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HomeMy WebLinkAbout038-1189-20-000 Wisconsin Departmant of A rnmerce PRIVATE SEWAGE SYSTEM Cou Safety and Buildings Division , INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.. Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)l. 384129 Permit Holder's Name: ❑ City Village own of: State Plan ID No.: ayes, Rick Star Prairie Township _ Iq 4 T] ST BM Elev.:. / Insp. BM Elev.: , j)escription: Parcel Tax No.: f2L)t._ 038- 1189 -20 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ��-t r5�0 Benchmark 0D.0 r Dosing - Alt. BM Aeration Bldg. Sewer 52 m Holding - St /Ht inlet ci* '3Z TANK ETBACK INFORMATION St/ Ht outlet . &,4 c `f. o8 r TANKTO P/L WELL BLDG. Airl to ntake ROAD bt Inlet — Air I Septic '-f Z S t $.5 I -- NA Dt Bottom Dosing t'► E°: L NA Header / Man. "t 3.D- Aeration NA Dist. Pipe 3.03' Holding Bot. System S PUMP / SIPHON INFORMATION Final Grade " 5 Man cturer - _ St cover y Model Num - GPM TDH Lift , Lr System TDH t I ( ForcwrCa I Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED / TRENCH Width r length N f Tenches PIT No. Of Pits kInside Dia. Liquid Dep th DIMEN IONS DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE /STREAM LEACHING act TeSETBACK : � INFORMATION Type O �. 02 r p r+ =� OR UNIT CHAMBER Num � e u System: DISTRIBUTION SYSTEM � Nom(- f/L. Header/ ni old Distribution Pipes) x Hole Size x Hole Spacing Vent To Air Intake u - Length �— Dia. SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over u Depth Over xx Depth Of xx Seeded / Sodded xx Mulched Bed /Trench Center '10 Bed /Trench Edges Topsoil ❑Yes ❑ No ❑Yes O No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1:01 Inspection #2: --= � Location: 2145 134th Avenue, Star Prairie, WI 54026 (NE 1/4 SW 1/4 l 3 T31N R18W) - 133118964 Northgate - 1,ot l S 1.) Alt BM Description = _ 51 2.) Bldg sewer length= a>� 8 - amount of cover = > LA Z Plan revision required? ❑ Yes "No Kb' � Z Use other side for additional information. `f 8 l o SSD -6710 (R.V97) Date Inspector - s Signature Cert. No. rI r N (� LP Safety & Buildings Division #k - Z I,`i S l 3 ; ° Sanitary Permit Application 201 � W. Washington Ave. In accord with Comm 83.21, Wis. Adm. Code PO Box 7302 14 s consi n may reverse side for instructions for completing this application Personal information you provide ay be used for secondary purposes Madison, WI 53707 - 7302 Department of Commerce (Privacy Law,S 1�:04(1)(m)] (Submit completed form to county if not state owned. Attach complete plants to the county copy o f6rfhe siLstem,,on pap &,notivss than 8 -1 /2 x 11 inches in size. Co State S�r Permit Number _ `UCheck to previousppp 1 'on State Plan 1. D. Number I ,�. I. Application Information - Please Print all Informat I\Y Location: Property Owner Name =, 1 r 1 Property Location ` 1/4 - zA /4, S / T 3 i,N, WJn (or) 00 Owner's Maitin A \ r , Lot Number Block Number Property d •'`� Ci , State Zip Code qN � : i .' Subdivision Name or CSM Number 7� "YL 6- 5 Z IV o xnt C ►ATE II. Type of Building: (check one) 41r, (�+� S i vev ❑ City ❑ 1 or 2 Family Dwelling - No. of Bedrooms : ❑ V i ❑ Public/Commercial (describe use):_ ]no L S F I T wn f ❑ State - Owned Nearest Road Parcel Tax Number(s) 0 C . o o 0 III. T e of Permit: Check only one box on line A. Check box on line B if a lica le , 11. IF - '7(a A) I. New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System B) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. � Type of POWT System: (Check all that apply) - IE &Non- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland • Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line • At-grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dis ersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (GalsJday /sq. 1) (MinJinch) Elevation ,qs-o -? 