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HomeMy WebLinkAbout038-1114-70-300 0 ® °� g 2 / C; \ 7 con r 4 «,i « k ƒ / CD z [ z ° t 2 = o q . & m CL ~ o 2 (D � ~ * ƒ 2 a (D :3 ° / ® (n e § ) \ C"-) \ 2 � ` — \ \ / @ \ ( k \ o ° Z 9 ( ± ( ƒ \ » Q3 CD w � \ \ f \ F C) m U 0 a f § ®� k 3 3 3 $ — \ \ ::c 3 \ < ° z OIQ C6 » m o § % » / / 2 y \ CD 7 cn \ ` [ 5 m § . z 77 \( , a G g \ \o O \ n ( / / O \ m a k \ _ (n » \ § ) ; Co � \ / / 2 & § \ ® z � § ;w | \ 2 I w � ? \ G2± § \ \0 f \;G 2 \/ \ m � 0 \ | 0 ® � � + D � _ $ \ \ . � \ G Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 453175 0 GENERAL INFORMATION (ATTACH T 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: Rafferty, Brian Star Prairie Township 038- 1114 -70 -300 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 29.31.18.486A30 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ' Benchmark Dosing Alt. Aeration Idg. Se Holding t/Ht I t TANK SETBACK INFORMATION S t outlet TANK TO P/L WELL j . LDG. Vent to Air Inta e ROAD \ Dt I et Septic Dt Bottom Dosing / Header/Man. Aeration Dist. Pipe Holding Bot. System Final Grime PUMPISIPHON INFORMA ION Manufacturer Demand Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBLDIJ WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing 1 71 SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil J Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1964 Nighthawk Drive Unknown (SE 1/4 NE 1/4 29 T31 R1 8W) NA Lot 3 Parcel No: 29.31.18.486A30 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? Yes No Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Signature Cart. No. Safety and Buildings Division County COnSI ` 201 W. Washington Ave., P.O. Box 7082 —, ,S Madison, WI 53707 - Sanitary Permit Number (to be filled in by Co.) ent of Commerce (608) 261 -654 � De artm Sanitary Permit Application State Plan I.D.,Number In accord with Comm 83.2 1, Wis. Adm. Code, personal information you p o`Vi x may be used for secondary purposes Privacy Law, Project Addr (if different than mailing address) 1. Application Information - Please Print All Information VE- Property Owner's Name Parcel # Lot # Block # MAY G 3 2oO 1 3 Property Owner's Mailing Address L. Property Location / w — 3� ZONiN C / tea 6 OF-F1 i City, tate ,�,_' /•, Section ty Zip Code Phone Number �` N; R c E ot® ircle one) H. Type of Building (check all that apply) a S/ z4t - T -.� L y�l�( 1 or 2 Family Dwellin g Number of Bedrooms Subdivision Nam /_ .3 / M Number g ❑ Public(Commercial - Describe Use C O L ❑ State Owned - Describe Use 3 b � C / 7 ❑City ❑Village Wrownship of STAR III. Type of Permit: (Check only one box on line A. Complete line B if applicable) - A ' f New System ys ❑Replacement System ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System B • ❑ Permit Renewal ❑ Permit Revision 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 41 Non - Pressurized In -Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ er expW ¢� V. Dispersal/Treat ent Area Inf rmation: 601 L 7 D Design Flow (gpd) Design Soil Application Rate(gpdso :xl Lq3 Dispersal Area Required (sf) Dispe posed (st) em Elevation d 6 ✓ io 1e7 v, o VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber asti Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank / Aerobic Treatment Unit �IOd Dosing Chamber U VII. Responsibility Statement- 1, the undersigned, assume responsibility for Installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plu 's Signature PRS ber Business Phone Number �" .2/ 7 /� - S Plumber's Address (Street, City, State, Zip Code) VIII. oun /De artment Ifse Onl Approved ❑ Disappro ed Sanitary Permit Fee (includes Groundwater Date sucd ssuing Agen Signa re (N mps) Surcharge Fee) wn Give Reason for Denial I X Conditions f Approva easons for Disapproval Af 7/ / YSTEM OWNER: Eli� ;dLt� -� ,LPiyn dr✓ti�/LQ/L�- 1 ep Ic an c, a luen ilter and CQ Wy f31 dispersal cell must all �gSxrviced I maintained as per management plan provided by plumber pall -h VkL T4,1&d 2. All setback requirements must be maintained /�� Q .3' if S es. Attach complete plaits (to the County only) for lbWystem an paper aot ks�t�haVI12 x 1 Inches la slrw LaVTO SBD -6398 (R. 08/02) w ' Gam , w� c-� a , S ✓Vl n Y •e�b � _ { °! fss� 3F!5vd of 3RTTU .'