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HomeMy WebLinkAbout040-1303-00-030 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 572829 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 040-1303-00-030 CST BM Elev: Insp.BM Elev: BM Description: Section/Town/Range/Map No: /3 - ,3 ( 22.28.19.1765 TANK INFORMATION A ELEVATION DATA TYPE MANUFACTURER ,"�5 CAPACITY STATION BS HI FS pE�LEV. Septic // r� � 1<L... � / lZ✓� /I Benchmar �3 L5 �j .c� /6/_.7. l-r•35 J GJ � ✓ aX V / II Alt. BM pq Dosing (..cvwba � � Lf! �b � !,r.✓ f Ga/w r � ' � / 1 AaFaEion Bldg.Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. ent Air Intake ROAD Dt Inlet Septic ---- Dt Bottom Dosing I `/5/U L Header/Man. z . 16-Z 7T l0 9 �' 39 � -- Aeration Dist. Pipe 2 . /!1Z 7g Holding Bot. System Z , g /,fL . Q$ Final Grade ,� � Ad 3 PUMP/SIPHON INFORMATION Manufacturer GPM nd St Cover !;t G v /� 3 &3, s G� a Model Number _ 15 T<� \ TDH Lift Friction Loss System Head TDI)� ��t S .15 /.3(0 (D Forcemain Leng�! DiaL t t --jDist.toWeIl A r^ SOIL ABSORPTION SYSTEM ,v1-J" BED/TRENCH Width L Length No.Of Trenche PIT DIMENSIONS No.Of Pits Inside Dia. Liquid De_th DIMENSIONS SETBACK SYSTEM TO P/L IBLD G WELL LAKE/STREAM LEACHING Manufacturer: CHAMBER OR INFORMATION Type Of m: Aj UNIT Model Number: DISTRIBUTION SYSTEM E 123 da /lei Header/Manifol Distribution t L l / x Hoe Size Ix Hole Spacing Vent Air In e Pipe(s) i/ v Length Dia Length 72 Dia Z Spacing Ll I- 3Z SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded jxx Kul h d Bed/Trench Center i Bed/Trench Edges Topsoil ' es 0 No Yes No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection 1: / �$ / �� 1 spection#2: - � Location: 246 Legacy Court RIVER FALLS,WI 54022(SE 1/4 SE 1/4 22 T2 8N R19W) W ut Hill Farm aka The Tri t Parcel No: 22.28.19.17 5 ) 1.)Alt BM Description 2.)Bldg sewer length -amount of cover= ! a n �}L a,�• cox, Plan revision Required? ❑ Yes Use other side for additional information. Cert.No. Date Insepctors Si ature 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 SYSTEM ELEVATION 101.0' 1.2' sand lift DATE 10/3/14 BEDROOM 3 CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK 1 MOUND XXX SEPTIC TANK SIZE i gallons LIFT TANK SIZE DOSE TANK SIZE �� b� HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA % of chambers none IL BENCHMARK V.R.P. Top of 1/2" steel conduit ASSUME ELEVATION 100° Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark All piping shall be SDR 30/34,within 10' Scaie = 1 /4" _ 10' of tank,piping shall be Schedule 40. Legacy Court Wel l is to meet al I WDNR setbacks Tank is to be properly bedded 1 Acre Lot and provided with lockdown covers with approved warning labels B.h1.A P ro'x Scale = 1 /4" = 10' 99.8' N Bedroom B- 1 House Property Line Huffcutt Combo Tank Area 15' below system is to 2% Slope Grading is to be done to remai n divert run-off away from undisturbed B-3 s y ste m B-2 100' Py 99 Property Line 1 9 Safety and Buildings Division Counls ✓"J/ 201 W.Washington Ave.,P.O.Box 7162 Sanitary Permit Number(to be filled in by Co.) Madison,WI 53707-7162 ur O ��oPM ", /j . 2J ,0013 amtary Permit App] t i State Trans /on Number In accordance whth SPS 3831(2),Wis.Adze Code,submission of this form to the appropriate governmental unit `-� is required prior to obtaining a sanitary permit Note:Application forms for state-owned POWTS are submitted to Project Address(if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law,s.15.04 1 m,Stats. X�b e I. Application,Information-Please Print All Information Property Owner's Name Parcel# Property Owner's Mailing Ad Property Location C Govt.Lot City,State Zip Code Phone Number 4j ;a, y4, Section (circle one T Z X N; R E or U.Type of Building(che4all hat apply) Lot# Subdivision N e r 2 Family Dwell' g(—Number of Bedrooms Block# Public/Commercial—Describe Use ❑City of CSM Number ❑Village of 11 State Owned—Describe Use Of-71�v III.Type of Permit: (Check only one box online A. Complete line B if applicable) A. New System ❑Replacement System ❑Trcatment/Holding Tank Replacement Only ❑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 O`vn® IV.Type of POWTS S stem/Com onent/Device: Check all that ROY) ❑Non-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grade ❑Mound>24 in.of suitable soil d<24 in.of suitable soil i ❑Holding Tank ❑Other Dispersal Component(explain) ❑Pretreatment Device(expl — V.Dispersal/Treat ment Area Information: _ l �' ' - c rgn Flow(gpd) Des i Soil Application Rate(gpdsi ispersal Area quired(st) Dispersal Area oposed(sf) System El vation ✓ o 3, � 5cz; /sr. v - r.2 VL Tank Info Capacity in To #of Manufa H Gallons Gallons Units 1, u New Tanks Existing Tanks as n tn Septic or Holding Tank I3ss Dosing Chamber 7 VA I VII.Responsibility Statement-I,the undersigned,as a responsibility for installation of the POWTS shown on the attached plans. Plumber's Name(Print) Plum s Signature MP/MPRS Number Business Phorte Number Plumber's Address(Street,City,State,zip ZY VIII. ountylDe artment Use 0 Permit Fee Date Issued suing Agent gnat ± Approved ❑Disapproved $ ❑Owner Given Reason fnr Denial / DL Conditions of Approval/Reasons for Disapproval SYSTEM OWNER: 1.Septic tank,effluent filter and dispersal cell must be serviced I maintained as per management plan provided by plumber. l✓' 2.All m I or the system and submit to the County unit paper not less than 812 x 11 inches in size as per applicab e coder ina� s� SBD-6398(R. 11/11) �� •'�y'! 