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HomeMy WebLinkAbout040-1252-90-000 Wisc-isin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Satei`jJand Building Division < ' INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 488023 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: S essard, Ken & Patti I Troy, Town of 040 - 1252 -90 -000 CST BM Elev: ( Insp. BM Elev: BM Description: Sectionrrown /Range /Map No: W .0 .O � ST "* 1 19.28.19.1330 TANK INFORMATION ELEVATION DATA TYPE ANUFACTURER /aPA IT Y STATION BS HI FS ELEV. o PL SZ. S"� ' ¢e- Septic Benchmar Dosing V Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMA� • Z� TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic / r 1 Dt Bottom Dosing Header /Man. 1 Aeration Dist. Pipe• 94, 0 1+ 11, P h >a t •. Holding got. System qp � MP /SIPHON INFORMATI6N Final Grade /b •� Manufacturer Demand St Cover � t GPM 1 S Model Number �j �� S L TDH Lift cti oss System Head DH Ft j.� aC Forcemain ength Dia. IDist.toWell SOIL ABSORPTION SYSTE N( /fveo C11 $' RENC Width Lengthy No. f Trenches PIT DIMENSIONS No. Of Pits Inside Die. Liquid Depth D! S 3 /�/� ? c7 SETBACK SYSTEM TO P/L BLDG IWELL ILAKEISTREAM LEACHING a act ' INFORMATION _/_ T Of Syste C-6A.A f CHAMBER OR J7R41r 01 N. 35 1 Z > !(��, ��"' UNIT Model =: DISTRIBUTION SY TEM � �, Header an older Distri ution x Hole Size x Hole Spacing Vent to Air Intake Pip s) :1Z U : Die Lang Dia Spacing SOI VER x Pressure Systems Only xx Mound Or At -Grade Syste Onl epth Over J) Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench enter n �j� Bed/Trench Edges Topsoil Yes No j Yes No r C E J S: (In Jude Qde crepencies, p s pr nt,, etc.) inspection inspection #1 � � Inspection #2: j V to L cation: 293 St. Andrews Drive Hudson, WI 540 6 (N 1/4 NW ]/ 19 SN R1 9W 1330, �(�. 1.) Alt BM Description = 5.Ti C 1ft1' 2.) Bldg sewer length = ^+ 1Z. ii % 4 f'� amount of cover - t! 2 -r ,"t-a;jr , ' 3• �� � C13 �3fl Plan revision Required? _; Yes WNo 4 - 3 0 t �• Use other side for additional information. _ _. �.___L -_ -_ _ - Date `11_WInsepcto Signature Cart No. SBD -6710 (R.3/97) Safety and Buildings Division County 201 W. Washington Ave., P.O. 62 J coe f X 1 Madison, WI 53 Sanitary Permit Number (to be filled in by Co.) consin 6 QQ Department of Commerce D D Z " State Plan I.D. Number Sanitary Perthit >1 tion ` �� In accord with Comm 83.21, W' . Adm. , p ation you provide may be used for secondurposes cy Law, .04(1)(m) 'ect Address (if different than mailing address) C 6T- _7 �! �"2Zf fe�� �d - C I. Application Information — Please Print All nformation` Alo A0,017 Property Owner's Name Parcel # Lot •7 Block # 0q0 - 0 a Property Owner's Mailing Address Property Location ra � VFo y6 �4Jt �� t / /U V,, /t /a, Section City, State Zip Code Phone Number o PLy� ou l f 1 Ssy 6� Ss I T e �B N, R g Ie W /J II. Type of Building (check all that apply) /1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name CSM N her ❑ Public/Commercial -Describe Use ❑ State Owned- Describe Use 3 N- A- / d- 5 C ❑City_ ❑Village VfTownship of (J III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A' New System ❑ Replacement System g