HomeMy WebLinkAbout018-2019-45-000Wisconsin Department of Commerce
Safety and Building Division
PRIVATE SEWAGE SYSTEM
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Personal Information you provide may be used for secondary purposes [Privacy Law, s 15 04 (1)(m)]
Holdings LLC
BM
TANK INFORMATION
TOWN OF HAMMOND
TYPE
MANUFACTURER
CAPACITY
Septic
_
OI ��
Aeration
7.2
Holding
TANK SETBACK INFORMATION
TANK TO
RL
WELL
BLDG.
Ventto Air make
on qT
ROAD
Septic
Aeration
y�
U
30
Holding
PUMP/SIPHON INFORMATION
Manufacturer Demand
GPM
Model T
ber
TDH Lift Fri n Loss System Head TD Ft
Forcemain n Dia. Dist to Well
SOIL ABSORPTION SYSTEM
ELEVATION DATA
• • �
IL•iifal►71����
•
-01FA
NMI
_
�t'L••7aZv�JWEM-
BEPrTRENCH
MENSIONS
Width
Length
No Of Trenches
PIT DIMENSIONS
No Of Pits
Inside Dia
Ligwtl Depth
r6ETBACK
INFO 710N
SYSTEM TO
P!L
WELL
LAKE/STREAM
LEACHING
CHAMBER OR
Manufacturer
Type Of Syst
Number
UID I Hi 1 IUN STJ I tM
Header/Manifold
Distribution
x Hole Srze
x Hole Spacing
Vent to Air Intake
Rpe(s)
Length Dia
Length Dia Spacing_
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Svstems Only
Depth Over
Depth Over
xx Depth of
xx Seeded)Sodded
xx Mulched
BedlTrench Center
Bed)7rench Edges
Topsoil
Yes No
Yes No
OMM�F�fN��—S: (Inclu a cods discre n s. ersons ent, etc.)
C4ocat on: 73g'gi STST
�t'\.�&
1.) Alt BM Description = 11/Ill C.wexS -
2 ) Bldg sewer length =a�.D
- amount of cover = �St`'I- w'. I WVpl.
i
Plan revision Required? - Yes No t'�/2f.� /•7
Use other side for additional informati� J l (/ v6�/� L
SBD-6710 (R 3/97) Date
Inspection #l, �7 �Z'-f'�� Inspection #2
�r's Signature Can. No. __:
SnIU-Ao;A I - 0SN
Safety and Buildings Division
County
St.Croix
't
201 W Washington Ave., P.O. Box 7162
Sanitary Permit Number (to be filled 1. by Co )
FELL 1 ZOZI
Madison, W;53707-7162
(G3 f Z51
'''444yyy
__,�1� y-:Perm t Appi tC$ti
State Transaction Number
In accordance with SPS 383 21(2), W is. Adm Code, submission of this form to the appropriate governmental unit
'Pwts 071901125-C
Project Address (if different than mailing address)
is required poor to obtaining a sanitary permit Note Application forms for state-owned POWTS are submitted to
the Department of Safety and Professional Servies Personal information you provide may be used for secondary
purposes in accordance with the Privacy Law, s 15 NJ 1 Am , Suits
738 161 St St.
1. Application Information - Please Print All Information
Property Owner's Name
el # ✓
WC Land Holdings LLC A1L��/�
018-2019-45-000
Property Owner's Marling Address
Property Location I ZLkISA)
626 Tremont Lane
con I m
NW SW ySection 29
City, State
Zip Code Phone
Number
River Falls, Wi.
154922
�✓
f 29 N R17 (circle oore)
H. Type of Building (check all that apply) Lot
#
Subdivision Name
Ll1 or 2 Family D.11mg- Number oritedrown 4 - 45
S`
Block
Rolling Hills Farm
#
❑ Public/Commencial - Descnbe Use __—
❑ City of
CSM
❑ Sate Owned -Describe Use
❑ Village of
Number
__
Town of Hammond
ID. Type of Permit: (Check only one box on lime A. Complete line B if applicable)
`f
New System
❑ Replacement System
❑'freatment/kIold Tank lacemrnt Onl
mg Rep Y
❑Other Modification to Ezist S stem (e lain
mg Y (explain)
B.
❑ Permit Renewal
❑ Permit Revision
❑ Change of Plumber
❑ Permit Transfer to New
I ast Previous Permit Number aril Date Issued
Before E innau.
