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HomeMy WebLinkAbout020-1370-44-000/* Wiscor~s~h Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice may be used for secondary purposes [Privacy LawXs.15.04 (1)(m)]. ~e~r~~~io~d~re's Name: ^ City ^ S~Slllp CST BM Elev:; tiD ~ Insp. BM Elev.: - ~ BM Description: ~ o~ -~ 1 ~- • ~ ~ ' SST s TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic (,J~~, 6a Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. vent to Air Intake ROAD Septic ~ I /J ~ ~~ ' /s ~ NA Dosing NA Aerati n NA Holding PUMP /SIPHON INFORMATION Manufacturer Demand Model Numbe GPM TDH Lift Lriction System TDH Ft Forcemain Le h D' Ff Dist. To well SOIL ABSORPTION SYSTEM ELEVATION DATA Countst. ~:rOIX Sanita~!/NO.: State Plan ID No.: Pa rcel~ax,Ng370-44-000 STATION BS HI FS ELEV. Benchmark S3S~ -o~L 100. r`~ f ~ 6 lc+~. 7 Bldg. Sewer '],CIS 9-B'.3 St/Ht Inlet $.$~ `17/ St/Ht Outlet S.QI g7.~fc/ Dt Inlet Dt Bottom Header /Man. ~. ~ 7 ~ Dist. Pipe Bot. System I1. o p 4 S. Z Grade S •(ob / !°o. G 7 ~,4CVG~' S.S l 100.7 J c~ .w ~. t'o~ °! to • 6 S~ Q.7d ~~ . SS BED /TRENCH Width / Length No. Of Trenches PIT No.Of Pits Inside D Li uid Depth DIMEN 1 N .~ DIMEN I N SYSTEM TO P / L BLDG WELL LAKE /STREAM LEACHING Man fa rer: ~ ~~ SETBACK ~ " INFORMATION Type O ~ `~ CHAMBER OR UNIT Mo a Num er: " lt ~ Syste ZS / q~' - - . DISTRIBUTION SYSTEM T-T~~,rl1,. I„~ -::,.~ Header 1 Manrfold Distribution Pipe(s) ~ vv v ~ x Hole Size x Hole Spacing Vent To Air Intake , , I Length /~ Dia. -cry-' r I Length (,~ZS Dia. 3 `"~ Spacing? ~ I -~ I -~ I SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over ~ I I Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center / Bed !Trench Edges Topsoil Yes No No I ~QMMENTS: (Include code discrepancies, persons present, etc.) S 9 o f - Location: 987 Parkview Lane, Hudson, WI 54016 (NW 1/4 N 4 16 T29N R19W) -1629192210 Parkwood Meadows -Lot 44 ~\~' ~zc~6 ~ _/ - v (~ 1.) Alt BM Description -To ~u~S r-. ~o '^~ ~'1 2.) Bldg sewer length = I ~I -a ount of cover = few - ~ c.l (~.wti y ko t ; n ti ~ I l t al `~ ``~' F~ - ~ e~ ,~~~~ S y S-4c I,,,. ~1 ~~ w-E~~ w k, s (o a-~rt~o{.st,-f i w l af-~- ~ ~~'`~ ~Gbe `fps ~i y~ u y e e ~n revision required? ^ Yes ^ No r Use other side for additional information. _~ ~ "~ SBD-6710 (R.3/97) Date Inspector's nature Cert. No. ape ~~ ~ wLLI Wus wD~T~.s~ Ii~~~~~ ~~ ~~ ~.Q i~~~~~~ ~~~ ~ D ~ (~ i~ ~ [o~w~~ ~ ~ l/G ~ .~ a ,~~ ~ a7a~ `~~'~~ PAS-KtJ1EW Sanitary Permit Application Safety & Building In accord with Comm.83.21, Wis. Adm. Code 201 W. Washii `~seo i See reverse sidc for instructions for completing this application PO ns n Department or Commerce Personal information you provide may be used for secondary purposes Madison. W 15 (Privacy Law. s. 15.04(I)(m)) (Submit Completed form to co sta Attach com lete laps (to the count co onl ) f stem, on a er not less than 8 •I/2 x 1 I inches in size. Coun~ ~ ` Stat $~anitary Permit Number ~] ei:k il'ge9i}ttxy~o previous application State Plan I. D. Number S ~' tih, ~ e ~----~ I. A lication Information -Please Print all Infor i n' ~. ` .