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040-1314-03-010
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 569588 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: Mulhollam, Chad & Paula I Troy, Town of 040-1314-03-010 CST BM Elev: Insp.BM Elev: BM Description: ,�y� Section/Town/Range/Map No: 5, 8 / ' Z Grj 33.28.19.2053A TANK INFORMATION ELEVATION DATA OQ TYPE MANUFACTURER , y� CAPACITY STATION BS HI FS ELEV. Septic 1 /Zoo Benchmark ` a(c /AO''7(v, �,ffj.lit� J Dosing (o Alt. B e�bo goo 0 .S 9� �3 Aeration Bldg. Sewer Holding y St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent t it Intake ROAD Dt Inlet Septic y C / ) Z 1 Dt Bottom `,/ 5 Dosing J / / / / Header/Man. �'`1 Aeration Dist. Pipe 2' A4 5, 7$ s Holding Bot. System 3. 1 PUMP/SIPHON INFORMATION Final Grade / 4 1.4, 1�7 $ Manufacturer j emand St Cover 44.512 D U S GPM u Model Number ' , 3 7 TDH Lift Friction Loss System Head DH Ft 7 Z.Ito /. /,5 4. 55 T 1-7,%G Forcemain Length i Dia. 4 If Dist.to Well /0b / SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No.O renc PIT DIMENSIONS No.Of Pits Inside Dia. r Depth DIMENSIONS /6 &� SETBACK SYSTEM TO �!J P/L IBLDG IWELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Types t1 / CHAMBER OR �I /,,Q_ UNIT Model Number. �-- DISTRIBUTION SYSTEM t ,vry Header/Manifold I Ii d I Ix Hole Size Ix Hole Spacing ( Ven Air Intake 7 Pipes) r L —2 )_ Length "Tia �+ Length Dia T'S Spacing �� �'547, 3• � SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of 1xx Seeded/Sodded jxx Mulc ed Bed/Trench Center / ( Bed/Trench Edges ` Topsoil Yes 0 No Yes L No IpJ \ COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / /4 10 Inspection#2: Location: 19 Serenity Co Riverffixalls, 54022(SE 1/4 SW 1/4 33 T28N R19W) Serenity eadows Lot 5 Parcel No: 33.28.19.2053A 1.)Alt BM Description / ' 2.)Bldg sewer length= b �� -amount of cover= T a tn.- Plan revision Required? 1 I, , �- -- — — - - -- -- - I J 4175 q ❑ Yes No 1 ,O i Use other side for additional informs ion. Date Insepctor's Sig lure Cert.No. SBD-6710(R.3/97) Y; _ Plot Plan Page S of 6 Property Owner GHAD-r. P,4ULA B. Legal Description, c :Et �.s�r, a� (except where noted) -Mx yg OF Tti E 5W!/�. s33�. T.Zg ri, i:kl,?W. "fib uJ.%j or =Backhoe pit North 4 opt 'u M A- ID 56) a-rfaK�� 3y pWNEl4 ���' Li Rv R 'PRoPos vJ `L �©n�..7��K 5Z5 r Site cation' >so� r r�al+^ �P,,Iur U> � � County Safety and Buildings Division p` �RE�EIV ED 201 W.Washington a Ave. , P.O. Box 7162 Sanitary Permit umber(to be filled in by Co.) it ermit Application State Transaction Number In accordance with jobta ' 1�4t� is required prior to t NI�,�i mission of this form to the appropriate governmental unit � t. Note:Application forms for state-owned POWTS are submitted to Project Address(if different than mailing address)the Department of d professional Servies. Personal information you provide may be used for secondary f0 u oses in accordance with the--vE Law,s. 15.04 I (m),Stats. ,/ (1 i I. A lication Information—Please Print All Information S elrCB" Property)Owner's Name n c�.T f ' Parcel# a Property Owner's Mailing Address 03 _ D r f Property Location 2 re h J 2d 5J City,State Zip ode Govt.Lot �J p Phone Number 5 ''1•, .i 4) %,, Section 3_ (J q 4 D d (circle one II.Type of Building(check all that apply) Lot T a8 N; R 1 9 E or(V� El or 2 Family Dwelling—Number of Bedrooms Subdivision Name ©k oA ry� ❑Public/Commercial—Describe Use Block#a. Y e—h AD L&Sdjf—i 6 ❑City of ❑State Owned—Describe Use CSM Number ❑Village of �D Mov _ Z a Town of�r©/C III.Type of Permit: (Check only one box on line A. Complete line B if applicable A. ) IN New System ❑Replacement System ❑Treatment/Holding Tank Replacement Only ------III Y ❑Other Modification to Existing System(explain) B. ❑Permit Renewal ❑Permit Revision ❑Change of Plumber ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV.T e of POWTS S stem/Corn onent/Device: Check all that apply) D at/ Q ❑Non-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grade A Mound>24 in.of suitable soil ❑Mound<24 in.of suitable soil ❑Holding Tank ❑ her Dispersal Component(explain) ❑ ) CJ V.Dis ersal/Treat ent Area Information: Pretreatment Device(explain Design Flow(gpd) Design Soil Application Rate(gpds) Dispersal Area Re © j f 9 uir A. Dispersal Area Propos (li System Eleva on VI.Tank Info Capacity in Total If of G Manufacturer Gallons Gallons Units d New Tanks Existing Tanks n c� U /f/ J O Septic atsidaddijol Tank D O !