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HomeMy WebLinkAbout026-1286-16-000 r Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 506155 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 . Richmond, Town of 026- 1286 -16 -000 CST BM Elev: Insp, BM Elev: BM Description: Section/Town /Range /Map No: j Q U° o lQ v` a 0 4 YQiX Sic CY y V'S 34.30.18.1438 TANK INFORMATION EL VATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark tai • 0 •1 /b0 . Dosing VV Alt. BM � �- S 40 Aeration D Bldg. Sewer 3 D3 Holding St/Ht Inlet , 3 92 , TANK SETBACK INFORMATION SU t Outlet �- TANK TO /L WELL BLDG. Vent to Air Intake ROAD t nlet U -- Septic > 56 1 -7D Dt Bottom 3. 3 Gl/ Dosing J O Header an. Z Aeration Dist. Pipe Holding fm ot. Syste r• S j nA, ,. f nal Grade I- PUMP /SIPHON INFORMAT Manufacturer y �� L / GPM t Cove � /O 3 - 1 3 3 Model Number ZS� 3v 10 1 1 TDH Lif t2 Friction System Head TDF - Ft J r 4 A Forcemain Len th , Dia. �� Dist. to VP / Nb / f,( &-7 � 40 I" SOIL ABSOR TION SYSTEM BED/TRENCH Width , Length No. Of Trench s PIT DIMENSIONS No. Of Pits e Dia. Liquid Depth 11A I DIMENSIONS U SETBACK SYSTEM TO / P/L BLDG IWELL LAKE /STREAM EACHING Manufacturer: INFORMATION C MBER OR Type fSystem: 'r ! \ IT Model Number: DISTRIBUTION SY EM - /' �� 3 t4l �. Header /M if 1 Distribution x Hole Size x Hole Spacing hVent to A ir Intake Length Dia Length Dia Spacin COVER x Pressure Systems Only xx Mound t Grade yste s Only Depth Over Depth Over xx Depth of eded /SoddedQ r 1 xx Mulched Bed Trench Center Bed /Trench Edges Topsoi Y No 17 ' Yes No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1:�! 2 / Inspection #2:_�U 2 1 Location: 1221 121st S tree t New bhmond, WI 54017 (W 1! SW 1/4 34 T30N R1 8W) Sunset Ridge Lot 16�� Parcet No: 34.30.18.1438( 1.) Alt BM Description = 1� )� / 6 "'^uv '"/Q 0 V— 2. Bldg sewer length = ' " S. "" L "" _ 0'o L - amount of cover = > 41 " a f J,rq,�Q � C� 2 h d.4� K �/ l ) e � n 4 y. *6 Plan revision Required? Yes Use other side for additional information.� Date Insepctor's Signat re Cert. No SBD -6710 (R.3/97) , Safety and Buildings Division County C j 201 W. Washington Ave., P.O. Box 7162 ■ n Madison, Wl 53707-7162!0 Sanitary Permit Number (to be filled in by Co.) Sanitary Permit Applicati State Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form, prop ' ernmental / ]:> / S unit is required prior to obtaining a sanitary permit. Note: Application forms for s ed POWTS Project Address (if different than trailing address) submitted to the Department of Commerce. Personal information you dary trarrios in accordance with the Privacy Law, s. 15. 1 m , Stats. �� Z, L Application Information - Please Print All Information Property Owner's Name A PR 2 4 -� U U Parcel # Property Owner's Mailing Addross �P�y Location q3 J C[ /� ST. CROIX COUNTY l G1 Govt. Lot City, State Zip Code Section �. s� a � �e T N; R E 4jw _ II. of Building (check all apply) # J r c /Co mnierc Dwe ' g- Nu mber of Bedrooms , Subdivision Name -- U410_ d4-.-j . � Block# 103 Pub ial - Describe se Y °�� ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of .--- Town of - 1 1 III. Type qf Permit: (Check only one box on line A. Complete line B if applicable) A System ❑ Replacement System ❑ TreatmentlHolding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. 