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HomeMy WebLinkAbout018-1090-54-000Wisconsin 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.15.04 (1)(m)]. 'ermit Holder's Name: City Village x Township Bonte, Ron Hammond Townshi .ST BM Elev: Insp. BM Elev: BM Description: 'ANK IN ORMATION EL ATION DATA L,, county: St. Croix Sanitary Permit No: 395269 State Plan ID N Parcel Tax No: 018-1090-54-000 a,_ B I TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ ~ r ~~l ~~ Dosing Aeration Holding PUMP/SIPHON INFORMATION l---~ GPM Model Numb ;- TDH Lift Fn ss System Head DH Ft Forcemain L th Dia. Dist. to well SO B ORPTION SYSTEM l ~,,,.,,,t S ENCH Width ~ Length ~ No. Of Trenches DIME ~ Q ~ ~ l~D' ~Z SETBACK SYSTEM TO P/L BLDG WELL INFORMATION Type Of System: I ~ DISTRIBUTION SYSTEM STATION BS HI FS ELEV. Benchmark .V l DO. io ~~'. (o a Alt. BM Bldg. Sewer ~ •.J~ 9 ~- ~ r SUHt Inlet 5 $2 , I~ SUHt Outlet ~ Dt Inlet Dt Bottom Header/Man. Dist. Pipe ~ 0.20 9b. ' Bot. System (Z . Ip ~ . ~B.Sa' .O Final Grade 6•~ ~ 9~fe St Cover ~ 2 ~ r ~. ~ t Of Pits CHAMBER OR UNIT Model Depth Head rg /Mali Distribution x Hole Size x Hole Spacing Vent to Air Intake ~ ~o(~ ~ pipe( ~ ~ ~ Length Dia Length Dia Spacing SOIL COVER r Prpssura Svs4ams Anly xx Mnund Or At-Grade Sv5tBm5 OnIV 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:~/ 2 `~ / d+1 Inspection #2: "'-7-""'-T~ Location: 1766 96th Avenue Hammond, WI 54015 (SW 1/4 NE 1/416 T29N R17W) Pr~sa~nt Hills J1 ~IParcel N,p: 16.29.17.719 1.) Alt BM Description = S~w~u.wl~a~--i\~* v„il ~ ~ ~ .~(1 n ~. t~~ ~~ , 2.) Bldg sewer length = (~~ / /.~1s1 ~ ~(Itl~'1 -amount of cover = ~}2" 5..; ~ ~-, v~/ / Plan revision Required? ^ Yes No ,~) t L~ ~-/ Use other side for additional informati n. ~ ~ I Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) t~~ i 9sa ~3 Safety and Buildings Division County $7" ~ ~ ~ 201 W. Washington Ave., P.O. Box 7162 j>/ }() lseonsln Madison, wl 53707 - 7162 Site Address ~ r l Q~ ~~ De artmel~t of Commerce e V~ Sanitary Permit Application ~.'~ ~ 3 ~S2 ~ 9 In accord with Comm 83.21, Wis. Adm. Code, personal information you provide Ch ~ ~~t ~ ~ ma be used for seco ses Privac Law, s15. 1 m :.-~ I. Application Information -Please Print All Information r- State an I.D. Numbe !: '' 't`._. Property Owned' j''ame Par ~ C~x % ~_, Property Owner's Mailing Address erty n c .~ -' ~ ;'~' p City, State Zip Code Phone Number Lot N Block Number Subdivision Name CSM Number II. Type of Building (check all that apply) OCity ,/~ ~1 or 2 Family Dwelling -Number of Bedrooms ~ ~~i0i1?oorvl ^Village ^ Public/Commercial -Describe Use d(c ~"` (°~Q^^-S t~'"'`~ ~.o~~p ~ ^ State Owned Nearest Road /?D ~ ST III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A. 1 New 2 ^ Replacement System 3 ^ Replacement of 6 ^ Addition to For County use '` O ~ S - O OiQ S stem Tank Onl Existin S stem q ~ L •019 • ~ ~ • 7 ~ B. ^ Check if Sanitary Petmit Previously Issued Permit Number Date Issued 1V. Type