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HomeMy WebLinkAbout042-1052-60-300 Wisconlin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division ` INSPECTION REPORT Sanitary Permit No: 463480 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: DeTomaso, Tony I Warren, Town of 042 - 1052 -60 -300 CST BM Elev: Insp. BM Elev: BM Description: SectionlTown /Range /Map No: Ylf\ ' IS; ( 19.29.18.295C TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI GbGri E{e J F S Septic ; J Zso Benchmark D�• J� Alt. BM �e Ca tom. 111. ►2 _ �' S Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic �725 � /� / �� / Dt Bottom �\ .�- Dosing Header /Man. d " V>' (P. 75 Aeration Dist. Pipe 47 7• 9 7g g7.rS q.y5 Holding Bot. System e lo Final /d Grade { , Ja f PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM / Model N er 7 TDH ift Friction Loss S TDH Ft 97,$ 7 Forcemain Dia. Dist. to Well � { 9b11 4 f5 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 1 BLDG ] WELL Y - + � LAKE /STREAM LEACHING Manufacturer: INFORMATION Y ` Type Of S CHAMBER OR System 't' , m / / 1 w UNIT Model Number: G � DISTRIBUTION SYSTEM e ,_t.-, TO Header /Manifold Distribution Hole Size Hole Spacing Vent t Air Intake i Pipe(s) C� Length Dia Length \ Dia Spacing i x x SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /S dded xx Mulched Bed /Trench Center �7 �s Bed/Trench Edges \ Topsoil L � Yes No "es No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 908 87th Avenue Roberts, Roberts, WI 54023 (SW 1/4 NW 1/4 19 TT2 R1 8W) NA Lot 2i — Parcel No: 19.29.18.295C ' 1.) Alt BM Description = �� �C � 2.) Bldg sewer length = 16 - amount of cover D Plan revision Required? !Yes No Use other side for additional information. __ -_ ___ _ Date Insep is Sign r Cert. No. SBD -6710 (R.3/97) 5arety and BuiWings Division W. Washington Ave.. P.O. Box 7162 County -L` 6fi?O I iscons�rn ` M 3 - 7162 Sanaary Permit N�im�ba t� filled in by Co.) � Dep artment Of COmmerce S1 Plan I.D. Numb Sanitary Permit A n in accord with Comm 83.21. Wis. Adm. Code, you h ( 1 % mail satires 0 Aadrme if diRerent tttm tng ) may be urea for secor- y purposes Privacy +r+) 0 5 JA 1. Application lstarrtetiow- Plcaae Psist All lrfereaetioa =ZONOFFICE Y / Lot # Block N Property Owner's Name / n otv � O , k" 4 S U .F I rj Q / Gi N e- Property 's Meiliag Address ProperU' Location ( ' 1 -- Section City, State Zip Code Phone Number y Aq,q ►Z `C� ��` /'Yr� S S U 2 G 9 / - o ? S G j ('� TN: R � W ) 11 11. of BuiWirg (creek a at apply) S CSM N TYiK 6- / 2 Family Dwelling - Number of B011 r C "t S z (/ / • cf 0 Public Commercial - Describe Use 0 Side Owned - Describe Use ❑CNy ❑Village ownthip of�_ 111. T,vpc of ermit: (Cheek Orly ore box or lice A. Crtrpkte list B if epplieable) A. New System 0 Replacement System 0 TreatmentlHokling Tank Replacement Only ❑ Other Modirwation to Existing System List Previous Permit Numbs and Due ImW R. 0 Permit Renewal 0 Permit Revision 0 Change or ❑ Permit Transfer to New ne Before Expiration Plumber Owner POWTS Sysiew Cheek all tb&t Non _pressurised b 4mund ❑ Mound > - 24 in. of = bie sal 0 Mound < 24 im. of wiabk sad 0 AvGrade 0 Single Pass SoW Filter ❑ Constructed Wetland 0 Pressurized In- Ground 0 Holdwg rank 0 Peat Filter ❑ Aerobic Treatment Unit O nn8 n ter Rairctdui S Mods Fitter O Chwnber 0 Lie 0 Gravel -tar ' ❑ Other V. i/Trd altar rt Design Flow (gpd) Dispersal Design . Appl.