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HomeMy WebLinkAbout026-1065-50-300 /* Wisconsin Department of Commerce y Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count St. Croix INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary3P /034kjo: Personal information you provice maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)). Permit Holder's Name: ❑ City ❑ Village ❑ T wn of: State Plan ID No.: Carper, Bill Richmond Township s /D* : 39 -f 5� CST BM Elev. Insp. BM Elev.: BM Description: Parcel Tax No.: tv . u t tA. o r T =CSC 41A& 026- 1065 -50 -300 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic �� Benchmark r] �,p 0 9 • o Dosi ng Alt. BM 3 a I I n I S Aeration Bldg. Sewer I ;. zs Q- 3s 1 0,+ 10. Holding St /Ht Inlet / )o2 S TANK SETBACK INFORMATION St/ Ht Outlet TANKTO P/L WELL BLDG. A to iri ntake ROAD Dt Inlet Ar Septic S5D / 3 D NA Dt Bottom 1 `F 3r q$ , q p' Dosing t< <' yp r NA Header/ Man. r Aeration NA Dist. Pipe ("o IfXo •6S Holding Bot. System 3o p S' 13• S. PUMP/ SIPHON INFORMATION Final Grade s # S Manufacturer Demand St cover k Model Number WSJ b GPM � ��'� g. qc> l •C) Friction S ste '' v DH Lift -J.o) L oss oZ a. TDH 15.3 Ft �v 13 zs 3.25 ate .O .i • I rro� �.a Forcemain Length Dia. 2" Dist.Towell SOIL ABSORPTION SYSTEM ED Width Length No. f T PIT N f Pits Inside Dia. Liquid Depth EN I N S DIMENSION SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHIN Manufacturer: SETBACK CHAMB INFORMATION Type of I r Mo um e_ System: Iq '' 4, '�� OR UNIT DISTRIBUTION SYSTEM 6 '" �� �� Header / Manifold Distribution Pipe(s)� I r / x Hole Size x Hole Spacing Vent To Air Intake 3 6" " Length 3 • 0 Dia. _� Length � _ Dia. � Spacing 3 • o 2`� SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/Sodded xx Mulched Bed /Trench Center Bed / Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1 • It/ to /oa Inspection #2. 11 /10 / co Location: 1286 146th Avenue, New Richmond, WI 54017 (SE 1/4 NE 1/4 22 T30N R18W) - 223018331C Pogdview Meadows - Lot 3 � 'Qj s � �•���� 3 1.) Alt BM Description =`� ���'�^^ a�.e<� Sru•>Pr . (s 2.) Bldg sewer length= 3' - amount of cover = ? (g P 7 - 1 CA) 3.) contour = 5.15 ' ' ' �} �+ $5 ,, - f 4 1 O • o c,.+ 4f* e e ttcp a c.i e+1. . Plarf revision required? ❑ Yes No Use other side for additional iin It 2. l� fie "` �"� « <J aq `��`� ciKA Date Iq�spedpr s Signature Cert. No. \J SB 6710 (R.3/97)�. �. •�a� k2-{-tic1C Ac�i P ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: _ . IF r 9 t Ij I € € � F R , € € of 3 P$ € ] E E ' E € € a 3 a � I € € € �.v I € 12-9, /q Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 isconsin Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of commerce [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not state owned Attach complete plan ( t o the county cop only) for the system, on paper not less than 8 -1/2 x 11 inches in size. County State Sanitary Permit Number ❑ Check if revision to previous application State Plan I. D. Number '5 , 3 3 I. Application Information - Please Print all Informatio Location: Property / Owner Name Property Location 1/4 ti,Fj/4, S a,4�4N, (orCW Property Owner's Mailing Address el Lot Number Block Number 7 T 3 City, State Zip Code Phone Number Subdiv' ion Name or CSM Number II. Type of Building: (check o .,, i ❑ City a s���✓5u.�i Sa..30 331 1 or 2 Family Dwelling - No. 1 rooms ❑ Village ❑ Public /Commercial (describe �'Y f1 Town of 11 State-Owned j Neares Road M INA():F j , : ,t ^ e / P T ' �V& "(s UL Type of Permit: (Check o on line h box on line B if applicable) CS a 7 S A) 1. FrNew 2. ❑ Replac n acement of 4. 5. 