Loading...
HomeMy WebLinkAbout018-1094-23-000Wisconsin 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)j. Permit Holder's Name: City Village X Township Schwechler, Mike Hammond Townshi CST BM Elev: Insp. BM Elev: BM Description: /00 - v /~ ~ o f TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~~~/t.. / O !, Dosing ~ G s~ Aeration ~ /1 l f 1 Holding V TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic \ O f ~ /a,., ~ f I Dosing ~ ~ ~ ~ Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number (L~1 ~ TDH Li~~ ~ Fri~tjon L~o~ System Head T ~ ~~ Ft Forcemain Le h Dia. Dist. towel r ~ Sr ELEVATION DATA county: St. Croix Sanitary Permit No: 420763 0 State Plan ID No: Parcel Tax No: 018-1094-23-000 Section/Town/Range/Map No: 17.29.17.763 STATION BS HI FS ELEV. Benchmark Alt. BM ~~ ,~ ~ O/• Bldg. Sewer D - '. b S ~ /O St/Ht Inlet ~ ~" ~~ .~ y~- ~ SbHt Outlet ~ ~ Dt Inlet Dt Bottom ~ 2~yb ~ Headtrr/M n 2 H~ 'G ~r T / V~ v O f r~ ~• S Dist. Pipe ~ g3 ( ~ f ~ Dy ~ Q ' Bot. Syste "~ p , y _I Final Grad e~ ~ ,-t 5~ G(Li , Z ...P.~ St Cover SOIL ABSORPTION SYSTEM 3...1-tn.., ~ G . ~ ~r /U (~/r/ay,, ~OM ~ ~Tl '~'f~-f~ BED/TRENCH Width t Length ~ No. Of Trenches PIT DIMENSI S No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ ~ .~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREA LEACHING Manu~ctth-er~ T r I INFORMATION CHAMBER O .~ ~'a.. ~'Yl MO -/ T epf S tem: yp/ ~ ~ ~ ~ ~~~ (~~/ ~~~j Model Number: DISTRIBUTION SYSTEM Header/M~agi~fold ~ Len th Dia Distribution,, ~ ~ ~ ~Q Len th Dia acin x Hole Size x Hole Spacing Ve~n-t~t(o~Ajir' Intake SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only ~a d C~tA'ijr, b.?~._.~r~yy, Depth Over f Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ~ p rr Bed/Trench Ed es g To soil p ~ Yes ~~ No ~ JI Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/~/~ Inspection #2: / / Location: 982 168th St Ham/m~o~^nd, WI 54015 (NE 1/4 NE 1/4 17 T29N R17W) Prairie Run Lot 23 ~//``CC~, Parcel No: 17.29.17.763 1.) Alt BM Description = ~ ~W ~~~ 2.) Bldg sewer length = 7~ / ~ ~5~~~~-/ -`_" `- / - + , p' ~l~"`"~~ ~ -amount of cover = ~ ~ .~-C,~ C (/~'t~ t~ ~'~Gt ~ • dP.u-~'L/~"'~- ~D~~'~~'`~ Use otherlside for additional information. No II~% w? ~ ~ I ~ GZ~_ _ /J~ ~ I ~`e' /~ ('~'~_''I SBD-6710 (R.3/97) lX LDate L 7~InQseXpctor's Sign ture Cert.VNo.-~/- Safety and Buildings llivisicn County ' 2D1 W. Washington Ave„ P.O. Bax 715? s~ CyY ~'~ ~ ~~0~~~~ Madison, Wl 53707 - 7162 Sanitary Permit Number (to be filled in by Ca.) ~ De artment of Commerce i~8) 266-3151 ~2.0 ~{ 3 Sanitary Fermit Application ; State Plan Y.A. Number personal information you provide ~ dm. Code Wis A In accord wvith Comm 83,21 ~ , . . , may be used for secondary purposes Privacy Law, s15.04(1)(m) Project Address (if different than mailing address) I ~ b 8 ~ ~T ~ ~~ ' I. Application Information -Please Print All Information ~ Property Owner's Na me Parcel # Lot # Block # j~ ,- K~ 5~1~~ ~~1~ r ~3 (-Property Owner's M ailing Address Property Location ~ City, State t Zip Code Phone Number ~ ~ ~ !,t S'b Jr ~ ( Y .r. II. Type of Building (check alt that ap,piy) ~ ~ ~~ eQaMs ~ ~ (circle o ) ~ T ,~~ N ~ R1~ E ot~ ~ ~ f~ ~d i I Subdivision i\'ame CSM Number E ^ 1 or 2 Family Dwelling -Number of Bedrooms blicJCommeroiai -Describe Use ^ P ~ Y ~ ~'~ ~ u _ ^ Stata Owned -Describe Use _ __ "' ~ ^City~JVillage ~I'ownship of ~.tn., ~J,~ III. Type