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HomeMy WebLinkAbout038-1205-60-000 W �'cunsin Department of Commerce PRIVATE SEWAGE SYSTEM county: St. Croix Sa,ety and Building Division INSPECTION REPORT Sanitary Permit No: 453176 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you providq may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Trout, Russell I Star Prairie Township 038 - 1205 -60 -000 CST BM Elev: Insp. BM Elev: BM Description: T V C �/� Section/Town /Range /Map No: a . 14.31.18.1101 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark C 724 - L >0 SSI� I*Aiwo Dosing _ Alt. BM Aeration Bldg. Sewer 4 • ,/ Holding St/Ht Inlet , St/Ht Outlet �! l TANK SETBACK INFORMATION =zv'� I TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 3 p / / Dt Bottom 3 ' I - Dosing /A,( Header /Man. C •qs 9 oZ / YI 6 Aeration Dist. Pipe Holding Bot. System (� a 'T' PUMP /SIPHON INFORMATION Final Grade 1,36 U Manufacturer Demand St Cover /2-,Q �� , d GPM / Model Number �- 2-D 3 TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. ,� Dist. to Well 1 vt a f i SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMEN NS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 7 T 4z/ Zg SETBACK S YSTEM TO G' / P/L BLDG WELL E /STREAM LEACHING Manufacturer: R_', _/r INFORMATION CHAMBER OR LC Type Of System: / L �? � h d l j yt UNIT Model Number: DISTRIBUTION SYSTEM Sow Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake i 1/ N Pipe(s) Length Dia_ Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of =eded/Sodded 1xx Mulched Bed/Trench Center r Bed/Trench Edges / Ta soil Yes 6,i No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #10 /S /Qqf I "" - - Location: 2159 128th Street Star Prairie, WI 54026 (SE 1/4 NE 1/4 14 T31 RI 8W) Prairie View Estates Lot 6 Parcel No: 14.31.18.1101 1.) Alt BM Description = p) 2.) Bldg sewer length = L1 .� N d�s u� -�QQ� 3ry1 - amount of cover = '7 d�� / 5� vm4t G( Oil o s (-e Plan revision Required? U Yes 2.0 ��� Use other side for additional informati Date �t nsepctor's Signature Ceh. No. SBD -6710 (R.3/97) 7 7 1 1 8 9 U .. 2 6 3 5 P 0 0 1 K ATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO.. MI DOCUMENT NO. QUIT CLAIM DEED RECfiIV® FOR RECORD 00/09/2004 01s30PM QUIT CLAIM DEED Country Livino Builders Inc., a Minnesota Corporation EXOPT # quit- claims to Russell D. Trout and Wendy M. Trout, as husband and REC FEES 11.00 wife the following described real estate in St. Croix_County, TRANS FEES 55.50 State of Wisconsin: RETURN Y FEEs Loberg La 359 West am 1 Ellsworth. WI 54011 Tax Parcel No: 038- 1205 -60 -0000 Lot Six (6), Prairie View Estates in the Town of Star Prairie, St. Croix County, Wisconsin. This is not homestead property. Dated this 28th day of July 2004 COU , NT , PY LIVING BUILDERS INC. (SEAL) (SEAL) a-Ir( G_ L Maus Sec e � AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) )ss. authenticated COUNTY OF ST. CROIX ) this day of 20_ Personally came before me this _28, day of � , 2004, the abov amed f.