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Home My WebLink About032-2183-08-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safetyend Building Division INSPECTION REPORT Sanitary Permit No: 514862 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)j. Permit Holder's Name: City Village X Township Parcel Tax No: Grand Properties LP Somerset, Town of 032 - 2183 -08 -000 CST BM Elev: Insp. BM Elev: Description: i Section/Town /Range /Map No: �A U BM lao U cf_k l ! f 23.31.19.1556 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic �BdU Benchmark O D f p a o ' o Dosing Alt. BM Aeration Bldg. Sewer / � i �•s /� / r � O Holding �`` SUHtlnlet ry • .! TANK SETBACK INFORMATION SUHt Outlet TANK TO P/L WELL BLDG. Air In RCIAU Dt Inlet p Septic / Z z Dosing G Header /Man. rt— 21 �� 1 . t I Aeration Dist � ipe C��•� � Holding Bot. System -7 ��r! 3. Final Grade ' r 2 96.5 PUMP /SIPHON INFORMATION Manufacturer emand St Cover Z t Al PM r/ c" Model Number TDH Lifj,�y, Friction Loss System Head TDH Ft Forcemain Length Dia. f/ Dist. to Well �9 SOIL ABSORPTION SYSTEM = 3 BED /TRENCH Width 3r Length / Yt No. Of Trenches PIT DIM NS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS `y /lL� SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM EAC ING nufa rer INFORMATION CHAMBER OR Ty Of System: 13 V � �� ` UNIT odel Number: 7 � � (�cJ QISTRkBUTION SYSTEM AcQ eade nifold Distribution x Hole Size Ix Hole Spacing Vent to it Intak�e /r L [_ Pipes) /�/ �l Length � Dia _____ Length l� Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded ed xx Mulch Bed/Trench Center J Bed/Trench Edges Topsoil 7 Yes E] No E] Yes E] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: A W / 5 0y Inspection #2: Location: 2081 62nd Street Somerset, WI 54025 (NE 1/4 NW 1/4 23 T31N R19W) Gavin's Acres South Add of 8 Parcel No: 23.31.19.1556 1.) Alt BM Description 2,) Bldg sewer length = ., �j P I lI� /, amount of cover 3 f _ 1 0 - r W4 l� .b� W�I,aJL /i (� �llSCI l�Yi� 1 0 Plan revision Required? ❑ Yes L�L Use other side for additional information. 1 _ — _ —_ —�� ( SBD -6710 (R.3/97) Date Insepctor's Cert. No. wt.gav Safety and Btnldmgs Div— Causy 2ol W. Washington Ave P. 7162 tA n Madison, W1 53707- Sanittuy Per mit f iled in by Co.) State Trion Number Sanitary Permit Application In accordance with s. Comm. 83.21(2), W is. Adm. Code, submission of this form to the appropriate em unit is required prior to obtaining it Sanitary permit. Note: Application farms for anw"woed Proja t Address if ditlaatt man mailing address) submitted to the Departmpft of Commerce. Personal information you / �� t' in accordance with the 1'riv Law s. 15. 1 m Stets. � D O � - 6 W l 1. A t" Iefarewtlon - Pose Print All Lfarnlalien # property Owner °s N <5 property Owner's Mailing Address ST. CROIX COUNTY I kwt. Lot Section City, State Zip Code 5�61�►t�Y✓<�� 0�. 41 _77 T N; R l9 ❑E QW 11. Type of Bnikling (check all that apply) p Subdivisioln Name �1 or 2 Family Dwelling - Number of Bedrooms 3 f fin x!/s'!