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HomeMy WebLinkAbout018-1039-40-000 3~ f7 d c f ~ o 3 ~ ~ ~ r' _1 ~ 3 ~ ~ ~7 'o ~ ~ m v .o c ~ :r ' ~ , ~ ~, ~ I I ~ 3 ~ ~ ~ ~ ~ r: O ~ ~ O ~ O ~ ~ O ~ • ~ ~ ~ N O ~ ~ ~ ' fD 3 ~ ~ ~ ~ .a ~ ~ tti ~ ~ tD ~ fG 7 V fOWD d ~ ~ 0- N O w n N O -~ A Q O N toil ~ O ~~ 7 y ' ~ O ~ ~ I cn z D C CT _ ~ Qr ~' ~, e~ m cix D y o. C ~ a W ~ s ; _ A A O I N N w Q H~ ~+ OOOa °Y z o pp '0 ~ ~ ~ ~ I < N Z I a ~ ui tin cn a D .. ~, Q ~ o v ~ N I o ~ , y ~ ~ ~' t~ D v' ~ ~ ~ m ~ I N M ~ ~ Q Q ~ ~ ~ Z I ~~ ° C Z ~ I D °' ~ o I N a A ,Tl J N O I c ~ w I ~ 'm ~ o m Z ~ to C ~ -i N p 2 tD ~ ~f N ~ j ~ e~+ tS A O 0 ~ o I _ N W ~ ~ ~ a ~ 3 ~ z .P ~ I ^' H z m ~ m ~ w ~ ~ I I a I o ' I w c I o a I ~ I I i ~ A I ~ I o Q N O Cn v ~ 0 b ~ ~ N A yp ~ ~ c A ~ ~ I ~ ° O ~ o ~ Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM S1)fety and Building Divisidn '~ INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 'ermit Holder's Name: City Village X Township Oeverin Homes Hammond Townshi :ST BM Elev: Insp. BM Elev~ BM Description: -A ' p ~ 00.0/ CST gwt.'~' SANK IN ORMATION ELEVATION DATA TYPE MANUFACT ~ ~ ~ ~~oaQ,14 -100 CAPACITY Septic t_)_ ~~ -~ T`"` ' ~a (0 3D Dosing ~ CaQ•w1, ~ ~ Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic , ~ i \ J ~. Dosing t ~ ~ ~ t Aeration Holding PUMP/SIPHON INFORMATION .~ ~~ r8 Manufacturer Demand ~~~ GPM Model Number ~~ ,~2 3 Li ~ Friction Lo s~ System Head T i ~ Ft g • ~ . 3 6 orcemain Length~+ Dia. ~ rr Dist. to Well SOIL ABSORPTION SYSTEM County: St. CirOIX Sanitary Permit No: 463195 0 tate Plan ID No: Parcel Tax No: 018-1039-40-000 Section/Town/Range/Map No: 18.29.17.2740 STATION BS HI FS ELEV. Benchmark ~, ~ ~ ~ ~Z ~v ~ ~ / r Alt. BM Bldg. Sewer 1 0 }.~ SUHt Inlet 8. S~ ~• St1Ht Outlet Dt Inlet Dt Bottom ~ Z • 3 ~~ ~0 / Header/Man. ~8 93' Dist. Pipe 3~f2 ; l o~ / Bot. System .~/ Final I~ r~ad,~ (~ ~ r ~.. t 2 •SD 4 St Cover ~v r~ O ~ ~,(p0 /~ 6 3-• 2d EDT Width ~ Length ~ No. Of T•renehe PIT DIMENSIONS No. Of Pi Inside Dia. epth DIMENSIONS C _7 J 7 Z ` C`~~ / "~~ '^ " ~~ SETBACK SYSTEM TO P/L BLDG W E L L LAKE/STREAM LEACHING nufacturer. INFORMATION CHAMBER O Type Of System: ~ ! t ~` J ~_ UNI Mode ber. DISTRIBUTION SYSTEM ( la'~4D-4oe_I HeaderlManifold ~ ~ Distribution ~ ~~ x Hote Size t~ x Hole Spacing Vent to Air Intake h ~ i ~ Pipe(s) ___l~ ~' " ~~~ ~ ~ 3 '~ ~ t• ~ ~~ Lengt ~ D a Length ~ iYa Spacing 1 SOIL COVER x Pressure Systems Only xz Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched BedlTrench Center Bed/Trench Edges Topsoil Yes No r ~~ Yes ~ ~ No COMMENTS: (Include code discrepencies, persons present, etc.) I spection #1: ~~ . I pection #2: / ~~C„~,~.ca t-fl~ Location: 1561 100th Ave. Hammond W 54015 (NW 114 NE 114 18 T29N R17~) N Lot 2 Parcel o: 9.17.2740 S: ~= ~~,I~d~,e.s~,Q, X3.0 ~s a,,,~ _ s~- ~~ t.,,~zdl~le w..~.~ 1.) Alt BM Description = 2.) Bldg sewer length = - amount of ~ ver = `N 1 ; ~ ,^ ~ ~~~5 ~~, ~ I~NJ1r! Plan revision Re uired? ,,' Yes ~No ~ r Use other side for additional information. ~ ~ '') ~ I c `~ Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) Safety and Buildings Division 201. W. Washington Ave., P.O. Box 7162 County )' /f~ l ~^ Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) (608) 266-31 S 1 ,~~O~~~r~ Department of Commerce State Plan I.D. Number Sanitary Permit Application ~ v ~ -7 2 ~ i In acrord with Comm 83.21, Wis. Adm. Code, personal info may be aced for secondary parposes Privacy Law. r l .04(1,~~ C E I V E D project Address (f different ~an mailing addmss) - f' ,~ ~ S~ / / 6 ~ ~v~e . I. Application Information -Please D IQ o s ~ Parcel # Lot # Black # ~~~ 3 ST. CROIX COUNTY ~/~- d3 9 0- Propertyowner sMailing ddr~ _ Property i.