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040-1318-00-009
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 488111 0 (ATTACH TO PERMIT) GENERAL INFORMATION ate PI ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 2 -� Permit Holder's Name: City Village X Township Parcel Tax No: Troy Development Corporation Troy, Town of oyo - / 3 /$ - - co l g CST BM Elev: 9 F,(q 4 B Description: - SectionlTownlRangelMap No: ��( 11.28.19. JZ��n zo y TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. �.' /4 !T eiv-'r 4) Septic J Z � Bench ark ��-� (Z "Q ----�- Dosing U Alt. BM C Aeration Bldg. Sewer r l �D �Z • 2`�� — Ho l ing T t/ t Inlet � .'-D S t/ Ht Outlet 1 f TANK SETBACK INFORMATION 07 3 TANK TO P/L WELL en o itnae t net R � 13�� &. d�' q, S eptic 2 - (CO' 35 4V Dt B ottom ) It". 39 I D, D osing O r r r tQs r ea er an. �3• /1L A eration Dist. Pipe (,P0 q r / 0:73. 1 7 L o Ing o. System L f o3Z• J 1 PUMP /SIPHON INFORMATION F;+ +r¢6 t, ?/ /4 anu ac urer eman ove c3a r 2 p 6c�1 -�S GPM 3 Opm L IU Friction LOSS ystem m ea 13. ? 1W t nw " ABSORPTION SYS F-M DIMENSIONS 1/ SD I 92 INFORMATION 7 l tOJ CHA ER 5 /� / lJ _ -- ` Lk Pipe(s) - Lengt Di F I �l2— Length r ')Dia ' D Spacing 2- l x Pressure Systems Only xx Mound Or At -Grade Systems Only th Of Bed/Trench Center Bed/Trench Edges Topsoil Yes No ;1.8-. es No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1. ( Inspection #2: Location: 487 Promirgnce Way River Falls, WI 54022� 1/ 1/4 1 R19W 1 i! s of ry o tt � Parcel No: . (N� a 4� N� 1 T28N ) Cup 1.) Alt BM Description r 2.) Bldg sewer length amount of cover - = *> t fy 50'1, � T Plan T isionRuired � No t Use other side for additional information. 1 �ert`No. _ - - - --- i s i u - ------ - - -- -_ - - - SBD -6710 (R.3/97) V Safety and Build' vision County m IF 201 W. Washington e., P: on5in Madison, WI 707 E emit Number to be filled in b y Co. ) I V De (608} 2 -3151 artment of Commerce Al A Sanitary Permit Applicati p 200 State P J.D. Number 7 In accord with Comm 83.21, Wis. Adm. Code, personal in o you 191vi z 4 17 ' 7 / may be-used for secondary purposes Privacy Law, s15. -' `��X C Pro'e Address (if different than mailing address) O J g es ) ' UNT � I. A , . Application 8 pp anon Information — Please Pri I �o,nn e Property Owner's Name ` Parcel q Bloc # Yo e- o e, a,,t/ / e � V �/3 N S U mil/ �e7�✓ h ! 1--- Property O er's Mailing Address P�ro�pe�rty I,oc lion �o- G Aj ' %, '/, Section i tty, State Zip Code Phone Number ✓ e trcl o II. Type of Building check all that apply) 6 K �,, N,; T N; R �/` E oa5� yp g { pp y } �,.�, I -Iaosc X-1 or 2 Family Dwelling - Number of Bedrooms 7 ' 0 1 ° C /Ylc.:.� 3 5ubdivisior. Name CSM Number �T El // ' o Public/Commercial - Describe Use �j .- ❑ State Owned - Describe Use Ao n �JD 'Y p� ❑Ci ❑Villa e ty_ g lkownship of p III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A, )Z Ne S s tem y ❑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. T e of POWTS S stem: Check all that a 1 o ❑ Non - Pressurized In -Ground 1 0Mound > 24 in. of suitable soil ❑ Mound < 24 in. otsuitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized in-Ground ❑ Bolding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recircula ing Sand Filter U� Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pi ❑ Other (explain) V. Dis ersaVrreatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (s Dispersal Area Proposed System Elevation a ao s 3 7 4 'r Vi. Tank Info Capacity in Total Number p ty um r Manu acturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing � �' / r / Tanks Tanks �/ G f^' Septic or Holding Tank � a � o � � Aorobic Treatment Unit Dosing Chamber r VII. Responsibility Statement- 1, the undersigned, assume responsibility for jpWilation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP PRS Number Business Phone Number ��•�fe' s as Plumber's Address (Street, City, State, Zip Codej VIII. Coun /Ae artment Use Onl 3K P - Proved � =,=enReason Sanitary Permit Fee (includes Groundwater Dale Iss d issui gent Signa re o Stamp Surcharge Fee) } G p© ial 1AA 3 3d d IX. Conditions of Approval/Reasons for Disapproval a J n l J r 2� M4 ✓�cz /� CQ SYSTEM OWNER: 3 �� :1 d�cf M 'S�- 5 u e. 1. Septic tttttlt, eftkoM fNw and J L dispersal OW must all bcssrAm I MaWfth P as per mumpmW plan p cold by Oinbw m ! n" be 1111�ailMd y� i �i 2 as per opp Code f i• O i CL Attach complete plans (re du County only) for the system on Paper not less tha7/ I inches in size 5 CD /L Q r� SBD -6398 (R. 01/03) 1 IR30WJ k a:ne ;ter +n�c�;tt� xr; •y r ib4"s r9� ;r•:tiy • D4h!VCxI ",G�:• '�t�e.7rn�[i6noiri `F9t.