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HomeMy WebLinkAbout018-1087-78-000 - Wisconsin Delp Count artm* of Commerce PRIVATE SEWAGE SYSTEM St. Croix Safety and Building Division , INSPECTION REPORT Sanitary Permit No: 453095 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Pl Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. - (TV W % �Ies�'., 6.* Permit Holder's Name: City Village X Township Parcel Tax No: M.W. Johnson Construction I Hammond Township 018 - 1087 -78 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: pp 1 GAD • 0 ' .�_ = c-ST I8 1 1 20.29.17.698 TANK INFORMATION r ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark �- va& (QOa 0 .Z50 Dosing � � it Alt. BM I OT Aeration Bldg. Sewer 1 Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 2 5 + 9 cp / � i Dt Bottom S r Dosing k � tt y l� , Header /Man. 9� 3, l .4-17— , f Aeration Dist. Pipe 4 .lS Holding Bot. System 4 , Final Grade d PUMP /SIPHON INFORMATION L-P , x Manufacturer Demand St Cover GPM n; mqs 1 . 90 1 0b SS % Model Number �ol,(p�/ /-, 1 (_ 1. ift Friction Loss System Head , TDH Ft d I- L . o ra • Sa C Forcemain Length Dia. ril Dist. to Well CJ�'^^""`� 3 b !� J� t It 2 > o0 0. s , cri SOIL ABSORPTION SYSTEM 10A �.&V Width I Length ( I PITDI NSIONS No. O Pits Inside Dia. Liquid Depth DIMENSIONS 69 SETBACK SYSTEM TO P/L B WELL LAKE /STREAM LEACHIN anufacturer. INFORMATION Type Of System: CHAMB R _� 'N['(x) r �� % ,a .`�• IT Mode DISTRIBUTION SYSTEM l y,t Header /Manifold I y Distribution r � x Hole Size x Hole Spacing Vent to Air Intake Length 3 . 0 Dia `Z Length 31;! •� i ` 2 Spacing 3 ' D I (g 2 40 SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over jxx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil li Yes ] No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:! 30 ! 0 Inspection #2: 01 / Location: 1648 86th Avenue Hammond WI 54015 SE 1/4 NW 1/4 20 T29N R17W ond Hamm Oaks s Add of 78 Parcel No: 90.0 .17.698 1.) Alt BM Description = 0 .T, , 2.) Bldg sewer length = 9 , amount of cover = `rZ 4- / Plan revision Required? Yes > O/ i n Use other side for additional information. SBD -6710 (R.3/97) Date sepctor's Signature Cert. No. 6 Safety and uildir�l - county AV 201 W. Washin n Ave., V mo Madison, 1 53707— 7082 sn Sa nary Permit Number (to a filled in by Co.) Department of Commerce ( 26i7,�M D �- ' Sanitary Permit Application s rt lan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal info ation T ovtdn C r ` Ito �� % trafts. /jt .4 may be used for secondary purposes Privacy Law, C �r � � �, ect Address (if different than mailing ad ess) I. Application Information - Please Print All Information �( ��' �o — Av C. .. Prop e t Ownees Name Parcel # , 6 Lot Block # Property Owner' fling Address p t ropetty Location 5 /ov V., y., Section o�t9 city, State Zip Code Phone Number la r ss�y - SZO 8 /.�(cr W II. Type of Building (check all that apply) 1t� N; R % Subdivision Nam r ❑ 1 or 2 Family Dwelling - Number of Bedrooms s r ❑ Public/Commercial - Des cri se �� j ❑ State Owned I escriI Us K � ❑ �j ity ❑Villa ownship o I _� Dft n jl r�j� � r III. Type of Permit: (Check only unc uu.