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Home My WebLink About020-1491-02-000 (2)Safety and isiConxnerce PRIVATE SEWAGE SYSTEM Salary antl Budding Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes IPrivacy Law. s.15.04 (1)(m)) Permit Hold Name: City Village w Tonship Matthew Lardinios CST 8M Ele TOWN OF HUDSON __ 1 TANK INFORMATION TANK SETRACK INFnoW1ATInu TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION vvri- r,oavrcr 1 IVfV QT j I tM BED/TRENCH Width Length No. Of Trenches DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL INFORMATION _ _ DISTRIBUTION SYSTEM SOIL COVER x Pressure Systems Only Depth Over Depth Over Bed/Trench Center BedlTrench Edges COMMENTS: (Include code discrepancies, persons present, etc Location: 859 CRANE HILL TRL 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? I Yes No Use other side for additional information. SBD-6710 (R.3/97) Date ELEVATION DATA Inlet Bottom CHAMBER OR UNIT Hole xx Mound Or At -Grade xx Depth of Inspection #1: Insepcior's Signature xx h Yes No Inspection #2: to Air Yes No Can. No. 5c. CID,)( oIeyA tinent of Safety ssional Services, Services Division 'amtafy Permit Application In accordance with SPS 383.21(2), Wis. Adm. Code. submission of this form m the appropriate governmental unit u required prior m obtaining a and senitary pemtit Note Application forms for swoownedthe POWTS are submitted m PIP' m maccordancof e with the Privacy pros Services. Peraaxl info'sumi you provide may be used for secondary acy LaW. s. IS OalIYml Crr. Lard1nioLxtj4j-D9I& 4MbIfoo is Hudson Wt 1 54016 Lot N 0 1 or 2 Family Dwelling— Number ofBedroomu 4 2 ❑ Public/Commercial — Deacnbe Use Bkncic N 0 State Owned — Describe Use s,¢,V - 20.2,3-6+1 '%T CROIX musty Permit Number (m be filled in b T?Z11) ?" CRf -OC— if ILL MCI N 020-1491-02-000 Govt. W 29 ❑ City of 0 Village of 0 Town of Hudson 13 Il0 New system ❑ Rephscenterd System ❑ 011W Modification m Exixi s xem e n8 Y (xplain) ❑ Additional Pretrcatmenri Unit (explain) B. ❑Holding Tank !n•Ground ❑ At -Grade ❑ Mamd ❑ Individual Site DesO Other Design Type (Main) C• ❑Renewal Befon; ❑ Revision ❑ Charnge of Plumber ❑ Transfer m New Owner Permit Number and Dace (cued Expiration 7 --- --^ �+v +ltapo PLIea r4o 857 900 Tarrk Information minty m Total N of Manufacturer dons Gallons Units o New Tdu Esieue`Tadu iaptio w Holding Tank X •nrn t.21 PAUL R KOEHLERJmber's Address (Brat, City, State, Zip Code) WISCONSIN DR NEW RICHMOND 54017 Mi Approved I ❑ SC� 0 .v nor Denial Conditions pprov ..tarfr�iaa 3/ M OWNER: 1 Septic tank, effluent filter and dispersal must be serviced 1 maintained as per management plan provided by plumber. 2. 1 setback requirements must be maintain aes sY A b , r Mper ant Ire &nM Ill a i 1 laeaer�y�--+--� ;J� f- tox SBD-6399 (R. 0322) 225410 y 91.9 rwarEl a e X 77ITS-2 one Number s-2r�n a ; ■ OP*4 f ' jsr/P •# W ctonc Lotl Mro cw Low); nio3 Pr 010 -1 yll-01-o0o SC41c. F GoPY CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Matthew Lardinios Owners Name: Owners Address: 859 Crane Hill Hudson Legal Description: 1/4 1/4 sec 13 t 29n r 19w Township. Hudson County: St Croix Subdivision Name: Crane Hill Lot Number. 2 Parcel ID Number. 