`;~ Location: Propeny Owner Name ~. •' , , ,,~ , ., , '~ ~ ~, Propeny t.ocation / Propeny Owncr's Mailing Address f ~ - Lot Number Blocl ~~ ~- i n.~ ~7r . ~at s ~ ~' y~ Ciry, Statc Zip Code ~;; bnc Number ~ ,~ ~~ Subdivision Name or CSM Number ~ ~ ~~; ~~ . _~ y I1 Type f Building: (check one) ~.' 1 , -~ cs ~'aP 4~ I or 2 Fa il D lli N f B ~ ' " ~ O City m y we ng - o. o edrooms: ; _ h 2 ' n tu O Public/Commercial (describe use): 1'`""' Tow of O State-owned [II Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest Roa ~ ~~ A) I . New System 2. O Replacement 3. O Replacement of. 4. O Addition to Parcel Tax Number(s) S stem Tank Onl Existin S stem O B) O A Sanita Permit was reviousl issued Permit Number ~ a~G "' ~j D't-}y--QQO Date Issued IV. Type of POWT System: (Check all that apply) a ~ l O Q~Non•pressurized In-ground O Mound O Sang Fitter O Constructed Wetland 0 Pressurized In-ground O Holding Tank O Single Pass O Drip Line O At•grade O Aerobic Tryatment Unit Recirculating O ther: ~/G~ V Dis ersal/T'reatment Area Information: - I .Design Flow (gpd) 2. DispcrsalArea 3. Dispersal Area 4. Soil Application S. Percolation Rate 6. System Elevation 7. Final ~ ~-/~C~ Required Proposed Rate (Gals./day/sq. ft.) (Min./inch) ~a~ ~ Elevatioi ~ 7s 7 ? /, VI Tank Capacity in Total Hof Manufacturer Prefab Site Steel Fiber• PI Information Gallons Gallons Tanks Con- Con- glass New Existing ~ ~ Crete structed Tanks Tanks _~ 1 • Ltil.~.c.~. O D D D D o 0 Vll Responsibility Statement I, the undersi ned, assume res onsibilit for installation of the POWTS shown on the attached Ians. Plumber's Name (print) Plum s Sign re (nos MP/MPRS No. Business Phone Number ~ ao 3~-~ ~7~ = ~8 -~~~ Plumber's Address (Street, City, State, Zip Code) ~ ~ 2 ~- (~J VIII County/Department Use Only ~ O Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued s ing Agent Signature (No sta Approved O Owner Given Initial Adverse Sur arge Fee) ~ - Determination ~ iX. Conditions of Approval/Reasons,~fwo~r ,isapprov~l y S~ ~ i'~ ~- 3-~NOpw. S~~~r.~ r `~~ , - , K~~o.2 a2X.~B ~jt+K¢. 6'+^.` ~W+.~ ~P ~1a'SR-w tue dr ~^ CoM r w • ~ , i r o~.C~t Ga ^ ~ ` ~ . ~ ~ ~1 w~ 5, q~. ~~-.`~_ -~- 'r~`~~'.~~` t~ ~ ~ - - ~ ~' ~ ('~ u f .. _ ~: -G.o 1J 1 _ 11_ ` _ ,~f •`.0~-1-~/ r_ 1„~ ~ .~1~-L _ ~,.a.!s / l V ~ NL Il ~.. .-...~-- •' ~+ 1 v f+c- ~- - w ~ • • r-v •. •a r.. v v`a9vv'w•v vc.i - __ ~ -/ }~ lS Je3 ewlS~ \f' C lS ~~ ~ VulG.t`r'1,'C~~K ~ ~ Wl a~~~S !`e ces+.~~t.w~ ~ . N 3- ~ _ ,, ~,,~ ~,.9..~. ' g-goo z~ N~ ~ ` yo ~~ ~ ,~6 , .~.._--'c~~ .