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HomeMy WebLinkAbout026-1290-12-000 ` Wisconsirl Department ofCommerce PRIVATE SEWAGE SYSTEM fet County: St. Croix Say and l3uil� ling Division Sanitary Permit No: INSPECTION REPORT 479265 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 N LeQue Builders LLC I Richmond, Town of 6Z�O' /Z9b- / CST BM Elev: Insp. BM Elev: BM Description: ( Se ion/Town /Rang ap No: / 03. - 7 l U 3. v (�C� Q,�t $ S r 2.30.18. /'-1 TANK INFORMATION ELEVATION DATA TYPE e4w4mFA T RJR CAPACITY STATION BS L HI FS ELEV. Septic Benchmark / Qt 1 63. 7 Dosing Alt. QM ( 10 �OS Aeration Bldg. Sewer Holding St/Ht Inlet Outlet TANK SETBACK INFORMATION St/Ht 3 TANK TO fp/L. WELL BLDG. Vent to 'r Intake ROAD Dt Inlet r r Dt Bottom Septic ' � � � � ./ Dosing Header /Man. Aeration Dist. Pipe V G1 Cf Holding Bot. System Fin Grade 31" PUMP /SIPHON INFORMATION Grade Q JAli •? Manufacturer J Demand St Cover 1 GPM ,o Model Number*-- D U TDH Lift Friction Loss ys d TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM 2 (�jtitit. BED/TRENCH Width / Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 1 SETBACK SYSTEM TO P/L BLD WELL LAKE /STREAM LEAC G Manufactur �/ INFORMATION CH R ` T e Of System: UNIT Model Number: /I ( i 1 6 , 5> � r Iro DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x HoleFSpacing Vent to Air Intake tf Pipe(s) ! ! /O ICJ d' Length Dia Length � Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only 3 ' r Depth Over Depth Over xx Depth of 1 xx Seeded /Sodded xx Mulched L Bed/Trench Center / }/ Bed/Trench Edges Topsoil 7" ,( [] Yes j ] No Yes [ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #11: ( 7 � /�^ Inspection #2: Location: 1421 129th Street New Richmond �WII 54017 (SE 1/4 SE 1/4 22 T30N R18W) Lundy's North Lot 12 /JJ Parcel No: 22.30.18.. ► 1.) Alt BM Description = WAjN^ d4 P't SIl! s�� irYt ' X k- y " -- f�— 2.) Bldg sewer length - ,,7 IdAc ��1_ — - amount of cover = L/ I T/�' Plan revision Required? j Yes o 1 Q -7 I0 _ % '_ L_ Use other side for additional information. (_ — -- - - -- - Da� - Ins Sign tune Cert. Njr SBD -6710 (R.3/97) • �Y alit Divtsaon C�-- - - llwtdtngs _ o+smY All 1 Ave.. P.O. Box 7162 - be ( E I V F permit Ntttnber (W die in by Co. ) De rtme rtt of Commerce Sanka pe } Plan I. D. Ntmsba In accord with Comm $3.21. Wls. Adm. Code. � �i m+t be vessatai , 2 0 0, i Y toed for secondar pnsposes Privacy Law. :fs. I}(ta i Address (if diffvent than mailitts address) E. Appiicadioco - S 1, CROIX COUNTY p i'lertse E'rErtt Ail Bltaee�rtioo — __ � 7 NiNG - OFFICE_ -_ r � �_ h�' hvp wvy Owner's L pu�� LL C, - -- �Pa Loe 's M aiihtg Address 2 & , 1 ^I - � Staoe °` Location Cky, - - -1 zP code PM�e Ntamiser S �. s F %.seer M a i 01 N t,` 0 w� ctrcl ) IL Type at (aiteck all mac apply) — S tea b T 3 a N, R A � E J or 2 Fumt — — y Dwdliag - NiuMer of Bodropras „D Subdivoi n Nanw CS o t 1 U PUNic/Comrrsercial - Dewmbe Use L ld fl s /VO r�1r` t Saw Owned -pacribe U ( ✓ _ _ ___ __ _ .__ _ _ .