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HomeMy WebLinkAbout030-2124-40-000 r - Wisconsin Department of Commerce Count Safety and Building Division PRIVATE SEWAGE SYSTEM St. Croix INSPECTION REPORT Sanitary Permit No: 463426 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: Fischer, Michael & Christina St. Joseph, Town of 030 - 2124 -40 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: /00 25.30.20.1008 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic '7 Benchmark Dosing Alt. M _ GC i1.3 �1. z 1 Bldg. Sew r '7 . �� r Zclv&Q A— Holding St/Ht Inlet . tv .43zF e.s9 TANK SETBACK INFORMATION SUHt Outlet -� TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic __44 /' % Dt Bottom 22 1 83 • 3 G Dosing 4<9 + + - — Header /Man. � Z 2 3 Pa z y 1 Aeration ------ Dist. Pipe _ I ztl- Holding Bot. System @ i Final Grade + PUMP /SIPHON INFORMATION C ,�_ \ Z. 4.7 Manufacturer Demand St Cover GPM r!1 " 3 Model Number - T 7 - %(,> ` 1-7 - L. lo.1il TDH 1-17 �� Frictiop Ljs System Fi@ad TDH 6 9 � • �e1 7 � J 0 ` ° r T'S 4T lD Forcemain ' Length f Dia. ii Dist. to Well N r ^ °t a lal 5� SOIL ABSORPTION SYSTEM BED/TRENCH Width Length 5 No. Of Trench e PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SEX- �. SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer/) ti INFORMATION CHAMBER OR it Type Of System: r 1 q UNIT Model Number: DISTRIBUTION SYSTEM eG- r J I aj__,k, Header /Manifold �� Distribution x Hole Size x Hole Spacing Ven o Air Intake 9 c1 Pipe(s)� Len th Dia 4 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 /S dded xx Mulched Bed /Trench Center � BedlTrench Edges Topsoil Yes j No _Yes -,;;' No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1335 Birch ParV?oad Hudson, WI 54016 (E 1/2 SW 1/4 25 T30N R20W) Birch Park Lot 4 Parcel f No: 25 0.20.1008 1.) Alt BM Description ��b�• v�� 2.) Bldg sewer length = - amount of cover Use other side for in Yes No I 'g i � `�?4 formation. • ___. _ Date Insepctor's S' nature Cert. No. SBD -8710 (R.3/97) Safety and Buildings Divisio .` 201 W. Washingto e., IIE St fOIX I sconsin Madison. WI 5370 Sauit Permit Number (o be filled in by Co.) Department of Commerce (608) 6 -3151 4 32 / _ Sanitary Permit Applicatio tate P n I.D. Num ber ` In accord smith Comm 83.21, NVis. Adm. Code, personal information eCROIX COU Y may be used for secondary purposes Privacy Law s15.04(1 ) ING OFFIC et cidress rf diff t than mailing address) lrch Dark n I. Application Information — Please Print All Information 133� PAf-e-- R-b) Property Chmner's Name Parcel x Lot ?t Block Michael & Christina Fischer 4 ---- Property O%Nuer's Mailing Address Property Location 7475 Flying Cloud Drive Apt. 308 SW City, State Zip Code Phone Number r a Section 25 Eden Prarie MN 55441 30 le one) T N; R l! r ' II. Type of Building (check all that appl3') ad S 01 or 2 Family Dwelling Subdivisi Name CSM Number hvelling — Number of Bedrooms 4 S . Public /Commercial — Describe Use Birch Park ❑ State Owned — Describe Use []City_U'illage Orommmhip of St Joseph III. Type of Permit: (Check only one bog on line 'L Complete line B if applicable) p Q —'L 2 — � ©� 0 New System ❑ Replacement System ❑ Treatment/Holding 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 IN'. Type of PONVrS System: Check all that a ky 0 Nim — Pressurized In- Ground ❑ Mound 24 in. of suitable soil 0 Mound - 24 in. of suitable soi ❑ At-Grade ❑ Single Pass Sand Filter 13 Constructed'vVetland ❑ Pressurized In- (mound ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ / Recirculating Synthetic Media Filter 0 Leaching Chamber 13 Drip Line Q Gravel -less Pipe ❑ Other (explain) r %. Dis rsal/TreatmentArea Wormation: 0 Design Flow (gpd) I Design Soil Application Rate(gpdst) Dispersal Area Required (sf) Dispersal Area Proposed (s System Elevation 600 .4 1 1500 1523:9 1 S 97.75 to 101.5 VL Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units U3/ Concrete Constructed Glass New Existing Tanks Tabs , ) Septic or Holding Tank; 1200 1200 1 Wieser Concrete X Aerobic Treatment Unit Dosing Chamber 800 1800 11 1 Wieser Concrete X A'II. