Loading...
HomeMy WebLinkAbout026-1098-10-000 Wisconsin D partmentofCommerce County: St. Croix Safety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT Sanitary Permit No: 506181 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 Cievering Homes I Richmond, Town of 026- 1098 -10 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: A)o (,j fir\ I Or 34.30.18.1432 TANK INFORMATION A ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. i Septic Benchmark v �-- r��•.�. s /0001 S. l► 105 .lo /� Dosing Q 5 Alt. B M iieq Bldg. Sewer 91 Holding SUHt Inlet TANK SETBACK INFORMATION St /Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic j jj r 1.6 �1$ 1 7 /qb Dt Bottom � 2 , j q 3 Dosing (0 1'a f , � Q 5 j 11-5 + ' Header /Man. Aeration ` Dist. Pipe 3•b /0�.5 Holding Bot. System S. Z- /oa,� Final Grade PUMP/SIPHON INFORMATION Z •lo �oZ • 5 1 PH O Manufacturer (( Demand St Cov / Z. 2► bZ . ; 1iZ.. f t� GPM v C.o Model Number , 1 _ 7t( q 7 TDH Lid. Friction,Los� System Head J TDH� C � I '' 77ff Forcemain Lengto Dia. it Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Of Length No. Of Trench PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 16 G6 SETBACK SYSTEM TO / P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Ty e Of Syste / i 1A / ^ UNIT Model Number ` DISTRIBUTION SYSTEM ( lAv N r iy Header /Manifold Distribution / �+ I x Hole Si [HofeSpacinq ' Nl -A i0 Air Intake Pipes) 7 i J 3 z f�JJd Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade S ystem s Only Depth Over ,o IDepth Over xx Depth of xx Seeded /Sodded xx Mulched Bed /Trench Center ' Bed /Trench Edges Topsoil , 1 �es No es No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: S / ZZ / 67 1 9 Inspection #2: Location: 1228 121st Str t New Richmond, WI 54017 (W 1/2 SW 114 34 T30N R18W) Sunset Ridge Lot 10 Parcel No: 34.30.18.1432 1.) Alt BM Description =� C o J �~ l__. 6L ( t 2.) Bldg sewer length = ` �5 1 I 0 W `�' e J - amount of cover = dk G.('G5 d Plan revision Required? Yes )(No 2 01 t(f�iJ/j Use other side for additional information. - — Date Insepctor's Si ature Cert. No. SBD -6710 (R.3/97) V Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 `� ;�e Madison, WI 53707 -7162 Sanitary Permit Number (to be filled in by Co.) 5 / Numb ion ume Sanita ry Permit Application Transact ( _ In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the app emmental 6 ` unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned PO Address (ef different than mailing address) submitted to the Department of Commerce. Personal information you prpLvide may n puipos in accordance with the Privacy Law, s. 15. 1 m , Stats. 1, J) 1 I. ApVlkation Information - Please Print All Information e ,*, . e Property Owner's Name / Parce # Property Owner's Mailing Address Pro Location , I3L City State A Zip Code Phone umbetD T. Up y, y Section l rti ) D l � (circle one H. Type Building (check aff that apps dG 4A Lot # T N; lt E o &j or 2 Family Dwelling - Number of Bedro /C/ Subdivision Name $ VbAo; -I Bloak .fur sew �,c� ❑ Public/Commercial - Describe Use l a`^- A)b G ti O Go ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of /D t A4 G r Town of &i (,A M. Type of Permit: (Check only one box online A. Complete line B if applicable) A. ew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) � B. ❑ permit Renewal ❑Permit Revision ❑Change of Plumber PC] List Previous Permit Number and Date Issued Permit Transfer to New Before Expiration wner IV, Type of POWTS S stem/Com onent/Device: Chec an that apply) ❑ Non - Pressurized In- Ground ❑ Pressurized In- Ground -Grade ❑ Mound ? 