� :ei 2!D:nrt�'n1 4 , -ADAO 9 1917 z6 c/ /0Ca ;Gn o>`' - ■Sao, " 1 ¢ de/ua �or, �, ♦ 16 Ile va-�or, • �oe�.�ed�orgo sz�,t -e L�9, P/az�w I of, — i oy , ' Err = 7S. /6' 12W . Sep � oPosto► �.J:est r' Cdnere�Ee �� Pa /y /pKOL- s2Sepf /acrr� � io73.;6 f /�ra� ou•� /Cft. � y, � C.c.s�occr ;u r v wc,o7st� - -nR o z &. 2. s3' R- 9e, (3 /ylou�dQr✓ 2z.l,3;r 99. z2' Ele,ji' �o67.s�z'a1s,r. � y s.'r 8/. S9'�'s�oersa/ ce� Sir(4J c 0 d, 5tr,ba.6an la 1 4 at;'X 3J .zo �. 8 Or /O r t lc� vler oy /OCCa- &iGn of ♦ GX�s�i'���ade 4le1/12 1�,�n . ' 40ca, 1 ,0 �,n .56 0 7 A i9uI, (�i Lly .zs3 Pr6po Std LA). /' cr." a-rc�e W/ .2SO Sep6:c. 6Y -n1( /y /0KpL. s2S elf' /k a.,6 io73. i6' ;u R- 9A ,a �eS�a/UIC� d bu;/dln? e+- ` r v W t or opa o ( , <) /oca -{�'on ��oposc -c� �;csci u' • � Q� z&,Z.5-3 R 9e- / ., d i e i of 6a, Oe. n io67 s�i'�1s. �. 4opvscd 1,youad az6 22.(o3'z 9R 2Z' / C. �/. Si r(4) �, 8 0-r /O W isconsiri Department of Co erce EID) SO , EVALUATION REPORT Page 1 of 3 Division of Safety and Building' in accordance with 8$ Ws. �hn. C c County ST. CROIX lar6 Attach complete site plan on paper riot less than 8 1/2 x 11 ' es In size. P'rno" include, but not limited to: ve ical and horizontal reference poi ctlon and Parcel I.D. (PENDING) percent slope, scale or dime sions�AottWdriv(AAHMEF tion a d distance to road. PI FILE vie Za Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 7 06 Properly Owner Property Location k - NORTH DAKOTA STATE UNIVERSITY C/O Leo Beskar Govt. Lot ---- NE 1/4 NW 1/4 S 11 T 28 N R 19 E Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# Rodli, Beskar, Boles & Krueger SC, 219 N. Main Street 9 ity - -- Hills of Troy City State Zip Code Phone Number village Town Nearest Road River Falls, WI 1 54022 ( 715 425-7281 Coulee Trail • w construction Use Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Q New �] Q Replacement Public or commercial - Describe: {�lL j'/ h , , a 1) e7�? f Parent material loess over till g lood Plain elevation i applicable NA ft General comments t /�,/� � /' / I /,�� r 'c vvl o n yste -- 1 00 fta sand fits -- G oading r t /� / � and recommendations: �/ V /"(��/V 'vLf �/(Q a(,(,(1 ' �j '1 'uv gr lz P-i) y �f. A� T3 ) C S (If pre -tre t i s st Ae o o nd 1 m a 6 - 7 Z D Boring Wlda a LCJ - t 7,7- q ❑ A Boring # / Pit Ground surface elev. 1 ft. Depth to limiting factor 32 ✓ in Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/If in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 qq 1 0 -4 10YR3 /2 - sil 3fabk mvfr cb 3vf-co 0.6 0.8 f ` 2 4 -9 10YR3/2 sil 3f -mabk mfr as 2vf -co 0.6 0.8 3 9 -16 10YR2/2 sil 2f -mabk mfr cw 2vf - 0.6 0.8 4 16 -22 10YR3/3 sil 2f -mabk mfr cw lvf -m 0.6 0.8 5 22 -28 10YR3/4 - sil 3fabk mfr cs lvf -f 0.6 0.8 6 28 -32 10YR3/4 - sl 2fabk mvfr cw 2fabk 0.6 1.0 7 32 -35 10YR3/4 c2f t0YR4 /6 scl Om mf -- -- 0.0 0.0 Borin 4 F Bonng # g 2 El pit Ground surface elev. 1 07 3. 4 ? ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fF I in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 04 10YR3/2 - sil 3fabk mvfr cb 3vf -co 0.6 0.8 2 4 -9 10YR3/2 sil 3f -mabk mfr as 2vf -co 0.6 0.8 -- 3 9 -19 10YR3/4 - sil 3fabk mfr as 2vf -f 0.6 0.8 4 19 -24 10YR4/6 sl 1 fabk dsh cb i of - -f 0.4 0.7 5 24- -- -- lsbr - -- -- -` -- * Effluent #1 = BOD > 30 220 mg /L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg /L CST Name (Please Print) gnature j CST Number Mary Jo Hollister 224832 Tele hone Number v luation Conducted p Address Date E a W9875 690th Avenue, River Falls, WI 54022 09-06-05 (715) 426 - 1775 l � s Feb 2 3 06 02:58p owner 7154264827 p -2 (Pending) Page 2 of 3 Property Owner NDSU (Lot 9) Parcel IDS / 1 El C Boring # Boring 25 ✓ Pit Ground surface elev. 1071# ft. Depth to limiting fador in Soil ication Rate Horizon Depth Dominant Color Redox Description Texture StnKtttre Consistence Boundary GPD/ll Roots .EtW-Ef1#2 in- Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0 -6 IOYR3 12 — sil 3fabk ds cb 3vf-co 0.6 0.8 2 l OYR_3/2 6 -12 sil 3fabk ds as 2vf-co 0.6 0.8 — 3 12 -23 10YR314 -- sit 3fabk dsh as 2vf-m 0.6 0.8 — sl lmabk dsh cs lvf -m 0,4 0.7 4 23 -25 10YR3 