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018-2013-15-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Builyling Division INSPECTION REPORT Sanitary Permit No: 538869 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Retch, William J. Hammond, Town of 018-2013-15-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: s, g (3 - G 5 f 08.29.17.1116 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 15 Benchmark 140-1 9 S <s Dosing g Alt. ~f q ~~M GeJ 7.7 /(r .7 Aeration Bldg. Se er Holding St/Ht Inlet \ \ TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet er~-tom., Septic 21q 7 ,vA A- z15 Dt Bottom Dosing 2_4 /t1q Header/Man. Aeration Dist. Pipe Holding Bot. System PUMP/SIPHON INFORMATION Final Grade 0 166, 1 Manufacturer rr .11 Demand St Cover y -7 2"- L / . N GPM Pv Co J[ C?(, Model Number 176 t-+ 46 ~a,>`,~-cam 3 S 7. L TDH Lift Friction Los System He TDH Ft 1`} 71 3• 2,1. Forcemain Length IDia. Dist. to Well 95 Z A*- SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length / No. Of Tren es PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS g• 57 /Be SETBACK SYSTEM TO P/L /tJ BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type O~fSat) / a ~A- /t/A-- / Y l O ✓.~--G~ ' 7 5 UNIT Model Number: v r l DISTRIBUTION SYSTEM A),J Header/Manifo~ ` I Disterisution Z 7 l/ x Hole Size Ix Hole Spacing V t to Air Intake Length Dia Z Length S~ Dia Z Spacing T 3L 1- SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of / xx Seeded/ dded xx Mulched Bedlrrench Center ' 4's Bed/Trench Edges Topsoil ' I ~I 0 No es No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection#1: Z/~15'y Inspection #2: Location: 1690 100th A . Hammond, WI 54015 (S 1/2 SE 1/4 8 T29N R1 7W) Corner Stone Ridge Lot Parcel No: 08.29.17.1116 1.) Alt BM Description = f -5 6 2.) Bldg sewer length = Jr6 C' oc. 5 P16 - amount of cover - Plan revision Required? Emj Yes No ~7 7/ Use other side for additional information. Date Insepc is Sig ure Cert. No. t; BD-6710 0.3/97,) 47- P~CjJECT Bill Fletch PLOT PLAN ADDRESS 1025 170th Ave Hammond Wi 54015 S 1/2 SE 1/4S 8 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX SYSTEM ELEVATION 98.4 BEDROOM 3 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1 .0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. Top of steel fence post ASSUME ELEVATION 100' Filter BEST GF10-8 ❑BOREHOLE i~ WELL *H.R.P. SameasBenchmark 93' Property Line Grading is to be done divert B-3 98 run-off away 207' Property Line 144' Property Lin from system 97.4' , 9 6' .M.* B- B-2 8% Slope 1 Area 15' below system is to remain undisturbed Well is to meet all Huffcutt Combo jTa setbacks found in Comm. 83 303' Property Line Pro 3 Bedroom 2 Acre Parcel House Scale = 1/4" = 10' 212' Property Line 100th Ave lcoPY COf1'1/1'1m"•WI•gov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 s~ 'sconsi n Madison, W1 53707-7262 Deparhrmrtt of commerce Sanitary Permit Num r (to filled in by Co.) , Sanitary Permit Application State Transaction Number In accordance with s. Comm. 93.21(2), Wis. Adm. Code, submission of this to the propr'ate governmental unit is required prior to obtaining a sanitary permit Nate: Application f for r- submitted to the Department of Commerce. Personal information you provide fo T dare roject Address (ifdiflerent hat mailing address) ses in accordance with the Privac Law, s. 15.04(1 m ,Stars. I, A lication Information - Please Print All Information Property Owner's Name Parcel # Property Owner's Mailing Address 2 Properly Locato~ n City, state p.2S Govt. Lot / / l tQ Zip Code Ph J ~ '/a, Se,1io circ ie one II. Type of Building {check all that apply) I.ot # N; E or 2 Family Dwelling - Number of Bedrooms Subdivision Name Block # ~e7 f ❑ Public/Commrercial - Describe Use ❑ City ❑ State Owned - Describe Use CSM Number ❑ Village of Town of III. Type of Permit: (Check only one box online A. Complete line B if applicable) r A. w System L1 Replacement System El Treatrnent/Holdin Tani: R lacemenr n-• Treatment/Holding eP lther Modification to Exis mg SystJ(e B ermit Renewal E] Permit Revision El Change of Plu