— Dispersal Area (s Require ProlMW (sB 3ystern FJevauon j � � 6 12 , 0®® too. �- Vl. Tank Info icy in Teal Number Manufacturer Prefab fiber Galloma of Units Concrete Consttucterl Glass New existiall Tanks Tacks sggic ar Holding T ank 1260 Amebic Tirahnear Unit Aawigcla wher VII. RespostsiM Statement - L the for IeaWlatioe of tbt POWTS Wwwe oe ft 1108 PlOm umber's Name (Print) a signtdue 407w" Number Business - Mm Number V/ I 223/ ` 2ls"� ��� -S "/G Plumber's A (S / , Ci sere. z ip ) R U F yn q G3 K G G c / L 11 / 4-/ r Vlll. County/Department Use pr �( Approved ❑ Daa Sanitary Permit Fee 0 Groundwater Date Irwin Agent Si ( Stamps) W' Surcharge Fee) '� ❑ fiat IX. Conditions Approve 3 , SYSTEM OWNER: 1 Septic tank, effluent filter and °� / dispersal cell must all be serviced / Y raine . S as per management plan provided b plumber. 2. All setback requirements must be maintained �� 5 as per applicable code /ordinances • Away to Vkft pbrr (to err Goad orb) tar dw sy>aatrr oa wNr sat tars duns Vt x U b4bu lu sirs SBD -6398 (R. 01/03) 1 :. 10 PI/' 1 " 1/75 - `gi _ G C , r4 Q ik c( } / 3 4 x S e 4 A � oe S 1 t � . ...... -.. �L tvG t; C.p G ". p N,4 JPk r- l? Alto poh.4 s G p Nr t 10A 0? ,'b toe A; m -'a p R�asn i'�� �� e- � Ll Q -/ - r(q. ? n / yt1` N GL �3 - LO OK A ' C, �. G h d ;z,'t G rh S G E 1 sA/ lq, r TOP? � t c� �. lr�n � _ 43 � pRcwn I'3y at.. Str9n 13s,P✓,ren L L �02�G to(-f. ? s' �i v s►vPL �, oo x ker� Ile L 3 f r QC P � pepaMtent of Commere a SOIL EVALUATION RE 1 3Wisconsin Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code stum Septic Service Attach complete site plan on paper not less than 8%Z x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference pant (BM), direction and _ percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parce _ parcel 30 d Please print all information. evie Da Personal information you provide may be used far secondary purposes (privacy Law, s. 15.04 (1) (m)). I I Property Owner Property Location Humbird Land Corporation Govt. Lot n/a SW 1/4 NW 1/4 S 19 T 29 N R 18 W Property Owner's Mailing Address Lot # Block # Subd. Name 332 Minnesota Street, East 1404 2 n/a 1 H 12 Pending CSM3 City State Zip Code Phone Number J City J Village 0 Town Neares oad Saint Paul I MN 1 55101 1 651 -222 -5555 1 Warren I Young Road / 92ND Ave. 01 New Construction Use: a Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement J Public or commercial - Describe: Parent material outwash plains Flood plain elevation, if applicable n/s General comments and recommendations: Part of 2.39 acres. Recommend multiple trench system. BM #1= el. 100.0'. BM #2= el. 98.95'. Boring # � Boring M !m Pit Ground Surface elev. 104.75 ft Depth to limiting factor > in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Q PD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 ff#2 1 0 -10 10y2/2 none sil 2msbk mvfr as 2f, 1m 0.5 0.8 2 10-15 10yr3/2 none