of Permit: (Check all that apply)(numbering scheme is for internal use) 44~Non -Pressurized In-Ground 21^ Mound 47 ^ Sand Filter 50 ^ Consttucted Wetland 22 ^ Pressurized In=Ground 41 ^ Holding Tank 48 ^ Single Pass 51 ^ Drip Line 45 ^ At-Grade 46 ^ Aerobic Treatment Unit 49 ^ Recirculating 30 ^ Other V. Dis ersal/Treatment Area Information: Z Z ,- ~ e,- Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(Gals./Days/Sq.Ft.) (Min./Inch) ,nQ ~ g~, ~ Elevation YI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Ezistiug Tanks Tanks Sepaco DOD ~y O i_,~" ~i(/~~ `/ ~l Dosing Chamber VII. Responsibility Statement- I, the geed, billty for Installation of the POWTS shown on the attached plans. Plumber~..Pfame ' t) lum is i MP/MPRS Number Business Phone Number ovA rarz ,~~ l~9 b Z ?/ - z3s'- 7.G Plumber's Address (Street, City, State, Z' C g)_ VIII. Coun /De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) ^ Owner Given Initial Adverse r- Z 5 Z 0 v q U Determination - . C7( L ~.~- IX. Conditions of Approval/Reasons for Disapproval -/ // /I / - / / ~E Sc,ST'a~ B(PVa~T"~a~- TD 6- ~'•~67 / fJ1 OW 6v~9.~h2~U 9v'A-de ~ ,Qn. SI.. rr T~K.~ dt IM.cYJ o / ~/ ~l,~P ~0(,~ rJp~1'frn- D'~ V~v /S /h. ~ f 50r~5. / ~ / `/ ~~i~~~c~~~ ~`j~~e.- ~b ~e i~-5~~~~ r ~ ~ - g ~~ . e u u• er s CCOht~r~e~•da~~-5~ k~ - ~~ :' ' l/Ll. (~.,5 ~ ~ Atta ~ ~Iet~laUns„ (to the \CSo~Y ~nl~ to~the4 stem on paper not less than 81/2 a 11 inches In size ~~ ~ SBD-6398 (R OS/Ol) 7`/ .~ ,, , T.L. Sinz Plumbing Inc. E5609 708th Ave. / \ Phone: (715) 235-2644 Menomonie, WI 54'751 Ss~~'P Fax: (715) 235-2592 (~~ ~,,,~ ~' www.tlsinzplumbing.com ~ u, ~~ ~ w ~,, N r ~ ~i 2"nsT~r,~ a- a.~ x ~s.7s E4-r ~vt~ Tv+efile S~eePs -~ ~4 ~' ~ ~ ' fl, C 1 -.~ ~ omits T'it-~i ~ ~ C~ rr (o00 ~,kct r,,, ` 5c pn~ Tim. iL w L~ Z~3~ (/k-lou ~~ Cfee, ~~S ~~ ~ ~~,~~ ~ ~~ w~ r c~ ~ ~~ sa -o s ,~ ~~ i .,~~ ~ ~ ' I I ~`` SefJ~c..E D ~ ~~~v R9.g Top d ~ % ~-~~~~ f ,g~M~_ ~oo.u ro ~ o.= '/t. Coti~w~T ~`` I I ~d ~~ 3 ~~, q wisoas;n Depar>mentt of Gommenoe SOIL EVALUATION REPORT Page ~ of Division of Safety and Buildings m aocoraarrce wrm c.omm a~, vvs. rvom. ~.we qty Pl n must i $1/2 1 l h ' g. a an x s ess t Attach wrrrp~e ~6e plain on paper not inctude, but not limbed to: vertcat and hor~l F ( and Parcel I.D. percent slope. scale or dimensions north arrow, to,nearest road. Please pri»t eN ~• •'' a by - Date ~,.,, i~~ Lsw. s 15:0 (1) (m)). Penwnal iiHormation you provide may be used for 1 ry p / party Owner '-- ~a~~ Q ~~ Y .~ LQ(~(, P ' Location ~ 1/4~(,/~ 1l4 S T Z N R~ E (~~ PropertyOwne~sMct6ngAtfdi@SSL --~\ COUNTY ~ j BbdC# Subd.N~nBOrL ~ .! I t!>f ~,~~, ZONiNGOFFICi: - ~ ~~ State Zip Code ~ ~~ ° City ^ Yllage .Town Nearest~oad . ~ iD I ( New Construction Use: C~ Residential / Number of bedrooms ~,= Code derived design flaw rate ~ ~ 0 GPD Replacement ^ Publ'ic or oommerrial -Describe: Fluent material '~ i ~ ~ Flood Plain elevation if appCrcable R cameral comrrrents S ys'•~t it z 1 t tJ • f o P q0•S"~ Lu~-+-t r' $'q..5 C~ and recommendations: ~ t~ f . '~ I"G U - '~ ~ ff 9 Qa L u u~ r` ~$• 7 ~ ~°^~ # ~ Pit C~ound surface elev. ~~/. [eD R Depth to limiting factor ~(~ in. Sod Raitie Hor¢on Depth Dominant Cob Redox Descripfion Teucture Structure Coris~enoe Boundary Roots in. Munsdl Qu. Sz Coat Cobr Gr. Sz Sh. 