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HomeMy WebLinkAbout042-1057-20-425 (3)Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)], Permit Holder's Name: City Village Township KEITH B & CHRISTINA E BAUER TOWN OF WARREN CST BM Elev: / � 0 � . C) Insp. BM Elev: I to t.0' I BM Description: �5—( ± n MQ,�- " , A /A_ 6j TYPE MANUFACTURER CAPACITY Septic Dosin Aeration Holdin TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic _ l5 Dosin Aer�err Hold1 g PUMP/SIPHON INFORMATION Manufacturer =TGP emand Model Numb TDH Lift Fri i n s System Head TDH F Forcemain L gth Dia. :t to Well SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: 651312 State Plan ID No: Parcel Tax No: 042-1057-20-425 Section/Town/Range/Map No: 20.29.18.319A-45 STATION BS HI FS ELEV. Benchmark Alt. BM Bldg. Sewer - n St/Ht Inlet St/Ht Outlet l�•7-4 7&.33' Dt Inlet Dt Bottom Header/Man. Dist. Pipe � Bot. System 15.9 f Final Grade # r� St Cover TREN H Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIM ONS 1 Z SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufactu r: INFORMATION CHAMBER OR Type Of System: 1qq > � pp UNIT Model Nu ber: t o vi--- DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Length Dia Pie Length Dia Spacing a -\ � SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 1°/2,,/2023 Inspection #2: Location: 816 106TH ST 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = 49__� 3M Plan revision Required? ElYes �4 No 0 Use other side for additional information. Date Insepctor's Signature Cert. No. SBD-671 (R.3/97) ,. cot Q-�ko � � Q �s S Khuhi V h1i industry Services Division A 09/12/2023 1400 E. Washington ve S . Box 716 O2 Paid via Ascent P.-7162 Madison, Wi 53707 #31275 S atare Perm 1 t A I i c at i o n In accordance with SPS .383.21(2). is. Adm. Code, -,u hril i,;-;ior fir this romi lo the arproprialc too Iverr-nieni,,il unit is required prior to obtainin a �an i I ar� perm it, Nate' A pi I IL'.-, I I is %I I t o rms for s t ate -ownc d 110 w I 'Is arc �,t �b in i tted to r -,C I0 r SCQk n a-rV the Departmcni. of Sal cm. and Protessional Services. Per-�miul intOrm ition you provide nia. N Lis J d purposes in accordance tIle privacv I 5.0-4(ULT-11) - sta.�ts� Informtion Please PrintAll Information A 11 ro pe ri y O%k ne r's Name K 61111 &. (:I iristin a Bauer prop Q rt v n e r',, M ai I in & Address I 0 1 oO' Sti ect City, State Roberts, WI n. 'fype of Building check all that apply) I or 2 J-jjaml� L)"clllng - Number oftkdrooms [-1 Pub] ic/Comniemial - Describe Use 0 State Owned - Dcscribe Use C q ouffiy SAN-2023-244 St- Croix. Saniumv Permit Numba (to be filled in by Co.) . lo!51 3 1 Z State Transaction Num Project A ddre ss (I 1w d I 11-Clre iii than mailing address) 8 1 u [ Q 60, Street llmcel i r 042-1057-20425 Piropcny Location Govt. Lot ' 'A, Section 20 Zip Code Phone Nunibcr SW '/4, S11- 54023 circle one) T 9N R 18 E o Lot # 9 Block # CSM Number Y1 17-582 , 1. 'I'ype of Perm it. _ACile iet� line 8 if appliclible) SAkQnly one box on line A. Com A70 New tem (1�e P I acement S V-Stem T re atment/Holdie g Tank Rep] acermn t OnlY Sxs0 Subdivision Name C— city of Village of I own of W arren [] Other Modi rication to Existing System (explain) F1, perri-ilt. Renewal El Permit Revision Change of Permit Transfer to New List Previous Pe rm i ( N Ll m ho r and DWe Issued B. -ne" LiJore Expirati IN umber Owner 430145.. 7/11 121R13 L i 70n P of POWTS stem/Component/Dev ice: (Check all that apply) 2) 3'K % =25? e?- 51 on-ftessurilied I n-0) round [3 Pressurized In -Ground Ai-( Trade EJ Mound :, 24 lrl. Ot"iLlitable N-Oil Mound < 24 in. of suitable soil Holding Tank E:1 Other Dispersal Corn, ponent (explain) I)rCircatment IJL-VP�k: texplairl) V. D nt Area Information: Design Flow �.gpd) Design Soil Application Dispersal Area Required (0) Dispersal Area Proposed (0) System Fievation 600 RatOgNsfi 9W 900 9d,21 00, 0.7 V1, Tank Info C:apaclty in 00 2 Ce Galloils T Total # of Gallons Units .7 New Tanks I — 'D SepliQ j,)f I JoIjiFig Tank 1260 1260 1 Weeks Concrete. Products L 0, 1: Dosing Chamber I VI.I. Resnonsibility Statement- 1, the underskined.as�,time responsihility for installation of the POVVTS. shown on the attached plans. r% J Plumber's Name (Print) Plum nature MFIA11IRS Number Business Phone NLLMbcr 223760 71 5s - 7 60-(A 96 John Schmitt Plumhcr's Addrc,;,-, (Sotreet- Cl(-\,. State- 71p C ode) 586 Valletv- Vie�k �omerrset, WI 54025 Vill. Countv/Department Use OIll Approved J 7 Permit F" Date lsIssuin sued g Agent Sign aure MOT] 03 l l $ 202.3. ... ........ . pprova IX, Conditions o 1!t�t SYSTEM:-2-VNER: s4mX*d- dw�- gr/1L1b?-3 �.+AuAA- a. ?r&W-4, L,;*,iL ?PmA4� C006imw� a*"• MeOdS ;0-64 OffACA;-r, URM 1. SWio W. effluerl filler and di5perul A fe -,.-.ttcQ 04%. lb nut to serviced I mainlainE�pas �er 6 managenwL pors ed �wplrnte.2. M setbwk raquimu�d ix.- riHii- laircl 110.0 �0 W-6 Utl &V 4— Ms.+ 1 0--6 as per appicable code i ordinances41hal-W — 5) �a�ve - & ".