5 25 -28 -- -- tilVlsbr — -- -- — -- a Boring # Boring ft. Depth to limiting factor in- Pit Ground surface elev. ep Soil liration Rate Horizon Depth Dominant Color Redox Description Texture Structure Conslstence Boundary Roots 'EfI#1 'EIM in. - Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Boring li Boring # Ground surface elev. ft. Depth to miting fador in. Pit Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Stnidrxe Consistence Boundary Roots GPD Eff#2 in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Effluent #1 = BOD, > 30:S 220 mg/L and TSS >30 < 150 mg1L ' Effluent #2 a BOD, < 30 mg/L and TSS 130 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. son- na�uroi (x.mn�» NDSU (Lot 9) 1 ID # (Pending) Page 2 of 3 Property Owner Be , l / /� Boring 7 (J'v 0 Z VP�"61 -e1 UAh�_� Boring # r " ° f LJ Pit Groun!Red a v. 1072.L{ ci Depth to limiting factor l'r Soil A fi tion Rate Horizon Depth Dominant Color ox on Texture Structure Consistence Boundary Roots GPD /fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -6 IOYR3 /2 sil 3fabk ds cb 3vf -co 0.6 0.8 2 6 -12 10Y /2 sil 3fabk ds as 2vf -co 0.6 0.8 - _ _.. 3 12 -23 10YR3/4 -- sil 3fabk dsh as 2vf -m 0.6 0.8 4 23 -25 10YR3 /4 -- sl lmabk dsh cs lvf -m 0.4 0.7 5 25_28 _ -- till/Isbr -" -- -- El Boring # E] 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/fe in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F-1 F] Pit Soil lication 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 *Ef(#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- 8330Te t (R.07 /00) Feb 23 OG 03:07p owner 7154264827 p•2 Plot Plan for Hills of Troy Page 3 of 3 Town of Troy, S t. Croix County, Wisconsin ' Lot 9 I" = 40 ft. Legal Description , /c► of ttr �► r� .1►, T_ 2 ft. contours g% 0 TpWA) 1�F Ti2D Y = Backhoe pit S W " %0 • l - / R —SA 1 l � 1 y R _ m ; � 1 i I 1 1 _r .=R or- 4� E r �L, 1obb. Benchmark #1: Aluminum cap (North 'A corner, Section 11,129N. R19W) 380' North of Mount Curve ChatdSummit Ridge intersection, elevation ° 1084.42. i Bencimiark #2: WDOT aluminum cap marked "Troy GPS^ located 30' Southwest of the Prominence Way /Coulee Trail intersection, elevation a 1090.08. , • Plot Plan for Dills of Troy Page 3 of J Town of l a'oy, �St. �;roix County, Wisconsin Lot q 1 " = 4o ft, Legal Description N- - tee Ky�;. /u, s 3, T 2 ft- contours OF TKt V = Backhoe pit ••..� I ' to } �o; f R - 2 I 0 I r' i 9 I R -98 1 EI-157 :,:*# 5' c 9 e- Li ► I >< 0 11 1 SF r T-- L l ti o A A Benchmark fl: Aluminum cap (North 1 /. corner, Section 11, T28N, R19W) 380' North of ! ' Mount Curve Chase /Summit Ridge intersection, elevation= 1084.42. ` Benchmark #2: WBaT aluminum cap marked "Troy GPS" located 30' Southwest of the Prominence Way /Coulee Trail intersection, elevation = 1090.08. i Safety and Buildings commerce.wi. OV 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 isconsin www.commerce.wi.gov /sb/ www.wisconsin.gov Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary March 15, 2006 CUST ID No. 227990 ATTN.• POWTS Inspector WILLIAM C SCHUMAKER ZONING OFFICE SCHUMAKER PLUMBING ST CROIX COUNTY SPIA 1070 SCOTT RD 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 03/15/2008 Transaction ED No. 1247974 SITE: Site ID No. 710 Glen Johnson Construction Please refer to both identification numbers, Londonderry Way L above, in all correspondence with the agenc Town of Troy St Croix County NE 1/4, NW 1/4, S11, T28N, RI 9W FOR: Description: Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1065328 Maintenance required; 750 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 101), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01101); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. COJ? (lit The following conditions shall be met during construction or installation and prior to occupancy or use: APPR Reminders DEPARTMENT F5 , • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manuals listed above. SEE CORRE • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the POWTS installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat WILLIAM C SCHUMAUR Page 2 3/15/2006 • Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on -site during construction and open to infection by authorized representatives of the Department, which may include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance With the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the - county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of c onstruction/installatior /operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II, Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday charlie.bratz @wisconsin.gov cc: James K Thompson, A.C.E. Soil and Site Evaluations Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 i MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGC Residential Application l- INDEX AND TITLE PAGE s O , �O Project Name: Glen Johnson Construction 4 bedroom residential moun o� Owner's Name: Glen Johnson Construction Owner's Address: P.O. Box 809 Hudson, WI 54016 Parcel Address: Pending Legal Description: NE1 /4 NW1 /4, Sec. 11, T.28N., R. 19 W. Township: Troy County: St. Croix Subdivision Name: Hills of Troy Lot Number: 9 Block Number: Parcel I.D. Number: Pending Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Site Plan )F CO YPERCE Page 9 Concave distribution cell deflectio calc YANIJ Page 10 Soil evaluation report S�t�bGs 3P0 NDENCE Designer: Bill Schumaker License Number: 227990 Date: 02/28/0 / Phone Number: (715) 386 -3121 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) I Version 4.01 (R. 09/04) Page 1 of 10 i Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 83 -443 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of - 36 inches. 600.00 Design Flow (gpd) 5.00 Site Slope ( %) 1073.16 Contour Line Elevation (ft) 24.00 Depth to Limiting Factor (in) 0.60 In -situ Soil Application Rate (gpd /ft I Distribution Cell Information 81.59 Dispersal Cell Length Along Contour (ft) = F 7 - 5 - 01 Cell Width (ft) 0.98 Dispersal Cell Design Loading Rate (gpd/ft) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest o in the distribution Pressure Disribution Information network? Enter Y or N (c or e) c Center or End Manifold 2.50 Lateral Spacing (ft) If N above, enter the elevation ft 6 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 2.00 Estimated Orifice Spacing (ft) = 5.10 ft /orifice 2.00 Forcemain Diameter (in) 40.00 Forcemain Length (ft) Does the forcemain drain back? 1067.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 6.52 Forcemain Drainback (gal) 6.70 Vertical Lift (ft) 48.90 5x Void Volume (gal) 1.95 Friction Loss (ft) 55.43 Minimum Dose Volume (gal) 15.15 Total Dynamic Head (ft) 49.43 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options _c in. dia. o tions choice _ 0.75 y 1.25 1.00 x x 1.50 x 1.25 x 2.00 x I _ _ x 1.50 x L 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information 750.36 Total Tank Capacity (gal) 1250.001 Septic Tank Capacity (gal) 37.001 Total Working Liquid Depth (in) Wieser Concrete IManufacturer 20.28 gal /in (enter result in cell B49) Dose Tank Information Efflu Filter Information 750.36 Dose Tank Capacity (gal) Pol lok I Filter Manufacturer 20.28 Dose Tank Volume (gal /in) PL -5 Filter Model Number Wieser Concrete I Manufacturer Project: Glen Johnson Construction 4 bedroom residential mound Page 2 of 10 Mound Plan View T 1/10 B : :O: J . . . . . . . . . . . Observation Pipe K. : :"—* .. . .. . . . .. . . . . .. . . T j W ; .,g,. .E... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . M . . L Mound Component Dimensions A 7.50 ft E 16.50 in H Aft ft K 8.81 ft B 81.59 ft F 9.00 in z ft L 99.22 ft D 12.00 in G 0.50 ft J ft W 22.63 611.93 (ft) Dispersal Cell Area 1367.83 (ft Basal Area Available 7.35 (gpd /ft) Linear Loading Rate 1 8.16 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 1075.91 (ft) —� t iirirfrr 2 F : : + 1074.66 (ft) Lateral ; . ; . ; . : f ::: ::: Dispersal Cell 1074.16 (ft)� — Invert Dispersal Cell t Elevation E D :Ix: y,.. :i ,r._]. ;`� \' ;' ''4'ti: ti { t • -:.: �: �.. �.l . 