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HomeMy WebLinkAbout018-1030-00-200- Wisconsi:l'DepartmentofCommerce PRIVATE SEWAGE SYSTEM Safetyand Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 'ermit Holder's Name: City Village X Township Elliott, Kevin Hammond Towns~ii ;ST BM Elev: Insp. BM Elev: BM Description: od ~~ a.b e ~ SANK INFORMATION ELEVATI N DATA TYPE MANUFACTURER CAPACITY Septic /- ~ trV e c r C7 Dosing ~ ~~ Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~~~ ~ ~~ ..~3~ / Dosing 7.}~ ~ Ae PUMP/SIPHON INFORMATION Manufacturer Demand ~ S GPM Model Number ~® 3 TDH Lift Friction L s System Head TDH Ft (S ~ ~ Forcemain Length Dia. Dist. to Well ~ ~ lZ 2 ~~ y SOIL ABSORPTION SYSTEM County: St. Croix Sanitary Permit No: 399552 State Plan ID No: Parcel Tax No: 018-1030-00-200 STATION BS HI FS ELEV. Benchmark • `/ ( ~ v Alt. BM 6,oZ CIE Q•Z , s g3.zs Bldg. Sewer Ht Inlet ~ ~y. ~o ~'~: z a SUHt Outlet Dt Inlet Dt Bottom 10 , 3 S _ ~• ~/ ~ (~ ~ ~ 3 ~ s Header/Man. A Dist. Pipe Q ~ P` G.3~ b.S2 6. 9'2.90 17Z. ~S 92. s Bot. System L- j ~L 3. [,~ ~ . o /• i~9/ y ~ Final Grade M 5.25" ~ '-`1 dZ .~AS 3- 3 St Cover ~ k ~ I v 9~- 3 ~ ~ ~ ~.T r y BED/TRENCH Width Length ~ No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 4 ~~, 1.~ r SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM L G M uf~c~rer. INFORMATION M OR _ Type Of System: -~-~~ ~ ~ ~/ ~ NIT ~i Model Numb r: DISTRIBUTION SYSTEM Header/Manifold Distributio ~ ~~ 2S Pi x Hole Size x Hole Spacing Vent to Air Intake ~/ ai Length Dia 7 pe(s) , Length 3".S Dia ~ Spacing 3"3• ~ ~. ~~ r 7 ~~ SOIL COVER x Pressure Systems Onlv xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes ^ No 0 Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ /_~/ OZ Inspection #2: / / Location: 1963 Cty Rd E Baldwin, WI 54002 (NW 1/4 NE 1/4 14 T29N R17W) NA Lot 2 Parcel No: 14.29.17.213620 I~ ( 3, r7 (,SPrv~~o~- opus ihs/mil/~~ I~ ~i~ .Z"~ ~r 1.) Alt BM Description = TDP s ~ p~e L~riC lOO K ~ , ~ ~e ~I 1 //~~ 2.) Bldg sewer length = 3 ~ ~ / ~ t-%~ -amount of co/ver/=~>(~"~~q5-~ ~~Gli(~ bC / JIJSy~'f~"`(~"~'`s` OYr~u~~%v..- ~~iV` %ttiSk ~G{~CM it 7 2 n ®t GotJC/ iS[Sf ftiJQi~~IC,. ~r1/~S YES '~~ C B ~Q Plan revision Required? ^ Yes No Use other side for additional information. I 3 >~ SBD-6710 (R.3/97) Date ~/~Insepctors Signatru '' r r /; Ceert. No. (o~~toty~~-tfA9tr I`i-t~led'~ iwt7~ d'~ .~a~,{rG/ar, 1~ ' ~.. a hem PvWc~ ~~(e ~aS gu^ ~ i h s ~a,Ll e~ ~3 x,~ bl N 1 ®-~ B ~ ~'~ i~aAco~c~N,e~- d~~ .~~ ^~~~ ~. _ _ ...... ~~ __.... 5afcty ucd ~uil4ir.~a .:+••~a,ta txu:.y .