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HomeMy WebLinkAbout040-1012-20-000 C0 WO O '- V O m f r 3 m ID m T ( o Z ° cWn 3 o L 7 N O a W O N O 1rJl (D M Cn (D 47 W F ! CD (/�\ cD O N W ? UD N O O a O� D p O O O G N n N O W 3 t0 p CO 00 CJ d � cn V D A Q ? CL N 3 ° _� 0 0 CD A <'I� V N N <D O O ! � Nhi N n 0 0 0 7 � • N 3 -4 fn . 3 Ul fn A m m � m 0) N 3 ( CD lV y N O 91 D m - a °Z z p z Z o A o D h O ^ p O (D rn ° m N m N (� c 7 ((D m m -i cn CD n z CL A Z 0 Z A WCD zw CL Z 1 A O '! Z O 3 m W z (D A A � (D 4t ()I > N. Ul t r3, CCt N 0. C O = p' T j ? 41 L1 Z G Q m O ID O O m O asp y cr CD a c F . w � � R `Z 0 e v � O N 7 m N zz O O (0 � I � � O � \ O O CD yp Qo . EA �. O Q is O ;J r ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner 0-1 Property Addre s ) ? City /State 3 Legal Description: Lot Block Subdivision/CSM # t /4J + t /4, Sec. 9 , T IN -P,� _ Town of d ` 4 PIN JAO -/ z-,?, /9 saw SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION Tank manufacturer,/' Wi � 1 !t� S Size ST/Pct G'G E C� Se back from: House Well er P/L Pump manufacturer f Model RC Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: C 1J. Width Length Number of Trenches Setback from: House Well -> 7 ` PAL �S� � Vent to fresh air intake - 7 /;Ax Ta'' ELEVATIONS Description of benchmark [;w ;/ 9 �le L� v Elevation Description of alternate benchmark Elevation Building Sewer ST/HT Inlet ST Outlet PC Inlet PC Bottom Header/Manifold Top of ST/PC Manhole Cover Distribution Lines ( ) () ( ) Bottom of System ( ) ( ) ( ) Final Grade () () ( ) Date of installation /? 4OPermit number State plan number Plumber's signature d) �e License number y ' I 7 Date 5 l dP Inspector u, Complete plot plan e NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW c o a --3 old .i jj �f 1 a� A rti lS Y4 Ca�'. �TI1'yAlpy'S J r 0 0 P YbpeS�.� INDICATE NORTH ARROW f • , Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count� Safety and Buildings Division t Croix INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) SanitnWwNo.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: ❑ City ❑ Village own.of: State Plan ID No.: nlow, David Troy Township CST BM Elev.: Insp. BM Elev.: BM Descripti n: Parcel Tax No.: Z, +��� = G� 8 2 040 - 1012 -20 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Alt �— 1 Z a p��o17 Benchmark ` Dosing Alt. BM Aeration Bldg. Sewer 6 B`� ��, O / r Holding St/ Ht Inlet (.O TANK SETBACK INFORMATION St/ Ht Outlet TANKTO P/L WELL BLDG. Air to I ntake ROAD Dt Inlet Air Septic 5 ( `+- �f, NA Dt Bottom 0. `(S cjp Dosing J + ) [ o� NA Header / Man. S. ` s c . I Aeration NA Dist. Pipe L Holding Bot. System �' Z Y ot PUMP/ SIPHON INFORMATION Final Grade Manufacturer 6 m j-d - Demand St cover �, 0 6 I a 3. Model Number O (r . GPM TDH Lift Friction I System - TDH Ft Forcemain Length-Iiil Dia. Z`f Dist. To Well SOIL ABSORPTION SYSTE kZ, I„�, 5 BED/TRENCH Width r Length N f Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIM EN I N 3 - 7" S OL DIMENSION Nl anuf c e SETBACK SYSTEM TO P / L BLDG WELL LAKE /STREAM LEACHING �� r. CHAMBER S«Q INFORMATION Type O M el Number System: �o•'^� . 