/S aG7/ef Public/Commetrial - DeacnL City of ri h� ❑vibe of State owned - Describe Use / ' °' _ �� Town of ea M. Type of Permit: (Cheek only ose box on line A. Cotaplefe NM B ff appliable) New System Replacernent Treannent/liolding Tank Replatxarwta only 0dw Modification to Existfntg Syown (explain) System B. p Permit Revision Change permit Transfer to Lrst lrrvtoM Peenit N0111 er ;id Date Ism Renewal Before Plumber New Owner 1V. T of POWTS S stenslcam neat/Device: Check All brat a rioted < Z4• ia, of suitable soil Non - Pressurized In. hound Pressurized In4hound At'(�rade Mould >_ 24 in. of sairobk soil �y Compopent (ex ❑PoVl� (ex Holding Tank ❑ f � Y L V. Dis 1Mwlfl'restttseat Ara Iefenaafion: `" t oo G p ( gystem Eleve Design Flow (gpd) Design Soil Application KBMB dsf) Dispersal Area �iW Of) l Area ,� X13 6s/- 6 fe �0 9 , o VI. Teak Info Capacity in Taal # of Material Cisllons Gallons Units Now Tsoks ExiatinB Tanks 7 Q f 1 j l Ulf - Septic or Holdh* Dosing Chamba �a ' VII. Res nslbi 34tteAtent- L fhe , assaaoe rrsPoasib>EtY fb b phdMik >a of the POWTS N the sUsd ed PIN Nmtrber ]3trsinesa Phew Number P1 's Name (prim) / pl 'a Signature '" SC.�i Is �7 -A/i'� ,vim--'` ✓'-"- Plumber's Address (Street, City, State, Zip Code) )�• " ------ 1. . C wtokent Use D Permit Fee i p Approv , in ur � ed Disappr G� _ Owner Gives Reason for Denial $ IX. Canditfons_tlfAp 11ks►pp 1 _ �y� / � v_` f LU /Nr'� ti C� SY$TEi -Mw NER: Septic tank, effluent filter and �(),{f dispersal cell must all be serviced / maintained as per management plan provided by plumber. sea,■ are CboMy eM' � t� not tas ths.lt t/t: 11 taetw m she as per applica 4 'Bl) -6398 (R. 011/07) Valid thru 01109 104 Cortli 2� �A 7 � 'l2 , acopy I i I I I I I I � OOL i I I � 2' C l�Gp�G�'- �✓cfiz' 7i G 1224 Wisconsin DeparUnent of Commerce SOIL EVALUATION REPORT page I of 3 Division of Safety and Buildings in accordance with Comm 85, W is. Adm. Code Tom Schmitt Attach complete site plan on paper not less than 8' /: x 11 inches in size. Plan must County St. CroiX include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Please print all infornodon. Re ' By Date Q� Personal information you provide may 15.04 (1) (m)). Property Owner Property Location Grand Properties, LP Govt. Lot NE 19 NW 19 S 23 T 31 NR 19 W Property Owner's Mailing Address APR 2 3 ) (j h. Lot # Block # I Subd. Name or CSM# 712 Rivard Streeet, Suite 300 8 Gavin's Acres: First Addition City State Zip GgQe'Pbpft Nurtti ^ I City ,J Village tjM Town Nearest Road Somerset WI p Somerset 210Th Ave. New Construction Use: SM Residential /Number of bedrooms 3 Code derived design flow rate 450 GPD I Replacement J Public or commercial - Describe: Parent material Outwash Flood plain elevation, if applicable na General comments and recommendations: Area is sir fora a s em with a 0.7 gpd/sgTt rating. Possible system elevation for Area 1 is (high tre h) 94.80' pow tr rich) 94.00. Slope is 5% B or i ng t3orin # 01 Pit g Ground Surface elev. 97.84 ft. Depth to limiting factor 95+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDff 'Eff ll 'Eff#2 1 0 10yr3/3 none Is 1csbk mvfr as 1f .7 1.6 2 7 -20 7.5yr4/4 none Is 1csbk mvfr gw 1f .7 1.6 3 20-95` 10yr5/6 none s Osg ml — .7 1.6 Z Boring # Boring tM Pit Ground Surface elev. 97.84 ft. to limiting factor 96+ in. Depth g Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF 'Eff#1 'Eff#2 1 0-9 10yr3/4 none Is 1csbk mvfr as 1f .7 1.6 none — 2 10yr4/6 Is 1 csbk mvfr gw .7 1.6 3 32-48 7.5yr5/4 none s On ml cs — 7 1.6 4 48-60 10yr5/4 none s Osg ml cs .7 1.6 5 60 -96 1 r5/6 none s 0 — Oy sg ml — .7 1.6 From -80" 2" bands of 7.5yr4/4 loa sand 1 msbk. ` Effluent #1 = BOD 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD <30 mg/L and TSS <_30 mg/L CST Name (Please Print) Sigrnature: CST Number Thomas J. Schmitt 227429 Address Tan Schmitt Date Evaluation Conducted Telephone Number 1595 72nd St., New Richmond, Wl 54017 4/20/04 715- 247 -2941 Property Owner Grand Properties, LP Parcel ID # Page 2 of 3 3 ] F goring # _ Boring !