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HomeMy WebLinkAbout032-2045-95-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County St. Croix S�fetyand Building Division INSPECTION REPORT Sanitary Permit No: 506140 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: Getschel, Ted I Somerset, Town of 032- 2045 -95 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 7 11 7 9 1 2i xa,.a,— V`t5 �Ar^�'L �(� d� 12.30.19.6618 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic � Benchmark / cs� �[. � 2 �D�� _ q 79 7 J V %/ / Dosing �0 D k— L� �I Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet _ 2_3 9�. q,4 TANK SETBACK INFORMATION St/Ht Outlet / f�GK Y a i 3 yF e 8 .S - 5 73. 6,� TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 7 10D I Dt Bottom 1 Z q Dosing Header /Man. L /•�PS G,�, Aeration Dist. Pipe � 1 0a 5+. Holding Bot. System Final Grade 3 PUMP /SIPHON INFORMATION V-6 �d1�n- OS Manufacturer Demand St Cover •� �� y y GPM -0 0 Model Number vbiQjyt 3 TDH Lift Friction Loss System Head J TDH Ft Forcemain Length Dia. ist. to Well SOIL ABSORPTION SYSTEM 311 Z 3 BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS �� IZ� � SETBACK SYSTEM TO L P/L jB LD WEI� LAKE STREAM LEACHI Manufacturer INFORMATION CHAMBER O Type System: f t f UN Model Number: L%xt.&thb,4 ItO 2y DISTRIBUTION SYSTEM Header /Manifold istribution x Hole Size x Hole Spacing Vent to Air Intake N Pipe(s) rr f IN , —f Length Dia Length (2L II 1 + I�a Spacing J' SOIL COVER 3o x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed /TrenchQente , B!j/T��cEdges Topsoil Yes No r es No COMMENTS: (Include code discrepen persons present, etc.) Inspection #1: � / 0 0 7 Inspection #2: Location: 898 160th Avenue Somerset, WI 54025�Sy,E�p1/4 SE 1/4 12 T30N R19W) NA Lot 1 '� `^ Parcel No: 12.30.19.661B 1.) Alt BM Description = I D � / �� �Z 2.) Bldg sewer length - amount of cover = �S1 �U��I�Qh�hCe 30 3q Plan revision Required? Yes No Use other side for additional Information.' Date - I epctor'sSig at r � � t Cer�- Nq. SBD -6710 (R.3/97) p C/ 9/ /�(//� ��jyl, commerce Safety and Buildings Division 2 County , — T — __� -- 01 W Washington Ave., P.O. Box 7162 CQ� Madison, ._707 --7162 Sanitary Permit Number (to be filled in, by Co j � t t p admeni of Commerce - -- -- 5 o 0 Sanitary Permit Application i State Transaction Number ,�- It, acccrdan c with s Comm 83.21(2), Wis. Adnt. Cone cubtnEStiion ct thi, form to the appropriate governmental L,_ - - unit is reguueo prier to obtaining a sanitary permit Mote App'r aticri forms rot state- olvnecl POWTS are Prodect Address (if dtfferernthanma — ,l,, addresx) submuted to the Departntent of Corrlm`erce. Person,;l tnt'Llmiation }: ,; prov may ay be used for secor+dary u Ns cs in acco! dan with the Privacy Law, s. i 5 Ci4( i )tn Slats. ♦ C 1 �/ =� 1. �t�al information - Please Print All I nf n ma io J +L� j ��C Property Qwner's Name / Parcel # �nn� 63z 2645 - 9:5 - ca Property Owner's Mailing Address H r R, L.UU T� ocaUnn City, Star - - _. vt. Lot City, � I Zip o Section hoP" ne hYUntb r' / -� / (ClrLle one) II. Type of Building (check all that apply) O Lot # - T � . -..-- N; R L�_ E o i y�l cr 2 Family Dwelling - N+imlter of tiedronms (_ �` J _� fl - Subdivision Name 9 6 I I ,n - Mal Blo k t --- ❑ Public - Describe Use ❑ City -- --- -- -- — C-b -nod - pes I CSM hu tber Village 0"" - -- -- - - -- - -- 1 I� State• a i�e Use �Q ' 7 + 'J� L✓ 3 �" 3 Z iGtvvtQ.Ld 1 i Town of 11 11. Type of Permit (Check only on box on line A. Comp lete line B if ap plicable) N Replacement System 1? Trealment /Holding Tank Replacement Only j ❑ Other Modification to Existing System, (explain j B ❑ Permit Renewal + ❑Permit Revision ❑ Change of Plumber ❑Permit Transfer to New List Previous Permit Number and Dare Issued [Before L :ratio : � iJw•ier �' + I V. _Ue of PO WTS System /Comt.