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HomeMy WebLinkAbout038-1205-20-000 c ° 2 2 T 7! V g CD � § F � 0 7ƒƒ o ° t 0 \ S co E ± a ;« i, 7- 2 o \ } CD § / \ § / E ; i k -n � ) 3 0 ° I (A § § 0 7 E c © ± a © 5 E \ E § e ,= 2. . E a p >� 3 o f � � $ D C »ƒ § 2' / \ § 40 0 2 E # ~ � k k 0 0 0$ ■. 2 0 o 000- �. § § § -; < � -0 \ R ■ @ U % G 91 Ir3 o ( ) / k k f \ < 9 § ' E $ _2 ± i / k ƒ E \ \ { @ ! . � . ƒ f CO) A \ f � � X � CL 9 ƒ ■ M i q # E § $ z § r ; § 2 / z CD » , �w=c> CD la f = 5 0, E ; CD CD F /fj \ \/ . ,ƒi±= :0 D 6- � ,- kg\f» � 0 - :3 i ® g =W] �Eo =r \ 02 * . n§Ec ƒ \�J ON CA ■ . g $ 2 ° ! 2 e o w § \ \ - I Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division - INSPECTION REPORT Sanitary Permit No: 1 420479 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: Johnson, Foy Star Prairie Township 038- 1205 - 20-000 CST BM Elev: r Insp. BM Elev: J B !!,( � W ion: tc�.a a),O eo(_ Na = Gsrs TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing w Alt. BM 3 V. T l r Aeration Bldg. Sewer `L.3 La Holding St/Ht Inlet l0• IB qf0• , TANK SETBACK INFORMATION St/Ht Outlet T ZG. 96 • YS TANK TO P/L WELL BLDG. Vent to Air Intake ROAD V >w * Z �• 3 Z ' 91:•39 Septic > �� ZD t - S * � �••b g ! b • 0 3 Dosing l S , `' 2 — eader /Man. .9 9 . 3-6 Aeration 4 •'{ Holding PUMP /SIPHON INFORMATION Final Grade - Manufacturer Demand St Cover PM 3• . S Model Numb TDH Lift Fria ss System Head TDH Ft F emain Length IDia. Pi r II y � r SOIL ABSORPTION SYSTEM Z t Z l 1 j S - BED /TRENCH Width LengttL No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 t Y �te i SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manuf cur ,[f INFORMATION CHAMBER OR M; l — J�t� I Type Of System: (O I -, ' � UNIT Model Number: H DISTRIBUTION SYSTEM • L, Header /Manifold Distribution x Hole Size x Hole Spacin Vent to Air Intake •Cc fill Pi S) �Q 1 Length L � eng a l SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded 1 xx Mulched Bed /Trench Center Bed/Trench Ed es To soil g p Yes ] No L] Yes 'ij No COM N S: Inc] de q repenc pers etc. Inspection #1: L L / Z40 l a inspection #2: Locitilori: 1289 217th Avenue_ t, WI 54025 (SE 1/4 NE 1/4 14 R18W) Prairie V' w Estates L 1 4 � 3 Q�,.. 1.) Alt BM Description = '�e!►� vt `� co —z b �awGt , �".� C•~ ^ 1 S §a(�iT•"""" 2.) Bldg sewer length = Ir r amount of cover = ,L -7 " 4 S &• ` s AIft GSRr -7 pia = 9f• 43 t• �E 9�F Plan revision Required? Yes No 20 0Z_ Use other side for additional information. j -- L — — Date f lnse�p ignat re Cert. No. SBD -6710 (R.3/97) d* !� 1W _ L a r Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 N 46consin Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Commerce p (Submit completed form to county if not [Privacy Law, s. 15.04(1)(m)] � � ,��/ p_ Z 7 state owned. ) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size. County I State S hazy P rmi Num er ❑ Check if revision to�rm i State Plan I. D. Number ,{ 1 7 ., f s.ra I. Application Information - Please Print all Information Location: 0 2 / Prope Owner Name / Property Location / Prop? Owner's Mailing Address Lot u Block Number Z-1 a 5 r City, fate Zip Code Pho a umber ion Name or CSM Number Z1 J4 II. Typoolof Building: (check one) r .P�i ❑ City Esj�l - 7� I or 2 Family Dwelling - No. of Bedrooms: S— ❑ Village ublic /Commercial (describe use):_ 3 r 7 / t y �O grown of ❑ State -Owned 3 3 -f '� �e G _. -tf r 2 �J�IC r C_ /�� �, ry Nearest Road L L GhGc d •e j�l�� �f Z !