„a line A. omplete line 11 if applicable) A ' XN.. System y ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modif ation to Existing System B • ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑Permit Transfer to New List Previous Permit Number and Date issued Before Expiration Plumber Owner IV.Type of POWTS System: (Clieck all that appl ❑ Non - Pressurized In -Ground A ound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filte ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treat ent Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Rtequired (sf) Dispersal Area Proposed (sf J ystem Elevation 5� /, © y� `M$ 0 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units t„ � ,4. MoD Concrete Constructed Glass New Existing Tanks Tanks eplic HoldingTua ®00 4LO0 Aerobic Treatment Unit smgChntn OQ VII. Responsibility Statement 1, the undersigned, assume responsibility for inst the POWTS shown on the attached plans. Plumber's Name (Print) Plu 's Signature bur Business Phone Number a - z2 /y / 71j� Plumber's Address (Street, City, State, Zip Code) VIII. County/ e artment Use Onl ,KApproved ❑ Disapproved Sanitary Permit Fee (i ludes Groundwater Date Issued I suit Agent Signatur No Stamps) Surcharge Fee) ? e {��___ ❑ Owner Given Reason for Denial J J v aCw IX. Condition pprova SYSTEM 3) At( )S -.I 1 Septic tank, effluent filter and Cow �� % t t�tr�� 1 dispersal cell must all W erviged / maintained as per management plan provided by plumber. �,-CQD t k 2. All setback requirements must be maintained as per applicable code /ordinances. 60- )oc- Attack eamplete plans (to the County only) for the a ste In she I SBD -6398 (R. 08/02) / POW-NR i : r , ZIDT fig! emit 0 1.3 INS + /► Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 '\Ifisconsin www.commerce.state.wi.us /sb Department of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary March 17, 2004 CUST ID No.221471 ATTN. POWTS Inspector DENNIS J GILLE ZONING OFFICE GILLS TRUCKING & EXCAVATING, INC. ST CROIX COUNTY SPIA 352 140TH ST 1101 CARMICHAEL RD AMERY Wl 54001 -2840 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/17/2006 Identification Numbers Transaction ID No. 976820 SITE: Site ID No. 671643 Troy Broker Please refer to both identification numbers, Town of Hammond above, in all correspondence with the agency. St Croix County SEI /4, NWI /4, S20, T29N, R17W Lot: 78, Subdivision: Hammond Oaks FOR: Description: Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 946280 Maintenance required; 450 GPD Flow rate; 26 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST (0 1/8 1) 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. Coll No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, APP stats. The following conditions shall be met during construction or installation and prior to occupancy or use: DEP R OF General Approval Requirements: SEE COR • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD - 10691 -P (N.01 /01) and the SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST (01/81) • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil S compaction, excavation vehicular traffic and other similar activities that impact the treatment and dispersal P , P P are prohibited. • The off setting (D) is proposed to be at six inches from the bottom of the tank. The pump pad, along with the legs of the pump, may leave the impellers out of the liquid effluent before the pump "off' setting is reached. This should be checked at time of construction to insure this condition is not encountered. This setting maybe adjusted, with the inches coming from the reserve capacity area. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c DENNIS J GILLE Page 2 3/17/04 • 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. Stat • Comm 83.22(7) A copy of the approved plans specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department which may include local inspectors Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /instal lation/operation. 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, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbratz@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, 715 P ( ) 726 -2544 MOUND AND PRESSURE DISTRIBUTION COMPONENT DE2 o INDEX AND TITLE PAGE O�V V oy Project Name: TROY BROKER Owner's Name: TROY BROKER Owner's Address: 1648 86TH. AVE. HAMMOND WI. Legal Description: SE NW S 20 T 29 NR 17 W Township: HAMMOND County: ST. CROIX Subdivision Name: HAMMOND OAKS Lot Number: 78 Block Number: Parcel I.D. Number: Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Purnp c ry and specifications Y A CQMMERC6 g 9-/0 In / � /4h So, ( �PS Designer: DENNIS GILLE License Number: 221471 Date: 03/07/04 Phone Number: 715 - 268 -6637 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 3.11 (R. 06/01) Page 1 of 7 03/16/2004 19:35 7152687080 GILLE TRUCKING PAGE 02/03 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) r. Residential or Commercial Design Note; Sand fill (D) ca1culatione assume a 300.00 Estimated Wastewater Flow (gpd) Table 83 in - situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 ^ 150 0,6) conform of <- 36 inches. 450.00 Design Flow (gpd) 4.00 Site Slope ( %) 97.20 Contour Line Elevation (ft) 26.00 Depth to Limiting Factor (in) 0.50 In-situ Soil Application Rate (gpd/ft Distribution Cell Information 75.00 Dispersal Cell Length Along Contour (ft) 6,00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest Doint Pressure Disrlbution Information in the distribution Y c ore network? Enter Y or N ( ) C Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation ft 4 Number of Laterals of the highest point. . 0.125 Orifice Diameter (in) (e.g. 0.25) 2.00 ft Ma a e Orifice Spacing (ft) 6.25 ft /orlfrce 2.00 Forcemain Diameter (in) 125.00 Forcemain Length (ft) Does the Forcemain drain back? 85.00 Pump 'rank Elevation (ft) Y Enter Y or N 6.50 System Head (ft) x 1.3 20.39 Forcemain Drainback (gal) 13.03 Vertical Lift (ft) 67.44 5x Void Volume (gal) 2.37 Friction Loss (ft) 87.83 Minimum Dose Volume (gal) 21.91 Total Dynamic Head (ft) 29.66 System Demand (gpm) Late aDiameter Selection Manifold Diameter Selection in. die. o (ions choice in_ die. T options choice 0.75 1.25 X 1.00 x L 1.50 x X 1.25 x 2.00 1.50 x x 3.00 2.00 x 3.00 x Treatment Tank Information GaRons/lnch Calculator (optional) ) 1000.00 Se tic Tank Capacity (gal) p y (gal) HUFFCUTT 41. 7'�� n�: 00 Total W Total Tank Capacity Liquid Depth (in) Manufacturer gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information yju.r;)U Dose Tank Capacity (gal) Zabel Dose Tank Volume (gallin) A10Q Filter Manufacturer HUFFCUTT Manufacturer Filter Model Number project: TROY BROKER Page 2 of 7 Mound Plan View - - -- - -- T 1/106 ........ 8 J . Observation Pipe 3 ' K. W — '—' B . . . . . I L Mound Component Dimensions A 6.00 ft E 12.88 in H 1.00 ft K A19.75 ft B 75.00 ft F 9.50 in 1 8.06 ft L ft D 10.00 in G 0.50 ft J 5.69 ft W ft 450.00 (ft Dispersal Cell Area 1 1054.69 (ft) Basal Area Available 6.00 (gpd /ft) Linear Loading Rate 1 7.50 (ft) 1/10 B Obs, Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finishefq "lade 99.83 (ft) --► ,� .ffffffffff 2 ffffff {i•. G 1 F Dispersal Cell 98.53 (ft) Lateral 98.0 d(ft) —0 — Invert Dispersal Cell 3 a Elevation E D . . .... . . . . . . .... 