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HomeMy WebLinkAbout020-1414-90-000dVisconsn Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GE~ERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)I. Permit Holder's Name: City Village X Township Bo Ian, John Hudson, Town of CST BM Elev: L ~ Insp. BM Elev: ~ + BM Description: ~ ~ / _ ~ ~ ~ ~`R,(~yti TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ ~' /~ slug Aer ~ Q"h f I?j ` TANK SETBACK INFORMATION ~_! TANK TO P/L W~ BLDG. Vent to A' ke ROAD Septic ! g ~ 7 ~V ~ ~ / iv-1A~. Dosing ~ ~ ~ _ Aeration Holding ....-,. _ PUMP/SIPHON INFORMATION ~/~~ Manufacturer / Demand GPM Model Number TDH Lift Friction Lo em Head TDH Ft Forcemain Dia. Dist. to well C(lll ARSnRPTInN SYSTEM 7 ~- ~ ELEVATION DATA county: St. Croix Sanitary Permit No: 499264 e/ ' ~ State Plan ID No: Parcel Tax No: 020-1414-90-000 Section/Town/Range/Map No: 20.29.19.2617 STATIC nA ~S ~ HI F ELEV. Benchmark~/~ /~~ -~ r+T ?Z~f/J'~.~ r ~ ~ l~ Alt. BM ~ , / (~'i'~'o'-v- si~.,~ .0 6 67~. Bldg. Sewer t ` t'~R! ~ Si ~~. ~~ St/Ht Inlet liN. ~ / 9 . St/ Outlet ~~ ~ ~ . ~~ Dt Inlet ~~ Dt Bottom ~ ~ _ ~ Hgader/Man. q' q ~ / / . ~S Dist. ~ ~ S ~ (}~ /l~il ~S • g ~. ~S Bot. System ~ ~. ~ Final Grade ~ ~ , ~ ~, ~ G ~. 6 St Cover / ` (o rr~e~o Z YhQ~'t ~G~- -~,~ ~j ~ ~" ~ ~'' s "~ ~-- ~/ ' il]rl%/ ~t.nl- GZ~P+f~.ClL~/Z."fD S2 -f7/l ~ '~/~w1 W ii^ BEDITRENCH DIMENSIONS Width ~ t Length.. I QD' Z, No. Of Trenches PIT DIMENSIO S o. Of Pits Inside Dia' Liquid Depth SETBACK SYSTEM TO P/L BLDG WEL LAKE/STREAM CH G Ma cture .. t. {~ w INFORMATION HAMBER X Type f System: ~ ' ~ i ~~! ~ ! ~/ Model Number - I~ISTRIRIITION SYSTEM [/~""~''""Y~ "' " ""'"""" Header/ ifold ~ Length ` Dia Distribution f ~~ ~ Pipe(s) ~/Q /v,-, Length 0 t1 ~ (Dia Spacing x Hole Size x Hole S Vent to Air Intak ~x ~ Coll r(1VFR it..n L .nom _ ., o.e~~.,.e c.,~~e.,,~ nni.. ..., Mnnnrl nr et_AraAw Svsfams Only /Ldl.f/JlG Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ~ Bed/Trench Edges Topsoil i~ Yes ! I No Yes ' i No COMMENTS: (Inc ude code discrepencies, persons present, etc. Inspection #1: ! / Inspection #2: / / Location: 734 Martin Aven~upe Hudson, WI 54016 (SE 1~/4~S~W 1~/4~0~U~n~kn~own) The Glen Lot 23 ~/~ Parcel No: 20.29.19.2~61Q7 1.) Alt BM Description =~"l ~~~ ~G~rV~'~"~~ C-~ ~"' _ ~~C, ~~,/~~'~,r/J~PI ~ K 2.) Bldg sewer length = 2' ~ 3y ~~ - amount of cover = / 5 ~ ~~'_, °" "" ~~Q I~ ~p,~- _- - v-- -•-r-- --- - Plan revision Required? Yes i ' o ~ ~ r 5 Nr ~~ Use other side for additional information ~ ~ ~ ~~~ _ ~.~~- ~~~`' S`-~ Date Insepctor's Signatur~ nn _ ~i/ SBD-6710 (R.3/97) ~ /~,ii 17yaf ,r.n ~ w L~ ~.,,!( _ ,,, ,(.~'-~ _ /_~ ~• ~-~j/~~ ,.___- - -.. hs ' ~~ r~~ -_ - _ Gommerce.wi.ggv Safety and Buildings Division ~ 201 W. Washington Ave., P.O. 13ox ?1G2 ~~c~-nsn ~ tifadisan, WI 5x707-- , j - tietaartment of Commerce I ---- ~ ~____~ Sanitary Permit Application --W,- -- In acco=dance with s. Comm. 83.21(2), 4t=is. Adm. Cotie, submtsstun of tins €'orm io the apptapnate govzrmrterr;.at 1 unir is rayuded prior to obtaining a sanitary pemm. Note: Appitcarion furnss tar state-owned Pilti"/TS are submrttr_ci to the 11e;,a:~•nent of Commerce. Persa+a information you provide may be used for secu ~u~ruses in accordance with [he Pelvic} Law, s. tS.04(Ij(m!, Stats__-__ ___~~~_ ~l. ~pfication information -Please Pri All Information _ ___- __ _~ _-_ _-_ ~ 1'teperty Owner's 4arne ~~ ~~~-- .~, J oL,,,~ ~_ ~~ ~~~ _ AN 1 8 2007 PfUperE}' Owl;er'$ l~'lnrllnk, Adds"e5$ ~~ --~-f l g /~~ ~ ~t ` ST. CROIX COUNTY City, state-' tf.~~ o WI- ~ Zip Coee ~ ~~ nr,~,,,` ------ i~ e of Building {ctseck aU that apply) _ Lot is ~_--- y- ^-~ 1 ur"? Family Dwelling.-Numl~r-ot'Bedro:rms yp__ Z 3 --- OC i ,r. 6v vw~ lock t? .-___..._.T_-_-- i_1 PuhFcJComm?reial - Ciascrit:e Use ~"_!~4~__~~a~ ~ ~ ~i ~" ~ _._.-~.~_-i r(-'`tit Numlxr i._i State Ciw^n~til - iucscrilic Use _.._..-- -_--. -- ---- - -- t Ili. Type of Permit. (Check only one box on line A. Catnplete titre B if applit~able) _ i 4-__1____._~_.------- ~' New System ! Li Replacement System ^ Treatruent~'Hvlding"Tank Replacement Ouly~ f-.