Loading...
HomeMy WebLinkAbout006-1035-20-050 St. Croix County Planning and Zoning Wednesday, March 28, 2007 at 11:32:48 AM Detail Sanitary Information Page 1 of I Computer #: 006 - 1035 -20 -050 Sub /Plat: >35 acres Section: 16 Parcel #: 16.31.16.240A Lot: TN /RNG: T31 N R16W Municipality: Cylon, Town of CSM: 1/4 1/4: SW 1/4 SW 1/4 Owner: Johnson, Jeffrey &Tina 2111 220th St Deer Park, WI 54007 State Permit: 453195 Issued: 05/12/2004 POWTS Dispersal: Mound 24" or more suitable soi Permit: New County Permit: 0 Installed: 07/22/2004 POWTS Detail: NA Bedrooms: 3 WI Fund: POWTS Pretreatment: NA N otes Issuer /Inspector As Built Plumber Other Requirements Additional Notes Money Owed Not determined NA Powers, Calvin this new system is on the remaining 37 acres after $0.00 Kevin Grabau ,Sim. ne:: Off Yes the owners split off the original house on 2.96 acres (2204 210th Ave.) in a CSM approved in April 2004 Maintenance Scheduled Pump Date Pumped 1st Notification 2nd Notification 3rd Notification 7/22/2007 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County St. Croix Safety and Building Division Y INSPECTION REPORT Sanitary Permit No: 453195 0 GENERAL INFORMATION (ATTACH TO f ERMF) tate Plan ID No: �J Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 4p 3 / =T -C . /A ?�' Permit Holder's Name: City Village X Township Parcel Tax No: Johnson, Jeffrey C Ion Township r « _ 1777 CST BM Elev: / Insp. BM Elev: BM Description: Section/Town /Range /Map No: (�9 • O fop , tTt t re CST Ao 100 4) / 16.31.16. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ' • \ � I / Benchmark 1 Dosing \.Jv y _ / t Alt. B r /1 Aeration Bldg. Sewer Holding St/Ht Inlet 2c) TANK ETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic , 5h I �5 i Z 1 Dt Bottom �. �� / Dosing ... 3 2 t Header /Man. A - Aeration Dist. Pipe Holding Bot. System Q I-D I O / Final Grade ,t PUMP /SIPHON INFORMATIONS at ►x 12+ 00 Manufacturer Demand St Cover c It'lak GPM Model Number t,*-o31 L �2.� a ��' 6 & O'• O TDH Lift ' Friction Loss System Head TDH Ft Q� T I t .� oi,o'' 210 to. To . ( jw. (p•� 1�•`fb W. o O rcemain Length t Dist. to Well Dia. ~ `� 2 " � SOIL ABSORPTION SYSTEM t -z �1 ! • q . 9S'� = g9.99 BED )rAGw" Width Length No. Of 4e LLDIMENSIONS Of Pits Inside Dia. Liquid Depth ENSIONS ( Gin f cL;�6 SETBACK SYSTEM TO O � P/L JBLDG WELL LAKE /STREAM LEACHIN Manuf ! er: INFORMATION Type Of System: r > f 5b CHAMBER OR UNIT umber: DISTRIBUTION SYSTEM Header /Manifold Distribution �� % x Hole Size x Hole Spacing Vent to Air Intake r fl Pipe(s) \ ( 3 , 0 ) // Length '3 ' 0 Dia 2 Length Qa • Dia Spacing 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 J No 1 C COM ' M�NT M $� (Include cod is epe cie�s, person p resent, etc.) s # % I pection #2 ��JJ� t�' Okspac w► �►• • '1e*.rK— p to � — Location: 2111 220th St Unkno SW 1/4 16 T31 RI 6W) NA Lot arcel No: 16.31. 