>onent/Devi (C heck all th aLLfo�_ on- Pressurized In- ground ❑ Pressurized In- Ground it At -Grade ❑ Mound '- 24 in, orsuitablF soil ❑ Mound c 24 ir., oft "suitaUle soil �t Holding Tank 11 Qther Disptms Component )explain} — — _ -� F° Pretreatment D vice (expiat _ 1�L V. Dispersaiffr Area Information: — � r. J� /• h f 1 Drsi gn Flow IKPd) - -fi -si n Soil A lice Lion te u t ' - -- b _ g pp a Ra .( �Ciisuersa .4re:a Required (stl ispeps3l A - ea Proposed i. 1 System Elrvaroc h V1. Tank Into Cipaciry in otal # of j anufacturer Gallons Units Gallons y u t New Tanks Existiiib Tanks _ _ __ �✓ L �t tLJ I a tg v v ( cn z. 5 a Septic o: Holding T ank - -- G Dosing Qiainher VIi. Respon Statement- t, the undersigned, a ssume responsib for Installation of the POWTS s wn o n the attached plans. Piunioer's Name (Print) P lumber's Signature � - -- P: lPRS Number —T B Phone Number l Flumbei's Address (Street, City, State, Lip Code) V111. Cbut�t artment Use Only C kpproved ❑ Di ppio% Permit Fee Date sued Issuing t Signature r -- ❑ r vo • iven Reasot De nial - - -- I I.N. Condid"M* ff n !asons for Disapproval - -- i. Septic tank, iftient finer and dispersal cell must all be services /ML ++•� 1 as per management plan provided by plumber. 2. All ae'1bacR requirements must be maintained a rich ro comp,ete p ins o+ ie syslcro and submit to the County ooh oil raper not less titan 8 uz x i i inches in s>ze - - -� SBD -6398 (R. 01 /07) Valid thru 01 /09 1 r y ��g o l ~ `t . 4 �1 ,. �� �� 4 � s� 1 l -�.� i u � � � �� � � �� � �. � t ti ���� `�, ` °may � R �_ �� - � T '°ter y � _ N s �. � � -�x� ��� � � � ,� �h�s �.��. `,�� y � � �� b .. � `� `�, � �, �� � � ___ Wisconsin Department of Commerce SOIL EVALUATION REPORT Page —/— of ' Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed Date Personal information you provide may be used for secondary purposes (Privacy law, a. 15.04(1) (m)) • l 7 Property er Property Location Govt. Lot 1/t.5 1l4 S T N R (or Propdrty Owner's Mailing Address Lot # 1 BI Subd. er �anJp, City State Zip Code Phone Number City ❑ Village WTown Nearest Road New Construction User Residential / Number of bedrooms - Code derived design flow GPD ❑ Replacement / ❑ Public or commercial - Describe: _ _ Parent material r1f Flood Plain elevation if applicable ft. General comments APR 16 2004 and recommendations: ST- RO B � O NE Y Bodng ❑ Boring jo Pit Ground surface elev. - ft. Depth to limiting factor 7 lW _ ' in. Sod Appl ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP /ft? in. Munsell Qu. Sz. )Con Color Gr. Sz. Sh. 'Eff#1 •Eff#2 -7, a r 4 9 M2 Boring # ❑ Boring Pit Ground surface elev. _z_ ft. Depth to limiting factor 7 //—'_� in. Sall Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 eLj d S 5 y 1� 2•� b t Efflyent #1 = BOD > 30 220 mg/L and TSS >30 < 150 ent ' E #2 = BOD < 30 mg/. and TSS < 30 trlglL CST - - - Number Data Evaluation Conducted Telephone Number Property Owner 4 4aae,6e Parcel ID # Page _ of F-? 1 Boring # C] Boring 1 4 Pit Ground surface elev. ft. Depth to limiting factor &5 7 in. r'Efl#1 oil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/ff in. Munseil Ou. Sz. Cont. Color Gr. Sz. Sh. •Eff#2 Q - - e BorkV s _ 4 Q ❑ # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture . Structure Consistence Boundary Roots GPD/ff In. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 ❑ Boring # E] Boring [3 Pit Ground surface elev. ft. Depth to limiting factor in. Sal Application Rate Florizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsefl Ou. Sz. Cont. Color Gr. Sz- Sh. •Eff#1 I •Eff#2 • Effluent #1 = SOD > 30 1 220 mg/L and TSS >30 1150 mgA- • Effluent #2 = BOD 130 mg1L and TSS 130 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. seD- eaao(eAW) r _ �) Property Owner , , / Parcel ID # Page of Boring Boring # ❑Boring LA ��.�L Pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 0 j1 e eJ F - 1 Boring # ❑ Boring C] Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture . Structure Consistence Boundary Roots GPD/ff° in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring F-1 # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDAf in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Effluent #1 = BOD, > 30 1220 mg& and TSS >30 < 150 mglL • Effluent #2 = BOD, < 30 mgA- and TSS < 30 nVIL 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. seD4330(rtfw) - +- r A mw IV L �i Y4 �` V POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page ____ of FILE INFORMATION SYSTEM SPECIFICATIONS Septic Owner # �7 _L :. _- ' _ s $ sptic Tank Capacity a l E3 NA Permit tj Tank M n p a ufa cturer W t ❑ NA I DESIGN PARAMETERS Effluent Filter Ma nufacture r �O�J`.� 0 NA Number of Bedrooms u a NA LEIf Filter Mo del (�D El NA Number of Public Facility Units Q NA mp Tank Capacity - g o di o NA Estim flow ( ( p O a� l /da�r mp Tank Manufact `� r ❑ NA Design flow (peak), (Estimated x 1.5) � , Dump Manufacturer __ — -- d O a6 /dit _ p y .1, fl NA Soil Application Rate al /daylftx Pum Model ❑ NA Standard Influent /Effluent Quality Monthly average" Pretreatment Unit - ❑ NA Fats, Oil & Grease (FOG) l -530 mg /L CI Sand /Gravel Filter O Peat Filter Biochemical Oxygen Demand (800 _5220 mg /L ❑ NA C] Mechanical Aeration at on O Wetland Total Suspended Solids (TSS) 5150 mg / ❑ Disinfection r• 0 Othe ction _ _ I Pretreated Effluent Quality Monthly average Dispersal Cells) �~ Q NA Biochemical Oxygen Demand (800 � , 00 mg /L b in- Ground (gravity) Q in- Ground (pressurized) Total Suspended Solids ITS& s30 mg /L Cl NA E3 At -Grade O Mound Fecal C oliform (geometric mean) 510` efullo0rnl 13 Drip -Line 0 O Maximum Effluent Particle S iz e J 38 in diia. CJ NA Other' C NA Other'. - - �-- iii Cl NA Glthpr. _ C] NA `'101t,es typical for dornestic wastewater and septic tank effluent. Other: ' 0 NA MAINTENANCE SCHEDULE Service Event Service Frequenc Q Y Inspect condition of tankls) At least once ,very; month .3 {hNaxlmum 3 years) CJ NA Pump out contents of tank(s) When combined sludge and scum equals one -third 0 of tank volume NA Inspect dispersal cellist At least once eve ❑ month(s)� yearls) ( Maximum 3 years) DNA Clean effluent filter At least Once every; j 0 Month(sl 0 NA �yeart Inspect pump, pump controls & alarm t At leas once every; ,, �, Q Month(a) © year(s) -- - -_ q NA _- _ _ Flush laterals and pressure test A least once every; .