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HomeMy WebLinkAbout040-1318-00-055 . Croix Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St Safety and Building Division INSPECTION REPORT Sanitary Permit No: 572844 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: 040-1318-00-055 Creative Homes, Inc., c/o Nathan Hidde Troy, Town of CST BM Elev: Insp. BM Elev: J BM Description: Section/Town/Range/Map No: 146pS L-7 M G5T' 11.28.19.2130 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. 44- 'tn W /Odd Benchmark 2. T Septic ~f J +~'v✓ -ii4-1 ` Alt. BM Dosing y~ 3 D w't~o~ Aem-Rftn Bldg. Sewer g • ` Z MAP t Holding St/Ht Inlet V q1 St/Ht Outlet TANK SETBACK INFORMATION TANK TO RIL WELL BLDG. Ven to Air Intake ROAD Dt Inlet Septic Dt Bottom ~3• 16 5 7• y Dosing Il^r / A4 s' Header/Man. 3,4 /Q(.7, 3 .66 s4 r Aeration Dist. Pipe 3 I aV 3 Holding Bot. System ` 4 • Lo Final Grade Z 4 /O ` rd, PUMP/SIPHON INFORMATION Manufacturer Demand St Cover G (o, / GPM Model Number 16-7s,77,5, Z, /D(P (3 /V d r1 oJ.r TDH Lift. Friction Lo~Zs Systems e TDB ~jt ~H1 / Forcemain Lengti o Dia. Z t Dist. to well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length NoAe Trench PIT DIMENSIONS No. Of Pits Inside Dia.` Liquid D` DIMENSIONS ~s I-`' SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM CLEA CHIR OR Manufacturer: INFORMATION Type 0 System: UNIT Model Number: DISTRIBUTION SYSTEM y Distribution x Hole Siz x Hole Spacing Vent it Intake Header/Manifo}d Pipe(s) ✓ Z, Length Dia Z Length s4 Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only ~.c Mu ed Depth Depth Over Over xx Depth of T Seeded/Sodded Hnspectio Bed/Trench Center Bed/Trench Edges Topsoil Yes Yes No 1 COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 2: o: 11.28.19.2130 Location: 474 Prominence Way Hudson, WI 54016 (NW 1/4 NW 1/4 11 T28N R1 9W) Hills of Troy Lot 5~ n 1.) Alt BM Description = P. 11i 010 2.) Bldg sewer length - amount of cover = 0.J Plan revision Required? - Yes 1*f No Use other side for additional information. 4LInsepctors ---JJJ Cert. No. SBD-6710 (R.3/87) Date PLOT PLAN PROJECT Creative Homes ADDRESS 707 Commerce Drive Suite 410 Woodburv Mn 55125 MN 114 NW 1/4S 11 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROix SYSTEM ELEVATION 1066.5 DATE 10/17114 BEDROOM 3 CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANS SIZE 1000 gallons LIFT TANS SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE . LOAD RATE 1.4 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. Top of survey Iron ASSUME ELEVATION Filter BEAR Filter 1.068.27' ❑ BOREHOLE 0 WELL %H,R,P, Same as enchmark I All piping shall be SDR 30/34, within 10' To Promi nance Way of tank, piping shall be Schedule 40. Scale = 1 /4" = 10' tank is to be properly bedded and provided with lockdown ~ NHo 3 covers with approved warning WelI is tom t II oom labels WDNR setbac e 300' Property Line 1.1 Acre Lit L©T Scale =1/4'1 = 10' 1066' S Huffc ACombo 6%, l.* 65.5' V11, BBB ❑ La t" System-I s-to-be - - - - - 15'7 installed along a uniform contour of 6%'Slcpe 1065.5' a m 61C N Drainaae Easement grading is to be done to divert run-off away from system g- D Property line q j 1064' Li ne Property UV P 7f N i i 54 t l S pQ 6,~~~ i r I { I { 17 M I 1.051 1 ACRES f IV J, 45,779 S.F. 1 " \ r 8S Stapo, 1ss.L._._._-i L-------I i ! Cal hQ r f-...°, 001 E 239 ggr 132.00` 132.00' { NI j N N 90°00' 00" E 264.00' 2~ J w f 7 0 66' WIDE SHARED S I6000f 325' 1 f ORf vEblr I F f ~ °t j 50, r j N 90-00' 00„ E 272.35 AYES c g j 2.318 ACRES f 216.14' 56.21' 60 Qoft E ~47• ~ 1 " ~v r 100,978 S.F. v i r aa-ID8361 50' i 55 i i ~6 • 2. a j' L4 r j 12.714 ACRES/ / t -t Z ' 118,212 S.F.% 1.043 ACRES j 3 1 24 apt wW . 45,422 S.F. i Sot LBO= S, 1063.61 L-u WIDE INGRESS o o ./,S^ "ry l r37 FECOAD-40- w) PAC 4071 c~F~ o oua G~2 1.000 ACRE 3 f cn F.4' ° n qkr _43,560 S.F. / to .04• ~~P ^•-S jy 2~, Opp, 1.1• J / N / a '``~•,:,Z17~' 6 to 07 1.085ACRE S $ 9 ° o n 47,091 S.F. % t , • o •3 cu 1 e` ~ ?"~°20QG'1~;,~`~tzs,~'~' ~ ' t~~o r, aQ r Q , ` 2 t4° w (?rjrC0 2 oar t^ ry o 44- UN'L A T TELL LAND X20 ~ There are no objections to this platwith respect to pq„ a s. 236.15, 235.16, 236.20 and 236.21 (1) and (2), Wis. Scats. as prav~zded by s. 235.12, W is. Sta 7 1 Certified 20 BENCH MARS: r ,~A • ~ t 97D.U.T. GPS MONUMENT "TRt ELEVATION-1096 Denartment of Adzninistrati I CountyS~ /1t0/ t Safety and Buildings Division it 0 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) r'~~~ ((IIMMa 1•`;. 162 H ! State Transaction Number G~ Permit Application In accordance with (2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required pri oL a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department afety and Professional Servies. Personal information you provide may be used for secondary pjaposes in accordance with the Privacy Law, s. 15. 1 m , Stats. 