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HomeMy WebLinkAbout038-1176-40-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH �'O P ERMIT) 453317 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: Bowie, Brent I Star Prairie Township 038 - 1176 -40 -000 CST BM Elev: Insp. BM Elev: BM Description: J � Q <� Section/Town /Range /Map No: 16 04.31.18.869 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark ( "� 166 Dosing Alt. BM 1 !""4_60,) i, Z I 9 4 ` 71 Aeration Bldg. Sewer Z •�l�1 J�.SI Holding St/Ht Inlet 3,z,� 94.1 TANK SETBACK INFORMATION St/Ht Outlet Z -o, c7`J 3q TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet \ \ 1 Septic � i � 7 /� " _ / � � , 5 , i Dt Bottom Dosing Header /Man. 3 , yZ Z 74 .O T .4 .15 Ewe • 15 73 gS Aeration Dist. Pipe P41fill., 3 9 L 9 7 0 4 .1 93.85 1 7� 1 Bot. System rj .O aT� 9 - 3 s. 4 waa Z - 5 PUMP /SIPHON INFORMATION Final Grade 1 ' 95 c r& •6 Manufacturer Demand St Cover GPM ` Z.1 G •7 Model Numbe TDH Lift Friction Loss System He TDH Ft Forcemain Len I Dist.toWell SOIL ABSORPTION SYSTEM BED/TRENCH Width Length / No. Of Trench PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS -3 / g "7 I r� E \ \ SETBACK SYSTEM TO QQ P/L ! BL LD DG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR ) c� Type Of System: I ) /x /t UNIT Model Numbe �Oh IVA hf- DISTRIBUTION SYSTEM Header /Manifold �� Distribution x Hole Size x Hole Spa cing Vgnkto Air ntake , Pipe(s) \ 1/L� 1 1-ength / Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only 4 A, C_ t,,- Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Z Bed/Trench Edges ` Topsoil *N; Yes F� No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / � • Inspection #2: Location: 2353 Canary Dr �Unnk�nown (SE 1/4 NE 1/4 0 Unknown) Mallard Run Lot 7 Parcel No: 04.3�1.11�8.j8�69 1.) Alt BM Description = 5 "1 J � aJ��• ` i I ` 2.) Bldg sewer length $ t , - amount of cover to f✓ / A ZA Plan revision Required? Yes \ \ No U l Use other side for additional information. J Date Inse tor's nature Cert. No. SBD -6710 (R.3/97) Safety and Buildings Division County i 201 W. Washington Ave., P.O. Box 7162 x �r� ®sco /+f Madison, WI 53707-7162 , Sanitary Permit Number (to be filled in by Co.) ■,* (608) 266 -3 1 Department of Commerce Sanitary Permit Application State PI n I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you p�rov may be used for secondary purposes Privacy Law, sI5.04(1)(m Project Address (if different than mailing address) I. Application Information— Please Print All Information ° - "w 235 CAIV Property Owner's Name JUN Ill Parcel # of # Block # t �2 Property Owner's Mailing Address I j; "� r , ; Property Location ZGNING 0FF1f1L= CT City State Zip Code Phone Number �lG Section // rcle II. Type of Building (check all that apply) (� S �t"` t /� .�i 5'Nor 2 Family Dwelling — Number of Bedrooms S S yj ubdivision Name CSM Number ❑ Public /Commercial — Describe U El State Owned — Describe Use - �/ dD ( ❑City_ ❑Vil geb ship o III. Type of Permit: (Check only one box on line A. Complete line B if pplica A. ;-New System ❑ Replacement System ❑ Treatment/Holding T eplacement Only ❑ Other Modification to Existing System B. El Permit Renewal C1 Permit Revision [I Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: (Check all that appl VL on — Pressurized In- Ground ❑Mound > 24.in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter El Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ " ula i and Filter El Recirculating Synthetic Media Filter caching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) Rec V. Dispersal/Treatment Area Inf rmation: i Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (st) Dispersal Area Proposed f) VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks I Tanks Septi r Holding Tank Aerobic Treatment Unit Vv Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibil for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' ture MP /MPRS Number Business Phone Number Plumbe Address (Street, City, State, Zip Code) VIII. County /Department Use Onl 1pproved ved Sanitary Pe it Fee (includes Groundwater Date Issued Issuin Agent Signatur o Stamps) ( Surcharge Fee) T n for Denial c IX. Conditions qfApprova SYSTC -iN OWNER. 