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HomeMy WebLinkAbout032-2018-70-000 , o T k FF © FF ® g \ [ & ƒ o § S = ' m k k mƒ k �§}§ S. ° ;o CD ° ;3 CL 0 CD 0 CD ` � k cr ) e I 2 { § f o § & a) § $ _ ± i A E " _ / � ( � [ § § CD / ( k / \ 2 E a k C. 2 � � � \ 0 0 0 k ; / } ƒ (a )) \ § / /\ if CA � � _ 2 ; . / / 7 0 / g q� $ { A 7 - f § § \ a ° B a = CL ° 2 C 6 )z \ / a i # k \ 0 - w � m d a CL § 2 / z $ m \ k E£ /%E± \ � A E § � a E�(7X (D ,, r § CL2f E M0*M co C ! ƒ22 B= E m t 3 $ a) G-0o E$�» : CD . / . ;a §E o� 0 2 E 00 j 2 E 14 . � \ _o �\ �� �2 � � � Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division ' INSPECTION REPORT Sanitary Permit No: 463210 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: Nagel, Robert Somerset Township 032 - 2018 -70 -000 CST BM Elev: Insp. BM Elev: BM Description: own /Range /Map No: 10,i I /o v D C4& knLaZ Section/T AA 'o 5 05.30.19.538A. TANK INFORMATION I I ELEVATION ATA TYPE MANUFACTURER CAPACIT STATION BS HI FS ELEV. Septic �Vl.! Benchmark /00-o Dosing Alt. BM Aeration Bldg. S er Holding St/Ht Inlet SVH Outle TANK SETBACK INFORMATION G(I TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic , i �/ Dt Bottom z s1e vp-d l qo. ?p Dosin T l , Hoa#edMan. a 7y � p Yv ` �` 7 1 a on Dist. Pipe 7 7� G� 7 q { Holding Bot. System 4 1 ! Final Grade PUMP /SIPHON INFORMATION or, --- /00, Manufacturer Demand St Co GPM Model Number Ul —2-71 (0 L TDH Lift Friction oss System H 7_90 Ft T 12 F a ain L r Dia. ? Dist. to I > 75' SOIL AIASORPTION SYSTEM BED /TRENCH Width f Length _ n, o. Of Trench PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO F BL WEL LAKE /STREAM EACHING Manufa INFORMATION CHAMBER O js IVY IFF T Of System: n U Model Number: �l DI UTION SYSTEM Y (� a Distribution f x Hole Size x Hole Spacing Vent too Aiir Intak ' �Pipe(s) r t `S —�'� 7 (O Dia Length 4 � Dia y Spacing 2Y I i SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only (� Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center /� Bed/Trench Edges Topsoil `7 ]Yes (;; ] No [] Yes H No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: -/ / d Inspection #2: / / Location: 481 180th Avenue Somerset, WI 54025 (NE 1/4 NW 1/4 - 5 T, 3� 0NR19W) NA Lot �Q Parcel No: 05.30.19.538A 1.) Alt BM Description= ��"` S?Z�Z [� ^/SNP J� CE I �J , r ( & 'W 2.) Bldg sewer length =S� - amount of cover �ja _ Plan revision Required? Yes No Z „✓� Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Signature Cert. V Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 ; SCO�S�� Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) ( 608) 2fo De aetrnent of Commerce 26 3 P Sanitary Permit Ap CF�V State Plan I.D. Number In accord with Comm $3.21, Wis. Adm. Code, pe to provide may be used for secondary purposes Privac s m ) Project ddress (if different than mailing address) A/0 1. Application Information - Please Print All Information T. CRO i Property Owner's Name /NG 'I }- ar m B - Property Owner's Mailing Address perry Location T// v� ALL v., ' 61W '/., Section J City, State Zip Code Phone Number Q - _ y 7 2 (circle o) o _ -r y .�� T _30 N; R�E o II. Type of Building (check all that apply) ® 1 or 2 Family Dwelling - Number of Bedrooms 3 Subdivision Name CSM Number ❑ Public/Commercial - Describe Use _ ❑ State Owned - Describe Use ❑City_ ❑Village l�fownship of ER III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A' ❑ New System 4 Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System List Previous Permit Number and Date Issued B. C1 Permit Renewal ❑Permit Revision ❑ Change of ❑Permit Transfer to New j Before Expiration Plumber Owner {! IV. Type of POWTS S stem: Check all that appl *Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter _ t Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: ( 3EL) 1 9 ( 01>11=Fmsdes Design Flow (gpd) Design Soil Application Rate( g sf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) �estem EI ati t VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Wf Cj,y..