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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT sanitary Permit No:
514892 0
ATTACH TO PERMIT)
GENERAL INFORMATION ( 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:
Jones, Pete & Alice I St. Joseph, Town of
CST BM Elev: Insp. BM Elev: BM Description: , Section/Town /Range /Map No:
C 19- z G S 1 26.30.19.
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER ;,,�� CAPACITY STATION BS HI FS ELEV.
Septic t „_ Z Benchmark
Z o � 4 . I'bb. q9.3
Dosing Alt. B 97
*eFatkg;�, n t � V, Bldg. Sewer
•
P. 1,
Holding St/Ht Inlet 7
TANK SETBACK INFORMATION St/Ht Outlet
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic 7 56 �� 2Cl 3 (10 Dt Bottom � 5 vp
Dosing 5 Z Q / 3 Header /Man. 7 �t g
Aeration Dist. Pipe q�q . 7
Holding Bot. System 'ij'� +D ' P• '
LJOINAA.— -7 4 7. 7
c� .
PUMP /SIPHON INFORMATION Final Gra �
6. ►5 l l
Manufacturer Demand St Co Q
-,L S GPM j p . C � 7. z5
Model Number
a
TDH Lif] � Friction Loss System Head TDH Ft
Forcemainn JJ , G Len% s Dia. Dist. to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 1 154 - 14 2 `( (b ^ �_ SETBACK SYSTEM TO P /L BLDG •' S WELL LAKE /STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR +`
Type Of System: , 6 �� f I ►/� UNIT Model Number:
Z
DISTRIBUTION SYSTEM Z Igo ZZ, T'
Header /Manifold J/ Distribution x Hole Size x Hole Spacing Vent to A' Inta
` 4 Pipes) \ \ \ 3P l`a
Length � • � — Dia Length Dia Spacing 1
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over Over xx Depth of T7;7e�odded xx Mulched
Bed/Trench Center �Ted rench Edges Topsoil No Yes i] No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2:
Location: 1382 Awatukee Trail H WI 54016 (SW 1/4 NW 1/4 26 T30N R1 9W) NA Lot 1 Parcel No: 26.30.19.
1.) Alt BM Description = � +,�'�''^ �• �� d
2.) Bldg sewer length =2
- amount of cover = / /
Plan revision Required? Yes to
Use other side for additional information.
Date Insepctor's nature Cert. No.
SBD -6710 (83/97) 7
convmrce.m.gov Safety and Buildings Div
sconsin
201 W. Washington Ave., P.O L'
t ri choptl r �"
Madison, WI 53707 -7 Sanitary p�K Number (to be filled m Co,)
r 11 of CON1111e000 I C 7
Sanitary Permit Application
In accordance with s. Comm. 8321(2), Wis. Adm. Code, submission of this form to the appraprate gavem VA--
unit is required prior to obtaining a sanitary permit. Note: Application forts for state- ovolud POWTS are
submitted to the Department of Commerce. Personal information you provide may be used for An°1ex4 Addaesa (if different than mailing address)
in accordance with the Privacy I aw a. 15. 1 m slat«. ;0 l inz A wn i /
1. Applicaden information — Please Print AN Iaferwwtion
Property Owner's Name Parcel # D (�
s r .E,_ n01 Lp i 1 Cr�.dl
Property Owner's Mailing Address jum 0 IA= f=
Gj: . Let
City, zip
code Zi Code e NIT16'fN G OFFICE �4/,U) %+, Section 2 `/
� - y � � (crsaerrwaat
It. Type of Building (check all that apply) dK ci0 Lot # T,3O o R f [] E w
19 or2FamilyDwelling- Number ofBe<h /
kb Bloch
< Sttbdivision3Jame
❑ Public /Commercial - Describe Use
rJ�prw� # s �fLrl1
�(ay.. City of
❑ State Owned - Describe use CSM Number p Z ❑ Village of
` a �1-- w 2 I a—zZ � $75 y`f `f Town of
mit
III. Type of Per: (Check only o e box on fine A. Complete line B if applicable)
A. New System Replacement Treatment/Holding Tank Replacement Only Otlrer Modification to Existing System (explain)
System
B. Permit Permit Revision Change of Permit Transfer to List Previous Permit Number and Date Issued
Renewal Before Plumber New Owner
Expiration .l► SI T
IV. of POWTS 3 temf Cem ngt/Device: Check all that S
N on- Ptessuam In Grou Pesgsuriaed In -0round Ar- (stark I►4atnd >_ 24 in. of suitable soil Mound < 24 in. of suitable mil
❑ Holding Tank [3 Other Dispersal Component (explain) []Pn�r+eamrent Device (explain)
V. Dis rsaVPreatment Area Information:
Design Flow (gpd) Design Soil Application gpdsf) Dispersal Area Required (sit) Dispersal Area (sf� ystem Elet'Mior► n
Vl. Tank Info Capacity in Total # of Manufacturer Material
Gallons Gallons Units X New Tanks F.xleling Tanks / j it/ K r
SepticarHolding Tank r "o
Dosing Chamber �Q,� + Y' e7 •✓
VII. Resp onsibility Statement- 1, the andtxsigaal, assatne respoasibiflty for testallatton of the PI)wT3 ea the atge6ed
Plumber's Name (Print) Plumber's rSignature Numbs 13wsiners Phone Number
Plumber's Address (Street, City, State, Zip Cade)
VID. our /De rtment Use On
PProved .y- Permit Fee Date I Issuing AWSignatule /
Owner en n for Denial $ ,q oo i0 b lj g
IX. Condit � easoas for Disapproval j l 11v "on�
1. Septic tank,.etfkient finer and
dispersal cell must all be services'/ maintained
as per management plan provided by plumber.