1 .� :. .., ' � �. .. i tr)`} ��: Y/ i w.ti� �,i r •. i IIIII IIII II III IIII {I 8265126 Document Number Document Title Tx:4216744 St. Croix County °03494 BETH PABST Occupancy Affidavit REGISTER OF DEEDS p y ST. CROIX CO., WI RECEIVED FOR RECORD C� V ex; 10/27/2014 3:05 PM Name — (Owne4 Typed r ed printed EXEMPT #: p 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 a St. Croix County Register of Deeds Offi e: Recording Area A par I of-land located in the %of the�L%of Section I—, TIbN Name and Return Address —RAW, Town of St. Croix County, Wisconsin, being duly . described as follows (include lot no. and subdivision/CSM or detailed legal description): v)6Ru�- �\i U -am L©� �0 Parcel Identification Number(PIN) As owner of the above described property, I acl�powledge that the private onsite waste water treatment system (POWTS) serving this residence is sized for a 61-bedroom home or a design flow of �gpd. The design flow is calculated by assuming)5&gpd for_2 individuals per bedroom. There are currently occupants living in this residence; a maximum of Q)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, thi§POWTS may be subject to premature failure and/or will neid 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 22 day of_OC,6 e_- ' (>I U V AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) )ss. St.Croix County. ) authenticated this day of j� Personally came before me this day of U Vf J/T t e above named u(avt 0e TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s)who executed the foregoing (If not, instrument and acknowledge the same. ti, •4.s1.4�.. authorized by§706.06,Wis.Stats.) THIS[NrqUMENT��WAS DRAFTED BY: (j.. "' lu No ry Public,State of Wisconsin `? '• +� . (Signatures may be authenticated or acknowledged. Both are not My Com fission is pelnanent. If not,state,di iration,date:'.. C: necessary.) Date: �✓ '•r. 3 7 � "THIS PAGE IS PART OF THIS LEGAL DOCUMENT—DO NOT REMOVE" This information must be completed by submitter: document title.name&return address,and PIN(if required). Other information such as the granting clauses,legal description,etc.maybe placed on this first page of the document or maybe placed on additional pages of the document.Note: Use of this cover page adds one page to your document and$2.00 to the recording fee. Wisconsin Statutes,59.43. �,o ^RT4j DIVISION OF INDUSTRY SERVICES . 141 NW BARSTOW ST FL 4TH ti AN WAUKESHA WI 53188-3789 3 t 0 s P j Contact Through Relay S www.dsps.wi.gov/sb/ y �' �o www.wisconsin.gov RAF SS7t__ V Scott Walker,Governor i . Dave Ross,Secretary October 22,2014 CUST ID No. 226900 A7TN.•POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1432 120TH ST 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/22/2016 Identification Numbers Transaction ID No. 2466813 SITE: Site ID No. 807080 Oevering Homes Please refer to both identification numbers, 246 Legacy Ct above,in all correspondence with the Town of Troy agency. St Croix County SE1/4, SETA, S22,T28N,R19W FOR: Description:Mound Object Type:POWTS Component Manual Regulated Object ID No.: 1508048 Maintenance required; 600 GPD Flow rate; 22 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.01 101,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. The owner,as defined in chapter 101.01(10),Wisconsin Statutes,is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: This system is to be constructed and located in accordance with the enclosed approved plans and wi Mound Component Manual-Ver. 2,0, SBD-10691-P(N,01/01,R. 10/12) and the"Pressure Distribu ' n Com Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10� � O 4 , Q, ) , S� �4� OA, In the event this soil absorption system or any of its component parts malfunctions so as to Czard, the property owner must follow the contingency plan as described in the approved plans. I ry Downer must comply with the operation, maintenance and monitoring duties as descri in t mo com vent manual. A copy of this information must be given to the owner upon completion ' All holding/treatment tanks are to comply with SPS.38425(7)(a). c�CC 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. 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. SHAUN R BIRD Page 2 10/22/2014 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. Owner Responsibilities: • SPS 383.52 Responsibilities. 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). • SPS 383.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. SPS 383.54(4)shall be considered a human health hazard. • SPS 383.55 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. 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. 