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Home My WebLink About020-1458-05-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safaty and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) 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 Luebben, Lar Hudson, Town of CST BM Elev: ~ Insp. BM Elev` BM Description: 00 . a on,~ PJc. TANK INFORMATION ~ ~ ~ ELEVATION DATA TYPE ,n~ANUFACTURER `CAPACITY Septic t ~ V`.~ Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ' ~ t ~ ~~ ~ ~ / Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM M el Number TDH Friction Loss System Head T H Ft F emain Len Dia. Dist. to well SOIL ABSORPTION SYSTEM I ~ ri..«~.. _ county: St. Croix Sanitary Permit No: 488233 0 State Plan ID No: Parcel Tax No: 020-1458-05-000 Section/Town/Range/Map No: 16.29.19.2941 STATION BS HI FS ELEV. Benchmark ~ 30 / ~ • 3 ' ~ . ~ ~ Alt. BM Bldg. Sewer s~ ~~ 0 •~ ~ SUHt Inlet 1_ •/7 !o J o3•'}t SUHt Outlet • D 02• 0~ Dt Inlet Dt Bottom /I Header/Man. .9~ ~OZ-33~ Dist. Pipe ~ 02.3 Bot. System cps' t p~.2s Final Grade S.Z~ o lo' St Cover Z ~ ~a • b o ~ DIMENSIONS Width ~ 3 Length / St Qa • v No. O Trenches ~.. PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK SYSTEM TO /L BLDG WELL LAKE/STREAM LEACHING Manufactured INFORMATION CHAMBER OR n~ fT Typ Of~~m: `~~ I ~, ~ ~~ ~ ~ UNIT Model umb~ 3l DISTRIBUTION SYSTEM Header/Manifold ~I Length ~ Dia Distribution pipe( Length Dia Spacing ole Siz x Hole Spacing Vent to Air Intake SOIL COVER x PrP_SAIIrP_ Svctemc ~nlv xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes No Q Yes ~ No COMTS' (I elude code discrepencies, persons present, etc.) Inspection #1~~~ ~. S ~' c~ ~ Location: 598 Granng~R~~ Hudson, WI 54016 (NE 1/4 NE 1/4 16 T29N R19W) Willow Bluff Lot 5 1.) Alt BM Description = S• ~- ~"^~~~ ~~ 2.) Bldg sewer length = - amount of cov~ern(= (g f _ ~ .,~ ~10 Plan re3ision Required? 0 Yes ~No Use other side for additional information. ~~ Date SBD-6710 (R.3/97) Inspection #2: --,I-~7"-' Parcel No: 16.29.19.2941 Safety and Buildings Division County ` ~ _ ' 201 W. Washington Ave., P.O. Box 7162 '~ ' , ,s~Ons ,~ Madison, WI 53707 - 7162 Sanitary Permit N (to be filled in by Co.) De artment of Commerce (608) 26 ~51 Sanitary Permit Applies ' n State Plan I. . N um ber In accord with Comm 83.21, Wis. Adm. Code, personal information ovide ~~ / (/ ~ /~ may be used for secondary purposes Privacy Law, s15.04(Ixm) ~~,,>; Project Address (' different than mailing address) I. Application Information -Please Print All Information RECEIVED % 7 C I Property er's Name Parcel # Lot # _ Block # :. , JUN 1 4 2006 Property s Mailing Address ST. CROIX COUNTY Property Location d 2 0 -~ y~- b~} ~' Ci State tY> Zip Code one um ~> ,dl~%•, Section /l: . Zq ~ - . ~ ~ (circle 9~¢) ~ ~ L II. Type of Building (check all that apply) (J ~ N; R E ort T/~ I or 2 Family Dwelling - Number of Bedrooms Subdivision amt CSi-4-Plut»ber ^ Public/Commercial -Describe Use ~ ^ State Owned - Descnbe Use ^City ^ ' lage ~'ownship of 1 III. Type of Pe/~rllit: (Check only one box oa line A. Complete line B if applicable) A. New S yttem ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System B• ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New Lrst Prevrous Permit Number and Date Issued Before Expiration Plumber Owner IV. T of POWTS S stem: Check all that a ,S" ~ Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter ®Leaching Cham np t e - i ^ Other explain) V. Dis ersaUTreatment Area Information: Design Flow (gpd) Design Soil Application Dispersal Area Required (sf) tspersal Area Proposed (sf) System Elevati Gt/ ~t -~ _ ~ ~ VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank V. _ Aerobic Treatment Unit w a e% S~ Dosing Chamber VII. Responsibility Statement- I, the undersigned, a ume responsibility for installation of the POWTS shown on the attached plans. Plumber's amt (Prir}t) Plumber' Si ~ MP/MPRS Number Business Phone Number P umber's Address (Street, City, State, Zip Code) VIII. Co /De artment Use On proved ^ Disapproved Sanitary Permit F (includes Groundwater Date Issued Issuing A t Si tamps) ^ Owner Given Reason for Denial Sure Fee ~ ) ~ ~ ~9 ~~6 - l~'~ IX. Conditions of ApprovaUReasons for Disapproval n ~ J~~ /n////yam// ~t ~l' ~ y~~V/ I L.~ ~ SYSTt=M OWNER: /h ~~ ~_~ 4;(~ `~2~?~y~~ ~'~" t filter and ffl ; uen 1 Septic tank, e dispersal cell must all be serviced /maintained -~~,~ tit- ~/ ~G^ ~ _ _ ~~~ w ~lte b er. as per management plan provided by plum 2. All setback requirements must be maintained as per applicable code/ordinances- Attach comphte plain (W the County only),for the system on paper not kss than 8112 z 11 inches in siu SBD-6398 (R. 01/03) ~~'1I~:~~,~ ~I ~7~5~' ,, r ~ `rr J j 'r r it fir' J' ~ ~'i s ~! ~ .lr~i .: fr ~ a ~ f i ~ ~~~ ~„U.Sd~,i ' / : ,% ~~~~~~€~ ;mar/ 2%g~,~~~ii~~~ ~~'.- ~;~ ~' t t 1 r i t t .Ce { r Y /~. Y /f .,i' ~'/{ j'~r /j. ,~ ~'~r(~f ` .J ~ ~GC$iirJ i ~ i / ~ ~ r f r F 1 r ` r/r f r r r r1i ,,~ i~ X ;`i~ Vii: ~ y i' ~ ~~>,ir~:~~. f f ! { r I t ~ i1 ~• 1 ~ ~ i ~ r I 1 ~ ~ ~ j : ! -~ - to - NE GOR. SEC. 16 ~a'. ~ is ~ i ,~~, ~,;l,i,~. i i y~~y . ,~ `` ~,,-..~.., ~ . , ~ ~ ~ ~ ,: -, '~, i ~ !~ ti _.. .. _ _. . __--- . ~ ~ ~ - '~ ~ i / / ~ ` I ~ ~ / r • - f ` / ' ~ ~ - r . i ~ : i .: FFF i . ~ ~ , , . _` :. ~~ ~ k -. -~ ~~ ~; - _ ~ _i ;S~h~ ie ~,r- i~c~ ,9/ :7 - _~ ~ i -' / , . _ ,. f rc _~ ~ fl ~~ .~p> ~ - 0, . ~ _-~ I D~ I -=-t- w~ ~.. ~- i - :` fi ~~ S` `~ ~~ _ ~. /','1 r J~kw°,z=Gs olih,)~ I~ j{ ~ f j f~I J ~ , ' i f J ~ r ~j i t ./j % ~ ~ 1 ~ f r ~ ~ , d I ~ (j !} t~f ,i j' ;' ' l;> ~ ,j .~ ,' ;~ NE GOR. SEC. 16 ! ~ I. t ~ r rr/ " /,, /f ~ ~ /f ~ t •/' i /f ~. II~ / r ~+~~{ ~ i~ ~fY~e~1~51F~~ f ~~ ,' ~ I + f ~ r ! p ~ a i f ~, ~' t t r t ~//J ~ `' - ;. ;, < <, / ~, , ~G ... _ .. -_ __ ~, - ~- -. . 15`~ i F .......• t 1 J i ': .,. w ~. .,_ ,. ~/ ~ ~ t t ~ .....-f .. ........~ 7cf ~ ,n ~~; _ Y t ~/~ ~ ,_ t `5 _ :~ r t, ~/ f ~ /j .~ ~ ~\ \• I] ~/ ~' s ,~ _ _ ,. ,~ +. f ~`~f 3 .~ ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer _ L_C~,r r Y ~. hq y.1. 2„c,. ~ ~ ,~~ Mailing Address ~~ ~rQ. ~,,a a.~.9 (. ,~,., ~' ~~ G(. w-a ~ ~ 'tw----_~'/'SD~L V ` Property Address (Verification requixed from Planning & Zoning Department for new construction.) City/State 1914 d Sd~ (~ /.