� 5 Z X U iii r w C7 L1. Dosing Chamber VII.Responsibility Statement- I,the undersigned,assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name(Print) Plumber's Signature MP/1vI13RS Number Business one Number a ss �� D Plum er's Address(Stree t,City,State,Z�Cod ) 49z t75�� W F.0- ' 0 1�r 1,��-, S VIII. oun /De artment Use Only t vc� 6 Z Approved tsap Penn it Fee Date Is tied Issuing t Signature ❑O teason for De al $ IX.Cond�l�� Reasons_for Disapproval r:` tapti4 NMI efouient filter 3 LOrj,a,p,�,5 r`.L QrG G 4! dispersal celi.must all be services/tnaintairuad , / G� r.J as per management plan provided by plum6er. I : shit'�I ,rlSqutrerletNs<mt�st,lk.frf�t�atried �P��Cody/O/dlfltitlCli.' Attach to complete plans for the system and submit to Inc County only on paper not less than a 1/2 x I inches in size SBD-6398(R. 11/11) 4AR711pNro DIVISION OF INDUSTRY SERVICES U0 ,i P 1 3824 N CREEKSIDE LA HOLMEN WI 54636 P (• Contact Through Relay www.dsps.wi.gov/sb/ www.wisconsin.gov roN AyS� 1 leD Scott Walker,Governor v Dave Ross,Secretary April 14,2014 CUST ID No. 224832 T CRO�X CO�OPM� ' DEVF ATTIC'POWTS Inspector MARY JO HUPPERT ZONING OFFICE HOLLISTERS SOIL TESTING&DESIGN ST CROIX COUNTY SPIA W9875 690TH AVE 1101 CARMICHAEL RD RIVER FALLS WI 54022-4011 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/14/2016 SITE: Identification Numbers Chad T&Paula B Mulhollam Transaction ID No.2387067 19 Serenity Ct Site ID No. 800934 Town of Troy Please refer to both identification numbers, St Croix County above,in all correspondence with the agency, S1/2, SWIA, S33,T28N,R19W FOR: Description: Four Bedroom Mound System/4%slope Object Type:POWTS Component Manual Regulated Object ID No.: 1478173 Maintenance required; 600 GPD Flow rate; 30 in Soil minimum depth to limiting factor from original grade System(s):Mound Component Manual-Ver.2.0, SBD-10691-P(N.01 101,R. 10/12),Pressure Distribution Component Manual-Ver.2.0, SBD-10706-P(N.01101,R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s)referenced above. C01V The owner, as defined in chapter 101.01(10),Wisconsin Statutes, is responsible for compliance with all code A requirements. � �EPr No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145. L�RrAD�E$S stats. "�i� The following conditions shall be met during construction or installation and prior to occupancy or use: "mi �N Reminders: • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19,Wis. Stats. • Inspection of the private sewage system installation is required.Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d),Wis.Stats. • A state approved effluent filter is required.Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required.Access to the filter for cleaning must be provided per SPS 384 product approval conditions. • The area within 15'downslope of the dispersal component shall remain undisturbed. Vehicular traffic, excavation or soil compaction is prohibited in this area. • A copy of the approved plans,specifications and this letter shall be on site during construction and open to inspection by authorized representatives of the Department which may include local inspectors. MARY JO HUPPERT Page 2 4/14/2014 Owner Responsibilities: • The current owner,and each subsequent owner,shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s.SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard,the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance.As per state stats 101.12(2),-nothing in this review shall relieve the designer of the responsibility for designing a safe building,structure,or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below,or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation,operation or maintenance of the POWTS. Sincerely, FRequired$ 250.00 Will Be Invoiced. yard M Swim eceive That Invoice, e a Copy With Your POWTS Plan Reviewer,Integrated Services Submittal. (608)789-7892,Mon-Fri, 7:15 am-4:00 pm W Payment ment S code: j erry.swim @wisconsin.gov cc: Edwin A Taylor,Wastewater Specialist,(715)634-3484,Monday-Friday 8:00 am To 4:30 pm Note: Effective January 1,2012,all codes under the jurisdiction of the Division of Industry Services(formerly Safety&Buildings)will be modified. Code references with prefixes starting with"Comm"have been replaced with " "SPS"to recognize the relocation of the Division of Industry Services from the former Department of Commerce to k t."tid' the Department of Safety&Professional Services.Additionally,all IS(formerly S&B)codes have been renumbers 'Addressed in a"300" series. For future reference,the Wisconsin Commercial Building Code will be addressed 4,tl °� °�" by SPS Chapters 360-366. NED 4 PI? "1 .2 a/it PM3- MOUND AND PRESSURE DISTRIBUTION COMPONENT Residential Application INDEX AND TITLE PAGE Project Name: CHAD T. & PAULA B. MULHOLLAM Owner's Name: (same) Owner's Address: 317 W. Pine Street River Falls, WI 54022 Legal Description-. SE1/4 of the SWII/4, S 33, T28N, R19W Township: Troy County: St. Croix Subdivision Name: NA Lot Number: 5 Block Number. NA Parcel I.D. Number: 040- 1314-03-010 Plan Transaction No.: ,Se AAf,* Page 1 Index and title N,4� '4L Page 2 Data entry 4V Page 3 Mound drawings Page 4 Lateral and dose tank M Page 5 System maintenance specifications Page 6 Management and contingency plan U PERT ?