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HomeMy WebLinkAbout040-1326-05-000 Wisconsin Department of commerce PRIVATE SEWAGE SYSTEM County. St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 617822 GENERAL INFORMATION Stale Plan ID No: Personal information you provide may be used for secondary purposes(Privacy Law.s.15.04(1)(m)I Permit Holders Name: City Village Township Parcel Tax No: DCCI Investments Inc 1:23k O T Y _) 040-1326-05-000 CST BM Elev: Insp.BM Elev BM Descriptk�n � t� , •' �q/Section/Town/Range/Map No: Nat- II1 ) r 17.28.19.2197 TANK INFORMATION ELEVATION DATA TYPE ! ox M�f .IFAIl12RE-t CAPACITY STATION BS HI FS ELEV. Septic �t�S� ` It Benchmark Dosi �1 I°O°7ea .fr�- Alt.BM Q rW 1O)•. f Aare- ( s 1 / Bldg.Sewer f - �.s'Z 94 `t3 Holdf St/HtInlet 571/ !S !n / St/Ht Outlet TANK SETB CK INFORMATION 443 51- TANK TO P/L WELL BLDG. Vent to Alr Intake ROAD DI Inlet Septic I + ` J-) 21 1 > 2 rf 'rn'v Dt Bottom Dosing J Header/Man. /_Ic Witt Aeration Dist.Pipe /// v 1 fl Holding �� Bot.System w„'1 2.,[ /.0 •olz, 93r73 1 Final Grade 3 ,` /,_I•RC/ -�?2 ry-) l PUMP/SIPHON INFORMATION .'f'j /�JQ `(� /brJ� Manufacturer Demand St CoverGPM . 90 lsO 051 Model Numbe TDH ILIR 'ction Loss System Head TDH Ft Forcemain Length Dist.to Well SOIL ABSORPTION SYSTEM ENCH Width ( Length I No.qt Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth WM 34eAc0, ff\\ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manym.r_ /2 !f r�-= INFORMATION c'�I` CHAMBER OR �{Z F'IYa�( Type Of S "`1 l J r 60 UNIT Modm u.,....r IA DISTRIBUTION SYSTEM /`a, ��C� 1 Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake r 11 Pipe( �.- 1 Lengttr ,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 ill Yes Q No U Yes E No 2 COMMENTS (InAclluude cod discrepancies,persons present,etc.) /Inspectyion#1: 2440 Lo Inspection#2: Ctrillion: MEADO oEEY BAY 5) [B....AD Wf!'l.�j2 ! c 6 pL .�QT. ac� (Vj�i- Y � t 1.)Alt BM Descriptiwa {� eve t• r� e.ti2.0. �sr t en . 2.)Bldg sewer length--`S- ft 6 • 1,Z% to a, bs� � k • ,. 4�a. -amount of cover= Z4 f .�.. _ ^ ��,1 .3)564 ow*c QR. � �) r,7/seer4 .4..�e. u.`U lee. to*' (a'4r `vr. Plan revision Required? ❑0 Yes l� No z/2 q 2 4 :r�'(7/ Use other side for additional information. ( -ld Date Insepctors Signature Cert.No. etatwZO 0.. V cS ( —2Pi 4 D/fs4 QC/s+wP. T7 SAN-a-goat, - G a3 �- ip ��II0•I �© County / Safety and Buildings Division ST CROIX FEB 04 2020 201 W.W hington Ave.,P.O. Box 7162 Sanitary Permit Number(to be filled m by Co.) l M n,WI 53707=7162 - � • I rq-SZz. St. L.ruix o rn.n nR A=•c1 G co • •s R 'ermit Applicati' • a - State TnmactiooNumber In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to the .,.. .. •r . . '..-. unit is required prior to obtaining a sanitary permit. Note:Application forms for state-owned POW are su... : to{project Address(if different than mailing address) the Department of Safety and Professional Service. Personal information you provide may be used for •- Q imposes in accordance with the Privacy Law,a.15.04(IXm),Stets. 