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HomeMy WebLinkAbout026-1133-04-000 � ' n o ;� ■ -0 n ; 2 g■ c a) o / , g , < M ( § @ � , " g / / o ° & 0 / B - w g i, 7 _ P_ - ■ . \ ��� CO / CL @ /{ \� Q � M § § e © ƒ § [ E / \ i C J \ # z 0 M ° 2 E A \ $ �. ( � 0 0 0 M Oft � t § ■ ■ ■ § CD Rm vvL < @ ( / � E w. \ ( o 9 / , - i { ! 2 § a 9 § . . E q k tT 3 CD CD � ) kk� E z o R 2 * q _ a § / 2 k ® & 2 4 w � ± . 0 � # n 0 % 1 ƒ . . . . k ! k . kj 2 ) § , \ \� �2 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 453080 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: 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 Parcel Tax No: Halle Builders Inc. I Richmond Township 026- 1133 -04 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: /o f ' / Z 8 I'h- Z cjs \ 06.30.18.917 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM (_ S Kk� 3 L, Aeration Bldg. Sewer 4, 96 O' 1 Holding - St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet to � TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic / t Dt Bottom Dosing -- Header /Man. -7 1715 Aeration Dist. Pipe " Z- 9. 5 '3 4.1L Holding Bot. System N /p .95 C t 3 - aZ ie,95 aZ CK PUMP /SIPHON INFORMATION Final Grade 7 7 Manufacture Demand St Cover GPM �� Mod Number TD �iftFriction Loss stem TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. O th DIMENSIONS Z � 70 4- 1 7 SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION Type Of System: �� I CHAMB OR Model Number: a>' DISTRIBUTION SYSTEM v Header /Manifold 1 Distr' x Hole Size 1 S acing Vent to Air Intake Pipes) -\j / Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx ound Or At - Grade Systems Only Depth Over Depth Over / / Depth of j xx Seeded /Sodded xx Mulched Bed /Trench Center ,ti Bed/Trench Edges ^ To - — r tt Yes 1 No Yes I -I No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 928 172nd Avenue New Richmond, WI 54017 (SE 1/4 SW 1/4 6 T30N R18W) Pine Valley Lot 4 Parcel No: 06.30.18.917 1.) Alt BM Description = r� 6s' CO "`c� Dcc� S• AS a 2.) Bldg sewer length = u , / �wS� •^ ""`;" � - amount of cover � .Nl ► a.6G.�@' OVA'- (N `��/ Plan revision Required? Yes No - 7 _ Use other side for additional informati C Date Insepctors Signature Cert. / 1 SBD -6710 (R.3/97) Safety an Buildi County ' 201 W. Washii on A e.,�R. � t �seons�n Madiso , WI 53707 - 71 ti Hilary Permit Number (to be tilled in by Co ) ( 08) 26 3151 Department of Commerce P A I1 grmation a /U �4 Mate Plan I.D. Number Sanitary a pp In accord with Comm 83.21, Wis. Adm. Code, personal in pu'proi'iMel r nt than mailin address) Privac Law • t�'(' • ,- - - ect Address (if diffe e g may be used for secondary purposes y � , J _ J 1. Application Information -Please Print All Information r� N ' � 7 V Property Owner'. Name 'arcel # \ Lot # Block # IS,Jj Property Owner's Mailing Address Property Location 'h, J W '/<, Section City, State Zip Code j Number trcle one) © 7 7bdivision R or W II. Type of Building (check all that apply) 5 rw� r Name gSM Number �I or 2 Family Dwelling - Number of Bedrooms ❑ Public /Commercial - Describe Use 3 09vV1. O In O ❑ State Owned - Describe Use vl£� City_ ❑Vi (o ship of III. Type of Permit: (Check only one box on line A. p ete line B if applicable) tp Z( 3 -- d — Opp k�' A. XNew System ❑ Replacement System g p Y ❑ Treatment/Holding Tank Replacement Only Other Modification to Existing System B. ❑Permit Renewal El Permit Revision El Change of [I Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. T ype of POWTS System- Check all that apil - e on - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil [I Mound < 24 in. of suitable soil El At-Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter aching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (st) Dispersal Area Proposed (sf) System Elevation yS0 , 6 q,3 65311 * -� Vl. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank Loop Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for i allation of the POWTS shown on the attached plans. Plu b 's Name (Print) Plumber ig ture P PRS Number Business Phone Number Plumber's Address (Street, City, State, ip Code) l V �C/ V ( 11. County/Department Use Onl Apliinved ❑Disapproved Sanitary Permit Fe� Groundwater Date Issued 1 sui Agent Signaau (No Stamps) Surcharge Fee) 2 JlJ El Own iven Reason for Denial rn �_ IX. Conditions pproval/ �` ) � SYSTEM OWNER: f _I� 1 •, 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained �-� l 0 0. Ve- 1 011 as per management plan provided by plumber. 4 t' 2. All setback requirements must be maintained Ss��S S L t4-S as per applicable code /ordinances, ��S t' ; 11 Attach complete plans (to the County only) for the system on paper not les than 12 x 11 inches in 6 i - _�o ptr q �c o S B 1/03 - r 3 --� i4 /a �z �_ o f y , � � S -1 64 ( 3 -g 0 0 �2057 �U !2 /060 a � T O` ( 0 3 0 D• . Wisconsin Department of Commerce SOIL E; 6 -- , N REPORT Page / of Division of Safety and Buildings in accordance with Ciro 85, Wis. Adm. Code County S . Attach complete site plan on paper not less than 8 1/2 x 11�fnch9s in sid �G� (1'�t �, �� ! C I x include, but not limited to: vertical and horizontal reference ipoft' (BM), h G ��( arcel I.D. percent slope, scale or dimensions, north arrow, and loca ion -Ond distance to nearest road. pen 6 j n1 Please print all information:'. �` A;?/ a 7 ?oo' evi wed by Date Personal information you provide may be used for secondary purppss'(Privacy Lai s (1) (m)). f' Property Owne�r / �' ,• 7_0N @g1�M!:oc i4p LQ tli?S `F' i l S J- trlC. ' - ," Govt. 1/4 CW1 /4 s6 T3() N R �$ E (or'oW PTO. rty Owner's Mailing Address Con�acf r ck # Subd. Name or CSM# 130K lObaa C RIC Meson) .'I va Ie Nve a m City State Zip Code Phone Number ❑ City ❑ Village gTown Nearest Road G) ,4 r laK-e I mAI 55 114 1 (6SI ) % - U4 yq �c � M a, d I 17 nd Cav£. New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate Q GPD ❑ Replacement 11 ❑ Public or commercial - Describe: Parent material 1 A.Gt 4 +` I F - t Flood Plain elevation if applicable ft. General comments �� 3 �, ► 6 � Ivs ; h tr4L 4 c7r S and recommendations: , � 0 � � � �' L V 5 ' � S e- a�c-1, S : �'e . ?'a gs.s�' S;�ca -r 93.9 v' M Boring # ❑ Boring Pit Ground surface elev. f & a1j a. ft. Depth to limiting factor I aS in. — Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 0 -9 l0 3 la L. aFUR P) F R a a ,S .S a q -1 104 5 >1q __.._____�� a F s Av, nn Fe 0 L j 1 C _� Q y 0 -3l0 p.S 12 y y ScL Sa —t -7'5�p y q �" L The soil test report for lot 3 was discovered to be qs inaccurate during the septic inspection on Nov 2, E] Boring S•t� l ll • l'2- 2001. The soil horizon reported as single grain Fa-1 Boring # r � loamy sand was actually massive loamy sand with LIB Pit Ground surface elev. 100a 8 ft. occasional pockets of sandy loam. Therefore the Horizon Depth Dominant Color Redox Description Texture loading rate must be .5/1 and not .7/1.2. If this in. Munsell Qu. Sz. Cont. Color error is discovered on any other lot, additional -Q 10 a borings /soil investigations will need to be performed for the rest of the subdivision. The plumber should ®� g - 30 - 7.Siqk q lq e L make note of the potential for error and prepare for �? 