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, Fee Required$ 250.00 This Amount Will Be Invoiced. ,00Z��_� When You Receive That Invoice, Julia A Lewis-Osborne Please Include a Copy With Your POWTS Reviewer 2,Integrated Services Payment Submittal. (262)397-6005, Fax:608-283-7481 WiSMART code: 7633 julia.lewis @wisconsin.gov 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 the Department of Safety&Professional Services. Additionally, all IS(formerly S&B)codes have been renumbered and addressed in a"300" series. For future reference,the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. Cover Page 111!ce,vE OCT `8 2014 Shaun Bird INDUSTRY SERVICES Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 10/3/14 Owner:Oevering Homes Location: SE1/4 SE1/4 S22 T28 N,R19W246 Legacy Court Troy Manuals Used: Mound Component Manual Version 2.0 (01/31) Pressure Distribution Manual Version 2.0 (01/31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contigency plan 9-11. Soil test 12. Filter Specific i ns and cr s section Shaun Bird -�q<< Signature Y License num r 26900 NQ S` q� % F 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 SYSTEM ELEVATION 101.0' 1.2' sand lift DATE 10/3/14 BEDROOM 3 CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK 1 MOUND )00( SEPTIC TANK SIZE i gallons LIFT TANK SIZE DOSE TANK SIZE'W'? b� HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA `AW of chambers none IL BENCHMARK V.R.P. Top of 1/2" steel conduit ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H,R.P. Same as Benchmark All piping shall be SDR 30/34,within 10' Scale = 1 /4" = 10' of tank,piping shall be Schedule 40. Legacy Court Wel I is to meet al I WDNR setbacks Tank is to be properly bedded 1 Acre Lot and provided with Iockdown covers with approved warning labels B.M.* Pro Scale = 1 /4'1 = 101 99.8' N Bedroom B- 1 House Property Line Huffcutt Combo Tank AL Area 15' below system is to 2 Slope Grading is to be done to remain divert run-off away from undisturbed B-3 system B-2 100' 99 Property Line Mound System Cross Section and Plan View - - - - - - - - - - - - - - - " - - - - - """ — - - - - - - - - - ` Dimension Feet J B 7 D / Z i:c 4 M.1 1 1 1\•4 4' Zmu M1 4 4 4 4 1 1.4 1`1 1.4.4 1;1 1 4 4••• 1.4.4. 4.4.4.4 ' E F •J•r J l l l l•r r r r.r r r r r r r•t r 7+r4 Z{Mf1{t.iJtr1 r J J J. J•J .J S}i:a J r1{%f•r:r r�+ _ 7 {•1.4.4.4• •4•;•4K•M4 M4 •.•1• 1K 1• .J•J•J}•J•J••h•I •J•h•l•t l 4 .4.1.4.4 4 •J• •J•r+}•J•}r}•rrJ• Y f•f}J •4 1.4{1•M•1.1{4.1.1.4•L.4. •J•J•J.f•f.r r•J • .4.1 . •r�J•J t•I• }} •.•S •1.4.1.1 •{ ♦ • •rM•J J , •M4.1.1 •44.1.4•MM4•'�•4 4 1 Z�•f••j. . }JM.J•J.(l•J•J.l•l•f•J Mr r•I. .4. ..•1.•.•1.4 4 4 • •.J•J•l•r•J•..J J J A Yirti�C}ti}1' ::tiiL`:JJ'r�rt.;{1.15:}`}4. :'1}K.4};}x}`.}:}:}}tr.rt}yr.}.r.r.J.r.J.r•f.J.J.J:Jufti+J:..••4• r ` J1}?r{i:ii:�:}:il'J}{i1r:r`l�••r:}�}:};•�17}4J}I'�}i'}}H•li}}}:r}7}•}1}}}}i1}4�1 4 4 Lr4f1Jti}4}J••l;}l•J7J'J ' 1 W Z i G - T T H b J i i K t L �! -- - - - - - - - - - - - - - - - W 72 ,I K B Z Slo e L I III t 1 =Topsoil — ASTM C_33 •1.1.{4J•4 Clean aggregate O =4 in, sch. 40 pvc r.J•J � Cap Material sand fill :��:�:� '/�to 2 '/2 in. dia. obse rvation pipe El I Geotextile G H Fabric J.: 4{4{1{4{1•Z:4i{ 4.4. F 'f�fir LJI•7J�}4fw411��r• ;'.: ; : : :'. �ef� / / /.{ 1.1{ 4.4 4.1.1.4•}4. � L4! /1/�/ 1 L D E Plowed Surface 9t9 Ft Contour Slope Direction GENERAL INSTALLATION: The mound area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The mound basal area (L x W) is plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a '/4 inch soil wire when a sample is rolled between the palms of the hands. ASTM C-33 quality sand is placed immediately after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or is placed overhead by a backhoe. Special care must be used when placing sand of less than one foot thickness to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire mound is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The observation pipes are slotted in the lower 6 inches and secured in place with rebar or a closet flange. 10/07lgj Page of Pressure Lateral Layout Two Laterals — End Manifold -- 'Threaded Cleanout Lateral Turn-up ---► Plug Manifold M X -- �' L. - Long Sweep Force Main 90 Bend Distribution Network S ecifications pressure System Construction Lateral Diameter �- In. ' Manifold Diameter . In. Laterals are constructed of Schedule 40 PVC Orifice Diameter � � Zin. pipe. Orifices are drilled perpendicular to X Orifice S._pacin� tn. the pipe with a sharp drill bit and face down. L Lateral Len th Ft. Lateral turn-ups terminate with a threaded M (Manifold Len th y Tt. cleanout plug and are enclosed in a 6-8 inch In. diameter lawn sprinkler valve box accessible Force Main Diameter _ 2•- from finished grade. Force Main Length G' I't• • • • • • Grade • • • • • • • .;�.:: .:::...: : . ..: 6-8 Inch Lawn Sprinkler Valve BOX Page —of 03/05 19)' Septic-Dose Tank Cross Section And Pump Performance Specifications Sep �` Tank E anufacturer Pump Manufacturer - Tank odel Number � Pump Model Number 1.�Z-- Alarm Manufacturer Total Tank Capacity Alarm Model Number ?cs ✓ Max. Bury Depth Switch Type Total Dynanuc Head(TDH) - Feet Filter Manufacturer Elevation Head />� Filter Model Number Distal pressure Network Loss Minimum Pump performance Required Force Main Loss • �7 ---_ TDH Total outlet Manhole Min.4"Above t'r'ade With Manhole Min.4"Above Grade Locking Device. Inlet Manhole securely Mounted With Locking Device <6"Below Grade Sealed Watertight Weather-proof -----r - junction Box - .. .