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Home My WebLink About030-1093-10-200 (1) oar County Safety and Buildings Division Q r 201 W. Washington Ave., P.O. BOX 7162 Sanitary Permit Number (to be filled in by Co.) a Madison, WI 53707-7162 47 V 6 164 4, ~F18fOrAti~ Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2), 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 different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be use for secondary purposes in accordance with the Privacy Law, s. 15.04(1) m), Stats. ~j 1[ I. Application Informatio - Plea nt AA40wv" ( Property Owner's Name it lyt&t' Parcel # f3 16A) VfFs c~` b ~o - l6 3 - o - o?oo Property Owner's Mailing Address 1 C,~0 P~ Property Location -/u 9 6 rO Govt. Lot City, State 1 Zip Code/ / Phone Number ,yam / 1/4, ~K, Section 51/ C~ 3 a; cle one) Ota / l r Q- / ( T b /Ira 7fS ' 760 - 0 T REorW H. Type of Building (check all that apply) Lo X or 2 Family Dwelling -Number of Bedrooms Subdivision Name B # El Public/Commercial - Describe Use ❑ City of El State Owned -Describe Use CSM Number ~ JMW I El Village of ,K Town of 5T T0- Q;s}s w S S Cl G ro 46115 IF III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. YkNew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision El List Previous Permit Number and Date Issued Change of Plumber El Permit Transfer to New Before Expiration Owner . r.hc!L a . 4,~- ~ IV. Type of POWTS System/Component/Device: Check all that apply) Non-Pressurized In-Ground ❑ Pressurized hi-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil Mound 124 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersal/Treat ent Area Information: Design Flow (gpd) Design Soil Application (gpdsf) Dispersal Area Required (sf) 'Dispersal Area Proposed ( System Elevation VI. Tank Info Capacity in Total # of Manufacturer o U Gallons Gallons Units New Tanks Existing Tanks _ y a C`, U in vl w C7 f-~ Septic or Holding Tank J'A laE Dosing Chamber / V VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' igna PRS Number Business Phone Number d9Aft je 35-7 7r-5 = 76o oyy6 PlumJep r's Address (Street, City, State, Zip Code) U~r////J/ / 3 0~ ^ G v .41 VIII ount /De artment Use Only pproved rove Permit FeeC Dat Issued Issuing nt Signat re iven on for Denial $ 47`~ X66 22-).3 IX. Condit R easons for Disapproval 1 S~o~r~o 4 19iod tank,. effluent f1ter and 3J D~p 'IP~' l d1~ A/ dispersal cell must all be serAe- 1 maintained as.per management plan provided by Plumber. ~~JAX lea dII om o maintained Q ► ~i s ~L~L q J•r id~G. Attach to complete plans for the system and submi to the County my on pap r,,njlt less th n 8 1/2x#1 inche n size l Orl G 'a'`' • x SBD-6398 (R. 11/11) ~rwjve, I tM~ /t 0. CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: IC V AIV5 Owner's Name: 9R VAA) Owner's Address: -Fb Legal Description: Township: County: S Subdivision Name: Lot Number: Parcel ID Number: Page 1 Index and title Page 2 Plot Plan Page 3 _ System Sizing & Cross-Section Page 4 Filter Specs _ Page 5 Maintenance Information Page 6 _ Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Designer/Plumber: 17 K/TP y urj~~ License Number: Date: -l (p -J3 Phone Number j 760 Signature Designed pur4to P-GrrounnddSoilAbsorp n Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01). Page 1 q 7- l l ✓ 3~y lvc - r~ 13 _ o 3 U 130, R yl a QQ ~rz X lZ9z 8 -3 ~ ~ '~~'v _ 3o3y p IDOL? (J 3a3 a Soil Absorption System Cross Section /o ft 4w Schedule 40 Final Grade PVC Vent Pipe With Vent Cap ft Leaching = a T" 1 = ~~,s Chamber T-~ =__y_j_ ft System Elevation _ ft ~ft Soil Absorption System Plan View ft ft IIIIIIIE ,J " j {f Leaching Trench 1 --t*- " Vent Or Obsewaftri Pipe Chambers III [Mill IIIINIIIIIIII 111111101 ~ 4" Dia. Z. 7 Trench 2 Header ! eachina Chamber Specifica,~,tone Manufacturer And Model TAI- )C ( A 7-X AT& ~e ~ Z/ pl u S EISA Rating sq ft per chamber Soil Application Rate r( gpd/sq ft gpd Design~F _ Soil Application Rata, © EISA = -~7-chambers /tf 2 rows of 1_ chambers r~ Page 3 of M , EMIM Quick4 Plus Standard Chamber Side and End Views - 48" (EFFECTIVE LENGTH) 12" j 34"---- --I Quick4 Plus All-in-One 12 Encap Front, Side and End Views 11.2" # 13" 8" INVERT 8" INV ERT 5.3" INVERT 33"--------I Quick4 Plus All-in-One Periscope oUICK4 PLUS ALL-"NE PERISCOP . e67 SWIVEL ) T 12.7" INVERT ouick4PLUS ALL-N-ONE 12 rNDC 511 9« ENDCAP F6uic1<4 Plus Standard Chamber, Speaficatlons. Size (W x L x H) 34" x 53" x 12" (86 cm x 135`cm x 31 cm) Invert Height 0.6",5.3", 8.0"; 12.7" - Effective Length , 48" (122 cm) (1.5 cm; 8.4 cm, 18.5 cm, 22.6 cm) INFILTRATOR SYSTEMS, INC. STANDARD LIMITED WARRANTY i (a) The structural integrity of each chamber, and plate, wedge and other accessory manufactured by Infiltrator ( "Units"), when installed and operated in a leachfield of an onsite septic system in accordance with Infiltrator's instructions, is warranted to the original purchaser ("Holder") against defective materials and workmanship for one year from the date that the septic permit is issued for the septic system containing the Units; provided, however, that if a septic permit is not required by applicable law, the warranty period will begin upon the dale that installation of the septic system commences. To exercise its warranty rights, Holder must notify Infiltrator in writing at its Corporate Headquarters in Old Saybrook, Connecticut within fifteen (15) days of the alleged defect. Infiltrator will supply replacement Units for Units determined by Infiltrator to be covered by this Limited Warranty. Infiltrator's liability specifically excludes the cost of removal and/or installation of the Units. (b)THE LIMITED WARRANTY AND REMEDIES 114 SUBPARAGRAPH (a) ARE EXCLUSIVE. THERE ARE NO OTHER WARRANTIES WITH RESPECT TO THE UNITS, INCLUDING NO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE (c) This Limited Warranty shall be void if any pan of the chamber system is manufactured by anyone other than Infiltrator. The Limited Warranty INFILTRATOR does not extend to incidental, consequential, special or indirect damages. Infiltrator shall not be liable for penalties or liquidated damages, including loss of production and profits, labor and materials, overhead costs, or other losses or expenses incurred by the Holder or any third party. systems inc. Specifically excluded from Limited Warranty coverage are damage to the Units due to ordinary wear and tear, alteration, accident, misuse, abuse or neglect of the Units; the Units being subjected to vehicle traffic or other conditions which are not permitted by the installation instructions; failure to maintain the minimum ground covers set forth in the installation instructions; the placement of improper materials into the system containing 6 Business Park Road - P.O. Box 768 the Units; failure of the Units or the septic system due to improper siting or improper sizing, excessive water usage, improper grease disposal, or improper operation; or any other event not caused by Infiltrator. This Limited Warranty shall be void if the Holder tails to comply with all of the Old Saybrook, CT 06475 terms set forth in this Limited Warranty. Further, in no event shall Infiltrator be responsible for any loss or damage to the Holder, the Units, or any 860.577.7000 - FAX 860.577.7001 third party resulting.from installation or shipment, or from any product liability claims of Holder or any third party. For this Limited Warranty to apply, the Units must be installed in accordance with all site conditions required by state and local codes; all other applicable laws; and Infiltrator's installation instructions. 800.221.4436- (d) No representative of Infiltrator has the authority to change or extend this Limited Warranty. No warranty applies to any party other than the www.infiltratorsystems.com original Holder. The above represents the Standard Limited Warranty offered by Infiltrator A limited number of states and counties have different warranty requirements. Any purchaser of Units should contact Infiltrator's Corporate Headquarters in Old Saybrook, Connecticut, prior to Such purchase, to obtain a copy of the applicable warranty, and should carefully read that warranty prior to the purchase of Units. e e ie r - - - • SfE jj~ U.S. Patents: 4,759,661; 5,017,041; 5,156,488; 5,336,017; 5,401,116; 5,401,459; 5.511,903; 5,716,163; 5,588,778: 5,839.844 Canadian Patents: 1,329,959; 2,004.564 Other patents pending. Infiltrator, E.quallaer, Oulok4 and Quick4 Plus are registered trademarks of Infiltrator Systems Inc. Infiltrator Is a registered trademark in France. Infiltrator Systems Inc. is a feglslered tradennerk in Mexico, Contour Swivel Connection Is a trademark of Infiltrator Systems Inc. 0 2009 Infiltrator Systems Inc. Printed In U.S.A. PLUS0510101SI-2 . it o O s "t Q N M M O co r N M co ~[7 O r - ( 1 i 7T- 14--- " z I Z LUL X W 57 ~ w LU Z U W U3 1-- 0 f- w z U ? ~ co w w - # U Ix O m v ° R~ 0 CL LIJ LIJ LLI n Z O v Ur 0 0 ca \ Z ' m i ® CD N cn W _ n 9 m O O ~n ~I.IM ZOc~ u dZe - POWTS OWNER'S MANUAL & MANAGEMENT PLAN FILE INFORMATION SYSTEM SPH3FICATIONS Pl' wner Septic Tank Capacity 106C> al 0 NA m tit ! Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer P 0 NA Number of Bedrooms 0 NA Effluent Filter Model- P - (3 NA Number of Public Facility Units III NA Pump Tank Capacity al NA Estimated flow (average) ~D al/da Pump Tank Manufacturer JV NA Design flow (peak), (Estimated x 1.5) s~ gal/day Pump Manufacturer ANA Soil Application Rate t al/aa /ftr Pump Model NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit V(NA Fats, Oil & Grease (FOG) 530 mg/L 0 Sand/Gravel Filter 0 Peat Filter Biochemical Oxygen Demand (SODs) 5220 mg/L ❑ NA 0 Mechanical Aeration 0 Wetland Total Suspended Solids (TSS) S150:mg/L 0 Disinfection 0 Other: Pretreated Effluent Quality Monttity average Dispersal C911(s) 0 NA Biochemical Oxygen Demand (BODJ 530 wqk M In-Ground (gravity) 0 In-Ground (pressurized) Total Suspended Solids (TSS) S30 mg/L 0 NA 0 At-Grade 0 Mound Fecal Coliform (geometric mean) 5104 cfu/100ml 0 Drip-Line 0 Other: Maximum Effluent Particle Size Ya in dia. 0 NA Other. 0 NA Other: 0 NA Other: 0 NA *Values typical for domestic wastewater and septic tank effluent. Other: 0 NA MAINTENANCE SCHEDULE Service Event Swvke Frequency month Inspect condition of tank(s) At least once every: 0 s(1 s) (Maximum 3 years) 0 NA Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume 0 NA Inspect dispersal cell(s) At bast once every: a 0 month s) (Maximum 3 yeas) 0 NA Clean effluent filter At bast once every: 0 month(s) 0 NA 1 01 ear(s) , Inspect pump, pump controls & alarm At beat once every: 0 M ear(s) month(s) NA Flush laterals and pressure test At bast once every: 00 emonnh s) QNA Other. At (east once every: 0 month(s) 0 ear(s) .~I NA Other: 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 surface. 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 IY3) 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 any service event. 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 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 o{ service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chaff w Comm 83.33, Wisconsin Administrative Code: • AN piping to tanks and pits shall be discormected 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: 17 A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. lated to identify -a sultabla replacement Me Upon lailuice of the o ng tank ImIlL 010a. 14%J W/91 slue e ai ?91)44115 1R7--► ~fi2- N CoNS'TRdC-7t D ❑ 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 x48881 SLED s JUN 2 0 2001 V' 34 K~ J CERYW En SURVEY MA _ LATED IN PART OF THE NE7 /4 OF THE NE7 /4 AND PART OF THE SE7 /4 THE NE7 /4 OF SECTION 32, T30N, R7 9W, TOWN OF ST. JOSEPH, ST. M COUNTY, WISCONSIN. ER- CURVE DATA TABLE {ALL LENGTHS ARE IN FEET) HALLET Number Len Igth Angleal Beanng chord Arc Tangent Bearing Length Length Tangent in Tangent out ARED FOR' C1 5789.58 00°70'01" N75°23'07.5"W 16.87 16.87 S76-18'07'E S75128'08°E C2 202.50 58°47'37" N34°21 '48.5"E 198.80 207.79 N04°58'00"E N63°45'37E 1416-3 1/2 STREET C3 5639.58 00'16'26" N76'1 7'29"W 26.96 26-96 N76°2542"W N78109'71 6`W TURTLE LAKE, WI 54889 C4 169.50 85°47'44" N47°51'52"E 230.75 253.81 N04°58'00E S89'14'16"E C5 396.00 30°49'38" N75.20'55"E 210.50 213.06 S89°14'16"E N59156'06"E SCALE IN FEET I"= 200" 200 pMD~ O 200 (9) HIED 0(9)U N121210 N1/4 COR. -2662.52'- NORTH LINE OF THE NE1/4 - / SEC.3 W z N139°57'36"E N89°s7'3_. E 769.36' ,i O _ VV NE CO 271.16'- - -338.13 C~ - 180. 07'EC. 32 2 F.-° w N01°09'06 E sex° 4'1 s"E 1 a.61' Z p 36.49% 186.70' 727.x1' LT, Uj W W m .64 ACRES .49 ACRES w v j O.H.W.M. 818.4 Q p w ' -POND z D J L,,OT 4 z D cn L` ~ 3 73 - ? 90 ACRES 04 4.682• CRES + (321.905 SO. FT.) INC. FRVw Ic-n- + D e % 7.063 ACRES' M 'S N C" Q+ °'S + + 4-0 (203,942 SQ. F~ INC. R/W + + N %267.646 SQ. FT.) EXC. RM/ + ~ Q o 3.991 ACRE Ae (173,848 SO. FT.) EXC. Fi~D... 0 r+ o + r 33-04'. 442.70' TAI > •K O o + W i j N87°4748"W 475.74' c:b LOT 2 % O $ Q + co 4.133 ACRES BENCH MARK: TOP OF _ Z 46 (780,041 SO. FT.) INC. R/W cg IRON PIPE, ELEVATION CL N Q + + 3.815 ACRES 831.4 ~ + (166.201 SO. FT.) EXC. R/W g 0! d + Z 6 N850°a.W 5~9 ~Z7 N 5&X 66' JOINT 69.OZ Os r O i DRIVEWAY EASEMENT-I-I 08 S ~50 f NOTE: 205 LOTS MAY BE SUBJECT J 328.35' r a+ O TO FUTURE SPECIAL Se9°53'S2"W 378.55' 40 ED ASSESSMENTS FOR ANY O' UPGRADES AND IMPROVEMENTS TO THE f co TROAD. ' CD LOT 7 Q3 N ~cv 11.452 ACRES o~ (498,840 SO. FT.) INC. R/W z Zzi _Ci T• La \ Z~ 9.879 ACRES 1 • NE+y 2 (430.320 SO. FT.) EXC. RAN ~ ' ~ `t~S`;pc9 OLL cuw SOUTH LINE OF THft' ' - Z m~ E1 /4 OF THE NE7 /4 N p ,6 OL C'_ ~ . _ 542"w 28.E S•'~ ~ M89051110°W 642.60' - - - - - - - LEGEND ~'S•42« 1 a'~ FOUND ALUMINUM COUNTY ir•r wZBj► MONUMENT = =.A N CORNER FOUND _ " PIPE SET 1"X 24' IRON PIPE, WEIGHING p 1.13 LBS. PER LINEAR FOOT ' • ' ' ' ' ' ° • • ° ROADWAY SETBACK LINE (10(Y FROM RIGHT-OF-WAY) - - - 75' SETBACK FROM THE ORDINARY HIGH WATER MARK (O.H.W.M.)Inb - PROPOSED DRIVEWAY C-3 ° o EXISTING FENCE w THIS INSTRUMENT DRAFTED BY: WILLIAM KANE JOB NO. 6006-01 DATE: 05/17/2001 114 COR. SEC. 32 VOL. 15 PAGE 4111 Swo.CROIX COUNTY SW~W T MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwncriBuycr 40- a ILA< Mailing Address 7-!t` °/7y P roperrydcirf:ss _ (D _ ~(Verificatwn requited from PtanniaYcation new co nstructiort.)^ D- ~tnn City!State Parc€I Idumber Property Location 'f, , '4 A ~ Sec. , T ~ C54 R) ~W, Town of _ S / ~OSam,/ /Ljl Subd!visutn Plat; _ Certified Survey Map # Volume / 57 -..,Page Warranty Dead # (before 2047)Volume ,Page tt Spec house yeso Lot tones iderttiftabklkyas t no SYSTEN MA.INTEkIAN!Q E AND OWNER CERTIFICATION Improper use and msii3 ano i of yostr SOP& vstm coukd result wits protrlA11WO failure W handle wastes Prow maintenance consists of pumping out the septic trttk emery three years or sooner, if nee" by a ticensc it pumper. What you put into the system can affect the function of lks: septic tank as a heatutent stage in the waste disposal system. Owner maintenance I»sptsr sibilcni s are specified in JCamm. $3.52(t) kid in Chapter 12 - St. Croix County Sanitary Ordinance. The property ownot agrees to submit to St. Croix County Planning & Zoning Department a eertificatioa form, signed by the uwneat and by a a.asur plumber, jourmeytnars plumber, restricted plumber or a licensed pumper verifying that (l) the on-site wastewater disposal system is in prupcr operating condition aatd/or (2) rtftcr :nspcction and pumping (if iizcessary i, the septic tank is xss r1,ari ;;:t thsll,)f sludge ilwe, the undcrsigacd have read the above requirements and agree to maintain the private sewage disposal system with the snandards set ford-, herein, as set by the Dqsatvmt of ComAsernce and the Depactitr+ W of Nataral Resources. State of W isconsm Certificatior stating that your septic system has been maintained trust be completed and retumed to the St. Croix County Planning 7,Qning Department within 30 days of the three year expiratioti date:. I/we certify that all statesmiNts on this m are tnre to the best of my/our knowledge. I/we amlare the owner(s) of the property described above, by virtue of a w ty dced recorded in Register- of Deeds Office. Number u bedrooms N~AURC OF APPLICANT(S) DA'rE nf«z,na,,on that is rrmtsrepreaerttel may result in the sanitary permit bcwg revoked by the Plaamiug & Zoning Depattmem. include with thus .application a recorded witrranty tired Dorn the Register v; 13ccilu Offrcu and a COPY of the ceviifiUd suncv rung It reference is made in the wariarotyy teed. iRF-V 08/05) 927273 BETH PABST State Bar of Wisconsin Form 6-2003 REGISTER OF DEEDS SPECIAL WARRANTY DEED ST. CROIX CO., WI RECEIVED FOR RECORD Document Number Document Name 11/19/2010 10:10 AM EXEMPT # N/A REC FEE: 30.00 THIS DEED, made between State Bank Financial, a Wisconsin banking TRANS FEE: 300.00 corporation PAGES: 1 ("Grantor," whether one or more), and Bryan Evans and Mary Evans, husband and **The above recording information verifies that this document has wife been electronically recorded & returned to the submitter ("Grantee," whether one or more). Grantor fnr a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in Recording Area St. Croix County, State of Wisconsin ("Property's (if more space IS N and henna Address needed, please attach addendum): -0, n T. nr~ R-0a 'I I l` Part of the Northeast Quarter of the Northeast Quarter (NE VA of NE'/.), and 104 part of the Southeast Quarter of the Northeast Quarter (SE % of NE of Ecd L'C , ✓Yl N 3 S Section Thirty-two (32), Township Thirty (30) North, Range Nineteen (19) West, St Joseph Township, St. Croix County, Wisconsin, further described as follows: Lot 1, Certified Survey Map recorded in Volume 15 of Certified Survey Maps on 030-1093-10-200 Page 4111, as Document No. 648881. Parcel Identification Number (PIN) This is not homestead property. 