0 Permit Renewal El Permit Revision ❑ Change of Plumber [I Permit Transfer to New List Previous Permit Number and Daze Issued Before Expiration Owner IV. Type of POWTS S stem/Com onentJDevice: C all tkat appl ❑ Non - Pressurized In-Ground ❑ Pressurized In -Gro t ❑ Mound> 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank D Other Dispersal Component (explain) ❑Pre nt Device (explain V. Dis ersaUTreatment Area Information: Design Flow (gpd) Design Soil App cation Rate(gpdsl Dispersal Area Required (sf) D*" Area Proposed W ter Eleva 0'r I . 5 1 VL Tank Info Capacity in Total # of Manufacturer Gallo Gallons Units � f � ]b -47 New Tanks E xistin g Tanks gg Septic or Holafinj Tank Dosing Chamber Y, x VIL Responsibility Statement - I, the undersigned, assume responsibility for installation of the POWYS shown on the attached plans. Plumber's Name (Print) Plurriberyyfpiature MP/MPRS Number Business Phone Number 4 b j I I 7.Z6 li �l� Plumber's Address (Street, City, State, Zip C ) �-U; -S((/D/ 7 VIII. o /De artment Use Onl proved ❑ Disapproved Penn it � I Date sued I wing Agent i ` Given Reason for Denial $ 60D onditions 0 foMlsap SYSTEM OWNE ; �2�G? o l 1 Septic tank, efflue filter and ers ust all be serviced / maintained as per management plan provided by plumber. 3` t. dal as per applicable C t"&Mft8Wnarorthe syste ma nbmn e of 7 ;7 CoantyoMy p x r �" ua SBD -6398 (R. 01107) Valid thtu 01/09 i 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 100.4' 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 GF 0- 1 8 ❑ BOREHOLE Q WELL *H. R. P. Same as Benchmark 458' Property Line B.M. 2 Acre Lot Scale = 1/4" =Yb ' Grading is to be done 101' to divert run -off Well is to meet all away from system B-1 100.4' found in C om� 83 99 , -2 o � ❑ r` B -3 6% Slope Huffcutt Combo Tank Area 15' below system is to remain Tank is to be properly undisturbed bedded and provided with lockdown covers with Pro 3 approved warning labels Bedroom House 121 st. St. 332' Property Line D Safety and Buildings 4003 N KINNEY COULEE RD commerce.wi.gov LA CROSSE WI 54601 -1831 ■ ■ TDD #: (608) 264 -8777 t i sco n s i n www.wisconsin.gov www.commerce.wi.gov /sb/ Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary April 18, 2007 CUST ID No. 226900 ATTIC• 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: 04/18/2009 Identification Numbers Transaction ID No. 1385954 SITE: Site ID No. 724222 Sunset Ridge LLC Please refer to both identification numbers, 120th Street above, in all correspondence with the a enc . Town of Richmond St Croix County W1/2, SWIA, S34, T30N, R18W Lot: 16, Subdivision: Sunset Ridge FOR: Description: Three Bedroom At -grade System / New construction Object Type: POWTS Component Manual Regulated Object ID No.: 1126594 Maintenance required; 450 GPD Flow rate; 44 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 - Version 2.0, SBD- 10706 -P (N.01/0 1) 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 durin construction and open to inspection by authorized representatives of the Department which may include local inspectors. coo iL r� SHAUN R BIRD Page 2 4/18/2007 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 antin this gr g 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 card 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. f C1' T7 Cover Page o 0 0 2 Shaun Bird IRP Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 4/9/07 Owner:Sunset Ridge LLC Location:W1 /2 SW1 /4 S 34 T30 N,R18W Richmond Lot 16 Sunset Ridge 121st. St. 