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HomeMy WebLinkAbout042-1020-90-600 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division ` INSPECTION REPORT Sanitary Permit No: 405128 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) �_2 0 Permit Holder's Name: City Village X Township Parcel Tax No: Collins, John I Warren Township 042- 1020 -90 -600 CST BM Elev: Insp. BM Elev: BM Description: 3 /c/ <y UD' Mo. 13 /Y7 J TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Cl J - (O„ 9 Z Septic Benchmark / /0V ° 2 /0 Dosing Alt. BM 0 1 S'T s_ v Aeration l Bldg. Sewer // Z • p 3 • s� /Oq. 3 Holding St/Ht Inlet ol-if 3 Oar o TANK SETBACK INFORMATION SUHt Outlet TANK TO IL WELL BLDG. Vent Air Intake ROAD Dt Inlet J N 6 Septic Dt Bottom I ou l is 41 9� Dosing Header an. 4117- h V-1 /t 1 2 . - 7S Aeration Dist. Pipe Holding l ZinalGrade t. System �o /. 8 D /0 /. PUMP /SIPHON INFORMATION � S X03. f" Manufacturer Demand St over �2 1 /✓ G� �[� GPM _t 7 I- J /Z.� G Oj. Model Number CPO el // Z /� TDH Lift Friction Loss System Head TDH Ft - r . , 7. , 75 - 1•3 g Forcemain Lenth Dia. Dist. to Well SOIL ABSORPTION SYSTEM -/b BED/TRENCH Width L Length No. Of Trenched PIT DIMENSI NS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS J ` • S SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LekCHIOG Manufacturer: INFORMATION / y / CHAM OR Type myster, m _- / ( W+ ,4J /� U rv/I.CJ Model Number: DISTRIBUTION SYSTEM Y67 Header /Manifold IDistribution x Hole Size x Hole Spacing V � o Air Intake h 1 Plpe(s) /� / i C 3 Length 2 l� Dia � Length 0 Dia Spacing /t kj � SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over 1� Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center '1 Bed/Trench Edges Topsoil :74 Yes � No � Yes � No COMMENTS: (Incl ode discrepencies, persons present, etc.) Inspection 1:/ / �� Inspection Parce 3 / / Z__ �- t08.29.18.118F Location: 1077 100th St Roes, WI 54023 (NW 1/4 NW 1/4 8 T29N R18W) NA Lot o/ ParcelrNo. 1.) Alt BM Description 2.) Bldg sewer length - amount of cover = 3. Contour = 6,01 / 100 w Plan revision Required? ❑ Yes No //-- ! i Use other side for additional information. [P �5 SBD -6710 (R.3/97) Date Insepctor's Signature Cart. No. r Safety and Buildings Division County 5r Ca PC 201 W. Washington Ave., P.O. Box 7162 ' N virsconsin Madison, WI 53707 - 7162 Site Address Department of Commerce 6 —G --p Z 5'3( z- 1 101011 W Sanitary Permit Application sanitary Perm A i j ` � N Q "m>>e` In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ` S � �� ❑Check if Revision may be used for secondary purposes Privacy Law, s15. 1 m I. Application Information - Please Print All Information S to Plan I.D. Number Property Owner's Name Parcel Number (a Zo o;o = i�c,�00 Property Owner's Mailing Address i fj'1( 3 1 Property Location j( I v 7 7 `� i� /v 0% /v ; S 8 T ZT N, R E City, State Zip Code M ICE Lot Number Block Np r /7' /S 6 �6 Z-3 Subdivision Name CSM Number // 33 l H. Type of Building (check all that apply) q,s S ❑City I or 2 Family Dwelling - Number of Bedrooms Village ❑Public /Comore ial - Describe Use ,A. ownship rr Q Pl ❑ State Owned l Nearest Road S' 91.20' MWAjCa D tt I s&-J I III. Type of Permit: (Check only one box on line. A (numbering scheme for internal use). Complete line B if applicable) A. For County use 1 New 2 11 Replacement System 3 11 Replacement of 6 El Addition to System Tank Only Existing System B • El Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal us j�_..