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032-2176-18-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 572801 0 GENERAL INFORMATION 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: Federal Home Loan Mortgage, foreclosure I Somerset, Town of 032-2176-18-000 CST BM Elev: insp,BM Elev: IBM Description: Section/Town/Range/Map No: In- 'v„ 4 G VKOVv ka-f-'-C CL " 12.30.19.1503 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark l�� tea e,"�-�` . �z lCp. &;,v 10 . Dosing —J- �F Alt. BM Aeration Bldg.Sewer Holding St/Ht Inlet /:�v�S I SUHt �•-T /U TANK SETBACK INFORMATION,� F � TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Z o /+t7 q00 Septic /S T- T, J �j C Dt Bottom t�" Dosing Header - y Aeration Dist. e Holding Bot.System "2 - Z - Final Grade PUMP/SIPHON INFORMATION c--A V n �{� o 2• (a Manufacturer Demand St Cover , G Model Number TDH Lift Frictlo s System TDH Ft ff Forcemain Length Dia. Dist.to C.p SOIL ABSORPTION SYSTEM y f 6 4/ a BED/TRENCH Width �/ Length No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS � O SETBACK SYSTEM TO P/L�-j BLDG W��LI� LAKE EAM LEA G N[aact J I' INFORMATION CH BER OR Ty Of System: UNIT Model Number: Lotywh' 'Mo , 75 DISTRIBUTION SYSTEM Ch 77� Header/Manifol A Distribution x Hole Size x Hole Spacing Ven t t Air Inta� Length Dia L ngth I Lf� Dia Spacing SOIL C VER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Cent Bed/Trench Edges Topsoil i x� �] Yes D No Yes 0 No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / �/ / Inspection#2: Location: 1617 83rd Street New Richmond,WI 54017(SW 1/4 SW 1/4 12 T30N R1 9W) Lakeside Estates Lot 18 /1 Parcel No: 12.30.19.1503 1.)Alt BM Description= 4`� (�l:4'V �( �'y �� � ,ht�Z�/I �J - t4 � LG 2.)Bldg sewer length= �, / -amount of cover= UiI JC Plan revision Required? [9 Yes [R/No Use other side for additional information. SBD-6710(R.3/97) Date Insepctor's Signature Cart.No. HARDINA SEPTIC SYSTEMS MFRS/CST 824825 ►av�z. .j- V"'T toot, q4L W6i564- -1-A^4 a •. 3 _9U IA NA LC � �� r Y"- a 0 All yalat 0 O 1 g lK ' e �c�wEr% V A I R Wisconsin s�tQ merce SOIL EVALUATION REPORT Page �of� Division of and Bu U m CR01X C OPMEN� in accordance with Comm 85,Wis. Adm. Code ST (�EVE►- County A ite plan on paper not less than 81/2 x 11 inches In size.Plan must in ut 17 s not limited to:vertical and horizontal reference point(BM),direction and parcel I.D. percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 3 A- 7(v Please print all information. Re ' Date .y/�J Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). �" -�'Vl v ! 3 /7 Property Owner Property Location �- hrONG �Z>A� l�I UST AEG- Govt.Lot S�.� 1/454]114 S 13- T 3o N R � E(or® Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# City State Zip Code Phone Number ity ® illage ■ Town Nearest Road Go45T Rfew Construction UseE] Residential/Number of bedrooms Code derived design flow rate GPD ®Replacement ® Public or commercial-Describe: Parent material OUTWASH Flood Plain elevation if applicable ft. General comments �f�`®c�I��µ��J S�S, C-LCV. and recommendations: �-- vN sa�rdo - &1441a4 Boring# D 12A a Boring 9444 110 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. I 'Eff#1 'Eff#2 10- SIL 2MSBK MFR GW 2M .6 1.0 U -0 5� 2MSBK MFR CW 3 Zb" `C SYc`� L Jr456k M1P rZ C !J14 e l b F7 Boring# ® Boring Pit Ground surface elev. ��`�3 ft. Depth to limiting factor �� in. Soil Appication Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/fF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 1 0-/Z lvY'Z d L H' : avti •�¢ l�t� 2 l Z-� Iv"P� ® S L MG 7•S* 5 o L �'7 I 6 Effluent#1 =BOD >30:5 220 mg&and TSS>30<150 mg/L 'Effluent#2=BOD <30 mg/L and TSS 130 mg/L CST Name(Please nt) a CST Number -'A-T A J'2� z Address Cooe Date Evaluation Conducted Telephone Number Property Owner 't• L .M. e— Parcel ID# b�°2'a — Page of 3 Boring# Boring _ ❑ ❑ Pit Ground surface elev. �'O Zs ft. Depth to limiting factor Ite_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 0-1Z /0A -1/5 o siL Cis a I•a 2 iZ-a b /o c ae so k1 M f- 6 c IC 1-a 3 A-53 1,5W 0 56K MFf Cam IV IA !-o 4 3-94 c 46 o 5 C L d A Ij/,4 1.� c�y� ./ Boring# Boring J 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 L l Yt3 O 5I a Iql6e M Cf- M LQ 04,-34 7.S X y b Lo i 1 ❑ Boring# Fit oring Ground surface elev. ft. Depth to limiting factor in. Soil Applicati on 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 I *Effluent#1 =BODS>30:<220 mg/L.and TSS>30:5 150 mg/L *Effluent#2=BODS_<30 mg/L and TSS<30 mgll- The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330Tw(8.07/00) J HARDINA SEPTIC SYSTEMS MPRS/CST 824825 To M dAJ 6�aCE C�ov6Q EX15T/&)6 IUD& q4L 606156-9- ro t 9 T � 0%A-e>f. H `v J - 3 '4 w County Safety and Buildings Division 5-J—, C 201 W.Washington Ave., P.O.Box 7162 Sanitary Permit Number(to be filled in by Co.) P$ 3 214 Madison,WI 53707-7162 7� 5f ( State Transaction Nunlber W it Ap I n In accordance v0OWWW21 1(2), Wis.Adm.Code,submission of this form to the appropriate governmental unit _ is required prior to obtaining a sanitary permit. Note:Application forms for state-owned POWTS are submitted to Project Address(if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary oses in accordance with the Privacy Law,s.15.04 1 m Stats. I. Application Information-Please Print All Information ✓on,op_s&--7- VV L Property Owner's Name Parcel# - 'o;?)