reviocrs Permit Num t nd Date Before Expiration - IV- T o OWTS S stem/Com 1--m/Component/Device: Check all that a C~ tn ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade` 1 utd < 24 in. of suitable sc tf ' ❑ Holding Taal: ❑ Other Dispersal Component (explain) r olain)_~ _ _ /7i f V. Dispersal/Treatment Area Information: ` n S - tgn Flow (gpd) Design Soil Appli Irate Y Y ' oayitm (gpolf) Dispersal Areal -pcrsal Area Prop sed (st) System Elel afon L 4_4 VI. Tank Info Capacity in TotA # of Manufacturer , Gallons Gtdlons Units New Tanks ° Existing Tacks o Septic or Holding Tank Wit, 7 / U cn y iw C7 C /JL~ 7L Dosing chamber 3o VII. Responsibility Statement- I, the undersigned, assume r nsibllity for installation of the POWTS shown on the attached plans. P1 her' Narne (Print Plumber's S' a MP/MPRS Number Business Phone Number ~z6Yav 7 J 6 Plumber's Address (Street, City, State, Zip Code) ~ v v VIICounty/Department Use Onl - 'Approved El Disapproved Permit Fee Date Issued Isatting Agent S atu~ ❑ Owner Given Reason for Denial $ IX. roval/Reasons for Disapproval 710 1 Septic tank, effluent filter and dispersal cell must all be serviced /maintained 114 as per management plan provided by plumber. 2. A ll setback requirements must be maintained i'Z s/~✓ fitfi*t ? a -9 I i. a1 for the system and k to the Couify only an paper not less than s to x t inches in size J ,+'i'l~tl-v"..~vc , ~+-~C.:G~(:.t! ?./to r ► f~~~i a.k~i' t~~~'r~7~2,~X.~~ F~ SBD-6398 (R. 02/09) V\ 6 < rnpr 0(n z X00 p z~ M 00 ~o Cl) O M E p m 0 ~ O -I -1 0 m N CO) mmi m m p w z c 0 ~ m z D...4 o z ° ~ 70 ~ m Cl) -n - = o0 O oZ - z N Ip ~ Z rn ~ C p Cl) C7 r C'1 z CO) G) m 0) C CO) c CO) a m X C rn m O F z -n - -•fl C r m o z ~ ~ O O rn ° v Z m INC C m Vi N V z - v m,~ Z V ° _ o _ ~N z o , ~ o m Z O C fV° N- . N® 01 G) m m ■ ~ ~ m m ~ 3 ~ ~ ao w o m ~ K m3 !x $m,~ o>>~ m e+ cd o ors 3 0 ~ m s ~ 3 . O a wllu -a- i, i Cyl C3 V! OD %A W S. V° ac m Q~$ Z T lJ J c IL 0 co ~ $ 5 c m r O m H S 0 N ~ O z o c) O n CA 0 3-0 0 d v1 c .r 'a CD m 1 ° ~ CD rr O z-0 y z O 0 T_ z-0 N z O cr -n = 0 0 • 3 OD 3 0) =r (D 1 `n > y co 7 CD p= y ((I ail 3 M < < ° < 7 N < P. N w ° n O CD o 3 a o 3 f o 7 f%1 7 fB L 7 O ° (0 (n A H a a 0 A m a a O I m o W o f m o W o', a o~ ~ o n o= ~ o o o < o No n w l oz m M a CD c 3 1 c 3 v CD 3 CL 000° a 000° c7 N. co PL co n I3 5 t~A N C d 3 a N N< N p U) v D O cn Q D D cn ! S O m N A ~ N (D N A N d Er a 'O o N 7 Ln O O ~ M 3 O p D D K O D D o s a a N~ m m 10 O O O Oro ° c 3 c 3 m O m' O 3 m 3 m (D N O N r 1 to 3 c c A Z C CA E; E N N A (z o o N co W T W T ! O z CL a U) A °o °o m co i z 431 A W W CD I I ~ N C O d 3 0 d O N y CC j N cc N 0 CD c m (D 'O 7 T N a 7 T x Co Dj w C N C l m oN °z a o o a 5'=r O fD ~p fD 0 0 N O N CD N 70 O. 24 O ~ N F, O S 0 80 ti ~ CA c tz. 0 co t-j 7 0 O ('D O a O 0) ti ti O O b m m oo v o O O o a °o n I Parcel 018-2013-15-000 PAGE E 1 O 10/20/2011 I 11:41 AM F 1 Alt. Parcel 08.29.17.1116 018 - TOWN OF HAMMOND Current 1K ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 01/10/2006 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner 0 - FLETCH, WILLIAM J WILLIAM J FLETCH 1731 96TH AVE HAMMOND WI 54015 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 1690 100TH AVE SC 2422 SCH D ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 2.030 Plat: 10-092-CORNERSTONE RIDGE 018-06 LOTS 1/18 SEC 8 T29N R17W PT SE SE; BEING Block/Condo Bldg: LOT 15 CORNERSTONE RIDGE LOT 15 (2.030C) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 08-29N-17W SE SE Notes: Parcel History: Date Doc..__ Vol/Page Type 01/28/2009 88751 AFF ' 04/01/2008 63 WD t(lv' a 04/09/2007 848085 QC 01/10/2006 816125 10/0092 PLAT 2011 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 11/04/2008 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 2.030 500 0 500 NO Totals for 2011: 2.030 500 0 500 General Property Woodland 0.000 0 0 Totals for 2010: General Property 2.030 500 0 500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Safety and Buildings Division County 201-W. Washington Ave., P.O. Box 7162 _ Madison, WI 53707-7162 Sanitary Permit Number (to be lied in by Co.) ns sco 4- 5 State Transaction Number Sanitary Permit Application 1 ? 