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Home My WebLink About042-1085-10-400 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St, Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 429984 0 GENERAL INFORMATION State Plan ID No: Personal information you' may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Stout, Richard Warren Township 042 - 1085 -10 -400 CST BM Elev: Insp. BM Elev: BM Des tion: Section /town /Range /Map No: 4 1 7 q 7• `7 q 41-- Z 31.29.18.476A40 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic h �, ,�y Benchmarks -� 3.1b / d / � Dosing � /((J Alt. BM �, Aeration Bldg. Sewer 303q 1 1.3 . v Holding St/Ht Inlet V9 9 � / TANK SETBACK INFORMATION St/Ht Outlet y - 7 / •S'- TANK TO P/L WEL IBLDG. V it Intake ROAD Dt Inlet Septic , lot Dt Bottom Dosing Header /Man. Aeration Dist. Pipe I( Y Holding Bot. System_ Final Grade PUMP /SIPHON INFORMATION o s , z) (o . 3 Manufacturer Demand St Cover GPM / Z . 7f. 7 Model Numbe TDH Lift Friction System Head TDH Ft Forcemain Le Dia. Dist. to e SOIL ABSORPTION SYSTEM 2 - CW BED /TRENCH Width f Length ( No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS �g / SETBACK SYSTEM TO P/L r'= BLDG WE L LAKE /STREAM EACHING Manufactur INFORMATION CHAMBER O J Typ f System: � Model Number: ZS r DISTRIBUTION SYSTEM IJ�der/Manifold I D istribution / x Hole Size x Hole Spacing Vent t Intake a PIPe(s) Length Dia Length Dia h Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over J 4- , �Q/� Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center / U "- BedlTrench Edges Topsoil _ to ❑ Yes I ] No I Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 1�7-z/_VV Inspection #2: Location: 694 100th St Hudson, WI 54016 (NE 1/4 NE 1/4 31 T29N R18W) NA Lot 3 Parcel No: 31.29.18.476A40 1.) Alt BM Description = b'r',�}/� "l �'� `"`S (,1 �.� n `c�O 2.) Bldg sewer length = A &A4 -... �� - amount of cover = •3 v "'L ��G" U 6- Aa�" Z j - -- - Plan revision Re q uired . Yes No � � - C41 Use other side for additional information. �� W �C�/!�I/� U" Date V - Ins �ti Signature __. _. S J" r C Np SBD -6710 (R.3/97) _ � A , /Z � NV /v /Ci/ V BLS _... Safety and Buildin s Division county 201 W. Washington Ave., P.O. Box 7162 57 - C , 1-12 Madison, on, WI 53707 - 7162 Sanitary Permit Numbep 0o be filled in by Co.) 1 Dep a rtment of commerce I (608) 266-3151 Z 7� Sanitary Permit Application state Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information yo umrQvidM may be used for secondary purposes Privacy Project Address (if different than mailing address) i I. Application Information - Please Print All Info t tion Property Owner's Na me MAI Parcel # Lot N Block p UY' COUNTY Property Owner's M ailing Address ZONING Property Location 4 r_ 14, Aoe ;4,Soction 3( City, State Zip Code Phone Number S'G Ydlli N; R,Z�E or� (circle one) T �Q II. Type of Building (check all that apply) t>kS s"� ` Subdivision Name CSM Number 9 1 or 2 Family Dwelling - Number of Bedrooms [] Public /Commercial - Describe Use d' f I L1O/61 El Owned - Describe Use C 2 1 3 X 6�' S "' ❑City ❑Village I, Township of rl -e.r/ W. Type of Permit: (Check only one box on line A. Complete line B if applicable) 76q- O� A. New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B, ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System (Check all that appl A- I W I'1&� Non - Pressurized in-Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculat Synthetic Media