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HomeMy WebLinkAbout032-2158-70-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Buik;itg Division INSPECTION REPORT Sanitary Permit No: 430113 0 GENERAn 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: Oberme er, Dean I Somerset Township 032 - 2158 -70 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: L i$ , I a> e- o , " tt 09.30.19.1367 TANK INFORMATION ILEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark ©L L Dosing Alt. BM C 2 U . hL_ l,/ o Aeration Bldg. Sewer Holding _ _ St1Ht Inlet 14 It 6 1 / TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic / / Dt Bottom z' to 3 a _ Dosing Header /Man. Aeration Dist. Pipe it it �.7Z Holding Bot. System Final Grade PUMP /SIPHON INFORMATION p 0-11 3' be L3 li `,, I ,1— Manufacturer Demand St Cover &CFL GPM 1 - 91,/D Model Number SoL to I o S ) . r, ,! S _ f �'t to.-n— 4 L' Y TDH Lift Friction Loss System Head TDH Ft 3 ,Z y Forcemain Length Dia. Dist. to Well tai+ 7•'7z- °S. Jf Z >7 IG o .S 5 5 SOIL ABSORPTION SYSTEM M� Z BED /TRENCH Zidth Length No. Of T4awhes.S [e C L S IT DIMENSIONS No. Of Pis I - Inside Dia. /, Liquid Depth l ae— DIMENSIONS S� 3 - 10' k� -�� Fs 12,45 v. SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer. ' INFORMATION CHAMBER OR E Z Type Of S UNIT Model Number: C on DISTRIBUTION SYSTEM Header /Manifold Distributi x Hole Size x Hole Spacing Vent to Air Intake L // f Length .5s Dia Length Dia (,_ Spacing 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 Cente ench Edges Topsoil Yes , ,] No 4 iI Yes No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: 10 / C /0. I z e Location: 1674 56th St Somerset, WI 54025 (NW 1/4 NE 1/4 9 T30N R19W) Roy Ridge Lot 7 Parcel No: 09.30.19.1367 1.) Alt BM Description = 4 0 (" i '� , Y_ (�C -3 1 2.) Bldg sewer length = 3 - amount of cover Plan revision Re uired? � ' II�D_— Use other side for additional information Yes I No D ate Ins Actor's Signature Cert. No. /\ v v_ SBD -6710 (R.3/97) L FROM : Schumaker Plumbinq FAX NO. 7153863121 Jun. 25 2003 11:59AM P1 � L , u�v je AA, a �5 5 S?6Ad P -bays - ,� ✓oF � gG9.3'a .A1 i ,.` 4 7: ,r• �6a( a / AD I Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 .� C�/� 1����,n Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) De artment o f Commerce (608) 266 -3151 ` 3O 1 State Plan I.D. Number Sanitary Permit Application In accord with Comm 83.21, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, s15.040)(m) Project Address (if different than mailing address) I. Application Information - Please Print All Inform on Kit 6 E� V f ED J�� 5 � • Property Owner's Na me R��Y Parcel # Lot N Block M e V e e 2003 ;7 Property Owner's M ailing Address ST CF�OI,, roperty Location ZONIN co" GuN7Y -"—l; OFFICE r i _ a,?4,Section City, State Zip Code Phone Number ' , /� / S � (circle o T N; R II. Type of Butilding (check all that apply) --J4 - e CSM Number or Y -1 or 2 Family Dwelling - Number of Bedrooms ab S rr Su Name [3 Public /Commercig7 - Describe Use Cit ❑vilia a owns i o ❑State Owned - Describe Use ( ❑ y_ 54ugg _ M. Type of Permit: (Check only one box on line A. 'Complete line B if a"p�lp ica le) 32 - zi "� — �uD • �� A. K NOW System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Tye of POWTS S stem: (Che all that apply) Q,Non - Pressurized in- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ ecirculating • d ' ter ❑ Recirculating Synthetic Media Filter Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) ti ^s .Sa' V. Dis ersaireatment Area Information: '' Design Plow (&pd) I Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) Sy to 7mm Elevatlo 11 - 6 a S`� Ila S Vi. Tank Into Capacity in Total Number Manufacturer Prefab Site Steel Fiber 1 Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank f "red ZV '-e e- r AC Aerobic Treatment Unit Dosing Chamber V / d A, � ' es „e y VII:'Responsibility Statement 1:, tht' ed, assume responsibility Par allation of the POWTS shown on the attached plans. Plumber's Na me (Print) Plumber's Si &nature M IMPRS Number Business Phone Number el Plumber'ss Addre ss (Street, City, State, Zip Code) Cf G%dZ� z- 4 VII[. CouAt /De tment Use Onl KAppraved Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) �S _ ❑ Owner Given Reason for Denial l IX. Conditions of Approval/Reasons for Disapproval ryeVw . .- b-e 1 4 ,.. cE vc✓��. sit S v�Cf h co p� let epleas W the County i for th system n per n 1 � 81 - (Z , x it inc sin size SOD-63 X 01103 r FROM : Sckumaker Plumbinq FAX NO. 7153863121 / Jun. 25 2003 11:59AM P1 d iy9 d�Cl► ��7 d L/ �LY�' .U� - v hou u Y' P. 7 F 1 -3 x i /,? -0 oe �GS 39G�6..•6eys ��'�G o 14 �1►zO�� g3 4-w L = cl o © 0 ' Wrsdor►rn o "` SO EVALUATION REPORT p f of 3 alts t�vision d Y 85f yam, pft, code Cau* c ; qtt ails pion paper not less inch then 8 U2 x 11 es to oh W _ om en afld I.D. L j not �'rllbd Rh YerfiCBl � �RA�LW am i� �� /, r . lord /y� nom s o {� and dtsteehce nesalSt road. , 11A �f'MU f a�M R7YY�wA� by` MOSM u �R Persard idamaean tar prrrlds arlr tar. a 75.04 (t) (m33. prapertylocatlon pmpwtyowfw f e w cs t N 0 4 2003 Govt. L ot 1 u< S T N R �(o Propert , g Lott # �S CS1utF ST, C�UIX CUUN Y T . Eoy State ❑ �l ViNage ❑ Town Nearest Road $2 New construction tim ® ResidenNat / Nheaber of bedrooms ...3._. _41 - Code aid design flow rate N4Z / l O o GPD 13 Repleownent ❑ Pubic or commavi - D esmkw N I ✓f R 1, er Flood Plain g e'l I e a # ® Pit Ground surface ew ' �d it. Depth to inhltlng factor in. Sol RMe ._ Hon mn 1) mi: Donan color Redoc Description Texbae Sbudure Consistallve Boundary Roots geow in. m resell flu. Sz.:Cont. Color Gr. Sz. Sh. `Ei�1 •Ef(#2 0 -1 ►o 3 - SL. sb C v S �L bk C5 - -� Z - x3 0 `" 1 a pt Ground surface elev. g ____ ft. Depth 10, baking ftclor -R --=— lo- Sub Rata Roots GPDNF Horizon Depth Dan6rant Color Redox peo *dm Texture Sbucdxa Cor�ence 8otendar), 1 0 k cc,✓ K- Ayj 3I r!s�Jak — X J • Eguent #1 =809 > 30 220 mg& end 783 >30 < 150 mgit. • E*Am t 32.= 80D <_ 30 mglL.end TSS _< 30 rrgiL csT Name (Please P �4,.��' 25 CST Water 3 Address D� Evaluation conducted Telephone #lumber v3 � 7� ) 2`f 7 - '4 0,6 9 P Ovrs�er �� �� a Parcel A� K _ Page d Pmpe►iy 9-m g1 o ftft b bclor_..? _L� Rafe (`,rood surfaoedev. gG,3 � Roots GPt?!� I DomU�ent R�edooc Desafplton Texbtrr+e Sbu�e ComieMnoe Boundary �' �� Floifaon Depth Gr. St Sh. Pa �. �� Llu. SL honk Calor � 0 ,d / I 0 4 El # a � iCs►aundsu�aCeeiev. R Dsp&biinifhg Rge a Pit' Horiaon D"% Dan�irant Red= Dsecrfp W TOW" Sbuduio Comdata Bourdwy Rails . GPDAF � q/ Liu. SL Conk COW Gr. SL Sh. F -I owklg # Q Ground mdaes dw fL b ine0 S %CkW in. pit Saif ApplppPM Rate Hoftm osPN Day k=* (red-;n Tabora $Uudme Cmaiswm Bam lwy Rook b munsol Liu. Sz. Cant. CAW Gr. SL Sh. 'Ef0F1 •EtTd2 • E*m t #i a Bpp 30 c 220 wq& wd TSS 3100:1150 MOL Gtpuerd#2 = 8W,:_ 30 uq& wd TSS <_ 301ng1L The Depecanent of Comnum is an eqW opponoft setvim P'm~ end cm fb>or. if rm aced assbteme to accM 5""c" OT need MaUVW in as alsanW fon=*, pkm aoWet the d at 608- M&3151 or TfY 6W2644M. seno»�e.rrwe� I PAGEaOFa NAME: Jo h YISo ✓\ LOT# LEGAL DESCRIPTION :_1 /4____1/4,S_T_,N,R, E(or)W SCALE: 1 yo f ELEVATION: 160 BM I DESCRIPTION: o .