�' ddW .13A2�71� 43i�i12i35 vAr ` =P l 107 t N bo t N O— VI '• LP q . `o \ OG b F O I co % V, m tA goo AO $ Q N ° 1163 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt Attach ete site n on County contpl plan paper not less than 8'/: x 11 inches to size. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nea 'D 038 - 1114 70 - P88�?j00 Please print all information. R iewe Date Persona information you provide may be used for secondary purposes (Pdva - c law„,,¢. 15.04 Property Owner { 1 Property Location Rafferty, Brian Govt. Lc SE 19 NE 19 S 29 T 31 N 18 W Property Owner's Mailing Address J-:� Lot # Block # Subd. Name or CSM# 1167 Englewood Avenue 3 CSM Vol. 15 Page 4206 City State, Zip Code Ptwne,Number City Village ✓ Town Nearest Road Saint Paul MN 55104 651 - 641625 — j Star Prairie Nighthawk Road ✓ New Construction Use: ✓ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe: Parent material Outwash Flood plain elevation, if applicable NA General comments and recommendations: Area is suitable for a conventional system witha 0.7 gpd/sgft rating. Possible system elevation for Area I is (high trench) 103.2' (low) 100'. Bores 1,2 &3 o n attached report. r�� S 2-Qa Fz] Boring # Boring 3'Ld G�2�G be Pit Ground Surface elev. 107.99 ft. Depth to limiting factor 96+ in. Sod 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 1 0-9 1Oyr3/3 none sl 2fsbk mvfr cs 2f .5 .9 2 9-40 1 Oyr5 /4 none sl 2fsbk mvfr gw 1 f .5 .9 3 40-96 10yr5/6 none ms Osg ml ----- .7 1.2 IG ' r7 IV' Ioo /— Pil Boring # Boring ✓ Pit Ground Surface elev. 107.19 ft. Depth to limiting factor 97+ in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture structure Consistence Boundary Roots GP Ht= in. Murrell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 - Eff#2 1 0-12 1 Oyr3/2 none Is 1 mgr mvfr cs 2f .7 1.2 2 12 -34 1Oyr5 /4 none Is 2msbk mvfr gw .7 1.2 3 3497 1Oyr5 /6 none ms Osg ml - -- - -- .7 1.2 Z / / A * Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L. and TSS < mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt �w , 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 1595 72nd St., New Richmond, WI 54017 7/3/03 715- 247 -2941 Property Owner Rafferty, Brian Parcel ID # 038 - 1114 -70 -000 Page 2 of 3 6 ] F Boring # Boring ✓ Pit Ground Surface elev. 99.34 ft. Depth to limiting factor 59 in. Sof Apply Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cord. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-11 10yf3/3 none Is lmgr mvfr a 2f .7 1.2 2 11 -24 10yr5/3 none Is 1fsbk mvfr gw if .7 1.2 3 24-39 10yr5/4 none Is 1 msbk mvfr gw ---- .7 1.2 4 39 -59 10yr5/6 none ms Osg ml cs ----- .7 1.2 5 59-102 10yr5/6 m3p 10yr618 ms Osg ml — .7 1.2 6 102+ ground water ----- - - - - -- -- - - - - -- --- ------ — --- - - - - -- - - -- - -- - -- - - - - -- n Boring # Boring 1 i ✓ Pit Gr Surface ele v. 99.34 ft. Depth to limiting factor 57 in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10yr3/2 none Is 1 mgr mvfr CS 2f .7 1.2 2 10-34 10yr5/3 none Is 1fsbk mvfr gw 1f .7 1.2 3 3457 10yr5/4 none ms Ogg mi gw .7 1.2 4 57 -73 10yr5/4 m1 S=18 grins Osg mi gw - - ---- .7 1.2 5 73-104 7.5yr5/4 map 7.5 yr6/2 8 rcos Osg ml -- ---- -- .7 1.6 r6/2 9 6 104+ ground water ---- ---- -- --- - - - - -- — ----- - --- -- - - - - -- —_ _---- - ---- F-1 Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD 5 > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD a 30 mg/L and TSS a 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or —A mot .r of ;„ — attarnata f r..sot -1—.. ­t—f tl,. ` --f—f of (./1R- 7/.