HomeMy WebLinkAbout026-1294-09-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
561040 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)). 1
Permit Holder's Name: city Village X Township Parcel Tax No:
I
Richmond Acres LLC, c/o Gerald J. Smith Richmond, Town of 026-1294-09-000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No:
~6b /J M I CST- 28.30.18.1491
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Benchmark
~ Septic T~ ~ ~
140 a / a
well
Dasiag Alt. BM
Fl. I . t .L, 5, AZ
Aeration Bldg. Sewer S•~OS 35
Holding St/Ht Inlet •7 G/
TANK SETBACK INFORMATION St/Ht Outlet ` V
TANK TO C PIL WELL BLDG. Vent tq Air Intake ROAD Dt Inlet
Septic 3 All, _ A* 2-44 Dt Bottom
j Dosing Header/Man. ` Q 7. Z
Aeration Dist. Pipe 7. Z Q
S•
7,-3 7
Holding Bot. System $ . Z 9
PUMP/SIPHON INFORMATION Final Grade 1. (,p 161-11
Manufacturer Demand St Cover
•~{S
GPM
l^ t J SS 167
Model Number
TD Lift Friction Loss System Hea Ft
Forcemal Dist. to Well
SOIL ABSORPTION SYSTEM
BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS -3 2. 1'Z,~.c.~0•d
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING ManufacturerINFORMATION CHAMBER OR
Type Of System:
ZQ ~/C • /JA_ UNIT Model Number: Q C~
/l
~ O TJ ~V J ♦ c~
DISTRIBUTION SYSTEM ! /G r. /(0 3L /mss
Header/Manifold Distribution x Hole Size TI e S ng Vent Air Intake
Pipe(s) ~ QS
Length_~ Dia T Length Dia Spacing _
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth f xx Seeded/Sodded xx Mulched
Bed/Trench Center Bed/Trench Edges Topsoil ~ I] No s No
COMMENTS: (include code discrepancies, persons present, etc.) Inspection #1: / / Inspection #2:
Location: 1173 133rd Ave New Richmond, WI 54017 (SW 1/4 SE 1/4 28 T30N R1 8W) Richmond Acres Lot 9 Parcel No: 28.30.18.1491
1.) Alt BM Description = I4'.~ G6J#LA- 61%411. 0.._
2.) Bldg sewer length = Z 7
- amount of cover = / /I n
Plan revision Required? ❑ Yes No T 3
Use other side for additional information. "
L ~75
SBD-6710 (R.3/97) Date Insepctor's Sig ture Cert No
PLOT PLAN
PROTECT Gerald Smith ADDRESS 11160 190th Ave NW Elk River Mn 55330
SW 1/4.SE 1/4S 28 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX
4/2/13 BEDROOM 3
MPRS Shaun Bird 226900 DATE
CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
1000 gallons LIFT TANK SIZE DOSE TANK SIZE
MOUND SEPTIC TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambe s 32
BENCHMARK V.R.P. Top of 1/4"steel pipe ASSUME ELEVATION 100' Filter BEAR Filter
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
SYSTEM ELEVATION 95.4/95.2 5.7 below qrade
116th ST Well is to meet all
setbacks required by
All piping shall be SDR 30/34, within 10' Z WDNR
of tank, piping shall be Schedule 40.