-74? - nUC . ) � l" V Property Owner's Mailing Address Property Location 47 57,►Tg. V I rsc Z U� . is�3� Govt.Lot City,State Zip Code Phone Number 5W /, Section ytT MILL �� o���> ��� trcle one) II.Type of Building(check all that apply) Lot# T , 0 N; R�E or W Q 1 or 2 Family Dwelling-Number of Bedrooms I� Subdivision Name /l Block# ` 1 iv^e`er`1) ❑Public/Commercial-Describe Use ❑City of ❑State Owned-Describe Use CSM Number ❑Village of 'town of �PJsal I'L sE T III.Type of Permit: (Check only one bog on line A. Complete line B if applicable) A. ❑New System R eP lacement S Y st ❑Treatment/Holding Tank Replacement Only Other Modification to Existing System(explain) ) List Previous Permit Number and Date Issued B. ❑Permit Renewal ❑Permit Revision ❑Change of Plumber ❑Permit Transfer to New �� / Before Expiration Owner 2a0`� IV.T e of POWTS System/Component/Device: Check all that appi on-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grade Mound(>>24 in.of suitable soil El Mound<24 in,of suitable soil ❑Holding Tank El Other Dispersal Component(explain) ' ,"T J ❑Pretreatment Device(explain) V.Dispersal/Treatment Area Information: Design Flow(gpd) Design Soil Application Rate(gpdsf) Dispersal Required(sf) Dispersal Area Proposed(sf) Syste§Elevation U 4 v `7.60 VI.Tank Info Capacity in Total #of Manufacturer Gallons _ Gallons Units E o ,b, New Tanks xisting Tanks �(// ( 0 c a ° Y 6 ''--`` 4 U yr yr w E5 a Septic or Bolding Tank 4- Dosing Chamber VII.Responsibility Statement-I,the undersigned,assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name(Print) Plumber's Signature MP/MPRS Number Business Phone Number Plumber's Address(Street,City,State,Zip Code) 7 7 176-Y4 e-_T LIC LA.U CJ i VIII.Coun /De artment Use Only Approved El Disapproved Permit Fee O Date I ued suing Agent Si atur . ❑Owner Given Reason for Denial IX.Conditions of Approval/Reasons for Disapproval y SYSTEM OWNER: 1.Septic tank,effluent filter and dispersal cell must be serviced/_maintained as per mana ement Ian provided b lumber. 2.All setback requi rerA#m*tl+r%*l913"kft 0heckstero and submit to the County only on pa ern dot less then,81/22 z ches�/ �� as per applicable code/ordinances. �J +(v''- -- !/ SBD-6398 R. 11/11 �� ✓ / r AAA �v 4e h�c�yD"� �. ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the following residence: (Street address) I (el-I I $, P-":) sT located at: '/a, 1/4, Section L N, Range__W, Town of , St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of SPS. 384.25, and it (they) appear(s) to be functioning properly. Most recent date of inspection or service Did flow back occur from absorption system? Yes No k (if no, skip next line.) Approximate volume or length of time: gallons minutes Tank Capacity: /,q vc> Construction: Prefab Concrete Steel Other Manufacturer (if known): &,)e l e,&9- Age of Tank (if known): I05-7'A LC-- 7 avy 5- Permit number(if known) Y6 3 Z q (Licensed Plumber Signature) (Print Name) (Title) (License Number) MP/MPRS 9a V- (Date) Form to be completed by licensed plumber(Dept of Safety and Professional Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 2/2012 CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Owner's Name: dOk1 C. 46 A Mo(C-i-E,AC-7 E C o 1 P_ Owner's Address: 3476 -.5-TATC-L Legal Description: , S�) , �>" , J 7. 30, fJ o I`77(� Township: 1 T County: �:SZ . C t2C) Z,V Subdivision Name: `7 Lot Number: 7� Parcel ID Number: �®� ' o'Z 47 Page 1 Index and title Page 2 Plot Plan Page 3 System Sizing&Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test&House Plans 'I Designer/Plumber: �j o (t�- P-Z)IAIA License Number: Date: /��/—/� Phone Number Signature Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P(N.01101). Page 1 HARDINA SEPTIC SYSTEMS MPRS/CST 824825 ova z_ V"-r . ?E,t' C� �� • p P c, ' loot's q4 L cd e i S.--C 9 ♦: � � �a'f Cis>> � p v co_ SOIL ABSORPTION SYSTEM DETAIL/GRAVELLESS LEACHING UNIT Page of Project Name: I- 14 M• e - No.of Cells Per Cell __ft Cell Width Total No of `7 _ '7oD ft Cell Length sq ft EISA Per Cell _ ±ft Cell Spacing sq ft Total EISA Manufacturer Model Laying Length EISA Rating Irifdtrator EZ1203H-5ft 5.0' 25.0 EZ1203H-10ft 10.0' 50.0 Gravelless Leaching Unit Manufacturer: /a p 2✓' — �� T Gravelless Leaching Unit Model: "e Typical Cross Section Finished Grade Observation Pipe with approved cap or vent ® •:• :.:;:•:. >>;:>:>::<::.