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020-1430-40-000
Wisconsin Department of Commefce 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)]. 'ermit Holder's Name: City Village X Township Sienna Cor Hudson, Town of ;ST BM Elev: Insp. BM Elev: BM Description: od ~~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Z. ~1 ~. ~ ~ SJ~. ~ ~ Z ~ ~' Aeration „~,,,,,,,_ Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic i t ~ ~~~ Dosing µ v. , Aeration ~, ...--~' Holding -`'" -.-------- °"" PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number ~" , . "".... ,_ ...,. TDH Lift Friction Loss System Hea~..~°' TDH Ft .--'` Forcemain Len Dia. _,,,..~- Dist. to well SOIL ABSORPTION SYSTEM -- County: -_----- ----- - - - --- St. Croix Sanitary Permit No: 463359 0 State Plan ID No: Parcel Tax No: 020-1430-40-000 Section/Town/Range/Map No: 20.29.19.2682 ELEVATION DATA STATION BS HI FS ELEV. Benchmark Alt. BM~, 1 i-~ ~ 3 ,~} Jp . t, Bldg. Sewer ~_ a 5 /C 3. ~c} St/Ht Inlet 6~<<~ ia>•~5 SUHt outlet .7 ~ /6~ • Z~ Dt Inlet ` _ Dt Bottom ~ ~` Header/Man. /~ •~,(, ~~ Dist. Pipe ~ // ~ ~g GI? Bot. System T' ~r.~ ~~ Final Grade a~ ~I Z"' ' /6/ • / 5 St Cover`' ~~ ~ ~ Q /a t, • G Ate,.,,....... ,... ~.. .. °,--._ , ~~ BED/TRENCH DIMENSIONS Width j ~S, Length ~~'Z No. Of Tre'nch~~^s _• f _~., ~ ~ '~e/~~y~] PIT DIMENSIONS ~_ No. Of Pits \ Inside Dia. `- Liquid Depth ~' SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: ~ ,' ~ INFORMATION CHAMBER OR crL_ .L/~Cl n. Type Of Syls~tie/m~: ~~ ~I / ~ //~ ~ / UNIT Model Number: ~ J ., l i IIISTRIRl1TION SYSTEM C'_ -.L'-- G ~ ~t GG ~ ~/t`~ Header/Manifold ~~ ~ Distribution x Hol Size x Hole Spacing Vent to Air n e ~d N~ ~ ~ Di Pipe(s) \ ` ~ i th Di S L ` Z ti a Length ng eng a pac SOIL COVER v Praccnra Svctems rlnly YY Mnund Or At-Grade Systems Only Depth Over i Depth Over xx Depth of xx Seeded/S ded xx Mulcl d C Bed/Trench Center ~ i5 Bed/Trench Edges Topsoil \ Yes No ~es ' No ~~ COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / Inspection #2:_ '__! Location: 427 Wren Lane Hudson, WI 54016 (SE 1/4 NW 1/4 20 T29N R19W) The Glen Lot 88 Parcell~No: 20.29.19.2682 1.) Alt BM Description = ~i'~ ~`,~~ ~ ~~'~~ s~,~ "`~ ~ ~ ~ i ` 5 ~. ~ ~ r i ~ 2.) Bldg sewer length = ~9 u ~ ~~, ~,~ e ~ _ ~ ~ ~~" b0 ~^~' ~ S ~ ~ ~` - amount of cover = •~"~ Plan revision Required? ]Yes oo ] ~ ~ ~~ - ~ [~ ~ ( 7< Use other side for additional informs ot~ n. " ' ( _ Date Inse ctor's nature Cert. No. SBD-6710 (R.3/97) rT 7 ' Safety and Buildings Division ~ County "~ ~ 201 W. Washington Ave., P.O. Box 7162 S'~C' , ` ~sCOns~n Madison, WI 53707 - 71 Department of Commerce ( - ECEIVE y ~ ~ ry Permit Number (to he filled in by Co_) 335 ~ Sanitary Permit AppIie ~ ' ~~ State Plan I. .Number In accord with Comm 83.21, Wis. Adm. Cade, persona! inform~tio o r~;e~ 2 5 200 may be used for secondary pur oses Pri L p vacy aw, s15. } ON roje Ad ss (if different than mailing address} Y I. Application Information -Please Print All Informatian IX CO O ONING OF ~'Z~ W ell L~~ ~ Property Owner's Na me Parce! # Lot I} Block H ~ d, ~4 ~ ' ~~ Property Owner s M ailing Address . ~ rr Y Property ocation / Ctty, State Zip Code Phone Number ,/// ~=''~~.~ `k,Section ~~ ~ c~ _ _ ~~' ~ I .Type of Building (check all that apply) ~ ~ S ,,,,`~ i~l or 2 Famil Dwelli -N b (circle T .~ Q N; R~_E or(~w Subdivisio IQ y ng um er of Bedrooms _ n ame CSM Number J ^ Public/Commercial -Describe Use ~ T ~ ~ ~ ~/ T_ _ _^~ ~^ ~ ~ I L ^ State Owned -Describe Use _ __ y_ ~ ~ / -I City_^Village `~Q`i'ownship of letl,~p..v ~ III. fiype of Permit: (Check only one box on line A. Complete line B if applicable) p .