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HomeMy WebLinkAbout026-1098-20-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Divisive INSPECTION REPORT Sanitary Permit No: 506274 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, C/o evering Homes Richmond, Town of 026- 1098 -20 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No 8 G-ji 34.30.18.1426 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI I FS ELEV. Septic ./tea Benchmark 7•' f07/' /00 Dosing A -7 (0(066 o o� rho,, FMS Bld . Sewer C r( L 5 . �; la.�s Holding St/Ht Inlet 9. 9 9' . Zf ` TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 3d , NAT" 3 / 37 / Dt Bottom 13, 9 '74 Z/ Dosing ,^ v 3 9 / Header /Man. g � r7 " q• 3 Paz . 8 Aeration Dist. Pipe Holding Bot. System 5 . , /bZ . $ PUMP /SIPHON INFORMATION Final Grade 3. 3 103 Manufacturer II L Z. Z �Z Demand St Covert, ` L.i7'T!� (�1 v�J — GPM Y� 4.+-. Model Number 24.,3 5 1 ��� y o r TDH Lift Friction Loss System Had TDH y GFt 11 . 4-1 3 , 1 Fcrcemain Le� tth Dia. Z it Dist. to Well SOIL ABSORPTION SYSTEM 5.3 BEDlTRENCH Width / Length / No. Of Trenchtfq PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS AD /U --- -- SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Tv p Of System: 1 Z' 3 �� f /� UNIT Model Number: CG DISTRIBUTION SYSTEM W� Header /Manifold IDistribution X Hole Size I,( I x Hole Spacing / VePio Air Pipe(s) r� 5 v Llia Length Dia Length go Dia Z Spacing 3Z 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 I "— Yes No Yes :]N, 4 ` COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: $ / in / 6 7 1 Inspection #2 Location: 1214 124th Avenue New Richmond, WI 54017 (NW 1/4 SW 1/4 34 T30N R18W) Sunset Ridge Lot P rceI N 34 30 18.1426 1.) Alt BM Description � 'ow 4 2.) Bldg sewer length = 0 G �Q' P1 - amount of cover = / C Plan revision Required? I1V Yes �>< No Use other side for additional information. `I � v Date Insepctor's nature Cert. No. SBD -6710 (R.3/97) Ilk Gp��,yyil,gpy Safety and Buildings Division Coup L 201 W. Washington Ave., P.O. Box 7162 C ounty • C✓0 i Y, �/1►�� Madison, WI 53707 -7162 Sanitary s b � z � 4filled is by Co.) Sanitary Permit ApplicatiORECEIVED state Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental ! / unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS are Project Address (if different than mailing address) submitted to the Department of Commerce. Pgfsonal information you p rovidejot b,2u4d 1 @0eondary ses'm accordance with the Privacy Law, s. 15. 1 m Stats. I. Application Information - Please Print All Informatio Property Owner's Nagle b 1 . Parcel # 0 0 Property owner's Mailing Address V Property Location P S,6 8 3 p .SLG 1M vLr.Qi✓ G ovt. Lot — i Ci ,State Zip Code Phone Number �� i/� J (� A, Section �� 1 r ) L tO T /t gr�1j N; R E II. ype of Building (check all that apply) p Lot # / v r'2 Family Dwelling - Number of Bedrooms 6.0 Subdivision Name Z � t o p Block ❑ Public /Commercial - Describe Use 1 ❑ City of CSM Number ❑ ViIlage of ❑ State Owned - Describe Use �j _ ?to � own of �l C./,[. III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. El Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Befe-e Expiration Owner IV. — Type of POWTS S stem/Com onent/Device: Check all that appl. v o u 740 3 ❑ Non - Pressurized In- Ground ❑ Pressurized In- Ground t -Grade ❑ Mound? 