/ Parcel Tax Number(s) — / , III. Ty a of P mit: (Check only one box on line A. Check box on line B if applicable) A) 1. J C&New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System $) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) Y �on- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wand ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line _ �� / �f j ❑ At -grade 11 Aerobic Treatment Unit ❑ Recirculating ❑ Othe . V. Dispersal/Treatinp e Area I nformation: I. Design Flow (gpd) v 1 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed /0�9 Rate (Gals. /day /sq. ft.) (Min. /inch) �� _ = 13;y. Elevation 7 �� G71 /� l/ / , ' - VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks VIII. Responsibility Statement I, the undersign assume re sponsibility for installation of the POWTS shown on the attached plans. Plumbe Name (print) Plumber's S' lure (no stamps : MP/MPRS No. Business Phone Number / Plu �s Address (Street, City, State, Zip Code) ;a �'�� d / & IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Is sued ssuing Ag t Signature tamps) Approved ❑ Owner Given Initial Adverse Surcharge Fee) C/U (�� Determinatio X. Conditions of Approval /Reasons for Disapproval: SBD -6398 (R 07/00) PLOT PLAN PROJFCT Fov Johnson ADDRESS 440 Lomesome Deer Ct_ Lonaview Tx 7 5604 SE 1/4 NE 1/4S 14 /T 31 N/R 18 W TOWN StarPrairie COUNTY ST. CROIX 10 -8 -02 BEDROOM 5 MPRS Byron Bird Jr. 2205 DATE CONVENTIONAL XXXX -Grade / CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 &800 gal ✓ LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE O LOAD RATE •7 ABSORPTION AREA 1071 # of chambers 35 BENCHMARK V.R.P. top of I' pvc pipe ASSUME ELEVATION 100' ❑ BOREHOLE (DWELL *H.R.P. same as Brn A Vent SYSTEM ELEVATION T -1 =94.8 T -2 =94.4 f�. 3 �y e l2" Sidewinder High Capacity Leaching Chamber with -7�� b 6 °° t "2 per chamber 34 „ (� Long Elevation 100' alt B 30' 10 30' PL > 100' B2 90' B 99' 98' 100' 75' 541 B 4 o ipe Barn 1' 4 Co C 10' t B1 0 ' Driveway 1 ' e Garage PLOT PLAN PROJECT Fov Johnson ADDRESS 4402 Lomesome Deer Ct_ Lonoview Tx 75604 SE 1/4 NE 1/4S 14 /T 31 N/R 18 W TOWN StarPrairie COUNTY ST. CROIX MPRS Byron Bird Jr. 2205 DATE 10 -8 -02 BEDROOM 5 CONVENTIONAL XXXX -Grade CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 &800 gal /LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE a LOAD RATE .7 ABSORPTION AREA 1071 # of chambers 35 BENCHMARK V.R.P. top of I pvc pipe ASSUME ELEVATION 100' L.J BOREHOLE O WELL *H.R.P. same as Bm A Vent SYSTEM ELEVATION T -1 =94.8 T -2 =94.4 a T' Sidewinder High Capacity Leachin Chamber with,11. 6 91 t ^2 per chamber Lon 34 v Long Flevation 100' alt B1V# 30' 1 0 30' PL > 100' B2 90' B 99' 98' 100' 75' 541' B 4 o ipe Barn 1 ' 4 Co C lo' t Bl 0' Driveway 1 ' Garage Garage i Wisconsin Department of Commerce SOIL EVALUATION REPORT Page / of Division of Safety and Buildings " T� in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County - r include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 1 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. i we y Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner —�^ Property Locati R �> tj Govt. Lot 1/4 01/4 S T �� N R E Property Owner's ailing Address Lot # Block # Subd. Name or CS # Cit State Zip Code Phone Number ❑ City E, Village Town Nearest Road v` d y► f�/ � 7.5 O (`1J �1 '5 -0 7tar New Construction Use: Residential / Number of bedrooms e i'ef design fl w rate �� GPD ❑ Replacement Public or commercial - Describe: Parent material 4 Floo , VI;in kle�ati4 ppli le ft. General comments U and recommendations: / Boring # ❑ Boring �J 0 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 /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 �l 0 0 zezz ® Boring # ❑ Boring 3 Rpit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 la o G l /.