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HomeMy WebLinkAbout038-1203-70-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division ' INSPECTION REPORT Sanitary Permit No: 5610$4 0 , GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). Permit Holder's Name: City Village X Township Parcel Tax No Slin erhouse, Steven & Lisa Star Prairie, Town of 038-1203-70-000 CST BM Elev: Insp. BM Elev:g8 BM Description: Section/Town/Range/Map No dum 6 - z G5T 23.31.18.1089 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic / Benchmark 4e~0 ~5 D~ Alt. r" I a / I f a f Aeration Bldg. Sewer ` 99c 2- Holding St/Ht inlet A 97,3 TANK SETBACK INFORMATION St/Ht Outlet (o~Z 47 TANK TO P/L WELL BLDG. VenttAir ntake ROAD Dt Inlet Septic - r.^ Z x 4 Dt Bottom Dosing Header/Man. Aeration Dist. Pipe f4 7__ Holding Bot. System 7 9 ~i L1 6le _9 5. PUMP/SIPHON INFORMATION Final Grade 7T -1.-% Manufacturer DeP ^and St Cover Z , G/ Model Number ~I TDH ILi Friction Loss System He TDH Ft Forcemain Length IlDia. Dist. to well SOIL ABSORPTION SYSTEM BEDITRENCH Width / Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type Of System: CHAMBER ORn f i~Y..#es-` Model Number: O J1.V r O,n4V :/C~ $ /"/T AA- UNIT DISTRIBUTION SYSTEM Header/M nifpld ! Distribution x Hole Size x Hole 9 cin\g Vent to Air Intake Le L~ Pipe(s) \ \ ,~;-.o a Length 11.1 Dia 1 Length Dia \Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center t~ 9 Bed/Trench Edges\ Topsoil Yes No Yes N. COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: / / Location: 1266 202nd Ave N w Richmond, WI 54017 (SE 1/4 SE 1/4 23 T31 N R1 8W) Wohlers Estates Lot 22 Parcel No: 23.31.18.1089 1.) Alt BM Description = Al 2.) Bldg sewer length = Z5 - amount of cover = 1 ^n Plan revision Required? ® Yes No 13 S3V75 c, Use other side for additional information. 17_ _ SBD-6710 (R.3/97) Date Insepct s Signat Cen No. PLOT PLAN PROJECT Steve Sinaerhouse ADDRESS 423 N 2nd St. New Richmond Wi 54017SE SE 1/4 SE 1/4s 23 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 5/23/13 BEDROOM 3 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1 157 # of chambers 57 BENCHMARK V.R.P. Top of 2" pipe ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark Vent. SYSTEM ELEVATION same as benchmark >6„ Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 5.6ft^2/pair of end caps All piping shall be SDR 30/34, within 10' 4' Long 12„ of tank, piping shall be Schedule 40. Grade at System Elevation 34" 'Id 308' Property Line Well is to meet all setbacks required by WDNR r% A Pro 3 Pro T wn Roa Bedr o •ope rty Line 30 Hou e S 100' B-3 Alt. Vents 25' B.M d 10 =k 99' B. 5' B-1 Slope 98' 100' 3-3' X 78' Cells with !3' spacing Scale is 1" = 40' unless otherwise noted Pro Town Road w°p 's^r County Safety and Buildings Division fig x r g+ ~ f+ IFV%W. Washington Ave.R VED SartiiW Permit Number (to be filled in by Co.) Alp Madison, WI 53707--7162 - _ -----MAY 23 2013 _ 51P M 'F Sanitary Permit Application - stateTrausuationNtanber--- t oix C AM- is accordance with SPS 383.21('2), Wis. Adm. Code, submission of this form to the appropna 5 te .v Gr cove cryueACa! Urr7t _ _ is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are subnritted to Project Address (if ditlrerent than m ailir igaddr ess} the Department of Safety and Professional Servies. Personal information you provide may be used for se„ondary -eur~oses in accordance with the