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HomeMy WebLinkAbout026-1127-06-000 ak �a.o / J % k c g 2 ■ ;R E 2 £ m G .' e k \ m § \ 3 % O g w o q � co 6 § 2 (D @ 7 0 # 0 fA W / % � o E � E (5 z i % " \ $ $ k a 4 > 0 0 ° 0 0 0 z C w $ § \ %- % 0 0 0 � 2 0 J # § ■ ■ ■ L g / f E I § § § ;E2 i ' A \ ) E A 7 .. E @ z 0 > k o .A -0, §�§ £gam \( m \ /I3 \E _ � k � § k k \ _ § ■ cr / 0. C � § 9 0 ^ i I k ■ M m/ U 9E E§ �z [ § § § a � \�l< vg2 0 =; § ® � CL Ea. „ 4 z % o% ƒg( 06 3 CA o3a E70 > Erri } b � =#Ek q L— =k EE =r i F § CD q S § \ § k CD f ? k � PLOT PLAN PROJECT Chriss Miller ADDRESS 518 Lavrel Dr. NewRichmond Wi. 54017 SE 114 SW 1/4S 25 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX A , �' z MPRS Byron Bird Jr. 2205 ATE 5 -5 -03 BEDROOM 4 CONVENTIONAL XXXX At a CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 -260 gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ❑ LOAD RATE .5 ABSORPTION AREA 1200 # of chambers 39 BENCHMARK V.H.P Top of lot survey stake i ASSUME ELEVATION 100 ! RECEI ❑ BOREHOLE t� WELL *H.R.P. same as BM i A; 15 2003 A Vent SYSTEM ELEVATION T -1 =101.77- 2 =99.2T - =99. 22 Sidewinder High Capacity Leaching c; Chamber with 17.2 699 t ^2 per chamber Long 34" Elevation PL 27 B3 10' B 121' 13' 106.25 1 38' 6' 137.5 tc ' eec B2 111' r ow 100 422' 1 st with filter st 30' Wisconsin Deffartment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 429967 0 GENERAL INFORMATION' (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Miller, Christopher I Richmond Township 026- 1127 -06 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range /Map No: 25.30.18.$/ TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Ua� a� Benchmark 9es+r L � 2 � Alt. BM Aeration t, �— mr Bldg. Sewer 13 Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Winlet 0 5T ZCu Septic , 5Z ( \ / Dt S Bekertt / ' 5 J l -� i Header /Man. Boom L J Aeration Dist. Pipe Holding Bot. System O P P /SIPHON INFORMATION Final Grade Manufacturer Demand St Cov M 2- Model Nu er TDH Lift ion Loss System Head Ft For main Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING of t r: INFORMATION Type Of ystem: CHAMBER OR �, SL UNIT Model Number: if DISTRIBUTION SYSTEM I Header /Manifold Distributio Hole Size Ix Hole Spacing Vent to Air Intake Pipe Length Dia Length Dia Spacing 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 L] No � ` Yes L] No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1:Au 4.14 kV .3 Inspection #2: rT Location: 1439 131st Ave NeewQPichmond WI 54017 (SE 1[4 SW 1/4 25 T30N R18W) Richmond Hills Lot 6 Parcel No: 25.30.18. 1.) Alt BM Description 2.) Bldg sewer length = - amount of cover = Plan Use o ther sid for additio ormation. NO SBD -6710 (R.3/97) �n�sepctonature x^ , /I No. /t 16 –�LE' 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 'Wi sconsin ' Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Commerce (Submit completed form to county if not [Privacy Law, s. 15.04(1)(m)] state owned.) Attach complete plans (to the county copy only) for the syste , on p 1/2 x 1 inches in size. County State Sanitary Permit Number ❑ Check if revis on to previous application State Ian I. D. Number Gro 99��L I. Application Information - Pleas Print all Informatio )Loci tion: Property Owner Name Prope Location yy, ST. CROIX COUN / ZONING OFFICE l4�1N1/4, ,7d,N, K( Property Owner's Mailing Address of umber Block Number Ci , State // Zip Code Phone Number Subdivision Name or CSM Numbe /A(2 Zh- II, Type of Building: (check one) oe der g u ❑ City 1 or 2 Family Dwelling -No. of Bedrooms :. ❑Village ❑ Public /Commercial (describe use):_ G7 d XTown of ❑ State - Owned —10,0 Nearest Road �/ ZS Cko5 Parcel Tax Number(s) III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) A) 1. WNew 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System $) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) kNon- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland tj Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatme Area Inf ormation: y. _ 3 rf Q,' 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) r _ / /Cy ` 7 Elevation 4;�,�p /a- - Try y . ;; �-, /oc3- 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 ❑ ❑ ❑ ❑ �� X ❑ ❑ ❑ ❑ VIII. Responsibility Statement •� I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumb Name (print) Plumber' gnature (no scam MP/MPRS No. Business Phone Number Plum is Address (Street, City, State, Zip Code IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued {s um Agent Signature o stamps) aApproved ❑ Owner Given Initial Adverse Surcharge Fee )Ll- s A Determination 12 �3 X. Conditions of Approval /Reasons for I D ' isapprov 1: ct aAb4L SBD -6398 (R 07/00) PLOT PLAN PROJECT Chriss Miller ADDRESS 518 Lavrel Dr. NewRichmond W. 54017 SE 1/4 SW 1 /4s 25 /T 30 N/R 18 w TOWN Richmond COUNTY ST. CROIX MPRS Byron Bird Jr. 2205 — DATE 5 -8 -03 BEDROOM 4 CONVENTIONAL XXXX t - Grade CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 -260 gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE 13 LOAD RATE .5 ABSORPTION AREA 1200 # of chambers 39 hk BENCHMARK V.R.P Top of lot survey stake ASSUME ELEVATION 100 ❑ BOREHOLE O WELL IH.R.P. same as BM k619 SYSTEM ELEVATION T-1 =1 01.7T-2=99.2T-3=99. f idewinder High C apacity Leaching C hamber with 17.2 t ^2 per chamber Long 34" Elevation PL 27 81' 10' 121' 4' 13' B 4' 8' [� 3 ' 6� B2 111' l 100' 422' 3� 1 st with filter st 30' PLOT PLAN PROJECT Chriss Miller ADDRESS 518 Lavrel Dr, NewRichmond Wi. 54017 SE 1 /4 SW 1 /4s 25 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX MPRS Byron Bird Jr. 2205 DATE 5 -8 -03 BEDROOM 4 CONVENTIONAL XXXX At- Grade CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 -260 gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ❑ LOAD RATE .5 ABSORPTION AREA 1200 # of chambers 39 BENCHMARK V.R.P. Top of lot survey stake ASSUME ELEVATION 100' ❑ BOREHOLE (DWELL «H.R.P. same as l3M V SYSTEM ELEVATION T-1 =101.7T-2=99.2T-3=99. >12" Sidewinder High °f Capacity Leaching Cov Chamber with 17.2 6" t ^2 per chamber Long 34 " Elevation PL 27 81' 10' 121' 4' 13' B �Z 4' 8 ' [j 3 ' �I B2 111' 100' 422' 1 st with filter st 30' Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 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 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal referencepo direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and.lgr,�jio� afic�diStmce to nearest road. endin Please print all �(okrpWon. �., . Re awed by Date Personal information you provide may be used purpoeye (Pr' acy Law, s. -13,04 (1) (m)). Property Owner F?;r"petty Location Cj R J C Develop Inc.!' GGvt• Lot SE 1/4 SW 114 S 25 T 30 N R 18 or) W Property Owner's Mailing Address - j , s Lot # Block # Subd. Name or CSM# 1868 Cty. Rd. C s' �;� . na 1chm Hills City State Zip Code - qne Numb Nt , , t 0 - pity ❑ Village ® Town Nearest Road New Richmonq WI. 1 54017 '(711 M- 5721 , Richmond I 130th, Av :91 New Construction Use: ❑ Residential / Numberd , bedr� _ Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material g l a6 } a] dr i i t Flood Plain elevation if applicable ft. na General comments and recommendations: trenches 3.50' below grade spaced to code F Boring Boring # 1 5 . 