Loading...
HomeMy WebLinkAbout040-1281-50-000 r _ n 0 p g'D n I►_ .. C 'i cn x z N z o A o„ o cs < O c 0 WO W I O CO � `f v N ~ C CD j a CL 0 rn n O m O C 1 N a ra Q 3 v, _ ^t O C O n ,N„ O W O .� O C v a 0 C 00 3 N n+ O O O m v? v D O. m o A w C. n M � ( N O p O O ? C . A Oo ! Oz O �� N N O A O W a! N ��+, C !� Z o 0 0 0 S • C) U1 (A N O W O o CD m o v q' < (n f0 A N j � O '' A (►j C D N � z r r ' a o a O z @ o o w O D N t\i 7.J N N N N a \( O � O G: N (D O. o 3 m 7 z (D N -i N T ZY c m d A C W T N M '; z 3 a o cn H z N A W � a Q C O O T i p1 C z a O CD N a 0 o O A 0 w i = CD p L ` Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix Safety and Building Division f a Sanitary Permit No: INSPECTION REPORT 430268 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 -50 -000 CST BM Elev: Insp. BM Elev: I BM Description: Section/Town /Range /Map No: 9 Z. S9 1 91 2- 51 1 CST ACT • It" = 19.28.19.259A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark � YDS / Z• Dosing Alt. BM OI 3 Q may! EHolding Bldg. Sewer f 60 l.S11 SUHt Inle t CorT TANK SETBACK INFORMATION St/Ht Outlet ` • 5) 3• GS' TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic t+ Dt Bottom Dosing Header /Man. l� pc( 1 2.0 2 e i S9� b2. Aeration Dist. Pipe Holding Bot. System t2 • o ML, 9Z • 2 Final Grade PUMP/ HON INFORMATION Manufacturer emand St Cover Model Number TDH Lift Fric Loss System Head T Ft Force in Length Dia. Dist. t SOIL BSORPTION SYSTEM q 6-e- ,a„ru.%%` D@kff RENCH _ Width Length jNo . Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIM 3 9 of 4 •G a• - \ SETBACK SYSTEM TO 1 P/L / WELL LAKE /STREAM LEACHING Manufac rer: ,... INFORMATION CHAMBER OR • 41 • PjU_ j Type Of System: / UNIT Model Number: tJ f .O DISTRIBUTION SYSTEM Header/Manifold 11 Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe 1 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 TxxMulched Bed/Trench Center Bed/Trench Edges Topsoil Yes ;;1 No I Yes l No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: / _— Location: 234 Muirfield Trail Hudson, W1 5 (SW 114 SW 1/4 19 T28N R19W) Troy Village 4th IQt 1123 �,� (� Parcel No: 19.28. 1.) Alt BM Description = 5T' K"_Jiz A. CAU'• �) (�fr co pto j"`'K- Y Q1k 2.) Bldg sewer length = .% 3z / . Y - amount of cover jL Plan revision Required? Yes No - T l J - -— -� Use other side for additional informa t 7 on. SBD -6710 (R.3/97) ` Dat /� Insepctors Signature Cert. No. Safety and Bnihtuw Division COY k 201 W. Washington Ave-, P.O. Boa 7082 scone n Madison, WI 53707 - 7082 Sanitary Permit Numbs to be filled in by Co.) Department of Commerce (608) 261 -65" / Sanitary Permit Application Sate Plan 1.D. Npmber In accord w kb Coma 8311, Va. Adm. Codo, personal infotmatien you Provide maybe used for secondary purposes pdvvA ) _ Project if "ftereat than mailing address) YrI D I. Applicatiat In formation — Please Print All laftnuti w a / Owner's Name , f _2 2UUj Parcel M Lot / lock e 0 c , I Owner's ling Address i Property Location City, State Zip Code Phone Number S w 'l ., section of to 11 Type of IlWh Ina (che& all Litt( apply) T R � E �1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name