~~ ~ a ~ G ~~i' ~V l SVHa ~~{ ~h, Trp Code ~ Phone Number ~~~ ]]` lJl./~ d / , IF~~"~~~~ TTT'~~~~ one T~N: ~ E W II. ype of Building (check all that apply) ~ _ ~ ~/ ~D (mod ~ ~ ~ Strbdivisio Name ~CSM Number ,, ~ or 2 Family Dwelling - Number of Bedrooms , / ~ ~ r ~ ~ ~ ~ 3 ~/ Pub idConunerT:ial -Describe Use ~ i i ~ / State Owned - Describe Use~7~Z~ Gty_ V" ownship of TII. T ype of permit: (Check only one boz on line A. Complete line B if applicable) A ew System Replacement System TTeatmentlHolding Tank Replacement Only Oder Modificrttioo to Existing System B. Permit Rcne~wal Permit Revision Change of Pcrmit Transfer to New List Previous Permit Number and Date Issued Before Exp'aation ~~~ ~'~ . I'V. a of POSi"TS S (Ch all that a 1) Non -Pressurized 1n~'im+md ound _> 24 in of suitable soil Mound < 24 in. of suitable soil At-Grade Sin8le Pass Sand Rilta CoTUtruued Weiland Pressurized in-Ground Holding Tank Peat Filter Aerobic TreatmuT[ Unit Recirwlating Sand Filter Recircu S tTthetic McTSa Filter Leaching Chamber "Line Gravel-less Pips ~(ex lain) V. D' ersaVfreatraent Area Infolwattion: Dis Area _ ploscd (sf) System'tIDevari~n r~ ~,~" / Oe/(gpdsf) spersal Design I•low (gpd) Design Soii AppG on Ra ~ ~ Z // ! , ~ Tank Info Capacity' Total Namber Manafacturer Prefab Site Steel Fiber P1asGc f Units Concrete Conatnrtxed G~ ll G ons o a Gall New Existing , Tsdcs Tsnks Septic a Holding Talc /~CYODIC TreannenT UIUY VV V v U DostDg Cliatnba ~ VII. R nsibility State t- I, the aadersiga a 'bility for installation of the PO shown oa the attached Plu s Name (Print) Plumber' MP/MPRS Number Baseness Phone Number ~iry, state. ~ ~ ~ Plambets Address (S ~ VIII. Co a artment se Onl t Si atnre tamps) Sanitary Permit Fee (inclades Grot~adwater Date tied ~ pppm ~ Disapproved Stttcharge Fee) ~ ~ ~ ~,~ (~~ / Owuer Given Reason for Denial IX. Conditions of Approval/Reasoas for Disapproval - ~ ~/yY~~,~~,~~~ ~ y~,~L,Q~P/~ YSTEM O~NNE~: /' d y,.~i t filt ff C~r~ y er an luen Septic tank, e / ~ ~~5 /~° - dispersal cell must all be serviced / m intained ~ ~`'"'~ ' ~~^~ as per mans ement plan provided by plumber. 2. se ack requiremen s ne ~- Vyt` ~~e` ~~~ / v'7/ ~L ~~ ~~~~'"'~t' as per applicable code/ordinances. ~~ ~ dYt~- ~3' ...., t.ce rt,sn xlf2 Y 11 in[hes la 5196 Attach rpmptere ptan5lw auc wumJ w.7 f w• ,+.~ .~~•.••• •••• r-r- • PLOT PLAN PROJECT Ken Oeverina ADDRESS 838 Summer Pines Circle Hudson Wi 54016 NW i/4 N~ i/4S 18 29 N/R 17 w TOwN Hammond SYSTEM ELEVATIO 97.8' CONVENTIONAL AT-GRADE MOUND XXX SEPTIC TANK SIZE 1000 gallons HOLDING TANK SIZE LOAD RATE 1.0 BENCHMARK V.R.P. Top of Steel Fence Post ^ BOREHOLE O WELL sg,R,p, Same as Be Grading is to be done to divert run-off away from system 100th Ave Scale = 1 /4" = 10' Property Line Property Line COUNTY ST. CROIX BEDROOM 3 CONVENTIONAL LIFT HOLDING TANK LIFT TANK SIZE DOSE TANK SIZE 630 ABSORPTION AREA 454 # of chambers none ASSUME ELEVATION 100' +I'lI' tCr ZabCl A-100 nchmark Huffcutt Combo Tank 6% Slope Pro 3 Bedroom B - 2 House ^ B -1 Tank is to be properly bedded Well is to meet all and provided with lockdown setbacks found in 96' covers with approved warning Comm. 83 Property labels 97 96'8' Line B - 3 B.M. Alt. B.M. is top Area 15' below system is to remain undisturbed of Survey Iron @ 95.8' • commerce.wi.gov isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. commerce.wi. gov/sb/ www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary October 29, 2004 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: 10/29/2006 Identification Numbers_ Transaction ID No. 1077241 SITE• Site ID No. 691787 Ken Oevering Pleasexefer to both identification numbers,' 100th Avenue ~ above, in all comes ondence with the aQenc . Town of Hammond St Croix County NW1/4, NE1/4, S18, T29N, R17W FOR: Description: Proposed Three Bedroom Mound System Object Type: POWTS Component Manual Regulated. Object ID No.: 989804 Maintenance required; 450 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1), Pressure Distribution Component Manual -Version 2.0, SBD-10706-P (N.O1/O1); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD-10691-P(N.O1/O1). • The pressure network is to be constructed in accordance with publications SBD-10706-P(NO1/O1) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems -Version 2.0". • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • Comm 83.22(71- A copv of the approved plans. specifications and this letter shall be on-site dur~ construction and open to inspection by authorized representatives of the Department, which may include local inspectors. P.O.W.T.S. Conditionally ~'PROV~'t~ SHAUN R BIRD Owner Responsibilities: Page 2 10/29/2004 • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) -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. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 may be 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, Gerard M. Swim POWTS Plan Reviewer -Integrated Services (608)-789-7892, Mon. -Fri. 7:30 am to 4:15 pm j swim@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 763'3 Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 10/20/04 ~F sq o cFi 'cF c~z ~F ~. ~~r ~~~~~ ~~~~~~ Owner: Ken Oevering Location:NW1/4NE1/4 S18 T29 N,R17W Lot 2 100th Ave Hammond System type: Mound System Manuals Used: Mound Component Manual Version 2.0 (01 /31) Pressure Distribution Manual Version 2.0 (01 /31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Cot/igency plan 9-11. Soil test /' o ~.- ShaunBird ~ e Signature License numb 226900 ukPARTMENT OF COMMERCE pIVIS10 SAFETY AND BUILD;NGS SEE GORRE ONDENCE , ~ PLOT PLAN PROJECT Ken Oeverina ADDRESS 838 Summer Pines Circle Hudson Wi 54016 NW i/4 NE_ 1/4S 18 29 N/R 17 W TOWN Hammond COUNTY ST.CROIX SYSTEM ELEVATIO 97.8' 3 BEDROOM CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 454 # of chambers none BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL *H.R.P. Same as Benchmark 100th Ave Scale = 1 /4" = 10' Property Line Property Line Grading is to be done to divert run-off away from system B-2 Tank is to be properly bedded Well is to meet all and provided with lockdown setbacks found in covers with approved warning Comm. 83 Property labels Line Area 15' below system is to remain undisturbed 6% Slope Huffcutt Combo Tank Pro 3 Bedroom House ^ B-1 9 6' 96.8' B-3 97 B.M. '~ Alt. B.M. is top of Survey Iron @ 95.8' ter... r ' /`. No Designer_ Date Non-Woven Filter Fabric ~DiitriDution. Pipt 4" Observation Pipe Perforated Below Filter Fabric ; ~yS-~UN^ ASTM G-33 S o n d -~ t" - ~ G `~ ~- ~ . " Topsoil ' .~i _.- ----=- ~`~ ` _ ° ~^ ---~ E ~ . _ _ _ -~ ~,q 6 ',~ S10pe ~~~Flow ~ ~ Force Moin Bed Of f~ 2 z From Rump L Yer ~ grain Rock ~D , ~ . . , ~ ~ ~-- , sttR- Usin F ~~~ Cress Section Of A µovndtion Area G ~_ A Bed For Tf1e Absorp ~,, A ~ F t . _ h , .~" 6 ~ Ft. I ~~:-~t . K Ft. ..__1`~ ~ .. L ~!~--i'' t . _ _.. __ `~ .... .. rr _ In ~~! t . L 4~Observotion Piet-''~_~_r K ~ ____. 