3 -7d 3 / In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide for secondary es in accordance with the Privacy Law, s. 15. 1 m 6 I A cation Information -Please Print All Worm4WU Parcel # Property Owner's Names Property Locaution Property Owners Mailing Addreac 11 D/~ o © 4" RO1)(OO - God` ` Lot ll s City,,State Zi NNING & - ~ 'A, won ' (gircle oOV ~ T N; R E II. Type of Building (check all that apply) Lot # / j Subdivision Name r 2 Family Dwelling - Number of Bedroo if op 16 if l h W h&d- Block # I1rt l Alez~ ❑ Public/Commercial - Describe Use ❑ City of s~ dtlUtQ CSM Number ❑ Village of ❑State Owned -Describe Use / Town of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) TB.01 System ❑ Replacement system ❑ Treatnenr/ilolding Tank Replacement Only Other Modification to Existing System (explain) List Previous Permit Number and Date Issued mit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New Expiration Owner IV. Type of PO VTS S stem/Com onent/Device: Check all that a 1 ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ treatment Device (explain) • /rt~l A- V.- Dis Treatment Area Information: Elev o~ Design Flow (gpd) Design Soil Appli Rate(gpdst) Dispersal Area aired (sf) Dispersal Area sad (sf) System Z. 1 (P ~ 75a ZIT- VI. Tank Info Capacity in Toter # of Manuf VI. Gallons Gallons Units New Tanks Existing Tanks Q. Septic or Holding Tank Dosing Chamber v/` VII. Responsibility Statement Cull dersigned, assume r ibility for installation of a POWTS shown on the attached plans. PI s Name (Print Plumber's S, re MP/MPRS Number Business Phone Number Plumber's Address (Street, City, State, Zip C) /Al U VIII. oun /De ent Use Oni Permit Fee Date Issued I mg emt si pproved ❑ Disapproved $ o t7 ❑ Owner Given Reason for Denial M Conditions of ApprovaUReasons for Disa Val seoueulpio/apoo a de jad se SYSTE OWNER: paulelul nw sl Jlnbaa joeglas Iltf 'Z Septic effl ter and egwnld Aq popln 6euew jod se dispersal cell must all be serviced / maintained aulelulew Incas aq Ile lsnui l( sip as per management lam provided by umbe[. pue aa31!I#i~'~lfaa!9~ say{tam !(eJj~j~piT~MCPitfftI~4N1~N9~'►41A1<AflAPR&abe :b3NMO N318AS as per applicable code/ordinances. SBD-6398 (R. 01/07) Valid thru 01/09 Safety and Buildings 10541 N RANCH ROAD commerce.Wi.gov HAYWARD WI 54843 Contact Through Relay isconsin www.commerce.wi.gov/sb/ Department of Commerce www.wisco isconsinsin.go .gov Jim Doyle, Governor Richard J. Leinenkugel, Secretary November 18, 2009 CUST ID No. 226900 ATTN.- POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1008 192ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/18/2011 Transaction ID No. 1 Ident No. ton Numbers ' 737031 SITE: Site ID No. 753161 Bill Fletch Please refer to both identification numbers, 100TH Ave above, in all correspondence with the agency. Town of Hammond St Croix County S1/2, SETA, S8, T29N, R17W Lot: 15, P'0 FOR: Condit Description: Mound, 3 bedroom residence P Object Type: POWTS Component Manual Regulated Object IDNo.: 1248533 Maintenance required; 450 GPD Flow rate; 27 in Soil minimum depth to limiting factor from original grade; Syst m '1Mound Component Manual - Version 2.0, SBD-10691-P (N.01/01), Pressure Distribution Component Manual - Verb 2.0, SBD-10706-P (N.01101); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Co SEE I✓ORJ and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be cons cted 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: Key Item(s) • 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. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • The proposed pump is near its limit with the proposed total dynamic head. If upon installation, the total dynamic head increases, the proposed pump must be reevaluated and may be inadequate. • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. Reminder SHAUN R BIRD Page 2 11/18/2009 • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(i). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. 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. 