6. � 1.) Alt BM Description 2.) Bldg sewer length = 1 - amount of cover = 3� 3.) Contour S .L w�L( 6 M_t CSClp � -- r — - Use other side for tional in YesNo an revision Re uire ? � I t� form ton. Bate \ Insepct4ignatu�re Cert. No. SBD -6710 (R.3/97) Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 IS- ` isconsin Madison, WI 53707 - Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 266 -361 ' 4531 15- Sanitary Permit Application sta Pan . D. In accord with Comm 83.21, Wis. Adm. Code, per so j ( 1 9'4 - I EA.JS. ( may be used for secondary purposes Privacy Law, Project Address (if differeni than mailing address) I. Application Information - Please Print All Informatio i MAY 0 4 2004 Property Owner's Na me Parcel # t# B IQck # ;kuln i,Uuiv J �r� 0JN_ ZONING OFFICE Property Owner's M ail' Address Property Location ` �k, 1 A,Section City, State n Zip Code Phone Number (circle one) T N; R I to E or W II. Type of Building (check all that apply) S V! - iVisien-Name Q911 Nuffibef- 0 1 or 2 Family Dwelling - Number of Bedrooms J owls. ❑ Public /Commercial - Describe Use _ tS� ,O 35 + Oz t %- ,,,tJ 37 .0 95 El State Owned - Describe Use G , )( V 6- Z- ' v,.r -" ❑City_ ❑Village `Township of p = of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) 'A. New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑Permit Renewal El Permit Revision El Change of ' ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. T ype of POWTS System: (Check all that a 1 ) ❑ Non - Pressurized In- Ground N Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Ai -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatmgmt Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) gigpe rsal rea Proposed (sf) System Elevation 4 480 /D VI. TaAk Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic Holding Tank v 000 Aerobic Treatment Unit Dosing Chamber Cc VII. Responsibility Statement- I, the undersigned, as ` `e`r sponsibitity for ins ' n of the POWTS shown on the attached plans. Plumber's Na me rent) Plot is Si gnatitre /MP Number Business Phone Number ,�� t 4t, .�. Plumber's Addre ss (Street, City, State, Zip Code) A ' I %D9 I d c, � "' A u2 1V .Qtu (ADZ VIII. County/Department Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued ss . g Agent Si re (No Stamps) Surcharge Fee) ❑ Owner Given Reason for Denial IX. Conditions A rov al SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced I maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) r t-e J G h r1S c Sim C l S J i J� � to tO /000AC"o s -,e i-� itr z ""IZ:4 A d toX E. I 'D I _ mo� r 1 9 x•75 A 6/4 = 00 1 � � s 7 All c Safety and Buildings 4003 N KINNEY COULEE RD LACROSSE WI 54601 -1831 a TDD #: (608) 264 -8777 isconsin www.commerce.statemi.us /sb Department of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary March 16, 2004 CUST ID No.220537 ATTN: POWTS Inspector CALVIN W POWERS JR ZONING OFFICE POWERS EXCAVATING, INC ST CROIX COUNTY SPIA 1969 185TH AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/16/2006 Identification Numbers Transaction ID No. 969394 SITE: Site ID No. 670823 Jeffrey Johnson Please refer to both identification numbers, 220TH St above, in all correspondence with the agency. Town of Cylon St Croix County SW 1/4, SW 1/4, S16, T31N, RI 6W FOR: Description: Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 942936 Maintenance required; 450 GPD Flow rate; 27 in Soil minimum depth to limiting factor from original grade; System: Ezflow Mound Component Manual, (N.6/03), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01 /01); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. 