�at Ar &Ft=. F 44 ❑ Non - Pressurized In- Ground 21�KMound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. Dispersal/Treatment Area Information: Design Flow (gpd) DispersalArea Dispersal ea Soil Application Percolation Rate System Elevation Final Grade d cu Requiresp dj) Proposed�stti Rate(Gals. /Days /Sq.Ft) (Min./Inch) Elevation q6 � -�rsk ' 196 � , Z8 ,zI14 161' '5 103-5 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank _ 1°L a r Dosing Chamber p ,_, �, - 1 VII. Responsibility Statement- I, the undersigned, assume responsibility installation of the PPOWTS shown on the attached plans. Plumber's Name (Print) i Plumber's Signature MP/MPRS Number Business Phone Number SC4 .2 � Z Co 2 7/ 5 - - 3 2 - I Plumber's Address (Street, City, State, Zip Code) VIII. Coln /De artment Use Onl 71)Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) ❑ Owner Given Initial Adverse . Determination 3LS , ZlD IX. Conditions of Approval/Reasons for Disapproval -- - Cb� / .� Attach complete plain (to the County only) for the system on paper not less thou SM x 11 inches in size SBD -6398 (R. 05101) i t s } N - s.9.r` ♦ �/ f qr P \ if N .� of r F� I f a .�- .g p i w b r �s �g 4 ion • p F ® jr + © f s Z Ac Ilk t( r F t Z 1 W r� A I I .°, `� p � pi Joe ,t � 1 - f N Y H Vf � N Safety and Buildings 4003 N KINNEY COULEE RD Al LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 .sc ns n www.commerce. viscon www.vrisconsin.gov Department of Commerce Scott McCallum, Governor Philip Edw. Albert, Secretary May 30, 2002 CUST ID No.226524 ATTIC• POWTS Inspector ROGER L TIMM ZONING OFFICE TIMM EXCAVATING ST CROIX COUNTY SPIA 3128 20TH AVE 1101 CARMICHAEL RD WILSON WI 54027 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/30/2004 Identification Numbers Transaction ID No. 754008 SITE: Site ID No. 645325 John Collins Please refer to both identification numbers, 1077 100TH Street L above, in all correspondence with the agency. Town of Warren, 54023 St Croix County NW1A, NW 1/4, S8, T29N, R18W Subdivision: CSM: Pending - lot 7 FOR: Description: Proposed Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 853649 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD- 10706 -P (N.01 /01). • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • Comm 83.22(7) - A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. Owner Responsibilities: • Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). P.o.w.T.s. Conditionally n ®eon\ /GIl _1 ROGER L TIMM Page 2 5130/02 Owner Responsibilities Continued: • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 0�f�(�t Fee Received $ 175.00 Balance Due $ 0.00 Gerard M. Swim POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm WiSMART code: 7633 jswim@commerce.state.wi.us cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544 t a John Collins - Mound Transaction # Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Mound, SBD - 10691 -P (01 /01) Pressure Distribution, SBD- 10706 -P (01 /01) Location: Lot 7, CSM NW 1/4, NW 1/4, Sec. 8, T 29 N, R 18 W Town: Warren County: St. Croix Date: May 24, 2002 Owner: John Collins RECEIVED Address: 1125 Spruce Court MAY 2 3 2002 New Richmond, Wl 54017 SAFETY & BLDGS DIV Plumber: Roger Timm L. Signature: License # MP /S 226524 Attachments: 6748 -Plan Approval Application SBD -8330 page 1: coverN WHO of 2: design criteria & calculations DEPARTMENT Ty AND BUI LDI NG>� 3: plot plan DIVISION OF Ty IWq UI 4: system cross section 5: plan view, lateral detail SEE CORRESPI . 