__ —_._ _._ _ L L.ICety L�Vctls(te ownship of h ; �7 am boys on A. litre a if opplieoble) Z tU i • /. h . S A_ New System ❑ Replroenses t System ❑ TrermseWHokfins Tank ltWlacemr" Ordy ' r �Otfht7 Mi hcation to Exiting Sysrcm i B. ❑ Permit Reuewai 11 Perm, Revision 1-1 Change of CI Permit Transfer to New List Previous Permit Number and Darr Issued — -- Heftxe FA&Uticm Plumber Owner f t+• 'hsK of rown S�ralae: t(7taet aEl IMtt appiri Non 4hes l Grotud LI boa > 24 in. of mumble soli i._i Mound < 24 in. of sunklib soil U At -Graff 1 ] Single Pass Sand Filter j U Cam Wedsnd Q Pressurized b"Gruatd U Holding Tank I. l Peat Filter Aerobic Trewmm Unit L) Recirculating Sand Filter Synthetic � l FJ Drip Im. OrGrsval -less Pgta 1j Odra (exY! nl Arm Row ( ►Soil Appiicautp Dapettal Ann Required (if) Dispersal Arta Proposed (sf) System Elevation ~ �j Yi, Taatit Infer Capacity in Total Number p Mamf r Prefab Site S Fiber Plastic Gallons Gallon of Unit i o f /J � Concrete Constructed Glass I New `( T " J Exisli Tacks Tanks Hollins Tank Aembic T"_"K" Unit �t ES V VD- S> aur.oeu- i, the araatare ier Na tae ( or the POWTS dwwo m the ach Uaed tom• 1 � ; gtuatre �. MPRS urnbcr Business Phase Number meter s Addle (sheet City, State. 2:0 53 7 /,S { S8111 Pam Fee Groundwater D7� Isming Sigaabsre No Stam Surcharp ow {srwe ista Reasor! oemw X. C — -- -` � SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all t!e serviced / rrlelniaint3d as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. �tY «hM site ue .. papa with tits tkee titQ a It krclua in Mae tj Po B ®x [S L Lt..v\ a y Is N.e-%o %8\vv\a ��r C Y`o SIC -9sot 0 -4 I o(o 7 - 3 o - � �,L c N c S Y / S'4 4 wx .. es o3,7 lop rr � o G f LinWb • o o. Wisconsin Dep artmen t of Comme SOIL EVALUATION REPORT Page of P Division of Safety and Buildings l Wis. Adm. Code count ty L Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Revi ad by Date Personal information you provide may be used for secondary purposes (Privacy law, s. 15.04 (1) (m)). u Z Z S Property Owner Property Location e r Govt. Lot D 1/ S 1A S OC�T_-�o N R J$ E Property Owner's MailiMAdd ss L t # Block # Name CSW '2 13AK s . � -- city State Zip Code Phone Number ❑ City ❑ Village ' KTowe NearrtRoad New Construction LlsegResidential / Number of bedrooms Code derived design flow rate QQ GPO ❑ Replacement ❑ Public oopommerce� Describe: Parent material a ^!7lU/G�� `-� Flood Plain elevation if applicable /f /� R l General comments and recommendations: Boring # Boring a Pit Ground surface elev. b ft. Depth to limiting facto in. Sal 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 -^ ,e I2 1 6,4 1 , 41 — � �S lL a Boring Boring # ❑ Pit Ground surface elev R. Depth to limiting factor in. Sal 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�v 3 GS .� 3 �l ► b r `/ ,� v 4 . v c� 3- (0 0 1. S- Effluent #1 = BOD > 30 220 mg/- and TSS >30 < 1 ` Effluent #2 = BOD _< 30 mtg/L and TSS < 30 mglL CST Name (Please Prin(I nature CST Number Bird Plumbing, Inc. Shaun Bird 226900 5� Address Date Evaluation Conducted Telephone Number -4516 1008 192nd Ave, New Richmond, WI 54017 _ 715 - 246 1 Property Owner Parcel ID # Page of F s - 1 �� # ❑ oring 7� Pit Ground surface elev �� r Depth to limiting fador y Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. I Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 •Eff#2 � r3 I K 0 Boring #. C Borin it Ground surface elev. J • Z ft. Depth to limiting fad/1Z in. Soil A kon 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 ss F-1 Boring # ❑ Boring Cl Pit Ground surface elev. ft. Depth to limiting factor in. Sal ication Rate . Horizon Depth Dominant Color Redox Description. Texture Structure Consistence. Boundary Roots GPOM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 I I Effluent #1 = BOD, > 30 1220 mg/L and TSS >30 < 150 mgiL ` Effluent #2 = BOD < 30 mg& and TSS < 30 mglL 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. seo.aw (R.