Loading...
HomeMy WebLinkAbout040-1281-40-000 r Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 430270 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: Derrick Construction Inc. I Troy Township 040 - 1281 -40 -000 CST BM Elev: f Insp. BM Elev: r BM Description: Section/Town /Range /Map No: `-j0 C� 3 • `{O � Z CST M -2 19.28.19.1585 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic w Benchmark kh 0 �3 Dosing Alt. BM Aeration Bldg. Sewer ' qo Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht outlet S 93.32 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic n. Z{ 5D Y L ^ 7 ' Dt Bottom Dosing Header /Man. 1 •3} �0 1pS IF 0.33 U Aeration Dist. Pipe Holding Bot. System ��. Z ., pi N • 2 TO Final Grade - PUMP /SIP ON INFORMATION Manufacturer G emand St Cover ? Z . �r R1 O Model NumIXer TDH Lift F ' tion Loss System Head T Ft Forcemain L4ngth Dia. Dist. to W SOIL ABSORPTION SYSTEM " e,.,) c BED /TRENCH Width LengtP No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufac ref ' INFORMATION CHAMBER OR ' Type Of = t � J 4 � > �s UNIT Model Numbe O ( s DISTRIBUTION SYSTEM (� Header /Manifold It Distribution x Hole Size x Hole Spacing Vent to Air Intake Pip L Dia Length Dia Spacing / SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil El Yes D No [] Yes ] No r MMENTS: (I clude cod repen ies r on ) . /,4 resent, etc.) Inspection #1:_Ogg . 2 � Inspection #2: - - � a E�- 7 oscation: il 236 Muirfield Ti Hudson WI 54 16 (SW SW 1/4 19 T28N R1 9W) Troy Village 4th Lot 122 Parcel No: 19.28.19.1585 1.) Alt BM Description = L " C S 2.) Bldg sewer length = 40 - amount of cover Plan revision Required? Yes No Use other side for additional information. SBD - 6710 (R.3/97) c (�C. 4 C S Insepctor's Signature Cart. No. Safety and Buildings Division county 241 W. Washington Ave., P.O. Box 7082 Madison, Wi 33707 - 7082 Sanitary Permit Number (to be filled in by Co.) 4 /�S/l1 (608) 261 -6546 a Department of Commerce Sanitary Permit Application State Plan `° Num In accord with Comm 83.21 Code. Wes. Adm. a� ;'�`�"-- �- ._��° -. may be used for secondary purposes PrivV Law, - + Project Address (if di t dim tailing address) C rn -,, I. tion Information — Please Print All Iaforana i i Applica c c rmw Property Owner's Name - Para! # #' as Block # n Property Owner's Mailing Address �. •� w S A City, State Zip Code Phone Number Yti /~ Secaon I M. \- I s o ! 1-71Sav T a � A"c N; R AB C M IL 'Type of BuUdieg (cbedt all that apply) Subdivision Name CSM Number V1 at 2 Family Dwelling - Number of Bedtootns k e _ -- ��-� kt:�f - Pubes - Describe Use ❑ Spate Owned - Describe use tw"r ty ❑Vi owm;t ip of III. Type of Permit: (Cloak only am box on line A. Complete line B if applicable) - A. system ❑ Replacement System ❑ Treattum tillolding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New I ism Ptovioas Permit Number and Date Issued Before Expiration Plumber Owner IV. TMW of POW'I'S System, Cbeck all that a pply) Nan - Pressmimd I t- Grommd ❑ M=W?! 