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersal/Trea ent Area Information: Design Flow (ad) Design Soil A plicati n Rate(gpdsf) Disp al Area Required �(sD Dispersal Area Propo (sf) System Elevation sa J`Z� Uzi ✓ � � :! VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units e New Tanks Existing Tanks � � $ !.✓ Q�6� f r L a U v� W U. Q a Septic or Holding Tank _..._ Dosing Chamber VII. Responsibility Statement I, the undersigned, assume s risibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's lure MP/MPRS Number Business Phone Nber �� Plumber's Address (Street, City, St�Zip 5� 7 VIII. Coun /De artment Use Onl Approved ❑ Dtt Permit Fee Date I ued Issuing Ag ignature ❑ O Reaso r Denial IX. Condi easons for Disapproval 3l et o ¢ (a &"J t. Septic tank, effluent finer and J dispersal cell must all be services / mainta#ISd i✓ ot- t I as per management plan provided by phunber. 2. AN w beck tequirements must be maintained Attach to compiete plans for the system and submit to the County only on paper not less than 8 rd x 11 inches in size SBD -6398 (R. 01/07) Valid thru 01/09 PLOT PLAN PROJECT' Sunset >Ridae LLC ADDRESS 838 Summer Pines Circle Hudson Wi 54016 W 1/2 SW 1 /4S 34 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 100.3 BEDROOM 3 CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none IL BENCHMARK V.k.P. Top of Survey Iron ASSUME ELEVATION 100' Filter BEST GF10 -8 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark B. M. Property Line Scale= 1/4" =1 0' 1.8 Acre parcel Well is to meet all setbacks found in Comm. 83 Area 15' below system is to remain 121 st. St. undisturbed 4% Slope B-3 100' 100.3' •1 --- ° 101 F1 _2 r Huffcutt Combo Tank Grading is to be done to divert run -off away from system Tank is to be properly bedded and provided Pro 3 Bedroom with lockdown covers House with approved warning - 526' Property Line labels PLOT PLAN PROJECT Sunset Ridae LLC ADDRESS 838 Summer Pines Circle Hudson Wi 54016 W 1/2 SW /4S 34 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 100.3 3 BEDROOM CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100° Filter BEST GF10 -8 ❑ BOREHOLE O WELL H. R. P. Same as Benchmark B. M. Property Line Scale = 1/4" =10' 1.8 Acre parcel Well is to meet all setbacks found in Comm. 83 Area 15' below system is to remain 121 st. St. undisturbed 4% Slope B-3 100' 100.3' B -1 101' B -2 Huffcutt Combo Tank Grading is to be done to divert run -off away from system Tank is to be properly bedded and provided Pro 3 Bedroom with lockdown covers House with approved warning 526' Property Line labels ri • ► ° I Z -- -- 985.75' - - -- 1 ca 87,804 sq.ft. 2.016 acres V 2 70,254 sq. ft. ,� 8 1.613 acres u; 9 c 99 3 ^� 2.: m 87,163 4 sq.ft. m 2.001 acres 92,469 sq.ft. - _ — — 2.123 acres 6'13` E 163.98' \ O 80' rod 2 \ \ \ cul - 6'13" E 1 63.8$ O O f +6 \ to be exi road 9uading Seth IN � L.B.0.a998.7 ft. \ � 8 5 5 -_ — — — 1.84.52' — — � 4ent , 82,74 � '�$ R�� �+ O7 6 - S 89'46'13 E 1� O - / 373.3; \ - 1.900 acres 263.37_ �� \ � �' © — - � 1 8 �_ F 80 373.43 S0578'15E / /- 14 . — -173 2W.23' — \ �) 32.21' / l �?; '� 3340' SZ ' ` ' / rims 08 _ _ t.6R tt =99617 ft eu dm settaak \ \ eo • / Z 4 IS 7 100, 2 N87;36's7' 63.22' f J' 1.750 \ \ / 76,241 sq.ft. rn acres / LB.0-=fQp7. ' \ 21 * .