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c ~f 3d o C I ~ 1 ~ ~1 I ~ I .O .#, ~ n I I. n d d m 0 W cD C O N ~ a ~ ~ ~p FD y CT 7 J H ~ Q F~1 ~yl I W m p o ~~ ~ o A ~ m o° a ~ c ~ ~ ~ c N ~ ~ ~ ~ ` 1 O I V ~ N ~ ? ' ~' C ~ y ~ O C d lr ~ I t/~ Z D ,~ a ~ e ~}. m c8 D '" a ~ C I ~ 3 m W ~. ~ D~ °~~ ~ N o W°~ O ~ °_ n c ~ y W y t n ~ 3 H ~ ~ ~ ~ ~ ~ ~ ~ °,: O O O Q I 3 ~~ G rn O ~ m A %* m~ m ~ I _ I ~ 3 m N I a oi p .. I ~„ I c 3 .. ~ o I ~ ~ O ~ ' ~ I ~ m o ~ ~ a m' I ~ ~ N .-. v, c I =~ N I G ~ m W I ~ ~ O A ~ ~ N ? ` ~ ~Lr. O. A ~ 7 .. ao~ Z -i N m~° a ~ ~ Z c 3 A r: cn y ~ ~ I Z F A I y~ o c a I ~~~3 a ~ ~I N C I d ~f N ~ f ~ Q d C ' i I ~?~~ o o. ~ a O <, ~ -~ m I v, ~ I ~~ja I ~ m obi ~°- '~7 da~~ ~ I v, O ~ I ~ ~ ~ p J A I N ~ `° W I - . ~, v ~' N ~ ~ N N C I W aO o I m o m °+` ~ p o ?~ I `° ao ~ <n O ~. p ° i ~ I I V~;~onsin Department of Commerce . PRIVATE SEWAGE SYSTEM Salti4j and Building Divis on ~ ~` INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 'ermit Holder's Name: City Village X Township Sienna Cor Hudson Townshi SST BM Elev: Insp. BM Elev: BM Description: SANK INFORMATION LEVATION DATA TYPE MANUFACTURER CAPACITY Septic r/~e-Q/~/ / o~ v a Dosing ~~ / ~ v ~ ~ r, CJ ~-~' Aeration ~-ll f-~'"T / '~ Holding TANK SETBACK INFORMATION TANK TO ~ ~P/L ~~ ~ WELL BLDG. Vent to Air Intake ROAD Septic ,Z , /-w~ ~ ,J~ ~~~ Dosing ~ ~ ~,,./.,. / Aeration Holding PUMP/SIPHON INFORMATION Manufacturer '~~~ GPM nd Model Number ~ ~l~ TDH Lift Friction L System He d TD Ft ~~ r ~ ~ Forcemain Len th Dia. y Dist. to Well SOIL ABSORPTION SYSTEM lLO/' /~~ G,o~-r~ ~i o ~ County: St. Croix Sanitary Permit No: 430515 0 State Plan ID No: Parcel Tax No: d ~r7 840-1414-00-000 Section/Town/Range/Map No: 20.29.19.2608 STATION BS H! FS ELEV. Benchmark 27i p~. l~~ Alt. Bc M~ ~ ~~ ~. Bldg. Sewer o3 5 ~~,~ /O/ S ~' ~ a. St/Ht Inlet ~~ ~~ c~ ~ ~~ O• ~Z StlHt Outlet y/ ~ -~ Dt Inlet Dt Bottom ~~~~ ~ ~~ ~Z (~ O ~ .s-- Header/Ma ~~~ a L~. T I~~ ~ ~_ Z Disk. Pipe U , ~ Z , L~ Z Bot. System / ~a, ~-~ Final Grade OYl iki~" - ~~- 5 ,~' 6 - o Z St Co er ~ / ~ . ~ . ~ (/h a/ BED/TRENCH DIMENSIONS Width 3f ~ Len th ~ ~ No. Of Trenche PIT DIMENSIONS ~-' No. Of Pits I s' a Dia. Liquid Depth SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM EACHING f,~~ Manu c ' / / INFORMATION CHAMBER OR _~ /~`~° Typ~ystem: I ~ i ~ ~ [0 ! ,~ ~ 1 _`-'-. UNIT Model Number: DISTRIBUTION SYSTEM r(~,~,~d -S,p„ ~,-~.r-, ~?in,2V S Header/Manifold Distributi n x Hole Size x Hole Spac in g Air Intake Vent to h 'S Di o K~ ( ' ~ f / Len t a Len th Dia S acin l% SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Onlv ` `~~ -~~~~-.'" Depth Over Bedrfrench Center Depth Over BediTrench Edges xx Depth of Topsoil xx Seeded/Sodded ~; f ;. j Yes L No xx Mulched i-, ~~ ; j Yes i N f' r COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ / G,i/ ~~" Inspe 'on #2: / / Location: 753 Martin Avenue Hudson, WI 54016 (NE 1/4 SW 1/4 20 T29N Rff1 W) The Glen Lot 14 Parcel No: 2t7Z3i9.2608 1 J Alt BM Description = } ~~2G~~/tS''^ ~ ~~`` - ~' ~ """".' ~ ~r~ ~ _"- 2JBldg sewer length = ~~ ~~ (/w~- ~ tt:D ~ vyL ~vt~ G(• -~vrt ~ Gu//~ ~~v ~'~~ t~ !~ - amount of cover~~ ~~~ ~4'~~y~~~-yam G{f--~ ~p~t,~~ .. Plan revision Required . i ~ Yes [,_ No ~ ~ ~,? ,rte G~iZ~L 1C/~ Use other side for additional information. L__~_~___t SBD-6710 (R.3/97) Date Insepctor's S gnature Cert. No. ,r,. _. _. Safe and Buildings Division County ~~ JAN 2 3 ~4D~~ w hington Ave., P.O. Box T162 yC1 E ,S r s ~~CO~ Ma on, WI 53'/07 - 7162 umber (to 4e filled in by Co.) .Sanitary Permit N ~ Department of Cam rce"'~ *'~ ~~ '~ ` '11~NTY (608) 2E>(i-3151 , p ~i~~~%a~U` '~jL?p S/C' ermi ' cation Sanitar State Plan LD. Number p y { F In accord with Comm 83.21, Wis. Adm. Code, personal information you provide " `~ may be used fur secondary purposes Privacy Law, s15.04(1)(m) _ Project Address (if different/t~hia~n mailing addre/s~) ~ GJ~ 753 ___ /7 [. ' "' I. Application Information -Please Print All Information _ _ LD-/ ~ - -GY~d _._.~ ~! Property Owner's Na me ' ~ Parcel >y Block ~ S~ ~~~~ GY l Property Ow rter's M ailing A ddress Property Location ~/-~~ l a ' g /J r- ~6l_y~ c ,~ `'.