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HomeMy WebLinkAbout040-1272-20-000 C r O 7 1 7 Cp A A r :r I I � _' CA) �_ m fJ (� 0 A o N ►�►� lA\ O C• o tD N C 1 N a O � m fn Z D a ! ♦� m ca D t' a = W 3 a ` �1 0 o 'N° " O L to N N CD ! N p, C _' 3 c c :2 T - 0 -0 (n m z 0 o o = cn CA C4 = to fD CD G °_ D y y m 3 m N 61 CD :. _ d d w Z a 0 = o o 0 f, m O pr p o so CD c m = m w y y CD CD _. m w O. O N �% CL a 8_ 3 _ _ Z < w CO) CD fA tb -i o (DCD D o A Z M, C) Z O m E G o _ c rn W m a Z OD cn 8 co 3 � � N ? CD co _ w O = O D N O. N 2 N — cn N O G CL M. Cc CD C m Z* o a o� CD CD CD v� a y = co 0 U) m -•a D 00 U),a c o v EL CD :3 m CD N =7 I y y N CD O O_ a = O CD fi ti O O 7 = •p S Vl N N G N V N CD O < w -p 7 CD 7 Q3 O CL 7 y d 0 = CIq O N t0 69 O W O cx ti rosin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix .,,wry and Building Division id ' INSPECTION REPORT Sanitary Permit No: 399684 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: Erdrich, Michael I Troy Township 040 - 1272 -20 -000 CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark / Dosing Alt. BM S C CZ Z - (� 0 I-Gcu r' J aLO C 6 2 Aeration Bldg. Sewer Holding St/ t Inlet St/ t Outlet TANK SETBACK INFORMATION 5 16C 1 4, TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inl Septic t Dosing Header /Man.upp�,V, 12 �!/� t 3 Lpu r Aeration Dist. Pipe v l • G NihXv- Holding Bot System D C l 9 - b Final Grade PUMP /SIPHON INFORMATION Manufacturer — mand S Cyy�L rl .7 GP Model Number TDH Lift Fric Loss System Head JT7 Ft Forcemain ength Dia. Dist. to Well SOIL ABSORPTION SYSTEM �, - (; U BEINQRENCY Width e3 / Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid De�tb DIMER114911S SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM I Ma a urpr: _ INFORMATION Ty e Of System: —� � E i CHAMBER R Mod 0 umber DISTRIBUTION SYSTEM Header /Manifold x Hole Size x Hole Spac Vent Air take N Pipe(s) / J� �p L Length 1 Dia Spacing O SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth -� r Depth Over xx Depth of xx Seeded /Sodded xx Mulched Be ran ch Cente / Z Bed/Trench Edges Topsoil Yes No Yes ,, No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / /_✓ Inspection #2: / / Location: ¢431 Lost Rock Lane Hudson, WI 54016 (S 1/2 SW 1/4 17 T28N R19W) Troywood Lot 33 Parcel No: 17.28.19.1509 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? n'; Yes :i No Use other side for additional information. -C — �G22 tors Signature ' D J Se c p . No. SBD -6710 (8.3/97) rvt" - h 7� �- - Y� 5L4 f — he /t- z1t-- S N Safety and Rui 1 i5 County ` ! 201 W. Washingto A „P.O. ox 7162 �(cn cons in Madison, ,3707 7 Site� ddress Department of Commerce _,' REC, -Mko [ 7 r dk#Lcjk Sanitary Permit Applic Wn q San it ta y Perm Number 4� In accord with Comm 83.21, Wis. Adm. Code, personal info ttlitipn yot� ovlid� L`90� 3 1 o f may be used for secondary purposes Privacy Law si,5:1r4t1)(m) ST G" 'Xi G k if Revision I. Application Information - Please Print All Information GUjW' kttie Plan I.D. Number 3 ZONMGG'f n operty Owner's Name " (, rcel Number Property Owner's Mailing Address f Property Location L Z ` �G t � /rit Q_ O�)at�'r�(/ t%LL 1� S4/ �.A: S ` 7 T J_�, R �( E City, State Zip Code Phone Number Lot Number _?P3 Block Number "`r 0/ Subdivision Name CSM Number H. Type of Building (Check all that apply.) QCity� .1I 1 or 2 Family Dwelling- Number of Bedrooms 3 El Village ❑ Public /Commercial - Describe Use _ Pkrownshi ❑ State Owned Nearest Road ill. Type of Permit: (Check only one box on line A. Numbering is for internal use.) (Complete line B, it