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HomeMy WebLinkAbout032-2138-40-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 420785 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: Richlin , Les & Martha I Somerset Townshi 032 - 2138 -40 -000 CST BM Elev: / Insp. BM Elev: 1 BM Description: Section/Town/Range/Map No: • 2 8: 3 Z CST 2 14.30.19.1221 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 12-ft/ emc, to ut Pt +.ate •5'S' rot. 98.32- Dosing Alt. BM Aeration Bldg. Sewer 1 Holding St/Ht inlet 1 4.3 . 93 • 1 TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic _ ?Sn ''�� 2' Dt 9 yo } 3 , 33 IZ• `�0•1`f� Dosing " U V Hea er /Man. L 1 IT qb - 1 Aeration Dist. Pipe ` Z •K, f to 9` •loo Holding Tot. System � �-• `�3p -' 95 �„ �o aI Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Co er U ` is GPM ) Model Number „ � %_4�0_ �� 9 - %fo " Ctr� , 4T ( DH Lift •VA Friction Loss System Heap^ •3 t i Forcemain Lengt S Dia. n 1 � Dist. to Well SOIL ABSORPTION SYSTEM �q R C Width e:41 ` No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS I VoT' SETBACK SYSTEM TO f /L BLDG WELL LAKE /STREAM LEACHING Manuf urer. INFORMATION Type Of System: 1 CHAMBER OR OOIr•F%&% 2 �1 ��-- UNIT Model Number. f • 0 1� Crrvct 1 DISTRIBUTION SYSTEM , Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipes Length Dia Dia Spacin SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded 1 xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil 0 Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) inspection #1:�/ (lip Ra3 Inspection #2: Location: 1585 72nd St Somers�e 1540 1/4 NW 1/4 14 T30N R19W) Rockamora Estates Lot 10 Parcel �NoQ: 14..30.19.12211' 1.) Alt BM Description = �� ► ` g 4) 1. w4ba . `� _OC . W�[tt.�+¢.P� 2.) Bldg sewer length = Ap %Y - amount of 3) Yb,. A,4% Mn Plan revision Required? ❑ Yes X No Use other side for additional information. � l SBD -6710 (R.3/97) Date J�� � In.epctors Signature Carl. No. Safety and Buildings Division County • 201 W. Washington Ave., P.O. Box 7162 ST MAX lsconsk Madison, WI 53707 - 7162 Site Address Department of Commerce / 5 S 7� a ST. Sanitary Permit Application S��y Permit Nujmbbeerr In accord with Comm 83.21, Wis. Adm. Code, personal ' ormat T' C I ii C ® / �C 0 7y� ; ma be used for seco ses Priva Law s15. ( �•+ ��// C 0 Check if Revision I. Application Information - Please Print All Information State Plan I.D. Number / Property Owner's Name Parcel Number N 32 �/ o � L S � 1\�1�T AA KiNLI I�tL� ST. CRUX co"Jw i� � Propert ?? y Owner's Mailing Address = Property Location /� 2 zz> b DEl� u L Ul . �E 4 N IVV , /4 5 l 4 T 3C� N, R�� City, State Zip Code Phone Number U r Block Number S " 'on Name CSM N �SCeDi-.k VV 1 S'� b7-D ADC 1:fa1U�D U. Type of Building (Check all that apply.) , ` GP- ❑City 1 or 2 Family Dwelling - Number of Bedrooms `� -4" 1'YLt9't.P� a - y. = ❑ Village ❑ Public/Commercial - Describe Use 1'Townshi D ❑ State Owned // 9� /3 �it'1LYr 2A L Gi- Nearest Road /h w o 3'X �/' 3' �Z 72 lvp III. Type of Permit: (Check only one box on line A. Num eying is for internal use.) (Complete line B, if applicable.) A. Ok Nmew 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑ Addition to For County use Tank Onl Existin S stem B ' ❑Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of