- Parcel Identification Number ~~ 0 " /~5~- ~S _ (~ LEGAL DESCRIPTION e~~ ~~ t Property Location ~ i/4 , ~ 1/a ,Sec. ~f~, T Z~~' _N R W, Town of , udsS~~z Subdivision s1.'~ L,C_V t,,~ Q ~u ~ ~ ,Lot # _~ Certified Survey Map # Volume ,Page # Warranty Deed # ~ ~ ~~ ,Volume 1~~~, Page # Spec house yes no Lot lines identifiable yes o 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 function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 113 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce-and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Nu ber of bedrooms G~~~---- GNATURE OF APPLICANTS} ~/ ~ /~ DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by-the Planning & Zoning Department. *** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08105) POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page ~ of FILE INFORMATION ~ Owner Permit # ' DESIGN PARAMETERS Number of Bedrooms ~ ^ NA Number of Public Facility Units l~NA Estimated flow (average} gal/day Design flow (peak), (Estimated x 1.5) i - ~ gal/day Soil Application Rate gal/day/ft2 Standard Influent/Effluent Quality Monthly average* Fats, Oil & Grease (FOG) <30 mg/L Biochemical Oxygen Demand (BOD5) <_220 mg/L ^ NA Total Suspended Solids {TSS) <150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand IBOD51 <_30 mg/L Total Suspended Solids (TSSI <30 mg/L ~I NA Fecal Coliform {geometric mean) <_10' cfu/100m1 Maximum Effluent Particle Size Y8 in dia. ^ NA Other: ^ NA *Values typical for domestic wastewater and septic tank effluent. SYSTEM SPECIFICATIONS Septic Tank Capacity gal ^ NA Septic Tank Manufacturer ~ S ^ NA Effluent Filter Manufacturer ^ NA Effluent Filter Model ^ NA Pump Tank Capacity gal ;ANA Pump Tank Manufacturer ANA Pump Manufacturer ~1 NA Pump Model Iz~ NA Pretreatment Unit ^ Sand/Gravel Filter ^ Mechanical Aeration ^ Disinfection ^ Peat Filter ^ Wetland ^ Other: J~ NA Dispersal Cell(s1 /~-C tn-Ground (gravity) ^ At-Grade ^ Drip-Line ~N.A ^ In-Ground (pressurized) ^ Mound ^ Other: Other: ^ NA Other: ^ NA other: ^ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tanklsl At least once every: ^ month(s) (Maximum 3 years) yd year(s) ^ NA Pump out contents of tank(s) When combined sludge and scum equals one-third (Y31 of tank volume ^ NA Inspect dispersal cellls) At least once every: ^monthls) (Maximum 3 years) ~ yearls) ^ NA Clean effluent filter At least once every: ^. month(s) ~ year(s) ^ NA Inspect pump, pump controls & alarm At least once every: ^ month(s) ^ year(s) ~ NA Flush laterals and ressure test p At least once ever y' ^ month(s) ^yearls) NA Other: At least once every: ^monthls) ^yearls) ^ NA Other: ^ NA MAINTENANCE INSTRUGTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined .accumulation of sludge and scum in any tank equals one-third (Y3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of <_12 months, shall be performed by a certified POWTS Maintainer. 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Pa neo 1 •}uanl;~a eq illnn ~a;enna~senn ssaoxa ayi pa~o;say s! ~annod ua p l ()II I p y~ ~ paB~eyos!p yM •slanal ~a~enny6!y lew~ou anoge illy /yew slue; dwnd sa6elno ~annod 6uuna •aoe}~ns an!;e~lll;u! ayi ie uaza~ aye suo!x!puoo pos uaynn ~naoo 1ou pays do Deis walsdS •asn o~ ~o!ad ~o~e~ado 6ulo!n~as a6e~das a ~(q panowa~ (s)lue; ayi bo slua~uoo ayx aney paloalap aye suo!1e~iuaauoo y6!y;l •(s)llao les~ads!p ayi a6ewep ~o/pue ssaoad ~uaw;ear; ay; apadw! dew ley; sleo!wayo gay;o ~o s;onpad Bu!