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HomeMy WebLinkAbout040-1113-90-100 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT sanitary Permit No: 488266 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: Solberg, Dan & Karla I Troy, Town of 040 - 1113 -90 -100 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: / 60 1 16 r 1 cS 30.28.19.4698 TANK INFORMATION Z ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. 3 4- Septic ' 1 ; A S / z Benchmark O R6 1 ,$ /Q1 • $, let) n Alt. BM �r : ► �i l _rAW Coo Z • Z. 97 • CP Aeration Bldg. Sewer Holding St/Ht Inlet �,� • 1 9(0.(0 TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic t0� /X) 0 p J _ I Z / i r Dt Bottom Dosing Header /Man. 10.35 T5 . �5 Aeration Dist. Pipe (p • 35 95. "f 75 Holding Bot. System PUMP /SIPHON INFORMATION Final Grade Z •°I Manufacturer GPM nd St Cover lw` • Z q Model Nu TDH ift Friction Loss S bad T Ft I T RS 93.95 Forcemain en Dia. Dist. to well SOIL ABSORPTION SYSTEM BED/TRENCH Width j Length j # INo.OfTrenches� PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 Z `- ` - --- __1 SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer: (� INFORMATION CHAMBER OR 1:;J . Type Of System: AIA � A UNIT Model Number: � / c 5 � , /n � J Cs r J i DISTRIBUTION SYSTEM Z 3 -I-' Header /Manifol� Distribution THole Size x Hole Spacing Vent to Air Intake 1 Pipe(s) ` 1 4� Length 15 Dia ' Length Dia Spacin SOIL COVER x Pressure Systems Only xx Mou Or A t - Grade Systems Only Depth Over / Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center ` • G Bed/Trench Edges \ Topsoil 1 \ Yes N No as Q No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 317 Plainview R iver Falls, Wl 54022 (NW 1/4 NW 114 30 T28N R19W) NA Lot 2 Parcel No: 30.28.19.469B 1.) Alt BM Description = e Ca fir. G(,,, «: fps �- Lac./c S a ,•� 2.) Bldg sewer length = /� - amount of cover = 3 Plan revision Required? Yes o ' O Use other side for additional information. V Date Insepctor's Sign ure 66r�. No. SBD -6710 (R.3/97) 201 W. wasl iogton Ave., P.O. Box 7162 r I' M M�nl "�`rn Madison, W1 53707— 7162 Site Address De artm�nt of Commerce 31 Sanitary Permit Application San Permi Num In accord with Comm 8321. Wis. Adm. Code. personal information you provide D Check if Revision yJ p yO & o may be used ADrsecoodwyaurposes ai3. i m L Application Information — Please Print AII Inf Stags Plan I.D. Ntmg RECEIVED A Property owner's Name Patoel Number t o b r JUL 0 7 2006 ay - - �, 1�40 Pmpetty Owm 'a Property Location 1� ST. CRC(X COUNTY • 4)� �: S�� '?� N Re City, Stage ` Zip Cak amm Lot Number Block Numb Subdivision Name ' CSM Number IL Type of Building (check all that apply) �G 2C � L7Cny 141 or 2 Fancily Dwelling - Number of Bedrooms 6 ovilla e 8 D Public/CotmnercW - DesenU Use owrulci /" ❑ State Owned N st Road ,A o leo ,Dr 13L Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A. 1 LNew 2 D Replicanient system '3 D Replacement of 6 D 'Addition to For County use. Tank Only EAstin atem B. 1 D Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for Internal. use) . ___ __ .. -'16 , Q 4/ 4 Pir h 44 9( Non - Pressurized In -Ground 210 Mound 47 D Saul Filter 50 D Constructed Wetland 22 D Pressurized In-Ground 41 D Holding Tank 48 D Single Pass 510 Drip Line 45 ❑ AWrade 46 D Aerob Trcatme4t Unit 4 Rccuculaxg 30 D Other V. D' rsal/Treatmen Area informa Design Plow (gpd) Dispersal Area Dispersal Area Soff Application Percolation Rau System Elev Final Grade Required Proposed Rate(Gals./Days/Sq.Ft) (Min./Inch) I N1 - Elevation 600 Fib -8 Utz 4 VL Tank Info Capacity in Total Number Manufacturer Prefab site Steel Fiber Plastic Galion Gallons of Tanks Concrete Constructed Glass New Existing Tanta