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HomeMy WebLinkAbout030-2141-00-020 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 563893 0 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)J. Permit Holder's Name: City Village X Township Parcel Tax No: Bird, Shaun R. I St. Joseph, Town of 030-2141-00-020 CST BM Elev: Insp.BM Elev: t/ IBM Description �� Section/Town/Range/Map No: yr� 36.30.19.2070 TANK INFORMATION ELEVATION DAT TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic / !D� Benchmark Dosing at (' Alt. BM , d J ! 10 . Aeration Bldg.aewe ?v-3'f- b S4-4 Ll FLY Holding SUHt�I� p v/D W , ,0 7 TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 1'` 0 Septic 1 Dt Bottom Dosing Header r/=_ ,sip -13, Aeration Dist. bb ! , l f 13 Holding Bot System 1 O ��• 1 FinA Grade , PUMP/SIPHON INFORMATION CtA 34 Manufacturer GPM Demand Model Number TDH Lift Friction Los ystem Head TDH Ft Forcemain Lengt Dia. 115!%.to well SOIL ABSORPTION SYSTEM /(" BED/TRENCH Width Lengi No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS X Z •-^� SETBACK SYSTEM TO CJ P/L BLDG WELL LAKE/STREAM EACHING Man tuJ�J INFORMATION CHAMBER O 1't'! DY Type f System: � �/ �DVt UN Model Number: DISTRIBUTION SYSTEM f Bader nif rd Distribution x Hole Size x Hole Spacing ent Air Intake Length Dia r I L ngth Dia Spacing > 1 �l 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 I Bed/Trench Edges Topsoil 'V Yes [g No 0 Yes � No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: � /2.6 /' �7_ Inspection#2: Location: 1264 84th S et Ne Riclhnnond_,YVI 5544017(SE 1/4 NW 1/4 36 T30N R19 Natalie's Ridge Lot 2200 � Parcel No: 3A6.30`.1199.2070 1.)Alt BM Description �7 W�r(ALGGTf/D" W� 6's • /6,04 lj a4 sx.// fp luT 2.)Bldg sewer length � -amount of cover= S C� � 3 Plan revision Required? � Yes No _-- Use other side for additional information. (O r SBD-6710(R.3/97) Date Insepctor's Sign ture Cert.No. PLOT PLAN PROJECT Shaun Bird ADDRESS 1432 120th ST. New Richmond Wi 54017 SE 1/4 NW 1/4S 36 /T 30 N/R 19 W TOWN St. Joseph COUNTY ST.CROIX MPRS Shaun Bird 226900 DATE 8/28/13 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 .7 ABSORPTION AREA 651 # of chambers 32 BENCHMARK V.R.P. Top of 2" pipe ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEV1A'TIO 92.742.6' 5.5' below qr de Property Line Pro 3 Q � k Bedroom J 4A V House 99' 144' 98' 68' Scale is 1" = 40' B-2 15' �o b� unless otherwise noted 1% Slope 15' 84' B.M.* 6' B-1 162' 2-3' 66' Cells with>3' spacing Vent Vents B-3 � � yr l .ti � SS ' w U3Z�iiin y 138 uick4 Standard Q i ' s�all be SDR 10 of Cover Leaching Chamber f tank, gping shall be Schedule 40. with 20.0 ft2 of Area t^2/pair of end caps 4, Long 12" y. 1 34" Grade at System Elevation � Town Road 154' • y • --i 33' 33' I 6W — . . . . . — — . . . . . — — . t 9226 x OT 9 ' 3. 5 A (3.0 A .) LOT . . G� 3.0 ;4v ; ® .95 I L.B.O.= 923.1 x 920.8 e: LOT 1 H.W.L.=921.1 / . 22 AC. �R (2.94 AC.) / �► I918.8 ' A Rau = sa ,@03 475 918.8 \ N x 918,4 i 'St 918.2 LOT 17 4A� � gl 0011 AC 917.7 ( 1 a x / LOT 1 .B 0.= 16.5 / w 3.00 AC. 2.7 AC.) d L.B.O. 910.0 ITz T 6 x 918.3 3.013 AC; County 14p+ , wr 4 Industry Services Division / L G tk s. r~ Sanitart Number (to be filled in by Co.) ~ 1400 E Washington Ave y $ on, Box 716?