�G L a- L a l lS TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the persons who executed (If not, authorized by$706.06, the foregoing instrument and acknowledge the Wis. Slats.) se THIS INSTRUMENT WAS DRAFTED BY L I Z2 Ca ac Loberg Law Office Robert L. Loberg Public St.Croix County, Wis. My Commission is permanent (if not, state (Signatures may be authenticated or expiration date: 9 -19 -2004 acknowledged. Both are not necessary) LG r Safety &Buildings Division - Sanitary Permit Applicatipi T, i` �� _ In accord with Comm 83.2 1, Wis. Adm.. Code 201 W. Washington Ave. v See reverse side for instructvins fo= uompleting this application PO Box 7302 CSC S Personal information you provide may be used for s cond 0se � Madison, WI 53707 -7302 a, y pure c Departmennt o rcp [Privacy Law, s. 15.04(1)(m)] ` Subm completed form to county if not 6 . Da 4.S 1 1 state owned.) Attach complete plans (to the county copy only) for the system, on per not; jtes x l l in es in size. County /+ rD / State Sane it Number 13 Check if revision to . Number Al I. Application Information - Please Prin all Information _ Location: / Z2 & J Property Owner Name �g Property L,,oyy�caattion L�1 /4A S� T �,N, IL ( W Property Owner pia ;rig Address]' Lot Number Block Number /av s - �Q City, State Zip ode Phone Number Subdivision Name or CSM Number II. Type of Building: (check one) ❑ City ,, 1 or 2 Family Dwelling - No. of Bedn s : ❑ Village ❑ Public /Commercial (describe use):_ , (P 4 200,A Town of ❑ State -Owned a DU ST: (���rT Wf'r71 � .,.. ., _�) C � .1 b Nearest Road G J 49, © ~�' �� l/ Parcel Tax N er(s) III. Type of Permit: (Check only one box on line A. Check box on line B if-applicable) 1. 2. ❑ Re lacement 3. ❑Replacement of - , / '- 5. 6. ❑Addition to System ystem Tank Only 7� ?A& CCZ OW/U� — ,P_ �C/��' K-C Existing System Permit Number Sanitary Permit was previously issued 7 5 3 6 Q , IV .Type of POWT System: (Check all that apply) ion- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ssurtze n -groun ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aero is Tya4ment Unit �❑ ecir ulating ❑ Other: Aj/ V. Dispersal/Tre tment Area Info ation: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed O / Rate (Gals. /day /sq. ft.) (Min. /inch) rf c 9a_ Elevation Cam✓ fJ � 7 Q l �s — .oz 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 undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (print) Plumber's Si re (no stamps): MP/MPRS No. Business Phone Number t _ _ 10 ry4i 26 Plum er's ddress (Street, City, State, Zip Code) e - fie% IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued suing Agent S gnature ps) pproved ❑ Owner Given Initial Adverse Surcharge Fee) Determination X. itiops of A proval /Reasons for Disapproval: M NE' Adhl d, � u 1 Septic tank, a uenfltlter and C �3 TZ dispersal cell must all be serviced / maintained as per management plan provided by plum 2. A rsut=k requirements must be ma twined as per applicable code /ordinances. SBD -6398 (R. 07/00) (J PLOT PLAN PROJECT E 1 J Ltd. ADDRESS 1430 220th Ave New Richmond Wi 54017 SE 1/4 NE 1 /'4S 14 /T 31 /R 18 W TOWN Star Prairie COUNTY ST. CROIX RS 'It ` ` BEDROOM MMMYYY � 3/29/04 4 di , ,fd'� � ATE CONVENTI(�i�1AL � IN- GROUND�PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1 g allons LIFT TANK SIZE 7�� DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE •7 ABSORPTION AREA 872 # of chamber & BENCHMARK V.R.P. Top of SE lot stake ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark SYSTEM ELEVATION 92.0/91.0 4' below qrade ell is to meet all se backs required by 128th St. W NR Plans Designed Using Conventional Powts 255' Pro Manual Version 2.0 Property bed om Line hou J t Standard Biodiffuser Leaching Chamber with 31.1 ft2 of Area 4 34 Grade at Sys tem Elevation / " 170' Vent 20' 80' 12% B- �e Slope � Ven 31 9 = � 140' 2-3'.X 88' cells with >3' spacing B -3 42' Alt. B.M. Top of 