oP Permit: {Check only one box on line A. Contplete line B if applicable) ~ l $ -- Qg ~{ - 3 ~- A' I ~~-~Tew System ^ Replacement System ii TreatmertlHolding Tank Replacement Only i ^ Other Modification to Existing System B. + ^ Permit Renewal ~ r~ Change of ^ Persnit Revision ~ 'List Previous Permit Number and Date Issued ^ Permit Transfer to New Before Expiration i Ptumt;er ~ Owoer i ~- - i 1V. _ _ T of POWTS S stem: (Check all that a I } i y~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 C Holding Tank ^ Peat Filter ~ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Ret;uculating Synthetic Ivledia Filter ~ Leaching Chamber ^ Drip Lire ^ Gravel-less Pipe ^ Other (explain) ~ ~~y~m~b ~ a~5" - V. Dis ersallTreatment Area Information: 3t1f , ~ Design fitow (gpd) Design Soil Application Rate(gpdsfj Dispersal Area Reruired (sfl Dispersal Area Proposed (sfl System Elevation i `LSD ~ . ~ ~Dd _ 94d ~'~D YQ,iO ' VI. Tank Info Capacity in Gallons Total Gallons Number of Units Mam,acturer t Prefab ~ Concrete Site Constructed Steel I Fiber Glass Plastic New i Tanks ~ Existing Tanks Segrc or Holding Tank ,~/~ ~i _ed~ ~ ,e ~' ~Y ~ Aerobic Trcatrtunt Unit ~S.O ~ ~~.~ e [leasing Chamber ~ I ~ VII. Responsibility Statement- I, the uddersigtted, assttiue resaottsibility farms lotion of the POWTS shown on the attached plans. Plumber's Na me (Print) Plumber's Si gnature to , PRS Number Business Phone Number 1J,'ll.' -~G u~ta/1'e!~' ~ ~ 2 9 13-~8'G- ~i al Plumber's Addre ss (Street, City, State, Zip Code) - I ~ 7 ~-~?~ ~~ ~~~5'0~ G~ i ~ ~ D ~ 1. VIII. Count /De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Is in Agent Signature (Na 5tannps) ~ ~ , Surcharge i•ee) n •~ ~® ~ Z ~ ^ Owner Given Reason for Denial ~ L~7 IX. Conditions of ApprovallRea~-so~~s, fo"wr Disapproval ~ e~~ 1.Q~,~te...; W~ sys"~^ ~e.~'°''l,.e,.. ~ ~ ~ ~s~d~ ~ ~ . , , .~ Sys .,,~,.~ - I ~ ~~ e-~-c~"`~°~r• (i1.p-.:¢- hu..~ ~,u 3` u ..,Pew syt~ •-Aa~.e.~to.. {-~ (~.~.~: ~ ~o-t~w: ~J ~{..q Se`,( •~ ~ll''~.,.Lt~Se_ ~ ~ s`PS~- ~ ~^dw~ .. t_ettQ.2 w..~~~•.+..,.. x ~2~t ~ ~~ S~S~^"" . .n.o+.w-lur~.t^~_f n ~ ~ ~ -~naa.~~aA~rtRd1 os ~i ~ ~ ~ ~ ,, . n (~ Nsu,d ¢a~d ~'~ • x/3!45... _~-aai~. ~QY,Is>~s;/1 ~~- -®°®.~ _ ,_ _-~~.r~+~S • ~~ o plate p~ t~La the toti~ on~or cn~~«u o++ ~,,.v~±~u~. ,Sp~ •• ~-•- ° - ; ~ -~ ~-~ SBD-6398 (R. 01103) r t S~~v~ t - g~wuP~t,JC- ~.( ~.t,0'lrtd[Qb/ Sul ~ 5~c- ~ ~~ o ~' .e ~ ~' a ~~ ~~ V i ~~~ s_ ~-~ a S~P7~~ °~~6 a~~` ~ `~° .~ `~~8 /f ~~ r-- ~.___ ~~~~~) ~~ `...~1 ~ yri ~i S, -I' 7 3e ~- ~~~~der~~d~/ r ,.-~ ~ u! ~l-e .SSG ~ ~! r G' ,e - ~ r` o v~~ /. /y ~, z ~ d ~~ d~ ®ws~ es.: ~`~ ~ s.~~7r c 1~1~6z ~ ~~ ~ ~~~ ~ ,~, h ----~` ~,( r-~ 3e c,~' ~ ~~~ y~ ~Q ~`se~ ~~ ~~ Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings ~"J Page ~ of County 1 ~ .. Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must f 0 I , TT 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. Please print all information. Revi ed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~ `~}~ J~~e"v~",` f~2 7G03 Property Owner Property Location I ~ ~ I `I(~L~I:K.I r~ Govt. Lot 1 /4 ~f/F 1 /4 S~~ T Z N R/ ~" E (or~ Property Owner's Mailing Address ~ ~ Lot # Block # S bd. Name or CSM# ~ ~ a 4 l 5 ' 23 airier un City State Zip Code Phone Number ^ City ^ Village L[~jTown Nearest Road ( fY/~~S (7rS )79G -Z~f3 l~rrtmotiaf ~~~~~~ ® New Construction Use: (~ Residential /Number of bedrooms ~^ fY Code derived design flow rate y-~ on GPD ^ Replacement /^ Public or commercial -Describe: ~~ "~ Parent material T ~ ~ / Flood Plain elevation if applicable ~.