sil 2msbk mvfr cw 1f 0.5 0.8 3 15 -24 7.5yr4/6 none gr. sl 2msbk mvfr cw - 0.5 0.9 4 24 -32 7.5yr5/6 none gr. s lmsbk mvfr cw - 0.7 1.2 5 32 -75 7.5yr4/6 none gr. Is lmsbk mvfr - - 0.7 1.2 b Boring # J Ong Ad Pit Ground Surface elev. 104.75 ft Depth to limiting factor > in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'E 1 0 -10 10y212 none sit 2msbk mvfr as 2f, 1m 0.5 0.8 2 10-22 10yr3/2 none sil 2msbk mvfr cw 1f 0.5 0.8 3 22 -28 7.5yr4/6 none gr. sl 2msbk mvfr cw - 0.5 0.9 4 28 -34 7.5yr5/6 none sl 2msbk mvfr cw - 0.5 0.9 5 34-75 7.5yr4/6 none gr. sl 2msbk mvfr - - 0.5 0.9 Effluent #1 = BOD 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD 5— 30 mg/L and TSS <_30 mg/L < CST Name (Please Print) Signature: CST Number Tom Gustum 227618 Address Gustum Septic Service Date Evaluation Conducted Telephone Number N13450 937th St, New Auburn, WI 54757 5/8/02 715- 658 -1344 Property Owner Humbird land Corporation Parcel ID # new parcel Page 2 of 3 3] Boring # -j Boring A Pit Ground Surface elev. 100.95 ft. Depth to liming factor >70 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 10y2/2 none sil 2msbk mvfr as 2f, 1 m 0.5 0.8 2 8 -13 10yr3/2 none sil 2msbk mvfr cw 1f 0.5 0.8 3 13 -21 7.5yr4/4 none gr. sl 2msbk mvfr cw - 0.5 0.9 4 21 -33 7.5yr5/6 none 1msbk mvfr cw - 0.7 1.2 5 33-70 7.5yr4/6 none gr. sl 2msbk mvfr - - 0.5 0.9 F-1 Boring # I Boring J Pit Ground Surface elev. ft Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # i Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPOW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 - 264 -8777. r CO 1 C 1 1 1 1 Property lane 1 I 1 1 N .r : ; � � ■ I m w m O v m 1 5 1 ►% 0 m oo i a $ w ------------- 1 � 700 o 1 . ' - - -- ------------------ T6& J 1 f i 1 i p,C4) I i i w 1 Property line c I 1 ' l z wm x. ca 0 o I LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF WARREN COMPUTER NUMBER 042 - 1052 -60 -300 Parcel Number 19.29.18.295C OWNER NAME: First Last NIELSEN ENTERPRISES INC PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment SECTION 19 TOWN 29N RANGE 18W 1 /4160 NW 1 /440 SW Line Description Line Description TOTAL ACREAGE 2.390 PLAT CSM 16/4376 042/02 LOT02 BLK 01 SEC 19 T29N R18W PT SW NW 15 02 LOT 2 CSM 16/4376 16 03 EZ- RD- 1990/591 17 04 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, 175 -Next Parcel, F7- Valuations, F8- History, F10 -Exit 69 1 255 APPROVED n 1k 1p s 2 Gv APO Afj'8 VOL 16 PAGE 4376 ST. CROIX COUNTY Plannino Zoninn and Parks Committee oyi Gu - ?A9 G KATHLEEN H. WALSH SEP 17 2002 �`��-' /o G� �' �s� ST. CROIX , WI ,c RECEIVED FOR RECORD if not rocwd{�ti approval deft F 1 E D SURVEY MAP 09 - 20 -2002 1 1 :00 A nuLddVrEq IN PART OF THE SWIX OF THE NW1 /4 CERTIFIED SURVEY MAP OF SECTION 19, T29N, R 13W. TOW N OF WARR REC FEE: 15.00 ST- - COUNTY, WISCONSIN. COPY FEE: 4.00 SURVEYOR PAGES: 3 S & N LAND SURVEYING NW CORNER OWNER DOUGLAS J. ZAHLER SECTION 19 WOODHILL LAND, LLC 2920 ENLOE STREET E1404 FIRST NATIONAL BANK BUILDING HUDSON, WI 54016 C^ 332 MINNESOTA STREET ,? Z ' ST. PAUL, MN 55101 � i UNPLA j W NORTH LINE OF THE N89 1 - E 487.38 SW1 14 OF THE NWt /4 271.80' 215.58' w z iO m O ;OIO �d 0 U73�Z