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010-1037-30-200
cn n a ~ ~ a r ~ s r\ ro j Q '~ ~ O Q co 'D C CD Q. w Z p ~. o N O Z I o n v I P I w I o '~! O N ~ cNn ~ m c ~ ~ p ~ 3 ~~ ~ ~ O ~ CD n O Q 7 v, j IN C> O ~ ~~~ O Z c, m a W ~ a ~ ~ a ~ ~ C 7 O S Q O C m m pA. 0~ N C~ j n 7~ ~ a ~3 °-cn aa~ c ° ~ ^• c~am~mov~w o f0 n 7 y 0 ~ O ~ O S N O O~~ w N 3'~O'K ~'(D Sa-0.P O p~ UN O N ~ C1 ~. SI1 y .A. N i11 ~ 6) N c0 Q N O ~,. C4 d (D ~ F N~~ np v 0 ~~ N Q O~ S 3 ~_ 0~ 7 vii ~ y' O N (Q ~ ~ O. < ~7 O ~ - _ fD O~ N (R O O N tD O...a pnj ~ ,z ~ ~ O C'1 ~ ma v~aw ~Do N~ ai fD O N. p O N Q~ fD O O r. ~ W 7 N W `~~ [JNO 00 (j "" N ~ S ~ N C7 3O3~fDm o ~ ~ m ~{x -o ~ ~ m N ~ ~ 4 Q CC Efl ~ O ~ ro °o ~ C1 UJ C Q ;' ~ i 'U C7 O ~ ri \/ ~ C rr ~ , 7 ~ ~ ~ 3 N ~ '~, i ~ A ~ ~ V ~ W ~ ~ ': ~ ~ (~ A7 1 3 '~ ~ ~ ~ ~ o ~ w ° r. m w o R ~ ~ '' a ' m ` ~ 7 ~ O ~ w N "'C ~ ` 1 o '' ~ O D N ~ O 3 N ~ i O O O ~ ~ ! ~ m m 4 ~ ', ' a w N O `O ~ C .~ b N A ¢ ,, °o o° ~ ~ n ~ r N o c ~ rn m 3 ' ~ ~ a '~ e. N y N ~ ~ ~ D ~o ov ~ ' ~ d s ~ ',~ -o K ~ N y cn N ~ v N N o D D a ~ ~• N O ~ ''I hl A Z ~ J ~ .p. Z O v W~ m o , a ~ -' z o ~ ~ ~ c .: ~ cn ~ _ rn ~ ~! z ~ O ~ _ ~~', ? i t T II C a S J b ~I ~ ' i ,i ti N ' N ~ o 0 ,~ ~ .. ` r ~ N ^~ A ~ a , N Parcel #: 010-1037-30-200 09/12/2007 11:14 AM PAGE 1 OF 1 Alt. Parcel #: 15.30.16.227A-30 010 -TOWN OF EMERALD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 10/16/2006 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O -TOWN OF EMERALD TOWN OF EMERALD 2898 CTY RD G EMERALD WI 54013 Districts: SC =School SP =Special Property Address(es): " =Primary Type Dist # Description SC 2198 GLENWOOD CITY SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 3.000 Plat: 5272-CSM 21-5272 SEC 15 T30N R16W PT SE SW FKA CSM Block/Condo Bldg: LOT 06 15/4076 LOT 5 NKA CSM 21-5272 LOT 6 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 15-30N-16W SE SW Notes: Parcel History: Date Doc # Vol/Page Type 10/20/2006 837076 WD 09/13/2006 834441 CSM 08/09/2006 831764 QC 07/23/1997 859/95 more... ~nn7 CI IMMeRV Bill #: Fair Market Value: Assessed with: -- - - - - ------- -- - - 0 Valuations: Last Changed: 05/22/2007 Description Class Acres Land Improve Total State Reason OTHER X4 3.000 0 0 0 NO Totals for 2007: General Property 0.000 0 0 0 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 Parcel #: 010-1040-10-000 09/12/2007 11:20 AM PAGE 1 OF 1 Alt. Parcel #: 16.30.16.247B 010 -TOWN OF EMERALD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O -TOWN OF EMERALD, %TOWN CLERK %TOWN CLERK TOWN OF EMERALD 2684 154TH AVE EMERALD WI 54013 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description SC 2198 GLENWOOD CITY SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 0.500 Plat: N/A-NOT AVAILABLE SEC 16 T30N R16W 1/2A SE COR SE SE Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 16-30N-16W Notes: Parcel History: Date Doc # Vol/Page Type 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/17/1988 Description Class Acres Land Improve Total State Reason OTHER X4 0.500 0 0 0 NO Totals for 2007: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2006: General Property 0.000 0 0 0 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 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.o4 (1)(m)]. Permit Holder's Name: City Village X Township Loaterman. Norman Emerald, Town of BM Elev: ~ UU -0 TANK INFORMATION ACK INFORMATION MP/SIPHON INFORMATION ~~'~- ~~ C~t~ Manufacturer Demand GPM Model Number TDH Lift Fricti ss System Head TDH Ft Forcemain Length Dia. ' t. to Well t+/1O A~cA~~T1A1J CVCTCAA /1 / ~~w i'w ELEVATI DAT/~ unty St. CrOIX Hilary Permit No: 499117 0 de Plan ID No: rcel Tax No: 010-1037-30-100 ~tion/Town/Range/Map No: 15.30.16.227A20 STATION BS Hi FS ELEV. Benchmark 2. Z /0 2 • ~ v Alt. BM Bldg. Sewer 5~`. ./ r S t Inl t 22° ~ ~ ~ 5. Si t •L'd1~,!'l ~I'Zf~ ' Dt Inlet 5 Dt Bottom Header/Man. • ~ ~~ ~ Dist. Pipe Bot. System Final Grade ~ ~ t Cover ~ ~' / ~~ , 4'-t b w ,~{-~(~~-- /Iv-/J`am`- ~ , - BED/TRENCH Width Length / Tre hes PIT DIM S No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO /L LDG W LL LAKE/STREAM LEA Manufacturer: BER OR INFORMATION Type Of System: UNIT Mode ber: 111CTCIQIITIl1AI CVCTCIU .l 1 / l'" ~ Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing G~/1n /+l1VCD ../ __.-__ n.._._.v_ ~~,.. .... nn,......a n~ t1r_f_rnNo Cvciomc (]nlv Depth Over Depth Over xx De th of xx Seeded/Sodded xx Mulche Bed/Trench Center Bed/Trench Ed es To soil Yes No Yes No COMM?ENT3S~(Incl d cod is r encies, persons present, etc.) Inspection #1: ~~ l ~ L l~ Inspection #2: / / LocatiolS ~ETVDING~own (SE 1/4 SW 1/4 16 T30N R16W) NA Lot 5 ~ ' .~ Parcel o: 15.30.16. 27A20 ~ ~~ ~~~ 1.) Alt BM Description - ~ ~ /~ ~~ I ~ ~~ /~~~,,t n ,_, ~' ~ /~ 2.) Bldg sewer length = 2 O -r ~ J,' n (~ "~ v'"UX - ~" " - amount of cover = ~ /~, ~ ~/J _ ~ ,~ f ~ ~ ;~ l~ Gf/~-~ ~ i~Q- ~ ' ~' 2 ~) a Plan revision Required? Yes o ) „~~~~! Use other side for additional information. _ .( . 12- ~Q~? -- ----_ --N - ~ "`~ r - ~ert~lN"o. ~N Date Insepctor's Signatur 'qD-6710(R.3197) sp. BM Elev: ,l IBM Description: ~~ ~ O ', TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding ,/~/ / TANK TO P/L WELL BLDG. Vent t Air Intake ROAD Septic Dosing Aer Holding ~ ~J' ~~ ~ .~ Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 Counry~F n ex (- (~j! ~ Madison, WI 53707 - 7162 ,~~O~~, Sanitary Permit Number (to be filled in by Co.) r (608) 266-3151 ~ 9 ~ ~~ 7 Department of Commerce Sanitary Permit Application State Plan LD. Number S ~ In accord with Comm 83.21, Wis. Adm. Code, personal information you p e may be used for secondary purposes Privacy Law, s15.04(I)(m) ect Address tf t Brent t ailing ~ress) / ( ~ ` ~ ~ I. Application Information -Please Print All Information E ` l Z ~ ~ OI 1OJ ~ Property Owner's Name p6 ~J ' ~ ~^ ~ arcel~ ~ Block # N A~ -~, l~ ~ r-~. ct~ 0 Property Owner's Mailing Address Q /~ ,~ ~,/n~ TY 6 ,~~ c7t-~ l~`t'~ ~' . COUN operty Location ~ '/<,~`~/, Section City, State - I ' M Zip Code Pho u er -7 ~~irc one + ~7 ~' ~ - ~ II. ype of Building (check all that apply) Subdivision Name CSM Number 2 Family Dwelling -Number of_/B,,edrooms C ~ ~ ~ ~ ~ I I J n L~ ~ ~ l ~`" ` ~O "' ""~ ublic/Commercial -Describe Use / O (~ r~ J- ^Villa ownship of ^City ^ State Owned -Describe Use _ III. Type o Permit: (Check only one box on line A. Complete line B if applicable) A. System - ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System ~~ List Previous Permit Number and Date Issued B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New Before Expiration - Plumber Owner IV. T e of POWT5 S stem: Check all that a 1 ^ Non -Pressurized In-Ground ^ Mound > 24 in. o uitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Consttttcted Wetland ^ Pressurized In-Ground~Ling Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ ~- ^ Other Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe (explain) V. Dis ersaUTreatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation 2 "` 3 - Prefab S ite Steel Fiber Plastic VI. Tank Info Capacity in Total Number Manufacturer Concrete Constructed Glass Gallons Gallons of Units New Tanks Existing Tanks Septic or Holding Tank ~ ~ J Aerobic Treatment Unit Dosing Chamber VII. Responsibility St ent- I, the undersig some responsibility for installation of the POWTS shown on the attached plans. RS N/umber Business Phone Numbe~r / ' tier's Name (Prim) Plumb ~ ature MP/MP p ~ ~ ~'~,c~ ~- Cam? ~J'-~o~ ~"'7J Plum/ber's~Address (Street~jCit1y,~ S~ta~ .Z/i1p C~ y~ /° . ~ / ~ VIII. oun /De artment Use Onl Sanitary Permit Fee (includes Groundwater Dat Issue Issuin ent Signet re Stam Approved Disapprov Surcharge Fee) ~ ~7~ ~~ $ ~ D~ G r riven Reason for e IX. Conditions of ApprovaUReasons for Disapproval 3~ ~~~ n r ~ ~~~ ~~.~,~ ~ ~ ~ !e ~ ,~... SYSTEM OWNER: 4 1 1. Septic tank, effluent lifter and ~w~~ V~-~ o ~ e , ~ dispersal cell must all be servitaa ~ mainta31I4li v r ~ ~~ J as per management plan provided by p n 5 , ,~, ,~,n,~~- 1~2, ~~CC„ d ~~ ~CJ tn i ~ M . 2. All setback requirements mtut be mainta ~ ~~~r2.. t7 as par applcable code ~ ordir-snces. ~ r n~~~.'''~, "SS~Q~,., ' ` r not less than 81/2 x 11 inches in size .- e Attach complete plans (to the County only) for the system on pap ~~ join. o~ SBD-6398 (R. 01/03) li o,n_ ow~- ~; ~~ ~a t~ tom- Cal ~~ ~~ J ~~J r~~: r~ -~ PLOT PLAN PROJECT ,Emerald Township ADDRESS 1315 260th St. Glenwood Wi 54013 ~~. 1/4 SE 1/4S ~~/T 30 N/R 16 '~ ~?, „S`~'ST~;M ELEVATION _ ~ )"`.' CONVENTIONAL W TJWN Emerald COUNTY ST. CROIX N/A 329 GPD AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE 3000 gallon LOAD RATE ABSORPTION AREA # of chambers BENCHMARK V.R.P. TBD ASSUME ELEVATION 100° Filter Zabel A-100 ^ BOREHOLE O WELL *H.R.P. SE corner of property CaICS: 30' X 45' assembly hall = 1350 ft^2 X 1 person/loft^2= 135 persons 135 person X 1.3 gpd/person = 176 gpd 3 floor drains X 25 gpd/drain = 75 gpd 1 employee X 13 gpd/ employee= 13 gpd 1 catch basin X 65 gallons/basin= 65 gpd Total GPD= 329 gallons 329 gallons X 5 days = 1645 gallons required Going to use 3000 gallon tank! Scale = 1 /4" = 10' 500' Property Line unless otherwise noted Tank is to be N ~ ,~~~e1~ properly bedded 3S~ and provided Assembly hall office/bathrooms Parking S ~ with lockdown v ~ 2.Z ~ ~ ~ covers with ~~+~ approved warning labels Garage HT ~r~ _ ~ ~ ,. Driveway DNR approval is also required for this holding tank. The proper forms are being submitted The siteis suitable for a future mound system, at that time this tank would be used for the garage catch basin only! The soil test indicated no high ground water conditions that would require anchoring of the holding tank oA 150' ~~,~ ~~~ H.R.P~ t LOT PLAN PROJECT Emerald Township ADDRESS 1315 260th St. Glenwood Wi 54013 ,~~' - 1/4 SE i/4S ~~/T 30 N/R 16 W TOWN Emerald COUNTY ST.CROIX C? ~, ,5~'STIM ELEVATION >`^.' CONVENTIONAL N/A AT-GRADE MOUND SEPTIC TANK SIZE GPD 329 CONVENTIONAL LIFT HOLDING TANK LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE 3000 gallon LOAD RATE ABSORPTION AREA # of chambers BENCHMARK V.R.P. TBD ASSUME ELEVATION 100° Filter Zabel A-100 ^ BOREHOLE O WELL *H.R.P. SE corner of property Calcs: 30' X 45' assembly hall = 1350 ft^2 X 1 person/loft^2= 135 persons 135 person X 1.3 gpd/person = 176 gpd 3 floor drains X 25 gpd/drain = 75 gpd 1 employee X 13 gpd/ employee= 13 gpd 1 catch basin X 65 gallons/basin= 65 gpd Total GPD= 329 gallons 329 gallons X 5 days = 1645 gallons required Going to use 3000 gallon tank! Scale = 1 /4" = 10' 5_00' Pro erty Lin ?.~'~' unless otherwise noted Tank is to be properly bedded and provided with lockdown 1 covers with Assembly hall approved warning labels office/bathrooms Garage HT r-~ _ ~~~1 o~ Driveway <25' from holding tank DNR approval is also required for this holding tank. The proper forms are being submitted The site is suitable for a future mound system, at that time this 150' tank would be used for the garage catch basin only! The soil test indicated no high ground water conditions that would require anchoring of the holding tank H.R.P~ Parking r''" ~~~I~~D~ ~' ~~~ • ~~ commerce.wi.gov i r ~scons~n Department of Commerce July 27, 2006 CUST ID No. 226900 ATTN.