>: <;;;:. Soil Backfill 3 ■>: :::~ :<<><:<::::::<<:::>:: <. Geotextile Fabric ft Infiltrative Surface 12 in ( I -- �`ft Limiting Factor D in Slotted and Anchored Ventl Observation Pipe with Cap Plumber/Designer Si nature: 9 9 License#: 8q'160? Date: (AVINER JAL PLAN YOL -t r A /00 rA r r L7 L CI NA 1-3 3 1 (T -UN2 'A C] 3 cf ' ild t,, Ile-ill 3 n,3 t" 1 Cl rl" 0 Fith(s) At rt monlh(s) l}i,'!'. F1 11) j) At ye-, IS Ly T 4 AINC E 1N S tl "IAINTE �ny cr_, mlid TS "-V,- IoT"'. cf p( or Lrok"M ify �;my rnlss��j nd I grcu, .aster js,,j�d inspQc:tion of 1,3, Of c f lu,; Jlc t3n�. 'I't on tits ins fjjd� _,, I - -r, UP C r f for anY c:u�d hr- ��, fc, Urn ,ind •To C; bnc', r:hec�� tion oipas to c,,-r,-,b;nrd sjjJqL3 and s- ilh,, obsel-VIt t. 't,,t ,Ovej�7 Ti nd luir" tj),1 VO!Un chcck tha off icat� -, f:1,4ing ccmditinn In SPLCC rl)�rj ind. Y 1) dispersal The 1c) :Jf1u.2nT ,P,1121i)d VIOPlif (,f effluent 01) 'L�.3 9 hority, f Ov, tank' IhE� TegulatQrf au' c J,,jitt-3 nctlfic:_�' y tank equafs NIP, 113 i rri d� anti "Cl-11.11 ill I With clisp a,c en�bin"f cc )ul-:,.z'ic)n of SIL, 1,3 a rj-)o,�,cd by OCI-1."nts of 5hall bel re I L,. I - n On tl3-,i,.a COdc- '-C'fr'Pc _Ons:n mirls to the Fnt filt�, s, ,in!'ItOd d pob%rTc3 Rcjjj&,q but, nDt I 113d by a rcctifl'� i - -) It,11 b. '�)'j at �ntc�rvals Of :�l 2 Ljayf, Of C_On)p�et�cl) of any �-ervicr) eve authority within 10 and any stry,�;, PrOVid0d to tho lot at ro rV report shall b,. TART UP AND 0PERAT10N ='i-structicn, !trier to us;s of tho POVv7S check treatment t�:-.nk(s) (v r !1)o I')rescnce of paiotinr) cr:.the(may i;6pi2da the treatment process and/or damage/ho elspersal cpWs). If high conc•ar.traticnO W-;i dzet,",,•:-d,h2ve tha •7f tta.,Ws) removed by 3 saptaq3 servicing operater prior to use. Start up Shall nvt occur when soil conditions arc frozen at the_u, po%I ver outages pump t ..iks may fill above normal kighwatc-r levels. V-,h-) a tar %--i'l �0 tha cfi:�persnl CRII(s) in one largo doso, overloadin..-I tha ciall(-,) nd ma- r."�s 111 t r. I h e b a ck u P c t ��i,rf a,-r- :+'sc h.a r. avoid this situaz:on h3vti LhO contents6of ih-.3 F;un-,p lank rerno -1 t-,y a Saot-1, ,.,L v i.r to the difluent punip cr contac', a Plumber Cr PQYVT':') tn 1;11c1-1:1 1111lIMPI layels -.vithifl the purnp tank. Do n<t (`riv-3 c, park vzhiclas ov r tnnk:; and dispersal cells. 01) not drive cr f-r_rk cr ,! e 15 fe=z dov.-n slopa of any ri-,ound or at-gra-da soil absorption arca. -2duct!,;n cc ellminaticn of the from flia wastev./ater Gtra:mn may iinpr.-vo �!1,3 pr�rf.crin-:nto ar.cl cr,-,!c.-. I q ' lira cf 11,,-2 -AVTSZ: ant-lblotics; tab.? -vinas, ciqnralta butts: ccndoms; cct-Lon -swebs; do�-ntal flr�s; fnT: f,.,undaiicn drain (sump pump) water, fruit and vegetabto peMiigs: gasoline; grease; h-rbic-.—es; o:;; -1 Products: Pa�Iicldas; sanita7l/ napkins; t31rpons; Ind vvat;r scftdnz.r it rt tits PC'.,IJTS fails cnd,or is perm .jiently taken out of sEqvica tI1,3 foilcv.�ing staps tiaki-,,n to .op�r;y and s= ely ahandonqd In ccnipflanco v4th 1--haPtor Corrini 33-33, Wis;r-oilnin Administrative cods-. -IL!l Piping to tanks and pits :,hall be discorinuctod and the ab.--njonij 1;ip,- cranings. The contents ol P!l tanks and pits shall be rernoved and propatly dIspc!:,-d of by a Sept Age S,:rvic nq ^itsr pumping, all tanks and pits Shall be excavate) and ramov-ad or ihi--ir covers rernoved nind i1i,-vol.-I rracn -,..-;,h soil, gravel or another inart solid material. UNTINGENCY PLAN If the 1:-'0%N7S 'tails End c-annot be r-apaired tha followinU measures have ,..r must be taken, *Zo prc-.',Ide a ccdl-a d and may be utilized for the location of a replacer-,, j-,t :I bsQ[pj:c,;,, A su* replacement area has beon evaluate e s-1. a A system. The replacement area Should be protected frorn disturbance and compaction and should not t be infringed upoin by required setbacks from existing and proposed structure, lot lines and walls, Fai!ur.), to protect ihe:replacement 3re? result in the need for a soil and site evaluation to establish a suitable replacement area. Fo�placen,ant sys-zoms mus*, comply with the rules in effect at that time:. El A suitably replacement area is not available due to setback and/or soil linlitatfons. Barring advances in Pol,lj-1 S technology a holding tank may be installed is a last rascrt to replace th(i failed POWTS. LJ The site has not been evaluated to identify a suitable repincomEmt area. Upon f,3ifure-- -af the F-0;VTS a soil and site ,waluation must b5 performed to locate, a suitable roplacpmont