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026-1165-17-000 (2)
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 645412 GENERAL INFORMATION (ATTACH TO PERMIT) Slate Plan ID No: Personal Information you provide may be used for secondary purposes[Privacy Law.s.15.04(1 xm)] Permit Holder's Name: City Village Township Parcel Tax No: Jeff& Nicole Hawes TOWN OF RICHMOND 026-1165-17-000 CST BM Elev: Insp.BM Elev: BM Description: Section/Town/Range/Map No: 22.30.18.1283 TANK INFORMATION ELEVATION DATA TYPE MANUFACT RE 15,( CAPACITY STATION BS HI FS ELEV. Septic 1 5 0( I� 4 tE{t+ t pon Benchmark L I /0d Dosing �/1��8v1 '1� t L BM U l rr p . 61A6 1 60 Pi-Aeration I. �t (� tir-g.VM wrnv ?t0 146 . D4 /( 1✓6 S - V lam^to 'k-1 I'tf( St/Ht Inlet I I Q I II° St/Ht Outlet 1 1 TANK SETBACK INFORMATION 4 i/ - , TANK TO PIL WELL BLDG. ROAD DI Inlet Septic riffi���-- DtBottom 11'C'lp ,�(� Dosing Q t 1 ; =-- Header/Man. � Aeration _MEI Dist.Pipe q �{ Holding ___-- Bot.System 6. O I V Final Grade /J /O� PUMP/SIPHON INFORMATION iI 1, i ei ? Manufacturer I' Demand ver / Q G r d i GPM ,�-( GJVf Y 47 l G, I a' U Model Number , s -I- Lt s trlA Kole_ S-o 7g ,6 TDH System Head Tr Q Ft 471 i ICI 1` lian �- •t I tTr Forcemain Dia. 1, Dist.to Well / SOIL ABSOR-TION SYSTEM f 6 BED/TRENCH Width ^i lien th No.Of Tres I Prr DIMENSIONS No.Of Pits tit()Dia. Liquid Depth DIMENSIONS -✓L 11 SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING M nut it/ INFORMATION CHAMBER OR' ��.�ND l Type Of System: /�I /t UNIT [[��r �l l� (.0 ►1 10 ` 14 iUt 7— DISTRIBUTION S ST Header/Manifold r Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Vr Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over to Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center J ///���!t Bed/Trench Edges Topsoil I a Yes W No n Yes K. No COMMENTS: (Include code discrepancies,persons present.etc.) � . ti �1:��y{�.F�f ���r'spechon 2: 0 pi ] 1-A-t Location: 1432 129TH ST HH I not 64 _ 4tLr�61 _'T _ "pl S_ t tot C o In(/I /� 1.)Alt BM Description- t' Wey /7 !t _0?aIf1 �QY(t+ 4 [ 'U,1/'Y�/-^A(�(C �' ��►y c/�� 2.)Bldg sewer length-�if t^1I6.16A 6Jrt 't1Gv"( �Vtl _Jt (l� �i�il Y, -amount of cover=.l�gr70 Q `0,,, ilk{ W 4j VI) i ,O pA all Plan revision Required? C)es �❑B o I ��/ 6 I, ttV Use other side for addition rnatio�T \ 1 V s g'riffe16{��ure S , SBD-6710(R.3/97) ley). - DP j 70 of 'TU � (� ( o k(.0 f-1��1 oc i r. f F TD Industry Services Dlvmon County _' : 4622'Wartime Yards Way Madison,WI53705 Rama Number �itOiX \4,: _ ,IQl1t • 1.U23 P.O.Box7162 �e�mitNttt»a,�(b>xslledmbyCo.) �.-��� w .�� MadittOq vvI 33707-716z St`-Sanitazy g@rmit Application tea•Tmosaction Number In accordance with SPS 33321(2).Wis.Ada Cods.submission of this fo m b the ypeapiate governmental unit is requiredo en prior • 1 ion forms Sir el a owned PUNTS ma oa6sWe0 b Project Address(if different than mailing Whims) theonel Services.Personal Formation you provide troy be and for purposes in accordance with the Privacy Law,a.15.040)(m),Stats. s0°°�y 1.Application Iaterasatlea-Please Print AB Information Property Owners NameRECEIVED 7 Pared 0 Property Owner's MailingAddea• Efif t N/cotE /5 /A1tJ6s JAN 31 2923 o.�6- /ilr- /7- ooa /yaa �Pary Location City,State /19 r I zip — P 1' 'CDD Govt.Lot NEiJ /�/cNNore1 Gil Syo 7 715 SfX— G4�7 /V4/l. $( y, Section .41 U.Type of Building(check all that apply) � Lot It T 30 N R eft?eft? too ©I or2 Family Dwelling-Numbe / ofBedrooms 7 /7 Subdivision Name ,.f/ �tnblirlComtnercial-DatTheUse Blodtr L4.J/Y / 1Fifoaid State Owned-Describe Use �.J�'�°�f� CSM Number aillage of EIPown of AL/VpiaJQ ilL Typlicablepe of f POW rs Perlin(C edt dtber"Flew"or"Replacement"and other applicable on line A. Check one box an Inc B.Complete line C if A- System r System 00ther Modification to Existing System(explain) ❑AdtGtivml Pretreatment Unit(explain) B. DHoldin B Tank ast.Groond at-Grade DMound i❑fodividtnl Site Design pther-tea( ) C. 0 1 Before ❑R��On of Plumber Diameter meter to New owncYI,.r -""-PrevionePamitNomber and Date honed Excitation IV. Area and TankIaformtiow; fig•Flow(dPd) Design Soil Application Ram I Diyletal Area Requard NO I Dupont Area Proposed(af) I Sy a Bavarian Coo ,7 Ise l /o nes 9e.o Tank Information Galion limpecity Taal f of Manufacturer _ Gallons Oaks Now Tech Fithtlsa Teaks3 Seek at Iia1 ..v U e cam'..o w 20o — /100 / a/SSCA. Cone. I P. I r71 I I Maim Chamber goo �� I CIE — V.Reap maduty Sit-1.ike aideriped,wane et the POWTS shown on the attachad piens. Plumber's Name(Print) I Plumber's S true INumberBosoesa Phone Number Plumber s AddressSn r �oxr .71 d/99 l 7/S 9s1- Y/sS _ (meat Car.State,rip Code) VI.c Po' fox /o, eoz,e4x� G1I smo ° y�rtmat Use Only I Permit Fee i Dos Issued I Issuing Aunt Signamee ❑Approved ❑Disapproved C Owner Given Reason be Daniel Conditions of Approval/Reasons for Disapproval /wadi ea amp4k phials Fir the arrest sae girt la the Canty nab as'sperm*`Oda a eon x 11 loam la she SBD-6398(A.