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1 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: r i (ATTACH TO PERMIT) 515073 0 GAM, INFORMATION State Plan ID No: Persnal 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 Oevering Homes I Richmond, Town of 026- 1286 -21 -000 CST BM Elev: Insp. BM Elev: BM Despription: Section/Town /Range /Map No: 34.30.18.1443 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic / b U0 Benchmark _ G Dosing n _ � & d-?) Alt. BM Aeration � �7„ � _ / /, Sew V u 3 �� • �� 5.. Holding �/� J � V t/ t Inlet , TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WE L BLDG. Vent to Air Intake ROAD Dt Inlet Septic �� Dt Bottom ' UW1 2 .so 90 • S' 4- 'vr Header /Man. • T J M "' !j •Z 'v Aeration Dist. l)IVo✓+ Holding Bot. System-3Z-4-1.1 ti Final Grade PUMP /SIPHON INFORMATION ---- / IDS Manufacturer LOP GP and St Cover ��}Z 3 ��, Model Number j TDH Lift Friction Lo System Head �, TD a 2 Ft �- r [yy, e 1> 7; —_�; Forcemain Length r Dia. 2 i Dist. to Well - c�•iT SOIL ABSORPTION SYSTEM t BEDITRENCH Width / Length No. Of Trenches V PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS It G 1 1 y . SETBACK SYSTEM TO P/L BLDG WE LAKE /STREAM ACHING Manufacturer: INFORMATION CH E Ty Of S em: � , _ � �/ U Model Number: DISTRIBUTION SYSTEM r /tic rn W S * ,4- , Header/Ma nif I 'i Distribution r / x Hole I7` Holing Vent to Air Intak Pipe(s) S I ll , t / Length Dia 2 Length Dia �. Spacing [ ' SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Sy ems Only Depth Over Depth Over xx Depth 0 � xx eded /Sodded xx Mulched Bed/Trench Center Sed/Trench Edges Topsoil 0 Yes [] No Yes [] No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: - 1_.(j2 /_L_ (_ nspection #2:Z/ 4 Location: 1217 124th Avenue New Richmond, WI 540117 (NW 1/4 SW 1/434 T30N R1 8W) Sunset Ridge Lo 21 Parcel No: 34.30.18.1443 1.) Alt BM Description = +� Y� KAJ� S> b u y ` / ) 2.) Bldg sewer length = � e �, �L [ .i 1�U i(;cJ G', i �i�� �{ t ic,' - amount of cover = U4Q� d1 'r=te c 5� r� t_ c 6 L L= —I — — �. L 7 6,7 Use other i side for additional i N ��� ____.— — - - - -- `-- - - - -- - - -� „ Date Insepctor's Signature Cert. No. hbhh.�_ - )-6710 (R.3/97) �J I 'S� ` /� QlX 4 ea 6 J PY of C r�✓r� . r..c4 �Ow �`' S � � rJ l - & tiC � elm �LI ,LV �iLO Ne P �f rv0. o " I vi a� E 1 13 a/V�j 9a I K &4 F b ° 1/o , /711 � vj I Prop ' 0 b _ S �a e Y iUlS (6 6n`farM xz87Z E SE ENT 8% 7 , 643 sq ft. \ \ \ \ LOT- 'N o0�res\ \ \ / 1 / 76'2 0 "' sq.ft. o r I 1 acres \ Ca 1 38 01 1.73' 4 Is / I / / /\ N rl o ` LOT / 19' 1860 alr ar / 1 /� 87'16. -18 ft i Q � 1 WI 2.000 �cres ( I l /� Z North Line o tpe South est Quorter o' 'gbuthwe Qu / 'fin I LOT -17 j ��� - - - -- 82,764.3 sq lo I I 1.900 acre \� — I I \\ 41' 'O000' I I �2,764.Sj ft. a, 9 DA.acree \ <1 Pa-+ cl ma, 1-x i commerce.wi.gov Safety and Buildings ,vision County 201 W. Washin t �rr 3"t. �. C/Lv/ X S / i sco n s i n Madiei� - anitary Permit Number (to be filled in by ) Department of Commerce 5/5073 State Transaction Number Sanitary Permit App ' atfiion y � In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate ove unit is required prior to obtaining a sanitary permit, Note: Application forms for stat -o Address (if different than mailing address) submitted to the Department of Commerce. Personal information you may purp oses in accordance with the Privacy Law, s. 15.04 1 p m , Slats. a 1 / e2 I. Application Information - Please Print All Information Property Ow' N /) Parcel # �-1t s Sri it- 5I- Property Owner's Mailing Address Property Location d �► c K�:�- E/ /L ' Govt. Lot C State Zip Code Phone Number w , � , Sw h, Section 0, �� S �� u i r 3 j /J -7 \ 19 ?e 9 Q /, T 3 0 N; R 9 E o 11. Type of Building (check all that apply) ❑ 1 or 2 Family Dwelling - Number of Bedrooms a1,4 z Subdivision Name 1 p r o Bl ock J k N S 1i ❑ Public /Commercial - Describe Use ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of to Town of r✓v� D N - e X 5 y — ��. III. Ty a of Permit: (Check only one box on line A. Complete line B if applicable) A. New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) Y P Y g P Y g Y ( P ) B. El Permit Renewal ❑Permit Revision ❑Change of Plumber ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that apply) • ❑ 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. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rat dsf) Dispersal Area Required (sf) Dispersal Area Propose System Elevation "(4 7S_6 - 7,5 Z VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units a o New Tanks Existing Tanks c m 6 4 eptic o Holding Tank sing Chaco er I K D v VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the PO shovzpn the attached plans. mber's Name (Print) Plumber's Signature MP R umber Business Phone Number A'S Z 9 -Z�Z Plumber's Address (Street, City, State, Zip Code) Z(o.59 6 _ t, fi �_k S `8 53 VIII. Coun /De artment Use Onl Approved ❑ =yenReQj,,Denial Permit Fee Date I ued Issuing g rit Signatur ❑ ('2 IX. Conditions of Approval/Reasons for Disapproval C 0 ' ..� -�-. d &, .✓ t � Gr A,) et cam. S /� Q /Oj 70 Attach t complete plans 1pr the system and submit to the County only on paper not less than 8 V2 x 11 inches in size SYSTEM OWNER: 1. Septic tank, eftlGent lifter and dispersal cell must all be services / maintained as per management plan provided'by pklmbw. SBD -6398 (R. 02/09) Valid thru 02/11 2. All setback requirements must be maintahik! as per applicable code / ordinances. Safety and Buildings 141 NW BARSTOW ST FL 4TH commerceml.gov WAUKESHA Wl 53188 -3789 Contact Through Relay mmerce.wi.gov /sb/ It iscons i www.co n www. wisconsin.gov Department of Commerce Jim Doyle, Governor Richard J. Leinenkugel, Secretary June 02, 2009 CUST ID No. 222872 ATTN: PDWTS Inspector JACQUE M 14AWKINS ZONING OFFICE HAWKINS SOIL TESTING & SEPTIC SYSTEMS ST CROIX COUNTY SPIA 2659 150TH ST 1101 CARMICHAEL RD LUCK WI 54853 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 06/02/2011 Transaction ID No. 1669412 Site ID No. 748319 SITE: Please refer to both identification numbers, Oevering Homes Lot 21 above, in all comes ndence with the a enc . Sunset Ridge Lot 21 Town of Richmond St Croix County W1 /2, SWIA, S34, T30N, R18W Lot: 21, Subdivision: Sunset Ridge FOR: Description: At- Grade, 3 Bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 1227690 Maintenance required; 450 GPD Flow rate; System(s): At -grade Component Manual, SBD- 10570 -P (R.6/99) The submittal described above has been reviewed for conformance with applicable Wisconsin Adtninistrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. 