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treatment Area Information: De } s � Flow (gpd) / Design Soil Application Rate(gpdsf) Dispersal Area Regmr d (sf) Disp 1 Area Proposed (sf) System Elevation. VL Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units a New Tanks Existing Tanks r A Septic or Holding Tank Dosing Chamber 5 ; V 1—�—i VIL Responsibility Statement -1, the undersigned, ass espoasibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumb gnaturo MP/MPRS Number Business Phone Numbor u - � %�,,� . ZC��G Plumber's Address Street, City, State, Zip C VIIL Countyl De artme Use Onl R.Approved ❑ s Permit Fee Date ssue Issuing t Signature � rt 5 9 ❑ foc e nial $ l.�v' OD Z 6 7 IX. Condi ' easons for Disapproval .L / Flo 8� 3� B� / A o a"Se- Qw� 1. Septic tats effluent fitter and D G t{- v ►�C t... �o,�t dispersal cell must all be services / maintained yNtit�a_ / as per management plan provided by plumber. , 2. Ali sdtback requirements must be maintained y C ori �� d ;` St g a e asper e system and submit to the County only on paper not less than a 112 x11 In dzel • e. � e & wl t,A'l•�c� SBD -6398 (R. 01/07) Valid thru 01/09 �, ;„� i � n l PLOT PLAN PROJECT Sunset Ridoe 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 101.0' 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 ,BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100' Filter BEST G1710 -8 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark 121 st. St. Scale = 1/4" =10' 417' Property Line Pro 3 Bedroom House Tank is to be properly Huffcutt Combo tank bedded and provided with lockdown cover with approved warning label B -2 Well is to meet all Grading is to be done to divert setbacks found in run -off away from system Comm. 83 2% Slope B-1 101' Area 15' below system is 100.5' to remain undisturbed B.M.* 2 -`t g a Property Line r 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 101.0' 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 121st. St. Scale = 1/4" =10' 417' Property Line Pro 3 Bedroom House Tank is to be properly bedded and provided with Huffcutt Combo tank lockdown cover with approved warning label B -2 Well is to meet all Grading is to be done to divert setbacks found in run -off away from system Comm. 83 0 2 /o Slope B- B-1 101' Area 15' below system is 100.5' to remain undisturbed B.M.* If Property Line '2- Lt. �, p Y Safety and Buildings 4003 N KINNEY COULEE RD commerce LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 isconsin www.w www.co e.w i. gov/s sin.go / t i� e partment of Commerce iscosin.gov Jim Doyle, Governor Mary P. Burke, Secretary Ma y 07 , 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: 05/07/2009 Identification Numbers Transaction ID No. 1392866 SITE: Site ID No. 724889 Sunset Ridge Please refer to both identification numbers, 120' Street above, in all correspondence with the agency. Town of Richmond St Croix County W1 /2, SW1 /4, S34, T30N, R18W Lot: 10, Subdivision: Sunset Ridge FOR: Description: Three Bedroom At -grade System / New construction Object Type: POWTS Component Manual Regulated Object ID No.: 1129056 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), Pressure Distribution Component Manual, SBD- 10573 -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. 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 enclosed approved plans and with the component manual(s) referenced above. • 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. • The area within 15 feet horizontally down slope of the dispersal cell shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent filter is required. 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. • Comm 83.22(7) - A copy of the approved plans specifications and this letter shall be on -site during construction and open to infection by authorized representatives of the Department, which may include local inspectors. P.O.W.T.S. Conditionally APPROVED l ni:PAQTMCAIT nC rn&A1=nre - SHAUN R BIRD Page 2 5/7/2007 Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) - 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. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • 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 Gerard M Swim POWTS Plan Reviewer, Integrated Services (608)789 -7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swim@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. RECEIVED APR 2 7 2007 Cover Page SAFETY & BUILDINGS Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 4/24/07 Owner: Sunset Ridge LLC Location:W1 /2 SW1 /4 S34 T30 N,R18W Richmond Lot 10 Sunset Ridge System type: At -Grade Manuals Used: At -Grade Component Manual version 1.0 SBD 10570 -P (R.6/99) SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01 /81) Page# 1. Cover Page 2. At -Grade Plot Plan 3. At -Grade Cross Section 4. Pipe Cross Section /Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7 -8. Maintance and Contigency plan 9 -11. Soil test Shaun Bird Signature License number 226900 OIVIS►UN OF SAFETY AND BUILDINGS SEE COR SPONDENCE T .tr K�- 2: 5 1 $ '— PVC 1 � ' L " uAA- UPS" - -- ter -- t� srA =�� - tc.s L ELL >5 1 Ir #/6B 1/6 B #/ B A= F t 30 l � Fabric ¢(( Di Lateral , ,,,-Soil . Cover sme; 7mra Qbst'rvation -- " -- -- w ,,,_ , • - � < Well 2 5 ' Crass Scction of ;7iscosssia At•gra VIftV and de UttiC PLars Site single A}ssargtion Area on a Sloping Page Of Qistribut ;an Pipe DetAil for Lateral $etwork ACce TURN -UP (CLRftV40U - Force Main ._. _ !t=— PVC Distribution Pipe P * Last Hole Sh wld Be Mmt To (� P Hol a Diameter �2�nch �� _ Ft.. X Inches Diameter Z Inch(es) � _ y ` inches Force Main Diameter inches # Of Holes /Pipe Invert Elevation Of Laterals I Pt- Signed: Licens Number: Number: Date: CROSS SE TAD? AND SP£CIi ICAItTiS S£pTIC TANK p�3KF Ci ;RM$£R wCATWitPRWF AFPR MrN. p►sov GRAD£ JUiICTIDN BOX j4,s ` EST FIP£ � �iHOLE COs+ ER WINDOW �> FR{3K D4f?i�, {lit 1411TH CONDUIT Wf FAPLOCK I � FR£a .IR INTAKE �t6 iABE� QtADII E � f v 1 8' ss f a I C S f . !! TIGHT SEALS TIGHT ; ; vlTH jet �3LTf-R 3` OM 8 4 ON S-11? SOIL APP1RdV� C _ s PIPE ; SOIL pj(p OFF D a: AP�'Rt£i7 BEDDING UNDO CACR£TE SPT'CIFIC Sr Dosr P'}`IC � DOS£ DZl� 9' - } iiC 1� virAcTliRER = £ v £) t4E N ggCIC tHE GAL. TAIiK SIZES SE /s GAL . -. , . /.� i3+iCE3E _ ,...- INCHE DOSE s � pACgTZES= A _ yAgt1 MANUFACWRE L� MODEL _ SWITCH TYPE � C-AL. Hp jFAC'FLtR£R = 1,6.23 WAC MODEL ��' IRZNG AS PER 23�'iR sw cH TYPE= Zy tvtsP s ALaAR /� g£ET .� pfif PIPE EMT .FQUIR£� t32SCI#AR�E ItA i ,�p OFF .AND DZSTRI . . - _ _ E ExCE sEEx PU - - £. #IFFER p$ESgUR 'ff I€�iI - FRZCTYOi� CJiEA /S F££T vERTICA 1 IH N£T�Tt3RK Stl ? c� FT • � ;C B { FE£T FOP-COW" Wk X LO$=�" TA s _ nTN DiAMM _--- Ii�T�NRL DLMENSZDN$ �'F Pt3?�F TANK'- I,IQDI LICENSE M$EN = SIGNED'- 'I88 Sent By: HP LaserJet 3100; 1 11b =L' Ove may -Q -VV 4.:,VF-N1, w y 7f 9 EH SERIES SUmP/EF'F'L.l.1EN T PUMP 11.65 o Specifications � 1� �:� ��. 9lR9f INK as . fu ► OW a st,93 9A IL i1S 81 9A9 �pii 9 it IF � 503244 MCA 466 115 314 13.0 1000 70 54 55 0 32 13.8 2P 24 s.H 11160x89 Oaf 509944 MCA V-0 230 814 65 1004 70 6a 55 41 32 13.8 27 X 9.11 x11b4AN g8{ -Ok" mm Wm 490 11S 314 13.0 10m 70 60 55 41 32 13.8 27 27 8.11 111.64% 8.80 e ig p 4r0 �p 3p 6.5 1000 70 64 55 41 32 1 x B 27 27 &11 x 1161 x CorOfnsms 6slyRStcd —dais Bisn2WpwsRsaesataOco +R�nua�sO�AYas bnpatlhe�' ansrtrtwMAinEroplOF�d ►>AlnOsfertiesemmDs FLOW- LITERS/HOW f construction 0 1004 2000 3= Motor Housimg Epoxy Coerced Cast Iron Im . ller Material Poly Carbonate pe to impeller' c Closed Vane 30 Volute ABS -.