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HomeMy WebLinkAbout020-1481-07-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 556389 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: 020-1481-07-000 Oeverin Homes LLC, aka Oeverin Pro ertie Hudson, Town of CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 6.57- 07.29.19.3056 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER n CAPACITY STATION BS HI FS ELEV. le ~"7 Septic Benchmark Q 9 g L> `f C7 f'~J ~TrGt~ ~ F'► ~ l r Bestr►g Alt. BM -K Aeration Bldg. Sewer ~i. 35 5.5 3 Holding St/Ht Inlet 9 Z - (0 5 6•Co TANK SETBACK INFORMATION St/Ht Outlet (o •`1 52.35 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet /VoC~- S 6t!-rv~ Septic 5a r N~ ~z 33 / Dt Bottom Dosing Header/Man. 7•`f q1 8s Aeration Dist. Pipe -7.4 '71 75 7•S 9/. 7S Holding Bot. System LJe`,i g, >1S . 8'S Ea 9a . 7 5 PUMP/SIPHON INFORMATION Final Grade Manufacturer Demand St Cover 5 GPM ~•1l,, Go ~u 1. 7lj `771 Model er TDH ~ift Friction Loss System Head TDH Ft Forcemain L . Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width /Length No. Of Trihes / , PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 9a -7 1 111_11,c, SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR .P' / Type Of System: p / UNIT Model Number: DISTRIBUTION SYSTEM Z CSC Header/Manifold / f Distribution pfd x Hole Size x Hole Spacing Vent to Air Intake Length I i 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 -7 Bed/Trench Edges Topsoil \ es Noes E] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1033 Autumn Oak Lane Hudson, WI 54016 (SE 1/4 SW 1/4 7 T29N R1 9W) Whispering Oaks Lot 7 Parcel No: 07.29.19.3056 1.) Alt BM Description GOJv Cf'"- ~k- d / G 2.) Bldg sewer length = 2 3 - amount of cover Plan revision Required? Fu Yes No 'Z, r ~s Use other side for additional information. SBD-6710 (R.3/97) Date Insepcto Signatur Cert. No. I I L 1~f lo, Q~ PLOT PLAN PROJECT Oeverina Homes LLC ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SE 1/4 SW 1/4S 7 /T, 29 'N/R 19 W TOWN Hudson COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 11/7/12 BEDROOM 3 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers 44 BENCHMARK V.R.P. Top of 1" pipe ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark All piping shall be SDR 30/34, within 10' SYSTEM ELEVATION 92.5/92.4 6.5' below qrade of tank, piping shall be Schedule 40. Well is to meet all setbacks required by Amber Ridge Drive WDNR Scale is 1" = 40' Vent unless otherwise >6„ Quick4 Standard noted h of Cover Leaching Chamber i1 with 20.0 ft2 of Area 12" 10.2ft^2/pair of end caps We, ' 4' Long ~ bd Grade at System Elevation 4 Pro 3 Bedroom House i 140' 'o ~e 10' ST 2-3' X 90' Cells with >3' spacing 0' B.M.* B-1 100, B-2 99, 20' Vents 40' Ke lace Qfec.~ 98.5' 50' B 3 1% Slope lq_ 283' Property Line - corf111'1e1'~Gm.Wi. OV g~1~ ,C Safety -,trod 13uildin r County t 201 W. Washington Ave. -1- Madison. Wt 5371162 M of COtI#tnfaCS ffr' . +p a 14' sw1liur WAG Y Yaru)~ tC. .360 b- nud to by c, , sanlts J" ermit Application State'1'ra0sa5ctionn Number In acsrordance with S. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the uPP-Priate governmental AA unit is required prior to obtaining a sarrutary permit. Note; Application forms for state-owned POWTS are submitted to the Department of Commrterce. Project Address (ifditfererH "inn mailing address) u Dees in a0ardatwe with Personal iatbrmativn you provide may be used for secondary the Private law, s. 15.o4(I m stets I. A lication Iaformatilun - Please Print Ali Info' tt ~d 33 A'✓~^~ ~w,~r` Oc G Property Owner's Name Parcel # r~ v Property Owner's Mailing Address CP Properly l.uuali Govt. Lot r City, S Ztp Code ) Phone Number" Vol3 /K, Section rcle o . T pe of Building (check all that app! Lot # C N; I E W or 2 Family Dwelling- Number of Bear msv Subdivi i n Name - 6k Gd Block ❑ Public/Commercial - Describe Use t°~/ / l Q ❑ City u ❑ State Owned - Describe'f Use CSM Number ❑ Village of Z 8' 4~-^ l5 2Z 2 Z G11w. J- own of III. Typo of Permit: (Check on[ one bolt on iine A. Complete line l3 if applicable) A. tSystem ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to l xisting system (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit'rransi6r to New List Previous Permit Number