p y g Y ❑ Treatment/Holding Tank Replacement Only Other Modification to Existing System B. El Permit Renewal El Permit Revision El Change of El Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner ' IV. Type of POWTS System: Check all that appl N - Pressurized L C:ro�nd ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter aching Chamber El Drip Line ❑ Gravel -less Pipe ❑ Other (explain) t V. Dis ersaVFreatment Area Information: t ► Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed f) System Elevation 600 ✓ 0.7 ✓ ✓ 1 F77 3-.7 `333 93 -7 1 a VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units /� r Concrete Constructed Glass New Existing Tanks Tanks I L• � 1J� I a k 525 1 Septic or Holding Tank l<V Aerobic Treatment Unit Cd C r n Dosing Chamber E r [,o 1 e ek_ VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' Signature MP/MPRS Number Business Phone Number GOICC11 (5 . 45424y C Plumber's Address (Street, City, State, Zip Code) (� 6 S � ?qv le-C _ o S VIEL,Countv /De artment Use Onl Approved roved Sanitary Permit Fee (includes Groundwater Date ssue IZ:S igna tamps) Surcharge Fee) 3 y� ` oo �� g t) 5 en Reaso Denial ((.•(VJ IX. Conditions of Approval/Reasons for Disapproval I t 4j SYSTEM OWNER: 3 \ /v to t. Septletank,emuentMWand lar\. D( L ) --p djap� a cell agement plan provided by pltnnbpr. ( ec v�,Q b�`� , �o i+ 2. All setback requirements must be maintained �� C-0 ` (� as per applicable Code / ordittatnces. Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) 03NWG M3T2vz h +6 btt� tnw�iN9 )hgt Xt t ON _13 i w w � r e 0 v � � a e % I V P �0 ♦ y T � � '�3 pC. T Z ` � �Z, �SSf' �` � l.� e� S �O O � � `• Ci 0 `� -a () %4` IA r 4 o, 0 I pr;v e S� L of 7 X93 { i w ep Z 14 Cj kAj n ly (a ti T 4 •� T fil s Zs � LV Wisconsin Department of SOIL EVALUATI I Q�Dn°T .--a Divisbn of Safety and eul lin x �. Page of in accordance with Comm 85, Wis. dm. C I ° t"°D County �^ Att,ach complete site plan on paper not less than 8 1/2 x 11 inches in size. PI must t hO IX include; but not limited to: vertical and horizontal reference point (BM), directi and par�ef .D. percent slope, scale or dimensions, north arrow, and location and distance to earest road. Please print all information. I - KC X by Date Personal information you provide may be used for secondary purposes (Privacy Law, S. 1 Property Owner Property Location ` p s d Qovt Lot - ME 1/4 N W 1/4 S T oZ N R -E(er W Property Owner's Mailing Address L t # Block # Subd. Name or CSM# I :. e? e Q t 6W A IrC' 1V 7 tar Vi6 /Jt �- h d ff d W/ .f/ City State Zip Code Phone Number ❑ ty (:1 Village [Town Nearest Road P1,2- " - -;'� Mri 55-44- ( 7"r- s) ,S"r? -399 i-o - = I F-/ Ahda eu.s- New Construction Use : Residential / Number of bedrooms 4 6ds,, Code derived design flow rate !;7 d C7 GPD ❑ Replacement ❑ Public or commercial - Describe: N 4 Parent material )- ot-a'.t oy c.. / 0) C,'l / o Wi j 5 Flood Plain elevation if applicable N General comments r and recommendations: Recw�aa►, en d r., tre k c�cr a 00 �C< T :h �� ,/?et— 1 kce c /. 1- -45 / f ir o- f'YCh c e-r .7 t � .� f H 9(E: Cl4 d C-/0. r A �se' C `l 1cxe�i�� f�r. r.G�&c+aa� F,re /� r. ..