020-1491-02-000 Page 1 Index and title Page 2 Plot Plan Page 3 _ System Sizing & Cross -Section Page 4 _ Fitter 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: � �J License Number. Date:, 'igr Agg Phone Number Signature Designed pursuant to the In -Ground Soil Absorption Component Manual Tor POWrS Version 2.0 SOO-10705-P (N.01/01). Page 1 i log w c<ory Hill Loll ` vn j�t tJ A l OS PT 030 -1 Y11-01-oco Scalc- I" � ►��ee S�-e-� :� E Roe 531. -4� It ,� Fi SOIL ABSORPTION SYSTEM DETAIL / GRAVELLESS LEACHING UNIT P•s•_w_ Project Name: 2 3 90 3 Matthew Lardinios No. of Calls 9 Per Coll fi Cell Width 18 Total No of 10 It Call Length 50 sq a EISA Per Cell n Cell Spacing 900 sq n Total EISA InMrator EZ12031-1-511 5.0' 25.0 ez12031+10n 1of 50.0 Gravelless Leaching Unit Manufacturer. infiltrator Gravelless Leaching Unit Model: loft Finished Grade ft Plumber/Designer Signature: Licenser: 225410 Typical Cross Section A Observation Pipe with approved cap or vent Sofl Backfill Geotextile Fabric 4 n Infiltrative Surface rt Limiting Factor ' Slotted and Anchored Ventf Observation Pipe with Cap ............................................... Date: feb6th nneaA OlMdan of PoyloA ht. PL-525 Filter PL-525 Effluent Filter The PL-525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok PL-122, the Polylok PL-525 has an automatic shut-off ball installed with every filter. When the filter is removed for cleaning, the ball will float up and temporarily shut off the system so the effluent wont leave the tank. Features: • Rated for 10,000 GPD (gallons per day). • 525 linear feet of 1/16" filtration. • Accepts 4" and 6" SCHD 40 pipe. • Built in gas deflector. • Automatic shut-off ball when filter is removed. • Alarm accessibility. • Accepts PVC extension handle. PL-525 Installation: Ideal for residential and commercial waste flows up to 10,000 gallons per day (GPD). 1. Locate the outlet of the septic tank. 1/16" Filtration Slots 2. Remove the tank cover and pump tank if necessary. 3. Glue the filter housing to the 4" or 6" outlet i If Accepts 4 e" pipe. SCHD 40 pipe the filter is not centered under the access opening use a Polylok Extend & Lok or piece of pipe to center filter. 4. Insert the PL-525 filter into its housing. 5. Replace and secure the septic tank cover. PL-525 Maintenance: The PL-525 Effluent Filters will operate efficiently for several years under normal conditions before requiring cleaning. It is recommended that the filter be cleaned every time the tank is pumped, or at least every three years. If the installed filter contains an optional alarm, the owner will be notified by an alarm when the filter needs servicing. Servicing should be done by a certified septic tank pumper or installer. 1. Locate the outlet of the septic tank. 2. Remove tank cover and pump tank if necessary. 3. Do not use plumbing when filter is removed. 4. Pull PLG525 cartridge out of the housing. 5. Hose off filter over the septic tank. Make sure all solids fall back into septic tank. 6. Insert the filter cartridge back into the housing making sure the filter is properly aligned and completely inserted. Replace and secure septic tank cover. 9 Outdoor SmartFilter® Alarm Polylok, Zabel & Best filters accept the SmartFilter%switch and alarm. Alarm Switch (Optional) Accepts 1" PVC Extension Handle Rated for 10,000 GPD 525 Linear Ft. of 1/16" Filtration Slots CortMed to NSF/ANSI standard 46 Gas Deflector Automatic Shut -Off Ball Extend & LokTM Easily installs into existing tanks. Polylok, Inc. 3 Fairfield Blvd. Wallingford, CT 06492 Toll Free: 877.765.9565 Fax: 203.284.8514 www.polylok.com 4" CAST -A -SEAL TO MEET 10'-0}' FILTER OR - BAFFLE -------------- WLP1250-MR TANK SPECIFICATIONS DIMENSIONS: WALL: 2 1/2- Borrow 3" 4" CAST -A -SEAL COVER: 5" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 52 1/2" LENGTH: 10'- 0 1/4" WIDTH: 7'-0" BELOW INLET: 41" LIQUID LEVEL: 36" WEIGHT: 8.810 LBS. INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN, SEE DETAIL /f0 (OTHER STATES SEE CHART) UQUID CAPACITY. 