&W) Soil Test Plot Plan Project Name Environmental Holdings LLP Shau it Address 706 19th St. Hudson Wi 54016 C M #226900 Lot 12 Subdivision Lundy's North Date 12/1/04 S 1/2 SE 1/4S 22 T 30 N /1418 W Township Richmond Fj Boring Q Well PL Property Line County S T. CROIX � Assume Elevation 100 ft. =T of Survey Iron T Ce�►•�� B r VRP System Elevation 98.7/84.4 *HRPSameasBenchmark Alternate Benchmark Top of 1/2" Pipe @ 100.3' Scale is 1" 40 unless otherwise Please note: soil test noted \ may not be suitable for \ owners desired building location, Soil test was done to satisfy zoning requirements, please verify system location Y before excavating. 195 , Property 104' Line �d V B -1 i 0' 5% Slope I B -2 40' B � 50' -3 B.M. * /Alt. 414' Property Line B. 150' • _ ' .� �..� ©tom ��I� •: r j EZ1203H Wo Vo ' we ►�� Est .: Vow ♦• i ri viv . }` t T 1.12 Ctm i &84 ♦!!!!e♦ s�ewVVW +lt.!!! b 24 P — 36 "--- �v.aQ., D1A. (ty V oid =oefTic m A St"o at 57.4% lamfi ta[ " u -a- efa° �9 r t%Ar = 4.623 edcr:ft S ' °!i° Pa 1.14 = �. 2J 123ir 1. i ? )J rzs r n / �' 0.1 i r3• t 4. D. oPaommer t cyi+eder Vwa ow s Tow so" loterhive Area �{ ltaoc of act '�3 1 • a '-�'° 1" ZS 12lr ' S_ L1 $O__ ' f M . 422 tl= i t2artt.,� l 1:R k j' � J j a ontsWe CV("% ers = 12 swciet / I 4`(Nd vof o,,tM r Projected Tree! .area 901 tr Sldew It a ker�hl 12 m oeet volume ar buta� between c�HW _ { 24- n, Swoo _ ' 36 in tdieeh.,12olt1i l.r4i � () - OU$y - Fr. ' 0 _t5R Pr Lnrd vole u , um o)K'ted Traractt Atea S� Et r 5.0@ . �`�r^ rn.xKrs { t f"t of vora, voiumc between L7ll�css) U 2 t ,f - ' . To7S! "'d vat t) 10� R' 17 4 b 1} S - 11.108• 17t3 cub_ fi•ft I (ia4ons P, ft = 1 763 X 7.48 r E r { I t 1 EPS Aggregate Trench System i EZ 1 203H J b i g lndustriai Group F IA t �rdu3tfia1 Park Rd. Oakland TN f l R` S MANUAL & ' MANAGEMENT PLAN Page of POWTS OWNER'S -d Sysnn" ,p�,lcaTroas *z wmfwmm� rE a _ W t %,aS Q r- d NA � 1 1 S � o f Vol. 1 got perrrrit # 2lo S d NA Manufacturer pE8i8t+1- PARAfME1'f1S D Spd 13 Oo se 13 N voi. Bel LA D NA Number of BlIdraoms EtftuaM ManuFa y �o DNA 0 NA K *w of Public FaatV Ur ft Effluetnt F#w Model L mated (average) flow QUA Pump Manufacturer (( Design (Pk) flow = (Estimated x 1.51 . r d Pta'np Model A San AppKcUftn Rata ard IrdluientIE"knarit Qual MonthlY ate D Sarah Filter D Peat Filter Fats, Oil A Grease IFOGi 530 rngn D Mechanical Aeration ❑ Wedend Biochemical Oxygen Demand (BODs) a20 mg/. ❑ NA D DisirdscOm D per• Total Suspended Sow (TSS) 516o O NA mgli- Monthly average pre"ated E V effluent Queft ts) Biochernicai Oxygen Darri arxl tBODs) 530 mSn (:"Ity) 13 krCiround sturixedl Total Sum S (TSS) 530 mgn- 0 �' p Mound Facet conform ( rriearil 510` chn/1 OOrtd am DNA p Drip -gape Q Other.' Maximum Effluent Particle Size Y in die. D NA Other: DNA 0 N Moir *Values typical for