~/ Jam' Ci - Q . J '~ ~ t~,~if/ 'b,Section ty, St ate Zip Code Phone Number ~ / ~ d ~' ~- ~~ .mss 8'3S ~8~~1 ' i (circle o ~ / ~ ~ Q II. Type of Buihling (check all that apply) n T E ar N; R ^ 1 or 2 Family Dwelling -Number of Bedrooms ~~J~j'h(L" Wy~~ Subdivision Name CSM Number ~ Public/Commercial -- Describe Use _ / ~/2 ~ ~ y - ^ State Owned -Describe Use v~ ~/sj. t~~..f litJ / ~ UCity_^Village~Township of ~~~i III. Type of Permit: (Check only one box on line A. Complete litre B if applicable) A' New System ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to >axisting System B. ^ Permit Renewal Pe~~evision Before Expiration (Z f ~ ~ ^ Change of ^ Permit Transfer to New Plumber Owner Ltst Previous Permit Number artd Date Issued ~~ v r/ ~ _ / ~ ~ ~ J rv• (C Type of POWTS System: heck all that ap ply) 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 n-Ground ^ Hording Tank %-~ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter Leaching Chamber ^ Drip Line ~ Gravel-less Pipe O r (xplain) j V. Dispersal/Treatment Area Informs on: ~_~~•_ ~ ~ - h t~ ! Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area R,eyuired (sf) Dispersal Area Proposed (sf} System Elevation ~y ~~~ ~ 7 ~~'~ 9l ~ D VI. Tank Info Capacity in Total Number Manufacturer Prefab ~ Site Steel Fiber plastic Gallons Gallons of Units ~ n_ ~ ncrete Constructed Glass New Existing ~1i~ /~ ~1/ /? r Tanks Tattles ' Septic or Holding Tank ~~® ~ ~ • e~ Aerobic Treatment unit - Dosing Chamber - CC PP ~~ - ~~ - VII: Responsibility Statement- I, the undersigned, assume responsibility for ' Ration of the POWTS shown on the attached plans. Plumber's Na me (Print) Plumber's Si gnantre MP/. PRS Number Busittess Phone Number '~l-a ~?7 990° Plumber's Addre ss (Street, Ctty, State, Zip Code) ~ = s ~' ~31~ l VI .Count !De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Surcharge Fee) ^ Owner Given Reason for Denial Date Issued Issuing Agent Signature (No Stamps} IX. Conditions of Approvalr'Reasons for Disapproval C~~' ~ ~ g~ f~(it:i/ J ~ ~`2Ei~ ~ 7 I / .. . ~~ ~ . ~ z ~ ~~J~ sys~, - syf~, ~ ~~~ ~.~.~~ ~'l/ D /] at ~ O.,.i r~!//.Ii s ~ ~~ir.,~c / /~DiG f~ a.L ~i ~+ ~_ /Ji+ ~ ~,. /'.r....~r~ i .t. I Attach complete plans Ito the ou ty on for the system on paper not less than $li2 x 11 inches in size SBD-6398 (R. 41/03) ~1 ~ ~1 ~ ~ o '~ ~ i ' `~ \. i ~~ Uo i w `. D r ,~~ y '~ - ~ ,~ ~ ~~~ ~ ~~ . ~~ ~ ~ ,d~ ~~ ~' (~ \ Q ~N ~~ ~~ °~ r ~~ ~~ ~~ C c~ ~~ v ~a ~~,'S a ,~~~ ~o P~ ~~~ ~ s~ ~ r~ ~~~ J ~~ 9~ ~. b ~~~ .~ ~', ~' .~ -,.` ~- ~ ~` . `~ t ~~' o o~ ~~ ~~ ~~ Wisconsin Department of coma Division of Safety and Buildings ~' ' ~'' 2004 ~~fia.~ix c:c~uw ~C'N~(VC orF,c~~1L VALUATION REPORT Page ~ of,~ n. awcn uaiica wnr~ ~.v~rnn oo, vrw. rwir~. wve County Attach complete site Plan on paper not less than 8112 x 11 inches in size Plan must r indude, but not kmited to: vertical and horizontal reference point (BM), direction and t l b di Parcel I.D. ~Z~ . Y~ QU ~' percen s pe, sca e or mensions, north arrow, and location and distance to nearest road. 7 Please print all information. R wed b ~ Date Personal informetidn you provide may be used roc secondary purpo~ea (Privacy L.aw, s. 19.04 {1) (m)). GG~ (~ /j'J/h ~ Z ~ J PropertyOwner -e 5 y ~. yN n q ~o r P Property Location ;1„ J v S o v-•_ o ,.~ Govt. Lot ~/ ~ 1145 W 114 S ~T z~ N R ~ E (or) Property Owner's MeilingAdd re s s Lot # Biodc ~ Stud. Name or CSAA# . / ~ / ~ / U fly. ~~ I ~ r ~~ ~ ~V ~ ~ ~ ~ ~ /~-~ City State Z~ Phone Number [j City ^ village ®Town Nearest Road Q New Construction Use: ® Residential 1 Number of bedrooms 3 -'~ Code derived desEgn flow rate _.-.y_, `Z'~ ° G GPD Q Replacement ^ Public or oornmeraal - Descxibe: ~ _____ ___ _ .,___.~ __ Parent material 6 (1 ~~.Ia~!^ ,_ Food Plain elevation if appUcable ~ ~ `~- ft. ` ~/h and neicorrtme s: -SySt ~ m Vic.- i/ , ~/ ~~ .S~/S~1"~ -a'a ~e- ~Z.er` 0 -~ , Cor~~~s aGe~~~~~ ~ u 1-Il ..........,..,.., .o..o o,v - -L ,.. wNu, w nu ~wny ,oww, i u,. Sdi Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 1fP in. Mansell Qu, Sz. CoM. Cobr Gr. Sz. Sh. •Eff#1 'Eif1t2 ~_,~ ~~ 3/z -- S ~ I ,~ ~ c S 1 ~ ~ ~s / q1~3 ' ~ (~ .Z " ~. 