7,S- 3. o '7 C? -% 6 97,-S VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete strutted Tanks I Tanks t�ct7 ue v .'L ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on ched plans. Plumbers Name (print) PI is Signature (no stamps): Business Phone Number � S C zZ% 71 7 /J - - -.2 Plumber's Address (Street, City, State, Zip Code) IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signa (No stamps) Approved ❑ Owner Given Initial Adverse Su ar a Fee) ` Determination :L 2801 X. Conditions of Approval /Reasons for Disa pr oval- rn lam_ Ct f a,c �te+.�s �.+ i ll L . �,- �'e.� ne>�.et- e�^'teK.� '- �-� -��• �' ,,.2.C,e3u `� s . •PACs AM.I,C.T � t� 4,i %� 0� .,�A two tkA:t� T3 Nk (A -�� Vc— low lee zo . 13 : i I t /Y AjrS S T3 /Ng 1F' : 721Y71 Lo 4A� ct deu.� oleli Z, r Z, c1g. 3 t s P� V1` O H Ip t 1 i Wisconsin Department of Comme ce ) 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 8 1/2 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. 0-3 S' Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). F ( b ' Prope Owner Property Location Govt. Lot ,5 1/4 115W1 /4 S 13 T / N R E (or) >d! Property Owner's Mailing ddre s Lot! Block # Subd. Name or CSM# C' State Zip Code Phone Number Dn El city ❑Village Town Nearest Road z ;2 La Construction Use: ❑ Residential / Number of bedrooms � _ Code derived design flow rate ❑ Replacement F3 Pubic or commercial -Describe: Parent material _ Flood Plain elevatio if applicable '� -- - � General comments .0 �`F >> and recommendations: "---1 P F_/1 Boring Boring c� r' g ❑ pit Ground surface elev. /�i �J_ ft, Depth to limiting factor >�y� in. ~ y tion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 0 L t� I(2 / Z ct S 4, z -a a' d YN ��� s K �� cz w iF / O Sr' L 1 F-1 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 GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ' 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 Nam (Please Print) Si ature CST Number w Il w Address Date Evaluation Conducted Telephone Number 3 � 2 4/ �` s/ /n•r r �� 'sY�ty ,� ` � = d ( 7� ',268= 6'6� Property Owner Parcel ID # _ Page of a Boring # ❑ Boring — ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Applica tion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 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 GPD /fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F 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 GPD/ff in. Munselt Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mgA. ' 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. SBD -8330 (R.6100) Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code 4 COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. Croix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. 038 - APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION [ Rr . IEW D BY DATE Zw PROPERTY OWNER: PROPERTY LOCATION Greenwood Enterprises, Inc. GOVT. LOT INE 1/4 SW 1/4,S13 T 31 N,R 18 FXor) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 1416 Third St. 15 na NorthGate CITY, STATE ZIP CODE PHONE NUMBER [:]CITY ❑VILLAGE 29OWN NEAREST ROAD Hudson, WI. 54016 (715) 386 -3674 Star Prairie 214th Ave. jc� New Construction Use [=:I Residential/ Number of bedrooms 4 [ ] Addition to existing building I ] Replacement [ I Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate _ bed, gpd /ft gpd /ft Absorption area required 858 bed, ft 750 trench, ft Maximum design loading rate _ bed, gpd /ft gpd /ft Recommended infiltration surface elevation(s) 04 _tin ft (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for s stem ® S El [OS ❑ u ® S ❑ U Gi S ❑ U 1R S❑ U ❑ S Z U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench ......1 1 0 -12 10 r 2/2 none 1 2msbk mfr gw if .51 .6 2 12 -26 10 r 4/4 none sicl lcsbk mfr QW if Ground 3 26 -84 7.5 r 4/6 none ms OSQ ml na na .71 . 