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HomeMy WebLinkAbout018-1096-08-000~~ i Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you providr~ may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Yeboah, Ernest A. Hammond, Town of CST BM Elev: I s . B Ele~~ BM DescriptiO ( I t ~~ .~ f7 eJ~ ~ 1# I j~-~n~.- G B TANK INFORMATION ~ .(~ TYPE MANUFACTURER CAPACITY Septic ~-~ c..u-rte ~ b ~ Dosing 1 ~ `-'J C~..l~ . ~t Aeration Holding TANK ETBACK INFORMATION TANK TO P/L + WELL a~ Vent to Air Intake ROAD Septic ,~~q ~ ~S+ Dosing It tt t, ~ ~ 3 Aeration Holding PUMP/SIPHON INFORMATION Manufacturer ~~T L ( (, Demand GPM , ~ Model Number -~~ ~~• TDH Lift . ~ Friction Loss System Head TDH Ft Forcemain Length r Dia. ~ .+ Dist. to Well ' ~S SOIL ABSORPTION SYSTEM ELEVATION DATA county: St. Croix Sanitary Permit No: 488028 0 Stat Ian ID No: 2 = T2rbUS. / D Pa I Tax No: 018-1096-08-000 Section/Town/Range/Map No: 09.29.17.783 STATION BS HI FS ELEV. Benc a ~+ I v~¢. ,~~ 0.2.0 ~+~DO Alt. BM jrJO~'~^~ S` + I o oz So• Bldg. Sewer ~ ~~~ 4 ~ i / ~' ~ SUHt Inlet ,~- ~ro.6,~~ St/Ht Outlet Dt Inlet Dt Be#tom~ p f ~ (~3~ ~ z 90 ~ Header/Man . Dist. Pipe 2 .~ I ~ ~ 3~ , Bot. System 3,6.0 .moo ~ ab• ~e o Final rade ~wi~~ ~ ~2+ s StCo ~ ~~~1 ~,~ `tcr ~ BED/TRENCH Width + Length f No. Of Trenches ~ PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS b ~(} C~ SETBACK SYS EM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufac ORMATION CHAMBER OR INF T e S stem• YP ^/~ ~ (~ _ ~ / ~Z i + ` ~ ~ _~_ UNIT od ' umber: q DISTRIBUTION SYSTEM `- Header/Manf I u Distribution f ~~ ~~ x Hole Size x Hole Spacing Vent to Air Intake Z Pipe(s) Z ' ~ S i ~ Length Dia Dia pac ng Length SOIL COVER x Pressure Svstems Onlv xz Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes ! No ~ °, Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Y~~L/Inspection #2: ~ Location: 1088 173rd Street Hammond, WI 54015 (NW 1/4 NW 1/4 9 T29N R17W)~Pheasant idge Lot 8 rl Parcel No: 09.29.17.783 1.) Alt BM Description = ~' S' T' ~~'~- C'~~' 2.) Bldg sewer length = ~`~ -amount of cover = ~ Z~~f-~ (,a7ve.~ 3) SyS~ ~-~- ~ us f- ~ s (.eRe_ ~-t~ P`{Ti -{„ ~ sys~ °`~ ~. '_ Plan revision Required? i` ;Yes I No Use other side for additional information. ~ ~' _ ~ L -_. ---- - ------ --_._i Date Insepctor's Signature SBD-6710 (R.3/97) ~_ _ _ ~ f 26 - Cert. No. and Buildings Division P A 7 62 County ~ ~ ~ ; ve., .O. Box ~ ~ ashington 1 ,SCO~~~ ~ Mad' on, WI (608)2 -3151R~ Sanitary Permit Number (to be filled in by Co.) ~? ~~ De artment of Commerce $$~z OO ,. Sanitary ermit Applieatio State an LD. Number In accord with Comm 83.21, Wis. Adm. Code, personal informatio you pro ~ ~ ,~ 200 / ~ ~ may be used for secondary purposes Privacy Law, s 15.04 xm) Proj t Address (if different than mailing address) ST. L Application Information -Please Print All Information ~/~ ~ ~ ~ ~ ~ Property Owner's Name 1 # Lot Block # ~ - • Q~ dt..1 Property Owner's Mailing Address Prop rt y Location e ' ~ > w '/ ~/ ti S City, State Zip Code ~~ ~~ ~ Phone Number ., ., ec on ~rcl e) ~` ~ T~~N 7~3 ~E C II. Type of Building (check all that apply) d k. caA ll..~, 5~~~ ¢- ; • r 2F il D li N ~ ~ Subdivision Name CSM Nu r or am y wel ng- umberofBedrooms_ t a/L drJSt?~ ~ ^ Public/Commercial -Describe Use .S' ^ State Owned -Describe Use ~d X ~_ ^City ^Vi11 hip of d III. Type of Permit: (Check only one box on line A. Complete line B if applicable) (~/~ . ~ _ ~ ~(~~ A. w System --~ ^ Replacement System ^ TreatmentlHolding Tank Replacement Only ^ Other Modification to Existing System B, ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. T e of POWTS S stem: Check all that a 1 ^ Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Un~ Recirculating Sand Filter ^ ~ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ O[her (explain) ,~ (~ ! / . V. Dis ersal/I'reatment Area Information: Design flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation ~ X50 0.5 ~~ 9c~ 9 9, B VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constmcted Glass New Existing ~ ~1 n /1 /1ST ~~ ~ ~ /V [ Tanks Tanks (.lJ p , ~ Septic or Holding Tank Aerobic Treatmerrt Unit Dosing Chamber D ~- VII. Responsibility Statement- I, the undersigns me responsibility for installation of the POWTS shown on the attached plans. Plumb 's Name (Print) ~ Plumber's ure MP/MPRS Number " Business Phone Number ~ D Z 2~ D /J 7~~' ~J l ~ ,~ o Plumbs 's Address (Street, City, State, Zip ) , ~~~7 ~ / o~ ~ /~ .