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042-1026-90-000
i H o o° a° c CD ° ° m g t3 a a s ca a o > m G mQ` ILOD tm U) a2ai o CL_�3 a��° y E w mw� N 3$ o m'xw E a o o ON= y �wY E ur E °a o cD c a) N c ai o0 �n O o u7 N w p C O C ` m O c V; .0 - a Y a) E gy p _ m 3 o2� o > o� ci m o w , w N w .O O C CD U c 0) . 0 .N 'N m t 'N N . Q <n c > • a) O �o -mmo0m ° 3L a�m'"3�� C9 U) m a v Zs a) - 0 c cn�w c 0 3 aa>" =_ c m c m� ` c O a m T O N a) m c c 3 p y a) c C i rn°occaa��mm O 4)-o 0) 0U QL-3 m co •- - N a- d N a m c . m p '9 0 o V m o °rn �'o m p p a � c �c . 3 E a) EYE m U y a) O N O S c a) a) � O ik co 0 0. xa m ro E c N m E ;oa c o (a w: a) o Z o ° c z a , ,(D0 a i° °a) � E o � m a c 6 E m c - C LL C L V) otS m w m LL c y o. L m o `-° E r O a) N O O c p Q a O V) m N m a) U O) O E w Q a) a 0 p > N X 0)= j� 0 O L 7 C O X m 7 0 :4 p L Z m I Q E >iOZ m m o � Q H-0 m o a� 0) MR t; 0 3 0 N M z iii Q yr a�o Z a o w p :!t O ` a ° C a m a m I i C Z :i c a d 2 ° c o N H 0 m O1 E E a) o ° 0) a m •g a m '9 . N II N � a� � N to fn fn N a) c O c O a) �l z ° �-z I I zr- z a d Z �i E a) R E aa) O N Q w w N Q r` ca o o a` a> ° o o a` > ca L ° -2 °' °' v a z d z • � �aaa �mCLma a CL o o c a � o U � rn rn •' m o o °D W N J U 0) a) (D d -} p ) 0 o C5 o N °` Co a ml v a N C\ LO Q } (n LO — Q A (n Q 0 4) Lr cn . 3 N O O f C = I� C O O = c V ° p O w m r \ N 3 0 c a) C O. c O -0 -0 C a N ° N N V O N ° N ° c E w m m m 3� N M a C7 U� N * 6i N n d N M H L N a) .c .c c a) N N i�l N N fa >° O N m E O O N > > .m U r r • �' o N o Z° Z! Y Y cn �• a* E :' E T 4) 1 V CD 0- � •� € a I � a I :. o m .a m a y a Z r`1v o 0 m 3 2 0 3 w o t A Ua2� 0 v) U 0 v)U N O ry M 4 a O O N n O v h a0 I V 3 � I W Z Z \ rn o � � o z NN v Y LL r V y H N U � f6 � � R a O � c N � C FBI N N � O � Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: �I � 144 GENERA. INFORMATION {ATTACH TO PERMIT) State Plan ID No: Personal i 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: Meyer, Ronald H. I Warren, Town of 042 - 1026 -90 -000 CST BM Elev: Insp. BM Elev: Description: + - Sectionfrown /Range /Map No: /� `tin. I -3 BM IPo N'ow, DF' -_— Plsl 0 10.29.18.151 TANK INFORMATION ELEVA ION DATA 5 I I I TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark ,l0 /�°{,ot, /oz • 39 Dosing Alt. BM Aeration Bldg. Se a, ii 8,9 Z.o7 Holding t/Ht Inlet g qB4O7 St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man, Aeration Dist. Pipe Holding Pjat System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain 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 SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution I x Hole Size I x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing 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 Sed/Trench Center Bed/Trench Edges Topsoil Yes E] No Yes ]No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 1053 120th Street Roberts, WI 54023 (SW 1/4 NW 114 10 T29N R18W) 40 acres Lot Parcel No: 10.29.18.151 1.) Alt BM Description = Z ° 7 ` � [ cs , 9 Z(�) 2.) Bldg sewer length = 76 � P VL - amount of cover = 6 L_ if Plan revision Required? Yes R1 No Use other side for additional information. – F4 - Date Insepctor' S1gna a Cert. No. SBD -6710 (R.3/97) v �M1 County Sanitary Permit Application ST. CROIX COUNTY WISCONSIN G pv In accord with Chapert 12 St. Croix County Sanitary Ordinance PLANNING & ZONING DEPARTMENT SSA Personal information you provide may be used for secondary purposes ST. CROIX COUNTY GOVERNMENT CENTER (Privacy Law. S. 15.04(1)(m)) 1101 Carmichael Road $ Hudson, WI 54016 -7710 (715)386 -4680 Fax (715)386 -4686 Attach complete plans for the system on paper not less than 8 -1/2 x 11 inches in size. County Sanitary Permit # ❑ Check if revision to previous application O/ . Application lnformation - Please Print all Inf mation Location: Property O Name /� / '5L 114 Ng- Sec /d /t O /1/4�dt� e ` �° i^- N, R E (or W Property Owner's Mailing Address of Number Block Number _T 10 5 3 / © S I GROIX COUNTY City, State Zip Code Phon € e umer Subdivision Name or CSM Number �^ fj `�0 � 3 7 /s 3 - 0 S 11 Ty Building: (check one) ^- Mity ❑Village own of ok Lf 1 or 2 Family Dwelling - No. of Bedrooms: ❑ Public /Commercial (describe use): 4ew `^°ty`'e- P� �... ` hA) State -owned Nearest Road / e� pe of Permit: (Check only one box on line A. Check box on line B if applicable) Parcel Tax Number(s) 1.❑ Repair 2. Ll Reconnection ❑Non- plumbing 4. ❑ Rejuvenation q Sanitation ©t - I D ( - !,f O - �� — Permit Number Date Issued ❑ State Sanitary Permit was previously issued IV Type of POWT System: (Check all that apply) * Non- pressurized In- ground ❑ Mound >_ 24 in. suitable soil ❑ Mound :5 24 in. suitable soil ❑ Mound A +0 ❑ Sand Filter ❑ Constructed Wetland ❑ Peat Filter ❑ Drip Line ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Other ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating V. Dispersal /Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application Rate 5. Percolation Rate 6. System Elevation 7. Final Grade r Required Proposed (Gals. /day /sq.ft.) (Min./inch) Elevation y 9� 1 706 e . 5 s 7. �8' �4� . 33 VI. Tank Information Capaicty in Gallons Total # of Manufacturer Prefab Site Con- Steel Fiber- Plastic New Existing Gallons Tanks / Concrete structed glass Tanks {r/ �' Mir 004 g U © goo Grp .e.tr - ••� k� onsibility Statement ersigned, assume responsibility for repair / reconnenction /rejuvenation/installation of non- plumbing for the POWTS shown on the attached plans. A not required for terralift repair or the installation of non - plumbing sanitation system. -- t , Name (print) Plumber's Si nature (no stam s): MP No. Business Phone Number Ec�t 440 •�� lS =7�f 33 2 Ad ress (Street, City, State, Zip Code) nty Us e Only Di ved Sanitary Permit Fee Date Issued Issuin ent Si atur (No st s) pproved Owner Giv n� verse b � Determination itions of Approval for Disapproval: ( t (� 4-r4; t er �sv�+.c �--p I pe r��" ty b , GQ -k n �e o �anc�i F,�ooFConcre -Ee 5/06 asc T/00. Corn ten 6 ,415 tc m e-W i 1 .� 4v EXi S X117 d;s&-;bLZ box EXi -S �QB�;cuc�xc✓a0 6 $y3 ¢<✓.= .or? �cJ(iSflnB 14cct55 Or`r 5 /uc.�/'e EA• So / /d,s tea,/ c�-CCs z " s�.,(. � Pd.c. s tip" aIts: 0 98• �oirenla�n. aal`6om o�'S.cl, r /O /, (0 =--- -� �- -• iS = /0 %3d' P. ABr /ficix� EK�S u e '� 8co o• bk; /di S¢wei Au"tp &arnb£/ ua/ A'e- cessarr S tru c./--u u re 5 M/ -re 5(059 P. 57'F- /oaA.2- / � p65C.cJ C 7 r �p. oPoAt.ol � clee� e-xr n9 we rl gyp. 6cfn k/ Co n, . 83 5�t6k s C. �c� L o,-• axce.