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030-2065-90-200
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 Richard & Aimee Case TOWN OF SAINT JOSEPH CST BM Elev: I Insp. BM Elev: BM scription. I I oo TANK INFORMATION - % ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic connbc) �/2_oo Dosing Aeraturr- i TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing An- He+di� PUMP/SIPHON INFORMATION Manufacturer Demand GPM ail 9� , IO cl OIG. Model Number ❑9 c0 TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM County: St. Croix Sanitary Permit No: 651229 State Plan ID No: Parcel Tax No: 030-2065-90-200 Section/Town/Range/Map No: 35.30.20.607A1 STATION BS HI FS ELEV. Benchmark AD Alt. BM J'oP &: FDVODMMAJ or 50 Co*Xv Bldg. Sewer St/Ht Inlet l'2 . a Suiiii Outiet Dt_14et Dt Bottom Header/Man. . co 9$. rjs Dist. Pipe 3.1�5 q�.ss Bot. System Final Grade �14V Cva lI g O 1. CN-ibu?, 5 -y Y? 2.. C.,Iit, ( q 90.q BED/TRENCH DIMENSIONS Width Length 1 �6 No. Of Trenches 1 PIT DIMENSIONS No. Of Pits \�_ Inside Dia. iManufacturer- Liquid Depth SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER OR UNIT Type Of ivstem. &aft A ..30 ?50 ,yo � �1 � Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing �� Pipe(s) ' 1 5 kk I Length 4 Dia - Length 11 Dia Z Spacing vmmmm���2 _ SOIL COVER x Pressure Systems Only x Mound Or At -Grade Systems Only Depth Over Depth Over x Depth of xx Seeded/Sodded Bed/Trench Center Bed/Trench Edges opsoil ❑Yes ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Location: 1243 RIVERVIEW ACRES RD 1.) Alt BM Description = 2.) Bldg sewer length - amount of cover Plan revision Required? ❑ Yes [,K No \\ Use other side for additional information. 1 Date SBD-6710 (R.3/97) Vent to Air Intake xx Mulched J Yes ❑ No Inspection #1: [61,12 � Inspection #2: D.gS X0TTorl FrPE> 1--rwr fib4 top of ,S -J VK. I ' No 6JC.11 -11.5441U lg 4i,,—, cC Insiep is nature Cert. No. t� ►_ Industry Services Division County2OZ u L) 4822 Madison Yards Way ovix . . ...... 0 2023 Madison, WI 53705 Sanitary Permit Number (to be filled in by Co.) . ....... S PS U L P.O. Box 7162 Madison, W1 53707-7162 65' ZZ� ON St. Cr L-alaS-� it AApplication" State Transaction Number - -�r In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit CO. 7,:�O 1 N) W - is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary 17-48 �Wif-C\J li�:Ikr S purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. OF I I Ion " o I I. Application Information - Please Print All Information r if VZ F Ida Pro erty wner's Name Parcel # q0 C,(, 11111% 'it iff 11 030- & Property Owner's _Mailing Address K __.kj - - Jt _*P Property Location 4FV V1!1i!:,W Acll� Govt. Lot City, State Zip Code Phone Number I 'F 4, '/4 —5 E - Section P 11. Type of Building (check all that apply) Lot 4 T D N R 1) E or VI or 2 Family Dwelling - Number of Bedrooms SUbdivision Name Block 4 Public/Commercial - Describe Use ---------- ElCity of E]State Owned - Describe Use CSM Number 7236) EJVillage of Town of Z7 D Doe,' V6S374 MT IH-. Type of POWTS Permit: (Cheek either. "New" or "Replacement" and other applicable on line A. Check one box on line B. Conilflete line C it app, cable.) A* New System Replacement System ther Modification to Existing System (explain) Additional Pretreatment Unit (explain) FjHolding Tank In -Ground Elt-Grade NMound 7 2- ❑ Individual Site Design Other "Type (explain) (conventional) List Previous Permit Number and Date Issued C. E] Renewal Before F'� Rev ision Elcliange of Plumber Elransfer to New Owner Expiration IV. Dispersal/Treatment Area and Tank Information: .A Hy IS U_"� alk 7= Design Flow (gpd) Design Soil Application Rate(gpd/so Dispersal Area Required (so Dispersal Area Proposed (sf) Systen Elevation COVC6U* Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units 40 Q U New Tanks Existing Tanks 0 0 a. U V) (A LZ 5 Septic or Ho1ding_Tank__ L►+7 � � � Dosing Chamber 1 RAN V. Responsibility Statement- I the undersigned, assume rpspolfbility foi- installati POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Si na . e 7/of the MP/MPRS Number Business Phone Number qt.AilA A14.., ' I r\ -714e,-_ q U_ q5y Plumber's Address (Street, City, State, Zip Code) VW VI. County/Department Use Only Permit Fee Date Issued Issuing gent Signature Approved roved C_ =11 5�Reasoii or e 6 T 2 2,0 7,3, Conditions of 62 LEE- a-.' l' Q a a SYSTEM OWNER: Lo <� I. Septic tank, effluent filter and dispersal cell must be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code / ordinances. Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x I I inches in size qlff)_61 QR (R 0301 ) System PLOT PLAN PROJECT Richard Case ADDRESS 1235 Riverview Acres Road Hudson Wi 54016 NE 1/4 SE 1 /4 s 35 /T 30 N/R 20 W TOWN St. Joseph COUNTY ST. CROIX SYSTEM ELEVATION 98.0' DATE E 6/21 /23 BEDROOM 4 CONVENTiONAIJ AT -GRADE CONVENTIONAL, LIFT IIOLDING TANK MOUND �OaC SEPTIC TANK SIZE 1200 gallons LIFT TANK SIZE DOSE TANK sin 801 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 600 # of Chambersnone BENCIIMARK V.R.P. Top of surve iirnn ASSUME ELEVATION 100' Filter Lifetime E]BOREI-10LE WELL * Il . R . P . same as benchmark COPY Riverview Acres Rd Well is to meet all WDNR setbacks 437' Propery Line Wieser Combo flank Area of 15' below system 95.5' Pro 4 Bedroom I Highway 35I House 8% Sloe 3 p 96.5 97' 97.5' B ` 1 Grading is to be done to divert run-off 98.5' B - 2 away from system COPY B.IVI.* � 579' Property Line a ITC9 ART.;, Wisconsin Department of Safety and Professional Services' To.� Division of Industry Services► 4822 Madison Yards Way PO Box 7302fi9;: Madison, W1 53707 4f x,4 July 5, 2023 CONDITIONAL APPROVAL PLAN PROVAL EXPIRES: 2025-7-5 Plan Review: PWTS-072301336-C Shaun Bird 1432 1201h St New Richmond, WI SITE: Case 11235 Riverview Rd St Croix County Town of St Joseph NE % SE % S35 T30N R20W FOR: Description: 4 Bedroom- 600 GPD mound- 26" to restrictive feature- Effluent Filter - Maintenance required. Phone: 608-266-2112 Web: htt p:llds s.wi. ov Email: dsps ji)visconsin.gov Tony Evers, Governor Dan Hereth, Secretary Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE Mound Component Manual —Ver. 2.11 SBD- 10691-P (5/22-5/27) Pressure Distribution Component Manual — Ver. 2.1(May 2022-2027) Verify proper dose is achieved and system is not being over dosed. The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders The site shall be properly prepared prior to plowing. Any grasses longer than 6" shall be cut short and removed. To avoid matting, any leaves or loose organic matter shall be raked up and removed. Cut trees and shrubs flush to the ground and leave stumps. Avoid operating equipment on the Mound site. If necessary, use only tracked equipment, during dry conditions, with minimal passes, to avoid compaction. Components and soil removed from an existing drain field shall be properly disposed of so that there is no risk to public or environmental health. • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec.145.20(2)(d), Wis. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. • A copv of the approved plans, specifications and this letter shall be on -site during construction and o en to inspection by authorized representatives of the Department, which may include local inspectors. Owner Responsibilities The current owner, and each subsequent owner, shall receive a copy of this letter. Owners shall also receive a copy of the appropriate operation and maintenance manual(s) and be responsible for ensuring that POWTS is operated and maintained in accordance with this chapter and the approved management plan under s. SIPS 383.54(1). In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, C.00-*ro�f IT&w4gye Joshua Rowley POWTS Plan Reviewer, Division of Industry Services (715)634-5124 Joshua.rowlev@wisconsin.gov Shaun Bird Bird Plumbing Inc. 1432 120th St, New Richmond Wi 54017 715-246-4516 Date: 06/21 /2023 Owner: Richard Case Cover Page Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES 6 Alua" AW+ SEE CORRESPONDENCE Location; NE114 SE114 S35 T 30 N,R 20W 1235 Riverview Acres Road Hudson Manuals Used: Mound Component Manual version 2.1 (May 2022-27) Pressure Distribution Manual Version 2.1 (May 2022-27) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7. Filter Specifications and cross section 8-9. Maintance and contingency plan Attach me r Shaun Birc Signature License ni Page 1 of 9 System PLOT PLAN PROJECT Richard Case ADDRESS 1235 Riverview Acres Road Hudson Wi 54016 NE 1/4 SE 1 /4 s 35 /T 30 N/R 20 W TOWN St. Joseph COUNTY ST. CROIX SYSTEM ELEVATION 98.0' DATE E 6/21 /23 BEDROOM 4 CONVENTiONAIJ AT -GRADE CONVENTIONAL, LIFT IIOLDING TANK MOUND �OaC SEPTIC TANK SIZE 1200 gallons LIFT TANK SIZE DOSE TANK sin 801 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 600 # of Chambersnone BENCIIMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter Lifetime E]BOREI-10LE WELL * Il . R . P . same as benchmark Riverview Acres Rd Well is to meet all WDNR setbacks 437' Propery Line Wieser Combo flank Area of 15' below system 95.5' Pro 4 Bedroom I Highway 35I House 8% Sloe 3 p 96.5 97' 97.5' B ` 1 Grading is to be done to divert run-off 98.5' B - 2 away from system B.M.* 579' Property Line a ITC9 Mound System Cross Section and. Plan View r w w w w w w �r �r r� w ww. wwr wrr rr • M now w s rrr w 4un w w wr -0 w ww r. UNA j A i I ti I tI E i� i 1 *4 I-* w 1� ..