domestic „vastawater and ssptie tank effluent• MA►f51[>rf►tANCE SCtl 1.E Service Fre+quane:Y Service Event }s)n 3 Years) ❑ NA Mspect condition of teu7k(si At bast once every. one -third tY') of tank volume ❑ NA When combined sludge end scum equals 0 When the high water alarm b scovated Pump out contents of tardclsl montth(si (Maxinaur» 3 ) DNA At bast once every: ls) inspect d'ispersai cow rriori�ts) ❑ NA Clean effluent filter At least One aVVr month(ss) A At bast once every: Q ) Inspect _purr, fop corittois &alarm ❑) A At least once every= D (s) Flush laterals and prss mare test ❑ rnanth(s) A r. At bast once every: 13 yes rle) N A or certifications: 1AUNTENANCE fNSTMIC IONS iridinridual carrying one of the following i O o r ca r (pumper). Mspecti ona of tanks and d+sparasi cols shall be made by , DOW TS Maintainer: Sep any cracks or Mash Plumber; Master Plumber PAMttictsd Sewer; POWTS or broken hardw►ate, khintft must include a visual inspe�n of the tm*(s) t i a yMbadc f of effluent on the ground Tank inspections for OW leeks, meawre volume and scum effluent pipes and to clock surFece. The dim cells) shell be vislume of combined sludge lnepect � surfauent levels in the observation may indicate a failing condition and The pending of effluent on the ground pond'ing of effluent on the ground surface- local reguletotli requires the immediate nom more of the tank volume, *4 scum in any treatrrien t tank squids axle third lY or of in accordance with chapter NR 113 When the om*k ed accurmIlIatim of sludge and entire contents of the tank shO be removed by a Septa SMvicir* operator and disposed Wisconsin Add Code: mechanical Of pressurized components, pretreatmen including but not limited to the serv of affluent filters. All other services, by a certified ppvYTS Mairitam'ier. units, and any servicing at intervals of 512 months, shade be performed of � of any service event. A � r eport bs provided to the locai mgulstory au"Writy w 10 days GMW (2102 l START UP AND OPERATION Page' of For new construction, prior to use of the POWTS check treatment tank(s) for the �cals that may i�hede the treatment Presence . painting products, solvents or other P se and/or damage the sod knits high conc ). tf have the contents of the tank(s) removed by ert wdons are detected g operator prior to use. System start up shall not occur when sod conditions are frozen at the infiltrative surface. During extended pow outages Pump tanks may fig above wastewater will be discharged to the kep normal mal is) in a highweter levels. When power is restored the excess discharge of effluent. To avoid this have the � dose and may overload them resulting in the backup or surface contents of the y Septage Servicing Operator prior M restoring power to the effluent pump or contact a Plumber or POWTS Makfteirw to assist in manmrelly operating the pump controls to restore non" levels within the pump tank. Do not drive or park vehicles over tanks and dispersal calls. Do not drive or park over, or otherwise disturb or within 15 fast down slope of any mound or at -grade soil absorption area. compact, the area Reduction or elimination of the following from the wastewater stream may improve the Performance and cigarette butts condoms; cotton swabs; prolong