area. If no replacement area is avei,abla a 1-,cIJ!ng rZf,.;: may he installed as a last resort to replace the failed POWTS. El Mound and at-grada soil absorption systems may be raconstructed in place following removni of ilia biomnt at zjic-i infiltrative surface. Reccnstructions of such systems must comply with the rulas in efflect at that-Lih,,I. VJARNING>> -EPTIC, PW.IP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIE`Jt O.WGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A P6RSON FRWA THE INTERIOR OF A TANK MAY FE DIFFICIJI.T OR IMPOSSIBLE-- DD[TIO(JAL COMMENTS :),vVTS INSTALLER POWTS MAINTAINER Name Name AJ A Phona Phone -PTAGE SERVICING OPERATOR(PUMPER) LOCAL REGULATORY AUT1-lORrFY Nana Name F-h cn o Phone Is doctjrr�eat was dr-ahad in Cornplianoa.w.,,h chapter Comni and 83.54111, (2) & (3), Wisconsin Administratija Code. rr ._ 5_ n x �g � Z Q yaQ g F FIB m m � Ig o � ° A IN w U D ggg C) 9- HSI HUM m p ��� O �m sg3smg� ti W _.3R m3m n a O ysum a' o d lit i NJ 4 X11 fit 81 Si NSS y ® CD fill �$ N LA X5 ov. m N 3 N �m �ms..g— � D s $ mm' �s mm�gga IRW Zq T T ao msw Mgt ° aaQ Ln o m ?10 go n m A C O QQ �► '.1 p T ' Q HE m Ga m O d z Sew x 5-08 O O �. a �. �• a' 1 rn '4 r��m� D m It 21111 mR �m CO cn m�� f m T acv CD + ° ; 8 —n s rn 989877 BETH PABST REGISTER OF DEEDS SHERIFF'S DEED ST. CROIX CO., WI Document Number RECEIVED FOR RECORD Drafted by:Duncan C.Delhey 12/03/2013 11:17 AM EXEMPT # 14 Case No. 12-CV-452 REC FEE: 30.00 PAGES:- i **The above recording information verifies that this document has Wells Far. ar o Bank,N.A. been electronically recorded g &returned to the submitter Plaintiff, VS. Ojuang Okello THIS SPACE RESERVED FOR RECORDING DATA Defendants. NAME AND RETURN ADDRESS: Pursuant to a judgment of foreclosure entered in this matter,the subject Gray&Associates,L.L.P. premises was sold at auction to the highest and best bidder,Federal Home Loan Attorneys at Law Mortgage Corporation. Therefore,the sheriff does hereby grant and convey 16345 West Glendale Drive unto said successful bidder,all of the following described land,located in the New Berlin,WI 53151.2841 County of St.Croix,State of Wisconsin,to wit: Lot 18,Lakeside Estates,Town of Somerset,St.Croix County, 032.2176-1$-000 . Wisconsin,together with a 66 foot wide access easement as parcel Identification Number(PIN) shown on the recorded plat. d (Type/Print Name) SHERIFF-DEPUTY Si WR!Fy (Strike the inappropriate title) STATE OF WISCONSIN ) )SS COUNTY OF ST.CROIX) Personally came before me this _day of _ 2013,the above named : personally known to me as the officer described above, d who executed this document as the sh ff or on behalf of the sheriff of this county. maw, i _ Notary Public Not"y P*VO St.Croix C state of W�st'�4t1sl1! My commission expires: 10fl ST- CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner <oPAR DEV- T C, Ek c-,i.F_ PO = NT g1V Cif }jiState j--RkE ELM o r1N, � S o y2 - Legal Description: Lot I f� Block )(, Subdivision/CSM # 1- 0; E si o E r sT A 'A AIJeL Sec - M , - 1 30 N -R 19 W, Town of So E s ET • PIN # Z - o ys_ y o _ c oo 2 M � 3 n 3 �- Zoos- s•.AOo SEPTIC TANK -- DOSE CHAMBER — BOLDING TANK INFORMATION Tank manufacturer , r Size 3T/1'C o6c /— Setback from: House Well PAL Parnp manufacturer Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ARSORVI - ION SYSTEM: Qv�c� —9L 4 Noy►- F EssvRe. Ty of sy stem : c'Rou�t,q � }'1' sy Width 3 Length '7 Ca Number of Trenches . Setback from: Haase 5Z` Well 5 4 ` P/I, 115' Vent to fresh air intake ELEVATIONS: Description of benchmark _C Cs r) . 2 STEEL z P E Elevation loo . oo Description of alternate benchmar To P o F M At t o k e 4 E Elevatian + oo. s 3 Building Sewer q q. b(> ST/HT Inlet Qg S ST Outlet q g d S PC Inlet PC Bottom �� Header/Manifold ' I • is S Top of ST/PC Manhole Cover 100 .5 Distribution Lines (w) Bottom of System (Ii) C IO . 9 S (E.) 9 O.3 0 { Final Grade {) gN.y6 {) ( } Date of installation 5/5/45 , permit a ber y(93Z9 (y State plan number N �A Plumber's signature 1K A License number Lp J Date / Inspector compiaee plat p[ar Ulbrleht & Associates Private Sewage Consultants 2812 1 Oth Ave. ORIGINAL Spring Valley, W1,547 o ti1/E5T Ot' E S/lfE ��szEE e L ccjP.�rFR, 3 b E.v i+oo m v£ W AY 11 Qcopds�� - Nom' 'tNSTllt.� 23 f � fill ion of t4hN p TN2TARY - i 10OS5 O STE.E` prrC r _ 100.00 CLEAN our as° V! Q 8� ToP of SNE� -` 92 .a1 o SYSTEM g D. �iS O as' 3x�t, roe,, SNE q i.37 Ulbricht & Associates Private Sewage Consultants 2812 1"'tA Ave. Spring Valley, Wl 54767 County: St. Croix Wisconsin DepartmentoiCommerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT Sanitary Permit No: 463296 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: Co par Development, Inc. I Somerset, Town of 0 32 —,2_0 W0 CST BM Elev: Insp. BM Elev: BM Descr ° 1 Section/Town /Range /Map No: -0 3 c� 12.30.19./ TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. n Septic 0 1 Benchmark_ d Dosing / Alt. BM jam, (�v C. V o Aeration Bldg. Sewer t,I(j Z- (I Holding St/Ht Inlet -- - 7 — T St/Ht Outlet TANK S&BACK INFORMATION — /!