Owner
615404 7/30/2019
W. T of POWTS S stem/Com memUDevice: Check all that sty, •tins �'
❑ Non -Pressurized I. -Ground ❑ Pressurized In-(:romd ❑ At -Grade 8 Mound>_24..Ifs
❑ Holding Tank ❑ Other Dispersal Component (explain) p,+ Pretreatment Ikvice (ezplam) HOOF 600 / Wieser
V. DisperiziliTreatment Area Information:
Design Flow (gpd)
Design Sod Application Rate(gpdsf)
Disper Area Required (sf) t
Di�spersal�` a Proposed (s
System El/e�va_tion
Z LAS
1800
Existing
(p,A qQt la
IfMwtOL 0v,.
t�
VI. Tank Into
Capacity in
Gallons
Total
Gallons
# of
i Units
Mario - -turer
Sim -Tech filters on
o
€
2
Dose pumps
o
u
s
>8
New Tanks
FxishaB Tacks
Septic or Holding I ank
400/921
1
x
Don.g Chanba
1250
1
Weser
VD. Responsibility Statement- f, tke undersigned, .as.in. responsibility for inijibination of he POWTS show. on tke attaehed plans.
Plumber's Name (Print)
Plumber S,
MP/MPRS Number
Business Phone Number
Keith Knudtson
I 648443
651-470-1737
Plumber's Address (Street, City, State, Zip Code)
927 150th St. Roberts,Wi. 54023
VRL County/De srtment Use Only
❑ Approved
❑Disapproved
Permit Fee
$q
Dale Issued
to Agent S� r,
\ I,V,_�'`-
❑ Owner Given Reason for Demal
to,
IX. Conditions of Approvat/Reasons for Disapproval
YSTEM OWNER' 'I1vl r n
. Septic tank, effluent filter and TS �S �,.� W.6, �
dispersal cell must be serviced /maintained � �� 4-k-S `l-3 _ t.-Y-
as per management plan provided by plumber l_ _ _1 l I `� ((`'
All setback requirements must be maintained Usti r ov14JL 5 � 14AOZJ& LTipr
as per applic,b',e CO e� f+r®rnglele p..+11-thesptem mdaobmitmue Co®Ty oo p.�pe-r.alik.aiaatt oeiomsve 1 tad \ t 1 u cA..,��p r, rtQ.QO_.yw_a- CQ w, y� i* SJB 6398 (lam I l/ )s— ^.rS�,ppTyt/{ dr'�QS J ` `�T•
26.0
12
39.0' o u S E
u I PROPOSED
DRIVEWAY I ^+ 25.5
12.0 l r...........
r
no
1z'� 7 ri
to
V
F o w
J
N¢
243,89'
� I
L 0 T 4 5 . __.... _.....,.._ _ •,
?,1,781$0. FT,
G,
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7'
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243,89' r
ww 1 . ! . r
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L 0 r 4 5
— HOUSE g
38.0 o o 24781 Sa FT, in
n � DROI ESA 25.5 .
2.0 •----,..wr...l
Polo i S 40 8'
12'
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31 74j"
4" CAS
11 ICI IC.
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a1 1611 _
41"
t
40"
TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227
O0 GPD GRAVITY D1?CWGE SYSTEM
H-600 A
TANK SPECIFICATIONS
DIMENSIONS:
4" CAS WALL: 3"
BOTTOM: 3"
COVER; 4"
3 MANHOLE: 12" & 24" I.D. PLASTIC RISER
HEIGHT: 70" 0.0.
-- POLYLOK 12" ACCESS LID (TYP) LENOTH 106" O.D.
WIDTH: 74 1/2" O.D.
BELOW INLET: 57" 00.
LIQUID LEVEL: 51"
WEIGHT: 11,135 LBS.