Filter Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation J 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 Aerobic Treatment Unit Dosing Chamber Y`- VIL 'Respo nsibility Statement- 1, th6'andersignei assume responsibility fo ation of the POWT shown on the attached plans. Plumber's Na me (Print) Plumber's Si 2nawc M iMPRS Number Business Phone Number Plumber's Addre as (Street, City, State, Zip Code) VIII. Cotmt /De tment Vse Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued ssu' Agent Signature jo Stamps 1 ) Surcharge Fee) �- ❑ Owner Given Reason for Denial IX. Conditions of Approval/Reasons for Disapproval t L Attach complete pleas (to the County only) for the system on paper not less than 81/3 x 11 Inches in size SBD -6398 (R. 01/03) 4 y�' �5` 5' aJ,c/ Gva rlY •�/ h r ,p g r� 4y 2 � 6 "s B3 � y �- -0W J . D dIG h� � 1 m Xt L 4f 61- M I (p �JL �- . a2 n 0, � p� Wisconsin Deparlment of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Ian must include, but not limited to: vertical and horizontal reference point (BM), dire 'on and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distarr to nea*Loal. Please print all information. wed ly Date Personal information you provide may be used for secondary purposes (Privacy La S. 15.0�4(t1 , ( . ` ' , I Property Owner Property Lo Fr�i - Q0Ed 7 Govt. Lot (V E 1/4 NE 1/4 S 3) T 2 9 N R l g E (or>&W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2- . mi 3 14 1 City State Zip Code one Number j ❑ City ❑ Village ® Town Nearest Road [-New Construction User Residential /Number of bedrooms - Code derived design flow rate GPD ❑ Replacement / E) Public or commercial - Describe: Parent material _ (�( 4 !:A.L� A Flood Plain elevation if applicable A �l1 ft_ General comments sy�1,-I 4eV A 7,5,E ZOwrr y /.5-0 and recommendations: M I Boring # [] Boring c� ® Pit Ground surface elev. / ��d ft. Depth to limiting factor )rO in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 -2 IL 312 -fir I — f)') 2rr mfr' 3 1$ — m5 O I — v �. �3 y sa i Boring # ❑ Boring n Ground surface elev. �y Pit ft. Depth to limiting factor _ �dJ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 b 31 --1 5 c 5 5 -$ Z tivN ID 5il k m4� c • Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg /L and TSS _< 30 mg/L CST Na a (Please Print) S' ature CST Number Address / Date Evaluation Conducted Telephone Number el - ¢Rn ^ (Pm /00) 1 Property Owner L =kec� Parcel ID # Page 2 of J ❑ Boring /,� a Boring # Pit Ground surface elev. y� �U ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft yn in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 c I q .t. •-5 y 0 F-1 ❑ Boring # Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. coil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ❑ ❑ Boring # Boring Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft 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. SB"330 (R.07/00) Property Owner �n e Z Parcel ID # Page Z of 3 Boring # ❑ Boring Ground surface elev. y� , lU ft. Depth to limiting factor - in. Soil Application Rate ® Pit f Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftf Gr. Sz. Sh. Eff#1 Eff#2 in. Munsell Qu. Sz. Cont. Color Ink ❑ Boring # Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •E GPD /ft E in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •E GPD/ft Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 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 at lease contact the need material in an alternate form p de at 608- 266 -3151 or TTY 608 -264 -8777. SBD -8330 (1.07100) j. PAGE_a_OF .3 NAME L e N -e r tZ LOT# !2 LEGAL DESCRIPTION SL X St t4 ,S 3/ T Z q ,N,R, / K E(or)Xf ✓ SCALE: 1 "= yO 1 BM 1 ELEVATION BM 1 DESCRIPTION --t- o �c --+- 1 T BM 2 ELEVATION J BM 2 DESCRIPTION I U c_ Q t SYSTEM ELEVATION .