Loading...
HomeMy WebLinkAbout020-1062-10-025Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Bu+!ding DivisiUn 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 Holder's Name: City Village X Township McPhilli s Holdin s, LLC Hudson, Town of CST BM Elev: Insp. BM Elev: BM Description: 1 t. ~ ~c~~~,MR~~ ~ 2 L S T TANK INFORMATION TYPE MANUFACTURER rtn CAPACITY Septic '' ff T7V ~~G v } ~ Z 4O0 Dosing -, i' Aernfiai 1AI t kf' 6 c't ~o ~'~.(.. ~ 3 + n Holding F~Fw~ ~- 3 •00 3 TANK SETBACK INFORMA710N TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic 31 ` 'q ~ ~ Z l ` ~ 2 M Dosing r-. ~ ~• ^' DNS K~ 2~ ~ l~+` f2~ ~~ Holding PUMP/SIPHON INFORMATION Manufacturer Demand PM Model N tuber TDH L Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to well RC)II ~RSnRPTInN SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit PJo: 514871 0 State Plan ID No: Parcel Tax No: 020-1062-10-025 Section/Town/Range/Map No: 23.29.19.235A 10 STATION BS HI FS ELEV. 1 nc~mark K ~, y ~~Y. y ,~.~p 4~ T~ ~~~ AI.BM ~UCr l,~tr(/' 2,~ (B (,S Bldg. Sewer ~« ~~ SUHt Inlet ~~ ~ i .~. yY SUHt outlet 7,3~' ~7 D?, Dt Inlet ~, Dt Bottom ~=- ~--- Header/Man. ?. '7 ~ 4, ~ S(' Dist. Pipe ?.'7 4 ` .6 r Bot. System 0.~ 7~~, ~• Final Grade '~, I,l.3 i StCo~gr !t/ u+t! ~.A i lt~ ~o bra t3U~. S~ z~y '~6,?2 DnR ,~~k ;h 4't 6 7 7, ~C,d Y l ~v ~vi`~~/ StlrtC ~ / `~.l ~ ~ 7. ~~ BED/TRENCH Widt . L N . Of Trenches PIT DIMENSIONS No. Of Pits Inside Liquid Dep DIMENSIONS ~ ~~ ~ ; i ~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: ~;`k y INFORMATION CHAMBER OR Type Of System: ~ ~ n ~Il.-~n ~ ~~ ~ ~ 1 ~'~U~ ~ UNIT Model Number: r11STRIR11T1C)N SYSTEM /t-~P~ Header Id Distribution x Hole Size x Hole Spacing Pipe(s) '"' ^-G i i `' S ^-. r---- ~ ~ ~ s~ An ~ Length Dia pac ng Length D a Snll CnVER v Prnec~~rn Ave4nme Anly YY Mnund Or At-Grade Systems Onlv +~h L~~ Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ~-__ Bed/Trench Edges ~_ Topsoil ~- I~ Yes '. No ~ Yes >„ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Location: 700 Norflex Drive Hudson, WI 54016 (NW 1/4 NW 1/4 23 T29N R19W) NA Lot 6 Ci v'k 1.) Alt BM Description = fi I~ // ~ ~ )5 , ~S~T~~ 2.) Bldg sewer length = YD t f/ d~~t St-vtr - amount of cover =~/~ 2 " ~ o y~+ Plan revision Required? ~'] Yes No ~ 6 ~ ~ B a Use other side for additional information. Date SBD-6710 (R.3/97) Inspection #2: / / ~arcel No: 23.29.19.235A 10 ~0 4ks ~ c~aiAS 0 e~ Vent to Airlntake Gn ~ c,! / Cert. No. commerce.wi.gov Safety and Buildings Division County ~ ~ ~ 201 W. Washington Ave., P.O. Box 7162 , / i sco n s i n Madison, WI 7-7 2 Sanitary Permit Number (to be filled in by Co.) Department of ComMerce 5/ 8 Sanitary Permit Application ---~...,,,~„ Number Spate Tiansach~ ~ / %~ ~ ~ Wis. Adm. Code, submission of this form to the appropriate govemmen In accordance with s. Comm. 83.21(2) / ,~7 , unit is requved prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are Personal information you provide may be used for seco artme~rt of Commerce submitted to the De Projectdress (if different than mailing address 7~ p . ses in accordance with the Privac Law, s. 15.04 1 m ,Slats. 1 ~ ~ - I. A lication Information - Please Pri All Information _ l~ ~ ~~ l. ~ ~ `~- Property s Na y t~ ~f ~, j„~, /~ ~ Parcel # ~~ ooa ~ ~ , ~ ~ ago ~ i ~ - f - dz Property Owner's ding Addre Properly Location ~ e // (E/ ~ ~/ `~ ~~ ~ / f%/(J~L T. CROIX COUNTY ` Govt. Lot l " 2 3J /7 ~` ~ J\ City, State Zip Code Phone r ~ y, ~h(,J y,, Section .~`~.~ //// ~~.`.~l'.~ ~'~ ~~t~~jv ~t~".~~^~'"~~~~~ T~N. R ~~circlEon~ ~/ II. Type of Building (check all that apply) Lot ^ 1 or 2 Family Dwelling -Number of Bedrooms Subdivision Name Block # r - C ~l ~ (w~ ~'ublic/Commercial -Describe Use ~ ~ /C(' J ^ City of _ e Owned -Describe Use CSM Number ^ Sta t ^ Village of _ own of i~.st'YI ( ~ ~~ W _ III. Type of Permit: (Check only one boz on line A. Complete tine B if applicable) `~' New S stem y -.