�. rrr w rrr ... •' L Dimension Feet A _ �? - B _ "% S r G ,. $ H J �4� _ L W Z Slone — Topsoil- ASTM C-33 Clean aggregate 4 in. sch. 40 pvc Ca + p Material � � ; : � : sand fi i l � % to 2 % in, die. 0 observation pipe Geotextile G I i Fabric tr - �� -*Z' 1+Ft Contour .11�`��1��L1�1�11`�t11�11ti1111ti.1r11ti%1f _ Plowed Surface "W"ft--- " Slope Direction GENERAL INSTALLATION: The mound area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The mould basal area (L x W) is plowed with a moldboard oi- chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to forma '�� inch soil vvii•c when a sample is roiled between the palms of the hands. ASTNI C-33 quality sand is placed immediately after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks o1• is placed overhead by a backhoe. Special care must be used when piecing sand of less than one foot thickness to minimise compaction. of the lowed surface. After the topsoil cap is placed, the entire mound is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. 'I"he observation pipes are slotted in the lower 6 inches and secured in place with rebar or a closet flange. 1 0107 lgj page of Pressure Lateral Layout Two Laterals — End Manifold Man Force Main ,�1 Pressure System Construction ded kou# 9 rid; Sweep 90 Bend Laterals are constructed of Schedule 40 PVC pipe. Ortflices are drilled perpendicular to the pipe with a sharp drill hit and face down. Lateral turn -ups terminate with a threaded cleanout plug and are enclosed in a 6-8 inch diameter lawn sprinkler valve box accessible from finished grade. Page A—Of�__Y__ 0 0 • 03/05 lg3 Septic,,I)ose'an, Cross Section Andf) urn t 1 'I"arik Mandacturer Tank Model �)-unibcr 1—'aii�kC acity , yMmf.► I3tiry Depth r � a .Mrl.r .. •.K.r+ W�•.r. �rrr• ,11' itter Mealufftcturer-1 ' `l r Model'Number 1 s _...._ a 4- - .I-,,...- ..ram._ ...� Minim = Pump Performance Required �ar�'Mit T Outlet )Aanhole min. 4" Above Grade With Locking De -Mice. Inlet Manhole < 6" Below a4de Sealed Watertight ifi PerfnceSpeccat-1011S pullIp N4Model Number Alarm manufacturer Alarm Model Number Switch Type -"'..�a."a""'• Ir...� . w�r^M'r..►.r"'� � • sw..+w....w w ., Total Dynamic Head (,rDH) -- Feet Elcytition head /74 I- . DictaPressure Network. Doss Force Mahn Loss Total ccu�dly M01111ted Weather-proof Junction Box Vent Min. i 2"' Above Grade With Vent C ai) Manhole.Min. 4" Above grade With Locking Device ;E Disconnect Means Oki Outlet Filter +� •1/Y Y'Y NetBaffle r 9+1± f4& ► ► ►tl ►II�r, 111 la11r /r111' B Off' Elevation C, ►Isar ram' +►a• • • j t: ti,/ , rt a' a' >r►#► 4�S� ►11 r 11a► ,►a� ►fir{t (y1' +11r► 1,1 ► • .ar1►Ir.►t►'►a1{1a►+1a►11 t►�r i►t► ► 1 + ► ! 1 i y s l r • "!'" "f" c_r" i'.�"T'tiF;!;T"' 4 r;"w.t•'i t'�.' 1 T: 1 t ► � t r t+ c c a 1 t 1 ► c c E c c e c.1 1 t a r c a t I T44 a t e t a 4 t t r l l t 1< i r r 1 r'.'1"1 I. c a • i 1! t o r a a r r a e l a c .. r a 1• I r c a a r I r 1 r. t 1 1 i s r• ► 1. • I+ 1 1 1. ► i r►► e 1 1 ►►>►► 1►1► r>► r s> r 1 r/ i 1 r s 1 r 1 1 i Y 1 ►► 1 1 1 1 ► r 1 i•1 / 1} 1 1 11► r r► ► r t r.► r ►•► r I r r r y r r +• . a t 1 t 1 a a, a 1 t a t a a a t t. a 1 1 r a 1 1 a♦ a a a 1 a r t r 1 1 1 a a... a. a at 1 a r r 1 t• I I t t 1♦t t! 1 i r 1 1! I a t 1 i!! f t l a t t�1LLL LL 1 1L�lti i �� t _a_t x�1_LJa _�-.#.-� x� y ; "L ,1 i . t Y . 1 + L, }►ice_• ! x.l_1.1 • a + : _t i_ 1_t..L,l,L_L�L..LL Za.l.. .L 1 1 l Weep Hole Bottom (-I'ENE tAL INSTALLATION: Tho septic/dose tar)k is budded and back filled in accordance with the manufact i-or's product approval specifications, Maximum depth of bury as specified by the manufacturer may not be exceet,'led without prior Approval. Manhole covers exposed to grade have an effective lacking devices (padlock) installed, Piping fit the inlet and *Outlet'is of approved material, connneeted to tho tank with watertight fittings, and laid on st, blsail to prevent settling or sagging. The force inain is sleeved with 4" Sch. 40 11VC to bridge the tank exc;aviltical A'id the sleeve is sealed watertight. 'Electrictil sorviee complies with NEE 300 and Comm 16.28. Page off 290-SERIES 3/4 hp Submersible EffluentlSump Pumps The Liberty 290 series provides a cost effective "mid- range" pump for on -site waste water systems, liquid waste transfer and commercial heavy-duty sump pump applications that require higher head or more flow. Designed around Liberty's unique "Uni-Body" casting, the 290-Series will provide years of reliable performance. All Models Feature: • Semi -Open impeller permitting passage of solids up to V, • 416 stainless steel rotor shaft . Permanently lubricated upper and lower ball bearing Epoxy powder coat finish • All fasteners -- corrosion -resistant stainless steel • 1 %" Discharge • Stainless steel bottom screen -- easily removable • Maximum fluid temperature:140° F. • 290-Series Cord Lengths Model 10' 25' (-2) 35' (-3) 50' 0L 290 Standard Optional Optional Optional 291 Standard Optional Optional Optional 293 Standard Optional Optional N/A . 