~. °J~ .. - (7t3(~ ~ 2(o Z A. f r- New System ^ Replacement System ^ TreamtendHolding Tank Replacement Only ^ Other Modification to Existing Jystem B • ^ Permit Renewal Before Expiration ^ Permit Revision ~ ^ Change of ^ Permit Transfer to New ii' Gist Previous Permit Number and Date Issued Piurnber ~ Owner 1 IV. T e of POWTS S sy rem: (Check alt that ap _ ply) _ ~~Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil ^ Mound c 24 in. of suitable soil ^ At-Grade ^ Single Pass Send Filter I ^ Constructed Wetland ^ Pressurized In-Ground ^ Ifoiding Tank Ci Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter ~`_Leachi Chamber ^ Drip Litte ^ Gravel-less Pipe ^ Other {explain) _ V. Dis rsal/Treatment Area Information: Z ^ ~2• c7 _ Design Flow (gpd) Design Soil Application Rate,gpdsf? Dispersal Area Required (sf) Dispersal Area Pro ed {st) ystem Iaevation ~~ ~~~ .fie-~C ~7`.w.y !~ ~ ~ ~ ~-~~ ~~~ _ _ VI. Tank Info Capacity in Total Number Manufacturer ~Prefa Sit 1'St ! Fib e ee , er Plastic Gallons Gallons of Utvts (,~~ /-~ - /~~ 1 I Concrete Constructed i Glas`s New Existi / ng Tanks Tanks Septic ar Holding Tank ' ~adD / -`-- ;~s~y , Aerobic 1 reaurx:nt Unit - -" -" Dosing Chamber ~ _ VII. Responsibility State_tnerit- I, tht tiittdersigned, assume responsibility for uts Nation of the POWTS shown an the attached plans. ' ~- Plumber s Na me (Print) Plumber's Si gnature ~ P MPRS Number Business Phone Number r Plumber's Addre ss {Street, City, State, Zip Cade) VIII, Count /De artment Use On1 -- Approved ^ Disa ov Sanitary Permit Fee includes Groundwater Data Issued Issuing ent Signature (No Stamps} ((( ~~` S h F urc arge ee) ^ Ow ' to Reason for Denial ~ ~- ~S ~~ . IX. Conditions Approv ~. - SYSTEM WNER: 1 Septic tank, effluent filter and dl8persal cell must all be serviced /maintain 8s per management plan provided by plumber. 2, Ali setback requirement s must be maintained as per applicable code/ordi nances. Attach compkte plaav ito the County only) for the system on papa not less than 8112 x 11 inches in size SBD-6398 (R. 01(03) ~','.e,~i~y~- ~~ ,rte ~ ~ ~ ~ ~ /"~C. 2~ T~~/I/ D ~ /~`~a.~/ 1~~ ~~U G f~6. ~ _---- 'j/ ~~~e ~ 3 o~ ~ ~ ~~u s ~ ;,:?"-G ,~ t~6~l~6dJ'e~ti w -:~, / ~~ ,~D 4 Q1 i~ P ~, .C f I V ~ h ~ r~~l `~ %' - -C~p.Y ~~~~~lln,~~-- -3~2-3/0.5' /~/~ ~~ ~9~~ ~'c~-~~ ~ `=016 ~6~- pB1n ~~ ~L~ l D.~ ----- ~ Y'~ -J ~. a-N O ~~~ ~~~ ~ lJ.. ;,. 'r-~i ~a~1~6~~.e~'t~ 6lJ ~~~y ~~ ah v .~ i~ `~ ~ ~ kU ~~ h~ .~1 /~ ~~yl Wisconsin Department of Commerce SOIL E~FALUATION REPORT Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must include, but not Ircnited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimemsior>s, north arrow, and location and distance to nearest road. Parcel I.D. Please print a// information, cured ~ Personalinfomration you provide may be used for secondary purposes (Privacy Law, s. 15.04,(1) (m)). Property Owner t ~ ` 'Prop@rty Location 1087 page 1 ~ 3 Steel Soil Service St. Crooc pending Date ~8,13.7,c10 Sienna Corporation i Govt. kot SE 1/4 NW 1/4 S 20 T 29 N R 19 W Property Owner's Mailing Address £, Lot # Block # Sutxl. -Name or CSM# 4940 Viking Dr, Suite 608 ~ k - °' 88 na The Glen City State Zip C Phone Numt~er jCity Village ~ Town Nearest Road f~r'nG, MN 5543 9.9'Z- ~.