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 CST Name se Print) Signature CST Number Address y/ DatWEvaluation Conducted Telephone Number SBD -8330 (R07 /00) Property Owner o ��� d Parcel ID # Page 2 of Boring # ❑ oring GG�� y �/ Pit Ground surface elev. 14 ft. Depth to limiting factor 7/o J in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 l -/ �-f D - j 6 W J 1 r F-1 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 /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # ❑ ❑ Pit Boring Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft 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) I Soil Test Plot Plan Project Name Foy Johnson Byron ird Jr. Address 4402 Lomesome Deer Ct. Longview Tx. 75604 CSA4 #220527 Lot 1 Subdivision Date 10/10/2002 County CROIX S E 1 /4NE 1/4S14 T 3 1 N /R W Townshi St arPrairie Boring Q Well PL Property Line# Alt. BM ec&� ,BM or VRP Assume Elevation 100 10 of I' white stake System Elv. T- 1= 94.8T -2 =94.4 H.R.P. same as Bm T 5 -Al, 0 100' alt BIV#0 30' 1 30' PL > 100' B2 90' 99 , % 9 B 100' 45' 541' Taft Barn 1' Co C B1 0' Driveway Garage Garage 127th ave 410' POWTS OWNER'S MANUAL & MANAGEMENT PLAN - Page / of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity gal ❑ NA Permit # L 121 Septic Tank Manufacturer ,ems ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms �� ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity a l ❑ NA Estimated flow (average) J-72 gal/day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) al /da Pump Manufacturer ❑ NA Soil Application Rate al /da /ft2 Pump Model ❑ NA Standard Influent /Effluent Quality Monthly average" Pretreatment Unit ❑ NA 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' A ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfU /100m1 ❑ 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: ❑ mo this (Maximum 3 years) NA ar(s) ( —_ — Pump out contents of tank(s) When combined sludge a scum equals one -third (Y o tan volume ❑ NA Inspect dispersal cell(s) At least once every: p month (Maximum 3 years) 13 NA Clean effluent filter / j5n t least once every: ❑ mo sl ❑ NA ar(s) ❑ month(s) ❑ NA Inspect pump, pump controls & alarm At least once every: ❑ year(s) Flush laterals and pressure test At least once every: ❑ O year(s) ) m r( [3 NA ) ❑ month(s) Other: At least once every: ❑ year(s) ❑ NA Other: ❑ NA 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 tanks) 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(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 l;� 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 phemicals 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 ceills) 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 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 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 lie "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. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with 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 replacement system: • A suitable replacement area has been evaluated and may .be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot 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 valuation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the .blomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < < WARNING > > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT.- RESCUE OR 'A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name o all Phone Phone 4 1 $' SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name „ 6'f Name '5y. z"- �r < Phone Phone 6 This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. ST CROI K COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer J Mailing Address t'9 / o Property Address 1: � a e7vt6 (Verification required from Planning artment for new construction) N ul �g eP City /State Parcel Identification Number 2 LEGAL DESCRIPTION Property Location %., ' /a, Sec. TN -R1.� W, Town of Subdivision I �l 1 �� �GtJ �ST� -S Lot #. Certified Survey Map # _ fc L/ 5 - 5 - — , Volume Li , Page # 56 7e Warranty Deed # , Volume , Page # Spec house ❑ yes J4 no Lot lines identifiable jXyes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of 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. owner a to submit to St. Croix z o ning ent a certification form, signed by the owner and by a The �g Department P�rh' � masterplumber, joumeymanplumber, restnetedplumber or a licensed pumper verifying that (1) the On 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 expiration date. SIGNA APPLICANT DATE OWNER CERTIFICATION to the best of m our I (we) certify that all statements on this form are true Y (our) knowledge. I (we) am (are) the owner(s) of the P ro pertY described above, by warrant virtue of a deed recorded in Register of Deeds Office. h' SIGN PLICANT DATE Z * * * * ** * * * * ** Any information that is mis- represented may result in the sanitary permit being rev oked by the Wing De P artment. •* 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 v 2 08 P 005 kk STATE BAR OF WISCONSIN FORM 2 - 1999 6 9 a - 7 2 6 WARRANTY DEED KATHLEEN H. WALSH Document Number REGISTER OF DEEDS ST. CROIX Co., WI t This Deed, made between EWLEN Properties, Ltd., a Texas f PECEI ED FOR RECORD Limited Partnership, 11 Z 10 -11 2002 9 :30 AN 0 42 RW TY DEED Grantor, and Foy E. W. Johnson and Helen L. Johnson c' , ;�: FFur,�� XE�T 15 F E: 11.00 TRA FEE: COPY FEE: Grantee. CERT COPY PEE: 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 SLot airie View Estates, Town of Star Prairie, St. Croix County, Name and Return ss sin. �D r1C�. �l I � 11 - 1 115� Sfi Parcel Identification Number (PIN) This is not homestead property. 04) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of October 2002 EW Pro roes td. C * * By Paul Anderson, Manager EWLEN Asset Management, AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF N= TEXAS) 8 ) ss. ekOLA— County ) authenticated this day of q Personally came before me this L T day of October , 2002 the above named Ewlen Properties, Ltd., a Texas Limited Partnership, by _ EWLEN Asset Management, LL TITLE: MEMBER STATE BAR OF WISCONSIN N (If not, to me known to be the person( ul10the 1e tltll f T xas instrument and acknowledged t MM Comm 1on ks authorized by § 706.06, Wis. Stets.) n Atgwt 23, 2006 WM Noisome, THIS INSTRUMENT WAS DRAFTED BY * '- Attorney Kristine Ogland Notary Public, State of VE&IT LYsBrjC Texas Hudson, WI 54016 My C mmission 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 company. Farad du Lec, N STATE BAR OF WISCONSIN 900.655.2021 WARRANTY DEED FORM No. 2 - 1999 H .W.1+ Hi gh W oter une W I F.F.E. F1nlxhed Floor Elevation V •' NO TH�. ,t r VARIABLE 907H R -O-W a.