297 Standard Optional N/A N/A 10' cord length standard on all models. For optional lengths, add "-2, -3 or -5" suffix to model number. Example: for model 290 with 36' card. Order 290-3 Motor Specifidations '/, hp 60 Hz 3450 RPM Oil filled, thermally protected 115 V. Models 10.4 amps 208/230 V. Models 5.3 amps Performance Curve: 290-Series 60 as 40 35 30 25 = 20 1s 10 16 12 9 = 3 0 1 i i 0 0 10 20 30 40 y2 50 60 70 80 90 Flow (GPM) F--�-- 38 76 114 161 189, 227 265 303 341 Liters Per Minute Dimensional Data: Weight: 31 lbs. Height 13" Major Width: 10" (model 297) Minimum Sump Diameters: Model 291, 293...14" Model 297 VNIF... 10" Factory switch Model 291, 293 Model 297 I settings VMF Turn on level 13" 9.5" Tum off level 711 4.091 The Model 293 features a fully adjustable wide-angle float. Differential adjustments can be made easily by tethering tho float to the discharge pipe or other mounting point. Vertical float model 297 is not adjustable. Model 290 Model 291 Model 293 Manual, Wide angle Wide angle no switch float switch float switch with quick- with series disconnect (piggy -back) plug MSMaaR � o Cus c Certified specifications sre subject to change without notice. 6 Model 297 VMF-Series Vertical mag- netic float for smaller pits - will operate in a 10" diameter sump Uberty Pumps • 7000 Apple Thee Avenue • Bergen, New York 14416,9 Phone 844-543-255Fax (585) 494-1839 www.11bertypumps.com Copyright ® Liberty Pumps, Inc. 2011 All rinhta rAaeanosbrl I i IT AAA1 Rng111 2 f A A Is -j- '--; 11 lZ4S2M A .CIGap between Case and SerPent;ne V 0 SfECTION A -A . . . ......... .... )DO 9.1 1.1921 59 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner zi I Septic Tank Capacity 0 NA Permit # gal Septic Tank Manufacturer 0 NA �)ESIGN PARAMETERS Effluent Filter Manufacturer 0 NA Number of Bedrooms 0 NA I Effluent Filter Model 0 NA Number of Public Facility Units OA 'Pump Tank Capacity 0 NA j Estimated flow (average) Pump Tank Manufacturer 0 NA I Design flow (peak), (Estimated x 1.5) _2al/day gal/ Wu day Pump Manufacturer El NA Soil Application Rate gal/day)ft� PUMP Model 0 NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit _ %NA 7 Fats, Oil &Grease (FOG) -,4;30 mg/L 0 Sand/Gravel Filter C] Peat Filter Biochemical Oxygen Demand (BOD5) :5220 rng/L 1:1 NA 0 Mechanical Aeration 0 Wetland Total Suspended Solids (TSS) �l 50 mg/L 1:1 Disinfection 0 Other: !Pretreated Effluent Quality Monthly average Dispersal Cell(s) 0 NA Biochemical Oxygen Demand (BODs) s30 mg/L 0 In -Ground (gravity) 0 In -Ground (pressurized) Total Suspended Solids (TSS) :530 mg/L NA 11 At -Grade *Mound Fecal Coliform (geometric mean) .� 104 CfU/1 OOM I 0 Drip -Line 0 Other, Maximum Effluent Particle Slze in dia. 0 NA Other: C O C1 NA -10ther'. 11 NA Other: F El NA *Values typical for domestic wastewater and septic tank effluent. Other* [I NA MAINTENANCE SCHEDULE Service Event Service Frequency linspect condition of tank(s) At least once every: 0 month(s) (Maximum 3 years) `Vyear� 0 NA JPump out contents of tank(s) When combined sludge and scum equals one-third (X) of tank v6lume 0 NA Ilnspect dispersal cell(s) At least once every: El months} (Maximum 3 years) 7�) X years) 0 NA 1'.N.#Iean effluent filter -1 At least once every: — C1 month(s) VYear(s) 0 NA Inspect pump, pump controls & alarm At least once every: 0 Ymonth(s) *Year(s) 0 NA 1::Iush laterals and pressure test -5ther: At least once every: 0 month(s) 0 year(s) 0 NA -6ther: At least once every: 0 month(s) 0 year(s) 13 NA --7— EJ NA MAINTENANCE INSTRUCTIONS lInspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master !Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must linclude a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of i0ombined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. 'rhe ponding of effluent on the ground surface may Indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (X) or more of the tank volume, the entire contents of (:he tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, lend any servicing at Intervals of !02 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page _�_....