�? 9S• D U how R9 y S SYSTEM TYPE co CONTOUR ELEVATION 4(, .moo y y Ala Pr J, i L - y5- r qo 0 o o l i SIGNATURE DATE SEPTIC TANK & PUMP CHAMBER CROSS SECTION A�� PEC3FICATI�Ns 4" CI VENT PIPE 12" MIN. ABOVE GRADE & JUNCT APPROVED >_ 25' FROM DOOR, WINDOW OR WITH CONDUIT MANHOLE COVER FRESH AIR INTAKE W/ PADLOCK & FINISHED GRADE WARNING LABEL 7 4" Cl RISER - 4" MIN. 18" IN. 6" MAX. NLET � WATER TIGHT SEALS GAS• A TIGHT SEAL ' JOINTS WITH ALM APPROVED PIPE PPRO B E ON T IPE 3' - r - , SOLID SOIL NTO SOLID C ' RISER EXIT OIL PUMP OFF ELEV . FT. OFF PERMITTER ONLY D IF TANK MANUFACTURER HAS APPROVAL 3 APPROVED. BEDDING UNDER TANK CONCRE'T'E PAD SPECIFICATIONS SEPTIC / DOSE NUMBER DOSES PER DAY: TANK MANUFACTURER: TANK SIZES SEPTIC �16ze GAL. DOSE VOLUME INCLUDING DOSE d GAL. FLOWBACK: ,e GAL. _�,.,�� ALARM MANUFACTURER: �.��vm CAPACITIES: A = � INCHES =GAL. MODEL NUMBER: n A y B = 2 INCHES = R GAL. SWITCH TYPE: ) -erc.: --' C = S INCHES =GAL. PUMP MANUFACTURER *. 6nc�,� � - --- -- MODEL NUMBER: D = INCHES = _ SWITCH TYPE: REQUIRED DISCHARGE RATE GPM PUMP & ALARM WIRING AS PER ILHR -16.23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE . •2 FEET + MINIM FEET . . . : � FEET + M FEET FORCEMAIN X �• F NETWORK SUPPLY PRESSURE T /100 F FR F • T.OTALDYNAMICHEAD = l - FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH ; WIDTH DIAMETER r � y LIQUID DEPTH le ,� /�� SIGNED: LICENSE NUMBER: ?279 DATE: d 1/88 Submersible �. Effluent Pump f , 3871 EPO4' EP05 APPt Tai!& • FLOWS: 300 series • Bully submerged in high i motor N"Ing: Cast iron feel. grade turbine oil for for effident heed transfer, SpodWO d4ft*d for the =Mrudgage lubtdan and e160t sttdnp�t, &M dumbllftj+. to heat transfer. Mgor`�owr: Thermoplas- ents. t c cover with integral handle * FM 1101W., manual • Hwrt� compon � Available for wtamsltc and and Ne>idsar�tch attacttrnent duty sump • M Sin glehase: 0.4 HP, Mobls l"j d mint poems' • 1i #r transfer 1 15 or 223313 , 60 Hz, 1550 flog $wttob saunbled and f Power Cable: Severe duty 0, ring RPM, built In overload with pMW It 1be btu. rated otl and hater resistant automatic reset: v gam; r aW lower • F.P0V le phase: 0.5 HP, Leavy d bearing SP�►TtO ...�,. 1 15 1350 RPM, fElTdw i con. Pwnp: EPO4 bulk In overload with a JR4 lmpot*-. Thermo- • So ds tandfing t biklty: auu mrttic reset. plastic; Semi -epert design AMOY UIM NO sic` McAmum.. • Pow ' cord: 10 foot with pump out wo for ,,.� • idea: up to 55 GPM. statrdard IV* 16 S,ITO mechanlcal seal protection. �. ipu�adla %%dash aka• 1 • Total heads: up to 24 feet with three prong ground!ng ■ EM WOW. , • purge am, I lb" NPT' plug. Optional 20 foot (CSA IWW model numbem • Maohanlcai seal: carban- ienpth,1613 SJTW with plastic eaEC ftr design for and lr. "F" or "AC.) rota /ceramic- stwonary, three sang growding plug improved Cuin peerformance. BUNA -N slastamerx. ;stanOard on EP05), thermoR thermoplastic dean provides • 104 41 C) continuous superior strorp and 1401 �60•C) ftniftnt. c rosiort rest ce. • I= aOers; 300 series MEURS rroes ,... — stairdw Capable of ramm ing dry wNW damage to s 3 r, components, _ _. _ _. + Pu mp -�- . �6 . • Salida handling capability: 26 I i 7. • GWIN: up to 60 GPM. a 20 .