Tunics Septic or Holding Tank _ Id oo Dosing C3asaber 1111 VII. &WonsibW Statement I, the asstude for o WTS am" on tits attached laps. Plumber's Name (Print) z m�/ Busin � M Number jA f Plumber's Address (Street. City. te Zip k) Ox X) 2 M e A 1` VIIL UM vea ❑ Disapproved Sanitary Permit Fee (includes Groatdwater Data issued signaatoe (No ) • stu+c}arge Fae) ❑ Owner Given Initial Adverse . y l 66, �1,9 fig, Detetmhcadon SY M OWNER' rV"UiteasonsforDisapprovai 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained OYL fa2.ch y as per management plan provided by plumber. 2. All setbpck requirements must be maintained glans (to the Coeo4 nab) for ao papa SO lesstban SM x u inches in a aAt SBD -6398 (R. 051911"'; y�7� e), -7,c�� �! Tt"OK- , 4 (J1e e as S r Iry - -- TT-6 L - - _ ire r -- . D lisp �,� Se fic w J r r! wow- 95.E I. I � �l i _.._i- }_- __- ___._�___ t `Wisconsin Department of Industry SOIL AND SITE EVALUATION e of Labor and Human Relations Pag Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Attach complete site plan on paper not less than 81/2 x 11 Inches in size. Plan must Count G,/J„�•� Include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # APPLICANT INFORMATION - Please print all Information. Re w Date Personal infonnatlon you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 1 - 77 1 066 6 Property Owner 3 Property Location '1l � I V 6 U aL� Govt. Lot NW 1/4 Ak 1 /4,S 30 T 2- 9 ,N,R E (or(D Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 3a./ p/,41,0 Vle w o� z e5144 PE4j9lA.�6-- cl r ` State Zip Code Phone Number Nearest Road / i /fiat/ /��'`�7 ��. S L/49 I Cl ( 7 IS ) •34 - 55 7& ❑city F1 fee a e Town ��� /,//!/ /�/�C/ 3,e . Ll' New Construction Use: QResidential / Number of bedrooms 3 Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: _ V - /f/,o T Xt.40. y,ti,(, ff& — Code derived daily flow & 00 gpd Recommended design loading rate bed, gpd/f? trench, gpd/ft Absorption area requiredbed, ft tree h, ft Maximum design loading rate bed, gpd/ftz___trench, gpd/ft Recommended Infiltration surface elevations) t` ft (as referred to site plan benchmark) Additional design /site considerations uSE L,O�� >f 7� -5 Parent material ,yIf* 1 Od-164, OW&14 . .S -f.0,0 Flood plain elevation, If applicable /U ft S = Suitable for system 7 B'S Conve nal M In- Ground PressAT- Grade System in Fill Holding Tank U = Unsuitable for system Q's O U LA'S ❑ u CS ❑ U 1:1 U ❑ S Iii ❑ S C'M SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft In. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed , Trench l 0-5 /aYR 313 - /t✓ I/efhe At1'�2 q S .3 2 S- 6-/0 Me SfL 12,{i ,6 /w �1 1 . ' • 6 Ground Q S/ ----- s (/ s ele, v. Depth to limiting fa or in. Ll Remarks: Boring # OW 10 ow 6e z s/✓ c S b � ol Ground -7 S S © — ' • !� elev. D limiting factor � /120 Remarks: CST Name (Please Print) Signature Telephone No. )P013e� ZY //>/cWr/— 7 /55- 3e &• 9195 Address Date CST Number Ulbricht & Associates Private Sewage Consultants 655 O'Neil Rd. Hudson, Wis. 54016 ORI GINAL t L ♦- "" I t PROPERTY OWNER 1y1P1paAe4—P e��1 SOIL DESCRIPTION REPORT Page Z of - PARCEL I.D.# Boris # Horizon Depth Dominant Color Mottles Structure 2 Boring Texture Consistence Boundary Roots al /L in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 2- I J 0 Ze 3,167 Sim 2, -AS 4e I m die Ground 3 s• �� ' '� ' , c� elev. - o 3 , -tt. S o S Depth to limiting factor ` Remarks: Boring # 2- 3 SL.. _ :.S Ground — S 7 � , 8 efev. t5 s •fi Depth to limiting factor 7 �m. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots D/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # JD 16 J� /L 17 444 Vl Py vo 3/6 3Y � Ground /0) elev. I0 5. &�L-n. Depth to limiting factor 7 1 0 ( Remarks: Boring # Ej Ground elev. n. Depth to limiting factor in. Remarks: SBDW -8330 (R. 08/95) i t • o ff o O � • �r N v N 0 0 , � e o� c m A G i W CERTIFIED SURVEY MAP BROOKE AND MARY WOLF Part of the Northwest 1/4 of the Northwest 1/4 of Section 3.0, Township 28 North, Range 19 West, Town of Troy, St. Croix County, Wisconsin. Nw COR. SEC. 30, r28N, R19W, N L /N£ NW 114 N //4 COR. SEC. 30, r28N. R/9 W, /COUNTY B£RNrS£N NA /L1 UN TTE LANDS /CO/1NrYsURVEYOR'SN ON. 1 S 89 07 "E 2.306.62' L - � I N V: YI i Jlf / V C R /E'A'ST! 693. //9 2.37' � 693.84' _21_6.38' 6 661b /00' ,� N 89_32'90TW 1194.14' t S0 /L. - 7_ SO /G M iv —� -- - } ROAD SE7BAY'_K LINE r LOT LO T 2 LO T 4 / _N Q I 2.678 ACRES „ 2. 686 ACRES N 3 1 2/. 000 ACRES //6,673 3 1 0 //6;986 SO.FT. cu 9!4,77! SO. Fr. ^ry so. Fr.r b M2.502'ACRES ` J Q 20.455 ACRES EXC.ROAOR.O.W. 2.100. AC. N in EXC. ROAV Raw. O � .I 8 9 89 1, O/5 S0. Fr. hVI EXC.g0A0 /0,9 'W 9 SO. Fr. l N R. O. W. p �n � O OI W Owner's Address: /oa/ /S SOFT. 2 / Q � a o 321 Plainview Dr. v River Falls, WI 5 022 I \ 01 2 / 6.37' 1 /5. 84' ZI 3 •1" iron pipe p N B9. 4 'OT "W 43Y.2/' �I p b 2 3 found. a N o 01 x 24" iron o N pipe weighing 3 C OR/VEWAY p ° 1.13 lbs. /lin. a NEOSG c 3 J 2 o ft. set. b N '' 2 t�Fence. Ow£cc 3 a ti R (10.00') o 0 0 3 Indicates 2 DPOOL $ a ? a previously '^ � Q O recorded data.. n SEPTIC ` O 3 L../ Q W � a LO T 3 9.699 ACRES \ WATER COURSE 422, 485. SO. Fr. 3 Q ' Q 9.643 ACRES EXC. ROAOR.O.W. Z W m r In � I 3 420,OJ4 SO. FT. \ J Q,) 1 '- \ SETBACK LINE ? I 1 � � 9 J 693.82' , 495.00' 3 /0' 91 N 89.43'57 W /I 2' S L INE NW 114 NW 114 6' h UN PLA_ TTE D LA W 114 COR. COR. SEC. 30, T 28N, `,C0/V R 19 W. /CO UN r SURVEYOR'S NON.1 ti, ,••'••••• •, I40 This instrument drafted by Laurence W. Murphy ;° LAUF C SCALE I " = 200' = W PHY : °C .0 50' /00' / 50 300' 4 00' SOD' 600' S 13 �•% RIVER FALLS,,:' •' ., WISC. Q. • Dated: March 20, 1997 /��9FQ LAN�•$,`��� Laurence W. Murphy Registered Land Surveyor SHEET 1 OF 2 I� SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer � Clli(PA I Mailing Address F Property Address zliex �!/ _ VA G (Verification required from Planning & Zoning Department for new construction.) City /State //� ��'� �1- Parcel Identification Number MO` 111- - M-MO LEGAL DESCRIPTION e�� B� Property Location 1�� 1 /4 , ` /4 , Sec. , T 9 R W, Town of l!D Subdivision , Lot # Certified Survey Map # — ,Volume , Page # o�U Warranty Deed # v , Volume , Page # Spec house ye no Lot lines identifiabl yes 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 I2 - 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. Uwe, 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. I/we amlare the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number 9f bedroo s eeaAz 7 17106 SIGNATURE OF ANT(S) 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. REV. 08/05 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page f of FILE INFORMATION SYSTEM SPECIFICATIONS Owner � Septic Tank Capacity jU gal ❑ NA Permit # a�� Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ) 00 ❑ NA Number of Public Facility Units �"A Pump Tank Capacity gal ❑ NA Estimated flow (average) L 7' 16 � gal /day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) �() (� gal /day Pump Manufacturer ❑ NA Soil Application Rate gal/day Pump Model ❑ NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD :5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) :_150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average i persal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD _ :30 mg /L n- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 51 fu /100 ❑Drip -Line ❑Other: Maximum Effluent Particle Size Y