2. AN selback r"Arements must be maintained
Attach to eaaeplotc phra, for the sp aa'nd wbrrb to sae cmity a* as paper mast let tlna g tr: s 1 t fnehs fa rime
S13D -6398 (R. 01/07) Valid thru 01/09
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, g , sin S IL VALUATION REPORT #2096
Department of Commerce I in cor a with Comm 85, Wis. Adm. Code Page 1 of 3
Division of Safety and Buildings Steel's Soil Service
Attach complete site plan on paper no : in size. Plan must County St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. 030-
Please print a R 'ewed Date
Personal information you provide may be used or secd pp E4�VED)cyl_aw s. 15.04 (1) (m)).
Property Owner / P perty Location
Stout, Richard A�ul APR G vt. Lot na SW1 /4, NW1 /4, S26, T30N, R19W
Property Owner's Mailing Address L t# Block # Subd. Name or CSM#
1353 Awatukee Trl. ST. CROIX COUNTY 1 na CSM LOT
City State Zi di6>°wa mie City Village Town Nearest Road
Hudson WI 54016 715 - 549 -6731 St. Joseph Awatukee Trail
New Construction Use: 1 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
Replacement Public or commercial -Describe na
Parent material Pitted outwash plains Flood plain elevation, if applicable na ft.
General comments Conventional system , system elevation 97.80ft. Trenches spaced and depth to code 1.5 ,below rade.
and recommendations: S M& ,55 l9in-, pU A( /7 "' f
14 * 1
a Boring # _-
Ground surface elev. 99.80 ft. Depth to limiting factor 100 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistency Boundary Roots GPD /ftZ
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -3 10yr3 /2 none SI 2msbk mfr Cs if .6 1.0
2 3 -12 10yr4/4 none SI 2msbk mfr Cs na .6 1.0
3 12 -27 7.5yr4/4 none Is osg mvfr Cs na .7 1.6
4 27 -46 7.5yr4/4 none Is osg mvfr Cs na .7 1.6
5 46 -66 7.5yr4/6 none Cos osg ml Cs na .7 1.6
6 66 -100 7.5yr4/6 none ms osg ml na na .7 1.6
1
Fil Boring # '` _ Ground surface elev. 99.30 ft. Depth to limiting factor 100 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftZ
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -4 10yr3 /2 none sil 2msbk mfr Cs if .6 .8
2 4 -11 10yr4 /4 none Sid 2msbk mfr Cs na .4 .6
3 11 -84 7.5yr4/6 none Is osg mvfr CS na .7 1.6
4 84 -100 5yr4/4 none sl om na na na 2 .6
I
It
r
' Effluent #1 = BOD? 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD <30 mg /L and TSS < 30 mg /L
CST Name (Please Print) Sign CST Number
David J. Steel - " 248956
Address Steel's Soil Service ` Date Evaluation Conducted Telephone Number
1699 150th St New Richmond, WI 54017 4/4/2008 715 - 760 -0347
SBD -8330 (R.07 /00)
Propdrty dwner Rbut, Richard Parcel ID # pending Page 2 of 3
Fil Boring #
Ground surface elev. 98.30 ft. Depth to limiting factor 100 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDV
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I *Eff#2
1 0 -5 10yr3/2 none sl 2msbk mfr Cs if .6 1.0
2 5 -24 7.5yr4/4 none Is osg mvfr Cs na .7 1.6
3 24 -64 7.5yr4/6 none Cos osg ml Cs gw .7 1.6
4 64 -100 5yr4/4 none sl om na na na .2 .6
F—I Boring # Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2
❑ Boring # Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I `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 and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777.