8s) ("is not) s Grantor warrants that the title to the Property is good, indefeasible, in fee simple and free and clear of encumbrances arising by, through, or under Grantor, except any easements, conditions, covenants, restrictions and reservations of record, and any municipal or zoning ordinances and +i rear estate taxes for 2010. E Dated S trA 10 2X QA u l o , STATE BANK FINANC (SEAL) (SEAL) + * Kevin R Ex a ice President (SEAL) (SEAL) * * Chad Hill, Vice Presr ent AUTHENTICATION ACKNOWLEDGIVIENT ) Signature(s) STATE OF WISCONSIN ) Ss. authenticated on ST. CROIX COUNTY) Personally came before me on bd ✓ a~~~ CIJT.eYh ~ * the above-named Kevin R. Leslie an Chad Hill t TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by Wis. Stat. § 706.06) instruin d acknowledged the_mWe. e. Z 2- THIS INSTRUMENT DRAFTED BY: A. Cw 1, o 5 Stewart L. Etten, Ruder Ware, L.L.S.C. Notary Public, State of WISCONSIN P.O. Box 8050, Wausau, WI 54402-8050 My commission (is permanent) (expires: 12.1 1 S 4Lo13 ) (Signatures may be authenticated or admowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATION TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. SPECIAL WARRANTY DEED 02003 STATE BAR OF WISCONSIN FORM NO. 6-2063 *Type name below signatures. INFO-PRO"' Legal Fouls • (e0 )5"21. Waprotomis.com 1 of 1 Y 45'-b• 6 6 v 1 b r L 1 I I I I r I ' x 1 1 1 m 1 I - b/0~=---- i , !d I UTILITf ILVI1 U W ,I 1 O_ 2/8L I II I ~ 11 1 I s ,I I 1 y ,I I '3 t 1 ,I I 1 ~ Y `ul IIT 1 / I I 1 I I 1 2'-O• e...e_ NOELLE N3382T ^ P6/09 /]D13 A31 New NoxlzoN NoI-ES o _ (5T GIZ0IXJ 33346 IYI4YIYti r Y~~ 4r~ s .~e..siree m..w.w.. ....e..e. 0 II 11 1 1 ~ L~ 7µµ~~~~II I I g I ~ ~ tl" 0 ~ 1 c ~ r ~ ~ RR v 4 11 ~ ~I I I I ~ 99 g I I II P II Q 1 1 0 O I VSfit266-2 GR I I VSKiD72 3-0-521 I d _ o e P g 2/pit 1 1 I $ A? . M U 1:1 N I < xx 1 I u A $ A ~ ~~Qm' d Z D ~ r ~ ~ x i U I+ O R_ m i~ ~ X ~ S@ O4 1 11 II ~ 2/. 11. 2 8 1 k 9 L11E PRARE 1 11Y,1( u O ,l II 4 II 0 ~ 11 II g II va z/eR ~ e ' y ~1 4 x D ~ O m & s II w ~1~0 lP @ l 0 rn. ~ N m r Y6 Yd ARCH 1 N m . y u m < 4 _ 2/9R A ~p x a - - ~ ro 4 3 N o A m O W-1/6 (a-V6 R $ N D `_"1 x o Y Y g y V9[i6W 2-8-581 zo - ze•-o• za'-e• S N ~ rn J ~`OEILE N~dgi ^~06/•oq/]o13 _ PNEH H021ZON 1101-~5 sv~3346 1= ~ ....e.~e H1 (4i Gla71X) MIY~~rY~Ybn. ...ox. .relax.. r a OR 4 1 too 337 n epartment of Commerce y vi of Safety and Buildings SOIL EVALUATION REPORT ,l (J~oY 1 of 3 in accordance with Camm 85, Wis. Adm. Code F )P',an complete site an on paper not less than 8 1/2 x 11 inches in size. Plan must County sr{inGude, of limtfe to: vertical and horizontal reference point (BM), direction and - percen Parcel I.D. ON 1 j ~ 0_ a Li r pe, scate.Q dimensions, north arrow, and location and distance to nearest road. LN C_ 0' Please b 1 iewe print all information. by Date smragbo provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). X10 Prope er A fr•,, Property Location \ _ +UD _~)t~0 l~ Z-Ukjlrr ~Z Ge,.4- o N1~z 1/4 tiE 1/4, S3Z T 30 N R 19 E (or W ro e s Mailing Address Lot # Block # Subd. Name or CSM# Ll Z 3 1 CZ ST2-~- - ?J I t2'D Csri-i S City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road T-i\TU U~'rZZJ ~Ij 1 Sy eq IS) as 7-6So _1 S;-- sos~~L-~ 17-EzeH LAS r_ aD. Eq New Construction Use: Residential / Number of bedrooms Code derived design flow rate 6 0 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material L L 0 V S Flood Plain elevation if applicable !Q ft. General comments PL/7-' w/TY/ /ST. rSOk G4,0--Ya S~a-:f and recommendations: Z~SW)I l a_)p 5 CELLS eft)A LW G' W / G U All LTS QF L1'16 N t VE~,~~ s L3)a v /tip e.t1*"8Ms ?M v~~yy~ w ~ A r~fr-x~U a ~E 4 L~3T 6 ~hrlU `f~l'~ S~i.~a ~~zo+v Boring # ❑ Boring ® pit Ground surface elev. ~l q. 5 ft. Depth to limiting factor > L D 6 in. Sail 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 a-l0 Lb~rz-3C'i - S11 Z~'sb Z ) o- >.d LIP- 31.. s, I z sb~c wl F- es - e 3 -lo ~.S ytZ31Y - b g y►'1 -7 L Z 9 •S" - ~o ~7`a f D S Z Boring # f❑~ Boring 11-~---~ L~11 Pit Ground surface elev. ti0 Q ft, Depth to limiting factor ? l08 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 C-8 lOy IZ 31Z. - s i 1 Z'~sb1z c S ~ ` . s • $ Z -33 13`( 316 - si I Z sb k ►~?`FI- ~S - .5 ~S 1 • Effluent #1 = BODs > 30 < 220 mg/L and T >30. < 150 mg/L • Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Arthur L.• Wegerer 42&dda, f. 220254 Address W e g e r e r Soil T e s t i n or & Design Service Date Evaluation Conducted Telephone Number 421 11- Hain St. River calls, WI 54022 ~/-19=0J 715-425-0165 Property Owner -S, V Kj ~L.L31Z Parcel ID # P V~1 IQ Page 2- of 3 Boring # ❑ Boring 3 ® pit Ground surface elev. VD l6 .0 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 o~ 8 Vo-.(LZ - s;1 Z-~5-61z ",13- 2 g _ ip~2 31b ~ si I Zms b m~Fi^ eS - -s .8 -3 S3 -ll6 .S Y2 -:~J - S CJ m 1 t.. 2 0'. - 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/ft' ' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 Boring # ❑ Boring F-1 ❑ 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/ft= In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 • Effluent #1 = BOD6 > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD6 < 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 altemate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8730 (RAMO) Property Owner Yj- Parcel ID # p hl G Z 3 Page of Boring # ❑ Boring ® Pit Ground surface elev. D b .0 ft. Depth to limiting factor 1~ 6 in. Soli Application Rate Horizon jeh Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fl2 Munsell Qu. Sz Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 Z`~ Z w 6- c-S tp`t2 ~1~ ~ sil zmsb m`Fh eS - .S ,g -3 S3 -116 .SY2 21-l _ S CJ s yy1 Lr Z ❑ 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/ft2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 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/ft= In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODE < 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. SHD-9330 (R.6/00) PLOT PLAN Page 3 of 3 Scale 1'= X10 t LoT 2 ' 51a~Z 32$.35' 1v ~ L oT 1 J 94 3~"1 I - ~L, L~0.0 aN 0 ySaDw OT 3-~•s' ~Rq Zz, n' 6`~4f16FF, 31y" biA. x B-2• PVL° PIpE W/Lj W N 180 3~,s~ ~ ~ 3-~. ~vC PcW~ w e-3 Su~~`k• p'c~-2f1 FaR Sv~~BI~ Y'~"A Toz 1~1T1Rc etn CE1..L-s. ~CST 75425-0165 220254 Signature Date Telephone Plo. CST 1,10. Job PTO. L 2011 Property Record I St Croix County, WI Assessed values not fina/iCed until after Board of Review Property information is valid as of Jun 13 2012 10:27PM OWNER CO-OWNER(S) BRYAN & MARY EVANS 4904 ARBOR MILL DR FORT WORTH, TX 80176 PROPERTY DESCRIPTION PROPERTY INFORMATION SEC 32 T30N R19W NE NE SE NE BEING LOT 1 CSM 15/4111 Parcel lD: 030-1093-10-200 Property Address: 469 PERCH LAKE RD Alternate ID: 32.30.19.3408-10 School Districts: Municipality: TOWN OF SAINT JOSEPH SCH DIST OF HUDSON Other Districts: DEED INFORMATION - WITC Section Town Range Qtr Qtr Section Qtr Section Volume Page Document # 927273 32 30N 19W NE NE 899278 32 30N 19W SE NE 844146 Lot: 1 1660 341 648350 Block: 1495 154 619517 Plat Name CSM 15-4111 030-2001 1204 389 551041 1198 386 549035 1173 301 542466 TAX INFORMATION Net Tax Before Lottery, First Dollar Credits: 1102.63 LAND VALUATION Lottery Credit: 0 First Dollar Credit: 0 Valuation Date: 0511212011 Net Tax After: 1102.63 Code Acres Land Value Improvements Total Amt. Due Amt. Paid Balance G1 11.452 77,700 0 77,700 Tax 1,102.63 1,102.63 .00 Special Assmnt .00 .00 .00 11.452 77,700 0 77,700 Special Chrg .00 .00 .00 Total Acres: 11.452 Delinquent Chrg .00 .00 .00 Assessment Ratio: 1.0109 Private Forest .00 .00 .00 Mill Rate: 0.014190825 Woodland Tax .00 .00 .00 Managed Forest .00 .00 .00 Fair Market Value: 76,900 Prop. Tax Interest .00 .00 Spec. Tax Interest .00 .00 Prop. Tax Penalty .00 .00 INSTALLMENTS Spec. Tax Penalty .00 .00 Period En Date