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040-1306-05-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 569549 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: Oevering Homes LLC, aka Oevering Pro ertie Troy, Town of 040-1306-05-000 CST BM Elev: Insp.BM Elev: BM Description: Section/Town/Range/Map No: /0U v G 08.28.19.1832 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER .r �5 CAPACITY STATION BS HI FS ELEV. Septic (' Z^- 3 Benchmark ��9 Alt.BM Y, , �jQa.... '1�.., G z•3 v�a� o Aeration Bldg.Sewer Holding St/Ht Inlet p •� gs 7 0 TANK SETBACK INFORMATION St/Ht Outlet 4 s (e- TANK TO P/L WELL BLDG. ent Air Intake ROAD Dt Inlet Septic 3 2- l I� , /C i Dt Bottom Dosing Header/Man. 9. 5 Aeration Dist. Pipe 9. 5 q ` ,7 Holding Bot.System `� 9 3 . `Z PUMP/SIPHON INFORMATION Final Grade 5 /00 .7 Manufacturer GPM Demand St Cover -Z I 3 /.6/ Model Number TDH Lift Friction Loss System Head T - Ft Forcemain Length Dia. o well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length / No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 /Q Z_ If�i�` � SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR r,' P,r L V--/A a--,- Type Of System: UNIT Mode Number: G o n►J-e�,�-.a�,�.Q. �D 3 B � /1/V�-"" C� DISTRIBUTION SYSTEM („)e8 Z + 1 Z v5 Header/Manifold 1 I Distribution x Hole Size x Hole Spacing Vent to Air Intake 4 Pipe(s) Length Dia Length Dia Spacing `o S SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only III Depth Over Depth Over xx Depth f xx Seeded/Sodded xx Mulched Bedlrrench Center 7 Bed/rrench Edges �\ Topsoil Yes No No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / / Inspection#2: Location: 469 Dylan Court.Hud on,WI 54016(SW 1/4 NE 1/4 8 T28N R1 9W) Sunset View Lot 5 Parcel No: 08.28.19.1832 1. Alt BM Description= / 2.)Bldg sewer length= 5 -amount of cover= / 1 ---- -- -- ---I -I Plan revision Required? Yes No Is Use other side for additional information. i SBD-6710(R.3/97) Date Insepctor's Ignatur Cert.No. i PLOT PLAN PROJECT Oeverino Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SW 1/4 NE 1/4S 8 /T 28 N/R 19 W TOWN Troy COUNTY ST.CROIX MPRS Shaun Bird 226900 4/21/14 DATE BEDROOM 4 CONVENTIONAL )OCX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 890 # of chambers 44 BENCHMARK V.R.P. Top of ground surface at corner ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark All piping shall be SDR 30/34, within 10' SYSTEM ELEVATION 97.5/97.4 5' below qrade of tank, piping shall be Schedule 40. 101' 60' 15' 75' 55 Property Line B.M.* 102' 2-3' X 92' Cells B-2 with>3'spacing 10' B-1 102.5' Scale is 1 = 40 2% Slope 15' unless otherwise noted 115' S 15' ents to be>5' from lot li e Pro 4 —� Bedroom House B-3 Vent >6» Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area ' Long 12" 5.6ft^2/pair of end caps 220' Property Line 34" Grade at System Elevation DPro town road County �r' Industry Services Division �� lJ d Al 1400 E Washington Ave Sanitary Number(to be filled in by Co.) P.O. Box 707 �� Madison,WI 53707-7162 f' �� ecRn tie�t9 Number /1k�A- - Sanitary Permit Application �< <„/ In accordance with SPS 383.21(2),W is.Adm.Code,submission of this form to the appropriate governmental unit O is required prior to obtaining a sanitary permit. Note:Application forms for state-owned POWTS are submitted to Proje ��di e nt than mailing address) the Department of Safety and Professional Servies. Personal information you provide ma used for secondary /V purposes in accordance with the Privacy Law,s. 15.04(1)(m),Stats. �lJ ,p'r )e_� G 1. Application Information-Please Print All Inf Property Owner's Name