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HomeMy WebLinkAbout042-1085-60-051 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 574311 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: Langer, Nancy Warren, Town of 0A+Z 1045 -(00- 0S CST BM Elev: Insp.B Elev: IBM Description: 66 Section/Town/Range/Map No: 31.29.18. TANK INFORMATION ELEVATION DATA (P pHolcring MANUFACTURER/,,/, SS CAPACITY STATION BS HI FS ELEV. Benchmark Alt. M 3.04 ���� Z C4,1 Bldg.Sewer .Zat St/Ht Inlet C , 1 St/Ht Outlet TANK SETBACK INFORMATION � D TANK TO P/I{_ WELL BLDG. Vent to Ptir Intake ROAD Dt Inlet �\ Septic N/'- Zg Dt Bottom Dosing Header/Man. Aeration Dist. Pipe �0 r g7A/ ,& Holding Bot.System q3` 7 PUMPISIPHON INFORMATION Final Grade to 4 97.5S Manufacturer Demand St Cover�- PM Ir; per, Z.Z l vZ.. Model Number TDH Lift Friction Loss Sys ad Ft Forcemain Length Dia. Dist.to well SOIL ABSORPTION SYSTEM BEDITRENCH Width / qength No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 41d L -1 C.."5N4 SETBACK SYSTEM TO ! P/L BLDG IWELL LAKE/STREAM LEACHING Manufacturer�� r INFORMATION CHAMBER OR .Y✓`�t �ad"�l. Type Of System: /D +� UNIT Model umber Con J e wJ-110 3 /v ��;t Gc.�f 5�.� DISTRIBUTION SYSTEM Header/Manifold x Hole Size x Hole Spacing Ventt it I ke 4 [Distribution Pipe(s) '`._ Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over jxx Depth of jxx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil _ Yes '-I 1 No Yes a No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / / Inspection#2: Location: 988 65th Ave Robe WI 54023(SE 1/4 NE 1/4 31 T29N R18W) NA Lot 2 Parcel No: 31 29.18. 1. Alt BM Description= ` "I Ga 0.tJ�. / 2.)Bldg sewer length= 37 -amount of cover= If i `t Z re,s -- Plan revision Required? [] Yes No �j�i� -- - -- - -- - - - Use other side for additional information. - - Date Insepctor's Si ature Cart.No. SBD-6710(R.3/97) r ` I kd IN 77 - _ -- 0 f _ County Safety and Buildings Division � a# 201 W.Washington Ave.,P.O.Box 7162 Sanitary Permit Number(to be fitted in by Co.) rl Madis , `•, State Transaction Number Sanitary Permit Application �A In accordance with SPS 383.21(2),Wis.Adm.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 diffMemt an mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary l U U 5 ,Q.)Q_ u ses in accordance with the Privac Law,s. 15. 1 m).Stats. / �U J I. Application Information-Please Pri I Information Parcel# / property er's Name / t 'J Property Location Property er' ailing Address Govt.Lot City,State Zip Code Phone Number ��/.,�-%,, Section (circle one j- T _N; R 9 Eor&/ II.Type of Building(check alt that apply) Lot# Subdivision Name 0.1 or 2 Family Dwelling-Number of Bedrooms 6;L 0A Block# ❑Pub lic/Commercial-Describe Use ❑City of a J' rCSM Number qq 7 7-54o ❑Village of ❑State Owned-Describe Use Town of GLLIS t,✓ 22i,-22 6 P Cu6—Z6 III.Type of Permit: (Chec only one box on line A. Complete line B if applicable A' New System ❑Replacement System ❑Treatmendliolding 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 Owner A/t �a IV.T e of POWTS S stem/Com onentlDevice: Check all that a 1 ✓� Non-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grade ❑Mound>24 in.of suitable soil ❑Mound<24 in.of suitable soil ❑Holding Tank er ispersal Component(explain) ❑Pretreatment Device(explain) V.Dis ersal/Treat ent Area Information: Design Flow(gpd) Design Soil Application Rate(g f) Dispersal Area Required(sf) Dispersal Area Proposed( System Elevation 7 9 VI.Tank