HomeMy WebLinkAbout026-1160-03-000 (2)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:
Dwight & Lucinda Beebe
City Village Township
TOWN OF RICHMOND
CST BM Elev:
Insp. BM Elev:
BM Description:
TANK INFORMATION
TYPE
MANUFACTURER
CAPACITY
Septic
Dosing
Aeration
Holding
TANK SETBACK INFORMATION
TANK TO
P/L
WELL
BLDG.
Vent to Air Intake
ROAD
Septic
Dosing
`
Aeration
ae,
V - -
PUMP/SIPHON INFORMATIONvowao,61wemtDemand
Manufacturer
vir�
PM
Model Number q�
TDH Fri c ion Loss System Head T H Ft
.3
Forcemain Length Dia. t. to Well Dis
�o 756
SOIL ABSORPTION SYSTEM
ELEVATION DATA
County: St. Croix
Sanitary Permit No:
651309
State Plan ID No:
Parcel Tax No:
026-1160-03-000
Section/Town/Range/Map No:
23.30.18.1209
Bldg. Sewer
St/Ht Outlet
I M10
14mo,
Dist. Pipe
Bot. System
��i�iltiil��
Pit RINRL
ffli, t
mmm
�1=91909mm
BED/TRENCH
DIMENSIONS
Width
Length
No. Of Trenches
PIT DIMENSIONS
No. Of Pits
Inside Dia.
Liquid Depth
SETBACK
INFORMATION
TE
L
/L
BLDG
WELL LAKE/STREAM
LEACHING
CHAMBER OR
UNIT
Manufacturer:
T e Of st
yp y
Model Number:
DISTRIBUTION SYSTEM
Header/Manifold
Distribution
x Hole Size
x Hole Spacing
Vent to Air Intake
X
Pipe(s)
Length Dia
Length Dia Spacing
SOIL COVER x Pressure Svstems Only xx Mound Or At -Grade Svstems Only
Depth Over 0000,
Depth Over
xx Depth of
xx Seeded/Sodded
xx Mulched
Bed/Trench Center 6,[ k k
Bed/Trench Edges
Topsoil
❑ Yes ❑ No
❑ Yes ❑ No
COMMENTS: (Include code disc epencies, persons present, etc.) Inspection #1: Inspection #2:
Location: 1356 146TH AVE
1.) Alt BM Description 51Wt Aov\ Do V,. 1a 4�. "0% Q il
2.) Bldg sewer length - ��5�♦
- amount of cover =
e
Plan revision Required? ❑ Yes ❑ ] No
Use other side for additional information. 'won
SBD-6710 (R.3/97) tu Date s c or's Signare I Cert. No.
+ . ko i.0, epailment of Safety�'���r�►� AA1, �
1z ` T I I I
OCT � ■ .w tart' Permit 1'�J�Imh� r i t4 h. ri1!u,i Ir
an 7 i ti k�'�.
Industry Services I ivision
s� 309
Sanitary Permit Apptication' Mate Transaction Number
I i a i c t ordance vv th S PS 3 $ 3. 1( ), Wts, y i d ni Code, submission of this form to the appropnate governmental unit
r�btaining a sanitary permit. Notc: Application farms for ,Mate-owne-d T are sub ed. t Froject ,address (ff dif`fcrent than mailing address)
r re4lll �� prior Safetyand �'"rofes,
r s , . sa�a i Services, Per n,al rnFormat Inn ���°nLI lit 0vkdc may be used for sego dary
Iance Wilk khc Pr ivacy Law, s. 15.04 (1 X rn), Stats.
1. 1�liva t i a n I n — P le ase PrinI AN Informixtion
_4
E t.i Parcel 4
026-1160-03-000
DEWIGH 1' BEE
Pro pctty Own-uj s 1.jil i ng Addness V V p Location
1356 14 TH AVE G'OvI I.kkt
City- State /-tp Code Plionc Number
NEW RICHMOND'I 54017 11, _°/4, Section 2.3_
IL Type Gf Building (check- all that apply) � cat � T 0 N � - E or
10 1 o r Z 1; am iiy Dwo1'11ng — N. kIFn her of I ICdr �o IT1 N Subdivision Nanic
El 31ock #WHITETAIL MEADOWS
Pull i�)��`orli G�Iere ial -� Describe C1 se
0 City of
11 S tate Owned Describe Use CSCE Nurnkr Cl Village of
q W Town
of RICHMOND
4� Y
IIr
_.w .. „ n�, �, �r�r �` �� � ���' � � � � I�r,-rpletl` line
icabl
��
n
A
11 New ,sx-sty`rn Replaceniernt S 'slc
_ der Modifical i n to F c l stl ng Sy stem (explal lAdditional Prelreatm ent Unit (explain)
ADDING D0111SF: TA
11 o1 d t n g `r.ink, a In -Ground 0 t- irrade Mound ® Individual Site Design El Other 'r , pe (explain)
I�cc�n�'rlt ir�I-L�1 �
Renewal Beforc F1 E?eV islora El Change of Plumber 0 Transfer to New Owner
t Previous Permit Number and Date issued
l.epirat 1On el- 7%o
NINON '111 r�� � -T
I V D ispersa Vrreaiment Area in Tank Info rrm atiort, �
i?esi Flo+. d Design , `
� Soil p11� i3tLt�Tl E�ate(gpsk-� isp�k �1 .l�r�a [���lu Lr��i j;�I'j �i�persal area l'rr�s�ci �s ��� ;k� m Elevation
4
Capacity in TOW N of Manufacturer ,
Tank Inform.-vion Gal tons Gallons Units � ` r� � �_
New Tanks I .XrI.�LL1i�F J�-a � � � �p
0
U
ire. R rspo n s i b I I itYtatemen1- 1, 1ht uride rsinned} a-5�-uwe re pun si f}Elii ' for irrsta1ratinn Of t frc POWUS sb vk a on the attached pla.
E cur i�e r 3 any PrIn1 i'1 clnihcr S .!,j 1L4I eaLu Rris.i nc:vs Phone Nurnhc r
Plurnber's ddrer ,� (Stroxt, Fitt', Stare. I') Code)
V1 Count/spa rt, m.c n1 11; w 0 nl
_
1a�.,rmlt 14� e l ��oot�: 8.�-:L1�•4.9 Issuni u, A',ent ''� ignalurc
a tin d or
-0 Or isap ro va
.� ti .STEM � - w � �SD SOU ac,
�
1. ,tic tca n 4, ;art,, w_aeri� pia er d dis c_.t sat r, li ��� �o?C ,�� ro V'
c
F Q
mint be. seFv1ced f m�i .ne(i ,as por S c � �' i� A. -1P
manal,-,,eni.eni pi:..r roviclic-i-1, k 7
. All setback re� u: r�� �rI n t � ; , ) ,. , s �as teJ.—. -I�-�- ''�,�- .�X -�. P fe-%�e.u�
{p'''� { r7 ` @d
W;� 'a�� I i Lf�l L.•' i �+J �� �� � ? � r,� 11. �� F n �t � C C I � �t�--
k91` �c 2m-1�_ SS tJ� �"�� W l'lflr vie,
11 141 I I10 ills' IC �I A:1 � ISM GI�.I N k �t� 13k ��114 'umit to the C uhcr.-�3 (R. 03122) 6— C-A-4 ek Ces-r
1�ril� on �� 05�F t�la,r I[�� M!h a�r1 � ��2 x � t iri�he� in ?r17C �
�J �
sco ems',
Qct ,
S�CreiX Ge��jD
1356 I`�c`�'A�
oZL- OLD -oJ - 003
Loft 3
5�..%y Ct�w�y Sec23
5 �a 0.18 W
lv Cl Off,
t300 SG Sv Ste.
