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HomeMy WebLinkAbout040-1303-00-023 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 574303 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: Oeverin Homes LLC, aka Oeverin Pro ertie Troy, Town of 040-1303-00-023 CST BM Elev: Insp.BM Elev: BM Description: 2 SectionlTown/Range/Map No: yl,g 8 -3 GS— 22.28.19.1758 TANK INFORMATION A ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic I i� F.- L'Z� 1600 Benchmark 5. 7- 163 97, 9 f7 Alt. BM ( n I.3 /� L 7 Aeration Bldg.Sewer , 45 s, S Holding St/Ht Inlet 7.9 RS St/Ht Outlet TANK SETBACK INFORMATION J TANK TO P/L WELL BLDG. en Air I ake ROAD Dt Inlet U1e3� 5 Septic 1 Dt Bottom �, \ Dosing Header/Man. V 9 L y, Aeration Dist. Pipe IF I- Z' .a Holding Bot. System 9• T 3 •Z 93 Final Grade � • Z 9'7.d� PUMP/SIPHON INFORMATION O Manufacturer GPM Demand St Cover Z p ��a • Model Number o TDH Lift Friction Loss System He TDH Ft Forcemain Dist.to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Dept DIMENSIONS �"{ Z 1.1 e,,,t ` SETBACK SYSTEM TO P/L JBLDG IWELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Tw t�i TypeDf System: ` SI / UNIT Model Num� �f t7 be. I ' C o n.^.L)e .0 � " DISTRIBUTION SYSTEM Vent vs Header/Manifoo 1 Distribution x Hole Since x Hole Sp inaF g Vent to Air Int ke Pipe(s) gth \ Length � Dia Length \ Dia Spacing \�. SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/ odded xx M hed Bedrrrench Center $ Bed/Trench Edges Topsoil ` Yes No Yes No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / / Inspection#2: Location: 264 Walnut HillVyay River Fall/s,WI 54022(SE 1/4 SE 1/4 22 T28N R19W) Walnut Hill Farm aka The Tribute Parcel No: 22.28.19.1758 1.)Alt BM Description= • ,�� 6je� C�,� .I,,_ {�G� Q a✓�. 2.)Bldg sewer length= Z7 -amount of cover Plan revision Required? [] Yes > No cert Use other side for additional information. �___.. Date Insepctor's Sig ture .No. SBD-6710(R.3/97) PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SE 1/4 SE 1/4S 22 /T 28 N/R 19 W TOWN Troy COUNTY ST.CROIX MPRS Shaun Bird 226900 DATE 6/26/14 BEDROOM 3 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1131 # of chambers 56 IL BENCHMARK V.R.P. Top of 3/4" rebar ASSUME ELEVATION 100° Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark il ent EM ELEVATION 9 5.7/95.4 4' below qrade >6„ uick4 Standard ��of Cover aching Chamber Scale is 1 = 40 h 20.0 ft2 of Area unless otherwise ft 2/pair of end caps 4' Lon noted 34" Grade at System Elevation Pro 3 Bedroom House 15' Property Line S 20' All piping shall be SDR 30/34,within 10' of tank,piping shall be Schedule 40. B-2 Property Line 00' B 5' 2-3' X 114' Cells with>3' spacing 4% Slope B-1 Vents 22' 100' B.M.* 106' 98' 99' Property Line `"1 Gaudy/'' -- Safely and Bt Mngs Division 201 W.Wasttington Ave.,P.O.Box 7162 Sanitary pennit Number(to be Bed in by Co.) Madison,w 53707-7162 7—D 7 43 0-5 Sanitary Permit Application �°eT Number In accordaoet with SPS 353.21(2 Vitis,Aden Code,submission of the farm to the " is regoirod prig to obtamhng a sanitary pemtit Nort::Application forms farshoo-owned �m Address(if diffiaea,t thran mailing address) the Dopatmeut of Safety and Pro*sskxW Savies. Personal information you provide may s G�J v�✓�` is a000edaoce with the Law s.15. 