2" z Boris # ^ Baring ® Pit Ground surface elev. ~ft. Depth to limiting factor ~ in. ~ ~~ Rate Horizon Depth Dominant Color Redox Descxiption Texture Structure Consistence Boundary Roots C3P D/IP in. MunseU Qu. Sz Cont. Color Gr. Sz. Sh. •Efff11 •Eft1f2 p • Effkrent #1 = BOD > 30 ;220 mg1L and TSS >30 _< 150 mg1L ` EfRuertt #2 = BOD < 30 trtglL end TSS < 30 tttgll CnST,fVame (Please Prtrrt} ature - ~,' f-~lci V1~ S`G _ S ~ / Address ~, ~ //`` ~~^" ~, ~ / Date Evacuation Conducted Telephone Number ~~/ ~ d ~ ~lrvt/i~'~!G li (ir~l ~y~Z.S/ ~~~~~0~ ~'/S -7/~ _~~~9 Property Owner _ ~ Boring # ,~G11 y~ S o r~ ^ Boring Pit Parcel !D # Ground surtace elev. r ~ Uft. Depth to limiter factor ~ ,~ in Page ~ of ~_ Horizon Depth in. O- S Dominant Color Mansell f~, Redox Description Ou. Sz. Cont. Color ~--- Texture ~i - Structure Gr. Sz, Sh. rY1S~ Consistence .- _.. Boundary ~ Roots /' U 1. SoN ication Rate GPDJrP 'Eii#1 'Eff#2 .5~ ~ C~ l~ U ^ Pit Ground surface elev. ft. Depth to Ifrttiting factor In. Horizon Depth Dominant Color Redox Description Texture Structure Consisierx;e Boundary Roots ~ GPp/ff Rate in. MunaeR t]u. Sz. Cont. Color Gr. Sz. Sh. 'Eft#1 'S1f#2 L___J ~~ # ^ Boring ^ Pit Ground srxface elev. ft. Depth to IirrdUng tailor in. Soil lion Rate Horizon Depth Dominant Color Redox Descxipdon. Texrixe Stnxture Consistence Boundary Roots GPD/ff ln. MunseA Qu. Sz. Cord. Color Gr. Sz. Sh. 'Eff#1 °Etf#2 " E#fuen! #7 = 8OOe > 30 _< 220 mglL and TSS >30 _< 4Sp mgll. 'Effluent #2 =BOOS _ 30 mglL and TSS <_ 30 mglL The Department of Commerce is an equal opportunity service provider and employer. if you need assistance to access services or nerd material in an alternate format, please contact the department at 508-266-3151 or T?Y 6618-264-8777. sewsso flt.6roo1 ;, ~ , ~~~~~~ :~~ ~~~o ~~ Q~ ~ o ~~~~~~ C'r-~ : Z s ~~ G 9 ,..-- ~~ ~~ ~~~ ... - _ •~! .I.+r~y.~+r~w„r~ 4r ~ ~ ~^~~.. l ~ ~~i\ .~l:l~ ` ~~ ~ it i V[~ 4 ~ "~'Iw _ 4" CI VENT EIPE 12" MIN. A84V£ GRgpE $ > 2 5' FROM DOUR • Wa NDpW pR WEA1'NERPROQ~ Ff~ESH AIR INTAKE JL'NC?IOti $uX APPRO',+Ei~ WITH Ct?NDU`IT `fA3Jf~OLE CG'JE~ FINISHED rRAt~!E ~ CI W/ PADLOCK & '' RISER -~--+~~ ~ WARNING ..,ABEL ~ ~ ~ ~ ;, an :.h' LE T ~ ~ ~ ' (~~c '~ 1 ~~ i WATER I'IGaiT SEALw ~ "'~ Gt~„- ' ~, '"`~..`. TIGHT ~ `,1 ^ 1 (' F~'ROy£D +APRflVE~ ~ ~ ~ r i APARgVEO P CPS ,. . 3l~Ct'0 S-'1~1C) ~ ~•-~ ~ ~ 'ON j ~ 3' ,ONTO ~O.i. ;. ~ SOLIO, SO~t, PJMP ?FF EI.EV . ~~F7 . -.~..... ~ r,~;.pr.` !~ I ~~ RISER EX: T D 1 ' P£RMY i TED u~3i~Y ~- ~ IF TANK "IANUFACT'JRER 3" A'FRQ~i ED $EDDING UtiDER TA~iKs~q,c AFPr~QVAL ~~h'~R£TE PAD ,_,,,,,,,~,EL I F r CA T I ~:~'~ S SEPTIC r DOSE TANK MANUFACTURER : Gam. ~~,F r,~Y TANl; Si~ES: SE~'iIC ~„?~,~'d GAL. Doss ao .~" ~A~I. AL~AA,M MANLiFACTG'AER: ~.., ~""~' MODEL NUMBER : .,~~~i......._..,. as"WITCH TYPE: ~:„rr~'_____. p, ~M?' MANUFACTURER ; MOREL NUM$ER: SWITCH TXPE; ~EQuIREA DISCHARGE R.AT~ _.L._r.. Nti?'4SER DOSES ?ER DA:': ~OSr VG:.,L'ME Zi~'Cw+.iD»NG CAPAOITIES: A ~ ~~ itiC::ES a•..~~.. oAw. ..~.. C = ~ INCHES z f,~8____~GA:~ . FUMP £~ ALARM Wa R.I NG AS : ER I Lt~it 16.23 ~'A;; ~ERT:CAL DIFFERENCE SE'~E~ ~ MINIMUM NETWORK SUPPLY PRESSURE OFF AivD DTSTP.IBUTICN PIPE ,/~ T rEE. _..~. ~`~ y ~l FEET F'pRCE;MAiN X ?,,..:.~d F ~ T/3;~fl FT. ~'RI;.TION FACTOP. F£iT ~ ~ FE£'~ Z o~~ T.pT.~L DYNAMIC HEAD . ::1TEftNAL DSMEA'SIQNS nF FUM? :,~,tr'K: LE!~'G'jy -- • WIDTH ~--- ~ ' ` r r r~ .---- ~ £R ' . , ~ ,.,~. .,_-_ ~ ~. -- ~ LIQUID t"~ r'P'"~" .....,,_ IGNED: ~ .--~'" NSF. ." 18b Submersible Effluent Pump 3871 EP05 ~~_Illllp~' III °~II'~~~~~~~i~l il~ APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS • Solids handling capability: '/a" maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size: 1'/i° NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. •EP05 Single phase: 0.5 HP, 115 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: l 0 foot standard length,16/3 SJTOW with three prong grounding plug. Optional 20 foot length, 16/3 SJTW with three prong grounding plug (standard on EP05). • fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Auto- maticmodels include Mechanical Float Switch assembled and preset at the factory. FEATURES ^ EP04 Impeller. Thermoplas- dc Semi-open design with pump out vanes for mechanical seal protection. METERS FEE 10~- 9 s °a 7 W x v 6 z s 0 a 4 0 3 z ^ EPOS Impeller: Thermoplas- ticenclosed design for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ^ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ^ Motor Cover: Thermoplastic cover with integral handle and float switch attachment points. ^ Power Cable: Severe duty rated oil and water resistant. ^ Bearings: Upper and {ower heavy duty ball bearing construction. AGENCY115TING ~' Catradimr Standards Association (CSA listed model numbers end in "F" or "C".) Goulds Pumps is ISO 9001 Registered. ®2000 Goulds Pumps Effective February, 2000 63871 0 2 4 6 8 10 12 m'/h cAPAaTr Goulds Pumps ITT Industries u0 10 20 30 40 50 GPM ~: gip' .q. ._ f~ :~ ~Y !EN ,~ :~ . ~ ~~ '~ ~$ ~~ ~~ ~¢ ~r f.F ~. ~~ ~~ ~; 7 ~; ~~ ~z 's ~' ~C M Y ~F s i A W a p~p~ N ~ L.