411-2-1 rr~ L Application Information - Please Print All Information a~d Property Owner's Name Parcel # Q C e~ Sin -nves)-, ©~/a - /3/d- e-0 -psi Property Owner's Mailing Address Property Location (.2130) -2 612 & C~ JL / V Govt. Lot City State Zip Code Phone Number /l!!dL ~/4,~~/., Section Z4-,l et" ~5 T ~O N, R irc1E -e'----' II Type of Buildin ec all that apply) Lot # Subdivis77Z Fam ily Dwelling-Number of Bedrooms f -4r Tw 0/~ al i ~,,Uv_a_ia M Block# / ❑ PubliciCommercial - Describe Use ❑ City of CSM Number ❑ VA age of El State Owned -Describe Use L Town of III. Type mt:, (Check only one box on line A. Complete line B if applicable) A' System 11 Replacement System El Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) List Previous Permit Number and Date issued B. 11 Permit Renewal ❑ Permit Revision El Change of Plumber El Permit Transfer to New Before Expiration Owner W. Type of POWTS System/Component/Device: Check all that a I ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At Gra d > 24 in. of suitable soil ❑ Mound < 24 in_ of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) Preis' ent ce (explain) V. Dispersal/Treatment Area Information: o sed 2(sf) System Elevation ied (sf) Di al ArePr Design Flow (4Desh soil ion Rate(gtdsf) XAr VL Tank Inacity in of Manufacturer allons its x On S C Y e_ -M 2 v 'cam Existing Tan} / V Septic or HoldinDosing Chamber VII. Responsibility State tent- I, the undersigned, ass ume res ibility for installation of the POWTS shown on the attached plans. Ptler's Name (Print) Plumber's Si MP/MPRS Number Business Phone Number Plumber's Address (Street, City, State, Zip ) t Countv/De artment Use Onl Permit Fee Date.Issue suing Agen Sign ure Approved ❑ Disapproved $ ✓ t l ❑ Owner Given Reason for Denial ~G V 291 ate, ri~Y1M~ / IX. Conditions of A rovaMeasons for Disapproval g/ ~✓1 r'U C/ ~K d SYSTEM OWNER: C3 S 't-ff71~a °J 1. Septic tank, effluent filter and dispersal cell must be serviced I maintained sal as per management plan provided by plumber. ,,~or pu,~ 2. All setback requirements must be maintained as per applicable for the system and submit to the Coon ly on paper not less than 8 to x I I inches in size SBD-6398 (R- 11/11) SHAUN R BIRD Page 2 11/4/2014 • The system was designed to meet the influent quality defined in SPS 383.44(2)(a) The quality of influent discharged into a POWTS treatment or dispersal component consisting in part of in situ soil shall be equal to or less than all of the following: 1. A monthly average of 30 mg/L fats, oil and grease. 2. A monthly average of 220 mg/L BOD5. 3. A monthly average of 150 mg/L TSS. • SPS 383.54(3)(b) (b) The servicing frequency of an anaerobic treatment tank for a POWTS shall occur at least when the combined sludge and scum volume equals 1/3 of the tank volume. • The inspection, maintenance and servicing reports shall be submitted to the governmental unit within 30 calendar days from the date of inspection, maintenance and servicing. • The owner is responsible for the operation and maintenance of the private onsite wastewater treatment system (POWTS) in accordance with SPS 383 and the approved management plan • The owner of a POWTS shall be responsible for ensuring that access opening covers remain locked or secured except for inspection, evaluation, maintenance or servicing purposes. • Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Provide a copy of the approved POWTS plans and this letter to the owner. • Prohibit vehicle traffic and soil disturbance within 15 feet of the downslope edge of the mound pursuant to "Mound Component Manual Version 2.0" SBD-10691-P (N.01/01; R. 10/12). • Insulate 4" 0 conveyance pipe as necessary pursuant to SPS 382.30 (11)(c), W.A.C. 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 f This Amount Will Be Invoiced. When You Receive That Invoice, dwin A Taylor Please Include a Copy With Your Wastewater Specialist, Integrated Se es Payment Submittal. (715)634-3484, Monday - Friday 8:00 am To 4:30 pm WiSMART code: 7633 edwin.taylor@wisconsin.gov o~PTUEN DIVISION OF INDUSTRY SERVICES Tor 10541N RANCH ROAD HAYWARD WI 54843 Contact Through Relay 3 t,_ S K www.dsps.wi.gov/sb/ P S w www.wisconsin.gov ssroNScott Walker, Governor Dave Ross, Secretary November 04, 2014 CUST ID No. 226900 ATTN: 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 Identification Numbers PLAN APPROVAL EXPIRES: 11/04/2016 Transaction ID No. 2473569 Site ID No. 807538 SITE: Please refer to both identification numbers, Creative Homes above, in all correspondence with the agency. 474 Prominence Way Town of Troy St Croix County NWIA, NW1/4, S11, T28N, R19W Lot: N55, Subdivision: Hills of Troy FOR: Object Type: POWTS Component Manual Regulated Object ID No.: 1510202 Maintenance required; 450 GPD Flow rate; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.0 1/01, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, 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. R ON No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, Condit stats. The following conditions shall be met during construction or installation and prior to occupancy or use: APPR DEPARTMENT SAKE • A copy of this approval letter and index sheet shall be attached to plans that correspond with the copy on file p 7RRE with the Department. Changes to the approved plan must be submitted for review and approval. Failure to properly attach the approval and index page to plans that match the copy on file with the Department may res in enforcement action under s. 145. 