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HomeMy WebLinkAbout020-1439-27-000 444 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 567214 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: Sharratt, Jonathan & Ste hanie Hudson, Town of 020-1439-27-000 CST BM Elev: { \ Insp. BM Elev: BM De ription: Section/Town/Range/Map No: t` ( • lJ~'~'►' 25.29.19.2753 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark l Z_ n--b i e►S c/ /O(N 0 Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet 3.7- TANK SETBACK INFO ATION St/Ht Outlet ~ tg -3 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic % Q U / t ) r / r Vi` " Dt Bottom f~ ~.1 Dosing 7) V7 ~y t Head ~ Aeration Dist. Pip c^ T l~ b s 4, Holding B m 7LJ L it ov'vjo Final Grade ' PUMP/SIPHON INFORMATION off:./ 5 Manufacturer Demand St Cover GPM 3 YI yl~' S h@ ~~~}-le 1. 13 Model Number ! It ' ~•.r 1 TDH Lift Fric i ss System TDH Ft Forcemain Length Dis . SOIL ABSORPTION SYSTEM aka -6 S' BED/TRENCH Width Length No. f Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS t ~t 2 S Z 4 SETBACK SYSTEM TO P BLDG WELL LAKE/STREAM ACHIN ' Ma64 wtur r. INFORMATION HAMBER- R 1r Type.Pf System:Y/v > 5U G Model Number: lC)'1 i DISTRIBUTION SYSTEM eader anifold Distribution > > ) x Hole Size x Hole Spacing Vent Air Intake i.~. 7 Pipe(s) 4 7 (n 6~ Length D It Length Dia Spacing IS2 tz- 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 " v- Bed/Trench Edges Topsoil Yes No 0 Yes 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 900 Highlander Trail Hudson, WI 54016 (NE 1/4 NE 1/4 25 T29N R19W) Indigo Ponds Lot 27 Parcel No: 25.29.19.2753 1.) Alt BM Description = f r1 u 1 ~ti2L j, LZ I I t ~C k~L~fG(.LY Lt,l bc.G7u ~c (if, 2.) Bldg sewer length = I t czo? C ~N rr L S~.C-.ILtCvtZ. - amount of cover = i,/A y Plan revision Required? 0 Yes C~ L~~.. Use other side for additional information. ==SSS D SBD-6710 (R.3197) ate Insepctor' Signature Cert. No. j rl 14- '7 7 0 ~ -Al ~ P ICU i F 19 rJ r A county Safety and Bttikungs Division in by Co.) A 201 W. Washkpton Ave.. P.O. Box 7162 Santlffiy Permit Number (to be fiw 707 7162 S b 7 2 i I Sanitary Permit App cation StdcT NrA I In oc orduxx with SPS 383.21(2), Wis. Adm. Code, submission of this form to the trait 1 is required prier to obtaining a sanitary permit. Notes Applicdian fo<ms for state-owned are Project Ad (if diifmmt thm► roar7ing address) the Department of Safety and Professiond Servies. Persooat k&mm aoa you provide may q00 / 1C~ / /~tkAID ~ 7-k in accordance with the Pflvmv Laws 15.04 1 m Stag !a C L licatioa Information -Please Print All Wormation 4 C Parcel4 bZC- 0137bl- 5-~ ~ tt~ rrE SA ARC.A IT _NZ 04' JD uty property owner's Mm ft Address Prop L°`a110II 2 f 5 3 RIO. 3es~ 358 cdy sty Z* Co/dye Phone Numbcr ~ fc M ~j v., searan 2S i I'1U>~c5t"~IV s V ~,1 J1 G~ T R (circle one) u Type of Building (check an that apply) j ` 1 of # ~l J '1 SubdivisiwtName i or 2 F Nrmmber of 1d"J Blodc# ❑ Publidcammacial - Dos %c Use ❑ (icy of CSM Number D village of - D State Owned - Describe Use 44Town t1U 6S e? i of IrL er ionly one box on Mae A. Complete B if tipplicaA. pNew Syste❑ TrearnenVMdmg TankReplacemmt Only D Outer MWiScatim to Existing System (explem) I3 D permit Renewal D Permit Revision O Change of Plumber D Permit Transfer to New st Praviota Permit Nnmber and DamIssued B. Before Expiration Owner IV. Typajot- era ent/Devke: Check alt that apply) pressurized D