~ ~~~' ' Q• 9qi; 7162 rL.t_ ?A +~', Wa~iotiAv~•. p. a ~~~~ { Madyots, R'Y 337th; - ~I62 i ~~ ~,~ 'thy Fe~aa~t Appi~cat,-,~ -R~~... ~ ~' 9 9 ssz • ~a cawed wak ra,~#. w~.. ter. near. road ~~ ~=~YSae ~. ~, ; ~ n~ xeviaioa + a, x>~ r r _~c~G~V ~, _ 1N-Z9./ _z s e U 1 ~~/ ~ ~tq, tioa ;` ~~ .sip' ~~ '~ ~ G ~ ....r.......,...~ ~ oY.r...~....--...-Vel. i s P9 . Yoh ~Gf~'~jl/, ~ v r. ' Lh 'Tyke Ot ( xPl~~ ~ ' ~ C:CJ~- ~QYZ~i~~ ~ Q/ ~ ~ d~R U~~i S ^ Ptibi~CoiomRO~ - ntgoClfl Vw ~ m °•~~ p SW14~i'lAR ~ N ~ i'~ .~i~ T Type dt" 't~lti t ~ oiu box on l~oe w (ar E afew a {~ ~ 3 ~ >~ytee A. n ClMilc It 1 lcrrvlot~y 1W~' tbt~t ~F1Fy 1 14Ntlq ^~nNW~/d Io~di'e<lYd ~a 1~Omtd ~ (a ~ ~ 4t d ~i0ld#tl Tactic o! 16 Ci Asl<<tdnA ~+ ~ Wtj __~_ 17 ©iylsnd ~dtas' !b ~ C~oatztr wetland ~V s~t.~w s4a~~ ~3 ~ s~ ~ ~~~~ ~ ~~d ~j~~ !~1!!Nt S Gattod at 3tiafu ; .. r ~ ~ ,r,..,„._...._._ ~lwatfon ,aa..,aervsQ.i=t.~ ~ ~ ly ~ ~ k 9~, . ~~- ~ .~~~ X33, S ~ 9~. ~ ~auiz bpd l , i<ibar Goes Cotntcucad ~ ~ 3h~s ' MIS es~ r ~J' tam ~c~udn-ee es- t Ml~i. ~ ~ ~ ~lililil'>a . 4 q h3p~rinreai L7 fired - ibiee~ Fa) Q awiorr a1ve.3eidet~lwsu• ~ . ~ z zs0~ I ~ l »~ ~ ~ ` ~ '~ ~~~1 ~~ ~~~~<~- ~ ~2 /N.cZ~n]`aiWa`~S~rdic p~ ~@r I.KAw~~'I'a~LweY S /CGal~h ~~OY~. S , - -- --- -. .~~ 4 't ~~ C ~I J ~. H O al 'x M ~~ ,~/ P~~j~ 3~ 1 Os Z ~~~ 'Ov iz J -~ ~ ~ ~ .p ~..~ ~ V to ~~ •~ I~ `~ '- c I~ ~~ .~ ~~'fn Win.' 1 ~~ v ~ °' ~r~ ~ ~ ~.~ _s~ °s ~ J ~'.oV 3 ~ -'`~` .~ ,N D l~ -_-~_- I I p~nr '~ ~ \ ( •' . `~ O~ i;` S x ~ 1 ~ V ® k,., ~ I r ~ • ~ G ~ _~ J u J ~ _ ti -:,. r ~S 5 y ~-, i~~ ~~ ~{--.~. R ~BAUj ll~ lI1J ~~ nas.. a~ o ~ p ~ ~~~ Q !1 ~~~ {~ j U ~~~ ~ ~~~ ~!~ ~....~ .. s ~~ s A ~ ~~~ _ ~~ac ~~~ o ,~~~~ ~' c~ ~ ~' QD N ~ ~ t ~ ~ ... ~ ~. ~o ?~ _ Q ~ a m _ m`~~~t ~ .o ~, ~• ~a~ ~ ~ ~ ~~ y C !~ ~m ~ .Q ~ ~ U ~ A ,~ ZAj ~~~ .~ t!. O = y tL ~ ~ ~ • C w ~ T X to y U~ ~ >C ~ ~ ~~y t , U ~ ti ~ S '~ ~~ ~ ~ ~' . ~ _ K J Z ~ ~ ~ ~ _ ~ O` '~ '' ~~ ~ ~ •~ ~~ ~~ 1 ~~ ~~ ~~ m ~`~ M v ~y O ~,~ `£y d Q ~ ~~ a :~ m M ~~ '~ ' r ~ ~ ~~ ~ ~~ ~ ~ (h j 2 b m ~ * g~ V N O ~ d •• Z N = • 'O . c~g M :~ ~1 (p m f. ~ ~ ~~ m ~ ~~ ~ A r ~ m M y a ~ ~ at3/ f Y s~j a! C ~0 $ aCJE~c1 ' ~ ~ ~S£PTIC TANK ~ PUMP~CHAMBER CROSS SECTION AND SPECIFICATIONS 4" CI VENT PIPE 12" MIN. ABOVE GRADE ~ JUNCTION OBOX APPROVED 25' FROM DOOR, WINDOW OR WITH CONDUIT V R WANP~L FRESH AIR INTAKE B OCK ----- --WARNING LABEL FINISHED GRADE ~ r 1 4" CI RISER __ ~~,~~.'f MIN. ' ._~- ~~ 18" IN. 6ir MAX. ;.` ~~ NLET ~ ~, 1 WATER TIGHT SEALS 1 GAS- `~ TI T ~IAPPROVED A ~ ~ AL SE JOINTS WITM _!_.. ; ; ALM APPROVED PIPE PPROYED B ~ ON 3' ONTO IPE 3' "-F"- ~ , SOLID SOIL NTO SOLID OIL FUMP OFF ELEV . FT. ~ ~ ~ ppF ~''' RISER EXIT PERMITTED ONLY D IF TANK MANUFACTURER HAS APPROVAL 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE TANK MANUFACTURER : /,,~, rP'S' e / NUMBER DOSES PER DAY : TANK SIZES: SEPTIC ld~~ GAL. ~` DOSE GAL. ALARM MANUFACTURER: ~ c v-~/~ ~ ~ MODEL NUMBER: ,~~ ~/ ~, SWITCH TYPE: ~yi~Yc PUMP MANUFACTURER : moo/CAS MODEL NUMBER : ~,aa ~!