6 Fy Addition to S ystem System ' `�-- k Only Existing System $) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) E ❑ Non - pressurized In- ground /(Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade a ❑ Aerobic Treat me t Unit ❑ Recirculating ❑ Other: C r cos - • `Fo '`d fl -s' 6 " V. Dispersal/Treatment Area Informatio 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) i Elevation VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks VIII. Responsibili ty Statement I, the undersigned, assume responsibility for installation of the POWTS shown n the attached plans. Plumber's Name (print) Plumber' Signa re (nos s): PRS No. Business Phone Number )61 �/ � �0_ ' Plumber's Address (Street, City, State, Zip Code) )/&') "o '� IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) [,Approved ❑ Owner Given Initial Adverse Su harge Fee) Determination CD � -I6- X. Conditiops of Approval /Reasons fo' a rov 1 '_ _ n • ^ � r D � • ( L . ly�t�l+s2 `'`'� �� �6i+�$� M �tQ.paA.t,tap 0.�n.0�•�'FC SBD -6398 (R 07/00) ' Safety and Buildings PO BOX 7162 MADISON WI 53707 -7162 TDD #: (608) 2648777 Visconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary October 06, 2000 CUST ID No.691727 ATTN: POWTS INSPECTOR ARTHUR L WEGERER . - - - -- ZONING OFFICE 421 N MAIN ST r. / ' , -ST CROIX COUNTY SPIA PO BOX 74 /k\\ CARMICHAEL RD RIVER FALLS WI 54022 4. HUDSON WI 54016 RE: CONDITIONAL APPROVAL ' l - 1 "" Identification Numbers PLAN APPROVAL EXPIRES: 10/06 /2012 w Y 1 ' MG - Transaction ID No. 439450 SITE: COUN f `� Site ID No. 200043 RICHARD LACASSE - RESIDEN �� ZOtdING OFFICE Please refer to both identification numbers, ST CROIX County, Town of RICHM {• " c• above, in all correspondence with the agency. SE1 /4,\ , NE 1/4, S22, T3 ON, R18W �:• � Lot: 3, Subdivision: PONDVIEW FOR: Description: MOUND SYSTEM / 450 GPD Object Type: POWT System Regulated Object ID No.: 765399 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: + On page 3, as specified in the approved mound system component manual, you must show two -foot contour lines in the system area and up to 25 feet surrounding the system area. An alternative would be to provide the ground elevations at the system's four corners. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. :Jcere DATE RECEIVED 09/28/2000 FEE REQUIRE D $ 175.00 FEE RE CEIVED $ AGELf_,07145 S LAN REVIEWER II BALANCE DUE $ 17 0.00 Integrated Services (608)266-2889, M J - 1630 HRS PEPAGEL @COMMERCE.STATE.WI.US WiSMA 37,33' cc: RICHARD WILLIAM LACASSE TITLE SHEET ` �ti Page 1 of 7 MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE This plan has been prepared in accordance with the Mound Component Manual SBD- 10572 -P and the Pressure Distribution Manual SBD- 10573 -P C z. 6 /qof) C1Z 6 . /9q LOCATED IN THE SE 1/4 OF THE QE 1/4 OF SECTION ZZ , T, 3 N, R lS W, TOWN OF ST. COUNTY, WISCONSIN. Lc�T 3 � � ' P�►� v ice, " INDEX CORRECTION NEEDED PAGE 1 of 7 TITLE SHEET SEE CORRESPONDENCE PAGE Of 7 SYSTEM MANAGEMENT PLAN PAGE 3�f 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW -CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUMPING CHAMBER CROSS SECTION PAGE 7 of 7 PUMP PERFORMANCE CURVE P.O.W.T.S. Conditionally E D PREPARED FOR DEP E T OF MM Eti -�� C_ - - -- DIVIS10 AFET AND DING H-Lyq ff:S, SEE CORRESPOND CE _ -- �( 3� 450 PREPARED BY WEG FEE E:ZER SO S L TEST S NG AND. DES I (BM SERV = CE P.O. Box 74 421 N.Main St. River Falls, WI 54022 Phone 715-425-0165 Fax 715- 425 - 6864 _ ' ARTNUA L 2 WEGERER j Z 6915 � 6LLSWORTM, i W bye, 1 G �1 ~ ft N80 JOB NO. �O - Z86 Mound System Management Plan Page Z of 7 Pursuant to Comm 83.54, Wis. Adm. Code Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. Tho operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The tlet fii shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are ma e o ism e n that ug o the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg /L BOD5, 150 mg /L TSS, and 30 mg /L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [SBD- 10572 -P (R. 6/99)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. • Contingency Plan if the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions on the operation or maintenance of this system should be directed to the County Zoning office at '115_38b- t1690 or to the licensed plumber who installed the system. , PLOT PLAN Scale - Page 3 of 7 . 