10, Stats. • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD-10691-P (N.01101). • This system is to be constructed and located in accordance with the approved plans and with the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0" SBD-10706-P (N.01/01). • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715.246-4516 Date: 10/17/14 Owner.Creative Homes Location: NW1/4 NW1A S11 T28 N,R19W 474 Prominence Way Troy Manuals Used: Mound Component Manual Version 2.0 (01131) 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 !.T 7-8. Maintance and Contigency plan Tonally 9-11. Soil test ,O'vl E D 12. Filter Specifications a oss section )F COMMERCE Y UIL IN S Shaun Bird 'PO EN Signature License nu 226900 PLOT FLAN PROJECT Creative Homes ADDRESS 707 Commerce Drive Suite 410 Woodbury Mn 55125 NW 1/4 NW 1/4S 11 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 1066.5 DATE 10/17/14 BEDROOM 3 CONVENTIONAL. IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK. SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION ARIA 455 # of chambers none BENCHMARK V.R.P. Top of survey Iron ASSUME ELEVATION Filter BEAR Filter I068.27' ❑ BOREHOLE (DWELL x 11, R. P . Same as enchmark All piping shall be SDR 30134, within 10' To Prominence 'Fay of tank, piping shall be Schedule 40. Scale = 1/4" = 10, tank is to be properly bedded and provided with lockdown Pro 3 corers with approved warning WelI is to meet al I Bedroom labels WDNR setbacks House 1.1 Acre Lot 300Property Line L0-r Scale =1/411 - 101 1066' Huffcutt Combo Tank B.HI.* 1065.5' BBB A L a 1" System Is to be 15,7 installed along e uniform contour of 6%'Slope 1065.5' 0 Blt m 13 Drainage Easement grading is to be done to divert run-off away from system 0 Property Line Bq 1064' Proper y La Line Section and Plan View System Cross Mound r _ r •r _ - Dimension Peet A I s B • I jip :j:• I J ~1• !I •V• D I - I ..•s E t I• 44} ;zg KIM! } r • 4,4 SS :'1 t x `r''';, ~4slt . rg2s^7+'ric•~ t .4,4#~,~~sc} 5;4~5~, rtsr ; I F ~ IF I YY z~ ~ x f•' I :j:• z -.8 :j. I =l' J I z I I 3 .f- r 1 ~2~• .j: 1 wo 401 . YY S. Z K B' SIo e % L > > = 1 =Topsoil A S T M C - 33 Clean aggregate = 4 in. sch.40 pve ~/z to 2'/z in. dia. 0 observation pipe I I I Cap Material sand fill - J 16 ' Geotextile H +t Fabric 4 t • :;tit: fS?c 'j1 i1i :I: Plowed Surface r .~Ft Contour - Slope Direction the design contour. Existing ong GENERAL ~gT~,I,LATION: the situ The mound basal area (L~x W) is plowed with a moldboard or vegetation is mowed and raked off chisel plow, Plowing May not proceed if the soil is wet enough at the3 plow ep3~ Ho fois plad r 4 inch soil wire when a sample is rolled between the palms of the hands. ASTM qualit after Plowing. Sand is planed with a tracked machine keeping 12 or or i ch ssof sand of less than one foot is placed overhead by a baclchoe. Special care must be used when placing d t placed fro,the entire gmound thickness to minimize compaction of the plowed surface. After the topsoil cap is is seeded and mulched to promote lower vegetative 6 inches az~.d secured in place with rebax or a closet flange. observation pipes are slotted am 10/071gj Page of Pressure Lateral Layout Two Laterals - End Manifold `.--'T'hreaded R Cleanout Lateral 'urn-up Plug Manifold . M . X L Long I Sweep Force Main 90 Bend f Pressure System Construction Distribution Network S ecifi a ions Lateral Diameter 2 TIn. n Laterals are constructed of Schedule 40 PVC o 3 Tn pipe. Orifices are drilled perpendicular to Manifold Diameter Orifice Diameter in. the pipe with a sharp drill bit and face down. X Orifice S acin Ft. Lateral turn-ups terminate with a threaded inch L ateral Len Ft, clesnout plug and are enclosed in a 6-8 M Manifold Len h) Tn diameter lawn sprinkler valve box accessible Force Main Diameter Ft from finished grade. Force Main Len th . • • • • • • Grade • • • • • • • • a • • • 6-9 Inch Lawn Sprinkler Valve Box page of 03105 lEj f pump Specifications And Septic-Dose 'elk CrosS Section An P Tank Manufeat Pump Model Number Tack Model. Number ' Alarm 1Namrfac=r v e. Tatai Tank CapaeIt 3~ Alatm Model Numbex ✓ ; Bury Depth ( switch Type fin e Total Dy lc Head (TM - Feet Filter Mannfaetutar glevation head; v Distal Psesause Filter Model Number Network Loss etformaacc itequired Farce Main'L•Aas mimmn Pump Pt TDH Total , 0 1'l . 4» Above Grade Vith Ms¢hole Min. V, Above Grade. Outlet ole '~Jifli Lookin8 DevicB booking •ce. Inlet Manhole se+ctuety Mounted < 6" Below Cade sealed Watertight vUamdu -proof Junction BOX a, M. ~ i • ~ Jr `il ~ gamed Grade 'Vast Nfin. lZ" Discomlect Above Grade Mews 'With vat ca . Outlet FUW . Inlet Baff1e Inlet : A weep jings and Reserve 1 Mole h g Swito GPl B Tank Volt Yme Inches Volume Gal. Dimsml , , ation (resersre A° 00 . S off B16v C 'Ft Botmi n 2 . 3 B, ~ ~ Elevation (dose) C 7 ' 105 7, D D OS 6. F D/3 (dead) : ; .;0'.:•; s>:'; :*.