� Of I ATION or other chemicals tht.'J START UP AND OPER titi® P0VV7S check treatment tanX(s) for the presenCe of painting products For new cunstructlon, prior to use Of If high concef1tration5 are detected have the contents of th P may impede the treatalelit process and/or damage the dispersal cell(s). tank(6) removed by 3 SePtsge servicing operator prior to LISID. System start upshall not occur when soil condItions are, frozen at the infiltrative surface. I d the excess wastewater will b�a ,-nay fill above normal highwater levels. When power 18 restore During power outages pump tanks It In the backup or surface discharge of affluen't. discharged to the dispersal cell(s) In one large dose, overloading the cell(S) and may result prior to restoring power to th�je k removed by a Septage Servicing operator p is To avoid tills situation have the contents of the pump tan operating the plimp controls to restore normal 19VO4 effluent pump or contact a plumber or POVVTS Maintainer to assist In manually within the pump tank. or otherwise disturb or compact, the area within Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park Over, mound or at -grade soil absorption area. 15 feet down slope of any m erformance and prolong the life of the POWT,'I:) elimination of the followIng from the wastewater stream wary improve the p Reduction or ondomr.; cotton swabs: deareasers; dental flo3s) diapers; disinfectants; fat; foundation drtaJr I edicaflom oil; painting produc-11S antibiotics; baby w1pes; cigarette butts* c herbicides; meat scraps; nn (sul.np pump) water; fruit and vegetable peelings; gasoline; grease pesticides; sanitary napkins; tarnpons; and water softener brine. ABANDONMENT ntly taken out of service the following steps shall be taken to insure that the systern Is prop(, When the POWTS falls and/or Is permane nsin AdmInistrative Code' and safely abandoned In Compliance with chapter` Comm 83.33, WiscO • 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. 0 After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with F101 gravel or another inert solid material. CONTINGENCY PLAN to provide a code compl,"'.111 If the POVVTS falls and cannot be repaired the following measures have been, or must bo taken, replacement system: or the location of a replacement soil absorption syste-,�r 0 A suitable replacement area has been evaluated and may be utilized f Id not be Infringed upon by requitIE The replacement area should be protected from disturbance and compactlon and shou sod struCtUre, lot lines and wells. Failure to protect the replacement area will result In then c setbacks from existing and propo %I for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rule,,' effect at that time. 11 11mitations. Barring advances In p0VVTS technolooll 0 A suitable replacement area Is not available due to setback and/or so holding tank may be Installed as a last resort to replace the failed POWTS. 11 tailure of the POVVTS a soil and site evalulf A I J The site has not been evaluated,to Identify a suitable replacement area. Upon a tiolding tank may be installedi must be performed to locate a suitable replacernellt area. if ric replacement area 'is available a last resort to replace the failed POWTS. following removal of the blornat at the infiltra-11 Mound and at -grade soil absorpti011 systems may be reconstructed in place surface, Reconstructions of such systems must comply with the rules In effect at that tinle. <<WARNING>> AY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO Nfl SEPTIC, PUMP AND OTHER TREATMENT TANKS M DER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE Oi- ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UN PERSON FROM THE OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. E I ADDITIONAL COMMENTS POWTS MAI NT R POWTS INSTALLER 1 Name _ Phone C- Name 4 It A A qe 0 Phone LOCAL REGULATORY AUTHORITY SEPTAGE SERVICING OPERATOE.IPLIMPER A I Narne a =rn Name 7, 5 4r, 10 Phone Phone .22(2)(b)(1)(d)&(o and 383.54(1), (2) & (3), Wisconsln Adminic.;trative Code. This docurnent was drafted in compliance with chapter SPS 383 ST CRo Tv. SANITARY SYSTEM OWNERSHIP/ADDRESS FORM File #: Office Use Only Creamed 212021 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. RJBUYER INFORMATI N Owner/Buyer '(A 71- --i& (�f� - Mailing Address �I&C City/State/Zip U Phone Number (required) Z Email Address (required) emol,hOM4.413 iftL,'CQM Parcel Identification Number " �- (found on the property tax bill) N=E : :S "STEM "LEGAL _�S"CRIPTI�O:N- Property Location 1/4 C5E 1/a, Sec. T N R W, Town of � Subdivision Plat: , Lot # Certified SurveyMa #XV Volume ---� , Page #t ---- p Warrant Deed # 17before 2006 Volurne _ Page # Y f ) 9 Number of bedrooms Spec house ❑ yes tXno Lot lines identifiable yes 13 no "ILY' .lit - - ... CE-?U - Q-1 W New Property Address —'.1W ! v ' +� . • (Verification of new address required from Community Development Departme t for new construction,) 17 2 �.