'Me owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: This system is to be constructed and located in accordance with the approved plans, and with publication SBD - 10570-P (R. 6/99) "At -grade Component Manual Using a Pressure Distribution System for Private Onsite Wastewater Systems". The pressure network is to be constructed in accordance with publications SBD - 10573 -P(R. 6/99) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) ". In the event this soil absorption system or any of its component parts malfunctions so as to cr to az rd property , the e owner must follow the contingency plan as described in the approved plans. In addi >� comply with the operation, maintenance and monitoring duties as described in section V I Ae component manual. A copy of this information must be given to the owner upon con I d£ pgR r'T Maintenance information must be given to the owner of the tank explaining that periodiC���gthe filter is required. Access to the filter for cleaning must be provided per Comm 84 prod roval con (fits. SE A Sanitary Permit must be obtained from the county where this project is located in accirlTance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. i w ti RESIDENTIAL AT -GRADE DESIGN (RECEIVED Pressurized - Sloping Site INDEX AND TITLE SHEET MAY 2 6 2009 Project Oeyerin Homes At -Grade Lot 21 Sunset Ride SAFET` & BUILDINGS 9 9 Owner Overing Homes Address P.O.Box 179 i New Richmond WI 54017 I Legal Description W1/2 SW1 /4 Sec.34 T30N -R18W Township Richmond County St. Croix Subdivision Name Sunset Ridge Lot No. 21 i Parcel ID Number Plan Transaction Number Index sheet Page 1 Calculations Page 2 At -grade drawings Page 3 Laterals and dose tank Page 4 Specifications Page 5 Management & contingency plan Page 6 Pump Curve Page 7 Plot Plan Page 8 Designer Jacque Hawkins License Number MPRS# 222872 Signature ` Phone Number (715), 472 -2421 Date a /21/09 Designed pursuant to: At -grade Component Manual for POWTS SBD- 10570 -P (R.6/99), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST - SAS (01/81) Version 3.11 (05/01) Page 1 of r R �kf,E pNCF NCE I PRESSURIZED AT -GRADE DESIGN At -grade Design Worksheet - Sloping Site Flows and Site Data Entry. (r or c) r Residential or commercial? 300.0 Estimated wastewater flow (gpd) 450.0 Design wastewater flow (gpd) 6.00 % Site slope 97.40 Contour elev. below lateral (ft) 45.00 Depth to limiting factor (in) 0.60 In -situ soil application rate (gpd/f A2) Distribution Cell Information (1 or 2) 1 Influent wastewater quality 10.00 Linear loading rate gpd/ft 8.00 Effective absorption width (ft) 10.00 Max. effective width permitted (ft) 94.001 Aggregate length (ft) Pressure Distribution Data Entry (c or e) c Center or end lateral connection 2 Number of laterals 0.188 Orifice diameter (in) e.g. 0.188 Not a final calculation 2.00 Estimated orifice spacing (ft) 2.00 Forcemain diameter (in) 3.23 Forcemain flow velocity (ft/sec) 110.00 Forcemain length (ft) y or n y Does forcemain drain back? 89.00 Pump tank elevation (ft) y or n y Are laterals at highest point? NA 3.25 System head (ft) x 1.3 17.9 Forcemain drainback (gal) 7 0 Vertical lift (ft) 42.0 5x Lateral void volume (gal) jOriction loss (ft) 59.9 Minimum dose volume (gal) 13.50 Total dynamic head (ft) 31.6 System demand (gpm) Lateral Diameter Selection Gallons /Inch Calculator (optional) Pipe diameter Design options Design choice Total Tank Capacity (gal) Designer 1 in Total Working Liquid Depth (in) must select 1.25 in Gain (enter result in cell G46) one lateral 1.5 in x x diameter 2 in x Treatment Tank information 3 in x 1000 Septic tank capacity (gal) Skaw Concrete Manufacturer Effluent Filter Information Dose Tank Information Best Filter manufacturer 642.0 Dose tank capacity (gal) GF -10 Filter model number 16.5 Dose tank volume (gaVin) Skaw Concrete Manufacturer Project: Oevering Homes At -Grade Lot 21 Sunset Ridge Transaction Number: Page 2 of 8 z AT -GRADE PLAN VIEW 1/6 B Observation pipes (2 typical) A 8.00 ft D B 94.00 ft t--� 1/6 B 15.67 ft W C 10.00 ft C D 5.00 ft E 2.00 ft D L 104.00 ft B W 20.00 ft A x B 750.00 ft ^2 L Cap Typical pipe. in th = Total aggregate cell A x B Slotted in the lower = Plowed area L x W se and anchored --1 cti rely. 6 ° AT -GRADE CROSS SECTION Svnthetic fabric cover 99.19 ft Finished grade Lateral elevation invert elev. 97.90 ft f— Observation pipe at aggregate toe E Surface contour ft C A 6 % Slope and system 97.40 elevation D ® = 12 in. topsoil and subsoil over aggregate and tapered to toes. Plowed layer below L x W 6 in. aggregate below pipe(s), and 2 in. above pipe. Project: Oevering Homes At -Grade Lot 21 Sunset Ridge Transaction Number: Page 3 of 8 PRESSURE DISTRIBUTION AND DOSE TANK Lateral Diagram - Center Connection P I 1+ x --4IE xJ2 x12 Laterals & force main of PVC Sch 40 Last hole drilled next to end cap (per COMM Table 84.30 -5) Hales drilled on the bottom of the lateral, equally spaced • = Turn -up wlball valve or oleenoutplug Lateral Specifications 0.188 Orifice diameter (in) Center Lateral connection point X 1.95 Orifice spacing (ft) 2 Number laterals 24 Orifices/lateral P 45.83 Lateral length (ft) 15.8 Lat. discharge rate (gpm) 1.50 Lateral diameter (in) 2.00 Forcemain diameter (in) F A 13. Sys. discharge rate (gpm) 110.00 Forcemain Length (ft) TDH (ft) Typical Pump Chamber Layout Approved manhole cover with Weather -proof warning label and locking device Final grade junction box disconnect 4" Tank component is Alternate properly vented f` outlet - ^ location 18" min. Electrical as per NEC 300 and /c Approved outlet Comm 16.28 WAC joint Tank full Inches Gallons JA Provide 1/4" $ A 21.3 351.1 Alarm on weep hole or .= B 2.0 33.0 f3 VSiphon E Pum p on C 3.6 59.9 o D 12.0 198.0 90.00 ft C Totalsl 38.9 642.01 Pump off D 3" Bedding under tank �— 89.00 ft Goulds Pump manufacturer 1S.J.Electro Alarm manufacturer EPO4 V Pump model number I Tank Alert Alarm model number Project Oevering Homes At -Grade Lot 21 Sunset Ridge Transaction Number: Page 4 of 8 At -grade Svstsm Maintenance and Operation Specifications Service Provider's Name Tri County Sanitation Phone 715 - 386-0114 POWTS Regulator's Name St. Croix County Zonin Office Phone 715 - 386 -4680 SvsWm flow and toad Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 750.0 fl? Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Freguencv Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Moundl Inspect for ponding and seepage once every 3 ears Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the at -grade component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The at -grade structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. 6. Areas within 15 feet of the downslope toe will be protected from compaction. 7. All other construction details are as per the at -grade component manual SBD- 10570 -P (R. 6/99). Lateral Turn -up Detail Finished • ............. • • • • • • • • • • • • • • • Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution - - - /- --------- Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Oevering Homes At -Grade Lot 21 Sunset Ridge Transaction Number: Page 5 of 8 At -grade System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals (SBD- 10570 -P (R. 06/99) and SSWMP Pub. 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Seo is T a nk The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. 611rrade and Pressure Distribution System No trees or shrubs should be planted on the at- grade. Plantings may be made around the at- grade's perimeter, and the at -grade shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the at -grade is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the at- grade be heavily mulched as protection from freezing. Influent quality into the at -grade system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 10 cfu/100 ml- for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contlinggftcv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the at -grade component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by renovating the biologically dogged absorption and dispersal media, installing new piping, and replacing other components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Oevering Homes At -Grade Lot 21 Transaction Number: Page 6 of 8 Page 7 of 8 GOULDS PUMPS Sub Effluent Pump EPO4 y 3 871 EP05 APPLICATIONS • fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower grade turbine oil for tic enclosed design for heavy duty ball bearing Specifically designed for the lubrication and efficient improved performance. construction. following uses: heat transfer. • Effluent systems ■Casing and Base: Rugged • Homes Available for automatic and thermoplastic design provides AGENCY LISTING • superior strength and corrosion Farms manual operation. Auto- resistance. � • Heavy duty sump matic models include _ � • Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron (CSA listed model numbers end • Dewatering assembled and preset at the for efficient heat transfer, in "C" or 7".) factory. strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic Goulds ftnps is ISO 9001 Regond. FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. '/4" maximum, ■ EPO4 Impeller: Thermoplas- 0 power Cable: Severe duty • Capacities: up to 60 GPM. tic Semi -open design with rated oil and water resistant. • Total heads: up to 31 feet. pump out vanes for mechanical • Discharge size: 1'/2" NPT, seal protection. • Mechanical seal: carbon - rotary/ceramic - stationary, BUNA -N elastomers. • Temperature: 104`F (40'C) continuous 140OF (60') Interm ittent. METERS FEET • fasteners: 300 series 10 stainless steel. 9 30 s GPM • Capable of running dry without damage to $ 2s rr components. 25 ° a Motor: _ • EPO4 Single phase: 0.4 HP, `—' 6 20 115 or 230 V, 60 Hz, 1550 5 RPM, built in overload with o 15 automatic reset. a 4 • EP05 Single phase: 0.5 HP o EPOS 115 V or 230V, 60 Hz, 1550 3 10 RPM, built in overload with EPO4 automatic reset. 2 • Power cord: 10 foot 5 standard length, 16/3 1 SJTOW with three prong grounding plug. Optional 20 ° 00 10 20 30 40 50 GPM foot length, 16/3 SJTW with three prong grounding plug (standard on EP05). 0 2 4 6 s 10 12 m'/h CAPACITY Gou Pu ® 2001 Goulds Pumps ITT Industries Effective May, 2001 < & 83871 i e. O l g .v to c1 i Q Z rA ' ")l /voo/t�0" 9 �re�OSe,� S `x94' �4 S MOuhd 3 W / o S S l av►, dell, of �' q'1 � 97•x' , 27-87X— , Y. A Wisconsin Department of commerce SO VALUATION REPORT Page of i Division of Safely and Buildings in accorda r I 8 . ze. Plan m my Q Attach complete site plan on paper not less than 8 1/2 x ' c in size. lE� include, but not limited to: vertical and horizontal reference (i3 rection and arcel I.D. percent slope, scale or dimensions, north arrow, and locati and Z oar st road. Please print all inform ati n. ST. CR 005 Review y Date b ! Personal information you provide may be used for secondary pur ru Ol .�i m)). 34116 y Property Owner Locatio Govt. Lot qy ` ��1/4 S T3 ® N R E (o W 1/ Property Owner's Mailing Address L t # Block # Name or CS► '' State Zip Code Phone Number Ctty [] Village own N est Road CilY 4 O x-0 New C esidenfial / Number of bedrooms _ _ �.� __ Code derived design flow rate �✓ GPD Construction Use: ❑ Replacement Public or commercial - Describe:. _ - -- - - -- -- - - - - -- — Parent material Flood Plain elevafion if applicable General comments and recommendations: t ► Boring Boring # , n ARit Ground surface elev. �� f . Depth to limiting factor in. Soi(Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF 'EtT#1 'Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 63 • El Boring —� L_ Boring # rn. Pit Ground surface elev. r t- Depth to limiting F Soil Application Rate Horizon Depth Dominant Color Redox Description _Texture Structure ndary Roots GPD/f in. Munsell au. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `E1ffYL a /.0 Z y's& iE— INJ i ' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < S: r 'Effluent i#2 = BOD < 30 ntg/L and TSS 30 rrxtlL CST Name (Please Print) _ ` CST Number Bird Plumbing, Inc. Shaun Bird 226900 Date Evaluation Conducted Telephone Number Address 715 - 246 -4516 1008 192nd Ave, New Richmond, WI 54017 ��1=— J_ i Property Owner _ Parcel ID # _ _� Page of L-31 Boring # C] Boring it Ground surface elev. ft. Deal: ;< limiting factor —5— in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture ' :'?:ciure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color _ 3h. 'Eff#1 'Eff#2 2 ..s y/, s � I r y e `f _ a a Co ❑ Boring # ❑ Boring ❑ pit Ground surface elev. ft. DeW I o limiting factor Soil A Rate Horizon Depth Dominant Color Redox Description Texture r tore Consistence Boundary Roots GPD/If in. Munsell Qu. Sz. Cont. Color t:',3z. Sh. 