HomeMy WebLinkAbout040-1310-00-007 Wisconsin Dtipartment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safetrand Building Division
INSPECTION REPORT Sanitary Permit No
(ATTACH TO PERMIT) 506298 0
GENERAL INFORMATION 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:
Stevens, Michael I Troy, Town of 040 - 1310 -00 -007
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No:
- g. ob l 17.28.19.1994
TANK INFORMATION ,',,, f ELEVATION DATA
TYPE MANUFACTURER F , CAPACITY STATION BS HI FS ELEV.
Septic 1., 1'2 , F► 3 � z l� ll Benchmar� -,t 5� 14q e 73Z 7 `t Z7. Z
De"V l a � r jzl j C V Alt BM Gove
Aeration Bldg. Sewer t
Holding St/Ht Inlet (� b q&
TANK S T)3ACW INFORMATION St/Ht Outlet
TANK TO WELL BLDG Entake ROAD Dt Inlet Septic vi Z 7 Dt Bottom
Dosing Header /Man. Sa
yZ 6.t
Aeration Dist. Pipe 9. So 913 2
. 5Z 9L 2ZZ
Holding Bot. System
.O, yb 9 2Z . Zs
Final Grade 7, 3` 7Z5 V
PUMP /SIPHON INFORMATION
Manufacturer Demand St Cover / q % Q
GPM t T! Z ' z� / 3� .
Model Nu ber
TDH Lift Friction Loss Syste ad TDH Ft
Forcemain Length Dia. Dist. to Well
SOIL ABSORPTION SYSTEM
BED /TRENCH Width Length • No. Of Trenc '� �`1 PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 3 / Z I TG wGw" - � L
SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer: CZ
INFORMATION Type Of System: CHAMBER OR Model Number:: L
cC>A ;6V% 33 Gg -
DISTRIBUTION SYSTEM wese L7 q { = /
Header /Manifold t Distribution \ x Hole Size x Hole Spacing Vgt to Air Intake
Pipe(s)
Lengt Dia �" Length \ Dia Spacing \ \
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only E — IrC'"'
Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched
Bed/Trench Center
3 - d t Bed /Trench Edges \ Topsoil \,1 \Yes No \Yes No
COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / !
Location: 468 Meadow Ridge Trail Hudson, WI 54016 (NW 1/4 SE 1/4 17 T28N R19W) Meadow Ridge of Troy Lot 7 Parcel No: 17.28.19.1994
1.) Alt BM Description = ( �,
2.) Bldg sewer length = 3g
- amount of cover = n
Plan revision Required? ]Yes No O-? f_ Use other side for additional Information. ��✓✓ -
Date Insepctor Signatu Cert Nc
SBD -6710 (R.3/97)
ZL Safety and Buildings Division
201 W. Washington Ave., P.O. Box 7162 t
(Ij C; r i Madison, WI 53707 7162 Sazutary � ®� Number filled in by Co.)
Sanitary Permit Application State Tga nsact ionbl ymber
�
In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate gove nrneutal /�
unit is required prior to obtaining a sanitary permit. Note- Application forms for state -owned POW M arc Projad (if diffixwtt than mailing address)
submitted to the Department of Commerce Personal information you provide may be used for sexondaty
purposes in accordance withthe Privacy law s. 15.04(lXml Stats. 4 ICJ rn c r
L A licoden, Information - Please Print AN Informatien 1 0 �.:
's Name t # /
c' CT �j 13 -to - coo
s Mailing Address - LOt"O° IM )
� l
City, Std i
Zip Code Phone V E I �U y., O /+. Section
W (S T N, R ( circ E
II. Type of Building (check an that apply) Lot#
r/ AU _
- I or2FamiIy- DwcHing- N— b-ofBed -- - _L. - - -- - -- - - -`- T -- -
0/� Block# cFtolxcou i Q l ro
❑
Public/Commercial - Describe Use 9e.> . N ❑
CSIAN ❑ Village of
❑State Owned - Describe Use
c - 1 N n ()rTownof � r0
12. Type of Permit: ( only one box on line A. Complete line B if applicable)
A ' New System ❑ Replacement System ❑ Tmmneafflohliug Tank Replacement Only ❑ Other Modification to E=tmg System (explain)
List Prevrotrs Permit Number and Die issued
B. ❑ Permit Renewal D Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New
Before Expiration I I Owner
IV. Type of POWTS 3 Co nent/Dence: Check all that a
0 Non - Pressurized In -Ground ❑ Pressurized In- Ground At -Grad ❑ M > 24 in. of suitable soil M amd < 24 ' of suitabl
Hoiding Tank ❑ other Dispersal Componmt (explain � v` SL�r ❑ Pr --e - --- 'rti (
V. D" reatmeat Area Information:
Design Flow (gpd) Design Soil Application Rate(gpdsO Dispersal Ar- Required (so Dispersal Area Posed (so System Elev -Son 2
00 ?a D
VL Tank Info Capacity in Total # of Manufacturer
Gallons Gallons Units .°
New Tanks E,ggr gan i - Tk. P.
