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HomeMy WebLinkAbout038-1196-20-000 Wisconsin Department of G`ommerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT sanitary Permit No: 408276 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: Kopp, Steven I Star Prairie Township 038 - 1196 -20 -000 CST BM Elev: Insp. BM Elev: BM Description: q7- s 1 C'-7, Cam, �E T z" C_ ,- TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic D 0 Benchmark Dosing Alt. BM � Aeration Bldg. Sewer 4s Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Int ROAD Dt Inlet Septic �-7 1 5 f Dt Bottom Dosing Header /Man. b Aeration 1 Dist. Pipe ( -7 Holding Z Holding Bot. System r/g PUMP /SIPHON INFORMATION Final Grade V 3 • 9a. Manufacturer Demand St Cover $ 6 q3 - 3 Model Numb r TDH Lift F ' ion Loss System Head T Ft Force Length D I F SOIL ABSORPTION SYSTEM BED/TRENCH Width-5 4- Length I INo. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS l / p SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHI c r l INFORMATION CHAMBER OR Typ Of System: e - / / 1 ,/, / UNIT M del Number: DISTRIBUTION SYSTEM V Header /Manifold Distribution Hole Size x Hole Spacin Vent to Air Intake J d Pipe(s) ` w � —�— Length Dia Length Dia Spacing x SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only s Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges To No IQ � � ] Yes [ j No � Yes [ COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: l / Zg ,O Z Inspection #2: Location: 1344 216th venue New Rich and WI 54017 SW 1/4 NW 1/413 T31N -R18W Pine Acres L1 Parcel No: 13.31.18.1026 A L xwU-wf 1.) Alt BM Description = Sj C( 2.) Bldg sewer length = 51 ' �n S�tt Il. PA P t of U - amount of cover = > L ` t Use other side for additional information. T Y ! b'v Plan revision Required? �', es o , I i 1 1 SBD -6710 (R.3/97) Date Insepctor Signature Cart. No. Safety and Buildings Division Cry / ,✓ 201 W. Washington Ave., P.O. Box 7162 Wisconsin Madison, WI 53707 - 7162 Site Address ��LL "� De artment of Commerce d/9 8 �--� �-� 3 �X� A-e- - Sanitary Permit Application Sanitary Numba In accord with Comm 83.21, Wn. Adm. Code, personal toformidon you provide p lc if� J 7-6 my be used for Law. s1S. 1 m L Application Information - Please Print All Information - -°' State Plan I.D. Number Al ll� Propert Owner's Name Pared Number 54'0 � q - I3 3�. /S. o 2- Property Owner's Mailing Address Property Location l �j O 21 64A, i 'A U1 T✓ N. E City. State Zip Code Lot J' Block Number Subdt ne CSM Number II. Type of Building (check aft that apply) "� ocity �4 or 2 Family Dwelling - Number of Bedrooms 0 Public/Commercial - Describe Use 0 State Owned 41A, C.vt rr a� - �C (pq r (�t// ZZ Nearest Road III. Type of Permit: (Check only one box on line A (numbering scheme for Internal use). Complete line B if applicable) A. 2 0 Replacement System 3 0 Replacement of 6 0 Addition to For Canty use Task B. 0 Chock if Sanitary Permit Previously Issued Permit Number Date Issued IV. t of Permit: (Check all that apply)(numberiog scheme is for internal use) -Pressurized In-Ground 210 Mound 47 0 Sand Fitter 50 0 Com�ruc Weiland 22 0 Pressurized In- Ground 41 0 Bolding Tank 48 0 Siogie Pass 510 Drip Line 45 0 At -Grade 46 0 Aerobic Treatment unit 49 0 Recitmuting 30 0 Other V. Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate Find Grade Proposed ✓ Rate(CWs.Msys/Sq.Ft.) (MinAuch) Elevation 3 7 X VI. Tank Info Capacity in Total Number bttun�aruer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Coated Glass t New xhliea t'VI; A'e / � // A Tads Tanks Septic aUZI& - Doaft Cb=*er VII. Respous&ffify Statmnent- i, the rrsponotility for man of the POWTS shown on the attached plans. PlurnWs Name (Print) PLtmber• MPIMPM Number Btuinese Phone Number Phmobees Address (Saul, C*. VIII. use onkr 0 1 Apprnved 0 Disapproved Permit Fee (includes Groundwater Date Issued ent Signature (N Stamps) Surcharge Fee) v 0 Owner Given Initial Adverse ;j Determination (J EL Conditions of A p r � L ovW Reaso for Attach oomplde Piano (m the ref a*) for dw aptac an papa cot lea than am x u hickes to SBD -6398 (R. 05101) I Soil T t d System PLOT PLAN PROJECT Steve K000 A S 1310 216th Ave New Richmond Wi 54017 1/4 NW 1/4S 13 /T 31 N/ 1 W T WN Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 8/30/02 BEDROOM 3 CONVENTIONAL XXX IN -GROU RESSURE / CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons /LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chamb s 22 BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' F'ilt Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 88.4/88.2 Vent >6 „ Standard Infiltrator of Cover , g Prop Leachin Chamber Line with 31.1 ft2 of Area Alternate Benchmark is 6' Long 12 15 Top of 2" Pipe @ 97.5' 34 11 Grade at System Elevation B.M. * Alt. B.M. Plans Designed Using B -2 Vents Conventional Powts <> 25' Manual Version 2.0 Im — 2 -3' X 69' Cells with >3' Spacing 5 l 70, 3 pp -� ° ICU �v B- 10,0 Vents CS ' ✓y'-'" r � a� Pro 3 Bedroom House I co 216th Ave 160' Property Line Wisconsin Department of Commerce SOIL EVALUATION REPORT Page--/ of 'y Division of Safety and Buildings in accordance with Comm 85. Wis. Adm. Code Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must ` ;X- include. but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope. scale or dimensions, rxxth arrow. and location and distanctc t road. / 3. ! ff. l0 Please print all in �T ' Y :. a evi by oats PersanM Wknnabon you provide may be used for (Privacy law, s. 15.01(1) G2i� Property rty tion <�f(42� � � Govt. Lot 1/4 /4 S T N R E( w Property owner's Mailing Addre B # Subd me . Na or C," 6 14 City State Zip Code Phone i t y ❑ Village j2Mwn Nearest Road Construction Use�tesidentmd / Number of bedroom Code derived design flow rate 11", _0 GPD ❑ Replacement ❑ Publi; esmmeroial - Describe: - -_- _ —,- Parent material Y- - Flood Plain elevation if applicable /'�/ , -- R General comments <4 SBA— /-t r�r� ✓� O't• and reoarrnendations: � 7 1� f Boring it Ground surface elev. ) � ft. Depth to NrN6ng factor /� a in. Sod Alopkadon Rate Mail= Depth Dorrtinmlt Color Redox Description Texture Structure Consistence Boundary Roots G PDff in. Mused Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 1 •002 Ac Vi6 ® Borir>g # O ( Boring '8 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. Mused Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 Z • Eftkuent #1 = BOD > 30 < 220 nv& and TSS >30 < 1 • Effluent #2 = BOD 1 30 mg& and TTS 30 mglL /7 ire Address Date Evaluation Conducted Teleptione Number IL11 Property Owner Parcel ID # Page of Boring # Ong it Ground surface elev. ft. Depth to Bruiting factor I in. SoN Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPM in. Munsell Qu. Sz Cont. Color Gr. Sz- Sh. 