1 . ~~~~ -- r w _ .. --- - - ~1•---------------------------------- j once Moin ~ ---------------- From P j ------------- _ -_ _, ~-- _ r--_-_ -. -~~-ter ~ f ^ o Distribution Bed Of ~y ' Z't p Pips - Droin RacK I 4 Observation Pipe-:~CG~ Permonent Morker g / ~j ~ j pi Pe or Rods Plon View Oi Mound Usin A Bed For Tie Absorption Areo PAG E_ ~F---- /~~ ~.ota~se Oa Bo~rom. Equoity gpoceo RfaT MILL KsxT re CanneC}jef Ft. Ft. Signed: ~ i tense Numbe~^ Oa to Hobe Diameter ~~:..~Ineh i.aterai ." '~- ~ Inch(es) Man i foi d ~- Inches Force Main ~ Inches ~ of naTesl~ipe ~~ Invert ~ievatian of Latetrals/l~ ~Ft. X ~ inches ~ inches Peftefatt~ o~t:e fletaii Tp,N1C ~ '°t3MP C~~3AM SEPTIC - „ p4SIi. ABOYE .t3RRD£ ~ ,~„ ~~. v BHT Pzp~ ~~I Ng0~ 4~ y ~~` ~`ROK D4flR , ~ ~ Fit~a~~ :h~A i~TAKE s~f~A^•~~ ~~ -~ GR~~ ~ y ~ ~`~~ _ ; tip: I#L~_l ~ +~---- trATER 'j'I6 MT 5 EAR A 8 "~-'_ ApPRt3YE1~ C PIPE 3` ""~"'_ O~ ~,ID. - ELF - ~DJ-.~FT • D 50iL pL#PIP gFF ~ ~ EC~IICATipN's' St£k~RP~~ Ji33+~CT~~JNDUflT ~ ETA S.~ `" ~ = s s s +. 1 i ~~MT r SEAL'- ~ ' : t AFFRO'+~ ED MA~iHE}LE COv ER Ud 1 PAD Lfl£K ~ wAR-KI~IG Lp$EL .~4" MIN- - t$u Mfd- pit r .w. ~~ _ ;~~~ ~~,O~SOIL g~DIT~G UbID£R TANR / / J CONCi~ETE FAQ g +~ APPRO~ ~ ~'/ ' ~a ~~ SPECZFSCA-:IOPiS ~ - ~3'SB%s't DOSES ?ER 3)AY = _.~.------"" SEFTSC f DOSE OflSE ~,'{yr;,,)ME FNL~C~ ...1-~---'~.3 GAL- ~~ Tl12SK MAN,~pACq'URER : OAi . _~3 GAL SEPTIC GAi.. _ ~~ J iP1CftES TANK SIZES = DOSE ~ GAL. ,~ , ~' . CAPACZTZ£5 = '"' r ~ I~HES = ~•-- ~y `~' II+iCHES = ~ ~ GAL AIA_~, ~'Nt7FA~l1R~ _ ~ $ '_f MODEI+ APE = ~~ C GAL ~ZTCIi I~HES C~fRER : `-'" a~ it = ~ R x.23 ~' pytsP »R~FAN~1t48ER % • ~~ ~~..- Z ~ M~I1L'C~ T3tPE= ~~~iItSP S ALARM i~tZRZlrG ~ -P ~O C'a!4 FEET 'FZ~ ?iP£ ~'""~~~-FEET R£QtiIRE'D 33ZSCHABCiE gRT£ EEN pz1I~P Oi f Ai$D •D,ZSTgIB~ - - - ' ,j'/ ~ FEET FRZC'TZF~t3 FACTOR ' _ /'.~.~~~-• Jcz--f EET vfltTZ;~j~ N£'I'~tGRK S{~PPLY PRS~,EIli3Q FT' DYN~IC ~~/ ~;..__----- F£ET FORCEISA.IR X _...-,~- TOT~iL i DI~rsETER ._------ iMENSIDNS~ 4~ ~~~ TAxK: ~.IQUID ' Ip~pEg~t,l. D Y~T£ r LIC~I~~~ ~IMB~ = - :188 w t 2- 0 w S U Z $. O J Q r 4 - TOTAL DYNAMIC HEAD/CA?AC!TY PER MINUTE EFFLUENT AND DEWATERING .MODEL t52 ~ Feet Meters Gal. Uters Gal. . 5 1.5 69 ~ 261 77 LITERS 0 g0 150. 240: 320 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATID~S • Timed dosing panels available. ~¢' ~ lied with • E;ectrical alternators, for duplex systems, are available and supp an alarm. • Variable level control switches are available for controlling single p ase systems. • Double piggybackuariablelcvel float switches are available for variable I~vel long and short cycle controls. • Sealed Qwik-Boz available foFoutdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. 15y153 Series i. i~ L_ sKxoa SELECTION GUIDE 1. Single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0477. 2. See FM0712 for correct model of Electrical Attemator E-Pak. du lex 3 3. Variable level control switch 10-0225 used as a control activator, specify p ( ) O CAUTION AU tnataaadon of controls, protectlon'devices and wU1ng should be done by..a queufied or (4) float system. licensed electrician. Ail electrical and safety codes should be followed including the mast recent National Electric Code (NEC) and the Occupational Safety and Health Act tQSFIA). RESERVE P01~t#=RED DESIGN For unusual conditions a reserve safety #actor is engineered into the design of every Zoeller pump. aRAa ro: ~.o. cox 1x347 LowsviHe KY 40256-0347 Manu/acturersof.. ` SHIP r0 3649 Cane Run Road d . O ® Lou,svlle, KY 40211-1961 QuaurrPuMPe S,rcE /99,9 w~ (502) TT8-2731.1(800) 928-PUMP ~' PUP ~Q FAX (502) 774-3624 hnp;//www.zoelter.com ©Copyright 2000 Zoeller Co. All rights reserved. FROM :OEUERING HOMES ~l.C FAX N0. :7155311282 Oct. 21 2004 08:06PM P2 ~ y f RfJM.:1 kJBYN 41EBER CPN -SAX-pl0r ~ S 565 3060 Dec. 01 2003 ~04 '24PM P2 RECEIVED ~a p ~~ NOV V 8 2004 ~ ~,p~,a,q~ Soli EVAI. TfON REPJRT~ ~ ~•w~.a- `~ a+rrNda.tirr.ne S~~CR01 COUe.wr. •arr. c.o. ~ -~. ' cawr ~ ~~~ rw.a YrJUM.