LOT 2 ° I u- o ' VI w w Om i+ p 2.39 ACRES m LL A ° �� ►- I 104,200 SQ FT I o O o o LOT 1 rn w Q 3.16 ACRES CR ;� Z 137,608 SO FT O C co 4� ° _ I I C b �N ------- - - - - -- �g6 6 °281�g 4 °`t ° , 411E Si 3 - -g7 '1,4 7 �c ' 'l 31 O �. W ,� 688 , • g .. E 9 66.00 a AVENUE $ ? gME 23g;6 I - POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of 2 ' FILE INFORMATION SYSTEM SPECIFICATIONS Owner G� do -.tx f Septic Tank Capacity j 20 a l ❑ NA Permit # Septic Tank Manufacturer Ls r� v ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer 'ZA*Z'e„ ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model jr)� (Da ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity al ❑ NA Estimated flow (average) D g al/dal Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) g al/day Pump Manufacturer ❑ NA Soil Application Rate ry gal/day/ft' Pump Model ❑ NA Standard Influent /Effluent Quality Monthly average` Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg/L lam- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510` cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service frequency Inspect condition of tank(s) 3 At least once every: El y ear( I (Maximum 3 years) E3 NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cellls) At least once every: 0 month(s) a (Maximum 3 years) E3 NA ❑ month(s) ❑ NA Clean effluent filter At least once every: E3 year(s) Inspect pump, pump controls &alarm At least once every: ❑ month(s) ❑ NA ❑ year(s) Flush laterals and pressure test At least once every: ❑ year(s) (s) ❑ NA Other: E3 month(s) ❑ NA At least once every: ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tankls) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in' accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. r Gage 4 of 2 START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tankls) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrbtian #t,*odet4cted.h4vb'& contents of the tankls) removed by , a septage servicing operator prior to use. System start up `shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or pgrk over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or-must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. T - if 110 loplImInelit area 7aftsm o ilank ruAy Le ng �� alua e ai e . VA�i•!1 rrF.a �� N D iv ❑ 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. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name �f'dG St 't+sl, Name Phone 4 G Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name 15t. C (V Lewdly 20AIII(f Phone Phone '71 5— 38'( (0 D This document was drafted in compliance with chapter Comm 83.22(2)(b)0)(d) &(fl and 83.540), (2) & (3), Wisconsin Administrative Code. 05 23:58 6512920006 TITAN CONSTRUCTION PAGE 02i'02 0�- 12 A5 'fl1i.'• 07,38 FDIC 715 386 4686 ST CROIX COUNW up TANK, mAwrBNAwB AtxEm""'T' AND f A( �� -mi l T ►' - - �� iVTaftg Addres �� � �. "�--�� W . 0"1 i (ve ' cati►7n ,oeac�w cd from PkWW > -- , • Cityfstwo 'ucc ) Tdr tt#i itcatian Nprab TgWWq Loc ou S W V., �, � - '��, mac. � � . T W, To� -f PC,,� Ixt# � corwied Morey map # �9 I a,5 ? "troiu�rce „.