SBD -8330 (R.07/00) Steel's Soil Service
STEEL'S SOIL SERVICE 3 of 3
David J. Steel Richard and Jane Stout 1699 150th St.
CST - POWTSM SWl /4,NW1 /4,S26,T30N,R19W New Richmond, WI 54017
Lic. #248956 Town of St Joseph, St. Croix Co. Direct 715- 760 -0347
CSM Lot 1 Fax 715- 246 -0318
This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use.
The location of this test may or may not be as shown, as permanent lot lines were not established at the
time the soil test was conducted.
Legend N
1 " =40'
♦ = Benchmark Ele. 100.00 ft
Top of 3/4" pvc pipe
• =Alt Benchmark El 100.00 ft
Top of 3/4" pvc pipe
= Borings
Boring Elevations
B1= 99.30 ft
B2 = 99.30 ft
B3 = 98.30 ft
B4 = 0.00 ft
G
n•
v �
SEPTIC TANK E PUMP CRAM ION AND SPECIFICATIONS
" CI VENT PIPE 12" MIN. ABQuA WEATHERPROOF
? 25' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED
rRESH AIR INTAKE WITH CONDUIT MANHOLE COVER
W/ PADLOCK 6
WARNING LABEL
FINISHED GRADE —
—
4" CI RISA ..:,., ,.' .�.� _ 4 1 ' MIN.
19" IN. 6 MAX.
t NLET
WATER TIGHT SEALS GA'S,
TIGHT i \/APPROVEQ
SEAL ' JOINTS WITH
ALM APPROVED PIPE
iPPROVED ON 3' ONTO
'IPE 3' ''' , SOLID SOIL
INTO SOLID ' air RISER EXIT
;OIL PUMP OFF ELEV . ' . , OFF PERMITTED ONLS
IF TANK
MANUFACTURER
j. HAS APPROVAL
3" APPROVED BETIi U
TANK
CONCRETE PAD
SEPTIC / DOSE ODES PER DAY: T
TANK MANUFACTURER:
TAN SIZES: SEPTIC 1�, p GAL. t 0I, M INCI,UDwNG GAL.
DOSE GAL, F LOWBAC K : ____- ---- --
ALARM
MANUFACTURER; PAPPTTU$: A = _ INCHES ( 4 G AL.
=
MODEL NUMBER: Dt-q B 2 INCHES ; �4 GGAL.
SWITCH TYPE: TT\qt . dd
PUMP MANUFACTURER: Cr C = 0 INCHES = �$� GAL
MODEL NUMBER: D = INCHES = G AL
SWITCH TYPE: CDe1eS
REQUIRED DISCHARGE RATE q 0 GPM PULP AI 49M WIRING AS PER zLHFc 15.23' WAS
VERTICAL DIFFERENCE BETWEEN PUMP Q�TI PIPE 5 FEET
+ MINIMUM NETWORK SUPPLY PRESSURE 01 o' -- ' 'FEET
♦ FEET FORCEMAIN X FTF .Oa P . , *L 'OVNAMIC - FEET
DIAMETER
INTERNAL DIMENSIONS OF PUMP TANK: eout 1
• LNB NIlt�: DATE:
SIGNED: IOr c�--
[qGOULDS PUMPS Submersible
�I
Effluent Pump
3871 EPO4
EP05
APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower
Specifically designed for the grade turbine oil for tic enclosed design for heavy duty ball bearing
following uses: lubrication and efficient improved performance. construction.
heat transfer. ■ Casing and Base: Rugged
• Effluent systems thermoplastic design provides AGENCY LISTING
• Homes Available for automatic and
• superior strength and corrosion
Farms
manual operation. Auto- G canadlanStandards Asmiadon
• Heavy duty sump matic models include resistance.
• Watertransfer Mechanical Float Switch ■ Motor Housing: Cast iron (CSA listed model numbers end
• Dewatering assembled and preset at the for efficient heat transfer, in "F" or "C ".)
f ac t ory , strength, and durability.
SPECIFICATIONS ■ Motor Cover. Thermoplastic Goulds rumps is ISO 9001 RegWered.
FEATURES cover with integral handle and
• Solids handling capability: float switch attachment points.