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At - Grade ❑ Single Paso Sand Filter ❑ Wetland ❑ Pressurized in4round ❑ Holding Tank ❑ Pat ' tr„_ f l s.,. * c Treatment Unit ❑ Recinvlating Sand Fiber ❑ Recirat S thermic Mafia Fiker ❑ I.eschmS Chamber ❑ Drip Graver -leas Pipe Other (.Ph.) V. Dk reatmcat Area Information: T�Ow Desi Flow (W) xis Sal APPS tta"W)ds* Dispersal Area Reryired (s!) Dispersal ( , -z 5o a to 14 a oo 87, S VL Tank Info Capacity in Total Number Manufacturer Trelsb site Steel Fiber Plastic Gallons Gallons of Units Conroe Conssbucted Glass P�GGh New ExWng TWIN TS y Sep MLngTook Op i R (0c) tic / Mabee Ttatmapa tJuk DW" Chamber VII. Respoassbility Statement- i, the asderdgaed, assume respoaaibliity for I the POWTS shown oa the attached plans. 's ) Phnnber's Si !MFRS her Business Phone Number en cis 3 �s a s r3 Plumber's Address (Street, City, State, Zip Code) � V. w k 61h 5 O t Coua rtn"t Use Onl Approved ❑ Desapptova! Sanitary Permit Fee (inckKks Groundwater Datq Issued ng Ajlont Signer o temps) ❑ Owner Given Reason for Denial Surcharge Fee / IaC. Cottftktns of App / roval/Rem for plsapprova J � l u Attach ceoplete phua (N the County amty) for the syaserE a paper no tas tluaa alt2 : t i Ioeb" In AN SBD -6398 (R.. 08/02) I .}.. . I I _ y , 1 I I I - y L , _ k - _ , , • I I i i I I I . , I • • I I , i _ 1 , 1 I 1 I 1 I , , i I i I i .IZ : i - -- I I � 1 • 7 -01- -r Qr I ; ' I I i i i ' i , 1 ' Plo P�xv-- Sw`) s S ic( T aZ N R l9 Lo - Tft� UA 4if 4- 6T I PIN 1o�c7 S �3(o n'1�� `�''r•« i C0 q-1 LS� rz 1 ZZ . 1 zz .�,��� ,5'0 • a • 30 ' Z O I ___ _ _ __ _ _' _ _ � _ __ _. M � r Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of - Division of Safety and Buildings • in accordance wi �`�: Adm. Code /� County ST C. Attach complete site plan on paper not less than 8 1 k4 es In SlzerP lust m I X include, but not limited to: vertical and horizontal r point (4, direction; and Parcel I.D. 0 1 >v percent slope, scale or dimensions, north arrow, cation�� to neare road. Q / - Please print all i 06 7l�nation. Re ' by Date Personal information you provide may be used for seorrd�ry pu (a$y L15.0 ) Property Owner H'�7 - fJ : Lv ZL�S ,SJ��OT CROIX Prop L cation �i14GO FIC �\ Sl� 1/4 SW 1/4 S W Property Owner's Mailing Address Block # Subd. Name or CSM# V8 o0 F�Bz2D Ez)'j S N E 's 4 tt Z � r'TLQV \- L -�C 4 Awn City State Zip Code Phone Number - [-]City ❑ Village ® Town Nearest Road S3q 9 New Construction Use: ® Residential / Number of bedrooms _/ Code derived design flow rate GPD ❑ Replacement E] Public or commercial Describe: Parent material _ � 3 Oy 1Z C —rvo Lprq- 1 30 - 1 -1 -1 /}s Flood Plain elevation if applicable la ft General comments and recommendations: � ti ST` NI-L- - -'s X1.1 s or- l H C14 C-M> PrC l`rj S I Dt w w:n L,epq�* CH-6H S3 eu *-� \' . \ U► rl'tS \ �2 e�L , � ' Old EISi� ` �L.m repo I✓ - M QE EL . 