1 "= 50' I - SUcc, / 3 B�Ry1 ►flow► E . � v lo'oF4 "�vC S 13 u p►„1 01= ': tZL.LUS.4' C RRECTION NEEDE6 9 �� SEE CORRESPONDENCt \� 'bo tioT Camppre—T ` \\ v Nz pkS Ml-e3 \ \ w P \ I- S Cti. 9 X Pcc � Vy6�± -- s _ io qz` oN LuT Sic{ -cL L—O t' MCJ NOTES: 1. Elevation n are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be l 000 /bSD gallon capacity manufactured by I`'1 Dw � P ST t Svc w lz�Bez E IE�u FA UZsri 4. Bench marks SE PrAovm 5. Divert surface water around system to prevent ponding at the uphill side. • _ R Page 4 Of Approved Synthetic Covering ASTM C33 Distribution Pipe Medium. Sand Topsoil = =H F G Elev. l0 S. 3 E D 3 b 5z% Slope Distribution Cell of Force Main Plowed 2" to 2- Aggregate From Pump Layer Ft . E CROSS SECTION OF A MOUND SYSTEM F 0.8 Ft. G o• S Ft. A Ft. H l• 0 Ft. Linear Loading Rate= 6-(3 GPD /LN FT B - )S Ft. Design Loading Rate= o•�?GPD /SQ FT I \Z Ft. S Ft. K o Ft. Position L q \ Ft. of Force Main W Z3 Ft- L I - Observation Pipe a - - -I - - - -- - -��s Co-- -------------- - - - - -- --------- - - - - -- - - - - -- 'S o x FA W - __�_ - -- -- - - - - -- --------------------- Distribution `— Cell of ' " t � 0 2 Pipe aggregate Observation Pipe (Anchbr securely) PLAN VIEW OF A MOUND SYSTEM - Distribution Pipe Layout Pa &e S of - 7 ..c Place the holes at the bottom of the distribution pipes at equal spacing. Remove all burrs from the pipe and holes. Extend the end of each lateral up with the use of Iona turn or 45 fitting to a point within six inches of the final Grade, Terminate the ends of the laterals with a valve,: threaded cap or • threaded plug. Provide access from final grade for the valve; threaded dap or threaded plus. T L CZOSS. pv c Fvc ,�vc Lateral Manifold Lateral x x x x x!Z x2 x x s x ' Lateral Length — Lateral Length —"P IT Distribution Line f' �� ccMc sflX h YYL11 F� � S • �'OQC� MfS1A.� P "7 Ft. Hole Diameter -S A6 Int:h S 3 Ft. Lateral I . Inch(es) X ?�_ Inches Manifold Inches Force Main " Inches #of holes/pipe-i-9 Invert Elevation of.Laterals Ft. Combination Se* c.Tank and PL!-MP CHAMBER CROSS SECTIOM AMD SPECIFICATIONS ' PAGE OF 7 -VEIJT CAP - WEATHER PROOF JUIJCTIOIJ BOX . ti C.Z. VEMT PIPE APPROVED LOCKIIJG 1 10 1 FROM DOOR, 7MANNOLE COVER AJIV :nUDow OR FRESH wARN1WG LI4gEL . ua3P 1oW PIPE ALR IJJTAKE cor�Du�r 1JLET PROVIDE I - •• AIRTIC.HT SEAL I I I I 84Ft =�cS � I III V Approved z�-�- A I I II Approved joint w/ I joint w/ PVC pip A PVC pipe 13 I I I 1 ow tyorE - __ C I 1 P�►KP UFF_ — LLEV! 6•l5 FT - 1 Pump - -� � OFF CO UCRETE BLOCK - RISER EXIT PERMITTED OJJLy IF TAN MAWUFACTURER HAS SUCH APPROVAL 3NAAPRcvlzD BFDD sEPTIC F SPECIFICATIC)KIS OOSE TA Li K5 MA►JUFACTURE.R: p WUMBER OF DOSES: y " PER DAy TAAJK :,IZE: L�oO �6S0 GALLOWS D05E VOLUME I ALARM MAUUFACTUFLER: S'S t :Z - LJQC R- S`I3Tk :5 , 1S INCLUDING, 6ACKFLOW: __ l `q GAw om.c MODEL ►DUMBER: lAw CAPACITIES: A - ZD IUCHES OR GALLOta SWITCH TtIPC: - ►�1 s�R"�1' g = Z I u CHES'OR G(�LLOA15 PUMP MAUUFACTURCR: 6ou�DS C= 7 IUCHES OR 1 1 9 GALLOIJS MODEL MUMBEK • D=--- L_IN,CHES OR �' GALLDAIS SWITCH TYPE: MOTE: PUMP AUDALARM ARE ` T0IS[ 6 MIMIMUM DISCKARGE RATE 16 GPM INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFERENCE CETWCEU PUMP OFF UD..DISTRIBUTIOU PIPE.. G.65 FEET + MII.JIMUM METWORK SUPPLY PRESSURE . , , 1 ZS FEET + O FEET OF FORCE MAIN X S 'dZ F oFCFRICTIOU FACTOR.. y L- SZ FEET TOTAL Oy1JAMIC HEAD = '`I EET As per manufacturer 1 gal /in. Liquid depth IS'" �>�__ZFO7JUlfpLiCE GV F__ o 7 - Goulds