•- - 4 i i Page 7 Pump curve and specifications D 1859 0 Page 8 Plot plan PALLS,*! Signer: Mary J Ruppert.1 1 License Number: 1859-007 We: 03/28/14-- Phone Number: 715-426- 1775 i§qature: Designed Pursuant to the Wound Component manual for PowTs version 2.0 SM-10691-P(N.01/01),and both S �MP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS(01181)and Pressure Distribution Component Manual Ver.2.0 SBD-10706-P(N.01/0 Versio 0 03/2012) Page 1 of 8 is Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) f R Residential or Commercial Design Note: Sand fill(D)calculations assume a 400.0_0 Estimated Wastewater Flow(gpd) Table 383-44-3 in-situ soil treatment for 1.50 Peaking Factor(e.g. 1.5= 150%) fecal coliform of<=36 inches. 600.00 Design Flow(gpd) 4.00 Site Slope(%) 97.00 Contour Line Elevation (ft) 30.00 Depth to Limiting Factor(in) 0.60 In-situ Soil Application Rate(gpd/ft2) Distribution Cell Information 60.00 Dispersal Cell Length Along Contour(ft) = f 10.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) I 1 Influent Wastewater Quality(1 or 2) Are the laterals the highest oint s in the distribution Y Pressure Disribution Information networks Enter Y or N (C or E) a Center or End Manifold 3.33 Lateral Spacing (ft) If N above, enter the elevation ft 3 Number of Laterals of the highest point. 0.156 Orifice Diameter(in) 3.50 Estimated Orifice Spacing (ft) = 11.76 ft2/orifice 2.00 Forcemain Diameter(in) 128.00 Forcemain Length (ft) Does the forcemain drain back? E-� 86.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft)x 1.3 20.88 Forcemain Drainback(gal) 11.09 Vertical Lift(ft) 55.97 5x Void Volume(gal) 2.11 Friction Loss(ft) 76.85 Minimum Dose Volume(gal) 0.00 In-line Filter Loss (ft) 27.46 System Demand (gpm) 17.75 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x x 1.00 1.50 x 1.25 x x .00 1.50 x L::!3.00 2.00 x 3.00 x Gallons/Inch Calculator(optional) Treatment Tank Information Total Tank Capacity(gal) 1200.00 Se tic Tank Capacity(gal) Total Working Liquid Depth (in) Wieser Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800 00 Dose Tank Capacity(gal) PolyLok Filter Manufacturer 22.24 Dose Tank Volume(gal/in) 525 _ ]Filter Model Number a Weiser --=manufacturer Project: CHAD T. & PAULA B. MULHOLLAM Page 2 of 8 Mound Plan and Cross Section Views . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1/10 B : :': :': : : : : . . . . . . . . . . . . ::::::.:.; . . . J Observation Pipe : ;�•:•;•: K. .�d1d•.d•d•d 2.d.v•l.d.d.d.d.d..••.d.d.r..••.d. . . . . . . . . . . : . . . . :'.',':' �.1 •L•Lrti.4.L....L. .L.L.L.t. L�'lr•`i1'.:1•dLr1�%4j1:'td•':•r•r•�'•d..••.r.,'.t�d'.d. l..'..••d T d.l.d,d.d.d..d d. d.d:S•L.L.......... • L•L•L•L•�L L L 4 L L•L•L.L•ti•Ld d•:d J d J d d•J�d•d•d•dt.•'o•L••.• ti•L L L d•d•d•d• d•J•d 1•r••.d d• 5 4•L.4•'•4•L•L•L 4 ti S L L•4•L 4 Ld1 L:•d•d r A L•L.L•L•L• 'L•L•L 1 4 L:•,,L:L L:1: d•d•d.d:d•:•d•:•°•d•'r•d:d•d•d•d•.••d• L.L.L. A ' 1�S�1,dSr1d1d�d•d,d.f•d.d.d.d..`.d./'.d.d:d:.�1~�:L•L••°•L•S'`..L:L.L.•..L.L.4.L.L.L. �yf e:d.d.d W L••.`L.`,..,`L•4`L•4•L•4•L,•..L.,L:L?L:tili::•%•3?4:ti:5:'ti:°d.d.d.d.d.d.J.d•dti��r:.• . L`4•L.L`•,•L.L`L.L•. L. !' B . . . . . .'. . . . . . . . . . . . L Mound Component Dimensions A 10.00 ft E 10.80 in H 1.00 ft K ft B 60.00 ft F 9.25 in z 7.40 ft L EAft ft D 6.00 in G 0.50 ft J 4.74 ft W 600.00 (ft) Dispersal Cell Area 1 1044.03 (ft) Basal Area Available 10.00 (gpd/ft) Linear Loading Rate 6.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 99.27 (ft) -----► 97.50 (ft)—*I— Dispersal Cell 98.00 (ft) Lateral Dispersal Cell ::::::: .::.':':': :•: .•: :•.'.•. ::::::::' Invert .. Elevation 4 4 i 4.0 % Site Slope 97.00 (ft)Contour Elevation Geotextile Fabric Cover Shading Key m �' T Dispersal Cell See lateral details on Q_ Topsoil Cap °• 1.5 ft r.d.d d.:.d.:d. d•d`: Page 4 for number,size, O L4L1 L4Ld'rLfLd1L4 Subsoil Cap _C T•d•d•d`.`•d•d`d•d•d•d•d d d.•' m o L. L Lrcr;f;r and spacing of laterals. L•Lr.. © ASTM C33 Sand T ;:r�fti•L•L•L• LjLfL•4.4.4 ti L:4 f Laterals are equally ® Tilled Layer d 0. ft rLd,T d:fL.Ld F spaced from the © Typical Lateral r•d.d•f P r• d � •r'r':'r'r'"':'r r•d•r• distribution cells L•L�'.Ni. Aggregate �l:d'�f�J~J°•fi�1':•�•�`••'j•:,•:,d,if�`• f d`d.:• 4•L•5� O 4•L•'.•LftifL•L•°.