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HomeMy WebLinkAbout002-1026-20-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 556374 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)j. Permit Holder's Name: City Village X Township Parcel Tax No: Manor, Taylor Baldwin, Town of 002-1026-20-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: W.j 13.29.16.184B TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic- Benchmark :3.13 i e) .15 Dosing 4,- 4L Alt. BM ` Z ALI #gffl Bldg. Sewer ` o` Z Ids sz 7 Holding St/Ht Inlet 11, 17 21 IG it TANK SETBACK INFORMATION St/Ht Outlet TANK TO + P /L r WELL BLDG. nt to Aire ke dRO D Dt Inlet ` Y 1U s Septic Dt Bottom Dosing y Z I j z f/ Header/Man. 7 / ?.Go3 5.3 .5 Aeration Dist. Pipe 3 . 9. '13. 5 Holding Bot. System G(f~' to (,~j 2 ;S PUMP/SIPHON INFORMATION Final Grade 7.0 I9'5. Manufacturer Demand St Cover , 66- X15' C~ ✓k GPM 7 Z-1 Model Number PC- 41 w TDH Lift 6 1 Friction Less System He TDH~ I Ft • ! . 4 Forcemain Lengthy Dia. Dist. to Well r ~j Z U% SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length No. Of Trenches t ' PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 16 -Z t c~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer„ INFORMATION CHAMBER OR I ' 1, Csi Type Of System: , w C~Lt C~ ~~J UNIT Model Number: DISTRIBUTION SYSTEM k-S Header/Manifold / Distribution x Hole Si Ix Hole Spa 'ng Ven¢t/~tb Air Intake C= Pipe(s) \ . Length Dia Length ` Dia-~ Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only C. k Depth Over / Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center,,./ ~ Bed/Trench Edges ` Topsoil Yes 0 No Yes ~ No M COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #i2: / / z 4" ~ Location: 982 CTY RD D Woodville, WI 54028 (NE 1/4 NE 1/4 13 T29N R16W) NA Lot 1 Parce No: .16.1846 ct~ bxk~ CA J ( S 1.) Alt BM Description= 2.) Bldg sewer length = / 3G 5 . - 5w Z amount of cover = vow J `~'L, 12 '_7 Plan revision Required? ❑ Yes No Use other side for additional informatio SBD-6710 (R.3/97) Date IXctors~o ature Cert. No. J r w in ~ f N 2 IL y Y a Q M i y~a r 7 s~ i ~ Q ~ c I a U ~ S d z u M \ f r' i 4' ~ LLl, ,i , V ~ F~! ~ ! ~ V i J, i 1 ~,~7 1 4 ~ ~ F a G~~y!r / ~f / I r ~ - ~ ~ 'r ~ 1 yY 2 Lift Station Information & Calculations Total Dynamic Head Calcs. Discharge Rate: 6.18 gpm OZ Forcemain Length 20 ft ' Forcemain Diameter 2 in Friction Loss from Forcemain 0.021 Z~ Vertical Lift 3.74 ft 0 • ~j~ Total Dynamic Head (TDH) 3.76 ft Dosage Volume Caics. Does forcemain drain back to tank?0 Dose: 60 gal Forcemain Volume 9.60 gal Total Dosage: 69.60 gal Tank Information Tank Manufacturer Wieser Concrete Inches Gallons Tank Capacity 650 gal A= 21.3 364.9 Tank Gallons per Inch Water Level 11.82 gal/in B= 2.0 25.8 Bottom of Tank Elevation 88.76 ift C= 5.5 91.5 Pump Manufacturer/Model Goulds D= 12.0 166.8 PE41 P1 Total= 40.8 649.0 Pump Curve Pump Tank Diagram WatertAght.locknq cowr q Inch with warnnq label Ntinnum FnAed f Grade PJkernate J OULIA ,ocaLion Nectreal per Facaman Comm 16.28 and NtC ~;00 req. Weep Hde, A or Ankr5phon pevee D C l7 Selected pump requires a minimum operating rating of: 3.761 feet of head pressure at 6.18 GPM MGOULDS PUMPS Submersible Effluent Pump PE FLUENT PUMP m~ SPECIFICATIONS MOTOR FEATURES Pump - General: General: ■ Corrosion resistant • Discharge: 11/2" NPT • Single phase construction. • Temperature: 1040F (400C) • 60 Hertz ■ Cast iron body. maximum, continuous when • 115 and 230 volts ■ Thermoplastic impeller and fully submerged. • Built-in thermal overload pro- cover. • Solids handling: 1/2" tection with automatic reset. ■ Upper sleeve and lower maximum sphere. • Class B insulation. heavy duty ball bearing • Automatic models include a • Oil-filled design. construction. APPLICATIONS float switch. • High strength carbon steel ■ Motor is permanently Specially designed for the • Manual models