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020-1439-08-000
r S~'. CRUX COUNTY ZONING UEPARTIVIENT AS BU[LT SANiTA,RY REPORT thvner ~ ~~... ~E'~"~Rso~f :'~dtlc~.s 1 ~ -,~ co ~. „~ pR. SuiTt #2v~ Cit3~ State ~ ODD r3uRY,,~N ~ S ~ 2 5 i..cgal Description: Lot ~ Riock ~ Subdivis[on/CSM # I ^~ Q ~ ~ o ,~Onl a S '/. N W '/, ~(~/ Sec_ ?~ T.~N-RAW, Town of _ ~IvaSory PIN # 0 2 0 -i4~3 9 -G~' Gtii SE~T'1C TANK -- DOSE CI~.ANIB~R -- I~ULDIlVG TANK ~NFt)ItMA1'IUN: Tank manufacturer W ~ E SE R Size 3T1FC N A Setback from: House 2 ~ WeII ~J PILE S Pnn-p manufacturer N Jar _ l-t,Yodel - ^' Alarm location -- (HOLDING TANKS ONLY) N ~ Ps Setbacks: Service road Vent to fresh ait intake Water Line Meter location Alarm location SOIL ABSORI--1'ION SYS'TEAS: a- u~~rc~ Type of system: ~ Na ,¢.o/ND Width 3 '~ ,, Length ~y O ' l~iumber of Trenches 3 Setback from: Hons~ ~ WeII 1' P/L I yo' Vent to fresh air intake ~~- ELEVATIONS: Description- of benchmark ld ~ o F MCI N t}v L ~ Co Description of alternate benclunark ~' S ? Riv- ~#2 Elevation /OD • o[ Elevation Scciiding Sewer ~y'• ~~, S"I'/IH' inlet 9~f'. FC Bottom ___^ __ Header/Manifoid ~'1 Distribution Lines () (~ _._. Bottom of System (~) 9 2.8'8' i ~) 92 ' w. - ~~ Final Glade () 9 ~ / ~ ) Date of instailaiion y'!18/DfoPermit number ~~ Plumber's signature inspector ~~ 1/(n/ ~%~~ Ulbricht ~ Associates Private Sewage Consultants 2812 1 Uth Ave. Spring Valley, WI 54787 $T Outlet ~ 3 •~ `~' pC ~~ `-" Top of STlPC Manhole Cover X00 • G7 U ~) EN,D {3) ~l2 • ~ I b 1(p State plan number License number Zz"C~3 ~ ` Date- ' ' _ Zg.a~ c Q~ a~ ~~ ~ ~ ~..~ ~ „~- ~,~e _ ~,, `to ~, ~e.~-_ -i-P~ n~,.~~ ~ _~ ., 2~ D t G 0 PouDS t.roT $ ~~~~-: k ~~,~ ~~ ~~~oe~ate g-- 5 eve. r~~-`~~< }1~~~~y, Vii! 5~~~s7 E~cvgr }at~s $.M. t : goo •ov CMa~~lot.~ ~v~,~) B.M.~~ ScAt~: ~,._ 30, • * SOiL 'TEST EORit~tlf ~40V S~ J 0 r A~~K CrARAC~E ~kIEL.C. 5` i~ItESEa. 1150 fsA~--. ~y~ -raNx w~4s• ~, RtSERS 8~ !o' ~i • • $a- $~. va~vE -- iW' 2~tFtt_TRMt~R 6tvi4C 4'S is (60'~ Ps~ -tR.E.~ru{~ B : aa~ B.M.a.._.~ •e.~ j3~y" StE~I, ptPE wl t..g1'N£ .~ .,~ ~t. ~,~°~ B3 ~ d p T r ~ s ~~ ?fit Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety end Building Division a 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 Rosam'i LLC Hudson, Town of CST BM Elev: ~ Insp. BM Ele~: BM Description: ~ ~ 60.0 00.0 2 = lc.)0•o CbT-I(3~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~~5~ $~ Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ' 25J t q r 2 r ~~ J Dosing Aeration Holding PUIGIP/SIPHON INFORMATION Manuf urer Demand GPM Model Numb TDH Lift fiction Loss System Head TDH Ft Forcem ' Length ia. - Dist. to Well .- ELEVATION DATA County: $t. CrDiX Sanitary Permit No: 488016 0 State Plan ID No: Parcel Tax No: 020-1439-08-000 Section/Town/Range/Map No: 25.29.19.2734 STATION BS HI FS ELEV. Bench ark uw~z- IZ•~FI 12.'H aa.0 r Alt. B Bldg. Sewer f t3.gz 1 g•~f9 SUHt Inlet I~•,~ 9S. ~1 7 C SUHtOutlet I~•gT T ~ ~.S} f Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot. System St~~_~~ ~'~"~ Final Grade St over ~.O+~S ~~ +°. r• ST. i~I,~F' ~' ~ o s ~ ~ 3, e3 ti^,- IL ORPTION SYSTEM 5 ' "' ~1 -kC 0 ~{". !o K • RENC DIMENSIONS Width ~f Lengt© r ~ P.at. No. Of Trenches 3 PIT DIMENSIONS No. Of Pits Inside SETBACK INFORMATION SYSTEM TO P/L LDG WELL LAKE/STREAM LEACHING CHAMBER OR Manufactur Type Of SyA _stem:w ~s r~ 3~r S„' / UNIT Model Numbed CXJ~~. DISTRIBUTION aYSTEM ~P..Qnt~ ~. -1'l o~'s 11. ct Header/Manif Ip d •,, ' Distribution x H ize Spacing Vent to Air Intake it A~ ~ Pipe(s) Length'"- Dia~_ Le is Spacing SOIL COVER x Prassure Svst~mw Anly YY Mound Or At.Grade SVStems OnIV Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes ® No © Yes ~ No OMMENTS: (fnciude code discrepencies, persons present, etc.) Inspection J ,(~{ "location: 854 Prairie Meadows Dri a Hudson, WI 54016 (NW 1/4 NW 1/4 25 T29N R19V1 1.) Alt BM Description = S• ~ ~ Cw.~~ v~s~4w~. ue+w: 2.) Bldg sewer length = ^' 3 2 r ~ -~" -amount of cover = a ~` ~Z Sal c>e~-. ~/ -_._ ---- _-- Plan revision Required? No (VI, ZZ/ Use other side for addition mat o _ _____ Ir SBD-6710 (R.3/97) ~" e_~ tr~-~ Q ~~c-I uC 0 / Inspection #2: i(,_~?.d9 A'bS ~onds ~ P reel No: 5.29.19.2734 Sys ~''~ f t2. ~$ Vic) ^95.8-~ r 1 ~• ~3 ~ S' C~) ' ~s' ~~-- _ -- - i. _ ~ ~~ 2 ~ >> --~~ -~,-,- -.