(. -11 G 1 n T`PV lAR- ')4A_2777 V 30 � i �s P �d� Pig � 2 J 4 P P QS qo 3 7 q �I f �d, '� �:3 �, : �c<a ��/ O�'�a,- Sc,,' l 4es -/e-,o— - eA 7,v 114 7 jp�i¢v lS`rS 7.1 s . ra ' s 1 Sur- fr4l.r^l P -�� g - -o/ t Wisconsin r)epartment of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Ws. Adm. Code County Lj� � y�ri, X lk Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. — — D Please print all information. Rev we y Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). S Property Owner Property L ti �, Govt. Lot 1/4 1 /4 S l T N R� E( W Property Owner's Mailing Address Lot # Block # Subd. Name or C M# City State ZipTode Phone Number City ❑ Village .[Mown Nearest Road lei V New construction Use: ( Residential / Number of bedrooms � Code deriv 4es "�. w rate _ 7 GPD ❑ Replacement ❑ Publjc or com rcial - Describe: ~�V ��, f Parent material l � Flood Plain vV4 on if a _�`"°Cpv ft. General comments ` and recommendations: j r _ 0 " j 1 f•' a.7 Cowry Boring # F1 Boring P J �Q pit Ground surface elev. �ft. Depth to limiting racto Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /N in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 / - ` s 15 Vyx j�' �i %' �` �,• -...� of , /� n Boring # ❑ Boring ❑ Pit Ground surface elev. `J ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg in. Mu nsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 _ TNJ 6� " 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 - ST me (Please Pri ) S' nat4re CST Number A ss Date Evaluation Conducted Telephone Number r , Property Owner n h j� Parcel ID # Page of U Boring # F1 Boring I Veit 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 z zz 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 /fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff #2 a Boring F-1 Boring # Ground surface elev. ft. Depth to limiting factor in F1 pit 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 Daniel Fleming Byron Jr. Address 1966 Nighthawk Dr. Somerset �I Wi.54001 CST #220527 Lot Subdivision = = =SE Date 12 00 1 -Count ST. CROIX SW 1/4 N E 1/4S 29 T 31 N /R W Townshi Star Prairie E] Boring Q Well PL Property Line# Alt. BM top of steel pi lv. 96.6 d U (�, a✓� ,BM or VRP Assume Elevation 100 ft top of wood stake X� System Ely. T- 1 =83.8T-2=82.8 H.R.P. same as Bm Nighthawk DR. #alt BM PL 279' BM Driveway 35' 89' Pro House 75' 75' 88' B3 B1 1 87' B2 560' Apple PL River Rio -- -- - « g — 3 - - - - S i. �QO Gl- �L - L A -jam 5 i ��- Ep -- A —1 - - -- - - - - -�' u' - 6 i / b -- - - -� - - 13/'�.SQ/�._1 _ �5 /EBL_g /LTA_ L L .y,�r -�L = _�A?� - - / - - - _. --op- - - - - - - At -l3�s - --- - - - - -- - -- — - - -- /IFS_ _S,NG_LcLIlG►L1la_. ✓4f1� - -- � - -_ . - -_ -- -- - � 8�__f/fALL_�? /_ (J /acv //1 S 7 - PAuc. I /7N -$ 5/a l/ . _ SW-2 s' gib 18 ' j -- 3Gtt &5 G[_PG. -- - - SOP ° vp uy r A WL - 4 / - - - -- - i I Y_GLt_Gf1oQ� ✓4U� -- - -- - - ._� 8� Uf)LL'� /� -lZ c A G/L ?1L/ �5 f 0 �/ - - - SOP 7C j � _... PA(;I PLJ! \F CHAtAEER CRiJ55 SEC 10!J AIuG cPECI FICA TIGk!