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HomeMy WebLinkAbout042-1086-10-101 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 430308 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: Stout, Richard I Warren Townshi CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 31.29.18. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER C-AP6CITY STATION BS HI FS ELEV. Septic d Benchmark S I Z O Z•o Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet 3•2- IS> f' TANK SETBACK INFORMATION St/Ht outlet 3. SO 1T.'( TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ' / Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Ik� 6 7- � �, Holding Bot. System, SS Final Grade 1 PUMP /SIPHON INFORMATIONt So. , bD Manufacturer Deland St Cover If. 6S ► Model Numb TDH Lift Friction System Head TD Ft Forc ain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length To . Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS V - 2,k SETBACK SYSTEM TO P/1 WELL LAKE /STREAM LEACHING Manufac rer: , 1 INFORMATION r CHAMBER OR 1 - Type Of System: ( UNIT - 7 57D Mod Number: Z /( DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length 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 Topsail 9 D Yes Ej No J Yes [ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:// n e tion 2: l � Location: 676 Hillary Farm Road Roberts, WI 54023 (NW 1/4 NW 1/4 31 T29N R18WI 40 a L a cel o: 31.29.18. ' I 1.) Alt BM Description = q) 51 44 r '""` 11^4 VIN . p f 2.) Bldg sewer length = � t � < Ou zt 04Le. amount of cover = " (�' �' e � qty-- ' do tf I Plan revision Re uired. s No Use other side for additional i formation SBD -6710 (R.3/97) �c , v- Date Insepctor's Signature Cert. No. V 2 Safety and Buildings llivision County 201 W. Washington Ave., P.O. Box 7162 Z cya ,, 1 \ �( v�����,� Madison, WI 53707 - 7162 Sani7i ermit Number (to be filled in by Co.) Department of Commerce (608) 266 -3151 Sanitary Permit Application State Plan I.D. Number in accord with Comm 83.21, Wig, Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, s15.04(1)(m) Project Address (if different than maifing address) I. Application Information - Please Print All Information 41 Property Owner's Na me i creel Property Owner's M ailing Address P r ati_ on 4i oy Z - 10x6 - 10 ` � l9 / p ��J !35'3 �Ja toff rra, ( 54, 'A,Section � City. State Zip Code (circle o ) I ,S GtJ� 5'� /G! g`YD 6 y — ea' 73 T a q N; R o U. Type of Building (check all that apply) k , or 2 Family Dwelling - Number of Bedrooms Subdivision Name n CSM Number ❑ Public /Commercial - Describe Use / � 47 � t° S ❑ State Owned - Describe Use t 2) � r x� - S ❑City_❑Village firTownship of f -,e,r/ III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New System ❑ Replacement System ❑ Treatment/Holding 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 Issued Before Expiration Plumber Owner IV. Type of FOWT5 ftstew. (Check all that appl —f X Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable ❑ 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 ❑ Leaching Chamber ❑ Drip Li ❑ avel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: -21- Design Flow (go) Design Soil Application Rate(gpdsf) Dispersal Area wired (s Dispersal Area Proposed (sf) System Elevation at eAw 1 16' 4 o 7 l'Y.s GY3 t VI. Tank Info Capacity in Total Number Manufacturer Prefab I ite Si Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank ZQ,,e Aerobic Treatment Unit Dosing Chamber �JrO ' S' cis/ VII. Responsibility Statement I, tht undersigned, assure responsibility for lAtallation of the POWTS shown on the attached plans. Plumber's Na the (Print) Plumber's Si gnature CVMPRS Number Business Phone Number lrJ�'il•�cr rn -rcAtli fi I I �?