� i Boring # ❑ Boring { t I l ! C3 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 /fl? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 - Eff# T C7 - 7. !o P R 3lA T11 Z P ` )- ►sz. J h C W 1' p 0 d Q C7 ! av ��p fob s� �.., as k. �. >�r c am. 1 Y f ,9. . O - S q3.9 a 9$•'i -� 133' 0 ix o S' /a e d 6 o.17 1 /0 $�C Ir .e., a As t r Boring # ❑ Boring qq o ❑ Pit Ground surface elev. < . 4 ft. Depth to limiting factor > in. — Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fi? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. °Eff#1 ' 'Eff#2 C'- /I /0 31.) -- s ,` 2 r w. f ;- c w Z �C LO- 6 0. 11-16 )olR�/.- r /.. 2 a,.a >~ P c w.. 1 y - f' d 0 -9 -7 K 7- S YXS S o s N, D. 7 1 - 6 Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L ° Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Sign CST Number �'� �r �°� --� ,�, . �1�,6� ;��. -. C_ �����'• 'O�/ .'� �,..v gam' X7.3 Address Date Evaluation Conducted Telephone Number s - '7 7,0 a ..�r� /�sw.w�fy u,%6z . - 4 oil 11 T!S -.z 72 -34 3 4 Property Owner, *h Pd ttl- peSS dhd Parcel ID # 040 -70- Page "\ of 3 F Boring f j Boring # i i Pit Ground surface elev. F 7- 7 ft. Depth to limiting factor 1 10 46 in. Soil A l::�ation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 1 ®- f 2 l ©� R 414 _Z iP � r� 4 c u- I �' o-4 o-7 la. - -z !o 1,R 3/j, s T � -2 w "Ub 4 40� c d s_` •� s Boring # Boring Q pit Ground surface elev. ft. Depth to limiting factor in. Soil Appligation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 - Eff#2 F1 Boring Boring # • �J pit Ground surface elev. ft. Depth to limiting factor in. Soil Appl ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Eff#2 i 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 sen or need material'in an alternate format, please contact the department at 608- 266 -3151 or TTY 608- 264 -8777. SBD -8330 (R 07 100) - Webster Soi T esting Et Sewer System Design Charlie 8t Kris Webster, Owners N5815 770 Street, Ellsworth, W1 54011 Telephone: (715) 273 -3430 Fax: (715) 273 -4181 Wt Licenses: MP220673, ST220673, ST 261669, PE18803 POWTS Index Sheet Page 1 of 6 Conventional System for a 4 Bedroom Residence Property Owner/Proiect Name: Ken & Patti Spessard Lot 79 — Troy Burne — 2" Addition Co ntents Page 1 of 6 Title Page Page 2 of 6 Sketch Page 3 of 6 Distribution Cell Cross Section & Calculations Page 4 of 6 Septic Tank & Filter Detail Page 5 & 6 of 6 Management Plan C O ...... si •. CN RL S WEBSTER E -18803 i 0 ELLSWORTH W a 3 WAS. .2 t AIL t� • pr;Ve St �- 7 ` h A j i aw r �, z � e b 1 F Ci rn c 0 eA Ice _. 9 � C� _ is - Sec ffOk �7c DiS�r,'bc, t,oa Ce //s t' d r Al a-i 4� 3 ° J tt.` S p e s s a #.- d 4 ,/ �,� � I+Z . q a-+� da`, �'� • t C CJI i h o r-, C�'r' i's 0 _ 5 Z's cpYi t /oh O / pC- s s.,..,, o I- 3 4 sc� � i t.�►, 6 tc„ti tr e.+c�zS Nv t� ahy scale cawf*•4ref IO c.as,, fawr cl 7 7. o t � Cow& 4w V -1 �3 9 syS7 eol 9 z . 7 si i,✓G cA1c44 L,4rio/✓S t �'� C f + Ne �.`s 1 G cR tr.,. c C l0 4 �gu• c�' ,'n �:' tJs'.N 6 S 9 • ✓� lC040 7,, 3 Sets i o fit! are ,v���. — x'77 S� T�kK � F /f A> 1? �P/>ro�e.� �oc�.�+ -i_ wtl ¢are► -s 4.n..