HomeMy WebLinkAbout026-1173-33-000 0
Parcel #: 026 - 1173 -33 -000 12/06/2007 s o5 AM
PAGE 1 OF 1
Alt. Parcel #: 20.30.18.1387 026 - TOWN OF RICHMOND
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
1012112004 00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner
O - ALBERTSON, ROBERT L & ANNE M
ROBERT L & ANNE M ALBERTSON
1433 109TH ST
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): = Primary
Type Dist # Description 1433 109TH ST
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 1.747 Plat: 10- 036 - WALDROFF MEADOWS IV 020 -04 LOTS 25/z
SEC 20 T30N R18W PT NE SE BEING WALDROFF Block /Condo Bldg: LOT 33
MEADOWS IV LOT 33 (1.747AC)
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
20- 30N -18W NE SE
Notes: Parcel History:
Date Doc # Vol /Page Type
03/08/2006 820220 WD
10/24/2005 810207 2914/470 EZ -U
03/01 /2005 788508 2756/633 WD
12/20/1999 615773 1479/210 WD
more
2007 SUMMARY Bill #: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 06/22/2006
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.750 26,600 181,300 207,900 NO
Totals for 2007:
General Property 1.750 26,600 181,300 207,900
Woodland 0.000 0 0
Totals for 2006:
General Property 1.750 26,600 181,300 207,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: 06/19/2007 Batch #: 07 -06
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
479296 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)j.
Permit Holder's Name: City Village X Township Parcel Tax No:
Miller, Brian I Richmond, Town of 026- 1173 -33 -000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No:
21.30.18.1387
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic 0 ( Benchmark
Alt. BM
w 4, )k 3. zg IN J
Aeration Bldg. Sewer ,f LA (p 166,17—,
Holding St/Ht Inlet
TANK SETBACK INFORMATION St/Ht Outlet y L q g 03
TANK TO P/ WELL BLDG. Vent to Air Intake ROAD Dt Inlet
'p J
Septic Dt Bottom
�
`
Dosing Header /Man.
Aeration Dist. Pipe
Holding Bot. System
t
PUMP /SIPHON INFORMATION Final Grade CO 9 7 4 74 4
Manufacturer Demand St Cover /0 0 471 Model Nu 51 q7,�✓
H Lift Friction Loss System Hea TDH Ft 77— y ' 7 w l '
AO
Forcemain Dia. Dist. to Well / 'f
Leng
SOIL ABSORPTION SYSTEM
BED/TRENCH Width i Length T. Of Tren ' - A PIT DIMENSIONS No. Of Pits Inside Dia. �_ Liquid Depth
DIMENSIONS °� Z y re�L �•
SETBACK SYSTEM TO , v P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR � P O
Type ��SY��� d r � �� UNIT Model Number.
DISTRIBUTION SYSTEM I_
Header/Manifol f Distributi \ x Hol Size x Hole Spacing Vent to Air Intake pe(
Length Dia T Length Dia _Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over Depth Over xx Depth of Sded /Sodded xx Mulched
Bed/Trench Center Z -el T ee Bed/Trench Edges Topsoil -Yes � `, No Yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ! / Inspection #2:
Location: 1433 109th Street , �` New-Picchmond, WI 54017 (NE 1/4 SE 1/4 21 T30N R18W) Waldroff Meadows IV Lot 33 Parcel No: 21.30.18.1387
> Alt BM Desc 1. i = w a ' ` Qvv i
2.) Bldg sewer length = Z5
- amount of cover =
Plan revision Required? [ j Yes -- 0
i
Use other side for additional information. 4 Date 4&gre Cart. No.