I1Nlrc.t.N.dl V-IVAl pisfir;�u�+,`o�
, ►. d� �a,Ps
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF EXISTING SEPTIC TANK(S)
This is to certify that I have inspected the existing septic and/or dose tank
presently serving the following residence:
(Street address)
at: 1/a,
Town of
1/4, Section , Town
N, Range
located
W,
St. Croix County Wisconsin.
Upon inspection, I certify that I have found the tank(s), to the best of my
knowledge, will conform to the requirements of SPS. 384.25, and it (they)
appear(s) to be functioning properly.
Most recent date of inspection or service
Did flow back occur from absorption system? Yes No
(if no, skip next line.)
Approximate volume or length of time: gallons minutes
Tank Capacity:
Construction: Prefab Concrete Steel Other
(Date)
Form to be completed by licensed plumber (Dept of Safety and Professional
Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer
(NR 113 Wisconsin Administrative Code)
Rev. 2/2012
CONVENTIONAL COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name: IM', W I (i I IT B E 13 EF
Owner's Name:
Owners Address'. 1356 146TI I AVE
Legal Description: SW 1/4 NW 1/4 SEC 23'r 30 R I M,
Township-
RK111MOND
County-
ST .OIX
Subdivision Name-
W1 IFFE TA I L M EA DOW S
Lot Number,,
3
Parcel ID Number-
026-1160-03-000
Page 1
Index and title
Page 2
Plot Plan
Page 3
System Sizin2 & Cross -Section
Page 4
Filter Specs
Page 5
Maintenance Information
Page 6
Manaqement Plan
P @ g e 7 St. Croix C!Y Sqptic Tank Maintenance Form
Page 8
Warranty Deed
Page 9
CSM or Plat
Attar,hrrients,
Soil Test & House Plans
Designer/Plumber-
PA I 11, R K () FI [L F R
License Number: 225410
Date-
10/ 1 () .."21023
Phone Number (715) 246-2660
Sig n2 t u r el
Dt_�5iq ned pursuant to the InaG-round Soil Ab�5o rption Component Manual for POW7 S Version 2. 0 SBD- 1 0705-P (N. 0 110 1).
Page 1
sco ems',
Qct ,
S�CreiX Ge��jD
1356 I`�c`�'A�
oZL- OLD -oJ - 003
Loft 3
Ct�w�y Sec23
5 �a 0.18 W
A*
3 0-
Z 'i P 0
nP
� p�sfir;�u�o�
PAGE 4 OF 5
GRAVITY -DOSED
SEPTIC / PUMP TANK SPECIFICATIONS
A4110 vent Pope (No Scale)
>1 0 ft ft'Dm
Building F It- c t n r-,a I must corner Wth
17 In, or 2.0 ft above SPS 316 and NEC 300
EstablIshed Fled Ere tier, Weatherpmof Extend manhNe d.".r as necessary,
App�ov(,d -Junclion Box Approved Locking Manhole
IMPORTANT: V0,111 CaD with Waming Label Attack ad
An chor tan k (s) ri s n ecessa ry C onduil (typical)
pursuant to BPS 383.43(8)(g) 4" M Ifi - or 2.0 ft above
Eslab lished Had Elevation
(typical)
Alripght Seal
Finished Grade
7�
0 u Ic k iscon r'i ect
CAPACITIES @ 811.2 gaiTin
A
V
18"
(typical)
Min,
Depth (in)
Volume (gal)
A
21
425.88
f
eep
Apprn%.-od
B
2.0
40,56
A
Ho!e
Joins Mh
Approve(i Pipe,] tt intoo
S, alid Groind
5
101.4
,;
(typical)
D
12
24336
B
[c]
PUMP -OFF
Purip Tank Liquid Level 811.2
in
Pump
ELEVATION 85 ft
Force Main Diameter = 2 in
Concrete
IN -SIDE BOTTOM
Blcck
ELEVATION 84 ft
Force Main Length = 230 ft
3" Approved Dedding Material Beneath Tank
S?V
Force Main Void Volume
gal A
[C] Total Dose Volume (TDV)
gal/dose
< D. desrgn flow + fofce ria1r) Void VOIL.Inle)
Vertical Lift = 8 ft
Volume r7 750 gal
Manufacturer: wiener
Puriv MarlLlf�lCtLjrer: Moulds
Pump Model-, M epo4 -1 (Scc a Ito ch ed pk,j m p r-4i rve
Controls/ Alarni Manufacturer: sl rombus
Controls/Alarm Modcl: DS patrol
SEPTIC TANK(S).
Total Volume n/a gal
Manufacturer(s): wiese r
tnstall approv(',ld effluent filter at the septic tr--ink outlet
irnmediatelly upstrearn of the Dumr) tank inlet.
Filter ManUfacturer: poly lock
Filter Model: 525
Float switcfies containing gjqtqgry arkp . d.
johibite
s ir? P r e c a s 1, ijDr,3� r? j � A& Zabel" f f lu ent Fi I ter
P-1
Ptoducis % A Diqi -JjO nCA Po ��Iak I rj(.. PL-525 E
PL-525 Filter
Thel"L-525 Filter is rated. for 10,000 GPD (gallons per day) ma kind it one of the largest filter,,,, in its class. it ]-I,- s
4D I
525 linear feet of 1/16" filtration slot,,. I ike the Polylok P[ 122, the Polytok PL-525 has in automatic shut-off ball
installed with every filter, lViiell tlLc,
filLer is reniov%,-J for cleaning, the ball will float tip and ten.ipc)irarily shut off
the system c;o the effluent wont I eave the to nk-.
Fcatui-es:
1tech for 10,000 GPD (gallons per day),
525 linear feet of 111b" filtration.
Accepk 4" and 6" SCHD 40 pipe.
Built in ,as deflector.
Automatic shut-off ball when filter is removed.
Alarm accessibility,
Accepts PVC extension handle.
PL-525 Installation'.
Ideal for rest d(",ntial and conitnercizil waste flows tip to
10, 0 00 ga I I o ns pe r da �i (GIDP D)
I
1. Locate the outlet of the septic tank.
2. Reirnove the tank cover a n d p u in p tank if necessary.
3. Glue the filte-r jjc)uc-ing to tilt, 4 1? or 6 1' outlet pipe. If
the filter is not centered unfit i. the access openinguse a
Poly I ok Lx Lend 4z Lok or piece of pipe to center filter.
4. Imertthe ,PL-5255 filter into its hOLISillg,
5. Replace and secure the septic to n k. cover.
PL-1'15235 Nlaintenallce:
7"he Pl--52-5 Effitle"t l"ilters will operate -efficiently for
several yeci,,r:S Un&r normal cond - tions before requ-irlllg
...I
clealliI
ng, It is recomniended that the filter L-K, cleaned
every time the tan k i s p Li ni ped . or i-cit leas t every th ree
years. If the installed filter containsan optional alarm,
the (-)%-*?ner will be notified by an alarm when the i Iter
ne(.,,ds serviciffig. S-eirvicing should be clone by a, certified
�,t'-kptic tank pumper or installer.