� Finished Grade _0 Vent Min. 12" Disconnect Above Grade Means With Vent cap X. outlet Filter Inlet '< �_____ _ - Inlet Bale >: A L!4" Switch S Reserve Capa�ty Weep Hole Tank Volume= '1 GPI B Dimension, Inches Volume Gal. (reserve}A' -,S >; Off Elevation C (al g 2 ; : Ft Bottom (dose) c / D Elevation Ft (dead) D > Total '=/S" ,.;:.<•:. and tack fined in accordance with the INSTALLATION: The septic/dose tank is bedded s�ified by the imanufacturer may not I depth o bury k GENERAL um a (padlock) GE Maxim doP ve lucking devic (p al effocti manufacturer s product appmv specifications. to grade have an t fittings, and be exceeded without prior approval. Manhole covers exposed to the tank with Wate�gl► the inlet and outlet is of approved material, connected 4,�Sch.40 pVC to bridge the tank installed. Piping force main is sleeved with laid on stable soil to ptrevent��'ng or saggn►8 ice complies with NEC 300 and Comm 16.26. excavation and the sleeve.is sealed wti ght. Electrical sue' Page_____ of 02105 U E R WNJ'�C ND L CURVE HEAD CAPA,' ' - i 103 WDEL 152/ L-j lW r-7 Z; 2 r.153 23' 43 12 52 - 4 4 42 < V C) 20 4--1 0 4V 00 I C)O� 20 GALLONS I '20 0 LITERS 8.3 "60 24C FLOW P p, NIINL.7E M APPLICATIONS CONSULT FACTORY FOR SPECIAL Va •Timed dosing Panels available. are available and supplied with Electrical alternators,for duplex systems an alarm Variable level control switches are availab,e for controlling single phase systems. e for variable • level float switches are avail& Double piggyback variable • level long and short cycle Sealed Qwik-BOx available ontrols., aa for outdoor ins;allations.See FM 420, •over 130°F.(540C.)special quotation required. 1521153 Series 1/6 — 52JI53 MODEL SI � I C Lnojl I g-lex M D M yo!q.Ph Mo de�m Sinplex —� SK'064 N52 115 I Non 85 3 5 2 or j -1 :jBN �j I Auto 2cr3 T--N—,n 0 1 '-- I E152 2% 1 — 4-3---T 2or3 —�u A 1�. —2�� or 3 �2330 or �BI15 2 1 SELECTION GUME 115 piggyback variable level float 2°r 3_t N153 115 1 Non 105 FjN-153 115 1 Auto 0.5 nclu.le(l 1 Single piggyback,YXIaDle level float TIVitch or double -:: �51 .1 i 2 or 3 E 153 230 1 n 5.3 1 switch. Refer to P�0477. BE1531 230 1 Auto 53 Eii,L:�ii——' �—0,�—� model of Electrical Alternator E-Pak ME�tt 2. See F[�j07',2 for correct MO control activator.specify duplex(3'; [A:j—CAUTION:1 g should be done by a qualified 3, Varaoie level C0,11rol switch 10-0225 used as a C All installation Of controls,protection devices and wiring ed including the most or(4)float system licensed electrician- All el�rjcal and safety codes should be follow recent National Electric code(NEC)andthe OrcuPatorlBt Safety and Health Act(OSHA). RESERVE POWERED DESIGN ' For unusual cudiffons a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: RD 2Qx 6347 Lovisvilie.Ky 402560341 SHIP TO:3649C6r?I R,jj Road- 11ALlrr 104IM"15'51*rr iouisviiielKY 40211-1961 /(502)775-2731 1;800,'425 PUMP FAX(502)774-3624 httpj1www.zoe11er-00n`7 rights reserved. @ Copyright 2000 Zoeller Co.All, -------- w I I I I I � Z I � � I r W rrl 57' vDi 50' 7• m 'N" 3' 47' N � m I C3 � M N DN cvi�1 ro fT1 1+31= r cNi m 17= tDd r---- Q' < rr m Imo= z 0 r m I � .�� m� IUI-I' C3 m A w ITl Z ti 1 0 Tl I w v7 m vC �� �� 200 2• i ;o� I I w L_______________________ D Z 7C r W BCD m D Z z II II 0 Z N N Q Qo w b 0 13 V r I I Ll � I I m A Z Q1 ID -u C _ C C < lc� N D 0 D D £ N 7r D N l7 'IZ Oy r D? 6.5' m m Q z rri cr D nt1�q -4m d� n m 0 0 C � m r D Z m m u O? 0 ODU -u 0 11 II O 0 Dm mr V 70 O C Z 'V m m 0� N C-) m m M 3W � Dm Ll m b C d N D m 1 m!; In t7 r 0 m D.. m l7 m= N� O O 4$' 9' O mm Z r0 p 45' :L7 r�Tl A r Cl A !7 1 ,T)O W D m< (7 c m N A Ll< Dm v NZ z D D fU PROJECT, HURCUTT 4154 A FALLS, STREET N.P.C.A. CERTIFIED PLANT CH]PPEWA FALLS, WI 54729 �� FU 1,250/750 (715) 723-7446 Ni (800) 924-1516 � MEMBER OF: C 0 A C R E T E. I A C FAX (715) 723-7111 w www,huffcutt,com o NATONAL k WISCONSIN PRECAST CONCRETE ASSOCIARONS SNOLLtlpOSSV 31380NOO 15VO3ad NISNOOSIM V 1VNO11VN g woD-j}n�4dny�MrM x IIIL-62L (91L) XVJ 40 2138W3W 9ISI-626 (008) 1 966L-62L (SIU °UI 313 b 0 V 0 3 NNVI 3I1d3S 80 dWnd N E- 11n���nH ��1 NOT W) OSL/OS2'I C 28 v �'� 62L6S IM 'S'lltl! tlM3dd[H3 1❑3f'❑21d AVld 0314112133 'd'C)'d'N '19 133211S PJC21 bSTb 13uno I I m v LO �o I L I .6E .6E I I AL CU i 3 ^ a j 0 10 o in v Z W Li ¢ ¢ (L CL w C3 C3s J � v T I I I '89 I I I I '2L I .8L z z w o„ _ d¢ (L a(L N v W 3333V9 I I 131N1 r TODD 131 e e S TE©7- t'roperty t7xnet Parcel ID# of 3� E) BO ff-3k u s-ss t Groundsuriaceetev. ft_ i)eptir to limiting factor kt. Soli Rate tivrizott_ Depth DornkmtColor Redox Des On Texture Structure Consistence Roots Dots GFDl1F in. Munseti Qu.Sz Cont.Color Gr.Sz.Sh. / o-G 10YR 5/3 L If ShK S w •F- . S . � 2 G• l o/ 3 qI / •22- / 1, Z,wtS CS / • S ytoe 2 .S c o is �/G L /-FS h � . Z • 3 F—] # ac-in ' Fit Ground surface elev. ft. Depth to limiting factor in. Soti irzarr Rate Horizon Depth 6ominant Redox Description Texhue Structure Consistenoee Boundary Roots Gtr Mansell Chi Sz. Corti.Color Gr.Sz Sh. 