8 81. _ . � L - I*L t_S} C �+Ain1 -��i1 �Z Z Boring # ❑ Boring IL y/ 0 1� n ' ® pit Ground surface elev. 8 �{ - ft. Depth to limiting factor > t Z S in. Soil Application 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 1_ 0 -1Z k i'M 2A - sal Z `fsb►z M c w wt's e W 3 D SO /b `I IZ Yl6 — l s 1 esb►z my =S 6 l - b\1 Ii Sly 1 3 y 2 S 6 s i t c� fn 'F�- e-S - - D . p oe S �►zs `t iz..S /6 — s o s >v, I - _ �_ Z tL2. Boring ❑ Boring ® pit Ground surface elev. $ R L1- S ft Depth to limiting factor > I l y in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munselt Qu. Sz. Cont. Color G Sz. Sh. 'Eff#1 'Eff#2 2 U Z — S11 Z )U - tz)- tiLw*1 — si) Z�sbk •S 5 � � CW ! 0`L P -316 Sc I Z.►+� ski t'. �tv . S .6 S So -62 R- -5/y '1'F- -S Y2SIP8 si ( i sbiz m'F► 03 — • Z 3 (, VE ent IoyfZyl . S S w! #1 = BOD , > 30 < 220 mg/L and TSS >30 _< 150 mg/L • Effluent #2 = SOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Arthur L. 'Wegerer 00�31� =122.` 220254 _ZLL� Address ; Date Evaluation Conducted Telephone Number W e g e r e r Soil Testing & .Design S e r v i c 421 N. Hain St. River Falls, WI 54022 LO Z-3 -Qp 715 -425 -0165 _s - 1 Property Owner COMI34FKj1VrL 0 3 L ) . eo P Parcel ID # _ � bJZ),/A/ G Page 2- of 3 . F Z Boring y.C7 [] Boring g ❑-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 /ft= In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Etf#2 1 o - lO�t � Z[ 2 s � 1 Z'- Fsb►-c, w�, - fti. cw � .F . s - Ps Z l Z$ to`!R 3/3 Si I Z�sbk CS - . S S 3 o kq1z VA - ) s 1 t, s blz rn v `F►- es kj 36 -Sy UV R S/y - S'r2 Sit © - n j . mom- cS - . •D sy -rzs to-mvA /V671 o LVT 122 L oT / 3 c oring # ❑ Boring D ® pit Ground surface elev. Sq3 . Z ft. Depth to limiting factor 1 g in. Soil Application 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 o -tz zo`��Z1 — s i p 1 s b�c wl'(� Z . 3 -SZ 1 S� �Si 1 C_Sb4c rn u 7 -►1 lo'�R- VA S C� Sci m L.Z , F-1 Boring # ❑ 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 /ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •E ff#2 Q � © S L°` IN S L. • 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. seD4330 (R.uroo) PLOT PLAN Page 3 of 3 Scale LET \Z 1 - -- 9 � L -- - - - - -- pQ------ - - - - -- T--- - - --__ 13. ►2ZA \ L.o �Zz I \ Ck 3 -4 o ' . t c r23 lZ e�c+o,��- LET tZ3 9 s �,���..OV 715- 425 -0165 220254 vp_31g_ �ZZ CST Signature Date Telephone IIo. CST Ido. Job PiO. ' 000 — /, ■... ■......B --40 _ _ LOT 4 O / C.S.M. f , — - VOL. 4 PAGE 99 f r 0 B -406 B-40 - r s / B -350 893. O ' ► O / / ' � l l �V r B -405 I f — — — — — — — — — — — — — — — — — — — — — - PT68 +d X04 � / I / 3 r I , 1 \\ 894.6 / / —_ _ ' I / 1� 1 9 r \ LOT 3 �. / 8 -349 T �—_ , ./ ; .. \ � T ' v \ — 'PAGE", � / f f. �C�' � fF-y2. � � y `� • —/ / / / 911.1 f � y ,f ��, / / /� ` 12.8 � ♦ i -1 8. ,5.0 ------ - - - - --c - - - - - - - - - —9 � , � !I I r r � / 1 1 y►�� 1 �I • I Ap r •' , a ; , ,� �J ` 3., 2`9,y 8 .9, 1 • To.�, Y V � ��cxq� Lc�T �# r a a. { EZ12031 w ilil. ii . '.� � _ • ..iwi i iii L ,•Iw ►ilR= !. w 4 p j R 4.62" ;; ► " °'" • `' w wi w V 1 ! i . i w www =w '► . l i► w ww rrr ( I12 C' trV w V' im' wvw *. v 2 4 *t k D V I2 -1 /2' , ra 5 ' V oid c IA. (h'p.) 7.49rp. '` t l O.A.oi4^ ti wf" p - Im R = 1 ,. • a s i2j� S Malt f2 sfden+afls # j ((( ra.s aoaom ttt 11 o+at a hm., �'� eE ( Totat Seit latcrface ,� emterc y y, r�3.ts +( 6'2xa )� 1 Cybyd 11 - 1 4 1 l .x7d 12'2 4, Vold vwwm f QOFft, ��3 C�1T Ar.. P + ( Vold rQjuw '8!! ttai f �1 { bOtioM beh„q�/y j �F .. � cytre� :q 2.00 t w ! F2ar(7 i2wrf (` 3.r�j— ..