- • Total heads: up to 31 feet.. ; ! • GlscltarQe sizr.1 W AlPt e • McCItin!cal "Al: carton- t ro /n"statlonary, 4 S 6 I3UWN f4etomem - --- - • 6 E I= V46 =*nuous 14D•f (VC) I t mitts t. Z b 0 O ' Ap 0 t - ' 4 ' M141 CAPORY @ t+Me a Auenpa ina. weab" may. togs POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page _L of 2_ FILE INFORMATION SYSTEM SPECIFICATIONS Owner lL p - >9�.'j� Septic Tank Capacity ga l O NA Permit # 447-01 c� Septic Tank Manufacturer �� , O NA DESIGN PARAMETERS Effluent Filter Manufacturer Z ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model 4d ❑ NA Number of Public Facility Units E3 NA Pump Tank Capacity gal ❑ NA Estimated flow (average) dV al /da Pump Tank Manufacturer � Se ❑ NA Design flow (peak), (Estimated x 1.5) TQ gal/day Pump Manufacturer m �' ❑ NA Soil Application Rate 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 l7 NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L E3 Disinfection O Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) E3 NA Biochemical Oxygen Demand (BOD 530 mg /L ❑ In- 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 O Other: Maximum Effluent Particle Size Y in die. ❑ NA other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Evart Service Frequency months (M 3 years) E3 NA Inspect condition of tank(s) At least once every: saris) Pump out contents of tanks) When combined sludge and scum equals one -third (Y of tank volume O NA earith(s) (Maximum 3 years) ❑ NA Inspect dispersal call At least once every: s) 3 IC y Clean effluent filter At least once every: month(s) O NA ear(s) month(s) ❑ NA Inspect pump, pump controls & alarm At least once every: •-- ❑ year(s) '[3 month(s) ❑ NA Fkjsh laterals and pressure test At least once every: ❑ ear(s) months) O NA Other: At least once every: ❑ ear(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 tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cellis) 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. f Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the gontents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal call(s) in one large dose, overloading the call(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the 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 falls and cannot be repaired the following measures have been, or . must be taken, to provide a code comAliant 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 proposA 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 availa )le due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed a i last resort to replace the failed POWTS. site a it tank rim Al O Mound and at -grade soil absorption systen s 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 > > NOT SEPTIC. PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO 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 'Q"//. ' a .:-. I- Name Phone 7 / _ a e _ _ 1? 1 _1,;� _ V Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name I Name �, Qp( OLL ofrflJ Phone Phone S , '��. 1 466 This document was drafted in compliance with chapter Comm 83.22(2)(b)(11( 101 and 83.54(l),12) & 131, Wisconsin Administrative Coda. F;:v: 1110. CROIX cou'NT" SEPTIC TAIN"K MAINTENANCE AQPEF-M7,_NT AN ()WN E p ,S Hlp CFRTIFICATION FORM t ; dr W 4, � meant f ar n ow ocns=ctice required f rom plultiq parcel ldciitifjca� % NumblU Tw, Town of T O=bon Ate S Lot ��t' °F �.1`y'lgtC111 w��,r,.'