`_• i �VEQ CAP 4"C.I. �E.,T PIPE APPROVED LOCKING wEATHERPRGOF JUNCTION BOX MAtJHOLE COVEF. - 25' DCDR, w�uiA�tN /hb [ �r<cE WIMDOW OR FRESH IZ "MIU. AIR IAITAKE ( GRADE I Y ° MIN. I 8" MIN. C01DDU1T � `— IB "MIN. \ INLET PROVIDE AIRTIGHT SEAL I I I I I APPROVED JOINT A I I APPROVED JOINTS W/C.I. PIPE III W /C.I. PIPE EXTENDING 3' I 11 A C LARM EXTEMDING 3' OIITO SOLID SOIL D I II ONTO SOLID SOIL I T I ON I ELEV. FT. PUMPS -�� OFF D COAICKETE BLOCK RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E SPECIFfCATIOUS DOSE TAWKS MAW UFACTU;LEK' = (DUMBER OF DOSES: PER DAy TAAJK SIZE: l7OO GALLOWS _ I DO ICLUDIIJG 6ACKFLOW: �Z� GALLONS URE ALARM MAWUFACT R' MODEL ►DUMBER: Tom- CAPACITIES: A= /9 _ /9 IMCAES OR 3.y GALLONS SWITCH TSPC: M�2 "12 L/ B= I INCHES OR 23, 2 GALLOUS PUMP MANUFACTURER: - J� C= INCHES OR CALLOUS MODEL NUMBER: /D D = INCHES OR 2 CALLOUS 5WITCH TYPE: - / '_ C -1112 L/ MOTE. PUMP AUD ALARM ARE TO DE MIWIMUM DISCHARGE RATE :ZfZ GPM / INSTALLED OW SEPARATE CIRCUITS N VERTICAL DIFFEREWCE BETWEEU PUMP OFF AND DISTRIBUTION !_ PIPE.. _O FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . 2 . 5 FEET + 50 FEET OF FORCE MAIN X 3 A F /p FTFRICTIOU FACTOR. �p FEET TOTAL DyJMAMIC HEAD FEET )UTERNAL DIMEWSION4 OF TAQK: LE:AC•TH ;WIDTH ;LIQUID DEPTH 37 SIGrJED: _ LICE.NSF ►DUMBER: L; � DATE: - eG . ■ . - = '® im ■L 113LI kINLIMMEMEMMEM MOON mm L MOMEM■■ ■�■ 60, Ilk IN k3i,Mi MEMNON mom k\kl 1n Io\ \MEMO ■ �� \ \I N IM�\ \\EE■■■M■ ■ \\ 11 ► \` !��� �������■ ��� \� 111 I\ �� \ \ \� ■� ■�■ M 619W I■ \■ �\MIMMISI■ ■EE\916 ■ON ME"' 1\ ■MM\ "NONE ►� \ &►mi.S!\��IN 0Ma0\0N0 �Nyil iii I \' \ \vMMML MM■ ST CROIX COUN'T'Y SEPTIC TANK MAINTENANCE AGREEMENT AND, 1 OWNERSHIP CERTIFICATION FORM Owner/Buyer 13 f?/&n A ,E/1 i `l Mailing Address 116- 7, ZAt1z 12A f 35J Y • � i Property Address (Verification required from PlanniYg Department for new construction) s City/State SOMEA?SC r /J1/= Parcel Identification Number �036 —/ / /!/ — 7'Q LEGAL DESCRIPTION Property Location' /,, ' /,, Sec. 2, TAN -R_W, Town of S 7A2 fIR " Subdivision L SZ7 jl aL, / �- 44 © , Lot # 3 C Certified Survey Map # CO 1 f , Volume 5 , Page # Warranty Deed # 7 7!Z , Volume /B� , Page # ��� Spec house 0 yes 8 no Lot lines identifiable ®t yes 0 no SYSTEM MARgTENANCE 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. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal 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. Itwe, 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 septicisystem has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 daysoTthe three vearexpiraW n date. f, SIGNA/i U W OF AoLfc DATE OWNER CERTIFICATION I (we) certifykhat all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property describeo above; by virtue of a warranty deed recorded in Register of Deeds Office. SIGNA�(J bF)P DATE ss « «4« « « « « «« . Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. •s 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 L POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page )of FILE INFORMATION SYSTEM SPECIFICATIONS Owner 131? 2A — —� Septic Tank Capacity /om gal ❑ NA Permit # Septic Tank Manufacturer 40 eL— 's ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer Z — ❑ NA Number of Bedrooms ` j ❑ NA Effluent Filter Model A _ ❑ NA Number of Public Facility Units ■ NA Pump Tank Capacity a l ❑ NA Estimated flow (average) g al/day Pump Tank Manufacturer s ❑ NA Design flow (peak), (Estimated x 1.5) 0 al /da Pump Manufacturer ZO — — ❑ NA Soil Application Rate , 7 gal/day/ft' Pump Model ❑ NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit 0 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 Cells) ❑ NA Biochemical Oxygen Demand (BOD S30 mg /L ■ In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L Xt A ❑ At -Grade ❑ Mound ' u Fecal Coliform (geometric mean) 5 /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. c3 NA Other: ❑ NA Other: C3 NA Other: ❑ NA "Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA 1, MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: [3 earl l(s) (Maximum 3 years) 13 NA 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: 3 ®yeaNs�(s) (Maximum 3 years) ❑ NA ® month(s) ❑ NA Clean effluent filter At least once every: ❑ year(s) Inspect pump, pump controls &alarm At least