-- 1S -9 8 G -3102 � Plumber's Addre ss (Street. City, State, Zip Code) { VIII. Count /De artment Use Onl ��A pproved C1 Disapproved Sanitary Permit Fee includes Groundwater Date Issued I win gent Signatur (No Stamps) �C7\ El Owner Given Reason for Denial Surcharge Fee) . �l� IX. Conditions of Approval /Reasons for Disapproval g� o.,se` a .,dci+�1Z ovtiars. SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced I maintained �S ` as per management plan provided by plumber. ! i 2. All setback requirements must be maintained �) l�n Cape4 4::;t- ? _ao% >� sUatNedl Lu as per applicable code /ordinances. Q A. Anaeh complete plans (to the County only) for the system r not less than $112 x It inches in size SBD -6398 (R. 01103) ake _S7ote, go" 6r fGre-f �/�%ti ,��J �i S3 /�afflfld v; � /� Yd a a3• n l' s t W` 2 m 1 Dh' e o 160- �r S i� Y'ri ! S4 �o l7b o 1 �a �4 d n 9 e w�- Y'd Q-7 �G1► -e3 .t/rU�/ .�d+J GlS3 /TaP/P /��was�Y�� ley AX & h lot J oe C`� W ? r r 1 �6. arm a& �I►°r�,o c 91, (ate aq d. C P— C- r - Wiecwvsirn Department of Commerce SOIL EVALUATION REPORT Page � of 3 Division of 8aiety and Buildings in accordance with Carmn 85, Wis. Adm. Code County S �� Attach complete aft pMn on Pepe, not less tiran B 112 x 11 inches in size. Plan must include, but Wert limiled to: vertical and hortaordal tderarrca pofit (BM). dkection and Petoel I percent slope. scale or dimensions, north anew, and location and distance to nearest road. Date Ptease print att ("ronnatton. by Personal inrormaiiM you Provide msy be used nor 800&XIMy WTI (Privacy law. s. 15A4 (1) (m)). Property Owner I Property Location C of 4 114�1O9 /4 S �f T a Q N R/Y E(or& property Owners Mawg Address C-9— Loi Block If Subd. Name ar CSM# 3 s G r Town Nearest Road fty Staff Code Plane Number ❑ 9e jp New Construction Use: Residential / Number of bedrooms Code derived design flow rate L ' 22 ( e O 0 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material d U a 5 Flood Plain elevation ft applicable / General comments S Y S p w� 2 j'e- U + �' (p, S-C) w 1 v i ° and recommendations: ❑ Boring Boring # [Y] �� ® Pit Ground surface elev. 4 �i 0y ft. Depth to Wailing factor _ 1— = ---�- in (icatiOW Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots .E GP F in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. 0 -0 to 3 - S� ' zM� W"' t S l v � _ 0 g , l 7. 3 i -9 ❑ Boring d Swing pit surface elev. ft. Depth to limiting factor in. Sol Nocallon Rate Horizon Depth Dominant color Redox Description Texture Structure Consistence Boundary Roots GPD/fF kn Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'EtT111 'EW2 Z", ) v s` Z IZ -30 — S.` s fo p -q U Effluent #1- BOD > 3D 220 mg& mad TSS ` 150 mWL. ' Etfluend 02 = BOD < 30 mglL and TSS 30 mgit. CST Name (Please Prim e CST Number S 3 3a Address Date Evakm*m Conducted' Telephone Number 7 i L/ 3 ,5- C j , Parcel ID # Page of 3 Property Owner _ _____- _--- -- ❑ Boring El Boring # Ground She elegy►• �' d ft. Depth tD liming factor _L.� -- in. Sol Rate (� Pit Horizon Depth Domkrant Color Redox Texture Structure Cow Boundary Roots GPDAY in. Munsell Qu. Sz Cont Color Gr. Sz. Sh. 'EW1 'EfW2 u C tl s� Z / Z Boring # ❑ Boring ❑ Pit Ground,surface elev. ft- Depth to luniting factor in. m Rate Horizon Depth Dornirt Color Redox Desaipfion Texture mucture Consistence Boundary Roots GPDIFP rmr In. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'EMI 'Etf#2 Boring # ❑ Boring _ _ ❑ Pit Ground surface env tt Depth to limiting factor in. F Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Conaistenoe Boundary Roofs GPDffF in. Munsel Ou. Sz. Cont Color Gr. Sz Sh. 'Et#i1 'Eff#2 • F%Iw t #1 = BOD 30!S 220 mgiL and TSS >30 <_ 150 mgiL ' Et kart 92 = BOD <_ 30 mg(L and TSS <_ 30 mglL The Department of Commerce is an equal opponunity 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. SBD•8330 W01100) r PAGE_OF3 QCRV CSQ.,� NAME: o v (r LOT# LEGAL DESCRIPTION: 1 /4 1 /4,S_T — , N,R, E(or)W /SCALE: 1 " = r &Ar ELEVATION: IOv 0 ' BM DESCRIPTION: 'V'F 0 -( i�� �e�' BM 2 LEVATION: qGj BM 2 DESCRIPTION y D Pile - 1- ---- �� -- -= SYSTEM ELEVATION: Q-a SYSTEM TYPE: '7o \ov�s Ito . SIGNATURE: DATE: S t C. L IJOAUJ o 7 $ O cn T > 0 i ca E T - U ` T C') E o a) x In u i O L c M E E a = x 1 I y�� U LO I C, - 0 co ' 0 r- v,00?� co _Q 0 CL cu CD _ Ems_ C D 0 N A a 2 m 0 CL i � . 0 m _ o) x > CL �c co i r1r 1 O .O � = � LL O U a X S 0 JU-0 cn N O . a) �$ Q) to fn 1 ti Y� J 't Ss - f rt � it u Q,L LO ca tl 1 $ p w lung= 0 ` :30 L 2 " ° es ii ��{{ 1� L�J w r� e c a co �'1 c m - 3 m - J .73 . SEPTIC TANK PUMP CEAMBER CROSS SECTION AND SP CIFICATIONS 1t NT PIPE 1.2" MIN. AB GRADE 8 WEATHERPROOF D � CI VENT JUNCTION BOX APPROVE f N 25 FROM DOOR, WI OR JU N FRESH AIR INTAKE WITH CONDUIT MANHOLE COVER W1 PADLOCK & WARNING LABEL FINISHED GRADE 4" Cl RISER MIN . 1S" IN. S" MAX. i � A NLET , i GAS- WATER TIGHT SEALS TIGHT PPROVED A SEAL i H JOINTS WIT ._1.,.. , ALM APPROVED PIPE PPROVED H i ON 3' ONTO IPE 3' � + , SOLID SOIL NTO SOLID i C RISER EXIT 3 OIL PUMP OFF ELEV . �. FT • y `'"— OFF PERMITTED ONLY D IF TANK MANUFACTURER HAS APPROVAL a APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC f DOSE NUMBER DOSES PER DAY: TANK MANUFACTURER: t�Y TANK SIZES SEPTIC GAL. DOSE VOLUME INCLUDING GAL. DOSE G 5� GAL. FLOWTACK: �„_. ALARM MANUFACTURER: 1; U���erf* -�_. CAPACITIES: A = - Lz - INCHES w _.Z GAI:- __r.__._ MODEL NUMBER: j2,4 y - B : 2 INCHES = 32 GAL, SWITCH TYPE: nerc- ~-�'-- C _ $ INCHES PUMP MANUFACTURER: eti ✓P- MODEL NUMBER: "e o 4/ -- D ; INCHES = _ ... ?AL . SWITCH TYPE: REQUIRED DISCHARGE RATE �,� GPM PUMP B ALARM WIRING AS PER ILHR 16.23 WAC ...�. ---- VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE • • FEET FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . • . • • . . . ' . . . " FEET + FEET FORCEMAIN X .2. FT /100 FT. FRICTION FACTOR . LE Z- TOTAL DYNAMIC HEAD = _ S 7 I'EET . K: LENGTH ; WIDTH_r� DIAMET TER INTERNAL DIMENSIONS OF PUMP TAN LI UTD IS� •' /4' ,,&� E - SIGNED: �� � � LICENSE Iv'{JMBER : a? DATE: � .._ I . I 1/88 submersible afflawt PUMP EMM &immww� 3871 r j E WAN FW1 So" OAAM Uftliflolf'o - IV ~Wt%vW. gplpli "�111�t1M jw" d Tw p wiflj �tntA t ig - tdiow" im +� ameoe #o ttaooawwM 4WO tio� �' >MAitiWt hr Mr �t1d lMI�#M�011� owwa�+o won li rl No: 0.4 HP lidieWOOM - Swo dvtj mob SPONC1111. 00 HL IN ri kW jjjjdW wd RPM, ba to over W wdh Ar tiotlM M nd , lower euo nat � d of 00 4 • �, • ,1C toot = =for 1 , ie �iT� � ONAGNIWAMANOOft . 