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HomeMy WebLinkAbout020-1450-04-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building [vision f 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 Glen Johnson Construction Hudson, Town of :ST BM Elev: Insp. BM,,gqE~~le~~v: BM Description: M /~ (_ Vv ~ ~ ~ l / C~J 1 TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic t ~ 3 ~.~ t ~~ ~ Q. ~ ~n- ~ a~ I / C~, V1-c.SC~ Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Z - l /~ J f ~~ / ~~ ~ / Dosing Aeration Holding - -_. PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Nu ~°•---_.._..~_.___ TDH Lift Friction Loss System Head TDH Ft Forcemai Length Dia. ~ Dist. to well SOII 4RSORPTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: 463451 0 State Plan ID No: Parcel Tax No: 020-1450-04-000 Section/Town/Range/Map No: 22.29.19.2874 STATION BS HI FS ELEV. Benchmark `' ~ I~ f r~ / / a ~ Alt. BM ~~esd" CoJ 3 ' Z 2 GI ~ • 3 Bldg. Sewer / p,/ / StiHt Inlet ~ • ~ ~~• 2 St/Ht Outlet ~~ • Dt Inlet Dt Bottom ~` -~. Header/Man. i Dist. Pipe ~s. 9Z . 7 Bot. System f~ _ 1 Final Gracde~ l ~ ~, St Cover ~~ • ~ Z ~ ~•~ //' / BEDITRENCH DIMENSIONS Width i ~ Length CZ No. Of Trenches ~ ~~~~ PIT DIMENSIONS ~~ No. Of Pits `~ Inside Dia. ~~ Liquid Depth ~~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER OR Manufacturer.~t ~ INFORMATION Type Of System: Cov,~~.~~o,~~ / ~ / -f~- J f1 N J-~'-- ~ n r( `~ UNIT Model Number. J 111STRIRIITION SYSTEM C ,.t~ I `7 e_a~4.. ~S i~~ Header/Manifold w Distribution V x Hole ize x Hole Spacing Vent to Airf~ntaken_ I Di ~ S i Length Dia pac ng a Length SOIL COVER Y Praceurra SvcYwme [lnly YY Mnund Or At-Grade $VStemS Only L''_"'~'' Depth Over ~ Depth Over xx Depth of xx Seeded/So d xx Mulched Bed/Trench Center ~ Bed/Trench Edges ~~ Topsoil ~~- Yes No ~ 'Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Location: 818 Germain Lame Hudson, 154016 (SE 1/4 SW 1/4 22 Tff 29N R19W) IH~udson Estates Lot 4 1.) Alt BM Description = ~~``~ J C~ C-1~~ ~. S >" ~ ~5 ~ ~ 2.) Bldg sewer length =rj -amount of cover = ~ Z ~ Plan revision Required? I J Yes No /f I ~~J /I~, Use other side for additional informati n. `~ ._ __../_ . v __ _ __- _. - -.. ~ P 9 Date Inse ct Si na Inspection #2:__/ / Parcel No: 22.29.19.2874 - -- Cert. No. SBD-6710 (R.3/97) O 4 Safety and Buildi i ri 2dl W. W~ington Ave., i,~~O~Si~~ Madison, WI 53707 - 7 Department of Commerce (t508) G~ Sanitary permit Applicatio G In accord with Comm 83.21, Wis. Adm. Code, personal information ou prt'~{ t~ ~ may be used for secondary purposes Privacy Lew, s15.04(1) ) I. Application Information -Please Print All Information - `~Kl,,x ~U ~ Proper Owner's Na me -~ ~e ,t,~' j ~ ~ / 3 County 5a Mary Permit, Number (to be filled in by Plan I.D..N/tunber N M ddress (if different than mailing address) I ~ Lot ~ Hlock ~ Property Owner's M ailing Address D 20 - /y5o -6~ - ooh . Z g Property Location r ~ iry, State Zi Code P j' / ~~ 'k,c7li.J'.4,S~tion _ ~j'~ I_ Phone Number L~ ~[J A /~ ~ ---. ~Es~ II. Type of Bulhlin g (check all that apply} (circle` gaoa / T ~ N; R~$ or UV / , i /~ or 2 Family Dwelling -Number of Bedrooms ~ ~k ~`'~ Pe-L- h ~ ~~-' P I a' '~- Subdivision Name ._, f ^ Public/Commercial -Describe Use / CSM Number / f } } ^ State Owned -Describe tise ~ ~ ~lG~v z'.A/ ~~ ~ I „l,,,I ! ; ~Ciry_^ViUage ^Township of ~ I ! ~ Type of Permit (Check only one boa on line A. Complete hne B if applicable} A. New S stem ~°'• Y ^ Replacement System ^ TrearmendHolding Tank Replacement Onl ^ O h ` y r er Modificapon to Exisung System ~ L B• ^ Permit Renewal ^ Permit Revision ~ ^ Change of B 1 List Previous Prrmi[ Number and Date issued I ' ^ Permit Transfer ro New efore Expiration Plumber , Owtter _ Iv T of POWTS S stem: (Check all that a 1 ) .Non -Pressurized In-Ground J Mound > 24 in. of suitable soil ^ Cotutructed W l d ^ ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Si ~ ogle Pass Sand Filter et an Pressurized Irt-Ground __{~-H~ng Tank ^ Rrcirctttating Synthetic Media Filt J ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter f e Leach Chamber ^ ri Li Gravel-less Pi ^ ther (e lain) V. llis rsaUTreatment Area Information: Desiygn~Flow (gpd) Design Soil Application Rate(gpdst) Dispers equired (sf) Dispersal Area Proposed (sq System evasion r VI. Tank Info Capacity in Total Numb r e Gallons Gal[am ( of Units N Manufacturer Prefab Site Steel Fiber plastic Concrete Conswcted Glass ew Existing ~ Tanks ~ Tatilcs Septic or Bolding Tank ~ ~ ---- ~ kerobic Treattnen[ Unit ~ ~~ ~ Dosing Chamber ~ ~`` ~ .. __ VIi, Responsibility Statement- I, the undersigned, ttsstune responsibility for allatlon of the POWTS shown on the attached plans. Plumber's Na me (Prinq Plumber's Si gnature P . PRS Number LJ~'~,~a~L ~~ Business Phone Number Plumber`s Addre ss (Street, City, State, Ztp Code) IlI Count tDe artment Use Onl Approved ^ D' Sanitary Permit Fee (includes Groundwater Da lssu Issui Agent Si a (No mps} i Surcharge Fes) ~ 3%%x'1 ~ ^ O for Denial I l.