'Efflf1 *Etf#2 Z gyp `'_, z ~ ~ . y '~ r4 m~ 9.0 ~~%.2 ~~ Z Boring # ~ Bonng ®Pit Ground surface elev. 9y. G a tt. Depth to 1 factor ' ~ 2 in. ~ ~ Hor¢on Depth Dominant Cob Redox Description Texture Structure t'.ar>sis~roe Boundary Roots GP DMF in. Mansell G1u. Sz. Cont Cobr Gr. Sz. Sh. *Eff~1 'Effli`•2 ~ --- g 2 ~ I ~ . 5 ~ . ~ 3 ~ y -- mS -' ~ ~ • 2~ ~' , a ' ,~ ~~.a 3.2„ * Effluent #1 = BOD_ > 30 < 220 mall. and TSS >30 < 1 50 moll. * EflluerK #2 = BOD. <_ 30 mglL and TSS < 30 mglL CST Name (Please Prim re CST Number ~h U c~l~ r - 2 Address Date Evakration Gorrdur~ed Telephone Number Z!!3 ~ ~ ~ 5~~~~ l~ ~i ~yUZS !U -ry -oc~ ~~5-Zy?- yva~ Property Owner,~~l,~ ._.... Parcel ID # page ~ of ~~ u 3 ~~ # Ground surface elev. Q 2 • ~ ft. Depth to laniting factor J 3 o in. SoU Rabe ® Pit ti Texture Structure Consistancs Boundary Roots GPD/ff Horizon Depti~ Dominant Cobr on Redox Desa~ "E~ in MunseU Qu. Sz. Coat Color Gr. Sz Sh. . Z ~ r.~ ~~ r 1.- ~ o mi ~ f ~, +~-~~ ~~ 4/ u ^ Boring # U Boring ^ Pit Ground surface elev. ft. Depth to Iunniting factor in• Sod Rate Horizon Depth Dominant Cobr Redox Descxiption Te3fixe Structure Consistienoe Boundary Roots GPD/l~ in. Munsell Qu. Sz. Cont. Cobr Gr. Sz Sh. 'Eff#1 'Eff#2 ^ Boring # U Boring ^ Pit Ground surface elev. ft. Depth to lenitbg factor in. Soil Ncation Rate Horizon Depth Dominant Cob ~ Redox Description Texture Strud~xe Consi~noe Boundary Roofs GPD/1F in. Munsell Qu. Sz Cont. Cobr Gr. Sz. Sh. 'Eff#1 'Eff#2 ` Ettluerrt #1 = BODg > 30 < 220 mgJL and TSS >30 _< 150 mgll ` Effluent #2 = BODs <_ 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. SBD-8330 (R.O7/00) r • PAGE~OF NAME 13a -~1 -~--e- LOT# 5 ~ LEGAL DESCRIPTION~s'/4rUE'/4,S1~o TZ4,N,R 14 E (or)~V SCALE: I"= ~ UU ` BM I ELEVATION ~~d ~ ~ t . BM 1 DESCRIPTION -9-0 ~J U -.~ z Co ~ U ~ -~- BM 2 ELEVATION ~ ~' ~~ ~~ BM 2 DESCRIPTION •}ri~ o -~ z. C c, P1~Q.u ~• -~- SYSTEM ELEVATION -app q ~ •SV /owe ~ g `~•'.~ ALTERNATE ELEVATION f -o Q ~G .~0 Gave( ~~•~ CONTOUR ELEVATION /(J/~Q• x~ /~ ~,"~~ P C ~ , ~d v ~ 1~ATF. ~~ ~0 ~. /i ~i ~ ST CROTX COUN'T`Y SEPTIC TANK MAINTBNANCB AGRSEMBNT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer -'l~ Matting Address (©~~ I~D~" ~U2 Na.~m~mond y~0 [ ~~~~" Proporty Address I'~ bla -- (Verification required from Planning Deparament far new NQ~ l.t?~" 5~1 City/Stato ~l>.XhYnO-'~ '~ i Parcel Identification Number t~l`6" lOq ®' S~ -~ ~,~.['~A~~, DESCRIPTION PropeRy Location .