the life of the POWTS: antibiotics; baby wipes; foundation drain ism pal discharge. fruit and degreasers; dental floor; dt scrap : medications, disinfectants; fat; tampons; Pings: softener 9oease; herbicides; meat scraps; medications; ail; P products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is Property and safety abandoned in compliance with chapter Conan 83.33, Wisconsin Adrninistrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of an tanks and pits Owl be removed and property disposed of by a Septage Servicing Operator. • After pumping. all tanks and pits shag be excavated and removed or their covers removed and the void see filled sod, gravel or another inert solid material. sp with CONT94GENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing, and proposed structure, lot lines and wed. Failure to protect the replacement area will result In the need for a now soli and site evaluation to nth a suitable replacement area. Replacement systems must' comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring a holding tank may be insial u�lsca the forted POWTS ted as a last resort to advances in POWTS . ❑ The alts has not been evaluated to identify a suitable replacement area. evaluation must be performed to locate a suitable nit Upon failure of the POWTS a soil and site may be installed as a last resort to replace the failed POWTS. tf no replacement area is available a holding tank Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the pries in effect at that tine. < <WARNING> > DER - A S KW W i7C A, ND PU OTHER MP OR TRE OTHER TREAT ATRT%WW TANKS MENT MAY TANK CONTA UNDER LETHAL CIRCU GASSES MSTANCES ANDIOR MWAM CIENT OXYGEN. DO NOT Mi ANY . DEATH MAY RESULT.. RESCUE OF A RMON ROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR NYIPo&"". ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTA�R Name U, n ®t.u� �rS Name Phone lS Phone SEPTAGE SERVICING OPERATOR (PUMPER! LOCAL REGULATORY AUTHOFM Verna Name C Phone is 29 (0 phis document was drafted by the staffs of the Green Lake, Marquette and Woustwe County Zoning imPter Comm 83 .2212)(b)l1)ld) &tf) acrd 83.54(1), (2) & (3). Wisconsin Administrative Code. kati agendas in °°mpiance with ST CftOIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 9 ),� 1 1 j d? Mailing Address P Property Address (Verification required from A for new construction) I po,r+ n City /State Pig I���d l �Xr-L Parcel Identification Numb b2ln' ) O LAo' 1 S " ()D LEGAL DESCRIPTION b 2p I o6l - JD' p00 r � r Property Location ;, 5 ' e %,, Sec. T 3 O N RRW, Town of kle 0. SSubdivision i Lot # . Certified Survey Map # Volume , Page # J �S Warranty Deed # 5335 Volume d S . page # ;;, 7 Spec hawse yes ❑ no Lot tines identifiable j4f yes D no Q � SYSTEM MA_R ' AE N use and Hof your septic system could result is its pceamnue &d me to Imndle wastes. Pwpwmaintemncc consists of pumping oat the septic tank every► three years or sooner, if needed by a licensed punq=. What yon put into the system can affect the function of the septic tank as a UMMUCUt stage in the waste disposal system. The property owner agrees to submit to SL Croix Zoning Department at orb' scat m fame, signed by The owner and by a m mastaplwnb" Jou�ymanpinmben phwg=ora licensed