�ded, O P * 4 (C]C®PY a • Ca le /zf — a f o of l oncre -6e ;5 asc e,YiSZ T Corn O-e d;s`;bwEion box EX /S1`%r►q Q8/�cctC'°l� cc.c S5 ory 5tr ueAcre ExiS So, /d,spersf./ c..CCs z "Suf • � Pd�. S y j6jM ¢leL! go. "I �orreMa�n. �om of` S:d i v ge eao9oP bcc ;ld;�q S¢wer r/ p u p A lm LGeSSOry sfruC�6ure s(M/T¢Ck / sTF - -IoOA Iy" e S ep6' z5a • '/ pascd O 7 y e laent ��C. pro N o s<� � clee•+ ou.f . yg x � p U e.l l' bct r✓'r of 40 . = 93z&; o{rr /oa E e 1. 9f� Tto /; = el 19 Conte. 83 Sacs 1n� a-• a�ceQSled, OP i ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the following residence: (Street address) Non /Ds� «© located 9 4 y at: 1 /4, 1 /4, Section , Town N, Range W, Town of Lv , St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of Comm. 84.25, and it (they) appear(s) to be functioning properly. Most recent date of inspection or service Did flow back occur from absorption system? Yes No (if no, skip next line.) Approximate volume or length of time: gallons minutes Tank Capacity: /ppo -+ 15 - 4 s" Construction: Prefab Concrete Steel Other Manufacturer (if known): (,[J,��,� Age of Tank (if known): Permit number (if known) (Licensed Plu ber Signature) (Print Name) Al (Title) (License Number) M MPRS (Date) I Form to be completed by licensed plumber (Dept of Commerce Chapter 5 and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 9/2008 V. - 7S84GD Y STATE 4R OF41EC3SR kRM 341192 QUIT CLAIM DEED KATHLEEN H. IiALSH Document Number Q REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Ronald H. Meyer, a single person, RECEIVED FOR RECORD 04/01/2094 W FWAM QUIT CLAIM DEED Grantor, and RONALD H. MEYER, sole Trustee, or his successors in EXEMPT t trust, under the RONALD H. MEYER LIVING TRUST, dated March REC FEE: 11.00 1, 2004, and any amendments thereto, TRANS FEE: COPY FEE: CC FEE: Grantee. Grantor quit claims to Grantee the following described real estate in PAGES: 1 St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): All of the NE 1/4, EXCEPT the Northerly 726 feet of the Westerly 600 feet of the Easterly 1018 feet thereof, and EXCEPT Lot 1 of a Certified Survey Map recorded Recording Area June 8, 1995 in Volume 10 of Certified Survey Map at page 2936, as Document No. Name and Return Address 529950 in the St. Croix County Register of Deeds, Town of Warren, St. Croix County, Wisconsin; Joseph P. Earley AND Langlais & Schumacher, P.A. All of the NW 1/4, all in Section 10, Township 29 North, Range 18 West, Town of 539 South Knowles Avenue , Warren, St. Croix County, Wisconsin. New Richmond, WI 54125 042 - 1026 - 10;042- 1026 - 40;042- 1026 -50; 042 - 1026 - 60;042- 1026 - 70;042- 1026 -80;" Parcel Identification Number (PIN) *042- 1026 -90; & 042 - 1026 -95 This is homestead property. 00 oxstott) Together with all appurtenant rights, title and interests. Dated this 30th day of March 2004 Cf YC. W * * Ronald H. Meyer AUTHENTICATION ACKNOWLEDGMENT Signature(s) Ronald H. Meyer, STATE OF WISCONSIN ) ) ss. County ) aut enticated this 30 day of March 2004 Personally came before me this day of the above named * Jol l ell P. Earley TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Joseph P. Earley Notary Public, State of Wisconsin New Richmond, WI 54017 My Commission is permanent. (if not, state expiration date: (Signatures may be aidwriticated or acknowledged Both are riot necessary.) ) * Names of persons signing in any capacity must be typed or printed below their signature. Information f'ratessiona s Company. Farad du Lac, VA STATE BAR OF WISCONSIN 800 -6SS -2021 QUIT CLAIM DEED FORM No.3 - 1999 Wis,pnsin bepartment of Commerce jt l - r PRI E SEWAGE SYSTEM County: St. Croix Safety and Building Divisiorj S . / Sanitary Permit No: 430598 0 � INSP TION REPORT GE,xVERAL INFORMATI N �#zoµ� 5fr A' I"A H TO PERMIT) to Plan ID No: Personal information you provide may used for secondary purposes [Privacy Law, s.1 .04 (1)(m)]. 9 Z� Z = '( ou's . 16 Permit Holder's Name: ge X Township areal Tax No: Meyer, Ronald Warren Township 042- 1026 -90 -000 CST BM Elev: Insp. SM Elev: I BM Description: Section/Town /Range /Map No: 1 0 35 1 t1Z_ 10.28.18.151 TANK INFORMATION I ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark N � sbs �- �}, �1• s� P0z -301 Dosing 1AIt. BM AeratieW Bldg. Sewer "--r (-4 (�, la0 to 1 6(o Holding St/Ht Inlet TANK SETBACK INFORMATION SUHt Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD jDt Inlet Septic 1 r '1 00 t' 1 l Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System PUMP /SIPHON INFORMA Final Grade Manufacturer Demand St Cover M 4.� 1 1 0 2. •SS Model Number TDH Lift Friction s tem Head TDH Ft Forcemain Length Dia/ ist. to w SOIL ABSORPTION SYSTEM BEDITRENCH Width No. Of Trenches PIT DIMENSIONS No. Of Pits In ' Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L WELL LAKE /STREAM ACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pres Systems Only xx Mound Or At - Grade Systems Only Depth Over >plfi Over xx Depth of xx Seeded /Sodded xx Mulche Bed/Trench Center Bed/Trench Edges Topsoil Yes !:,; No ,Yes No COMMENTS elude code discrepencies, persons present, etc.) Inspection #1: 1 / / 0 3 Inspection #2: Location: 1053 120th Street Roberts, WI 54023 (SW 1/4 NW 1/4 10 T28N R18W) NA Lot Parcel No: 10.28.18.151 1.) Alt BM Description = 3 •) 2.) Bldg sewer length / - amount of cover = tz tr Q w^ r ou +a Plan revision Required? No r Use other side for additional information. SBD -6710 (R.3/97) i ( A S Insepctor's Signature Cert. No. 1 • Safety and Buildings Division County � 1 *is 2 01 W. Washin o � �) c O `X cons Madi n, WIfa J E® Sanitary Permit Number (to be filled in by Co.) Department of Comm 8) 3 D 519 Sanitary Permit Applic tiolo 0 9 2003 State Plan I.D. Number In accord with Comm 83.2 1, Wis. Adm. Code, personal info ation you provide S , f- o < (o 7 D © / $ 1 may be used for secondary purposes Privacy Law, s 5.04(1 ro ect Address if different than mailing address � I • CROtX COUNTY' 1 C g ) I. Application Information — Please Print All Information Property Owner's Nam Parcel # Lot # Block # Fa ,4 4 jd In E y e s 6 yz - 1 0,;2,6 — ? ,0 Property Owner's Mailing Address Property Location /j)s3 / "go 10 W 1 /4, 41 section City, State Zip Code P T N; R c hone Number Rc,bft f — S � ` 5 Q23 (circle one) II. T of Building (check all that apply) I or 2 Family Dwelling — Number of Bedrooms Subdivision Name CSM Number ❑ Public /Commercial — Describe Use O cc,-_S ❑ State Owned — Describe Use ❑City ❑Village ownship of W q )4 E III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A ' ❑ New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only O the r M 4dification to Existing System 0.00 fq 1.56 _5,T, _� to . B. [I Permit Renewal 11 Permit Revision ❑ Change of ❑Permit Transfer to New rs Before Expiration Plumber Owner Y IV. a of POWTS S stem: Check all that apply) A'1 ¢c 1 F — / o0 2 e � ae a f 1 `-- >.� .