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HomeMy WebLinkAbout040-1231-50-000 I - � Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Div.sion INSPECTION REPORT Sanitary Permit No: . 405051 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: Kelly, Brian I Troy Township 040 - 1231 - 50-000 CST BM Elev: Insp. BM Elev: BM Description: 160 InO I (V r,�rt�y r o 4 - ttt., ,'n TANK INFORMATION ELEVOION DATA / TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark / ( 00 �. Dosing 1 I Alt. BM lr CCt� V" odr 50 ~ j � Aeration Bldg. Sewer Ct Holding S t Inlet • g[� Is-_ bs SUHt Outlet TANK SETBACK INFORMATION S' TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Dt Bottom Septic O� I _ J Z - 0, )_6 i � Header /Man. Dosing I'' r$S� Aeration Dist. P' e I • bs q 4 _Q S 2 Holding Bot. System ; '15T ( 7 - O Z I Final Grade 3 b�� Q 1�Ys PUMP /SIPHON INFORMATION t Manufacturer De and St ove �� �• Model Number TDH Lift F ion Loss System Head H Ft F main Length Dia. Dist. to SOIL ABSORPTION SYSTEM Cvyi�iQjtj/ 36 BED /TRENCH Width / Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 9 q / SETBACK SYSTEM TO PILC BLDG IWELL LAKE /STREAM LEAC NG Man tur r: INFORMATION CHAMBER OR Type System: ,Nj q / / Model Number: DISTRIBUTION SYSTEM �/ ` 1 Header /Manifold I D �stributio x Hole Size x Hole Spacing Vent t Air Intake 1_ength Dia Length Dia y �� it] (- �pacing 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 Yes jai No Yes No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 696 Butterc3jp ouq H�uds WI 54016 (NE 1/4 SE 11/ 3 R19W) Countrywood Addn. I Lot 5 Parcel No: 03.28.19.1141 1.) Alt BM Description fr � -�"� r�^``r' """' IJ n'`A-C� 2.) Bldg sewer length= o[ D s l - A� •0 ��`� cam/ / - amount of cover = C $ It 1/ �f � Use othes de for additional n� revi sion Yes I , No formation. - Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) ""mo current gaA�ess': LloOl Re!�wn�1 U a0`1 huge gd��sS � 9� fvlAru--cl. fePlov2 7P12 ocLpocy JW4vl FInM the 3 kfoolv) Ylc, .�j Ic d3 lime ` 381 - V/6 - - - - - - --- - - s dings Division 201 W. Washington Ave., P.O. Box 7162 C ourtly �7 VV i iconsin Madison, WI 53707 - 7162 Site Address Department of Commerce � Sanitary Permit Application qp s O S / Permit Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide Check if Revision may be used for ses Priva Law, s15. 1 m State Plan I.D. Number 1. Application Information - Please Print All Info RECEIVE D Property Owner's Name Parcel Number ,��,/ Property Location ST. C MAY 1 3 2002 a o- z3( — St--Mm Property Owner's Mailing Address ROIX COUNTY S Gc� 4� ZONING OFFICE /G 1< ✓ — 'A; S T' N. R E' City, State Zip Code Phone Number Lot Number Block N umber Subdivision Name CSM Number C z Type of Building (check all that apply) ❑City 1 or 2 Family Dwelling - Number of Bedrooms ❑village Public/Commercial - Describe Use ownship Roid ❑ State Owned Nearest C 3 x III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B V ap ble) A. For County use 1 ew 2 ❑Replacement Sysj1swed 3 El of 6 ❑Addition to stem Tank Onl Eris ' stem B. heck if Sanitary Permit Previous Permit Number Date Issued IV of Permit: (Check all that apply)(numbering scheme is for internal use ' 44 on _pressurized In -Groin 21❑ Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland �� 22 ❑ Pressurized in-Ground 41 ❑ Holding Tank 48 El Single Pass 51 El Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Reciiculating 30 ❑ Odrer V. rsal/1Yeatment Area Information: Design Flow WM Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(Gals./Days/Sq.Ft.) (Min./Inch) Elevation Kob 3 VI. Tank Info Capacity in Total Number Manufacturer Concrete Co Snstructed Steel Glass Plastic Gallons Gallons of Tanks New Existing Tanks Tanks Septic or Holding Tank - / Dosing Chamber VII. Responsibility Statement - 1, the undersigned, qpume respoasrbility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) ' MP/MPRS Number Business Phone 7 Number { Plumber Z 6 7 Plumber's Address (Street, City, State, Code) V. Count /De artment Use Only Agent Signature o Stamps) Sanitary Permit Fee (includes Groundwater Date Issued Issuing gna (N Approved ❑ Disapproved Surcharge Fee) ❑ Owner Given Initial Adverse �- Determination Conditions of Approval/Reasons for Disapproval - ��, Attach complete plans (to the County only) for the system an paper not less than 8111 x 11 inches to size 1Qan -A'A4R !R . 0.5/011 'L PLOT PLAN P ROJECT Brian Kelly A RESS 2514 Whv 100 S. #512 St. Louis Park Mn 55416 AE 1/4 SE 1 /4S 3 /T 28 N/ 9 TOWN Troy COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 5/11/02 BEDROOM 3 CONVENTIONAL XXX .IN -GROUN PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 LIFE TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 SORPTION AREA 933 # of chambers 30 BENCHMARK V.R.P. Base of Shed Sidin F' ASSUME ELEVATIO 1 00_ Filter Zabel A -100 ❑ BOREHOLE O WELL .H. R. P. Same as Benchmark SYSTEM ELEVATION 93.0/92.6 Alt. BM Base of Shed Shingles @ 103. V r 478' Property Line Od .M. B.M. 0 ' Nf✓' S SA 40' ST 20 1- Pro 4 Bedroom House 10' 45' 4% i B-3 Slope 0 c System elevation is to be T,,., Y s at at 4 ' Below Grade c� �, g,s' 4 / - .- 2 -3' X 94' Cells with >3' spacing Vent >6 „ Standard Infiltrator f of Cover Leaching Chamber with 31.1 ft2 of Area g U Lon 12" Grade at System Elevation 4 " 00 Plans Designed Using Conventional Powts Manual Version 2.0 PLOT PLAN i PROJECT Brian KeW A RESS 2514 Whv 100 S. #512 St. Louis Park Mn 55416 NE 1/4 SE 1/4S 3 /T 28 N! , 9 TOWN Troy COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE5/11/42 BEDROOM 3 CONVENTIONAL XXX IN -GROUN PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 SORPTION AREA 933 # of chambers 30 BENCHMARK V.R.P. Base of Shed Siding ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL •H.R.P. Same as Benchmark SYSTEM ELEVATION 93.0/92.6 Alt. BM Base of Shed Shingles @ 103.1' 478' Property Line .M. B.M. 0 ' 45' B- 40, 40' B 0 ST 20 o 4 Bedroom H ouse 10' 45' 4% i B-3 Slope a� a. 0 System elevation is to be set at 4' Below Grade 2 -3' X 94' Cells with >3' spacing Vent ALong Standard Infiltrator Leaching Chamber with 31.1 ft2 of Area 2" U Grade at System Elevation 34' t; Plans Designed Using Conventional Powts Manual Version 2.0 Wisconsin Department of Commerce SOIL EV LUARI@ttLRff0T Page of Division of Safety and Buildings in accordance with Comm 85, V is. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan MAY 1 3 include, but not limited to: vertical and horizontal reference point (BM), di action and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distan to nMreE'�U� Please print all information. ZON ING O F 'ewed y Date Personal information ou vide ma be used for seconds (Privac () ( ` ,8 y pro y secon purposes Privac Law, s. 15.04 t )) m Property Owner Property Location Govt. Lot ; 1/4_, S T YN R d E (or W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# s 1 -- S/ City to Zip Code Phone Number ❑ City ❑ Village jffTown Nearest Road C4 M New Construction User Residential / Number of bedrooms Code derived design flow rate OCJ GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable ft. and 'bons: S Sf ., �! _ �j O Col 9a�93.9 E.� Uzi a Boring # ❑Boring 1 1 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 ©-� z .3 _ /, G L 47 g1 Raring # ❑ Boring H pit Ground surface elw�_ ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 2 Effluent #1 = BOD > 30 < 220 mg/L and TSS > 150 mgA. ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST me (Please Print Signature CST N umtpr I '; k a"— f,-� - '�J� .1-- 22 Address �e /1 Date Evaluation Conducted / Telephone Number Property Owner _ Parcel ID # Page of Boring # ❑Boring ��— a 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# -g Y X31 �D 3E" i 3' T o a Boring # C] 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 Boring a # ❑ 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 Effluent #1 = BOD > 30 1220 mg/L and TSS >30 150 mgll_ ' Effluent #2 = BOD 130 mglL 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. SBa8730 OLUOD) Soil Test Plot Plan 'Project Name Brian Kelly Shau rd Address 2514 Hwy 100 S. St. Louis Park Mn 55416 IM #226900 Lot Subdivision ---- --- Date 1 5111/02 NE 1/4 SE 1/4S 3 T 2 8 N /R W Township Troy n Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Base of Shed Siding System Elevation 93.0/92.6 *HRpSame as Benchmark Alt. BM Base of Shed Shingles @ 103.1' 478' Prop Line Ak A �t B. M. B.M. _ 0' 45', B- 40' J 3 v 1 B- 40' 90' 1 0 4 Bedroom 98' 10' H ouse o 45' 4% � :1 97' B -3 Slope 0 U a a U 1878P 978 y 677282 KATHLEEN H. VALSH REGISTER OF DEEDS ST. CROIR CO., VI Document Number Document Title RECEIVED FOR RECORD St. Croix County 04 -25 -2002 12:30 PH ZONING AFFIDAVIT Occupancy Affidavit EXEMPT : REC FEE: 11.00 TRANS FEE: COPY FEE: 2.00 CERT COPY FEE: Name — (Owner) Typed or printed PAGES i being duly sworn , states, under oath, that: 1. He /she is the owner /part owner of the followin parcel of land located in St. Croix County, Wisconsin, recorded in Volume Ig 7� Page /(p a Document Number St. Croix County Register of Deeds Office: Recording Area me A parcel of land located in the W E %4 of the '/, Na me and Return Address of Section � , B d Aelle Ret u TA_ N - R 1g_ W, Town of - rr , St. Croix WP /PPI A /9Ve . County, Wisconsin, being duly described as fe4lows (include lot no. and ��� subdivision/CSM or detailed legal description): �� ��n� �IPo� 7uwn ����y., 0`'o- D 31 -517-0 oo I / ' 0 „ Parcel Identification Number (PIN) As owner of the above described property, I acknowledge that the septic system serving this residence is sized for a 3 bedroom home, or a design flow of y5o gpd. The design flow is calculated by assuming 150 gpd for 2 individuals per bedroom. There are currently �L occupants living in this residence; _ occupants are permitted based on the design flow. Therefore the septic system serving this residence is code compliant. However, I understand that if there are intentions to exceed the number of permitted occupants, the system will need to be modified to accomodate any increased wastewater flows