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HomeMy WebLinkAbout040-1310-00-014 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County St. Croix Safety and,Building Division INSPECTION REPORT sanitary Permit No: 506149 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: DCCI Investments LLC I Troy, Town of 040 - 1310 -00 -014 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: C -j 17.28.19.2001 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic i �r„ 1d� Benchmark Z •G � 5 c . ✓ 1• P�, 6 ( 6 6 7 Z� �✓�� Alt. M . L /�9 F. v Aeration ,_ - -- Bldg. Sewer X . Z 5 y Holding �,•� St/Ht Inlet St/Ht Outlet 7� y �, qZ a � 7 TANK SETBACK INFORMATION it yZ I b3 • �`� TANK TO 4/l1 WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 7 50 1 > 75 cj / i Dt Bottom q �r ! b � Dosing _ Header /Man. l � - t T $l 7 Aeration r' Dist. Pipe />, . b /. (o � /3.3z . ! 13 Holding Bot. System T 1-25 // • yb 7! - 1 - �++-5 A, 196 IT , .77- (aZ ' . PUMP /SIPHON INFORMATION Final Grade '7• T9 � Manufacturer DP and Stgpve c> * — J . L d Model Num TDH L Friction Loss System J T Ft f Forcem@in Length _ Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width / Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 `) ICIG+. ! 4 SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer: r (� INFORMATION CHAMBER OR Ty p Of System: , / UNIT Model Number: _54Z .... DISTRIBUTION SYSTEM 9-Se 5 c•.%5 = 5 4 4 Header /Manifoli Distribution x Hole Size x Hole Spacing Vent to it Inta u Pipes) ' &--,% Length 32. Dia Length_ Dia Spacing_ Q SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed Trench Center �' L� CQ Bed /Trench Edges \ Topsoil ✓ v Yes No Yes No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / / Inspection Location: 491 Meadow Ridge Lane Hudson, WI 54016 (NE 1/4 SE 1/4 17 T28N R19W) Meadow Ridge of Troy Lot 14 Parcel No: 17.28.19.2001 �•' -,5 .� 1.) Alt BM Description = 2.) Bldg sewer length - amount of cover = q � } ,�. 5 O rq Plan revision Required? YesNo 071 Use other side for additional Information. — Date Insepc Signature Cert No. SBD -6710 (R.3/97) Safety and Buildings Division County v 201 W. Washington Ave., P.O. Box 7162 _� � N Madison, WI 53707 -7162 Sanitary Permit Number (to be filled in by Co.) ■ SbNu Sanitary Permit Application State TransactionNnmber In accordance with s. Comm. 83.21(21 Wis. Adm. Code, submission of this form to the appropriate governmental I`f unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS are Project Address if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary purpom in accordance with the Privacy Law, s. 15.04(l m , Slats. I GL t?c i , t� I. Application Information - Please Print All Information Property Owner's Name Parcel IF "! tz S -1 -oc -- j #Wpi r - ty Owner's Mailing Address I Property Location / , 02 I O G�ovL Lot ( �( City, State Zip Code um Y,, S � Y,, Section _ — ' — 0V (circle V TN; R W IL Type of Buildhi (check all that apply) Lot R % Subdivision Name - - l,��o.., r�//2''FF�amily-Dwellingr- Number ofB ms MCI PPP (,i�Y-Y7'G2 � BI k # ❑ Publ"c/Commencial - ❑ City of C" APR 7 � Nurn _ ❑Village of ❑ State Owned - Describe sc n f ST. CROIX COUNTY /+� TI 1Townof M. Type of Permit: (Check only one a if applicable) A' New System ❑ Replacement System ❑ Twatatent/Holding Tank Replacement Only ❑Other Modification to Exiling System (explain) B. ❑ P "Renewal ❑Permit Revision ❑Ch of plumber ❑permit Transfer to New List Previous Permit Number and Date Issued Bel piration Owner IV. of POWTS S tem/Com onent/Device: Check sU that a IST xi- Pressurized In- Ground [I Pmmtrized In -Ground ❑ At-Grade ❑ Mound ? 