~ ~ -may ~~ ~ ~ , Q ~ -~ ~;~~ Safety and Bui Division ZO 1 W W hi County JJ /~ ` ~ R d ~ X S s ~ ' . as ngton ., P. .Box 7162 T ,S ~Q~~l~ Madison, 53 162 Sanitary Permit Number (to be filled in by Co.) De artment of Commerce (608) -31 ~ 8g ~ I Sanitary Permit Application State Ptan I.D. Number ~// In accord with Comm 83.21, Wis. Adm. Code, personal information you provid may be used for secondary pu ~ Prpojeect Ad ress ifddifferentdtt>arl mailing address) ~ ~~ ~~ ~ ~/C~1t I. Application Information -Please Print All nformation O J / ~OQ ~ ~~ ~~ S ~ O, Property Owner's Name :., ,, Parcel # t Block # Property Owner's~ailjng Address ~ ~ ~ Z`Y~ ~rL ~~ ~ ZONING OFFICE Property Location N ' ~~' Ci State tY> ,,,,II ,) ~~~ ~~•(/VI ~0~(/ ~l Zip Code 5~0~~ Phon(e/Humber ~ 7C7 7~~ ~ ~~, Section ~~, ) /~ Z. /J't '~(cE Ie T ~.y ~ II. Type of Building (check all that apply) ~ OIC ci.S ~a~- subv~~ ~e /// W N R l Subdivision Name ~BB~M-?ieft:ben• t T' or 2 Family Dwelling -Number of Bedrooms I • ^ ~` ^ Public/Commercial -Describe Use ~ ~N Ot ~~ ~O ~ ~ ~/ ^ State Owned-Describe Use 2. ~ 1,.J ~~ G ^City_^Village ~'ownship of I~.~ 1II. Type of Permit: (Check only one box on line A. Complete line B if applicable) A' New S stem Y -~ ©R lacement S tem eP ys ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System B• ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. T e of POWTS S stem: Check all that a 1 on -Pressurized In-Ground ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. ofsuitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constmcted Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Fitter ^ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drib: Line ^ Gravel-less Pi ^ Other (explain) V. Dis ersaUTreatment Area Information: ~ ' c ~- 2 Design F~lo+w~(gpd)/ Design Soil Application Rate(gpdsf) Dispersal Area. Required (sf) Dispersal Area Propos (sf) System EI ation • p VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Fasting ~ ~ /~ ~` Tanks Tanks ~ t Septic or Holding Tank / Z Aerobio Treatment 1)ni[ p Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsi ility for installation of the POWYS shown on the attached plans. Plumber's Name (Print) t ~aRi c~,T" Plumber's Si P/MPRS Number zZU Business Phone Number ~s• ~~a •3yy Plumber's Address (Street, City, State, Zip-Code) z$! Z- p /~- >¢!/,Q . ,Sid/~i~tJG- ~/~` Gt>/. Sy ~ ~ VIII oun /De artment Use Onl Approved ^ Approved Sanitary Permit Fee (includes Groundwater Date Issued Issu' gent Sign re o ^ Own ven Reason denial Surcharge Fee) 3l~ . ~ ~ 2 I t15 IX. Conditions of Approval/Reasons for Disapproval ~~ ((~~ SYSTEM OWNER: ~~ ~J ~1Q~ ~ ,MJS~' ~JV ~ t , ~ 6 1, Septic tank, effluent filter and 1 _ ~~~ dispersal cell must all be services /maintained ~, ctr~2,~c.,~nC~2..J Va as per management plan provided by plumber. 2. AN sdbsck requirements must be maintained ~'~~ ~ t~p/~- ssper eppllcNtlecode / or~ances. ~' 1 ~ d t cJ v! ~J rc'~,I1/L- 1 Hcmcw compete grans (to the l:ounty only) tar the system on paper not less than 7112 x I I inches in size ~aSe M~ s• ~/ SBD-6398 (R. 01/03) ~.o ~" ~-g ~ ~~ ~s ~^ ~ = Gpv ~vRs >~ -' 3 0~ 3~ ~ TAP 5 ~1 ~~~ ~--~ a ~ ~o ~s~/' $s 5~~~.' s~S~E~' c°~`~'~` ~,pW-~ PER ZPg~1. ~V 4.~~aP~~A~(P P~OpEC~ y~ J a ~~ ~~t2~~ooEL ~ ~-1 D ~~~-DER ~~ ;r ~,D i ~ ~m~ s t'I ~~ ~t I~ ~~ I ~ i i ~I~ ~{ ~ P ~; '~~ I-~----~s .~- II I,t~ !~ ~ ~ I I ~~~~5 `0~ ~~5~ a ~ w~ ~ ~5 ~ ~~ ~~ -j \~- ~.. 1 ~I~ ~ I 10 ~ i t ! '-'~""'! I t1 l~ ~! ~t t°I t t I~ ~ ~~ 8~ . ~o ~ © ~ s~~ 5 ~, ~ 9 ..~. ,0 ~~~ z ~'~ N ~ of ~3f~,, i ~ T~ _.. 0 Ep ~~~~ ~~ ~z 7 5 y ~O 0~ f ~2/'~ ~~ /~ ~ .~ ~z , ~! :/ a ~ -~ ~_ ~. 0 o ,_ ~. ~q ` ~ ~~ i -~ ~j3 v y~l ~~u ~' ~o~-n.: tv~w, . p~ +-e.~. so,.~ ~ ~ ~ • &oS • 3 S ~ ~ 1(p ~'~7 u90oD~,~ ~Ip. S(9 i ~,Q,,, ~ 20 S cc9oaDRvl~y ~-tN. SS~ZS ~' Wisconsin Department of Commerce SOIL ALUATION REPORT page / of Division of Safety and Buildings ~ /'~ * s~ New Construction User. Residential / Number of bedrooms Code derived design flow rate GPD ^ Replacement ^ Public or commercial -Describe: ^~ _ Parent material ~~ ~'SS dV ~ si'r}~D Flood Plain elevation if applicable ~~ tt G OU ~ LIJ~-8'jti and tr3oonunerrdations: Area ~ Spot Tested Suitable fOt a conventional inground system (P.O.W.T.3.) r)$ o f ^ Pit Ground surface elev. ' a 0 O R Depth to Kiting factor ~ /~ 7 in. soa Ram Horizon Depth Dominant Redox Desaiption ,Texture Shud~e Consistence Boundary Roots GP D!(iz in. Mur>sed Qu. Sz Cont. Color Gr. Sz. Sh. •EtT#1 •Etf#2 ~ o• ~ a YR ~' SSG ifs ~ -e ~ 3 f . ~ . 3 5 ~o -- /L f b ~ i f • G 0 / S R~Fi a,S ~' G • o o~ ~ ~. s o s 5 ~ Pit Ground surface elev. ~ fL Depth to limiting factor l~ ~ in. s~ Ram Horimn Depth Dominant Redox Description Texhue StrucUne Consistence Boundary Roots GP D/ltt in. Munseli Qu. Sz Corrt. Cdor Gr. Sz. Sfi. 'Eft#1 •Etf#2 ~' O /Z S/ G ~ trFR W 3 'F ~i -r--- 'F /-v-~~ W • - ~ ~ nr'F~ o '(p S O.S G - ~. • 4 ~ S D. 1. - t=tfKrent m = t~ > 30 < 220 mglL and TSS >30 < 150 mgfl. F #2 = BOD < ~ n>gIL and TSS < 30 mglL ~ Name I'"~ L l'G ~ ~ 2Z 5 Add Date Evakratior- Conducted Telephone Number ~. • zoo S' 7l S • 77.2. ' ~~ ui acxvraancx wnn wmmae+•x wo County 7 1 Attach complete site plan on paper n~ less than 8112 x t 1 indres.i Plan must include. but not gmited to: vertical and horizontal refererx;e point (BM), dire ~..