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HomeMy WebLinkAbout026-1025-10-400 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix I Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 429974 0 GENERAL INFORMATION 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: Kelly, Dan I Richmond Township 026- 1025 -10 -400 CST BM Elev Insp. BM Elev: BM Description: ,, `` Section/Town /Range /Map No: N t.AJ '� 5 07.30.18. 7 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ? ,' r Benc rk Dosing .I 7M BM Aeration Bldg. Sewer Holding„ St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL B DG. Vent to Air Intake ROAD Dt Inlet / ��— � Sf 6 t Septic S rl z o f C Dt Bottom Dosing Header /Man. • �, Aeration Dist. Pipe,, t 0 Holding Bot. System 0A_ • .3 s PUMP /SIPHON INFORMATION T Final Grade 11y3 795 any Manufacturer Demand St Cover GPM / / a Model Number TDH Lift Friction ,l es§ System Head TDH Ft Forcemain Length "� _ Dia. Dist. to Well SOIL ABSORPTION SYSTE - ___.__ BED/TRENCH Width + Length No. Of Trench PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ONS ' SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEA HIN Manufacture( I I INFORMATION CHA OR t # ��• �_ Ty f System: 4- UNIT Model T Number: pa" ) DISTRIBUTION SYSTEM Header /Manif Id Distribution x Hole Size x Hole Spacing Vent to Air take (./ Pipe(s) 1 "lam Length __ Dia_ Length_ Dia Spacing_ Q SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only bxd - ' y' Depth Over Depth Over xx Depth of xx Seeded /Sodded Mulched Bed/Trench Center Bed/Trench Edges Topsoil xx 1=J Yes [� No ['' °'; Yes No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1:b /L_/ -03 Inspection #2: Location: 910 160th Ave New Richmond, WI 54017 (SW 1/4 SW 11 /'4,7T,3p0NR18_W�)) N Lot 4 pez C Parcel No: 07.30.18. 1.) Alt BM Description = �1c 0 ` � /s+ 2.) Bldg sewer length = 30 t qu", 3A 3 Y - amount of cover = y 3 1 - -- Plan revision Required? I %Yes ` ,._No I � i 10 �.- Use other side for additional information. L SBD -6710 (R.3/97) Date Insepctor's Si nature Cert. No. I - Safety and Buildings Division Cour+ty y— � V l 201 W. Washington Ave., P.O. Box 7082 5 / . Madison, WI 53707 — 7082 Sanitary Permit Number (to be filled in by Co.) ScOnS,n (608)261 -6546 l Department of Commerce l 1 Sanitary Permit Application State Plan I.D. Nu ihbqr In accord with Comm 83.2 1, Wis. Adm. Code, may be used for secondary purposes 'vary D Project Address (if different than mailing address) 1. Application Information - Please Print All Infor ationMAY 0.9 2nni � ` D Owner's Name Parce t V / Block t1 I ST. CROIX COUNTY pd6- /ohs a t- operly Owner's Mailing Address v Property Location P L 1 , 5 3 ` W Y., ✓ Y., Section City, State Zip Code Phone Number 7 4 -576 6 Y ( circle one) II. Type f Building (check all that apply) I / � T �Q N; R / C� E or W n� '� 1 or Family Dwelling - Number of Bedrooms f� Subdivision Name i ❑ PublWCommercial - Describe Use J 926 7� - ❑ State Owned - Describe Use ❑City ❑ ❑ o of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) - A. p(New System ❑ Replacement System ❑ 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. Type of POWTS System: Check all that appl A Non - Pressurized In -Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ 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 ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dis ersaUTreatment Area Information: Design Flow (gpd) Design Soil Application Rate( dsf) Dispersal Area Required (sf) Dispersal Area Proposed (st) System Elevation la 00 / 7 �5 - 7 8�� lD�r�l� VI. 