Loading...
HomeMy WebLinkAbout026-1294-34-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 572877 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: Oevering Homes LLC, aka Oevering Propertie L Richmond, Town of 026-1294-34-000 CST BM Elev: Insp.BM Elev: BM Description: _ Section/Town/Range/Map No: 7COt5 I to ' / G5( 28.30.18.1516 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER 4,-.4.,7-S CAPACITY STATION BS HI FS ELEV. ' Septic 146 c ti - '�� Z / 61 LA a-S /o o 3 Benchma3 -t' 6,5Y 3.3 /63.s . Boa .s g,'I1.4.`, AI " es� t"e,i l 8e- - 431A /• I Paz .7 Aeration Bldg.Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO ?/L WELL BLDG. 0•Ai Intake ROAD Dt Inlet U,et — sy� - — Septic S'7 / / ZO / . Dt Bottom �` Dosing Header/Man. 7. % 7 Co Aeration Dist. Pipe 7•lg 7q° 7. d 9$. 7 Holding Bot.System /CP 74/..9 Final Grade PUMP/SIPHON INFORMATION 3.3 /Gb •S Manufacturer Demand St Cover GPM Z • (I /41.Z Model Number I TDH I Lift Friction Loss System Head TDH Ft C-------_. ■ . 1 Forcemain Length Dia. /Dist.to Well J `\ SOIL ABSORPTION SYSTEM BED/TRENCH Width 1 Length r No.Of Trenches -L/ e ^^ PIT DIMENSIONS No.Of Pits Inside Dia. 1LiqukLDeQ[ DIMENSIONS 3 'Length z T e•.,,.e '`---- SETBACK SYSTEM TO Y� P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: , C �( INFORMATION / CHAMBER OR ^,�, Type Of System .tom r N 4-- UNIT /� C6H tIGw Q Z3 36 � �•V Model Nury�.J:� <4 �1 y (►'d" DISTRIBUTION SYSTEM Wear 3z (�4-.� GA4T.,.,.. _ Header/Manifoly // Distribution x Hole Size x Hole Spacing Vent Air Intake ,-, Pipe(s) �ti �_ �_ �� O Length IC Dia Length Dia Spacing C ti all SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only I Depth Over Depth Over xx Depth xx Seeded/ odded xx Mulched Bed/Trench Center ' („ Bed/Trench Edges � Topsoil w No gyres im No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / / Inspection#2: // / Location: 1152 132nd Ave New Richmond,WI 54017(SW 1/4 SE 1/4 28 T3ON R18W) Richmond Acres Lot 34 Parcel No: 28.30.18.1516 1.)Alt BM Description= 1 pi r.. P— 0 aeL, 2.)Bldg sewer length= 24 / -amount of cover= i / / Plan revision Required? 0 Yes W No " 3� j Use other side for additional information. _ , v 1 11' �.• aosmllIllrI- i L SBD-6710(R.3/97) Date Insepctor' -gnature Cert.No I. „xrtr County j �v Safety and Buildings Division / 201 W.Washington Ave.,P.O.Box 7162 i Sanitary Permit Number(to be filled in by Co.) Madison WI 53707-7162 ki G� Permit Applica ion Stan Tran sa Number In accordance with � l{_),Wis.Adm.Code,submission of this form to the appropriau governmental umt is required prieR g a sanitary pc=t. Note:Application forts for state-owned POVVTS are submitted w Yrpiect Address( different than maiiing address) the Department of Safety and Professional Servies. Personal information you provide may be used for second I purposes in accordance with the Privacy Law,s.15.04(1)m),Stats. i 1. Application Information-Please Print A111nformati d Z Property Owner's Name Parcel# Property Owners Mailing Address Property Location I�� N3 3 (if r a L)Av u<, S � Govt.Lot I City,State - i Zip Code Phone Number �';.