405 MEADOW VALLEY V I. Application Information-Please Print AU Information Property Owner's Name Parcel r C0 f,Zg. I Q1 . 2/1.7) 040-13265-000 Property Owner's Mailing Address Property Location 1505 HWY 65 PO BOX 445 Govt.tot City,State Zip Code Phone Number NW ,i NW !i, Section 17 NEW RICHMOND WI 54017 (circle one) II.Type of Building(check all that apply) Vitt II T 28 N; R19 E a<is Ia 1 or 2 Family Dwelling-Number of Bedrooms 12 Subdivision Name Block 4 me-viAtcw A L I e O J y ❑Public/Commercial-Describe Use ..-------- ❑City of ❑State Owned-Describe Use CSM Number 0 Village of —._-- [it Town of TROY III.Type of Permit: (Check only one box on line A. Complete line B if applicabk) A. ew System 0 Replacement System 0 Treatment/Holding Tank Replacement Only 0 Other Modification to Existing Syst®(explain) B. 0 Permit Renewal ❑ Permit Revision 0 Change of Plumber 0 Permit Transfer to New List Previous Permit Number and Date Issued Before Expiation Owner IV.Type of POWTS System/Component/Device: (Check all that apply) (Igjion-Pressurized In-Ground 0 Pressurized In-Grormd 0 At-Grade 0 Mound>24 in.of suitable soil ❑Mound<24 in.anorthic soil ❑Holding Tank 0 Other Dispersal Component(explain) 0 Pretreatment vice(explain) V.DlspersaVlreatment Area Information: X T3 ' - Si t.MT.AQ 5, =( • s E. LZ . mt..) ti-attr } Design Flow(gpd) Design Soil Application Dispersal Area Required(sf) Dispersal (af) System Elevation Z -5b - 7 ro7-1. 1i2S 73. -0 VI.Tank Info Capacity in Total • M of Manufacturer Gallons Gallons Units "ca G Per �e � f) 1 g New Tanks Ex' Tanks /:Iii !!"« 111�1G u inn c.7 a Sepik or Holding Trek x 1600 1 WIESER X Dosing Climber VII.Responsibility Statement- I,the■■dersiped,assume responsibility for Installation of the POWFS shown on the attached plans. Plumber's Name(Print) Plumber's Si .'M/P/MPRS Number Business Phone Number PAUL R KOEHLER 1225410 715-244-2860 Plumber's Address(Street,City,State,Zip Code) 321 WISCONSIN DRIVE NEW RICHMOND WI VIII.County/Department Use Only �4pproved 0 Disapproved Permit Fee Da Issued I Agent Signature 0 Owner Given Reason for Denial S 5KJ. 6 Iota e IX.Conditions of roval/Reasom for Disapproval ,, �f(�l IOI r SYSTEM OWNER: �' •�` �� rSK ��•IT lD� 1.Septic tank,effluent filter and Lauri lac !53 G NKr& C . dispersalcell must be_se plan eed/ b alum �� g _`_ 6 nO as per management plan provided by plumber. , Me+Ss_ n_�`e� rtf�w0� 2.All setback requirements must be maintained C µVso► � le-a— Mt he-- as per appluCaDi*t(aQliAliiiMiligNai par Ue systewi a.d wbour to d e C sty Daly m r wing nag a vt s II laelw b due f e f pS Ca..`, b,t `a-► SBD-6398(R. I I/11) �" tI� P ,av4- ,a,e aQ (_ c&SIw-s' . eb-.\ 5) 1 roil) & S Mr" 4 R ^ a k 9c'COPY SYTEM ELEVTIO 93• 7o BENCH MARK 1 in BENCH MARK 2 98.71 SCALE 1=4oFT. SLOPE 6% LOT s MEADOW VALLEY Bench mark = A Boring = 0 3 0 I 1 well O 6,1.it ••• 5 BED HOUSE ." 