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HomeMy WebLinkAbout030-2137-04-000 0 c co� �a 0 ƒ ƒ E ° & $ § S Z I ;/ E e g ® e - co §$E \ K / § C2. ! E - o . �-4r 2 k o k \ § � � E § \ a © CD Z> t K A 2 - p / �_ g 3 o § $ 2 _ C co 00 � / / 2 E a § / 0 0 0 CD ` F3- ) § § k ^ \ 3 / � 2 to 7 § ; 7 CL z i § ƒ 0 \ Q k % / { (§- _ CO) ° N / / f E / ° § / _2 z / E / z E P 2 / § ° w T § E § z § } j 7 2 k 2 k � ^ % @&+ /2 cL u,) \_ dU :) < ar0) Z k \ C : CD / . . Eck § \T 0 CD <° @E \ \C { -3-2 -- 2 2 3.0 0 a 0 [ o\ §/ 2 § �aJE ° k2 /g $ ) �/ §2 ] g�q§ 7 � � # 0 * § p / k � 8E � ®7 � Page 1 of 1 Pam Quinn From: ted kotlowski [tedkotlowski @sbcglobal.net] Sent: Friday, October 21, 2005 1:14 PM To: Kevin Grabau Subject: RE: House remodel, Town of St. Joseph, St. Croix County Parcel #: 030 - 2137 -04- 000(.2030) Attachments: 168210249- list1.jpg Hello Kevin, Thank you for sending out the letter. I have a question regarding paragraph three about "the original system was installed in 1998 by Calvin Powers "? Our place is new construction built by Derrick Custom homes this year. The septic was done November / December of 2004 and was installed by Powers Excavating out of New Richmond. I have enclosed a copy of the main subcontractors from Derrick listing the Septic System information. Please advise. Thank you, Ted Kotlowski 467 Bluebird DR N Hudson WI 54016 Home: 715- 549 -6318 Cell: 651- 271 -2144 Work: 651- 361 -5057 Email: tedkotlowskigsbcglobal.net 5/6/2010 CROIX COUNR PLANNING &. ZONING October 18, 2005 TED KOTLOWSKI 467 BLUEBIRD DRIVE N k' H SON, WI 54016 "RE: House remodel, Town of St. Joseph, St. Croix County Parcel #: 030 - 2137 -04- 000(.2030) Code Adminisrrat 715 - 386 -4680 :. Dear Mr. Kotlowski: Land Information &,; YOu have requested the Zoning Office to review your remodeling project for Planning `''" compliance with the state sanitary code (COMM 83). When remodeling or adding onto a dwelling you are required to examine whether or not the construction involves Real Property an increase of wastewater load to the septic system. 715 -.386 -4677 I have reviewed your construction/addition plans that were submitted to this office. Recycling As I understand the project, the net result will be one additional bedroom. The septic 75 -386 -4675 system was designed and installed based on wastewater flow for four bedrooms. This project will increase the total number of bedrooms to five. In such cases the septic system can be sized based either by the number of bedrooms in the structure, or, by the occupancy of the residence. Only eight people will be allowed to reside in this structure unless the septic system (POWTS system) is modified to accommodate the increase in wastewater load. You have indicated that there will be three occupants residing in the structure. An Occupancy Affidavit is required to notify any future owner of the septic system sizing. This affidavit must be recorded at the St. Croix County Register of Deeds office. This affidavit has been recorded as document number 809462, (v. 2909/p. 381). The original system was installed in 1998 by Calvin Powers (MPRS #220537), and was inspected by zoning staff to be code compliant at that time. A visual system inspection by Paul Koehler (MP #225410) found no evidence of system failure on October 12, 2005. All requirements of Comm chapter 83 have been satisfied. Please contact the town of St. Joseph to obtain a building permit. As a reminder, to prolong the life of the system, remember to have the septic tank pumped once every three years or when the tank becomes 1/3 full of sludge and scum. Other efforts to prolong the life of the system could be as simple as fixing or replacing plumbing fixtures with water conserving fixtures, reducing shower time, washing ST. CROIX COUNTY GO IiERNMENT CENTER 1 101 CARMICHAEL ROAD, HUDSON, W1 54016 715386 -4686 FAX P O)CO.SAINT- CROIX.WI.US 1MNW.00.SAINT- CRC- 1XV0.US dishes when the dish washer is full, avoid using a garbage disposal, using a wash machine with a suds saver feature, etc. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. If at this system should be found to be failing at any time in the future, the system will be ordered to be replaced according to current code requirements and all appropriate permits will be required. Should you have any questions, please contact this office. Sincerely, Kevin r au Zoning Specialist 10/20/05 THU 14:56 FAX 715 386 4686 9 001 * ERROR TX REPORT �x TX FUNCTION WAS NOT COMPLETED TX /RX NO 4752 DEPT. ACCESS CODE 1245 �L �� Z CONNECTION TEL 93770791 SUBADDRESS �� v CONNECTION ID _ �a ST. TIME 10/20 14:56 �r ` USAGE T 00'00 PGS. 0 RESULT NG � 0 #018 I 1 %z co V--v--- UNff PLANNING & ZONING . r' xxr � r•,. yea, ur: r,+ tixewa: mrnr., r maerexincawv uw, araxauwarnwr.. etiuumywrv-+. � + vtmtw, xcwrs � wiurwa t , � , u� .