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HomeMy WebLinkAbout040-1298-40-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 572869 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: Creative Homes, Inc., c/o John M. Eral Troy, Town of 040-1298-40-000 CST BM Elev: Insp. BM Elev: BM Des iption: Section/Town/Range/Map No: j - ( CS 1 09.28.19.1722 TANK INFORMATION ELEVATION DATA HI FS ELEV. TYPE MANUFACTURER CAPACITY STATION IBS Septic jr. ! ~QDd Benchmark ~ 99, 3 ~ Dosing 11t) we" J t F: L,... 3 / Alt. BM Aeratien e J Bldg. Sewer •7 ~ 7, z Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ~y zb Dt Bottom /f./ cZ Dosing /V , / Header/Man. S Q L Aeration Dist. Pipe 9f J• i Holding Bot. System -7-7 96'/o Z- q3. PUMP/SIPHON INFORMATION Final Grade 3.6 Manufacturer Z e, ~Le~ Demand St Cover r /I• I q~ GPM Model Number 5_3 TDH Lift Friction Loss System H TDH Ft J2.ty 32 Lel3 . Dia. I/ Dist. to Well Forcemain 1 .41 AA SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Ot Inside Dia. Liqui epth DIMENSIONS 3 r? Z J SETBACK SYSTEM TO ' / P/L BLDG WELL LAKE/STREAM LEACHING Manufact~Jr. INFORMATION CHAMBER OR ~ tG~,'1 Type Of System: UNIT Mode umber: DISTRIBUTION SYSTEM 7_344-43 = yl. ~o~~Jz ~ng Vent to Air Intake x :Hole Sizes x Hole Sp G4 Header/Manifgld / Distribution l y \ ` Length 5 Dia Pipe(sLength) Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/S xx Mulched Bedfrrench Center G; Bed/Trench Edges Topsoil !LYes [E No es No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 406 Glen Ridge Rd Hudson, WI 54016 (SW 1/4 SE 1/4 9 T28N R1 9W) Glover Glen Lot Parcel No: 09.28.19.1722 1.) Alt BM Description = r ~ Hu' x / 01 4~.fi 2.) Bldg sewer length = 26 - amount of cover = 4/6" Plan revision Required? Fm] Yes o ~ Use other side for additional information. Date Insepc s Sign Cert. No. SBD-6710 (R.3/97) PLOT PLAN PROJECT Dannv Schnackv ADDRESS 707 Commerce Drive Suite 410 Woodburv Mn 55125 SW 1/4 SE 1/4S 9 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 94.7/93.8 4.6' below grade DATE 1/29/15 BEDROOM 3 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE •5 ABSORPTION AREA 933 # of chambers 46 Ilk BENCHMARK V.R.P. top of 3/4" pipe ASSUME ELEVATION 100° Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark 150' 378' Property B.M.#2 10' @ 102.14' Additional boring will be 20' 99' t~ dug to lower system 10, 97' v elevation to a suitable depth! B-2 Glen Court Scale = 1 /4" = 10' 4-3 9 , 2-3' X 94' Cells with >3' spacing 10% Slope B-1 6' 101' B 0 20' S 30' Pro 3 Bedroom Glen Ridge Rd House Zb All piping shall be "SDR 30/34, within 10' of tank, piping shall be Schedule 40. )C CO mty L Safety and Buildings Division B 201 W. Washington Ave.; P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) p 'y Mso~V11 ,37 2 sip ~~1~ 57Z~~~ " State Transaction limber ermit Application rt ~'P in accordance with SPS 383.'.1(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application fortes for state-owned POWTS are submitted to Project Address ( different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary ores in accordance with the Privacy Law, s. 15. 1 m), Stats. 