~__---------- .___._._.__~_..._._..~..... _._.-..; R•%t Renewal Permit Revisson j ^ ~: change of Plumber ^ Permit Transfer [n /vew , ~ Befutt: Ext trahun '~-~_, Owner L_ ~~ _ - t- County Sa Permit :Vumiyer (to be filed in by Cu.) -- ^State Transit:iorr Numiyer - +..~wrrr° .~^ _. Pro}ectAddress(ifdiffereatthanmt,ifinga;idressf- ~ '~/e-. Parcel q^ °20~ ~y~y - 90 - trio Property Lrxation .._-_.-~-^ ------' CiOVt. i.ot a : F i:, ~L~ s=, Section ~~ ~~++ l- tclt one} J~ 1 i Subdivision t3atne ~--~ ^ Cih cr ~.~ _..--------------------- ^ Village o{ _,~_-___ _ _ _ ~' ~Tuwnof' ,,t,t~t~.~J~~" _.1_ ! _ _---- --- -----._ -___.._.---- ^ Other Moditicatien to Existir:g System (expiair:j , and ilate ISSUr.d , ~~or:-i'res~ a.zed fn-Ground ^ Pressurized in ~•tuund ~ottrede ~ ylounl~> 2/4~in. e'sattable sail ^ 4lound <L•7 in. ct suitat;Iz so n`om' -~i ~~~~I ^ I{n1:1~:~tg 1 ink _! Other Dispersal Component (explxmj~~~~.+b`~-+^`~`- . ~~'{-s=" ne' merit Pevicc {explain)-____ ~y `ii~-' ~'~*'~ ! - ~ Dis ~ersal/Treatmenl Area Information: -- ---------_-~___~....__- ~_.____..~_~___._.._ i~estfn Flow (gpd) _ Uesign Soil Apphcatiun Rata(gpdsti ' D specsa Area Required fs;j -r )tspeYsai Area Proposed ~ System Blevatioo - Vt. Tank Info -- _ Capacity in~ _ ~-~ j lutal ~ Gallons ~ Gallons ~ NtwTanks E~.istingTunks # of i?ntts -- --~- -Manufacture I r, ~ y e r--- o y o~J, ~ i y ~ ! I u $' ~ e I ! ! Sttrae ire tialdmg Tsnk _ _ _ _ / ~ r~ ~a li_. SZS ~~1.~.~. a ~ / ---- ~ ~ ~ + ~. v ~• ~ tlosingClrarnbzr ~----_.~^~~ _- t i ~ VII. Res onsibiliiy Stetetnent- I, the undersigned, assume rusponsibtiitp for installation of the POW'T'S shown on the attached peat+s. _ _ Ph:mber's Name {Prrntj - P!uiatbe:'s Scgrra',ure ~ rvfPrMPRS Num~,er ~ f3usine: PY,one Namber- -' t c ~,r ~ S ~~6~ l' ,L.[. ~-r~~--~~ a---'~. _----~ - ---------~--.____._____~ _ ~a~y-9d---i?_..~~= -- 3-fir, t'Iwnber's .~dJeess Street, City, State, Zi Code} Vltl•-_•~ Ca~ unyty'UeLartment Use Ong ~~----- ; ----___.-.~____. __-- ___....._._._ ~~ ~prove.i L~. Di p i Permit Fee Date I sued issutn;,t ru Signature 9 ~ ~- . •, gs . by I /// _ _ _ I t.,J O n van Reason for anti[ _~ --_- ~ ~ -- ~_-~-~ ~ ~IK. Conditi - essons for Disa roti•ai - - -- _ _ ~~~ _~ ~ g~~~i~ pp ; ~-- t . septic tank,, eint~t,t rner and 3 ~ /[~o ~.~,:~ a ~-' o ~ ~ fie.. tl~persal roll must all be services /maintained f- _ l Pe,,,,~:~~g as per n~thagement plan provided by plumber. 4`-1-a-) ^-^-}(~,r e 2 AM se('batck requirements must be maintained ~ V ~ , ~ /~1(r'~< c e , rr syst+: ru and snumit Iuyhe Euuntr a Ep oa paper aot it~ss than 8 In z t! incc~e .._ SE3D-6398 (R. O1'0?) Valid that Ot109 S~ o~~ / ` `~ ~'O tkda'Y"~,~- V W ~ ~~ ~"~~ 6^ i / w~ . ,.~ L ~~` ~~. l ~4 ~~~ r /~,,.- ~~ ~ ~ ~~ ~ ~,~ ~~~ ~ r ,~ ~ SAS, ~~ I/ ~ I ~ L U~` ~~ ~. ~,,,~- s`~`' ' ~f ~ ~?~ ~ ~ i ~~.b ~ ~ ~~~ ~ ~~~ ~ ~~~~.~ ~ ~_~ ~ ~ ,~~ / ~~ _. ~~ ate, ~sn, -Q-v~-~ 6~ ~~ ~~~ %// /o ~ ~ ~-' _~ ~,. ~~~ ` r~ g~ / ~~, ,~'~ ~~,L ,~~ P~ ~~ ~ ~° ~ i a~ /mod ADD sc' r'r ~~ ~// ~°T . 1~----y'"" Wisconsin Department of Commerce .SOIL EVALUATION REPORT ,~,~.~..-dye :~ of~ DlviBion of Safety and Buildings ~'~"r nt awutuant:e wun ~,ornrn oo, vvts. aunt. ~.vuc County / r 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 Parce! I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all informati Revie d by Date Personal information you provide ma a use ~L'~ (Priva y Law, s. 15.04 (1) (m)). ~ / ~ a 7 Property Owner ~ ~ ~ , Property Location ' v f~ (ncC ( ZQ07 ( Govt. Lot S~ 1/4 (vl/4 S G T ~~ N R E (o W P pe~ Owner's Mailing ddress /''~~ ~ j,~,. _ Lot # Block # Subd. Name oyr M# City State 'p ode Phone Number ^ City ^ ~Ilage [Town .Nearest Road ;1 /hv~ ( S "Z ~Grr~~ e (~ New Construction Use: [}~ Residential / Number of bedrooms ~_ Code derived design flow rate y_s?~l"6 ~~ GPD ^ Replacement / ^ Public or commercial -Describe: ___________~~_ ______ _ Parent material O t_) t-r,~G_~ Flood Plain elevation if applicable ~(/~~ ft. General comments [ / u ~ and recommendations: S~S7ef/~ ~f'eUrj~ -( ~~G~^-5 ~ ', ~p~~,i ~ ~czs ~en ~ ~~ Wtc,.