97.20 (ft) Contour Elevation 4.0 % Site Slope Geotextile Fabric Cover Shading Key d FL � Dispersal Cell See lateral details on 1❑ _ Topsoil Cap c M 1.5 ft Page 4 for number, size, } }f,f 0 5 �:•i� and spacing of laterals. Subsoil Cap ASTM C33 Sand `-° `° .'' f Laterals are equally :6 :cr:' F ® Tilled Layer c °� 0.5 ft 'ti Typical Lateral :;•r;•; spaced from the ❑ .o �•� ; "s��: : distribution cells 5 }'r A `° c °s� 'rj; �ro centerline in the �--- -- A distribution cell (AxB). Project: TROY BROKER Page 3 of 7 03/16/2004 19:35 7152687080 GILLE TRUCKING PAGE 03/03 en C __ Ac LatWl Lqgou d' ram For*! mai n oonneatfon via tee or cross to manifold at any point Laterals are identlo al P S • =Turn- upvdbsllvsjvsor 'max— yjEHf2 xt2 �� atsttnautpfup Laterals & force main of PVC Sch 40 par GOMM Table 84.30.6 Hales drfNed On the bottom of the lateral. Number of Laterals 4 Orifice Diameter r 4r'n in Lateral Diameter 1.50 in Orifice Spacing (X) ft Lateral Length (P) 36,75 ft Orifices per Lateral Lateral Spacing (S) 3.00 ft Orifice Density fe /orifice Lateral Flow Rate 7.41 gpm Manifold Length ft System Flow Rate 29,66 gpm Manifold Diameter .in Total Dynamic Head 21.91 ft Forcemain Velocity 3.p3 ft/sec Dose Tank Information Locking cover with warning label and locking device and Electrical as per NEC 300 and - ---(1► sealed watertight Comm 16.28 WAG 4 In, min. Disconnect Tank component is properly vented F -- Alternate outlet location HUFFCUTT Forcemain diameter Manufacturer 2 in. Ca acit 77? ) , Gallons — � Volume , 73 ;: gal /inch A Dimension Inches Gallons Weep hale or anti - A i siphon device 2,00 9 C �7 P off elevati ft C :�.1 r'c on �– 85.50 f 6.p0 D Total 41.99 � - '�`�?.00! 'ox Dose SEE CORRESPONDENCE 3 "Bedding un er tank. tank elevation ft es.00 Alarm Manuafacturer [LEVEL ALARM Alarm Model Number DVL Pump Manufacturer ZOELLER Pump Model Number 140 Pump Must Deliver 29.66 Pm at E=ft TDH Project: TROY BROKER Page 4 of 7 ~ r TOTAL DYNAMIC HEAD /FLOW LL PUMP PERFORMANCE CURVE PER MINUTE I MODEL 140/4140 EFFLUENT AND DEWATERING 55 1s MODEL 14014140 3 7/8 6 5/16 50 Feet Meters Gal. Liters 4 5/a 5 1.5 86 326 LES 14- 45 10 3.1 80 303 15 4.6 73 276 0 3 29/32 i2 40 20 6.1 66 250 * —1 25 7.6 59 223 ° o 140,4140 35 30 9.1 49 185 1 1/2 NP 9 - 11 ,/2 T = tp • 35 10.7 38 144 30 • 40 12.2 28 106 Z 45 13.7 17 64 8 25 Shut -off Head: 50 ft.( 5.2m) of 0109408 zu 6 iz 13/3z 15 4 4 s /3z 10 SK1524A 2 5 0 10 20 0 40 50 60 70 80 90 • • ' a - GALLONS LITERS 0 00 160 240 320 FLOW PER MINUTE 010940A ��• 3 713 6 5/16 CONSULT FACTORY F SPECIAL APPLICATIONS ♦5/6 29/72 • Electrical alternators, for duplex systems, are available and supplied with an ° alarm. ° • Mechanical alternators, for duplex systems, are available with or without 1, 1/2 N PT alarms. • Control alarm systems are available for 1 phase pumps used in simplex system. See F100732. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level 16 1/6 long cycle controls. • Sealed Qwik -Box available for outdoor installations. See FM1420. —� • Refer to FM0806 for applications above 130° F (54° C). 