and /or contaminant loads. I also acknowledge that I will make this information available to any future parties interested in purchasing this property. Dated this day of i d, AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) )ss. authenitcated this day of St. Croix County. ) oZDO onally came before me this a day of r' the above named * r- e 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. Stats.) instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY • ' v Notary Public, State of Wisconsin (Signatures may be authenticated or acknowlWO. Both are not My Commission is permanent. If not, state expiration date: necessar •. ' 0 Date: I - - a o 3 ry) �, a "THIS PAGE ARj OF THIS Ltd'AL DOCUMENT — DO NOT REMOVE" 1 •` T1, - � 11 This information must be completed by submitter: document title. name & return address. and PIN (if required). other information such as the granting clauses, leagal description, etc. may be placed on this first page of the document or may be placed on additional pages of the document. Note: Use of this cover page adds one page to your document and 52.00 to the recording fee. Wisconsin Statutes, 59.517. I ­AW"A J . ci aa.,a rnppucattun satety Dt Buildings Division In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 Department of Commerce Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 s,7 -0 [Privacy Law, s. 15.04(lxm)] D// V (Submit completed form to county if not Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size. state owned.) CountY� J , State Sanitary Permit Number ❑ Check if revision to previous application State Plan I. D. Number O L Application Information - Please Print all Information Location: Property Owner Name IVED ffD� Location c c� Y l - 1/4 1/4, S3 O rProperly Owner's Mailing Address t Number Bl APR 2 5 zooz � - Lo umber f f:f t City od e P ne N IX COUNTY Subdivision Name or CS V I ZONING OFFICE ( J II. Type of Building: (check one) as s City 1 or 2 Family Dwelling - No. of Bedrooms • V" - VCW16 : ❑ Village ❑ Public/Commercial (describe use):_ �,.„� f ❑ State -Owned N t Ro 2_) 3 1 IC.93.1 e.He.Qn cQQQs Parcel Tax umbers) ©Y/1 - rz3i 0 -d IIL Type of Permit: ((;heck only one box online A. Check box line B if applicabl A) 1. a 2. ❑Replacement 3. ❑Replacement of 4. 5. 6. , Addition to System System Tank Only Existing System B) 13 A Sanitary Permit was previously issued Permit Number Date Issued IV Type of POWT System: (Check all that apply) 'E -too n-pressurized In-ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In -ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic T ent Unit Recirculating ❑ Other. V. Dispersal/Treatment Area Information: 1. Design Flow (gp) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Perco 'on Rate 6. System Elevation 7. Final Grade Required 9o() Proposed I Rate (Gaislday /sq. R) (MinJmch Elevation VII. ank acrty in To # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons ons Tanks Con- n- g lass New Existing Crete stru Tanks lTdc� ❑ ❑ ❑ ❑ 13 15� 13 VIII. Responsibility Stat9fient I, the undersigned, assugk responsibility for insolj#tion of the POWTS shown on the attached plans. um is Name (print) Plumber's S' (no stamps): MP/MPRS No. Business 1W Number Plumber`s Address (S City, State, Z. GWW 6z2� � 1 S IX d l CountylDepartment Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) O.A pproved ❑ Owner Given Initial Adverse Surcharge F ) CD Determination ZZ ( 2 X. Conditions of Q Approval /Reaso for Disapproval: 0 Z P -L, i r cam__ C acQBo �. s �. t�ca��•s . 