7,6 3 75 ft tren ezfio •4c (�� r 600c•• •• • ank System eleva- ��► ase. don 93..70 y1 ;-placementA Polylock 525 filter (, SLOPE 6% 0 BM1 elevation 100 top of BM2 elevation 98 71 top of 2" pipe/7/ p P_.A*0-4( l�-sEM // CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: DCCI INVESTMENTS/RADFORD Owner's Name: RADFORD Owners Address: Legal Description: NW 1/4 NW 1/4 S 17T28NR 19W Township: TROY County: ST CROIX Subdivision Name: MEADOW VALLEY OF TROY Lot Number: 5 Parcel ID Number. 040-1326-05-000 Page 1 Index and tide Page 2 Plot Plan Page 3 System Sizing&Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test&House Plans Designer/Plumber. PAUL R KOEHLER License Number. 225410 Date: 01/28/2020 Phone Number (715) 246-2660 Signature Designed pursuant pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P(N.01/01). Page 1 MI I 93• ° SYTEM ELEVTION- BENCH MARK t f o0 BENCH MARK 2 98.71 SCALE t=4oFT. SLOPE 6% LOT 5 MEADOW VALLEY Bench mark = Boring = 3 well 0 5 BED HOUSE 4.2 3 75 ft trenches ez flows Wieser 1600 combo sep r "•......_ tank System eleva- fb7' tion 93..70 \ 'A Polylock 525 filter SLOPE 6% ' ~ BM1 elevation 100 top of BM2 elevation 98.71 top of • / 7vcP1P/ // SOIL ABSORPTION SYSTEM DETAIL I GRAVELLESS LEACHING UNIT P.gel a 1 project Name: RADFORD 3 No.of Cells 7.5 Per Cell 3 ft Cell width 22.5 Total No of ez flows 75 n Cell Length 375 sq it EISA Per Cell 3 n Cell Spacing 1125 sq it Total EISA Manufacturer slodN Laying Length EISA Rating IrAllrafor Q1203H-5r 25.0 5.V Q1203H-10n 10.0' 50.0 Graveness Leaching Unit Manufacturer ez flow Graveness Leaching Unit Model: ez 10ft and 5 ft Typical Cross Section Finished Grade ft Observation Pipe with approved cap or vent 30 Soil Backflll'� n .::.:;.: :::: .:;,c. ;.x> .::<>••, ;.:.::..: Geotextile Fabric -° , it Infiltrative Surface 121n LI G •J / , R Limiting Factor .70 In Slotted and Anchored Vent/ Observation Pipe with Cap • Plumber/Designer Signature: ucenae e: 225410 Date: 01/28/2020 � I 1 7 7:1111 ) 11 r I�II \ \ I1 T1 al I in: M�- I I- -I 1 . , 2 = vV) NJ mT C.JI r m C n D ?I - 1 A O D D i T •F :I_ I Z �� 4. _lO :�/ / � 0 0 g m =_ - m D 1 'i _ - •i I A% / C I •, _ T � -0-, -0 e - — -I J:1 -1 , ? \ - - _ o m - m -0 T _ _- - - O m D % n /////%////D4, _ 0 • POWTS OWNER'S MANUAL & MANAGEMENT PLAN • Page I of Z FILE INFORMATION SYSTEM SPECIFICATIONS Owner D D/ C= /MU@'RTsM Septic Tank Capacity 1600 gal 0 NA Permit S 62 I -f 0 . Z �'" Septic Tank Manufacturer WIESER 0 NA DESIGN PARAMETERS C� Effluent Filter Manufacturer POLYLOCK ❑ NA Number of Bedrooms 5 ❑ NA Effluent Filter Model 525 ❑ NA Number of Public Facility Units Xi NA Pump Tank Capacity gal Q(NA Estimated flow )average) 500 gal/day PumP Tank Manufacturer X NA Design flow (peak), (Estimated x 1.5) 750 gal/day Pump Manufacturer t NA Soil Application Rate .7 gagdayntz Pump Model X1 NA Standard Influent/Effluent Quality Monthly average• Pretreatment