3883 s FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER j TOWNSHIP fas i.t ,�r'' SECTION N -R W ADDRESS �-' = z` � ST. CROIX COUNTY, WISCONSIN CAL -I SUBDIVISION LOT LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 7 t I � 0 O� r 4 F INDICATE NORTH ARROW BENCHMARK: Elevation and description:] ` C Alternate benchmark r p I SEPTIC TANK:Manufacturer: L�;rr��/ ,�� Liquid Cap. Rings used: - Manhole cover elev: grade elev:,_,_ Tank inlet elev.: Tank outlet elev.:- 0 No. of feet from nearest road:Front , Side, Rear Ft. JL l From nearest prop. line:Fro t , Side_, Rear — Ft. No. of feet from: Well , Building (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump /Siphon Manufact.: Pump Size Elevation of inlet: Bottom of tank elevation Pump on elev.: Pump off elev.: Gallons /cycle: Alarm: Man.: Switch Type: Location Distance from nearest prop. line: Front_, Side_, Rear Distance from: Well Building SOIL ABSORPTION SYSTEM Bed: _ - Trench: Seepage Pit: Width:Length E® Number of Lines: Area Built�� Exist. Grade Elev. Proposed Final Grade Elev. Fill depth to top of pipe: No. feet from nearest- og. line:Front Sid - e ` �, Rear Ft.�' No. femt from well r No. feet from building HOLDING TANK Manufacturer: Capacity: No. of rings used: Elevation of bottom tank: Elevation of inlet: No. feet from nearest prop. line:Front , Side , Rear Ft. No. feet from: Well building , nearest road Alarm Manufacturer: 0 INSPECTOR: DATE: PLUMBER ON J H: ` L. LICENSE NUMBER: 6 /90:cj DEPARTN)ENT OF INDUSTRY INSPECTION REPORT FOR S AFET tr & BUILDING LABOR &HUMAN RELATIONS DIVISION P.O. BOX 7969 ON -SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION M I I$ON 1 37 p�+7 p State Pian I.D. Number: N 4 , 4 ,eC • l , T 28 — R17 (If assigned) T of Rush Riv ❑ CONVENTIONAL ❑ ALTERATIVE 200 St. � Holding Tank El in-Ground Pressure El mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Jeff Wahl uist 1 595 200th St. B aldwin, WI 54002 — �d BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. . ELEV.: CST REF, PT. ELEV.: C5% Name 7 f PI ber. MP /MPRSW No.: County: Sanitary Permit Number: Cavin Powers Jr. 1563 St. Croix 128717 SEPTIC TANK /HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLERELEV.� NK OUTLET ELEV.: WARNING LABEL LOCKING COVER n n c/ PROVIDED: PROVIDED: - I �J r 7 �' a l� ES ED NO ❑ YES N BEDDING: VENT DIA.. VENT MATL.: HIGH WATER NUMBER OF PROPERTY WELL: BUIL ING: VENT TO ALARM: FEET FROM LINE: ' ❑ YES O El YES ❑ NO NEAREST —♦ f X DOSING HAMBER: MANUFACTURER: I BEDDING: LIQUID CAPACITY: LIMP MODEL: PUMP /SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO GALLONS PER CYCLE: PuM A D LS OPERATIONAL: NUMBER OF PROPERTY WELL BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF ES ❑ NO NEAREST --- 01 SOIL ABSORPTION SYSTEM. Check the soil mois re t t e pth of plowing FORCE LENGTH: DIAMETER: MATERIAL AND MARKING: or excavation. (If soil can be rolled into a wire, co r tion s all cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: #PITS: LIQUID BED /TRENCH I J T TRENCHES: DEPT M:Y DIMENSIONS RIAL DEPTH: QO U c`� GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE ATERIAL: N0. D TR. NUMBER OF PROPER WELL: BUILDING: VENT TO FR H BELOW PI ES: ABOVE COVER: 4EV. IN ET: ELEV. END: PIPE : FEET FROM LINE: / AIR INLET: —27Z 'P_ NEAREST --- 5� MOUND SYSTEM: Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ❑ YES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ❑ YES ❑ NO ❑ YES ❑ NO DEPTH OVER TRENCH /BED DEPTH OVER TRENCH /BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: BED /TRENCH WIDTH: LENGTH: NO. OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: � DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO DISTR. I DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEV.: ELEV.: DIA.: ELEV.: PIPES: DA.: ELEVATION AND DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑ YES ❑ NO ❑ YES ❑ NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEI LINE: ❑ YES ❑ NO ❑ YES ❑ NO AREST �� 1 V T -2^ w -- t ,..m Sketch System on Y Retain in count file for audit. Reverse Side. SIGNATU _ TITLE: /} SBD -6710 (R. 06/88) ( /�� VY �ILHR SANITARY PERMIT APPLICATION � In accord with ILHR 83.05, Wis. Adm. Code STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ � 8% x 11 inches in size. c f Pev iefo to revious application —See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER I. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERrTY OWNER PROPERTY LOCATION ®1J /a Y" S , N, R j PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # 54 44 Zo� CITY ST �!, ZIP CODE PHONE NUMBER SUBDIVISION NA OR CSM NUMBER 11. TYPE OF BUILDING (Check one) ❑ State Owned ❑ VILLAGE : NEAREST RDA . ❑ Public ®1 or 2 Fam. Dwelling — # of bedroom EL TAX NUMBER(S) 0 0 � ` 1 f _ TO cc (3 111. BUILDING USE: (If building type is public, check all that apply) (V V 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility /Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales /Repairs 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 in line A. Check line B if applicable) A) 1. ® New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit ¢# — Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 N Seepage Bed 21 El Mound 30 ❑ Specify Type 41 El Holding Tank 12 Seepage Trench 22 ❑ In- Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3, ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals /day /sq. ft.) (M'ndinch) ELEVATION C Feet Feet VII. TANK CAPACITY Site in aallons Total # of Prefab. Fiber- Exper. INFORMATION New xistin Gallons Tanks Manufacturer's Name C oncrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank Lift Pump Tank/Siphon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation oft onsite sewage system shown on the attached plans. Plu er' Name int): Plumber's Signatur Stamps) MP /MPRSW No.: Business Phone Number: Je Z Plumbs 's Address (Str t, City, State ip Co 2!= ACA&V20A(D /,J1 , � �, - 7 IX. COUP TY /DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee (Includes Groundwater Date ssue Issuing A ent Signature Approved ❑Owner Given Initial Surcharge Fee) Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD -6398 (formerly PIb -67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Saniltary Permit Transfer /Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly riiaintairied. The septic tank(s) must be pumped by a licensed pumper whenever 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 & Buildings Division, 608 -266 -3815. To be complete and accurate this sanitary permit application must include: I. 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 in 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 in ##1 -7. VII. Tank information. Fill in the capacity of every new and /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. IX. County /Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than B% 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; (Jose 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 ipst data on at 115 form; and F) all sizing information. GRbUNDWATER SORCHARGE 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, ground - water contamination investigations and establishment of standards. SBD -6398 (R.11/88) . APPLICATION FOR SANITARY PERMIT 9TC -100 This application fotm is to be completed In full and signed by the ownet(s) of the pcoperty being developed. Any lnadequacles will only result in delays of the peta►lt issuance, -Should this development be intended lot resale by ownst /contractoc,(spec house), then a second form should be retained and completed when the propetty Is sold and submitted to this lattice with the approptlate deed recording. -------------------- ------------------ - - - - - - - --- -- - -- -�.