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HomeMy WebLinkAbout026-1167-08-000 . o■ o I■-0 o tv 2 E § § K § ° J % - R ® 2 k � CD » j $ 0$ o °& C f 74 § o = & w � § k $ \ ta S E § K) CL z �� 8 2 Q / ° c f p (n � o E ; n e © rc) , @ z > E .. � E e > co 0. ¥ 2 $ 10 \ § § g @ # k e 4 § § $ n r CO) $ k k \ m rr % �- j o 0 0 ; Oro \ 0 ƒ § / ! g ■ m § § E § 7 a M p q / o � st _0 % 5 £ E § \ $ z w § i ® ƒ k ° / C \ ° / !7B , � E w g 2 E . _ \ \ / k CO) } k k / z E ■ M m 2 % 7 . : § z 7 z / CA) % � §�(k ) § a =aE § , zzz E /0 . \g% / \a @ \q§ =c X 0) CmC % 77\ q a�c CD \L . k m \ < % f = K Nisconsin Department of Comm County "� PRIVATE SEWAGE SYSTEM St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 463183 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: ` LeQue Builders LLC Richmond Townshi CST BM qv Insp. M Elev: BM Des lion: Section/To n /Range /Map N : 6.6 O� �1/ 27.30.18. TANK INFORMATION tLEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM / �� 34�' Aeration B ldg. Sewer Holding - - - - -- — _ _ - -- - - - - - -- St/Ht In q. S t/Ht Outlet �i Z TANK SETBACK INFORMATION SG- LS TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet �— Septic 1pb I ? z I Dt Bottom / �— Dosing h / Header /Man. �-- i2,�S .3� r6�7. t Aeration _ -- Dist. Pipe / h ` q Q S Holding Bot. System Final Grade PUMP /SIPHON INFORMATION �- _j 2 6•°Ili X2.2 Manufacturer J Demand St Cover I GPM hX� Model Number 0� r11 9 3,t0 _ t TDH Lift Friction Loss jsystenn TDH Ft Forcemain Length ia. Dist. to well a SOIL ABSORPTION SYSTEM BED/TRENCH Width Length / , O No. Of Tr hes PIT IMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS i SETBACK SYSTEM TO P/L WIBLDG WELL LAKE /STREAM LEACHING Ma ` INFORMATION CHAMBER OR A� f- T e Of System: 0 ^�, / UNIT Model Number:, ! f Fj S BUTION SYSTEM i ✓ { Header/ nifold Distribution / x Hole Size x Hole Spacing Vent to Ai ntake I Pipes) ` " //yy-� ! Length Dia� Length Dia Spacing i ' oo SOIL COVER x,Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over r Depth Over xx Depth of odded xx Mulched Bed/Trench Center Bed/Tren 7e� .�. rich Edges Topsoil f Yes No � Yes No El COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: f a /( / 0( � Inspection #2: / / Location: 1368 129th Street New Richmond, WI 54017 (NE 1/4 NE1 /4 27 T30N R1 8W) Lundys Preserve t 8`"' Parcel No: 27.30.18. / 1.) Alt BM Description = 1 d �`� %L�- t" 11 ti(-�r fj �? A j a(,tnr— gt , p 2.) Bldg sewer length � t444� - amount of cover Plan revision Required? [] Yes o Use other side for additional information. SBD - 6710 (R.3/97) Date Insepctor's Si natur Cart. N w� ( c;6 / Gi S�s�i r Safety and atpltliflg5 Divtston County _ -- i 201 W. W&SM11910a S� ., P.O. Box 7162 De artment Of Commerce '~ J v / 6&REGE Permit Number (to be filled in by co.) S=ftaU Permit App ' n sae Pfau I. D. Number lu word with COMM 83.21. Wis. Adm. Code M.,as,l j �. � � � 3 � y-1 E j may be used for ry Pt+rPt pycy Law, a15. lXm) - Pro t Address if f. Apps R01 X 0 (" ` ( ffcrent d mailing ailiug address) e - fdonn A ic�e Poet I! >a� -- - 5 � �y Owner's Na me P _ Z Parcel / Lot r Block Property Otvoer's ing Address `l t p ('S — IIJ� P - O . Is Al Location city. state �J zip Code Phone Number �-=— '- = 'A. E7 � 'A.Sect"j a. � d l � (o - a•5 `7$ (curl ==-!