Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
020-1395-09-000
f't...i. S~ wis~tnsin Delaartment ~f commerce PRIVATE SEWAGE SYSTEM Safety grid Bui??:ng DiV~Gn 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 Township Carria a Homes Inc. Hudson Townshi CST BM Elev: r Insp. BM Elev: BM Description: X8.33 q8.3 3' Cs-r ~tn„~'Z-- TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ ~~ ~ ~ O Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P!L WELL BLDG. Vent to Air Intake ROAD Septic. ~ ,rye ~(J ~ ' Z ~ r--.. Dosing Aeration Holding PUMP/SIPHON INFORMATION Ft c°"°~~ St. Croix Sanitary Permit No: 399639 0 State Plan ID No: ~------ Parcel Tax No: 020-1395-09-000 -Z~ , z 9 ~~ ~ ya3 ELEVATION DATA STATION BS HI FS ELEV. Benchmark ~ 2. 7~0 9 ~ ~ ~ 3 , Alt. BM r $~ .9~ t Bldg. Sewer 3.10 10~,•69i SUHtlnlet 3 BS '~(,.Q~{r SUHt Outlet ~~ T• ~ ~ IQro .}`f Dt Inlet Dt Bottom Header/Man. rw ~,.ti5 Dist. Pipe ~ : 12•~ , z. its- 4~•• s ~ Bot. System ,~,~ ~ ~ 30 1 , 20 - Rb~r°I Final Grade ~' 3~ ~ O 3 .'{~ St Cover ~ ~ }Z . o f SOIL ABSORPTION SYSTEM l-~-a\ v.L l,L.,y~4...~ ..L.~sk ENC Width en h No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DI s 3' ~ I~ N ~.,2 SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREA LEACHING nufactu INFORMATION CHARIBER OR Type Of System: 25t ~- ~-~' ~---~ UNIT oriel umber. v , DISTRIBUTION SYSTEM `--~ Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake u Pipe(s) 7 ~ O / Length ~' Dia Le Dia g SOIL COVER Y Proecuru Rvs4oms Anly YY Mnund Or At.Grade SVStBm3 Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ®Yes ®No [] Yes ®No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #'I~>A~/ ~ O /.~2_ Inspection #2: Location: 842 PrairieMre~edow ive Hnu1d_son, W...It. 54016 NW 1 NW 1/4w~T2a9.~ 19W) Scenic Hills LQt ~ P~e~pt 25.29.19.2403 1.) Alt BM Description = 1 ~ ~ ~~~^^~'~ l8''~!/~ ~.( ~ ~~ ~l~ ~ , {fit 2.) Bldg sewer length = Z.~ ~~t ~ { ~ '1i~O.. 0 +.~ __ _Q ~,~. "r,9P" 2.. ...ro - amount of cover = ~J~nu ~.E s' --, y~---- Plantr '~ Yes J No ~ f~X i Use other sib de fo additional I formatigp. _~. ~ ~ N'! _ ~ , SBD-6710 (R.3/97) ~~ ~ ate ~~~ ,~ ^nnsepctor's Signature ~ 5'~ 0 ~/ .,~,rt. No. ~ ~~ ~~ (j7 m ~ ©0 SDi ~ I,~tp/~t.~l'u~ ~• " -xI"u~'w{ ~J y ~ct-T~'ro-9~ l~a ~G S ~.y ~- ~cb ~ 9 -s'e e,u~`~ ~ ll y'o~d o f-' i6/ud~~ d Bfnla ' `~y~r~ lDd~ ° Bm ~ z ".our 9P~ a9 ----~ /l` a;'f.Cor ~ Nay' u~ a~,~e ~~ ~,~ ~~~~ 5~~~ ~ ,1~ ~~ ~ 5 1 f _ a C/' ..ti~ ~ ~ U~ .1-.3x $9 Tre N ~o L~.,s y 5.:'fz /G ySSertY:'c O ~/.1~~ 3 v J ~~ ~~ -- -- n .-~ ~-~ r- -~ evs' ?O7s l i ~ ~` ~ /,~ l~ ~ /1 J31 I" /J `N~v N 4 ~~~ t , t Safety and Buildings Division County ~~~ Ord r~5s 201 W. Washington Ave., P.O. Box 7162 I~~O~$I~ Madison, WI 53707 - 7162 Site Address Y~ ~- CSC ~ - ~ ~ ~ Z ~ ~~ } Department of Commerce 1 t. Sanitary Permit Application Sani`aryP"mi`>~ ber ~ In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ^ Check if Revision ma be used for seco ses Privac Law, s15. 1 m I. Application Information -Please Print All Information State Plan I.D. Number Property Owner's Name Parcel Number (SLD- I3RS- aQ-aDp r ~ ~ ZS L Z O Property Owner's Address Property Location ~ ~ ~ ~ Cd ~ 'T~' m ~e' si ~ v " ` . A ..''., .NLJ 14 .~Ll~4: S S~ T o2q N. R l City, State Zip Code , ~. Ph r Lot Number Block Number ~~ ~ `'' ~! l.r '?~ CSM Number i bdi i N S v s on ame u ~~ ids __ ttt; ?'t~t~ ..~ .S-G ~.Ui' L [`'r i~r!(S II. Type of Btulding (check au that apply) ~,'~ ST CRpIX ,, ^ciry - ; cou-~n~ , ~ - ^ i or 2 Family Dwelling - Number of Bedrooms ~ ~t~ge ~ As pcr ~ Q~n-5 ' 'l ^ Public/Cotnmercial -Describe Use < „ 6 », ; i.,; % ownship ^ State Owned ` 1 ~ , Nearest Road ~_.. III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A. 1 New 2 ^ Rep1aCCIIlent System 3 ^ ReplaCem;:nt of 6 ^ Addition t0 For County use y.