available. shaft. lubricated for extended following uses: • Pumping range: see PE31 Motor: service life. performance chart or curve. • .33 HP, 3000 RPM ■ Powered for continuous • Mound Systems • Effluent/Dosing Systems PE31 Pump: • 115 volts operation. • Low Pressure Pipe Systems • Maximum capacity: 53 GPM • Shaded pole design ■ All ratings are within the working limits of the motor. • Basement Draining • Maximum head: 25: TDH PE41 Motor: ■ Quick disconnect power • Heavy Duty Sump/ PE41 Pump: • .40 HP, 3400 RPM Dewatering • Maximum capacity: 61 GPM • 115 and 230 volts cord, heavy 20' duty 16/3 standard d length, SJTW with • Maximum head: 29' TDH •PSC design 115 or 230 volt grounding PE51 Pump: PE51 Motor: plug. • Maximum capacity: 70 GPM • .50 HP, 3400 RPM ■ Complete unit is heavy duty, • Maximum head: 37' TDH • 115 and 230 volts portable and compact. • PSC design ■ Mechanical seal is carbon, METERS FEET 40 ceramic, BUNA and stainless - MODELS: PE31, PE41, PE51 steel. PE51 HP:.33, .40, .50 ■ Stainless steel fasteners. 35 10 I 2 GPM AGENCY LISTINGS 30 1 FT w 25 C us v a 20 I Tested to UL 778 and } } 1 CSA 22.2108 Standards o ; By Canadian Standards Association 15 i File #LR38549 O Goulds Pumps ISO 9001 i is Registered. 10 _ 0 0 0 10 20 30 40 50 60 70 GPM 80 ' Goulds Pumps 0 5 10 15 m/h CAPACITY 2004 ITT Water Technology, Inc. E ITT Industries Effective June, 2004 w BPE31/41 rarT r County Safe and Buildings Division e2o-fX k 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) a S Madison, WI 53707-7162 _ A.-`` TriaAA ary Permit Application state , n Number, In accordance with SPS 383OF2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if dill nt than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04 1 (m Slats. J~ 1. Application Information - Please Print All Information Property Owner's Name Parcel # X02- -/o2 - 26 - oho a for ~a.ho Property Owner's Mailing Address Property Location 9 e z Cmu14-~ RA b Govt. Lot City, State Zip Code Phone Number AV E '/4 -/,,Section 13 pQcwIUV 5g028 (circle one Tgg N; R to Eor H. Type of Building (check all that apply) Lot # / I or 2 Family Dwelling - Number of Bedrooms 3 Subdivision Name LV"-w"i Block # ❑ Public/Commercial - Describe Use ❑ City of umber ❑ Village of El State Owned -Describe Use VSM VV 2 112 5 Town of Ed III. Type of Permit: (Check only one box on line A. Complete line if applicable) A' ❑ New System Replacement System Treatment/Holding Tank Replacement Only El Other Modification to Existing System (explain) List Previous Permit Nu her and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New ff Before Expiration Owner f /U ~L (i IV. T of POWTS S stem/Com onent/Device: Check all that a 1 $Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ ound > 24 in. suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) Pretreatment Device explain) V. Dis rsaNTreatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation q,5 0 61 .07500 '7 53.9 VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units a R U U U y y New Tanks Existing Tanks o d a = cO Septic or Holding Tank 9 tj ~~p /~V t sC Dosing Chamber / / Sd S VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) P ber's Signature MP/MPRS Number Business Phone Number te!',444- I J, Yh s 2 !&7485 ? s 245- Y~ /S Plumber's Address (Street, City, e, Zip Code) 2 (3a~~. R v-~ ~ len ccs !gr G~ / Sao/ 3 VIII. oun /De artment Use On Permit Fee Date Is ued suing Agent ign pproved ❑ Disapproved ❑ Owner Given Reason for Denial GO (O 2 j G~~ IX- Conditions of Approval/Reasons for Disapproval _I p~~ ,_yr Gti SYSTEM OWNER: 3 1. Septic tank, effluent filter and JPS 3J? 3, 33 dispersal cell must be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable c plans for the system sod su11A3it o the C my my on per not less than 8 1!2 x 11 inches in size 36 SBD-6398 (R. 11/11) Page 1 of 4 a SYSTF=MS I N C Enoirt7nme;n?, 1 c t ;farr dcrrgolutions" Leaching