� b TANK TO P/L WELL BLDG. Vent Intake ROAD Dt Inlet Septic � 23 / Dt Bottom Dosing f Heaade_r /Man. ,gi N,qS Aeration l- � Di Pipe �� ` Holding B Ste I I .5 goo X Final Grade PUMP /SI INFO RMATION Manufacturer Demand St Co ver GPM �- 3 • a Model Nu TDH Lift FS stem Head TDH Ft Forcemain Leng Dist. to Well SOIL ABSORPTION SYSTEM CQ BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia, Liquid Depth DIMENSIONS 7 / 7 SETBACK SYSTEM TO 1O P/L BLDG W LL LAKE /STREAM LEACHING Ma nu re INFORMATION CHAMBER OR Type Of System: I C � v , / n ^ UNIT Model Number: AI DISTRIBUTION SYSTEM Oar Header /Manifold Distribution t / I x Hole Size I x Hole Spacing Vent tc Air Intake S /� Pipes) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of ] 77�dded xx Mulched Bed/Trench Center 4 Bed/Trench Edges Topsoil Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 1 � / / P Inspection #2: Location: 1617 83rd Street New Richmond WI 54017 (NW 1/4 SW 1/4 12 T30N R19W)) Lakeside � Estates o 8 Parcel No: 12.30.19. 1.) Alt BM Description = S"r'?/ �'� �—V� _�o 2.) Bldg sewer length =-.21Y • �l - amount of cover =� , L I�b f Plan revision Required? Yes I./No � Use other side for additional Information. Date Insepctor's nature Cert. o. t SBD -6710 (R.3/97) I � Safety and Buildings Division County S • G pot 201 W. Washington Ave., P.O. Box 7162 visconsin Madison, WI 53707 -7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 266 -3151 L10 a q 6_7 Sanitary Permit AppHC io E 1 V E [ tat, Plan I.D. Number/ In accord with Comm 83.21, Wis. Adm. Code, personal info don you provide �(° may be used for sewn v s .04(Ix ; Project Address (if d� than address) 1. Application Information - Please PruW All to r ST_ CROIX CUuiv rty Owner's Na me Parcel # ? w ZO _IA? �� • ock 1+ �OM /}.US�•� Gp ?),Q U,� �y G 31 • 2 O • SD • �o Property Owner's M ailing Addfess Property Location feCol - 7 F/¢&A �a %v % ��U�• tVW W ui / �i4, ✓` ,SeCt10A Z City, State Zip Code Phone Number G,4•,ee 6 Itf Sso Z/ I MP • MOM 30 19 ( circl � II. Type of Building (check all that apply) T N; R E o W Af 1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name CSM Number ❑ Public/Commercial - Describe Use _ .4r ❑ State Owned - Describe Use $ a" W I -� �— ❑City_ ❑Village Township of - SO III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only El Other Modification to Existing System B. ❑ Permit Renewal El Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner I I IV. Type of POWTS stem: (Check all that apply) ;N Pressurized_I�Sir9urtd ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In-G El Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter chmg Chamber ❑ Drip Line ❑ Gravel- s pe ❑ Other (explain) V. Dis rsal/Treatment Area Information: — 3 Design Flow (gpd) Design Soil Application Rate(gpds0 Dispersal Area Required (s0 al Area Proposed (sf) System Elevation - -_ Y s 0 ✓ 6 y3 G� ✓ 1/• 0 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel -Fiber Plastic Gallons Gallons of Units Concrete Contracted Glass New Existing Tanks Tanks Septic or Holding Tank • f s 1 Aerobic Treatment Unit i• ` C s Dtsing Chamber ©� VII. Responsibility Statement- I, the undersigned, assume responsi ility for installation of the POWTS shown on the attached plans. Plumber's Na me (Print) Plumber's Si gnature PRS Number Business Phone Number R . , 74 X13 R 1' C (47 — !,� 3 - S 71S • 77A • 3 V Y Plumber's Addre ss (Street, City, State, Zip Code) z 0 &/ z-- /0 49 14 Ve . S��Pi�if 14ft Iv/• 5 11 74 7 . C oun /De artment Use Only Approved ❑Disapproved Sanitary Permit Fee (includes Groundwater Date Issued mg Ag Si ) Surcharge Fee) J , ( Z 7 0 6 C 11 Owner Given Reason for Denial v ` 1X. Conditions of Approval/R ons xPtsapproval (Nl Gsd Odisp ersal STEM OWNER: r !'►� Septic tank, effluent i ter and cell must all be serviced / maintained as per mana em 2• All setback requirements must be maintained as per applicable code /ordinances. vG ` v7N4 0•'7 s s• �5_3" Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in six '' �0 6�� SBD -6398 (R. 01 /03) �(iu t�n�cv r%,► ` 31� � e AT , 2 /,,g lop or 103,60' 1 1,0 70 f d g17 5 +, ? Re + /a I -A d y 6 3 1 I sy g r�M 1 v - 30 V , - 25 h I y 3 � � �iPi�tS ° P�eopo5 d Z,6 7� C HIS POWT SYSTEM SHALL INCORPORATE PER COMM. 83.44(2)C A PROPER ZABEL FILTER MODEL # .4 -lod . C OPY 2D � 2 , � 1P 10 3,60 ' 11 f I d o 07- 10 /0 �► d ' I I L33 Rim' I � I y,5 7'�Nr OtA 10 y Pl h� o� o` \� 3D ' v / � /0 1, 0 y4je*�C- 3 � ° r Z,6 T /c? POWT SYSTEM SHALL INCORPORATE PER COMM. 83.44(2)0 A PROPER ZABEL FILTER MODEL # .4 -ioo ' ULBRICHT & ASSOCIATES CO. 2812 10th Ave. • Spring Valley, WI 54767 Reg. Designers of Engineering Systems 715- 772 -3442 Private Sewage Consultants 2 CP _ S I PLAN ID PROJECT I L# DATE (6 3 06 *16 6 -0 OWNER ADDRESS dt� 7� �•4t, -/-e p d /.0 T ���. 