'Efl#1 •� 1 Sonng# El Bor>ng Q Fit Ground surface elev. ft. Depth to faruting facto/ In. Soil Applicadon Rate Horizon Depth Dominant CoW Redox Description_ Texture Structure emsdary Roots G in. Munselt Qu.Sz Cont.Color Gf Sz.Sh. 'E##1 'Elf#2 Baring# Boring i S a 5 F-I Q Fit Ground surface elev. 0 Depth to Depth fara . Soil Appkation Rate Horizon Depth DomwianlCokw Redox Descdption. Texhwe Struck" Consistence Boundary Roots GPON in. Munsell Qu,Sz Cont.Color Gr.Sz Sh. 'Etf#1 'Eif#2 i 'Effluent#1=Btu?,>30:S 220 mg&and TSS>30:S 150 nxilt. °Effluent#2=BOD,130 mglt.,and TSS 130 mglL 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,pleases contact the department at 608-266-3151 or TTY 608-264-8777. IL seoazmr2�mor r �w~i wwjn Department orCommerce SOIL EVALUATION REPORT Page / of 3 Division of Safety and Buildapgs in accordance with Comm 85.Wis. Adm. Code Co G/X— •V Attach complete: C include,but not a, EROSION CONTROL PLAN must be Parcel I.D. �^ percent slope,so completed before sanitary permit issuance L c�T fr— ��� b wed by Date Persons!htomaSon Vou provicie may be used for secondary purposes(Privacy Low.s.15.04(t)(m)). Property owner TODD) /, Property Locaation p TV PP 133ERS T�f�� % 410^)�liy GovL Lot I41/ 0*4 5 1/4S ZL T 2B N. R // E(or)W Property Owners Mailing Address Lot# Block# Subd Name or CSM# &D►S CA It LL AV-2 • 30 WAL"O r w i I City --CMWR State Zip Code Phone Number ❑City ❑Village 15d Town Nearest Road 6*or t f T% MN 5507(P ( &Sl)a'/8. 10f 1 TRoy o- t©DER 0 New construction Ilse:[9 Residential/Number of bedrooms 3 code derived design flow rate r D s� GPD �► ❑Replacement ❑ Public or cornmerdaal-Describe: - .- to Parent material 1PE55 AA4 f P Flood Plain elevation if applicable fL � General comments and reoararrendations: • ,+R&,f• TES 7-eZ) SS01 T/te1j!5:' /10�2 N Boring# 0 Boring ® Pit Ground surface elev. ft. Depth to raniting factor in. Rate Horizon Depth Dominant Color Redox Description Texture Strukitcxe Consistence Boundary Roots b in. Munsell Qu.Sz Cort Color Gr.Sz.Sh. `Etf#1 `Eff#2 / 0-9 /o /t'31 L 2,w, sh Cw • 13 /0 f ----- L If s Cs • 4 %A /? /0 Y�e Y//, F 7•S l/ z� �o rs S/o� -e • Z •3 ® Pit Ground surface elev. ft. Depth to limiting factor _ min, Sod Applicadon Rate t„ Horizon Depth Donanant Color Redox Description Texture Structure Consistence Boundary Roots GPDff in. Munseli Qu.Sz. Cont Color Or.Sz Sh. `81#1 `Ef1#2 (� l 0- 6 10,114- 313 L �f S Cw 3 f. 5 N Z z f L 1 S o(SA I cS /If •z /o l Y16 2/0-1 h C • S C zd- h0 1-s • 3 Effluent#1=BOD >30:S 220 ngfL and TSS>30 1150 mgfL `Effluent#2=BOD <30 and TSS 5 30 mg(L csr�(Please Prird)R.'ZtL61'2 i G�.`I'"— Signature aZ�ri�r i4dd`ess Ulbricht &Associates � e Private s�� 7s, �7 �yy 2,_ 2812 10th Ave. Spring Valley, WI 54767 \) . oyD • /o8S • so • o� oyo . f©S(, • /o • OW oya. /09(p - zd • ov'o o yo /o'?G CV° oyo • %��� - 70 . 01" oyo - io�t� �o • oaa i 4'+ PLOT- PLAN WALNUT HILLS FARM. LOT # 30 Pg. 3 of 3 d = Contour elevation lines. a = Backhoe Soil pits. Q = Benchmarks set, maRKED WITH FLAGGED lathes. 1/2" steel conduit pipes. dej SCALE: 1 ®®• tq f 3 jq sv6 & yip o w"V/ 1140 11,V 10 i �` �Nom-.. / D�• � • S U STEP ,Mo u� y90 Sys rl r qg - � /o% i7 i 2 QO,��. 0,41 , ► I TRUCTION FILTER CARTRIDGE 1, ,U Installation outlet pipe to ensure re it is case onto the end 0 fthe PP fitter ca the STEP e Dry fit the Into centered under the access opening. If not, then either Insert more pipe tank through the outlet or solvent weld (glue) additional pipe onto the outlet pipe. STEP 2 While the case is still dry fitted on the outlet pipe, measure the length of 3/4-inch pipe needed to brace the filter side to the tank end support method wall if tilizing the optional supplemental side supp proceed to step four. STEP 3 For installations utilizing the optional supplemental side support: solvent weld the 3/4-inch pipe onto the filter case. If side support method is not utilized, proceed to step four. STEP 4 Solvent weld the filter case onto the outlet Pipe. Insert the filter cartridge into the case, pressing down until the filter locks into the bottom of the case. STEP 5 If a VRS switch is utilized: insert into the filter and lock by turning clockwise 90°. Maintenance 1. The effluent filter should be cleaned every time the septic tank is serviced. 2. Open the outlet access opening to inspect the tank and filter. I f 3. pump the septic tank completely, making sure to remove the sludge ; v layer on the bottom of the tank and not just the scum and effluent, 4. Once the effluent level been lowered below h the outlet pipe,fimlY pul up on the filte handle to dislodge te cartridge from the case. 5. Slide the cartridge up and out of the case for cleaning. f VRS switch connected to an alarm is present, the switch ed6; o n If a lea 6. and c rciac kw {se 9 0 n counterclockwise should be removed by turning with water only. 7. While holding the cartridge on its side (large flat surface facing down) over the access opening, rinse off the cartridge with water t material is rinsed back into the tank. only, making sure all septage , 8, If VRS switch is utilized, replace by inserting into filter and turning clockwise 90°. tl u 9. Insert the filter cartridge back into the case, pressing down until the filter locks into the bottom of the case. 10.Replace and secure the access opening on the tank, BEAR QNSIIE"FILTER CARTRIDGE-FIVE-YEAR LIMITED WARRANTY s_ar Ons.te _-onsumer pur_tase. BEAR QNSTFET'Fit ter case-Lifetime Limitedl warranty E .sunny na . 