~ CJ2. _C~ ~ ~~~°/tcr, ~~ ~-~~¢ cya Boring # ^ Boring .,~/ ~`p~-~ . `~ '~- 7 ~ U ~jt'..~2-~ 4~'l_ G~l./`Ltin.~-(~ /ZU1.riL2 -~' -~ ® pit Ground surface el v. (G. ~ U d ft. Depth to limiting factor ~yo in. a _ Soil lica6on Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/tf in. Munsell Qu. Sz. Cont. Color Sh. Gr. Sz. •Eff#1 •Eff#2 / > / ( ~ ~ r !' n2f ~ Apt r ~ - / sy-~y o ~ - ~ t -- ~- ~ Z N Bering # f~~~ Boring 2 LC7 Pit Ground surface elev. Q~~ ~C3ft. Depth to limiting factor /~ ~ in. Soil lication Rate Horimn 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 2 ~o-Za rS7 -- Sty/ ~ -~~- ~ , ~ • ~ o-t o r'~/ S yn ~ -- -- F l z ~ta t ,( ,~ 'Effluent #1 = BOD > 30 < 220 mglL and TSS >30 < 150 mglL • Effluent #2 = BOD < 30 mg1L and TSS < 30 mglL CST Name (PI~',Print) , -'" Signatur ,.,..--" ~ ~ CS3 Address ~~ Date Evaluation Conducted Telephone Number ~~ ~ 9 f~ 9~5.~ /fi~w /~ ~c./lono~ ~.,~/. .s~ol~ 1 ' >~ '~ ~ ~~ S =~ o-~z ~g ~lc.1F~.f,,; Properly Owner ~ ~ ~~ /~ Parcel ID # ~~ ~ ~J Page ~ of 3 a ~ng # ^ Boring ~~_ , _ pit Ground Surface elev. ~ ~ ft. Depth to limiting factor 12 ~ in. Soil lication Rate Horizory' Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= in. Muns e ll Qu. Sz. Cont. Color r . Sz. Sh. G `Eff# 1 `Eff#2 ©7 ' / y l /~ ~ ~~r y es ~//C L 1 ~ ~ (/' ~T ~ \y t J -/Z ~-- S ~5 ~ _-- ~ ,, ~. ~ Boring # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting factor in. Soil liption Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 Q Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to IimiGng factor in. " Soil lication Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GP D/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 'Effluent #1 =GODS > 30 < 220 mgll and TSS >30 < 150 mglL 'Effluent fr2 = BODS < 30 rrrg/L 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. sev-eswlrt.~oo) Property Owner ~ ~ ~~ /~•~. Parcel ID # ~~ ~ ~~ Page Z of 3 a Boring # ^ Boring C~, ~ ~ ~` [,~ pit Ground Surface elev. ~/~ ~ ft. Depth to limiting factor 12 q in. Soil lication Hate Horizon' Depth Dominant Color Redox Description Texture Stn3cture Consistence Boundary Roots GPD/ftt in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 07 l ~3 - 5,° Zm ~f C u ~ ~ , z i~-3 s - ~i/ ~ ~ - , ~ -lZ ~- S C>5 -- _ 1 ~~ ~' ,~ ^ Boring # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DKf 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 Roots GP D/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 `Effluent #1 =GODS > 30 < 220 mglL and TSS >30 < 150 mg/L 'Effluent #2 = BODS < 30 mg/L and TSS < 30 mgfL 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. SBD-8330 (Rb/00) ~~~~~~ - ~ ~-`~U r ~~4-f errs ~-~e.~J r_ ~~ /'' \. ~~. ~~ ~~b ~~ q~ ~- ~~~ ~ ~ s ~~~ ~,~ O ~ y` ~ ~ ~i ~ ~ b~ ~° ^~ ~ ~ a~l~o~ q2 ~o ~.r~`~ ~. nr. a~ ~~~ ~~ ` ~ ~ ~ D ~~GIJ.i~ ~'~f ~1 ~ ~~~e ,, ~s~ ---••••,.~...-e.w~.yvv safety atttJ Eiurldu7gs E)ivjsion lOd W. Washiagtc~n.4ve.> P.O. Box 7162 I County -- ----, ~ ,S'~Cy®,~ 1 ' $~~ n~ ~ ~ ~ A$adison, Va`I J:,"?Gi'-7162 Ospartrnent of ~otrtmerce --`~-- ~ Sanitary P mtit Dumber {to e ti"led in by Co.) ~ qq ~~ ~ I " --- ~~ Sanitary Permit Apiaiicdt State TransactionNumbtr ---~ In accordance with s. Comm. ~3?t(21, 1?/is. Adnt. Cede, submission ofthi, tLrm [o t gov~'rrmental un+t is ,equired anur to obta:nmg a sanitary perrrrt. Noce Applicarior+ 4`orms or ;ate-owned PO`s"TS are submhtcd o th ;) ~ ~ _ FroiectAddresst}f differentthwnmsilin addres g ~ e cpn~mtutr of C omnterer Pesoral utfonnuhor you pravide rrra,y b~ raed for secondary turtose5 ict a c.o+i~rtc.e itt+ the Privacy LaH sti!5'J4t1 ntj, ~ta~s. - - ~- j ~ ~ ^n~.~ I 1 4 - l A plicatton Information Please Pnnt All Infarntaf[on _ _. _ ~ ~~ rn /~ ~uG ~ TT~+ \6 p, ___ _-. _ _. _ _._~_, Property Owner s Name __- .'____; a Parcel *x ~__~'~L.,~_ __-~~~ s Zoos ~ aaa ~ ~ Q~~-~o '~ ~~ ~ Property Owner's Mailing ess ~-- ~~ '-~~~` i Property Lac .,_l~a_~ G` __ ~~Y /l _ ST. CROIX COUNTY .~_ ~ Govt. of 3 City, State j Zip Code ' Phure Number ~~ , Gc~_S_O_it/ -T~1J/ _ t~~6~f° __~_-._._..