24 W, t wlii► wne ��%undMp � w aW Th1 n tloodsl numbim �1 i�,1 t 'I'f Htth c �dt end ki T or AT.) • Malolii WI:' wil JTW f Mprowd �� thn�r rano orout,dina pith ad tear. NOW mot �� on )' thereto n Od 4" � JO =w t .w�rr M • � t�f�biliyl; 7 a � i 1 f low S�i11 up 10 31 ta ' e �0 tat • p � t�" lrPYa i 4 • �' 3 10 " Now i Y i � a POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of Z __ FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity Q 16 of ❑ NA Permit # ZOO Septic Tank Manufacturer 1 1 ❑ NA Effluent f=ilter Manufacturer 6 e– C3 NA DESIGN PARAMETERS ❑ NA Number of Bedrooms 3 O NA Effluent Filter Model A d'© Number of Public Facility Units ❑ NA al ❑ NA Pump Tank Capacity Q Estimated flow leverage) 3CV al /da Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.51 aUda Pump Manufacturer f'aG i] NA " D ,�•e� Soil Application Rate al /da /ft' Pump Mode; Standard Influent /Effluent Quality Monthly average' Pretreatment Unit Fats, Oil & Grease (FO 530 mg /L I [I Sand /Gravel Filter ❑Peat Filter Biochemical Oxygen Demand 1BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSSI 5150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) O NA Biochemical Oxygen Demand (BOD 530 mg /L In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA © At -Grade C3 Mound Fecal Colfform (geometric mean) 1W cfu /100ml 13 Drip -Line D Other: 5 Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: I3 NA Other: ❑ NA Others O NA "values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE Service Event Service Frequency mont s {Maximum 3 years) ❑ NA Inspect condition of tank(s) At least once every: r {sl Pump out contents of tanks) When combined sludge and scum equals one -third IY of tank volume ❑ NA month {s) (Maximum 3 years) ❑ NA Inspect dispersal call(s) At least once every: 3 setts! month(s) ❑ NA Clean effluent filter At least once every: earls) ❑ monthisl ❑ NA Inspect pump, pump controls & alarm At least once every: •"'— ❑ ears) ' ❑ months! ❑ NA Bush laterals and pressure test At least once every: ❑ yearisl ❑ month(s) ❑ NA Other: At least once every: ❑ year(s) p NA Other: 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(sl 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 ceN(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 equate one -third M) 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 - Z'O f START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tankis) for the presence of painting products or other chemicals that i s and /or damage the dispersal celi(s . If hi h concentrations are detected have the contents a may Impede the treatment process g p ) , i{ _ 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 cellis) in one large dose, overloading the cellis) 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 safety 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 falls 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 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. C3 T s'te site e tank ❑ 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 r `�,'� �, , y , Name Phone 7 _ _ .r � Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Rby Nam Nam dir. . � /)C Phone Phon — :!Z. This document was drafted In compliance with chapter Comm 83.22(2)(b)(1)(d) &If) and 83.54(1), (2) & (3), Wisconsin Administrative Code. �, o�nwnc��ccr rlum�inq F�iX NO. . 