'Eff#1 'Eff#2 a Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Dept i .o limiting factor in - Sod Application Rate Horizon Depth Dominant Color Redox Description. Texture �',,t ucttre Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz Cont Color <,r. Sz. Sh. `Eif#1 'Eff#2 ' Effluent #1 = BOD, > 30:5 220 mglL 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 provides aid employer. If you need assistance to access services or need material in an alternate format, please contact the deparment at 608- 266 -3151 or TTY 608 -264 -8777. SBD -8330 (8.6(00) Soil Test Plot Plan 'Project Name Sunset Ridge LLC Shau it Address 838 Summer Pines Circle Hudson Wi 54016 M #226900 Lot 21 Subdivision Sunset Ridge Date 4/15/05 W 1/2 S W 1/4S 34 T 30 N /R W Township Richmond F Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100% Top of Survey Nail /iron System Elevation 97.4 *HRPSameasBenchmark Pro Town Road Scale is 1" = 40' unless otherwise noted B -2 50' 0 ' 308' Property Line B -3 5' 6% Slope .M. 110' B- 1 97.5' 96.5' 1a� 162' Property Line •) ,� 0� Y GOUN -f PLAT or SUNSET RIDGE t Located in par: � of the Northwest Quarter of the Southwest C o -ter and part of the Southwest Quarter of the Southwest Quarter of Section, 34,Tawnsnlp 30 North, Range 18 West, Town of Richmond, County of St. Croix, - State of Ksconsin UWLATTEO LATIOS sw p n9f war «ca. :.� I - _._.___. ---- ___- Ne9'30'SfC sxmey -- n...r«n rarsr Raw as - ________ -_ N 89 E rn «n ooa ru _ I + '>± I • �._.._ ' 9es.xs' - -._ .____.. -' u.r awue caws I I `' I V /C/N /T Y If P lea l° 11,2 « 11, Y 3 i' . 4 .iei n.. f ! v 9 r 2-1 «.« xli ..,., - - - - -- a " n' *+r+ _I I x s eeve'u• [ \ eo' r.a ar I I s esve'u' [ 1-11 r - _t"'`!J____ I \\,� ,�.�> 4�.N� •mil _ _ _ - e "xa«�su «v /_" ! i � I \•+ --tea„ � 4 ��, \ � � � J \ SecOPn 34, TJAV, R16W III u \ L6a•99U n'� {, �. >� � 6 - -- ., • - -- - -- - - I ce .'Mr \ y \ h `8 .. , .. s _ saa.e•u ,/ n».ar � 6 � t - xa3.T LEGEND \fig i9°0o ••.�� ` l B seavru_[ p0nxu• o.00t� $ n St. Cr.i. 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IeLCFQ6T wAIJ3[T POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE AFORMATION SYSTEM SPECIFICATIONS 4 Owner �-� r a�• 5 Septic Tank Capacity J pQ Ia ga l ❑ NA Permit # Septic Tank Manufacturer CA kA.* ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer /3 / ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model p ❑ NA £S� Number of Public Facility Units tnA Pump Tank Capacity 6 0,0 gal ❑ NA Estimated flow (average) gal /day Pump Tank Manufacturer A- ❑ NA Design flow (peak), (Estimated x 1.5) 37.5 gal /day Pump Manufacturer v U S ❑ NA Soil Application Rate - to gal/day/ft' Pump Model Y ❑ NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) :530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD :5220 mg /L IAA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) :_150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD <30 mg /L ❑ In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) :530 mg /L I-NA kAt -Grade ❑ Mound Fecal Coliform (geometric mean) :510 cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. M-NA Other: ❑ NA Other: Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA ❑ year(s) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: cZ ❑ month(s) (Maximum 3 years) ❑ NA „0'year(s) Clean effluent filter At least once every: / 1p )2ftonth(s) ❑ NA ❑ year(s) Inspect pump, pump controls & alarm At least once every: / ❑ month(s) ❑ NA Flush laterals and pressure test At least once every: ❑ month(s) ❑ NA -a-year(s) Other: At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of S12 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4/01) Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other cliemScals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents" of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structurd, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluatiow to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTAtLER POWTS MAINTAINER Name CX C ut Name " vt. L `ms Phone I 27Z — L Y Z t Phone y Z. Ltij Z/ SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name S �- Name S"t". t� o r k C, d u � Phone Phone J 64, This document was drafted in compliance with chapter Comm 83.22(2)(b)0)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. ' START UP AND OPERATION Page of For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals ;that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. ; During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive, or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structur4, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluatiorr to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTA ER POWTS MAINTAINER Name 0, Name G .ti L Phone y Z- _ y y z 1 Phone y L — SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name (2A -0. C,. 0 u •�¢ Phone Phone 6,(, y�o 8d This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND " OWNERSHIP CERTIFICATION FORM Owner /Buyer �£ IJEiG��,t, /- f'-#r✓JJ - Mailing Address .0" Property Address j Z 1 1 ( 4 a y C 694 o r (Verification required re Department k /� uired from Planning & Zoning or q g g new construe ion.) City /State '''�� Parcel Identification Number 4 Z-1 J V LEGAL DESCRIPTION Property Location L " �j�,,, � '/, , Sec. _ 7 , T 3 0 N R /6' W, Town of � LA rye O)L cj Subdivision Plat: A ,6�-�" ��� � , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # (before 2007)Volume Page # Spec house yes . Lot lines identifiable 0 no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and /or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. l /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of m /our knowledge. s . I /we am/are the owner (s g () of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms �/4 /09 SIGN TURE APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) E U 2660? 