✓� P8 Ground Surface elev. 96.15 ft. Depth to limiting factor 97+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *091 *Eff#2 1 0-7 10yr3/4 none Is 1csbk mvfr as 1f .7 1.6 2 7 -21., 7.5yr4/4 none Is 1msbk mvfr 9w 1f .7 1.6 3 21 -97 10yr5/6 none s Os9 ml — 7 1.6 r, 41 Boring # � M Pit Ground Surface elev. ft. Depth to limiting factor 35 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 1 0 -7 10yr3/4 none Is 1csbk mvfr as 1f .7 1.6 2 7 -22 1 Oyr4/6 none Is 1 csbk mvfr 9w — .7 1.6 3 22 -35 10yr5 /4 ne s Os9 ml ce .7 1.6 4 35 -84 5yr4/4 7 5 5y 2/8 al 1 csbk mfi — .4 .7 F-I goring # 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 'Eff#1 *Eff#2 * Effluent #1 = BOD 5> 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. Red LY XM �l Page 3 of 3 Conducted by: Conducted for: Schmitt Soil & Site Evaluations Name: Grand Properties, LP Thomas J. Schmitt, CST 227429 Address: 712 Rivard St. Suite 100 1595 72nd St. City, State, Zip: Somerset, Wl 54027 New Richmond, Wl 54017 Phone: 715.247.2941 Subd. Name: avin's Acres, First Addition Lot No. /V 1/4,N4� 1/4,S23,T31N,R19W Township of Somerset BM EL 100.00' 7d f� A 1 -C A Alternate BM EL . YJ ?ate d 7 Slope = _�% Contour Line EL a Scale: I"= 40' ion 149 AP 6,4 Sx� 1�D� II This soil report was done to fulfill a Zoning requirement. It may or may not be in a location that is suitable for your use. No permanent lot markers were in place when the test was conducted. SEPTIC TANK PUMP CFA1`3ER CROSS sl: G. 7r)m ANn sPECIr rc:h�l�ti� 4" CI' VENT PIPE 12" Hh1 . `ABOVE GRADE WEATHERPROOF AFPROVED WITH >_ 25' FROM DOOR, WINDOW OR JUNC FRESH AIR INTAKE WITH CONDUIT WP CO VER PADLOCK FINISHED GRADE WARNING LABEL 7 - 4" CI RISER ,.,.,. 4 " MIN . 18" IN. 6,f MAX, ET �. WATER TIGHT SEALS GAS- -�'- TIGHT `� APPROVED A SEAL JOINTS WITH ' ALM APPROVED PIPE PP ' Efl B ON 3' ONTO IPE 3' "i SOLID SOIL NTO SOLID * RISER EXIT OIL PUMP OFF E LEV. FT. OFF PERMITTED ONLY D IF TANK F 7 tL 7 j MANUFACTURER HAS APPROVAL 3" APPROVED_ BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE NUMBER DOSES PER DAY: TANK MANUFACTURER : /,), `e tgr - - - TANK Ste; SEPTIC ,^. GAL • DOSE VOLUME INC B GAL DOSE 4 _ GAL ALARM MANUFACTURER: CAPACITIES: A = INCHES = -• ,�Ef GAL. MODEL NUMBER: B - _2 INCHES = 22 GAL. SWITCH TYPE: �c rc , ..._. C INCHES =GAL• PUMP MANUFACTURER: L9�►v;� MODEL NUMBER : o p INCHES = SWITCH TYPE: /W --o REQUIRED DISCHARGE RATE_ GPM PUMP E ALARM WIRING AS PER ILHR 16.23 WAC � FEET VERTICAL DIFFERENCE BETWEEN PUMP GFF AND DISTRIBUTION PIPE FEET + MINIMUM NETWORK SUPPLY PRESSURE "'""' FEET S / + FEET FORCEMAIN X •A FT /�fl4 FT. • = /27 FEEfi • WIDTH ; D � I / AMETER LENGTH INTERNAL DIMENSIONS OF PUMP TANK: LIQUID Fr T t - LICENSE NUMBER: � ?4 DATE: SIGNED: 1/88 GOULDS PUMPS Submersible Effluent Pump EPO4 . A.k �E 3871 EP05 APPLICATIONS • Fully submerged in high ■ EP05 impeller. Thermoplas- ■ Bearings: Upper and lower ecificall designed for the grade turbine oil for tic enclosed design for heavy duty ball bearing Specifically Y 9 lubrication and efficient improved performance. construction. following uses: heat transfer. ■ Casing and Base: Rugged • Effluent systems thermoplastic design provides AGENCY LISTING • Homes Available for automatic and superior strength and corrosion • Farms manual operation. Auto- 4• Canadia�tsfa &1*A=dWW • Heavy duty sump matic models include resistance. ■Motor Housing: Cast iron (CSA listed model numbers end • Water transfer Mechanical Float Switch for a M heat transfer, in "F" or "C • Dewatering assembled and preset at the ".