5 �, Depth to limiting factor + 9 6 in. Pit Ground surface elev. — 9 Soil A plication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -12 10 r 3/3 2 12 -28 10 r4 4 none sicl 2msbk mfr gw if .4 .6 28 -80 7.5 r4 6 none fs osq mvfr qw •5 •9 4 80 -96 5 r 4/4 none sl m na- .3 .5 / 2] Boring # Boring ® Pit Ground surface elev. 105.50 ft. Depth to limiting factor +84 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft= in. I Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -11 10 r3/3 none 1 2msbk DSH gw if .5 .8 2 11 -23 10 r4 4 none sicl 2msbk mfr yw if .4 .6 3 23 -32 7.5 r4/4 none sl 2msbk mvfr gw na •5 •9 4 32 -84 7.5 r4 6 none fs osy mvfr na n .5 .9 i lei ' Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg /L ' E nt #2 = BOD < 3 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature . CST Number Gar L. Steel -02298 Address ate Eval ation Co ucted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 10 -14 -200 715- 246 -6200 r Property owner RJC Development, Inc Parcel ID # pending Page 2 of _3_ Boring # ❑ Boring 3 pit Ground surface elev. 102. 00 ft Depth to limiting factor +86 in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg in. Munsell Qu. Sz. Cont Color Gr. Sz Sh. 'Eff#1 'Eff#2 1 0 -10 10 r3/3 none 1 2 .5 2 _ .4 .6 3 r4 4 none s1 2msbk mvfr q w na .5 .9 4 30 -86 7.5 r4 6 none fs osg mvfr na na .5 .9 F 4� Boring # ❑ Boring ® Pit Ground surface elev. 1 03.00 ft. Depth to limiting factor +86 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I `Eff#2 1 0 -18 10 r3 3 none 1 2msbk DSH w if .5 .8 2 18 -40 10 r4 4 none sicl M na if .0 .0 3 40-53 7.5 r4 4 none sl 2msbk mvfr tAW na .5 .9 4 53 -86 7.5 r4 6 none fs osq mvfr na na 1 .5 .9 r t7. / ❑ Boring ❑ Boring # Ground surface elev. ft. Depth to limiting factor in. F] pit Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz Cont Color Gr. Sz Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30:s 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. SBD4330 (RAW) STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. RJC Development, Inc. CSTM2298 SE4SW' S25- T30N -R18W New Richmond, WI 54017 MPRSW -3254 town of Richmond (715) 246 -6200 lot #6- Richmond Hills N 1 " =40' BM. =- top of SE lot survey stake @ el. 100.00' Alt. BM.= top of 1" pvc pipe @ el. 107.20' 1 \ lit 390 p � D �Z t ZZ, 3ac I3` Z?k Gary L. Steel 10 -14 -2000 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner _ ^ Septic Tank Capacity 6760C a l ❑ NA Permit # A � 2 � c? 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 VNA Estimated flow (average) p al /day Pump Tank Manufacturer t A Design flow (peak), (Estimated x 1.5) B!V al /day Pump Manufacturer NA Soil Application Rate al /da /ftz Pump Model NA Standard Influent /Effluent Quality Monthly average" Pretreatment Unit 6KNA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspe Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (ge ometric mean) 510" cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA "Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA ear(s) 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: yea t 1(s) (Maximum 3 years) ❑ NA IX ❑ month(s) ❑ NA Clean effluent filter At least once every: years) Inspect pump, pump controls & alarm At least once every: ❑ year(s) (s) NA ❑ month(s) FNA Flush laterals and pressure test At least once every: ❑ year(s) Other: ❑ month(s) CNA At least once every: ❑ year(s) PC NA 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. GMW 14/01) Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) 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. The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed 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 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 y- Phone p�6� Z�l� Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name as L 6 Name �m iJC Phone l 6 G Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.5411), (2) & (3), Wisconsin Administrative Code. ST CROIX COUNTY`' d SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM / �/� �ry owner/Buyer Mailing Address L a v r e life+ Property Address (Verification required from fanning Department for new construction) city/State �!?