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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix uilding Division Safety and B INSPECTION REPORT sanitary Permit No: 514915 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: Sunset Ridge LLC, do Oevering Homes I Richmond, Town of 026- 1286 -03 -000 CST BM Elev: linsp. BM Elev: BM Description: Section/Town /Range /Map No: /bc> G 34.30.18.1425 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER 1 CAPACITY STATION BS HI FS ELEV. I Septic y,� 1ti / `60cs Benchmark fi. L Ab ''• Dosing 3 S tJ� Alt. � �^ /� Bldg. Sewe • �S, Z 3 Holding St/Ht Inlet St/Ht Outlet T' /c `f 7 16 / / 91 TANK SETBACK INFORMATION 1 TANK TO ` P/L I_ WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 7 � 2_1 Z7 / Dt Bottom y. fl fo 77 Dosing J Header /Man. 6 . 60 lO S N Z 7 Z7 Aeration Dist. Pipe � . I b b A �. d Holding Bot. System 7' 16 D ek J !� PUMP /SIPHON INFORMATION Final Grade ( 7 Q Manufacturer f� Demand St Cover / ` 9 /D 5 V6Cj (z6 PM ✓ 7 Model Number EP x Z 5 TDH Li I L Friction Los System�Hea L TD , /' aF �• P. 3 L /p9.73 b �d�� 3 7 , 3 ✓ �7 �F J Forcemain Length i Dia. Z 11 Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width ♦ Length / No. Of TrenchA PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Dept` DIMENSIONS //C `75 �•�� SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION Ty stem: CHAMBER OR Yp ,4p / f l _ 1 UNIT Model Number: DISTRIBUTION SYSTE / M � 1 Header /Manifold IDistribution / x Hole Size x Hole Spacing / Vep Air Intake 't 4' L Pipe(s) 3/ ! TS I d 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 r xx Mulched Bed/Trench Center / Bed/Trench Edges Topsoil ' Yes No Yes No r COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: 6 / � �3 0 Inspection #2: Location: 1210 124th Ave New Richmond, WI 54017 (NW 1/4 SW 1/4 34 T30N R18W) Sun et Ri ge LQZ3 1 (� Parcel No: 34 0.18.1425 �V dC 1.) Alt BM Description = j 2.) Bldg sewer length = Z4 -M C 5 ,�. 3 / ° w amount of cover = -:;� a Plan revision Required? [] Yes No Use other side for additional information. CN� Date Insepctor's ignatur Cart. No. SBD -6710 (R.3/97) Pud may ui Re- Safety and Buildings Division County W Washington Ave., .O. Box 7162 ��: L /L co n s 1 *is in 201 W. Madison, on, WI 53707 - 7162 Sanitary Perin it Number (to be fiIle in b o.) Departm of Co mmerce (b08)266 - 3151 514 p�G Sanitary Permit Applicatioi I REC E J 1 3 tate Pan I.D. Number ✓ In accord with Comm 83.21, Wis. Adm. Code, personal information ou provide / 5 5 Y 3 3 9 may be used for secondary purposes Privacy law, sl5.04(l) m) p 2 200 UProjjec d tf different than mailing address) I. Application Information — Please Print fo n ST. CROIX COU L/ v Property Owner's Name Lot # '3 Block # 0L lo_ _ DD Property Owner's Mailing Address/ Property Location City, State Zip Code Phone Number 1 /., Section 3 7 l)[�<Xi j^_,1 ,. J-V , 9 4?1,q T 3 ' 0 N; R� c EorW one) II. Type of Building (check all that apply) r Subdivision Name CSM Number l or 2 Family Dwelling - Number of Bedrooms t'.YC i ❑ Public /Commerciat - Describe Use k." ❑ State Owned - Describe Use ❑City_ ❑Village (�'f ship of �H III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New System y ❑Replacement System ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System B. List Previous Pen Number and Date Issued ❑ Permit Renewal ❑Permit Revision ❑ Change of El Transfer to New Before Expiration Plumber Owner IV. Type of POWTS System: Check all that appl ❑ Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil rAt -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Un� Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dis ersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate( Dispersal Area Requrre (sf) Dispersal Area Proposed f) System Elevation jr Y 17 IV �` _75-Q ,0� s VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing L , Tanks Tanks �V Septic rHoldin Tank X Aerobic Treatment Unit V sing Chas r Lo o t) II. Responsibility Statement- 1, the undersigned, assume responsibility for install . of the POWTS shown on the attached plans. umber's Name (Print) ture /MPR Number Business Phone Number Plumber's Signa Vft h nb is Address (Street, City, State, Zip de) VIII. County/ e artment Use Onl X A - isapproved Sanitary Permit Fee (includes Groundwater Date I sue Issuing nt Signature o rips) Surcharge Fee) �� Y t7d Z ❑ en Reason for Dema IX. Conditions of Approval /Reasons for Disapproval (� .n (� L (} ^w , SYSTEM OWNER: 3) aJltb - `UGC �b Prol.) I ke f . Septic tank, efffutnt filter and dispersal cell must all be servlcis'/ maintained ��... Av L t J • /ING.