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 Conti ency plan 9 -11. Soil test Shaun Bird r Signature License number 6900 k �ETY A b �`` ° �� 4 s iv���ati� U SEE C Of�RESp �,DENCE PLOT PLAN PROJECT Sunset Ridae LLC ADDRESS 838 Sum Pines Circle Hudson Wi 54416 W 1/2 SW 1 /4S 34 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 100.4' 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.R.P. Top of Survey Iron ASSUME ELEVATION 100' Filter BEST GF10 -8 [_]BOREHOLE O WELL *H.R.P. Same as Benchmark 458' Property Line B. M. 2 Acre Lot Scale = 1 /4" =10' Grading is to be done 101, to Well is to meet all away from system B -1 100.4' setbacks found in Comm. 83 99 , B -2 B -3 6% Slope Huffcutt Combo Tank Area 15' below Tank is to be properly system is to remain undisturbed bedded and provided with lockdown covers with Pro 3 approved warning labels Bedroom House 121 st. St. 332' Property Line 2:5 $ � > 5 M — 2 �.�"tt1R� L�QS EA �-- �iSTRrs�.IT ;off �AT�RAt i ir i! V 1 /2B s =fib Ft.. r Distribution Fabri Distribution Lateral STA6u:mr.D Observ©fion - --- - Sot} Cover Well 6° L WfEA >` A scaa+si Mara Viaw and Cross Sactioa of i.73 a tLt- �c With S :Lngle Absorption Area on a S1.op3nS Szte I Page t }f Di strtbutioe Pipe DeW l for Lateral network { uftM - UP t • ' PVC Force Main PVC 01strifutioa P P �• -- * Last Mole Shw3d Be text To Tu "- u .� P � _ �Ft� Hole giaeeter , �, ;mitts x off . Inches Lateral Diameter Inch(es) y, I bes force Main Diameter 2— ,,,, Imes of Hales /Pipe 4 -__ invert Elevation Of Laterals A/ _. - Ft. Si gned; ' License der: Date: i SPEEif ICATION € � CRS r ..R CRO SECT"-: R ANA B I S£ IC TANK AB V v E GRADE ju )ICT - 10H BOX APPROV C" GI VINT PIPE ;WT j�C�1 OR #,� ITS CQ� IT W� � ER mm.. D OOR VJWJUNG LABEL FRESjj . GLAD - T c ll • ii 4 s .. INLET - aA WA TZGI€T STA •S 5 ' PIPE 3% OXW SMID SOIL A� C. f SOIL j FEW y SE VD ING am U 3 s'..AP3 ROV L a S�'�I'I'ZCAT3'tI3+i5 r. ;. D DAY: S r _pTIC DOSE S _ = SEFTIc GAL- � _ ���� SZZFS }2�kSiE Z�gRC?CZS= a SWITCR W MOVE1. 00195= c7 41 Err FF -My arw . �'YP eEg CA£. 3f FMENCE Y pgE55€7RE - - ' Fg ;CTIO FACTS - t.�-� FED x� X 3 HEAD F Y� � T�� � +� xcE �-- 2 gig a�wt� I, 31Ii'4I�SI£�l'IS d3•� ��P TASK- L � �g • LICE le$ i Sent $y: HP La 3100; i 71 'J5 t3if'C! 0nlly-a -VC c.vvrw�s • Fy "•• '9E:H SERIES SUMP /EFFLUENT PUMP- &95 0 0 Specifics5 NL1: +.ate "room ar»I m m WAR= mm 8uee Um er aes ar.w a 841 fu 04 8a e8t sag 2a 24 8s 911 x41Btx991 7=— a 998730 W m'ie 113 34 13.0 in 70 S4 55 55 4 32 ns 8a 24 9n :ssaa :ase gw7w amm mm ;$ 380 Sa 6s '1000 70 32 13.8 22 v 3.11 z11bf=am 981QiR8 508850 Otres .Ls�O 415 371 130 1000 70 81 55 gt1 :_stBfx$99 tmm► ira 280 S 301 ao 70 54 95 4t St 1581 ZQ 27 C e4—' SINeB�ctM$ s�i�P��sa� w � bs0 �� fa � rrar► rrd0in4r0 !. FLOW- LITE Ilnn 1m 2 H � _ � 0 000 ._ Ira�ett4:f M$tatal Poly G`arbOalate a e Clasod Vane 30 10 —' ADS — votute Paavc Cord S.ITVIT A r 73 Nitrite with carbon aad 42a cerawi Mechanical Shaft Scsl faces s a Fasteae:s S>etess Saed _. -- - gtail:lesm Sleet 2 3 � U� SICM and tOM"r PAR Bearinp 0 7M 0 20 +0 60 so FLOW- GALLS t C0. Pt1MP PERFORMANCE CLEVE ���*t>idN►ed � ItSV i01R pk=c 411s."72sti 'Frn; 40 =8 � www LKtftG tPainp