POWT System: (Check all that apply. Numbering is for internal use.) [ Q�(. �,; �,� sad 44 Non - Pressurized In Ground 21 ❑ Mound 47 ❑ Sand Filter 50 ❑ onstructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line ��JA /l ¢a� 3� l iq 45 ❑ At -Grade 46 OAerobic Treatment Unit 49 ❑ Recirculating 30 COther V. Dis ersal/Treatment Area Information: D S Design Flow (gpd) Dispersal Dispersal Ar Soil Application Percolation Rate System ation Final e Required Proposed Rate(Gals./Days /Sq.Ft I (Min./Inch) Elevation L Sao l2 ®9 = _39 �p �, +�amaF ids 95, S 98, 5 VI. Tank Info Capacity in Total Number anufacturer Prefab - Site Steel Fiber Plastic Gallons Gallons of Tanks W lo 0 Concrete Constructed Glass New Existing // Tanks Tanks (cam Septic or Holding Tank t�'7 ,� / ! ' �� Dosing Chamber 1 L /oC VII. Responsibility Statement- I, the undersi , assume r nsibility for ' n of the P OWTS sho wn on the attached plans. Plumber's Name (Print) P gnu MP RS umber Business Phone Number .--ELF FD x zz3��► L X15 Z 9 y - .3 1 y Plumber's Address (Street, City, State, Zip Code L Env- 29 5 D�►Z WI SLI OD9 VIII. oun /De ent Use Onl Disapproved Da Issued sluing gent Signs e o Stamps) Approved ❑ Owner Given Initial Adverse Sanitary Permit Fee (includes Groundwater y Determination Surcharge Fee) ` � w r � �� 7 ]X. Conditions of Approval/R�f�Disa proval � �y��L. �� - - S�� G��i�2� -ate �O 7 9- CL�tt�2 �a Sd-c. - Q r . `��G�c�f�4.a� ' 2 �s� G�itll!2�C / G CtR'�G(�c -G�m .c� ���O�s�t- c.�i- "il -B�ri 3� �F / /GC /Y Attach co � pl p1 �s the County only) Poi ` em�,o�a , p ' aper not less than 8�/2 x 11 inches u � . /. /0 o - � �•�., -rl l�_Lt, 7�l ��r7�W YU//`✓ ��;,//,r--/ � �L� 2�CLtt vt � LUTS � < , G��.�.� �..' rw� /� �• .�.�t . a SBD -6398 ,�/ (R. 0 /�O1) n 7 Z IJD N� r V� 5N L - m� Q �C3, a a r z LA 3 m LA r p W p ' rl N n N s " r N Lu N A k < °Q r-> nQ s- r C> � m LIN - s Ll � o cl, p G N _ Ln V J CP �9 w " Tel to Ties Z 1�D ni s V� D' C7 y � N rn Q CA LA N N a � � m J� t 7 d O F � � N 9 �q Z f'1 H a � � b II II II � �p p � p � II II i o• _ '• \ C11 I TI CD cr CIA '.... • .\•„ �• CD CD s.• CD CD CD • � [ yy u 6 am p II a C'� •� •• - \ tom � t� �" • ' =/ t ... ....... 4 it II I� ' L'1 C'1 Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code 'rom Schmitt Attach complete site plan on paper not less than 8 %x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal r oivt (BM), direction and St. Croix percent slope, scale or dimensions, north an �r�d o4ation en�slistance to nearest road. r _ _ Parcell.D.# ! 0 032 - 2049 -60 -0 & 032-204'9-70-0 APPLICANT INFORMATION - pfinll information. I view Date Personal information you provide may be us d foi n PWF0 Privacy Law,`�5. 15.04 (1) (m)). c O 'J Property Owner Property Location Rivard, Harold And Belisle, Rol"d ,A r,r J 7 !! ' ovt. Lot na NE 1/4 NW 1/4 S 14 T 30 N,R 19 W Property Owner's Mailing Address �,a( Lot # Block # J �Name or CSM# 812 150th Ave �>>r;Y'+ 10 na Rockamora City State', Zip 'Codezdtltl ber n City [] Village Town Nearest Road New Richmond WI 54017 715- 246 - 529.1' Somerset 16011 Ave New Construction Use: Residential Z of bedrooms 3 [Addition to existing building [ Replacement [] Public or commercial describe f 156 Code Derived daily flow 450 gpd Recommended design loading rate .4 