~-~$~ Hudson Carmichael Rd. /_ ~ New Construction use: / Residential /Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial -Describe: Parent material Patted outwash Flood plain elevation, if applicable na General comments and recommendations: system elevation 92.70ft, trenches spaced and depth to code 5.50ft below grade a Boring # Boring ` 105 / Pit Ground Surtace elev. 98.20 ft. in. Depth to Limiting factor Boil Application Rate Horizon Depth Dominant Color Redox Description ... Texture Structure Consistence Boundary Roots GPDHtz *Eff#1 *Eff#2 1 0-18 10yr3/2 none sil 2msbk mfr gw 1 f .5 .8 2 16-44 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 44-105 7.5yr4/6 none ms osg ml na na .7 1.2 apt' 4 Z ~ ~° ~~~~~ z Borfng # Boring ~~ , ~ _,~~ ~' 105 N Pit Ground Surtace elev. . 98.20 ft. Depth to limiting factor in. Snit Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz *Eff#1 *Eff#2 1 0-12 10yr4/4 none scl 2msbk mfr cs 2f .4 .6 2 12-105 7.5yr4/6 none ms osg ml na na .7 1.2 ~G~IoL tnruent ~ r = csvu ~ su ~ c~u mglL ana i ~s >su < ~ 5u mg/L - tttluent iFZ = ttctu < "sU mglL ano l :iS <~u mg/L CST Name (Please Print} Signature: CST Number David J. Steel (~~~~G~wi1/~` Q ,~ 248956 Address Steel Sal Service _~(/ /~,~,~ Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 9/3/2002 715-246-5085 Page 3 of 3 STEEL'S SOIL SERVICE David 3. Steel 1564 Cty Rd GG CST-POWTSM Sienna Corporation New Richmond, WI 54017 Lic. # 248956 SEl/4,NW1/4,S 20,T29,R19W (71S) 246-6200 Town of Hudson, St. Croix Co. (715) 246-5085 The Glen lot 88 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the soi! test. was. conducted. Legend ~" 1" = 40' • Benchmark El. 100.00Ft p of ''/2"pvc pipe • Alt Benchmark EL 100.OSFt op of/2" pvc pipe '~ o =Borings Boring Elevations B 1 =98.20Ft ~~ _ B2 =98.20Ft rye _nc cnr.. ~_ V~ r _ _ ~_. ~ i @• ~ , i ~ _ i~ ' /~ ~ ~ - b ~~. ,~ ~ _- - _ _. ,~ -- __ I -- .~ .._ _ _ ,- _ s - il` .._ n :. t ~ -~ - I ,, _ ,. ~. ~ ;, ~ ~ ` ;...4 w ; ~ ~ ~.~ , ~ .. •• \\ ... . ~ sue' ~ \ .' r ~~ ~ _' . _ _ Aa ,fir ~ y_ .~ . ," `N . ., , p ~. ~ _. 1 83 81 " ~ .. • .._ ;. • ~ i _ . 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A~~v~ a.~a~ a F'R~'S~f A3'a aNTikKL WSh~~QW Oft F+HISHI~r '3RAr:~E ~+" C Z l! ~, 5 L,~ ~~ ~~ t ~~ ~ I f ~1~At'N~RDRt~C1F JVNC?tQN DCX wzrH coutwz; ~ ,, ~, Ay~/+.~`P/R/ft1~1,'}*~ FB ~~R~r/~1~ iQ1l£ -~ ~ PAD S.OC K t ~ARNrNG LABF ~ ~t Mi h' ~~ w,~~; ~R ~ ,, ,,,,,,,~ ; - .,,,, IGi3~ SEAL& GA5• i ' ,'' ~ TlGHT ~ ': ,Rp~ ~ ~ A . ~OT1. SCI. i~D ~ ~' ~ '"~.,,` ~ 'ON ~ ~ P:~ MP vFf KLEV , ~~' T ..~..,.,~,.~ ~ ~ 4-~-' ~"CPi~ 1 j~ -- -- 3" APpRvV~`J $EDCING J:1'DPR TA!~~K '~$T:C i D03L SWX MAN',~FACTJR~R: aPLCIF`«"A'"r~e :...... SE''r"'Z C l GAL . DOSE ~~ Gr.L, ~~`! MA!-1tJPAC',~!RER M4DLL NUMD~R z C~-- SWITCH TYPL: HODEL 1WMaER sw~tz~K z~rPE: -``. '^^.•w ~~~;RCD ~YSCKAR3£ R,A'Z `~ r .~~w.~ ~~Z':C~AL DIFt"$gJNCE gg ~`IN ~ . d0?IMPS ~!?t~ ~P~kTO~ P IAA SOLiO. SQir. r* RI~FI! EX:fi pERMrT?ED CNL iF TANK ~'1~AAN?ACT'JRER NA S A PPR QVA L CONC~tD'fi~ PAD h"~-~d~iR ~C~ES pER JAY; ~..,.. :OS» VC:~."s~ ZrTC:.~DwNG fLOw~iACKt i~ GA:~. CAI~A : Z : I E 5 : A . ;:~CKIS • .:~i+i...~. SAL. ~ * .,,. Z„ T AfC NE 8 ~ ,,,,~„~„~GA i a ~ ..,,~ iNChES ~~^=, P~.'MP ~ ~+:•A~i."~! WwRING ~-5 rElt ZLI~R Z~~Z3~ `+;A~ IMUn N~~'~ipR~ S~P1~LY PRESst,TR~~~~r Ati,~ ors Tr: aurr c~ ~zp~ l.? rt~F:' ".,,r.., FLIT C V~C~~~Z~ A ~~~,~i11' ~"'~r:~~V ~.~. r~~a ` ?' t , ^ , • ' ..~.i.,. ,. T.J1~ FA~TQ~t ~~ FLET + C"•'.+1L 1, YNAIi.C NERD ' ; ~ ~`L~T "'ANAL DI1'tE:~'~:C?~S Cg Fi,~~la ~"I+,r'~`: PEi':' .~1'G.. -...._.~... _ .~ ^ ter. '•~...aa i.