+ m m..+ nrvmud a „ rTn�: x�wL�s, nw,.,x,,: pn na: r _ aL xr�, ,..., �Hry sor +rntw ✓ .p FAX M E M O Oc :r IJC 2 D C DATE: l GCJN ` l "Y To: �'ED DoT Lpc�a S f� � Code �ldminisirati y F, FAX N UMBER: T+4 o 0 1 715 - 386 -4680 Land l n jor maaig 4 s2'fY ' FROM: '�&/AJ 6eAgA -tA nra5 -386 - . k! j' 715 -38G FAX NUMBER 715- 386 -4686 4 r, PHONE, NUMBER: 3� , q�$D Rea roperey -386 -4677 Re . 1 g in NUMBER OF PAGES, INCLUDING COV SHEET: (3) 71 6 -4675 ;Qn„ RE: Ir. F;i:4 ST CROIX CO AA.1k UNTY PLANNING & ZONI FAx MEMO DATE: TO: T6 Y- o" i' L,o w S L Code Administrati FAX NUMBER: -3 _ 0 70 715 - 386 -4680 Land Informati FROM: K& /m CgABA -Lt Planning FAx NUMBER: 715 - 386 -4686 715 -386- 4 R erty PHONE NUMBER: 30 , 400 e op - 386 -4677 R Zing NUMBER OF PAGES, INCLUDING COVER SHEET: (3) 71 6 -4675 RE: Oct• ?A umo a 0 ST. CRO/X COUNTY GOVERNMENT CENTER 1 101 CARM/CHAEL ROAD, HUDSON, W/ 54016 71 X386.4686 FAX PZ @CO. SAINT- CROIX_WI US WWW. CO.SAINT-CROIX INLUS 10/18/05 TUE 15:45 FAX 715 386 4686 Q001 xc * ERROR TX REPORT x� TX FUNCTION WAS NOT COMPLETED TX /RX NO 4732 . ACCESS CODE CONN 93770791 SUBADDRESS CONNECTION ID ST. TIME 10/18 15:45 USAGE T 00'00 PGS. 0 RESULT 0 #018 r"lr b C ROIX Cu AA IL U e PLANNING & Z ONING r .,xw:r..,�«�ruw.,r,r.- rer,,.sr ,.., ., e�nxrrwavwr: rnr_: u7rcrrurtwra�:. , r., rcawirKn�„ mra•. vxr. wrrtrra ►,4w7ww:,svr.,:�:.r.+K,w .cvu�rmdnacm�n wpm., nur.. www ,rtixr.:w.neea;'enxe- >�a+�mre y'r' x4 FAx MEMO ., ' . iu;l7sy"�7fF,i� DATE: i �p TO. - T - bb Yo`r L-ow 5 I ` Code Ad »tinistrati . FAx NUMBER: r,, Q ^� 715- 386 -4680 7 !%N L and lnfosmatioll;- FROM: ' &/N 6eAg� Planning '', FAX NUMBER 715- 386 -4686 715 - 386 - 4 x `. PH ONE NUMBER: 386 -40D Re ropeny 386 -4677 Re ling NUMBER OF PAGES, INCLUDING COVER SHEET: (3) 71_' G -4675 RE. p L. ETT p�, <r a¢,74R 10/18/05 TUE 15:23 FAX 715 386 4686 Im 001 ERROR TX REPORT �cac TX FUNCTION WAS NOT COMPLETED TX /RX NO 4731 DEPT. ACCESS CODE 1245 CONNECTION TEL 93770791 SUBADDRESS CONNECTION ID ST. TIME 10/18 15:23 USAGE T 00'00 PGS. 0 RESULT NG 0 #018 CROIX k--'® AA 0 ,7 pLANNING & ZONING . axveer. riNFR +W'x�rmiuu.rd4tl! /Nn•'Wa�aamnm 41a-- o¢: a1. YF1f+ ItlAnMoWYa f��+° mre�" g1Fm:nnrvianvum- rec-- J/:Y147G7� - raeuo �rsod' /,. - 'U' /�'VN'.nreiryromnxn . [KfM' v l k FAX M E MO DATE: C. I ► s {� } CodeAdminisCrdtt';t FAX NUIVISER: O 701 715 -385 -4680 lti Ole, F ROM: K 6V l N F ROM: planning .� ^`� " FAX NUM B ER: 71 5- 386 -4686 715 - 386674 , ' A PHONE NUMBER: 390 - 400 Re �roperty 7 ' - 386 -4677 �i Re NUMBER OF PAGES, INCLUDING COVER SHEET: C3) 71 t,. j6 -4675 "r RAE: s �- tZp &L- Le rr�a l�fb•':1` U1 2909 P 381 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROI X Co., WI Document Number Document Title RECEIVED FOR RECORD St. Croix County 10/17/2005 10:45AK AFFIDAVIT Occupancy Affidavit EXEMPT # REC FEE: 11.00 TRANS FEE: COPY ME: Name — Owner Typed or printed CC FEE: — (Owner) Yp P being duly sworn , states, under oath, that: PAGES: 1 L Helshe is the owner /part owner of the following parcel of land located in St. Croix County, Wisconsin, recorded in Volume 2k1-(v Page J oD Document Number --1 St. Croix County Register of Deeds Office: Recording Area , r— A parcel of land located in the N � ' /. of the A)6% of Section Name and Return Address —rr, - D Kv-nx ws K ' T z °) N — R 1 W, Town of St. Croix L46- Ail Al County, Wisconsin, being duly described as follows (include lot no. and subdI , io r detailed legal description): > c)- Parcel Ide Wfiication Number (PIN) As owner of the above described property, I acknowledge that the septic system serving this residence is sized for a , L bedroom home, or a design flow of 6c7o gpd. The design flow is calculated by assuming 150 gpd for 2 individuals per bedroom. There are currently ..j_ occupants living in this residence; T occupants are permitted based on the design flow. Therefore the septic system serving this residence is code compliant. However, l understand that if there are intentions to exceed the number of permitted occupants, the system will need to be modified to accomodate any increased wastewater flows and/or contaminant loads. 