3\ ) - 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber. C?.!^� 2. All setback requirements must be maintained � � v I as per applicable code /ordinances. `> Attach complete plans (to the County only) for the system on paper not less than 312 x 11 inches in sizr- A1ACVL14 5;( SBD -6398 (R. 01/03) PLOT PLAN PROJECT Brent Bowe ADDRESS 2084 110th st. NewRichmond Wi. 54017 SE 1/4 NE 1/4s 4 /T 31 N/R 18 W TOWN Mallard COUNTY ST. CROIX MPRS Byron Bird Jr. 220527 J DATE 6 - 10 -04 BEDROOM 3 CONVENTIONAL XX At Fade CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE a LOAD RATE .4 ABSORPTION AREA 1125 # of chambers 37 IL BENCHMARK V.R.P. Top of PL stake ASSUME ELEVATION 100' ❑ BOREHOLE (DWELL sH.R.P. Same as BM Vent SYSTEM ELEVATION T -1 = 97.3 T -2 =97.0 T -3 =96.8 > 12" Of Bio Diffuser with Cov 31.1 ft ^2 per chamber 6" Grade- at System Long 34" Elevation ,o- C,0 3 Bed House Canary Dr. 15' Garage st Driveway 10' PL 100' 80' B3 81' 25' 9 O ob pipe 99' 73' 15' 45' B 1 Alt B 10' PL P y I .�;�`"#� PLOT PLAN PROJECT Brent Bowe ADDRESS 2084 110th st. NewRichmond Wi. 54017 SE 1/4 NE 1/4s 4 /T 31 N/R 18 W TOWN Mallard COUNTY ST. CROIX MPR9 Byron Bird Jr. 220527 DATE 6 -10 -04 BEDROOM 3 — CONVENTIONAL XX At rade CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1125 # of chambers 37 BENCHMARK V.R.P. Top of PL stake ASSUME ELEVATION 100' ❑ BOREHOLE O WELL *H.R.P, Same as BM Vent SYSTEM ELEVATION T -1 =97.3 T -2 =97.0 T -3 =96.8 >12" Of Bio Diffuser with Cove 3 1. 1 ft ^2 per chamber 6" —Cyradt- at System Long 34" Fdevation \\ dt k¢ 3 Bed House Canary Dr. 15' Garage Driveway st 10' PL 100' 80' B3 81' 25' 9 O ob pipe 99' 73' 15' 45' B2 12Z Alt B 1 M 10' PL Wisconsin Department of commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code — count Attach complete site plan on paper not less than 8112 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direct' Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance ne� ad. 3 oa��7Please print all information. P Re 'wed by Date / Personal information you provide maybe used for secondary purposes (Privacy Law, s. 04 m)). ( — tn C� Property Owner Property Location I D W L Govt. Lot � 1/4 ; 114 S T �� N R *�5E Property Owner's Mailing Address Lot # Block # Subd. Name or C M# City State Zip C6de hone Number ❑ City E] village g9Yown Nearest Road G� �/1 c s �� �i�6 �l 7 J�fa �" �/'� r;-• r '� �c n 4 r 4��". New ConstrucAion Use - 'Residential / Number of bedrooms Code derived design flow rate C GPD ❑ Replacement ❑ Public or commercial - Describe / : Parent material f ` / tic.lG 5'7 Flood Plain elevation if applicable �r w �, General comments and recommendations: Tr _ / ��, �v75 S� `� 3 7 6, F - il ry Boring # &l. Boring a° ❑ Pit Ground surface elev. ft. Depth to limiting factor 7 y/ in. '- Soil Appli cation Rate �C• Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 O 'g p'� �� /' • � r /7l r G� � `P + a - 2 a Boring # Boring ❑ Pit Ground surface eiev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 AL ALW • r * 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 (Ple se Print) / Sign u CST Number Address Date Ev _ Telephone Number Property Owner ee4 --Q1 - Parcel ID # Page of # Boring F - 5 1 Boring K pit Ground surface elev. '9y`_ ft. Depth to limiting facto 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 ( P F 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 F-1 Boring # ❑ Boring El 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. SBD -8330 (R.07 /00) Soil Test Plot Plan Project Name Brent Bowe Byron ird Jr. Address 2084110th st. NewRichmond Wi. 54017 cs6m #220527 Lot 7 Subdivision Mallard Run Date 6 /10/2004 — County- ST. CROIX S E 1/4 1/434 T 3 1 N /R W Township ring Q Well PL Property Line lt. B Top oPL stake BM or VRP Assume Elevation 100 ft.top of 1" pip �g ystem Elv T -1= 97.3 T -2 =97.0 T -3 =96.8 H.R.P Same as BM tl V f f. . 