— Type of Bair fcbecit all the agsly) -` -- — r'�, ) or 2 Fautily Dwelling - Number of 9appss T - �J' R�E or W� Subdivaioa Name CSM NNfxr PuNiOC ❑ -- __ mf� tn►mercial - Describe Use L I State Owned - Describe U B R -Kn L._.._ �! [ _icily[ ow _ itlage i riship of J "L Type of fit: f teatf aee bent an ties A. li 2 yp � ) �� ••• try System ❑ Replacement System ❑ TrmurreWlieldm# Tank Rephicemen, only L_� Other Modillwxaon to Existing System I R• [) Permit Renewal ❑ Permit Revision iJ Change of i Permit Transfer it; New List Previous Permit Number and Date lssuetl _ Before Expuratian Plumber Owner IV. of t*pWt$ (f7teek atiB that ) - Non -Pressurimd !n-Ground ❑ Mound � 24 in. of suitable soil ]Mount < 24 in. of suitable soil U At Grade [ Si - -- [..] Ceutsmtcted W single Pass Sand Fdte►_ —__ etdard ❑ Pressurrsed In- Granod U Nodding Tank i a Peat Filter U Aerobic Treaurtem Unit L) Rrcircumting Sand Fi R lter ❑ a itcttla Symhetic Mrrdia Fuser ❑ "Ching Chamber ❑ Drip Line Gravel -leas ❑ Oates e Ana Iefareaetian: �- (tWlainl Dessip Flow (gpd) Applicaeitm R Dewaru Soil tue(gpdsf) -- - - -_ —_ _ -' Dksper 1 Area Requirat (sill Dispersal VI. Tap Info Area Propt>sed (so System Elevation l 0cs �( Capacity in Total Number Marwfat turn - -- Prefab Site Steel Fiber Gallons of Units PI uc / New Ex"M Concrete Consuvcrexi Glass K T Tanks Tacks Q OCODO Ariabic Treumeta Unit �f ss IJm" Chamber VII. Rewons"ty sweEll I. •s Na me (Pri ) Y for ' of the POWTS sbown m the attached plus. •s Si ture 7MM umber t Bhrsitness Phone Number s Addrc ss fSttza, City , State. tP Code - �S7 Approved ❑ Disapproval SanielrY hermit Fee (includes Groundwater Date Ill Agent S our N _ _._._ ______,_ 1, 0 Owner Given Reason for Denial Surcharge Fee) ( r IX- of ApprovW/Rpts for Dhapproral YSTEM r! ✓W (hfTU s ptic tank, effluent filter and e C dispersal cell must all be service m In i e as per management plan provided by plumber. 2 as per app licable code /ordinances. Assail _ _ _ _ ._ _ . . _ _ . ttfaas he the Coerty d•bi fee the > ee ppet Oat Mee thtr s i n . ll tneMee i til ~ -- L � R�LL A'Q WS `1 N - E y s a7 -r'3 ti R Ig L - � � L k v� f `off m on , W� S a! , mo►r\L s T j 3 eg � a�� s�. poo�aQ., S� ;�,f (v � �.s�rs�� � t l,c� C) q� £) *s (., a.' aac, } AS�,CQ f ST i Q Alt �& r � • A r � Q $3 9 i - LQQ N'C:` Nf: s a7 T3o �,e o Lt-t - rres Qry - e., r 3 to8 aT' S� r- f-aa 0 IOU I N� • C 1 n 63 RECEIVED r O JUN 01 2004 Lundy's Preserve Comments: ST.CROIX000NTY ZONING OFFICE The soils in this subdivision are quite variable and differ across the 80 acres. Some consist of a clean outwash sand, other consist of glacial tills. In certain areas, the medium sands have a very deep red color unlike I have seen in all of St. Croix county. The color does not indicate high ground water because the color is so consistent. If you go through the red sands then the sands turn off white/yellow but not those of a sand stone. In talking with Pam Quinn from zoning, she commented that there could be a different chemical reaction with a sands. I believe this is the case for the sands have a consistent size, and no mottles were found above or below the sands. Sometimes bands were present, but were very slight, and were mentioned to have the systems sized a little bigger in order to accommodate for any inconsistencies in the soil. Also it is worth mentioning