~~/. !~ ! ~` ft. General comments S~/S7~-Ci1~ ~~-~~' a • •~ L'~~q9 /O ?~ c~•~-, ~ ~ and recommendations: ~z,~/ -U'•Gt/~ ~ ~ [? r,. Boring # ^ Boring ~~~~`:~~ Pit Ground surface elev. ~• ~ ft. Depth to limiting factor ~~ tiyn. ~~~' ' Soil AppliFa n Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Bound3r~' .Roots. ° . P /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. S h. ~ _ ... 1 *Eff#2 4--I Z I(~ r Z ~'- SL ` , Zm ~ mfr c `J~ rJ . `~ 2 12-3~ lD r~I ~-- LS I s Im ~r cS _ .-1 ~,2 3 3g S l0 yr~ ---- 5~ Z ~ ~ ~S . 5 -q ~{ 6Z -(oi ~D -~ ~~~ F2P 1.5 y1 L~ S Zm ~'( _ ~" .'-~ _ ~..o r ^ Boring 6trGr' ~~S'tr''^-. ~ ~ V Boring # ~I. Pit Ground surface elev. l~~' ~d ft. Depth to limiting factor ~~ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 3 -~ L 2-m k m•~r- L5 I ~.~ . 5 .9 Z- 1 - LS 1m v ~ - . '7 !. Z ~ ZO- 1U ~3 SL cs .~ . `~ y 3~ F2 f' 1.5 ~FI(c~ L-~5 k - -- . ~ . Co s z~ * Effluent #1 = BODS > 30 < 220 mg/Land TSS >30 _< 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number ~c~r~rY, ~ch,~,~t ker - ..-~~---- L~5"3 30 Address Date Evaluation Conducted Telephone Number 2113 ~U~ ~-- ~~ry-r-~erQ,e~~ ~J~ ~Fbzs~ l /~ 2 8 -d ~ ~ ~/y"~ z~f 7- ~Fl ~~~-~ss~ tnt,~~~~) Property Owner ~Qftlf~fn~ Parcel ID # Page ~ of Boring # ^ Boring ~ Pit Ground surface elev. 9 ~ ft. Depth to limiting factor ~(~ in. ~ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ~ 0 l{ ~2 5 ~-- ~.m k rn~r ~ s 1 v~ • 5 . `~ 3 y -~„~ y 3 ~ 2m ~'r ~ 5 - ~ 5 .9 ~ -~ IL~~Itp Fz 1-5 r y L~ S Z fn k ~ - - . ~I . (o ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Appligtion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 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 Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * 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. $BD-8330 (R.07/00) PAGE~OF 3 NAME ~ ~ ~ S LOT# Z ~ T EGAL DESCRIPTION ~lJ F ~ N E ~ ,S 1 ~ T Z `- ~,N,R ~ ~ E(Qrl~ /SCALE:1"= ~D ~ BM I ELEVATION /~O • U ' BM 1 DESCRIPTION ~pPa •~' ~i ,~Py~ P~Qe ~ BM 2 ELEVATION `~ `~, ?j O ABM 2 DESCRIPTION •-f a ~p a ~. ~ z~ Q J ~ ~~ p ~. SYSTEM ELEVATION foP 99. ~ ~ 9q• ID 3id 9'g.loo ALTERNATE ELEVATION ~~ • 70 CONTOUR ELEVATION lyc~ 70 ~ 9Y• ~'O a_~ • . /U~' ~,c a_ Z ^ ~g'"c • QrnZ X _ --- -~' S ~c - l ~- ~ ~'~t.c. SIGNATURE ,~, ~/! /µ /~ v DATE / z - / - u/ IFiCATIv^r~5 SEPTIC TANK ~ P'~MF CHAMBiR CROSS SECTiU^i Ar•~D SPiC Y - ~+" Cx VENT PIPE 12" MIN. ABOVE GRADE ~ ?' 25 ~ FROM DOOR, WINDOW CR FRESH AIR INTAKE FINISHED GRADE " C I RISER ---~ ~,$" IN. 5'r MAX. i _ ____ N LET + /" ~ / i l~ ~„~, a~, /' WATER TYGHT SEALS --~--- A ' --E-- PPROV~D $ IPE 3° ~" NTO SOLID , C OIL PUMP OFF ELE~' . F': • ~ -~"° i~EATtiERPROOF JU NC,TION POX WITH CONDUIT ., ',~ ~. s~ i `, GAS- , ' TrGHT ~ ~~ SEAL ~ ~ ' ~ r ~ { ~ r a APPROVED MANHOLE COVER W / PADLOCK ~ WARNING LABEL :..._._ u " M I N ~c ,~ VApPRO~lED JOINTS WITH ALM APPROVED PIPE ON 3' ONTO SOLID SOIL OFF ~"~ RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS APPROVAL - 3" APPROVED $EDDING UNDER TA2vK ~ TE ~ ~ PAD CO NCRE ~~. SPECIFICATIONS SEPTIC ! DOSE • !~JMBER DOSES PER DAY : , TANK MANUFACTURER: eSe _ , f , TANK SI2E5' SEPTIC 1a,~ -_ GAL• DOSE VULliME INCLUDING FLOWBACK: l G A L DOSE ~~ GAL. _.