7153863121 Jun. 10 2007, 2 • r� ST CROIA COUN'T'Y SIaPTIC TANK 'MAINTENANCE AGREEMENT A. OWNE P ISHIP CERTIFICATION FO Owuer'ftyer 1`� Y`j � J C& :MAiling Address P - 3.5 - ? U i'roporiy Address (Vartgmiou required from Platwiag Department for new conmucti=1 ...._ Cit /State dsntilication 'Number See Par G alt Propa�ty Lowlorl�/ -„ , , , T �4 N -1'1_N Town of ° Subdivision 3 e 7 f/c re- s C'ep' and Survey Map � , Volume Page # nrralnty Deed , Volume , Page yes t no Lot lines iden.ifiab?e 0 yes 7. no �V'QT .M M�1'N'�`FATA.hrr ImPropea uw and.sawiz t azoeof your septic system could result in its pretrsattsre 1,34U3 to barsdlr wastes. Propn: r�kze;4c ; soasists Of plump* out the mptic tank avert' t'h= years or Boomer, if doodad by it lioertsed pumper. WbAt you P;zt ::c oaa W00t to fxutotion of the septic taa as it 4"tM=t MSG its the waste diwosal system T'he property owner agrees to subrait to Sr. Croix Zoning Department a cartifseatiuts form, signed by the o'�Aewr snsstar plurabar, ,jotiraa�+mnn lsiumt�er, restrintcd plum `ae r or a kstsed pumper verify* that (1) the on-site vwzsmwates c s� pw is it proper operating condition u& x (2) after iasptcti= and pumping (if weaaary), tie acpdc tank is leas that" 113 n-11 o ° X/wt, tho U44drrigned hays road the above requim moats and *groe to asaiataia the privato sewage disposal system Witt „he ;si a �:.t ®et forth, horein, art oat by t*Depr=01tof Carnatsarao sad tho Dsputraont of Natwal Resourcos. State of Wiwonsia, Cart-, st*titsg *&I V= is pdo System has beau maint ed must be the St. Craix C4:=? ya of y dA else t� you eapitsdou date. 91614ATUR OF "PLYCANF DATE 52 8 nTIFI`iCAT1gN I (we) mortify that 4ll awwatws on this farts ate true to the bast of my (our) imowledge. I (we) ax-., (are) tt.e the property dUCetbod t iurre, by vittuo of a uq:rmnry dee8 recorded -�n Register of Detdv Off". j� , a ; (� 6� SIGNATM 6 APPLICANT BATE "'aB * *a Any inf'ormtttioa ft ie rais- rapYaaortod may resin: in it* sa: itary pant a being revoked by the Zoning pepam� Lev, w� Include with tlbir applicadow is stamped wsrr n7 deed hom the 1 oe l3eeds ofYlee ° a copy of the certified survey map if referent a 4 mauls in the wan=%y dtsed Parcel #: 042 - 1086 -10 -025 11/1912007 11:07 AM PAGE 1 OF 1 Alt. Parcel #: 31.29.18.481 B -10 042 - TOWN OF WARREN Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 06/23/2006 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - ROSCON PROPERTIES LLC ROSCON PROPERTIES LLC 1353 AWATUKEE TRL HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description ' 904 67TH AVE SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 35.070 Plat: NIA -NOT AVAILABLE SEC 31 T29N R18W PT NW NW, PT SW NW, PT Block/Condo Bldg: SE NW, PT SW NE, PT NW NE COMM W 1/4 COR SEC 31; TH N01' W 1479.01 FT TO POB; TH Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) S 85'E 452.65 FT; TH S55' E 1501.30 FT; 31- 29N -18W TH S84' E 1293.10 FT; TH N56' E 1187.27 FT; TH NO2' E 284.22 FT; TH S74' W more Notes: Parcel History: Date Doc # Vol /Page Type 06/23/2006 828166 WD 10/30/1998 590366 1371/568 WD 10/3011998 590360 1371 /554 CO 07/23/1997 1071/235 PR more 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/08/2007 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.000 20,000 189,400 209,400 NO 2 UNDEVELOPED G5 34.070 52.600 0 52,600 NO Totals for 2007: General Property 35.070 72,600 189,400 262,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount 018 - RECYCLING SPECIAL ASSESSMENT 15.00 Special Assessments Special Charges Delinquent Charges Total 15.00 0.00 0.00 c� 3m o d v1 0 d y 0 0 m y 0 W e N • c F'p p y �C� FD p o co ;0 W to O N n 7 7 G O N d 3 7 Q 3 3 3° c N v v O m to rn p I 1Z _ cnl� Z my Z ( Vi Z uD m �' D c D y c m D U D y a � a o I W � a m - IW o � Fit ° O w w o 0 0 0 w w M c Z Z 000 o cn to v ° cn cn n c c 3 c c 3 N N 3 3 3 3 g v v_ CD CD m m N y W m C Z 3 z 3 3 ' ° ° ccnz =i -i O m -jp > >> C m 7< < n o �mm y 03,:; m o a 8 °' ° ma - ' (D & .0 a y 0) CD n N �'J O CD n .