bed, gpolft .5 trench, gpd /ftz Absorption area required 1125 bed, ft 900 trench, ft M.Q design loading rat .4 bed, gpd /ftz .5 tr ench, gpd/ftz Recommended infiltration surface elevation(s) =Area 195.5 referred to site plan benchmarl Additional design / site considerafio Area II 95.5' t Parent material Pitted Glacial Drift Flood lain elevation, if a licable ft le for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank table for system ❑ S❑ U ❑ S U ® S❑ U ®S ❑ U ❑ S ®U ❑ S M U SOIL DESCRIPTION REPORT Horizon Texture Consistence Boundary Depth Dominant Color Mottles Structure GP ftz Bed Boring# in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Trench ry Roots 4N gg, 1 0 -11 10yr3 /3 none sl 2fsbk mfr cs 2m .5 .6 6 �� 2 11 -29 10yr4 /4 none sl 2msbk mfr gw if 5 6 Ground 3 29 -46 10yr5 /4 none is Osg ml gw - - - - -- .7 .8 elev 97.58 ft 4 46 -90 1 Oyr4 /6 none sl 2msbk mfr - - -- - - - - -- 5 6 Depth to limiting factor >90" Remarks ­ 7 177 7 7,77 4-77 W 1 0 -10 10yr4/6 none sl 2fsbk mfr cs 2m 5 .6 F 2 10 -26 10yr3/3 none sl 2msbk mfr gw if 5 6 Ground 3 26 -66 7.5yr4/4 none sl 1 msbk mfr gw - - - - -- 4 .5 elev 98.68 ft 4 66 -92 I Oyr4 /6 none is Osg ml - - -- - - - - -- .7 .8 Depth to limiting factor >92• Remarks: CST Name (Please Print) Signature: Telephone No. Thomas J. Schmitt 715 -549 -6651 Address Tom Schmitt Date CST Number Ref # 586 Valley View Trail, Somerset, WI 54025 5/3/00 227429 1004 3 �� sum �4r� ��� �� .9Ca -n4, a-le /�us�e k-k PROPERTYgWNER: Rivard Harold And Belisle, Roland SOIL DESCRIPTION REPORT ,004 page _2 of 3 PARCEL lA# Part of 032- 2049.60 -0 & 032 - 2049 -70-0 Tom Schmitt r Horizon Depth Dominant Color Mottles Texture Structure onsistence Boundary Roots GPD/ft 6 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. B tench vp 3 1 0 -11 1Oyr3/3 none si 2fsbk mfr CS 2m .5 .6 2 11 -24 7.5yr4/4 none sil 2msbk mfr gw if .5 .6 Ground elev 3 24-44 10yr4/4 none is Osg ml gw - - - - -- 7 .8 98.46 ft 4 44 -73 10yr4/6 none gyms Osg m1 cw - - - - -- .7 .8 Depth to 5 73 -90 5yr4/4 m2 10yr5 /3 Sil limiting 2msbk mfr - - -- - - - - -- .5 .6 fact 73" �• s S S� 7/. 5Z /� Remarks: i 1 0 -13 10yr3/3 none sl 2fsbk mfr CS if .5 .6 2 13 -30 7.5yr4/4 none 1 2fsbk mfr gw - - - - -- .5 .6 Ground elev 3 30-43 7.5yr4/6 none sl 2msbk mfr gw - - - - -- .5 .6 97.57 ft 4 43 -84 1 Oyr4 /6 none sl 2msbk mvfr - - -- - - - - -- .5 .6 Depth to limiting facto Remarks: 1 0 -11 10yr3/3 none sl 2mgr mfr CS if .5 .6 2 11 -24 I Oyr4 /4 none Sl 2msbk mfr gw - - - - -- .5 .6 Ground elev 3 24 -34 7.5yr4/4 none is Osg ml gw - - - - -- .7 .8 99.03 ft 4 34 -44 7.5yr4/6 none s1 lmsbk mfr gw - - - - -- .4 .5 Depth to limiting 5 44 -90 1 Oyr4 /6 none Is Osg ml - - -- - - - - -- .7 .8 factor -/' >90" .310 Remarks: l Ground elev Depth to limiting factor Remarks: v i I 1 6 = T - 1 - - - i I � _ I : I�' 3 33 -- — - - - -- — — —1 ' I I I I I I I I > y� y'` d I I I d K=� ✓ollc�� �1°� i I I , 1 _ I , I Till: , I I I I �I i i i L I I : I I i I I I -- I I I � I I � , I I � I I , I ' I 1 , I , I ' I I I I _ I , I I I , I I 1 { , I L i I r I . I r , , I 1 i , ! i I I , , i L i , , , r I I 1 1 , , I : i : I , I t POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page j of 10 Z , FILE INFORMATION SYSTEM SPECIFICATIONS Owner L£S y� �-r rl A R.tCI�Li t�L Septic