� T Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit l S Dosing Chamber (� ) VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) P is Signature PRS umber Business Phone Number !S' Plumber's Address (Street, City, State, Zip Code) Ell VIII. County/Department Use Onl Approved ❑ tsappro Sanitary Permit Fee includes Groundwater Date Issued Issui g Agent Signature (No Stamps) d wn Surcharge Fee) -7 i ❑Oer Given RDenial 25d-- •1 7tD _ I IX. Conditions of Approval /Reasons for Disapproval ,_ 1 SYSTEM OWNER: - p� 1 Septictank,effluent `� - dispersal cell must alt serviced I maintained rS as per management plan provided by plumber. � D , a �� 're 2. All setback, requirements rriust be rr)aintained as ,per applicable codelgrilae Attach complete phas (to the County only) for the system on paper not kss than 8112 x 11 inches is size r a z ov sq r r r § SBD 6398(R 01/03) Y'a�` °1 -y�yEy 4 N M ►mmmmm■ , � ®mm�r►� ®� ®mmmr�om ®m�■r� ��►�m��� mmsaooao ®o■ ®ommom ®memmoaaveo�so■�� ®mr� n Li 0��� `n■me■eo■o■000eeoome■���a■a m ®■�000■e�ooaome■o� moo mmmmmmm'� ®e ®e „ mmmmmmmo� e ■�omo�sme■�ovove■e�■ea . ������� ® ® vooam � siseaioemmooa „ va�m■emoo■a■�emeovoo �. �� ��� ��Immmmeemeeo■me■aevevee�s h I0114mmmmME NNE 116 \13 601mmmm■ ■mm■ ROME e=Z= i m ENO 11 1 11 \m11� \mmmmmmm■ 1 \\ X11 \1 \1111111■ " �� ®m ®veoo�m 0 ®0m�■ ®ae■vo0m 1 \ \ ►11�Im \1�1m111 mm0 ®0 ®veoomm mRsl� SI �mmmmmmmmm as ® ®0m ® ®o0�v ��m11m ma�sa ®moo ®m ®m aaaa00aa0 ®o■® m \m \19VIm►1m1►111■ �■ause■meve■ ® ® ©v 2� • maaaavae�oa�ea ® \ ►�11` \!11111111■ aae�saevao ®ve \� \ill 1►�1�11m11m ° s ° a ° s ° a ° a ° aa ° e ° a ° e ° a ° a .,��►.;1 t wo \111■ \'1m It ■ ►\ \11 111 \ WIN1m1► ■ ■1\\O!1 I,0 SOME \ SEWAGEAND DEWATERING 0E� ®tea ®0� MOM • ..MEN ■■■■ ®�m000�i�0�000�0 ®iF�� ®E�0 Ml�l��'sl�mm!!s ® ®� ONE��m.�0 �mm■s m�l,��� :mlal� 0 ®000 0000l�00ml��mlSl�mC7 MEN so 0 on IN - I � i I I �-- _ ' _ 2 -- -� II o Sy i � I I � I I I i - u� i I l i I I I H I ! I r I I I I I I I - - y�y per' VE/Yr Z'NSPEcTr'dw ?IP6F - - - _ - A o V `c �Ull.d r f Y - 3 t- - /f/A 3' --- — -11 S Y S S7 16FI%l FG 97 0 - - ZO7 - - - ® Q _ J ' 9 r ✓7 5 40My NE[CJ 5 YST ,F/"/ E I' r - IYA � z L 1?O13Ck /80 TH U� �'6 VA L E - Vl �z� Vi __ __ - - __ _ _ _.. __ __ -_ __ __ - __ _ __ __ __ __ ___ _ _. _ __ ___ __ _ __ __ __ __ __ I__ _ _ __ __ _ _ _ _ _ __ _ _ - _ _ _ __ __ _ _ _ _ _ _- L_ __ _ _ _ _ _ _ _ _ _ _. __ - -_ __ __ -- - __ _. __ __ __ _____ _ __ _. - - __ - _ _ __ -- __ -- -_ __ __ __ __ __ _ _ __ __ __ ___ - - _ _. _ _ _ _ __ __ -- -_ 1300 Wisconsin Department of Com iTe ., -'-" ` ` EVALUATION REPORT Page 1 of 3 r Division of Safety and Building R � $ F. 6 � � P Tom Schmitt W in accor ante with omm 85, Wis. Adm - code County Va Attach complete sit e plan n paper not le s tt)aafl% ches i size. Plan m f St. Croix include but not limited to: ertical andhor¢ontal = int M direction l )' ParcelI.D. percent slope, scale or di erosions, north arrow, and location and istance to ne Pl se ZUN! Or e ' By Date Personal information you p F( �t "alcy Law, s. 15.04 (1) (m)). zrin Property Owner Property Location Al ' Y Nagel, Robert Govt. Lot NE 1/4 NW 1/4 S 5 T 30 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSWfiX 481 180th Ave. 38.84 Acre Parcel City State Zip Code Phone Number City Village Town Nearest Road Somerset WI 1 54025 715 - 247 - 3477 Somerset 180Th Ave New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe: Parent material Glacial Till Flood plain elevation, if applicable na General comments and recommendations: Area is suitable for a conventional system with a 0.4 gpd/sgft rating. Possible system elevation is 97.0' Slope of area is 4 %. a Boring # Boring Pit Vol Ground Surface elev. 99.60 ft. Depth to limiting factor 