CA= Pam 996M r Wisconsin Department of Commerce SOIL E. VALUATION REPORT Page of Division of Safety and Buildings in a e County S '"8" / `_ d � Attach complete site plan on paper not less than 8 2 i CE in size. an must include, but not limited to: vertical and horizontal refer i [3A"), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and I A dj ityncg tgneQFASt�oad. R "ewed Date t' K 7 VV LLIIJJUU Please print all informaf n. Personal information you provide may be used for secondary pu es Properly Owner � q C -E e . i Govt. Lot �1.c11/4 S T ®N R f E (o w Property Owner's Mailing Address �- Lo ' # Block # Name a CSM# ,� U s� r J' -�-,,� ® Ck State Zip Code Phone Number City ❑ Village own Nei est Road c New Construction Use: esidential /Number of bedrooms _ _'�i_ Code derived design flow rate -`s� GPD ❑ Replacement Public or commercial - Describe: _ - -, - - -- - -- - - - - -- - -- -- Parent material _ _ -_ Flood Plain elevation if applicable —1 ft. General comments �' o and recommendations: 5 Boring # /1 Boring � pit Ground surface elev. f . Depth to limiting factor . in. Soil ication Rate Horizon Depth Dominant Color Redox Description to xture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Eff#1 ff#2 0-11 101.,131L- Boring # //J'�, El Boring y !� ®P it Ground surface elev. -f �' 1 t. Depth to limiting factor � in• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f 0 in. Munsell Qu. Sz. Cont. Color _ Gr. Sz. Sh. `Eff#1 'Eff#2 �, a ��r �� ,� 7 • Ef fluent #1 = BOD > 30 < 220 mg& and TSS >30 _< 5.. rgA- ` Effluent #2 = BOD _< 30 mg/L and TSS < 30 mg/L CST Number CST Name (Please Print) Cigna Bird Plumbing, Inc. Shaun Bird 226900 Address . Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 ��� 715 -246 -4516 it Property Owner _ Parcel ID # _ _ Page of [_31 Ong # ❑ Boring it Ground surface elev. f ft. Dept: 2< i viting factor. in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture `n (:cure Consistence Boundary Roots GPDIff in. Munsell Qu. Sz. Cont. Color 3h. 'Eff#1 'Eff#2 17 3� S i a,C, c a '& /'0 2- C LC M I�Sc CA U-) V 0 -7 IS" e % r e y. S i 1-y — a O ❑ Boring # ❑ Boring ❑ pit Ground surface elev. ft. Dept - i c) limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture : tr>v Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color G 3z. Sh. •Eff#1 'Eff#2 Boring a Boring # Ground surface elev. ft. Dept i .o limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description. Texture ` =tr uctire Consistence Boundary Roots GPD/ff? in. Munsell Qu. Sz. Cont. Color < r. Sz. Sh. `Ef1#1 'Eff#2 • 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 deyar'ment at 608- 266 -3151 or TTY 608 -264 -8777. SM8330 (RbNO) Soil Test Plot Plan project Name Sunset Ridge LLC Sh ird Address 838 Summer Pines Circle Hudson Wi 54016 TM #226900 Lot 16 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 1 00.4' *HRpSameasBenchmark 458' Property Line 60' B.M. 20' B -1 90' 25' 101 B -2 40 15 Scale is 1" = 40' B -3 unless otherwise 6% Slope noted 99' 332' Property Line I i PLAN Pw of � MANUAL SL MANAGEME POWT O sYSrf is S PL=t II NA �.` �► II NA F� [p� Q #4 *Inlw P P. HA H ofC cV1� Ups 3 — M . X g wfffr0 P a�1A t x •�.