~~ l Parcel I.D. 0 Z o • ~ y 3 q . O ~?Oo O percent s ope, scale or dimensions, north arraiv and loption and distance to nearest road. Please print l! in~p~ ~~} Re ' by Dot f'ewonat information You Provide mey be used secondary Purposes (Prnracy t.aw, s. 5.04 (1) (mp. x II 3U d 5 Owner R~S~M`~ ~ ~•`•G' " i.. `v _% ~ ~ (~ (~'' • P Loca~ti~on) ~ ~ ~• Q ~j z/ ~ w Lot 1/4 1/4S T N R / E( W Property Owners Mailing Address!^ A 2I GT / • ~v C S7. C R U i;~c C G U uT`; ZU~ING C)FFICE t # Block # Subd. Name or CSM# ~NO~ ~~ ~pwd S' City f ~1 State ~ Code ~G1~MO~u l7 49I• SY01 Phone Number c7lS)~~/~• 747 ^ C fly ^ Village Town .1.~V Sp n~ Nearest Road PRl~rleJ~ M rrlvate Sewage Consultants 2812 10th Ave. Spring Valley, WI 54767 ~~ ~~ ' ~ t . Ouvrrer ..:.Parcel ID'# Page of ^ # ^ ~~ ^ Pit Ground surface elev. ft. Depth to rxrdting factor in. Horizon Depth Dominant Redox Soil ~ Description Texture Structure Consistence Boundary Roots GPD/fF in. Murrell Qu. Sz. Coat Color Gr. Sz Sh. 'Eff#1 ~ 'EffiY2 a# ^ - . ^ Pit Grourrd surface elev. R Dedh to I'unifinn ~,~..' Horizon Depth Dominant Cd R d D ~-. MunseN e ox escription Qu. Sz. Corti. Cobr Texture Strucbre Gr. Sz: Sh. Coruistence Boundary ^ Ong __ ~~ # ^ Pit Ground surface elev. ft. Depth b 9 ~~ in. Horizon ~~ Dom~tt Redox Texlure Struchrre Cow BourMa ~. Munsep Qu. Sz. Cort<. Color Gr. Sz Sh. Roots GPD/fF _ 'Eff#1 ~ 'Eff#2 Eif~ertt ~ ° BODE > 30 _< 220 mgfL and TSS >30 a 150 rrlglL ' Efll #2 = BODs < 30 mglL 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 fnnmat, please contact the department at 608-266-31 S 1 or TTY 608-264-8777. seo.a3wteboo> ~.o~T~ ~~ ~ ~~ r"s ~,ti ~ ~ ~ ~ 3 of ~~ ~ T°P ~~ ~¢ ~~ to 85 s ~ N' ~~ ~~~ ~ y~~ ... , : ~'. _._ - ~ ._~ ,~ ~` ,~ _ `~ ~ ~. a' C' ~ <+~ ~a ~ ~-=-- f f s+~ $~ ~ //~~ 7(/ O i s~~~Z ~~ ~~~ b~ ~ 3~~ r~ 1 ~~ ~~ ~~ ~~ J d I~ P ~0~~6 ~2 ~~- .== `~nn, iP~~ e ~* e r~~_ ~' 6 i s l; ~` i` t /~~ I~ ~. s 1302 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel Soil Service County Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I D percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. . . " pen g Please print p r~ 1 1 ~ ~ ~ A ~ ~ Review By Date y~w, s. ) (m)). Personal information you provide may be u for seco c ( v 5. ( de -p ~ ~ 3~ Properly Owner Pr perty Location ROSAMJI, L.L.C MAY 1 3 ~ G .Lot na NW 1/4 NW 1 S 25 T 29 N R 19 W Property Owner's Mailing Address L # Block # Subd. Name or CSM# 2141 Cty Rd. C ST. CROIX COllN7,, ~ 8 na Indigo Ponds City State Zi K%c J City J Village ~ Town Nearest Road New Richmond ~ Wi 54017 715-248-7071 Hudson Prairie Meadows Drive /~ New Construction Use: _fy Residential / Number of bedrooms 4 Code derived design flow rate _J Replacement J Public or commercial -Describe: Parent material Sream terraces and pitted outwash plains Flood plain elevation, if applicable General comments ~ and recommendations: system elevation 91.95 ft, trenches spaced and depth to code 4.25 ft below grade 600 GPD na Boring # J Boring 1/ Pit Ground Surface elev. 96.20 fl. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 10yr2/1 none I 2msbk mfr gw 2c .5 .8 2 8-26 10yr4/4 none sl 2msbk mfr gw 1f .5 .9 3 26-120 7.5yr4/6 none cos osg na na na .7 1.6 2Ub1{ GbD~~ ments = 36" COS <35% coarse fra & g >35% - <60% = 60" below system Boring # ~ Boring N Pit Ground Surface elev. 96.20 fl. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-5 10yr2/1 none I 2msbk mfr cs 2c .5 .8 2 5-20 10yr2/1 none sil 2msbk mfr gw 1c .5 .9 3 20-39 10yr4/4 none scl 2msbk mfr gw na .4 .6 4 39-120 7.5yr4l6 none cos osg ml na na .7 1.6 silt lems at 84", 13" in diameter * Effluent #1 = BODS> 30 <_ 220 mg/L and TSS >30 <_ 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print Signatu CST Number David J. Steel ~~--~~ 248956 Address Steel Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 5/9/2003 715-246-5085 Prolierty Owner ROSAM)I, L.L.C Parcel ID # Pending / Page 2 of 3 Boring # J Boring Pit Ground Surtace elev. 88.70 ft. Depth to limiting factor 120 in. Soil Application Rate Horzon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-6 10yr2/1 none I 2msbk mfr gw 1c .5 .8 2 6-15 10yr2/1 none sil 2msbk mfr gw 1 c .5 .8 3 15-39 10yr4/4 none sl/scl 2msbk mfr gw na .4 .6 4 39-60 7.5yr4/4 none Is osg mvfr cs na .7 1.2 5 60-120 7.5yr4/6 none cos osg ml na na .7 1.6 ^ Boring # ~ Boring _J Pit Ground Surtace elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ^ Boring # -~ Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODS> 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. ~ ~ ~ ~ ~ Page 3 of 3 STEEL'S SOIL SERVICE INC. David J. Steel 1564 Cty Rd GG CST-POWTSM ROSAMJI, L.L.C. New Richmond,WI 54017 Lic. #248Q56 NW1/4,NEU4,S25,T29N,R19W Bus.