96+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1f1 - Eff#1 - Eff#2 1 0 -9 10yr3/3 none sl 2%bk mfr cs 2f .6 1.0 2 9 -18 10yr4/4 none sl 2msbk mfr gw 1f .6 1.0 3 18 -26 10yr5/4 none sl 2csbk mfr gw -- -- .6 1.0 4 2 -82 10yr5/3 none Ifs Icsbk mfr gw -- .5 1.0 5 82 -96 7.5yr4/6 none sl 1 msbk mfr I T4. O Boring # Boring Pit `/ Ground Surface elev. 101.90 ft. Depth to limiting factor 97+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftl *Eff#1 - Eff#2 1 0 -7 10yr3/3 none sl 2msbk mfr as 2f .6 1.0 2 7 -22 7.5yr4/6 none sl 2msbk mfr gw 1f .6 1.0 3 22 -59 7.5yr4/4 none sl 2msbk mfr gw -- .6 1.0 4 59 -97 7.5yr4/4 none sl 1 msbk mfi -- - - -- .4 .7 S - Effluent #1 = BOD 5> 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) Signature: CST Number Thomas J. Schmitt 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 1595 72nd St., New Richmond, WI 54017 9/24/04 715- 247 -2941 Property Owner Nagel, Robert Parcel ID # Page 2 of 3 f 3 ] Boring # Boring Pit .V Ground Surface elev. 100.20 ft. Depth to limiting factor 96+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD *Eff#1 `Eff#2 1 0 -4 10yr3/3 none sl 2fsbk mfr ca 2f .6 1.0 2 4 -16 10yr4/4 none fSl 2msbk mfr gw 1f .4 .8 3 16 -31 7.5yr4/6 none sl 3msbk mfr gw ---- -- .6 1.0 4 3155 7.5yr4/4 none sl 2msbk mfr gw .6 1.0 5 55 -96 7.5yr4/4 none sl 1 msbk mfi -- -- .4 .7 F—I Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP `Eff#1 *Eff#2 F—I Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP *Eff#1 *Eff#2 * Effluent #1 = BOD 5 > 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. Page 3 of 3 Conducted by: Conducted For: Schmitt Soil and Site Evaluations Name: Robert Nagel Thomas J. Schmitt, CST 227429 Address: 481 180th Ave. 1595 72nd St. City, State, Zip: Somerset, Wl. 54025 New Richmond, Wl. 54017 Phone: 715-247-2941 Subd.Name: CSM Lot No.: 38.84 Acres excluding R/W Legal Description: NE1 /4 NWl /4 S5 T30N R19W Township of Somerset Bench Mark EL 100.00' Bottom of siding on walkout wall Alternate Bench Mark EL 1 02.65 ' Bottom of steel on pole shed Slope= 4% Contour Line El. NA Scale I"= 40' e Po \ N� P' \ 4 'ORTH LINE 01 THE NWI /4 . O F SECTION 5 IBOTH _., _ I S 7 °51`03 "W 574.24' - T _ - �66.71 NI / CORNER • I SECTION 5 52.54+ 5W08• a � LCl T / _ u (D I rn 0t CERTIFIED Z I • . S88 "W 300.00' mAP 3 VO =. i7 , I?G. 2763 0 _10 — ° ti HOUSE S O "} GAR Z 01 : m EMI -s i �o 0 W -�I - S87 °51 03 "W 466.7 b z N t iSHED POND Co� o N LJ — ( w O rI N N lI u_ O ° 1 0 a-1 v 38.85 ACRES INC. R /W M z 1,692,090 SO. FT ti 38.84 ACRES EXC. R / W 0 1,691,699 SO. FT. '; 3 ' O w Z f� POND ° w � O U Z U. 0 z� d W 0.48 NORTH OF LINE — + N88 ° F 9'E 1345.24 (S88 ° I5 + O4 „ W ) 1 SOUTH OF LINE I. I �1e ' x I OF I L7 I S IVEI /4 — OUTH LINE OF THE I L _ _ _ I THE NWI /4 OF SECTION 5 ' � 377 -3..� � r .� l ,— rlrr SU��`JC\( ��1Af' R 1 I;_ �D -- -- I V ')L. , PG. 1868 I POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity a l ❑ NA Permit ,/ Septic Tank Manufacturer / ❑ NA t � 27 1 c, DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms 3 ❑ NA Effluent Filter Model j j 4 z ❑ NA Number of Public Facility Units Iff NA Pump Tank Capacity a l ❑ NA Estimated flow (average) 30 0 gal/day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) g al/day Pump Manufacturer zOt _ ❑ NA Soil Application Rate , al /da /ft2 Pump Model ❑ 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 ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended S (TSS 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L & In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510` cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y. in dia. ❑ NA Other: ❑ NA . Other: �10 NA Other: ❑ NA 'Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA i MAINTENANCE SCHEDULE Service Event Service Frequency 0 month Inspect condition of tank(s) At least once every: 3 i ear( ,(s) (Maximum 3 years) ❑ NA 