`L L•4••.. d•d•d centerline in the l•d•d• d•d•:•d•d•d•l• d• -----A ---} distribution cell(AxB). Project: CHAD T. & PAULA B. MULHOLLAM Page 3 of 8 l l � I '.t End Connection Lateral Layout Diagram Centel thrtatfral over tM A 6B 4imsarrbdr •.ruedt.upvebaar,..q o,old AnCa LP1u,p e P A;1ltateraasate:deent;a,. IE-x—il tiofas�ilradcnthaeoetea►eithc6sterate e4waMgxpaaea S LaRerals 8i'orcemsira Sch 40 PVC pew SPS Toble 384 30-6 s Forge grain atanneaeion via tee or cross to momk)44 at any poinc umber of Laterals 3 Orifice Diameter 0.156 in teral Diameter 1.25 in Orifice Spacing (X) 3.66 ft teral Length (P) 58.56 ft Orifices per Lateral 17 teral Spacing (S) 3.33 ft Orifice Density 11.76 ft/orifice ateral Flow Rate 9.15 gpm Manifold Length 6.67 ft ystem Flow Rate 27.46 gpm Manifold Diameter 1.25 in otal Dynamic Head 17.75 ft Forcemain Velocity 2.80 ft/sec Dose Tank Information Locking cover with warning label and locking device and Electrical as per NEC 300 and r----► sealed watertight SPS 316.300 WAC 4 in.min. Disconnect ank component is property vented F--- Alternate outlet location Forcemain diameter eiser Manufacturer 2 in Ca c' 800.00 Gallons T Volume 22.24 gal/inch A Weep hole or anti- irnension Inches Gallons B siphon device A 19.62 436.26 B 2.00 44.48 C C , P� ump off elevation(ft) 3.46 76.85 86.91 10.90 242.42 Total 35.97 800.00 D �__Dose tank elevation(ft) 3'Bedding un er tank. 86.00 Wrm Manuafacturer SJE Rhombus Note: Switches I rm Model Number Tank Alert AB containing mercury ump Manufacturer Gould may not be used in ump Model Number PE 41 - - this system. ump Must Deliver 27.46 gpm at 17.75 ft TDH Proj -HAD T. & PAULA B. MULHOLLAM Pa e 4 of 8 9 Mound System Maintenance and Operation Specifications Service Provider's Name Darrell's Septic Service � Phone 715 425-1025 POWTS Regulator's Name St. Croix Coun Zoning Phone 715 386-4680 i System Flow and Load Parameters Design Flow-Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow-Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 f:2 Maximum FOG 30 mg/L Type of Wastewaterl Domestic I Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for onding_and seepage once every 3 years Other _ Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis.Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis.Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished ............... . . . . . . . . . . . . . . Grade �>1 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: CHAD T. & PAULA B. MULHOLLAM Page 5 of 8 Mound System Management Plan Pursuant to SPS 383.54,Wis.Adm.Code General This system shall be operated in accordance with SPS 382-84 Wis.Adm.Code,and shall maintained in accordance with its'component manuals ISBD-10691-P(N.01/01),SSWMP Publication 9.6(01/81),and Pressure Distribution Component Manual Ver.2.0 SBD-10706-P(N. 01/01)1 and local or state rules oertaininq to system maintenance and maintenance reoortina. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383.33,Wis.Adm.Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers,access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound,defective,or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified 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 fitter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm,the fitter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment,maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However,if such products are used they snag oe approvea for septic tanK use oy the uepartment of t;ommerce. Pump Tank The pump(dosing)tank shall be inspected at least once every 3 years. All switches,alarms,and pumps shall be tested to verify proper operation. if an efnueni niter is insiaiied wiiifin iire iank ii Shaii be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter,and the mound shall be 5eeied and,i-e-wi had,'as iiacassaiy to Prevent erosion and to Nroviuo 50� i�8 Ni0tcGtivi�fi0�i�fr35t Nanetrativn. Traffic(other than for vegetative maintenance)on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations(October-February)dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODS, 160 mg/L TSS,and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5,30 mg/L TSS,10 mg/L FOG,and 10"cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral,and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner,and any levels above 6 inches considered as an impending hydraulic failure requiring additional,more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank,pump,pump controls,alarm or related wiring becomes defective the defective component(s)shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface,it will be repaired or replaced in its'present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media,and related piping,and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: C HAD, T 4 a&A g, 114V Lf/0 LLAA Page 6 of 8 a ' .L(qjMOULDS PUMPS Submersible Effluent Pump PE Pump—Generlll: IN Corrosion reshar}t • Disdlarge:l% AST Pme aoroucdon. • remperature:I off Ora • 60 Hnttz ■Cast kw bait'. meoanwrn,oo ftM whm. • 115 and 230 volts ■Thermoplastic impeier and fully 260"0. • st soft ha 'Am �wi ao adc ree ■Up*dmw and lower matdrm rn sphere. • crass B insulation. M"duly ball bearing • Autonladc modek hlchlde a 'MAW design. corlstilkb" APl�ICAlIONS float switdt. ' High sttd}carbon steel ■Motor is perrnanw* Specially(WW*u l : for die a. PW*rap: PE31 Motor. 