Amount Other Charges .00 .00 .00 1 01/31/12 551.32 TOTAL 1,102.63 1,102.63 .00 2 07/31/12 551.31 Over-Payment .00 PAYMENT HISTORY (POSTED PAYMENTS) General Special Date Receipt # Source Type Amount Tax Status Assess. Status Interest Penalty Total 12/27/11 12372 C T 1,102.63 N N .00 .00 1,102.63 FLIEP 6 JUN 2 ~ 3 648881 AUG 2 9 Z00( Kt+ P Sr. ¢ uo 'OR'S RE CERi !9 &&*u 0avEy MA i/~'? LOCATED IN PART OF THE NE1/4 OF THE NE1/4 AND PART OFT HE $E114 OF THE NE1/4 OF SECTION 32, T30N, RI 9W, TOWN OF ST. JOSEPH, ST. CROIX COUNTY, WIRVEODASA TABLE (ALL LENGTHS ARE IN FEET) OWNER: Curve Radius Central Chord Chord Arc Tangent Bearing JENNIFER HALLET Number Length Angle Bearing Length Length Tangent in Tangent out Ci 5789.58 00°10'01" N75023107.5"W 16.87 16.87 S75°18'07"E S75°28'08"E PREPARED FOR: JIM JUNKER C2 202.50 58°47'37" N34°21'48.5"E 198.80 207.79 N04°58'00"E N63045'37"E 1416--3 3 1 C3 5639.58 00°16'26" N76°1 7'29"W 26.96 26.96 N76025'42OW N76°09'1 6"W 1/2 2 STREET TURTLE LAKE, WI 54889 C4 169.50 85°47'44" N47°51'52"E 230.75 253.81 N04°58'00"E S890141 60E C5 396.00 30°49'38" N75°20'55"E 210.50 213.06 S89°141 6"E N59°56'06"E SCALE IN FEET 1 200' MMPRAU K D RA p@ 200 0 200 @WH[EFP) [BU D U NIER93 N1/4 COR. -2662.521- NORTH LINE OF THE NE1/4 / SEC. 3 N89°57'36"E 769.36' _ i , 011-1 w Z N89°57'36"E NE COR. F Q ~ 1893.16' 271.16'- - --338.13 160.07'.. EC. 32 ~ 5 S89°14'16"E 14.61' ~C N ° w - N01 06"E 18677o' 127.91- - L 36.49' Z 't co j r cr / f . to . N u 11 w - LL W - co ; 64 ACRES .49 ACRES 18,+ ¢ O i O.H.W.M. 818.4 Q O W co ~.11 ~ POND OT 4 18 7. 90 ACRES ~ cl w Z D ` 3 (321,> SO. FT.) INC. R/W U) CCID) Q N Q ~i i rn 4.682'(ACRES N % 7.063 ACRES m Q i g i 1011V a (263,942 SO. M.JINC. R/W ° 067,646 SQ. FT.) EXC. R/W i Q, N o' 3.991 ACRES ~12 /Q ~I 1^0 (173,848 SO. FT.) EXC. RSV... F _ ~ ~ , I M 33.04 0 i- i O i fii rl 442.70' m W y-, o to 1 o i W 11 r- W N87°4748"W 475.74' o N lei cc be I o oo I _ LOT 2 O' 00 I% rz LO Co. 3 iI n o 4.133 ACRES BENCH MARK: TOP OF a c~ . a a g Q i o ro IRON PIPE, ELEVATION O. Z i= i 4.018 Z (t 80,041 SQ. FT.) INC. RNV 831.4 r N 1@1 N 3.815 ACRES r Q Q i all ' (166,201 SO. FT.) EXC. RAN pQ ° LW] 0011 W Q02 ~SyZ N [r'- on ro c° ~i W ~ = 6 NB5 ' a - 1.1 01 4 i 1 ) -17. OT .56' 66' JOINT s6°~Oil I 11 IVEWAY EASEMENT,\1-1. 0 d NOTE: US 328.35' Q LOTS MAY BE SUBJECT I 9°53'52"W 378.55' TO FUTURE SPECIAL Q ASSESSMENTS FOR ANY I co UPGRADES AND m IMPROVEMENTS TO THE I.° '&9 LOT 1 ~p ROAD. N cf) N 11.452 ACRES w a) (498,840 SO. FT.) INC. RAN Z o Z 9.879 ACRES w C. ri~ J (430,320 SO. FT.) EXC. RAN tit LL c~~SS Z SOUTH LINE OF THt' ' ' • C~,r■~. nEn_ _ Q p , N76~l /4 OF E 34 VV S,0 8.0g,5 `N89°51'10'V 642 •4 ia'± LEGEND W28~. FOUND ALUMINUM COUNTY Ca 1 ry~iry ~ , _ I ~ SECTION CORNER MONUMENT FOUND 1" IRON PIPE - Qaa p o t (\0 SET 1" X 24• IRON PIPE, WEIGHING 0 1.13 LBS. PER LINEAR FOOT • • • • • • • • • • • • ROADWAY SETBACK LINE (100' FROM RIGHT-OF-WAY) b - 75' SETBACK FROM THE ORDINARY HIGH WATER MARK (O.H.W.M.) MIS PROPOSED DRIVEWAY ~rIN ODOM a o EXISTING FENCE co 1/4 COR. THIS INSTRUMENT DRAFTED BY: WILLIAM KANE JOB NO. 6006-01 DATE: 05/17/2001 SEC. 32 VOL. 15 PAGE 4111 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Sanitary Permit No ' Safety and Building Division INSPECTION REPORT 561049 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)i. Parcel Tax No'. Permit Holders Name: City Village X Township 030-1093-10-200 Evans, Bryan & Ma St. Joseph, Town of Insp. BM Elev: BM Description: /1 Section/Town/Range/Map No: CST BM Elev: #1 32.30.19.340B10 TANK INFORMATION © ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Benchmark Septic /.►r. I /CAD ' r(LA) 55ecr" Dosing ' ` ) L~ Alt. BM / I O 3 !6 Z . P J Aeration Bldg. Sewer U119 e~.1I gZ 7 Holding SUHt Inlet 77 St/Ht Outlet TANK SETBACK INFORMATION TANK TO NP L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom 5d A/ /J ' 2-7 Iz. Header/Man. S3 Dosing 115 Aeration Dist. Pipe tZ , ► 9 Z . 5 Bot. System /3.1 qZ' Holding 3 92 • $5 Final Grade / 3 • PUMP/SIPHON INFORMATION Manufacturer Demand St Cover GPM 'j, 919 16Z. F•1~ J•••~•. M el Number TD ift Friction Loss System H Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth / •~1 DIMENSIONS '3 -3 LEACHING SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM CHAMBER OR Manufacturer: INFORMATION Type f System- / UNIT Mode l umber ~on, ded .'~ZS 27 7Zaa 5~~..,,1J DISTRIBUTION SYSTEM of x Hole Size x Hole Spacing Vent t /fir Intake Header/Manifold Distribution r Pipe(s) Length ~a Dia length Dia Spacing SOIL COVER Pressure Systems Only xx Mound Or At-Grade Systems Only Mulched c~ Seeded/Sodded xx Depth Over Depth Over xx Depth xx n. Bed/Trench Edges Topsoil Yes E] No es 'I No I I Bed/Trench Center ti 4' -73 J COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: / / Parcel No: 32.30.19.3401310 Location: 469 Perch Lake Rd Hudson, WI 54016 (NE 1/4 NE 1/4 32 T30N R19W) NA Lot 1 1.) Alt BM Description = L' 2.) Bldg sewer length = ,9 / p~`~--{'~,~, M - amount of cover Plan revision Required? ❑ Yes ,No Use other side for additional information. - - - - Date Insepc s Signat Cert Nc SBD-6710 (R.3/97) o 10 t w ~ I Q r 1 c7~5 County ' ~~yiaax~,r Safety and Buildings Division moo' < D 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) S P` . K Madison, WI 53707-7162 S. 5~p State Transaction ~Ny~► er S it Application /V/ In accordance with SPS 383.2. ission of this form to the appropriate governmental unit is required prior to obtaining mtit. Note: ication forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and ss' s. Personal information you provide may bi used for secondary r / / y purposes in accordance with the Privac Law, s. 15.04 1 (m , Stats. f '~~r-~^ ~l ~0~ 1. Application Information - ase Print All Inform aY Property Owner's Name /t / ryy ~o arcel 70 030 -/073- /07 0700 Property Owner's Mailing Address C,Q Property Location (S D '-+.c0 Govt. Lot City, State Zip Code Phone Number A/- 1/,, - Section -F 7/G 7 - 9 (circle one TQN; REo II. Type of Building (check all that apply) Lot # Subdivision Name ❑ 1 or 2 Family Dwelling - Number of Bedrooms dF ~ Block ❑ Public/Commercial - Describe Use J ❑ City of El ❑ State Owned -Describe Use CSM Number Village of ~ ^ ,Town of 5 III. Type of Permit: (Check onl one box on line A. Complete line B if applicab ) A. kNew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) List Previous Permit Number and Date Issued B. ❑ Permit Renew Permit Revision ange of Plumber El Permit Transfer to New Before Expiratio Owner ~~"~►.~JM1. k- -I- - - r~3 lV. Type of POWTS System/Component/Device: Check all that a I Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Ho mg Tank Other ispersal Component (explain) Pr eatment Device (explain) _ YTan rsal/Treat ent Area Information: ow (gpd) DesignSoil Application Radsf) Dispersal Area Required (sf) Dispersal Area Propose sf)s~E np 7 ~ y 3 ~ --'q3* New k Info Capacity in Total # of Manufacturer Gallons Gallons Units Tanks Existing Tanks c o E 0 w C7 C 7~-- Septic or Holding Tank o a 4 - ~Qb Q Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the PORTS s own on the attached plans. Plumber's Name (Print) Plumber's S' ature RNumber Business Phone Number Fvp Z ur~-A)e~) Plumber's Address t, City, State, Zip ode) f L-113 VIII. fov_Tn /De artment Use Only Permit Fee Date sued Issuing t Signature Approved El Disapprove $ er Given Reason for Dent V ! 6 517 ) 3 IX. CondWYftM WY easons for Disapproval 3, ;444' o i,tr G r~^, 1. Septic tank, effluent filter and S~ AL cell must all be seadw t Maitlta$eed 20 V' ✓ t ~n ~ i as per management plan provided by, plog6w 't3 d- a•. olC, All k requirements must be triiM" Attach to complete plans for the system and submit to the CouVY only on paper not less than 81/2 z 11 inches in size IftCL,,.a,J SBD-6398 (R- 11/11) 0 E1 MIS o E. t J~ G 0 0-1 o i 1 t r6 t , I ~ Z 0 Page J- of Wisconsin Department of commerce SOIL EVALUATION REPORT Division of Safety and Buildings in accordance with Comm 85, \A/is. Adm. Code County s , 4 7~ Attach complete site plan on paper not. less than 8 112 x 111 inches in size. Plan mus# T,,,, ~ ~a1 D C D U _ D p - 01 D include, but not limited to: vertical and horizontal reference point (BM). direction and 'F Date percent slope, scale or dimensions, nor h arrow, and to nd distance to nea( f ~ by Reviewe y Please ;prW4 n l ''ff~~ p j3 5 /7 /3 f ndary PLI rivacy Law, s. 151(13 (m)). Personal information YOU provide may be Property L a E 1!U Govt. _of ENt 1.1 1/a S T3 D N R 15 E (o Property Owner S lt_.