5(+" - OR UNIT { DISTRIBUTION SYSTEM Header/Manifold fr Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length !lame- Dia. L f Lengt Dia. Spacing 7 f ` SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over t A Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center '1) y- Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: 5 Inspection #2: 1 —! Location: 590 High Ridge Drive, Hu son, WI 54016 (NW 1/4 NE 1/4 4 T28N R19W) - 04.28.19.50A 1.) Alt BM Description = `T''` a"A� ate-- , ` C ST {-o UT_ 2.) Bldg sewer length = 1 0' 4 - - amount of cover = (( > 3<v �• L .p.._ t / l 1 C.Aj� -� r eC_G1�e �, Plan revision required? eNo Use other side for additional information. M4 A z/ ova SBD -6710 (R.3/97) Date Inspector's Signature Cert No I ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: a.m b , , s r ."w s i k t i t , k n S � t k Y ! e j p d j i } t E r , f � 9 � " s Po r € 1 1 1 4 t , 4 i P � 6 r L' 9 k , r w I , SANITARY PERMIT APPLICATION Safety and Was Avenue ln *6 onsin ' 201 W. Washin P O Box 7302 In accord with ILHR 83.05, Wi5 Department of Commerce s . N.�; �. Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the sy �. �► per not less County ,,,... than 8 v2 x 11 inches in size. :' • See reverse side for instructions for completing this app ►ication� State Sanitary Permit Number 3 Personal information ou provide may be used for Y P Y secondary purposes ❑Check if revision to previous application ]Privacy Law, s. 15.04 (1) (m)]. S'76 +4_ R�� P r State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INFORM F R .` ProppAy Owner am rt Location;` Y 4 1/4, T ' , N, R E (or)d Property O ner's Malli A dress LAt1N0rrjb8r .. Block Number _ CUer _ _L _ w .! 50 Cit , tat Zip od Phone u ber Sub ivision N e q N er / ( ) I a mac,+ II. T P F BUILDING: (check one) ❑ State Owned It N ar st a ' village Public 1 or 2 Family Dwelling - No. of bedrooms Town of _D III BUILDING USE (If building type is public, check all that apply) Parcel �' Tax Nu E] el .1 Apartment/ Condo �(o 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1.�New 2. ❑ Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5_ ❑ Repair of an __System ________System __Tank Only_ ______ _______ Existing System ________ ExijiggSystem B) C] A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 []Seepage Bed 21 []Mound 30 ❑ Specify Type 41 Holding Tank 12 Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 1' ,� 43 ❑ Vault Privy 14 ❑ System -In -Fill ©�� N k Q a ' rn �' /4 r e, fo!'S y t� one 1 c°S VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6 �S�ystem Elev. 7. Final Grade Requ ed s ft.) rop Q�se (sq. ft �(Gals/da /sq. ft.) (Min. /i ch) ' . f6 ✓ El ti� b v � 7 10 �L met 1 Feet VII. TANK Capacity in gallons Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existing structed Tanks Tank Septic T k met* K fl S � S 1` ❑ ❑ ❑ 0 ❑ r ❑ 1 ❑ ❑ Cl 1 ❑ ❑ VIII. RESPONSIBILITY STATEMENT [,the undersigned, assume responsibility for installation of the onsite sew tem shown on the attached plans. Plumber's Name: (Prin Plu s Signature: (Np Stamps) M /MPRSW .. Business Phone N be Plum er's Addres (Street, City, Sat , Z Cod ) t �� IX. COUNTY/ DEPARTMENT USE ONL ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate I ssued Issuin Agent Signature (No Stamps) N Approved ❑ Owner Given Initial Surcharge Fee) Adverse Determination Z - L X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: e C - I�f:, 5ysf �+1� sf 4, l Sy3��r -�- r�ttiS� �is �xfGk�� -Gtr acccoknf' � +I�t �tok.�../ a i— c v r U * lc -4 a ,1 V r y /Z7 SBD- 6398 (R.11197) DISTRIBUTION: Origifial to County, one copy To: Safety & Buildings Division, Owner, plumber a. INSTRUCTIONS 1 _ A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever . necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608- 266 -3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply_ IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI_ Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons,.number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII_ Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX_ County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. f 1 f 3 0 2_ fr o veS C� � f b tt lo t Lem,gr? _ 1 qj 1 r ___ '�, _ . _ '� __ ___ I '� � I _ . �� _ i __ _ _ ___ __ _ . •lpr andHumanRelations ATION RE Page / of 3 Rivislor4 of safety & buildings in accord with ILHR 83.05, Wis. Adm. Code } 150": Uwe (,u, tfv{f_4l _ JS mil/, �•4�Dvasool� 7e . COUNT 1 (o/ 7 77" q.71�� G�,�c s GO o/ 'Q✓ Atfach complete site p an on paper not less than 8 1/2 x 11 inches in size. Plan mint include, but ' 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. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION WED Y DATE /� Ua PROPERTY OWNER: �yq E PROPERTY LOCATI O A 174A1 6 f�q / L y W U ST f»# - GOVT. LOT 14 IJ16 1/4,S T T ZF ,N,R E (o& PROPERTY OWNER':S MAILING ADDRESS LOT BLOCK # I SUBD. NAME R C # CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE E FOWN NEAREST ROAD �✓ v� c 57; me /-, 7 Ted �(] New Construction Use [)q Residential / Number of bedrooms ✓ [ j Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 4/ v_g_pd Recommended design loading rate - bed, gpd/ft2 do trench, gpd/ft Absorption area required led, ft 75 D � ch, ft Maximum design loading rate • -7 �ed, gpolft wench, gpolft Recommended infiltration surface elevation(s) 3 ft (as referred to site plan benchmark Additional design/ site q= '4U 01, 0 s ` Z/S�` 7W ��-k s w �� ee d>< a i "S 7;&1 Parent material .,xs 7y '6 - fllfu4 o� _V4,r4 Flood plain elevation, if applicable �- ft [ S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK IJ= Unsuitable fors stem CnS ❑U S ❑U AS 0 El ❑U ❑S K)U ❑S 411 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 0-12-. /o y2 3/L S/ /, sd� �,v�ie 3 y s <x - <: Ground C - f6 /D y/2 sl � -- s dev. /p oG ft. Depth to limiting This test 8 fact a Remarks: Boring # 1O ` 3 / .� j /�7� S�J�' �hty� / 3 4 S ' ii: :•i:tiii:•:t / ;<:.v<< 20 z o /D yle 5 14'. L Ground le 3,1(0ft 1 Depth to limiting Y lb Y AL factor CST Name se q�' 5 0'NF !t. RD., HUDSON, WIS. 54016 Phone: n 71 3 d G e 5— Address: q Y i NIP STER PLUMBER LIC. NO. 3307 M.P.R.S. Signature: g't t ALLEP « Date: �� CST Number: 1 PROPERTYOWNER �t 1 r ^ SOIL DESCRIPTION REPORT Rage i;' • _ PARCEL I.D. 0 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /tt 3 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench e 1;0 7 Ground G I� // . /0 ye S/ .5 , e, sT 4, el /D ft I Depth to I limiting II` factor „ f Z�_ � i f Remarks: t Boring # } i a �3 G Ye y s/ 1, f sbr rwl,e s a S t, elev. to f Depth to limiting �. of� ? factor s �� JO A 4k 0 1 1;W&- cTl . Gyt S� .t // 411P / �fi�� —See �173aa� Remarks. SJ S i S Boring # J/z s/ / 3f , y s - 3 L /0 Vii s,6 /C _1'1 —ins /oro Ground ' elev. 1,93 7 4 ft. Depth to Z db limiting factor i Remarks: Boring # _ 2 rl - of sic' � -��e rf 3 Ground elev Depth to limiting factor Remarks: SBD- 8330(R.05/92) 1 � �1 A?2 ; d I � 13Z, / ,03 /33 /03. G!� 1' / 1 pQoPoSEO I 0 \ 1 ff°oSES� ' 3 S 13 ss. G oo S o (to i tv � IS 3G k4 'y v S 3 1 0 , I . 0 . !v G y G5 2 ' 9y I �3 4 c Sv ES 7��7� S � STf�'I o � � �i'ls�- �, �',vGG • I� 3 Lott/ - rf £.ve-j!�' . �O I Ho}'~SITE SEPT 1C PLUMBING CO. � 6a6 O'NEIL RD., HUDSON, WIS. 54016 3 sGi} GE , O ROBERT ULBRIGHT cs T yY Pz- WIS. MRSTER PLUMBER LIC. NO. 3307 M.P.R.S. AAtNN. IMS'fALLER &DESIGNER LIC. N0.006 E 63 _ Property Info. Sheet ADDRESS EAST -�- R O Y XX High Ridge Drive _ PART SEE ""` `� � PRICE $ 29,600 c" "yS . 