(J IX. Conditions of ApprovaUReasons for Disapproval --(~~~ (~ ,,,_ 8YSTEM 01AIAIER: 3~ I c7J ~ I hied ' I~'1,~5~' S O ,nR~ IiJ. Sepik: tank, eMuent filter and ~~ ~ ~,~~wt;szr ~ c~~ ~ ~~~ dispersal cell must all p ~:t~ ~ par management plan provided lay pittmpK, /~ V 2. AN sttllbadt rsrµdretnents moat be makttaittad { / Q(/1'lea.JNVt'_f - ~ PM appliC~bla t:odt / ordlttMteas, Q rj ~~~ Attach wmplete plans (to the County Duty? ror a rem on paper aot Jess then 81/Z l I ches io sise, (~ SBD-6398 tR. 01/03) SD; ~ ~~- o~~ Gov~~~ ~-c ~~ ~~. c C ..~ r.. r~nr. ln~i! Y,vq~,Nl~, rt'r;+..ii?:i,:t', t w,',c=+~flili{'ry_,: 7J f:: 9~:. ~E i~i'U%~: F'-='icy@ib 7~:.St7C- tidm~rl~ ~~ -,ag,+.,..*; ~si~; rr~4msL,. t,r.~~! °!r~ :sB p~nigirnem 9d I~~r~n x+nsmyrtupsa >rabd'-s~e tiEA ! sboa sldsaiMOs wal M ~~ :~~ ~~ ~ mom, ~~ ~y~ `r c'. o y ~~ ,,t l ..-- ~ ~°~ {}~ ~~/ s.~. ~', ~~~~ c ~~ `~-~ ~bJ V ~. ~: ~ O V 2 `\_i D _~~ ~ ,, ~ ~ U ~ J ~. ~- •~ _.~~ a yp ~s 2 ~~~,~ y~ r ~~ ~~ ~o~ ~~ J~ ~~ .~ ~~~ ~~ 4` ~~~~ ~-~ ~v f ~~b~ 1...~T- ~ ~. - l--~C-~r~,~ E-s-~-T~ . , `~oPEl~rrowNER. ~a>~o~,~.Lr SOfL AND SITE EVALUATION 1~ ~ 3 ~ a PARCEL I.D.# 'tom Sc6roiU REPORT MEMO Discontinuous silt inclusions were observed in B1 with redox features. The redox features in the silt are present because the smaller particle size of sift holds onto the water stranger than the surrounding sand, it even has a stronger hold than the force of gravity trying to pull the water down. The water that flows into the silt inclusion will not seep out until the silt inclusion is completely saturated and cannot hold any more, then the force of gravity can start to make the excess water start to flow. This is why redox features (mottles) are present in the inclusion. The outwash sand that the silt inclusion is deposited into showed no signs of seasonal saturation or high groundwater. ** INSTALLERS** When a ill inclusio (silt ball) is encountered, the chambers that are installed in the sift should not be counted. More chambers shout a added to the end of the trench in sand to make up for the lower gpd/sgft rate of the silt. This way the 0.7gpd/sgft rate of the sand can be used and the system is only a larged as needed. ~, ~1d~s ~eo-wt csT- IrT ~~ S ~ lt~ ,e.v\.c~~~ o-~ ~ ~.,_~- (ems i ~ `-~-~5 S u-b ~ ~~ -' S ~ , ~~ o~ ~ S -~ 1 a~.u ~< ~~ `S~ . o ~, 2do S . ~'~S ~S ~ r C ~~ S~ ~s7-~`~S =_ i ~ `~ ~°~ ~ ~'; Wisconsin Department of Commerce Division of Safeiy and Buildings SOIL EVALUATION REPORT in accordance with Comm 85, Wis. Adm. Code 1202 page 1 of 3 Tam Schmdt Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must include twt not limited to: v rti l nd h r¢ rtt l r f n i di ti t BM d Courtly St Crobc , e ca a o o a e ere ce po n rec on an ( ), percent sbpe, scale or dimemsbns, north arrow, and location and distance to nearest n~ad. Parcel I.D. oZv- /~So - oy-a Please print all information. Reviewed By Date Personal informatan you provide may ~ used for secondary purposes. (Privacy Law, s. 15.04 (1) (m)). 5 ~ d Property Ovvner ...._.,..., ..~ ~ r ,w,:,,.,,#, Property Location Grand Properties, LP Govt. Lot SE 1/4 SW 1kt S 2 T 29 N R 19 W Property Owner's Mailing Address ~ ~ ~ ~ ~ r `~~~ i Lot # Block # Subd. Name or CSM# 712 Rivard Streeet, Suite 300 4 Hudson Estates City S e Zi p Code< Rhone°~ tr J City J Vllage ,~ Town Nearest Road 7 ~ ,- Somerset ~ 54 !NG~~E7-5900 Hudson Badlands Road New Cor>struction Use: ~ Residerrtial /Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement J Public or commercial -Describe: Parent material Outwash Plain Flood plain elevation, if applicable na General r~rr-rr~rrts and recommendations: Area is suitable for a conventional system. Possible s em elevation for Area 1' is (high trench) 95.50' (low Boring # ~ Boring Pit Ground Surface elev. 99.05 ft. Depth to limiting factor 97+ in. Soil Application Rate Horizon Depth Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots GP D/fEz 'Eff#1 'Eff#2 1 0-8 10yr3/3 none I 2mgr mvfr ~ 2f .6 .8 2 8-17 