Parcel# Property Owner's Mailing Addr s Property Location `>'3 3 Q In 0/_4,, J Govt. of City,State ) Zip Code Phone Number J y, �/ /., Section �t t /t °le or �_N; k-z-�—E r W II.Type of Building(check all t apply) fck Subdivision Name or 2 Family Dwelling-Number of Bedrooms �� CAD �l/'�JlJ!Public/Commercial-Describe Use �D ❑City of ❑ Village of State Owned-Describe Use own of Ill.Type of Permit: (Check only onf box on line A. Complete line B if applicable) A' nPOWTS ❑ Replacement System ❑Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System(explain) B. ❑ ❑ Permit Revision ❑Change of Plumber ❑Permit Transfer to New List Previous Permit Number and Date Issued Bef Owner �QZ, IV.Type stem/Corn onent/Device: Check all that a I r y Elf Non-Pround ❑ Pressurized In-Ground ❑At-Grade ❑ Mound?24 in.of suitable soil ❑ Mound<24 in.of suitable soi&I- T ❑ Holding Tank ❑Other Dispersal Component(explain) ❑Pretreatment Device(ex !V1.Dis ersal/Trea ent Area Information: ign Flow(gpd) Design Soil Application R (gpdsf) Dispersal Area Required f) Dispersal ea Prop System evatio Tank Info Capacity in Total #of Manufacturer Gallons Gallons Units n °' ° 2 = New Tanks Existing Tanks n �`�w r o a U Septic or Holding Tank X, Dosing Chamber VII.Responsibility Statement- I,the undersigned,assum esponsibility,for installation of the POWTS shown on the attached plans. Plum Name(Print) Plumb ature MP/MPRS Number Business Phone Number Plumber's Address(Street,City,State,Zip Code P mil. /?1 VIII.CountVIDepartment Use Only Approved tEl isap Permit Fee Date Issue Issuing A Signature iven Reason for Denial Af_75. «b q 2 3 r IX.Conditial($tlt ►�t4gasons for Disapproval 3 ( QUA id t.✓ 1. &eptic tank,effluent filter and / a`c VAC Q dispersal cell must all be services/maintained V0VV_0t,-lv1aA._ W as per Management plan provided by plumber. t I All k ragtlirat is+xiue t be7►)aint e� .. Attach to complete plans for the system and submit to the County only on paper not less than 8 112 x I I inches in size SBD-6398(R0313) � 111111111111811111 ll II lllflll 8229401 Document Number Document Title Tx:4187639 St. Croix County BETH 5PA ST Occupancy Affidavit REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD Y 05/12/2014 3:24 PM Name -(OvAer) typed or printed EXEMPT #: being duly sworn , states, under oath,that: REC FEE: 30.00 PAGES: 1 He/she is the owner/part owner of the following parcel of land located in St. Croix County,Wisconsin, recorded in Volume Page Document Number 99 —Q'�St. Croix County Register of Deeds Office: Recording Area A parcel of land located in the-50 '/a of theN '/a of Section , TZ?? N Name and Return Address —R 4 W,Town of ro St. Croix County,Wisconsin, being duly L described as follows (incILMe lot no. and subdivision/CSM or detailed legal 20 011 A11�- description): 43o Parcel Identification Number(PIN) As owner of the above described property, I ackn wledge that the private onsite wastewater treatment system (POWTS)serving this residence is sized for a bedroom home or a design flow of�gpd. The design flow is calculated by assuming.6-0 gpd for 2 individuals per bedroom. There are currently,occupants living in this residence; a maximum of S occupants are permitted based on the design wastewater flow. Therefore the POWTS serving this residence is code compliant at this time. However, I understand that if there are intentions to exceed the number of permitted occupants,the POWTS may be subject to premature failure and/or will need to be modified to accommodate the increased wastewater flows and/or contaminant loads. I also acknowledge that I will make this information available