Chamber Design Spreadsheet Project Name: Manor Owner's Name Taylor Manor Owners Address 982 County Rd D Woodville, WI 54028 Legal Description _ % FE _ I'/4 Sec 13 T 29 N, R 16 w Township Baldwin County Saint Croix Subdivision Lot# ParcelID# D02-102& -20- Q~ Table of Contents Pg- 1 Cover page 2 Calculations and Drawings 3 Management and Contingency Plan 4 Plot Map total # of pages: 4 Designer Name: Michael J. Myers License 267985 Date: 10/26/2012 Ph. 715-265-4115 Signature: Design Methods Used "IN-GROUND SOIL ABSORPTION COMPONENT MANUAL FOR PRIVATE ONSITE WASTEWATER TREATMENT SYSTEMS" (Version 1.0) SBD-10705-P (R.6199) • " • Infiltrator and the Infiltrator logo are trademarks of Infiltrator Systems, Inc. SYSTEMS INC Spreadsheet provided under license to Infiltator Systems, Inc by: 3bAdvisement N12486 220th St, Boyceville, WI 54725 nk'13191-PT) Me- Calculations and Drawings Page 2 of 0 SYSTEMS INC Site Conditions Infiltration Elevations Site Type: Private Trench #1 Trench #2 Trench #3 %Slope 3 % Contour Elev: 95.61 95.74 Ft # of Bedrooms 3 Infiltration Elev: 92.50 92.50 Ft Depth to limiting factor 78 inches Limiting Factor Elev: 89.11 89.24 N/A Soil Application Rate: 0.6 gal/ft^2/day Treatment and Dispersal Zone: 3.39 3.26 N/A Effluent QualityLEff #i V Cover Material Required: 0 0 N/A In Design Flow: 450 gal/day Finished Grade Over Cell: 95.61 95.74 N/A Max BOD 220 mg/I Max TSS 150 mg/I Distribution Cell Choose chamber type: Septic Tank Infiltrator Quick 4 Standard Manufacturer: Wieser Concrete # of trenches: 2 Volume Chosen: 1000/650 Chamber Length: 4.00 Ft Effluent Filter Selected: Polylock 525 Chamber EISA: 20.1 Ft2 Note: Access opening of sufficient size to be provided to allow removal of filter. Endcap EISA: 5.1 Ft2 Opening to terminate at or above grade. Required Infiltrative Area: 750.0 Ft2 Actual Infiltrative Area: 753.9 Ft2 Total # of Chambers: 37 Ca~ Cross Section of Septic Tank Total # of Endcaps: 4- 12" Combined Length of Cells: 152.0 Ft r Min 'IN1 1/~'~ Cross Section of Cell 7-M C over Material Observation Pipe (if required) Final Grade All joints to be water tight D3034 or Ground Sch40 Contour q3- Effluent Sa JJ Filter Pipe Leaching System c~ Chamber Elevation , 3" Bedding Under Tank 9'? L C Wild!ilh t'Jbs~rt,t IrvaUGn fm or 5ch ~O 111 Foe PVC P W Infiltrator and the Infiltrator logo are trademarks of Infiltrator Systems, Inc. Spreadsheet provided under license to Infiltator Systems, Inc by: 3bAdvisement N12486 220th St, Boyceville, WI 54725 Page 3 of 4 In-Ground System Management Plan pursuant to comm 83.54W. A. C. Owner's Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make periodic inspections of the components, checking for surface discharge, treated effluent levels, etc. The owner or owner's agent is required to submit necessary maintenance reports to the appropriate jurisdiction and/or the department. Septic Tank: Septic tank(s) are to be inspected routinely and maintained by department approved individuals when necessary in accordance with their approvals. The use of chemical/biological "treatments" is not required or recommended. If such additives are used, make sure they are approved by Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & cleaned as necessary, with provisions to keep solids from passing the septic during removal. No more than 1/3 of the usable tank volume may be occupied by sludge/scum. 3 year inspection: If tank has greater than 1/3 volume sludge, tank contents must be emptied and disposed of in accordance with NR 113 Wisconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank, then the owner must be notified of when pumping should be done as to not exceed 1/3 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. Absorbtion Cell The absorbtion component must remain free of ponded surface water prior to pump operation. If 4 inches or more water level is detected in the observation