34.81 GALAN HOLDING TANK: OUTLET HOLE PLUGGED ACTUAL CAPACITY: 1.323 GALLONS OUTLET 1 I � � I I LOADING DESIGN: 8'-0" UNSATURATED SOIL TANK CAN BE USED AS: SEPTIC / HOLDING / PUMP OR SIPHON COVER: MIX DESIGN /8 (NO FIBER) TANK: MIX DESIGN j10 (STRUCTURAL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE REVIEWED BY REVIEW DATE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: a OF / j C S1, 2011- 19? wisoottsgL Commerce SOIL EVALUATION REPORT Pale 1 or-x—q IN ancadamoe whir cam. tS, Wis. Adm Code - Attach sac plan on papa am Ieu then ti % a I I inches in size. Phe emu Coroty St. Croix tinned to: vutical and Uodm W rd mhoe post (Btu. dneation u d I.D. $EP C , or dimanwm north prow, and BM referenced to ap M j i) 1 - i Uto1X p�lrT Please Print all laroruadnw 1' M Dee letrWpmvi& may he aced for secondary papa F4PR2XV071 GY4 / /$ Rolling Ridges LLC. .w... La v4 u s 3 T N R 19 w Property Owner's Mob% AM= La a 1111odif &let Name a CSA4t %5 Alexander Rd. 2 rAxc,' 1 City sure zip code Phone O City ❑ Village 0 Town Nearest Road Hudson W1 54016 651-248-0390 Hudson Alexander Rd. 0 New Construction Use: 0 Residential / Number of Bedrooms Code derived design flow nun GPD O Replacement 0 Public or Commercial — Describe: Parent Material loess over Outwash Flood Plain elevation if applicable N/A ft. General comments and. ecosoendatimm: hkmH the system in the third horizon. 26%4 .7C JBoring # 0 Pit' Ground Surfi►ce Elevation 99.9 fL Depth to Limit6ug factor > 110 m Sol Ilaizon Depth Dominaru Color RWmc Duo"M - Texture Stnichn Conshtanom ml Boundary gs Rook 3f Qpw 'EMI 0.7 'EM2 1.6 1 0-10 10YR312 GRLS 0-ap 2 1053 7.6YR4/4 - GRS O-W ml gw 2f 0.7 1.6 3 53-110+ 10YR4/4 S 0-e61 ml - 0.7 1.6 4 O 8 M Bwing ® Grand Surface Elevation e% 41.44 ft. Depth to Limiting factor > IOG in. Monaco Depth Dominant Color Redw Daacrow Teodwu structure C insisWice Sevedwy Raft ap, we 'EW1 Tan 1 0-10 10YR312 - SIL 24-gr muff gs 3f 0.6 0.8 2 1049 10YR4/4 - GRS 0-69 Ma gw 1f 0.7 1.6 3 39-105+ 10YR4/4 - S 0-49 rd - - 0.7 1.6 1 n5 0.t 1 S4 esll i •• `w , . or • Effluent el - DOD,> 30 < 220 me/L and TSS > 30 5150 mr/L • Effluent e2 - BOM < 30 nrfl. and TSS < 30 aa/L CST Name (Pkme Print) Siprsase CST Number Mark Iverson 22: rC 46672 Add= Dow Evaluation Co duacd Telephone Number P.O. Box 155 Hammond, WI 54015 August 30, 2017 715-796-5664 Property owner Rolling Ridges LLC. Lo / 2, Page 2 of � p goring ✓ 3 Boring # �� Ground Surface Elevation 98.6 ft. Depth ro Limiting factor > 105 in. SO Apolli RAM Mormon DqM Do n wr t Color Radox Deacrodon Taxwm Sbuelum CariaMnea Boundary Roft GR 'em 1 0-12 10YR312 - GRSL 2-f-bk Mfr pe 3f 0.6 1.0 2 12-42 7.5YR4l4 - VGRS 0-69 ml yea 2f 0.7 1.6 3 42-105 10YR414 - GRS Ogg ml - - 0.7 1.6 :J • EfFluent N 1 - BOD,> 30 < 220 mg/L and TSS > 30 <_ 150 mgA. • E0luent N2 - BOD$ <_ 30 mg/L ud TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you new assistance to access services or Need material in an alternate format, please contact the departrncnt at 608-266-31 S 1 or TTY 608-264-8777. • EfFluent N 1 - BOD,> 30 < 220 mg/L and TSS > 30 <_ 150 mgA. • E0luent N2 - BOD$ <_ 30 mg/L ud TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you new assistance to access services or Need material in an alternate format, please contact the departrncnt at 608-266-31 S 1 or TTY 608-264-8777. POWTS OWNER'S MANUAL & MANAGEMENT PLAN FILE INFORMATION F0wn&r=,1UL111VVV Lardinios i Number of Bedrooms Number of Public Facirrty Units Estimated flow (average) Design flow (Peak), IEatimated x 1.51 Soli Apprrcation Rate Standard Influent/Effluent Quality Fats, Oil & Grease (FOG) Biochemical Oxygen Demand IBOD,) Total Suspended Solids ass) Pretreated Effluent Quality Biochemical Oxygen Demand (130[y Total Suspended Solids (TSS) Fecal Co)'rform (geometric mean) Maximum Effluent Particle Size 4 400 600 Septic Tank Capacity Page ! of Z Septic Tank Manufacturer WIE R crmisnt Filter