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HomeMy WebLinkAbout026-1078-30-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division • INSPECTION REPORT Sanitary Permit No. 0 463299 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: LeQue Builders LLC I Richmond, Town of OR & - /! (07 r CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: /� 8�► s t 27.30.18. )4Q TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 3 �� Benchmark t �Sx�. � 5e-t► / �r3 Alt. BM 6 ✓. (o f Ile 4 Aeration Bldg. Sewer tp .7 8 qq • T Z.. Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet -' CNI TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic J i Dt Bottom Dosing Header /Man. c� <15 J Aera ' Dist. Pipe / C Holding Bot. System 1Z.y 3 9`.{. 4k Final Grade �� 1 qw` PU MP /SIPHON INFORMATION Manufacturer Demand St Cover 2.99 1a cnt GPM Model Numb TDH Lift Friction Loss System Hea TDH Ft Forcemain Length Dia. st. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ? O6 3 (lewd `-- SETBACK SYSTEM TO o P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: I � INFORMATION Type Of System: (� , CHAMBER OR /dam Z7 � Model Number: `�L S DISTRIBUTION SYSTEM J Z 4 4 t) w %1' d- Header/Manifold ,� Distribution x Hole Size x Hole S acp ing Vent to it Intryk_e C P 0 (� Length �5 Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth oi� xx Seeded /Sodded x COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: x Mulched Bed /Trench Center 2 �� Bed/Trench Edges Topsoil \ \yes No \Yes No / / \ Inspection #2: \ / "N / Location: 1380 126th Sttrreeet New Richmond, WI 54017 (NE 1/4 NE 1/4 2 T30N R18W) Lund s Preserve Lot 20 Parcel No: 27.30.18. 1.) Alt BM Description = r7 t �OG�IJ 2.) Bldg sewer length = �� / Wgna - am ount of cover Plan revision Required? Yes No —7 �� _�Use other side for additional information. tf/ / Date Insepctor Cerl. No SBD -6710 (R.3/97) Safety and Build' n Corauy� . 201 W. W A O x 7162 c � fiJ S +O►ll�L�l/I' Sanitary Permit Number (to be 1`11led in by Co.) EDe artment of Commerce ISRECEIV 32 Sanitary Permit Applicatio _ s Plan I. Number in accord with Comm 83.21. Wis. Adm. Code, pertwtr! may be used for secuadary purposes privacy Law, s[5.04( )(m) P t Address (if different than trailing address) I. A� Infer - plum print All tdormtriiwa ZONING 0r- ��_;E_ CAN A>1� Property ,s N Parcel r _ Lai f a o Blo wn c�lc, / Gt -pock P 'x M ailmg Address ply Location A 1S sac secnwt City. State Zip Code Phone Number srcie ky iii (cIi A all that apply) T Q N: RInE or o X i or 2 Family Dwelling - Number of Bedrooms Subdivision Name CSM Nytg bg; ❑ PubiiclCommercial - Describe Use � u / Q S r v �Q (T El owned -Des Use _ ci illage ownship of t III. of Clerk only one box 4onNneA. e ' B it appoe") •U� Pere tvt A- System ❑ Replacement System D Treatinent/Hoiding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision « Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner ^� _ Iir. of Pow 7s : (Cheep an that ) _ } } i Non - Pressurized "rwnd CJ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil �� At-Grade ❑ Single Pass Sand Filter A J Constructed Wetland D Pressurized In- Ground ❑ Holding Tank U Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter D Recirculating SyM etic Media Filter ❑ Leaching Chamber 0 Drip Line Gravel - less Pipe ❑ (explain) V• ' Anita Infarenattion: 9 SD — .a Design Flow (pd) Design Steil AppJireaa Rate(f) Dispersal Area Rcquirat (sfi Dispersal Area Proposed (s System Elevation i S o 9'7 VI. T Info Capacity in Total Number Maratfacturer Prefab Site Steel Fiber Plastic Gailotrs Gal[or►s of U� 1 Concrete Constructed Glass New Existing /( Tanks Tanks _ Septic w ok►ing Tank 0 ©cJ 'es 'e r s'. Aembic Treatment Unit Dosift chamber VII. Rt biBty Statenkmt- 1, the p=,UjW V for awamtka of the POWTS shown on the attached I;Wts. Plurnber's Na me (Pri Si time / umnber Business Phone Number Plumber's Add- ss (Stmt, City, State, Zip Code) A ' 9 ug !