} fa�ory strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic C is W 900 FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. 3 1+• maximum. ■ EPO4 Impeller. Thermoplas- m Power Cable: Severe duty • Capacities: up to 60 GPM. tic Semi -open design with rated oil and water resistant. • Total heads: up to 31 feet pump out vanes for mechanical • Discharge size: IVe NPT. seal protection. • Mechanical seal: carbon- ' rotary /ceramic - stationary, BUNA -N elastomers. • Temperature: 104°F (40°C) continuous - ------- FEET _ -- - -- `r -- --'- 140°F (60 intermittent 10 1 — - • Fasteners: 300 series - -_.. stainless steel. 9 30` _..- ..._._.._._ _......_ i_ __.._.....l.._._...._.._...____ _ __ .._ 5 _ • Capable of running dry without damage to s I is Fr N ( components. 2s - -� - -- 7 .._... __ �.._.___._� _ _._ { I � Motor: x � • EPO4 Single phase: 0.4 HP, — 115 or 230 V, 60 Hz, 1550 s ! RPM, built in overload with n 15r t _ automatic reset. q V - EPOS • EP05 Single phase: 0.5 HP, e , 115 V, 60 Hz, 1550 RPM, '' s 10_ built in overload with _.. .___ . :.... _...... : - _ :._.._ EPO4 automatic reset. z • Power cord: l0 foot 5:- i standard length, 16/3 _1 _ S1TOW with three p ron _ ;_ . - _ .:_ __. roundin lu O Option 20 0 % 1 o zo _ _. 30 40 50 GPM foot length, 16/3 SJT N with three prong grounding plug o z q 5 s 10 1 2 m'/h (standard on EP05). CAPACRY Goulds Pumps ® 2000 Goulds Pumps W ITT Industries Effective February, 2000 83871 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page / of ' FILE INFORMATION SYSTEM SPECIFICATIONS Owner ank Capacity g al ❑ NA Permit # �/, Septic Tank Manufacturer ❑NA �t a DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms 3 ❑ NA Effluent Filter Model �D/C ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity gal ❑ NA Estimated flow (average) gal/day Pump Tank Manufacturer fe ❑ NA Design flow (peak), (Estimated x 1.5) g al/day Pump Manufacturer ❑ NA Soil Application Rate gal/day/ft2 Pump Model ❑ NA Standard Influent /Effluent Quality. Monthly average* Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg /L O Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg/l, ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cells) C1 NA Biochemical Oxygen Demand (BOD 530 mg /L ❑ In- Ground (gravity) ❑ In- Ground (pressurizedl Total Suspended Solids (TSS) 530 mg A ❑ At - Grade ❑ Mound Fecal Coliform (geometric mean) fu /100m1 Drip ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE Service Event Service Frequency monthlsl (Maximum 3 years) ❑ NA inspect condition of tank(s) At least once every: eat(8) Pump out contents of tank(s) When combined sludge and scum equals one - third (Y of tank volume ❑ NA ❑ month(s) (Mwdmuln 3 yew) (3 NA Inspect dispersal cells) At least once every: �'year(s) morth(8) (3 NA Clean effluent filter At least once every: earls) ❑ month(s) ❑ NA inspect pump, pump controls & alarm At least once every: e--- ❑ year(s) ❑ month(s) ❑ NA Flush laterals and pressure test At least once every: ❑ earls) ❑ month(s) ❑ NA Other: At least once every: ❑ yew(s) ❑ NA Other: MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certif`catTio k Master Plumber; Master Plumber Restricted Sewer; POWTS inspector; POWTS Maintainer; Septage Servicing Oper inspections must include a visual inspection of the tank(s) 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 back up or ponding of effluent on the ground surface. The dispersal cell ndition and requires