~ � �S FAR FUTURE 720WN ROAD In ON 14 Ex7ENS/LW ro MAR w v A S8M 410.81' �----` — — --- --- JQ3.7r— ---- T 1 e. 84' G 12' V MJTr CAMUEA r I �V T,J) � c o � I 100' BOIL DINC SETBACK ,... .... ............ ....... n ( I D &n I O0 2 I z g 2 - 40'W 11 ,72' g ( J ' 'H. W. E. Q 3,95 4 g 209,914 M FT, °o 'n 4.80 A CRrS Al" o I l o O in MMctland Ln •�: CSU lorI IN C£ E9/T. KYtAI/i`' 1.0 PWOF .WIV �I u ua';7 �e^c UOC.rAE7VT AR1 QgIS" O Ln v w I C) 0 I S89'42 '40 OW 11.16' 0 � i` N89 450.42' to § \-� v _ 3 - o w• > �S a o cx rrFn LANDS ON N • O� o N89'01'50`W 450.42' I ° Uly 77.7 31a05 6 W U• I CC,• I� Parcel #: 038 - 1205 -20 -000 06/09/2006 09:03 AM PAGE 1 OF 1 Alt. Parcel #: 14.31.18.1097 038 - TOWN OF STAR PRAIRIE Current X] ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - JOHNSON, FOY E W & HELEN L FOY E W & HELEN L JOHNSON C - GRAHAM SARAH GRAHAM SARAH 4402 LONESOME DEER CT LONGVIEW TX 75604 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description * 1289 217TH AVE SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 4.800 Plat: 2351 - PRAIRIE VIEW ESTATES 038/01 SEC 14 T31 N R18W SE NE LOT 2 PRAIRIE Block/Condo Bldg: LOT 02 VIEW ESTATES Tract(s): (Sec- Twn -Rng 401/4 1601/4) 14- 31N -18W SE NE Notes: Parcel History: Date Doc # Vol /Page Type 10/11/2002 693726 2008/05 WD 11/0511999 613378 1468/556 WD 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/13/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.800 48,000 339,600 387,600 NO Totals for 2006: General Property 4.800 48,000 339,600 387,600 Woodland 0.000 0 0 Totals for 2005: General Property 4.800 48,000 339,600 387,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 • ............. Building Setback Line (As noted) — — — Proposed Centerline Driveway w — — — Drainage Easement t0 12' Utility Easement, Typical I O j ZS 20O Lli, Wetland M r RONALD F. H.W.E. High Water Elevation r JOHNSON >lh -11N H.W.L. High Water Line AMERY, IN. F.F.E. Finished Floor Elevation W19 C.S.M. Certified Survey Map `' ~� aui Q THIS INSTRUMENT DRAFTED Ty R. DODGE I UOI BY N0 TH 3; i BENCH MARKS: All elevations shown are TOP OF IRON PIPE unless indicated otherwise. O I w1 Elevations of Top of Iron Pipe shown as: 900.00 I I I v� o. I U I al I I QI 1 VAR /ABLE MIDTH 601.68' 57.00 I of N89'01'50 "W 410.43' ' M O I � -- -i - - -- 393.77'- - - - - -- _ � O I 1 ILU I $ I 00 ' m I of I I I N� . .....M ............... I.............................. oo ( O I N M se W •�' O W I 3 i O �1 Co i UI O 81, 775 SO. FT. I i� W I Q' A CRES 2 1. ( wl 88 S C E o _ Z 1 o � I I , N I a, SSO a4 W 2 S89 "W 19.72�� , V p ( � " 5 3�i .. R 339.50' •,N i I 1 .p1 s6?. � 208, 914 SO. FT. (� 01 H. W.E. =385.4 4.80 ACRES I Q i l 0 �, 1 r I ; l o 1 a{1. I i (0 o v= Wetland o ( O I O � 1 C S AI LOT 1 � U 1 1 1 I 4 y WLUMF 14 PAGE 3870 ---- f00 - -- I N Q1 1 1 L SB81123 . 16 _ . —__ - - - - -- : I l 7,615 SO. FT. W 55 ACRES ,° a I *0 Q F.E. =389.4 ^ F (l to '" I to N89 . 