• POWTS Inspector Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. commerce.wi. g ov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1 l0i CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/27/2008 Identification Numbers Transaction ID No. 1295890 SITE• Site ID No. 716060 Emerald Township Please refer to both identification numbers, County Hwy G above, in all corres ondence with the a enc . Town of Emerald St Croix County ` -' 1/4, 114, S~ T30N, R16W )N`O'R: ,,.,~ Des~ption; Commercial (Assembly Hall, Office and Garage) Holding Tank System Object Type: POWTS Component Manual Regulated Object ID No.: 1088552 Maintenance required; 329 GPD Flow rate; System: Holding Tank Component Manual, SBD-10571-P (8.6/99); Cormercial System 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: Requirements: This system is to be constructed and located in accordance with the enclosed approved plans and with the "Holding Tank Component Manual for Private Onsite. Wastewater Systems" SBD-10571-P (R:6/99). •, This plan has a written statement of concurrence from. the Department of Natural Resources. • A notarized Holding Tank Agreement between the local governmental unit/Municipality and the property owner is required prior to the issuance of a sanitary permit. A Holding Tank Servicing Contract may also be required if no other service provider for the holding tank has been identified. • A service drive or road is to be provided to the service access opening or pump out port. The minimum measured distance. required is 25 feet. • The well must be a minimum of 25 feet from any POWTS tank. 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. APPRQ SEE SHAUN R BIRD Page 2 7/27/2006 • 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/installationloperation. 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 maybe 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, ~~~~ ~ ~r~ _~ Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday charlie.bratz@wisconsin. gov Fee Required $ 60.00 Fee Received $ 60.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 i Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 7/20/06 ~ -J 1. r. ~~ Owner: EmPr~ld Township Location... °~'1/4 ~e= ~/4 S'~ T30 N,R16W Cty Rd G Emerald t~ ~ J System type: Holding Tank Manuals Used: Holding Tank Component Manual Page# 1. Cover Page 2. Holding Tank Plot Plan 3. Holding Tank Cross Section 4. Maintance and Contingency Plan Signature, License nurryb,~r 1864-007 RECEI~/ED JUL 2 1 2006 SAFES ~ E~~~-~rNGS ~. ..sNgv ~ti '; Blgp R _ _~ o . NEW864-007 ' ~~ : RICHMONO.,~ w` ~~~ ~ POV1~ ,.~` . {~~~~ ,. ~~ ~° ~~ ~ ~'oattii~~cs ~~ 1NGS 'ONDENC .. Approved -dent Cap 4" C.I. -- Vent Pipe ~~~ MOLDING TANK CROSS-SECTION Weather Proof Jurdti on Box Approved Locking Manhole Cover With Warning La el ~ tached Minimum 12" ~ ~~ Final Grade f ~ 4" Minimum ., ` ~ ','~~~ Approved Joint (~ ~ ' 'Water Tight-°` Seal ~ High ~a~'~ ~ ' 1 ~ a~a S~ii~'° '~'`~ ~ ' ~ SPECIFICATIONS ~ ~. ------_~ TANK New ~ Existin Menu a~cturer: ~~ Blind C.I. Tank Sixe._3 ~~ Gallons "Plug ALARM Manufacturer: (/C,~f-o ~-- .~P Model N~;i~~er: .Switch Type ~,, , NUMBER OF BEDROOMS: /vj ~ GALLONS PER DAY: 302 3" of Bedding Under Tank Owner's Name: ~~~~ o~,s ' Address: 3 js- .~. ~~ ~ ~~ SYv, 3 legal Di scri pti on : ~ < '; ~j~~ TownshiplMun'cip~a qty: 2~~ County: ~.~,~„,~ PLUMBER/DESIGNER Signature: License Num er: Date: ,- 18" Minimum Approved Join w/ C.I. Pipe Extending 3" Onto Solid So HOLu[~a TANK MANAGEMENT PLAN This Private Onsite Wastewater Treatment System (POWYS) has been designed, and is to be installed and ma{ntained according to Comm 83, Wis. Admin. Code, the Ho{ding Tank Component Manual (SBD-10571-P 6/11/1999), and the ~, ~ • ~ .- ~ ; ~ _ County Sanitary Ordinance. 1. This POWYS is designed to accommodate an est{mated domestic wastewater flaw of J o~ gpd. 2. The owner of this POWYS is responssble far system operation and maintenance, including ail provisions in the attached Holding Tank Servicing Contract and Main#enance Agreements. 3. Each time the wastewater in the second tank reaches a level of 12" below the inlet invert (at which time the alarm will activate), the pumper listed in the current Servicing Contract must be ca{led to empty the tank's contents and dispose of them in accordance with NR 113, Wis. Adm. Code. 4. At each service even#, the service provider should visually inspect the condition of the tank, risers aad manhole cover(s) and verify that the alarm system functions and manhole locking devices are present. Discrepancies are reported to the owner in a timely manner for corrective action. All corrective actions shall comply with the county san{tary ordinance and Comm 83 and 84 Wls. Adm. Code. 5. Ail service events or inspections of this POWYS shall be reported to the county within 10 business days. 6. The owner may not remove any of the wastes from the holding tank(s), or cause such wastes to be removed by any person not authorized to do so under Ch. 281, Wis. Statutes. The discharge of wastes from this holding tank to the ground surface, including intentiona[~discharges and discharges caused by neglect, constitutes a failing POWYS and may result in issuance of correction orders or a citation by the county or state. 7. No one should enter a holding tank for anv reason without being in full compliance with OSHA standards for entering a con#ined space. Ina atmosphi3re within these tanks may contain lethal gases, and nsscue of a person from the interior of the tank may be di#1';cult or impossible. 8. In the event that this POWYS fails and cannot be repaired, a cads comp{iant~replacement holding tank may be insta{led in the same location (a new sanitary permit is required for such a replacement). Connection to municipal services would also be considered at this time if they are deemed available to the proQerty. 9. if this POWYS is rep{aced, or its use discontinued, components no longer in use it shall be abandoned in accordance w{th Comm 83.33 Wis. Adm. Code. 10. !f there is a problem with, or question abo~ut,~ is a.installer ........................... ~~ b. Service Provider ................ ~czs' c. County Zoning or Health Dept 11. installation, the fo{{owing persons should be contacted: ti Phone: 7~.