1073.16 (ft) Contour Elevation 5.0 %Site Slope Geotextile Fabric Cover Shading Key g T Dispersal Cell See lateral details on 1❑ _ Topsoil Cap c a 1.5 ft Page 4 for number, size, ,, r: (2 — ] Subsoil Cap c ;4; fi� p;y. : {r�c{ . . and spacing of laterals. ASTM C33 Sand •:' �:�:�: •••:••:;• Laterals are equally F Tilled Layer c a 0.5 ft 'Typical Lateral spaced from the 0 Ego ti Aggregate v c distribution cell's centerline in the �- A distribution cell (AxB). Project: Glen Johnson Construction 4 bedroom residential mound Page 3 of 10 Center Connection Lateral Layout Daigram Force main connection via tee or cross to manifold at ang point. Laterals are identical S T P s t} = Turn -up wlball valve or I< X-4IE s12 1 x12 4I Laterals & force main of PVC Sch 40 clean out pl u g per COMM Table 84.30.5 Holes drilled on the bottom of the lateral. Number of Laterals 6 Orifice Diameter 0.125 in Lateral Diameter 1.00 in Orifice Spacing (X) 2.01 ft Lateral Length (P) 39.20 ft Orifices per Lateral 20 Lateral Spacing (S) 2.50 ft Orifice Density 5.00 ft /orifice Lateral Flow Rate 8.24 gpm Manifold Length 5.00 ft System Flow Rate 49.43 gpm Manifold Diameter 2.00 in Total Dynamic Head 15.15 ft Forcemain Velocity 5.05 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and —► — _ Comm 16.28 WAC Disconnect 4 in. min. Tank component is properly vented y location otrtlet location • Forcemain diameter Wieser Concrete Manufacturer 2 in. Capacityl 750.36 Gallons Volume 20.28 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 20.81 422.11 B 2.00 40.56 C Pump off elevation (ft) _t C 2.69 54.47 ♦ 1 1067.96 • D 11.50 233.22 D Total 1 37.001 750.36 il Dose tank elevation (ft) 3" Bedding un er tank. �— 1067.00 Alarm Manuafacturer LevelArm • Alarm Model Number DLV Pump Manufacturer JGoulds Pump Model Number 13887 EP05 / Pump Must Deliver I 49.43 gpm at 1 15.15 ft TDH J Project: Glen Johnson Construction 4 bedroom residential mound Page 4 of 10 kL Mound System Maintenance and Operation Specifications Service Provider's Name Bill Schumaker Phone 715- 386 -3121 POWTS Regulator's Name St. Croix County Zoning Phone 715 386 -4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1250 gal Maximum TSS 150 mg /L Soil Absorption Component Size 600 ft Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Ins ect for ponding and seepage once every 3 ears Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished ............... Grade \ 6 -8" Diameter Lawn �/. Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Glen Johnson Construction 4 bedroom residential mound Page 5 of 10 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the fitter shall be serviced if the alarm is activated continuously. Intermittent fitter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent fitter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg /L BOD 150 mg /L TSS, and 30 mg /L FOG for septic tank effluent or 30 mg/L BOD 30 mg /L TSS, 10 mg /L FOG, and 10' cfu /100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Glen Johnson Construction 4 bedroom residential mound Page 6 of 10 M/G. OULD$ PUMPS Submersible Effluent Pump 3871 EPO4 EP05 r -- APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower grade turbine oil for tic enclosed design for heavy duty ball bearing Specifically designed for the lubrication and efficient improved performance. construction. following uses: • Effluent systems heat transfer. ■ Casing and Base: Rugged • Homes Available for automatic and thermoplastic design provides AGENCY LISTING • Farms manual operation. Auto- superior strength and corrosion $P' Canadian Standards association • Heavy duty sump matic models include resistance. • Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron • Dewatering assembled and preset at the for efficient heat transfer Goulds Pumps is I50 9001 Registered. factory. strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. ' /a" maximum. ■ EPO4 Impeller: Thermoplas- 0 Power Cable: Severe duty • Capacities: up to 60 GPM, tic Semi -open design with rated oil and water resistant. • Total heads: up to 31 feet. pump out vanes for mechanical • Discharge size: 1 NPT. seal protection. • Mechanical seal: carbon - rotary/ceramic - stationary, BUNA -N elastomers. • Temperature: 104 °F (40 °C) continuous 140 °F (60 ° C) Intermittent. METERS FEET • Fasteners: 300 series 1 stainless steel. 9 30, ��5GPM • Capable of running dry without damage to 8 !-2.s Fr components. 25,. 1 t Motor: = • EPO4 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 a 5 RPM, built In overload with automatic reset. Te•7� 15 Q 4 • EP05 Single phase: 0.5 HP, o EPOS 115 V or 230V, 60 Hz, 1550 '' 3 10 RPM, built in overload with EPO4 automatic reset. 2 • Power cord: 10 foot 5 standard length, 16/3 1 SJTOW with three prong grounding plug. Optional 20 0 0 0 10 20 30 40 5 0 GPM foot length, 16/3 SJTW with three prong grounding plug (standard on EP05). 