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POTS shown on the attached plans. Plumber's Name (Print) ber's Signa NIP NIPRS Number Business Phone Number Darrell Hubbell 7 221073 1715 273 -6360 Plumber's Address (Street. City, State, Zip Code) N6490 U S H 63 Beldenville WI 54003 VIIL County artment Use Only Approved El Disa roved Sanita PePermit Fee eludes Groundwater Date Issued Issuin , gent Sign r No Stamps) Surcharge Fee) u 11 C en Reason :rorAerri.1 i Il. Conditions of Approval/Reasons for Disapproval 3) LVLI. SYSTEM OWNER: / , 1 Septic tank, effluent filter and �-�-; is dispersal cell must all be serviced / maintained / as per management plan provided by plumber. ` 2. All setback requirements must be maintained as per applicable code /ordinances. Attach complete plans (to the County only) for the system on paper not less than 81/2 s 11 inches in size SBD -6398 (R. 01/03) Scale " =ko' o" Ell 5w� SAC T-30N IR.2ow 1-1.17 4cre PurceL L- c T 14 f3,'r P urr Taws 0 -1' Sr TvSePh Q .. 1 gm z . (�w► i S 1 y Puz l pe Jfo��d Located 1 tj q N /�vrth ��ruPe►�'y t '3y weir oe ,3m 1 (• (� � t Yo I 1 )i at' St Ke h Lvt L,•Y►2 J ? 4;� l4 scfl Le- l o3.7 p,•STr'b t T} 4"jp&fe To New n-S f f �` (�v d v J ed LoCatt'o h p QM :! L; H 2 west of lip► LaPe ntvAvS =� b y o a we if H,.hbe LI B t vu ir,�r5 Q21073 trhaT e y -i2 -oS / f•�vvSe ACt I Sy57-e»? Area Wiovnj Fkurn Tef7 1 o- n - v t Well T O tae a7` Lea St 29' Fk o"^ TG h k S ySTekri paye 5 n� 7 Cj 100 C1Y KL� r INDEX AND TITLE SHEET In- Ground Residential Design Owner's Name: Michael & Christina Fischer Owner's Address: 7475 Flying Cloud Drive Apt 308 Eden Prarie MN Legal Description: E 1/2 SW1 /4 S 25 T 30 N R 20 W Township: St Joseph County: St Croix Subdivision Name: Birch Park Lot Number: 4 Block Number: Parcel I.D. Number: 030 - 2124 -40 -000 Plan Transaction No: Page 1 Index and Title Sheet Page 2 Plan View and Calculations Page 3 Pump Tank Cross - Section Page 4 Pump Curve Page 5 Plot Plan Page 6 Management Plan Page 7 Management Plan Page 8 Designer: Darrell Hubbell License Number: MPRS 221073 Date: 4/4/2005 Phone Number: 715 273 -6360 Signature: bawe I,4 Design Information: In Ground Manual SBD- 10705 -P (N.01/01) Page 1 of 7 Pt a h v e w 6�•5' 2 „ P•1e - v . o j a pa "e iz � o T3 o p w ' P S e i 6 NQt a T u o � S - ' o / �; STr,'hvi 130 X c� TS a o 1 q rye X rv” 1'hsl�'ct� art PotTY F „ sPecn'oh or Ptr.x ytaft sl'tatl, 'it 2MCI charhbe)' veN t5 .'n caST mares arnhef he anLkoleer Due ro SloPe and 5ta_jXked Etetrr fi yP1 cl+aw,hers v�ljj be S' rl - 99�5 TS- llwsrrl�i.c S���gte Ise /ps'' �M+•+o'� odyrll.+i. 4wrailY,gttw+� K4�t�w��sai1. iYiO rAr �� Orr�rr rr cl7r ��•$ ...do.. r '� t 1al.S� c..rw C ie. .+.+.. 99,5 �i 1 vo•S �� . d..ti„ w�rsw- -r -r r.�.w_ I' - �..ir..s_ I 1 .•d.� w..,,m.r u.... a„yshow .,..r.,.� bed(► -oop- hpuSe �vr a {Sao 5g * 49 - S 1100 8 D c h 4 enk -ek - f F1 A a rar/aL f H-lo 3 i S Ier CA&mber 1900 sx er ' 3/ g. 2 3 or N 4 m. h rK VV•n c a 4Yn L e rt SYStem w 'II be S`o < ers 6 ,2 •5 The KCkes 1/-} SurtA e e etevo r •on o Nr•'n�'rn vrn 1 � ' ` 19.3 ..�„ sysTevr� Ete. 3 13 dePIA S 6.9' ur {ace e teya7�'Dvl ' -- i oS � ,ete 10 1.2' TI a 1? S extra F.'rt F I-o" 4 char„ hers vsed 7 %ce If(, g r0 Orl hra 1' 11 i' rv+I'hl •� so 7-3 Le f Giho c•ti - TL/ rLe 100,5 TS Foe 1 01,5' Page o� 4 ` SEPTIC TAN !r PU CHAM CROSS SEC AND SP Ir'CCAT(O u" CI VENT PIPE 12" MIN. ABOVE GRADE E WEATHERPROOF ?!2S' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED £'RESH AIR INTAKE WITH CONDUIT MANHOLE COVER W/ PADLOCK E FINISHED GRADE �_ WARNING LABEL G ".cfax. w�v.re 1 — _ r 4" MIN. Zy n 1$" IN x_p_ (�' 'SivnHert 18 mits. INLET WATER TIGHT SEALS GA TIGHT \APPROVED FILTER - A SEAL e JOINTS WITH APPROVED Zalei Aioo g rr _}, A APPROVED PIPE PIPE 3' --� , ON 3' ONTO ONTO SOLID SOLID SOIL SOIL C � PUMP OFF ELEV . SS' y FT . —- OFF D rLe �S' 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE TANK MANUF'ACT'URER: w -�se1 1 2 , 60 / g 00 L NUMBER DOSES PER DAY: � T ANK SIZES SEPTIC 40 GAL. DOSE VOLUME INCLUDING DOSE oo � GAL. 16. 3 yep FLOWBACK: M- 2 GAL. A LARM MANUFACTURER: Zoe1tek QwK -13 oX CAPACITIES: A = ,21 INCHES = L16Z0g MODEL NUMBER: jo -go S3 SWITCH TYPE ^ Tw at B = 2 INCHES = '4 q, 1 41 GAL. PUMP MANUFACTURER: ZpBtle` C = S INCHES = 1 t • 2 GAL. MODEL NUMBER: G!Z SWITCH TYPE: w�eci,a&It' g� !