CSM N umber ❑ ftbkXommacial - Describe UM 0 ❑ State Owned - Describe Ua� ❑Ci _Dviwwg UL Type of P'a vdt (Chedt otdy one boa on line A. Complete line B if appikaMe) " F A System ❑ Replacement System ❑ TtatrneaM ldiog Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑Change of ❑ Permit Transfer to New List Previous Permit Number and Date tsstnod Before Expiration Plumber Owner IV. Type of POW" Systew. Wbeck all that a pply) Non - Ptesswind h Ground ❑ Mound >_ 24 in. of suitable sal ❑ Mond < 24 in. of suitable soil ❑ At Grade ❑ Single Pass Sand Filter ❑ constructed Wetland ❑ Pressurized in Tank ❑ Peat F is Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter - — wi Drip A lm Pipe (explain) V. DisPersaIlTreatmeat Area Design Flow (gpd) Design Sat Appix*x n Rate(gpdsf) Dispersal Area Required {sf) Dispersal Area Proposed (SO System Ekvatioo 1 4 5 v ► S Q00 C)0 j!o VL Tank Info Capacity in Total Number fA=Ufwwm Prifab Site Steel Fier Plastic Gallons Gal ats of Units Concrete C instructed Glass New Euistiag --- Tas Talks Septre err Wiog Tait C7 t I Q f v l Acerbic Trot bait Dosing member VII. Responsibility Statement– f, the aadasig asswase Wky for Ne POWTS siwwa on the ariaered phis:. P bar's ) 's Si PRS Basins: Phone Number Atwi6ees Address (Street, City. Same, Zip Code) k) .-Q— Pv c� rht wt Use O 4 pwv.d ❑ Disappioved Sanitary Permit Fee (inckdes Granddwater Rate issued g Signature (N ) Surdnuge Fee} ❑ Owner Given Reason for Denial VC Conditions of Approval/Rdistaas for Disapproval 92 &J2 ' -� d,�i� ¢" d,• Av d'3 •�fi�--�. 6/ Attack complete planes (N as County sally) tar Ne systses r n am lea Nora air! x 11 Incises is ow 7 L{yftll�/ �I'Nll,�iri 3 a 3 , S-Z G 1ij �a%jft/TC.J SBD -6398 (R. 08/02) i L L_ 1 [A. i ' Wit' _ 11 Q3- -- - 1`��e..� -?__ - �- y • i I I I j ( � I iC - - -- -- �� pr o • I ; I . i I I i ( � I • I I , � I 4 p I i , i � I I I -- • I I , I I i I I i i I , • i/ • ' I. �O fT Q d3/.1 , i ( I i V123,& i • i M , i i -�c "VIN, 9 -ram Li 'P t_oT a3 F P t 0 9 0 - t a�R 1 od e l ©O© s- e,c� /Lccb� AtO��w��scs�r lc��{ FAV- a 7 A I T7� 3 s o3 r I s- ;3/23 I 33i.t7 .)-o /� y __ _ _ __ ,_�. r Wr- Low t �k3 FEZ? 203H r++ T `' � ,_.+!'^ �`,'j�,.„�� .: . � ► e i • t r '04 s T t I eTTT �'` �' 12 4 .6 2 5 ## i T sr T♦ T 11 TTY T T .:iii - T• 112 CU, iT eTf iiT TAT Tf T ►Tr. ATTTT iT � - _• rf iTTifT *eTe Tf TTi e'► e . ! i 24" i 36tt Vaid +t 7 o.U, ors- _A—�M pq* V hL 12 wiurae �► lid � < J. to •�u_,..! �:r }. S '�'+'�i► (� S�'�+itsj • 18.8<i . lairtit • �R - o.tf�f,. l2i� = 3.l� 1 Itr cyho*, •- 12.3 cira ' t out v°i`rnp Sat ®f on u, �74wter - 6,±3 Twat salt Intcrfaer 14 .pres ?•UO? J. • a 1 jj t12iRr 3- 14- l 5.14$t O. t). O! outsgk cyb Ilia t 11 ,r 3 '14 4 « ,21 ft' 1 ' u��cs i c Y►�krs � s . S. ri{ —�.._ t . �'eCt F '� 1tar��yd sa._ 4At fr I al Tre�N Are. i f € fora a o sidciv tl lfet� t2 ii t f wOt a m A cytrn� j ( 1sw •` • 2.00 54 Fa r < t7 h • llw p' �at� a � a 36 i i oui voles at 0r%uc R t t7is ; g ({ 0 -2 15 tt• n. = 3 10 Sq. >Deal void mom C*-- f 1,2 of "'q wOl+++fte 1 r t'ro /acrd Trracp Ar s 0,1 17 r w era rYt.".,) 0.21.5 : S4-P t 0_ 422 +11,213 , . Q t Ad NN F Gstf pQ t3 = 1,;b3 X ?.ds < = O = t 763 o F i Trench Aggreg s ystem' EZI 203H 1 ?'