- ----, ALARM MANUFACTURER: ~1 ~u$~~~~ CAPACITIES: A = ~ INCHES ~ p t~ = ~ -ao~..._GAL• MODEL NUMBER: ~ r.~ s•?~ w g - 2 - INCHES - 3~Z GAL. SWITCH TYPE : 1r1 ~ r ~._____._-_. PUMP MANUFACTURER: ~'v~,•,f~ C = S INCHES =~~GAL. MODEL NUMBER : ~~ ~! y___._ D ~ G INCHES ~GAL . = SWITCH TYPE: hr,~s^e, ,~ _ RE U~'RED DISCHARGE T RATE GPM PUMP S ALARM WIRING AS PER ZLHR I6.23 WAC Q VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIFE _~_____, FEET MINIMUM NETWORK SUPPLY PRESSURE • • ~ FEET + FEET FORCEMAIN X ~.G FT/1OC~ FT. FRICTION FACTOR r.~ FEET TOTAL DYNAMIC HEAD = J3,~ 7 FEET •~ DIAMETER INT AL D?MENSIONS OF PUMP TANK: LENGTH i WIDTHw-„~; ______..._ LIQUID SS`F~ ~~ ~G',,~/~'.t,r ~ ~~ SIGNED: ~.~-~=~~~~~ LICEAISE NUMBER: ,?~79~d DA'"E: ,~3~~. 1/88 ~~: . ,..-. f Specifically designed for the fallowing uses: • Effluent systems . • Domes • Farms • Heavy duty sump • Water transfer • Dewatering APPLICATIONS ~' } SPECIFICAT10N3 Pump: EP04 • Solids handling capability: 3/a" maximum. • Capacities: up to 55 GPM. • Total heads: up to 24 feet. • Discharge size: l'/z"NPT. • Mechanical seal; carbon- rotarylceram'sc-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Pump: EP05 • Solids handling capability: 3I4" maximum. • Capacities: up to 60 GPM. • Total heads: up to 3i feet. . • Discharge size:l'~Z"NPT. • Mechanical seal: carbon- rotary/ceramio-stationary, BUNA-N elastamers. • Temperature: 104°F (40°~~ continuous 140°F (60°C) intermittent. GOUIus p~~~ G ~~ ~° Submersible Effluent Pump ~~~~ 3871 EP05 ~` .. °o • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available fnr automatic and manual aperaUon. Automatic models include Mechanical float Switch assembled and preset at the factory. FEATORES ^ EP04 Impeller: Thermo- plastic Semi-open design with pump out vanes for mechanical seal protection. ^ EP05 Impeller. Thermo- plastic enslased design #or improved performance. ^ Casing and 9ase: Rugged thermoplastic design provides superior strength and corrosion resistance. ^ Mator Housing: Cast iron far efficient heat transfer, strength, and durability. ^ Motor Govsr. Thermoplas- ticcover with integral handle and float switch attachment paints. ^ Power Cable: Severe duty rated ail and water resistant ^ Bearings: Upper and lower heavy duty bail bearing construction. AGEIliCY L[STiifG SP• Canadian Standards At~sociaiion (CSA listed model numbers end in "F° or "AC".) , ` ~~ ~ r I ~v.L ~t ~~fi . ~~ :, , ~k;µ k ~ + j ~ - r k ` - ~--- _ _ _ - e n r!eu to 2E3 :sti w .,.. .~~... ~- ' p 2 4 6 8 t0 12 msfi CAPACCrY .'. ~.;'t 01995 C;oulds P~nps, inc. Edectlve May, t 995 83871 • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase: 0.4 HP, 115 or 23rD V, 60 Iiz,1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP, 1 i 5 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord:l0 foot standard length,16/3 SJ~'0 with three prong grounding plug. Qptianal ~0 foot length,l6/3 SJTW with three prong grounding plug (standard on EP05). METERS FEES', to~- ~ ~' 30 2s a 7 z v s zo a 5 Q 15 J 4 F~- a 3 1U -.