358' Property Line
i
Pro 3
!8 Bedroom
b House Vent I
30'
jJ „ Quick4 Standard 1
of Cover Leaching Chamber
it .0 ft2 of Area
b 1 5 ^2/pair of end caps
y
4' Long 2" i Grade at System 6evation
34
"
~ B-1
I
`7 a additional boring is to be don to
lower system to a proper elev tion
105' 3% Slope
2-3'X 66' with >3' spacing _
>5' B-3 1 4j
.N
Vents
Scale is 1" = 4 '
unless other is
60' noted
B-2
i
15' B M 201' Pro erty Line
11
commerc e.wt. aw -
D Safety and Huildings Dsion County -
r 201 W. Washington Ave_ P.O. Box 7162 cX~+'~
1sconsin r [Madison, Wl 53707.-71~ -~S
SucaiL[ary .[>urnaiL Nuaaabur
of Comteen¢a - •
State 'l'F'FIIIS~~7L er
ermit Application In aceorda/nDe with s Y32~f Ic dm. Code, submission of t1iis firm tD the npprop f~c cnnmenttil
unit is rnquirrxf pri *btaiI n a s ermil. Note: Application loans for st' wned f'Cl, : - - -
VI(i are Project Atftbess (if ditii rent than mailing address)
submitted to the Depart[ o Commerce. Personal intbnnation you provide Ina for secondary
Purposes in accordance with the Privacy Luc•/, s. 15.040(rn), Seats. N /~J /I~
/L~1i J
L Application Information Please Print All Information li
Properly Owner's Name rj ----z3 Parcel i!
6 ec~
Property Owner's Mailing Address cy ) Property l.ex:ation
----~C7 0 _LVw Govt. Lot IA1 /
City, f Lip Code Pboue Number Z -
"Ole oFIY4-,
.Ill. 'ype of Building (check all that apply) - - /E ~ W
Subdivisiomr Name
r 2 Family Dwelling - Number of Bed, minis
ak
*A PL,
_t Public/Commereial - Describe Use - - C ! SL6S~-------
U City ar, -
State Owned Describe Use CSM Number U Wage of
-
2 Noy- S!~_-~wJ~ ~!woof,
11I. Type of Permit: (Check on! one lbox on line A. Complete line B ifapplicable) -
A"
, ew System L1 Replacernwit System U TreatmeuUHold ng Tanis Replacement Only U Other Modification to Existing System (explain)
10,
R. D Perunt Renewal ❑ Permit RV.-ision CJ Change of Plumber 1J Permit'hansfvr to New List Previuus Permit Nluriber and Dale Issued
Before Expiration Owner :Tfie.
- ---r-•' 4-~'---- - - - -sh-
1T e of POWTS Sys tendCompog,errt/Davice: (Check all that apply)------- - - -
Nun-I'rrssurizeal In-Ground ❑ 1'ressm ized In-Ground ❑ Al-(trade _I Mound 24 in. of suiluble soil ❑ Mound < 24 in. of suitable soil
❑ llolding'raark ❑ Other Dispersal Component (expla - - - - F] etreaUneut Device (explain).. _
V. Dispersal/! teat ent Area luforrntution: - T - - -
Design Flow (gpd) Design Soil ApplicaLion Rate(g dst) Dispersal Area Required (st) - Dispersal Area Propos s ti n
1' Z
Vl.'1'anklydu Ca,raeityin Total #of Matt acturor
C iullons Galion Chits c
New 'IFUrks - - ! xisliug'furlks - - - v
& e.A_ a tg in r w 6 a
Septic or Holding Tank X -
Dosing haad►m - - ,Z
V.11. Responsibility Statement- I, the undersigned, ass responsibility for installation of the POWTS shown on the attached plans--
Plumber's Name (Print) Plumb • ignature - - MP/MFRS tan Or Bninrss Plume Numlxx -
Plumber's Address (Street, City, State, Lip ( ode}
VIII an /De artment Use Only
Approved rsapp Perirui(EFee Date sued issuin ent Signature,
Ow Reason ]or Do / y 13
Cond' '~Pi' Reasons rur Disapproval
1: Septic tic tan k, rr L -
'~"l' tank Cj,1 / I~e.. QCtX~ oV TeT ~0 o ►h~a: A
effluent finer and 11 I
dispersal cell must all be servtces'/main tained
as per management plan provided by plumber. rRC eoww-! ,
2. Ali setback requirements must be maintained
as per **Hcable code / ordinat(Cea:
Attach to cominiete l►lans fu/' the system and submit to the County Duly on lrapor not less Ilium 8 r1z it f }inch" in size
SIID-6398 (R. 02/09)
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 4/2/13
Owner:Gerald Smith
Location: SW1 /4 SE1 /4 S28 T30 N,R18W Lot 9 Richmond Acres Richmond
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 Specific tions Sheet
Signature''
License Timber #226900
PLOT PLAN
PROJECT Gerald Smith ADDRESS 11160 190th Ave NW Elk River Mn 55330
SW 1/4,SE 1/4s 28 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX
4/2/13 BEDROOM 3
MPRS Shaun Bird 226900 DATE
CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
1000 gallons LIFT TANK SIZE DOSE TANK SIZE
MOUND SEPTIC TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambe s 32
BENCHMARK V.R.P. Top of 1/4"steel pipe ASSUME ELEVATION 1001 Filter BEAR Filter
❑ BOREHOLE O WELL *H.R.P. Sameas Benchmark
SYSTEM ELEVATION 95.4/95.2 5.7 below qrade
116th ST Well is to meet all
setbacks required by
All piping shall be SDR 30/34, within 10' WDNR
of tank, piping shall be Schedule 40.