01'50 "W 277.77' :3 S89 42 40 W 11.16 j 0 , N ja o S00'17'20 "E 14.9 - - -70 -- •°0 386.73' ( 63.69 3 I N89 "01'50 "W 450.42' ° I - o 1 3 (� o 1 I 5 � o I IiZ o I_ 76, 767 SO. FT. N 3Q o O 0 06 UNPLA TTED LANDS I I 1.76 ACRES 0 N V F - I I �1 1 . NI Wigconsji Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 ' ;�abo( and Hlrman Relations Dission of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. Croix not limited to vertical and horizontal reference point (BM}; direadorr/aad % of slope, scale or PARC dimensioned, north arrow, and location and distance to nearest road/ jam. 038- 1057 -60 -000 YV- APPLICANT INFORMATION- PLEASE PJ'lNT ALL INFRMAT.ON REVI ATE I Pte.. •,. PROPERTY OWNER: P , PERTY LOCATION New Richmond Church of Chz ist 0 LOT SE 1/4 NE 1/4,S14 T 31 N,R 18 �(or) W PROPERTY OWNERS MAILING ADDRESS ` ' ° "' LOT # BLOCK # D. NA OR CSM # box 65 r, 1 na csm CITY, STATE ZIP CODE PHONE NUM 81E E �, Y [:]VILLAGE NEAREST ROAD New Richmond, WI., 54017 /715)246`- 7F Star Prarie Ct . "C" *:4 New Construction Use[ ] Residential / Number of be [ ] Addition to existing building j J Replacement [x Public or commercial describe church -150 parishioners -1 employee -2 floor drains Code derived daily flow 1245 gpd Recommended design loading rate .7 bed, gpd /ft .8 trench, gpd /ft Absorption area required 1778 bed, ft 1556 trench, ft Maximum design loading rate .7 bed, gpd /ft .8 trench, gpd /ft Recommended infiltration surface elevation(s) 97`:80 - 4096. ft (as referred to site plan benchmark) Additional design / site considerations _ Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ®S ❑U ®S ❑U ®S ❑U ®S ❑U ®S ❑U ❑S au SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft Boring # Horizon in. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. Bed Trer& 1 0 - 13 10yr3 /3 none 1 2msbk mfr yw 2f .5 .6 2 13 -31 7.5yr4/4 none scl 2msbk mfr gw if .4 .5 Ground 3 31 -12 7.5yr4 ?6 none ms Osg ml na na .7 { .8 elev. 1 Depth to limiting factor +120" Remarks: Boring # 1 0 -15 10yr3 /3 none 1 2msbk mfr gw 2f 1 .5 2 2 15 -31 10yr4 /4 none sicl 2msbk mfr gw if .4 .5 3 31 -42 7.5yr4/4 none is Osg mvfr gw if .7 .8 Ground elev. 4 42 -12 7.5yr4/6 none co s Osg ml na na .7 .8 10 ft. Depth to limiting factor + 120° Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715 -246 -6200 Address: 1554 200th. A New Richmond W1 54017 Signature: y® Date: 4 -11 -2000 CST Number: m02298 PROPERTYOWNER N.R. Church of Chris SOIL DESCRIPTION REPORT Page �f• PARCEL I.D. # 038 - 1057 -60 -000 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0 -10 10yr4 /3 none 1 2msbk mfr gw 2f .5 .6 2 10 -25 7.5yr4/4 none scl 2msbk mfr gw if .4 .5 Ground 3 25-100 7.5yr4/4 none co s Osg ml na na .7 .8 elev. 10 ft. Depth to limiting factor + 100" Remarks: Boring # 1 0 -16 10yr4 /3 none sl 2msbk mfr gw 2f .5 .6 >» 4 > > 2 16 -27 10yr4 /4 none scl 2msbk mfr gw if .4 .5 3 27 -10 7.5yr4/6 none co s Osg ml na na .7 .8 Ground elev. 99.7 ft. — Depth to - limiting factor +100 Remarks: Boring # 1 0 -20 10yr3 /3 none 1 2msbk mfr gw 2f .5 .6 >' 5 2 20 -41 10yr4 /4 none sicl 2msbk mfr gw if .4 .5 3 41-100 7.5yr4/4 none ms Osg ml na na .7 .8 Ground elev. 1 Depth to limiting factor Remarks: Boring # Ground elev. j ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) r J 4 , ' V V STEEL'S SOIL SERVICE Gary L. Steel New Richmond Church of Christ 1554 200th Ave. CSTM2298 SE4NE4 S14- T31N -R18w New Richmond, WI 54017 MPRSW -3254 town of Star Prarie (715) 246 -6200 lot #1 -csm N 1 =40' BM.= top of NE lot stake C el. 100.00' Alt. BM.= top of 1 pvc pipe C el. 103.55 g4 / 6� PRE J Hwy \ t ^ 142 Zo � D 8 �. JL �S C4 Gary L. Steel 4 -11 -2000 JOHNSON JUL 2 6 FILED s -11sa AMER Ot ' JUN 0 8 2000 �► q Wt OF JUN ST. CRI COUNTY KATHLEEN H.WALSH dr " ",.