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. - Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 ` Balance Due $ 0.00 - Patricia L orf POWTS Plan Reviewer, tegr ed Services WiSMART code: 7633 (715) 634-7810, Fax: (715 -5150, M-th 8:00 - 4:45 pat.shandorf@wisconsin.gov L~ cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Monday, 7:00 A.M. To 3:30 P.M. Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings Division of the Wisconsin Department of Commerce. "Construction business" means a trade that installs, alters or repairs any building element, component, material or device that is regulated under the commercial building code, chs. Comm 60 to 66, the uniform dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to 87, or the public swimming pools and water attractions code, ch. Comm 90. The term does not include the delivery of building supplies or materials, or the manufacture of a building product not on the building site. For further information, go to our website: www.commerce.wi.gov/SB/SB-BuildingContractorProgram.html 4 , Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 11 / 5/09 Owner: Bill Fletch Location:S1/2 SE1/4 S 8 T29 N,R17W Lot 15 Cornerstone Ridge Hammond System type: Mound System Manuals Used: Mound Component Manual Version 2.0 (01/31) Pressure Distribution Manual Version 2.0 (01/31) Page# lly Bona v 1. Cover Page iOoMM 2. Mound Plot Plan 3. Mound Cross Section A~sppNaEN 4. Pipe Cross Section/Pipe Layout O 3' 5. Pump Chamber Cross Section 13 6. Pump Curve 7-8. Maintance and Contigency plan 9-12. Soil 4te Shaun BirSignature 114 Z License n PLOT PLAN P1tOJECT Bill Fletch ADDRESS 1025 170th Ave Hammond Wi 54015 S 1/2 SE 1/4S 8 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX SYSTEM ELEVATION 98.4 3 BEDROOM CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1 .0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. Top of steel fence post ASSUME ELEVATION 100° Filter BEST GF10-8 ❑BOREHOLE O WELL *H.R.P. Sameas Benchmark 93' Property Line Grading is to be done divert B-3 98 run-off away 207' Property Line 144' Property Lin from system 97.4' 96' B-2 B.M:B- 1 8% Slope Area 15' below system is to remain undisturbed Well is to meet all Huffcutt Combo Tank setbacks found in Comm. 83 303' Property Line Pro 3 Bedroom 2 Acre Parcel House Scale = 1/4" = 10' 212' Property Line 100th Ave Mound System Cross Section and Plan View Dimension Feet Will ~t A B J r' D O E A W F G i H :ta 6 3 fain 3~ .a- -aii•' a a•••• 3•iii:a: ii-i-s s •i 3 :i: ~1-a•a, 3 •la:•:, 7 I I J e' i i K r I L O w a ,l Z /D K Slo L ~ - ~ =Topsoil = ASTM C-33 1/z tlean diga.~ 0 obsemrvattc'o p40 ipe c . Cap Material sand fill toa,~s Geotextile < H Fabric F p T 1 Ft ,L. D E T . Plowed Surface 97 , Ft Contour Slope Direction. GENERAL INSTALLATION: The mound area is staked out along the design contour. Existing vegetation is mowed and. raked off the site. The mound basal area (L x W) is plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a 1/4 inch soil wire when a sample is rolled between the palms of the hands: - ASIM C -3j quality sand .is placed immediately after plowing. Sand is placed with a tracked machine keeping 12 or more inches. of sand under the tracks or is placed overhead by a backhoe. Special care must be used when placing sand of less than one foot thickness to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire mound is seeded and mulched" to promote vegetative growth, limit erosion and protect from freezing. The observation pipes are slotted. in the lower 6 inches and secured in place with reber or a closet flange. 