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: General Approval Requirements: Conditic • This system is to be constructed and located in accordance with the enclosed approved plans, with the EZ APPOt FLOW Mound Component Manual (June 6, 2003),.and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD- 10706 -P (N.01 /01). DE RTMENT OF N0 FIE) • The minimum dose to this system is 67.85 gallons assuming a 110 feet of two inch force main is used. SEE CORRESI • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil n, - excavation; dehicular traffic- and- othersimilar - activities - that impact - the treatmentand are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. I CALVIN W POWERS JR Page 2 3/16/04 • 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. Stat • Comm 83.22(7) A copy of the approved plans specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department which may include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings 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 to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 ` � i ��� Z � ✓ � ��`a��2� Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbratz @commerce. state. wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 RECEIVED FE 8 18 ?004 SA FETY & BLDGS DI TITLE SHEET V, DATE: Q411 PAGE�OF� MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE This plan has been prepared in accordance with thq Mound Component Manual the Pressure Distn'bution Manual VERISION 2.0 SBD- 10706 -P. (N. 01 /01) LOCATED IN THESUA /4 OF THEE k? 1/4 OF SECTION / tp ,T�N, R_&W, TOWN OF ST. CROIX COUNTY, WISCONSIN. INDEX PAGE 1 OF 8 TITLE SHEET PAGE 2 OF 8 PLOT PLAN PAGE 3 OF 8 PLANVIEW CROSS SECTION PAGE 4 OF 8 DISTRIBUTION PIPE LAYOUT PAGE 5 OF 8 PUMP CHAMBER CROSS SECTION PAGE 6 OF 8 SYSTEM MANAGEMENT PLAN PAGE 7 OF 8 PUMP CURVE PAGE 8 OF 8 CROSS SECTION OF E Z FLOW PREPARED FOR g r�I - -JO lV\ V-\ a a D A �-- N wt " 1007 P REP D BY #22053 P RS EXCA ATING INC. 1969 185 AVE. OMAIMCE NEW RICHMOND, WIS. 54017� 1'411es PHONE: 715- 246 -5135 'o►voENC FAX: 715 -246 -5135 CELL: 715- 381 -9920 {{ t _.. .. � V t 1 ��((,T�(? .� Y' i?rt rl` i�C ✓ '' �" ^ � F i 1 �.a?(�isl' , t.CJ✓a.�c. -- ��K, (7��}j,?- < '�`Pi�a. -_ -. X . A Lz .i..y \.i�.._.._.. . -- . .. .. _.. - .... a y pa Of 8 Synthetic Cov °:ring M -tm- C33 ©istribution Pipe Medium Sandi Topsoil F Ao/ V 3 J E D % Slops Bed Of 2 Force Main Plowed Aggregate Layer Cross Section Of A Mound System Using A Bed For The Absorption Area G A Ft. li XC2 U+- i,�.F� 1Z� B Ft. K %3 6R. L 9,7Xt. J 6.7 Ft. Position I 9,Y Ft. Force Main �" �-•. W aj Ft . observation Pipe - A k- , 6 ° It --------------- ._-------------------- Distributi CSI Of "- z -2 Pipe Aggregate t Observation Pipe aetClsio r- Sc c.� r�.l�, , Plan View Of Mound Using A Bed For The Absorption Area Diycriburioa Pipe Layout p f� SEE CORRESPONDENCE p e the h01e 3i'ir the botcon of the discribucion pipes at equal Remove all burrs from the pipe and holes. Emend ** 40d ofes* JIMM op w A der a of log am or 45' Onng to a poiaa nithm sic im*a afte ftd Vadt, T=MWft 6g aai afis WOW a* a Wj4 tit+e WW ap or pw &M AW Prk for do v4 eaeea * 1 iW ar d pbW �cc�zs � &%Who talwd • i — -e P --L=— F t • N0?* Diameter / Inch S .