•z.a emu,.. ��� I O P r /.k a e,�'�' 4 . etir F, f 1 �^ V , + P Alto, to, /1 �4K de, t � .y,..h�, 'T �€ 1�•��c a,. �.., rat : � to �:�� �� ® Calf es-, T e1:eHs f`on�- ,L �� 1 U �`yt �� O �/?• w.' t4 ' MANAGEMENT PLAN Page 5 r of 67 POWTS OWNER'S MANUAL &MANAGE FILE INFORMATION SYSTEM SPECIFICATIONS Owner ti ?d 7V S"p e SX—? f-a/ Septic Tank Capacity 1 2-S -0 a l ❑ NA Permit # Septic Tank Manufacturer W, eser ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer Po/ /alts ❑ NA Number of Bedrooms 4- ❑ NA Effluent F ilte r Model .S — v 2 .,5' ❑ NA Number of Commercial Units Nq Pump Tank Capacity al NA Estimated flow (average) 400 g altday Pump Tank Manufacturer XNA Design flow (peak), (Estimated x 1.5) CO O gal/day . Pump Manufacturer ANA Soil Application Rate 4_ 'T aVda /ff Pump Model A InfluentfEffluent Quality Monthly average' Pretreatment Unit XNA ❑ Sand/Gravel Filter ❑ Peat Filter Fats, Oil &Grease (FOG) 530 mg /L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BOD 420 mg/L ❑ Disinfection ❑ Other. Total Suspended Solids (TSS) 5150 m /L Manufacturer Pretreated Effluent Quality . ❑ NA Monthly average" Dispersal Cell(s) Biochemical Oxygen Demand (BOD 530 mg /L lK In- grbund (gravity) ❑ In -ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ At -grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu/100m1 ❑ Drip-line 0 Other Maximum Effluent Particle Size Y inch diameter Values typical for domestic (non- commerciao wastewater and septic tank effluent. " Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every y ❑ months Wyear(s) (Maximum 3 yrs.) Pump out contents of tanks) When combined sludge and scum equals one -third (Y,) of tank volume Inspect dispersal cell(s) At least once every ❑ months )9year(s) (Maximum 3 yrs.) P Pe 3 Clean effluent filter At least once every months . ❑ year(s) Inspect pump, pump controls & alarm At least once every ❑ months ❑ year(s) )KNA Flush laterals and pressure test At least once every ❑ months ❑ year(s) )ANA Other At least once every ❑ months ❑ year(s) 0 NA Other. At least once every ❑months ❑ year(s) MINA MAINTENANCE INSTRUCTIONS dispersal cells shall be made b Inspections of tanks and y 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 %) 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 ch. NR 113, Wisconsin Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreattment components and any other maintenance or monitoring at intervals of 12 months or less shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event 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. i I -- Ke h Pd tl` sp� Jr�c -o! Page of System start up shall not occur when soil conditions are frozen at the infiltrative surface. During pow @r,othages 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 Plu or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump 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 melimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONt4 E N When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is property and safely abandoned in compliance with ch. Comm 83:33, Wisconsin;Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings seated. • 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: 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 