1ur,erAer,ded •tiMoww System perbManm chart or curve. • 3314p,3000 RPM ■Powered for contirluous • Eifluenb4bosing Systems PE31 ftw • 115 volts • low Pneswrn Ripe Systems • Ma>dlrxall=S3 GPM • Shaded polo design in=ale addtirr dw • Basement Draining • Maxhrxlm TDH PE41 Motor; no of the mote► ' HaN Dmy sump/ M41 Pump: • .4014P.3400 RPM M�tdc per Devnate* • Mal nUM tap *..61 GPM • 115 and 230 vah coK 20'standard kn^ • Maximum head:29'TDH • PSC design heavy duty 163 SIiW wNh PE51 Pump; POI Motor: 115 or230 vokgvovnding Ift •AAmdmtnn capadhl;70 GPM • .50 HP,3400 RPM A unk k heavy duly, • Ma dinurn head-37'TDH • 115 and 230 vobs -' Portable and compact. METERS FEK • PSC design ■Me ft"seal Is carbon, BUMAandshigas .� AA00"PBL p"1,Plat Steel. -1 1 35 rr sA.Ao•.W r Stainless stall fasterlem 10 AL z GPM AGEMUSFOM 1 ' i FT CSO us N' ..,.. ���778atd It 1g -' ayi'anadthshwtM�Aoe�itlen -r _ .tom• ; --1:.�"}' _' .'�- �- •_. ..� o � Y -44 0 o to 20 4—o5 " Gc 40 70 GPM 00 o 5 10 t 5 mjih • N j • Plot Plan Page 8 of-8 Property Owner eWlAI)-: P,4ujA E. M u L 1-tt�wpm 1» =40,f� Legal Description c0-.s��.;Zl. OF (except where note 'y at= 71M-54/4, .s31,,, Tig,J KI-q W. -M WAJ or =Backhoe pit �V�_ ST. C/�DI��uN'�'Y; W�s,�S��• J,d0�IC�2b� North PLP, IV g to v 1 �M�� ®-----...r► �s 4'k pill �. Q° AG erbo' L1 OPose-t� W ' t2oM Site cation. so, F R oM piarf�c c 39 1ti Apr 14 14 02: 45p Hollister 's Soil Testing 715-426- 1775 p. 2 Apr-14.2014 10:50 AM St. Croix County Plan/Zoning 715-386-4686 2/3 mAs-L ff1111 �111n�I ;rmLffft 6 6 7 2 B-214� 14 Ic:4p04 84 /3 Jry 9ZZ032 BETH PABST CERTIFIED SURVEY MAP IiGG=STER OF DEEDS ST. CROXC CO.. W= LOCATED IN PART OF THE NW 1/4 Or THE SW 1/4. PART OF THE SE 1/4 RECE=VED FOR RECORD OF.�T�HE SW 1/4 AND PART OF THE NEt/4 OF THE SWI/4 OF SECTION 33, 09/03/2010 3:62 PM T26NI R19W, TOWN! OF TROY, ST. CROIX COUNTY. WISCONSIN. BEING LOTS 1 EXEMPT 0; N/A ANb 3 OF THE PLAT OF UNITY MEADOWS. REC FEE; 30.00 PREPARitD FORT SUAVEVOKs PAGES: z AARON CLAY OOUG ZAHLER ZO[SERENITY COURT S & N LAND SURVEYING !OVER PALLS. WI 54022 2820 ENLOL ST. 'MITE 101 54 HUDSON. WI 016 THIS CERTIFIED SURVEY MAP WAS PREPARED PURSUANT TO CHAPTER 236.45(2)(0)3 OF THE WISCONSIN STATUTES AND CHAPTER 13.18.1c,3) OF THE ST. CROIX COUNTY LAND USE ORDINANCE. THIS IS A RE-ARRANGEMENT OF LOT LINES. NO CURVE DATA TABLE (IOVOTHv Aow#v fEIV ADDnIONAL LOTS ARE BEING CREATED. Rodius Len th Central An le Chord Bsarin Chord Len th ; Len th Tan cent In Tan ent Ou 01 67.00 34`17 N Z3 E 152.17 93 p'11 33 W S84'22 S3 W C2 'J17.00 4210'44' W75 -E Z2&13 233.30 SS,P2'33•W Na3'26'23"W 03 197.00 4 -t2'ze- SZ410'2'J-E 136.40 140.51 N4816'3" N00b4'10 1W C4 317.00 0896'."' N39 2W37% 44673 44677 CS 317.00 349547" N79`30'50'E 103.63 106.00 co 00.00 4030'02- N09MV22.WW 66.31 60.37 NI W40'42"E N34'I V27"W C7 80.00 62'14'33" 90109'35.5 0C 70.44 72.83 324137'21'W S^A7971 24C C6 00.00 2096'22' 317"14'31-E 27.91 28.06 S27'17'12`9 807'11'8o"E m P0.1! 0 UAB04 061.98' 10310 E 3207.27--- �1l. ./_ ...- -,509'Jgi mc-.19!!'J.96'.............r.A........ 2049L. 6-m DRA4VAW LEQENO ` EmwAmNT _ Ls nav JJ FOUND ALUMINUM COUNTY �• =0110N CORNER MONUMENT '�., •. `. FOUND 1" OUTSIDE DIAMETER IIR/O�N PIPE LOT 6 '1 • E MNE 931M KdN' PIPES r , 6 '� eBa,lit s,2 Fr c C SET 1-1/4" OUTSIDE DIAMETER BY l O 27s ACRES; 1B' LANG IRON PIPE. WEIGFBNC 1-68 \ •9 A'''- _ PER U R FOOT � 4 IAOIAW �-ZRCKITY OIEI-CONSULT PLAT Or ` I MQA00 rqR w ADDITIONAL INFORMATION �- �EUBlEN07U1S._GL_-_�J �1 �i1 IIB1 PEITTAININO TO DRAINArA ZPVC MAW ell @GdCpW17 SLR Cie A8AIf11,•ELO '1. @7' `I /iMLRN/SE:SHOR11y.._. r. �_ z .=Vq..... �„• 1 \� r S 1 Ne2341 a 402.61' �; 1 �o LOT S (yg� so0i sit rr `I`! S�ooD A1�S Q 1 J6. ,� o�I�IKat✓elvtr+�vAVr r ; I�. +G RSV As ZIM 'y SCALE IN FEET 1' •• 300' I ®T� 1� •.- car J avow tot I �pB9.®48 mss'^ 'V> PER PLAT Ar 300 0 300 I I COKWAMr FILED AS 1 I ova NO. ".YIJ7 tiMIQ ,YQl�I NfftiIT hn�G�l.. aA w..•.- �........ .-- .._ �--- _-- - _ _ �vED J ° P��4F W►~� tis RAG ".' fD �„ !(illIIlllil(IIIIII I I III LER 8 0 0 6 3 7 2 *: S-214s �P� 2 _ Tx:4004964 t s 922032 UR CRO,X�O�NN BETH PABST ,,S REGUR� REGISTER OF DEEDS CERTIFIED SURVEY A ST. CROIX Co., WI LOCATED IN PART OF THE NW 1/4 OF THE SW 1/4. PART OF THE SE 1/4 RECEIVED FOR RECORD OF THE SW 1/4 AND PART OF THE NE1/4 OF THE SW1/4 OF SECTION 33, 09/03/2010 3:52 PM T20N. R19W. TOWN OF TROY, ST. CROIX COUNTY. WISCONSIN. BEING LOTS 1 EXEMPT *: N/A AND 3 OF THE PLAT OF SERENITY MEADOWS. PgREPARED FOR: SURVEYOR: REC FEE: 30.00 AA*ON CLAY DOUG ZAHLER PAGES: 2 RIVER FALLS. VA COURT 54022 2920 ENLOE SST SUITE 101 HUDSON. VA 54016 THIS CERTIFIED SURVEY MAP WAS PREPARED PURSUANT TO CHAPTER 236.45(2)(0)3 OF THE WISCONSIN STATUTES AND CHAPTER 13.1B.3.a.3) OF THE ST. CROIX COUNTY LAND USE CARVE DATA TABLE (LENGTHS ARE/N FEET) ADDITIONAL LOTS ARE BEING CREATED. OF LOT LINES. NO Nd. Radlus Len th Central Angle Chord Bearin Chord Len th Ara Length 7S5422*53'W n Ton ant Out C1; 167.00 54'1100 N27'1 23-E 152.11 157.93 'W S5422'53"W C2 317.00 42'10'44" N7528'15'E 228.13 233.36 C3 167.00 48'12'26• 'W N8326'23'W C4 317.00 524'10'23'E 136.40 140.51 'W NOO'04'10'W 08'05'28' N5825'37 E 44.73 44.77 C5 317.00 34'05'17" N79'30'59'E 185.83 188.60 Chi 80.00 48'58'09" N0948'22.5"W 66.31 l aa.6 "E N34'1 T2TW C7 80.00 52'14'33" S01'09'55.5"E 70.44 72.95 W S27'17*12-E C8 80.00 20'05'22" S17'14'31'E 2791 28.05 E S07'11'S0'E IlDbPl�/Rlll IT ® f�41�ni®� 661.98' --------------- ---589'S0'43'E 5297.27'--- �L E' E37 S89'50'43'E 19857095' A ST 1,14 L/NE 26433' W1/4 CORNER............ : ..........................................h ............ . SECTION 33 �, DRA/NA GE fJt-�� `"ff E111'4 CORNER _ LEGEND EASEMENT \F `SEC770N 33 FOUND ALUMINUM COUNTY SECTION CORNER MONUMENT FOUND 1' OUTSIDE • DIAMETER IRON PIPE � FOUND 2-3/8' OUTSIDE ^, I LOT 6 DIAMETER IRON PIPE 'e 2,66.9,15,- s0. FT. w O SET 1-1/4" OUTSIDE DIAMETER BY \ 61.275 ACRES I�. 18 LONG IRON PIPE. WEIGHING 1.68 ` \ U3,":L PER LINEAR FOOT NOUSLr NOTE:-CONSULT PLAT OF \, LOTA I SERENITY MEADOWS FOR I ADDITIONAL INFORMATION I ®® • MEU PERTAINING TO DRAINAGE / \ --- -----------'- "'--- .,V,)7C TANK EASEMENT. . `\\�,<^ 2 ts`74 "� .� .Ems? '•• . F I BU14DING SETBACK ARNNt74D / \s :(50'UNLESS brHERMISE SHON7V) ?1• �h���yp \\ `�F2� C I m N89'09' - ®1T '21'W §58.92' z ;`�y� .................�.\ 307.04 Fes. g r F k9 # S I W CS N H N8954'19 W 492.61' \ 1 :o LOTS :W � N ���• -- - - o m a c .,j 217,Boo s0._Ft >• p� :o' I m 5.000 ACRES ± 1 Q �?c� LOT 10 11 ,8 `� �,� �! �\`Ste_ M EADOWS DRIVEWA Y COVENANT Ii - --- I ! easy. :of RECORDED AS Doc •y5'' NO. 793136 _ C) E� DR/VEWA Y EASEMENT SCALE IN I �` --272 07._ _ oa'i C �J FOR LOT 3 NOW LOT FEET 1" = 300' it ®QDTf�®T - ----------- OUTL T� ----- I 5) PER PLAT OF 300 1 I (; ------_ CERTIFIED SURVEY MAP LOCATED IN PART OF THE NW 1/4 OF THE SW 1/4, PART OF THE SE 1/4 OF! THE SW 1/4 AND PART OF THE NE1/4 OF THE SW1/4 OF SECTION 33, T2�N. R19W. TOWN OF TROY, ST. CROIX COUNTY, WISCONSIN, BEING LOTS 1 AND 3 OF THE PLAT OF SERENITY MEADOWS. PREPARED FOR: SURVEYOR: A N CLAY DOUG ZAHLER 2I:S:E RE NITY COURT S & N LAND SURVEYING RI FALLS, NA 54022 2920 ENLOE ST. SUITE 101 HUDSON, WI 54016 DRAINAGE EASEMENT LINE TABLE SURVEYOR'S CERTIFICATE: NUMBER DIRECTION DISTANCE E1 N8 59 O 43 W 565.50 I, Douglas J. Zahler, Registered Wisconsin Land Surveyor, E2 NOO'1t 53"E 365.90' E3 NOO'11'53'E 32.14' hereby certify that by the direction of Aaron Clay. I have E4 N8326'23' "W 212.79' surveyed, divided and mapped part of the NW 1/4 of the E5 .505'5700"E 76.19' $W 1/4, part of the SE 1/4 of the SW 1/4 and part of E6 N89-5419"W 11.05' the NE1/4 of the SW1/4 of Section 33, T28N, R19W. Town E7 N0557'00-W 41.76 of Troy. St. Croix County, Wisconsin. described as follows: E8 N8326'23 W 50.23' Lots 1 and 3 of the count y E9 589'5419 E 51 0. rnecorded in Volume 10 of county Page 59. as Document No. E110 NOO'11 53 E 67.708' 793135, in the office of the St. Croix County Register of E12 SOO`11 53"W 47.45 [Deeds. E13 N16'07 59 W 273.63 E14 N1607'59 W 302.62 I also certify that this Certified Survey Mop is a correct E15 N47'19 58 W 275.57 representation to scale of the exterior boundary surveyed E16 N61'15'45'W 322.99' and described; that I hove fully complied with the E17 N13'14'54'W 160.51' provisions of Chapter 236.34 of the Wisconsin statutes and E18 N6722 O3 E 88.69' the land subdivision ordinance of St. Croix County and the E19 N6722 03 E 88.67 Town of Troy in surveying and mapping the same. E20 N57'15'15"W 240.68' E21 N69'32'39 W 158.98' • q/3 O E22 N6623'55'W 189.74' gouglas�J. Zahl e� RL E23 449'09 23 W 368.35' S dt N Land Surveying 2145 Date E24 N57'1515'W 261.90 2920 Enloe St. Suite 101 E25 46-9-32 39"W 155777 Hudson, WI 54016 OE WIS E26 N66'23 55 W 196.90' �,•'•�'•�-c0 E27 N49'09'23'W 306.21 (715) 386-2007 Q f• .�k CO DOUC3LA3 J. �2 E28 S32-25'23 E 150.11' ZAHLER E29 S00'39'41 E 180.15' *• S-2145 * E30 11461'15-4o-w S47.42 56"W 384.03' 1 HUDSON. E31 S80'44 05'W 183.55' '`� WI 'Q E32 50039 41-E 247.16' q�Lp&URVE�lO E33 N47'19'S8 W 235.91' E34 143.41' E37 S89'50 43"E 300.00 E38 S12'00 0WW 273.17 E39 512'00 08 W 278.31 E40 .505'58 29"E 139.00 Each parcel shown on this map is subject to state, county and E42 '517'5243 E 119.53' township laws. rules and regulations (i.e., wetlands, minimum lot E43 S17.52 43"E 129.59' side, access to parcel. etc.) Before purchasing or developing any E44 S28-56 31 E 139.50 parcel contact the St. Croix County Zoning office and the Town of E45 S28'S6 31 E 138.09' Troy for advice. E46 50558 29'E 95.71' E47 S21'05 09 E 336.12 E48 S21'05 09 E 325.56 E50 N29"05'13"E 180.52' E51 N28'08 54 E 311.23 E52 N39'48 04 E 123.74 E53 N29'0513 E 176.44 E54 N28'OS 54"E 347.33' Exemption verified under 13.1 B. 3. a.3) of the St. Croix County Land Division Ordinance a Section 23g 45 (2) (a) (4) of the Wisconsin Statutes. By.