and Date issued Before Expiration Owner IV. Typo of POWT-S S stem/ComaoaentSevice: Check all that a t r Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable: soil ❑ Mound < 24 in. of suitabhs'soil /'r` J -S~, ❑ Holding Tank ❑ Other Dispersal Cornponeat (explain) El Pretreatment Devine {explain) G ~al►~ S V. Die ersal/Trea out Area Iaforntation: Design Flow (gpd) Design Soil Application (gpdst) Dis erW Area Raqui (St) Dis emnal Area Pro sed (st) stem Elevati VL Tank Info Capacity in Total # of ufacturer Gallons Gallons Units New Twits sting Tanks U ~1 v rn m r/1 A septic or Bolding Tank 1Josurg Chamber IVII. Responsibility SYateme t- I, the undersigned, assu esponsibitity for installation of the POWTS shown on the attached plans, Iber's Name (Print) Plumber' gnature MP/MPRS Number Business Phone Nu ber 'lumber', Address Street, City, State, Zip Code ~C f Iil Count /De rtment Use Only Approved Permit Fee Date sued Issuing nt Signature Z _ n lbr D $ / $ / Re on ial X. CondiiNglReasons for Disapproval TCA%- (aJJ G, onsr ~a•~ U ,Q r 1. Septic tank, effluent filter and dispersal cell must all be services I maintained r ; y P►n ti.. . as per management plan provided by plumber. 2 AU "Itpack requirements mtatz be mttintafnt#d 6~ ~ As per applicable Code I Wdihitr m. Al PaJ-a(- r Attach to complete plans for the system and submit to the County only on paper a Ices than 8 U7 s 1 t inches in sise • lI;BD-6398 (R 02/09) PLOT PLAN PROJECT Oeverina Homes LLC ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SE 1/4 SW 1/4S 7 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 11/7/12 BEDROOM 3 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE • 5 ABSORPTION AREA 900 # of chambers 44 BENCHMARK V.R.P. Top of 1" pipe ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark All piping shall be SDR 30/34, within 10' SYSTEM ELEVATION 92.5/92.4 6.5' below qrade of tank, piping shall be Schedule 40. Well is to meet all setbacks required by Amber Ridge Drive WDNR Scale is 1" = 40' vent unless otherwise >6„ Quick4 Standard noted of Cover Leaching Chamber with 20.0 ft2 of Area 10.2ft^2/pair of end caps Long 13439 Grade at System Elevation 34" Pro 3 Bedroom House 140' 10' ST 2-3' X 90' Cells with >3' spacing 0' B.M.* B-1 100' B-2 99, 20' BOB Vents 40' 98.5' 50' B-3 1% Slope 283' Property Line . Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 11 /7/12 Owner: Oevering Homes LLC Location: SE1/4 SW1/4 S7 T29 N,R19Wwhispering oaks lot 7 Autumn Oak LaneHudson 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 Specifications heet Signature License nu 44r #226900 PLOT PLAN PROJECT Oeverina Homes LLC ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SE 1/4 SW 1/4S 7 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 11/7/12 BEDROOM 3 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers 44 BENCHMARK V.R.P. Top of 1" pipe ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark All piping shall be SDR 30/34, within 10' SYSTEM ELEVATION 92.5/92.4 6.5' below qrade of tank, piping shall be Schedule 40. Well is to meet all setbacks required by Amber Ridge Drive WDNR Scale is 1" = 40' vent unless otherwise >6„ Quick4 Standard noted of Cover Leaching Chamber with 20.0 ft2 of Area 10.2ft^2/pair of end caps 4' Long 12" Grade at System Elevation 34" Pro 3 Bedroom House 140' 10' ST 2-3' X 90' Cells with >3' spacing 0' ~ B.M.* B-1 100, B-2 99, DOE] 20' Vents 40' 98.5' 50' B 3 1% Slope 283' Property Line 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 To be >1' above grade 10.2ft^2 pair of end plates Finish grade elevation Typical Installation 99.0' Vent Grade Vent 3' 4„ j3p x/30/34 Septic Tank 5' Long 1 11 5' S' Long 1 Grade at System Elevation 3691 Grade at System Elevation Spacing 5' 2-3' X 90' Cells Same on other end Observation tubeNent At end of cell A B 22 chambers per cell System elevations: A-92.5' B 92.4' ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Bu er f eJ•P n Mailing Address 3 P,1 _ - ~G Property Address t 0 ~v-- 14~ (Verification required from Planning & Zoning Department for new constructian.)