3 Bed House Canary Dr. Garage Driveway PL 100' 80' B3 25' 77 ' 1 45 B2 100' Alt B 1 ' M 1 PL POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner - Septic Tank Capacity a l ❑ NA Permit # 3 3 �L Septic Tank Manufacturer, f ❑ NA DESIGN PARAMETERS T Effluent Filter Manufacturer / ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units A Pump Tank Capacity al A Estimated flow (average) al /day Pump Tank Manufacturer Design flow (peak), (Estimated x 1.5) etw gal /day Pump Manufacturer NA Soil Application Rate — al /da /ft2 Pump Model A Standard Influent /Effluent Quality Monthl average* Pretreatment Unit ❑ A Fats, Oil & Grease (FOG) 530 mg /L ❑ 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 Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L 'In Ground (gravity) ❑ In Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA * Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ onth(s) (Maxi years! NA ear(s) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: 0 mon j(s) (Max! m ❑ NA Clean effluent filter At least once every: ❑ month(s) ❑ NA year(s) Inspect pump, pump controls & alarm At least once every- ❑ mo nth ❑year(s) l A pressure test At least once eve ❑ month(s) Flush laterals and P every: ❑year(s) Other: ❑ month(s) At least once every: ❑ year(s) Other: FNA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank 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 o f effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires 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 512 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. GMW (4/01) Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment 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. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or ark vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area p P 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 and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • hall be excavated and removed or their covers removed and the voids ace filled with After pumping, all tanks and pits s P soil, gravel or another 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 replaZ ent system: ` 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 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 e installed as a last resort to replace the failed POWTS. Mound and at -grade soi a s structed in place following removal of the biomat at the infiltrative su Re o structions of uch s must c wit a that time. < <WARNING> > r'°` SEPTIC, PUMP AN OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name `► (' ,,, J^ Name, Phone Phone yt 7 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name d p,- Name e Phone ` -, 4-1 Phone — c�-O This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.540►, (2) & (3), Wisconsin Administrative Code. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND. OWNERSHIP CERTIFICATION FORM Owner/Buyer ►° Mailing Address D 7� Property Address 3 53 (Verification required from Planning flepartment for new constructio City /State Parcel Identification Number 3`��' 1 Z � -0 — CEO C• $ LEGAL DESCRIPTION Property Location � %4, i/4, Sec. T�N -R W, Town of Subdivision �f, r �i�s�t . Lot # Certified Survey Map # . Volume . Page # Warranty Deed # �� � , Volume °� � Page # Y59n . Spec house ❑ yes Wno Lot lines identifiable Jam' yes ❑ no SYSTEM MAINTENANCE Improper use and maintenanceof your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a ma wplumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the year exp' date. S10 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 property ribed a , by virtue of a warranty deed recorded in Register of Deeds Office. o SIGNAIVRh OF APPLICANT DATE ** * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed r i Wisconsin Department of Industry SOIL AND SITE EVALUATION / ,3 of Labor and Human Relations Page Division of Safety and Buildings in accordan 3.09, Wis. Attach complete site plan on paper not less than 6 1/2 x 11 inche ' i . Pja,_n, m st ,? County include, but not limited to: vertical and horizontal reference poi direofl'tTr� percent slope, scale or dimensions, north arrow, and location tangq �)�ft st rQ rcel I.D. # APPLICANT INFORMATION - Please print all in ate w ' viewed by Date Personal information you provide may be used for secondary purposes ( aw, s. 15.04��1'�j } Property Owner / f AJ d /9 Ot — at /v61 /4,S 7` T 3 N 8 E (or) W Property O er's Mailing Address lock# Subd. Name or CSM# / 7 7 /'f IVY cd �iu City State Zip Code Phone Number �f d�j age i 6 Nearest Road 51-' if�fk /,S l�� SYaz S� (��S )��? 