� ?( 36I 00 1 how vat �uato / 122in.h� (j 'U -?.:3 ff' t. R. .�) s4. FY. ®f voM 111 ro %ecie Treoeb q I 'Dial 0.1 17 r brrwees 0 .4 ?2 w a.90t ,. Ybnge+sF Q.d IS :: ' ft t G X 43� fl.22S.0.t0a +F io3�A+cb /h 0dff *�� Per i, 7.63 x. a t r` f Er S Aggregate Trench ��1203H n g Indvstrid croup l ow O *kland. TM d ark Rd. IZ t 2mm*-,M, ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address 4 4 t i Jz_ ( cad tAa I-Lo WT 54gz I Property Address �� I `�1 t EA.f) T (Verification required from Planning Department for new construction) City/State �uOSo ( Parcel Identification Number 09 Z$ LEGAL DESCRIPTION Property Location 5 " Y - Sw V4, Sec. N -R L'� Town of . Subdivision Lot # Certified Survey Map # Volume . Page # Warranty Deed # Volume O a 5 'b . Page # Z. '!;;, Spec house >&s D no Lot lines identifiable es O 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 an& by a masterplumber , journeyman pbjmber, restrictedphunberor a licensed pumper verifying that (1) the on-site wastewaterdisposal 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 Commence and the Department of Natural Resources, urces, State of Wisconsin. Certification. stating tha our septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of a ee exp do Q ,7, 3 SI ATURE 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 pro d d a ve, f a warranty deed recorded in Register of Deeds Office. 8� - 7 0� S ATURE 6V APPLICANT DATE * * * * ** 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 P6WTS OWNER'S MANUAL & MANAGEMENT FLAN Pogo -7t of SYS SPI�IFICATK3trtS ]3NA :: zME NFOO fATIIOfM Tank facts U9 � �eS �2rS t3 r. ` Septic L1 Dose O H Vol. 00 (� permit Tank Mar sfact PAitRM ©NA 0 Septic p oase p H vO• Number of B Number of public Facility units O NA Effluent f�ter Mufa OD � f Modal o � Estimated leverage) flaw Manua Design tP flow - (Estimated x 1.5} b Sort Application Rate Pump Model p NA Mon" average Pfd Unit Standard of uentlEffluent qty p SsrWV3ravai Filter p Peet Fitter Fats, On A Grease (FOG) 530 mg1L n O Wediend 5220 mgfL ❑ NA O mechanical Aeration Biochemical O� Demand tt3 W Cl l]iskdection C Other. Total Suspended Sodas (TSa} 5150 mgtt- monthly average Manufacturer ❑ NA Pretreated Effluent QtORtY D g) eiodwnical o xygen De man (BOD 53o marl Dispersal tgF+Vtyl [3 kn- .round „r�edl Total S� Solids ITSS} 530 mBn ❑ NA 13 Mound O /4t -Grade Fecal` Cai{form (g Teen} Ste` cfn,t10am1 ❑ other: K in dia. ❑ NA other. DriP-Li e Effluent [3 NA MaximuEffluent Partir�a Size ©� Ol�+er; C3 NA +Values typed frx dornestic water and OePuc up* affkwd M/►NtTENANCE SCE Sarvfte Fr sarAw E'nrarrt rrrorstl►tel V&wdmun 3 yeast ❑ NA At least once every- s} I condition of tankis) When cornim� sludge and SCUM Ong (V of tank volume p NA Pump out cam of tank(s} ❑ When the high water alarm is ar tiv eted O NA nV th}ts) � g ors} At least once UVery Inspect dispersal COW p montthis} ❑ NA