� -A-U-2 VHL F Ounq�v m � ti 0 Approved ❑ $ vtd : / Sanittry Permit (includes Groundwater Date Issued Issui Agent Signan (No Stamps) D i � � -._` Surcharge Fee) IX. C4ndltlew A fem Dbapproval n SYSTEM OWNER: 3 � ` `�4 a. !'o° -u'` °`.alt° 0,AQ 1 Septic tank, effluent filter and t L� "° f -0 - St (S w dispersal cell must all be serviced / maintained as per management plan provided by plumber.' q � S��y,� 2. All setback requirements must be maintained de s as per applicable code /ordinances. Attagr - -ptaa pints (1s tie C-a.w eo tar Im a.. tire. it ieclmas is size AA e - NT �5 >7 T3a ° �a. - rug _ - 1 I Y e �•b gas 01.1 7 , , ~-� a. _7 19- On Z.�a , , , , CA 4 , : i : 1 ! 1 \ , : M , i , , , , { , t5 i 1 � , , 4 i , i i QQ , _ V I ' I , , 1 t i _ r VL ; P Sao -P� ®► /�' L� ►mod s �-. �- r,o �r f �7 ,a3 VrCN � . t a n f n �r 1 1 r �� ' fRECEIVED N 0 1 2004 Lundy's Preserve Comments: CROIX COUNTY NING OFFICE The soils in this subdivision are quite variable and differ across the 80 acres. Some consist of a clean outwash sand, other consist of glacial tills. In certain areas, the medium sands have a very deep red color unlike I have seen in all of St. Croix county. The color does not indicate high ground water because the color is so consistent. If you go through the red s sands then the sands turn off white/yellow but not those o f a sand stone. In talking with Pam Quinn from zoning, she commented that there could be a different chemical reaction with a sands. 1 believe this is the case for the sands have a consistent size, and no mottles were found above or below the sands. Sometimes bands were present, but were very slight, and were mentioned to have the systems sized a little bigger in order to accommodate for any inconsistencies in the soil. Also it is worth mentioning that the intersections of lots 6,7,8, and 9 have a extremely poor soil present not suitable for a mound system. The surveyor and I discussed this condition, and the resulting tests were spaced as far away from this area as possible. All the soils tests were done to the best of my ability and 1 hold no liability for anomalies and other oddities that can be found on this site. Shaun Bird CSTM #226900 5/28/04 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 nches • ow IF �) include, but not limited to: vertical and horizontal refer int (BQ), Parcel I.D. percent slope, scale or dimensions, north arrow, a locati and distance to nearest road. Please print all in .JUN 0 1 2100 Revi ed by Date , p I S Psneonat information you provide may be used for sewn pu (Privacy Law, s. 15.04 (1) (m)). Property Owner �bcation F F C 1/4 �/4 S T N R E (o W Property Owner's ailing Address j Lot # Block # Name or CSM# City State Zip Code Phone Number ❑ City ❑ Village wn Nearest RqV o New Construction Use. Residential / Number of bedrooms Code derived design flow rate �+� GPD ❑ Replacement L Public or commercial - D sc nbe: - - - -- -- Parent material 4 - n ��a4A---1 Flood Plain elevation if applicabl Q General Q mm comments ` P ��- e ` �Qi lJ E� p C3 ! ! 