- Altneb to COT"Plete PIA " ra r the qvslewn a n1d swbmn it to the ('auntyan ly on ps per not k-m. Ota n 8 1 a x I inch ins7e 1)-f98 (1R.03; 14 SYSTEM PLOT PLAN Bauer 4 Bedroom Septic System Project Address- 816 106th Street B1 1 ymboll' Bill Elevation- 100,00' SA BMDeSGrIption- Top of 1" Steel lot tine pipe BM 2 Symbol- L BM Elevation; 101 -00' WDescription- NVV corner of transformer base S lope G rad ile nt of Tested Area: (1 Well Symbol (if applicable) Notes: See Plat Map for Comlete Lot 1pm� M J�Iae pfopl� 91.1"'�� slope B" 1 94' Design Flow- 600 GPD AtUich design flow C-aICUlavons for commercial plans: Pipe Materials I ASTM Standard Tables 384.30-3 & 384.30-5 4" SCH 40 PVC pipe ASTM- 02,665 4" SCH 3034 PVC pipe ASTM-1133034 E xi 5,ting Garage Vlaell 0 Existing 4 Bedroom House _KN Scare: 1 150, 90 120 z z -1 00veway Ex isbn a -120 0 ga J;o n weeks Septic tank B 7 ES To 106th Street TI j., T2 T3 Proposed Valve M 134 T 1- F-Asting 3'x6.Y 51a ser Trench El =95-36' T2- Existing Xx57'61odiffuser tiv4zb El.=93-90' T3- Existing 3'x57' 51odiffuser Trench El =92.82' BMI T4-Proposed 3'x90' EZ Flow Trench U =92,0 ci�" q. TS-Plmposed 3'x90' EZ Flow Trench Ell. =92-00"� C � Py (000' ► X9 ILI CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name- Bauer 4 Bedroom Replacement Septic System Owners Name: Keith & Christina Bauer Owner's Address 816 106th Street Roberts, Wl 54023 Legal Description: SWI14o SE1/4, S20, T29N, R18W Township Warren County: St. Croix Subdivision Name: Lot Nurnber. 9 Block Number Parcel I.D. Number 042-1057-20-425 Plan Transaction No. Page I index and title Page 2 Plot Plan Page 3 Septic Tank Specifications Page 4 �Exi5tin g Tank Certification Page 5 Effluent Filter Information Page 6 System Sizing & Cross Section Page 7 EZ Flow Information Page 8 Management and contingency plan Page 9 Sanitary System Ownership/Addres5 Form Page 10 Warranty Deed Page 11 CSM or Plat Attachment I Soil Evaluation Report Designer: John Schmitt Date: 9/12/2023 Licnese Number, P. 223760 Phone Number: 715-760-0486 Signature: in -Ground Soil Absorption Component Manual Version 2,1 May 2022 Page I MR, 6" 19 -4 A I a Eel a a Wi"k i Bauer 4 Bedroom Septic System Project Address- 816 106th Street RIV11 Symbol. A BM Elevation- 100 00' BN1 Description Top of 1" Steel lot line pipe BIV12 Symbol- L BIVI Elevation-, 101 -00' BIVIDescription- NVV corner of transformer base Slope Gradient of Tested Area- f�) Well Symbol (if applicable) Notes, See Plat Map for Complete Lot ME— M �:Iae pfoql� Design Flow, 600 GPD Attach design flow C-alCUloons for commercial plans'. Pipe klaterials I ASTIM Standard Tables 384.30-3 & 384.30-5 4" SCH 40 PVC pipe ASTVA- 02,665 4" SCH 3034 PVC p,pe ASTM-D3034 ME E xi 5,ti ng Garage well 0 Existing 4 Bedroom House OWWW_ 4 N Scale, 111 60' 0 60 90 120 152 00veway To 106th Street TI T2 T3 Exi,sbng -1200 gai;on M 134 weelk!5 Septic tank Pr ciposed 137gl ■ T I - Fixisting 3'x63* B iodiffuser T r" ch E 1 -95 36' T2- Existing yx57' 8 iodiffuser T ren ch E 1 =93 90' T *�- �_ xJs9n g 3'x5 7' 'B 10 04 iff U se r Drench E I = 9.2 82' T4-Proposed 3'x,30' EZ Flow Trench U. =92,00' T5-Pmpased 3'xgO' EZ Flow Trench El. =92-00' commerce-wl.gov 4 isconsin 1 department of Commerce April 8, 2010 WEEKS CONCRETE PRODUCTS RAY WEEKS 1832 215TH STREET NEW RICHMOND WI 54017 SAFETY AND BUILDINGS DIVISION Plumbing PrOdUCt RPV,ew P.O. Box 2658 Madiscr. ftscofissn 53701-2658 T7Y - C on tact Through Relay j;km Doyle, Governor Richaird J. Leinenkugel, Secretary Re: Description: SEWAGE TANKS, CONCRETE Manufacturer: WEEKS CONCRETE PRODUCTS Product Name, SEPTIC. HOLDING OR PUMP Model Number(s)- 1260 (58 IN. L.L., 21,76 GAL/IN. CYLINDER, 84 IN. MAX. DEPTHOF BURY, 604 G.P.D. WHEN USED AS A SEPTIC TANK BAc.�'_-D ON A 3'YR. SERVICE INTERVAL FOR RESIDENTIAL WASTEWATER: TANK DIMENSIONS = 80 IN. INSIDE DIAMETER X 58 IN. H) Product File No. 20100129 The specifications and/or plans for this plumbing product have, been reviewed and determined to be in compliance with chapters Comm 82 through 84, Wi isconsin Administrative Code, and Chapters 145 and 160. Wsconsin Statutes. The Department Mere byissues an approval based on the Wisconsin Statutes and the Wisconsin Administrative Code. This approval is valid until the end of AUGUST 2015. � P This approval is contingent upon compliance with the following stipulation(s),-, This tank must be designed to withstand the pressures to which it will be subjected_ Themanufacturer must keep al the manufacturing plant a set of plans and specifications bearing the department's stamp of approval- The plans and specifications must be open to inspection by an authorized representative of the department. When this product receives wastewater from dwellings and is used as a septic tank, it will produce an efflur;'nt quality with a maxinium mantly average value for BOD5 of greater than 30 mg/L and less than or equal to 220 mg/L TSS, or greater than 30 mg/L or less than or equal to 150 mg,L TSS. and F.O.G. of less than 30 mg/L. 