that the intersections of lots 6,7,8, and 9 have a extremely poor soil present not suitable for a mound system. The surveyor and I discussed this condition, and the resulting tests were spaced as far away from this area as possible. All the soils tests were done to the best of my ability and I hold no liability for anomalies and other oddities that can be found on this site. Shaun Bird CSTM #226900 5/28/04 r . r Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, mss. Adm. Code � Attach complete site plan on paper not less than 8 1/2 x 11 inc 7 dist ancet o include, but not limited to: vertical and horizontal reference iParcel I.D. percent slope, scale or dimensions, north arrow, and locati nast road. Please print all i orma p Q4 R ew Personal information you provide may be used for s es (1) (m)). Property Owner bation ,�- 1' 0 G F I 1/4 /4 S� T N R E (o ( W) Property Owner's ailing Address Lo Block # Tubd. Name or CSM# oc, .��� S' oft r City State Zip Code Phone Number ❑ City ❑ Village wn Nearest R i S Q1 (2LaZ22- o .0 IE X /yv New Construction Use. Residential / Number of bedrooms Code derived design flow rate Go GPD ❑ Replacement Public or commercial - D scribe: - - - -- -- — Parent material r-t/ Flood Plain elevation if applicable General and recomme ndations: f � F. O ❑ rin aBoring # pit Ground surface elev. 1 �` R. Depth to limiting Soil ication 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 —j z o 314 r— D 2 /z - - ---- -� A-1 ' Z IJ SU L� r r // Al S 2� a © n ❑ ring a Boring # pit Ground surface elev. t ft. Depth to limiting factor 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 'Eff42 A y s 0, 0 ' rl 7 � • Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 :5 150 _ ' Effluent #2 = BOD _< 30 mg/L and TSS 130 mg/L CST Number CST Name (Please Print) Sig 226900 Bird Plumbing, Inc. Shaun Bird Telephone Number Address Date Evaluation Conducted 1008 192nd Ave, New Richmond, WI 54017 715 - 246 -4516 r , Property Owner Parcel ID # Page of 7 , ❑ Boring # Boring Depth to limiting factor M• Pit Ground surface elev. �• P 9 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 'Eff#2 F c s 2 O 3 30- - ;— 12 11 n1p SAL Os F-1 Boring # ❑ Boring C] 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/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F ❑ Pit I 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 Effluent #1 = BOD > 30 220 mg1L and TSS >30 150 mg1L ' Effluent #2 = BOD, < 30 mg& and TSS < 30 mg1L 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 OL6100) J Soil Test Plot Plan 1 Project Name Environmental Holding L.L.P. Shaun Address 706 19th St. S. Hudson Wi 54016 CS #226900 Lot 8 Subdivision Lundy's Preserve Date 5/24/04 N 1/2 NE 1/4S 27 T 30 N/R 1 8 W Township Richmond ❑ Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 86.2/85.8/85.4 *HRpSame as Benchmark Alternate Benchmark Top of Survey Iron C 96.0' B.M. It. B. 28' Property Line Area of extremely poor soils Scale is 1" = 40' unless otherwise 20' B -1 905 B -2 IbF noted Please note: Soil was 92 done to satisfy county zoning 70' 40' requirement. Soil test may not be B -3 suitable for owners 45' desired building 90' location. 7% Slope Pro Town Road I LQI.O- P l.2 l \Q GS +EZ'1203H wwRw! *! t !t it IV 24 VT wfw r - `• !!• wwli 4.625' .., w!! -w wti !w♦ !! !w! - *- www w !! 