� , \ *f E 271.71' 40i. 1444 erg / �• 19 N w 65,333 sq. ft. L. B. O. =998, 7 ft. 4 52 , 9 14 / loo. 1.500 wets1' Safety and Buildings 4003 N KINNEY COULEE RD commerce.wi.gov LACROSSE WI 54601 -1831 TDD #: (608) 264 -8777 isconsin www.commerce.wi.gov /sb/ www.wisconsin.gov Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary July 20, 2007 CUST ID No. 226900 ATTN: POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/20/2009 Identification Numbers Transaction ID No. 1417444 SITE: Site ID No. 727959 Sunset Ridge LLC Please refer to both identification numbers, 120 Street above, in all corres ordence with the a enc Town of Richmond St Croix County W1 /2, SW1 /4, S34, T30N, R18W Lot: 4, Subdivision: Sunset Ridge FOR: Description: At -Grade / Three Bedroom / Sloping Site Object Type: POWTS Component Manual Regulated Object ID No.: 1142275 Maintenance required; 450 GPD Flow rate; 36 in Soil minimum depth to limiting factor from original grade; System: At -grade Component Manual, Version 2.0, SBD -10854 (N.03/07), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01 101); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defied 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. cond ti The following conditions shall be met during construction or installation and prior to occupancy or use: APP Reminders Q ktFNT a oN SAFTf • This system is to be constructed and located in accordance with the enclosed approved plans and with the SEE COi;ES component manuals listed above. • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • 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 POWTS 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. Stat SHAUN R BIRD Page 2 7/20/2007 • Comm 83.22(7) 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. 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. 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 C Balance Due $ 0.00 Charles L Bratz J POWTS Reviewer II, Integrated Services WiSMART'' code .7633' (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday charles.bratz @wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. A F�Fit, JU4 1 �D Cover Page sqF�, z 2Opp GS Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 7/8/07 Owner: Sunset Ridge LLC Location:W1 /2 SW1 /4 S 34 T30 N,R18W Richmond Lot 4 Sunset Ridge System type: At -Grade Manuals Used: At -Grade Component Manual version 1:e SBD 18579 Pressure Distribution Page# 1. Cover Page 2. At -Grade Plot Plan 3. At -Grade Cross Section 4. Pipe Cross Section/Pipe Layout NED 5. Pump Chamber Cross Section 'CO MMERCE 6. Pump Curve LQ +NGs ,, ID 6 7 -8. Maintance and Conti cy plan,, 9 -11. Soil test Shaun Bird Signature License number 226 0 _--- > �. 