~m Tank Onl Eris " S stem B. ^ Check if Sanitary Permit Previously Issued Permit Number Date Issued lv. Type of Permit: (Check all that apply)(ntrmbering scheme is for internal use) 44 Non -Pressurized In-Ground 21^ Mound 47 ^ Sand Fitter 50 ^ Constructed Wetland 22 ^ Pressurized In-Ground 41 ^ Holding Tank ~'S ^ Single Pass 51 ^ Drip Line 4S ^ At-Grade 46 ^ Aerobic Treatment Unit ~9 ^ Recirculating 30 ^ Other V. Dis ersaUTreatment Area Informati on: G m e rs ~ / Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevad99n Final Grade n ti fl C Required Rate(~;,:lis./Days/Sq.FtJ (Niin./Inch) Propost eva o ,~~~/ x-S d:.rv~ /2S~ ~ ~" / ! e 9/ /h - VI. Tank Info Capacity in .Total Number Manufacturer Prefab Concrete Site Constructed Steel Fiber Glass Plastic Gallons Gallons of Tanks New Tanks Existing Tanks I ~& ~ ~ _ ldi Tank S ti H ^ s l+~ c or o ng ep _ ~ ~ Y ~ r ~ J ~ y Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for ' tion of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP RS Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) ~ ~d ~ ~ --L~Q~~ VIII, Cotm /De artment Use Onl ~~Y Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) A roved ^ Disa roved ~ pp Surcharge Fee) ^ Owner Given Initial Adverse /j ~ 2 ~- Q Q {~ ~ Z ~ ~ Determination IX. Conditions of ApprovaUReasons for Disapproval 1. Effluent filter to be installed and maintai>ti ,~ Pl+~ manufacturer's recommendations. 2. Chamber louver shall be installed in soil-`tvr~a soil application rate of .7. t 3. An additional boring shall be evaluated' Iwo the NW corner of the proposed septic system prior to installation to verify that soil conditions are consistent. The paperwork shall be st~wa{}ed prior to or at time of inspection. _..~ .~...., a~ n ~ ~ \ s....~... t...s.,. Alden Nmpusr. pcaua \w we a.wua~ vuy/ w• w~ .~...,.,..... rr-- -~ SBD-6398 (R. 05/01) Via- rat a~- y ~ too ~G S ~.y ~ ~ d ~ ~ -s' c e.y. `C" ,~, `l ~ yo ~,,~/ d .~-'' ~6~'u~sa ~ ' `T~ S~ ~t~C e- l ` ` = Yd Btr~la ' `1~rrr:, ldd~ ~ -,. ,B~ J a~v~ 9P~ ~~ !l~ I ~.,~~= ~~ 3v'x 8'~ ?re,/~h~es 3~'Giia-~.b rvs' ~i7~ / N ~/o as ~ e,.d.~ /~ ~% 3 ~~v j ~~ ~ ~ /~a.~ /n ~aa ~~p~ ~1~~ ~lD~ ` w~sconsin Department of Commerce - SOIL EVALUATION REPORT Division of Safeiy and Buildings Page I of m aoooraar-ce wrm ~;ornm ~, vvrs. r+arn. ~.ooe Plan must 11 i h i 8112 a th f ~~ - 5 ~• C r0 t ~ n s e. an x nc es Attach complete site plan on paper not ew inducts, but not limited to: vertical and horaontat reference point (BM), direction and Parcel 1.D. . percent slope, scale or dimensions, north arrow, and ro nearest road. ,Please print all i n. ~ J. ~l R . • by Date Personal information You provide mey be used for rivacy ,~ fit. .04 (1) (m)). ~ f L Z Property Owner - ,' / riy Location - ~ ~ . . ~ of ,U,,J 1l4 ,(~i,~,/ 1!4 S ~~ T Z W N R J~j E (or)~ - `_ Property Owner's MaiaigAddress l~ot# Block # Subd. Name or CSMIf CO ~ Z O S'~ i ~ ~ l.v T' FiOIX ~ S G ti ~. City State Zip Code N4~bpG OF FACE . .City ^ ~fdlage l~ Town Nearest Road ~S7i: L t w«•+-cr IM r~.. LSD ~Z ( ` `~ . 4 , _v . s K ,~~ r- !°d ® New Construction Use: ® Residential (Number of - ~{ Code derived design flow rate LSD l ~o O O GPD ^ Replacement ^ Public or commercial -. Descnbe: Parent material OU fcaJ0.S (.