33Z� ❑ ct u Vill Town e-&a �d,✓a�� �/� new Construction Use: Residential / Number of bedrooms N , a Addition to existing building ❑ Replacement Public or commercial - Describe: Code derived daily flow �' gpd Recommended design loading rate bed, gpd /ft - 3 trench, gpd/ft Absorption area required r bed, ft trench, ft Maximum design loading rate bed, gpd/ft - 3 trench, gpd /ft Recommended Infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design /site considerations �y d . F11 �' f b�� %S'oi Parent material Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system 1 ❑ S Xy Nr S ❑ U EIS 9 U ❑ S ( U ❑ S Lk u ❑ S j4 u SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 1 C126 Ground elev. S o _ P P j ©�ft. 7s y „�, ys - Depth to limiting f actor O in. Remarks: Boring # 13 Cq- d /5 'S/ '51 / 7S� 4 �S �c f — .z� 3 Ground / ..f �i! �� i C' / �-r+ ✓ T i �!P , /� Depth to limiting factor 21-3—in. Remarks: CST N (Please Print) dinature Telephone No. Address a tl Date CST Number (p/s a?66 dd z qc x AA' sYR53 dam, e '-"9X , y �� NrtJc7�E SOIL DESCRIPTION REPORT 7 ' PROPERTY OWNER Page of PARCEL I.D.# Boring Horizon Depth Dominant Color Mottles Structure 2 g Texture Consistence Boundary Roots OE ,,,;- a in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Ground LP" Q y� `fi �.� Si '� /TcJ6i� c� .S . Z_: t elev. - 27- AJP 7 S �( i � %8 , c l mot;'' � Al Depth to imiting At p A/ , l factor 7 in. Remarks: Boring # a / 1,J6k C ZJ 2n, Ground elev. 0 Depth to limiting factor Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # Ground elev. ft. Depth to limiting factor in ' Remarks: Boring # Ground elev. ft. , Depth to limiting factor in. Remarks: SBDW -8330 (R. 08/95) o n C�u a Z � o � Q �D (R 3 • U. 2511P 390 7E5e+ STATE BAR OF WISCONSIN FORM 1- 1999 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX co., WI kECfiIVED FOR RECORD This Deed, made between James R. Moe and Melissa M. Moe, 02/18/2004 09 :30A1f husband and wife Grantor, and Brent P Bowe a single person WARRANTY DEED Grantee. EXEMPT if Grantor, for a valuable consideration, conveys and warrants to Grantee REC FEE: 11.00 the following described real estate in St. Croix County, State of Wisconsin TRANS FEE: 81.00 e space is needed, please attach addendum): COPY FEE: Lot 7 fat of Mallard Run in the Town of Star Prairie, St. Croix County, CC FEE: Wisconsin. PAGES: 1 Recording Area Name and Return Address WESTCONSIN CREDIT UNION 4 �p P.O. BOX 269 NEW RICHMOND, WI. 54017 038 - 1176-40 -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 16 tot day of February 2004 D ' O'er * -- - -- - -- - - - - -- * James R. Moe - --- �� - �� — r ''= u -- - - -- -- - * * Melissa M. Moe AUTHENTICATION ACKNOWLEDGMENT Signature(s) _..._ _..- -- - - - - -- -- - - -�- - -- - -- STATE OF - W / V - - - - -- - - ) ) ss, __ County ) authenticated this day of — Personally came before me this & y,�l day of _ February , 2004 the above named James R. Moe and Melissa M. Moe, husband and w ife 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 Ogland _ F AR VlEUIC Hudson, WI 54016 Notary Public, State of Publi -- - - - - -- - -- - —_- -- My Commission is permanent. arnnt sRAW6 te: - - (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, wl STATE BAR OF WISCONSIN 800. 655 -2021 WARRANTY DEED FORM No. 2 -1999 I N N ) p w O O C 1 O / / SO. FT. A.P. 2.53 AC. ... sg0•op`oo •- 15 , -- -' / f - - - uT /L /TY J s►S � - C Po cn EASEMENT I _ p0 a 4723 i u i p , N 9 N o o ;UTILITY �. 104,216 SO may, \` ` I 100 EASEME �� t te a+., 2.39 AC. n A.P. I o / ,' O -� N ` cP. n \ S �i 5,975 SO. FT. �,�: 00 ; \ A.P /.74 AC. `��, loo' /� O I� _.. O // C � �t� 88, 442 SO. f . AC. 2.03 ♦ �` 7 .P /' \ ♦ d ,485 SO. fT. �, _ ► I o \ S A .P. , - -- o y \� S.86 001'45 01W. 568.08 / ♦� urlurr / \ \ EASEMENT l \ j , 2 ♦� \� UNPLA T TED LANDS l 3 _ i � \ � B Y OTHERS /0 P. 2950 \ \ \ BENCH MARK —�Wl F COMC. LOT / \ \ - EL.= 984.61 — �gl 78 h2� 111.6c -- - - - - -- 1117.59 - - -r7 .189.8 8 H „ S. 89°29 5 o / S.89 29 58 W. 1307.41 , NPLA T TED LANDS BY OTHERS