5 , a l 1/6B I VG 13 Ft: L 1170 CELL Of Soil Cover -sTAi6t0 Observation— Weli I 5WE g View and Cross Seotzaa of so os siss dLt- grsEds Ua&r- with sink ,bsa=ption Arta art a 5 o sirsg Site KL Page Of Distribution Pi Pe VeWl for Lateral $etw*rk A, to sr TuRtA - UP . (you Qvc Force !lain --• - _ pvc Distribution Pipe P Last Hole Shw1d Be Next To T URN- u p ._ Hole Diameter 5�3,�. Inch X inches Lateral Diameter Z- y v__ Inches Force Main Diameter � Isms # of Holes /Pipe Invert Elevation Of Laterals Ft- Signed; ,. License Numbe:': Hate: r ..inn AND "S'VCif'ICATIONS ? IlP C { SER �Ss SECT! 1 EPT kppRoV ED Z I mDUi T iIt iii , Y# GAS ; a WITH wgrm 'TISH� SEAS c� s£� a PIK 10 SDIL C. PIPE Ev - { �- O pump {yam' �� � SOIL � CDC PAD a E�? - // DOSES. ER D Y : ---- DOSE q 7 � . I:NC rlo AL GA MANX SIZES ? . .5 ;c �� - •/` ms s , rACIMS ► _ S "COEL PE = �� c � �� '� ;�jC�� I la �F,ACWV£R = V r _ 16.I3 VA Fl q _ ... MODEL � x . � £ A H WIRI MG AS PEA �H U FEET , ,. E Z r g I �I t;I~ - A DIS K - FEET . �L EEN SSUS t7z AND - - - - �` i+C'ft - /FEET VEU'ICA'L VI �P'pLY PR£s�URE - - L Y E - Ec V1 r SET bl DIANE Xceig z N: )J �T1 F - LICENSE . S IGXED !fee Sent Yy' HP l.BS eriet 3100; 1 735 bO2 Me / ; May - e.acx en •may•• •.,•• N. ri £ - s jd� v . a !P f EH S E RIES SUMP/EFFL-UENT PUMP 8.95 0 >M CO. SM1578E if1s� 1eJ1�(Fpr�BB S� � >'iL1f. M ;111B� Ail. re � Br an pia 4t1s1 M Q >t or g Ss3 All OW Italia of-M SWM MCA 4/S8 115 314 lau 1037 7Q S4 % 41 32 136 2P 24 311 sU.84c694 954-M 50M ld7CSA AM 230 3W 65 100E 70 64 55 41 32 138 21? 24 MI s1lrAX& 4 SM411t.0 Sl138sft Wa 408 li5 39 13AS 10M 70 6d 55 41 32 1 33 N 27 311 xuradxLN RIM -MM 4 M 2W 9! 63 12M 70 84 S 32 i s8 27 27 311 silSI �FSnmusDetyRel e#—' t36ieha�a04rWnpassr�l edcm�wss�ll tasf�gas�fa FLOW- LITERS/i43 2 C�structIon n nano 2oaa 300 Motor Homing Coate d Cast IrIM aer Material q er ed Vane — — �° Volute ABS Z Power Cord S.tM A Mech11nic4d Shaft Seal Nitsile with carbon amd ceramic faces u Fasteners _ _ Srairlleac :`ueel _ Z ia Shaft Stainka Steel zs BesrirsSs - -- Upper Stevm and Lower Ba li Bearings a 20 40 60 so FLDw- CIAd..t014SMfNM PUMP PERF13RmMC£ CURVE Lftue aftnt romp Co. :15V flow PO Bas 13MOO r'" - 0ls><CIMOK 73157 Phaoe:4eLp7isn -Pass 46B - 211.13619 www.LfnlealianWamp.cAm 43 fom►,o96236- -07/03 ��-�-g QV�sR's MANUAL � ,� SP��� d � T t ra► s Ic Tank Mais� CI P!A Of 13 KA c1,Err>l� �� der hlauc'u P= NA taw jw of Pump TatlK Mlaru� (�'i �•�� � .Pi.:rnp Lftn y_ DNA x PuraP met �rA Dawn how , i U rsa Peat Quay MOIL II s� � ` II {ner. F � t titlorithlY .. 8io� � s 1 average in -g r ound rgviril3 m C3 Mound P t �0 � t7 C 13 09W- s' O gads Ow foe Few C ya dtarne r s Enters Pw" Sfie SeMoe Fregegar-Y t�tt�ucii�u-.n 3 YM.) GE SCHEpULE ths s) Ser a Event At least o nce every fl MO; ua� art �g - (V of rank erne coon of W 0140) vvhpn combined siudas and s1 tawdrnunl 3 YM-) Pump out contarAs O tanKs) At least Once evoy 13 S) Inspect oettts) At �, once every �i II s1 t3 NA CIe >l At least once every Q s l Q NA IMP" , purnp c onvols & alarm At least once every 4 r: a Y�s II NA Flush lsdouls and PVGSU—m t At least once every 0 II sj II NA 09we At Wast COOS CVWY offiry� C of I" �� or , cuCn0XS � be . nla do by sn md'� P 11 �nrrs lns�r or I oe s plurn e on of tietarrUOC ds2 � ar d V,,macfo l `�s Idenft j 'WW must Se T cf or��eaks. fie ms ' s) std We p ca+�. on � s� - d of of the local r+e ps, the or parley and to Cb for ' � f1Cqusres th® irnrreed� sso if voiu Aam g to