11 !w- !.. !. r In cam. ►it�i-si RliRi�Ri! ! • fwiRlt! � ww ♦wwlw - !lwtw !!!!•!!! !t!!t�!!� ! • 24 36" 12-1/2" DLA. (".) Vast C octT w A Biwea u 37.1li_ '���A Q.D. ofd" �4 Void PNx ` 4.623 iacttcs s lb a Sidewa!$} 1114in °id `'°t Pa theca R _ 114 •( 13123u • 2 12in � 3.13 12i, /a j, '0_!l7lZs itt Bottom O. b. of tamtcr cyti�r =1 irfch� Void ? t34 Tel So " Are volrmc in s6geg� orcerttc f 4 3,14 SQ. �' 3. ti • 1.14 • 23 t25pt 12w/te� �,?iarq S � i •.e32 Et' O.D. of oatside cyiwdO . 12 weber ` • { Void roiume in Projeetal Trenck Area ouisidt cvt .. ; .l.tif —� _�� •.57a . SiQ !}' k 12w tRf Sidewatl Height ' 12 m, '2 a 3.0t3 Sq.Ft. laid voiwrac at bottom b cvhnders Zara • ar Bottom 36 in = ! 12in i eea R �` j Is� 6a - ft 3_00 Sq.Ft. I Zia s tr Projected Trench Area j Void uolurst at outside bottom or $q.Ft. j to+mets (i1? or void voluftw between c i"riLa1 vo d volume - 1 in�rs10.213 : 2 = U 108 R' f , lume 0.117 - 0.422 + 0.901 + 0,213 .0.109 = 1.763 cubic h t h C;allom Per R • 1,763 X 743 - s 13_ �aNeas e>_r � F ( 1 ! w J • t ErS Aggregate Trench System EZ7 2 ©3H lo Rin - Inat,s#rfrlt Group aw Industrial Park Rd. OOk'Ond, TU 48060 j SCALE ME NOW= Qt ST COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND • OWNERSHIP CERTIFICATION FORM O wner/Buyer Mailing Address bQX N U 1� • -- � 3t� � Property Address (Ve requited from Planning Dgmunew for new conswaction) City/State- Pl hwo nd ti a Parcel Identification Number Parr 6P ON 10 • DO an,, , LEGAL DESQgU! _rON �2-� f 78 � QUO Property Location /., Y., Sea TN RW, To of Subdivision Lot # Certified Survey Map # RAI Volume _ . Page # Warranty Deed # 7 –7 ,U 95 7 Volume Page # Spec house D yes no Lot lines idenUfiable l o yes 0 no SYSTEM M_Ainrrl�NANCE Doper trse and maintenanceof your septic system could r csult in its pr=e failure to handie wastes. Propertnaintenaace consists of pnmpiag out the septic tank eve Y three Years or sooner, if needed by a licenwd pamper. What you put into the system can affect the fhncfm of the septic tank as a fteaftnent stage in the waste disposal system The Xqpe" master owner agrees to submit to SL Croix Zoning Department a ceatilication faun. signed by the owner and by a is in Proper operating piumbe:' terdpIumberorali ==dpumperv=fying that (1)Meon-she wastewaterdMosaisystem condition an&" (2) aver inspection and pousping (if ncesswyj the septic tan& is less than 1/3 fail of dodge. the undersigned have read the above requircuients and ague to maintaut the private smage disposal system with the standards ortk herein, as set by the Depattment of Commcree and the DVartnzent of Natural Rtso mcM State of Wisoonsno. C hou / � Yow �cxpiratfoo m has been be and nturnW to the SL 1 days t y dam C ay Office writhin 30 SI GNATURE OF APPLICANT DATE 0 FA 'ImfAMN I ( certify that all statements on this form arc trot to the best of my (our) knowledge. I (we) am (are) the owner of aboM by virtue of a warranty decd recorded is Regnier of Deeds Office. S1 TURE OF APPLICANT I L' / •��j C DATE Any information that is mis.represeaud may r=dt in the sanitary permit being rt voked by the Zoning Depa:traent. • • Include with this application. a stamped warranty deed from the Regmw of Deeds oftioe I copy of the certified survey map if rderenee is made in the warranty deed s ENT PLAN page W -- ° PQTS OWNER'S MA NUAL &MANAGEM V E, iATltNI acttrf= t�j D WA Owner r S c O , D - D Holdiing Vol. p c 9>d +P pink # � anufacturer E3 NA D Septic D Dose i7 He e� 3 a NA Vol. gal © rere � a NA lumbet of Bedrooms NA Effluent t public Facety Units EffNreM F ilt er MO" C�go — 3 0o a NA cstsnated ( flow pump Manufacturer Design 1peak) flow A (Estimated x 4.51 .SC pump Model A pretreallnent Unit lnfE MoMNY � F�t*p Cl Peat Fflte► Fats, Oil & 50.30 E3 C3 M Aeration ❑ Wetland Biochemical Oxygen Viand (8001 15220 �- ° "�' O Dleinfe� ° 00w: Total Suspended Solids Ct•SS) 4160 age Manufacturer D NA pretreated Effluent tlue�itY iDspersal Cewsl Biochemical Oxygen Demand 530 mg/L D in- (;round cad) X N A '' sofas (TSS) s3o � " a Mound Toth Sided tfu/ttwml Q t -Grade Face] CaMO"" f ) DNA ° Drip -Lice ❑ NA D Other: y in dia. Maximum Effluent Particle Size D NA 0 NA Other: wastew and sepic tank OMMI . +Vahroes typicei dorrrasbc S motfth(s) {s 3 ❑ NA At least once every" .3 f I condition of tankts) When (anbi� sludge and scum n-tMrd (%) of to * volume p NA Pump out contents of tank(s) When the high avatar alone I activ D maMt+� 6) pAuctmtta 3 Yews) ° NA I dispers ceti491 At Mast Once every: ❑ rrwtt sl D NA least arm eve": ' [] NA Rj Clean effluent fitter morns At least once every: O (s) D NA Inspect pumPt PumpControls &storm ❑ morrtlKsl At Mast or oa every: D year(s) D NA Flush laterals and plum test D ppwnt pthar: At least once every= ❑Year! DNA be vist of the fotiows+9 licertiee3 or Cept}fications: one atop (pumper) }. Car any S Open p caps shalt 6e made by individual �tax►er; Septa M � any ( pecks °r insPectians of tanks R e stri cte d Sewer, POWTS Y any or broken hardware an blip Master plumber, M of the tankts) for �, back up or ponding nk for and ground Tank inspections naval owkwe a visual r sludge area scum e� a check effl Mvefs M the observation condition Pipes and to Oral leaks, measure the volume of combined to check tier on th e g round may induces a fang ceilCsl shad �y surface. The The ponding of effiueeffluent t on ttc surface. ponding of effluent an the grate o f � fora) � authority y) more of the tank volume, tt►e not'ftxdon one -(had (� R 113 late �k equals a N requires the itnrned �atment i once with c hapter q xt spun ar+Y fin accord and o of sludge � Operator and disposed When flip combined accum of by a Saptage entire contents of the tank shut b e � or pfessurizrd components, Pretreatrnen Wisconsin Administrative Cade• to the servicing of effluent filters Marnta'Rer• All other services, including but not limited �, shall be Performed by a certified at intervals of St rnoti authority witfiin t b days of compl of any service *vent- units,. and any servii�9 GMW (2102 A service report shall be to the local regulatory Pa Z ar 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 cell(s). H high Concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shag not occur when sail conditions are frozen at the infiltrative surface. During extended 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 hqp dose and may overload thorn resulting in the backup or surface discharge of effluent. To avoid this sputa im have the conteras 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 coils. 