^9 Industri rZl crow ow 65 okland. -18060 Inciustr"' P luic Rd, SCALE a t_Z� -Or j i I �. Wisconsin Department of Commerce SOIL L '( - 11OIi�EPORT Page of 3 Division of Safety and Buildings ^ �" "` in accordance with C Wiiss;p..;.^A*. Code Z 3 U f 77 Attach complete site plan on paper not less than 8 1/2 x 11 i eft in sizel lPfalc{:lrhi i ; County S�- C ` l X include, but not limited to: vertical and horizontal reference OQ61,(BM), direction and Pqdcel I.D. cal ►V �9 Z�, i9 percent slope, scale or dimensions, north arrow, and locatic+ agtf disp" to jerl _ I d-F1 _ "E;D lt)� �" ' UUU Please print all informatio - . - - -',, iewe b ST CROIx y Date Personal information you provide may be used for secondary p - urpos (Privacy 1) m)). Property Owner Fy°L rN C �"PR . U 3 S . ,30V., Property Lo 1/4 S W 1/4 S 1� T °t E r W Property Owner s Mailing Address Block # Subd. Name or CSM# \ L $ O �Z►Z D ) s i-_ iv E S u l`r u D Z3 — `r'TLG V \ >- L % L L! - r4 Pao , City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest R M N 3 (763) ? -756 T�U�( �;:x '„. [ New Construction Use: ® Residential / Number of bedrooms �_ Code derived design flow rate 00 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material C, UA C \-- %� V FE\7 S o- PM— pvl � A S H Flood Plain elevation if applicable ►y A ft. General comments tiv s �S 0 F- ! HGt4 C and recommendations: 1°c'P�t'1°n S 1 D(Z - Vv )w t5m Lj`keta- wlTF \3 v►vlZ'4 �� t_• two s Lt -, tz UPT-ra s `Tu , - 8 ,_.8_' C l�-tt� eWLs 1 Z 2 Boring # ❑Boring .... ng _ , ,Lam, 311 / ,f C ® pit Ground surface elev. g C) �- O fL Depth to limiti factor l� S in. _ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Color Gr. Sz. Sh. •Eff#1 •Eff#2 o- ti % ii_ zt i si I Z rz-z$ X) I fL -V 3 1 . sit Z'Psbtt wt e S 3 *--16 1 )6 -1 11- V/4 _ is l dzbvt Mvkf - Os 36 =S tom /y S YZ S / s i J oY►-� ►tit'Fi- �S _ -c� .D o = W- o � ❑ Boring # Boring . _ ... .. .. _. ® pit Ground surface elev. $Q 3- Z ft. Depth to limiting factor > 1 l8 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ttz in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. •Eff#1 •Eff#2 o��Z 1D`L2Z - LZ. -- _. - S!) 1`�b►z wl�- as 1 w� .z; ;3 z: 12 - i8 lOYfZ3l3 -- si z 'E�Sbk m�- ew - ,s .$ 3 Za Z Z l o 4 t2 5/6 sl V-S, I t "s b PC wlf Vn Uf l- I LL, • Effluent #1 = BOD > 30 It 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 ture CST Number Arthur L. Wegerer 220254 Address W g e e r e r So Test in Service Date Evaluation Conducted Telephone Number D Testing & Design 421 N. Fiain St. River Falls, WI 54022 Lp - ZI - 715 -425 -0165 Property Owner �� ��C�. � — ° l)'R P Parcel ID # PQXJ Z 1 /1/ G Page Z of 3 \Z- Boring # ❑ Boring Pit Ground surface elev. 8 -7 ft. Depth to limiting factor ? Z 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 —i � U'l Z all 14- S b�L ►n'A- ew lv `F •Z, .3 Z \& 31 1p�ttZ 3 c3 — Si 1 sbk M-6- etw 3 3i - �o �RSIb — st.l 1 csbhc 'M ft- CS -- .Z. -3 q s8 -IZ.Z 1 0-2 iZ VA _ S D S. u '1 0 - ",- 6 Z Boring # ❑Boring - , ® pit Ground surface elev. 8 a 4 ••D ft. Depth to limiting factor � l 2 S (n, Sol( 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 0-1.Z LO'12 zlz _. S 1`�S� Wl Fi �S 1v`F .2 . 