Locate the outic-q of the septic tank.
2. Remove tank cover a n d P U rnp t �-i -nl, if n ec ess�.
3. Do 110 t u se pl urnbin g Nv I i c- n filter is removed.
4. Pull PL-525 cartridge out of the housing.
5. Hose off filter over the septic tanl<.flak e sure all
solids fall back into septic tank-,
6. Insert the filter cartridge back, into the 11()t1sing nla'kang
SUTe the 1-1It l-'
S proxvrly alic4i.1ed tand ct)rriplclely insc-fted.
7. Replace and secure styptic tiink- c)Nyej-,
1)q6" Ffltration Slots
E40,000 GP - D.
Accepts 4" 010
SCHD 40 pipe
Alarm 5-witch
(Optional)
Act,epts I" PVC
Extvnsion Handle
Rat(-d for
I 0,0f �) G3 PD
525 hllear
F i i t r L) t Ion '-';lots
Certified to
NSFIANSI Standard 46
-�' Gra,; D-efluctur
k) Ic
ball
Outdoor Alarm Extend & LokTm
PoI Y lok, Za tic, I k Bc.-, t f I I t v r5 ac ck? 1)
Easily installs
the Smartl"i I L(Ls I %-'L t t lI 11-1 L3 alarm. into existing tanks.
Polylok, Inc. 3 Fairfield Blvd. ,'hill LTf-o r d, CF 0649 2 Toll Fr e e -. 877.7 65 ,9 65 F1 i --v 2 , 0 S 4 4 1 Ylo k'. co ni
: ant
Wastewater
METERS . FEET
10
9
30
8
�
7
25
2
U
6
20
a
5
93
15
J
Q
a
3
lofts
z
f]
n
,.; V u r
0 2 4 b 8 10
12 mew
CAPACITY
MODE. INFORMATION
Order
Iir��muM
Float
Number
Fop
o
Vohs,
AmP�Circuit
Phase witch
Cord Discharge
Minimum Minimum
l�lrrr�rx�uen �rtrur�w F�����n�
Breaker
Style
Length Connection
Or, Level
Off Level
BasinSolids height
Diameter Size lb:s.kg
EP 41 1
plug
No Switch
� ��
Manual
Manual
0 / 9.1
P0411 A
l"199ybac 1
115 12
20
Wide-angle
'
12 "
6H
1 / 9-5
E P0411 F
Plug /
-4
No Switch
�"
af)uap
Manual
01 91
EP0411
Piggyback
Wide- .ngl,e
12
6
1 / 9-5
EP0412
1 Plug
3
10
Ala Swatch
101
Manual
�I
Manual
15 3/4 2019.1
EP041 2F
Ply., l
No witch
�Manual
Manual
0 / 9-1
EP051 1 P
Plug
115 1
o Switch
�_
2 0'
Manual
Manual
22110
i EP 1 1
h9gy,ack /
--
201
1 u
6
/10.4
EP0512F
F2 30 6.5
10
Plug
No s,-vr tch
Manual
Manual
22110
4" CAST--A-SEAL
r�
W
w j
,�
FILTER OR
BAFFLE
rr
rr, .� �
4" CAST -A --SEAL
0
d�
o�
INLET - OUTLET
ul d - i •IN d
Lo =
to
21 -^--�.
PUMP PAD
TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS
WLP750-MR
TANK SPECIFICATIONS
D
0
D
D
4.
DIMENSIONS:
a-
I
v
WALL: 2 1 f 2"�-
BOTTOM: 3"
COVER: 5"
MANHOLE: 24" I.D. PRECAST CONCRETE RISER
Q
HEIGHT: 54"
OUTSIDE DIAMETER: 7'-O"
BELOW INLET: 42"
LIQUID LEVEL: 37"
WEIGHT: 6,150 LBS.
INLET AND OUTLET:
E
4" CAST- A- SEAL BOOT OR EQUAL GASKET
�.
o
INLET AND OUTLET BAFFLE AND FILTER:
WISCONSIN, SEE DETAIL #1 O
a
(OTHER STATES SEE CHART)
V) 1
a
v
LIQUID CAPACITY: 20.28 GAL/IN
HOLDING TANK:
OUTLET HOLE PLUGGED
ACTUAL CAPACITY: 790 GALLONS
U-)
°
LOADING DESIGN: 8'-O" UNSATURATED SOIL
W
ra I
�o
TANK CAN BE USED AS:
SEPTIC f HOLDING f PUMP OR SIPHON
. I
COVER: MIX DESIGN #8 (NO FIBER)
m 00
TANK: MIX DESIGN #1 O (STRUCTURAL FIBER)
Ln
CUSTOMIZED TANKS:
FOR CUSTOM TANKS CONTACT WIESER CONCRETE
I�
I
0
REVIEWED BY
a
REVIEW DATE ;9
Q
Q
1=
w
SHEET N0.
OF
1
POWTS OWNERS MANUAL & MANAGEMENT PLAN
Pace I of
FILE INFORMATION
Owner WI HT BEEBE
Permit
DESIGN PARAMPTF-R-1;
Number of BedFOOMS
3 El N A
Number of Public Fac.ility Units
El NA
Estimated flow �aver aged
300 gal/day
Design flow (peak), (Estimaied x 1,5)
450
Soil AppkCatiDn Rate
.3 lid ay/f
Standard Influent/Effluent Quality
Monthly average*
Fats, Oil & Grease (FOG)
<_30 mg/L
Biochemical Oxygen Demand (BODO
'20 mg/L NA
Total Suspended Solids (TSB)
-<1 50 Mg/L
Pretreated Effluent Oualilty
Vionthiy average
Biochemlcai Oxygen Dernarld (DODO
�30 mg 1
Total Suspended Solids (TSS)
�-30 mg/L 11 N A
Fecal Cofiform (gcam erric mean)
10' cf u/ 1 00m I
Maximum Effluent PartiCle Size
I, —
X� in d ia 11 NA
Other,
13
u es Typi c a I for domestic vv a si ew at c.-.r and septa , a n k c,, f fiu �! ni,
MAINTENANCE SCHEDULE
Service Event
W-000�
Inspect condition of tan0s)
Pump out contents of tank(s)
Inspect dispr.--.-sal cell(sl
Clean effluent fi[ter
Inspect pump, pump controls & a)larm
Flush laterals and pressure test
.there
Other -
SYSTEM SPECIFICATIONS
peptic i ank Capacity
Septic Tank Manutact urer
,gI.X N A
iXNA
Effluent Filter ManufactuTer poly lock 11 N A
Effluent Filter Mod el 525 11 N A
Pump Tank Capacity 750 q al 0 NA
Pura Tank Manufacturer VVIESER El NA
Pump Manufacturer GOULDS L1 NA
Pump Model
EP04 0 N
Pretreatment Unit
XNA
El Sand/Gravel Filter
D Peat Filter
El Mechanical Aeration
® Wetland
,J D;s;niection
EJ Other:
Dispersal Col ks)
D NA
X In -Ground (g.-avity)
L-3 In -Ground (PressurlzedI
® At -Grade
0 Mound
01 Drip -Line
L1 Other:
OtheL,.