24 in of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑Other Dispersal Component (explain F /LtJ ❑ t Device ) V. Dis rsallTreatment Area Info Design Flow (gpd) Design Soil I" Ra fJ Dispersal Area (sf) ) a (sf) System Elevation te r- l � V 9 .1 I. Tank Info in Total # of Manufac Gallons Gallons Units a E � j 1 New Tanks ExistingTanks U rn � rn w C7 R+ ±H-:Idi:,.g Tank ©OU DOO r y. O S ng_Cbawber__— _ . - - -- -- - - __ - VII. Responsibility Statement - 1, the undersigned, assume reo for installation of the POWTS �Nr the attached plans PI ber's Name (Print) Pl to 's Signa umber Business Phone Number Plumber's A dress (Street, City, State, Zip Code) VIII. n /De artment Use Onl Pem»t Fee Date s f ed suing A - t Si pproved ❑Disapproved S / `_, / /)� ❑ Owner Given Reason for Denial 7 V IX. Conditions of Appro J / vj S lUReasons for Disapproval SYSTEM OWNER: Septic tank, effluent filter and ill dispersal cell must all be serviced/ maintained a submit to the County only on paper not less than s to s is inches m stu All setback requirements must be maintai e '/1 as per applicable code /ordinances. 6�� `y2 �tJ D-6398 (R. 01107) Valid thru 01/09 �� � Yy SIE: Xf S 1 - 7 'T u-) PD) e� A Me�Aow PA y 04 1 �UQO G «Q S �'�`�i c, /W`��s c�,:.��t'�?�}r �o� v � �"� ► ��czC�c�� `1C`� C s�.� to . . .............. ... .. . . . . . ...... ......... . As a 10 4, oo- -\A Z[ IL hh�,s`m��ha�1 �. u N �`/y % �� 7 -T-,),& tv ) Q ( q ij Po g ©x �L�s -- T�O /&T \R"c6 7310 00 v1 y 1 o 0 0 aQ S ���`� c.`1� �`� s v, `i' ��r l ok S aS 17 f�vc"Ad ,:) `1C i p ca n: A s ry eo r,d o_ W \ i EZ1203N cT •914194 • y •.�_ "•' �•• •`'•� �•�•: � : � ♦999040 4vT 0040 •: f �h....,T: •.. �. e. • y .. � •.. 9499900 �} v9v '•�1�•~'�'.... ,..'•:.� ••'`t. �. wf " �' T144v99 12 t '99. ; rr ;,j' :„ f : . 1 . = Fv: It 24" /� ♦94 1[ �' � v V VV :: �, w. 900 4.625► 9 9 9 909 �� ., 4 P99 9v9 990 ° 994 - -- 1 " 1/2 circ. = 18.84" P4s er ev9 41v 944 99.9♦ 009040 9944999 9 WTvv v00 OF v0447- 9- v94049 04v 4, 0040094 9vvvvvv vvv9P0 T F99vvvvv OvOYt9T v vv40TVOFVVV9vv4 s4vvlr'v9 1t i 36 12 -1/2" DIA. (typ -) YaW Vainme - Soil Interface Area �L• �2 jj. s �q FS Void CoCfHCiC t is Aggmgace given at 57.4%. Sidewall (2 Sit9twailt;) 18.84in O.B. of 4" Pipe < 4.625 inches 2 4 12in - 3.14 Void -1— per linear fk - 3.14 • l i2i T2 t25ia n /ft )' . tfr $ 0.117 fr Bottom l$ 2.00 l O,D. of centercyfioder= T2.5 itches Total Soil Interface Area 5.14 SQ. Void volume in aggregate of center cylinder +-14 6.25ia _ 3.14 ( 2.3125ia ' (12u /ft) ` — 12i.1 ft ,• .574 -.422 ft' 0 - 1)- of outside cylindcrs=12 inches // Projected Trench Area Void volume in outside cylinders = 2.3.1 ( 6a ` ,574 - , `12in 1 ft, ' 90t fN Sidewatt Height = f 2 in. •2 - 2.00 Sq.Ft. 12 rr Bottom = 36 in. = 3,00 Sq.Ft. Void volume at bottom between cylinders b [( bin 1 ) 2i-If, 3.14( 4 1 1 °0,215 ft' Projected Trench Area 5.00 Sq.Ft. inlfr 1 Void volume at outside bottom comers (112 of void volume between eylinders) 0.215 t 2 = 0.108 ft' Total void volume - 0.117 + 0.422 + 0.90 3 + 0215 + 0.108 = 1.763 cubic ft I ft Gallons per ft = 1,763 X 7.48 13.2 eallona ner t_ t, g_ r ft 3 to it )(lo = So EPS Aggregate Trench System EZ9ZQ3H �, AltoW Ring- tndustrtoi Group 65 industrial Park Rd. Oakland, TM 48060 scaF l p E tui tzt2t -mot sir t of 1 t t -z7 -ol 4 • A IL Wisconsin Department of Commerce EVALUATION REPORT p age 1 of 3 Division of Safety and Buildings 'rd War FLW Comm 85, Wis. Adm. Code Attach complete site plan on paper not /2 St. Croix incude, but not limited to. vertical and h ' refer ce Parcel I.D. percent slope, scale or dimensions, north arrow, and ion and distance to nearest << �'� Please print all info tl on. 0 E P 2 1 2005 Review b Date o Personal information you provide may be used for secondary (Privacy Law, s. 