1 also acknowledge that I will make this information available to any future parties interested in purchasing this property. Dated this day of Q C+04;3 2 0o S . * * y i ENT" ION ACKNOWLEDGMENT Signewre(s) /SrJ� STATE OF WISCONSIN ) authenitcated this day of St. Croix County. �'� , Personally came before me this day of 204 tF,e ve clamed TITLE: MEMBER STATE BAR OF WISCONSIN (if not, to me known to be the person(s) who executed the foregoing authorized by § 706.06. Wis. Slats.) instrument and adknoWedge the same. THIS INSTRUMENT WAS DRAFTED BY R r use- Notary Public. State of Wisconsin (Signatures may be audwilceed or acknowledged. Both are not My Commission is ary permanent. H not. state a :: necess.) Date: � _ � "THIS PAGE IS PART OF THIS LEGAL DOCUMENT — DO NOT REMOVE" 7 kdb ftn must be owpWed by submrrter aW fffl #fmquft4. Otherirrfarn surer as the 105 m graritirrg dauses, leagd desaroHon. era may be placed on this first page of ft doaxrr M or may be placed on addNond pages of the document. &W use of this cowrtrpage adds orre pay& to your document and x,00 to ft 16020/10 fee. Wsoonsln Statures, 59.517 i PK:jm OU �l e LUMRING I& HEATING, INC. 321 WISCONSIN DRIVE NEW RICHMOND, WISCONSIN 54017 (715) 246 -2660 TOLL FREE 1- 800 - 542 -4243 October 12, 2005 To Whom It May Concern: In regards to Ted Kotlowski property with address of 467 Blue Bird Drive, North Hudson, WI On date of October 12, 2005 the plumbing and septic system was checked at the above address. All appeared to be functioning properly and in compliance with all state and local applicable codes. Respectfully submitted, Paul R. Koehler Countryside Plumbing & Heating MP225410 • PLUMBING • HEATING • AIR CONDITIONING • SHEET METAL WISCONSIN REGISTERED DESIGNER (MP CREDENTIAL k 224081) Wisconsin Department of Commer;;e PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Divizion INSPECTION REPORT Sanitary Permit No: 463123 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)i. Permit Holder's Name: City Village X Township Parcel Tax No: Brushy Mound Partnership St. Joseph Townshi CST BM Elev: Insp. BM Elev: Description: Section/Town /Range /Map No: /00 ba BM G S T 05.29.19. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark (,J� ��� /Z5d 5, >> Jos,►► �a� Dosing 1 Alt. BM 05 Go u �r Aeration Or r Bldg. Sewer I � J6 n Holding SVHt Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet ` Septic 7 5a / / 2 Cv Dt Bottom T 3 J I Dosing i /V n (� ' Header /Man. '9 Ct � 'i/ Aeration Dist. Pipe Holding Bot. System q d e14 F nal rade PUMP /SI HON INFORMATION 1' (/ , /0?S ' 411 urer u L SU'1 PM t Cover Model Number / qb TDH Lift 00 Friction Los System H\ T;H ` Ft Forcemain Len th SZ 7 D z ia. if Dist. to well SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid epth DIMENSIONS � .Z SETBACK SYSTEM TO P/L JBLIDG IWELL LAKE /STREAM LEACHING Manufacturer: / '7 INFORMATION Type Of System: � � /rx / � � CHA uNET OR � +(J Model Number: 0%\ V ;1 DISTRIBUTION SYSTEM Header /Manifold Distributio x Hole ize x Hole Spacing Vent to Air Intake Pipe(s) \ \ JS� W"C.L1 i Lengt h____I_ Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over / Depth Over j xx Depth of xx Seeded/So d xx Mulched Bed/Trench Center g Bed/Trench Edges \ Topsoil ; ° Yes [] No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection i / / Location: 467 Bluebird Drive Hudson, WI 54016 (NW 1/4 NE 1 5 T29N R19W) Bluebird Bluffs Lot 4 Parcel .19 1.) Alt BM Description C AS O -- c/ 2.) Bldg sewer length = z AfA 9 `�f s� 1 - amount of c over = 5 5�'�,,n•�� &A b k Plan revision Required? 0 Yes o Use other side for additional information. Date "Insepcto Cart. No. SBD -6710 (R.3/97) I C � c m o J J% D M � � e � 0 0 § 2 . S +(� §ƒ'CD 2 0 = r }° = --I ) CL , ■ 2 § F § 4 7 © / § £ ¢ ID c . \ d\ ® OD 0 § i § o Z § 7 Z' _ o o o < 0 § § § ƒ # 2 ` CO) ■ CO) C ) 0 v Q § & c § ° � r & E@0 \ \(\ m c CD ( . [ % E 2 N ( — w m 3 a Z; Z ; k [ + z E Z a a k { k § F m = � &cn NaM \mEM2a § =}92$j �i2 % «m IE° 0 i cn E; E00Q. % . « ƒk »C 2 mom= / / 3 cu > = =o $ co 3 ( 2 [A§/ e�0) o $ a@ - ;7 /m Isi / \\ \ � / � f i § 14 » Safety and Buildings Division Coun�_ . s 1 ingto Box 7162 ,WF53Z A Sanitary Permit Nu (to be filled in by Co.) Department of Commerce 151 Sanitary e t t !D i ) S Plan I.D. M In accord with Comm 83.21, Wa. Code, personal info on you provide r(!