(715) 246-6200 ~~ Town of Hudson, St. Croix Co. Fax.(715) 246-9372 Indigo Ponds Lot 8 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted. Legend • =Benchmark Ele. 100.00Ft Top of 1/2" pvc pipe • =Alt Benchmark Ele. 100.30Ft Top of 1/2" pvc pipe ~ =Borings Boring Elevations B i = 96.20Ft B2 = 96.20Ft B3 = 88.70Ft B4 = OO.OOFt ~ ' inY 11 ~" ,4 6~ ~,~ z ~~ ~, 2z r%` ~~ y- 0 3 __ ~ 6-1 ~ ~., ~~-~~~oF~ ~ Gti2~Y~ ~~.ti~•z~~ yg~ 8"~, ~3' ~o ~.~- In ~k t-: ,~ ~ t ; ~ ~ ` ,` . .~ ~ N" ~ IRON FD~ND' 2.81 FILET i ~~~\` ~ , ' ~ ; ~ ~ ~~~ ~" o I ~ ~~ EAST AND 7,71 FEET t ~ .~ -o ~ ~ ; ~ ~ a f" ~ ; ''NORTH OF PROPOSED `_ ,} ~ ~-- ~ / _ J~, \ (t ~~Nl" ~ ,r` LOT CQRNEg,~ ~. _ -` j I ` i J • I FOUND 8.41 F~ ~~ "~ '- 1''' NORTH OF PROPOSED `~_`, ~~ v V t _ . ~ t v~~ ~ n ~ 7 ~_ ,~, ~„~ ~i ~• %' ~ L T CORNER ~~' - ~ ,,,.., :-- `~~ ~ "..: - -- -_^ -(S89°53'W 793.22' ; '~ i ~ ! ~ t ` '' ' -=== " `'~ ,- ~ .N 89 °56' 47"E. - ~ 79 4.98 ` + ' r ; 8 45 ~ .180.00 x177.00 426.53 i _ ~ / . ~ ~ °~ "dip ~ ~ o '~ ~ ~ I , DRAINA ~ ' : ~ °' , ~- -- __ ~ ~ `,,~ moo. \\ AiiyA~ "fc+ ~ ' ~ASEM T--. o ~ ~ ; "50, 7 --" ~- --~ ~ \ ~ ~.~ y4¢ r ~ME,y~ , _,- ~ ' 29.67 ~ i~ I ~: _; IO t ~ \ 99804,S.F \ ~ i -,.,~ '`~. _ 42.90% t _~ / ~~ `~J ' OF', "IJNE A'_ •` `~• ` _. r'"~ f "7 -~ '-~,. `- i . ~ $7417_-S.F. ~. ._.i r- (2.291 AC.),. ~ ' "~~ `~ ~ ~ y'"- '' , r' f ~ I ~- - (1.155 AC. N.B.P.A. ~ , ` ~ ~ ~ a~ / % , (2.007 AC.) l ~ ____ _.--._ -_ ~.,,~ ~ ~ E ._ _\ ~ ~ _~ / , (.346 AC. N.B.P.A.) ~i f ~, ~ ~ ~• 1~ o ®13 , c ~ 524.70' ~ ; : •- ~, ~ , ~`~ ^ ~ ! 99982 S.F. ~ ~ ~ ~ -'` /~ / ~ !! ____ /~ } j `~ N : , ~ (2.295 AC.) ~ , ~ ~ . ,. /~ f •~ o ~ (1,568 AC. ~N.B.P.A.}- ~ _ ~ ~ / l ;* ~`,_ J _ - _ - ' ---~ 88400` S.F. ~ ~`I ~,, , _ ~ .} ~ N; ' ~ i' /~• - - ' ` (2.029 AC ~ "`,: •- -; ` , .~ '~ (~` /1`i ~ ~ ~ _'~t (1.682 AC. ~N.B.P.A.Z ~'"~ ' l'•' `~ ~ , ~ i + N ~ 1, / ~ , '~ 97,854 S.F.~ t ( t `` '~ ~' ~'" -.r '_ (2.246 AC.), e l ~ 1 .002 A . IV _ -188.1 - - - `23.22 ~ . q `38.05 r` ~ - ~..~ ~.,, m w' •fi49.40•' ,t j4, w~ ~ ,S',~, PRAIRI .t ~ w~ ,. -~ ? r E M -~ - E sf ADOW -~ ,~ S RIVE. _ 8 - - - _ . .493.7 µ, - ?4S p, OC ';6.00 ~ - - _ _. -_ --- ~ 3 96' 9.63' .p ~ -- ''gip ~ ; ' ~.,,,,` ~, ~ ~ i ~ ~ j' ""fie , i ' ~~ DRAINAGE EASEMENT 6 see ~ L y ~ ~~ ~~ f ~ ( ~ X20._.. __ 121132 S.F. s'e~ ~ ,, `~ .~ ~ -- _ ~4 ` 1 _ (2.780 AC.) ` 8sp ~'~ ~ .~~ ~ ; ' t ` t IN `_ `183. O~' - --(1.000 AC. N.B.P.A.)\S' ~ \~~ ~ ~ ;~, ~ i ~---- ~- -~~-`~. ~ Foy ! ~ ,~ :.'~ ,( ~ 1 ~~ t ,~ .' ;~ l •~~ , , ' ` , ,~~,.~ ....~ ~~~ ,` ~`~ `•= O.H.W. I 'n,~ •~ l {' j '' t^~ i ." ,4'J• ~~ .t. ~.- - -1._,,135.03'. `; ' ~ ( 919.6 ;~ ' !; ~ / ~ ~ / ~ ; ~ ~ ; 97744 S;F. ~~ ,.-- i` ~ , ~ . I~ ~ ' ;~ ,~• / 5. • : r , , ({ (2.244 Ac.) ; i 1 ~ ~~•, ~ ~ %"~ 92458 S~.F. ,r~ / .;'' 1•~ AC. N.B.P.A. 4 l ~ 1 ~ l ~ ~ •` (2.123 AC.) ~ --_ . / ~ 8$27$ SL.F. _ '~~ /f / i . J 2.0265 AC,~ \I\~ ~ ~ ~ (1.578 AC. N.B.P.A.) -- ' -- ULBRICHT & ASSOCIATES CO. 281 ~ 10th Ave. • Spring Valley, y1Jl 547fi7 715-772-3442 PROJECT INDEX PLAN ID # ~.~-" OWNER I~oS~ .J~t J i LL G . ~' ADDRESS ~~ G~f (j~!/• ~~. C ~~~ LEGAL DESCRIPTION ~ ~" Reg. Designers of Engineering Systems Private Sewage Consultants p. Z1'~ S DATE PHONE Z.Y~`'• 7 O 7 ~i.~~ld ti/~ ~U / - ~'~uDt~~~ ~D~~~s' SAO r TOWN OF ~l "Y`~ O~ ST • ~t~DP ~C.. CSTM R• ~ ~~~ f Z'Z~ 3 ~ 5 COUNTY LOCAL AUTHORITX/ SUPERVISION S`~ • C R-O t' K G~ ~ ~ ~ {~~.,, PROJECT DESCRIPTION: .. ` « ,~ `~ ~.~, .~~ ~.-r~-~,,~ G~~ll'S . _. ~_ ~~- _..~ ~ , ~-i6 ~ . _ ~.__ !y '` 1C Z..a '' l`~~1~`S~- ~Z,~3 -~ ~ l~oT3-~12T 2C l~bI~GCG~.~ Uibricht & Associates Private Sewage Consultants 2812 10th Ave. Spring Valley, Wt 64767 Pg•1 INFILTRATOR SIZING WORKSHEET Pg.2 SYSTEM PLOT PLAN Pg.3 CROSS SECTION OF SYSTEM, WITH ELEVATIONS. Pg . 4 ~~ ~~ ~~ ~~ ~~ n K R m g D .~ m Q a z 3 I Z a z~ ~' ~~ ~~ ~' ~~~ ~ ~ ~ -~ ~ ~ ~ ~~ ~ ~ o ~ ~ ~ y d ~~ ~ ~ ~ ~ ~ ~ ~' ~ - In ,, ~ b ~ \ ~ N ~ ~ ° ~ ` ~ ~h _ 1' ~ ~~ ''{ ~~ ~ y ~ ~ ~ ~ ~- ~ ~,,~ ~ ~' ~ ~ O ~ ~~ ~ ~ ~ ~ ~ . c ~ `n M ~~ ~ -j- ~ ~1 '~ ~ ~~ o ~~ ~ ~ v, ~ ~ ~ "~ o ~ Io ~ ~ ~ w ~ ~ ~ ~ x c„ `~ ~ •• ~ ~ oo-+ CN . ~. x N, ~. ,uiv • i z ' 1/r _ 1 `` ~ A~~~ `f ~ ~ ~~~~~ ,, X i,~~'~~7~Td~' L~~~~ ~~~~v r~~ ~' r -`2~ ~~i~tSff~"D T~'~~1 ~ ~ ~~ s~ A ~ ~ ys ~~ /~U, ~ ~ . C,~o SS Sic ~ i©~ ©~ T~'~"~vG~s" ,~ ~~ ~' ~ w,~.. ~ ~ . j _~~~ ~~; c~-~,~~r/ f s~--~ ~ -~~ ~, ~Il~t/. f 2 ' ~(l ,, sr~ , ~o ~, ~~ 1 _ _ ~ ~J _ ~~ ~~ ~~~- ~ ~T ,~~, # !tt/ yam, go ~ ~ p~c I//~ -`2~ Div r S lt~"D 9R•~9~~ 1~z-o ~i~~~ c~ ,i ~~ B P~VNTS QWNER`S MANUAL & MANAGEMENT PLAN FItF INFORMATION SYSTEM SPECIFtCAT1UNS owner /1,(7 f L , L. G Permit # l3ESIGN PAt±iAMETERS tVUmber of 6et)rooms ^ NA Number of