- 7te' g14,Klni.tvv� Date `�-3-''2-01 a 2 1W 1l INSTRUMENT DRAFTED BY: DOUG ZAHLER JOB NO. 6990-001 DATE: 08/31/2010 SHEET 2 OF 2 Vol. 24 Page 5729 Oct-19-2010 01:59 PM St. Croix County Plan/Zon ng 715-386-4686 1i 1 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM D Q Mailing Address `j- Property Address ¢ /C1 r, (Verification required from rjanninM Zoning Department for new consnueti ,) City/State ] �(f ?2rcel Identification Number _/ / _ 3 d o!0 L L DE PTYdN Property Location s �/ . S �/ ,Sec. -- 3.3, T,29 N R—LLW,Town of �s'P Subdivision Plat: Lot# , certified survey Map# - ? Volume��� page#S42? . 'Warranty deed# �--J- (bcforc 2007)Volunte page# Spec house -yes Lot lines identifiable,-0 no SYSTEM MAINTENANCE ANb ER CERT FICATI N improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists ofpuntping out the septic tank every three years or sooner,if needed,by a licensed pumper. what you put into the system can affect the flinction of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities arc specified itt§Cotitnt.$3.52(1)and In Chapter 12-Sr.Croix County Sanitary Ordinance. 'The property owner agrees to submit to St.Croix County Planning&Zoning Department a certification form,signed by the owner and by a master plumber,journeyman plumber,restricted plumber er a licensed pumper verifying that(1)the ott-site wastewater disposal system ii in proper operatint:condition turd/or(2)after inspection and pumping{if necessary}, the septic tank is less than 1!3 tii11 at'sludge. 1/we,the undersigned have read the above requirements and agree to maintain the ptivate sewage disposal system with the standards sot forth,herein,as set by the Department of Commerce and the Department of Natural Resources,State of Wisconsin, Certification stating that your septic system has been maintained must be completed and returned to the St,Croix County punning& Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on pis form are true to the best of my/our knowledge. I/we am/are the owners)of the property described above,by virtue ora 7ftnty deed recorded in Register of Deeds Oftioe, Number o ecirooms URE OF APPLICANTS) -ilel-I Z�A DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning&Zoning Department, Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV.08/0$) III�NI�II�III State B 1-2003 I I�IIIIIII�I I I ar of W II III tsconsm Form 8 0 1 0 8 9 9 WARRANTY DEED Tx:4008320 Document Number Document Name 925473 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI THIS DEED,made between Aaron Clay and Shelly Jo Clay,husband and wife RECEIVED FOR RECORD ("Grantor,"whether one or more), 10/26/2010 2:27 PM an d Chad T.Mulhollam and Paula B.Mulhollam husband and wife EXEMPT #: N/A ("Grantee,"whether one or more). REC FEE: 30.00 Grantor,for a valuable consideration,conveys to Grantee the following escribed real TRANS FEE: 195.00 g PAGES: 1 estate,together with the rents, profits, fixtures and other appurtenant interests, in St. Recording Area Croix County,State of Wisconsin("Property")(if more space is needed,please attach addendum): Name and R Addrcss That part of the Northwest Quarter of the Southwest Quarter(NW 1/4 of the SW etubavid J. Estreen 1/4)and part of the Southeast Quarter of the Southwest Quarter(SE 1/4 of the SW 304 locust Street 1/4)and part of the Northeast Quarter of the Southwest Quarter(NE 1/4 of the SW Hudson, WI 54016 1/4)all in Section 33,Township 28 North,Range 19 West,being Lots 1 and 3 of the Plat of Serenity Meadows described as follows: Lo 5 f Certified Survey Map W ' recorded in Volume 24 of Certified Survey Maps on page 5729 as Document No. 922032 _�.,. Part of 040-1314-03-000 Parcel Identification Number(PIN) This is not homestead property. (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 restrictions,if any,of record. Dated 10 * (SEA (SEAL) *JoCl * (SEA (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) Aaron Clay and Shelly Jo Clay, husband and wife STATE OF ) authenticated on ss. COUNTY ) *Kristina O land Personally came before me on TITLE:MEMBER STATE BAR OF WISCONSIN the above-named (If not, to me known to be the person(s) who executed the foregoing authorized by Wis.Stat.§706.06) instrument and acknowledged the same. THIS INSTRUMENT DRAFTED BY: * Kristina Orland Estreen&Orland Notary Public,State of 304 Locust Street Hudson WI 54016 My Commission(is permanent)(expires: authenticated(Signatures may be NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ®2003 STATE BAR OF WISCONSIN FORM NO.1-2003 *Type name below signatures. INFO-PROTm Legal Forms 800-655-2021 www.infbproforms.com 1 of 1 .�`� '�"* �� � :: a �: c.:F ,�° -�v *� 6 �,.,,�^ sue.. �:� � � „ �, r _+ .�. "� �. x Y� _ �:. :may" ,�; ..�. .. '", ..,. ap , ;� .„- , t ,,�`t , , �'J' L, �� :,. -- _. 'y .. ....