()r may be used for secondary purposes Privacy Law, sI 04(1 ���! oject Address (i dif &rent than mailing address) Z nCUuivl d l --7 ' I. Application Information - Please Print All Information E { & 1 �r u- , t :� i v Property Owner's Na me Parcel Lot tV Block l� _ c Property Owner' IM ailing Address Property Location 4,Secaon 4�ae��/ City. State Zip Code 1 7 1 onc) Number II. Type of Bmlding (tick all that apply) `f(1 or 2 Family Dwelling - Number of Bedrooms ok B ( Subdivision Name CSM Number ❑ PubliclCommercial - Describe Use S n !) OS ❑ State Owned - Describe se I_�City Township ofS c _ �►� C;e III. TyPe of Permit: (Check only one box on line A. Compltte Fine B if applicable) A. X New System ❑ Replacement System ng Rep y g Y ❑ Treatment/Holding rank lacrtttetu Only ❑Other Modification m Existing System B. ❑ Permit Renewal ❑ Permit Revision El Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: (Check all that apply) KN. - Pressurized ht-Gmu d ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating synthetic Media Filter ❑ Leaching Chamber ❑ Drip Litz ravel -less Pipe ❑ Onus (explain) V. reatment Area Information• 2 Design Flow (gpd) Design Soil Ap�plicatioa Rat Dispersal Area Required (sf) Dispersal Area Proposal (sf) Sysum El o dor � VI. Tank Info Capacity in Total Number ---- -- suer Prefab Site Steel rGlus Pia C Gallon Gallons of Units Concrete Constructed New Ex isting a� A 7 Tanks Tanks Septic r Holding Tank Aerobic Treatment Unit �,tJ Dosing Chamber !'1/( ,, /5 VII. Responsibility Statement 1, lJV , responsibility fur of the POWTS shown on the attached plats. ber's Na me t) � ber's Si N MPRS tuber Business Phone Number Plumber's Addre ss (Street, City, State, Zip Code) l l �` u �` ►� t ��,� l�J 2 Q o r VIII. County/Department use Only pproved El Disapproved Sanitary Permit Fee (includes Groundwater Da t ing S' Stamps) Surcharge Fee) ❑ Owner Given Reason for Denial l� IX. Conditions of Approval/P for Disapproval r eptic tank, effluent filter and G� dispersal cell must all be serviced t m l dined as per management plan provided by Plumber. setbaCK requlremenis mu�malntalned u/ as per applicable code /ordinances. Attach onnoeae fawns (to am Conaty oaly) Pr to on paper t less ifi x 1 w sbe 0 -7 �� i ' I i I l i ' I I L,J I ' I ill i i � J , I I L- - -!- -� - ' - -i -- - - - -1 -- �- - - -� - -- -� - - I : i I I � 1 I =� - -!- J - ____- - � - 1 - -- -� � -- ? ! 1- - - - ► -- -� - -�- -- - mil- - - - -- - -�- -- �- -- I I I I ; 1 ' I I I I I I I I I I I I I I l rf)(D. a P� w Y N E ��� s s 7 �, 9 F, qto � LLellk r corn bo W/ m d4 - ,LQ_ PIN 4' 4A . . .... ........ . L7 J .� BM to P , P J f� @�� � , Pre '' ��► ` Qa 3 t77 r A s s EZ1203H vw I v, 4 .625`► !•• ,.. ... VIVV ... .. .s " ♦ • • . ! • * 1/2 Ciro. ♦.iii�i •.......... • •••r... ..e •• •r••.,.•* • *.s•,. •..,..s.s.• ft.iiry s • 24't Boaoat 36" 12 -112" DIA. (h'P•) vow CaelTxaab to A given &15 7.4% -A," Q.D. of 4" !Lt Ens 1'r P've ` 4.625 +nckes Sidewall t2 Sidew :lts � tB.Eten v04d volume Per linea ft. _ : A4 • 23IZSo '. t 12in - 3.14 12ie,& j o .l 17 D.D. o£ oeaier eylntdtr - r2-3 inetbe 2.00 Void voI— in awfpft of censer 44iw, a 3 14 • Cz5a, 3 i t23>a Total Ssif iwtertaee Area 5.14 SQ. (1 1)t) ` ).14 • �-� • .574..422 fV t2in/A D.D. or J outsucle ey€iacierrs m 12 xml� i void volume in uutaid. eW�ders . Z • 3.)it 1 P- Jetted rreach Area k ltin 3R) • - S7a > 901 ft' Sidewall Height = 12 in. •2 2.00 Sq.FI. oid volume at awtsaan 24iu Bottom bet+w~een cylinders 36 in 6a / yp ! �t2L�1l� i atw16 `7.14 ---- 3-00 Sq -Ft. ume at 0 213 R' 1'rojeeted reach Area 'aid vol ou+side re ! I j 7o2ai ( Cr runt vul", between cytu�s) 0,2 t s ? -0 i � 0 � t! void volunrr - Y).1 17 . 0-422 + p5 .01 &.71 s . 1 ( 0.109 = 1, 763 =+attic h ! ft I f Gallons per ft = 1. T63 X 7.43 . I w ) r - �.l�as aer �r R 1 36 X (D -5 t7 EPS A99regote Trench System EZ1203H taZdus Z, Ring .tria! Group flow 65 industrial Paris Rd. �}akland. 