Info Capacity in Total #of Manufacturer S e Gallons Gallons Units V°" y y _jr,.Tanks Tanks 8 Fxistin Septic or Holding Tank x Dosing Chamber VII.Res sibility Statement-I,the undersigned,assume respo ility for installation of the POWTS shown on the attached plans. Plum a ame Plumber's igna ° MP/MPRS Number Business Phone Number , Plumber's ddress Street,City,S ,Zip Code VI oun !De artment Use Only Permit Fee Date ued Issuin ent Signatu pproved Disappro S DD ❑Owner Giv on for IX.CondiReasons for Disapproval '8eptio tan fester and' disf*sal cell must all be servlces/maintained as per management plan provided by plUmbor. 2. All saWack requkemrtta mast t>et`M*ftittbd asm 6 tf/ County only pa not less than 8 IR x li inches is site Attach to complete plans for the system and submit to the Conn o on per CONVENTIONAL COMPONENT DESIGN Residential application INDEX AND TITLE PAGE Project Name: Owner's ;::.>:.:::.:...::.::: : : :: . . :.,•::::::::::::.:.:::.:�:::;:.: Name: (Owners er s Address: ' < Legal Description: A / s r, �/—27 isA Subdivision: Lot# Town: -- County: Parcel ID# Designer/Plumber: 7 - License#�� Signature: Date: Comments Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 _ 3 Sal?. ?�du -- _ _ _ $0 AbsonAon SVSbm— Cross SKOOG I Fin �/'".".w.,�u►.r✓ Final C 4 Schedule 40 K71 PVC Vent Poe ft Leaching _-- /J Chamber Elevation ft ft System El Soil Abso lkn S s-ftm Plan Vi®w ft TM } Leac Wjng - Trench 9 y't Vent Or Observation Pipe Chambers 47 Dia. Trench_2' Header Leachina Chamber Saecifications Manufacturer And Model ,,, EISA Rating 2(f2 sq ft per chamber Soii Application Rate �7 gpd/S4 It i gpd Design Flow-: 7 Soil Application Rate EISA= Trbers Z rows of chambers each. Page��of INSTALLATION INSTRUCTIONS ® Zaber PL-5251PL-625 FILTER INSTALLATION INSTRUCTIONS with opening : r °`.-min 3 ��00�� ti uj�+•'L�i � q C "x'"`5t .0 " -c g .a � .,i"iJ •-z,.�Ll�Q I` p r i v-� ',�.�' S++��� ..t..._ � Step is Step 2: Step 3: (A)Locate the outlet of the septic tank. (A)Before installation,place the (A)Glue the filter housing on the (B)Remove tank cover and pump tank filter housing on to the outlet pipe. outlet pipe. if necessary, (B)Make sure that the housing (B)Insert the filter cartridge In the is positioned so the filter can be housing,making sure the filter removed from the tank for cartridge is properly aligned and maintenance and service. completely inserted in the housing. MAINTENANCE INSTRUCTIONS .. r _ •fey �" SS ? t s•. .. sSy -v r. 11rx5.a. '.,Ys' -`• vN 'ts�.t`+ f -Zig' .¢.v'.y ,� ♦ ti � rr -rus- t"'y t 2"'T'fi���."�r�if. •,-.t s R' '"ti�� .,u °" - Step 1: Step 2: Step 3: Locate the outlet of the septic tank. (A) Remove tank cover and pump (A)Insert the filter cartridge bade F. k�, if necessary. into the the housing making sure DO PLUMBING N (B)Pull the fitter out of the housing. the fitter is properly aligned REMOVED WHEN FILTER IS (C)Hose off the Ner over the septic tank. and completely Inserted. B Replace septic tank cover C7SE R ,�R GLC? S Make sure all so fall back into the ( ) ep p �Nli ld GL KIN FIT=TER Sulk teoK POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page'_�2_of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity gal ❑ NA Psrmit# '1 Septic Tank Manufacturer, ❑ NA Effluent Filter Manufacturer DESIGN PARAMETERS ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units M NA Pump Tank Capacity gal 0 NA Estimated flow (average) gal/day Pump Tank Manufacturer NA Design flow (peak), (Estimated