1" pipe @ 92:1' 356' property line B.M. P PLOT PLAN PROJECT EvdawPOMINVus Ltd. ADDRESS 1430 220th Ave New Richmond Wi 54017 SE 1/4 NE 1 /4s 14 /T 31 , . /R 18 W TOWN Star Prairie COUNTY ST. CROIX ,t_ ` ATE 3/29/04 4 M RS �Ii . �Y! �' BEDROOM CONVENTI AL XXX IN- GROUNK RESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 12,Wballons LIFT TANK SIZE ��-� DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 872 # of chamber 6 IL BENCHMARK V.R. Top of SE lot stake ASSUME ELEVATION 100 , Filter Zabel A -100 ❑ BOREHOLE O WELL H.R.P. Same as Benchmark SYSTEM ELEVATION 92.0/91.0 4' below qrade Well is to meet all setbacks required by 128th St. WDNR Plans Designed Using Conventional Powts 255' Pro 4 Manual Version 2.0 Property bedroom Line house Vent 25' >6„ Standard Biodiffuser of Cover Leaching Chamber with 31.1 ft2 of Area 4 6' Long 1 1 " Grade at System Elevation AL )4 " ' 20' 170' Vents 80' 12% B -1 Slope Vents 31' 2 -3' X 88' cells with >3' spacing B -3 140' 42' Alt. B.M. Top of 1" pipe @ 92.1' 356' property line B. M. PA cF PUMP CHAMBER CROSS SECTIOIJ A►JG SPECIFICA'TIMS c k VEAIT CAP i v 4' VEA1T PIPE - fr7 WEATHERPROOF APPROVED LOCKIAIG 25' FROM DOOR, JUMCTIOU BOX MAMHOLE COVER � WINDOW OR FRESH 12 "MILL. AIR IMTAKE GRADE I y.. MIKJ. I COIJDUIT -- - 18 "MIN. ---- - - - - -- INLET PROVIDE I — - -- - T AIRTIGHT SEAL I � / * A I III I I ALARM i I *APPROVED I om JOINTS WITH ELEV. FT. APPROVED PIPE 3' ONTO PUMPS OFF D SOLID SOIL COKICRETE BLOCK , RISER EXIT PERMITTED ONLY IF TANK MAMUFACTURE:R HAS SUCH APPROVAL SEPTIC f SPECIFICATIOUS DOSE TAMKS MAMUFACTURER: � �! S NUMBER OF DOSES: PER DAy TANK SIZE: Ws DOSE VOLUME � GAL} O ALARM MALIUFACTURER: /�t�n ���r INCLUDING 6ACKFLOW: /w - GALLONS MODEL NUMBER: CAPACITIES: A= ¢� IIJC14ES OR 4 1 ea GALLOKIS SWITCH TYPE: G B IMCHES OR _!�44 GALLOKIS PUMP MANUFACTURER: e / �/^ C= IMCHE$ OR — GALLOWS I MODEL NUMBER: /,S o� D= IKICHES OR ./B'y GALLOWS i j SWITCH TYPE :._ MOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE PM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWELU PUMP OFF AND DISTRIBUTIOM PIPE. j✓ F IS + MINIMUM NETWORK SUPPLE PRESSURE . . , , , .. . , 2.5 FEET S> �'�►'h � T ,� , + / 9,0 FEET OF FORCE MAIN X _ - /l/- - GI : � rtFRlCT1oKI FAC'rOR.. -` ± FEET o ply TOTAL OtMAMIC. HEAD = , FEET I� Wj �� INTERNAL. DIMENSIOWS OF TA N K: LENGTH _ ;WIDTH ;LIQUID DEPTH 4<o SIGUE D: LICENSE NUMBER: 2 ,2 0 - 72 " �? - DATE: U�" DYtJ �C` AClr HEAD CAPACITY CURVE ' INOTE 5' : "1 it EFFLUENT D �bEWATE h � S ,, 7 N MODEL 152/153 ^ l 153 I .r M 50 ;Feet Meters ';G Liters' Gal. ! I 153 , >,.,5 �1 > 81` °r ,77r 1 fi 12 40- 10 3.a1: 70.' 65 152 :15 4:'6 4t 61 231 , M �q u: _ 30 r °'25 t �,7,,6;� �F•' g: ; 42; 59 '' �Z 8 .25 22 85 20 r 35 -- H k a.•. ti, 1 11 `12 •1 '2 7� 2t 1 7 T Y 4 gyp, :Lock VoFyt +i 38• (1.6m) A4.O i. ••` ?p Yy.�" 10 i F H 4t1+ t s1' 014 O • { �.. ` 20 40 60 80 '1 GALLONS � LITERS >� Ot; 80 160 240 320 4t13�8 f FLOW PER MINUTE r 3 2 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing penels available. 3 27 • Electrical alternators, for duplex systems, are available and supplied with r ' an alarm. • Variable level control switches are available for controlling single phase systems. •Double piggybabk variable level float switches are available for variable ` +' level long and short cycle controls. • Sealed Owik -Box available for outdoor installations. See FM1420. • Over 130 °F, (54 °C.) special quotation required. 1521153 Series _ 1521153 MODELS Con !