7K 38060 SCAU ME NOW t7t2tlaw,., Stl[tT: 1 � r x -01 i r f 1072 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel Sal Service Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County St. Croot include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I. D. percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Please print all infonrration. pe ding R �By Date p Personal information you provide may be used for secondary purposes (Privacy taw, s. 15.04 (1) (m)). Property Owner Property Location Derrick Construction Inc. Govt. Lot NW 19 NE 1/4 S 5 T 29 N R 19 E Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1505 Hwy. 65 4 na Bluebird Bluffs City State Zip Code Phone Number City Village r Town Nearest Road New Richmond WI 54017 715 -246 -2320 St.Joseph Rolling Hills Trail New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Des " . Parent material Pitted outwash p lains R E C E r VE p lood ain elevation, 8 applicable nor General comments and recommendations: system elevation 99.62ft, trenches s ced ®e1$h10 5.33 below grade B3 SOY/ B or i ng Boring ZONltN6 0 lcE Pit Ground Surface elev. 104.95 ft. Depth to limiting factor 100 in. Sotl Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft *Eff#1 I - Eff#2 1 0-7 10yt3/3 none sil 2msbk mfr gw 1f .5 .8 2 7 -24 10yr4/4 none sicl 2msbk mfr gw na .4 .6 3 24-41 7.5yr4/4 none sl 2msbk mfr cs na .5 .9 4 41 -100 7.5yr4/6 none ms osg ml na na .7 1.2 Borng # Boring im Pit Ground Surface elev. 104.95 ft. Depth to limiting factor 100 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' - Eff#1 I •Eff#2 1 0-6 10yr3/3 none sil 2msbk mfr gw 1c .5 .8 2 6 -36 10yr4/4 none sicl 2msbk mfr cs 1f .4 .6 3 36-53 7.5yr4/4 none sl 2msbk mfr cs na .5 .9 4 53-100 7.5yr4/6 none ms osg ml na na .7 1.2 ' Effluent #1 = BOD ? 30 < 220 mg/L and TSS ?30 < 150 mg /L • Effluent #2 = BOD a 30 mg/L and TSS <�30 mg/L CST Name (Please Print) Sign u CST Number David J. Steel 248956 Address Steel Sal Service V Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 8/19/2002 715 - 246 -5085 PropeFty Owner Derrick Construction Inc. Parcel ID # pending Page 2 of 3 [ ] Boring # Boring Pit Ground Surface elev. 100.95 ft. Depth to limiting factor 100 in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fe *Eff#1 *Eff#2 1 0 -5 10yr3/3 none sil 2msbk mfr gw 1 C _5 .8 2 5 -16 10yr4/4 none sicl 2msbk mfr gw if .4 .6 3 16 -32 7.5yr4/4 none scl 2msbk mfr gw na .4 .6 4 32 -52 7.5yr4/4 none sicl 2m mfr gw na , _4 .6 5 52 -100 7.5yr4/6 none CS 2msbk mfr na na ( .7) 1.2 s - C F 4 ] Boring # � Boring 0 Pit Ground Surface elev. 100.95 ft. Depth to limiting factor 100 in. Sot Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDI(t= *Eff#1 *EfW 1 0 -24 10yr3/3 none sil 2msbk mfr gw 1f .5 .8 2 24 -56 7.5yr4/4 none sl 2msbk mfr gw na .5 .9 3 -100 7.5yr4/8 none ms osg ml nor nor 7 1.2 5zj. ❑ Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. F§od Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft *Eff#1 *Eff#2 * Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg /L * Effluent #2 = BOD <30 mg/L and TSS <-.�0 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or Page 3 of 3 STEEL'S SOIL SERVICE David I Steel 1564 Cty Rd GG CST - POWTSM Derrick Construction, Inc New Richmond, WI 54017 Lic. # 248956 NWl /4,NE1 /4,S 5,T29,R19W (715) 246 -6200 Town of St. Joseph, St Croix Co. (715) 246 -5085 Bluebird Bluffs lot # 4 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted. C r /ab, q7o 3 y r r� y /3 7 a+Vr 1 A ' Puc 0 : /3or, - o i r ' f Or 'AG C t . 3 I9 ` 1?3 % ioo, S3Tf � 1 wf5� l� -aZ �o� +ti Lod �r'Ne ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Sty'- �c t6-� �Af2 /C�25 /Ll6C -�} A��Z. /� 57 if S Mailing Address � C 1L � 5� 7 JQt /Ltd 14 D W/ WC) 1 0 Property Address es "t E rb l rLb oa4 vc OP 10Q (Ve ication required from Planning Department for new construction) City /State /7/U &I Parcel Identification Number LEGAL DESCRIPTION Property Location ` W l,, N� y,, Sec. , T N R 109 W, Town of Subdivision &L b t dZ (3t.-U F Lot # Certified Survey Map # , Volume , Page # Warranty Deed # Volume t °� , Page # T '7 q Spec house yes ❑ no Lot lines identifiableXyes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterphunber, journeymanplwnber, restrictedplumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the abo►e requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification . stating that septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of th year 7/ da SIGNA URE OF PLICANT DATE OWNER CERTIFICATION I e) certify that all state is on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the pro gibe abo , by i o a warranty deed recorded in Register of Deeds Office. Z ✓ l 0 / 7 / � SIQKATURE 09 APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed r POWTS OWNER S MANUAL &MANAGEMENT PLAN.. Pam ---�. of -, sYST� s+' ❑ vA E T 11 S`� e Tank Menufacum to t -es .Q �S Qwer rws Oct d Q ' � (g�se ❑ Hold # Y00 p HA Tank gal M M PAiililYlElT:tirS a pose L7 Holdln9 Vol. O NA D NA lumber of Bedrooms p N A Effluent FVW Maexefactu r © (" ^ dumber of