-to 0 = INCHES = � . kz GAL. DISCHARGE RATE 3 GPM PUMP & ALARM WIRING AS PER 11,1-IR 16.23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE 6' 6 FEET • MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . . . p,0 _ FEET • ._j n0 FEET FORCEMAIN X 2,5 FT /100 FT. FRICTION FACTOR 2,S4' FEET TOTAL DYNAMIC HEAD = U INTERNAL DIMENSIONS OF PUMP 'TANK: LENGTH ; WIDTH DIAMETER LIQUID 6T't � 3(" Hegdes- 02' 16. v9 F_ q1 Payer 3 j -d 7 w HEAD CAPACITY CURVE 3 7 / 8 6 1�4 30 MODEL ° 98" 4 5/8 i{ e I ��TYo7l: rnG1 BC y 6 20 = - -- - — 3 5/8 - 18.6 6f'h'I 1 5 -- — + - a o 1 0 -- -- _ \ 4 3/16 2- 5 - -- - - U -- -- 1 1/2 - -11 1/2 NPT U ^ GALLONs 10 20 30 40 50 60 7U 80 LITERS - 0 60 160 240 FLOW PER MINUTE 4 r7""X:y-4 `Ly 32 6 )ern MODEL 98 60 CYCLE — Fee t — Gallons Me ters Liters 5 72 1,5 273 — 10 61 3.1 231 15 45 4.6 170 20 25 6 -1 95 12 omit lack WFrx: 23' 4 3/16 SK 1102 CONSULT FACTORY FOR SPECIAL APPLICATIONS Electrical alternators, for duplex systems, are available and Variable level float switches are available for controlling single supplied with an alarm. and three phase systems. Mechanical alternators, for duplex systems, are available Double piggyback variable level float switches are available with or without alarm switches. for variable level long cycle controls. SELECTION GUIDE Standard all models - Weight 39 lbs. - Y2 H.P. 1 - Integral float operated 2 pole mechanical switch. no external control required - 98 Series Control Selection 2- Single pn99Yba(* variable level float switch or double piggyback variable level, float switch. Refer to FMO477_ Model volts -ph Mode Amps I Simpiax Duplex 3_ Mechanical alternator 10-0072 or 10 -0075. M98 115 1 Auto 9.4 1 or 1 & 7 — 4- See FM0712, for correct model of Electrical Altema tor. 198 115 1 Non 9.4 2 or 2 & 6 3 or 4 & 5 5. Control switch 10-0225 used as a control activator, specify duplex (3) or (4) D98 230 1 Aldo 4.7 1 or 1 & 7 — float system - 6, Four (4) hole J -Pak, junction box, for watertight connection or wired4n E98 230 1 Nark 4.7 2 or 2 & 6 3 or d & 5 simplex or duplex operation, 10 -0002. 7. Two (2) hole J -Pak, for watertight connection or splice. CAUTION For Information on additional Zoeffer products refer to catalog on Piggyback Variable Level Switches, All installation of controls, protection devices and wiring should be done by a qualified FM F_ kdricalAll ernat or, FM0486; MechanieWAkernalor, FMO495 ;Sump/sewageBasins,FM0487; licensed electrician. All electrical and safety codes should be followed including the most Single Phase Simplex Pump Control, FM1596; Alarm System, FMO73Z recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. Page 4 01, 7 MAIL TO: P.O. BOX 16347 t.ouisvt 3 6 49 Cam 347 Ru S1BP 349 Road Alanufadrnersot.. I.MWDe, K 40211 -1961 �Q[seurr P uwPS S. acE /9,99 hapIzowww.zoeAer -com PMM� 1O. (602) 778.2731.1(800) 926 -PU W FAX(502) 774 -3624 Sc I " =uo' o" E� Sw% S ;S T 3 0N 14•17 4 cje PurceL LCi T N (3.4 Pet ki< T 0 4 S t 7 5 ePh Q North'. ,prv1'erty t,••�e y'' ur 1�'►�e ° ° � 9�ovtict Located $ A ; ., .hart►` ovpel - 3y' we47- p 13rw 1 i Coil trall f 13m2 Brov►�4d II °� qj 5t'e4 Ke ski Lvt L'v►P Slog L e 10. 7 , o p c S °ry O` i f r > aMsPoSed Ta �} �,�,� t j W o a j ed rr LoC «lion ;y► A pertY QM �, 1 "'�- ptapriSed b y 0 a We r t N �hbe yl t3e d Faa►�! .hP, -s a2►o73 A� y -i2 -a5 / Hvvse / Sysreyn Atea r>1o�.„d F� U rn TcST 10.22- or i Well 7'o $e of Lea Fr o-'► Tu h t< 0 1 14 So' l= r " " SySTevit p Paye .$ v# 7 �� v�- V4 � �� 4 POWTS OWNER'S MANUAL MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS ' owner Septic Tank Capacity 19,00 gal ❑ NA Permit # Septic Tank Manufacturer w,• e S 6 - ❑ NA Effluent Filter Manufacturer Z bet AI u0 ❑ NA DESIGN PARAMETERS Effluent Filter Model 4 10 u r' C3 NA Number of Bedrooms I OOgpolbedroom �/ NA Pum Tank aci Ca Number of Commercial Units NA p p ty U V gal C3 NA Pump Tank Manufacturer Estimated flow (average)* �d D gal/day t.