Manufacturer POLY LOCK ❑ NA Effluent Filter Model 5Me jl NA Pump Tank Capacity aUd :Purnp Tank Manufacturer sl/day p Manufacturer Monthly average* — S30 mg/L 5220 mg/L ❑ NA 5150 mg/L Monthly average 530 mg/L 530 mg& ❑ NA 5104 cfu/100m1 Y. in die. ❑ NA ❑ NA `Vak m typical for domestic wartewater and septic tank offNrnt. MAINTHMNCE SCHEDULE Samice Evem Inspect condition of tank(s) At bast once every: PUMP out contents of tank(s) Inspect dispersal cellls) Clean effluent filter Inspect pump, pump controls & alarm Flush laterals and pressure test Pump Model Pretreatment Unit ❑ Sand/Gravel Filter ❑ Mechanical Aeration ❑ Disinfection Dispersal Collis) Q In -Ground (gravity) O At -Grade ❑ Drip -Line ❑ Peat Filter ❑ Wetland ❑ Other: ❑ NA ❑ NA ❑ NA ❑ NA Ot NA ® NA 10 NA JD NA X NA ❑ NA ❑ In -Ground (Pressurized) ❑ Mound ❑ Other: (Maximum 3 years) When combined sludge and scum equals one-third (y,) of tank volume At least once every: 3 At Batt once every: At least once every: At least once every: At least once every: Service 3 ti ❑ NA ❑ NA ❑ NA ❑ NA ❑ NA IR earfi (Maxmum 3 yeam) [INA � � ❑ monthlal 4i year(a) ❑ NA ❑ month(s) Q_year(sl ❑ monmis) ❑ YWe) ❑ month(s) ❑ year(s) jf7 NA — Q NA — M NA MAINTENANCE INSTRUCTIONS Q NA Impactions of tanks and dispersal cells shall be made by an individual carrying one of the following licensee or Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector, POWTS Maintainer Se to eg certifications: inspections must include a visual inspection of the tank(s) to identify p g Servicing Orator. Tank measure the volume of combined sludge and scum and to check orr an back upr oerro onding were, identify any crocks or bake The dispersal cellls) shall be visually inspected to check the effluent levels in the observation g 1pais and to affluent check ti for any surface. of effluent on the ground surface. The ponding of effluent on the ground surface may indicate as fal(Ing conditioand requires the immediate notification of the local regulatory y pondng e9 ory authority. When the combined accumulation of sludge and scum in any tank equals one-third (y) or more of the tank volume, the an*@ contents of the tank shall be removed by a Septaga 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 unite, 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. START UP AND OPERATION Pegs ?,of 7/ 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 coals). If high concentrations are detected have the contents Of the tanks) removed by a eeptage servicing operator prior to use. System start up shall not occur when Boil 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 cattle) 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 dfe 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 postings; 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 Prop" and safety abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Coda: • 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 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 falls and cannot be repaired the following measures have been, or -must be taken, to provide a code compliant replacement system: IPL 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 faded POWTS. alu . 9ZDFl18 rEt�. - RRµ/ ° mg k e eh L'ONS,TRrJ�7LD�► ❑ Mound and at -grade soil absorption systems may be reconstructed in Place following infiltrative surface. Reconstructions of such systems must complyfremoval of the biomat at the with the rules in n oaffffect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFRCIENT 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 Hams PAUL R KOEHLER Phone 715-246-2660 Phone 715-246-2660 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name POWERS SEPTIC Name Phone 715 715-246-5600 S - C ( 20AIl� [�� hone % 1 — 3 g (P— (O r� This document was drafted In compliance whth chapter Comm 63.22(2)(b)0)Id)&(f) and 83.154(1), (2) 3 (3), Wisconsin Administrative Coda, IIIIIIIIIIIIII , uuw IIIIIIIII R IIIIIIII►; ` IIIIIIIIIIIII ■ ice` _ IIIII IIIIIIIIIII 11„""""' � - ..