3 /+" 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 (40°C) continuous
140 °F (60 intermittent. METERS Fgigir ...... .........................._..., ..- __._.__ ......_...__....,..............._........._..... . _ ..... ._........_._._.___.
a ...._...__....__...__...._.....__._. _
..._.._....._..........._....,
10
• Fasteners: 300 series ,._.. i
stainless steel. . sG - _.._- .....J
9 30i � A __.._ ..._ —► PM
• Capable of running
dry without damage to 8 f .
_ zsFr I
components. 25'_ ... .. ___._ -._. __._.
7 '
i
_ . �..
Motor: x
• EPO4 Single phase: 0.4 HP, u 5 20
115 or 230 V, 60 Hz, 1550
..__ 1 ...._._ . ._.
RPM, built in overload with c 5 15
automatic reset.
• EP05 Single phase: 0.5 HP, o a s giros
115 V, 60 Hz, 1550 RPM, 3 1 of
built in overload with E ros ._ -_ . '._ .... _ --
automatic reset. 2
• Power cord: 10 foot 5
standard length, 1 6/3 _
1
SJTOW with three prong
grounding plug. Optional 20 0 00 .._..... 10 20 30 _ 40 so GPM
foot length, 16/3 S1TW with
three prong grounding plug o 2 4 6 s 1 1 ml/h
(standard on EP05).
CAPACrrY
Goulds Pumps
® 2000 Goulds Pumps ITT Industries
Effective February, 2000
03871
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer Pt+e/ kA (R e S
Mailing Address �7 P6V e', I VA A Ci lei S Cz1l� I 5 +0 ( Co
Property Address 1 >g '� N a
(Verification required from Planning & Zoning Department for new construction.) �—
City/State kA 5tLn 1 ul/ Parcel Identification Number fhtAv 0c-ybd ?JO 7-0 `'( 2' 6 Q ® d
LEGAL DESCRIPTION
CWk of TLq, >Vv oft Nw o,.v� in Q - t 1 ke , NJv'lq aflw �`I�{ a„� .(n. P2vk Ja/vht►�� 145
_L' l
Property Location 1/ , 1 /a , Sec. 'L , T o N R��W, Town of SE. ISM In
Subdivision Vowev `S Lot # �.
Certified Survey Map # 0cm Lnk S� �' , Volume Z , Page # 5 J 3
Warranty eed # c , Volume , Page #
ty g
Spec house yes Lot lines identifiable es 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.
Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin.
Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County 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 my /our knowledge. Uwe am/are the owner(s) of the
property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
N ber of bedrooms
/ 08
SICWATURE Of APPLICANT( 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. 08105)
I
POWTS OWNER'$ WNW ,& MANAGEMENT PLAN Page � of
FILE INFORMATION !iT $PEClFlCATlQNS
L Own e r ank Capacity O NA
t � a S O al
(peptic rank Manufacturer W � � ❑ NA
DESIGN PARAIiAETERS F ilter Manufacturer ❑ NA
Number of Bedrooms 13 NA
#Hue F ilter Mod
Number of Public Facility Units Q NA Ppnip Tan Capacit g O 1J ❑ NA
al
Estimated flow (average) , p O d Pump 'tank Manufacturer ❑ NA
Design flow (peak), (Estimated x 1.5) 4,00 i P'ilrn Manufacturer Cs o �1 ❑ NA
Soil Application Rate / /fufrr�} flAodel _ ❑ NA
Standard Influent /Effluent Quality Monthly ave�ratreatment Unit ❑ NA
Vii..
Fats, Oil & Grease (FOG) 530 mg /L Q SrAnilGravel Filter Q Peat Filter
Biochemical Oxygen Demand (BOD 1 5220 mg& P NA P Mephenical Aeration O Wetland
Total Suspended Solids (TSS) 5150 mg /L P1 Infection ❑ Other:
Pretreated Effluent Quality Monthly average Dispersal Call(s) ❑ NA
Biochemical Oxygen Demand (BOD S30 mg1L 0 lh-Oround (gravity) ❑ In- Ground (pressurized)
Total Suspended Solids ITSS) 530 mg /l, p NA i P At- tirade ❑ Mound
Fec Coliform (geom etric mean) 510^ efu l9Qgrnl Q Drlp�Une ❑ Other:
Maximum Effluent Particle Size Y in dia.