15.04 (1) (m) z o a S Property Owner ST. CROIX &gWV Locs ion DCCl Land Planners Inc ZONING F E ti4 SE tt4 S 17 T 28 R 19 0 0 Property Owner's Mailing Address Lot # I Block # or CSM# 1505 HWY 65 14 Me adow Ridge Of Troy City State Zip Code Phone Number ity ovflage own Nearest Road New Richmond WI 1 54017 1 ( 3 Troy i East Cove Road New Construction usela Residential i Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD 0 Replacement 0 Public or commercial - Describe: Parent material Loess over glacial till Flood Plain elevation if appHCable A ft. General comments / * fill over tlatural soi GLi� -� and recommendations: Sa^^ll! conventional s stem M FT] Boring # 0 Boring ID pit Ground surface elev. 92 7.00 R. Depth to limiting factor >98 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fi? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *EfM *Eff#2 1 0 -13 10yr3/2 - sit* Om dh cw - ,0 .2 2 13 -23 1 1 w3/2 sil lmsbk dsh c 2f .4 .6 3 23 -29 10yr4/3 sil lmsbk dsh cw if .4 -6 4 29-42 7.5yr4/4 1 msbk dsh cw - .4 .6 5 42 -98 7.5yr4/6 s dl - - .7 1.6 7 2 Boring # [] Boring 925.97 >98 0 pit Ground surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDN in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 *Eff#2 1 0 -19 10yr3/2 - sil* Om dh Cw - .0 .2 2 1 19-40 10yr3/2 - sil imsbk I dsh cw 2f- .4 .6 3 40 -50 10yr4/4 - _ _ _ _ -siL _ l msbk dsh cw if .4 .6 4 50 -98 10yr4 /4 - s1 Om dh - - .2 .6 * Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/I_ ' Effluent #2 = BOD < 30 mg& and TSS a 30 mg/L CST Name (Please Print) Signature CST Number Thomas C Nelson L `-- 227387 Address Date Evaluation Conducted Telephone Number 1432 120th Street, New Richmond, WI 9/18/05 715 -246 -2454 Property Owner DCCI Land Planners Inc Parcet tD # P Page 2 Of 3 [ :3 Boring Boring g E] Pit Ground surface elev. 925.47 ft Depth to limiting factor 1 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#t *Eff#2 1 0-45 10yr3f2 - sil* 4111 dh cw - .0 .2 2 45 -56 t 1 3f2 - sil lmsbk dsh cw 2f A .6 3 56 -100 loyr4 /4 - sil lms dsh - - .4 .6 a�7 F1 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 GPDIf! in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # Boring 18 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& in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Ettluent #1 = BOD > 30 < 220 mglL and TSS >30 < 150 mg& * Effluent #2 - BOD < 30 mglL and TSS < 30 mgIL The Department of Commerce is an equal opportunity service p rovider and employer. If ou need assistance to access services or Pin e9 plm h' P Y need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608- 264 -8777. SBD- 83307ed (807/00) i I ` V DCCI LAND PLANNERS, INC. SOIL BORING 1 ww Lot # 14 - MEADOW RIDGE OF TROY ® • \ NE 1/4 OF THE SE 1/4 OF SECTION 17, BENCHMARK ., y \ T28N, R1 9W, TOWN OF TROY, ST. -TOP OF CflNWT •�' CRODC COUNTY, WISCONSIN. a ALT BENCHMARK • t - TOP OF CONDUIT • • • • • TOM NELSON CST - Lio. # 227387 N NOTE: THE CONTOURS IDENTIFIED • ENVIRONMENTAL EFY DESIGN ARE PRIOR TO CONSTRUCTION. wr,r 14$2 120TH ST. CONSTRUCTION GRADING WAS IN ING PROCESS DUR SOIL TESTING. wr,r wr,r NEW RICHMOND, WI 54017 CONTRACTOR MAY NEED TO ph. # 715- 246 -2454 CONFIRM FINAL CONTOURS DURING INSTALLATION. • • SCALE IN FEET 1 40' • aae•r0 1 100 0 100 o \ \ �, cM \ . V 62 7 27.00 '~ B3 0925.4\ 932.'1 9 .82 d J t9 \\ ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerB uyer T)C C--1- LA/44 P I MIQq4-1; �t S Mailing Address �� /. X 4qS ` , E A cAy,4( , 0 14 0 eZl Property Address q i (Verification required from Planning & Zoning Department for new cons on.) City /State 4 -50N Parcel Identification Number j0 q©- 1 3 / O 'O ©- �➢ l 7 LEGAL DESCRIPTION Property Location W 1/4 5 1 / a , Sec. 1 7 ' T -29 N R 14 7 W, Town of SubdlViSioII �'IEL� �� W / ©C.