� i >"'�7 .UM-- t - pc °� UZ - t3 Pe$t 1=rner • 0 m1wW ; man D&jumd s SV ss �,s caul$) t �c,. „zss� (Pmessufted) £31 O Mound p BM0 00 . :S30 nV& At-$f Q t Mod��� Sd�s moon) � 00mi Q s � �rsoa p4stTde SUB vs , Sarw4c�e 6r�e4oO� s -) CE sCHIS s3 fM u m Y� ser+r3cs s"'s ps least arzc:e every C3 rr%Onk6 QD of tank vo"JM n of is KS) When ', WMd sludge and scum S) (&ftA aum s yam-) Pum) out contetsi of tanKs) L At least anca pmt s3 At toast once every ' s} 13 HA fit rme eWsry Q HA Cfesn ,at least o s} Q ms hww p�senp, puag ss At least trace suety C a yest(s) 0 NA Fh3sh g and Pwom At RmSt once every II n �S) t3 NA coma At least 0r=6 every oars $ofdw�� or hop ft a and °°t#" sever dt a ppal F�i 1 i or � e p RxesUIPI-I —d t Pi�u�tsb®t: hsdude a visual � of and == and w td:edt $for sny' iaveTs . oats. rrsust ed e e w Tatec She `roj= -, e of .be v1s � fa ds t 11 s o 626 a a'r'm cal{ Tw � ��c xmdhV of u -I mm of the kawt seS�°o'ry a° `Sfso the In tfta obi+ Pipes and Mqt VDWme, � $tam s� in any bink ecu1s one- ##'Ird � ��'�� dL MR a� Setvldng � ft == b& std be �a� W S ~I add MY 113. WbcombAdn;k9dI,6" Code. PC9WrS P�. Y a p . �$ of � • n i t cf.12 =nthS 0I shy �#atl�t sew event dheimakeraw arm �� 1 0 d2P Of COMP STAN' dP At0 O PERATION itY�S t men# tanks} �• � � of For0ew P �i $,W r damage the d' ° } � 6-mg nw o af to r) � WVW by a sePM90 servicing apefsWc P� to Um de Wdad hanV the amp I - ioszs art; frazerr at the ine surface. � up sho r= 0cac�,nkireri , yin P maw is resw ed e Dural P e4 ca(s? in om � dose. o boar tt °edtsl � by � aV '� as She this tsave lire oc PO�t�ITS erg S bad Me SerwWwo P� m7nat ie WS wffm use '• } assisti tiYqWASW to paw W &Sp&,W E) *na ri�e kvd s ,� 2a. or gmdeson abs ate- am 15 fedton thew���mwofiM ftP n��P ft� . � .dgatsme btMir, dtxn� n swabs: d �ftt aid vegstale Pee&*K at PeockkK Sam AEAI � f ylaiaw out of service the m its ! sn oorrspt COft tlxh me w1h ch. Comm is s Ya ecbed and the abwxWted PU � • - Ag pipTi� to taiiics 2ncf pits StMa be rerrsavud and prOPOrt r of by a Se 9 The *0nte� ,0f=x ftrdw and � or r rovers ra:«r wvsd� tire. SPReO CDNT06INCY PLAM t to P2SLtrL°S have been• or n=st be talGM m P a COft tt the Pt3wf5 fa3s and r,�ot be r. . a � evatuaari and may be utMed for the of s n � should nar t3 A h� � shoe W be protected from dssb� ar t F by � *orn J and PmP� a s `at be ko*xjed the � area Wi �R in the need for a new sotF and s?Ee ,gvatu went area. Rapbo n rncsst c ornPty with the rules in of G-ct• at f% l - advacires B3 er:t sysLen'►s Pt3SAtTS . D A sxe fWPUMM"erlt $gee is rmt aymnabte'due to setback andlor soif be $cts'�iiied 85 at t� resort ZD c+cpiarae tia3 � gy a c n�aY a sortable stisp� area- UPOn t of t#3e PL3f�YT5 a 90� $ a mice has ✓sot been °'uh•� tD iderrW etli area- tf m repbwenuw t arse is a ern mast be pew tv locate a sortable tank raW to butRftd as a last resort to e e b rye � P�cx fo S of •fie bkw=d at t[te and at ofns s must comply + the rotes of aLthatt&re± <- cVVARMWG>> • TAPU< . S MAY CONTAIN LETHAL GASSm Ailiflfm it ��� oxY�' SEAM pUMP AND mWM TREATM �� T R� T1itiErF t TANK E11+tDER AH t'tM ��- DEATfi MAY PUW grn R NO T. RESCtti_•O P7 H M'l E �OR OF A TAfjK MAY 8E DVg1C�13 T OR 8WP ADDMONAL COAGMW TS POW TS owl's T'S �� }i(8ift8 9 Name Pmne s�P FAME sBRVK�tG QP�RATOIt Laca� �ut�tr�r a�I x Agency -5� (,- M2M 921. Phone proms = a� -� ;sararerm:�mn.r•rr ��w �„rty,�asar- ms mspsameee � arts. Cm= e.'432�1�(�XrXq 3 and S3•5K=). C4 (3). � �m 1f ° Cc*-* itsi of tf�is S � wit o„ woe of Powers f ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM 5 2-1 C_/a OwnerBuyer D Property Address Departme far new construction -) (Verification required from Pl anning & Zoning ��G�ji►yt�li� City/State 1 � Parcel Identification Number (� _ � L E AL DESCXWDQN / 7.39 ) 3 �W, propaty Location 2 Y S ^� 4, 3 Sec. T Town of D N R Z Lot # _L_.JO Subdivision 5 z4L � _, Volume -- - page'# Certified Survey Map # �f Warranty Deed # T Q ,Volume PaSe # � _ � e' Spa house Y uo Lot lines identifiable no TION STEM �Ze�INTENANCE AND OWNER CEYtTTFYCA and maintenance of your septic system could result in its premature failure to handle wastes' Prop or sooner, if needed, by a licensed pumper. What y Put into Improper use maintenance consists of pumping out the septic tank every three y _ owner maintenance the system can affect the funcdon of the septic teak as a treatment i2 St C ix counry di sposal �' responsibilities are specified in §Comm 8352(1) and in Chap to St_ Croix County Planning & Zoning Department a �icatim form, signal by the The property owner agrees to submit m d lumber, restricted plumber or a licensed pumper verifying that ( the on -site Wants and a master p roper mau plumber, condition and/or (2) afar rnspecuon � and pumping (rf �TY)• the septic tank is wastewater' disposal sysstete m is s i s proper p r less than 1/3 full of sludge. sewage disPWSat sy s t e m with the vwe, the undersigned have read the above requirements and agree Dcgartmcar to tuaintsiuot Np vale s taw of WiscoaaiA- standards set forth, herein, as set by the Department of Commerce and the to the St Croix County Planning & cal ication stating that your septic system has been maintained must be completed and returned Zoning Depa t went within 30 days of the three year expiration date. vac am/are the owners) of the 1>�- ents on this form are true to the best of my/our ksiowledge. described above, by warranty deed recorded in Register of Deeds office. S) DATE SIGNATURE LIC {SU/�`Ss�T �C $* on that is misrepresented may result in the sanitary permit being revoked by the plammg & Zoning Dp =gLs** A information � a warranty decd from the Register of Deeds Office and a copy of the certified survey map if baaclude with this app ' reference is made in the warranty deed. (REV. 08/05) U 256Q? 305 r? 774c340 STATE BAR OF WISCONSIN FORM I - 1999 WARRANTY DEED KATHLEEN H. WALSH Document Number REGISTER OF DEEDS ST. CROIK 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 E EWT # 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 & 091and 304 locust Street a Hudson, W! 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 7' 2004 w. * 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 1 2 e ? da of {/� 2004 Personally came before me this day of 2004 the above named Herman W. Keller, Sr., Herman W. Keller, Jr. and Karen * Krishna 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, w1 STATE BAR OF WISCONSIN 800.655 -2021 WARRANTY DEED FORM No. I - 1999 r tl 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 conbue 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. r t in �BuildQnq Setbodc I 76.241 sq.ft. 1.750 acres S WOW E 271.71' - X lei 19 � 1pp. 1.'500 Gera �.J w N I - r • I' M I I I; ` 17 84.989 sq.ft. i 1.951 acres 33 33. 1 459.29' 10 1 13 \\ µ 85'15'41" E 11 1 100' 16 j 82.338 sq. ft. 1.890 acres N a `ri