----„ ^ R lacement S stem ep y ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System (expaai ) B• ^ Permit Renewal ^ Permit Revision ^ Change of Plumber ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner ~~' ~~.dv IV. a of POWTS S tem/Com onent/Device: Check all that a 1 t Q~Non-Pressurized Infiiround ^Pressurized In-Ground ^ At-Grade ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable so' ^ Holding Tank ^ Other Dispersal Component (explain) ^ Pretreatment Device (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application t) Dispersal Area Required (s Dispersal Area Proposed (s System Elevation VI. Tank Info Capacity in Gallons Total Gallons # of Units Manufacturer ~ ~ ~ '° ~ New Tanks Existing Tanks r-• ~ ~~~ ~ ~ ~ U ~ ~ ~ ~ ~ VIL Responsibility Statement- I, the undersigned, assn rcsponsib' ' nstallation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' gnature MP/MPRS Number Business Phone Number TODD L . SIlVZ ~,~r, ~ ~:~ 139462 715-?35-2644 Plumber's Address (Street, City, State, Zip Code) ES609 708" AVE MENOMONIE, WI 54751 VIII. ona /De artment Use Onl proved oved Permit Fee Date Iss Issuing ent Signature $ ~~ ~ ~Q ` J ~ DU iven R r Denial IX. Condifiq s ~~ffA[~ ro~a~easons for Disapproval ' /~. ; ,~ ~~ ~~ ~,.~„ e~('G. : ~. pQ(~~ S~STEM p81INER: ,~ G~O~b~•~a+lb 1. Septic tank, effluent finer and e~~,,, ~~ ~~~, ~,( dispersal cetl must ail be services /maintained ~`_ Y 1 ~„~,~ J ~.,.~ / as per management plan provided by plumber. ~\ F ~~~~ ~~ ~ ,~,_ Pl~.tScc ~ F ~ i i A t ~ ntained J ll se back requ rements must be ma 2. Attach to complete plans for the system sad sabmit~~to//the Coaoty only on/n~pape~.r not Mss~thlan 8 1/2 11 inches ' sin ~ ~~ Sa ~ (~ "~ } ~ ~pp'.22-2008::.10,+04° PN- ~~'HEIDT ~, o ~ ~$ z _.~ ~ ~` ~~: ` 158327525 =~ _ °~ ~ ~ ~~~ ~~ a~ ~ _ ~ ~: _ a ~~.Q . - ~ ?~ ,~- r ooh ~- ~" ~ ~ ~ ~'~ '~ ~~- ~ I` ~ J LL 3 Q a- ~~ 2 ~ (_ ~~ ~~ ~~ ~~ ~ ~, ~ C~ ~~ Q '"3" ~ ..p `v~~ 3 3 ~ (~ ~ Z \` ~- ~ ~ °~ ~1 O~ Q. ~~ ~' ~~~~ ~` ~~¢a ~- ? 4~+~ O O .:~ P, 5 r~ _~ -~ a -~ ~ .J ~ ~~ ~ ~ ~ ~ ~n ~~' ~ ~ n ro ~b v ~~ ~~ °~ .~ 1 ~ ~ ~" Q~ ~ ~ - h a '~ ~- ~ ~ ~ .a "' a ~ cc) ~~ ~~ r- N d ~~ ~ o ~L a ~l S' ~~ ~~~~ sA~ s~ ~ Q~COPY 3 ~~ '~,~~ tiy;O~R 22-2008..1Os04,+~N~ ,NEIDT s) R67V~ ,',' ~, a ~ ~, ~ ~~ € ~~ a .~ ~ ~.~ ~z ~ ~ `~~. o ~~, a ~ ?~ d ~ ~ ~:, ~ 4 0' nom... 4~ 2 ~ (~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Z \~' C3 ~, -~ ~~. 0 ~ O `~ ` ~ 3 ~' 3 o ~ Z ,1 q `- 17158327525 ~, J `~ ~~~ J.~ O ~" r ~'~ ' ~~ ~~ ~~`~~~ io ,..Y V) ~~' ~ ~ a-- ~b u M 8p c ~ Q ~~ ~J ~~ ,~ e~~~ ,~ ~. a ~. r 4~~. ~`~ 0 0 =~ 0 4 4~ ^~ !' ~~ J ~, d M` 6~" ' o _a ~ M i~ N d ~.O ~ ~ 0 ~gg~ ~~~~ ~.. P. 5 ,~ ^~ _a ~~ ~ ~ -~ ~~ 3~ commerce.wi.gov isconsin Department of Commerce Safety and Buildings 3824 N CREEKSIDE LA HOLMEN WI 54636 TDD #: (608) 264-8777 www. commerce.wi. gov/sb/ www.wisconsin.gov Jim Doyle, Governor Jack L. Fischer, A.I.A., Secretary May 07, 2008 CUST 1D No. 139462 TODD L SINZ T L SINZ PLUMBING INC E5609 708TH AVE MENOMONIE WI 54751-5520 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/07/2010 Identification Numbers Transaction ID No. 1534635 SITE: Site ID No. 737114 Mc Phillips Larson Please refer to both identification numbers, Norflex Drive above, in alT corres ondence with the a enc Town of Hudson St Croix County NWl/4, NWl/4, 523, T29N, R19W Lot: 6, Subdivision: CSM Volume 10 Pg 2778 FOR: Description: Non-pressurized In-Ground /Commercial (Office /Shop Employees) Object Type: POWTS Component Manual Regulated Object ID No.: 1181511 Maintenance required; 194 GPD Flow rate; 90 in Soil minimum depth to limiting factor fnm original grade; System: In-ground POWTS Component Manual, SBD-10705-P (N.O1/O1); Commercial System, Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the. state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation aid prior to occupancy or use: Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manuals listed above. • The leaching chambers must be installed in accordance with the manufacturer's printed instructions, the plan approval and Comm 83, Wis. Adm. Code system sizing criteria. If there is a conflict between the manufacturer's instructions and the plan approval, the plan approval and code requirements will take precedence. • The plumbing for this project discharges to a private