pipes, the owner must be notified of possible problems/failure. The designed daily flow capabilities of the component should never be exceeded. Trees and any other deep rooted vegetation should never be planted, or allowed to grow anywhere on the component. Activities OTHER than mowing/maintenance (i.e. excessive walking, pets, vehicles, etc...) could compress the component and reduce it's absorbtion capabilities and/or possibly cause it to freeze in winter conditions. Performance Monitoring: Performance monitoring must be done at least once every three years following the installation or at the time of a problem, complaint, or failure. Contingency Plan: If the septic tank or other components therein (including floats, alarms, etc) become defective, the defective tank or component must be replaced immediately to ensure that the system can operate as designed. If the absorbtion component cannot accept wastewater or ponds wastewater to the surface, the component must be repaired or replaced in it's current location by removing the clogged bacterial mat, aggregate/leaching chamber cell, and distribution piping within the cell and replacing failing components in order to return system to proper working order as required. If repair is not feasible, a new system is to be constructed in a designated replacement area r w ~ J ~ y c 1v _ I 14, N1` r~' Q F 5 . wu~ c ~ ~ F µ a i c~- a s u A ~ 5 ST. CROIX COUNTY SEPTIC TANK MAINTEN"AN"CE AGREEMENT AND 'OWNERSHIP CERTIFICATION FORAM .)xvnerrBttVer 16r nA Mailing Address ------~$2- -~vna~ Prol)ert\ Address S- (Verification required from Planning & Zoning Department for new construction.) City/State ©j JC1 W Parcel Identification Number 062 -10L(o 2 0- 060 LEGAL DESCRIPTION Prol)erty Location Sec. 13 T N R W, Town of Subdivision Plat. , Lot # Certified Survey Map # dr' 3 , Volume 2- , Page # 1-1Z5 Warranty Deed # l ~P ~P ~5 (before 2007)Volume _ Page Spec house yes no Lot lines identifiable yes no SYSTEM iiNIAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 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 i-~ less than 1 3 full of sludge. 1/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 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. Iwe certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms f=,2-571--2 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. 08/05) NVIsconsin SOIL EVALUATION REPORT~'- #84 Department of Commerce in accordance with Comm 85, Wis. Adm. Code Page 1 of 3 Division of Safety and Buildings Northland Plumbing, Inc. Attach complete site plan on paper not less than 8'/Z x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and par percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 2 , 20 ~ ao ~ Please print all Information. Reviewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 0 ?1 Property Owner Property Location Taylor Manor Govt. Lot AIM, NE1/4, S13, T29N, R16W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 982 County Rd D City State Zip Code Phone Number City Village Z Town Nearest Road Woodville WI 54028 612-597-6400 Baldwin County Rd D New Construction Ilse: ~J 1 Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Y Replacement Public or commercial - Describe: Parent material Glacial Outw~ashp, b 3 - (l. k Flood plain elevation, if applicable ft. General comments Ct / ccx-C.