__._ - T - T o2~ N; R ~7 irclEo ~ II. Type of Building {check all that ap j ~ * -~t ~ 2 Famil i7w I tli 2 ~ N ~ b f B d ~-T _~~ ~~- ion Name ~ Subdivi s y or p ng -- , e ar o um tao ~ e 1111 3i k ~ ~ /1 ~L ~i!' .c~ ^ public/Ct;mmerciul Descrax Use ~~ . __._.~.,~ ~ ^ City ot` _ __ n ~(' R1 Nurttbe- ----~~ u State tared - Describe to ^ Village of ~ _-___~-_-- - i I ~ Town of.-~f1~~~ ------- I~-- 1[I.Type of Permit: (Check only one box online A. Comp a line B if rlicable) T~ ~ ----~----- __._._----_ --_..~-__.-----._---- ~ A' '.few S stem ~ E ~ ~ Y' ~ ^ Replace+rrenc System ; ^ Treatment/ Idi Tark Replacement Onto ^ Other hlodtticauon to Existing System (etplain) -~;-__ - I I ----Y_..r_ - I ~• ^ Permit Kenewal ~ ^ Permit Revision C~ Change o' lumber Pemtt Transfer to tvew E _ List Previous Permit Number and Bate Issued ~ [tiNCOrii zprrarinn I er r- --- - ---- ~ ---_..- ----__ ~.i i IV. Tv to of POW"f5 SystemrCnnt~tonentll?evice: Check n Chat a 1 ~ _ - 1'C-SZ~~+-,~-- -~ !~~ ------ -- - T~_-. ___ ~. _ Non-Pressurized 1n~~Grnund ^ Pressurized In-Ground At-Grade ^ Mouitd % Z4 +r. ~fsuitabie soil - ~ ^ Mowtd < 24 in. a:~suitanie so;i i~ ^ ltoiding Tank ^ ;?thee Dispersal Component (zxylain) _ _ _.__ ^ Pr atment C+evice (c-xplain)____ _~--.____~ , V, Dispersaf/['reatment.area information u;.~~_ ~%~5~~?_z~~ _ Desi n Flow } ti) De : r S i! A l ti ft f ~ ~S E ~ f g gp > b . o pp :ra on a ;t! , ) Dispersal urea Recurred (st) ilispersa levation I ez Pro Sysrem ' ---- --ter-- - ----- --- -- -- - - ` rVl. Tank Into I Lu}sacity r Total - ;u of ~ Manu acturcr ~ ~-i--- i I ~ i _ ~~ t.lallo Cra!lons Units ~ Nrw a anks xisriarg Tanks ~ i i I v r, v e ~ I ~ ~ ~ i y ~ i a ~ ~ ~ ~ ,' ~ ~~qQ ~ ~ - Se tic or }{ottlin 'S'ank --•t---1-------*..------t--- --t"`~--t r Dosingt'.hawnber 6o I -' --' ---1~=-- I ~ -____._._~ ~_-.--. ~'II. f2esponslhiflty Statement- 1, to undersigned, assume responsibility for installation of the POWTS wn on the attxch e d p [s. - j Pluml.,e!-'> ?~iame {Nrmtj -• Plumber's Sr},ntattu - •~~_-~-~ - P _ _ ' PRS Number T Bu toss Phone Number --- ._C_r ~ air __ 1 / (lumber's Address(Sueet,City. ate.~ipCaie) ~-~-----------T._~_"-~"'-___...__-~._____ _ _ _--_._-._-_____.-; Vlll. CountvJl`)epartment Use Qnly _ ___ _ ___ __ I - ~-~ I Perm- it Fee - ~ Date Issued ~ 1~suing ge iynature Approved I ^ Dis: roved $ ~~yr~ ~ - .^--- __ ~ ~ Ow ven fur Denial ~~ ~~'• 0 ~/ `^"~'F,~ _ r [\. CondlNote At pr flease~ts-t~ai- ` _- n . ~ SYSTE ER: 3J ~ I~ t i ~~ Q S I 1 Septic tank, effluent filter and ~ ~ S ~ ~ T2 ~~~ P°'^ - dispersal cell must all be serviced /maintained t~ 1 t3s per management plan provided by plumber. __~ ---~- [ I .~ t ,~ ~If~.ubmit to fire Coun y s.nly un paper nu~s titjln 8 !2 x 11 inc es it sia~-~ --V~---------- as per applicable code/ordinances. t~ `(fit-'~'~~ ~ s~o-~3~s r~ «ixr> valid th,~t ahoy rv~~- ~2 ~,~~;~.u.,~~ '~u ~~ ~o.•..~ eS ~ ~Jcs.~~-Q~~ . 1 i m ~ ' m m ~ -~ N ~,..I. 0 m v ~~ ~- r ~~; ~, ~ ,~ 1 4 ~ ~ ~' ~~ ~a ~r ~~ ~+ ~~' q ~ ~~. Q 4 L ~ ~ m o c n x m " .~ O N < _ ° v Wisconsin Department of Commerce SAIL. EVALUATION. REPORT Division of Safety and Buildings ;~, ~,~.~~,~ vuitr, ~~ A-5 Wrc Acirn Curie 1162 Page 1 of 3 Steel Soil Service Attach corrrplete she plat[ ~ paper Trot ass than 8'h x 11 inches in size. Plan nnist County St. CrObc include; but not limited to: vertical and horazorttal reference pornf (BM), direction and Parcel I D percent slope, scale yr dimenisions, north amnv, and location and dbtarx:e tanearest road. . . pending Please p-mt all irrforn-atio~n, evieu~d Date Personal. information you provide may lie rued for secondary purposes (Privacy Law, s. t5-04 (t) (m)). ~ ~ ~ O 3 Property Owner ~ ~., , ~~ ~ ~ Deaf. Sienna Corporation ` '~ ` govt SE 1 /4 SW 1k1 S 20 T 29 N R 19 W Property Owners .Marling Address L~ # BI k # Subd. Name or CSM# 4940 V~Cing lk, Suite 608 5 L t' ~ SQL nor The Geri .City Stake Zip Code Ph Number City Village Town Nearest Road 4 ~~Cirlu MN _55435 9,~ 83,5= ,~'` ~'_ _ ;__ , udson Carmiettae{Rd. New Construction Use: ~ Residential 1 Number of bedrooms 4 Code derived design flow rate 600 GPD .:Replacement ~ Public or commercial -Describe: Parent material Pitted outwash Flood plain elevation, if applica}sle nor General comments and recorrrmendatioris: System elevation 95.27ft, trenches spaced and depth to code 5.33ft bebw grade ~ ~~ ~ ..