_election � Model VOlts•P -.= Mode Amps— Simplex Duplex • c ,, S N152 1t5 14 Non 8.5 1 2or3 SN152 t 115 1 "' Auto 8.5 Included L�2 or 3 ;° 'f 1 sK2e =: E752 230 1 Non 4.3 1 2 or 31 BE 1521 230 1 Auto 4.3 Included _ _ 23 3 h N153 115 1 Non 10.5 1 2 or 3 BN153 . 1 f5 1 Auto 10.5 Included 2 or 3 SE �TI O N GUME .— _ E153 230 1 Non 5.3 1 2 or 3 1 Sfl ate p(ggyback Vida'Is level; s t)f OOUb(e nr�ack variable level nos% BE153 230 1' Aulo 5.3 Included 2or3 s441f'ch:: Refer tbFN10df7 ti A CAUTION 2 . Sep FM0712 for correct model a A14�Mator -Pak. All installation of controls, protection devices and wiring should be done by a qualified 3 Vadabte level control switch 1 ^ u3as 8 OO ntrol av elc .specify licensed electrician ;:All electrical and safety codes should be followed including the most pj f 4) (6t System. recent National Eleelftc Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POINERED�DESIGN �. For unusual conditions a reserve safety factor is eng(rteetr'ih o the design of a oer pump. r+• MAIL 70r'P 'B& 16247 :. HUeCfu►e +tit°•, tou(svm ►� e, vr4o2ae -03ar ra or r .0 SHIP TO 349 Cane Run Road f O LotdsvAle, K1�'802i1.1981 ! ; M 77 111411 1, •• /9�.9 x� (502) 778 273f ` s�: !O. • http: / /www.7oeller.com fAX�3�624'`'r 0 Copyright 2000 Zoeller Co. A11''rlghts'reserved. `. Wisconsin Department of Commerce SOIL. EVALUATION REPORT Page 1— of 3 ` Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County St Croix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal refereaee ploinC()3M},.direction and Parcel I.D. percent slope, scale or dimensions, north arrow, ar�`ecagoiii and dlstanca to nearest road. pending Re ewed by Date Please print alllfn ation. a- I Personal information you provide may be used fq£se`Cgridary pu rtke Law, s. 15. (1) (m)). \ fQ Property Owner r _ ( Pro, e Location Ewlen Properties Ltd. DEC Govt_L t SE 9 1/4 NE 114 S 14 T 31 N R 18 X (or) W 3 . Property Owner's Mailin Address Lc t # Block # Subd. Name or CSM# S T -C R,'- . 1430 220th, aVe, couNry na Prairie View Esta City State Zip Code ,,,P +fdPe PEKE City ❑ Village Q Town Nearest Road New Richmond WI 54017 (�7f,5 . 8- 7313 "'` Star Prairie ] New Construction Use: Ck Residential / Number of be r 4 Code derived design flow rate inn GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material outwa shi Flood Plain elevation if applicable ft• ria General comments and recommendations: trenches @ el. 92.40 spaced to code 4.00' belwo grade ❑ Boring .Af� Oil, FT Boring # r 96.40 tit Pit Ground surface elev. ft. Depth to limiting factor +96 in. Soil 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 1 0 -8 10yr2/2 none L 2msbk •5 2 8 -38 7.5yr4/4 none 3 38 -96 7.5yr4/6 none ms Os m1 •�} 92 0/ - 2 Boring # El Boring 2 ® Pit Ground surface elev. 95.30 ft. Depth to limiting factor +96 in• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 1 0 -6 10 3 2f 5 ' 2 noni • � 3 56- 7.5yr4/6 none MS 0 ' q2, � 3c). (� •,e ` Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L ent #2 = BO < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Gar L. Steel 02298 Address - re E luation &nductea Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 12 -5 -2000 715 - 246 -6200 Property Owner Men RKI p rtle-s r Ltd Parcel ID # piuli& Page 2 of 3 ❑ Boring # Boring Ground surface elev. 90.80 ft. Depth to limiting factor +84 in. 3 4� Pit Soil A lication 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 1 0 -18 10 4 3 none S1 2=jr mvfr CFW 2f 5 2 18 -39 7.5 4 none Usg myf r cpa 1.2 3 39 -84 7.5yr4/5 none Mq Osg M1- na .