x 1.5) al/day Pump Manufacturer NA Soil Application Rate gal/day/ft2 Pump Model e NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit E9 NA Fats, Oil & Grease (FOG) :_30 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD5) :5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) :!9150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD5) :530 mg/L if In-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ NA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) 5104 cfu/100m1 ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size Ye in dia. ❑ NA Other: ❑ NA Other: _ ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA InAWTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ month(s)®' ear(s) (Maximum 3 years) ❑ NA sludge and scum equals one-third (Y3) of tank volume ❑ NA When combined q Pump out contents of tank(s) g At least once every: ❑ month(s) (Maximum 3 years) ❑ NA Inspect dispersal cell(s) 19 year(s) Clean effluent filter At least once every: ❑ month(s) ❑ NA 0 year(s) ❑ month(s) J5 NA Inspect pump, pump controls & alarm At least once every: ❑ year(s) ❑ month(s) h laterals and pressure test At least once every: ❑ year(s) ® NA Flus p ❑ month(s) Other: At least once every: NA ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s)to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW(4/01) Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s)for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. r • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replaVA nt system: suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon b required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area wil, result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER/ POWTS MAINTAINER Name l Name 7777E] Phone _ Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name Phone Phone _ This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f)and 83.54(1). (2)&(3),Wisconsin Administrative Code. ST. CROIX COUNTY SEPTIC TANK MA \M3NANCE AGREEMENT AND OV�,h-ERSHIP CERTIFICATION FORM owner/Buyer Failing Address Property Address • on from Planning&Zoning Department for new construction.) (t enficazt required City/State Parcel Identification Number ��,.�` 0�2�' /0y S-1"-)^_-- T LEGAL-DES CRIPTIOI\ Property Location 1l4: . _zl4 , Sec• = T�N R_Z�LW,Town of i Lot# S ubdivision Plat: Z ' ed Survey Ma # ,Volume � ,Page# Certified P Warranty Deed# �j l (before 2007)Volume ,Page# Spec house 0 yes i no Lot lines identifiable j1yes 0 no SYSTEM MAINTE1vANCE Ah'D OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner,if needed,by a licensed pumper. What you put into the system can affect the fimction of the septic tank as a treatment stage in the waste disposal system. Owmer maintenance responsibilities are specified in§SPS.353.52(1)and in Chapter 12-St.Croix County Sanitary Ordinance. The property owner agrees to submit to St.Croix County Planning&Zoning Department a certification form,signed by the owner and by a master plumber,journeyman plumber,restricted plumber or a licensed pumper verifying that(1)the on-site wastewater disposal system is in proper operating condition and/or(2)after inspection and pumping(if necessary),the septic tank is less than 113 full of sludge. Uwe,the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth,herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of%r1sconsin. Certification stating that your septic system has been maintained must be completed and returned