6 ~~Glti L A lication Information - Please Print All Information parcel Property Owner's Name L ~►n ~lC) lV (JV~/ Property Location Property Owner's Mailing Address Z \J 0--, r J Govt.. Lot i city, state Zip Code Phone Number 5(,t~ ;4, Section p y~ ) , le one I.CJ L4 T Z N; R E II. ype of Building (ch all that apply Lot # 2 Family Dwelling -Number of Be Subdivision Name droo _ ~~~~p 6L ~ Block# ❑ PublicJCommercial - Describe Use n• 11 City of E LZ5 11 Sta te Owned Describe Use CSM Number F1 own Village of of 2 Z ~l ► 51- Cell t,tJ III. Ty of Permit: (Check only o 6e box on line A. Complete line B if applicable) A. ew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New Before Expiration Owner W. T prof POWTS System/Comp onent/Device: Check all that apply) esized In-Ground El Pressurized In-Ground ❑ At-Grade El Mound > 24 in. of suitable soil 13 Mound < 24 in. of suitable soil sur ❑ Holding Tank ❑ er Dispersal Component( I ) Pretreatment Device (expl .l V. Dis rsaUTres ent Area Information. Area Prsed ran Elev on Flow (gpd) Design Soil Application Rate( dsf) Dispersal Area Required (s D730 t ~ ~ a V G ank Info Capacity in Total # of Manufacturer V1. T Gallons Gallons Units U h o T v New Tanks Existing Tattles [ ' U ;n o cn i Ci Septic or Holding Tani: j Dosing Chamber VII. Responsibility Statement- 1, the dersigned, assume r n ' ility for installation of the POWTS shown on the attached plans. Plumber's Si MP/M?PRSS Number Business Phone Ntanberr / Plumber's Name (Print) j ✓ ) ~ '~L,~< L~ llr~~~.~ Plumber's Address (Street, City, State, Zip Cod) 3 Z~ ~-.k- /vA VIII. ountvlDe artment Use Only Permit Fee Date sued Issuing, tSib Signature Xpproved tsappro S Ll 36 15 er Given Reason for 'al J TX Condtt~Ygasons for Disapproval 3~ ~S 1 • Septic tank, efflux filter and dispersal cell must all be services ! maintalneSt ►~J mber. as per management plan provided by plu 5 2. a 1`s0 k requirements must be trraiMairiesl, J as per appi"We code / ordir>ancss. Attach to complete plans for the system and submit to the County only ae sper not Less than 8 to z l l inches m size SBD-6398 (R. 11/11) PLOT PLAN PROJECT Dannv Schnackv ADDRESS 707 Commerce Drive Suite 410 Woodburv Mn 55125 SW 1/4 SE 1/4S 9 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 94.7/93.8 4.6' below grade DATE 1/29/15 BEDROOM 3 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK 1000 gallons LIFT TANK SIZE DOSE TANK SIZE MOUND SEPTIC TANK SIZE HOLDING TANK SIZE LOAD RATE •5 ABSORPTION AREA 933 # of chambers 46 BENCHMARK V.R.P. top of 3/4" pipe ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark 150' 378' Property Line B.M.#2 20' 10, @ 102.14' Additional boring will be 99' dug to lower system 10, 97' elevation to a suitable B_2 Vents depth! Glen Court Scale _ 1 4" _ 10' 9 B-3 2-3' X 94' Cells with >3' spacing 40' 10% Slope -1 6' 101' B. 20' S 30' Pro 3 Glen Ridge Rd Bedroom House All piping shall be 'SDR 30/34, within 10' of tank, piping shall be Schedule 40.~C C) p o Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 1/29/15 Owner: Danny Schnacky,P Location: SW 1/4 SE /4 S9 T28N,R19 406 Glen Ridge Drive Troy Manuals Used: In-ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance and Contingency Plan 7. Filter Specifications eet Signature License n er #226900 PLOT PLAN PROJECT Dannv Schnackv ADDRESS 707 Commerce Drive Suite 410 Woodburv Mn 55125 SW 1/4 SE 1/4S 9 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 94.7/93.8 4.6' below grade DATE 1/29/15 BEDROOM 3 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 933 # of chambers 46 Ilk BENCHMARK V.R.P. top of 3/4" pipe ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark 378' Property Line 150' B.M.#2 20' 10 @ 102.14' ' Additional boring will be 99, dug to lower system 10, 97' elevation to a suitable B-2 Vents depth! -2 Glen Court Scale = 1/4" = 10' 9 , B-3 2-3' X 94' Cells with >3' spacing 40' 10% Slope -1 101' B. 20' S 30' Pro 3 Bedroom Glen Ridge Rd House All piping shall be SDR 30/34, within 10' of tank, piping shall be Schedule 40. Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells ' Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber To be >1' above grade 5.'6ft 2 pair of end plates ,V Finish grade elevation Typical Installation 100.3' Vent Grade Vent 3' 4" 3' X30/34 Septic Tank 5' Long 1 11 5' S' Long 1 91 3699 Grade at System Elevation Grade at System Elevation Spacing 5' 2-3' X94 ' Cells Same on other end Observation tubeNent At end of cell A B 23 chambers per cell System elevations: A-94.7' B 93.8' ST. C.'ROIX COLTN SEPTIC T ANK MAIN ENNNCE ri( -2 ?F..MI ' f AND OWNERSHIP CERTIFlC ~"TIC.N I'ORM. Owner/Buyer - - C~,1Z C ' c Mailing Address,,-,--,,-,__, zn,_ '7,,p /7''%c.? r t 1 _ -'~1 - . ~a4 Property Address (Ve ificatton required fiotn 'lanru ng Zoning 1)ehatt~nent for new atusiruc.ttun.) Cif /State ~ - Parcel Identification in -iper ~ LEGAL DESCRIPTION N //W, Town o(- ~f Property Locataon ,(w1-) e- sec Subdivisi0sl ( r~~ t? CC'~~.o [ ,ot . Certified Survey Map # _ _ Vt lutrte' Nagc ~t . Warranty Deed VGtutne Page rr, Spex. house yes ru,) l .ot lirn~ identifiable. yes no SYSTEM MAINTENANCE AND OWNER CERTITICAIJON Improper use and maimenwice of your septic system could result in its pr,rmature faihtre to handle wastes. Proper maintenance consists of pumping out the septic tank every three yetus or sooner, it 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, wasic disposal, systerti. OWrler maintenance responsibilities are specified in §('onun. 83-52(1) and in Chapter 12 -St. Croix County Sanitary Ordinance.. The property owner agrees to subtrut to St. CCOix County Planning do Zo ng 1.)epartrnent it certification fitrnt, signed by the owner and by a master plumber, journeyman plumber, restricted plurrtber or a licensed pumper verifying that (.t) the ort-site wastewater disposal system is in proper operating condition and/or (2) after inspcc,ion and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above- recluirenients aixl agree to maintain the private; sewage disposal systeni with this standards set forth, herein, as set by the Department of'C'onttneicc and ill(-, DeParttr,enc of Natural Resources, State of Wisconsin. Certification stating that yolu septic system has been marritaitted mast be coinpletc, l and i:etiaried to the St. Croix County Planning, & Zoning Department within 30 days of the three year expiration date. )/'we certify that all statements on is foun are true to il~c hesi of tt»; our k uowlccige. liwe atti/are. the ovvtter(s) of the property described above, by virtu,, of a arranty decd recorded iu Register of l)ee( is Office. umber of bedroom § 3 SIGN OT DArJ ~ ***Any information that is misrepresented may result ill the sanitary pennit being io.! vobed by the Planning & Zoning Department. }//elude with this application a recorded warranty deed from the Register of Deeds r--jffice and a copy of the certified survey neap if reference is nrade in the warranty deed. (REV. 08/05) POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of SYSTEM SPECIFICATIONS p NA laro 977E d G6~ Tank Manufacturer: ~ Septic O Dose ❑ Holding Volume: J (gal) `NA Tank Manufacturer: DESIGN PARAMETERS Number of Bedrooms: `3 0 NA ❑ Septic ❑ Dose ❑ Holding Volume: (gal) Number of Public Facility Units: gLNA Vertical Distance Tank Bottom(s) to Service Pad:~ (ft) Estimated (average) Flow : (gal/day) Horizontal Distance Tank(s) to Service Pad: '15L (ft) (TD Specific servicing mechanics must be provided 'rf vertical is >15 feet or Design (peak) Flow = (estimated x 1.5): k-3 0 (gal/day) rEffluee:nnt ontal Is >150 feet. Specific instructions to be provided on back. In Situ Soil Application Rate: (9daylft~) Filter Manufacturer. ❑ NA Filter Model: Standard (Domestic) Influent/Effluent Monthly average Manufacturer: Fats, Oil & Grease (FOG) s30 mg/L p / Biochemical oxygen Demand (BOD5) s220 mg/L C1 NA Pump Model: Total Suspended Solids TSS 5150 m L Pretreatment Unit High Strength Influent/Effluent Monthly average (FOG) >30 Manufacturer: 4NA (GODS) >150 mg mg/L IA ❑ Mechanical Aeration ❑ Peat Filter ~ SS) >150 mg/L p Disinfection ❑ Wetland Pretreated Effluent Monthly average ❑ Sand/Gravel Fitter ❑ Other. (BODs) 530 mg/L /`~"'A Soil Absorption System Ground (gravity) ❑ In Ground (pressure) ❑ NA (TSS) 530 mg/L -pl V Grade ❑ Mound Fecal Coi'rform (geometric mean) s10" - to dia. ❑ NA [3 Drip-Line C1 Other: Maximum Effluent Particle Size Other: Other: NA ❑ NA MAINTENANCE SCHEDULE Service Frequency Service Event y hen combined sludge and scum equals one-third of tank volume Pump out contents of tank(s) ❑ When the high water alarm is activated ❑ month(s) (Maximum 3 years) O NA Inspect condition of tank(s) At least once every: year(s) At least once every: `S mo inks) (Maximum 3 years) ❑ NA Inspect dispersel cell(s) j month(s) ❑ NA Clean effluent fitter At least once every: ( year(s) r- ❑ month(s) :::rNA inspect pump, pump controls i3< alarm At least once every: ❑ year(s) month(s) Flush laterals and pressure test At least once every:. ❑ year(s) ❑ month(s) Other: At least once every: p year(s) ❑ NA other: MAINTENANCE INSTRUCTIONS licenses or certifications: Inspections of tanks and soil absorption systems shall be made by an individual carrying one of the to a following ng l icO Operator Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer or Sep g Servicing p~ (pumper), any crack Tank inspections must f include a sludge and scum and a check for any back missing or broken hardware, grrou or ponding of effluent on the g d surfaces Tor le he aksoil measure the volume ing effluent aP gacondition~and forrequiresany immediate absorption system shall be visually inspected to check the effluent levels in the observation pipes on the ground surface. The ponding of effluent on the ground surface may indicate notification of the local regulatory authority. of the tank volume, the entire When the combined accumulation of sludge and scum in any treatment tank equals one-third (X) or more contents of the tank shall be removed by a Septage Servicing Operator (pumper) and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code: pretreatment units, All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 30 days of completion of any service event. GMW 005 (02/05) 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, solvents or other chemicals or sediment that may impede the treatment process and/or damage the soil absorption system. If high concentrations are detected have the contents of the tank(s) removed by a Septage Servicing Operator (pumper) prior to use. under these in one largedose ca sing an Pump tanks may fill above normal the eater wastewater willrtbe discharged to the soil absorption restorati have the sitUation this conditions is not recommended, as the excess s avoid overload that may result in the backup or surface discharge of effluentand dam~go resiagng pow' to the pump or contact a Plumber contents of the pump tank removed by a Septage Servicing Operator (pumper) prior or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank. System start up shall not occur when sal conditions are frozen at the infiltrative surface. not