c or outing Tank
VII. Responsibility Statement I, the sadersigHed, assume respoasibillty for installation of the POWTS s the attached plans.
PI s Si �°� Phone Number P e Name (I'n 3 7 IS a
Phanbees Address (Street, City, State, Zip Code)
OUR nt Use Onl
Approved ❑Disapproved Permit Fez _ Date Issued I g 5i
A ySD
-
❑owner Given Reason for Denial rr�/
DL Conditions of Appro fur Disapprov
SYSTEM OWNER:
1 Septic tank, effluent filter and V
_ 3 /.3-5-
dispersal cell must all be serviced / maintained m %� �'�
as per management plan provided by plumber.
All SelbaCk t eh . sad sabmnit ro eke Capnty o as p. sot bs ttaru tRtne
as per applicable co a or finances.
SBD -6398 (R 01/07) Valid thru 01/09 ! `�
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241
A Bottom
36
void Volume it Interface Area in. IQ Ft. so Ft
Void Coefficient in Aggltgate given at 57,4%. Sidewall (2 Sidewalls) 2+ 18.84in = 3.14
O.D. of 4" Pipe a 4.625 inches 12in
3125w ft
Void volume per linarr ft. - 3.14 � 2. Ifr = 0.117 ' IR
Bottom 2.00
l2in / ft
Total Soil Interface Area 5.14 SQ.FT
O.D. of eentereylinder =R.S inches 1
Void volute in aggregate of center cylinder =�3.I4 • 6.25in + _ 3.14 • t 2 3125in l2 )-.574-.422 R
f2in /R J
O.D. of outside cylinder ( 72 - - 1 ft l = inches .Projected Trench Area
Void volume in outside cylinders - 2.3.1 6in V 574-.901 fP Sidewall Height = 12 in. •2 - 2.00 Sq.Ft.
�12in /ft� •
Bottom = 36 in. = 3.00 Sq.Ft.
Void volume at bottom between cylinders - �( 24in • 6in _ �3 1 6in
126irfl l2in /ft12mrR, �� =0.215 ft' Projected Trench Area = 5.00Sq.Ft.
Void volume at outside bottom corners (112 of void volume between cylinders) 0 -(),log ft'
Total void volume - 0.1 17 + 0,422 + 0.901 + 0.215 + 0.108 = 1.763 cubic ft t ft
Gallons per ft = 1.763 X 7.48 - 13.2 eallopa per linear ft
3(�`l )( 10 = 50
EPS Aggregate
Trench System
EZ7 203H fl Ow
Ring-lrtdustrial Group
65 industrial Park Rd.