Submersible Effluent Pump �.r 3871 EPO4 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- • Homes components. Available for automatic and tic cover with integral handle • Farms Motor: manual operation. Automatic and float switch attachment • Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical points. • Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, built in overload with preset at the factory. rated oil and water resistant. automatic reset. ■ Bearings: Upper and lower SPECIFICATIONS • EP05 Single phase: 0.5 HP, FEATURES heavy duty ball bearing 115 V, 60 Hz, 1550 RPM, construction. Pump: EPO4 built in overload with ■ EPO4 Impeller: Thermo- • Solids handling capability: automatic reset. plastic Semi -open design 3 /4" maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. CO. Canadian Standards Association _total heads: up to 24 feet. with three prong grounding E EP05 Impeller: Thermo- ` Oischarge size: 1 NPT. plug. Optional 20 foot (CSA listed model numbers _ • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in " or "AC".) rotary/ceramic- stationary, three prong grounding plug improved performance. " BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 I • Capable of running j dry without damage to s so >►�� �5GP1u1 components. ry Pump: EP05 a I I t- • Solids handling capability: c 25 t 3 /4" maximum. a LU • Capacities: up to 60 GPM. s 20 • Total heads: up to 31 feet. g i • Discharge size: 1 NPT. Z 5 ��. Z • Mechanical seal: carbon- c rotary/ceramic - stationary, _j 4 BUNA -N elastomers. �<_ EP05 • Temperature: ° 3 10 104'F(400C)continuous EPO 140 °F (60 °C) intermitt nt. 2 5 0 00 10 20 30 40 50 GPM ' _ L 0 2 4 6 8 10 12 m °/h CAPACITY ©1995 Goulds Pumps, Inc. Effective May. 1995 1 "s�saArsinDepartment ofIndustry, SOIL AND SITE EVALUATION REPORT Page of Labor and Human Relations Division of Safety & Buildings in f HR'83 -.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than es 1n size f'l'an must include, but �# ° not limited to vertical and horizontal reference pocn'�d% of sldpe scale or PARCEL I.D. # / dimensioned, north arrow, and location and distaroad' '1'' S Z:!ID B Y DATE APPLICANT INFORMATION- PLEASE PRI RMATIONr_" , PROPERTY OWNER l PROP:, LOCATION GOVT S L 1/4 /vL 1/4,S ZZT p , N,R 8 (a) W PROPERTY OWN R':S MAILING ADDRESS , 40I # BLOCK # SUBD. NAME 0 M CITY, ST ZIP CODE PHONE NU, , ' CITY VILLAGE [MOWN NEAREST ROAD )r' alt' ��. 5 t (�i�) -�-4 (.h m c& #lo S [�Q New Construction Use [ Residential / Number of bedrooms ,3 [ j Addition to existing building [ j Replacement [ j Public or commercial describe Code derived daily flow 56 gpd Recommended design loading rate _bed, gpd/ft __ trench, gpd/ft Absorption area requir 0�?5 bed, ft ,3, trench, ft Maximum design loading rate _ bed, gpd /ft .S trench, gpdtft Recommended infiltration surface elevation(s) / 0'j 8 --� ft (as referred to site plan benchmark) Additional design / site considerations /Z // Parent material ;�; // /� /�i�� Flood plain elevation, if applicable -1 ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem [IS ®U as El EIS JO U C] S 111 [3 S ID U El S +ffU SOIL DESCRIPTION REPORT P Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots ;GP D /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Tiench Ground - 75 2 '4/ GUC S l `>d S ►" 1 v► 0 cj �A , - 1 .6- . L( elev. _?7 Depth to limiting factor Remarks: Boring # >n�� > 0 41 v ,2 3 /3 0 0 2 4 / t)0) IV C_7 Sc Z ✓>7 SOS YVI 4L Ground 95 1- 1 Goo n1c 5( am s i m cc) lev 7 (o -6 7, 52 b I\j L /I/ ,9 1 - 15 - 4 .3 Depth to limiting factor Remarks: CST Name: Please Print Phone: Z 4 _ & Zoo Address: Ova 1 d Signature: Date: CST Number: y C z �9B PROPERTY OWNE � -,Y K SOIL DESCRIPTION REPORT Page' "—' -of a PARCEL I.D.