� 20 (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 made in the warranty deed. Community Development Department -- Land Use Division 715-386-4680 St. Croix County Government Center 71 5-245-4250 Fax cdd@sccwi,aov 1101 Carmichael Road, Hudson, WI 54016 www.scG STATE BAR OF WISCONSIN FORM 7- 2000 TRUSTEE'S DEED Document Number Kenneth. J. Anderson and Kathleen M. Strom., co -successor trustees of The Elizabeth A. Anderson Revocable Trust Dated January 17, 2006, for a valuable consideration conveys without warranty to Richard F. Case and Aimee Lynn Case, Husband and wife as survivorship marital property, Grantee, the following described real estate in St. Croix County, State of Wisconsin: SEE ATTACHED EXHIBIT A Dated this day of May, 2023. Trustee AUTHENTICATION Signature(s) authenticated this TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Lamy S. Mountain, Attorney at Law (Signatures may be authenticated or acknowledged. Both are not necessary.) `Names of persons signing in any capacity trust be typed or printed below their signature TRUSTEE'S DEED St. Croix County 1166687 Page 1 of 3 1166687 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 05/12/2023 11:36 AM EXEMPT#: REC FEE 30.00 TRANS FEE 749.70 PAGES: 3 **The above recording information verifies that this document has been electronically recorded & returned to the submitter � Recording Area Name and Return Address: Land Title Inc. 2200 W County Road C, Suite 2205 Roseville, MN 55113 9675818 all of #030-2065-90-200 and part of #030-2065-90-000 Parcel Identification Number (PIN) 411 *-"'Kathleen M. Strom Trustee ACKNOWLEDGMENT STATE OF S0 Ldlt - } _ Oco _ COUNTY ss. Personally came before me this (54' ` day of May _ , 2023 the above named Kathleen M. Strom, co -successor trustee of The Elizabeth A. Anderson Revocable Trust Dated January 17, 2006 to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. PA, *Print tTy Name:&Q-&�-h-b 1111A&S: Notary Public, State ofCM, ( t }qtL, 1V y commission is permanent. (If not, state expiration date: MEGAN E. CHAVIS Notary Public, State of South Carolina STATE BAR OF WISCO SIN MY Commission ExplreSVo No. 7-2004 March 1 4, 2033 Page 2 of 3 11 In Grantor',," Kenneth J. Anderson, Trustee State of ,County of This instrument was acknowledged before me on day of May, 2023 , by Kenneth J. Anderson, co -successor trustee, of The Elizabeth A. Anderson Revocable Trust dated January 17, 2006. (Stamp) [Trustees Deed] St. Croix County 1166687 Page 2 of 3 LT File No. 675818 EXHIBIT A Parcel 1: Lot One (1) of Certified Survey Map recorded in Volume 32 of Certified Survey Maps, page 7230 in the office of the Register of Deeds for St. Croix County as Document No. 1165374, Town of St. Joseph, St. Croix County, Wisconsin. Parcel 2: A non-exclusive and perpetual easement for ingress, egress and regress purposes, appurtenant to Parcel 11 as established by the instrument recorded in Vol. 412, Page 473 as Document Number 279882 and in Vol. 445, P. 7 as Document Number 293374, over the following described area: A 66 foot ROAD EASEMENT located in the East Half (E %x) of the Southeast Quarter (SE %) of Section 35, Township 30 N, Range 20 W, St. Joseph Township, St. Croix County, Wisconsin, being 33 ft. on each side of the following described centerline: Commence at the stone monument located at the SE. corner of Sec. 35, T30N, R20W, St. Joseph Twp., St. Croix County, Wisconsin; thence North along the East line of said Sec. 35 for 817.88 ft. to the point of beginning of this centerline description; thence by a deflection angle to the left, 940 01% bearing of S. 85" 59' W. for 213.54 ft.; thence on a curve to the left, central angle of 27' 15', radius of 410.47 ft., for a distance of 198.76 ft.; thence on a curve to the right, central angle of 810 39', radius of 120.69 ft., for a distance of 171.96 ft.; thence N. 40° 07' W. for 155.58 ft.; thence N. 530 34' 56" W. for 372.77 ft.; thence on a curve to the right, central angle of 79° 39' 56", radius of 209.8 ft., for a distance of 349.7 ft.; thence N. 26° 05' E. for 172.8 ft.; thence on a curve to the left, central angle of 240 50', radius of 1362.6 ft., for a distance of 590.5 ft.; thence N. 10 15" E. for 484.6 ft. to its intersection with the East & West quarter line of said Sec. 35, being the centerline of Wisconsin Highway No. 35, also being the end of this 66 foot ROAD Easement. St. Croix County 1166687 Page 3 of 3 ONE MEMO MEN IWWI�AS 8 1 a 0 a imam mul. -rm 041 .016901hem is 441 FAW, NA 14P. cy 11 1 a$ .PIN ill I mo," 0101,7001 .62.12 1., Mum X-0 a ov , *1 - wool 46 ou onamemes N.N.-K, V81-vo■ l 11 FW, ." ME an mallass It ,ME ISM -FrIE l"goo me I I p 5-1-04-M-EM R.K. 4-1 1 goal 1 0. 