Privacy Law_ s. 15.04(1 (m , Stats. - /Z 20 A 2- Ad 1. Application Information Please Print 1l Information Property Owner's Name d- f t ~IC~_ - - r Parcel fJ - - - 38- 12 6 Propero Owner's Mailing Address`) Q--l 7Z - ddd Property Location ---fit Govt. Lot City, State Zip Code Phone Number -''v, ~ - c/<, Section hule '1 N; R 11. Type of Building (check all that aly r 2 Family Dwelling -Number of'Bedroa le" ~L_ Subdivision Name =0~ Public/Commereia] - Describe Use o l_.] City of CSMNumber State Owned-Describe Use Village of V Town of C7 Ili. Type of Permit: (Check only ne box on line A. Complete line B if applicable) System El Replacement System D 'Treatment/Holtibig Tardc Replacement Only ❑ Other Modification to Existing System (explain) B_ ❑ Permit Renewal 0 Permit Revision - U Change of Plumber Permit '1'rtmsfer to Fiew List Previous Permit Number and Date Issued Before Expiration Owner -----IV. Type of PO'_WTS System/Compotrent/Device: (Check all that a~r~lyL - - c~ L - W-on-Pressurized In-Ground Pressurized In-Ground 0 At-Grade U Motuid > 24 in. of-suitabio soil 0 Mound <'24 in. of suitable soil G~a.w~e _ Holding Tank ❑ Other Dispersal Component (explain) - - - ❑ Pretreatroent Device (explain)-_ --_-i~_- pproved ~l. Dis ersal/Tree ent Area Information: j `------De i flow (gpd} Design Soi~A~placation Rate dsf) Dispersal Area Required (sf) i-~ispr;r;,al Area Proposal TS ystem Elevation ----Z - ?---5 -..~s - 'VI. 'l'ank Info Capacity in "otal ff o1• Manitfacturer Gallons Gallons Units 21 Uc, Septic or Holding Tank ~1 nosing Chamber `VII. Responsibility Statement- 1, the undersigned, as to responsibility for installation of the 110NNTS shown on the attached plans. p'lumber's Naine (Print) ZZ 69 ~6 L Is Plumbers Address (Street, City, State, Zip Code) CLI (A ourrt /De yartment Use Onl U DPermit Fee Date I -sued Issuing it Signature wn iveu R.eas or Denial 5 ~ ~ 7i7'/~.J W1. Condr Reasons for Disapproval I 'e e~ i Ptic tank, Want friltter an 31) f /rv C~, ere- dispersal cell must all be tietvilces f mainta><ined t 1/~ + t SO t~ J JG' at per management plan provided by plumber. J A5 ` Z A arr r"waments must be maintakW G (*5 / / t ('-t C _ _ PK wp_ I. oweI W*Vai~_ 54t ✓G S Attach to complete pious for the system and submit to the Ci alt1uu pup of less th 8 i!1 x it ut h r sue ~r'f L} SBD-6398 (R 11/11) /w'~^' Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 5/23/13 Owner:Steve Singerhouse Location: SE1/4 SE1/4 S23 T31 N,R18WLot 22 Wohler's Estates Star Prairie System type: In-ground absorbtion system(conventional) Manuals Used: In-ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance and Contingency Plan 7. Filter Specifications Sheet Signature License nu er #226900 PLOT PLAN PROJECT Steve Sinaerhouse ADDRESS 423 N 2nd St. New Richmond Wi 54017SE SE 1/4 SE 1/4S 23 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 5/23/13 BEDROOM 3 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1 157 # of chambers 57 BENCHMARK V.R.P. Top of 2" pipe ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark Vent SYSTEM ELEVATION same as benchmark >6» Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 5.6ft^2/pair of end caps All piping shall be SDR 30/34, within 10' 4' Long 1 of tank, piping shall be Schedule 40. 