~uled ;o aouasa~d ay; ~o; (s)lue} ;uew;eaa; ~loayo S1MOd ayi ;o asn o~ Loud 'uo!;one;suoo nnau god ;o ~'a6ed NOllb'si3d0 aNtl dfl 1lIb~1S Wisconsin Department of commerce SOIL EVALUATION REPORT Page,~of~ Division of Safety and Buildings in accordance om 5, s. Adm. Code - County / Attach complete site plan on paper not less than S 1/2 x 11 in la .' t include, but not limited to: vertical and horizontal n3ferenc~,~oint (BM), direc io d Paroel l.D. percent slope, scale or dimensions, north arrow, and location aTltf'di to nearest road. P/ease print a ~ ' ` Date Personal information you provide may be use for ~ Law, s 15.04 (1j (m)). ~ / ! i~,~ Properly Owner roperty Location ~ ~, JUN Y 4 200 ovt. Lot 1/4 ~ 1/4 S T N R ~ (or~ Property er's Mailing Address Lot # Blodc # Subd Name or ST. CROIX COUNTY r ,_ ~ i C' ~ ~ State 'p ode r ^ City /' ^ Vllage Town Nearest Road _~ ~/rae~rd_ ~~/~ I ~~r'.~fJ I l ) ~ ~t7 ~~' i car t.~1;~F ,~~.~~ [~ New Construction Use: ~ Residential / Number of bedrooms ~ Code derived design flow rate '~ GPD ^ Replacement ~~ ^ Public or commeraal - Desaibe: Parent material r~~' ;, ~~ Flood Plain elevation if applicable ft. General comments _ and recommendations: ~,~n~n ~o~F;r:~s ~j/--5 Boring # ~ Boring- c~ ft. Depth to limiting factor -> ,~~J~ in. pit Ground surface elev. . Soil licaflon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ~. S 'i ~ 9 v 4 ~ Boring # ~ Boring ~ Pit Ground surface eVev. /~ 7 ~^ _ ft• Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ff? in. Munsell pu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 "ETf#2 - ~ i a 4 y° - - ~~ 9 _ "Ertl t #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mglL Event #Z = BOD < 30 mglL ana i ~ < 3u mgrL CST Na ase nt) I 7 Signature CST Number ,~'" ~; Address Date Evaluation Conducted Telephone Number Property Owner Paroal-ID # Page of ^ 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 GP DHtz 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 lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Raots GP D/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Ef(#1 *Eif#2 ^ Boring # ~ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 =BODE > 30 a 220 mglL and TSS >30 < 150 mg/L * Etfluent #2 = BODg < 30 mgJL and TSS < 30 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. sso-as3o (rto~ioo> -=?.1 ~`~ ~r~.r~ w ac's ,lsc;k: ~ s 1~ r i ' _ ( ~ Jf~ f J 1 + r r .. ~` ~ s !~ J ! i r ~ tf ~ ~ r I ~5((,~ ~ ~ ~ f' ~ / 1• ~ NE GOR. SEC. 16 E. i t ~ 1 1 t ~' ~~ i ~; N r ~ •r ~ t ~ ~. ,~ { 1 ~ i i ~' •F` ~ e h,'~ 11 iii ~~~'? ~~~~%i~o~,~~. •' i t t f Y ` ~ ~• ~ 3 , . Vie. :~ ~ ~ ;_ ~ s , 1 i '; • . •. .; ~ ; ~~ ~~,~~ ~~ 8~ /.,~ :~j._ ~._.. ~ i `•~ y ~ ~ ,~;~ tip, `,'~,~~•~ ~ ~ _; .~' ~,~ \ y ;. .. __. ___. _. . ~ .- .. ..._~ ._ t . ~ „ ., ~' / ./ / .7 . ~ ~ ` .