'S product is approved to use the following., Two inch schedule 40 PVC cast in riser for electrical wiring. Pipe materials constructed in conformance with Table 84-30-2 or 84.30-11, Wis. Admin. Code poured into tank cover or access cover, - Department approved effluent filter designed to be installed in a fOUr inch diameter t+-?,e with extension and installed in accordance with the product approval for the filter including a properly sized and located access opening for service and maintenance. - Department approved EZ Set and Pollyllok Inc., 24" riser cast into the tank cover. This approval supersedes the approval issued on 8/30/2005 under product Ne number 20050675. SBID-10564-E �'N10-.'97) Pilo Ref: %JV§2,DOC ST. CROUX COUNTY ZONING OfIICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to cei-tify that I li'c-ive inspected 61�2 �3���������� �:�i�+�I.��_` ,�1 t�i �� � � � ��� � �.ti�x presently serving the followmg residence: (Street add.ress) 8 16 1 06th Street located at. SW /4' SE 1/4, Section 20 4 Town 29 W4 — Town of Warren St. C1-('11'\ (-OulltN: wiscollsill. I i i n. sp e en o ii, I c ert 1 fy diet I 'have fou the t -,i n k (. s), to t1i c 11e S t 0 f 111 will conforn-i to the requiremems ot-'SI'S. .'4.25, aiid it W Z7I cl 1,11) k�L-Iqs) to be functionincy properly. Z:4 - \1�)st rceetit date of inspection or service DRI 110W back c u trom absor-ption system? Yes No (if no, skip next lisle.) Amroximate volume or length of tinic: gall,ons Minutes; Tatik Capacity 1260 Constniction: Prefab Concrete X Steel Manufiicturer (if known). I Weeks Concrete Products Age of Tank (if known): 7/28/2003 Pcrma number (if'known) 430145 (Licensed Plumber Signature} (Title) (Date) John h m ift (Prlrit ',"aine) I=, (License Number) MP/MPRS Foriii to be completed b%, 1j,,.:et'ised plumber .Dept of Services Chapter 305 and s. 145.06, Wiscotisin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 2/2 -0 12 2=1 PM' GE 2 of 2 The interval for servicing septic tanks is set by state and local code. Throughout the United States, there is a wide difference of opinion on what this interval should be, but most regulatory agencies suggest two to five years. The Libel filter, which does not increase the frequency of servicing for the tank, should be cleaned when the septic teak k is normally inspected and pumped. However, our filter is virtually self-cleaning. The continued action of the anaerobic organisms on the Zabel filter causes lodged particles to disintegrate and fall to the bottom of the tank, If your filter contains a SmartFilterED alarm, you will be notified by an SerVjC7 alarm when the filter needs Ing. Step 1: Locate the outlet of the septic tank and remove the tank cover. Step 4: While holding the cartridge over the access opening, rinse off the cartridge with fresh water, being careful to rinse aN septage maten al back into the tank. Step 2 - Rem Ove the tank cover and purnp the tank if necessary to prevent any solids from escaping to the the drain field when the filter is removed. Step 5: Insert the filter cartridge back in the case, making sure the filter cartridge is properly aligned and completely inserted in the case. Replace the septic tank cover. M Step 2: Firmly pull the filter handle and slide the cartridge out of the case, 01 Res'IderAial Applications Cerbfi ed to AN S P N S F Stiamiard 46 Copyrtgm 2 0 7 4, f 3olylok, � t; (-. A H righis resei ved Produ cf(s) covffrad by one or mote U S � a n d1b r rnfem a r 0 net Ps Te n ts, Oth 0 r U. S arl d In ferna No n ol p 8 le its rr?ay be parading, 11,8 -1­1" -'-(7 ('-'p'(5-9565 / www.polylok,.com Page 5 IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with EZ1 203HP Bundles 3-ft Trench (down -sizing credit) 12" Geotextille (typical) Cover SOIL C OV E R 11 M _LU I T A min trench b6 depth (typical) 92.00 vat System Eli ion (ty pli Ca I) TYPICAL TRENC PLAN VIEW I Septic Tank(s) Manufacturer Weeks Concrete products Se pfic TanK (s) VOI LJM9,(S)' 1260 gal gal gal gal Effluent Filter Manulacturer-. Zabel E f-fi tj ent F i I t P r Mod el #- A-1 00 TYPICAL TRENCH CROSS SECTION VIEW (No Scale) Provide minirnuirn3tt separation between trenches. (Show locatior i of Inlet I out -le I pipe connection on plan view.) (Na Scale) 4pt 0 Perforated Lateral (typical) -A B_ 90 ft (typical) ]'A' L PER TRE N CH 1 0-ft b u nd I iet; @ 50 fe E I SA/linit 4 50 fti + 5-f t b u nd I es (cD 2 5 ft E I SA/L ini t 0 I OBSERVATION PIPE DE-14 I i. No Scale) I 5�.rpw-Ty-pe or G-rade S! 11) co P Moose) imulchE3d & seeded) 4"0 PVC Pipe I a P of r)A PF' to Jer`rNnatO (rain. I fo,7;t) ai -Dr abovL- flni-,--hed g�adc, 441 V4' " X 6" Slots a -ri potl A; ut%ormil Dl?viuQ lnfiltVion S LJ ftCG Observation pipe shall be ln:Stallucf all junclion Detweer, two unds. 10 ft Observation Pipe (typical) (typical) A 3.0 ft (typical) EZ1203H Bundle (typical) (mfd by Infiltrator Systems, Inc.) ,nstall pur,%LJant to manufactures instructions. Proposad EISA per trench = 450 ft R10.fjl_J1.,-ed hifl,trAlcin Area =900 ft2 x 2 trenches - Propc)se.d Total EIS A 900 ft2 RESET Distribution Method. branched manifold Installation Instructions for to E OwIrm I EZflox Systems in Wisconsin Z flbvy IMMILTRATOR *4 good N49#R*** 0 soon ip*&m O'be 0 een V 04 'A pbs000p off posom *90 & 0 Wsconsin Department of Commerce, Safety and Buildings 5. The Absorption area (SF) necessary for a given site shall Division, has reviewed the specifications and/or plans for this be sized based ei ri m aximu r) daily sewage flew (GPD) and produCt and determined it to be in compliance with chLzpfi.