~,1S;~ ~GOULDS PUMPS Su~me~sible Effluent ~u~p 3 V ~ 1 EP05 APPUtATI0N5 Speaficaliy designed for the following uses: • EfRueM systems • Homes • Farms • Heavy duty sump • Water transfer • Dewater{ng SPEClrFICATIONS • SokdS handiiny Capability: '/~" maxfmum. • Capatities: up to b0 GPM. • Total heads: up to ;1 feet, • Diuharge size: l'(:"' NPT, • Mechanical sea!: carbon- rotary(eeramic-stationary, 6UMA•N elastomrrs. • Temperature: 104°F (4tj°C) eaMinuous t40°F (60K~ intermittent. • Fasteners: 300 series Stainless steel. • Capable at rurrning dry without damage to components. Motor. • EPS."4 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, buih in overload with automatic reset. • EPOS Sing9le phase: 0.5 HP, 1 t 5 V, b0 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: a 0 foot standard length, i6J3 SJTUW with three prong grounding plug. Optional 20 foot length, t6/3 S1TIN with three prong grounding plug (standard on EP05;. • Fully submerged in ~tigh grade turbine oil for lubrication and efficient heat transfer. Available for automatic and marru~ operation. Auto• malt models include Medtankat Float Switch asumbled anti preset at the factory. FEATURES ^ EP04 Impeller: Thermopids- tic Semi-open design with pump out vanes for mechanical seal protection. ~nert:ns seer ro~ ; ~ ; a Z5,. T r--~-.."".'.r- s 5 o ~" o al w z i t~ I r; ^ EPOS Impeder; Thermoplas- tic enclosed design for approved performance, s Casing and Base: Rugged thermoplastic design provides superior strength and canosion resistance. ^ Motor Housing: Cast Iron for efficient heat transfer, strength, and durability. BI Motor Cover: Tlnermaplastic cover with integral handle and float Switch dttathmetlt paints. ~ Power Cates: Severe duty rated ai and water resistant. tr-w-city ~ 8earings: Uppe: and lower heavy duty ball bearing eonstrudion. AGfENCY USTiNG ~' Can~Nan su.,derds A+wciatior+ {CSA listed model numbers end in "F" ar "C".? SeWds pumps is Ko 9oor Registered. ~~~ P05 GPM .. m>>~ Gauids Pumps m 2000 Gourds Pimps ~ ITT tndu5tries effective February, 2000 83871 ~,...~~ .~ IIIC~C4~ STANDARD CHAMBER Quick4 Standard Chamber ____.---___- 52°--_.____ _ -_~~ S!UE VIEW MultiPort End Cap FFiON7 V1EW S!C)E VIEW Size (W x L x H) _ ~..~, 34° x 52" k 12" Etfect!ve Len t~ h __ _ qg• Invert Height grr TOP VIEW ,„ t;;l~u(tlP,orta:End Cap Nomlaal.Specitt~atfons ~~~~' raj ~' r ~ Size WxLxH) I~ 4..r'~ 34'x18'x12" invert Height 8x nr 3.25' 1I~1.~IL-t.9$I4~.~~^7EMS. INC. 3TAnf~HD L11~;17Ej~ 1~p.RRANTY di I lp dn.'kpx rlerJrily a Bar h chdfnhBr, fled plBta, w'eCy i ,pia nmrx '.h.C09Sn y nt :I wl ~ f J r a J + ~~r t- wnan nal I'd rrl plxra[eo '.n +E IC fr id n. ar c - ~!ta uopu crsWro In accorrianca with IorMrnlpr'a u,t xk r t 1 t. rrl ,a.'.: i:na :eery Pr+u:d0 agtlxr.]I ne!eclw0 In alx ass :uW.Nw n gryutl ln: d,x yBar kern Inp dale Not tMa 6CWi('. i1G ixmraa r t a :rux; 4Y.le.n ca dax wlll Iwl 1:+x15 ProWdetl, r4lNVtvclr, .Tral I ~ Seld _ rormrt s ant rL>I].rrrad ray EN7p~hY0WM. ttw wMr,ANY hNir.1,Y p u[4i- ~apc tr x- I,un r Rr r :nNaNOn of rrr c r s b10 •i fl.la'IBnpy$. •,: Bxen: ca tc warranty ryrn9 iklAer rcu.s1 naay I, diliraipr r wraury a1 it tavu, •.atv t+eadrp, u e r: er• Ukl .iilyhrppk iw~rcux:ICt1 wglm iM110an ; Ih} td . f Ilia altB;led OdIC:'.1 iMdtllNd Wiif sup{.ly tnpgt:arnen! 