✓ +�e SeY ❑ NA Design flow (peak), estimated x 1.5* GoU gal /day Pu Manufacturer Z ae t el' ❑ NA Pump Pump Model DNA Soil Application Rate . y gaUday Pretreatment Unit 181 NA Influent/Effluent Quality (NAC3) Monthly Average ** p Sand/Gravel Filter O Peat Filter Fats. Oil & Grease (FOG) < 30 mg/L 0 Mechanical Aeration p Wetland Biochemical Oxygen Demand (BODs) 220 mg/L E3 Disinfection p Other: Total Suspended Solids (TSS) Manufacturer: Model: _< 250 mg/L Dispersal Cell(s) Pretreated Effluent uality C3 Monthly Average * ** Q 63 In-ground (gravity) ❑ In -ground (pressurized) Biochemical Oxygen Demand (BODs) < 30 mg/L C3 At -grade ❑ Mound Total Suspended Solids (TSS) < 30 mg/L. 0 Drip 0 Other: Fecal Coliform (geometric mean) <I0 ❑ Leaching Chamber Manufacturer Maximum Effluent Particle Size 1/8 inch diameter Model ( 10 D 8 Q Approval Stipulation *Wastewater Flow Verification on and calculations: Soil Application Rate • gpdJfl? Area Req. (SV Of ^ (Other than bedroom based) Absorption Area Credit per unit 3 �• � ft Minimum Number of Chambers 14 �1 D Aggregate Design Flow/Loading Rate= W min ** Values typical for domestic (non - commercial wastewater Materials: all materials must comply with WI Adm. Code and septic tank effluent. COMM84 and be installed per manufacturers specifications ** *Values typical for pretreated wastewater. and approval letters. DESIGN CRITERIA C3 "Wisconsin At -grade Soil Absorption System, Siting, Design & Construction Manual" (Converse etal.1990) ❑ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 O "Design of Pressure Distribution Networks for Septic Tank -Soil Absorption Systems" Publications 9.6 ❑ "Design of Conventional Soil Absorption Trenches and Beds ". R.J. Otis — ASAE Publications 5 -77 and "Design Manual — Onsite Wastewater Treatment and Disposal Systems ". EPA 625/1 -80-012 October 1980 E3 SBD — 10570 P (1-6/99) "At -Grade Component Manual Using Pressure Distribution" C3 SBD — 10567 —P (R.6/99) "In Ground Absorption Component Manual" M SBD — 10705 —P (N.01 /01) "In Ground Soil Absorption Component Manuai" Version 2.0 ❑ SBD — 10628 —P (N.6/99) "Recirculating Sand Filter System Component Manual" ❑ SBD — 10656 —P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual" ❑ SBD - 10572P (8.6/99) "Mound Component Manual" ❑ SBD - 10691 —P (N.01/01) "Mound Component Manual" Version 2.0 C3 SBD - 10595 —P (R.6/99) "Single Pass Sand Filter Component Manual" C3 SBD - 10657 —P (R.6199) "Drip -line Effluent Disposal Component Manual" ❑ SBD - 10573 —P (R 6/99) "Pressure Distribution Component Manual" p SBD - 10706 —P (N.01 /OI) "Pressure Distribution Component Manual" Version 2.0 0 Drip -line Effluent Dispersal Component Manual for Multi -flo Onsite Wastewater Treatment Units 0 MAINTENANCE AND MANAGEMENT MAINTENANCE MONITORING SCHEDULE Service Frequency Service Event Inspect condition of tank(s) At least once every ❑ months IR year(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one -third (1/3) of tank volume Inspect dispersal cell(s) At least once every 0 months ® year(s) (Maximum 3 yrs.) Clean effluent filter At least once every D months to year(s) C Inspect pump, pump controls &alarm At least once every 1 0 months Ycar(s ) p NA Flush laterals and pressure test At least once every 0 months C3 year(s) ® NA Valves At least once every 0 months O year(s) ® NA Other: At least once every p months ❑ year(s) p NA Page of 7 � S ?ART UP For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treahnent process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. Systerh start up shall not occur when soil conditions are frozen at the infiltrative surface. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of water - saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetablelfruit peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non - biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. 