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 (stump pump) discharge; fruit and getable peelings; gasoline; gresss; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and wetter softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shelf be taken to intro that the system is property and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shelf be disconnected and the abandoned pipe openings sealed. • The Contents of all tanks and pits &#moil be removed and property 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 cornpaction and should not be infringed upon by regorad setbacks from existing and proposed structure, lot fines and wed. Falk" to protect the replacement area will result in the need for a now soil and site evaluation to establish a suitable replacement area. Replacement systerns must comply with the rules in effect at that tine. O A suit" 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. T13 � not bean eva to iden ` suitable i on failure of the POWTS a soil and site u ati ti be pert to ovate suits f no re s t� is a�abie a holding tank be Knstal as resort to the failed POWTS. 0 Mound and at -grade soft 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 INSUFRCIENT 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 RRIALLER POWTS MAINTAMIER Name t � Name Phone J �'^ Phone . SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name t. Phone Phone l S This document was drafted by the staffs of the Green Lake, Marquette and Wa nta" Couerty Zoning and Sarnitaoon agues in compliance with dmpter Corm 83.22(2)(b)(1)(d) &(f) and 83.54(1). (2) & (3). Wisconsin Administrative Code. 10/27/04 NE'Ds 08:27 FAX 715 386 4641 stvxaasu yr Mr-r".0 "77 9 M� 1� on OF �I -=0 r" OF Pyto arA[�►1 DM sr_ C0. YI D•eeerett4raber T rM SEC= '1'ils Deed, lmeee betaASm tat 801dim gem it t'$" LTA Gsata�r, � and LOOM Hofldsi La+C WC FFT:: 7ZS. i� Cc" s tire. a r l Grenow. far a oa�idersodoo, —WOP m t]MdW the MOW" MS described reel esm in st. c rals Comty, stove of WW=wa Qhc (if mae *oce is needed. pkne oftwk adaes3am Lets 5,6, B, 9, L1radY's poseezvl, Tom of llidsswnd RauftA ea ltrsad Rsen ANiede T&t2.0 Qa! t0raup, �. 706 19th Straot Radom, 54016 part of 026-1 0-O6d and 026-"70 - Faod WcolklMOVIlwha Togetba WIIb ail appoelsoaot t, d!e sod INS is not boo calood property. (is) (is W* Grantor wetvous lost dw tide tQ to Pkenty is good, indefeasible is lea simple tad free and chs of arooept l advays, Trasaasocts, and of usawd. Dowd d ds 21st dsy of Sratunbeie 2004 . • + Biarldfnor Oe:. � as= Was:rass, vZooldsnt • s svc�► srAIE of Wry Via) Ar ) s. R- rMts Comty. ) auRhertsieated ftWediycoonslsitatsondin 21st _ day of 4aotaatMr . , 20" , ie drwre named NLC OF • ! T� 7ir�ea nTi.E: STATEEAR 4W (if Oak to ase iosoaia>o be the persao w6u awc%md eeitboriaed by 1701F.0k Via ft ft) #ta toesears WW nGTXtAQ1TNASnMAFM DT • Migbao1 S. Ilaceaki., Att:osnw mor Pabfic. soft of tau culzo, ad.�a ...� MY CoaMoa ii Pte- (If unt. Oftle 'S Ye vAgod ed or Balk ov v of J MOW � afpeanMt psi i � �! wen ie rypief W prwea tostor aetspsiae. WARRAN" DRM SATE 4AR OB IVISCO M Yom W 1..2096 AuW=y Mkftd B FGMMW3M0*&aadiftrM P lie I. Pei C Wa WI MM4M Phone (M)i3S AS for (7MI 4112 71600pessirOsoep TMM41412YX ttioveetvilh�rFane� at rEtq�rabC iR+C'11e8'iArrutalNa� CaEeTierlaahbelle ••earer.trEl7aseeeS a'sE�ata •!, • `• � saw ftft MUM 1 � 1 � 1 s t s• t i • � a