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Mrantt ~rwrraye Hre danrape to n10 Un t. due to prt. t wear ann fra . arty alit 1 awidaru ntix s0. atru c a raSpe;,l N lira Unts Inn i.hnr ~ci,q sUnka .ptl'o vpt+iCW Ira'kn w p!hb ccrdiuors wnet. ra n ~ ;"--euunal ny me n,;allatran x151n r.tiors; tap,m r. ~ cxninlan the ni:nin um p.nunrY r cyerS SUt klRh in iris h5liNalerl +IStNaidns~, !ho Ufacemrx ~!,r-,:sc:t wr r+'rafe'ry:. me fn0 syslern al^Ieinisrg ~:tw ,utt:, IetlW4 W 1`i< U ks or tlrH snptu, syst0•n :nay to ~tr~pg7pr sing dr irtpKafNtr shiny, eAWsnrt, :varK us }1 l.rrvpper Nn3a;,e alb,-rral. d im o Wrnrtan~r aYt3tYt IA7[ „aua(xY !;r IMYr:SO'. T}yg LrrwiCrl Wartanty atr.dl lea w:..t ,! the 'Wki.r rrJtr 7o GCanpiy wren aU Ji Ina tirnxS m~am rn 1hs~ eu f •,rnhnr, in rq axr~ v;ul1 Irytlral7 [b rn5,n:msiDk kar aiy kaF t1r Uan13Qe iJ tnu Fy~r~. Iha Uri te, o' any IhuO pnM1V upn~ Iran rnbtal,T,ipn Or Ship. rne_t. ur bcm ay qc fact ~a,y ,guns M Houser a any !twd [ra^Y~ Wr EMs Exceed Nrandnry ru apply, too Unxs m: =r to rns4:r+urt n xcordnncp wrn uo sao ror:dtiore reulwen !ay slate and Iocal cafes: ~, older aourexore laws; vrtt rrlWratur's ulewuaticn atelrr.cGrii4. ndl i R~ :2rrta:ivH Of IntlNrator slid II^e arrVlhNy to c,rq!eye G' pri[•Id Inlb ;.urliled w:urar•y. 1o wa:•mty suures 'd dny parry arhyr alas trw o'V.y. t.r:. obv~wi ryprrr.Ser r ati :!nndard Lhn:tad Wanergy oYenr dy inrnlrar4. A Crnilrxl nu:+ uw u cae:~ ar,7 cpurtki, na:o a11NHnr warranlY rrxiuua- ilrRr'Ia A!IY Ptati asnr JI' nNts SltouW Ct7n1aG11nf1UrllOfs C...T•cta1P hearhp,anars h CJW 2rryLrrlR, ~: •ar,ruwl uw, Iukyr to ylrlt r;urtJxaw, tp ppfwrr: r rzruy c! +ra aparc~;U:e +rdrrunly, mat vrwldd Gxaklly Nrw; trod wanmltY' TrrUr w fta txxc:Rasa oI I:nas ~ ~ ~ .~ SYSTEMS INC o LrfWlf~IfnlMtB/ ~lfirl6 WiftlWtApl/ 30fUt~0AS' " 6 Business Park Road • i'.O. F3ox 78& Qid Saybrook, CT 06475 8fi0-577-7000 • FAX 860-577-IEK)1 800-221-4436 U S. +'1 C'lts d,7,a9 GGl r~.017,1145; 5,156,488; 5s.9tSA17; SAOY.1 t5. 5,n41 4 J ~ -;t t 80 3.5,7!tf,YG3; c.,;fSB. •78. 5,i1sG,844 __ .,anatilan Patents 1 gng I~:l~, 2,U4A,564 Oltter patents ,ending. h'~ftgralor, Equali2e anti Sf;SHVJ nUSi' aro legl61ert3d trademat'k8 G` inll4bdGv SySt~ rl : Inc:.:nfiltrator is a •egrsterrstt trademark in ;=renc:e. InGFtraWr SYattBrny Irc. aw I Ivry vlr.w _~ • PGWT$ OWNER'S MANUA-I. & MANAGEMENT Pi.AN Page or FILE iNRORMATION Owner , Permit * /_ 3 3 5-q Number of Bedrooms Y p N,q Number of Public Facilky Unite A Estimated fbw leverage) da pes+.gn flow (peak}, (Estimated x 1.51 ~~ d al/da Soil Appiiaatlon Rate alld !ft' Standard Mffuent/Pffluent Quabty Monthly average" Fats, Oii ~ Oreaae (FOQ} 530 mg/L i3iochemicaN Oxygen Demand 1130De! 520 mglL p NA Total Suspended Solids tTSS} 5160 mg/L Pretreated ffftuent Quality Monthly average Biochemical Oxygen Demand (B4Ds} 530 mglL Total Suspended SoNda (TSS} s30 mg/L q NA Fecal Coiiform lgeometrla mesni 510; afu/1oQrni Maximum Effluent Particle Sire Kin die, f~ NA 0thsr: O NA "Values typical for dane:tic wae~wetar end septic tank effluent. SySTlHM ll`PECIFiCATiONS Septic Tank Capacity ,~ GJ ai O NA Septic Tank Manufacturer ~ ~~ 0 NA Sffiusnt Filter Manufacturer ~ ,,~ O NA Effluent Filter Model S~' O NA Pump 'tank Capacity al i;3 NA Pump Tank Manufsoturer ~r~`r, • ~, Q NA Pump Manufacturer G,.,~ / p NA Pump Model ~ ~!A Pretreatment Unit O SandlCiravel Fitter Q Mechan>cai Aeration O Oiainfection O Peat f=liter ©Wetland D Other: I~C61A~ Dispersal CeU(a} in•Grourld (gravityi O At•Grade ^ Grip-Line O NA Q ln-Ground (pressurized} O Mound U Other: Clther: O NA Other. O NA 0 NA MAINTENANCi" SCFNAtJLE Sarwce Ewr+t Service Rrequency inspect candkion of tanktsi At least once every: 3 ~ e MMaxmmum 8 yearsl a ~ NA Pump out contents of tank{s} Whore combined •fudge and scum equals one-thlrtl (>~i of tank volume i~ NA in:peat dispersal cell(s) At least once every: ~ e~{srf al (Maxhnum 3 years} DNA Clean effluent faker At least ones every: ( O more e} ,'$' earls} O NA Mspect pump, pump controls 1k alarm At least on4o every: -- roonthisl O lsl O NA Hush laterals ~d pressure test At least once Avery: ---- rrron (ai O cans) O NA Ott' At bast once every: _.