--~F -r --a S V 4 Lot # Block # Subd. Name or SM# p Properi Owner's Mailir g Addre s ' O J• 5 1 Q y I LJf C.' D ❑ City illage %Town Nearest Road Slate Zip Code Phone Number ~ Per tV. K 7101-9y1~. Use } Residential ! Number of bedrooms Code derived design flow rate _ GPD 'New Construction I Public or commercial - Describe: iCI R G>; Flood. Plain elevation if applicable - I Parent material ._0\Z-%41-4.5 4e.hc-%~ 5 C,7~ Foy- ~ el^ 3 1+ s... General comments = 'r S~Sgt 5~ 3 ;:-t VNA46%, ~Oe. and recommendations: C ?i N 9 6 3~`~ _V s Q a t 93.bS~~ S ~c o1: 1,5 ( 16,q ~ 1Usc~~~ ~t7r a T a (9ZL- Boring Pit 1.3p in. goring # Ground surface elev. /'dev 'V i fi. Depth to limiting factor _ Soil A lication Rate Texture StructureConsistence Boundary Roots GPDlf° Horizon Depth Dominant Color Redox Description ~ t. Color Gr. Sz. Sh. . ~ , in Mansell Cu. Sz. Con `Ef1 "Eff#2 i 0-i Io Q3~ _ 5',L aFS V MFG a w CA M1 T~6-1 kC w I rr1 y . L c~ iS'l R$1 L -7.SIR'S S 0-$~__ M l ell l Boring Boring A C~ # Pit Ground surface elev. 9 a • ft. Depth to limiting factor Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *E GPD/f?Eff#2 Cont. Color Gr. Sz. Sh. in. 11unsell Qu Sz. • I d yQ31 6; L FS M r ~,a a b 3: 51 - 5; L- b M f r c nvl >D- .sy~ i ~ F 1. sa 4 :9 If P'S •la .SyRs~ t_ a F o `t q " Effluent #1 = BOD5 > 30-:< 220 mg/L and TSS >30 51 mg/L " Effluent #2 = BOD5 E 30 mg/L. and TSS < 30 mg/L Signature CST Number CST Name (Please Prnt)~y y 17 -OD 4 6-. 1 a - - Date Evaluation Conducted Telephone Number Address 1-1 [BSI-Z%- 6 -n,- S- 7- a o Ist to 5 Yoato r j 4 N 4- Mq r1 Property Owner E y aN s Parcel ID # Page of 41 FS1 Boring # ~ Boring ~]t Pit Ground surface elev. 5 9. S ft. Depth to limiting,factor_ in. 4 Soil Application Rate Horizon Depth DominantColor Redox Description Texture Structure Consistence Boundary Roots GPD/flz in. Munsell' Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *EfF#2 o - I`p,3 :L s6k Qu> arrl x8-35 s S -5 ML t,,;P I J F 1'7 1 1. In I 5 YV S -S Mn L 1. V 11 t e. Y Fil Boring# F] Boring ~G,py Pit Ground surface elev. l ft. Depth to limiting factor a in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fCz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 0-IQ 1040-31- - S.l -A FSb Ile e b .g 4- -oIF Boring Boring # ❑ Bo 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/flF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 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 (R.07/00) Property Owner j 4N S Parcel ID # Page of Boring Boring # pit Ground surface elev. c1 g s ft. Depth to limiting factor I AS in. Sol Application Rate 51 q Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlflz in. Munseif Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 "Eff#2 a-t o'it~3 6.t- .~Fs6K a ark , ~b a ;L-,v3 7-SIP-SA 6VL v Cw -35 Y 5 S -S VVN L- CL,t2 I J F , t S YV S p -S th 1 . 171 1 n ~r C 5 - We + 1Z Th. Boring # El Boring Q Pit Ground surface elev. g y ft. Depth to limiting factor a in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 N 0-ID 1044--3/ . b .g b-3~ .5`t s~ S. art rA H 3 s~r~v! s b- F ► , 4 3-t -7.syrst 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 GPD/fR in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-I i * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/_ 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 (807/00) A ~b U) 9 r , -ate lop IW~ 0 00 OA cr -1:. °p 9 tT a- Sl o °A 7 0 £p d. Ci O d f m 1 r • e ~ 1 t Gib d1 ~ Z v "•I a b D. d • S - o 00 %0 - v ~ 22 1 a 1 a r h , 8 0 •h L W W a4 `Z +648881 s 0 ►3l ¢ memo, CERTIFIER SURVEY NIA , LOCATED IN PART OF THE NEI /4 OF THE NE7 /4 AND PART OF THE SE7 /4 OF THE NE7/4 OF SECTION 32, T30N, RI 9W, TOWN OF ST. JOSEPH, ST. CROIX COUNTY, CURSVE DA A TABLE (ALL LENGTHS ARE IN FEED OWNER: Curve Radius Central Chord Chord Arc Tangent Bearing JENNIFER HALLET Number Length Angle Bearing Length Length Tangent In Tangent out PREPARED FOR' C1 5789.58 00°10'01" N75°23'07.5"W 16.87 16.87 S75°1 8'07'E S75°28108'E C2 202.50 58°47'37" N34-21 '48.5--E 198-80 207.79 N04°58'00"E N63145'37"E JUNKIER JIM 1416-3 1/2 S C3 5639.58 00°16'26" N76°1 7'29"W 26.96 26.96 N76°25'42"W N76'09'1 6"W TURTLE 12 S LAKE. WI STREET 54889 C4 169.50 85°47'44" N47°51'52"E 230.75 253.81 N04°58'00"E S89°14'16"E TURTL CS 396.00 30°49'38'• N75°20'55"E 210.50 213.06 S89°14'16"E N59°56106"E SCALE IN FEET 1" = 200' M[r]. plpUUM LZRMD25 OO ~ 200 0 200 Cr~iC~D D_ w O `4C~CG3~ N1/4 COR. -2662.52- NORTH LINE OF THE NE-1/4 N89*57*36"E 769.36' SSEC LU z N89_5T36"E NE COR. 189316' - 271 .1 6'- - - -338.13~Cr~ 160.07 EC. 32 NOi °o9'Q6". E S89°14'1 . 14.6? cn ' ` 186.70' 127.91' OOo i w 1Z m f .64 ACRES .49 ACRES 18'+ w O M O.H.W.M. 818.4 t ~ J n +j, POND aO° 1 cm I,OT4 to Z Z= N L 3 Q 7/390 ACRES Z J C/) . ( + (321,1$f55 SQ. FT.) INC. R/W LO 4.682 EiCRES v / 7.063 ACRES M -4 ,07,646 SO. FT.) EXC. RMI M Lo cv 0! r Q i O f N (203,942 SQ. .)INC, R/W g pqI Q+ N o 3.991 ACRZSLC w 01 r j Lo (173,848 SQ: FT-) EXC. 10v... p (I ~'i r 33.041: 442.70• to _ c~ sQ I ~o + + Ulf N87°47'48"W 475.74' Qi °(j 0 N C i J' fff o LOT 2 ci + u d : BENCH MARK: TOP OF r~ co 4.133 ACRES >v IRON PIPE, ELEVATION + ~JI rl~l Q" 1 Z (180,041 SQ. FT.) INC. R/W O 831 .4 ! N Q o IL f` ° N 3.815 ACRES ,3 r Q+ Q c 'N~i V r a (186,201 SO. FT_) EXC. RAV ° oa no af, I N a - (O' Qo, d. ; c7 66' X 66' JOINT ~g OZ 0 j + N DRIVEWAY EASEMENT,,?-T gg S ° 3 w NOTE: 50 26 ` 328.35' LOTS MAY BE SUBJECT S89°53'52"W 378.55' y i O TO FUTURE SPECIAL O ASSESSMENTS FOR ANY r UPGRADES AND j IMPROVEMENTS TO THE ~6 LOT 1 ROAD. N ab co r 1 1 .452 ACRES w aD v( (498,840 SO. FT.) INC. R/W r Z o Z 9,879 ACRES w (430,320 SO. FT.) EXC. R/W iE C. z SOUTH LINE OF T141 o E1/4 OF THE NE1/4 Q1-_C`T` E _~N89°51'19"W 642.611'- - S 5'4~.'N/2g 14'1 j LEGEND FOUND ALUMINUM COUNTY v~ r rye n~y ^1" _ _ I SECTION CORNER MONUMENT FOUND V IRON PIPE - ~_Q '/'~uC~.~-, ^ b SET I" X 24" IRON PIPE, WEIGHING 1 .13 LBS. PER LINEAR FOOT ROADWAY SETBACK LINE (100 FROM RIGHT-OF-WAY) 'r- PROPOSED 75' SEBACK FROM THE ORDINARY HIGH WATER MARK (O.H.W.M.)I- DRIVEWAY c IN - - EXISTING FENCE O 1/4 COR. THIS INSTRUMENT DRAFTED BY: WILLIAM KANE JOB NO. 6006-01 DATE: 05/17/2001 SEC. 32 VOL. 15 PAGE 4111 2L3dBrTyTa~ County Safety and Buildings Division 5- S K 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) P Madison, WI 53707-7162 ~3$)p,vAti Sanitary Permit Application State Transaction Number N~ In accordance with SPS 383.21(2), 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 different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be use for secondary purposes in accordance with the Privacy Law, s. 15.04(1)(m , Stats. _ 1. Application Informatio - Plea nt AJWfwwMfJM Property Owner's Name iV of 9~ ®L Parcel # P AN Vf}J-S l6 3 -/0 - a?oo Property Owner's Mailing Address Property Location Q lie Govt. Lot rJ City, State ` , , i► Zip Code-Phone Number Section 0 / 1 lam( Q- 1~Q71 / X (-3/76 / ~S ' 7~d ' D y ~j cle one) T REorW U. Type of Building (check all that apply) Lo or 2 Family Dwelling - Number of Bedrooms Subdivision Name ❑ Public/Commercial - Describe Use ❑ City of JS.Q_ ❑ State Owned - Describe Use CSM Number U 4401 I ❑ Village of _ J 5T ~C?-8 e~ 4 Q:4 GAS L.-.4 / V 4-1 46115 A4111 K Town of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. SNew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) ❑ Permit Transfer to New List Previous Permit Number and Date Issued B. El Permit Renewal El Permit Revision El N e of Plumber Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all t I R1 Non-Pressurized In-Ground El Pressurized In-Ground El At -G e ound > 24 in. of suitable soil Mound < 24 in. of suitable soil ❑ Holding Tank El Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersal/Treat ent Area Information: Design Flow (gpd) Design Soil Application R (gpdsf) spersal Area Required (s Dispersal Area Proposed ( System Elevation x.50 .e VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units o o New Tanks Existing Tanks c ai N l C, U v~ v rn w C7 17 Septic or Holding Tank doo Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' igna PRS Number Business Phone Number Y 357 71- 3, = 76o v yy6 Pl1!~ is Address (Street, City, State, Zip Code) D/-? Sao o/ VIII ount /De artment Use Only pproved rove Permit Fee Dat Issued Issuing nt Signatre iven on for Denial $ 47`~ a5b ZZ J IX. Condit 1; PA easons for Disapproval 3J II epGc tank, efnuentfilter and 3 D~O lle6 t di* 4A. • jX K SwOfr~e dispersal cell must all be services I maintained as per management plan provided by plumber. ~ti~ /d AAO Q,fC. Al Pet Wements must be maintained r hs"pK app le code./ onk*'n. 01 ti Attach to complete plans for the system and submi to the County my on pap r~nAt less~h n 8 1/2 xd1 inche n size 45 ej SBD-6398 (R. 11/11) ~/r~d✓el Afe0. 