306 774940 STATE BAR OF WISCONSIN FORM I - 1999 WARRANTY DEED KATHLEEN O DEEDS 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 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: 1440.00 See attached Exhibit A COPY FEE: CC FEE: PAGES: 2 Recording Area Estreen & 0giand � 304 Locust Street Hudson, WE 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 r ecord. Dated this day of A n V `7' 2004 * Herman W. Keller, Sr. * Herman W. Keller, Jr. F * 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 "I da of 2004 Personally came before me this day of 2004 the above named Herman W. Keller, Sr., He 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 I STATE BAR OF WISCONSIN 800.655 -2021 WARRANTY DEED FORM No. 1 - 1999 • U 2660P 307 w EXHIBIT A Located in part of the northwest quarter of the southwest quarter, and the southwest quarter of the southwest quarter of Section 34, Township 30 North, Range 18 West, Town of Richmbnd, County St. Croix, State of Wisconsin described as follows: Commencing at the southwest comer of said Section 34; Thence North 00 degrees 08 minutes 04 seconds East along the West line of the southwest quarter of said Section 34 a distance of 484.68 feet to the POINT OF BEGINNING; Thence contiue North 00 degrees 08 minutes 04 seconds East along said West line of the southwest quarter 2157.27 feet to the West quarter comer of said Section 34; Thence North 89 degrees 50 minutes 54 seconds East along the North line of the southwest quarter of said Section 34 a distance of 1018.75 feet; Thence South 00 degrees 08 minutes 04 seconds West on a line parallel with the West line of the southwest quarter of said Section 34 a distance of 2007.79 feet; Thence North 89 degrees 59 minutes 59 seconds West 694.55 feet; Thence South 00 degrees 08 minutes 04 seconds West along a line parallel with said West line of the southwest quarter 164.50 feet to the northeasterly corner of a Certified Survey Map recorded in Volume 5, Page 1400; Thence North 87 degrees 49 minutes 24 secons West along the northerly line of said Certified Survey Map 324.40 feet to the POINT OF BEGINNING and there terminating. St. Croix County, Wisconsin. 1 yy o ai fi 14'd a _ • - _------ "-- - " - - -- ----- •_•-"------------------------------------------ 1 { b• FLOOR TW1!!E8 j p � r • 19.2'0.G idVER) � b I r 5 V I � r l�� b •'_ , E ' r 3 b � /71VfJ i ' I u — - -- -- - — - -j T - 1 q x i - t- 1 " 1 -I" -1 -L ; s __ _ ___ _____ ______ ____________________ • ,_. __ . 0 m Pi A ! _ _YN"AI'1�.'�ALL' —, b -- IF r r - w m a , 7 r ` it r jI p U IS It V > z 1 O uS qq ti �i r � d A .` S � "' � � I I 1 , t • FLOOw tauseES r r r r . , r . � i r - r r i c m .r b ________________ _________ ____________ ____ .. u sb Z 24-e D p y 45W m TV - N p ti p 0 F z �l A O D Y - z z O m A c Ll a A 6 p • \E (P A1; w�j -?AA\ D E 1 �j <O 3 �Aaa F ��>1 AS 'zm i z� _ � � • r N b N w� V -10W I 114 A 1 m ' A �I 1 w m ot r0 n P Z z i • d z i i P � i ttll 1 � v • O � n i i m „ J7 _ Z I I F rn 4'-414" I8, ' 1,32" E4 B RIB. • Q 1 1 2 " 11 11 N _ O 6� -103s° g p' A A ,, o F z A ' s 3 H Z � a A b i a r { z O z � 0 Z Ag N A � z � z 0 � 3 d O z Q b � m A z � a ll b S R Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Buil&^g Division INSPECTION REPORT Sanitary Permit No: 506108 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 -21 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: CST BM Elev: Insp. BM Elev: 7 34.30.18.1443 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer , Demand St Cover GPM Model Number if TDH Lift Friction Loss ste Head TDH Ft Forcemain Len Dia. Dist. to Well SOIL ABSORPTI YS BED /TRENCH Width L th o. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM T P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of Syste UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade S ystems Only Depth Over IDepth Over xx Depth of xx Seeded /Sodded 1 xx Mulched Bed/Trench Center Bed /Trench Edges Topsoil Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1217 124th Avenue New Richmond, WI 54017 (NW 1/4 SW 1/4 34 T30N R18W) Sunset Ridge Lot 21 Parcel No: 34.30.18.1443 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? Yes No f Use other side for additional information. Date Insepctor's Signature Cert. No SBD -6710 (R.3/97) commerc e.Wl.gov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 4 >r C sco n s i„ Madison, WI 53707-7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce 5 a i 6 Sanitary Permit Application S tate Transaction Numb Sanitary I O v In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form t I ' 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. Personal information you provide may be used for secondary p urposes in accordance with the Privacy Law, s. 15.04(1)(m), Slats. I. Application Information - Please Print All Information Property O is N P cel # e Owme' Mailin Address Pro rt r Pr Location 7r��tyy /► �j MAR 2 1 2007 '�`� /. lg p lJ S(� I ✓IJC V W 4 G vt. Lot C City, State Zip Code PI one N8r3beCcROIX I y<, Section ` a, CLL �rcle e LL/ c JZ T N; R or 11. Type of Building (check all that apply) Olt ad Lot ^� Family Dwelling - Number of Bedrooms A O'J Subdivision Na�me �+7`)bi A .><.sL Bloc S lLrl S�iC. ❑ Public /Commercial -Describe Use ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of own of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ew System ❑ Replacement System y p y ❑ Treatment/Holding Tank Replacement Only El Other Modification to Existing System (explain) B. El Permit Renewal El Permit Revision El Change of Plumber El Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS System/Component/Device: Chec all that apply) ❑ 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/Treatment Area Information: Des!* Flow (g pd) / Design Soil A lication Rate(gpdst) Dis real Area Required (sf) Dispersal Area Proposed f) System Elevatio/ VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units n U New Tanks Existing Tanks /vS o H Septic or Holding Tank Dosing Chamber VII. Responsibility Statement- I, the undersigned, assuW&Ponsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' azure MP/MPRS umber Business Phone Number Plumber's Address (Street, City, State, Zip de) 5 Vill. County/ e artment Use Onl Approved El Di pprov Permit Fee Date ssued Issuing Men Signa re El O iven Reaso Denial $ �� , 00 3 2! /� 7 IX. Condit' easons for Dis ��1�: 1. Septic tank effluent filter and 9 n e_w � ovw2 -D dispersal cell must all be inta services t mained as per management plan provided by plumber. 2. AN so bsck requkaments must be maintained ,e. Attach to comp e p ans a �e system and submit to the County only on paper not less than 8 1/2 x 11 inches in s' SBD -6398 (R. 01/07) Valid thru 01/09 f PLOT PLAN PROJECT Sunset Ridae LLG 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 97.4' BEDROOM 3 CONVENTIONAL AT -GRADE X0( 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 121 st. St. 308' Property Line 2 Acre Site Scale = 1/4" = 10' Pro 3 bedroom House Tank is to be properly bedded and provided with lockdown covers with approved warning labels Huffcutt Combo Tank B-20 Area 15' below system is to remain undisturbed Grading is to be done to 6% Slope divert run -off away from system B-3 B.M. a B-1 97.5'97.4' 162' 96.5' Property Line I PLOT PLAN PRWECT Sunset Ridoe LLG 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 97. BEDROOM 3 CONVENTIONAL AT -GRADE )00( 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 loo' Filter BEST GF10 -8 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark 121 st. St. 308' Property Line 2 Acre Site Scale = 1/4" = 10' Pro 3 bedroom House Tank is to be properly bedded and provided with lockdown covers with approved warning labels Huffcutt Combo Tank B-2[] Area 15' below system is to remain undisturbed Grading is to be done to 6% Slope divert run -off away from system B-3 B. M. B-1 97 5'97.4' 162' 96.5' Property Line _ UNPL ATT 0 _ LAWS _ - 200 ir 3 . 