358' Property Line
Illo-
Pro 3
Bedroom
House Vent
/409 >6„ Quick4 Standard
of Cover Leaching Chamber
it .0 ft2 of Area
5 ^2/pair of end caps
4' Long 12
Grade at System Elevation
B-1 34"
a additional boring is to be done to
105' lower system to a proper elevation
3% Slope
2-3'X 66' with >3' spacing
>5' B-3
Vents
Scale is 1" = 40'
unless otherwise
B-2
LBM.* ' noted
15201 ' Property
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
5.6ft^2 pair of end plates Finish grade elevation
Typical Installation 100.0'
Vent Vent
Grade
3' 4„ 3'
A~30/34 Septic Tank
5' Long 191 5' 5' Long 1 Grade at System Elevation
3699 Grade at System Elevation
Spacing 5'
2-3' X 66' Cells
Same on other end Observation tubeNent
At end of cell
A
B
16 chambers per cell
System elevations:
A-95.4'
B_95.2'
^ 2^_':C C3 24 386.4686
2i2
ST. CROIX COUNTY
SEPTICTANK MAINTENANCE AGREEMENT
AND y:
OWNERSHIP CERTIFICATION FORM
Owner'Buyer _~~i- s_,?,~ f
Mailing Address /Y? S-5330
Property Address 11 153 rd
(Verification required from Planning & Zoning Department for new construction.) a
City/State Parcel Identification Number e%'o d ~4~)M
LEGAL DESCRIPTION
Property Location-S~'/a Szf- Y~ .Sec., TN RW, Town of i czetz~.
Subdivision Plat: Kr~ , Lot #
Certified Survey Map Volume , Page # Warranty Deed # y 2 b
(before 2007)Volume Page #
Spec hou ye Lot lines idendriable yes no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of y cur septic system, could result in its premature failure to handle wastes, Proper
maintenance consists of pumping out the septic tank every three yearn or sooner, if needed, by a licensed pumper. What you put into
the system can affect the function of the septic ta,.k ks a treatment stage in the waste disposal system. Owner maintenance
responsibilities are specified in §Coutm, 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
1'hc 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
wastewvatcr disposal system is in proper operating condition and/or (2) uncr inspection and pumping (if naeessary). the septic tank is
less thnn 113 full of sludge.
I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal aYstem with the
standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin.
Certifloation staling that your s stem has been maintain
Y Y kd must be completed and returned to the St. Croix County Planning &
Zoning Department with' is
ui 30 days of the ,.,nee year expiration date.
I/we certify that all statements on thi form are true to the best of my/our knowledge. I/we am/are the owner(s) of the
properly described above, by virtue of a wa my deed recorded in Register of Deeds Once.
Number of bedrooms
SIG T Rlt 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 file warranty deed.