�P Du' O BM 2 ELEVATION: BM 2 DESCRIPTION: 4 ak SYSTEM ELEVATION: e{5. Sa t�we `ly S � SYSTEM TYPE: fit I � 6 { l � -i 2 �o lit SIGNATURE: ,/.4 DATE: 3 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page __L or 'FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity ga l 0 NA Permit # 3 p (3 Septic Tank Manufacturer DNA DESIGN PARAMETERS Effluent Filter Manufacturer AX6.4 e ❑ NA Number of Bedrooms D NA Effluent Filter Model dd ❑ NA Number of Public Facility Units D NA Pump Tank Capacity gal 13 NA Estimated flow (average) if SD g al/day Pump Tank Manufacturer fe ❑ NA Design flow (peak), (Estimated x 1.5) T4 g al/day Pump Manufacturer � D NA Soil Application Rate al /da /ft' Pump Model ❑ NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit D NA Fats, Oil & Grease (FOG) 530 mg /L O Sand /Gravel Filter 0 Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L 0 NA ❑ Mechanical Aeration D Wetland Total Suspended Solids (TSS) &150 mg /L 0 Disinfection D Other: Pretreated Effluent Quality Monthly average Dispersal Collis) DNA Biochemical Oxygen Demand (BOD 530 mg /L q In- Ground (gravity) D In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ NA O At -Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /1O0m1 0 Drip -Line D Other: Maximum Effluent Particle Size Y in die. ❑ NA other' fl NA Other: D NA Other: ❑ NA "Values typical for domestic wastewater and septic tank effluent. Other: D NA MAINTENANCE SCHEDULE Service Event Service Frequency months (Maximum 3 years) D NA Inspect condition of tank(s) At least once every: J ear a! Pump out contents of tank(s) When combined sludge and scum equals one -third %) of tank volume D NA monthis) (Maximum 3 years) 0 NA Inspect dispersal call(s) At least once every: 3 Ryearlsl 4 m , onthis) D NA Clean effluent filter At least once every: A arls) nth(s) ❑ NA Inspect pump, pump controls & alarm At least once every: D yearW ❑ monthis) ❑ NA Flush laterals and pressure test At least once every: ❑ Y ear(s) month(s) ❑ NA Other: At least once every: Q year(s) Other. 0 NA I MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized gomponents, 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. 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 rsal cell ;sl. if high concentrations are dete that may impede the treatment process and /or damage the disper�ted hive 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 call(s) and may result in the backup or surface discharge of effluent. To avoid this. situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or at disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. the Reduction or elimination of the following from the wastewater stream may improve the performance and prolon disi t lif a o fa POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; 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 compl(ance 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 Sep tags Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space fiiled 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: 14?V 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. 13 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. VJT site • The A it tank rift e • Mound and at - grade soil absorption systems m ay bmreconstructed m Ywith in at that time, the biomat at the infiltrative surface. Reconstructions of such sy < < WARNING > > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER / Na Name `J `l.'GC .as-� yr r. Q 10. N Phone 7 a _ �Q „Z Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY CROK Name Name It—. Phone Phone This document was drafted in compliance with chapter Comm 83.22(2)Ib)(1)(dl &(fl and 83.5411), (2) & (3), Wisconsin Administrative Code. l ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM e cr 0,b � e e—Y Owner/Buyer � � � Mailing Address 1 1 .,LJI ° c -0/ w-e— Property Address 7 (Verification required from Planning Department for new construction) City /State Parcel Identification Number . LEGAL DESCRIPTION Property Location tLk /4, , 4 /,, Sec. . T Yd N -R /V W, Town of _ 4,- -e .9e Subdivision N t Lot # Certified Survey Map # , Volume . Page # Warranty Deed # BOO �,r , Volume Mo . Page # Spec house ❑ yes/Q( no Lot lines identifiable yes ❑ no SYSTEM MAINTENANCE 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. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mastcr 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. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of t4a7threc year exp' 'on date. J J / SIGNATURE OF APPLIC DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the pro described a ve,,-by virtue of a warran ty g deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT DATE ••`••• Any information that is mis- represented'may result in the sanitary permit being revoked by the Zoning Department. `•• «" ' •• Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed I I r 2 70 6� I gs I h� I ,�h'll �1nz 8o �4. s >' i µ S, x ¢ aL b SEPTIC TANK & PUMP CHAMBER CROSS SECT:ON SPECIFICATIONS 4" CI VENT PIPE 12" MIN- ABOVE GRADE a WEATHERPROOF APPROVED 25' FROM DOOR, WINDOW OR WITH CONDUIT MANHOLE COVER FRESH AIR INTAKE W1 PADLOCK & FINISHED GRADE WARNING LABEL 7 - 4" CI RISER .__._ 4" M 18" IN. 6" MAX. :•� ' NLET 1 � GAS - WATER TIGHT SEALS TIGHT � A SEAL + JOINTSWITH ALM APPROVED PIPE a PP ROVED B t ON 3' ONTO x I PE 3' `i"' SOLID SOIL. NTO SOLID C ' RISER EXIT OIL PUMP OFF ELEV . FT. OFF PERMITTED ONLY D IF TANK MANUFACTURER HAS APPROVAL t 3" APPROVED_ BEDDING UNDER TANK CONCRE'T'E PAD SPECIFICATIONS SEPTIC / DOSE NUMBER DOSES PER DAY: TANK MANUFACTURER: TANK SIZES SEPTIC _Z GAL. DOSE VOLUME INCLUDING 1 GAL DOSE •,•,•,' GAL• FLOWBACK: ALARM MANUFACTURER: �$I CAPACITIES: A = INCHES 2 GAL. MODEL NUMBER: B 2 INCHES = GAL. SWITCH TYPE: � i PUMP MANUFACTURER 4. is o v5 �r.C' G = S INCHES =GAL MODEL NUMBER: ,c'j © 4/ -- . D = INCHES = _GAL SWITCH TYPE: AW-Oy REQUIRED DISCHARGE RATE M !�&_ GPM PUMP & ALARM WIRING AS PER ILHR 15.23 WAC ,2 ' FEET Ib. VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIP£ • FEET + MINIMUM NETWORK SUPPLY PRESSURE FEETSI + FEET FORCEMAIN X e= F T1xoo F TOTAL I DYNAMIC A HEAD • -• FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTHH ,�••_ �; WIDTH.� DIAMETER DATE: LICENSE NUMBER 1/88 10/20/2000 14:16 17154256864 WEGERER SOIL TESTING PAGE 07 Goulds Submersible �- Effluent Pump r, . EPO4 3871 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housinr. Cast iron Specifically designed for the Stainless steel. grade turbine oil for for o iclent heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer, t Motor Carer: Thermoplas- • Homes components. tic cover with integral handle Motor manal to automatic and and float switch attachment •Farms mama! o peration. Automatic + EPO4 Sin p hase: 0.4 HP, •Heavy duty sump 11 or 230 V, 60 Hz, 1550 made Include MaaheAloel points. • Water transfer Float Switch assembled end ■ Power Cable: Severe duty • tiewaterirtg RPM, built in overload with preset at the factory. rated al and water resistant_ automatic reset. a Bearings: Upper and lower SPECIFICATIONS * EP05 S.ngle phase: 0.5 HP, FEATURES heavy duty ball b sAng 115 V, ti Hz. 1550 RPM, construction. Pump: "M built in. overload Vft m EPM Impeller: Thermo- Solids handling capability: automahu meet plastic Ssmi-open design AGENCY 11.11111111118111 '!4" maximum. • Power cord: 10 foot with pump out vanes for ,. — • Capacities: up to 55 GPM. standard length, 1613 SJTO mechanical seal protection. g. c=WW $W AUDOWN _ i tai heads: up to 24 feet. with throe prong grounding o EPOS impeller: Thermo- • Mectttani� seal: carbon- length,10 �S,11W with plastic enclosed design for ( � in l isted r or model numbers rotarykeramic- stationary, three praig grounding plug improved performance. BUNA•N elastomers. (standard on EP05). a Casino i w design R av • Temperature: p provides 104 °F (40°C) continuous superior strength and 140°F (WC) Intermttem. corrosion resistance. • Fasteners: 300 series LWTMS FEET stainless steel. 