INLET AND OUTLEI%,
4" CAST -A -SEAL (CAS) BOOT OR EQUAL
COVER: MIX DESIGN �6 (NO FIBER
TANK: MIX DESIGN A� (SMALL FIB )
CUSTOMIZED TANKS:
FOR CUSTOMNTANKS CONTACT WIESER CONCRETE
5Z SET RISER (TYP)
d
DRAWINGS SUBMITTED
FOR APPROVAL
- APPROVED BY:
S
APPROVAL DATE;
1 ,
RECIRREAIENTS PRODU?5 NEEDED By:
W
WIWI.,
tkmllo,-uric -
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNE/RrrSHIP^CERTIFICATION FORM
/ _
Mailing Address � Iry-�
M/ / j
YO l
Property Addresc �✓�' �` / Gi tin 0 IA/y .S
(Verifiratmn required turn Planmnq& Dcpartrrcat for new aaetiaa)
✓
City/State Parcel Identification Number Q l IS —Z4
—y s — o C7C' J
LEGAL DESCRIPTION
Property Location '/. , T f.j) 'V. , Sec. ,L? , T L� N Rj;2_W, Town of
�f.�t
S�di�tianR oll��� ;lip
LO
Certified Survey Volume • Page #
Warranty Deed N I10 1T . Volsane
Spce hours Yes no Lot limes identifiable no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and rrumemance of your septic system could result in its Premature fsdure to 1-11, wastes. Proper
maimema, candsts of pumping Out the septic unk every three yvrs or sooner, of"ceded, by a lecastd Pamper. What you put into
the system can affect the function of the septc tank w a entmmt urge in the waste dupoW rYmat Owner rrwroteancce
respoartbilitim arc specified in §Comm 83.52(1) and to Cnapter 12 - st. (]ors County Sanftr Ordusmc
The property owner agees to submit to St. Oro ix County Plam®g & Turing DepartmW a cerufianon form, signed by the
ow sad by a master plumber, journeyman plumber, restricted plambes or a hcemcd paper verifying that (1) the on -site
wasawater deposal system is in proper operetmg con ition and/or (2) after unprtian and pumping (if na:esvary), the septic tank a
less than W fu0 of sludge.
1/we, the undersigned have mud the above requirements and agree in maintain the pivam sewage dLw sal system with the
sisadards set forth, bcr + as set by the Department of Commerce and the Depmtment of Natural Resources, Sutt of Wiscomsm-
Cuti£fiweon tuning thin ywa septic system his been mamdmad man be completed and rebnmd to the St C1 County Ptavitmg &
Zamng Deparm mt within 30 days of the three year mpm ton d.t
Uws; certify that all narem®m on this form are me to the best of my/or¢ kttow)edge. Uwe amtme the ownerW ofthe
Property described above, by virtue of a warranty deed recorded m Register of Daeds Office.
Number of bedrooms
SIGNATURE OF APPLICANT(S) DATE
... Any information that is misrepresented may rwlt m the —may permit bring revoked by the Planning & Zman Depnmem. "'
Include with this apptiotim a recmded wuramy deed from the Register ofDW& Otbcc amd a copy of the certified surrey nap if
rofbr z is rnak in the warranty dad.
(REV. UM5)
Private OnSFte Waste Treabnent SVstem (POURS) Inspect m Agreettrent
The mne<toperation of theequipmentnoted blewsigrdfinantiymfiu s the fifeoftbewastewatersystem
Palodk inspeotwe: will help extend the fife of the system and prevent the need for costly repairs. The agreement
authodaaaccess to your POWIS ergipnent by a trained and authoriad tedmican, dtahig daylight hours. to
Provide regular inspemoras and mutt me IIIaIm[erarlte to help assure the e*fiPmenf is working properly.
it is hereby agreed by and between Purdasa and Kr u llson Plumbig and Contracting that in radon of the
paymmos Provided for hared., Knu Minn plumbing and contrarling will Provide the services of afanny-trained
mW=w dmtoperformpolodkgutstitheeWWncntd=Obedbidow. KnultanPlumbitgand
Contracting will prepare a written report after each itspectian and provide a ropy ofthe report to the Purchs
This report will contain remmmmdab r for any operation and manterance deemed appropriate by the
Inspector.
ibis agreement does not assume any responsibilities for obligations that are normally the responsibilities of
pbrdaser and dins not emend W rover any mrtstlat may be associate with any mo mmmdatimns made under
this a imewnent In no event shag Kmdtson Plumbing and Contracting be responsible for any spatial n
musequumnal dames, indudiurg but not limited to lass of time, injury to person or property or incidental
eaononicka duetoegugp tfailume fbranyotherreasonwhanoewer. Knudtron Plumbing and Cmtraoig
may apply additional servioess. Parts or labor only after audoriration by Purchaser.