>:::.::::r• : , the < ' k filled is accordance with •c/~sc lank is bedded and ban. by the ewrer may not RAID IKST ,j•A7'~O~T: The. WPM, depth of burs! as speeifi adlock) GE device l ificatious. lvis:dmum We an active looking (p mauufaeturees product ioxovd le vers eXpoeed to gra,do lis Watertight 5ttings, and or eppraval. Manho cornet tar a the out 24 to'the tank be exceeded ed material, 47' q,0'?VC to bridg at the inlet and outlet is of appcorov ,O' face msin-is slee'cred with 80d Comm i~ 23 300 MC, laid on Able soil to povent i0r 1W t~'l:seM~ CO'r!ptie6 v~ri{ A avaxi dthe.slee.i$ sensed wat~tight• . ; on an Page' Of 0210S Lx TOTAL DYNRAA RICA hU D/CAPAC!TY EFFLUENT AND DEINATERING HEAD CAPACITY CURVE 133 MODEL 152/153 rooEL 152 I Liters 4 Gal. Liters r Gi Fee. I Meters Go.. 291 50 5 1.5 64 261 77 l 61 231 1 70 153 265 1Q ' 3•t 53 201 61 231 15 4.6 52 '97 12 40 152 20 6.1 44 167 I o 1 129 42 1 159 25 , 7 6 34 125 87 i 33 I 8 30 330 5 1 ' -7- - 1 21 I 85 ~t t e 11 42 I o I 40 12.2 I 3.4 r+) 20 \/01ive 132.0 } { i 1 5m) 44.0 Ft. ~ k ,,p~k oases r-- L 10 1 0 40 60 80 100 20 E 1/4 ;j GALLONS _ 3 27/,2 240 320 LItERS 0 80 160 t t I I 3 27!32 FLOW p£R MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS d 27/32 t ! Timed dosing panels available- systems, y ^ Iced with I . Electrical altemators, for dun stems, are available and supplied le phase I an alarm. 51n9 • variable level control switches are availabl e for controlling l 1 , 4 systems. itches are • Double piggyback variable level float sw availabte for variable long and short C lab abe controls. I I level tallations, See FM1420. , I Sealed Wtik-Box availe for outdoor ins Over 130°F• {54'C.) special quotat(on required, 12 Vs r t l l { 1521153 Series l 5 1 /6 C ntr Serect { I 2!153 M 0 s Sim lex 9u lex ` arczae+ (dose! Vons•Ph Mc~e 1 2 or 3 96 N15 115 1 Non 8,5 Ineluded 2or3 BN 52 11S 1 AuW 0 1 2 or 3 £152 230 1 Non 6.3 Inctwed 2 or 3 SELEC110K GU'DE 88152 230 1 Auto 1 2 r3 or double Plggyback variable level float N163 116 1 Non 10 tnclu.ed 2 or 3 1. Single piggyback variable level floe[ switch 9N153 115 1 Auto 5.3 1 2 or 3 £153 230 1 N5 3 biduded 2 or 3 switch. Re[er to FMOA77 Bg153 230 1 Auto 2. see FMo712 for Correa model of A>remator E•PSk n c uION d be done by s QuallRad 3, variable level control switch 10.022.25 5 us used d as a .,Vol acti++ator, speedy duplex {3) otecDOn devices dad wir1nQ shoal the most or (4) float system, All ~g,It don of controls, Pr oodesshouldbefoltowed Including licensed eleeWj , AB~Ode (NEClnd saf ft OeeuPationat Safely and Health Aa (0.1114 andthe recent Madura Elactfic RESERVE POWERED DESIGNeslgn of every zoellsr pump. ered into the For unusual conditions a reserve safety factor is ma91To P.o. BOX 16347 ManfidcturersOf - . Loul$46, KY 40256,0347 SNIP T0: 3649 Cane Run Road QuaurrP~~P6 ,rcf 199 Loo.,viUe KY 40211.1961 ® f'lf/VIP CO, r502a 718-2131.1(600) 928•PUMP FAx(5a2) n4-36524 https//wlvw•zoetler.com Copy ri9ht 2000 Zoeller Co. AU rigflts reserved. ® PLAN Rage of POWTS OWNER'S MANUAL & MANAGEMENT SYSTEM SPECIFICATIONS FILE INFORMATION Septic Tank Capacily al 1110, I y Septic Tank Manufacturer [3 NA l F wner e ❑ NA ermit # Z 6 `7 71 Effluent Filter Manufacturer DESIGN PARAMETERS 131~1A 0 ~ Effluent Filter Model Pump Tank Capacity al 13 NA Number of Bedrooms Number of Commercial Units - Tank Manufacturer ❑ NA Pump da Estimated now (average) aU DNA: Design flow (ppan (Estimated x 1.5) X27 ' ' ~Ud Pump Manufacturer Pump Model /t J .>~L 13 NA Solt AppFtcation Rate ~C~ tlda lftz A Monthly aer1ge Pretreatment Unit Peat Fitter Influent/Effluent Quality O Sand/Gravel Filter Fats, ON & Grease (FOG) 530 mglL (3 Mechanical Aeration ❑ Welland ❑ Other. 131ochemlcal Oxygen Demand (BODG) 5220 mglL ❑ Disinfection Total Suspended Solids (TSS) 5150 m1L Manufacturer Pretreated Effluent Quality ❑ NA Monthly average" Dispersal Cell(s p in-ground (pressurized) 00 m911- ❑ In-ground (gravity) _und Biochemical Oxygen.Demarwd (S S8) 534 mgt ❑ At-grade D Other Total Suspended Solids {T fit), cfuf100m1 Q D ' Inc Fecal Coliforrrt (geometric mean) values typical for dofnestic (non commerdaQ wastewater and Y. inch diameter • Maximum Effluent Particle Size septic tank efAaeat. Values typlcai for pretreated wastewater. MAINTENANCE SCHEDULE Service Frequency Service Event O months-A*ear(s) (Maximum 3 yrs.) At least once every Inspect condition of tank(s) equals one-third (Y,) of tank volume When combined sludge and scp X09th$ ar(s) {Maximum ~ ym-) pump out contents of tank(s) cells At least once every (s) Inspect disp~rsal At least once every O months ar Clean tsffluenf filter p trtonth ear(s) O NA um controls & alarm At least once every ear(s) p NA Inspect p. P. pump At least once every ~ O mon Flush latLrals and pressure test ❑ months ❑ year(s) ❑ NA Other. i At least once every At least once every ❑ months 13 year(s) 17 NA Other MAINTENANCE INSTRUCTIONS one of the following licenses or Septage inspections of tanks and dispersal cells shall be made by an indidldual prtylrtg POWTS Maintainer, or broken POWTS Inspector- Certifications: Master Plumbe dfy any missing r; Maosns must Include a visual lnspecbon of the tank(s) to iden for 8n back up SeMcIng Operator, Tank inspect' sludge and scum and to check any tsal celsmshallbe visually inspected to check the effluent levels hardwlrare, Identify any cracks or teaks, measure the volume theuent on m the ~ate no ground surface, The ponding of effluent an the or poetding of effluent on the ground surface. The dispe ( ) regulatory