�� i�, Section Z .9 l ktrcle o IL Type of Building(check all that a � Lot# � � 2 Family Dwelling—Number of drooms_ _ �� f Subdivision Name ❑Public/Commercial-Describe Use Ci►`” �✓�� j Block# ��/ r � ---- �. i ❑City of _ 11 State Owned--Describe Use r- i I CSM Number _� [I Village of of — i 111.Type of Permit: (Check onfy one box on line A. Complete tine B if applicable) Q A. ` ew System ❑Replacement System i ❑Treatment/folding Tank Replacement Only L Other Modification to Existing System(cxplain) B. ❑Permit Renewal ❑Permit Revision 1 ❑Change of Plumber El Permit'I ransfer to New ' L�itt Previous Permit Number and Date Issued Before Expiration ` Owner IV.Type ofPOWTS System/Component/Device: (Check all that apply) n-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grade ❑ Mound>24 in.of suitable soil ❑Mound<24 in.of suit lc soil GJ ❑Holding Tank Otber Dispersal Component(ex p m)_ _ — _ r_1 retreatmenY Device(expl . V.Dis ersal/Trea went Area Information: Design Flow(gpd) Design Soil Application Rate dsf) Dispersal Area Required(sf) Dispersal Area Pro os d System Elevati VI.Tank Info Capacity in 4 Total it of Manufacturer Gallons Gallons Units c 4 o j New Tanks Existing Tanks Septic or Holding Tanis Dosing Chamber =-- I VII.Responsibility Statement-1,the undersigned,assume nsihility for installation of the POWTS shown on the attached plans. Plumber's Name(Print) Plumber's re MPlMPKS Number Business Phone N i Plumber's Address(Street,City,State,Gip Code z ----i County/De artment Use Only Approved rsappruved I Pe.tn't Fee_ Date iued Zent S❑Owner riven Reason for Denial � I3:.Conditi so 44 O Dis pproval _.40ersal cell must all be_seWe&!maintained at pet maMQement plan RroyWed 4Y plumbw. 1�' .OtrtJ I�1 2 ssnlstt QfdillAtl�, fl4ICled t t J��af,H..�Q�'e,r�. I Attach to complete plans for the system and submit to the County only on paper not less than R tr_1 11 inches in sin y- � k �v"4— ",A- 62(:F/Z_ SBD-6398(R. 11/11) PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SW 1/4 SE 1/4S 28 /T 30 N/R 18 W TOWN Richmond COUNTY ST.CROIX SYSTEM ELEVATION 96.5/96.3 5' below grade DATE 3/11/15 BEDROOM 3 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TAN HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of cha er 32 , BENCHMARK V.R.P. Grade at 2" pipe ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark Scale = 1 /4" = 10' 132nd Ave j4' Long ent AL All piping shall be SDR 30/34, within 10' of tank,piping shall be Schedule 40. Quick4 Standard Leaching Chamber with 20.0 ft2 of Area �5.6ftA2/pair of end caps 75' Grade at System Elevation 34" 101.5' Vents B-2 0' 2-3' X 66' cells with>3' spacing 3% Slo e B-3 Pro 3 80' Bedroom 40' House ' S B.M. 5' T 30 2 �- 30' B-1 20' 100.5' I Property Line Qr 1� Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 3/10/15 Owner: Oevering Homes Location: SW 1/4 SE 1/4 S28 T30N,R18 1152 132nd Ave Richmond Manuals Used: In-ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance and C ntingency Plan 7. Filter Specification eet Signature License num #226900 PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SW 114 SE 1/4s 28 /T 30 N/R 18 W TOWN Richmond COUNTY ST.CROIX SYSTEM ELEVATION 96.5/96.3 5' below qrade 3/11/15 BEDROOM 3 DATE CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANS S HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of cha e.32 BENCHMARK V.R.P. Grade at 2"pipe ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark Scale = 1 /4" = 10' 132nd Ave All piping shall be SDR 30/34, within 10' Vent 1?