� y fD � 0 N n Ot N 3, =. 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CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF WARREN COMPUTER NUMBER 042 - 1086 -10 -000 Parcel Number 31.29.1 481 B OWNER NAME: First RtCHARD O & JANET P Las FS TOUT PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment SECTION 31 TOWN 29N RANGE 18W %160 '/ +40 Line Description Line Description TOTAL ACREAGE 9.000 PLAT LOT BLK 01 SEC 31 T29N R18W NW NW 1 5 02 S OF HWY 94 EXC PT TO ST OF 16 03 WI AS DESC IN 913/201 17 04 18 05 19 v 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF WARREN COMPUTER NUMBER 042 - 1086 -20 -000 Parcel Number 31.29.18.482A OWNER NAME: First RICHARD O & JANET P Last STOUT PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment SECTION 31 TOWN 29N RANGE 18W'/ +160 '/.40 Line Description Line Description TOTAL ACREAGE 22.700 PLAT LOT BLK 01 SEC 31 T29N R18W SW NW 15 � 02 EXC CSM VOL 1/221 & EXC � PT 16 � 03 TO ST OF WI AS DESC IN 17 n 04 913/201 & EXC PARTS TO QC'S 18 05 1436/464 & 1436/469 & EXC 19 111 � V IA- �, n 06 CSM 13/3678 EZ -U- 1648/138 20 l� 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF WARREN COMPUTER NUMBER 042 - 1085 -50 -000 Parcel Number 31.29.18.478 OWNER NAME: First RICHARD O & JANET P Last STOUT PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment SECTION 31 TOWN 29N RANGE 18W 1 /4160 '/.40 Line Description Line Description TOTAL ACREAGE 31.000 PLAT LOT BLK 01 SEC 31 T29N R18W SWyI ,E -45 02 EXC PT TO ST OF WI AS ­ DESC 16 03 IN 913/201 17 04 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF WARREN COMPUTER NUMBER 042 - 1085 -40 -000 Parcel Number 31.29.18.477B OWNER NAME: First RICHARD O & JANET P Last STOUT PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment SECTION 31 TOWN 29N RANGE 18W %160 '/40 Line Description Line Description TOTAL ACREAGE 0.300 PLAT LOT BLK 01 SEC 31 T29N R18W PT NW NE 15 02 S OF HWY 94 EXC P ST OF 16 03 WI DESC IN 913/201 17 04 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit 1 1 PARCEL C A PARCEL OF LAND LOCATED IN PART OF THE NW1 /4 OF THE NW1 /4, PART OF THE SW1 /4 OF THE NW1 /4, PART OF THE SE1 /4 OF THE NW1 14, PART OF THE SW1 /4 OF THE NE1 /4 AND PART OF THE NW1 14 OF THE NE1 /4 OF SECTION 31, T29N, R18W, TOWN OF WARREN, ST. CROIX COUNTY, WISCONSIN; DESCRIBED AS FOLLOWS; COMMENCING AT THE WEST QUARTER CORNER OF SAID SECTION 31; THENCE N01 ° 16 1 38 "W ALONG THE WEST LINE OF THE NORTHWEST QUARTER OF SAID SECTION 31 A DISTANCE OF 1479.01 FEET TO THE POINT OF BEGINNING; THENCE S85 0 11'18 "E A DISTANCE OF 452.65 FEET; THENCE S55 ° 43 1 34 "E A DISTANCE OF 1501.30 FEET; THENCE S84 ° 38'39 "E A DISTANCE OF 1293.10 FEET; THENCE N56 0 53 1 56 11 E A DISTANCE OF 1187.27 FEET; THENCE NO2 0 00'11 "E A DISTANCE OF 284.22 FEET; THENCE S74 0 34'20 "W ALONG THE SOUTHERLY RIGHT -OF -WAY OF INTERSTATE HIGHWAY "94" A DISTANCE OF 716.96 FEET; THENCE S40 0 50'29 "W ALONG SAID RIGHT -OF -WAY A DISTANCE OF 618.54 FEET; THENCE N84 0 38'39 "W ALONG SAID RIGHT -OF -WAY 4 A DISTANCE OF 1189.39 FEET; THENCE N48 ° 14'11 "W ALONG SAID RIGHT -OF -WAY A DISTANCE OF 1586.55 FEET; THENCE N70 0 13'35 "W ALONG SAID RIGHT -OF -WAY A DISTANCE OF 66.43 FEET TO A POINT ON A 5594.58 FOOT RADIUS CURVE, CONCAVE SOUTHWESTERLY, WITH A CENTRAL ANGLE THAT MEASURES 05 ° 03'24 ", A CHORD THAT BEARS N72 0 45'17 "W AND MEASURES 493.59 FEET; THENCE WESTERLY ALONG THE ARC OF SAID CURVE A DISTANCE OF 493.76 FEET TO SAID WEST LINE OF THE NORTHWEST QUARTER; THENCE S01 0 16'38 "E ALONG SAID WEST LINE A DISTANCE OF 606.36 FEET TO THE POINT OF BEGINNING. PARCEL CONTAINS 35.07 ACRES. SUBJECT TO ALL EASEMENTS, COVENANTS, AND RESTRICTIONS OF RECORD. VOL 1. 