�c fI -CQ �/ , Lot # 7 Certified Survey Map # , Volume , Page # Warranty Deed # T6 S © 5 3 , Volume 2-73/ , Pagc # Spec hous yes o Lot lines identifitg 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 §Conan. 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. Uwe 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 descri d above, by virtue of a warranty deed recorded in Register of Deeds Office. Number b dr , A / ,0 7 - S1qNA ­ TbfZE OF U PL ANT(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 Office and a co of the certified survey ma if pp on recorded warranty deed from the Register of Deeds Offi copy y p reference is made in the warranty deed. (REV. 08/05) POWTS OWNER'S MANUAL &MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner � �� S,' Septic Tank Capacity /1)00 ga l El NA Permit # �' ` Septic Tank Manufacturer ! rs ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model L-, ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity al ❑ NA Estimated flow (average) 3 © 0 g al/day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) gal/day Pump Manufacturer ❑ NA Soil Application Rate r gal /daylft2 Pump Model ❑ NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit NA Fats, Oil & Grease (FOG) :530 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 -- - -- - speFSal £ellls) -- — -- ,❑ N- ► _ Biochemical Oxygen Demand IBOD 530 mg /L Xln Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L �A ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 5 /100 ❑ Drip -Line ❑ Other: : II Maximum Effluent Particle Size Y in dia. ❑ NA Other ! ❑ NA Other: ❑ NA Other: ❑ NA *Values Values ical for domestic was w er tic tank effluent. ❑ NA typical to at and sep e t MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once eve 2 ❑ month(s) (Maxi 3 ears) El NA every J ear(s) mum y Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell year(s) At least once every: ❑ month ar(s) ) (Maximum 3 years) ❑ NA 04 Clean effluent filter J At least once every: ` ❑ year(s1(s) ❑ NA Inspect pump, pump controls & alarm At least once every: months) ❑ NA ❑ year(s) Flush laterals and pressure test At least once every: ❑ ye arls) 11 m r (s) ) ❑ NA Other. At least once every: 0 yea�(s) ❑ NA 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 cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized 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. START UP AND OPERATION Page ;.— of For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products 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 fife 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 replac ment 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 suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. • The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. • Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of s uch systems must C ompl y 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 MAINTAINER Name rS Name Phone S( Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name C t Phone Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. - vai ic! riu, tiracti IU G4b474d H.162 ' U 2731 P 55� KATHLEEN R- WALSH REGISTER OF DEEDS ST. CROIX Co., w I RECEIVED FOR RECORD LIMaTED WARRANTY DEED 61/i4/2085 61:66pK WARRANTY DEED Document No. fXW i REC FEE: 15.99 This Deed made between VALLEY LAND RAAY � S FEE: 10956. COMPANY, a Minnesota corporation, Grantor and CC FEE DCCI LAND PLANNERS, INC., Grantee PAGES.