13 Valves Valves shall be operated in the following manner: a Alarms Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back -up of sewage into the dwelling or surfacing. I NPECTIONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). ®. Septic Tanks Component Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any backup or ponding of effluent to the ground surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one -third (1/4) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NRl 13, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. p Pump Chamber/Treatment Tanks Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of the filter. Any service needs or repairs shall be promptly taken care of. 0 In- Ground Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. Page 7 of 7 ❑ Mound, At- Grade, In- Ground Pressure The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any - evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the system. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. 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 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 soil, gravel or other inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: to 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 limes and wells. Failure to protect the replacement area will result in the need for a new soil from existing and proposed structure, lot lines and wells. Failure to protect the replacement 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 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. ❑ 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 rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN 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 INSTALLER POWTS MAINTAINER [ Name 1aAilIRIS- rl Ht,47 rte Name T ck61 x Se (E Sy5ree -+f Phone 7 15 3 0 16 3 o Phone 7 5- U -+ 670 SEPTAGE SERVICING OPERATOR (Pumper) LOCAL REGULATORY AUTHORITY Name -k v - 0 VN ty SQ h � Agency �" [I X fo k / Z &M, K Phone - 7 (S - 3 i - g 13 0 'tk7 +' a" � Phone ? ! S - dt 7 3 - 6 2 Y K:\WPDATA \FN \POWYS OWNER'S MANUAL.doc Page 7 of 7 Wisconsin Department of Ci�,v�D OIL EVALUATION REPORT Page I of 2 Division of Safety and Bu ings in a with m 85, Wis. Adm. Code •/, County ST. CROIX Attach complete site pla on pap �le n 8 1/2 x 11 i es in size. Plan must inducts, but not limited to: rtica horizon ce t (BM), direction and Parcel I.D. 030 - 2124 - 40 - 000 percent slope, scale or di n i? sionv W 0 d distance to nearest road. P Se Q fmation, Ze ewed by Date Personal information you provi be used for secondary purposes (Privacy Law, s. 15.04 (1) W). 4. ZQ Z2 Property Owner Property Location 11 El BIRCH PARK LLC (Buyers: Michael & Christina Fischer) Govt. Lot - -- E SW 114 S 25 T 30 N R 20 Property Owner's Mailing Address Lot # Block # Subd. Name or CSW 10700 Old Cty. Rd. 15 4 -- Birch Park City State Zip Code Phone Number ity ❑ Village Town Nearest Road Plymouth, MN 1 55441 1 ( ) NK Birch Park Rd. Q New Construction LlseE] Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material outwash sands Flood Plain elevation if applicable biA ft. General commends Conventional In- ground trenches -- 0.4 loading rate and recommendations: This additional boring was required to move system area. Initial report completed 10 -22 -01 by Thomas C. Nelson (Top 12" disturbed soil -not suitable)�co Ll^1e5 Ioe*rtav Of -a1 CORRgC -TCO 1❑ Boring # 0 Boring 11 pit Ground surface elev. 99.30 ft. Depth to limiting factor 6 n. �� 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. `Efr'#1 *Eff#2 1 0-11 10YR2 /1 - is Ifsbk mvfr cs 2vf-m 0.7 1.6 2 11 -26 10YR2 /2 - A lmsbk mvfr cs Ivf-m 0.4 0.7 3 26 -36 10YR3 /2 is lmsbk mvfr cs lvf-f 0.7 1.6 4 36 -50 10YR3 /3 - s Osg dl cs lvf-f 0.7 1.6 5 50 -62 10YR3 /4 - s Osg dl as -- 0.7 1.6 6 1 62 -64 10YR3 /4 f2f 10YR4/6 A lmsbk mvfr -- -- 0.4 0.7 1 �_ Boring # 11 Boring ❑ ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDN in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Efr#1 *Eff#2 ` Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg A_ ` Effluent #2 = BOD < 30 mg& and TSS _< 30 mg1L CST Name (Please Print) i nature `t - CST Number M Jo Hollister �' 224832 Address Date Evaluation Conducted Telephone Number W9875 690th Avenue, River Falls, WI 54022 03-23-05 (715) 426 - 1775 A 4 . PLOf PLAN p � 1319cif ARK LLd I. l amazzEk �aq, is/ PAP OF u, . W - 55 M 00 • T 20W — Qp&j"4fZ Sit CE T LOT c.l CONMA 99 R \ 4, 1 ACRE5 Q= AAAJD $DRUJ(s 8 ' 8 r10RTtt PRj El, q 5 Q Cs��110US'T>�ST p{�SE E. t BOO' ID-VU, D1 /i C, sLo �3 i IN cy rv& pxtvlous Est w > HV . VV isconsin Department of Commerce SOIL EVALUATION REPORT r Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Coun St. Croix Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. Q 3 0. Z( YO . 