� ............. ® _� ® _� IIIIIIIIIIIII .......�...... IIIIIIIIIIIIIIIII uunnnm IIIIIIIIIIIII IIIIIIIIIIIIIIIII IIIIIIIIIIIII � �� Illlllllllllllllllli' IIIIIIIIII�III�II►,� "" = ®= � ®� ®� • IIIIIIIIII_iin � III �. DERRICK HOMES 715-236-2320 LARDINOIS RESIDENCE IIR II LOT 2, CRANE HILL $ j w HUDSON TOWNSHIP, WISCONSIN i Fr- 0 0 DERRICK HOMES 7I5-246-2320 v LARDINOIS RESIDENCE LOT 2, CRANE HILL i n " HUDSON TOWNSHIP, WISCONSIN , 1 L CONSTRUCTION --------- - - - - - - - - --- - --------------- �; ann H}____ � ;.�� .. ....... .. L ....... ... C4 to ------------ it !tv - — -------- DERRICK HOMES 715-246-2320 LARDINOIS RESIDENCE LOT 2, CRANE HILL HUDSON TOWNSHIP, WISCONSIN i Ito �w it 0 N x EEC a'Ijt�`'� t t t TT ,.. o� I ❑� \� ! o � bH R b It � e i `i I Z 0 y O' n 0 2 C n DERRICK HOMES 715-246-2320 LARDINOIS RESIDENCE LOT 2, CRANE RILL i c 1 RUDSON TOWNSHIP, WISCONSIN ( t ` Sr CR TY SANITARY SYSTEM File #: Only OWNERSHIP/ADDRESS FORM Office Community Development Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources. Once approved, this completed form and educational information will be sent to you by email. If you would like to view your issued sanitary permit online, you can do so by using the Pro er y Files Scanned weblink. Owner/Buyer Matthew Lardinols Mailing Address 859 Crane Hill Trail City/State/Zip Hudson WI 54016 Phone Number (required) 715-914-7274 Email Address (required) miardinois80(a�gmail.com Parcel Identification Number 020-1491-02-000 (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location 5W1/4 , N6-114 , Sec. 1,4-, T 2-1 N R-ftW, Town of Hudson Subdivision Plat: Crane Hill Trail Certified Survey Map # Volume . Page # Warranty Deed #f I I Sci( 39 (before 2006)Volume . Page # — Number of bedrooms 4 Spec house O yes ■ no Lot lines identifiable ■ yes O no Lot # 2 OFFICE USE ONLY New Prope Address 4 t U— L^ rg-r (Verification of new address required from Community Develo)yment bipartment for new construction.) 216/�� (Staff Initials) (Date) This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New System: Include with this form 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. Community Development Department - Land Use Division 715-386-4680 St. Croix County Government Center 715-245-4250 Fax cdd0sccwi.aov 1101 Carmichael Road, Hudson, WI 54016 w}vw.sa i Eyov State Bar of Wisconsin Form 1-2003 WARRANTY DEED Dwmmt Nwober I) Document Name BY THIS DEED, Rolling Rktges, LLCI a Wlscons u limited liability coatpany, Lal d Whether one Of more), Convoy and warrant to tthelr Prep , Lardiaoia, husband and wife as sarvavorahlp marital ." whether one or more), the following described real tau in St Croix County, State of Wisconsin_ Lot 2 County Plat of Cane Hill of Hudson, Town of Hudson, St. Croix County, Wisconsin. Exception to street right�ta ofwanwi; wayseasements, restrictions and covenants of record; highway and under them; and fiathef ex Municipal and zoning °�moes and agreements entered apt real estate taxes sccrumg is the year of thla coaveyaace. Dated S qMW r-& 22 20 ZL Rolling Ridges, LLC, a Wisconsin limited liability Company 11S9138 BETH PABST REGISTER OF DEEDS ST. CROIX CO., W, RECEIVED FOR RECORD 09/23/2022 10:13 AM EXEMPT*: REC FEE 30.00 TRANS FEE 600.00 PAGES: 1 **The above recording Information verifies that this document has been electronically recorded at returned to the submltter Recadmg Area +V a ans rreMm Address St. Croix County Abar.tx & Title Co., Inc. 575 N. Knowla Ave., Suite MB New Ridtmoad, WI 54017 020-1491-02-000 Pavel Idermfieara„ Nwmber (PIN) This IS NOT bomestead propcoy. `Jip oo �¢i• �1�j i3 B bso ' and Ro dent) rji •. C� i ham: 00 e• AUTHENTICATION Signature(s) ACKNOWLEDGMENT authenticated m — _ STATE OF WISCONSIN ) St Croix COUNTY ) ss. TTrLE: MEMBER STATE BAR OF WISCONSIN (If not. authorized by Wis. Stat. 4 706.06) THIS INSTRUMENT I7RAF-I ED BY St. Croix County Abstract = Title Co., h%ie. y Andrea S. Carpenter at the direction of the Grantor. 