to the St.Croix County Planning&Zoning Deparhnent within 30 days of the three year expiration date. I/we certify that all statements on form are taste to the best of my/our knowledge. Uwe am/are the owner(s)of the property described above,by virtue of a r deed recorded in Register of Deeds Office. Number of bedrooms e t F APPLICANTS) DATE I _ ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning&Zoning Department ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV.04/12) 7 0 997756 BETH PABST REGISTER OF DEEDS CERTIFIED SURVEY MAP ST.CROIX CEIVED FOR RECORD. RE ECOCO RD LOCATED IN PART OF THE NE1/4 OF THE NE1/4,IN PART OF NW7/4 06/26/2014 11:28 AM OF THE NE1/4,IN PART OF THE SW1/4 OF THE NE1/4 AND IN PART EXEMPT*: OF THE SE1/4 OF THE NE1/4 OF SECTION 31,T29N,R18W,TOWN REC FEE:30.00 OF WARREN,ST.CROIX COUNTY,WISCONSIN;BEING OUTLOT 1 OF CERTIFIED SURVEY MAP RECORDED IN VOL.24,PG.8666, COPY FEE: 3.00 DOC.NO.907042. PAGES: 2 ► t] ■ • A� J*c <O Z C 0>z o a a 0 p C r BEARINGS ARE REFERENCED TO THE 92;-' Z D Z F x 0 Z S M EAST UNF OF THE NEt/4 OF SECTION 31, g ti $ 4 P n 0 3 m GRID). S00°09saw(ST.CROIX COUNTY rn�_U 9Z m v Zn Z m Z m C CC T r t CO ?m = m Do a 0 n 0 Z O On OS o ZZ- Q= �� yT rtl CZ . a=S OQ OZ Z �I , o UNPLA77E0 LANDS ���I##fee NO2"3726"E 1368.62' 33.03' 1051.56 EAST LINE OF THE W 12 OF THE NEIA 1335.48' 283.92' ® WEST LINE OF THE E1/2 OF THE NE1/4 N I� ly I•_ 463.99 12 \ 385•63 78.35' Im • 35.44' 301"29'37"E 499.42' iy Im \"c"oa ' z rn Z > a r m m Q m `fn'm i I W a a to • �L'99t ,6l'VL£ x 292 m m N (7 0 W Z .� i c1 �y, �1y _ m m r Z ip ~ S£l bt-9t11 fiV'£8Z p AO' \�\O m m (11 �N jw rJ ,l9 tS4 3.9£i£.50S O\G a o \ . I� n '� 4 EXMTNG II N � ► ► G Nq o $ g -o 4 is IAn"$ M gs0(r09'51rW 777.94' QZ soo°arsow LoorHSrReer 33.0a Z w �,n/0 49063' EAST LINE OF TH NEt 4 SOO'09'SO"W 804.98' 2 6a �z f� PR 1 O THIS INSTRUMENT DRAFTED BY EDWIN FLANUM Z z JOB NO.14-47 DATE 523/14 SHEET 1 OF 2 SHEETS ca n St.Croix County 997756 Page 1 of 2 Vol 26 Page 6028 L ' CERTIFIED SURVEY MAP LOCATED IN PART OF THE NE1/4 OF THE NE7/4,IN PART OF NW1/4 OF THE NE7/4.IN PART OF THE SW1/4 OF THE NE1/4 AND IN PART OF THE SE1/4 OF THE NE7/4 OF SECTION 31, T29N,R7 8W,TOWN OF WARREN.ST.CROIX COUNTY,WISCONSIN. OWNERS SURVEYOR GLENRIDGE PROPERTIES EDWIN C FLANUM 1353 AWATUKEE TRAIL NORTHLAND SURVEYING,INC. HUDSON,WI 54016 P.O.BOX 152 AMERY,WI 54001 CURVE DATA TABLE CENTRAL CHORD CHORD ARC NUMBER RADIUS ANGLE BEARING LENGTH LENGTH TANGENT IN TANGENT OUT Cl. 600.00 07.50'36' S75'34'03'W 82.07 82.14 S79'29'21'W S71'38'45'W C2 720.00 22'29'52' S78'52'22'W 280.90 282.72 S67'37'26'W N89'52'42'W C3 633.00 07.22'12' S75'48'15'W 81.37 81,42 S79.29'21'W S72'07'09'W C4 687.00 23'25'53' S78'17'08.5'W 279.00 280.95 S66.34'12'W N89'59'55'W SURVEYORS CERTIFICATE 1.Edwin C.Flamm,Registered Wisconsin Land Surveyor,hereby certify that by the direction of Richard Stout I have surveyed,mapped and described the parcel of lard which is represented by this Certified Survey Map;that the exterior boundary of the parcel of land surveyed and mapped is described as follows: A parcel of land located in part of the NE7/4 of the NE1 14,in part of the NW1/4 of the NE1/4,in part of the SW1/4 of the NEi/4 and in part of the SE1/4 of the NE1/4 of Section 31,T29N,RI OW,Town of Warren,St.Croix County,Wisconsin;described as follows: Commencing at the NE Comer of said Section 31;thence 500°09'50"W,along the east line of the NE114 of said section,1295.60 feet to the point of