�• 1 !n Non — Pressurized In -Ground El Mound > 24 in. of suitable soil El Mound < 24 in. of suitable soil 11 At-Grade El Single Pass Sand Filter J Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil App ' ation Rate(gpdsf) i persal Area Required (sf) Dispersal Area Proposed (sf) System Elevatiop f'A 1!::::� _± — — — VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank /5 /000 Aerobic Treatment Unit Dosing Chamber $ OD L y C I V , VII. Responsibility Statement- I, the undersigne assume respons ibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP PRS mb Business Phone Number Plumber's Address (Street, City, State, Zip Code) X 6 7 4w �s o j6 � 6 wr yo�3 VIII. County/Department Use Onl Approved ❑Disapproved Sanitary Permit Fee ( includes Groundwater Da X ' te Issued Issum Agent Si ature (No Stamps) _ 8 � Surcharge Fee) ❑ Owner Given Reason for De (� s D 10 713D3 IX Condition A roval/Reasons Disapproval SYSTEM OWNER SYSTEM ER; 1 Septic tan off, filtt: 1 Septic tank, effluent filter and dispersal ce st all b, dispersal cell must all be serviced / maintained as per ageme an provided by plumber. as per management plan provided by plumber. 2. All s ack requireme a nts maintained 2, All setback requirements must be maintained per applicable code /ordinance 08 per applicable code /ordinances. ' I Attach complete plans (to the County only) for the system on paper not les t 8 1/2 aa11 Inches in size — mF v+ a�R�S re ���� &,,n SB-6398 (R. 08/0 ' ' a � a anaF, %o�ooFConc�e S /a6 � S cale . sc ¢;riSting Cvrn e �, b . A sSuinec(e -1w. ( - C /Gl�•�� d ;SEr;bw�;on box EX%S -07 Aet ca&wd 0 a Y. s e e , - OV EXisElnB Access J�uc�trZ ExiSf! SoJ�d,s�ocr'sR -/ c..CCs z "sc,/E. �f0 Pd.�. �q S SE.crn ¢ Ili` = Ve. "I �o �e+►1a; n. �om off` S:d i a 39; BC��.OM Pr Src�rilq : /O /. (09 � .'/ �_ /. 1 rO P ✓, �r . V EX /SE.'r� BCtO e.Q. 7 6cc J i� / S¢c.)e�' E i s-�i g A rr'cu,h4crx ( 9 AeCessarr S4-ruC.6Ure Slr+ /Tel. �, {�an�C• r - oa z- Scp sF/ A ��opascd eArlik /ae. pro P osc.d eXiS�irt9 Cie // v U .o r Eled £ on at ' in /e barn of P.e. 9.3..2.(0' 04 t( -Oca f a I. c syr T to / /. = 4( S /. 17 0 6c: �� o,-• �eee�led. PI Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 9 Mir TDD #: (608) 264 -8777 I�c onsi� www.commerc .wis ons Department of Commerce www•wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary December 01, 2003 CUST ID No.222781 ATTN.- PPOWTS Inspector ZONING OFFICE HENRY J NECHVILLE ST CROIX COUNTY SPIA 967 HIGHWAY 65 1101 CARMICHAEL RD ROBERTS WI 54023 -8510 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 12/01/2005 `Identification Numbers Transaction ID No. 938212 SITE: Site ID No. 667780 Ronald Meyer Please refer to both identification numbers,' 1053 120TH St above, in all correspondence with the agency. ' p,0 W Town of Warren, 54023 Coll ditto St Croix County SWIA, NW1/4, S10, T28N, R18W FOR: Addition to existing non - pressurized in ground system, 450 GPD j Object Type: POWT System Regulated Object ID No.: 928929 pp SPFt The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Cod and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in SSE GORF 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: Key item(s) • This approval is for an addition to a non pressurized in- ground system that will serve an existing dwelling and a new accessory building (common system) for the owners' exclusive use. The design wastewater flow will not be increased. • The designer proposes to install an outlet filter to achieve the requirement of wastewater particle size. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the septic tank outlet filter will be required. The outlet filter shall be installed per product approval stipulations. • The existing septic tank(s) must be inspected for structural soundness, size and baffles and must be brought into conformance with the requirements of COMM 83, Wis. Adm. Code. If it does not conform a state approved tank must be installed. • This system is designed for wastewater strength with monthly averages of less than or equal to 30 mg/L of fats, oils and grease, less than or equal to 220 mg/L of biochemical oxygen demand and less than or equal to 150 mg/L total suspended solids. 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. 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. F HENRY J NECHVILLE Page 2 12/1/03 W The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation, ox- maintenance of the POWTS. } Sincerely, Fee Required $ 175.00 /7 Fee Received $ 175.00 Balance Due $ 0.00 u� Patricia S liandorf POWTS Plan Reviewe , Integ ted Services W RT cod' .3633 (715)634-7 1 , Fax: i(715 4-5150, M -f 7:45 am - 4:30 pm pshandorf @commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 L ' w COMMERCIAL SYSTEM DESIGN Conventlonal system INDEX AND TITLE SHEET Project: Accessory Agricultural Structure Owner: Ronald Meyer Address: 1053 120 St. Roberts, WI 54023 n Legal Description: SW1 /4NW1/4, Sec. 10, T28N, R18W. Township: Warren County: St.C roix F Subdivision Name: NA Lot No.: NA I ESQ Parcel ID Number: 042 - 1026 -90 -000 / Plan Transaction Number: 1 Index and title sheet Page 1 Sizing calculation worksheet Page 2 System inspection report Page 3 Pump curve Page 4 System cross section Page 5 Multiple structure Affidavit Page 6 Site Plan Page 7 Designer: Henry Nechville License Number: 222781 Signature: Phone No.: (715) 749 -3322 Date: October 6, 2003 WORKSHEET JOB DESCRIPTION: Accessory structure restroom — Ronald Meyer property:_ Proposed restroom with lavatory to serve existing accessory agricultural structure. Resoom will be for the private use of the property owner and will contain one lavatory, one toilet, and one shower. Maximum use per owner will be one shower per day. Estimated daily wastewater flow calculated by applying standards as specified in In- ground Soil Absorption Component Manual SBD- 10705 -P, table 4. Reference to "employee" in calculating daily flow below is intended to reflect waste generated by owner and is not intended to indicate a commercial use of the property. PROPOSAL: Install new concrete septic tank to serve accessory structure. Effluent %Nill be directed to existing dose conventional septic system currently serving owners three bedroom residence. Daily wastewater flow to existing soil absorption system will not be increased. Accordingly, additional absorption area is not proposed. DAILY WASTEWATER FLOW CALCULATIONS: 1 employee @ 13 gpd per employee = 13 gpd 1 shower per day @ 10 gal/shower = 10 gpd 23 gpd DESIGN WASTEWATER FLOW CALCULATIONS: - 23 gpd daily wastewater flow X 150% = 34.50 gpd design flow SEPTIC TANK CAPACITY: 1. 