applicable.) A, ew 3 ❑ Replacement of 6 ❑ Addition to System 2 ❑ Replacement System Tank Only Existin S stem For County use B. ❑Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of POWT System: (Check all that apply. Numbering for internal use.) 44 ACNnn - Pressurized In- Ground 21 ❑ Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 11 Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 Cl Drip Litre 45 ❑ At -Grade 46 Cl Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑Other 1 V. Dispersal/Treatment Area Information: C ,a �- Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate /System evation Final Grade Required Propo ed Rate(Ga1s./DayslSq.Ft.) (Min.Jlnrh) vp �� levation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks _ Septic or Holding'fank �; Dosing Chamber VII. Responsibility Statement- I, th u ndersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's a MP /MPRS Number Business Phone Number T Plumber's Address (Street, City, State, Zip Code) VIII. Count /De artment Use Onl ❑Disapproved Sanitary Permit Fee ludes Groundwater Issued Issuing Agent Signature (No Stamps) Approved Owner Given Initial Adverse I Surcharge Fee) (�S t� .Zq 2ft Determination , IX. Conditions of �ot+Q - foaova a- (ac- di�9rtCe , t tM.LEad Q �. '�.yoAX1, l _ °" _ �0�./betiv. 7�t.��yv �E� �.�IA9 , L s�t�4.N.�..+ -- YS c �orc+C'"yI`y C OIt l ,5 c etisr `s Attach complete pigCounty only) for the sy tem on er not erm l iA1 ll inches in size ( t C I C I PD� / / VV�tuC G / Yf� l an udIM ��iL{JttlQrt ,f e, ,,,,, unit 2ue�u4 - Wch& I Caorob Ave. ROMMO nt, MN saoeo Town at Tby Sec 17 T28NRIOW PwcW tW 040-1272-20 y� 6 BI1 �atr e � , g 103 acp�d Hmm =END ■ = SOIL. BORINGS WITH BACKHOE BM 1 a EL.EV.100,0' Top of oWdit ft 1obyyM- WO H RF SCALE - t SO ' S M2 = EIEV. OS.V 7bp Of tde0W* PWO01 Page 3 of 3 M� d mM Erdnch 14879 Colorado Am Raem u t, MV $8088 Town of Troy Sec 17 T28NRIOW parcel 11W 040-1272-2D-WO #A Mic aMI at Q 82 ! Boa. S3 Piop d lag.! 3 aM ropn LEGEND Mo1Me ■ = SOIL BORINGS WITH BACKHOE BM1 0- ELEV. 100,0' -Top o f oWditVanofi MW 00 H RF SCAM - 1" • 30 BM ELEV• 08.0 -7bp of WGIMne PIdU I Pegs 3 of 3 1520 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Gustum Septic Service Attach complete site an on County pl plan paper not less than 8'/: x 11 inches in 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 nearest road. 040-1272 -20 -000 Please print all information. viewed By -Date� Personal information you provide may be used for secondary purposes (lacy Law, s. 15.04 (1) (m)). Property Owner Property Location Erdrich, Michael Govt. Lot n/a 1/4 SW 1/4 S 17 T 28 N R 19 W Property Owner's Mailing Address Lot # Block If Subd. Name or CSM# 14879 Colorado Ave. 33 n/a Troy Wood Subdivision City State Zip Code Phone Number J City I Village kjr Town Nearest Road Rosemount I MN 1 55068 1 651 - 322 -1929 1 Troy I Lost Rock Lane 61 New Construction Use: dM Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement J Public or commercial - Describe: ' l Parent material outwash plains efevatibn, if applicable n/a General comments and recommendations: Part of 1.52 acres. Recommend system el. 99.5 1I Boring # _j Boring ° l (� ty ?Pei i Vol Pit Ground Surface elev. 102.4 ft. De t to l itin factor in. i % Sal Application Rate P 9 Apo Horizon Depth Dominant Color Redox Description Texture Structuk Consists n GPDAt' in. Munseil Qu. Sz. Cont. Color Gr. Sz. StkQ ,. 0 E *Eff#1 *Eff#2 1 0 -14 10yr2/2 none sil 2msbk ,! r as -�'�:; m 0.5 0.8 2 14 -19 10yr4/4 none sil 2msbk ? 