(13121) RECEIVED JAN 31 2023 Page Iof¢ St Croix County CDD Private Onsite Wastewater Treatment System Index and Title Page Project Name: fE N/coLe 41dv 5- y dot. /414464,4a /o‘11-$ (4)(1.0) Owner's Name: Owner's Address: /Y3,7 /l9 L'sf 5r. A/ /U4' ro.+o, GJ I 59a/7 7/5 S5 - O L J7 Legal Description: NId, SE+ 1l, 3a N, /I/J Municipality: Town, Village, Eiey of /1/4Vevo..do County: Sr L'.t/X Lot Number: /7 Block Number. CSM Number. Subdivision Name: dad or fie-A ad&)s - /r-'2 1.19 4-E Sr. Parcel I.D.Number. d,?G- //GS- /7-don Page 1 Index and Title Page Page 2 Plot Plan with Cross-Section&Plan View Page 3 Septic Tank Specifications Page 4 POWTS Owner's Manual&Management Plan Page 5 POWTS Owner's Manual&Management Plan Page 6 Filter Information Name of Designer. re v r o,rE License#: /'f/ I2Y/99 Signature: . / ! - Date: 9- G - d o a 2 Designed I to the followine POWTS Component Manual and DSPS 381-385: "In-gro , . '1 Absorption Component Manual for POWTS"Version 2.1 (May 2022-2027) Attachment Soil Evaluation Report RED JANl1Gg � B NA / St Croix m&%c§ LA » > 7 ». k � G - \ » Lk / a o 3 a4 \ N ¥ t ., t\� k 4 , a ' � \ • �2 ! y �� > % ( \ % 4 - 2 2 . | % N. \ �� � . 6 � � > / | \ N $ to \ a a . , ( x ; t Cs §� > } / Ix R. t tr\ IS \ \ ¥ \& :� 1.2 \c ~ o fR ! k } • c R ¥ N Z. \ °� i x { h I. \ ill . a i ) . X t N .i - 2 O ` \ w 2 $ f ] t v v\ & % k a ' tt1 �(• I 2 ° \ i t = % - p is I ƒ . • / ; - vi t , • w ` � t — w § t \ \ k / '- &yL ° {\ . 6 ( /• • § k\ k P1[ ` °_ _ & \ . • ! \ ` \\ t. L. \ --e �. - - e •1 ! N. t \ ; - o| i , \'''' ' l4 N. r. n1 • r h `, \ \ '';' .1 � \ 3c� `` �� RECEIVED JAN 31 2023 St Croix County CDD Pageof COMBINATION SEMrsg SE oTANK CROSS-SECTION �^ FINAL GRADE MANHOLE RISER 8 COVER •. (RP, arrr�aom ♦erBPS aa4.200)edid deem Iseal �°r'° r min.Sc0. T4a PVC Olt Tt ed kb*MOM gl ee ELEc7RICAL_ neem Robbed ye o BUILDING SEWER mewirabowaailQar JUNCTION BOX (pw LPS 38230(11)) dhow liar good dmeon (=MAY with 316 300} / n C� v FORCE `,I Til:':::: :. F . �tiZ. MPUN 1/ and �[�. � r :II .-OPTIONSsScwa � ,� r � yle•lawmull- • eortora�raarp.tr■rep �rrr.. _ I rs. Wm y/ •• Frosss-ive ° �wile � in c e ea[re�a or•eeaerenre, �� nor Wier «..e•.e acvr.a�se, a.�.uonoua.r I arrrc MINIMUM OF 3 OF SUITABLE BEDOING BENEATH TANK&MAXIMUM BURY DEPTH OF 9Q' Mmorbgof tar*may beapdiadp BFB f(X9) Tank Manufacturer. (J/E3E1 (e icictrs Daily Wastewater Flow (DWF): Goo GPD Septic/Pump Size: /,76e Agee gallons Number of daily doses: 5.3 (M.. 9%) Alarm Manufacturer. SE,YRawcs Model Number Ay J-,�-I Force main volume: Va ft x .43 gaifft= 4..5 gal Switch Type /e!/Ec r tryuc Ac hmi dose whirls: /,70 gel - 4-5- gal= //3.5- gal (total dose volume-volume of force main) Effluent Pump Manufacturer: - Li rrit Gi,mT Model Number. 9 EC DOSE TANK CAPACITIES: Reserve above alarm 26.4 in= YSB. 1 gal (D) Minimum Discharge Rate: a0, 0 GPM Alarm float above on float 2 in= 4'$5 gal(C) On/Off float measurement .5`i in= /la gal(B) Vertical lift(pump off to lateral invert)..........,, 90 ft Off above tank bottom System h distal _ 8 n= lTI.9 gal (A) pressure x 1.3 f� ft Y ' It Force man x /G 1100ItI AA . y ft DOSE TANK DIMENSIONS; • Filter Motion loss ....................:_. — ft Length //Lii in Width 96 in Total Dynamic Head(TDH): 9 5- ft Outlet height 36 in Gallons/inch .?.,.TV RFCETGTn A. of JAN 312023 EFFLUENT PUMPS St Cron count, CD]} 9K SERIES-4/10 HP IMIIIMIIMIIIIIIMIL MIURA momsB 11$ �AI . v 1 B ..; r.l:aii I, u il n.l.pu IN. 9BC UA SPS WC-C*1F 6103M aB A I 7,-,,-,,,r--•-,„. . ri��I:ii N�i.,Hi1I_ k\_i ....._...„,„,,_:.„)..,,,.. arctic , .... Nets Hoeft Ena tsoaten Gist iron E Yap- MINN Theng du plastkADinv bepelerlypo Non-dog Mae cast E Ne0erSalt Steel Nedmica151NRSeel NA1l0Wlllalbmaadaere* - Nos t stainless steei is __ • sleeve and low boll bonne a `--� ® sis Pow Cord 5f1W-SHOW s •asq.rt -e.sr lltdN OF a1 Wil udt 10 0 a a D w 50 N N N LNnF0111 • 0 Pronldln INNeeftrks ■NE NeNUN1 1 w_uytrse RECEIVED JAN 31 2023 St Croix County CDD Page 'f' of L POWTS OWNER'S MANUAL AND MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS Owner ,T cf..- N,4 r✓ES Permit# Septic Tank Capacity /)Q O gal O NA DESIGN PARAMETERS Septic Tank Manufacturer L✓/EfEa Least., 0 NA Number of Bedrooms y Effluent Filter D,r(.sico O NA NumberNumber f edroom Commercial Units — Effluent Filter Model f rd 1i-Jy,6 O NA Estimated flow(Ave)(100 gpd/bedroom) re,0 and Pump Tank Capacity800 gal 0 NA Pump Tank Manufacturer !../!E S la 0 NA Design flow(DWF)—mated x 1.5 6 too gpd Pump Manufacturer Soil Application Rate ,7 gpd/112 Pump Model /rat O NA p ec.G 0 NA Influent/Effluent Quality(0 NA) Monthly AveragePretreatment Unit (0 NA) Fats.Oil&Grease(FOG) <30 mg/L O Sand/Gravel Filter O Pee ti r Biochemical Oxygen Demand(BODs) 5 220 mg/L O Merhertical Aeration O Wetland Total Suspended Solids(TSS) <150 mg/L on 0 Other Model: Pretreated Effluent Quality(19 NA) Monthly Average Soil Absorption Component(O NA) Biochemical Oxygen Demand(BODs) 5 30 mg/L SI In-ground(gravity) O In-ground(pressurized) Total Suspended Solids(TSS) <30 