_ 3 S / ~j S r"' Madison, WI 53707-7162 State'rt"ansactlon l~llt/Yf 1 n Permit Application N In accordance wit Sg3. , ts. Adm. Code, submission of this form to the appropriate governmental arlur address) _ is required prior t i mg a rani trt, Note: Application forms for state owned POW'I'S are sttbmitt1llt; t Actdryss (if ditTerent than m the Department ut ety rofessional 3ervies. Personal information you provide may be used for secondary -1 purposes in accordance_with the Privucy Law, s, I5.04(I)(m), Stalls - _.-e ---.-r}tr O 1. Application Information . Please i II anon V~s Property Owner's Name ~perty Location / 20-7 Propert Ow e 's Mailing Address ry t -1%%~~[~~`~ - - Govt. Lot - zip Code Phone Number Section34 City, state cle o II. ,ype of Building (check all that apPl Subdivision Name r 2 Family Dwell ng - Number of Bedro _ 6k_ O-A 1)a- _ -q ❑ ❑Public/Commerotal - Describe Use City of CSM Number Village of ❑ State Owned - Describe Use Al;G cl,--~ 4 11I.'I'ype of Permit: (Check onl one box on line A_Complete line B ii' applicable} 7".) Treatment/Hoidin 'l'ank Replacement Only ❑ O[her Modification to Existing System (explw System ❑ Replacement System g List revious 'rranster to New ❑ Permit Renewal Permit Revision Change of Ylumber ter Ownetmu 3e11 e Expiration - - - - - IV. e of POVVT'S System/Component/Device: (Check all that? y -s - - Pressurized In-Ground ❑ Pressurized In-Ground U At-Grade ❑ Mound =°L4 in, of suitabh soil Mound < ~24 in. c sot ~ ❑ ~ _ sZ__ ❑ I loldmg'l ank D Other Dispersal Component (explain),_ ''etreaunent Device (explain V. Dis )ersal/Treat ent Area {nformation: - - ~)is~al Are Proposed (sl) Syst G1cr ' n . ` gpd) Ueslgn ,sod Application Rat' pdst) llispu,al rea Requnc d (s17 PCT Design Flow( Capacity in rota # of Manufacturer 2 I. Tank Info Gallons - Gallons Units b y r 1 0 CJ 7, NewTtnkr - FExisu.gs SepticorlinldingTank Dosing Ch.nber _ ~ - - - VII. Responsibilit'l Statemte t, the undersigned, assn e- onsibility for installation of the PONVT show R on tun attached plainness Phone f Number - Plur r' Name (Print) Plumber' lure ✓ P umber's Address (Street, City, State, Zip Cod - VII1. CO, /De arfine It- Clse Only _ - Issuin A nt Signature yP,~ermit Fee-- Datc I 'ued g ~ Approved ~ " / 175. Od g~3~ ~3 - - even Reason fo nlal ] - J p IX. ConditjqV$ asons for Disapproval vi nQ'~aW~ 'e / ;,~1- -5 J-C I Septic tank, effluent filter andr - dispersal cell must all be services / maintained W t t as per management plan provided by'plumber. n 2..A'fiset(~ackrequirements must be-mmaintainiW P. r w- a ~ ✓ t~~-e t~ as rode [ordatianoes. _ - ~g - - Attach to complete plans for the system and submit t- to tie C°°nbY only o° PntPer uul less than 1t2 -.l1 SBD-6398 (R031:i) Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 8/28/13 Owner:Shaun Bird Location: NE1/4 SW1/4 S36 T30 N,R19W Lot 220 Natalies Ridge St. Josepj 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 S e 8.