SBD -6710 (R.3/97)
-
a WY AW >nds Division County� `
iBmt 7362 �C,J`
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Oe astfrtent of Commeree ) 26Cs•3tS�
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zip Code P►mae N �- u. S ><. Secta,a _
— _!_.__
�� N�OCIt [IM f1 Yt i>t *y) . T M: R E
tar 2 Family DarecOias - Number of 801roorw subdivision Narne CSM Numbsr�
_ NN
PuMictCanrntercial - Describe Use
- - _ V
L -rit OVdla a wnshi r
- — o
Suoe Owned - Describe _
1Qt. Type ei 1hiRflrita (G'Mee} attdy am bore 4t Um Inc a applit obit) � II
A. —i
New Syssem ❑ Repacetneet System l TMOnendHoldmg TANA Rg7 Tmmfk-r Otdy f,_a Omer Modtfic lion to £.xisting System
Q, n P'erntit Retrewal ❑ Pettnet Recision f_l Chit of _ List Previous Permit Number and Date Wired
Before � � C l Permit -) New
Plu mber Owner
►aswiygd Ln Grltend Lj "Ound > 24 b►. of suitable soa U Mound c 24 im of wiaw sal U At -Grade [.1 Singh Pass Sad Filter j
U Camsaucsed wind t l Prataueiaed IaGrou d U Hording Tack I l Pear Finer U Ac obit Tn unmet Uttit C l Rxcircuhtartg sand Filter
U $yet�tic Chamber ri Drip I anc - Gravel-has PiN U c svu
Flow (Wd) DONAM SoR Appicatioo Dispersal Area Required (sf) Dispersal Arm isf) System Elevation
5 - , 0
YI. Tack Into O C)
resin Tool Number Muf f Prefab Site Steel Fiber
Gag" of Units
New � `"'I �/ as[ it
PD� IO K PL m _� Coe CO Class t
Tanks Tyot
sew Tank OO -
Aerabk Treannen, Unit _.
art Chunbet - - —
Yfl. Sttltotpt r, *man" _- __ __ — ______• _ �
•: N, met > s s er tie POWTS 9611101 an the attadtad peas. i
s Si !U/pR$ Btuirtess Plane Number
5 - TM S
' s Addre as (Slra%t Ci Zip Coot)
1
irm iJce V
e
�AWroed Q f SS,hary penrw (includes G rowdwaser DSe rssued Isst►
Sorchargt Fee) O p nql gent St (No Stamps) E
X. moos Iteasoa for
SYSTEM OWNER:
1 Septic tank, effluent filter and
dispersal cell must all be serviced / meintelnt3d 2 5 .a � S
as per management plan provided by plumber.
2. All setback requirements must be maintained C G�F oo,u— sfee-Q-
as per applicable code /ordinances.
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It ft"n Zi n SOIL EVALUATION REPORT #1727
Department of Commerce
in accordance with Comm 85 Wis. Adm. Code Page 1 of 3
Division of Safety and Buildings 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 location and distance to nearest road. Parcel I.D.
_ 026- 1173 -33 -000
PI ev' By to
Personal information you provid forAsY�fl Fivacy s. 15.04 (1) (m)). Q �'
Property Owner C: i Property Location
Brian Miller !; ICI( 8 Govt. Lot na NE1 /4, SE1 /4, S21, T30N, R18W
Property Owner's Mailing A Lot # Block # Subd. Name or CSM#
816 MoonBeam Rd W S i CROIX COUNT 33 na Waldroff Meadows IV
City tate Grhber City ❑ Village Z Town Nearest Road
Hudson 1 1016 - 73' 386 - 6532 Richmond 109Th St
❑ New Construction Use: ❑ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD
❑ Replacement ❑ Public or commercial - Describe na
Parent material Loess over Outwash Flood plain elevation, if applicable na ft.
General comments Conventional system, system elevation 97.70ft Trenches spaced and depth to code 5.00ft below grade.
and recommendations: Adjust system elevation to silt inclusion depth or grade adjustments.
F-11 Boring # X Ground surface elev. 102.70 ft. Depth to limiting factor 144 in.