drive or park over, or otherwise disturb or compact, the Do not drive or park vehides overt tanks and or soil at-grade soil absorption absorption system. area. area within 15 feet down slope of any and prolong the life of the treatment Reduction or elimination of the following from the wastewater stream may improve the performance dental floss, tanks and sal absorption system: acids, antibiotics, baby wipes, cigarettebutts, condoms, cotton swabs, degreasers, ~oline, greases, herbicides, meat diapers, disinfectants, fats, foundation drain (sump pump) discharge, fruit and vegetable peelings, g88, scraps, medications, oils, painting products, pesticides, san"ry napkins, solvents, tampons, 'and water softener brine discharge. 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 prop y and safely abandoned in compliance with s. Comm 83.33, Wisconsin Administrative Code: • All piping to tanks, pits and other soil absorption systems shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator (pumper). • 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 l absorption system. repla ent system: and for the utilized may be ! suitable replacement area has been evaluated from d sturbance and co mpaction wand should knot be~thfri g1ed upon by required The replacement area should be protected setbacks from existing and proposed structure, lot lines and wills. Failure to protect the replacement area will r with the rules in for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply effect at the time of their permit issuance. system cannot be C1 A suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption rehabilitated and barring advances in POWTS technology, a holding tank may be installed as a last resort. ure of the site and P0VVTS evaluation ❑ The site has bow t locate a to identify a suitable noo replacement sea islavailable a holding tankmay be installed as a replacement area. replacement must be performed last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconthsttruN1e edd in place afollll at ing removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with WARNING TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE ADDITIONAL INSTRUCTIONS: POWTS INSTALLER POWTS MAINTAINER . Name J Gc c.~ EName Cl )J) , -a 7 Phone n J " ~)J J fj SEPTAGE SERVICING OPERATOR LIMP LOCAL REGULATORYAUTHORITY ER L c ~ Name / q Name Z2==_Z2y2' 4& Phone Phone '5f1 - This document was drafted by the staffs of the Green Lake, Marquette and Waushara County POWTS regulatory agencies in compliance with sections Comm 83.22(2)(b)(1xd)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. FILTER CARTRIDGE INSTRUCTIONS Installation STEP 1 Dry fit the filter case onto the end of the outlet pipe to ensure it is centered under the access opening. If not, then either insert more pipe into the 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 to the tank end wall if utilizing the optional supplemental side support. If side support method is not utilized, 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 900. Maintenance 1. The effluent filter should be cleaned every time the septic tank is v_~~w x serviced. 2. Open the outlet access opening to inspect the tank and filter. ~ t 3. Pump the septic tank completely, making sure to remove the sludge - layer on the bottom of the tank and not just the scum and effluent. 4. Once the effluent level has been lowered below the invert of the s ; outlet pipe, firmly pull up on the filter handle to dislodge the cartridge from the case. 5. Slide the cartridge up and out of the case for cleaning. 