mg/L O At-grade O Mound Fecal Coliform(geometric mean) <io cal/1wog, O Drip-line 0 Other. Vertical Distance Tank Bottom to Service Pad: ft Maximum.Effluent Particle Size 1/13 inch diameter Horizontal Distance Tank(e)to Service Pad ft DIspenal Unit Mfg./Medel Number: Ezf[ot./ /,7e3A' A i i r O NA Calculations: Soil Dispersal End Cap (Dispersal Unit EISA) DWF + Application Rate = Area Reauire4 - EISA + or(Trench Width) — #Unite cc Total Lenath of Trench(s) Loo + , 7 = 8s8 - + So,o f r - A0 ,si/.UIJ (Moo Fri) DESIGN CRITERIA O"At-0rade Component Marcel furPOWIS' (Pressure or Gravity.Version 10(May 2022-2027) O"Design of Pressure Distribution Networlu for Septic Tank-Soil Absorption Systems." Publication 9.6(SSWMP Manual) O"EZ Flow Mound Component Manual"Version 12/152017(April 2018-2023) IS"In-Ground Soil Absorption Component Manual for POWTS"Version 2.1 (May 2022-2027) O"Mound Component Manual for POWTS"Version 2.1 (May 2022-2027) O"Pressure Distribution Component Manual for POWTS."Version 2.1 (May 2022-2027) O Other. MAINTENANCE MONITORING SCHEDULE-MAINTENANCE AND MANAGEMENT Service Ewers Service Fn4m.ef Pump/Inspect dinsersal cell(s),data fitter At least once every: 11 13 months 19'3 years O Other. Inspect Pump&Pump controls,alarm,pretreatment unit At least once every: 0 months 0 3 years ' NA Flush and one test laterals At bast once every: O months O 3 years 0 NA $TART UP AND OPERATION: For new construction, prior to using the POWTS check treatment tank(s) for the pie 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 contents of the tank(s)removed by a septage servicing operator prior to use.System start epshall ootecear when sail ceaditt.d are frame at the Infiltrative surface. The property owner is responsible for the operation and maintenance of the POWTS end submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of water-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners,iron removal units, other clear water treatment devices and foundation drams should be discharged to the ground surface whenever possible.Note: this does not include laundry waste,showers,dishwater,etc. This system is designed to handle domestic strength wastewater;however,the disposal of food based greases,oils,vegetable/fruit peels, seeds,bones,and food solids,such as those produced by a garbage disposal should be minimized Toilet tissue is the only paper that should be discharged into the system. Other non-biodegradable items,such as baby wipes,tampons,sanitary napkins condoms,cigarette ter dental floss, and cotton swabs, should not enter the �, system. Chemicals, such as petroleum products, paint, disinfectants,pesticides, antibiotics,solvents.etc.,should not be flushed into nito the system an they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week.Avoid vehicle traffic over all system components.Compaction of snow over the dispersal unit may cause it to freeze up. rnrl\ / Gn %S1r, .1, c-CC if 5firy'0ZOe9,-- 3q �..,�, Iv,t l .�/ L 1 V 1— I Industry Savica Cow Sk-7,:sps ,, 1 4822MadisonY Way Sr f to,x e', `0 9 2022 Madison,Sri 53705 Sanitary Permit Number(to be shed ;� $EP P.O.Box7162 /'�4; Nfadnon, •3711 71. 4�35-41 COmmu e . .:i►"'.[Tit 4-01 t 't Application � ► � • �°'r�"�°a Nam` ' ie y la accordance wa,. " 383.21(2),Wis.Adm.Code,subaoisike of this fain to . ,• govenmeml unit is required prior to obtaining a smitary permit Noce:Application form for Ante-owned a • ant submined to Project Addiea(if disaaas than mmli n addles) the Department of Safety mid Professional Services.Pawl information you provide rosy be used for secondary q3...... / y purposes in accordance with the Privacy Law,a.15.04(1)(m),Stets. "6 ! Z? l A 5 fi G Applieen..l.fermtle.-Please Print Al fitt(er.alio. Property Owner's Name Perd# TEAC f N/role /I/,o 4.10s all- /71.f- /7- 000 Property Owonr's Mailing Address Property Location 27. 50. I rtg3 /932 /,J9' Sr, Govt.Lot City,Slate Zip Cade Phone Number /Vfr.) karl0/o.re w1 fIo/ 7i5 SST- a417 ��' 10° IL Type of Bidding(cheek an diet apply) �l feat# T 36 N R /8 !o© fBeom©1or2 Fondly Dwelliay-Number odros 7 /7 Subdivision Nemo elect# LU.)/r "AG4,aws Dublin/Commercial-Desaibe Use ❑C'dy of Date Owned-DescribeUse CSM Number DVillageof ITowo of //L,i 1#.lA SisllcN, die 4 III.Type of rovers Permit( Maaer"New"eer"Replacement*and esker applicable of lime A. Clock sae lox ea line B.Complete lime C if app .) " m.m A. [}new System l p��cepra *EMI DDuher Modification to Pxistiog System(explain) additi®l Preneaftwat lUnn�ttt(explain)- B. D1oldhtg Tank la.c round -D cwie DMound 0 hidividud fie Design l ioma Type(explain) (coavo aienal) IF—' C. ❑Renewal Before Revision amnia of Plumber Dona.to New Owner Pte . PeglPertyll Numb". Daro Teamed Ei pirstinn Z y ZO kZ G_rS iv.Des gn Plow Cre eat n So and p Task Rylate�atlo.:(i er J \ i :e` 1 y,L�r Dingo Plow gam/ Design sill Appliation p�d� Dispersal Axo Rapt Dispersal Ara�Aopaed_ (sp' System Goo ,7 BSB /aoo v 9l0' , Capacity is Total IS of Mseati er Cnllons Gorham Unite - 1 ; Taruklafatmtien Tim Tanks 6mnksTmks b✓LYtCO ft ( I tt ante En EnIZo a toot" 1k /a7So - /?se) I GlidSIA Coax•. I II ( i Daisies Musky C—1 0 Do v.Responsibility Statement-I,the e.dseagnee,amseme far lesteledee Mae POWTS shwa as the attached plena. Plumber's Nam(Print) Plumbers ' MPAY d RC Number Bondage Phone hem r /<'*,r /Voxs ti .22•1/99 7/5" 942- '//55" Plumber's Adthea(Street.City,Sem,tip Code) Po. 4ox /or edcswx, 41I 31730 VI.C...ty Use Only Pmmit Pee Dpw E Ag®t %/ ) Approved ❑Duapptoved ! Z.