~ 1 ~ ~ ~1 ~ VIII. Coun /De artment Use Onl Approved ^ D~ pproved Sanitary Permit Fee (includes Groundwater Date Issu Issuin t Sign S ^ er G~ eason for Surcharge Fee) x O~ G,~ I Z 9 ~S IX. Conditions of ApprovaUReasons for Disapproval SYSTEM OWNER: t. Septic tank, effluent finer and dispersal cell must all be services / mainUinad as per management plan provided by plumber. 2. AU sefbaclc requirements must be maintained as per appficable code / ordina-ces. Attach complete plans (to the County only) for the system on paper not less than 812 z 11 iuchea in size SBD-6398 (R. 01/03) . PLOT PLAN PROJECT Ernest Yeboah ADDRESS 1763 96th Ave Hammond Wi 54015 IVW 1/4 NV1l i/4S 9 /T 29 N/R 17 W TOWN Hammond COUNTY ST.CROIX SYSTEM ELEVATION 99.8' 3 CONVENTIONAL AT-GRADE BEDROOM XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none ,BENCHMARK V.R.P. Top of 1"pipe ASSUME ELEVATION 100' Filter ZabelA-100 ^BOREHOLE ~ WELL *H.R.P. Same as Benchmark Scale = 1 /4" = 10' Property Line Well is to meet all setbacks found in Comm. 83 Pro Town B.M. Grading is to be done to Pro 3 1 i e divert run-off away Bedroom 11 p p from s stem Huffcutt Combo Tank House @ 99.5' Y B-1 B-2 B.M. #2 100' Tank is to be properly 99' gg,g~ beddded and provided with lockdown covers with 98, B - 3 approved warning labels Area 1 S' below s stem is 355' Property Line 4% Slope to remain undisturbed ~~ PLOT PLAN PROJECT Ernest Yeboah ADDRESS 1763 96th Ave Hammond Wi 54015 NW 1/4 NW 1/4S 9 /T 29 N/R 17 W TOWN Hammond COUNTY ST.CROIX SYSTEM ELEVATION 99.8' 3 BEDROOM CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none ,BENCHMARK V.R.P. Top of 1" pipe ASSUME ELEVATION 100' Filter ZabelA-100 ^ BOREHOLE O WELL *H.R.P. Same as Benchmark Scale = 1 /4" = 10' Property Line Well is to meet all setbacks found in Comm. 83 Pro Town ~ B.M. Grading is to be done to 1 " pipe divert run-off away 99,5 from system ,B-1 B.M. #2 9 9' 8,- _~..._ ,-, B - 3 4% Slope Area 15' below system is to remain undisturbed Huffcutt Combo Tank B-2 Pro 3 Bedroom House .100' Tank is to be properly gg.g~ beddded and provided with lockdown covers with approved warning labels 355' Property Line ~~ 9EH SERIES SUMP/EFFLUENT PUMP Specifications MODEL CAT. l1STIN0 NP VOLTS SOIIOS SIZE RUNNING PERFORMANCE (GPM Q NFAD) SHUTOFF P1YR. CAD. NEIONT DIMENSIONS M0. N0, )Die. u.) AMPSpFATTS 5' 1 Y 15' 21' IF~I PS.I. IF~I I~sd IN x L x A) 9Di-qM 509330 UUCSA 4/10 115 3I4 13.0 1000 70 64 55 41 32 13.6 20' 24 9.11 x 11.64 x 0.94 9EH•CIM 509340 UUGSA 4/10 230 3/4 6.5 1000 10 64 55 41 32 13.6 20' 24 9.11 x 11.64 x 6.94 9EH-CIA-RFS 509350 UUCSA 4110 115 3/4 13.0 1 D00 70 64 55 41 32 13.8 20' 27 9.11 x 11.64 x 0.94 991-CIA-RFS 509360 UI/CSA 4/10 230 314 6.5 1000 70 64 55 41 32 13.8 20' 27 9.11 x 11.64 x 8.94 Continuous DutyRated-"Little GiantWastewaterpumpsare rated continuous duty as long as they are run wtthlnthe published ratings forthese pumps E OW- LITERS/HOUR" 0 100 2000 3000 30 ~~~iic i_~~ i i i i t- 10 w ~.s w ~ 20 W f ra 5 \~'~,~ a A w Q ~p~ to 2.s 0 0 0 20 40 60 BO FLOW GALLONS/MINUTE PUMP EREpRMANCE CURVE 115V 60HZ - ~~.3 ~„~,. . Construction Motor Housing Epoxy Coated Cast Iron Im eller Material Poly Carbonate Im eller T e Closed Vane Volute ABS Power Cord SJTW-A Mechanical Shaft Seal Nitrile with carbon and ceramic faces Fasteners Stainless Steel Shaft Stainless Steel Bearings Upper Sleeve and Lower Ball Bearings u~rR~, 3.