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HomeMy WebLinkAbout020-1420-50-000~~ 5 0~ r/ Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety 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 older's Name: City Village X Township Sienna Cor Hudson, Town of CST BM Elev: ` Insp. BM Elev: ~ BM Description: ~ ~ .~ Q~•a ~ ~ ~ IBti-S WL TANK INFORMATION TYPE MANUFACTURER w ! t~ .'~ CAPACITY Septic ~ t ~6~ ~ ~ ~d Dosing Aeration Holding TAN~BACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic r.. `~~ ~ ~5'~ 't pi __~ Dosing ~ .... ~ ~ ~ I -4 ~S ~ Aeration Holding PUMP/S PI HON INFORMATION ~ i ~ JVIL AC~7VRr I IVIY J 1 J 1 GIYI [ / l -tr~1.1AC.t~ I' I~LXL 'Lti 111STRIBUTION SYS~M ELEVATIOIV DATA County: St. CrOiX Sanitary Permit No: 430275 0 State Plan ID No: Parcel Tax No: 020-1420-50-000 Section/To /Range/Map No: r 20.29.19.2673 eade istribution x Hole Size x Hole Spacing Vent to Air Intake Pip Length Dia Length Dia Spacing SOIL COVER x Prassura Svstamc ~nlv Yr Mound Or At-Grade SvStems OnIV Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ,, Yes 0 No ~ Yes 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/~~ Inspection #2: / Location: 861 Carmichael Road Hudson, WI 54016 (SE 1/4 NW 1/4 20 T29N R19W) The Glen Lot 79 Parcel No: 2g.2 .19. 73 1.) Alt BM Description = ~, ('~~-} ^ 2.) Bldg sewer length = ++ S'Q ~t ~ ' tl•~~rM~'~' ~ ~~p,pQt~0~ ~ $ ~~ ,/ ?~,~,- o ~Q,pQ,Q -amount of cover = ~ ~Z ~ (,~~arQ.- , ~ ~` .~~ ~ / ~ ~ ~ ~ s (, ~ ~ _ ~ , Plan revision Required? ^ Yes ~No ~ ~" Use other side for additional informs on. ' ~1 `"'`~~ ~~~~~ ~ ~- SBD-6710 (R.3/97) ate ~ Insepctor's i d~ `1r~~,+tc, ~ - - - Property Owner's Na me parce{ # ''O1 ° - ~ ~ Z(J! 7~3 ~ ,/yZo-Sa-~ 1~ ~'~Nti~ ~ ~ryf- Property Location Property Owner's M ailing Address ~ i tion ~ y I S 'k j ~L/Q ~ ~~.. ~ .~ ~. u. '~~ _ I ec , ,j ~ , '~,d~~, City, State Zip Code Phone Number / ~ i (circle o I dpi ~~ R~ .~~ .~ T ~O _ N; R~_E o II. Type of Buil ' g (check all that apply) ~1 ~ ms ~ G~ dro f B N b Subdivision Name CSM Number D~j ~i o er o e um or 2 Family Dwelling - , ,' f ^ PubliclCommercial -Describe Use __~ _~ _ !dam --~lq ~___ ~ ~~ ^ State Owned -Describe Use ~ - ~` - ~ 0 __ ~~ ~ ~ --~-f~ ~ ~'} ~ ^Ctty_^Village,~Township af~w.•~,Sa'~ I~ _ _~ .._ j _~ ~0~. -6 III. Type of Permit: (Check only one box on line A. Complete line B if applicable} ~_ A_ ,New System ' --~'^ ^ Replacement System ~ ^ Treauttent~Hofding Tank Replacement Only ^ Other Modifieatian to Existing System -- B. ^ Permit Renewal ^ Permit Revision List Previous Permit Number and Date Issued ^ Change of ^ Permit'Transfer to New j Owner Plumber Before Expiratian I ~ ?Jd ~75 ~ _. L . ~ ~T ~~ IV. Ty a of POWTS S stem: (Check all that a 1 J ~__ -- -- - --I ------ - - ^ Non -Pressurized ln-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 Tarilc ^ Peat Filter ^ Aerobi c Treatment Unit ^ Recirculating Sand Filter ^ Recirculaung Synthetic Media Filter Leaching Cham ^ Drip Line ^ Gravel-less Pipe ^ Other (explain) _ V. Dis rsal/Treatment Area Infor T______ _ ~ ~~ _ __ Design Flow (gpd} Design Soil Application Rate(gpdsf} Dispersal Area Required (sf) Dispersal Area Proposed (sf) System E levation Q ~i Q(J a ~ ~ ~.~7 ~~7 .3~ ~Ni°~O~ L..°B~i/~ ~ VI. Tank Info Capacity in Total TN-u~mbe-ram--- Manufacturer Gallons Gallons of Units New Existing Profab Site Steel Fiber ~ p]astic Concrete Constructed !. Glass j ~ _ Tanks ~ Tanks I ~ _ Septic or Holding Tank .~/ J ~ / ~ r~5 ~ ` /`- ~-- Aerobic Treatment Unit T-~, /1 Vje~,L, _ Dosing Chamber ~~ /~_ ~ y , ~~ _ VIL Responsibility Statement- [, th0 tutdersigned, assume responsibility for ' •tallation of the POWTS shown on the attached plaits. !` P]umber's Na me (Print) Plumber's Si gnature ~ MPRS Number _ Business Phone Nutnber ,' se ~ itit.a e~ ~ ~z~9~` d /..s -3~~' 31~~ Plumber's Addre ss (Street, City, State, Zip Code) l ~ c- ~ ~ ~~ ~ ~~'O" G' - ~ VIII. unt /De artment Use Onl _,_ Approved _ Sanitary Permit Fee (includes Groundwater _ Date Issu d Issuin gent Sig ter No mps) Surcharge Fee) ~/ ' ~eC- ~ w en Reaso enial "_,^, ~J • t~ l~ ~/ OJ j _ j IX. Conditions of Approval/Reasons for Disapproval f ~~o,., 1 ~ SYSTEM OWNER: ' ""' sa ~ 1 ~ ~~ ~~ ~ J 1. Septic tank, effluent tiltlr snd I t dispersal cell must all be services / maitthYtrd ~ 6 ~e..~._ ~ tSCG~ v J~ ~ as per tnanagemeM plan provided by pNlrtMtsr. 2. AN setback requirements must be msirtt+,ktt~! I Attach complete plans (to the County only) for the system oa paper not less than 81/2 x 11 inches in size Y r ~~ C v.r ~`~ ~ o~ ~~x ~., D I ~~c/~G~ ~~~D ~ ~_. i- i 13~'!