5 -1 SK1524B SELECTION GUIDE 14014140 MODELS Control Selection 1. For automatic use single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0477. Model Model Volts -Ph Mode Amps Simplex Duplex 2. See FM1228 for correct model of simplex control panel. N140 N4140 115 1 Non 12.0 1 or 2 3 3. See FM0712 for correct model of duplex control panel. E140 E4140 230 1 Non 6.0 1 or 2 3 O CAUTION BN140 BN4140 115 1 Non 12.0 ' - -- All insta llation of cor protection devices and wiring should be done by a qualified BE140 BE4140 1 230 1 Non 6,0 ' r_ licensed electrician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). *Single piggyback switch included. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL T0: P.O. BOX 16347 Louisville KY 40256 -0347 Manufacturers of. . SHIP TO: 3649 Cane Run Road Z Louisville, KY 40211.1961 Qvaurr PYA,1 -9 ,S,vcf /9,99 //w ,/p �O (502) 77 8 - 2 7 31 FAX(502J 7403624 PUMP http: / /www.zoeller.com ff "A 0 Copyright 2003 Zoeller Co. All rights reserved. • NX E CL/0- sP /; i 1 or ] Ion : f • V ... vyisconsin epartmentofCommerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings in accord with Comm 83.05, W is. Adm. Code Gustum Septic Service Attach complete site plan on paper not less than 8Y x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix percent slope, scale or dimernsions, north arrow, and I istanoe to nearest road. } Parcell.D.# APPLICANT INFORMATION - p/ea i alt in or '6067 R ed BY D e Personal information you provide maybe used for ty purposhp (Privacy taw, S b5.04 (1) (m)). (-,-C) Property Owner ; , _ :_: . Pr erty Location Humbird Land Co oration Govt Lot n/a SE 1/4 NW 1/4 S 20 T 29 N,R 17 W Property Owners Mailing Address p ` " Lot Block # q � - -- Subd. Name or CSM# �-r 332 Minnesota Stree E ast 140 Block Hammond Oaks 2W Addition City State Zi r Code PhonOW#ibir: City ❑Village MTown Nearest Road Saint Paul MN 5 Ol 652 =S r Hammond 160Th Street ❑ New Construction Use: ❑ Residential / NWmbe rA ms 3 ❑Addition to existing building ❑ Replacement ❑ Public or coin escribe Code Derived daily flow 450 gpd Recommended design loading rate .5 bed, gpd/W .6 trench, gpolft Absorption area required 900 bed, ft 750 trench, ft Maximum design loading rate .5 bed, gpdr .6 trench, gpd/ tz Recommended infiltration surface elevation(s) along 97.2' contour ft (as referred to site plan benchmark) Additional design / site considerations BM 2 = 97.5' Parent material ground moraines Flood plaii n elevation, if applicable n/a ft S- for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U= Unsuitable for system ❑ S M U ® S❑ u C S ®u ❑ S ®U ❑ S ®U ❑ S M u SOIL DESCRIPTION REPORT CsAL A* ki & ,, f:6k. Horizon Depth Dominant Color Mottles T Structure Consisten Bounda Roots GPD/ftz Borin Texture ry g# in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 1 0 -9 10yr3 /2 no sil 2msbk mvfr as lf,im 0.5 0.6 ip 2 9 -12 10yr4 /4 none gr. sil 2msbk mvfr cW if 0.5 0.6 Ground 3 12 -17 7.5yr4/ none gr. sit 2msbk mfr cW - 0.5 0.6 elev -- ___ -- 97.5' ft 4 17 -27 7 .5yr4/6 none gr. sl 2msbk mfr c - 0.5 0.6 k Depth to 5 27 -34 7.5 r4/6 1. c2 -3d 10 /2 De - - _ p y 7.5 /g gr. sl 2msbk mfr 0.5 0.6 limiting factor 27" Remarks: 1. Bands of 7.Syr4/4 sl. Z 1 0 -7 10yr3 /2 none sit 2msbk - mvfr as l f, l m 0.5 0.6 2 7 -11 7.5yr4/4 none gr. sit 2msbk mvfr cW if 0.5 0.6 elev 3 11 -16 7.5yr4/6 none gr. sil 2msbk mfr cW - 0.5 0.6 96.3' ft 4 16 -26 7.5yr4/6 none gr. sl 2msbk mvfr cW - 0.5 0.6 Depth to 5 26 -35 7.5yr4/6 1. c2 51 10 /2 gr. sl 2msbk mfi - - 0.5 0.6 limiting - -- -- factor Remarks: 1. Bands of 7.5yr4/4 sl. CST Name (Please Print) Signature: Telephone No. Tom Gustum 715 -658 -1344 Address Gustum Septic Service Date CST Number Ref# N13450 937th St., New Auburn, W1 54757 2/29/00 227618 1173 PROPERTY OWNER' Humbird Land Corporation SOIL DESCRIPTION REPORT + 173 Page of 3� PARCEL LD.