p=ursed In-Cuound D Atdkade ❑ M > 24 in. of nibble -0 O M nd < 24 ' of sow soil Other Dispetstd component (gyp Z s b✓ -f' Z 1( V. Dis tmcat Area Information: ICIC as Design Flow (gpd) Design Soil Application R fj DBpersal Area ✓ Dial Area Proposed (st) 'f z _-7~ ( '7 t/ X57 y 8 ~ a VL Tank fife Capacity Ciallons Gallons in of fu r Um / New Tanks Eidsting Taol3 1 Z ST) V H 'v10i 1 A w t7 P. Stpdo orllotdiog Tack 1 2 Die aunuar vu Bag t/ a is i V I VIL Responsibility Statement` I, the andersigaed, swum responsibility for t Non of the POWTS sh attacked plans. i Plumber's Name (Print) S' Business Phone Number Fi- 2Z3AZ -71-5- 7SS- 24 Plumber's Address (Sucet, City. StatS Zip Code) nn at Use Oubr Approved D Dis" oved Pemtit Fee Date" g Agent ❑ Owner Givuat Rtesan for Denial s 7 5- 0 0 8120 13 w, % Qw gaUReasans for Disapproval - 1. Septic tank, effluent filter and tr~ dispersal cell must be serviced ! maintained ~p 30 -fp Q~~ as per management plan provided by plumber. n~ Q C~ 2. All setback requirements must be maintained code/ordinances. is arse O Atpa3 is piwa> Or the s arW Y7= 7per act less 8.12 :11 IftCbP /0 y rs s~hce soy l des / or f-e - e0I& ICs A ~ m~trkJ SBD-6398 (R. 11111) D Z X En 721 86" D m r. 53" D Z z m c m D N 0 n m v g\~ o CrUP 57T-F m 4" CAS m D O N I m > I m m 3" 47" 4" o o m < < D m m co I v I D~ m . N UP 49" m 4" CAS N N v m 0 O ~ y A O ~ ~ ;a 50" ° ODz m m r D > N co -Ti r N O~~ D 00 D m m r xM n D Z O m n c ZO<~ D Z O r Z Z -r1 O mom. 7zC D Or cc m m m D nm xX m Z Z r-N 0 nCp 0 0~Z DIZ ~prrazmDO ODD ~ Nv (Am m -0 C' m ~F' --I -a ~CN>0 ~0 0 2p~~pz5ZA Orfzn 0 -0 -4 y Nm o m 1= cn r--IZ 0 ~zp --iU)p ~r-- .~pr- .N.. - Oz p0 c r D O NC -4 M<ZO M~ 0 Fl r DZ~ DDS Nrm~ ~"N OWN M CT1 ~N 4kk Z O m -0 D ~ r p D O OD Dm N N N I O O a 0= a n 0 Z O co v D v A D Am cnmm I m r~L" ~ p a- ZC7 v U N Z GZj in C ~ - (no -n D r ao a `a O D c) n 0 p O I O O' a D OG z w cvi~ 0 O p Z Z 0 0 mm r j cnao N 0 m z 0 W Z 0C -n ao c --I (n W0 r, 0DD D0 ~ m _I v m x H n ~v Z A Z D~ m~ D p Q m Z -I D O N ;o O 1 p ?1 O ju -.-I O z -n r .TJ O D O~ m 0 0 N (n Z c D p O D O O m 0 m to z D n O 3 p A --1 O N m'- m co r0 Z r 0 Z H 0 O r- 0 m z ; z r m 4 \ cn W1250-MR = DRAWN BY: SME SCALE: 1/4"=I'-O" PRE-POUR: ° m SEPTIC MANUAL MIEBER CCIICAETE REV. \ z W3716 US HWY 10 MAIDEN ROCK, WI 54750 DATE: JANUARY 2,010 DATE:. POST-POUR: P REVISED JAN. 2010 800-325-8456 FILE: W1250-MR CONVENT]ONAL COMPONENT DESIGN Redder" Appficatim -INDEX AND TITLE PAGE S,~tcf 4A Prof pwner's Name owners Adder 35; O 1 Legal DesWiPtl0m Township- AI bo County. s`t C mj)L SubdiMsian Name: 1 1Z)0w z R oa W Number. Z? Parcel ID Nub 6ZC-- (,7- MZ Page 1 Index and We Page 2 piot Pian Page 3 m Sizing 8~ Cross-S1On Page 4 FftwS Page 5 Maintenance information Page 6 _ AAana9>anent Man Page 7 S#. Groiac GtY Septic Tank i 6artsnce Form page 8 _ Warraw Deed Page g CSM Plat Attachn wrft SCA Test & House Plans R~ UDons Nurntw- Mt~S Z`Z3Z`IZ_ 30,-D6 PhorW Number Dale: Signature ~ e~ soY'~ c ~ Po'Y~rs vex zo sea-,o~os-P c?