��c�t.� as per management plan provided by plumper. 2. All setback regtaremertts must be Miliintailsld X11 A � as per f� � 4 / . ) &,1 C IA. e� G✓ f Attach complete plans (to the County only) for the system on paper not less than $112 x 11 inches in size SBD -6398 (R. 01/03) 1 � � 0 O � " v 1 0 , M � (s a U 1 v h "\ w C � G vc� � s r� b w r / L 3 CL U Ai 10 a N r - Safety and Buildings 141 NW BARSTOW ST FL 4TH commerce.wi.gov WAUKESHA WI 53188 -3789 TDD #: (608) 264 -8777 sco s i n www.commerce.wi.gov /sb/ D of Commerce www.wisconsin.gov Jim Doyle, Governor Jack L. Fischer, A.I.A., Secretary June 24, 2008 CUST ID No. 222872 ATTN: POWTSInspector JACQUE M HAWKINS ZONING OFFICE HAWKINS SOIL TESTING & SEPTIC ST CROIX COUNTY SPIA 2659 150TH ST 1101 CARMICHAEL RD LUCK WI 54853 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/24/2010 Identification Numbers Transaction ID No. 1554339 SITE: Site ID No. 735179 Oevering Homes Please refer to both identification numbers, Lot 3 Sunset Ridge above, in all correspondence with the Town of Richmond, 54017 agen St Croix County , SWl /4, S34, T30N, R18W Lot: 3, Subdivision: Sunset Ridge FOR: Description: At- Grade, 3 bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 1188609 Maintenance required; 450 GPD Flow rate; 36 in Soil minimum depth to limiting factor from original grade; System(s): At -grade Component Manual, SBD- 10570 -P (R.6/99) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: This system is to be constructed and located in accordance with the approved plans, and with publication SBD - 10570-P (R. 6/99) "At -grade Component Manual Using a Pressure Distribution System for Private Onsite Wastewater Systems ". The pressure network is to be constructed in accordance with publications SBD - 10573 -P(R. 6/99) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Net %s f $T -SAS (01/81)" • 4 In the event this soil absorption system or any of its component parts malfunctions hazard, the property owner must follow the contingency plan as described in the approved plansS� a owner must comply with the operation, maintenance and monitoring duties as descn ection VI a at -grade component manual. A copy of this information must be given to the owner upon c C f t11e project. p Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. JACQUE M HAWKINS Page 2 6/24/2008 A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. 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. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101. 12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Julia Lewis - Osborne POWTS Reviewer 2, Integrated Services Wi MART "� 7631 (262) 397 -6005, Fax: (608) 283 -7481 julia.lewis@wisconsin. gov i RECEIVED JUN 1 9 2008 SAFETY & BUILDINGS RESIDENTIAL AT -GRADE DESIGN Pressurized - Sloping Site INDEX AND TITLE SHEET Project Oevering Homes At -Grade Lot 3 Sunset Ridge Owner Overing Homes Address 201 Packer Dr. Suite H Roberts WI 54023 Legal Description SW1 /4 Sec. 34 T30N -R18W Township Richmond County St. Croix Subdivision Name Sunset Ridge Lot No. 3 Parcel ID Number Prt. Of 026 - 1286 -03 -000 Plan Transaction Number Index sheet Page 1 Calculations Page 2 At -grade drawings Page 3 Laterals and dose tank Page 4 Specifications Page 5 Management & contingency plan Page 6 Pump Curve Page 7 Plot Plan Page 8 Designer Jacque Hawkins License Number MPRS# 222872 Signature Phone Number (715) 472 -2421 Date 06/13/08 "all Designed pursuant to: �+ At -grade Component Manual for POWTS SBD- 10570 -P (R.6/99), and CoM SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST - SAS (01twi U,Rci Version 3.11 (05101) Page '4-� OFNC� PRESSURIZED AT -GRADE DESIGN At -grade Design Worksheet - Sloping Site Flows and Site Data Entry. r or c r Residential or commercial? 