# Gustum Septic Service Horizon �� Dominant Color Mottles Structure GPM in. Munsell (,�. , Coat Cow Texture c � sistence Boundary Roots Bed ; Trench 3 1 0 -9 10yr3 /2 none sil 2msbk mvfr as lf,lm .5 j .6 -_ 0 0.6 2 9 -13 7.5yr4/4 nonet- gr. sil 2msbk mvfr cw if 0.5 0.6 Ground - - -- - - - - -- -- - - _ elev 3 13 -18 7.5yr4/6 none gr. A 2msbk mfr cw - 0.5 0. 6 97.5' ft 4 18 -29 7.5yr4/6 none gr. sl 2msbk mvfr cw - 0.5 0.6 Depth to 5 29 -37 7.5 4/6 1, a2-3d 10yr7/2 limiting Yr 7.5yr5/8 gr. sl 2msbk mfi - - 0.5 0.6 - factor 29' Remarks. 1. Bands of 7.5yr4/4 s Ground -- - - -- - - -- - -- elev Depth to - -- limiting factor - -- - -- - -- - Remarks: Ground -- elev Depth to limiting factor Remarks: Ground — - elev Depth to limiting factor _ - - - -- - - - -- -- -- - - - -- Remarks: P �# � C.4 7 8 Ll 20 S)6p� c m;L 7 l q� . Cu ur Z -e in r(X ,9M l = EL /0o.cD 7�P Gee" Si p( I( F-L 77 J x Sol i3o rl" VN a/)&c k Js t �u m m 6 J 00, ks 4/4*� Ate; 6; a;�7 fc�, I, /® yo S45 NO Sec ,2 Tag tJ R1 w 7owrn of earn n -mm,rl �f• C fo,�� �a�c ?o F 3 r r ST CROIX eC OUNff SF,PTIC ';'ANK NMINTINANCE AGREEMENT Al °11) OWf ERSHIP CERTIFICATION ICATION FORM owner /Buyer .� ��_.�✓ v _ ..�.__.._�.__._ . - - _ Mailing Address _ _._ / Property Address. - (Ve3ritic,atturt rcquired frou t Planning Dopartnent for new constructior,)� City /State * _ Parcel Identification Number 0 /8 / ©9 7-- L EGAL DES CRIPTION Property Location. 5r_ VA, Si c. 20 Te? --I N ft_.,/...Z.W, Town of Subdivision –� C a /'�S . , Lot 9 Certified Survey Map # Volume_.. P # - - -- Warranty Deed # -- ' - �7 i �_ , Vulunte� �/ Page # Spec house 0 yes �f no Lot limes identifiable U yes ❑ no SY51`E M MAMENAN Improper use and maiutenanceaf your sal pc system could result in its premature failure to Dandle was t e s. Pr+7pCrzrwi•raa3nCr consists of putnping out the septic tank every tbi( a yeAn or sooner, if tieeAdby a licensed pumper. What you rut into the system can affect t;ae function of the u,Ttie tank as a tra3 �neut stage it flit: w aste disposal system. The property riwner of rees to submit to St, Croix Zoning Department a etittifloaticwn form, signed by the owner and by a masterplurtiher, jvtrrt7eyr]�atl pltimber, restrictedpl.' ixriber Ora licanA9 4uuiper verifying that (1) the ou -aite wsatewaterdisposal system is in proper operatb)g coudi.tion and/or (2) after in, ! ection a.0d pump h4 (if neeassary), the sel ?tic MA is less than 1i3 full of slticfge. 1/We, the urtdersigoed have read the above requirri i! ftnts and area to ari,aintain the private sewage disposal aysterri with tha standards Set forth hcx'ein, as set by the Depa rtineat O f Cot '"-MP, And the Departttmoat o Natural ReGot kUA, Stato Of Wisaousk. CE:i'[i tiCatibn swing that yours 'e 3ysteni Iias been maintainer { MIA br, cample�;ed and ratlrrned to the St. C f x Ceuaty Zoning Of�'iti! w ithin 30 d1'QANA'r-TNAT he three 'i expiration date tJR] Ci F APP1.1G DATE O 4 ER C F r CAT1 ON I ('eve) cez that all state ants o a srrax are erns d best of my (our) knowledge. I (we) am (are) the owner(s) of th - operty des i d above, Ley i u • a a wa a ity decd race rd in Register of Deeds O9't:ice. 5 GNA P A.PPLI l' DATE 1? Aay information that is rims- represetacd a ity result in the sanitary permit boing revol-.