�P� g of tank,piping shall be Schedule 40. >6" Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 12" 5.6ft^2/pair of end caps 4' Long 75 Grade at System Elevation 34" 101.5' Vents B-2 0' 2-3' X 66' cells with>3' spacing 3% Slo e B-3 Pro 3 80, Bedroom 40' House B.M. ST 3 25' 0' 30' B-1 20' 100.5' Property Line Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard Leaching g Chamber with 20.0 ft2 of Area per Chamber To be >1' above grade 5.6ft 2 pair of end plates Finish grade elevation Typical Installation 101.5' Vent Ael Grade Vent 3' 4" 3' X30/34 Septic Tank 5' Long VI 5' S' Long 1�� 36" Grade at System Elevation Grade at System Elevation Spacing 5' I 2-3' X 66' ' Cells Same on other end Observation tubeNent At end of cell A B 16 chambers per cell System elevations: A-96.5' B 96.3' POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner fr( ` Tank Manufacturer: ❑ NA Permit# Septic ❑ Dose ❑ Holding Volume: ,o (gal) DESIGN PARAMETERS Tank Manufacturer: 'ANA Number of Bedrooms: �,3 ❑ NA ❑ Septic ❑ Dose ❑ Holding Volume: (gal) Number of Public Facility Units: —,K�4A Vertical Distance Tank Bottom(s)to Service Pad:x//,4 (ft) Estimated(average)Flow: �670 (gal/day) Horizontal Distance Tank(s)to Service Pad: (ft) Specific servicing mechanics must be provided if vertical is>15 feet or Design (peak)Flow=(estimated x 1.5): .SV (gaUday) if horizontal is>150 feet. Specific instructions to be provided on back. In Situ Soil Application Rate: . (galldayltt) Effluent Filter Manufacturer:-�3dF;00912— ❑ NA Standard(Domestic)Influent/Effluent Monthly average Effluent Filter Model: Fats,Oil&Grease (FOG) 530 mg/L Pump Manufacturer: Biochemical Oxygen Demand (BODS) s220 mg/L ❑ NA -><NA Total Suspended Solids(TSS) s150 mg/L Pump Model: High Strength Influent/Effluent Monthly average Pretreatment Unit (FOG) >30 mg/L ' Manufacturer. (BODO >220 mg/L A<NA A ❑Mechanical Aeration ❑Peat Filter (TSS) >150 mg/L Effluent Month/ average ❑Disinfection ❑wetland Pretreated E y g ❑Sand/Gravel Fiftar ❑Other: (HODS) 530 mg/L Soil Absorption System (TSS) s30 mg/L NA Fecal Coliform(geometric mean) s10' Ground(gravity) ❑In Ground(pressure) C3 NA Maximum Effluent Particle Size 'a D in dia. ❑ NA El Mound Dr ip-Line Grade ❑ ❑Drip-Line ❑Other: Other: NA Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Pump out contents of tank(s) en combined sludge and scum equals one-third(36)of tank volume ❑Wh the high water alarm is activated Inspect condition of tank(s) At least once every: 1_:?-;94❑month(s) (Maximum 3 years) ❑ NA ear(s) Inspect dispersal cell(s) At least once every: months) (Maximum 3 years) ❑ NA year(s) Clean effluent filter At least once every: month(s) ❑ NA ear(s) Inspect pump,pump controls&alarm At least once every: ❑month(s) NA ❑years) Flush laterals and pressure test At least once every:. ❑month(s) NA ❑year(s) Other At least once every: ❑ month(s) NA ❑years) Other: NA MAINTENANCE INSTRUCTIONS Inspections of tanks and soil absorption systems shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer or Septage Servicing Operator (pumper). 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 a check for any back up or ponding of effluent on the ground surface. The soil absorption system 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 treatment tank equals one-third (k)or more of the tank volume, the entire 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: All other services, including but not limited to the servicing of effluent fihers, 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 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. Pump tanks may fill above normal highwater levels prior to startup or due to pump failures. Start up or restoration of power under these conditions is not recommended, as the excess wastewater will be=discharged to the soil absorption system in one large dose causing an overload that may result in the backup or surface discharge of effluent and damage to the system. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator(pumper)prior to restoring power to the pump or contact a Plumber 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 soil conditions are frozen at the infiltrative s urface. n stem. Do not drive or ark over, or otherwise disturb or compact, the Do not drive or ark vehicles over tanks or the soil absorption system. P P areo 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 treatment tanks and soil absorption system: acids, antibiotics, baby wipes, cigarette''butts, condoms, cotton swabs, degreasers, dental floss, diapers, disinfectants, fats, foundation drain (sump pump) discharge, fruit and vegetable peelings, gasoline, greases, herbicides, meat scraps,medications,oils,painting products, pesticides,sani4ry 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 properly 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 properly 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 replacement 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 by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will 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 the time of their permit issuance. ❑ A suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption system cannot be rehabilitated and barring advances in POWTS technology, a holding tank may be installed as a last resort ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a 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 TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK SUFFICIENT OXYGEN TO SUSTAIN UFE, 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 Name Q Phone )J �- �— Phone '7 6- SEPTAGE SERVICING OPERATOR P MPER LOCAL REGULATORY AUTHORITY Name Name Phone �- — Phone 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)(1)(d)&(f)and 83.54(1),(2)&(3),Wisconsin Administrative Code. . ........... FILTER CARTRIDGE INSTRUCTIONS Installation STEP i 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 901. Maintenance 1. The effluent filter should be cleaned every time the septic tank is w e °'° g a " ► serviced. 2. Open the outlet access opening to inspect the tank and filter. 3. Pump the septic tank completely, making sure to remove the sludgeA 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 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 4 ,, should be removed by turning counterclockwise 901 and cleaned with water only. 7. While holding the cartridge on its side (large flat surface facing dti down) over the access opening, rinse off the cartridge with water only, making sure all septage material is rinsed back into the tank. j' k� 8. If VRS switch is utilized, replace by inserting into filter and turning clockwise 90'. 9. Insert the filter cartridge back into the case, pressing down until, .'- Y M the filter locks into the bottom of the case. + + 10.Replace and secure the access opening on the tank. BEAR ONSITE"FILTER CARTRIDGE-FIVE-YEAR LIMITED WARRANTY f„ , BEAR ONSITE`"Filter Case-Lifetime Limited war-antq _ ,..,... _ ..� .... . ,. =m} North, Range 18 West, Town of Richmond, St Croix Cow 7 p (SEE SHEET 1 ) Presowtkn S89-53.36"W 170.00' N81 '11'Ot'W ———— — 236.92 o S89'53'36"W 519.87' -- of h j to 2. 18 acres 969 s 95, 137 sq. ft. N84 26'43"W ry 200.20' 514.68' v 314.48''..""" �o 1.81 acres 2.11 acres ft. 78,767 sq. ff. 91,88J sq. ft. U ° V �� 1 r*i Ad o �Q J 1.9Q acres 1.62 acres 82,753 sq. ft. 70,659 sq. ft. k NW ` • (0) tA S7 X05.00 ..