- O mon~(si 0 NA Other: ^ NA MAINTENANCE M1S'itRUCT10NS inspections of tanks and dispersal tees shall be made by an individual carrying qne of the following hcenaa or certifications Master Pkmsber; Master Plumber Aestrieted Sewer; POWTS inspector; POWTS Maintainer; Septage Servicing Operator. ~ Tani inspeaxiona must inolude a visual inspection of the tsnkls) to identify any mis:ing ar broken hardware, identffy any creaks or leaks measure the volume of combined sludge and scum and to check tar any back up ar pending of effluent an the ground surface The dispersal celllsi shall be visually inspected to check the eff-usnt leveia in the observation pipes and to check tar any pond'rnl of effluent on the ground surface. The pondiiny of affluent cn ~e ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined eccumulaticn of sludge and scum in any tank equals one-third iY,l or more of the tank volume, the entire contents of the tank she!) be removed by a Septage Servicing Oparstor and disposed of in accordance with chapter NR 113 Wisconsin Administrative Code. Ali other oervlGes, including but not limited to the servicing of efflwent filters, mechanical or pressurized 4omponents, pratreatmen~ units, end any servicing at ~tervals of st 2 months, shalt bs psrtarmed by a certified POWTS Maintainer. A service report shalt be provid~f to the Iocal regulatory autftofity vrhhin 10 days of cornpietbn of any service event. •apo~ pniis}iSluNttpy ulsuoos!/H '!E) R (t) 'llY4S'i;8 P~ Il}~lp)14){gl(Z)LL'£8 tuu~o~ isid8ya yyM sau~woa u{ pa3le~p esM w>tiur-ooP ~!l ~ it ~ ~J ~ ~ ~- ouayd euot~ AllarlNlstil A>i011f'If't®s» 11d~01 I~dW[id) >dO1Vai~dO l7NI~IAN~3 3OV1d3S •uoyd ~N >~8~11VJ.NIVW $1MOd »S'11V13N181N10d - - StNSWW00 'tVN0111G171~ '899188UdWl >el0 ,t1flOId~10 88 AVW ~Nb-1 d d0 aOttl31N13N1 WWl3 NOStl3d d ~4 3f1~S3>3 '11t1S3>;1 AdW H1V30 '83~NV11SWnaa1~ ANrf >~QNtt BNMl 1W3w1V3dl a3Hlo ao dwnd 'audas ti lF~J.Ns lON Oa 'NBDJIXp .LNidlOlddnSN1 N010Nb S83St/J '1VH13'! 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ZO . T 2~ N~K~w, Towfl of Hv~sU Property Y,ocation '/•, Subdivision .. ~~E Lot # ~~ ' ~- Volume _~- J Pie # Cer•tificd Survey Map # Warranty Decd # ,_ ~ ~~••- ~~0 _, Volume LL'~--~ Page # Y 3 Lot lines idcatifiable ~ yes ^ Ao Spec house ~ yes Q no S Z(~z) Ir<rproper rue and mainttrlaa~ce of your kptic system could resrilt iri its ptr:mattrte: failtrre.to htndlefnstes. Propcc ma1Ot~aare ae tank every tht« yt~ or woos. if acedod by • 1;coa~cd P~• Qvhar you vut into t!u eyetcaa oorai5ia of pttmpittg out tL~e cep • as affect the fuactioa of tiu optic taak as a trutmeat aq~e im tbc*rnste disposal s7'i~' t a cati5ration form. cip~ by t1u owaa aay! by a 'Itte prvpaty owacr agstcs to rnbmit to S`t CSroix Zbaisg D ~ that (1) ilse on~ite ~v4stevnt~ocdisp~ ~m mastCrplumber, joumeyrnanplumbcr, rest:utodPlumba or s licaaaodpr~ap~ ~.