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HomeMy WebLinkAbout020-1481-08-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 556350 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: Delta Construction, Inc. Hudson, Town of 020-1481-08-000 CST BM Elev: Insp. BM Elev: BM Description: f i2-2 Section/Town/Range/Map No: V__7 S SAP 07.29.19.3057 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark i 1(~Ol~- 5 da '77 Dosing Alt. BM q1_ Aeration Bldg. Sewer Holding S Ht inlet Ht Outlet fit' TANK SETBACK INFORMATION , 5-Y TANK TO P/I i WELLi BLDG. Vent to Air Intake ROAD Dt Inlet Septic 'L 3 5 / i 6 I Dt Bottom rG YD Dosing Heade3r/Man. / 7. -7 3,Zj Aeration Dist. Pipe Holding Bot. System g'. ~ PUMP/SIPHON INFORMATION Final Grade ~L 3. y~.~ Manufacturer G ~ Demand St Cover i N A GPM Model Number L IrT I -1~9Z TDH Lift Friction Loss 3ys'tem He d TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width t Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 NSETB ACK SYSTEM TO P/L BLDG WE LAKE/STREArM HE anufacty , ` iT INFORMATION 7AM ER OR '~J'h Ty Of System: IL--Model Number: DISTRIBUTION SYSTEM s / 0.7- V Bader anifold r JDistribution f x Hole Size x Hole Spacing Vent to it Intake Q / I Pipe(s) - / r Length a Dia Length N I D Dia Spacing r~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Bed/Trench Center r Bedlrreench Edges Topsoil Depth of xx Seeded/Sodded xx Mulched H Yes 0 No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:t/t 7- Inspection #2: / / Location: 346 Miller Rd Hudson WI 54016 (SE 1/4 SW 1/4 7 T 9N R19W) Whispering Oaks Lot 08 Parcel No: 07.29.19.3057 1.) Alt BM Description 2.) Bldg sewer length= - amount of cover Plan revision Required? ° Yes 'No Use other side for additional information. Date Insepctoes Signatur Cert. No. SBD-6710 (R.3/97) PLOT PLAN PROJECT Delta Construction ADDRESS 400 South Second St. Suite 135 Hudson Wi 54016 SE 1/4 SW 1/4S 7 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 10/1 /12 BEDROOM 4 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1000 # of chambers5 Gj ,BENCHMARK V.R.P. Top of steel Fence Post ASSUME ELEVATION 1001 Filter BEAR Filter ❑ BOREHOLE O WELL 11 H.R.P. Same as Benchmark SYSTEM ELEVATION 92.6/92.3 6.5' below qrade All piping shall be SDR 30/34, within 10' of tank, piping shall be Schedule 40. Well is to meet all Scale is 1" = 40' setbacks required by unless otherwise WDNR noted 177' 3 CR)S 1^d 1-7 B.M.* 340' Property Line ho- 97' 20' S~ -2 100' B-3 +v wad N/ 30' ND ~L lZo ~wnda~~ 99' 50' 5% Slope B-1 3 Area of poorer soils S 2-3' X 102' Cells with >3' spacing 5 911 Pro 4 Bedroom House y'~/~~-✓ LA/C7 Road Vent >6„ Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 10.2ft^2/pair of end caps Scale is 1" = 40' 4' Long 12" Grade at System Elevation unless otherwise 34" noted ( I 1 t I t 0.sa'Easy PROPEpTy I I I~ t t i ~ 66 - FOOT WIDE ACCESS i t I EASEMENT AS SHOWN ON <<"„ ° • I 1 CERTIFIED SURVEY MAP t I VOLUME 24, PAGE 5709 - f I t i ,P I ,-4 M' t t cn n 4 So t t wm ! t a ca C4 I oo r, cR - I ! N 8_ N~071 qa SW31 %E 340.55- -4 i w {922 o y & LOT 8 .15} 62 SO. FT. w' w 9 AC. ao nt i T. 2.4 wo 41, - - MILLER PAN o Z \ ~ j LOTT t w 68 964 SO. FT. } $ 1.58 AC. 1-2.0- = 914.3 {915.97} ; e i S83°46-25V 28:1.53' r ' tQ co I 1, ► ~ ® f LOT 6 43,906 SO. FT. r' 1.01 AC. i ~ s r~ ti , , E r~iv N oolmtraera~'Vd C Safety and Buildings Division Count 201 W. Washington Ave., P.O. Box 7162 ~J 4L seonSlln 0 X12 111adiSOri, WI 53707-7162 5nnLuryYernileNurn6ur Qepertmetnt of Co 55 c c tin ru,a ,n ny Sanita>sy Application State lr«ion NJUmber In accordance with s. Comm. 83.21(kAW A 1t, ode, submission of this forrn to tl i to governmental N unit is required prior to obtaining a sanitary permit. Nate: Application fonts 11'~gb~w submitted to the Department of commerce. Personal information you provide maybe us ~ for Tt are project Address (if different than mailing addr ) u ores in accordance with the Privacy Law, s. 15.