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 Q �tJ / , _ Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for in llation of the POWTS shown on the attached plans. Plumber' Name (Print) Plum s i re PRS Number Business Phone Number Plumber's Address (Street, City, State, t Code) VII . Coun /De artment Use Onl Approved ❑ Disapproved Sanitary Permit Fee (inclu es Groundwater Date sued I§sTing Ag )nt Signature ps) Surcharge Fee) dV ❑ Owner Given Reason for Denial IX. Conditions of Approval/Reasons for_DisVproval i C/l. �� off, lal•v o'2 PU . V��o� Attach c plete plans (to the ou ly) for the system paper aot less than 81/Z s 11 lathes size SBD -6398 (R. 08/02) (� 10 -19 wsocnsin De;iartment of Commerce SOIL EVALUATION REPORT Page L of � Division of Safety and Buildings � in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8112 x 11 inches in size. Plan must County ro include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Z�Q� 9 2,6 'lJ— Please print all Information. R owed Dame Personal information you provide may be used for secondary purposes (Privacy law, a. 15.04 (1) (m)). Property Owner Property Location C-t \ I C /% O e✓ Govt. tot Gv 1/4 ��1i4 S 7 T 3L N R �8 (or 1� Property OwOwner's Mailing Address Lot ( /i # Block # rianel Name CSIM , o /&v ( o "5 gZlo State Zip Code Phone Number ❑ City ❑ ®Town Nearest Road M e w i 1 0 - Ti L 0 17 1 (7 15- ) 0 SJ 73 18 New Construction Use: (3 Residential / Number of bedrooms y Code derived design 0 GPD ❑ Replacement ❑ Public or commercia - Describe: Parent material �2 4t 2 L� " Flood Plain eleva ' # p ficable an General recommendations: �Yi � ry c 1e Sysf c'p ycL, /o% 9� c r '' ► � � � Boring - CAS OPW Boring f a Boni # ® Pit Ground surface elev. � • 9 f ft. Depth to finning or ` 2 � �' in. •�_ .r' . �' ;, Sa'I Application Rate Horizon Depth Dominant Color Redox Description Texture Str jj� Botrda -Aoots GPDM In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -9 /oy/? Z 9 -2 Y /o I e i 2/nr)-e /'1 " a- S 3 Z y s6 7, r7X 6 �� /fnrd� rn �'.- CC-1 l vF y . 6/ Of 72 �) C� 16 .� - o �17 F � # Bonne Ground surface etev. 6 s ft. Depth to limiting faclibr7 l in. ® Pit 3 0 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 TIM J 4' /2 /D /) / � � . G 2 12`2.5 /D��Q / /� ,f 2�sbk }"tom 6 j� e S a O ZS' r 7,SYR 6 /� S/- f Y'hi�h sr C w JL `/ - 6 9- irb oLw 6 IP A )" os r�L ._ — o -7 i s /v/ • Effluent #1 = BOD > 30 _< mg& and TSS >30 1150 mg& • Effluent #2 = BOD <_ 30 mg& and TSS 130 mg& CST Nme lease Print) Signature n CST N umber Address Date Evaluation conducted G Telephone Number �9� /�/ /1 -o/ �/s zy� 3zo. zof 7 Q r Property Owner G � ��` �,' e �kA 0e 4 - Parcel ID # Page of FT] Boring # El Boring q Pit Ground surface elev. A , 3 ft. Depth to limiting faclor /�a in. SoiI Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfff In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 I •Eff#2 0-,? /0W -4— IV A J6't (- / / - y 6 6 i / �✓ 7i5 Boring # ❑ Borin ❑ Pit Ground surface elev. �• ys ft. Depth to limiting facto o _ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDiff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 I •Eff#2 2 z y� AL Z�1sk /L7 -4 Z An a B oring # Boring ® Pit Ground surface elev. ft. Depth to limiting factor a in. Soil Application Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDfff In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 *r:ff#2 cix 7 2� 3y 7s� ,G,¢ I • Effluent #1 = BOD > 30 1220 mg& and TSS >30 1150 mglL • Effluent #2 = BOD < 30 mg& and TSS 130 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 department at 608- 266 -3151 or TTY 608 -264 -8777. sao43ocr<&N) N pi oD N �� to 1, y,5 �3 ' 0 d (0 s y /vI -ys f l . Sao 3� S > olo CIO PP 4 �3 ' r a C l ut: b I 83 D� d D 5 OWNER' Page 3 of 3 Name Gent Brian Parnell Address /9 U' CST 231314 #AICW Ri t- 5V617 Date 6-17-01 A Benchmark 1 - 411 L o 57 4 /M. 0 � �G��� A Benchmark 2 - rOP I P;fe IV AN, ❑ Soil Boring i- -1 Suitable Area 1 = 40' Scale T 1 T L /00 U /0U-0 0 6 i --T P e . . ....... i CERTIFIED `BuRvtY MAP Iooated In art of the Fractianol Southwest Quarter ; f the SoutnweAt,�ljrgw and pat of the Northeast Warter at the North~ Oudrter all In Seatlon 7, Tgwmphlp 30 North,',, Amos a Woof. Torn of Riehmdnd. St. Crag County< Wlpconorn. ; Prepared for and at the request at: Gorda A. I lockhoter Sectlan Comer 11an�riopt R91 pak�, Inc. of Renard is It 9th Street • sit 1" s 2e iron R! p wel lnq New Rlthmand, N1 54617 1.13 pounds per lhp�i flpat ardfled oy,' Ty R. ➢adga • • • •. • • ...Bullglnp Sotbook 1,IR (1Q0' M t of Way) Him f I I �� 46CONS�H t�'sr f/4 COW" , poo E �* j seerrGw T aa- ra �ra,iva f• rsnw �1 ; ! w5a9a gj c U UNPLATIED 1,ANPS QF OWNER ` 4f r A SUfl��„�a Ty i i (,Yr, - a' � N &9�05`b2"E 630.14' I W I 210,04' 210.04 p4' 1 NOT 3 LO' 4 ' LET TOTAL AREA TOTAL; 139,259 ACR SQ; FT. 138,26 SO. I• . TOTAL AREA! ARF ES 3.20 A OtS AREA E1iG, 'ltriD -% 138,235 50. irT. AREA ; C. W: I 3,20 ACRES 132.324 S0; FT. 2,62 s I x AREA ERC- A -O-W, 3,.04 ACRES 3, A I ' 132,324 SO. FT. t q 3.04 ACRES o I Ii I it I .. ! 0 6 s - - Na9.05's21,630,,x' ! i .h �r.. — 210. G 4 ... t` 2 r : � '�.. ,r j� d 4' �. 210 0 1 .04' ,� Ndg' S'54'E 2066.65' 06 62 YY b 0,1 r. _ _. T - SWINREST t7GYPA�fq SECrAW 7— .rP-rs SWIM LM rr ' sw !f4 satin+ r, II CCA WR A� UNP Tt>c11 LANL15 SfCncw 7 -Jo Id I rvOTF: Tha parcels shown an this map ore subject to '$totq, County and Township laws, r4Pe6 and regulations (I.a. netiands, minlmom lot 6128, ae os '•o porco" etc.), astore piachasing or doweloping any portal, coritoct thpJSY. s crolr county Zoning Office and the approprlote Town $oora fo odAca. Joe N wlas7sual j Prepmed 6y_ N TH EQ RHIC Phan* No, (715) 244 -4319 SCALE IN F T. 1 In h 150 toot =ax No (715) 246 -3t910 REARIN05 AR 1tEfFfi NCEO TO THE $0UTH LINE OF 11 P:O. Bos 325 SW 1/4 OF 3 4 TUNSHIP 30 N., RANGE t5 W. Mar Rfchmand, W 64017 *HCH IS A,S&t:l {i 1 NEAR S49'R5'52'W. Sheet 1 of 3 i i , I II ST CROIX COUNTY . SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Aj e Mailing Address u Sa Sc, 4/J_.(.. L g bra.. Lev o a,� A ti ASS % / q 9 / Property Address (Verification required from Plaaning Departmcat for new construction) aty /State �j£ 12 , n.►ov © ,kl parcel Identification Numb LEGAL DESCRIPTION Property Location ,LL %, S 4 y, Sec, �� T : 0 N -RAW, Town of c14 0A) Subdivision Lot Certified Sarvey Map . Vo1Ume Page # J`�. Warranty Deed # 7 9 �Q � Volume o7a3 O . Page #. o Spot house €7 yes Xno Lot lints idea tifiablox yes ❑. no S�STEM�ViA3N��T1lNG� 7 �ropatrsesadeofynarrepticsysticaioonldzrsaltmitspn�satut+ �ta�, etobaadlevvaste "s.Propeea�abcaamoe - ooasists ofpumping out the sdrtictaalc evcxy &= y = or sooner; if acedodbq t &=c dpamper: - W hit you put.iaw ft eaa :ffoct � •firtrrtian of � sepiLC- taalcas.: trcat�t tage ia Ss; �raGe.