~i~~,•l~~o:~ fiuN x:45 f~:4s. ~1R :. d5 169a S'3~ GFt~ c: E! ZCi^~FM1G ""." P+QiUYT$ ~VMf IYI~R`& MANUaAL. St lV9ANA+~MEl4~' ~+'LAN Paps _ ~ ei,~~' ICI 'flGlfil f~wriar 'ff e Parrott ~ ~{ZD t~lurnber er fiadrwrmr 13 DNA ~~ t-iumi~ aft Psrblla ~aaNftlr Unite t7 NA Eetfnwtrd flaw {avengal ~~O Dasipr+ now ltt-ea~1, {Estkttet+d x rt.b) t d soli Aptian i~ • J / ~tanaero inffurntl~ttiiu+uvt t~tullty Monthly average" ~ Oit +1k Cireaaa iPBG) s30 rnptl B{oaharrtiitai l7xyEen fJernanaf fDODiI ss2f3 mp~fL O NA T~ Suep~ed SolGds fTBSI St t30 mp/L pretrsspd t t~t+i Morith{y avtsrspes ~~ f3xt+~at p {gppsi ~D mp/L q'p~ gummed gp{~ia {T5S3 *,8f3 rapli. C7 NA fF+~oai Coli'FOftYe {gaorna'bic masnl S 14'' of W t taar-i Meslrttum gfMraarit Perdcie fie ~a in dla. G NA ' i7 NA "YsIwM /ta' dartvet~ westawaar rna aapt~a tank •trsrsrrs• e TeRk CeWaciky Qb I G NA 9eRrio Tank ~lattufaotuser ; ~ ~ y o NA etflu.nt filarr M~ Zayb,l ~ o NA Effluartt Auer Maiel ~~Q C NA iharnp ~-~ capauttlr _ vat o NA .... Pump Tank AAanufacnuer O NA IWmp Menufwawee!' ( rt 1 o NA ~¢ ~ ~ fl N/1 p~p+htrtlMtt Unit ~ G $and/Grsvei Freer D tr+eax fester o Meehrnic~d Aarat-on Q Wrtfand o Oittini'pat{on D f~tltar: Dispersal C1~tst ®NA ~n•grouad {pravitYt ®In•f3lrourMd {pnssurttadi D Atttrade ^ Mound a orip•uurw a Clthar: o NA oA~ft: o NA ~~; ©hIR- fid ISt%!i tlsr'elee fi4lfeAt ~ aandldon of tertWsl Ae lease onoe aver+n ~a1YjOM 3 pulan 8 ~ ©au iPurnp atrt ootzt~tta of tsnkial When aornbk-ad skrdpa and ~+um equs{s anrthlyd tYsi of rank volunw O ~lA ~-~{ ~te1 At !east ar-ne +svseY: 3 dtdlaxlrrturrr 3 rear•l DNA Ciasn eflluerR tlhiw At terser once aver: ~ . (- 2. esr DNA f,~ MA Irtat?~sa't Wf!rtp, purt+a a+antrais & alarm ht it:eit or+oe wary: s'+ N Flush lasscots and prassurs tset ~ At leant once evaryr mc p A ~ ~' At tease once every: Ye Q ~ va ~ O NA faNAg~ITifitlAN~ fe1s1'fttlC't'IONS trugp~sodor+a of tanks and dlgrersai Belie sha@ ba rnade by an indi~iidrEai conyin~ one of tt~e ~o~ intt Opara~• 7sntr Nampa Pl+amber: lubfttter PYart>tyar f~ttrictsci $ewes; PCatNTS inapeator. P4WT3 iulsintainer; araoks ~ taafcs. fnspaot3tyr-s musk inoluda a vitae! insspaa'cian of the tankta) i4 idantifyr any missing ar itirokan hsudwsr~ iderni'fY sr-Y n+a~wuro the w~Dierme cf rsorr~binad ahtdpa and scum and to cheek for arty baelr up or pondinp asf e411uent an the praund euelpo~b. Tha d{apsrsi!< oaWsl tNmii ba viauaiiY inaFwotad to check tiw affluent iavei6 iA the absarvselsr- picas and to classic fbr anY t~~6 erf effha4fte on the around tutfefrt. "ChB pa'+r-din0 ~ efNuertt on the procrnd surface rnsv indicate a failin~p cor-ditlon and raquit~se u1e icttntetgate twtlficael®ri of the local reyulatnry Butt~arhY• Whari the c~oenbkiad acerrmulstiori of tRx#pa and scum in stay tank epuais onathird {Y,1 a more of the :tr+at volume, the rr-tir• eontaftta ref tria tank shaft sus reerwvet# by a Saptapo Servicing t?aerator and diepenrrti of In aoaordanae with chapter ~ ± t ~. ifViaoaas{n Admiriistrativt Cpda. Afi other sarvU:tys, M~oiudinp fiat rsot !imbed to tba serviofng pf aMltsar~t fibers, rnachanicz~t w pressurised ~ernpor:anta, prartrssriat'+ens units, and anY aervicie~ ek kttsrvalt of ,cis rnor+ths: shaft ba performed by a aatl~ileei POWi'8 Ma6ttslner. A eervi0e report ,dtdl be ptavkied to tM focal f!apulaeorv sutharity within 'l0 days of eornPifebn Of any aprvioe went. p:},•,~,;,rU3 DiCh 14:2.5 p~~ '1:~ 3&6 4dB8 9T CRT LO LQ.ZItiC --~ • Papa ,"OCot STA>itT UP /~D QhENATtC1N osluCta of other W~rsri}oals fat nl+rv exrr-stn~a~'id~n, per to uta of the POVYT'S dkck treatmet-t tanictei for tta prets~cs at p pr that trNgr Mrtpada tilt tiri04titetlt prooeae stellar danafle the ditpo-sal celiiti. If high oere~ntrwtiont ue detao'tsd haw the cc+rrtentt of the tsnkttl ssrt:oved i:Y s saptatle aarvidna operator Pntu' to use. 