~ SWITCH TYPE: y7~Yc REQUIRED DISCHARGE RATE ,3~ GPM DOSE VOLUME INCLUDING CAL. F LOWBAC K : CAPACITIES: A = ~ INCHES = .37 GAL. B = 2 INCHES = GAL. _____ C = ~' INCHES = 3~~GAL. D = ~ INCHES = /~2 --GAL. PUMP E ALARM WIRING AS PER I LHR 16.23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE ~- FEET + MINIMUM NETWORK SUPPLY PRESSURE -FEET +~p~Q FEET FORCEMAIN X (.SG FT/100 FT. FRICTION FACTOR ._. ~ FEET TOTAL DYNAMIC HEADFEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH ; WIDTH; DIAMETER LIQUID ~T~_, 3 ~'` 17~~~' / ;~ SIGNED: ~ .~ „ ~% LICENSE NUMBER: .~ ~ DATE: ~ ~ ~ 1/88 `~ ~V ~ r ~ ~ 1 t.~ 1LJ . f^) rti,~ ~.r :_, `-'~`~ lr• `V ~ ~~ 4 ~ G r. ~ , /1 ' :`t { i ^' Subr~e~s~~~e .. . , .'; o r~~~ u ~. EP~Q4 EPOS _.. . ,,.;, , APPI:ICAT:oi±~ ; ';-Fasteners: 30~? series • F~!iy~ suhr~erQad in high ~ li+fa~r Nausing: Gast iron . , Spec~cally designed for the stainless steel, grade #~~rbine oil for for efficient heat transfer, foiiavaing uses: • Capatlie of , unning iuoricaticn and efficient strength. and durability. • , .~ ~Effluerrts~t~ms ~ ~;,clry withop# damage to campoiisnts; heat fsr;. -.:. - . _ _"ii~ltitor~l±over:7hermoplas-.- -.: Homes • Farms wr~~ r : ...: - -Motor .:, .. Availabte for automatic and do cover with Integrl handle and float swrtch attachment ~~4 >w ~:Xy . ~~; ~!~,,sump ~' ~~,~~!+Y ~ . EP04 S~gie phase: ~.4 HP, manual operatien. Au#omatto d ls i " points.. , =~,,~ r ~ •-:}:~:'bevva~n~;Q . ;:115 ar 230.V, SO ~iz,1550 ..RPM b lit isi overload with r { u a mo nclude Mechanical - Float ~+~~ assembled and ~ . ;. ~ Power Cable: Severe duty ~ - `~ wz ~~ ~ ~ , t :. . .. •-: automatic"reset ~ ~ preset of the factory, rated oil and water resistant ,~` : '``~';~" "`~"':'~'~;° . ` ' SPECtFICATlQNS :-. ~ ' ~ EPOS Si{7gie phase: 4.5 HP :. ! Bearinps;~Upper and rower ' 115 V, 60 Hz 1554 RpM FEATlJRE~ heaa j dui~ ball baanng ;-~ , ~- ~~~: • . ., ~•"'. '~;•""'~."`~~ ,~ y ®Uds ~n~llmg capability:.. ~~ •3.... , , built in overload with ' :automatic reset ~ EP44 tm slier, Therma- p ccnstructton :` ,~ .. maximum '" C~?actt~s' up to 55 GPis,~. ' . _ r,•.~. .. • Power ccrrd:l ~ foot standard iength,l S/3 SJTC plastiC.Bemi-ol;ert design with pump out vanes for t ' AQENCY l18TilNIG ~ ~.:r' ~.ti;.~~„z' ~ A~ heads:`up to 24 feel. with three prang grounding mec :a~nicai seas protecticr;. ~. L"anedlan StandardsASSOetatlan pit: z;' ~~OlscharQe's%~e:1'!z" tdPT, ."~"- • Mec~iarsical seal: carbon- P!ug. Optional ?4 foot rength i 6i3 5J7W with ^ trPUS lmpai(er.'fiermo- piasue enctased design <o, • - {GSA listed model numbers ~ ,t ~-;; " _~ ~ ro ... ~ taryr.