-,- °'"^`'. _•- N�s��X \ � � � r '( M t 105 0 ' . tG 2�. �' "'i-- �- 14.84 _`� 242.46 t� 5 6.40 88.60 74 40 �s „ C?2 • 582'42'38 `N — r -P A 242'48 • cua N82'4238 N CS to z : w v; 0 p; o �.. `LS Q , N--1 La ro G! 44 46 _ N, 1.97 acres 45 85,936 sq. ft. W 1.96 acres ` y 1. 79 acres 1.74 ccres � i ft. � 77,876 sq. ft. N 85, 178 sq. ft. 75, 741 sq, ft. C4 Fn ! w (Ci CO a 50'Easwwf w I" for Prvirie Gross rn Preserwtion __ _ ——_ _ _ _————— 3996' N69 '50'27'E 28365' , I w 1a L4 180.00' 180.00' s8 47 S89'49 16"W 600.00, 0) (R=EAST) L Q T 1 968.2- y 1.96 acres Q CER TIFIE SUR VE Y l�ir°A P u 1 0 —— —— sq.85,398 ft. ( i j VOL 8 PG 2199 M ST. CROIX Co"'17Y SEPTIC TANK MAINFENANCE,AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer, --——------- Mailing Address /Y a Property Address (Verification required from Planning&Zoning Depa t for new construction.) City/State 1 Number t� Parcel Identificat'on LEGAL DESCRIPTION Property Location < Y'l S V4 Se(;.Z -6 T 30 W' Town offt Subdivision Lot# ('ertifted Survey Map# .............. Volume ---------- Page# Warranty Deed 4 _-ft-S 7 volume page A. 8PCc house S (E)no Lot lines identifiable(S no SYSTEM MAINTENANCE AND 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 finiction of the septic tank as a treatment stage in the waste disposal system. owner maintenance responsibilities are specified in Womm. 83.52(l)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,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 inspection and pumping(if necessary), the septic tank is less than 1/3 full of sludge. liwe,the undersigned have read the above reqUiTements and agree to maintain the private sewage disposal systern with the standards set forth,herein,as set by the Department of Commerce and the Department.of Natural Resources,State of'Wisconsin. Certification stating that your septic system has been maintained must he completed and returned to the St.Croix County Planning X. Zoning Department within 30(lays of the three year expiration date I/we certify that all statements on this for",are true to the best ofniy/ouf knowledge. I/we ant/are the owner(s)oftht- property described above,by virtue of a warranty deed recorded in Register of Deeds Office, Number of bedrooms-- L/I 3 o I 1NATUJ670FAPPLICANTS) DATF ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning&zonting Department Include with this application a recorded warranty deed lioni the Register of Deeds Office and a copy oh-the certified survey map if reference is made in the warranty deed, (REV.08/05) IIIII � IIIIIIIIIII IIIII 1111 I DOCUMENT No. STATE BAR OF WISCONSIN FORM 1-2003 8 2 4 0 9 9 0 WARRANTY DEED Tx:4197210 ! i 998137 THIS DEED,made between Richmond Acres,LLC,a Wisconsin limited BETH PABST liability company("Grantor"whether one or more)conveys and warrants to REGISTER OF DEEDS Oevering Homes LLC,a Wisconsin limited liability company ("Grantee", ST. CROIX CO., WI whether one or more),the following described real estate in ST CROIX County, 07/03/2014 09:57 AM State of Wisconsin: EXEMPT#' NA Parcel 1: REC FEE: 30.00 TRANS FEE: 825.00 Lots 7,11,17, 18,25,26,27,31,3 37,40,41,44,45 and 49,Plat of PAGES: 2 Richmond Acres in the Town o chmond,St.Croix County,Wisconsin. RETURN TO St.Croix County Abstract&Title Co.Inc. 219 S.Knowles Avenue New Richmond,WI 54017 Tax Parcel No: see attached This is not homestead property Exception to warranties: 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,and further except 2014 real