44 6/1,0 � �• LEGAL DESCRIPTION 4 0 7' �� G,g�f' PA!t �s A P.S SSO N60 s'W , ,S'EC, ! Z , T'3 a, k / y'Gv 00 ? - o f PINS 3 2. 20 YS • YO .Oav TOWN OF 54 OA40neS& r- 32 • 2O115' . S'D - 0'-C COUNTY CSTM !? • ?�l,�iit'%C(J - 1� 2Z(,3 '. LOCAL AUTHORITY/ SUPERVISION ST • C(ZO(.)C C * t y. ( �-- PROJECT DESCRIPTION: • & W 40.v S 7X v C rro .v fie o 0 i�� � o s�v sr` vi'Ct4C !•v / Oc;� c Ulbricht & Associates P01VT SYSTEM SHALL Private Sewage Consultants 1111' CORPORATE PER COMM. 2812 1 0tth Ave. 83.44(2)c A PROPER ZABEL Spring Valley WI 54767 ` FILTER MODEL# . io-a -S d P9•1 INFILTRATOR SIZING WORKSHEET P9.2 SYSTEM PLOT PLAN Pg.3 CROSS SECTION OF SYSTEM, WITH ELEVATIONS. P9.4 it if It IF P9.5 OWNER MANAGEMENT PLANS & ZABEL FILTER SPECS P9.6 (OPTIONAL) CROSS SECTION AND SPECS FOR DOSING TANK. PG•7 (OPTIONAL) PUMP PERFORMANCE SPECS. Absorption C om ponent t Plans and pecifications lan b ment Systemsen ual For ar e based on "In- (Version Private Ground Onsite 2.0) SBD- 1075 - P(NO /Oj_.. Wastewater o � A N � v � v3 C NN � open - kA �. 4PPI 04 oe Ire �• � TiP�.v C�I'� S S T�� � y Ck'o SS Sic f ion © 7Alf W�s Z 1ti i K � �- 1�V G, 7rfi9- To�'S � U & �S 1 cis pz see sir .ems c,oS - . ,. s9Pf'*&kR: VJ.ti 7 c, K K 77 v Y. 73. o OVER: See Reverse Side for Vent/ Observation Pipe Details. OWNER's MAINTAINCE OP SEPTiC SYSTEM POWTS (landowner) is reponsible for maintenance of proper operation a nd syste I I servicing Y Regular periodic inspections and - 9 is necessary for the safe healthy operation.of, this sYsten. The owner is required by code to submit all necessary maintenance /inspection reports to the controlling•authorities.. SPECIFIC CONTACT AGENTS ��/ * Governmental auth ' S77 C�0/'X G�!• Y/ inspectors: go * Licensed installer, responsible for providing an op eration maintenance "Users" manual: l -7 15.7 - 7a - 3 Liq Z � • 21��6�i r ' serv&ce / inspection agent other than installer: S *, Electrician, f or pump, electric controls, whin unit s. IMPORTANT OWNER MAINTENANCE RE UIREMENTS Y- Winter t raffic , (sleddin - area shall not -be permitted, or frost etc the the cell, freezing.up the system. Discontinuos useeinateinto winter . {a vacaction tri lead to freeze ups, p, resulting'i no water use) can also 2• Water conservation -needs to be exercised! Or system Y m can be hydrolicall Y overloaded and destroyed. This sys�em was designed for a maximum wastewater flow of gals. daily. 3. POWTS are not designed to accomodate wastes fro m a garbage,_,_ disposal unit, or any other unnatural sources of`wa _ :. Any introduction of such waste materials will see destroy this system. over load and 4 • If a power outage occurs, or a Pump fails, it may result in a temporary overload of effluent bein cell, which may adversely impact the cell p umped i n' the recommended that a licensed ( l g ). It is allowing th pumper empty the dosing tank, Consult p to return to dosing the correct amounts. Your instal.le.r immediately for advice. 5. Neglect of the vegetative cover erosion preventive) can (the cells insulation & traffic also can des can lead to failure.. Compaction or heavy it REGULARLY WATER THE VEGETATION system. IS NECESSARY OVER SYS t TO the system beneath IS NOT sufficient alone SYSTEM!! Efflue in �1 %J ovwr. maintain a 6. Periodic inspections by Inspection y the owner, or his agents, is Into the system' on theiMoundn inspection pipes), cleanout basaltarea (effluent been incorporated t level laterals, at each ti erminals on the pressurized out The filter s P r for flushing and cleaning the laterals ground cover Ystem in the tanks (via a locked above Person lmanhale). Only a licensed should be pe- rformi Properly quali6i ed n t severe safety g his work which involves health & se system's Y risks. Evidence of effluent pon i in the treatment cell. shall also be regularly i n spected. Y _57: 6 PA R P&mezop tte-,u c/ To v /y.9NSE�c1 ¢o In .L1A /iv ST REV Cv /ivG�, �j�v. SSo 6, S/ • 3 88 /Cv o0 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page ` of 3 Division of safety and Buildings In accordance with Comm 85, Wis. Adm. Code ..a.