� D month(si - _ _ p NA _- ❑ yearls) nth(s) _._.. At least once every: �-- ® yea C month nth 1:1 NA C NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tankls) 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 u p or ponding of effluent on the ground surface. The dispersal cellist shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of affluent 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 tarok voiurne, the entire contents of the tank shaft be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All cither services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of s12 months, shall be performed by a certified POWTS Maintainer, A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. STA UP AND OPERATION ?'Ape _ _ g Far'new cgnsrruction, _ prior to Uea of the POINTS chock treatMorlt t for the presence of p ainti ng that may impede the treatment process and /ar damage the di Collie). If huh concentrations are de eded have the c c ' o f the tanks} removed ontents by a septags Se rvicing operator prior to use spersal System start up $hilt not occur when soil conditions are frozen at the infiltrative surtacs. During power outages pump tanks may fill above normal hl hw discharged tq the dispersal csli in one large flter ievafa. rge doaa, overlgading the celllal ay stilt restored the backup or surface, discharge at affluent. To avoid this situation have the contanta of the purt4tt tank removed by a Ssptaga Servicing Operator prior to restcrin.. Power to the effluent pump or contact a Plumbar or POVeeTS i illintalner to assist in m anuall y operating the pur controls t restore normal levels within the pump tank, 3 Co not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area withir 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the teNgwing from the may wastewater ettMMtt improve the performance and prolong the life of t`je f'OW'rS: ar!tibiotics: haby wipes: cigarette butts; oondomel tspttOrt a1N ta; ae reaeera, foundation drain (sump pump) water; fruit and ve g dental floss; diapers; disinfectants; f�aintin e g eeetin ll; gaaettnel WSW, herbicides, meat scraps; med +cations; Oil: fJ products pesticides sanitary napkins; tampons. and wet*r aoltene► brine. ABANDONMENT When the PQWTS fails and /or is permanently taken cut Of service the following *taps shall be taken to inavre that tre system is properly and safely abandoned in compliance with Cheptor Comm $3,33, 1NisconMr, Administrative Code: All piping to tanks end pits shah be disconnected and the abandoned pipe openings sealed. The contents of all tanks and pits shall be remov and properly disposed of by a Septags Servicing Operator. • After pumpi all tanks and pits s hall be excavated and removed or their covers removed and the void space rifled , v th soil, gravel or another inert 60114 material. CONTINGENCY PLAN ,f the PQWTS fails and cannot be repaired the following R; easures have been, or roust be taken to provide a code compliant replacement system; 13 A suitable re replac area has been eve ot replac system. The tsd and may be Utilized for the location of a ropl acernent s o +' absorption ement area should be �SrgtMad from dipturWnoe and Compaction and should not be infringed upon by required setbacks from existing and Proposed structure, lot lines and wells. Failure to protect the replacement area will result In the need for a new toil and site *valuation to sstabiish a suitable r eplacement area. Replacement s ystems :-just comply with the rules in effect at that time. C7 A suitable replacement area is not ava ilable due to setback and /or saii limitations. Barring advances in POW technology a holding tank may be installed 64 a last resort to repl" the failed PQWTS. The Site s not en evaluated to identify a suitable replacement area. Upon failure of the POW TS a soil and site evaluation be performed to meat* a su itable replVICOMOrft arise. It no repfacament area is available a holding tank may b tails 9 a last resort to replace the failed POINTS. 