-10. Soil Test Signature License number # 00 PLOT PLAN PROJECT Shaun Bird ADDRESS 1432 120th ST. New Richmond Wi 54017 SE 1/4 NW 1/4S 36 /T 30 N/R 19 W TOWN St. Joseph COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 8/28/13 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 .7 ABSORPTION AREA 651 # of chambers 32 BENCHMARK V.R.P. Top of 2" pipe ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 92.7/92.6' 5.5' below qrade Property Line Pro 3 Bedroom House 15' 99' 144' 98' 68' Scale is 1" = 40' B-2 15' unless otherwise noted 1% Slope 15' 84' B.M.* 6' B-1 162' 2-3' 66' Cells with >3' spacing Vent Vents B-3 138' >6" Quick4 Standard piping shall be SDR 30/34, within 10' of Cover Leaching Chamber f tank, piping shall be Schedule 40. with 20.0 ft2 of Area 12"ft^2/pair of end caps 4' Long 5. 1 Grade at System Elevation 34' Town Road 154' Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber To be >1' above grade 5.6ft 2 pair of end plates Finish grade elevation Typical Installation 98.4 ,jV ent Grade Vent 4" 3' x/30/34 Septic Tank 99 5' 5 ' Long 1 Grade at System Elevation 3699 Grade at System Elevation Spacing 5' 2-3' X 66' Cells Same on other end Observation tubeNent At end of cell A B 16 chambers per cell System elevations: A-92.7' B 92.6' POSITS OWNER'S MANUAL & MANAGEMi1ENI FLAN Page._°f__.....___ FILE INFORMATION SYSTEM Silt:GIFiCATI()NS Owner Sepiir Tank Capacity gal.- Permit # Septic Tank Mai wfactwer I-.] NA DESIGN PAI7AMETirRS C ffluent Filter rdlanulactutei t1 NA Number of Bedroor is Ll NA 1-1fluent Filter Model IJ NA - urn iTan k0a coal Number of Public Facility Units ANA P K pa'citY 1-1 N Estimated flow (average) al/day Pump [ ank Manutactuvir t NA Design flow (peak), (Estimated x PurTlp Matilr`actLlM0 I 1 A Soil Application Raie ' al/da /ft~ Pump Model L. NA - - - Standard Influent/Effluent (Quality Monthly average Pretreatmont Unit 6 C=ats, Oil & Grease (FOG) 530 mg/l. ❑ Sand/Gavel Filter 1.1 Peat Filter Biochemical O cygen Demand (BODs) 5220 trig/t. U NA C7 Mechar ical Aeration I I Wetland C-otai 5usperrdeid Solids (TSS) <_950 rng/L 1_I Disinfection 1-1 Other: _.C'r`tC3ioc.t~rnlical U,rUualer~ty Demand (-13.0Us) ~ii average Ui er5a1 ~.,c~tt(s) C.I NA (ground (gravity) l_I In--GJror.rnd (pressurize(J) o0 m !I Total Suspended Solids (T56) <_30 mg/1. NA 1-1 At-Graoe 1"I Mound recai Colirorm (geometric mean) <1()4 ctu/100rn El Drip-Line [-I Other: Maximum Effluent Particle Size ~ in dia. E] NA Li NA LL .1 C.I N/~ C )t her: NA Other, A "Values typical for domestic wastewater arid septic tank effluent. [A NA MAINTENANCE SCHEDULE - u - - Service Event - -`~Se irvice Frequency ❑ Inspect condition of tank(s) At least onus every niont I, s) (Maximum 3 years) 1-1 NA -.:5. ~`C yearns C'urnp out conterits of tank(s) When combined sludge and scurn equals one-thiicl (~i) of tank volume I-I NA Maxirncrrn 3 1-1 NA dispersal cells At least once every. :2- G1 ears ( years) Inspect Clean effluent filter At least once every: ear $ E J NA C_I rnon i s NA 1115pet.t purnp, purnp controls & alarm At least once every CJ years; 1 Flush laterals and pressure test At least once every: 11 C_I mearonth hi5) I i NA Other: 1:7 Inonthl s l I NA At least once every: El year(s) Other: C= 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 lrspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual intipection of the tank(s) to identify any missing or broken hardware, Hentify arty cricks or leaks, measure the volume: of combined sludge and scurn and to check for any back up or poridinc3 of effluent or the ground siMac:e. I he dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to chect: for any ponding of effluent on the cfr-ound surface. The ponding of effluent On the ground surface may indicate a failing condition and requires thr~ irnrnediate notification of the local regulatory authority. When the combined accurnuration of sludge and scum iii any tank equals one--third or more of tl ie tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordant with chapter NR 113, Wisconsin Administrative Code. 1\11 other services, including but not limited to the servicing of effluent filters, rnechar ical Or' pressurl.ced cornporrents, pr'etreatrnenr: units, and any servicing at intervals of .x'12 rnonths, shall be perfornied by a certified POW T'; Maintainer. A service report shall be provided to the local regulatory authority within 11) days of Completion of an!, service event. Page Of START LDP AND OPERATION For new construction, prior to use of the F10M S' cheat treatment tank(s) for the presence of panting products or other, chemicals that pray impede the treatment process and/or danage the dispersal cell(s). If high concentrations are detected have the contents of the tank{s} removed by a set tage servicing operator prior it) use. System start up shat not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill ab7ve normal highwater leveis_ 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 ttb~ pump tank removed by a Septage Servicing Or.►erator prior to restoring power to the effluent purnp or contact a Plumber or POWTS Maintainer to assist in manually operating the rcump controls to restore normal levels within the pump tank. t)c► not drive or park vehicles over tanks and dispersal cells. Do riot 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 strearn may improve the performance and prolong the life of the POVVTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; (lentil floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbic.ldes; meat scrap: ; medications; oil; painting products; pesficides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When tyre POW-1-13 fails and/or is permanently taken out of service the following steps shall be taken to insure ttrat the system is properly and safely abandoned in compliance with chaptiv Comm W1,33, Wisconsin Administr.3tive tsado, 0 All piping to tanks and pits shall be disconnected and the abandoned pipe openings seale':I. 0 '11ie contents of all tanks and pits shall be removed arrd properly disposed of by a Septap:: Servicing Operator. a After primping, all tanks and pits shall be excavated and iernoved or' their covers rernoved and the void :space filled with soil, gravel or, another inert solid material. CONTINGENCY PLAN It the POW'i'S fails and cannot t►e repaired the following measures have beer, or must be taken, to provide a code compliant re la ent system: Iitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system, 1hE: replacement area should be protected frorn disturbance and compaction and should (tot be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the r-:aplacernent 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. IJ A suitable replacement area is not aNmilable due to setback and/or soil limitations. Barring advances in POWI S technology a holding tank may be installed as a last resort to replace the failed PO11UFS. 1-1 The site has riot been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. It no replacement area is availtitrle a holding tank maybe installed as a last resort to replace the failed POWTS. 