�+ �O �� Registar of Deeds SURVEYOR'S RECORD k, SL Croix Co, W1 </ %�:R�'�ERTIFIED SURVEY MAP Located in part of the Southeast Quarter of the Northeast Quarter of Section 14, Township 31 North, 4. .�'" Range 18 West, Town of Star Prairie, St. Croix County, Wisconsin. Prepared for and at the request of: OWNER: NORTHEAST CORNER Ewlen Properties LTD SECTION 14— ,31 -18 700 N. St Mary's Ste (ALUM. CO. MON.) San Antonio, TX 78205 -3501 . (a Drafted by. Ty R. Dodge r I M r UNPLATTED LANDS 3 • — NORTH LINE OF THE SE 114 OF THE NE 1/4 I = — I — — .. — .. .. I I b UN PL A TTED LAND _OF_O o S89'01'50 'E 450.42' I N 393.77' 56.65 " I OR I I 50- I rnl `° ° I 7n w J U N O L I ""0 LOT 1 '�, ° o 'o� i� c W I O) W O I Z a `°' ° 3I Ln TOTAL AREA: 0 in I I O o �I 244,089 SO. FT. E C) $ OI 5.60 ACRES a , o rn '+,I cMM oN AREA EXC. R —O —W: z NN ° E c 3 zl w 208,914 SO. FT. \ 2 NN .� ° -1 g 4.80 ACRES v u o c a, o 0 3 .4 a�;, • I P OO a� a Q di 0 J, dv ?I O O Z o . O \ c ` a� t O U, = N Q 2 C U c 3I Q rn o = O 7 N O R I Z VI a 0 oI OR L O Vl O m � O Or o ~ i o vi u ^� N89'42'40 "E to lV V ° oaz 2: 1 ; 11.16. ^ Z n ai a 386.73' U w c oQ x N89'01'50 'W 450.42' W H 3 ° t -60'-- cnl z r 2 6) I UNPLATTED LANDS VOLUME 1158 PAGE 257 m I zzl a l -- 60' - -- o —' LEGEND Section Corner Monument ( I al of Record w -I • Set 1" x 24" Iron Pipe weighing ° mot z a minimum of 1.68 pounds per o 1 I i� linear foot. P / 0 R= Recorded As C -Building Setback Line (100' from R.O.W.) NO TH EAST 114 CORNER AP 6VED SECT /ON 14 -31 -1B (ALUM. CO. MOM) T C X COUNTY Planning oni an JOB #A00039 d Parks Committee Prepared by 100 0 100 JUN O 200 _ A & E , LAND SURVEYING do CIVIL ENGINEERING GRAPHIC SCALE Phone No. (715) 246 -4319 SCALE IN FEET: 1 inch = 100 feet If not recorded within 30 days of 109 East Third Street, P.O. Box 325 approval date approval shall be mono New Richmond, WI 54017 BEARINGS ARE REFERENCED TO THE EAST LINE OftfM51void NE 1/4 OF SECTION 14, TOWNSHIP 31 N., RANGE 18 W. Sheet 1 of 2 WHICH IS ASSUMED TO BEAR N00'00'40 "E. 0 Vol 14 Page 3870 t Parcel #: 038 - 1057 -70 -050 06/09/2006 08:44 AM PAGE 1 OF 1 Alt. Parcel #: 14.31.18.247B -10 038 - TOWN OF STAR PRAIRIE Current LX; ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner ERIC R & MARLA R WAHLQUIST O - WAHLQUIST, ERIC R & MARLA R 2160 CTY RD C NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 2160 CTY RD C SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 2.272 Plat: N/A -NOT AVAILABLE SEC 14 T31 R1 8W 2A IN SE NE COM NE COR Block/Condo Bldg: TH WLY TO WEST R/W HWY C, TH SLY ALG R/W 608 FT TO POB: S 208.71 FT, TH WLY Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 417.42 FT, N 208.7 FT TH E 417.42 FT TO 14-31N-18W SE NE POB ALSO COM E1/4 COR SEC 14;TH N 00 DEG E 468.95'POB;TH N 89 DEG W 455.42';TH N more Notes: Parcel History: Date Doc # Vol /Page Type 05/29/2001 646546 1646/633 WD 07/23/1997 1158/257 WD 07/23/1997 1090/627 TI 07/23/1997 541/462 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/13/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.272 33,400 244,000 277,400 NO Totals for 2006: General Property 2.272 33,400 244,000 277,400 Woodland 0.000 0 0 Totals for 2005: General Property 2.272 33,400 244,000 277,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 203 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 DRA /NA"r EASEtIEIVT VOLUME 74 PAGE Ja /U - o I i I L S88172 36 E 162 74', 67, 