Oakland, TM 18060
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Wisconsin Department of Commerce SOIL EVALUATION REPORT P 1 of 3
Division of Safely and Buildings
in a , ance with Comm 85, Wis. Adm. Code
County St. Croix
Attach complete site plan on thapofa x 11 inches in size. Plan must
include, but not limited h I reference point (BM), direction and Paroai I.D. _ '4rn- vQ
r► prim lan m!xD tl
Personal information you provide may be used for secondary Purposes (Privacy Law, s 15.04 (1) (m)). /
Property Owner P Warty Location ■
DCCI Land Planners Inc Lot NW 1/4 NW 1/4 S 17 T 28 N R 19
Property Owner's Mailing Address C K0! X. CO 11 NT` ;fty Block # Subd. Name or CSM#
1 1505 HWY (� 7r��,1!NC 0. ;r 1 I I Meadow Rid Pe Of Tmv
City State Zip Code u [] Village ■ Town Nearest Road
New Richmond Wi 1 54017 1 ( ) East Cove Road
E] New Construction Used Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD
n Replaoement n Public or eommeraal - Describe:
a rwnt matwriai Loess over elacial till Fkxmrt Plain PIP.vatinn ff annRratrM — • ft 1
General comments - - and recommendations:
t.-.:1
Pit Ground surface elev. 927.95 ft. Depth to limiting factor >90 in.
Soli Application Rate
Horizon Depth Dominant Redox Description Texture Structure Consistence Boundary Roots GPDW
in. Munsd Qu. Sz. Cont. Color Gr. Sz. Sh. 'EW1 'E11102
1 0-10 10yr3/2 sil 2msbk dsh as 2f .6 .8
1 2 1 10-21 I IN—A /d I - I sil I 2mchk l dsh l kw 1 if 1 .6 1 .8 I
3 21 -49 10yr4 /4 - sicl lmsbk dsh cw _ ,2 .
4 49 -90 7.5yr4/4 I s 059 dl - - .7 1.6
2� Boring # 0 Wng 925.43 X90 ✓
El Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Red= Descdotion I Texture Structure Consisteras Boundaw Roots GPDW
I I in I wa,-wi I a., S, rnro cnk,r I I rr S, Sh 1 I 1 1 =F,�; I •FfW
1 0-19 10yr3/2 - sil 2msbk dsh as 2f .6 .8
2 19 -26 1 4/4 - sil lmsbk dsh cw if • •
3 26-40 10yr4/4 sicl lmsbk dsh cw _ .2 .3
4 ArLM 7.Jy14 /Y - S vsg QI
'Effluent #1 = BOD- > 30 < 220 mc/L and T >30 < 150 mcUL ' EMuent #2 = BOD- < mclL and TSS _< 30 mclL
f :.RT mmno n mw Prim\ — - — Rinnah ew — MT Kh m o w r
Thomas C Nelson �"� 227387
Address Date Evaluation Conducted Telephone Number
1432120th Street, New Richmond, WI 9/18/05 715- 246 -2454
i
Y
Property Own — - DCC — I La Plann Inc Parcel 1D # Pence page 2 or 3
W Boring
a � # Pit Ground surface elev. 923.75 ft. Depth to limiting factor >90 in• c A pp l ication Rate
Horizon Depth Dominant Redox Description Texture Structure Consistence Boundary Roots GPDHf:
I 1 in. I Munsell I Qu. Sz. Cont. Color I I Gr. Sz. Sh. 1 I I I - Ef1#1 •Eff#2 I
1 0-8 10yr3/2 - sil 2mshk dsh as 2f .6 .8
2 8-21 1 4 _ sil 2msbk dsh cw if .6 8
3 21-3 7.5yr4/4 - is 089 dl cw - .7 1.6
4 �1 -9t1 7 c�;� /n - s Ogg •','• - - '7 1
icy 2
I I Boring # ! c""
U Pit vrounu su"U"r ererv. n. wew to mrnmiy Teavr m.
Sal Applicationt Rate
Horizon Depth Dominant Color Redox Description Texture Shicture Consistence Boundary Roots GPDW
in. Munsa Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 - Eff#2
F Boring Boring
Pit Ground surface elev. ft. Depth to smiting factor in.
sal AWfication Rate
Horizon Depth Dominant Redox Description Texture Sinxxure Consistence Boundary Roots GPDW
I in. I Munsell I Qu. Sz. Cont. Color I I Gr. Sz. Sh. I I I I 'Eff #1 I •Eff# I
• r-rm ww* m = Rnn > 3n < m1 mnn and Tcq >sn < ism nw+n = Ffm i nnt W = Rnr1 < sn nw,n aril TR. < 3n mnn
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- 2648777.
saD433OTer (R.07/00)
DCCI LAND PLANNERS, INC. ® SOIL BORING
Lot # 7 - MEADOW RIDGE OF TROY O1R° ' • •
NW 1/4 OF THE SE 1/4 OF SECTION 17, Ak BENCHMARK • •
T28N, R1 9W, TOWN OF TROY, ST.