# (n Z /0 — T6 Boring # Horizon Depth Dominant Color Mottles I Structure I GPD /ft ) in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence B Roots Bed (Trench Z Ground /VO io G S Z m S6 cc) `U .4 elev. /-�2 c) 7 .s ,� iz 4/ 51 r4 A/ yn� r 3 Depth to limiting factor X3 " Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(R.05/92) t A STEEL'S SOIL SERVICE Gary L. Steel ' e C.S.T. 2298 p y� s, �" „-,, , K New Richmond, WI 54017 MPRSW -3254 S 715) 246 -6200 SC-7y+ NeY� Szz_ �30A/ -�2►�� � gyM = -� C��.1v C S . W V &I r, / -s = 100 m A-y b k keu9w d 4 0 Qnd1s4 \ 17 3 I J X40 h e.,_,,, ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer a �� 7" Mailing Address Property Address �a% - ®�1/� �����,� - / C /(, / (J' (Verification required froni Planning Department for new construction) City /State - Parcel Identification Number 0i^7lo _,1�'�S- �5 �' `SC►c� LEGAL DESCRIPTION Property Location 51' '' /,, A z5 '/4, Sec. Z L , T 30 N -R JA W, Town of Subdivision Pry - lj Z 60 �Y ��, >� , Lot # Certified Survey Map It �� y , Volume Page It 22 . Warranty Deed # C L �� , Volume � � Page # Spec house O yes o Lot lines identifable>4-yes El 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 master plumber, 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 Conunerce 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 d of the three year expiration date. •-�-� /o SIGNATURE OF AP ANT DATE OWNER 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 the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. `, 4 1 - 4 /D 1l116 SIGNATURE OF ArCANT DATE * * ** ** P g Y g p * **s ** Any information that is mis- represented may result in the sanitary omit being revoked b the Zonin D ** 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 ,1t14"AU0UU — 1982 II I STATE BAR OF WISCONSIN FORM 11 II LAND CONTRACT Ii I; Individual and Cor ' I (TO BE USED FOR ALL TRANSACTIONS WHERE OVER $25,00015 FINANCED DOCUMENT N0. �I AND I N ON-CONSUMER {�EG�T��� OFFICE Loren D. Derrick, Rose H. I1'. G�2 CO.. WI Contract by and between errick and Joan Rit0d 1W t{ ;,rd L. D Derrick, Richard L. Derrick, De rric ( "Vendor ", $gip U 3 W 8 Robert J. Derrick Ca ran whether one or more) and llliatr► H. 17"30 Christie J. Care husband and wife, \ , + ( "Purchaser ", whether one or more). and full p R 1st 049ds Vendor sells and agrees to convey to Purchaser, up on the prompt P nce nce of this contract by Purchaser, the following property, together with the rents, profits, I fixtures and other appurtenant interests (all called the " County, State of Wisconsin: THIS SPACE RESERVED FOR RECORDING DATA I NAME AND RETURN ADDRESS KRISTINA OGLAND II Zi1z, Estreen & Ogland �I P.O. Box 359 Hudson, WI 54016 26 n�5 -50 -X00 PARCEL IDENTIFICATION NUMBER P of the SEl /4 of N E1 /4 of Section 22, Township 30 North, Range 18 West, St. Croix County, W1s cousin, described as follows: Lot 3 of Certified Survey Map filed April 18, 1994, in Vol. ag t � as Doc. No. 515_494 TRANSFER �5 FEE This is not homestead property % (is not) lace Vendor directs to Vendor at Purchaser agrees to purchase the Property and to Pay in the following manner: (a) $ 1 000.00 3 �a �o the sum of $ 9 0.00 lfi 800 .00 until paid in full, as [ollows: together with interest from date at the execution of this Contract; and (b) the balance of $ o ; n y,� percent per annum hereof on the balance outstanding f time t on the 30th day of each and every ng fro time at the rate of al and interest in the amount he 30th day of August, 1998, and Commencing on t al monthly installments of princip 1999, month thereafter, equal on the 30th day of January, of $200.00, until January 30, 1999. Commencing al monthly installments equ and on the 30th day of each and every month ther until p until aid in full. of principal and and interest shall be $500.00, p 9y r annum on the entire amount in default (which shall Following any default