$rainlc-statlona ~ ~> ' , three ran roundin ~u p g g 9 A g improved performance. end ~n F or AC" ~ ~~' h;. a , $UAiA-[d siastomers. ~ (standard do EPOS;. ~r Casirtp and Base: Ruggec+ " ~ - ~'~`~'`~~":,~ ~ !„Temperature: '; n'1t}4°F (40'C) continuous thermapia~ic design prov!das supe>fcr strength and _~,,~ , ,- , •. 14i1°F ~60°C} intsrrni~tent.. ` " . corrosion res+stanca. ~Y r ..: ,e yr ._ ~ ~,~` Fa s feners 3nQ series ~ t~~ERS ~r . . - y fining ur~ags to • ' 9 !- ~ - .. + r,` LIT,OS. Inp. . i ~ .~= . . Jt ~.3 ~ ..:~Y' !y 41'SY',. :.~f '"' M ~: _ ' {~ '.tvs „•/JSr 1 ~`.~, a~^ r ~ s¢~a .xx - 'Wta~~ • i ~, L W - t - f _ 'X t a } l sail rH'~. '/NS~' -r ~aF ~~{ r'Jn ~ ~ ~~ s~t r r a o , . = t?t• -f~. .'i~Xir ~ :. " ,,,: t. ,=ao ~,._ ,.:ao -so . w ~ ao ,. s o ..~; ,, ~,. 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'a Q v 1~ r L U J 1/ r c r' d d «~ a`i ,o ~ ~ . o' N ~ y. -- ~ o .n O ~ I al t~ C_ ~ "a .~ ~3 as m r~ ~o a o m0 Seo I G a~ a~ s, v+ -c ~ L L~ .r N QJ ~ N to /~ Q fi LJJ O N ~ ~ Z ~ ~ O_ v ~ H N _ LAC ~ ~ V1 R o ~ z .~ o °~ ~ ~ a J ~ ~~ o ~ a ~ N v ~ ~' c0 ~ Q N v m q H O ~ .,~ C C ''- ~ o ~, ~ acs w yC+~ L ~ ~ ( I ~ (~J nE DS ~-~ o • ~~ ~ z O~ N~ ~J a 3 ~ ~~ ~ - ,- ~N : , ^ n v' ~ , ~ ~ °; ~ 0 ~ O C t (~ Y Y Q i+ ~~ T~ N C ~ ° ~ a v ~ n v t0 - p ~ ~ o o a a o~ a, o ~ a~ N ~ L d ~ ~ t0 .: 9 ~ ~ ~ LL ~ ~ Q '" o m V ~ ~. d Q+ > .U 3 c o ~ X ~ N O A ~ , ~ .. v ~ ~ d O //^^ v, ~ o .. 0 ai 1 ~ 3 ~ ~ w ~ T ~ N ~ A c " o ~ C ~ ~ ~ ~ c (p _ E ;; Q N V ' T V w ' v + (~l ~ ar t ~ 1 f/ j N + n /- + ;~ ~ ~ ~~ ~ ~ ~ ~~ ~ r r m , a ~ o _, 3 ` ~, s ~ "> ' o r ~ ~ a o~ 7 ~ ~ O O ~ V ° ~ N 3 z ~ ~ o i a o ~N ~ r 2 a ~ x ~ {,, L j / ~ J ~ 2 ~ v ~ ~ _ _ N -, ~ ~ u T~) F L 3 I~ R ~ ~ ~ ~ l ~ 4 o ~ C r ~ J ~ p ~ `~~ d a 2 C ~ E ~ ' ~ ~ O 4 ~ ~ z~ at' , o 0 E 3 ~ E ~. f.-~ a O rn O N __11 `~ I v f T ~~ r~ ~~ 1 Q ~ o z ~ N ~. c 0 ~ ~ a ~, r ~, v ~"' ~ c l~ _~ ~ ~ N N 7 C H N V s Y N Q' L ~ ~ ~ R y ` 7 ` ~ ~ O L~ V t `~ o -v-, a' ` c ai ~' Q o' ~ ~,~ _> ~ ~ ^ ~ .n O ~ I pl f~ C ~ "aG~_ G/ '~rn~ a m r~ ~a a o ~O ~ ~ a ~ r C1 d s_ N _~ ~'^ w ~~ .~ J~ ai ~ r ate. 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OwnerBuyer Mailing Address Property Address ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND //OWNERSHIP CERTIFICATION FORM (Verification required from Planning Department for new City/State ;,,1~~('y1Pi~- ~ ~ti~'' Parcel Identification Number ~'f ~ ~ ~3c~ , d© -~ ~©D LEGAL DESCRIPTION Property Location ~~ '/., ~rl: '/4, Sec. ~, TAN-RAW, Town of ~ lY1 h'1 C Subdivision .Lot # ~ Certified Survey Map # ~ ~/~/ Q~r' 7 ,Volume /S .Page # Y~~J Warranty Deed # /'~83/ I ,Volume _~73~ .Page # ~ ~ Spec house ^ yes ~' no Lot lines identifiable ~ yes ^ no SYSTEM NIAA.INTENANCE 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 caa affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeymanplumber, restrictedplumber or a licensedpumper verifying that (1) the on-site wastearaterdisposal 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 Zoning Office with 30 da o the year expiry 'on aate. gg~~~ ~~~ ~ ~~ l rJl l~ l 1.~~' SIGNA OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the ro rty des bed above, by virtue of a warranty deed recorded in Register of Deeds Oflice. ~ ~f c:~ ~~ / / CS GNA OF APPLICANT DATE ****** ****** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made is the warranty deed * •. Y Private C~nsite Wastewater Treatment System Management Plan Septic Tank And Gravity In-Ground Soii Absorption Gompanent Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System {PQWTS) shall include information and procedures for maintain'sng the system within the parameters of Cornet 83 and 84, and the conditions of approva4 by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comrn 83.54, Wis. Adm. Code, and the In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- Tahia 4 ~ Svslarr~ D~sien Sl7BCI'flCatiOnS +l ~ - - Sanitary Permit Number .~ - - - ___ Number of Bedrooms 3 Desi n Flow -Peak { pd) DSO Estimated Flow - Avera a {gpd) 3 Se tic Tank Ca achy { al) Soil Abso flan Com anent Size {ftz T pe of Wastewater Domestic Tarnld 9• _Cnil Ah~erefien Camnnna3nt -Limits of Reliable Operation Se tic Tank Component Soil Absorption Com anent Desi n Flow -Peak ( d) Maximum Influent Particle Size (in) 1I8 Maximum B4D4 {mg/L 220 Maximum TSS (m !L} 150 Table 3• Maintenance Schedule Septic Tank Outlet Filter ins ect and/or service once every 3 years ins ect once a year and clean at Isast once every 3 years Soil Absorption Component Inspect. once eve 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, State. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease - Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet flier shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. if the .. •~ Management Plan for a Septic Tank ar.d Sail Aosarptian Component filter Is equipped with era alarm, the filter shah be serviced if th® alarm is activated continuously. Intermittent Piker alarms may indicate surge flows or sn impending continuous aiarr». The septic ink stssii hstre its contents romovad when the volume of scum end sludge In the tank exceeds 919 the iiqu~d voiurne of the tank. It the con#ants of the sank are rtot ronx~iad at the time of an aseesemertt, mslntanance personnel shall adv)se the owner Qf when