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: ❑ month(s) (Maximum 3 y ears) ❑ NA 3 ■ year(s) Clean effluent filter At least once every: 0 month year (s) l ❑ NA / {s) ® month(s) ❑ NA Inspect pump, pump controls & alarm At least once every: J L: Y ears) ❑ month(s) ■ NA Flush laterals and pressure test At least once every: ❑ year(s) Other. At least once eve 11 month(s) ❑ NA every: ❑ year(s) Other: ❑ NA rcr 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, _3 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, x Wisconsin Administrative Code. r 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 512 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. _ s R 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 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. dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area drive or ark vehicles over tanks and dis P Do not p P 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 structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation 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 DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name o Name p a _ Phone ^' Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name A ale - Name /i t Phone Phone ^: tiv Code. This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrae 3'_.' ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT i AND OWNERSHIP CERTIFICATION FO owner/Buyer Mailing Address 7/ ` Property Address Zg O7,1 (Verification required from Planning Department new cons ction for ) City/State S3M,6F126A T Parcel Identification Number % C�ifi' G� COO �..3 FA) LEGAL DESCRIPTION Property Location '/,, ,4e&_ ' /,, Sec. � T 3t� N -R��W, own of Subdivision Lot # ff/1 Certified Survey Map # , Volume Page # Warranty Deed Volume Page # 3/3 Spec house ❑ yes 2 no Lot lines identifiable N yes ❑ no SYSTEM NANCE Improper use and maintenance of your septic system could result in its prcmatul a failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licAmsed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system- The property owner agrees to submit to St. Croix Zoning Department a ce ication form, signed by the owner and by a _ a system y stem master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that ( ) the on-site wastewater disposal 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 gn undersi ed have read the above requirements and agree to maintain the priv to sewage disposal system with the standards Resources State of Wisconsin. Certification the Department of Natura , herein, as set b the Dc artmcnt of Commerce and p set forth, m, Y P Zonis Office within 3 0 stating that your septictystem has been maintained must be completed and returned to a St. Croix County g days' oTthe three ,vear expiratfgn date. l of SIGNAII UFf.lJ OF APPfICVr17 DATE OV,rNER CERTIFICATION I (we) certifyithat aU statements on this form are true to the best of my (our knowledge. I (we) am (are) the owner(s) of the,pmperty describett above by virtue of a warranty decd recorded in Register of Deeds Office. SIGNA� ? CANT DATE •�ra4 r�" Y P y ,An information that is inns -rc resented may result in the sanitary permit be' g revoked by the Zoning Department. '• Include with this Application: a stamped warranty deed from the Register of Deeds office ; a PY of the r surv f reference is de in the warranty deed co c ccrtif cd Y ma P ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the &13,5 T � "CEL residence located at: �[� 1/,, AIL 0 _W Sec. T ­ 10 N, R Town of ��� St. Croix County, Wisconsin. Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced _4/,E�zpr,�F/t vZaa� Did flow back occur from absorption system? Yes Nom (if no, skip next line. Approximate volume or length of time: gallons minutes Capacity: / ©pp az , Construction: Prefab Concrete tl Steel Other Manufacturer (if known) : Age of Tank (if known) : (Signature)' (Name) Please Print o tzp R S o2 ;-L7 y / (Title) (License Number) (Date) Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank, to the best of my knowledge, will conform to the requirements of ILHR 83, Wis. Adm. Code (except for inspection opening over outlet baffle). Name b� AuIAv Salk / z /' Signature MP /MPRS y, plo. 11•1. Warranty Deed — Common Form (STATE OF WISCONSIN) �I Sea 236.16, Wis. Statutes. FOrID No. 1 Published by Eau Claire Book & Stationery Co. II 3 U 52 G PACE► ' . This hid @Iitilr @� Made this �� � day of Iv1�.1,y A. D., 19 , between ,filbert Parnell and Gertrude larnell, husban(l and wife • part i C bf the first part, and -Robert �a °el and Johanna Nagel, husband and t part i C �)f the second part Mttnr0ttb: That the said part i e s of the first part, for and in consideration of the sum of .One doll��r and. other considerations to us in hand paid by the said part i e s of the second part, the receipt whereof is hereby confessed and acknowledged, h'Yegiven, granted, bargained, sold, remised, released, aliened, conveyed and confirmed, and by these presents do give, grant, bargain, sell, remise, release, alien, convey and confirm unto the said part i (' sof the second part, th eM s' e I v e s, t 1; e i r heirs and assigns forever, the following described real estate, situated in the county of 6t. Oroix and State of Wisconsin, to -wit: The Last ImIf of Northeast cu��r.ter of Z�ortlh -est quarter (E.': of 1 -13- Nli4) of Sectiw 5, ( oWn, ship 30 N 1 9 1j(?St e: c'e )t a . parcel. of 1'.1,110. I in t!1e Northeast Corner ?'7liich is described ^.:_: (ioni'.('ilclTl'* <Lt, tZ'_e vortheaS corner of NE4- of Nhra; ti�ence +Nest 466.7 feet; tloonce Sol 'h ;3?.?3 feet; thence last 466.7 feet; t elicc 933.28 feet to ;loilit irT. I I � This deed is made In. r. snimit (o a laic, con.tr -pct l,et,veen these iwrties and recorded in Vol. 464 ;)acre 508 a.s I I stirUir,eIit ','o. 3019??1. FE11 I' EXEI`, i • 'COQttjtt with all and singular the hereditaments and appurtenances thereunto belonging or in anywise appertaining; and all the estate, right, title, interest, claim, or demand whatsoever, of the said part i e s of the first part, either in law or equity, either in possession or expectancy of, in and to the above bargained premises and their hereditaments and appurtenances. AGO 4?abt anb to 1?O1b, the said premises as above described with the hereditaments and appurtenances, �I unto the said part i e s of the second part, and to th a i. rheirs and assigns FOREVER. AnO the Safb Albert Par_ne.11 and Gertrude P>r.riie)_l, hT.lsba.ild and �4i "e fort 1T e rn s e l- ve s , their heirs, executors and administrators, do convenant, grant, bargain and agree to and with the said part e s of the second part, t11. e i r. heirs and assigns, that at the time of the ensealing and delivery of these presents tIiet- <Lre well seized of the premises above described, as of a good, sure, perfect, absolute and indefeasible estate of inheritance in the law, in fee simple, and that the same are free and clear from all incumbrances whatever, and that the above barganied premises in the quiet and peaceable possession of the said part i i? s of the fl second part, their heirs and assigns, against all and every person or persons, lawfully claiming the whole or any part thereof, t?ley will forever WARRANT and DEFEND. Jn Witntoo (Oberrof, the said part i e s of the first part ha hereunto set their hands and seal s this 28 day of Z' , A. D., 19 Signed and Sealed in Presence of ICU .............. ...... ..:.............. ....................................... .. _ ....._............._._(Seal) '- idler+ 1 ttrnel _.... . _ . .._ ................... ..................t...... .. ._.... _.. - - - .(Seal) e FU (. e T a r n s. .......................... _ ....... ........... _ .... _ ............... .. ........ .. ............ __ 1 ... 1 F bF- � ::...�........._ ... _.._ .._... ...._ .................................._...._........... .._................_...._....._ Lorenz Jolinson Matt of (ifSconoin, ss. .�t. Crow. County.` I` r ., Personally came before me, this day of , A. D., 19 the above named .Llherl; 1', rne].1_ 2Ln(" (r0rtru(!e P,!.rneLl, huSb Mnd o ")CI wife to me known to be the persona who executed the foregoing instrument and 4ckqowledied the same . 11 V ............. ._...._ ......_........................ _.. �� "; ;� �,� Notafy Public, ^?t ... Ci;oix••_••••• County, Wisconsin My commission expires Per. n!<tinentA. D., 19 3`.` °` �ll• V n �iFLrt�, Attorney, iv (?W i'1C1lt'v. �' -�, Viscorls (N.B. —Ch. 59 Wis. 9tats. provides that all instruments to be recorded shall have plainly printed or typewritten thereon the names of the gran- - tors, grantees, witnesses and notary.) .f yF _ i 1 0 ri i ( t` 'b N 1 1 y ON of a, H r i v ` i Q � ~ c N l A Q `b = i ! i i ho G •y V b i s _ r 1 N r-I N a i STATE OF WISCONSIN CIRCUIT C TRT ST. CROIX CO(MPY _- _- _--- --- ---------------------------------- ------------.------- ' IN THE MAT'T'ER OF CORRECTING ' A DESCRIPTION UNDER SEC. 847.07 PETITION WIS. STATS. Now ccm -s Scott R. Needham, of Reinstra, Van DA & Needham, S.C., attorneys for Robert Nagel and Johanna Nagel, husband and wife, and petitions the Court as follows: 1.. That Robert Nay: l cir Jc;hG. �B IVag; �? obta ine•3 t: i tl e to the fellcA.ring deserflxEd jav-siises from Albert Parnell and Ckxtrud, Parnell by Land Contract dated August 28 1970 and recorded SF tE-Inber 3 1970 in Volume "464 ", page 508, Document No. 301981 in the office of the Register of Deeds in and for St. Croix County, Wisconsin. That subsequent thereto, on May 28, 1.971, the said Alert and Gertrude Parnell., 1,y Warranty Deed, corive!ycrl to Rc>tx!rt and Johanna Nagel the following described property, said Warranty rk-- d being recorded .Tune 3, 1971 in Volume "472 ", page 212 as Document No. 305226: The Fast Half of the Northeast Quarter of the Northwest Quarter (Fj of NFj of NWj) of Section Five (5), Township Thirty (30) North, Range Nineteen (19) West, EXCEPT a parcel of land in the Northeast corner which is described as: Ccvn enc:i ng at the Northeast corner of the Northeast Quarter of the Northwest Quarter (NFj of NWT); thence West 466.7 feet; thence South 933.28 feet; thence East 466.7 feet; thence 933.28 feet to point of beginning, St. Croix County, Wisconsin. 2. That there was an error in the description contai.nEx7 in the Land Contract and Warranty Dexsd described in No. 1 herein, and that the correct description should be as follows: The East Half of the North Half. of the Northwest Quarter (F.} of N} of NWj) of Section Five (5), Township Thirty (30) North, Range Nineteen (19) West, FXCT?T a parcel of land in the Northeast corner which is descril - wed as: Ccvimencing at the Northeast corner of the Northeast Quarter of the Northwest Quarter (NET of NWT); thence West 466.7 feet; thence South 933.28 feet; thence East 466.7 feet; thence 933.28 feet to point of beginning, St. Croix County, Wisconsin. 3. That petitioner has reviewed the original handwritten notes of William W. Ward, the attorney who prepared the Land Contract and Warranty Deed from Parnells to Nagels; the recorded Land Contract and Warranty Deed from Parnells to Nagels. 4. That petitiorwr has also re:vie wxl a Warrwity N*d fr(ni Albert Parnell and Gertrude Parnell to Richard H. Jonk and Karen A. Jonk, dated Septt:nber 24, 1973, recorded October 2, 1973 in Volimm! "503 ", page 549 as Doctunent. No. 318785 for the following described Premises: The WF,st Half of the North Half: of the Northwest Quarter M of N} of hwj) of Section Five (5), Township Thirty (30) North, Range NinE!te4.!n (19) West, EXCEPT that part lying Northerly of a line that is Southerly o£, parallel with and 141 feet distant frcm the centerline of the main track of the Wisconsin Central Railway Company, subject to 50% interest in and to the oil, gas and other minerals:, St. Croix County, Wisconsin. 