This agreement shalt remain in face for a period of_1_years, beginnig_May. 2020 and w1l
automatically renew each year thereafter foray year anlas canceled by ebber party with at least 30 days wnttrn
noon This agreement may be canceled ere led by the Purchaser only ifreplaced by a servkr agreement with an
authorized service provider forthe equipment listed blow. Knudson PFmnbing and Contramng may delay or
.. future arspectia5 if payment beumng ar least 15 days past due
Pervidchispectaons:Assodatiai agrees to pay Knudtson Plumbing aced Cmnoactitg$_20r1.00 pawl
house's annual impetti n. Any add'ntonal testirg or services required will be ogled on time and material amounts.
EOuipritem Covered Under This Agreaaerrt
Desaipllon
Model tb.
Serial Nis
Irrstafl Dare
Location ff ®t
front system Oise
AT WS Foot or Micro -Fast
Knudtmn Phimhing and Canhactlng
927IS& St. Roberts, Wl54023
651470-1737
System Owner.
Sgmatura f
Date: I
Rolling 41RIs Fior� urners Inj
Print Nacre: CA'F
Suvet
� /'z�vla S�- gyp-
7/
Z 7d
G , S'
tma 14-4, /'mot - e-zwk,
Contractor Gaidetines for ATU Septic Homes
The septic sys0oo for this Lome will depend an the proper funchor ng of the Aerobic Treatment
Unit (ATI I), which is designed to treat and degrade solids prior to discharge into the shared
septic system. As contractor, please observe the following construction guidelines:
As port of design and consbuuchon, arrange for any clear water, including that fitter
condensate lines, sump primps, etc. to go to an eskmal dish. Backwash hum watts
softeners should also be dischm mdernally.
• Garbage disposals are not rem.nmended.
Avoid allowing soy inert construction maUSials such as plastic, rubber, cigarette filters,
bandages, tags, cloth and t5we6 m enter the system Likewise, prevent construction
c lvmwals and torins such as paint and pant thinners, solvents, ew, , fiom entering the
System
. The ATU manubcuaet does not recommend tank installation m fimen ground, and it
will be done only at the contractor's request and risk- Installation under these conditions
will likely also incur added costs related to requiremeuls such as snow removal, frost
nppin& ere.
Fieem wamlow Do not allow water firm fitmace come Lrm yr other sanrrLl,
nKlMbM sinks and toiltt& to Im imo the systeat churn& wiNer POOMW4on. as this can
cause the Mk and comncatents to fim= and feu], Unlike traditional w0c tanks, ATII
tanks are shallow with vertical walls, plus them a no bacterial action at this stage to
generate heat Contractors; failing to observe these psctatoom may be liable for system
repair and/or replacement due to ftm=& Whenever possible, keep interior water lines
turned off during winter until the time of occupancy_
tf the syst® has been used during construction at other times of the year, the tank must
be pumped prim to homeowner occupancy.
For questions regarding obese «atstruction guidelines, call:
Kandtaon Plt®ling and Contracting
651-470-1737
I have reviewed and understand the above guidelines:
combactor Date
Id It
L�ORTANT NOTE
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MAIN LEVEL PLAN PAf#
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QIPORTANT
VOTE.
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FOl1NDATION PLAN
d
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IIIII5�I6I 6 9I6
Tx:4646743
Document Number Document Tide
1123144
SETH PABST
REGISTER OF DEEDS
St. Croix County
AEROBIC UNIT (ATU)
ST. CROIX CO., WI
�TREATMENT
SER cY ICING AGREEMENT
RECEIVED FOR RECORD
02/11/202103:09 PM
EXEMPT #:
REC FEE 30.00
PAGES:1
fate Plan Transaction Number--0?14o)Py5-C
.in, �I vtgSLL�
Name —(Owner)Tvped or printed a
li
He/she is the legal owner of the following parcel afford located in St. Croix CounTy,
11711 _
Wisconsin, with their deed or document ofownership interest recorded as Document
II
Number /103at'i% _ St Crex Register of Deeds Office,
1,
FEB �1 2�21
This Property is described sus follows (include lot no. and subdivision/CSM or detailed
1
legal description);
/�/ 1 ,n �I 1
—Io'4 �i Jy Pl of ea, t�]i i Ps For'" 1✓i !NA 701.,.n r�'
RemNi Area
Vd C L L L 0
11
1l
fte+Wl WeOK1y si Cr-]A 16wvl./ WT.