�- ❑ 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 GPDKf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 ❑ F] Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ pit Soil 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 ` 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.6100) STEEL'S SOIL SERVICE Gary L. Steel Ewlen Properties, Ltd 1554 200th Ave. CSTM2298 SE4NE' S14- T31N - R 18W New Richmond, WI 54017 MPRSW-3254 town of Star Prairie (715) 246 -6200 lot #6 Prairie View Estates This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted. N 1 =40� BM.= top of SE lot stake @ el. 100.00' Alt. BM.= top of 1" pvc pipe @ Er. 92 r \ `fC 3� . I Gary L..Steel 12 -5 -2000 I > -� I zm0r O M p n C OD m z s 0. r m O Z n1 (T (14 v rn � � Oo � O Cl) - r .n � 0 m O M -1 z -� m (J) _ m .q m 0 �7 Z m O 0 V D Z "'� o, n m 0 z c r) _ M O z X r -Zi m L' O O, r Z Z Z o Cn n M ._ — n m �r co) y 2 w m CO) c � r' z O C O m O m V1 --� z - O mm m Z �' N Q m< C X �C �7 m � � a� ���� CA no z z G) M n � � S i n« ,s Z o « O LOW cr Y � _ g It �1 d 0 ± ; 0 g s Z o Cm �« w a o s �c r ti O z J 2550 P 572 75'989 1 STATE BAR OF WISCONSIN FORM 2-1999 KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO.. MI This Deed, made between EWLEN Properties, LTD., a Texas RECEIVED FOR RECORD Limited Partnership Grantor, 04/16/2004 10:06AN and Count T,i vi ng)3tti Ide Inc and Russell n- — T mi and en 1z M _ Trn _ Grantee. WARRANTY DEED rn Grantor, for a valuable consideration, conveys and warrants to Grantee EXERT # the following described real estate in St. Croix County, State of Wisconsin REC FEE: 11.00 (if more space is needed, please attach addendum): TRANS FEE: 113.70 COPY FEE: Lot 6, Prairie View Estates, Township of Star Prairie, St. Croix County, CC FEE: Wisconsin. PAGES: 1 Recording Area Name and Return Address Estreen & Ogland 304 Locust Street Hudson, W( 54016 w I - t Lit Li Lt 4 03 8-1205 -60 -000 Parcel Identification Number (PIN) This is not homestead property (is) (is not) Exceptions to warranties: Easements, restrictions and right - of - way of record, if any. Dated this day of April 1 2004 LE PP r ro operti . LTD BY: Paul Ande — AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF L((�`, ) ) ss. Guar County ) authenticated this — — day of —_ -- — Personally came before me this _ej� _ day of April 2004 the above named EWLEN Propert LTD., a Texas Limited Partnership, B Paul Anderson _Y 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. uu , wi STATE BAR OF WISCONSIN j ZM 0 6 021 WARRANTY DEED FORM No. 2 - 1999 NMy Public, s R.. Wx C.pmmi AuQgst o 0 o 0 C o ■ 2 0 e \ 7 ! k 7 % G ; § � - . (D � ( � � � � � � ■ - z \ gy m z- z c #¥ 2 o 0) o g t & J o §§ # w$ _ \ \ (A q ; + m / w_ �� J N I s a °ƒ ® c 7 ' D CD \ 7 S § CD CL g § g c S g © / § CA a - / § ± CD / 2 \ a - § � i o af i o �m 4 = 4 S a c n § ■ 0 % 0 n r ■ . � � \ � c E 2 � o 0 o E o o o 2 r C 9 S k _ - u 4 ] ■ 2 £ & ) @ 2 @ i CO § k (/ � < [ 7 / 2 = , o § £ = 0 �i ƒ ' 7 s m : \ o : / � 7 � \ ƒ � ƒ \ CL ƒ 2 g C I 7 @ § i s . 3 7 \ \ / 0. CD § 2 ( w ■ CL 0. / $ ■ ■ T $ ) # . E § E § / 2 k k / » 7 z ¥ % § F22 fc CD § EA77 \J� § ;0 \ \ / % CD 0 1 0 0 z % g ƒ % ƒ } 0) ID CL \ CD CL k 0 \ C $ 7 / ƒ � C, � Ea � / (/ % , in CD � ac m ED ± 2 CL I 0 0 G G \ f o f ? ; ® a » E E 8 E I�: t Safcty and Buildings Division ty —_ 201 W. Washington Ave., P.O. Box 7082 <_ w Madi 707 7082 Sanitary Permit Number (to be 51Jed in by Co.