Tank Capacity 1Z�?a al 13 NA Permit # a0 Z 7 6' Septic Tank Manufacturer Wc- ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer 201_1F ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model A - W ❑ NA Number of Public Facility Units &"A Pump Tank Capacity a l C"A Estimated flow (average) gal /day d� Pump Tank Manufacturer ANA Design flow (peak), (Estimated x 1.5) 45100 al /day Pump Manufacturer NA Soil Application Rate Is gal /da /ft2 Pump Model I $(NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit JK NA Fats,. Oil & Grease (FOG) <_30 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD <_220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD :530 mg /L K 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: ❑ NA Other: ❑ NA * Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: 3 ❑ month(s) (Maximum 3 years) ❑ NA IR y ear(s) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume 3C�"NA Inspect dispersal cell(s) At least once every: 0 mon (Maximum 3 years) E3 NA Clean effluent filter � �e-p At least once every: El on( ,(s) ❑ NA ear Inspect pump, pump controls & alarm At least once every: ❑ month(s) I NA ❑ year(s) Flush laterals and pressure test At least once eve ❑ mo year(s) P every: ❑ year(sl �NA Other: At least once every: ❑ month(s) NA ❑ year(s) Other: 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 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 cells) 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 components, pretreatment units, and any servicing at intervals of <_12 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. GMW (4/01) Page — Z'-0f 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. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area 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 ita le repl ceme. - area 7s not 'vailable due to se ack and / r soil limi tions. o k a a to t fail he sitIst not be valuat tdentif suitable r lace ent �rea �eplace allu re o h POWTS a soil and site va a 'ust be erfo o loc sulfa le rep ce area. a rea is ab e a ho g tank may a led a last resort to replace the fai OWTS. ❑ 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 BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MA INTAINER Name Name Phone S 2 — 3/ Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name f Ce." �1 Phone Phone v6 — (SO This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(0 and 83.541), (2) & (3), Wisconsin Administrative Code. t 02/26/2003 10:42 7152473038 BELISLE EXCA'miATTFJG I PAGE: 01 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer 4e5 Mailing Address a3`-/0 e Propeny Address g 5 a (Verification required from Planning Depamnent for new City /Stag: Parcel Identifications Number � LE 032- -2 13T D —cam S_CRTPTi1V 0 0 - 1 Property Location AT '/ Iii � y,, Sec. T.3 0 N -RiW, Town of 52M 0. 5 e Subdivision P a , Lot #. Certified Survey Map # Volume , Page # ao m Warr anty Deed # _ D r �� 3 Volume I , past # 'Lt'" w 3�� 3 D Spec house ❑ yes 0 no Lot lines identifiable $0 yes ❑ no SYSTEM MAINTEriIANCE ..,, Improper use and maintenanceof your septic system could result in its pratnature failure to handle wastes. Proper mai4tenanee consists of pumping out the septic tank every three year$ or sooner•, if needed by a licensed pumper. What you put into the stem C40 s P Pe Y an affect tl p Y .r function of the septic tank as a treatment stage to the waste disposal system. The property owner agrees to submit to St. Croix Zoning Depamnent a certification fmm, signed by the owner and by a masterplumber, journeyman plumber, restricted plumber or a licensedpwnper 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 113 full of sludge. 