(
OR
.},gyp/aO�
� (
T/Q.HOYrt 0.'V t:z1r
❑ See attached deed copy for legal descdetonations6!fp
f✓'
c II Zozl
Agreement Date: FC )
DIf3-Zo19- `?S-rx�o
parcel ldenhfienon Number it
As an inducement to the county to issue a sanitary permit for a POWTS equipped with an Aembm "treatment Unit on the above-deacnbed property, we
agree to do the following:
1. Owner agrees to conform to all applicable requirements of SPS 383, Wis. Adm. Code relating to Acrobic Tmatmemt Units (AM and the
maintenance requirements for the proposed POWTS (Provide Onsde Wastewater Treatment System) technology. If the owner fails to have the
POWTS and ATLI properly serviced in response to orders issued by the governmental unit or the Department of Safety and Professional Services
(DSPS) to prevent or abate a human health hazard as described in s 254 59, Stabs., the governmental unit (Town) may enter upon the property
and service the batik or these to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a specral assessment
for... services rendered The charges will be assessed as prescribed by s. 66 0703, Stets_
2 The owner agrees to maintain a contact with a licensed POWTS maintainer for the life of the system The POWTS maintainer will perform
periodic inspections and maintenance as required by the manufacturer and the Department including, but not limited to: the blower, electrical
controls, and Ireatrnent unit operation and sludge depth These inspections are to be scheduled every 6 months for the first two years of operation
and yearly thereafter
3. The owner agrees to concoct the POWTS maintainer immediately upon any malfunction of the neatrment unit and to maintain the unit so as to not
create a human health hazard az described in s 254.59, Stets.
4 The owner recopi es that the county, DSPS, or POWTS maintamer may make periodic mspentons ofthe components to complete performance
monitoring afthe unit.
5. The owner or the owner's agent agrees to report to the department or designated agent at the eomplenon of each inspection, maintenance or
servicing event in a manner specried by the department or designated agent within 10 business days from the date of inspection, maintenance or
servicng
6. This agreement will remain in effect only until the county office responsible for the regulation of -POW fS certifies that the aerobic teaarent unit
no longer serves the property. In addition, this agreement may be cancelled by executing and recording said cemf cation with reference to this
agreement in such manner which will permit the existence of the tern fi cation to he determ lned by reference to the property.
7. This agreement shall be binding upon the owner, the hors ofthe owner, and assignees of the owner The owner shall submit tits agreement to
the Register of Deeds, and the agreement shall be recorded in a manner that will permit the existence of the agreement to be determined by
reference to the property where the Aembic'I'restment Unit is installed
Owner(s) Name(s) -Plcam prior
Subscribed and swum to before on thisdate
1
eme
Notaraed Ownefs Signatuie(s)
NN Public
cU�O
Governmental Unit Official Name,Lde-Please Print
My Commissin
puns
R�
on,
Cwvemmental Unit OtLmal Signature
—
Dmfle by
54 groin
lT� GO
Ca uvr� Comm-, 15
trainer in orommen you pmv,de may ne used for secondary fathoms [Novas, Law s 15.04(IxmJ]
St Croix County 1123144 Page 1 of 1
__an•,
watery-ri in Ijn^:e-1 Dr �.n^Imn.rr RIVATE SEWAGE SYSTEM St Croix
$atery enn �...�iny 4ivn p-
INSPECTIONREPORT an tary Pellon Ne
GENERAL INFORMATION ATTACH •o PERMIT, a•e, a 1 615404
��: -a -_ ..__.... - :e _s.e' ,. .. :cus,l .s. _ta s' '.a •
�.•.!�,-� ,yea,- '�..rsn: V•e•ca O.Y•
Rolling Hills Farm Residential Propertp TOWN OF HAMMOND 018-2019-78-000
_ . �!•,t I L. I� sy 3N Ele. �R.t Cew a..- Secucn.Tn,. wy-ye.Mao Yn
/•� /' / �` �� r .wLt 209 29 29 17 1278
TANK INFORMATION ELEVATION DATA 2.4 /h,M•7• i6S�/• i
TYFi
61 AN 1.1 A;.1 Un-r^^.
Se06o
QJ
_cs '
Aer on
/1 r�
i�
mold ng
57
TANK SETBACK INFORMATION
TA%K TO
I•!T
t%l I -
BI U:1
'vent, n hlr.e
RCAU
Seanc
is
Ac
H olCina
PUMPfSIPHON INFORMATION
ManufactuH!, �I� /1 [aemaqd
',1...
it
k Or l:emai9 Pl y1t, ! 10d .1 r•,1 Li A*11 �'rt
V Z Nl�
SOIL ABSORPTION SYSTEM
STATION
hs /
s. ZZ
r.