300.0 Estimated wastewater flow (gpd) 450.0 Design wastewater flow (gpd) 10.00 % Site slope 103.30 Contour elev. below lateral (ft) 36.00 Depth to limiting factor (in) 0.60 In -situ soil application rate (gpd /ft ^2) Distribution Cell Information (1 or 2) 1 Influent wastewater quality 10.00 Linear loading rate gpd /ft 10.00 Effective absorption width (ft) 10.00 Max. effective width permitted (ft) 75.00 Aggregate length (ft) Pressure Distribution Data Entry (c or e) c Center or end lateral connection 2 Number of laterals Not a final 2.00 0.188 Orifice diameter (in) e.g. 0.188 calculation Estimated orifice spacing (ft) 2.00 Forcemain diameter (in) 2.55 Forcemain flow velocity (ft/sec) 110.00 Forcemain length (ft) y or n Does forcemain drain back? A95.00 Pump tank elevation (ft) y or n y Are laterals at highest point? NA 3.25 System head (ft) x 1.3 17.9 Forcemain drainback (gal) J, 5 7.80 Vertical lift (ft) 33.5 5x Lateral void volume (gal) it 1.52 Friction loss (ft) 51.4 Minimum dose volume (gal) 12.57 Total dynamic head (ft) 25.0 System demand (gpm) 116 Lateral Diameter Selection Gallons /Inch Calculator (optional) Pipe diameter Design options D esign choice Total Tank Capacity (gal) Designer 1 in Total Working Liquid Depth (in) must select 1.25 in x Galin (enter result in cell G46) one lateral 1.5 in X X diameter 2 in x Treatment Tank Information 3 in x 1000 Septic tank capacity (gal) Skaw Concrete Manufacturer Effluent F ilter Inform ation Dose Tank Information Best Filter manufacturer 642.0 Dose tank capacity (gal) GF -10 Filter model number 16.5 Dose tank volume (gal /in) Skaw Concrete Manufacturer Project: Oeverin Homes At -Grade Lot 3 Sunset Rid 1 9 e 9 Transaction Number: Page 2 of 8 I� AT -GRADE PLAN VIEW 116 B Observation pipes (2 typical) A 10.00 ft D B 75.00 ft t— 1/6 B 12.50 ft C 12.00 ft W D 5.00 ft -- t E 2.00 ft �-- I L 85.00 ft B W 22.00 ft A x B 750.00 ft ^2 L — E� Cap = Total aggregate cell A x B Slotted in the he l ow er 6 ", and anchored = Plowed area L x W se curely. 6" AT -GRADE CROSS SECTION Svn fabric cover — 105.09 ft Finished grade Lateral d Z elevation invert elev. 103.80 ft �— Observation pipe at aggregate toe E _ 10 % Slope Surface contour 103.30 ft C A and system _ elevation /by D ® = 12 in. topsoil and subsoil over aggregate and tapered to toes. Plowed layer below L x W = 6 in. aggregate, below pipe(s), and 2 in above pipe. Project: Oevering Homes At -Grade Lot 3 Sunset Ridge Transaction Number: Page 3 of 8 PRESSURE DISTRIBUTION AND DOSE TANK Lateral Diagram - Center Connection P , I I F 7(--f Exl2 x/'2 +1 Laterals & force main of PVC Sch 40 Last hole drilled next to end cap (per COMM Table 84.30.5) Holes drilled on the bottom of the lateral. equally spaced • = Turn -up wfball valve or oleanoutplug Lateral Specifications 0.188 Orifice diameter (in) Center Lateral connection point X 1.97 Orifice spacing (ft) 2 Number laterals 19 Orifices /lateral P 36.45 Lateral length (ft) 12.5 Lat. discharge rate (gpm) 1.50 Lateral diameter (in) 2.00 Forcemain diameter (in) 25.01 Sys. discharge rate (gpm) 110.00 Forcemain Length (ft) 12.57 TDH (ft) Typical Pump Chamber Layout Approved manhole cover with Weather -proof warning label and locking device junction box Final grade 4" disconnect Tank component is y Aftemate properly vented outlet / location 18" min. Electrical as per NEC 300 and /� Approved outlet Comm 16.28 WAC joint Tank full C Inches Gallons A Provide 1/4" c A 21.8 359.6 Alarm on weep hole or c B 2.0 33.0 g antisiphon Pump on E C 3.1 51.4 device. o D 12.0 198.0 96.00 ft I C Totals r 642.0 Pump off D 3" Bedding under tank 4 95.00 ft Goulds Pump manufacturer S.J.Electro