(14(1 m , Slats. 1. A kation Informtation - Please Print All Information Property Owner' ame Parcel # 141g ae Property Owner's Mailing Address Properly Location S. f-)-,go C° C 3057 City, S - • ~ G vt. Lot Zip Code Phone Number ~ l/lJ a C ~ ~ Section rile one II. Type of Building (check all that apply) Lot # T N; R E U wJ or 2 Family Dwelling - Number of Bedrooms Subdivisto C g n Name 6k- o d /1 ~aA- Block " f r .c V ❑ Public/Conur►ercia! -Describe Use All, ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of _ Z tJ c'.S G ~~1~. of IQ. Type of Permit: (C eck only o e box on line A. Complete line B if applicable) A. New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only El Other - Y Modification to Existing S stem f(explain)J B. 11 Permit Renewal ❑ Permit Revision 11 Change ofPlumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner a~. ype of POWTS System/Component/Device: Check all that apply) *on-Pre ssurize d In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound 24 in. of suitable soil ❑ Mound a 24 in. of suitable soil G4w..r. " ding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Disper sal/Trea eat Area Information: Design Flow (gpd) I Design Soil pplication Rate pdst) Dispersal Area Required (si) Dispersal Area Proposed (s System Elevation CIO X~ VL Tank Info Capacity in Total # of Manufacturer Gallons Galion, Units New Tanks Existing Tanks 'R N U av G~ ge fir,'! a 8 w (Septic or Holding Tank ~ r Dosing Chamber 1/7 VII. Responsibility Statement- 1, the undersigned, assnm s onsibility for installation of the POWTS shown on the attached plans. ?1u4er's Name (Print)- Plumber' M MP/MFRS Number Business Phone Number / ZZ C L5' ~ItunberA ddress (Street, State, Zip Code) ~ ~ l J d) 7 ICI ount /De artment Use Only Approved Disapprov Permit Fee Date I ued Issuing t Signature $ /75.60, 7 Z /L 'D~JiTLrftr ven Reason for Dental` -T ~X. ConditlF~lReasons for Disapproval 31 Q~.?•~ wee P/rD✓," /1G,r.! rue 1. $epgc tank effluent fifter and ,dispersal cell must all ll be services ttnalntattud -M.,44- X-15 /'Natr4,k vt,ebwt~t. w~w1'7 , as per management plan provided by plumber, 2. Allse(back hogs VemeMs must be mainWmN " #e per q4 ft", code / OF o Attach to complete plans for the system and submit to the County only on paper not leas than s to s 11 inches in size -6398 (R 02/09) '1313 L Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 10/1/12 Owner: Delta Construction Location: SE1/4 SW1/4 S7 T29 N,R19W Lot 8 Whispering Oaks Hudson System type: In-ground absorbtion system(conventional) Manuals Used: In-ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance and Contingency Plan 7. Filter Sp4ation eet Signature License n0 PLOT PLAN -PROJECT Delta Construction ADDRESS 400 South Second St. Suite 135 Hudson Wi 54016 SE 1/4 SW 1/4S 7 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 10/1 /12 BEDROOM 4 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1000 # of chambers 50 BENCHMARK V.R.P. Top of steel Fence Post ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark All shall be SDR 30/34, within 10' SYSTEM ELEVATION 92.6/92.3 6.5' below qrade piping Well is to meet all of tank, piping shall be Schedule 40. Scale is 1" = 40' setbacks required by unless otherwise WDNR noted 177' B.M.* 340' Property Line 97' t220' B-2 100' B-3 Vents 30' 99' 50' 5% Slope B-1 30' Area of poorer soils ST 2-3' X 102' Cells with >3' spacing 5 5 Pro 4 Bedroom House Road Vent >6„ Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 10.2ft^2/pair of end caps Scale is 1" = 40' 4' Long 12" 3 4" Grade at System Elevation unless otherwise noted . Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber 10.2ft^2 pair of end plates To be >1' above grade Finish grade elevation Typical Installation /e 99.1' Vent Vent i Grade A~30/34 ti T Sep c ank ALong 4" 3' 1 5' S' Long 1 Grade at System Elevation 3 6" Grade at System Elevation Spacing 5' 2-3' X 102' Cells Same on other end Observation tubeNent At end of cell A B 25 chambers per cell System elevations: A_92.6' B 92.3' POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity ❑ NA Permit # al Septic Tank Manufacturer ❑ NA 4Zd )ESIGN PARAMETERS Effluent Filter Manufacturer ? ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units A Pump Tank Capacity of 13 NA Estimated flow (average) gal/day Pump Tank Manufacturer NA Design flow (peak), (Estimated x 1.5)gal/day Pump Manufacturer 13 NA Soil Application Rate t al/da /ftz Pump Model IAI NA Standard Influent/Effluent Quality Monthly average" Pretreatment Unit NA Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODs) 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD5) 530 mg/L In-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ANA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) 5104 cfu/100m1 ❑ Drip-Line ❑ Other: !Maximum Effluent Particle Size X in dia. ❑ NA Other: ❑ NA (Other: ❑ NA Other: ❑ NA "Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA IAINTENANCE SCHEDULE Service Event Service Frequency !inspect condition of tank(s) At least once every' 11 month(s) ears (Maximum 3 years) ❑ NA (Pump out contents of tank(s) When combined sludge and scum equals one-third (X) of tank volume ❑ NA IInspect dispersal cell(s) At least once eve ❑ month(s) ear(s) (Maximum 3 years) ❑ NA ry' Jkx Clean effluent filter At least once every: 'XT ❑ month(s) ❑ NA ear(s) Inspect pump, pump controls & alarm At least once every: ❑ month(s) ❑ NA ❑ year(s) [:lush laterals and pressure test At least once every: ❑ month(s) ❑ NA ❑ year(s) I6ther: At least once every: ❑ month(s) ❑ NA ti ❑ year(s) ther: , ❑ NA MAINTENANCE INSTRUCTIONS !Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master IPlumber; 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 ic;ombined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cells shall be visually inspected to check the effluent levels in the observation pipes and to check for an ondin of effluent on the round surf 'l'h Y p 9 g ace. e ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local 1'e9ulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (X) or more of the tank volume, the entire contents of j;he 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, land 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 of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals thElt may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of thjs tank(s) removed by a se to a servicing operator prior to use. ved b p 9 System start up shall not occur when soil conditions are frozen at the infiltrative surface. excess During power outages pump tanks may fill above normal highwater levels. When power is restored surface di wastewater of effilllene backed the discharged the dispersal cell(s) in one large dose, overloading the cell s) and may result in th p to restoring power to the To avoid this s situation have the contents of the pump tank removed by a Septage Servicing Operator prior g P 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. the area within Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, 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 POWT : antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; s disinfectants; oil; fat; painting foundation fond dralin water, ; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medication ils; (sump pump) ralin 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 stpil, 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 compliilint replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. / he replacement area should be protected from disturbance and compaction and should not be infringed upon by requirled setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the