veiifyiug that(I) the on sift �dispoW "Sum in proper operating condition andfor (2) after inspection and pumping (if necessaty), the septic tank is hss than W &H of sludge - � undowped rea have d die above rcquu� and mm to maintain the private sewage disposal system with the standards by the of Commence anti the Dew of Natural Rr.saurcm State of WiaconshL Carton gy as stating Er has been man must be complemd and mtumied to the St. Croix County. Zoning Owe within 30 days expiation date GNATURE OF APPL ANF la /to DATE OWNER rAP PLstatements TI H lt on this form ant trot to the best of ray (our) ImoMedge- I (we) am (ant) the owners) of the , by virtue of a wane nh deed r000rdd in RegisLcr of Deeds Uffice. NT j - ° 1 O�5 DATE Any information that is mis iclutsented may trsalt in the t •esrs• tary p� bemg rmked by the Zoning Department. • Include with this application: a stamped warranty decd from the Regimr of Deeds office a copy of the certified survey map if reference is made in the warranty &cod U. 2805 P 272 79533 State Bar of Wisconsin Form I - 2003 XATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS ST. CROI CO.. WI Document Number Document Name THIS DEED, made between Environmental Holding Company, RECEIVED FOR RECORD LLC, _ . a Wisconsin Limited Liability Corporation 05/18/2005 12:45PH ( "Grantor," whether one or more), WARRANTY DEED and LeQue Builders, LLC EXEIPT # ( "Grantee," whether one or more). REC FEE: 11.00 TRANS FEE: 750.00 COPY FEE: Grantor, for a valuable consideration, conveys to Grantee the following CC FEE: described real estate, together with the rents, profits, fixtures and other PAGES: 1 appurtenant interests, in St. Croix County, State of Wisconsin ( "Property") (if more space is needed, please attach addendum): Lots 9, 11, .1@2, 14 and 15, Lundy's North, Town of Richmond, St. Croix County, Wisconsin. Recording Area Name and /' Return Address X`" k , lob /9 .St So - Par Of 1066 -95 -00 and 0 6- 1067 -30 -00 Parcel Identification Number (P ) This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Roadways, Easements and Restrictions of Record. Dated May, 17, 2005 Env' ding Company, LLC (SEAL) (SEAL) * *Jeff arren President (SEAL) (SEAL) AUTHENTIC �/ ACKNOWLEDGMENT Signature(s) N0 TAR STATE OF WISCONSIN ) —sue 7t ) ss. authenticated on ti CPA PURLM St. Croix COUNTY) .y = Personally came before me on may, 17, 2005 the above -named Jeff Warren TITLE: MEMBER STATE BAR OF WI to me known to be the person(s) who executed the (If not, for oing instrument and acknowledged the same. authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: * lerileo J. Bune Michael H. Forecki, Attorney at Law Notary Putilic, State of Wisconsin Eau Claire, WI 54701 My Commission (is permanent) (expires: 11/20/2005 (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1 -2003 *Type name below signatures. Anomey Michael H Forecki 3452 Oakwood Hills Pkwy Ste 1, Eau Claire Wt 54701 -7928 Plwne: (715) 835 -3029 Fax: (715) 835-4112 T6011577.ZFX Merilee 3, Rune Produced with ZipForm by RE Formshiet, LLC 18025 Fifteen Mile Road, Clinton Township, Michigan 48035, (80D) 383 -9805 www.z �52`1s �`II•`�' rpmx mutm,v P{.AT on LUN S NORTH l I�PIIRi` t� 1F�ww"4 ZONED AQ/RES i P7.11T OF LI7r'UY1f�I)U� LIS 8 ��� 19 ar� �' _ AT LOT" � IA� Or 06r 12 s+ Mrrw '_ Ywwrr M °!