10yr4/4 none I 2msbk mfr gw 1f .6 .8 3 17-31 10yr5/3 none I 2msbk mfr gw .6 .8 4 31-97 10yr5/6 none s Osg ml - .7 1.6 Boring # iJ Boring I Pit Ground Surface elev. 99.05 ft. pepth to limiting factor 96+ in• Soil Application Rate Horizon Depth Dominant Cobr Redox Descr~tbn Texture Structure Consistence Boundary Roots GP D/ft' 'Eff#1 *Eff#2 1 0-8 10yr3/3 none sl 2mgr mvfT as 1f .6 1.0 2 8-16 10yr4/4 none sl 2msbk mfr gw 1f .6 1.0 3 16-51 10yr5/4 none Is Osg ml gw .7 1.6 4 51-~ 10yr5/6 none s Osg ml - - .7 1.6 `Effluent #7 = BQD ~ 30 < 220 mg/L artd TSS >30 < 150 mg/L ' Effluent #2 = BODS< 3p rytg/L and TSS <~0 mg/L CST Name (Pk~se Print) Sgnature: CST Number Thomas J. Schmitt ~+-sa~+-sew ~~~~ 227429 Addr~ Tom Schmitt ' Date Evaluation Conducted Tet~hone Numjlpr I, 1595 72nd St., Never Rk:hmond, WI 54017 4/12/04 715-247-2941 .-~ Property Owner Grand Properties, lP Parcel ID # Page 2 of 3 Ong # ~ Boring fir!' Pit Grand Surface elev. 95.30 ft. Depth to limiting factor 98+ in. Soil Application Rate Horizon Depth Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots 'Eff#1 'Etf#2 1 0-8 10yr3/2 none I 2mgr mvfr as 1f .6 .8 2 8-19 10yr4/4 none sl 2msbk mfr gw 1f .6 1.0 3 19-98 10yr5/6 none s Osg ml - --- .7 1.6 goring # ' ~9 ~ Pit Ground Surrace elev. ft. Depth to limiting factor in. Soil Application Raie Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 'Eff#1 •Eff#2 ^ Boring # ~ Boring PR Ground Surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 'Eff#1 'Eff#2 * Effluent #1 = BOD ~ 30 < 220 mglL and TSS >30 < 150 mgA_ " Effluent #2 = BODS < 30 mg/L and TSS <30 mgJL 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 ai 608-266-3151 or TTY 608-264-8777. N l -^,.~ Conducted by: Schmitt Soil & Site Evaluations Thomas J. Schmitt, CST 227429 1595 72nd St. New Richmond, WI 54017 Phone: 715.247.2941 RFC -~ Dada Page 3 of 3 Conducted for: Name: Grand Properties, LP Address: 712 Rivard St. Suite 100 City, State, Zip: Somerset, WI 54025 Subd. Name Hudson Estates Lot No. y SE 1/4,,1../ 1/4, S: 22 , T 29 N, R 19 W Township oP Hudson BM El. 100.00' ~ a ~ ~" /~(~~ /~if/~~° Alternate BM El. 9~%ca.?' T j ` ~ ~? " ~~/G ~/~~ Slope ~_% Contour Line EL /Vii I Scale: 1" = 40' ~~ ~ Aa ~ ~~ ~`° ~~ i `~ / ~ ~ ~ ~~ ,' ~ ~ ~ / / c~ `~ ~ ~ ~~ ~ ~~ ~`~' ~ ~ ' / / / / ~ n~ a3° / 3`' ~ a ~o~ S~ ~~~~ ~~~ C M~,~ ~~ This soil repoa~t was done to fulfill a Zoning requirement. It may ~ may not be is a location that is suitable for your use. No permanent lot markers were in place when the test was conduced. A ~ I I. I Z6I~'`Jd S~'"IOA y~ I xz ~s3 [ 7.oz I ~ ~-.s sru,a aw, ~ ~ ~L~ strop a.-eu~os _ ,x•u. c Q .%C1R _. ~f0"GtL ~ ~ ~~,(~c t r ~~~ ~~~ ~ ~~ ~~ ~'•I ~~ V E~ .. e a ~~ ~ ~/ .. _ . .. i . ' ' . oral yo.~s ..-.. _.• y~~ ~,, alS~~ yam. • V QNQ ~~ c svua µtaaooN = ~0 ?~ sacsvz a~.vzaxn x,~arvr- ~.uarooc yY'LK ~~ ~~ a `~i i •~ .~` ~'~ r.KS~ .~ \~ ~~ v ~*e ~ dye T q; ~ ~`~. y ~~~ ~i, \ . o\ ~ ti#~ Y ~ b! .~. ~ my ~ b bt ~ ~ • ~ ~ . _~; y e ~ 4L ; ~~ o~ ~~ . J ------ ~.;: .~vx.~. z~rvNts I saHVZ a~.vzaHn ~ (~. ~ M ~ \~ 1 \ ~ ~ ~ ~ ~\ N ~~ I .i I r. ~,, ~~ ; ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Q~}6(~~8 ~~ Q~~ ~ ca oaQ ~~ 2 ~~~ der: ~ ~$ 9~ ~~ ~ ~ ~~~~~~2'~~~~~ ~~~~&~d{R~Y~~~Y~~~~ ~~~ ~-.toss°°H yX1t ~ ~ ~ ~ d ~ ~ ~ Z ~ ~ '~ ~ t 1 ~ ~t 1 gg ~`' l~tS~~~~~~~~~~~~g~~~~~~~~y~~~~~~~~~g ~. l~4i~~~5~3~~~~~~yx~~~~~~~x~~x~~~~~~~~~ 3 p ~t~~~~1~~ ~~ ~~ ~!~~~~~ ~~~~ ~aa~ z: t z '~'* w.mv~o-ruraaa~arr-ow 'a wou.oa~ ~o inn -n wn~•~uuow . Yu of ~w~oww3e i 2 w i ~z ~ ~~ ~ ~ i~ ~ ! I~ ~ ~ ~r ~~ ~d ~~ ~ ~ ~~ I~ I~R I c N ~~i ~~ na' ~ti' ~~~ #1 °~1 ~~ y' ~~ ~~ ~~ ~ ~~ ~~ IZ N ~ro °o ° I~ W I~ I~ m I r I ~ 0~ ~d ~~ ~ ~ s~o N89°48'23"E- 31.25' a v, A CO ~~~ h 889'44'41 "W ~9 223.20' '~ '• w \ ~ C)" ~s ~ 1+ • ~ e~. HWL = 903.10 1 N v ~ ti~ a ~I c ~ 0 / . 8 / 06 • LOT 4 ~~ ~ ~ 2.546 ACRES ~^ ~~. ~~ _ ' d • °~ 0 ~i~/ ~ 110,897 SQ. FT. L.B,O. = 905.10 HWL = 903.10 681.04' ~... ,~ 457.84' 0~0 LOT 3 2.100 ACRES 061 91,476 SQ. FT. ~ L.B.O. = 905.10 .~' ~ .. - .' O/~ .' ~ ~~ ~~ ~ ~ L .~ '•/ \ r~ 1 I ~: LOT ~ . 2.003 ACR • 87,243 SQ. ~ ' w . . ? w •. . ao ~ N. ' N G ••• ~` 240.6! N i~ ~ N ~ „ ~f ~ Nes'2g'a ~.- ~-~ ,r3 j ?. ~ . ~ ~o ? ~3w • 11 6 077 0 . u 0~ o / N ` `"~ _ ~~ LOT 5 C DRAINAGE 2. 4 ACRES I EASEMENT 'D' 87,278 SQ. FT. L.B.O. = 905.50 ~o 321.71' . S84'25'16"W BENCHMARK: TOP OF IRON PIPE=915.4 ~, . O~ ~ / _-~. _ .~~. 4'' C::~ VENT PIPE ~I2" MfN'. ABOti'E GR,AAE S wEATHERPROQf ~ 25' FROM DQOR, WxNDOW OR JUNG?1'CN BOX APPRt7VE FRESH AZR INTAKE ~ G'YTH CONDUST MANHOLE CC•~'ER FINISHED GRADE WARI~IhG4LABEL 4" CI RISER ~ { ~tp :• i~ NLET ~ ~, ~, 1' WATER TIGHT SEALS GAS• ~~ '.