0 Mound and at-grade soil absorption systems may be reconstructed in pkice following removal of the biomat at the infiltrative surface. Reconstructions of such Systems must comply with the rules in effect at that time. <<WARNINGx~, SEPTIC:, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAI_ GASSES ANDIOR INSUFFICIENT OXYGEN. DO NOV ENTER A SEPTIC, PUMP OR OTHER TREA'i'f1AEN'i"TANK UNDER ANY CIRCUMSTANCES. W ATH MAY RE:SUL 1'. RESCUE OF A PERSON FROM T"E INTERIOR OF A TANK IAAY BE DIFFICULT OR IMPOSSIBILE. ADDITIONAL-COMMENTS PO WT'S INSTAI..twl:;Ft POWI"S MAIi VAINER Name Narn(- _ Phonr~~ Phone SI: PTAGE SERVICING OPERATOR P MPEit~ m I_OCAt., REGULATORY AU r"HORITY Marne Name - - - - Phone U I'Irone ~~cJ _ _ This document was drafted in compliance witt► chapter ! iPS 383.22(2)(b)(1)(d)&(f) and 3133.54(1:, (2) 1(, (3), Wiscoirsiri Administrative Code. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNS HIP CERTIFICATION FORM Owner/Buyer Mailing Address Property Address 2-`~'~ Q (Verificatio required from Planning & Zoning Department for new construction.) City/State 1~~ ~+1(~'~ w Parcel Identification Number aj~0 L/'Q~ LEGAL DESCRIPTION Property Location 1/4 1/4 , Sec. 49N R /0 W, Town of v dS Subdivision 14 ~ "4~' -a , Lot # ZO. Certified Survey Map # r , Volume , Page # Warranty Deed # Volume Page # I l9 1 \J j Spec houlc~ no Lot lines identifiab yes o 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, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank 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 system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warn my deed recorded in Register of Deeds Office. Number of bedrooms S C 01// ~ ATURE OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) k-- INSTRUCTIONS FusTER CARTRIDGE :a rM Y pry lit "m ;Ilww, catsrt aft ths Wtd of tim outlat pipe to ensure it it echturad under' tlw iwcwfr- opunim. If trot, tiww althnr insst't mairu 1000 Oft the tank thrmuYh -Alwt 4r eviubat wotd (giwr) additiar,al pilre Ole" the uuthet pipe. ;MEP .2 Whq tier sm Dry ltt W on ON cutlet 010m, tarloartrrra tbu ismo ut 46-10A Wp iwe Awam the "War to" tank a W UA 0 tImul"o the oPt+loaai mupp, nrMal ow wwt. If aids support tnathoi is WA utYizt:i, protmed Eo AO **V ~i• .4 Pot it utlJsir~pt tine 9ptb11N tg1 rada ubppbrt: soiu.M rwld tf.e Ilsch Pe a+rtu the filth cams. Et *W9 support MAW is twA d. irroood to oelr trur. SsNii tF t)N}'111tel vase I*ft lilt! r~tll~t iritin. ir.anrt the, filter cartrrage nrta a cater, p►lrtlslttr( doinwi thb ttm lillw k>rks into the 6uttnrx of t it''s 1 attltcdr in uHlk J_ mbwt 1140 tlrb r anu igck try tt{rtrirr9 clacktplse 90b. l~aifiirterllai~lce 1. I'hr• "Ml-lenli Mier 11644d ill t$0btred artery tlrrrrr riot g tptiC tank iy svraiced. Z. Opatl the ulrtlat am"" upbr,6rp