~- r~. No ~-~0 r~ . aap3s N 3- ~~ ,5y ~ . y ~, ~/O v /oUG g,~'Q nv~'"`~ ~-~po z~` ~~ ., , ~~ ~a e ` T ^ ~ l `%~C/~ ~~ ,, ~~ ~ ,~6 , ~~ i6. ND ~-'~U ~ . aap3~ Wisconsin Department of Industry, $ O I L AND SITE EVALUATION F~.EP 0_ R T Labor and Human Relations r.wi~inn~f Safaty ~R Rllildinne ~ Y~` ' Page 1 of 3 ' - - 111 QVVVIV ••~til ILI 111 VV.VV, • J/"/ny,~ VVV ~11 .:~• .'w f ~ UNTY ~ ... PI ~:rndst inclu~; b~; er not less than 8 1/2 x 11 inches in size Attach com lan on a lete site St. Croix ,,~. p p p . p ~~ ~ , l BM di i i i d fo" i PARCEt, LD. # ,~ e or e sca ), rect on an zontal reference po nt ( % o s ~ not limited to vertical and hor dimensioned, north arrow, and location and distance to nearest road. I ~~' ^ '~ 020'-1028-90 i ~ ~' ~ APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATIO ; ~_; Y ~ ~, ~ R VIEW D B DATE ` ' .~ ~ . ; ~I , ,. ~ IIo PROPERTY OWNER: R P~ ~ LaCasse Custom Homes, Inc. ~~~, '1/4,5 16 T 29 ,N,R lg ~ (or) W G Vi. LflT ~ PROPERTY OWNER':S MAILING ADDRESS LOT .; ;~°61;t~CK#. ;S~JBD:~IyAME OR CSM # 521 McCutcheon Rd. 44 / < '~~aood Meadows First Addn. CITY, STATE ZIP CODE PHONE NUMBER ^CITY ^VILLAGE [ tOWN NEAREST ROAD Hudson, WI. 54016 (715f 381-5405 Hudson McCutcheon [x] New Construction Use [ x] Residential / Number of bedrooms 4 [ ]Addition to existing building j ]Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate • 7 bed, gpd/ft2 •8 trench, gpd/ft2 Absorption area required 858 bed, ft2 750 trench, ft2 Maximum design loading rate • 7 bed, gpd/ft2 •8 trench, gpd/ft2 Recommended infiltration surface elevation(s) 96.40 ft (as referred to site plan benchmark) Additional design /site considerations na Parent material outwash Flood plain elevation, if applicable na ft S =Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U =Unsuitable for s stem ~] S ^ U CAS ^ U f7 S ^ U ®S ^ U ~7 S ^ U ^ S ® U SOIL DESCRIPTION REPORT ~o,,J G,{4~._ -~jJ~ (,?a'rtr0 0~`"""r~ Boring # .................. ................. .................. ................. 1 Ground elev. 100.4 ft. Depth to limiting factor +90" Boring # 2 ................. Ground elev. 99.8 ft. Depth to limiting factor +90" Depth Dominant Color Mottles Texture Structure Consistence Bourldal ROOts GPD/ft Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. y Bed Trertdi 1 0-11 10yr3/3 none 1 2msbk dsh cs 2c .5 ~ .6 2 11-38 10yr5/4 none sil 2csbk dsh gw lc .5 .6 3 38-90 7.5yr4/6 none cos Os ml na na .7 .8 Remarks: 1 0-12 10yr3/3 none 1 2msbk dsh cs 2c .5 ~.6 2 12-35 10yr5/4 none sil 2msbk dsh gw lm .5 ~.6 3 35-90 7.5yr4/6 none cos Os ml na na .7 .8 Remarks: CST Name:--Please Print Gary L. Steel Phone: 715-246-6200 Address: 1554 200t ve. New Ric on WI 54017 Signature: ~ - Date: 10-1-99 CST Number: m02298 PROPERTY OWNER LaCAsse Custom Homes SOIL DESCRIPTION REPORT Page 2.,_of 3 . - ''vi PARCEL I.D. # 020-1028-90 , Boring # .................. ................. 