•MnNInM•dm:~•rtl.r~n.I+eruranw~Mr~/~ipMt~M"•^0. ~iiOMLD. .. Mre..ra.r., rw•ar AM.+rrbn•. nary anOYr, a+• ivo•tkn nrl ~mnom.Nrd{ turd. D.r Nwsn YrbA aM Mlhrrn~Nrr. N.wr.va sy . rww~rMMw.we Mi N++7rrnr7 w•...Nw.am..~~w+.w Irr'rr./ 1,aw. ~ 1d,Y ~I0^IJ~ r.raly ~' . mur. ~x tm ,k s Y n ~ e w ,~„~, tar aoa r ~ nrnm v aM J V Lv 'Q ^ ....~ ~ n ~7q 0~ .~ AA CAy G''i;•Ca ru.a.rq~•~r ~.~ 1N.~C~•1a01~t111r My.~It.en.Ifal NM~llrr.l.~reni.~y~ 1~a•OYM..aAi~~'w~!+~ OPD A...r.r~.~.IQll~ltll"~'.(~Lk~r~~- iirlmor'rina•Niennirrae~• ~Y R ?~lJ4....{ /rsr.~.C,, ~ I/1 561 sar aar+e.whara•mv.It 0.•narnMV.ae.,~~«. rr+amo.~o•ow~~~(! ~.. o«~a.~j':-.r~.T-~.~ar..~ ..,...y ~»r `a.err \ ' ~ ~~ i~ nn~ ara.,da•.Ar..•~.~ r ~ a o•rwr.~.wa.. d Vin. •oia.n o.oer aan4.r. ewer pesos owc•arm ' ~rna~. forth. ww«. P...r~ r nc.ma v" D.r en~a.r s.nnaoese TrlsrMr+• rrrw 100J! 1pZnd Ava IWw RloMrlona, W15f017 ,,~/~~i5'•~J„3 y1G-z4B-A!ftb ~ U~~9 ~ y,~ cS~ FROM :OEIJERING HOMES LLC FAX N0. :7155311282 Oct. 21 2004 O8:O6PM P3 ~ + rRt1M : Rf.1F1vN 416BER (~ITURY 21 FAX N0. :715 565 3060 I>co. 01 2803.04:25PM P3 ~~. ~~ • ~'~-~ e,~s.rer eew• ~ y ~ p~pen M IM~7 ACA ~ YA ~.~f.+ ~ wrw~ ~~ .~ . NM _~ M •lll~d~t•ptil.r70~~~M1~'"A'11~s7osl~Onp1~ ~EA41MII/i`~~~7~~A'rMTrilO~Il. rr dCannaro• to ~ ~ ple~9 ••^~°• pewtln wa..N tae ut~m~r ~~im ~ r eeei ~n1d M .. e1~e1Ma fb~w, p1e~e eeeeeCt the ~epne~e ~.~ det~ew ew !] weu ~~~• L~ ~ p ora~MMrMwwa.~...~~ M~rM~A~~aer ~~.._. ~~ Mee ~' ~ ~ F ~ ~ Soil Test Plot=Plan Project Name Ruth Ann Erickson Shaun Bir Address • 1450 S. Wasson Lane River Falls Wi 54022 CSTM 26900 Lot Subdivision ------- Date 11 /27/03 N W 1/4 NE 1/4S 18 T 29 N/R1 ~ W Township Hammond Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 97.8' *HRPSame as Benchmark Alt. BM Top of Survey Iron @ 95.8' Scale is 1" = 40' unless otherwise noted 100th Ave 217' Property Line 217' Prope ] 97' 96' B- 6% Slope 10' B-1 50' 5' 3' 20' B.M. * B-3 0 264' Pro a Line B.M. Lip ' ST CROIX CO C pGREEMEN'I' -SEPTIC ~ NI~I~EN~ .. . - ~~ERSHIP CERTIFICATION FORM t i ~ e ~ d f' S~ (~ ~ . ~w Mailing Address ~ , _ ,_ ~ _ i 10 0 ~ ~, _ Property Address iced from Planning Department for new cv~u~~.....•~---~.-~--- (Verification requ ~ `j , l O OI , [..~ (j-~ p parcel Identification Number -~ ---d 1-=--- d .l~n,vl,/y~ Fn C{ty/State ~ ~~~~ LEGAL DESCRIPTION /l~ ,~ N-R,~y~, Town of ~j- pro erty L,ocation,C~ ~~~i j,ot # P ,~- Subdivision ~ ,page # 3~_~___. c~- C a ~ j .Volume 2~ Certified Survey Map # ~,a' Volume a 5~.3 Page # Warranty Deed # ~-~ 8 ~ ~ tifiab yes D no es O no Lot lutes tden S~_. femawre failure to handle wastes. Proper maintenance ~~ w tNTENANCE tic stem could result fa its p r aThat you put into the system SY~r -- a*+~r of your seP ~' d b a licensed pumPe ' improper use aaa m~w~--- ev throe Y~~ or sooner, if aecde ~ ~ system. consists of pumPmg out the septicnt ~ ~ fitment stage in the waste disp and by a can affect the function.of the sep meat a certification foam, steed by ~ ° oral em to submit to St. Croix Zoning Dep r verifying that (1) the on-site wastewaterdisp ~ owner agrees or a licensedpumP° the