~• a ~~ s ~ • ,o ;'~ Little Giant Pump Co. PO Box 12010.Oklahoma City, OK 73157 Phone: 405.947.2511 • Fax: 405.228.1550 E-mail: customerservice@IitUegiant.com Form 995235 - 07/03 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. com merce.wi.gov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary December 06, 2005 CUST ID No. 226900 SHAUN R BIRD BIRD PLUMBING, INC 1008 192 ND AVE NEW RICHMOND WI ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 12/06/2007 SITE: Ernest Yeboah 110TH Ave Town of Hammond St Croix County NW1/4, NW1/4, S9, T29N, R17W - __ Lot: 8, Subdivision: Pheasant Ridge Identification Numbers - Transaction ID No. 1220478 Site ID No. 708055 Please refer to both identification numbers, above, in all corres ondence with the a enc . FOR: Description: Three Bedroom At-Grade System Object Type: POWTS Component Manual Regulated Object ID No.: 1054351 Maintenance required; 450 GPD Flow rate; 38 in Soil minimum depth to limiting factor from original grade; System: At-grade Component Manual, SBD-10570-P (R.6/99); Biofilter The submittal described above has been reviewed for cgnformance 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: Reminders • .This system is to be constructed and located in accordance with the approved plans, and with publication SBD= 10570-P (R. 6/99) "At-grade Component Manual Using a Pressure Distribution System for Private Onsite Wastewater Systems". • The pressure network is to be constructed in accordance with publications SBD-10573-P(R. 6/99) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" and/or the sizing methods C of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81)". ~~ • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. EPAF Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and ~ dispersal are prohibited. ~_ SEE C • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. SHAUN R BIRD Page 2 12/6/2005 • Inspection of the POWTS 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 durinir 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 fox 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/operatlon. 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, t, Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@commerce. state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WSMART code: 763'3 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 11 /28/05 Owner:Ernest Yeboah Location:NW1/4 NW1/4 S 9 T29 N,R17W Lot 8 Pheasant Ridge Hammond System type: At-Grade Manuals Used: At-Grade Component Manual version 1.0 SBD 10570-P (R.6/99) SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01 /81) Page# 1. Cover Page ~FC~jV~~ 2. At-Grade Plot Plan DEC ' S1. pp5 3. At-Grade Cross Se~~E]~ 4. Pipe Cross Section/Pipe Layout ~'S 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contigency plan 9-11. So Shaun B Signatur License li~i~~r~~ty ~~ ~r of con~~rln acs ~TEYAN ~ ~ S ~~ r~ESPONDENCE ,; ~: >, ~ t > ~i B >~ [ ~ PYG FoAC.~.MAti~l ...~ ~ J - - _ ..~ Z _ ~../TUR~- UpSN ~-- D~ST'Rc~~[Ttawf tAt~tLAL } STABtLtZ'~~ o~~xv*r-ers y~tEi.L~ ._..~-- il~ B ~ ~ = ~ ~'t. 8 --jj ~ ..,. ~t. //~ ~-~. ~ - ~ ~t. ~~~~a,c~a S~t~Tt~.~c.. ~abr;c -- 5T~83L~~~b ~bserva#io~----.~ Vice l l ~ } ~` _~~ °~ S~.oP~ a A I /6B f f/2B r------ ~, GELL o~ ~ _ Z/2 AfsGR~GsATE ~is~ribu~ion Lct#eral --Sail Cover ~o ~ Zt~ 6 .~ I -2 ~ .-- ~LbvtiED f. aYEK 5' pig View and Cress Section of iJisconsir~ At-gr'g~ Unit with a S$agls Absargtian Area on a Sloping Site ~.tcE~lSE.~: Cr,i~t~t~7u KE ; Page Of Di stributian Pipe t3et~i l for Lateral ' ,network * last Hole Should Be Next To TURN- uP ,_ "TURN -uP" ~CL~n~our~ P1iC forte Ma Z h ;"'~'~"'1 `- PVC !}istribut#on Pipe -,~ ~ P ~ - Aece s~' _~~: . !"-" `~ P ~~ Ft. Hole f~iacneter ~~~ ~- I~uh ~~ f.~ X ~'~L_.. Inches Lateral Iiameter ~-- InCh~es} Y~~~ inches force Main Diameter ~ +__,. Istches ~ Of HoleslPipe ~~~ Invert EIevation Cif Catera7s ~ . 3 ft. Sighed- license tictta:a-er: Date: .. ~ % .~~ ,flSS S~CTaG;~ A~~ SP€CIFiCPE"FIQ~S S€PTIC T~NiC ~ ?