in payment, inter st hall a ccrue a accel he rate of maturity the entire principal balance). include, without limitation, delinque used b Vendor, agrees to pay monthly to Vendor amounts sufficient to Pay Vendor agrees to paymesntsst° el Purchaser, unless exc y se reaso assessments, Eire and required insurance premiums wh T a of taxes,iassessments and insurance will be deposited into an escrow extent obligations when due. Such amounts received by the Ve ndor for P ym fund or trustee account, but shall not bear interest unless otherwise required by law. interest on the unpaid balance at the rate specified and then to principal. Any amount may be prepaid Payments shall be applied first tot day .Of Closing- without premium or fee upon principal at any time after balance of E an prepaym this contract shall not be treated In the event of p re p ym ate as unpaid as in default with resp m principal) a less than thelamount that ayments shall ed that principal, and interest (and in such case accruing interest from month to month shall be cre rovid btedness would have been had the monthly payments been made as first s de imned a emises being there[ er uded herefrom. urance or condemnation, ndemat be said inde ion the co P ' n continued in the event of credit of any proceeds of ins that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except: Purchaser states f final ayment. At such e time o P Vendor will furnish an abstract of title to Purchaser at the title defects, Purchaser shall time as Purchaser has abstract ex amins d a n COrrect the same within a bstract, it shall be ret ained b y reasonable rims Re Vendor until no tify Vendor in Writing and Vendor Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an a the full purchase price is paid. day of elosina X . Purchaser shall be entitled to take possession of the Property on • cross out One. _ . ..._7Z - -=- -xc__._. _._ --- -- -- - - Wreconsin Legal lane - STATE BAR OF WISCONSIN LAND CONTRACT - individual and Corporate Form No. 11 - 1982 • Nurchaser promises to pay when due assessments levied on the Property or upon on demand receipts showing such payment Pe Y everest in it and to deliver to Vendor Purchaser shall keep the improvements on the Property insured against loss or damage occasioned by fire, extended coverage perils and such other hazards as Vendor may require, without co- insurance, through insurers approved by Vendor, in the sum of $ N/A but Vendor shall not require coverage in an amount more than the balance owed under this Contract. Purchaser shall pay the insurance premium or when due. The policies shall contain the standard clause in favor of the Vendor', interest and on final of all P olicies coverin ,unless Vendor oth g [ erwise a g rees in writin g he Pro perry shall be deposited with Vendor. Purchaser shall promptly five notice of loss to in g the and Vendor. Unless Purchaser and Vendor otherwise agree in writing, insurance proceeds shall be apple d to restoration or repair of the Property damaged, provided the Vendor deems the restoration or repair to be economically feasible. Purchaser covenants not to commit waste nor allow waste to be committed condition and repair, iLed on the Property, to keep the Property to to keep t P good tenantable P p he Property free from liens superior to the lien of this Contract and to comply � Y g b e regulations affecting the Property. ply with all laws, ordinances and Vendor agrees that in g case the urchase p puce with interest and other moneys shall be fully paid and all conditions shall be fully performed at the times and in the manner above specified,Vendor will on demand, execute and deliver to the Purchaser, a Warranty Deed, in fee simple, of the Property, Purchaser, and excep free and clear of all liens and encumbrances, except any liens or