6. If a VRS switch connected to an alarm is present, the switch should be removed by turning counterclockwise 900 and cleaned, F , 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 only, making sure all septage material is rinsed back into the tank. 8. If VRS switch is utilized, replace by inserting into filter and turning clockwise 900. 9. Insert the filter cartridge back into the case, pressing down until d °r the filter locks into the bottom of the case. 10. Replace and secure the access opening on the tank. BEAR ONSIT - FILTER CARTRIDGE - FIVE-YEAR LIMITED WARRANTY a. i >e free 0. Ir d~c Id` 6 a: Or6i`.B fiiCe= tarsi o r, ere ~or..;«rn_.. Nom: _hase: BEAR ONSITE- Filter Case -Lifetime Limited Warran Y bkear Cmgrc-. warrants e hfte• rase ::d1 he. .et .I_.t. the v :nal purchaser owns the vociu_,- is faun: In .iJ rnal u5 Fea 0".sI wl far` o i - v a 7c^ r c, a e s r .,gee r. I aG,7r c. ate BOIL st:-en Ja Ida t a rc,ot w,..11 i.- tri a . a - th Ins t vn um'S Pot a 0: ,al nt pr~In fr n- w. r;: re r r - Ine s, 'Y a n Pl 1, Sf 1o1ra. sales :e F `7 ..li _,me, IUe df Or it- all.. W t c-e w.:ra r< IE u lain s , -3 r n I itn all n Ca4al , -.:;,allw, e C 11 I- r e S 3 1 _h I ar,i 61 f e SI H - g w V It, vt1 - ,e U Ic Of yr c UCJ . z s c r. S ~ ,£ti trri x 3 aCt , N is • o * t/ 3l 3H 3.41 i JO W IW3 , i 16 f.M,90-00 S- r"O" c lei [ ~~cc lien cm . g fit,, A r ^ _ $ b~ rya `l ,4' / f ! 1007223 BETH PABST REGISTER OF DEEDS State Bar of Wisconsin Form 1-2003 ST. CROIX CO., WI WARRANTY DEED RECEIVED FOR RECORD 01/29/2015 8:00 AM Document Number DocumentName EXEMPT # N/A REC FEE: 30.00 TRANS FEE: 224.70 THIS DEED, made between Michael E Mankowski and Karen Mankowski PAGES' 1 married to eadli"other ("Grantor," whether one or more), **The above recording information and Creative Homes Inc. verifies that this document has been electronically recorded. & returned to the submitter ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real Recording Area estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix 'County, State of Wisconsin ("Property") (if more space is Name and Return Address Return to: needed; please attach addendum): Burnet Title. / 5151 Edina Industrial Blvd. #500 Lot 4, Plat of Glover Glen, Town of Troy, St. Crow County, Wisconsin Edina. MN 55439. 1 Attn: Post Closing 040-1298-40-000 Parcel Identification Number (PIN) This homestead property. (is) ' not Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: None - Dated (SEAL) (SEAL) Michael E. Mankowski * Karen Mankowski (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT- Signature(s) STATE OF - ) ss. ) . authenticated_ on 4 Personally came before me on 14 the above-named Michael E. Matkowski and [Caren TITLE: MEMBER STATE BAR OF WISCONSIN Mankowski married to each other (If not, to a known to be the person(s) who executed the foregoing authorized by Wis. Stat. § 706.06) e t aclaao dMthee #-LL I NDA MAE ~CRAEMfR Ne"v Put THIS INSTRUMENT DRAFTED BY: in ewer Burnet Title-Scott Tranby, 5151 Edina Industrial Blvd, b 0oi~~ 1Eq* aim 91,zoeo Notary Public, State of Wis#500 Edina, MN 5 5439/ 14-19087 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 0 2003 STATE BAIT OF WISCONSIN FORM NO. 1-2003 * Type name below signatures. St. Croix County 1007223 Page 1 of 1 2D'-O' 12'-O' "a'rnm".nd:lem m D41' 04• Y{4' fJFADYBi¢ 10 T-2• 1V• DW oW aapppppp lD~II abr. ap.b'0104 o.r w.yue~p / I r~r o.rlr.. M. BATH ,(II, ~ S VGA I~ I I 0•m°ru w..r a-s I I /I I „ AlelR I I F 1, 9 ual p~~1pEDW~~. ro 4• Y ,U M. U M. IM. L l aC.Vm I * ~'r I I .V\ I s'w• ear - I •I s'-r 4• I Q • nAac - WIG - y N Ind DC~`Y. n $ sD --------'I ~z D " $ 5 WIG I W at I a s Bay HALL !o elan 2a : aAUw LOFT I t e t c D4. § I Iggggig yp A QrQ I i C P BEDRM. 