Unit X NA Fats, Oil & Grease (FOG) 530 mg/L 0 Sand/Gravel Filter 0 Peat Filter Biochemical Oxygen Demand IBODe) 5220 mg/L 0 NA 0 Mechanical Aeration 0 Wetland Total Suspended Solids (TSSI 5150 mg/I ❑ Disinfection 0 Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) 0 NA Biochemical Oxygen Demand (BON) 530 mg/L Min-Ground (gravity) 0 In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L 0 NA 0 At-Grade 0 Mound Fecal Col'rform (geometric mean) 5104 cfu/100m1 0 Drip-Line 0 Other: Maximum Effluent Particle Size Ye in dia. 0 NA Off: 0 NA Other: 0 NA Other: 0 NA 'Values typical for domestic wastewater and septic tank effluent. der 0 NA MAINTENANCE SCHEDULE Sella Event Service Frequency At least once every: ❑ month)*) (Maxdmum 3 years) 0 NA Inspect condition of tank(s) 3 armies) Pump out contents of tanklsl When combined sludge and scum equals one-third IY') of tank volume 0 NA Inspect dispersal cell(s) At least once every: 3 ❑ monthle) (Maximum 3 years) ❑ NA ❑ month(*) Clean effluent filter At least once every: 1 e I P4 year(*) 0 NA Inspect pump, pump controls & alarm At least once every: ❑O month I(NA •❑ monthtsl Rush laterals and pressure test At least once every: ❑ year(*) m NA 0 month(s) NA Other: At least once every: ❑ year(*) Other. X) 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 cellist 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 IYJI 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 of v 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 cellist. If high concentrations ere 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 cellist 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 property end 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 fails and cannot be repaired the following measures have been, or.must be taken, to provide a code compliant replacement system: Z"' 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 end 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 pt� technology a holding tank may be installed as a last resort to replace the failed POWTS. • alu • 'Pko erg tank ( ai Di-1811Ea ¢bR-/jQ� CotvSTKtWCt prJ nillY— ❑ 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 COUNTRYSIDE PLUMBING AND HEA-ING Name PAUL R KOEHLER Phone 715-246-2660 Phone 715-246-2660 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name DARRLES SEPTIC Name —• CAD l}L LDUh. 2-0.rtl i&k1 - Phone 715 426 1025 Phone -1/S- 3176,0- 4•7f1 1 a This document was drafted in compliance with chapter Comm 83.22(21Ib)(111d)&(f)and 83.54(1), (2) &(3),Wisconsin Administrative Code. ST.CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer DCCI INVESTMENTS LLC Mailing Address 1505 HWY 65 PO BOX 445 Property Address 405 MEADOW VALLEY BAY `v (Verification required from Planning&Zoning Department for new construction.) City/State HUDSON/WI Parcel Identification Number 040-1326-05-000 LEGAL DESCRIPTION ( •L$ • 1'q , /qV /s, Sec. T N R W,Town