~, / -~ n ..... , . /" _-. ` i.I `t ~~ti 7~~ ~ L ~ ~ f _ ,. - _ _ - _ ~` '> f ~ ~' ~` • - 1588 ~~ ~ ~ ~ EVALUATION REPORT Wisconsin Department of Cbmmerce L~~ Page 1 of 3 Division of Safety and Builc~ngs in accordance with Comm 85, Wis. Adm. Code Steel's Soil Service, Inc. { County Attach complete site anon paper not lessthan $',/i ~~ 1 inches in s¢e. Plan must St. Croix include, but not limit to: vertical and horizontal reference point (BM), direction and Parcel I D percent slope, scale r dimerhsions; harth arrow, and location,hnd distance to nearest road. " . . g Plees~.ptitl!~ a~ ~-formatiop. R sewed By Date Personal information you provide may be used for secondary purp~es (Privacy Law, s. 15.04 (1) (m)). ~ . 2 Property Owner Property Location Hieb, Matt Govt. Lot na NE 1/4 NE 1!4 g 16 T 29 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1271 140th St 5 na Willow F~,Pen ing City State Zip Code Phone Number J City Village ~! Town Nearest Road New Richmond ~ WI 54017 715-381-5277 Hudson Grange Rd ~ New Construction Use: ~ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe:na Parent material outwash Ftood plain elevation, if applicable na General comments 3.OOft below grade. de system elevation 100.70tt. trenches spaced and depth to co and recommendations: Conventional system, -~ / (LG~ ~ ~d ~ ~ j ~~~Cx2-~Gf L~'' ~1L/ Boring # Boring 10 0 100 in. L~f Pit Ground Surface elev. 3.7 ft. Depth to limiting factor Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIft2 in. Munsell Qu. Sz. Cont. Cdor Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10yr3/1 none I 2msbk mfr cs 1f .6 .8 2 9-19 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 19-30 7.5yr4/4 none ms osg ml cs na .7 1.6 4 30-64 7.5yr4/4 none cos osg ml cs na .7 1.6 5 64-100 7.5yr4/6 none cos osg ml na na .7 1.6 f log. ~ ------ 3b /~ Boring # Boring Pit Ground Surface elev. 103.70 ft. Depth to limiting factor 100 in. Soit Application Rate Horizon Depth Dominant Golor Redox Description Texture Structure Consistence Boundary Roots GP DIft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 10yr3/1 none 1 2msbk mfr cs 1vf .6 .8 2 8-25 7.5yr4/4 none cos osg ml cs na .7 1.6 3 25-100 7.5yr4/6 none cos osg mfr na na .7 1.6 ;b/~~ s * Effluent #1 = BODS> 30 <_ 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODs < 30 mg/L and TSS < 3u mgiu CST Name {Please Print) 'nature: CST Number David J. Steel r 248956 Address Steel's Soil Service, Inc. Date Evaluation Conducted Telephone Number 994 200th St., Baldwin, WI 54002 11/8/2004 715-684-5680 ' Property Owner Hieb, Matt Parcel ID # Pendin Page 2 of 3 Boring # ~ Boring N Pit Ground Surface elev. 96.20 ft. Depth to limiting factor 100 in. Soil Application Rate Horizon De th Dominant Color Redox Description Texture Structure Consistence Boundary Roots P p in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-13 10yr3/1 none I 2msbk mfr cs 1f .6 .8 2 13-36 7.5yr4/4 none cos osg ml cs na .7 1.6 3 36-100 7.5yr4/6 none cos osg mfr na na .7 1.6 ^ 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 PD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ^ Boring # -1 Boring _( Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Descripfbn Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODS> 30 < 220 mg/Land TSS >30 < 150 mg/L * Eft1uent #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 608-2b6-3151 or TTY 608-2b4-8777. ., David J. Steel CST-POWTSM Lic. #248956 STEEL'S SOIL SERVICE INC. Matt Hieb NE 1/4,NE 1 /4,S 16,T29N,R19 W Town of Hudson, St. Croix Co. ~x1;ll.,~x~ Falle ~ n4 994 200th St. Baldwin, WI 54002 Bus.