34.5 gpd / 75 gpd /person = 0.46 person equivalency (34.5 gpd) + (11.61)(0.46)(3) + (46.77)(0.46) = 72.036 gal. minimum tank capacity 2. Tank Manufacturer & Capacity Proposed: Wieser Concrete W 1565 -MR PRESSURE DISTRIBUTION SYSTEM: Existing 800 gal. dose tank with Zoeller Model #BN98 effluent pump. SIM/Tech STF -100A2 effluent filter to be installed at dose chamber outlet. System does not require pressurization. Accordingly, friction loss and pressure loss calculations have not been presented. Total design wastewater flow will not be affected by addition of septic tank to existing system. Float setting calculations based on 450 gpd design flow. Dose chamber: Manufacturer & capacity: Weeks Concrete 800 gal. pump chamber liquid depth: 42 0" 19 05 gal /inch ( 800.10 gal. actual) Sizing: A) One day holding capacity: 22.50" = 428.62gal. B) Alarm setting: 2,00"= 38.10 gal. C) Dose volume + flow back: 5.50"= 104,78 gal (450gal.x 20)+ (.164)(105') = 107.22 gal. max. dose D) Reserve storage: 12.00" = 228.60 gal. TOTAL 47.0" = 800.10 gal. Page 2 of 7 LL Jji ti'VIKONin Department of Industry, Laborand, Human Rielations PRIVATE SEWAGE SYSTEM County: Safetyand8uildings INSPECTION REPORT ST. CRbI GENERAL INFORMATION (ATTACH TO PERMIT) sanitary ermrtNo,: �—T 1 s ROVALD City ✓J Village Town o " r E le v.: �I =r Iptiun: parcel T ax No,; TANK INFORMATION ELEVATION DATA f TYPE MANUFACTURER CAPACITY STATION BS HI FS Septic � � , J y ELEV. �' �> � Benchmark , Dosing %( L - Aerati Holding• �Vr _bldg. Sewer T 5t /�E Inlet FDA TANK SETBACK INFORMATION TANKTO P/L WELL BLDG. vent to St / Outlet Arrintake ROAD Dt Inlet Septic 1 — t1' 99`. i ,r,4 NA Dt Bottom /S7 Dosing Header. is Aeration NA Dist. Pipe i �Hofdi .d Bot. System S ., PUMP / SIPHON INFORMATION Final Grade Manufacturer Q.i Demand �;' Model Number -W t `dPM TDH Lift,53) i 1 Friction ,, stems TDH, 37! Ft Forcemain Length Dia, SOIL ABSORPTION SYSTEM -- 8ED /TRENCH Width _ r Lo ng o No — (Tren(hes IT No, Of Pits _ Inside O.a. IMEN 1 Liouid Depth DIMEN D _ _ _ SETBACK SYSTEM TO P / L BLDG WELL LAKE / STREAM Lu atturer; — INFORMATION Type d System: (? r., T � .� , C rOK UMS R o e Num r. I DISTRIBUTION SYSTEM HPader/Manif Id � istn utronPII:F Length i ,/� , x HoeSize x Hoe5pacing Ve o SOIL COVER it nta e O a. y Length ? 7YfD 1)4- Spacing � �--- _ x Pressure Systems Only xx Mound Or rade Systems Orpth over Depth Ovar * Bud /Trench tenter T Dept of xx SEeded i Sodded xx tviulched .3 "r�7 � bed /Trench E fles S � a'� �` T op soi l ❑Yes [] No ❑yes COMMENTS.' (Include code discrepancies, persons present, etc.) -- N LOCATION: V;A.RREN. NW NW ,1209,'H STREET g c.d ��J�c,.� y,_:.'�r'�•<.- r_f � / d.�ncl�e.,s � ,. ��,- � wc--,, CGJ� - 4 Plan revision raquired? C] Yes USQ other side for additional information. $B 6710(R 05/91) nn Data Signatu Cert. No. HEAD/CAPACITY CURVE. N � w • W .LL HEAD CAPACITY CURVE EFFLUENT MODELS TOTAL DYNAMIC HEAD /CA'At11TY PER MINU TE 34 1 10 EFFLUENT AND Ul W:,TERING SE HI 57-W I 91 9tl 13 7.138 14 1 F 53 166 t lee - �68 tE� CO FT Zi GAL Lrl Gal. LW G Lrl G. Ln 1441 Un V 7 L 146 Gal ltr1 Gd 461' Gal 1r6 Gai lrl a.l Lrt G _ 95 - 6 1 � '. u 18J 6a 212 72 273 101 JOp tCS dat 81 61 231'' 6B 2.1! 156 58 166 10 3 O6 71 129 46 .171 f l - 231 7 J - ..� - -^ - - '- -�- 28 _ _ JO{1 tP7 379 61 'z�l 61 Y31 r _ 68 _2Ai IA9 b0. 161 pT1 90 t5 4 57 19 72 35 '13J 45 :f 70 6: 212 91 J1474 BC 2:7 80 ?27 -� 68 `22p 112. 53) 145 64: 6 20 Q l0 : 15 + 6/ s5 ' 86 3u 1 * : 82 310:' 65 2 60 727': 1 T BS -- 68 ?20 I'm ' 61! 140 67J 26 74 ?fA 21 B bD 223:. 6d 22G 3Q 6) 128 18.1 133 60.1 _ BO 30 A I1T 66 2.1 66 200 !'>d TlJi W .�40 58 ?2C 121 166 127 A li I� 40 .1216 _ 48 174:: 16 1/2 ES 2s kI 'S 26.1 ? ICb - 397 2t 60 33 114 131 186 64 Ib 21 1 _ - t9t 8 21; 58 280 W:1. 341 7 D 60 10. 29 - 7 u 181 .16 :136 r 68 220 )1 :69 65 3.2' 0 70- _T21�jy -- :. _. 65 165 __ 111 - 10 1 97 61 I w1 70 266 802A.36t4 W _ 15 170 it ;'t:0 51: 2.k 60 - ltl W 32 1 21 2 1 77 11J Z7. aJ • 155 163 110 1W JO+b 16r !J2 o0- -- -- "` - 7 = 1 JO 150 LocK bar.. . 1926' 2375 - 'l3 ' '8 - 66 - _ ' 6 , 73' 116 91 1 12' ° - - EFFLUENT & tit- WATERING J5- 165 Warning. Model 18;. should not be subjected to less ° - 30 -- than 30 feet TDH. _ -- -- -- Note: For Head Capacity on Model 112, industrial 5 0 column- explosion proof pump, see FM 219. S 6t 97 tl6 as ;77s 13 139 SEWAGE & DEWATERING' GALLONS ,° 2J - 3° <G 50 6G 70 ,° 9G tOG 111° 120 I1 -0 1 ,0 ITS° 160 WARNING: Model 293 should riot be subjected LITERS 80 160 240 320 400 46C Shp E40 ° to less than 15 feet T0H. �c4 mP de h've -s 72 p. /a. m. 6v aa i5 6 das-e Gin Ii Lea, -ec / w w 24 80 - - TOTAL DYNAMIC HEADICAPACI''Y PER MINUTE " ^ 75 I SEWAGE AND DEWATE R114G SERIES - 282 266 A 268 1 82 284 292 I «93 294 70 - F_ _ - _ _ _ - FT. M G al. 1-1,5- G al. L4 5 Ga. 1 (_cI Lvs Gsl L t, l al. I �. Cal. I(s_ C81 L 5. Gal Lin_ ua llrs. 20 S 152 90 341 128 49 4 1 r.a 404 37 492 d( 68x. 40 530 1)0 74: i2 . 652 65 10 3.0 - - 60 221 69 337 89_737 _E 737 95 360 58 598 _ 24 +_0 1 __ - _ _ - - 1dl 6d5 10-_'7c 15 / 5 ' 125 BS 50 189 50_ _ 189 5) 188 _ _ 238 _ 35 511 ,x 401 130 492 115 625 18:. )00 18 60 20 8 r _ t0 3 1 0 3a 1 3 OB _ _ __ 33 125 _ )6 401 86 133 119 450 15 0 5 68 160_6 25 7_61 - C /6 198 68 257 106 4J7 176 -_ Sts 30 9.14 - -_ _- _F - -.-_- _ _ -_ _ -_ -�- _- 55 - __ -_ 43 163 47 1 90 3 4_0 IN 458 u: i 5 16 10 1 2,15 -- - - - - -- - 5 t 9 50 1 rib 54 356 t 1 : c 35 SO 15.24 -- 50 60 iB.75 - - -.- -..._ __ -- _ - -�_ -- -.-_ _- S8 22G _ 77 17 14 70 21.31 _- 2 'y5 45 lo yeNO 18' 21 5'_ _21.5' - 2 L5' - � 26_ , 35_ 12 - 5V" 12 40 10 8 - 293 - -�- - 25 j 6 20 ,5 262 -- - � -'' -- - � -- '� - -- -- -- - 1 292 2 1 - - - -- -- 262 266, 267, 261 -- _� 294 295 _ -- a GALLONS 10 20 30 40 50 60 JO 80 90 tU( 110 120 130 140 150 160 170 160 1'4 2C0 210 22) 230 LITERS 0 80 160 240 32U 400 46U 560 640 /20 80J 880 PO o� U o CA rl o S ca /e f?. ti 1 M � W W A n 1 Q H r a 3 0 0 LA fa �e n N O I � N •p ao R1 I a° U I I Z vl I � I � I ; n Document No. AFFIDAVIT Multiple structures serve(I By common POWTS Owner name and address: Ronald Meyer _ 1053 120` St. Roberts, WI 54023 Return to This indenture, made by "owner" and their successors in interest, o A n a Si. Croix Co. zoning Dept. POWTS (Private Onsite Wastewater Treatment System) serving multiple i tot camuchael Rd. buildings or structures on the following parcel(s): Hudson, W1 54016 Parcel ID #: Lot: NA Block: NA Subdivision/CSM: NA_ 0,4z being part of: SW 1 /4 NW' /4 of Section 0 T. 29 N., R. 18 W.. - — -- - - - - -- — — Tn. Of Warren St. Croix County, Wisconsin. PWOTS DESCRIPTION: Existing dose septic system serving existing three bedroom residence and proposed new workshop owned and operated by "owner' of residence. OWNERSHIP RIGHTS AND RESPONSIBILTY FOR POWTS: Property "owner' as described holds sole ownership rights. '`Om ner" is responsible lbr operation and maintenance of POWTS. 