of TROY Property Location `/. , ' Subdi�isionplat:MEADOW VALLEY OF TROY mot# 05 Certified Survey Map # ,Volume , Page# ^� Warranty Deed # 5,7 p,�� (before 2007)Volume . Page fl Spec house Oyes(2110 Lot lines identifiable(]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§SPS. 383.52(1)and in Chapter 12-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 I/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 Safety And Professional Services 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. Uwe am/are the owner(s)of the property described above,by virtue flfa warranty deed recorded in Register of Deeds Office. Number of bedrooms 5 ✓ (\a(C laar` ` SIGNATURE OF APPLICANT(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.04/12) I I 7/7•2 1"))(r/". .......,ss\ 0 L Fy B A 1 LEGEND __- • WIRE FLAG SET / ' -- • WOOD HUB SET AT OR IS'OFFSET OR �-� ON BUILDING EXTENS ON /// .P .O *I - - O DRAINAGE DIRECTION / / \/� T. .•IOOLAI � • FOUND MON MONUMENT / / I/ SETBACK LIE // / I DRAINAGE AND UTILITY // I EASEMENT // / I / —--—--— DRAINAGE EASEMENT SCA�EMDt1N IM / I I ENT RANCE TRANCE i1 / LOCATIONU 1S SO / 4F l NOTE- / MI • FRONT AND SIDE SETBACKS ARE / •v SHOWN PER THE APPROVED AND // ` I RECORDED PLAT OF MEADOW / J ELEVATIONS SHOWN ARE NAVE/196E DATUM. VALLEY. / / PRELIMINARY / 'ja• . FOR REVIEW / 1 ►AosfB // T.O.N. x. SITE ADDRESS: r� JOOLIO � a ; _ OMIIWM X11 405 MEADOW VALLEY TRAIL / \ - ��-.` HUDSON,WI 54016 ; _' \ ' 26.5' • • / / -• • •� 0.11.410LI0I 1 0 \` ,QT I III a .• ',T'T ACM RI FT 9�'" / I \ \ 1 588'35'33'W — — —— _-- -- a - i _ C- __ -_ -_i-_ - _TA.►. TA.►.,100L10I -———7TE 110.Oa - - -_ //�__ -__ __-- pRlOT1 -- -_ -_--_- - �i yy�� OIfB S►AC[ i i �r� _ / 7Nw a 1 DERRICK CONSTRUCTION (.1 .v... �F LOT 5 MEADOW VALLEY (RADFORD RESIDENCE) \'I _.. 1 TOM OF war woo r+...� "•� • ON MINIONVIMM, Mr WO ter• a . STAKEOUT PLAN ArKwBIYrfINdlls VAlallBrryq ��*' re w /' • 65i05 3 1 P 591 KATHLEEN WALSH REGISTER H. DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 01/14/2005 01:00PK LIMITED WARRANTY DEED WARRANTYT DEED Document No. REC FEE: 17.00 TRAMS FEE: 3900.00 This Deed made between VALLEY LAND COPY FEE. CC FEE: COMPANY,a Minnesota corporation,Grantor and PAGES: 4 DCCI INVESTMENTS,LLC,Grantee Witnesseth,That the said Grantor conveys to Grantee certain real estate in St. Croix County,State of Wisconsin,legally described on Exhibit A hereto (the"Property"), Together with all and singular hereditaments RETURN 03'���d q and appurtenances thereunto belonging, - retaining,however,to Grantor an easement as set forth in Exhibit B hereto; This conveyance is without warranty, Tax I.D.: Op ••/(,f-/O'006 except Grantor covenants and represents the G yd -/ab 8-90-o0 0 Grantor has not made, done, executed or suffered any act or thing whereby the above- described property or any part thereof,now or at any time hereafter, shall or may be imperiled,charged or encumbered in any manner, and