authority in the ob,etvation pipes and to check ~~a cn andndin requires of effluent tification of the local ground surface may indicate a failing or move of the tank volume, the accordance with ch. NR When the combined accumulation of sludge and scu tank equals one-third (4) of in entire contents of the tank shall be removed by P 9 Setvidn9 Operator and disposed , nts; and any 113. wisconsin Administrative Code. meal ° f pressurized P~WTS ce onents, pretreattment comport Masntalner. The servicing of effluent filters. matervals of .12 months or less shalt be pe,formed by a certified se POWl"NiSe~ event. other maintenance or monitoring within 10 days of completion of any A servo report shall be provided to the local regulatory authority START up AND OPERATION For the presence of palniif><g products or other ro f are For new construction, prior to 'p use of the PO andmagee dispersal cell(s). It high ainCe chemicals that may impede the treatment process operator prior to use. , detected have the contents of the tank(s) removed by a septage servicing p - Pegs , of Of ainting products or other chemicals tlheit a presence p START UP AND OPERATION ~ concentrations are detected have the contents oft o if high Idlor } for the For new construction, prior to use of the Pt7WTS damage chock dispe sal treatment C811( s). may impede the treatment process ar operator prior to use. tank(s) removed by a septege servicing op stewater oil ho frozen at the' infiltrative surface- ondltl over is restoredp or surX001-65 large of ® itil b t. System start up shah not occur when sail c Curing power outages pump tanks may 1111 above normal hlghwater cell(s) levels and may When Pw result to the operator backu prior to restore restoring power this normal levels In one large dose, overloading lama~ed by a septege Servicing discharged to the dispersal cal{(s} , operating the pump controls to To avoid this situation have the oonten~~ the pump nttainer to as st in manually effluent pump or contact a plumber or act, the area within vehicles over ranks and dieperr;al cells. Do npt drive or park o~cer, or otherwise disturb or compact. within the pump tank. Of the POVVC~• Do not drive or park at-grade sole absorption area, i the life 15 feet down slope of any mound or Im rove the performance and prolong dental floss; diapers- dialnfectaedications;nts; fat: foundation ~u~~fi ail; Painiing p Reduction or ellminetlon of the following coridorns Sttonaswabse m Idegreasera; herbicides; meat scraps m antiblotice; baby wipes: cigarette butts; gasoline, gaeas®; (sump pump) water; fruit and vegetable PWIngs; 8 j. pesticides; sanitary napkins: tampons; and water softener bt9ne. steps shall betaken to insure that the system Is propefly ABANDONMENT When the POWYS fads andf~opHis permanently pter taken out Comm of 133.33, servl vh!the leconsfoliln following Administrative Code., safely abandoned in com e o anings sealed. • All piping to tanks and pits shall be disconnected and thelabandonad pip P septege Servicing Operator. • The contents of all tanks and pills shall be removed and property dlsposed of by a • After pumping, all tanks and Pits shall be excavated and removed or their covers removed and the Void space filled with s41111, gravel or another inert solid material, vide a code cornpilipnt CONTINGENCY PLAN aired the fonowing measures have been, or must be taken, to Pro If the POWTS falls and cannot be rep ion s m' replacement system: be sjtllized for the location of a replacement soil dabsorptio requiaeim, e neled [2 A suitable replacement area has been evaluated and may action and should` of entnrea e will result in th The replacement area should be protected from disturbance and comp must comply sawith lt the rule:} In setbacks horn existing and proposed structure, lot tines andwells. aa~a to erpIaCelaceme the M snapystems for a new soil and site evaluation to establish a suitable replacement effect at that time 13 A suitable replacement area is not available due to setback anlP ~Smitahons. Barring advances In POWTS techno o9N a holding tank may be instalied as a last resort to replace the failed on failure of the POWTS a soil and a" s olledll a& e site has not been evaluated to identify a suitable replacement area. UP must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be infiltrative last resort to replace the failed FOWTS• ~sliR'e at that ti ~e moval of the blomat Ski the i nd and at-grade soil absorption systems may be reconstruct surface. Reconstrucitans of Such systems must comply with the rules WAI. GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT <evifPTIC, P r~ FENTE P13MP AND , POTHER TREATMENT TANKS MAY CONTAIN LET IRCU ST ENTER A SEPTIC, Pump OR OTHER OTHER TREATIMFNT TANK UNDER ANY P CIRCUMSTANCES. DEATH MAY RESULT' RESCUE O PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR At3D1Ti0NAL COMMENTS PpWTS MAiNTAINi;R POWTS INSTALLER ~ llama Name y✓ Phone Phone l J J~ w LOCAL REGULATORY AUTHORITY SI=PTAGE SERVICING OPEfiATOEt PU f'R Name ~O 7j3-:;- Name Phone ' Phone This document was drafted In compilance with ohapter SPS 383.Z2(2)(9)(1)(d)W and 383,54(1), (2) a (3), Wisconsin Administrakiue Coda • 1 T GE I NS ' STRU, Pd qL RT *V ' ^k•t,tt,w ' Installation Simp i Dry fit the filter case onto the end of the outlet pipe to ensure it is the 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' measure the length STEP 2 While the case is still dry fitted on the outlet pipe, of ,A/.