~ ~~31(~ ~. ~ ~ ~ L7 ~ ~~ Phone: /s $ ~ ~ ~iN~-~ Project: Transaction Number: ST. CROIX COUNTY SEPTIC TANK 1VIAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ~ " e r n`''~f~'`~ ~ o ~ ~ '~ ~~^~ Mailing Address ~ ~ Property Address City/State (Verification required from 1 'ng & Zoning Department for new construction.) > ~ _l~ ~ 7 ~ 0" ~ Parcel Identification Nurnbe LEGAL DESCRIPTION ~ ~ ~ / / ~ ~ ¢=J"-1 /~O T ?J[:~N R~?~W, Town of i Property Location< /a /a ,Sec. , Subdivision Certified Survey Map # Volume Warranty Deed # ` ~ `~ ~ ~ ~' ,Volume Spec house yes V r J ,Page # ~~~~ Page # Lot lines identifiable es no _, Lot # y~ ~ . ~~ . SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. ~ /~? /~ SIGNATURE F APPLICANT(S) DATE *~* Any information that is misrepresented may result in the sanitary permit being revoked by the Planning ~ Zoning Department.*** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified stuvey map if reference is made in the warranty deed. (REV. 08/05) HOLDING TANK SERVICING CONTRACT ConCt?tact Date ) b ~ ~-- ' ~ ~" This contract is made between the Holding Tank Owner(s)/N,ame(s) and Pump^e~r'-s Ncame ,~N~ac ~ owls geihe ins~llatign ofs(a~ding tank(s) on the.foll( wing ro erty. (Provide le a~escriptions;) ~ o t b --------------------------------------------- 1. The owner agrees to file a copy of this contract with the local governmental unit that has signed the pumping agreement required in Comm 83.52(1)(c)1. Wis. Adm. Code and the approved Holding Tank Component Manual. This agreement will also be filed with the St. Croix County Zoning Department. 2. The owner agrees to have the holding tank(s) serviced by the pumper and guarantees to permit the pumper to have access and to enter upon the property for the purpose of servicing the holding tank(s). The owner agrees to maintain the access road or drive so that the pumper can service the holding tank(s) with the pumping equipment. The owner further agrees to pay the p,er for all charges incurred in servicing the haiaing tank(s) as mutually agreed upon by the owner anti p~tnper. 3. The pumper agrees to submit to the local governmental unit that. has signed the pumping agreement and to the County, a report for the servicing of the holding tzatk(sj on a semiannual basis. The pumper further agrees to include the following in the semiannual report: a. The name and address of the person responsible for servicing the holding tank; b. The name of the owner of the holding tank; ' c. The location of the property on which the holding tank is installed; d. The sanitary permit number issued for the holding tank; e. The dates on which the holding tank was serviced; f. The volume in gallons of the contents pumped from the holding tank for each servicing; g. The disposal sites to which the contents from the holding tank were delivered. 4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event of a change in this contract, the owner agrees to file a copy of any changes to this service contract or a copy of a new service contract with local governmental unit and the County named above within ten (10) business days from the date of change to this service contract. Owner(s) Name(s) (Print) Owner's Signature(s) ~~ ~~ Pumper's Name (Print) Pumper's Signature Pumper's Registration Number I ~n+2,-~-z~Z~ i Subscribed and sworn to me on mis aate: ~-~ -o ~ Nt:~f:~ry ~'tiblic Signature n. ~~}} ~~- ~~~~ ~{l.~ I __ - -- Comrnission ~~~ ~~ ~_ ~ 2 # ~s i ~. - . `~.'~~,~,-: ^i ,r '.. ~ '.°~' ~S° d y _F ~~ ,.p~' r# ~ FE ~-"''°z. WI}~_ 1` :~ 5'*'~. 3.~'~'".--~ ~'ya" ~ ~' ~ `T` ~' ~ 'Zi .t; ,~. 4 fin. ~V V'*~'~ _„ 1~4:~~ "h _,~ ~~ ~F .* .'fir b ~ ~ ~- -0~~ l t} ~ } TR~ ~^ 3' yip t+T ~l+ I ~ ~^." $ u. ~ II ~ . t1t .F ... sib ~(;t;~gii~n~a-~ a~tla ~a~a ~. Dra~f~a. t1~i~e i~ii~aiett~a,- ~u~f~in~l.:i~);i~-~irl~e'-its ~` ~o~a~ tanari*s ... (~~~ :~.......:....~ .. ... ..~. ..... ... » ~ a.oc~ .. . ~~ and vrarranb a...~rl~ua.zt. ~..- . ~" jtax~aa sad..~tsr.~c:a. ~ +ir~-w~„ .... Lc~zeraaa,. h~abalid and YrS: u ,~.oi.nt. tenants ~, First Ilatf~l Bank ....... ~ PO Box 245 tM follewinF described rest asate in ........$t.....GLt).17C .................Conngc, ' ~ 8tsts of Wieeoesin: f Ta: Payee! No :................._._......... The South One-half of the Southeast One-fourth (S~ of SW}) of ' Section Fifteen (15), Tornship Thirty North (T30N), Range Sixteen ,i Nest (R16N) EgCBPT for One-hal! (~) acts on the Southeast (SE) corner ;l for school grounds. i AND The Northrest One-fourth (NWT) of Section Trenty-tro (22), Tornship Thirty North (T30N), Range Sixteen West (R16W} ERCEPT that E ~ Fart of the Northrest One-fourth of the Northrest One-fourth (NWT of NW~) of Section Trenty-tro (22). Tornship Thirty North (T30N), Range Sixteen West (R16W) described in Volume 4 of Certified Survey Maps, page 1141 as Certified Survey No. 1141, as Document No. 375247. •-•-•-----•---.(SEAL) ~.~GU.9 4 a -.-- .......-(SEAL) -----........--.....---------------------------------------...... • --.Engene~.Krnizen4a..- ------- - -- - - _......-•----•--.-(SEAL) .~.6L<LUi._f _' .(SEAL) ...... ........................................................... ' - Ma-tie- R-ru-i-zenga _ _._ - -._ This deed is given in fulfillment of a certain land contract between the above parties Dated January 24, 1981, and recorded February 2, 1981, in the office of the Register of Deeds for St. Croix County, Wisconsin, in Volume 624 of Records, at page 485, as Document No. 369117, as aElended by virtue of that certain Amendment of Land Contract dated April 6, 1982, and recorded April 6, 1982, in office of the Register of Deeds for St. Croix County, Wisconsin, in Volume 645 of Records, ~j at page 112, as Document No. 377010. ~~,~ This ....-...i8 nOt---.. homestead property. a (is) ('ss not) Exception to warranties: Easements and restrictions of record, and except any liens or encumbrances created or suffered to be created by the acts and defaults of grantees,. their heirs, successors, or assigns. ,:. Dated this --.....-.-i~~ ..... Cay o! ...-.... Dec. .---- ----- -•--- -- ------------- ----- ----• 19..