1 �1L, - (Owner signature) (Data) OF SCONSIN: Subscribed nd sworn to be f e t ' _ � _. 2003. --� - ARY PUBLIC, IIC,, }S. t�ate of Wisconsin My Commission Expires: November 23, 20 03 a asc e'XiSWing Corn er, b. ,4s5umeVe-1w. /60.GO: ior, box EXisvn� Aq1 CU& a0 6 5 s: e r ✓. - oZ cX�sEina Access y , +- - Ud4icre EXi S f! 5oi/ d, ��ou sa / c. CGs s Y j6em ales =98• "' Forte►na�n. omo�'Sd ;� 6460m a 5,cl, : /o/ &9' - --� !/ w "sal. do P. ✓, c . Ejc is - �ir►q AOr�,•c4cli,crtt j - x, 8�9o-P bcc; /d��C' Se P LL m am bF� ca/ Pr j� se�1 / SlvS� Q. /4 C - Cess S tr u Gnu re 2 5 / M/ T¢ c/, ��� STp' - /ODA,2• �j,e.p �'� stn Proposccl O �p�oPose.d ems /aen�. Inc. v C /24n o u.f . Sep6 - c. z`�n� Ara., cy• ce�slecl. DEC -02 -03 03:13 PM GTI PARTiGULICH TRUCKING 715 749 3878 P.02 Be 04 OWN ER 'S MANUAL. �� Powrs MENT PLAN page _ of , Ft INFORMATION SYSTEM SPECIFICATIONS er n Septic Tank Capacity 00 a l O NA P m ' it it :; 5 Septic Tank Manufacturer NA D ION PARAMETERS Effluent Filter Manufacturer A N Tiber of Bedrooms -3 0 NA Effluent Filter Model A N Mber of Public Facility Units O NA Pump Tank Capacity al 0 NA E (mated flow leverage) :— al /dg Pump Tank Manufacturer " 0 NA sign flow (peak), (Estimated x 1,5) g ailday Pump Manufacturer O NA S1 I Application Rate gal/do /ft? Pump Model 0 NA S ndard Influent/Effluent Quality Monthly average • Pretreatment Unit A Fats, Oil & Grasse (FOG) 930 mQ /L O Sand /Gravel Filter O Peet Filter B iochemical Oxygen Demand (SOD.) .5220 mg /L ❑ NA O Mechanical Aeration O Wetland Total Suspended Solids (TSS) 5150 mg /L O Disinfection O Other: Pr treated Effluent Quality Monthly average Disp al Cells) E3 NA Biochemical Oxygen Demand (SOD S30 mg /! n- Ground (grevlty) 0 In- Ground (pressurized) Total Suspended Solids (TSS) 130 mg /L O NA O At -Grade 0 Mound i Feca Collform !geometric mean) S10` cfu/100ml 0 Drip -line O Other: L CM)t imum Effluent Particle Size Y In dia, 0 NA Other: O NA r: O NA Other; 0 NA ' luss typical for domestic wastewater and septic tank effluent. Other: O NA MA TENANCE SCHEDULE Service Event Service Frequency In set condition of tankla) At least once every-, y ear (W th(ei (Maximum 3 years) 0 NA pout contents of tank(s) Z When combined sludge and scum equals one -third M31 of tank volume 0 NA dispersal call(@) At least once every: ' �n(al (Maximum 3 years) 0 NA 8'year(el C1 4m effluent filter At least once every: . O )is) O NA In t pump, pump controls & alarm At least once every-, 13 we nth(s) 0 NA FI laterals and pressure test At least once every: 0 months) O A year(s) 0 r: 0 month s) At least once every: 0 earl's) DNA 0 r: O NA MAi TENANCE INSTRUCTIONS In ecUona of tanks and dispersal cells shall be made by an Individual carrying one of the following licensee or certifications: M tar Plumber; Master Plumber Restricted Sawer; POWTS inspector; POWTS Maintainer; Septage Servicing Operator. Tank in actions must include a visual inspection of the tanks) to identify any missing or broken hardware, Identify any cracks or leaks, m sure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. Th dispersal coll(s) shall be visually Inspected to check the effluent levels In the observation pipes and to check for any ponding of fluent on the ground surface. The ponding of effluent on the ground surface may Indicate a failing condition and requires the I ediate notification of the local regulatory authority. W n the combined accumulation of sludge and scum In any tank equals one -third M or more of the tank volume, the entire co enta of the tank shall be removed by a Septage Servicing Operator and disposed of In accordance with chapter NR 113, Wi onaln Adminletrative Code. All Cher services, Including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment un , and any servicing at Interval@ of s12 months, shall be performed by a certified POWTS Maintainer. A rvlce report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4/01) DEC -02 -03 03:13 PM GTI PARTiGULICH TRUCKING 715 749 3878 P.03 ST T UP AND OPERATION Pige — 'of, F new construction, prior to use of the POWTS check treatment tank(el for the presence of painting products or other chemicals t t may impede the treatment process and/or damage the dispersal cell(sl. If high concentrations are detected have the contents o he tankial removed by a septage servicing operator prior to use. S em start up shall not occur when soil conditions are frozen at the Infiltrative surface. D ing power outages pump tanks may fill above normal highwater levels. When power Is restored the excess wastewater will be d harped to the dispersal ceills) In one large dose, overloading the cellisl and may result In the backup or surface discharge of a uent. To avoid this situation have he a t contents of the pump tank removed by a Septage Servicing Operator prior to restoring p or to the effluent pump or contact a Plumber or POWTS Maintalner to assist In manually operating the pump controls to r ere normal levels within the pump tank. 0 not drive or park vehiclaa over tanks and dispersal cells, Do not drive or park over, or otherwise disturb or compact, the wan w In IS feet down slope of any mound or at -grade soil absorption area. R uction or elimination of the following from the wastewater stream may Improve the performance and prolong the life of the P WTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss: diapers: disinfectants; fat; t elation drain (sump pump) water; fruit and vegetable peelings; gasoline, grease; herbicides; most scraps; medications; oil; p nting products; pesticides; sanitary napkins; tampons; and water softener brine. A8 DONMENT on the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is pr erly and safely abandoned In compliance with chapter Comm 83.33, Wisconsin Administrative Code: e All piping to tanks and pits shall be disconnected and the abandoned pipe opening@ sealed, e The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servlcing Operator. e 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. o CO iNGENCY PLAN If a POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code compliant re 7 c ame t ayst eM: suitable replacement area hoe been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement was 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 amply with the rules In effect at that time. d A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS t*nclogy a holding tank may be Installed as a last resort to replace the failed POWTS. The alts 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 y be Installed as s teat 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 such systems must comply with the rules In effect at that time. t < ARNING > > S iC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. 