~S ~~ .. ~o :o~ s c F -~.,,_ - -,._ a, a D rC 41 m w n W ~ ~{{{ ~ f 3 U J ~' b s ~ i Q ~© ~ m .~ . e 3 a ~. Q ~. ~ _ W ~ x r x _ _ cn wtv ; x `~ ~ x w ~ u 1 ! • • S ~m~ ~m c a ~~ ~ ~ ? - ~ G cn ~, sz a ~ - ~ m stn a~~cco ~: Q ~ _~_ 'ms's Q ~' s 3 ~ ~ b~ o~'a~ ~Q ,~~°~c ~ ~~ Q~ ~ n n aN .~ ~a3~ ~ ma~ ~ ~~ ~C ~ ~,~ a _ n .+ '~ ~. ~. '~ ~ ~ W ~` 4 '?~ (D N a 4 t`n i f; {. { 4 W Z (Q ~ ~iD ~ ^~ W n ~ ~~ ~ ~~~ p ~~ o. c~ ~n n ,~ ~ ~~~ ~~ 4D r '~.'-.. ..%~ t' ~ °=~ js _..~~.____.__ _ __ ~_lz^- i~ ~ Safety and Suiid:ngs Division County ~" i ~ 201 W. Washington Ave., P.O. Box 71b2 ~"~'ra ,' ~~sl;~ , ` Madison, WI 5370? -- 7162 (~Qe artmen~ommerce (fi0$) 2 _ Sanitary Permi Number (ro be tilled in by Co.) Sanitary ~t Applieatio ~ State.: Platt Y.D. Number In accord with Comm 83.21, Wis. Adm. Code, pemorwl information vu rp~ !!d ~~ 7 r n~Y to used fqr secondary purposes Privacy l.aw, s13.0~i(1 (rn) p tJ~t,,~ ti ~~~ Project Address (if different ttran mailing address} ' I• Application Infarmutiatl - Plt~ee Print Alt tnformatiou -" S'-'~'ROtx ~~rv i i \ ZONfNG ~FFICt= ~ 3 ,/blA-2T7N - Property Owner's tie ttte -._.. ' ,,r~ Parcel N Block X Property pwtter's M ailing Address ~-- --_ ~- Property Location ~ City, State ~ Zip Code ~ Phone Number ~ 'k.,su~ ;a,Section ~~ ,c•- n eT~Y~• Type of Building (check all that apply) ~' ~ S " ~~5 ~~j- ~ ~ T R~EoI~ 1~ 1 or :Family Dwelling -• Number of Bedrooms f~A~ [?XAtM.S `_~ SUfXh fOR NamC CSM Number i~ Public/Commercial -Describe 'se ~~-`m- ~ -~ ~/ Tyr e=-~~~_ r:' Stan Owned - pescribe Use ~~ ~ ~t - ---- ~-=~--xu-T"S~r "-,,. ^ _ (City-~Village~Totvnshipof~~' III. Type of permit: (Check only a box on line A. Complete line i3 if applicable) t A. 1 .~ New System If ~ Replacem Sysxm U Treatment/F3oldirg Tank Repfaceit,er rely ^ Getter Modification to Existing System ----- .. I B• ^ Permit Renewal ! ^ permit Revisio ~~ l I Change of - ~ Q Perr,iir T nsfer t~ New l List Previous Pcrmir t U Before Ezptratian Plumlxr Owner -~-1_-___ .~_ _ _ 1~'• Type of POW TS System: (Check all that 1 } -xC ~~- ~ ~ •-- - ,~,Non -Pressurized ln-Ground ^ ?yotlnd > Zq tn• suiwble soil C1 Mfr < 24 in of suitable soil ~ At-Grade L_~ Single Pass Satxi Filter r :Constructed Wetland C~ Pressurized !n-Ground oldie Tan!< ~ P t ' B eat Filter ~ Aerobic Treattnert L'rit ~ Rec%rculating Sand Filter ~Li Recirculating Synthetic Media Filter l.eachin Cham ' 1 ll Line ~, aver-less t'ipe "~ Oth r (ex n) `_V. Dispersal/'i'reatment Area Information: _ - -~-- 1?esign Flow (gpd)Dest nst n Soil A - ` ~-. ,-~ V ~ _. __ K pplication Rate(apdsf} Dis al area Required isfr j Disper~at Area Proposed (sf) System Elevation VI. "I'iutk Lnt'a Capacity iri 7'utal Nunt Mttnuia~turer -• 1-,_.:._ Plas[iC Prefab Site Steel + htber Gallons - Gallons + of its ~ Concrete + Constructed Glass New Existing 1 I r~_ Tanks Tanks ~ ~ ~ Scpac or Nulling Tank ,_,.-__, -- __ _ nergbic 7reatntent tr4rit -- - -- - ~ __ _ ---r- i i ihising Chamher -• " - ._.._...._----- .-~ ~__ ^._ vie xes -•'~-~- '--~~ - ~- ~_ • !we-st t rty taiement- 1, the erslgne_d, assume r_esponsibTlity fur ' Uatr r of the POK"T5_shown oa the attached pleas. Plumber's Na me (Print) tuber's Si gnanue - - - MP/ PRS , bee ~ -'~-~ - ;Business Phone Number Ptumber's Addre may, te, ~od~ --------I _y ~~ ~ I '7/3'- .3'~rv .•~~s<~ ss (Street, Cit Zip C ) ~ ....M...._._ Vl(II. County/De ariment Use pnly - -'--~ ------_--- __ ~Approvnd 1 pisaptxnveQ Sarurary Pznn;t Fee <<r,clu:fes Groundwater Da[ sued Iss in gent Signature /N S I Surcharge Fee} I~._. J Owner Given treason for llenial 2~ -- 0 1X. Conditions of Appruvai/Reasons for Disa rov ~~`-`-__ - ~ ° ~~ ..