31 13 M k1 ~l 3~6 i36X 133 ,~M Q 30 3 y 3631 i' a CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: )E V AA)_ Owner's Name: 9,1? 7 / lP 5 11)91VS Owner's Address: % 90 y egox Legal Description: Township: j T. County: S r C~ Subdivision Name: Lot Number: Parcel ID Number: Page 1 Index and title Page 2 Plot Plan Page 3 System Sizing & Cross-Section Page 4 Filter Specs _ Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Designer/Plumber: (7 1-4T~ License Number: pc~D ~S~ Date: -l (a 13 Phone Number Z/_5 = 76o Signature Designed pursuant to 'VGround Soil Absorpt n Component Manual for Pov Version 2.0 SBD-10705-P (N.O1/01). Page 1 I'loc N yl -,per-"13bX 0-3 A,#-mv - 3o3y ~ 3a3y I a Soil Absorption System Cross Section /n ft d- ~d 4° Schedute 40 Final Grade PVC Vent Pipe With Vent Cap ft Leaching [ a r-1= X9,5 Chamber T-~ 'ft ti System Elevation _ ft ~ft Soil Absorption System Plan View ft ft ft Leaching Trench 1 Vent Or Observation Pipe Chambers ! 4" Dia. Trench Header ! eachina Chamber Soecificatlone ~ Manufacturer And Model T,NTrf TG zy P U 5 EISA Rating a7 sq ft per chamber Soil Application Rate r7 gpd/sq ft gpd Design l F*N e + : c: Soil Application Rata, EISA Z Chambers 2 rows of i~ _LZ- chambecs¢ Page 3 of E Quick4 Plus Standard Chamber Side and End Views 48" (EFFECTIVE LENGTH) --r 12" Quick4 Plus All-in-One 12 Encap Front, Side and End Views 11.2" 4 13" 8" INVERT 8" INVERT 5.3" INVERT -18.2" 33" ----------I Quick4 Plus All-in-One Periscope QUICK4 PLUS , ALL-K-O-IN-ONE PERISCO 60- SWIVEL E P ) t QUICK4 PLUS 12.7" INVERT ALLONE tz ENDCACAP -y-j FQuick4 Plus Standard Chamber Specifications Size (W x L x H) 34" x 53" x 12 (86 Cm x 135 &-n x 31 cm) Invert Height.. 5.3", 8.0 12.7" (1.5 cm; 8.4 cm, 18.5 cm, 22.6 cm) Effective Length „ e 48" (122 cm) ; INFILTRATOR SYSTEMS, INC. STANDARD LIMITED WARRANTY ' (a) The structural integrity of each chamber, end plate, wedge and other accessory manufactured by Infiltrator ( "Units"), when installed and operated in a leachfield of an onshe septic system in accordance with Infiltrator's instructions, is warranted to the original purchaser ("Holder") against defective materials and workmanship for one year from the date that the septc permit is issued for the septic system containing the Units; provided, however, that If a septic permit is not required by applicable law, the warranty period will begin upon the dale that installation of the septic system commences. To exercise its warranty rights, Holder must notify Infiltrator in writing at its Corporate Headquarters in Old Saybrook, Connecticut within fifteen (15) days of the alleged defect. Infiltrator will supply replacement Units for Units determined by Infiltrator to be covered by this Limited Warranty. Infiltrator's liability specifically excludes the cost of removal and/or installation of the Units. (b)THE LIMITED WARRANTY AND REMEDIES 114 SUBPARAGRAPH (a) ARE EXCLUSIVE. THERE ARE NO OTHER WARRANTIES WITH RESPECT TO THE UNITS, INCLUDING NO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE (c) This Limited Warranty shall be void if any part of the chamber system is manufactured by anyone other than Infiltrator. The Limited Warranty INFILTRATOR ® does not extend to incidental, consequential, special or indirect damages. Infiltrator shall not be liable for penalties or liquidated damages, including loss of production and profits, labor and materials, overhead costs, or other losses or expenses incurred by the Holder or any third party. systems inc. Specifically excluded from Limited Warranty coverage are damage to the Units due to ordinary wear and tear, alteration, accident, misuse, abuse or neglect of the Units; the Units being subjected to vehicle traffic or other conditions which are not permitted by the installation instructions; failure 10 maintain the minimum ground covers set forth in the installation instructions; the placement of improper materials into the system containing 6 Business Park Road • P.O. BOX 768 the Units; failure of the Units or the septic system due to improper siting or improper sizing, excessive water usage, improper grease disposal, - or improper operation; or any other event not caused by Infiltrator. This Limited Warranty shall be void if the Holder fails to comply with all of the Old Saybrook, CT 06475 terms sot forth in this Limited Warranty. Further, in no event shall Infiltrator be responsible for any loss or damage to the Holder, the Units, or any 860.577.7000 • FAX 860.577.7001 third party resulting.from installation or shipment, or from any product liability claims of Holder or any third party. For this Limited Warranty to apply, the Unfts must be installed in accordance with all site conditions required by state and local codes; all other applicable laws; and Infiltrator's installation instructions. 800.221.4436- (d) No representative of Infiltrator has the authority to change or extend this Limited Warranty. No warranty applies to any party other than the www.infiltratorsystems.eom original Holder. The above represents the Standard Limited Warranty offered by Infiltrator. A limited number of states and counties have different warranty requirements. Any purchaser of Units should contact Infiltrator's Corporate Headquarters in Old Saybrook, Connecticut, prior to such purchase, to obtain a copy of the applicable warranty, and should carefully read that warranty prior to the purchase of Units. - e a e s s - • - IFb U.S. Patents: 4,759,661; 5,017,041; 5,156,488; 5,336,017; 5,401,116; 5,401,459; 5,511,903; 5,716,163; 5,588,778; 5,839.844 Canadian Patents: 1,329,959-,2,004,564 Other patents pending. Inflitr&it)r, Equallsar, Quick4 and dufckd Plus are registered trademarks of Infiltrator Systems Inc, Infiltrator Is a registered trademark in France. Infiltrator Systems Inc. to a registered trademark to Mexico, Contour Swivel Connection is a trademark of Infiltrator Systems Inc. 0 2009 Infiltrator Systems Inc. Printed in U.S.A. PLUS0510101SI-2 o O = o S oil a N Lf3 O __-w{ fry M N M co unp i O III - co I i - t Z w~- ~p W L1J = W u7 ~cn - V U W Z 0- cTJ X O m v° CL~ f1 wU- w= CL Uw m I ~ n Z a- co Z lC~ ~ m V5 C.9 J } - ® O N cn W "q- m C5 cd c°''> Z O cd F- U- POWTS OWNER'S MANUAL & MANAGEMENT PLAN FAE INFORMATION SYSTEM SPECMATMS Owner f~Y~/lf AT /U Septic Tank Capacity 1ODU al ❑ NA Penh Septic Tank Manufacturer 5 C ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model - a ❑ NA Number of Public Facility Units AP NA Pump Tank Capacity gal NA Estimated flow (average) ~O gal/day Pump Tank Manufacturer *NA Design flow (peak), (Estimated x 1.5) s0 gal/day, Pump Manufacturer ANA Soil Application Rate t al/da /fe Pump Model d NA Standard Influent/Effluent Quality Monthly average' Pretreatment Unit O[NA Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODE) 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSSI 5150 rng/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Montw average Dispersal Cep(s) ❑ NA Biochemical Oxygen Demand (BODJ 530 mg/L M in-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ NA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) 510' ck#100ml ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size Ya in dia. ❑ 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: ❑ mon sl s) (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: a mkt ,(s) (Maximum 3 yeas) ❑ NA ' Clean effluent filter At least once every: O month(s) ❑ NA ear(s) month(s) Inspect pump, pump controls & alarm At bast once every: C3 ear(s) NA Flush laterals and pressure test At bast once every: 13 ❑ mono) A oar (s) ~ Other. At bast once every: 0 month(s) NA Other: 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 surface. 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 (Y3) 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 any service event. 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 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 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. 