~31~Sr~ C~~~~rR ~F #~E1ktH£~P1t~F r ~ AppRfl~ ~ ,~ H'[ 3~ . ~.BOV £ ~RRI~., .Sii 33C'~`~£1i~ $0X +[Hi3Lr COQ Eg ~,z G~ ~EN'f PIPE ~~ ~€~~ C€3~1IT ~dl~i#ai~ ~R tai gF~7L~CIf ~ y -. ~}` ~`R0~ DCflR , ~TAF~ING LABEL .. ~~. ~ }I i3+tT.fLi4E ,c t ~ FII~~ ~. _'~:~ GRACE y ~" i s, p. - ~" ~1trlf- Y~---.. ' _, 18° IId- -. _ ~ ~ s . 1 . s . Il'tLET .. _ G.AS' ' ---;--- 'FIGHT = 1~ilt3i 1rA•F~ TI6~ gEALS ~ SEAL ; t ~`'lt1I~ ~~PE Fs OH ~,IB SAIL _..,~- _ . APP~'~ ~_ ' = FF ~~~ ~ $E€3~~3~G ~~TI3ER TA~~ COi3 BETE ~'~ SprCI~,ICATY~3~is _ ,_ SEPTIC # DOSE ~~~ v~3~~E I~cL~Q~~ p,, ~L- ~~: RE~= ip,Zi~C ~~g'AC`3'~.1 GAL. ~ J ;I+i~ES c~ !iL rA~tK s~ DES : s~PTi~ ~ ~ ~ ~~ - ~ ~ ~ ,. 8 = ~- I3JCHES ALARK ~~f'AG1~3RERi_ = _ ~ • J II~ICt€ES ~~_- J ~~ _ I L'f~ MpDEL ~t#BEg - ~,, ~- £ A . ~ ~ZRI ~tG AS P£R ~;TCIi T'1'~E' ~`!= gs~3i~' L~ FEET ~T" ~' G~~' -~Ipt~f PIP£ I ~ ~ ~-~ FEE'S REQ~;TtE3 37IS~C'~R$~ ~~ ~~ ~,,#P Os F #31+i~i -~I$.TR - ~ - _ _ -~._----"' F£REHCE H£T~ s5t3RE - FRgC'TT~H FACTOit - J~.s-~'r" FEET F~SZ,Y Pit£ / j MIHIl4`s~ ~~ ~ ~~~.AL ~~ L£IdGY'H ~~ ~~ _ PUMP '~Ai~t K = ~~QU Ili ~~M ~'`r~ F3~YERNAi, ~ZHEi~S~i3NS ~}F i~IC€IdS. ~IH~~ = .. iIBB Hi=AD CA°AC-TY CURVE ~l MOQEL ~ 52/153 753 I \i /I I /1 _ t2-j Y"T752 30~ { 0 20 , \~~` - D~ 4 ~ J I 7 o ~ e0 , 2c 4o So GALLONS LITERS 0 80 750' ?~0 320 fLONl P£R MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. ~" .Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase systems. • l3ouble piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik-Bax available for outdoor installations. See FM742t). • Over 1~°F. (54°C.~ special quotation required. 1521153 Series r©T,a>_ oYrh~UtiC ;'EAo/CAPkcirY • PER MINUTE Eli=t_uEi1'T F.ND DEwaTERtkG I MOCEL t52 753 feet ~ters Ga. Lifers Gol. ~ liters g 1.5 E9 ~ 2ti? 77 291 i0 i 3.t ~ Et 231 70 i 255 75 4.6 S3 207 61 231 20 - ~ 6. ~ 44 i 57 52 'r 97 25 7.6 ~ 729 42 ~ 759 30 9.t 23 87 33 ~ 725 i 35 t ~.? -- -•- 22 ~ 85 ~o ~ t2.2 -- -- t ~ I 42 i I L ~ VOivc: ?S.0 F~ (] 7.6m) { 44.0 Ft. (t ;.4m)- C~~n~ Q,>~ ~ 3 ?7 ~- 72 ~i/S iI I t ~- :z i2 3 SELECTION GU}DE O CAUTION ,qt- instailatiort of controls. protecdon devices and wltin9 should be done by a qualified ilcenged elecb'iGiao, All electriq! and safety codes should be followed including the most. recent NaHanal Electric Code (NEG7 and the Occupatroaal Safely and Health Act (OSHA). 1. Single piggyback variable teve! float switch or double piggyback variaole level float switch. Refer to FM0477. 2 See FM0712 for correct model of ErectriCdl A16errrator E-Pak 3. Variable level control switch 1 t?-D225 used as a conUOl acDvator, sperdy duplex (3) ar (4) float system. RESER~IE POWERED DESIGN For unusual conditions a reseNesafetyfactor isengineered-into the design of every Zoeller pump. .~, ~utrc ro: Po. aox ts~ai' - Louisville. KY 40256-037 ManuFa~rers~.. 5HJP T4: 3649 Cane Run Raad , gyp' Lows~i~te,KY4o2rf-tssf -. Qvaurrpu+~as,iNCE /J39 ® {507) 7'8-273'1 • 'r {800) 92B-PUMP (gyp;//1nr-yw.zod/erccm PU/L1P L!7- fAX {5d2I 77a3624 ©Copyr;ght 2000 Zoeller Co. RII rights reserved. ER'S ~pt+tUAL & MANAGE1~ttE~~~ POWTS OVYT~ cYSTI`~i SPEGIFi N~ber of 8edroaT'S Numt>~~~~~ Units . EsSttiabed fiflw (anref~t9e? sled x 1-~ ~n flow {peak), ~~~' Soil App~Or' Rafe lnltuerttlEtiiu~ Quad"rtY Fats On Ps Grease {FOG7 ~~ ~ 0~ and${BGSS) P ~~'t QuaCdy . en Demand {SOOs} g,odsemicat Oxy9 ded Solids {TSS) Total Suspen memo rriean) Fecal Colrforrn (9e° Maximum Etttuertt Partide S'¢e ~~'-- Service Event tnspe~d Cp~pi°n of tank(s) Pump out contents of tank{s) ~nsped dispersal ell(s) Clean effluent filter lnspe~ pump, pump °Onu'cts 8. ata~ ~~ taterais and pr~ess~ test ~y`-~-~ SePtic?anic CaPa~ ___. $eQtiG Tank Manufa~r Et~lttecrt Filter iVtanetfaduTer "- DNA ~flquenf ~(fet~Model pimp-Tank ivapacity ~ aFld pump TanK Mariufac~mr --.,.~...; .Pump Mantsfacfurer Monthly ave~e: ~~ mgt ~fl rrtgn- Q~e o! _ !~ ~ ^~ ^ taw ~~~' ntva ~~ j p NA ;~~~~ nNA ~ NA Q.c/ ^ NA z Pump iy-odBl ~ - P~~~neni Unl~r _ p Peat t-liter n3 Aeon ^ Wetland p Other. ^ D'ssinfec~ion Monthly aYerage" t]ispersai ceuCs/ rpund {pressuri¢ed} ^ -gr'Ot1nd (Qn~~~ p M d S30 mglL an ~.gratie ^ Other_ S34 mglL SS Q` cfu14 QOmi p 'ne n~.