1f 0.5 0.8 3 19 -30 10yr4/6 none sil 2msbk mfr cw - 0.5 0.8 4 30-47 10yr4/6 none gr. Is 1 msbk mvfr cw - 0.7 1.2 5 47 -85 10yr5/6 none s / gr. s 0 sg ml - - 0.7 1.2 Boring # Boring Pit Ground Surface elev. 103.5 ft Depth to limiting factor >90 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD in. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -11 10yr3/2 none sit 2msbk mvfr as 41m 0.5 0.8 ( 2 11 -28 10yr2/2 none sit 2msbk mvfr cw 1f 0.5 0.8 3 28 -34 10yr4/4 none sil 2msbk mvfr cw - 0.5 0.8 4 34-42 10yr4/6 none sil 2msbk mfr cw - 0.5 0.8 o c to 5 42 -65 10yr4/6 none Is 1 msbk mvfr cw - 0.7 1.2 6 65 -90 10yr5/6 none s / gr. s 0 sg ml - - 0.7 1.2 * Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS <30 mg/L CST Name (Please Print) Sign CST Number Tom Gustum 227618 Who Address Gustum Septic Service Date Evaluation Conducted Telephone Number N13450937th St., New Auburn, WI 54757 12/12/01 715- 658 -1344 I 1 Property Owner Erdrich, Michael Parcel ID # 040 - 1272 -20 -000 Page 2 of 3 F Boring # _j Boring 16 Pit Ground Surface elev. 103.5 ft. Depth to limiting factor >90 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Tut re Structure Consistence Boundary Roots GPDr in. Munsell OU. Sz. Cont. Color I I I Gr. Sz. Sh. 'Eff#1 'Eff42 1 0-8 1 Oyr2 /2 none SO 2msbk mvfr as 2f,1 m 0.5 0.8 o n ` Q 2 8-19 10yr4/4 none sil 2msbk mvfr cw 1f 0.5 0.8 3 19-26 1Oyr4/6 none sil 2msbk mvfr cw - 0.5 0.8 h 0 4 26 -32 1Oyr4/6 none gr. sl 2msbk mfr cw - 0.5 0.9 e 5 32�5� 10yr5/4 none s 0 sg ml cw - 0.7 6 55-60 10yr4/6 none s SS fro 1msbk mvfr cw - 0.7 1.2 i i 7 60-90 1 Oyr5 /4 none s 0 sg ml - - 0.7 1.2 �qq � 2 � Boring F4j Boring # i/ Pit Ground Surface elev. 102.4 ft. Depth to limiting factor >85 in. F Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. MunseN Ou. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 1 0-11 10yr2/2 none sil 2msbk mvfr as 2f,1 m 0.5 0.8 2 11 -20 1Oyr4/4 none sil 2msbk mvfr cw 1f 0.5 0.8 3 20-26 1Oyr4 /6 none sil 2msbk mvfr cw - 0.5 0.8 4 26-34 1Oyr4/6 none gr. sl 2msbk mfr cw - 0.5 0.9 5 3456 1 Oyr5 /4 none s 0 sg ml cw - 0.7 1.2 6 56-60 1 Oyr4 /6 none s SS fro 1 msbk mvfr cw - 0.7 1.2 7 60-85 1 Oyr5 /4 none s 0 sg ml - - 0.7 1.2 F Ong # f Boring Pit Ground Surface elev. ft. Depth to limiting factor in. SoA Applicato Rate Horizon Depth Dominant Color Radox Description Texture Structure Consistence Boundary Roots in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 *E = > < > < — Effluent #1 BOD 30 220 m and TSS 30 150 m _ < < 9ti � Effluent #2 BOD 30 and TSS 30 _ _ a s s _ �- _ m9 IL 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. BM2 BM 102A ' \ o 024 o" \ JF' 102.4' Contour' �� � 103.0' Contour''" 103.5' 103.5' Contour'" Proposed \� 03.5' 3 Bedroom House Michael ErdriCh Plot Map ` Tro Subdivision 233 14879 Colorado Ave. ` 1.5 ' � 1.52 Acxes � Rosemount, MN 55068 Town of Troy Sec 17 T28NRl9W Parcel ID# 040- 1272 - 20-000 LEGEND ' ■ = SOIL BORINGS WITH BACKHOE ` BM1 ELEV.100.0' -Top of electric transformer- also HRP V BM2 = ELEV. 98.0' -Top of telephone pedestal — — — — = Construction Setback SCALE =1" : 50' Page 3of3 , ,I i 3 - ___ - i a OF o -` __ _L_ - j i � I I I i _1 1 : 1 -. _ Private Onsite Wastewater Treatment System Management Plan .Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall Include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In -Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Des i n Specifications Sanitary Permit Number Number of Bedrooms Design Flow - Peak ( pd) Estimated Flow - Average (gpd) -� Septic Tank Capacity (al) Soil Absorption Component Size (ft a Type of Wastewater Domestic Table 2: Soil Absorption Component - limits of Reliable O ration Septic Tank Component Soil Absorption Comp2nent Design Flow - Peak efs Maximum Influent Particle Size (in) 1/8 Maximum BOD mg/L) 220 Maximum TSS (mg/Lj (mg/L 150 Table 3: Maintenance Schedule Septic Tank Ins and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tgnk 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 (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). 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 tie 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 Management Plan for a Septic Tank and Soil Absorption Component filter Is equipped with an alarm, the filter shall be serviced If the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge 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 an 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. 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 the tank. No one should enter a septic or other treatment or holding tank for any reason without being In full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be dlfflcult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorotion Component The soil absorption component serving this structure Is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions Improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 Management Plan for a Septic Tanh and soil Absorption component I Plantings of deep -rooted trees and shrubs directly over or within ten feet.of the component should be avoided since root intrusion into the component may obstruct wastewater flow. 3 i CONTINGENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or must be liken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized lot the location of a replacement $0 11 absorption system. The replacement area should be proWUd from disturbance and compaction an d show not tae In {rlspd upon Dy rtqulred setbacks from existing and proposed structure, lot nna and wells. Failure to protect the replacement ar..a will result In the need for a new soli and sett evaluation to establish a sultable replacement AMA. Replacement systems must comply with the rules in effect at that time. Q A suitable replacement area is not available due to setback and/or loll limitatiom gaffing advartots in POWTS technology a holding tank may be Installed as a last resort to repfaoe the failed POWTS. 0 The site has not been evaluated to Identify a Sultabb r+epiacantnt tea. Upon failure of the POWTS a soli and site evaluation must be performed to locate a sulubie replacement area. if no replacemment area Is available a holding tank may be Installed as a last resort to replace the failed POWTS. O Mound and it-grade soli absorption sysunu may be reconstructed In place following removal of the biomat at the t st com with the rules In effect at that time. f a ve surfa Re<onswatons of such s mu ply nfl u t1 ce sY tems < < WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TRILATMLNT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT, RESCUE OF A PERSON FROM THE INTLRIVR OF A TANK MAY EL DIFFICULT OR IMPACURI V ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINfA1NEIt Name Name o Phone F — Phong S1PTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY Name Agency l j C ro ' o Phnrtr ors'' - r ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND - OWNERSHIP CERTIFICATION FORM OwnerMuye��'N AA I� Mailing Address _ t� � Go u � ✓���6 ° O Property Address (rtaOt w«oD L-ar 2 (Verification required from Planning Department for new c ns ( p / �! l City /State Flaw N If g��� � `'P rcel Identifiiction Number 040 ` l 2-�Z'20 LEGAL DESCRIPTION Property Location 1 /, � 1 /4, Sec. T N -R W, Town of Subdivision fi ©dD - Lot # 2. Certified Survey Map # Volume , Page # Warranty Deed # '� q Volume` ge # 1 `f Spec house ❑ yes,4 no Lot lines identifiable ❑ yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman lumber, restricted lumber or a P � p 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. I/we, 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, p so rces, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. Z z / /S /0Q SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property desc 'bed above, by virtue of a warranty deed recorded in Register of Deeds Office. d c�' SIGNATURE OF APPLICANT DATE r ****** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** 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 Vol. 1 8GOPAGE 144 STATE BAR OF WISCONSIN FORM 2 • 1998 66Aa WARRANTY DEED KA H. WELSH REGISTER OF DEEDS . Document Numbcr ST., CFOIX CO., WI This Deed, made between Day Farm Investo L LC, u M inne so ta RECEIVED FOR RECORD Limited Liability Comp _ — . — 01- 22 -2M2 11:45 AM - -- - -- _ WARRANTY DEED Grantor, and Michael D. Erdrich and Theresa L.G. E rdrich EXEMPT N —, —--- - — - —. -- CERT COPY FEE: COPY FEE: - - -- TRANSFER FEE: 269.70 — — RECORDING FEE: 11.00 __ -- PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croi County, State of Wisconsin: Rccurdin ,treu Nim N a , nd _ R _ ¢turn lddres. Lot 33 Troy Wood, Town of Troy, St. Croix County, Wisconsin tw tw0- 127 -20 -0 00 _ Parcel Identi Gcat ion Number (FIN) This is not homestead property. (is) (is not) Exceptions to warranties: Subject to notes, easements ,restrictions,coverumts and rights of way of record, if any, including but not limited to those for draitlage,water retention ponding,and or utilities as may be shown on the plat of Troy Wood recorded in Vol. 8 of Plats, page 28,St. Croix County, Wisconsin. The warranties of this deed, either expressed or implied are limited by the grantor to the grantee, or anyone in the chain of title, to the consideration expressed herein, that being the sum of $ 89,900.00. Dated this 14 day of Jan 2002 Day Farm Investors, LLC President + . A ustin J. Baillo AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Si�naturolSl____ __, Ra msey County.) Personally came before me this 14th day of authenticated this day of January . 2 tllc ahove named —_ ..__,_. -- Austin J, Baillon Tl'fLE. MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, instrument and acknowledge the Same. authorized by § 706.06, Wis. Stars.) J _ ..._._. PAtA A BA1tLQN THIS INSTRUMENT WAS DRAFTED BY ` +` nc 1Crd,NNE$Ou Paul A. Baill Att orney at Law ` Paul A. Baillo ,� r AYC_I,.. _ _nP, AES - 31200 _ -- Notary Public, Stat w vw +. My Commission is permanent. (if not, state expiration data, (Signatures may be authenticated or acknowledged. Both are not January 31 20(IS necessary.) 'Names of persons signing in any capacity should be typed or printed Meow their signatures STATE SAR OF W ISC'ONSI.N WARRANTY nEED FORM No. t - 1998 WFORMATION PROFESSIONALS COMPANY FOND DU LAC, W1 800-655-:021 -• s J' �� �� • •P �� "`` �� i� �� / ; iii %si%�%iiiiiiiii% %� ���I►��jl��\\���� �� i%iii iiiiiiiiiii 1 , O I / rill i .♦` \ � % , ` r� / ,/� / j // jam/ j j� /..�,,ii APM WMPAP IV of JF ♦ • / / //• /�// / /� / %// / i�v i as �3 E O J b• i _ a� ZV I \ ok �� W \ .� \•\ � � X08 \ � N \\ M N to �'' � a r • \ \� � �w r / r ENE aA8• V Sir to CM CO i • w I I � r ` 806 °47'61 °E 469.92' r� co V N m� r i -- - - - - -- a C / .98 L M•90J.0.009 ---- - - - - - N •- G � I W . 