�... F 71 Power Cord SJT'W A zo Mechanical Shaft Seat Nitrite with carbon and ceranik faces s Stainless Steel Fastesters — = 10 z Shaft - -- Staintem Steel z.5 Bearinp Upper Sleeve and Lower Ball Bearings 0 20 40 60 8o FLOW- GALL04S/NINt1TE PUMP PERFORMANCE CURVE Little G�ia�nt Pump IOV 6048 P1? aqx 11910 • UNIAOM CIM" P6oar. 4VS.Y47.1511 • p"-. 403.229.1!59 F.ssdl: crstoa,ersez.i� www.Littleelantramp.com 0 Forth 948235 -07/03 T PLAN Page at pOWTS 01Nt+iER'S MANUA SY s f „ ICATIONs NA naN �� $ Task CapadtY [i riw me 04FOtR► sic Tank E.M u ent FAW Pertt>- a NA E!lluetlt F'ftr tires p� Q ` n NA morns Pumg•Tanic Cam* e Numb firer NA tsumber Of Cote units PUMP T9 NA low E ;tad x tA(;dcl Pump P int unit - t3 Pest Ftibsr Son APP�°t' Raft month svefaw Q Sari�MVW Fly fl Wetland uetrt tZua1lty Site mgn- D Mechan� A6=500 II Oilier: � d {6010 S22o rag/- 13 Didmf=Wn BOWS {T ) — <I SO m /" ��rer Totat sus (c,nttily a age~ DisAeiz�al Cell(sc II lrt -groin EPA +�' Qua* ODs) S3p mg/L D in{J �nd (R D Mound Pr g semicai Oxy9� De $S) 53o rng[L ❑ Ori a ©Outer TOW Suspendad Sonds {� st w cfu� l oomi foe dab"OP (noncoavr y Fecal Co1KoCC11 tric mean) w indzdsameter elttl�- k � at Parade Size y dor Service FreQuency MAINTENAN SGEIEDUI.E t S ) (Mlnturn 3 yts.) ce Even D months Serer At feast Once every LS e quals one -usird (147 of tank volume inspect Con �ton of tank(s) Wt1en combined sludge and scum s) ( M. U dmum 3 yrs -) Pump out Content' of lank(s) At least Once every � D mo s) cell($) __ / D months , inspect dIsP@� At least anoe every ` � s} a NA Clean affluent At least once every i3 moms tits Y s ) Q NA inspect Punp. >�p contlots � alarm+ At least once every II tsson S) a NA test (3 months fl Y Flush >ata� and At least once every fl yem (s) a NA rrionths odar At least Once every D War_ r icenses or one of t" f000�s ruiMUTE'i�t"CE dope sal oils shalt b+� � �e�r, � r POWTS MakTw ns SePgSe of POWTS 1nsix • m or broken any LispedWA M� Plumber: Master Pl de a visttat inspection of ilia tarik{s) for any bads up °� Tank insPecu°ns must volume of comblin a and uent fas check the efii levels no Serwki or teaks. urge the . ed sludge hamMsM kwwgfy any cracks rheas Ttie d"1sPe� MRS shall be visrr�Y The por�S of af�uertt on faze or ppog of Iktertt on the grnitrsd y �d'uV o f eMuent on thO 9 oa o f the � +agu ry in the � P� and WIdigon end requires the Immedsabs mt�tE the tank volume, the "W irtd s tr�uTiilg min any tank e4u�s ont'. -tha�i ' o f in accordance vwth - NR uistior► of fudge and vCU $etvidnQ Ope fStor and d5, When the combinied avarm oved by a Sepwe entitle of !fie tank shalt be rem - ant ponw%s. and any 113, W =stn Ad Co or pressurized POWTS components. ad by PO � lyakdoln� die sue$ of effluent Rita.' of 12 months 0 M. shall be PWI& n 1 y = V = gilt. othermat ce ar regu latory authotify within 10 � of c�F to We local r� A rrgPo�t U Provided Or DO uCtS START UP AND OPERATIO POWTS check treatrnent Wk far the Preseroe For clew = . prior to use of the mat CWKS). if high coneerlbgns are bo the igtmen process anchor damage the d"P n4r to use d . w have the ts of the tanks} rerrizved by se s septage rvidng opera prior + r Pace af_, Oonditions are frozen at the in&&ative surface- Sysfem start up shall not occur wi�eri sod is tes%xvd ft ocr iges FMW tanks rlr y ja Above nomW highwafer te�ts� themg �(s) ants may rem ttin the Dung P cW(s) in one �e dose, wo be � � To avoid 01,s sit>satiort have the contertis o f the P� tank removed by a tam the pump Setvktn9 O Power to the effluent pumP or Contacts Prtm oc PO1I3lT; Mager m Prior to restore normal lemEs r�ifttin �. ;n mark ►� � old d� .. Do not d rive Or patio �t orb (bU or comp Do na ddo Lx mom or at - grade scxl absdrg�rt area- a[sa Wf t 15 feet down slope a€ any the perbnnarxe and pr�octg � � . � �aA��szr>3am � im prove