estate taxes. Dated this 27th day of June,2014. Richmond Acres, C,a Wisconsin limited liability company By:Je a iiliams,managing member AUTHENTICATION ACKNOWLEDGMENT Signatures authenticated this day of STATE OF WISCONSIN 20_. ss. COUNTY OF ST CROIX * TITLE:MEMBER STATE BAR OF WISCONSIN Personally came before me this 27th day of June,2014,the above , (If not, named Richmond Acres,LLC,a Wisconsin limited liability authorized by§706.06,Wis.Stats.) company,by Jeffrey S.Williams,managing member to me known to be the person(s)who executed the foregoing instrument and acknowleAdge/the,same. THIS INSTRUMENT WAS DRAFTED BY df.0 i'�/C�//TW Robert L.Loberg/Loberg Law Office * k .��/1 �� ' `',;t•"'"" Notary Publ�is St.fCroix 6unty,Wis. :.,;, 0,y 1417332/alm j� ' °•°' O My Commission is permanent. (If not:'s fe'e pv—tion?daW: (Signatures may be authenticated or acknowledged. Both are ) '' not necessary.) *Names of persons signing in any capacity should be typed or printed below their signatures. ref WARRANTY DEED Form No.1-2003 St. Croix County 998137 Page 1 of 2 J 'J U NJ Z NQ �a �a W m 2 O J�1LiLF11 L1IU pm z t 11ilHlll�� �� � G 1�tlt i tfill v!1{ � a{r r t f Ifr u t 1 wry,; I a �qq4 F: t � el 1 iN wb � ziia s�ia jyS��,� w < w I:wo ,w CL co K | - -- -- ® � ) � \ \ @ % - O Cl --------------\-- t00 � ° | j � / ; ! ' } . �.�° � ) � ; \ } --= - -- --- —----------\-- -- /) __z �_. � � � lu�t I'l- .a �R --------------------- '50 sax.a or.Mamwncra I � I q I en3N __—__—____ _ 1r______��____ 1 i I I I �•. 1 a $ I i e I Iq V I I i I yrvl I 1 J - „ 11 ---T T ___Xi J __ ______ I I e 1 �1,,—___ rin'sx'_______1 ® I 1 T i .rm..-.s a�r .•-rl ., , I ;I _� i�F �otc�sasnw bomsni � I ,� �S� i I 1 I II 9gpp g°� '71 4 - _ I I j11 � n � 1 1 I I I 8 8 �S Property Owner_ Parcel ID# Page of Boring#F3-1 / W,Pit Ground surface elev. ! 1 - ft. Depth to limiting factor 1 V in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/ff in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 •Eff#2 ❑ Boring# ❑ Boring ❑ 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 F-1 Boring# ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon ')epth Dominant Color Redox Description. Texture Stricture Consistence Boundary Roots GPD/ff in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 •Eff#2 •Effluent#1 =BOD,>30<220 mg/L and TSS>30<150 mgA- •Effluent#2=BODS<30 mg/L and TSS<30 mg/L 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. Seo-asw(R.W00) ' Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85,Wis. Adm. Code County -� Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Please print all information. Revie by Date Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). Lto Property Owner Property Location Govt.Lot 5 i j 1/45E 1/4 S T j© N R E(o W Property Owner's Mailing AddreU Lot# I Block# I Subd. or CS %4'�-"3 Car }. 3uAA-, 4 q - ZI City to Zip Code Phone Number ❑City Village .Town Nearest Roa g3-New Construction Use,,Q Residential I Number of bedrooms Code derived design flow rate �/' GPD ❑Replacement ❑ Public o/y/commercial-Describe: --_—___- __ ---------- --- Parent material Flood Plain elevation if applicable ft• General comments l,�c.�j�. and recommendations: k � r System Type zr '/ System Elevation —14-Z-- Boring n] Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAf in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 •Eff#2 _ _ O Z- J ,. 1 fo 1-36 -�I_ �• rt Il Pit Ground surface elev. 5 ft. Depth to limiting factor ZZ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftr in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 -Eff#2 H 3 ti t� ti •Effluent#1 =BOD.