22-S34453 Personally came before me on �' .%♦' o109a the above named David Robson. President of Ra Waa Rid LLC. a Wisconsin I mited liabWri comoas, to me known to be the person(s) who executed the foregoing instrument a aelmowledged the same. • Notary Public, State of Wisconsin MY Commission (is Permanent) (expires: N07t THIS IS A STANDDAARDR�pp�RM aattwatteatad or aeluovlydF•d, both are aot neaamryJ WARkAM DEED ANY MOD TO THIS FORM SHOULD t16 Q BARLY 1DRrYl IlUa Type name below. dgnenua. O 2863 STATE RAR OF W18COPOIN FORM IVO_ t_fasa St. Croix County 1159138 Pape 1 of 1 SEPTIC LOCATION Ll e6 q HILL O� FOR: CRANE F HU�DSON 0 loo 200 Ems uc 95 ��t 11 SB\5110RM' 0 It '131 t so L20i N' A37.27 k' L28mi Lza"M3 so i L3 ---Rss L20 �92 3 j .00 CIA60 R30-- ..28 sp:; DENOTES SOIL i? BORING LOCATED ON 9-13-17 NORTH CORNERSTONE LANE) SURVEYING, INC: �� 6x. zrJ 20 i Azrz V -- ho wJ+ r s i},e_ ' >503*37'2U n see W I 22.18 2 IlU) p v 42.49' �LOT 15 33.22' — �� ` hyN Q 5.096 ACRES Z sz00j76\ IVE-H��C37 221,976 Q .4g-W 51.g535C38 N83 SS7yy 57rLB09O 'j�29EC58s''E gTRAI6000- 's ��--CS---- ♦ 'a' \ J?9 SYa �N773850'E I I i �a � ♦. ��. � � O ♦ � df �p � \ II H.W.E. o�� I I =929.6------ zj4 �D&U L 146 II I I\ ♦ C30 �\ mII �� _CS N � b SLOT I `s �-- vh 4.948 ACRES �s8•.L56 I 21 S,527 SQ.FT. LBO=936.0 0 l l LOT 2 5.002 ACRES w r� o 217,900 SQ.FT. OPLAIN AGE LBO=936.0EASFMEDKAK4rArti LO S.000 H.W.E.=934.0 II 173i`�\ EASEME''Wr 0 217,79� s H.W.Er934.0 LBO= 295.09, �•, �°9 351.82' _ _ `. 4 a2lo N ? /C. 13, T2914, R19W � A I EAST -WEST I/4 LNE OF SEC. 13, T20N, Rlqwxl LOT-25 --T--- ql FXAAI/7FR I MF4TJnWl' FIRST l AttA QMap1t3sia%& on Include but not limited to: ve �"�� S�gbi>1�bendl� SOIL EVALUATION REPORT In accordance with Comm 85, W is. Adm. Code %169 not less than 8'fi x 1 I inches in PI lust ti and horizontal reference point (� of north arrow, and BM referenced t�ate`Crpytl.- print all information-7X1.ilL—_ be used for secondary purposes (Privacy LAw, s. 15.04 (1) (m)) C-D-r-2014 �$Ll Pagc 1 of 4 St. Croix ). 020- 1411-0 .' / Rolling Ridges LLC. Gout Lot f V 'A V✓v4 sf 13 T 29 N R 19 W Property Owrwcr's Mailing Address Lot N lBtock# jSubd.NameorCSW/Q Q _ - - Oa0 965 Alexander Rd. 2 C Ir4ne k,1j / 3. 29, 19, 3133 City State Zip Code Phone ❑ City ❑ village ® Town Nearest Road Hudson WI 54016 651-248-0390 Hudson Alexander Rd. ® New Construction Use: ® Residential / Number of Bedrooms Code derived design flow rate GPD K ❑ Replacement ❑Public or Commercial -Describe: Parent Material Loess over Outwash Flood Plain elevation if applicable N/A ft. General comments and recommendations: Install the system at 65" below surface. Insuall the system beginning at the drainage easement boundary (see page 4). Reserve the area upsl to B-4, as the alaccriGFt area_ Boring B-4 was initially completed IS' north of the location shown on the map. There was much nmr- tVn15M ng and reducedsoil below the sat this location. St Croix county inspector Ryan Yarrington observed the soil at 84 and agreed that the redox was no longer present at B4. The redox north of B4 is not a result of a high water table. I I Boring 4 21 Pit � Ground Surface Elevation 99.9 ft. Depth to Limiting