~ City/State Parcel Identification Number .0 A/ g 0 7`tV LEGAL DESCRIPTION Property Location '/a Sec. , T 2~ N R///' W, Town of Subdivision Lot # , Certified Survey Map # Volume Page # _ ^ Warranty Deed # (5) Volume Page Spec house yes no Lot lines identifiable no SYSTEM MAINTENANCE MP 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 miaintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter .12 - St. Czoix 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 (I) 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 113 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 Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & .caning Department within 30 days of the three year expiration date. I/we certify that all statements on s 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 arranty deed recorded in Register of Deeds Office. Dumber of bedrooms AIGNAT OF~APPLICANT(S)~ DATE +**Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. (nclude 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) POWTS OWNER'S MANUAL & MANAGEMENTPLAN Page of PILE INFORMATION SYSTEM SPECIFICATIONS Owner ? t Septic Tank Capacity ~M!t2 gal ❑ NA Permit # Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ~ ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units >16 NA Pump Tank Capacity al NA Estimated flow (average) al/day Pump Tank Manufacturer NA Design flow (peak), (Estimated x 1.5) al/day Pump Manufacturer NA Soil Application Rate al/day /ft2 Pump Model NA Standard Influent/Effluent Quality Monthly average` Pretreatment Unit NA Fats, Oil & Grease (FOG) s30 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODs) 5220 mg/L O-VA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Disp al Cell(s) ❑ NA Biochemical Oxygen Demand (BOD5) 530 mg/L -Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) s30 mg/L -14A o At-Grade ❑ Mound Fecal Coliform (geometric mean) 5104 cfu/100mi ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size 16 in dia. p NA Other: ❑ NA Other: ❑ NA Other: ❑ NA Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ monthi) ear s (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one-third (IS) of tank volume ❑ NA Inspect dispersal cell{s} At least once every: ❑ monthss) -5 Ag(year(s (Maximum 3 years) ❑ NA NA Clean effluent filter At least once every: monthts) years; Inspect pump, pump controls & alarm At least once every: ❑ monthis) NA ❑ year(s, Flush laterals and pressure test At least once every: ❑ monthis) NA Cl year(s) Other: At least once every: ❑ monthis) NA ❑ year(s) Other: NA NIAINTENANCE 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 si.irface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third 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 an!, 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 that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the 1 ank(s) removed by a septage servicing operator prior to use. 3ystem 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 cell(s) and may result in the backup or surface discharge of effluent. ro avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the ?ffluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps.; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely 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; A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. -replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ 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 romoval 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/Oft INSUFFICIENT OXYGEN. DO N ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEIATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS 5OWTS INSTALLER POWTS MAINTAINER Name Name ~ Phone U ' SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUV'HORi ,Y - Name C LQ. Ivy Name Phone Phone This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. FiLTER CARTRIDGE INSTRUCTIONS Installation STEP I pry fit the filter case ant, the and of the outlet pipe to ensure it is centered under the access opening. If not., then aiti4er insert more pipe into the tank through the outlet or solvent weld (glue) additional pipe Onto the outlet pipe. STFF 3 Whik the case is still dry fitted on the outlet pipe, measure the length of '14-inch pipe needed to brace, the filter to the tank end wall if utinzing the optional supplemental side support. If side support method. is not utilized, proceed to step four. S•rir•f' ~ For installations ut8lzing the optional supplemental side support: solvent weld the '/,-inch pipe onto the filter case. If side support method is not utilized, proceed to step four, y Solvent weld the filter case onto the outlet pipe. Insert the filter cartridge into the case, pressing down untif the filter locks Into the bottom of the case. If a VR5 switch is utilia -d_ insert into the filter and luck by turning clockwise 9(P. ;.'1•"•' y, 1 h ,4;'a +y', ' j' a1'' Maintenance 1. The effluent filter should be cleaned every time the septic tank is serviced. { i I 2. Open the outlet access opening to inspect the tank and fitter, • s. Pump the septic tank corrophetely, making sure to remove the sludge layer on the bottom of the Lank 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 on the filter handle to dislodge the x cartridge from the case. 5. slide the cartridge up and at it of the case for cleaning. 6, if a Vlts switch connected to an alarm is present, the switch should be removed by turning counterclockwise 90° and cleaned r.. with water only. 7. While holding the cartridge on its side (large flat surface facing h ti. down) over the access opening, rinse off the cartridge with water only, making a sure aY sto e> material p g material Is rlatsed back into the tank. .,.,X.*. r.. a. IE VRS switch is utilized, replace by insetting into filter and turning clockwise 901. #4ni ,n 9. Insert the filter cartridge back into the rase, pressing down until " ' .4.. . the filter locks into the bottom of the case. 'w a IQ. Replace and secure the access opening on the tank. " ir' •.iW:.:.. d l: "°r; ~ •LPi l"4Y.'.TMr{! ' Ue:- n.' : irFt':.4~ '.N:+r!6ks •i.... r . i .beamnsitexom 877 -4583 wv-NL[LTtR5 (653 8 1 0 3 0 5 9 Tx:4080874 STATE BAR OF WISCONSIN FORM I - 2000 966857 WARRANT' DEED BETH PABST Document Number REGISTER OF DEEDS WI THIS DEED, made between NWP Holdings, LLC, a Wisconsin Limited ST. CROIX CO 11/06/2012 O. PM Liability Company, Grantor, and Oeverin~ Homes, LLC, a Wisconsin Limited Liability Company, Grantee. EXERECMPT MPT#:NA NA FEE: 30.00 Grantor, for a valuable consideration, conveys to Grantee the following TRANS FEE: 141.00 described real estate in St. Croix County, State of Wisconsin (the PAGES: 1 Praperty Lot 7, hispering Oaks, St. Croix County, Wisconsin. Recording Area Name and Return Address: Land Title Inc. File No. 390239 2200 West County Road C, Ste 2205 Roseville, MN 551 13 Together with all appurtenant rights, title and interests. 020-1002-50-055 Parcel ldcntification 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, if any, of Record. Dated this 31 st day of October. 2012. NWP old 1~:. * J ht Parotti. Member * AUTHENTICATIOKN- ~A -rk ACKNOWLEDGMENT a 11 ~O Signature(s) &''Vo% f, .ESTATE OF WISCONSIN ) `5-,SjT~,. CROIX COUNTY. ) ss. authenticated this 31 st day of October, 20tl,sj~ Personally came before me this 31 st day of October, 2012 the above named John Parotti . Member of NWP Holdings, rip * LLC , a Wisconsin Limited Liability Company, to me known to be the person(s) who executed the foregoing instrument and TITLE: MEMBER STATE BAR OF WISCONSIN acknowledged the same. (If not, authorized by § 706.06. Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY * e tl a J. Bune Notary Public. State of Wisconsin Larry S. Mountain, Attorney at Law My commission is pemianent. (If not, state expiration date: 10/27/2013 ) (Sien;ttut'e, may be authenticated ur at knuwlcdged. Ruth arc not ncccssaly.) *Names of pcisons signing in any capacity IDUSl Ile hyped of printed below their timialure 1 of 1 WARRANTY DEED STATE BAR or NVISCONSIN F010-1 No. 1-2000 COO CO = 12 C" C.0 ca C t' ~ ~ ,,fit ~ ``~r .~d,~:_ i► a -U) RN LL IL P- -•l ~ ~ ` CS tU rn LOT 6B,964 SQ. FT. cr v, °o_ 1.58 AG. a'3 r3 t L.B.O. = 914.3 1 ' f t t rn , 1r 10 E {915.97} 283.53 r cif 47. € € t t j ! €u E : LOT T co t 43,906 SQ. FT. 1.01 AC. 