beginning;thence continuing S00°09'50'W,along said east line,804.98 feet to the centerine of 651h Avenue;thence S79°2921'W,along said centedine,627.36 feet to the point of curvature of a 600.00 foot radius curve,concave southerly,whose central angle measures 07°54361,whose chord bears S75'3403°W and measures 82.07 feet;thence southwesterly along said centerline and the arc of said curve,82.14 feet to the east line of Lot 1 of Certified Survey Map recorded in Volume 24,Page 5666,Document Number 907042;thence N09°2424 W,along said east line, 407.58 feet to the north line of said Lot 1;(hence S68°06'12'W,along said north line,412.32 feet to the west line of said Lot 1;thence S01°29'371,along said west lure,499.42 feet to the point of armature of a 720.00 foot radius curve,concave northwesterly,whose central angle measures 2229152'.whose chord bears S78°5222'W and measures 280.90 feet;thence southwesterly along said centerlre and the arc of said curve,282.72 feet to the west line of Oullot 1 of said Certified Surrey Map;thence NO2°3726"E,along said west line,1368.52 feet to the south line of U.S.Interstate*W;thence N87'4423E,along said south fine,1268.83 feet;thence S00°09'501W 172.65 feet to the south line of the Nt/2 of said NE1 14;thence SW1614°E,along said south fine,80.00 feet to the pant of beginning.Described parcel contains 31.43 acres(1,368,912 Sq.Ft.). Parcel is subject to town roads(100th Street and 65th Avenue)right-of-way and all other easements,restrictions,and covenants of record. 1,also certify that this Certified Survey Map is a correct representation to scale of the exterior boundary surveyed and described;that 1 have fully complied with the current provisions of Chapter 236.34 of the Wisconsin Statutes,the Land Subdivision Ordinance of the County of St.Croix,and the Subdivision Ordinance of the Town of Warren,in surveying and mapping same. APPROVED `NANNSi JUN 2'.6 2014 # ST.(:KUTA UUUN I Y , PLANNING 8 ZONING OFFICE y 4 �fnfnar` COUNTY TREASURER'S CERTIFICATE STATE OF WISCONSIN)SS COUNTY OF ST.CRON 1,Laurie Noble,being the duly elected,qualified and acting Treasurer of St.Croix County,do hereby certify that the records in my office show no unredeemed tax sales and no unpaid taxes or special assessments as of (d JLGj_q-affecting the land included in this Certified Survey Map. 4sSlLttA9K�4iSIN1 0-cl(1e 5 20t�j Laurie Noble, Le1}15C Arden Date County Treasurer f�fCt Dipu{iq Each parcel shown on this map(plat)is subject to State,County and Township laws,rules and regulations(i.e.,wetlands,minimum lot size, access to parcel.etc.).Before purchasing or developing any parcel contact the SL Croix County Zoning Office and the Town of Warren. SHEET 2 OF 2 SHEETS St Croix County 997756 Page 2 of 2 Vol 26 Page 6028 8242022 Tx:4198057 State Bar of Wisconsin Form 1-2003 998341 WARRANTY DEED BETH PABST REGISTER OF DEEDS Document Number Document Name ST. CROIX CO., WI 07/08/2014 4:10 PM THIS DEED,made between GLENRIDGE PROPERTIES LLC,a Wisconsin EXEMPT#: N/A Limited Liability Company, REC FEE: 30.00 ("Grantor,"whether one or more), TRANS FEE: 105.00 and NANCY A.LANGER,a married woman PAGES: 1 ("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 Recording Area needed,please attach addendum): Name and Return Address Located in art of the NE 1/4 of the NE 1/4 in art of NW 1/4 of the NE 1/4 in art c/o Dick Stout of the SW 1/4 of the NE 1/4 and in part of the SE 1/4 of the NE 1/4 of Section 31, 1353 Awatukee Trail