-_ SYSTEM OWNER: pp ~ 1 Septic tank, effluent fitter and i dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances. ~... Attach complete plans (to the County Daly) for the system oa paper pvC Iesa tLan gli2 x l i idches fo size sBD-6398 (R, o~ro3) `~~ .~ w ~ _ ~ U ~ t~ .\ 1~ _ K 0 ~. L .~ ~~ ~~ '~, `~l p'u=~y'' Z. COPY ~~ ;'w~' ~~ ~ ~ ~" a:. p U o~ `~ ~ i~ Q ~` ~ ~~ ~~ ~~ r~~~ z. = z. Wisconsin DepattmentofCommerce SOIL EVALUATION REPORT Division of Safety and Buildings in accordance with Comm 85, Wis. Adm: Code Attach com a sde on rx>t less than 8%: x 11 inches in s¢e. Plan must County ~ f~ Palms include, but not limited to: vertical and hor¢ontal reference point (BM), direction and percent slope, scale or dimemsions; -north arrav, and location and distance to nearest road. Parcel t.D. Please pnrrt all infonyration. R i Personal informatson you provide may be used far secondary purposes ( .~,¢ .15.04 (1 m)~. / Property Owner ~~~.,~,+M- Location 1161 Page 1 of 3 Steel Soil Service St. Crour pending Date L Sienna Corporation .Lot NE 1/4 SW 1/4 S 20 T 29 N R 19 W ,, Property Owner's. Mailing Address ~ ,~ ~) L # .Block # Subd. Name or CSM# .4940 Viking: E)r, Suite608 ~~~-` y4 na The-Glen ,:. - , ~, C ~.. City Sfate Zrp Code Numb , ~~c _ ' : Village ~ Town Nearest Road ~~r~~t MN 55435 ~ -2-~r33' a~+~' ~ Hudson Carmichael Rd. New Constructer .Use: ~! Residential t Number of'bedrooms 4 Code derived design t7aenr rate 600 GPD Replac~nent Public or commercial -Describe: Parent material Pith outwash Flood plain elevat~r,rf applicable na General comments and recommendations: System elevation 9250ft, trenches spaced and depth to code 4.75ft below grade' S~~Z .~- w~s ~ de- 2 -{~ - ~ ,6a~ ~ . Boring # Boring ''' ~ y Pit Grormd Surface elev. 97.25 ft. Depth to ._ ~~ in. limiting factor Sod Application Rate Horizon Depth Dominant Color Redox Description Textun; Structure Cor~tence Boundary Roots GPD/ft' *Eff#1 "Eff#2 1 0-12 10yt3/3 none sil 2msbk mfr gw 1f .5 .8 2 12-28 10yr4/4 none sict 2~btc rnfr cs na .4 .6 3 28-96 7.5yr4/6 none ms osg mt na na ~ 1.2 Boring # Boring - 120 Pit Ground Surface elev. 97.25 ft. Depth to limiting factor in. Sod Appticaton Rate Horizon Depth Domirrarrt Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= 'Eff#1 "Eff#2 1 0-12 10yr'3/3 none sil 2msbk mfr gw 1 f .5 .8 2 12-24 10yr4/4 none sict 2msbk mfr di 1vf .4 .6 3 4~ 10yr4/6 f2d 7.5yr5/6 sicl .2msbk mfr di na .4 .6 4 45-120 7.5yr4/4 none cos osg mvfr na na ~ 1.6 `~ k ~n r~~ f ~ 7 ~~ l~G~ Horizion #3 has noncontiguous mottling - tirlU~li ~~ = tsc.au 5> :SU < l"l(l mgtL ano I SS >30 < 150 mg/L `Effluent #2 = BOD~< 30 mglL and TSS <~0 mg/L CST Name {Phse Print} Signature- .CST. Number David J. Steel ~ ~Y%~ 248956 Address Steel Sal Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Rictxnond, W t 54017 9/16/2002 .715-24f~5085 3 Properly Ownet Sienna Corporation Parcel ID # Pending Page 2 of 3 Boring # Boring 94.75 ff. Depffr to limitin factor 96 in. / Pit .Ground Surtace.elev. g Sod Application Rate Horizon Depth Dominant Dolor Redox Description Texture Stricture Consistence Boundary Roots GPD/ft' 1 0-17 10yr3/3 none sil 2 17-43 1Uyr4l4 none s~i ,_--- 3 437 7.5yr4/4 none cos ----- 4 67-9ti 7.5yr4/6 -none ms n *Eff#1 'Eff#2 2msbk mfr gw 1 f .5 .8 2msbk mfr gw na .4 .6 osg mvfr cs na .7 1.6 osg ml na na .7 12 ~ ~ S ~ ,. (o = 7. Z "~'Y~.~-vke,..~- c~ !oh ti a- Z p.Q ~~ :_- 3 6 `' 'Boring R~rina # ~- gZ• ~ 2(63 ' Effluent #1 = BOD ~ 30 < 220 mglL and TSS >30 < 150 mg/L ' Effluent #2 = BODS <30 mg/l_ and TSS < 30 mg/L T$e Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or Boring # Bonng Page 3 of 3 STEEL'S SOIL SERVICE David J. Steel 1564 Cty Rd GG CST-POWTSM Sienna Corporation New Richmond, WI 54017 Lic. # 248956 NEi/4,SWi/4,S 2o,T29,Ri9W (715) 246-6200 Town of Hudson, St. Croix Co. (715) 246-5085 The Glen lot # 14 This soil evaluation was conducted to satisfy a zoning rec~rement, it m~y or may not be suitable for your ase. The location of the test may or may not be as shown as permanent lot lines were not established at the time the soil test was conducted.. iv ~~51~~ ~a~ ~~ ,~ ~ ~~~ ~ ~- .4 = &„~~,.k~k ~~, ~oo.~~t ToP~a-rte /Z t' I° ®% Q~~~ j~t~Gyw..gr k ~~. r7J.S~~~ I ~Po~I~y,,/~IIG (~~~b.e.. ~jor~~NyS 1 ~3i = ~~. z s~F a3- y~1x~f~" • , .. ~.. - - ! ,,, .~ rig ~:'. D ',~C '. .. - I 1 ;~.. f ~ 83 1 ;' _. R. ~ pp \ +' I y,~ \ _ 'rT_..