{tt peopet opcsatiag c°°didoe tad/or (2) ^tter~spxti+aa ~ P~~ (it-0eeetsary). the septic talc ii less than 1!3 frJl of eludes ednd^=ds 1/we. rho uudorsip~od have road the ibeve: rcQulrzmc~5 cet forth. ~~. as cct by nc~ I)cpattrutflt of t;,ooisnc ~~ ~ upaz rysum }~bccn m~ d^vs.nf throe Y~ p~ira dart. ~} a~:+ee .w maiattia the privau eewe8a disposal ~~ w'~ C~,~'fiatioa sad tho Dcpastmcnt of Natural B~caaurce:~ State of Wiacons0~~ thin 30 be cnmplckcd and retutnod to the St_ t~oix t^,otmty Zonin$ OWIY,~.Rt ~.,x•rtti.yi~.r-Fivi. Y ) ccnity shoe all s oJs o this forrn arc tau to Qu: besc of metyof Deeds Offieeo~ t'~e Qy duon~sbov a warrsaty dad rowrdcd in Regist ~ d~ DAVE I (we) ana (tee) the owner(s) of 3 ~/ c~ DATE •••••• Aoy informati.:u ,~t(/rs mis-eeprestntedmay result to the uaitarYPe[~t bomB ~vokedby-tbtZot~6 p°Pa~°t' •••••• •• Ypctude w~itb this appGc^tioa: a cramped wamary dtod Ftvm tht ReBrttet of ~~ office a copy of tha cert9fiod cruveY map if itfc~[~ it tnarlo ~ the watantY Bred TOTAL P.02 xr-eu-etxk w•cu ,+.u..r, .....~ 1 , STATE' BAR OF WISCONSIN FORM 1 - 1996 WARRANTY DEED DoC,xrq,r, ~..~, vn~. ~ 797o~,I 613 This Decd, made between Bane Corporation. _ .,___ a Minnesota corporation ..... -- _ .,..... _.._... _ ... ___, Grantor, and Sienna Corporation. a Minn~g4 a co potation __._„_.~ .._ _.. . _.. .... ..... ....... Grantee. Grantor. for a vabrable rorulderarlon. conveys to Grantee the fallowlrtR ~ described rral estate u, St . Croix County. Stale of Wlscorutn I (the 'Property'): See Attached Exhibit A Together with au appur[enart rights, Utle and Interests. Gronta• warrants that the title to the Property u good. Indefeasible in fee simple and free utd clew of atcwnbrarxes except See Attached Exhibit B. Dated thi: 20th - _ day ~ Decamber 2001 Bane r oration (SEAL) by Jo M. Nassef ~~ Its of ExecutivQ Offi (SEAL) AUTHENTTCATlON SlRrtature(s) ... auttrenticatad this Jay of TITLE: MEMBER STATE BAR OF WISCONSIN (If ml. utthortzed by §7i)F.06. Wts. Stau.) TFUS INSTRUM[NT WAS DpAFTEp BV Lockridge Grindal Law rirm inn Wn,_,~ursuaa-Scwth- Minneapolis, MN 55401 1r 6660Si>D KATHLEEN H. WALSH FEGISTEk OF DEEDS 3T. CROIX CO., 4I RECEIVEI FOR RECORD 12-21-2001 3:10 Ph YARRiWiY DEED EXEMPT 1 cERT Gaut ~: cBPr FEE: Tf~SFER FEE: 9163.10 kECORDiM6 FEE: 17.00 aasES: ~ rt.rrwn:,g scat Nome erd AelWn Aotirass Uni~r~.4 i~~~ 5~ap 5 m2+r~t Ur ~ ~. ~i+e. viol ~(ivtne -l~tnka~u 553' 20-1048-3D-000 O ~~ Pmcel taov+it:auon Number tPa~ti .. _'_- II Tr,u is not homestead property. ' (1s) (13 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 20-1052-10-000 ACKNOWLEDGMENT (SEAL) (SEAta Minnasota State oCiNtYCCTtiZ11- ss. {~ .~«`•;< -f Count . Pc- rsona~baftvA me th[s r'~ day ut December .__ 2001 , ~ above rammed John M. Nasaeff, Chief Executiv_e,Officer -of Sane Corporation, a Minnesota corporation . -_ i- 1 ..»..-_ ..... __ to me tvxwn to be pe~ __ wtw exarured the fotegoLtg inslnmxnt artd ~ same. - HARRY E. GAt1AHER ` IntC0laelagMpflYaD t•staeea J. Noytq ublk, $ule of WlseoruLt y commicclon Lc pcnn:uunl. (If trot. srsre ~%Niratitm dau' (Slq,tatw'es nwy br autnerrttcated w~ rrckrwwisdQed. Both urr: rwt JenuarY 31 , 2005 ,) necessary.) "' ' _ . _. ..:•- ' N.u,es W p,.;o,w naneryr N ,ny Gpr<xy toast u. rypa a yrLeeJ 4eluw ur,.:gtMpeft. WARRANTY DEED STATE. RAR OF WISCONSIN WltrgAUA tie py~,a Ca.. yK PORM Nw. 1 - 1998 M,M.~e, Wk. Y~i, ! 19?PA~f X14 File No: es-04900 EXHIBIT "A" A parcel of land in the Northeast Quarter of the Northwest Quarter, iri the Northwest Quazter 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 minucQS 02 seconds Easc, 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 west, 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 thQ southerly right-oE-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 429.09 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 84 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 3302; thence South, along said west line, a distance of 703.32 feet to tho 