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. slue ing jtank /461 e al ~Df-!t8 Tt~ Q 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 r"\ N ~ 648881 s SLED JUN 2 0 2001 31 CERTIFIEM SURVEY MA ~'?r,~ ~r LOCATED IN PART OF THE NE1/4 OF THE NE1/4 AND PART OF THE SE' OF THE NE1/4 OF SECTION 32, T30N, RI 9W, TOWN OF ST. JOSEPH, ST. [CROIX COUNTY, WISCONSIN. OWNER• CURVE DATA TABLE (ALL LENGTHS ARE IN FEED Curve Radius Central Chord Chord Arc Tangent Bearing JENNIFER HALLET Number Length Angle Bearing Length Length Tangent in Tangent out PREPARED FOR' C1 5789.58 00'10'01" N75'23'07.5"W 16.87 16.87 S75'18'07'E S75°28'08"E JIM JUNKER C2 202.50 58'4737" N34.21'48.5"E 198.80 207.79 N04'58'00"E N63°45'37"E 1416-3 12 STREET C3 5639.58 00°16'26" N76'1 7'29W 26.96 26.96 N76'25'42"W N78.09'1 6"W TURTLE LAKE, WI 54889 C4 169.50 85°47'44" N47°51'52"E 230.75 253.81 N04"58'00E S89°14'16"E C5 396.00 30.4938" N75°20'55"E 210.50 213.06 S89°14'16"E N59.56V6•E SCALE IN FEET t" = 200' U PL L%VVLEED dLQMD,@ 200 200 _(9)wmC D QV OTIM19M N11/4 COR. 2682.52' NORTH LINE OF THE NE1/4 w o SEC~3a,/,~" 'ss"E, N89°ST'36'E 769.36' ~ , ~-/Pes~s7_ NE COR. 189q .16 271.1 4'1 6"E 14.61' 338.1 ~C+'~ - - 160.07' EC. 32 N01 M9,06 E O 186.70' 127.61' Z o 36.49/ / WH ur co O.84 ACRES .49 ACRES Ix f- + O.H.W.M. 816.4 POND L~bT 4 LL LU ~ -.1 co w _ = L~ 3 - p /7690 ACRES rr F- Q , (321 ,805 SQ. FT.) INC. RNV to &D n 4.68 • CRES / 7.063 ACRES 1c'n- &D n OP - c%j 7.063 ACRES Hsi u si Q r °r r ✓6 r 40 N R (203,942 SO. Hsi n-,i~gl ) 40 R (203,942 SO. PT-4 ~ INC. R/W ~ 02 3.991 ACRE ~f7.648 SQ. FT.) EXC. Fi/W $ ~i Q r N o .1 $ a ~1 U j (173,848 SQ. FT.) EXC. RM f o r i i 33-04': 442.70' M ULI o 0 o r Or r W N87'47'48"W 475.74' CSR O o S r r LOT 2 8- r° Qr r d N °n 4.133 ACRES BENCH MARK: TOP OF a Z ~j I ='i HJ~ 2 n (180,041 SQ. FT.) fNC_ RAN g IRON PIPE, ELEVATION OF I r l o ni N 3.815 ACRES 831 .4 N I Q Q r ~r r (166,201 SO. FT.) EXC. R/W 01 r--: Q r 17. 02'00"W 402 5 0^ r r - Qo r W r 6 Y 85- 79 t2 R Ei r ¢6' x 66' JOINT i 111 N ARIVEWAY EASEMENT1.I7 g$ S6 oeF ~r ll~if]j NOTE: LOTS MAY BE SUBJECT 20+ 328.35' TO FUTURE SPECIAL S69°53'62"W 378.55' ASSESSMENTS FOR ANY UPGRADES AND Ij~o IMPROVEMENTS TO THE 9r~ LOT 1 ROAD r~ 11.452 ACRES N LZ (498,840 SQ. FT.) INC. R/W Z yo r Z 9.879 ACRES W wi 2 (430,320 SQ. FT.) EXC. RAN t ~ ~ - ~3`;pc? _ LLO SOUTH LINE OF THE' = s73 OLD ~s i r~ g - O _ N ewd 42 TH E 4 u~ - - 526 09' 1 LEGIEND NOWSI'10"W 642 - - - - - - 141- (9 SECTION FOUND ALUMINUM COUNTY •Tr 4 . , CORNER MONUMENT 0 FOUND 1 "IRON PIPE O SET 1"X 24' IRON PIPE, WEIGHING I_~ 1 .13 LBS. PER LINEAR FOOT _ • • ROADWAY SETBACK LINE 100' FROM RIGHT-OF-WA - 75' SETBACK FROM THE ORDINARY HIGH WATER MARK O.H.W.M.) PROPOSED DRIVEWAY v 0 o EXISTING FENCE THIS INSTRUMENT DRAFTED BY: WILLIAM KANE JOB NO. 6006-01 DATE: 05/172001 114 C cl) SEC. 32 2 VOL. 15 PAGE 4111 CROLX COUNTY 'p,&4, MAINTENANCE AGREEMENT AND O CERTIFICATION FORM OwncriBuycr, 40 z AMU---, Matting AddreSS Property Adds+;ss Tcation (v erification reqed Planninor new conca.) Cit}f'State Parcel idumber (D 30- l6, ?roperty Lucal ion , r---" '/4 , Sec. , T w3C54 R)_'~W, Town of _ S 1 jcf -S5_ IY Sut;cl;vision Plat: Lot ft Certified Surrey Map # 6- < , Volunle j , page # Warranty pei.d# d 7,,,? 7~3 (befM '2fi07)Volume Fine a_ _ Spec house n yes ~Tio Lux hots identiftabk)(yes 0 no SjSTEN1 ;v1A.jNTFNAN!QE AND OWNER CERTIFICATION improper use and maintenance of your septic systm couki result in its preMWO failure to hmWe wastes Proper maintenance consists of pumping out the septic tarok efery hulas years or sootier, if nited A by a licetiazd pumper- What you put into the system can affect the f motion of brit: septic tank W a keaunwt stW in the waste disposal system. Owner maintenance t ipcu;sibilints tue specified in Comm. $3.52(1) and in Chapter 12 - St. Croix County Sanitary Ordutalice. The pr%ierty owner agrees to submit to St. Croix County Planning & Zoning Department a eertificatioa form, signed by the Jwne.( and by I ir.asw plumber. )oumtry tt Plin*ar, rd Vicred plumber' or ;k licensed pumper verifying that (1) the on-site t wastewater drejicirtat System is in prupcr operating Ct]nditiott irttd)ar (Z) i1Rcr :nspet:tian and pumping (if t,acessary t, the septic tank is - -ss thpw i, 3 hdl,)f sludge riwe. the undersigned have read the above requirements and agree to iuaintaiu the private sewage disposal system with the standards set fords lrGrairr, U SCI by the t of Commea+ce and the Department of Natural Resources, State of Wisconsin. lfartt~A e-ertificatior stating that your septic syu am has been maintained must be coinpieted and returned to the St. Croix County Plannmg & X011119 Department within 30 clays of die three year expiratiort date. I/we versify that all statoments on this m arc trt►e to the bast of my/our latowledge. I/we am/are the owner(s) of the )j%3pCity describes above, by virtue of a Warr ty treed recorded in Register of Deeds Ofticc. Number- u bedrooms (iNA URL Or APPLICANT(S)ICS DATE 'An y tfifr>zma; on that is mtsreftresaitted may resift in the sanitary permit being revoked by the Ptannarg & Zoning Depiurmeni. iriciude with tits Application ti recorded witrranty decd from tits Rcgistcr of Deals Office and it copy of the cenificd survcv trap it inference is made in die wan,anty deed. iREV Q8/0-5) 927273 BETH PABST State Bar of Wisconsin Form 6-2003 REGISTER OF DEEDS SPECIAL WARRANTY DEED ST. CROIX CO., WI RECEIVED FOR RECORD Document Number Document Name 11/19/2010 10:10 AM EXEMPT # N/A REC FEE: 30.00 TAIS DEED, made between State Bank Financial, a Wisconsin banking TRANS FEE: 300.00 corporation PAGES: 1 ("Grantor," whether one or more), and Bryan Evans and Mary Evans, husband and **The above recording information verifies that this document has wife been electronically recorded a returned to the submitter ("Grantee," whether one or more). Grantor for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in Recording Area St. Croix County, State of Wisconsin ("Property") (if more space IS N and Return Address needed, please attach addendum): et' ".O`er ~ pus~S #t q-I o Part of the Northeast Quarter of the Northeast Quarter (NE %a of NE 114), and kajou N 3 S part of the Southeast Quarter of the Northeast Quarter (SE 1/4 of NE 1/.), of F M1a Section Thirty-two (32), Township Thirty (30) North, Range Nineteen (19) West, St. Joseph Township, St. Croix County, Wisconsin, further described as follows: Lot 1, Certified Survey Map recorded in Volume 15 of Certified Survey Maps on 030-1093-10-200 Page 4111, as Document No. 648881. Parcel Identification Number (PIN) This is not homestead property. 0s) Cis not) t Grantor warrants that the title to the Property is good, indefeasible, in fee simple and free and clear of encumbrances arising by, f through, or under Grantor, except: any easements, conditions, covenants, restrictions and reservations of record, and any municipal or zoning ordinances and ij real estate taxes for 2010. 4 f Dated S mA tm` tD e,1r QLA ~ Z-41 1D STATE BANK FINANCIAL, (SEAL) L (SEAL) * ]*Kevina R Ex e ice President (SEAL) (SEAL) * * Chad Hill, Vice Presr ent AUTHENTICATION ACKNOWLEDGIVIENT Signature(s) STATE OF WISCONSIN ) ) Ss. authenticated on ST. CROIX Comfy ) Personally came before me on I h rJ(✓, t * the above-named Kevin R Leslie an Chad Hill t TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by Wis. Stat. § 706.06) rostrum d acknowledged the e. THIS INSTRUMENT DRAFTED BY: ('rn uos Stewart L. Etten, Ruder Ware, L.L.S.C. Notary Public, State of WISCONSIN P.O. Box 8050, Wausau, WI 54402-8050 My commission (is permanent) (expires: I t S 1 acl_3 ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATION TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. SPECIAL WARRANTY DEED 02003 STATE BAR OF WISCONSIN FORM NO. 6-2003 *Type nffine below signatures. INFO-aROw Legal Fe"aa • laoolass-2021 • Mp aforma.caa 1 of 1 0 g g ♦5'-D' ra 0 V X11 s r ~ b z r 1 1 1 I r I ' r N 'I 4 m 1 s/o I W I I unux racer I w _ ~ 1 O_ 2/& _ _ _ _ - I II ~ I ~ II 1 I x ,I I 1E y ,I 1 1 Y - I YY 1 1-ai ""-11- -1 1 I I I I I I I I ~nY\(-~v/ s sy . 1- e_ NOELLE N2202T dY/O4 /2013 A~I NEYV HORIZON HRaE5 a....e. c _ ..w...e P.1 (5T-1%) 2939D lYYYrti D. WD4` ..e.iw.ee w...iw.. x ee._D. 9'-e• 43._6. I'-0• D'-e• 21'-e• le'-D' D'~D• ~04 i! ~'60~ ii . 1 tel. I ~99 ~ 1 II C~I7 II p 11 p ri t 0- II VSiii266-2 GR I I VSFfl002 3-D-511 I I _ _ _ _ _ i.. as l/e• NFII~t xEKNT _ _ _ PAMURi Y _ 2 I I Pii, . g _ U a _NpAREH D O O U i:l ti $ I I ~ xx Il ~ ~ m b ` < I I R ± S i! Q lm m O m I u O 3_m it z 4 I I ~ ~ - B i z it ~ ~ a II ~ ~ o I~~1 w ~ 1. I I , I I • j' II II H 2/BL 2/BR 2-8-91 I 1 B UTE PRARE g II q M1_ ! 11 1i < D it 4 13 ~ . 