b installed as a last sort availab e re to replace the failed POWTS. advances in POWTS technology a holding tank may be • The site has not been evaluated to identify a suitable replacement area. I Upon failure of the t arrea ea is a soil and site evaluation must be performed to locate a suitable replacement area.; If no replacemens available a holding tank may be installed as a last resort to replace the failed POWTu. • Mound and at -grade soil absorption systems may be reconstructed in pl�cee follow { effect remova O th time at at the infiltrative surface, Reconstructions of such systems must comply <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASS CIRCUMSTANCES. DEATH MAY DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Of » K'+dK POWTS MAINTAINER Name Name Phone Phone SEPTAGE SERVICING OPERATOR PUMPER 64* LOCAL REGULATORY AUTHORITY i h Name Agency ,St. �ao.,r c Phone Phone 71,:F 3 �6 This document was drafted by the staffs of the Green Lake, Marquette and Waushara County Zoning and Sanitation agencies. This document meets the minimum requirements of ch. Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), wisconsin Administrative Code. Use of this document does not GMW (2/01) guarantee the performance of the POWTS. i � �� . ,r , i 12/06/2005 10:34 763- 509 -4048 STANDARD CASE PAGE 01/01 DEC -06 -2005 TUE 08:36 AN WOODDALE BUILDERS FAX NO. 9523460544 A. 01/01 ST. Coom COL1M SEPTIC MAMMUNCE AG IEWMT AND OWNI MM G'4tTJPiCATIOFN FORM 1293 A..� tli , Pa., , balmy ss aye (V*Mn roo jj zmw D•pwmft toe OW wmu .. �,��, ��„ ,�,+ , � _ Pasrel ]ee�,�5auiai I�erba ¢j+o - i as�� ^ 4 a • oeo,,;,: . yea svmy mo Warr�ty'Detid# $b7r Y _ ��,...„.._ - . Vohane J Pie �-- _..._._,• " boeeo ( lat lien ideetitbla �A0 . • " +�v� �t � l'i C.la O'Widi�RCFR� . '�ep& nrt oft* bsgeoparwno szd��esDtks7+Q0!ldsaultin#�P� W YaapNc -- a[�{n{ me tha lose yaws nF sew ifmo ■d. by 11W�sp � • � syskrn een ■tltttibe AMtetlot� aTdt■ � tsdt,ir ■ beiestn�i � i0 tAe wss.4fsi�al iy}xm. Ov.Aa me lakowuea .. , , tppeAiii+�lda are epaifOhd ie §CotetR. 83.'�R(i) and is 18- tlt. O�dX Ceoet7" sdtaxQ�datae� ' pap�sy oaeas sboees to lttbadd to bk Gt+ebi CavotT>P!■m1n� & p�easaret w sstieu tae+u reload by the eenear 1atl by a maslst pbt�a, joaeo■ymin pbm6w. mopmd p)Ym*' e es ■ Fir Mt ii) qws es•elss wit r4 dirpaysi iR in 1 epasa'ed coeditaosl > 1 #tom ! mdm sad �itnropipary), the is its" )13 taA ofdad�s r • ' ��! U;,e, tbs ttodaW igVw tsad tlYe atiw. ratntct 0 NN m �m Aa pd"ft Be" sytbsmwidl b° asdejo eet f rk him. w m by Wr.A■pi0W! t Of C mm and I* ollda" Belo ou. Sate of Vi1 , f mssyatsr,apptis,�ysssa+Mrs e.w s■dasrbeed�es!!e oassglaed aaa atieotoed to the K Qvis Canty Ptes * & prp,ugneat MiOda 3o d6jN of tlM tladu yut datp6�doa dssa Vw2 � *w 611 gape la i * s feat to w boil W agM►ow kaa+rtedp• )A■w awo�lle! tue ewusoe( :) of flu psopaty'AiseeIDed abeva by �i�toe al a i►w3Y d■oA ' coded in�,eilisaref Dwbds t�v■, • §ft A3�'I ) DA't� •+' My kifty� d atop rank lu dw saoiMvy penpK b�K revalued bl►d►t P>awoes do Zo>�i •w Iael■de * a ddb � a tamsded wpm mly dead (M� !