F5
1 LTV
165 4.
Henchman
- r
Hltlg Sewer
J
0
SL'H! Intel
i
U• Ink:
9•
S
/ y7.5
DE Bottnm
Last Pp.
4.16
/b
'15.Systc.0
I
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DIMENSIONS
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PIT DIMENSIONS
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INFORMATIONr
CHAMBFR ON
UNIT
sle^A
DISTRIBUTION SYSTEM
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COMMENTS ;nr. tile: rvJrds. e(.wrri.s ur•sonstt •es••id I,, L,;vr,•,on al ;, 1 I IrsfPrnnn a2 S'�J'Q/�y
Location •. :,,;a-<gc A,a .,,: _,. _ 1
1 I All B1A U,•a:r 1)1ion I �0 �� � �-
2 1 Mg suwet length n
amcl, nt A co.er
Plan Teo, pn 11t 1're0., '1,-. ><-
LSe other side tin add'bmil ell Urwat�cc
'sin :.'IVW li
pl c'� C.k_
9 2b ter
In I•s:;.., u' Lena rrrt N�
)01V-a1c 11 _u?1_?
Safety and Buildings Dlvlsxm / „a t Croix
rl 24 L 1' 1 201 W washingkxl Ave, P O Bon 7162 sa„narM1 Paunn Nun
a \ a d WI 53701 7162
(to tm I'll" In 1"{ u)
- Sanitary Pennit Appi�catil („ales 1.,,u u n, N.nrllrl
IR.tiu,LLlalaC"th.14NIg1'tIl1.W.,A3kn,,y<. w6nu..a.�n.dthr.I.gn, u 11m.,tr, ,u,alc ymanma,{al uu,t (f71901125-C
' mynrrd r.rm.-..nod Fr ,K 1, arc art:nm<d ,r I Pow" 1d,lrca l It d lloox t nud,ry; .kk.)
! Ifx 1Pm.. r,a. :::: r.:ti... ., a rM1 .At m_.. 1. u,e4!
.c. u, au.rdacc..nl, tl. l'm.lr. Ln. 14'Af: Mal Nu" �
"ncaues Isrnmatk,n Pkase Priest All Inform■tion 1 61 nd `St_
copede
Proms, I I..ner-< \ones I �— nn (�_ nn Parcel K
- —
�1�; Nt�l, �Cnr� KG6:Q!'d�1;r3C. 018-2019-79-000
11n,.cn. I lvr.r . Mmim. \.l.ln.• � 1 I4i{w r,.i �.,I,. r, � ti.' y.j T
7— Labore Rd
pr l,��� Mi ■ate
rR,:,4no -��G� r'iw sw 29
f• ,rytl.l(1
Vadnals Heights Mn 55110 LZ! �9
IL T)pr of Buildinll tcb" all that npph 1 I "
@I,r'laud,Ihr<Ilnry N.O.ulHedn,.gn. j _�13
`tilrhk,DeesNWIK -- —
Ill,.k y -� Rolling Hills Farm
�Pd•:..,.a.n r,cui 14 rlehel .. ,.�J
❑,ia,r /2:5 C / 1 ,\1 Numlr, ❑ '\ Jlatn .•I
p 15 I ' . "of �11_ Hammond
[ll. 1 %pe of _ (link osh mar M,a onlaw \. (ompietr line P If oppheablel._-- _
A ,
— — r--� t
Ip Vcw ,..ICnI ❑RcPwaurul ,...1rm •LJ lrcatmcM'l6dd+Pp LW Ngxxrrtt<'OI,MI, ❑Ixlr, b- l a,AmF S.a<m l rgIAM,
I •.t 14, • n . P' a Nnnd,cr .1 Date lard
it.it I•rrmr Kerlew ui ❑ Pcrnn M. v.,�m �] (hnCe IIq.nr:hn � El f'o,mn f ranaler e� V.0
141-r.1 Nrxerg IA•xr
—i
1. 1 Apr of PON-1 brrk all that ■pphL,
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14.,y„,od r\ I„n t{algYhlutl Ih.}t,�,i A,ra gwrcd ,.rl Ulyx, �d Arca r, d1c11 M.<rm Ile, W..