sewage system. The approval covers only domestic/sanitary wastes directed into this system. The Department of Natural Resources must be contacted regarding the treatment and disposal of all industrial wastes. Conn ~~ DEp/-~~, g E COR • State and federal regulations prohibit the discharge of hazardous wastes to a private sewage system. Accidental discharge of any hazardous substance to a private sewage system must be reported to the Department of Natural Resources or the Wisconsin Division of Emergency Government • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet fr~ the absorption area. chs. NR 811 & 812e TODD L SINZ Page 2 5/7/2008 • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the POWTS installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions ofSec. 145.20(2)(d), Wis. Stat • Comm 83.22(7) A copy of the approved plans specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department which may include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be madeto me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday charles.bratz@wisconsin. gov Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 VJiSMART code: 7633 cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544 ,Friday, 7:00 A.M. To 3:30 P.M. '~`~'~EIVED ~~~~ ~ s 2008 Stirs ~ ~ ~ uu+~t~INGS Construction Materials & Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manual: In-ground Absorption (v. 2.0) -SBD -10705- P Location: NWl/4 NWl/4 S23 T29N R19W Lot 6 Norflex Drive Town: OF HUDSON County: ST CROIX Date: 5-2-08 Owner: McPhillips Larson Address: 1615 Livingstone Rd Hudson Wi 54016 Plumber: Todd Sint ~~ Signature: ~~. License # MP 139462 Attachments: 6748 Plan Approval Application SBD-8330 ~~~ a~dly ~ Page 1: Cover ~ 2: Design criteria and sizing ~ cot~~sr~r,~ iLtioNGS 3: Plot plan 4: Plan view/system cross section _t~~N~t~z~ 5: Maintenance Page 1 of 5 .~, ~:. ~ ~• ~~eoss ~~r ~ o n S ., ~~~J oQr~ ~ v~~- I ~j J ~ ~L~ ~ -!-`1 ~-! if ~r+-~~ 5 j___ 02 p / SYs; t~ ~F~ ~N€ sc~ow,~ o ~ ~ q 5~b ~~%~l g~cK F~ l I ~ 8 ~~- s -~ a, ~ Io•L ~ a., ~ o Dbs~rv~T„h wEU.S ~~~ ~f" pvC. Se~vicE ~P~ System Management 00 q ' „." ~ Management of this system is critical. As a condition of approval of these plans this system management section • must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, T. L. S ii1Z Plumbing, 715-235-2644, or the $T c/'oi~ Zoning Office should be contacted at'l iS- 31T6-5~b~efor their assistance. General Proper functioning of an on-site disposal system, "septic system," is significantly dependent on the volume of ~~ atcr which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lo~~ er tl~c level of contaminants, the better and longer the system will function, Typical system components include a septic tank o~ compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small paruc~e, of the same density as water, a pump tank or compartment to allow a dose to be accumulated, a pump and controls, tti~d finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public hea!t!: 1. If the septic tank is installed prior to sheet-rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria, Z Install water-saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly. 5. No paper products other than tissue should go into the system, 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. ~, Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10, If septic or pump tanks arc no longer used, they must be properly abandoned. 11. !f construction timing and weather could create a frozen infiltration system, weather-proofing with plastic sheetin; and heavy mulching may be required to maintain a functional system at start-up. Maintenance I . The septic tank must be inspected every three years by a properly licensed person. 2, [f necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the ..combined scum and solids volume equals one third of the tank volume. 3. Periodic observation pipe inspections should be made by the owner to examine the state of the in-situ soil adsorption cell. Quarterly inspections are recommended, and a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 4. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications.. . . 5, Avoid compaction such as vehicle traffic within 1 S' down-slope of the adsorption system. 6, Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of tl~e system. 7. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 8. Surface drainage must be diverted around the system; avoid landscape changes which might send surface rttti-off iitt~ the system area. 9. Warnings Do not enter septic, pump or other treatment tanks; death may result because they may contain lethal cases o~ insufficient oxygen.' Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for non-high strength wastewatet~ ~~ systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall, be done in accot~d with the requirerttents of Comm 83.54 (2). Pumping and hauling of wastewater maybe necessary while analysis and repairs are implemented, Additional testing, designing, and/or installation of additional treatment components or conversion to a holding tank maybe necessary. Page S of 5 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page ~ of Division of Safety and Buildings - in accordance with C f~;,lr s 's. C de ty S~-, C ~ ` ~ ,'attach complete site plan on paper not less than 1~1~~~ include, but not limited to: vertical and horizontal rel~F'~nce point (BM), direction and arcel I.D percent slope, scale or dimensions, north arrow, and location and distance o Please print all i p.-.-- ~(~ Revie by Dat R personal information you provide may be used for sec ary ~~~~Y~ s t s~ t~1 tm1) ~ /~ D " property Owner Prop rty Location p ~ ~i !~~ S ~a--~`5 MAY .12 2008 Govt t.ot /1/I.J 1/4MJ 1/4 S 3'T ~• / N R l Q Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1 ST. CROIX COUNT ~ ~~ ~ /DI J~ G-p ~ a,~;~ ID Z-I ~ I N ~°~~ FICE V City State Zip Code P ^ City,,l Village '~ Town Nearest Road f~u~5or~ QU a ~~~ cc aF~ ~~ Z ~ 9~ ~'' New Construction Use: ^ Residential / Number of bedrooms ~ Code derived design flow rate GPD ^ Replacement ~ ublic or commercial -Describe: --,-r ~ t..7 ~ -{- (,,..\~ G._.J~v^^-- Blood Plain e:ev~tion i; app;icable , V q. Parent material ~ / General comments N.n,e~ C'~.~ Qw .~,Q y~,~5 3~ u~Z ` r ~ ~ an~0 0~ (~trD~lJ 0~ ~.as9 ~.Q `~( / ,I U Boring Baring # ~_ ~' pit Ground surface elev. ~r ft. Depth to limiting factor rn• Soil ligtion Rate t T Structure Consistence Boundary Roots GP D/ft? Horizon Depth in; Dominant Color Munsell Redox Description Qu. Sz. Cont. Color ure ex Gr. Sz. Sh. ~ 'Eff#~ ~~~ ~ a-/~I ~~3/c ~~-~~ s -~ b ~...~- ~.s . o- o-n ~''~ 3 ~-,3 /a`i I'L. ~ S ~ s wr`.~ 5 ~ o- ~ - ~ S ~r~'~ ~ ~~2 ~~ s ~ ~ ~S °- ~ ~, ^ Boring i. ~ D ! ~ GTl1 (/ II r ` j V V y ~ Pit Ground surface elev. I q' "~ r. L'ep;h 4o irrn;t+ng r:c:or ~ - rr'• Soil ligtion Rate i ti D Texture Structure Consistence Boundary Roots GP Dfft= Horizon ' Depth in. Dominant Color Munsell escr p on Redox Qu. Sz. Cont. Color Gr. Sz. Sh. ~+ 'Eff#1 'Effiy2 z t, ~ 5 ~ , s 1 ~.-s -~~ J a-~ r '6 ~ S o~c w ~~-9a X15 ~ `~ ~~ 2 ~ rl ~ S 5 ~ ,,,,,,.~ ~ - - .~- v D, f a~ ,t 1~6 ' Effluent #1 =GODS > 30 < ~Q mg/l_ and I ss >su ~ I JU mglL ~~ ~~~~ ~~ ~~ - """s = -- ••~~~- -• •- • -- -- CST Name (Please Print) Si na ~ ~ G}~~~e~ Will Heidt Z t es ng 8NIC9 to Ev anon Conducted Telephone~b~~ Address W 3503 Hemlock Rd. ~ 02~ ~Oa ~ ~.3Z (7f 5) 83~-0020 Property Owner Parcef ID # . ` Page ~'` of Z a Boring # ~ Boring 1 ~3 ft. Depth to limiting factor 9V in. Ground surface elev n Rate ti il li . ca o So pit Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDHF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~{ a -'7 3 ~ ~ ~ o- -~ c`s I nl -o r s l ~s b ~- p-1 to `~~ ~ ~ ~A CI ~ ~ J .rte [~' ~ (~ g-~ ~ 1 5 - ~ ~I -6 ~~~ "b 7 ~Y t.L . ~ 5 ~ ~ ~ d 7 ~-~ - ~ / ~J ~ r• tt 1R . LJ Boring ~~ ' Boring # ^ Pit Ground surface elev. ft. Depth to limiting factor )n• Soil lication Rate l i t C D Redox Description Texture Structure Consistence Boundary Roots GPD/fF Horizon Depth in. or nan o om Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 U Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ^ Pit Soil lication Rate n ti ri d D Texture Structure Consistence Boundary Roots GP DlfP Horizon Depth in. Dominant Color Munsell p o esc Re ox Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 'Effluent #1 =GODS > 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 need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. °' ~~} 560.6370 (R.07/00) Property Owner ' Page ~ of 2 ,~j Boring # ~ 8°ring (,~' Pit Ground surface elev. 1 ~3 ft. Depth to limiting fador 9V in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIfF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 D-l lo'(~ ~ ~ n1 -o r s 1 ~s 6 ~-~-- c`s 3~ cr ~{ a-~7 3 0~ 2' 0 ~ o a~.v~ f ~s tM..