T29N,R18W,Town of Warren,St.Croix County,Wisconsin;being OUTLOT 1 of Hudson,wl 54016 Certified Survey Map recorded in Vol.24,page 5666,as Document No.907042; more fully described as: / LOT 22 of Certified Survey Map recorded in the Office of the St.Croix County v/ 042-1085-60-050 Register of Deeds on 06/26/14,in Vol.26,Page 6028,as Document No.997756. Parcel Identification Number(PIN) This is not homestead property. (is)(is not) Grantor warrants that the title to the Property is good,indefeasible in fee simple and free and clear of encumbrances except: easements,restrictions and rights-of-way of record. Dated July ],2014 i (GLENRIDGF,PROPERTIES,LLC-VENDOR (SEAL) *Richard O.Stout,Member -- (SEAL) (SEAL) * anet P.Stout,Member AUTHENTICATION ACKNOWLEDGMENT ••••,•......ti••• Signature(s) STATE OF WISCONSIN ) )ss. :NOTARY•: authenticated on St.Croix COUNTY ) PUBLIC Personally came before me on July 1,2014 •�'•. "' ��..•�• * the above-named Richard O.Stout and Janet P.Stout ..... ' TITLE:MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by Wis. Stat.§706.06) instrument and acknowledged the same. THIS INSTRUMENT DRAFTED BY: Janet P.Stout 1353 Awatukee Trail,Hudson,WI 54016 Notary Public,State of Wisconsin My Commission(is permanent)(expires: (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. WARRANTY DEED C 2003 STATE BAR OF WISCONSIN FORM NO.1-2003 T na a below si natures. St.G o x�ounty 9$341 Page 1 of 1 Property Owner A Parcel ID# Page of IE Boring# Boring Pit Ground surface elev. _ft. Depth to limiting factor > in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft Z in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. * ff#1 * ff#2 .Y a a Q Al F-1 Boring# ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. —go-7il—Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft Z in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. ff#1 ff#2 Boring ❑ Boring# Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu.Sz. Cont.Color Gr.Si.Sh. * ff#1 ff#2 *Effluent#1=BOD 5>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD 5<30 mg/L and TSS <30 mg/L The Dept.of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,contact the department at 608-266-3151 or TTY through Relay. SBD-8330(RI 1/11) tWis�> SA R fey �essionalServices SOIL /A AMU-REPORT Page of Divisdof SafPt 'A vN ME� in accordance with SPS 385,Wis. Adm. Code �eto:- %0P County Attach compl��tt t5n paper not less than 8 1/2 x 11 inches in size.Plan must include,tacnbt� vertical and horizontal reference point(BM),direction and Parcel I.D. percent sIQ� tadimensions,north arrow,and location and distance to nearest road. �O Please print all information. Re i ed by D Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). 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If you need assistance to access services or need material in an alternate format,contact the department at 608-266-3151 or TTY through Relay. SBD-8330(811/11) � 'D g .( PAI, Wis. �� S dWAssionalServices Sol L /A lTn NBEPORTCO p of a Division of Safejty �ildin .A \ VN sr`� in accordance with SPS 385,Wis. Adm. Code Coun P COO ty Attach comp) �Sn paper not less than 8 1/2 x 11 inches in size.Plan must include,bn el9 to:vertical and horizontal reference point(BM),direction and Parcel I.D. percent s_IQ��scale or dimensions,north arrow,and location and distance to nearest road. 10 Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). 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