s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any of effluent on the ground surface. The ponding of affluent on the ground surface may indicate a failing co the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y 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 NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters . mechanical or pressurized components, pretreatment units, and any servicing at intervals of S12 months, shall be performed by a certified POWTS Maintainer• A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. P age of 2— START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tan818forf the c tt�ons ar de tected h vg t he c ontents that may impede the treatment process and /or damage the dispersal c ( ) l of the tankis) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. wastewater During power outages pump tanks may fill above norm verload overloading star h ceills) and may result in he backup surface disch g of discharged to the dispersal call(s) in one large dose, effluent. To avoid this situation have the conte or POWTSpMaintanerto assist Septage operating the r pump contr u to power to the effluent pump or contact a restore normal levels within the pump tank. Do not drive or.park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance a a pes! disinfectants; t l ife o fat; the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cation s s li e gre e; herti des floss; scraps, medications; oil; foundation drain (sump pump) water; fruit and vegetable peelings; g 9 painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken o G Comm following Wisconsin Administrative Code:cnsure that the system is properly and safely abandoned in compliance with chapter • 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. r their covers removed and the void space filled with • After pumping, all tanks and pits shall be excavated and removed o soil, gravel or another inert solid material. CONTINGENCY ]PLAN rovide a code compliant If the POWT fails and cannot be repaired the following measures have been, or. must bQ taken, to p replaceme system: may A suitable replacement area has been evaluated an m dis urbanaeeand compaction and should not be infi n ged upon by system. The replacement area should be protect to Protect required setbacks from existing. a d prop to establish a su itable repl af acement area. Replacementtssystem must result in the need for anew sal comply with the rules in effect at that time. d/or soil El A suitable replacement area is not available due to s oaeplace the failedpOy limitations. Barring advances in POWTS technology a holding tank may be installed as a last re site oil tank �A ❑ e e Prit graft e biomat at the of rern 'f 0 Mound and at -grade soil absorption s y be reconstructed c omply h the place following effect at that ®• h infiltrative surface. Reconstructions o f such systems < < WARNING> > TIC PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETH RC ASSES AND DEATH M Y SEP , RESULT. RESCUE OF I ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSS ADDITIONAL COMMENTS POWTS MAINTAINER pOWTS INSTALLER Name Name �"11"e< a�G.+l. Phone Phone SEPTA(iE SERVICINti OPERATOR (PUMPER) LOCAL REGULATORY AUTHORffY Name �fi . C Name cl Phone Phone This document was drafted in compliance with chapter Comm 83.220(b)(1)(d) &(f) and 83.54111. (2) & (3). Wisconsin Administrative Code. ...,..rr"j rv.cn rA.u, toa,ru t nn ivv. aep. rra trWr-A� ire. .4m i rG ST. CROLX COUNTY SEPTIC TANK MAIN'TENANC'E AOREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/B u yer I Q--s (C, Mailing Address i t'S-t1t-';�a' m x 4 oS Property Address; 63 (fa ro' Sf IQ IQ (Verification required from Piamrting & Zoning Department for new oonstruction.) City /State �irn �,►r5 } (,J Parcel Identification Ntunber LEGAL DESCRIPTIOx Property Location `l4 , '/4 , Sec. , T �LN R W, 'rowu of Subdivision .