^. j I r , •_ 2 y G = `! Y71 t};8, ~p^ ll7 1 y.i 1 ! ._.. ` - 1 ~ ! ._ ~,, ~ "" ~ ~~ ''_ 1 - w ' ..~ -., + ~ - ~ w + ! + ~. jr7~ , _. .. \ ., - - .. 1 ,: . ! \ ~ ; _ A _ ~ 344 ,- \ 1*2 \ ~ t _ ; `- ' 1 t, Yom. 1 .. _- ~~~,f r ., ' r - __ ..: 39 ~ ~~ ~~ - '. , . - ~ }~~_ :~ 7~ir,' N _ ,: 22~c + .._. .. ~. +J" - ,, •. Z ... - t' ,V~•' I.. ,• ! ,. ,_ `~- `I,II i•.,t ~_ .~ 245 i, 1~` _ „~ s "" ~ l ;~ ' ~ 1,97 : 1. ! I' +,~ I y1~. ~ _ - • ::~I . i I ( ~ "r•..` .. \~ r:. v ut~ ..1 ! _ ..\ 4 I ,~ ^ ~ .. - ~~ `' ~ /'! ` N ! I 1. rl ;t ~`t •\' I ,! I 14„ 1 ! (r t r. ..N.•: r Z\A/ ; iI •' ( 1 .~y ' 'c •, 1 1 1, 1 f\ • -! I I I I I 1 1 'I 1 1 + ,. I 1 4 \ \ ~ • \ { ". , ! \ , ~ :, %! I' ~ n . f . - -~` I .... i I ICI, , /;, .' ., 14 \' ~ \ _ , ; ~~,, ; i -- 1 , , ,, , L, ~ ; I 1 ~! 1 ~, I III - I` `; 1 1 111 '~ ~;1~ ,~' `. 1 1 + I III ' ~ ~ 4 '' 1 --____ I - ~ i~ ' , \ q. '._ , . , .. i1 ~! ! • ! N , _ :, _ , I ~ I ~__ ! ~~ _ ------ ,: ;;\. k l l .a.. ~ t .. I/ +\ I I t /, III -~ ~ I 1 ~ } *' iii i ~ ,'~ ,, .' Ili, ,,=~ ~, r \\\, ~ ~ . ~,' ~ i . , i 11 1 I III ( I 1 ~ 1 1 q ~ ( 1 1 1 ~ I. i • Pt3WTS OWNER'S MANUAL & MANAGEMENT Pi.AN Page ~ ot~ FILE iNI~ORMATION Owner .,-' ------- Permit ~ -T3 p SI ~ 06SIGN PARAMETER8 Number of Bedrooms 4j` d NA Number of PubQc Facility Unite A Estimated flow leverage) , L -[~ al/da Assign #iow tpeak), tEstimated x i .5) ~L~ d aUd Soil Appiicatton Rate atlda lft~ Standani lnfiuent/fffiuent Quality Monthly aversge• Fate, Oil 8e Grease (FOG) S30 mglL Biochemical Oxygen Demand t80D6) s220 mg/L DNA Totsi Suspended Solids tT55) 5160 mg/L Pretreated fffluent Quality Monthly average Biochemical Oxygen Demand iBOD,) X30 mg/L Total Suspended Solids iTSS) S30 mg/L DNA Feoat Coliform igaomatric mean) s10' cfut100m1 Maximum Effluent Particle Sire Y, in dia. p NA ate' O NA ''Valuer typical for domestic wrstawater end septic tonic lftluerrt. SYSTEM SPECIFICATIONS Septic Tank Capacity ~ ,7 ~J ai DNA Septic Tank Manufacturer " ~ ' ' ~ ~ ~ ~~ 0 NA Efflusnt Filter Msnufscturer ~ ~'.~ ^ NA Effkient Filter Model ~'f ^ NA Pump Tank Capachy al DNA Pump Tsnk Msnufactursr E' ~ rBS d NA : tr r Pump Manufscturer ~,.,~ / Q NA Pump Model ~ 0 NA Pretreatment Unit O NA O 3andlCiravel f=filter C7 peat Flitar O Mechanical Aeration D Wetland O pisinfection D Other: Disperse! Csilts? DNA O 1n-Craund {gravity) O Rn-t3round {pressurized) O At-tirade D Mound D Drip•Line ^ Other: Othw': O NA fir' DNA Other: 0 NA MAINTENANCI: SCFIEQUt,E 8en+ioe !Event g~~ fey lnspoct candkion of tsnkts) At least once every: 3 more a s {Maximum 3 yeses) DNA Pump out content: of tank{sl When combined sludge and scum equals one-third IY~y of tank volume DNA inspect dispersal cents! At !seat once every: ~ e~a'i~r? s1 (Me>Idmum 3 years) DNA Clean etfiuent #iltsr At least once every: ~ month e) O NA Inspect pump, pump controls & alarm At least once every: ,~-- n~nthts) D earls) Q NA Flush laterals end pressure test At least onoe every: .--- monthts) Q earls) DNA ~~: other: At least once every: ...r f7 mpnthla) D arts} 0 NA NA MAINTENANCE IN8TRUCTlONS Inspections of tanks end dlspersei cells shall be made by an individual carrying one of the fctlowing Iloenses or certifications; Master Plumber; Master Plumber Restricted Sewer; POWYS inspector; POWYS Maintainer; Septege Servicing Operator. Tani inapeationa moat include a visual inspection of the tsnkts) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for sny back up or ponding of effluent on the ground surface, The dispersal csl)ts} 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. Trio ponding of effluent on the Around surface may indicate a failMg 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 {Y~) or more of the tsnk volume, the entire contents of the tank shah be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wrsoonein Administrative Code. Ait other taervices, including but net limited to the servicing of effluent filters, mechanical ar pressurized components, pretreatment units, and any servicing st intervals of 512 months, shall bs performed by a certified POWYS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. •apo~ aniigfis}u!wpy ursuaosiM 'IEl ~ tZ) '! 1145'E8 Pus !