septic tank is less than 1/3 full of sludge. The P ~y~plum~~ ~trictedplumbor tag (if necessary) masterplumber, j 2 altar ~pectioa and pump ~ ~ pmpeZ operating conditionand/or () e system with the standards e to maintain the Private sewag disposal cation eats and afire artment of Natural iZesources, State of WisconsOffi ~ 30 Uwe, the ~dersigaed have rand the above requuemerce and the Dep ed to the St. Croix County Zoning as set by the DeparCment of Comm feted nad retuaa set forth, he uu~r optic system has been msmtaiaed must be comp stating tha Y iration date. /~ ~ days thre y~ exp DATE SiQrNA r[JRE OF pppLICANT our) laiowledge. I (we) am (arc) the owner(s) of TII+'ICATION on ~ form are ~~ to the best of mY { nWNER CER I (we) certify that all statue of a warranty deed recorded in Resister of Deeds Office. the pro erty described above, by ~ ~ DATE OF APPLICANT revoked by the Zoning Department. ««*'`"« SIGNATURE errnit being ««:«t~ An information that is mis-repnsontedmay result is the sanitary P y f Deeds office warranty decd from the Rergeifercnce is made in the warranty deed «t Include with this application: a stamped a copy of the certified survey map ' ~j 2538 t' 2$2 STATE BAR OF WISCONSIN FORM 2 - 1999 Document Number I WARRANTY DEED This Deed, made between Ruth Anne Kobs, f/k/a Ruth Anne Ericksen Grantor, and Oevering Homes, LLC. Grantee, Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Part of the NW '/.of NE '/.of Section 18, Township 29 North, Range 27 West, 5t. Croix County, Wisconsin described as follows: Lot 2 of Certified Survey Map filed May 25, 1977 in Vol. 2, Page 379, Doc. No. 340293. Recording Area ?SE3241 KATHLEEN H. wALSH REGISTER OF DEEDS ST. CRDiX CO., Iii RECEIVED FDR RECDRD 03/3I/:2QQ)4 12:15PN MARRANTY DEED EXEi~T ~ REC FEE: 11.00 TRANS FEfi: 90.00 COPY FEE CC FEE: PAGES; 1 Name and Return Address ~~ 018-1039-40-000 Parcel Identification Number (PIN) This is not homestead property (is) {is not} Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. Dated this f~~~`,~ day of March , 2004 * Ruth Anne Jobs, f/k/a Ruth Anne Ericksen AUTHENTICATION Signature(s) __ --____-_ ------__.__ ~. _ -- __-- _ -- - --- -- - ------------------ .-- -._ authenticated this _ dayCo~~C 7 ~u ~1 ~ - Nota-~y.~l`s_~~~ S'~a * TITLE: MEMBER STATE BAR OF WISCONSIN (If not, _ _ _ authorized by § 706.06, Wis. Scats.)-u---- ACKNOWLEDGMENT STATE OF _ ~~ pp1 \~, ) ss. ~~~.1~:.~,~,~'~~'>,T~_ County ) Personally came before me this'- day of --~-~ March ,2004 the above named Ruth Anne Kobs, f/k/a Ruth Anne Ericksen, _ , ` _ to me known to be the person(s) who executed the foregoing in~lment and acknowleQ~ed the same. THIS INSTRUMENT WAS DRAFTED BY W Attorney Kristina Ogtand * yy`gn Hudson, WI 54016 Notary ubli , fate of My Com 'ss' is permanent. (If not, state expiration date: (signatures may be authenticated or acknowledged. Both are not necessary.) , " Names of persons signing in any capacity must be typed or printed below their signature, Information Professionals Co., Fond du Lac, W I STATE BAR OF WISCONSIN SW-bS5-202 t WARRANTY DEED FORM No. 2 -1999 Page ~01 ENT Pt.AN NER,S MANUAL & MAKAGEM ' pOH/'I'S ~~ SYSTEM SPEGIFiCATiflAIS 81 p NA . Sepfyc lank Ce1P~ f~tn p In{Jr~und (pnessurized~ ound D Other_ ,ri ine ld for domestic fn°o-'°°mmerd~n was~w end V~ ~~ik alftuont Vse~ tYP~ for Pm~~ wastewsur• o~ ~- licenses or an ind'Nfduai carry~'-9 one or POfoWTS t~taintainer, Sep~Se Uc7'IONS li be made by g tnsP~o ' misstnf~ or bfvKen MA1NTfEH~AN~ ITIS't"R di:Ae~l oe1~ she R~~ $eWer. POD g tD ider-~Y