~ .. •QTS=MTICA?IOM ACHIVOWLSDGIdSNT n(s! .-----•-------------------------•-•--•------..._..._...__._ STATE AF WISCONSIN ~ tai thin »..:_._~Ifj d. ...:_._--._....».., il...._- Personally came before ma Lbis .__.1~~ _..ds' °! ,_ ~ ~ ~` ,w. `~ * ' 19~ ,~ named .»__,.._ ....... ......... ............ Bps ne Rruizen a, a k a u ens - -----9._..------~-- -•--•--- ------------------------------------•-----•_-- -----D--Kruizenga-'---and Marie Kruizenga - TITLIE: 1[EI[BEB STATE BAB OF WISCONSIN (If not. -°--------•--------•-------°-------°-----------•- ------•------•---•--..-.------------ -------------- --------•-----•-••---•---- 9„ aot)sorised by 1 708.06, Wis. Stats.) ~~aee~ 6 ~ihi, me kno to be the person s ~ ~~ S`C -_..- -..-. xecu the ii ny~ ~~ _..e.._ •/~~..mnn! ri~n4nre~ilow o ~ - - f ~- ~--. 3 F1L.E~ MAY 0 1 2001 - xrrt+LSl+ lta~istar d Deeds ~ s~. a7~ix co.,w1 1.; CERTIFIED SUR VET' MAP Located in the SE %s of the SW '/. of Section 15, T30N, R16W, Town of Emerald, St. Croix County, Wisconsin. BEARINGS REFERENCED TO THE SOUTH LINE OF THE SW 1/4, PREVIOUSLY RECORDED AS AND N1/4 CORNER, SECTION 15 (ALUMINUM CAP FOUND ) ASSUMED TO BEAR N87°18'20"W. NOTE: I"IRON PIPE FOUND S77°S8'00"E 0.50' FROM COMPII'I'ED ~ UNPLATTED LANDS PosITION. - - O ~ +- 7° 39' 18° E 1061.28' NORTH LINE OF THE SE1/4 OF THE SW 1/4 g SCale 'I" = ZOOS OWNERS / SUBDIVIDERS NORMAN do MARYLOCTERMAN 1 S60 240 STitEET EMERALD, WI. 54012 ~~ i ~, ~ LOT ~ Q~ 1,380,354 SQUARE FEET (31.890 ACRES ) J INCLUDING RIGHT-OF-WAY Q, ~ 1,342,175 SQUARE FEET (30.812 ACRES ) ~ ^ ~ EXCLUDING RIGHT-OF-WAY ~I ~i I ~ _ a? N _ Q ~ ~ ' ~ APPROVED ~ °o ST. CROfX COUNTY ~ I z Planning Zoning and Parks Committee MAr o 1 2o0i i ff rr}}ot recorded within 30 days of ~, ^a¢proval date approval shalt be ~ ~ ~v/ nuifl aiM void ~ PAR CEL DESCR1BEp IN VOLUME 7024, PAGE 633. z A A w r «- a_ O in O c _~ A m n 0 z r Z rn g I~ A ~~ y m I~ v w N ~a v I~ .... 1~' BUILDING - CK LINE 87° 18' 20" ' - g ~ 138.1~W .. iFROM RIGHT OF-WAY N87°i8'20"W 1.588.89 W 52-x' "'~ .- q ~- N87°18^20"W 398.88' N 87° 18` 20" W 24.52' 47.25' N 136.13 N 87° 18' 20" W ~ ~•••- ~Q~1K~' rRUd[C HIrzH~VAY 4p1.oo• ` SOUTH LINE OF THE SW I/4 --~-_ -" - L061.65'--- SW CORNER, SECTION 15 T- --- UNPLAT7rED LANDS S1/4 CORNER, SECTION 15 (ESTABLISHED FROM TIES OF RECORD j - - - _ (2" IRON PIPE FOUND ) LEGEND SCALE IN FEET 7 " = 200' SECTION CORNER MONUMENT 100' 200 400' ~S ~ NS~'.y ~ ( AS NOTED) { °° ti • 1" IItON PIPE FOUND. S-2285 PREPARED DY: NilAl RIwC1HMON0 J ~----~•- FENCE GRANBERGSURt~EYING J 1239 C.T.H. "E" NEW RICHMOND, WI. 54017 'THIS INSTRUMENT DRAFTED BY: PHONE (715) 24f,-7529 JOSEPH W. GRANBERG JOB NO. Ol -0 l2A Vol . 7 5 Page 4076 644289 1 OF 2 Schuettpel~, Duane N _ -~ From: Schuettpetz, Duane H Sent Thursday, July 27, 2006 8'30 AM To: Gratz, Charles Subject: Holding Tank concurrence -Emerald Town Hall I've received the application for approval, from Shaun Bird, for a wastewater holding tank for the Emerald Tnwn Halt, Glenwood City,. St. Croix County. Based on this information provided, DNR conuus with Mt mixing of the wastewater from the garage catch basin with the domeStir./sanitarl- vw7-steweter into tht holding tank proposed for this facility. Installation of the holding tank can proceed following your approval. I will fax a copy of this rnessagt to Mr. Bird for h~ tnform~ion. ~11~~~ w.rl~ll~e+Irrnlrew..e+IMr ~al~ttttil~t~~ c~ra~: ~n~ ~:~a~ ~~ I- :; :~ e-~a: rrwsawlt~le~~Ara .. . ~` Wisconsin Department ofConmteroe SOIL EVALUATION REPOFjL„~,_„~..., Page 1 of 4 Division of Safety and Buitdmgs m accoraanoe wr[n ~.omm ua, vvis. ram. ~.oae County St. Croix er not less than 81/2 x 11 inches in size Plan must Attach com lete site lan on a p p p . p inGude, but not limited to: vertical and horizontal reference point (BM), direction and Paroel I.D. 10-1037-30-100 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Revie by Date Personal information you provide may tre used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). '$ / ~p Property Owner Property Location ^ ~ Buyer :Town of Emerald /Owner: Norm Logterman Govt. Lot SE 1/4 SW 1/4 S 15 T 30 N R 16 E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# Henery Hurtgen 1315 260th St. Proposed Parcel City State Zip Code Phone Number ity ~Vllage ^ Town Nearest Road Glenwood City Wisc. 54013 ( 1-~15-265-4878 St. Croix Cty R G New Construction ® Replacement Parent material General comments and recommendations: Use Residential /Number of bedrooms ~ Pu ' Gl E I V E d 12" AUG ~ 7 2006 ST. CROIX COUNTY Code derived desgn flow rate Flood Plain elevation if applicable ound System /Contour at 99.40 __ ~ n __ GPD ft. Boring # ^ Boring Q pit Ground surface elev. 99.40 ft. Depth to limiting factor 32 in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Strur~ure Consistence Boundary Roots GP D/f'~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 "Eff#2 1 0-12 10YR3/3 ---- sil 2fgr ml cs 3m 0.6 0.8 2 12-32 10YR4/6 ---- scl 2~k ml cs lvf 0.4 0.6 3 32_68 7.SYR4l6 csndSYRS/2 ~~ sl m ml cs ---- 0.2 0.6 ----~~ 2 Boring # u Boring 99.40 20 / Q pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/t~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-12 10YR4/4 --- sil 2fgr ml cs 3m 0.6 0.8 2 12-20 10YR4/6 ---- scl 2fbk ml cs lvf 0.4 0.6 3 20-50 7.SYR4/6 cmd5YR5/2 spots sl m ml cs ____ 0.2 0.6 ~---- "` Effluent #1 = BOD > 30 < 220 mglL and TSS >30 < 150 mglL "` Effluent #2 = BOD < 30 mg1L and TSS < 30 mglL CST Name (Please Print) _ Signature CST Number Thomas W. Gedatus - 962178 Address Date Evaluation Conducted Telephone Number Stang Plumbing & Electric P.O. Box 263 Woodville, Wisc. 54028 6/22/2006 1-715-684-5166 PT1T 1H1~1I, T/1~//~/~\ Property Owner Town Of Emerald Parcel ID # 010-1037-30-100 2 4 Page of 3 Boring Boring # ^ Prt Ground surface elev. 98.60 ft Depth to limiting factor 24 n. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eft#1 *EfF#2 1 0-10 10Y1L3/3 ---- sil 2fgr ml cs 3m 0.6 0.8 2 10-24 10YR4/4 ---- scl 21bk ml cs lvf 0.4 0.6 3 24-48 7.SYR4/6 cdm5Yr5/5 spots sl m ml cs ___ 0.2 0.6 ^ Boring # !.! Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft'- in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ^ Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Etf#1 *Eff#2 * Effluent #1 =GODS > 30 < 220 mglL and TSS >30 < 150 mglL * Etlluent #2 = GODS < 30 mglL and TSS < 30 mglL 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. SHn•sssar~ tPtoTioot v w- n v~` ~ t~~-~A- ld = ~3u~ e~ }-~ ~~ ~r~ ~l~~~ y ~~ ~,,,~~h l{JO4 C ~t,2%~ ,~~` ~' ~, c~sT ~ ~~a~7 8 Pr'~~' ~~Z,Z~O ~ ~ ~~ ~ ~~~L~ _ ` ~ r ,~ i3~~, ~~'`l ~ ~ ~ ~_ ~~ L ~a-~ / ~ ~ ~ ~ ~o ~ t ~ ~~ ~ ~, \ ` ~ ~ ~ ~ ~ ~~ ` ~ `~ t l ~ ~ ~ ` y w~~ c- ~ ~ L ors' ~~_~ _ _= ct ~ __ ~ ~~w c 3 ~ ~{ Document Number Document Title St. Croix County Holding Tank Agreement State Plan Transaction Number - /'Malt ~ o~ ~~ !°~1~/Z., Name - (Owner) Typed printed being duly sworn ,states, under oath, that: 1. He(she is the owner(part owner of the following1arcel of land located in St. ` J L'oc-u.ment Croix Countv.. VV;scnn~n, rPcordaa in `.'cl•.:m..c ~ j ~~ Page. Number ab St. Croix Countw Register of Deeds Office: A parcel of land located in th~~'/o of th~~/4 of Sectio ~ ~ , T~ N - R ~ W, Town of t9t ~° P~3 ~ ~ , St. Croix County, Wisconsin, being duly described as follows (include lot no. and subdivision/CSM or detailed/l'egal description): ~d ~ .~L/ Y~ /' /.~ a~ ~d7 Agreement Date: ~/~~i~ ~ Q7' ~# ~ ~~ I f ~ ,~ ® ~!7 ri KATHLEEN H. 1VALSH kEGISTEk OF DEEDS °T. CROI?i CQ. , NI RECEIVED FUk kECGkD 0~S ~ O J/ 2006 1:~ : 00PM HC-l.lilNf TANK AGkEEM;xNT REC FEE: 11.00 TRANS FEE: COPY FEE: 2.00 CC FEE: PAGES: 1 Name and Return Address i bn~~ Parcel Identification Number (PIN We acknowledge that application is being made for the installation of (a) holding tank(s) on the above described property or that continued use of the existing premises requires that a holding tank be installed on the property for the purpose of proper containment of sewage. Also, the property cannot now be served by a municipal sewer, or any other type of private onsite wastewater treatment system as permitted under Ch. Comm 83, Wis. Adm. Code, or Ch, 145, Wis. Stats. As an inducement to the county to issue a sanitary permit for the above-described property, we agree to do the following: 1 . Owner agrees to conform to all applicable requirements of Ch. Comm 83, Wis. Adm. Code relating to holding tanks. If the owner fails to have the holding tank properly serviced in response to orders issued by the governmental unit or the Department of Commerce to prevent or abate a human health hazard as described in s. 254.59, Stats., the govemmental unit (Town) may enter upon the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by s. 66.0703, Stats. 2. The owner agrees, pursuant to s. Comm 83.54 (2), and Comm 82.40(3)(e), Wis. Adm. Code, to have a water meter installed in the structure. The water meter shall be installed by a plumber authorized by the Department of Commerce to make such installations, with said installation complying with State regulations and manufacturers specifications. The ovrner agrees to be `'nancially responsible for the purchase, installation, maintenance, and repair of the water meter, and agrees 4o a~iovr the governmental unit or the Department or Commerce to enter the above-described property on a regular basis to read and/or inspect the water meter. 3. Owner agrees to pay all charges and costs incurred by the govemmental unit or county for inspection, pumping, hauling, or otherwise servicing and maintaining the holding tank in such a manner as to prevent or abate any human health hazard caused by the holding tank. The governmental unit shall notify the owner of any costs which shall be paid by the owner within thirty (30) days from the date of notice. In the event the owner does not pay the costs within thirty (30) days, the owner specifically agrees that all the costs and charges may be placed on the tax roll as a special assessment for the abatement of a human health hazard, and the tax shall be collected as provided by law. 4. The owner, agrees to contract with a person who is licensed under Ch. NR 113, Wis. Adm. Code, to have the holding tank serviced and to file a copy of the contract with the govemmental unit. The owner further agrees to file a copy of any changes to the service contract, or a copy of a new service contract, with the governmental unit within ten (10) business days from the date of change to the service contract. 5. The owner agrees to contract with a person licensed under Ch. NR 113, Wis. Adm. Code, who shall submit to the county on a semiannual basis a report detailing the servicing of the holding tank. The govemmental unit or county may enter upon the property to investigate the condition of the holding tank when pumping reports and meter readings may indicate that the holding tank is not being properly maintained. 6. This agreement will remain in effect only until the county office responsible for the regulation of private onsite wastewater treatment systems certifies that the property is served by either a municipal sewer or a private onsite wastewater treatment system that complies with Ch. Comm 83, Wis. Adm. Code. In addition, this agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which will permit the existence of the certification to be determined by reference to the property. 7. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shall submit this agreement to the register of deeds, and the agreement shall be recorded by the register of deeds in a manner which will permit the existence of the agreement to be determined by reference to the property where the holding tank is installed. owner(s) i'.a^,e(c - P:a-.... ern? Subscribed and sworn to before me on this date: ; ~2 ~~: ., t ~~ ~,. Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT flow rate m accoroance w¢n t,omm na, wis. ram. t,ooe Plan must lan on er not less than 8 1/2 x 11 inches in size lete site Atta h om a County ~~ i/ Cr O ~ X ( p p . c p p c include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. ~~ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. O / ..- ® ~ . p o p Please print all information. Re ewes IyD,at ~ D .Persona! information you provide may be used for secondary purposes (Privacy Law, s. 15.04 {1) {m)). / Property Owner Property Location d Govt. Lot S 1/4 ~1/4 S ~ T (f N R~ qtr) W Property ers Mailing Ad`d~re C Lot # / Blo~ # Subd~ ame or CSA~I ~ ~_ /i O d / J s 1=0 Ol~ City State Zip Code Phone Number ^ City ^ ~Ilage ®Town Nearest Road (~( New Construr~ion Use: ® Residential / Number of bedrooms ^ Replacement ^ Public or commercial -Describe: . Parent material ___ t1~~4t~/i4 ~.._ 1~1~~- __~ General comments and recommendations: f 6- Page / of GPD FIr~^ pa~vation it~ppli ble ~~- ft. t, ~ _ ~ `~~ ~ ~~~~ S~ ~~x / ®' /f~ f ~/~~ y // '~~ ~~{t~ / t' ' `'C Boring `" ~ t~'" Boring # , ~-~ ®Pit Ground surface elev. ~~ft. ~ ~~ ~o ir~~ or °~ / in• Soil licatwn Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft'- in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~~ S ~ 4~~ ~ / ~14 .~ i~ 7 ~' s ~rT --- -- d 0 ® Boring # ~ Boring pit Ground surface elev. 9~; 3~ ft. Depth to limiting factor ~_ in. Soil icatiort Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fit in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 a- ~ 3 ----~ ~. S6 -- S Jul ..~ 8 ~ s 6 -^ a Effluent #1 = BOD > 30 < 720 mg/L and TSS >30 < 150 mg/L " tmuent ~1= tsw < su mgtL ana i a~ < su rrxyt_ CST Name (Please Print) i ature r. CST Number Addr~ Date Evaluation Conducted Telephone Nu +~~ f~Lti l'7v ~~ etN mod u~G ~ n G>-~.-°O ~/-.5=~ ~ = 8.38 .sy~ i3 ~ ~~~ ~. Property Owner LC~~'f M/} /y L~ O~~v /~/1i1HIti/ Parcel ID # ~/D~ ~D-? fJ-~o-ooo Page ~ of a Boring # ^ Boring v ~~~~ pit Ground surtace elev. ft. Depth to Limiting factor ~ ~ in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 ~- o --~ 9M~6K M z ~ yr , , ~ s ~ s a Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in, Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 `Eff#2 ^ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ^ Pit - Soil icaGon Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GP D/ff? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 • Effluent #1 = BODS > 30 < 220 rrxyL and TSS >30 < 150 mglL 'Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L 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. seo-ssw cR.arooJ i ~ --- ~ j ,Q r• ~ ~ _ - p Ll ~ D l _ ~ ' ~ -. - _ - _ -- _ . ~~ _ - -- - - - -- _-. _- _ ---- __ ___ ~ ___ -- -_ ___ __ ~ ~ _ -__ ___ _- - - - - -- ____` -- __ _ -~ ---_ __ -- --- -- -- I --- -_ _- -- --- -- -- - -- - - -_ 1 -_ - - i -~~ -- _ __ _ _ _1 - -- ----- - -- - -- ~ ~ ~ ~~ ~ __ _ __I - -- - ~ ! ~ - ~ ~ - _- - , - - i -- - ~ --~ r--~ - - --- _- ~ ---i I -_I _ - ___ __ -~ _ " -- ~_ ---; ~- - - ---a - - - - -- ~ - _ - C ~ , ' _ ~~ ~ --- a -_. ~ ' ~ ~ ~ i - -- -- ~ _ __ _ ____j - I ___ - _ - - _ - -- ~ ~ __ - _ - - - - - - _ _ - __ _ _ _, ---- _ -- , ~f a 2 I ! - ~ _ __ ____ ~ _ - - - --- --- -- __ _ _ _ - _ ~ __ , _ - --. - . '~ 1 -- ~ __ -_ i -- - _ -- - __- -- ---- ~- -- -- -- - -- - ~ -_ _ _- --- --- -- r- i I - -- --1 --- - - - ~ r - - -_ -- - - ~ -- - - -- + - 'a '- ~- - RECEIVED ocT 3 o Zoos ST. CROIX COUNTY i IavCVno~~+ ~~,..._. ~: ~~o~ ~~~ ~ ono ~ ~ ~J~ ~~ ~~o~~ y .~ ~ ~~ LL ~ Q ~ ~ 2 W aoo~o ~~s~ C ~ ~ '~ ~~Y Hwy ~ V B O O J 2 ~ ~ Q 'n~QO~ B>~~ ~ ~y ~~~ ~~zz~ ~~ ~ Vp ~~~~}2Q N ~ SI ~a~~~ ~~ ~~X~ ~~z~o o~~~~ ~~~-~-~ W .J 8y~ ~~~~o p v ~ 3Nll N01103S ~ HJ!)OS - H1NON -~ ~£L"SlEI 3.9V~V1.00S ~ `' " £tr'ti8ZL a `~ ~: ~ ~: ~~ ~~~ W ~~~ 0 = W {~ gl ~~"' W ~ ~ W ~ ~ V ~ ~ ~ ~ ~ ~~ I I ©' ~I ~ 1 ~I t31 i gi a ~ ; ~~ , ~,~, ,~i~l I~ I ~i~lal ®I~I~i ~1~I~i ~I~1 ~I I 8 3 4 4 4 1 VOL 21 PAGE 5272 KATHL~ER H. REGISTER OF DEEDS ST. CROIX CO. , MI RECEIVED FOR RECORD 09/13/2006 03:30PM CERTIFIED SURVEY KAP PAGES: 2 ~~ w~~~~~pp = G GV O oo,, cS~~S~ a z ~~~~ ~~~°~~' ~ N W z AE' lV---- ~~ c~b ~ ~~ ~~ ' I -. ~~> I BL'8t .~A I . ~~~ -~ ~. "- ~<_, ~i ,oo~as sz trr-- ~ ~ ~> 1 -~ al ~ :~ ~ ,~a ~ : ~ "~ ~~ ;m ~ ~ ~, ~ m .9E'b8Z . z ~ ~' M.9£~4L.UOM ~ ' ' £bZ ,0£ l4~ F. ~' ,90 . $ 1 '_-------- i ~ ~ ,68'4£Dl lIA.9£~01.00N ~ 1 ~ ~ ~ FZ t~ ' ~ 1 rs d .9o 'EVa AE' l ~ ~C'bQ7 ~ OO.bL_tV1C~ 3.OS.8l.L8S 2lV39 Ol 03W11S8V QJVSVAISflOlA3tld'9t N01103SOIVSd0 •i( MS 3Hl d0 3dll H1f10S 3Hl Ol 030N3il3j3L1 S`JNI?1d38 tof2 Vol 21 Page 5272 ^_ F- ~ y ~ ~ y ~~~~~~ ~ ~8~~~~ Q ~ ~O ~ W ~S 1 1 i 9B i ~ ~ ~ LL I p ~ wLL 1 8 ~ o_ ~; W ~, 3 ; ~" `~ ~ 5r i a I ~I r '~ ~I =I zl ~~ ~~ oil I v y; ~ ~ ~ i° ~ _ _ _ ~ W N~wN~ i i~ 25ppr~ t¢p~ fzQj~~ J ~~,~i [p ~ Cl, p ~?~ V r~ I~ N O N o~--~~--„5 NNE ZI ~ _ $ N m ~ ~ o ~vuinLUVr.vr inn~wii4, o PREVIOUSLY RECORDED AS AND -' ASSUMED TO BEAR N87°i8'20"W. NOTE: 1"IRON PIPE A FOUND S77°58'00"E ~' 0.50' FROM COMPUTED UNPLATTED LANDS POSITION. M A '- - ' ~ S 87° 39' 18" E 1 061.28' ;'- 2' +. +- N 3~ NORTH LINE OF THE SE1/4 OF THE SW 1/4 - -' 9' +. ZO Scale 1 ° = ZOOS OWNERS / SUBDIVIDERS z NORMAN & MARY LOGTERMAN in 1560 240 STREET ~ c EMERALD, WI. 54012 = A m n -~ z ~~ I i L~T ~ m ~ I ' QI 1,380,354 SQUARE FEET (31.890 ACRES ) J INCLUDING RIGHT-OF-WAY I ~ r, O 1,342,175 SQUARE FEET (30.812 ACRES ) ^ ~ ~ EXCLUDING RIGHT-OF-WAY o ° I Z I 3 ~ I N `"~ QI ~~ NA ~~ ~ ~~ ~ a A m APPROVED W I o Z o , sr. cROrx couNrY w P ~i Z lanning Zoning and Parks Convmittee P' ~ p ,~~' MAY 01200 w z o `~- I~ I If not recorded within 30 days of approval date approval shall tae t1li~tl aMd vodct VOLUME 024 PAGE 6 3. ~ ~~ a ~ . 100' BUILDING SETBA 87° 18' 20" ~ • ~ • .. CK LINE , , , , ~U .. FROM RIGHT 136.13 OF-WAY r. ~~ ~ c o . .. . z g ~• ~. N N87°18'20"W 1 588 89' S2~ ~ ° - ~ N87°18'2Q/'W ' c . 