Public Facility Units ~" ~NA Estimated #low {average) gal/da Design flow {peak}, {Estimated x 1.5- ~ at/day Soil Application Rate ~ ftz Standard lnfluentlEffluent Quality M ly avers e' Fats, Oii & Grease {FOG) _30 mg/L Biochemical Oxygen Demand iBODS) <22fl mglL ©. Total Suspended Solids {TSS <150 Pretreated Effluent Quality y average Biochemical Oxygen Demand {BOOS} 530 mglL Total Suspended Solids tTSS 530 mglL NA Fecal Coliform {geometric mean S ° OOmI Maximum Effluent Particle Size Y8 in dia. ^ NA Other: ^ NA Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEQULE Page _ / or Z Septic Tank Capacity Z v gat ^ NA Septic Tank Manufacturer jv jr~'s ^ NA Effluent Filter Manufacturer Zj~ ~' ~ L. ^ NA Eff{uent Fitter Model !~ ~ / ~ C7 ^ NA Pump Tank Capacity gat ^ NA Pump Tank Manufacturer ^ NA Pump- Manufacturer ^ NA Pump Model ^ NA Pretreatment Unit ^ Sand/Gravel Filter ^ Mechanical Aeration ^ Disinfection ^ Peat Fker ^ Wetland ^ Other: ^ NA Dispersal Ce{{ts) ~ln-Ground {gravity) ^ At Grade ^ Drip-Line ^ NA ^ 1n-Ground {pressurized) ^ Mound ^ Other: `" Other: ^ NA Other: ~ ^ NA Other: ^ NA Service Event ~ Service Frequency - inspect condition of tank{s} At le month{s} {Maximum S years) ^ NA Pump out contents of tank{sJ When combined sludge and scum a DNA Inspect dispersal cell{s} Ai feast once every: ^ monthis} year{s) {Maximum. 3 years) ~ NA Clean a##luent #iiter At least once every: ~,monthts} ^ yeartsl - ^ NA Inspect pump, pump controls & alarm At least once every: ^ month{s) - ^ year{s) ~NA - Flush laterals and pressure test At least once every: - ^ month{s) ^ year(s) NA Other: At least once every: D month{s} ^ year(s) - J~NA -`"'C Other A MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells steal! be made by an individual carrying one of the following licenses or certi#ications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POwTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank{s} 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 cell{s} shall be visually inspected to check the effluent levels to the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent 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 tY3i or more of the tank volume, the entire contents of the tank shalt be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 1 i 3, Wisconsin Administrative Code. A8 other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of _<12 months, shall. be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Ulbricht & Associates Private Sewage Consultants 2$12 10th Ave. Spring Vaiiey, WI 54767 START UP AND OPERATION ~ Page 2of For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting. products or othet,chemical: that may impede the treatment process and/or damage the dispersat cells;. If high concentrations are detected have the content; of the tank(s).. removed by a septage servicing operator prior to use. System start up shall not occur when soft conditions are frozen at the infiltrative surface. Baring power outages pump tanks may fiat above normal highwater levels. When power is restated the excess wastewater will be discharged to the dispersat cel(ls) in one large dose, overloading the cell{s) and may result in the backup or surface discharge of effluent. To -avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POwTS Maintainer to assist in manually operating the pump controls tc restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells, Do not drive or park over, or otherwise disturb or compact, the area .within 9 5 feet down slope of any mound or at-grade soi) absorption area, Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the fife of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; caftan swabs; degreasers; dente[ floss; diapers; disinfectants; fat; foundation drain (sump pump] water; trait and vegetable peelings; gasoline;- grease; herbicides; meat scraps; medications; ail; painting products; pesticides; sanitary napkins; tampons; and water softener brine, ABANDONMENT When the POWTS faits andlor is permanently taken out of service the following steps shalt be taken to insure that the system is properly and safety abandoned in compliance with chapter Comm $3.33, Wisconsin Administrative Code: • Atl piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. * The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After Bumping, all tanks and pits shah be excavated and removed or their covers removed and the void- space filled wrth soil, gravel ar another inert solid material. ` CONTINGENCY PLAN It the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ® A suitable replacement area has been evaluated and may be utilized for the location of a replacement soi{ absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, tot