Grantor will warrant title to the above-described property against all persons claiming the same from or through Grantor as a result of any such act or thing, provided, however, that the conveyance hereby made and the warranty of Grantor is further limited by and subject to those matter set forth on Exhibit C hereto. Dated this day of January,2005. VALLEY LAND COMPANY, A Minnesota corpo 'on • Its: Roger D. Bevers ACKNOWLEDGEMENT Notary Public State of Wisconsin STATE OF ) /� /��/1 ;SS COUNTY O !'�(. Personally came before me this13 day of January, 2005, the above named Gary B. Valley, as President of Valley Land Company, a Minnesota corporation, having full authority to do so and to me known to be the person who executed the foregoing instrument and acknowledged the blue, State o y mmi ion�Y� pres): /p*", ! 7 31 P 5 9 t 122704 LEGAL DESCRIPTION/INVESTMENTS • EXHIBIT A PARCEL C SE % OF NW% OF SECTION 17, TOWNSHIP 28 NORTH, RANGE 19 WEST; TOWN OF TROY, EXCEPT PART OF PARCEL DESCRIBED IN THE LAND CONTRACT RECORDED IN VOL 1170, PAGE 26 A.S DOC. NO. 541630 AND • NW % OF NW V4 OF SECTION 17, TOWNSHIP 28 NORTH, RANGE 19 WEST, TOWN OF TROY, ST. CROIX COUNTY,WISGONSIN. EXHIBIT A P _a `.\ ',• r 1 I IIIIIIIIl11Il, 1 tI. �' tFlHllftllfl EBB e > e — J• EN 1 IIIIIIpellingOAN 1 0� r Y O vise J. 1 )>:. 1Lkie:f�Eii�Eie� f r Itiii iii;il s = ycll Icc"nu } e.cic ilipcR lrelc ir•I`•e_,` III III �' I / I1 II �A e c�. mil. _ ell' €i1�IR MIIII ,Ic e•,_�•1_ Cti _ cR PC 1 leek IccllccllccICIt .IR� •R•,IcI,lcl•Ic. MLR� 1 VI /AI\\ •Icicic1Lll1tlltri — ki. b .: iRl yyI_ [ y i i� I I�Ieele�R;ss / } We.le..NM y . 11 ..J• X O n 0 cn 4 c n ,_. �D a DERRICK HOMES 715-246-2320 -:',!:1`...;.,-..-_� ��� a a r11141 RADFORD RESIDENCE S :, 114: I e• LOT 5, MEADOW VALLEY _ _ ir IU 11 d1 F. HUDSON, WISCONSIN ! Il �I __ \ ' ,\A MAMMY I • MN MN , gal ill ,� iq ip� 4if i ill � is i �; I tei `� .i E a .� aII' A . A - li �� Till 1/1 I I :�� I 4ili ;ii '!tjr' I # i 1 I: I ix 1i EEl Eli ; 1 ; ROI i 1• R �1 1. i • Ill I1 E II a I x J , _ 0 b.4Wat , wo b b .---i .i A=3ii E 1 7f l -- : lilt ,! ._. �T --—_P _ - — I - ' i E ii a i 91 /1 NI . ...--iilli tv *—k-1 ip IL 1 , L i y ^41 i —t 11 ....—--- ' n O En 4 C illitamamp- rs_LEE E 1 I 'Mil DERRICK HOMES 715-246-2320 _ :ai�tG :I A' RADFORD RESIDENCEs� y_ - � qte ¢ a t LOT 5, MEADOW VALLEY i 1 1, HUDSON, WISCONSIN ^` ii� P 4i) -- 1 I i t !. ,,,, 4 It 4i� t v I t � Lam. _. i .. O t t �' '"_ • I ,-., • ~cii ,„%ri . ,.., • • t t —. ... ... N t Paa N 03 _�: . ] i PI 0: ; , :i : NI„ 1 1 1M 4ii 4 t . ,_,J, 1 _.. 211 ilk . 1 x to .sWx t 1 -�i b =y � .�. v mod. }� .�. cn 0 y 2 w ,.c v o — , .r 44 0 A n 0 2 y k C n 0 IJ,) [pi DERRICK HOMES 715-246-2320 ,`.-;;,�r�:, hits i RADFORD RESIDENCE . ^— w ' �, R HUDSON.MEADOW CONSINIEY ' --�'r , �F iml P I �I! so , lk to \ E4AT 4.1.• 1 > n' t -L .1 irl awli_ • I: o 42 Ni c [ .1 I # s H - I. t al e R RI I ie§i JI k- 1 • oi • Al Al ma ow II o �, fff 1: c • ...i. ,-- ` a b El --.1—. --I y ,s CI y R i 4 .I a a a O I C R i Is a II- 1 c n o d =- 1119 DERRICK HOMES 715-246-2320 , .