in di ❑ 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: 2-3 ❑ y art(s) s (Maximum 3 years) [I NA ) 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: 2 ❑0 month(s) (Maximum 3 years) ❑ NA u+ryear(s) Clean effluent filter At least once every: , ❑ mO (s) ❑ NA ar(s) Inspect um ❑ month(s) p p p, pump controls &alarm At least once every: ❑ year(s) ❑ NA Flush laterals and pressure test At least once every: ' ❑ 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 512 months, 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. Page 2 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 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. 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 replaceme 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 t t p y at t e. ❑ 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. MUM 0100. Of Ilu I UZI IS alua ' a o ing ank be ' e ai e . ?f2Dl-/11 MtT , nR- A/6%J Co"57 R(l� D^J ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such 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 QM 0 Name Phone 2,5 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name ST-, C9 OU 24At1 1� Phone Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.540►, (2) & (3), Wisconsin Administrative Code. Parcel #: 040 - 1113 -90 -100 07/10/2006 01:00 PM PAGE 1 OF 1 Alt. Parcel #: 30.28.19.469B 040 - TOWN OF TROY Current X I 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 LYLE MCGEE O - MCGEE, LYLE 321 PLAINVIEW DR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description ` 317 PLAINVIEW DR SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 2.686 Plat: N/A -NOT AVAILABLE SEC 30 T28N R19W PT NW NW BEING LOT 2 Block/Condo Bldg: CSM 12/3264 2.686 AC Tract(s): (Sec- Twn -Rng 401/4 1601/4) 30- 28N -19W Notes: Parcel History: Date Doc # Vol /Page Type 03/30/1998 575966 1309/559 WD 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.686 56,000 0 56,000 NO Totals for 2006: General Property 2.686 56,000 0 56,000 Woodland 0.000 0 0 Total s for 2005: General Property 2.686 56,000 0 56,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ' f328g�P.� KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI STATE BAR OF WISCONSIN FORM 2- 2000 RECEIVED FOR RECORD Document Number WARRANTY DEED 07/03/2006 03:30PM THIS DEED, made between Lyle McGee, a married man ., Grantor, ° WARRANTY DEED EXEMPT # and Daniel Solberg and Karla Solberg, husband and wife, as Survivorship Marital Property, Grantee. REG FEE: 11.00 Grantor, for a valuable consideration, conveys and warrants to Grantee TRANS FEE: 264.00 the following described real estate in St. Croix County, State of Wisconsin: COPY FEE CC FEE: Part of the NW '/, of NW '/4 of Section 30, Township 28 North, Range 19 PAGES: 1 West, St. Croix County, Wisconsin, described as follows: Lot 2 of Certified Survey Map filed May 28, 1997 in Vol. "12 ", page 3264, Doc. No. 560007. :%ietro Legal Services EDIRET 501258 A 589269 WD 416852 Recording Area Name and Return Ad s: RET{!RN TO: Edina Realty T' , nc. METRO LEGAL SERVICES, INC. 400 S. 2 —Suite 115 Exceptions to warranties: Huds 54016 330 SOUiI' 2iD /" /Fh' "IE, SUITE 150 Easements, restrictions and rights -of -way of record, if any. 5 58 M)NNEAPOLIS, MN 55401 -2211 040- 1113 -90 -100 Parcel Identification Number (PIN) This is not homestead property. Dated this 16th day of June, 2006. c '� * 1 cGee * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ST. CROIX COUNTY. ) ss. authenticated this 16th day of June, 2006 Personally came before me this June 16, 2006 the above * named Lyle McGee, a married man . to me ]mown to be the person(s) who executed the foregoing instrument and TITLE: MEMBER STATE BAR OF WISCONSIN