7 and recommendations: J Boring # ` El "ng t P it Ground surface elev. � I ft. Depth to limiting factor / / 0 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Mursell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 L Z -3 U s � rn bl� Lc� � A4 14 1 a t 3 "'Q' 5 v Z a Bori ng # El ring pit Ground surface elev. V ft. Depth to limiting factor " in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fl: in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'E to `Eff#2 o Q 2 3/6 �� rn s �' c cJ IL Effluent #1 = BOD > 30 < 220 mglL and TSS >30 1150 ` Effluent #2 = BOD < 30 mg/L and TSS <— 30 mg1L S. re CST Number CST Name (Please Print) 226900 Bird Plumbing, Inc. Shaun Bird Telephone Number 715- 246 -4516 Address Date Evaluation Conducted 1008 192nd Ave, New Richmond, WI 540 • Property Owner Parcel ID # Page of F 1 3 ] Boring # Pit Boring Ground surface elev. ®� ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. // Munsell Qu, Sz, Cont. Color Gr. Sz. Sh. yy� 'Eff#1 'Eff#2 3, Z2111 Sy F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Apoicabon 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 '0142 [] Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Appication 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 'Ef1#2 Effluent #1 = BOD > 30 1220 mglL and TSS >30 1150 mgt ' Effluent #2 = BOD <_ 30 mgll 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. SOD -8330 (86=) Soil Test Plot P1a Rroject Name Environmental Holding L.L.P. S ird Address 706 19th St. S. Hudson Wi 54016 STM #226900 Lot 20 Subdivision Lundy's Preserve Date 5/24/04 N 1/2 NE 1/4S 27 T 30 N/R 1 8 W Township Richmond Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 98.0/97.0/96.0 *HRpSame as Benchmark Alternate Benchmark Top of Survey Iron C& 96.0' Please note:Soil was done to satisfy Scale is V = 40' county zoning unless otherwise requirement. Soil test may not be noted suitable for owners desired building location. B- 20' 213' Property Line 45' 10% Slope 30' B -3 45' B -1 98' 102' 30' 100' B.M. jr 566' Property Line B.M. 450' L.t,c_ Y1 A i' EZ1203H � � ti RRi ii j � irf iTii ; i rRiirr rR r .,, h I � �� " � iii \_ f�� i 1 2 " � iii _ -"; ,t �'�: •fir rri 4.62 tr re n s o U2 Ciro. _ ��� 18.R•2 riiRiRi R f i• *iir ►irir :�� rriiriR t sitiiii { ^� .arm j E r 24 r' r 12- 1/2" VOW Coeff' U.D. ° p 9 a An ilmLt4cs !L IQ�t { Vold S +iaif (2 Somalis) }a,"n r U. b. of tuMer c}udcr Ott _ ifl f ` 5 _- UC t O wi�rue .a as of Totee/ Snit twttrtarr Aria ^-/ `t"i°°tyLr�dn- 3- 3.- � ---' )' aJ {zs �'� 5.1 "'i 14 -1 f?_D of h p � t7wrp f s7r- 42 ft , ° j�� Cytrredar= - 12 ewtleaa ( woad vptw art py fWt Cyfind � ,. ; • },, °r` Prp3KECQ Treeret Area r t2arrp� s ��' 901 w ( ' ( Sidewalt ficq0, = 12 in °� "aJurrr a< Gush hcyw eew t Bottom 3b �n ` ltlintfa � i1. {K sip Fr 30 0Sq -Ft. 1 {{ " '"'d Trtnci Area S r �" � ��d �oiy� ,u +'wsaAC 64tto+o cw7a4rs (t f$ of vood Sq.Pt. Tool } r ,, mC 0422 + f1.90! watt�ac t+ttWcen ct a +wtlkrS! 6 : { � ? ' ti {qs t2° Q-2r t 3 - t2_ t ¢� p ! ?� cues fi ,• h Gagons per ft t -763 X 7 48 - { i j i s I j EPS Aggregate -----1 Trench Syste E2 3 2Q3H � IV } � ' Reng - Industrial Grouv fi5 ) ndus'tr'01 Pork Rd. aakitlnd Tiv i8[�60 t a OWNER'S MANUAL & MANAGEMENT PLAN P'°° --' °f "`_ POWTS OWN SYSTf.M 1 .�S 'Q r-S 0 WA E. ATK1N Tank MajWfa gal weer S p Dose p Molding vol. C� 0 NA errr�it # 3 2 'rank manuhwbm gal N pp}1ANtE[lkRS NA n NA a Septic 0 DoDow ©F vol. lumber of BedroBedroom p NA Effluent Filter umber of P't�iic Fad[ih► Units Efftueat r Modal — V v — Estimated (average) flow PUMP Manufacturer C3esrgn (l9W flow ffi (Estimated x 1.51 `J Pump Model SOB Application Rate pratre strnent Unit Standard tlEffNrent cluatitlt average wl SwWGr� FRW 0 Peet f it° Fats, oil & G (FOG) 530 mgr- ❑ NA 13 Mew Aeration C1 Wetland Biodornical oxygen Demand 11110 522 mWt p Diairdection 0 otha: Total Suspend Solid$ TT S1 rCAaverr&9e re Manufactu D NA pretreatad Efflu ent t WWW !mod cents) C fpt ed) Bioctwrra Oxygen (8Q0.) 