~- S I D - ~ ~ 1~~- ~{ S ~.~ .5 - 4'~ (r ~ ' ~ u ~ _ ~ ~ ,. - .,f , - ^ Boring # ^ Boring '~ ~ ^ Pit Ground surface elev. ft. Depth to limiting fador in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. °Eff#1 'Eff#2 ^ Boring Boring # Ground surface elev. ft. Depth to limiting fador in. ^ Pit Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P D/ff' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 'Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mglL 'Effluent #2 ~= BODS < 30 mg/L and• TSS < 30 mg/L The Department of Comrnercc 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. .~ Parcel ID # sao-s»o tR.o~roo1 a ~~ ad ~~ c i ~~ ~ a ~N`~~ ~~ 1 1 NM ~4 pQ\G~Na~ 0 d J ,~ 0. ~~ ~ o w ~ ~ ~ ~~ ~ ~ ~` ~- c.~,~ t ~ oQ Z a1 g ~s~~ ~~ ~- N `~ N ~ ~` y' ~ OL ~- - _, o ~ ~ _, ao ~~ _ ~~ ~ M ~ ~~ r N d 0 ~~ ~~ G ~a ~~ ~ ~ z ~~ U' ~ ~ U ~ O ~ ~~~ ~m~ 4 ~ (~~ ,~,, 2 ._ tMV m Np 000 ~ ~ i JJ _~~,~; ~ ~ 7591 09 N1 ~ \ ~o~n~o L'~~ U ~ dOd ° pC~o ~4~~0 ~~ N ~, ~ ~pN~ 3/4" REBAR FOUND t - ° ' " ' ~~ ~-- N70 31 05 W 9.82 FR~ ---- ~ -'" SET 1' IRON PIPE ~ ~ ° ' ° N00°05'26" - E 670.31' 500 05 26 W I ~ ` ~ . 148.96' II ` 1371.20' 299.11' - N89°27'4T"IIIWi ~' o~v, 198.00'` ~~ ' Zlm = ~ N00°05'26"E' ~~ `~~` mlm ~ D d 149.05' ~ N~~ ~ cn m e, N89°26'19"W~l 117' ' i ~ o O 208.24' ~~~ ~=-~;~ ~ ~ ~ y 1 ~ ~ I ~ '~ II I ~ z 1 \ ~ ~m z 186.65' 1 ~ ~ ~' ~ /~' Z c~~ y ~ m`a-' I O ~ °~z C I~ ~ oz c ?oZ C (~~,~=o~~ ~ ~"'O m ~' zC+Zm cntn~ ~~2 -o~ p rn~~ ~ I~ ?m m~ D ~~ II~~O Nm -r~ -1 II a m Z o ~ -'1 I~-s6' -< CNp ~ o°w ~ ~_ oOZ fl1 D zoo a Z ~m~ m o~z ~ ~ ~ °' m ~ m ~ O m Z 0 N O ~~~~_ pOOXZ ~~Dn~ oX~~~ ~~~ o -• ~ ao co °wW~G~pp'orn JJ10N0 ~ W ~ W N (n N W m O O 1 1 O O ~O ~ A O o G,I w Z T`', o / Z ~~~~ ,,,40~ ~I m m ~ ~ O ~ .~ 1-~ a ~~~ D ~ ~ ~ -~ D ~- (~0 O N ~ m m T1 m ~ w w D 1cwi+ °o ~ m O N W \ \~ P \ lO I~ G~ 1 \O~ /' ~ ~~ \o`O ~~ ~ ~ I~ ~ i ~Do ~M-`, ~ i ~ tO 9~ i 2 T \ ~~ ~ o O ~O ~d \; ?. O z ao r ~ r Cp cn oco~Z -tm DrU' DAD=_~~ n Z ~ N~ Z a vmi ~ Zvo~o.~c...{{ ~ m ~~-`~N ago ~ ~^' v n ~ rim 7C D (~ Z D ~ ~ -v ~ ~ a ~~ ~~ \ ~ i I \~,i i ~ ;~ I ~i~ ~I W i ~~ I I ~p I I A I~ I ~` z c~ 06 ~~`` pzs 5~~n ~ ~ \ ~~ O NOS m~ ~ ~ ~ ~ O ~~ N q ~~ ~m~~ a ~' m2 ~N 0 •® 0 O O OAO C C HOC Z Z ZXZ ~ ~ ~ ~ '~ ~Cr ~ ~ ZZ~ Z m ~~c ~ ~ Zm~ VOL 18 PAGE 4728 RATAL~EA H. REGISTER OF DEEDS ST. CROIX CO. MI RECEIVED FOR ~tECORD 04/12/2804 09:45AM IFIED SURVEY MAP FEE: 15.80 _FEEs x.80 ~i C~ril~ ------- - ~°~m0 ~ I~ i0_ G~Z~~ WEST LINE OF THE ~ \ m~ p N Z p \\~ \ N SECTION/23OF I~ ~Q 1 p 0 N Z ~' Z ~~~ ~ ~ ~__ , o m~~o ~~ ~ \~\ ~ °~ j~ I ~ o Z ~ m \ r = ~ o m ~ _ \ \\q I ~p I° <cg~' -~ ~ ` O ~` ~ \I` v w ~ O 2 ~ C!1 ~a ~l O m ~`- \O~h~~ 1p I A c~i = Z `{'~ ~ \~\ \ I fn~,OII z O~ m 5~ti ~N~ ~`\~ \ n (~I Ip a,n~,~ ~y ~ y2 ~~~~~ \ \MiJ I~IQ o = ~~ ~~ ~ 4~0 ~~~~~ ~ \\~~~° ICI can Z ~~ J O ~ ^ 1 CC~~ m~~ O `/ r ~ _ Z EAST LINE OF THE ~ ~, ~j ~ ~ rt=1 v NW1/4-NW1/4 ~a ~ ~ I(L5~ = n1 y C~~cn N \o_--- rn~~ i ..~' ` ~` O I ~f ~ p O \o \O 00 Ni rN~ \ O =~ w \` o ';~~ ~ MiJ \b ~~J N 1" i G~ \\~ z l rn \~ \ m i~iJ ~ ~ ml \ 0 \ \\ m r N\ O ~~ . ~ ~\ b CERTIFIED SURVEY MAP LOCATED IN PART OF THE NE 114 OF THE NE1 /4 OF SECTION 22, !N PART OF THE SE1/4 OF THE SWl /4 OF SECTION 14, IN PART OF THE NW1 /4 OF THE NW 1 /4 AND PART OF THE NEt/4 OF THE NW1J4 OF SECTION 23, ALL IN T29N, R19W, TOWN OF HUDSON, ST. CROIX COUNTY, WISCONSIN BEING LOT 2 OF CERTIFIED SURVEY MAP, PREPARED FOR: VOLUME 10, PAGE 2778 DETAIL BOB ANDERSON NOT TO SCALE 720 NORFLEX DRIVE HUDSON, WI 54016 SURVEYOR: I I ~ I ~ ~ .... HIGHWAY _ ~ oCc ~ SETBACK ~•°~ LINE ~'' .