� � / 1 rl:� - c Certifted Survey Map 0 _ _ _ , Volume . _ . ,,,,, , Page # Warranty Deed # 70 3 — 7�) , Volume 25 , page # spec house (� no Lot lines identifiable v no SYSTEM MAINTENANCE AND 2MER CEBTTFICATION Improper use and maintenance of your septic system could result in its premature failure to hastily wastes. Propel maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensod pumper, What you put into the system can affect the function of the septic tank as a treatment stage to the waste disposal system Owner maintenance responsibilities arc specified in §Comm. 83.52(1) anti in Chapter 12 . St. GYoix County Sanitary Ordinance. T'hc property vwrwr agrom to subedit to St. Croix County Planning & ?.onwg Department a certification form, signed by the owner and by a msster plumber, jouruvymsn plumber, tvstrict plumber or a Uooraed pun4w vvrifona that (1) the on -Rite waxtewatcr disposal system is in proper operating condition and,'or (2) after ins;wtiou and pumping (if neeossmy), tha septic rank• is lest than 1/3 tuIJ of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as sex by the Department of Commerce and the Department of Nattual RmmccA State of Wiso otmia. Certiscation stating that your septic system has been maintained =t be completed and returned to the St. C'.roiX County Pluming & Zoning Department within 30 days of the three year expiration date. I /we certify that all statements on this fomi are true to the best of my /our knowledge. Uwe amlare the owner(A) of the property describod above, by virtue of a warranty deed recorded in Register of Doeds Office. Number of bedrooms tin r Iv�CJ / O — SIGN A OF APPLICAN'T(S) DATE "Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded wan ty deed from the Register of Deeds Office and a copy of the certified savey reap if reference is made in the warranty deed. f 6tEv. 083/os J 2580 Q 296 763781 `? STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX CO., WI This Deed, made between Walter E. Germain and Debra C. RECEIVED FOR RECORD Germain, husband and wife Grantor, 05/2512004 11:50Al1 and Grand Properties LP WARRANTY DEED Grantee. EXEMPT it Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin REC FEE: 1 TRANS FEE; 1972972.. 80 (if more space is needed, please attach addendum): COPY FEE: See Attached Exhibit "A" CC FEE: PAGES: 2 Recording Area Name and Return Address Al; K2 7/9, ,2 d a.r d St - A-4 032 - 1060 -40- 000;032-1060-80 -000 032- 1060 -90 -100: 032 - 1060 -90 -500 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 day of May 2004 * * Walter E. Germain * * Debra C G ermai n AUTHENTICATION ACKNOWLEDGMENT Signature(s) Walter E. Germain and Debra C. Germain, STATE OF ) husband and wife _ ) ss. County ) authenticated this ((day of May 200 Personally came before me this _ _ _ day of the above named * Kristina 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 Attorney Kristin Ogland Hudson, WI 54016 Notary Public, State of My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ) * Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co., Fond du Lac, W I STATE BAR OF WISCONSIN 800.655.2021 WARRANTY DEED FORM No. 2 -1999 . U 2580P 