1 m Stets. S C: NIT z�j� �,,( L Infor awtion-PWm Print ^ tJi / z # property Owner's Name ' 3 i ownee$ Property Location Govt Let C I �, Stec yip Code Phone Numbs y Y., Section II. of Banding(cheek all that apply) Lot# eo� Subdivision Name or 2 Family Dwelling-Number of Bedrooms dk �V. Bleak# ❑PublidCommerciol-Daxaibe Use �, ❑City of CSM Numbs ❑vmw of ❑State Owned-Desaibe use Town of Z C Ll 1U of Permit: (Check o>tly out box en line A. CompWe line B if applicable) New System ❑Roplacemmt System ❑T folding Tad:Replaceanent Only ❑Other Modi9400n to BOWS System(explain) B. ❑Permit Rawwal ❑Permit Revision ❑Change of Plumber ❑Permit Tra *r to Neer Last Previoea Pamir Number and Daft bared Before lie i ation Owner �L F�'r a fez o f T Iv. of PowTS S mn Cheek all that S Noo-Prassoriad la-Cuamd ❑Pr w ized b4round ❑At-Grade ❑Mound>24 in.of suitable soil ❑Mound<24 is of sui able soil ❑I o g Took a 0ma Dispersal Campooart(=Plain) ❑ D c°�l�°) V.Die rea Area Yniermalioa: Aros (st) Sysu r • Fkw(� Doupn Soil Disp rW Amer (sfj lsPsl � . VL Tank Ido ' C>�9 in Total #of Manufacdarer Gallons Gallons Units r7ee redo E�Tads , 3 r' Septic or Hold'm`Tads Dosing Cbu*w VII. Statesoetst- the for miles of the POWTS dAsovns ea tie attached Pirmnber's- M'PAOM Number Business Phone Number C Clrti /� z /`J^'� � Plumber's Address(Strad.CAY,20M" /"' / � ) ✓� V%Aze en!use oftbr _ Signatwe Apprrnod Reason Darial y75 Z7 i� /Zz� IX.Co Jgr Disapproval fiy'14e'pttc tank,effluent fester and ;dispersal cell must all�°°'rvtcoa Peed 0 per management plan provided by plumber. 2 `J���� mt�t;l�mtNMairwd p�applidl�la code/txdindrto�. AAwb to eaapiale plus for n e gataer wad sabedt n the CNOtp oalr er ppor or tees o,.a a u1:116eha s sine SBD-6398(R.11/11) Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 6/26/14 Owner: Oevering Homes Location: SE 1/4 SE 1/4 S22 T28 N,R1 9W Lot 23 Walnut Hill Farm Troy In-ground absorbtion system(conventional) Manuals Used: In-ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance and Contingency Plan 7. Filter Specifications Peet 8-10. Soil test !, Signature License numb #226900 PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SE 1/4 SE 1/4s 22 /T 28 N/R 19 W TOWN Troy COUNTY ST.CROIX MPRS Shaun Bird 226900 DATE 6/26/14 BEDROOM 3 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1131 # of chambers 56 BENCHMARK V.R.P. Top of 3/4" rebar ASSUME ELEVATION 100° Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark V ent SYSTEM ELEVATION 95.7/95.4 4' below grade >6» Quick4 Standard of Cover Leaching Chamber Scale is 1" = 40 with 20.0 ft2 of Area unless otherwise 5.6ft^2/pair of end caps 4' Long 12 noted Grade at S stem Elevation 34" Pro 3 Bedroom House 15' Property Line S 20' All piping shall be SDR 30/34,within 10' of tank,piping shall be Schedule 40. B-2 Property Line 00' B-3 45' 2-3' X 114' Cells with>3' spacing 4% Slope B-1 Vents 22 100' 106' B.M.* 98' 99' Property Line 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 5.6ft^2 pair of end plates To be >1' above grade Finish grade elevation Typical Installation 99.7 Vent ACI Grade Vent 3' 4„ A31 f�30/34 Septic Tank 1"5 Long 5 1 Grade at System Elevation 36" Grade at System Elevation Spacing 5' liq 2-3' X6 ' Cells Same on other end Observation tubeNent At end of cell A 40 chambers per cell B System elevations: 2-3 A-95.7' B 95.4' POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page FILE INFORMATION SYSTEI{A SPECIFICATIONS Owner O e o r t Tank Manufacturer ❑ NA Permit# eptic D Dose ❑Holding Volume: ( ) Tank Manufacturer. NA DESIGN P E`rERS c ❑D� ❑ Holding Volume: (gal) Number of Bedrooms: ❑ NA ❑ Septic Number of Puglic Facility Units: NA Vertical Distance Tank Bottoms)to Service Pad: (tt) may) Horizontal Distance Tank(s)to Service Pad: (n) Estimated(average)Flow'. (g mechanir�must be provided if vertical Is>15 feet or eCflio serviang Instruotkm to be Provided Design(pea ) _ (gelldaY) H horizorsad is>150 feet SpedAc on back. k Flow (estimated x 1.5): In Situ Sol Application Rate: c C (galldaye) Effluent Fitter Manufacturer: �- [3 NA Standard(Domestic)Influent/Effluent Monthly average.. Effluent Filter Model: Fats,On&Grease (FOG) s30•mgJL Pump Manufacturer Try-eL Biochemi al Oxygen Demand (BODE) s220 mglL ❑ Pump Model: - Total Solids SS 5150 High Strength Influent/Effluent Monthly average Pretreatment Unit (FOG) >30 mglt - � Manufacturer A (BODE) >220 mglL �\ ❑Mechanical Aeration 13 Pee Filter SS >150 mgA. ❑DWnfection ❑Wetland Pretreated Effluent Monthly average ❑sandlGravel Finer ❑other (BODe) s30 Soil Absorption System (TSS) �nd(gravity) ❑in-Ground(pressure) ❑ NA Fecal Colfform(geometric mean) 510`' ❑At-Grade ❑Mound Maximum Effluent Particle Size ❑ NA ❑Drip Une ❑other Other: Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Fre4u�cY Pump out contents of tank(s) an combined sludge and scum equals one.ti'mird(Ys)of tank volume ❑ an the high water alarm is activated Inspect condition of tanks) At least once every: ❑month(s) (Maximurn 3 years) ❑NA months) (Maximum 3 years) ❑NA Inspect dispersal cell(s) At least once every: s) (s) ❑ NA Clean effluent filter At least once every: A s) month(s) NA Inspect pump,pump controls&alarm At least onowevery: ❑ya(s) months) NA Flush laterals and pressure test At least once every:. .❑YW-s) month(s) NA. Other: At least once every: ❑ s) NA Other: MAINTENANCE INSTRUCTIONS one of the fatiowing Ifc�rmses or certifications: Inspections of tanks and sob absorption systems shall be made by an individual carrying Servicing operator m Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, any missing Maintainer or Sardwa g �s or leaks, Tank inspections must include a visual inspection of the tanks)to identify any missing or broken hardware, identify y soil measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on ground and surface.of effluent and absorption system shall be visually inspected to check the affluent levels in the observation pipes on the ground surface. The PMg of effluent on•the ground surface may indicate a failing condition and requires the immediate � notification of the local regulatory authority. more of the tank volume,the entire When the combined accumulation of sludge and scum in any treatment tank equals one-third(�S)orn accordance with chapter NR 113, contents of the tank shall be removed by a Septage Servicing Operator(pumper)and disposed of Wisconsin Administrative Code: components,pretreatment units, All other services,including but not limited to the servicing of effluent filters,mechanical or pressurized components, and any servicing at intervals of 512 months,shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 30 days of corrtpletlon of any service event. GMW-005(025) Page START UP AND OPERATION ucts, solvents or other For new construction, Prior to use of the POWTS check treatm or damage-the soil absorption system. high concentrations are chemicals or sediment that may impede the treatment process� m ar to use. detected have the contents of the tanks)removed by a Septage Servicing Operator(pumper)prior Pump tanks may fill above normal highwater levels prior to startup or due to pump failures. Start up or restoration of power under these conditions is not recommended,as the excess wastewater will be:dscharged to the SON absorption system in one large