3 ................. Ground elev. 1QII.1 ft. Depth to limiting factor +90" Boring # 4 Ground elev. 100.3 ft. Depth to limiting ~~ f+90 Boring # 5 <` Ground elev. 99.7 ft. Depth to limiting factor ~~ Boring # .................. ................. .................. ................. .................. ................. .................. Ground elev. ft. Depth to limiting factor Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends 1 0-11 10yr3/3 none 1 2msbk dsh cs 2c .5 .6 2 11-33 10yr4/4 none sil 2csbk dsh gw lm .5 .6 3 33-90 7.5yr4/6 none cos Osg ml na na .7 .8 0 a~-4~-Yo s`f`' ', ' ~~ ~°~• Remarks: 1 0-8 10yr4/4 none 1 2msbk dsh cs 2c .5 .6 2 8-30 10yr4/4 none sil 2msbk dsh gw lm .5 ': .6 3 30-90 7.5yr4/6 none s 0 g ml na na .7 .8 .~~ 0'1 Remarks: 1 0-13 10yr3/3 none 1 2msbk dsh cs 2c .5 .6 2 13-35 10yr5/4 none sil 2csbk dsh gw lm .5 .6 3 35-90 7.5yr4/6 none cos sg ml na na .7 .8 Remarks: Remarks: SBD-8330(8.05/92) .t STEEL'S SOIL SERVICE Gary L. Steel LaCAsse Custom Homes, Inc. CSTM2298 NW4NW4 S16-T29N-R19W MPRSW-3254 town of Hudson. lot #44-Parkwood Meadows First Addn. 1554 200th Ave. New Richmond, WI 54017 (715) 246-6200 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted.. "=40' top of 1" pvc pipe ~ el. 100.00' Alt. ~n=top of 1" pvc pipe C el. 100.90' 2U1o r~~ ~o. ~, vSkE~ 56. ~ t~ GAry L. Steel 10-1-99 /~~ \~ ' ~,~ ~5 ~~ 3-86-1995 8:28PM +~wy 6o~r~tutA'.Num~en~Relatior~ ~~• [~etOn of SatetY tl8uilei•Crge FROM P. 1 SUIL AN~1~'1.1 t'tVALUAI It;JN fttil'UFi 1 • ~. _, r~~.~ ' .- --._.._... ,..,.... _..~..._.... ----- Attach complete site plan on Paper not leas than 81/2 z 11 inehas in size Plan must include but N St' C'~~ , . not limited to vertical and heriiontal referents point (BM), direction and % of sbpe, sret9 or PARCEL l-D• tt • .dimensioned, north snow, and location and distance to nearest road. 020-10213 APPLICANT INFORMATION-PLEASE ppINT ALL INFORMATION REVIt:WEDB PATE 2i'JO J Pf1oPERTY OWNER PROPERTY IOCATI ON 7.aC~asse Cur 'Hauer Inc. GOVT. LOT IviJ 1!4 Ny,T tla~s 16 T 29 •N~R 19 ~ (tx) W PROPERTY OWNER".~^ MAILING ADDRESS LOT g' BLOCK * SUBp. NAME Oq t3131u1 g 521 IY~cC~.teY>reoa Rd. 44 na Meadt~ First Addn. • CITY, STATE zIP CODE PNONI: NUMIBEcR QCITb ILLAGE DOWN NEAREST ROAD Hodson, IiVI. 54016 (711 381-5405 ~ Htadsom McCuttheon pq New Construction Use (yg Residential / Number of bedrooms 4 [ J • Addtion to existing truilding • j J Replacement ( J Public a eonttrterdN describe • Code derived daily ifpw 600 ~d Recommended design loading rah . 7 bed, gpd/R2 -8 trertdt, gpd-ft~ Abscxptieon area, required 858 ~, {I2 750 trerK~, ft2 Maximum design loadirg rate .7 bed, gptllft2 .8 trench, gpolR2 Recorttrrlended infiltration surface elevation(s) 9~ _ 40 ft (as retened to site plan bendtmark) Addt+onal design !site considerations 2>~ Parent maileriell _ tsutvash Flood plain elevation, it applicable _~a n $ = Suitable for system CsJNVENTIONAI MOUND IN•CiRplJNlp PREssURE AT GRADE SYSTfJYI IN FILL t1pLDINd TANK U = Unsuitable br tc7 s C] U C~kS D:U ~ S ^ U ®s ^ U $7 S C7 U (.