299 - 34" Grade at System Elevation 308' Property Well is to meet all setbacks required by WDNR Pro 3 Pro T wn Roa Line Bedroom oPe Y 30' House I S 100' B-3 0' Alt. Vents 25' B.M 10 ~k 99, B. 15 4 -2 B-1 Slope 98' 100' 3-3' X 78 Cells with 73' spacing rep/ Scale is 1" = 40' unless otherwise noted Pro Town Road Cross Section of Quick 4 Standard Leaching Chamber Typical cross section for 2 of 3 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber 5.6ft^2 pair of end plates To be >1' above grade Finish grade elevation Typical Installation 99' Vent ACI Grade Vent 4' 4" 4' X30/34 Septic Tank 4' Long 1 5' 4' Long 1 3491 Grade at System Elevation 3459 Grade at System Elevation Spacing 5' 3-3' X 78' Cells Observation tube/Vent Same on other end To be located on end of Cells %A B System elevations: C A__94.2 B94.0 19 chambers per cell C__93.8 POWTS OWNER'S MANUAL $ MANAGEMENT PLAN Page,- FILE INFORMATION SYSTEM SPECIFICATIONS Owner - Septic Tank Capacity &2:5ro dal 0 NA - - Permit # CSI ' / p Septic Tank Manufacture[-- NA DESIGN PARAMETERS Effluent Filter Manufacturer © NA Number of Bedrooms ❑ NA Effluent Fi ter Model 7 NA Number of Public Facility Units ;NA Pump Tank Capacity F NA Estimated flow (average) ' c al/day Pump Tank Manufacturer NA Design flow (peak), (Estimated x 1.5) '5;JZD -_gal/dam Pump Manufacturer NA Soil Application Rate z Pump Mcrc el _ _ _ dal/da /ft NA Standard Influent/Effluent Quality - Monthly averages Pretreatment Unit NA Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter El Peat Filter Biochemical Oxygen Demand (130135) 5220 mg/L ❑ NA 0 Mechanical Aeration 11 Wetland Total Suspended Solids (T-SS) 5150 mg/L ❑ Disinfeclion 11 Other: Pretreated Effluent Quality Monthly average kn-Ground ersal Cell(s) r.1 NA Biochemical Oxygen Demand (BON) <-30 mg/L (gravity) 0 In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ At-Grady ❑ Mound - Fecal Coliforrn (geometric mean) 5'10' cfullt)Oml ❑ Drip-Line l_1 Other: Maximum Effluent Particle Size in dia. El NA Other: NA Other: A Other -1 NA "Values typical for domestic wastewater and septic tank effluent. Other: F NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once ever : 11 month?s) y_ ear s (Maximum 3 years) CI NA Pump out contents of tank(s) When combined sludge and scum equals one-third (X) of tank volume - 0 NA Inspect dispersal cell(s) At least once every: 0 months) ~ (Maximum 3 years) 0 NA ,dear, effluent filter At least once every `g month, s) C] NA _l_f+LYearW Inspect pump, pump controls & alarm At least once every: ❑ monthrs) - 17 NA - D years; Flush laterals and pressure test At least once every: 0 months s) NA - - - - ear s other: ❑ manthls) At least once every: E4 ears U NA - - - - Other: - - I NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: aster Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Saptage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any crscks or leaks, measure the volume of (;ombined sludge and scum and to check for any back up or ponding of effluent on the ground sr rrface. 