133• � i'.l�' - -"\ 230.82` o i o 1 ob t ip N ' 2 47� 31 /i 1132.02' � r I N f N W 'f _ IS ! 10©' W ' p Z do O -310 60 _ 1 .2 '1 4 13 6 0 _ ___ — 1 ' 3 1.68• 1 74' 462.26• i I rn 121ST STREET 82- ------------- ------------------------------- C' t / O VA r. v / .. S / ^ Y ;e 0) * _ g / w !� ^ C ID GOI.JIN' - ", PLAT o 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 LNPLATTED LAPNQS I - aea'S05. "E 5xxe.e�' -- FMwdon rBn.w>'rva N) BB �, ., us � �C.nn� ,'I � —/BM R C.,1 - xbn Wmre. l;ne _.. • '. el..srw, +rwv..u' Naro se - ' I - N 89'50'54` E 7018.75' +.lx / VI C/NIT Y MAP I x. -e<,., - 2 x 5 I nw L o AVE -_'_ a„ ox3 4.., _ _ __t —. I 1 I I I I I IBr » s eevs n• 9 e , 8 - . a s I'o Section 34, )"JON, RTBW I;� \1 \I uBa- s %llr'•C.rree r ,y 5, zB +e LEGE 2-ev� �o' -r p St. Croix county section Cornar, As Note 0 set 2 and 3/8" (O.D.) x 30' trop Pi pe (3.65 ft. ) I i• �'- +eau o<.., / »'(' l ' _ B M - m \� [a. � v 1bs/Tin. (ry 89 "JJ'40' w I306.04) ftocord Dola I Iy a l o• J I ' _ - - - - -- 12' utilit Eoaement a f csrw. m l 20 uecur -- - - - - - -- Bullding Sel — Lm. Bas t.ao. Loweai Building Opaninq = I Z I - < i 21 J o Loweal Permitted Door or Nendow Elewllon Iv Z yfo I •I: 8 F o / All nfher tar co s f s plot, w4 cadenced oy a 0 u I� x.5 .c•e l I B.. o<w, 1.05 -1 (0 O.J r . e 19 /wch ,e I 9 9wsef Ridge, LLC I j I Jel summer pines C-. t N dson, IN 54016 1 ■ J , 4I 10 i I 1 ■ 1 I 17 �— .,,,.me4 t00 1 100 200 ,)0. = as isiiii SCALE IN FEET 16 -- - -- ---- r - - - - - - i 72 31 33. I 15 14 I ! yam omr I e E + .A a z1 �a LOT 17 s,e1„4 gL s DUCK P O N D E S C A P E I B a' azoo ..r., a 89'5959 "W 694.55' I i ee -1- —11 nem oI is I N I e o o c0 %.% i !OT 2 — I1r , ' £ r C. S. M_ - N87 4 4 24 9 2"W 3.40 - 1215T- .AVENUE_`I (56l'Sr56 "E 324.J9)I ValumB ]9 ',i Volume_ !9 1 Page 4852 Page 4852 C.SM. LOT 15 LOT_ 16 ' eI - - I l I I Volume 5 l y Poge I4oO MELCHERT WAI"Y - lendscepe architecture 946 H7¢h Ls Hveeon, Tri 34030 Cl Vfl engineering thane ('lte 9e -'n3e r I/` (op) Sheet 2 of 2 Sheets land surveying rex (,7613ee -aeo ueccxe7rr ..x[acr 7 Safety and Buildings s commerce.wi. OV 4003 N KINNEY COULEE RD g LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 i sco ns i n www.commerce.wi.gov/sb/ Department of Commerce www.wisco isconsin.gosin.gov Jim Doyle, Governor Mary P. Burke, Secretary March 16 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: 03/16/2009 Identification Numbers Transaction ID No. 1380107 SITE: Site ID No. 723269 Sunset Ridge LLC Please refer to both identification numbers, 120th Street above, in all correspondence with the agency. Town of Richmond St Croix County WI/2, SWl /4, S34, T30N, R18W Lot: 21, Subdivision: Sunset Ridge FOR: Description: Three Bedroom At -grade System / New construction Object Type: POWTS Component Manual Regulated Object ID No.: 1122214 Maintenance required; 450 GPD Flow rate; 45 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(R6/99) 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 inspection by authorized representatives of the Department which may include local inspectors. P.O.W.T.S. Conn tlollal v t " l ,conuTMENT OF COMMERCE SHAUN R BIRD Page 2 3/16/2007 Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to ro er use and maintenance of e e all receive a co of the appropriate o eration and p p e t s ystem. Owners sh re ve copy p 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 Z�r'l�lO Balance Due $ 0.00 b'er'ard 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. RE CEIVED MAR 15 2007 SAF�y& BUftU1fYu.� Cover Page 4 Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 3/13/07 Owner:Sunset Ridge, LLC Location:W1 /2 SW1 /4 S 34 T30 N,R18W Richmond Township Lot 21 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 5HrE1Y priu nui�� � Signature* pw► °� License number 226900 co�RESP °ENCE J �- i }5j $ > 5 --- OTUP,g- UPS �... pLSTiRi TEftAtr ��j �tlfE7aes Vic" Y' A >5 y�y� 1l6 V 1l2 B L CE LL Of %Z G6�CE.�sATE 2 Distribution Lateral kite R.Ovr Fabric Sail Cover ST&BjCmr.b ObservctiOn --b.,- n• WeH 6 .. A x2 >15 ° j 5WE 0 plAa View asad Croas Section of '47is�o At•zas Uulr- wit Single Abs- Orption Area on a S#vg3ug Site UGEr-J L stt,��'fu RE. Page_,_ Distr ibution Pipe €�+et3 iI For L ateral �etwar�c Di str Ae rr Y u TuR - TAP . t�.�RttOit Tl 4 f _ _ Pvc Farce Na Pipe ---- P * Last #dole Shwid Be Next To r ""- ur 1 e £� #aaueter ;Lath ft. P Inch(es) L 1 Di amen' X Imes Z Farce Hain g;amter Inches - Inches of Holes /Pipe A I Elevation of Lateral s 7! Ft. Signed; License er Date: i CROSS SECT #tND SP£CIi T�TIC3i+is TAIM � �i•FRi''iBER SEPTIC GRAM; £ �$t3X A FP OP�C0�1ER 14-114. •* 14-114. ABOVE G VET Vim .ICI now OR WITH CON! I'� My PtD�I £ : DOOR , ARKI LABE. j ? 141H - - - �• �- t8 nwt�t- T s c s- I # *11TH 1„iA� R TIGHT $�� � SEA£* ; � � � PIK ON �,ySOIL C. FT PIPE I3� 27. FT- woismlo. SOIL a API DAY DO ? DAY E5. = $ EwCEa = GAL- 1t1�K SITES = . D OSE IC L. C3�gRCI T i4UI7E�. C J ac - SWITCH L ' ✓ _ -- z 16.23 VAC lip LIM: p�T4P rte gt. � £ A gtti ir7l�tZ�G D gEE't Sti1 a gliT£ �Prt itiP 110T.ION PIPE - - `j� Ft: T ttEi3UIR OISCIfi�,RG�£ $ £� pUtj,, Of F f�KO - ISIS - - _ 7 �FFER'F'IC PRESSUSE - FF- FR IO �£ - �1ER"aCAL D' 0 SEmpty �f1xog , SAE I)YNO / r, gGvi MK? Ll�IAD I%TSgML DLi`�E S Dt � D9 E rf$S ; Sent By: HP LaserJet 3100; 1 715 55L t%Mel f LP 9EH SERIES SUMP/EFFLUENT PUMP 8.95 o 0 Spegfileittion5 11a41 @Bi1R soassr nittoir ewr saeewt asaa rat saps m ami eu My :ExOj 1K�s a► ms XLk) tmillmR IF it 19 39 351-m 5oea8O WO 4A4 113 130 1000 70 54 55 41 32 18.8 20 24 911 x 11b4xB 91 991 cm 5mo MCA K.0 280 34 u 1000 70 64 55 A 32 1&9 27 24 9.11 ,11.5416A4 41 32 tla 20 27 9.11 x ttbtION 99t-a 5N O MCA d�0 tt5 am ?1A 1000 7O 94 5S ` 11 32 t'B 2ff 27 9,11 x14.64: Ammm 065E 110 280 3N 65 1000 70 fib - Cci�Tn�oa4 Du1YRt1,i— 'tlnit 6I aEWn�ttp�PSSlraedr se�0inuausO�AYab rWss9rYxetanwlan 9rOt��' FLOW- LITERS/HOW C■Structlon 0 1000 2000 3000 Motor HousingEmory Crested Cut Iron ler Material Pol Carboteatc L to lm lle Tic Close Van e .. _ ... _. . 