the next service needs to be perforrtaad to maintain less than maximum scum end sludge accumulation in the tank. Manhole risers, access risers and covers should be Inspected for water tightness end soundn. Access openings used for seru4ce and assessment shall be sealed watertight upon the completion of BeNlcB. Anti opening deemed unsound, defective, Or sub)ect to failure must be replaced. ,Exposed access openings greater than 8-inches in diameter shall be secured by an effective loc:k~n~g ditvioe to pmvent accidental or unauthorired ®ratry into the tank. ., Na one shou#d eniru a septic or outer tr+eatmRent or holdlnyf brisk For any nrrson wlthcwt bslrin~ in Putt compliance with CBNA sffhdarafs k~` erelsllf~ r corl~nsd apace. The atmosphan within the septFe trr other trrwttmerrt of holdln~ tank may Qontaln i'ethal yasosi a»d roscuv of a person from the lrrtirtar oF' the ta~rrk ma y ba dfFpswit ar ImpoiiPSlble. Tank abandonment shall be In acxordanoe with Gomm 93.33,1Nis. Adm. Code when the tame is no le~ng+s+r used as a PQWT8 component, Ti~te sell absorption component serving this structuro is designed to accept domestic wastewater from a reeid,nt}att facility. The limits of operation of this camptinent ere shown ire Table 2. fii>e kortgevlty of a soi! absorption component depends greedy an proper and timely m8lntera6inCe, and system use within or below the limits 4f roliabie operation. Qood water conservation practices by ail occupants and the instatiation of water conserving plumbing fixtures aro key factors in extending the useful life of this component. The soil abst~rptlon conaponsnt`s opers~on moat be $ssessed by ina~pection art least once every three years. The Inspection sha># lnalude recording the levels of pending, if a»y, in the observation pi}aea, and a vlsua€ Inspecbon for any evidence of surface seepage or discharge frem the component, On steeply sloping sites, areas of erosion should be identified and reported to the owner tar repair, The surface discharge of domestic wastewater or sewage from f'i'fe system is prohibited end cvruidersd a human i~eelth hazard, Traffic around or over the soil absorption component mhouid be avoided partlcuiariy duriraq winter months, The compaction ar removal of snow cover over the component may lead to hydraut}c N-llure by fs~e~ezing. This type of {allure is usually temporary, but fs d~cult or impossible to repair until weather condittcns improve, In general, soil compaction over this component wNi reduce diffusion of oxygen lMp the soil and dispersal cell, i~vhtch may 48ad t4 more intense, and earlier, organic clogging of the soli. .