P NA I3th - ❑ NA
Other &1 4th r; ❑ NA
* Values typical for domestic wastewater and septic tank efflulsnt. Qthar; ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
13 month(s)
Inspect condition of tank(s) At leaii3t Qntpq eygry; j (Maximum 3 years) ❑ NA
0l yearls)
Pump out contents of tank(s) When cQr�illad alildq and scum equals one -third (Y of tank volume ❑ NA
inspect dispersal cell(s) At leash once ip�+ery; � ❑months! (Maximum 3 yeaml ❑ NA
]�3 year(s)
Clean effluent filter At le oripe evs¢r f. O month(s) ❑ NA
r _ :K Yearls)
❑ montMa)
Inspect pump, pump controls & alarm At lams( on, Oe every: * ❑ setts) ❑ NA
Flush laterals and pressure test At (east a!na� aV.�ry; ❑ month(s) ❑ NA
❑ year(s)
Other: ❑ month(s) ❑ NA
At least q p sty t; El year(s)
Other:
❑ NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made py. . an Individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer, 1POwfii 1nslp�c f r; POWTS Maintainer; Septage Servicing Operator.. Tank
inspections must include a visual inspection of the tank(si1 tp idsrltif . , ny rnigsiing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum ; to ithttdk for any back up or ponding of effluent on the ground surface.
The dispersal cells) shall be visually inspected to ch4�c th dtllrent Ievots In the observation pipes and to check for any ponding
of effluent on the ground surface. The ponding of off i�jer►t on tea 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 eruialh Qperaltor and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All other services, including but not limited to the servloing of effluent
see
units, and any serv icing t filters, mechanical or pressurized components, pretreatment
' at intervals of 512 months , 1 0 h Il be prf''rm d b a cert�ifled POWTS Maintainer.
. �• .., , ,ii „Y
A service report shall be provided to the local regulatory authority wixhin 10 days of completion of any service event.
°f -- --- --
START UP AND OPERATION Page
For new construction, prior to use of the POWTS dhgltll >2►,eitjnjrlt trkiti� fair the presence of painting products or other chemicals
that may impede the treatment process and /or dahh{ �I 4l�� { {0) if high concentrations.aire detected have the contents
of the tanktsl removed by a septage servicing open br " { t U
System start up shall not occur when soil conditiol�e rlfl; l f} I ilk f Ile h'0101111"ve surface.
During power outages pump tanks may fill above ridlt h (1 I r !it' hen power is restored the excess wastewater will be
discharged to the dispersal collie) In one large doslb d may result in the backup or surface discharge of
effluent. To avoid this situation have the contents tt.,by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber F �'tc ` .t W >tb assist in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispsMl It I } , 11 i�1 h►0 dr park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at -grade 4*1 lisp tli tt ft,
t ,
Reduction or elimination of the following from the rnttlt Ml iTl1ll: tir prove the performance and prolong: the life of the
POWTS: antibiotics;
baby wipes; cigarette but l , ;,degreasers; dental floss; diapers; disinfectants; fat:
foundation drain isump pump) water; fruit and ; grease; herbicides; moat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tarrillitj 1#I~f Frine.
ABANDONMENT
When the POWTS faits and /or is permanently taken did; dli fhi' ¢at )ow1{tg steps shall be taken to insure that the system is
property and safety abandoned In compliance with 0400ttl f > i S 'f n si n Administrative Code:
• All piping to tanks and pits shall be disconrle} ll{Id{ wlbtrf+xltdl i ipe openings seated.
• The contents of all tanks and pits shall be riri+ssr ?r$ly dfllpased of by a septage Servicing Operator.
• After pumping, all tanks and pits shall be 0 ilrlti 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 f � 1 i atlfll>i1.1?Ave Iy n, or must be taken, to provide a code compliant
replacement system:
D A suitable replacement area has been evtll 9.1jjj04 for the location of a replacement soil absorption
system. The replacement area should be pt#tElj }`Moth .411} t�llMp�b ,find compaction and should not be infringed upon by
required setbacks from existing and propoal i r6 "wells. Failure to protect the replacement area will
result In the need for a new soli and silt e av gyp. Ili�I1i .w Iii sli $table replacement area. Replacement systems must
comply with the rules in effect at that time
❑ A suitable replacement area is not availf! #Ipr soil limitations. Barring advances in POWTS
technology a holding tank may be installed �gjbjeitl�;lthe failed POWTS.
A❑ The alto as not en evaluated to identt
} M` area. upon failure of the POWTS a soil and site
evaluation be performed to locate a sUli< A . If no replacement area is available a holding tank
may b ails s a last resort to replace '
CZ Mound and at -grade soil absorption systsrho f o r 1Q #ill! 100 in place following removal of the,biomat at the
Infiltrative surface. Reconstructions of such.b�► oy 1h the rules in effect at that time.