neled for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rule:l in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technologN a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed) as a last resort to replace the failed POWTS. ❑ 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 Name 1~ , czu. / Phone ~ Phone - - C ~ SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY Name Name p2 ~0 Phone Phone J This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(fl and 383.54(1), (2) & (3), Wisconsin Administrative Code. RLTER CARTRIDGE INSTRUCTIONS .y= 0 Installation f STEP I Dry fit the filter case onto the and of the outlet pipe to ensure it is centered under the access, opening. If not, then either insert more pipe into the tank through the outlet or solvent weld (glue) additional pipe onto the outlet pipe. STEP While the case is still dry fitted on the outlet pipe, measure the length of -U-inch pipe needed to brace the finer to the tank end wall If utilizing the optional supplemental side support. If side support method is not utilized, proceed to step four. !s-T P + For installations utilizing the optional supplemental side support: solvent weld the y,-inch pipe onto the filter case. If side support method is not . utilized, proceed to step four, Solvent cartridge into thevcaset pressing down n until the filter locks into the bottom of the case. If a VRS switch is utilized: insert into the filter and lock by turning ~y clockwise 906 Maintenance 1. The effluent filter should be cleaned every time the septic tank is serviced. 2. open the outlet access opening to Inspect the tank and Rfter. ' 3. Pump the septic tank completely, making sure to remove the sludge layer on the bottom of the tank and not just the scum and effluent. 4. Once the effluent level has been lowered below the invert of the outlet Pipe, firmly pull up an the filter handle to dislodge the cartridge from the case. S. slide the cartridge up and out of the case for cleaning. 6. If a VRS switch connected to an alarm Is present, the switch 7 should he removed by turning counterclockwise 90° and cleaned with water only. 7_ While holding the cartridge on its side (large flat surface facing down) over the access opening, rinse off the cartridge with water isr. fh„r' only, making sure all septage material is rinsed back into the tank. c f:' a. If VRS switch is utilized, replace by inserting into filter and turning clockwise 90°. 9. Insert the filter cartridge back into the case } n, the filter locks into the bottom of the case, pressing down until id. Replace and secure the access opening on the tank. , tr :ft':. ~AA~:r J?irC '4 u: Q:^ r'..',yrai'~.l;i :Xr... www bearonsitexom 877-MLRLTERS (653-4583) 12 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address Property Address (Verification required from Planning & Zoning Department for new construction)T City/State Parcel Identification Number DOS eq L"v U LEGAL DESCRIPTION Property Location SE 1/4 yq , Sec._7 T Z N' R_ _W, Town of ~ Subdivision Lot # Certified Survey Map # ~ m----- ~ Volume , Page # Warranty Deed #Q b ^ Volume Page # Spec house / e no Lot lines identifiabl esI 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 li~,ensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 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 verTying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. 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 Commerce and the Department of Natural R esources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned tc the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this rm are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a wa my deed recorded in Register of Deeds Office. Numb r of bedrooms GNATURE OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Pimning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) s gis 340.55 {922,151 T~z Cl) LOT 8 0 co 13 73,462 . FT. 1.69 . L.R.O. . 