Alarm manufacturer EPO4 Pump model number JTankAlert Alarm model number Project: Oevering Homes At -Grade Lot 3 Sunset Ridge Transaction Number: Page 4 of 8 At -grade System Maintenance and Operation Specifications Service Provider's Name [— Tri- County Sanitation Phone[ POWTS Regulator's Name St. Croix County Zoning Office Phone 715 - 386 -468 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1000 gal Maximum TSS 150 mg /L Soil Absorption Component Size 750.0 f: Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 ears Mound Ins for ndin and seepage once eve 3 ears Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the at -grade component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The at -grade structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. 6. Areas within 15 feet of the downslope toe will be protected from compaction. 7. All other construction details are as per the at -grade component manual SBD- 10570 -P (R. 6/99). Lateral Turn -up Detail Finished •............ •000000 *00 Grade 6 -8" Diameter Lawn y Threaded Cleanout Sprinkler Valve Box ::::: Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Oevering Homes At -Grade Lot 3 Sunset Ridge Transaction Number: Page 5 of 8 At -grade System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD- 10570 -P (R. 06/99) and SSWMP Pub. 9.6 (01181)] 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. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off 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. 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 finer is installed within the tank t shall be inspected and serviced as necessary. At -grade and Pressure Distribution System No trees or shrubs should be planted on the at- grade. Plantings may be made around the at- grade's perimeter, and the at -grade 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 at -grade 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 at- grade be heavily mulched as protection from freezing. Influent quality into the at -grade system may not exceed 220 mg /L BOD5, 150 mg /L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg /L TSS, 10 mg/L FOG, and 10 cfu /100 mL for highly treated effluent. 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. 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(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the at -grade 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 renovating the biologically clogged absorption and dispersal media, installing new piping, and replacing other components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Oevering Homes At -Grade Lot 3 Transaction Number: Page 6 of 8 Page 7 of 8 XGOULDS PUMPS Submersible Effluent Pump . EPO4 3 871 EP05 APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower grade turbine oil for tic enclosed design for heavy duty ball bearing Specifically designed for the lubrication and efficient improved performance. construction. following uses: heat transfer. ■ Casing and Base: Rugged • Effluent systems g • Homes Available for automatic and thermoplastic design provides AGENCY LISTING • Farms manual operation. Auto- superior strength and corrosion �ar►dards+ti�oasnon • Heavy duty sump matic models include resistance. a' • Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron (CSA listed model numbers end • Dewatering assembled and preset at the for efficient heat transfer, in '•C" or "I"'.) factory. strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic Goads Pulps is ISO 9001 Wired. FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. /<" maximum. ■ EPO4 Impeller: Thermoplas- E power Cable: Severe duty • Capacities: up to 60 GPM, tic Semi -open design with rated oil and water resistant. • Total heads: up to 31 feet. pump out vanes for mechanical • Discharge size: 1' 12 NPT. seal protection. • Mechanical seal: carbon - rotary/cera mi c- stationary, BUNA -N elastomers. • Temperature: 104LF (40` continuous 140'T (60`C) intermittent. METERS FEET • Fasteners: 300 series 10 stainless steel. 