r bnnar�ae �9 a Sow ' . & " M c� eGrizi:� of the baits; condoms, cot�n swabs; deg: dertt�a3 . � of the POWT&- � * fruit and vegetable peelif igX gam% Same 1111-11; dish fat foci dfallt {sump Pig) Earls: tampons: •sue �W sQ�erte� brine. s� me&a�o� ct S t�� �` can ary r>ap ASMO ONIMENT r.laken out of ser�rice she fc8owing stets sitatt to Da lnstue that fie WW the Ape's too andfor is p� syseern is p ij .and safely abandoned in carnPTtance wl� ch_ Comm 83.33. Wisvo Add t:oder All to tanks and Ails shall be �nnected and ttie abandoned 'Pe opener sealed. M ss of all Lanka and pits sttatt be removed and properly disposed Of by a SePtatge Sery Ope he v ration. s After pump7B, atl Unks and t� shad be e=vated and rerno�ct or tne'r ors n ar�d t he mace Bled w0h Wk 8= Ord i solid m2taftL CoNTLr c PLAN tTM fisrros+vrng measures have been, or must be U&M ID Provide a code if the POWTs fads and crarirtot be r+eP� The re ertt location of replacement cartmp�nt � �" been evaluated and may be ub7ized far the . p dable �t'ar�aa has and shMW trot a�yon �- lent area should be protected from A su tract r lot � and yells_ Failure to from e2dsting acid proposed.struciure u nrqua+ed setter .evaluation to establish a sudable be mfnnged P � area � r;esuLt in the need far a new soil and. s:£e Proms the �� s must comply with the rules in effect at aWL tne. went area Rjvlacement system TS advances in POW p Asuitable riepras�ement is not available to setback art re place sett funiG Wed S OWTrS - S_ teclwalrogy a holding tank may be � fed as a Last resort to rsplac� the fazed fi identity a suitable replamment area_ upon failure of the P area is a a so3.ar e sib has not been evaluatBd area is available a evaluation must be � fi rotate a ' suit�te reptacerneni area. ff no � tank maY be wed as 8 fast resort to nePia� the failed PO c, folta�g tatrroval Of the bbnud at and at-gra sod abs�P� s ystems be reconstructed in Imo, �g rotes in elfeCt at fiat *Tm the irtfiiLragve srWIMe. Recontsbuc icon Of such systems rnust comply <<WARNING TANKS MAY CONTAIN LETHAL GASSES ANWOR INSUFFICIENT OXYGEN. gEMC, pump /LAID OTHER TRP OR Crr TREATMENT TANK UNrDER AMV CIRCIiMSTANGES. DEATH WAY 00 N ER OT ENT A SEFMC, PIUMIP OR OTNER OR Of A TANK MAY HE DIFFICiiLT OR MW' OSSiBLE. RESULT. RESCUE•OF A PERSON FROM THE INtTER1 ADDMONAL_ COMB EEWS✓ POWT NWNTAIKER Potnr�s iNSTALLeR `✓ Name Q Marne C 4 r � _ Ptlorze Phone Z5! SEPTAGE SEf�YIC G OPERATOR P LOCAL REGULATORYA€FTNORftY Agency Name �/ � Phone Phone J_— — �J T This mats , gr ape i�lfs of iDe teen r sae. �tarQua and Waushard county zoning s; SanR24ott - me e of a& ,e4am W ft of aL cacao L a&Z= XjXg3M and 53-554(j). 0 & M. Woognsin A tstra[fnc code i3s t � pe ftmace of ft POWM . 04/26/2007 07:33 7152460745 OEVERING HOMES PAGE 01/03 wr: iron DePwtnwg Of Commerce SOIL; EVALUATION REPORT' page °< Division Of Sabyand Btrddings in sowrdanoe with Comte N5, WIs. Adm. Code (` Attach oomvlelo site Dian on paper not less ratan 8 112 x 11 Inch- N, size. Plan must Include. trot not r' Inclu I~ to: v+ereeal and hoAZO W ►etsrsnoe PWnt (ham'•), diredon and Parcel i.D, veatrt stove, scab or dimensions, nOM amow, and WCV00n and ii - tano®to nearest road. Reviewed by Date pmese print all fefbmistan. f'M�rarral wawwAftn Y- orwiea mar be wed for �dery owl Mr-cnrr Lpw. S. t�fePertSr PropeAyLo�c�ow / GOA Lot W thV LJ1 S -r Z(W Q N R ( E J r ' `•� f Lot f1 Bloat x Name or tSw ptoperytaMtefsMaiC ss Addre .K.f r olf C' Prone Number Ci4t d Ydlage own J A c New Cohl4btxan else' / Number of bedrooms Coda derived desiStn ft- rats t Publie or commercial - Desalbe: �--- [� RQplao9rtleM Flood Plain dev�on If BoP�We IL Pararht rthalariat „ __i��i.�'� -�= t4marat cornrnc��ts sr� E ao*v A to hg Wound surboe astir. _.!.