0 Mound and at -grade soil absorption system" may be r econst ru ct stl m place following removal of the biornat at the infiltrative surface. Reconstructions of such SvI tams roust Comply with the rules in effect at that time. < wARNINO > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN WTHAL GASSES AND /OR iNSUFFICIENT OXYGEN. 00 NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TMK UNDER ANY CIRCUMSTANCE$. DEATH MAY RESULT. PERSON FROM RESCUE Of A THE INTERIOR F T Q A TANK MAY BE DIFFICULT OR IMpQggl$LE, ADDITIO CO MMENTS POINTS INSTALLER M I TAiNEIh r _Name SERTAQ@ $ERYiCINQ OPERATOR (PUMPER) 4 E ULAtOR AUTHORITY Name / f �.......� »,_. _ - ..�..� -.�� N" 5 '�'- Phone �/5 - 33 Ns ao curnont was drarten;n comc,iiance with Charier 7 omm 83 .22129bil'.iiat;4kiti end 83.640:, 12, & 131, `Alisconson Ac- -nistrauve Cana. N V w V SEPT TANK E PUMP CHAM5tA CIie,�Sa 59CTION AND SPECIFIC..k.TION 4" CI VENT PIPE 12" MIN. ABOVE GRAI}E & WEATHERPROOF ? 25 FROM DOOR, WINDOW OR JUNCTION BOY APPROVED F FR SH i AIR INTAKE " WITH CONDUIT MANHOLI. COVER G'4 x.R FINISHED GRADE W/ PADLOCK F u" CI RISER WARNING LABEL 4 " MIN. 18" IN. 6" MAX. JR :NLE'T WATER TIGHT SEALS ` GAS- ' TIGHT '� PPROVED A SEAL JOINTS WITH APPROVED --- ' 'ALM APPROVED PIPE 'IPE 3' 1 ON 3' ONTO INTO SOLID ' ! SOLID SOIL. TOIL PUMP OFF ELEV. FT. -�- i i 'OFF RISER EXIT b PERMITTED ONLY IF TANK MANUFACTURER HAS APPROVAL 3" APPROVED BEDDING UNDER TANK CONCRETE PAD 5PEOZFICATIQNS SEPTIC ! DOSE `T TANK MANUFACTURER: F.Se� NrJMB�:R DOSE'S PER DAY: TANK. SIZES S I��'Q GAL. DOSE VOLUME INCLUDING DOSE GAL. FLOWBACK: I 9 GA.". Ai.ARM MANUFACTURER: Ltv,r_ra.M CAPACITIES: A = INCHES = tl�,�, GAL. MODEL NUMBER: t, y SWITCH TYPE: M�9, r. B = d 2 INCHES = GAL, PUMP MANUFACTURER: Gl sl�c� , C = 0 INCHES = �a� GAL. MODEL NUMBER: � a SWITCH TYPE: MopC .._._.w D = INCHES Qjo GAL, REQUIRED DISCHARGE RATE ' GPM PUMP 8 ALARM WIRING AS PER I LHR 16.23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE !,;), FEET + MINIMUM NETWORK SUPPLY PRESSURE 2.5 FEET + �Q D FEET r ORCEMAIN X . .66FT110G FT. FRICTION FACTOR*. ; S FEET TPTAL DYjiAMIC HEAD = jLTj FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH WIDTH DIAMETER LIQUID I &.4L pout 1 ,0 LICENSE NUMBER; .. q 15 1/88 GOULDS PUMPS Su bmersible Effluent Pump EPO4 { 387 EP05 APPLICATIONS • Ful submerged in high ■ EP05 Impeller, Thermoplas- ■ Bearings: Upper and lower Specifically designed for the grade turbine oil for tic enclosed design for heavy duty ball bearing following uses: lubrication and efficient improved performance, construction. • Effluent systems heat transfer. ■ Casing and Base: Rugged thermoplastic design provides AGENCY LISTING • Homes Available for automatic and superior strength and corrosion • Farms manual operation. Auto- 4 Qmdtat Swdu&Auodasw • Heavy duty sump maatk models include resistance. • Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron (CSA listed model numbers end • Dewatering assembled and preset at the for efficient heat transfer, in "I'" or "C ".) f strength, and durability. SP ECIFICATIONS ■ Motor Cover Thermoplastic Goulds Pumps 6 ISO 9001Reg'imred. FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. '/i' maximum. ■ EPO4 Impeller. Thermopias • Capacities: up to 60 GPM. tic Semi -open design with ■Power Cable; Severe duty rated oil and water resistant. • Total heads: up to 31 feet, pump out vanes for mechanical • Discharge size: l'h" NPT. seal protection. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA -N elastomers. • Temperature: 104°F (40 continuous METERS FEET 14VF (60 intermittent. 10 • Fasteners: 300 series stainless steel. s 30� ...""-- -._ ........._ . —. .— soPnn' • Capable of running dry without damage to s 25 Fr components. 25 ..... ~_--� Motor: • EPO4 Sin le phase: 0.4 HP, it 5 20 . __.. 115 or 230 V, 60 Hz, 1550 s RPM, built in overload with automatic reset. A _ _ E. 05 • EP05 Single phase: 0.5 HP, c 115 V, 60 Hz, 1550 RPM, �- _._...._ 3 t� built in overload with automatic reset. 2 • Power card: 10 foot 5 standard length, 16/3 SITOW with three prong grounding plug. Optional 20 0 ° a - t o 20 30 _ :.. so _ .... GPM foot length, 16/3 S1TW with , three prong grounding plug (standard on EP05). p 2 4 6 8 10 12 m /h CAPACITY Go Pumps 02000 Goulds Pumps � ITT In dustr ies fffective February, 2000 83871 POst4r Fax Note 7671 al+ p,° Te Or— COJOeOL Ca Phorse r Phone . _ 7 6 7 e 0Q!p "` • .. �"' OL 1TRL3,E! PAGE 4780 RM11WIM cw IDE£DS ST_ CIMIX Co. w2 RECE3YBD Fait ftfifmgp CERTIFIED SURVEY MAP °�'n'� Q2:45P,t CERTIFIED SiBYey RAP LOCATED IN PART OF THE SE L4 OF THE SE 1/4 OF RFP Fes Z3 • CDPY lrfiE: 3. N SECTION 12, T30N, R19W, TOWN OF SOMERSET, PAGES: 2 ST. CROIX COUNTY, WISCONSIN_ PREPARED FOR: SURVEYOR: EAST RT SEC. 12 Q LU u R ICK FLANDRICK DOUGLAS J. ZAHLER �\ ac W O o 85TH STREET S& N LAND SURVEYING, INC. 2 S § SOMERSET, WI. 2920 ENLOE STREET � a on H uOSON, WI 54016 1 �xm % W UNPLATTED LANDS on ----- - - - - -- N89 0 05'53 - E 351.52' APPROVED err, CR017C COUNTY Plarxtir+9 Zang oed P p,A • 2 5 2004 100• --: 1 Ir l c 1 I1 nol .KOroed wllrlin -IA.; : d--l' O o* LOT '! � ' app-,W dots eppmwal Shall 043 1 r"I end void 1 Ny O l a, I v � o � 1 1 � a 1 NO>i'OB'87'E ;v c O CD 1 1 1 �i► ..' ............ • ......... 8ETBACX o en � I SOUTH LINE OF THE SE 114 1 SOUTH ttt777 ' 1/4 COR. 6 8.01• SEC. 12 ki b N89'08'SZ 333 2A �° �, 4� a —io•— 160_T _ S89 °08'52 - W 331.97' " ENU H - - _ �_ --- 1 r889'08'441i 2638.Br _ se COR - -- SEC. 12 _LOT 15 ( BOARDMAN ESTATES ' LOT 5 _ 1 O W / ox, , 0 { ly l do DOUGLAS J. # i. E a R LEGEND POUND ALUMINUM COUNTY *9CTION CORNER MONUMENT SET 1' OUTSIDE DIAMETER BY 18' LONG IRON PIPS. VWWGHING 1.13 LBS. PER LINEAR FOOT SCALE iN FEET 1" - 100' PROPOSED DRIVEWAY 100 O 100 ............. BUILDII40 3ETBACX LINE THIS INSTRUMENT DRAFTED W. WES ANOERSON JOB NO- 639"I DATE: 2118/2004 ' REVIS 4/23/04 SHEET 1 OF 2 SHEETS Vol 18 Page 4780 -7 c=qo -.e i 9 �\ ' u. 2 7 9 8 P 1 8 2 KATHLEEN H. WALSH STATE BAR OF WISCONSIN FORM 2 - 1998 REGISTER OF DEEDS ST. CROIX CO.. MI RECEIVED FOR RECORD This Deed, made between Richard A. Flandrick and Nancy M. 05/06/2005 10:15AN Flandrick, husband and wife, Grantor, and Ted J. Getschel and Melissa H. Getschel, husband and wife, as survivorship marital property, Grantee. WARRANTY DEED Grantor, for a valuable consideration, conveys and warrants to Grantee EXEMPT # the following described real estate in St. Croix County, State of Wisconsin (The REC FEE: 11.00 "Property "): TRANS FEE: .195.00 COPY FEE: CC FEE: Part of the SE 1/4 of SE 1/4 of Section 12, Township 30 North, Range 19 PAGES- 1 West in the Town of Somerset, St. Croix County, Wisconsin further described as follows: Lot 1 of Certified Survey Map filed .Tune 25, 2004 in Vol. 18, Page 4780, Doc. No. 