< W of nendr OlAve �# ■ oepl° of d� aeetlflaA � �■! a eenoa is sew& Sm sm WNTUN �• i` a ss ea an an ama .U; 2993 P. 5 90 KATHLEEN H. YALSII State Bar of Wisconsin . Form 2 =2003 - RE GISTER OF DEEDS _ ST. CRDIX CO. , MI WARRANTY DEED' RECEIVED FOR RECORD Document Number Document Name 09/22/2005 893 WARRANTY DEED THIS DEED, made betwees EL111tQA. Brau4ego and ingueL. Brandeis, husbago REC FEE: 11.00 and wI(p TRANS PRZ.: 539.70 ("Grantor," whether one or more), COPY FEE: CC FLEE t and I,enaetb G• SpMxrd an# Patricia K Snessard, husiband and wife PAGES t 1 ("Grantee,• whether one or moue). Recording Area Grantor, for a valuablA consideration, convoys and warrants to Grantee the following described real asM, together with the rents, profits, fixtures and other appumuant Name and Regan Address interests, hi St. Croix County, State of Wisconsin ( "Property'0 (if more space is needed, please attach addendum): Let 79, Troy Village Second Addition in the Town of Troy, St. Croix County, Wisconsin. RVAT 2682"5 oeoassaAn -unn Parcel Idemification Number (PM This is not hom anead property. (is) (is na) Exceptions to warranties: Easements, restrictions and rights- of-way of record, lfany. Dated September 21 � 2005 , (SEAT.) - (SF.f�L) * *F lip A. Brindeen. ,,� f� (SEAL) O - (SEAL) * " e L. Brandeeo AUTHENTICATION ACKNOWLEriGNMT Sigl4aturo(s) _authenticated on STATE OP Wisconsin ) �,,N1t41 /q�rr� /. St . Croix COUNTY ) TITLE: MENSER STATE BAR IS' y1jl 2 Personally came before me on SePtemher 21, 2005 (If not. : the above-nmedPhillig A. P randeen and Jean L Brandeen authorized by Wis. Stat. ¢ .06) = husband and • AV B � • \G .` ` m me o n to be the persons) who exoou the foregoing THIS INSTRUMENT DRAF'T'ED Bj$';h Q��.•' iAsn en and acicnowled ed the same %�OF IG��`� Attorney Kristiria Galand Hudson, WI 544 6 * e ixsatl Notary Public, State of WisCOnSin My Commission (is permanent) (expires: _ (Slgaatures may be authenticated or acknowledged. Botts are not nccamry.) NOTE: THIS 15 A STANDARD fORM. ANY MODIFICATIONS TO THIS FOW SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED D 2403 STATE BAR OF WISCONSIN FORNI NO.2.2m + Typo name below signaturoa, INFO -PRO= Legal ROrme 000$$6.2021 www woprofomw com ZO /ZO 39tld 3Sd3 MdVaNaiS BOOP- 609 -69L 91:LZ SOOZ /10 /ZZ Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safe and Buildings � g in accord with Comm 83.05, Wis. Adm. Code Environmental By Design Attach complete site plan on paper not less than 8 11 inches in size. Plan must County include, but not limited to: vertical and horizo erertce�vint,(BM), direction and St. Croix percent slope, scale or dimemsions, north 0( cation aiid- distance to nearest road. e -- Parcel I. D.# APPLICANT INFORMATION A se ri4all informs ion. —GYM Personal information ou ovide ma be secon Privw a. 15.04 1 m . Reviewed By Date Property Owner ! Property Location Continental Develo went °^ Govt. Lot - NE 1/4 NW 1/4 S 19 T 28 N,R 19 W Property Owners Mailing Address _ S r C901X Lot # Block # Subd. Name or CSM# 12301 Central Avenue NE, ` 2 �21-' ; Y j 79 - Troy Village Second Addition City Sta ipGode n bef,.; E] Cit ❑ Village ❑Town Nearest Road Minneap ` '` ''' ..w Troy St. Andrews Drive New Construction Use: ❑ Resi y mber of bedrooms 4 [:]Addition to existing building ❑ Replacement ❑ Public or commercial describe Code Derived daily flow 600 gpd Recommended design loading rate .7 bed, gpd/ft .8 trench, gpdhf Absorption area required 857 bed, ftz 750 trench, ft Maximum design loading rate .7 bed, gpd/ff .8 tr ench, gpd/ftz Recommended infiltration surface elevation(s) By Designer ft (as referred to site plan benchmar Additional design / site consideration Parent material Loess Over Glacial Outwash Flood plain elevation, ff applicable ft S= Suitable for system Conventional Mound In - Ground Pressure AT - Grade System in Fill Holding Tank U= Unsuitable for system NS El U ® S❑ U N S❑ U N S❑ U ❑ S ®U ❑ S N U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/fts Boring# Horizon in Munsell Qu. Sz. Cont Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench 1 1 0 -19 10yr2 /1 - sl 2mgr mvfr cw 2f .5 .6 2 19 -45 10yr4 /4 - s osg m1 cw if .7 i .8 Ground 3 45 -56 7.5yr4/4 - s osg ml cw - .7 ! .8 elev 99.75 ft 4 1 56 -140 7.5yr6/4 - s osg ml - - .7 .8 Depth to limiting factor >140 Remarks: 2 1 0 -13 10yr2/ 1 - sl 2mgr mvfr cw 2f .5 .6 2 13 -40 10YR5 /4 - s Ogg ml cw if .7 ! .8 Ground 3 40 -120 7.5YR6/4 - s osg ml - - 7 8 elev 97.63 ft Depth to limiting factor >120" Remarks: CST Name (Please Print) Signature tom_ Telephone No. Thomas C. Nelson 715- 246 -2454 Address Environmental By Design Date CST Number Ref # 1432 120th Street, New Richmond, W1 54017 2/2/98 MO2605 18 PROPERTY OWNER: Continental Development SOIL DESCRIPTION REPORT Pa ,a e 2 of 3 [� 9 PARCEL I DA Environmental By Desi Horizon Depth Dominant Color Mottles Texture Structure �o nsistence � Boundary Root GPD/fts in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ; Trench mfr 2f .5 .6 3 1 0 - 36 10YR2 /1 - SII 2msbk ctv 2 36 -55 10yr4 /4 - sl 2mgr mvfr Cw If .5 i .6 Ground elev 3 55 -86 7.5yr4/6 - s osg ml Cw - .7 .8 97.17 ft 4 86 -91 10yr3/4 - IS 2fgr mvfr Cw - .5 .6 Depth to 5 91 -140 7.5yr6l4 j osg I ml - - .7 .8 limiting factor >140" Remarks: 4 1 0 -47 10yr2/1 - sil 2msbk mfr Cw 2f .5 .6 2 47 -92 10yr4 /3 - A 2msbk mfr Cw if .5 .6 Ground elev 3 92 -140 7.5yr4/4 - gcs osg ml - - .7 .8 101.2 ft Depth to limiting factor >140" Remarks: 5 1 0 -36 10yr3/2 - sil 2msbk mfr Cw 2f .5 .6 2 3646 10yr4 /2 - sl 2mgr mvfr Cw if .5 .6 Ground elev 3 46 -80 7.5yr4/4 - A 2msbk mfr Cw - .5 .6 96,27 ft 4 80 -96 7.5yr4l6 - s osg ml - - 7 .8 Depth to 5 limiting factor >96 Remarks: Ground elev Depth to limiting factor I Remarks: NVI 0NM NTfiL B D 1432 120`h STREET, NEW RICHMOND, WISCONSIN 715- 246 -2454 PROJECT NAME TROY VILLAGE 2nd ADDITION DESCRIPTION: NEB/, NWI, SECTION 19 „T 28 N, R19W TOWNSHIP: TROY COUNTY: ST.CROIX LOT: ;' =79 SUBDIVISION: TROY VIU AGE 2'd ADDITION a I cl a� i l 0 y CA c cs 1 f 1 i SCALE I"=40 Tom Nelson BM 1 NEcorner post g round surface elev. 100' cstmo2605 BM 2 Parcel: 0�0- 1252 -90 -000 11/22/2005 09:03 AM PAGE 1 OF 1 Alt. Parcel #: 19.28.19.1330 040 - TOWN OF TROY Current j X j ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner KENNETH C & PATRICIA M SPESSARD O - SPESSARD, KENNETH C & PATRICIA M 128300 46TH AVE N PLYMOUTH MN 56442 -2319 