6: pump tank exit detail 7: pump curve 8: system management page 1 of 8 ' s r Design Criteria Y Residential Wastewater Contaminant Load: 30 mg /L < BOD < 220 mg/L Anticipated septic tank effluent 30 mg /L < TSS < 150mg /L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L 3 Bedrooms x 100 gal/bedroom/day x 1.5 gallons /day hydraulic load Design Calculations In situ designed loading rate It gallons /sq. ft. per day Depth to estimated high ground water 4 in. Depth to bedrock ' 8 in. Cross slope at system % Force main length ft. of Z in. Manifold/header length i.s ft. of z in. Drain -back 2 Y gallons Lateral length 1 @ 5 ° ft. of Z in. Lateral elevation 3 ft. @ bottom of lateral Lateral hole size 3 �t b in. @ b in. ( S ft.) Spacing \ 9 holes /lateral 3 g holes total Lateral volume V b gallons Total lateral discharge rate zs• ° gallons /minute @ Z ' S ft. head Network pressure compensation losses ° •� s' ft. Elevation difference • `� 5 '•s� ft. Friction loss t A. ft. @ zap gallons /minute Total dynamic head Q 5 ) ft. Pump /sipho gpm @ ft. of head Manufacturer �'- ° i~` �-� Model # L' y' ° 4 Dose volume S gallons Lift /sip'Xon tank gallons Septic tank n gallons Effluent filter «� Measurement pump on and off in. Height alarm from tank bottom in. Reserve capacity 47.& + gallons specs.calcs.res Page Z ` of ;4 J c�c cX er . r. IA pA a 2 s Cl f 'w t --+ d �, ✓+^ d p Z m © + ® Z f so s d (e c j J �' g �* • ,c r 3 � � 7 J NN.tN.v Ir PO P t _ ' N o x I 'fir.. �•��z ,... :�� ; �. 3 � � 0. w Y! U.tt � �,►i 1 Ow Z,r ' r 4bOV s.V , �o � o,p a �•� 1 $ 1 � �•c � � ,3SYr �-� 3 \ h t &.a— �•� � d wwy 1, n i 'j • 1 ,0.M � :a.w a' �•,� I � 12.Q• c. � Ore li.+NV �'�•�ey wa�l1 � �• �o+. � t ��� � (� 1 . 1 6 c l QuL Sc. ' � , 6 pO�C.t +mil �/ V0.1Vt 170�(tL CV• K:VR,10wj a J � 11D �'1 p` G� O r l �.�C f2X �X QIIr�� Qom► � 0 1 i p w. � . •. � � — � \ / \ let. t�t.a�w I I LOCKING�GOVfiR 311NCTIoN aWCK DNCD�IVtCT --1 , 17 7 77 777,17 IL 44 Fvc ,.I, ► /7l� DIP6 3' P np Np►bSuR6ED so)1— 2 4'' Z.D. 4" 40 KANUOLE /A" T � a 3s• g 1 �� 4,o s"T auiwT', FLE, l � 1 aL 3' DKro MINI EWr101NS �`� � (A VU T GGoUw0 4 � •�Si OGa: PUA? p L „ COKGRFTc SEPTIC t 5 PCGIFIGATI0 t`.15 UU DOSE T'Aw,S MAWU FACT U P R: IJUM6CF1 OF DOSES' S � � PEk DAB TAWK SIZE; I, u � -6 GALLOWS ..DOSE VOLUME ALARM MAl„►UFACTWKLR: S c1 1 �I �'-� �� INCLUDING 6ACKIFLOW: t%\ODEL WU"EK: ° �`} ``' CAPACITIES.' A= 35 "� wCHES OK 4Z C,A,"� SWITCH TJFE: 4,►.a.�` ° Z Z 6 c IuCNES OR C.ALL S Pump MAWUFACT Usk [R: $ S•� 0 � C • IAlLnES OH GA�,CLS MODEL IJUMpfR; t O D■ INCHES 0 :42 C,Alt.3u: SWITCH TtIPE; ��V ►JQTE: PUMP A1J0 ALARI.1 ARE TO 6E. MIWIMUM DISCKARU RATE Z �_ G PM INSTALLEO OW SEPARATC CIKCLI',� VERTICAL DIFFEREAJC( 6ETWEEU PUMP OFF AWO OISTRIbUTIOW PIPE.. FEET + MIAIIMUM WETWORK SUPPLY PRESSURE . . . . .. . . . . 2 '� FLET + l " FEET OF FORCE MJ►IIJ X..�q F /ooFtFKICTIOW FACTOR. �' FEET "— TOTAL DyWAMIC HEAD = FEET WTERAIAL OIMEWSIOWf. 0I TAWK: LewwrH \.• (� ;WiDTH LIQUID DEPTH [q GOULDS PUMPS Submersible Effluent Pump 3871 EPO4 EP05 APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower Specifically designed for the grade turbine oil for tic enclosed design for heavy duty ball bearing lubrication and efficient improved performance. construction. following uses: heat transfer. • Effluent systems ■Casing and Base: Rugged • Homes Available for automatic and thermoplastic design provides AGENCY LISTING superior strength and corrosion • Farms manual operation Auto- Canadian Standards Association • Heavy duty sump matic models include resistance. • Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron (CSA listed model numbers end • Dewatering assembled and preset at the for efficient heat transfer, in "F" or "C ".) factory. strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic Goulds Pumps is ISO 9001 Registered. FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. ;/4" maximum. ■ EPO4 Impeller: Thermoplas- N Power Cable: Severe duty • Capacities: up to 60 GPM. tic Semi -open design with rated oil and water resistant. • Total heads: up to 31 feet. pump out vanes for mechanical • Discharge size: 1'/2" NPT. seal protection. • Mechanical seal: carbon - rotary/ceramic- stationary, BUNA -N elastomers. • Temperature: 104 °F (40°C) continuous 140OF(60°C)intermittent. METERS Feel • Fasteners: 300 series 10 -- - — + stainless steel. 