- PAP + 4. (L z a I 3 i 1 i i N 72 2 N .;jo;'S-2013 0$:53 AM St. Croix County Plan/Zoning 715-386-4686 4/4 1 of Aboaffm c 97Z ft 4P t PVC Vft v« QW 73, Z. Ctber CM 2 2 ft it a r,2, 0 ~Aft Mal-M&W*M f ' R Vent Or ObsurveHon p' ChwnbsM Trench t e Die. Trench 2 Heater e~blaa G'IfatrL ' ga~Mtai#lana M®nufadurer And Mods[ _C010- K t( /1~=jL`tit1t~ EISA Raft sq ! Pa chamber Sots App h adon Rate ~-7 gpd/agr ft 9Fd Deelgn Fbw 804 Appl ioh Rabe 4 EiSA = Chsmbem 2 rows of Z/ Z ohembem each. 1NGROUND SOIL. ABSORPTION MANAGEMENT PLAN PURSUANT TO COMM. 83.54, WIS. ADM. CODE General This system shall be operated m accordance with Comm.8244 Wis Adm. Code and shall be maintained in accordance with. is component manual [In ground Absorption Component Maul for POWTS Version 2.0 SBD-1070-P (n-01/01) and SSWW publication 9.5 (01181) and local or state rules pertainma to system msmtaximce and maintenance reportiis, No one should ever enter a septic rank or pump tank since dangerous gases may be present that could cause dealt Septic and pump tank abandonment shall be in accordance with Comm. 8333, Wis Adm. Code when the tanks are no longer used as POWTS components- Septic Septic or pump tank manhole users, access risers, and covers should be mspecled for water tig7.,/ Wass and soundness. Access openings used for service and assessment shall be sealed and watertight upon the completion of service. Any opening deemed unsound ,defective, or subject to faihne must be replaced Exposed access openings greater than 8-inches m diameter shall be secured by an effective Iockm ; device to prevent accidental or unauthorized entry into a tank or component_ Septic Tank The septic tank shall be mamiamed by an individual wed to service septic tanks under s. 281-48, Stats. The contents of the septic tank Shall be disposed of in accordance with NR 113, Wis Adm Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filfier shall be cleaned as necessary to ensure proper operation- The filter caroidge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from W. enclosure. If the filter is equipped with an alarm, the filter shall be serviced ifibe alarm is activated continuously. -Intermittent filteralarm may indicate surge flows or an impe=ding continuous alarm The septic tank shad have its contents removed when the volume of sludge and scum in the tank exceeds 113 the liquid volume of the tank. If the contents ofthe tank are not removed at the time of the triennial assessment, mice personnel shall advise the owner of when the next service needs to be performed to maintain less than maxium scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is gemaally not required However, if such products are used they shalt be approved for septic tank use by the Dept of Commerce. Pump Tank The pump tank shall be inspected at once every 3 years. All switches, alarms and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Soil Absorption System No trees or shrubs should be planted on,d`ie absorption area. Plantings may be made away from the cell's perimeter, and the area shall be soled and mulched as necessary to prevent erosion and to provide some protection $am first penciraigacL Traffic (other than foot or for vegetative maintenance) on the am is not recommended since sod compaction may hinder aeration. ofthe infiltrative surface within the system and snow compaction in the winter will promote frost penetration- Observation pipes withm the dispersal cell shall be checked for effluent pondmg. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an hopending hydraulic failure requiring additional, more fiiequent monitoring. Contingency Plan If the septic tank or any of its components become defcetive the tank or component shall be repaired or replaced to keep the system in proper operating edition- If the dosing tank, pump, pump controls, alarm or related whing becomes defective the defectiire component shall be immediately repaired of replaced with a component of the same or equal performance. If the dispersal area faits to accept wastewater or begins to discharge waste-water to the ground surface, it will be repaired or replaced in its' present location by biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Replacement in a suitable area nearby is also an option at which point a diversion valve will be installed between the old and new systems to allow dispersal cell rotation at a schedule to be determined at the time of cell replacement. ~_c- v 2w'3 C2-53 AM St. Croix County Plan/Zoning 715-386-4686 214 Pao. Z of 2 START UP AND OPERATION For new construction, prior to use of the POWTS ohook treatment tsnk(a) for the presenae of pshsdng products or other chemleais that mey impede the treatment process and/or damage the dWpsrsal collie). If h1o concentrations are detected have the oontenta of the tank(s) removed by a septage servicing operator prior to use. system start up shall not occur when soli conditions are frozen at the ktflkretWe surface. During power outages pump tanks may fill above normal hlghwater levels. When power is restored the excess wastewater will be discharged to the dispersal collie) in one large doss, overloading the cep(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 effluem pump or contact a Plumber or POWTS Malntsiner 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 oeils. Do not drive or park over, or odwrwlse disturb or oompam, the area within 15 fast 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; ootton swabs; degreasers; dental floss; diapers; dt Mectants; fat; foundation drain (sump pumpi water; fruit and vegetaWs pea0nge; gasoline,* grease; herbicides; meat scrope; medications; oil; painting products; peatioldes; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS folio and/or Is permanently takers out of service the fo(lowlg srops shall lie taken to insure that the system In properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and plus sine)) be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pis shall be removed and properly disposed of by a Saptege SmIcing Operator. • After pumping, ail tanks and pits shall be excavated and renoved or their covers removed and the void apace filed with soil, gravel or another inert solid material. CONTINGENCY PLAN- If the POWTS falls and cannot be repaired the following meashu•s have been, or must be taken, to provide a code compliant maple~j"si=VMWW. l~7 A repiacemerht area has been evaluated and may be utilized for the location of a replacement colt absorption system. The replacement area should be proteoted from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wails. Failure to protect the replacement Won will resuk in the need far a new soil and site evaluation to establish a suitable replacement am. RelAwama t systems must comply with the rules in effect at that time. la A suitable replacement area Is not available due to setback snWor soil limitations. Barring advanc e@ in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The eke has not been evaluated to Identify a sultabie replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area Is avaNabls a holding tank may be installed as a last resort to replace the failed POWTS. 