owledged the sa (If not PAMELA J. GOULET authorized by § 706.06, Wis. Stats.) NOTARY PUBLIC THIS INSTRUMENT WAS DRAFTED BY *Pamela J. Go et Peterson, Fram & Ber gman — Steven H. Bruns Notary Public, State o My commission is permanent. (If not, state expiration date: 50 East Fifth Street, St. Patel, MN 55101 10/11/2009 ) (Signatures may be authenticated or acknowledged. Both are not necessary.) *Names of persons signing in any capacity must be typed or printed below their signature WARRANTY DEED STATE BAR OF WISCONSIN FORM No.2 -2000 loft � � �'C31NN of TROY P MIT FOR ACCESS DRIVEWAY Permit # J / C reel # Ppiicant Name: Applicant Address: Sa - 9G/9 - Address of D rlVeway : 1,41 f !Cr► Frt ✓!� Driveway T p ' tie Shared Public Field Access Number of Driveways l - - Proposed Land Use Residentia Commercial Agricultural Driveway Location E -f - skle of the road, `� aD of - -C �4 st Nl•J 1/4 of the (.9 1/4 of Section 3o Township o� North, Range We Subdivision Name C S Lot # - — A7 2 Required Drainage Structure I �lv c.� 1 �.Jas 1 (if none requi state why) Al DESCRIPTION OF PROPOSED WORK ( Include special restrictions, intersection clearances, other details and references to any sketches which may be attached ) Permit Fee $25.00 Culvert Deposit $ 3ss Total $ Any driveway shall be constructed in accordance with all requirements printed on the reverse side, and any special conditions stated henn. The maintenance of the driveway shall be the resposibility of the owner. . issuance of this permit shall not be construed as a waiver of the applicants obligation to comply with any more restrictive requiements imposed by local ordinances. APPLICANTS SIGNATURE Date APPROVED BY BUILDING 1 TOR pate 7 .>'O �J u M41 2 !9 \� ..2... .7.. ► ro,... +arrr�K' " �, l�eolslenx needs • st croDc Co; Wf ,r CERTIFIEI] SURVEY- MAP- BROOKE AND,. MARY WOLF Part of the Northwest 1/4 of the Northwest 1/4 of Section 30, Township 28 North, Range 19 West, Town of Troy, St. Croix County, Wisconsin. N.W GOR. SEC. 30, T PI N. R /9 W. N L/NE'N'W I14 K 1/4 COR. S£C. 30. T PB N. R / /COI/NT Y BER NTS£N NA/L/ UNP T FIcO LANOS /C� TY SURVE Yp R'S MONJ — "�: b SB9'45'OT' ?,?06.6 ?� /_ 1 •� i� R(CASTl - b . /3/237' 6.93. 216. "38 • < .•. 2/7,'91 - ° N 09.32'50 "W {194.14' ROAO SETBACIf L I NE ' `.° LOT Q LO T 4 y ' ; 70 ACRES q 2. 666 ACRES 2 1. 000 ACRES 1.4v So. ,-T / 6.675 Cq1FT. h Q 9 / 4. 77 I SO. FT. 02 ACRES ~ �I 20.4.33 ACRES EXC.ROAOR.O.W. Q 2.500 AC." N h EX C. ROAO 'VA W. ° Q 001.01S SO. F T. " q 'n EXC. 97AO N 10 @.999 SO; FT. W./ o h �. I w Owner's Address; / vs. 9/ 3 SO. Jr x Q 321 Plainview Dr. River Fails,' WI .5 t9 22 216,37• IS. 84 Vi 0 1 11 iron pipe t N e9.4 07-w 43r-z/ 3 b found. o 01" x '24 iron pipe weighing 3 c DRIVEWAY r G a 1.13 ibs . /lin. b /�HEOS Q M z o ft. set. _° / N ti xt�Fence. — 0W£LL (10.00' o t� ° 3 Indicates P OOL ° o =' U " N previously recorded data. t O SEPT /C c C i .. 9- LO T3 ,. f 2 b 2 'Z N N 9 22 .699 ACRES � 4 . 405. S.C.. FT. 3 a 1. WATER COURSE - k 0 1 � � 9.643' ACRES EX C. ROAD R.O.W. � W I b M POND £LEV. 420, 034 SO. FT. ti 3e �- W Q h r . - UA y SETBACIr LINE 100.00. ri S , a. 3 4' PO 97.10 ' 9^ BEh/CHMARK rOP P /PE ASS j' M ED kt'10' - 093. B2' 495.00' K B9.4¢'ST • 'W S LINE NW 1/4 NW 114 9• 6' UN PLA TIE LA NDS ``�gttt�i +tUy6 m w I/4 COR. CDR. SEC. 30. room, R /9 W, /COI/N r SI/R YEYOR'S MOW.J '.� f.••••�•••• This instrument drafted by Laurence W. Murphy LAUR C . r W PHY = oC r SCALE / "+ ZOO' w p 40' /00' /30'!00' 300' 400' 500' Soo S 3 • '*' • 1 RIVER FALLS-0 S . WISC. •' q. �� w " Dated: March 20, 1997 �� LAND ��►, "Revised this 21st day of May, 199 Laurence W. Murphy '', Registered Land Surveyor SHEET Z. OF 2 Vol. 12 Page 3264 I