3 Z 1.Z_60 3 _1 75 lO�lRV1 — 0 S I • •,q 113 �1 ( S/V s 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 •Eff#2 C��C� S S h 1NS`I'Yt2.L Q W N'J D LCA Lo Aje ' 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. SOD -8330 (8.6/00) r PLOT PLAN Page 3 of 3 Scale 1'= SO' &I -et uo' w zy� L � � �-z- eaY Z.S' bo �� Lo' v °1 0 Std 1 M F VZ ! h1 L `r) p L, F ' S LI SS 1E14 - �- L8^ _� 5 � - Et _ $q7 —Sci oN m L0 - - 00 715 425 - 0165 220254 OU - 3t$ - -123 CST Signature Date Telephone Ido. CST No. Job NO. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address _ �® 6a X 44 S, r4— l t k4 wl 1,.L0, W-T-7 '54gZ l 1 Property Address 2 'M l E %..t� h� (Verification required from Planning Department for new construction) City/State Parcel Identification Number 0 -443 _ 1 — S o LEGAL DESCRIPTION Property Location 5 kv %4; SW %4, Sec. T N -R LI W, Town of Subdivision ��Y V► L.. aC3;;E1 , Lot # I Z3 Certified Survey Map # volume Page # Warranty Deed # (O (0 Volume ��� 3 . Page Spec house >(yes ❑ no Lot lines identifiable es ❑ no SYSTEM MAINTENANCE : ImprOPOr 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 masterplumber, journeymanp*nber, restrictedphunberora 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 t of Natural Resources, unces, State of Wisconsin. Certification stating t your s tic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days e t . /.7/ 03 A OF APPLICANT DATE OWNER CERTIFICATION (we) certify that all statements this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of WNAIURE de a b e f a warranty deed recorded in Register of Deeds Office. 8 3 OF 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 P©WTS OWNER S MANUAL &MANAGEMENT PLAN TWN V.9 Q sQ ( -S ❑ NA o VTW* anuf O ' ® pose O HokWV Vol. 6tJ0 t l*errr+it � p2 M arssfeattirer DNA PARAIlffnms D NA O S 13 Dole 13 HolftV val. sm Wwtbw of OWbO "s Ma NA Ef aetures' E1 NA fluent ' w Number of Pubes Fa tit t!nft P"kw* FVW Model d� Estimated tge1 flow ®� A pump Manufacturer DesiM (peak) , flow - Mstimated x 1.51 5 ltanp Model Rate Pretreat Unit NA Sti+andud ❑ S�and1G>r+� Filter O Feet l�lter & Grease (F 530 D Med+i Aeration O wetland Bioc OxVW sa2O �- D NA Demand tie► O em O Other. Total Suspended Solids (Ml 51 So mglL Manufactum p Effluent tsuafltY Monthly Cuts} 13 NA &oc wnical 0xygan Demand (WD 530 nVX [g lln-Ground ( Y) O h to ed} T � solids (TSS) 530 � D At -Gnats ❑ Mound Fecal C MOM {� "w" 51 D NA O DriP"L� D Other. d'ia. DNA Maxirrnwm Effkwd particle Size ❑ NA Ys DNA Ux►ser: Other. *V"m types for domestic vve62awai�r and sept+c tank eftkaerrt. gIITE RANGE S ,DW E Servic Serviws Event �YIbf 3 >� 13 NA condition of tank1sl At iesst = Inspect When and setun ic vbhmne D A N ecemw PUMP ou t cerrtants of tank(e) D When the f�lgh water alarm is monihtal 3 ve" D NA inspect dispersal e0(s) At least once every: D NA Clean effluent filter At least once evYc D mortth(s} .DNA Viols &. alarm At WNW once