dose causing an overload that may result in the backup or surface discharge of effluent.and damage'to the system. To avoid this situation have the e Servicing Operator(pumpor)'Priortorestoring Pow to3he Pump o'contact a Plumber contents of the pump tank removed by a Septag the controls until normal effluent levels are restored within the pump tank. or POWTS Maintainer to assist in manually operating PUMP System start up shad not occur when son conditions are frozen at the Infiltrative surface. Do not drive or park vehicles over tanks or the soli'absorption system. Do not.drive or park over.or otherwise disturb or compact,the are@ within IS feet down slope of any mom or at-grade soil absorption area• improve the ante and prolong the fife of the treatment Reduction ar elimination of the fbhowing from the wastewater stream Tray P condoms, cotton swabs, degreasers, dental floss, tanks and soil absorption system: acids, antibiotics, baby wipes,-dgaretgnd v ts, eases, herbicides, meat diapers, disinfectants,fats,foundation drain (sump pump)oischar'gs,trait vegetable peelings, gasoline, scraps,medications,oils,Painting products,Pesticides,sani�y napkins,solvents,tampons,and water softener brine discharge. ABANDONMENT taken out of service the following steps shall be taken to insure that the system is properly When the POWTS fans and/or is permanently. and safely abandoned in compliance with s,Comm 83.33,Wisconsin Admiriistrsth+e+rode:: sealed. • All piping to tanks,Pits and other soil absorption systems shall be disconnected and the abandoned pipe openings d of by a Septage Servicing Operator(PumPar)- • The contents of an tanks and pits shall be removed and properly disposed , • After Pumping, an tanks and pits shah be excavated and removed or their covers removed and the void space Oiled with soil, gravel or another inert solid material. CONTINGENCY PLAN vide a code compliant If the POWTS falls and cannot be repaired the following measures have been, ar must be taken, to pro replacement system: on system.on of a -�--A suitable replacement area has been evaluated and may be utilized for the and should note be infringed upon y required The replacement area should be protected from disturbance and comps west area will result in the need setbacks from existing and proposed structure,lot lines and wells. Failure to prated the replacement with the rules in for a new soil and site evaluation to establish a suitable replacement area'. 'Replacement Systems must comply effect at the time of their permit Issuance. ' on system cannot be .❑ A suitable replacement area is not available due to setback and/or to soil limitations. ff the soil a sort. rehabilitated end barring advances in POWTS technology,a holding tank may be installed as a last resort ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soh and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a Koldkng tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil of absorption systems May be reconstructed such systems must comply with the rules in dfect at that�bm removal of the.biamat at the infiltrative surface. Reconstruction WARNING TREATMENT TANKS., .PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE- ADD IONAL INSTRUCTIONS: P POWTS MAINTAINER OWTS INSTALLER . N m ae y Name Phone J r j Phone r T SEPTAGE SERVICING OPERAT PUMPER LOCAL REGULATORY AUTHORITY . Name / Name Phone Phone This document was dratted by the staffs of the Groan take, Marquette and Waushara CountY POWTS regulatory agencies in compliance with