to any future parties interested in purchasing this property. Dated this /cl day of �l [ AIJITHE C o� ACKNOWLEDGMENT Signature(s) y1 e/� STATE OF WISCONSIN ) )ss. St.Croix County. ) `/ M authenticated this day of a ersonally came before me this day of the above named * • DIN, i 11 R 8/10 TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the persq�(s)'who'ezecute a egoing (If not, instrument and acknowledge the-ea�T rA9, _ �,. authorized by§706.06,Wis.Stats.) ' THIS INSTRUMENT WAS DRAFT BY: `L rs Notary Pubr ,State of Wlscons10tt�rrrll����A� (Signatures may be authenticated or acknowledged. Both are not My Com sio is per anent If not state expiration date: necessary.) Date: / "THIS PAGE IS PART OF THIS LEGAL DOCUMENT—DO NOT REMOVE" This information must be completed by subminer: document title.name&return address.and PIN(if required). Other information such as the granting clauses,legal descri lion,etc.maybe placed on this first page of the document or maybe placed on additional pages of the document.Note: Use of this St.i�49jxm** SW A7g5 P63,064166i1ent and$2.00 to the recording fee. Wisconsin Statutes,59.43. Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 4/21/14 Owner: Oevering Homes Location: SW 1/4 NE 1/4 S8 T28 N,R19W Lot 5 Sunset view Troy 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 Sp4ation 8-10. Soil Signature License n PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SW 1/4 NE 1/4S 8 /T 28 N/R 19 W TOWN Troy COUNTY ST.CROIX MFRS Shaun Bird 226900 DATE 4/21/14 BEDROOM 4 CONVENTIONAL )00( IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 890 # of chambers 44 BENCHMARK V.R.P. Top of ground surface at corner ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. SameasBenchmark All piping shall be SDR 30/34,within 10' SYSTEM ELEVATION 97.5/97.4 F below qrade of tank,piping shall be Schedule 40. 101' 60' i 15' 75 55, Property 3Line I B.M.* 2-3' X 92' Cells B-2 102 with>3'spacing 10' B-1 102.5' Scale is P = 40' 2% Slope 15, unless otherwise noted 115' S 15' ents to be>5' from lot li e Pro 4 —� Bedroom House B-3 Vent >6" Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 4' Long 1219 5.6ft^2/pair of end caps 220' Property Line 34" Grade at System Elevation Pro town road 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 Lj 5.6ft^2 pair of end plates To be >1' above grade Finish grade elevation Typical Installation 97..5' nt Grade Vent 3' eptic Tank ,tv.e, 5' S' Long 1��36 Grade at System Elevation Grade at System Elevation Spacing 5' 2-3' X 92 ' Cells Same on other end Observation tubeNent At end of cell A B 22 chambers per cell System elevation B_92,4' ST.CROIX COUNTY - SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer c6 e'/•,n Mailing Address _ �13- Property Address _y�p (Verification requir from Planning&Zoning Department —cons t-r--ct- .) - City/State — Parcel Identification Number -' LEGAL,DESCRIPTION Property Location -5�j Y4, Sec. p .-, W, Town of T ZO NR� c7 Subdivision �u s �if P-✓ - G — -- Lot#_ Certified Survey Map#_ �j �L� Volume —, Page# Warranty Deed# t�- -------_____ Volume S Page#pec house es iio --------------- _____. Lot lines identifiable es no SYSTEM MNTENANCE AND 0 E CERTIFICATION Improper use and maintenance of your s tu.s maintenance consists of-pump in$out the eY' system could result in its rema the system can affect the fiinction of the she tank every three years or sooner,pif need�d,fbailure to handle wastes. Proper responsibilities are specified in Ca tank as a treatment stage in the waste disposal system. owner ma What You put into mm.83.52(1)and in chapter.12-St.Croix County Sanitary