tines and wefts. Failure to protect the replacement area will resuh in the need for a new soil and site evaluation to establish a suitable replacement area.. Replacement systems must comply with the rules in effect at that time. D A suitable replacement area is not available due to setback and/or soil timitations. Barring advances in POWTS technology a balding tank may be installed as a last resort to replace the failed POWTS. t~The site has not been evaluated to identify a suitable replacement area. ; , ilpon failure of the P01JItTS a soil and site evaluation must be performed to tocate a suitable replacement area. tf no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. D Mound and at-grade sail absorption systems may be reconstructed in place #oilowing removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time, < <WARNING> ~ SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGt_N_ DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE 1NTERtOR OF A TANK MAY SE DIFFICULT OR tMPOSStBLE. ADDITIONAL COMMENTS ~1lbricht & Fowrs uvsrauER t•'rivate Sewage Consu tarts (dame ~prinr~ 1f ~~ley, W I 5 47fi7 Phone ` ? ~) / / '~~ ,~ ~ ~.L ~ ~ 'T ~! POWTS MAINTAINER (dame ~ . Phone SEFTAGE SERVICING OPERAT'O`R~{,PUMPER) LOCAL REGULATORY AUTHORITY iVame ~r(j' / K//~ ,/~+/~ I~tame C O 1' J~C. C 1 ~O ~~ ~ ~+ ~+ Phone ~1tJ ~. ~ ~ D Phone '~~ J ~ 8~ ~ LJ This document was drafited ire compliance with chapter Comm 83.22(2){bl{t)ld}&{#) and 83.54(1}, t2j & i33, Wisconsin Administrative Cade. Page ~f START UP AND OPERATION i=or new construction, prior to use of the POWTS check treatment tankts} for the presence of painting. products or other chemical: that may impede the treatment process and/or damage the dispersal cells}. If high concentrations are detected have the content: of the tanks}.removed by a septage servicing operator prior tc use. System start up shat} not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater wiN be discharged to the dispersal cet((s} in one large dose, overtoading the cell{s} and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage ,Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS IVLaintaLC~er to assist in manually operating the pump controls tc restore normal levels within the pump tank. - flo not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area .within T 5 feet down slope of any mound or at-grade sot! absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and pro}ong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cation swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump} water; fruit and vegetable peelings; gasoline; grease; heroic}des; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS faits andlor is permanently taken out of service the following steps shalt be taken to insure that the system is proper}y and safe}y abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Gode: • AU piping to tanks and pits shall be disconnected and the abandoned pipe openings seated. • The contents of all tanks and pits sha(I be removed and properly disposed of by a Septage Servicing Operator. • After pumping, at} tanks and pits shall be excavated and removed or their savers removed and the void space filled with soil, gravel or another inert sold material. ' . . CONTINGENCY PLAN if the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ^ A suitable replacement area has been evaluated and may be utilized far the Location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed stnacture, Lot Lines and wells. f=ailure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area.. Rep)acement systems must comply with the rules in effect at that time. © A suitable replacement area is not available due to setback and/or soLl Limitations. Barring advances in P(7WTS technology a holding tank may be installed as a last resort to replace the failed POWTS. [The site has not been evacuated to identify a suitable replacement area. ,. °iJ'pon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. }f no 'replacement area is ovaitable a holding tank may be installed as a last resort to replace the failed PQWTS. Q Mound and at-grade soil absorption systems may be reconstructed in p}ace following removal of the biamat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time, < < WARNING > > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTA}N LETHAL GASSES AND10R INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSQN FROM TFIE INTERIOR OF A TANK MAY BE DIFFICULT OR tMPOSSiBLE. ADDITIONAL COMMENTS _,_ i,llbricht & Associates POWTS INSTALLER rl\fat0 f'Wc~~@ COrI~IJ~t~1S POWTS MAINTAINER Name ~prin~ ~~~~~~/, ~(~ 59.7~~ Name Phone '~~ S ' '~ '"~ ~- ' ~ (,~ ~ ~ Phone SEPTAGE SERVICING OPERtiT[lct tattnnnao~ Name `'~ ., f ~vtf / ~'vf~ .