1 a 1 11-0. PINES C Mai Im— ta of is is all mail logo 1" mamaF. tti�No MIMI] I.? P-4415 A �ZZZZZZZZZSl 0, ro N. 1 7� av low IYAM '01 Ga. it he is 41Wp.IP, No1(t 1 IN .0I 083 $4mIo m ,f 7 mmI%dlr wool low A1 soot. ttw■t I- son some I rIN, ME WR i F11rr on US Eft, vul".6hill'.11 u j Igo 711111 son vinighm, -i ■-g 11, MINI P. & a jff on aqw. '. .0 in j a- 65-01 11 . ; 49 1. I oil 1141111i .1 leall m . S ;.... ae Its so 4 0 0 %W. WIT. "Jal soinaimpoin, wa— ■mals, We lain r 0 ! I I R. W I R v I I IN 1 04 Am 'vial lialsoolo. 4119011111 a 0 a is maimminalmaimalas 00 110111111 loop ---I 1 9 will I t IN I . . , I . "m ■19 gm- I.P.P b tt WVL MINI 6 I I a 0, a I SO, 'i xg .1 Zro PON Loo— I 14 1 11 17 - , 0 CASE RESIDENCE — — --- �� *PM�a:• w D.FP. PLANNING aDESIGN MMMKoo ofty f'7«I. r.7! •k �r•11 a,, x< ■.�•r.+r s• wr a..t ar w.K r x... +!• rrr 4rR1� ! YN rf„�.N sir �1Y NOOM I DNNNV1d dp --A) V-4- kI 7. z ti- i ! � � WSHOOM 1i1 9 W � l 1 � j-;cl; , !� C() csp :m m us 1]ftm %mv "WWI I ONONVId cr:ra L E "No *Per" ilium "NMGW"4F*L. . U0 . 7�= L I.A jUN 2 3 2023 Wisconsin Depwimet of Commerce SOIL LVA SAT REPORT - -.VKL L Page of �j i FO-X 0U11tY Division of Satety and Bujidings;',- - , 1 C-5 T- �--or-nrnunl"l-y De Comm 85, Wis. Adm. Code f Countr5 Attach complete site plan on paper not less than 8 Irz. x 1 inches in size. Plan must include, but not limited to, vertical and horizontal reference point (BW direction and Parcei I.D. percent slope, scale or dimensions, north arrow, and location and distance tc nearest road. Please print all information, Reviewed by Date c7�2fz Personal infofmation you provide may be used for Secondary purposes (Privacy Law, a. 15-04 (1) (m)) 1 z 2 Property Ovmer Property Location IL Govt. Lot 1/4 1/4 S3 T N R E (or(W 0 )) Property Ownees Mailing Address Lot # Block # Subd. Nam or CSNW City State Zip Code Phone Number 1-8v CD city 0 Village 10 Nearest Road i 9LNew Construction tu, s e Residential I Number of bedrooms 4/ Code derived design flow rate GPD Replacement blic or DT commerdall - !cribe: � _^ ____- -- - _ _z�__ Parent material /11 � cL r_ eS Flood Plain elevation if applicabie General oornments and recomirnendations: System Elevation �-- System Type Boni ng # [] Boring rGround surface ele Depth to limiting factor Pit I Rnil Annifiratim Ratp- Hortzon Depth in. Dominant Color: Munseff Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff Eff#1 *Eff#2 9-5 / Z6 X/ 7 d-, [] Boring .0-� - Bart # ? pit Ground surface elev. ft. Depth to limiting factor in. I Soil Annfination Rate I Horizon Depth in. Dominant Color Munsell Redox Description Qu, Sz. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/fF *Eff#1 *Eff#2 101�50 r F Effluent #1 = BOD. > 30 < 220 mQ& and TSS >30 < 150b a Effluent #2 = BOD. < 30 mg& and TS5 < 30 nVtL CST Name (Please Print) ure CST Number Zo� Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, Wl 54017 715-246-4516 Property Owner _ FEkxing # -a I [] Boring 91 Pit Parcel ID # Ground surface elev. ✓ ft. Depth to limiting factor in. Page :-�, of / Sod Application Rmsk 60-MAUMMINS21111111I111�s�k�l1l�l:������ M 1,, W illi' I Boriry # Q Ong Pit Ground surface eiev. ff. Depth to iiffiff g factor in. Soi! Aoaiication Rate Oil M:tr M. Eft #1 = BW6 > 30 c M ffv& and TSS >30 c M ffV& t Eftwit #2 = BOD5130 ffV& and TSS < 30 nV& The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-31 S 1 or TTY 608-264-8777. SBD4U3O OUM) Project Name Richard Case Soil. Test Plot Pla 'I S S it Bird 1AUUre55 Pix/orxiiam/ Ar-rinc Pnnri lI, , -- Hudson Wi 54016 Lot 1 Subdivision ------ NE 1/4 SE 1/4S 35 T 30 N/1320 W F Boring 0 Well 111, Property Line B.N1 or VR13 Assume Elevation 100 ft System Elevation 98.0' Scale = 1/4 11 - 10 XSTM #226900 D e 6/21/23 Township St. Joseph County ST. CROIX Top of survey iron * H R pSame as Benchmark Wsoonsin Department of Commerce SOIL EVALUATION REPORT Page � of Division of Safely and Buildings in accordance with Comm 85, Ifs. Adm. Code L Count t � Attach oomplete site plan on paper not lass than 8112 x 11 inches in size. Plan must Indude, but not limed to: vertical and horizontal reteren©e point (SM), direction and Parcel I.D. ' �,,, �. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. �.� "' p� � � 901) Please print all Information. Reviewed by Date Pell infomslion you provide may be used foe secondary purposes (Privsq Law, s.15.04 (1) (m)l. Property Oymer Property Location 0 e&'� e...' - IGovt. Lot 1/4 r 1/4 S T,3O N RZQE (or W Property �s dManfMauIddress Lot # Bock # Subd. Name or CSNW t j P 3 r.�A3 .� 72 ioeocji State Zip Code Phone Number ❑ City 0 Village 91 T - Nearest Road AV c4j; (rti 'ex'] i c� Con$btxcion Use. Residential ! Number of bedrooms Code derived design flow rate GPO [I Replacement blic or commercial - Describe: _�.........