- _ ST cRo x Attach complete site plan on paper not less than 8 1/2 x 11 I fe In mu f Include. but not limited to: vertical and horizontal reference pM) d lcttand ` ° i " p I.D. percent slope, scale or dimensions, north arrow, and locatioistance to ne arest road. Please print all Informatio . t` ;�Q ? wed b Date _ Personal Information you provide may be used for secondary purposes Privacy Law, s. 15.04 (1) (m)). zJ Property Owner - rq rty Wc9tfon - 71 41 ,TaFF) 3oA)Pl�M�4 � . - _ 4 1/ S lx 30 N R 19 OE (or) W Property Owner's Mailing Address of # Block IN I Subd. Name 8 Z Z / &d 4 A o x • / 6' 1 0 NJ1406 ~7O/e PlAr— City State Zip Code Phone Number City ❑ VINage (0Town Nearest Road RiGA,,Aie v!7 1v1 syoi7 ( 7i5 ) -ZY6 -Y3,G Sd I t l o o ) 0 New Construction User Residential / Number of bedrooms 3 Code derived design flow rate 4 ` Oy GPO ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation If applicable General comments and recommendations: 4 &4 TD'S 7`EP , rV1 j j / E , �le /9itJ �itJy/j�v vNf� Boring sys7 - e'ti! � PowTs� z�S�N�- � :apiFFvs� Ge /S # Boring f • 70 O Pit Ground surface elev. R. Depth to limiting factor In. SoA Amicatlort Rate tlorfnon Depth Dominant Color Redox Description Texture Shock" Consistence Boundary Roots GPDIff In. Munsel Qu. Sz. Carol. Color Gr. Sz. Sh. 'Eff #1 'Ett#2 z �� •�g /o R y/ -- S4 1 fs k' Icle 't 3 2 2 .3 .s y ,P y - /,ter f1 p dle cs — . -, �• z a Bating# Boring 163. > Pit Ground surface elev. R. Depth to limiting factor In. Sol Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/If In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'E�1 •Eff#2 / o• // m//R•3 1- fS6t •h„ f2 14ol 3 1" . s .8 / ifsk >��' as 17A • y 3 / • 7•S -- S L 17cshK et-s' 8 • 7•s t/R nM-�P. s o..s d� • 7 z Effluent #1 = BOD > 30 < 220 mgrL and TSS >30 < 150 nV& ' Effluent #2 = BOD � 5 p mgt. and TSS < 30 mg1I- CST Name (Please PrM) / Signature CST Nlxr>l�er ► 0 13,e -- le 7— ZI /!7/l� /��� ' 2 (o 7S Address Date Evaluation Conducted Telephone Ntanber Ulbricht & Associates 9"1003 71S• 77.,• 3Y Z. 2812 10th Ave. Spring Valley, WI 54767 I "if S 41 9 Sg SAC. // 6 3 Z -- 2 0 yJ pv ' aev For issuance of min ermits and designin g Se / .see. Contact: Ulbricht & Associates Registered private wastewater consultant ar o Z - .2 O qS • SD • o z S 2812 10th Ave. 3 Spring Valley, WI 54767 1 plumbers 715 -772 -3442 N p �' yGv /SGtJ SEf /Z 3 ' Z ° yS - yo' oaa NU V f Sr) ? 840/ivW C. Z (� RI�II�AL 3 o•0z o32 - Z�1/ yeV lJ A Property Owner _ Parcel ID # Page of n Boring # ❑ Boring ! / • /o Pit Ground surface elev. ft. Depth to limiting factor M• Soli Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPM In. MunseA Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 OW 10 Y t 313 S� /7� Sb,� IM1116e Cs 3 )r • y . C... 2• • L3 /o Y 314& 4 Z,.r --- • 7 A Z 3 3 Y 1? de C — • 7 • Z a = F] Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to rim" factor in. Soil A Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. MunseA Qu. Sz. Cont. Cola Gr. Sz. Sh. •Ef1#1 'Eff#2 ❑ BMng # ° Pit Boris ❑ Ground surface elev. ft. Depth to NmHin9 da hr. Lion Rate Horizon. Depth Dominant Color Redox Description Texture S Consistence Boundary Roots GPD/ff In. MunseA Qu. Sz. Cont. Color Gr. Sz.Ah. 'Efr#1 'Efr#2 I w i w Boring # ° Boring ❑ Pit Ground surface elev. ft. Depth to WW" f I►' M*Efffl#I*Efffl#2 Horizon Depth Dominant Color Redox Descdpd Texture St Consistence Boundary Roots i In. MunseA Qu. S71 Con. or Gr. Sz. Sh. i Effluent #1 = BOD, > 30 < 220 mg& and TSS >30 150 mg/L ' Effluent #2 = BOD, < 3o nV& and TSS S 30 ng& 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. sec -e»o la.�► d � i a `T o • a ap o\Ey s p `• X Co �e vi o �I i � � I n �1 Al k c � o y ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM G s/ • 3 Owner/Buy 40 y � Mailing Address 9G - 7 7 r 6 '1-0- �dlN f" 13 /O(rf • lid /CE e� /V, . Property Address 3 �^ -r , (Verification required from Planning Department for new construction) 0 Dr --� 31.• �o4(5• 4(D- moo City /State --Parcel Identification Number l �E�uvi -- 3z 20' 5 •54 -04>0 �.EGAL DESCRIPTION Property Location N r/4 y ' /s, Sec. T 30 N -R q W, Town of - SO MERS&I— Subdivision Lot # Certified Survey Map # . .. Volume . Page # Warranty Deed # 7 I . Volume 2415- . Page # 2 Spec house � yes ❑ no Lot lines identifiable )<yes ❑ no SYSTEM MAINTENANCE Improper use and maintenanceof your septic system could result in its premature failure to handle wastes. Propermamtenance consist 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 masWplumber,journeytimplunibm, restrictedplumberoralicensedpumperverifyingthat (1)theon -site wastewaterdiRmudsystem is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 113 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, bereiu, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certific8tioa stating that your septic system has been maintained must be completed and retained to the St. Croix County Zoning Office within 30 days - of the three year expiration date. �5 — D S L A L TUIM OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of