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 thc; immediate notification of the local regulatory authority. When the combined accumulation of sludge and scorn in any tank equals one-third (1,3) or more of tl re tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of 1-i accordanc,: 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 con: pletion of am , service event. START UP AND OPERATION rage of 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 Orwr'ator prior to restoring power to the effluent purnp or contact a Plumber or POWTS Maintainer to assist in manually operating the Bump 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 scrapf ; 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 tak,an to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Adminisirative 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 remof-ed 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 lo 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. CI The site has not been evaluated to identify a suitable replacement area. L. pon failure of the POM-S 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 pla,e following wmoval of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the nudes in effrict at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GA.- SES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUM ;TANCES. DY: ATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAIN`FAINER Name Phone l~ ~~G -/rl ~ =Phone °t~~- SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name - - Name Phone ~/y X027 ~ ' j I Phone This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (3), Wscorsin Administrative Code. FlatTER . C`S'I,. ]Crt~itte~~l~ft~unr , ~'1"~'W .r ISry Ilt tfrr IV11;1u• Cugtdryrd urtdar till attsw u 1! 'IrN 111('1 444 t Chu truf8v k terik tail lrtyrh lfltir rtalluif ar ltoluttrlt wWfyr~~ UbilbalY wltlr~r Ihpswrt pint('. intlreep106 into tlwt J Ildlilanu~I Irirta la1Yd tiro witrat cu 41:P 4 Whi pip, M,.Iej to le tlttx grew, is Ittlil ury httipd rfh Ctle oufl t, tripe, rr,ebaurv dw Ietlytit dlrtltrhld x ur +Ui~InchWrphllritlUtsll lie the IWtwl to aw tt"YI11t 1f1id welt N ot9YLrln Ifni RI'ut~I 4d bit stay YUUt~ Yrtwxrt. If side salrpnrt I"Wood to Irut "0163d, `I'M of Put itrrt wmotlrtrttl tldwilly thlo C+I+4hlrtel! lsUp111Uirrawt18l side s Vellauttt waW "'d sire-irralw PIP41 001111, tiler fist:-*r ae6el, wrt•or~ UtIlizol prtrrvegd to stttp YmIH: It Wile sappnrt ►rtekltilri 4: rrtrt SOlutlrtt Wehl thlt tlitul gaol(' Uhta the ctrl('rldye ureasitr trNttt Itiwm, Yr+sr 1,t rite irto the rose, wet. tilt(' U"U. I dorm('(' IIIrg1 ttiti WWII? trieka httn the likahrnr y1, y • Yuj t y It tt AS s~WIWIN im GtliiSn r g:1 r~aCkwiEte . irreutlt into ties rYt•Ur' atnl tgI;1C by Cllrrllrrtd r~,{Y - 1• The ditllierrt Met t11rtf111d be t;Itttirred Uvery tierrrd yTa atipClc ('bait Is seruived, 2. 0011th the tilitiot accesd deksAN,lp to Inagjimt the tallk 411d ltltlsr, S. PUrrtp 13011 septic tw"k X%Wf4*11'etiy, rntekitly SiUYg to tCitrNtVY1r thv alfattyvy L ibryt r tra rite ltdtttrrrt of ('1118 Wyk aced hot,lar t o the gGllrrr nhd ViiHlleelrt. p. Urw a l3tm tltlitrwvtlltvttl Irlrtt ('rwmrt YaWrered bidow outlet pipe, 1lrtaly pith rip on t6k, titter lou"a to tilt(' tilWtlkrt 1#1 tors curlrb1W ttwrr tiro t isf). dlrrltftlaU the + Slldu the rrrlrhiu t 4N artel .till. rrr'ths tettU All, rlRi1111t1y~ lea VAS sWlWN twrlthtwtrtd to art Idarlrl hr 11rogSt1j, rile sWiti l► W ShtwW his tdtttoveli by tnt•nlltly uytlritdrr3trr3tui111Iw Mite waltzer inriy 5tCI" A11d L1tdlhNr} . Y. Whilr 111108111(} the ralq'lWgt d, 1 r" th vm) Over it, a1st.'wcw U er4i , VII id4g('1111` s N it c t tdute tl, t trl t r .t i" Op t;ultridp,rr ttlltit WwExtr only, IvIb Aril more an Saptatbv, I'I'mierltrl itt rlriagd bdCtt 111b) filth L'Iad tU. It` VRL; switch Is Unitized, t'mplol a try tllfiw'thim into 111th('' tunic hiptthra detritwlr,u ttq '~Mtlrt +J. Ytmgd then fmcm, cartridge back lirku tlig to" the 141tttr Iaaira; ihtd tits haitorrl W hill c ~ 11fUdalyl111( dduvYl atltlY Bald. ta.tleplace and Swurw the ftVatili Ii[IWN110 1711 Cite tihk 1 Yr l1,• ''IC}.