-� Wlirrunty Deed # Spec house Q yes Q no L Rw IdmAMble Cl yes Q UO lC �C �useaacfa�fitd�azecao£ y► �xusygricsystcmcautdresultinitsprataatu�t�ex�re� �]�� y , aut tea �epda O thsee yatua ox sooner, if noed4et by n I sad �. CM aff x;t the fwnctiou of the scpdc teak as at 6coa#xucaax Aga is 4c w 1 s4Gm.. - rU 1�dW►artT►' oWp a 20 SUWt to St C mix Zoning Dot a certifi0fil6n 6orm, 61gwd by ft ovt x aid by a har p ,* 3'mnlph , testnotedplumberorahmocdPM"VV4 t (1)theaarextwa~ateWQ%xdu: pe'�sa1 ,$ a VMW opftudo g eft&don indlor (2) aver hll�aatloat and puM (if aq), the taulf is Lass thn 113 fall of ;sludge i/wra, the afta=igto d blue Md dle abot wTjkcm� ad We to Micultt t& gate sewage d%P°W s3rMM &r 6WopxdS mot fq"N hor@bt, Is by the ant of Coon = sad. the Dvpu of N 1 4 UU0�� Stuee q f q�yo�rsi�a � rat3nn Mfinonow septic system bas bom mafrtta Wdmatat lm eompxeted aaA retaxa+ed ao the SL C�uix e.6anty zonju boa wWAR 30 ds f the flit year WTittttota7l ( We , SIG ATMW OV AFPr TCANT DATE U'VVAT� G'fr+"XC�i'IC1T wa) oaz f r &U uXl statements an flute farm are true to the best of my (out) kuowlex%cr I ('aye) ;un (are) the OVM, Ks) of lhc P erty dewnUd above, by Virtm of a wapt W dead M*90-d i s Rtgisbtr of heeds Offib :. • +' * *• Arky infwMion ttt t is vjb-rep=eAtr4z=y result in >the 5Aaituy Permit being zavoke,d by the Zoning lb&p Mt. Titteludt W tlj tfcls *pp1i¢; dow. a stamped warn:nty deed tt om the keek1w of DSO& ofG= a aopY of tho oast rod &uvoy >< 4p jr M is ma4o in the warranty steed I - �9d =QI ri���i SO -zi -S4 05 - 12 - 05 13 :02 TO: FROM:6512920806 P02 r U 2802P 246 79494,3 �� • STATE BAR OF WISCONSIN FORM 1 — 1998 KATHLEEN H. WALSH REGISTER OF DEEDS WARRANTY DEED ST. CROIX CO., WI RECEIVED FOR RECORD Document Number This Deed, made between Nielsen Enterprises. Inc.. a Wisconsin 05!13/2005 04:20PIt Corporation , Grantor, and Antony R. Detomaso. Sinoie and Cindy K. WARRANTY DEED Turner, single, Grantee. EXEMPT # 7 13 — rantor, for a valuable consideration conveys to Grantee the following REC FEE: 11.00 described real estate in St. Croix County State of TRANS FEE: 299.70 Wisconsin (the "Property "): COPY FEE: CC FEE: PAGES: 1 Recordin2 Area Name and Return Address n — i5fl IFyomq Pop- # 21- 11 042 1052 60 300 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Lot 2 f Certified Survey Map filed September 20, 2002, in volu , page 4376, as Docu nt No. ;6i olx County, Wisconsin. Located in part of the SW '/. of a NW '/. o ec on , Towns W. Town of Warren. Together with all appurtenant rights, title and interests. Grantor warraratE that the title to the Properties good, indefeasible in simple fee and free and clear of encumbrances except �Y\ Dated this day of April 2005 (SEAL) (SEAL) Thomas K. Ni Is resident Nielsen Enterprises, inc., a Wisconsin Corporation (SEAL) (SEAL) R AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, I ss. St. Croix County authenticated this day of �t ersonally came before me this 13�- day of 2005 the above named Thomas K. Nielsen as President of Nielsen Enterprises. { Inc.. Wisc n 1 Corooration to me known to be TITLE: MEMBER STATE BAR OF WISCONSIN the person who executed the foregoing instrument (if not, and acknowledge the same. authorized by §706.06, Wis. Stats) THIS INSTRUMENT WAS DRAFTED BY - C ' ip, i Ss taQL Coldwell Banker Burnet Notary Public, State of Wisconsin 1301 Coulee Road Hudson, WI 54016 My commission is permanent. (if not, state expiration date: 5 -25945 (Signatures may be authenticated or acknowledged. Both are not necessary.) NdTARY PUBLIC " Names of ersons signing in an capacity must be or printed below theilf signature �� WISCONSIN APPROVED Es I3 l z S E5 ST, CROIX COUNTY VOL 16 PAGE 4376 Planntna Zoninn and P?rk5 Committee KATHLEEN EGSTR OF DEEDS 5EP 17 2002 ST. CROIX CO., MI !f not rrpdrd��y RECEIVED FOR RECORD OF �pprovr t d��,i/ r � . FIE l SURVEY MAP 09 -20 -2002 11:00 A rtu �TED 1N PART THE SW1 /4 OF THE NW1 /4 CERTIFIED SURVEY HAP OF SECTION 19. T29N. RI 8W. TOWN OF WARREN. REC FEE: 15.00 ST. CRODC COUNTY. WISCONSIN. COPY FEE: 4.00 SURVEYOR P S & N LAND SURVEYING OWNER DOUGLAS J. 7JIHLER NW CORNER WOODHILL LAND, LLC HUDSON. W I 544016 016 SECTION 19 EN $ E1404 FIRST NATIONAL BANK BUILDING HUD W 2 332 MINNESOTA STREET (A -+ o ST. PAUL, MN 55101 Iq o . n 1 NORT OF THE NW1 4 N89 7 66 E 487.38 271.80' 216.58' m N t to to z LOT 2 ° i ° 0 A 2.39 ACRES O r a LOT 1 ni 2 406 ,� u al 3.16 ACRES al 7� S2 137.608 SO FT V ° t219 i 0 --- ?o� N --------- - - - - -- 0 868 Z $b „ yv- 743 WOE 66.00 92nd AVENUE T -& .1 7' O N88 *29'Q6 "E 30.14 v - - - -- — 6i cs Xm LOT 3 C4: I LO }® ® C 4 8 0 m 3.29 ACRE !to t `0 (1 89,36 SO FT 111 � g 143,174 SO cx i ` S r r � EACH PARCEL SHOWN ON THIS MAP 1S BOTH WITHIN AND p ADJACENT TO SPECIAL DEEP CASING PIPE DEPTH REQUIREMENT AREAS ESTABLISHED BY THE 250.ON 260.04' WISCONSIN DEPARTMENT OF NATURAL RESOURCES ("DNR'). O 4 889 S 10.08 GROUNDWATER IN THIS AREA HAS BEEN AFFECTED BY p P UN PLATTER _I�__ ER L�ARaS LEGEND VOLATILE ORGANIC COMPOUNDS. OWNERS AND W ALUMINUM COUNTY SECTION CORNER OCCUPANTS OF EACH PARCEL MONUMENT FOUND SHOULD CONTACT THE DNR FOR S 1 6/ 16' OUTSIDE DIAMETER IRON PIPE FOUND INSTRUCTIONS REGARDING WELL W1 /4 CORNER Q 1" OUTSIDE DIAMETER X 18" IRON PIPE SET INSTALLATION AND SECTION 19 WEIGHING 1.13 LBS. PER LINEAR FOOT MAINTENANCE, AND WATER ---- - - - - -- 100' ROADWAY SETBACK LINE SAMPLING. • 2 3/8" OUTSIDE DIAMETER IRON PIPE FOUND SCALE IN FEET .1. = 1 50' X CENTER OF MY RADIUS CLIL- DE-SAC (XXXXXXXXX)0) PREVIOUSLY RECORDED MEASUREMENTS 150 0 150 300 .4 PROPOSED DRIVE LOCATION - - -- "- - - - 12' UTILITY EASEMENT SHEET 1 OF 3 Vol. 16 Page 4376 C o 0 o I M ~ 6s M QO N N � C M 4 0 r C ' O O N N i e I s a I 'es I ti I I � I C Z 3 LL c C O 3 a a I Z E c Z a m rn H N c t7 I O Z d c 0) C O m Z d 'a c CL N H S rn N O I c � v � I I m C7 � N • � _O N 0 Z S Z N` _E Cl) y E I L IL d L N C z O w Cl) W d Q T N� (� O Q G CL m LO Z N > F F @ § o 0 o a •ry is 0aaa *�. n 0 Lo Lo O O O ' LO N co LO _ n �I Q o o y CL a0 ° N o v w Q Z FU) m 1 O C N C C E co © 0 E O LO 3 I-- N .0 m €1 C1. O E O O O O C W @ C .O. @ C O LO } N a) E 00 �r �0 0 O q r.r N N @ • ''a O O C l " . 