398.88 N 87° 18' 20" W 524.5 ' 41.25' uS - -- c$ ~' • •, ~'A/ /AI~ __ _ 36,13 N 87° 18' 20" W 401.00' _ S!Y'T ~'RUISIK bl/ A _ ~ SOUTH LINE OF THE SW I/4 CHIN Y `"C" - SW CORNER, SECTION 15 _ _ - 1,061.65'••- ~ S1/4 CORNER SECTION ` 15 , (ESTABLISHED FROM TIES OF RECORD j UNP~T7 ED LANDS 2" IRON PIPE FOUND - _ ( ) ~~ LEGEND SCALE IN FEET I ~~ = 200 -~- SECTION CORNER MONUMENT ~ 1000 400 ~ ~5 ~ NSA ~ ~•• .,~ ~ t (AS NOTED) r J SE W. ~. * : G BERG • 1"IRON PIPE FOUND. ? S-2295 CHMONO ; PREPARED BY: t NEW RI O -r-+~-- FENCE ~ . GRANBERG SURVEYING °°y °.~ DAL' `<F» C, 1239 C T H , 9 y f . . . NEW RICHMOND, WI. 54017 '1'p ~"Uav~'~ ~~ PHONE (715) 246-7529 ~ THLS INSTRUMENT DRAFTED BY: JOB NO.OI-012A JOSEPH W. GRANBERG HEET 1 OF 2 Vol. ~ 5 Page 4076 commerce.wi.gov isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.wi.gov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary July 27, 2006 CUST ID No. 226900 SHAUN R BIRD BIRD PLUMBING INC 1008 192 ND AVE NEW RICHMOND WI 54017 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/27/2008 SITE: Emerald Township County Hwy G Town of Emerald St Croix County SW1/4, SE1/4, 516, T30N, R16W FOR: ~ Identification Numbers ~ Transaction ID No. 1295890 Site ID No. 716060 Please refer to both identification numbers, above, in all correspondence with the agency. Description: Commercial (Assembly Hall, Office and Garage) Holding Tank System Object Type: POWTS Component Manual Regulated Object ID No.: 1088552 Maintenance required; 329 GPD Flow rate; System: Holding Tank Component Manual, SBD-10571-P (R.6/99); Commercial System 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: Requirements: This system is to be constructed and located in accordance with the enclosed approved plans and with the "Holding Tank Component Manual for Private Onsite Wastewater Systems" SBD-10571-P (R.6/99). • This plan has a written statement of concurrence from the Department of Natural Resources. • A notarized Holding Tank Agreement between the local governmental unit/Municipality and the property owner is required prior to the issuance of a sanitary permit. A Holding Tank SHAUN R BIRD Page 2 7/27/2006 Servicing Contract may also be required if no other service provider for the holding tank has been identified. • A service drive or road is to be provided to the service access opening or pump out port. The minimum measured distance required is 25 feet. • The well must be a minimum of 25 feet from any POWTS tank. 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. • 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 maybe 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. SHAUN R BIRD Sincerely, Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday charlie.bratz@wi sconsin. gov Page 3 7/27/2006 Fee Required $ 60.00 Fee Received $ 60.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 Wisconsin Department of Commerce SOIL E~/AL N REPORT Page of `Division of Safety and Buildings 1, 1,, m acuwroanc:e wnn wrnm ao, vv r~arn. County C to T ~ Plan st Attach complete site plan on paper not less than 8 1/2 x 11 inches in size v p 1 - indude, but not limited to: vertical and horizo percent slope, scale or dimensions, north a 'at w, an~lEe . ~BM n i~e ton crest d. parcel I.D. Please print al information. Revi ed y D ate Personal information you provide may be used for eeond~ryp~-pr~esOPriDiEN~ ~w, s. 1 VMI ~Yr vv vv LL l1 U 04 (1) (m)). // V Properly Owner rty e / 3 6 ~ fi~ n" ~ C ~ ,~'X OUNTY Go Lot,j~ 1/4,rjy 1/ S T R E(or Property Owner's Mailing Address ~ Block # Subd. Name or CSM# . 3 S ~6 0.~ s- Cily State Zip Code Phone Number ^ City ^ V'iilage -Near st Road er.. ~ 3 ( ~ ~~/ New Construction Use: ^ Residential / Number of bedrooms Code derived design flow rate ~_ GPD and ndafl /Z ~, L', ^ Replacement Public or commerctal -Describe: 7'~ ~ __.______ Parent material f Flood Plain elevation if applicable General comments ~/ ft. reoorrWne ons. +. ,, ~ System Type~OG[...~.P ~C System Elevation a sori # ~ Boring m ~.~ pit Ground surface elev. ~-s`-~ ft. Depth to limiting factor In. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 -----~ l !' ~- r T' ~ r _ 7 r ® ~~ # ^ Boring ~ pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 ~ 'J D ~(~.. ~-" ~ ~ rte • Effluent #1 = BOD > 30 < 220 mglL and TSS >30 mg/L 'Effluent tt2 = BOD < 30 mg/L and TSS < 30 mg/L CST IVarrts (Please PrinU Sig CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation C nducted Telephone Number 1008 192nd Ave, New Richmond, WI 017 ~ ~-- ~ ~ 715-246-4516 Property Owner ;, ~~ .~,.. ,~~ ."`.. rParcpMfi~.# Page of ^ Boring Bori # ~ ~ pit Ground surface elev. ~_ ft. Depth to limitng factor ~~ in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 / ` ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure ~ Consistence Boundary Roots GPDlfP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 ^ Boring Bonng # Ground surface elev. ft. Depth to limiting factor in. ^ Prt Soil icatlon Rate Horizon 'depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GP D/ff in. Munsell Qu. Sz. Cont. Cdor Gr. Sz. Sh. 'Eff#1 •Eff#2 • Effluent #1 =GODS > 30 < 220 mglL and TSS >30 < 150 mglL 'Effluent #2 =GODS < 30 mglL and TSS < 30 mg1L 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. seo-sa3o (R.eroo~ r' Soil Test Plot Plan Pro~ct Name Emerald Township Shau B rd Address 1315 260th St. Glenwood Wi 54013 C #226900 Lot Subdivision -------- Date 6/6/06 S W 1/4 SE 1/4S 16 T 30 N/R16 W Township Emerald Boring ~ Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 1 /2" pipe System Elevation 98.4' *HRPSameasBenchmark Alternate Benchmark Top of 1/2" pipe @ 99.8' ,~ At1.B.M. ~B~11~ 50' ~ _ 98' 10' 10' -3 40' 30' )' 97' B-2 4% Slope B-1 Property Line Please note: parcel was not field staked at the time of testing, property lines must be field verified prior to installation Scale is 1" = 40' unless otherwise noted