� P 9 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 •Eff#2
1 0 -8 10yr3 /1 none sil 2msbk mfr rs 1vf .6 .8
2 8 -16 10yr4/4 none sicl 2msbk mfr gw 1vf .4 .6
3 16-24 10yr4 /4 none sci 2msbk mfr di 1vf .4 .6
4 24 -50 10yr6 /4 none sl 2msbk mfr di na .6 1.0
l'
bo�`1b 5 50 -144 7.5yr4/6 none ms osg ml na na .7 1.6
l0yr 6/4 sib inclusions with 7.5yr5/6 redox features due to texure changes are present from 24 to 50 inches. Adjust system elevation with depths of
Boring # ❑ Ground surface elev. 102.70 ft. Depth to limiting factor 144 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
1 0 -12 10yr3/1 none fill na mfr a 1vf .0 .0
2 12 -30 7.5yr4/4 none sl 2msbk mfr gw 1vf .6 1.0
3 30-44 5yr4/4 none grcos 2msbk mfr gw na .6 1.0
4 44144 .5yr4/6 none cos osg ml na na .7 1.6
" Effluent #1 = BOD 30 < 220 mg/L and TSS >30 < 150 mg /L " Effluent #2 = BOD s 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) !Si gn ure: CST Number
David J. Steel / 248956
Address Steel's Soil Service, Inc. Date Evaluation Conducted Telephone Number
994 200th St. Baldwin, WI 54002 7/1/2005 715- 760-0347
1
Property Owner Brian Miller Parcel ID # 026 - 1173 -33 -000 Page 2 of 3
3 ] F Boring # N Ground surface elev. 98.80 ft. Depth to limiting factor 144 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. *Efr#1 *Eff#2
1 0 -3 10yr3/1 none sil 2msbk mfr cs 1vf .6 .8
2 3 -9 10yr4 /4 none SO 2msbk mfr cs ivf .4 .6
3 9 -16 5yr4/4 none scl 2msbk mfr cs 1vf .4 .6
4 16 -29 5yr4/4 none grsl 2msbk mfr cs 1Vf .6 1.0
5 29 -60 7.5yr4/4 none grcos osg ml cs na .7 1.6
6 60 -144 7.5yr4/6 none cos osg ml na na .7 1.6
F-1 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/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
Boring # ❑❑ Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate
F
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
* 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 (K07 /00) Steel's Soil Service, Inc.
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Bottom
36"
v d Volume 12 -1 /2" DA. (t
Void Caefffcientin A SiW Inge Area
gl,'ltgate given at 57.4 %. In. I0 FL �
O.D. of 4" pipe= 4.625 inches Sidewall (2 Sidewalk) 2 . 18.84in
Void volume per linear ft. = 3.14 2.3125h, = 3.14
l 2.3125nt _
I2in l ft) ft = 0.117 ft, Bottom IR
O.D. ofcenterc finder= 2.00
Y T2.5 inches T 0121 Soil Interface Area
Void volume in aggregate of center cylinder = 3,14 • 6.25in 5 SQ,FT
J.I4 •/ 2.3I25in
(12;/ftJ - t 12in1ft)
O.D. of outside cylinders = 12 inches
Void volume in outside cylinders m 2.3.141 bin _ projected Trench Area
` l
12in! fl) • '574 -.901 ft, Sidewall Height = 12 in. •2
= 2.00 Sq,Ft.
Void volume at bottom between cylinders = 24m • Bottom _ 36 in. = 3.00 Sq.Ft.
/ l
12uUft t2in bin � @) bin ll2 in projected Trench Area 3.14r 1 � =0.215 re
=
Void volume at outside bottom corners ( 112 of void volume between cylinders) 0,215 12 - 5.00 Sq.Ft.
Total void volume - 0.1 17 + 0.108 ft
0.422 + 0.90 i + 0.215 + 0, = 1 .763 cubic fi ! ft
Gallons per ft = 1.763 X 7.48 = 13.2 caflons n_ e r _ t
1!
ErS Aggregate
Trench System
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65 9n ustrial a Park Rd.
Oakland, TAt X8060 '4
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SHEET: 1 of 1 11 -27 -01
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P
QWTS OWNER'S MANUAL & MANAGEMENT PLAN Page — of Via,
sYST� c�►�NS `
Ovrnuer t � Tank Manwfacturar � �, � S 'e r
$
DNA
G} q vol. gal
Pemwt � �" I � 1(p 'a L7 Dose 0 Ho{ding
Tank manufacturer ❑ NA
won PA1iNMETERS D ❑ Dose p Holding vol. gal
Number of Bedroom El NA I� NA € Mane � y ( t1 ❑ NA
N of Public Facility (knits
Estimated (average) fMw p� €ffk�ent
.5) Filter Model
,
rSoLaApp7fiCE&thM w = (Estimated x 1 5C7
Pump Manufacturer / A
Rate /t Pump Model
M�entlEffluent Quality Monthly average' p�tmerut Ufa [ A
[3 S�/Crave) Filter Biochemical, Peat Filter
Fats. Oft & Grease (FOG) 530 mg/-
Biochemical Oxygen Demand (BOD 5220 mall. ❑ NA ❑ Mechanical Aeration ❑ Watland
Total Suspended SopCls Cm) 5150 mg/l.