-rs the Permeability foi the site, If certain C-Iritena is met, the Comm 82 Lhrough 84, Wisconsin A&-nin. Code, and Chapteis EIISA siizing can be used in Wisconsin, i-esulting in a 40% 145 and 160, Wi;SC0P5T) Statutes, .411 sl,tes must meet the Site sma[ler drainfield. & Soil Conditions & Lg�(atign5 & Isolation. disiances as ncAed in -ation ap- 6- Place Uflow bundle(s) in the EZflow corfigur loc-al regulations. -nit specified for flhc particu- proved by system design peri pipe, itl laf site. The top or cznter-rnosl bundles con taiiiing pipe he approved products are 1 203H (8-12" buridlus with Pi center bundle in 5' OF 110'lengths ) and 1203HP (3-12' bundles are joined end to �nd with an internal pipe coupler. Any additional aggregate only bundles that may be required, with pipe in each bundle in 5' or 10' length,,;, y should be butted against the other aggregate-onlbun- A single pipe bundle contains a four inch perforated pipe, Sur,- dies and do not require any type of connection. JL rounded by EPS ­q tl` U CAL,gregate and held together" w ") P ly- ehtylene netting. A single aggregate bundle contains aggregate 7. The top of each GEO cylinder coMains a �ilier tabric pre - only and is held together with polyethylene netting. manufactured in between the netting and aggiegate. The fabric is inserted to prevent scil intrug-lor). The installer Materials and Equipment Needed shall make suIS poSiti Ur re the the GEO I upward and is EZflow Bundles in contact with the fabric conizilned in the adjacent cylin- F_ i ing, & zTtow Geotextile Fabm-.­ der before L)ackfilli 0 EZflow Internal Pipe Cout)lers 8. The EZflow Drainfield Syste,-rns sn ahould be installed i 0 Pipe for Header and Inlet 0 Backhorl/Excavator level trench in all directions across and along the trench botlorri) and should follow the %-.-,untour of k :he giuund Installation instructions surface elevation (uniform depth), with a.11 continuous The instructions for installation ui EZflover products are given adjoining 10-foot cylindrical bundles placed end to end, below. This roduct must be installd in accordance with state vvith central bundle dist6bution pipe interconnected, pe rules defined ir; �I-hapters Comm 82 thi-ough 84, Wisconsin Ad- %vithout any dams, stepdowns or other water s1cps. niinistrative Code, and Chapters 145 and 1,160, Wisconsin Stat- -11 not T S 0 9. The trench top :5hall be �graded such that water wl utes. as -vvell as the local health departmeN.' current design # Mar70 pond. Backfill should be seeded or sodded immediately ijal. 0 after completion .to reduce erosion, 1, After thc lo,,_al health depaTiment has determined S,,L1[­;9, y5efllSt 4 10 10. Ezflow EPS buiJes are flexible arid can fit in curved configurati'uil, and layout for tht LZflow S 1 l6 Ld�N�e 0 or mark with paint the location of trenches and lines. Be trenche!5 as may ue nece:s,5aii-Y to av oio trees, boulders, or careiul to set correct tank, invefl pipe, header line or d115- other obstacle. tri'hution box and trench botom elevations hefor� ins fal- 1 ,atlDn of pipe bundles. 11. EPS aggregate is lighter grater, ater, then : ot-e, it be expects that natural buoyancy forces would tend to "Iuw assemblies L of ground when -tor to placing cause ELI to tioat OU" Rerrove plastic FZf[ow shipping bags pir bundles in the trerich(es), Rernove an; plastic bags in the ponding occurs. Field experience has shown. however, trench before syslern 'is cove i-e ci. 1.hal this is not a problem when systerns h,,eve a minimum 5' of soil cover as reccir,-rnended bianufacturer. 0. Tjis piod1j,"' t lust have geotextile fabnc that meets fe,- qu,re,ments of s. Comm 84.30 (6) (g), Wis. Adm. Code, installed directly on top of the product and extending 1203H-GEO down along the sides of the product to a point at least six Gcotexhle from the bottom of product. 