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 QuaztQr 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 Quareer, a distance of 191.71 feet to the north line of Certified Survey Map in volume iS, Page 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, Page 4173, a distance of 1123.42 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 southezly extension, a distance of 591.64 feat; 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 OB degrQQS 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, Page 3128 and of Certified Survey Map in volume 12, Paye 3292, a distance of 687.86 feet to the northwest corner of Certified Survey Map in 5th'-Lk~-~1~G by ~ e 1 5 ~ r~wvM ~uKr - ~..~. ~.~.. ~ .~.." ~ ....~, vor: ~ 7.97P~r,E 615 Volume 12, Paqe 3292; thence North O1 degree 24 minutes 30 seconds East, along the northerly extension of the west line of Certified Survey Map fn Volume 12, Page 3292, a distance of 5.66 feet to the easterly extension of the north line of parcel recorded in Volume 1390, Paqe 163; then South 89 degrees 30 minutes 27 seconds west, along the easterly extension and the north line of parcel recorded in Volume 1390, Paqe 163 8nd the north line of Certified Survey Map in Volume 3, Paqe 776, a distance of 508.92 feat; thence North 00 degrees 07 minutes 56 seconds East a distance of 1003.47 feet; thence North 89 degrees 54 minutes 15 seconds west a distance of 270.16 feet to the west line of Certified Survey Map in Volume 5, Paqe 1317; thence South 00 degrees Z7 minutes 53 seconds East, along said west line, a distance of 193.97 feet; thence South 89 degrees 16 minutes 33 seconds west, a distance of 533.93 feet to the west line of the Northeast Quarter of the Southwest Quarter; thence North 00 degrees 36 minutes 14 seconds west, along said west line, a distance of 820.23 feet to the point of beginning. SEP-20-2002 09 ~ 21 51 tIWVH LUKt' ~o~ . 1 ?~7~~~t 6:I 6 Exhibit B to Warranty Deed dated December Z0, 2001 by and between Bane Corporation ("Grantor") and Sienna Corporation ("Grantee") 7JG oaJ r ew~o r . e~.., 1. Building and zoning laws, ordinances, State and Federal regulations; 2. Restrictions relating to the use or improvement of the premises without effective forfeiture provision; 3. Reservation of any minerals or mineral rights to the State of Wisconsin; 4. Utility, drainage and roadway easements which do not interfere with Buyer's proposed development of the property; 5. L-ncroachment of Qwest Communications, Inc. fiber optic cable along the northerly property line; 6. Agreement between Bane Corporation and John and Pearl Gies dated August 22, 1997 to exchange property following final determination of the location for Carmichael Road; and 7. Ameritech General Non-Exclusive >~sement Agreement by and between Bane Corporation and Wisconsin Bell Telephone Company a/k/a Ameritech Wisconsin dated December 10, 2001. TOTRL P.05 ,~.: ~,. ~.. ~_ . __.~~ ., ~ ~ ~ ~ SBL ~ ~ ~ ~ ~ __ L . '_ .. . _ -- J ~- 1 __ ~- __ 37 v: _ mss" 133.6 ~,~1'1M`N ~84~~5, II .~-_ PN~ - -- -- -=-- '" _ ~. ~ '~ ~ ~ ~ ' ~ 1 `- ~9' ~ s W; ~ ''. ~ ~® ~ 72 aa.66~ ~ ~ ~ ' ' - ~ ~ . 1 ~~~~~~ ` ~ i ~ ~ ~ ern, ~` `~ 1 1 ~ ~~ ~ ~° ~8 1 1 J ~. ~N+ (1.101 AC.) 1 N ~ t ~~ SBA . ~ i~. B ~ ~ SBA ~ ~ LOGi~ 9 ., ' ' ~~ SBA g9 i i ~~~~ ~ 43593 S.F, ~ 1 1 ~ ~ ~ --------------------------------- _- ~ ~ r ~ ti-- 124.2 ~~ `` 1:1 57~ 352.. .~ ... - ~.. --- 1 _. -~ __ _-,- Z ~~ 28.36 0 ~ : -- - oO ~ + ~ V _ ~~- ~f - w~OY r.. .r-~~ ~ ~ 13 ---------------- - '_ "_ ~- ~ C~ ~~~ ~ ~ ~~ ~ ~ u:~ ~~- ~ ~ ~ ~.