-TOP OF CONDUIT . U"ll LM+• "°"'
CRODC COUNTY, WISCONSIN. ALT BENCHMARK . w* 70 • • ,p„
-TOP OF CONDUIT
L
TOM NELSON CST - Llc. # 227387 N NOTE: THE CONTOURS IDENTIFIED OT ' 1O7'
ENVIRONMENTAL BY DESIGN ARE PRIOR TO CONSTRUCTION. 4
CONSTRUCTION GRADING WAS IN
1432 120TH ST. PROCESS DURING SOIL TESTING. • / • • • • • • • •
NEW RICHMOND, WI 54017 CONTRACTOR MAY NEED TO
ph. # 71 5- 246 -2454 CONFIRM FINAL CONTOURS • •
DURING INSTALLATION. wrw
wr w
SCALE IN FEET 1 - 40' wr w ►or »
60 iiia
1 100 0 100
1�
2
� EL=92 � 2.22
B1
� f
J EL= 925.61 83
EL= 23.7 S V
B3 L= 925.05 9
®E = 923.09 2
f f
6' EL =925.3 X
ko
f /
• f B1
1 ® 9 5.43
924.
1 5'
L =927.9 • \• i l� f 25.37
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page j of
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner
,C an rs �`e Septic Tank Capacity O ga l ❑ NA
Permit # �7�1r Septic Tank Manufacturer ❑ NA
V eS
DESIGN PARAMETERS Effluent Filter Manufacturer t ❑ NA
Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA
Number of Public Facility Units A Pump Tank Capacity al ❑ NA
Estimated flow (average) 40 0 gal/day Pump Tank Manufacturer ❑ NA
Design flow (peak), (Estimated x 1.5) pp al /day Pump Manufacturer ❑ NA
Soil Application Rate 7 gal/day/ft2 Pump Model ❑ NA
Standard Influent /Effluent Quality Monthly average* Pretreatment Unit A
Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BOD <220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other:
Pretreated -Effluent.- Quualibr__ - —` —Dispersal—Cell(s)—-
Biochemical Oxygen Demand (BOD 530 mg /L ( On- Ground (gravity) ❑ In- Ground (pressurized)
Total Suspended Solids (TSS) S30 mg /L NA r ❑ At -Grade ❑ Mound
Fecal Coliform (geometric mean) 510 100m ❑ Drip -Line ❑ Other:
Maximum Effluent Particle Size Y in dia. 13 NA Other: ❑ NA
Other: ❑ NA Other: ❑ NA
* Values typical for domestic wastewater and septic tank effluent. Other. ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every: ❑ months) (Maximum 3 years) ❑ NA
ear(s)
Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA
Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA
year(s)
Clean effluent filter At least once every: ❑
ja month(s) ❑ NA
year(s)
Inspect pump, pump controls & alarm At least once every: ❑ month(s) ❑ NA
❑ year(s)
Flush laterals and pressure test At least once every: [3 month(s) ❑ NA
❑ year(s)
Other. At least once every: ❑ month(s) ❑ NA
❑ year(s)
Other:
❑ NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank
inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface.
The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding
of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment
units, and any servicing at intervals of _ <12 months, shall be performed by a certified POWTS Maintainer.
A service report shalt be provided to the local regulatory authority within 10 days of completion of any service event.
Page v of
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals
that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents
of the tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at -grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the fife of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
I� A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
• A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS
technology a holding tank may be installed as a last resort to replace the failed POWTS.
• The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site
evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank
may be installed as a last resort to replace the failed POWTS.
• Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of s uch systems must comply with the rules in effect at that time.
< <WARNING> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name VE Name
Phone Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Name (!.1`O i O f i t P1,
Phone Phone t
This document was drafted in compliance with chapter Comm 83.22(2)(b)(10AM and 83.54(1), (2) & (3), Wisconsin Administrative Code.