+" - ui,; ••rty 4 t 12 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTUICATWN FORM: Owner/Buyer 5 , nip A / Mailing Address /0 Z~ :~q o1 ~ 'Property Address d (Verification required from Planning & 7 oxiing Department for new constnnction.) City/State k~"_ I&J M M ( -T- Parcel Identification Nuriber D 3 J 2 v 3 - - LEGAL DESCRIPTION Property Location 1/4 , Sec. Z3 , T N R_/_3.W, Town of 54./- Subdivision - ~-~~5-~._-------_. Lot # Certified Survey Map # VOlurne Page # Warranty Deed # J Volume Page # Spec house yes no Lot luxe;; identifiabl yes no _ SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, ii needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage m the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal systern with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic systern has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. 1/we andare the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deel.ls Office. Number f ed, J SIGNATURE OF APPLICANT(S) DATE E **Any information that is misrepresented may result in the sanitary perniit being invoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds 0ffxce and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) SVAJIUN PEAMITFEO WITHIN DRAINAGE EASEMENTS. y - - 12' Wide Utility E< NORTH LINE C R~S89 ~9;J6 "W ___-N89'28'28"€--2404.69'--- 00' 248.00' 248.00' 248.00' . I WEST LINE OF r THE SE 1/4 OF „ THE SE 1/4 a 33' LOT 22 LOT 21 LOT 2 FT. 76,362 SQ. FT. w 76,270 SO. FT. w 76,179 SQ. f S 1.75 ACRES 1.75 ACRES M 75 ACRES ••---rte' ~ I ion'---~ I ~ ;q S 89'28'15" W 811.17' m N 89'28'15"i E 811.07' 8 0 3 2 5 5 3 Tx:4023475 STATE BAR OF WISCONSIN FORM I - 2000 938756 Document Number WARRANTY DEED BETH PABST REGISTER OF DEEDS THIS DEED, made between Brian L. Johnson and Cindy L. Johnson, ST. CROIX CO., WI husband and wife, as joint tenants with rights of survivorship, Grantor, 07/13/2011 12:29 PM and Steven t1_" K. Sin erhouse and Lisa M. EXEMPT#: NA Singerhouse, r1U5Ioa1 L,,.,, _ **Z Grantee. REC FEE: 30.00 Grantor, for a valuable consideration, conveys to Grantee the following TRANS FEE: 54.00 described real estate in St. Croix County, State of Wisconsin (the PAGES: 1 .Property"): k WIU~Y~p YYldnix~,~►~(~ Lot 2>lat of Wohlers Estates in the Town of Star Prairie, St. Croix County, Wisconsin. Recording Area Name and Return Address: St. Croix County Abstract and Title Co., Inc. 219 S. Knowles Ave. New Richmond. WI 54017 SFA8387 Together with all appurtenant rights, title and interests. Parcel Identification Number (PIN) 038-1203-70-000 This is not homestead property. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements, covenants, and conditions of record. Dated this g day of July, 201 1 * Brian L hnson b and L. Johnson, AIF * Cind L. nson AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) COUNTY St. Croix Q ) ss. authenticated this Personally came before me this U day of July, 2011 the above named Brian L. Johnson by Cindy L. Johnson, AIF * and Cin y L. Johnson to me known to be the person(s) who TITLE: MEMBER STATE BAR OF WISCONSIN exec to fo e oing instrument and ack" nowl 3. idgLed t- same. (If not, 11).. ' il, authorized by § 706.06, Wis. Stats.) - IF, CL F7'L , THIS