*-~ ~ 6.21'x__ ~ r `- S87°40'04"W' _ r 59.41' C ~ ~ ~ Iv0:7 JO CJ-VV LUd.Z4'/~~ ~~7~ ~ -- ~-CENTERLINE 9.36'`' ~ WiS. D.O.T. N0.55.12.3756.2003 N D.O.T. NOTES PER TRANS 233 ACCESS RESTRICTION NOTE: All lots and blocks are hereby restricted so that no owner, possessor, user, licensee, or other person may have any right of direct vehicular ingress from or egress to any highway lying within the right-of-way of U.S.H. N12'; it is expressly intended that this restriction constitute a restriction for the benefit of the public as provided in s.236.293, Stats., and shall be enforceable by the department of its assigns. Any access shall be allowed only by special exception. Any access allowed by special exception shall be confirmed and granted only through the driveway permitting process and all permits are revocable. HIGHWAY SETBACK LINE NOTE: The Highway Setback Line (per Trans 233) shall be 50 feet from the highway right-of-way, or 110 feet from the highway center line, whichever is the greater distance. No improvements or structures are allowed between the right-of-way and the highway setback line. Improvements include, but are not limited to signs, parking lots, parallel driveways, wells, septic systems, drainage facilities, etc., it being expressly intended that this restriction shall constitute a restriction for the benefit of the public according to section 236.293, Wisconsin Statutes and shall be enforceable by the Department of Transportation. Contact the Wisconsin Department of Transportation District Office for more information. The phone number may be obtained by contacting your County Highway Department. NOISE NOTE: The lots of this land division may experience noise at levels exceeding levels in s. Trans 405.04, Table 1. These levels are based on federal standards. The Department of Transportation is not responsible for abating noise from existing state trunk highways or connecting highways, in the absence of any increase by the department to the highway's through-lane capacity. VISION CORNER NOTE: No structure or improvement of any kind is permitted within the vision corner. No vegetation within the vision corner may exceed 30 inches in height. CURVE DATA TABLE (ALL LENGTHS ARE IN FEET) S & N LAND SURVEYING, INC. 2920 ENLOE STREET HUDSON, WI 54016 CERTIFIED SURVEY MAP LOCATED IN PART OF THE NE1 /4 OF THE NE1 /4 OF SECTION 22, IN PART OF THE SE7/4 OF THE SW1/4 OF SECTION 74, IN PART OF THE NW7/4 OF THE NW1/4 AND PART OF THE NEl/4 OF THE NW1/4 OF SECTION 23, ALL IN T29N, R19W, TOWN OF HUDSON, ST. CRO1X COUNTY, WISCONSIN 8E1NG LOT 2 OF CERTIFIED SURVEY MAP, PREPARED FOR: VOLUME 10, PAGE 2778 BOB ANDERSON 720 NORFLEX DRNE HUDSON, WI 54016 SURVEYOR: S & N tAND SURVEYING, INC. 2920 ENLOE STREET HUDSON, WI 54016 SURVEYOR'S CERTIFICATE 1, Thomas M. Heaiy, Registered Wisconsin Land Surveyor, hereby certify: That 1 have surveyed, divided and mapped that part of the Northeast Quarter of the Northeast Quarter of Section 22, part of the Southeast Quarter of the Southwest Quarter of Section 14, and part of the Northwest Quarter of the Northwest Quarter and the Northeast Quarter of the Northwest Quarter of Section 23, all in Township 29 North, Range 19 West, Town of Hudson, St. Croix County, Wisconsin, described as follows: Beginning at the north quarter corner of said Section 23; thence South 00 degrees 08 minutes 23 seconds West along the east line of the Northeast Quarter of the Northwest Quarter of said Section 23, a distance of 144.24 feet; thence North 89 degrees 14 minutes 51 seconds West, a distance of 57.88 feet; thence westerly, a distance of 197.47 feet, along a tangential curve, concave to the south, having a radius of 540.00 feet, a central angle of 20 degrees 57 minutes 08 seconds, a chord bearing of South 80 degrees 16 minutes 35 seconds West, and a chard distance of 196.37 feet; thence South 69 degrees 48 minutes 01 seconds West, a distance of 1946.10 feet; thence southwesterly, a distance of 331.66 feet, along a tangential curve, concave to the southeast, having a radius of 272.75 feet, a central angle of 69 degrees 40 minutes 