0 2 4 6 8 10 12 ml /h CAPACITY �9f43��� %�;macm.sW1Yra- -4e /equ��cd Goulds Pumps o 2002 Goulds Pumps <X> ITT In ustries Effective September, 2002 70 r V /l� B3871 1 Distribution Cell - Concave Deflection Worksheet Johnson Construction 4 bedroom residential mound Lot 9, Plat of The Hills of Troy, Tn. of Troy, St. Croix Co., WI. Site Information: 1. Design wastewater flow: 600 gpd (4 bedroom)(100 gal/bedroom)(1.5 peaking factor) 2. Depth to limiting factor: 24" 3. Land slope: 5% 4. Infiltrative capacity of soil at system elevation: 0.60 gpd 5. System elevation: 1074.16' at 12" above 1073.16' contour. Dispersal cell sizing: 600 sq.ft. required (600 gpd / 1.0 gpd/sq.ft. ASTM C33 med. sand) Cell length (B) 80.00' Cell width (A) 7.50' Dispersal cell deflection: 1. Percent deflection: (6'deflection/80' down slope effective cell length)(100) = 7.50% 2. Adjusted cell length: [(7.50% x 0.00265) + 11 x 80' contour effective cell length = 81.59'. 3. Actual cell length along contour = 81.59'. Pg. 9 of 10 FEB- 199 -2006 15 53 CONTINENTAL DVLP CORP 763 757 2532 P.01 /03 +. Wisconsin Department of Commerce SOIL EVALUATION REPORT Page l of 3 y` msioh of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County ST. CROIX Attach complete site plan on paper not less than 81x2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. (PENDING) percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location NORTH DAKOTA STATE UNIVERSITY C/O Leo Bcskar Govt. Lot ---- NE 1/4 NW 1/4 S 11 T 28 N R 19 E ❑ (or)W Property Owner's Mailing Address Lot* I Block # Subd, Name or CSM# Rodli, Beskar, Boles & Krueger SC, 219 N. Main Street 9 -- Hilts of Troy City State Zip Code Phone Number i { �Vllage ■Town Nearest Road River Falls, WI 54022 ( 715 425 Coulee Trail Q New Construction Use[D Residential / Number of bedrooms 4 Code derived design flow rate 600 _ GPD © Replacement D Public or commercial - Describe: Parerd material loess over till Flood Plain elevation if applicable ETA ft. General comments Mound System -- 1.00 ft. sand fill -- 0.6 loading we and recommendations: (If pre treatment system - below ground drip - irrigation) Boring # © Boring Q Pit Ground surface elev. t077.46 ft, Depth to limiting factor. 32 tin. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fF in. Munsell Qu. Sz. Cord, Color Gr, $z. Sh. 'Eff#1 'F -ff#2 I 0 -4 10YR3/2 - sil 3fabk mvfr cb 3vf -co 0.6 0.8 2 4 -9 10YR3/2 Rif 3f -mabk mfr as 2vf -co 0.6 0,8 3 9 -16 1 10YR2 /2 sil 2f -mabk mfr cW 2vfm 0.6 0.8 4 16-22 1 0YR3/3 sil 2f -inabk mfr cW 1of = 0.6 0.8 5 22 - 28 102YR3/4 • sil 3fabk mfr cs 1vf - -f 0.6 0.8 6 28 -32 10YR3/4 - s] 2fabk mvfr cW 2fabk 0.6 1 .0 7 32 -35 10YR3 /4 c2f 10YR4 /6 scl 0M mfi -- -- 0.0 0.0 n Boring # Boring 1 24 El Pit Ground surface elev. 1 D4 y, L! g ft. Depth to limiting factor in. Soil Application Rafe Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munselt Qu. Sz. Cont. Color Gr. Sz. Sh. "Efi#1 - Eff#2 1 0.4 10YR3 /2 sit 3fabk mvfr cb 3vf -co 0.6 0.8 2 4-9 10YR3 /2 sit 3f mabk mfr as 2vf-co 0.6 0.8 3 9 -19 10YR3/4 Rif 3fabk mfr as 2vf -f 0.6 0.8 4 19 -24 10YR4 /6 - sl I fabk dsh cb l of - -f 0.4 0.7 5 24- -- - lsbr -•- .. -- -- -- Effluent #1 = BOO > 30 220 mg/L and TSS >30 < 150 mg /t- - Effluent #2 = BOD 30 nxA and TSS 30 nvA CST Name (Please Print) ignature CST Number Mary Jo Hollister L a 224832 Address ` ate Evaluation Conducted "telephone Number W9875 690th Avenue, River falls, WI 54022 09-06-05 (715) 426 - 1775 13 -2006 15 :53 CONTINENTAL DVLP CORP 763 757 2532 P.02iO3 Property Owner NDSU (Lot 9) Parcel ID 9 (Pending) Page 2 of 3 # ( —� Boring # Boring Pit Ground surface elev, f 07Z.H�( g. Uepih to iimiung factor 25 Ill. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W in. Munsetl Qu. Sz. Cont Color Gr. Sz. Sh. *Eff#1 •Eff#2 1 0 -6 10YR3/2 sil 3fabk ds cb 3vf-co 0.6 0.8 2 6 -12 1OYR3/2 _ sil 3fabk ds as 2vf-co 0.6 0.8 3 12 -23 10YR3/4 -- sil 3fabk dsh as 2vf -m 0.6 0.8 4 23-25 1OYR3/4 sI linabk dsh os 1vf-m 0.4 0.7 5 25 -28 -- -- till/Isbr -- — -- — E Boring # 0 Boring l D pit Ground surface elev. ft. Depth to limiting factor in. mil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in, Munsel! Qu. Sz. Cont, Color Or. Sz. Sh. *Eff#1 *Eff#2 Boring ❑ Boring # Ground surface elev. ft. Depth to limiting factor in. Pit Soil lication 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 *EfX2 " Effluent #1 = SOD, > 30 c 220 mg /L and TSS >30 5 150 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. 