2 D y# ! I airrDU. ron wr ~ D ! 2 ! y I ~ Itca` a •4• I 4 - w. avo• eao' O4• T-O' D'-0' sw IIV' h4' 12'-O' o7b' NOTE: nA! K..E -LI.00lf 116VM0 TO 12' WR YNO. ~~Y UPPER LEVEL FLOOR PLAN BRACED WALL LINE ~&Av m-m2-anoy u". ~•.Ib. PANEL DETAILS iOYl HM WW WM TO DD #%W Ml. YNO. ~.ae era. anoe m nw: ALL tMlrtr,W.Le ®ao sn~nDK INDS DIeM1aY war ~IFl'Ol 1'LR CADI 2 W, D 9 kW ®IXmEm M• eauv cae IDr. coalea nwaw» oYr 4-10 x~o• el~•• •4• I]ti]• s4• rlsrLa'~' rxemaaarm ra~rlu61a.m1 °a'~s' uvseer iatw ^I":`i a~ rr°~n "~_w ::.T' Ir« • _ a1 e~wn uz Ie1. § KITCHEN i „M DINETTE *v`'"i,~ O S 9 I 00 Io•o}• 2`84' Y I 3 ~ I I L - - - - lu I I ~ i I z scar ! s ~ ~ to • ~I GREAT RM. J.J =w I~ OL p Irons a+ucn.®. n aswu i I } OC - wovetwee 3 li Aw x Q ao ° GARAGE Z z 1V• e • ' 4w• ~ .a. I~ ca11G. ~a. ♦ Iat ro oAn.YMr y1 •W ro o•nrxr ■ Y + U 4 a.wLL b Tu« F ,Taxaooxev~01t~ ~ II ~ ,~1 v / Y 'n K'YO.GM ~+f ~ II ~ Y'-o••s'4 ox eNt elt ~-j ,~e• ~I,I~~ s 4vo• i I i I I\ i t d t C d C p[~ d Ij ~ I ~ ~ I II I I ~~b~Ad v... F ~ 100 ]-I N,k 2b LY I e,Y ~ • 4llIA®FQ! F+ ~r-!'-O• 4Y' T-] v SN ~ S ,'d• - 164• . 11.0• ,~o• uw• 64• e4• ww• low• nw• ]0'4• NOTE: flA amcnzy w WALL LINE BRACED MAIN LEVEL FLOOR PLAN ~.wow« re.~r• mo eewme, 66o ee,em xme, PAMFI DETAILS 7014-0" 11~Oa6 T00.' ~-2,WY UIVJ. U4• • I'O• WFerxNmc -MK HIM H M6 W W 7110• Ml. 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POAM IIIeILATION w&fr x1111ffR ilAOaf TO w: O-2~10 ONO. V4• - I'C ®4o wwcmul.►N6 weA119Y1 ®e 2 X10 AlIVLT aMxm arccualrEaaaa PIL MalaWf e~HMAmta nc ? YNlM IPttTW ~a+rr~r. 6 # PEON VMM1 Maa LIC MIVLT aM/Im e. W~ _w .r I~ra~ r lalasll! ~ _ LU PEON vxn eronls Z cLLTaID Brae a - • Q FRONT ELEVATION DC v r IM' . I'-0' ~ IL YtEa v rl. r~ ~ Z m Z QM VV ~ ~ rl. rv E[rE ' 9999 Mr-I ~GOLUMN DETAIL Moil' LEFT ELEVATION - RIGHT ELEVATION q E g w• . I'4' ve' . I'-0' M EIE18 8 NOTES: I. ILL INI➢~0'MYTIPIYOMIl/RQIq! I]0 PROJECT IAIABFR 1 NL CNNfIa Ml601! 2014-OM a Kut svialnxeoee 1aoRls'Ime~ aIEETwRaw: REAR ELEVATION 1-10 W . I'-P• L or Properly Owner Parcel ID H O 7 t~ • /v(D / • Page 2 -of 3 florl"g o u Boring a 3 W- pit Ground surface elev. it. Depth to limiting factor / Z In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence koundar~ Roots GPD/Q' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Ell#1 'EH#2 ioYR ~3 /fs6.~ fh' z Y Z / L3 /o y(, 2,wf h,~-- f . s 3 2,3 • 100 M16 I slCr 11`f br 7`i' a. S , Z Z !a R s 51- 2 fSht A" f s. 9 Boring # LJ Boring - pit Ground surface elev. It. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Il= In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'EfflN 'Et►f!2 1r f Boring 0 Ll Boring U ~ pit Ground surface elev. fl. Depth to limiting factor in. Soil Application Rate I Iorizon Depth Dominant Color Redox Description Texture structure Consistence Boundary Roots GPD/fl' In. Munsell Qu. Sz. Cont. Color Gr. Szlsf~ •Effol •Effl12 Effluent #I = RODS > 30 < 220 mg/t. and TSS >30 < 150 mg/1- • Effluent #2 = ROD, < 30 mg/l- and TSS < 30 mg/l The Department of Commerce is an equal opportunity service provider qnd 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. SRb-R) Jfl rR F/fMl) I M. 