11we, the undersigned have rend the above requirements and agree to maintain the private sewage disposal system with the standards act 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 trust be completed and returned to the St. Croix County Zoning Office within 30 days of the ttuee year a ation date. SIGNATURE OF A PLICANT DAT - DATH -QWyElft f, 1F1 T1 N I (we) certify that all statements on il'us form are true to the best of my (our) knowledge. 1 (we) am pare) the owner(s) of the property described ove, by virtue of a warranty deed recorded in Register of Deeds Office, t SIGNATURE OF APPLIC O DATE * « « « «• Any information that is mis represented may result in the sanitary permit being revoked by the Zoning Dept, & ,I «* Include with this application: a stamped warranty deed from the Resistor of heeds office a copy of the certified survey map if reference is made in the warranty deed J 20761' `178 STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX Co., MI This Deed, made between Steve Schmitt RECEIVED FOR RECORD 12/11/2002 09:30Am EXERT # Grantor, and Leslie D. Richling and Martha M. Richling, husband REC FEE: 11.00 TRANS FEE: 179.70 and wife, COPY FEE: CERT COPY FEE: PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in — St. C roix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Lot 10, ockamora, Town of Somerset, St . Croix County, Name and Return Address WWisco sin. THE RIVERBANK PO BOX 188 OSCEOLA. WI 54020 03 Y- -000 4 32- 0 2/ 3Y- !f �_ _ Parcel Identification Number (PIN) This is not homestead property. CK) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of November , 2002 . * * St�Schmitt * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) Steve Schm itt STATE OF WISCONSIN ) ) ss. County ) authenticated this Z' of Nove 2002 Personally came before me this day of the above named * Kristina Ogland (/ TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY * _ Attorney Kristina Ogla Notary Public, State of Wisconsin Hudson, WI 54016 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 Professionals compan Fond du sac, Vw WARRANTY DEED STATE BAR OF WISCONSIN e00-655 -2021 FORM No. 2 - 1999 1 ........................ MW ------ : Por i ow w jw w A 6P' w ry at lit Ya k alm I 1261.62' ------------- 3W73'23OW MOOR= — PW+3'1.3'V PLAT OF 21AR�CLLO ACAES PLAT OF IdARCELLO ACRES 3 c� nf q c- K. �� ��3 Page Of Les tNtr4.T MBINATION SEPTIC TANK /PUMP CHAMBER (No Scale) 4" CI Vent Pipe with Approved Locking Manhole Cover Approved Cap, +25' With Warning Label Attached From Buildings � Weatherproof Approved _ Warning Label Junction Box Vent Cap - -� 12 Minimum Final Grade 6" Minimum 4" Minimum i 6" Ma ximum Quick 4" C.I. ' 18" Minimum } Ins Pi a Disconnect I 1/4" Weep ' Hole Baffles n Approved Joint I w /C.I. Pipe ; A Extending 3' Alarm B Approved `Joint Onto Solid Soil On 6; w C.I. Pipe I C Extending 3' ' Onto Solid Soil Off 6' D Conc. Block 3" of Bedding Under Tank—/ Note: Pump and Alarm Are On Separate Circuits Number of Doses: 1 1 Per Day Gallons Per Day/ of Doses: /sj) Gal'lon's Volume of Backflow: ...... .. 