�...—_._ �_._.-..._...�.r..._...�.._._---...-..._._..--,.._. Parent materiel Flood Plain elevation If applicable ft. General conwrats and worm nendaMm: �� n System Type- System Elevet • soling IE # s9 r Pit Ground surface elev j ° R. Dept# to HmMng factor �L in. Soil Anoiir.aion Rate MEN Redox Description Qu. Sz. Cont. Color NrA a, W-18 M'' � # Boring ,.� Pit Ground surface elev. '4 > ft. Depth to limiting favor in, Ani1 Aneiimtian Rita TIM �►r}.71G�11/.11i�0�!v:�,l�lJ/�7�CRimm� OR�d►1.�117Ll�� R�ll�/4'/7r7.1JliJ�lTi7 �F�►Isil�illJ�l�1/..�C.��..�/a7;��J1J'�J1�DLa'�" Eft" #1 ■ SOD. > 30 5 220 mg& end TSS )1-30,1 150fiart` Effluent #2 = SOD,:! 3o mg2 ano -i tiz, j ;xu nviL CST [Name (Please Print) ure CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address - Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, W1 54017 , , '�,,?, 715-246-4516 no Page Of Property 0VMer Parcel ID Boring # Boring L L Q pit Ground surface elev. I I % Depth to firnifirin farinr LJanM To, Jimilinn t.%r4r%r Boring # Boring Ground surface elev. Depth to limiting factor In. Pth DoSoil Application Rate Ho 'Mon le rninant Color Redox Descripbon. Texture Structure Consistence Boundary Roots GPD/tf in. MunseH Qu. Sz. Cont. Color Gr, Sz. Sh. *Eff#1 *Eff#2 Effluent #1 = SOD6 > 30 M< 220 Mg/L and TSS >30 < 150 MgA • Effluent #2 = BODO 130 mg/L and TSS < 30 nYA The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-9330 (R.6=) Soil Test Plot Ply Project Name Richard Case S Address 1235 Riverview Acres Road Hudson Wi 54016 Lot 1 Subdivision ------ NE 1 /4 SE 1 /4S 35 T 30 N/1120 III [� Boring 0 Well PL Property Line BM or YU Assume Elevation 100 ft. q Bird STM #226900 D� e 6/21 /23 Township St. Joseph County ST. CROIX Top of survey iron System Elevation y0•UI *HRPSame as t3encnmarK Scale = 1/4" = 10' Riverview Acres Rd 437' Propery Line Highway 35 95.5' 8% Sloe B ~ p 3 98.5 97.5' 98.5' B - 2 B.M.* 579' Property Line 1165374 BETH PABST REGISTER OF DEEDS CERTIFIED SURVEY MAP ST. CROIX CO., WI RECEIVED FOR RECORD LOCATED IN PART OF THE NORTHEAST QUARTER OF THE SOUTHEAST 04/03/2023 01:38 PM QUARTER OF SECTION 35, TOWNSHIP 30 NORTH, RANGE 20 WEST, CERTIFIED SURVEY MAP TOWN OF ST. JOSEPH., ST. CROIX COUNTY., WISCONSIN; VOLUME: 32 INCLUDING LOT I OF THE CERTIFIED SURVEY MAP RECORDED IN PAGE: 7230 VOLUME 7, PAGE 2058 AS DOCUMENT NUMBER 444311. REC FEE: 30.00 PAGES: 2 Ln Z-11 LEOEND PREPARED FOR: 0 L-jo FOUND COUNTY SECTION CORNER; ELIZABETH A. ANDERSON REVOCABLE TRUST ALUMINUM CAPPED MONUMENT KATHY STROM 0 LL. 1014 McLELLAND STREET SOUTH lzr 0 FOUND 1-1/4 INCH OUTSIDE DIAMETER IRON PIPE MAPLEWOOD, MN 55119 Ln Uj 0 SET I INCH OUTSIDE DIAMETER BY 18 INCH LONG SURVEYOR: IRON PIPE, WEIGHING 1.13 LBS. PER LINEAR FOOT DOUGLAS J. ZAHLER 0 co T-4 AUTH CONSULTING & ASSOC. Uj z 0 wl rn (NO3 -4256 "E) PREVIOUSLY RECORDED INFORMATION 2920 ENLOE STREET SUITE 101 Z:) ED < HUDSON, WI 54016 cz) cc Ln a LnFIELD WORK COMPLETED: 11/30/202-2= 0 NOTICE m C FURTHER DIVISION OF THIS LOT RESULTING IN ADDITIONAL SCALE: I INCH = 150 FEET BUILDABLE PARCELS WILL REQUIRE THE APPROVAL OF THE NORTH TOWN OF ST. JOSEPH AND MAY REQUIRE THE UPGRADE OF ISO 75 0 150 ACCESS ROADS OR ASSESSMENTS FOR THE FUTURE UPGRADE OF ACCESS ROADS. UNPLATTED LAND EAST 114 CORNER--` STATE TRUNK HIGHWAY Z 35 r SECTION 35 1 (SB9045'02"E 423.05') LU __j :z cn N89028"17"E 423.07 i_ 'IT c� < t I J _-_j : 331 -33' LOT I VO L. 7 PG. 2058 DOC. NO. 444311 CD Irl n LOT I Lwl 214,229 SQ. FT. 01 1 %�::b 11 cc 11 4.918 ACRES ---SHARED DRIVEWAY EASEMENT cc I RECORDED ON SEPARATE DOCUMENT Lai I ill 1 �__ei SEE DETAIL ON SHEET 1 (SHOWN FOR REFERENCE) CL_ cc 710 0 p SHARED DRIVEWAY EASEMENT DETAIL NOT TO SCALE ",,goo 66. 0o, C.-) m Q) gs f'N of c>0 cn Ln Ln CD Lq Ln cn f"N U:3 C) a kc� UD zz Ln Ln nj cm l C:) I00 - -cn 01 Ln G) Ks" . 0 V6- p -vzo IRON FOUND S77'28'12"E 0.35' 11 1 r-mum LOTCORNEROF C� , rin Ic A_�Z_ d' 4 DOUGLAS J. ba Ui ZA14LER ell'i S-2 145 j o UDS IL U vrj 121 �O/ 22 SE CORNER SECTION 35 THIS INSTRUMENT WAS DRAFTED BY. JLV JOB NO. 8104-002 DATE. DECEMUER 30, 2022, REVISED 02123123 SHEET I OF 2 St. Croix County 1165374 Page 1 of 2 ?)-�Z- 7a3 o �6r-v U Nk 0 Df 4--- rod UouNxMilroxv No. 6122, ....... ......... ...... .... ..... . . . . .... .. . ..... . . . .. . . . . . . . . ... ................... t ... Eii�TSF�?Q/1_�LI�LWAZPREVIOUS NO. -4f M6C Cos CVV PLUMBER �n,4un! gtR.� LIC.# 22b96 0 TOWN OF 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 the permit, please contact the county authority. - DATE :?'-21�jZQZ3 IF T T111S Z.025, U N L -T"-Jld S S R E N 11 E' J W E "" B"VE j - f � R E T -11 A'I-' ITJ% A T r-E j SBD-06499 (RI 1/20)