�ysbcxn. .. - - Tlbe property owner agoxs to submnt to St CLak Zoning De ut=nt IL cafficatioa form, signed by *0 •owaec and by a P 7 P l?km&moratvaasedpumpav +iagthat(Ij�eonaitawad=ati rdrsposalsysbc is in "a opaft conmw sad/or(z) aftcr kVcc = nerd puarpicg (if aoa sa y), the septartanlris Jess fban W •tull of dadge. Ywo. ffie tmdesignedhasne•read the:beet rogair and agox to maimtaiat5e pdvite sewage disposal system wise the standards r' at Seraa.xs see by the Dcparta�at of Cbmmerve sad t5e Departaaeat of Nataral Resoa State of wis000 b_ a� $ Ufmg &dyear=PCMsys6embasbaamakftb odtoastbecompldcdaadrtodtoMoSGQoix .Couatyzaft days. of the iffir a cViration date. SIGNATURR B APPLL DATE OWNER CERT ICATION I (we) certify that all statameats on this form are true to the best of my (our) knowledM I (we) am (are) the owner(s) of the d�'bed abov virtue of a ProP�Y e, by waaaaty daod r000rded in Register of Dodds Office, SICrNATURE Cg APPLICARr U DATE s « «sa« AttY information. that is mis- representedazy rc=& in tree sadtuy permit being revoked by the Zoning Depattment •« Include with this application: a stampod vvm unty deed from the Register of Dodds ofliee a copy of the ccrtifred survey map if rcfercaoc is c adc in the warranty deed I � POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pa I of 2 FILE INFORMATION t SYSTEM SPECIFICATIONS Owner Septic Tank Capacity al ❑ NA Permit # Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity al Estimated flow (average) © al /day Pump Tank Manufacturer E Design flow [peak), (Estimated x 1.5) Q d g al/day Pump Manufacturer NA Soil Application Rate al /day /ft2 Pump Model NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit A ats, i Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspe nded Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispers ell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L X NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 51 ° cfu /loom ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: 0 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: c� ❑' ointh(s) (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: 0 month(s) (Maximum 3 years) 0 NA 4 J9 year(g) ❑ month(s) Clean effluent filter S At least once every: 1 year(s) ❑ NA Inspect pump, pump controls &alarm At least once every: ❑ month(s) ❑ NA 0 year(s) pressure test At least once eve ❑ month(s) 13 NA Flush laterals and p every: ❑ year(s) Other: ❑ month(s) ❑ NA At least once every: ❑ year(s) Other: 0 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 Z of 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: ❑ A suitable replacement area has been evaluated and may be utilized for 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 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 alua ' a o ing�ank b e ai a ?R D14115 >� "i2 N>� at J e(lCTt D ❑ 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 Phone 7 l _ ,�- ,S SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name ST. G ( (SUN L Phone Phone 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. w w 652926 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO. WI RECEIVED FOR PIED CERTIFIED SURVEY MA -&014 :25 D" Located in part of the Fractional Southwest Quarter of the Southwest Quarter and part of E 14,00 Quarter of the Northwest Quarter all In Section 7, Township 30 North, Range 18 West, Towre�lchmond, 3 St. Croix County, Wisconsin. Prepared for and at the request of: LEGEN Off � Section Corner Monument Gardd A. Kfackho�fsr 862 �35theStre of Record e't Inc a Set 1" x 24" Iron Pipe weighing New Richmond, WI 54017 1,13 pounds per linear foot Drafted by. Ty R. badge •••••••••Building Set g ' Woy) i PPROVED t I y CR00000UNTY N 14f ST 114 CORNER Zoning and Parks Cn c+ :'}ne SEC770N 7 -JO -18 ( G 3 2001 FOUND 1' IRON PIP£) rded within 30 days of . UNPLATTED LANDS 0 date approval shall be - ------- - - - - -- null and void V N I N89'D5'52`E 630.12' I 210.04' 210.04' 210.04' I 2 LOT 3 0 ' Z LOT 4 0 y u ON TOTAL AREA: CA LOT 2 139,255 SO. FT. 13 55 SO. FT. rn S I 3.20 ACRES . a TOTAL AREA: 3.20 ACRES r i 139,255 SQ. FT. AREA EXC. R -O -W: AREA EXC. R -O -W: N > 132,324 ACRES 132,324 SO. FT. 132,324 SQ. FT, a p rn z AREA EXC. R - -W: 3.04 ACRES No 3.04 ACRES w$ 132.324 SO. FT. N o IC H N c 0 3.04 ACRES ° 1 i Z g C O W � Ir> W r*1 Ow 1i f p 01 W + I w I r ^i ' a rn o+ g # N N N N 10 I - I0 I 1 1; I ..................... .................... w t W w w p - - N89'05'52'E•630.12' 7t —� A 2 21 0_04' �r _210. r 211 210.04' r 210.04' N89'O5'52 "E 2069.65' w \ S89 - 05 - 52 • W 630.12' v - -- ----- - - - - -- �Y� ,, SOUTHN£ST CORNER l --- S89'05 2699.77' - S£CAON 7 -JO -18 SOUTH L1N£ OF THE SW 111 SOUTH 114 GARNER (FOUND ALUMINUM UNPLATTED LANDS SECI70N 7 -30 -18 COUNTY MONUMENT) -------- _ _ _ _ _ _ (FOUND ALUMINUM COUNTY MONUMENT) NOTE: The parcels shown on this map ore subject to State, County and Township lows, rules and regulations (i.e. wetlands, minimum lot size access to parcel, etc.). Before purchasing or developing any parcel contact the St. Croix County Zoning Office and th ro date TqyD for advice. JOB # WI057SU31 �gtnnunmuq�r Prepared by. J �� ° � o �, sCON$�� +t 150 1 tsa � N TH J corf alp crorlP I na � Y T R. , � � GRAPHIC SCALE Phone No. (715) 246 -4319 _3 >ft. DODGE SCALE IN FEET: 1 inch . 150 feet Fox No. (715) 246 - 3830 " S•2434 BEARINGS ARE REFERENCED TO THE SOUTH LINE OF THE P.O. Box 325 ' 4 OF SECTION 7, TOWNSHIP 30 N., RANGE 18 W. � CLEAR LAKE, SW 1 � Now Richmond, WI 54017 V71 5 WHICH IS ASSUMED TO BEAR S89'05'52 "W. Sheet 1 of 3 may.' �0 OQ '" • -• ' SUAN.: cg ' "'�rusnum• V01.15 Page 4145 -2 --o1 I I i �1 2230P 262 c 72GD 1 65 STATE BAR OF WISCONSIN FORM 2.1999 KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Rolling Hills Dairy, Inc. RECEIVED FOR RECORD 05/05/2 @03 04:30PK WARRANTY DEED EXEMPT # Grantor, and Daniel J. Kelly and Emily M. Kelly, husband and wife, REC FEE: 11.00 TRANS FEE: 135.00 COPY FEE: CC 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 That part of SW1 /4 SW1 /4 Sec. 7 T30N - R18W described as follows: Lot 4 Nw e AMEY BANK NA of Certified Survey Map recorded in Volume 15 of Certified Surv Maps, page 4145, as Document No. 652926, St. Croix County Wisconsin. 1301 Coulee Rd PO Box 70 Hudson, Wl 54016 026- 1025 - 10-400 Parcel Identification Number (PIN) This is not homestead property. QK) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this '0A 41 day of April 2003 Rolling Hill iry, Inc. • + b t- s r AUTHENTICATION ACKNOWLEDGMENT Signature(s) Rolling Hills Dairy, Inc., by STATE OF WISCONSIN ) l,G ) ss. County ) authenticated thi day of April 2003 Personally came before me this day of �- the above named • Kristina Ogland 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 and acknowledged the same. , THIS INSTRUMENT WAS DRAFTED BY + Attorney Kristina Ogland Notary Public, State of Wisconsin Hudson, WI 54016 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ') • Names of persons signing in any capacity must be typed or printed below their signature. ►nrormation Proraaionab company. Fond du Lac. W STATE BAR OF WISCONSIN 5- WARRANTY DEED FORM No. 2 - 1999