>30<220 mg/L and TSS>30:5 150 •Effluent#2=BOD,<30 mg/L and TSS<30 mg/L CST Name(Please Print) ature CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 5401 tl /"'/ —/-,r— 715-246-4516 Property Owner_ Parcel ID# Page of ❑ Boring# ❑ Boring / Pit Ground surface eiev. < -5 ft. Depth to limiting factor�_in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/ff in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Ef1#1 'Eff#2 q 15 r>w > e r o G l� a Boring# ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Effn ❑ Boring a Boring# Ground surface elev. ft. Depth to limiting factor in. / ❑ Pit Soil Application Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Efr#1 'Eff#2 Effluent#1 =BOD6>30<220 mg/L and TSS>30<150 mglL 'Effluent#2=BODS 130 mg/l.and TSS 130 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD4330(8.6/00) Y Soil Test Plot Pla Project Name Oevering Homes Sh B' Address 1433 Cernohous Ave Suite A New Richmond Wi 54017 STM #226900 Lot 34 Subdivision Richmond Acres Da e 1/17/15 S W 1/4 SE 1/4S 28 T 30 N/R18 W Township Richmond Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Grade at 2" pipe System Elevation 96.5/96.3 *HRpSame as Benchmark 132nd Ave Scale is 1" = 40' AL unless otherwise noted 75' 101.5' B-2 o' 3% Slope B-3 �] 80' 40' B.M.* 30' B-1 20' 100.5' Property Line �i Property Owner Gera 16Q Ak Parcel ID# Page _i;;p_of Boring# ❑ Boring Pit Ground surface elev. b .23 ft. Depth to limiting factor 110 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 Li ,L r � 14 eAV4 Yy-kSlol,' L4 -. YR 4j, --_- S U-5� G �.> i F-1 Boring# F1 Boring — ❑ 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 ❑ Boring# ❑ Boring — ❑ Pit Ground surface elev._ ft. Depth to limiting factor in. Soil A lication 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 Effluent#1 =BODS>30<220 mg/L and TSS>30<150 mg/L 'Effluent#2=BODS<30 mg/L and TSS<30 mg/L 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. SOD-8330(R.6=) a L Wisconsin Department of Commerce r� EVALUATION REPORT Page--L of Division of Safety and Buildings in acco ce with Comm 85,Wis. Adm. Code County C ' -r/ i,�a Pia min ��� �" � ' Attach complete site plan on paper not less than 81/2 —� gt \ include,but not limited to:vertical and horizontal refere ce poi i Parcel I.D. ^ 2 v percent slope,scale or dimensions,north arrow,and to tion n t r st roa tJ { '3� d Please print all inform ition. R awed - Da e ll t��Q Personal information you provide may be used for secondary �rposes(f A PM44y aw;fs.o5p. r(y)(m))• a� �1' Property Owner ST.CROIX PUNT}'Coca o� S6 G e ra l SM.-Ilk ZONING PPAL t W 1/4 Ls 1/4 S a g T3(� N R E(or Property Owner's Mailing Add jLo # BI # Subd.Name or CSM# 90 e• N'W `l at to F 12 �c 1, A c rc City State Zip Code Phone Number ❑City ❑Village ®Town Nearest Road IF-1K R-VM I KIN 30 ( - 8 I? I Ana A•�t.. I$ New Construction Use:IS Residential/Number of bedrooms Code derived design flow rate^ $ __GPD ❑Replacement ❑ Public or commercial-Describe: - Parent material_0-LAWA -k Flood Plain elevation if applicable ft. General comments = 5 0 e—5-r -rf`G.n C..k�5 and recommendations: -T. 1 E IS.S Y') —r.3 0 S,S 0 010 N IF 6#'-f e- T, a 95.74�� Sic a1;: T,Y ( 9;5"Y01)`) l: Ft i s �e.u9�S1 a Boring# Boring Pit Q 'dS in. Ground surface elev. 7���ft. Depth to limiting factor 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 II=s�Y. 3 aa_3A -7.5 Yl to SL �7 s b Ye vi-4'r C LO v t LA `1 1 5/ 5 <.. m L Boring# Ej Boring ® pit Ground surface elev. 99_!Z ft. Depth to limiting factor / s 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 .)a Y2 a ._ �a-au IoY(L 14/1P - L.. ......... Effluent#1 =BOD >30_<220 mg/L and TSS>30_<150 mg/L E'ffluent#2=BOD <30 mg/L and TSS<30 mg/L T Name(Please P' �� Signature �� CST Nu'bar q Add�ss a *M S, Date Evaluation Conducted Telephone Number O � . �7+ ,�, 5 -7 aya 35ss ,gYo;110 '► r� _ _ ___ ___. ___ _. ___ _. __ __ _ . _ _ _ _ _._. ____ _.