INSTRUMENT WAS DRAFTED BY Notary Public, State of Wisconsin My commission is permanent. (If n ratio td Robert L. Lober 3 Loberg Law Office Img/ y (Signatures may be authenticated or acknowledged. Both are not necessary.) *Names of persons signing in any capacity must be typed or printed below their signature WARRANTY DEED STATE BAR OF WISCONSIN FORA No. 1-2000 1 of 1 w + l #W t Wisconsin Department of Commerce SOIL ~ 0RT Page _ of Division of Safety and Buildings In accordance with C", P5, Wis. Ad, de Attach complete site plan on paper not less than 8112 x 11 lliCtte in siz$~Klel t ' include, but not limited to: vertical and horizontal reference gohrt jBM), direction and rh~~ I.D. Q 3~'~ 3-7v percent slope, scale ordimenslons, north arrow, and loca&M and distanc?2 npaf,9st`I~rJ~ Please print all informatidh` - = ! 5S GP~ y b Date Personal Informadon you provide maybe used for secondary purposes ;'Ioacy Law, s. 1 S )Gl- I Q Q Property Own rty Locatieh t ; OPT Govt, t.t t; / 1/4 T N R E Properly 's Melling Addre lot # . _ # Subd. Name or CSM# r t 3 d r City ~ Stet Zip Code Phone Number ❑ City ❑ Village Town Nearest Road 4 _ l 5 YL, t ( r Construction UsaV-311tseldential / Number of bedrooms Code derived design flow rate GPD Q Replacement ❑ ~Publl m_ I -Describe: Parent ntatertal ..a.~~~ Flood PlaitUelevatlon 3fa plicable ft. General corrinents and recommendations,5,Y .5 z-e (Y1 lZegy W,-~w a,-z- a Boring # Boring Pit Ground surface el v. $ ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox De Texture Structure Consistence Boundary Roots GPD/If In, Munsell Qu. Sz. Cont Color Gr. Sz. Sh. "Eff#1 •Eff#2 ~ 4'y o s/ l r yYi ,7 W S v✓ 2 ' # Boring Bolling i ® 5 pit Ground surface elev. g /Z ft. Depth to limiting factor / La in. Sol licatlon 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 0-16 20 r nc SL - r F LS , S 16-3D l S/ r oe-'e- r J6 4Z t I X " Effluent #1 = SOD > 30 , 220 mg/- and TSS >30 1 IL ' Effluent #2 = BOD 30 mg/L and TSS 30 nV& CST NameCPlease Print) ` ign :T Nwbor ~Crw~✓ ~ .9~TU Address Date Evaluation Conducted Telephone Number h t to~ Property Owner Parcel ID # Paga _ of F-37 Boring # ❑ Boring C1 0/ EY Pit Ground surface elev. _ Is ft. Depth to limiting factor _ In, S011 ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP0/f8 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 "Eff#2 , l 0 0 3 5 1" Cs .S lo- o s r 1 F' b `I/ n a r-2 51 1 y , 7 ❑ Boring # ❑ Boring ❑ pit Ground surface elev. _ ft. Depth to limiting factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIff In. Munseli Qu. Sz. Cont. Color Gr, Sz, Sh. `Eff#1 'Eff#2 ❑ Boring # ❑ Boring - - ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Icetion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 "Eff#2 i I " Effluent #1 = SODS > 30:E 220 mg/L and TSS >30:5 150 mg& ` Effluent #2 = BODE 5 30 mg/L and TSS 5 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. ssD-8330 (RAMO) L ii Soil Test Plot Plan Project Name Ronald Wohlers Shaun Address 1282 200th Ave N ew Richmond WI 54017 C W249060 Lot 22 Subdivision Wohlers Estates Date 8/16/00 SW/SE 1/4 SE 1/4S 23 T 31 N/R 18 W Township Star Prairie ❑ Boring Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 2" Pipe System Elevation 93.8 *HRPSame as Benchmark Alt. BM Top of 1 1/2" Pipe @ 100.6' 308' Property Line a~ o ~ o a ~ 00 N B-3 100' Alt M. 25 10 * 99' B. 5' B ll - -1 40 5%40' -2 Slope 98' 100' Pro Town Road