maintenance p The property owner agrees to submit to St.Croix County Ordinance. owner and by a master plumber,journeyman ty aging&Zoning e wastewater disposal system is in Proper Plunmber,restricted plumber or a licensed pent a certtf"ication form,signed by he less than 1/3 full of sludge p gating condition and/or(2)after inspection 8nd��verifying that(1)the on-site pfihg(if'neeeasary),the septic tank is "we,the undersigned have read the above requirements and agree to maintain the private sewage disposal standards set tbrth,herein,as set by the b Certification stating that your Septic syste haas be n maintained must be completed and re g pASa2 system with ttre amerce and the Department of Natural Resources,State of Wisconsin. Toning Department within 30 days of the three year y expiration date, turned to the St. Croix County Planning Etc '/we certify that all statements ou Property described above b v' this form are true to the best of my/our knowledge. I/we am/are the owners)of the y virtue of a wary - deed recorded in Register gister of Deeds Office. Number of bedrooms y 4 CNA OF �PLICANT(S) ***Any info DATF, information that is misrepresented may result in the sanitary permit being revoked by the plan' rnclude with this application a recorded warranty deed from the Register of Deeds Office and a copy of he fled s Department. *** reference is made in the warranty deed, survey map if (.REV.08/05) I ' POWTS OWNER'S MANUAL & MANAGEMENI PLAN Page m___ FILE INFORMATION_ SYSTEM NS owner Septic Tank Capacity Septic Tank Manufactuier -4 Effluent Filter Manufacturer 0 NA DESIGN PARAMETERS 11 NA Effluent Filter Model UJ NA Number of Bedroorris )16--NA Pump Tank Capacity I I NA Number of Public Facility Units Pump Tank Manufactur-r IINA Estimated flow(average) pump Mar lufacturer I NA Design flow(peak),(Estimated x1.5) Pump Mociel 1-1 NA Soil Application Raie Standard Influent/Effluent Quality Monthly average* P.retreatment Unit NA Fais,Oil &Grease (FOG) -�30 mg/L FJ,5and/G,avei Filter Ll Peat Filter Biochemical Oxygen Demand (BOD5) !�,220 mg/L. El NA F1 Mecharical Aeration [I Wptland Total Suspended Solids (TSS) :�150 mg/L nDlsinfec tion El Other: Pretreated Effluent Quality Monthly average DIS Mal ;ell(s) LI NA Ground(gravity) El In-Ground(pressurized) Biochemical Oxygen Demand (BODs) ��30 mg/L /�4( Total Suspended Solids (TSS) !�30 mg/L >4�NA F1 At-Grace Ei Mound Fecal coliform(geometric;mean) !A 04 efu/i 00mi El Drip-Line 0 Other: Maximum Effluent Particle Size X in dia. El NA Other: -11..NA Other: Ej NA °vamenhmmm|uxonmoouowam�wo�raxdnu���oxom"mo — �- MAINTENANCE SCHEDULE Service Event Sorvice Frequency Inspect condition oftank(s) At least once every: 0 mOnth"s) (Maximum 3 years) FJ NA Pump out contents of tank(s) When combined sludge and scum equals one-third (�6)of tank volume L1 NA Inspect dispersal c(Al(s) At least once every: -13 — (Maximum 3 years) 1-1 NA monthi s) NA Clean effluent filter At least once every: ?V.Lyear(s, ;r—Elmonthis) 1-1 NA Inspect pump, pump controls&alarm At least once every: 0 year(s', ......... Flush laterals and pressure test At least once every: 0 1-1 NA [I monthl s) J NA At least once every: D year(s) -------- NA MAINTENANCE INSTRUCTIONS Inspections of tanks and d�pomm cells shall be made by on �d�Nuo omnymg one of the following licenses or certifications: �asbx Ptumbet;Master Plumber Restricted Sewer; POWTS|nspector; POWTS Maintainer; SeptageServiing Operator. Tank inspections Must include a visual intipection of the tank(s)to identify any missing or broken hardware, identify any crlicks or leaks, measure the volume of � combined