0 m 8n ~ ~ 4 ~ 3 _ N d II g m a s 3 2/6 LL tl ym$ O " > W; 4 w m 4 0 0 T 4 oS t u w m A ~ G m W-1/6 (2)-V6 - - - - - - - - - - - - - - - - - - - - - - - - - - - ,..m VBfiYifiO o 2-8 1 ~ /Zp1 ~ m o 0 ry'i J so N22e2T 04/09/2013 V - A3 'NEN -N HO"E5 233 O NI (ST L! JIX) DWIYIMYD:/~.rw ..ox~ ~r ..a~ r F* ~'7 337 l nkc( k Z' n epartment of Commerce SOIL EVALUATION REPORT L4~Xdt) of 3 ~7. vi of Safetyand Buildings in accordance with Comm 85, Wis. Adm. Code County S _r • C ~Zz I )r A&h complete site lan on paper not less than 8 112 x 11 inches in size. Plan must iriGudel~ot limtte to: vertical and horizontal reference point (BM), direction and Parcel LD. D>~ ~Q3~ a 6 percen pe, scald-Q dimensions, north arrow, and location and distance to nearest road. ! Q~;y I Please print all information. iewe by Date art L s R3 C~ m~at)bp provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Prope ner Property Location 3, /D ~ +U~ ~~Z30 l~ ~UyV 6evt Lot NfZ 114 tiE 1/4. S3Z T 30 N R 19 E (or W roe s Mailing Address Lot # Block # Subd. Name or CSM# I - CSN S / 17ZITLTILE State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road U~' ~ tiU I SYlJ9 ( ~ 1S) 3S7-6S0,~ s;- Sose~:>L4 IFETL(2 H aD. New Construction Use: Residential / Number of bedrooms- Code derived design flow rate 6 0 0 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material L t P'rt- 0 V f~ S ~,L Flood Plain elevation if applicable !1 ft. General comments 6V/714 rSOX G~Z ~ and recommendations: CZ T~.lll Ma-)t 5 CZLLS „ k a 'X ~'l, S U4 G W / 6 u1V irs of ~ (N ~JV ~'Prn -rr sLD;aAj/tibQ'R L e~+ etT-iBMZ ?M cetL, L~ akn w A wt A x M 0 a~ E L T C, 1 `1 ~t~ S 2t zorv F 1 Boring # ❑ Boring ® Pit Ground surface elev. q q. S ft. Depth to limiting factor ? L D 6 in. Solt 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 a-Z0 lbKrL3L - S~ Z`PSb S .`t3 Z ) to L12 311, - s, I Zvrr bit ~►t`fr CS - e 3 -lD -).S y2_31Y - b g ~n -1 t Z Z4 9 •S - Ceo r p, 7 s D Boring # ❑ Boring ❑ pit Ground surface elev. LO l• Q) ft, Depth to limiting factor ? Lob in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Etf#1 `Eff#2 b-8 1.0`12 3LZ ~ - S t 1 Z'~Sb1z h1.`Fl^ C S'F ` . S • 8 Z ~-33 t~`~ 316 _ si I Z~sb~ h?`Fl•- ~S - -S `S 3~-LD ~.SY~ 3l~ S Q 1~J ~ - -7 ~•Z 36 ' Effluent #1 = SODS > 30 < 220 mg/L and TS 3 >30. < 150 mg/L ` Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please print) Signature CST Number Arthur L.. Wegerer agifte Off'' I 220254 Address W e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number 421 N. 14ain St. River Falls, WI 54022 /-/_19-0J 715-425-0165 Property Owner V 1~ ~L.LIZ Parcel ID # P~►r~1 w G 2 2Page of a Boring # ❑ Boring 3 ® Pit Ground surface elev. -1D b . D ft. Depth to limiting factor L~ In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fl2 In. Munsell Qu. Sz, Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 Z loYrZ 316 sit Zmsb m`Fi^ eS -s ,8 -3 s3 -~l6 .S tz ~l _ S v rn 1 L. Z ~V J ❑ 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/ft2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 Boring # ❑ Boring F-1 ❑ Pit Ground surface elev. ft. Depth to limiting factorin, 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 i • Effluent #1 = BOD6 > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODE < 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 (86100) T Property Owner Yy 1rLL~Z Parcel ID # Page 2- of 3 ❑ Boring # ❑ Boring 3 ® Pit Ground surface elev. t T 3b .0 ft. Depth to limiting factor L~ 6 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 o 10.1 TL Z Z loYrZ ~1~ ~ sit zmsb m~Fh eS ~ -s .8 .S2 it -Al ❑ 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/112 ' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 Boring # ❑ Boring E] 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/ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 • Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD6 < 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. S13D-9330 (R.6=) 3 of 3 ~ n PLOT PLAN Page Scale 1' _ ~l0 LOT 2 ' Sze. 'as PL1ZC'!1 LRk-6 T"YQ PLP~, ~ oT 1 U _ - J Z U)NJ 5, 1,00.0 aN \ SDOT ~ 1-,,' n' 6`'1f161F, Sly" DI A. x B-2• PV e PipE w/ N 0 N 2; `~1~ttd}-2 _ tTL. l Ol.~(ON Su~~~ R~z2t1 WR Sv•~'~L~ 1°C~>L~`A To1Z L1~t1 T l Prt e BLS F~ L'1~-`~1~P~-E CE-LL-2 L 715-425-0165 220254 I-8 S -1 CST Signature Date Telephone Ito. CST ATo. Job PTO. 2011 Property Record I St Croix County, WI Assessed values not fihal&d until after Board of Review Property information is valid as of Jun 13 2012 10:27PM OWNER CO-OWNER(S) BRYAN & MARY EVANS 4904 ARBOR MILL DR FORT WORTH, TX 80176 PROPERTY DESCRIPTION PROPERTY INFORMATION SEC 32 T30N R19W NE NE SE NE BEING LOT 1' CSM 15/4111 Parcel ID: 030-1093-10-200 Property Address: Alternate ID: 32.30.19.3408-10 469 PERCH LAKE RD School Districts: Municipality: TOWN OF SAINT JOSEPH SCH DIST OF HUDSON Other Districts: DEED INFORMATION WITC Section Town Range Qtr Qtr Section Qtr Sect on Volume Paoe Document # 927273 32 30N 19W NE NE 899278 32 30N 19W SE NE 844146 Lot: 1 1660 341 648350 Block: 1495 154 619517 Plat Name CSM 15-4111 030-2001 1204 389 551041 1198 386 549035 1173 301 542466 TAX INFORMATION Net Tax Before Lottery. First Dollar Credits: 1102.63 LAND VALUATION, Lottery Credit: 0 First Dollar Credit: 0 Valuation Date: 0511212011 Net Tax After: 1102.63 Code Acres Land Value Improvements Total Amt. Due Amt. Paid Balance G1 11.452 77,700 0 77,700 Tax 1,102.63 1,102.63 .00 Special Assmnt .00 .00 .00 11.452 77,700 0 77,700 Special Chrg .00 .00 .00 Total Acres: 11.452 Delinquent Chrg .00 .00 .00 Assessment Ratio: 1.0109 Private Forest .00 .00 .00 Mill Rate: 0.014190825 Woodland Tax .00 .00 .00 Managed Forest .00 .00 .00 Fair Market Value: 76,900 Prop. Tax Interest .00 .00 Spec. Tax Interest .00 .00 Prop. Tax Penalty .00 ,00 INSTALLMENTS Spec. Tax Penalty .00 .00 Period End Amount Other Charges .00 .00 .00 1 01/31/12 551.32 TOTAL 1,102.63 1,102.63 .00 2 07/31/12 551.31 Over-Payment .00 PAYMENT HISTORY (POSTED PAYMENTS) General Special " Date Receipt # Source Type Amount Tax Status Assess. Status Interest Penighy Total 12/27/11 12372 C T 1,102.63 N N .00 .00 1,102.63 E!? s FLI0 648881 FAUG 99 2001 JUN 2 3 pgp~9td0~ ST. ¢ VA ,r CERTI 6~ Au VEY mAO,~~ LOCATED IN PART OF THE NE1/4 OF THE NE1/4 AND PART OFT HE -SE,/4 OF THE NE1/4 OF SECTION 32, T30N, RI 9W, TOWN OF ST. JOSEPH, ST. CROIX COUNTY, WISCONSIN. CURVE DATA TABLE (ALL LENGTHS ARE IN FEET) OWNER: Curve Radius Central Chord Chord Arc Tangent Bearing JENNIFER HALLET Number Length Angle Bearing Length Length Tangent to Tangent out C1 5789.58 00°10'01" N75°23'07.5"W 16.87 16.87 S75°1 8'07"E S75°28'08"E PREPARED FOR: 02 202.50 58°47'37" N34°21'48.5"E 198.80 207.79 N04°58'00"E N63°45'37"E JUNKER JIM 1416--3 3 1/2 /2 STREET C3 5639.58 00°16'26" N76°17'29"W 26.96 26.96 N76°25'42"W N76°09'16%V TURTLE LAKE, WI 54889 C4 169.50 85°47'44" N47°51'52"E 230.75 253.81 N04°58'00"E S89°1 4'16"E C5 396.00 30°4938" N75°20'55"E 210.50 213.06 S89°14116"E N59°56106"E SCALE IN FEET 1" = 200' N~Ip~VVC~ ~a~~ 200 0 200 @MMI D ° OVNI N1/4 COR. 2662.521- NORTH LINE OF THE NE-1/4 / SEC. 3 N89°57'36"E 769.36' _ w z N89°57'36"E NE COR. - - -338.13- 160.07'... EC. 32 1893.16' 27136196' O U d o " 1416' E 14.61 w NOi 09 06 E 186.70' 127.91 wu- r 36.49n Zoo w w; o7 / / . 11 w w w 64 ACRES .49 ACRES 18,+ a :;E O i O.H.W.M. 818.4 QOw ° N 11 J POND ~ OT 4 * Z O I$i 7/390 ACRES Z ` 3 1 (321,965 FT.) INC. RM/ U) CC F- Q 4.682-QCRES N % 7.063 ACRES co Qt . Hain (203,942 SQ. NC. R/W W ° P67,646 SQ. FT.) EXC. RAN co, PA, Q t c! o 3.991 ACR S, _ je' o t o r l ,^n (173,848 SQ. FT.) EXC. 0 0 t i a: i wn 33.04' : 442.70' , rQ i @11 i W i 5, o 111 87°4748"W 475.74' o NO Q t a ~t ~t o LOT 2 coQ ~1i Ali C 3 t nn i iI F BENCH MARK: TOP OF a t~ t cl. n: ° CST cp 4.133 ACRES t t t 00 (180,041 SQ. FT.) INC. RM/ N IRON PIPE, ELEVATION ! I [rL~t 18 oH l o Z ^ 831.4 a 0 t N 3.815 ACRES ~4 r• ~ t t -6 1 4' ~ (166,201 SQ. FT.) EXC. RAN cn 4' o t t occ 19I W i = 6 - NBpZ'00"V1/ ~~1 \ 67g~`~ g, N oo j ~ i am i N • .66' 66' JOINT 86 07 08 I Ir°7~ ~ t rn S IVEWAY EASEMENT,\17. r NOTE: t3 328.35 LOTS MAY BE SUBJECT I `O c TO FUTURE SPECIAL 9 'W 378.55' ED @: ASSESSMENTS FOR ANY I to UPGRADES AND IMPROVEMENTS TO THE M LOT 1 n! st ROAD. O co ~ N 11.452 ACRES cr) a) V (498,840 SQ. FT.) INC. R/W Z I o o 9.879 ACRES w ~rig J (430,320 SQ. FT.) EXC. R1W SOUTH LINE OF TH~ -i m 40 /4 OF THE NEI /41 co C,T■H■ nEn- - s 0 ` _ N,6°2542 W ---z - I 28.0g, N89°514 0"W 642.60' 6°?s• - _ . 14,+ _ LEGEND ` ~ _ ~ ` FOUND ALUMINUM COUNTY SECTION CORNER MONUMENT FOUND 1" IRON PIPE ~?Qaa_p o a , , O SET 1 X 24 IRON PIPE, WEIGHING 1.13 LBS. PER LINEAR FOOT ROADWAY SETBACK LINE (100' FROM RIGHT-OF-WAY) - 75' SETBACK FROM THE ORDINARY HIGH WATER MARK (O.H.W.M.)I PROPOSED DRIVEWAY ~a ❑ EXISTING FENCE uoj r 1/4 COR. THIS INSTRUMENT DRAFTED BY: WILLIAM KANE JOB NO. 6006-01 DATE: 05/17/2001 SEC. 32 VOL. 15 PAGE 4111 i