~'°' ':IGI~~" ~ PROVED ~ SEAL s JOINTS WiTF+ PPROVfO --~-- ~ ALM APPROVED PIPE IPE 3` e ' ' ON 3' oNTa pro so~ta -~- ' so~.to sari i ~ ~ ~ ~~~` Pl1MP OFP ELEV . ..~ T ~ ' -F- OFF ~ #* RISER EX,fi D ~ PERMITTED CNL~ IF TANK MANUFACTURiR }ug pppROVAL 8" APPROVED. BEDDING UNDER TANK CQNCREI'E FAD SPECIFICATIONS jE~T~C i DaSE '"AN K MANU ~' AC TU R ER : ~~~...,.,~, ?1tJ M 6 ER L 0 S E S PER DAY o ,_,_,_ aANK SIZE SEPTIC GAL. ~ DOSE VO;~'ME IN'CLUDII3G DOSE , ,~,,,, ,~ G~,~D ,~ GAL . ~ F LOWRAC K s ~,,.~.r.,,, GAL . ~I.,ARM MANUFACTURER: ~"~"~`~ ~~,~~„~ CAPACITYES ~ A = „~„ INCHES ~ ~,,~~ ~a= MODEL i~tUMBER : SWI;CIi TYFE~ s~ ~. v ~a~r~-~. 8 s _,_? ryAL. ~ INC1~iE5 r .,~, v ?LIMA MANUFACTURER d ou+/ _ C = ~ ~ p INCHES = ~,(;~.fL--GAL. ~""""' MODEL N'JNB~ : SWITCH 'TYPE ~ .r.~ r~,tr~ „ D ~ INCHES = w ....,.GAL . ~EQtiIREO DISCHARGE RATE ~~ GPM PUMP S A ARM wIRxNG AS PER ILHR 16.23 wAC 'i'£RTICAL DIFFERENCE BETWEEN PUMP GFF ANC ~ tSTR19vTIaN PxPE ~.,~~,,,.~ FFIT ~- MINZML'M NE7"WORK S UPPLY PRESSURE ~ ,~, ~ FEET ,~ FEET FORC EMAIN x .r3:~i2~ x' +~ 4 ~ ~ . FRICTION FACTOR ~, "' . r EST ' TO TAL DYNAMIC HEAD EiT = ~,~„~ ~~ifiERNAL DT•MENSZO~iS AF PUMP TANK: LENGTH ; WIDTH ; DIAIr:ETER LIQUID PTA" ~~,~rrv~,, ti r G NEr; : L~~!~----~J~~~~i'~ - L i C ENSD NUMBER : ?,F ~ ? ~ ~~ , , DA"" E : -,~~."~7 -.- r~ ~GOULDS PUMPS APPLICATI®NS Specifically designed for the following uses: • EfNuent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering 5PECIFICATIONS • Solids handling capability; • Capacities: up to 60 GPM. • Total heads: up to 31 feel. • Discharge size: l'/:" NPT, • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA•N elastomers. • Temperature: 1 oa°F f40°C) continuous t40°F (609C} intermittent. • Fastener: 300 series stainless steel. • Capable of running dry without damage to components, Motor. • EP04 Single phase: 0.4 HP, 115 ar 230 V, 60 Hz, 1554 RPM, buih in overload with automatit reset. • EPt15 Singgle phase: i?.5 WP, 11 S V, 60 Hz, S 550 RPM, buih in overload with automatic reset. • Power cord: i0 toot standard length, 16/3 S1TOW with three prong grounding plug. Optional 20 foot length, tb/3 SITW with three prong grounding plug (standard on EPOS), 4 X000 Goulds Pumps Effective February. 2000 83871 • Fully wbmerged in high grade turbine ail for lubrication and efficient heat transfer. Available for automatic and manual operation, Auto• matk models include Mechanical Float Sauifcll assen~ied a+td pre~t at the factory. FEATURES ^ EP04 lmpelirr: Thermopias- tic Serr~1-open design with pump oui vanes for mechanical seal protection. Submersible Effluent Pump 3H7 ~ EP05 ~ >fP05 Impeller: Thermoplas- tic enclosed design for improved performance. ~ Casipg qnd ~: Rugged thermoplastk design provides superbt strength and corrosion resistance. ^ Mptot Hausfnq; Cast iron for efficient heat transfer, strength, end durability. • Motor Cover; Thermoplastic cover with integral handle and tioai switch attachment points. Power table: Severe duty rated o3 and water resistant. METER5 FEET . , ;., ._ . .. SU ' 1 i. ,._.. _ _ . _ _ .: ti a s v 6 5 ~ a 3 2 1 0 GPM O ~ 4 6 6 1 O t 2 m~/h CAPACITY f Hearings: Upper and Tower heavy duty ball bearing construction. AGENCY LISTING ~,' Canadlrn 5t+nderds Associotbn (CSA listed rnodei numbers end in "F" or "C".) Goulds lumps ~ ISO 9001 itagiacred. Goulds Pumps !TT Industr-ies .~ ~~~ :~ u~ick4~ STANDARD CHAlL1BER Quick4 Standard Chamber SIDE VIEW MultiPort End Cap FRONT VIEW r ;'y: . QuiCl Size(WxlxH) - 34X52^x12" ,-: Etfectlve length 48" Invert Height g:r INFILTS~.~QR SYSTEMS -I T RD ~UI!T~p WARR NTY Wl The :An.X~h,»al ntpgnty of each charniier. end nfate, wedge and ether a:a assvry manulaemn~ try I, liltr ~tor t Un4s'6 wlwn installer; and orleralad 9 IGrlrlielrl 01 'ih onsitD sr?phc syslern ;n aa-cUrdafca w+M ;nfl`ItratOr'S insl•rr.rgns rs werrar>!ad to rho i gira nurchesar PNUd[•') egairrsi tblectiva nruierals and workmanship for orre year iron the dale IMy Nre septic re it s is4rW for the septic sysem uvdaut,ny Itar UrriSS~, mvvrcraa, howa.