~ fob. ~ ~ ~.Uh ~~ # -' ~~ 100 ~` Pit Ground Surface elev. 100.60 ft. in. ~Pth to limiting factor Sod Application Rate Horizon Depth Daninant Caor Redox Description Texture Stricture Consisterrce Boundary Roots GPD/ftz *Eff#1 "Eff#2 1 0-18 10yr312 none sd 2msbk mfr cs 2f .5 .8 2 18-52 f0yr4l4 none sic! 2msbk mfr cs na _4_ .6 ~- 3 2-100 7.5yr4/6 none ms osg ml nor nor L/ 1.2 ~~11 /. / ~ Q Boring # -' Boring / 124 ~ Pit Ground Surtace elev. 100.60 ft. Depth to limiting factor m- Sat Application Rate Horizon Depth Dominant Cokx Redox Description Texture Stricture Consistence Boundary Roots GPD/ftt 'Eff#1 *Eff#2 1 0-11 10yt3/2 none sil 2msbk mfr gw 1f .5 .8 2 11-19 10yr4/4 none scl 2msbk mfr cs nor -4 -6 3 19-48 7.5yr4l6 none ms osg ml cs nor .7 12 4 48-124 7.5yr4/4 none cos osg mvfr nor nor ('.7~ 1:6 ~~~ ~~ lr ~2~~, _ tnruer>; ~ r = esvu ~ su < r1u mgrL ana i 55 >su < ~ ~ mg/L `Effluent #2 = BODS<30 mg/L and TSS < 30 mg/L CST-Name (Please Print) Signor CST Number David ,!- Sleet .~ 248956 Address Staet Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, W 15401 9!192002 715-246-5085 /y pr~riy pW„~ Sienna Corporation Parcel ID # Pending Q B ~ # ;Boring Page 2 of 3 onng /' Pi# .Ground Surface elev. 99.20 ft. Depth to limiting facfor 100 in. Soi Applica4ion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftZ 1 D-1 D t 0yr'312 none sii 2 40-44 40yr4/4 none sol ~~ 3 44-100 7.5yr4/6 none ms ~~ ~ /b,P-C'~,J ~j GL G~- _ ~ ~/rid ~l Boring #;Boring *Etf#1 'Eff#2 2msbk mfr gw 24 .5 .8 2msbk mfr cs na .4 .6 osg ml na na ~ 1.2 ' Effluent #1 = BOD $> 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #'L = BODS <30 mg/L and TSS <30 mg/L The Department. of Commerce is an equal opportunity service provider and employer. ff you need assistance to access services or n Borinr~ # _ _ Boring 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 SE1/4,SW1/4,S 2o,T29,R19W (715) 246-6200 Town of Ht~san, St. Croix Co. (715) 246-5085 The Glen lot # 23 This soil evaluation was conducted to satisfy a zoning requirement, it er may not be suitable for our use The lo n of th ti t t ma h n t l t lin e t t b y . n ca o e es y or may no e as s ow as perman o es were no established at the time the soil test. was conducted. ~, Qq ~enc~ ~// ~ rf ,~ = (3~•~ di~~- ®~ /~(h. t3ov..cl~~~~' 01~10~~ T~Do~%=` ~~c~P<- ~_ ~ofi~gS ~drin9 ~~e~a~ions' ~/ = /00~ 66p'~ 8Z~ Sao. 60~~- /33- y~ ?-~~' ~ ~o .GoFf ~~' yp~- ~ ~, l~,o~ f ~~ Zo-~~- a -- ~ w s ~~ ~~~ ~~~~' ~ ~o. qq /.h(b 1 ~~ ~- 75' ' ~ ~ ~i ~' 5 ~ ~~v,. ~ ~ ~~ $2 -- __ ,y„r- - obr ~ ~ ~ d ~~ i S~ a ~ ~a ~ 7 g vv~ -4t~ l~or Co~r~o~~ ~ ~,~ ~~~ ., ,\ c..- ~ { • . . , a )- . 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' t i,, l ,. , I ill D ;1 ~~ ~.\'. {: N I i ~ __ t x'17 ~ ~ `' `` _ -------- Iit I ... ~4.: t .' h: -. - -- I I I -- ''' 'i ~ ' IZZ : ' H------ ~I I~D~ lit ;, 1,1 ~f I ',; 4: _ ~---------~ I l I qt I I l i l I II ~ I I 1 1 ~ 1. } POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page f of ~'' FILE INFORMATION Owner ~ ~~ ~p Permit # ~/ DESIGN PARAMETERS Number of Bedrooms ^ NA Number of Public Facility Units NA Estimated flow (average) gal/day Design flow (peak), (Estimated x 1.5) ~ gal/day Soil Application Rate 0 ~~ al/day/ft2 Standard Influent/Effluent Quality Monthly average* Fats, Oil & Grease (FOG) <_30 mg/L Biochemical Oxygen Demand (GODS) 5220 mg/L ^ NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODS) 530 mg/L Total Suspended Solids (TSS) <_30 mg/L ^ NA Fecal Coliform {geometric mean) <_10° cfu/100m1 Maximum Effluent Particle Size %8 in dia. ^ NA Other: ^ NA *Values typical for domestic wastewater and septic tank effluent. SYSTEM SPECtFtCAT(ONS Septic Tank Capacity ~ZW gal ^ NA Septic Tank Manufacturer (t,J1 ~~R~ ^ NA Effluent Filter Manufacturer aL Lp ^ NA Effluent Filter Model ~LS~LS~ ^ NA Pump Tank Capacity ~-(}~ gal ^ NA Pump Tank Manufacturer w(~' ~ ~~~~ ^ NA Pump Manufacturer L_ ^ NA Pump Model ~ ~' ^ NA