� Ft. Latmi ' J21A rm*(es) x . , Inches ftatfold " JL Jachn Force Mt in #of holes /pipe off© Invert £levotion of Laterals JDf Ft. 4 Cl VENT PIPE 12" HIN. ABOVE GRADE 6 2S' FROM.DOOR, WINDOW OR WEATHER PROOF FRESH AIR INTAKE JUNCTION BOX APPROVED WITH CONDUIT MANHOLE COVER 4" Cl RISER W/ PADLOCK E S" MIN. ---- WARNING LABEL ABOVE G ADE� -4" MIN. .[� NLET Wit 1 � WATER TIGHT SEALS GAS_ r TIGHTS I PIPE a Aeoa A SEAL PROVED E ONTO LM JOINTS W/ Cl tLID - f ON PIPE 3' ONTO OIL - SOLID SOIL PUMP OFF ELEV . T, -f-- oft RISER EXIT D PERMITTED ONLY IF TANK MANUFACTURER 3" APPROVED BEDDING UNDER TANK HAS APPROVAL CONCRETE PAD SPECIFICATIONS �P1'IC l DOSE 1NK MANUFACTURER: % i NUMBER DOSES PER DAY: \NK SIZES SEPTIC _ (}()(D GAL, DOSE VOLUME INCLUDING DOSE (, GAL. FLOWBACK: /a7, 9 GAL- -ARM MANUFACTURER: y CAPACITIES: A = ff X INCHES = 3 GAL. MODEL NUMBER. SWITCH TYPE: B = 2 INCHES = 33 S GAL. IMP MANUFACTURER: S C = 4,'q'q INCHES = GAL. MODEL NUMBER: SWITCH TYPE: r -` D = ,), INCHES = /5 , GAL. -QUIRED DISCHARGE RATE � GPM PUMP & ALARM WIRING AS PER ILHR 16. 23 ATICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE . g FEET MIN IMUM - FEETOFORCEMAIN X %300 FRICTION FACT R . ��_ FEET F -�.� TOTAL DYNAMIC HEAD = FEET TERNAL DIMENSIONS OF PUMP TANK: LENGTH WIDTH ; DIAMETER LIQUID DEPTH �� �(p�ir7e�a -� L/n POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pooe i of t � � �S� cs ❑ t�lA o+ranar C� h cry Trot l+old� vol. 1 000 � T ang � s v n NA tlfilNdl llARi111AE'ft#S vol. llutatbar Brtltoaerts DNA a StiPlic Ooze a titnl 1 Ntrrnber of Pt"c Fod t Units L3 NA ar& mw MAs ► Z-0 lR C� NA E ( I" C) ) Filler Nis" M� Ct NA flow _ Mated x 1.6) - ,� p` 90 �� , 0 N so do d lr l r Ott tlttir Fete, oa s Greae WOO s3o mglt a �wi Fftw a p F iliodtetrtiottl Ow" mt �"d i S2" mW& o aA a Medwnicd Ae D Othe Total Suspo d•d sr� (I stso MOIL ab o ate: l tsd E"knrtt mawA t► erw trl artsr 0 NA � OxVVwn c�. a t®oo,l s3o trs� a �i Tow � sol k � '-Q* 019& ❑ NA Ci #n- t3ronrd Food Comarm ! � s1o" cfWtof�tr+i a At cis �r"°"'a do. © NA a urip4Jkw a Odwl #Ibad"Wrrt Eff�ant Partied° Size K ` 0 NA a Na a VA WA NS tYpiel for doanaaft womwetar and wobc tent eftkM*. sGlwi Etiartt, CI NA cos+dit3ort of "I") At Nast ones SvWV- ji Whmn MOMM sL040 artd acwn etptde *n* f Of tank "k" C3 NA PA=* out owt unto of tankisi a tsfltart *0 ak of is OdW@Ud $ �aarai 0 NA Mwpwt damsel cow At lsaatt mmm eta a Q NA • � t3adtt otfletartt fitter' At least ttatea even/ p NA > Ptnp. pump A alarm► At hest once wVwr nto i 0 NA tkah tetwW& and pie toot At beet rMcm a+nr1F a rna a NA At Mast etas atretll: C © NA Otw UWAnSWCE 069YWLICTIOM vne of the is�arvritr8 O �' wmpectom of teaks and dapersal � shall be nmo tf by an � carry" Sarvicir>il * or cw ip " Moster �. "8~ Plturtltar R� Sewer: PQWTS pnspectar: any crocks or of the tardctai to idarttffY ant► or broken hardware. idertlifY Tank crts tram include a visual k"mc ien ffttnerr bet* up or of efftuartt on the w oum lacks, rneaswe the vek me of cart&kwd aiudpe and scum and a r &Il for art11 in e observation pk" *Rd to check for Snv attrferx. The diems 1 ahal be � b�pe id to e#tscic the t levels sur th face mev i b # anc porndkv of effkmrtt on ** ltd attrface. The pot+db a o f etlhm* on the requires the irnnwdk" rwtifkation of the #ocd VOIld orll When the oarr►ained acasrmulrffott of attttlge WW scorn in WW Item tertic oWmft on ' do Vg kh c hapter NR 113 entire cwt nts of the tarok shall M nw nwA4 by • Sipe