9 30 5 GPM • Capable of running dry without damage to a 2 5 components, 25 o a Motor: _ • EPO4 Single phase: 0.4 HP, v s zo 115 or 230 V, 60 Hz, 1550 1 5 RPM, built in overload with automatic reset. ° 4- 1 5 _ • EP05 Single phase: 0.5 HP, o EP05 115 V or 230V, 60 Hz, 1550 3 10 RPM, built in overload with automatic reset. z EPO4 • Power cord: 10 foot s standard length, 1613 1 SJTOW with three prong grounding plug. Optional 20 ° ° 0 10 20 30 40 50 GPM foot length, 16/3 SJTW with three prong grounding plug ° z a s s 10 12 m31h (standard on EP05). CAPACITY G Pumps Ef 2001 Goulds Pumps ITT Industries Effective May, 2001 B3B71 4 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page / of 3 Division of Safety and Buildings e in accordance {{�� County Attach complete site plan on paper not less than 8 112 11 incl�Tcf�efi) I t7 include. but not limited to: vertical and horizontal refere ice point pence pe, (3At ,direction d .✓ Parcel I.D. D. /� n v percent slope, scale or dimensions, north arrow, a nd I tionanddi_ta nce to near t APR Reviewed Date Please print all inform tion. � � Z f Personal information you provide maybe used for secondary urpos&_fp0R()R,ttoS.prt,(1) (m) Property Owner 70 RIff FFOarty Lo ion C � N R E o W yy !4 S T � ( Govt. Lot 11 li.11 Property Owner's Mailing Address Lo Block # Name or CSM# State Zip Code Phone Number ❑City ® Village own e N est Road city. New Construction Use: esidential / Number of bedrooms _ -_ Code derived design flow rate '� GPD ❑ Replacement Public or commercial -Describe! - - -- - - - -- - -- - - -- - - -- - Parent material _ _ _— Flood Plain elevation if applicable General oomments and recommendations: Boring F/I Boring # © f . Depth to limiting factor _ in. . pit Ground surface elev. � P � Sal Application Rate r' - Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots +E _ Eff#2 in. Munsell ()u. Sz. Cont. Color Gr. Sz. Sh. Q _/ 3/ I S � r f /0 25 /10 3 2 r� of iJ s l ' [� Boring Boring # r � Depth to limiting factor in• Pit Ground surface elev.� / . t. p 9 7'EEff#2 Dominant Color Redox Description T3xture Structure Consistence Boundary Roots Horizon Depth in. Munselt au. Sz. Cant Color Gr. Sz. Sh. $ �� " s m F� -3 � - y ' S ( V 3$ -7 r Effluent #1 = BOD > 30 < 220 mglL and TSS > 30 'Effluent #2 = BOD _< 30 mg/L and TSS `_ 30 mglL CST Name (Please Print) lure CST Number 226900 Bird Plumbing, Inc. Shaun Bird Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 540 715 - 246 -4516 Property Owner _ Boring Parcel ID # _ — — / Page of Boring # ❑ 1 J it Ground surface elev. �/ r ft. Depk: is isr icing factor in. [ 3 _ 1 Soi! ication Rate Horizon Depth Dominant Color Redox Description Texture `n xAvre Consistence Boundary Roots GPDlft in. Munsell Qu. Sz. Cont. Color az. 3h. 'Etf#1 "Eff#2 ®" �? lO 3� --. a C - 6'L /f) � 1 J , m ! Ili _3 d �y ,� a Baring # ❑ Boring ❑ Pit Ground surface elev. ft. Dept i :o limiting factor in. Solt ication Rate Horizon Depth Dominant Color Redox Description Texture •= it ictture Consistence Boundary Roots GPDIFF in. Munsell Qu. Sz. Cont. Color C - 3z. Sh. 'Eff#1 -0142 ❑ Boring Boring # Ground surface elev. ft. Dept -I .o li -niting factor in. ❑ Pit Soll ication Rate Horizon Depth Dominant Color Redox Description. Texture :,b uctire Consistence. Boundary Roots GPD1fP in. Munsell Qu. Sz. Cont. Color R:;r. Sz. Sh. "Eff#1 'Eff#2 ' Effluent #1 = BOD > 3 220 mglL and TSS >30 _< 150 mg(L ' Effluent #2 = BOD < 30 mgt and TSS < 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the deparment at 608 -266 -3151 or TTY 608 -264 -8777. sao.eaw (a000) I Soil Test Plot Plan • Project Name Sunset Ridge LLC Shaun Bir Address 838 Summer Pines Circle Hudson Wi 54016 CSTM 6900 Lot 3 Subdivision Sunset Ridge Date 4/15/05 W 1/2 S W 1/4S 34 T 30 N /R W Township Richmond Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Nail /iron System Elevation 103.3 *HRpSameasBenchmark B.M. 140' Property Line Scale is 1" = 40' unless otherwise noted 10% Slope 102' 30' B -3 55 , 104' 120' B -2 35' 5 ' B -1 435' Property Line 25' Property Line LTEI L ANDS_ ryg 89'50'54" E 1018. 