10/071gj Page of Threaded Gleanout Lateral Turn-up Plug Manifold M L Lo Force Main Sweep 90 Bend Distribution Network S ifications Pressure System ConsUmetlon Lateral Diameter In. Manifold Diameter in. Laterals are constructed of Schedule 40 PVC Orifice Diameter In_ pipe. Orifices are drilled perpendicular to X Orifice Spacing) In. the pipe with a sharp drill bit and face down. L (Lateral LenWh) Ft. Lateral turn-ups terminate with a threaded M ' (Manifold Lengdi) PL cleanout plug and are enclosed in a 6-8 inch Force Main Diameter 2 In. diameter lawn sprinkler valve box accessible Force Main Lengdi Ft. from finished grade. Grade 4 6-8 Inch Lawn Sprinkler Valve" r Box . I' JL~ i Pag . of 03/051] Septic-Dose Tank Cross Section And Pump Performance Specifications Pump ManufFeaure r f¢/~ ; a Tank Manufeoturer. HA CAAr- Tank Model i~Tusabes >j Pump Model Nuipber E Total Tank Capacity Alarm Manufacture'. ve c j4v, S f,P~-a Alarm Model Number v Max. Bury Depth Switch Type Sjn lWe.4 Filter Manufacturer' 1t J Total Dynamic Head (TDII) - Feet Filter Model Number G Elevation Head i Distal Pressure 0 Network Loss Minimum pip ecformar~ce Required Force Mafia Loss , Ft TDH Total GPM, 3. 3 outlet Manhole Nf m 4" Above Grade With Manhole Min. ' Ab6vvc Grade Looking Device. Inlet Manhole With Locking Device < 6" Below Grade Seded'Waterti0t Securely Mounted . Weather-proof 1 T .-.._...0" Junction Box e Fuushed Grade . Vent Min. 12" Disconnect Above Grade Means With vent Cap Outlet Filter -----inlet - Inlet Battle - Inlet 1/47 erve Capacity §ett s • Weep Tank Volume = / S GPI . . B Hole Dimension; Inches Volume Gal. (reserve) A 3 Off Elevation C alarm B : 2 O ' dose) C Bottom (dead) D 9 D Elevation y Total Ft GENERAL INSTALLATION: The septiic/dow tauk is bedded and bank Fined in accordance with the manufacturer's product-approval specifications. Maxim= depth of:bury as specified by the maatufacturer may not be exceeded without tive looking device (padlock) Manhole covers. exposed to grade have an effec pion APP- installed. Piping at the inlet and outlet is of approved material, comieclod to the tank with watertight fittings, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the tank excavation and the sleeve is seated.cvaierdght. Electrical. service complies with NEC 300 and Comm 16.228. P OZ/OS L7 age of . - ~ '~'jxi `-J~iL ~SifGl t ~~-tICS G..7sacts} h r~yv w v seat By:: lip. fsw"t 3MoQ:. p WOW- Villa, MP/EF'FLUENT PUMP 9 E H S BRIE MM =a WAR is &to sumum 40 a SWAB ~io~ed dat 3s~ . now u'R'~sn+aM mow a aa°° aoo° ~odL 73 S&att 3 N3~e'rid' Cofto snd m - 3e+s i9oed a so. ° ~ ~ ~ ruty£ 'Cosa ra..~ ~•t,,r,,.. f~,,acros~ pap PLAN ggEUSJT _ MMUAL&MANA POWTS 00 DNA Ulff O KA. 5 S( i a INr ~ T aid p - 0 NA r p ` D NA 6 3~ 139A p-Tarric 131M urm AM* € a Arta x - 011*6 PUMP slow n pampow s3Q.- D II WOL 13 13 00 ~O oor a Te~Id '4 gfi;` a s YM) SwIt OFUN* 3 D tQ W csfine~ds3 cctrjakled 064.111.3S~ 3 Yom-) puny CdCOOM" of tas+c(s) At umst ester OMY Ensp~ ~t issst ateY ` / II H'i , .1 13 NA & Iit ilsxt Drava en+mzlf a rmxww CI NA Ati~t~'~Y YINAR a NA Fkam, ,d st Ats611st crss+ e*WY 3 a NA Ubest waeSMY oa r` r arcs Otto, aoseAM W _ r am~ Br~3'lf tae ~ssa~ ~!►vldstsi cep 001"O"mmaw Pan- taint wm*j" a vivid k . sD be vmww ca t Sam CWPC sib macom sw fn WY tank ee d s '"th egisfte aid V%m aobssept I i mss. ~ ar b. p-ft.W OYat 'M.ftd PC' Dew MdOMM Or St •~~ac t A taws) farft P °E aFa mw coe wucmL ti &M at" -It proem ~ ~ a pww cwt- to is& . r pvt am ft=ft St in tf~ mdace- , the stag root 0= S1Af.r' t c7elt{S in am huge When i u ies~[~ the mem e V.) ii2t~ hahwata kv b- go COKS) aid MWsa M*ai the vrffi bg s dose. C _ Tra apower to tto id s t pthe cOnbuts a pkm*wcr POINTS i tp ob 10 a tyotrttat isvats v&ftfn ! PAP tmt. f S S ora CSOL Do not dt11f8 or OW- Do ~ mtMOOOrPM* WON ObW sod a~ area. am tttiif>i~t 15 fed dates sbps ~ stz~am rimy impm" the ~ and pmbW ft ift osi or-~ frost: the yr vser of Me t#e buttk cord tin swabsi hater digit (ice) water, s w+lwYr sassst assd ss+aesier bsirre. s id SCOW nodk*50=a~ ABANDONOMT t gent out of mn*o the f watt h f yet:"tsm= #W &A iAlttdt 1lt6 #tOY 'S t6e5s ouvorls pcptarm with ch- cmrm 83.33. Wlsc0n*'i4dES~ Code: sta be wed and this abandoned sstszatt bo ses:save+d and psapo* 4,poaad of by s SeDtW Swvkft CtwfxWr. s .llp j,j.icW:pjjgd*mffbe -h Slid removed or #f M 96M* sat wave, CONT YPLAN q nvs gave been, cc nusst,be f tDa O°~ if the Pauv S f~ and clot be tteptxi iias beers eva.koted and aW be lea for 0* lOcKftft Ofs re~ soff p AsUMObb Tin ~ ~ amo sh*uid be praaedsd from ds grid aabsncpBM t shot4d fta:rs e~dsticig arid ~ tort. Saes. mid visas. Faitune b be t by setba~ in the need fcr a new sob and siteevat3t ors fa a< s<tsabie Woposed the ~ era=s vim! e3~ trstrst ~pM the res~s ass, etfecx at.tta~ ; ammices in POW TS Bmft axe due to an.