-- """' -,.�.— �� I�� survey MAP c page 4 Deed 4 Volurne 'K Y % 7, to ,4 hCUSA`K yes Z- lU Pre=tUle failure to hatdi* SyStOM Y= =Uld TMUlt � '41Mper. %lbat y0l; PlIt into t atizrtazzce of 1,,dlp three years or sooner, it ne,�ded by a li,:c,, 01.11, th e, septic talc 8 " &SPOSS1 system . the M;ltr tazl 0 a 'Maz= eags I, dfAo *A j� of tbt 2, certif form, s igned 'OY he Lywn,,�T to lobzai Croix z Depar=ollt 2,t" I) flu on-g;te wlstewajc�j Sygre Ilse ply Cwaaa saes t licets8d P =Per ve,4" th Of sllldgc restriOiAdzl=b�el Or tallk is ICU V= 1)3 full c ondition 0 607 (2) a far � r-*'-Otiot �, with the StlLr4uds a �� pier opera &ac zW ee to rclAintaiA the Privam w jcatic'n 3. 1 Sute Of Wi SconsiVL' �4d the above V' ' of NOW w_ the Undetlitzed have teed and tht Delut� hartimai Urt by the D = j Ut& j t ed mcit be C=PlMd = Mt= to tl St. C Zoning Offiae WSU= teas bee tiell ziste, the throe real expia DATE j (we) am (are) c lwnerW 'A Wdfy ftt a n ftt On thiz fornt 2.fe true t ia-c beat of MY � nc'w Wo c,0j in J�egilter of'oeeds Moll y vLrtuo of dtoii c 4q 0) rlATF 11 yrmwrw SIC'NKMW Of begin tevrz b y the zor�ing nep arts T sguji �n the sanitE* per.,w �)zd May AAY t h e Register Of Q� Includ with this j ppUcatj= , llln�ed warranty dec "I jjce,& made de LI , t ,, deed 4 Co py of the ertifled RIMY Map it r�f cTe r - J 1975P 633 • STATE BAR OF WISCONSIN FORM 1 -1998 6 HL S8 KATHLEEN H. MALSH WARRANTY DEED REGISTER OF DEEDS " ST. CROIX CO., MI Document Number RECEIVED FOR RECORD This D oW , made between • ' Frederick Q. L 00Ap= Lend And Cattle ..09-16'-2002 10:15 AM Comp any. LC A Wisc main Limited liability Company . Grantor, and WARRMTY DEED Richard'O Stout and Janet P. Stout husband and wife EXEMPT M Grantee. Grantor, for a valuable consideration conveys to Grantee the folkwving REC FEE: 1 1 .00 described real estate In 3t Crobc County State of TRANS FEE:, 627.00 COPY FEE: Wisconsin (the "Property': CERT COPY FEE: PAGES: 1 Area E' /, of NE 4 /. of Section_ 31, Township 29 North, Ran ge N.mewA liflUrn address l Wwd.o. sane 18 West, St. Croix County, Wisconsin lying Northerly of J&* P. 8100A Iniet'sttnle_ N hway 94�xcept land lying West of the following x sold U descsit�ed �e:Commencing at the Southeast c omer of that part of the NE % of NW Y4 of Section 31- 29 -18, lying North of Interstate Highway 94; thence S78 0 57'42 "E 10.25 feet to the betnning of the fence line herein deapribed; thence N01 °52'32 "E 861.46 feet to the right -of -way of 70 Avenue. 042- 1085-10.000 CS V.^, Pwad Ideri atkm Number (FIN) This 7 not tgmestead PWONY. I (p / � I f Together with ail appdrtepant rights, title and Interests. &M Grantor worranta that the title to the Properties good, indefeasible in simple fee and free and clear of encumbrances except I Dated this J§! day of August , Zl24Z. l (SEAL) (SEAL) -- . F erlok G. Lenertz -�" (S) (SEAL) d `FZ — /os'S' — 10 AUTHENTICATION ACKNOWLEDGMENT Signatures) Al Stab of Wisconsin, , JY RLi� ,• } sa. St. Croix County authenticated Us Personally came before me We lid day of Aumm n ebo A amed Co^+oany. LLC. A Wisconsin Limited LWMI Company. by FMderick 0. Ln,rt,. TITLE: MEMBER STATE BAR OF WISCONSIN President to me known to be the person who (if not, executed the foregoing and acknowledge the w� ( � authorized by §708.08, Wls. Stats) same 77 THIS INSTRUMENT WAS DRAFTED BY J Coldwell Banker Sumet 1301 Coulee Road Notary