�/Z Z ❑OwnerGivenReamoeforDadel : +�. uo _ _ ` r Conditions of Approval/Reasons for Diaappcovslr �kilo 1,42 ,�.a.c.,17' „( L f/.'ti-�f�/'eQJ 1\, SYSTEM OWNER• . 1.Septic tank,effluent filter and y Mill r /+(,( r/b de 3 x/5�{h ?tut;et> 6c YWG d'upersal tell must , x /, J //l'' at per management plan provided by plumber. y/1 l Wl W T'"r� P/bt&,s c/ o%J b�/'1 / 2.All setback requirements must be maintained / se pro applicable reek#OftlittintK F j I� I 1/_ / , � . ) 5./_ 9.f , 3 doer krn 6•.rano"^(f /)(. TR Aaatl basglese pima far spaasm red aeierats the Como only us paw net km dm Nd it beim lady ` � l (r S>1- iK `evw - P�rH-tr ( fQv;Y'a0 saD6398(R on' d-or f , ( �L PQ I eiLTn a e.y* 6('.>~og (lu-o' 1 c �!-/I CT V J �t \ti tit 0 v v O •t V NI 1• h 7 t` G tt V W C a v W 1.. ty V z M V • SQ xw \ li' ~e ^�X A ZW a11 Li ; �, WIC , o a 4 i O. Io y . �V VV W .` 4 % C tr ..a �', .. .. s V . v lel v stNI -N. N >Q1tn o x d h V X L. Is Io: 44. ve e 3 y ` Z o Z 1\•i W 1/4 '. 0- p ros 1 a t vi el 14.- - .Q � Na ` �0a � ,O v g _ av ti v .5 N� h le g .:1 u v / Z - GOP Page of Private Onsite Wastewater Treatment System Index and Title Page Project Name: TE/X'/Viceze /Y461Es- y 4c. /ii Aou&, Poilrs �,viro) Owner's Name: Owner's Address: /Y3,7 /d 9 II Sr. /V r4.) �i�.v�ra.�e !J I 59d/7 7/5 5SS- o 4.27 Legal Description: Ncl, .fE aJ, 3o N, /1/J Municipality: Town, Village, Eity of keiln'a.+o County: Sr. L'A v Lot Number: /7 Block Number. CSM Number Subdivision Name: Line r /`/EnoeArs - /y12 jag c� Sr. Parcel I.D.Number. e 26- ///5- /7-Goo Page 1 Index and Tide Page Page 2 Plot Plan with Cross-Section&Plan View Page 3 Septic Tank Specifications Page 4 POWTS Owner's Manual&Management Plan Page 5 POINTS Owner's Manual&Management Plan Page 6 Filter Information Name of Designer. r /7/o License#: /Y/- 07,74//99 Signature: Date: 9-6 - Designed immanent to the follow' Component Manual and DSPS 381-385: "In-ground Soil Absorption Component ManuaThr POWTS"Version 2.1 (May 2022-2027) Attachment Soil Evaluation Report J . o �\ � K a .6. -4: 1 N.% . c t * W sa vs yi NJ r, `t V W o`yl A 'a v v h a c \ e ` e 6 W • a v• S. \ C �o � ` t? vM �O � to A `'n Z g t t ri ` \ w . v® vt a � �- - "4 3 a �. y n if Q - .i y ' k, o W •.. N. O. t v 4•a �., a _ Z b ,; 7 C vi o� x " e IN • _ ' `0, � � t H 9 �\ Rf a o to t v "4 � W v j I\/ W % �o 1 o : .-` M ! O a t 1 Q = a• :" VI / a tl V a | 2 • P. 1 of / tn A 524. AS s $ Rm c 41. k _Zr § ' II - I �- ° II / f \ _ % § I | /� k � ` ) e — ~ § I. ® �� ® - l \ 1 § I § I « 3 l @ a . l coj 2 \ H �&�� � ~� z� XI INI1 1\ A6 / / @ � __ lim;- | �- d II k } { / a § k§ % § § § § ri z ° §§�8V12^E`§ x \ �§ §\ \ k§_� /}{ \/@ ® 27)§�)) • % TII & .. §Z co ..u: tkg ~$ Q •) $7q °�q t§§�§\k `d» _ 01 2 @ % (o at a t d0� §1.. o • �%_.#2 M � M O 2» eon . , 1- \ , \ � | o ® \� ( mR� �� P o2§ 14. 2 § i n 2 )\ 2 ¢ §G \ }� §\ ® R JJ ) 2 m E g f ° z §2 § Z m § ® 2 xi > ° °R gm Vil § _ ; r a \ I d q02 k .. \ \ % f } ' m 2 q o < m 22 § I- q m m 0 \o— Q G r �-'.ril �USH 10 �����E7EtRA DATE: ��� POUlt T. , - � SEPTIC MANUAL en _ s __ R , . s �`\0 a o-325 8458 __ Page y of POWTS OWNER'S MANUAL AND MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS • Owner .T£FA- /SVA as-5Septic Tank Capacity 7;5'0 gal 0 NA Permit# Septic Tank Manufacturer L)'ii t fere., 0 NA DESIGN PARAMETERS Effluent Filter Manufacturer Odee•aco 0 NA Number of Bedrooms `1 Effluent Filter Model fTd p»-hold O NA Number of Commercial Units — Pump Tank Capacity gal SI NA Estimated flow(Ave)(100 gpd/bedroom) V0o gpd Pump Tank Manufacturer ❑NA Design flow(DWF)=estimated x 1.5 6 00 gpd Pump Mmnfachner O NA Soil Application Rate .7 gpd/& Pump Model O NA Influent/Effluent Quality(0 NA) Monthly Average Prutraa>m Unit (lie NA) Fats.Oil&Grease(FOG) 530 nhg/L CI Sandhanical Filter O PeatFilterlad O Mechanical Aeration 0 wetland Biochemical Oxygen Demand(BOD,) <_220 tng/L 0 Disinfection 0 Other: Total Suspended Solids(TSS) <_150 mg/L Manufacturer. Model: Pretreated Effluent Quality(CS NA) Monthly Average Soil Absorption Component(0 NA) Biochemical Oxygen Demand(BOD,) 530 mg/L SI In-ground(gravity) CI In-ground(praauized) Total Suspended Solids(TSS) <30 mg/L CI At-grade CI Mound Fecal Coliform(geometric mean) <10 cfu/loOmL O Drip-Tine Cl Other. Vertical Distance Tank Bottom to Service Pad: ft Maximum Effluent Particle Size 1/8 inch diameter Horizontal Distance Tank(s)to Service Pad: ft Dispersal Uak MfgJM.del Number. EZf/osJ /Jo31/ ,6uJ0«t ❑ NA Calculations Soil Dispersal