encumbrances created by the act or default of t: Easements, restrictions and ri hts -of - of record, if any. Purchaser agrees that time is of the essence and (a) in the event of a default in the payment of any principal or interest which continues for a period of days following the specified due date or (b) in the event of a default in performance of any other obligation of Purchaser which continues for a period of days following written notice thereof by Vendor (delivered personally or mailed by certified mail); then the entire outstanding balance under this contract shall become immediately due and payable in full, at Vendor's option and without notice (which Purchaser hereby waives), and Vendor shall also have the following rights and remedies (subject to any limitations provided by law) in addition to those provided by law or in equity: (i) Vendor may, at his option, terminate this Contract and Purchaser's rights, title and interest in the Property and recover the Property back through strict foreclosure with any equity of redemption to be conditioned upon Purchaser's full payment of the entire outstanding balance, with interest thereon from the date of default at the rate in effect on such date and other amounts due hereunder (in which event all amounts previously paid by Purchaser shall be forfeited as liquidated damages for failure to fulfill this Contract and as rental for the Property if Purchaser fails to redeem); or (ii) Vendor may sue for specific performance of this Contract to compel immediate and full payment on the entire outstanding balance, with interest thereon at the rate in effect on the date of default and other amounts due hereunder, in which event the Propeny shall be auctioned at judicial sale and Purchaser shall be liable for any deficiency; or (iii) Vendor may sue at law for the entire unpaid purchase price or any portion thereof; or (iv) Vendor may declare this Contract at an end and remove this Contract as a cloud on title in a quiet - title action if the equitable interest of Purchaser is insignificant; and (v) Vendor may have Purchaser ejected from possession of the Property and have a receiver appointed to collect any rents, issues or profits during the pendency of any action under (i), (ii) or (iv) above. Notwithstanding any oral or written statements or actions of Vendor, an election of any of the foregoing remedies shall only be binding upon Vendor if and when pursued in litigation and all costs and expenses including reasonable attorneys fees of Vendor incurred to enforce any remedy hereunder (whether abated or not) to the extent not prohibited by law and expenses of title evidence shall be added to principal and paid by Purchaser, as incurred, and shall be included in any judgment. Upon the commencement or during the pendency of any action of foreclosure of this Contract, Purchaser consents to the appointment to a receiver of the Property, including homestead interest, to collect the rents, issues, and profits of the Property during the pendency of such action and such rents, issues, and profits when so collected shall be held and applied as the court shall direct. Purchaser shall not transfer, sell or convey any legal or equitable interest in the Property (by assignment of any of Purchaser's rights under this Contract or by option, long -term lease or in any other way) without the prior written consent of Vendor unless either the outstanding balance payable under this Contract is first paid in full or the interest conveyed is a pledge or assignment of Purchaser's interest under this Contract solely as security for an indebtedness of Purchaser. In the event of any such transfer, sale or conveyance without Vendor's written consent, the entire outstanding balance payable under this Contract shall become immediately