'AR, u t nE:l 6 C'f ci E d .0 l i.1d3 t U'1 y dl d esLjlt rq IT 5 J .XI{_ P '!'FC tc Sc l' ..d.a,,....,,.o ,i; r+t. • . 3 c tP, d 4Ft . _... 1 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of SYSTEM SPECIFICATIONS FIt.E INFORMATION Septic Tank Capacity al ❑NA Owner PT Septic Tank Manufacturer ❑NA Permit# 2 Effluent Filter Manufacturer d- ❑NA DESIGN PARAMETERS Effluent Filter Model ❑NA ❑NA ❑NA Number of Bedrooms A Pump Tank Capacity ,� -- al Number of Commercial Units . NA Pump Tank Manufacturer Estimated flow(average) ❑NA I Estimate x 1.5) W aUda .Pump Manufacturer Design flow(peak), d( Pump Model J j Z 0 NA 0 l/d Soil Application Rate � Monthly average` p ent Unit ❑ Peat Filter I fluentlEffluent Quality p Sand/Gravel Fitter ats,Oil&Grease ( ❑Wetland FFOG) 530 mg/L ❑ Mechanical Aeration Bioc�lEmical Oxygen Demand (BODE 420 mg/i- ❑ Disinfection ❑Other. Total Suspended Solids (TSS) 5150 m /L Manufacturer Monthly average" Dispersal Cell(s) ❑ In-ground(pressurized) Pretreated Effluent Quality AO mg/L ❑In-ground(gravity) ,gund Biochemical Oxygen Demand (BODs) ❑At-grade Total Suspended Solids (TSS) 530 mg/L ❑ Dri .ne ❑ Other. Fecal Coliform(geometric mean) 5104 du/100m1 Y8 inch diameter Values typical for domestic(non-commerdaQ wastewater and Maximum Effluent Particle Size septic tank effluent. •. Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Frequency Service Event At least once every C1 month ear(s) (Maximum 3 yrs.) Inspect condition of tank(s) When combined sludge and scum equals one-third(Y,)of tank volume Pump out contents of tank(s) At least once every [3 months ar(s) (Maximum 3 yrs.) inspect dispersal cell(s) � ❑ month year(s) At least once eve ry i Clean effluent filter ❑ month ear(s) ❑ NA At least once every ar(s) ❑ NA Inspect pump,pump controts&alarm ❑months At least once every Flush laterals and pressure test At least once every ❑ months ❑year(s) ❑ NA Other At least once every ❑ months ❑year(s) CI NA e 0W. MAINTENANCE INSTRUCTIONS inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or cto f POWTS Maintainer; Septage certifications:ations: Master Plumber Master Plumber Restricted Sewer, Po4riWf het tanks)to identify any missing or broken Servicing Operator. Tank inspections must include a visual Inspectio backup hardware,identify any cracks or leaks, measure the volume of combined sludge and scum ��tkheoeffiuent levels or ponding of effluent on the ground surface. The dispersal cell(s)shall be visually inspected PeC ponding of effluent on the i es and to check for any ponding of effluent on the ground surface. The Po g in the observation P P authority. ground surface may indicate a failing condition and requires the immediate notification oor more the tank the a Septa a Servicing Operator and disposed of in accordance with ch. NR When the combined accumulation of sludge and scum in any tank equals one-third(Y,) entire contents of the tank shall be removed by 9 113,Wisconsin Administrative Code. ntcat or pressurized POWTS components, pretreatgment components, and any The servicing of effluent filters, m p performed by a certified POWTS Maintainer. other maintenance or monitoring at i ervals of 12 months or less shall be Pe letion of any service event. A service report shall be Provided to the local regulatory authority within 10 days of comp products or other START UP AND OPERATION If high concentrations are For new construction Prior to use of the POVVTS check treatment tank(s)for the presence ig painti ng e the treatment process and/or damage the dispersal cell(s). 9 chemicals that may impel a septage servicing operator prior to use. detected have the contents of the tank(s) removed by Page ._ _of for the presence of painting products or other chemicals thr_It START UP AND OPERATION ell g If high concentrations are detected have the contents of th1:p0VVTS For new construction, prier too use the damage the dispersal saltcta ( )s) may impede the treatment p operator prior to use. tank(s)removed by a Septage servicing o hwoter levels. When Power is restored or the discharge Wastewater effluwill eril- - System start up shall not occur when sail conditions are rmaf frozen at the infiltrative surface. t�n the backup power to the pkjring power outages pump tanks may fail abov the cell(s)and may rest rior to restoring p lank removed by a Septage Servicing Operator p averloading discharged to the dispersal cell(s)in one large dose, operating the pump oontrols to restore normal leve!s tion To avoid this situaont have the contents of the pump , the area within effluent pump or contact a Plumber or POWTS Maintainer to as in manually p r otherwise disturb or comps within the pump tank. cells. Do not drive or park over, o Do not drive or park vehicles over tanks and dispersal roiong the rife of the POW"�3: 15 feet down slope of any mound or at-grade soil absorption area. improve the performance and p