< <WARNING> >
.R
SEPTIC PUMP AND OTHER TREATMENT TANKS SE$ OR INSUFFICIENT OXYGEN. 00 NOT
T'M AND/OR
ENTER A SEPTIC, PUMP OR OTHER TREATMENT . f STANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY 0E I R[I4
ADDITIONAL COMMENTS
POWT$ INSTALLER . , TAINER
(Name
Phone '7 ! 15 3 S
S EPTAGE S ERVICING OPERATOR {PUMPER) IATQRY AUTHORITY
Name GCs; u Z e ,
Phone l 1�» - 715- 3 -
This document wan drafted In compliance with chapter Comm.00810 } } f► Arid ,aa( 71. 12) & 13), Wisconsin Administrative Code.
I
STATE BAR OF WISCONSIN FORM 2 - 1998 �lllll IIIII `�'!� IIIII lllll IIIII IIII llllll IIII I'll
WARRANTY DEED * 8 7 6 0 6 8 1
Docuent Number 876068
m
KATHLEEN H. WALSH
REGISTER OF DEEDS
This Deed, made between ST. CROIX CO., WI
RICHARD O STOUT and JANET P. STOUT, RECEIVED FOR RECORD
husband and wife, - 06/04/2008 10:45AM
Grantor, WARRANTY DEED
and PETER A JONES and ALICE H- JONES —_ __ i EXEMPT I I
husband and wife li REC FEE: 11.00
COPY FEE: 2.00
_ Grantee. PAGES: l
Grantor, for a valuable consideration, conveys and warrants to Grantee the following
described real estate in St. Croix County, State of Wisconsin: 1
Located in:
Part of the SW 1/4 of the NW 1/4 and in part Name and Return Address
of the NW 1/4 of the SW 1/4 and in part of '' Peter A. Jones
Government Lots 6 and 7, Section 26, Township 1 1353 Awtukee Trail
30N, Range 19W, Town of St. Joseph, more fully Hudson, WI 54016
described as: Lot 1 of CSM recorded May 23,
2008 age 1, as Documen
No. 875A said CSM ormer y being o of , --
T at of Powers Addition. 030 - 2092 -05 -000
This lot is subject to a 66' wide joint driveway arcel Identification Number (PIN)
easement as shown on CSM recorded May 23, 2008, is not
in Vol. 23 page 5531, as Document No. 875444. This homestead property.
(is) (is not)
Exceptions to warranties: easelfients restrictions, rights -of -way and covenants
of record.
Dated this day of June 2 0 0 8
(SEAL) c ___ / /�` �" "� (SEAL)
Richard O. Stout Janet P. Stout
(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signature (S) — State of Wisconsin,
St. Croix ss.
Counj
authenticated this day of Personally came before me this day of
June 200 , the above named
Richard O. Stout and Ja net P.
Stout
TITLE: MEMBER STATE BAR OF WISCONSIN to
(If not, me known to be the person $ who executed the foregoing
authorized by §706.06, Wis. Stats.) X nt and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY -
Janet P. Stout
1353 Awatukee Trail Prt.„�e
Hudson, WI 54016 Notary Public. State of Wisconsin
_ Pa mela AMA s is permanent. (If not, state expiration date:
(Signatures may be authenticated or acknowledged. Both are not Notary T a y . U tr �� t'r'a T�a
necessary.) .St$te
1 `&I } mes of persons signing in any capacity must he typed or printed below their signature.
STATE BAR OF WISCONSIN Wisconsin Legal Blank Co.. Inc
WARRANTY DEED FORM No. 2 - 1998 Mawaukee, Wis.
,�k,. I IfilffLS` It I �1�Fi17�1 "�ti1 R cif 111
— 4 4 4
M44
KATHLEEN H. WALSH
REGISTER OF DEEDS
CERTIFIED SURVEY MAP ST. E4IX C RECORD
LOCATED IN PART OF THE SW1 /4 OF THE NW1 /4 05/23/2008 02 :30PM
AND IN PART OF THE NW1 /4 OF THE SW1 /4 AND IN CERTIFIED SURVEY MAP
PART OF GOVERNMENT LOTS 6 AND 7 OF VOL: 23 PACE: 5531
REC FEE: 13.00.
SECTION 26, T30N, R19W TOWN OF ST. JOSEPH, COPY FEE: 3.00
ST. CROIX COUNTY, WISCONSIN; BEING LOT 2 OF PAGES: 2
THE PLAT OF POWER'S /3
WER S ADDITION.