sections isconsin AdmiM Comm 83.22(2)(b)(1)(dM,(f)and 83.54(1),(2)&(3),Wstrativa Code. FiLTERCARTRIDGE INSTRUCTIONS InstaftUm STEP 1 Ory Ile tlu Mar mw arcs the MW of the outlet Pipe to ensure t is centered under the ell caps opening. If"at,thus tither Must more pipe lets the tank fhrmgb the Outlet Or sohnnt wdd(Vlue)additlofeal pipe onto the outlet Idea- STEP 2 WMe the case it stil dry Mt'ed an the outlet pips,meaerxe the length of a1 -busk pipe needed to bran the filter b the tw*end Wall if utMaing the ptlonsl "support.If skis aupPort method is not utiixed, proceed to step fotw 5•7f-P 3 for' - --tlons UtUd !the OlIthmWoupplanantefeMg support: sohvent weld the%finch pipe once dm!bell case, if side support rnaWM is not ud lmd.proceed to step form. Solvent Mreld the ldter caaa onto the outlet cartridge into the tap, ice' into floe r r the case. Pntslnq down untM the Altar fucks into the bottom of ,`;t?r :.� .,yam If a VRS se*ch is utilisd:insert Into the fter and lock by fuming ..:: clodmist w. MaiMellmaace 1. The afVkmnt Ater should be domed every tiffm the septic tank is serviced. 2. Open the outlet access olm"to inspect the tank and ffftet 3, PumP the septic tank eonoplatalir,nuddng sure to remove the sludge layer on the boltun of the tenk and not just the scum and effluent. 4. Once the effluent level has bean lowered below the invert of the \ dga�frorn�P�on the filter handle to dislodge the S. Slide the cartridge UP and out of the case for cleaning. 6. If a VRS switdr emweeeted to an afum is present,the switch r Ao only.m�by�9�go-and cleaned with aster :f ♦ r ' 7. WWk hOhft the cartridge an Its side(large fist surface fadng " •• down)mor the acc s Opwdn&rkrsa Off the ewbidge with Water orft rnskMug aura of sePfeage MatWW is dnaM bade into tfu tank_ ` & If VRS switch is uWized, ca by t turning dodmvise quo. rrsertifeg Moto f{Rer and ti: � •� S. Inert the Agar cartridge balk Mete the case,pressing down tmdf r. •_ � } the filter lodrs into the bottom of the case. w 10.Replace and sewn the access opening On the tank, , r,?Lr•.yypr r'•+!t'2S:arr"R:lx,,� -ltiE-•'f r..:i tet':.w`:v:.ao,x-•. WWWJM UUdM co>ole 877- UMM(6S3-4583) ., ST.CROIX COUNTY SEPTIC TANK MAINTENANCE AGREE » AND DWNERSHlP CERTIFICATION FORM Owner/Buyer 2 y Melling Address SS Property Address :# 2(01 (Verification required fro P `( `S` �� laantng&Zoning Department nee►cons rD ��—City /State U Parcel Identi.6cation Number /Q —LEGAL DESCit._.rarrn>~r _ � Property Location V4 t — 7-�- ---- -N R. -- _�W, Town of� Subdivision �' Lot# Ce rdfied Survey Map# "J 'Volume r—'— Page#_"— Warranty Deed# -J % ---._---._.__ Volume Page# YS�M Spec kio Y no Lot lines identifiable es no s OWNER�TIFiCAT'iON lnpl''oPe'use and maintenance of nwntenance consists of pumping out the y atptic system could result in its preaudum fail the system can affect the �'tc tank every three years or sooner,if ure to handle wastes. Proper �.�nsibil can affect function of the septic tank as a treatment stage in the waste�d,by a licensed P�pw• What put into specified in§Comm,83.52(j) I70pn t and in chapter 12-St.Croix disposal Owner maintenance � CO1i'h'5��7+ordinance. The property owner agrees to submit to St.Croix Co owner and by a master plumber,journeyer l unty pig&Zoning DVL a certification fo wastewater disposal system is in proper Plum restricted plumber or a licensed signed by the less than 1/3 full of e, o condition and/or(2)after i PuW�er Venfy�ng that(1)the on-site al+idg inspection and pumping(it'necessary),the septic tank is