9 30 _._ ____ . . . . ._.__ —► 5 GPM • Capable of running dry without damage to $ zs Fr components. 25 Motor: _ T • EPO4 Single phase: 0.4 HP, u 6 20 _ ... _ . 115 or 230 V, 60 Hz, 1550 - RPM, built in overload with i~ 5 automatic reset. 4 • EP05 Single phase: 0.5 HP, c EP05 115 V, 60 Hz, 1550 RPM, '' 3 10 -.__. _ __...._.._. _.._...__..__. __ . _. built in overload with -EPOa automatic reset. 2 • Power cord: 10 foot 5 - standard length, 16/3 1 !... SJTOW with three prong grounding plug. Optional 20 ° ° 0 10 20 30 40 50 GPM foot length, 16/3 SJTW with three prong grounding plug ' (standard on EP05). 0 2 4 6 8 10 12 m3 /h CAPACITY Goulds Pumps z 00G Goulds d� g 0 0 o ds ITT Industries Effective February, 2000 83871 System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, Timm Excavating, 715- 772 -3214, or the St. Croix County Zoning Office, 715- 386 -4680, should be contacted for assistance. General Proper functioning of an on -site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or compartment to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. I . If the septic tank is installed prior to sheet -rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2 Install water - saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly. 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. 9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. If septic or pump tanks are no longer used, they must be properly abandoned. 11. If construction timing and weather could create a frozen infiltration system, weather - proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. Maintenance 1. The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back - washed into the septic tank to remove accumulated material. 4. Periodic observation pipe inspections should be made by the homeowner to examine the state of the in -situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down -slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run -off into the system area. 11. Warning: Do not enter septic, pump or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and /or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 Wisconsln Department of Industry SOIL AND SITE EVALUATION Labor and Human Relations Page of Division of Safety and Buildings in ac lte'l Wiifi s -AH R".09, W's. �. Attach complete site plan on paper not less than 8 1/2 x inches in (� ust County �• y Include, but not limited to: vertical and horizontal refere ca point (B nd percent slope, scale or dimensions, north arrow, and lo�atton and distance to nearest road. Parcel I.D. # 9 (9112 1020 • 110 • 0 &V APPLICANT INFORMATION - Please print 1 01 informa owO{ ) Revipyw by Date Personal Information you provide may be used for secondary purp se Prl- F6"aa "W) (nI)). •'Ir/ 1 f �d l Q Property Owner nJ i? L 9 4 j� /` ., � _ P dy ova��til1on / \ A ! t v�1lJi/p� G /4 /1/ N COQ Try of � 1/4/�/& )1 /4,S v T 2 9 ,N,R /10 E (or)o Property Owner's Mailing Address AI . �yDy Lot # Block# Subd. Name or CSM# 332. 