&Or sail ftmS&W S• D A sc~abtffi IS riot av the fad POAIIM " Uc?U~ a tmAdW tattknisy be b-,std1t d. W a last resort m rePtam fad of fire POiKtSs sod and i ,Ihe s tsar clot bees: avatsoWd f o idenW a s~bte reps if tsa rap~aoe s a~rai<abbe sk ame m ~ sulb~ :~zzs teat may be hndm ted as a ftst resort to replace the ft w POVVM of iha btan>ai at . and at- axes W,,SW= may be cted In piscD ftftmoko s8xrtoval ~~1ltat` ttrne~. the tcsti e : R~oortstssrdiosss of sisds * rust carpi Y waft 030 alter In <<VVARMR4G,-> - ~ ~C~T MYt,'M SoMc,, PUttttP AM OTHM MEATAMWT TANKS MAY Cvt~rrAts~ I ANY ~ DF~tTH MAY l1tOT EitirTHtA SRO,, . t CK CT HM TREATMENT TANK L E1tZt= IDH" T OR aumo om E DO - Resut m .mmc uE OF A PEA Ft TM OF A TANK MAY 90 DlFF~CiTL ADO3' MAi . CDlfi 33 MMS ikAWA . PUWfS tHS"TJ4t.L.F.R i'tarsie Q Iv fJ ,r" . ' `_Narne /t Plxu a f' SEP' AM S'ERytC.M UAfEJR1T1 :s { T rtes aoesnant.~sar~eed' bX~+: s~ atlhs , tam, amr~ea and W~rsrs .covaty?oN+sg . ~ smodbavoift efdLCa=m 45.2 }ftJ ar083_Sgf).(Z M% oorlskAtt CVdew tlwofttsbdoeus~~does,rot ianst ,M p ow woe of the pilir ' cW ST. CROIX COUNTY SEPTIC TANK MAINTENANCE A AND OWNERSHIP CERTIFICATION F RM Owner/Buyer 1 l ~U,tl.~ Mailing Address f / 1 s C) Property Address (Verification required from Phmm g & Zomng Deputrow: for new constmcaoa) N aD►~ s~~ city/sW10 b''~ y»vvn~7+~ Parcel IdCnttficatton LF,gAL DES '/4 Sec. T ~N R W, Town of T!z m 0 Property Locatlon, Lot # S Subdivision a r Certified Survey Map Volu ne , Page # Volume ,Page # Warranty Deed no Lot linos le ~ no ~ hou" y~ SYSTEM IVfAMF'yANCE AND OWNER CERTIFICATION improper V" and ice of your septic system could result m its Preentm fx*n to beadle wastos. Proper a liamood pumper- Wbail yen pw ~O consists of pwpiug Dort the septic tank every *M years or sooner. if the system can affect the function of the septic tank as a tteatment stage in the wasu disposal system. Owner x ospons~'bitities are gwified in §Comom. 83.52(1) and in Chapter 12 - St. Croix CMIXtY Sanitary fie' St Croix County Planning 8t ZM* Department a certification form, signed by the The property owner agrees to submit to luWber or a li ptmoper Vein*g that (1) the on-site owner and by a Wastes plumber, join plumber, restricted P and pumping (if necessary), the septic tank is wastewater disposal systesn is in proper operating condition and/or (2) after inq~ less than 15 full of sludge: have read the above mgpneavents and toweiv the private sevmge disposal sy~ta with the 1hvc, the of Natnxal R Stale of Wisconsin. standards sae faith, b ezein, as not by the Degm meat of Commerce and the D to the St. Croix county Plate ~ Certification stating that your septic system has been maintained moult be compl and returned Zoning Department within 30 days of *0 three YM expiration date. dis' fora are true to the best of my/our knowledge. Uwe atdare the owner(s) of ft I/we certify that alt stataoorcnta on deed recorded in Registcr of Deo~s Office, property deamibed above, by virtue of a Number of b ms S SIGNA OF APPLICANT(S) DATE ***Aay information that is misrcpren owd may result in the samitary permit being ievobed by the MILL13 ia8 8r Zoning D 7 .L lnrbde, with this application a recorded warranty deed from the Register of Deeds ce and a copy of the certified survey map If refu+eaee is made in ttxe warmly deed. I (REV. 08/05) I Wisconsin Department of Crxnmercis'/ IL EVALUATION REPORT Page Division of Safety and Buildings in accordan Comm 85. Wis. Adm. Code County Attach complete site plan on paper not less than must include, but not limited to: vertical and horizontal r eren n and Parcel I.D. percent slope, scale or dimensions, north arrow, a location and distance to nearest oad. Date 1 6 2005 Revie by Please print all informati Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) Property Owner ST, CKOIX erty L tion tCE of -1; 11 ~t1/4 T 97 N R E ( r) 1 l Property Owners Mailing Address Lot # Block # Subd. Name or CSM# / 5- e r cS~ 1C J&Y4 State Zip Code P e Number ❑ C. ❑ Village own Nearest Road 5-1 t G P D New Construction Use Residential J Number of bedrooms Code derived design flow rate 91 ❑ Replacement ❑ Public or commerci I - Describe: Parent matedaks74-fP u ~w7E ~ T°- Flood Plain elevation if applicable General and recommendations: r i l?