'fir II IIIIIIIIIilllllllllll IIII III 8 T Tx: 9 7 7 6 4 68861 STATE BAR OF WISCONSIN FORM 1 - 2000 964081 BETH PABST DocutnentNutnber WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI THIS DEED, made between NWP Holdings, LLC, a Wisconsin Limited 09/25/2012 11:41 AM Liability Company, Grantor, and Delta Construction z n c . , r a n t e e . EXEMPT#: NA Grantor, for a valuable consideration, conveys to Grantee the f1) o iiiwo g REC FEE: 30.00 described real estate in St. Croix County, State of Wisconsin (the TRANS FEE: 142.50 "Property"): PAGES: 1 Lot 8, Whispering Oaks, St. Croix County, Wisconsin. Recording Area Name and Retum Address: Land Title Inc. File # 336153 2200 W. County Road C, Ste 2205 Roseville, MN 55113 Together with all appurtenant rights, title and interests. 020-1481-08-000 Parcel Identification Number (PIN) This is not homestead property. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Easements, Restrictions, Reservations, Roadways and Rights of Way, iI"any, of Record. Dated this 7th day of September, 2012. j NW tpl~- Uohn Parott i , Member '0~s ~-Jz-, AUTHENTICATION " NOTARY ACKNOWLEDGMENT of Signature(s) k ."0.100 STfvTE 01: WISCONSIN ) , S u CROIX COUNTY. ) ss. authenticated this 7th day of September, Personally came before me this 7th day of September, 2012 le above named John Parotti , the Member of NWP Holdings, * ..G LLC , a Wisconsin Limited Liability Company, to me known to TITLE: MEMBER STATE BAR OF WISCONSIN be the persot1(S) who executed the foregoing instrument and acknowledged the same. (1 f not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFI'L"-D BY e lee J. 13une Notary Public, State of Wcousin Larry S. Mountain, Attorney at Law My commission is permanent. (]fnot, state expiration date: 10/27/2013 ) (Signatures may be authenticated or acknowledged. Both are not neceSSap.) *Natnes dpersons signing in any capacity must be typed nr printed befuu their Si Unalurc 1 of 1 WARRANTY I).en STATE BAR 01 'WISCONSIN r•010-1 No. 1-21)(10 Oct 01 1202:04p p.4 xr sa RIn 1R~ , 1KE t[3E P.Q.' 11Y4• . 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WI 69016=gd PAID r nsin Department of Commerce SOIL EVALUATION REPO Page of 1Nisoo ihsion of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code r. • County '54. 71, Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. /gyp percent slope, scale or dimensions, north arrow, and location and distance to nearest road. OZ t7 - l J a l 0 J, 27D Please print all information. awed b Date Personal information you provide may be used for secondary purpons. 15.04 (1) (ml). Property Owner c^!F roperty Location 1 V C0 /0 40~ 1,VJ G:V ovi. Lot s 1/4550/4 S T 2,9N R E (o Property Owners Mailing Address of # Block # Subd. ~ame or CSM# goo- -52--3 nrl 3 GrJ (n Q city tate Zip Code Phffii Number City ViIlag T earest cad r 1 JCI gT.GKUpt ?~r 'Xe 'd New Construction Use•~tesidential Number of bedroans .3/V Code derived design flow rate av GPD 00 77- ❑Replacement ❑ Publi orcommerciai-Des Parent material Flood Plain eleva)ion if applicable A--~IV ft• General comments S /t`~ and reoarwnendations: / Gta--G~a-CJ~-G.P d C"-L System Type ~~?Ur42 j System Elevation 7- fS to u q~ S 5 ❑ Boring / ®n# ja pit Ground surface elev.. ( ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "Eff#2 a-8 31z- JOY i -f2 D .yll .r// Al 41 I a ~ # Boring Ground surface elev. ! / L ft. Depth to limiting factor /,-I?- y in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 6-/-s 0 31 L S/ Y In '6- 17-r- S r--- rnl n'I 1-3-.?Y S la AIM Of 17. 