-Inch Pipe needed to brace the filter to the tank end wall IY side support me t hod islnot uitii ed the Optional supplemental side support, Proceed to step Four. supplemental side support: STEP 3 For installations utilizing the optional solvent weld the -3/.-inch pipe onto the filter case. If side support method is not utilized, proceed to step four. locks unto the bottom Of STEP 4 Solvent weld the~ss fig case down Until the Piet pipe, pressing cartridge into the case, the case. STrcep S If a VRS switch is utilized: insert into the filter and lock by turning clockwise 901. Maintenance tic tank is 1, The effluent filter should be cleaned every time the sap yjt:A serviced. r:'•' ;a. Open the outlet access op'enin9 to inspect the tank removelthe sludge 3, pump the septic tank completely, making layer on the bottom of the tank and. not just the scum and efFluent- been bew the Invert of 4. Once the effluent level has up on the filterrha dle to dislodge the the outlet pipe, firmly cartridge from the case. and out of the case for cleaning. 5. Slide the cartridge up witch i J 4 s fi. If a VRS switch connected to an alarm is present, the s should be removed by turning counterclockwise 90° and cleaned i with water only. I .3 surface facing bile holding the cartridge on its side (lathe cartridge with water 7. W ' down) over the access opernngr rinse off only, making sure all septage material is rinsfd back into the tank. ! ti,e1':. 3 ,^:,~,lr{ g. If VR5 switch is utilized, replace by inserting into filter and turning clockwise 900• " 9. Insert the filter cartridge back into the case, pressing dawn until the filter Locks into the bottom of the case. 10. Replace and secure the access opening on the tanK. 4RRAN71 5 ears from t`e date of 55AA ONSVEr,s KLTER CARTtiIDCs> - FT1rE~Af: macerlat ar,0 :.rorkmansRlF for five ; '1 Y Bear float:. Rttf,r ca cw9es are warraneee to Oe lree of Wit= in consumer purchase. 2EAR ONSrrE" Ffater case -f_ifedlns Irmlted warranty sear On3tiE war2nts the filter ca ro6ulCDe free of defects if, mie;al and ~jorkrManshic dvnnp normal use for the make f Cline the original purchaser owns she q vide a rezilacement part or produC of 1'2L defect is found In nomral use, sear Onsite will, s`- is 6ccAction, i!3erl repair, qro agpraona acco dance WAh lnattuct ons Orovided Wile te adjustment. Damage to a product ceusad by era n or nma n asneC In care or n to adRldns resulting Iron, units not in stalled, op raw6ed to Bear Orsite with all warranty clams. Bear void the ~arranW. Fr-oaf of purchase iort91nat sales rece'i"'mmuss: ;tahe A 0,~,~ I$ not rRSoonsttr,e for labor charges, removal charges, llattan,oi other incidenwl or consequential costs, yn no event si+aii the 112tdlty of sear onsae ex.^eed rile purchase grits of `.h: Product. S'T'. CROIX COUNTY SEPTIC TANK NIAIN TENANCE i k,GRI rEMENT AND 0WNERSI'11P CERTI ICATIGN FORM Owner Buyer E~ Mailing Address 707 Property Address (Verification required from Planning Zoning Dt art,ttent 161 new coast, -lion.) CitylState Parcel Identification Nin ber 941d -/'3 / 4 _"_0 0 UA.SQ N ~ - -_w 11 LEGAL Dp SCRIPTION Property Location Lot #r Subdivision Page -9 Certified Survey Map Warranty Deed VO lurnc, Page it r Spec:. house j es no Lot line, identifiable yes no SYSTEM NiAINTENAN'~"E AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its pr,.-rnat ue fail-cue to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, o needed, by a licensed pumper. What you put into the system can affect the function of the septic 'tank as a treatment stage in the wasie disposal system. Owner maintenance responsibilities are specified in §Comtn. 83-52(l) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Ylarn ing & "Zoning Department a certification forth, signed by the owner and by a master plumber, journeyrnan plumber, restricted plumber or a licensed pumper verifying that (1) the on--site wastewater disposal system is in proper operating condition and/or (2) after inspccJon and pumping (if necessary), the septic tank is less than 1/3 frill of sludge. I/we, the undersigned lwve read the above requireuuents and agree to mair tarn the private sewage disposal systern with the standards set forth, herein, as set by the Department. of Conunerce,, and the Duparitr eat of Natural Resources, State of Wisconsin. Certification stating that your septic systern has been maintained must be cornplete, t and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements oil this forth are true to the best of my/our k nowledge. I/we arn/are the owner(s) of tile property described above, by virtue of a warranty deed recorded in Register of lee ts Office. Yr? Num er o bedrooi GATT' APPLICANT(S) -TSIG AT(JR OF ***Any information that is misrepresented nuay result in the sanitary permit being revoked by the Ptauuting & Zoning Department. Include with this application a recorded warranty deed liotn the Register of Deeds Office and it copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) Wisconsin Department of Commeri1i4Tl REPORT Page 1 of 3 A Division of Safety and Buildings N in accordgncp with Comm 85, Wis. Adm. Cde County ST. CROIX Attach complete site plan on paper not less than 8;1/2 x 1 q li(icl~ies:~ $-ze,~ must include, but not limited to: vertical and horizontal r4ference point (BM), dife~ and Parcel I.D. percent slope, scale or dimensions, north arrow, acrd location and distance to neares road. r i Please print all infi~rmatior~f,;!' Revi d by Date Personal information you provide maybe used for secondary purposes (Privacy Law, s `T5:04'jt) (m)). l ~d U~ Property Owner Property Location LEONARD & MARGARET DELAURIERS Govt. Lot NW 1/4 NW 1/4 S I 1 T 28 N R 19 E (or) W )W Property Owner's Mailing Address W55 Block # Subd. Name or CSM# 706 Coulee Trail Hills of Troy City State Zip Code Phone Number Vllage OTown Nearest Road Hudson, WI 54016 ( ) Coulee Trail Q New Construction User] Residential/ Number of bedrooms 4 Code derived design flow rate 600 GPD E] Replacement 0 Public or commercial - Describe: Parent material loess over till Flood Plain elevation if applicable ft. General comments Mound System -84 ft. sand fill 0.6 loading rate plow depth 12" and recommendations; S/qe i-~' u - c s~~ q' ~y nd cc~r~>Lh off. ~2 f Y 4- ~ d , (if pre- ea ent - beow gro drip imga ' s~ .8 loading rate) A❑ Boring # 0 Boring n Pit Ground surface elev. 1063.39 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 0-4 10YR3/2 - sil 3fgr mvfr as 3vf-m 0.6 0.8 2 4-12 10Y sil 2fgr&abk mr as 2vf-m 0.6 0.8 3 12-16 10YR3/4 s sil 2fabk mfr cs lvf-m 0.6 0.8 4 16-30 7.5YR3/4 fsl lfabk mvfr as lvf-m 0.2 0.6 5 30-36 7.5YR3/4 f2f7.5YR4/4 fsl Ifabk mvfr alb lvf-m 0.2 0.6 6 36-42 - till/lsbr Some gr in all horizons; few cobbles. F B Boring # 0 Boring 1063.59 31 0 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 1 0-4 10YR3/2 - sil 2fa&sbk mvfr as 2vf-m 0.6 0.8 2 4-10 sil 2fgr&abk mfr ab lvf-m 0.6 0.8 3 10-20 10YR3/4 sil 2fabk mfr cb Ivf--m 0.6 0.8 4 20-31 10YR3/4 sl lfabk mfr as lvf-f 0.4 0.7 5 31-35 7.5YR3/4 - fsl Om mfr as 0.2 0.5 6 35-38 till/lsbr I Horizons 4,5 have some gr; few cobbles. * Effluent #1 = BOD > 30:5 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) gnature CST Number Ma Jo Hollister L~~ Vr' 224832 Address Date Evaluation Conducted Telephone Number W9875 690th Avenue, River Falls, WI 54022 05 - 05 - 05 (715) 426 - 1775 f r DeLauriers (Lot N55) Parcel ID # (Pending) Page 2 of 3 Property Owner C Boring # Bornq 1066.45 ❑ 26 E] pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redo x Structure Consistence Boundary Roots GPD/fF x Description Texture in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-4 10YR3/2 sil 3fgr&sbk mvfr as 2vf-m 0.6 0.8 2 4-11 10YR3/ sil 2fabk mfr as 2vf-f 0.6 0.8 3 11-17 10YR3/4 sil 2fabk mfr as 2vf-f 0.6 0.8 4 17-26 7.5YR3/4 fSl Ifabk mfr as lvf--f 0.2 0.6 5 26-36 7.5YR4/4 c2f 7.5YR3/4 fsl Om mfr 0.2 0.5 ❑ Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring ❑ Boring # Ground surface elev. ft. Depth to limiting factor in. Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP 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 < 30 mg/L ~I 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. S1313-8330Test (R.07/00) Plot Plan for Hills of Troy Page 3 of 3 Town of Troy, St. Croix County, Wisconsin Lot 5s 1 40 ft. 2 f~ contours Legal Description Nw Y,, cr=-•rric:~;~V'/~ - Backhoe pit BENC MARK; CH MARK: TOP OF 1 1/4" TO OF 1 1/4" / IRON PIPE r IRON IPE ELEVATION = /D(, 5Z ELEV ION = t~~ I 66' WIDE SHARED \ 150, ~ ~ 55 / . ~ ' BEIyCH I Lr TOp OF ARK : ECEVq TIO 114„ : )CL3 N B-96A 0 I c ~9 mr e 7% III 111111 111 IIIIIIIII IIII I I II 8147904 State Bar of Wisconsin Form 6-2003 Tx: 4120163 SPECIAL WARRANTY DEED 976926 BETH PABST J Document Name REGISTER OF DEEDS Document Number ST. CROIX CO., WI 04/16/2013 11:52 AM THIS DEED, made between BMO Harris Bank National Association successor by EXEMPT#• NA merger with M&I Marshall & Ilsley Bank REC FEE: 30.00 ("Grantor," whether one or more), and TRANS FEE: 2025.00 Creative Home Construction Investments, LLC a Wisconsin limited liability PAGES: 3 company ("Grantee," whether one or more). Grantor for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is LRn needed, please attach addendum): 3 Address See attached Exhibit A. RsthLCtt~nn vestcrtenu, bLC rive Land T++ Stnc. 082w Co• Rd- C,~cf~ ftpSGv i IIr~MN SSU3 See Exhibit A Parcel Identi lication 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 arising by, through, or under Grantor, except municipal and zoning ordinances and agreements entered under them, recorded easements for the distribution of utility and municipal services, recorded building and use restrictions and covenants, general taxes levied in the year 2013, and Permitted Encumbrances described on the attached Exhibit B. BMO HAJRJS BANK NATIONAL ASSOCIATION, Dated February 28 2013 success th &I rshall & Ilsley Bank (SEAL (SEAL) * * B : S. autze , r President (SEAL) (SEAL) * ` ~4... * By: AUTHENTICAgrV]~ARY pGi1+,f ACKNOWLEDGMENT Signature(s) s STATE OF WISCONSIN ) 50 CA,, c~'! ) ss. authenticated on , . CRS L I % MILWAUKEE COUNTY ) N ~ Up