(REV. 08/05)
POWTS OWNER'S MANUAL & MANAGEMEN7 PLAN Page of
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner
6 rs Septic Tank Capacity al ❑ NA
Permit #
Septic Tank Manufactui er ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA
Number of Bedrooms ❑ NA Effluent Filter Model 4N
Number of Public Facility Units ANA Pump Tank Capacity
Estimated flow (average) vU allda Pump Tank Manufacturer
Design flow (peak), (Estimated x 1.5) ~j-~j gal/day Pump Manufacturer
Soil Application Rate - gal/day/ft 2 Pump Model 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 (BODE) 530 mg/L -Ground (gravity) ❑ In-Ground
(pressurized)
Total Suspended Solids (TSS) 530 mg/L ❑ At-Grade ❑ Mound
Fecal Coliform (geometric mean) 5104 cfu/1()Oml ❑ Drip-Line ❑ Other:
Maximum Effluent Particle Size in dia. ❑ NA Other:
Other: ❑ NA
~NA Other:
❑ NA
"Values typical far domestic wastewater and septic tank effluent. Other:
❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every: ❑monthls) (Maximum 3 years) 11 NA
ears!
Pump out contents of tank(s) _ When combined sludge and scum equals one-third (3~} of tank volume ❑ NA
Inspect dispersal cell(s) At least once every: month+s) (Maximum 3 years) ❑ NA
ear(s;,
Clean effluent filter At least once every: / ❑ month(s)
/ year(s) ❑ NA
Inspect pump, pump controls & alarm At least once every: ❑ month(s)
11 year(s- NA
Flush laterals and pressure test At least once every: ❑ month(s)
Other: ❑ year(s) NA
At least once every: ❑ monthls)
Other: ❑ year(s) NA
NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master
Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer: Septage Servicing Operator. Tank inspections must
include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of
combined sludge and scum and to check for any back up or ponding of effluent on the ground s((rface. The dispersal cell(s) shalt 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 (X) or more of the tank volume, the entire contents of
the tank shall be removed by a Septage Servicing Operator and disposed of in accordanco3 with chapter NR 113, Wisconsin
Administrative Code,
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units,
and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
Page of
START UP AND OPERATION
Fbr 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
tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(s) in one large dose, overloading the 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 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 seale':t.
• 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:
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 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 ANDIOR 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
Phone /__57 Phone -7!,_ -7
13EPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY
Name e7- I Name ~ `,L "-2
Phone o- a4- - ,5 -,IV5? ~j Phone ✓ 3
This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wiscoi isin Administrative Code.
40
VILTER CARTRIDGE Installation
s•rKp .Y Dry tit the 1Yifer case ,nrrCp lira
COW of the outij.-t Oip.
entered under tier as ctirgas oparaihy. If r91t teltltNr hs;~ arore !rn it is
tank through tlteY awtlet or
pipe. ealuoaat weld (0111116) Odditioinaf pipet Urrko the untlet tires
~,Y EP a While the case is Stlii Irv fitted an the nutlet pipe, tnua8ure the length
uf+u-tlpdr pipe nareded to brar ~ thhe'"tot-t-0 tits tank ems well It U01411111 the
uptiontri aupplierrttlltal side SUPP rrt. If wide suplaort rnethud fs not utiilrxd,
prometd to atop four
a's'ks' :t Fur' inNtallatiorrsr ui9fiaring the Optlormi SUppltantontal side support:
sofuebt weld tine sli••rtich pipe unto the filter case. If side support haekkod fs trot
utliired, proesed to step tout;
Solvent weld the later came uhto the otrtiet
cartridge into the +ale' ru6islttr p+pe. Tnbvrr flee niter .'~jl.
this case. p i down uhklf that filter inCks into the isuttrvnr of . ~ct
If ,a VAS switch is utilk avd_ insati't irate tiro
Cktckwixe yon, filter and luck by ttlrr►ir~y s
r r,
M~1111>r>~~olrlL`~!
1. The efrloant rffter should be Cde aned every tuna tuts sttptlC tannk Is
serviced. f
2. 006h that Outlet access eperagriy to Inspect the tank od fillet; I
8. Pump the septic tank completer making sure to remove the sludge
laVor bo the bottom of this wink and Vint 3uut the sourer ahd efftumnt.