00 NOT E ER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A P SON FROM THE INTERIOR Of A TANK MAY BE DIFFICULT OR IMPOSSIBLE. AD OVAL COMMENTS PO S INSTALLER POWTS MAINTAINER ame lle J-y t Name one ?j�c - � 7y9.2 Phone OE SERVICING OPERATOR (PUMPER) LOCAL no ULATO1. A TH RITY ame Name , C Lo; it Ce u, IZ'oNi ° f Phone This omen was drafted in compliance with chapter Comm 83.221211b)(1)1d11i(f) and 83.5401, 121 At (3), Wisconsin Administrative Code. ' T'I DEC -02 -03 03:12.PM GTI PARTiGULICH TRUCKING 715 749 3878 P.01 � 4 ST CROlX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owns uyer 00 Mailing Address j D / S3 /,'zo�11 Property Address R 017 ,E'j-+S LoJ7 0 I Wrifiicalion required from Planning Department for acw construc(ion) City /State w� Parcel Identification Number 6 Y z — 10 .A4, - ?6-00 0 1 FfiAl. UFW- RIPTIM Property Location S.W- t /,. 4LU %, Sec. J&_, TAN -R.�LW, Tovm of (tea. - �3°'J✓ Subdivision 1#0 G -S A —100 4 — Q XR4 -- Lot # Certified Survey Map # �a � <A /X• , Volume , Page # Warranty Deed Al / 5 - - . 107/0 , Volume /1 ' �. Page # Spec house; C3 yes �o U- AjE'M KA, NTE'NANrF 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 lank 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 irealmeni 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 Ices 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 forlh, 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 the three year expiration dale. x o, a l 03 SIGNATURF. OF APPLICANT DATE OWNER rFRT1F1rAnQN I (we) certify that all statements on this form are tau to the best of my (our) knowledge. I (we) am (ate) the owner(s) of the property described above, by virtue of a warranty decd recorded in Register of Dcods Office. i SIGNATUREOFAPPLICAI T X DATP� O ...' Any information that is mis -represented may result in the sanitary permit being revoked by the 'Zoning Department. *• *••• • • Include with this appll atlon; a stamped warranty deed from the Register of lkeds office a copy of the certified survey map if reference is made in the warranty deed ,.��7estrh, t X -" /1'ai, cv-L s4�o� -3 i� � i s � ¢ q DOCUMENTNO. STATE BA OF WISCONSIN FORM 1-1982 THIS SPACE RESERVED FOR RECORDING DATA • . , , 1hI'ARRANTY DEED Ts vo-'. 1128PACE 255 Sl CA0rn This Deed made between Lehart J Priedrich and JUN 3 0 1996 1 Prances H. Priedrich at t;ar��0. A. V Grantor, y_i1fL_ . \ . and Ron& dfl. Meyer `L��►�++�• �1� Reg�darolDer;�a Grantee, ee Witnesseth That the said Grantor, for a valuable consideration d conveys to Grantee the fol!owing described real estate in St. Croix RETURITO Vin Hugh H. County, State at Wisconsin: P.O. Box 106 Hudso WI 54016 042- 1026 - 10;40 ;50 ;60 ; Tax Parcel No: 80-90- & 9r,- All of the NE 1/4, EXCEPT the Northerly 726 feet of the Westerly 600 feet of the Easterly 1018 feet thereof, and EXCEPT Lot 1 of a Certified Survey Map recorded June 8, 1995 in Volume 10 of Certified Sc•^-JLr Map at page 2936, as Document No. 529950 in the St. Croix County Radister of Deeds, Town of Warren, St. Croix County, Wisconsin; AND All of the NW 1/4, all in Section 10, Township 29 North, Range 18 .Z West, Town of Warren, St. Croix County, Wisconsin. Thi is not homestead property. Together with all and singular the hereditaments and appurtenances thereunto belonging; And grantors warrants that the title is good, indeieasible in fee simple and tree and clear of rncumbra^ces except and will warrant and defend the same. Dated this 29th day of June 19 95 t ' /�2 (SEAL) (SEAL) I Lehart J. F- r c �G�rrY.� - Pl H ( , (SEAL) (SEAL) Frances H. 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I $ m z a i y z z 200 W I CL CL I i� I N � I I I o Q I a Ve I I I I o I o I a A I N O r CD OQ A 1p O I CO * V A I L` CD O a IL Parcel #: 042 - 1026 -90 -000 07/03/2006 11:12 AM PAGE 1 OF 1 Alt. Parcel #: 10.29.18.151 042 - TOWN OF WARREN Current !_X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner RONALD H TR MEYER O - MEYER, RONALD H TR 1053 120TH ST ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1053 120TH ST SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A -NOT AVAILABLE SEC 10 T29N R1 8W SW NW Block/Condo Bldg: Tract(s): (Sec- Twn -Rng 401/4 1601/4) 10- 29N -18W Notes: Parcel History: Date Doc # Vol /Page Type 04/01/2004 758404 2539/412 QC 07/23/1997 1128/255 WD 2006 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/20/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 25,000 138,600 163,600 NO AGRICULTURAL G4 35.000 6,000 0 6,000 NO UNDEVELOPED G5 3.000 1,100 0 1,100 NO Totals for 2006: General Property 40.000 32,100 138,600 170,700 Woodland 0.000 0 0 Totals for 2005: General Property 40.000 32,100 138,600 170,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 206 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 STC — 104 ';•:� AS BUILT SANITARY SYSTEM REPORT a r OWNER ADDRESS SUBDIVISION / CSM # LOT # SECTION jQ T ° s�o N -R Town of LL) W'ky� ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM „�1 ce Isr 7/ ' , 'y' I i 0 INDICAW LTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: BM SEPTIC ALTERNATE BM. SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION b - Manufacturer: X" A Liquid Capacity: j) p � Setback from: Well 1 9 I House Other 3 900) d"' k Pump: Manufacturer 4;:�a oa Model # 9 g Size el Float seperation Gallons /cycle: Alarm Location Ina, 3 3 SOIL ABSORPTION SYSTEM Width: Length 2CJ - `3 Number of trenche Distance & Direction to nearest prop. line: / Setback from: well: 7 House Other / ��`' -- � ,d�►� 9 x,07 ELEVATIONS Building Sewer '>3,5 5 ST Inlet 9,� c7� / ST outlet �� PC inlet 9k 7 PC bottom 23 Pump Off Header /Manifold Bottom of system Q J C ? Existing Grade Final grade 3 3 / DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: _ ;,a �6 INSPECTOR: 3/93:jt 17Jv, Wiscohsin Department of Industry PRIVATE SEWAGE SYSTEM County: tabor and Human Relations INSPECTION REPORT ST. CROIX ,Safety and Buildings Division j (A TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION Per N m j H Beer's RONALD ❑ City ❑ Village ❑ Town of: State Pt CST BM Elev.: Insp. BM Eiev.: BM Description: Parcel Tax No.: /late vie a_._> i C�— TANK INFORMATION ELEVATION DATA �� 4 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic tti / �J j Benchmark Dosing 1 4 1 5 / Aerati Bldg. Sewer $ SS Holding' -- -- --~-- St /yf Inlet �j�' X,d�� TANK SETBACK INFORMATION St /J4 Outlet TANK TO P/ L WELL Air Intake BLDG. vent to ROAD Dt Inlet Septic 7/� ` � �� / NA Dt Bottom 13, 57 3, Dosing 7 (fi f5(` >a0 ' NA Header s. _ Aeration NA Dist. Pipe / Z 33' Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand t ° l ° h c.