13 Mound and "reds soil absorption systems may be reconstructs in place following removal of the biomet at the infiltrative surface. Reconstructions of such systems must comply with the rules In effect at that time. < <WARNING> > GEPTIC. PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUPFiCIENT OXVa1N. 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 ON DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMIINTS POWTS INSTALLER POWYS MAINTAINER Name ZUFF ~)C Name Phone - 7W Zt3 (p 1 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHOiiM --7 Name Name '7s7r, `x C G~p~ Phone [--Phone Z (S ~ -8 G- 1 This doaument was dratted In compliance with chapter Comm 83.2212)(b)(1)Id)&i wd a3.5411),121 a (3). Wisconsin Admmnvamnre Cosa. FILTER CARTRIDGE INSTRUCTIONS instawition f STEP I _Pry fit the filter case ortto the end of the outlet pipe to ensure it is centered$nder e access opening. If not, then either insert rare pipe into the tank-throUgh the outlet or solvent weld (glue) additional pipe onto the outlet pipe. STEP 2 While the case is still dry fitted on the outlet pipe, measure the length of V4-inch pipe needed to brace the filter to the-tank end wall if utilizing the optional supplemental'side support. If side support method is not utilized, proceed to step four_ STEP 3 For installations utilizing the optional supplemental side support: solvent weld the Vk-inch pipe onto the filter case. If side support method is not utilized, proceed to step four. STEP 4 Solvent weld the filter case onto the outlet pipe. Insert the filter cartridge into the case, pressing down until the filter locks into the bottom of i the case. STEP 5 If a VRS switch is utilized= insert into the filter and lock by turning clo6 wise 900. Maintenance 1. The effluent filter should be cleaned every time the septic tank is serviced. , 2. Open the outlet access opening to inspect the tank and filter. } f' 3. Pump the septic tank completely, making sure to remove the sludge layer on the bottom of the tank and not just the scum and effluent. 4. once the effluent level has been lowered below the invert of the outlet pipe, firmly pull up on the fitter handle to dislodge the , - - cartridge from the case. 5. Slide the cartridge up and out of the case for cleaning. _ z, 6. If a VR5 switch connected to an alarm is present, the switch should be removed by turning counterclockwise 90° and cleaned with water only. 7. While holding the cartridge on its side (large flat 5urface facing a down) over the access opening, rinse off the cartridge with water ;n only, making sure all~septage material is rinsed back into the tank. 8. If VRS switch is utilized, replace byVerting into filter and turning clockwise 9010, i 9. Insert the filter cartridge back into the case, pressing down until t;7- the filter locks into the bottom of the case.;- _i - 10. Replace and secure the access opening on the tajtk. BEAR ONSITS"' FILTER CARTRIDGE - FIVE-YEAR LIMITED WARRANTY from trip date of Bear Onsite filter cartridges are warranted to be :-s n and wo-%hmarshig for rive 1,5) yearc consumer purchase. - BEAR ONSMm Fitter Case -Lifetime Limited Warranty Bear Onsite warrants tite `lter case wilt tne free c! defects ^ T?l°" ' and :,vrkfrdnsher 6-ing normal use ter the period of time the original purchaser owns the odu_ If a defect- is found in normal use, Bear Ons'te at,ts e:ectinn• repair. provide ~v revacement part or product, or make appropriate adjustment. Damage to a pto--ct t-. a_cldent, misuse, n, atuse is rrt covered by this we arty. Improper care or'Ifunctions resuiting,from units not Ld.: _!rd. - maintained ,n accordance w,th instructions provided will void the warranty. Proof of purchase forigmal sates recr r,-=id=_^ to Bear Onstte :with all warranty; r.a+ms. Bear Onsite is not responsible for labor charges, removal chara_,, c-.or €he=- incidental or conseauential c s''s. in no event shall the liability of Bear.Onsite excce~ the purchase price of the product. i~roli~sit e'din 877-MMU IN (653=4583'` te.24. 