8yrt11m ataR up shad not ot~ur when so}I aondhkxw are frozen at the in#iltirettve aurtaae. Osxk:O pewer +xrtsA+ro purt~p tankf may flu shove normal hiphwater levels. With power ~ natwed the axspist Wkstewatar tviti bs died to the pRtpertai celitsii Gt or-a lames dots. oveeiotdis+0 the aslital end maY Teems ~A~v'~c~inq~ pnator prior to rnp ef1luerK. Tp evr+id thin situation have thN eantenta et the pump tank rerno~wd by a Septe9 the pump eontro&r to power to the sMdieoti purrrp qr aentaCt a Pb~mbsr ar POWdT'S Msintaia:ar to aaaitt in rnar+uai}y epeeating +setwa nasrruf ievsft vYleh~ the p~R tank. do not drive nr park vehlelea awr tanks end dispsnia! aeds. ~u net dries ar park aver, at asharwlte diaturb ~ aompect. the area vvitlw+ 1 sS feeR dpvm slap! of arfir mound ar afi-aradt soli ri~torptia!+ rd'ea. Racluotlce or eiimlru-don of the IbU6W1A# frarr+ the wattW~vat+ar ttnam +~Y iMprove the parfarrnence and prolors6 the lies of the PC1W'f8: antitrlatiQt, baby war; ctQetette bunt; t~ndarnt; canon swebt: depreatsre: dental ibes: dlspers; dit}nfectarce; ist: faundetian drag tar~mp pump) wetu; fruit atxi wAsable peelings; 4aaafina; greats: herb}oidee: moat torspeJ rnedioations; oii; pw~tlr:p prodl,ratt; geatiddaa; tanitarY napkana; rampant; and water softener krktie. ABANDiN~lMA13bi"f` YiflNen yha l~1Af'fS fans and/or is psnrienantlY taken out of service the faliowir-9 atspt thsii be'~w ~ rn'wrn that the aystom s p~pdrly and eafegr abarManad }n eompl}snae with chapter Comrn 83.33, Wltuanain Adze Cods: • Ail i~~ to tar+let and pile alrad ba dlasonreated and the abaru}oned Rjpe ! s 'fhe eont+tnte of cep tanks and pits ahaU be removed ar:d properly dlapaaed at byo a ~ $arvicanp t~Par~+'• • Afar perrr:ping, aN tike and Plu shalt be excsvatsd and removed ~ their aoverf rsrno~red end the void apace fikad wlth sole, ~'wd or snot~et iru+rt told materGel. fX-1WTNIItf611CY 1rtJ1N li ttta PIyYVI'>i tabs end rannat bs repslred lire fatlawinp rsteaautee have bean, w ~ mwt be taken, m provide a cads cornplant n~ ~~`' t oii aDSarDtton n ~A o A auhable seplsoearent area has hs~ ovafuated and may be united fat tfie taaMla+~ofthouid ~ h^Q~ upon ey ayetern. The npiacan+eett arcs ahcukl t:e pratac•.,ad Isom disturbance sr+d cart^ arse wlil eequk+ed eKbaeka from secatirrA and propeted ttrueture, lot liner and weNt. Paiitsre tt are:. Raplacart+e~ suet refult M ti:t tweed far a new and and she avaWatton to astabllsh a wkabia seplaaat+ten aomphr with the suks h efrteot at dhat frtwe. A wh;sblt rephoarntr-t area ~ net avalla4ie due to settyaok andfar tail Ilmltsttar:a. darting advancaa In PQWTS ttchnoloflY a hdda+p tank msY be inttsliad sa a left rsaart to replaces ~- fsiMrd POWTS. . ~ _ .,.,..r..c _ W.~~ .,,,.e a~, < ~WA'AMiKid> y OXYGt>"~t. W KtYC ~JrTiC, !'~11A!' AI~O OTltEli TRdpt'M@NY TARipLS MAY CONTA1At f.Ei'hIAL @ASBES ANQIt'Ait iAi$Uf~bC1611T EpIT~t A , Pt,NiAP OR opt Tf0E14T1rAi~IT TANK UNg6R AAtY CtRCt3R18TANC~S. DEATN MAY ABSLILT. R6:gCt1E OF a I~iON 1'lIDM TiR; iN'~I~MOR OP A TA~i lMAY AE DlMl~iff:T OR fiA1Mi . 8 ALL>iti< POVitT6 MAHITAli~IBR Name Wi'/1.' to Sc a~1es- Narnf p'horn -~ 3 / l Phcna ATtM MtER! ipCl-t I~tIEUi.aY'QIRY atJTiiOi'ilY'Y ~N /N ~T eiarr~e hlsr-we ~. Coo qC Gswt>TY ~,, deesaatnt wa ersri.d M oorapsem. wkh w,apta Comm aa.~ixieert NdldtHi ar~f a•4.6My i. ~i d cam, W~~"''a1° ~„~nirtraeiv cad. p.......~..._.~_~ _~_..___.