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/B Di -G-S L,4440 P LACN -► t4!E t M 1 c-V+ A Q.-- 5TE e i-t-S
Mailing Address PCB b c' X 44 (� , V-10L r V- L L-A �<l tJ , \IV 1 S 4-<3 1
Property Address 4 lo4b M.tEc��w �tZa 1p
(Verification required from Planning & Zoning Department for new construction.) V
City /State Parcel Identification Number
LEGAL DESCRIPTION
Property Location b�' '/4 '/4 , Sec. 1 , T Z'b N R 19 W, Town of
Subdivision MEAr OL -arc r,:F— '::A , Lot#
Certified Survey Map # , Volume , Page #
Warranty Deed # Volumc Z-� 3 , Pagc # Z S
Spec house yes )no Lot lines identifiab6yes 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.
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, 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.
I /we certify that all statements on this form are true to the best of my /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 bud&pums
,/74
1
A(M X11 Of APPLICAN ) 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.
"«`� + +-'�� 1 1 \VII 1 \1VC1 VQ11Cl�. flE.1J 41 QIr4 IV GYVYJYV (. r..�C
U 2 7 3 1 P
KATHLEEN R. WALSH
REGISTER OF DEEDS
ST. CROIX CO., MI
RECEIVED FOR RECORD
LIMaTED WARRANTY DEED 81/ 14/28e5 81 s $@PK
WARRANTY DEED
Document No. FIEW #
REC FEE: 15.00
This Deed made between VALLEY LAND TRAITS FEE: 10958.
COMPANY, a Minnesota corporation, Grantor and CFEE'
DCCI LAND PLANNERS, INC., Grantee PAGES: 3
Witnesseth, That the said Grantor conveys to
Grantee certain real estate in St. Croix County, State
of Wisconsin, legally described on Exhibit A hereto
(the "Property"),
Together with all and singular hereditaments
and appurtenances thereunto belonging.
This conveyance is without warranty,
except Grantor covenants and represents the
Grantor has not made, done, executed or Tax LD.:
suffered any act or thing whereby the above- '
described property or any part thereof, now or 7
at any time hereafter, shall or may be -Y V11 /07 dry Gl �TL'�
imperiled, charged or encumbered in any
manner, and Grantor will warrant title to the
above- described property against all persons
claiming the some from or through Grantor as
a result of any such act or thing, provided, however, that the conveyance hereby made and the
warranty of Grantor is further limited by and subject to those matter set forth on Exhibit B hereto.
Dated this _ day of January, 2005.
VALLEY LAND COMPANY,
A Mn a corpora
g �
Y:
Its:
ACKNOWLEDGEMENT
STATE O
) SS
COUNTY OF
Personally came before me this day of January, 2005, the above named Gary B. Valley, as
President of Valley Land Company, a Minnesota corporation, having full authority to do so and
to me Imown to be the person who executed the foregoing instrument and acknowledged the
Sam
blic, State of
commission
I s JqEADOW
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LOT AREA TABLE
rota- U
Le' l 60. Fr Wr 60. FT Uyr j S0. FT LOr
d Lot Z 1 Lot tt 44256 Lot 21 123147 Oy
- � , 43a6D let t2 QUO Lot 2Z 72M 4 �:
3x62 Lot 13 70744 tot 23 ta06s1 OL
' t L et s =M Lot /4 tav274 Lot 24 461110 OL .
a6366 Let is 7aa64 Let zs 46637 OL:;
• • t Lot .6 46064 lot M on" Lot 26 x0367 (LL i
UTLOT ounor .: •� <' s ..o j a a
Lot 4 a48a0 lot /a 66064 am OL
` lot 4 47452 ZO 53042 Ol t
! �'"- .•— .._.._.._.._.._..� •°0O.0 6� Let /4 66073 Lnt 20 47462
•�.i�' ;y ' lot 10 x0.740 Lot 20 t47ats Lot 30 6a03t OL 1
�$ Lot 31 atat OL 1
a•ssr, ,sa fr �>s� NOTE: ALL LOTS CONTAIN GREATER THAN 1.00 ACRES OF NET4411Epge
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