Pretreatment Unit j1i~1~A `~ ^ Sand/Gravel Filter D Peat Filter ~ ^ Mechanical Aeration ^ Wetland ^ Disinfection ^ Other: Dispersal Cellls) ^ NA -Ground (gravity- ^ In-Ground (pressurized) ^ At-Grade ^ Mound ^ Drip-Line ^ Other: Other: ^ NA Other: ^ NA Other: ^ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tankis) At least once ever y' ^ month(s) (Maximum 3 ears) yearls) y ^ NA Pump out contents of tankis) When combined sludge and scum equals one-third (Y3) of tank volume ^ NA Inspect dispersal cell(s) At least once eve ry' ~ ^ month(s) year(s) (Maximum 3 years) ^ NA Clean effluent filter At least once every: _ ~ ^ month(s) year(s) ^ NA Ins ect um p p p, pump controls & alarm At least once every: '?j ^ month(s) ^ year(s) ^ NA Flush laterals and pressure test At least once every: ~ f ~ ^ month(s) ^ year(s) ^ NA Other: At least once every: ^ month(s) ^yearls- ^ NA Other. ^ NA MAINTENANCE INSTRUCTIONS 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 IY3) 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 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. 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 or other chemicals that may impede the treatment process and/or damage the dispersal cefilsl. if high concentrations are detected .have the contents of the tank(s) removed by a Septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not. drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area 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 POWTS: antibiotics; baby- wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. 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 chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits 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. • 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: A 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 that time. ^ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. alua ' a o Ong ank ~~ T be ' e a~ ~fl~l-ll8 TTi~ ~Di2~- I~l>~ CaNS77zcJca~.O~ ^ 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> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Name (~IC~A~ k~ Phone ~~5. 3~ , 3Iz POWTS MAINTAINER Name Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Phone t, Name ST. C~ l GU 20/JI ~ " Phone ~/S- 3~C0- (~ (~ This document was drafted in compliance with chapter Comm 83.22(211bi11)(d)&If1 and 83.54(1-, (21 & 13), Wisconsin Administrative Code. ST CItOIX COUNTY SEPTIC TA1VK MAINTENANCE AGREEMENT AND OWNERSI~IP GFRTIFiCATI01~1 FORM. O~mer/Buyer ~o ~ y I~T~, _ Mailing Addrt~ss __~ LGl f3 ~~~ r ~!, %l .,~ s o ~ - Properly Address _ ` 3 ~ ~ (Verification requited fzom planning Department for new construct City/State Parcel Identification Number 02.0 -1 f`~- ~o-~ .~ ,2~r~ ~EGA~k`SO~I T~,Oi~i Property Location ~ %, ,~G~'/~, Scc. ~~ , T~-'~ N-R ~ 91~v. Town of ~~'S6~ Subdivision ~~~- ~~e-~-~ ~ _ _. Lot # ~3 _ ~--- '-~ CerEiflcd Survey Itiiap # ~- ~ Volume ~, ; ,Page # - Warranty Ueed # ~„~39 7 7-3 ,Volume .Page # ,~ Spec house ^ yes ~ nv Lvt lines identifiable J~yes ^ no SYST)F1M hiA.il±i'~~ A14'CE Improper use and maintenanet of your septic system could result in its premature failure to handle wastes_ Prvpti tnaiiltenatlcC consists of puruping out the septic tank every three years or sooner, if geedad by a lictnsed pumper. what yott put Into the system can affect the function of the septic tank as a treatment stage in tha waste disposal system. Tl~e property owner aa=ees to submit to St. Croix Zatting Department a certification form, signed by the owner and by a rnastetptumber, journeyman plumber, restrictedpltunberor a licensedpumper verifying thac(!)the on-sitewastewaterdisposal systetzl is inn proper operating condition and;'or (2) after inspection and pumping (if necessary), the septic tank is less than 1!3 full of shtdge. 'Uwe, rite undersigned boor toad the above requirements and agree to maintaim the private sewage disposal system with.tlte standards set forth; herein, as set by the bepartment of Commerce and tba Department of Natural Resources, State of Wisconsin. Certification stating tt-at your septic system has been mairttaincd must be cotnpieted and returned to the St. Croix Counry Zoning Ofticc within 30 d the t! ee year expiration date. NA'T'URE OF.AI?F[.1CANT ~ D•~`T~ OSti'NF.R CERT F..