OWNER SURVEYOR
RICHARD AND JANET STOUT EDWIN C FLANUM o Q���� �0�4� I
1353 AWATUKEE TRAIL NORTHLAND SURVEYING, INC. p@gf ,Rig _ _ _ _ _
HUDSON, WI 54016 P.O. BOX 152 ----------
AMERY, WI 54001 QDp ff DUOQO M I '
BENCHMARK L@'T T 2.
LOO T [al TOP OF 1 �' IRON PIPE Lg If I 0
ELEV. = 936.78 - "' - - (S89 °31 10'W) - - - - - -
��� -0 � S89 0'42'W 768.82' _ J
w 198.82' I 195.40' 250.00 I 124.60 �l,Qo 4
MOo 0 9 [L Pa. 2,22,23@T 3 * - I °I
o } ------------ - - - - -- r WATER DRAINAGE AREA
CONSTRUCTION OF STRUCTURES, GRADING v 0 1 �]
Lu _ _ I a AND FILLING ARE RESTRICTED WITHIN WATER O I
w o — — _ I DRAINAGE AREA.
i s � I
¢ ¢ Lu U - O I N HIGH WATER ELEVATION OF 929.0 PER THE
Lu gN
� z
I I
Cr U a N a PRELIMINARY PLAT OF POWERS ADDITION
cr �t1LQ[�L� 4G3LQC�4 s N Z _ _ _ 10 _ - - o �; o0
cU) O --- -'----- - -' - -- p N -- ----- - 570.00' t2 O
C7 U O LOT 1 �i a
z N
°C O (S83 °10'24 "V� 9,55 ACRES
M► 385.1 416,140 SO. FT. N88 °18'34 "E
co 0 $82 0 49156 BENCHMARK --J LOWEST BUILDING OPENING = 933.0 ? 83984�',NK0lilailtkq�f�
\ � TOP OF 1" IRON PIPE ♦ \�\�
\ ELEV. = 947.97 y `►"• �/ji
JOINT DRIVE 859.96'
1
EASEMENT 526.
526.21' &I g EDWIN C.
FLT, a
v l 1 w 333.75
♦♦ LOO 1RR'@ QDDD 04�0M a I 4 evl
d 33' 33 rn LOT 2 ;
:-
_ 6.31 ACRES
I
275,015 SO. FT.
O
LEGEND
I .J , I i LOWEST BUILDING OPENING = 933.0 O
- I I ALUMINUM COUNTY
N89 °48'05 "E 853.84' It SECTION
o i i I 345.24' 272.73' 235.87' CORNER MONUMENT
O _
$ FOUND
�i di Wi '� i
l ca I „
W � pp 2 3/8 O.D. IRON PIPE
I I WI T c •
I NOTE: LOTS MAY BE SUBJECT 0
;. O N ?
� i p � I FUTURE ASSESSMENTS FOR ANY � FOUND
CJ I I I Q I I UPGRADES AND IMPROVEMENTS
W I TO THE ROAD. 0
o' 1" O.D. IRON PIPE FOUND
(llj I Ch i a I � I� 1 O
Q i I N Z 3/4" X 18" IRON REBAR
Qi D I I p O "d OUTLOT 1 p SET WEIGHING
0o d 1 I 1 12.44 ACRES � Q I 1.50 LBS. PER LINEAR
N 541,885 S0. FT. FOOT
I i
75' ROADWAY SETBACK
W1/4 CORNER 1 �� LINE
SECTION 26
♦ SOIL TEST
Q I I I
wn PREVIOUSLY RECORDED
0 o I i :............................. ............................... I DATA
N
g I I - - -• -- 12' UTILITY EASEMENT
N89 °48'05 "E . L -- -- -- -- -- -- -- -- -- -- -- - - -- -- -- -- -- — _ All � u -_- --- - - - N88 ° 48'05 "E 853.79' - - - - -- — — —
g - — — ---
co _(S8 _ _
-'� 132ND AVENUE
o �, 7 - - -- d04
T ��
g RIM MOOdo g ° a° MM
SW CORNER - -- I -- -- -- -- - - - - -- S CALE IN FEET 1" = 200'
SECTION 26
THIS INSTRUMENT DRAFTED BY MICHAEL ERICKSON
JOB NO, 08 -19 DATE 3 -13 -08 SHEET 1 OF 2 SHEETS 200 0 200
Vol. 23 Page 5531
• � P t. I
CERTIFIED SURVEY MAP
LOCATED IN PART OF THE SW7 /4 OF THE NW1 /4 AND IN PART OF THE
NWI /4 OF THE SW1 /4 AND IN PART OF GOVERNMENT LOTS 6 AND 7 OF
SECTION 26, T30N, R19W, TOWN OF ST. JOSEPH, ST. CROIX COUNTY,
WISCONSIN; BEING LOT 2 OF THE PLAT OF POWER'S ADDITION.