31 voluu ABS -- — - Powcr Cord SMIN -A r 73 W _ M Shaft Scat Nitrite with carbon and ceramic faces s 4 Bearings Fasteners Suirtlars Sue! Ld so = Shaft Ststtn Steel 2.s Upper Steevc and Lower i i Hall Bearings 0 20 40 60 e0 FLOW- GALL&iS /.'%IWTE PUW PERFORMANCE CURVE Lftue Gtant Pump Co. u5v 60HZ PO Box 12010. 43% OK 73IS7 . rham 4153471SU • Fw 405.276 M9 F.axx>k %FWW Utt1cG1anWmmp.com 0 Fam 996236 -071M t � q �I+tT PLAN P� of ��1► ■�.S Q .7 i�iA 3r�.� S v++ D Tank tl'tFOR Tangy owcKSr u n S �� �r ��� Q NA p � Q� � ` 3 II Dt �� Purnp-Tank Cea* NA �i Units pump Tank M��� °f Coar� i i Vie} ,.� .pump i,� � � ❑ N�► Es t(a x 7.� T PumP WcIOI .Unii AMA r.7�Q t110� tk 13 Pe Fffb i average" r$Wvl AN °" Wo w Greg" � -<30 mg- n �` °" a other B sio* CC averag6l, Dispe Ce UCs) II t- Wad* P �et�t a a w O s} : s3O 91- 0 ln-S D Other . TOW Ouir, Sys Cr I � �4 pOmI Q e for sna VaWas Fiscal Cob mea ic►dlQlamet v 25*A� Wme w-d for pardde sue .- . EMM Msc � Sarvroe �CE SC JE Q nsonths s) CMa�3raus a 3 y� - Sen4ce Event At ieast anx every hats on&4*d (lr„) of tank volume 1nsPed on of ffinkCs3 yvtren � mbinod sludge and scsscn e4 s) (NtaX n Urr& 3 yn•) Pump of tanic(s) A D months s out cont lest once every s) inspect disP asU(s) Rt �� once every Q motes :) Q t�tA CWan UftIwAIV er At leant once every s) Q t�tP► Q moped pacrsp. PUOV oorstxcts 8 asz + At once every 0 mom II yrsarEs) 13 NA Flush ism ar>d Pry fast At least once suety 0 fl � 0 NA OOWC At 10ast , once ever5t or o csrrYine one of t11e �� e ACTIONS oe s� t w made by an mod" ppw('S tr.P+�r= P�S� tl+tss�+g of ttr+oi D � of ism" and Pkn'*W Rest on of the taw i° i wi i PUVnw " lion a ny check e UP � [ attic � tnt::t gndude v a�� wed stu�e � � . S ww �dcs or testes. �� disD0r98k O S) strait surf 'ThO Pam COOL" °f wm aut ft. itard� of act the S;t*Wd s d*A- ding of effluent on the 9 of the local or Pouft fnft � and to d 9ck 1 p n and �� she Irtzmedra�e aotii ' of the � �vme. " MR gmww MY irufica�e $ �wdge and swm to anY tank eqa o � d5�d of bn saoo ' d ' - Wban Mnoved a SeP nrtdng Y aw wo of" UV* etapoa 113. VV Cod or pr�essurtz� POVVIS �,p�erlts, P d by e a � ppWS The 9 of efdttt . � of 12 tncnOS or less � b ' e set= ewers ott>a� to go toCat It��IY ali�toriiY min 10 dAYS of co ffi p bIbn of 21 Or C SiWIJV mPa� as Paoded START UP AND OPERA VON ppffs check 6-�rnent unit($) fir S tr9t� ate tiew oor- m tie of the andlor damage the d"isp For ttrat MW impel do t PAS a septage serviang operal>x P� to demand hV6 ate cgnbii% of the tantaEa r'�'°'red hY r Page_ aEons ant frozen at the 'anff5m&e sun - ace- t tmt �ccjrYVtteri s� cond. is nesWmd ffie amess System �� to,,$ VW ig e S n }r . in one UiMe ose, overload' cWs) and MW ream tie; twist bG � sJO tfte V& s h ave the conUxVs of Sit pcs� to* by a avoW b� orsattwe a Of Pte£ t the effluent pump or cactta Ot 8 Plnttr ar POM�ITS Maims m rP.stOte n0M W kwWs vfiM n the pump tank 3 WSW old & ti0 d itYB at QC (roub or ulm Do not ft a os PA Val ° mound or at-grade Sorg absarpdOn �- tlte arva vwiBt� 45 f�xt dowrx slope sirsafn may irnpMe It perbmarxe and ft a n aer4a �1e rrt � butts I=Wn swains: d of ate POwt War, fit and vegetable pew MO dirt {ststlp pF�ry tampons: andWSW soamw be 9at� rat ;0t � p� - ASMOONNUENT falls � �yloon out of service the f1otfowhv stem ��� Yilherl� ttte t ri =np � c h - Cornm 83.33. W seated. Codes sysoem is Mgwdy so* and the abandotsed p� opeR� AS piprn9 to tactics arsd Pits she. � and properly &sposad of by s S [he eon fs of 29 tanks and a1zd d or V esr c avem ma —vd ",d The "DW sPa� s AfW P=4409, a t nki; and pits Wed id/ t Sad, 9MMI or bmt sood M&Arm(- �QI1�T P� j � 1`Oj(q r�s tllP$SL37�5 113Y E b@P.ti. or Must be take" 1D �idB S code If� Mp ect sy cmviot be ' P acme has been evaluated and tttay be uh�ized for the IocaSo� �pacdon and siMW Wt a n ntarea should be protected from dLStcsrbance� and woos. b0 The raptvae be ir>Eringed upon by �� 5 from e>�ng and Proposed. a tb&sh 2t suiFdble Etta wig nesutt in the need fair a new soil and site �ev8t at that firers_ pn°Lect the d went SyS�•5 must corn the rules in eKe rept�rnent area. l3ep bte due to setbacFc arrdlor soil r mnatiom t advances in PpWTS C3 A sutlaWe repfaeoemesit as a cast resort atata is not avaa7a t=jwQUW a twrc�rtg tz* tttay be �� to replace the fatr7ed p'Q1NTS area is avasa the POWTS a sol Upon t - bo ideaTtify a suitable repraoement area. aa ur a .and tae sift has riot bees, evaraaa�ted iocs� s stioabTe reek erTt area if no r� We a 1 1 site e+rafuatian must be PAD b Stank maY be bwtMIk4 as 2 Est resort to replace the faired d in place o€ Ste baanud ai and at -grade =A absorp�n syst+�s ` m t h e eledatthatt M he k Sur&= Reoons of such s�sterns must comply <cVtIARFtttrrt�� TANKS MAY CONTAiM LETHAL GASSM AhIDIOR iNSt1F GM �fC, pLggp A w OTHER FRFA?ME1+tT TR TMIIKT TANK L1l+tDER ANY C1R�AM�' MAY no xrn' ENTER a s'tc„ i�uhiP oR RESULT. RESCUE•OF A PERSON FROM THE ItStTERIOR O� A TANK MAY BE Dr�G{,ILT OR �4 'ADDRIONAL ODMhY MM pOWTS MAIhTfAIMER POW MI INSTALLER Name , S�rc u �✓ r" Name C.0 i j SEFTAGE Sl=RVMG OPERA PUMP LOCAL REGULATORY AU HOMY N am Agency phone ��cJ / `f !� Phone treeerx Tt+a aoeMno rt,.®es �C itarlfs affAr 4 t>wtre, ar�d Waushara Cauaati` Zararta9 srsd Sat? fns e:+ir of da Cataa Bs."X1Xa 0 and S-�TS• (x) 8. (3)• W A*nf N Code th s of fhls d r e PaIM M of the POWTS If 1 03/14/07 WED 08:06 FAX 715 386 4686 1¢4007 wi Department d gyros sa! SO VALUATION REPORT Page tJiviWnof &oalyandeuildings in V ri ft , / f Attach Complete site Man on par not IM #M 6122 in size. Mark inehrds. but not Ymded to: verticat and horizontal rr:hn and pwwd slope. scale or dimensions. north arrow. and and Reviewed by —_. Data pj"" print as inlhrma Sr ,.c.AHRforMSUOft V" WW mint beussabrsscondwy /. PYnpertyOwnsr {C..1 J} `./ Govt. Lot 1 14 S T p N R ( E CIO # Block # . Natns or t PIOQOAyQMtlat'31�t f"1 � � ad Ov O v °wtt � cv syol c Ail 2 Nurtiper at pedrorxns _: Code der K*d design itowrate t Pup ap : 4eoral - Describe: ._. elevation Flood Pla 1L raront maieelat 'v� if aDP��bis --- .- - -.r,r �"W� FT Bo** 0 t Ground sultum eleV I -TI 2 t. Depth to WAWV fadar — in soli NO GPOW ttotiapn Oplh Dominant Raft DaiCdplion �7ex�re 9treK.itme Cortsfstenos Bound�Y Roots ym Mt�sep Cu. Sz. Coat Color Gr. Sz Sh. `614!1 `Etfl12 i ! 6- s / 1 90" i n g agar — ril SO � Ground surface elev. _ Red" Oescstption 7axttxe Spttcturs consistence IMundar)r Roots *M t�iori m 0001 Datrrinsrx or. W. Sh $ t1v SZ Cant Color 3 J w 0. • >i > -C '�(} ..