4� SELLER: wsf Hudson, WI DANA FAMILY TRU T " += CITY /TOWN WAYNE G. & AL I C A. DANA 1706 Larpenteur Ave. E DISTRICT wf� ;, � �� r���a S t . Paul MN 5 v .S'�itir � +�Ir im.K nFfr , f roa%y BUYER: Ff � -- / H!r f ii Z...4 n• UWE W. & MARIA- LARA RUHM Mme" 1J¢rd6 +..5 te 5 A. or'� LOT SIZE/ACRES 8592 N. Ironwoo Trail �" kk "" F derfof � Lake Elmo, MN 15001 -,[A A vr����Pvne,fi JOB NO: 74 -06-1 S`l/R V,, Y MA P "p rok V - e c© , ed j LESTi:R DANA Part o{ the NE %} o { 5¢etion 4, Townshr'p 28 North, Rang¢ /9 Weil-, Town o{ Tro Sf. Croix coanfy YYl's- - - n/64 °52'E n/89 °52'E -, 220.0' I 1 N Eas {� 0. Y of in 5. 7' 35 op o a � t5. D5 Ac. q ° V 220.0' /V 89 O INDICATES IRON PIPE STAKE BASED ON A SURVEY MADE 9174 DATE 9 -23-74 SCALE DRAWN JL CHECKED LOC. 4 Part of the Northwest Quarter of Northeast Quarter (NW 1/4 of NE 1/4) of Section Four (4), Township Twenty -eight (28) North, Range Nineteen (19) West, described as follows: Commencing on the East line of State Trunk Highway 11 35 11 , 75.0 feet South of North line of said Section 4; thence N89 degrees 52 minutes E parallel with and 75.0 feet Sough of said North line 1050.5 feet to the point of beginning; thence N 89 degrees 52 minutes E 220.0 feet; thence S 0 degrees 44 minutes W 999.5 feet; thence N 89 degrees 53 minutes W 220.0 feet; thence N 0 degrees 44 minutes E 998.5 feet to point of beginning, subject to a non- exclusive access easement for property to the west over the Wc1T�i °ly 20 teat theraoT as decuc'rihad in Vo1111il - "635", page 37, as l ST CROIX COUNTY SEPTIC, TANK- MAINTENANCE AGREEMENT • _ AND WNER:SHIP CERTIFICATION FORM i Owner/Buyer �DI U i t Mailing Address y J l Leis- . Property Address (Verification required from lanning Dep nt for new construction) City /State L s o//) b, . - parcel Identification Number _An lw 2 6 6 LEGAL DESCRIPTION Property Location dL ' / y4, Sec. �, T "U N -R I A Town of G Subdivision Lot # Certified Survey Map # / Volume L . Page # Warranty Deed # Volume / ( Page # Spec house ❑ yes p no Lot lines identifiable 12 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 master plumber, journeyman plumber, restrictedplumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal 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. Uwe, 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 da s of the three ear expiratio date. SI ATURE OF APPLICANT 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 property de cribed a ve, by virtue of a warranty deed recorded in Register of Deeds Office. q lev 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 • 1484 6� ,a ` Yi pAGE 1 U STATE BAR OF WISCONSIN FORM 2 -1999 161 [692 $ Document Number WARRAMI'Y DEED KATHLEEN H. WALSH REGISTER OF DEEDS This Deed, made between Uwe W. Ruhm and Maria Mara Ruhm,, ST. CROIX cc., WI husband and wife RECEIVED FOR RECORD Grantor, conveys and warrants to David S. Inlow, a single person 01 -14 -2000 9:30 AM Grantee. VARRARTY DEED EXEMPT / Grantor, for a valuable consideration, conveys and warrants to Grantee the CERT COPY FEE; following described real estate in St. Croix County, State of Wisconsin (The COPY FEE: "Property"): TRANSFER FEEr 215.70 RECORDING FEE: 10.00 PAGES: 1 Recording Area Name and Return Address d ATTN: Mortgage Dept. Z/ First National Bank of River Felix PO Box 166 River Falls, WI 64022 040-1012 -20 Parcel Identification Number (PIN) This Is homestead property. Part of NW 'k of NE 'A of Section 4, Township 28 North, Range 19 West, St. Croix County, Wisconsin Described as follows: Commencing on the East line of State Trunk Highway 35, 75.0 feet S of N line of said Section 4; thence N89 °52'E parallel with and 75.0 feet S of said N line 1050.5 feet to point of beginning; thence N89 °52'E 220.0 feet; thence SO °44' W 999.5 feet; thence N89 °53'W 220.0 feet; thence NO °44'E 998.5feet to point of beginning. Together with and subject to a non exclusive roadway easement for ingress and egress over the West 20 feet thereof as set forth in Vol. 635, Page 27, Doc. No. 373135. Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this z 9 day of December, 1999. i "Uwe W. La,cr " • Maria Kura Ruhm ACKNOWLEDGMENT SPATE OF' ) AUTHENTICATION ) ss. County } Signature(s) Uwe w Ruhm and Maria K1Ara Ruhm Personally came before me this AJ day of December authenticated this 29 day of December, 1999. 1999, the above named 1 tnQ to me known to be the person(s) who executed the '�Lcistiaa pgiatt� e e a J. P anew foregoing instrument and acknowledge the same. TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) Notary Public, State of Wisconsin My Commission is permanent. (If not, state expiration date: THIS INSTRUMENT WAS DRAFTED BY _ } Attorney Kristin Ogland Hudson, W154016 B (Signatures may be authenticated oracknowledged .ltothare not necessary.) REBECCAJ. PHANEUF NOTARY PUBLIC STATE OF WISCONSIN - f r03 -Names of persons signing in any capacity should be typed or printed below their signatures WARRANTY DRRn BTATE BAR OF WISCONSIN FORM Nn. 2 - 1990- INFORMATION PROFESSIONALS COMPANY FOND DLI LAC. Wt 800L55.2021 f 1 H!� w — RIDGE 5rv7.'69' 365' 128.02' _ -- 25L24' 191.69 2 of N 0 d CD LOT I 872 (D 873 M M 9 �q/t2- N 50 C a �1soo 50A it 492.81' �bO uW NW L - NE 114 � ` -' � �, NE QPG" wo SL 877 Ze.s G 2 0` ���0- 5`, E 1 N_- `a (� LOT 2 7 N N 878 1? � - s � S 364.27' sso.Ta' 14 200' 15 0 886 887 888 17 _ 50 D -- o — -- — -- / to N 231.25 LANE /3 , �t N 200107' L UNDY r ---� — "4 — 88 ,:- 890 ON 165 20 230 19 l "893 892 891 SE j�BO Coq,,! yep I ic-T Op0rI PAGE OF PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS ` y Y'ns�c +ini'� VC WT CAP WEATHER PROOF APPROVED LOCKIN MANHOLE COVER W� 25' FROM DOOR, IZ~Mifvl. I.Vrir/�iJ�l WINDOW OR FRESH I AIR INTAKE I GRADE I y" A 18" MIIJ. COWDUIT N 111 • PF OVIDE I - -- INLE T AIR IGHT SEAL APPROVED JOIWT A I I APPROVED JOINTS W/C.I. PIPE I III W /C.I. PIPE EXTENDING 3' I I) ALARM EXTEWOtNG 3' ONTO SOLID SOIL ONTO SOLID SOIL I I ON 17 GaI c I I I . CLEV. FT. PUMP --�„ - -� � OFF D CO RTE BLOCK /� r o 3" APPRov RISER EXIT PERMITTED Ly IF TAWK MANUFACTURER HAS SUCH APPROVAL.7gEpfl�µ� SEPTIC rz SPECIFICIC ®US DOSE TAWKS MANUFACTURER: WUM BER OF DOSES L —PER DAU TANK 51ZE��Od �fVQ GALLOWS DOSE VOLUME ALARM MANUFACTUii,LR: - � � �e��r� ��/ INCLUDING BACKF GALLONS LOW: MODEL WUMBCR: �� 1� CAPACITIES: A = �� INCHES OR GALLOWS SWITCH TUPL: f 5 = a INCHES OR GALLONS PUMP MANUFACTURER: r n A 1 , 1 1 A C= a . IW CHES OR � ,✓ ..� GALLOWS MODEL NUMBER: 2I �p D- _L.._ INCHES OR GALLONS SWITCH TYPE: ,NP� MOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCKARGE RATE °_a GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWECN PUMP OFF AND OISTRIBUTIOW PIPE.. le) , FEET + MINIMUM NETWORK SUPPLY PRE S6URE ......... .. -r !" 5' LET ♦ -96 `r EET OF FORCE MAIN X , w j F y .,, FRICT1 0 la FACTOR.. 1 FEET TOTAL DtIWAMIC. HEAD = ..1 FEET INTERNAL DIME.IJSIONZ OF TANK: LEWGTH / . 1 .;WIDTH ._s.L_.;LIQUID DEPTH SIGNED: LICENSE WUMBER: Al" c � 7 L9 _ DATE: f t ubmersible MODEL: 3871 SIZE. 3/4 SOLIDS Effluent Pump R PM :1550 METERS FEET 8 25 7 - -- = 6 20 Z 5 - .15 �Q 4 p 3 10 2 5 0- 00 10 20 30 40 50 GPM 0 2 4 6 8 10 12 m' /h CAPACITY qGOULDS PUMPS. INC. SBiECA FALLS WW YOW 13148 Etbcd" October, I ft 01M Gourds Pumps, Inc• SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE PRINTED IN USA