3 -��� y __ the possibility of increasing the size of the drainfield. FI-tzu ,54R I y L S C) " Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L C J Name (Please Print) I ` Signature ' U n'n R -. STC� LC Address I Property Owner k C, C�S } i ��$ , , Parcel ID # Page of _ FT Boring # ] Boring Pit Ground surface elev. GD � ft. Depth to limiting factor I +1 Q in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 iow 3 1a, SL. a 9 . m q as a F .5 A C3 )a - ►b 10�k s 14 SL F.5 eW 1 F . s .9 3 16 - 3�1 , S4 R L l q - -- Ne sL`� m J S • q 34 -q6 � y - sL aF 58 MF9 �2�J .S .9 ' S 0 -S M\lF ----- .� a F4-1 Boring # ❑ Boring p Pit Ground surface elev. 7 8, ft. Depth to limiting factor / in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I *Eff#1 I *Eff#2 0 -9 104 P, SL a F&P rn r R a S a F , S .9 � a q -a3 - 7,5 R q1 J �ea�y rn r-K 5 .9 3 a3 -ya - 7 ,S y SL 3 Fsg K rnr P, CW Ivr . s y ya e 0 rnyrR - . - 7 i. a F-1 Boring # ❑ Pit Boring ❑ Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 *Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L ` Effluent #2 = BOD < 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. SBD -8330 (R.07 /00) . �•aK�s + Pa c 3 3 i� "! c� � , c a ac. c C � 'r +mot � � t � � �• Sc� 1 c o rn At a Ru VIA �� - -- POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of Z FILE INFORMATION SYSTEM SPECIFICATIONS Owner L Septic Tank Capacity a l ❑ NA Permit # S Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS �v Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model _A00 ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity a l ❑ NA Estimated flow (average) g al/day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) -5-0 gal/day Pump Manufacturer ❑ NA Soil Application Rate i gal/day/ft' Pump Model ❑ NA Standard Influent /Effluent Quality Monthly average" Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD :5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Susp S olids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L it In-Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 5 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) :510 cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA * Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: 87 ❑ month eaarrl(ss ) ) ) (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA ❑ month(s) Maximum 3 ears) ❑ NA Inspect dispersal cell(s) At least once every: p� year(s) (Maximum ❑ month(s) ❑ NA Clean effluent filter At least once every: ayear(s) Inspect pump, pump controls & alarm At least once eve ❑ month(s) year(s) ❑ NA Ins P P P every: El years) ❑ month(s) ❑ NA Flush laterals and pressure test At least once every: ❑ year(s) Other: ❑ month(s) ❑ NA At least once every: ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the 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 in 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 (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 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. Page y of y START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tanks) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have -the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall 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 will be discharged to the dispersal cell(s) 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 to 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 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All 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 pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid 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: j A suitable repla has been evaluated and may be utilized for the location of a replacement soil absorption (( system. a replacement area )should be protected from disturbance and comp action and should not be infringed upon by required in se g and proposed structure, lot lines and wells. Failure to protect the replacement area will result 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. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. T aluat a o ing ank C06JS'7WdC7 0" ❑ Mound and at -grade soil absorption systems may be reconstructed in place following 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 OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name Phone _ y Y Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name s"r, ( GV 20Af 1 � Phone Phone ��_ (0 (� This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM 0wner1Bu Y er / 4J/e 9L L� III L � f �7 Mailin Address &W A E� I /l � � / * ` / g / Property Address 7 P A (Verification required from Planning Department for new construction) CAJ City/State AJE � /dtMTjy Parcel Identification Number O ZG - 13 3 - o �{ - oc�o �• `� }� LEGAL DESCRIPTION Property Location J ' /., ' /., Sec. �, T 30 N -R `� W. Town of d N� Subdivision Y'/A- - 1/A(A -? j . Lot # �. Certified Survey Map # --.3 Volume ,. Page # , Warranty Deed # l d Volume Z Page # Spec house ❑ yes S8( no Lot lines identifiable K yes ❑ no SYSTEM MAINTENANCE 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. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewaterdisposal 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. I/we, 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 to the St. Croix County Zoning Office within 30 days o e three year ex do TORE OF PLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. 1 (we) am (are) the owner(s) of ; ; ;AT perty described a ve, virtue of a w deed recorded in Register of Deeds Office. 3 /�/ a4 URE 9F AP VLI CANT DATE « « « « «« Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department• •• Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed 'J 1 9 1 5 1 t� $ y 682535 STATE BAR OF WISCONSIN FORM 2 - IW9 KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., UI This Deed, made between Hillvale Development Limited, a RECEIVED FOR RECORD Minnesota Limited Liability Partnership, 06 -25 -2002 8:30 AN WARRANTY HEED Ell7VT # 17 Grantor, and Halle Builders, Inc REC FEE: 11.00 TRANS FEE: COPY FEE: CERT COPY FEE: Grantee. PAGES: 1 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Name and Return Address Lots 2, 4, 13, 14 and 15, Pine Valley Addition, St. Croix County, Wisconsin. S&CMWK PO Bat 475 Now Pichnwal, VN 54017 This deed is given in fulfillment of that certain Land Contract between the parties hereto dated July 30, 2001, recorded August 7, 2001, in Vol. 1694, Page 568, as Doc. No. 653155. Pc 026- 1020-20 Parcel Identification Number (PIN) This is not _ homestead property. Dj) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this � day of November 2001 Hillvale Development Limited L + + By Richard Nelso + s AUTHENTICATION ACKNOWLEDGME STATE OF WISCONSIN ) �g5SA,1, 7v 5 Signatures) ) P p�" �). Crr,k County * NOTARY authenticated this day of Personally came before m hti5, November 1 2 9 the a e e Hillvale Development Limited, a Min i + Partnership, by Richard Nelson !$C TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY + Attorney Kristine Ogland Notary blic, St a of Wisconsin Hudson, WI54016 My Commission is permanent. (If not, state expiration (Signatures may be authenticated or acknowledged. Both are not necessary.) (J! * Names of rsons signing in an capacity must be typed or rimed below their signature. trdonnadon Pmwsicnma Compan Farad du tea W1 {� g 8 Y P tY tYP P g SM-655 -2021 WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2 - 1999 'ER /f (JT.