`~J y 130 ~~~ ~~ ~~0 ~ t~ { Wisconsin Departrrrent of Commerce R '`~~AT Di i i v s cxi of Safety and Bui N REPORT Page ~ of in a ~ ~~~o~, rr~.85, } Qr • Adm. ~ Code ~ U Aftach complete site plan U ~ M~ ~ a ~m ~ty the 81/2 r, s size. Plan m include, but not limited to: to refer peroent slope, scale or dimens ion an ~ ions, l ~ `y a~ ~~~~~ t Parcel I.D. ~... ~C~ n ear ~ ?I )i Pleas e prinf tread. ~ Z C5 - d 4~ SO OZS n, Revie y Peaomy information you Provide may be used for xecond orY P++-DOSex (Arivaey Law. x.15.04 (1) (m))• ' ProPertYOwner Date S I~ C9S S 1'2. Property Location Property Owrter'a MaAinp Address O <3ovt. Lot S E 1/4 ~~/4 S Tat N R I ~ E (orb Lot ~ t~ C~ ~ ~ ~ `,`~ ~ ~`Z.. ~~-~ ,~ ~ ©~ l Bl ock # Subd. Name or CSAA# She Ph , one ^ ~(tY ^ yl~ ®Town -.~~tV C1~ t~$,S ,~/ ~ ~ Nearest:Road New Comtnxxlon ~~: (~ Resider>tial / Number of bedrooms ~~ Code d i er ved design flow rate a Replacement a PubAc or c«nrnerc,~ -.Describe: O GPD _ Parent material _ ~ v ~ ~,~ S ~:-L Flood Plain elevation if appbcable ~ ..L-' / ~- ft. ++ecotrtrnendaitions: 5`l ~t-e r/t •e (e v . ~ Z , S~ Horizon ~ Depth - _ - .. Dominant - _..M,............«.a .a.,.,..._ ... ~.. Redox Destxlptfon Tune stiucxure Consistence Bouutdary Roots SON ication Rate. in. tvltrnseM Qu. Sz. Goat. Dolor Gr. Sz. Sh. 'Etf~1 'Eft#2 ~ Z U~IC~ I~-ZU f r3(Z la ,e~ ~. ~- ~ i ~ ~c fC n r ~r C S c S (u-~ - ~ 5 .^ i I , J,,, ii ` ~ . ~ . ~ ~. J ~~ ~ ^ 9orrn9 ®Pit (around surface elev. ~~ ~ `(U ft. Depth to limiting factor ~~ ~ ~ So9 tion Rye Horizon Depth gominant Color Redox Description Texture Structure Consistence Boundary Roots GP Dlit' in. MurtseU Ou. Sz. Cont. Color Gr. Sz. Sh. 'F.fNi1 'Eff 1t2 () Z S e~ l rJ'I YV ~ ~ p ~ U 1 :~ C 0 1 lv. / r- '~ ~ ~ ~ ~ ~~~ .~~ 3`~ x 2 1 . t:flluent ~1 = t30D_ > 30 < 220. nridL and TSS >30 ~ 15 0 mall ' EfDuent tirt = BOD. _< 3p. and TSS _< 30 nnp-1. CST Hama (Please CST Number c ~. U J PropeRy Owner SG ti ~-.. ~- ~. Parcel 1D # i U ~ 7 `~ -~"` ~--~ ,~ Page Z-- of 3 B°'tn° # ° ~~ -•~--~--- ® Pit Ground surface elev. ycJ ft. Depth to IImiW~y factor 1Z~_ in. soil Rate Horizon 'Depth Dominant Redox Description Texture Stnx~ure Consistence Boundary Roots GP D1fP in. Munaep Qu. Sz. Cont. Color Gr. Sz. Sh. 'Etf#1 'Eff#2 ~ rL d / a ^ pit Ground surtaoe elev. tt. Depth to timidrg factor k-. # Sop Rate Horizon Depth Dominant Redox Descrip4ion Texture Stn~cture Consistence Boundary Roots GP D/tf in. Munsep Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eit#1 'Efi#2 a ^ Pit Ground surface ~av, ft. Depth to ~mitirp factor In. # Sop lion Rate Horizon Depth Dominant Redox Desaiptton. Texture Structure Consistence Boundary Roots GP DIfF in. Munaep Qu, Sz. Coat Color Gr. Sz Sh. 'Eff~k1 'Etf#2 ' Ef rtuer>< #1 ~ 8ODs > 30 : 220 mplL and TSS >30 < f 50 mg/l ' EAtuent #2 ^ BOD, ; 30 m~IL and TSS _< 30 mail. The Department of Commerce is an equal opportunity service provcder and employer. If you need assistance to access setvicas or • need tt-aterial in an alternate format, please contact the department at 608-2ti6-3151 or TTY 608-264-8771. ssc-eswcsao~t NAMt - ~,. LOT# Lt At- tSCRtI'-TION ~/r '/. 8 T N R E oR w •SGAL~': i " s 7 ~ ~ BM 1 Et.eVATtON /dG C7 BM 1 De8CRlPTfON ~, a ,'l ~'v~ lU ` p~'r.2 BM 2 ELEVATION `~ BM 2 DtBGRIPTION SYSTEM ELEVATION ~ Z, S~U SYSTEM TYPE ,~v~ /\ J ~ /L ~ ~ *G ~ ~~ ( . ~.-- -- _ •g,,,,~ l ~_ z • q,~ du ~~" 3 ~US.G 8lC3NATiJFIE //~~ / C ~ _ DATt ~ ! ~'~ S • ~ Safety and Buildings I)ivisron Cpunty t ~ - 201 W.'1jJashir~ton Ave., P.O. Box 7162 ,J ~ ~YI ~ x ~S~O~~/~ Madison, WI 53707 - ?162 Sanitary Permit Number (to be filled in by Co.) De artment of Commerce (~$) Zb6-3151 3oa~-s" Sanitary Permit Application state Plan I.D. Number la accord with Comm 83.21, Wis. Adm. Code, personal infarrnation you provide tray be used for secondary purposes Privacy La ; ~13:U4{1){m) - - . ~ Project Address {if different than mailing address) ~.. I. Applicatiott Information -Please Print All Information ~ Q~, r /"'~ ~ y~, (L ~L R D • Property Owner's Na me o J , ' ~ Aaesef~~ C..-'t~- Lot Block M x ~'~ ''e .rJ a.- G~ v' ~ ~ r Zr1-iyZo - 7~ ~ Property Owner's M ailing Addy a~..r_.,~,.. _ , , _~; Property Location ~~ y U~~~Y, `,v ,r- ~ ~~ ~D ~ S'l 14,~>6,Section o24 City, State Zip Code Fhone Number ` Z~73 ~~~.N~ m~ ,Sll3 (circle o C N; R~E o~ ~ II. Type of Buildiag (check all that app _ a~ s v 5 •( Subdivision Name CSM Number or 2 Family Dwelling -Number of Eedroo i ~~ ~~ ^ PubliclCommercial - Describe 'Use ~~~ ~~ "" ^ State Owned -Describe Use 3 ~ K (Q2.i~ ~ IJCity~^Vitlage.