0 "ovT IVV I'll, V V 7 ? W V Bxtler Ma'LeFl al 1 1. Iff 1� V V W V ir -e 41 When Installed in a trench, the trench Should be dug to wY, 2" :�".. a 'dih of 36'Inches. This not only saves [abor in excava- tioni but also provides be!Cer load -bearing capacity ;after backfilling is complete. #ffi0*9 41960 6*4 IP w**0 *tip 7 .n-ground Gravity Management Plan IMPORTANT: The owner of this in -ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383-52 (2), Wisc, Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Ftirt',Permore. all inspection and maintenance activities shall be performed by a registered PO Ts Maintalner in accord,ance with OS 383.52 (3), Wisc, Ad rrli r-i. Code Maximum Dig rsal Area Qperatin UrniftZ)e- - _q . Design Flow 600 gpd, BOD5522OrngL.": TS-S:5150m9-L_"" FOG:5 30 nigL" Ins p ctin Checklist INSPECT EVERY 3 YEARS • type of use • age of system 0 nuisance facters (te- odors, user complaints, etc.) mechanical maltuj­ctio' i . i.e., pumps, valves, switches, floats, etc.) c t o material fatigue (i.e-, leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e-, distribution drop boxes) 0 neglect or improper use (i.e., exceeding design capacities.. prohibited activities, etc.) o extent of pond ing in distribution cell prior to dosing o dosing irregularities - if applicable (i,e., pump re -cycling, float switch settings, etc.) o electrical components - if applicable (i.e., wiring, connections. switchescontrols, timers, alarms, etc,) o dFzjribu-Lion lateral or lateral orifice plugging (measure lateral distal pressure — compare to design specification) o s,_!_)rfar_,P discharge of effluent or sewage back. -up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) SeDfic and dose tan shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Stets. when the volume of solids in the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) or as required by local ordinance, Disposal of contents shall be pursuant to NR 1131 Wisc. Admin. Code- o Effluent fi iter shall be -inspected every 3 years and shall be cleaned when necessar-y to remove any accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12 months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to: Narne of individual or company: Local government unit: Schmitt &Sons Excavating, Inc. St. Croix County Community Developement Phone-: 715-386-4680 Local govern [110F�t. Unit address' 1101 Carmichael Road, Hudson -6: e-760-04&"t' .r_ hon- 715 ZIP: 5401 no Any defective part of this system shall be repaired, replaced, or removed pursuant to SIBS 383-51 (1), Wisc. Admin. Code. Repair or replacement of failed or malfunctioning components shall cornply with SPS 383, Wisc. Admin. C i ode. No product for chemical or phy'sical restoration of the POWTS may be used unless approved by the deparlment in accordance with SPS 384, Wisc. Admin. Code. ContinsLency Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed 'in -ground dispersal component may be abandoned and replaced by a code -complying dispersal component in a pre -determined area of suitable soils. System Abandonment If use of this POWTS is discontinued, it shall be abandoned In accordance with SPS 3813,11 Wisc. Admin. Code. ffm: S T. CRo1'UNTFileY SANITARY SYSTEM Office Use Only OWNERSHIP/ADDRESS FORM Created 212027 Community Development Department will utilize this information to provide the property owner with information regarding operat'ion and maintenance of your new or replacement sanitary system! This infori-nation will be provided as part of our ongoing efforts to protect pubic healtl-i, 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 SAllitaiy permit online, you can do so by using the Property Fi,jes Scanned eblink. OWNER/BUYER INFORMATION Owner/BLIVer Keith & Christina Bauer Mailing A&,'fress 816 106th Street City/State/Zip Fir, W1 54023 Phone Number (rPqtjirPd)715-279-3506 Fm,�i I I r ait- Kit u r @ ii.cram- P_--jrcel Identification Number 042-1057-20-425 �found on the pr-operty tax bill) NEW SYSTEM: LEGAL DESCRIPTION SW It S 20 Property Location '14 r 114 Sec. rT29 N R18 W, Town of Warren Subdivision Plat; NA Certified Survey Map# 1017582 Warranty Deed # 1012901 Number of bedrooms 4 . Volume (before 2006)Volume , Page # . Page * , Lot 4 9 Spec house 0 yes 0 no Lot lines identifiable 0 yes 0 no OFFICE USE ONLY New Property Address N - V (Verification of new address iequired from Commun1tv Development Department for new constructs ao. 1 (Staff Irlitials) (Ddte) This �'�)rm must be submitted with o1i Private Onsite Imo tee- Treatment System (POWTS) appfications. New System: Include with the 's form a recorded wigrranty cjeeLi from the Register of Deeds Office and a copy of the certified survey rnop if reference is made in the vvorraqy deed_ mmunilty Development Department - Land Use Division --'86-4680 St- Croix County Gcvernment Center / �)_l I C' (,J. 1101 Carmichael Road, Hudson, Wl 54016 7'15-24.5-4250 Fax WAW ..jSCCWLaQy Page 9 ta te Ri r o F W 1 sconsi n Form 2-200 3 WARRANTY DEED Docunient Number 11 Docunient Name THIS DEED, niadc Steven M. Dakon (­(iranLori" vvheilwi, inore), and Keith B. Bauer and Christina E. Bauer., husband and wife Grantor, for a VZdLF1h1e ennsiderationl conveys and warrants to Grantee the following deser'bccl rual estate. ioocilicr with the retits, profits, fixtures and other arrtirten-cant I interestS. Irl St. Croix County, State