- 3 Witnesseth, That the said Grantor conveys to Grantee certain real estate in St, Croix County, State of Wisconsin, legally described on Exhibit A hereto (the "Property"), Together with all and singular hereditaments and appurtenances thereunto belonging. d y This conveyance is without warranty, except Grantor covenants and represents the Grantor has not made, done, executed or Tax I.D.: 4 - 14: -4 suffered any act or thing whereby the above- described property or any part thereof, now or ? 'CU57 at any time hereafter, shall or may be DyG /D7 - ,Vkf A no imperiled, charged or encumbered in any manner, and Grantor will warrant title to the above - described property against all persons claiming the same from or through Grantor as a result of any such act or thing, provided, however, that the conveyance hereby made and the warranty of Grantor is fiuther limited by and subject to those matter set forth on Exhibit B hereto. Dated this day of January, 2005. VALLEY LAND COMPANY, A Mn corpora 9 50 y Its: ACKNOWLEDGEMENT STATE O COUNTY OF SS Personally came before me thisoday of January, 2005, the above named Gary B. Valley, as President of Valley Land Company, a Minnesota corporation, having full authority to do so and to me Imown to be the person who executed the foregoing instrument and acknowledged the sam blic, State of commission TROY 4 9 0W. Pt4oT.D E OF D CCI LAND PLAW-W EBS INC. 1505 34'WY 65 NEW RICA CMOND, 'WI 55017 SOMME u r amen 1 �•• �".�•.., � •.` stawlrat00 MOBIOFIOHOOMIAEI .PUANPOaTi °°4:"°..,e�� � wcur omeurawru +n®toateeisuvonassinlene. \aoru� Iffi � wowu�aaearo� ~ woeiew�ra ? ! �• Past ! ` tmrrs� t ..a� � '` awranaeriraanewiass�+as rs r 1 !� f tart 1 lr • - ..� ! aarae �. ! 1 '•^ WoMp71pt11 TO DAL STM B J j { rrr • o 2L SEMPOK ea morr a caFwcteaTam Nopmaos BUMMOCAMES AMID BE i -mow S -- e t �l trnnmR r --•- -. �_` �_~ 't \ t 1 s7FART .•rwcai MMURI Awnarw+eoa tar to , smEruwETreaSwoea \�s i ; \torar• ` .rte l swr ' r ` Laarar l �ia*av' 1 �� �FORMA�EEFOn aRwaic Lary ',� � :t �i LOT So \ FIAVwB A1eRIOLFrTC BBnuE 7FE APEA ounm \ a�aeasHOUxannieww�sasieenosrAnE YN+o r SEPOM NnESa1DPE618 w UFMA AFU➢6.MNYIIY •j,•• �arsa�Aece9eror Mace.Etclae�sc�srsaa 692LOW0. LyG7 i = eerenr., a .wrwwcacaxr�crnESrewOxcasmrmw�s OFFMANDIMEMMMOFINYTFORmyom �• - ASpEWL S3g3W Nt#6EMftWM FORTFE S �...,,� dsn�u+ cEOFataFESmsawca +GwlEnFiorsFaros�Ows `b THBTIMEOH7FE APAa0EF9 PUATOR CEM 7tas PBiYBrIS AI+PLWD FOR TFfKXM A PUBLIC FEAMM PROCESS By 'M St' i CR=CMMffy BDARCOFACARIST~. 771PrjL 1qf in =ME ■LUMN sET&M LMS Attth•Con W iWassod&Ws QxRow guffaw on" \ L°T SO Land Sure 09 >rp• `was BiOM OFP1C& STREET 2920 1 01ce Stmt We 101 HodsoLL 11 54016 LOT /UREA TABLE Tel 715- 98t_sC/7 tOf # SIL FT tOf i sm Fr LOT } s0. Ff LOT 0 so, tT Lot 1 43061 tot tt 44M Lot 21 123147 oL 1 27606 Fax 715 - 381 -5398 tot 2 4 WW Lot tz 4WD tat 22 72101 01- 4783 6ad30u8BnUtc0nauitio9com i tot 3 43302 tat 13 70746 Lot 23 1[[0631 UL 3 174006 tut 4 52m6 Lot 14 162210 Lot 24 46100 GL 4 22407 tx1RMTE OFFICE R` Lot 6 06366 tat 13 70206 Lot 6637 ,. 25 4 oL 6 843406 IN tot .b 46006 tut M 06614 tat 20 04067 (LL 6 2DW3 406 Technology Ome Pmt Lat 7 Dom tot 17 OOOt4 Lot 27 50001 AL 7 46512 Suite A lat a SQB56 Lot to Oa0B0 tot 26 63062 Ol. 8 7363 lle6061B61e, 1n 54751 s• {� tot 6 4740 Lot 16 - 06033 Lot 20 47162 OL 6 1171!1 Lot Lot 10 30106 Lot 20 1676[6 tot 30 WM OL. 10 3606 Tel 715-232-8498 tat 31 SM at. n t207t3 Fax 715 - 232 -8492 i # NOM ALL LOTS COWAIN GREATER THAN TAS ACRES OFHEf• ADAMEAFEA. men*authcoasultiBs.cGM �� g 3 E *.o a ounarr wr_ 1� »raaw ( i ton CA.WL n,v��rc an I 1 1 1 MA 1 1 1 ( odnarr ' I r .._..� r —•. — i .. �..� �. i Lr: 1 j L.�— — r— — � ♦ I t • Lora 1 Lora ! i 1 :Lam a i CRRLDTV i \ LOTa kN LOCATION SKETCH TOWN OF TROY 1 _ CA LoTas EA ST COVE 'O ��� i L'' •/' t , i LOT25 ... i LDTZP t' i SECTION 17, T28N, R19W E;I j `► SCALE W FEET t 100 0 700 ,� �z