~Township of~~Fa~2JA N , III. Type of Permit: (Check only one box on line A. omplete line B if appli le) A' New System ^ Replacement System ^ Tr endHolding Tank placement Only ^ Other Modification to Existing System List Previous Permit Number and Date Issued I3, ^ Permit Renewal ^ Permit Revision ^ Change ~ ermit Transfer to New Before Expiration Plumber ner IV. T of PQWT5 S stem: (Check all that a 1 ) ,~ Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil ound < 24 in. of suitable soil ^ At-Grade ^ Sittgle Pass Sand Filter ~ ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding T eat Filter ^ Aerobic Treatment Unit ecirculating Sand Filter ^ Recireula ' S tlthetic Media Filter ^ Leaching Chamber _ -Drip Line ^ Gravel-less Pi ^ Other (explain 3 •~t V. Dili rsal/Treatment Area Information: (~'~~ Design ow (gpd) Design Solt Application Rate(gpdsf) 1 persal Area Requi (sf) Dispersal Area Proposed (sf) ys m Elev ti >S a •Z VI. Tank Info Capacity in Total Nu r Manufac er Concrete Cons twcted Steel FCTib~es Gallons Gallons o nits New Existing Tacks Tanks Septic or Holding Tank ~~Sd ~ ~; ~vr ~ y l~. ~~ Aerobic Treatment Unit [sing Chamber 8~ ' ~ e VII.' ResponsibUity Statement- C, the and geed, assutne responsibility for allatitiit''of the TS shown on the attached glans. Plumber's Na me (Print) Plum is Si gna re PRS Number Business Phone Number a~79y~ 7~3"- 3~c- 3f21 Plumber's Addre ss (Street, City, State, Zi ode) d >D sc u~ u~g'v.fJ , r dl VIII. Cotult /De went Use On! Sanitar Permit Fee (includes Groundwater Date ]slue Iss in gent Signature ( Stamps) Y ~1 Approved ^ Disapproved Surcharge Fee) 2Sp- ~~3 ^ Owner Given Reason for Denial 17t. Cotldltioas of Approvtal/Reasons for Disapprov ~~ N~ ~ JWIIIt~ ~~ ~ ~ (' ~^ ~"'"""'" Attach tx-mplete plans (to tits Couaty onlq) Por the system on paper not less than 8111 x 11 inches in size SBD-b398 (R. OI/43) ~ ~ ~~ r~~ ~~Q, ~ I ,~ l ~~ eJc -, ~~ ~ ~~1~ as ~f9D' ~'/~ d .~ l ? i- ~ ~ ' Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Cade Courriy Attach complete site plan on paper not less than 8%: x 11 inches in s¢e. Plan must include, but rrot limited to: vertical and hor¢ontal reference point (BM), directron and Parcel l D percent slope, scale or dimensions, norttr anow, anrt kxation and distance to nearest road. Pease print all infonrration. _ _ ~ ~ Personal information you provide may be used fors :tf' .15.04 () (m)). ~ Property Owner -Prue Location 1142 Page 1 of 3 SteeF Sal Service St. Cron pending Date Sienna Corporation ~ b 20 Govt. ~ SE 1/4 NW 1k1 S 20 T 29 N R 19 W Property Owner's Mailing Address j C. ~ Lt~t # Block # Subd. Name tx CSi1A# 4940 Vilking Ek. Suite608 ~,x, ~ J ~r~ : ° 79 na The Glen City ~~(,yyct State Zip C Phor~TN,~ffi~erJ. ~>r~ ~ - - Village Town Nearest Road MN 55435 -2808 Hudson Carmiettaet Rd. New Construction ttse: -r_; Residential /Number of bedrooms 4 Codederived design fkiwrate 600 GPD Replacerrrertt Public rx commerciaF-Describe: Parent material Pitted outwash Flood plain elevatia~n, if applicable na General comments and recommendations: System elevation 96.45ft, trenches spaced and depth to code 4.OOft below grade based on boing# 1 - - 3 - sc' ~a.~ art~2 ~ 83 Borfng # , - Bortng ~ / Pit Ground Surface elev. 100.50 ft. in. Depth to limiting factor Soi Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/ftP *Eff#1 *Eff#2 1 0-8 10yr3/2 none sil 2msbk mfr gw 1f .5 .8 2 8-19 10yr4/4 none sicl 2msbk mfr gw 2f .4 .6 3 19-29 7.5yr4/4 none sl 2msbk mfr cs na .5 .9 4 29-96 7.5yr4/6 none ms osg ml na na .7 1.2 Banng # _ Bing / 96 ~ Pit Ground Surface elev. 95.90 ft. pepfh fo Itt-titing factor in. Soul Appl~ian Rate Horizon Depth Dominant CMor Redox Description Texture Structure Consistence Boundary Roots GPD/ftz 'Etf#'1 *Eff#2 1 0-6 10yr3/3 none sil 2msbk mfr a 1f .5 .8 2 6-24 10yr4/4 none sicl 2msbk mfr gw 2f .4 .6 3 24-36 7.5yr4/4 name sl 2msbk mfr es na .5 .9 4 36-96 7.5yr4/6 none ms osg ml na na .7 1.2 - ttrwent ~~ = t3t~u ~ :s0 < zzo mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name {Pl~se Print] Signature: CST Number David J. Steel o ~ 248956 Address Steel Sal Service ~-c~ Date Evaluation Conducted Telephone Numb 1564 CR GG, New Richmond, Wt 54017 3/18/2002- 745-246-5085 y owner Sienna Corporation opert Pr Parcel ID # Pending Page 2 of 3 ~ ~ j ~ ( Boring # ' ~~ 7(7 91 th to De ft limiting factor 96 i ~~ ~+! Pit Ground Surface elev. . p . n. Soil Application Rate ' Worizon Depth Domir~nt Color Redox Description Texture StnKture Consistence Boundary Roots CPD/iP *Etf#1 *Eff#2 1 l1~ 1 t1}rr3/2 none sl 2msbk mfr cs 1 f .5 .9 2 6-15 10yr4~4 none sci 2msbk mfr gw 2f .4 .6 3 15-27 7.5yr4f4 none cos osg mvfr cs na .7 1.6 4 27-96 7.5yr4l6 none ms osg mi na na .7 1.2 ~~ R„~„~ ~ Boring * Effluent #1 = BOD s> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or I 1 Rnrinn # BOfing - .. _ . C~ ra '..:.; ~ r'~ W a..