70 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. dzrO Please print all information. R iewed by Date I %J AA Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Zz �W, Property Owner Property Location Quest Development, Inc. Govt. Lot E 1/2 1/4 SW 1/4 S 25 T 30 N R 20 E )W (or)W Property Owner's Mailing Address Lot # Block # Subd. Name or CSW Suite 150 10700 Old County Road 15 4 1 1 Birch Park City State Zip Code Phone Number ity F ■ Town Nearest Road Plymouth MN 1 55441 1 ( 7¢3 -595 -9512 County Road E Q New Construction Use Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD E] Replacement F1 Public or commercial - Describe: Parent material T .oess over out wash sands Flood Plain elevation if applicable ' ft. General comments This site is suitable for a mound system. Additional soils investigation may v a s pte st for and recommendations: grade conventional system L �\� f� 2002 ST C FT] Boring # Boring �jhh-ij g n Pit Ground surface elev. 100.10 ft. Depth to limiting factor >72 ZONWRF Soil n Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence BoundNj Rooft !fF %� in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 *Eff#2 1 0 -3 10yr2 /2 is lfsg mfr cs -- .7 1.2 !� 2 3 -36 7.5 r5/4 s Osg ml cs - .7 1.2 3 36 -72 10yr2 /2 - ifs Ifgr mfi _ - .4 .6 S� Z F- Boring # Boring 102.20 82 Q Pit Ground surface elev. ft. Depth to limiting factor / in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff #1 I *Eff#2 1 0 -82 10yr2/2 Ifs lfsg mfr cw - .4 .6 2 82 -94 10 r4/4 f2f7.5yr5/4 sil lmsbk mfi - - .2 .3 * _ > < > < - D < a TSS < 30 m /L Effluent #1 BOD 30 _ 220 mg /L and TSS 30 _ 150 mg /L Effluent #2 30 mg/L nd g s — — CST Name (Please Print) Signatur CST Number Thomas C Nelson 227387 Address Date Evaluation Conducted Telephone Number 1432 120th Street, New Richmond, WI 10/22/01 715 -246 -2454 NAL E y Property Owner Quest Development.Inc Parcel ID # Page 2 of 3 3 Prop" # Boring ❑ g Q Pit Ground surface elev. 108.75 ft. Depth to limiting factor 20 in. �— Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -6 10yr3 /2 - is Ifgr mvfr cs 2f .7 1.2 2 6 -20 10 r4/4 - sil 2msbk mfr cs if .5 .8 to 3 20 -30 10yr3/2 f2f7.5yr5/6 lvfs Ifsg mfi - - •4 .6 Boring # D Boring M Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring ❑ Boring # Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. if you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 -264 -8777. MD- 8330Test (R.07 /00) i 1 r 3 of 3 QirC �1 �q � A y i� tom- to of la `� .a L t3f"1 i - C�� v� Cun�ht l 160 at toot o 43 i o 8.'75 ® CIS J N - 'homes �e1Sn� •�. �. 7 '313 7 Aj� iV (,- L O T To &E +SS' / ( , ,v & 0 3 ,0 . Z 03 y. SO • &OV - �'GC�v,;�� Z447fS7 0 • zo 3 • /o • OaV !� /vi�ll��` S �N 0 3d 2— 0 yQ . ;7 Ulbricht & Associates Private Sewage Consultants 0 3 655 2 a yV ' �v /� y} I i55 on, is. �/ `� " Hudson, Wis. 54016 7/5. 3 .'(o • oO/ g s- 1 7i 5 - 7 7 '. • 3 y4✓Z ST CQOI$ CoubTY SSMC TANK WDUM NCE no r AND • IFMCATM FORM 0 CA Maw Ad imm CLOUQ LWY a•r f ► t V Pt'cpatiy Atl�eas 3 W Petit (V mgamed d� Pimnin De pw unt* fa now cortu+acdat t3ty/Shfe sr. .3o S N1 W� _„ Pmvd Ikon Nm*w L�1l�t n�sc�t�rro�r . Loom y-4 sec T W, Town of p o_ 1 _ Doti Il 2c�a( PAr"r— �o� '� . rat # .....�,.,� waaTmty own .it /? 7 © o G _ v ow= / 7 pw # , 0, __/ *w house 0 yas ® no tat lmet menmi& 15(yros o no t, �peopdr, nsaod�e�io�aotyoar�epa�es�eea .codda�Itiritspaea�+��Y•oee� �ear.Met.raopsraride�tdee oet+tittt a[paoipitR apt 1be atpd� teat � dwec yaan cr tosasy ita�oedad b� s Raastedputopat: "'Whtit yos prt Isla fs try�taau as apiece *0 tuaoti M Of 90 septic east m a ta�aatneat stale iea dra �+aMa dypotal srntot. Ut p mpt* owl= agrees b as&* b W. Caoiu ?,osiat Dqm t vd a su dbefts ft =6 stud by fa asd bq a s.