1I /NNF5W - 5r- - 7 AE/Vp /N (r• City State � / Zip Code Phone Number Nearest Road 5 ,. Dl� U L / i at /V• 55 (d' � )ZZZ � SSSS ❑ City V Ia e � own nl s ff ' New Construction Use: [R6 dential / Number of bedrooms '3 , Addition to existing building • ❑ Replacement ❑ Public or commercial - Describe: ySo -• lo &o Code derived daily flow gpd Recommended design loading rate •! bed, gpd/ft ' s trench, gpd/ft Absorption area required .5 bed, ft 2 St� trench, It 2 Maximum design loading rate y bed, gpd /f1 — trench, gpd/(t Recommended Infiltration surface elevation(s) ft (as referred to site pla benchmark) Additional design /site considerations DI�.v� Parent material Flood plain elevation, if applicable N ft S = Suitable for system Conventional Mound In- Ground Pressure AT- Grade System in Fill Holding nu U = unsuitable for system [j S I J U [A ❑ U ❑ s [A-t- ❑ s [A u El u E01 s 0 s SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles ' Structure GPD /ft Texture Consistence Boundary Roots In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench I o - y /O Y,e 3/3 Y CX CS z• 9• 2 C /o YX 31 SL / f iC y,+ Yeie s• 17 �{ ; . S Ground Zp• J 7. S I/X 4 V — • 7 ' •S ele Depth to ,� G f t�l S� S "K limiting factor Remarks: Boring # z 2 z /o Y ,LO 3 /11 — 5 L l C .5 – • Y ; . S 3 f/.3 75geV, f/ r M6tS SL /ffp 4oy — .Y :.S Ground 100. , Y X X Depth to limiting tact r � In. Remarks: C T Name (Please Print) Signature Tele hone No. R O GER1 — uG U � I��T 7 1S• $6. 619- Address Date CST Number • / 2-2.Ce Private Sawag• 0®nktitants 655 O'Neil Rd. Hudson, Wis. 0400 4 7Z0 5!7 % SST i•v 6: 7 / ;e &v OR IGINAL ,���s Do � If."v4T- so, ls' &Z- 157 V5,1 . PROPERTY OWNER SOIL DESCRIPTION REPORT page of PARCEL 1.01 4 Boring # Horizon Depth Dominant Color Mottles Structure 2 In. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed ,Trench '/3 �oY�' 3 /3 G. /fs,6k 4.4yX Ground 3 LS l /I'11 S Qom( .S , • �o elev Depth to limiting factor Remarks: ng # o •e / e ye X3/3 4 6e �,e /� • Y • S z � �0 3 Ground Ao S ; elev. Depth to limiting factor S in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots I In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # Ground elev. — - — it. , Depth to limiting factor in. Remarks: Boring # Ground elev., ft. , Depth to limiting factor in. Remarks: SBDW -8330 (R. 08/95) s � V O 3 6 =P �Vo G v T G_ o - - -- - gyp , Z4G S} T'; 13� of 3/y • P� f 90 } s� 0 • 2�iu i�0� � o . fS O / 7 of V c w 3iy �P pit / f sys7eeti c571p . wl AC/ s ; , f , vD hL �3a — I r � N z o t f d � A <GCG« .^CCCOO LLLL o A) tic �.� f/ 9 eo �- f 3 a V 6 � 6 O ! � P K � 4 I r- s M vo 91 � .- N D �� r� ;j z m ��.. 6z m V w ° < a o m s m - r l ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer )/ ,-us Mailing Address Property Address /0 77 / ©* h (Verification required from Planning Department for new construction) City /State -r , LA, Parcel Identification Number C 2 —/0 Zoes LEGAL DESCRIPTION " r Property Location N+ /4, Yy U) 1 /4, Sec. , T_ZLN -R_/ Town of ar e Subdivisio C� L j j� J Lot # M 7 Certified Survey Map # /) / , Volume 13 , Page # 7 Warranty Deed # (- `7 Volume /9q,0 , Page # a - 7 Spec house ❑ yes no Lot lines identifiable I, 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, 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 Zoning Office within 30 days of three lion date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that a statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the pro described virtue of a warranty deed recorded in Register of Deeds Office. 