❑ Disinfection ❑ Other:
PMOXY Effl amity Monthly average Manufacturer ❑ NA
Demand (BOD 530 mg/L DW Cepls)
) E3 w around {pressurized)
ceded Sords (TSSl 530 mg/L ❑ NA In- Ground (�tY ❑ Mound
Fee) Conform (gam rte) 510` cfu/itXlml At- Grade
❑ Off:
Maximurn Effluent Particle Size Ya in die. ❑ NA ❑ Drip- ❑ NA
❑ NA
•values typical for c wastewater and septic tai* effluerlr.
Other. Q NA
MAIN [ENANCE SIB Service F
Service Event month 3 ❑ NA
Inspect cortiditlorE of tanks) At least once every:
tMaa years)
ItWhen combined sludge scorn e qual s r Na) of tank volume ❑ NA
pump out contents of tanks) /p When the Mph water alarm is acted
D month(t) {fylaxhmm 3 years) ❑ NA
Inspect dispersal calls) At least once every: {s)
months) ❑ NA
Clean effluent filter At least once every: {s)
❑ month(s) ❑ NA
Inspect purr. PUMP Controls & alarm At least once every: p s)
❑ montl*) ❑ NA
Rush laterals and pressure test At least once every: D yearls)
❑ monthn(s) ❑ NA
At least once every: 0
❑ NA
NIANTENANCE WSTRt1CTlONSi orne of the following licenses or certifications:
Inspections of tanks and dispersal halls shall be made by an individual Carr S Operator (pumper).
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector: POVrI iS Maintainer: ken h e ardware, identify any cracks or
Of the tank(si to identify any missing or broken h
Tank inspections moat include a visaed inspection for any back up or O of effluent o the ground
leaks, measure the volume of combined sludge and s ' a check
surface. The dispersal call(s) shall be
v i su ally to ndusck the effluent levels s th fee May Indica a �� nd
po"rig of effluent on the ground surface. The ponding of effluent on the ground surface may
requires the imme diate notification of the local regulatory authority third (Y) or more of the tank volume, the
When the combined accu mule on of sludge and scum in any treatment tank equals ' of in accordance with chapter NR 13.
entire contents of the tank shall be removed by a Septage Servicing Operator and disposed
Wisconsin AdministrI#Ive Code. urized components, pretreatmerr
AM other services, irududing but not lirnitad to the servicing of effluent afilters echanica t or S Pro
M tamer.
units, and any servicing at intervals of 512 months, shall be Part of any service event.
A service report shall the Provided to the local regulatory �Y within 10 days of completion GMW (2 /02)
I
i
Page m ot
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other
chemicals that may impede the treatment process and /or damage the sod dispersal ceQls). ff high concentrations are detected
have the contents of the tank {s) removed by a septage servicing operator prior to use.
System start up shah not occur when soul conditions are frozen at the infiltrative surface.
Doing extended power outages pump tanks may fill above normal highwater levels. When power is restored the excess
wastewater will be discharged to the dispersal coNs) in one tarps dose and may overload them resulting in the bat*up or surface
discharge of effluent. To avoid the situation have the contents of the pump tank removed by a Septa" Servicing Operator prior
to restoring power to the effluent pump or contact a Phrrrhbw 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 coils. Do not drive or park over, or otherwise disturb or compact, the area
within 15 feet down cope of any mound or art -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 (stamp pump) discharge; fruit and vegetable peeler gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; umVons; and water softener brine.
ABANDONMENT
When the POWTS falls and/or is permanently taken out of service the following steps shall be taken to insure that the system is
Property and safety 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 property disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shag be excavated and removed or their covers removed and the void space filled with
salt, 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
t 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 firms and weft. 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 fast resort to replace the failed POWTS.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site
evaluation must be pedonned to locate a suitable replacement area. K no replacement area is available a holding tank
may be instelled as a last resort to replace the failed POWTS.
❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the b)omet 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
TALLER POWTS MANNTAINER
Nam JS Name
Phone LS Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Name
Phone Phone
This document was drafted by the staffs of the Green Lake, Marquette and Wawa County Zoning and Sanitatbn agencies in compliance with
dtiapter Comm 83.22(2)(b)(1)(dl &(f) and 83.54(1). (2) & M, Wisconsin Administrative Code.
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer
Mailing Address o Ual
Property Address
(Verifteation required from Planning Department for new construction)
City /State Parcel Identification Number
LEGAL DESCRIPTION . on )
Property Location U t /., S£ 1 /,, Sec. , T�N -R�W, Town of R 011
Subdivision U- 1 y , Lot # 33 -
Certified Survey Map # , Volume , Page #
Warranty Deed # _ a 2 Volume a'jSf4 Page # ( �� .
Spec house ❑ yes Rno Lot lines identifiable yes ❑ no
SYSTEM MAINTENANCE
Improper use and maintenanceof 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 Depain, nt a certification form, signed by the owner and by a
master plumber, journeyman plumber, restricted plumber or a licensedpumper verifying that (t) 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.
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 to the St. Croix County Zoning Office within 30
lays of three year ex iLation te.
IGNATURE APPLICA DATE
DWNER CERTIFICATION
I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of
he property described es. by v'rtue of a warranty deed recorded in Register of Deeds Office.
1
S
iIGNATURE OF APPLICANT 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 decd from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
�1
U, 2 7 5 6 P 6 3 3 78El510 8
State Bar of Wisconsin Form 2 -2003 KATHLEEN H. WALSH
REGISTER OF DEEDS
WARRANTY DEED ST. CROIX CO.. WI
Document Number Document Name RECEIVED FOR RECORD
03/01/2005 10:00AN
WARRANTY DEED
El1ElPT Ii
THIS DEED, made between David J. Waldroff and Julie A. Waldroff, husband and
wife ( "Grantor," whether one or more), REC FEE: 11.00
and Brian J. Miller and Mary Ellen Miller, husband and wife TRANS FEE: 114.60
COPY FEE:
( "Grantee," whether one or more). CC FEE:
PAGES: 1
Grantor, for a valuable consideration, conveys and warrants to Grantee the following
described real estate, together with the rents, profits, fixtures and other appurtenant Recording Area
interests, in St. Croix County, State of Wisconsin ( "Property") (if more space is
Name and Return Address
please attach addendum):
Lot 3, Waldroff Meadows IV. St. Croix County, Wisconsin. -%
026 -1062- 60-000
Parcel Identification Number (PIN)
This is not homestead property.
(is) (is not)
Exceptions to warranties:: Easements, restrictions and rights -of -way of record, if any.
Dated O Z/ _
(SEALS (SEAL)
* * avid J. Waldroff
( L - (SEAL)
* *J a A. Waldroff
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) David J. Waldroff and Julie A. Waldroff
husband and wife 4 STATE OF )
authenticated on Y 1-4 ) ss.
COUNTY )
*Kristina O land Personally came before me on ,
TITLE: MEMBER strATE BAR OF WISCONSIN the above -named
(If not, to me known to be the person(s) who executed the foregoing
authorized by Wis. Stat. § 706.06) instrument and acknowledged the same.
THIS INSTRUMENT DRAFTED BY:
*
Attorney Kristina Ogland Notary Public, State of
Hudson. WI 54016 My Commission (is permanent) (expires: )
(Signatures may be authenticated or acknowledged. Both are not necessary.)
NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED.
WARRANTY DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003
* Type name below signatures. INFO-PRO" Legal Forms 800. 655 -2021 www.infoprotorms.com
Wisconsin Department o ommerce SOIL EVALUATION REPORT p age 1 of 3
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
County St. Croix
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must
include, but not limited to: vertical and h ntahre on and parcel I.D. 2 en ding
percent slope, sale or dimensions, nort arrovu� _ _ �ance nearest road. 0 3
Please prIY4 all information. ` Rev ed b Date
Personal information you provide may be use I for sec" p,?oS�es i y Law, $. 15.04 (1) (m)).