2033 10.41AM No.2235 P. 1 ST. CRODC COUNTY SEPTIC TANK MAWAMVCIK AGgEnM" AM OWKERSISP CICRTMCATZ FOLtM J"gn f 51eoh 4A it SW 4rrq 1I - FO' six are W fOK, z g Property address 40 94h ty T-r C c ityjstate~! Patael IdmMatioa Number Z ~ $ -W AV LEGAL DES ON ,gyp If Property Locatera'h, Y+ SeaF At I~ R 17 W, Town of ~fAN Subdivision ~o dads Lem 77 Certified Sarvcy Watrar►ty beed#~yZ13 / , Volmge pag'~ Spec how Tres -K-.W Lot limes idludliable-~ 2ao U&TEM MAYNTMMCE Improper use aedmaiatcn=w ofymaeptie sya om could result its pramnWO Tailors to ~mdle VVaStss per mui deneaee condsts of pumpmg Out clue septic trick aunty three years os sooner. if needed by a licensed pwnper. WRat.you put iada the.systetan ad 5d tbafimdion of the septic Tank ass tratowt stage m the waste disposal system. ~ The propatyowner-agrees toaubmit to St. Croi7(7.mfinB Dcpaihmi^nt e certificationfarm, arced by the tl~ the on- site and by a mas~plamber journei►mm plumber, restricted plumber ors tic umd pumper vaffift (1) site vlWcwatta disposals isiaprspez apstatiag condition an&" (Z) aft bgedtoa and Fnmping (if ry}. the septic tank is less than M fall of stto p.' 1 y v,*. the tIISdemgwdlavwoad-t118A60V6sCt111i26'IIYmtS a11d aPTj EO tO m8imulit thoPi'tYate SemSe duposal, Wlill the standards set forth, berem, as set by th Depattamrtt of Comm<roo and use the Depuftnut WN*wW Resources, State ofQViscon SitLCeAfiratirgo.staisngtbatyow-vvticsystem. Ywsbeesmamtaimdmostbeeom ldedandret vndto the St. Croix County Zoning Office within 10 days of the three year eotpirstion dabs. 4P 13 SIONA OF APPL[CANf DATH #4 Proposed be&=," OWNER CKRTIFIC TION I (we) certify that all statewents on this taFm are true to the best of my (attr) knowledge I No) stn (gre) the awnes(s) of the property dmmbed above, by virtue of a itrarranty deed recordad m RcVstor of Oceds Offtc& iia14A~ OFAPPUCANT 5ARTE Anyadamitiaadtatiameagwwoodwayma mitwamixypoomtbmgmvd"bydmZmrogD " h~cbdowel~d~ia~plamsasa~eoPed~raaYdeedfromtLeR~egrterafDeedso&ea soaQydWeox~ied.~rvey coop $sdsmm iaso>rl. mtfrew+Raer-jr d~ I I I I7 II i } STATE BAR OF WISCONSIN FORM 2 - 2000 8 x34027267 $ Document Number WARRANTY DEED 942139 BETH PABST THIS DEED, made between American Classic Homes, LLC, REGISTER OF DEEDS Grantor, and Jonathan M. Sharratt and Stephanie A. Sharratt, ST. CROIX CO., Wi s husband and wife, as survivorship marital property, Grantee. 09/28/2011 2:38 PM Grantor for a valuable consideration, conveys and warrants to EXEMPT#: NA Grantee the following described real estate in St. Croix County, REC FEE: 30.00 Wisconsin: TRANS FEE: 129.00 PAGES: 2 Lot 27, Plat of Indigo Ponds in the Town of Hudson St. Croix d County, Wisconsin. S t P Recording Area ! Name and Return Address: 1 Edina Realty Title, Inc. 400 South Second Street, Suite 115 Hudson, WI 54016 1001783 3 Exceptions to warranties: 020-1439-27-000 Easements, restrictions and rights-of-way of record, if any. Parcel