nw a 11 in any tank eq� °ae C & of In of +� `� NR ac don Of ar►d Sepme ce g �. . S=tn Who Ana c O tt Cod ��' 113, V� r¢ed QC31�At"5 cool lgo „ ��d by a M . #7 mod s of ASS% 10 � Of WM of � offw .w � to to k� �aDry alpha ttY "f Pow �� START �fP � a nON men# � s} a f " � � +vie pf B P � mar dan�m prix m as �s 5j ;ress,a*�red by a s�9e servicing °P - - QE �sndificns ara at the 'snftz&e sts �` Syem s wtieri sz hvraier levels When D ov aSes �L' tt l mss) in in cne to go dose. ouerfo®dsn8 iM aetd mar tot in the may # be ifks avoid this s� have the ar o f t I� sic rersros►ad bya Wn"ft � gm & mss. � rat drirri✓ t}r pad cn�r= Or � � �' X O ra � '� s � ate' rn>s��d or al -grade SCA abs& - �5 f+ t d alum may imps the P &*� wid p� >e � Red cres Of t' wasbes�ea`er 2s; d0nW �� �Y z ASAIW ENT out of serves the foIIas sig steps s ta3G tctsxtta drat file When &,e Powys � arxi/'a� vvft ch_ Comm 83 -33. iRt Code: rs praP dY be e � mid the abar�rsed pip-_ � Al to tantcs mid pits stsa be rernaved and property disposed of 1Py/ a •� . - rho contersts cd�a&�s and If thaw cpv�css raox wnedar d the � spmte and p"s� soli be e=MAIS —d and nenxw ed or led w:it+t sal#. gm,81 °FaW inert sold rrs2UMML 0DMnVCEICY PL4X the OWM measures have been, asr rrttsst be Ulm% its P�'Mg a code if &,p i�fA►TS lays and carmot be t� C.r.pomt €epbo eme tt systerm and may be uWaad for the won of a r eps soil 0 A re� has been s be protected from d� and - � net. . � s'l se# fr+ m esds�ng and PfcP S 2 V cWM be � upon by WM x in the need for a newsy soil anti site �evaty 10 � a motect the � must cacxiply vvxt> r the rules in of bct at � *n& t� area .; p�rrtent sys�s � fn P0WrS - f, 3 Ass sle i� rxier3t no# avas7abte' due to setback arg9dr soil Grxi� ittolagY a i�otding tandc may be ktstAged as a fast re sort tc replace the failed of the POWTS a soi.artd sibs has net been +evak� to idervW a suitable repleoen ant area- upon area is avanable a site evaluadon lust be p fns iocaft a siriabje replacern� area If rso refit k rrW be $wed as 2t last resort to Mptace the f8ilesd PO S - ffmy be reconstructed is place fi�flosedtsg r ya£ one blo�rrat at acrd st- �o'� c�'t � must carnplY ►vltf} lire n.499 in a at $saeCtxre~ cc A#"cblt%dC�'� TANK . a MAY C:)WAIN LErHA€ GASSES AMMOR D1mF occamT OXY - AMCEr DEATH ' WAY SeMc� PLOW AND OTHER TPIEATM0ENT Do NOT 81ITER A SEPTtCY pUju P L3R DER TREATMENT TANK UNDER ANY C� Itl✓SL • an-at it w A PERSON THE �RjoR OF A TANK MAY D TLT OR M A3D1TfONAL CCM0WPSKM poviTS NIA1i!c TA€M R PQ}htTS i3�S3 - �.F.� € Nam u r✓ a�te pf=e -712 S EPTA:GE SERVI MG OPERATOR LOCAL REG#3 T #J7�HfliA TV Y cz Agency N2ft Pie �, 1 Pions : J� i — Greets res aoc.eet�.ms d irftFai sra srd'Vs t Lalt, it and �a Zc} sold - €t�s o m wnents of dL Caxton ss.22tZ0)CfX�t� � SIB)• C4 8 (3). rjj== R� 0"-- fir's of ft deeumestdoe6 trot @sc Ptsmc= of tm Powrs. (,fdW (7A13 07/09/07 MON 13:58 FAX 715 386 4686 Q001 ' VAsW=DeportmentofCamarerca SOIL E-VALUATI 2 M PORT Page — Of oi�isian of Safeyarrd &rit�rrgs . in accordance with C xnr Attach wnpkft sits prat► an paper not 1655 then 8112 x 11 in in size. Plan must nrdbdc but not Bailed 10: vortical and horixoenel reference Pc u (Blki). direction and IA- ;are ntarope.sc000rcLgm Womrraro+atrow.molocabm nddi= tCtAte . Dare Please pd nt aft information t�ervardinFormaScnyauorovia .