~l~tP)I tl{gIIZlZZ'E8 uuwa~ ~aideyo yifm aausf!dwoa u! pai;sip seal iuawnaop sMl Q8 ~~'~~ '.S~ suoyd suoyd N/ ,11vtw"~ 7t/~ '1S eweN _ au.~aN JLLI~i0H1l1V Aa011f"Ili'IOSa !1/001 tl13elWfld) aO1Vtl3d0 DNI~IA!!33 30V1d93 suoyd ewaN 2l3NIV1NItrW S1MOd ~"~~' '~ G - / G suoyd >:t3771~-1gN! 81MOi1 S1N3WW0~ 'IVNOI1K1011 '31815$OdWI !l011R01ddK1 ~g A1/W ~NVI V d0 ~1tJltl91N! SHl W011d N081l3d tl dQ 3E1933lI '11t133a AbW H1V3d '330NV13WCI0>i10 AWV >;I~GNt1 11NV1 1N~W1V~i1 !l3H10 Ii0 dWfld '011438 b lI~1N~ lON 00 'N3laAX0 1N3101ddRSN1 >iO/ON~f S38SV0 'IVH131 Nlf/1N00 AVW SHNt/1 11VdW1V3lIl >~Htt3 aNV dWAd '0t1d3S c <ONINMlVM> > •auui;eyi ie 3ae;}a u! se}nJ vyi yilM Aldu~oo isnw swais~ts yaps;o suafianiisuooe>:{ •aaa;ans an!3sa3}!juf ayi i¢ iewofq ayi }o !snows! 8ulmo!lo; aoe!d u! psian~isuooa aq Aau~ swoisAs uopdJOSq~t 11os epea6-is pus punaW ^ 9115 glrypd of saouenpe Ouf~~e13 'SIAAQd Pat!g~ ayi •3e!rS9J 01 iJCEaJ ise~ a Se pad}eisul aq Aew ~{uQi $u}ploy a Ado!OUyaei suo}isilwp Ifos ~o/pus hoagies of anp e!ge~fene iou s! aaJS >uewaos!daa a}geifns d CZ •ew!i isyi is joeHa ~ selnJ ayi y3{m Aldwoo lsnw swaisAs iueweoa!daa •aem luauieae}dea a}gei!ns a ysf!gaise of uofianiena oafs pus }fos mau a Jo; peso ayi w i!nsaJ IIlm seas iuaweae!dsJ eyi iaalaxf o3 asnlled 's}!em pus sou!! lol 'ami~na3s pasodo~d pus Ouf3slxa woo} si{aeg3es psknbsi ~cq uodn pedui~~uf aq 3ou p(noys pus uo(2aedwoa pus sauegmislp wva; peiaaiad aq p!npys sa.ta 3uawaoe}daa syl •we3sAs uof3d~osga pos iuawaos)dea s ;o uo(iado} sy3 ~o{ pez1113n aq feu, pus peienlsne ussq sey sere ausu~aae~de~ e~gQ3(ns y :waisAs 3uaweoeldea wef;dwov apao a eplnoJd of 'ue~{si aq isnw ~o •ueaq aney saJnseaw Dufn~opo; ayi peJ}eda~ aq iouuea pus s}}sj S1MOd ayi N NVld Jl0N3DNIINOQ •}euaisw p}}os i,ieuf ~ayioue Jo }ane~d •!}os yi!N+ paNl; aaeds pfan ayi pus panouial s~anoa afeyi io panoweJ pus peianeaxe aq }}eys sifd pea s~fusi pe `6u)dwnd Jei;y • •JOie~adp Ejura)nle, aBaidog a Aq ;o pssodsrp h~~sdad pus panowea eq ()eys s3)d pus s~fue3 Its ;o siueluoa eyl •palsos sBuluedo adld pauopuege aye pus peiaauuoaslP eq !}eys sort pus s~fusi of Buldld I}V • :apoQ en}isais!u}tupy ufsuooslM 'Etr'E8 wwo0 ~sideyo yifm aous!!dwoo u! pauopuege A}a;as pee"A}iedoad sf weisns eyi ieyi aansuf of ua~fei aq !lays sdeis Dufmopo; eyi aofnJes ;o ino ua~fei AlluauswJed sf aoOPu¢ sl1e~ S1MOd s41 u~IM 1N3WNOONVBf/ •auf~q oausl}os .~aism pus :suodu,ei :su-~ideu A,ellues :sap}al3sad :elanpad Duliu}ed :Ifo ;suo!ieafpeua :sdeJas iesw :sep!a)q~ay :eses~8 :euryosa8 :sBuflead alge3eBan pus i)n~; :~eiem (dwnd deans) u!eJp uo)iapuno; aed aiueiae;u!s1P sJedefp asoi; leiuap :slasaaaBep agems uo3loa awopuoo sung a33e.tebfa sed}m Ageq ao!3ofgliue :S1MOd ayi ;o a;!} eyi 6uoioJd pus aauewJO}Jed eyi eno,rduu stew wseJis ~aiemaisenn eyi wog; 6ufn++o!lo; ayi ;o uolieufwf}a Jo uofionpea •eeJe uofid~osge ~fos epeJB-ie so punvw Aue ;o adols umop Sae} g l ulyilm eeJe ayi 'iogdwoa Jo gJnislp aslnnJOyio ~o 'Jano >1Jad Jo enfap iou oa •apeo }esiedslP pus s~fuei Jano selalyvn {Jed Jo an}Jp ivu oq •~{usi dwnd eyi ufyl)m slanol Isw.-ou sJVisaJ of s}oJiuoa duand eyi Su}3saado AI}snuew u! is}sse of JeuleiuleW S1MOd Jo Jagwn~d a ;o¢iuoo Jo dwnd 3usnl;;a eyi o3 iennod BufJOisaJ o3 ioiid JoleJadp bulofnJeg eBaidag s Aq penoweJ ~{us; dwnd ayi ;o siueiuoo eyi aney uolienifs sfyi plona off, ^iuenl}}g ;o eDJeyaslp eae~ns Jo dn~foeq ayi ur i!nsea Aew pus (slllaa ayi Dufpeolwno 'asop eDael suo u! (s)pas IesJeds)p ayl 03 paSJeyOStp aq p1m ~aiamaisem ssaaxa eyi peJOlsaJ sf ~amod uoyM •s}enei JsiemyAfy IBw~ou snags (Ifl stew s~luei dwnd seBeino Jannod Buena •eos;Jns en!isJi!#;u! ayi is uazoJ; vJe suofl!puoa !fos uaym Jnooo iou pays do Leis u~aisAg 'esn of io}id JoisJado 8u}ofnJes ebaidas a Aq panouJeJ (s}~{uai ayi;o siueiuoa ayi ans~{ pelaaiep aJS suollaJiueauoa y6fy ;} •(s)pao IasJeds!p ayi aBawep Jo/pue sseooid 3uawlae~i syi apedw) Aew lay? s!eafweya Jey3o Jo s3anpoJd Duf3uled ;o aauaseJd eyi Jo; (s)~lusi 1uauJiean ~foeya SIMOd eyi ;o esn of JorJd 'uollonJisuoo mau Jod NOIIM!l3d0 ONb- dfl 1Li1~18 ;0 2 a8a,; 2 ~d/r ,a _a-~~~~3 i a ~ 23 ~ ~ ~NNH l.l.iKf~ ~' --:% ST CR01X ~ ~ ACSRSa~l~t'T ~ TATS ANA O~fJ~~' CRR'~~'TYQ21 Ft3RIv~ ~ ~1 ~AJ,~.I/~ C.o ~~d eiF?- a ~ ~ ~~ ~ UwttadSuY ~ i"'t vl r ~'DQ- Such lv~b ,Addr°ss ~~~ ~. ,5.