~_ '/+, ~~ `/,, Sec. ~ ~P . T~N ~! L~~ Town of 1-~~x,m and n C~ s Lot # Subdivision Cectfdted Survey Map # _ .Volume _ -, .Page # Warranty Deed # toa,~ 00 7 .Volume i~a0 ,Page # ~~ Spot house ^ yes Q no Lot lines id~tifiable ^ yes ^ no ase and main#eaan~eof your septic system could result in its premature failure to handle wastes. Proper maiatenaticc ems of pttmpmg Dirt this tank e~y three Y~ or sooner, if neesded by a liocnsod pampa'. What you put into the system qtr acct the fanction of tho septic tank as a trcatauant stage m the waste disposal sy~- 'Iho y agrees to submit do st. Croix Zoning Departa~t a certrficatien form, signed by the owner and by a p,~urneyrpsaplumber, restuctedplumbex m a licensodpumpav8 that (I) the ova-site wastewaterdisposal system ~ ~ proper operating condition arxl/m (2) after inspoctioa and pumping Csf aY}, ~e septcc tank is less than I!3 full of ~udgc. have read the above requir~eaaents sad agroe to maintain the private sewage disposal system with the standards ~' ~ ~ of Nataaal Rte. Statie of Wi~onsin. motion set faih, herein, ~ ~ b3` ~ of Commecne snd the ~~ Office within 30 that your septic system has hoer maintained mast be ~mpleted and rct+nncd ta- the St. Croix CmmtSt ~8 days of the three year irati date. SltslNA OF APPLICANT DATE OWN ~R CERTII~CATION that all stataneats on this form are true to the best of my (our) hsowledga I (we) am (are) the owner(s) of I (we) aeitify the property descn'bed above, by virtue,;of a warranty deed recorded is Register of Deeds Offioe. SItiNATURB OF APPLICANT DATE sstss~ ssssss ,s~,ny infom~ation that is mis-represented may result is the sanitary permit being revoked by the Zoning Depaztment~ ss Iaclade with this application: a stampod war:ar-ty deod from. the Regista' of Deeds office a copy of the certified survey map if references is made in the warranty dosed Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity ln-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWYS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval 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 Comm 83.54, Wis. Adm. Code, and the In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- Table 1: System Design Specifications Sanitary Permit Number Number of Bedrooms 3 Design Flow -Peak (gpd) p Estimated Flow -Average (gpd) d m /Yl Septic Tank Capacity (gal) /OOD Soil Absorption Component Size (ft2) S fir'" Type of Wastewater Domestic Table 2: Soil Absorption Component -Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow -Peak (gpd) S-o 3 ~i Maximum Influent Particle Size (in) NA ~ 118 Maximum GODS (mg/L) NA 220 Maximum TSS (mg/L) NA 150 Maximum FOG NA 30 Table 3: Maintenance Schedule Septic Tank Inspect and/or service once every 3 years Outlet Filter Should inspect once a year and clean once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. 