7 - - - - - - s, - - -- i t 4 3 51 S o if 5 "FiF o 0 . Fly SO A rn (D ;2 I X a O V cn ls, ;s 1 4 . N89'S9'5 'W 694.5 '49 377 J�; li. t I N87 - 0 > Z— z G) 0 bs x 0 ' 0 0 r, rn mom m z GOUNT{ PLAT o� SUNSET RIDGE Located in part of the Northwest Quarter of the Southwest Quarter and part of the Southwest Quarter of the Southwest Quarter of Section 34, Township 30 North, Range 18 West, Town of Richmond, County of St. Croix, State of Wisconsin 1 UNPLATTED LANDS_ __ ---- Ne9']6'SOE sne.e]• - - -- n.wfwn lor Nxro ee " --- --- We4f Ouwi.r Cwner� I �' - -� -- ess "rxf ' nwu4 -reu /T ear - w.f aerf.r l.w. Ewwfbn 1ooa3e• NAro ee tse.or l _ N 89'50'54" E 1018.75' — ' -- -- ,•'-I• ]OJI 111.11 1]9.91 IB7.59 twe ` �- i I l� 1 _ I ___ ___ 9esas•____ ____. E «o awr.r c1,m. I r s «fan J4 8 1 _ r cn«rer. Nan I I I l00' I 1 k ' V7 CI NIT Y MAP z n 2 s e 5 I L .15. .c.f1. z °iers 2. Nw _2 LOTH AVE. I. or.e. 3 4 cr. .. _ _T____�. 9),Ifi1 w.n. 2.001 I n .9.n. r/4 1 NE r/ 3 13 \ I 1• 3 � � _ _� _ _ _ _ _ � F i m s aeveu• E Is].ew � ` \ \ `yam, No! la Str.le I I g� IBS.eB'O3 N 14air1y �� say 4 e & - - ee1eN s.meewJ/ I \" C. T. H. "E" IIN \ Section 34, T30N, R78W III o' \\ t.ao. -99x7 re , \ � \e, Q �' --- leas • - -- � / - - le rw � - E.:m L � ° ... • � •1 4) E 1- =: Teo. ') $ \N \ s e9.4B nx LEGEND \v r _ - _r4 zoo.2s 1] 'er ".zx 4o• > Q• St. Croix County Section Comer, Ae Noted I '\ 5ps491s7 7 \� NSeW'.oB O Set 2 and 3/8' (O.D.) x 30' Iron Pipe (3.65 Ibe./lin. ft.) >>yc ! w J• z I " "'B„iie�nq s Ilea " -" x\�E4'.mMr \ JTT1 (N 89'11'90" w 1306.04') Record Delo I Ism fl m ?Ie €z � In kg. �U ` -- ------ 12' Utility Easement II~ e N e $ i. u .l m . y� \ 6 /m I / I 20 N 61.22' m - - - - - -- Building SelbOCk Line I �� ' 1 / i I)so 2 j Eos m £� \ I I I 0011 <.a.a -roe r.4 rr. y m ).a0.. Lowest 9ullding Opening 1 m IZ = yl- N 1 too.�9961 rr. �� I 1 21 O Lowae! Permitted Door or Window EN-U.. �D I 8 �T\\ All other lot n n this plat, wll be eWdenced by o to o m I z ? za9 « c.11. I p l r t.B1a acre. z 1.05 inch (0.0.) x inch it n pipe (1.13 lis.,4in. !f), fief I O to P m /I 66TT 1 9• F m a ° 19 p 6 . R 44 UI m 4 / !' k es,J3J pol. 6 � o I / loo. w Eaa.m�f SI -P-- 11. 452.44. I 9) I Siej IZ �69Ta E 2 y Io - az.no .9.ry s. y 1 12 I.es9 acres 1 a y +BN fiB •y�'y 6 18 g Sunset own Ridg e. LLC Su I m I 1 163 mmer Panes Cbcle I I Hudson, X954016 V � I u' 10 1 I i a15 I� I I 1 1 17 S 9-.1" ws nrw.ns.d 19 M. ) 1 Weir lM. e%he 6e,f� of �w[w el I I ,� ,951 0� f1 ' oaumed f sar Noa9e'a4'E I ]]•']]' 1 \ 100 0 100 200 11 SCALE IN FEET I e i z e]z e9.ft. r ( 11 \ 1 loo• � 8.902 owes I I � 16 el evo e oo:: - � Q I IN1 \ -- __-- �_ - - - - -J A I 12 \ "6 3s :',.; - I I I ,'rye s 14 1.0 15 I e E 2 ne 0] °tree . 56' LOT_ 17 g 13 J 2 ear.. m a3. DUCK - POND ESCAPE a B• $ � -. X89'59'59 "W F x00 I I j I I '�'. � O Clrrofwn raJZJr N4ro ee o l u p I ro t ° I I I o_ i LOT 1 LOT 2 I -- — — _ -- Ir I C.S.M. C.S.M. — — — '- N8T49'24 "W 324.40' �- $ 121ST _AVENUE I i (5 873756' E J24.39) I ✓ lume 19 I Volume 19 — — — — — — — — -r— — — — -1 I I I Page 4852 Poge 4852 3I I LOT 1 I -_- • C. SM. LOT_ 15_ LOT 16 I m I y fume 5 14 - - -- MELCHERT WY P - 1400 landscape archit ecture 'roe xle]n.e7 12 engineer civil .e... w1 134- •� �I 22]8 Ph. vnon• ca) ee -77se _ -0seerh"..l cwnw er sefwn J4 Sheet 2 of 2 Sheets land surveying r.: (716) VIII? founI I and r/T• (0.e.) Irvn Pw. ]¢E.c1¢er wwE.lam U 2660P 307. - EXHIBIT A Located in part of the northwest quarter of the southwest quarter, and the southwest quarter of the southwest quarter of Section 34, Township 30 North, Range 18 West; Town of Richmbnd, County St. Croix, State of Wisconsin described as follows: Commencing at the southwest comer of said Section 34; Thence North 00 degrees 08 minutes 04 seconds East along the West line of the southwest quarter of said Section 34 a distance of 484.68 feet to the POINT OF BEGINNING; Thence contiue North 00 degrees 08 minutes 04 