19 seconds, a chord bearing of South 34 degrees 57 minutes 51.5 seconds West, and a chord distance of 311.61 feet; thence South 00 degrees 07minutes 42 seconds West, to the south line of the northwest quarter of the northwest quarter of said Section 23, a distance of 186.65 feet; thence North 89 degrees 26 minutes 19 seconds West, along said south line, a distance of 208.24 feet; thence North 00 degrees 05 minutes 26 seconds East, leaving said south line, a distance of 149.05 feet; thence North 89 degrees 27 minutes 47 seconds West, a distance of 198.00 feet, to its intersection with the west line of the northwest quarter of the northwest quarter of said Section 23; thence South 00 degrees 05 minutes 26 seconds West, a distance of 148.96 feet, along said west line to its intersection with said south line; thence South 89 degrees 32 minutes 58 seconds West, a distance of 59.36 feet, to its intersection with the east line of Lot 1 of that certain Certified Survey Map recorded in Volume 9, Page 2490, on file in the Register of Deeds Office, St. Croix County, Wisconsin; thence North 00 degrees 05 minutes 26 seconds East, a distance of 670.31 feet, to its intersection with the south right-of-way line of the Chicago & Northwestern Railroad; thence northeasterly, a distance of 94.15 feet, along a tangential curve, concave to the northwest, having a radius of 5779.65 feet, a central angle of 00 degrees 56 minutes 00 seconds, a chord bearing of North 70 degrees 16 minutes 01 seconds East, and a chord distance of 94.15 feet; thence North 69 degrees 48 minutes 01 seconds East, along said right-of-way line, a distance of 2805.72 feet, to its intersection with the east line of the southeast quarter of the southwest quarter of said Section 14; thence South 00 degrees 00 minutes 47 seconds West, along last said east line, a distance of 383.77 feet to the point of beginning. Containing 31.91 acres, more or less. Subject to roadway easements over that part taken by US Highway 12 and LaBarge Road and all other easements and restrictions of record, if any. That I have made such survey by the direction of Bob Anderson, owner of said land. That such is a correct representation of all of the exterior boundaries of the land surveyed and the subdivision thereof made. That I have fully complied with the provisions of Chapter 236.34 of the Wisconsin Statutes and the subdivision regulations of the Town of Hudson and St, Croix County, in surveying, dividing , and mapping the same. ~ _~~, GQi~ ST. ~CROIX COUNT'Y' SEPTIC TAN'I~C. MAINTENANCE AGREEMENT AND OWNERSHrP CERTIFICATION FORM V OwnerBuyer ~ ~/ ~ ~ /~-S .~ _ ,/~ Mailing Address l ~ l~ ~ j ~1' //`~ 5'/ D/I /,r /~. C) %-~ c:.~ _... Property Address ~OO /~~c~~YL~ ~ ,~J~'I (Vorification required from Planning & Zoning Department for new consuruction.) City/State ~(/DSdjy ~ l//~ LEGAL DESCRIPTION parcel Identification Number dv~~ ' /O(Ov~~- _/O- f~a S Property Location ~ 1/4 , IVd~1 ~l4 ,Sec. ~.~ , T ~ 9 N R~ Town of Subdivision, ~, Certified Survey 1VIap # ~~ q ~ OqT ~..~ ~-~ , volume , J , I ~ ld Warranty Deed # g7~ ~~' 7 ,Volume , P Spec house yes ~~. Lot lines identifiable yes no SYSTEM NIAINTEI~TANCE AND OWNER CERTIFYCATION I.ot # # ~7~ ~? 7 Improper use and maintenance of your septic systcm could result in its premature. failure to handle w es. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pump .What, you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner intenance responsibilities are specified in §Comm. 83.52(1) and ui Chapter 12 - Sr. Croix County Sanitary Ordinance. The property ownor agrees to submit to St. Croix County Planning & Zoning Department a cer4ificario form, signed by the owner and by a master plumber, journeyman plumber, rostricted pluxnbcr or a licensed pumper verifying that (X the on-site wastewater disposal systcm is in proper oparatiug condition and/or (2) after inspection and pumping (if necessa ), the septic tank is less than l/3 full of sludge. I/we, the undersigllcd have read the above requirertients and agree to maintain the private sewage disp sal system with the standards set forttl,,, herein, as set by the DepattmonC of Commerce and the Department of Natural Resources, St to of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Cro x County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my/our knowledge. I/eve atn/are the property described above, by viriuc of a warranty deed recorded in Register of Deeds Office. Number of bedrooms SYGrNATURE 0~' APPLY .ANT(S) '~"*Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the ce reference is made in the warranty deed. (REV. 08/05) ~t~f-r-~1 IVIC ~ it.c.