~unecGari,Kasf~~ 1°'~ aomes4c t ~ ya inchdiameter enc V ~ ~e e~Niu u •.~ Yatues tyPi~ ~ ~~~ Service Fre4usncy +'(s) (Maximum 3 yrs.} p month A2 least once every ieais ane-third {Y) of tank volume n eq When combined slu dge and scor r(s) {Maximum 3 yrs.) Atleastonce every r p mont p months ~ ~ r{s) y At least once eve ~,,~9~r s} p NA °~ p months At feast once eti'ery .. ^ month s} D [~+ At feast once every ~ ^ months n YesRs) p [WA AL least once every p ~,nths ~ 3f~{S) p PtA At Least once every hs ovbr licenses ar FaA1NTENANt~ iNSTRUCnONS one of the foltowin3 loins'" Set~ge _ li be m2:de by 8R r~~r~' POW1~s l[ sPe~~ PEyV~Il~ ~g or bnvlaCn d real Cetls sha tnspec6ions~ Masher uPt mb~er'. Master Piurn d ~e-~ ' I inspection of the tanK{S} fio lden~Y am for any bad up ce ns must a ands ~ ~~ ~e e~~i levels Seivicin9 OP~bOr. Tank inspec~o measure the volume of pombirsed slu sv`~ any of eftW~t on i~ cracks or teaks. ~ Cett{s) strati tie t,ar~dware. ktentlfy a~ n the gm>md surface_ The diatom effluent on the gm~nd surface. Trie t,~ondingulalorY sutl,ority. ~ pondiltg of et;iuen and ~ cnecic for any ponding lion of the locsrt re9 in the observation p-P~ ~condroon and r'e4~,res the Immediate notifica or more Of the tank wiume. the gtnimd sWfao~ ~Y indicate a fa~Ting #ank eclt.tats one-fhirri (K? of in aocor~an~'"'~' ~~ NR mutation of stu~e and scum in any for artd disPc~ When the combined acw cored by a Setatage Servicrng 4F~ . entice txtitents of rite tank shall be t~ t ~ponents, and any 113. Wiscatisiri Adminstratrve Code components. pmtr~n pOWTS Maint~er. ~anicai or pressurized POY~ITS a cer~fied The g °f et±!taent if'1tP.t'S. ~ tef[on of a+~ry service int. cirtorin9 at interests of 12 morittts or less shalt o~ a ~mP oitterrrtatnteriance or coo taro auttttarity wiffiln 1 days A tepo~ shall ~~ provided to the total re5u 'Y ~~ ar other' treatment tanks} for ate P~~ of painting P , START UP ANO OPERATION PODS r~eck. et~si nett{s). If high concP~6'ab~otts arr' For crew eDttsWcti4n. pn~ tO use of the mss and/or damage the lisp ~ e the tr~eatmeni p a sepro9e servicing operate Prior tc~ use_ ~~~ that ~Y , ~ of the tanks} removed by Qtst+eCied have the contents i Jr.'. Page of__,_,,, • g start up shall not occur when srn-I conditions are frozen at the snfritrative suifiace- is ct~otrrd the elODesS Yarn ~~ ~y fits above notznal highwaier levela_ v~hen P°1~ . ~ ~ ~ calf{s} in one large dose. o~'e~dng the ce~(s} and tnaY result in the no the d"~ t>ado~P ,~ ~~~ dtscf-~ge of t To avoid this situation have the contents of file pcitrtg tank removed by a , e Ser~g ~~ ~~ poMYer to the effluent pump or concoct a Plttrtitaer- or POVVTS Mafitainer to tin tTlaflti8l[y Ope~n9' ~ p~P ~~ fo restore normal ievets within the purnP tank. " e or veiitdes octet fags and dtsper~a} tats. Oo riot drive rx p2~iC over] ar ~ disturb or ~omp~t, po not tirnr t~ mound or at-grade sa'( absorpiQn area. the aria within 15 feet dam sk~ae of anY the rf4rntartce and prtrtorig l~ (de RedctGaon a-eriminatton of the ~olla~ring fmrn the ~teysrater sfr~eam may improve Fe _ of the pt}Y1tTS: atilt"b~otic:s: ~f d~~ ~utfs; ~andoms; ~tton swabs; degrt: d~ t~rbttxdes' " ,meat hxuidataori drain ~sttmP p~P? Mrater, fruit and vegetabEe geeCtitgs= fie; gr~ease:• d'am' 1~ }~esiicides: sanitary napkins: tampons; aiYd wafer sofi~rter brirt~ s«a-ps: ate: o~ Ong P~~ _- '~~~~~~ fatten out of service file foilos~ving steps shaft to taken ~ lnsura that the y~1e„ the POWi'S fails sridlor is pem-ane~Y- n Admiri~Sra6Ye Code: system is prvPedY alnd safety abandoned in camprance with ch_ Comm 83.33. Virrsconsi , qti piplrtg m tanks and pits shall •tae di~_ °nr~ected and the abandoned Pipe openlnSs sealed. r'ts shall be removed and properly disposed of by a Septage ~SetYicing OPere~ .. TTe corsterets of air tanks and p • ' pt~P~g. an tanks and Pits shalt tae excavated