•ar, that -f a septic p8n11it is not re4liratl by aAP4rabie law, the warrarttY period wilt tX~irr upP thx; darn prat slaNetion W t1>e sekNin sYS?Erli :ArMterlca5. Tc exsnise its wananty ngnts, Hv,der must nWiry IntipraMr in writing at ris vnprxale Hsadiv:aners in r]vl SayMuOa, Crxrnxtica wrnlrl Irhe6n (15} nay Pf Ula aueged detect Infiltratpt wdl ?C48'cIY rzNlacpmera Un@s for llnd, determined try ~nfiitrata w tra cwcr~t by tars ~ rmired WarrarNy. Inr 1t al x s Iiabrlily 9peoillcDlN excludes the rost d remGVal and/or in8tallation or the Units, ib nN' UMITEU WARRANTY ANC) REMEDIES Na SLit3pgtLh ,RAI+H cr) nEC XCV.i°IVF 7iu. RF nriE NOOtHEre WARnA+vT1E3 Wln RESPECT rt rRE UNIT`;, INCI UDn, NU IMPVED WnRp,ANlIES O~ MERCHAN7n91LITl C+F; FlThf .: ri;r; A FnR7rGUlAR PlN1PO;;E. ;r:l 1 r 1 imAotl Wa eery hall u~ w,rd i1 arry part of the chambw- sYSluni s - anvla:.tcueu py xyurw; other than InXN nlOr [he ~, imnwl war!anty does I'~Gt Ici.d Id inc dental un~.:c(uen(ial, spec'al or r~d~rect Ramagas, InfiNrato shall not Ce Irabq ttx per altin cx li0uidated damage, :rwk.dirm bas of prvdu^tron and U oGis, latex artl .materials, twarnaa; rests, cx Other losses a +ixPenses 'awurrad q• tM; Hurler or arty Inirci ,;af1Y afrecifialfy e;rt,tr,ded from Eimitad WanarNy covcvage are damage tv the Units due fo rxclinary wna~ ann tear, alteration, aceitlenl, misuse, aA.se w rregk~C;t of Ihp Vnlta~. Iho Un is being aub;ocied to vehicle Ireflic or Other condil'gns vhKn are wl VarmNlnd ny the instaBatton in5tmctiUr4; failure in maintain Aw m'•nimu:h gr~cgd covers se; tank m the irkstallallon instructieTts; the placement n} improper materials into the systa~r. containing the Unds; IaJure of lhr Units a the septic system due to impmpar siting or improper aliing excessive water usage. unpropp grease drspcisal, or improper nteration; a any Otnsr event not caused by IMiitratOr. This l.Nrrited WananlY shall be void it rite Hofder Nils !o ix~mply wish al! Of Iho terms set tddh ut ttus lsrtitad warranty fiuther, N rro want SYral! aNtarDlOr b0 reslxr,ibla to any bw^ or damage to tM 1i,ydaq ll,o Units, or arrv tntrrf Pony rasu,ting can irutarabon or shlP~ man(, or lrpm FxN product NadlrtY c;alnla GI Hr~lOar N any aNrd cedY Far This i ircufud Warrant'V fo appy, the LMi(s moat be irlStallW in acCOrdarl0e won all site epnCllfgnS reQlN[Bd I,7y slate arXt local Cd(bs; all OIhRY a(~rrwble ImvS, rmd Infrltratur5 N154dUetron ilstrt:c§On3- (dl NO rnpfasnnlallvD W kUrl[ralo, has the erNlx+nly q champ cx e"IOnd Ihls LnrAG) Warranty. No warranty aPP4e5 b sny padY whet the: r the nr"jr- ~a~. ra~dcr. Tho aixna rePrese+tts I!tH Siatdard t,in':i;e+f Warranty crlfrxoo by MNNrabr. A iirrri'ed nornlrer of stales and cow eras Iraw7 ditlerorv wartantY ranuire- mcrLLe, a,y purU:asnr Of UrNts snrwld cUr4at,'i lntill:ator's CorpO;ale Headquxlers in Old Saybrook, Cgnnecnuul, prgr to such Iwrcnase, lU obtain a OUPY at ih0 appilCabie warUnly, and SFUUId cN8tlNly read Nyat warranty p4Ur t0 the ptE:fiase Uf Vni1S. ,r~~ __~ -~1 r~,. ~ ._~--I-_.L- ++ SIDE VIEW TOA VIEW ::.'Size (W z l.'x ~~ .,:. , . ~. • , • r 34° X 16' x 12" Invert Height 8" or 1.25" . ~ SYSTEMS I N C ~ Emfronmentai Onsite Wastewater Solatioas`" 63usiness Park Road • P.O. Box 768 Old Saybrook, CT 06475 860-577-7000 • FAX 860-577-7001 8Q0-221-4436 U S. Patents: 4,759,661; 5,0'7,041; 5,156,488; 5,336,Ot7, 5,401,116; 5,407,459; 5,511.903; 5,716,163; 5,588.778; 5,83:+,844 Canadian Patents: 1,323,959: 2,004,564 OtFter patents pending. Infiltrator, Lqualizer ano Sidewinder are registered trademarks of Infiltrator Systems iru: inlntrator Is a registered trademark m France. Intihraic~r Sysietns Inc. is a regls[ereA trademark in Mexico, Contour, GOrtIOw Swivel fonnection, MicrOLaacYlitxi. POly7utt. G;apLOCk, ChamberSpaoer, PparLUCk. (~urckCut, OrtickPlay Alb[YCLEAPAPEA and i)trck4 are trademarks of IntiiVata Systems h1c;, to 2GO3 infilbator SVSlerns Inc arinted in V S.A. .. ............ .... _ .,....,,~.rv vrcvv ~ ~~~ 12oz Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt Attach complete site plan on paper not less than 8% x 11 inches in s¢e Plan must County . include, but not limited to: vertical and horizontal reference point (BM) direction and St Croix , percent slope, scale or dimensions, north anow, and bcation and distance to nearest road . Parcel I.D. Please rint all infonna6on p . Personal infom~ion You provide maybe used for secondary W~ (~acY I-aW. s. 15.0411) (m)). Reviewed By Date Property Owner Property Location Grand Pro rties, LP Govt. Lot SE 1/4 SW 1kt S 22 T 29 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 712 Rivard Streeet, Suite 300 4 Hudson Estates CttY State Zip Code Phone Number J City J vliage / Town Nearest Road Somerset ~ WI 54025 715-247-5900 Hudson Badlands Road J New Construction ~~~ /_J Residential / Number of bedrooms 