71. P4cf 5 68 _ 590366 WARRAN DEED Document Number: _ �� 1 S T F_ S O F C �T, CROIX ft, 11(1 Rsc'4 '�r B�eeN Return Address: OCT 3 01998 r7 Coe Parcel C Re tilts ar ONde Parcel I.D. Number (PIN: �2-� 20; 042- 1088- 40; 0wZ•1085 -80; •1088.40• 2- 1085 -20; 020 - 1108 -50; 020-11 og -80; 020.1 0.020-1108-80 Thls Deed, made between Frederick G. Lenertz Land and Cattle Company, L.L.C., a Wisconsin limited liability company, Grantor, and Richard 0. Stout and Janet P. Stout, husband and wife, as survivorship marital property, Grantee, Wltnesseth, That the said Grantor, for a valuable consideration, conveys to Grantee the `. following described real estate in St. Croix County, State of Wisconsin: NE 1/4 OF SECTION 36, TOWNSHIP 29 NORTH, RANGE 19 WEST, ST. CROIX COUNTY, WISCONSIN THAT LIES SOUTHERLY OF INTERSTATE HIGHWAY 94. y `l NW 1/4 OF SECTION 31, TOWNSHIP 29 NORTH, RANGE 18 WEST, ST. CROIX COUNTY, WI CON YING SOUTHERLY INTERSTATE HI EXCEPT CERTIFIED SURVEY MAP IN VOL. 1, E 221 AND EXCEPT PART IN 3' VOL. 634, PAGE 138 AND EXCEPT PART IN VOL. 913, PAGE 201. NE 1/4 OF S C 9 NORTH, RANGE 18 WEST, ST. CROIX TY, WISCONSIN LYING NORTHERLY ENUE A D SOUTHERLIL O F INTERSTATE HIGHWAY 94 EXCEPT PART IN VOL. 913. PAGE 201 This is not homestead property. Together with all and singular the hereditaments and appurtenances thereunto belonging: And Grantor warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements and restrictions of record and will warrant and defend the same. Dated this 30th day of October, 1998. FREDERICK G. LENERTZ LAND AND TRANS CATTLE COMPANY, L.L.C. 5 0 Steven B. Goff, Power of Attorney i t Frederick G. Lenertz ACKNOWLEDGMENT r STATE OF WISCONSIN ) ) ss. f ST. CROIX COUNTY ) Personally came before me this 30th day of October, 1998, the above named Steven B. Goff ' to me known to be the person who executed the foregoing instrument and acknow!edge the same. I I - • t ••'' Pamela A. Skorude, Notary Public - v . y St. Croix County, Wisconsin y My Commission expires: March 17,,�Q . J .. .; THIS INSTRUMENT DRAFTED BY: s •�'" " "' t +": Steven B. Goff r.. 1 Bye, Goff & Rohde, Ltd. /,I,,s " " „ PO Box 187 River Falls, WI 54022 SBGILENERTZICLAPPID 1 WD s ■ ■ AVE u, ° u WIWam u I (��� ■ 13 12 1, 3 qt g Booth ■ \ Darren S�C W x : �J ■ 9 I oG n La C1 Rueben 1 ■ Donahue D Thomas ■ ■ ■ to , �h • ■ ■ ,,, • ■ BrtnB6old ■ sullvwld ■ j I�1 V " ■ 1 ■ ■2 ■' ' ■ Arlen Strate ■ Thomas ■ 100th AVE tom. ■ l,� R ussell ■ ■ e/s R 1 1/3 \ 1 1 Donald • 96th q • Strafe N hi Fred 0 11 AVE , _ j 8 ■PaYang ��� p 17 is� 16 \" ■ FEE 15 Mona . L 1 U 8 o 5 � Ted ■ ■ lames Q I a x Quilling GuBch Z , a '� Fred Joseph u ourdeans p � r QI j � ■3 \1 JI a LLJ Thomas I Hau tt u ° Ilartmon u David ■ i i • Boom ■ rown . ■ ■ ■ ■ a ■McKenna ■ 2 ■ ■ ■1 ■ ■Frederick QQ D ■ _ a ■ ■ ■ ■ ■ Hoard � � P � :, ■ I ■ 1.6 ■ Naugen Rohl 1 - ei.aooe 89th AVE g o u ■ ■Richal w� g ci Braun William a I oManey I 1 86t AVE o ■ all SNOWN Cn waltz Tltmarsh ■ 6 0 21 E Guy ' / s . I .ilbur 1 9 96 th 83rd I 2 0 B '- Thomas .: Robert AVE , Refs ■ ■ Albright 13 'O w 84th AVE Paul Gudiaer ■ ■ ■ 14 ■15I row 5i o v C 9 Wilcox ewe Graham ■ / Robert D ' Earl I Gary 8 0th • • 9 v u ti • � U ones Maw ( \ \�,\ ohnson Pechun 1 Hoyer ■ , Kevin J i° ,9 tz ' J 1 .x. 1 ■ U J ■ AVE Potrn �a` 108 Buck ■ O lr • �. ,n 99th Gene ■ , Maier ■ Hdm• 1 ■32 4 1 M� u a �` �i • Richard Rick ■ 2 ■ I Janson I i- Eaaylen `Miller Graf ■ �+ P S T r • �, o � r 1, N' 4 6 �ti � � H 3 t Blair w I w O Teem I r■ u • !o'x I A E 65 2\ r Henry z 30 Donald ■ 2 Q S col,' 1 . G Mderson 4�!