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 293 ST ANDREWS DR SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 1.074 Plat: 2558 -TROY VILLAGE 2ND ADD'N 98 SEC 19 T28N 19W LOT 79 TROY VILLAGE Block/Condo Bldg: LOT 79 i SECOND ADDITION Tract(s): (Sec- Twn -Rng 401/4 1601/4) 19- 28N -19W I I Notes: Parcel History: Date Doc # Vol /Page Type 09/22/2005 807145 2893/590 WD 02/28/2003 711602 2157/462 WD 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/22/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.074 139,900 0 139,900 NO Totals for 2005: General Property 1.074 139,900 0 139,900 Woodland 0.000 0 0 Totals for 2004: General Property 1.074 139,900 0 139,900 Woodland 0.000 0 0 Lottery Credit Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount � es Special Assessments Special Charges Delinquent Char p p g q 9 Total 0.00 0.00 0.00 . o m o § - � c \ ) \ /k-0 E . T (D , ;W _ § 7 � 0 M l< w 0 ° OD -0 f / 7 f§ G« E m \_ \_ ( 9 } ® ^ \ \ ° \ § Z � J C> / - - 0 6 ® E E « \ 8 2 g §2\ [ / > f ( 8 � - G \ ± \ ; 0 \\ f\ n r 2 m cn ! \ 2 R ( \ \ \ 2 r-3 � w 7 C' C' C) Ev ; 0 £ m ■ _ f \ ; 2 4 \ CD N D )_ 2\ \ 0 z z + > 2 0 £ § a\ ) z CD ƒ i § CD ¢ \ / � ) 0 � z \/, a w� M \ z ° U e § M & / { ƒ E ¥ z 9 w T ; m = \ E 2 z $ k % z k z . 2 \ ® � . \ > } 0 § ¥ [ Z \ 0 CL / [ / C \ � { � 0 § . / , \ � o \ G § ; S \ \ ) 10/25/2005 08:44 715 -273 -4181 WEBSTER EXCAVATING PAGE 01 N58 770" Street Ellsworth Wt S4011 Telephone: (715) 273 -3430 Web Fax: (715) 273 - 4181 Fax Tot l t?K Fww- Page- CC: .... E1 U' rat For 0-view ❑ Piaaso Gommant APlaao• Reply di rl S - 7, y �"o,tiy JVe /s e � -Z` E? !© c fe tie - ,0, .l ^ `e�'Gl- e- � s y ✓s. l�,e� f, of i.o 1J c /eZr y_ �"'1f; ,�S ho 7F' 'd /e„ ,�L --�` � 4�, a •7d�.k'� � r� c S e .r �l►ld'Xw_ �Z' Li P ,� ls ° ,►,, 1 o/ .ny 00 ivy, �e al "A1i 7 ;0? /-sr S - Ae a., , 'I-�J T/c ek j -,� 7 - "o.2S . �op 7` r - .d or.�ip.s o f Ta,., .OZO A l /a r h C.. � �Y� Z�m+� �Il / 4Z/ J '7 c e.S' �e�[rr �G°1't �t�h� ir� S � 7` ` t- /V b e�f • . p' gy p, Jr� St 14 , w a Y ea, b ..� A'- r A. 0 Se4'� � c.E s�d4, 40-*' rea a. �'a.,s �� i, c'- e.-cs;' lj .S"'td^ "CS Aye ,/ �1 fi Ark-* 6 �WtC l-Ce� ?�C� Q� fc s�r ��',!►�,1��� C"A.y, ,7e' -7- - rl - e fc ,� �'�� -�.�. T �► s sd• 10/25/2005 08:44 715 -273 -4181 WEBSTER EXCAVATING PAGE 02 4GT ^242005 ICON 07:05 An WOODDALE BUILDERS FAX NO. 952 948 8875 P. 04 " 190NM EN TM BY DIIE51GN 1432 220°" STpimr, , NEW fjCHMOND, WISCONSM 715 - 2 46 -2454 EJECT NAME: TM VIIJAG)l T.ad AMT= I)ESCRiP lo'f NEK MW' SfSCTION 19„T 28 N, IL19W TOW 94W. TROY COSY; sl:CILM T;4"ri ;?fi9 S[]$i?�IMOhf!: TROYVIIIAGE 2- AMMON �f3f f z f ' SCALE z vv =40p Tom Nw"s um �' 1? t ,�` � 'fa+CQ idg v.1Q4' rStMO2605 �I 10/25/2005 08:44 715 -273 -4181 WEBSTER EXCAVATING PAGE 03 O ga { a: Y �: 1 Q � t ZT Ql v < u -Z zo A Ad tl � � 4 ? i • 1 i b �y . 05 s � W N 83"00' 00" E� a 66.00' Q U N • +� BENCHMARK. TOP OF 1 bb y 44137 S.F. RON PPE. ELE - 887.38 337' - 1 1.013 ACRES x 7 { `W— W oo S 3 S.F. r N 2 ACRES � ' h i Z z " Z$0. �` S 1/4 CC �n o ?• SECTION 0' 00" E 8 7 9 PK NAL �.2 t' $_ c 46775 S.F. RON F N -- " 1.074 ACRES m 33 ` ' $ �8 S.F. 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