00 men• ❑ NA in- Ground (mi) D In cirou*�d Total Suspended s (-rsSl !00 o [1 At -Carte Fecal Mound c mean) S10* cf IODTl p NA D DriP-UQe D Ott': l' diform � n Y. in di &. A Maximum Effluent Particle Sire D NA A otter. +Vehies types � dorr�bc wastewater and optic tank afftusr+t• CH S L Service MpMITENANGE � E�►aEet morrth(s) �d�n 3 yearral DNA At {east once � st ud" ow s one- tfrird %) of tDr* volume p NA inspect con dition of tank(s) Vytx�► Pump out � of tank(s) p 1Mt�eR ilia tfth water °term N rt�hIs) Mleximum 3 years) ❑ NA At least arcs every. rreontfets) ❑ NA �l(sl every: Inspect dispersal i At Least Once every monthtsl t� Clean effluent filter p i p con t r ols & &tarn At least ose every: p El IWWW rrrorrth(s3 �NA Inspect pump D yee(s) At least onae every' NA push laterals and pressure test n (s1 At once a ('nher. t�' NA oet�►= or u certifications, p carrv�9 � follow" licens" operator (pumped. • cells shall be made by an koyyjS or broken h any cracks or inspections of tanks and dispersal r icted e we; POWTS of e ffl u ent on the groom Master plumba'. Master Plumber of the tw*(s) to identify any up of g for and Tank inspections �t 'ncluds a visual inspection scxr�r► a c rack for any volume of combined sl to check the levels b► the observation pip" ng carom and teaks, m eas ure the celt(s) shall be surface t' ircate sur f... The dispersal Tim, ng of e ffl uen t on u° yound surface. Ron rrOr ng me t on no tification of the local -t Regulatory hird (Y,l or more of the tan k volu requires the kn 'n of s l u dge and �t Servicing operator and disposed of in accorda> with chapter NR 7 t 3 When the combined by n entire contents of the tank shag be mnwved o, pressurized com ponents, Rretreatme Wisconsin AdrnInistretive iknited to the servicing of effluent filters. meth ces, including but not performed by a certified POW'tS Maintasr�r. All other sarvr &srvicin9 at intervals of 512 months. "' be perf con of any service GMW (2102 °vent• units, and any within 10 days of 00"Wiat" A service report sh be provided to the local regulat°r1► au ritY w All Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other chi mlcals that may impede the treatment process andl damage the sod dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During extended wer outages tanks fill above normal levels. po trtag pump may hr�nwater When power is restored the excess wastewater will be discharged to the dispersal cellts) in one lope dose and may overload them resulting in the backup or surface discharge of of 1twit. To avoid this stuntim have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring poorer to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the ank. t�p t Do not drive or part vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade sod absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butte. condors; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) discharge; fruit and vegetable peelings;, gasoline; grease; herbicides; meat scraps; medications; oil, Painting products; psticitim, sanitary napkins; tampons; and water softener brims. 