3D -6398 (R. 07/00) '' " PLOT PLAN PROJECT Brian Keliv RESS 2514 Whv 100 S. #512 St. Louis Park Mn 55416 NE 1/4 SE 1 /4S 3 /T 28 9 W TOWN Troy COUNTY ST. CROIX 4/17/02 BEDROOM 3 MPRS Shaun Bird 226900 DATE CONVENTIONAL XXX IN- GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK -WE LOAD RATE .5 ABSORPTION AREA # of chambers 30 IL BENCHMAF R.P. To of V Steel Pip ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL IH.R.P. Same as Benchmark SYSTEM ELEVATION 95.3 _ Buttercup Ct. Ayl� - s�.,� ; �� � _ �0 3. Zo � Otto �s S i t st . � Pro 3 Bedroom House 20' .M. B. M. t T B -5 48' 50' 6 ' Vents B- 2 System elevation is to be B -4 83' 46' set at 3' Below Grade _ 1 3 ' 2 -3' X 94' Cells with >3' spacing Vents 108' 0 Vent B-2 >6 „ Stan Infiltrator ¢ Leac g Chamber ° of Cover wi 31.1 ft2 of Area 9 9t 00 6' Long 12„ Plans Designed Using Grade at System Elevation Conventional Powts 34$' Manual Version 2.0 197' Property Line r PLOT PLAN PROJECT Brian Kelly AP RESs 2514 Whv 100 S. #512 St. Louis Park Mn 55416 f NE 1/4 SE 1/4S 3 /T 28 4r` 9 W TOWN Troy COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE4 /17/02 BEDROOM 3 CONVENTIONAL XX)C IN- GROU;; PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 LIFT TANK SIZE DOSE TANK SIZE HOLDING TANeKE LOAD RATE .5 ABSORPTION AREA # of chambers 30 BENCHMAR R.P. To of 1" Steel Pipe ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL sH Same as Benchmark SYSTEM ELEVATION 95.3 Buttercup CL -- fo3.Zo Pro 3 Bedroom House 8 ' 20' B.M. M. T t B -5 48' 50' 6 ' Vents B- 2 9 System elevation is to be B -4 83' set at 3' Below Grade 46' B -1 3 ' 2 -3' X 94' Cells with >3' spacing Vents 108' N B -2 j L Standard Infiltrator Leaching Chamber c with 31.1 ft2 of Area 97' 00 Plans Designed Using 34 Grade at System Elevation Conventional Powts Manual Version 2.0 197' Property Line 'iVisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations Division of Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY 1: Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but r01 / not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PA 3� eFk /� dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION R 0 199 ATE PROPERTY OWNER: PROPERTY LOCATION t Richard Stout LOT NE `1/4 SE 1 / T 2800 19 ) PROPERTY OWNERS MAILING ADDRESS �, LOT # LOCK # SUBD. NAM 1353 Awatukee Trl. A na CITY, STATE ZIP CODE PHONE NUMBER []VILLAGE [[TOWN R A Hudson, Wi. 54016 (715)549 -6731 Troy Tower Rd. (x) New Construction Use (x] Residential /Number of bedrooms ( ) Addition to existing building j I Replacement [ I Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate gi bed, gpd/ft _ trench, gpd/ft Absorption area required 900 bed, ft2 750 trench, ft Maximum design loading rate .5 bed, gpd/ft .6 trench, gpd/ft Recommended infiltration surface elevation(s) 95.35 ft (as referred to site plan benchmark) Additional design / site considerations alt. site - 94.85' Parent material ground moraine 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 for system 5 S ❑ U 3 ❑ u [3 S❑ U I ® S O U 0S ®U ❑ S MU SOIL DESCRIPTION REPORT NQ, Un-: 0 7 U j Aj 1,10M . Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bartdaty Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tierdt ti 1 ...... 