/y10 � Z'arcel Identification Number -- 11 0� 7 - LEGAL DESCRIPTION Property Location V4, �GJ y,, Sec. _4 ? T AN- 4W, Town of Subdivision l �� ,��°�'� /l/" 5 . Lot # Certified Survey Map # - . Volume g Warranty Deed # 7 f t� - , volume . page # -- Spec house ❑ yes �f no Lot lines identifiable JZ yes 0 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 properly owner agrees to submit to St. Croix Zoning Department a certification form, signed by ,the owner. and by a masterplumber, journeymanplumber, restrictedplumber or a licensedpumperverifying that (1) the on -site wastewater ftdsal'sysbem is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 16. fill 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 Offr<x within 30 da of the three ear expiration date. 3 9fdNATURE F APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the'best. of my (our) knowledge. I (we) am (ire) the o'wnet(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. S O 3 SIGNATURE OP APPLICANT DATE « « « « «« Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning DepartmeU ** 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 '1 °� c��''s ���� .� � � �� � a ��� a `� o� �� _� �-�' _ � o� V TOTAL AREA. I • N 2 93, 344 SO. FT. i 4 LOT 8 2.14 ACRES TOTAL AREA: • • • • • • �� 95,285 SO. FT. 2.19 ACRES ........ , , . , J - N :Z - - - - - -- S89'43'24*W - - -- y \.�' i0 � i • © 218.93 M - 41. - S89'43' 24 "W 351.92' I I M Lu :� I S89'43'2eW " L - 6 218.87'_ ,n F �A • in -J LOT 7 N8g'49'31 ' \ 0 � ' TOTAL AREA: 95,J44 SO. FT. �� a Z ...... . 2.19 ACRES ' ' ' ' y I � LOT 5 1 TOTAL AREA: `�. �, 95 .753 SO. FT. LOT 6 2.20 ACRES I • TOTAL AREA: a 104, 654 SO. Fr o a; J 1 2.40 ACRES I � iV 1 � � I C 522.15' 194.32 I r JI r ! ------------- - - - - -- S89'43'24 "W 714.48' ! ! - ..1.._.. It u j LOT 3 I LOT 4 3 i --- - - - - -- --- - - - - -- O j CERTIFIED SURVEY MAP 0 O o I -------- - - - - -- ----------- - - - - -- ! VOLUME 14 WAGE 3901 01 r O c � -------------------------------- --- J--- i---------------- J------ - - - - -- �cr —ate wAr i S89 43'24`W 2038.48' — ..— ..— ..— ..— ..— ..— ..— .. —.._ ..—..—..—..— ..— ..— ..— ..— ..— ..— ..— ..— ...... -- — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — - -- — — — S89'43'24 "W- 2644.48'- — — - i.q TH d VF U 1897P 131 �\ 679886 STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. wALSH Document Number WARRANTY DEED RE OF DU VI This Deed, made between R Development, In a Wisconsin RECEIVED FOR RECORD Co orP ation _. 05 -24 -2002 8:30 All WARRANTY DEED EXEMPT # Grantor, and Christopher J. Miller and Lori A. Miller, husban and -- - --- REC FEE: 11.00 wife, __.— TRANS FEE: 105.00 _ COPY FEE: CERT COPY FEE: PAGES: 1 Grantee. 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 Lo , Plat of Richmond Hills i n the Town of Richmond, St. Croix County, Name and Return Address Wisconsin. First National Bank of New Richmond PO Box 89 New Richmond, WI 54017 026- 1127 -06 -000 Parcel Identification Number (PIN) This is not homestead property. 0f) (is not) r Exceptions to warranties: Easements, restrieEions and rights -of -way of record, if any. Dated this day of May 2002 RJC Vlopment, Inc. tyl son, Preside AUTHENTICATION ACKNOWLEDGMENT Signature(s) RJC Development, Inc., a Wisconsin Corporation, STATE OF WISCONSIN ) by John H. Carlson, President — ) ss. County ) authenticated t is day of M s�v_ 2002 Personally came before me this _- day of the above named + Kr istina Ogla TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (if not, _ instrument and acknowledged the same. authorized by § 706.06, Wis. Stars.) 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. Intonation Professiaals company, rood du tea. W 800a55 -2121 WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2 - 1999 Jane Hansen Subject: Byron Bird /Chris Miller conventional Location: Richmond Start: Thu 08/14/2003 2:30 PM End: Thu 08/14/2003 3:30 PM Recurrence: (none) 25.30.18.816 l 1