~lfi•~ Phone ~~S ~, ~ ~Q This document was drafted in compliance with chapter Comm 83.22(2}(bl{1)id}&(#) and 83.54(7), (2} & (3), Wisconsin Administrative Code. LOCAL REGULATORY AUTHORITY Name ~ ~ ~ Q~` ~ CT ~ ~ ' Phone '7r S ~ -3 (~ ~ ~~ ST. CROIX COUNTY ' SEPTIC TANK MAINTENANCE AGREEMENT ' ~ AND OWNERSHIP CERTIFICATION FORM Owner(Buyer ~ OSi4 ~! ~ 1 ~ 4~~ ~ i S • 2 ~~ • 70.7 / . Mailing Address 2l y~ G~~ ' 2~ . ~ /VFW ~% ~i ~dN l7 W l , `S ~ ~ l Properly Address ~ ~ ~ ~ ~ ~[ ~ ~ (Verification required from Planning & Zoning Department for new construction.} City/State ~~ So ~ ~ ~ ~ Pazcel Identification Number ~ Z ~ • ~y31~' ~d ' ~ ~ LEGAL DESCRIPTION ,, -- ,, ~j Property Location ~~'/4 , Nei 4 ,Sec. 2 ~ , T Z. ` N R / ~ W, Town of I'~t'1~'S'O~ Subdivision ~Ny~ •~ ~ONl~~' ,Lot # y Certified Survey Map # Volume ,Page # Warranty Deed # ~~ ~ ~ ~ ~ ,Volume ~- ~ Z `~, Page # Spec house yes no Lot lines identifiabl yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 30 ~ Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter i2 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master phunber, journeyman plumber, restricted plumber or a licensed pumper verifying that (i}the on-site wastewater disposal system is in proper operating condition and/or {2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned m the St. Croix County Planning & Zoning Department within 30 days of the three yeaz expiration date. Uwe certify that ail statements on this form aze true to the best of my/our knowledge. Uwe am/are the owner(s) of the property descnbed above, by virtue of a warranty deed recorded ~ Register of Deeds Office. Number of bedrooms _. .:- ,... x. _.. _ .__._ x' tl ~2~~ oS SIGN OF APPI;ICANT(S) DATE **$Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. *** Include with this application a retarded warranty deed fcorn the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08105) /k lr~ ~o ,S~ti, ~ . GL~ I1 t •~3 1 2223 f' 306 ~ STATE BAR OF WISCONSIN FORM S - 2000 ' 7 1 9 3 ~ 9 _ PERSONAL REPRESENTATIVE'S KATHLEEN H. MALSH ~.~~ Dc+:ument Number DEED REGISTER OF DEEDS ST. CROIX CO. , NI Jud~_ iViccum, as Personal Representative oftheestate ofFlorence K. Polen RECEIVED FOR RECORD ("Decedent"), foc valuable consideration conveys, without warranty, to 04/29!2003 03:00PM Rosamii. LLC Grantee, the following described real estate in St. roiz County, State of Wisconsin (the "Property) (if more space is needed, please t'ERSONAL REPRESENTATIV attach addendum): tltf]O~T t Please see the attached legal description. REC FEE: 13.00 ' TRANS FEE: 3448:80 DOPY FEE: ' CC F1;E PAGES: 2 • Recording Area Name and_ReturgAddress Edina Realty T1tla, 400 S. 2nd St., #116 rr _ Hudson, WI 54016 ~~l~~s Personal Representative by This deed does convey to Grants all ofthe estate and l~ interest in the Property which the Dxedent had immediately prior to Decedent's death, Parcei Identification Number (PIN) and all of the estate and interest in the Property which the Personal Representative has This Is not homestead property. since acquired. {isnat) Dated this 28th day of ADril , 2003 ~: S~_, •" ~ ~ ' Judy .Niccum Personal Representative Personal Representative AUTHENTICATION ACKNOWLEDGMENT Signature(s) Judy .Niccum :STATE OF WISCONSIN ) ss. ST. CROIX County ) authenticated this 28'" day of April , 2003 Personally came before me this 28'" day of April 2003 the above named ' drsayf q!C/ ` Judy ~ Niccum TITLE: MEMBER STATE BAR OF WISCONSIN (If not, ~ to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Stats.) instrument end acknowledged the same. • THIS INSTRUMENT WAS DRAFTED $Y Heywood, Cari & Anderson,S.C., 1200 Hosford SL, Suite 106 • P.O. Box 125, Hu_ds_on, WI 54016 Notary Public, State of WISCONSIN My Commission is petmancnt. (If not, state expiration date: (Signatures may tx wlhenticated or acknowledged. Both are not necessary.) .) • Names of paaons signing in any wpacily must be, typed m printed below their signature. tNFO•PRO (aoo)653.2021 rvww.infoprofoma.con, STATE BAR OF WISCONSIN PERSONAL RLPRESENTATIVE'S DEED FORhI No. S - 20110 2223 r' 307 Parcel A: That parcel located in part of the Northwest Quarter of the Southeast Quarter, the Northeast Quarter of the Southeast Quarter, the Southwest Quarter of~the Southeast Quarter, and~the Southeast Quarter of the Southeast Quarter, all in Section 24, Town 29 North, Range 19 West, and the Northwest Quarter of the Northeast Quarter, the Northeast Quarter of the Northeast Quarter, and the Southwest Quarter of the Northeast Quarter, and the Souiluast Quarter of the Northeast Quarter, all in Section 25, Town 29 North, Range 19 West, Town of Hudson, County of St. Croix, Staff 