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 r U 1890P 274 it STATE BAR OF WISCONSIN FORM 2- 1998 6 a 9 5 S KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number Co., VI This Deed, made between Francis Land, LLC, a Minnesota Limited RECEIVED FOR RECORD Liability Company 05 -14 -2002 11:30 AN WARRANTY DEED Grantor, and John P. Collins and Jacqueline (M. Collins , Husband EXEMPT t and Wife REC FEE: 11.00 TRANS FEE: 133.50 COPY FEE: CERT COPY FEE: Grantee. PAGES: 1 Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin: Recordina Area Name and Return ddress P a f Certified Survey Map filed September 30, 1999 in Vo1�, Page s Document Number 611331, St. Croix County, Wisconsin. 042 -1020- 90-600 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: Subject to easements, restrictions,reservations,covenants and rights of way of record, if any. The warranties of this deed, either expressed or implied are limited by the grantor to the grantee, or anyone taking from them in the chain of title, to the consideration expresseed herein, that being the sum of $44,500.00. Dated this 30th day of April 1 2002 Francis Land, LLC « « by President « Austin J. Baillon AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature ) SS. Signature(s) Ramsey County. ) Personally came before me this 30th day of authenticated this day of April 1 2002 the above named Austin J. Baillon « TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, instrument and acknowle a sa e. authorized by § 706.06, Wis. Slats.) � • `_ . THIS INSTRUMENT WAS DRAFTED BY NOTA1;r PUauC•MINNESOra Paul A. Baillon, Attorney at Law 'Paul A. Baillon MY COMMISSIOfi EXPIRES 1.31.2005 Notary Public, State of W' ■ (Signatures may be authenticated or acknowledged. Both are not My Commission is permanent. (If not, state expiration date: necessary.) January 31 2005 ) "Names of persons signing in any capacity should be typed or printed below their signatures WARRANTY DEED STATE BAR OF WISCONSIN. ' FORM No. 2 - 1998 INFORMATION PROFESSIONALS COMPANY FOND DU LAC, WI 800.655 -2021 1 J F vs \9 v,? 4 oti s��� �� S x'.1:531 CERTIFIED SURVEY MAP IN PART OF THE NW 1 4 OF THE NW 1 /4 OF SECTION 8, 1t�D i1RT OF THE NE 1/4 OF THE NE 1/4 OF SECTION 7 ALL IN T29N, R18W, TOWN OF WARREN, ST.CROIX COUNTY, WISCONSIN. NW CORNER LOT OWNER SECTION 81 I -- 1 HUMBIRD LAND CORP. 3 C.S M. IN E1404 FIRST NATIONAL BANK BLDG. N -------------- -- 332 MINNESOTA STREET - n v V 10, PC. 2802 ST. PAUL, MN 55101 Z o° � Li N N89 22 27 W 472,52 L, I 32 440,00' __ I z 33' 33' I EXISTING I I DRIVE I LOT 6 a Q 3 OD 'Z 2 ACRES INC, R/W o7 97,115 SO. FT, c) 3 o m o (L N v N �. I ti 2.080 ACRES EXC. R /W' Z0 Ems. IL.I; 90,629 SO. FT, v [. I LJ ! 2D 32.35' � CD Imo 233,92' C3 Z S89 "E 266,27' =I N00'45'54 "E 66.00' Grj q; N89 "W 266,43' V,w 0 F.1 I D j 234,13' j 30' N co �� I 0 LOT 7 I 3 m F _ _._ 0, N I 2.414 ACRES INC. R/W �� W I N I N 3 I 105,152 S(]. FT. m o I I n I c) o a m v 2.222 ACRES EXC. R/W a a s Z CD I I 96,812 S0. FT. N Za f1J Q z>L' m � o I n w W 66 - I v wwm o 32.08' M S89'22'27 "E 410 I Q; w Y J .99' LJ G a o ° I 378.91' � E� + L w o JOINT j ° � ; r (A < i w 10 1 DRIVE ; LOT 8 Z m 3 ao Lo I �' m / 2.203 ACRES INC, R/W = o 96,977 S0. FT. a APPROVED N / / ST. CROIX COUNTY a o i 2.117 ACRES EXC. R/W PI- n gZ"^9ArldPiftCafffflo i 92,234 SO, FT. Z rZ rR ui / SOUTH LINE OF %THE NEI /4 OF THE NE1 /4 OF SECTION 7 'SEP 3 Q 1999 D K V) S89 "E 413,61' iIONS1� lWt.8PPMv WWbe z X189 '18'12 "E 3 SOUTH LINE OF THE NWI /4 OF THE NW1 /4 OF SECT 60. e' a LEGEND tn Oq �) 0 UNPLATTED LANDS N :° ru -- ---- --- ------------------ - - - - -- ALUMINUM COUNTY SECTION CORNER �I N v ° o ^ MONUMENT FOUND N' W1 /4 CORNER V' I • 1" IRON PIPE FOUND SECTION 8 1" X 24" IRON PIPE SET WEIGHING �j SCALE IN FEET 1 = 100 1.68 LEIS. PER LINEAR FOOT IIIIIIIII ---- -- 100' ROADWAY SETBACK LINE 0 100 200 300 Vol. 13 Page 3745