(JRE OWNER: OWNER OF RECORD: C.S.M. VOL 11 PAGE 3229 )EVELOPu EARL dt ttAARY ANDERSEN RICHARD NELSON 347 W. RIVER DR. 106 NEW RICHMOND. WI 54017 R LAKE. MN 55110 — .51) 748 -0448 1 --' 748 -044 ASSUMED 81 OF THE Sl RANGE NORTH GRAP — - -� 1314/001 1 o ° 'O No UNPLATTED LA NORTH LINE OF THE S 1/2 OF THE SW 1/4 -- ;96.63 19aoo �u •AO R �+ 2 F� 620.00 _ --- S - '" 2s�.� BuRiD NG SETBACK tJNE 96.648 SqFt* . 4 2-22 Acres* » 88.1 SgFt* �a�• `,� 2 2.02 Acres± 16 3.60• m 3 p •- 40 wi rl 87.857 SgFt± ? 8 2.02 Acres* g ♦ 87.9 - L5r o N. ���(� \ \ s+! Hof ?j `� •---- - - - - -- - - -•- C 12' UTILITY E T C23 154.86* — — — — — - xest - -- \ C24` � I - 1 /I1tD AVtl`lVim: 765.22' � N8r21'40 "E 1693.12 r 1433 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 2 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel's Soil Service Inc. Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and lo cation an d distanc to , rest road. Parcel I.D. - - - - Pending Please print ❑ m . 'I�:a. *�- ~ -��: -- R L Date Personal information you provide may be us®d for secondary purposes (Privacy Law, s.15 (1) (m)). Property Owner ,, S 700 P pertyLocation Lakes & Hills, Inc G . Lot na SE 1/4 SW 1/4 S 6 T 30 N R 18 W Property Owner's Mailing Address I . (;RU COIJN L # Block # Subd. Name or CSM# P. O. Box 10622 ZONING OFFICE 4 na Hillvale City 1' State Zip Code Phone Number J City J Village t1 Town Nearest Road h eft -�/ 4 " n e I MN 1 55110 1 651 - 748 -0448 Richmond 1 172 Nd Ave. A/ New Construction Use: t1 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD I Replacement Public or commercial - Describe: Parent material Glacial Drift Flood plain elevation, if applicable na General comments and recommendations: Addendumm to original soil report. If this alt. site is used system elevation should be 92.63ft.Trenches spaced and depth to cod 5.416ft below grade. Boring # I Boring if Pit Ground Surface elev. 96.45 ft. Depth to limiting factor 96 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftl in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 1 0 -12 10yr 3/2 nine sil 2msbk mfr cs if .6 .8 2 12 -52 7.5yr4/4 none sl 2msbk mfr gw na .6 1.0 3 52 -105 7.5yr4/6 none Is osg mfr na na .7 1.6 ❑ Boring # Boring 1� Pit Ground Surface elev. 96.45 ff. Depth to limiting factor 100 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Ef1#1 *Eff#2 1 0 - 14 10yr 3/2 nine sit 2msbk mfr cs 1f .6 .8 2 14-42 7.5yr4/4 none sicl 2msbk mfr gw na .6 1.0 3 42 -65 7.5yr4/4 none SIAS 2msbk mfr gw na .6 1.0 4 65 -105 7.5yr4/4 none Is osg mvfr na na .7 1.6 * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD s30 mg /L and TSS < mg/L CST Name (Please Print) Signature: CST Number David J. Steel 248956 Address Steel's Soil Service Inc. Date Evaluation nducted Telephone Number 1564 CR GG, New Richmond, WI 54017 6/3/2004 715 - 246 -6200 Page 3 of 3 STEEL'S SOIL SERVICE INC. David J. Steel 1564 Cty Rd GG CST -POWTS Lakes & Hills, Inc. New Richmond,WI 54017 Lic. #248956 SE1 /4,SWl /4,S6,T3ON,R18W Bus.(715) 246 -6200 Town of Richmond, St. Croix Co. Fax (715) 246 -9372 Hillvale Lot, 4 Legend 1" = 40' ♦ = Benchmark Ele. 100.00ft Top of 3/4" PVC Pipe • = Alt Benchmark Ele. 00.0 Oft Top of 3/4" PVC Pipe ❑ = Borings Boring Elevations BI = OO.00ft B2 = OO.00ft B3 = OO.00ft B4 = 98.05ft B5= 96.45ft B6= 96.45ft 0 � -Mqj � ! �f G� i r �\ �s Jun 08 04 08:08a LISH ANN KROLL 715 - 246 -5700 p.5 Page 3 of 3 STEEL'S SOIL SERVICE INC. David J. Steel 1564 Cty Rd GG CST -POWTS Lakes & Hills, Inc. NewRichmond,WI 54017 Lie #248956 SEl /4,SWi /4,S6,T30N,R18W Bus.