(715) 684-5680 Fax.(715) 684-3449 3of3 N ark Ele. 100.00 ft ' pvc pipe ~^ ;hmark Ele. 100.50 ft ' pvc pipe ~- Boring Elevations = 103.70 ft = 103.70 ft 96.20 ft = 0.00 ft y,. ~, v c ~~~ ~~~ /!- 8 1 9 3 8 1 State Bar of Wisconsin Form 2-2003 WARRANTY DEED Document Number ~~ Document Name THIS DEED, made between Matthew D. Hieb. ("Grantor," whether one or more), and I.arrv H. Luebben and Pamela J. Luebben, husband and wife ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): Lot 5, Plat of Willow Bluff in the Town of Hudson, St. Croix County, Wisconsin. XATHLEEH H. YALSH REGISTER OF DEEDS ST. CROIX CO., MI RECEIVED FOR REGARD 02/27/2006 10:30AM MARRANTY DEED EXEMPT # REC FEE : i i. 00 TRANS FEE: 377.70 COPY FEE: CC FEE: PAGES: 1 Recording Area Name and Retum Address The First National Bank PO Box 89 New Richmond, WI 54017 Part of 020.1028-00-001 Parcel Identification Number (P[N) This is not homestead property. (is) (is not) Exceptions to wan: anties: Easements, restrictions and rights-of--way of record, if any. Dated 0 ~' ~~ ~Lt/O(p (SEAL) ~ ~ (SEAL) * *Matthe D. Hieb (SEAL) ~ (SEAL) * * AUTHENTICATION Signature(s) Matthew D. Hieb. authenticated on iJ i~ tJ ~ *Kristina O and TITLE: MEMBER STAT BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) ACKNOWLEDGMENT STATE OF ) ss. COUNTY ) Personally came before me on , the above-named to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. THIS INSTRUMENT DRAFTED BY: Attorney Kristina Ogland Notary Public, State of Hudson, WI 54016 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 FORl1f SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ®2003 STATE BAR OF WISCONSIN FORM N0.2-2003 * Type name below signatures. INFO-PRO"" Legal Forms 800-855-2021 www.infoprotomis.com 819381 1 of 1 Parcel #: 020-1458-05-000 06/19/2006 10:18 AM , PAGE 1 OF 1 Alt. Parcel #: 16.29.19.2941 020 -TOWN OF HUDSON Current ! X ~ ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 06/02/2005 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O -LUEBBEN, LARRY H & PAMELA J LARRY H & PAMELA J LUEBBEN 2888 BREWERS LN STILLWATER MN 55082 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description * 598 GRANGE RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.210 Plat: 10/062-WILLOW BLUFF LOTS 1-5 020/05. SEC 16 T29N R19W PT NE NE WILLOW BLUFF Block/Condo Bldg: LOT 005 ' 05) LOT 5 (2.210AC) ( Tract(s): (Sec-Twn-Rng 401/4 1601/4) 16-29N-19W NE NE Notes: Parcel History: Date Doc # Vol/Page Type 02/27/2006 819381 WD 06/02/2005 796531 10/062 PLAT Anna c11MM a 1?v Bill #: Fair Market Value: Assessed with: 0 Valuations: Description Class Acres Land RESIDENTIAL G1 2.210 75,800 Totals for 2006: General Property 2.210 75,800 Woodland 0.000 0 Last Changed: 05/30/2006 Improve Total State Reason 0 75,800 NO 05 0 75,800 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 CURVE DATA TABLE NUMBER Radius Length .Central Angle