J z~ 9C K'NS / Personally came before me on 2013 , ry( t the above-named Gary S Kautzer Vice President of BMO TITLE: MEMBER STATE BAR OF.VOhFSIN Harris Bank National Association (If not, to me known to be the person ) who executed the foregoing authorized by Wis. Stat. § 706.06) trument d ac wl a the me. THIS INSTRUMENT DRAFTED BY: * Carol Lee Hopkins Marvin C Bynum II Godfrey & Kahn, S.C. - Notary Public, State of Wisconsin My Commission (is-perfxiarreut) (expires: April 6 2014 ) 9003373_2 (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. NO. 6-2003 SPECIAL WARRANTY DEED 2003 STATE BAR OF WISCONSIN FORM 4 Vp3name below signatures. EXHIBIT A Legal Description Lots 2, 11, 13, 14, 15, 16, 17, 19, 24, 25, 26, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 48, 52, 53, 54, 55, 56, 57, 58 and 59, Plat of Hills of Troy in the Town of Troy, St. Croix County, Wisconsin. Parcel ID Nos.: 040-1318-00-002 040-1318-00-011 040-1318-00-013 040-1318-00-014 040-1318-00-015 040-1318-00-016 040-1318-00-017 040-1318-00-019 040-1318-00-024 040-1318-00-025 040-1318-00-026 040-1318-00-032 040-1318-00-033 040-1318-00-034 040-1318-00-035 040-1318-00-036 040-1318-00-037 040-1318-00-038 040-1318-00-039 040-1318-00-040 040-1318-00-041 040-1318-00-042 040-1318-00-043 040-1318-00-044 040-1318-00-048 040-1318-00-052 040-1318-00-053 040-1318-00-054 040-1318-00-055 040-1318-00-056 040-1318-00-057 040-1318-00-058 040-1318-00-059 2 of 3 EXHIBIT B PERMITTED ENCUMBRANCES i 1. Any encroachment, encumbrance, violation, variation, or adverse circumstance affecting title to the Property that would be disclosed by an accurate and complete land survey of the Property. 2. Easements or claims of easements which are not shown by the public records. 3. Any lease, grant, exception or reservation of minerals or mineral rights appearing in the public records. 4. Subject to the building set back lines, utility easements, drainage easements and wetland areas as reflected on the recorded plat. 5. Subject to the terms and conditions as shown on the recorded plat of Hills of Troy. 6. Restrictive and protective covenants as recorded in Document Number 816569, amended by Document Number 841464. (These restrictions contain no forfeiture provision.) (Omitting any covenants or restrictions, if any, based upon race, color, religion, sex, sexual orientation, familial status, marital status, disability, handicap, national origin, ancestry, or source of income, as set forth in applicable state or federal laws, except to the extent that said covenant or restriction is permitted by applicable law.) 7. Subject to the terms and conditions of the Landscaping Easement in favor of Hills of Troy Homeowners Association, Inc. as shown as Document No. 816571. 8. Subject to the terms and conditions of Conservation Easement recorded on July 1, 2005 in Vol. 2834, pages 155- 173, as Document No. 799119, amended in Vol. 2937, page 68-77, by Document No. 813315. 3of3 11/1o/zo AM Parcel 040-1318-00-055 P PAGEE I OF 1 Alt. Parcel 11.28.19.2130 040 - TOWN OF TROY ST. CROIX COUNTY, WISCONSIN Current OX Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 01/17/2006 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner 0 - CREATIVE HOME CONSTRUCTION INVESTMENTS LLC CREATIVE HOME CONSTRUCTION INVESTMENTS LLC 707 COMMERCE DR STE 410 WOODBURY MN 55125 Property Address(es): * =Primary * 474 PROMINENCE WAY Districts: SC = School SP = Special Type Dist # Description SC 4893 SCH DIST RIVER FALLS SP 0100 CHIP VALLEY VOTECH Notes: Legal Description: Acres: 2.714 SEC 11 T28N R19W PT NW NW & PT SW NW HILLS OF TROY ('06) LOT 55 (2.714AC) Parcel History: Date Doc # Vol/Page Type 04/16/2013 976926 WD 01/10/2011 930266 WD 01/17/2006 816571 EZ 01/17/2006 816568 10/095 PLAT more... Plat: * = Primary Tract: (S-T-R 40% 16o~i. GL) Block/Condo Bldg: * 10-095-HILLS OF TROY 040-06 LOTS 1/6 11-28N-19W NW NW LOT 055 10-095-HILLS OF TROY 040-06 LOTS 1/6 11-28N-19W SW NW LOT 055 2014 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 11/09/2009 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.714 48,800 0 48,800 NO Totals for 2014: General Property 2.714 48,800 0 48,8000 Woodland 0.000 0 Totals for 2013: General Property 2.714 48,800 0 48,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 [i I a-= id ME I Hl- F11 Ffl F-I = - 00 COLUMN DETAIL - .v. a FRONT ELEVATION - - LU - - z LU - Q LEFT ELEVATION RIGHT ELEVATION IU ~ LU - - - - CIO T Ell -1 L LILJLJ REAR ELEVATION ~ . p i : , [i r,Ano_ E _ - , I ~I I I - SME RM. F Ft ILY r _ I I ~ I I ww MALL ~ ! ' I I 11, ------l-- - C 111 1 1 1 M i5 I I ` ?r - Beni Z FUTWE K I~ EAWZI I I I _ i3 .1_---------_-yll I I V _ II _ (a z x UM%EAVA- W k y - ~ IlMM u ceeee 999999 ➢ ~€y~il9 - - J, .-y , }I' I AALKOUT BASEMENT FOUNDATION PLAN NOTE: L 2- -7 [i 1~~ DyININ6 ~ ~ GROWN DETAIL . Vie, t i= k 8 KITChEN w :o. Y ~~g M i ' .vu M~BATH 0OLUMN DETAIL C'~ES~T t- (q€~x .w• .b .a-.> z 3 POR4N I SARA6E 0 ~y1!!t9 4 ~~{g3gc~~g BRACH MALL LINE } A A F PANEL DETMLS ®ae.n.e.wW rrraaw. yC ~ ~ NOTE: _ - MAIN LEVEL FLOOR PLAN EN =%a? _NE 6FREAr RM. LPUIDRY M1D W4. PORLN BEPRM.2 HALL SroRA6E i :.owe woow ^ W V z w p ie~ p j z ~i a m r eccee ROOF PLAN I1~€3@ SECTION 4= 7