__ ___._.. _ __ __ _._ _.. _ _ _ _ ___ _ ___ _... __ __ _._ __. _ _._ _ _. _ __. _ ._ __. __. . . _ _ __ _ _ _ _ _..___ _. _ __ __.. __.. __ __ _ _ _. __ __ _ __. . _ __ __ _ _ __ _.___. ____. Ge ) I3W, R.1<90 Gg . QM 7nP ot Nom. lob 3y+ 35 �ti /at 1 ►'rl�. Ins , 3 l 3 A+ 3 s 5 y i"Aft ' & , hoe 3� � o , �z LP '-f5 Lo " o -t aaa a so _I oQ AsPsSy CO CCL 1 -- 21 •�\ _ � 970b I\� �r 1 3U1 5 J _....80'.YEWPOPARY CUL-DE-SAC EA-,; wmt +r 70 BE MWOKb � V is 21 \ 85�`aCrGS Exrr vs7cw c� n+E ROAD) c N B.A. .98 �.C/�e .. /.. 'tq, 1. acres 1.8�,acres 0 9 ° gcreS�, t N'B..A. 7'6 7' _ �! 1_ 1�cc 9773 ti i�B.A.�. 1 +. 1. ores II ,, _ 1.9 J. cc x 9.A 1.98''apre3 .. T 7 94 ac!es W NBA' N B A '.. /4 4, 16Z' Gres acres 196 t ti \ \ \ -� 3.0/- �i �9�o's�es•� ......_'$�.� � } %6.3/ `•� �'i I T .� I, _ �� .. ....-�- __Y.•-. \�� � •, '� •` � t'! ( 977 Iy� Itme O'QQARY CUL-gE-s�C / vo WT fm BE REAIO r ( `• .t �` '\ ... .:,` ..� \ �., \,. ,,�'......��:- .. \ - ./)/�J 1 i XIENV57cN OF ME ROAD1 3 � ...,' U1 x 962.6 7\ qCr 1 r �acrgs 1 , B.A. �, ` 73 ocr�s i \ f \\W `� "• .1' 6 qcr SrV.B.'A. + 2.tjJ4( aCIL G'S �.6� �.. `\ 26 i7cre,4 X62 e ' 1.4 N.BA (.97\ 0&'es \ \UCrqS . \�. B \21 5 `Cores;' 10 . j 1 x ` f a res 3 t�1 r 976.5 L. `. 51 N .A. acn � X2,.6 } s 2. J2 2.O i" N.B.A. yL Y'_ 1.75 acres i 967.7 %4.5 1"O I \ �ti Y' ` X2•'12 OCrl'S x Zb3' 23R' -•..R ,, t\ 1, `� `.. �,� ,�"_ _ __ `209' �� ,._ _ acres � ,_,`/ 97. 46�`.'`.' -- _"38 p 37 3 20 2 1B /' `-6-2 M, ;�, acres 1.81 acres 4s j \ 2. \ °�, x 9/ , �rf 2 J� acres.. J 2. 1 Ji acres � , 7z.a I'. J aCrB.S`, N. .A. %( -4.A. %V. t �q l �•B.A. 1:86 acres 1.6�. cre 1 1 2.10 acres f x N.B.A. Q -211 ocre� 2Ol acres 1 \ 9602 34 1.,00 0 acres~^o�//. / f 47-8' S y 1,62 acr 475.6 1 955.0 t I 959 f `� 1 1.90xocres :8 1171 t, %6.B '' 1,6'2 acres 7 2.2.4 acre 1 -- / i ��,,,, _ t. . ....... \ 974,8 f��� 7,752 N.B.A. f y05 ! t r .- tl ' 8' _ J I x. 2.24 acres J 1 Wo c 1 1 200 - \_ b ..� ; x .960.7 &� .� \� 2 17 acres q I �\ 974 11 r, N.B.A. j J:-' 217 aces `fJ 973.4 ! i 41 - 469' 6 \ / ........ ' /�/� x%9. v `pt 96 V 6.5'973.7• \ \� 9 r - fit , r '4� v §7 awes ' +96 cr - . �. 6 w - %7.5 1. 79 acres 1. 74',acres \ \ 1.94 acres ' v1.83Y acres x / N. A. . N.B.A. •f/ = ! N.B.A. NBA.. N B.d 1:36..4cres. \ f A. _ � �y 1.79 acres N. AA. gcres 1. /acres 'EJ acres t %R.9 1.74 ocrek �Q 1.94 acres ; 972.7 ..I j f %B.7 x 284 , -= N1 A. I t 43 2.63 acres J� f ti �r /1 8 vx r� f w4 11 I 120 0'%x3 I iL' 18�' V' �7 I r 9 I _i V %1 x j 96s� x i ._..,_1.96 acres o) �� ;;`�1 r 89 a res x y 97as / L, LOT 1 W x N.B.A. I I /1.89 es Ix l CERTIFIED SURVEY MAP %7,7 E 1.96 acres 1 -- - 436';''' I 17203 VOL 8 PG2199 �� 1452` x ---{ �... r + I ...� APPRONNG AUIHFBL�; ~ , -1'F+ I 2 'FIP /'[NDING SEC ta.7.30�e w. TOWN OF RICHMON / 1 acres -%92--`�) TOM OF RICHYONO, ST. CROW COUNTY �t , •. LO/ 2 � 2. (`..a ST.CF"X�ETY,W I 70NiN. O 1.$5 acres. -.¢/ - : 96,.5 r - - - RLATIED AREA IS ZONED: O - I N B.A. _ /r�� N.B.A. ___ / /Q 2.21 acres HUG-ee-20t 11:4,