5. That. a portion of the real estate: tax stat:&rent for 1971 and subsequent years came in the name of Aibert Parnell. 7;iF iu.:3e= rsi�l;�- is. informed that Albert Parnell informed Robert and Johanna Nagel. that he no longer corned any property in the North Half of the Northwest Quarter (NJ of NWJ) of Section. Five (5), Township Thirty (30) North, Range Nineteen (7.9) West, St. Croy County, Wisconsin, and that the tax statement was for Nagcil.s' property. That Nagels paid the real estate taxes in 1971 and thereafter for the entire Fast Half of the North Half of the Northwest Quarter= (F}_ - -of NJ of NWJ) of said Section Five (5), F.XC W parcel excepted from their description. That Albert Parnell., in a subsequent year, had the county clerk and tax lister change the name on the parcel to Robert and Johanna Nagel: However, no quit claim deed was ever Executed by Albert and e- extrude Parnell to correct the Error in the description. That the Parnells are now deceased, and cannot correct the &-sc:ri.ption. Copies of the death certificates for Alhext and Gertrude Parnell are attached hereto for reference:. 6. That the sale price of the Jonk property was $7,650.00 for 51 acres, and that the sale price of the Nagel property was $6,150.00 for 41 acres, which amounted to the $150.00 pPx acre sale price for both parcels. That the erroneous description rnntained in the deed to Nagels was 20 acres, rather than 41 acres, and the exception contained in the Nagel description is not includEK3 in the Jonk description. 7. That copies of the hand written notes of William W. Ward., the Nagel Land Contract and Warranty Deed and the Jonk Warranty Deed are attached hereto for reference. 8. That the descriptions contained in the above referenced Land Contract and Warranty Deed from Al1:x-�rt and (,extrude Parnell to Robert and Johanna Nagel are clearly erroneous in that they do not include the entire parcel. intended to be conveyed to Nagels, on which Nagel have been paying the real estate taxes since the date of purchase, and is correctly described as follows: The Fast Half of the North Half of the Northwest Quarter (Fi of N} of NW}) of Section Five (5) , Township Thirty (30) North, Range Nineteen (19) West, EXC1W a parcel. of lard in the Northeast corner which is described as: Camencing at the Northeast corner of the Northeasts Quarter of the" Northwest Quarter (NE} of NWI); thence West 466.7 feet; thence South 933.28 feet; thence East 466.7 feet; thence 933.28 feet to point of beginning, St. Croix County, Wisconsin. 9. That the Grantees, Robert Nagel and Johanna Nagel, husbajxj aixl wife, their succo sors and assigns, have )xx in exclusive use and owne:rshiV of said prendses; hav(- held said property openly, notoriously, continuously, and uninterruptedly since August 28, 1970; have made substantial improvements to the property including the construction of the have and accessory buildings; and, have paid the real estate taxes on said promises since 1971. 10. That the undersigned is an attorney adroittvd to practice law in the State of Wisconsin and is familiar with real estate descriptions and other real estate matters. Further, the undersigned has reviewed the records at the Register of Deeds office for St. Croix County, the deeds of conveyance, the abstract of title, tax listing descri pt.i ons, and surveys of the area. Also, the: undersigned has interviewed and discussed this matter with thz: title h.:lder� WHhRFT'ORF, Petitioner prays that the Court issue its order, pursu- ant to Sec. 847.07 of the Wisco nsin Statutes correcting the description of the premises conveyed by AJlx-rt Parnell and Gertrude Parnell to Robert Nagel and