~ u 1-1 Boring Boring # ~ 57, Depth to limitifactor/ i4-E ` Pit Ground surface elev. L- ft. limiting Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence BouD/fF Gr. Sz. Sh. •E1f#2 in. Munsell Ou. Sz. Cont. Color 7_ -00- ~4z4~1 3 O ring e elev., ft. Depth to limiting factor in. Soil lication Rate Boring Ej Pit Ground surfac Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF Gr. Sz. Sh. •Eff#1 •Eff#2 in. Munsell Qu. Sz. Cont Color -3 l ( r Effluent #1 = BOD > 30 1220 mglL and TSS >30 < ' Effluent #2 = BOD 130 mg/L and TSS < 30 mg& CST Name (Please Print) CST Number Bird Plumbing, Inc. Shaun Bird ignature 226900 Date Evaluation Conducted Telephone Number Address 1008 192nd Ave, New Richmond, WI 54017 p-- 715-246-4516 Property Owner _ Parcel ID # Page of Boring # ❑ Boring ® pit Ground surface elev. Oft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPOIit? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 r3/ / o~ lY► c , (P I,o 2_1 Lj /11 "1 10 -70 a L) b Boring F-1 # ❑ Boring ❑ Pit Ground surface elev. ff. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant color Redox Description Texture Structure Consistence Boundary Roots GPD/fE in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 Boring C] Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate. Horizon Depth Dominant color Redox Description. Texture Structure Consistence Boundary Roots GPD/W in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'EflW • Effluent #1 = BOD$ > 30 < 220 mg/L and TSS >30 150 mg/L ' Effluent #2 = BOD5 130 mg/L and TSS < 30 mgA_ 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 608-2648777. seas3w (RAW) Soil Test Plot Pla4aud,,/ Proj~t Name Cornerstone Properties LLC ShAdd ress 1025 170th Ave Hammond Wi 54015 C ?M Lot 15 Subdivision Corner Stone Ridge Date 111105 S 1/2 SE 1/4S 8 T 29 N/R17 W Township Hammond Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Fence Post System Elevation 98.4 *HRPSame as Benchmark Alternate Benchmark is Top of Survey Iron @ 95.7' 93' Property Scale is 1 = 40 unless otherwise 144' Property Line noted B-3 50' 98 30' 207' Property Line 96' AO~ 30' 100' B-2 B-1 8% Slope I I 303' Property Line 212' Property Line 100th Ave L .0 PROPOSED DRIVEWAY NOTES: DRAINAGE EASEMENT ® PROPOSED JOINT DRIVEWAY AL SULDOM 70 BE CONS WM N PRONUW of NOTE. FtlOH WRIER ElEYAION SHALL HA~E1MAq W~MfST NO 00" OR PENDENT !HILL 00 MY*M M CH HWE HIGH WATER ELEVATION Ae i r~w1OMUiEP Eity np gpMK MOULD NWW`M "OR O&ANK M M'MM OF WE APPROVED COMPPEHBI W WAI R DRANALC PR01NT . AND SOL OtOSKH KM FOR 7W PUT. IRS LBO LOWEST BUILDING OPENING SETBACKS: So REAR - (WLESS 071iJKMISE MOM) NC1AE4 BUT O HOT OHIIED TO BLRDHO UP011. COUNTY SECTION MONUMENT ' ( ) 7M rdxwAY4 uR OR (FOUND AS NOTED) CULYEWNS, BERMS, OR GRASS SEEDOM SET 1 1/4" BY 18" IRON GENERAL NOTICE PIN Wr. 4.172 LBS./FT. STATEMENT. -1- SET 3/4" BY 18' IRON PIN pPCATR3 ~ * ON To sTA1N: COINTK AHD Td N19RP uW5 WEIGHING 1.50 POUNDS 1HS NAP E PER LINEAR FOOT AT ALL LOr S AND ~ D E' $ IMHYIY OT U- ACCESS % 70 PPAROEL. G ETC.) BEFORE OTHER LOT GARNERS OONTACT K ST cMm ANY PAKEL OF LAND, zwo AID THE APPROPRIATE TOMH BOARD FOR AONCE iJMUTY EASEMENTS: NO POLE OR allRM CABLES ARE 10 K PLACED SUCH THAT THE OWALAIM MOULD NSIM ANY nRYEY STCR SAN.TROR OBSIRUGT %4" ALONG ANY f LBE EET NNE TIE DISTURBANCE OF A N $•4'31'05' E 465.51' - - - - - - - SUM" STAKE BY ANYONE IS A NOLAION OF SECOON 276.32 YA5COIISMN STAWIES 01LIlY HMM SET FOM ARE HWA7E/1+ FOR 11E EASBAEM OFU9E PUBLIC BODIES AND G u,M7UE5 HANNO A PIIiIT TO SUM TIE RECEIVED 8' 90 S.F. 2.01 Ac. 9k9 AUG 2 3 2005 u NMIE-T0.70.6o 41 o 030.103260 ai1'~ry " 7'n ST. CROIX COUNTY o ZONING OFFICE LOT B 102663 S.F. c 2.36 Ac. u a I ' ®1 I 66' 1 N 82'28 56• E 440.05' ' / LOT 9 E 1/4 COR SEC Iv 8 T29N R17W 75629 S.F. ~4 FOUND P.K. NAIL 1.74 Ac. Kn UNPLATTED LANDS o N 81-47',39- o u W 483,74. N 89'20'10" E 610.00' LOT 10 577.00• iA / 86121 S.F. ' 100• I w 1.98 Ac. W LOT 18 of $ 116164 S.F. II "I 2.67 Ac. ( I 33 33' I N 76. x•49• 10 W 513.60. o 1 I o y N 89'34'21' E 585.59 -L -9 14 80567 LOT 11 S.F. z I Kn 93.46' 492.13 I 1.84 Ac. 0hti~ Z o I a, w g• 1V `A'DO o LOT 17 s c Ri ~2g5, h o, 93446 S.F. /ol w oo ~m 1 I/ I o N 8935'14' E 230.17 0 L 4 2.14 Ac. s►id 10 I LOT 15 oI Le.o.