\L.. If- Daps eo rrrta" facts b. Sp8 ice%on tieoe it l�olim0a Depth Oomkfartt t4edox Desm"M 'tom s Consistence Boundary' Roots In. w flu 3L COM Color rig. SL Sh. - Efrift 'C- 2 • I ,.. s.r ---- ® tiorino A / � f —. t t etew. _- F•___� of►t� tins facer . In. Reb OepBt ooff,irhant C40W ftdox DeW+Ptmn -Tie stn,�,re COnshstenOa ttoulfdarN Tel •rte in. Munson citr --'L cant Color Gr. SL sh. A r^ 3 ElRUent ht t =800 > 30 a xt0 rrlQll and SSS >30 i S; r. • EffkWt 92 = SW c 30 rn yL and TW 30 RM L CST NUN*W CST Nome F aes Prtr+g 226900 ..J Bird Plumbing, Inc. Shaun f3i� Address Data 6vatha+tion Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 64017 - ,,y S- 715-246.4516 04/26/2007 07:33 7152460745 OEVERING HOMES PAGE 02/03 Parcel to A _ _ Page of L3 " tt D 8onng Ground surb" 4bv/p - R. Dept. k • imft fader,. , . Rata it Redox Dtrsoriptton Texturr ~�° Gonsister.ce Boundary Roots G Hortmn OsPlfti Dominant WWI 'E1Ati2 MunseM tau. S7- Copt cow _ '- '�+ .�/ � 1Z Ave V Ic D ~~- 3 [_ ✓ r / _ a a eadny Pit 6rocacd surt�ca alev. R 0""' n r4ntrir+9 tact E - ---^ -- Y" so'i ran Rate Flmimon Owth Ooh RWMDesatPtlon TwcUe $trj*m C.arrststance 8oundarY OPDIH' in. Nhrnsell Qv. SE Cont•cow G_ 3z Sk El ❑ Ewnp ❑ Wt c�v 2 ufaoseiev. n Deoc, . o IF�ki<g factor _,_._�� in. Sol Rate Fbrtxon Depth oomimnl RedexDesatp W. Tafdure !�eue4AO Cat9t�enoe 8ocrnderY Races GPOAE in. m~ Du Sz Cwt Cater Or. Sz. Sh. 'EA42 • Efton S9 = BOD > 30 s 220 mgtl- ant! TSS >30 1150 m9L ° E}WW *2 = BOD,130 nVk and TSS 130 nVL The Department of Commerce is an equal oppottuvity service provi6er aa4 employer. if you txxd assistaatx to access services or nod material in an alternate tonnat, please contact die dcFzrmertt at 608 -266 -3151 or TTY 608-264-SM. sso.+nr.tR.aun Soil Test Plot Plan Project Name Sunset Ridge LLC Shaun d Address 838 Summer Pines Circle Hudson Wi 54016 CSTV #226900 Lot 10 Subdivision Sunset Ridge Date 4/15/05 W 1/2 S W 1/4S 34 T 30 N /R18 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 101.0' *HRpSame as Benchmark 417' Property Line Scale is 1" = 40' unless otherwise noted B -2 80' 100.5' 0 ' 2% Slope -3 10 50' -1 101' 100' k 90' B.M. 248' Property Line 7.9 Wisconsin Department of commerce OIL EVALUATION REPORT Page of Division of Safety and Buildings RE @E U County in a a Ccm: t e coon - X �. Attach complete site plan on paper not less than 8 i e-- ii i s;ze. Plan must include, but not limited to: vertical and horizontal refer I 3 11 direction and Parcel I.D. O ZG y /ZS � : percent slope, scale or dimensions, north arrow, and I n tn oad. Revi ed by Date Please print all informa 'on. ST. CROIX COUN `� �67 Personal information you provide may be used for secondary p es (PZ4f�11�5 (�Fr�1 1�(m)). Property owner rope n t 1C `. Govt. Lot W / 1/ X1 /4 T3 N R �1 E (o W Property Owner's Mailing Address f 1 # Block # Name or CSM# Gty State Zip Code Phone Number City ® Village own NefTr Road New Construction Use: esidential / Number of bedrooms �— Code derived design flow rate `� '�� GPD ❑ Replacement Public or commerciai -Describe: - - -- - - -- - -- - -- - - -- Parent material _ _ Flood Plain elevation if applicable _A! � ft• General comments ` and recommendations 4�' Ipe 9 M ❑ it Boring # it Ground surface elev. l �! ! I f • Depth to limiting factor 3 / _ in. 7-E App Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Eff#2 in. Munsell Qu. Sz. Cont. Color _ Gr. Sz. Sh. v s Z m TT 3 - 2- S r y►'t - n� r✓ Nl /4 11 Boring Boring # �b� y in. � Pit Ground surface elev. t=1 I t- Depth to limiting factor Soil Application Rat Roots GPD/ff Horizon Depth Dominant Color Redox Description T3xture Structure Consistence Boundary 'Eff#1 'Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Z F �, / -� 