~~:~Y~ I (we) certify that al! statements on this fotzn are true to the bast of my (our) knowledge. the rope d ove, by ~•irtue of a :~•arranty deed rccocdeci jlY Register of Dce~is Uf(ice. ~` NATLJRJr 4.C APPLICANT _.__ I (we) any (arc) the o:4~er(s} of ~-~_~!~ nAT~ • **•"~' Any information that~is mis•represcntedmwy result in thz sanitary permit being revoked by the 7_oning Department. """` •" Include H•l11~ this application: a stamped ~varcanty decd frau. the Register o.f Deed, office a cagy of the certified survey ntap tf reference is made in rite warranty deed SEPTIC 'T'ANK ~ PUMP CHA!/~~R CRASS S~C'~TGN_ ANA ~^rLCIF~CATIOh'S s _.~. _..._. _~._. ~+" CI VENT PIPE I.2" MIN . ABO~i £ GRAS 25' FROM DOOR, WINDOW OR FRESH AIR INTAKE FINISHED GRADE 4 " C I RISER ~-- 16" .IN. y 6" MAX. WATER TIGHT SEALS A dPTPR•4VFD '".~". lNYO SOLID :O I l ~'t.~ MP tJFF ELEV . F T . -~-~- .__.._m D WEA7HE~PROOf JUNCTION BOX WITH CONDUIT -~- ;, a 4 i ~ ' i tips- ~ ~ti miGHT~ SEAL ' ' ALM ' ON ,~ , i ~~ ~ n, 0 F F' 3" APPROVED BEI3l~ZNG U~iDER TANK APPkOV EJ MANHCi.E CCVER W( FAD LOCK ~ !WARNING LAB£t~ --4" MTN. de ~ JOINTS WITH APPROVED PIPS 3' ON'f0 so~IO saFL ~~ RI5£R EXIT F£RMITTED ONLX i F TANK MANUFACTURER HAS APPROVAL CONCRETE PAD SPECIFZCAT;: ON'S SEPTIC f DQS£ TAhX MANUFACTURER; ~1~..'~~c.tl<.. '"ANK SIZES: SEPTIC 1'a.`j Q GAL. ~~ DC}S£ ,~,~ GAL. A i.,A K?~ MA NU 1:'AC TL R £R ; ~U.~'.s•~,$•~- MODEL NUMBER: SWITCH TYPE: 't*c'°~,~.i~c _ _. _- PiJMP MANUFACTURER: ~ ~ MODEL NUMBER : P c~ SWITCH TYPE; ~~~~C RE~L'• iRED DISCHARGE RATE y ~ GP2; NUMBER T~OSES PER DAY: ~c~s~ vot~urs~ INCLV~~NG F LOWBAC K :~~ GAL . CAPACITIES: A = ~ INCHES = ~I~~,,,,_GAL. B ~ ~ ?NCHES = AL. C = ~ INCHES = ~~$ GAL. D = ~ INCHES s ~,~D_„_GA'~. PUMP 8 ARM k'IRING AS PER ILHR 16.23 WA:. ';'FRTaCAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE _.___~ FEET +~ MINIMUM NETWORK SUPPLY PRESSURE 2.5 FEET t~OFT,'100 FTC FRICTION FACTOR + _. ~._ FEET FORCEMATN X ~~ ~~ r EET T.aT~L DYNAMIC HEAD - ~,1~~,~;' -! FEET hTERNAL DIMENSIONS OF PUMP TANK: LENGTH ~.~- ; WIDTH ---~' DIAMETER '~ I G ;; E D: .1~~.L_ ';.,..~G,..~''~''~---- L T G E N S£ NUMBER : ~~~-I--~, v L AZ' E: :1/88 . ' [~]GOULDS PUMPS • Fully submerged in high grade turbine oil for lubrkatbn and ef"icient heat transfer. 3871 E~ APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer * Dewatering SPECIFICATIONS • Solids handling capability: '!d"maximum. • Capacities: up to 60 GPM. Total heads: up to 3 ~ feet. • Discharge size: t'/~" NPT. • Mechanical seat: carban- ratary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40gC) continuous 140°F (fi0°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor; • EP04 Single phase: 0.4 HP, 115 ar 230 V, fi0 Hz, 1550 RPM, built in overload with automatic reset. • EPOS Single phase: 0.5 HP, 115 V, 64 Hz, t 550 RPM, built in overload with automatic reset. • Power cord: l0 foot standard length, t fi/3 S1TOW with three prang grounding plug. Optiona120 foot length, tfi/3 SJTW with three prong grounding plug (standard on EP05). ~ 2000 Cwulds Pumps Etfective February, 2000 83871 Available for automatic and manual operation. Auto- ma~c models include Mechanical Float Switch assembled and preset at the factory. FEATURES ^ EP04 Impeller. Thermopias- tic Semi-open design with pump out vanes for mechariKal seal protection. METERS ,FEET Subrr~ersible Effluent Pump ~~ ^ EP05 Impeller: Thermoplas- tic enclosed design for improved performance. ^ Casing and Base: Rugged themnoplastic design provides superior strength and corrosion resistance. ^ Motor Housing: Cast iron for effiaeM heat transfer, strength, and durability. ^ Motor Cover: Thermoplastic cover with integral handle and float switch attachment poirtts. ^ Power Cable: Severe duty rated ail and water resistant. ^ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTING ~' Canadian Standa~ Assodadon (CSA listed model numbers end in "F" or "C".) Goulds Pumps is fS0 4001 Registered. 