} Vi ( 608 ) `f 53 0 S nt of Ct,lnmerce State Plan LD, Number Sanitary Permit APO ati u ¢ta in accord with Comm 83.2 1, Wis. Adm. Code, personal project ? .j project Address (if different mailing address) may be used for secondary purposes Privacy L& , s 15.04(1)(m) J 1 sr 4 2-159 1 28 J 1 I. Application Information — Please Print All Information P Lot # 4NMk"!f p try Owner's Na Vv_ ~ Pr o pe anon Property Owner's Mailing Address f V"0 Section / Ci , State Zip Code Phone Number f T N; F�relr W H. a of Building (check all at ap ) 0.4 S Subdi sion Name C,SM Number Or 2 Family Dwelling— Number of Bedroo S !// J ❑ PublictCommercial— Describe Use ❑City ❑Village wnship of ❑ State Owned — Describe Use IIL Type of Permit: (Check only one boa oa line Complete line B if applicable) p 3 2- S (06 ' CV0 r . I 10 1 A, tmenVHoldiag Tank Replace ant Only ❑ other Modification to Existing System System ❑ Replacement System List �y� Permit Number and Date Issued ❑ Chan of [] Permit r New S'�� B. ❑Permit Renewal ❑Permit Revision Owner Before Expiration Plumber ivaxp of PO WTS S stem: Cheek all that a 1 ❑ Single Pass Sand Filter on— Pressurized in- Ground ❑ Mound >_ 24 in. of suitable soil ❑ and < in. of suitable soil ❑ At -Grade g Q Constructed Wetland ❑ Pressurized in- Ground ❑ Holding Tank ❑Pea it ❑Aerobic Treatment Unit C1 Recirculating Sand Fil /r Recirculating Synthetic Media Filter Lxachin Chamber ❑ Drip Line vel -less Pi ❑Outer (eup]ain) V. Dis ersal/Preatment Area Information: ersal equi (sf) Dispersal Area Proposed (sf) S Elev 'on Design Soil A lication Rate(gpdsf) p 167 Desi Flaw (gpd) gn �/ ,1 prefab Site Statl Fiber Plastic VL Tank Info Capacity in Total Number Mangy Concrete Constructed Glass Gallons Gallons of Units New Existing T Tanks septic or Holding Tadt Aerobic Treatment Unit Dosing Chamber attached plans. VII. Responsibility Statement- I, the undersig su responsibility for iostallatioo of the PO shown on the Business Phone N er� Plumber' Name (Prins) Plumb r MP/MPRS Nu her J Plumber's Address (Street City, State, Zi ode) VIII. Coun!y Use Only Date Issued ssu' g Agent Signature o Stamps) Sanitary y Permit Foe ncludes Groundwater .-Approved Disapproved Surcharge Fee) 2 {] Owner iven Reason for Denial Ix Conditions Approv 1 SYSTEM 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber 2. All setback requirements must be maintainer as per applicable code /ordinances to the Cous only) for the system OR paper sot less than itR s 11 lathes to siu Attael costpkte pisas ( tY 150-6398 (R. 08102) OT PLAN PROJECT Ewlen Properties Ltd. ADDRESS 1430 220th Ave New Richmond Wi 54017 SE 1/4 NE 1/4S 14 /T J31N/ W TOWN Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 3/29/04 BEDROOM 4 CONVENTIONAL )00C IN-GRqa PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 872 # of chambers 28 ,BENCHMARK V.R.P. Top of SE lot stake =g w ,* ( ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 92.0/91.0 4' below qrade WdW to meet all setbacks required by 128th St. WDNR Plans Designed Using Conventional Powts 255' Pro 4 Manual Version 2.0 Property bedroom Line house Vent 25' >6 °� Standard Biodiffuser of Cover Leaching Chamber with 3 1. 