sludge and scum and to check for any book up or puocHnQ of effluent or the ground mirfane. The dispersal mel|(s) shall be � visually inspected to check the effluent levels in the observation pipes and to ohox}:for any pnndivg of effluent on the ground surface. � The 'ponding on the ground oudano may indicate a failing condition and requires ihv immediate notification of the local regulatory authority. � When the combined accumulation of sludge and scum in any tank equals one-third or more of tl ie tank volume,the entire contents of � � the 1unh shall be removed by u 8eptogm Servicing Operator and disposed of in mocmrdanc* with chapter NR 113. VVimuunain � Administrative Code. � � All other services, including but not limited to the servicing ofeffluent filters, rnechar ical or pressurized components, pretreatment units, � and any servicing at intervals of-,A 2 months,shall be performed by a certified POWT S Maintainer. A service report shall bm provided 1n the local regulatory authority within 10 days of completion ofan,'service event. Page of_ START UP AND OPERATION For new construction, prior to use of the POWi S check treatment tank(s) for the presence of painting products or other chemicals that may impede ede the treatment process and/or darrage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s)removed by a se tag e servicing operatorr n' or 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 cell(s)and ma result in the backup or surface discharge of effluent. the discharged to the dispersal cell(s)in one large dose, overloading y To avoid this situation have the contents of the pump tank removed by a Septage Servicing O aerator prior to restoring power to the t• operating n the pump controls to restore normal levels effluent pump or contact a Plumber or POWTS Maintainer to assist in manually p g F P within the um tank. P P 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; condoins; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump purnp) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scrap:; 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 chapOr Comm 83,33,Wisconsin Administrative Code: * All piping to tanks and pits shall be disconnected and the abandoned pipe openings Seale-:t• A 'The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. After all tanks and its shall be excavated and removed or their covers removed and the void space filled with soil, Aft r p gravel or another inert solid material. CONTINGENCY PLAN It the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be projected from disturbance and compaction and should not be infringed upon by required s and wells. Failure to protect the replacement area will result in the need existing and proposed structure,lot line n p setbacks from ex g 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. Barring advances in POWTS technology a setback and/or soil limitations. g A suitable replacement area is not au.�ilable due to et p holding tank may be installed as a last resort to replace the failed POWTS, eva evaluated to identify a suitable replacement area, Upon failure of the POWTS a soil and site evaluation CI The site has not been I y p be installed as 's available a holding tank may must be performed to locate a suitable replacement area. If no replacement area i av 9 y a last resort to replace the failed POW'FS. Cl Mound and st-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 ANDlOF: INSUFFlCIEFIT OXYGEN. DO NOT ENTER A SEPTIC,PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. W-ATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK FRAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS ------------ ---- POINTS INSTALLER POINTS MAINTAINER Name fY u/►� / �� M Name Phone J� ` ., Phone S'r - 46 SEPTAGE SERVICING OPERATOR P PER LOCAL REGULATORY AU�'HORITY / � . Name Name 1 f� T•_��J!?