+ w Suhmereible EHIueM PumV ~~ 3871 E~ ~~ATWNt ~`~ Stir dafi~+edlatlN foliaw~q •~ms duty sump ~ ~~ fi~~r • ~~ up Ur- 86 FPM. ~' t~atla: up to 2~4 tae, • DGwht 1~s: ~'le" NC'I', • Ma<~~ii aql: rarban- ' elatat't11a. f~t~ ~~ +nuous 14Q'F ~10°C~ ~~t, • ~R~t~RM~~10t, W ire ~ r • ri~~ lalppbilhy; ~ t0 ~ GPM. • p~llpl~ ltp ~ 31 f8et, ~ ~ r~e a~~x 1l~` NP1', ~ M~o~l~~ai ~+~. U" 11111~i~ 1 WfifiY 14i'~'F.~Q'G iYr~bt~t • ~ ibe°, aeries c~ompan~c~mape~ Ii~O~: • tt~~ a6MV Qb ~~ ~0 RpM, built in overtood with autome~c reNt 115 YBit~~lt~p 51 50 RPM P, built In aalrloed w1~ • P c tmti~fnot fin! t~'t~ih, ~8i3 taJT~ wRththree prang ~prourui'.s+n pjup. Optical 2D tact hn~t1,1~l3 SJTW with th~nq gro~-diaq plug ~ ors F.FaS), t , ~II/ ~ ~ ~~.~~ -~ ~ ,r ~ . ~ '~ * Q ly ~uq~merpd! ~ h~+ iutu~on i~ aft haft trivia. Anitib{1 far ~utomWa tnd t Maala>aiNl ftast ~tlteh ~ aetd gnat at Itw iil~• f~At'llfUi _ ~ ~W ~ 11~ecmo- Qi 8aml~apat deei~n wig pump cut wda far mechenlt~l siai pratedit+n. • ~f~ i~ t~erma- ptastic aalaad can ibr imprOV~d pl~• a aad filar RuQped the~c ciaiprr pr~dee sl;uperiar e~rol~ arwwll~d ~~ YY +on ~iretipq~, Ihd dttrattllitY~ lil~~Ow~ naplas~ ~ oouww~ int~nli hNdle a,~ ~~ p • Posi~+rr Ctbta: Swera ~~~+ ratrd oU use wr~r rea}ariat ^ ; Uaoer a~ lower ~~.et((tb~utrq error u~wr~c {~ rn ~ 1 umbers I. i I ~ , Y_ 1~ + ~ (' S ~~ D ~ ~. i i~~ t • • r~r ~ ~ ~ ( R S ~ a o ^ '~A,NK ~ rLMP CHAM?iR CRASS SEC~~'h` At,'~ SprCIF~CA%IG?vS 4'•' CI VENT Pf}OR 1WINDOW ~ ORgO~ E GRADE ~ 2 S' FROM D FRESH AIR INTAKE FINISHED GRADE ~„ Cy RISER l' I,g" IN . 6,r~X [NLET 1 ~1 1'~ __ ~ WATER TIG"riT SEALS -PPROYEO B 'iPE 3' ~ INTO 5~LIA C aOIL PUMP OFF ELEV . ~ T . -'~"' D WEATHERPROOF SUNCTION BOX WITH CONDUIT ,. • ~~ ~~ ~, GAS- , 1' TIGHT ~ ~- sEAL 3" APPROVED BEDDING UNDER TANK SPECIFICATT.ONS SEPTIC f DOSE TANK MANUFACTURER: ~,~~s~'/ __ ~~{~ giZES: SEPTIC ~o~s'd GAL. DOSE ~~ GAL. ALARM MANUFACTURER: _•~~a._r~. ""~'~"" MODEL NUMBER: ,~` v_-_- SWITCH TYPE: yrjerC PUMP MANUFACTURER : ,~~ v~~.s,~ - _..^__ MODEL NUMBER : ,~' ,~,,, SWITCH TYPE: _ ~ REQUIRED DISCHARGE RATE _~ J GPM APPROVED MANF~IOLE COVER W! PADLOCK B WARNING LABEL ~4" MIN. ~~ vaP~Rov~~ JOINTS WITH ALM APPROVED PIPE 3' ONTO ON SOLID SOIL j OFF ~'~ RISER EXyT PERMITTED ONLY IF TANK MANUFACTURER HAS APPROVAL CONCRETE PAD NUMBER DOSES PER DAY : __, ~ ,-- DOSE VOLUME INCLUDING FLOWBACK: 1~ 9' GAL. CAPACITIES: A = ~~ „ INCHES = _, ~ rr~,_GAL• g = 2 INCHES =GAL. C s $• ~ INCHES = t__(8_,,,_,.GAL. D = ~ TNCHES = ~~~rGAL. PUMP ~ ALARM WIRING AS PER I LHR 16.23' WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE la FEET + MINIMUM NETWORK SUPPLY PRESSURE FEET + G!~ FEET FORCEMAIN X 2.6d FT~loa FT. FRICTION FACTOR /~?' FEET ----- TATAL DYNAMIC HEAD = ~~~'EET INTERNAL DiMENSIt~N5 OF PUM? TANK: LENGTH '-""' ; WIDTH~_; DIAMETER r` LIQUID ISEP'I'Ir' 3~", ~t~~/~.~y l " SIGNED: ~~/~, %~ ~„ ~ ~ LICENSE NUMBER: ~7 99D DATE; ,~ > D,3 __ 1l8~ POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of ,__ Fii.E INi~ORMATION Owner ~ i.~ety_~0.~. y~~ ~.wlll~~lwl~w Iww~~~IwwAw~~w wl~w~w~~ll~ww~A~~ DtiiSIQN PAttAM@'11N;~ Number of 8edroome *~' ~ NA Number of Publlo FeofiitY Unite C~AIA Estimated flow {average) ~{~ al/da Design flow tpeakf, !Estimated x 1.51 e!e L1 d al/da Soil Apptbatk~rt ~° atlda /ft' Standa-d InttuentlEffluent Quality Monthly averags• Fats, Oil br Qrease {FOCI 530 mgll. t3iot~temkul Oxygen Demand {BOD`I s2~O mglL Q NA Total Suspended Solids iTSS) x160 mg/l. Pretreated Effluent Quality Monthly average Biochsmlosi Oxygen Dsrnand (BOQs} s3O mg/1. Totes Suspended Solks tTSSI 530 mg/L [] NA Fecal Calirorm taeo~-etrie: means s10• ctu/1 oOml Maximum Effluent Particle Sise Kin die. DNA 0 DNA '"Vahaa typktal for domestto wastewater and septic tank eftlusrK. SYSTEM SPECtFrcArrvrss Septic Tank Gepaolty ,Q d ai L7 NA Septic Tank Manufacturer ~ ~ DNA Effluent Filter Manufacturer ~ „~ O NA EHkient. Filter Model d'0' !~ NA Pump Tank CspaoitY ai d NA Pump Yank Manufsaturer i 9 ~ DNA Pump Manufacturer ~,~,u / DNA Pump Modal ~ i7 NA Pretreatment Unit t7 9and/Gravel Filter ^ Meohanica{ Aeration a alair-fsction ^ Pest Fltter O Wetiartd D Other. NA Dispersal CsUt:I ~in•Ground {gravity) (O At-tirade O drip•Line O NA L7 tn-Ground !pressurized) ~ Mound Q Other: thsr: q Other. A Other: VIVA tMAfN SGFIEDIii.a 8ervt~oe Event Servke Frsgtrertoy )respect oonditiort of tank{af At least once every: ,3 s s tMaxlmurr~ 9 years) DNA Pump out oorttant>! of tank{el When combined slutdge and scum equal: orte-third iK1 of tank volume n NA Inspect disperse) celltal At least onoe every: 3 motttttt}lel {Matdmutet 9 years} DNA Clean effluent filter At least onoe every: ~~ a} ~ ~ Insp pump .pump controls & alarm At least