seconds East along said West line of the southwest quarter 2157.27 feet to the West quarter comer of said Section 34; Thence North 89 degrees 50 minutes 54 seconds East along the North line of the southwest quarter of said Section 34 a distance of 1018.75 feet; Thence South 00 degrees 08 minutes 04 seconds West on a line parallel with the West line of the southwest quarter of said Section 34 a distance of 2007.79 feet; Thence North 89 degrees 59 minutes 59 seconds West 694.55 feet; Thence South 00 degrees 08 minutes 04 seconds West along a line parallel with said West line of the southwest quarter 164.50 feet to the northeasterly corner of a Certified Survey Map recorded in Volume 5, Page 1400; Thence North 87 degrees 49 minutes 24 secons West along the northerly line of said Certified Survey Map 324.40 feet to the POINT OF BEGINNING and there terminating. St. Croix County, Wisconsin. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner deV � N / o�► S Septic Tank Capacity / 00 D a l ❑ NA Permit # Septic Tank Manufacturer S64"'- ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer rd 9 ,Y t / ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model /5CJ' f /d ❑ NA Number of Public Facility Units [TVA Pump Tank Capacity ( A gal ❑ NA Estimated flow (average) �J� al /day Pump Tank Manufacturer S1 &"o ❑ NA Design flow (peak), (Estimated x 1.5) 3 - 7 :r al /day Pump Manufacturer tJ5 ❑ NA Soil Application Rate L gal /day /ft2 Pump Model rR o S ❑ NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg/L 0 Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L MIN ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) _ :0 50 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cells) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L ❑ In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L (3- X Jil:�At -Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. Ct1 Other: ❑ NA Other: EI-N 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: p ear(s)(s) (Maximum 3 years) 11 NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Ins Inspect dispersal cell(s) At Least once every: ❑ month(s) (Maximum 3 years) ❑ NA P P 2- $year(s) Clean effluent filter At least once every: -ET-month(s) ❑ NA 6 ❑ year(s) Inspect pump, pump controls &alarm At least once every: j ❑ month(s) ❑ NA �- year(s) Flush laterals and pressure test At least once every: Z El month(s) ❑ NA -B- years) Other: At least once every: 0 ea��s ❑ NA Y Other: ❑ 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 IY 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 provid to the local regulatory authority within 10 days of completion of any service event. 4L`c_ �'�-' "_ S Z L9 7 2- GMW (4/01) 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 Phone Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name 1 5 . cto' Phone Phone 7/S — mo _ q & This document was drafted in compliance with chapter Comm 83.220(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. ' START UP AND OPERATION Page of For new construction, prior to use of the POWTS check treatment tanks) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ 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 Phone Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name GCo, Phone Phone 716 f t - q & This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. st Quarter of the Southwest Quarter and part of the athwest Quarter of Section 34, Township 30 North, ichmond, County of St. Croix, State of Wisconsin - UNPLATTED LANDS_ 73M 13 - - -- N89'50'54 "E 5276.53' - - -- Elevation 1011.87" - - - - Erut - Wast Quarter Line - TOM P r fom58' NAW 88 N 89.50'54" E 1©18.75 IF 317.71 171.72 139.92 167.59 166. 1 - - -- 985.75' - - -- -- v C* 87,804 sq.ft. 2.016 acres Z 8 2 5 9 99,395 1 70,254 sq.ft. M N 2.282 a P 1.613 acres • 3 m 4 m 67,183 sq.ft. 92,469 sq.ft. 2.001 acres 2.123 acres 80' radius t E 163.98'O` \ cu be � � N to be e tingu rood ext NI =E — 163.88' NI CO \ — — Bu 5 89 E 77 -- 263.37' • $ AV .1 E '1 J r — 200.23' �. W J N5679'4J*W< — � 14 7 J 3.3' 33' J J 8 106.06' L18 wM 7 ft. J J } J J 1 3' i lat. r rs "amt 7 s} U 2660? 