'Eff#1 'Eff#2 11 l 31 z. .1 / S Mz ❑ # ° Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. SW — Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 F-1 # Boring 3 ° Wn9 ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Sal ication Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •EffW1 'Etf#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mgA- ' Effluent #2 = BOD < 30 mg& and TSS < 30 mg1L 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 fonnat, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. s604330(IL6=) 201 W�waanP.O. Box 7162 N VIs co ns G Mme. WI 53707 - 7162 Sue Add Depar tment of Comelefes Sanitary Permit Application Saub`'' Plermit Number In accord wbh Comm 83.21. Wis. Adm. code. personal information you provide ❑ Check if Revision way be 129011 for 90001111817 PWWM PdVW Law sl . L Appficatim DMWF OM — Plem Print AR hdx=ation ® State Man I.D. Namrber Farrel Number Property : Q U l� L 2 3 2002 8 — 114(0 — 20 , Pc+opartjrOwnar'sI►tailmgAddmas ST. CROIX COUNTY Location ZONAG OFFICE l / / / 3 / 'li : SJ T N R E City. state Zip Code Pbone Number Lot Numfw Block Number Name CSM Number l or 2 Esamf�y Dwelimg — xoa of Bedrooms DVMP ❑ - Describe use lffw Sate owned Nearest (2 V ' Fr cis ©(`/ HL Type of Pau t: (Check and one boat an fine A Oumt mft scheme for ill use). Complete One B if appBCabk A. 6 ❑ Replacement System 3 ❑ R of 6 ❑ Addition to For County we Tank B. ❑ L'Leck if Stcaiary Pkxmk Previm * Issued Pausuk Number Date Issued IV ; of Pernft (CbKk all mat apply)(,t®bu�g scbenee is for Wand me) k --((n.1 Non —Pressurized fit-Ground li 11 oa ald a7 Sod lamer so ❑ ca wanted 22 ❑ Psessurl ed h Ground 41 ❑ HcWffng Tank 48 ❑ Single Pass s1 ❑ Drip Line L � 49 ❑ 30 ❑ 45 ❑ At -Goode 46 ❑ Amble. Treatment IJng xg V. Area Infoamatii Design Flow Wd) Dispersal Ara Dispersal Area soil Peraalasaa Rax Blevation Final Grade Rid Pr 09 Rate(Gals./Daya/Sq Ft.) VL TM* Info Capacity in Total Number M Prefab Site seed I%w Plastic GacU= Gallons of Tanta Concrete Camnacoed (Baas New Bdsft Tub Boats septic or Badmg Tanti Doft fiber VII, ResponsWRity State 16 the respondipfflty iar tm of the POVM shown an the adtarhed plans. Pbmbefs Naaoe (FrioO / � / Busbiess F1 Number v 1 PSm9nes Address (sweet. City. Sate. W*( ) /X�/ J .� V>II. use only 9 APlxoved ❑ ImaPPtmrod Saustuy Permit Fee 0& udes Gmimawater Date Issued Issu�g Agent a (No Ste) , ❑ Owner Given h>;oal Adverse V1Q Deter EL CondlMdons of T mzl/Re'a�om foF Dssa L AttarII aemptete pUM (M me L dot kit tom SM X u kKkaf to doe PLOT PLAN PROJECT Steve K000 bRESS 1310 216th Ave New Richmond Wi 54017 1/4 NW 1/4S 13 /T 31 18 W TOWN Star Prairie COUNTY ST. CROIX 7/24/02 3 P n Bird M RS Shau d 226900 DATE BEDROOM CONVENTIONAL XXX IN- GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22 BENCHMARK V.R.P. Top of 2 " Pip 12E ia� ,d� ASSUME ELEVATION 100' F 11 r Zabel A -100 0— ❑ BOREHOLE O WELL "H.R.P. Same as Benchmark SYSTEM ELEVATION 99.0 AL Plans Designed Using Conventional Powts jL— Standard Infiltrator Manual Version 2.0 Leaching Chamber with 31.1 ft2 of Area 34 Grade at Syste m Elevation u 2-3'X 69' Cells with >3' Spacing o -Vents 0' 20' Pro 3 T Bedroom B-3 House 0' 60' B -2 30' 15' B -515' B -1 15' Mac 60' Vents B.M. Alt. B.M. 216th Ave 160' Prope Line PLOT PLAN PROJECT Steve K000 ` ;DRESS 1310 216th Ave New Richmond Wi 54017 1/4 NW 1/4S 13 /T 31 18 W TOWN Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 7/24/02 BEDROOM 3 CONVENTIONAL XXX IN-GROUND , PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22 