- .. ~Aanagement Plan for a Septic Tank and Soil Absorption Component Plantings ofi deep-rooted trees and shrubs directly over of within ten feet of the component should be avoided sine root intrusion into the component may obstruct wastewater fiiow. Contingency Pion {n the avant of system failure, a new cyst®rn caufd be Inataliad in an alternaM area, With the instaliatcun ofi s diverter valve, the existing system could also be reused after a period of three to faur years. It is the property oHmers responsibility to maintain the alternate area free from any planting of trees, shrubs, etc, in case of failure of the orlginab system, the alterrtata area w!f i be needed. if any trees, shrubs, etc. have been planted on the alternate area,. they wi{! have to be removed at property owners expense. If aitemate area is destroyed, there are other altemaklve ayatems that oan bs used, in which, could result in added expense to that property owner, Any tank abandonment shai{ be done In accordance with Wisc, Cede 83,35. Any questions regarding this Dods, please contact your kx;al Zoning c3tflce or contact the installing plumber. k Yt. ~ 1. rx. t,r,1~ ~ r, ~ (7 S~ 3 9s ~ r to Document Number Pace YOL 173> 2 ~'~ STATE BAR OF WISCONSIN FORM 1 - 1998 WARRANTY DEED This Deed,,made between / 655319 KA'iHLEEN H. WALSH kEGISTEk OF DEEDS ST. CkOIK CO., WI RECEIVED FOR RECORD 10-44-2001 10:10 AM YARRANTY DEED EXEMPT D 8 CERT COPY FEE: COPY FEE: 2.00 TRANSFEk FEE: RECDRDING FEE: 11.00 PAGES: 1 urancee. Grantor, for a valuab~ley consideration, conveys to Grantee the following described real estate in _~~4 %~~ County, State of Wisconsin (the "Pr~o'p'e~'r't}`y'~")' F2ecordiny Area 7' _ ~ ~ ,V W ~N ~~M~U / v ~ ~T ~ ~7, .Name and Return Address ~9 ~1,~' / ? #~1,4'Tcw>?. 'a.~n~,--cep, ~ca.clu.~dl .T~w ;• y h f Irv Rl w ~' n- A,a.o~v~ a2 ~ru /u-cvto(.~~~;~~~ /Qs ~ Comity ~o~~ 'E „ ~~ /5, ~~ -S~oB /, ~ • ~~a~^" .l'.i.G""`a.u~ t+~ 4__ _ _" ~c /ctw ,•.t , /~/Z SS/o o y o~,cc"~/ d/~- /a3o - oo -020 0 Parcel Identification Number (PIN) This omestead property. (is) (is not) Together with all appurtenant rights, title and Interests. Grantor warrants that the title to the Property is good, indefeasible to fee simple and free and clear of encumbrances except Dated this ~_ day of ~ CrtU h-F 1~ a0U (SEAL) ~~-~~. _ (SEAL) AUTHENTICATION Signature(s) authenticated this day of (SEAL) TITLE: MEMBER STATE BAR OF WISCONSIN (SEAL) State of Wisconsin, ss. ~~A"~1l County. / Personally came before me this Th rrG day of ~~~ ,b ~ ~" 0 0 ,the above named to U rranMr ACKNOWLEDGMENT .