+earbeweelorsecon0a�r S7 C 0 .� Propedty0ow )) —5 r ru C� � �/ GOA Lot 1 /4 S34/ T Q N R (• E( w Properly Owners M2i6rt9Address , I Lot Block # Name or C%W ` 500 ZV Code Phone Ntmtw O CRY 0 %nkw ROM LAXV., L LW i I -fXo/'4 (2�n 6w )j -1 NamCwawucWn fNrerrberofb6drooms_._�_ Code derived design flow rate .� r D ❑ RWInownent 42 Public or corrlmemW - Desrxibs: - -- - pm. t mataiel , _.— Flood Plain etevadon (f applicable endj mmmenls end nrcannrendapons: j,.� 7 a soft I/ FT & ft s L ff ± Gtr surfaoselev — f. Depot to lrru'fst+g fatter ✓ in. r Rsle Motizott D6pth Doatiriant Rtrdox Deaaiow ' lexhxe st uc4re Consistence f' rr+ Y Roar in. Mtxael CkL Sz. coot Color _ Gr. St- Sh. •eflAll 'Eflfl2 .31�. 2� O_ poring F - 71 111, +o * it Ground surfacer elay.. 4 L D m re in. Horizon Depih Dgrrirrant Color Redox Description Tathrre Struck" t;orrsisterx a $olstdaN Rods GPM *M1 •E1f#2 b Munsed CkLL Sz Cont Color L Gr. Sz Sh. 5 /• o F IT 6Z f y` � _ �, • � • : 3o and TSS <_ 30 mprl £Alttent e 1 a 80D > 30 < 220 mgM1. end TSS >30 _ <' S- - Etfluenl tit BOD < - (ST Number CST N" owes P*o ' 226900 Bird Plumbing, Inc. Shaun Bird Date Eva Telephone Number � Evaluation Conducted 1008192nd Ave, New Richmond, WI 5401 715. 246 -4516 07/09/07 MON 14:00 FAX 715 386 4686 @003 ftpertyOwner Pare 1D # -- — P"e of ❑ Boring Bing Ground stwfaoe etev. ` ` 4 ti Dep7t: k aniimg tactor � °' Son Apokagon hate Hodson, D"M Dominant Odor f eft Description Tom" : :n mm C.mwoernce awway Roots C-PW in. Mtun" Du. ft Coat cofar G.- 3tt. *ewi 'Ew n-j Pr JF S/ .•1 ,� ❑ ❑Pic t3ra,nd sunfaee alev. 1t. Dept; a odor in- son sate Ha®on Dq oonfswcoloq fled= Description Tenmae G tr Xhze conswenoe GPM kL Uutael Cu. Sz. Cont. Cuter C: 4z. W '601 'Ew — F om # ❑ _ ❑ n G" atafaos elan ft 1Jepri o fiisniting factor ss MAD Modmn DOPM Dominant fLedez Description. Texwm nvucame Consistence Boundary Rook in. 1Atstml Qu. SL Cart. Coto .;;c Sz. Stn. 'ERJ�1 'EtfR2 • Ef kmd #1 = f3OD 3o ^ 220 n vL and TSS >30 _ 150 n & ' F11 m t 92 = SOD 130 t4, and TSS S 30 n9t Vw Depata =t of Comma+ce U an equal Wit' service Pmvid sad esspIoyer. If YOU need aafstaace m access suv"" or omcm the - mur+ent at 608 -256 -3I51 or TTY M 2+64-8777• rued material i= an alternate fomtat; Please � sewa�oatsAq 07/09/07 MON 14:00 FAX 715 386 4686 10001 - Soll Test Plot P Project Name Sunset Ridge LLC Bird Address 838 Summer Pi Canes rde Hudson Wi 54016 STM #226904 Lot 4 Subdlvkdon Sunset Ridge pa 4/15/05 W 1/2 S W 1/4S 34 T 30 N/R18 W Township Richmond [] Boring 0 Well PL Property Line County S T. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey NallAron System Elevation 100.3' *HRPSame as Benchmark 167'Pwperty Line Scale is l" = 40' unless otherwise noted 100' B -3 4% Slope 30' 4 _ 20' B -2 101' 526' pro1erY Line » Wisasrtsin Department of Commerce SOIL. E.VALUATIO PORT Page I of Division of Safety and Buildings ��� in accordance with mr i f ount Ste. A �. Attach complete site plan on paper not less than 8 1/2 x 11 in heE in size. Plan must include, but not limited to: vertical and horizontal reference nt (i3R'), direction