767000. Together With the right of ingress and egress as contained in Access and Utility Easement in Vol. 2594, page 241, Recording Area Doc. No. 765638. Name and Return Address Ronald L. Siler VAN DYK, O'BOYLE & SILER, S.C. Post Office Box 118 New Richmond, Wf 54017 Part of 032 - 2045 -95 -000 Parcel Identification Number (PIN) This is not homestead property. I Exceptions to warranties: Subject to all easernents, restrictions and covenants of record. Dated this vq 7 2005. day f / L Y �— *Richard A. Flandrick *Nancy M. ndrick * * AUTHENAATICATrrION / ACKNOWLEDGMENT Signature(s) 1'C l,.a -J STATE OF WISCONSIN ) ✓VI �(a rL ) � �c � St. Croix County SS. ) authenticated this 2 / day of 47or, 2005. Personally came before me this day of ,2005 the above named TITLE: MEMBER MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed (If not, the foregoing instrument and acknowledge the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Ronald L. Siler VAN DYK, O'BOYLE & SILER, S.C. Notary Public, State of Wisconsin My Commission is Post Office Box 118, New Richmond, WI 54017 permanent. (If not, state expiration date: _ ) (Signatures may be authenticated or acknowledged. Both are not necessary.) *Names of persons signing in any capacity should be typed or printed below their signatures WARRANTY DEED STATE BAIL OF WISCONSIN FORM No. 2 - 1998 INFORMATION PROFESSIONALS COMPANY FOND Do LAC, WI 800- 655 -2021 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer /I, z _ _ _ Mailing Address A lv �� 3' �i ✓� — - Property Address _ 0 _' lga r/t �G (Verification required from Planning & Zoning Department for new construction.) City /State _ Parcel Identification Number U 3 2 - Z0 '4 S - 2 : 5 - OS 0 LEGAL DESCRIPTION Property Location _S'&� t /4 , � 1 /4 , Sec. 1 .1 , T - ; 74 ' N 12 / W, Town of ��t�re .r s'�c-Z' Subdivision _ z 'r Ili , Lot # Certified Survey Map # Volume , Page # Warranty Deed # , Volume , Page # Spec house yes no Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. 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 Planning & Zoning Department within 30 days of the three year expiration date. I /we certify that all statements on this form are true to the best of my /our knowledge. I /we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. I Number of bedrooms 113 1©1 SIG14ATURE OF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) Parcel #: 032 - 2045 -95 -050 04/19/2007 03:20 PM PAGE 1OF1 Alt. Parcel #: 12.30.19.661 B 032 - TOWN OF SOMERSET Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 06/25/2004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - GETSCHEL, TED J & MELISSA H TED J & MELISSA H GETSCHEL 752 210TH AVE SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description * 1603 89TH ST SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 4.000 Plat: 4780 -CSM 18 -4780 032 -04 SEC 12 T30N R19W PT SE SE CSM 18 -4780 Block/Condo Bldg: LOT 01 LOT 1 (4 AC) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 12- 30N -19W SE SE Notes: Parcel History: Date Doc # Vol /Page Type 05/06/2005 794310 2798/182 WD 06/25/2004 767000 18/4780 CSM 06/14/2004 765638 2594/241 EZ -U 12/30/2002 704042 2095/97 QC more... 2007 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 08/09/2005 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 4.000 500 0 500 NO Totals for 2007: General Property 4.000 500 0 500 Woodland 0.000 0 0 Totals for 2006: General Property 4.000 500 0 500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00