once every: N month(s) ❑ NA ❑ year(s) Flush laterals and pressure test At least once every: ❑ year(s) month(s) 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 tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(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. l When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume,. the entire' .:r1 contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, 0 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. Page-2w ? � 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 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 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. • 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: 0 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 welts. 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. he s to as not been ev ted to identify uitable r ac ent area. on failure of WTS a soil and site e alu ti m be f rmed o locate a itab repi ement a o repla area is avails ing tank may b ins fled a last resort replace he failed WTS. ❑ Mound and at -grade soil absorptio stems may be reconstructed in place following removal of the biomat 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 OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name 7 Name ce- — Phone — F phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name _ Name OU v Phone Phone - _ 5 This document was drafted in compliance with chapter Comm 83.22(2)1b1(1)(d)&!il and 83. 4 1 11, ( 2 ) & 3 11, Wis Administrative Code. n N O M 0 r� o m E c �' ° d �1 3 3 T 1 a xt c .. r. o z T. to z o � A '' cn N) o W a 3 % -4 ; . • [D -► - d. W A O � � ro 0) O 7 ro N O Q C n 0 C9 CL • � W 0 0 3 tll O y A O <' z w a a 'I D y a ro Go V ca o = r o z -4 O 0 o co n o c �+ N a z . CD � O O O� =r I D g o G' D aQ -3 W C' Co � v v a o° CD d o g',I - I d to 7 O z r Z o D N CD 0 p w �• C - ) N !N ro ( $ C 3 3 a CT m Z CD CD C) C W O W m CD z 0 3 Z C z OD 3 "' N Z ro A W o > 3 n 3 - _ N Q T O X N C o a CD a m f y o c � t v 0. m �? 3 CD N 0 N � O Q V O R D O 17 O ro !wl EA 0 o ro Parcel #: 038 - 1114 -70 -300 06/29/2007 10:30 AM PAGE 1 OF 1 Alt. Parcel #: 29.31.18.486A -30 038 - 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 - RAFFERTY, BRIAN J BRIAN J RAFFERTY 1167 ENGLEWOOD ST PAUL MN 55104 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description ` 1964 NIGHTHAWK DR SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 9.230 Plat: 4206 -CSM 15/4206 SEC 29 T31 N R1 8W LOT 3 CSM 15/4206 INC Block/Condo Bldg: LOT 3 PT OF PARCEL DESC 1758/217 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 29-31N-18W Notes: Parcel History: Date Doc # Vol /Page Type 03/06/2002 672779 1848/138 WD 11/08/2001 661559 1758/217 QC 07/23/1997 1040/109 QC 0712311997 682/337 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/14/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 9.230 90,100 0 90,100 NO Totals for 2007: General Property 9.230 90,100 0 90,100 Woodland 0.000 0 0 Totals for 2006: General Property 9.230 90,100 0 90,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 314 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisobnsin Department ofCommerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Ws. Adm. Code County !1 Attach complete site plait on paper not less than 81/2 x 11 inches in size Plan must P ( ) , direction and -,P, include, but not limited to: vertical and horizontal reference point BM Pane! LD: - percent slope, scale or dimensions, north arrow; and location and distance to nearest road. Q — 0-- Please, print all Information. Reviewed by Date Personal information you provide mdj tie used for secondary purposes (privacy Law, *A5. (1) Property Owner Property L i �.... Govt 'Lot �t�.1 14 114 N R/ E ( W Property Owner's Mailing Address t #.; Block # Subd. Name or CSW City State ZiplCode Phone Number . _ : ,; Q Village Mown Nearest Road New Construction Use: Residential / Number of bedrooms :✓ tode'derived design flow rate ✓ s - d GPD s Replacement ❑ .: Pub c or com rcial - c nib e: Parent malaria{ Flood Plain elevation if applicable R General comments and recommendations: Boring # ❑ Boring .. ,. FTI pit Ground surface elev. DeP� b limiting ractor ;.1. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture .-Structure Consistence Boundary Roots GPD/fl in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh:. 'Eff#1 'Eff#2 / d v .7 - e .5 AV YX ell 17 ring Boring- 5 BO ❑ pit­­ f... Ground surface elev. 7 R peph to limiting factor 7�� �' in: Sol lication Rate ., . Horizon Depth Dominant Color Redox Description Texture re Consistence Boundary Roots GPD/ff In. Munseii Qu. Sz. Cont Color tz Sh. 'Eff#1 'Eff#2 b uft _ n u~, * 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 me (Please Pri ) Xattge :� CST Number D Aft1 /,�' 4 -Z I `A06ess / Date Evaluation Conducted Telephone Number 7 -22 1,6 a Property Owner parcel ID # f ?" Boring # �❑ f3 onnga ; ,... s." „��... �.^' tr x;t Page Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description f Texture' 'Vo,structure.: Consistence Boundary ..Roots GPD/fh in Munsetl Qu. Si. Cont. Color ... ;,.. -•'" Gr' Sz Sh. •E01 'Eff#2 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/ff In. Munsell Ou. Sz. Cont. Color `Gr Sz. Sh: •Eff#1 •Eff#2 Bori ng # ; ❑ 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. Munseil Ou. Sz. Cont .Color Gr. Sz. Sh. •Eff #1 •Eff#2 1 • Effluent #1 BODS > W:5 220 mg/L and TSS >30 <.:150 mg/L i • ,Effluent #2 - BOD 130 mg/L and TSS < 30 mg& s The Department of Commerce is an equal opportunity service piovrder;an'a�employer. If you'need assistance to access services or need material in an alternate format, please cbritact th u d partment at 608- 266 -3151 or TTY 608 - 264 -8777. SOD -8330 (R.07/00) ` Soil Test Plot Plan Project Name Daniel F l e ming Byron filtM Sr. Address 1966 Nighthawk Dr. Somerset a Wi 64001 CST 05 #22 27 L Y Lot3 s, on ° - SE Date /312001 C f ST CROIX SW 114 NE 1 �5 291`i `31 p W Star Prairie Al oun N/ �� Townshi Boring Q We11 PL Property Lined BM op of steel pipe Elv: 96.6 . ,BM or VRP Assume Elevatlon 10 + 0 ft of�wood stake System sameaff"Be � �. 1 Nighthawk DRr E #alt BM ;.. , PLA 279' M Driveway 1 4 f 35" " 89' Pro House 88 ' B3 1 ms s- ST �132 R $ks 560',,r APP1e PL '" River :e "•sT:, t •'3 y� ra .; l5 \SCONb ° DODGE JAN 9 S - 2484 �- 66 2. C-31413, 1 .. t CLEAR LAKE ,..* � KATHLEEN H. WALSH 1.,,,. O� I S TER OC ST. CROIX COUNTY %�� �� SURVEYOR'S RECORD �''' IiN� SV��a`` a „ 8, R� � � d CERTIFIED SURVEY MAP �� ia=2oo> 00 Located in part of the Southwest Quarter of the Northeast Quarter and part of the COPY FED 3 3 . 0 0 0 Southeast Quarter of the Northeast Quarter all in Section 29, Township 31 North, al fl�Ejr23.00 Range 18 West, Town of Star Prairie, St. Croix County Wisconsin. p/ ' r Oyal 1 a COUNTRY LIVING LOT 1 I �.9I�. ��3T1FlE,2�S1�v_�Y MPF I -'• ;.. ''ISr.�.;;" . /1�fGHThG4 WK Y44�_9- .PME -U9? I ---- -- A NORTH L /N£ Of THE 7N" AIL A S£ 114 OF 7HE NE 114 - — — - �- _ VOL. 1040 23 E PG.109 \ I 135.92 I S 8'52'33 "E \ Z 2.74 rn O / m o0 / �� \ m cn m on 0 oos a► I�1��7 •o � �• �� �lh10 "►� �mC to ITl A1R1v0 I I \ 1Z �i O Ord "1 I 2 0 Q c� O ^1 m ;w s I� Im - ,q m B 1 2 '0 4 8411 \\ 1 y a �" 2 I� Z rn - 1 lO I s w T. I ©tl I I ^1 a -1 z 0 L.T - -66 = -- lam. ^1�i v ID �_ m o I BAS+ �� ��o i 1� I : #\ Z I ; ,�] m LOT 2 1I �, �^\ `�m DETAIL "A ko D 6 , l q wP __ 3 :Y \ 7M \ \ 1 „ =100' �U M Z �s ����� 2 �9.5I' \\ FLOOD ELEVATION c+� �,-'- �g-15� 1 d'�,, \ ��� \\ PER FEMA MAPS: te a. s•au, S�z �,>P \ Sso.o_ _-- - - - - -- \c �'- ���'- LOT _ ` _ ra N \ '4 ' T ,�� —�37t B 14 jq, � �N� - \ m �% 861.3 . f�EYq C 'Aq , \\ I o I� �''• AA, APPROXIMATE 859 ?S \\ ' m LOCATION OF ((,� M I 860 CONTOUR. I s ¢ a . -\ LANDS TO SOUTH AND EAST ARE IN FL ODPLAIN. E q� O � • \\ *0 Cif r1i 2 •\` tr p /ij� , � v4,j,, I ��`rSG'1c�`F, \ ,'•'• 51 � \ \\ lh/ I� \ R1 W. \j- � 0 S FE�� ZOT ��l r9�li \ 4 y�P'{� � WEST 114 CORNER P y i ` 1 1 I ��\�, �' l p A iq� �pa'1 � � I I SEC710N P ?9 -31 -18 (FALLS /N R /WR) D \\\ � \\ � ��T BE- o�N EAST -WEST 114 LINE N 89 ' 45 ' 33 "W 4379.27' 2 — .. — .. — . 