~ 5 ~ U . SAIL D~SCRIPTION• REPORT Horizon Depth Dominant Color 11Agtdes Texture Structure Consisteno3 id01X~ry RCOt5 GPa/ft in. Munsell Gtr- $Z. Cont Color Gr. Sz. Sh. B9d Tietdr 1 0-I1 10yr3/3 nom 1 Zmsbk dsh cs 2c .5 j.6 2 11-38 i0yr5/4 mane sit 2csbk dsXt yw lc .5 .6 3 38-90 7.5yr4/6 ngne ca s Osg tnl txa. >ne .7 .13 f~emgrtcs: 1 0-1.2 10yr3/3 norms: 1 2ntstalc dsh es 2c .5 € .t3 2 12-35 10yr5/4 narle six 2msbk dsh gltr lm .5 ~ .6 3 7.5yr4/6 nc~e cos Osg tt-1 na, na .7 .8 ,.~Z •c -9 -y , y .~ • u~-~- Remarks: •Print, taar~+ L. Sleet _ ~ tom: 71 5ignaturo:. ~~~ r ~!~ .~ Date: 10-1-99 CST Nut>t1~r: m0229tt ~. Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWYS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- Table 1: Svstem Design Specifications Sanitary Permit Number 3~3 Number of Bedrooms Design Flow -Peak (gpd) "o Estimated Flow -Average (gpd) ov Septic Tank Capacity (gal) m9v Soil Absorption Component Size (ftz) 3~-S i Type of Wastewater mestic Table 2: Soil Absorption Component -Limits of Reliable Operation u ~~D,a,,.:lo~ Septic Tank Component Soil Absorption Component Design Flow -Peak (gpd) tsaO 3 z - Maximum Influent Particle Size (in) 1/8 Maximum BODS (mg/L) 220 Maximum TSS (mg/L) 150 Tab le 3: Maintenance Schedule Septic Tank Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the se nk and outlet filter shall be assessed at least once every 3 years by inspection. Th outlet filte shall be cleane ry to ensure proper operation. The filter cartridge shou d not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from fhe inferior of the tank maybe difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 APR 10 '®1 16 24 FR ST PAdJL F[RE S. MARINE612 31® 8439 Tb 917153816541 P.®2/02 f4PFR-10-2i>tk7, TUE 18e®i ID:LAGASSE G~T~OM H0ME8 T0.~71S-ffii-6641 P:OQ sx ~:ttolx ~aulwr~r slslMrt~ •1•AI~iK, MAIN`i'131~tAt~tCl3 aott1313Mt;tri'!` 1WD ©WN131t3iI1l' Cliltl'1l~IC~i't~N lt~lliMt Owrtcr~iluyor ~ C~ Madling Atklt~asa '" ,/ Pmlterty Addtaaa (VeriCtGaltorrieg~aircd fiibu l'I~uuiis~l: uaparhrulrl liar ucw ., = ~O C~ity/Sil,lc 1~ ~ ~~ _ ~,_ Parka! Idurtitl~atk-n NutlilsQr !t,l,~1tL.y,c~t~ r.~rialy Prolict`Iy tlocatlatt ,.~~. Y+..+O[#~~ 'f~~ :3ai:. 1 ~ . '[',,,~~i~t•1t~..W{~~ e~ ~ ' " . f'itrlxlivisi4n '>f Lri( IE ,_, Cenlt[letl 8ttrvey Malt # ~_ Vuluura --` PAga ~1~ /' _ ~-- 4Varrttuty Doot! # G ~ 5 ~ ~~ ,_,., Votutno ~So~ lyttga # a ~lx:a Iwrtso ^ yea 18~ ua I.ul linos idwrll linblo ~ycs Ct no larpmper n.e:uxl audntauuwcui ywn isl-rk iySlant e~~ri~l realult in Na preu>rlnre fniluro to luncile waatea. Prolrermalattee^aae tottiltts o!' Puwpi!