irons the wastewater stream maY dental floss; diapers; disinfectants; fat foundation g u Reduction or elimination of cigarette condoms; cotton swabs; degreasers; s medications; oil; painting p antibiotics; baby wipes; 9 vegetable peelings; gasoline; grease; herbicides; meet scrap ; (sump pump) water; fruit and pesticides;sanitary napkins Tampons;and water softener brine. ABANDONMENT steps shall be taken to insure that the system is propeSlY When the POWTS fails and/or lie permanently it chp ek Comm t33 33,,Witsconsin Administrative Code: and safely abandoned in P e openings sealed. its shall be disconnected and the abandoned pip p a Septage Servicing Operator. q� • All piping to tanks and p' rl disposed of by • The contents of all tanks and pits shall be removed and properly • After pumping, all tanks and pits shall filled with si be excavated and removed or their covers removed and the void space gravel or another inert solid material. li,N nt CONTINGENCY PLAN repaired the following measures have been, °r must be taken, to provide a code comp • If the POWTS falls and cannot be p replace soil absorption systelm- replacement system: re uiiled rotected from disturbance and compactton and should not be infringed upon by 4 ❑ A suitable replacement area hasebeen evaluated and may be utilized for the location s replacement area infringed result the rulerled The replacement area should b p must comply with setbacks from existing and proposed structure,tot tines and wells. Failure to p for a new soil and site evaluation to establish a suitable replacement area. Replacement systems ces in POWTS technologif r effect at that time. ❑ A suitable replacement area is not s{aileSabol due placetthe avted,POWTSmitations. Barring advances a soil and site evaivatjio oling t ank may be installed as a is n failure of the POWTS be installedi a site has not been evaluated to Identify a suitable replacement area. Upo s l e rforrned to locate a suitable replacement area. if no replacement area is available a hooding tank may a infiltraIN u t Pe a last resort to replace the failed POWTS. removal of the biomat at th be reconstructed in place �Mound and at-grade soil absorption s{cysts musmcomply with the rules in effect atithat time. e. Reconstructions of Y <SEPTIC,ING >> CONTAIN LETHAL GASSES AND/OR INSUFFICIENT AY RESULT. RESCUE OC SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY ER A SEPTIC,PUMP OR OTHER TREATMENT TANK FFICULT OR IMPOSSIBLEANCES �►F-�►T TENT F A TANK MAY BE PERSON FROM THE INTERIOR 0 ADDITIONAL COMMENTS ----- pOWTS MAINTAINER M NSTALLER Name r l e cis-c.� � Phone �/J:-(�ne 7/cl p? LOCAL REGULATORY AUTHORITY SEPTAGE SERVICING OPERATOR LIMPER Name ✓Ji Name y� Phone Phone n document was drafted in compliance with chapter SPS 383.22(2){b}(1)(d)&(f)and 383.54(1),(2)&(3),Wlse;onain Adminrstrative Code. This I ST. CROIX co,tfNTy SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERS111P CERTIFICATION FORM Owner/Buyer Mailing Address Property Address 10�(Ve-fification req d fro amal City/State. 119&ZO -�Pa r t�n t&T 1-1 e construe LEGAL DESCRIPTION Parcel Identification Number-0 Property Location V4, Sec. Z , T 2 N,R -W,Town 01' 1 f 19 Subdivision ------ Lot#-3o Certified Survey Map# Volume Page# Warranty Deed# pec house 0 Volume Page S SYSTEM MAINTENANCE AND Lot lines ldentifiable0o, ND Improper use and maintenance of your septic system could result ill its premature maintenance consists of pu - failure to handle wastes. Prop the system can affect the function 'talk every three years Or sooner,if needed,by a licensed pu rnprug out the septic uinction ofthe septic tank as a treatment stage in the waste disposal Systern. Owner rmintenanc responsibilities are specified in InPer_ What You put into Co§Cnmn.83.52(l)and in Chapter '2- St.Croix county Sanitary()rdinance. The property owner agrees to submit to St.Cr Owner and by a master plumber,journeyman pi er,Croix County Planning&Zoning Department a certification form, wastewater disposal system is in proper opera unib Signed by the -restricted Plumber or a licensed pumper verifWng that(1)the on-site, less diau 1/3 full of sludge. t'U9 condition and/or(2)Hite,•inspection and pumping(ifnecessary),the septic tank is Uwe,the undersigned have read the above Standards set forth,herein,as set by the Department requirements and agree to maintain the Private sewage disposal system with the Certification stating that your septic system h of Commerce and the Department OfNatuxal Resourcs,State Of Wisconsin. as been maintained must be completed and returned to the Stec Zoning Department within 30 days Of the three year expiration date. roix County Planning& 1 1we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owners)ofthe Property described above,by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms XL� -'�YGNAT OF AiPL1C�ANi(—,§)-- 'Any information that is misrepresented may result in the Sanitary permit being revoked by the Planning&Zoning Department- fnclude with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified st reference is made in the warranty deed. H-vey map if (REV.08/o5) 715-386-4680 pam.quinn(c�r�,co.saint-croix.wi.us