~ ' ` ~ `:~' _: FI~~,D F . ~ ~ ~,~ , £ MAY 0 9 2001 - 9 St L' Fi~J~ ~.H.wAtSH -- ~:. ~- CERTIFIED SURVEY MAP - w PART OF THE NWI/4 OF THE NEI/4-AND PART OF THE NEI/4 OF THE NWI/4 ti v~ SECTION 14. T29N. R17W. TOWN OF HAMMOND ST. CROIX COUNTY. WISCONSIN w N ~ UNPLATTED LANDS , v NORTH LINE NWf/4 SEC. 14 NI/4 COR. SEC. 14 NORTH LINE NEI/4 SEC. 14 c ... $ U 3 ................. ........~, ; ~4~tl.W~ _E' 88° 53 ' 14' E z S 89° 59'40"E ~' .. ..................... .. 695.13' ~~~~•~~ z 2506 31' 148.50' 312.64 382.49' 33.00. .. .....•.33. 3.1~2~.•97.,........~ ............382.45 .......... 952.43' S 89' S9 ' 40' E IImo~--,, 33.01 ' 148.18' ~I S88°53'14'E 695.45' 33.01' o •~.. .. woo ..- LOT 2 •• - 0 0 -..° ~ 108.877 SF ° 0 ~ 0 0 'O - 2.50 AC. I NC. R/W ^ `r 0 0 0, d' o .n _ o0 ,':~ °°o ~ ~ N °oo ~' 96.255 SF . `^ N ih 2.21 AC. EXC. R/W N Z N N ~ C Z (Z N88° 53 ' 14' W 382.49 ' N ~ I~ ~ 3 BUILDING SET BACK - ~ ~ o ow ~pNaS 100' 0 3 lm ~" LOT 1 ° °o r v o> o n r ; "n '_~0 40 I .000 SF . ° z '0 9.21 AC. INC. R/W v ~Iv°> SCALE I ' - 200' Iz° Z'a' Mo o 385.782 SF. co 0 0 100 200 N Moo 8.86 AC . EXC . R /W ,^.~ v, z LEGEND • SET 3/4" X 24' IRON N 88°53'14'W 695.13' REROD. WT. 1.50 LBS/FT. UNPLATTED LANDS ~ SET PK NAIL FROM - COUNTY TIES BEARINGS REFERENCED TO THE NORTH LINE NWI/4 SEC. 14 (ASSUMED S89°59'40"E) I. LYLE L. ELLIOTT. REGISTERED LAND SURVEYOR S-1300 DO HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THIS MAP IS A TRUE AND CORRECT REPRESENTATION OF PART OF THE NEI/4 OF THE NWI/4 AND THE PART OF THE NWI/4 OF THE NEI/4 OF SECTION 14 T29N. R17W. TOWN OF HAMMOND ST. CROIX COUNTY. WISCONSIN AND MORE PARTICULARLY DESCRIBED AS FOLLOWS: BEGINNING AT THE NORTH QUARTER CORNER SAID SECTION 14. THENCE S88°53'14'E ALONG THE NORTH LINE OF THE NEI/4 SAID SEC. 14. 695.13 FEET: THENCE S00°00'00"W 663.13 FEET: THENCE N88°53'14'W 695.13 FEET: THENCE N00°00'OOE 333.13 FEET: THENCE N89°59'40'W 148.50 FEET: THENCE N00°00'00'E 330.00 FEET: THENCE S89°59'40'E ALONG THE NORTH LINE OF THE NWI/4 SAID SECTION 14 148.50 FEET TO THE POINT OF BEGINNING. SAID PARCEL CONTAINS 11.71 ACRES MORE OR LESS. AND IS SUBJECT TO ANY EASEMENTS OR RESTRICTIONS OF RECORD. ,'~ -~; `,,; I CERTIFY THAT I HAVE FULLY COMPLIED WITH THE PROVISIONS OF SECTION 236.34 OF THE WISCONSIN REVISED STATUTES AND THE ORDINANCE OF ST. CROIX COUNTY IN SURVEYING AND MAPPING SAME. THIS SURVEY WAS MADE AT THE REQUEST OF DWIGHT ALWIN 1957 CO. HWY. E BALDWIN. WIS. 54002 PH. I-715-684-2517 TOWNSHIPCLAWSHOREGULATHONSMANDIRULESJE~T,e~ WETLANDS~UMINIMUM LOT SIZE- w^aa~\s_C_~NS/~~i~ ACCESS TO PARCELS ETC.) BEFORE PURCHASING OR DEVELOPING ANY PARCEL ~' ~ ~~ •.•,~~~~ CONTACT THE ST . CRO I X COUiJTY ZON 1 NG OFFICE FOR ADV 1 CE . .' ~ ~'~,,. LYLE L. ELlIOTT'~: PRIOR TO CONSTRUCTION AN EROSIGN CONTHBL PLAN MUST BE SUBMITTED TO THE ~= S•1300 COUNTY PLANNING AND ZONING OFFICE ON EACH LOT . - ~. Hiinenr.~ ~.,,