�...... .. Y i l �_f tt C�,; f.: psp f ��� �i'(1( �'t • I f ., Parcel #: 040-1314-03-010 11/15/2013 01:04 PM PAGE 1 OF 1 Alt. Parcel#: 33.28.19.2053A 040-TOWN OF TROY Current 0 ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type #of Units 09/03/2010 00 0 Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner CHAD T&PAULA B MULHOLLAM 0-MULHOLLAM, CHAD T&PAULA B 317 W PINE RIVER FALLS WI 54022 Districts: SC=School SP=Special Property Address(es): '=Primary Type Dist# Description "19 SERENITY CT SC 4893 SCH DIST RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 5.000 Plat: 5729-CSM 24-5729 040-010 SEC 33 T28N R19W PTS NE SW&SE SW FICA Block/Condo Bldg: LOT 05 SERENITY MEADOWS LOT 3 BEING CSM 24-5729 LOT 5(5 AC) Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 33-28N-19W NE SW 33-28N-19W SE SW Notes: Parcel History: 040-1314-03(2053)&040-1314-01 (2051) Date Doc# Vol/Page Type WERE RETIRED TO CREATE CSM 24-5729. LOT 10/26/2010 925473 WD 5 IS 040-1314-03-010(2053A)&LOT 6 IS 09/03/2010 922032 24/5729 CSM 040-131-03-050(2053B). NO REMAINDERS 05/27/2005 796051 2810/175 WD 05/04/2005 793991 2796/096 WD mote... 2013 SUMMARY Bill#: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 08/18/2011 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.500 44,300 0 44,300 NO AGRICULTURAL G4 2.500 600 0 600 NO Totals for 2013: General Property 5.000 44,900 0 44,900 Woodland 0.000 0 0 Totals for 2012: General Property 5.000 44,900 0 44,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch#: Specials: User Special Code Category g ry Amount Total Special Assessments Special Charges Delinquent Charges 0.00 0.00 0.00 Wisconsin Department of Commerce SOIL EVALUATION REPORT page ldd of 3 Division of safety and Buildings in accordance with C6r�rti G3 Code f County ST.CROIX Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan dust include,but not limited to:vertical and horizontal referenceloAiht( direction and Parcel I.D. percent slope,scale or dimensions,north arrow,and location and dis at;4 jdgnearest road. 040- 1314-03-010D� 1 Please print all informati9n... r7rL�- Date J Personal information you provide maybe used for secondary purposes(Pridacy a 4A5.04(1)(m)). 1015— /? r!Property Owner Property Location ❑J CHAD T.&PAULA B.MULHOLLAM Govt.Lot ----SE 1/4 SW 114 S 33 T 28 N R 19 E(or)W Property Owner's Mailing Address Lot# !1ock# Subd.Name or CSM# 4 o 1- 317 W.Pine Street 5 - C M 24-5729 City State Zip Code Phone Number ity �Village Town Nearest Road River Falls, WI 1 54022 1 ( 715) 821 -9910 Serenity Court New Construction Use[D Residential/Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement ❑ Public or commercial-Describe: Parent material loess over till Flood Plain elevation if applicable NA fl. General comments _ Y and recommendations: Mound System--0.50 ft.sand fill--0.6 loading rate To be designed after dwelling staked. a Boring# ❑ Boring 0 Pit Ground surface elev. 96.50 ft. Depth to limiting factor 36 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. I *Eff#1 *Eff#2 1 0-13 10YR3/3 sil 3f-msbk ds as 2vf-m 0.6 0.8 2 13-19 10YR3/6 sil 2f-mabk dsh as 2vf-f 0.6 0,8 3 19-29 7.5YR4/6 Is Osg dl cw 1 of--m 0.7 1.6 4 29-36 7.5YR4/6 scl 1 fabk mfr cw 1 of-f 0.2 0.3 36-lsbr F 2] Boring# � Boring El 99.50 36 Pit Ground surface elev. ft. Depth to limiting factor in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 I *Eff#2 1 0-10 10YR3/3 - sil 3f-ma&sbk ds as 2vf-m 0.6 0.8 2 10-19 l 0YR3/4 sil 2f-mabk dsh as 2vf-f 0.6 0.8 3 19-36 7.5YR4/6 - s Osg dl cw lvf-m 0.7 1.6 4 36-46 7.5YR4/6 f2f 7.5YR5/6 sl Om -- -- mfr 0.2 0.6 Horizons 3& 4 have some gr. *Effluent#1 =BOD >30:5 220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD <30 mg/L and TSS 5 30 mg/L CST Name(Please Print) Signat CST Number MARY JO HUPPERT Hollister's Soil Testing&Design 224832 Address ate Evaluation Cod ed Telephone Number W9875 690th Avenue, River Falls,WI 54022 09-24- 13 715-426-1775 Property Owner Mulhollam, Parcel ID#Chad&Paula 040- 1313-03-010 Page of 3 _ 3] Boring Boring g El pit Ground surface elev. 97.90 ft Depth to limiting factor 30 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-10 10YR3/3 -- sil 3f-ma&sbk ds as 2vf-m 0.6 0.8 2 10-16 10YR3/4 -- sil 2fabk dsh as 2vf-f 0.6 0.8 3 16-30 7.5YR4/6 -- s Osg dl cw lvf-m 0.7 1.6 4 30-34 7.5YR4/6 c2d 5YR4/6 A Om mfr -- -- 0.2 0.6 Horizon 3 has some gr. 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/fF 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/ff in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 *Effluent#1=BODS>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BODS<30 mg/L and TSS 5 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SM-833MM(R.07/00) Plot Plan for Site and Soil Evaluation Page 3 of 3 Property Owner eV4Ab r. � 04i to B. N► U L i- b Li-,4,M 1» = 40 ft Legal Description carte, wr- aF (except where noted) vq OF THE --4q, -s3-3, Tzv J, �i�w, ��� of = Backhoe pat T"V. st c,jaxe-OuN,y, wlt>CDYQZ5 � 5eo � North O�V3 fife, Tq I © ql mil. b _ --- - -- rg7,601 stfaK�.D by ©WNEK �' Site LqOc ation: d ° 190.