~ Fbad Plain elevation if applicable 93l • y R General onmments S ~ S ~ ~ ~. l e. J0. f.b /~ - Q(~ • SO and recommendations: ~ (., ~ e. I ,e. J 0. •(•-; d r~ - ~~y - S U Apr Pit Ground surface elev. lOZ, a ~ ft Depth to limiting factor ' 1 Z in. Soli ic~tion Rate Horizon Depth Dominanf Cobr Redox Desr~tion Texture Structure Consistence Boundary Roots GP D/li? . in. MunseU Qu. Sz. Cunt Cobr Gr. Sz Sh. •EtT#1 •Eff#2 a-tl s' 2 k ~ v~ • 5 ~ ® Pit Ground surfaoaelev. /O0 • $~ fL Depth to limiting fador'~.,~~~ in. Soil Rade ~~ # ^ ~~ Horaon Depth Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots GP D!(~ in. Munseil Qu. Sz. Coat. dolor Gr. Sz. Sh. - 'Eff#'1 'Eff#2 ~ . U-~ l~ 3 ~ S~ I 2r>~b cs 1 v~ • S 2 . ~y . 3 -•-, ~ 1 Z ~ -. 5 . $ l ~. lb S(~, y ~~ Z. • Etfluent #1 = BOD_ > 30 < 220 ma/L and TSS >30 < 1 50 moll ' Efliuent #2 = BOD. < 30 rn_HL and TSS < 30 mgA. CST Name (Please Prfit) Signature CST Number ~.r" ~ ~ 25'3 Address Date Evaluation Conducted Telephone Number z I ''' er- e-~- S~IoZ 6 ~- ~/ 7/5-Zy ~--~lao g Property Owner A. r ~~ l ~ Parcel ID # 'Page z of _~. Boring # ^ Bonng ® Pit Ground surface elev. lX~ • /d ft. Depth to limiting factor_.1! G~._ in• Soil lication Rate th D nt Color D i Redox Description Texture Structure Consistence Boundary Roots GP DIfr? Hor¢on ep in. om na Munsell Qu. Sz Cont Color Gr. Sz Sh: *Eff#1 *Etf#2 - -I Z I Si I Zrrr~,bk ~ c 5 _. 1 v ~' • ~ - 2 12-y0 Ip r 3 `_ Si 1 2 k c5 5 ~ / r -s Q~ ~~- ~~ ' ~vt- z~ • J .'t ss 4~ ;, -;1.3t x•32 a Boring # ^ Boring _ ^ Pit Ground surface elev. ft. Depth th limiting factor in. ~ icon Rate on H i th De Dominant Cobr Redox Description Textun: Struc~une Consistence Boundary Roots GP D/tt= or z p in. Munsell Qu. Sz Cont Color Gr. Sz Sh. 'Etf#1 'Eff#2 Boring # ° B°""g . ^ Pit Ground surface elev. ft. .Depth to limiting factor in. Sal lication Rate Hor¢on De th Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots GP D/ft? p in. Munsell Qu. Sz. Cont. Cobr Gr. Sz. Sh. 'Eff#'1 'Eif#2 • Effluent #1 =BODE > 30 < 220 mglL and TSS >30 <_ 150 mgA. ' Effluent #2 = BODS < 30 rr>g!L and. TSS _< 30 mgll. The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the departmerrt at 608-266-3151 or TTY 608-264-87TT. SBD-8330 (R07/00) property Owner A.r~~ ~~ ParoellD# page z °f--~- ~~ # ^ ~!9 ® Pit Grourd surfacee elev. W • /d fc Depth to r , faabor ` I I $. in. ~ ~ Horzon Depth Dominant Color Redox Descxiption Texture Stnkture Consistence ~~rY Roots - GPiJIt~ *~ 2 ~ in. Mansell Qu. Sz. Cunt Colo[ Gr. Sz. Sh: 2 12 -yo lp r 3 `--' S i t 2 k ~5 ~ ' 5 3 , (o ~ m5 D . • -l J, 2/ _ • /o' N y~/., ,. Boring # U Boring ^ Pit Ground surface elev. ft. Depth to limiting factor ~n• ~ Rabe d Roots Gt r Horizon Depth in. Dominant Cobr Mansell Redox Description - Qu. Sz Cont Cobr Texture Structure Gr• ~• ~• Consistence Boun ary ~~ ~~ Borg # ^ Pit Ground surface elev. ~_it .Depth to limiting factor ~• ~ Rate ^ ~~ Horizon Depth Dominant Colo Redox Desaiption Texture Structure Cons~6enoe Boundary Roots GPD/ff in. Mansell Qu. Sz. Cont. Color Gr• ~• ~• ~~ ~~ • Effluent #1 = BODa > 30 <_ 220 mglL and TSS >30 <_ 150 mgll. ' Effluent #2 =GODS _< 30 mglL 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. ssasaw rR.mroo~ PAGE 3 OF~ NAME Y~ -e-- LOT# ~ LEGAL DESCRIPTION +V ~~4~(/I.J1~4 S ZST 2 N R E or SCALE: 1"= y0 BM I ELEVATION (U~ • O BM I DESCRIPTION ~{op o~ Z "pJ` P: pe BM 2 ELEVATION 9S! ~ 3 BM 2 DESCRIPTION •/ap o_ ~ 7 '~o~~ ~~0., ~ SYSTEM ELEVATION ( . S o ALTERNATE ELEVATION 9fv . 5 0 ~(lNT(~TTR F.T.F.VATT(~N /inn. r, ~n(.c~ . 1D7. d ~ x -(- - ~ 5ec. zS _ r p,,,pa~ rc -. 2~P r. SIGNATURE ~~ /~ ~~-- ~ DATE 6' S -o f :., :i '. ~. ''4 ~~ ~--~ ~ 1. ~~nU~ } ~~ ~~ ~~ ~~ " ~.. ~ ~ ~ ~ U ~~~ ~ a i ~~ ~~ _ ~ ~l ,. ~ . a ...,q i ~~ ~S • Z ~. ~ ~ ~ M ~~ ~ ' ~~ ~~ A~ ~ o ~ a~ ~ . n N R ~ • ~ 3 ~ ~ _ ~ ~ .~L. ~ ': : ~ ~ , r a 3 . ~, ,. ... ~ . ~ ~ ~ t ~ ~~ ~m~ ~ ~~ ~~~ ~ ~ ~ ~ x an ~ ~ ~ ~ .~ • iA ~ ~ ~ ~ K • 1"' y '"' ~- ~ ~~ m~ ~~ ~ ~~ a w3 0 ~~v ~'~ ~ ~' ~'. ~ ~ ~ ~~ ; . ~ ~ a~ c ~ L tL ~ `~ ~ ~ c3 a 1 , ~ ~ ~ ~ 3 ,„ ~ tl C O.