�ed by the 7oniiog Departs e *" Include with tws application- a stamped wane My deed from Vie Register of Dee& office a copy of the a rtified survey imp if reference is ,trade re the wan - maty deed RIVER VALLEY ABSTRACT Fax:715 -386 -7664 Mar 29 2004 11:58 P.02 STATE PAR OF WISCONSIN 2. 1998 SATdLM N. YAM WARRANTY DEED 06I8M OF DUN Oactimeei N�mtbcr im MMx Co., V1 XRQEI This Deed, made between Merlfm Lend, LLC, a 111bM"acta )Umited M FOR F&CM Liablltty Co mpa" 12/22I2M IMAAMIi rARRAitrr MM Einar e Cato; and KW. Johuaoa Construction, lac — — 61E1C Pa 11.00 -- �M pal 143. -_ CC FEE; Grantee. FAtt : 1 Grantor, for a valuable consideration, conveys and aairants to Grantee the following described reRI agitate in St, Crvfx Coanty State of Wiscoasitl; WAM %Ad Retain ,At*M _ ....... I.pt 7 Hammond Oaka ]st Addztron SabdMsioo,Town afHara fond, St. Cotmlp, ttaito 016-1087- -76-000 • _ ParcalIdamdtiedloctv�mab•riFa� . This is= homestead property: (is) (is act) )3acaptiens to w=ines: Sttbiect to tastes, eRSetueata,resmltldons cot^enetus and tights ofway o.f Mw d, if at w, including bat not iintided to those for drainap,water mtlrati MP0*.thw,and or utilitiles as xasy be shown ou the pl a o1; Haucand Oaks let Addition Snbdrvision recorded la VoL S of Plats, OW 25, 5t. Crola Couety, W390080W.T11e W= 16M of tbia deed, cWmr wwsoed or implied are limited by the p¢ar m the grmge% or am= in die cbab of tMe, to an a mu* not to exceed. the cotwideiatilon expressed lkrein, tbat being the aL6 of $47,900.04. Dated this 16th defy of tieoe"er 2003 Metim L wod,LL+C by )Preaidmt V . i A. :. AvAkJ.laafoa AUTHENTICATION A.CX(NOWLBDGMSIV•t' STATE Or MSCO4 &N 3i gaatare(e) 1ttittatly C ) Personally came befo me ttvTe X5th day of Rinbcaticoted this day of December , 2003 the above aemed Austin L BzMan _ TrME; MEMBER STATE BAR OF W130CiL MN to me known to bo the yereon(e) who executed the faMoiag Clf uctr usat ==t and acknowledge th too. - 0mrr+.cdby ¢ 706.06. Wis. Stets,) . TWO USTUMCWT WAO DMMP AY pUt. A. BAILtphi, Paul A. ImMon, Attorney at Law " Taal A. Adllom No" liAblix. State of (Sigoatetze mag be anthetxtieuad our aakuowlvdged. Hoch ere acs • MY Commissica is perrpaaent. eeeeseety.) , Jaanara 31 2005 •xxnn of,pRrsew nipping I» ew capecit kould be typed or priwrA braew their sigak WARIGIMTv DIRa STATI UR Or Wrlcorww" POW P. x - e99r L�"FC.RMA'rlOtrPBAAAARIONA�a cot,�A7ax tro�ao mr [:aa. wi 7oa.�S•xxt S89- 45'08'W 624.17' EXTENSION Of K'JAU1 w 87 AV E_ . _ _ 1 9 4 ' S89'45'08'W 624.14' - - - - -� - - - 3781`1' _ 227.38' -- 396.76' )R — 18.5 \' — — OT 7� - — AE G &tA E� MEN T J ( 0 s, 1,57 Acres HIGH WATER . 68194 sq. ft ^' J s ELEVATION 1079.00 4 \ 152.58' 95.16' ` D - N88'23't6'E 247.74 —�? 5 R• tat �8s.07. 420 .14 - r S o °cv' / s's.\ � \'s• 152.62' m — — - �' I f \. z 0 LOT 77 ,� ��� \�' NOTES: 1 2.33 Acres ;+' . :,z o --4 I C 101317 sq. ft n 30' DRAINAGE \ N Z ALL BUILDIN( o EA - / \ WITH DRAINF ,N \ LA FINISHED FL( 0 1 78 \�,�� l D THAN TWO(2 I o i \ S88'55'02'E Z ^ o fp / `Si \ \ \ 57.71' 1.92 Acres m 83873 sq. ft S88'55 "E N r LOT 79 69.73' v ( Z 2.68 Acres a? -n 116775 sq. ft N 6.61'' n tD'S6'19 "W �� rn + N _ 90 8 1.111 / 0 N o It ©4 t I S72 y 6 's2 lt9 7. 11 ' � 4 \_-- / • Sc )T 81 �--- -� 0 9 Acres 6 sq. f t LOT 80 BEARINGS RE NW 1/4 OF `. 2.95 Acres WEST, WHICH 128412 sq. ft v i 2585:96' S 89' 554.37' 12.25' ^ Cn