-a apt rle ~+tk teak avw y tlgq yonra ar an+raor, if wGaled uy a Itcc~~e~t pn~nrK~. What yon pat lato the ryitesu c#e t~lYieat the lhsdloq of the sgttks tardc Ac a uenruead stage in illo wseto d1y,~aat ayilelrr. ~ laapcety owner aereea to aWrnlit a, !~. ftoEx ~ortloe 1)cI>arlrtrsnf a carclnwuat form. alerted ty t6e ows~r and by a ussc[ap}rmstra, jrnrrneytgr-rt }thunUsr, rocr~;atalhluuuhrr urs ticonaa,I pwnpar vedlylgg ibat (1 } the ort•aite wagewatetdtapeolayatent is l~r psaipor operattag oen~Fltlum sad/or(Z) •rt~r in:I-aCtiwr artJ lttlaq,ieg (it na+:oisity)~ 16a ietNio ta11tC !a ten tliia !/31IrU of ahu~. Vwo, rho nddenlgpad Ir-,vo seed ilra abe+-e ro~p~i~en^enir arst agree t~ urilai~rr eha prirata isVYage dlapOeai syatomwlflr lbe atnndarda ~ ~h. iirseh>. ~ ~ by ttta iUepattmrart o[ C:nnur[aroe .ud the 1~q~attrueet of Natural lteaouraaa, $tsN o[ W}woaaln. Oaetllfaaihm atattrte ttn<t ya~r ~o=-tto ayatem Iwo ltCCS nutiniaiuo~l emit lte canplelad sad totxrfletl M rho lit. Crgbt catnty Zodutg t~loewltbis 90 dgl-a of ttre tiraq~y~r n~piraQon daro. 1L~y r BtQNA~7Ri3 8l7 AN1ii3~ANl'~~ qA~ . = taro} ~(tify t11at all atatatuanr: un t4ii fw~q era tlua to lbp i•eat rrf my (-nrr) !cr-dwiedu~e. 1 (wa) seq (are) the o~nlet(r} of tt>tt y +1+seorLUai sbora~ hY vi~trre yf a wrrlalay dead ~ea~taelt in Itcplitar of l~oetta 0lt4oe. ouA'ctJ~ OF Arl•LIt,.ANr >~A78 rr~rt. Aiy/ inl'outlatlWr U-ar ti 1nll•rci-fei~t-ra~t r1Yiy sail{{t tll IIfO aiaitary r.cS~glt itoiag aovokgd ~y gte ZagiitQ, >~ rftiM* •' tilelude ~rft6 thfa sttlrlIestto~u a arbmpe~l wori~aury deed !Yarn tllo ltcglpte u[ Useda a(Yloe :t copy of rile uatilied w-cvey mall ff rcl'~-po li maeb iu !tie arattauty deed ** TOTAL PAGE.02 ** - 4i;,• .1524 PA« 492 STATE BAR OF WISCONSIN FORM 2.1999 Document Number WARRANTY DEED This Deed, made between LaCasse Custom Homes, Inc., a Wisconsin Corporation i_ Grantor, and Steven Lacke andHeather Tepley,both single persons Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area /o°~ 625'355 Y.A~iHLEEN H. WALSH kEGISTEk OF DEEDS 5T. CRDIy, CO., WI RECEIVED FOR RECORD 07-07-2000 8:30 RM WARRRNTY DEED EXEMPT ll CERT COPY FEE: COPY FEE: TRRNSFER FEE: 239.70 RECINtDING FEE: 10.00 PRGES: 1 Name end~Re~tum,Address Lot 44, Plat of Parkwood Meadows First Addition in the Town of Hudson, /riZ ~--~ St. Croix County, Wisconsin. 020.1028-80 Parcel identification Number (PIN) This is not homestead property. pf) (is not) Exceptions to warranties: Easements, restictions and rights-of--way of record, if any. Dated this ,Tl~day of June , 2000 LaCasse Cnustom Homes, Inc~.~ - ~ ~"`~~ ~~ ~A~ ~l d , « Richard W. LaCasse, President ~ - « AUTHENTICATION « ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) ) ss. sr' ~ tize;; v coanty ) authenticated this day of ~ Personally came before me this ~ C7' day of June 2000 the above named LaCasseCustom Homes Inc. a Wisconsin Corporation by - « ^,ti_~;,; ii,r. ''`r'^ Richard W. LsCasse, President '` ^ (i r'7 TITLE: MEMBER STATE BAR OF V4t;8 N ~ to a known to be the person(s) who executed the foregoing (If not, Star 06 Wis § 706 d b i h K. ~~ s u t acknowledg~dthe~CmF.