~ .~rLQi ~ ~ ~ ` ~ ~~ e ~ ~ ; ~. ~., - --.~r,~ ~..~ sr ciZUlx cuuN rl~ SEPTIC TANK MAINTENANCE AGP,EEMENT A1~iD OWNERSH[l' CERTiPICATION f'ORM Ou-ncr/13uycr ~i~r-~icta ~_ y~ _ - ~'~'~ _~~._ Mailing Address 4- 7J y~ ,,~,5/ / ~r~ cr~~ .~ // `~ _ Property Address 1S 7:~- ,~Y~x- e ~' o` ,e 7n e (Verification required from Planning Departmxnt for new construction) CitylState Parcel Identification Number ~,FGAL I~ESCT:2IPT'ION Property Location t~'/<, .~`/<, Sec. -~~T~N-R~W, Town of ~' r Subdivision 7 ~- ~.~ 1 G ~ ~ ~' .Lot # ~_. Cet-firied Survey Mai # .Volume _ ~ Page # ~ ___ Warranty Deed # ~~~~~ , Volt~e Pagc # Spec horse ^ yes ^ no I.ot Lines identzfiablo ^ yes ^ no ~S3'~M MAIl~I'I'Ei~IANCE Imlxaper use tad tuamteaanoc of your septic system could result m its faire to handle w:sLcs. Proper ncx gists of poarpiag ouL tlu septic taaY suety thrice years or sooner, if needed by a Iioea-~1 pumper. What yon put iuso the system . can offal the func-tian of the scptie taalc ss a treatment stage sn tlye ~vasie d'LSposal syzrem. The pmpcrty owner agtoes to tobmit to St t~oix Zoning Dcpaztntest t eatificatioa faun, siga*.d by the owner. and by a ~~p~~.l~ey~aP~~ ~~'~p~~or:lictasrdpc~a~crt'crifyiag that (1) ti:e oa~site wastcwatcrdispoul:ys~ is in pr»per operating condifion attd/oc (2) after iaspoctioa and pumping cif necessary), the septictactic is Icss than II3 ~ of sludge. Ilw~c, t!u rmd~ctsignad knve read tin above t,oquiremeats and agree to maintain the pcivatc sewage disposal system wit3i the standards set forth, hernia, u ter by the Department of Commcree and tfte Dcgartmeat of Natural Resources; State of Wisconsin- Cctti,{catioa stating that yoaz septic systevz has been maintained must be coaipls~d and returned to the SL (~oix County Zoning Officx within 30 days of year expiration dat~c ~ p~~~ DATE OV4'NER CER.T>[~'ICA'1'XON I (we) certify tha statements oa tl>u form an true to the best of ray (our) io~awledge. I (we) am (are) the owa~s) of the pr+opetty , by virtue of : wanarsty deed rocordcd in itcgistcr of i}cods Office, ~~ SI 'LURE OF APPGICA2zT DATE ssssss ~, information that ~ mis-represcatcdmay result iu the saaItary pcraut being revok,~d by the Zoning Department. """`• •• Iadude with th{s appiieattion: a stamped wactaaty dcod from -the Register of Deeds office a copy of the certified survey map if reference is made in the warranty decd Private C?nsite Wastewater Treatment System Management Plan Septic Tank And Gravity In-Ground Soii Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWYS) shat! include information and procedures fo Tmaintai {he ~ partment, agent, the parameters of Comm 83 and 84, and the conditions of app oval by or govemmenta! unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies Wvate Ons to 1Nastew' ater Treatment Syst ms SBDund Soil Absorption Component Manual for Pn 10567-P (R.6199). Table 1: System Sanitary Permit Number Number of Bedroams Design Flow -Peak (gpd) Estimated Flow -Average (gpd} Se tic Tank Capacity ( al) Soil Absorption Component Size (ft2) Type of Wastewater Table 2: Soil Absvr tion Com Sept Design Fiow -Peak (gpd) imam Influent Particle Size (in} Maximum BODS (mg1L) (° Y ~ D~_~___. t;c Went -Limits of Reliable Tank Soil Table 3: Maintenance Schedule Septic Tank Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at feast once Soi! Absorption Component Inspect once every 3 years Seatic Tank Com 118 220 3 The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.4$, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (rises etna e P ts, Seepage TrenchesuPrvl esCor P rtable tease Interceptors, Seepage