Public Facility Units C Eff g Model - Cg a a Estimated (were S) flow o Pump Manufacturer Q NA D tpk1 flow (Estimated x 1.5) Pump Mom NA Soil Ap effluent y Monthly aware" Pret reatment � 0 Peat F ilter Starsla� ❑ We"" Fats. Oil & Grease tFOG) S30 mg11- p Med usr� Aeration Biochemical Oxygen Demand ( s2 20 mgn- E3 NA (3 Disinfection p Other. Total Suispended. SoRals n-SS} Manufactu� ❑ NA Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BUD 530 OVn In- Ground (may) p 1n - Ground �} Total SLISPOided So lid s (TSS) 530 max At -Grade p Mound Fecal Cofaform tg } 510 chill 0 Other: y in die. 0 NA p CNiP'� O NA Maximum Effluent Particle Size p NA ❑ NA Other: Other: •Vake's typicai for dome wastewater and septic tardc efFiuent. MABiTENANCE Ssty Evert Service is) {M 3 Yew} p NA Inspect condition of tankts} At mast sludge and s� e� one third tY,1 of tat volume p NA When alsrrn is activated P� aut contents of tank(S) When the high p mvenh10) 1fA 3 yews} (3 NA At least once ev�ary. s) ) ❑ NA � ceN(s} moatthts inspect dispers tsi At least once Ovary- ❑ monthis) O NA Clean effluent falter D } controls & alarm At least Olme may' p NA trrspaict Pump, PunV O monttt(s} ❑ yearts} push laterals and test At least every' p morutts(a) ❑ NA Other: At least Once Ovary- C7 --will O NA or c ertifications: INS WCTKMS carrying orre of the pta Operator 4pumPer► calls shall 6e made by an in YTS Nlsintai idecetifY my cracks or Inspections of tanks a Sewer, POWTS or broken hardware on the grew Master Plumber; Ma�ate plu i de a visual inspect of the tw*lsl to identify or n UP of g chock for any Tank inspections Must include sib and scum and a dtieck for any p i p es 04 m vokeme of com b e vd to check the off cent ground � f o alin9 conditin and leaks, mrassure the Vie} shall � Y surface. The The ping of effluent on the g ro und p ing of e ffiuertt motion o f the local ruguiatorY WdwdW' ty or more of the th tank chnt voivarn the W re quires corm ration of sledge and scum in Servici Opwator and di of in accordance wiaR 113 When by a SO!t entire .contents of the tank shaft be nsrwv� I of press urized components. pretreatmen Co Wisconsin Administrative de' servicing of effluent filters, �� � Maintainer- the services, includ limited to c ertified PO All other serviing but of 512 months, "1 be performed by a within 1 O days of co ion of any service event. units, and any servicing to the local � er �ority cMw taros A service report shad be provided � 1 Page . o€ 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 chemicals that may impede the treatment process and /or damage the sod dispersN 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 sold conditions are hum at the infiltrative surface. During extended power outages pump tanks may fill above normal highwater levels. When pourer is restored the excess wastewater wiff be discharged to the dispersal cell(s) in one Carpe dose and may overload diem resulting in the backup or surface discharge of effluent. To avoid this situation have the contei of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the purer controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal ceps. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the perforrnance and prolong the life of the POWTS: antibiotics, baby wipes: cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) discharge, fruit and vegetable peelings; gasoline; grease; herbicides; meet scraps; medications; oil; painting products; paSOCides; 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 Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and remove or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY 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 replacerrment area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lies and wed. Failure to protect the replecerrient area will result in the need for a new soil and site evaluation to establish 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 advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. The siA has n9f an oval identify �rnent a Upo fail of tte a sal and site avail be to i a rep �arnent boo replacement area is available a holding tank m led as a I to the fail WTS. ❑ Mound and at -grade sod absorption systems may be reconstructed in place following removal of the taomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC. PUMP AND OTHER TREATMENT TANKS MAY CON'T'AIN 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 INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS IWTALLER POWTS MAINTAIi" Nacre Name Phone ( a (0 s r3s l"hone . SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL T&GULATORY AUTHORITY Name Name i A i Phone 7 Ls 39 C� This document was drafted by the staffs of the Green Lake, Marquette and Wa nhara County Zoning and Sanitation agencies in compliance with chapter Comm 83.22(2)(N(1)(d) &(fl and 83.5401, (2) & (3). Wisconsin Administrative Code. ' 20 6 5 1 917 � -4 X A THLF.EN H. VALSS STATE BhR OF WISCONSIN FORM 2 -19,99 RESISTER OF DADS Document Plumber WARtRANTY DE D ST. CROI7C CO.. MI RECEIVED FIIR RECORD This Deed trade betwe ft DoaMid J. Nestrad and Yirglsia 1VL 1 2/02/2082 10:28A1! Nestrud, husband and wife — E7(FlPT i REC FEE; 1I.01a Grantor, and Brusby Mound Partners, LLP or their TRANS FEE; COPY FEE; CE IM COPT FEE. PAGES: 1 Grantee, Grantor•, for a valuable consideration, conveys to Grantee the following described teal estate in Str Croix C ou 4 ty, State oP Wisconsin ('tf tttore space is neoded, please attach addendmm): c . NE 1/4 of i3W 1/4 of Section S. Township 29 North} RwwdWg Range 19 West, St. Croix County, Wisconsin E%CEPT Lot 1 of Certified Survey Map filed January 8, 2002 Nao►eaadtb�nmAdd`ess in Vol. 15, Page 4233, Doc. No. 667583 and EXCEPt the North 83 feet thereof. NW 1/4 of NE 1/4 of Section 5, Township 29 North,; Range 19 West, Sr. Croix County, Wisconsin EXCEPT Certified Survey Map in Vol. 9, Page 2676.1 030- [018-SO-000 [ [deq ' utober This jl' A7 IKI- baoxsscW property_ i (is) Cm no t) Excepdoas to warranties; Basements, restrictions and rigtft- of-way of record, if any- Dated this day of November 2002 - • Doriald J. Nest rod ` # Vi ri: ]W. lYestrud AUTHENTICATION j ACKNOWLEDGMENT Signatures) STATE O W ISCONSIN ) County ) authcnttoated this day of Personally came before me this ay of Vovamber 2002 The above named a J. Nestmd And Virginia M. Nestrud, besband and wife TITLE: MEMBER STATE BAR OF WISCOIdS" , ' ,� (If not, ' �^ tti me ie be parsons } who executed the foregoing authorized by § 706.06. Wis. Seats.) ins d nowledged the same. THIS INSTRUMENT WAS DRAFTED BY Attorney lCristina ag>sud oe, Notary State of W'sconsine 15A01 P i . " n is girt. (If not, state � 5t ma � ( gna�res y be autlfeaticattd or aalmvwiedged. $otfi am not necessary.) � Names of persons sWmg to any capacity must be typed or printed below their sipo& ; kOMMO n Pm%w ruff Cawipw,y. Fad du t g VA STATE HAIL OF W $Vv WARRANTY DEED FORM No. 2.1999 i i l i 33 _ A� • Y M. W e I �1 M OM `°♦ C •' Za M • • IV r. • O • x •' A � '� k V' f ��l T �p a; tl n '� r � � � � y o --� S89'43'53 "E 2638.14'- �.: UNPLATTED LANDS _ Pondin " Q=. S89'43'53 "E 1319.19' H wt —" 4 o - 34' p' 418.36 -6.70" • . n� o , Conservati 1297.92'— Conse �y28.00 �o Easement rq w - �� ��s• F �.. • - LOT �2 LBO= 943.5• SB9 LBO= 932.0' • 336.03' .' • . os LOT ff '0) o . 'se 4353E ' . ... - ' S89'43 • 1 ,� � - LBO--9J2. . w' ' � I 00 ... , 350.00 o , . .55 6 00 • . o y m . EASS WDVr ka? 33' 33' . £.45 upvrFold S �. X_ - N78'42 8 ESj8�2o9. W (3 37� -a � 56•' •P .la 66' X80.4 6 �$ RIv E Ss8 s '"O °� Gg N89 V. 9 �G w f �•S >> 8 >• C147 �^� /� • / .�� N89 4L 051 Ng'r. ��- LOT 4 LBO =909 / LBO = 924.0' • O M _ CV / ` • 3 A0.• .Z LBO= 924.0' Pond / • 68, • _ .. Easerr N8979a7T H. W.L Leo= 9.30.0' 177.55' a L - -, '"" 14200' N8979;33:E ` ^, 93 . LOT 5 59.12': � 0.21 ,'� S89'1 9'37 "W Ponding y -Easement H. W.L. =920 O a o ti (� I ; M � _ Ic.. 4" Cl VENT PIPE 12" 141N. ABOVE GRADE E WEATHER PROOF 2: 25' FROM-DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR "INTAKE WITH CONDUIT MANPADL.CKVER WARNING LABEL 4" MIN. 14 LET GAS ET i WATER TIGHT SEALS _F TIGHT i c , L4 A � ., A SEAL APPROVED JOINTS WI CI I PIPE B ON PIPE 3' ONTO 3' ONTO �' i SOLID SOIL SOLID C SOIL FT. •- -- r' OAF'S RISER EXIT PUMP OFF £LEV. PERMITTED ONL) D IF TANK MANUFACTURER HAS APPROVAL 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE , TANK MANUFACTURER: ( ►; v ,rs �ep�� NUMBER PER DAY: —S — TANK SIZES SEPTIC I O GAL. DOSE VOLUME INCLUDING / DOSE _ - 0 GAL. FLOWBACK: GAL. ALARM MANUFACTURER: _ CAPACITIES: A = LINCHES = LY► GAL. MODEL NUMBER: ry 11 GAL. SWITCH TYPE: c. -� B = 2 INCHES - 3�• C = o�� INCHES = GAL 37 PUMP MANUFACTURER: c� MODEL NUMBER: W D = INCHES = - GAL SWITCH TYPE: REQUIRED DISCHARGE RATE GPM PUMP £ ALARM WIRING AS PER ILHR 16.23 WA( t , 6G ' FEET VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE , FEET + MINIMUM NETWORK SUPPLY PRESSURE . • • • ' ' . FEET + __L_�.