IL BENCHMARK V.R.P. Top of 2" PIP (2, , d' ASSUME ELEVATION loo' Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark �— SYSTEM ELEVATION 99.0 ✓ AL Plans Designed Using Conventional Powts jL Standard Infiltrator Manual Version 2.0 Leaching Chamber with 31.1 ft2 of Area 34 Grade at System Elevation a� 2 -3' X 69' Cells with >3' Spacing o ✓ Vents 0 , 20' pro 3 T Bedroom B -3 House ouse 60' 60' B -2 30' 15' AC B -5 15' 1 -1 15' "' 60' Vents B.M. Alt. B.M. 216th Ave 160' Prope Line r , Wisconsin Deparlment of Commerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County 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 1.D.# L APPLICANT INFORMATION - P/ f*, � ` ation. Pendm Personal information you provide may be used for purposes (Privacy a. 15.04 (1) (m)). 56 viewed By Date . Ofo '7at) Z Property Owner � w Property Location Lake & H ills Develo men '� Govt. Lot 1/4 NW 1/4,S 13 T 31 N,R 18 ❑W❑ Property Owner's Mailing Address - L31 Block # Subd. Name or CSM# d X // 4 �. Ptne Acres City State T Zip _Code Phbr(a er ❑ ge L� own Nearest Road w' - 114 S✓ /d . 216 TH. Ave. ❑ New Construction Use: esidentiat /Number 9 be ooms 3 _]Addition to existing building -- ❑ Replacement ❑ Pu6tisoreorttl► rdi scribe Code Derived daily flow 450 gpd Recommended design loading rate .7 bed, gpd/ft .8 trench, gpd/ftz Absorption area required 643 bed, fF 562 trench, fF Maximum design loading rate 7 bed, gpd/ftz .8 tr ench, gpd/fF Recommended infiltration surface elevation(s) 99.2 ft (as referred to site plan benchmark) Additional design / site considerations t Parent material - - - - -- Flood plain elevation, if applicable ------- -- ft able for system Conventional Mound In - Ground Pressure AT - Grade System in Fill Holding Tank uitable for system ❑ S ❑ U ❑ S ❑ U ® S ❑ U ® S ❑ U ❑ S ® U ❑ S ® U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft Boring# Horizon in Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Bed Trench 1 1 0 -10 10 /3 ----------- -- - - -- I lmsbk mvfr as 2f .4 .5 r� 2 10 -21 10YR4/4 ------------ - - - - -- 1 lmsbk mvfr gw lvf .4 .5 Grm;nd 3 21 -39 10YR4/ Cl lmsb mfr as - - -- 2 3 . Z e1ev - - ----- - - - - -- — 1029 ft. 4 39 -58 7.5YR4/4 ------------ - - - - -- cs osg ml Cw - - -- .7 .8 .+ 5 58 -88 10YR4/6 s osg ml - - -- .7 .8 } Depth to _ ---------- - -- Hmiting f - -- -- - - -- factor > 88 11 .� .� /�'r( OO Remarks: _ 2 1 0 -11 10YR3 /3 -------- - - - - -- 1 lmsbk mvfr as 2f .4 .5 I 2 11 -19 10YR4/4 ------------ - - - - -- 1 lmsbk mvfr gw if 4 .5 Ground 3 19 -40 10YR4/6 ------------------ Cl lmsbk mvfr as - - -- .2 .3 • 2 elev 103.9 ft. 4 40 -60 7.5YR4/6 ------------ - - - - -- Cs osg ml gw - - -- .7 .8 • �- Depth to 5 60 -95 10YR4/6 ------------------ s osg ml - - -- - - -- .7 .8 limiting $ .8 9 •8 factor >95 Remarks: - - -_ -- -- -- — CST Name (Please Print) Signature: Telephone No. Jacque Hawkins .,.. _ V 71 I' /V. Address 7 Date CST Number Ref# 4 ✓ , c' liter,' y ,� 3 4/10/00 404 PROPERTY OWNER: Lakes & Hills Development SOIL DESCRIPTION REPORT Page 2 of PARCEL I.D.