Clean effluent fitter At least once every. p rtnonttn {si O NA Inspect pump, Pump `�►trols & alarm At least ones every. D 7 El E3 NA Rush laterals and MGM" test at bast ono.evary: O year( O mahth ttfsT O NA : At least Once ev wy p _ s} ❑ NA MAINTENANCE tNStiTitUGTIONS c one of the following fides or certifications: shall be made by � individual arryrng Servicing Operator {PUMPWI- of tanks arxf , Inspections WTS Mant pOiae: Sep Master Plu be r; Master PHA Restr l Seer of the tenkisl t � any missing or broken hardware. i 1► a ny cracks °` Tank Inspections must. inclu de a visrmi inspection be and a check for any back UP Or P° of effluent on the ground baks, measure the volurrc of comb&ed sludge and ctneck effluent levels in the observation pipes and to rick sur face. The dispt nadirs} shag be vlsuY Mace may a fang am of effluent an the surface. The ponding of effluent On the PO" r the immediate noWwA tlan of the local re tn►Y 113 and scexrn in anY treatnvant tank equa arm-th {y or more of the tank votuFnr�, �' When the combined accumuFaR of sludge Operator and dispose of in accordance with c h ap t e r NR entire contents of the tarok shall be removed by a S8089a SwvK*V Wisconsin Adrnk*Ar8IWe Code- - Pretreat Alt other services, irtciudlrng but not limited to the servicing of effluent filters, Maintairnar. of .512 months, shall be performed by a cer tified POWTS units and any servicing at intervals � within 10 do" of � o f any service event. A service report shall be provided to the local regulstmY Gmw (2102 Page C:;�=of START UP AND OPERATION For new construction, prior to use of the POVVTS check treatment tanks) for the presence of painting products, solvents or other chemicals that may knpede the treatment process and /or damage the sod dispersal call(s). if high concerhtrattions are detected have the contents of the tank(s) removed by a amp tog a servk*V operator prior to use. System start up ,shad not occur when soil conditions are frozen at the infiltrative surface. During extended power outages pump tanks may fill above round highwater levels. When power is restored the excess wastewater will be discharged to the dispersal call(s) in one large dose wed may overload them resulting in the badcup or surface discharge of effluent. To avoid this s(tuation have the contents of the pump tank removed by a Septage Sew Operator prior to restoring power to the effluent pump or contact tact a Phumbar or POWTS Maintainer to assist in rmeramlly operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cads. 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 eifrrinerion of the following from the wastewater stream may improve the perfonTwnce and prolong the life of the POWTS: antibiotics; baby wiped. cigarette butts; condone: cotton swabs. degreasers: dental floss; dispeai disinfectants; fat; foundation drain (wimp pump) discharge, fruit and vegetable peeling ge sour ; grease; herbicides: meet swage; medications; oil: painting per: pesticides, sanitary napkins; tampons; and water saftener 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 