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 filter 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 filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic Management Plan for a Septic Tank and Soil Absorption Component tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the sepfic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank maybe difficult or impossible, Tank abandonment shall be~inaccordance with Comm 83.33, Ws. Adm. Code when the tank is no longer used as a POWTS component. ` Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation'of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful (ife of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. Plantings ofdeep-rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. 2 CONTINGENCY PLAN If the POWTS falls anti cannot be repaired the lollowing measures have been, or must be liken, to provide a code compliant replacement system: O A sultible replacement area has been evaluated and may be utllhed for the IoGtlon of a replacement soil absorption system. The replacement area should be protected horn disturbance and compaction anQ should nat be Inlringed upon by requlrcd setbacks from exi:tlnY and proposed swcwre, lot 11nss and wells. Failure to protect the replacement area will result In the need for a new Boll and site evaludgon to esabllsh a suitable replacement area. Rsplacement systeri~s rnusc comply with the rules In effect at that tlrne. O A suitable reptacenunt area is not available due t0 setback andlor soli limitatloru. 6arrln~ advancts in POWTS technology a holding tank may be InsaAed as a Ias7 resort to reptacs the !ailed POWTS. O The site has not been evaluated to Identify a suitable replacement area. Upon facture of the POWTS a soli and site evaluation must be performed to locau a sultabk rep!ace+a~ent area. If no replacsment area b avaAable a hoping tank may be instilled as a last resort w replace the failed POV+r1'S. O Mound and at•gradr soil absorption systems may be retonstructed In place following removal of the biomat at the inflluative surface. Recvruwalons of such systems must.comply with the ruks in sffect at that dme. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR iNSUFFIGIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM TKE INTERIOR OF A TANK MAY 6E DIFFICULT OR IMpntC1R1 i. ADDITIONAL COMMENTS POWTS INSTALLER Name ~ Phone S- L3 SEPTAGE SERVICING OPERATOR (PUMPER Name Phnn• POWTS MAINTAINER Name Phone WCAL REGULATORY AUTHORITY 'Agency S~: G ro ' ~ on ` n n his- - 152Q~ 93 ~ o'' . _ ~ ~. mo ~ ~ SOO YTA1 E tiAR OF iM1SO0t~ISIN FORM 7. 2l94 ~~ ~~ ~ h A TRUST'BE'S DEED R ~ DEEDS E6IS7E R • Dounrtcfit Narabu ST. tXtGIX CO., WI Rwb..t I. RltlAnlaaA ~~ ~ ~ --- - 0~-19-P000 9:301M1 us Truareoe of 1Gteiiet Citeri4erk Ttowwiitr Uwitrwst ewtialatl 11frr: 6S, 2000 ]~'~ for a raltwDic ctu-sldcrnio® coaetreys without Warranty m Rawid G peHa and COY ~' 1 ~_ ~•~ (:Irww Kwtdlalpw REf;~ROITMi FZ:E: 1.00 pll~t 1 Grawtca the fo!lowir~ dcecrlbed teal estarc lw $t Crt+h ('.ounty, Stale of W4cunsin (if mote SPCC rS 1v:aClod, plraye rttwCh adJendum): Raoordar0 Arco IvE '/.. except etta Soibw;ts{y P~~~ Nwwe and ReaatA Addloss - - ~ (1)Fast 3d rods of tTlc North 31 lab of SEU Nl:K "- lir~CQRMl1iCK A (2) Sout}- 19 takt of Il+e Fart 38 +oda of I~ffi!'