# Pending Depth Dominant Color Mottles Structure GPD/ftZ Horizon in Munsell Qu. Sz. Cont Color Texture Gr. Sz. Sh. nsistence Boundary Roots Bed ! Trench 3 1 0 -10 10YR3/3 ------------ - - - - -- 1 lmsbk mvfr as 2f 4 .5 2 10 -21 I0YR4 /3 ------------ - - - - -- I lmsbk mvfr gw lvf 4 .5 .y Ground l - _- efev 3 21 -39 10YR4/6 ------------------ c1 lmsbk mfr as - - -- 2 .3 103.1 4 39 -56 7.5YR4/4 ------------------ cs osg ml cw - - -- 7 8 Depth to 5 56 -88 10YR4 /6 ----------- - - - - -- s osg ml - - -- 7 8 } limiting - factor > 88 „ - -- - - - -- - - - Remarks: 4 1 0 -11 10YR3 /3 ------------ - - - - -- 1 lmsbk mvfr as 2f .4 .5 2 11 -20 10YR4/3 ------------ - - - - -- 1 1 msbk mvfr gw 1 of .4 .5 ` f Ground elev 3 20 -40 10YR4 /4 ----------- - - - - -- cl l msb mfr as - - -- .2 .3 , Z - -- - -- 103.3 4 40 -59 7.5YR4/4 ------------ - - - - -- cs osg ml gw - - -- .7 .8 �- Depth to 5 5 9 -89 10YR4 /6 ------------ - - - - -- s osg ml - - -- - - -- .7 .8 • •} limiting - — factor X89° - - Remarks: 5 1 0 -11 10YR3 /3 - ----------- - - - - -- I lmsbk mvfr as 2f .4 .5 .� 2 11 -23 10YR4 /3 ------------ - - - - -- 1 l msbk mvfr gw l of .4 5 Ground -- - - -- - - - -- - - -- 3 23 -39 10YR4/4 - - cl lmsbk mfr as - - -- 2 3 2 elev --------- - - - - -- - - - -- - - -- -- — -- 102.6 4 39 -56 7.5YR4/4 ------------ - - - - -- cs osg ml cw - - -- 7 8 Depth to 5 56 -83 10YR4 /6 - - - - -- ---- - - - - -- s osg ml - - -- - - -- .7 .8 limiting - - - - - factor X83" - Remarks: - - - -- - -- - - -- — -- - Ground _ _ - -- - -- - - -- -- - - - - -- - - elev ft. Depth to limiting -- - factor Remarks: X31 d �3 o ���U /�d • O i i C� �-� 31 Y Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 Contingency Plan 1. If system fails, determine cause of failure, use alternate area and install new system or install system at a lower elevation. 2. Replace any other failing components as needed. Plumber: Shaun Bird 715 - 246 -4516 St. Croix County Zoning 715 - 386 -4680 Pumper Tom Mondor 715 - 246 -5148 Shaun Bird #226900 ................... ......................... .... ........ .............. - ------ — ......... ----------------------- ST CROIN C"OUNT"i S "PTIC E TAN"K MAINTTENANCE AGF1 AND CAAINERS UP CERTIFTCATIOZl FURNI ..... ..... . � .. ��� �..., _.._ .._ ....� ��',,....'�� �-- . _,_ .... `�,� _� Eck\ �n �� I ------ Prop: Ly (Verffica:ion requirmi fioin Pianning Department for new ('AtYP*tat- 1 Identification Numh� r t, 3 T. la=k N-R\�_,W,Townof Prot',! "n- * S Cerili. iedSuv-'!: Map 4 Volurn"! p4gQ if �;j � alt�'y' y. ?f t ! lu _ �� � � _..... �� :11tlli:: ..�_ ... _.. �'f�f "," kF iouse/- (.'.J' no fx)t lines identifiablic YOS L rio Impreperrite and train cenanceof your septic system could result in its premature iaitureto handle wastes. Prnpervapr.tenancc consiv., of purapi;i: , out thezq! tank every three years or sooner, if needed by a iieensed .% you pui: into tho. system can. al.-tet the I an of the se phe tank as a treatment stage in the waste disposal system. The p:m:!:::-.y owner aj!xees to submit to SL Croix Zonwg Depmtruent a certification form. siF—wd by the, owner...'xod by a master is in c; -)per ig condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than V/3 full W 1 /we, ic undersi �)-A have rest;: the above requirements and agree to maintain the private sewage disposal system with the ; set fori-3, heieik li mt by the Lepartinent of Commerce and the J)epu of Natural Resotuxes,' State of Wisconsin. CerdliCatiOn statitip'that yovr ide system tas been maintained must be completed and reftirned to the St. Croix County Zoning;. Offica-1 30 days o e.hr ec:,- -c irtypirgfic.i datc DATE (wc): that all i ratements on this form are true to the best of my (our) Icnowledze. I ( am ( din, Vj t of the p:r-. . dczsc 6� Izd