Identification Number (PIN) t This is not homestead property. Dated this September 28, 2011 7 t Ameri n assic Homes, LLC BY- } nald F. Nelson, , P sid t i s i i ~ i II WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2-2000 r M 1 of 2 € a R ~ s AUTHENT ATION yF9i ACKNOWLEDGMENT r Signature(s) STATE OF L~~~ SLbn~in t ~1G COU Y OF authenticated this September 28, 2011 S/ N e nally came before me this Sip~t~htvZ~j2N~ * th above Donald F. Nelson, President of American TITLE: MEMBER STATE BAR OF WISCONSIN Classic Homes, LLC to me known to be the person or (If not, persons who executed the foregoing instrument and authorized by §706.06, Wis. Stats.) acknowledged the same. s i t THIS INSTRUMENT WAS DRAFTED BY i Martin D. Henschel 6800 France Avenue South, Suite 410 Cheri Brown Edina, MN 55435 Notary Public, State of Wisconsin (Signatures may be authenticated or acknowledged. My commission is permanent. (If not, state the I Both are not necessary.) expiration date: 03/01/2015) *Names of persons signing in any capacity must be ? typed or printed below their signature. pp ~ i i 4 i F E}{F 1 1 t i t f~ t 7 } i i z 1 I 3 ii Ii 1 y3y d WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2.2000 i. 2 of 2 Lr) LLJ LC) / I r/•1 ; R f~, 1 % f 87317 S.F. t I z 'a 2.005 AC.) . ` cNo 1.604 AC. N.B.P.A.~ • ( c~ wry ' \ ` ri r ' 00% J i , D p j_• t _ ~ , ' ~ ~ ~ Cif o W crm .5 k, 26t a. 102593 S. ; r N s~- ,Q (2.355 AC.) (1.013 AC. N:9.P.A. ~.~C ~x. "moo ~ ~ ; " • C• ~ V) L.Li cc C3 CIO I U Cl- C14 CL LL 1 - .f 1 A NA: 0:5 Its 3 N.B.P.A) ,5 a lob wak t / _Y/lry+ V 0 / .rte ~ 2 E ~ ~ a w~ r •8,537 S.F.~•~ 1'r3< «o~ ~ s to (2.010 AC.) 1 !r' (1.086 AC. N.B.P. # 7. FIZZ 'ON V10:01-Eloz W .aas 1283 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel Soil Service County Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. Please print all information. Review By Date Personal information you provide may used lrCl V aoy s. 15.04 (1) (m)). Property Owner Property Location ROSAMJI, L.L..C r Govt. Lot na NE 1/4 NE 1/4 S 25 T 29 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2141 Cty Rd. C -Y 27 na Indigo Ponds City State Zip 0 6 ~"q"r _J City J Village e Town Nearest Road New Richmond WI 715-248-7071 Hudson Highlander Trail New Construction Use: J Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD . I Replacement J Public or commercial - Describe:na Parent material Sream terraces and pitted outwash plains Flood plain elevation, if applicable na General comments and recommendations: system elevation 93.45 ft, trenches spaced and depth to code 3.75 ft below grade M Boring # Boring If Pit Ground Surface elev. 97.20 ft. Depth to limiting factor 96 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff# 1 PD/ft*E~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-4 10yr3/2 none I 2msbk mfr cs 2c .5 .8 2 4-12 10yr3/3 none sil 2msbk mfr gw 1c .5 .8 3 12-30 10yr4/4 none sicl 2msbk mfr gw 1f .4 .6 4 30-36 7.5yr4/4 none scl 2msbk mfr gw na .6 .6 5 36-46 7.5yr4/4 none Is osg mvfr cs na .7 1.2 6 46-96 7.5yr4/6 none ms osg ml na na .7 1.2 2 '(r q& Boring # 0 Boring Pit Ground Surface elev. 97.20 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff# GPD/ft' Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-4 10yr2/1 none I 2msbk mfr cs 1 c .5 .8 2 4-12 10yr3/4 none sl 2msbk mfr gw 1c .5 .9 3 12-24 10yr4/4 none scl 2msbk mfr gw 1f .4 .6 4 24-36 7.5yr6/4 none sicl 2msbk mfr gw na .4 .6 5 36-54 