•- . •• -- •------- - --- Owner o[ to etty J Z" 9 5a - r r Location of property Aj1L 1 m AlAl --, /t, section T Y Township �✓ Malting address Address of alts subdivision name J • Lot nuabar Previous owner of property a rye S 's Total size of parcel Z . Date parcel was created Ate all corners and lot lines Identifiable? Yes jl 0 Is this property being developed for resale (spec house)? _Yes 0 Volume and Page Number -461 as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWINCI WARRANTY 021D lch Includes a DOCUMRNT NUMORR, VOLUMi AND PAOt NVNStR, and t 0 Hi RBOISTBR OP DBBDS. In addltlon, a cottifled sutvey, It available, would be helpful so as to avoid delays of the tovlawing process. It the deed description references to a Ceitlfled survey Nap, the Certified server Map shall also be required. --------------------------------------------------------- -----••-•---------••-- PROPBRTY OWNER CERTIFICATION I(ve) certify that all statements on this forte are true to the best of my (our) knowledge; that I (we) am (ate) the owners) of the property described In this lntotmatlon totm, by virtue of a warrant dead recorded in the office of the County Register of Deeds as Document No. S`/ .4' 1 and that I (we) presently own the proposed alto for the sewage disposal system (at I (we) have obtained an easement, to tun with the above described property, tot the constructlon of said mystem, and the same has been duly recorded in the office of the County Reglots of D ads, as Document Ho. ). 7 • %W. owner signature, signature, of co -owner ttf Applicable) Dale ' na use Date of Signature r (f� I • ,°` r DOCUMENT NO. STATE: BAR OF WISCONSIN FORM 1- 1982 THIS SPACE RESERVED FOR RECORDING DATA 451253 WARRANTY DEED - wc: 8 50PArr 401 REGISTER'S OFFICE ST. CROIX CO., WI This Deed made between . -.Char 1_e s_ ah 1 i s t_. _ a_(k , ( il�ar_ les ___R, ... Wah_lguis_t.�___an_d_ _Naomi --- Wahl_gu- ist ... a_ /kJ_a Recd f0� Record b .anal-- a_nd.. - Tnt_i f e...... - - - - - S LR J 51989 --------------------•--------•-••------------------------ ••-•---- ••- ••-- --••• -• -- -- •-•- •- ----• -, Grantor, Gt 4.20 P M a,d..Je_ff --- _C Wahlquist, James R. -ahl_q_uis•t_,.- - -..._ Charles . - W Wahlq uis t_and Robert L Wahlquist, V as t en an t_s___in___c ommo_n_,_____ ------------------------------- Register of Deeds -- - - - - -- -- ----- -- --•--- ----- -- - - -• -- - - -- Grantee Witnesseth That the said Grantor, for a valuable consideration.... -- of one dollar and other valuable consideration ---- - - - - -- -------- - - - - -- -- - - ---- .................................................. S t C r O i X RETURN TO conveys to Grantee the following described real estate in .... _. .... Count State of Wisconsin: Tax Parcel No- ----------------------------•---- The North Half of the Northwest Quarter, also the Southwest Quarter of tle Northwest Quarter except the West 100 feet of the South 356.31 feet.. tlereof, also the North Half of the Southeast Quarter of the Northwest Quarter; all in Section One (1), Township Twenty -eight (28) North, Range Seventeen (17) West. This deed is given in complete satisfaction of the land contract between the parties dated November 23, 1981 and recorded February 2, 1982 in Vol. "641 ", p.250 et.deq. as document numbert 375661 which was amended August 3, 1988 and recorded December 19, 1988 in Vol. "829 ", page 521 et. eq. as document number 443914. TRANS= 1 $ S'70-00 This is •.- • ........ homestead property. F (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And... - Charles Wahlquist and Naomi Wahlquist ........................... warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and covenants of record, if any, and except the mortgage(s) to the Federal Land Bank of St. Paul, which grantees assume and agree to p ay according to its terms. and will warrant and defend the same. Dated this 3rd -- -- •-- ----- - - - - -- -- day of ----- -- • Au g ust - - 19..$.8.. - -- - _(SEAL) - - - - - - - -••- -- • - - - -- - - •- - - - - -- -- -- - - - - -• - -- (SEAL) * .. _Char 1es ah1quis - ----------•----------- - - - -- (SEAL) E f;�ir (SEAL) * aomi Wahlquist AUTHENTICATION ACKNOWLEDGMENT Signature (s) . - - -- o f - ---- h a r l e s W a h lgu i s t - _ • ___ STATE OF WISCONSIN and Naomi Wahl uist____ ________ _______ ss• . 3 o�h ------------- • ----------- •- • - -- -- -. --- County. auth ed j1IS •....__ -day of..... - • - -._. _ -- Personally came before me this ................ day of = ------ - - - - -- ........................................... 19 ........ the above named * Robert F . Wall --------- - - - - -- --------------------•-----------•-- - ---------------------------- ---••--------------------------------------------------------------------------- TITLE: MEMBER STATE BAR OF WISCONSIN (If not- ............................................................ authorized by § 706.06, Wis. Stats.) to me known to be the person ............ who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY RobertF. Wall ---.•------ ----------- •---- •- ••- -------- - - - -- .... ...................... WALI r-- & --- HARR- I- S................. --- ••- • - - - -- .................. 522 Second Street *--------------------•--------------- •------------- - - - - -- ..................... Huds- on -,--- W. 1 ------ 54. 01. 6--------------------------------------- Notary Public _-- .................................... County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (if not, state expiration are not necessary.) date: ......... 19 ......... *Names of persons signing in any capacity should be typed or printed below their signature,. WARRANTY DEED STATE BAR OF WISCONSIN wiseonsin Leal Blank Co. Inc. FORM No. 1 — 19s2 Nf it wauke' , Wis. .. lk DEPARII NIENT OF REPORT ON SOIL BORINGS AND SAFETY &BUILDINGS INDUSTRY, � DIVISION LABOR [�� a TESTS (115) MADISONI WI 53707 P.U. BOX 7969 AND LABOR RELATIONS PERCOLATION TE (1463.090) & Chapter 145.045) LOCATION SECTION: ! TOVUNSFIIP /P:11JfJICIPALITy; LLO f NO.. B�K. NO: SUBDI VISION NAME: M NW -- '104 1 14 1 /T28 N /N1.7xK ( Rush River _� --' 1/a n/a n/a COUNTY. -- OWNER'S I3X7CKN3 NAME: h AILIN G ADDR Ess. St. C roix Jef Wahlquist _ 5 95 200 St., B Wi. 54002 USE DATES OBSERVATIONS MADE NO. BEDRMS.: 1 COMMERCFAL SCRIPTIQN: PRO 1 EE D SCR PTIO S: O A ION TESTS: Residence 3 n/a —` -- �Ivew —❑ Replace 6 -29 -90 n/a RATING: S= Site suitable for system U= Site unsuitable for system _ CO MOUND: IN- GROUND�PRESSURE: SYSTEM- IN -FIL.L HOLDING TANK: RECOMMENDED SYSTEM: (optional) U S ❑U ®S �U �S ❑U S J U • S conventional If Percolation Tests are NOT re wired rsIGN RATE: If an portion of the tested area is in the under s.H63.09(5)(b), indicate: Class 2 � Floodplain, indicate Floodplai el evation: n/a decimal' PROFILE DESCRIPTIONS page 78 PIA [ BORING TOTAL DEP H TO GROUNDWATER - INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH UMBER DEPTIIM, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) BA 7.50 98.82 none >7.50 83bl.1. 1.67bn.cl. 4.00bn.l.s. &gr. 1.00bn.m.s. B-2 7.59 98.24 none >7.59 .92bl.1. 1.25bn.cl. 4.75bn.l.s. &gr. .67bn.m.s. 3 7.50 98.03 none >7.50 1.17bl.1. 1.33bn.�l. 4.25bn.l.s. &gr. .75bn.m.s. 4 7,17 97.64 none >7.17 .7561.1. 1.50bn.cl. 2 .50bn.l . s. &gr. 2.42bn. 8 -5 7,83 98.36 none >7.83 .92bl.l. 1.,58bn.cl. 4.00bn.l.s. &gr. 1.33 bn.m.s. PERCOLATION TESTS WST '1SYEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL - INCHES RATE MINUTES NlJM7BEf IN CHES AFTER SWE LLING INTERVAL -PAIN. PERIOD 1 PERIOD 2 P R O PE INC P- -- see d_e 3ign rate �P _ PLOT PLAN: 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 slope. SYSTEM ELEVATION 94 � . 