8 elev. Depth to limiting factor +84 11 8 Remarks: Boring # 1 0-12 10yr 2Z2 none 1 lcsbk mfr if .4 4 .5 2 12 -24 1 4 Ground 3 24 -84 7.5 r 4/4 none ms os ml na .7 .8 1' elev. Depth to limiting / factor _ / - +84 1 1 s r polx ZONING OFFICE j. Remarks: CST Name: -- Please Print Gmy L. Steel Phone: 715- 246 -6200 -' / C j Address: 1554 200th. Aye New Richmond, WI 54017 Signature: Date: 10 CST Number: m02298 PROPERTYOWNER Greenwood Enterpris DESCRIPTION REPORT Page _2_of_- PARCEL I.D. # 038 - 1055 - 10 } Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft .................. in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trend ................. .................. ................. .................. ................. 3 <` 1 0 -8 2 8 -24 10 r 4 4 non sicl lcsbk mf Ground 3 24 -84 7.5 r 4/4 no e Cos elev, 98 ft. Depth to limiting factor +84 Remarks: Boring # 1 - 4 <`> 2 11 -22 10 r 4 4 none sicl 2msbk mfr w if .4` .5 Ground 3 22 -84 7.5 r 4/4 none cos osq ml na na .7 .8 elev. 97.9 1t. — Depth to - limiting factor +84 Remarks: Boring # 1 0 -10 10 r 2 2 none 1 2rnsbk mf if .5 .6 5 = <' 2 10 -23 10 r 4/4 none sici 2msbk mfr aw if .4 .5 Ground 3 7.5yr.4Z4— none Ms osa I Mi na na .7� .8 elev. 9 7.8 ft. Depth to limiting factor +84 Remarks: Boring # Mom Ground elev. j ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) Y STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Greenwood Enterprises, Inc. New Richmond, WI 54017 MPRSW -3254 NE4SW4 S13- T31N -r18W (715) 246 -6200 town of Star Prarie lot #15- NorthGAte This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted. 3 1 =40 1 top of 1" pvc pipe C el. 100 ✓Alt. BM.= top of 1" pvc pipe @ el. 98.30' �t 'b 1 I. �i Gary L. Steel 10 -28 -98 Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number 12 Number of Bedrooms 3 Design Flow - Peak (gpd) S�'D Estimated Flow - Average (gpd) '3w Septic Tank Capacity (gal) Soil Absorption Component Size (ft') < < Type of Wastewater DoYnestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorpt'on Component Design Flow - Peak (gpd) [A Maximum Influent Particle Size (in) 1/8 Maximum BOD (mg /L) 22 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank - The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the s and outlet filter shall be assessed at least once every 3 years by inspection. Th outlet filter hall_ be cleaned as necessary to ensure proper operation. The filter cartridge shoul not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep- rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. 3 ST CROIx COUNTY SFpTtC A-NK ,MAINTENANCE AG REEMI - ?NT AND OWt CE,RTIFICATION FORM Owner /Buyer ' Mailing Address � ! - i zJ A4 ± -4 %�C' _ o x �j r- Property Address (Verification required from i Planning Department for new construction) City /State Parcel Identification Number 0 3 L-7 //F _ L EG AL DESCRIPTIO Property z.acabiam /�,54?! /, C. 13 . T3-L--Y-R,/W, Town of �_• Subdivision 4� ` j — -- > Lot # Certified Survey Map # b a 3 S'O -3 Volume 7 Page # Warranty Deed # ( . Volume Page # Spec louse O yes'. no Lot lines identifiable Z yes EJ no SYSTEM MAMENkNCE Impropa use and maintemuceof your sel Iie system eould result in its premature failure to bandle wastes. Proper znaiutensnce consists of pumping out the septic tank every dart a years or sooner, if ateedod by a licensed pumper. What you put into the system can affect the function of the septic tank as a trmt tmeut stage in the waste disposal system. The property owner agrees to submit to 5t. Cxoix Zoning Department a cortiflcatian form, signed by the mmcr and by a master; plurabor, journeyman plumber, restrictedpl umber or a licenitAputnper verifying that (1) the on -site wastewaterdisposal system I s in proper operating condition and/or (2) after in: �eetion ozd pumping (if neeessary), the septic =k is lass than 1/3 full of sludge. Uwe, the undersigned have read the above requirri hunts and agree to maintain the private sewage disposal system with tht standards set forth. herein., as eet by the Department of Cout serve eased the Dopartruont of Natural Resources, Stato of Wisoousin. C.ertiffoation stAtiag that your septic system has been maintainer I must be completed and rcturnod to the St. Ctolk County Zoning Office w6in 30 days of eC year ex ' on date. �64XTUiKF OPLICAW DATE OW CERTMI T� ION I (aye) certify that s.11 statomonts on this ; ►rm are true to tho boat of my (our) k owledge. i (we) am (are) the owner(&) of tie prope described abo by virtue, of a watts 1ty decd recorded its Rtgktrr of Deeds Office. DATE "•�' "• Any information that 6 mis- represented rr ay rosult in the sanitary permit being revoked by the Zoniug Department. ••••'• Inctuda with this application' a stamped wart tnty deed from tho Register of Deeds office. a copy of the a rtified survay intp if reference is rttnde in the warmaty deed JAN-17-2001 12:02 FROM- METROPOLITAN MEDHCAL 651-232-4325 T -159 P.006 /006 F -364 VOL 1404 rnt 51 szwa sswa Q. vtrtscoivslrt PO>ot>►4 i . �► �t REQiST R Of- PC be z p� Ntoabar w D$' ST. CR 91X CO-9 WT ^ - -- wrwd YLM vt4..� Y..�... Wieconniss FSMVEA FOR REWRP M �d� m�0 bCtwR1A1RR Y .i.... i Rrwrlc. 1 w' Gtaatdr, an w._... and bd _. al1ocBr. �. pl- I3 -?�fo0 LOaoo RM CitaAt or, fi3r a v 4 — mable aoaaad mt on. c eaveys to Gmnt+b the f0.-.. via$ WAFARMY W= de.o:a'b.:d ravel egtrto in St i . — , - C—ty+, state Of Wiseonaia ('late -PrwpaLlY')= CERY CMY FEES copy FF.R.a TRMFER it'EI 59.70 ane CM1 F fps i o. 00 PAGES; 7 Bank of New PO Bo RicYimo> 1d Nww RI 5140'17 a1:.� f 03� 11 89 -r� Yataa Motdi tduaihar Q'� (ir aot) on M& Thio I.ot 1 a£ tlae P �t of rlortl tC3Mr+. in tho of6oa of tk F - gia"W of DaecYa !'ar 9t. Crape CouatY wisDOUeiw 7� 909 in Volume 7 of per; at ruSe 46 as Docwmaot No, 603503. Tc,ged or with all rppurteagmt rtahts. fide —d ionterest». Grantee WucnLnts &" dw dtlo to the VmVerty is good indefoasiWa in fee situplo Sad trey Sisd of eQvd0 btwcos except m m rents, rdatriadGms Iiad rtserTudOOa, 1f sumyl of record. Dated Uric .62 4 _ 0 -da y of 2 am - $J U. RasaE► iAa r rM r A[Ti7•>1>�l�T><CAT[Qi+l' AClI;S1A BiRawF +ms(� James 8. Ruw6, ias PRV*WOat S'><A'CE 4P WiSCAN9II�T ) yt_ CrA" CDVMY ) d of tact+ Ood �- day of s.ln trry. 2 Pbswnnl2 heF me the or ,W �Marr A Wusch. its gglQ the above usttwd �o up. Lo ba am Para a) N*A oueauted t)aa roXainE ic..lteumant PAW UMkA0WA04Ze p Iwamo. C o S if Tl't' n. mr-MZ -P. STALTE DAM. OF WISCONSIN autborisceci by S . Wia• Smta.) Notary Yub)ia, Step. W12c THIS vgwrnX .dffi�Tr wns aSlc %rT v a w Cnmmiaston t. at not, mcp6r�LOn date Lois A. bgurmyt Zilx, ]UUe o & Ogluud 1-7-'P ) 304 Lppast sorest. Iffudroa W= 54016 �J"fJ3J7d �tW1QN (sisn.a...s any be mahaadOawd er — Xmwisdsw- nod ato ww df13N1a Hd 'T voo3gst1 ...a.sarY•) J .--- r +r aws of ps:r om slsnlnr in any oaoadw than" ttb wrad or YAuvAd blow datit Nge.ma s. rrw sw w^% ar wsaaoDt r, WnWMnN>f'r O.'� worm Ws - t LfAI INMM.�ATION 'I{O'COOIONALI GOM�AN1 OY L/m. M11 000.0.Miaa7 I Q C) I 00 N O 0ll o 00 6 � ci!y � N ! .00 OOE ° �. o "' r- ,001 - OD OD CU Q • VOA ,00'882 3,bE,2S.0 N � } v 5�� .�: o I N o 3 ct N • a o �, o ,00 OOE • Z a cn > o r + N I b • �J � J� � .' � • N O M I O C7 0 ,,; RE GGS; �, " o I w o co ffflf /111111 00 I N ON ,00'882 3.yE,2S.0 N C) I W I b\ o 9 ` > a\ co NON tU 100'00£ 13.t►E,< ci o 1 o o gN C:) 3 I N t in T I N O 0 f 3 O oC - .� co 3 .� ,00'882 3,bE,2S.0 N z I � " I tif � I o � ,00'00£ 3. a - �-+- o- 8 30 j O 133HS 33S - 3NI� I I CD ° I E ° o ( J .EE E OD _ - - - -- S °0 co Nih I .o ,00'882 I .l- S H1 .D ,00'882 3.b8 N m ,00'00£ 3• N d o n A NF S 13 T31 Nk a u, - - - -- _� ------ - - - - -- - -- - -- -- - 2 z: y» I L Pam Quinn Subject: Meet with Lisa Lebreck Start: Thu 10/7/2004 8:00 AM End: Thu 10/7/2004 8:30 AM Recurrence: (none) 651 - 232 -4135 3 years old - addition Regarding septic, wanted to meet with Kevin but he will be out of state. 038 - 1189 -20 -000 13.31.18.964 2145 134th Avenue - Northgate Lot 15 septic system is not where they had planned, so check our inspection report and information i 7 7 r S U / � i 0 ( 0 % 0) e/ S < -t- 90 {7 / E 2$ a @ E a @; 7 i� 2 0 , _ ! :3. a Q § } 2 Q c 2 / 2 \ & \ :3 E r cn w § ± ¢ \ : 0 27 CD 4 G$ E Q m \ \ ¢ �. M M \� z 0 0 0 9; Or o z } / CD £ 7 7 7 g § 2 E m E CL E ¥ z / o \ E - o g $ , / § § I . \ \ 3 0 \ � \ k \ ¥ $ $ ; E (D CL ° UJ - z » 0 \ R � £ � 0 ( � � , k , $ � � $ ' { � . 2 I � ) / \ eo ��