Johanna. Nagel, husband and wife, to the description shown at No. 8 above. Scott R. Needham ___• STATE OF WISCONSIN ) ) SS. ST. CROIX COUNTY ) Scott R. Needham, being first duly sworn on oath, deposes and states that he is the petitioner in the foregoing Petition; that he has read the foregoing, and knows . the contents thereof, and that the same are true to the best of his knowledge and belief. Scott R. Needh� - -- - - -- - ^- -- - - - Subscribed and sworn to before me this day of March, 1994. --- - - - - - --- - - - - - - - - - --tic St. Croix County, Wisconsin Carmission F- spires: Drafted by: Reinstra, Van Dyk & Needham, S.C. 201 South Knowles Avenue, Box 127 New Richmond, WI 54017 r / ' &•� Ve . D I P STATE OF WISCONSIN CIRCUIT COURT ST• ' wa `eLiatir--v� - -ma IN' THE MATTER OF' OORRDCTING A DESCRIP'T'ION UNDER SEC. 847.07 ORDER CORRECTING DES � WIS STATS � _ -- ___. ------ -------- _--- __�_�_____ Oil Upon reading and filing the Petition of Scott R. Needham of Reinstra, Van k & Needham S.C. Dy , attorney for Robert Nagel and Johatma r?a — husband and wife, to corrects the description in that certain Land Contract and Warranty Deed from Albert Parnell and Gertrude Parnell to Robert Nagel and Johanna Nagel, husband and wife, and the C being fully advised in the premises, that the Grantor, Albert Parnell died April 19, 1985 and that the Grantor, Gertrude Parnell, died February 3, 1986, and that the Grantees, their successors and assigns, have been in exclusive use and ownership of said premises have held said property openly, notoriously, continuously, and uninterruptedly since August 28, 1970; have made substantial improvements to the property including the construction of their home and accessory buildings; and, have paid the real estate taxes on said premises since 1971. IT IS HEREBY ORDERED that pursuant to Sec. 847.07 of the Wisconsin Statutes the description contained in that certain Land Contract dated August 28, 1970, recorded September 3, 1970 in Volume "464 ", page 508 as Document No. 301981, and that certain Warranty Deed dated May 28, 1971 and recorded June 3, 1971 in Volume "472 ", page 212 as Document No. 305226, from Albert Parnell and Gertrude Parnell, husband and wife, to Robert Nagel and Johanna Nagel, husband and wife, are hereby corrected to read as follows: The East Half of the North Half of the Northwest Quarter (Ei of N1 of NW}) of Section Five (5), Township Thirty (30) North, Range Nineteen (19) 6 -:Qst, EXCEPT a parcel of laid in the Northeast corner which is described as: Ccnw- -ncing at the Northeast corner of the Northeast Quarter of the Northwest Quarter (NEI of NW}); thence West 466.7 feet; thence South 933.28 feet; thence East 466.7 feet; thence 933.28 feet to Point of beginning, St. Croix County, Wisconsin. Dated this / 4 '^- day of March, 1994. _ of Wisconsin ,:,;iflty of St. Croix < ;lc .ereby certify that this document is a full f... n,o and correct CON of th original o , and of rocord in my of and ha F J, eII, Circuit Judge ;ompared by me. v ti St. Croix County, Wisconsin Attest day of MAP 17'lr fvi �'� Lori N. f • D o N Clerk o N. Mey moo• 180 ; , -- , , .; AVE NUE THE NWI /4 O F SECT 5 _ RTH LINE OF = f . Te 15'03 , M1 57 S8 $87 "W , . 'r- " w - y66.T 1 NVcI CORNER 2 SECTION 5 ` 52.54 F f LOT I (D (D - -- - io O a) ,� / `o CERTIFIED to o n to p I ` Z I 88 S°55'58 "W rAAP N f VOL. 10 _2763 71 c O in — (D — d' M ' aD HOUSE a Z GARAGE CD (,�)1 L']i —I io jI 0 1 � 3„W% 466:70 . y`....r ✓r- P., �..... 587540 f � SHED ! POND N C]� o N UJI O '+ , N O JI ° Q 0--I 38.85 ACRES INC. R/W 7 - I Z 1,692,090 SQ. FT._ r• 38.84 ACRES EXC. R / W` U. _1,691,699 SO. FT. Z POND ? +� 1 - �t Z o . ,i Z 4 3 0,48 NORTH OF LINE r� ir +� as1t, 1 _--- ui N88 °Il`59 "E 1345:24` cssa °1�'o4 "w1 k 1.4a' SOUTH AE NW 1/4 OF OF. LINE' C , �. )UH LINE OF. THE NEI /4 OF T SECTION .5 — I I t� ! , PG. �� �F