of WisConSirl (-Pro-peny") if more spacc I necdcd, p:e,,Jsc auach aJJendurn ): See atfached Exhibit "A."' Tx: 4251914 1012901 BATH PABST REGISTER OF DEEDS ST, CROIX co., WI 06/01/2015 12:48 PM EXEMPT#: NA REC FEE: 30-00 TRANS FEE: 37.50 PAGES: 2 Recording Area KRJ&TiNA OGLAND SN & GLAND 304 Locwst Hudson, W154.016 1142-1057-20475 Parcel Ideritilicalson NuMhCr (PILN) pions to warn nt e Li ic s: Fase m e it i s. res t i-i ct i o n s a n d r- Ig h is-0 . f- w (I 'N' () f reco rd. i f a n N'. Excei Dated. (SE�(S E A I-) AL (SEAL) AUT14 ENNTI CATION' Swrnature(s) Steyen 'At Whon authonticated oj K riDina Op -la 4 TITLE- MEM6STATE BAR OF WISCONSIN (if not, authorized by Wis. Stat. § 706.06) TH I S I'N STR U M ENT DRA FTE Attc)rney Kristina Ogh.;'Ind litidson, W1 54016 (SFA0 ACKNOWLEDGMENT S'VA I E 01.' COUNTY Personally carne before me on the above -named to me known lo be the pel'Son(s) who execLited the foregoing jilstrujilent and acknowled fed the same. Notary Public, State of ,My Commission is permanent) (expires: (Signsitures may he authenfiralvil cir acknoi�lcdged, j3otlb are itqpi 10UN11FIED. 'A(TE'� 1111S IS A SlANDARD 1-ORN1. .%\) N10Dj [- R, VT'10%%_4 1_0 THIS FORNI S1101 LLB HL CLEARIA FOR,%l N'O..2-7003 " Tvpc mjnleb-0(1�% �ign.11lums_ INFO.PRO"' I.eqal FDrrrs 800-655-Mll www.imfoprolorms.com page I0 St CroiK CountV 10 12901 'Facie 1 of 2 EXHIBIT "A" -cel ofland located in part of the SNV 1, T 9N, R 18 W, To x.vn of A ai /4 of the SE I �4 (A Sect'on 20, 1 described as folk)%Vs: tVarrcii. NMI\ Cowity, 'Wisconsin, Commencingatthe S1/4 Comerof said Section 20. t1ienceNNS9'10'56"E,a1ong the south line of the SE1/43 499.07 feet; thence NOO'49'0-4'V 46'-1.i-' fect to the Southwesterly Corner of Lot 4 of Certified Survev Map rec orded in Volume 17, PaLyc 4444, Doc-urrient Number 70.5988 bc*l na the point of beL;nimn(.-,,, flience S7V,3`,; 29"W., long the westerIv extension of the southcriv line of said of 41, 1 104.66 feet- thence N I 8'07'24"W 210,5 9 feet to the �-�.-,esterlv extension of the north i1ne of said Lot W -'0 4. thence N78 -)3'29"E. alonvy said xvesierlv ens. 1-1 .32 feet to the Nortli-we..$)terly Comei- of s at 'd Lot 4; thence S01'09'34"E, along the westerIv line of said Lot 4-� 154-20 I /- feet; thence S 3 6'0 6'0 1 T, along said we ster I Ni I I n e, 6' .1 feet to the po of nt C) f b�egirui j ng. De sc ri btd parc e I c-c) ntairis 0.50 acres �(21,783 sq. Ft.). -Paa(3 2 of 2 St roix Countv 10129,01 1017592 BC-TH PABST REGISTER OF DEEDS tl ST. CISO IX CO., W1 RECEivED roR RECORD 013/26/2015 9-.-56 AM I F1 IE 141WIEV MALIM' CERTIFtED SURVEY MAP 40102,7 P- 6-143 :-OCATED iN PART OF THE. SWIM OF THE SEI/4 OF SECTION 20, T29N. REC FEE: 30-00 R;8VV. TOVVN OF WARREN, ST, I. COLJN7Y. WISCONSIN- COPY FEE: 3.00 PAGES' 2 IN(71.-[-JDIN(7,; L(D"- 4 OF CERTIFIED SURVIFY W%PIN VOLUME 17, PAGE 4444, DOCUMENT NO, 7013088 5603, V, p u 7 4-68 D�i -_p LAN L-0 t_Aj E Nn silt 1z �A LOT 9 - 5-- F -I % I 10 690 S C-) r-7 AI L OT 4r 444, p, 4 A3 # 7 0 LIN III p0c. C) 7-4 OWNER SURVEYOR KEITH & (7HR11,;T1k%A B41,JER FWIN C F-LANI-JV 816 106-FH STREET N0RT�-ILAND SURVEYING. INC "0B'E,RJS, Wi 5-10,1 BUX 157 AM RY, W1 54001 S 1 /4 COR SEC 20 SE COR SE'C 20 ALUM 1hv'.r-rQ ;7n SC)UTH LINE OF THE SEI/4 5EC. 20 ALUM VICN. FE), AND, N 8q-1 0'5 WE 2 10 G 4 2 Mxer 1 ipL Cir, ve,,. f ted uncier Section 13 1 S :3, a _J) o! i. St Croix (.aunty Land Div Ision 0(ci Inance, anc., Se.ctlof��3115-45 (2) (a) (4) of the Wiscons,!', F & Dare - By_ -0144""ImIct e, ST C-;;01)< COurJTY SECTION CC-)HNC--R PO S I TION VERIFIED WI-T H TIES OF RECO RD OR MON1 J MENTED AS NOTED 3.,.c - X '8, 1 iL i3i;NR S1,'T WEIL-ji I I NG ,.50 LB S PER L.INEAR F(D(D"r 1' 0 E) I 1--I () N F1 F " 1, U IN D 3/4' IRON RF-BAr-q,-:0LJN0 Ito N SCO C Ile. Rib .00 PN % oipipperr 41visst SCALE IN FEET 140 -m 120' 120 Ito T-41S �NS19UMENT QRAFTED By EDWIN PLANUM JOS NO 15-02 0WG - CSM DATE 8-18-15 Q* r,^Itnft# -in-$,76;A9 ptameb 1 ^fm) Vo 1. 2 7 Page 6143 SHEET 1 OF 2 SHEETS Page 11 Wisconsir, oei;)artmonh, of CDrumce RECEIVED PRIVATE SEWAGE SYSTEM safety anC .9 Lj I oing D 1v is ion 09/12/23 19 1 1 A Paid via Ascent INSPECTiON REPORT CST-2023-306 GENERAL INFORMATION # 31275 (ATTACH TO PERMIT) a a s Pe rso n ai information you provide may beused for socondary PLrPOSeS [PH v cy Lew, .1 5 o - 4 1 k 1 Pe remit I Holdees Name. city Village X Township D a I ton , Steven A Warren Township CST BM Elev- Insp, BM Elev, BM Des&pfian-. TANK INFORMATION ELEVATION DATA County St. Croix S a n Rary Permit No, 430145 0 State Plan ID No" Pame] Tax No' S8ct0rL(TowrjjR:ange;Map No: 20.29-18. 0 ---- I PAPArITY I STATION BS I H Septic I lBerchmark sing Alt: BM Dodg. Sewer BI Aeration L Holding I St/Ht Inlet T� SETBACK INFORMATION TANK TO P/L--- WELL BLDG. Vent to Air intake ROAD Septic Dosing Aeration Holdirtg KNPISIPHON INFORMATION Manufat rer Demand GPM Model NUr+ TDH Lift Friction Loss System Head TDH Dist- to Well F&rc7 4r 'Length SO�L ABSORPTION SYSTEM BEWTRENCH Width L n No. ()f;reqches V [31MENSIONS SETBACK SYSTE7A TO PIL BLDG 'VVELL INFORMATION Type 01 ystem. 