4. once thte etauent level has t,ucrrr fuwered below rF
outlet pipe, firmly pUft up on the Altar handle to than iarvetrt of tfrrn
cartridge freer tits case. rlielvdHe the
i
5. slider the earirldge up and sit it: of the casts frrr ciseurihy.
6. it a VRs switch conruncted to art alarht is ordsent, the switch f1~.
should be removed by turns-V couhterdackwisu goy attd deaudd
with water only. r.
7. While holding the cartridge rrn bts hidd fiarge Hat surfaue fs+rirsg
duwa) over the atz"s uperlingr r*60 UN Cite Cadrldge VAlk wrrtae rtr
only, rrraldhg sure all sopialyo: nvattnrtat Is rlrrsod bark lotu the tank.. A~.
a. ir'vlts bwvftch is utgiredr replaft by iirarrtileg into tifitetr and
`
turnrbg dodcwise Sri°.
+rt
y. lirsart the fift'er cartridge back irate the tail, preashig dtoWn until ti' r 4'i,^
the filtur locks iistu this hoitam of the, caau.
lq.Repiace and secure the access twoohrll on the tank.
r.: b• • iw?,r ~ • •'Ic -yr; ~ 4N'~':~'n(rti ' 1,'ur' "f l1J a rrai i,t? :,v:,iml.iJl* ,
w%mbeatwii>1> dW.leom 8t77'•- Cr-MM (653-4583)
RICHA X WD ACRES
(A COUNTY PLAT)
rter of the Southwest Quarter, port of the Northeast Quarter of the Southwest Quarter, part of the
?uarter and part of the Southwest Quarter of the Southeast Quarter all in Section 28, Township 30
th, Range 18 West, Town of Richmond, St Croix County, Wisconsin.
'E SHEET 1)
1 i
i ' 80' RADIUS 7ZWPMAJ
p / S89'53'36"W 519.87' v i CUL-DE-SAC £ASEM
(M W REM0PW Uf
as ~•f , 45.7()-
u 1./ i I ~r L 210.72' • •589 2 •
2.18 acres . l A 13a.2o'
S
1 969.6 95,137 sq. ft. A ~210.72 1 138.ZO; "~'3s°
' ~ ~ h I ~ ~ • C6 N 89'50 7" E ~ •
N84'28.43•W •
N \
200.20' 514.68' rp~ 1
314.48'
~h 2.10 acres
Z h ^ 91,514 sq. ft.
° 33 a ~ rye,
G N ho
34 ~ 1
m 1.90 acr•'es
1.62 acres 82,753s4 . ft. l "ry ho N89'50'27"E 478.27'
70,659 sq. ft.
/ ( ati o r
•
N ! 2.24 acres
W . 97, 480 sq. ft. °
l J~ ~J
14_ _.84 ~I N
24248
W
C?? • 582'42'38"`N
w j~ • N89'50'27'E 524.70'
C7B - N82'4235"E 242• 7
17 acres o
I ` o 94,407 sq. ft.
G Nt1A ~D
N89'50'27'E 468.85'
J ~W G`
W 1.96 acres ] . - 9)
CO
1.74 acres C* _ _
B24Ea96
VIALSH
State Bar of Wisconsin Form 3-2003 KATHLEEN H.
REGISTER OF DEEDS
DEEDS
QUff CLAIM DEED ST. CROIX CO., WI
Document Number Document Name RECEIVED FOR RECORD
05/08/2006 10:40AN
QUIT CLAIM DEED
THIS DEED, made between Dennis F. Ball and Nancy A. Ball, husband and wife ExLwf # 13
and David A. Ball and Kimberly A. Ball, husband and wife REC FEE: 13.00
("Grantor," whether one or more), TRANS FEE:
COPY FEE:
and Richmond Acres LLC CC FEE:
PAGES: 2
("Grantee," whether one or more).
Recording Area
Grantor quit claims to Grantee the following described real estate, together with the rents, Name and Return Address
profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin
("Property") (if more space is needed, please attach addendum):
See Attached Exhibit "A".