Other.
Service Frequency
At least once every-,
3 0 MDnth(s) (
X vaarfs) Maximum 3 years)
C NA
When combined sludge and scum equals or (Y.) of tank volur-ne
El NA
At least once every:
3 mend is) (Maximum 3 years)
year(s)
0 NA
At least once every:
.� 0 monthW
0 NA
At least once every-
P. month(s)
X year(s)
171 N A
At least once every.,
11 monNs)
E2 yeads)
D( N-A
At least once every:
El mc)nthis)
0 year�s)
PQ NA
MAINTENANCE INSTRUCTIONS
I W 0 C rt Ca 0 S
Inspections of tanks and drispersal cc -Ills shall be made by an individual carrying one of the following licenses T e Ifi ti n
Mast-E!r Plumber; Master Plumber` ReStriCtr0d Sewer- POWTS Inspector- POWTS Maintalner4 Septage Servicing Operator. T(an k
r
irispe.-lions must include a visual inspection of the tank [s) to identify any mt�-,slrlg or broken hardware, identify anyCFLIC k-S Dr Inalks,
measure the voluryie of combined sludge and scum and to check for any Liack- up or pond ing of effluent on the ground sur-.;ace,
The di8persal cell[sl Sfjtffl be. v5ually i^spected to -heck t'he efflijunt levels ir. the observation Pipes and to check for any porkdaig
of effhien-1 on to e OrC)Lj nd surf ace. T h e pond ing o f 8f f I wont on tri e groun d surf ace may ind is ate a f di ling conditio ri and req wires the
irnmediate notification of the lci��al regulatory authority.
When the comblned accurnuiaicm cif siudq e and S-urn in any tank equals an�-ihird 'Y
1 3) or more of the tank volume, the entire
, Cnntonts of the rank shall be rennoved by a Septage Servicing OpeLrator and disposed of in accordance with chapter N-R 113P
L
Wisconsin ,Ad rninistrative Cc)clel..
All its, seRlices, Including bw not limited to -Lhe servicing of effluent filters, mechanical or Pressurized components, pretTeatment
units, and any servicim-,, al, intervals of S1 2 monthis, shall be performed by a certified POWTS Maintalner.
"
4 sr-�rv',. Teport 5hall be provided to the ic)cal regulatory authority vvithin 10 C ay f ompletion of any service event.
of
START UP AN [) ONERATION
For new �o-.svructiori, prior to use oip' the FA S check treatment tanks.i for the presence of painting products or other criemip�als
that may irnpede the., treatment pm.cess and/or dam -age the ditspersal cell l,$). If high concantrations are de--.0cted have the cantenis
of the tanks) removed by a Sept age servicing operator prior to usa .
Syslern -start up shall not occur when soil conditions are fro -.en at the infiltrativo surf ace.
During power, outages pump tanks may fill above nx-mal highwAter le�Pels, Whan power is restored tho. excass wastowater wil, be
discharged to the dispersal celks) in one iarge dose, overjoraCiing the ce111W and may result in the backup or surface disrharge of
efflue-nt. To avoid this situation have the contentF, of the pump tank removed by a Septage Servi-.iniq Operator pfio-r to restoring
power to the effluent pump or contact a Plum, ber or POWTS Maintainer to assIsl in mart uail y operating the pump controls to
restore noralleve[s within the purnp tank.
Do not drive or park vahiclas ove., tanks and dispersal cells. Do not drive or park over, or otherwise disturb or COMPaCtr the area
vvith'in 15 fe-.at down slope of any mound or at- gradex soli,l absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
PW OTS: antibiotics; baby wipes; cigarette butts; coed ores; r,-Dt-ton swabs; degreasers; dental floss; diapers; ditsinfe-c-tants; fat -
foundation, drain �nump pump) water; fruit. and vegetable peelings; gaSlDlinel' grease; herbicides,- meat scraps; modications,- oil.
painting prodUCtS; pesticides; sanftary napkins.- tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and/or is permapnently taken out of service the following steps shall be taken to insure that the system is
properly and safely ahand oned in compliance with chapter Comm 83.33, Disc orsin Admin irstrative Code:
All piping to tanks and pits shall be disconnected and the abandoned pipc openings sealed.
The contents of all tanks and pits shall be removed and properly disposed, of by a Sept -age Servicing Operator.
After pumping, all tanks and pits shall be excavated, and removed or their covers removed and the void space filled with
Lsoil,,grzivei or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the lollowing rneasures have been, or -must be taken, to provide a code- corn pliant
reaDlacernent syz;tem:
El A suirtakale replacement area has been evaluated and may he utilized for the iocation of a replacement soil absorption
systems. The replacement area should be protected from disturbance and compaction and should not be infringed UpDn b'y
required setbacks from existing and proposed structure, lot 11ries and wells. Failure to protect the replacernent area will
resuft in the need for a nevv soil and site evaluation to establish a suitable replacement area. Rep[acement systems must
comply with the rules in effect at that time.
El A suitable replacemcrit area is not available due to setback and,�or SC]j[ llirntations. Barring advances in POWTiS
techna logy a holding tank may be installed as a last resort to replace the failed POWTS.
T 4_L';-Lj6fV uuirati�; r
r 'M t0i'i RT.Tt -er -u 3 IS d
o ding in k
r
e -5. Ff It � FDA 'AV � e'j 5779 D
0 Mound and at -grade sol: abz3o:-ption systems may be recon stru Cted in place Jollowing removal of the biomat at the
infiftrative surface. Reconstructions of such systems must comply with the rulies in effect at that time.
< <WARNING> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANOR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSfI13LE.
ADDITIONAL COMMENTS
POWTS INSTALLER
Narne C 0 IIJ N T RYS I D F PL 0 rvl I N C_1
Phone 715 246 266v
SEPTAGE SCR VICING OPERATOR (PUMPERI
Name RONS SEPTI('i SERVICE
Phon'-
POW-rS MAINTAINEF1
N(-aiiien PAUL R KOEHLER
7152462660
L("CAL REGULATORY AUTHOWTY
N �1
2 oAj' o�Uj
This doc.Liment wa8 drafted in campliancL- with chapter Comm 831.2212)(b)(I)Id�&L(11,1 and 3.54(11, (21 & (3), Wisconsin Administmrivp Code.
ST. CRO UNTY SANITARY SYSTEM File#:
Oa«e�zo���y
OWNERSHIP/ADDRESS FORM Cr
Con-irnunity 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 pern-iiit online, YOU can
do so by using the Property Files Scanned web[ink.
*WNER/BUYER INFORMATION
Owner/Buyer DWI HT BEBEE
Mailing Address 1356 146TH AVE
City/State /Zlp NEW RICHMOND WI
" 332
Phone N1 --1151
Plumb (required) U;�)
Email Address (require d)DWIGHTBEBEEI@GMAIL.COM
Parcel Identification Number 026-1160-03-000
(found of) the property tax bill)
NEW SYSTEM: LEGAL, DESCRIPTION
Property Location SW 1/4 1 NW 1/4 , Sec. 23 � T 30 N R 18 W, Town of RICHMOND
Subdivision Plat: —o Lot # 3
Certified Survey Map # . .... Volume--,. Paae #
Warranty Deed #
Number of bedrooms 3
(before 2006)Volurre Page #
Spec house 13 yes N no Lot lines identifiable ® yes 0 no
OFFICE USE ONLY
New Property Address
(Verification of new addre.ss required from Cii,mrnUrlity D,v!�Iopment Dep,irtment for n.ew (onstruction.)