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 Comm 83.33, Wisconsin Administrative Code: u+ All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. e The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. + After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with sot! gravel or another inert solid material. gr a CONTINGENCY PLAN g the POWTS fails and cannot be repaired the following measures have beers, 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 exlsting and proposed structure, tot lines and weft. Failure to protect the replacement area will result in the need for a new soil and sits evaluation to astablistn a suitable replacement area. Replacement systems must comply with the rules in effect at that time. 0 A suitable replacement area Is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a test resort to replace the fated POWTS. to The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. if no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. Q Mound and at -grade soft absorption systems may be reconstructed in place following removal of the inomat at the infiltrative surface_ Reconstructiorns of such systems must comply with the rules in effect at that time. < <WARNiNG> > SEPTIC, PUMP AND OTHER TREATMiENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE MTEP40A OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS At.LBt POWTS MAINTAIkER I TZM7 --- -I t�s ot. i 0 rs Name �s Phone , SEPTAGE SERVICING OPERATOR ) LOCAL REGULATORY AUTHORITY Name Name C ✓l i h Phone Phone Thin document fted by the staffs of the Green Lake, Marquette and Wwshara County Zoning and Ssnkation AW%cles in c:ornounce with ctrapter Comm 83.22(2)(b)(9)(d)&tf) and 83.54(1). (2) & 13). Wisconsin Administrative Code. YF CROIX COUNTY 'SEPTIC TANK MAWM4ANCE AGREEMENT AND 0VR4ERSHIP CERTIFICATION FORM OwnerfBuycr e)LAA0, Mailing Address P Q . 6c)x I Property Address I " +-�,, ./ (vecifiaeeioa resod fray p}muing Dc f jw „ ) City/statc chrYtanc� _ ()U _ 10 - t<� � � � Parcel It#entifit�tion hTutnbef � � ^ O a �� r LWAL DESCREMON PrVer[y Location N " W �E K. Sec. T- SLN -Rj..g W. Town of Subdivision Lot # Certified Survey Map # Volume . page # Wasraaty Deed # �� , 5_ Volume �a 7 7 _ P # Spec house O YC!A no Lot Imes k1cadfiablea yes 0 no bnp perascandmaintma magyasrSepbr- systm owAdn=k=itg ftgnntD rormim --- - -moan= caosbu of P=Vft out do septic tam every dK ee yem or soamw if seeded by a Hamad pumper- Wbats you pat h4D We system can a8ixt do Awed= of ffie scptk tu& as a stage in dbe wwsm &w osat symom. Thc P[ PAY a wz= asren to sesbmu to SL ov& Zomog Dqmnnwma catifiattsan faem, signed by the awmer and by a PhWiamidumaymn ca s plumba era goeascdpasapC1 dm (I) dw on4e tvasuaaautiixposst system is in ppa coal aadfarM sfbr sad pmmpbg (if necesmg).Oe ta* is bm tbas W Stil ofshag-. mdaskwd 1+ave read the abort: row and ag3ooe to the psivate taWage systea rorith the at:adsr+ I 2d fort% by do Dqxwhowe 0ftbmaesaeand do DquWam ofKaft at Rewows, State of WboaoAijL C&difimdm. : has 6eea wed mast be oomo�pEesed and turned tas the SL Ctoi�c toasty Zooi:tg O v4ddn 30 czpumm C,NATURE OF CAN — '` — '� 5 DATE we) tenet sit its on dais €Oren are tree to the beat of my (aa) age, I (rove) am (are the o*=Ks) of 'bed shore, by victpe of a wrmttsny deed =Cmdcd m Register of Deeds Offiem 1 /2105 %WhfitE OF APPLMAW DATE *** ** AjY issfoa'natim that is anis- may =Sub in Qc smtu7 Pcrmk bang =VWwd by tk 7Anim t :sass Lutadts with tbbz • s 9pp�tion. sbsa3aped warranty dad ban the Register of Deeds office a copy of dw cmdfl d sm wey map if settee is mach in the wramm ay decd U; 2 7 3 7 P 1 8 2 State Bar of Wisconsin Form 1 - 2003 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number Document Name ST. CROP X CO., WI THIS DEED, made between Environmental Holding Company, RECEIVED FOR RECORD LLC ( "Grantor," whether one or more), 01/25/2005 02:10PH and Leque Builders, LLC WARRANTY DEED EXEMPT i ( "Grantee," whether one or more). REC FEE: 11.00 TRANS FEE: 198.00 Grantor, for a valuable consideration, conveys to Grantee the following COPY FEE: CC FEE: described real estate, together