__~ ~a aurfa~ada ceAac~ ~ tioeas of uad s~ytsanu mu edmp~ the ruis~tfin aft $>~e.d+e biwnas at t ,e ST CItOTK COUNTY SEPTIC TANK MAINTENANCE AGRL'EMLNT AND OW1 ~NERtSHIPcCERTIFICATION FORM )weer/Buyer I - `1 ~-e. ~ I"t 1 CrYL ~~ t~+Ci J C~ ~ G ~ ~tY'' Mailing Address ~ `"~'S ~ Oak-~+ d L Gi r ~ v ~'~' ~ d So n '1n~ ~ S't'o I to 'roperty Address ~ $ z' ~ ~° ~ ~ S t' !-4'av+~w~on d 1+~ 1 5 `-~' o (S / (Verircation required from Planning Department for new construction) ots'- 109(- 23-c7etJ (.~3) ~ity/State Parcel Identification Number LrGAL DESCRIPTION Property Location ~~ .'/+, ~~ '/,, Sec. ~ ~ , T~ ~ N-RL ~ _W, Town of Lea m s~~-u~ Lot # 23 . Subdivision ~~^a; ~' ~ ~ ~-~ Certified Survey Map #~ ~- ,Volume _ ...Page ## `-~ Warranty Deed # ~l`/8'lr l ,Volume _~ 8'S .Page #1 ~?'~ Spec house ~ yes ^ no Lot lines identifiable ,~. yes ^ no SYSTEM MAINTENANCE Improper use and maintenanceof 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 systeur. The property owner agrees to subnut to St. Croix Zoning Department a certification form, signed by the owner aad by a mastCrplumber, joumeymanplumber, restricted plumber or a licensed pumperverifying that (1) the on-site wastewatecdisposal 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 Comrnerce 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 ~~ 30 of the rce yea expiration datC. 3 i~5i° 3 SIGNATURE Or APPLICANT DATL~ OWNER CI+~RTIFICATION I (we) certify that all statements on this form are true to lire best of my (our) imowledge. I (wc) am (are) the owner(s) of e property escribed Bove, by virtue of a warranty deed recorded irr Register of Deeds Office. i~ io 3 SIGNATURE OP APPLICANT DATL~ ****** Any information drat is mis-represented ruay result in tl~c sanitary pcm~it being revoked by fire Zoning Department. ****** ** Include with W(s application: a stamped warranty decd frorrr the Rcgisler of Deeds office a copy of the certified survey map if reference is made in the warranty decd U 2185P 277 DOCUMENT NUMBER WARRANTY DEED Midwest Equities, LLC, Grantor, conveys and warrants to Michael and Michelle Schwechler, husband and wife, holding as survivorship marital property, Grantee, the following described real estate in St. Croix County, State of Wisconsin: Lot 23, Prairie Run, being the NW 1/4 of the NE 1/4 and part of the NE 1/4 of the NE 1/4, and part of the SE 1/4 of the NE 1/4, and part of the SW 1/4 of the NE 1/4, all in Section 17, T 29 N, R 17 W, Town of Hammond. This is not homestead property. Exception to warranties: All easements, restrictions and rights-of-way of record, if any. Dated this ~-~~ day of March, 2003. ' (SEAL) wry J. llens, anaging Member of M st Equities, LLC (SEAL) AUTHENTICATION Signature(s) authenticated this day of 20_ (Signature) (Name Printed oz Tviced) TITLE: MEMBER STATE BAR OF WISCONSIN (if not, authorized by §706.06, Wis. Stats.) THIS IN3TRUMENT WA3 DRAFTED BY: Leo A. Beskar Rodli, Beskar, Boles & Krueger, S.C. P.O. Box 138 River Falls, WI 54022 3 -a~c~~3 7 1 4 8 6 1 KATHLEEN H. IiALSH REGISTER OF DEEDS ST. CROIX CO., MI RECEIVED FOR RECORD 03/27/2003 04:00PM MARRAHTY DEED EXElPT # REC FEE: 11.00 TRANS FEE: 103.50 COPY FEE: CC FEE: PAGES: 1 ~~'~~~~NK, NA ~ 1301 ulee Rd 75So f~a~ ce~J PO Box ~s m ~ ssy3s Hudson, 5401 g Ol$_ (031o-~O-OSU 018-1036-70-000 • Parcel Identification Number ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. Ya ~x COUNTY ) (SEAL) (SEAL) r~. Personally came before me this day of March, 2003 the above named Larry J. Wellens to me known to be the persona(s) who executed the regoing instr ment and acknowledge .the game. . r„ , '~ ~ ~~•. (Signature's / a ~}''~ ~ . • M l~ kJ~~V~,lnQS~e~n(~ '/ _ iName ~P l,r~ted or typed) Notary Public L.T ~ ( I'~~J~-: ,, _ _ County, wis. My commission isis permar~ent. .