Be p g Restrooms). The operating condition of the septic tank and outiet filter shall be assessed at least once every 3 years by inspection. The outiet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the ' Management Plan tof a Septic Tank and Soi~ Aosarption Component .,- „ filter is equipped with an alarm, the filter shall be serv-ced if tea{$iac~ontinuous aarmnThe us1y. intermittent fitter alarms may Indicate surge flows or an imps n9 ss tsc tank snail have its contents removed when the volume of ~ k aro not re~ ed at ~e p exoeede 113 the liquid volume of the tank. if the conten~+ o t e tdme of an assessment, maintenance personnel shall advise the ownedr e a hccumulat on~n h®ics Heads to be pertormed to maintain less than msxlmum scum and g tank. Manhole risers, access risers and covers should beninesn shaldl be ~ ~'~ ertlQht open soundness. Access openings used for service and est;~ the Completion of saroice. ~y opening deemed unsound, des t~ I~ ams~r she b f s®c~ d by b® replaced. ,Exposed access event$acctdentel or una thorized entry into the tank. an effective locking device to p No one should snte~ a septic or other two w ~ pSHA ls#andards br any reason wrlthout being In dull compllana* o or other entterlarg a conilned apace. Tho iittmosphN al s~~ a d rasrcue of a trwttmer~t of holding tank nijsy oonta person ~ interior of the bnk may be dltlllau/t or Irrrjposslbla. Tank abandonrner-t ehali be In accordance with Comm 83.33- Wis. Adrn. Code when the tank is no ion9er uffied es a P~WTS component. The soil abaocptian component serving this stru~tionlof this compo e~are sho~"+~n wastewater from a residential facility. The limits of cps Table 2. ~ long®vity of a sot! absorption component depof re4ia i~ ope«tion P Good water maintenance, and system use within or b®tow th® limits conservation prsctlces by ail occupants and the lnst8listlslon~m antent ~n$$rving plumbing fixtures are key factors In extending the useful life of th p The soil absorption component`s operation must be assessed by Inspection at {east if any, En once every three years. The inspection shall inaiude recording the levels of pon$ ~~ or discharge the observation pipes, and a visual inspectlon for any evidence of surface seep g from the component. On steeply eloping sites, areas of of ~ iot~~es c wastewatsrf or sewage reported to the owner for repair. The surface discharge #rom the system is prohibited and considered a human heaith hazard, anent should be ecvoided particutarty Traffic around or over the soil absorption comp nartt may lead during winter months. The corrtpactlon or removal of snow cover over ~bu~s d~icult or to hydraulic failure by freezlnQ. This type of failure is usually tempo+~~'Y~ im sslbte to repair until weather conditions improve. In g dls ai ~ ~mWt,~omayeieadlto P° en Into the soli and Fe component vali# reduce diffusion at oxyg in of the soil. more intense, and earlier, organic clogg 9 . r,, Management Plan #or a Septic Tank and Saii Absorption Component Plantings of deeQ-rooted tress and shrubs directly over of within ten fit of the component shauki b® avoided since rant intrusion into the component may obstruct wastewater #iow• Contingency Plan in the avant a# system failure, a new system could be installed in an sltemate area. With the instailatkan of a d}verter naive, the ®xisting system could also be reused after a period of three to four years. k is the property owners responsibility to maintain the aitemate area free from any p}ani}ng of trees, shrubs, etc, to case of failure of the original systemm, the attemate area wilt be needed. 