�ecpi�bas.3ap w►pb 6 - lrl=&wmrx&mmdVuW w #od(t)fta**% mi , Mrfpaa rAm is ie potpec apaatfiagoo.dbite aaiIar M r&w bWse" sad pumpig (if moattaitj # w map& a.t is tats drm 113 *R ofdm ft . Y.14 d�a asdtedgsadbaw t� dr above argai.mw ad agree is miaielaft pdnb MwW ditpood ayattatwidt ftdndatdt aatfiatd, �, as aet>q faDepseteeata�f�oatmeesoaaad the Depaetatestail�iattetBaaaaw�oa„ 8Me dNNsaosrs. Ctstifartioa sb t tm ym npft rim= Mt bas mdaaeiaadmnt by computed aad:eheaed a fe 9t Ombt asaayr T�aridS mioa eddda 30 ipa of drs ftw ran eeZpiettiew die. j2o""' 25 0� 'Im cr !'LK?ANf DA I (we) mft dwt aR sttNm a% w fAk I= an ttue to ft bat of mW (am) lotswlodee. I (we) sea (am) der *wm*N) of 1Ga tapaciy &*=Red *om by vhtiae of a =may deed noeeded is Regina of Deodt Ot6oe_ t_.51 L TtAtB M DATE ••e••• Asp iadt,rmadoa dent ie aas-t eptmaarbedmsy run* In da noltmy pmw* be ft my oimd by the 7.odog Dapu*mmL •e4t •• fackWle wft dell apptim& : a clamped wanp" decd 6om do lqftw of Deeds affla a copy of dire oaltOod antes awp if eeAwnoe ft mob is dw wwwo and ST CROIX COUNTY SEPTIC TANK MAIIVTENANCE AGREEMB1r1T AND OV44ERSM CERTIFICATION FORM Ownwffluyer(C 1 S i 1r.�r4 �Il l CG�A, �- -► SC�i Mailing Address 141S_ L 11/ CL©U0 [*UX- NOT 308 ��� Yra �,�, , MN . Property Address L IX cu 1 9 1'94 K-uft- (Verification required from Planning Department for new construction) City/State ST ; Parcel Identification Number SAL DESC�tII'TI1�N Property Location ,� iq, %4, Sec. T N R 0 VV, Town of St - Subdivision. & CU Pte- �v'� � . Lot # ..�: C rti$ed Survey Map # . Volume . Page # Warranty Deed # 1 Volume 1 . Page # Spec house ❑ yes ® no Lot tines ida ffmble ® yes ❑ no bVwper use and mamftwnceof 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 pttnoper. What yon put into the system can affieet tha funWon of the septic task as a treatnnent stage in the waste disposal system. 1U PMpMty owner agues to submit to SL Croix Zoning Department a aertific stion form, signed by the owner and by a masWplumber, jounw ymanplumber, reshicted plumber or a licensed pw4w verifying that (1) the on - site wadewaWdisparal sysbam ism pMw opw"g condition► mdlor (Z) dtar inspection and pumping Cif necessary), the septic tank is less than M fnll of sludge. Vane, the undersigned have read the above requirements and agree to maintain the private sewage disposal system wiih fine d sndards set forth, herein, as ad by the Department of Coaxnewe and the Depu rent of Natural Resources, State of Wisemwin. Certification shft that Your se pti c sys has bees mainbsined must be clod and whnned to the St. Croix County Zoning Oboe within 30 days of the time year expiration date. j 25 O CM pp CANT DATE 9MM CER I (we) cerfy that all statements on this form are trine to the beat of my (our) knowledge. I (we) am (are) the awnar(a) of the dc:errbed above, by virtue of a warranty deed recorded in Register of Deeds Offiic e. t GNATURE OF CANT DATE *** * ** Any informaiian brat is mis- represenbedmay result in the sanitary permit being revolmd by the Zoning DopardnMkL * * * * ** ** Include with this application: a stamped wan=ty deed fioni the Register of Deeds office a copy of the certified survey map if roferemce is made in the warranty deed 2 i 10;-3 "I S c) �jf �,IWri�, S'�+Y Oi- W�Scwsi� �f w ve„ 75 V �5CUn5. ✓` �� el l . � a383 III/If 41 � OR IKE .I� _ s �F1 P1Xt1 5i19G 'Til ff�ii!�Qt ■■lll�rl��_ °; 4, ^ r �ti fIWiU2!SRUS'An ■►E'I12 " . '!y. w 'yid ■ r L r/r Ir - l� 1 ' /PASPIKn■ �,..as__ �' .• r' • •►��ar.u�r rll�ll ■UEinll■.1 ,� ■� +86911 "�`w 1 o n e a 2• ■ I �6it�. ' a! #. �ttirM IRL II■lhi4 >E/L■ ■t >■■ iilf iiitl�■!'�IC@ ; ■ �1i.._ ^i�ka r 1E .i�910 .,�� `7 �Fltt/ ■11 ■ ^ 102 lew4vis"If lam `rr ��:u■ ■��■� d I I P — AIt ac - m"; ro a F t...uln_ s► a pie Ow Ila 191111111'- AMA i� ��! 1f� C�����a .F.�l�,h ■ fi�� %�� ■�a1■■■71� / ■�■ �����q�n:L ;'rs'h �Y�► 11i: ��i `sZ�s?r'� 11�iii�1►,1'.f:� \''1 ;!Y 1�a ■i!SC ■ii►r1�1M ■ ■i!! %l7 ■ ■ /.!i ■il�I �f ■�i3_ � �s lip, "'I - c■a�-uwM 't TkaVINU@i. +� iF�s ;.�� ■�:.G■1.' w�,w � �w sa - � ���� ■ e. p it . Ali .11�3ii O �� WAR awma N/ �I i, I1 " %: i ■•►�i/J'I ■��ip' +�_ �I!,a 5% do fy{ Ml■M�+ ■E- WS-■e. �sL41t!R���ilf■i_/ Rtrr� ago REM Its � .�.rn�^ f: , iS�C1� ��81 ►a —�az�a �� C, f11i1Cf/ /q IRll. ■LMM; PE!'Si7 ■�Ala►V■"a■9■ .jCTr ■� /!; r .