( •.nOt~, expiration dare:) ~ '~N,1, ~ o!f ~ ~ , 1. th ~ ~~ ;,. E. ~3 Ate. t a ~r~ ~ ~~Ti 4 X 1~~{ ~.: i• ~C~x t-. .''~' . / ,:~ .-~ -~ '/ ;Y COUNTY PLAT OF NOTES: PRAIRIE RUN lNlf TO IE CONfTRYC1E0 IN IRpffM17Y ~IN~ LSE( ~ATIW ~ LE'MI~ MN ST A•OYE /1E NreN twtet er.everra. BE 1 NG THE NW 1 /4 OF THE NE ! /4, AND PART OF T TINT rae.c uTet nle rv~crrr of nE AND PART OF THE SE 1 /4 OF THE NE ! /4, AITtt •RAIMAE AI1EA rs -Nawrtneu. SW 1 /4 OF THE NE 1 /4, ALL ! N SECT 1 ON 1 "r UNPLArrED LANDS TOWN OF HAMMOND, ST. CR01 X COUNTY ---eea.artmNanra,ANhNCOa~N~--------------~wuNCarzrcNrur -------------- ---- ~ - N89.04' 4'E -------------- ssaoe laa oeoraTEO to Irlr<rc rwtwor 14'E eot.oaftNle r •` _~.K~~~ - - - - - . -- - - - - - - - - - - - I Od r-.-----tartitt~--------- -~-rte-_ ® ----- ~ e I I ~ ~ I rare.4s' Ito rw cat. •r.or r) $ ~ ~ ,CERTIFIED SURVEY rr/AP I I ~ ~ ten~ar 1.~~ "'i Qi .................._..._..._ ....... ............................. : ........... I LOT 9 I ~ '°' ~ LOT 31 ~ LOT 30 ~ LOT 29 ~ ~; ~or•.i_ I $ ~ r. ao ACRES 8 r. 0o Aatsa 8 r. ao ACRES ~ I I-~ ~ ; re.eoe SFr. ee,eot wlr. ea.eoe sarr. ®_: I is 1 ~ 8 ~• ~ I ~- - - - - - - - - - - - I ~I ' ~ ~ tae. sr sae. ta• R N8A• 04' ! 4' E 3P6.30' I In , '~ ra•e ste.•a ' i I ~ LOT 10 ~~ I g ; I $ LOT 33 LOT 34 ~ LOT 35 I rti I $ ~ ® LOT 32 ~ r. so ACRES :. ~ ACREs R~ E 1. N ACRES ~ 1. N ACRES E r, ee• ea FT. I I I I ~ 7!. 8W f0. FT. $ 7N. DII d0. FT. ~ 7d. 0e1 e0. FT. j r. w .~uleee ~ ww~NMK ~ ~ I r- - - - - - - ~ .....~.._.__ . ...................._-.. - - - ,~•.• Is-e r...~ ~ ... . ........_.__........_ ...................... .......... ~I _.. I :.............1-.....~.... rcee.ev etuNAE ~ Ien I ~ ® ® ~~'- ---- --~--------ee..sr~------------- ------~t,•.,~•---------- -------- e.e. ~a•---------- .I.er- ---- I New04' 14'E 14lI.e0' • i LOT 11 ~m I PUBL !C ~ I m I ' sews' r4•w u>• ry I aae•oe' r4•w sr».se' 4 • ® ~ r -------- I ;~) ~ ~ i e~Ti~ar•-_ ~ uw>E , ~ GD . •-ie»eai- ~ Imj ~ ~ :Lor 2 ~ $ Lor 22 ~ ~ ~~ ' LoT 2s $ Lor 27 ,~ r. a r ACRES E r. >sa ACRES ? ~• ,~ ' - r. n ACRES ~ r. as AcREs ly T = ® m ~ °0''• Ta.oa taFT. eT.aw ea Fr. I I-A I & Taaow ea Fr. eT.ear saFr. I LOT l2 I :.~ ; ~ ~ ' ; - ~.~ ~' ~ I ~ ~ $ i, I I a. 1 ;'® ~ m~\ ., , j ~ ® ~ .rriaaa• rat ra.ee• ~ ~ ; '- era.sr ste-~' ~. ®~ a la a aaa. st - - - - - --~ ~ 1 ~ ~ ' I "°re~weaa- ' ~ / ; ~; I - aa.er ., ~ %'®: LOT 23 ~` ---- . ~ ' "~ .. ~C„ Y a ~ ~ ~ ~~T Aa~s r. n ACRES t~ ~'''•• s.. ......... •~ LOT 25 o .• ea. aae sa Fr. ~ n. r ria~ oe. i o .... ~6. !. 74 AptE8 i O / / / ~ I y 61~•«N~wee y ~ >•s. ws to Fr. + ~'~°. LOT l 3 / f ~ '~'• ~ I ~ i _` ~'~ • ,~ LOT 24 ,> r. ar ACREs y / /~/ o w 'i e`JS' / ~ ` t`"~ •~ ~` // j / ~"ei•~ r WI~;~°`~ ,ty, ~8 ta.aa saFT. 4t •Q t / ,' Qej i / ~ ~ Ne-i+e ----------- ---1-/r--~~ ----------------- ht q,, ee-Nt ~ / /I / ~ ~ LOT ! 9 sN la• ~ r ~oo.er / , ~, ~ \ ~. ~ ~ \ , ~/ ~ ~ ~ ~ TNwt a \ , Noutt c ~ y /,' '~, Lor 18 ~'~ LOT 28 ~ ~ ~ j ~ ~ / ~ \ j ~ . / v ~ / LOT 17 ~ ~ ~~ ~ , t' ~ ~ St~ET 1 OF 3 e•DDlewe nlle namudr eeAFleo er .Ilr stew v