This deed is being given by and between all parties re6nquisbing all right, title and
interest they have in that certain Agreement dated May 16, 2005, recorded June 3,
2005 as Document Number 796642.
026-10820-000:026-1082-70-000:
026-1082-95-000:026-1083-10-000
Parcel Identification Number (PIN)
This is not homestead property.
Dated 6
J (SEAL) (SEAL)
*Dennis F. Ball *Di Ball
(SEAL) (/~(J t (SEAL)
*
* (ancy A. Bah *Kimberly
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) Dennis F. Ball and Nancy A. Ball, husband
and wife STATE OF ~'~Y1s11'1 )
authenticated o ) ss..
. C rOtX COUNTY )
* DO C_e,~L-- Personally came before me on T~
TITLE: MEMBER STATE BAR OF WISCONSIN the above-named David A. Ball and Kimberly A. Ball, husband
(If not, and wife
authorized by Wis. Stat. § 706.06 d pLJg~ to me known to be the person(s) who executed the foregoing
0 trument and acknowledged the same.
THIS INSTRUMENT DRAFTED BY.0
2, p►M, sY'
PM C 7
Attorne Kristina O gland
Hudson WI 54016 tary Public, State of
WA4 y Commission (is permanent) (expires: -llo- b )
ilk" 4~ 3;••..•„~•..• ~S
~ ed or acknowledged. Both are not necessary.)
(Signatures ma~Rd*",
%
NOTE: THIS IS A STANDARD FORM. IFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED.
QUIT CLAIM DEED O 2003 STATE BAR OF WISCONSIN FORM NO. 3-2003
* Type name below signatures. INFO-PROW Legal Forms 800-655-2021 www.infoproforms.com
I of 2
EXHIBIT "A"
Parcel 1: The East Half of the East Half of the Southwest Quarter (E%?/E3%(SW'/.) of Section Twenty Eight (28),
Township Thirty (30) North, Range Eighteen (18) West, Town cf Richmond, St. Croix County, Wisconsin,
EXCEPT Lot One (1) of Certified Survey Map flied April 24, 1990, in Vol. 8 of C.S.M., pg. 2199, as Doc. No.
457843, being part of the Southwest Quarter of the Southeast Quarter (SW'/dSE'h) and part of the Southeast
Quarter of the Southwest Quarter ($E%./SW%), both in Section Twenty Eight (28), Township Thirty (30) North,
Range Eighteen (18) West.
Parcel 2: - The West Half of the Southeast Quarter (WY:dSE'/.) of Section Twenty Eight (28), Township Thirty (30)
North, Range Eighteen (18) West, Town of Richmond, St. -Croix County, Wisconsin, EXCEPT the following
described parcels:
•i , Lot One (1) of Certified Survey Map filed April 24,1990, in Vol. 8 of C.S.M., pg. 2199, as Doc. No. 457843,
being part of the Southwest Quarter of the Southeast Quarter (SW'/JSE'/.) and part of the Southeast Quarter of
the Southwest Quarter (SE=W'/.), both in Section Twenty Eight (28), Township Thirty (30) North, Range
Eighteen (18) West;
2. Lot One (1) of Certified Survey Map filed August 13, 1981, In Vol. 4 of C.S.M., pg. 1093, as Doc. No. 372738,
being part of the Southwest Quarter of the Southeast Quarter (SWYdSE'/.) of Section Twenty Eight (28), Township
Thirty (30) North, Range Eighteent (18) West;
3. Commencing at the Southwest comer of Lot One (1) of Certified Survey Map fled August 13, 1981, in Vol..4 of..,
C.S.M., pg. 1093, as-Doc. No. 372738, for the point of beginning; thence N89'59'15" West 20.00 feet; thence
NO'01'41" East 282.00 feet; thence S890591 5' East 224.00 feet; thence SO'01'41" West 15.00 feet; thence
N89059'15" West 209.00 feet; thence SO'01'41" West 242.00 feet to the point of beginning;
4. Commencing at the Northeast comer of the Northwest Quarter of the Southeast Quarter (NW'/dSE'/.) of said
Section 28; thence South 18 feet; thence Northwesterly to a point 10 feet West of the point of beginning, thence
East to the point of beginning.