lsoo 1 as .io Tsoo toes I1000 3boD 10sa.ao /
Yl.IaskWa 'yr«mnl .aJJ.�2-
.u.nr „
> Sefnlec 100T
250 1250Wieser x
V71. ReaponsiWdih \btrmeal- 1, ,1r
I'I,anlrr . Nanl<IF4,nll bI'lumtxr•. ,r7�rWlurc fur ,ay.11ar.■of III. 14M IN.►waelanbed pb•x7 -OM
- PN, N,md,e, nunoc luw Numl<,
Keith Knudtson 1648443 651-470-1737
Hvntxr, 4d.1,ca l,tn.. , ,*. it..m /,J`1 d<, •~
927 150th St. Roberts Wi 54023 f
A—_
AR,,... cd
2.
Ru-+.I,r lic'W
414)'1lI:':•1 cell n\mt d6 W Me2_c11
y pa.twayemen' *n?'L '�
r lW /Xftth [aloe %:M •.SY.f 1
va
J
18fI-b.vglK 1111,
LOT 47
tiani an c all
For- I.mc Properties LI (
Rolling Hdh Farm ( (utlul 2
Part of the yA% 1 4
Sec. 24 1'29'N-R I'N
T (m n of Ilammood - St. ( roix ( ouoh
6ix me
LO 45
21,781 hl
Drip - sm qoc
25' a, LOT 44
21,781 SC cT
LOT 43
21 781 SC `7
Pate : of
w
OUTLOT 3
c 42.7' ACRES
v 1.8m a59 St] Fl
A As
45 liim��
.r ti
DW-- 0' 1e0C ga* -1 OC - 13X Y R Wf - 12:, t
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8�
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Pr000eW •' SCn 40 PVC. w --�
Axnn D-3m4 PVC Corwove "'Pe . -%-
24626 ,(15287
er.•ioc
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I fry.
-
owl - ecoo wd
N(fi7'D!'d?'W 25285'
1R52.
Wveyn Rd WI: watsln. ssmocR pa
5?5 3en "t"L
8g
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LOT 42
21, W S.Q FT
w
1mr.e,
S07'55:'7-M' 257.77
t (Fil 3
i
LOT 41
21.7111 SO FT
SB9RYt1IN 2e4.3T
LOT 40
21 78' Sv
$B8'11'13'N' 267.61'
LOT 39
? .7 5r
l le%auun Duo
r;
M3.81'
C
1051 75
Pr000eo4 Wien Con ael.
W:P125"R w• Dwku PunpS
w'smd l Sly 10L �Vtt^
1�
Drop ouaa Duplex 2' Sc', 40
P�' Fp2t near
DEUNATED w
YET" -NO .01915 ME AT Ah
APPFICIMATE ELEVAnde Or 100
H.W.L. 1048.8
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SOUTH LINE OF THE N1r OF ME SWl 4
NORTH LINE OF THE SIR OF THE CW114
O� 8M - Top 1 1 4" toon Piet \ N Lof (orne,
GHRP � yam:
ASSU.W.D F.LEV. - 1 tar (41
lop &AT&"
qc5mr. Colic COUNTY NO.
631251
STt'ITE SAT4�ITA1;Y PERMIT
aas i�i ��j
mossm- rt"e_-
PLUMBER
TOWN OF
SEC- 2.q_, T
/OR LOT
THIS PERMIT EXPIRES
PREVIOUS NO.
Lie. a 6�3
N, Rjr_
BLOCK
HUW SUBDIVISION
CHAPTER 145.135 (2) WISCONSIN STATUTES
(a) The purpose of the sanitary permit is to allow installation
of the private sewage system described in the permit.
(b) The approval of the sanitary permit is based on regulations
in force on the date of approvaL
(c) The sanitary permit is valid and may be renewed for a
specified period.
(d) Changed regulations will not impair the validity of a
sanitarypermit
(e) Renewal of the sanitary permit will be based on regulations
in force at the time renewal is sought, and that changed
regulations may impede renewal.
(f) The sanitary permit is transferable.
History: 1977 e. 168; 1979 c. 34,221; 1981 c. 314
Note: If you wish to renew the permit, or transfer ownership of
the permit, please contact the county authority.
AUTHORIZED ISSUING OFFICER - DATE
UNLESS RENEWED BEFORE THAT DATE
POST IN PLAIN VIEW
VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION
SBD-06499 (R. 10/11)