39 j` /gyp 1 � ,q S - A �,S ` v Otrtyl %t, T N { C) �A t, ,` 1.s • S -.- 4, 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print) TESTS WERE COMPLF T ED ON: Gary L Steel 6 -29 -90 /\t ?CTV`ESS -- - - - - -- - - -- —.._ -- ._ - - - -- - - - -- CERTIFICATION NUMBER: PHONE NIJMRER(or)linnal) _988 N. Shore Dr., New ARichmond .Wl . - 54017 _. _ . _ _ _2��$____ 715 -24 -6200 _ -- — — CST SIGNATU DISTRIBUTION: Original and. one copy to Local Authority, Property Owner and Soil Tester. SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/ BUYER C I � 0 Fire Number______._ :3 ROUTE /BOX NUMBER e 0 CITY/ STATE ZIP i�i4r°� M rt rt PROPERTY LOCATION: ", Section L,• Ty�,'_N, RZ_W, Town of - ,St. Croix Count , Subdivision ,, Lot number Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Prover maintenance con - sists of pumping out the septic tank every three years or sooner, if needed, by a licensed 's*e tic tank pumper What you put into the system can affect ze unct on o, the s eptic tank as a treat- ment in the waste disposal system. St. Croix County residents maL be eligible to recieve a grant for a maximum of 60% of the cost.of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new 'systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or.a licensed pumper veri- fying that (1) the on -site wastewater disposal system is in proper operating condition and •(2) after inspection and pumping (if nec- essary), the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. H I /WE, the undersigned have read the above requirements and agree o to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Depart- w ment of Natural Resources. Certification form must be completed b and returned to the St. Croix County Zoning Office within 30 days of the three year expiration.date. 1 SIGNED DATE St. Croix County Zoning ffice 911 4th St. Hudson, WI 54016 386 -4680 Sign, date and return to the above address. u Sec i Jj lAJ Rush 1 Ue r Se p " 7a n k �C P1600 k p� sc � y > 7 =a 3 fi as o l PAGE OF C r U A �e►7 S r Ftoih Ali IM616 And Obtsrvollon Pipe /••� /�� /�� A ----- Approvld Vent Cop MlMmum 12* Above final Grad• 20- 42' Above Pipp _ 4 Coal Iron To final Grado Vent Pipe WrM Nor Or SrMt CovarMy "in 2 Ayyrayala Oral Plpa OI�II Ib �Oon ' Plpa o 0 0 ^ Too 4 Aiy Pipe o Parlorolod Pipe balav Bana Ub Plpa V o 'Cowpllny Tarallnollny At Bollom Of Si ►lam 9� Pru � e D �l i•1 �. � � ri. �1 < .. P SOIL FILL DISTRIBUTIOVI PIPE APPROVED S4)JPF - TIC COVER r ° `�' — !'1 I►T Rift OR 9" OF ST R A W 2" OF 1G69EGATE —� OR MARS►+ HAy A a /e AGGREGATE AL V. O F F EET—.• DISTRIBUT1O►J PIPE TO BE AT L E K -4 - T INCHES BELOW ORIGIIJAL GRADE AQU AT LEAST LO I►JCHES BUT AIO MORE THAI) 42 IEICHES BELOW FINAL GRADE MAXIMU M MTH OF F-X /1 VATIoF.➢ FXD1.1 o KIGW gI. bRnvF- WILL BE _s5"L'� IIJCHES lvromm gCP rN of EXCAvnTION NO^ olk '61WAL GRAPE WILL »[ INCHES SIGHED: LIC E►J SE IJUMBE R: DATE: 1 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115 P.O. MADISON WI 79 HUMAN RELATIONS (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP /MUNICIPALITY: OT NO.:BLK. NO.: SUBDIVISION NAME: NW ��, VW 1/4 1 /T28 N/k7A (or) W I Rush River n/a n/a n/a COUNTY: OWNER'S LAME: MAILING ADDRESS: St. Croix Jeff Wahlquist 595 200th. St., Baldwin, Wi. 54002 USE DATES OBSERVATIONS MADE NO. BEDR AL DESCRIPTION: PROFILE DESCRIPTIONS: 1 PERCOLATION TESTS: MS : COMMER 1UResidence 3 n/a 9 ❑Replace ( 6 -29 -90 n/a RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN- GROUND PRESSURE: SYSTEM -IN -FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) S ❑U P S ❑U CAS ❑U [:]S ®U ❑ S CCU conventional DES If Percolation Tests are NOT required IGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: class 2 �Floodplain, indicat Fl elevation: n/a decimal PROFILE DESCRIPTIONS Page 78 PIA BORINGI TOTAL DEPTH TO GROUNDWATER- INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTRM. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 13-1 7.50 98.82 none >7.50 83bl.1. 1.67bn.cl. 4.00bn.l.s. &gr. 1.00bn.m.s. B -2 7.59 98.24 none >7.59 .92bl.1. 1.25bn.cl. 4.75bn.l.s. &gr. .67bn.m.s. B 3 7.50 98.03 none >7.50 1.17bl.1. 1.33bn.cl. 4.25bn.l.s. &gr. .75bn.m.s. B- 41 7.17 97.64 none >7.17 .75bl.1. 1.50bn.cl. 2.50bn.l.s. &gr. 2.42bn..m.s. B -5 7.83 98.36 none >7.83 .92bl.1. 1.58bn.cl. 4.00bn.l.s. &gr. 1.33 bn.m.s. B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL - INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL -MIN. PERIOD 1 PERIOD2 PERIOD PER INCH P- P _ see de ign rate P- P-_ P- P- PLOT PLAN: 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 slope. SYSTEM ELEVATION 94.39 z e . II i Q : at v bl�s�i I S " `^ i I ti _ _ i I I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedu e d me 0f, s�ecified in the WIsco in Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge an f. J t-' L i J1 NAME (print): TESTS WERE CO ED ONCC)ON7TY Gary L. Steel 6 - 29 -9 / ,. 20111 N G OFFICE ADDRESS: CERTIFICATION NU R: PHONE NU BERG( ional): 988 N. Shore Dr. New ARichmond Wi. 54017 2298 715- 4 6 CST SIGNATU DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR -SBD -6395 (R. 02/82) — OVER — r 7 INSTRUCTIONS FOR COMPLETING FORM 115 - SRI - 6395 To be a cornplete and accurate soil test, your report must inchlde; 1 . Complete legal description, 2. The use section must clearly indicate whether this is a residence or commercial project; 1 MAXIMUM number of bedrooms or cornmercial use planned; 4. Is this a new or replacement System; 5, Complete the suitability rating boxes- A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 5. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scal € =, is preferred. A separate sheet may he used if desired; B. Make sure your benchmark and vertical elevation reference point are clearly shown, and are permanent; 5. C,�rnplete all appropriate 'boxes as to dates, na -rres, addresses, flocad plain data, percolation test exemp- tion, if appropriate; 10. If the infortnation (such as flood plain, elevation) does not apply, place N.A. in the appropriate box; 1 1 . Sign the form and place your current address and your certification number; 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st - Stone lover 10 „ ) BR - Bedrock co b Cobble (3 - 10 ") SS - Sandstone gr Gravel (under 3 ") LS Limestone s - Sand HGW - High Groundwater cs -- Coarse Sand Pere - Percolation Rate rned s - Medium Sand W - Well fs - Fine Sand Bldg Building Is -- Loarny Sand > - Greater Than sl - Sandy Loarn < ..- Less Than r - Loam Bn - Brovvn '0 _ Silt Loam B! Black si - Silt Gy Cray cI - Clay Loarn `e' Yellow set- Sandy Clay Loam R Red sicl - Silty Clay Loam mot - Mottles Sc Sandy Clay wl vvitla sic - Silty Clay fff few, fine, faint r; - ' Clay cc - ccsrrtrnon, GOarse I1 Peat n i m Many, medium m . Muck d - distinct: is - prominent HWL- - High watvr level, Six general soil textures surface water for liquid waste disposal BM - Bench Mark VRP - Vertical Reference Point TO THE OWNER: h;S",uil test repoit is the first Stop in securinct a sanitary permit. The counts sgrtfai-, Department may request Ye;! ifiCa3,KM Of this Sol! test ill this fr::ird pair r to pe.vnit issuavice. A cons mete set of }Maras for the pikiate ovfage sysli "ill and a permit Eapplwiau',r; rntast i)e sr' ,ar,qed to the apd3 ;opriate IL'M'11 tratlaority Ill Order tta t f b i a m i a p. ". rt. T tL sarlita1"y perli no 1w obt4 a zied a r ; d po5terl Imo rto * hp slZltt of any