7? Gallons Tank Manufacturer: Iift_ Ci2 Total Dose Vol ume: ....... .= Gallons Tank Si ze -Septi c /Pump : /Z/,[1 0Q Gallons Alarm Manufacturer: - rAW (_ ALC Model Number: /L) / Capacities: A /q inches or t /JB Gallons Switch Type • /11Ewup_ + EF i nches or yy` Gallons _� K + C 7 i nches orb - Gala ons Manufacturer: EafLl Model Number: Y. S2 + D=inches or ? Gallons Minimum Discharge Rate: � Total ..... _ inches or `7 Gallons Vertical Difference Between Pump Off and Distribution Pipe: `7 Feet Minimum Required Supply Pressure: .......................... — Feet `/S Feet of Force Main x /,Sy Friction Factor /100 Feet: + ,�7� eet Z Inch Diameter Force Main Total Dynamic Head: ... _ - 7 7 Feet Internal Tank Dimensions: Length Width Liquid Depth No o Q- YCP- Signatu License Number Date TOTAL DYNAMIC HEAD /CAPACITY w ~ HEAD CAPACITY CURVE PER MINUTE � w , L.J MODELS 53/55/57/59 EFFLUENT AND DEWATERING 25 Model 53/55/57/59 6 20 o Ft. Meters Gal. Ltrs. = 5 1.5 43 163 15 10 3.1 34 129 z 4 0 15 4.6 19 72 10 o Shut —off Head 19.25 ft. (5.9m) F- 2 5 3 15/1 6-6 5/32 -- 4 5/8 1 1/2 —11 1/2 NPT U.S. GALLONS 10 20 30 40 50 LITERS 0 80 160 / 3 15/16 FLOW PER MINUTE 009897 — 4 1/16 CONSULT FACTORY FOR SPECIAL APPLICATIONS I I • Variable level float switches available. • Variable level long cycle systems available. • Available with special cord lengths of 15', 25', 35' and 50'. • Alarm systems available. • Duplex systems available. 10 1/16 l 3 3/32 SKa56 Single Seal Control Selection Listings SELECTION GUIDE Model Volts Phase Mode Amps Simplex Duplex CSA UL 1. Integral float operated mechanical switch, no external control required. M53155 & M57/59 115 1 Auto 9.7 1 - -- Y Y 2. Single piggyback variable level float switch or double piggyback variable level N53155 & N57/59 115 1 Non 9.7 2 3 or 4& 5 Y Y float switch. Refer to FM0477. BN53 115 1 Auto 9.7 1 - - - -- Y Y BN57 115 1 Auto 9.7 N Y 3. Mechanical alternator "M -Pak" 10 -0072 or 10 -0075. BE53157 230 1 Auto 4.8 Y Y 4. See FM0712 for correct model of Electrical Alternator. D53155 & D57/59 230 1 Auto 4.8 1 -- Y Y 5. Variable level control switch 10 -0225 used as a control activator, with Electrical E53/55 & E57/59 230 1 Non 4.8 2 3 or 4 & 5 Y Y Alternator (3) or (4) float system. Single piggyback switch included. O CAUTION For information on additional Zoeller products referto catalog on Piggyback Variable Level Float Switches, FM0477; All installation of controls, protection devices and wiring should be done by a qualified Electrical Alternator, FM0486; Mechanical Alternator, FM0495; Sump /Sewage Basins, FM0487; and Single Phase licensed electrician. All electrical and safety codes should be followed including the most Simplex Pump ControVAlarm Systems, FM0732. recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16347 ` Louisville, KY 40256 -0347 Manufacturers of. . SHIP TO: 3649 Cane Run Road a ® Louisville, KY 40211 -1961 r=IrY�!/AlP6 SNCE lff3Y http ✓/www.zoeller.com PUMP !O_ (502) FAX (502) 774- PUMP © Copyright 2002 Zoeller Co. All rights reserved. . AIP !� G D �- 7 Ln m 1�z z = Q a n � � m p � G LAj � w n