and removed or their covers rsmaved•and title void space filietf with soli, $~ or another inert solid rnateriaL . . GOKTINGE~ICY PLAt11 the foirorving measures have been, or- must be fakers< m Pnmde a code tf the FOW1S fails and cannot tae repairr'rd aompGant r,eplacernent system ant sor7 fl A suitable ~p{aoement'area has ~~ erratuaied and may be utt~fized for the Location of a ~ should not absorption system- Ttae replacement arm stiouid be praofected from disturbance grid corrtpa be infringeQ crpon by required setbacks from e~dsting and proposed sirudure, Eot trees and vrelis_ Farlure to probed the replacement: area r~r[-ll result in t?ie need far ~srith fihetrules n effect at ftsat tirne~blish a sudabie replacement area- Reptaoement systems must carripiy D A suitable repfaoenierit area is not ava~abie due to setback andlor soil runitations_ Barring advances in POSIIli'S technology a tioiding tariic [nay be installed as a last resort to replace the Eased ~O ~ of the POWTS a soil.anef The site has not been. evaluated do lderttify a suitable replacerrtent area Up0 i~ evaluation must be perforrried ~ k>cate a suitable replacement area- if na repta~erit area is available a cling tank may tae installed as a Iast resort to replace the failed PO~YI'S_ rerriovai of the D"tornat at i~'~~~~ocrrid anti at-grade so7 absorption systems ma3' be r~eoonstruded in piaoe fatlotiring ,~ mfi(tratlve surface. Reoonstsuc6°ns of such systems must comply rvifFi file totes in effect at that time. «ffirARNINC~> SEPTIC, PUMP AND OTHQi TREA7'1~EI+1T TANKS ti~rAY CONTAIN LETHAL GASSES ANDIOR tP15Ui=F1CtENT' OXYGEJti DO HOT ENTER A SEPTIC, PtJ1ViP pR Q'T'I'TER TREJ~-TM>=NT TANK L1NOiER ANY C1RCflMSTANGES. DEATH MAY RESULT. -RESCUE OF A PERSOI~I FROM THE IN'iER10R Ole A TANK MAYBE pIFF?CULT QR IMPOSSIBLE IgDptnOttiAL COMMENTS _ POYitTS ?NSTAI3/.ER Name ~/t - 9 ~ / f2 Phone f J ="cX~~~ .S~ POVYTS MAIAiT'Ai1KER Name ~,~C~Lt Ptlarre ~J,, j ~ ~- f J~ SEpTAGE SERViC[NG OPERATOR PUMP' L~CAE.. REGULAT/a' KY AtTiHORl7Y l+SamE: ~~ /~! Ag~~' - ~ G s/~ ~.~- C- ill r1I ~ ^ Phone ~J, --"'~ "' ~ ?bans ? ~ j ueffe and 1Naushara Carnty ZanTng and Sanitation 8gt~deS_ This doa>nteN mt~ rids ao«m+d+tsas dratted tiY. the sus of the green tafre. A+lar4 - t Apes rttlt me rtin~wn ~pgviceri7er7LS of tt>_ C.anun 83x~7~XiXdl~dtl acid 83_Ss{S}. (2) i~ (3), W,sportsin AdrriGttstra~e Cctfa Use of tl>Is doattntm y~ararttee the performance of the POWTS- ~'~ (IIQt 1 Wisaansin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings ' in accordance wrth Comm 85, Wis. Adm. Code County Attach com~,lete site plan on paper not less than 812 x 11 inches in size. Plan must ~ indiide, but not IirNted to: vertigl and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ~~ ~' Please print all information. re by Personal information you provide may be us for se~r~r~~n cy l.a . s. 15.04 (1) (m)). u Page ~ of C`ra ~ x ~9~ - ag-tom d Date ~ ~ a/a~/a 3 ~~ Govt. Lot i~/(~ 1 /4 N~ 1 /4 S g T 2 9' N R ~~ E (or V~ Property Owners Mailing Address Lot # Block # Subd. Name or CSM# Ic~li ~~U~ s-~:ci~~oix~~~il~T~ ~ ~he~~ ~~d ~.. City State Zip Code Ph / ^ City ^ village Town Nearest Road New Construction Use: ~ Residential / Number of bedrooms ~-`~ _ Code derived design flow rate ~SU~C.o LY, GPD ^ Replacement ^ Public or oommerdal - Descxibe: Parent material ~' ~ ~ Flood Plain elevation if applipble /lJ ~- ft. General comments `~ t?y}/) e ~'eV ~ AGO' / and recommendations: ~ l ~ ~ v>S ~ SQ~i~ , f~ S~'L~~ ~ 2t 13.3 . ~ ~,~-~~ ~Iev r 9~' 0" ~D Boring # ~ Boring C~ 2Q ®pit Ground surface elev. ` 4~_ ft. Depth to limiting factor J~ in. Soli Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. MunseO Qu. Sz Cont. Color Gr. Sz Sh. 'Eff#1 'Eff#2 (~-13 I 3 Z -- Sf ~ Z k fir'- c~ I -~ ~ g ~ ~~ ( r ~l C3P 7.5 ~ yl~ S. ~I Zms~ rr,-F,~ - . ~ • ~ Boring # ^ Boring ® pit Ground surface elev. lC~Ccl ft. Depth to limiting factor ~~_ in. Soil Appliption Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Cdor Gr. Sz. Sh. 