avert= D NA trss Pump P� O montfits} Flush laterals and pressure test At bast once every: D yamt 0 marat t(s) DNA At least orwe evWT- DNA lions= MARVIV ANCE , TIONS canYlo9 of this follow f'v �a 1 i of tanks and dispers cells shalt be made by an wTS Maulntamer; Sep any cracks o, Restricted Sevier. FOWTS 0 or broken hardware, Master Wound Pkartber, Master Plumbo i� of the tank(s) to i %"OfY enY or pw dhs9 Tank insp onS waist and SCUM and a check far any bads up observ ation pipes and to check for ant e e� w g to the effluent b' s m su face n%ay s�cate a failing eomdition arK surface. p�onding of effluent on the Wound surface. The por+dmg of effluent on the group requires the immeaiste r►,tification of the local rsgulatorY sutho,"- one-d*d (Y'l or more of the tank volume. th' When the combined accumulates of sludge and scum m amt U,etment �k of in accordance with chapter NR 113 and cftx*W entire contents of the tank she" be remved by a Septags Sartvic M for components, pretreatmer Code. tau Wisconsin Adnvnssirat� of effluent lifters. mad or pressurized At other services, � but not limited to the senric" orrrscd by a r�ibed pOWTS Maintain- units, and any serviang at intervais of 512 months. shiril� vv� 10 days of completion of ant service evert• A service rePort shall be provided m the local regulatory GtAW 12102 l Page of START UP AND OPERATION , For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other chemicals that may impede the treatment proms and /or damage the soil dispersal call(s). If high concentrations are detected have the contents of the tank(s) removed by asep lag a sernicirp operator prior to use. System start up shall not occur when sail conditions are frozen at the infiltrative surface. During extended power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be disclvirgW to the dispersal cell(s) in one large dome and may overload them resulting in are backup or surface disCt►arge of effluent. To avoid this situation have the conearm of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Mainbeir or POWTS Maintainer to assimt in y operating the pump roritrols to restore normal levels within tine 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 16 feet down slope of any mound or at -grade sod absorption area. Reduction or elimination of the following from the wastawa ter stream may improve the performance and prolong the life of the POWTS: antes; baby wipes; cigarette btras; condonm cotta n swabs: degreasers; dental floss; mss; disinfectents;, fat; ( foundation drain � (sump g' p ua mp)� fink and vageta� peelir� .. g �. meat scraps; medications; al; pamtmg products, sanitw7 y ! r ; tempo w, and wa sa b. ABANDONNIBff 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 • AN 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 property 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 fail and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A st&Able ant area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area shoold be protected from disturbance and compaction and should not be Infringed upon by remiked se&acks from wwrOW arid