0 Z N Z 2 Cn 1. C� a ! d L a T • c� a m 'L m £ u c c `�� A 0 � a O N v ` Wiscotlsin Department of Industry SOIL AND SITE EVALUATION Labor and Human Relations Page of 3 1 Division of Safety and Buildings in accordance wit ! F ,Q�, Wis. Attach complete site plan on paper not less than 8 1/2 x 11 inches in si must C° �C• Include, but not limited to: vertical and horizontal reference point (BM *l tion andyil?? -ti,� tyJr «0/ x percent slope, scale or dimensions, north arrow, and location and di roc to ngarest parceh D. # -/v 2 _ 7O 7 f APPLICANT INFORMATION - Please print all in for. S'j C % eiriew by D Personal information u p rovide me be used for seconds �� Yo P Y second Purposes (Privacy s� 1� [ ti �� Property Owner P14vG ,Props do f, /Y/S! `• �� ¢ - /4 AIW1 14,S /? T ,N,R ld E (oro Property Owner's Mailing Address v Subd. Name or CSM# � 332- 1W;1�soX -- 5'7"• 7 y f� 7- ps: PI�v G- cz5 City State Zip Code Phone Number Nearest Road ✓�/ • l��t M/N �.S /D/ (his/ )2t t ~ $ ❑ City V'Ila a L9 Town y0�/,vG- lip B New Construction Use: Residential / Number of bedrooms •� ^ Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: 'Y7s -Go Code derived daily flow gpd Recommended design loading rate bed, gpd/fl trench, gpd/ftz Absorption area required �� bed, ft -50 trench, ft Maximum design loading rate bed, gpd/fl ' S trench, gpd /ft Recommended infiltration surface elevation(s) 'S' ft (as referred to site plan benchmark) Additional design /site considerations .5,( 7,=- 74 E4yv�iPES �vvvl� •s�rsr, Parent material 9 AIR &(IrW 0 UA 5 V ?1 W4 0 A1 . Ce Flood plain elevation, if applicable N _ _ft S Suitable for system Conventional �Mound In- Ground Pressure AT -Grade System Inn Holding Tank U = Unsuitable for system ❑ S 21j 't_f' S ❑ U ❑ S [-l' El e ❑ S U u ❑ S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench / d • 8 /o 1 3/3 — L S /,m 25 z f .7 2- 13 -7 •s yR '-//Kg f . S Ground 3 3 • /(7Y — S /L. // �,6 �° C� • Z �D5 elev. ., •� /0Y 7 C l M°rs U SL Depth to YX limiting factor . 57. S Remarks: ' Boring # YO /oYR 3 13 Ls 1,, de c s Z -P- • ? • S /0 YR GS /a,., d e CS' -- . ? •S �o YR 1.3 ID Ground 9 101W�u !( elev. /v S D rs • v Depth to limiting factor �In. Remarks: CST Name (Please Print) Signature hone o �` RS D L k3 ! 3 Address Date CST Number Ulbricht & Associates Private Sewage Consultants 655 O'Neil Rd. Hudson, Wis. 54016 0 RIG PROPERTY OWNER I'1I D * • SOIL DESCRIPTION REPORT Page Z of 3 , t I , PARCEL LD.A j,06 /—Or Z QTL — `D.�Z 70 Boring # Horizon Depth Dominant Color Mottles Structure 2 Texture Consistence Boundary Roots In. Mansell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 2- Age dV4 Ground ! /�0�1� ��- ��S6/�C /1YI ! — - tip ; 'tom X Y s �/ Depth to DJ <k 12— ! imiting factor S S Remarks: Boring # Ground elev. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 In. Munsell Ou. Sz. Cont. Color Gr. Sz. -Sh. Bed , Trench Boring # Ground elev. ft. Depth to limiting factor In. Remarks: Boring # Ground elev. Depth to limiting factor in. Remarks: SBDW -8330 (R. 08/95) i r r r ` O o C 0 c Ns -b Q QQ kA l Cl - CIO O � � G � Ib W w �c l oo �o o � O L A.) o � M AILK \\ N82 °07'31' 1,4 8,64" CD u �o 'o II C:) C �tp 0 SSO o �r� � 4 o > > �Y 265.73 � � ti`O2 R � N � Ao F �- LINE - -_ °l -P z LOT 2 ° J�- E o' er, so;� TEST _ o 9"&5 / 4 3 " W p --(54,90' 3j),001 � 150.31 N89�25/43/ NOO'34/17//W J � '� 183.31' 8 7 610 Soo°