property and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: All pipin to tanks and pits shed be disconnected and the abandoned pipe openings sealed. • The contan of all tanks and pits shad be removed and property disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shag be excavated and removed or their covers removed and the void space filed with soil, gravel or another inert solid material. CONTiNGBYCY 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 bifrkV*d upon by required setters from existm and proposed structure, lot Ines and wells. Failure to protect the replacement area will result in the steed for a new sog and site evaluation to establish a suitable replacement wee. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not avaiable due to setback wWVw soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to ►apiece the faded POWTS. 0 The site has not been evaluated to identify a suitable replacement wen. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replace me t area. If no replacement area is available a holding tank may be installed as a List u>asnrt to replace the faded POWTS. © Mound and at -grade sod ash systems may be reconstructed im place following removal of the biomhat at the infiltrative surface. Reconstruc of such systems must comply with the rules In effect at that tune. < <WARNING> > SEPrM. PUMP AND OTHER TREATRUM TANKS MAY CON1A@R LETHAL GASSES AND/OR INSUFFICIENT OXYGHii. DO NOT ENTER A SMIrM. PUMP OR OTHER TREATMEKT TANK UQMHt ANY CIRCUWTANCEL DEATH MAY RESULT. RESCUE OF A PERSON FROM THE LfMT9iIOR OF A TANK MAY BE DUMMT OR 08POSSOLE. ADDITIONAL COMMENTS POW I a iMSTALLIER POWTS MAINTAINER L" "Wo"M Name ( S Phone - SEPTAGE SERVX3NG OPERATOR (PUMPER) LOCAL REGULATORY AUTHOR{TY Name Name IL i Phone Phone g This document was drafted by the staffs of the Green Lake, Marquette and Woushare County Zoning and Sanitation agencies in compliance with chapter Comm 83.22(2)(b)(t)(d)&(f) and 83.5401, (2) b (3), Wisconsin Administrative Code. 1" v"iN vnL-t_t_ t n LJ i r\nt, r r ah • f I VV4 Jdl I )U LUUJ 1L -UO r. UL 1658MGE 273 64S�OIa � KATHLEEN H. �q STATE BAR OF WISCONSIN FORM 2 - 1998 REGISTER OF DEEDS WARRANTY DEED ST. CROIX O0`' W1 RECEIVED FOR RECOU Document Nuffew 06-124001 8:0 PA This Deed, made between VWNTT DEEA Troy Develo it Cor�oratioa, a M innesota corporati �' FEE; COPY FEE: Cr:,r,t„r. TRANSFER FEE: 207.00 and flertick ConstrtlCtion_. Cogritaany —^ RECORDING FEE: X4.00 PAO. '1 Cmrttor for a val uable conskleratlon. Conveys and warr ant, to Grantee the following described real estate in St. Cro ix _ ___- County State of Wi�consirs: Lot 122 „ of the Plat of Troy Village Addition in the Town of Troy, St. Croix County, """" ow Pmwn Ao&8 Wisconsin. Ck Const ; Subject to Declarations of Covenants, Conditions and 1505 Hz 65, PO Box A N ic hmond, 54017 Restrictions for Troy Village, recorded in vol. 1241, 9 �1/ C Page 256, as Doe. No. 559964, and the Declaration of Golf Course Covenants, Conditions and Easements, recorded in Voi. 1241, Page 301, as