8ED.833Qi'est p1.07 /M1) :9-2006 15 :53 CONTINENTAL DULP CORP 763 757 2532 P.03iO3 Blot Plan for Hills of Troy Wage 3 of l bwn o f_ Troy sX Croix County, Wisconsin Lot q 1 " � 4o ft_ Legal Description _ a,E ., IcI �lw�Ju, sic . I �, V 2, ft contours r�tR th,,) A; 0-c Tr a y X = Backkoe pit to ' R --9A oil 9 ! R-9 1 � 4 et- lo-,:� 4 4 f i R -9C '•Z r l : 'Top DF !:f ato�e�,8z- t 1 1, Bencbmsxk fl: : Aluminum cap (Notch V. Comer, Section 11, T28N, R19W) 380' North of Mount Curve Chaae./Summit Ridge intefsecction, clevation — 1084.42. Scnahmvk 92; WCMT alur_ninurc cap Marked "Troy OPS" located 30' Southwest of the prominence Way /Coulee Tn'il intersection, elevation = 1090.08. TOT P.03 a, 1� of 9 0?5 � 96 Qd i— � ` 9 m (c p' pProx 0 FEB -0B -2006 15 :14 FROM River Valley Abstract TO 3777681 P.02 5 U 2 8 F' (� 9 5 2 5 9 e10 -T410.4 i STATE BAR OF WISCONSIN FORM 7 - 2000 KATHLEEN H. MALSH Document Nwnber TRUSTEE'S DEED REGISTER OF DEEDS ST. CROIX CO., MI JASON L. WOHL (AN, ASSOCIATE EXECUTTVE DIRECTOR, RECEIVED FOR RECORD - 09/26/2ft5 19:10AN as Trustee of NORTH DAKOTA STATE t1NtV1ERSITY DEVELOPMENT W AS TRUSTEES DEED TRVSTEt OF THE DAVID ROMER CHARITAttt.E REMAINDER UNt77tUST EXEIPT II for a valuable consideration conveys, without warranty, to TROY REC FEE: 11." DEVELOPMENT CORPORATION, A MINNESOTA TRANS FEE: 7086.99 CORPORATION COPY FEE: Grantee, the following described real estate in ST. CROIX — CC FEE: PAGES: 1 County, State of Wisconsin (if more ce is needed, ple h addendum): NW% OF THE NE% AND NE' )OF THE Wr OF SECTION 11, TOWNSHIP 28 NORTH, RAN WEST, S oI WISCONSIN. X COUNTY, Recording Are& SWY. OF THE NE% AND SE% OF THE NWV, OF SEC71ON 1 1, Name and Return Address TO WNSHIP 28 NORTH, RANGE 19 WEST, ST. CROIX COUNTY, A. BESKAR zlp Jam, WISCONSIN LYING NORTH OF THE TOWN ROAD. R LI BESKAR BOLES & KRUEGER, S.C. 21 NORTH MAIN STREET, PO BOX 138 R FALLS, WI 54022 040- 1047 -31"M 04f.10474040 040- 1047 - 20400 p1� -fig Parcel Ideotificatton Number (ptN) This IS not honietrad property fir) (is not) Dated this 22ND day of SEPTEMBER 2005 Trustee • JASON . WOHL H� ASSOC. EXECUTIVE D OR AUTHENTICATION Trustee Sigaatul'03) JASON L. WOHLMAN ACKNOWLEDGMENT STATE OF ) ss. County ) su this 22ND of se�auae 2005 came before me this day of • LE ES the above named TITLE: MEMBER STATE BAR OF WISCONSIN ----- (Jfnot, - -____ authorized by § 706.06, Wis. Ste to known to be the persons) who ed th execute foregoing 'n�ument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY LEO A. BESKAR RODLI SESKAR SOLES & KRUEGER, S.C. — N osy Public, State of (SW-M— —y be wthene xt d or aetnow! M y Commission is edged. J3otb are rot ncau�y) Permanent. Nartres of persons sinning in any caP>citY (If not, state expiration date: ' must be typed or printed below their signature. TRUSTEE'S DEED STATE BAR OF WISCONSIN , FORM No. 7 . 2000 INFO -PRO (800)635 -2021 www.inloprorp,t,s.00m FEB -09 -2006 15:15 FROM River Valley Abstract TO 3777681 e * 8ta1'74t�5 'U 2 *8 9 S P 2 G O REGISTER OF DE ST. CROIX CO.. 11I WARRANTY DEED RECEIVED FOR RECORD 09/26/2093 10:10AN This Deed. made between Leonard J. DesLauriers and WARRANTY DEED Margaret A. DesLauders, husband and wife, Grantors, and Troy EXEMPT I Dsvetopfnsnt Corporation, Grantee. EE: F 11. N Grantors. for a valuable consideration, convey to Grantee, REC REC F FEE: 30 the following described real estate in St. Croix County, State of COPY FEE; Wisconsin (th0 "Property'): CC FEE : PAGES: 1 NE% of the NEV& of Section 10, Township 28 North, Range 19 West, St. Croix County, Wisconsin, EXCEPT that part tying South of the Town Road; ALSO EXCEPT Certified Survey Map in Reno Area Volume 7, Page 1894 and Certified Survey Map in Volume 16, Name and EM Address Page 4332. NWY4 of the NWV. and SW% of the NWY. of Section 11, Township 28 North. Range 19 West, St. Croix County, Wisconsin, lying North of the Town Road EXCEPT Certified Survey Map in Volume 16, /(7Z07 ZG 9 �Y3 Page 4332. 040- 1044 - 10.0150, 040- 1047480 -100, D40. 