onoe every: ~ e,~ay sl (7 NA Flush ass and pressure reef At least onoo every: mo tsl ~` Q earls) p NA other: At !seat once ovary: month{s} --- pearls} DNA Other: DNA MAMiTENANCE INSTRUCT10N8 inspeotinne of tanks end dlapera$i calla shall be made by an indiv[dual carrying one of the following lioertses or osrtifioatlons Maatar Plumber; Master Plumber Restricted Sewer; POWTS inspector; POWTS Msintainer; Septage Servicing Operator. Tan inspeaslons must lnolude a visual inspection of the tank(s) to identify any missing or broken herdwsro, identify any cracks or leak. measure the volume of oombined stodge and Baum and to oheok for any bask up or pending of effluent on the ground surface The dispersal oetits} shalt be visually inspected to check the affluent levels in the obseevation pipes and to cheek far any pondin of affluent on the ground surface. The pending of effluent an the ground surtare may indicate a failing condition and requires th immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equate one•thiM {Ya) or more of the tank volume, the entir contents of the tank shall be romoved by a Ssptags Servicing Operator and disposed of in accordance with chapter NR t 1 c Wisconsin Administrathro Code. Atl other eetvlcea, including,but not limited to the servtainq of effluent filters, mechanical or pressurized 4omponents, prstreatmer units, end airy servlaing at IntervaN of si 2 months. shall be performed by a oertitied POWTS Maintainer. A service reptx! s?talt be provided to the local regulatory authority within 10 days of oompietion of any service event. ' pa40 _~.~ of r • START lip ANQ OPERATION For new conatructivn, prior to use of the POWTS check treatment tanktsi for the presence of painting products or other c em~ca s that may impede the treatment process and/ar damage the dispersal celllsl• if high concentrations are'detected have the contents of the tank(i! removed by a aeptage servicing operator prior to use. _ _ ' System start up shall not occur when soil conditions are troxen at the infiltrative surface• Ouring power outages pump tanks nay fill above normal highwatar levels. When power is restored the excess wastewater will 6e discharged to the dispersal cellts! in one large dose, overloading the collie! and may result in the backup or surface discharge of effluent. To avoid thin situation have the oontents of the pump tank removed by a Saptage 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. - Qo not drive or park vehicles aver tanks end dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 1 b feet down slope of any mound or at-grade sail absorption area. Reduction or elimination of the folowing from the wastewater stream may improve the performance and pf0~ disinfectantsf tat pOWTS: antibiotics; baby wipes; cigarette butts; condoms; cottons 80bnbdeg`r~e,rherbic'dea i msatisc~aps; rnedicationa; oil; foundlrtson drain (sump pump! water; fruit end vegetable peelings; g painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS tells and/or is permanently taken out of servic® the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chaptcsr Comm 83.33, Wisconsin Administrative Code: s Ali piping to tanks and pits shall be disconnected. and the abandoned pipe openings sealed. e The contents of all tanks and pits shall be removed and properly disposed of by a Septags Servicing t7psrator. • After pumping, ail tanks and pits shall be excavated and removed cr their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWT$ falls and cannot be repaired the follcwing measures have been, ar ~ must be taken, to pravlda a code compiiarn replacement system: A suitable replacement area has been evaluated and may be utilized tar the looation of a replacement soil absorptoor system. The replacement area should ba protected from disturbance and compaction and should not be infringed upon b~ required setbacks from newtsoil and sf to evaluat on toeestalslish a sutlt bleissp aaiement pea~cRep3acement systems mus result in the need for a oomply with the rules in effect at that time. d A suitable replacement area is not avaiisble due to setback and/or soil Iimkations. Barring advances in P4WTE tenhnolagy a holding tank may be instaiied as a last resort to replace the tailed POWTS, d sit ~~ l] it tan 0 q Mound and at-grade soil absorption systems may be reconstructed in pla'ee8 ~Il®fwf~t at tmhotatime-.the biomat at th infiltrative surface. Reconatructiona of such systems must comply with the ru < <WARNINO> > SEPTIC. PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES Al11DlOR iNSUEFiCIENT OXYdEM. QO N ENTER A SEPTIC, PUIMPEROIOR OF~A ANK MAY SE DIRFiCULT OR IMPOSE BLE.T~C~• DEATIi MAY RESULT. RESCUE OF , PERSON FROM THE ADWTIONAL COMMENTS ~n..r.