(~s ~ CoS/ - ~O~ - a 7~7 r(s) of the S/ ~ /~ 1~ATL g Department. *** survey trap if b0 /80 ~9dd JNISWfI~d ZNIS ~ 1 Z6SZ5EZSTL 9b~80 800Z/60/50 State Bar of Wisconsin Form 1-2003 Document Number WARRAI~TTY DEED THIS DEED, made between Anderson Holdings, Inc. ("Grantor", whether one or more), and McPhillips Holdings, LLC ("Grantee", whether one or more). Grantor, for a valuable consideration conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in Saint Croix County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): See Attached "Ezhibit A" for legal Description nderso Ho dings, c. L _ Robert A. Anderson RETURN TO: McPhillips Holdings, LLC 1615 Livingstone Rd. Hudson, WI 54016 Tax Parcel No. 020-1062-10-025 This is not homestead property. Together with all and singular the hereditaments and appurtenances thereunto belonging; and Robert A. Anderson warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except: Easements, encumbrances and encroachments of record, and all exclusions or exceptions from coverage, if any, as set forth in the title insurance policy issued to Grantee as a part of this transaction, if such a policy was issued. Dated `'t - ~ ~ , 2008 Seller Seller - AUTHENTICATION Signature(s) Authenticated on TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: Schrader Law Office, Tonv R. Schrader (715)232-7770 ACKNOWLEDGMENT STATE OF WISCONSIN Saint Croix COUNTY REC FEE: 13.00 TRANS FEE: 720.00 PAGES: 2 ss. Personally came before me on ~ 10 f l' I ~ , 2008, the above named Robert A. Anderson to me known to be the person(s) who executed the foregoing instrument and acknoaacle~lsed the.sa~~e. Notary Public, State ~f Wisconsin My commission (is-pmt) (expires: ~'Z~ `~~~ (Signatures may be authenticated or acknowledged. Both are not necessary.) 13 WARRANTY DEEDE: THIS IS A STANDARD FORM.3~ TE BAR OFTWISCONSIlV S FORM SHOULD I~I~ ~~~^ ERS * Type name below signatures. NOTw ~ ~V~IG~~~'7~ STATE OF WISCONSfI~ File No.: 08-04370-ATSH Page )L of 1< Illll 11111 IIIII IIIII IIIII IIIII IIII 111111 IIII IIII * 8 7 3QQ 0 ((4~'~ //~~7 2 V~~V`1'~ KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 04/18/2008 11:30AM WARRANTY DEED EXEMPT # EXHIBIT "A" LEGAL DESCRIPTION -Case Number: OS-04370-ATSH Lot Six (6) of Certified Survey Map recorded in Volume 18 of Certified Survey Maps, Page 4728 as Document #759109, being a part of Lot Two (2) of Certified Survey Map recorded in Volume 10 of CSM, Page 2778 as Document #518326, located in part of the NE'/a of the NE'/4 of Section Twenty- Two (22) and in part of the NW'/4 of the NW'/4, Section Twenty-three (23), all in Township Twenty- nine (29) North, Range Nineteen (19) West, Town of Hudson, St. Croix County, State of Wisconsin. EXCEPT A parcel of land being part of Lot Six (6) of Certified Survey Map recorded in Volume 18 of Certified Survey Maps, page 4728 as Document No. 759109, more particularly described as follows: Commencing at the Southeast corner of said Lot 6 thence N89°26'19"W a distance of 208.24 feet; thence N00°05'26"E a distance of 149.05 feet; thence N89°27'47"W a distance of 198.00 feet to the Point of Beginning; thence S00°05'26"W a distance of 148.96 feet; thence S89°32'58"W a distance of 2.00 feet; thence Northerly on a line parallel with the above-referenced line running S00°05'26"W to a point due West of the Point of Beginning; thence East to the Point of Beginning. Located in part of the NE 1/4 of the NE 1/4 of Section 22, Township 29 North, Range 19 West, Town of Hudson, St. Croix County, Wisconsin. ~~ ©StreamLine Legal Description -Exhibit "A" Rev. 4/14/2008 10:48:00 AM