1# sny trees, shrubs, etc. have been planted on the alternate area, they will have to be removed at property owners expense. if altamate area is dastroysd, there are other attemative systems that can be used, in which, aouid rasa}t in added expanse tQ the property owner. Any tank abandonment shah be done in accordance with W(so. Code 83.33. Any questions regard}ng this rode, piesae contact your local Zoning Office or contact the installing plumber. ~~,~.~-, ~k~~ ~~~.~, b; N~ C ~ ~s~ ~ $ ~ ~ 3 ti a t . 11 ~,~,1GG2P~~289 Warrc~n.'~. ~cc~ !y. 64860e~ REGISTER OP DEEDS ST. CROIX CO., WI RECEIVED fOR RECORD 06-16-2001 12:15 PN EXMi DEED CERT COPT FEE: COPT FEE: TRANSFER FEE: 9900.00 RECORDING FEE: 11.00 ' . PAGES: 3 Rreordist i4'a Name and Aelma Address Lar.l T~-11~~ lrc. 1900 ~'~ lv e c /..c~ k e IZo~. Alc,,,a $rt~(~ d ~, MN SS/IZ OZC~ - l 069 - -7 p _ oo d P,Ra zap x~ 0'~1 (~ZO-lO6Y-~SO•-dOp .. Ozo -I06y_`10-v~v U 20 - 1 D70 ' too - Cx~p 020 - l070 ., iv -crop v2o lob _zo _~ "THIS PAGg IS PAST OP T$IS LHGAL DOC[MIPN'p - DO NOT RPXOVE^ 7LL iofoewtioa aw 3. ~P1~ad ~ ~~, cfmoa, 4(d (tty(yy(p, sfi rM) k I"~~ M ~ ~ Kh111 CQCKJf QII ~ (vK~•/~/~ OJ1Lf I1~0/~P11 A1C~ ~; Vft pJd(t CvMtf pate gddr ons ~,`~•• yejs q/dIS Aoaoweu a we7 br dew eddfdp~ef f'~K `Y'om/ ~eaa.4v o~Q S'].Q7 W d` i[tv Y~ ~.ul__ peja oJd~e ~YMM1Iyr WET/. S~ J17. ~A 2% I' DOCUMENT NO, YDI_ .~Us2p~ f ~(~ THIS INDENTURE Made b ,RICHARD N, PEARSON and JEAN M. PEARSON, husband and ~ife ............._......_.............................._.._.._. grantor.s....of..._.St:~C~oix..._....~._........._...._.. .. _._.._......Countp, Wisconsin,~~ h~reb conveys and warrants to..._C2.IRRIAGE.110MF$ XXI, INC. r a .1 Minn~sota oor ration, -.._.._...._......._ ........................ . .._.. . .._.._.._ ........................................................_... t. nutee........ of:' asliriglon ~.~ ......._:..._..._...._.......____._ ............................_.:_...Count , >Rf( Y or the sum of; Otl~_Qgl~ar:,and. noj100_,(~2; 00).,and„other good ,and_valuable..,(;aert,ara TO t~ A_.~l T~ /t t 9Q!?.~.~dex.~~l,4n..... ~rzrr t ..... .......................... iltl3 / L'e S. 1 vrt Lrtl~r Inc . ......... ......_.. .~, S f J v G ._.. the following tract of land in.._..~G.,,. ~I:olx.,,,_.., County, '~ ~ ~ T// Z Wisconsin: .A1.~..41:..kFIC„pjp;thwe~,t„Qy~,rtieC_..j~~~.and._,(~IQt~h__[ialf (N~) of the Southwest Quarter (SW~) of Section Twenty-Five (25), Township Twenty-Nine (29) North, Range Nineteen (l9) West, St. Croix County, Wisconsin, except Lot One of Certified Survey Map Filed June 29, 1994, recorded in Volume 10, Page 2782, St. Croix County Register of Deeds, as Document No. 518944, See Attached Exhibit A Parcel Identification Number This is not homestead property Ia Witness Whereof the said grantor. S_ haVe_.... hereunto set......... their hand 5... and seals.... this ..............._......_..._ day oL.. !~aY.............._................._......, A. D., Y9C.2001 _........... BIDNEp AND 8HAL8D !N PRSeSNCE Off I ........................................................................._................... (SEAL) Stta~te of g~spta ,,,,,,,_WaShingtOn _ ebl~~~unty. Personally came before me, this.~"~`. day of..~.`,.'?._...... RICHARD N >~EARSON and JEAN M. PEARSON husband and wife ~~~~~' A. D., i'~..39,01 the above named ..............._.._....~.................._. ................. ! , .............................. . . .. to me nown to be the persons.... who executed the foregoing instrument and acknowledged the same. a.~ ........ Z. _.. T'NI• IN1TgUM[NT A~ D A!7 ^v aaMRR+-tVtOUNTAIN Richard J. Ga~rLet, 1~~2864 ;,,• . 