'Eff#1 'Eff#2 ~ o-i i~ Iz s ~~ ~ 2r,~ ~ ~5 1~ . 5 .~ Z t~- 1 ry ~ Si~~l c5 ~ . ~ g C y ~m5 1 - - - Z 'Effluent #1 = BODS > 30 < 220 mglL and TSS >30 _< 150 mg/L 'Effluent #2 =GODS < 30 mglL and TSS < 30 mg/L ST Name (P ale Print) Signature CST Number h ~--- ----~ Z5.3 0 Address ate Eva tion Conducted Telephone Number Property Owner d..~U n'e- Parcet IO # ~ ~`" ~ Page ~ ~ of ~ - Boring # ^ ~~ Pit Ground surface elev. q • ~ ft- Depth to limiting factor ~ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Mansell Qu. Sz Cont Color Gr. Sz Sh. 'Eff#1 - 'Eff#2 l p-lZ FD ~~12r ~ S~ 1 r e5 lv , ~ . 8` z ~2- ~ ~yl~ --~ S~ ~~ ~m '~ ~g ~" ~ y - ~ I t~ ~ .~ - ~~4 S ~ ~-- Z r - - . `l ^ Boring # ^ Boring Pit Ground surface elev. R Depth to limiting factor in. Sai Appliption Rate Horizon Depth . Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfftz in. Mansell Qu. Sz ConL Cdor Gr. Sz Sh. 'Eff#'I 'Eff#2 ^ Boring # ^ Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon th De Dominant Color Redox Description Texture Struchue Consistence Boundary Roots GPD/ftt p in. Mansell Qu. Sz. Cont Cotor Gr. Sz Sh. 'Eff#1 'Eff#2 - 'Effluent #1 = BODS > 30 < 220 n-gfL and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 mg1L 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. sari-saw cRmroo> PAGE~OF~ rT~~~~~~ t LOT# ~ I EGAL DESCRIPTION 111 Us %A/u114 ,S ~ T Z~ ,N.R. / ~ E(or~x/ SCALE: 1"= y~ r BM 1 ELEVATION /G+U ~ C BM 1 DESCRIPTION~(J ~ -~ ~ ~,(~uC_ P,D e BM 2 ELEVATION `Tq.,sz~ BM 2 DESCRIPTION ,(,z_~` " pU ~ ~~ •p~ SYSTEM ELEVATION QU • 3C~ SYSTEM TYPE -g- ~ - (y- ~~~ CONTOUR ELEVATION ~, kU ti N! ~ ~„~,6 N _ --~- Sec 9 8'x`2 (?,'~ 0 \ ~`•~ J~ ~' v ~ = ~ p~-z \`~a L/ s s -3 ~ 99. o d SIGNATURE /1J~----~ ~' r~ _. _. ~ -~~°z ~ + ~ • NPL A TED L ND x 1095.3 _ ._ .._ - - - - - --- --..---- ~- ------r~- 3®g 24 01' ® 2 4. 4 ~T, x I c 8 1095.2 o~~: y,,, .......... ........... ... M .... ................ .................. .............. ................... .~ .. ... .... "' ,~ LOT 1 T ~ , ~ B-'33 ~ N 8-46~ py L O 1. T8 ACRE S ~, gg CRES 1. Ac L T ~ 1. ACRES ~ N ~ ' o n4j O) N O 0 ~ ~ 3 y o• ~3' 9/ • .... /9~. 3~ M ~ .~ aye 6• v '` a t ~. 3 s ~ ~ 6~ ''~ ~ 9 t ~ t O' ~~ a :~ !ntom .32 t • w N ' LOT 1 1 W s so,s, 5~ N : 1.32 ACRES a. ~ Q~ /, ~5 , 3 :' M~ 49Yo' ` ~ 39~ ~ ' .4~s ~ : ~ 0 3' ~ LFE 1072' h ~ ~ c? ' t 5 O ~ •. \ ~ O 2 ~ 66 ~ t 't o ~ . o ~ L 0 10 ~' , g3 ~o~° ~ . S4 ACR a ~ 76: ~ a °~ F'°SF~Nr 1070 r 6 ~ ~ ~ 2 D L E 1072' ~ • SO ~ t ` ~ x . ~ Z3 y4, , ~'J'' cc I __ ~" L T 9 ~ °' ' \ + NT c d• 1.6 ACRES ~ 6 ; O IS" ~ V ~~ N~ W 1 - _ ~ 893, 36' ~ ~~ ~ ` ~ ~ ~ _ o °_~ F ^^.... ~'~ ,, ss. ~~s`o 2sq p ~ , , ~ ~ .` 'x'73.33' ~ ~ ~ ~•~ tu,J ~• ~ ' - ,p ' , LOT 2 -$o tp A.,eQ. s M " ,,.. a 1. TT ACRES tv ~''' • • • ... .......... ,~.......... N w1 , ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND O/WNERS/HIl'' CERTIFICATION FORM OwnerBuyer ~/' /L2 s~ 2 !n D a--!/~ Mailing Address Property Address City/State Parcel Identification Number ~~~ ~~ ! (~~ ~ ~-r~~ LEGAL DESCRIPTION ~~ ~ Property Location 1v~,t 1/a ,/f~'l~'/a ,Sec. ~, T _ „ -~ /~' i Subdivision ~' ` e ~' `S ~ '~° ~`-~l Certified Survey Map # ~N I~~W, Town of '~~ ,Lot # ~- ~- Volume ,Page # Warranty Deed # ,Volume ,Page # Spec house ye no Lot lines identifiable yes no 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 certificationform, 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 ertify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the propert~,~ 'bed above, by virtue of a warranty deed recorded in Register of Deeds Office. ~~ 7~oS SIGNATURE OF 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 survey map if reference is made in the warranty deed. ~, J S~ erification required from Planning & Zoning Department for new construction.) (REV. 08/05) U 2582P 20 . I STATE BAR OF WISCONSIN FORM 7 - 1999 Document Number TRUSTEE'S DEED Dine M. Bonte as Trustee of Karl M. Ulferts and Katherina G. Ulferts Family 'Dust