306 7 e+ r2 STATE BAR OF WISCONSIN FORM 1 - 1999 KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Herman W. Keller, Sr., Herman W. RECEIVED FOR RECORD Keller Jr and Karen M. Keller, husband and wife 09/21/2004 10:25Ali Grantor, and Sunset Ridge, LLC Grantee. WARRANTY DEED Grantor, for a valuable consideration, conveys and warrants to Grantee EXEIPT # the following described real estate in St. Croix County, State of Wisconsin REC FEE: 13.00 (the "Property ") (if more space is needed, please attach addendum): TRANS FEE: 1440.00 See attached Exhibit A COPY FEE: CC FEE: PAGES: 2 Recording Area Estreen & Ogland' 304 Locust Street Hudson, W154016 Together with all appurtenant rights, title and interests. 026 - 1098 -20 -000; 026- 1098 - 30-000 Parcel Identification Number (PIN) This is homestead property (is) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and reservations, if any, of record. Dated this day of V e Ir 2004 * Herman W. Keller, Sr. * Herman W. Keller, Jr. * K ren M. Keller AUTHENTICATION ACKNOWLEDGMENT Signature(s) Herman W. Keller, Sr., Herman W. Keller, Jr. STATE OF WISCONSIN ) and Karen M. Keller, husband and wife ) ss. ST. CROIX County ) authenticated this ?/? da of _ _{/�rq , 2004 _ Personally came before me this day of 2004 the above named Herman W. Keller, Sr., Herman W. Keller, Jr. and Karen * Kristina Ogland M. Keller, husband and wife TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Stats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY Kristine Ogland, Estreen & Ogland 304 Locust Street, Hudson, WI 54016 Notary Public, State of 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. Information Professionals Co., Fond du Lac, WI STATE BAR OF WISCONSIN 800. 655 -2021 WARRANTY DEED FORM No. 1-1999 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer y 1-4 , l�. 5 �o � 1 S Mailing Address Property Address �(Vgca�ttoot rm PlapninDeparlment for new construction) City/State V V x7c7lv, 1/N X 0 7 3 Parcel Identification Number O L D— Z S to — a 3- v o a LEGAL DESCRIPTION / Property Location 1 "' �', :W `/., Sec. 3 , T 3 0 N -R W, Town of i t h .►�r� u ti � ! Subdivision �u �S t J £ . Lot # Certified Survey Map # , Volume . .Page # Warranty Deed # , Volume , Page # Spec house ❑ yes (Y-no Lot lines identifiable V yes ❑ no SYSTEM MAIIVTENANCE 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 maswr plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal 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 days of the three year expiration date. I / SIGNATURE OF AiPLICANT 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. SIGNATURE OF APPLICANT DATE �• * * *• Any information that is mis- represented may result in the sanitary pernut being revoked by the Zoning Department. • 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 L L 8 7L, it - u G o y , u z rc a m 0 a z to , r 1100❑ ❑❑ 0011❑ 1 A 1111❑❑ NY 0000 z ° 1111❑❑ O 0000 0 s ?d ;i ........................ _ P 0 �Z o �s g � �W s 0 ® ®® z � z � O } w Lu ---------------- ------------- Q 9 � U v Q 0 ao �s �z >Q s ' 0 0 ' Z O d ............ } w li lillm Hill 1 � Q a ------------ - ----------------------------------------------------------- ----------------------- - --------- ----------------------- ------ --------------------------- ------------------- (e AO) ED ------- -- - Fr lo LL ------------- �-71 ------------------------------------------------ j id ---- ----------- IL y -------------- (bWAO) - VO.Z-A - - M"nbU soma .0 - --------------------------------------------------- ----------------- O,Vz To LD - Q ej lu (tQAO)'3/O.K �w doob p Q 7 LU ooii. rmm d 4L 7 v 41� " _z � i �il V LL i t _ � �I s � ; I _ I z 's zl � ; ; I IIK '101 91x61 I 0 @ > (L di jwuj, 4 4 � S a m 0 a � s i= a n > a ll O - �0 e0 i �I II „ , I , i i I II O , , e• . •sla a va „zs•L . •sl V lu Z d) � � J W Ul „ r u� m td u O ^ a „ ? 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