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I PG. 178 ` S00°13'45'W 1954.12 S00°13'451W E as \ 134 \ \ \t3 1 - / 1 a2i / 112 J 182' \ - - - - I- - - 94 ~ \ \ \ \ \ \ \ I ~ -1'23 OT- ~ / I - / / - \ ~ I w v~ \ \ I \ \ \ \ \ e2 / ww1O \ CC X.: cl, \ \ OAS \ \ \ 1 \ , , \ 2y C.S.M. VII VOL. 23 PG. 3588 A L) 04 C, co LQT 3 I LOT Z ! i J / \ r ow a , :::m: • :.pi?t:r ;:~a;:;:; ::e:.: ......:.::::::::r::::::;:xt;:;t;::.::s::;tz :::::::[::::::z:;:;::~s::::s~+'' 125 97' c - 375 - - S3bDV9!'01 10"J1/10- - - 405.11' I ' OVOU NMO-L\ - -127"m -139' - _ .126:~ "I IZv 1 1-' 139'- -j J LOT 1 C.t."K: UU / VOd_2 -837 WX C / / /j / I M Na \ UU \ COW) m on S00'00'10'E / ~o it / _ 'O 1 ~UV \ I Na - i p N (Ny r / m rn i .DRAINAGE _ ~ c wwi \ I a 8. LOT AJ l \ \ J m M. lid wal"L PG. 5li 7- 7 1 2' / o J3 ' / 148' \ 160' \ 145' 126 \ \ 140' / y - 2'E-1 26"/ / / / \ - s / / \ \ \ \ EAST N \ THE ST 1839.79 OF THE SW X \ \ \ j / A SMALL TRACT r- Q 9 w ` d 1 wt a~ _ A a3 .ssc,~ NO sir ssr Eol R i (p~ w NNW I IIN f y t t 16 Wisconsin Department of commerce SOIL EVALUATION REPOR PAIDPage L of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8112 x 11 inches in size. Plan must ccu include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print aft Jnfonnation. evie Date 71 Personal Information you provide may be used for secondary purposes (Priv .04 (1) (m)). GI~YV~^' ~Q a7 ~v Property Owner C 'Ivrtj P erty Location /L/co 1 RE G A Lots 1/45014 S ~ T 2,9N R E( Property Owner's Mailing Address 1Q Lot Block # Subd. or CSM# 10;4 jen~? -1 CC 2 20 - Cv r `A Q city State Zip Code hone NundrOlX )0*11 FI Villag T Barest cad 1 A S ]It & ZONING 0 At ~ r I Y~ ~ e, New Construction UseMesidendal / Number of bedrooms w Code derived design flow rate J~ GPD ❑ Replacement ❑ Publi or commerdal - Des Parent material ~ax A? Flood Plain elevation if applicable ft. General comments 9a L!/Q-& and reoorrtrnendetiorts: ~ 7 15 SystemType System Elevation Boring # E] Boring J? pit Ground surface elev. 0 ft. Depth to limiting factor V in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 Z~ Boring # Boring rn~ IR Pit Ground surface elev. z/ ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Desorption Texture Structure Consistence Boundary Roots GPD/ff In. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •042 o f z- )O r 31 L S T < <v < < Z 1.z-bI6 , S r S 411- 1 6G/ U r s s I - '7 1 r II 14 • Effiuertt #1 = BOD > 3 i < 220 mg/L and TSS >2k):5 150 ' Effluent #2 = BOD < 30 mWIL and TSS < 30 mg/L CST Name (Please prktt) S CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 715-246-4516 f -7 l arcel ID # Page _ of Property owner _ ❑ ® Bodng # Boring g ° 1 vin. Ground surface elev. ft. Depth to limiting factor Sh Pit c wa ion Rate ~ Color Redox Description Texture Stricture Consistence Boundary Roots GPDJ Horizon Depth Dominant Col •Eff#1 'Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1, 1 I I ~ Z r 5 Yr rn 10 E Boring # ❑ Boring Ground surface elev. ft. Depth to limiting factor in pit Soil Application Rate ❑ Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1fF •Eff#1 'Eff#2 in. Munsell Qu. S7-. Cont. Color Gr. Sz. Sh. ❑ Boring in. El Boring # Ground surface elev. ft. Depth to limiting factor Pit Soil ication Rate ❑ Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDM Gr. Sz. Sh. •Eff#1 'Eff#2 in. Munsell Qu. Sz. Cont. Cola' Effluent #1 = BOD5 > 3o:< _ 220 mglL and TSS >30 150 mg& ' Effluent #2 = BODE < 30 mWL and TSS < 30 rngll. 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. seau3o pe.6/o01 I 1 Soil Test Plot Plan Project Name NWP Holdings Shauk*d Address 573 CtY Rd A Hudson Wi 54016 C&A #226900 Lot 7 Subdivision Whispering Oaks Date 10/18/10 SE 1/4 S W 1/4S 7 T24 N/R19 W Township Hudson Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 1" pipe System Elevation TBD *HRpSameasBenchmark Amber Ridge Drive Scale is 1" = 40' unless otherwise noted 140' B.M.* B-1 100' B-2 99' 20' 40' 98.5' 50' B-3 1% Slope 283' Property Line 08/24/2012 09:40 AM Parcel 020-1481-07-000 PAGE 1 OF 1 Alt. Parcel M 07.29.19.3056 020 - TOWN OF HUDSON ST. CROIX COUNTY, WISCONSIN Current ❑ Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 11/08/2011 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner 0 - 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 1033 AUTUMN OAK LN SC 2611 SCH DIST OF HUDSON SP 1700 WITC Legal Description: Acres: 1.580 Plat: 11-039-WHISPERING OAKS 020-011 SEC 07 T29N R19W PT SE SW WHISPERING Block/Condo Bldg: LOT 07 OAKS LOT 7 (1.58 AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 07-29N-19W SE 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 1.580 38,700 0 38,700 NO 05 Totals for 2012: General Property 1.580 38,700 0 38,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00