I I
(Date)
ibis form fraist be submitted witli all Private Onsite Water Treatment System (POWTS) app(ications.
New System: 111chicie with this form a recorded warranty deed from the Reylster of Deeds- Office and c7 copy of the certified
sw-vey rnap 1-f reft?rpnce t-s mofle t'n the wc7rran ty deed.
Coniri'i�,jnity Devolopniet)t Departmeiit — Land Use Division
7115-386-4680 St. Croix County Government Center
g,dd L(j)sccwi,.q_ov 1101 Carmichael Road, Hudson, WI 54016
71' "145 �O Fax
"1', 1. (1 () V
s cousin
1 Den artment of Commerce
Saf.ccy and Buildings visi iDCovnvF
[)"51 � 1
701 W. Wishijagion Avc., B0 I
Mitdison, W1 5AL07 samury Pcrmit !qumtKr fro tK Allicd in by Co
(69W
mmly N 451Y Z6 7
Sani*tary Per it Appli*cater
in accord wjCow 83-21. Wlt. Adrn. Code. per3onjJ inforrrad u prow p
t1l0e.ac
ma � t.�! us cd for second Lry purpo6sc4 PTiv ac y Law. j I S.C44 1)(m)
1. pp cation Wormation - Please Pnint All Wormation
0
Prorry b wncf s Na me
SUIC P[&n 1.0 Numtxf'
roci AdCl s s C, (fe r crii ' n m2 0' ni 2dd rn$)
parcei 0 L401 I
61
alling d res rrqxiLy, cxviv-
STCROIX COUNTY
'A 'A -Cc t 10 rt
City, suce Zip Code L_ im
R E cics
I]. "-Type of Building (Cht,-ckaU that apply)
a696v0Lad
F OPJw.�J' or 2 F di rrj I y D we r n g u m N-i o I Bcd f
;.ieSj
Sijbdivssion N'.amc CS?vf, Numbcr
NbliclCommcrcial - Dc,scribc Usc
Swc Owned - DtscriN Usc
�Ivlflagc J�Townshlp of
111. T� of Perms t: (Check only out box on be A, Complete Une B if applicable)
I A�firqcw�00-1'�r
system 0 Rcpimctrmcn( System
E) Trca mcnV Hold Inj Taft� Replacemcni Omv
Modik-Ation IQ Exmin& Systern
151 Pit �-.icijs Ptrmi� NLrmb<r and Dild Issued
B. Per= Renewal Permri Revisor)
C2 TChangl: of 0 Pr!rmit Traru.`v 'o ql.'c %k
Cn)l
Before Expirvion
P1 u rn ll:�e r u
llm�_ - ..__ -I
6&
I'V. Type of POWTS System: (Check all Ott .2ppjy�
/ V
d
:.�oilqcn -Pressurized In -Ground Mound > - ;A in of suio bit soilM 0 u r1e, < '14 7-. 01� SuIL3lit Sr,
or
At -Grade Single Pass Sand Fificr
Constructed Wettam, Press urized In -Ground LJ HoJdjreg Tank pe.11 Ffhe- t)i.L
catmeni �)nit 111ccircuiving Sand Filiv
4R.CcIrculaung Sir nuR c:tc Media FLILcr 0 Lmchin& Chtmb:r Drip, �Ine Cr r I Fc
0EhCF (explainj
V. DiArea (or tnation:
,ersaVTmatment
Nsign Flow (gpd)
De -sign Soil An It n. F-2 t L'(.:11;;ds 0
D is pc:rs tJ fey Req L, I r ed s fb :! P o po s cd (S SY51cm Lit on de
I if 50 4
005
560
I V1. Tank Info capaciry in Total ll Number
Prefab 51(c Stec I b-C i Plastic
Gxllons
6 x1 [OrL -of Uruu
*ncrcle I Glass
New Ex-giOnt
T�.rib Tmb
2.- t
Sepic or Waidinj Tv�k
ACrobK Treacmcni Unli
Oosirij Chjmt>-,r
V1[ Re!spon,sibility <F.'ifomen t- ii, (he undersigned, 3LS'.MMC r'C:SP'00SibW1Y tOr MS12Ll.31jDrY
shown on the attached P12• ,,Ls
Plumbcf's N� rnc �Prinf) Al u ni be 5 71 rL;L rmw r
"•t,rj-<-
P!vmber's Addre ss (Screcr. City, Sutc. Z i p C
.02 f--
T_
Vill. "'f,:;iY/Depajimeat Use -Only
(7,
�i<vprovvo ljappLrov cid Issuing ni SIZOA ric 0
g'c .� r - r!,
r ivcn Rcuo r Dclu"al
LX. Condi t' easori% for Dkzippro�.Ul
m1i4WAW, W %
1, Sepik torrk, effluent fifter and
dm;*ml cell must al; I Mal
C>'�
oe-1- b443
per fna �, 3 q Ej r n e - I. plan p ro vi ei�d by p [umberrp
-
2, Alt st4ha c,'k r t L; I t e t ne nts> m%j rA. main ta it
as pef� app4cab4e code I ordinances-
�'j
A u,k- h comoIrte IU uni : L.0 L-"-t C Q LL-3 f L3 -i,- 'i r,) r (h f. g 7-% e rn. cn r nor T h IhAA A X C i 'knc hc;s Ln tuf
,SBD-6398 (R 01/03)
Amsin nt of Commerce PRIVATE SEWAGE SYSTEM
' �fe and�Su�D`n►ision
INSPECTION REPORT
GENERAL- INFORMATIONATTACH TO PERMIT)
i Personal information you pmVxJe may be Used for secondary purposes [Privacy Law, 0 5.G4 (i Xm)].
Permit Holders Name: City YiDaoge X Township '
Beebe, 2eviqht I Richmond, Town of
CST BM Eiev: Insp. BIN Elew BM Description:
TANK INFORMATION
=7
TYPE
MANUFACTURER
CAPACITY
Septic
ca
Dosing
Aeration
Holding
TANK SETBACK INFORMATION
lj�
ventto
Air IntakeAs
+
Vk-
ELEVATION DATA
STATION BS
County: St. Croix
Sanitary Perm t No: 488267 0
State Plan iD Na.
Parcel Tax No:
026-1160-03-000
Sectionnownftnge/kUp Na.
23.30-18.1209
ov�w�n��an
Alt. 8M
Bldg. sewer
StlHt Inlet 6A
sit owe
cx Inlet �1S' tZ �� (.o'
[H7;;-der/Man.
Dist. Pipe /" 46 %_j ,0''
1 C
05,7
3.
o ff9
�- Flnal Grade
PUMPISIPHON INFORI#ATION 13 3 I&I44do
Manufacturer mand Ist com r
2q
rL� 61
` GPM S ~ �� CA... ...