01q- /77Z AIM AI)d ` Effluent #1 = BOD > 30 220 mg1L and TSS >30 11 5" Effluent #2 = BOD 130 m 4l- and TSS < 30 mg/L CST Name (Please R" CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 ~,f -/v 715-246-4516 -Property owner - Parcel ID # Page of ❑ Boring 1 Boring # S Pit Ground surface elev. Vk Depth to limiting factor in. Sal Application Rate a ` 'ion Texture structure Horizon Dominant Color Redox Description e Consistence Boundary Roots GPDIf( Depth 'Eff#i 'Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. All U-I /0 S 00 In l h/) h~l~4 Boring # ❑ Boring ❑ - 11 pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM Gr. Sz. Sh. 'Eff#1 'Eff#2 in. Munsell Qu. Sz. Cont. Color ❑ Boring ❑ Boring # Ground surface elev. ft. Depth to Ihniting factor in. Soll ice<ion Rate ❑ Pit th Dominant Col Redox Description • Texture Structure Consistence Boundary Roots GPD/ftz Horizon "lep •Eff#1 'Eff#2 in. Munselt Qu. Sz. Cont. Color Gr. Sz. Sh. ' Effluent #1 = BODE > 30 < 220 mglL. and TSS >30 150 mgA- ' Effluent #2 = BOD, < 30 nXVL and TSS 130 mill 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-8330 (RAW) Soil Test Plot Pla Project Name NWP Holdings Sh Bird Address 573 Cty Rd A Hudson Wi 54016 # 26900 Lot 8 Subdivision Whispering Oaks Date t1l/10 SE 1/4 S W 1/4S 7 T24 N/R19 W Township Hudson ❑ Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Post System Elevation TBD *HRpSame as Benchmark 177' B.M.* 340' Property 97' 20' B-2 100' B-3 5% Slope 30' 99' 50' B-1 EF4 30' Area of poorer soils Amber Ridge Drive Scale is 1" = 40' unless otherwise noted > ¢ Z=vi vi r > w a ¢ g 9m~~Z=Zf ZQ ~wFx-Z > w E aa;~yZZ fpz0 wLL o¢ _ x m O W z 0 y w a. 5 z J O o W r S aa a2 O QN - _ 8~ m 6 3LL¢UZdOxcSU r o O w r F p Z L a W 62-1-Hu - Z - . . - 'c S.myr I ?OJW>wyp~n F(jp aw ~FwSvOi _mm F - ~ BD~~~B I xap~UaWjoW ~Sru7d'z~~ ~wy~~ W'~w B~Gb ~¢~o3moU¢ y~1yo p Ow~x W r LL yC7 W 2UC~ `L toC ~LL pu~-'viw¢> ¢OO¢z=d -w 20 $o aw. 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I PG. 978 \ \ \ \ S00°i 3'45 W 1954.17 -SO0°13'45'W E a> \ f\ \ I - / I da34 -13 / t 1r 94. \ \ \ \ \ 1 1-123 OT- / I ! 1 y y \ \ \ \ \ \ yWY I R m / I I04-m \ \ \ \ C72o ~ 1 / • \ \ \ 1 < ` ~ ~ W / / , Mtn ~ ~ N I j \ \ \ \ 1 ` \ ~ \ N \ ~ ~ ~ / - _ w w `n ~ l ~ ~o m67 ~ n nn a ap ~a yY h W/ / rt ¢ U~. ~1o.o➢.IRll. ~W l/®ls. u~,°71 PWI.~~~ \ _ 0 \ \ \ 1 y W 1\ 7 1 \ _ N \ 3 /<W ~ \1 \\~~\~~\\I i~ N~</// \ Q \1 ~\-`11 ~~~PO \4 LOT 3 1 LOT 21 `f fi------- ~ N8R~//~/ / 1'0o'W 16 aJ ¢z / / 362.OT =w / r N / l1 W l - •Q y _...._1 12¢....x,_ .,....97, \ Q~- g75 S3tiD6'91'0)4 10"un0-"-- / N00°01'00'E 405.11' -----I -139'- --_f2T,._/ LOTI / / \ 11 / 119 VOL. 2 437 cTU< e, \ 21 N y / N/ / ~NY 1 / M og ` ToW < / / N / / / a m I 1 N N \ W - soo°oalo'E / /~O^ / / o ~1 Qwx \ / cc 2.82 _ O w wi i OR,4/NAriE - - - l ~ o \ 1 O ° / a` / e2 -_coaa/ / a-sx,.a . I \ V ~ 1 14Z / o •139'\ / 148 160' \ \ 145' 121 \ \ 140' / y EAST IN F THE ST 1839.79' OF THE SW Y, \ \ / ma~nn a ~m n wa r ` I SMALL VIIACT Parcel 020-1481-08-000 08/24/2012 09:40 AM PAGE 1 OF 1 Alt. Parcel 07.29.19.3057 020 - TOWN OF HUDSON Current ❑X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 11/08/2011 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - NWP HOLDINGS LLC NWP HOLDINGS LLC 573 CTY RD A STE 100 HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 346 MILLER RD SC 2611 SCH DIST OF HUDSON SP 1700 WITC Legal Description: Acres: 1.690 Plat: 11-039-WHISPERING OAKS 020-011 SEC 07 T29N R19W PT SE SW & PT NE SW Block/Condo Bldg: LOT 08 WHISPERING OAKS LOT 8 (1.69 AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 07-29N-19W SE SW 07-29N-19W NE SW Notes: Parcel History: NEW FOR 2012. RETIRED 020-1002-50-055 TO Date Doc # Vol/Page Type CREATE 8 LOTS & 2 OUTLOTS. 03/22/2012 952988 COVNTS 11/08/2011 945347 AGREE 11/08/2011 945346 11/039 PLAT 06/24/2010 918098 EZ more... 2012 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/18/2012 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.690 40,400 0 40,400 NO 05 Totals for 2012: General Property 1.690 40,400 0 40,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00