Property Owner roperty Location
David WaIdi of C`tOIX J N Tt ovt. Lot NE 1/4 SE 114 S 21 T 30 N R 18 E( W
Property Owner's Mailing Address of # Block # Subd. Name or CSM#
398 River Road 33 - Waldroff Meadows IV
City State Zip Code Phone Number ity Village ■ Town Nearest Road
Hudson WI 1 54016 ( 715 - 549 - 6601 144th Avenue
New Construction UseE] Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD
Replacement 0 Public or commercial - Describe:
Parent material Loess over outwash sands Flood Plain elevation if applicable 19- ft.
General comments ./ ' /
and recommendations: /
S jj/ �, t `� 1/ r 6Z�d�Z [� c�
E Boring # 11 Boring
spit Ground surface elev. 108.60 ft. Depth to limiting factor >96 in.
Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f�
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -11 10yr3 /2 sil 2msbk dsh as 2f .6 .8
2 11 -29 1 4/4 sil 2msbk dsh cam if .6 .8
3 29 -40 10yr5/6 tIf5yr5 /8 sil lmsbk dsh cw - .4 •
4 40 -96 7.5yr5/6 s Osg dl - - .7 1.6
F 2 Boring # 11 Borin 108.40 >96
Q pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/(P
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -14 10yr3 /2 sil 2msbk dsh as 2f .6 .8
2 14 -25 10w4/4 sil 2msbk dsh cam' If .6 .8
3 25 -38 7.5yr5/6 s Osg dl cw _ .7 1.6
4 38 -96 7.5yr5/4 s Osg dl - - .7 1.6
* Effluent #1 = BOD > 30 220 mg/L and TSS >30 150 mg/L * Effluent 5 = BOD < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signatu � CST Number
Thomas C Nelson 227387
Address Date Evaluation Conducted Telephone Number
1432 120th Street, New Richmond, WI September 8, 2004 715- 246 -2454
I,
Property Owner Waldroff Meadows IV Parcel ID # Pending Page 2 of 3
❑ 3
Boring # Boring
g Q Pit Ground surface elev. 106.10 Depth to limiting factor >92 in.
Soil Application Rath
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/tf?
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Effn
1 0 -10 10yr3/2 - sil 2msbk dsh as 2f .6 .8
2 10 -19 1 4/4 - sil lmsbk dsh cw if .4 .6
3 19-27 7.5yr5/6 - is Osg dl cam' - .7 1.6
4 27-92 7.5yr5/4 - s Osg dl - - .7 1.6
5
a Boring # Boring
Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rath
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
F-1 Boring # Boring
. ft.
Pit Ground surface elev . Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlfP
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
*
Effluent #1 = BOD, > 30:5 220 mg1L and TSS >30:5 150 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- 8330Test (8.07/00)
10 Waldroff Meadows IV
Lot 33
N o d
�0s
�r
i 2i
04
yL '
to
/ 23 jb
Seale 1 " = 30' I
BM1 Top o iron pipe 100.00'
BM2 Top of iron pipe 104.70'
B1 108.60'
82 108.40'
B3 106.10'
Thomas Nelson
227387
Parcel #: 026- 1173 -33 -000 07/08/2005 09:19 AM
PAGE 1 OF 1
Alt. Parcel #: 20.30.18.1387 026 - TOWN OF RICHMOND
Current - X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
10/21/2004 00 0
Tax Address: Owner(s): * = Current Owner
*
BRIAN J &MARY ELLEN MILLER MILLER, BRIAN J & MARY ELLEN
816 MOONBEAM ST W
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): " = Primary
Type Dist # Description * 1433 109TH ST
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 1.747 Plat: 10 /36- WALDROFF MEADOWS IV 020/04 LOTS 2
SEC 20 T30N R18W PT NE SE BEING WALDROFF Block/Condo Bldg: LOT 33
MEADOWS IV LOT 33 (1.747AC) Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4)
20- 30N -18W NE SE
Notes: Parcel History:
Date Doc # Vol /Page Type
03/01/2005 788508 2756/633 WD
12/20/1999 615773 1479/210 WD
07/23/1997 824/221
12/05/1990 464663 887/615 LC
2005 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 06/21/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.750 26,600 0 26,600 NO
Totals for 2005:
General Property 1.750 26,600 0 26,600
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch #:
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Jul 01 05 08 :43a Steel's Soil Sevice Inc. 715- 684 -3449 p.4
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