proposed structure, lot lines and weft. failure to protect the ant area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replecament systems must comply with the rulers in affect at that time. ❑ A suitable replacement area is not available duo to setback and/or soil limitations. Barring advances In POWTS a holding tank may be installed as a last resort to replace the faded POWTS. The site not been evaluated to ' a suable area. Upon failure of the POWTS aF-s bill and site evaluation be perfomirad to- a su acmment anon. a holding tank may be a LaaR to replace the failed POWTS. ❑ Mound and at1rade soil absorption systems may be recorhstru cted in place following removal of the biomst at the infiltrative surface. ReconaLnictions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC. PUMP AND OTHER TREATRUM TANKS MAY CONTAM LETHAL (MASSES ANDIOR INSUFRCIENT OXYGEN. DO NOT ENTER A SEPTIC. PUMP OR OTHER TREATMB1IT TANK UNDER ANY CRMAINWANCES, DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TAN( MAY IE DET#cULT OR NAPOSSELE. ADDITIONAL COMMENTS POWTS POW a MAKIMI ER N Name Phone - 7 Phone SEPTAGE SERVICING OPERATOR (PUNIIPER) LOCAL REGULATORY AUTHORfiY E Marne Phone This document was drafted by the staffs of the Green Lake. Marquette and Waushara Cowry Zoning and Sanitation agencies in compliance with chapter Comm 83.22(2)(b)i1)(dte(f) and 83.54(1). (2) b (3), Wisconsin Administrative Code. I \1-1 VFILLL I nlJJ I l\i141 I QA • 1 1. JVV I Vy&4 JQI I JV LVVJ 1z-v" I VJ KATHLEEN H,'IQALSH STATE BAR OF WISCONSIN FORM 2 - 1 008 REGISTER OF ! DEEDS WARRANTY DEED 19T• CR ©IX C-0. I WI 000~4 N~ RECEIVED FOR RiCOV This Deed, mad. betwan 1.813 451 01 -14 -2402 43.44 AN �I 1 ' iiARRMM DEED '( o1x at on :, �! M .nnesota Co ss EXEMPT M CERT COPY FEET end Granter, COPY FEE: TRANSFEQ FEE: , 206.70 i RE FEET : 11.00 Grantee. i Cantor, for a valuable consideration, conveys and warrants to Grantee the following �f Described real estate In St. Croix County, Stara of Wlseorultn: ! Lot -UJ-- of the Plat of Troy vill 4tb ; Vr, -u - 0j *co Addition in the Town of Troy' Name _ -::`` :`-•�° Tro y, $t. Croix area Aetlxn AOaraee ;. Wisconsin. i � TROY DEVLOPMENT'00MRATION Subject to Declarations of Covenants, Conditions and 11800 ABERDEEN Restrictions for Troy Village recorded in Vol. 124 N �: SU � 100 Page 256, as Doc. No. 559964, and the Declaration of B LAINE, ELAINE MN.6b449: Golf Course, Covenants, Conditions and Easettnts, recorded in Vol. 1241, Page 301, as DOC. No. 559969. All as appearing in the office of the Register of Dsteft 040- 12$1 - 50-000 for St. Croix County, Wisconsin, and such other Fff" ae►>Mllo+u NcMw P" ' easSMOnts, restrictions and reservations of record, This t �i or in uw, and the "Buyer" obligations contained in homestead propeny, the Purchase Agreawnt for this lot. (!s) (is not) C 1 Exceptions to warranties! li Dated this — S?tYl__ _ day of D 2001 , J (SEAL) (SEAL) �rlsg s ;,, Cook, President I Troy Developawnt Corporation -- IJ (SEAL) _ _ (SE11L) AUTHENTICATION ACXNOWLEDGMENT signatures) Minnesota State of W+&gVYr#i A7tO1Ce Co unty . authenticated this day _ Personally carne before me this Gth �h2r 2001 day Charles S. Cook P ros nt � at�ove named — Trov 11 =tnt Cororat 4n f TITLE: MEMBER STATE BAR OF WfSCOaVSIN I a ; pthot, me known to be' the person ! author/iad by §ypg.46. Wis. Seta.) me who executed the fortgolrig ' �{ instrument and acknowlei the same. THIS INBTWMENT WAS CRAFTED BY TROY DEVMPMW CORPORATION Rick A.. Johnson !