factor >110 in. Horizon Depth Dominant Color Redox Description Texture Stnxiure Consistence Boundary Roots i I r. h. —.1ioatlon Rate 'EfW1 EfF#2 1 0-10 10YR3/2 - GRLS 0-sg ml gs 3f 0.7 1.6 2 10-53 7.5YR4/4 - GRS 0-sg ml gw 2f 0.7 1.6 3 53-110+ 10YR4/4 - S 0-s9 ml - - 0.7 1.6 ❑ Boring q 2 Boring # ®Pit Ground Surface Elevation / �� ft. Depth to Limiting factor 1 O s in. Horizon Daplh In. Dominant Color Munsell Redox Description Qu. Sz. Cont.Gr. Texture Structure Sz. Sh. Consbtence Boundary Roofs 'EW1 'EW2 1 0-1 10YR3/2 - SIL 2-f-gr mvfr gs 3f 0.6 0.8 2 10-39 10YR4/4 - GRS 0-s9 ml gw if 0.7 1.6 3 39-105+ 10YR4/4 - S 0-s9 ml - - 0.7 1.6 (. QO �fip - tnlllent a 1 a lXwy> SV LlU mglL ale r JJ >!V � 1 U MB% - trrpell NL a tlVUS c .rV MFL alp 1 as = JV ffW L CST Nuns (Pit = Print) S CST Number Mark Iverson 46672 Address Date Evaluation Conducted Telephone Number P.O. Box 155 Hammond, WI 54015 August 30, 2017 / Nov. 9 2018 715-796-5664 L6T � Property Owner Rolling Ridges LLC. Parcel ID# 3 E3 Boring FBoring # ®Pit Ground Surface Elevation 98.6 R. Horizon Depth in. Dominant Color Munsell Redox Descriptlon u. Sz. Cont. Color Texture 1 2 0-12 12-42 Joy 7.5YR4/4 - GRSL VGRS 3 42-105 Joy - GRS Boring Al O Boring ®Pit Ground Surface Elevation 101.3 ft. Horizon Depth Dominant Color IIcow Redox Description Texture 1 0-7 10YR3/2 - SIL 2 7-20 7.SYR4/4 - SIL 3 20-31 7.5YR4/4 - GRS 4 31-46 tovR4/4asrn4M - ----- RS8F7 5 46-53 7.5YR4/4 - FS 6 53-105+ 10YR4/4 _ S Page 2 of 4 Depth to Limiting factor >105 in. ure h. Consistence Boundary Roots 'E1ff1 TO E mfr gs 3f 0.6 1.0 ml MI gw 2f 0.7 1.6 - - 0.7 +4 Depth to Limiting factor 105+ in, Structure Consistence Boundary Roots -f-gr 2 mfr mfr gs 'Efllt TOM 2f 0.6 0.8 gs 1f 0.6 0.8 0-s9 ml gs 1f 0.7 1.6 0-s9 —_ ml Cs - 0.5 1.0 0-m mfr Cs - 0.5 1.0 0-s9 ml - - 0.7 1.6 Boring # Boring ®Pit Ground Surface Elevation R. Depth to Limiting factor in. Horizon Depth in. Dominant Color Mu I Redoz Description u. Sz. Texture Structure r. 6x Sh. Consbtence Boundary Roots 'Efff1 'Effi2 Effluent e 1 - BOD>> 30 5 220 mg/L and T33 > 30 < 150 mg/L • Efilucni #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 6o8-266-3151 or M 608-264-8777. 1 \ 1 / _ � I 1 , I \ 1 se '54 B\ 24.54 I \ j \\ IN I i H.W.E. I =929.6 LBO=936.0 \ II I I I I ,f I II II II tI IL II I I CBA-0.74 ACRES P4� 440 so \7B7 \ sa 7811 937 77 Ia 0<137.20 93e 936 SO L2eM3 - — U-5.70 58 L7B7 932 0931 80 LOT Ve 930 5.00 ACRES I I .- I I I Ili -SOIL BORING LOCATIONS AND BENCHMARKS SHOWN HEREON WERE FIELD LOCATED ON SEPIEMBER 13, 2017. -CONTOURS SHOWN WERE DERIVED FROM AVAILABLE UDAR DATA AND NOT FIELD VERIFIED. NORTH 40 80 1 `I 1 r � Sub 61 67SO Sdkw , 6Ad. K St95w[a, YM S5067 Ph" 6S 1.775.6969 fu 651.775.6976 as O cswlwy nSt CORNERSTONE LAND SURVEYING, INC. Wiscommi Departmentp �C°'n11C ce SOIL EVALUATION REPORT C Si- a017- 197 Divisi�oin� Page 1 of R� In accordance with Comm 85, W is. Adm. Cade Anach�p a site plan on paper not less than 8 '/2 x 1 I inches in size. Plan must County Sr I�lie limited to: vertical and horizontal reference St. Croix P 1 sI point (BM), direction and 020 O� CO ope..S�tle or dimensions, north arrow, and BM referenced to ncpt maw � 9, Parcel I.D. ly�/- 02 - Ooo �nl OPMEPIT Please print all information I�� f 9 p Revi by D� you provide may be used for secondary purpo, ' e / fl F4PR2XV071GY4 tJ Rolling Ridges LLC. --i,11L Owner's Mailing Address vv`' Lot ' /. S 3 T 9 N R 19 W 965 Alexander Rd. Lat # Block # Subd Name or CSM# City State ZipCoac 2 �1O1G D City D Village 0 Town Hudson WI 54016 651-248-0390 Nearest Road Hudson Alexander Rd. 0 New Construction Use: 0 Residential / Number of Bedrooms Code derived design Flow rate GPD D Replacement D Public or Commercial —Describe: Parent Material Loess over Outwash General comments and recommendations: Install the system in the thirFlood n!zonelevation if applicable N/A ft ZOtsa. kC I Boring # `' Vi rrrg 0 Pit Ground Surface Elevation 99.9 ft. Depth to Limiting factor > 110 in. Horizon Depth in.. Dominant (Color Redox Description MunU. Texture structure Consistence Boundary Roots 1 0-10 nt. 10YR3/2 - GRLS ►. 