0 ~2 4 6 8 10 12 m>/h cAPaaTY Goulds Pumps ITT Industries . ~ Q ~ ~/ ~ 1 ~~~ ~ v ~ ~ ~ '~. ~ ~~ ~ • '~ e ~ d ~~~ ~ 3 ~~ a 1 b c ~ 1 0 .~?, i~ o~ , ~ _ °~ ~ --- ~'~ A ~ ~ ~ \ ~\ ,, State Bar of Wisconsin Form 1-2003 WARRANTY DEED Document Number ~ Document Name THIS DEED, made between West Lake Builders, Inc., a Wisconsin Corporation and John F. Boylan and Jennifer S. Boyle ~----- antor," whether one or more), I wife ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys 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 please attach addendum): Lot 2 lock 4, Plat of The Glen in the Town of Hudson, St. Croix County, tsconsin. ~39~73 KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CD. , NI RECEIVED FOR RECQRD 11/30/200b 12:30PN NfARRANTY DEED EXEMPT 1« REG FEE: 11.00 TRAAS FEE: 377.70 COPY FEE: CC FEE: PAGES: i Recording Area Name and Return Address River Valley Abstract & Title, lnc. 1200 Hosford Street, Suite 201 Hudson, WI 54016 File #:2692029 020-1414-90-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and cleaz of encumbrances except: Easements, restrictions and rights-of--way of record, if any. (SEAL) (SEAL) AUTHENTICATION Signature(s) authenticated on TITLE: MEMBER STATE BAR OF W (If not, authorized by Wis. Stet. § 706.06) THIS INSTRUMENT DRAFTED BY ACKNOWLEDGMENT STATEI~ OF WISCONSIN ) ..31' , ~ D ~ x COUNTY ) ~~ Personally came before me on ~~,~rP~e~ 3yj ZOIJ the above-named Richard Grekoff, President ~~- :'rtd known to be the person(s) who executed the foregoing .~ pU`ip~it;trijrtent and acknowledge the same. *. * • _l era f.tJ (.Ua S In (Signatures may 6 NOTE: THIS IS A STANDARD FORM. WARRANTY DEED * Type name below signatures. Nt~at~ Public; State of Wisconsin • ~ • • •~Commission (is-pai~t~aaeat) (expires: s-/(,-ZD IO ) i ~~ aclmowledged. Both are pot necessary.) FICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. ®2003 STATE BAR OF WISCONSIN FORM NO. I-2003 1of1 Dated 1 f -3 (~ ~ ~P .. ~ ~ Tf I SEE SHEET 7 L°~Pte° ,., the NP.tne°,1 ~,,,,,,. °r the ,t°an„„ a°.te. ur the No.tn,.ev, aat«. m the swrn.e.1 0~°aa..e the No-tn„est G„rrv or me Swtne°st 0 Oumte. Pt the Swtne°st Oualer, a1 n Sedan 20 ~ 1 ~___ __________ 28 I ------------- 589'S9_te_E ~~ X6507 SF I r --- ---- (1.068 aC )I I I -~ i _-__I I I I I _--, I I I I 1 ~ I 14 1 i° 1 ~ 67528 Sf. ~ ^ I p ssB Ac ) I I I 27 ;. ; I 0 I ts338 5 F I I ^ (1.018 AC.) I 1 1 I f o ~, L------------ S69'S9'tB`E arl I n ----- -----' P ~ ~---~ ---------- a ----,------ ~ I ry ,~ I ~ ------_-_-_-_ N69'S9'iB~W 260-99--_-_-_-_ -- J F °o I 1 1 I I C 1 i I t` I I I 59759) 5 V I $ I 1 (t 372 M ") I I m I o O I ^1 + ° I W 26 ( I ~ ' I I ~ $ as}495 H I I rv ~ ~ (1.m9 c> ~ I o lO I ~ I 1 --_------- N8E't E't5'E 1389.]2-_-_-__ I I ~--- ---- - _' ~ I O Z I ~--- I I I I I I I I I ~', ---.----- N89°59'tB"W 761_35----- --- J I 16 i _-_--_-__~__--_-_-___ ~ I ~_ - _ , , 52030 S.G n I ry 1 (t t9e aC) I I ~I i ~I I ~ I i j9Z 6~ , 25 ~ I ~ ~ N7p'e ~i ` ~ , ~ - I _ x5295 S. F, ''/' iii' u' _ i \ I ~ _ \ ~~~~`_I ~ _ -57-5 9__ -_~~~ 1 1 I \ \ I I _ _-~ ___--~ 11 1 1~ - _ 't\ \ ESI .IL ,I _--~ ~ ~ .~ \ ) t u192 S.F \ \ (.289 AC.) 1 (t.015 AC) \ \ \ ~ \ ~ ~ ,p, I ' ''l//''~~i~~ \ I ' '~ ~ NC CWELLING C') • \ ~\ 1 FLOOR EIEVATONS \ T BELOW 863.0 \ //A ~\ \ -3 \\ --- -- \ /IY/ -. N8A't O'ae'E ta3.0~ I \ 1'~ PONp1NG EAGFMENi vl ~ . \ \ ~~\ I 1 ^ {VVV~' ~ ~ 3 Imv- ovl ~ `~- uoi 1059x' I mN1 ~ ~:~ -- `- f 1x250' I ~- I60 a8' ~ ' °o n ~ --- > 1,.r-I - r-., S89°30'2TW 508. F I ~' .- "oo s} .~ , V -~ 1 \ .. L_l_ _~~ L_ v .- (xESi) ~ ~~ ~~ N ~ ~ ~ NORTHFRi7 _ -- ~ ~~ • V v L-. 1 ~~ 1 _ - - _ '~ ~'? n / ~ r- EaSi v ExTENSiON OF iRE NORTR LINE i 5.66' 1 \ ~~ -THE VrE57 u V V L.. ~ \J ~ ~ _~.\7 ~_ ~ AND THE NORTH LINE OF PARCEL REC. 1N I 1 VOL 17. PA J n ! ~ r - - > -- - - - I - - - - - - - - - - - - - ^ •/ VOL. A07. PAGE x55 41Jp THE NORTH ~ I NORiHNfST CORNER _.,\]L_ /r /~~ .nl ,r /t _ -----_- LINE OF C.S.M. VOL. }, PAGE 776 N -Of C.SN --------- v vL_-_r ll /~--1~ --r--~ ° - (89'St'36'W rr9095'j ~ I ~ VOL. t7. ~:7 r_ -F •r„~ + PAGE 3292 -,'L a.~il..,