7.5yr4/4 none sl 2msbk mfr cs na .5 .9 6 54-120 .5yr4/6 none cos osg mvfr na na .7 1.6 l/ * Effluent #1 = BOD? 30 < 220 rr(g/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 <.30 mg/L and TSS S30 mg/L CST Name (Please Print) ignature: CST Number David J. Steel 248956 Address Steel Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 5/3/2003 715-246-5085 t Property Owner ROSAMR, L.L.C Parcel ID # pending Page 2 of 3 r 3 ] Boring # Boring V1 Pit Ground Surface elev. 89.90 ft. Depth to limiting factor 120 in. Soil Application Rate F Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-4 10yr2/1 none I 2msbk mfr cs 1 c .5 .8 2 4-12 10yr3/4 none sil 2msbk mfr gw 1c .5 .8 3 12-20 10yr4/4 none sicl 2msbk mfr gw, na .4 .6 4 20-30 7.5yr4/4 none scl 2msbk mfr gw, na .4 .6 5 30-45 7.5yr4/4 none sl 2msbk mfr gw, na .5 .9 6 45-120 7.5yr4/6 none cos osg ml na na .7 1.6 COS <35% coarse fragments = 36" & F-1 Boring # I Boring >35% - <60% = 60" below system J Pit in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring # _ I 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 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *EM * 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. Page 3 of 3 STEEL'S SOIL SERVICE INC. David J. Steel 1564 Cty Rd GG CST-POWTSM ROSAMJI, L.L.C. New R.ichmond,Wl 54017 Lic. #248956 SEl/4,NE1/4,S25,T29NAl9W Bus.(715) 246-6200 Town of Hudson, St. Croix Co. Fax.(715) 246-9372 Indigo Ponds Lot 27 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted. Legend 1" = 40' ♦ = Benchmark Ve. 1 OO.OOFt Top of 1/2" pvc pipe 91 • =Alt Benchmark Ele. 100.1 OR f7.~J Top of 1/2" pvc pipe n = Borings ` L Boring Elevations B l = 97.20Ft ~y. B2 = 97.20Ft B3 = 89.90Ft B4 = OO.OOFt 3 ~ A10' 50 33 , z soJ41 l' h(*- 5 + -95.07' 1 . <•; k 2.000 AC.) ((1.539 AC. N.B.P.A.}r` ! L : • ' 188.13 508:102* 26. r, - 102593 (2.355 AC.) o (1.023 AC. N.B.P.' YV N' 'gel ell (2.266 AC.) a% (1.635 At. N.B.P.A} , 'Vot .f/ 75 . \5. Cr- B.P.A.} r'o,: r 0 1.68 ~ / 15411 109074 F. 'j,; . (2.504 AC.) . r= 87180 S.F.,~ 1.062 AC. N.B.P.A. h~ (2.001 AC.) 1 ~A1.063 AC. N.B.P.A.) /-~~.~7trv I ' ~r 5th t i /tfl -I'.Y•- y ! 'j 7 0- c -7~~.^ ~ N _ - ~ / $753!_7 SF: x. < Nj,~` so. / bDy (2.010 Ac.) (1.087 AC. N.B.P.A> 09800 S.F. t t ` r 143. 1 _ L ' t '(2.521 AC.) ` • r : r' l 59.57 A 4 7w[ a, ~r t de. aat ~ , ICA 44- C. UL a ~~N a v AS At n s00°29'o3"w 2616.18' U ;14 C~ L r; Parcel 020-1439-27-000 09/26/2013 09:59 AM PAGE 1 OF 1 Alt. Parcel M 25.29.19.2753 020 - TOWN OF HUDSON Current 0 ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - SHARRATT, JONATHAN M & STEPHANIE A JONATHAN M & STEPHANIE A SHARRATT PO BOX 358 HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ` 900 HIGHLANDER TRL SC 2611 SCH DIST OF HUDSON SP 1700 WITC Legal Description: Acres: 2.504 Plat: 09-071-INDIGO PONDS LOTS 1/57 020-03 SEC 25 T29N R19W PT NE NE INDIGO PONDS Block/Condo Bldg: LOT 27 LOT 27 (2.504AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 25-29N-19W NE NE Notes: Parcel History: Date Doc # Vol/Page Type 09/28/2011 942139 WD 10/28/2005 810571 2917/380 WD 07/10/2003 729699 9/71 PLAT 2013 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/18/2012 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.504 71,800 0 71,800 NO Totals for 2013: General Property 2.504 71,800 0 71,800 Woodland 0.000 0 0 Totals for 2012: General Property 2.504 71,800 0 71,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00