`c4_ ' Model Number #' TDH Lifts �� I Friction System J TDRS �) Ft Forcemain Length Dia. H � ° Dist. To Well 9 � SOIL ABSORPTION SYSTEM BED/TRENCH Width Leng �h No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIM N SIO SETBACK SYSTEM TO P/ L i BLDG WELL LAKE / STREAM LE u acturer: INFORMATION Type O gZ. BER M ,( > C�iorfl7I V e Num e, System: 0, r e„ �(� - %5 A OR UNIT { DISTRIBUTION SYSTEM Header/manifold I/ Distribution Pipes x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length �7 �9� Dia. �` Spacing �s SOIL COVER x Pressure Systems Only xx Mound Or rade Systems n Depth Over 0 Depth Over 3 xx Dep Of xx Seeded/ Sodded xx Mulched Bed /Trench Center 1 ,3–,27 1 Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) /7Re LOCATION: WARREN.10.28.18W, NW, NW 120TH STREET X L� a � �/i `�' ✓ /' I s/A! � .. �"L'd '� r ' (✓ .(t. /I� �.� >!� th" O .+r �` � / ,�'�1f /Y/_ "' ..�� .r vt% � /.� , V G�1�C�/1�4 � �c�`�'r, � �?�3J'r �*,1.P��.X%a ,�_.f'� '; ,f'..C% ✓' � -�' � � � -��-. �r✓I.�^ -� . C � ,, Plan revision required? ❑ Yes []'No Use other side for additional information. SB 6710 (R 05191) Date sped Signatu Cert. No. c l � CC�� C %d Y ��t tJGC G �JC '4S — o4 ADDITIONAL COMMENTS AND SKETCH ` SANITARY PERMIT NUMBER: i ' SANITARY PERMIT APPLICATION COUNTY .5 In accord with ILHR 83.05, Wis. Adm. Code 5 % K.a STATE SANITARY PERMI # —Attach complete plans (to the county copy only) for the system, on paper not less than �0 ? �� 8% x 11 inches in size. 1:1 Check if re / vision to previous application —See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER I. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPS TY OWNER PROPERTY LOCATION c xlr N ILI % N f W %a, S 0 T--, �, N, R E (or) PROPERTY OWNER'S MAILING AobRESS LOT # BLOCK # c , - PA CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER N G: (rdheck one) CITY NEAREST ROAD 11. TYPE OF BUILDIN J, /� ❑State Owned ❑ LAGS : � WN OF: ❑ Public 1 or 2 Fam. Dwelling —# of bedrooms PARC L TAX NUMBS (S) loop III. BUILDING USE: (If building type is public, check all that apply) 1 ❑ Apt/Condo 076br v 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 ERMIT: (Check only one in line A. Check 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 Existing System B) ❑ A Sanita Permit was previou issued. Permit## Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Aeepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 IrJ Seepage Trench 22 ❑ In- Ground` 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 14. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals /day /sq. ft.) (Min. /inch) �y ELEVATION �� � Q� '� / 7` - Feet �- Oo 7 Feet VII. TANK CAPACITY Site in oa Ions Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tank4l Tanks structe Septic Tank or Holding Tank Lift Pump Tank/Siphon Chamber Vill. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps MP /MPRSW No.: Business Phone Number: Plumbers Address (Street, ity, State, Zip Code): 1X. COUNTYIDEPARTME T USE ONLY ❑ Disapproved Sanitary permit Fee (includes Groundwater roue Water a e Issued Issu g Agent Signature (No Stamps) X I Approved ❑ Owner Given Initial Adverse Determination X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: SBD- 6398(R.08/93) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the 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. Onsi to 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 & Buildings Division, 608 - 266 -3815. 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 in 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 in ##1 -7. VII. Tank information. Fill in the capacity of every new and /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 forma IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% 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; um model and um manufacturer; D cross section of the soil P P pump ) e o 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, ground- water contamination investigations and establishment of standards. SBD -6398 (R.11/88) Wisconsin Oepartrnent of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 L ^,.bor'and Hur;ran Relations Di1lni't .'f Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Aftch complete site plan on paper not less than 8 1 1 h s* Plan must include, but St. Croix not limited to vertical and horizontal reference po , re io d /o slope, scale or PARCEL I.O. # 1 l- dimensioned, north arrow, and location and di c o ne esj,�ad. / Z t� �o APPLICANT INFORMATION- PLEASE Rd ALL`I9�� TIO REVIEWED BY DATE 4 PROPERTY OWNER: 0 tM4PERTY LOCATION Ron Meyer , �� J LOT NW 1/4 NW 1/4,S10 T 29 XR 18 xll:(or) W PROPERTY OWNERS MAKING ADDRESS k� # BLOCK # SUBD. NAME OR CSM # 2223 Cypress Dr. a na na CITY, STATE ZIP CODE MBE CITY (]VILLAGE ®GOWN NEAREST ROAD Woodbury, M. 55125 Pj _ 6 Warren 120th. St. (� New Construction Use fx l Residential / Number of bedrooms 3 (] Addition to existing building j J Replacement (J Public or commercial describe Code derived daily flow — 450 god Recommended design loading rate — bed, gpd/ft .5 trench, gpd/ft Absorption area required 1125 bed, ft2 900 trench, ft Maximum design loading rate • 4 bed, gpd/ft . 5 trench, gpolft Recommended infiltration surface elevation(s) 97.50 alt . =98.70 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 I MOUND IN-GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem I S 0 U ®S 0 U 1 0 S 0 U e s 0 U 0 S � CIS Im 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 ITmr& 1 -9 10yr3 /3 none 1 2msbk mfr cs if .5 .6 2 9 -24 7.5yr4 /4 none sicl lfsbk mfr caw if .2 .3 Ground 3 4 -82 7.5yr4/6 none sl lfsbk mvfr na na .4 .5 elev. 10 ft Depth to limiting factor +82" Remarks: # Boring :coring Z -11 10yr3 /3 none 1 2msbk mfr 9w if .5 .6 ? w 2 2 1 -26 10yr4 /4 none sicl 2msbk mfr gw if .4 .5 3 6 -35 7.5ry4/4 none scl lfsbk mfr caw na .2 .3 Ground el 4 6 -84 7.5yr4/6 none sl lfsbk mvfr na na .4 .5 99 ft Depth to limiting 04tl Remarks: CST Name:— Please Print Gary L. Steel Phone. 715 -246 -6200 Address: 1554 th. Ave. New Richmond WI. 54017 Signature: Date: CST Number: 8 -11 -95 cstm 02298 PROPERTY OWNER Ron Meyer SOIL DESCRIPTION REPORT Page 2 , of 3.' 2 PARCEL LD. #� (�'�" L " Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots • GpD /ft in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. Bed iTmench 1 0 -6 10yr3 /3 none 1 2msbk mfr yw if .5 j .6 3 `v 2 6 -24 10yr4 /4 none sic 2msbk mfr gw if .4 I .5 Ground 3 242, 7.5yr4/4 none scl lmsbk mfr gw na . .2 ! .3 1 4 32-69 7.5yr4/6 none sl lmsbk mvfr gw na .4 .5 Depth to 5 69 -84 5yr5/6 c2p 5yr5/6 1 fs Osg mvfr na na .5 .6 limiting factor 6 9 1, i f er'ar'o:,s: Boring # 1 0 -12 10yr3 /3 none 1 2msbk mfr cs if .5 : t< 4 2 12 -28 10yr4 /4 none sil 2msbk mfi gw if .