•e e~e~rs~ ~ ee PV<f.V w Name •nrrr.~ ~ r'~1l,' ~ s.-- ~ a l~ Phnne 7 C ' ~ ? ~ - g' POWTB MAINTAINER Name Phnne SEPTAOE SERVK:INf3 OPERATOR iPUMPER! LOCAL REGULATORY AUTHORITY Noma Name ~. t"-,R~O~ ~~~ ~~ Peon. Phone s, 3 This document was drafted in oamplisftce with chapter Comet 83.ZZt2ltbl(1lld!&if! and 83.54{1!, (2! & (31, Wisconsin Administrative Code. 8T cRa~c co C~ Aaxa~~r~T SpFI'IC TANK AND 1`IOI~ FORM ptif~I~iAR8HIP CS'RT~G- OvvDe~/Buyer ~! ~,c1 A C. o,C P~~F"Tr o ~ J -D 2• , . Su t~ ~ pmpetty Address ~o•r Jn- (YarllYrsdoa requited ftara Plaa~oiay Dolt for near r~ ~ T ~~ ^x~g ~„~~y+ =av+a og ~'l C1 DDS r ~3 S a~- ~(1L3SprJ ~,cJ~ paz+cel YalentifiGaao4 Ntsmbar T~~ ~pe'~Y moors .~ !/., ,L~..~~ %•, Sac. ~~ Subdivisiaa a~,ee m taatntaia the pdVtte d~P°~ ~~` tlLe Depettment of ~stetsal geao~oas+ Stst~ a~f °n be eomplotad and eeast'e~ to tl~a 3t- t~oiac C3o~y T~~ pica origin 30 . voi~,t~ _ ---,.per ~ Ccriif ai Survey Msp # _ t0 ~ ~ D.~D - Volume ~.~~_~ Page # t 3 wirranh+ Deed # spgG ~pusc yes ^ ao Lat liaes idrutifi~ble ~ Y~ ^ no of tnu do esxl e+oyld resole pi its pttimatvas tallt~ ~ }sa4c11e~stea-Piop~t'~~ Improper use end ~ Y . s°P ~ ar soooa~, ~ e~re8ed by a licars~'l pta~ Ribat Y0° ~ ~o ~ s'Y~ ooh ~p~qg aut the szptie tsttk cvat'!- thtse y~ ae~ affeet die timc~tioa of the aeptie tantc as a ~~ent adage is tie ~~ dhP~~ ~'~' t a catiScttWa fotm- ~ by the 4waea aad by a 'f yae orwa~c ages to sObmit to St CStoi~ Zoa~ia,~ ~ ~~ ~eraf~ec disFo~sa~ ~ p lumbar tea'ttictodPlumbaocalitededp~~t~i~ msstQrPhttubes, jonmaP aReti aod. g~~ (it ne~oessm5-)~ ~ ~ tsa1~ is Ices tbaa 1/~ ~ ~ ~~ is is pt~ ~~ ~ttao sad/or ~) ~, the a0adards ~. me wed have rtsd t6o aboao iaquieemot~s eet faeth, be'eein. a: icr by tip of t:o ~tb~ saptio system' that art way iaco~nti«, ~~'a .~~ DATE ~ihis form im true to ~ des: of t~y- (our) Ipao~+kdge. a vraaaaty docd cerorded in Register of Oecds Otfiaa. Let #~ .~_. I (wo) am (~) ~ ow~~s~ of ~ ~~ DA"I'8 / e befng rewked b~+ the Zatstai DaF' sst`rs is mis-eapre~~ ~Y reavlt is tYta sanituy p~ stamped drart,aty dead txvm the Aagi~t~ of Dads office •• Lselude wdlts tbla •pp[ieatlas: a ~ if izfete:~ ~ tasdrs is the ~~Y ~'d a csypy of ebe eeeot5c+d survey P TOTAL P.02 ,~ w • ~ ~ ~ STATE BAR OF WISCONSIN FtORM 1 - 1998 6660$0 WAR}R~7A{N~TY DERD KATHLEEN H. WALSM Document Nurnb ;; of .,. Val. ! 1:1~pAG[6~~ 5T G1CFTc02XaCODEEWI ,- This Deetir _ _.._ ,. _ RECEIVED FOR RECOkD ' rnadebetween Bane Corporation, _ a Minnesota corporation 12-21-2001 3:20 PlE -'. -' _- -- ---~ - {)ARRANFY DEED ------' " and Sienna Corporatiptt a M~nne4 ~, Crantor, '' Ff(ERDi A or-a re~y_o~~iga_T_ ~r ~Y FEE: CBpY FEE; -~--•- -- -- ~ ~, ?RANSFER FEE: 9863.44 -- _ --.. RECDRDIBG FEE: 21.OD - __ -" - __ -' PAGES: i .~, Grantee. Grantor, im' a valuable consideration, deseNbed real estate In S t. Cr01x conveys to Grantee the following __ ~ -County. Slate of Wisconsin , (the 'Property"): +iticr~omg M1tea See Attached Exhibit A " gene andAeturnAderess '~ L~nit~r~rLt i~ ~~ S~C~ 5m2}ar~ ~ri+~, ' .~l..t4~ 4'L1t ', ti{ i nne i'c)nha,- ~ ~ 553 _.. 0 20-1048-30-000 Pared IdanlifiWSron Number (PIN) This iB not homestead property. ~ (IS} (ls not) ' 20-1048-60-000 20-1048-90-000 20-1049-90-000 20-1050-00-000 20-1050-80-000 20-1052-20-000 2a-los2-lo-000 'together with ail appurtenant rtghss, title and interests. ;. Grantor warrants that tl:e title to the Property is good, Indefeasible !n Fce simple and free and clear of encumbrances except ' See Attached Exhibit B. 'Dated this 20th day of December 200I_ Bane rparation (SEAL} (SEAL) by ~ Jo M. Naese Lts_ C ief Executive Offic (SEAL) (SEAL) AUTHENT[CATIpN ACKNOWLEDGMENT ', Signantre(s) Minnesota State of'iMt~it.'tmstn- ~"'~~~` authenticated this day oF------------.• f Count f Personally carne bed fore me thts _ ; ~~~ L,,,,_ day of ' December ,2001 ,theabcve named -- -- -- John M. Nasseff Chfef Executive Officer of Sane Corporation, a Minnesota ' ' corporation -"' ( [TLE: MEMHER STATE BAk qF WISCONSIN "~ (it not, authorized by §706.06, Wls. $tats ) ._ to ' me known to be ff~~~~``, a per ~,~ who executed tits foregoing ' ' . instrument and atikn~w same, 44`` . , iHiS lNSTAUMENT WA$ DAAFTEO BY ~` ~ -~ - f{ARRY F, t;~AU.AHEA Lockridge Grindal Law Firm ~ anawttl~t,wnrstalaaoe -..1Q21, fe7___?