any beck uP fnspsetfon: of tanks and tHaster Plumber visual inspectfon of the tanict) scum and m check for any~nt levels ~: Master plumber: ns must indude a ed sludge and ~ ~~ the effl ServfdrrD Operatior• Tank inspecbo measure the vofu~ coif tf{s) sh~U be visually rnsP ~ ~ of effluent on the hardwarm, klen~f ~+y ~~ °r teaks, -rhe disPs round surface- ulatory g~'On~' wing of effluent on the ground surface- nding of effluent on the 9 ration of ti a tordl re9 lutne, the ~ D peg and ~ ~~ for any Po uires the immediate noti or more Df the tank vo ~. NR in the o r indreatie a taring condition ~4 ~ in any tank eRuals one-third (K? s~ of fn accordanOe "r'~' ground sutface a and scar a gervidng O~yor and disPo When the Combined emulation of moved by a Septa9 " and any of the tank shall be re meat ~ponents, Iner. enl3re ooW{~~~ pdtnirl~tive Code- P4WTS oomPonen~~ e ~~ pOWTS Heinle 113, mechanical or pressurized Brent. of efiueM ~ 12 months or less shall ~ ~ of ~mpietion of any slice The setvid~9 at intervals of autnor-tY within 10 days other malttUenana er monito ~ to the local re9ulatoly roduds or other A servl4e rePo~ shaft be t~ resence of painting P , ~ pp~NTS check vestment tank(s) for ~e P If high ~t0erltradons are START fJP ANO OPERaa-?70N a #te dlSP Celt(s). Fa c'ieN- ~nstrucbon, p~~ to use °~ ant Pis andlot dam39. rator Prior to use. ctterniceis m$y n"~e the treatm moved by a sep~9e servicing oPe dtatecxed have the tronte^ts of tt,e tanks? ~ ElAuent 1 sitar M PumP-Tank CapadtY _. pump TanK ~~ctttrer Pump ~~ Yre~~••..-~,~I p Med~d' nriii~r lon p pisinfec~on DLSPB~a..~ -- - - ~ q~~rade ~gravtty) ~gc Tank ~~~cer :tc.E cNFOw~-nofK ~ ~ ^ ~- pwnar> :_ / Effluent Filter Marw~~'nrr Page~ot~ ~,.-_,~ .• < Rat the to ~~~en P~ ~ ~~~ ~ cyCCE:55 ~i•~nditions 8~'h'o~ tesuit in the matt not ~r wt-et' ~ $~$ nottrai ti~gfiwater ieve p~f£ftoad'in9 the Outs} and may gyy-rem staff u? tQ ~ Pew °~t~s} in one Sat9e dose. of tt~e PAP ~k removed by a outages PAP ~~ tton have the ~n~~~ a PlumDec oc p'OYVTS Maintainer m Oufu+9 P~~ be dt~a~~ ~ To avoid ti'w S~ ~uent pump °C ~~~ ~ ep~ck,@r"g~s~eC~rthe normal tenets w'~''i" ~ Q~po ~ecwise distufb or comp~t, sets seta ~ t#>e PuRtP .- ~, Do not drtvs or pa . open tend dtsi~ trade sa'! absctF~ott area. and prolong the fife '~ ~~ over of any mound or at-q Im rove the perforrrtartoe f3o ~ dove orp5a foetvst°~ t~nom ~ yyater stream ~Y ~ P dental floss; diaper aye area wtt~ of the totbr+rint3 d~roesers; ited~n or-eCuninat5on dgatefte butts; condoms; Dolton sv~ f~9~ S~t~e~ 9~~~. herbicides; meat •baby~P~ itvit and ve9etabte Pe ns; softener brine. of the PO ~ dt~ {~ ~P ~~des sanitary naFk,ns; tacnt~o and v~ d~~on8; oi>; ~~ g f? shall lye taken ~ lnsur~e tfiSt the fps: pgANQONMM~T fatten out of service me touowi ~~consin Aaministrathre Codes When the PO1~S tFatle andlot is Pe~~'~ <fance Mrith ch. Comm 83.33 Wings Seated. artd safatY ~doned ~ Dom ceded and the abandoned Pipe oPe e gervicing Operator. system ~ Pro~M ifs shaA -be ~~° and properly disposed of by s SeP~9 Att pfptn9 ~ ~~ and F ~ shall be temoved and the void space .. tt,e eonf8nts of at[~ and p~ shalt Gee exeava~ and removed or their covers rem+>~~ After pumping, ~ ~~ yv[{tt soil, gravel or anotiaer inert solid material. e a !code Or. must be taken, iO p~ CONTtNGENiCY P1J4N following measures have bee . If the pp1MTS fails and cannot fDe t>apa~ ~$ ~ utilized for the Location of a reptacemu't soil ppmpGant teP~C°ment ~~ hay been evaluated and +'naY from dwturban~ and comPa~On and should not trlea'tt'arr:e ent area