~ 2.1 Sr A ,W f and recommendations:- Pi~ Z Boring # Boring Ph Ground surface elev. 95.61 ft. Depth to limiting factor >78 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Efr#1 •Efr#2 1 0-6 10YR3/2 51 3sbk mvfr a 2f .6 1.0 2 6-16 10YR7/3 sl 35bk mvfr C5 if .6 1.0 3 16-32 10YR6/8 fs Osg M1 Cs if .5 1.0 4 32-53 10YR3/6 Cos Osg ml CS .7 1.6 5 53-63 10YR7/6 5 Osg M1 CS .7 1.6 6 63-78 10YR3/6 s Osg ml CS .7 1.6 Boring 2 Boring # Pit Ground surface elev. 96.13 ft. Depth to limiting factor >80 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#l *E02 1 0-4 10YR3/2 51 3sbk mvfr cs 2f .6 1.0 2 4-13 10YR7/3 51 2sbk mvfr Cs if .6 1.0 3 13-47 10YR6/8 fS Osg ml Cs .5 1.0 4 47-60 10YR3/6 Cos 05g ml a .7 1.0 5 60-80 10YR7/8 fs Osg ml a .5 1.0 * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 <_30 mg/L and TSS <_30 mg/L CST Name (Please Print) Sig ature: CST Number Michael J. Myers d , ~Q 267985 Address Northland Plumbing, Inc. Date Evaluation Conducted Telephone Number 2943130th Ave Glenwood City, WI 54013 8/22/2012 715-265-4115 SBD-8330 (8.07/00) Property Owner Taylor Manor Parcel ID # Page 2 of 3 3 ;_J Boring Boring # Pit Ground surface elev. 95.74 ft. Depth to limiting factor >78 in. Soli Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fts in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Etf#1 *Eff#2 1 0-8 10YR3/2 sl 3sbk mvfr CS 2f .6 1.0 2 8-16 10YR7/3 Sl 2sbk mvfr CS if .6 1.0 3 16-36 10YR6/8 fs 0s9 ml CS if .5 1.0 4 36-56 10YR3/6 Cos Osg Ml CS .7 1.6 5 56-78 10YR6/8 fs OS9 mi CS .5 1.0 ,4, ]Boring # Boring 0 Pit Ground surface elev. 95.59 ft. Depth to limiting factor >81 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fe in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#t *EfW 1 0-10 10YR3/2 sl 3sbk mvfr C5 2f .6 1.0 2 10-21 10YR7/3 sl 2sbk mvfr CS if .6 1.0 3 21-36 10YR6/8 fs OS9 M1 CS if .5 1.0 4 36-45 10YR3/6 Cos OS9 M1 Cs .7 1.6 5 45-68 10YR7/6 s OS9 Ml CS .7 1.6 6 68-81 10YR3/6 Cos OS9 Ml CS .7 1.6 Boring ❑ Boring S # Pit Ground surface elev. 94.60 R. Depth to limiting factor >7$ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10YR3/2 sl 3sbk mvfr Cs 2f .6 1.0 2 10-31 10YR6/8 fS OS9 M1 CS if .5 1.0 3 31-39 10YR7/6 s Osg Ml CS .7 1.6 4 39-44 10YR3/6 Cos Osg Ml CS .7 1.6 5 44-78 10YR7/6 s Osg MI Cs .7 1.6 *Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30<-`! 50 mg/L * 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-8330 (R07/00) NW#darW Plumbing, Inc. Q i r4,- V,-) s _W a 17 0 vi w 3 ~ ti A V G A 3 3 R nn, i i I Ca u m~ F i i i !xad z u c~ ( II IIIIIIIIIIIIIIIIIIIIIIIIIIiII 8 0Tx:4077254 966045 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI 10/24/2012 3:00 PM EXEMPT*: N/A REC FEE: 30.00 TRANS FEE: 316.20 PAGES: 5 DOCUMENT NO. SPECIAL WARRANTY DEED When recorded mail to: Taylor J. Manor 982 County Road D Woodville, WI 54028 Parcel ID No.: 002-1026-20-000 This is not homestead property. This instrument was drafted by: Recording Area James W. Ramseyer SBN 1003705 5 This Special Warranty Deed is made between DEUTSCHE BANK NATIONAL TRUST COMPANY, AS TRUSTEE FOR LONG BEACH MORTGAGE LOAN TRUST 2005-WL2 with an address of 7301 Baymeadows Way, Jacksonville,FL 32256 (hereinafter called "Grantor"), and Taylor J. Manor, unmarried with an address of 982 County Road D, Woodville, WI 54028, (hereinafter called "Grantee"). Grantor, for $105,400.00 and other good and valuable consideration, conveys to Grantee that certain real estate in St. Croix County, State of Wisconsin, more particularly described on Exhibit A attached hereto and incorporated herein (the "Property"), together with all appurtenant rights, title and interests. I i 1 of 5 Grantor warrants that the title to the Property is free and clear of encumbrances, arising by, through or under Grantor, except as shown on EAbIbit B attached hereto and incorporated herein (the "Permitted Exceptions"). I 2of5 DH t/67215426.1 Wisconsin Special Warranty Deed Form I 2o15 Dated this day of 2012. DEUTSCHE BANK NATIONAL TRUST COMPANY, AS TRUSTEE FOR LONG BEACH MORTGAGE LOAN TRUST 2005-WL2 by JPMorgan Chase Bank National Association, as Attorney-in-Fact By: 6 Name: Vilosa Devolll Vice President Title: G a/ ACKNOWLEDGEMENT STATE OF J~tIC. ) 05 . COUNTY OF I I FORE AfE, the-undersigned, a Notary Public in and for the aforesaid County and State, on this da nersonally anneared (Name) VIC1` (Title) of DEUTSCHE BANK NATIONAL TRUST COMPANY, AS TRUSTEE FOR LONG BEACH MORTGAGE LOAN TRUST 2005-WL2 by JPMorgan Chase Bank, National Association, as Attorney-in- Fact,on whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed the same as the act of such corporation for the purposes therein expressed and in the capacities therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this day of f /C.EObe.