�... 3 28-80 7.5yr4/4 none sl lmsbk mvfr na na .4 .5 Ground elev. ' 1 Depth to limiting Remarks: Boring # 1 0 -12 10yr3 /3 none 1 2msbk mfr gw if .5 `:.6 tier 5 `< 2 12 -2 10yr4 /4 none sil lfsbk M gw if np ? .2 3 29-36 7.5ry4/6 none sl lmsbk mvfr gw na Ground �10� 4 36 -5 7.5ry4/4 none sl lmsbk mfr Td na .4 .5 5 54-80 7.5ry4/4 none sl lmsbk mvfr na na .4 .5 Depth to limiting factor +80" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(R.05/92) STEEL'S SOIL SERVICE Gary L. Steel Ron Meyer 1554 200th Ave. CSTM2298 NW4NW4 S10- T29N -R18W New Richmond, WI 54017 MPRSW 3254 town of Warren (715) 246 -6200 t N 1 =40' BM.= top of cement base of storage bin 18 el. 100' 2 03 b �.� 70 0 n N 4;,W es�u�fL Gary L. Steel 8 -11 -95 STC -105 SEPTIC TANK MAINTENANCE AGREEMENT / St. Croix County OWNER/BUYER GC' ' CZ I MAII.ING ADDRESS PROPERTY ADDRESS �� J r� -5 ® sz- -31 (location of septic system) Please obtain from the Planning Dept. CITY /STATE ' Q / "� � ; ' Q'� ©° PROPERTY LOCATION , i4l 1/4, 141 W 1/4, Sectio T N -R TOWN OF ST. CROIX COUNTY, WI SUBDIVISION �j LOT NUM13ER CERTIFIED SURVEY MAP , VOLUME , PAGE , LOT NUMBER 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 licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge arid scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: DATE: - +� St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, %VI 54016 11/93 S T C - 100 This application form is to be completed in full and signed by the g' owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner /contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. ------------------------------------------------------------------- Owner of property N�'� r '° ; ,� Location of property VC) 1/4 IV, d -11/4, Section ,T.-2 N -R /2 Township Mailing addres j� 7` e4L /r %L /:2G ZY Address of site �� Al Subdivision name Lot no. other homes on property? No Previous owner of property M1 �A Total size of property Total size of parcel �o Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)? Yes 41' Volume r/ �7- g and Page Number -S as recorded with the Register of Deeds. ------------------------------------------------------------------- INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. if the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No. r 30 7/ 11 1 1 1 and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of the County Register of Deeds as Document No. Signature of Applicant Co- Applicant Date of Signature Date of Signature PAGE OF PUMP CHAMBER CROSS SECTION AM SPECIFICATIOMS VEIJTCAP ., v E.idT PIPE WEATHER PROO APPROVED LOCKING JUNCTION BOX MAIJHOLE COVER 2a,'5'' ,F k"t m DOOR, p{3W K FRESH I2'MIU. t# O ITAK£ t GRADE Ai k COUDUIT —_ —_ -- - - - - - - - k 71 © fiET PROVIDE I I - - -- AIRTIGHT SEAL I° I APPROVED JOINTS QVD. JOINT A E,I Pt�E I 1 1 I W /C.I. PIPE ,110104 3' I III ALARM EXTE AIDIMG 3' 1 ONTO SOLID SOIL SQI.1tti SOIL e S i I . C3 , I� I oN y c 3 I PUMP -� -" —� . ..OFF I ° COAICRETE BLOCK RIMER EXIT PERM17ftD OIJL4 IF TAUK MAMIJFACTURER HAS SUCH APPROVAL SPEC-IFICATIOKIS ° ?lmrV KS MAIJ'UF'ACTLIRER: L° aN r �tl' NUMBER OF DOSES: - PER DAH N SfZE : r, 1�0 / ► / I . + {3 I GALLOMS DOSE VOL TAK UME: / c GAUA -GUS ARM MAMUFACTUR.ER: � T I�f', � 1 f a � 0 CAPACITIES: h- 'v'�.1 C-MES ILOAI3 MODEL NUMBER: Z2 �•� S= Z IMCHESOR GALLONS + SWITCH TYPE: _7� I`�°� I �; ^/OQ C= IsICNES Oil LLOkIS i MIR MANUFACTURER: � -Q F � Irk � D� tAILHES OR ;&I iL CALLOUS M0I)EL AIUMBER: L NOTE. PUMP AND ALARM ARE TO BE SWiTCH TyPE: �� ,., I INSTALLED OW SEPARATE CIRCU ITS . lC. �.� tint PUMP DISCHNIRGE. RATE A AQ GPM =1(ERTICAL DII- V ERENCE BETWEEN PUMP OFF AIJD DISTRIBUT {OAI PIPE.. L t T mliuij UM NETWORK SUPPL 9 PRESSURE . . . . . . . . . . . 2 5 FEET FEET OF FORCE MAIN X ' F pFTFRICTION FACTOR. « -'FEET TOTAL. DYNAMIC. HEAD FET - )jTEK&JAL. DIMEI sWMs OF TAMK:'LENCGTH ;WIDTH .;LIQUID DEPTH x..�IGItJEb.' - 3 L i �, +` � LICENSE HUMBER: S — ' DATE: V .Steel Ron Meyer 1554 200th Ave. NW4NW4 s10 T29 -R18W New Richmond, WI 54017 3254 town of Warren (715) 246 -6200 .= .top of cement base of storage bin @ el. 100' V Ca I _ A, , 3 �JroP 2 20,E }� "70 ` EV& s,� J A AL m ., IlkyO' � 7L .S,E�o c 7 c, n c oil oo m J-t v lAl& -- ,aom 16 x is coo - DOOR, Kr 7CEIEn/ 'v 0 LAW�LD?Y JZ' ooM � NALL s X G �lfix� r d � ►�.t t �,/ FURNACE X 1' t ,! t� i " DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1 -1 982 THIS SPACE RESERVED FOR RECORDING DATA f WARRANTY DEED This Deed made between Lehart J. Friedrich and Frances H. Friedrich JUN 3 0 1995 ` 10:10 A. ; a.� Grantor, and Ronald H. Meyer K n � 0 i Grantee, e o Witnesseth That the said Grantor, for a valuable consideration d RETURN TO conveys to Grantee the following described real estate in St. Croix Atty Hugh H. GWin County, State of Wisconsin: P.O. BOX 106 Hudson, WI 54016 042 - 1026 - 10;40;50;60;70; Tax Parcel No: R Q ob- ' & All of the NE 1/4, EXCEPT the Northerly 726 feet of the Westerly 600 feet of the Easterly 1018 feet thereof, and EXCEPT Lot 1 of a Certified Survey Map recorded June 8, 1995 in Volume 10 of Certified Survey Map at page 2936, as Document No. 529950 in the St. Croix County Register of Deeds, Town of Warren, St. Croix County, Wisconsin; AND All of the NW 1/4, all in Section 10, Township 29 North, Range 18 West, Town of Warren, St. Croix County, Wisconsin. This is not homestead property. Together with all and singular the hereditaments and appurtenances thereunto belonging; And __ Qrantors warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except and will warrant and defend the same. Dated this 29th day of June 19 L Lehart J. Fr ric p� (SEAL) (SEAL) � — (SEAL) ( SEAL) Frances H. Friedrich AUTHENTICATION ACKNOWLEDGMENT MINNESOTA Signature(s) STATE 0F'oC1XWGUSM Washington County. ss. authenticated this _day of , 19 Personally came before me this 29th day of I l June , 19_ the above named I I _ Lehart T Fr iedrich and Frances H Friedrich TITLE: MEMBER STATE BAR OF WISCONSIN (It not, to me ow to be the person - S who excuted the authorized by § 706.06, Wis. Stats.) foreg ng in trument and I owledge the same. THIS INSTRUMENT WAS DRAFTED BY t LAWSON, MARSHALL, McDONALD & GALOWITZ, P.A. _ - 3880 Laverne Avenue North (ROM) Lake Elmo, MN 55042 Notary P Ii ounty, WI s MN (Signatures may be authenticated or acknowledged. Both My Com I p��v't""L��1C jlM(fl 0 to expiration are not necessary.) ,� ) date: +� hin ton Count 1s Names of persons signing in any capacity should be typed or printed below their signatures. Yd SB1 NTF 0020 'If F WARRANTY DEED STATE BAR OF WISCONSIN Nelcol ores. P.O. Box 10208, Green Bay, Wl54307 -0208 FORM No. 1 -1982 r � ; .. ., �,�� i -� ���� "� �� � `