to i~ltBCt the funk, ,tttd Nltut; r+uMp tllb aayptic trrrrk ►rnphrtrnly, rrrakrtl() anUrtr to rHtrlhr/e L'ho sludyu 4, onfayc.ate err the ,twktorrr rrbtlat pipe, tlr r f thw t"irii< and nut gust the n"Wr Lind ei iuulit. f , flernr n levrri ham kOu6n tuWered ttelyW tht, invoet el tine : fJr pa j) up nlr inter dleladUu c4lrtrid1lgy /rgnr !!rirlp otter bundle to dirt S. SNdrt the r while w W, Bbd at Pt tot the F - 6. rr a VAs switch c. hne,:t d to a,rr alai ca~ss Syr deaabry. should be rerriaut d by turuinr c 01 4 b'Yeilient tile switt it wikh Water utdy. Y orlrltordotltWisiu ypw 4iri detllrrid Y. W 'r. bile hW41hp Vhe tjrrlydql u w r down) over the h 126 its WF>1tl (tartt+a ,tai I:Urf~ro Fw: Q,p anly, rr'akhry more aft aire:rllPI& rhlsp nit-tht~ C:tlrlYld mWrt+ryre rrralkerla! is rlna1 b 9it ,vita wa a n ir' Vrts srWtch Ia utNiaed rk Intro tflet trdrrh. trrenirrg eieFCkFreise 9uiare by Ilraarklitgi anti? HtCeF' ;rttd , J, irryat; RfMC Minor Cartridge thb Yiltar lacks, Ittn tFr ss i{y`rk~ i kFr~ case. h'rtlbblga dt►Wrr until ia.Rrrplata btld secure the irCGttlyd u ' ps" WU Gh the isYtlif. ~et~rr,rr •r, .y~. WY'V'V4be1t]lWt1t.COj" 12- )S NORTH LINE OF TW 51/2 OF THE NWI/4 231.32 462.63 DRAINAGE 88 OflAINAGE 462.69 EASEMENT 33' 33' \ 62 09'43'W E SEMEN'J' ' I 616% - - e0' RADIUS TEMPORARY C -DE-SAC TO ~BELDMNdJISHED EASWENT I EXTENTION OF ROAD LOT 8 1 I LOT 10 N IC 130,682. -.r]I 13ao8~98 80CRESfT i S r z It r ~75 I L75' = I I 1 g gg ( Q~~ I I I~ ~r 9 9 3 ~ C 6 m ` ACAS Se931'08'E 462.66 N 58235'0 'E 462.69' I i t 130,682 SO. Fr. LB.0.- 940.0 + I t' I I C 8 8 I I q lu. LOT 9 LOT 11 1 SS2 Sm I 1J06N SO Fr. °92&0 59' I HALL- 00' RAM'A .1. ORANVAIiE EASEMEN EASEMENT 7,'1 I 33' 33' w I . ao0 YY c2, 6J' ' WI c- J: u N I - - e, 01 G5 G6 Se931'0rE 2064.21' u H1 589'S1'OrE 482.69' u - - - - - - - 126TH AVENUE- - w u -N8931'0e-W 1314.66' N8931'Oe'W 46269' `'1 X, Z 4 -1 t ' - - ' - - • - 33' 133' J i y. ti ~ IN ~ 6 8' = e KJ 40 a l ID « 7s' g a I Ito, H.W.E- 916.0 r LOT 19 I ♦ H m I LOT 12 3.045 ACRES 3.013 ACRES I N N 13$637 SO. FT. I o 131,241 SO. FT. la V .b - + c 76 L.B.O.- 91&0 N ,ry LOT 20 I m DRAINAGE °i 1008 ACRES -II I EASEMENT I!' 131,031 SM Fr. I L.B.O.- 923.1 I ~75'35E 469•Q8 BENCH MARK: TOP I i c OF 1* IRW ♦ ORAINACE ELEVA ON 9116 3 ~ ( F S , EASEMENT V. . P / V ~ '/^4) / 75`1 I ~ IM 13 LOT 18 LOOTACRES I I t 3 022 ACRES 130,917 SO. FT, ( E i t 131,848 SO. FT. i 4`y/ ` ` I I C 115ee' HeCtd 22 E 474.69 - ~ / S\/1.15 I LOT 14 1 ' ; • L 33 j-, &ODO ACRES N LOT 17 1L~B.o- 9 9110.0 9 1011 ACRES 131,141 SO. FT. LOT L&0.- 916.5 ` S 000 ACRES / DRAINAGE ts' 130,686 SO. FT. EASE iwr 7l' 4 L&0.- 910.0 E M i s \ T ~ H.W.E- 90&0 LOTA RES a BENCH MARK: TOP 3.012 PON ,y 131,21e 90. FT. OF EELEVA ON 912.0 nm+ ?w` / LB.0.- 918.5 H.W.E.- 914.5 r~''Myyy1E 461.97 4 CA i . DRAINAGE -4- N H _ u: EASEMENT !C i y i + CIO i / K1j /~rrOr~C $ St /4 COR. / i SEC 36 81111111111111111111111111:11 . 8 1 1 2 2 Tx:4089263• STATE BAR OF WISCONSIN FORM 3 - 2000 969022 Document Number QUITCLAIM DEED BETH PABST REGISTER OF DEEDS THIS DEED, made between Citizens State Bank, a Wisconsin banking ST. CROIX CO., WI corporation, Grantor, and Shawn Bird, a single person, Grantee. 