(715) 246 -6200 Town of Richmond St. Croix Co. Fax (715) 246 -9372 Hillvale Lot, 4 Legend 1" -40 1 ♦ = Benchmark EIe. 100.00ft Top of 3/4" PVC Pipe • = Alt Benchmark EIe. 00.0 Oft Top of 3/4" PVC Pipe f1= Borings Boring Elevations B i = 00.00ft B2 - 00.00ft 83 = 00.00ft B4 - 98.05ft 135= 96.45ft B6= 96.45ft 9 7. f t G' J �,- 3-dy Mks zs S - d ZLE6 -94Z -SIG - DUI OOFnaS Ito$ s,Iaa%S e00 =60 40 60 unr THE SW 1/4 OF RANGE 18 W., Ac NORTH . `— GRAPHIC --'� 1314/001 wo C S0 100 UNPLATTED L AND ( IN FEET = 1 a NORTH LINE OF THE S 1/2 OF THE SW 1/4 -- 1 inch 190.00 132- 200.00 'r �- 200.00 � j R Sa9�O*M' ► 267.7Y ft± - - BUKL+HG SETBACx lmE 4 88.184 Wt t �\ i 2-02 Acres± 3 2 so � 87,857 SgFt± 1 74 g + 2.02 Acres± g + 87,920 SaFt± 2-02 Acres± \ N. " N ' r., \ss `YS�4C �' '�? 12' U T1UTY E N T � \ � N, \ }' �'` C23 - � 154_86— — — — — — 200-00. C21 Na9�1'40" - _ _ _ - C2 24 MqD AVENUE F 765.22' N89 21'40 "E 1693.12 ,CURVE TABLE foment Out Curve Lot Ton4ent 1n Chord Chord Arc Delta Out Jun 08 04 08:07a LISA ANN KROLL 715- 246 -5700 p.4 1433 Wisconsin Departmeat or Cormmerce SOIL EVALUATION REPORT P age I of 2 Division of Safety and 8taldr qs in accordance with Comm 85, Wis, Adm- Code Steel's Soil Service Inc. Attach =node site pan on paper not less v= az a 11 ind in sire. Plan must Courtly, irhdude, trot not lid 1a vertical and horironlal rekrerhoe point (BM), diaec5ah and _ St. Croix prroeni slope. 30016 or dimenslors, norM arrow, and location and date lo nufaw mad. Parcel I.D. Pending Pftwe print an n kdbi mation. Peso ir6 i I" you n provide or/ to iaadtor Reviewed By Pend" secaea)r purports I�'aa' har, o. rSO4 (t) i�N)• Property Owner property Location Lakes 8 Hills, Inc G0141601. no SE 1 SW 114 S _6 T 30 N R I& W SUM. Ownefs Mailing Address - — - lot • Block 0 Su. Name or CSI{ P. O. Box 10622 4 n _ Hillvale City L State Zip Code Phone Number City Village ✓. Town Nearest Road i o n sfg-&/ 4sR e I MN 1 55110 651- 748 -0448 Richmond 172 Nd Ave. ✓,' New Construction Use: oe Residential / Number of bedrooms , 4 Code derwed design flow rate 600 GPO Reprocerne"t _ Pubfic or commercial - Descr be:_ -- — - - -- -- Parent material Glacial Drift - Flood plain elevation. if applicable no - General comments and recommendations: Addendtmtm to original sal report If this alt site is used system eleration should be 92.63R.Trenches spaced and depth to cod 5.4168 below grade. Boring d -= Boring W. Pit Ground Shwface elev. 96.45 1t. Depth to limiting factor 96 in. — S o l AWCOM Rare Marto Depth 0011ioantcow Reft pesrritrtion TOM= Structure Cmaiorce B-Wary iiooRs in. M 0U. Sz. C0m Color Or. sz. sh. aser 'EAA7 - 1 0-12 10yr3/2 nine sil 2msbk mfr cs if .6 .8 2 12-52 7 .5yr4/4 none sl 2msbk mfr ... ._. -._. _ _ 9W nor .6 1.0 3 52 -105 7.5yr4/6 none Is osg mfr no na .7 1.6 a Boring a 'Baring if Pit Ground Surface wev. 96.45 R Depth to limiting factor 100 In. Sd App pyk tforizon Deph Dominator Cmor Rectos Deseriplimn Telue Conssoe BourAlry im. Morten on , SL Cone Color Gr. Ss Sh. Roole - EIAR I 1 p t 7 0-14 1 32 nin sil 2msb rnfr cs if .6 .8 2 14-42 7.5y r4/4 none Sid 2msbk mfr gW no .6 1.0 3 42-65 7.5ymm none sole 2msbk mfr gW no .6 1.0 4 65-105 7.5yr4M no Is 0s g mvfr no no .7 1.6 Effluent #1 = BOD 30 !220 mg/L and TSS >30-c 150 mg/L ' Effluent 02 = BOD <_30 mgA. and TSS <_30 mg/L CST Name (Please Print) nature:. CST Number David J. St" 246M Address Steers Soil Service Inc - Date Evaluation Conducted Telephone Number 1564 CR GG. New Richmond. WI 54017 6/32004 715 -246 -6200 �'d 24166 -9*21 -914 'oul aO;naS ITOS S.1081S e00 =90 40 90 unC