Servicing opwstm artd dimpometl Of in mcco Wiscor s Adn*%lotrad" . pt co"Wonents• protmotrner AN other services, �ut 9 6 not limiwad to the servicbV of s 't t s, r a un , end any servime at WIW"kc of $l2 m ts ond, shell be perfor erb med by a cf+ed POW TS L ts �rltlan 10 dwp of � of WW event. A service attad be provided so the b�l nor oiY ea tM1► Gmw 12 102 START UP AND OPEPATNM . For new coma �. to use of the P'p —. tlfet may kwfPede the � c t the a for pe preen o€ paj�� ���. sol�enfs or orbs d helve the cortterr� of the taffk(s) removed by pr sat cells}. if high corwcer� are beta M a s u" motet -tor prior t o use. S"tam start upr shah not occur frrfuen soil conditions we €nm en at the infetrative surface. Will be discbar ear w+amwat f+ fv,rarosr k�ve4s. When power is rest+o ed the excess � ,a re stowiry power . To &Void *As Mve die � " and w rem ovewiosd them in tine ba�eup er sum cowvbvb toto "M 40 "m rxirrnfrl k a � Or �S Marine So t p rior removed by a seo 040 not drNme o part p ump WkWn i 5 feet d s any Over mound or MW dkpemW c DO Mt drive ar park over. or O#ww rise b or Wit. the area UIW or � of the fotittvving P hpry � ,ld,UC z b ��� �we tte btu a mss' d ental and prolong tfie life of the WMa; fruit O W pa°'wMg Products; peed, sanit nepbn awfdaw� w � Medications, trill; AEUT When th MW tAfTS farts and/or is per, tly taken out of sawvice the �Wv abandoned comp � B wept ar tart Leiden to insure that fire system is dwapaar f.`gKnaf 83.3, N�ta000ruek► P1ef#k* � Gods: e All Pip" to tanks and Wft shall be e W*mwwwctW and the "wWoned pipe Ww* s ," W TM contents of all tanks and pier shall be arrtorvsd and e 'After � ON tanks and Pits shall be mead of by a Septaga Sarvfang t�perator. "W. t or another kw"t soil material. a nf►atisd arwd removed or 0. cwwtr.. removed and the vrold space fled with cownN GENCY PLAN E * c wwnw* : aftf carrwot be repaied ilte folbvmng have been, Of must be taken, to Provide a code co rnplEant [7 A suitable w'eP�att area has beet+ edd enrekteted s y st em- The replacement Ones stfv bar d a nd may be uukt*d for the location of a repl t " sbsognwn required satgumdm from 40064 and Prailmommed structurg, rbarAOe and lamed wpon by not �t the fused � MW a to ltri roes and Failure to F+wvte,st tlwe area vrdt ISW ctarnply wft the ndes in Offset at that tithe, a ale t anfw. Replacernent systems must A u*abla rim**'0w""nt aces Is net a h tank w wv be Installed area bet num Is wept -,:s the failed , _ Berfa'Q eaver as in POWTe Q The s16e has net been evskwead to avf n must be pewfo =pad to � ► bar UPOn failure of the P' WTS w soil and site ' Installed as a last resort to replac the fated PQ area N no �t area is swaths a tank Motwfrf and at -grade sod sy"ems may be M=Mbucftd in piece c <wAaMat surface. Rxo»et Wwwwne of such - ystan+� conWIV t off the ta,,m at the ' PUAW MD OTHER TIEAi'Mt>!»iT TAX" MAY COWMAN tJ£T!lili�, iMTIM A . PU<MP OR QTiiM TMTMEAT TAM tA�Mll R Illtfr A lOR � lIXYt J1i. DO NOT Il � TW M"'l'BWR OF A TAM MAY jW 8..,, JLT OR ALE. faFATH MAY REStp.T. WSCUE OF A w" Must 4e1ne POWN, ttilR>MtTAtil®t lylama haws F'lwane _ PTAM 3 OPERATOiI i ante LOM REIAATORY AUTtionlyV Nane hone OA 1 h amon ent was drUfted by the Phone / _ men C.txrnn 83 22tZ Ndilltfl and t Ow Green tO 54111, t21 8 (31. w � Z°wwitfk pail Swuludon +ganco in negwsncb with ; �Fi • F r ,. �r ,r .