~ehin~>~~~renau Cnftt•h _ + ~ M i nn a apo 1 i 5, MN 5 5 401 Na>ity"Pubhc. State of Wisconsin _ l'141y commission is permanent. (If not, state expiration date: f5ignawres may be authenticated or acknowledged. Both are not Januat 31 _ ~~_ ) necessary) ~----•- •-- _. _ - ' Namrs of urrsoiu signing in any capacity must be typed or prenretl below Neir signa~itre. iVAkRANTY DEED STATE BAR OF WI5CDNSIN w~sco~sn Legw aronw Co., ins PORN No. I ~ 1998 ronws,sn.cs, w:x. ~~/ 1 zoss~ sus Document Number STATE BAR OF WISCONSIN, FORM) • [998 WARRANTY DEED 34tlst Deed, made between John Gies and Pearl Gies, husband and wife, Grantor, and Slenoa Corporation, a corporation under the Isws of Minnesota, Grantee. Gralttor, for a valuable consideration conveys to Grantee the following described real estate in the County of St. Croix, State of Wisconsin: See Exhibit A, attached hereto 7 o es Pearl Gles Fredriksat & Byron, P.A. 1000 Plllebury Center 200 Sonth Siztb Street Minneapolis, MN 55402 Parcel Idertificatinn Number (P1N) 02D.1D48.30.Ix10 This (is) (is rat) homestead progeny. The parcel shown on this document is being added to the parcel shown on the document recorded in Volume 1797, Page 613, Document Number 886080, described as a parcel of land located: to create on parcel, and this transaction in thareby exempt from Chapter 18 of the ST. CROIX COUNTY LAND USE REGULATIONS pursuant to Section 18.05 (A}(3). Together with all appurtenant rights, title end interests. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: restrictions, covenants, conditions and easements of record, if any. Dated this day of November, 2002. AUTHENTICATION Signature(s) autheraicatrd this _ day of TITLE: MEMBER STATE BAR OF WISCONSIN (It' slot, authorized by§706.06, Wis. Slats.) THIS INSTRUMENT WAS DRAFi'ED BY Fredrikson & Byron, P.A. (SMM) 4000 Pillsbury Center 200 South Sixth Street Minneapolis, MN 35402 612-492-7000 2682096 (SignaNtes rosy 1>a authenticatod a ackttowledgad. Both are tat necessary.) 699t96tEa KATHLEEN H. tfALSH REGIaTER OF DEEDS ST. CROIX CO.. MI RECEIVED FOIL RECORD 11/25/2002 10s00AM Ezi~r ~ REC FEE: 13.00 TRAAS FEEL 87.90 CGPY FEE: CERT CGPY FEEL PAGES: 2 ACKNOWLEDGMENT STATE OF WISCONSIN ) COUNTY OF ST. CROIX ) Personalty came before me this Ors4 day of November, 2002, the above named John Gies and Pearl Gies, husband and wife, to mr known to br the person who executed the foregoing instlumem attd acknowledge the same, "Notark Public, Starr of ~i M Commission is permanent. (If not, state expiration date: . ~) Mk:helie Beck Notary Public State of Wisconsin 'Humes or persons signing le any wpaclty mould be typed or printed 1,e1aw dwir Ngtutuns WAR1tANTY DEFD SrwtE ens or wtSCO.VSDP roaAS Via. t • sues iMerrtylian Grofeeaonsh C«,panr gone du Loa Wtscmwn aoo-5as-~o2r 13 ~~ 2059P 6Z7 EXHIBIT A LEGAL DESCRIPTION A parcel of land located in the Northwest Quarter of the Northeast Quarter and in the Southwest Quarter of the Northeast Quarter, both in Section 20, Town 29 North, Range 19 West, Tawn of Hudson, St. Croix County, Wisconsin, more fully described as follows: Commencing at the Northwest corner of said Northwest Quarter of the Northeast Quarter of Section 20; thence South 00 degrees 20 minutes 54 seconds East, along the west line of said Northwest Quarter of the Northeast Quarter (for the purposes of this description the north line of said Northeast Quarter is assumed to bear South 89 degrees 13 minutes 56 seconds West) a distance of 1314.36 feet to the southwest corner of said Northwest Quarter of the Northeast Quarter; thence North 89 degrees 19 minutes 30 seconds East, along the south line of said Northwest Quarter of the Northeast Quarter, a distance of 741.51 feet to the west line of Certified Survey Map in Volume 12, Page 3302 and the point of beginning of the parcel to be described; thence South, along said west line of said of Certified Survey Map in Volume 12, Page 3302, a distance of 182.31 feet to the south line of said Certified Survey Map in Volume 12, Page 3302; thence East, along said south line of Certified Survey Map in Volur.~c 12, Page 3302, a distance of 79.03 feet; thence North 00 degrees 15 minutes 50 seconds East a distance of 712.09 feet to the southerly right of way line of the Chicago-Northwestern Railroad; thence South 84 degrees 37 minutes 27 seconds West, along said southerly right of way line, a distance of 50.27 feet; thence southwesterly, continuing along said southerly right of way line, a distance of 32.43 feet, along a tangential curve, concave to the southeast, having a radius of 1859.86 feet, a central angle of 00 degrees 59 minutes 57 seconds and a chord which bears South 84 degrees 07 minutes 28.5 seconds West, a chord distance of 32.43 to said west line of Certified Survey Map in Volume 12, page 3302; thence South, along said west line of Certified Survey Map in Volume 12, Page 3302, a distance of 521.74 feet to the point of beginning. Containing 57100 square feet or 1.311 acres more or less. #26933960 - to