4iAAJ SUHt Outlet Cat Inlet Dt Bottom Header/Man. Dist. Pipe (30t. System Final I I r, r Final Gr I r'�k 4 Otc Ist over tT DIMENSIONS No. Of Pits �5 kz- Inside Die, FS I ELEV. �■ 6 Imp"I I ff M M MWA��M � LIquid Depth LAKE/STREAM LEACHING Ma Ldactumr.,,- /-)01'1 CHAMBER OR G t UNIT Model Number-, I I (-) / DISTRIBUTIOLN S TEM I . NEEMERF-000� veni to Air Intake Distribution X Ho�e size [Hea der/Ma nif 0 15- piw�s) 1 5= Ler Qt 4F(M epgtlh Dil a spacin SOIL COVER x Pressure Systems only xx Found Or Alt -Grade Systems Orly Dapv,) Over Depth aeer >LX Dep!h of xx Seeded/Sodded xx Mulched Bed/Trench Center GetirTrench Edges T=qoil Yes No No Yes No Inspection #i: inspection #2-. COMMENTS. (include code discrependes, persons present, etc.) Location., 816106thS1,Ro[,)erts,WI 54D23(SW 1/4SE1142OT29NR18W NALal:4 Parcel No: 20.29-18. 1.) All BM Des cdipbon r t - at I -w 075% 3(v 2.) Bldg sewer length q0 r V, 13-1a f - amount of cover 4J.") d 2, 6 Plan revision Requ re Yes No K Zvi 70.7 Use other side for additional information. 0"I CAfto Nap SB D-67 10 (R, 319 7) LJLQX,,.- � COON �ujo" ix*— %. 0WXX &VsV% CQA LQ � .1% 1=84 eplt of SOIL EVALUATIONJtkPORT ` � and in a COMM*, Wjs. �m. � R of A ! �m Soil T , Ine- 41'_•��County Arch complete afte plan on paw'' not toss ftn 8 x 11 i n ee in s . Plan must St, Croix include, but not liar to: venicalend hob refe t (), direction and Parcel I.D. percent ems. scale ear dirnenskm. nc a , and and distance to nearest i, D42-10 - 0-- 5 print all laftwMeton. Il'Ifo1'C17 Pion you pArjkle jM be USWfor p d n ry pufposas "6vaq Law, IL 15. (1) (MW By I amill Proms Owner Bad, Keft Chdsfins Govt Let Sind 11 , SE114r $20, T29K I 1 Propedy OwrW's Mailing Address Lot 0 Bbck # Subd. Nuns or StWe Zip Code aty one Number � � VLIL Ia 7 Town Nearest Road Roberts i 1M I 54QZ3 1 715-279-3506 Warren I 108Th Ave. NewOrs Gn • �1bal fiber dr rns 4 Code� n r PD U86- R is r nt Pubk or commemial - Pa mnt mat `Ial offish @urkhardt Sandy Ism Flood plain elevation, f applicable N ft. General oo mrne nts P40mement aw 1, 02, & B3) is SU ' an find =wwOwd Rstmn witfi a 0.7 rate. PDON8 RStW aria rommmendatfons: ejqVa#M fV ft 1 r j myt am is 92,W. Uppigr bwch wRl be deW to acheive gr"ty flow. Sloes of NW is 19% Baring j Phi Ground surface elev. .� Horimn DWh Dominant Cow Reds DwaIPWn in. Mum Qu, U Cwt Color 1 0-10 10yr3/3 none 10-1 1"1 1 10yr6/ wring Pit surface . I. Munsell Qu. SL Cont Color 1 13 none 1% 4 -96 10064 room 96.0 ft. Depth to Cling fadOr In. r. Sz. Sh. I Sail ApIkation RzW -01 *082 gr i 2msbk mfr 9W 1Vf 0.6 1. ► M1 0.7 1. Effluent #1 = DOD > 220 m9L end T �o3o4c T Name (Pkmge Print) Address Schmin SO T"Unge Inc. 01 a -1 �. !; Thu r ` Dep4h to limftM9 WtOr ___ - - __ - __ " chn 0-Consistenoe SourWary in. Roots 1 MI AWleation Rate GPD & - d 51 mgr nwfr as 2Vf 0.6 1.0 grsi 2msbk mfr 9W 1 0.6 1, 227429 Daft oluallon i ll tiwomw P4UMiWf 76C61978 pwpeft der Bauerp._Kelth & Chr6tna P,amel I D # D42-1057- 20-42 5 3 l3oring # Boring 1 Depth to limiting factor 96+ in. 77 Pit Ground curt ehw. 94-82 ft. Page P Horizon Depth in. Dominant CoW Munsell Redox DewAAon Qu. Sz. Cant, for TeAure Structure Gr. Sz. SIB , Conskance, Boundary Roots GPOW VF-ft#l, TIM 0-16 10yr3/3 none S1 2mgr mvfr as 2v( o-6 1.0 2 16-27 10yr4/4 none g msb 1 rnfr, gw 1' 0.6 1.0 3 27-96 IDyr6/4 none grs Osg M1 0.7 1.6 330$q q EWring # [-� Boong 94.30 IL Depth to limifting factor F K1, Fait Ground surface e4ev. 84+ in. ISoll Avollcation Rate Horizon 11 Deplih in. Dominant Color Munsell Redox Dew.-ripffon Ors. Sz- Conl- Color Texture Structure Gr. Sz- Sh. Consistence Mimmmmv� Boundam Roots GPDW *EM" NEIT42 0� 1 0-9 10yr3/3 - FILL_-, Sli 2mgr Mvfr as 2vf .6 .8 2 9-2.5 10yr3l/3 none Sil 6- 2fsbk Mfr gW jVf 0.6 0.8 3 25-45 10yr4/4 none Sid 2msbk Mfr Cw 1vf 0.4 0.6 4 45-58 1"/4 none Imsbk mfr 9w U 0.6 5 58-72 7.5yr4/4 none S1 Imsbk mfr cs 0.4 0.7 6 72-84 5yr4/4 none S1 OM Mfi 0.2 0.6 Boring # Boring 92.88 1. Depth to 11miting factor FKJ, P ft Ground surfaos eWv. 96+ In. ISoll Awl leafion Ratel Horizon Depth In. Dominant Cok�r Munsell, Redox Deaciiption Qu. Sz. Cont. Color Texture Structure Consistence Gr. Sz. Sh, Boundary ROLOtS GPDW *EfW 1 0-14 10yr3/3 none S11 2Mgr mvfr as 2vf 0.6 M 2 14-27 10yr4/4 none Sid 2fsbk Mfr gw 1vr 0.4 0.6 3 27-47 10yr4/6 none SIAS 2rrrsbk firwry, 9w 0.6 1.0 4 47-96 10yr5/6 none grs OS9 M1 0.7 1.6 I L I EMuent #1 = BOD :o 30 -S 220 mg& and TSS >30 s.1 50 mgA- Effluent 02 a OOD5 4 30 mo/L and TS8 4.30 mQA. 5 0 Thc Depwqment of COMMMW b an CQUAI unity 3coice provider and employer. If you need aulstww to acma smicas or neM mvitfti a] I n on aftmate fomSt, ptear. contse the depaArmnt at 609-266.3 15 1 ar TTY 609-264-2 77 7. wry .M1OAX-?