�...+ /ti■�Lf' "d lop 11■ rar �`ffl ■ Ikk i� @�P1 �v�.' :t'�.i 1/, ' r !r p j ■ v- �- '1193 y� ■ IBM .J•� �� �� ■■itv �i rh��i ■CGS :. ;�. t � �1 G� U 2 7 9 6 P 2 8 5 79�+0�+9 STATE BAR OF WISCONSIN FORM I - 1998 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO.. WI Document Number RECEIVED FOR RECORD This Deed, made between Birch Park L.L.C. 05/04/2005 11:15AN a limited liability company under the laws of the WARRANTY DEED state of Minnesota EXEMPT i and Michael A. Fischer and Christina Grantor, REC FEE: 11.00 sc er, TRANS FEE: 434.70 husband and wife COPY FEE: CC FEE: PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate In St . CrOiX County. State of Wisconsin (the "Property "): Recording Area Name and Retum Address emi Title Lot 4, Birch Park 73 Metro Blvd., #300 in , MN 55439 � LAND TrrLE, WC. v NEW BR':'31-1 - 0 - NON � 030- 2124 - 40-000 FILE NO. Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Property Is good, Indefeasible in fee simple and free and clear of encumbrances except all easements, reservations and restrictions of record, if any. tf� Dated this day of April, 2005 (SEAL) BIRC , L.. . C. (SEAL) . By: -` ames M. Waters, Its Chief Manager (SEAL) (SEAL) l AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of V{AiY8SUCsiGSa,Minnesota ss. Hennevin County. authenticated this day of Personally came before me this 22 .c/ day of April 2005 the above named James M Waters the Chief Manager of Birch Park. L.L.C., a Minnesota limited e liability com p any, on behalf of t e LLC TITLE: MEMBER STATE BAR OF WISCONSIN to (If not, me known to be the person who executed the foregoing authorized by §706.06, Wis. Slats.) s rumt ac owledge the same. STEPHEN A. LUDOVISSIE THIS INSTRUMENT WAS DRAFTED BY NOTARYPUBUC wr ce.NllnW Eallkn irL al, x010 Wilkerson S Hegna, PLLP r ■ 7 0 Metro Blvd. , 300 Notary Public. State o r M Edina, MN 55439 My commission is permanent. (If not, state expiragRn date: (Signatures may be authenticated or acknowledged. Both are not /�3/ Ott 1P •) necessary.) • Names of persons signing In any capacity mu low st be typed or printed be chair signature. STATE 11AR OF WISCONSIN Wisconsin Legal Blank Co.. I\ WARRANTY DEED FORM No. 1 - 1998 Milwaukee. Wis. U 1877P 091 V E+77i00i6 QUIT CLAIM DEED KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., MI • Dakota Development, LLC, a Minnesota limited liability company, RECEIVED FOR RECORD and Eugene W. McPhetres, quit -claims to Birch Park, L.L.C., a Minnesota limited liability company, the following described real 04 -23 -2082 li:ae Ali estate in St. Croix County, State of Wisconsin: QUIT CLAIM DEED EXEMPT • 3 REC FEE: 11.00 TRANS FEE: COPY FEE: CERT COPY FEE: PAGES: 1 Return to: Robert F. Wall 522 2 Street Hudson, WI 54016 30- 2038 -10 30- 2040 -80 30- 2039 -20 30- 2039 -50 30- 2040 -70 30- 2039 -90 30- 2041 -60 30- 2040 -10 (Parcel Identification Number) Lots 1 through 38, Birch Park. Dated this - 3 1_ day of March, 2002. Dakota Development, C Eugene W. McPhetres� �., �� / By: Paul A. DeWitt, resident By: EtWene W. McPhetres ACKNOWLEDGMENT STATE OF MINNESOTA RAMSEY COUNTY Personally came before me this day of March, 2002 the above named Paul A. DeWitt, President of Dakota Development, LLC, to me known to be the person who executed the foregoing instrument and acknowledge the same on behalf of Dakota Development, LLC. i l.111413A SM GAJENTFEA'f"tARRY Notary Public "Ramsey Zounty, MN X05 NOTARY PUBLIC - IupNNES40TA My commission expires: I - 3 � 2005 My Cammisslon Eq*n 1-11 -2005 ACKNOWLEDGMENT STATE OF WISCONSIN ST. CROIX COUNTY Personally came before me this 9(N day of March, 2002 the above named Eugene W. McPhetres to me known to be the person who executed the foregoing instrument and acknowledge the same. �P.blic,' \� �� Publi o Notary St. roix County, WI Notary My commission expires: , 20ori S tate of Wisconsin This instrument drafted by: Robert F. Wail, Member State Bar of Wisconsin. QuestQCD02 -2A S2trbara J. Burke e 104 4 op 1 48 w r $ wip N leg ti Qn Ich �5 4 27TR STRFl ET — `S r ;•84S S0T�4�4T- rar LM ar 27TH V. 4 TTFn I AAlnC -� r n 7 o lzp W � • a N