Doc. No. 559969, all as Appearing in the office of the Register of Deeds 040-1281 --40 -000 for St. Croix County, Wiscsin, and such other Pa" taentiacatan "► (AM easements, restrictions and reservations or record, This not homestead propertyi or in use, and the "Buyer" obligations contained in (is) ( is ls not) the Purchase Agreement for tills lot. Exceptions to warrantteS; Dated this 6th tr or June 200 _ (SEAL) GSEI►!.) Charles S. Cook, President Troy Development Corporation (SEAL) (RAL) AUTHENTICATION ACKNOWLEDGMENT Signatures) _ Minnesota -•— — .�,.,, _��__.___...___.. _.__ ._ State of W+Pe.�osesFer. ss. An Countx authenticated this ,day of _ Personally came before me this _ 6th dAy of 'brie _ 2 tFte above earned Charles S. Cook, President TM D evajqMMt CoE20ration TITLE: MEMBER STATE BAR OF WISCONSIN to (It riot. me known to be the }person who executed the foregoing 8uth0rl28d by 5706.06. Wis. Scats.) instrument and acknowledge th same. t THIS INSTRUMENT WAS OAAFTED BY TROY DEVEWPM1r'NT CORPORATTON L: Charier S. Cook, Pr esident Notary Public. S%we&k4( aemj*Anoka County, Miles, My commission Is permanent. {If not. state expiration, '• date: (Signatures may be authenticated or acknowledged. Both are not —_ Jams 31 2000 ) necessary) — Names of Deteom signing In eny <eptlly must be typed ar printed below their elg,teaue. WARRANTY DEED STATE EAk OF WISCONSIN w t n Logy parlt Roc FORM No. Z - 1848 Mwauws. W4. Clo . � � NO'A1R1' �PtlaKr_ .UJ hleftt cv = 43 S.F. 1 - � ► SE 1/4 OF 1 ? ........... ......... . LOT 5 _ UL U _ S_.M_ U Coco' o I I _VO 1 122 v K) 1.021 ACRES I Q I PAGE W) " 44,461 S.F. _ II I I DO_C. J W N 89 0 40' 20" W � I to ~ v 0 335.03 o ' o� r� I I I 123 N I co f 1.028 ACRES V • I , S 890 4.04' 2 6" 2 I_ - 44,774 S.F. _ 3 - - - - - - - N 89 0 40' 20" W v 331.17' i•� O ^ ;' "n v) ONo 7 - - � I U `�� I N 89 0 55' OUTL_O T 1.010 ACRES EXISTING _ 5 � , 124 �I I °°' o - � 37.22 •t Z �, O OF' TROY VlL L A GE L _ x' 016 S . F . _ i J I ° ' ° �u IN VL L UUM c�, ` S 89 N 89 0 40' 20" W I v I w 3 43.85 33 I L _ 3 - ' I N % LI 125 I z cn ' '� � 3 c I o o cn N 1 1.012 ACRES 0 ,'� o v ° O w - 44,065 S.F. v' . o o� I • o o = o rn � o P N N. 1 � w F Z rn N 89 0 40' 20" W �'- ON N N N J o 0 331.40' 1� N o,�I ' 126 f�� - - - - -- - - N ' 1.027 ACRES I 44,743 S.F. V I I I _ _ N 89 °40' 20" W 1 N W I n - - 334 _ 1 LL. IN w l � II � I I ' 127 OUTI � -- I I f � 1.022 ACRES v , 1 , I I 23,9 _ 44,532 S.F. _ I w 3 N 89 °28' 54" W - — — — — — — — — — — — — 325.00' M �p- _ pm b) N ul) 00 00ui n"1 06 M ►7C0 to W ° ) ,q N 128 � J)o , ° c°,o 1.037 ACRES �st 45,173 S.F. Z cn // 3N / Mo ooz °I 129 `� `' �''� °k N 1.036 ACRES / / i / U O OU TL 0 T 9 w M l 45,130 S.F. / N )F — TRO Y V/L L A GE / I I I o S 89 0 28' 14" E G�� \ I w Z 57.89' yWl �1� 1 � POINT OF ;�IZI ~ o - ./ 0\ \ 0 BEGINNING co N C�6 �-� V " 7 6.62' o o o 89-28 W 57.89' 0 1x 01 `�� \ � Z - - - -- —_ 'I� 66.00 ' 1 _210_.3_ 3_' N 89"28' 14" W 395.17' 1 — — — - — r ° I _PL_AIN_V /EW_ N 8 40' 23" W 2506.91 i 1 _D ! OT 1 ' LOT 1 0 1 — I 3 CENTER _ -- 1 _ -- M inr _ v n r.�_