3 Cade derived design flow rate 450 GPD J Replacement J Public or commercial -Describe: Parent material Outwash Plain Flood plain elevation, it applicable na General comments and recommendations: Area is suitable for a conventional system. Possible system elevation for Area 1' is (high trench) 95.50' (low trench)94.0') Q - ~ G ,~ ~~~ 1 ~ f ~~ # ~ Borng 1/ Pit Ground Surface elev. 99.05 ft. Depth to limiting factor 97+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Bourxlary Roots /ft' •Eff#1 1 0-8 10yr3/3 none I 2mgr mvfr as 2f .6 .8 2 8-17 10yr4/4 none I 2msbk mfr gw 1 f .6 .8 3 17-31 10yr5/3 none I 2msbk mfr gw - .6 .8 4 31-97 10yr5/6 none s Osg ml - _ .7 1.6 goring # J Boring N Pit Ground surface elev. 99.05 ft. pepth to limiting factor 96+ in. Sod Application Rate Honzon Depth Dominant Color Redox Description Texture Structure Consistence Bourxfary Roots 'Etf#1 'Eff#2 1 0-8 lthrt3/3 none sl 2mgr mvfr as 1f .6 1.0 2 8-16 10yr4/4 none sl 2msbk mfr gw 1f .6 1.0 3 16-51 10yr5/4 none Is Osg ml gw - 7 16 4 51-96 10yr5/6 none s Osg ml ---- -~ ,7 1,6 - tmuern rfi = tsvu ~ 30 < ~0 ~ and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mglL and TSS <~30 mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt `~~tmc~ ~,/,~~..,-/ 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Nurnp~r 1595 72nd St., New Richmond, WI 54017 4/12/04 715-247-2941 Property Owner Grand Properties, LP Parcel ID # Page 2 of 3 3 goring # J Boring Pit Ground Surface elev. 95.30 ft. Depth to limiting factor 9$+ in. Sal Application Rate Horizon Depth Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots 'Eff#1 •Eff#2 1 0-8 10yr32 none I 2mgr mvfr as 1f :6 .8 2 8-19 10yr4/4 none sl 2msbk mfr gw 1f .6 1.0 3 19-98 10yr5l6 none s Osg ml - - .7 ~ .6 ~~ # J ~~ J Pit Ground Surface elev. ft. Deptfi to Limiting factor in. Sal Application Rate Horizon Depth Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots 'Eff#1 •Eff#2 Baring # J Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth l~rninant Cobr Redox Description Texture Structure Consistence Boundary Roots •Eff#1 •Eff#2 • Effluent #1 = BOD > 30 < 220 m and TSS >30 < 150 g/L and TSS <~0 mg/L s - ~ _ ~ • Effluent #2 = BODS < 30 m 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. ,_ Conducted by: Schmitt Soil & Site Evaluations Thomas J. Schmitt, CST 227429 1595 72nd St. New Richmond, WI 54017 Phone: 715.247.2941 1L,.,.,..~1 BM El. 100.00'_ Alternate BM El. I Scale: 1" = 40' Page 3 of 3 Conducted for: Name: Grand Properties, LP Address: 712 Rivard St. Suite 100- -- City, State, Zip: Somerset, WI 54025 Subd. Name Hudson Estates Lot No. y S~`' 1/4,~ 1/4, S: 22 , T 29 N, R 19 W Township of Hudson Slope = ~% Contour Line El. ~~ ~ ~a i ~`~ ~ ~ P° ~ ~ / ~ ~~ ~~ /~~J~d o,. ~ , 'i/-~ R~~ S~ ~~~ ~~~ ~ r CG ,,,,w, e~ This soil report was done to fulfill a Zoning requirement. It may or may not be in a location that is suitable for your use. No permanent lot mazkers were in place when the test was conducted. ST CROIX COUNTY SEP'T'!C 'TANK MAINTENANCE AGREEMENT AND 0`rVNIrRSHIP CERTIFICATION FORM OwnerBuyer J,%/~:° ~ ~C.~ ~~s,,~ Mailing Address ,,~U ,~if~~~ ~~~~~~`~~f /~ 6 Propery Address .~ (Verification required tram Punning Department for new construction) City!State Parce, Identification Number 6 Zp - i~lSd - ~ ~ _ o~ LESAL DES -RIPTION Property Location v~ ~/,, ~Gr/ ~/,, Sec. ~r2 , T~„N-R~W, Town of ~/~~'"~.~ Subdivision ~~~'d~cl ~~ r'' .~ ,Lot # ~,_. P/~-- Certitiy Map # 7738(a I ,Volume /a ,Page # ZS Warranty Deed # __~~4/C~ ,Volume _ ~~~~ ,Page r~ ~ Spec house J yes~no .Lot lines identifiable'yes ~ no SYSTEM MAINTFNANCE Improper use and maintenanccof your septtc system could result in its premature failure to handle wastes. Proper matntenancc consists of pumping out the septic tank every three years or sooner, if needed tsy a licensed pumper. What you put into the system can affect the function of the septic tank as ~~ trcatntent stage in the waste disposal system, The property o+vner agrees to rubrtit to St. Croix Zoning Department a cenifcation form, signed by the owner and b: a masterplumber, journeyman plumber, restrctcci plumhcror a licer!sedpumper ver,tying that (f) the on•site wastewaterdisposa! sys~e'r is in proper operating condition, and/or t2} after inspection and pumping (if necessary), the septic tank is less than l/3 ful! of sluegc Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standares set forth, herein, es set by the Department of C'ammerce and the Department of Natural Resources, State of Wisconsin. Certtficat~er. statini; tha ur sc a system s been mau,~;~;ncii must be cnmplcted and returned In the St. C:rotx County Zoning Office wtth~r^, ~C days of nee car xp,rat n data SIGNATURE 0 PLICANT ~ / DATE OWNER CERTIFICATION l (we) ce tha II statements un tius form arc tn,c to the best of my (our) knowledge. the pro desc ibe ab c, by virt,ie of a ~~arranty deed recorded in Register of Deeds Office, SIGNATURE 0 PALlCANT _ 1 (we) am {arc} the owncris) of ~..