above, b y virtue of warranty dead recorded tu Register of Deeds- Uffice F) ATE 7AT1 Any ixif �rf:iation that i.; nus-represented may result in the sanitary poxmit being revoked by he Zoning Departmea' liho. ude with 4 h 19 applicati.;m: a stamped warranty deed from the Register of Deeds office a copy of the certified sluvey trap if reference is made W the werxinry deed 00, 0 W ad LL. 10 ol W E' ni so i C7 N 0 I 1 i O I + � 1 ' 1 � I� I� 3 1 6 STATE BAR OF WISCONSIN FORM 2.1999 6 8 3 7 2 4 KATHLEEN H. WALSH WARRANTY DEED Document Number REGISTER OF DEEDS ST. CROIX Co., III This Deed, made between La an d Hills, Inc., a Minnesota RECEIVED FOR RECORD Corporation, _— — — 07 -09 -2002 9:30 AM -- —. - -. —_ WARRANTY DEED Grantor, and Steven F. Kopp EXEMPT t -- - - -� - —. -- . REC FEE: 11.00 - - - - -- —_. TRANS FEE: 83.40 —" —" — COPY FEE: Grantee. -- CERT COPY FEE: Grantor, for a valuable consideration, conveys to Grantee the PAGES: 1 following described real estate in St. Croix _ County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Lot 31 Pine Acres, Town of Star Prairie, St. Croix Courty, Wiscons in in. R ecur A Addrss ---- -� Bremer Bank, NA 532 South Knowles Avenue New Richmond, WI 54017 03 8- 1196 -20 -000 _ Parcel Identification Number (PIN) This is not_ _ homestead property. Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. (E) (is not) Dated this day of J uly 2002 Lakes and Hills, Inc. .. ", s By: Richard S. Nelson, President AUTHENTICATION ACKNOWLEDGMENT Signaturc(s) Lakes and H Inc. by Richard S. N its STATE OF WISCONSIN ) Preside ) ss. -� n County ) authenticated this day of _J 2002 Pcrsonally came before me this __ day of the above named • Kristine Oglan TITLE: MEMBER STATE BAR OF WISCONSIN _ (If not, to me known to be the person(s) who executed the foregoing authorized by § 706.06, W is. Stats.) — instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY Attorney Kristine Ogland Huds o , WI 5401 Notary Public, State of Wisconsin n - _ 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. k4ore stun Prd ss-ws t:ompany, Fora Flu to 4 N7 STATE BAR OF WISCONSIN 800-655-2021 WARRANTY DEED FORM Nu. 2- 1999 I 4.. `' },j '° of 65,340 s ft.. �° 0 3 ro q• 65,381 sq.ft. p N 1.500 acres ^ 1.501 acres N 65,589 sq. ft. 1.51 acres 2 65,458 sq.ft. 0 3 0 3 1.503acres o d► o �' $ �' , w Q:X C8 \\ 200.90' 108.89' NO2 °06'44 "E 309.79' — STREET �4 -- n S02 ° 06'44 "W 309. 79' 9 C41 6 0' _ � _ F 4 C40 w} i 196.14' 11765' q . $� aa03 \ Qf CL o I C' N 3 0 W 29 In I ' N C' q 67 922 s ft. 65,992 sq.ft. 1.51 acres 1.56 acres r , �6 LEGEND: ..� J q w 5 6' I d' • Denotes Count ° 41 n� S0805 b'16' - I1 I Aluminum Cap 58' 31 t.. - - -- 4 o Denotes_ 2 X , Weighing 3.65 . 67.930 sq.ft. PR I W • Denotes 1 Iron 66 1f6 acres II (unless noted IN Denotes Curve f I ° I I - - Denotes drainag �\ 36`.99' so3 °56 12ft. in widtl - 61.54+- w J I I I 9s!\ 177.69' ��' i w Denotes Buildi 5 qA \ \ t �� � ° SSt` I I 67,220 sq. ft �� Ati . " - -,\\ � __ I y 1.54 acres Denotes Total sq. ft. 32 PROPOSED I (rec.) Denotes recorc ,res "' ;.I 67,082 Sq.ft. DRIVEWAY c', I i (meas.) Denotes measL n o N Mi P 1.54 acres ( ' I Vertical Datum is U.S.G. w (X) n I ; All Other Lot Corners A of ,/\ 362.83 r•100 °49' "W I i 1 X 24 Iron Pipe Weic nl 34. ors' ;';' I i Distances are comput( o C o �, �,/ 0.001' and measured n , Angles are computed t I " and measured to th I ri PROPOSED DRIVEWAY QQ '10 i M i ��