1 0 -9 10 r3 3 none 1 2msbk mfr gw if .5 .6 . S `° 2 9 -17 10yr4/4 none scl 2msbk mfr 9w if .4 .5 • `F Ground 3 17 -80 7.5 r4/6 none is osg mfr na na .7 .8 .� elev. 9 8.8 ft. Depth to limiting fac a f � �E Z 1 � Remarks: Boring # 1 0 -12 10 r3 3 none sl 2m r mfr gw if .5.6 •S^ 2 2 12 -80 7.5 r4/6 none is osg mvfr na na .7' .8 Ground elev. 98 ft Depth to limiting x+80„ Remarks: T Name: — Please Print Gary L. Steel Phone' 715- 246 -6200 Address: 1554 200t Ave., New Ri hmond, Wi. 54017 Sgnature: Date: 10 - - CST Number: MO2298 PROPERTY OWNER Richard Stout SOIL DESCRIPTION REPORT Page , 2 ofd_ PARCELI.D.x Pending Boring # Horizon Depth Dominant Color Mottles I Texture Structure Consistence l&UT ly I Roots GPD /ft in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh . Bed iTrendi 3 1 0 -12 10 r4/3 none 1 2msbk mfr if .5'.6 r" 2 12 -21 10 r4 4 none scl 2msbk mfr aw If A .5 •`f Ground 3 21 -84 7. 5 r4/4 none lfs osg mvfr na na .5 .6 elev. 99. ft. Depth to limiting f a c tor 84 Remarks: Boring # » 1 0 -8 10 r3/3 non 1 2msbk mfr 9w if .5'.6 •S" 4 2 8 -16 10yr4 /4 none scl 2msbk mfr gw If .4 .5 .,............. 3 116-42 7.5yr4/4 none scl 2mgr mvfr gw na .4 .5 Ground elev. 4 42 -80 7.5 r4/6 none lfs osg mvfr na na .5'.6 .� 98 ft. Depth to limiting factor +80" Remarks: Boring # , S 1 0 -12 10yr3 /3 none 1 2msbk mfr if .5 .6 5 <> 2 12 -21 10yr4 /4 none scl 2mgr mfr gw If .4 .5 3 21 -83 7.5yr4/6 none is osg ml na na .T .8 +�- Ground elev. 99 ft. Depth to limiting factor +8 " Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 6330(R.05/92) STEEL'S SOIL SERVICE Gary L. Steel Richard Stout 1554 200th Ave. CSTM2298 NE4SE4 S3- T28N - R19W New Richmond, WI 54017 MPRSW 3254 town of Troy (715) 246 -6200 lot #68- Country Wood I X02-1 /N I" =40 BM.= top of 1 steel pipe @ el. 100' Alt. BM.= top of steel fence post @ el. 103.20' S I 2` � 108 V� 1 Z ©0 f �C" Gary L. Steel 10 -30 -95 Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 Contingency Plan 1. If system fails, determine cause of failure, use alternate area and install new system or install system at a lower elevation. \ 2. Replace any other failing components as needed. I Plumber: Shaun Bird 715- 246 -4516 �P" Shaun Bird #226900 04;12 /2002 15:43 FkK 6514500113 Hoffman Q007 F" PC COLL EiLM 88RMmER5 EXC FAX N0. : n52943M Mar. 19 29Q 09: 9141 Pi ST CR OIX COUN" SEPTIC TANK hWNT8MV4M AGNMAPNT AND OM1M tldlh callpiCAT]ON FORM fey AAdon ` ,[3a "=' et l {r,soz �v.0�6 ; ve++Seaeia. �•r•!r+ uem t�aeetee .... ckws4td thz�X4 a�T rat idandge t:on Number Fmpwty F.pzww A , Y., �e- v" Spec. i y .R Rtt, Lawn of a&-la �v sab�itrooan _f1vr1�'rY iL �` cw" Sara",. Map I yai ?Age wwwwq Dad ti �q7� vokmwl'6 7_ f3 IV= ban (3 .es OY w rat Ul= :4Mifiai:le t yesx 0 no � V 1t�O/Ietlaa riwilw�resit7orr �tJcayseestaeldtrtretio � resltaae•faJaene i,� wasb.l'ee�1o%oleseaos 44M" atroll4frs rot tM 3MwW tank - MT done yaaa a .eat ir asdd by a i trasad der. wbI yon roe bo tin 11t ae adt ttie fisliaat ei ;Ye aarala aeait es a ttateoW >t v it the 'wo &*ad mum �sr 1 w s rwr Ide to MlM* 10 S. Csaa Zowe D%mumm a swdRuYM fim, VW by lye arr ad by s a a psgw aI 1& 9 4 oMWt.. atr" M Slue wise Ind yaoariss (if mil), do settle ant is tae arse U3 ddt al atadp. L4.. ie..l.efpld b w ease ois aM.. W /p..Ia sairde tie > .w W+W dtspoW srn® tie Me"** Ie: fib bassi. as a.I y►16s 27sraelsac ec C�aIsllse aoi D.p srtse.e e( Atelataf a&%=w , Saw arWbrass. CoAgal Iq Mas 6*70 sopfo Mar. whw bone ireidao d mug bo omop wl aed.aa...if W 6A SI. C n:s CMy ZO" Oma W ftb 30 dllyoo a[tlot .off daft �=vrts aa� owrs 1 (04 sm* dw aR Nowasso da trio ONO we tm w *6 tax ac ear di4. 