------
Model Number CrE
TDH Lift Faction Loss tam Head TDH Ft . -~
Forcemain Length a. t / . to Well
A"-.& A SPA"
A SPA"
SOIL ABSORPTION SYSTEM � � = vase*
SEWRENCH W kith Length Trenches PIT DIMEN Q Pits inside Dia. �.iquid Depth
DIMENSIONS 7;
SMACK SYSTEM TO PILL- -.-. --- - --- WELL LAKFJSTR LEACHING Manufacturer.
INFORMATION Oro
T Of System: � 1 � - EMEMMEWNEdbNO&A CHAMBER Ul ff Mods Number.
DISTRI ON SYSTEM
Hq ertMani�otd Distribution x Hale Sire x Hole Spading vent to Air intake
PipeW 1
D� �. � s�
length �►_-�---
SOIL COVER x Pressure Systems Only xx Mound Or Apt -Grade Systems Only
Depth Over Depth Over roc Depth of roc Seeded/Sodded xx Mutct�ed
SedlTrench Canter Bed[ Trench Edges ITOpsod Yes No ® Yes No
t t I I � '` Ran #2:_.��__w_
COMMENTS: include code drsa�e cles, arsons present, c,� inspection pection #I :
Location 1356 i46th Ave. New Richmond, Wl 54017 SW 1I4 NW 1/4 23 T30N R18W) WgpW1 Mea ► s of 3 Parcel No' 3.30.18.1209
1.) Alt BM Description
2.) Bldg sewer length ► }
- amount of cover
Plan revision Requlred? Yes o Use other side for additional informafon.
Date pctor's Signature Cart Na.
5BD-67 � 0 lR.3J97� � %,
s f:
Koe,r(x4-16fjL
tL)gt-rt,-rp(ct, 1?�E�w� �3e�V►SreT.(
iaT 3
67 co `H-N wl(-q s z3 -r-3a tj
&E6C
�Arsucc?&Dcw , 4-
wE5t s r
541E [ ' � �b-
rAAJ (k35 (9T?64We5E S7%*
Bird Plumbing Inc.
1008192nd Ave
New Richmond WI 5401 7
715-246-4516
Steed: Whitetail Meadows Soil rests
To Wtwm l# may rn.
1 Shjaun Bird did the sol tests on this sucdhvision known as Wh'itetafl Meadows in
r
nd township. Aftbr a couple of installations, some of the soils were found to have a
nnore weak struck" than what was found in some of the borings. In order to protect home
and orontracwrs, It is ffryrecorni nendatio n after discussing the issue with Darn Quinn
from St. Groix County Zoning ce that the systems be oversized using a .3 loading rate
In
d of theoriginal .4 rate. On the lots that were originally sized for a _5.1 recommend
using a A not the new .6 that the state has suggested. The soils are what the tests indicate
but the large areas tested did not reveal sorne of the weaker structures that were found
l labons. If a lr�ier canprove otherwise, that the weaker structures do not exist,
upon nst�
then the installer should proceed with the soils that he/she believes are present.
Shaun Bird
CST #22690
a-d
Page 2 of -t
S7��M'S INC Calculations and Drawings
Re Conditions Infiltration Elevations
S it Ty p e,' Private
Trench #1 Trench #2 Trench #3 jkt�4
%Slope
6
%
# of Bedrooms
3
Depth to limiting factor
]96
inches
Sail Application Rate-,.
:3
0.3
gal/ft'12Ida y
Effluent Qua lit Y,
Eff #1 N.
Design Flow:
450 gal/day
Max BD
220 mg/1
Max TSS
150 Mg/1
Contour Elev
Infiltration Elev
Limiting Factor Elev
Treatment and Dispersal Zone
Cover Material Required
Finished Grade Over Cell
— IN
Manufacturer: Wieser Concrete
Volume Chosen- 1000
E ffl uent Filter Selected: r Zabel
Note, Amass open I ng of sAcient siize to be provided to aflcrw re mova I of N to r,
Open iw to terminate at or above grade.
Cross Section of Septic Tank
-T
-1k �2" Min
' Gmdo
All joints to
be Yvater fight
85,00
84.80
3.00
3,20
0
0
9100
92.80
Distribution Cell
Choose chamber type,,
F
Infiltrator Wick 4 Standard
# of trenches:
14 LVJ
Chamber Length-
4.00 Ft
Chamber EISA.
19.1 R2
Endcap EISA-
5.8 Ft2
Required Infiltrative Area.
1500.0 Ft2
Actual Infiltrative Area:
1513.0 Ft2
Total # of Chambers:
78
Total # of Endcaps,,
8
Combined Length of Cells: 320,0 Ft
F� Cross Section of Cell
18" in Cover Materl al' bs Oefyabon Pipe
7
(I f re q uj re d) UU':
Finai Grade
D3034 or Ground?"
/EFffuent Sch40 Contour
R Iter Pipe Leach'ing
Chamber
3" Bedding Under Tank
0
JL
15W 1.5,05-1 069crmt*r 06ermtbi WWI
a 5cb Jio pipe
pry
PVC roe
Infiltrator and the Infiltrator logo are tradernarks of Infiltrator Systems, Inc.
Spreadsheet provided Linder so- to Wfiltator Systems. 3bAdvisement N 12486 220th S1, BoyCevilte, W1 54725
System
Elevabon
I e:c
)2 c;)-Y/7/—
Page 3 of 4
In -Ground System Management Flan pursuant to Comm 83.64 W. A. G.
Owner's Responsibility:
The component owner is responsible for the operation and maintenance of the component. The
county, department or POWTS service contractor may make periodic inspections of the
components, checking for surface discharge, treated effluent levels, etc. The owner or owner's
agent is required to submit necessary maintenance reports to the appropriate jurisdiction and/or
the department.
Septic Tank:
Septic tank(s) are to be inspected routinely and maintained by department approved individuals
when necessary in accordance with their approvals. The use of chemical/biological "treatments" is
not required or recommended. if such additives are used, make sure they are approved by
Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & cleaned
as necessary, with provisions to keep solids from passing the septic during removal. No more
than 113 of the usable tank volume may be occupied by sludgetscum. 3 year inspection: if tank
has greater than 1 /3 volume sludge, tank contents must be emptied and disposed of in accordance
with NR 113 Wisconsin Administrative Code by an approved individual. if the inspector does not
recommend pumping of the septic tank, then the owner must be notified of when pumping should
be done as to not exceed 1 /3 sludge volume. Septic tank should be routinely inspected to be
watertight and of good repair.
Absorbtion Cell
The absorbtion component must remain free of ponded surface water prior to pump operation. if 4
inches or more water level is detected in the observation pipes, the owner must be notified of
possible problems/failure. The designed daily flow capabilities of the component should never be
exceeded. Trees and any Other deep rooted vegetation should never be planted, or allowed to
grow anywhere on the component. Activities OTHER than mowing/maintenance (Le. excessive
walking, pets, vehicles, etc...) could compress the component and reduce it's absorbtion
capabilities and/or possibly cause it to freeze in winter conditions.
Performance Monitoring:
Performance monitoring must be done at least Once every three years fallowing the installation or
at the time of a problem, complaint, or failure.