due and payable in full,, at Vendor's option without nonce. n ' - 1 -1! _ 1 ' all d rCnis whin due under any mortgage outstanding against the Property on the date of this Contract (except for an mortgage granted by Purchaser) or under any note secured thereby, provided Purchaser makes timely payment of the amount then due under this Contract. Purchaser may make such payments directly to the Mortgagee if Vendor fails to do so and all payments so made by Purchaser shall be considered payments made on this Contract. Vendor may waive any default without waiving other subsequent or prior default of Purchase. All terms of this Contract shall be binding upon and inure to the benefits of the heirs, legal representatives, successors and assigns of Vendor and Purchaser. (If not an owner of the property the spouse of Vendor for a valuable consideration joins herein to release homestead rights in the subject Property and agrees to join in the execution of the deed to be made in fulfillment hereof.) Dated is 3 t day o July 98 19 D. rri (SEAL) (SEAL) 1 lam Carper (SEAL) � (SEAL) ose H. erric istie J. arper Richard L. errick (SEAL) I 1 (SEAL) an L. Derrick, a/k /a Joan M. (SEAL) Rober J. errick AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, St. Croix ss. authenticated this da Count �� y of 19 Personally came before me this _ day f July y 19 the above named Loren D. Derrcik, Rose H 9S . Derrick, Richard L. Derrick, Joan I.I. Derrick and TITLE: MEMBER STATE BAR OF WISCONSIN Robert J. Derrick, William H. Carper (If not a Christie J. Carper, hu sband and wife, authorized by §706.06, Wis. Stars.) to me known to be the person who executed the foregoing inst ment and acknowle th me. THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Ogland Hudson, WI 54016 Mary E Cahalan Notary Public, Pi Prue County, Wis. Signatures may be authenticated or acknowledged. Both are not My commission essary) expires 6 18 00 ,19 ) ersons signing in any capacity should be typed or printed below their signatures. RACT — individual and'Corporate — State Bar of Wisconsin, Form No. 11 — 1982 s � � FILED AP R l g 1994 ► JAMES O'C0%%ELL O tot MINIS 515494 Rte' w► StCrdxC CERTIFIED SURVEY MAP Located in part of the SE4 of the NEh of Section 22, T30N, R18W, Town of Richmond, St. Croix County, Wisconsin. OWNER AREA N Loren D. Derrick 104 885 S . Ft.) t,l LOT 1 2.41 Acres ( q Rose H. Derrick Richard L. Derrick LOT 2 2.00 Acres (87,161 Sq. Ft.) r- a d o c Joan L. Derrick +� LOT 3 2,00 Acres (87,162 Sq. Ft.) Robert J. Derrick ° Cn 1310 Highway 1165" Lot 4 2.00 Acres (87,161 Sq. Ft.) - w o New Richmond, Wi. 54017 v z W C- W L L 2 N d W 4- d AT ^ i�\�fP' A I I LJ �AI L. 4j o y � o v ar e ® NE CORNER C/) I S89 03 339.73' SECTION 22 C) I p, I i6 b N tD O I I m W N <I I 3 U S89 4303 "W 273.73 z in 0 o J ' L1j a a N ao 0 rn ap O III M O N LOT 4 N "' z (,,I L7 I <I 0 0 0 � le I 50': r) j o S$9 ° 43'03 W 337 13 11 W v so' 4d _ J tiff 771 L4 L n ° w S89 °43' 03 "W 543.48' L!J I O 0 n 0 o Y : y 395.61' 80.00 3 T I— o a - 8 - I— I tun) o 01 o V N I — I <I o: a 6� -JI LOT I 66'` o a o N CL I ® _ �' 0 N f_ I ILL N37 ° 25'Od'E 0 -� I LOT 2 , .� o y ° 50: N �. ° _ N89 07 "E < • ............... ........... $ 00.' @AO ' 3 80.00' rn ', ° O 1 239.08' '� \GP�E�� _0 S89 0 39'3 E 289.08' E � N z o \ ROAD 0 APPROVED © 589 "E N37 ti -' 289.08' 50.00' = o o to I DI r I 1 " A � r ^ o z I U- LEGEND 4j N ST. CRM COUNTY o `" �omprehensive`Pisa* o Aluminum County Section Monument Found d `o ZoMng erfd d ... - \ Large Nail Found ' 4, EI /4 CORNER r k 5 Cornniitte O 1 x 24" Iron Pipe Set, weighing.1.68 w SECTION 22 lbs. per linear foot W C if notretordod nn within 30 approval'dit 41 y " "' "',Roadway Setback (` i �J nAProvat slMll'tm C \ ` nil & void SCALE IN FEET SHEET 1 OF 2 SHEETS- Ioo 50 o zoo VOLUN.'E 10 PAGE 2 745