880 Sibley Memorial Hwy., #114 NOTART Nocar Public,. ~ NOTARYPUBIIC-MINNESOTA Y aswL Y ~r .......................................... Count Wis. • My Comm. Eaplra• Jan. 31, 2006 -1736 Afy commission (t3 ' (Satioa 79.71 (1) of the Wircauin Statutd proridet th,t all In,uvmmu to M retarded shall ha.e plainly pinted m ryprrriMen thereon the nausea or the ~rant•u, pantep, ritnmtca and notary, SKi1on )9•)17 similarlr ngairo that Ihr name •t the person rhe. a aovern~ mental aatntT rhuh, dnlted fade inarrument, shall Ir printed, typcrrirten, aumppeed r rriuen thersoe in a leaibl< manna.) WARRANTY DEED STATE'. OF WISCONSIN a Wlaeerutn Leant Rlanlc OOmpaay D'nRR! No. 1 YtMaakaa, wee, (Job sash / i'r wwnnwx~rr aeima f7ATC OF WIfCON{IN-IOgM O ' TNIa ti!•Aea gHttlva0 /Oq tl[t:OaOIMO DATA EXHIBIT A Parcel Identification Numbers 020-1069-70-000 020-1069-80-000 020-1069-90-000 020-1070-00-000 020-IO70-10-000 020-1070-20-000 . . ._ '~ 117-M-Cot~wration ' STATE OF MINNESOTA ' COiJNTY OF _ _ _ _ _ _ and _ _..._..__. ___.___. ____ --- being fast duly sworn, on oath says(s) that: 1. a are) ( he is) the - and the _ _ __ _. _.-_- . _ ___--- -- ---. _ (Th Y __ - - - --- respectively, of ___ ___- _-- _ Cariiabe_Homes.XXI,.Inc _-- `--_ _-_-" _.- a - ~~e~o~ _____-_____.__.__ corporation, the corporation -- -- named as - - -- --- - ------------- --- --- -- -- _ ' in the document dated ,and filed for record -__ _.-~_-----_-- -- -- - - -- --- -- --- - - as Document No. _ _ - - __ (or in Book ------ ------ of ---------------- -------_._._ Page ____ ___ -__ __ ..___-) in the Office of the (County Recorder) (I~E~kOt~9 - ___ of _. St. Croix- .. _. _ County, Minnesota. 2 . Said corporation's principal place of business is at _ - - -- -- - - ------ --- --- --- ----- ---- - -- - - - and said corporation's previous principal place(s) of business during the past ten years (has) (have) been at: 3. There have been no: a. Bankruptcy or dissolution proceedings involving said corporation during the time said corporation has had any interest in the premises described in the above document ("Premises"); b. Unsatisfied judgments of record against said corporation nor any actions pending in any courts which affect the Premises; c. Tax liens filed against said corporation; except as herein stated: 4. Any bankruptcy or dissolution proceedings of record against corporations with the same or similar names, during the time period in which the above named corporation had any interest in the Premises, are not against the above named corporation. - 5, Any judgments or tax liens of record against corporations with the same or similar names are not against the above named corporation. 6 There has been no labor or materials furnished to the Premises for which payment has not been made. 7. There are no unrecorded contracts, leases, easements or ether agreements or interests relating to the Premises except as stated herein: i '+ 8. There are no persons in possession of any portion of the Premises other than pursuant to a recorde ocument except as stated herein: .~ ~ - 1 9. There are no encroachments or boundary line questions affecting the Premises for which Affiant(s) (has) (have) knowledge. ~ Affiant(s} know(s) the matters herein stated are true and make(s) this Affidavit for the purpose of inducing the passing of title to the Premises. ~' ~~7 ,l.i ~.t, i __ _ Carriage.Homes, ~ .. ~~ - - - - -- Minnesota Uniform Conveyancing Blanks (19'78) Miller/Davis Co. ° St. Paul, MN 651.642.1988 ss. Affidavit Regarding Corporation ~ ~_Q,,1..~.~ ,..c.~ _ _. ~-+z ~ --. Subscribec~d sworn to before me this .. _ - _. -- (~ " - day of ~ ~- G_ ~ _ .2001. }' ~ ~ DOCItiMENT NQ. Ir/ '~ I r ~ ~' r + 1 . ~_~___ . -_ I THIS INDENTURR, Made b .RICHARD N. PEARSON and JEAN M. ~~ PEA&SON, husband and ~ife, Yraptor.s+.of.. St. Croix'--_......