��( Phone — - --------- Phone This document was drafted in compliance with chapter;;PS 383.22(2)(b)(1)(d)&(t)and 383.54(1),(2)&(3),Wisconsin Administrative Code. FILTER CARTRIDGE INSTRUCTIONS srrlf5w, I ney"t the Whil,C-01fiv Argo th"tmd(it the(j[ltl*t 0joe to ,,Sur"it i, tviAel-cod silldar the acc,"W4 ovalling. If svot,th"to Witirer insert 41ji3y"k)tol§440 tho tank kil►'umph the outhit or"itist whM(Vie t)iliddibuilia Igilig oylti,tile ullf.1"t pipti. SVLop a Wh"ic time ca"Is 19till dry 11ttlad Qtl the audet#,hit"inuatary tivw jojvqtf. of 4-l►di,pipe vinvided to toract.,the 111tur to the tan*gold WWl it Utftijjtlq tilp up"i"oul vul"Ploolls"tal N"'"suppxwt-If Wda"UPPurt#vVistilud W tout istliked, prorsed to stela rater !rYWO- 1 For kviotallsUolti;titijilaltill thq,Uptk"l SUpi3laftlatitw)side wilaixot- s#AutmA wimfol tine ►4•-iisclo Pl"vilka thtc h1tty caug. If 4de sulloun hiettidd 4i i4of 11462041,Isroesed tu step four. 504y out WOW the Wei case wito the imitimt ojj,n. jt,sIsrk tfol,filter c;so-trJdVv iot*j the r@Sly, 11FOUSIN davin OWN the fikee laekt;ikittw tile biottt*tv, 01t,time- lf,d VRS swih+ is UtWAY& irrtcert it'stu 000 Ali-filid flick Isy Wrotioltj rl c"Wifie I 111t0t slultild be Nobnod livery tiowto rive tw0c i;d"I(bi 2- Give"thd Outiol"gccu""Pe"49 to l"r-PaUt the tank-aod filtrt, Polhill t6ft W"Pt►c tellik auftstill4vty,fromkitioslAvo to ruttitillis tflo dolid-jo lbvwk-tm the hatscovo of time turtle amd Visit Pilot"to livaim atid eMkItirit. vb a. Duce 61%,offlumill;Its-rk has Wan lowered Who"tilt:invert Wif tiro Dkit6t pipe,HMVIV PUN UP Oh the filter handle to olegodgil the t6 S. Aide the rario-WW up;end dill:of tile am&f4w 0hounilig. G. le it V1116 siorkah to ortm-Arid to all palort"Is pritsent,tho,smitep, 144luld he rumtPoOtl by t"i"'OnIf-uht"I'duckwisu 9W killd t►e"glod with wiater tinly. i. Whife hwdhlti the carlyidub m7 fts side(large flut rutf4m& dawo)over this"u"N opbribq),vilme uN tile ubtrWile With Wjvt_rjf vollyl roakikoyj Mur"all N*Ptooli.lumtW411 is r1iftsed bath Intri tile barak- 8. if mi;sWitch Is utili"ll,felimin,by 11*11040 Wtv""tor mul turvoij,q abdomsm Sol. 9, lissatt itow Nor cartridge bark kite the ckw,Pre"Aig dtsw"-malf Ole filter WAr,inku ftso hatt"Nvi lit Wit vaoia. 10,118jolace WW secure the An teas%WNW110 ut,the tank- WWW.b&8mmi*-it0.4r.01M 871-MMMILS(653-45834 12 �� ... IIIIIilllllllllllllllllllllllll 8223017 Tx:4182640 State Bar of Wisconsin Form 1-2003 994613 WARRANTYDEED BETH PABST REGISTER OF DEEDS Document Number Document Name ST. CROIX CO., WI 04/09/2014 4:11 PM EXEMPT#: N/A i THIS DEED,made between B&L Land Development,Inc.,a Wisconsin REC FEE' 30.00 Corporation TRANS FEE: 179.70 ("Grantor,"whether one or more), PAGES' 1 and Oevering Homes.LLC,a Wisconsin limited liability company ("Grantee,"whether one or more). Grantor,for a valuable consideration,conveys to Grantee the following described real Recording Area estate,together with the rents,profits,fixtures and other appurtenant interests,in St.Croix County,State of Wisconsin("Property')(if more space is Name and Return Address I needed,please attach addendum): River Valley Abstract&Title 1200 Hosford St. Suite 201 Hudson WI 54016 Lo 5lat of Sunset View Development in the Town of Troy, File: 400389 St.Croix County,Wisconsin. 