End Cap (Dispersal Unit EISA) P E + Application Rate = Area Required - A + or(Trench Width) a ft Units or Total Length of Trench(s) 600 - , 7 - Ss8 - + ,,-0 fr. _ e./onus') DESIGN CRITERIA CI"At-Grade Component Manual kr OWIS' (Pressure or Gravity.Version 10(May 2022-2027) 0"Design of Pressure Distribution Networks for Septic Tank-Soil Absorption Systems." Publication 9.6(SSWMP Manual) 0"EZ Flow Mound Component Manual"Version 12/15/2017(April 2018-2023) (l "In-Ground Soil Absorption Component Mama!for POWTS"Version 2.1 (May 2022-2027) 0"Mated Component Manual for POWTS"Version 2.1 (May 2022-2027) O"Pressure Distribution Component Manual for POWTS."Version 2.1 (May 2022-2027) O Other: MAINTENANCE MONITORING SCHEDULE-MAINTENANCE AND MANAGEMENT Service Event Service Fregaeacy Pamp/mspect dispersal cell(s),clean filter At least once every: ell 13 months 73 years CI Other inspect pump&pump controls,alarm,pretreatment unit At least once every. 0 months 0 3 years IS NA Flush and pressure test laterals At least once every. O months 0 3 years SI NA PART UP AND OPERATION; For new construction, prior to using 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 contents of the tank(s)removed by a septage servicing operator prior to use.System start apskallmtta:cur when soil conditions are frozen at the infiltrative surface. The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of water-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible.Note: this does not include laundry waste,showers,dishwater,etc. This system is designed to handle domestic strength wastewater,however,the disposal of food based greases,oils,vegetable/fruit peels. seeds,bones,and food solids,such as those produced by a garbage disposal should be minimized.Toilet tissue is the only paper that should be discharged into the system.Other non-biodegradable items, such as baby wipes.tampons,sanitary napkins condoms,cigarette buns. dental floss, and cotton swabs, should not enter the system. Chemicals, such as petroleum products, paint, disinfectants, pesticides, antibiotics,solvents,etc.,should not be flushed into the system Incas they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week.Avoid vehicle traffic over all system components.Compaction of snow over the dispersal unit may cause it to freeze up. disinfectants,pesticides,antibiotics,solvents,etc.,should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week.Avoid vehicle traffic over all system components. Compaction of mow over the dispersal unit may cause it to freeze up. INSPECTIONS&MAINTENANCE:Inspection shall be made by an individual carrying one of the following licenses or certifications:Master Plumber,Master Plumber Restricted Sewer,POWTS Maintainer or Septage Servicing Operator(per the attached Maintenance Schedule). Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks or leaks,measure the volume of combined sludge and scum and check for any backup or ponding of effluent to the ground surface and test all electrical equipment such as pumps and alarms.Any defects shall be promptly corrected.Exposed openings greater than 8 inches in diameter shall be secured with effective locking devices to prevent accidental or unauthorized entry the tanks. When the combination of sludge and scum in any tank exceeds one-third(1/3)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 NR1 I2,Wisconsin Administrative Code. The outlet filter(s)shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications.Solids washed from the filter shall be retained in the tank.Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. Alarms should be tested on a regular basis by the borne owner.Van alarm sounds,contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions,however water should be conserved until any problems with the system are corrected to prevent back-up of sewage into the dwelling or surfacing. ABANDONMENT:When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch.SPS 383.33,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 other 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 render it unusable. Replacement systems must comply with the rules in effect at the time of replacement ❑ 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. 0 The site has not been evaluated to identify a suitable replacement area.Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area.if no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface.Reconstructions of such systems must comply with the rules in effect at that time. <NVARNING» SEPTIC,PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND/OR INSUFFICIENT DO NOT MAY ATMENT TANK UNDER ANY DEATHb.RRESCUE OF A PERSON FROM OTHERR A SEPTIC,PUMP OR THE INTERIOR OF A TANK MAY BE DIFFICULT OR CIRCUMSTANCES. RESULT. IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAIN IA ,(CENT Na,' M, - 1JY/99 I (Name N}N Lu;La_G Name Phone 7/S !r/SS I Phone 7/,f 94 1- Y/S,x LOCAL REGULATORY AUTHORITY Name ESERViCINGOPERATOR(Pamper)-7• Agency Sr, (Hone (U HOrRI 4EUf6. Name I phone 7/S 3�!' 