105±' YY \ I N89'45 33'W 402.33 r Y . , ` ----- N89'45 � 33 " W - - - - -- 5260.98 � i I1NP�ATT�Q�gl- - - -- N89 / 5'33" W SEE SHEET 2 FOR CURVE TABLE, LINE TABLE, LOT AREAS AND NOTES EAST 1 GARNER NOTE: The parcels shown on this map are subject to State, County and SEC77AN 29 -31 -18 Township laws, rules and regulations (i.e. wetlands, minimum lot size, access (FOLWD ALUA&VU to parcel, etc.). Before purchasing or developing any parcel, contact the St. CAUN7Y MANUM£NT) Croix County Zoning Office and the appropriate Town Board for advice. LEGEND: ij} Section Corner Monument B;Sp; Denotes elevation, top of iron pipe. of Record • Set 1" x 24" Iron Pipe weighing 1.13 pounds per linear foot Prepared for and at the request of: N O Found 1 OWNER Iron Pipe R= Recorded As Daniel W. and Judy C. Fleming ' 1966 Nighthawk Drive . • • ...... ­Building Setback Line (50' from Right of Way) Somerset, WI 54025 JOB # WI057SU18 (75' from Navigable Waters) Drafted by. Ty R. Dodge Prepared by. 200 0 200 NO TM J EO Consuldilag Group, Inc. GRAPHIC SCALE 109 East Third Phone No. ird 24 Street, P.D. P. O. Box 325 SCALE IN FEET: 1 inch = 200 feet ird et, P. BEARINGS ARE REFERENCED TO THE EAST -WEST UNE 1 / 4 New Richmond, WI 54017 UNE OF SECTION 29, TOWNSHIP 31 N., RANGE 18 W. Sheet i of 2 WHICH IS ASSUMED TO BEAR N89'45'33 "W. to �'' =� Vol. 15 Page 4206 LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF STAR PRAIRIE COMPUTER NUMBER 038 - 1114 -70 -300 Parcel Number 29.31.18.486A -30 OWNER NAME: First BRIAN J Last RAFFERTY PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment X66 /�6NIGHTHAWK DR SECTION 29 TO 31N RANGE 18W %160 '/440 Line Description Line Description TOTAL ACREAGE 9.230 PLAT CSM 15/4206 LOT3 BLK 01 SEC 29 T31 N R1 8W 15 02 LOT 3 CSM 15/4206 16 03 INC PT OF PARCEL DESC 17 04 1758/217 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1 - General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit 'A9 TY R. DODGE _ = S•2484 ? �� 6619+81 ///4/ ?'0 Zoo 11h -20 = CLEAR LAKE _� , , KATHLEEN H. WALSH ..�•iZ =; •'••.,, WI REG TER OF DEEDS SO A19614 -od �''�o�,g SUR��OQc� pad sT�. CO. Wi CERTIFIED SURVEY MAP Located in part of the Southwest Quarter of the Northeast Quarter and part of the COPY fE if 13.00 , 3.00 ir''I Southeast Quarter of the Northeast Quarter all in Section 29, Township 31 North, not re c . 2 � Range 18 West, Town of Star Prairie, St. Croix County Wisconsin. apUrova�� RECORDI r, .,E COUNTRY LIVING LOT 1 �4I� ��3��EQ��SV�Y MAP I •'•: -r,. .y'lsl,,rir1;`' - - - - -- NORTH LINE OF THE I \- . — .. — !. — .. S E DETAIL A SE1140FTNENE114 - - -- _ VOL. 1040 1 �• .. - — — f Z PG._109 , ?92 S88 ,4 "E Z \ k\ ` 2.74 \ ma Co. \� ®' LOT:. 1 �. \ ®1=o 000� •"wS :FIC i \ r R' cn . r�20 � $ v �imm� to I�/B�A-ro °1al I g I< M v o I r i '• i � y Z a I I� � + N o C IS s > i m 66'' I ,�, 4 \' \�� ro � � � p � a I � ^ A E' ; K ZZ 1 8411 a t b�� I IN� m� �p I� " A © � ru IC K . = I I BARN !� ��� ` \� �� I .# m VO W I I> IM L LOT 2 -, �� ���m DETAIL $$ k 1> ,�s,O 1 " =100' 1� -7- � ss� 66 279. \� \��\ FLOOD ELEVATION - va 9P Napa' j : �4 877.9 a \`� 860.0 EMA MAPS. -- LOT 3 ' .` �O /,v v qS y� � � 1� FS $ I aan A_.3rT _. �:��. - '37f B r m �'' sl. • ' . O� E4A A r CPO/ `� r- . I a 40. o � APPROXIMATE 859 25 �� P ' rn LOCATION OF •� 94 �\ M 860 CONTOUR. 