I/we,the undersigned have read the standards sat forth,herein,as set by the above re uirements and agree to maintain the Certification stating Department of Commerce and the D private sewage disposal system with the g that your septic system has been maintained must be completed of Natural Resources,State of W' '')Wing Department within 30 days of the three mpleted and returned to the St GYorx Coua �sconsin. Year expiration date. ty Planning& Uwe certify that all statements on Property described above, form are true to the best of my/our knowledge. ,Uwe am/am the o by virtue of a dt�ed recorded in Register of Deeds Office. wuer(s)of the Number of bedrooms IGNA F APPLICANT(S) /j� *** DAT Any information that is misrepresented may result in the sanitary permit being revoked by the planning&Zoning D *** f'nehuie with this application a recorded warren Department. reference is made in the Warr ty deed from the Register of Deeds(mice and a copy of the certified survey anty�' y map if (REV.OUS) i IINIIIIIII Illllllll II 111111 II 8140849 Tx:4113918 STATE BAR OF WISCONSIN FORM 3-2000 975248 QUIT CLAIM DEED BETH PABST Document Number I REGISTER OF DEEDS ST. CROIX CO., WI THIS DEED, made between Citizens State Bank, Grantor, and Oevering 03/20/2013 09:08 AM Homes LLC,Grantee. EXEMPT#• NA Grantor quit claims to Grantee the following described real estate in St. REC FEE: 30.00 Croix County,State of Wisconsin(the"Property"): TRANS FEE: 449.70 PAGES: 2 Lots being sold`as is'. SEE ATTACHED EXHIBIT A Recording Area Name and Return Address: Title One File 19240 Together with all appurtenant rights,title and interests. see attached Parcel Identification Number(PfN) This is not homestead,property. Dated this 15th day of March,2013. Citizens State Bank *Tak if Van erBroeke, tce Presl ent * AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) ST CROIX COUNTY. )ss. authenticated this 15th day of March,2013 Personally came before me this 15th day of March,2013 the above named Citizens State Bank,Alan H VanDerBroeke, Vice President to me known to be the person(s)who executed TITLE:MEMBER STATE BAR OF WISCONSIN the foregoing instrument and acknowledged the same. (If not, authorized by§706.06,Wis.Slats.) -':�Evelyn �Jaeger THIS INSTRUMENT WAS DRAFTED BY Notary Public,State of Wisconsin My commission is permanent. (If not,state expiration date: 12/1612016 ) Michael H Forecki,Attorney (Signatures may be authenticated or acknowledged. Both are not necessary. EP *Names of persons signing in any capacity must be typed or printed bel i PVC �S�e�oNNlisc°�gtn 1 of 2 QUIT CLAIM DEED STATE BAR OF WISCONSIN FORM No.3-2000 File No.: 19240 EXHIBIT A Lots 8, PIN 040-1303-00-008;Lot 9, PIN 040-1303-00-009; Lot 23, PIN 040-1303-iA Plin 3 Lot 28, PIN 040-1303-00-028 and Lot 40 PIN 040-1303-00-040 of Walnut Hi arm, the Town of Troy, St. Croix County, Wisconsin. 2 of 2 0 N Tv COf �I _Z f 7p—- t ,� I to (x 3 r E-• Leo N •a 4 ci lr i ,A ,\� ! R1 ate° °t h► \\ .,gear k •� r � / / , � O I ` =�� f - y N 5 00'42'59.0' E vs�tnl > 220.19 N p + ^ti I r� jo- I --- ••�� '-'� a / / d Halol ro - ^ol\ N •r LL qt Cq La .. � � � ui# � 1,� 1 o � N � in Vs I io7• Og,4201- w 3ps-8o�R _/ / '`••:� � ,°� 0i 02'3§-'-5r t�14'- �i Y Y RN r r � N 0 mss► �J ww Y TDOl� �1&P S TE©7— / //nn pns¢terty owrt�r Parcel ID# L y Fags Z of BOMg w C) BO X17. �a 13 P t C'rourrd surrace slain fl. Depth to g factor in. Sod Rate Ho tun I Depth Dornira nt Color Redox Desor"on Texture SbUCt ne C XWAence Boundary Roots GPDRf in. Munsed Qu.5z. Cont.Color