'of Wisconsin; further doscrrbed as follows: Beginning at the south quarter corner of said Section 24; thence North 00 degrees 3 l minutes OS seconds West, (for the. purposes of this description the south line of said Southeast Quarter .assumed m bear North 89 degrees 53 minutes OS seconds West) along the North-South Quarter line of said Soctioa 24, a distance of 158.3? foot; thence North 89 degrees 56 mirmrtes 47 seconds East a distance of 794:98 feat to the point of beginning of a line hereinafter described as "Line A"; thence North 00 degrees 16 minutes 57 seconds East, along said "Line A", a distance of 1049.18 feat to the point of termination of said "Line A"; thence North 47 degrees 03 minutes 07 seconds West a distance of 118.06 feet; thence North 27 degrees 46 minutes 10 seconds West a distance of 196.02 feet to the center line of Badlands RAad; thence North 67 degrees 30 minutes 13 seconds East, along said center lino, a distance of 708.39 foet•, thence North 67 degrees 56 minutes 31 seconds Fast, continuing along said center line, a distance of 674.75 feet to the westerly line of BOUNDARY R1DGE, according to the rabrdad Plat thereof thence South 00 degrees 25 minutes 17 seconds West, along said westerly line, a distance of 1826.90 feet to the southwest corner of Lot 7, said BOUNDARY RIDGE; thence North 89 degrees 43 minutes 38 seconds West a distance of 66.00 feet to a poirrt 66.00 feat westerly of and perpendicular to said westerly line and hereinafter described as "Point A"; thence South S9 degtbes 56 minutes 47 seconds West a distance of 961.84 feet to a point 66.00 feet oasterty of and perpendicular to said "Line A"; thence North 00 degrees 16 minutes 57 seconds East, parallel with said "Line A", a distance of 1036.45 feet; thence North 89 degrees 25 minutes 43 seconds East a distance of 82.43 f~cct; thence North 77 degrees 28 minutes 43 seconds East a distance of 343.87 feet; thence North 83 degrees 18 minutes 47 seconds Bast a distance of 201:86 feet; thence North 58 degrees 53 minutes 32 seconds East a distance of 263:23 feet;. t3rerroa North 54 degt~ .19 minates 28 seconds East a distance of 112.69 feet; thence North 42 degrees l 3 minutes 44 seconds East a distance of 46.55 feet to s point 66.00 feet westerly of and perpendicular' to said westerly line of BOUNDARY RIDGE; thence South 00 degrees 25 minutes 17 seconds West, parallel with said westerly line of BOUNDARY RIDGE, a distance of 1370.64 feet teen said "Point A"; thence South 89 degrees 43 minutes 38 secmrds Bast a distance of 66/00 feet to said southwest conacr of Lot 7; thence South 00 degrees 25 minutes 17 seconds West along said westerly line of BOUNDARY RIDGE, a distance of 163.55 feet to the North line of said .Northeast Quarter of Suction 25; thence South 89 degrees 53 minutes 05 seconds East, along the north line of said~Northeast Quarter and the south line of BOUNDARY RIDGE, . a distaaae of 760.75 feet to the northeast corner. of said Northeast Quarter, thence - ____ __ Soutfl 00 degrees 29 minutes 03 seconds West; along the east line of said Northeast ~Quartcr, a distance of 26]6.18 feet to the southeast corner of said Northeast Quarter; thence South 89 degrees 25 minutes 58 seconds West, along the south line of said Northeast Quarter, distance of 2606.35 feet to the southwest corner of said Northeast Quarter, thence North 00 degrees 24 minutes !0 seconds West, along the west line of said Northeast Quarter, a distance of 2647.29 feet w the point of beginning, St. Croix County, Wisconsin, except that part described as follows: All of the Southwest'/. of the Northeast ~/. and also the West SSO Feet of the Southeast'/4 of the Northeast `/.. and Also the South 250 feet of the So~rtheast'/. of the Northeast'/., except the West 550 Feet, all in Section 25; Township 29 North, Range 19, Town of Hudson, St. Croix County, Wisconsin. ~l~/~~D~lo~l~~~G1Uo, ~o-/~~~-~v-o~, ao~/a~c~-y~-~ ~a-~oro~~~-o~ d o, ~o~ Q~ 30 ~aoo, ao~~o~q- yp-p~0, alr la~I ~~~vCY,, d~i0~ ~d-ate. NORTH QUARTER ' ° >.3.,,, , ----CORNER SEC. 24, ~~.; . T. 29 N., R. 19 W. 1p `~~~~ I :~, k'a., ~ rn 3 ~' . _ ;~` ` (3 ~ O W ~ ' c ~ ~W (: ~ •) ~ °z O ~ z IRON FOUND 2.81 FEE ;~; ~ ~ `'' N W N ^EAST AND 7.71 FEET ~ ~ ~ 1- NORTH OF PROPOSED z ~ Q ~"; LOT CORNER ' ; F3ENCMARK BENCMARK C ~~ ~ ;~ . ~ TOP STEEL PIPE- ~ ~'ELEVA'IION 935.99' ELE TOP STEEL PIPE- VATION 930.01 188 45 ~ 177 00' 3~ t w ~~ M~ O~ Z~ ;' I ~N3 rn Q W ~ oN~ ~ZZ' ~QN U ~ ~i~ c - ~~S E - ~ u_ ~~i ~~ J `'J+ (/ ~I lJ~ C,I ~~ ~~) u_I ~~~I i_I :>I 1 NO DWELLING EXTERIOR .. OPENING BELOW ELEVATION 926.3' o 99804 S.F. a (2.291 AC.) 9~~~~9i ~y`~~s 56 ~g3 ~. i 1~~• `~~ 924.37 ~~"~~ ~~ ~, \~. 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