1 ft2 of Area T 6' Long 11" Grade at System Elevation 40' 34 B- 170' Vents 20' 80' 12 B-1 o , Slop Q Vents 31' 2 -3' X 88' cells with >3' spacing 42' Alt. B.M. Top of 1" pipe @ 92.1' 356' property line B. M. OT PLAN PROJECT Ewlen Properties Ltd. ADDRESS 1430 220th Ave New Richmond Wi 54017 SE 1/4 Nr= 1 14 /T 31 N/ W TOWN Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 3/29/04 BEDROOM 4 CONVENTIONAL XXX IN -GR PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 872 # of chambers 28 BENCHMARK V.R.P. Top of SE lot stake =g Kk ,� ( ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 92.0/91.0 4' below grade WdW to meet all setbacks required by 128th St. WDNR Plans Designed Using Conventional Powts 255' Pro 4 Manual Version 2.0 Prop P Y bedroom Line house Vent 25' >6 " Standard Biodiffuser of Cover Leaching Chamber with 3 1. 1 ft2 of Area T 6' Long 11 " 40' 4" Grade at System Elevation 3 13- 170' Vents 20' 80' 12% B -1 Slop Vents 31' 2 -3' X 88' cells with >3' spacing B-3 4 4 42' Alt. B.M. Top of 1" pipe (@ 92.1' 356' property line B. M. Maintenance and Contingency Plan for a Septic System Maintenance Plan m 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 ac rees 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. Watershod is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 Contingency Plan Option #1. ystem fails, determine cause of failure, use alternate area and install new tested replacement area. Option #2. Install sys tem at a lower elevation, by removing chambers, removing biomat, and install new system. Option #3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace ,any other failing components as needed. c• _ - Plumb ��haun Bird 715 246 45 16 St. Croix County Zoning 715- 386 -4680 Pumper Tom Mondor 715- 246 -5148 Shaun Bird #226900 ST CROIX COUNTY SEPTIC ' MAINTENANCE AGREEMENT - AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ;D, (' J Mailing Address Property Address ,Fl (Verification required from Planning Department for new construction) City /State _______ Parcel Identification Number a 3� — 12Os —(acs ^ 060 1101 LEGAL DESCRIP7 ION n T� N -R /0 W, Town of c �i Property Lo cation, 1 / +, �'= /•, Sea /JL, —, Subdivision ___Ct �- Ad C ' Volume Page # Certified Survey Map # , � Volume —� Page # J Warranty Deed ## _ � -3 $ 11 Spec ho C7 no Lot lines identifiable-124 O no SYSTEM MAE1Cff tics stem could result improper use as in its premature failure to handle wastes. Proper maintenance d maintenance of your sep y Put into the system consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you p can affect the function c f the septic tank as a treatment stage in the waste disposal system St t it agrees to submt o . Croix Zoning Department a certification f signed by the owner and by a The property er veri that (1) the on -se w masterplumber, journeynan estrictedplumber or a licensed : plumber, r g o n-site disposal system the s eptic tank is less than 1/3 full of sludge. is in proper operating co adition and/or (2) after inspection and pumping (if necessary), P requirements and agree sal system with the standards ed hz.ve read the above requir ee to maintain the private sewage dispo y Uwe, the undersign Department of Natural Resources, State of Wisconsin. Certification set forth, herein, as set ty the Department of Commerce and the Dep office within 30 stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning : days of the three y expiration date. / fl c DATE GNA ":' APPLICANT OWNER CERTIFI y j knowledg we a the owner(s) of I (we) certify that all statements on this form are true to the best of m (ours g • I ( ) m are ( are) the property descri d ¢above, by virtue of a warranty deed recorded in Register of Deeds Office. n