7 JO Phone Page S of 6 Maintenance Instructions or.nw sraams 1-800-348.9843 Biotub& Effluent Filter Y i-TG ? /5'IJ - �S " How to Clean Your Effluent Filter 7o ensure your effluent filter is?unctionng properly.it snould be .nspec:ec every year.Under normal conditions,your effluent fitter will function for several years before clear.=nc is necessary The fitter should be cleaned when is becomes clogged enough to restrict normal flows out of the septic tank.A:a minir^urr.the filter should be cleaned whenever the tank s c;;mped. Most peocle prefer to have a septic tank service prouder take care of filter ma ntenarce and cleaning.You cart t nd a septic:ark sere ce provider in the Yellow Pages.under Septc Tanks&Systems.'Or you car contact your country health ;eoacrnent for a list. If you wrs+to inspect and/or clean your effluent filter yourself,be si..re to dress properly.Wear ruli-lenoth pants and shin. shoes,gloves,and goggles or glasses.Then follow these mstructcans 1. Remove the access lid to your septic tank by unscrew- ing the stainless steel lid bolts with hex head wrench !� provided.If your lid is above ground,a will be easy to - find.If it is buried below grouna,find the marker that indicates its location. 2. Remove the filter cartridge by grasping the tee handle v �t and fitting it out of its housing(see photo 1). • • 3. Spray the cartridge tubes with a hose to remove any t material sticking to them(see photo 11.Ensure the three 4 • orifices in the optional flow modulation plate insioe the l filter are clear of any debris.Make sure the rinse water photo I.Remove the filter cartridge by lifting it out of its runs pack into the tank,but do not allow solids material housing. to fall into the open filter housing. • 4. Firmly place the cartridge back into the housing. 5. Some effluent filters come with an alarm that activates • when the filter needs cleaning.if you have an alarm. - r check to make sure it is working by lifting the float with a stick.An audible horn should sound.The alarm • panel is normally mounted on the side of the house or f' • in the garage. • Note:If your effluent filter doesn't have an alarm system ( and you would like one,call your local septic system installer. Photo 2.Spray the cartridge tubes with a hose 6. Record the date that you inspected and/or cleaned your*otter on the form that follows.If you checked the alarm or made any other observations about the tank or system,include that information under'Notes. 7. Attach access lid by placing it on the riser,matching the openings in the lid with the bolt catches.Insert lid bolts into catches and tighten with hex head wrench provided. 1 • Nesoxadn nskty and • dhfek dsty oes �olrsdbrNl Swim POP I of SOIL EVALUATION REPORT ..G� In aecordanoe with e e 3$6.vMComb a. Mn.Adm. Cods b 6-_/ C Alterh tl� pooran on not ins l than B 1/2 x 11 Sohn In as.Plan mast Inds* �`O C(L tat ncttllrlia6Sa laapp811Q wlbpaledttMQ,ddaodorlendprcentdope, Pacsll.D. sods et dimension.north arrow.and Sodom old dime b nearest mud. PIMA pilot all Infonnallon. Wow by cuts • Pr.md lahmilpeou aroNda mw ba used b noondw msosas,(PM";Law.s.16A1t1ttrrlll. Props*MTV Properly Landon ❑ ❑-'\ C' M 14 j A9 D. is o�"l.%\o< Qov.LotSI I S T N R E torJ WPr ' Owner's Sienna Lot! Monk 8uhd.Nearst1 Y r t0-u� city Swe Z Code . Pho Humber ❑of /� L1vWsp. Town `�l� NemMt I 1 1 .7.5 -o6Z 't'( -,....9�.9- .11 fi parzq is4-, . ri.... trtnaon ...,11Maklerdld/Nu beratbsdroome�{ cans dedwddeabrtSow rats_opo - Repleasmemt e ❑nab rm co erolal-DaeaPoic __ Prre,t mul.Md • tu_..1"-f.J 11.6N. Flood Plan eMvaaon If appliasDY tt.&t-$wrye(/ General cornmeal and recona a dslank C rteca".n - 2-(oaLtneartky7.`1-64LI'G G tz14.5---o(, Boring s iQ+elkhw t iik Ground surface alevl lk DOM m an thl6 rector, In. Soo Aaolio.don Rib Hodson Depth Domdment Color Red=Desaplon Torture r Structure Conaiaswbs Boundary In. Mused 'Cu.Az.Cont.Color Gr. �8/s�Sh. �� J 071 - . ))-snic.? aJ a s I r' nr.4 n^ ire 3 3s 13 A-7 Z is ` 07 -rP� 75r1n. y 2 (' '�b-/z.- 1-6 b 5 —10 9Sy� S, I er*-e e__ (.1 61 5�6-1f6 1-s-r� did— -4MA '� 6-7 76 S. Ire Ground A� ' 4 aurree..le„fio m them to wane tempr/0 ; I. Soli Andloadin Rals Karon Dapm DomMrt coley Rados DusabtIon " Texture Structure Damletence Boundary Noce ` In. Wm' Qu.Az.Coen.Odor Gr.Sz.8n. ►-►rr r 3T 0r7 �3o rr C' or e•? `I °23�-3� c� Y sI elv f -�— a- Ira . 3g-St-t /5/47# . p'n _ .It %y. C--• Z � ��1a.t�r� >tiO d�C Ar 5 Y-7‹ 2s'en. \i„. .5 / --ww--- maYL ♦ d T > / r.. CdT dime(Pisani Plhq ! I Ad<wiss Will Heidt Solt Tests Data TMaptlon.����Z W35031-letnlnck Road �D 'U.-- "'7 5-ref Mondovi, WI 54755t* • (715) 579-9584 . - 2. Sortie di ' BIZing Ground surface elei IC4. DipM to 6 erningtoctopieL .--------- • INS Asordirs Mg 1 Madam Dosit DoralmatCotx Max DoscrOdos Tatum I Simon 1 Consists= I awn/1W RM. • ' ' a I a In. Amid Cm.Az Cot.Color i Gr.Sz eh. 1 t I 1 , 0/ .,04(0/,'i p5 6 4 E- t isormumaimmwramie .