2of2
I
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i
WiJasin Department of Commerce a 1~ EVALUATION REPORT Page of
Divisidfi of Safety and Buildings with Comm 85, Wis. Adm. Code y
~y County S,t ~ C o 1' ~Attach complete site plan on paper not less than 8 1/2 x 11 nches
include, but not limited to: vertical and horizontal reference int (M D Parcel I.D.
percent slope, scale or dimensions, north arrow, and locati and distance to nearest road.
64
Please ~lrfnt all Informatia F, I I Re awed b Date
l+ l,.1 d 3 v 2005
Personal information you provide may be used for secondary purp as (Privacy Law, s. 15.04 (1) (m)).
~l tJ
Property Owner 6 1. R H(~T)y'at(on
Ge fQ' Sri r~~ ZONI O FI E N 11/45E 1/4 S aq T30 N R E(or
Property Owner's Mailing Addre { Lot # T lock # Subd. Name or CSM#
1//10 1 90 e. NW at o F -,c m crc
city State Zip Code Phone Number ❑ City K; ❑ Village ® Town Nearest Road
FIK R dC- P, PIN 30 ( ) YYI. 8 c.h IM • fV A ~ 1,33' Koe
C9 New Construction Use: T~ Residential / Number of bedrooms Code derived design flow rate GPD
❑ Replacement J ❑ Public or commercial - Describe: _
Parent material -_0 u.l~e Zg it Im 'L Flood Plain elevation if applicable
General comments '4: St'gSe 5-t Lj - -Pre;- C-1, Is C , 4 ) F*,D c
and recommendations: (9 5.39, u rv K h p "J N 1 F
+e) T.t (9t..aa)
S: e T2 (`if,.oo'~ ~ ~ a ~ T ~D (95.w) Y Cte-9 1-e3L i
r"Fe T•3 (9y 9a') t 5
r,Y (95.18 )
9s.571 -r.tt3 04.70')
Boring # Boring
Y 6K 1-10-r a t9 Pit r and surface elev. 1 b_ 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
0-11 1p g 31ij _ L_ m Er a E o
.1 1 p L - ft7 - - , 7 1
G1 -1 D5
3rd _ 7-S yI (o L a
lit L4 S VZ +h - "/L/ S L- D wr c. K e.
Boring # Boring da~nli -to A,4 ' L4 7- IOs 31 , /ASS
❑
btf~
Fi-al Pit Ground surface elev. _ /g • Y ft. Depth to limiting factor 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
o-11 10YR 3 L _lEslyk, ein r aw o? F- .
- S- I s L- I Es b! rm 17 1 C,t,--) I-
S S1 -IDS CIS- '7
VWW
LIL
} r c
• E 4 #4 - _ 5-MV mg E-lueRM2 = BOD < 30 mg/L and TSS < 30 mg/L
T Name (Please P Signature CST Nu, bar
01 V a M .S"~ Date Evaluation Conducted Telephone Number
! -a 3-bs -715 aye 35
Property Owner Gera Ik Sm , Parcel ID # Page C-~_ of
F--31 Boring # ❑ Boring
Pit Ground surface elev. 10 ft. Depth to limiting factor a 0 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
0-11 IoY 3 a Fs 6 k. S Fr at,o o?~ . . 2
II -a9 y, y/ 5 L b r, Fr C".; F . .
3 a9-97 -7.5 YrZ % 5 0- mL c,o lvF
L4 I/ On' M
F-1 Boring # ❑ Boring
E] Pit Ground surface elev. Depth to limiting factor - in. Soil lication 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
a Boring # ❑ Boring
❑ Pit Ground surface elev. _ ft. Depth to limiting factor 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
Effluent #1 = BOD6 > 30 5 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS 5 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 (RAM)
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