Contingency Plan:
If the septic tank or other components therein (including floats, alarms, etc) become defective, the
defective tank or component must be replaced immediately to ensure that the system can operate
as designed. if the absorbtion component cannot accept wastewater or ponds wastewater to the
surface, the component must be repaired or replaced in it's current location by removing the
clogged bacterial mat, aggregate/leaching chamber cell, and distribution piping within the cell and
replacing failing components in order to return system to proper working Order as required. if repair
is not feasible, a new system is to be constructed in a designated replacement area
ST CROIX COUNTY
C iSPTTC TANK MAINTENANCE AGREEMENT
AND
OWNERSEUP CERTIT41CATION FORM
Owner/Buyer tAk &A- -?
I :�> U
Mailing Address
Property Address
I (V e Ir c a t i o n rc q umic d front Planning D epa rtmen( for near coastm c ti o a)
City/State
LEGAL DESCRIPTION
Parcel Idenfification Number
Property Locafion 5 W VA 1/4, Sec. S3 R W, Town of f�► s t�a►� f�
0-� . ) --- T-3C N-
Subdivision �i�:t U P A g Ah g� s 9 Lot # &
Cerfified, Survey Map ft
Volume Page #
Warranty Did # Page 9
Spcx,N house 13 yes no Lot lines identifiables [I no
SYSTEM MAINTENANCE
Improper use and maintcnancc Qf your septic system could result mi its prematum failure to handle wastes. Proper maintenamce
c*nsists of pumpmig out the septic tank every three years or &Doncr, if needed by a licensod per. What you put into the syslem
can affect the function of the scptic tank as a treatment stage in the waste disposal system.
The prop-erty ovmer agrees to submit to St, Croix Zoning Irtment a certification form, sigaed. by the ow&r and by a
mastc r p lumb-c r, j ournc ymaz p I wmber, restricted plumber or a licensed pumper vcrSying that ( 1) the o n,-site wute water disposa I syste M
is in proper operatin g c onditi on and/o r (2) a Wspfter ' ction and pumping (if neccssary), the septic tank is less than 1/3 full of sludge. e -
I/Wep the and emigntd hAve read thit, SbOVC IrCqUir=ents and agree to maintain the private sewage dLqosal system with the standards
sit fbhere in, as set by the DcP&rtmcnt of Cova erce and the Depu=ent of Nawml Resources, State of Wisconsin. Certification
stating that your septic system has been maintained must be completed and returncd to the St. CroLix County Zo - g Office wiffiin 30
da f the ffime e;r-4.Npiratrio n date.
L--'x- K
SIGMA OF TU)Kt A-PPLICAN-1� DATE
OWNER CE&TMCATION
I (wrtify tlia,,' all staicmtnt-s on ti),
.� form are true to the best of my (our) knowledge. I (we) am (are) the owner(of
t props rty sic scribe al-,,oye, by virtue of a �T, af a n ty &-- c e4 recorded in Reg ister o f Deeds Officc.
SIGNA-DrkE OF A-PPLICA.,NT DATE
Any information that is a-tis-rcpresented may resin (Lia the saaftary peratit b-eing revoked by the Zoning I)cpart-racrit.
Include with this applicition-, a stamped WarraInty do fro thc' P"Cr'l-51cr of, Dcc& offlict,
A cOPY Of the certified survcY E'12r� �f TCf�ICPLCC is t1.'Zd-C i% th<- V,,'2,L'TaL-.ty deed
I
-NTY PLAT)
carter and wart of the Southwest Ouarter of the Northwest
----------
'8 West, 7o*wn of Richmond, St. Croix County, WIsconsin, .
UNPLATTED LANDS North line of the
;10616D*ll SE-1 4 of the NW-114
2637.27'
/mod]. 64 T Existing
/�
?4. 04 # 446. 029 � �I i ! Wetl��7 d 443,15' 282. 65'
� ' ��,. � 1"Yetland
- °- 764,625'_
�
,
�¢
db
•� �� �, �` #E Lora'.
.. �
" �.
0,010 123.�44 sq, f Dom, t.
2 84 acres s Lai
78,988
in .5M
1.81 c
VIM IL
Lorg ILX
IJ5, 817 sq. ft.
Exist�ng
3
we bland acres �.
80 =1 DD 7.5 ' LOr4 I
> A
Drain age 139, 016 sq, ft. , . ' E0.
Easement 01 J.19 acres
55532 Oa
a 4 .66
06• t4
0; CCOM
LCT of N 0 Joint Drimewoy Cs
0 Easerrren t "I
�• '.10
to N S 18,4s s-►. ft, U
o 2.55 acres
FN ..., 8 t
;� r
Existing VON- �
wetland 1016.0
M 25 £ 539.41 �
262
LordLOr5°� + �,dk .82
*- 8.3, 465 sq. ft. 81,871. sq. ft. , 0 ._
ONAW , _
FROM NORTHLAND PLUIBINGv INC. FAX NO. 715-643-2520
T V •
L G + -r 13 CQ c
Ste &-Ofx.ccn..;Ajvoq-r
WtfitEl�lL /�EA'Dat�,iS Ss/3t71Vt5i��•,!
LoT 3
s Z& T36A( t2.t 8w
SCA L 45 ( r ofb
WJ�.E35 6ZT�EI�+rISE �"f�
3 Sort-k^_ 441
Awvse
n a
0
4
.j
ti
p A
•
y
1
�4 Qj q 16fj L o/
' �� ;� f •- t .r ;irk !,
' i
45 Z2 -7 4S is 101
State Bar of Wisconsin Form 2-2003 KATHLEEN Rd, WALSH
REGISTER OF DEEDS
WARRANTY DEED ST. CROIX CO..o W1
Document Numbcr Documcni Namt RECEIVED FOR RECORD
11 @61e201200fi 02:25PK
THIS VEED, made 'between O'Brka Builders, InejL-Minnesota CoIrporadon
("Grantor," whether one or more),
and PnjZh( Beebe and Lucinda Abe, husbitnd and wife
"Grantee," whether one or more).
Grantor, for a valuable consideration., conveys and warmts to Grantee the following
described real estate, togedier with the rents, profits, fixtums and othcr appurtenant
interests, inCraiyouny,Stateof WIsconsinC'Proper) (I or space
is
needed, please attach addendum),
Lot 3, White Tall Meadows. St. Croix County, Wisconsin.
WARRANTY DEED
EXEMPT #
REG
1P FEE 6 11.00
TRANS FEE: 13a.00
COPY FEE@ 0
0
GC FEE*
PAGES: I
Recording Area
ekt Estreen & Og1d Q
304 Locust Street j L2!
Hudson, W1 54016
026-106"3-M
Vued Iderat it" kstion Number (PIN)
This is ot - hon-ocstet-ad property,
(is) (is not)
Excepti o n s to warranties: Easeme nts, restrictio as a ad rights -of -way of record, ifany.
Dated O'Brien Builders, Inc.
SEAL 0 AO 1 6(-S--'E A L)
*Aeeph A. O'Brien, President
Al �
(S E, L)
AUTHENTICATION
Signature(s) O'Brien Builders, Inc, a Minnesota.
Corporotion by Josmh A. O'Brien, President
authenticated on
74
0 Krisfino 0
end
d
11TLE- MEMBER Sf ATE BAR OF WISCONSIN
(if noL
authorized by Wis. Stat, § 706.06)
TIA I S IN STRUMENT DRA FTED BY:
STATE OF
ACKNOWL-El>GMIENT
)S5.