1(vo) awt (ISO tin owwAS) of •a P�*0► b *ywa a f • y dsed wooWW is Room of band Oaten. MMMM OF AftgtWr aA � Air dose Ie aiiw+.rneaNaa mq seestt ie tYa +Ir nwtei ....1ce3 �r dR ta.+.s Oapastars ••• •« 'y tedeea wMi We ppgsNlw; a M MPQd .aaaWat •=d Mm to %%suer d O Iles ■ Off of Ito e W fiad Horeb Mq u sahano same as at *Wnw v And •U 1875P 162 � STATE BAR OF WISCONSIN FORM 1 - 2000 WARRANTY DEED 6 7 6 6 9 8 Document Number KATHLEEN H. WALSH REGISTER OF DEEDS This Deed, made between Cory J. Breunig, ST. CROIX CO., WI a single person RECEIVED FOR RECORD Grantor, 04 -19 -2002 10:30 AN and Brian Kelley and Robin White, _ WARRANTY DEED both single persons as joint tenants EXEMPT# Grantee. REC FEE: 11.00 TRANS FEE: 147.00 Grantor, for a valuable consideration, conveys to Grantee the following COPY FEE: described real estate in St. Croix County, State of CERT COPY FEE PAGES: 1 in (the "Property ") (if more space is needed, please attach addendum): Lo 5, Plat of Country Wood, Town of Troy Recording Area Name and Return Address Edina Realty Title 400 South Second Street, Suite 115 Hudson, Wisconsin 54016 4 _ 040 - 1231 -50 -000 Parcel Identification Number (PIN) Together with all appurtenant rights, title and interests. This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Roadways, Easements, and Restrictions of Record. Dated this _�11 day of _ April 2002 . s * Cory J. Breunig AUTHENTICATION ACKNOWLEDGMENT � ttt STATE OF WISCONSIN ) t Signature(s) F1 P e� ht IIr4 ) p ry St. Croix County. ) ss. authenticated this day of Personally came before me this �z eI day of �0 April 2002 the above named M Cozy J Breunig_ - y TITLE: MEMBER STATE BAR OF WISCON 9l Ili, OF 1,1 Icy` (If not, tome known to be the person who executed authorized by §706.06, Wis. Stats.) the fore go¢tg in Ste d acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY t Ka V. alm Michael H. Forecki Attorney No Public, State of Wisconsin Eau Claire, Wisconsin My Commission is permanent. (If not, state expiration date: ( Signatures may be authenticated or acknowled ed. Both are not necess December 12 4 *Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1-2000 norney Michael H Forecki 1830 Brackett Ave, Eau Clain: WI 547014627 T6409013.ZFX Phone: (715) 835.3029 Fax: (715) 835-4112 Michael H. Forecki Produced with TpFO M­ ty RE Form,rdet, LLC IW25 Fifteen We Road, Claw Tawnahp, Michigan 48035,(8W) 3839905 *CHARD 0. STOUT 6 JANET P. STOUT a� 1343 AWATUKEE TRAIL r ` NU060N WI 54016 ct - W d� EI 14 CORNER E toast �'4I'H'L •�� SECTION 3 Lei O 11�N1.M� Imo. AT MQ 30 TO V/4 COR.) mg FOAM 116lr90'41 . 8 0.96 rmw coruTID R iw. yQ O � V $ v N ro to v r C ro I ?T I " u VOL. 3, F'G. 2130 a a " IRON PIPE FOUND r )" IRON PIPE FOUND N86'52'56 "E, N89P02'00 "E, 0.87' r z� Q.88' FROM COMPUTED CORNER FROM COMPUTED CORNER N89 0 41 X 26 ( EAST) 590.00 , o° 197.57' _ 210.90' 5.47' 181.53' m 25.E-00' 14 A 953.02 I` 1 g 4 z 5 ° 3 c 8 2.10 ACRES 4 2.20 ACRES j 2.01 ACRES m = 91,476 SO. FT. 95,830 SO. FT. 87,460 SO. FT. CJ 0� o N I D N 1l O SHEET I 2 \ S8 P52'31"E C F 125.50 � �' o ve" /