for valuable consideration conveys without warranty to Ernest Yeboah and Ernestine Yeboah Grantee, the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Lot 8, Pheasant Ridge. St. Croix County, Wisconsin. Recording Area 7641002 KATHLEEN H. 1t1ALSH REGISTER OF DEEDS ST. CROIX CO.. MI RECEIVED FOR RECORD 05/27/2009 10:00AM TRUSTEES DEED EXEMRT ~ REC FEE: 11.00 TRANS FEE: 125.00 COPY FEE: CC FEE: PAGES: 1 Name and Retum Address FCHISTi~J~ OGI.AND ATTOR: f~Y ~1T l.AY1/ P.O. E?7:t 3,i~ HUDSi~iJ, 1,VI 5~J16 o18-IO96-os-ooo _ _ Parcel Identification Number (PIN) Ol~t~ Dated this i ~ day of Mav ,2004 -~~:1.LL1lG.r-J-L-L'- --- s Trustee AUTHENTICATION Signature(s) Dine M. Bonte, Trustee of Karl M. Ulferts and Katheriua G. Ulferts Famfly Tivst authenticated this ~ ~ ~ day of May ,2004 * Kristine Ogland TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stets.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristine Ogland Hudson, WI 54016 (Signatures may be suthendcated or acknowledged. Both are not necessary) persons signing in airy capacity must be typed or TRUSTEE'S DEED * Dine M. Bonte Trustee ACKNOWLEDGMENT STATE OF ) ss. County ) Personally came before me this ____ day of . the above named to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. * Notary Public, State of `_ ____ _ _ My Commission is permanent. (If not, state expiration date: STATE BAR OF WISCONSIN FORM No. 7 -1999 .) lnforrtation Profesaio~ls Co., Fond du [.ae, WI 800-655-2021 ~\ r S, ~ ;~ y ~ ~ ' _ _ ~ ~ I• 0 O I ~1 r , I ' ' / 'i' _ _ _ ~ %' jam 2y ~ ,, - - /,,3g• ~~____ r ; ~ ~ ~r;l `¢ ~ _0 _ n 0 W/OE BR ~~p A /NAGS r / ~, EASE~,Lr r .i e , NT 4 m ~ ~~0 Z ,~ ~~ rv_ o_ o A N , li ~ ~ : l; r I r, "/2 °25 29" •~ E r~ 33 /. 87, ' r; ,- /' ~~ ~~r r ~. %b® • a0 2 ~ : e r; n ; u ~ ~ ~; o o , /; ~ ' 1 - •A co , N08°5/' 47" E ~ i `33 / • 79' 248. 87~ 2 / 3.25' rn - P~ m ~ ~~ n y 1 vI V V N ~ ~~ ~ N Q 0 '! ~ _ 1 ~y ~ I ' -1 I L i ~ ''- _ .~ 3 E' i 29 ~ ~ I _ nom, ~ ~ ~ Q N ~v ~ O O ~I n N O pA N~ y y V, ~~ ~ p ' m SO 1 ° 16' 08" W 304. 90' , ~ ~ n ' 1~ rn - r- i ~ "i m ~~ ~ N ~ ro I o D y W ~ C'1 o y' ;'1 ~ ~ ;+ 01 ~ ®~ r94. 3O, 362. 5 / ~ ~ ~ , 232. 38 s ~ y $ n y rn rnv o ~ cn ~ ~ ~ I O m .... V O~ ~ ,p i ' ~ try O ~ ~ ca -'.., ~° -~ , r"~ ,001 ~ i ~ • ,~ woo ~ N~o ~;~ n y . ~ y o. o ~ O T /~~ NO ~ ~ •~ 44'32"W ~ ~ ~y~ W yyy ' ~ i 260, O2 ~ v ~ cfl cp •~ co ~ m o~ ;~ . = :n U c O z w .•••••• SOO°42' t3"W 30~. 00' ' :~ • Rt to W •~ ~ ~ V' ~1'7~ •+~ to W ,,,,~ : W i ~ _ •1~ p~ _ I ~ tTO ~,~s~ Oy pU m ~ I .......... ~.. i -~? cn n rn, w o ~~' ''/ l i m oy~ ~i ~ ?_5 _j_- 0 !~ ~ I O ~~ ® ~... ~`` O / ''~ ~ /~"~ .;mow I i J 1 l ,ti ~~; ~ ~p~-- r~ . r r r r "r ~~ ~ ~ 1 O s • ~... F ~ r rM / "j'e~°, ~~ ~~ 1'tbM .~It? ! u• tee, ~~ ~R ~"P ' ~~ l zid wdba :eti ve0z di •~aa zezt I~SSiL : •oN xad ~7~ S3WOV-I JNIa~(1~0: woad Ztd Wdbt:Ot b00Z bi '~aQ Z$Z~Z£SSIL: 'ON Xdd ~l~ S~WDH JNIa3(130: WO~id Parcel #: 018-1096-08-000 12/09/2005 04:24 PM PAGE 1 OF 1 Alt. Parcel #: 09.29.17.783 018 -TOWN OF HAMMOND 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 CaOwner ERNEST &ERNESTINA YEBOAH O - YEBOAH, ERNEST &ERNESTINA 1763 96TH AVE HAMMOND WI 54015 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description * 1088 173RD ST SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description; Acres: 1.510 Plat: 2299-PHEASANT RIDGE 1/32 018/02 SEC 09 T29N R17W PT NW NW PHEASANT RIDGE Block/Condo Bldg: LOT 08 10AC O 8 1 L T .5 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 09-29N-17W NW NW Notes: Parcel History: Date Doc # Vol/Page Type 05/27/2004 764002 2582/208 TD 08/06/2002 686239 9/26 PLAT 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 91031 41,900 Valuations: Last Changed: 06/30/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.510 34,600 0 34,600 NO Totals for 2005; General Property 1.510 34,600 0 34,600 Woodland 0.000 0 0 Totals for 2004: General Property 1.510 34,600 0 34,600 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