__ FEET FORCEMAIN X 3,3) FT /100 FT. FRICTION FACTOR , _ FEET TOTAL DYNAMIC HEAD INTERNAL DIMENSIONS OF PUMP TANK: LENGTH ; WIDTH __� DIAMETER LIQUID DEPTH J 1 ►. - s i S t1 II r i 11 men memo l rl I 1 1 f 1 CI , i+w / /ww // MIN .Nmw /ww /w/w//�.f..�l:ww /w // w �+�.r/w / /'1 /w //w/ mhonwww /awa q/ / /// /r'-- -rwww :w/ / /// onomm a�+r: /wwmah" ri�i�wwwwwiimeaiiwMi�i�i�i Lr..i wWWWWW=wiwww�ww /iw iwi a'` •aw NO /ww + . .." . , r .. , . -, ti:�•,�, \�1 �.?7 /iwww�aw /ice �''''1r� ►ri a�i► �iwwlrw /riwwwwww /ww ., f ,:,. ,. ,r•- .."1 /w. �. / ■r /w■ /�rr►�www►wwiiiia/ir ' ,;.. : 1 " i iiii�tnr ►±� wwV!f ►pia iiiriil www /iw /wwwis������ \ ww /i \w \� /w w ,:,;, , wwww/ / /w ww /wwww/w�r // wwwwrww f, 7 lZ l (, '30 Parcel #: 030 - 2137 -04 -000 10/05/2005 09:53 AM PAGE 1 OF 1 Alt. Parcel #: 05.29.19.2030 030 - TOWN OF SAINT JOSEPH Current *1 ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 03/22/2004 00 0 Tax Address: Owner(s): O = Current Owner; C = Current Co-Owner O - KOTLOWSKI, THEODORE P & SUSAN M THEODORE P & SUSAN M KOTLOWSKI 7445 ORINOCO CIR STACY MN 55079 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description " 467 BLUEBIRD DR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.000 Plat: 10/01- BLUEBIRD BLUFFS 030/04 LOTS 3/13 SEC 5 T29N R19W FRL NW NE BEING BLUEBIRD Block/Condo Bldg: LOT 04 BLUFFS '04 LOT 4 (3.00AC) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 05- 29N -19W NW NE Notes: Parcel History: Date Doc # Vol /Page Type 10/15/2004 777050 2676/100 WD 03/22/2004 757255 10/01 PLAT 12/02/2002 700547 2065/474 WD 07/23/1997 1095/410 QC 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 05/31/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 75,500 69,800 145,300 NO Totals for 2005: General Property 3.000 75,500 69,800 145,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 1� d, 2 B ? s p 10 O -7-71Zs0 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO.. WI THIS DEED made between Brushy Mound Partners, LLP, a RECEIVED FOR RECORD Wisconsin Limited Liability Partnership ( "Grantor") and Theodore P. 10/15/2004 08:30AN and Susan M. Kotlowski, husband and wife, as survivorship marital property ("Grantee"), WARRANTY DEED WITNESSETH, that the said Grantor, for valuable consideration EXEMPT # conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin: REC FEE: 11.00 TRANS FEE: 262.50 COPY FEE: Recording Area CC FEE: Lot Four (4), Plat of Bluebird Bluffs In the Township of St. Joseph, Nan, and R St. Croix County, Wisconsin �/ p r �TN�tiDh Part o and 030 - 1017 -80 -000 (Parcel Id"kkaton Number) Tfhis tilt hanestead pmpeny. Grantor, Brushy Mound Partners, LLP, a Wisconsin Limited Liability Partnership, is an affiliate of Derrick Homes, LLC, a Wisconsin Limited liability Corporation. Grantor develops land and Derrick Homes, LLC is a home constructions contractor. Grantor agrees to sell this lot to Grantee on the condition that Derrick Homes, LLC Will be the builder of the home for Grantee. If Grantee does not commence construction with Derrick Homes, LLC as the contractorPouilder within two (2) years of the date of sale of this lot to Grantee, Grantee gives Grantor the Irrevocable right to re- purchase the lot for the same price as Grantee paid Grantor for it when Grantee bought it from Grantor. If Grantee desires to sell the lot to anther purchaser before constructing a home upon this lot, Grantee gives Grantor the right of first refusal to re- purchase the lot for the same price as Grantee paid Grantor for 9 when Grantee bought it from Grantor. Dated this jib day of Qatobak. 2001. • on . f�rkl r t nlel AUTHENTICATION 7 ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ST. CROIX COUNTY Personally came before me this ZID day of QGkibor. 2094, the authenticated this _ day of i g_ above named Michael R. Stevens and Ronald L Derrick, as partners of Brushy Mound Partners, LLP, a Wisconsin L fled Liability Pantne to me known to be the persons slgnab re wR10 the stnxnent and acknowledge the type or print name same. LA PAUE . RUTUME TITLE: MEMBER STATE BAR OF WISCONSIN thra Pubft (If not, ghtt Wh�msln authorized by' 706.08, Wis. Slats.) type or point name Qla Notary Public St. Croix County, Wisconsin. THIS INSTRUMENT WAS DRAFTED BY My Commission Expires: July 27th 209$. Brushy Mound Partners *Names of persons sipnhnp in any capacity should be typed or PO Box 445 printed below their loWsamres. New Richmond, WI 54017