12/07/2012 1:23 PM Grantor quit claims to Grantee the following described real estate in St. EXEMPT#: NA Croix County, State of Wisconsin (the "Property"): REC FEE: 30.00 Lots 41 51 61 1), 13 20, 1, 26, and 27 Natalie's, Ridge, St. Croix County, TRANS FEE: 764.10 Wisconsin. PAGES: 2 Lots are sold `as is' with all faults. Recording Area Name and Return Address: Title One Premier Group 706 19th St S Hudson, WI 54016 #18811 Together with all appurtenant rights, title and interests. see attached Parcel Identification Number (PIN) This is not homestead property. Dated this 7th day of December, 2012. Citi IK~ Bank * Gene Haberman, ice Chairman * AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) ST CROIX COUNTY. ) ss. authenticated this 7th day of December, 2012 Personally came before me this 7th day of December, 2012 the above named Citizens State Bank by Gene Haberma, : Vice Chairman to me known to be the person(s) who executed TITLE: MEMBER STATE BAR OF WISCONSIN the foregoing instrument and acknowledged the same. (if not, authorized by § 706.06, Wis. Stats.) *Jay p field THIS INSTRUMENT WAS DRAFTED BY N u lic, State of Wisconsin My, co ission is permanent. (If not, state expiration date: Michael H Forecki, Attorney 8/7/2016 ) (Signatures may be authenticated or acknowledged. Both are not necessary.) 'Names of persons signing in any capacity must be typed or printed below their i ~giAY red; PFf~IPIEwl) i ;dotary Pubiic 1 of 2 QUIT CLAIM DEED STATE BAR OF WISCONSIN FORM No. 3-2000 Parcel 030-2141-00-020 08/28/2013 04:20 PM PAGE 1 OF 1 Alt. Parcel M 36.30.19.2070 030 - TOWN OF SAINT JOSEPH ST. CROIX COUNTY, WISCONSIN Current ~X Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 07/08/2005 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner SHAWN BIRD O - BIRD, SHAWN 1432 120TH ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 1264 84TH ST SC 2611 SCH DIST OF HUDSON SP 1700 WITC Legal Description: Acres: 3.008 Plat: 10-065-NATALIES RIDGE LOTS 1/32 030-05 SEC 36 T30N R19W PT SE NW NATALIE'S Block/Condo Bldg: LOT 020 RIDGE LOT 20 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 36-30N-19W SE NW Notes: Parcel History: Date Doc # Vol/Page Type 12/07/2012 969022 QC 12/07/2012 969021 QC 02/12/2010 911845 QC 02/12/2010 911844 QC more... 2013 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 05/11/2011 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.008 34,000 0 34,000 NO Totals for 2013: General Property 3.008 34,000 0 34,000 Woodland 0.000 0 0 Totals for 2012: General Property 3.008 34,000 0 34,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 1337 Wisconsin Department ce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and w gs Tom Schmitt 'irk acco ancewith Comm 85, Wis. Adm. Code County Attach complete site plan on paper nti ess an : x 11 inches in size. Plan must St Croix include, but rat limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel L D. Please print all information. Reviewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). U 1 4 Property Owner Property Location Grand Properties, LP Govt. Lot SE 1/4 NW 1/4 S 36 T 30 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 712 Rivard Streeet, Suite 300 20 Natalie's Ridge City State Zip Code Phone Number