2 Z-3 3 � 3/ F r y - I -S d Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 : 5: r ' Effluent 1#2 = BOD < 30 mg/t. and TSS < 30 ffmj& CST CST Number Nance (Please Print) Ei re 226900 Bird Plumbing, Inc. Shaun Bird Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 �� .1 � 715 - 246 -4516 Property Owner _ Parcel ID # _ _— Page of Boring # ❑ Boring q� it Ground surface elev /P(/ ft. Del; ?f: ;c 'ii- siting factor _ in. Soil Application Rate Horizon Depth Dominant Cola' Redox Description :extUre c;ture Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color 'Eff#1 'Eff#2 >;�. >h, D�iz 3/ ,r I-- s ` - -� a rrt -� Z Z- I& w o 3 - ✓ 3 r `�� V ES - m- ❑ Boring # ❑ Boring ❑ pit Ground surface elev. ft. Dept i o limiting factor an. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture i -Ar 3cture Consistence Boundary Roots GPD/f in. Munsell Qu. Sz. Cont. Color _ G 3z. Sh. 'Eff#1 ' Eff#2 ❑ Baring Boring # Ground surface elev. ft. Dept,, .o li miting factor in. El Pit Soil Application Rate Horizon Depth Dominant Color Redox Description. Texture `�t uctare Consistence Boundary Roots GPOtfP in. Munsell Qu. Sz. Cont. Color < ;r. Sz. Sh. 'Eff#1 'Eff#2 I — Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mg/L and TSS <_ 30 mg/L The Department of Commerce is an equal opportunity service provider aid employer. If you need assistance to access services or need material in an alternate format, please contact the derarment at 608- 266 -3151 or TTY 608 -264 -8777. SBD -8330 (8.6(00) Soil Test Plot Plan Project Name Sunset Ridge LLC Shaun Bird Address 838 Summer Pines Circle Hudson Wi 54016 y r CSTM # 00 Lot 10 Subdivision Sunset Ridge Date 4/15/05 6 W 1/2 S W 1/4S 34 T 30 N /R W Township Richmond R Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Nail /Iron System Elevation 100.0' *HRpSameasBenchmark 417' Property Line Scale is 1" = 40' unless otherwise noted B -2 80' 100.5' 0 ' 2% Slope -3 10 50' -1 101' 100' 90' B.M. 248' Property Line to— / Or C M � co �i d'1 ►J 227.78'— - - - 213$.61 - -- 2157.27' - -- c,,. - - - - N00'W'04 "E 2641.95' - - - - I I S p��0 Cl _ Q � I 2 O W It . t 2 U- $ I z I `ti =N I 0 J � I � I J of x� 64; a , dM�n COUNT( PLAT C r 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 UN_PtnTTEO 'ANUS N 89'50'54" E 1018.75' V r e 1 N I r r bay 0 35 +9 £ g9 S -11. 4 I Il. m 4 1.61J a ^, a I U v 110TH avE. I i �.._�___- N 3 q 87 ones a I 133 J I L — I _ \ a �I _ w ry vi fi b 9 J f ea S1 2 rval e , b I Scale Sncf on 74, T30N 418W / ' oo r, 5 v � > , s " Ill l2 1 g 6 4ti Lf GL ND qw, . _ 4z I73ao 1 - - QQ SL Ganz Lounty Soct— comer As Noted 1 .2 mP 1 O Set 2 and 3/8• (0 D) x 30• Iran Pipe (3.65 Ibe./Iln, It) 6 I u q 1nac. � �,• (N 89:iJ'40' W 1J06.04'1 Record Dalo ______ 12' Wilily E---t Zp u fisrw. - -- -- - -- Bullding Setback Llne I ,so fix 23 m o i. N. p. Lowest 8uilding opening 21 V o Lowest Pennitted Door or Mrdow Elevatlon ly tiv 8 ,7� m ea—..' All M b, lot co rs n this Plat, will be evidenced by o IA 1 8 m m . 171!9 acr'll. I �� \l I fi m mi I 1.4+ ocre+ . 1.05 lnph (O.D.) , i —h il n n i n e 0. 13 lu , 5 a ,I T owner_ � --- -3ai.eL— i A1dye, LLf: S8l 5 v Pl.5 s Lircle N_ I w9 .5 015 17 s.�.b � er fir zs JS E 1 .., 'bb"" z 1 � I e Jn � too 1 too 200 1 1 li o) es5 u' E U c 11 i 52) SCALE I r'EEt q g / i.ego on.. I � f u e I p Lim 1 � I v 75 Jo +e' 14 0,eoq , n. I I 6 l icm ones I 6'Z8 E LoT 1s_ r6I an., LOT_ 17 g I v 13 0 U C K P O N D E S C A P E I 66• g I H. —+m n. ro 'J ._ N89'59'59 "W 694.55' +rolb, 10J1 JJ' N.ro fie LOT 2 i, N87'49'24'W 324.40' �5 9]'SJ' J24,.S9 o u r c iG ✓olurrie i. 1Zti� f. Jr_`!UF I I�::11� 4H52 Pugs 4852 LO7 1 I �I ,uT 15 • LOf 16 m - -- - ' ' - ✓olume 5 I I _ l y Pb g, 1400 MELCHERT WAL.KKY 9 - -- landscape architecture *e N4nw.y Iz ClYll a In Berl Hudson. 