040-1306-05-000 Parcel Identification Number(PIN) Dated: April �—,2014 This is not homestead ptopoly. (is)(is not) Grantor warrants that the title to the Property is good,indefeasible in fee simple and free and clear of encumbrances except: Easements,restrictions and rights-of-way of record,if any. B&L Land Development,Inc.,a Wisconsin Corporation (SEAL) (SEAL) LL"f T.We therh t President/Treasurer I (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) ) STATE OF KENTUCKY authenticated on JEFFERSON COUNTY )ss * Personally came before me on-A� ,2014 , TITLE:MEMBER STATE BAR OF WISCONSIN the above-named Lyle T.Weatherholt, President/Treasurer of B&L Land Development,Inc (If not, to me known to be the person(s who executed the foregoing authorized by Wis.Stat. §706.06) instrument and acknowledged he sa e. Y , IiNf fgff THIS INSTRUMENT DRAFTED BY: - "— Fran Iverson T ,•. tax Notary Public,State of Ke tucky J �: 1200 Hosford St. Suite 201 Hudson WI 54016 .d My Commission(is permanent)(expiresr �). (Signatures may be authenticated or acknowledged. Both are not necessary.) , Q. m z NOTE:THIS 15 A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CIEF Y�N Imo. ; WARRANTY DEED C 2003 STATE BAR OF WISCONSIN �`.. �O O;1-Q�O,-6 *Type name below signatures. .t-• . .• , ... . ' ~�•`� St. Croix County 994613 Page 1 of 1 '•,,3 § 5.�`� . f'�ftlfl11111111"� . y Pni Lo Ou . VOL v E-4 VA MEN MEN ----------- IIIIIIIIIIIII '© % W It E 0 6 3: C\j T 0 0 z di 7 H lllplp LOL I [ILI L-11] cc EL m ------------- - r ------------------''- ---------- ------ --------- r ----------- ----------:::: til L-J, -- --------- ----- -- ---------- ------ I I ------------------------ E g ,l a h, a E fn W 6 a W � Ja tl m a q I � _ I I I W I ------- I I '1 I to A 2I2I I I OF N 9 ouniaaa3i,nrn I i a - 11 �� 88 I II as4 .3x,rnMO3oru • ti Property Owner L �N�-U(�M�l�y- Parcel ID# �'�'�/1]J tV Page of Boring# El Boring // ® Pit Ground surface elev. �Z ' S ft. Depth to limiting factor'? b In. Horizon Depth Dominant Color Redox Description Texture Structure Consisten Soil Application Rate ce Boundary Roots GPD/f 2 In. Munsell Qu.Sz. Cont.Color Gr.Sz. Sh. •Eff#1 •Eft#2 I D-Z Z 2 3 lZ — S I Z h�S brb l►-i`�lr CI�U Z`� �S .f3 3 W1 (Z VA S � s9 ►� r - � �- Z �� ❑ Boring# ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil 1pplication 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 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 =BOD5>30<220 mg/L and TSS>30<150 mg/L •Effluent#2=BOD5<30 mg/L and TSS<30 mg/L The Department of Conunerce 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. I SBD-8330(R.6/00) Wisconsin Uepartment5 ,nla�Wicr SOIL EVALUATION REPORT Division of Safety and E�VED Page ` of in accordan with Comm 85,Wis. Adm. Code Attach complete site paper t s County S` C �}p 8 1/2 x 11 inches in size.Plan must �—u) include,but not limitarfd t(t5ri ont I refer ce point(BM),direction and Percent slope,scale s, north arr�;\and I tion and distance to nearest road. Parcel I.D.ROIX CO U( f9H/4 t%On. R dewed by Date Personal information y be used for secondary purposes(Privacy Law,s.15.04(1)(m)). Property Owner Property Location 1/4 n�1/4- S �S • T 7 N R %� E(o()W Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# City State Zip Code Phone Number ❑City ❑Village Town Nearest Road New Construction Use:® Residential/Number of bedrooms -4 Code derived design flow rate L! S — �j 00 GPD ❑Replacement ❑ Public or commercial-Describe: Parent material G LAC) 14 L Q�11�V1 i� } Flood Plain elevation if applicable 1`1 General comments ft and recommendations: rwt D� CET7� a Boring# ❑ Boring ® pit Ground surface elev. � b Lft. Depth to limiting factor 7 �� in. SOD Scil Application at Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Rcots GPD/ftz in. Munsell Qu. Sz. Cont.Color Gr.Sz.Sh. c� 'E;fR1 11 'Elf#2 O S I - • -� �, Z a Boring# ❑ Boring ® pit Ground surface elev. �UZ`� ft. Depth to limiting factor 10 S in. Soil Application Rate j Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. fZ �Z _ 'Elf#1 'Eff#2 3 Z 1�-3�31.C�`t23L6 — si Zvnsb� h2`Ft- eS -- •S � `� .