Gr_Sz.Sh. w TIM 'Eff#2 z l o �� d �W / f . S S /o I3�N S / 5 .5 • C # soling o� � ii � � �•GG� , �O.v %vZC !r S 0 pit Gmtmd surface elev. ft. Depth to drrniting factor in. Sod Application Rate Horizon Depth Dominant Colm Redex Desa*KW Texture Shftre Consistence Boundary ,Roots GPDff kt Mu nseit Qu.SZ. Cont.Color Gr.Sz.Sh. SM,V# pit Ground surface elev. ft. DepM to factor in. Rate Hmtzon Depth Donnfnant Color Redox Description_ Texture Consistence Boe n"Y ROots GPM in. Munsell Qu.Sr- Coat.Color .Sz.Sh. `EW1 'Etf#2 r a t # tQn9 El Q pit Ground sraface elev. ft. Depth to B""fiar Rate Ho coon tit Dornklantcolor Redox ptiar. Texb" suumne Gornatence Boundary Roots r3PDrrP IM Munsed Qu.SZ. COtOr Gr.Sz.Sh. `Etf#1 'Ef(#2 Efthierd#1=BODs>30< mgI&and TSS>30<150 mg/L °Effluent#2=BOD,130 mg1L acrd TSS 130 mglL The Department of Commerce is an equal opportunity service provider and employer. If you creed assistance to access services or treed material in an alternate format,please contact the department at 608-266-3151 or TTY 608-264-8777. saaasxitR�no> Department of Commerce SOIL EVALUATION REPORT pa of 3 of Safety and Buildings In accordance with Comm 85.Wks. Adm. Code �y ST= GA o/' include, of EROSION CONTROL PLAN must be ( c percent scope.f kd- , Parcel I.D. ��T 4Wr� Cr" �Z � completed before sanitary permit issuance R( v��s�a�� Date Personal infortna6on you Provide naY be used for secondary P�+rP�es tY�.t.ts.00(1)(m)). ID 2Y Q Prey ow 1er �, TOAO p roperty LoTOT �3EIV Te7fl� iv f���6- 9M ovt Lot !till � S�1/4 S N R �9 &(or)W rt ProPerty Owner's Maft9 Address Lot# Block# Subd.Name or CSM# (P 0►5 CA t j U— AV-P– - �-3 IVAL NO r w t t fA RAI Cky siv(JAR State 2p Code Phone Number , ❑City ❑village (5d Town Nearest Road b,�ov� HTT MN 5SOWo ( &51) 1-99' 109 s©. !3•fo�ER New Construction (se:19 Residential I Number of bedrooms 3— � Code derived design tow rate _ GPD ❑Replacement ❑ t?k,dniic or commercial-Describe: _ _ 91 Parent material_1D,e J S o yt. -sf46-7D y 60 7 q _ Flood Plain elevation if appGcabie General comments •�• and recommendations:ndations: •"e-4 7-&-ST2�Fl) .�C,/'7"�9,8/L=" ?*,f 1' 4D.v0,&--A to vq L FT] 0 N ® Pit Ground surface elev. R Depth to rxniting factor m. Sall Application Rate Horizon Depth Dominant Color Redox Description Texture Strudkxe Consisterkce Bokrndary Roots GPQff b in. Mu nseti Qu.S?- Cont.Color Gr.Sz Sh. *M1 'Eff#2 y 63 - ,L2 �- •z� Sic 2,,-K, AS 11 e / ' SG � W,S,4 c • S s t 5 . R r 14--4 S cs • � -2- ,IF �•� 5'1 7 i• �. .� # ❑ Boring ® ff Pit Ground surface �/ ft Depth to Nmtting factor ? / in \ M*EfW1j Rate tit Horizon Depth Dominant Redox Description Texture Structure Consistence Boundary Roots It, in. Murnsell Qu.Sz Cont.Color Gr.Sz Sh. F#2 l 0 -/0 IOYe 3 ----- 3 f- S • b' N ho L192 ------- S�� a be s C14.) • s X9.3 / ------- G S • '? �• 7 S O kl Eftikrent#1=BOD >30 1220 m9 L and TSS>30 1150 mgil 'Effluent#2=B09,:5 30 irk &and TSS 130 mWL CST Name(Please Prid)•� .0 t G �� 22 G j T 5 Address Uibricht &Assgciates Data E' on C "�d ee7Nww Private I 7 3 7f a 3 Z 2812 10th Ave. Spring Valley, WI 54767 Pius• FOR 4PAR0 X . 2 oy • /o*s • so • COD 0,Y0 . 10 Flo • io • oar Ar d yp • /0*G • 20 - oe,0 .,_.. o yo• /081 - �o • � o yo • io*6 - 70 • oaa ` ` �� - At y a yp . io�� jp • oar G L r l` PLOT PLAN WALNUT HILLS FARM. LOT # Z3 • Pg. 3 of 3 1 d = Contour elevation lines. = Backhoe Soil pits. O = Benchmarks set, maRKED WITH FLAGGED lathes. 1/2" steel conduit pipes. t SCALE: 1 " = 3o Lo -r 23 o v so � y ga a q11�j P � y' /10 yi b I O0 �4 13M 44 1 Q //1F