the p t described above, by virtue of a warranty deed recorded in Register of Deeds Office. s 0 ; SI TURB OF APPLICANT 5A TE 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 ttur warranty deed o (AN 8L i K P 1 0 q u SWR p 1 _ STATE &R & 41I I N F"2 KATHLEEN H. NALSH Document Number WARRANTY DEED ST. CROIX CO , W1 This Deed, made between Elaine G. Boardman, a single person RECEIVED FOR RECORD Grantor, 11/19Y2093 01: 20PH and Copan Development, LLC WARRANTY DEED Grantee. EXEMPT 11 Grantor, for a valuable consideration, conveys and warrants to Grantee REG FEE: 13.00 the following described real estate in St. Croix County, State of TRANS FEE: 1725.00 Wisconsin (if more space is needed, please attach addendum): COPY FEE: See Attached Exhibit "A" CC FEE: PAGES: 2 Recording Area Name afTRdprq , *aA\ LNO SUITE 200 1900 SILVER LAKE ROAD ltdE`N BRIG O , MN 55112 L FILE i+la 32- 2045-40 -200: 32- 2045- 50-000 Parcel Identification Number (PIN) This is not homestead property (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this I'Wh day of November 2003 * * Elaine G. Boardman AUTHENTICATION ACKNOWLEDGMENT Signature(s) Elaine G. Boardman, a single person _ STATE OF / i — - -- ) ss. - -- — - - - - -- - _ -.. County ) authenticated this f t hday of N_ ove_mb _ , 20 0_3 Personally came before me this �`� day of u,,3 the above named * Kristin Ogland - 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 acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY _A ttorney Kristina Ogla -- - - - ^- — * - -- - - - -_- -- LARRY MOUNTAIN Hudson, WI 54016 Notary Public, State of "'" NOTARY PUBLIC -MINNESOTA _ - - - - - - -- -- -- - -- - -- - - - - -- - - -- - My Commission is permanent Nyaw'eRp goSI'e. X1 .2005 (Signatures may be authenticated or acknowledged. Both are not necessary.) a ) " Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co.. Fond do Lac, WI STATE BAR OF WISCONSIN 800.655 -2021 WARRANTY DEED FORM No. 2 -1999 M U. 2459P 218 EXHIBIT "A" A parcel of land located in part of the SW 1/4 of the SW 1/4, part of the NW 1/4 of the SW 1/4, part of the SW 1/4 of the NW 114 and part of the SE 1/4 of the NW 1/4 of Section 12, Township 30 North, Range 19 Wost, Town of Somerset, St. Croix County, Wisconsin; being part of Lot 23 of the Plat of North Bass Lake Estates; described as follows; Beginning at the W 1/4 corner of said Section 12; thence North 88 57'3 1 " E, along the Fast -West 1/4 line of said Section, 599.05 feet to the NW corner of Lot 1 of Certified Survey Map recorded in Volume l5, page 4186 at the St. Croix County Register of Doeds Office; thence South 00° 20' 09" 6, 410118 the West line of said Lot, 660.05 feet to the SW corner of said )mot; thence North 88° 57' 31' E, along the South line of said bot, 660.05 feet to tho 0 comer of said Lot; thence North 00° 20' 08" W. along the Fast line of said Lot, 677.53 feet to the Southerly line of 165'" Avenue and a point on curve of a 383.00 foot radius curve, concave Northerly, whose central angle treasures 17 °22' 37 ", whose cord boars South 82° 21' 10.5" C and measures 115.71 feet; thence Basterly along said Southerly lino and the arc of said curve, 116.16 feet to the East -West 1/4 line of said Section; thence South 88 57' 31" W, along said FAst -West 1/4 line, 48.59 feet to the East line of the West 1/2 of the SW 1/4; thence South 00° 20' 08" E, along said East line, 2654.23 feet to the South lino oftho SW 1/4 of said Section; thence South 89° 14' 08" W, along said South line, 223.78 feet to the SE corner of Lot I of Certified Survey Map recorded in Volume 16, Page 4345 at said office; thence North 00° 45' 52" W, along the East line of said Lot 1, 385.13 feet to the NE corner of said Lot; thence South 89° 34' 47" W, along the North line of said Lot 1, 372.54 fact to the NW corner of said Lot; thence South 00 0 45" S2" E, along the West line of said Lot, 387.37 feet to said South line of the SW 1/4; thence South 89 0 14' 08" W, along said South line, 437.60 feet; thence North 00 45' 52" W, 165.47 foot; thence North 35 15' 13" W, 101.43 feet; thence North 58° 51' 18" W, 219.64 feet; thence North 02 36' 46" W. 315.02 feet; thence South 87 23' 14" W, 28.05 feet to die West line of said SW 114; thence North 00° 27' 04" W, along said West line, 1968.67 feet to the Point of Beginning. e Cn • W �q Oo2s E� V N 201.90 • .p 29.sr 173.19 � $� p • S ° 4'.f'S2 °E 387.37' V G' yy 0 S 0 ` 10.00 - -- - �A C �A QD • I �� o 77 I�JIc� A $ V I v v I V � ® ti i ix se ® 0� 0 o 214.19 497.79 MOf'51'08.E 0 V , 9,.11' W 28ggy X00 )0 °45'52•W 385.13' it 31Blor S: w r y Am fd w r • o N A o 531.32 1885.,8 800 2I EA6 HE W12 iHESYW /4 238.09 MG1GPdq��p dQ[#1D� O1�71�GD Dt7 05�]�� 806�O'08•E MR1PdG,15r�C�D L�G1tY1 If (J J © y G