--7 . y : INFRAMPIIIME49111111Parl.A. it,- • 11 A 7 IllrairCYM-4': - WAIREINIIIIIIIIMMENIFINIMMINVVIMMIMIE ‘-.6 ELIIIMeawriaLiMINIIIIIIIIMMINIVAIIIIPOINIPM1171111/101r /411.1111111111111MEMNIMMIIIMIII ---- 1,1211101111011111110111MallMall • (-- 4? i .. IMIIIIIMMWS211111111101. ._ 4 i lotto II S Pt Baring Ground surface slim_ft. Dopth to Mac%Dior.....,,..1n. 77-7—, . . .• •J .. Modem Moth Itortdoant*tar I Red=Description I Texture i Structure 1 Consistence 1 Boundary Rods - ..._.• M. LIMO 1 qtr.Az Cori Cc' ; 1 • Gr.ST-1111. • 11.11. 11111111111111611.11111 . 111111111111.1"11.11111111111 11.1111111111111116111111111"1"1.11111111111111illilill INIMIll SOM. E Boring Plt Gratuld surface elev.____ft. Ds.to WM rector---in; 1-' -'- E '---.--- --- • Hodson De. Dontnent Clot Ridge thesCriptlec , TIMM Stucture 1 Consistence I Sountaty 1 Roots ' • ,..i•Lc M. Memel i Q .Az.Cont.Odor I Or IX St. I I ! 1 _,. . lIllNlmmmmNNliwIIINNIIIMIIIIMIIIIIIIIIIIIIIMIII • ! ' i . ! . I • 1111111111111MMINIIIMIll -efanntr-500,7,20s2=mon_sad-riss,301150r41. •Steutuit St 2 BOO, 30 o 220 mtOL act TSS P 30 s MINA. • d. S ec---y-a _ p ` � � --s. -3. 1 I .. 4%-‘1/‘ 3 4. � -t- '� 4a : . o...,-r‘____,. ), 110 , -fp t.... %jr; o - 7- 0- ,,,F r , _ cN v, ci °%- e- b d NS P I 1 & (..0 =. Rr ?0 --?..-i �„ ° crl p 0 9-3 .0 Li; o = Q ' k. ' ') CO -a VD) a--- T_ -1 CZ oa v0 iii yl-- ) JN '\ d 1 ® © © ® O ® 4 ii 11 II 11 P 11 i I I 111911111111 111 5 ll 111911110911111111 V ill I ill 1 I 3 I 1 i 1 11 18 11 Ill I1f ill Ili III I'I rI 1qq ,' i �vl 1 !B g 8 le g i Ir . rJ iI 1 1 22.i i W I i,a e L N n-, . . . . ... f 1 .1 .. Tr.7- 4 ,II I - �j_ _ tr--• - -C-._ I 1 1 �1 x ! II . . ` S 11..-- 1 i elp ii DRAFT - NOT FOR CONSTRUCTION � aN¢.,E,NwWES PI C ; NEW RCIMOND Wlypl) �' 3 I 11 ® ® 4> ® ®' ® ® ® ® O ® ® ®i 1119 11i 'l11111 9 i I- 111 111 111 - II 1 I I ill 111 11 11 i I . ill I I . I$ . 11� Psi PI ' I I ' Ind I ' r I ' ' i Im I® 1 1 I 1. ' I ,LU - 5u, ! I 1 00, �__ - -�-- i! •1 i , I , i � 5 , p., ` ' i - - i .._ 1, , f".4,-... . T- .,, Osi ai ; 4,1,, . _. ,_ ) . I i 1 , , , r _ .\ � ir-,. _ JJff f� _ , r �� �T --z._ ®� ' �i _.r III! y.. I ;O 0 .III 1 , .�.r1 �a.-yid k II I , p PF _ y,�lIh � � , , Ill L_1_ 1 1II II �' i, __ i1 ' II � Io o .. Fj L 1 - !! iit''' ' iti a I a€ : _F •SS A ] -F i11-- 1.. ' iji 1. ill 1> 771 '11f I I I DRAFT - NOT FOR_CONSTRUCTION gl r' rEw lacrDv tazw]2pRxn�so fws., a Iq ! 7 , ST. C Ro NTY SANITARY SYSTEM Filets " Office c..due a.�azt OWNERSHIP/ADDRESS FORM /2021 Only Community Development Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources.Once approved, this completed form and educational information will be sent to you by email. If you would like to view your issued sanitary permit online, you can do so by using the Property Files Scanned weblink. OWNER/BUYER INFORMATION Owner/Buyer \ef Qi(bet Mailing Address f3q 471 City/State/Zip Mein 12 -i ChTh()h(1, ja 5 /0)7 Phone Number(required) 1 IG)' D 5 i f 5 Email Address(required) n(( � �� sang O t COY' Parcel Identification Number a - I IC/6- - VV s (found on the property tax bill) NEW SYSTEM LEGAL DESCRIPTION 1 , Property Location J\IN 1/4 ,SAC 1/44�,�"Sec. aR, T ON R )fe W, Town of IUGhmb S Subdivision Plat: L/ .n.)/ /"Y ES , Lot# / 7. Certified Survey Map# Volume , Page# Warranty Deed # /1.53 -r G z 8 (before 2006)Volume , Page# Number of bedrooms Spec house 0 yes 0 no Lot lines identifiable 0 yes 1 no / OFFICE USE ONLY New Property Address I '4 3Z I 7Q H- 571- (Verification of new address required from Community Development Department for new constnxtion.) z42z (Staff Initials) (Date) This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New System:Include with this form a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is mode in the warranty deed. Community Development Department-Land Use Division 715-386-4680 St.Croix County Government Center 715-245-4250 Fax cdd@sccwi.gov 1101 Carmichael Road, Hudson,WI 54016 www.sccwi.gov M F* _ . CST-a°a01 _a I / iNIsconeln• .�% �:a( ;G . •n Services I pap '• of.. DMslonoft t ,V JV SEE 152022 ,golf- . - - a -T . • . SAP ountsi in -- Minos with SPS 385.Ws. Adm. Code County 64- C rb C IL Attach complete sits Ian on • • • „ , •'f- 1 Inches In else.Plan must Include, but not Meted to •- ands •,. ',a • point(BM),direction and percent slope, Parcel I.D. scale or dimensions, t 1 ^ocetlon and dlstent=to nearest road 02-6 -1/ 5- /7 -U Please print all Information. Reviewed by rCD Paso!�Iinallo raU orovide may be used for secondary Dumont(Pdva Law,�,16.04�Im)1. r r t�i / Z PtOpuW Owner Property Location _ 14o.4-44-, 6. F'S q(„t 6 Govt.Lot A)l.�14 /7 % S Z ZT 36 N R /8 E (or) Property Owner's Ma1Mp*dress Loth 7 Block# Subd.Nan or Cr (i (� c�r.v. 1't�lJ� City State Zip Code _ PhoneNumber ❑city village Town Nearest Road 1 !. 