9 ��•. a • `\ LANDS TO SOUTH AND G -0 F � EAST ARE IN F� ODPLAIN. ` \ ' • �\ D c'` 1Z �.��5 7b�. q N Q ' S �`E L4i� S OT +•�y t� �O `�\ \S� - pf. �l�iy�C q `�'yE� 3 MIST 1/4 CORNER c� I \ ^�i \� I \�, 7� �� �vAn A P R y� (FA LLS /W R/V£R�1B P I \ \ \ S &4 yNOT,q�� qR 1 Iz \ ' rn �• BE- fq U) N i N89'45'33`W I(A ��� EAST– MIST 1/4 LINE 2 / 4379.27' \ 1051: YY �•� \ I� N8945 33 W 402.33 •. ��' 479.38, UN_P( ATTE[Z LAND -$. ' N89 45 - 33 "W ----- N89'45'33 "W - - - - -- 5260.98' - - - -- SEE SHEET 2 FOR CURVE TABLE, LINE TABLE, LOT AREAS AND NOTES EAST 114 CORNER NOTE: The parcels shown on this map are subject to State, County and SE•C71aV 29 -31 -18 Township laws, rules and regulations (i.e. wetlands, minimum lot size, access (FOUND ALUA&WM to parcel, etc.). Before purchasing or developing any parcel, contact the St. COUNTY MOMIM£NT) Croix County Zoning Office and the appropriate Town Board for advice. LEGM Section Corner Monument 87501 Denotes elevation, top of iron pipe. of Record • Set 1" x 24" Iron Pipe weighing 1.13 pounds per linear foot OWR• Prepared for and at the request of: N O Found 1' Iron Pipe Danlel W. and Judy C. Fleming R= Recorded As 1966 Nighthawk Drive . • . • • .. • . .Building Setback Line (50' from Right of Way) Somerset, WI 54025 JOB # WI057SU18 (75' from Navigable Waters) Drafted by Ty R. Dodge Prepared by. 200 0 200 NO tTH J EO Cons ng Group, Inc GRAPHIC SCALE Phone No. (715) 246 -4319 SCALE IN FEET: 1 inch = 200 feet 109 East Third Street, P.O. Box 325 BEARINGS ARE REFERENCED TO THE EAST -WEST UNE 1/4 New Richmond, WI 54017 UNE OF SECTION 29, TOWNSHIP 31 N., RANGE 18 W. Sheet 1 of 2 WHICH IS ASSUMED TO BEAR N89'45'33 "W. Vol. 15 Page 4206 f p pp c� p Y01. 1 8 4OPAGE 138 1\ STATE BAR OF WISCONSIN FORM 2- 1199 6 7 2 7 7 9 Document Number WARRANTY DEED KATHLEEN H. WALSH OF DEEDS ST. CROIX Go., WI This Deed, made between Daniel W. Fleming and Judy C. RECEIVED FOR RECORD Flemin husband and wife, -- -- -- -- _ — 0 3 - 06 -2002 9:30 AN WARRANTY DEED Grantor, and Brian J. Rafferty EXERT t REC FEE: 11.00 TRANS FEE: 357,00 -- — — — CERT COPY FEE: Grantee. PAGES: I Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Part of the SE 1 /4 of NE 1/4 and part of S W 1/4 of NE 1/4 of Section 29, Name and Return Address Township 31 North, Range 18 West, St. Croix County, Wisconsin, described as follows: Lot 3 of Certified Survey Map filed November l3, 2001, in THE RIVER BANK Vol. 15, page 4206, Doc. No. 661981. PO BOX 188 • 204 3rd AVE OSCEOLA, WI 54010 Together with and subject to a joint driveway easement as shown on said Certified Survey Map. Pt 038 - 1114 -70 _ Parcel Identification Number (PIN) This _ is not homestead property. OI) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this 7 iQ day of Fol'r'i"ry 2001 w . 9- _, —, •Daniel W. F emin __ • Glu_ dy C. ming C� AUTHENTICATION ACKNOWLEDGMENT Signature(s)L Fleming and Jud C. Flem husband STATE OF WISCONSIN ) and wife, — ) ss. n ^ County ) authenticated this !.f/ay � 2001 personally came before me this „_ day of the above named • Kristina Wand — TITLE: MEMBER STATE BAR OF WISCONSIN — .. - (if not, to me known to be the person(s) who executed the forcgoin3 authorized by § 706.06, Wis. Stets.) _ instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY • _ _ Attorney Kristina Ogland Noublic, State of Wisconsin H udion, Vt`[ S 1 _ tary P My Commission is permanent. (if not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) • Names or persons signing in any capacity must be typed or printed below their signature. W-1— Proas.w.1t company. Fond du L wl STATE BAR OF WISCONSIN ataass.2oat WARRANTY DEED FORM No. 2.1999 Gdf y RAF- �/rt�A 7� 8- a 3 ,4T Gov cc'ti7��e �� : as