�, M-kos 10,1 2 416 — S QS Effluent#1 =BODs>30<220 mg/L and TSS>30<150 mg/L 'Effluent#2=BOD,<30 mg/L and TSS<30 mg/L CST Name(Please Print) Sign re CST Number Arthur L 'Wegerer L O 3 Z Is S 220254 Address W e g e r e r S O i l Testing & Design Service Date Evaluation Conducted Telephone Number 421 i1. Main St . River Falls , I]I 54022 \ZZ- 2 2.—U3 715-425-0165 ` -Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Ccmm 85,Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Flan must County include,but not 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 I.D. �= ` Please print all information. Reviewed O�� � 'Date Personal information you provide may be used for secondary purposes(Pr'vacy Law,s.15.04(1)(m)). Property Owner Property Location 1� � � ��V�0�:✓,! i;'�.J` S1� 1/4��1!4• S �• T ?J N R �•. �- Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# E(cr)W o. fox 3 3 S ISU v�s State Zip Code Phone Number � V 1�� --`— []City ❑Village Town Nearest Road New Construction Use:IS Residential/Number of bedrooms - Code derived design flow rate U S - UO GPD []Replacement ❑ Public or commercial-Describe: Parent material G Lv�e) };:L t�� } Flood Plain elevation if applicable J`1 General comments ft, and recommendations: w t !n,)P1 L �o`Tnlwt c 10 a ��/ti .Sy" ► ,� v R U�ti} C�'fi',l gGq_s Pry- Boring# ❑ Boring ® pit Ground surface elev. 1 Cj Depth to limiting factor in. Horizon Depth Dominant Color Redox Description I Texture I Structure Consistence Boundary Rccts Sc'I �P�/ftZn Rate in. Munsell Qu. Sz. Cont.Color Gr.Sz.Sh. =-T-"#I 'Eff2 Z \z _yZ l��►z3�6 — I s� � � ?� sD� l m��- c� - . S ,� 3 LIZ-��b !0`22 X116 — S O Sg I Boring# ❑ Boring ® pit Ground surface elev. I U n, Depth to limiting factor )0 S in. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Scil Application Rate in. Munsell r1 GPD/ftz Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 •Effn2 Z�sHt�_ `Fy cw Z�' • s Z 1�=38 tc��t23L6 o s -- i Effluent#1 =SODs>30.<220 mg/L and TSS>30<150 mg/L •Effluent#2=SOD <30 m Name(Please Print) - s_ 9/L and TSS<30 mgil CST Na .. -Arthur L. �Wegerer Sign re 03 �'S ` S CST Number Address Wegerer Soil Testing & Design Service 220254 Date Evaluation Conducted Telephone Number 421 N. Main St. River -r'alls , tJI 54022 \-Z-ZZ-Cl3 715-425-0165 Property Owner �, �— Parcel ID# 1��1'L/��]) V [j Page � ' of � Boring# ❑ Boring / ® Pit Ground surface elev, L S ft. Depth to limiting factor 7 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 o-zZ 10-I rz-3 /z _ s'lI zknasb - m � ew z .S .8 Z Z?--Q IU-M- 3A S1 3 Z,Y>7 Sbl2 Mf4- 3 5"C) F] Boring# ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor In. Soil 1pplication 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 F-1 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 Effluent#1 =BOD5>30<220 mg/L and TSS>30<150 mg/L 'Effluent#2=BOD6<30 mg/L and TSS<30 mg/L 111 Department of Conunerce 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. SDD-8730(R.6/00) PLOT PLA.d Page oz /Scale 1 ' = '-�0 ' S� �v i C'1 i Jr';7 Y✓l�-� ` jk- 3Y/� 1 1 r ti \ lL)T S � �f�-J_^�� 10�Q r-OI�1 6KQUN✓� Su�Z�cC:_�'T_�-07"'_�112iC7L�{2-�_- PrT_ (:)UT.LUT_/P�y;�v„'�/\�Z _.-- a9L - �Z-ZZ._03 715-425-0165 220254 CST Signature Date Telephone No. CST No . Job NO.