5 5 96 l`c "---- -er-J .t / /-C4-oss — tNewConntttlationCan User.Residential/Number of bedrooms cf Code derived design flow rate"'�GPO - Replacement ❑Public Qr commercial—Describe: ,_ Parent materiel fir. , fa'6"` Flood Plan elevation If applicable R S•eQ-St General comments and recommendations: r'e.c..Cr nal- Z—(oaCIrvh,..1;1, ,Z-1-, `C ) 1, tt•J's--(3 C • 6 O ❑Boring // /,� Boring# D �� spit Ground surface elev(�I'�ft. l)spth to limiting factor �! In. f Soil Application Rate Horleon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Fta In. Monad •Qu.Az.Conti Color Or.Ss Sh. Wee DMZ S'c4KV e.18 :S r 6:15 O- �7 2 f2-zn 3 96 yi, ►s 9 ` aC r�- f16 el 33- �s 76 _- s t4( o- 16 y5--s o a5yrZ s - :S - (.1-C- 6- /d 1442-9-7d• .5-' (i. .3"" /577 Aor o,�J V Boring /M,,,,,e�.e;;` py ""^'�' 2.- Bores# ;�Pit Ground surface elavJ -ft. Depth to limiting factor/05 in. • - ;: Soil Appicatlon Rate Horizon Depth Dominant Color Redox Description ' Texture Structure Consistence Boundary Roots GPD/Ftt In. Munson Cu.Ax Cont Color Gr.Sz.Sh. WIWI • J Q—k-- �S7K 3� • a t i TN E ( _ ram•.-1 --- if .3.C. (y 0-77z y -2$ie y/3 ' . j ! r�-0 C o'1 6-? 3 d2t3 1) ci S .� Osn -(� -O PO y •3�-38citlijIL Ya sS 11f. s a• / 6•9 s -��il I 5 le , . — . �, 6- 1-ls •Eti�lllet#�. �7 s 914 s 2�C mall $s 9 Midkt Bo s 22o mg/Land Tas>�o s 1a maf. CST Name fO n ! ce, CST Number !2 7.n Z Address Will Heidt boll fest"rr Date Iuetlon Con ets Telephone Number . W3503 Hem)nck Road 'D �- / J Mondovi, WI 54755 © ?6. o ''MBD-8330(Roma) -- _ (715) 579-9584 51///v — — - — Va-lok.. .-- - U Boring S BPoit Ground surface elev..Q'�tt. Dean to tinting 5111. l Sod AooHoadon Rat Horizon Depth { Dornttunt Color I Rodox Deacrlption ': Teidure 1 Structure I, Consistence I Boundary 1-Roots I . GPDIft' In. Munein j Cu.Az.Cont.Color ; Gr.Si Sh. 1 r VIM l r* 0I� yf- l Ala ', ,‹f /( ti S � tom '� 4 ' � 7 p lD J y(( ' /s r ; , 1 ta .2 ,-zf 14 y 3s0 2Y1� ,/ ' 1 �� sic �' f s ! P o, i /ft ' -1� *tea 4.(i3LAJIS alLe--- 7 ! ' Boring p g _�.� Boring# ?p l0 6 P4 Ground surface elev.�,ft. Depth to!WIN factor Sol{Apatcaaon Rob 1 Dominant Color RedoxDeualption ; Texturebtructuns Consistence Boundary Root P Ho oa Ore ' Munson l Cu,Az.Cont.Color t 1• Gr.Si SF.. , 'E - F F I h • • t--^ $ Boring • Depth to l mating factor In' l ; ❑Pit Ground surface elev._R LJ i Soft AaOdoafQn Rite Depth Dominant Color 1 Redox Des-aloft • Texture •Structure ! Consistence i Boundary I Rom '1 " GPDJIR' In. MunoeA I Qu.Az Cont.Color l l Gr.Si Sh. { 1 R I . • 1 i l• l , i i { l I i 1 f , .P11Want:91 a g00,'3O S 220 mglt.end TSS>SO s 15C mgrt 'Eftluent/i2=SOD,>30 s 220 mglt.and TSs>30 s t eta mg& P. ec: 0 tr) .L411. _3_t) cp sti- ir) 0Q. 4 i-- . Lo c,) N ,(,3, ,,\ i. -, . , cy) d a� � � � qo a' ic6 = o � s cam( , 4 � g c8tr � 3 7 fi `° d � i. U & .J .--e 0 9. M _� T� ---1\t 0 _ 1 lir" list ; 0 1 S iie 1 f Ab -,.. . c; LI- Nk-- , v't._% - t,,> / ' - . -P W .. H z a 4 w I4, E w .. € A O y W J O � C9• i 1 1 rw-1 )/ i ilhil .1�1z g�� °:.,-,..In � 0 61 3 ciDE-4 T.: N 0 61 �i/ i ht � I ' !Iill n a � � O„., 02 11-J--4 ••d W I 8 $ S Ei4 1' a w � R $a i s - ri E. A p... 4 F aF'p ��iV � �a$ � �. 5 4 rm. z a • d z a z'g 4 Q �...., 244z � i . "yent C . c i ~ o w w � �-+ C�4 n Q E � Emq ,.., I Th4 omi 1-4 3 ,,, . - � IN r V "t 4 .4 w 8 ,,,tA 4 ..) N .1 a w z--, z � �. q N = Iv P4 I V1 � a D o d pCw 0W4 1, zv O � s _ o � kl %,044 Emi N % a4 vc---1 1:4 1-1.4 0 w g e (' ', ncon W ; zr, O k W alVa cd 4 . . c.) .4 � C � H 0 a, 1153928 BETH PABST State Bar of Wisconsin Form 1-2003 REGISTER OF DEEDS WARRANTY DEED ST. CROIX CO., WI RECEIVED FOR RECORD Document Number Document Name 06/01/2022 01:57 PM EXEMPT#: REC FEE 30.00 TRANS FEE 359.70 THIS DEED,made between Steven M.Dalton PAGES: 1 ("Grantor,"whether one or more), **The above recording information and Jeffrey C.Hawes and Nicole J.S.Hawes,husband and wife verifies that this document has ("Grantee,"whether one or more). been electronically recorded & returned to the submitter Grantor,for a valuable consideration,conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Recording Area Croix County,State of Wisconsin("Property")(if more space is needed,please attach Name and Return Adare:5 addendum):Lot 17,Lundy Meadows in the Town of Richmond. Attorney Kristina Ogland Estreen&Ogland 304 Locust Street Hudson,WI 54016 026-1165-17-000 Parcel Identification Number(PIN) This is not homestead property. (is)(is not) Grantor warrants that the title to the Property is good,indefeasible in fee simple and free and clear of encumbrances except: easements,restrictions and reservations,If any,of record. Dated �!/ �� • (SEAL) 4 (SEAL) + • *Steven M.Dalton (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s)Steven M.Dalt authenticated STATE OF WISCONSIN ) ss. ST.CROIX COUNTY ) *Kristina Oelan TITLE:MEMBER STATE BAR OF WISCONSIN Personally came before me on (If not, the above-named authorized by Wis. Stat. §706.06) to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. THIS INSTRUMENT DRAFTED BY: Kristina Ogland.Estreen &Ogland 304 Locust Street,Hudson,WI 54016 Notary Public,State of My Commission(is pennanent)(expires: ) i (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. 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