t3tate Of Hudson, WI 64016 My commission. is a7 (If not, state expiration date. 2.37876 (Signatures may be authenticated or ackhdV; dged. } Both are not necessary.) • Names of one ni in &M mustDs Wed or printed belowthatr signature. STATE 13gR OF WISCONSIN Wisconsin Legal Blank Co, Inc. WARRANTY DEED • FORM No. 1 -1908 Milwaukee, Wis. .1 V r I :)oc �? CERTIFIED S MA LOCATED IN PART OF THE NE1 /4 OF THE NE1 /4 OF SECTION 31, T29N, R18W, TOWN OF WARREN, ST. CROIX COUNTY, WISCONSIN. BEING A CERTIFIED SURVEY MAP RECORDED IN VOLUME 16, PAGE 4366, AT THE ST. CROIX COUNTY REGISTER OF DEEDS OFFICE. SURVEYOR: PREPARED FOR: DOUGLAS J. ZAHLER RICHARD 0. STOUT DOT NUMBER 55 -94- 3553 -2002 S & N LAND SURVEYING, INC. JANET P. STOUT 2920 ENLOE STREET 1 1353 AWATUEKK TRAIL HUDSON, WI 54016 1 HUDSON, WI 54016 70TH AVE. I Q3 I Oo��G o UK OL �4� o m Pa. 0601 -- - - - --- --- —L NO L INE OF T HE NE S89 0 0718 "E 2640.04' 'c'o 89 8W 686.11 c c O ) d NE CORNER 1953.To 212.04' m 212.04' � 262.03' SECTION 31 N1/4 CORNER 212.04' 0 212.04' b� 228.46' r SECTION 31 * 0 0 33' 33'I � S89 °07'18 "E 652.54' rj o co 'lI 6 6' ................ ............... ...1.�..._ .,,100' NI 2 r --� v 2.168 ACRES 'IT 2.4 3 CR O Lo - I W c y) z cg 2.237 ACRES w O ��(97,453 SQ. FT.) (94,453 SQ. FT.) 2 �� (10 � 0) �I w S F - 2� �p 07 ° - 8,413 S ) w co z 1-- = INC. RNV INC. R/W Lo w w O w �I N't 2.077 ACRES ' 2.008 ACRES o � INC. R/W Lo = (n 1 - C/) v 'N 2.009 ACRES 000) co D w 0 0 I (90,456 SQ. FT.) o (87,455 SQ. FT.) 0 (87,511 SQ. FT.) EXC. R/W 0 EXC. RAN °°� LL �° I =I U d � ° �I r . C/) EXC. RAN °� i O O �I z w ol w rz O w, r O Z �I �zQ I CO OI J �I LL w w � I Z C/) C r � ?_63:. 33.72' Q r� I i �" @- I w r a 2(jU. i u Q O w D w L 4 213.57' 477.39' z a l S89 °07 18 "E 212.04' _ 9 8 " -- r �! U) _ - - -NB3 " -- OJ� I O t Z T m a l /� . 47.00' CI <frQ I o m z J U) W • 50' `o 33 80.46' S 4 a.— I2 N cy) S89 °51'03 "E 5.084 ACRES'. ' N (221,473 SQ. FT.) INC. R/\/\/ � � 80' U W 80' 160' I N 5.004 ACRES n (217,954 SQ. FT.) EXC. RM/ U r Co Q L 50' SETBACK PER TRANS. 233 0 � ° 50' O NO 50' AC ESS -- ° 06.06 ,�.--- N87 E6 CAUTION: HIGHWAY SETBACK RESTRICTIONS f � 7c) PROHIBIT IMPROVEMENTS, SEE SHEET 2. r° � o p �l' o N E1/4 CORNER ' N SECTION 31 IN HIGHWAY "— CENTERLINE OF THE EAST BOUND LANE — 11 �- - ----- C d r -- - NOTE: THIS C.S.M. IS INTENDED TO REPLACE C.S.M. IN VOL. 16, PG. 4366. NO r ADDITIONAL LOTS ARE BEING CREATED. M[pLLa44G�0D LEGEND - - - - - - - - - - _ - - FOUND ALUMINUM COUNTY SECTION CORNER MONUMENT 0 FOUND 1" OUTSIDE DIAMETER IRON PIPE SCALE IN FEET 1' = 150' SET 1" OUTSIDE DIAMETER BY 18" LONG IRON PIPE, O WEIGHING 1.13 LBS. PER LINEAR FOOT 1 0 1 • • • • • • • • • • ROADWAY SETBACK LINE (AS SHOWN) THIS INSTRUMENT DRAFTED BY: WILLIAM KANE m FOUND MASONRY NAIL JOB NO. 6052 -15 DATE: 11/07/2002 PROPOSED DRIVE SHEET 1 OF 2 SHEE n CO) o ■ w � d of ■�c \ 0 � . @ ■ 2 z o # -; $ » 2 . O N 0 m o -: « 2 e 3 m S @: e a£ o R ;§ o § a 8 2 0 k § CD ° -4 m 3 E E �I K\ 0 � g■ �i � ft 7 / I ¢ ; / \ 03 2 @ }; , 4 \ / CL . CL / \ \$\nr■ ftA. T -0 -0 i \ z 0 0 0 5 0 ƒ § R ch k § 3 $ v \ o a) . m ■ _ m CL z = 0 Q ® { \ § \ co m \ § i k k_ 2 g ' _ 0 , 3 $ m - , ■ a 0 CL F § 9 o m / § e 0. 0 k Z 2 0 \ $ } ƒ \ / I � � E»eE /= \� } \i &k /k\2k /# 2} \�[2) � § c 0Mm00�E ® 2} % 0a , < «E° = CD m CD \eEE }; §3 �f\ §& §m£$ m q m9E$& q /7w_« D, 0 CD00. v . n 22 - / \B to ® ° i > na / / \� Q�E0 k =kaq k-j EE0 S�2% a } w /k k CD § cn 0 ■ cn � ƒ ° m 2