~..---• ...................................Count ,.Wisconsin, I g .... .. ..... ......................................................... h~rcb conveys and warFants to.-..C~IAGE. HOMES XXI , IN . - a .........-•-----•--........--•-_....__....r.... Minn sots corporation, .. ~. _._ ..._.._.._ ................................................ rantee..._.... of ~ G~as6ing~on ............~~~ ~ -------=---........ ..............................•-•-•---...................County, or the sum of ~pr~~__~/g~ppllpa }r._7_-(a~nnd.. no1100-•.-($1 00} and_other_•.good.-and_-•valuable... WAILIiANTY DICIDD BTATE OF WISCONSIN-FORM 9 THl/ /PACt R[/[RV[D POR R[CORDIND DATA RETURN TO it ..........»»...._......_ ..............................-.......................................-...--.....................................II_. , the following tract of land in....,~t.:...C~Q1)C ...............................................County, Wisconsin: .A~-.1,_Q~...t~~...NQ~.t.hW~~.~..Que.rt<e.r_..~Nw';;~,._and..,~orth-.Half (N~) of the Southwest Quarter (SV1~) of Section Twenty-Five (25) , `T'ownship `I~venty~Nine (29) North, Range Nineteen (19) west, St. Croix County, Wisconsin, except IAt One of Certified Survey Map filed June 29, 1994, recorded in Volume 10, Page 2782, St. Croix County Register of Deeds, as' Document No. 518444. Ia Witness Whereof the said grantor. s.. haVe...-.. hereunto set:......_ their-.•-..--.., hands... and seals.... this ..............._........... day of... ~aY..................--••--•--•--...------, A. D., ~~C..2Q0~ ............................................................(SEAL) BICiTJI~D AND A>~DAL$D TN PItEBti'NCP+' OF ................................. y:... . ... .~ _~ .......................(SEAL) ........ M : ~O1V .......................................................Y (SEAL) lyi,~~~ta r1 ~ ~~ W ~ O Qo• M A ' • `~~ ~ Q~ ~~ ~ ~ t~~~ ZW ~ 'pN W W ~~~ ~ ~ ~ ~ ~ Q ~~~~ ~ LL -.- U~ w 0 i %, ~~ ~ ~. 3` ;. I ~ ~, - - ='lry W W \ N ~r~ S `b r ~ L ~ I ~ ~~ N d ~--- O ~o ~~ A O ~ ~~ 8a~ r ~~~ ~~ ~~~~ • -Q-------- O r ~~ . os~ . _ _ J ~~ 1 ~~ •'I N ~ ' ~ y~ . -A. `~ , ~ /~ ~ 1 ~ - .,I -- . ~ 10'rll ~620~' - -----~ ~ H.W.L. ~ i ~ 935.5 ~ 1 i t~ 1 / 1 1 ~ ~~ T 87.473 SQ FT 2.008 ACRES ~v u cS I~~~~ ~I~jj~~~' ~-H.W.L= 948.0 ~- ~~i~i~ `~J 10 8 ~ ` 9 _~ ~ 1 s,968 sc A 93,532 SQ FT ~ 95,679 SQ FT .. 2.685 ACF ~ 2.147 ACRES ~ 2.196 ACRES j l ~! ~ 0 . H,W.L.= - - - 939.0 ~ '1 - ~ -- - -- -_.~ - i l - --~- A ~ '"'T- - - - -- ~ ~ - ~- N99"30'53'E 899.38' '~ ~~ - - Prairie Meadows Drive - m ~ - ~g s89°5as3w 889.36' N8T 389_ %~ H.W.L.= --. .- j~ -- -- -- -- -- --j-- -- - -- - 938.0 i j 1 •~* ~_- J . . .: cG.~ ~ ~~~` ~ ~~\ ~~~~ ~ ~~~~i H. W,L = ~~ ~~ J , ' ~tnoi 3'on d I o ~ ° ~• o ~ AI' c o •~ ~ ~ ~ ' ~ c A :: I ~~ ~ ~ ~. ~ .. ~' ~ ~' _ ~ ~ z y 0 ~ ~ N C VNi N `C ~• ~ Sl• < fl- Np Y~I ..a C ~ ( ~ 7 ~T ~ ~ ~ ~ ~ W ~ N Q N n~ ~ = ~ N~ ~ ! n ~ ~ fD Q C I A O W p "~ ~ O ~ ~ ! fD W N y 1 N ~ O O ~ ~+ ~ ~ ~ ~ ~ y N v v I m ~'a' D ~' ~ ~ .. N I I ~ W i N 3 ~. i N t3 Z C N O a ~ ~~ Q I ~ ~ ' ~ 3 ~ N• ~~~o °' ~~ I ~. ~~ ~~ ? v,~nv,x I o ~ m ~ W~ y ~ ~ ~ ? _ m ~ ~ .. ~ y ~ ~ ~ ""'' y N I o• y ~ ~" I Z ~ o_ o j W Z ~ ~ w 3 ~I ~ ~ (A N n ~ d d fD 7 ~ ~ ~ ~ 7. ~ N I C ~ m » ~ u! ~ 3 ~ ~ a a i . c v ~ ~ ~ C 7 N 7 7 D O _ A Z n =i y G N N m H C d ~ ~1 =' A~ 7 o a ~ a I ~~ W 7 y c~p Z N fN11 o g = + 7 O ~ ~ I ~ g pp m ~ w Z co I a y a ~ ~ ~ ~ I ~ ~ g .P I '~ f/1 fA 07 ~ d a nm :. ~ I o ~ s o I . ? nm u7i ~ y ~ m m n 2 a g~ I ~ ~~ w ~ I ~ ~ ~° b ~ i +g o ~ m ~ O ~ m A N I ~ N N y ~ ~ 3 m 3 ~ ~ a I °' ~ °~ ~ ,~ I ~ as o0 N ~D fD O ~ O d A I ? no j ~ I o H ~ ~ ~ ~ ~ ti ti : ~, a i o . I ~ ~