•tk f ..,. /silt t. serf it ,i 1 tat ,t FA +. u.• s ! �' is r. t- .r. _ 1 `F. e t:.ti t fi ., •I::a, t 1 :.:t pit ..+. '1 f�4 i :t•t.�e'., � ,;J �. R • ,. rr _ t) � 1 � ip1 t i r'E':M 1. is 'pw ^w::l . ht. it +r i Fi 1 1' .1• r . •►� ��� � tt1FFF Banss�r�r WOMEN ■ ■wn 7^ man p 11 • �_►''�.�i�_ial�1��. ®��� /sue ►��a����■ All �"+ ''ri�if�i Jag tilt, ==NOUN m -low t •::, .: l("'`# w►► '�� airs!t11►�1��w ► MtI10 ME WON Nunn IMUMM mammon I e e i 6 e ' 1 r � HECEIVED EXAMPLE CENTER FEED.NV)UND SYSTEM DESIGN OCT 0 8 IM SAFETY & BLOCS, DIV CUT VIEW SIDE VIEW 3 " 0.". cow /i I" p" %-"V- PIN t.". 0 b ...... C40 :4w*~ V* ow"llitill P" %WWAA Pp �u ran 10 I � rljcllmj' flow Cclut-1 Fit Ow tar the dviitqo 411 the I./Ookill, product. .r s• je jilot 11 titlltfll -tepirilmon ill file cvIlm Lit Illound 01:11 is equil to 1110 (11,11110411 am, orec mam hr if.-Ing .1 tee, it 'is lolportant to inert ti shoulders of 1110 tee into 111v 1 4 pipe ;tll Ila as pos - to olinjim/c Ole swilit! oftfic gap. I'llis call lie whieved h\ millicii til 4- irrttr a cormeallon that is illy vitiotigh into the I ' '/11im pipe flot 111111ti life sillotildas ol'illic lords main we From IX-111 1''111ii inserml into the i /n 4" pt till 1 the (tap still ojj 1 0 silo as the diall1iiiii ol tilt: 111,1111 lv"atisc file 11111'1► 1 oil cash side of f thv still it it 141 14111 hr tile los imiiii pilife Rec.111w the I'll Inall) 1 Offers tile L/111iii btindle ot all de Ilial rommalek 0 higher ilmn tile level J 1 rille ; al, it emi ittlpllliititt !++ P R hacklill filet cli'mer a ap ii,ill, sill .1 grtvsoliir maieri such ;l ., 11lotlo( 'I tA i I it'! Vft=wh Ospatinsntatcammeroa SOIL EVALUATION REPORT pop / 3 sataayandsaldrgs l�rsip► p�woaP "Wrbnoma vtxit �Nasftwpamavm �ft ae t sarra�c ad eaW fftdbM a►and a to Ph*" paint aN F'\ � Daft o� q 0 9 20 SW WSum s s,3 "it to E w awes stoats a" +i�.art'M 7l^ A "e St. CROIX COUN ti Tiaw+ finrestfigatl t um �Nast+araleasoesia c�od.d.a b�rai - Iwo �aat Cl �erawa�w,oi�- tti,,,r,e o'�naRasalaiY waosw.w.ru.wrrap.d. tt ('rlou nd on y ar C'o��i'0 El OWA � a aoaapwearar�arasr k " «r... SL cta omw GLXL k ,ern im 0 - 9 m C (, s ^► S' nX4 r G LJ S se 6 rr\ -- aas El s ' 0 d" 0 Ps ewiwmftmow 11 30 Ma�ea« Oapw QaatM�l f�Ntr Tomwe asm M skoft apom AL altnao! CAL ate: Out cow ®r. 'ES:t '16s� m -09 1 , w I S f 8' (o 3v 7� / �. lY►�T r W I k Eoi Ads *do: '��_ �a0�z'�aapLandT��< „�. - �wutlt� <ao aadTBB N U S o1 / 7f -SI MMISA W ON � U r mm�r mm Q 1 r 6 on A cal Alf t 7 i ` eo 1 Vr 1 ue PP -- - s' 5 0 - K S6 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer c Mailing Address r1 a JQ Property Address I a (Verification required from Planning Department for new construction) City /State Parcel Identification Number LEGAL pj&CWj Property Loeation y., y., See . ( Q � , "I'- -R) ow f v` Subdivision acv 06vt a.t CSm t 3S ors t# pew. Certified Survey Map # Volume age # Warranty Used # - - ki 9 7 Volume _� q S c4 Page # Spec house ❑ yes 9 no Lot lines identifiable yes ❑ no SY STEIaI MAtIVT 10 A consists of i use sad Hof your could result in its premature failum to handle wrsste:. Proper pumrpiag Out the aeptc %sale every do= ,yeses or ,amen; if needed by a licensed pumper- What you put ire the system can affect