10 • Capable of running dry without damage to s 30 �;;.•, s components. i• Pump: am e • Solids handling capability: Q 25 l �i maximum. • Capacities: up to 60 GPM, a 20 ! • Total ham: up to 31 feet. ' • Discharge size, I W NPT. g • Mechanical seas: carbon- 16 rotary /ceramic- staticxtary, 4 BUNA•N elastamers. a • amperatura: continuous a T 10 104•F 40 °C) 140 °F �80°C) intermittent. 2 s 00 10 20 30 40 _ 50 GPM 0 2 4 6 a td 12 Ofh CAPACITY Wisconsin Department of Commerce SOIL EVALUATION REPORT Page ` of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County (fr0/ Attach complete site plan on paper not less than 8 112 x 11 i include, but not limited to: vertical and horizontal reference p int (Bw �f lDp t n Parcel LD. percent slope, scale or dimensions, north arrow, and locatio and di n t e oad. Please print all informatior. Reviewed by Date � l� Personal information you provide may be used for secondary purpos s (Priva 1 1.O TITn )). Property Owner ST. CR cation IA►'1 A/ ZONI I E 1/4 u 1/4 S 9 T 3U N R E (or)CO Property Owner's Mailing Address j Lot # Block # Subd. Nne or C M# If) 33 . q fu p/ een 7 City State Zip Code Phone Number ❑ City ❑ Village ® T wn 0 Nearest Road Pr f a is c✓( TYaZ.Z I (7 1S - 98.31 1 Sa r /70 C" ® New Construction Use: (3 Residential / Number of bedrooms 3 - y Code derived design flow rate O d GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material r ; I 1 // Flood Plain elevation if applicable General comments S y S��v►� e{ Q U /00. and recommendations: Ud F Boring # E] Boring ® pit Ground surface elev. 6 ft. Depth to limiting factor Z� in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 I 'Eff#2 Z 2 lI -29 1 -1 Iq ,Sic! 21m5 6k mfr S - 4 � 3 10 r31(o Scl 2rr) bk ry-yPr — — 1-1 4, Boring # ❑ Boring ® Pit Ground surface elev. /0 3 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 ! o -( i0. IZ 51 Zry-,� ' c 5 ( VP z (O — . i ci msb c — y 4 1 co S.I - - 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 (Piease Print) Signature CST Number ds3 a Address Date Evaluation Conducted Telephone Number - 7 - X ff SSD -833n (P07700) p Page of Property Owner v Parcel ID # Q Boring # Borin p U V � Ground surface elev. / �/ 1 ft . Depth to limiting factor 3 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 511 ZrV w4, M Vr c g Z I( -33 I I'4 -- s c1 Z rrisbk c s — y -(0 3 33 -91 l v (o Z 1 .5 `f (V 5C Z rV15bk. Boring # ❑ Boring a ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff42 ❑ ❑ Boring # Boring Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg1L ' Effluent #2 = BOD < 30 mg1L and TSS < 30 mg1L 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.07 100) 3 a property Owner 1\ haaelo Parcel ID # Page 2 of 3 E Boring # [] Borin [j —Pit Ground surface elev. �' ft. Depth to limiting factor 3 in. Soi Application Rate Horizon Depth Dominant Color Redox Description Texture q Boundary Roots .E GPD� E in. Munsell Qu. Sz. Cont Color 0- t I 10 3l2 — 5 i r c S I -J i j - 33 iD /4 c s El a Boring # ❑ Bering ❑ pit Ground surface elev. ft Depth to limiting factor in. Soli Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 'Eff#1 PD/ft Eft#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ❑ Boring Bor # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate El Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftt in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Etf#1 'EtT#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mglL 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 - 2648777. M -11130 (R07100) r I PAGE 3 OF 3 II NAME /t 1'\ LOT# l LEGAL DESCRIPTIONk' - j f ,UC % ,S R T-36 ,N,R_, 11 E( r SCALE.: I"= 7 ' BM I ELEVATION 10 6 a BM 1 DESCRIPTION 4 a� 1 1iL. �- � BM 2 ELEVATION Qq 3C= BM 2 DESCRIPTION DUB SYSTEM ELEVATION Z , O ALTERNATE ELEVATION Al 1j CONTOUR ELEVATION elf, c / Bml g - z SIGNATURE ,_- �� _ DATE J 19101' 590 ` STATE BAR OF WISCONSIN FORM 2. 