should tie protected I tines and wells. Failure to 0 a Sin The replacern sed structure. of wined ~~~ from e~aslyn9 and proPo evaluation to establish a suitable be infringed upon by ~ ~-u npsutt in the need for a new sot( and site' at mat time. . toted the ~plaeement area ms must comply w'ti'' the rules in effect n adv~ces°'in POWTS Qpiaaement area- Reptaoament sys~ ~ ~ is not avaifa~bl asue to ~~~ and/or soil lirnttabons. cement area a fast resort to reP~~ the failed POWi'S• p q suitable . P a reply ent a logy a holding tank may be a Su- nt area is available a, entify en area_ If no reP~n'e r of been ev_ at suitable re tac8 y e s tO lace the fatted POWrS. . s' I lion ust tae s resort to rep ,n lace fo[ta!^~~9 n:moval of the Dlomat at- j 1 ems may be reoonstnicted I pvtti'~ 1fie N(es in ailed at that time. ound and at-Drade soQ abaorPtiOn f such system's must comp Y ! the tt~ sut#aoe. Raoonsw~On A1N LtTWAL ASSES AhtD10R INSUFFICIFJ~T OX1rGEN. «WpRNlN© - TMEAi'C TANK UNOt:.R APdY CIRCUMSTANCES. DEATH MAY SEPTIC, PUMP AND OTHER TRF.~-` ER TFtE~- ON FROM THE 1NTERiOR OF A TANK MAY t3E DtFF1CULT DR tMPOSSi6 00 NOT ENTER A St:PTiC, PUMP OR CTM RESULT..RESCUE OF A PERS ApOtTIONAL COMMENTS POVIf'l'5 INSTALLER Name ,s ~~- POWi'S MAiNTAtA[ER Name ,G:~- ~ , Phflne ~~.~'~ Phone ~/.i ~' Z ~'~ MPER LOCAL REGULA70EtY AUTHORITY SEPTAGE SERYlCtHf3 OPERATOR "'"" Agency ~ • ~~~ Name ~~^-' Phone ~l~ ~:; ~'~ ~ ~ . Phone ~/J ~~ ~ ~'~ This dorxrment meals uotte and Wausftsra County Zontn9 and Sane ~~ men! does not t~ syfb ot` the Gn+l~ Lane. Marcl Cede. Ilse of thle door Thts aoattnont was drsttOd by t and 83.Sfi(t }, (2) ~ (37. yrsapnsin Admtnls~d+fQ G~ (11pt1 Ylf'ORlYnts of e+- cornrn g~.22~(bH Hd?~ ~~ ~~ ~ guarantee Ihs performance of the ppVYTS. - ',. 3~f129~ ~ ~ ', 4 ~~ F~~.~© MAY 2 ~ 1977: ~ INL7li o' G•:Mi~_~L ~. c..«.:...~y, ~. tirrsr,~:i~n I, Arthur L. Wegerer, registered land surveyor, hereby certifq: That in full compliance with the provisions of Chapter 236.34 of the Wisconsin Statutes and the provisions of the St.Croix County Subdivision Ordinance and under the direction of John E. Foster, owner of said land, that such plat correctly represents all exterior boundaries and the subdivision of the land surveyed; and that this land is located in the NWT of the NEB of Section 1$, T 29 N, R 17 W, Town of Hammr~nd, St. Croix County, Wisconsin, to-wit: CERTIFIED SURVEY MAP Commencing at the North ~ corner of Section 1$; thence S $9°32+25" ~- along the Section line a distance of 264.00+ to the point of beginning; thence continuing S $9°32+25n E 1056.00+; thence S 0°06+30tt W 250.00+; thence ~d $9°32+25" W 1056.r~0+; thence N 0°06+3on E 250.00+ to the point of beginning. Contains 6.060 acres of land subject to .Town Road right-of-way over the Northerly 33+ thereof. Dated this- l()th. day of March, 1977. Arthur L. We erer Wis. R.L.S. No. S-963 Dittloff Engineering Co. River Falls, WI. 54022 APPROVAI, OF THIS MIN©R suapn~PROVED ~ ARTHUR L. DOES NOT Melly APPROVAL ~ ~ WEGERER •~ ' SYSTEM. REFER TC~ 2 POR SE~'T!C Z 5-963 MAY 18 1977 c ~ ELLSWORTH :, \'., wls. .: ST. CROlX COUNTY !I. SAND ZCMNGpGOMJWTTEENING ,,,•~i~~~`7/~O'S'~••• VE~O~,,,,,,,, PK NAIL SET AT N I/4 CORNER OF SEC. 18, T 29 N, R 17 W ~ ....264. u O O 0 O PK NAIL SET AT N E CORNER OF SEC. I8, T 29 N, R 17 W AO......... .. .~ 3300 .33.00 O,3 ,~, 0 o~~s264.00` 0 264.00 0 264.00 0 26400~2~ o .O O ~ t~ 1.515 AC. 1.515 AC. ~ 1.5 5 AC. ti 1.515 A~. ~ N ~ N - cv N 90 N 9 2\ 264.Ca0~ 264.00 264.00 ~ 264.00~~"' ~N 89°32` 25'° 1056.00` ~ SCALE ~ I'~ = 200