1047 - 70-050 (Parcel Identification Numbers) This homestead property. Together with all appurtenant rights, title and interests. Grantors warrant that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: subject to all easements, rights -of -way, covenants, conditions, and restrictions of record, and will warrant and defend the same. Dated this ZZ� day of ' 2005. Roger D. Bevers Notary Public State of Wisconsin (SEAL) '...,.... Leonard J. De aurora '� s (SEAL) (SEAL) •Mar r 4 w.t ,�e �_ (SEAL) g rat A. DesLauriers AUTHENTICATION Signatures) ACKNOVyLED0Wff"T STATE OF WISCONSIN ST. CROIX COUNTY authenYaated this day of .2005. P r/ m f b6fOrS me this Z - itt6 day o f 2003. tl» above nanwd Signature LswlRrd J. DesLauriom ■nd MaryaraI A. DesLauriers, to me know t to be the persona who exuted ec the forgoing Type or print name owledge the same. TITLE: MEMBER STATE BAR OF WISCONSIN (if not Pu $ e of in. autttorfzad by #706.06. Wis. State.) COMM' Sion � / ^ a 3 THIS INSTRUMENT WAS DRAFTED BY C. L. Gaylord Attorney at Lew P. 0. Box 48 River Falls. WI 54022 (S 1on m ow stures may be authenftewd or earnlaopad. goth ere not - Names of peso" signing In sny —patty Should be typod or printed below their signetures. .�p1UMr,O,r „ OtMO.W.CdrMlr rep ey AQ.YWCdV�I y►r ►i/T _ __ ���v ��•� I AuI r<,ver valley Hbstract. TO 3777681 H.04 U 8 9'S P 2 6 I 810'7406 KATHLEEN H. WALSH STATE BAR OF WISCONSIN FORM 1 .2000 REGISTER OF DEEDS t)oc,lrttent Number WARRANTY DEED ST. CROIX C0.. WI RECEIVED FOR RECORD 'Phis Deed, made between RONALD M. HANDLOS and HELEN 09/26/2885 18 :180 G. HANDLOS, husband and wife, WARRANTY DEED EXOPT # Grantor, and TROY DEVELOPMENT CORPORATION, A REC FEE: 11. MINNESOTA CORPORATION TRAITS FEE: 3294.30 COPY FEE: CC FEE: PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in ST. CROIX County, State of Wisconsin (the "Property") (if more space is needed, please attach addendum): NE'A OF THE NE'h AND THE SE'/h OF THE NEIA OF SECTION 11, TOWNSHIP 28 NORTH, RANGE 19 WEST, ST. CROIX COUNTY, Recording Area WISCONSIN EXCEPT CERTIFIED SURVEY MAP IN VOLUME 9, Name and Return Addres PAGE 2427 AND EXCEPT CERTIFIED SURVEY MAP IN VOLUME EO . BESKAR ��/ 7 �S9y 13, PAGE 3629 AND EXCEPT PART TO ST. CROIX COUNTY IN O LI BESKAR BOLES & KRUEG R, S.C. VOLUME 800, PAGE 356. 2 NORTH MAIN STREET, PO BOX 138 R FALLS, WI 54022 010 - 1017 - 400.000 040-1047 - 10-000 Parcel Identification Number (PIN) This is not homestead property. Together with all appurtenant rights, title and interests. tit) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except EASEMENTS, RESTRICTIONS AND RIGHTS OF WAY OF RECORD, IF ANY, Dated this 22ND day of SEPTEMBER 2005 RONALD M. HANDLOS • • HELEN G. HANDLOS AUTHENTICATION ACKNOWLEDGMENT Signature(s) RONALD M. HANDLOS and HELEN G. STATE OF ) HAN OS ) ss, County ) auth this 22 D day of sE t mach , 2005 Personally came before me this day of the above named + LEO . BESKAR 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 acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY — LEO A. BESKAR Notary Public, State of RODLI BESKAR BOLES & KRUEGER, S.C. My Commission is permanent. (If not, state expiration date: (Sianatums tray be authenticated or actmowkdged. Both are not necessary.) ) • Names of persons signing in any capacity maul be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM No, r . 2000 INFO -PRO (Ot10 )O55-2021 ww..inrq..forms.com TOTAL P.04 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Troy Development Corporation /Glen Johnson Construction, Inc. Mailing Address 634 Commerce Drive, Hudson, WI 54016 ro Mi Property Address PENDING Z16F7 (Verification required from Planning & Zoning Departmegs4or new construction.) City /State Hudson, WI Parcel Identification Number PENDING LEGAL DESCRIPTION Property Location OU2) 1 /4 , Sec. _LL_, T NR 9 W, Town of Troy Subdivision Hills of Troy , Lot # 9 Certified Survey Map # , Volume , Page # Warranty Deed # FO -7 4 161/ , Volume .7 8'Q5' , Page # .? 5'f Spec house ye no Lot lines identifiable 8 no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system Owner maintenance responsibilities are specified in §Comm 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certi fY my /our all statements on this form are true to the best of m /our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms 2 / / CMG SMNATIM OF APPLICANTS) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) dv • • v. 1 1/ 0 ^ dy • '� j., w LA s aj lL r � ' • 3 .. ) • I I • •. • • • • •. •. t ray I Y IT 4 . 1 Y r 'il , i� d tt { +tFtlti a v , lda s J ,4 • • 4+ 351.x^ d �; �� '• • • � F��( d irk ,. , .,. 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