~.~~ DATE """ Any information that is mts-rcprescnicd may result in the sanitary permit being revoked by t1x Zoning Department. •'••" '• Include with this application: a stan:peti warranty deed from the Register of Deeds office a'copy of rile ccrtilied survey map if reference is made in the warranty deed r FILE INFORMATION II Ow~._~ Permit # DESIQN PARAMETERS Number of Bedrooms 3 ^ NA Number of Public Facility Units ^ NA Estimated flow (average) ~f S`O al/day Design flow (peak), (Estimated x 1.5} ,~'~ al/da Soil Application Rate allday/ft~ Standard influent/Effluent Quality Monthly average ` Fats, Oil & Grease (FOG! 530 mg/L Biochemical Oxygen Demand tBODs) 5220 mg/L ^ NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent fJ.uality Monthly average Biochemical Oxygen Demand (BODE) 530 mg/L Total Suspended Solids (TSS) S30 mglL ^ NA Fecal Coliform (geometric mean) S10` cfu/100m1 Maximum Effluent Particle Size Ys in die. ^ NA Other ^ NA wValues typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE POWTS OWNER'S MANUAL & MANAGEMENT PLAN -- 11 SYSTEM SPECIFICATIONS Page _~ or Septic Tank Capacity Q'©(} al ^ NA Septic Tank Manufacturer ~re~-~ ^ NA Effluent Filter Manufacturer 6 ~ O NA Effluent Fiiter Model ~ Q'© ^ NA Pump Tank Capacity Q al DNA Pump Tank Manufacturer shy ^ NA Pump Manufacturer ~aA ~ ^ NA Pump Model ^ NA Pretreatment Unit ^ Sand/Gravel Filter ^ Mechanical Aeration ^ Disinfection ^ Peat Filter ^ Wetland ^ Other: ^ NA Dispersal Cells} ^ In-Ground {gravity) D At-Grade ^ [)rip-Line ^ NA ^ !n-Ground (pressurized) ^ Mound ^ Other: Other: ^ NA Other: ^ NA Other: ^ NA Service Event Service frequency Inspect condition of tankfs} At least once every: month{s) (Maximum 3 years) ear{s) ^ NA Pump out contents of tankfs) When combined sludge and scum equals one-third iY31 of tank volume ^ NA Inspect dispersal cell{s} At least once every: ~ ~y~llls) {Maximum 3 years) ^ NA - month{s} ^ NA Clean effluent fitter At least once every: ear{s) • ^ month{a) ^ NA p p, pump controls & alarm Inspect um At least once every: •- ^ year{s1 ^ month{s) ^ NA Flush laterals and pressure test At least once every: r-- ^ year(s) Other: At least once every: ^ month(s) ^ earls? ^ 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 tankfs) 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 cellls) shat! be visually inspected to check tho effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of affluent 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 {Y31 or more of the tank volume, the entire contents of the tank shah 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 Fomponents, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. 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Aew wee.lis aaiennaisenn ayi wad Butnnollod ayi do uotieutwt)a io uotionpea •ea~e uotidJOSge ltos epe16-ie ~o punow Aue do adols umop lead g I utyi!nn ease ayi 'ioedwoo ~o ganistp asinniayio .~o 'ieno died ao an!ip iou og •speo les~adstp pue s~luei iano se)atyen ~{ied io an!ip iou oQ •~{uei dwnd ayi ulyllnn sienel lewaou eaoisa~ of slo~3uoa dwnd ayi Burieaedo ~llenuew ut islsse of iaweiuleW gl/~/~pd Jo ~agwnld a ioeiuoa io dwnd luani;da ayi o1 ~annod Buuoisa~ of ~ol~d ~oie~ad0 Bwotn~eg aBeideg a Aq penawe~ ~luei dwnd ayi do siuaiuoa ayi aney uolienits styi Atone of 'wenl;da do eBaeyastp aae}~ns ao dn~loeq ayi u! linsai Aeua pue is)llao ayi Butpeol~ena 'asap aBiel auo u! is)peo lesiads!p ayi of paBaeyos!p aq ptnn jelenneisenn sseoxa ayi paioisai st aannod uByM •sienel aeiennyBty lewiou anoge ptd Aew s~luei dwnd saBelno iannod Buuno •aoe;ins enlieillidu! ayi le uazold vie suai!puoo )tos ueynn mono iou pegs do leis weisAg •esn of ~otld ~oie~edo Butotn~es eBeides a Aq panowa~ 1s}~uel ayi do siueiuoo ayi aney peioaiep see suoiiaiiueouoa yBly ;I •ts)Ilao les~edslp ayi aeewep ~o/pue sseooad iuauneaai ayi apedwt Aew ie4i sleolweyo ~eyio ao sionpa~d Butiuled ;o eouesald ayi god lsl~luei iuawiea~i ~laayo S1MOd ayi do esn of iohd 'uotion~isuoa nneu god NOiltla3d0 ONV dll .l.