°fww i r r ,r' r L ' rrr .. i ♦�' LO'r A 1'""OT r La � rrs r i M �ttf.tNt.Nt /NMNtt tN*tt Ntttgtt tNt t Nttts�Naarn p ��� � �• T w. rt.aar .�.wR! i 'i.ei�'� a.r. ara a.� awa : .tot **as $Dolt /tN ttlttt Ly N jt�Nttt tlllltt• Atl ��ii • w ���'''AAAAAA� ! w M } ir war IR �! LOT 0. RADwW X" �tr"`lr err + mop f �I s LOT T ✓ .. t� tt r r �' 14 W6MM 1Q, cwj%m4 VR UMP.;30 aM:GtJN"v*. MAYINU IML MWII l IV =KVL 1111 AKLA. FLAT OF Ll s, w , 19 po C LOT 20 � L C ________ NORTH UNE OF THE r - , r , �, S1 /2 OF THE SE1 /4 33' (S89'47'03 -W) N89 °47'01 "E 1 496.60' C ---- -x -- ----ic 9lOC�t 86 ; 421.49 199.09 iQ Y l I OT 12 '� ,/ (81,3 SO. FT.) 1 a ( LB.d. - 966.5 56 t S89 56 O WN" \ el � ' S'5276'Q1"W 52.06'4 —_ �� �ti N89'57'29'E 413.85' LOT ' `� . TQ , 5� 2.07 ACE E;'. t \� {90,057 SC .4 `, �,� ! I.B.O. so 9E 2 3.78 `. L T `� ,,.' 2.10 A � TOP OF 1 1 - 1- 1. �� ` `�'• (51,677 1 , • r p j IRON PIPE. `� `� •, L .5 /'s 0 h ! ELEVATION k DR GE nl! 964.0 FA IN '. / ' t ` \fit_. /� "` 1 ♦ {!? HWE �► \� ♦� 964.5 1 c0.5 LOT '�• . � ` N88'151t E ' -- -- 129TH S1 1.93 ACRES . ". .k`t 92' S88'1S'!1 "W (83,924 SO. FT.) ire 960.5 r 1 !t DRAI/VAGE tip I • 1 EAs_rm,FYT 1 58 9 .02 1 04' p il 292. " f #% --- — -- N HWE m 963.8 411.03 _ f �a E / • • z a89*02'04"E 4 / .... .... fT, g�O' _ _. 6G' _N / j p _ S ; -r _ 2.65 6 1 P M p2 162.521 TO t 2267 5 T8 j ACRES . SO. 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Code derived design flow rate__ _ —_ —____ GPD ❑ Replacement ❑ Public oreommercial - Describe: — ,...._,._.__._.. —._._....._.—_..._.--....._...----_...—_.-...---...----- Parent material _ _ _ _ — — _ _Flood Plain elevation if applicable aGeneral r mmme comme s: w� �1 �Td� — l� -Q — 1/h c 3 4 m l: 5 cj- 33 CST, 'J I Boring ❑ W i' ��3 / P✓� I �t Ground surface ekv. Depth to limiting factor � �j ___ fi. _. ----in. gal Application Rate Horizon Depth DominentColor Redox Description Texture Structure Consistence Boundary Rods GPDAP in. M1unsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#f1 `202 0 -12- 2- 2'33 S 1 33--qc 0 Vle S 5 ,1 -72 F-1 Boring it ❑ Raring ❑ Pit Ground surface elev. _-- - -_ft. Depth to Amiting factor in. Sall Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Rods WWII in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. .01NI 'EW2 ST. CROIX COUNTY ON-SITE VERIFICATION FORM Property Owner Parcel ID # Page ❑ Boring # ❑ Boring l ❑ pit Ground stdawelev. _----fL Depth to limiting faclor in. Shc Iication Rate Horizon Depth DomimntCobr Radox Descriplion Towure - Structure Consistence Boundary Roots GPDff in Munsell Ow. Sz. Cont. Color Gr. Sz. Sh. F-I Boring # C] Soring ❑ pit Ground surface elev . ...... . . . ................_.ft. Depth to Ming factor . . . . . . . .............. in. Sall Application RM ToMm Structure Consistence Boundary Roots GPDIP Gr. Sz. Sh. Horizon Depth 'M1 0 #2 F-I Borl ng # E] Boring Ground surfaceelay. — ---A. Depth to limiting factor in. ❑ pit I Soil Awlication Rate Horizon Depth Dominant Color Red ( ox Descdplon TexWm Structure Consistence Boundary Roots GPDff )LL 1 Co *01#1 'Eff#2 in. Munsell oLL Sz. Cont. Color Gr. Sz. Sh. . ............ 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