• 71 { (~ . . . , y or ze aut i 1F S INSTRUMENT WAS D~' .~,,~ `_ KISNE7. L.LDR ~ /~nQ,~ D BY .'' « l , THI Attorne Kristine Ogland ~' , , 1,} -J='+ ~/ Notary Public, State of Wisconsin Hudson, W 54016 '~ /` : ~ ~ ` ' My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) u -~ U~ ~ ') « Names of persons signing in any capacity must be typed or printed below their signature. tnrarmNUn arweesmab comt,any, rw,a au uc. Nn 90055S2n21 WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2. 1999 PARKW00 - D M ADOW S FIR T AD S D ITION ATED IN THE NW 1 /4 OF THE NW 1 /4 OF SECTION 16, T29N, R 19W, TOWN OF HUDSON, ST. CROIX COUNTY, WISCONSIN. UNPLATTED LANDS R19W S 89.18' 46" E 2638.43' NORTN LfE OF ThE NW 1/4 N 1/4 1319.22' SE PONT OF ~ ~'iy;' 639.61' ~ b 1319.21' - r~~ BEGNIWO 4n ~?. '~2 .. ~ h ~ ~_ ~~ ;.:- ~ 41 : ~ 42 g .,.,,i ,~ ( ) p ~v N 3.492. ACRES n °- ~s ~23~5 e07.0 N.W,E. N 4C ;~' 152.099 SF. ~,~^ . ?' pp ~' o ~7 't ` N 89.16' 46" W 361.e9' y _ - DRANA6'E ~ ^O: ~,•;o~.:.~ 244.12' 11 ~ i. 8 16' 46" W ry~' ~ne~' ^^' ' - ~' $ ~ a ~ EASEI,ENr ti°'~ ~'~"~ Zi 1eo36~s.Fs /" ' a16o ASS ~~' q'' . ~ 136,s1o sr. ~ - 734 ~ N 99.16' 46" W 38230' ~ R~0' '~' 306.04' SO' I ~ 8 ,b+. 306:04' _ ~ _~ rK ~j ~'~'3t" g, ~1~ ' j ~~ ~i1 I 391.6e• 39 aoso ACRES r~ s~ ~ ~ "~, ~' p ,~' S 6139 9" E 131.968 SF..,M S ~ G9.18' 4 " W 1 ,g3 t~' ~ R~ Z I • ~ti~ T 260 ~~ ~ Q ~I 0' .. 239.79• ~,~b ~' ~ 340.23' _~' ~ 1 ~ //,3./4'02 A4t'RES ~' oI ~ •`", `/ 148,191 SF. ° HI 396.00' N 89.16' 46" W 660.04' 264.04' - ' ~-891.0 (N.WE) iv ~ ~" ~ ~ ~ R m <I \ ~r f ~ 41 i ti \ >r~ ~ N 8FM W ~~ ~j I z~ ' io .e3~i'~s.F. ~ ~ 2.oo33~cR~s ~ 1 t `~ - • 7 $ \ . r e~,19o sr. ° 1 1 N O 1_. _ 45 $ 893.0 (H.WE.) 2.248 ACRES ~ ~' DRA91ACa: ~ 3 97,933 SF. EASEhE1JT N v 46' " W 414.96• ,• 6 I . 96 ~ I N 80"46' " W coo j N 9`46' " W 1 gyp,, 30.00' XIW r ~ ~•-_• Q.J $•~ I 3 a 2oo93~cx1ES -~ ~ -~- _ .~ ~ "' $ 87,303 s.F. ~ : '~ 46 $ _~ n ~p•~L~ ~ I ~ 98.344A~ ~ ~~Y N 89.46' 00" W ; N 9• ' 00" W ~~~ 34 4 I 11. 3 ~~ ACRES ~ SCALE IN FEET 114,680 SF. ~;, ~ ~ ~ ~ 60' - - a ~,.q,,~, _ _ 35 _ ~ ~+ _ ~ ~ _ 47 o So 100 200 ,.j 2.104 ASS N g 42310.00' ~ ~• k~~ ,~~• • N 91,667 S.f. ioi ~azcS s a i My . .1 $ I ~, ~ ~ g .L~4~3 ' ~ y 12aoo' ' N ~~~ 499.34• .~ NOF 7-€N 89'33' 03" W 1313.87' _ _ ~: r- - - - - ~+'.l[4.9E ~€ -~I~ 1~ - McCUTC1iE0N ROAD ~ - ,~ ~ BENCFIMA1tK: ~ SDE - I - - -T - - - - ~ - - - _ - r - - - - - I E~LEVA~ 91~2.3e I ~ ~ oo ERNO~"vo~ I PARKWOOD MEADOWS I i I UNPLATTED I I ELEVATI0N.p16.03 I - - ~ - - - - - II ANDS a, I I I ~', I s I g I a I 3 I 2 I '_ I) '~ I I I I I I I I ~II h/4 coarFR I I I I i OUTLOT t --.tl 9N, R19W I ' ( I I II I I