1999 6 8 1 A 1Z 5 Document Number WARRANTY DEED KATHLEEN OF DEEDS ST. CROIX CO., VI This Deed, made between Jame D. Henry and A C, N yhage n RECEIVED FOR RECORD 06 - 17 -2002 8t30 AN i1RRWIM DEED Grantor, and Glen Johnson Construction, Inc., a Minnesota EXEWT i C orpora t ion, '— _ ._ REC FEE: 13.00 TRANS FEEL 960.00 _ COPY FEE: Grantee. — CERT COPY FEE: Grantor, for a valuable consideration, conveys to Grantee the PAGES t 2 following described real estate in St. Cr _ County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area (See Attached Exhibit "A ") Name and Return Address r u✓.� > y7sl Pt 032-2 _ Parcel ldentiftcation Number (PIN) This — is not homestead property. PEl (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of Jun 2002 t AllenC. r gen _ AUTHENTICATION ACKNOWLEDGMENT Signature(s) James D. H enry and Alle C. Nyhagen STATE OF WISCONSIN ) ) ss. County) authenticated this) da of June 2002 Personally carne before me this _day of the above named ristina gland TITLE: MEMBER STATE BAR OF WISCONSIN - (If not, to me known to be the person(s) who executed the foregoing - -- instrument and acknowledged the same. authorized by 0 706.06, W is. Slats ) THIS INSTRUMENT WAS DRAFTED BY • _ Attorney Kristina Ogland Notary Public, State of Wisconsin H udson , W 1 S4 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) - , .._ . _._ _ ) *Names of persons signing in any capacity must be typed or printed below their signature. information Pretasionsa c ompan y. Fwd du Lac. wr STATE BAR OF WISCONSIN WO-MS - 2021 WARRANTY DEED FORM No. 2 -1999 J 1917' 591 EXHIBIT "A" Lot 1 of the Plat of Roy Ridge Estates excepting the following: Commencing the Southwest comer of Lot 1 of the Plat of Roy Ridge Estates; thence S89 1'44"E 221.13 feet along the South line of said Lot 1 to the point of beginning; thence S89 1'44'E 180.00 feet along said South line; thence N01 °41'50'E 60.01 feet along the East line of said Lot 1; thence N89 180.00 feet; thence S01 °41'50'W 60.01 feet to the point of beginning. Also including the following: That part of Lot 4 of a Certified Survey Map recorded In Vol. 15, Page 4239 at the St. Croix County Register of Deeds Office, further described as follows: Beginning at the Northwest comer of Lot 4 of a Certified Survey Map recorded in Vol. 15, Page 4239 at the St. Croix County Register of needs Office; thence S01 59.72 feet along the West line of said Lot 4; thence S89 220.97 feet; thence N01 °41'50'E 59.72 feet; thence N89 11'44W 221.13 feel to the point of beginning. Lot 2 of the Plat of Roy Ridge Estates excepting the following: Commencing at the Northwest comer of Lot 2 of the Plat of Roy Ridge Estates; thence S01 10 41'50*W 263.92 feet along the West line of said Lot 2 to the point of beginning; thence S01 °41'50'W 60.01 feet along said West line; (hence N89 °11'44"W 40.00 feet along the South line of said Lot '2; - thence N01 °41'50'E 60.01 feet; thence $89 "E 40.00 feet to the point of beginning. Lots 3, 4. 5, 6, 7 and 8 of the Plat of Roy Ridge Estates, ALL in St. Croix County, Wisconsin. -------------------------------------------------------------- - - - - -- - - - - - - - Y /13N3H1304 /lMN ��� 0 • Q91HAQ igQmn Q�nd�� - x j 3HI30 3Nl 1SV3 3 w QQ � Z ul 1 ir in w rL � � � Q 00. . CD gg it a o LU 5 s �• � i N .\ 6 p `r .\ • � C w k r z fw1� ce r a La _ - _1- ; i cnC cm �jj �- (— � `�; - ;. t7 1►.1 1 t s LQ CV T � � a NZ n ` EU VtOAD o l 0 Lu o LL o r sue' l 3 � r 0 N � 00 v p N ~ I W z 0Z O i I - - -- --------- - ---- - - - - -- = i — — _ — — - ----------------------- - - - - -- -------$----------------- I