From: Laura Meuwissen [mailto:Laura @OeveringHomes.Com] Sent: Wednesday, October 22, 2014 8:00 AM To: Pam Quinn Subject: 246 Legacy Court River falls WI Morning! Wondering if you can send me the form I need to fill out for an affidavit to deed on this property?Thanks! LAURA OEVERING HOMES, LLC 715.243.0001 i 2 Pam Q uinn I From: Laura Meuwissen <Laura @OeveringHomes.Com> Sent: Wednesday, October 22, 2014 8:24 AM To: Pam Quinn Subject: RE: 246 Legacy Court River falls WI Thanks so much! I'm still learning how to do this stuff so I appreciate all your help! LAURA OEVERING HOMES, LLC 715.243.0001 From: Pam Quinn [mailto:Pam.Quinn co.saint-croix.wi.us] Sent: Wednesday, October 22, 2014 8:21 AM To: Laura Meuwissen Subject: RE: 246 Legacy Court River falls WI I don't have lot 30 of Walnut Hill Farm on our list of permits we've issued yet. You can certainly get the affidavit recorded ahead of time. I sent it as a word document so you can type in the parcel number, legal description and the necessary items for number of bedrooms, max. occupants (2/bedroom) and design flow(150 gal.x#of bedrooms) Pam 2ufnn, Land Use Specialist (POW73) St. Croix County Community DeveCopmen.t Dept. nol CarmichaeCRoad '4udson, 'W-T 54o.t6 715-386-468o pam quinngco.saint-Croix.wi.us From Laura Meuwissen [mailto:Laura(EbOevering Homes.Com] Sent: Wednesday, October 22, 2014 8:15 AM To: Pam Quinn Subject: RE: 246 Legacy Court River falls WI Yes it is and yes it does I believe, I don't have it in hand yet but I think shaun said it was ready? LAURA OEVERING HOMES, LLC 71 5.243.0001 From: Pam Quinn [mailto•Pam Quinn co saint-croix.wi.us] Sent: Wednesday, October 22, 2014 8:07 AM To: Laura Meuwissen Subject: RE: 246 Legacy Court River falls WI Laura, is this for a larger house than the size of the septic system? Does it have a sanitary permit yet? Pam 0-uin7,4 L'andUse Speciatist (POlVVTS) St. Croix County Community Development Dept. noc Car}nic:haeCT oad 914c6on., W1 54oi6 i Ad Il�x, Wnd,_ 61 (715)248^3010 m- O ARE .n« ,.,ff ,V YeE _ NOTICEI MI x ownnEe YOagaraxwi. f IIII tl .I I Oevenng Homes — .I I 14-12 Burnt/Hanson — I ELEVATIONS I E�H F� rxoxr ax 16 SO. 465 SO. 696 SO.PT. FINISHED ISHED D GARAGE UNFINISHED Al MAIN 8 UPPER LEVEL LOWER LEVEL NNW, (715)248-3010 ---------------- T-------- e- --------- ----- - - -------------- NO�CEI.,... ------------------------ Cl ----------- ---------- ---------- w°,wue are t---------------- ----------- - ---- --------- ------ ------------------ lr�l —---------- j ------ -------- ------ -------- BRACED WALL LINE PANEL DETAILS Oeveiing Homes W213unh/Henson FOUNDATION A2 F,l wla� (715)248-3010 it NOTICEI Cl (D 6! BRACED WALL LINE PANEL DETAILS Oevedng Homes 895 SO.FT. MAIN LEVEL 14121ilurthlHenson MAIN LEVEL ----------- A3 IW 1'5`)�2'4*8-3��0`1,0—_ --—-—-—-—-—-—-—-—-—-—-—-—---—-—-—-- ----------------------------—-—-—- ----------- ------------------------------------ NOT'T ILI> ------------ 16 A ------------- --------J! ------------- --------------------- ------- BRACED WALL LINE PANEL DETAILS Oevering Homes 795 SO.FT. UPPER LEVEL 1412 Bunh/Hanwn UPPER LEVEL --AM-11 A4 111111111111111111111111111 li 8194391 Tx:4161632 STATE BAR OF WISCONSIN FORM 3-2000 9$$962 QUIT CLAIM DEED BETH PABST Document Number REGISTER OF DEEDS THIS DEED, made between Citizens State Bank, Grantor, and Oevering ST. CROIX CO., WI Homes,LLC,Grantee. 11/12/2013 2:46 PM Grantor quit claims to Grantee the following described real estate in St. EXEMPT#: N/A Croix County,State of Wisconsin(the"Property"): REC FEE: 30.00 TRANS FEE: 636.90 PAGES: 2 Properties sold`as is'. SEE ATTACHED EXHIBIT A Recording Area Name and Return Address: Title One File#20076 a Together with all appurtenant rights,title and interests. see attached Parcel Identification Number(PIN) This is not homestead property. Dated this 8th day of November,2013. Citi State Bank 'k U-A, * ene Habetman,'Vice Chairman * * AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) ST CROIX COUNTY. )ss. authenticated this 8th day of November,2013 Personally came before me this 8th day of November, 2003 the above named Citizens State Bank to me known to be * the person(s) who executed the foregoing instrument and TITLE:MEMBER STATE BAR OF WISCONSIN ackn9wk4ed the same. (If not, .... authorized by§ 706.06,Wis.Slats.) /0 M• 4T-velyn W Jaeger THIS INSTRUMENT WAS DRAFTED BY Z ;'NOTARY: °; Notary Public,State of Wisconsin ` P116 My commission is permanent. (If not,state expiration date: Michael H Forecki,Attorney :•q • ;t 12/11/2016 ) (Signatures may be authenticated or acknowledged. Both are not n "Names of persons signing in any capacity must be typed or printed below their signature 1 of 2 QUIT CLAIM DEED STATE BAR OF WISCONSIN FORM No.3-2000 i l File No.: 20076 EXHIBIT A Lots 1, 6, 30, 34, 41,64,and 71 of Walnut Hill Fann,Town of Troy, St. Croix County,Wisconsin. Lot 41 of Walnut Hill Farm,Town of Troy, St.Croix County,Wisconsin; together with driveway easement over lot 42 as shown on said plat. PIN 040-1303-00-001; PIN 040-1303-00-006;PIN 040-1303-00-030; PIN 040-1303-00-034 ; PIN 040- 1303-00-041; PIN 040-1303-00-064 ;PIN 040-1303-00-071 2 of 2