the function of the septic tank as a trestarent stage in the waste disposal system- The ma ter i air agrees to to St, Croix Department a certification form, signed by the owner and by a plumber, journeyman plumber. restricted plu nber or a licensed pumper verifying dw (1) IbL aaa -site w d6WA -- rsMW s ystm is'tia grope:• operating edition amd/or (2) aflntr bVectiOu and P (if necessar the sapdc took is less dim 1/3 full of dodge. Uwe, the uodrxsagned have read the above mWArements and agree to maintain the private she disposal systaa widt die standards fortk ben" as set by the Department of Coerce and the Department of Numal Rewwcm State of Wbeansin. Ck$t&ea&w stating that your septic system has been n amtained maus1 be completed said returned to the St. Croix County Zoni C wn'dgn 34 da of the expiration date Zoning N ae� _ � o SIGNATURE OF _ A PPLICANT Dl1TE O WNER C . V % � — ATION I (we) certify that all atatttments on this fora are true to the best of my (cur) knowledge. l (we) am (are) the awner(a) of the prcgretty desct;bed above. by virtcue of a warranty deed recorded in Register of Deeds Office. SIGNATt1RE Ir APPLICANT I ! 0 D TE Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department'•••'• `• include with this application. a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed ' 6 8 7 4 9 7 XATHLEEA H. WALSH REGISTER OF DEEDS DOCUMENT NO. WARRANTY DEED ST. CROIX Co.. wI RECEIVED FOR RECORD This Deed made between Ilene A. Zielsdorf and Charles R. 08 - 19 - 2002 3:45 PM Krueger, as tenants in common, Grantors, and Jeffrey L. Johnson and Tina WARRANTY REED L. Johnson, husband and wife, as survivorship marital property, Grantee, EXEMPT # Witnesseth, That the said 1.00) and other REC FEE: 11.00 valuable consideration co o Grantee the following describe estate in TRANS 486.00 ro Co= e of Wisconsin: PAGESCOPY FEE: The Southwest Quarter of the Southwest Quarter (SW1 /4- SWI /4) of Section ixteen (16), Township Thirty -one (31) North, Range Sixteen (16) West. ** ** EDIRET 362999 199094 WD 118271 ** RETURN TO: Edina R Title, Inc. ' r_ 400 Second Street, Suite t 15 Llr\ (� n/fC H son, WI 54016 ttt�J LAA 0 9� 7 Parcel ID#:006- 1035 -20 -000 U. %% /Ip 03S Pd. $ 11.00 Ck. ** This is not homestead property. Together with all and singular the hereditaments and appurtenances thereunto belonging; And warranty that the title is good, indefeasible in fee simple and clear of encumbrances except easements, restrictions and covenants of record and will warrant and defend the same. Dated this 26th day of July, 2002. _ (SEAL) CSC/ (SEAL) Ilene A. Zielsdorf Charles R. Krueger AUTHENTICATION Signature(s) of Ilene A. Zielsdorf and Charles R. Krueger authenticated this ACKNOWLEDGMENT 26th day of July, 2002.s�o- ��w•"" """" STATE OF WISCONSIN ) DIANA M. BARROW )� Notary Public ST. CRO1X COUNTY ) Jeffery J. Drach, Esq. 6t 01 • Personally came before me this 26th day of July, 2002, the above named TITLE: MEMBER STATE BAR I� Ilene A. Zielsdorf and Charles R. Krueger, to me known lobe the persons (If not, who executed the foregoing instrument and acknowledge the same. authorized by ¢706.06, Wis. Slats.) THIS INSTRUMENT WAS DRAFTED BY Jeffery J. Drach, Esq. Drach Law Firm Not au`blic, State of Wisconsin. / 500 Third St., Suite 202 My commission