„X' �_ imp I a :I s o RADFORD RESIDENCE _J M,_^. Ida a 1 a LOT 5, MEADOW VALLEY - . t I CA if i ` FrHUDSON. WISCONSIN '`' I �' \-1' 1 —7... III. ;41 I , , , 1 1111 liji, -,. . \ r . $. 0 1 ��,I+ :a flhi"1 . i , .,,,. oN _ ov ,. __. jj—[ ',±' I I I 1 111 a If r . !r rr �r it . u _ �■uo..!!. rrn .a_s..n I 1 ! �. u al_ ill 1 .". r - r : � II iiI 4Tt..11, 1 �,_ IJIlII1111111l1mUIIIIIIIIIIIIIIIIIIL4o111,i11:11111 11 _�- 1 , t,,, ,..: ,.. . o } 1111111' b� , . r o ' - I y - " F- _ IIIIIIIIIIIIIIII, ny y '—llrr■ry ti LA! I! I1! 11 DERRICK HOMES 715-246-2320 - r RADFORD RESIDENCE 7r-� LOT 5. MEADOW VALLEY t ' 11I $ . HUDSON. 4ISCONSIN i II 49,538 SQ. FT. 47144 / 4 / 71- (ONT.0P 1137AG �,� Y io L..8.O.-862.40 44 c, . p � � - - .� , �� G __ Q 9 , ,.... pip 4_• .�. IP '0� 4641 by L C1� •/ C8 ' / • I 0. 1 • r 4 6 > ''s �, / 1 I 44 30 SI 60,531 SQ. FT. / 0°� / _ { ,3 1.390 AC. �, 1.018 AC / A / I ..4 { 111, � to `' / k / o� /4 / { \12,� gyp. • - 48,874 SQ. FT.%Nov i/ // 1.122 AC. 1 1 ‘ / / { 5' / / 125 2 1 _ _ 918'35'33"W _. 1 - �- 2S7 0- 81.16' ea $ D ,N �' Pfr5 Carr - / a • 60.0o' 4`. N88'35'33"E - .64' 1' 'LOT 1 triOPEN SPACE — 0 c..-r`°r ( _ °P ". sp ;,...,W, ., E1VE[� PAID r .. SOIL ALUA11OW REPORT 01744 ',Is Safety Page 1 of 3 and 1 O j l: in accordance with Comm 85,Wit.Adm.Cods e - Professional 1 Schmitt Soil Testing,Inc. •, - . C s UNTY County Attach complete site plan on giiipi e�i;� pfplaNifiches in size. Plan must St.Croix include,but not limited to - -rence point(BM)•direction and parcel ID- O percent slope,scale or nsions,north arrow,and location and distance to nearest road. Please print all information. R • I'' A pnp�y�,,t�77�w Personal mfonnatwn you provide may be used for secondary purposes(Prnaoy Law,a.15.04(1)(m)). 174 _ 1�'/—✓ i y/�Z/� Property Owner Property Location //( DCCI Land Planners Govt.Lot NW1/4,NW1/4,S17,T28N,R19W Properly Ownat's Mailing Address - Lot i B MN lock• Subd.Name or CS 1505 Hwy 85 P.O.Box 445 5 I Meadow Valley Of Troy City Stab Zip Code Phone Number U City ❑Village ❑ Town Nearest Road New Richmond i WI i 54017 1 Troy 1 East Cove Rd 0 New Construction Use. ® Residential/Number of bedrooms 4 Code derived design flow rate 600 GPD ❑Replacement ❑ Pubic or commercial-Describe:DeesQ // _ 1' �u �� Parent material Outwash Sand ��—` /,vu Flood lain elevation,if applicable •NA ft. General comments Area is suitable for a conventional system with a 0.7 gpd/sgft rate. Possible system elevation for Area 1 is 93.3'. Slope Is 8%.B and recommendations: 1 2 T/iet (,.r�r M4 l -141 f/�� r Att4 l(h e Sr 5 uck Li Boring "( /4'T 10 N ( r/ D &Ms 1 Borne ❑Pg Ground surface elev. 97.55 _ft. Depth to limiting factor 110+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPI' In. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eat 'ElB2 1 0-13 10yr3/2 none I 2mgr mvfr as lvf 0.6 0.8 2 13-26 10yr4/4 none sd 2fsbk mfr gw lvf 0.4 0.6 3 26-35 7.5yr4/6 none Is lcsbk mvfr gw lvf 0.7 1.6 4 35-110 10yr6/4 none grs Osg ml — — 0.7 1.6 2 Ban]* ❑Boring El pit Ground surface etev. - - 97.30 ft. Depth to limiting factor 112+ in. Soil Application Rate Horizon Depth Dominant Color ' Redox Description Texture Structure 'Consistence Boundary Roots GPD/R' et. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. 1 'Ent 'EI2 1 0-12 10yr3/1 none sit 2fsbk mvfr as lvf 0.6 0.8 2 12-25 10yr4/6 none sid 2msbk mfr gw 2vf 0.4 0.6 3 25-30 10yr4/6 none grsl 2msbk mfr gw lvf 0.6 1.0 4 30-37 7.5yr5/6 none gds QJ ml gw — 0.7 1.6 5 37-112 10yr6/4 none grs 0sg ml — — 0.7 1.6 .04— °13.70 'sys r..? Pe, - . 413.z 9• 4 •Effluent#1 =BOD5>30<220 mg/L and TSS> < 150 mg/L *Effluent 02=BODs<30 ng/L and TSS<30 mgll. CST Name(Please Print) Sg eture: CST Number Thomas J. Schmitt 227429 227429 Address Schmitt Soil Testing,Inc. Date Evaluation Conducted Telephone Number 1595 72nd Street New Richmond,WI 54017 5/5/2014 715-760-1978 SBD-$330(R ab00) Property Owner DCCI Land flamers Parcel ID#__. Page 2 of 3 D Boring# j f Boring Pit Ground surface elev. 99.60 ft. Depth to limiting factor 116+ M. Soil Application Rate Horiiaon Depth Dominant Color Redox Description Texture Structure 'Consistence Boundary Roots GPD/R' it. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. •EJNI TAM 1 0-16 10yr3/1 none ail 2mgr mvfr as lvf 0.6 0.8 2 16-27 10yr4/6 none sd 2msbk mfr gw lvf 0.4 0.6 3 27-42 7.5yr5/4 none sl 2msbk mvfr gw — 0.6 1.0 4 42-48 1Oyr5/4 none vgroos Ogg MI CS — 0.7 1.6 5 48-116 10yr6/4 none s Osg ml — — 0.7 1.6 Q.,f- 93. 40 S ye. . . • . o s7 i 04 , ❑Boring Boring# npit Ground surface elev. ft. Depth to limiting factor- in, Soil AppYCatlon Rats Horizon Depth Dominant Color Redox Description Texture Structure 1Consistence Boundary Rods GPO/Rs in. Munsell Qu.Sz.Cont.Color Gr. Sz.Sh. *EMI •En112 Bonng Boring# Pit Ground surface elev. ft. Depth to limiting factor lo, Soil Application Rate Horizon Depth f Dominant Color Redox Description Texture Structure 'Consistence Boundary Roots GPD/ft in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. 1 VI VI I VON Effluent#1 =BOD5>30<220 mg/L.and TSS>30 c 150 mglL •Effluent#2•BOD5<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. SBD-83301R Ov00) SdnNt Sol Testing,Inc. - Page 3 of 3 CSetictiitbj — - - - -CO.dseiedl'on Schmitt SoilTesting,1nc.. . __Name: DCC1 Lsall Ptm.r, Thomas J. Schmitt, CST 227429 Address: 1505 Hwy 65 1595 72hdSL--7— -- - City, State, Zip: New Rie-imb d jl New Ricdmopd.WI54017 ------ --- ------ ------- Phone: 715- t3 -1976 Subdivision: Meadow v iey Of Troy s,a,r.. Lot-No. : 5 Dee — — Y Legal Description=NW114-NW1/4S11-USNJU'9V1t-------- - --- - -- Backhoe Pit ' Township, County: Tro_y Tow ip,St.Croix Coi sA - Benchmark 1 El.100.V Top o�r C pipe. Pfu�� Bench Merle 2f1. 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