CO LJN'TY )
(SEAL)
Personally came before me on
the above -named
to me known to be the person(s) who executed the foregoing
instmment and acknowledged the same.
A!t2rney Kris(ina O&I'and Notary Public, State of—,_
Hudson, W154016 hey Comm 1 ss i on 0 s perm an ent) (expires:
(Siguaturn may be au,then6coled or acknowledged. Both are not atcemry.)
NOTE: TI I IS I S A NAND" RD FORM. ANY MOD I F I CATI ONS TO 111 IS IFORM S110 ( JLD R IF, CL E A RLY IDENTIFIED.
WA R RA N-11' D F, ED 0 2003 STATE BAR OF 1► TSCOM. IN FORM NO. 2-2043
' Ty pc namr. Wow signatuces.
INFO-PROm Legal F(xm 8W455-2021 www h(Wrokgrns crvn
Parcel ##: 0264 160-43-000 0711 o/2oos 10:11 AM
- PAGE 'I of 'I
Alt. Parcel #: 23.39. 1 8. "1299 926 - TOWN OF RICHMOND
Current { iC
ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
01 /02/2004 99 9
Tax Address:
OBRIEN BUILDERS INC
1796 LARK AVE
MAPLEWOOD MN 55109
owners): D = Current Owner, C = Current Co-owner
O - OBRIEN BUILDERS INC
Districts: SC = School SP = Special Property Addresses): * = Primary
Type Dist # Description " 1356 146TH AVE
SC 3962 NEW RICHMOND
SP 8929 UPPER WILLOW REHAB DIST
SP 1799 WITC
Legal Description: Acres: 2.840 Plat: 09/97 WHITETAIL MEADOWS 926104 LOTS 1130
SEC 23 T39N R18W PT SE NW BEING Block/Condo Bldg: LOT 93
WHITETAIL MEADOWS (104) LOT 3 (2.840AC)
. Tracts): Sec-Twn-Rng 49 114 160114)
23-39N-18W SE NW
i w
Notes: Parcel History:
Date Doc # Vol/Page Type
02/2912004 754739 2513/ 133 WD
01 /02/2944 759596 99197 PLAT
2006 SUMMARY - Bill #: Falr Market Value: ,Assessed with:
9
Valuations:.Last Changed: 06/2912005
1% r
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.849 31,700 9 31,700 NO
Totals for 2006:
General Property 2.849 311704 9 319709
Woodland 0.000 9 9
Totals for 2005:
General Property 2.349 31,709 9 31,799
Woodland 9.000 9 9
Lottery Credit: Claim Count: 4 Certification Date: Batch #:
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
S T. CR IX COUNTY
WISCONSIN
ZONING DEPARTMENT
ST. CROIX COUNTY GOVERNMENT CENTER
of 11 rk 11 V
11 1 Carmichael Road
Hudson, W1, 54016-7710
Phone: (715) 3864680 Fax (715) 386-4686
Front Pam Quinn
Re: Sandy k)am strvcture rnisintWetaticn on subdivision soil reports
Recent soil on -site determinations have broughi a problem to our attention. During these on -
sites, bonngs were excavated to confirm soil conditions where two conflicting soil reports had
d
been submitted for zone dg department review. 7"he soil profiles, evaluated by myself, Dave
Fogerty, and Dave Steel (all certified soil testers) differed from the original soil reports in that
massive (structureless) sandy loams were encountered in hon*zons that were described as having
either moderate, medium subangular blocky (2msbk) structure by Adam Scbumaker or weak,
medium granular structure (Imgr) by Shaun Bird. There apparently has been a
misunderstanding between "'structure"' caused by handling samples of the soil during textufing
versus the soil characten'stics m situ. The soill when chunks were taken out of the profile to hand
texture, with pressure parted into ','crumbs %I that appeared at first to be subangular or gmular in
shape. However, these were not true peds that broke apart along planes of weakness, but
fragments created by handling. The soil when observed in the horizon did not have distinct units
of ILL structure and should have been reported as massiveVp .
Added notation: on 4/23/04 Mark Iverson (Cedar Corp, certified professional soil scientist),
Shaun Bird, and myself did an evaluation of soils on Lots 6 & 9, Richmond Meadows where the
original soil report described the third horizon as sandy loam, "Imgir". Onlot 6wecheeped
soil profiles within a POWTS distribution all and then excavated a test pit on Lot 9. The sandy
barns in question were a weak, coarse to very coame subangular blocky stmcture, where planes
of weakness were just discernible wbeet Peels were parted from the profile. The peds separated
with vqa light pressure by soil tester. Sand coatings were observed on the ped faces in the Lot 9
pails, 1 'ch 0 mov at whsupported. the deter that some structure existed to all w water to e
thj,-ough the upper portion of the sandy loam lien zon, I 10\��cr, below the weak-structuired soil
%ve found massive (structureless) sandy learns and the boundary between these horizons was
irregular, which would. mean a distribution cell could encounter alterrianng weak and massive
sandy loam. Shaun said he would amend his soil reports with a memo recommending that any
sandy loams he i denti fied as ", I m' or ""2 mge"be assigned alower loading rate of 0. 3 gpd/ft2
(see attached memo for'Whitetail Meadows) to provide a larger dispersal am,,
Page Two Soil Memo 4/27/04
• assigned a soil application rate of. 0. #2 with the code
Massive sand barns have been as gn pp �
y
changes iCommn Com83.44-2, effective as of 211104. The application rates listed on the soil reports
were higher clue to the structure having been described as either weak or moderate, which affects
e calculations for sizing of POWTS distribution cells. [obviously, one of the concerns is to
Y
e sure loading rates for the soils are not in error and allow undersized PowTS to be
make �
. For example, in December 2003, Lot 35 of Richmond Meadows subdivision had to
installed. p .
rate reduced to 0.3 s . ft. when the installer encountered massive sandy
have its loading � �
foam at the system elevation. The sandy loam horizon had been described on the soil report as
" 1 mgr" with firm consistence.
Leroy jansky, Dept. of Commerce Regional wastewater Specialist, has been consulted on this
�
. the zonin de artrnent to require on -site verifications for any lots with this
situation and advised � P
' ' tion on the soil reports. All soil reports with sandy loam "l or 2 mgr" as
potential misinterpretation p
its structure will
be uired to use a desi req based on the current code's soil application rate for
sand loam 0.2 s . it. unless additional soil testing proves otherwise.
massive y � � q
0
D e10-- i I
CQo 1K. COUNTY
OWNER ow tc-ntk7... . .. ... .. .......... �: Lv,�4zA r,,�43 tllt........
B"D L di
AND/1-Oxx 3
su-no -""" -I& -r
U)S
D'V1 %J-N
S10A
AUTHORIZED ISSUING OFFICER
. . . . .............. .. .. . . . ....... ... ..... - - --------
.. . ........... . .... .....
...................................
r
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
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 p117
2eZ3
"Ito IIIZP13� U W 1", D B E F U` R E T lux A'I-' D Al
T f I 19 Pr Er. j R M 1, �Tit' E -X - P" h I R ES NLESS REN'"
. ... ... . ...
SBD-06499 (RI 1/20)