� soon ow kw. Property Ower SaUer Keft & ChlisUna Boring # Bodng 6 1 71 P ft Ground surface eWv. Parcel 100 042-1057-2"25 92091 ft Depth to firniting factior 4 in. Page 3 of 5 1&0 Awlication Rate] Horizon Depth tn. DornInant Color Munsell Rix DOSWpfion Ou. �Sz. Cont. Cabr 'Texture structure Gr- Sz- Sh. Consistence Boundary Roob � GPDAN11 vEff#1 MMMMM� *'Eff#2 Mmi 0-10 10yr3/3 MM1vwMMMMP� FILL S11 2mgr mfr as ZM,2vf .6 2 10-20 20-29 10"3/3 1OVr513 none S11 2msbk Sil 2fsbk Mtr gw 2M,1vf 0.6 0.8 3 none mfr Cw 1W 4 29-46 10yr4/4 none sil Irnsbk mfr gw 0A 0.6 5 CA 46-5-1 7.5yr4/4 m2d 7.5yr6/8 7.Sw6/2 S1 Imsbk mfr gw OA 0.7 6 54-84 7.5yr4/6 m3d 7.5yr6j6 7.5yr6/1 grsl OM Mfi 0.2 0.6 Boflng Boring 104.72 ft, Depth to limaing factor 2 N Ground suffew elev. ISoll ication late� Horizon Depth tn. Dornfn ant Color Mun"11 Redox Descrtpfion Our Sz. Cont Color Texture structure Gr, Sz. Sh. Consistence Undary Roots GPOM *Efl#1 dEfW 1 0-14 10yr3/3 none Sil 2mgr Mvft gw 1vf 0.6 0.8 2 14-20 10yr4/4 none S1 2msbk mvfr gw 1vf 0.6 1.0 3 20-32 10yr4/4 mid 7.5yr6/6 7.Ey!:§L2 Sd i,msbk rnfr CS 0,2 0.3 4 32-78 7.5yr516 m2d 7.5yr6t8 Sd Imsbk Mfi 0.2 0. 3 [] Boring F1 Boring # pft Ground 3urfaw elev. g in. Depth to lim*n%cW ISO Anotickion Ratel Fioftcn Depth In. Dominant Color Mu nsell Redox Desc#tlon Qu.- L. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDW *EMW *EW2 j Effluent #1 a BOD :o, 30 - 220 mg& and TSS -%-30 <-- 150 in p /L Effluent #2 = SOD5 � 30 mg& and TN 49.30 mq& 5 The Demn, ment of Commww is a equid I I ity wrvice provIder wd employer. iryou need miltance to so= SM10H or n-ced matMaJ In im altwrAft foutad, plew wntact the depaWnent sr 609-266-3151 or TTY 609-264-4777., 5," U--U 3 0 f R Q'7100 t 1dWMe IM Lr.. - Conducted T'-OF a, Keith & Christina Bauer 816 106th Ave. Roberts, VVI 54023 PID- 042-1057-20-425 LOT 9 OSM 27-6143 SW1 /4 SE1 14 S20 T29N R 1 8W Town of Warren Conducted by: Thomas J, Schi-nitt LOT 10 CST 2274 29 9/5/2023 5 21 7' lox= SEE PAGE 5 of 5 FOR FULL VIEW (".'IF PARCEL, �g54 9( 1,, LOT 3 St Croix County. W1 Legend La 5 o 11 Ito! r -j F , . - ; . us L cjr,otll Rawt-. p ust-C R'4M;)--3 Railroad!; CnTwevanicti U .) 0 4 U bull 10 be cGn-rjUq-Ki ri-S i if. i r i r0.Lqiqjf.$Vh4jty tj I 'I 4w *7 V 0.0 Y - K I A 4F 4 ,!IdK ALt AF7 lit At jo t i I v Alk- I js 40 + AL 419 I 150ft L Al M I R T ws, map is nit! � i uaf alAkitw-J To 00 c - e c)in pl--rr, Ind n AM 1110 ff:r I On-�Il of "he Loser. 1017592 BC-TH PABST REGISTER OF DEEDS tl ST. CISO IX CO., W1 RECEivED roR RECORD 013/26/2015 9-.-56 AM I F1 IE 141WIEV MALIM' CERTIFtED SURVEY MAP 40102,7 P- 6-143 :-OCATED iN PART OF THE. SWIM OF THE SEI/4 OF SECTION 20, T29N. REC FEE: 30-00 R;8VV. TOVVN OF WARREN, ST, I. COLJN7Y. WISCONSIN- COPY FEE: 3.00 PAGES' 2 IN(71.-[-JDIN(7,; L(D"- 4 OF CERTIFIED SURVIFY W%PIN VOLUME 17, PAGE 4444, DOCUMENT NO, 7013088 5603, V, p u 7 4-68 D�i -_p LAN L-0 t_Aj E Nn silt 1z �A LOT 9 - 5-- F -I % I 10 690 S C-) r-7 AI L OT 4r 444, p, 4 A3 # 7 0 LIN III p0c. C) 7-4 OWNER SURVEYOR KEITH & (7HR11,;T1k%A B41,JER FWIN C F-LANI-JV 816 106-FH STREET N0RT�-ILAND SURVEYING. INC "0B'E,RJS, Wi 5-10,1 BUX 157 AM RY, W1 54001 S 1 /4 COR SEC 20 SE COR SE'C 20 ALUM 1hv'.r-rQ ;7n SC)UTH LINE OF THE SEI/4 5EC. 20 ALUM VICN. FE), AND, N 8q-1 0'5 WE 2 10 G 4 2 Mxer 1 ipL Cir, ve,,. f ted uncier Section 13 1 S :3, a _J) o! i. St Croix (.aunty Land Div Ision 0(ci Inance, anc., Se.ctlof��3115-45 (2) (a) (4) of the Wiscons,!', F & Dare - By_ -0144""ImIct e, ST C-;;01)< COurJTY SECTION CC-)HNC--R PO S I TION VERIFIED WI-T H TIES OF RECO RD OR MON1 J MENTED AS NOTED 3.,.c - X '8, 1 iL i3i;NR S1,'T WEIL-ji I I NG ,.50 LB S PER L.INEAR F(D(D"r 1' 0 E) I 1--I () N F1 F " 1, U IN D 3/4' IRON RF-BAr-q,-:0LJN0 Ito N SCO C Ile. Rib .00 PN % oipipperr 41visst SCALE IN FEET 140 -m 120' 120 Ito T-41S �NS19UMENT QRAFTED By EDWIN PLANUM JOS NO 15-02 0WG - CSM DATE 8-18-15 Q* r,^Itnft# -in-$,76;A9 ptameb 1 ^fm) Vo 1. 2 7 Page 6143 SHEET 1 OF 2 SHEETS Page 11 STCRoIk COUNTY NO OL51312 OWNER KE" � 5107--A(tt FkL1 AV L1Uff-'rM-1-1hE'9R S!�=*vv.LT L1R`-0'0#-- 223AD. . . ... .. :Alk T lift I sr-ju '2o 21 .119 �M -W ?I= % J% C tj " d-*% � AND/ xx -LIJ.-I 11 L X.P S- SU101,11VI 11"-N I .4" AUTHORIZED ISSUING OFFICER ........................ ....... . ... ... . ..... .... .. .... ........... . .... ..... . ..... .............. .. .. . . . . .......... CHAPTER 145.135 (2) WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit. (b) The approval of the sanitary permit is based on regulations in force on the date of approval.. c The sanitary permit is valid and may be renewed for a �� YP Y specified period. (d) Changed regulations will not impair the validity of a sanitary permit. (e) Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. (f) The sanitary permit is transferable. History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314 Note: 1f you wish to renew the permit, or transfer ownership of # ca authority. t e erm�t lease contact he uu h permit, P tY DATE 1 ° I f g 2jo2a F M.M DA1 W" , D BEF RE THA' VIAM. NLESS RENFJ Irld SBD-06499 (RI 1/20)