'Msconsin Department of Commerce 110slon of Safely and Buildings SOIL EVALUATION REPORT Page / of in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1112 x 11 Inches in size. Plan must County S7; ~~0/ Include, but not limited lo: vertical and horizontal reference point (HM), direction and percent slope, scale or dimensions, north arrow, and localion and distance to nearest road, Parcel I.b. Please print all Informatlon. Reviewed by Date Personal Information you provide may he used for secondary purposes (Privacy Lew, s. 15.o4 (1) (m)). /s-- owner ` l! 7/21/06- Property Property Location RF Re/•-ff S Govt. Lot .SW 1/4 56' 114 S T 2 N R / Properly Owners Mailing ,Address (m) W 3 p O lot # Block # Subd. Name or-~SpAfL 7 / G/o 0ER G/,'--•v Z AGf eS City State Zip Code Phone Number /JUP5O~ s ❑ Cily ❑ Village ® Town Neares( Road T~ ~U/. yore (~!s , 41 2(p • /Z y3 ~tPa New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate yS0 - ~pQ'a GPb ❑ Replacement ❑ Public or commercial - Describe: Parent material d(JJfAejf. Flood Plain elevation if applicable General comments fl. and recommendations: S.G~ 3 MAY 1 5 Z002 ST. CROIX COUNTY / Boring # Boring q~3o q . Pit Ground surface elev. fl. Depth to Ifmlting factor ` In, Horizon Depth Dominant Color Redox Description Soil Application Rate Texture Slruclure Consistence Boundary Roots GPD/1112. In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. _ •EI►#1 'Err#z / o•!a /oyie z/3 SL //19•I sl,~ 414• cle 17&7 3 y . G /o • 2 ioY2 31, S!L ! f S 114 r . ~ ' L I Boring # ~ Boring /D/• ~O C~/~ u pit Ground surface elev. ft. Depth to Iimiling factor > / ~P In, Horizon Depth Dominant Color Redox Description Texture Slruclure Consistence Bounds Roofs Soil Application Rate In. Munsell Boundary GPD/tl' Qu. Sz. Cont. Color Gr. Sz. Sh. 'EQ#1 'Eff#2 /o '20 /0 V J"" o • /o io y~ S!✓k Olaf v,5~ 'W 3 7~ . f 4; fShk- .ur f/t? k, 2 7' s 3 /p R SIC 2 fshk /1rUl fl C5 . S 8 37• ~.S GS /1441 Effluent Ni - SODS > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = SODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature R0 34EIP T 7/6/P! CLi7- Z 2 ( 3 ?S er Address • Date ~Ealuaualldn Conducted Telephone Number ,too/?/ 3v ~~s 3F • /4U Private Sawage Consultants Zp~ 2 655 O'Neil Rd. Hudson, Wis. 54016 W 1 l lS r °c Sc91, ORIGINAL --~p 0.-- \~ak- te-t-v► .4 G~ov~R Grew - 1~i~i 'uS o • y ~ Properly Owner Parcel ID N 1/0 1061 Page 2 of 3 Boring N ❑ Boring Q0 ' a pit Ground surface elev. V it. Depth to limiting factor / Z In. pSollAApplicallon Rale Horizon bepih DOrninanl Color Redox bescriplion Texture Structure Consistence Boundary Roots WON In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sit. l 'E1142 /0 Y~ ~3 L fSd4 4g4 d r L I f~ G/ 2 r~ Y . Z l • z3 io lr 2. of h,O-I- 4" fie / f . s 3 23 • ~gp /ff4e fi` a.S` . z •3 Z /,0 R sL z fsti~ At 7 s Boring # r❑tt Boring tJ pit Ground surface elev. ` It. Depth to limiting factor in. Soli Application Rate Horizon bepih Dominant Color Redox Description Texture Structure Consistence Boundary Roots GpD/ti' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 --+7Z ❑ Boring r Boring # 1 ~ pit Ground surface elev. it. Depth to limiting factor in. Sell Application Rate I Iorizon Ueplh Dominant Color Redox bescriplion Texture structure Consistence Boundary Roots GPDJft' In. Munsell Qu. Sz. Cont. Color Gr. Sz 'Efffll 'Eff#2 Effluent #I = BOUs > 30 < 220 mg/L and TSS >30 < 150 mgA- ' EMuenl #2 = BOD$ < 30 mgn- and TSS < 30 mgn. 1'he Uepartrnent 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. sno.e~wotrt Fier i " r \ fa p p No, GoT L.. 3 78 20► ~M~~5,r1% T°p °C ~ 02,/4( PUG PiJ4-1- y~.o 2 e u P- GOa ~ r Ulbricht & Associates 9 Private Sewage Consultants 655 O'Neil Rd. Hudson. Wis. 54018 , 9d YO , B 3 iats o Coat f~vR f or of 3/y „ BUG P► -a EST~D dirrpse-~ aL_ l 7•~ G o W 7"i ,G,~ G~ 9 S, d' = ,134 c,~~ e P Ts ,c 3,0f 3