with the rents, profits, fixtures and other PAGES: 1 appurtenant interests, in St. Croix County, State of _ n ( "Property ") (if more space is needed, please attach addendum): Lot 29), Lundy's Preserve, Town of Richmond Recording Area Name and Return Address Title One Premier Group 706 19th Street South Hudson, Wisconsin 54016 part of 026- 1078 -30 -000 Parcel Identification Number (PM) 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 January, 25, 2005 (SEAL) (SEAL) * Environmental Holding Company, Jeff Warren, President (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ) ss. authenticated on St. Croix COUNTY) Personally came before me on January, 25, 2005 the above -named Jeff Warren * TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the (if not, p. FEq� foregoing instrument and acknowledged the same. authorized by Wis. Stat. § 706,06) THIS INSTRUMENT DRAFTED BY: NOTARY nnif r Fer on Michael H. Forecki Attorney 1C ry Public, State of Wisconsin Eau Claire Wisconsin P h Commission (is permanent) (expires: _ 03/23/2006 ) (Signatures may be-a nl ledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANODTFYdA TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED STATE BAR WISCONSIN FORM No. 1 -2003 'Type name below signatures. Attorney Michael H Forecki 3452 Oakwood Hills Pkwy Ste 1. Eau Claire Wt 54701 -7928 Phone. (715) 835 -3029 Fax (715) 8354112 T4644226.ZFX Title One Premier Group Produced with ZipForm^" by RE FormsNet. LLC 111025 Fifteen Mile Road, Clinton Tavnship, Michigan 4131335, (900) 383 -9805 www.itptorm.com LUNDYLS PR i C.S.M. IN VOL.12_PG. 3421 LOT 3 1 LOT 2 -- --- --- - -- -- - LOT 1 1 1 -- - -- -- 1 •— - - -____ _I— _ — - - - --- .— — -- .— '— — '_ — — 140th � OF 1K£ W — — — — — — /4 N89°3rl1*9 2652.ar Iwo MAC •—... ... ... ... .... 1 ® 3s 3s 13Y 1 I I I I ........ ............................... ........... ...:::::................. �........r- ...:............. ................ .............................. . ...... ® LOT 1 ® LOT 2 LOT 3 LOT 16 I ® ® 1 I us a I ®e 1 I _ LOT 15 s: S I LOT 17 1 . �\ �'•® L.®T 14 ' .: ♦ ��� % � LOT 11 zi z v LOT 18 �' OIAI � .� � ~' +.,._ ® �\•"\ \ `��� \ \\ ••• LOT 12 olz, m 1 LOT 19 . ► �j �'�/ ' I` _ p _._ N - y LOT 20 .. .. .. zo�R 10 04 , i LOT 24 L C O V14 OFF ' � ' r�' ee0.m ws 1 LOT 23 i /I1 1. \ " r LOT 22 rA LOT 21® — ► t / /1 :'. ® 1 ® I 33' 1• v,e IIE S89 2235—W--S( A W L IEf /4 UNPLATTED LANDS PREPARED FOR: ` PREPARED BYe PREPARED BY: PRELIMINARY PLAT OF. LV N DY'S PRE! EN41RONMENTAL HOLDINGS. L P S&N LAND SURVEYING AUM CONSULYIN iLASSOCIAMS 708 19TH ST. 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Zahler, Registered Wiscansb • � N wt . aw NCa7 WA1ER LME l eEY AT ON O Land Surveyor, hereby certify that the L"..96as LOWMBU D94OPEMW -THE above described and mopped property 1L B23 ® 9DDOMA LONMWSIDOW01TDOOREIEYAT was surveyed by me or under my direct W - WIERYEWTE CONTOLM -- •�•�•— 17 UnUTY EASFMENf ---- --- supervision and that this map is a o -1 — .70—_- W)EXEOCONTDws 143 AC.) NET BUMDAME AREA correct representation to scale of the boundaries to the best of my knowledgE XMW” SFOfMhVATON and belief. 1111- ZC1iSLOEE •– ..... •� 1W MMWAY SETBACK UNE � �""o wrE F01K1M(iA11EA g ROAD LENGTH • 4148' �" TE1EI++DNEFD,E 6UWAT0GDETEFLMED9YCn.a ELECTAC FED OBSERVATION AS REFERENCED TO NA.V OWSI C/.A7C M7 LTCT 1 � '1lYT' Z 133HS 339 o r � � o C J g043T34 -E 413.35' � v � U � ti►•ISb 3 „85 Za -a00 1 i r 1i I '393s� 410 � \ s5 \ � Z9 *W 3 6Z SQt06 cl \ \ \ 1 N g — o o < on ; j N o � 4 m J g � i�1 � �< N � l Z I I _ ! ... V� I — I Ne G .� U) . 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