lvt DATE SIGNATURE F APP: "ICANT rmit being revoked by the Zoning Department. Any informatil)n that is m i s - r epresented may result in the sanitary Pe * * * * ** *� Include with this a pplication: 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 vi.! 1468PAGE 556 613375 STATE BAR OF WISCONSIN FORM 2.1998 KATHLEEN H. WALSH REGISTER OF DEEDS WARRANTY DIFFD --- ST. CROIX CO., WI This Deed, made between Ernest J Dosedel and Mariorie B. RECEIVED FOR RECORD Dosedel, busband and wife 11-05 -1999 10:40 AN Grantor, conveys and IIARRAIM DEED EXEMPT N warrants to EWLEN Prouerties Ltd a Texas Limited Partnership. CERT COPY FEE: TRANSFER FEE: 1060.00 RECORDING FEE: 10.00 Grantee. PAGES: 1 Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (The "Property "): Recordina Area EST 31— . aCUS 1, wl A i ; 038- 1057 - 50.000 & 038 - 1057 - 60-000 Parcel Identification Number (PIN) This Is not homestead property. S'' /2NE' /4, Sec. 14- T31N -R18W except commencing at the Northeast corner of said SE' /.NE' /4, Sec. 14- T3 IN-RI 8W; thence Westerly along the North line of said SE' /4NE' /4 to the Westerly edge of the right of way of County Trunk "C'; thence Southerly along the Westerly edge of said County Trunk "C" right of way a distance of 608 feet to the point of beginning; thence continuing South on the Westerly edge of County Trunk "C" right of way a distance of 208.71 feet; thence Westerly and parallel with the North line of said SE' /4NE' /4 of Sec. 14- T3 IN-RI 8W a distance of 417.42 feet; thence Northerly and parallel with the East line a distance of 208.71 feet; thence Easterly and parallel with the South line a distance of 417.42 feet more or less to the point of beginning. Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this ?S day of October, 1999. + Ernest J. D del 1 r „ * Mirioric . Dosedel AUTHENTICATION ACKNOWLEDGMENT Signatl ' . "' st J. Dosedel and Marion B. Dosedel. STATE OF WISCONSIN ) .ftloe; ) ss. h !+ County authenticated this_ ) r, A 999 Personally came before me this _ day of .L = •<` t � 1999, the above named ftstiOglanil to me known to be the person(s) who executed the y foregoing instrument and acknowledge the same. TCF$ER STATE BAR OF WISCONSIN rat, authorized by § 706.06, Wis. Stats.) r THIS INSTRUMENT WAS DRAFTED BY Notary Public, State of Wisconsin Attorney Kristina Oglaud My Commission is permanent. (If not, state expiration date: Hudson, WI 54016 — ) (Signatures may be authenticated or acknowledged. Both are not necessary.) *Names of persons signing in any capacity should be typed or printed below their signatures WARRANTY nEEO STATE BAR OF WISCONSIN FORM No. 2 - IM Jl, 4be JG1. r /. % - 6 16'k \ - \ ; (_ see o2 �6 E 162.74', DOCUMENT N0_._6 2.12 ACRES 1 \ \ 67,615 S0. FT. ACRES ~ -- - -- -- - 1.55 ° r. V \ 16J1N F.F.E. = 389.4 ° `O N89 "W i I \ 277.77' 3 N I SC � O N89'01'50 "W� © O 0 386.73' 318.04' ° N89'0 • I O I a, °� to o� N o 76, 767 SO. FT N O UIVPLA T 10 co 1.76 ACRES O 0 - - - - - -- — o N N o 04 PARCEL 88,918 50. FT N 3 3 i 0 VOL UME 2.04 ACRES I ° O o - -- ° o I \\� SHED ° C 586'55'26 "W 275.63' 77_78' 83 '35'28"E I 3 07.14' N 6 N 016 Q. FT. 1.88 ACRES N I 0 I 17 SO. FT. \ ACRES / S "� BA RN 359.96 rn O 0 0 O Z 1 81,001 SO. FT. 76,552 SO. FT. s ��, 1.86 ACRES 4 153, 704 1.76 ACRES °• 3.53 A( - - 2116.75' - - - - -- 550.58' 236.55' UNPL A TrC i A AIDS ------- - - - - -- - ---- - - - - -- 100 0 100 C._ S. i VOL. GRAPHIC SCALE - SCALE IN FEEI : 1 k,a, - loo r sc I SF