~ NE'ti - THUMrA~S (3)NaKh461lratrtt'tRaR.aet132r1.3]katafN'/,NTi'!. Attorney at Law (~ Let f. Vol. " 2", ~teti~ed 5un''sY t~lsgi, M64 417, Part ofthc SEV. Nl;i4 J-020 iat'" Jgv'e . All in Scctioa i 6-29.17. pp Box 212 0 Haldurin, TPI 54002 OlR-1033->!•y •ti-Ib74~00-IAR, Mi-19.7LtR,24,30 . Petuci hlmaCeration Ntraba (PIN) Dated this _ dwy r~l' Jawc . - -- 21100 • Ttiu • - - uslae Trustoc -• AU7HENTICATTON ACKr1UW4JCDGMtiVT S~(tn~ure(s) Robert J. Rlegardsww ____ $TATB Ot' WrWwelA ----.. -..._. _.... __ ._- . ......_ ) 54. St Craa Caunty uuthentrceted this ~~.. day oY Jerre ,2040 1'ersanally catttc getons ma Mix day at' _, 1uA. 20A0 the above riout~sd T~i~+•rAS R• Se~srs,~set.~.aatr¢- ~.``~ R~dra~re.er TITLE: MEMBER STATE B/1R 4Tr WISC(~iVSFN .. _. ._ ._.... (Tf aot, t+o me knom ~ be ehc potsott(s) who executed eho fotesoin0 aatl~xixod by ~ 70b.06, Wis. St~ts.)uavtrlutra4tt red wdtrwwkdtt~ tho arena. T1t1S tN3TRUt~T WAS DRAFTED L1Y 7'tewwas lt<. Sctlaaraderr Nte•was. (S~epum mart' `a e~tlembaaral or rclcworteJOpl, flutfi ere nW arC~eary.) Nataes u[ paaoas eiptjaL is ~' ~f' a>spt be tyrd or YRU5T[F.:i W:FD Nomry Publk. Sate of witcerNe _.... _ --_ .. . My Couutts+eba l: pattrtattet+:. AOt, stew axpQra o raww vaPw eweer npleunC. rrae~aaae rrw.wornr Comer. fans m ua +~ ~`7 ATY tiA1t Qi 11rISC~Od(S/N eoo4ed.+o2t FARM Ple- ~ - tfy9 ff`~`'. iv~ea )T 50 0 ACRES l2 S 0. F T ?eo • ~G'~'.o ~'~ ss3o .•..~qTT . ~ ------ S9. ~' . ~ 3~ti F . F. A~~ DRAINAGE N ti m N R TOWN OF HAMMOND, S T, NOTE: NO OWNER OR RESfI ~ WHICH WWLD INTERFERE I i OPERAT f ON OF THE APPRO DRAfNAGf AND SOIL EROS ` THIS INCLUDES BUT IS N~ i UPON, OBSTRUCTING, AL TI ~ EXCAVATING OR PLANTING I WA TER DRAINAGE D 1 TCHES. CULVERTS, BERMS OR GRA: ~,4~ ---------------_NW-NE_ ~__ NE_NE _-^ ~' • • OS SW-NE ~ Sf -NE 6~ ~ . ~' S9, 3 ~~ 19. ~ ..UNPL.A.TTED i LANDS ................ S89°28' 02" E 892. 09' (TO NE CDR. LOT 260. ^ ~/~ LOT 5 J ~~-~ 2.81 ACRES 122, 531 S0. FT. 3 / a LOT 53 $ 3g I . 42~ 0 4. 49 ACRES u 11• E v> 195, 615 S0. FT •U NTZ~ ~ ' m DRAINAGE AREA-~ / ~'/ - LOT 52 / M //~ 2.34 ACRES ! 01, 983 S0. F ~ i +~-M i ~- ~oee.a g7~ ~2 • 520. ~' (TH 1 S SHEET AI LOT 55 3.54 ACRES 153, 984 SO. FT. rn A .... .. ...../.... ~~~ I ............. .. ...... ® j SFTBACK ~ ••~~"" 8 .........~/Nf ........•~ 14 ---------------- i .. ... is S88.25' 24' E 352. 78' -------Z40.00'--------- SETBACK 983.3!'Y8' --fo6.3i'- ~~ ---~ ®104.67,_. IBb.88~ - 975 -~ _ 58.39----- 106. Is 83•3/'Pe"W 332 86' R ~-~` X41' 24.yr 185.8----__- NTg. ® ©- _ Oqp Srs ,6,___ -, 27.32' , ,~ ----- 226.67•----__ ---158' u ® ®® ....LINE ........................~/ ,,,~ ' ............. ® ~ - - - - - - ~ ® .....~................................... DRAINAGE AREA LOT 66 2.57 ACRES 1 i 1, 895 S0. FT. A A U a m a LOT 65 g 2.43 ACRES ,; 106, 002 SO. FT /'= ~/ /~ U LOT 64 2.30 ACRES ! 00, 021 SO. FT. z 8 A / ~ ~ ~ a ORAfNAGE AREAL >~. Q~ J4 3. 71 ACRES 61, 700 SO. FT. i ~ 2 8 LOT 63 ~: 2.36 ACRES ~ 02, 707 SO. F T. +- u LOT E 2. 6 I ACI 1!3,732 SG