� Notary+ PuDik. AHI- 441@vatolftAnoka County C13arles 5. Cook. President , Mann. My cotnmisslon is oe►Inanent. (1f nw, state ex (Sign pirstica date:: : a tures tray be Authenticated or acknowledged. Both are not Jana 31 2006 necessary.) . . 1. Nan Wi wW7.,,w .lanl.y, In ay. ,•IIIw uy lt"M W IY)r.I w• IMMN Iw1W Ilwn•.W)%R,F \ 5 WARRANTY DEED STATE SAN Op WISCON ��� KORM No. Z - I VII s (� 'natllll lka Glink NOWhfN11RIC- WiE�D1 a"'�+uew. Ww ' MY COAdMiBSIOIIE ,1A31 t" 21. MW OtgFiEB i r r / / . ..............B- 407"""'....."""' " LOT 4 C.S.M. VOL. 4 1 2 4 oy + / I / I . � , � ,' , " PAGE 99 0 1 B -406 B-40 , I • - rI / • ,' / B -350 893. a -I ce � If ob O I B -405 I - \ - - - - - - - - - - - - - - - - - - - -- / 168 +d?04J If ob i I r /, I 1 / 894.6 /' _ - - l ' I I gl LOT 3 C.S.M. / I 1 �i _, \� �\ V , '""SAGE, 9 3 8 - 349 T_�'" " "` / \ ,, v � .. / II ' '' 1 / / r �T/ � 2389 \ +� ~ •` s 8.. �1,� f �� ol ft Oslo 15.Q / � ` \ '1 I' 1 --- - - - - -- -- ` - - - - -- / / •1 I /� I I I i i\ 1 i /I • • 1I � B�403 l I i • , \91 8 1 I \913.1 \. I / . , r B -348 63 +64.09 I 1 09 63 +0�•�0 3 8 la LOT 1 -441 1 '� C.S.M. I I a VOL. 6 I ► \ 1 1 / PAGE 1627 1 , � 1 1 1 � ' 32 o \ 1 •tee �• 131 \ /. � '� / \\ de / • r fti, 891.4 It I Awr r I 1 \ I I !r I I 1 1 %4'fHC 31%4 - cv = 43,790 S.F. - 71 SE 1/4 OF "i . N.. 9.a '..'a :- ............. I •••• LOT 5 _C. (0co, VOL. o " ` 122 N I =�) I _PAGE N^ 1.021 ACRES 44,461 S.F. 2OG. W N 89 W I co �• v 0 335.03' v I 0 123 o n 1.028 ACRES ' �. v I , S 8 24.026" Z I_ — o� o 44,774 S.F. — W— — — — — — — N 89 20" W ' � ) U 331.17' ^" "& rn N CR 0 001 U 0 .°� v� �� I n N 89 OUTL O T 5 124 0 0 ;, 37.22 1.010 ACRES � I O EX /STING �F TROY VlL L A GE L _ ".0 16 S .F. _ � 1 , �' 1 � ":' �; TN VO c �, c° "� S 89 N 89 20" W IN U -� 3 43.8v 33 I cy I 3 N� w - - _� L, 125 Z P I o o 3 C N 1 1.012 ACRES I 0 M 0 o o w V 44,065 S.F. cr • p o op p I . p 0 = Z — — — .PN w P o r rr �� f 0 1 N N Z J la. p N 89 20 W - ON N' I o ° ° 331.40' J I N o_ - - - - p�� CJ! 'I - -- 126 - - - - - N 1.027 ACRES I 44,743 S.F. VII I •I � 1 1 4b. N 89 20" W I N W 'n v+ 334.37' I c� [z IN I ., 127 OUTI 0 1.022 ACRES U I , I I 23,9 — 44,532 S.F. — I w 3 N 89 54" W -- — — — — — — — — — — — 325.00' - - - - - c6 00 n ^•\ co 2S o 00� N. 0 to t ,j ti X ACRES lt � 45,173 S.F. � ' z N/ It°, 129 I 00;t \ V o � OUTL O T 9 ,N I 1.036 ACRES U o�' )F - TROY VILLAGE , 1 / I o o S 89 14" E G'\% �,� ' w yWl yWWl POINT OF ►� IZI BEGINNING "� N �W z I I n "�Ivl �IVI --- G �6 �'��' �' `� .62' 0 00 0 Dr o r o N P F — — — — — 89 0 28' 14" W 537.89' . 1 66. 5 ' \ �\ z 66.00' 1 _210_.3_ 3_' N 89 14" W 395.1, "I PLA /NV/EW I N,8 W 2506.91' I 1 O / VE 9T 1 I LOT 1 0 1- ------- -I - - � - -- cENrER _ - -. - -- M lnr VOT.3