7, 1 6a01e 1.!bs Sheet 2 Of 2 Sheets lands veying PIP... 7,1.) 3a -aeusa ..na r and i, (an.) o-w, oa• acicasar walao[v ST. CROIX COUNTY SEPTIC TANK MARTMNANCE AGREEMENT AND pVrr,*ERSFIIp CERTIFICATION FORM owner/Buyer-5 A S MAUbg Address property Address Dep artment for new construction-) (verification required from Planning & Zoning, r . Parcel Identification Number v u T L � ' 177L1 City /State LEGAL DESCRII"Z NN 2 a Sec. T " N R�W, Town of Location / , - Property (, Lot # Subdivision Certified Surveil Map # •� ,Volume / �- per'# Warranty Deed * . Volume Z 6 Page �# 0 t Spec house yes no Lot lines identifiable a no SY TEM 11�LAIN'I'ENANCE AND OWNER �RTIFICATION Improper use and maintenance of your septic system could result in its p i needed, failure Pumper What oY u Put into maintenance consists of pumping out the septic tank every three years or sooner, f needed, by owner maintenance in th waste dispoW system the system can affect the function of the septic rank as a treatmrn I2 St Croix County Sanitary Ondinanm responsibilities are specified in §Comm 8352(1) and in Chapter ft to submit to St. Croix County Planning & Zoning Department a certification 'fo signed by The proP�y owner agrees lumber, restricted plumber or a licensed pumper venfyxng that ( the on-site owner and by a master plumber, journeyman condition on and pumping (if necessary), the septic tank is wastewater disposal system is in proper operating condition and/or (2) after i less than 1/3 full of sludge. with the agree to maintain the private sewage disposal system I/we, the undersigned have read the above requirements and agr state of Wiscon�im standards set forth, herein, as set by the Department of Commerce and the Department of i�Iatural to the xs, Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Pianniag & Zoning Department within 30 days of the three year expiration date. Uwe am/ate the owntr(s) of the Uwe certify that all statements on this form are teat to the best of my /our knowledge. des eve, by virure of a warranty deed recorded in Register of Deeds Office. ATE SIGNATURE APpLICANT(S) J!0 7 in the sanitary permit being revoked by the Planning & Zoning Depar ML *** * ** Any information tbat is misrepres anted may result Office and a copy of the certiftted survey map if Include with this application a recorded warranty decd from the Register of Deeds reference is made in the warranty decd OkEV. 08105) U 2 6 6 0 P 3 0 6 .774914�a STATE BAR OF WISCONSIN FORM 1 - 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 09/21/2904 10:25AK Grantor, and Sunset Ridge, LLC Grantee. WARRANTY DEED Grantor, for a valuable consideration, conveys and warrants to Grantee EXEMPT # 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% 1449.90 See attached Exhibit A COPY FEE: CC FEE: PAGES: 2 Recording Area EStreen & Ogland ' 304 locust Street ao Hudson, W1 54016 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 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 ?4 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, W t STATE BAR OF WISCONSIN 800.655 -2021 WARRANTY DEED FORM No. 1 -1999 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 Richmond, County St. Croix, State of Wisconsin described as follows: Commencing at the southwest corner 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. I i I i \v �� �� i l� E7 . -.- -------------- - - - --- -- I ow MW LL vow r p R � S R ► Y a � VALT ow TTd WdbT:OT V002 VT 'aaQ EWTTESSTL: 'ON Xdd 01 S3WOH EJNI83A30: W08A { - - - - - -- ---------- ---- - - ---- - - -- 1 s r - � r t r i • ra r Y • oi ------ -- -- - - - - - -- - -- -- ......�. o $ � K r Zld Wdt?i:OS OWE bi 'Oa0 Z8Zti£SSTL: 'ON Xad 0 SSWOH %18arM: W08d