>;IV1S ;o aged U 2768P y2y ~` 79111 ~. p State Bar of Wisconsin Form 2-2003 KATHLEEN H. MALSH REGISTER OF DEEDS WARRANTY DEED ST. GROIX G0. , MI REGEIVED FOR RECORD Document Number Document Name 03/22/2005 09:30A11 MARRAIITY DEED EXEMPT ?I THIS DEED, made between Grand Properties. LP ("Grantor," whether one or more), REG FEE: 11.00 and G{en Johnson Construction. Inc. TRANS FEE: 599.40 CO ("Grantee," whether one or more). PY FEE: CC FEE PAGES: 1 Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant " Recording Area ) (if more space is interests, in St. Croix County, State of Wisconsin ("Property needed, please attach addendum): Name and Retum Address Lots 4 and 18, Plat of Hudson Estates in the Town of Hudson, St. Croix County, ~j~~ Wisconsin. `'~ Part of: 020-1059-00-000: 020-1059-10-000 020-1058-90-000:020-t058-BO-000 Parcel Identification Number (PIN) This is oot homestead property. (is) (is not) Exceptions to wa~rantie/s: Eaysements, restrictions and rights-of--way of record, if any. Dated d ~/ ~ ' 1 /d~ Grand Properties, LP (SEAL) (SE * * chael J. G rtnain (SEAL) (SEAL) * AUTHENTICATION Signature(s) Grand Properties, LP B :Michael J. Germain authenticated on ~ ~ / c *Kristina Ogland I TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: ACKNOWLEDGMENT STATE OF ) ss. COUNTY ) Personally came before me on the above-named to me known to be the person(s) who executed the instrument and acknowledged the same. foregoing Attorney Kristine Oeland Notary Public, State of Hudson. WI 54016 My Cotnmission (is permanent) (expires: ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: TH[S IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ®2003 STATE BAR OF WISCONSIN FORM N0.2-200:. * Type name below signatures. INFO-PROT'" Legal Forms 800-855-2021 www.in(opro(orms.com ~~ ' ~:~; ~- ' ~ State Bar of Wisconsin Form 2-2003 ~;~;; ._ WARRANTY DEED ~ ..1 . o Document Number Document Name THIS DEED, made between Grand Proeerties. LP i ("Grantor," whether one or more), and Glen Johnson Construction. Inc. ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croiz County, State of Wisconsin ("Property") (if more space is 4' needed, please attach addendum): Lots 4 and 18, Plat of Hudson Estates in the Town of Hudson, St. Croix County, Wisconsin. ~,; '; __ Recording Area. Name and Return Address I< Exceptions to warranties: Easements, restrictions and rights-of--way otrecord, if any. F."; €.- Dated ~ ~/ I '1 /d`~ Grand Properties, LP ~,. - -- - (SEAL) ~Yt.~~~a~/- ~ s •IVKchael J. Germain Part of: 020.1059-011-000; 020.[039-10-000 020-[038-90-000.020-1038-60.000 Parcel identification Numbs (PM) This is not homestead property. (is) (is not) (SEAL) (SEAL) # s AUTHENTICATION -': Signature(s) Grand Properties. LP • M ha I er ain '~' authenticated on ~w *K ina O land -~y TITLE: MEMBER STATE BAR OF WISCONSIN ~''~ (If not, authorized by Wis: Stat. § 706.06) ACKNOWLEDGMENT STATE OF ss. COUNTY ) Personally came before me on the above-named to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. ~,. ' THIS INSTRUMENT DRAF'T'ED BY: ,:~ ,~ k, Attorney Kristine Ogland Notary Public, State of Hudson. WI 54016 My Commission (is permanent) (expires; l { (Signatures may be autheaticated or ackaowledeed. Botb are not necessary.) ~b' NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. ~ ` WARRANI•Y DEED O 2003 STATE BAR OF WISCONSIN FORM NO. Z"200x' '.' • Type name below signatures. INFO-PRRp' Legal Fomu ti00.855.2021 www.lnioproforma.com ~',' ks ~._ t Parcel #: 020-1450-04-000 05/09/2005 08:35 AM PAGE 1 OF 1 Alt. Parcel #: 22.29.19.2874 020 -TOWN OF HUDSON Current ' X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 09/09/2004 00 0 Tax Address: Owner(s): ' =Current Owner "GRAND PROPERTIES LP GRAND PROPERTIES LP 712 RIVARD ST STE 300 SOMERSET WI 54025 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description ' 818 GERMAIN WAY SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.546 Plat: 10/25-HUDSON ESTATES 020/04 LOTS 1/18 SEC 22 T29N R19W PT SE SW BEING HUDSON Block/Condo Bldg: LOT 04 S ' E TATES ( 04) LOT 4 (2.546AC) Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 22-29N-19W SE SW Notes: Parcel History: Date Doc # Vol/Page Type 09/09/2004 773861 10/25 PLAT 9A(1~ CI IMMARV Bill #: Fair Market Value: Assessed with: 0 Valuations: Description Class Totals for 2005: General Property Woodland Last Changed: 03/07/2005 Acres Land Improve Total State Reason 0.000 0 0 0 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