299 EXHIBIT "A" A parcel of land located in part of the Northwe4st Quarter of the Northwest Quarter, part of the Northeast Quarter of the Northwest Quarter, and part of the Northwest Quarter of the Northeast Quarter of Section 23 To rt east Township 31 North, Range 19 West, Town of Somerset, St. Croix County Wisconsin, including part of Lot 3 of a Certified Survey Map recorded In Volume 15 Page 4037 as recorded in the Register of Deeds Office for said County, described as follows: Commencing at the Northwest Comer of said Section 23; thence, on an assumed beating along 9 the west line of the Northwest Quarter of said Section 23, South 00 degrees 13 minutes 18 seconds West a distance of 938.33 feet to the south line of Lot 3 of said Certified Survey Map and the point of beginning of the parcel to be described; thence, along last' said south line, South 88 degrees 56 minutes 22 seconds East a distance: of 415.04 feet to the southeast comer of that property described in Volume 2077 Page 239 4s recorded In said Register of Deeds Office; thence, along the east line of last said property and the east line of Lot 2 of said Certified Survey Map, North 00 degrees 13 minutes 19 seconds EAst a distance of 574.67 feet; thence, along the east line of Lot 1 of last said Map, North 05 degr 14 minutes 28 seconds East a distance of 330.65 feet to the southerly line of 211P Avenue (A Town Road) as dedicated on the Plat of Gavin's Acres; thence, along last said southerly ilne, South 88 degrees 49 minutes 54 seconds East a distance of 959.37 feet; thence North 00 degrees 09 minutes 35 ' seconds East a distance of 33.01 feet to the north line of the Northwest Quarter of said Section 23; thence, along last said north line, South 88 degrees 49 minutes 54 seconds East a distance of 1271.30 feet to the north Quarter comer of said Section 23; thence, along the north line of the Northeast Quarter of said Section 23, South 88 degrees 50 minutes 02 soWnds East a distance of 155.50 feet; thence South 01 degrees 03 minutes 38 seconds West o distance of 625.87 feet; thence South 88 degrees 56 minutes 22 seconds East a distance of 102.52 feet; thence South 01 degrees 03 minutes 38 seconds West a distance of 693.00 feet to the south line of the Northwest Quarter of the Northeast Quarter, thence, along last said south line, North 88 degrees 56 minutes 26 seconds West a distance of 235.84 feet to the north -south Quarter line of Section 23; thence, along the south line of the Northeast Quarter of the Northwest Quarter and the South line of the Northwest Quarter of the Northwest Quarter, North 88 degrees 56 minutes 22 seconds West a distance of 2370.40 feet to the east line of that property described in a Volume 1227 Page 497 as recorded In said Register of Deeds Office; thence, along last said east line, North '00 degrees 04 minutes 38 seconds East a distance of 320.00 feet to the northi line of last said property; thence, along last said north line, North 88 degrees `56 minutes 22 seconds West a distance of 306.19 feet to the west line of said Northwes t Quarter, h n thence, c e, a ng last said west io a a't a line, degrees 13 North h 00 gre minutes 19 seconds East a distance of 66.02 feet to the point of beginning. Pk o 4 - s r b ,�� , �`�3• P3Q, 964 sq. ft. • `rS'� � 3.01 acres 91 _ 130, 876 sq. ft. t30, 830 sq. ft. ray J. 00 acres � 3.00 acres - '�8• LBO — 9.39.20' 1.30, 7d I. S ft C -•. r 7 r, 8+L , 3.0 acres 9 \ - 9 -. g 4► LBQ — 94100 At 'h 0 ; 33, 613 sq. ft. g . .5. 07 t?'cres _ �