/ / ■ S ■ ■ Ci • O I J ot I Donald p ■ 7 en • smith Daniel ] ■ Elbert ■ Haase x I ■ Andy it I E aooer a ■ TWIN Greg Gra c u ' cordr oai.►e ■ LAKES ■ D Jim ■ An er Meredith == ^� I ■ e im - Naumann Hilpert ■ ad ■ Gerken 0th AVE T � E • • a F ■ k t; u I C Peskar S y y F 94 3 ALEX BIKEWA� •Hera ■i ■ y� I N SY.AM W Ed 6 ■ ■ 7 Julius 3 4 w ' 1-4 ■x X 32 I 33 ,�' 'STAR Gibb N � 14 19 AVE Ch" V Z Gerald ■ 1 • ILN • a��y ■ '� Altmann I �, BA ■ ■ Bruce • is n Beskau Brian N ■ w Todd ■ u. x M E u b � � Hable sorlie ` 3 ■ 2 Cron Va eo V119 Stone t EC KEA LN I • ■ ■Arian S Richard � Ixm 14 ran ,_ , biat o 224 25 N Kritta °N • Busker ■ •� � —' th AVE KINNICKINNIC PAGE 19 THE ROBERTS LIC Proudly serving the Community of Good ' Y Sponsor of Roberts Good Neighbor Days t : Also, sponsor of Cub, Boy and Girl SCOT Flag Football and various programs at St. C Active participation in Wisconsin Lions - and mentally handical ii "' S89 0 52 1 38 "E N89 °52'38 "V17865.82' m 2 1 .00' EAST -WEST 1/4 LINE I I — '� �Ii � ° I I �j I I ' CA I Lu p) �I plVl I I �I I I I o @; lai I o l O °I I I IN z 0 w S89 r1J I I cn 0 Lli z N 1 I o PARCEL A s 42.8 AC. ± POND I z $ TO ORDINARY 1 "s89 3816 HIGH WATER MARK \ CV \`�� I ' co M / W pp °� N z co w S89 0 33'04 "E 356.68' T T o w SOUTH LINE OF THE NE1 /4 OF LL THE SE1 /4 OF SECTION 31 cS io 0 r Z Z O O r Z M ° O O 04 0 z wU Lu S89 0 32'50 "E 1104.65' � Q) LL LL 00 W eT z r J � Q � Q w LLl l CO CR CO • f` O PARCEL B $ 41.62 AC. S89 0 33'04 "E 265.04' 0o @1$1 u') I I Co �I� I � N fn COR. N89 0 40'44 'W 1577.84' SEC. 31 SOUTH LINE OF THE SE1 /4 OF SECTION 31 C ' 7 1\ ,IIIIIINICILM > RICHARD STOUT 0171"w°�^`� m b°'"`"` °`°�"" rVmoa o* n 54751 Bodom 1154010 DAM 08/15/03 7d 710- 000 -UN 7r 710 -001-5m ni 710 -22-M n. 754 -381-M Dwo FLIb 0062 -20 TOWN OF WARREN, ST. CROIX COUNTY. WISCONSIN bw"*_Qo_duw _ , „ eoM—ae 35 + ACRE PARCELS Auth•Consniting/Ilwiato SO land Surveying .a. WA�.o6z -26 1 , c escr 7m Immel "7m 1 aLva :mvN oaaaaM NOWON cc-rm wam ow kdumS pu'I pS salgmnpac FaoJ"qlnV S130NVd 3NOb + 5C ra-�oo 3u �r �•mnm•�aww�mpv aew- asz-s m ZZ NGNOOSWI 'ALNf1O0 WHO IS 'N3HHVM d0 WM ct�90a � oMa ess� -uc-au w ■v �Qvoo ova TUN MS L `N6Zl `L£ N01103S NI kl83d08d lot "Ps 1f101S 0WHOIN D'C u. a�a Iwo •m ome as a" 0 ww► u. rwvyo s�s� zmrcmm I I S00 0 26'47 "E 982.00'_100TH ST. I S00 18.58 — _ _ _ --- -_ —_ -- I YYY I T � ' W M I 1118 58 i EAST LINE OF THE NE1 /4 �� 1 c� 0- I I 1 z I I c (D o T N 1 r W O Z N �ni co I Z c �D ?� U) d W 0 I ,o 8 Lj a d I BEARINGS ARE REFERENCED TO THE Z c c M N I V, EAST LINE OF THE NE1 /4 OF SECTION 1-+ c rn v ! 36, ASSUMED TO BEAR N01 "16'38"W L J � z z u 00oZON I z I 3" l l 00"ZON A V1 L M" I. LAO"ZOS Q m y v I Z 'b8Z a�rn� I I = I i a - N Q Q . Lo I *2 Z L o LQ Q Q o u,I ti J 0 ca Z Z U) I �` I pq II "�� Q U< O a0 M N A I c g A - 'egg W �91g - - I I Z E u U Z (688 Zs I � R c � I M II SO co 9 II �' cl A I I d I Z o I 1 / p c j H *�590�5c% S00 59 L_ — — — — / N00 "39'51"W 273.81' CD o Q Q o0 o� ZM o 0 0 / W I $ �3 w r / 3 a M " ccZ Z Lu / L WEST LINE OF THE NW1 /4 N01 "16'38 'W 775.92' N01"1 6'38W 703.09' 5 00 N0 6'38"W 535.01' S01 16'38 E 606.36 V 8 �...._.. —.._.. W pdQ4 O 044 0 HT8@ D NO I E 1 1 w i �Y