OWNER SURVEYOR
RICHARD AND JANET STOUT EDWIN C FLANUM
1353 AWATUKEE TRAIL NORTHLAND SURVEYING, INC.
HUDSON, WI 54016 P.O. BOX 152
AMERY, WI 54001
CURVE DATA TABLE
NUMBER I RADIUS I CENTRAL ANGLE I CHORD BEARING CHORD LENGTH I ARC LENGTH TANGENT IN TANGENT DUT
C1 233,00' 44'59'39" S22'50'34,5 "E 1 178.31' 182.97' S45'20'24 "E S00'20'45 "E
SURVEYOR'S CERTIFICATE
I, Edwin C. Flanum, Registered Wisconsin Land Surveyor, hereby certify that by the direction of Richard and
Janet Stout, I have surveyed, mapped and described the parcel of land which is represented by this Certified
Survey Map; that the exterior boundary of the parcel of land surveyed and mapped is described as follows:
A parcel of land located in part of the SW1 /4 of the NW1 /4 and in part of the NW1 /4 of the SW and in part
of Government Lots 6 and 7 of Section 26, T30N, R1 9W, Town of St. Joseph, St. Croix County, Wisconsin;
beiing Lot 2 of Power's Addition; described as follows:
Commencing at the SW Corner of said Section 26; thence N00 0 20'45 "W, along the west line of the SW1 /4 of
said Section, 1385.90 feet to the north line of 132nd Avenue; thence N89 0 48'05 "E, along said north line,
586.00 feet to the SW corner of Lot 2 of the Plat of Power's Addition recorded at the St. Croix County Register
of Deeds office, being the point of beginning; thence continuing N89 0 48'05 "E, along said north line, 853.79
feet to the east line of said Plat; thence N00 0 2028 "W, along said east line, 1142.09 feet; thence N88'1 8'34"E,
along said east line, 233.84 feet; thence N00 0 2028 "W, along said east line, 347.15 feet to the north line of Lot
2 of said Plat; thence S89 0'42"W, along said north line, 768.82 feet to the west line of said Plat; thence
S00 °22'25 "W, along said west line, 371.11 feet to the northerly line of said Plat; thence S82 0 49'56 "W, along
said northerly line, 385.19 feet to the easterly line of Awatukee Trail and the point of curvature of a 233.00
foot radius curve, concave southwesterly, whose central angle measures 44 0 59'39 ", whose chord bears
S22 "E and measures 178.31 feet; thence southeasterly along said east line and the arc of said curve,
182.97 feet to the point of tangency; thence S00 "E, along said east line, 904.58 feet to the point of
beginning. Described parcel contains 28.31 acres (1,233,040 Sq. Ft.).
Parcel is subject to all easements, restrictions, and covenants of record.
I, also certify that this Certified Survey Map is a correct representation to scale of the exterior boundary
surveyed and described; that I have fully complied with the current provisions of Chapter 236.34 of the
Wisconsin Statutes, the Land Subdivision Ordinance of the County of St. Croix, and the Subdivision
Ordinance of the Town of St. Joseph in surveying and mapping same.
APPROVED a �p C. 'A S S
ST. Cft= 00twIry FLANUM ,a =-
PIa1mk i Zwft s-2487
,+tM is r
, �0
COUNTY TREASURER'S CERTIFICATE MAY 2 3 2008 Z ev►s
STATE OF WISCONSIN)SS if not recorded witNin 30 d8Y6 of "'uN/ it; , r �rN �l
COUNTY OF ST. CROIX) apprevsl date approvN shalt be
null and void
I, Cheryl Slind, being the duly elected, qualified and acting Treasurer of St. Croix County, do hereby
certify that the records in my office show no unredeemed tax sales and no unpaid taxes or special
as : sessments as of r 81 affecting the land included in this Certified Survey Map,
C d arn 1 42 0. CAS 0 —nF
eryl Slind, A)r6t 2j �" TiZ. 6W2U - Date
County Treasurer __
Each parcel shown on this map (plat) is subject to State, County and Township laws, rules and regulations
(i.e., wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel contact
the St. Croix County Zoning Office and the Town of St. Joseph.
COMPUTER NO. 030- 2092 -05 -000
PARCEL MAP N0, 26.30.19.771 B SHEET 2 OF 2 SHEETS
Vol. 23 Page 5531
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