615 SO, FT. 1 I o v i , CV Q 1.,55 ACRES ° N F. F. E. =389.4 `° I o I i I N IoI S89'42'40 "W 11.16' I p i , C I D I� • N89'01'50 "W 277.77' 3 I N , a • o S00'17'20 "E 14.9 -- -- ° 386.73' 63.69' 3 I N89'01'" ' L 50 W 450.42 ° a g ' I o I'tv • I= 0 76,767 SO. FT N 0 � 0 UNPLA T �t0 N V) log 1.76 ACRES TE LANDS (� , p ON PARCEL IN WARRANTY DEED I o II� N I VOLUME 1158 PAGE 257 i IW - aI III l o l l �\ SHED I Z, e I O I s86-55'26"W S89'01'50 "E 450.42' ( 275.63' 77_78 310.05' 62.59 i I 387.83' • I 3 Ioi I o �I 82,076 SO. FT. ~ I 1.88 ACRES N SHED I In • NOOSE M � I �•� S79- 47' 5 ti 7 f 35 9.96' rn W I 3 I LjI 0 I `w o I v d I N Z 1 I 0 — o> N o �I �� 81, 007 50. Fr. � I o o i 153, 704 SO. FT. I V I 1.86 ACRES s o. N 3.53 ACRES , I I f-I 236.55' 312.64' 60.01 100 0 100 Q. LOT - 1 - I VOL. _5 PAGE 1425 S C7 7CW 1 4ORNE 1 8 � GRAPHIC SCALE - (FOUND ALUM /NUM SCALE IN FEET: 1 inch - 100 feet COUNTY MONUMENT) SHEET 1 OF 2 SHEETS I WEST 114 CORNER SEC. 14 -31 -18 / \ °f m UNPLATTED LANDS (END 1/2' IRON PIPE) 01 N00'00'25 "W 1308.26' - -I, 0'00W' - ' 1 '25 " 1 1 2628.99' 1 I NORTH -SOUTH 114 LINE j \� Ong i I wo a�z Ng i 2 n i a U� Z"oA Z7 0 o a 0 0 > > >• z 2 R'� r m N o f o - 0. fD ysOtlMlPS 2 A > y ° Imo a m 3 Q ® ry ox =m 0 03 <n z 0 0 a 3 :g a7 - 1- O(n0() cOm D D 7 0 ° +[ 3 = Z iq 1 0 Kzl o� n 3 �� .. m �n o tn,2 T 0 ""D ro� (E12 0 r 0. m -N m c m o . m :'z �' = r,-) �1 CL �3 ' o� �` s tn o��� "z s y . Z , a ,a oomnD v s z . ? my �� C �Jja4 a y o r.3 rt m II� N p� o a� ° Q�' u r C, ' ° o D cn o ft v' n Z 'O - O I p m 0 00 m S a c 4.Aa6AaMRWOt� ?AOIJ� �Cnnl , w 3 .w.. sl N 8 N c rt p p O m V mZ m ° f 3 c0 N D rt O N C -1 r N ip' C D - "I v C a 0 M E n Z 1 C) 7 p '0 S �r N a o m N mN a p d I u o to rno m 0 3 y �v p O 10 A p o z I \\ o \ C m I i s �� D N I I V N I I A � s � � F x Z mN Nw Vy+ ^ i A, A N o' o T m 03 W t 4 00 " O1 I A j p OO IZ N m n m n cni'0 0D ONE N m� m � (;� ID �D _ N A N A `C n Z 1 NO2'23'55 "E 492.83' c i 3 x--- X-- X --- x- -X --7� m i> Q �1 N -I I % �c A Ln If�l rt C 1 N 1 m CD ID .iI I I -N 'N m m ° g O I ' x m m 0 , ^I rn a m y k 1 rn_ _ � a w o I a � ,. � A �, p J � I on v 0 I y ti ^ co w ti II I on a O y n Ld a o° ° w BOO �O I A K 2 1 (A ILLI 1 j O S q h I S R C+ T V ti c O 2 O r\ 1 N # V N� A • • G f �p� 2 ")M. 1 + tti o I U I N s a m e I }t O 3 0 ;u v N00'00'40 "E .9 X z v 51—A =5 O 500'00'40 "W / rt m m 01 z i m Io 08.71' z 244 08 SO. FT A rn I� \I > f m�� m 5.60 ACRES j o o . I Q Ig 1r 7c D C O Ir .. IX d ��' Q) �O - P 5 o z o m ...:.:.v - w Im I� IN w AREA EX CC U0__ R. L? W. u, jr �N �... m� z D;�s;; m OI, ID I� N m i� ��� I to m m m z v 1 = 12 o m 2D8, 914 SU FT. i ° o 1 m m z s �: j CJI � I Ir uJ co Z 0 In I ly m D I Imo? Im 1 0 �� W 4. t3D ACRfS On nl I I d O I NN �..o I I Ir= + �J I �O x m IN 1 � f (r D Iii: 1 ID �� I� G);1' LA m W m m:l ..�..;.1 o�m `�Imrn al 4 4 W �p N f o I I 1�., p 1 101 mN o m N N R.O.W.O 1� I' 1 I N °- S00'00_40_W 250.00' i /\ 5001Q_E T 493.95y`_ \ — — — 1 _. y� -76.8 x'60.01 ` ° \�\ 208.71' C\ L2 v VARIABLE 50017'20'E 342.89 R.O. W. o \ ♦'- � 500'00'40 "W�' CENTERLINE _ S00'00'40 "W 493.95' o + ' " S00'0040 W 608.00' o — C.T.H. C -- -------- SOO'00'40 "W 2621.32' - - -- � 2 k a - R= NO'01'18 "E 2621.46' n n y 1 EAST LINE OF THE C LOT 1 C.S_M. NE 114 OF SEC. 14 i n o cw a ----- - - LANDS VOL. _9 PAGE 2460 UNPLATTED LANDS Q ' m LINE I DIRECTION DISTANCE g a I I 1-1 (ROW LOT 1) N89'42'40 "E 11.16' L2 ROW LOT 1 SOO - 20 "E 14.96'