~ a y ~ ~ ~~ eat r ~a ~ ~edoay ~P~` (Vcttlic~+~aa r :qu~red $oas PlseninC Dapac~ C~tY/Stata /-~ V DSO ~ G~ ~ Pa:cel Iddatificatian Nttmboc ~~.r nrst~'~~. ~f (Jt~sa n1 ~-- ~' r ~ ``~ s~ Zp ~ T Z~ ri.. W~ Tuwn of on ,.~.._..,~ , ~„W p"'°p~ty' '' _ r ~ Lot # ..! -~ Gcrt~"ied S~ritoS- lVlip # . !J D ~ Volume ~ p~° ~ -~~_-'...,--~ 'R'azranly Deal * ~/ G' . Lot Zioes idetd~able ~ y~ ^ no $~ ~~ ~ y~ o ~-~ ~~~ of ou: ~pde ~~ C°'~td resvl ~ inoo t~ ~ ~+p~ use atad ~ Y . ~~ Yea as ~~ if nreded by a 3irenstd pt~- ~t y~ ~ ~ g out the is 'dale rrosY ~ e im the usstA ~' eat t+l~ dos n of Lbw teak +rs s teeat~mmt ~ ` ~ fotm. ~ >:y ~ ot~ ~ by a ~ pevpeciy ovraa agues ra rabmit m St G toix Za'Qi~g t ~t ~t~ dae a ~ ~°°m' ms.~apYv~a~,~a~uaeya~'ap~ edptus~ta o`~,p'~~+~7-~, ~ ~ t>znYc is k~ tbsc~ 1/~ fun of a is is ltro~ ~~ eet~dtdan aadlat C~) any P'm~ ~ ~ erad+utds ,fie vata ~~ *Y~`'°' oa Ihie. the uuo~ love read Qme ahcrre o f* ~ °~ and tlro Depitt~~ of N ~~a1 ~ ~ ~~ d~ 0 mt Cats b~~ ~ rct by tLe Dopett~m bz ~ t to t'ba St- atidttg the m~ d, t~ ~~ .. ,_., ~ . .. DAB v t/ ot+v~te~ of '1~;".`~''~',R CF~RT~"Y~~ i?H _ kue.~+lyd~e. i (ae) sm Late) tho Y ) citify tfsat all ~' oa vanafnty docd coca ~~ ~,pog~tat of 1Jecds af~• drsca Rbo ~, x ' DATE Si A ~ ~~ s.t... its[ormatioa v :ais-tept~cvsed oast' rcNu in the as~ie+ri p~a~e a0~ r.wlcsd b~- the Zoa~ DaP •• jaeludc ~vit11 this •ppticstioa: a ssaucsspod avs~ttsatY dead ftooa~ t~lC j~p8itid df ~~ o~ a copy of the eetd$cd auNGy tromp if tt:Tec~ ~ ~° ~ the t~~ dexd TOTAL P . ~S2 STATE 8AR hr 'vV]SCChYSIN FQRh! 1 - 2998 WARRANTY D6EB Ea6rEy0847 .' kATHLEEN H. IrALgH oooumtnt nwunoer ynr ~ 7~?pAf,T ~~3 k£GIS7ER OF DEEDS oT. CftOIX CQ. , W1 rhts aetea, made between Hans Co~~ roorat on BECEIUED FOR RECORD _ a Minnerota cazooratloTS ,_~ ""' 12-21-2001 3:lD DII ~-- ----_ a,:d _3j~~S~L.~ntfrati^n- a Kin - ~`..._~ ~_, Grantor. ~ DEED _'_. :llStttB cer o atip~--~-~ d 1~1r FEES ______..~.._~ "-A-~ - ",""" ~~#~. _ T IN6fF~EE~s 19i 040 Craruoe. s ~ Grantor, for a wluabts eonstdoratlon, ~~~~~'-`~' '; dexribadroalatatetn Sa. Croix canveys to Crantea the fe!lowing ' '~ {tile "~rR rt "~"~ CWft$ State Df Wirconsln pa Y7" .. rasa a dn:y ;:M1tA See Attached Exhibit A ' ++v~+md•AwartA~r~' ~ ~ '' 1 ~ n±>~r~lt~ ~ #~~ '~ 5'1Ga~ 5me. Ur i ~. ~i.~.i-~,. ~'CJ~ I~{in~ie f~r-ha+ Wu6a3~ 2o-la4a-30-o00 PrrM tdrnti4cruon tat,mba,>'~p "`~"""'~ Thy 38 HOC homestead propery (tf) pa not} 20-1048-60000 20-1048-40-000 20-1049-90-000 z0-Iaso-oo-ooo 20-1050-80-000 so-IOSZ-ao-oco zo-los2-~o-000 Together wuh aii appurronant rt8hu, ^Ue and interesu. ', Grantor warrants chef the rich iq the Property is goal, trxsdeastbit In tee slmpk end few and clear of encumbrances sxt:eyt SeQ Attached Bscbibit B. 1 Dated this 20th „^ day of Dsca._..,,,,, Rb~` 2Q01 i Sane r oration. -_.._ (SEAT,! .,,_.-~..~-.~-_....... (SSAL) by l D seas _ ~' I•t~ eg Exeeutive Offi (SEAL] .__ _.. -_ (SEAL} AUTHCiNTCCATiON Ssgnature(s} authenticated this oay of ~~ 'i'ITLi n16M8ER $?ATE BAR OF WISCONSIN ('}riot, autnorizrtt by §706.06. tigt, Staff,} ACKNt)WtEC)GMlcNT State of iMtfeetntlRtt- l } ss. ._'...<, e - County~ J prt70ruily :arrse before ms this olt day s:f _ Dacambor ~. tht above named John M•- Naesetf Chief Lrxecuttve Otfic~r -oE Hans Corporation a t{ianraota ,_-'dot oration '-- me ky~ Hewn to br a to pert i~,;.._ who rxecdted the fore8oing iristrvmont and a n ./<<,.f...... Tktg :N$TgVA,tENT Wq§ pggFTEO BY _ ~~ Lackrid~e Grint3al Law Firm ~~B~ -..--.1-QL. r wa~raraoaawUlat~tir Minneepoliar MN 55401 - __N,,~~yry ~ubltc, Sreta of Wisconstr, '~~`~' "--- ~Y eornmisston Is permanent, (U not, sta;e exptrfuon date: +;Sla(tttltlY~s may be aut}lentlcated or aCltnowladaad. Both sr- trot JaDtiaXY ;~ ~~. ..... 'Nernn~f;,ersmusi t ,Han c _ ~.. ~....: . tF1111 Y ~eY matt be tYMd of pstimesf below thrv s~neut.r ... . w'ARRANTt DEED STATE 6Af OF WtSCOASiN Fgasa Ka 1 - it>QE rY~aeonen 4apr lfa.W Ca., Ins. nraataw. ws. f~..r~.~ ~~.+.* w~+. * w~ wew~ flrnw w s. ~rr.w orin., ~ w~ wr~w.vr ~~ y w M M ~y ~WMrMt ~rtfr ~ ifV ~VVwAf1 ~ ~ Y WY LrMwl O+irtlr ili My S~IH~wA hMlt4tt. M ~ lM 1 ,Y1 *7 ~t ~+~- tYCyeMw t 'IM.1w~ ~1 ~ UOS. • M lr.MM~ ]0. 4wr« t! MMNk +1w~: M wrt. 1w. y . k. QEr 7t 11MCw1 S ... «~ j ~N` 19 i I +r+a ~~ 1 1 M ~ J e~:rf~ar, 1++M i i t ~~. 4 ~ 1 1 ~ ~ xr. ` 1 ... f' --" '~ 1 ,,, d ,~ w, tAi \ +{ d ,,, ~, ~ ~" ~, ti r fem.