~ 12012. (Notary signature) typed or printed name) My commission expires: ~7 ~~gr Pc~G JUDY LITTLE Notary Public, State= of Texas MY Comrmission Fxpues March 5, 2016 O~F 3 of 5 Exhibit A Legal Description LOT ONE (1) OF CERTIFIED SURVEY MAP RECORDED IN THE OFFICE OF THE REGISTER OF DEEDS FOR ST. CROIX COUNTY IN VOLUME 2 OF CERTIFIED SURVEY MAPS, PAGE 425 AS DOCUMENT NO. 341883. (LOCATED IN THE NE V. OF THE NE'/. OF SECTION 13, TOWNSHIP 29 NORTH, RANGE 16 WEST, IN THE TOWN OF BALDWIN, ST CROIX COUNTY, WISCONSIN). 4 of 5 OB 1/67215426.1 Wisconsin Special Warranty Deed Form 4 of 5 ~ Y Exhibit B Permitted Encumbrances 1. The lien of taxes and assessments for the current year and subsequent years; 2. Matters that would be shown by an accurate survey and inspection of the property; 3. All covenants, restrictions, conditions, easements, reservations, rights-of-way, and other matters of record, to the extent valid, subsisting and enforceable; 4. Zoning requirements, statutes, rules, orders, restrictions, regulations and ordinances of governmental agencies or their instrumentalities relating to the property, the buildings located thereon, their construction and uses, in force on the date hereof (if any such exist); 5. All roads and legal highways; 6. Rights of parties in possession (if any); and 7. Any licenses, permits, authorizations or similar items (if any) in connection with the conduct of any activity upon the property. DB 1/67215426.1 5 of 5 Wisconsin Special Warranty Deed Form 5of5 CERTIFIED SURVEY NO. 4225 34188:3 Part of the NE4 of the NE4 of Section 13, T29N, R16W, Town of Baldwin, County of St. Croix, State of Wisconsin, described in Volume 2 of Certified Survey Maps, page 425 , as Certified Survey 425 Filed July 27, 1977 at 8:30 A.M. James O'Connell Register of Deeds St. Croix County Wis. „ Do.45, 41" W N L4° OA 14 261.31' ,y ORG. REF. TO THE EAST LINE OF THE M. E. 1/4 LIZ ~O ~,y O„`~ SEC. 13, T29N, R16W. ASSUMED ERG. NORTH sa. r3 \``b J W _ r LEGEND 3 • 3/4"° 30" ROUND IRON ROD LOT 1 ae a WEIGHING 1.302 LRS./L.F. 0 5.21 ACRES± SCALE 1". 200' w0 ~O. e Q]'1 419.39' r7ti WEST SOUTH 33.00' _ 790.16' _ _ _ C T H ll Del SOUTH FOUND PK NAIL H.E. COR. SEC. 13, T29N, R{6W %EAST. LINE' dFTHE' N.E.-1/4%SEC,, ,13.. I, Thomas G. Kuester, Registered Land Surveyor, hereby certify: That I have surveyed, divided, and mapped a part of the NE4 of the NE4 of Section 13, T29N, R16W, Town of Baldwin, County of St. Croix, State of Wisconsin, more particularly described as follows: Commencing at the Northeast corner of said Section 13; Thence South 780.16 feet; - •••~yGO S/~ Thence West 33.00 feet to the point of beginning. 1! Thence South 419.39 feet; 3 ~ IIwalMnil~ ~ ~ Thence N 89° 49' 20" W 491.39 feet; ; Thence N 14° 06' 14" W 192.90 feet; $ VFty` Thence N 00° 45' 41" W 251.31 feet; Thence S 87° 49' 36" E 542.12 feet to the point of beginning. Said parcel contains 5.21 acres more or less. That I have made such survey, land division, and plat by the direction of LaVern Johnson. That such plat is a correct representation of all exterior boundaries of the land surveyed and the subdivision thereof made. That I have fully complied with the provisions of Chapter 236 of the Wisconsin Statutes and the subdivision regulations of the County of St. Croix and the Town of Baldwin in surveying, dividing, and mapping the same. Dated this OFday of 1977. APPRO APPROVAL OF THIS MINOR SUJBNV1S10N DOES NOT MEAN APPROVAL FOR J U L 2 0 1977 BUILDING WM OR SEPTIC SYSTEAL R::r-R TK± HA2.20 ST. CROUX r-ou.`SY Vol. 2 Page 425 COMPREHEAS1VE PARKS PLAKNR40 AM ZONING COMMITTEE