-1a1.o I I -Al OD I~ 88639 S.F. ~ m +,.4 Io o LOT 14 zo 2.03 Ac. .4Z H^ 0 70135 S.F. o oni IIwE-1035.27 riAj~ N 89'41.34' E 439.12' 1.61 Ac. as Le.o.-1037.27 j o", 100' I ~IA LOT 16 ~ _ _ " LB.o..1o4T.o 90914 S.F. j to no °r` f e7'c Z_--- 2.09 Ac. V7' 3T r N 0 4: AAINAtMTFYFNT --1388.84_-Pi Y I "8 o I ~I YI a ul ~I 230 245.82' - - - - 0429.84'-------=.~I 33 33'~ S 89'04'17" W 1796.45' _S 89ro~4'17' W 1830.54' - 100TH AVENUE LINEOFSEC.18,L29N,R.17W --T-------_r---- SECOR-- _LOT 29 I _LOT 1 I LOT 2 1 I I TSEC 8 29N ILIN ~RICULTURE-RESIDENTIAL I CERTIFIED SURVEY MAP - I CERTIFIED SURVEY MAP R17W SHEET 1 OF 2 • ' IllllllllllllllllVllllllllhill(IIIIIIIIIIIIIIIiI State Bar of Wisconsin Form 1-2003 8 7 1 8 6 3 1 WARRANTY DEED 871863 KATHLEEN H. WALSH Document Number Document Name REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 04/01/2008 01:45PH THIS DEED, made between Fletch Investments, LLC, a Wisconsin limited liability WARRANTY DEED company, 66.69% interest and Craig Shermoen. 33.31 % interest EXEMPT t ("Grantor," whether one or more), REC FEE: 11.00 and William J. Fletch a married person TRANS FEE: 590.10 ("Grantee," whether one or more). PAGES : 1 Grantor, for a valuable consideration, conveys to Grantee the following described real Recording Area estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is needed, please attach Name an¢ AffldddtessEstreen addendum): 304 ~oCUSt Street Lots 1, 8,11,12 and 15, Cornerstone Ridge, St. Croix County, Wisconsin Hudson, Wl 54016 LtD1- 17 1502-P,- 018-2013-01-000; 018-2013-08-000; 018-2013-I1- 000;018-2013-12-000:018-2013-15.000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: easements, restrictions and reservations, if any, of record Dated -3 '108 Fletch Inv/estments, LLC Fletch Invest ents, 1 By: a. 6,74- R-4& !wv It, c (SEAL)By: - , t I i~ 49Ah) *Jay Floie ch, member *William F1 A, member (SEAS,) (SEAL) g ermcen AUTHENTICATION ACKNOWLEDGMENT Signature(s) Fletch Investments, LLC, a Wisconsin limited liability company, by Jay Fletch, member and STATE OF ) William Fletch member ) ss. authenticated on d COUNTY ) Personally came before me on L~ ' / *Kristina land the above-named Craie Shermoen TITLE: MEMBERS ATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, in rume -ackrrawiedjed the same. authorized by Wis. Stat. § 706.06) s , THIS INSTRUMENT DRAFTED BY: Notary Public, State of Kristina Ogland, Estreen & Ogland My Commission (is permanent ( pires. ab , _24/ 304 Locust Street. Hudson, WI 54016 (Signatures may be authenticate(l or NOTE: THIS IS A STANDARD FORM. ANY MODIFICAT Y IDENTIFIED. WARRANTY DEED ® 2003 STATE B FORM NO. 1-2003 * Type name below signatures. INFO-PROTM Legal Forms 800-655-2021 www.infoprofbrrns.com J S •00'10'23" E 641.97' 170TH STREET abet - 'M S' 00'10'23" E 609.12' --.0i; 201.04' , 201.18' 206.90' 33' 33'1 rS ' ' - VX I i I N l ~ I I i 100' 1 CD I QI pl ~ Q Oo ~an p rn o ► I of CC) LL: OD 04 OD 0) a.1 ~L d- Q W E-4 (qD s o I I ~ I (D C~ o(D`° N aPO (V0 \ \ I V- 0) C6 M ~ $ m of wl OD J I ~I z MI i I F o I l \ 2'41'41" W I ( Wl ~I N w 2°6'9 3 4&5'r 11.75 I ;I I I V I ZI 15 I g co 0 - Q) ~ W 1;~3 "9Z,81.Z0 N POI Oo NI C~ W w I ~ ~ 00 N y m $ 8 s~.sr 9 Z ~ I I s8• `s~► ~ Wei I 118.43' GLOW m N 00'26'02" W ' 303.31' ' _ f__ I I rn i~ 1isa'oz' N M 00 w Q00 I ~I z 1 co U- 0 Q M ~p wM N I in 0 N co M a0 I I I Iw r- r--1 ui V I I 0) N NIL < 00 t- I'~ r &.4 r- LO z 3 O to p 00 N 00'19'57" W 306.39' 1 3 j\ 10 2 00 105.40 19999' LLI I i Q I P _ °jh I N U) 1- v U- r ~ r o ' - ~ , VAW VL} is IMdp f I i 1 fir- ~ r M e r "r l ~ f ! O F r • C Is, r