1351 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Gustum Septic Service Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal refgranw1pQir*(8MI) direction and percent slope, scale or dimemsions, north arr S nd *al,iod and dis6ce Parcel I.D. to nearest road. Please print a�liQtia�lri l n. Reviewed By e Personal information you provide may be -AF rr co Qgrpo fi Priray Law, s. 15.i)A (1) (m)). ` U Z ' 1 77 Xl Property Owner r . =' f `" Property Location Humbird Lan Corporation l.. i ° Govt. Lot 1 /4 SW 1/4 S 17 T 28 N R 19 W Property Owner's Mailing Address j 1 Lott Block # Subd. Name or CSM# 332 Minnesota Street, East 1404 , - 3 n/a Troy Wood Subdivision City State code gh*wtju E .,/j City village sej Town Nearest Road Saint Paul I MN I 58i pi _651 - 222 - 5 & Troy 1 E Cove Rd / Lost Rock Lane J✓ New Construction Use: a Residential /�I 6n%beccf-l6edr 3 Code derived design flow rate 450 GPD Replacement J Public or commercial - Describe: Parent material weathered sa ndstone Flood plain elevation, if applicable n/a General comments and recommendations: Part of 1.52 acres. BM #1- 100.0'. BM #2= 102.2'. Recommend at -grade system along 100.0' contour. P38 from preliminary boring work done 5 -5 -00. [ P3 - 8] Boring # _1 Boring f/ Pit Ground Surface elev. 100.7 ft. Depth to limiting factor >72 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft' *Eff#1 *Eff#2 1 0 10yr3/3 none sl 2mcr mvfr as 3f,lm 0.5 0.9 2 6 -16 1 none sl 2msbk mvfr cw 1 f,2m 0.5 0.9 3 16 -34 10yr4/4 none sl 2msbk mvfr cw 1m 0.5 0.9 4 3448 10yr4/6 none sl 2msbk mvfr cw - 0.5 0.9 5 48 -72 5yr4/4 none sl 2msbk mvfr - - 0.5 0.9 Boring # rl Boring 1I Pit Ground Surface elev. 99.2 ft. Depth to limiting factor >65 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF *Eff#1 *Eff#2 1 0 -12 10yr3/3 none sl 2msbk mvfr as 1 f, 1 m 0.5 0.9 2 12 -19 10yr5/4 none sl 2msbk mvfr cw 1f 0.5 0.9 3 19 -29 10yr4/6 none sl 2msbk mfr cw - 0.5 0.9 4 29-42 7.5yr4/6 none gr. sil 2msbk mfr cw - 0.5 0.8 5 42 -54 10yr4/6 none gr.ls Imsbk mvfr cw - 0.7 1.2 6 54-65 10yr4/6 none gr. sl 2msbk mfr - - 0.5 0.9 * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD -s mg/L and TSS <30 mg/L CST Name (Please Print) Signature: CST Number Tom Gustum 227618 Address Gustum Septic Service Date Evaluation Conducted Telephone Number N13450 937th St., New Auburn, WI 54757 11/20/00 715 -658 -1344 property Owner Humbird Land Corporation Parcel ID # ndin _ __ Page 2 of 3 F 2] Boring # J Boring A Pit Ground Surface elev. 99.3 ft. Depth to limiting factor _ 41 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots SPQLiL__ 'Eff#1 *Eff#2 1 0 -3 10yr2/3 none sl 2msbk mvfr as 1 f,1 m 0.5 0.9 2 3 -14 10yr3/3 none sl 2msbk mvfr cw 1 f 0.5 0.9 3 14 -22 10yr3/4 none sl 2msbk mfr cw - 0.5 0.9 4 22 -34 10yr4/4 none sl 2msbk mfr cw - 0.5 0.9 5 34-41 10yr6/2 n one sl 2 msbk mfr cw - 0.5 0.9 6 41 -55 10yr7/3 none sl 1 msbk mvfi - - 0.0 0.0 ❑ Boring # J Boring _ j Pit Ground Surface elev. _ _ __- ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots fP0/fl _ 'Eff#1 *Eff#2 Boring # J Boring _f Pit Ground Surface elev. -__ _- _ -_ - - -- ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots _ -- - GPDIft ­- *Eff#2 1 i I I 1 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. v \ v CID v o co 1) O IN N COO c NJ) o \ \ . NZ u iZ 2 O c� U _ \ \ ` Jtn NZ OU� cljd w \ZU >. v v v 2WMln I�JZFN � \ t�A Q \ \ CO o, ` O \ \ O L p p U � O � c - c-.) O N n1 0 w U O m N 6J O) � D7 V Q2 In d. W I I I I o � O U U 2 d O = o � o U o Q m ^- I = I 0 j cn o o �- Z d > > Q V7 w w (n II II m m co II - --