City Village ✓ Town Nearest Road / 2(0 V Jn Somerset WI 54025 715-247-5900 St.Joseph ✓ New Construction Use: ✓ Residential/ Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe: Parent material Outwash (stream terrace) Flood plain elevation, if applicable na General comments and recommendations: Area is suitable for a conventional system with a 0.7g~d/sgft rating. Possible system elevation for Area 1 is 93.50'. Slope is 1 - - ❑ Boring # Boring ✓ Pit Ground Surface elev. 98.74 ft, Depth to limiting factor 110+ in. Soil Application Rate Horizon Depth Dominant Color Rix Description Texture Structure Consistence Boundary Roots GPM? 'Eff#1 'Eff#2 1 0-12 1Oyr3/2 none I 2fsbk mvfr as 1vf .6 .8 2 12-30 1Oyr3/3 none sil 2msbk mfr cs 1vf .6 .8 3 30-51 1Oyr4/4 none sl 2fsbk mfr 9w 1vf .6 1.0 4 51-65 1Oyr4/6 none grls Osg ml cs .7 1.6 5 65-110 10yr6/4 none grs Osg ml .7 1.6 ❑ Boring # Boring ✓ Pit Ground Surface elev. 98.74 ft. Depth to limiting factor 105+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF 'Eff#1 'Eff#2 1 0-17 1Oyr3/2 none sil 2fsbk mvfr as 2vf .6 .8 2 17-34 1Oyr4/3 none grs( 3fsbk mvfr cs 1vf .6 1.0 3 34-55 1Oyr5/4 none vgrs Dag ml cs .7 1.6 4 55-105 1Oyr5/6 none grs Osg ml .7 1.6 d ' Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOD <-30 mg/L and TSS <-90 mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt ~zor4 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 1595 72nd St., New Richmond, WI 54017 4/14/05 715-247-2941 Property Owner Grand Properties, LP Parcel ID # Page 2 of 3 3 Boring ✓ Pit Ground Surface elev. 98.14 ft. Depth to limiting factor 98+ in. Sal Application Rate F Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF *Eff#1 *Eff#2 1 0-21 1Oyr3/2 none I 2fsbk mfr as 2vf,1f, .6 .8 2 21-35 1Oyr4/4 none I 2msbk mfr gw 1vf .6 .8 3 35-42 7.4yr4/6 none ms Osg ml gw .7 1.6 4 42-98 1Oyr5/4 none grms Osg ml .7 1.6 r ❑ Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate i Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD *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 *Eff#1 *Eff#2 * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 <_30 mg/L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. Pale 3 On 'Conducted by: Conducted For: Schmitt Soil Testing, Inc. Name: Grand Properties, LP Thomas J. Schmitt, CST 227429 Address: 712 Rivard Street 1595 72nd St. City, State, Zip: Somerset, WI. 54025 New Richmond, WI. 54017 Phone: 715-247-2941 Subd.Name: Natalies Ridge Lot No.: arc / - Ox Legal Description: ,CIA At-414 S36 T30N R19W Township of St. Joseph, St Coix County M Soil Boring ® Bench Mark El. 100.00' Top of 2" pvc pipe 0 Alternate B nch Mark EL 9,9. 338 f Top of 2" pvc pipe Slope-/ Contour Line El. N.9 ,~b~ Scale I"= 40' Idf /Ov r a lip 4 S © 90( 'd This soil report was done to fulfill a zoning requirement. may or may not be in a location suitable for your use. 33' 33' 66, 9226 - - - . - - .1 OT 9' 3. 5 A (3.0 A I LOT G~ 3.0 A ® .95 A~. I I L.B.O.= 923.1 X 920.8 I 9. I p. LOT 1 H.W.L.=921.1 / . 22 AC. (2.94 AC.) 918.8 x 9 RAD = 80' ,903 47v 918.8 ` N x 918.4 . , ` c 918.2 LOT 17 v N o4.011 AC 917.7 ( 1 A x / LOT 1 L.B.O.= 16.5 / 3.00 AC. y (2.7 AC.) d / i o L.B.O. 910.0 2 / DOT 6 x 918.3 ~ 3.013 AC. 10% 1^- Ift 0% Ik