Chord Bearing Chord Length -Arc Length C1 80.00' 45°04'10" N67°50'16"W 61.32' 62.93' C2 80.00' 34°14'25" N62°25'23.5"W 47.10' 47.81' ~o~do~ ~od~a ~~a~~ paaa S89°49'34"W 328.15' _ ~~dd0~ dd~~ r~ d04 4 SEE COVENANTS FOR LOT OWNERS RESPONSIBILITIES REGARDING MAINTENANCE OF DRAINAGE WAYS AND STORM WATER PONDS LOCATED ON THEIR LOT. EXj~'iT~i~~~~~r ~~~ ~~ ,' P OF COUNTY rrrrrrirrrrrrrr~L~JFAINUM MONUMENT rrrrrri,rrrrrrrlrLEVATION = 923.63 •~////////////r///// oYrrrrlrrrrrrrrrrr. - rrrrrrrrrrrrrrr . rrrrrrrrrrrrrrr ~r rrrrrrrrrrrrrrZ.21 ACRES rrr rrrrrrrrrrrrr~g~•~9 SQ. FT. rrr rrrrrrrrrrrrrr'rrr rrrr rrrr/rrrrrrr.f,,~6:0.~$55.0 ~rrto~ •,~rrrrrrrrrrrrrrrrr, ~rr d, J,c.Iy~ rrrrrrrrrrrrr. rrrr ir,~P~q rrrrrrrrrrrrr w~ <rrr~ rrr~•.~O,g, rrrrrrrrrrr. rrrrr .~,rrp~r/x~ir rrrrrrrrr. o ~r~rr r,~r191~f Ti. 7i~!rrrrrri~ .i r~yrr 'YI;~,! 1~~8 :>;virrrrrrr ~r~°rr rrP~b,~ r~AS,c;ixirrrrrr r,fyrrr rrrr/1[~.rjG~jY rrrr ~r-rajr rrrrrrl~..,,rrrrrr~rrr •r,tJ•rr rrrrrr/•.~~;.rrrr/.err //cA~/ ///////// ~ ~2~ •r,~pcrr rrrrrrr .~. SEE COVENANTS FOR LOT OWNERS RESPONSIBILITIES IN - r r ~~ r r r r ~ ""' ~ ~ ' ~ ~.~ ~ PREVENTING EROSION ON THEIR LOT. ' rrrrrrr.d~ ~~ ~~ ~.,. .r, rrrrrrrrr .~ 1 ~~ ~Gy EACH PARCEL SHOWN ON THIS MAP 1S SUBJECT TO ; " r " "' ~ "~ f~i~ 7y" IRON PIPE ~ "'~ ~.' ~ ~? STATE, COUNTY AND TOWNSHIP LAWS, RULES AND r . ~, REGULATIONS (i.E., WETLAND, MINIMUM LOT SIZE, r el~auoN = s21.n . , , r , , ~~ ~~ '~d;~ • ECT.) BEFORE PURCHASING OR ACCESS TO PARCEL rrrr ~ ~d'o , DEVELOPING ANY LOT, CONTACT THE ST. CROIX COUNTY ~ ~ r ~ ~\ ZONING OFFICE AND THE TOWN OF HUDSON. 6o • o Sp 2 r NO OWNER OR RESIDENT SHALL DO ANYTHING WHICH `r ••• F~F O~ L .. SfTggCK Nj WOULD INTERFERE WITH OR CHANGE THE OPERATION 9Ta73i ~ •'•• 1 rol a ni. O 0 Iv N •~ CJt 0 OF THE APPROVED COMPREHENSIVE WATER DRAINAGE ~Y ~O 2 UT~CJ ' ~I AND SOIL EROSION PLAN FOR THIS PIAT. THIS INCLUDES ~ 9~Ar )-fASfMfly~~•..., BUT IS NOT LIMITED TO BUILDING UPON, OBSTRUCTING, ~~ A ~ ~ "~ ALTERING, FILLING OR EXCAVATING, OR PLANTING IN 69 C2 ~ isl ANY POND EASEMENTS, WATER DRAINAGE DITCHES, ~~~ WATER RUNWAYS, WATER CULVERTS, BERMS OR GRASS C~ SEEDINGS: UTILITY EASEMENT DEFINED. C~ ~ ° Gj1CC G3OQD An unobstructed easement for the construction and maintenance of all necessary overhead, underground or surface public utilities, including rights to conduct , trimming on said easement. This easement shall have no permanent obstructions (fences, trees, shrubs or other obstacles) that interfere with installation, function, or maintenance of utility systems. Public utilities shall not be held liable for any damage to prohibited. obstructions. ~.®T Jr'1 L,EGiEN® ~ FOUND 1"OUTSIDE DIAMETER IRON PIPE FOUND 2" OUTSIDE DIAMETER IRON PIPE L.B.O.= LOWEST BUILDING OPENING NORTN SCALE: ~-~~ 0 25 50 100 200 l~ D 51~? Q tl~ d04 I, Douglas J. Zahler, Registered Wisconsin Land Surveyor, hereby certify that this Certificate of Survey was prepared under my direct supervision and is correct to the best of my knowledge and belief. F N ~ ~ O O ~ 0 ~ i N 4 ZUZ F- O Y ~ t0 W OJ N m ff ~ o ~ ~ ~ .~ ~ ~ ~ rr~ ^C p~s ~~~ ~~~ ~ ~ +~ ~~~ ~o ~.~ ~#~ .~ e~ ~~: ~_ S U1 ~~ J ~ m 3 O ~~ J~ ~ ~= o 1 } LEI O Q U l~ F= W U