expires: t a Y — a 00 a Wausau, WI 54403 (Signatures may be authenticated or acknowledged. Both are not necessary.) CERTI FI ECG S V RVEV MAP LOCATED IN PART OF THE SW1 /4 OF THE SW1 /4, SECTION 16, T31 N. R16W, TOWN OF CYLON, ST. CROIX COUNTY, WISCONSIN. OWNER JEFFREY AND TINA JOHNSON 2204 210TH AVENUE DEER PARK, WI 54007 SURVEYOR EDWIN FLANUM NORTHLAND SURVEYING P.O. BOX 14 ROBERTS, WI 54023 SURVEYOR'S CERTIFICATE 1, Edwin C. Flanum, Registered Wisconsin (rand Surveyor, hereby certify that by the direction of Jeffrey and Tina Johnson, I have surveyed, mapped and described the parcel of land which is represented by this Certified Survey Map; that the exterior boundary of the parcel of land surveyed and mapped is described as follows: A parcel of land located In part of the SW1 /4 of the SW1 /4 of Section 16, T31 N, R1 6W, Town of Cylon, St. Croix County, Wisconsin; described as follows: Beginning at the SW Corner of said Section 16; thence NO2 °01'22W, along the west line of the SW1 /4 of said Section, 331.38 feet; thence S89 °29'54 "E 386.60 feet; thence S03 °07'40 "E 331.73 feet to the south line of said SW1 /4; thence N89°29'54"W, along said south line, 393.01 feet to the point of beginning. Described Parcel contains 2.96 acres (129,051 Sq. Ft.) and Is subject to Town Road (220th Street and 21 Oth Avenue) right-of -way and all other easements, restrictions and covenants of record. I, also certify that this Certified Survey Map is a correct representation to scale of the exterior boundary surveyed and described; that I have fully complied with the current provisions of Chapter 236.34 of the Wisconsin Statutes and the Land Subdivision Ordinance of the County of St. Croix in surveying and mapping same. 7fk . EDWIN C. *_ FLANUM 5-2487 S -2487 AMERY z W 13K ¢ Each parcel shown on this map (plat) is subject to State, County and Township laws, rules and regulations (i.e., wetlands, minimum lot size, access to parcel, etc.) Before purchasing or developing any parcel contact the St. Croix County Zoning Office and the Town of Cylon. SHEET 2 OF 2 SHEETS Vol 18 Page 4735 CERTIFIED SURVEY MAP OMER ANOTINAW G0 x LOCATED IN PART OF THE SW114 OF THE SW114 SECTION 16, T31 N, wom pfG11� r WI54001 Ali ;� SECTION�16� A16W, TOWN OF CYLON, ST. CROIX COUNTY, WISCONSIN, DBPAK d p .� �.4 nm , o a ! EDW1bIHAN N <xG� N�t+1 w o 4' I NORit6ANDSl1RVEYING MAW - &M� M W ` 0 N o�fIVISD ° II V L7W!! Ul7Uu ri M h �W oix? Z - � a u a c�a $ Y 68919141 386,60' W g 33.03 353.5r LEGEND wz Z I ON 9 AL1N�g4uMC01MmsECTgN 33 33 omomowNT@m pt MOUND SYSTEM I o o 1 X18'WONwSEiWf,N>YtlNG °ill �I�j 1,13LBS. PER UNEARFOOT r I � I GARAGE LO ° j i o I+UISSONRYNNAIII FDUND O t, C X161 91 W ASEPTIC 2.96 ES INC. RrW W Olai 1001WAY iBAp(LINE i� N �► 1 1 -� F CLEAN OUT : 129,051 S0. FC ' �I a pl �I SHE 44AMEXC -PJW o jai I � � j i r N II o 24650, FT 0 IQ a 9� Wo CI I '1\0 E o a l a i a � 1 N NI W r o �•- EXISTING 0 w I DRIVE FIELD __. L , DRIVE W5413592 _ ___. swCORNER 210TH AVENUE sv4coRr� SECTION 16 m _ _ _ _ _ - - - - - -- _ 1�9°29'54w2235.45 SECO16 N89°2950 393.01' SOUTNUNE0F THE SW114 M —a— —; .� 't "�" ,EXISTING !FIELD ~ 3 �' 61 I DRIVE n THISI�iTfI��DWIfTFABYMIQNEIERI (SON SCALE IN FEET 1' = 80' ` I �� °_ ° �_ JOBNO. 431 DATE3A6-04 I I -- OfD b 041�� so o SHEET 10F 2 SHEETS so _ _