�.�..���rr and TSS > 3p • S. n elluent a = BOD _ 30 �• and T58 < 30 mgil. CST Number CST Neff0 P" 226900 Bird Pl u mbing, Inc. S haun Blvd pate Evaluation COrKWed Teleph Number pddreiS r r j ti 71. 4516 1008 192nd Aye, New Richmond, WI 54017 — V 03/14/07 SPED 08:06 FAX 715 386 4886 l} t&00S Property pvirw Parcel 1D !f _ Pap of ❑ O t Ground stYface atay. R• Deptt ;c kiting Isew +► S A Pgae }fin Depth Dominant Redox Desaiptlon Te�dues nxxuns Consistence 8oundery Roots in. MunseY CAL Sz Cont. Color _; 3tt. "Etffi I *m 7, • !o .7 ❑ ❑P * ❑ P" tstiotsrdauri�oeelev. �. Depta� —� �' Sea Rate tSAM Depth Dons Cdor Redoes Dacaipf M TeafOUte s_ r k*" Conaiatenos BaridarY Roots GPDx! h Muwd 00. SL Cont.•Color G-_'az. Sh. - awl 'ts1Ak2 ❑ � Q * 0 PH Groesd sur6ce ebv. tt Dept � o imi0rg factor � Wes HpFmn Depth DominsetColor Redw Desatpdon• Texture :,6uojm Consiefenoe Boundwy Rwft GFKW in. Wins" CAL SL Cone Coker Sz Stb "E1f+111 •Etilt2 Eft w4 M1 = SW, :P 30: 220 a9t and TW 40 1150 nV& • EffAw t S2 ;o BW,,l 30 mqL and TW 130 mpg The Department of Commerce is an equal opportunity service provider sad employer. If you need assistance to aces $er+icea or used material in as akernate farn+at. please contact &e de;:u ment at 608- 266 -3151 or TTY 608- 264-8777. asaanoPtAM) I I I I I 03/14/07 WED 08:07 FAX 715 386 4686 4009 Soil T est Plot Plan Project Name Sunset Ridge LLC Sha i Address 838 Summer Pines Circle Hudson W1 54©16 Lot 21 #2900 ____ Subdivision Sunset Ridge Date 4/15/05 � 1/'2 S W 1143 34 T 30 N/R18 W Township Ridynond Q Boring a well PL Property Line County ST. CROIX BM or VRp Assume Elevation 100 ft. Top of Survey NallAron System Elevation 97.4 *NRPSameasBenchmark Pro Town Road Scale is 1" = 40' unless otherwise noted B -2 so 308' o' I Prope rty B -3 4 6% Slope k B.M. 110' B- 1 97.5 96.5' 162' Property Line ST. CROIX COUNTY � SEPTIC TANK MADUENANCE AND OWNERSHIP CFRTInCATION FORM Owner/Buyer v Mailing Address Propaty Address l & Zoning Department for new con =c=on -) ('Vezific� lion regt� from Planning z parcel Identification Number a! City /State LEQ&L DESCRY Q n r/4 J � 3 /a , SeC�.� 'r R�w' Town o. property Locatio � ot Subdivision Volume ; Pa g e ' # Sure Map # (� CerbSied Survey 6 page# 3 "7 ,'Volume Warranty Deed # / Spec house/ yey� no Lot lines identifiable yes no TI+�MTENANCE ANDvOWNER CERTIFICATION and p failure to handle wastm Proper u into Improp use maintenance of your septic system could result in its , If ne eded, a ucensed ptonP�. What yo put out the septic tank every three years or sooner, if needed, by tena� main teasnce consist s PP waste disposal system. Owns main the system can affect the function of the septic tank as a treatment stage in the Ozdtn�e- i §Cowin. 8352(1) and in Chapter 12 - St. Croix County Sanitary nspousibilities are specified fob, signed by the planning & Zoning Department a certificattan- weer to submit to St Croix County licensed pumpe vaAy g that (1) the on -site o �s or a P tank is owner and The by pro perty master plumber, jottrneYtnan plumbetr, restricted plumber on and pumping (if necessary), the sep wastewater disposal system is in Proper operating condition and/or (2) after inspecti less than 1/3 full of sludge. system with the tie to maintain the Private sewage disposes 1/we, the undersigned have read the above requirements and the ent of Natural Resoza ties, State of vrmonsm- standards set forth, h as set by the Department of Commerce and the Dep le to the St. Croix County Planning & tut system has been maintained must be completed and returned Certification stating that your sep b Y main daft. within 30 days of the three year expir Zon s rung � ) to the best of my /our knowledge- Uwe �STe � Oa+ner( of the that all statements on this form are true f Deeds Office. Uwe c 9 : SIG a NA of a warranty deed recorded in Register o ve, by virtue DATE TURE AP PLICANTS) may result in the sanitary permit being revoked by the Planning & Zoning Dep�eMt *** * informatiOn that is C red Include with this a pplication a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey MOP if reference is made in the warranty dee& MEV. 08" U 2660? 306 774940 STATE BAR OF WISCONSIN FORM 1 - 1999 WARRANTY DEED KATHLEEK H. VALSH Document Number REGISTER OF DEEDS ST. CROIK CO., VI 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 Ri fte, LLC Grantee. WARRAKTY DEED Grantor, for a valuable consideration, conveys and warrants to Grantee EXEIPT # the following described real estate in St. Croix County, State of Wisconsin REC FEE: 13.00 (the "Property") (if more space is needed, please attach addendum): TRAKS FEE: 1440.00 See attached Exhibit A COPY FEE: CC FEE: PAGES: 2 Recording Area Estreen & Ogland 0- 304 Locust Street Hudson, Wl s401 g 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. * �r, 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 P 7 da of V' 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 I STATE BAR OF WISCONSIN 800 -655 -2021 WARRANTY DEED FORM No. 1 -1999 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 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 corn6r 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. FROM :OEUERING HOMES LLC FAX NO. :7155311282 Dec. 14 2004 10:1 PM P12 .'I 1.4 a ------ - - -- ----- - - - - -- - -- F ------------ z 1 0 o t N + a i M i f FROM :OEVERING HOMES LLC FAX NO. :7155311282 Dec. 14 2004 10:14PM PH If A .�.. .--- - -- - -- .- l p R N � • usvn El 86 O see s +a N N •------ -r, -_- , _ Parcel #: 026- 1286 -21 -000 03/21/2007 02:12 PM PAGE 1 OF 1 Alt. Parcel #: 34.30.18.1443 026 - TOWN OF RICHMOND Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 08/26/2005 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner % OEVERING HOMES O - SUNSET RIDGE LLC SUNSET RIDGE LLC PO BOX 179 NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description ' 1217 124TH AVE SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 1.844 Plat: 10/073- SUNSET RIDGE LOTS 1 -21 026/05 SEC 34 T30N R18W PT NW SW SUNSET RIDGE Block/Condo Bldg: LOT 021 LOT 21 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 34- 30N -18W NW SW Notes: Parcel History: Date Doc # Vol /Page Type 08/26/2005 804638 10/073 PLAT 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/22/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.844 27,400 0 27,400 NO Totals for 2007: General Property 1.844 27,400 0 27,400 Woodland 0.000 0 0 Totals for 2006: General Property 1.844 27,400 0 27,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00