0-s9 'EM ml 2 10-53 7.5YR4/4 gs 3f 0.7 3 53-110+ 10YR4/4 GRS 0-s9 ml 9w 2f 0.7 S 0-s9 ml - - 0.7 Boring # D Boring ®Pit Ground Surface Elevation 9 ` . 4/ ft. Horizon Depth Dominant Color Redox Description Texture In. u. Sz. Cont. Cobr 1 0-10 10YR3/2 - SIL 2 10-39 10YR4/4 - GRS 3 39-105+ 10YR4/4 _ S fAsrem # I BOD>> 30 < "V mg/L and TSS > 30 < I50 ma/L CST Name (Please I Mark Iverson Depth to Limiting factor_>10G in. Stn re4Con�mftnoW( 'r. Sz. Etf#12-f-gr0.60-sg.70-s9.7 P.O. Box 155 Hammond, WI 54015 A HODS 5 30 mg/L and TSS 5 'onducted ,2017 46672 715-796-5664 1.6 1.6 1.6 0.8 1.6 1.6 Property owmer Rolling Ridges LLC. Parcel I D# 0 Boring 31 Boring # OR Ground Surface Elevation _ 98.6 g, Floc M Depth Dominant Color Radox Description Texture u. Sz. Cobr 1 0-12 10YR3/2 - GRSL 2 12-42 7.5YR4/4 - VGRS 3 42-105 10YR4/4 - GRS F Boring # 13 Boring ®pit Ground Surface Elevation g, Le Z Page _ 2 of---XA Depth to Limiting factor >105 in. Strad Gr. Sz 2-f-U r:•,u: •.•:.xit:•alCt:c7 Depth to Limiting factor a Boring # O Boring ®Pit Ground Surface Elevation g Depth to Limiting factor in, Motaon Deptlt Dominant Color Rsdox Oescr ---t Texture Structure ConsisOsnceT Bomldary 7 Roots 'EfftR2 • Effluent # I = BODs> 30 <_ 220 mglL and TM > 30 <_ 150 mg/!, • Effluent #2 = BODr < 30 mg/L and TSS < 30 mg/L The Dleparlmem of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or Need material in an alternate format, piense contact the department at 608-266-31 S 1 or TTY 608-264_8777. SEPTIC LOCATION FOR: CRANE HILL OF HUDSON 13 i. L25M3- 935 Pp SP5 0 loo zoo %7%= _T \ Y� 9,p O J \ se sroRn \ 979.5454 \ y, n � S i pA 2E \SB L2B1 o 937.27 33 L25MI \ SB L 3 �937.2p 6 92 � LOT 2 I Area : S.00 S$-,L \93?$0 930 t6 � 0 `a 9 W D SB L3 9r DENOTES SOIL BORING LOCATED ON 9-13-17 CORNERSTONE LANE3 SURVEYING, INC 020149102000 Show search results for 020 Z .J Feet Measurement Resole 334.7 Feet Clear vre.. CTRL to enable .naep,nq X q TOK Hbtcelt 020-1491.02-000 Fuff Ten Report More �fo Fret Name Middle Neme Lest Name ROLLING RIDGES LLC PameiNumber 0M1101.02-000 Ten Key 13.29.19.3133 Mun.cipelay TOWN OF HUDSON DeKnpbon Tax Year 2022 Legel Dexr,pt,on SEC 13 T29N RI .,'. =- SW NE COUNTY PLAT CRANE HILL OF HUDSONLOT2 Plat Destnppor Z044n CRANE HILL OF STATE SANITARY PERMIT rl 19509 cz" Na-nu OWNER PLUMBER TOWN OF SECJ3 •T AND/OR LOT 27 N, R19 E/VV 2 BLOCK 11600 Is- -- - PERMIT EXPIRES PREVIOUS NO. dl� OIS SUBDIVISION ISSUING OFFICER - CHAPTER 145.135 (2) WISCONSIN STATUTES (a) The purpose of the unitary permit is to allow lusenilation of the private sewage system described in the permit (b) The approval of the unitary permit is based on regulations in force on the date of approval. (c) The sanitary permit is valid and may be renewed for a specified period. (d) Changed regulations win not Impair the validity of a unitary permit. (e) Renewal of the sanitary permit will be based on regulations In force at the time renewal is sought, and that changed regulations may Impede renewal (f) The unitary permit is transferable. History: 1977 c.168;1979 c. 34,24j; 1981 c. 314 Note: If you wish to renew the permit, or transfer ownership of the Permit, Please contact the county authority. DATE X UNLESS RENEWED BEFORE THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING COpN�ST UCTION SB0.06199(RI 120) URIPJAIIx &W r�I