and rcel I.D. percent slope, n 'm �• , nt dimensions, north a and now, location nd Ji: Pe sca le or dl a �� t �� re � Date Please print all information e wed by, ST. CR01 NTY'' Personal information you provide may be used for secondary purpos (Pr r :a� ) L_ Property Owner L Govt. Lot 1/ '- LJ/ 4 s.3 T_3 ® N R E (o W Property Owners Mailing Address Lot# 7Block # Name or CSNW City. State Zip Code Phone Number C] City C1 village own N est Road 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 . L_Z� General mmrn men d /� r and recommendations: l F_/1 Boring Boring # it Ground surface elev. _ � f. Depth to limiting factor � � in. Soil Application Rate Horfzort Depth Dominant Color Redox Description _ + exture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 2 7 ® Boring # ❑Boring APtt Ground surface elev. Uv t. Depth to limiting factor � in. Soil liption Rate Horizon Depth Dominant Color Redox Description _ Taxture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 '042 rh C S C C k F �� L l Y/ 4 r fo - t h a �' • Co _ > < - 6: r ' Effluent #2 = B08 < 30 mg/L and TSS < 30 MgtL • Effluent #1 - BOD > 30 < 220 rrgR. and TSS 30 _ CST Name (Please Print? r r CST Number Bird Plumbing, Inc. Shaun Bird 226900 Date Evaluation Conducted Telephone Number Address 1008 192nd Ave, New Richmond, WI 5401 ��-- 715- 246 -4516 Property Owner _ Parcel ID # ___ _ __ Page of F _31 Boring # a [] Boring !Y pit es Ground surface elev. � ` t � ft. Del:�"t::c T 1i7�iGng fadar . —. in' Soil Application Rate Horizon Depth Dominant Color Redox Description Texture lure Consistence. Boundary Roots GPD/f� m in. Munsell Qu. Sz. Cont. Color 'Eff#1 'Eff#2 .� F-1 Boring # Boring ❑ pit Ground surface elev. ft. Dept a limiting factor m. Soil liption Rate Horizon Depth Dominant Color Redox Description Texture _ : tr 3ctture Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color < 3z. Sh. 'Eff#1 'Eff#2 ❑ Ong # ❑ Boring Ground surface elev. ft. Dep) a :a limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Descxiption- Texture tr uchare Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color =r. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 1220 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 aid employer. If you need assistance to access services or need material in an alternate format, please contact the der :rment at 608 -266 -3151 or TTY 608 -264 -8777. ssD -8330 (RAW) Soil Test Plot P Project Name Sunset Ridge LLC u Bird Address 838 Summer Pines Circle Hudson Wi 54016 STM #226900 Lot 4 Subdivision Sunset Ridge pa 4/15/05 W 1/2 S W 1/4S 3 4 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 100.3' *HRpSame as Benchmark 167' Property Line B M Scale is 1" = 40' unless otherwise noted 100' B -3 4% Slope 30' 45' 45'----10'044 20' B -1 40 ' B -2 101' 526' Property Line ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM � L OwnerBuyer ,3u � S{ :sq Q Mailing Address Property Address lle ifieation required from Planning & mina Department for new truetion ) ly a ? yg -aa�- City /State Parcel Identification Number LE A r DESCRIPTIO /� R l W, Town of tA t �l� i/a ,Sec. T Property ro - — r - Lot # Subdivision 2 �— Volume Pte' Certified Survey Map # Volume 6 page : # 3 d Warranty Deed # Spec house ye no Lot lines identifiable (9 no SYSTEM MAINTENANCE A ND OWNER CERTIFICATION of our septic system could result in its premature failure to handle °��' Proms er use and maintenance Y b a maintenance consist licensed pumper. Wbat you put into Prof out the septic tank every three Years or sooner, if needed. Y� maintenance s of pumping the system can affect the function of the septic tank as a treatment stage in the waste County S s responsibilities are specified in §Comm. 8352(1) and in Chap ter 12 - St. Croix County Sanitary ordinance. submit to St Croix County Planning &Zoning Department a certificatioa form, signed by the The prop owner ad to su s lumber, restricted plumber or a licensed pumper ver the septic tank is fyu►g that (1) the on site owner and by a master plumber, journeyman P n and pumping (if necessary), wastewater disposal system is in proper operating condition and/or (2) after inspectio less than l n full of sludge- se the to maintain the private sewage system I/we, the undersigned have read the above requirements and agr ee cut of Natural Resources. State of Wisconsin. standards set forth, herein, as set by the Department of Commerce and the Departm & Certification stating that your septic system has been maintained must be completed and returned to the St Croiat County Planning within 30 days of the three year expiration date. s of the ZOO � Uwe am/are the o��C ) I/we certify that all statements on this form are true to the best of m y/our of Deeds Office- pro described above, by virtue of a warranty deed recorded in Regis (� DATE SIGNATURE APPLICANTS) *# that is misrepresented may result in the sanitary permit being revoked by the Planning & &ning �epa =Ilt. Any informmu on Include with this application a recorded warranty decd from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. M05) 2 6 6 0? 3 0 6 774940 � STATE BAR OF WISCONSIN FORM I - 1999 WARRANTY DEED KATHLEEN H. WALSH Document Number 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 10:25AK Grantor, and Sunset Ridge, LLC Grantee. WARRANTY DEED Grantor, for a valuable consideration, conveys and warrants to Grantee EXEIPT ii 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 •• .��' W ' 304 Locust Street Hudson, WI 64016 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 7' 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 ' 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 Kristina 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 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 Richmond, 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 contius 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 tine of the Map recorded inVolume carter 164.50 feet to the northeaster) corner of a Certified Survey M cor ed i 5 Pa southwest q Y Y p � e 9 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. i i FROM :OEVERTNFj HOMES LL.0 FAX NO. :7155311282 Dec. 14 2004 10:14PM P11 -- •--- - - - - -- - -- Will � w a �b Y1Y &I M Y a ROG Am ` -- --------------------- --._._ _ , Vl FROM :OEVERING HOMES LLC FAX NO. :7155311282 Dec. 14, 2004 10:14PM P12 vou Jule lw ., •ar• o s Sol F N `i Ali O R 1 1 I