Sienna Vhf. ~ / ~ ! PAfE ~14 File No: 85 - 04900 EXHIBIT "A" A parcel of land in the Northeast Quarter of the Northwest Quarter, in the Northwest Quarter of the Northeast Quarter, in the Southeast Quarter of the Northwest Quarter, in the Southwest Quarter of the Northeast Quarter, in the Northeast Quarter of the Southwest Quarter, in the Northwest Quarter of the Southeast Quarter, in the Southeast Quarter of the Southwest Quarter and in the Southwest Quarter of the Southeast Quarter, all in Section 20, Township 29 North, Range 19 West, Town of Hudson, St. Croix County, Wisconsin, more fully described as follows; Commencing at the West Quarter Corner of said Section 20; thence North 89 degrees 25 minutes 02 seconds East, assumed bearing along the East-West Quarter line, a distance of 1319.52 feet to the point of beginning also being the southwest corner of the Southeast Quarter of the Northwest Quarter; thence North 00 degrees 36 minutes 14 seconds Weat, along the west line of said Southeast Quarter of the Northwest Quarter and Northeast Quarter of the Northwest Quarter, a distance of 1325.15 feet to the southerly right-of-way line of the Chicago-Northwestern Railroad; thence North 79 degrees 56 minutes 29 seconds East, along said southerly right-of-way, a distance of 451.00 feet; thence northeasterly a distance of 807.03 feet, along said southerly right-of-way, along a tangential curve, concave to the northwest, having a central angle of 09 degrees 54 minutes 03 seconds and a radius of 4670.25 feet; thence North 70 degrees 02 minutes 26 seconds East, along said southerly right-of-way, a distance of 429.04 feet; thence northeasterly a distance of 445.52 feet, along said southerly right-of-way, along a tangential curve, concave to the southeast, having a central angle of 14 degrees 30 minutes 21 seconds and a radius of 1759.75 feet; thence North B4 degrees 32 minutes 47 seconds East, along said southerly right-of-way, a distance of 7.57 feet to the west line of Certified Survey Map in Volume 12, Page 3301; thence South, along said west line, a distance of 703.32 feet to the south line of said Certified Survey Map in Volume 12, Page 3302; thence East, along said south line, a distance of 593.00 feet to the east line of the Southwest Quarter of the Northeast Quarter; thence South 00 degrees 26 minutes 06 seconds East, along said east line, a distance of 1127.21 feet to the southeast corner of said Southwest Quarter of the Northeast Quarter; thence South 00 degrees 26 minutes 55 seconds East, along the east line of said Northwest Quarter of the Southeast Quarter, a distance of 191.71 feet to the north Iine of Certified Survey Map in Volume 15, Paqe 4172; thence South 89 degrees 37 minutes 27 seconds West, along the north lines of Certified Survey Map in Volume 15, Page 4172, and Certified Survey Map in Volume 15, Paqe 4173, a distance of 1113.42 feet to the west line of Certified Survey Map in Volume 15, Page 4173; thence South 32 degrees 43 minutes 57 seconds East, along said west line and its southerly extension, a distance of 591.64 feet; thence South 07 degrees 13 minutes 18 seconds East a distance of 323.01 feet; thence South 08 degrees 41 minutes 11 seconds East a distance of 413.63 feet; thence South 08 degrees 43 minutes 31 seconds East a distance of .229.88 feet to the north line of Certified Survey Map in Volume 11, Page 3128; thence North 89 degrees 52 minutes 10 seconds West, along the north lines of Certified Survey Map in volume 11, Paqe 3128 and of Certified Survey Map in Volurne 12, Paqe 3292, a distance of 682.8§ feet to the northwest corner of Certified Survey Map in Parcel #: 020-1420-50-000 osi27i2oo7 09:27 AM PAGE10F1 Alt. Parcel #: 20.29.19.2673 020 -TOWN OF HUDSON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O -ENGEL, PHILLIP M & KATHERINE E PHILLIP M & KATHERINE E ENGEL 425 CY RD A HUDSON WI 54016 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description * 425 CTY RD A SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 1.097 Plat: 1983-GLEN, THE 02 SEC 20 T29N R19W SE NW LOT 79 BLK 8 THE Block/Condo Bldg: 8 LOT 79 GLEN Tract(s): (Sec-Twn-Rng 401/4 1601/4) 20-29N-19W SE NW Notes: Parcel History: Date Doc # Vol/Page Type 05/02/2006 824223 WD 01/12/2005 784826 2730/163 WD 12/21 /2001 666080 1797/613 W D 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 05/30/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.097 96,700 283,900 380,600 NO Totals for 2007: General Property 1.097 96,700 283,900 380,600 Woodland 0.000 0 0 Totals for 2006: Gene ral Property 1.097 96,700 283,900 380,600 Woodland 0.000 0 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