Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
018-1045-90-000
Wisconsin Department of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Guise, Steve & Jud Hammond, Town of CST BM Elev: w Insp. BM Elev: BM Desc ~ ti n: - 3 TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic 2 ~ / Dosing ~ /~'_ ,_ ~Q~ /~ ~'~ Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ ~ /' ~~ .~/ Dosing mlvll Aeration ~- ~ Holding PUMP/SIPHON INFORMATION ~'~Y~ Manufacturer Demand GPM Model Number TDH Lift Friction Loss yste d TDH Ft Forcemain Dia. Dist. to Well ~ ELEVATION DATA county: St. Croix Sanitary Permit No: 514920 0 State Plan ID No: Parcel Tax No: 018-1045-90-000 Section/Town/Range/Map No: 21.29.17.321 D STATION BS HI FS ELEV. Benchmark ~3 ~ . 5 ~~ ~~ ~.~ Alt. BM ~ S,' O~g /~ a• 9 Bldg. Sewer 2 J~ • ~j SUHt Inlet ~ f J • •a i7 Cf ~~~ ~• ~. S Ht Outlet Sc~- ~- ~ ~ /a ~ S L 9G- z Dt Inlet ~ ~' Dt Bottom ..~. Header/Man. ~ / Dist. Pipe ~ Yt'~o / / ./ (! /~ S- -~ 7 Bot. System D~/ ~ .,S y_ ~. Final Grade St Cover / ti~ 6, ~ D . SOIL ABSORPTION SYSTEM //) ~ e~./~o~t„/ /,vr~d BED/TRENCH Width ~ Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS V v / SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM ACH Mar~stur }f ~ INFORMATION HAMBER ~ V _Jy Ty f System: ~ ,~ f/ ~ ~ UNI7 Model Nun}~:~._/ " j / C~' Y DISTRIBUTION SYSTEM ~ - Header/Mani~ld Length 13ia Distribution Pipe(s) 7 ~ Length Dia Spacing x Hole Size .~-- x Hole Spacing .~~ Vent to Air Intak Zh~ ~( SOIL G6VER x Pressure Systems Only xx 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 ~ Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/ /Z / ~f Inspection #2: / /. Location: 1785 Hwy 12 H~mgnd, W{ 54015 (NEt1/4 NE 114 21 T29N R17W) NA Lot 1 `%/ ,~ Q/G _ /~/, 1.) Alt BM Description = ~ ,S 1~ 6LlOh~~ /~~~//~,~ / -Tv(~(/tOh(• 1, G Or 2.) Bldg sewer length = ?)~ ) l /~ -amount of cover = ~-/ ` n ~" ~'JI 1~.7 ~ ~ t ~, //~ ~~~ I'11~,~(~Pi>~~-JGtE _~ ` ~ ---- . ___ _ -__ - _ _ _ __ ~I~G r~ Plan revision Required ^ Yes ,~No I ~ arc 1 No: 21.29.17.321D ,~ ~~~~~ . ~, s1Y ~x .b~ Use other side for additional information. _/ i (__~_ ~(~' i __ GG~Z~Z~-_ __ _ ~ _ ~~ ~ _ - - SBD-6710 (R.3/97) Date Insepctor"s Sign ure -~ ~O t f Cert. No. 04/22/08 TiIS 0$:30 FAX 715 S86 4686 RECEIVED ~ ooi COIIq't101"t.O.ti11.~'V 24l W W _ A ~~~ ~ ~ ~~Q~ ~ ~ ~s'-rtVIX ~arts~~ i+M~co.) ~ OUNTY Sanitary Permit Application ~"` Tt'"aa°°a''''~`r ~ ~ SI ~ ~~ tiw>1l, s. Caame. 1321(2), Wis. Adm. Coda. s~dtomaistt aftt+s facto to units wgrirsd prior t4 ebtairrryl a ~Y p~ DI00t; APPS fOeeAt !'OVIrIS srs . Prgjeet Addrosa (if dd7anat dan mnlia8 sdd-+ess) wfenittad m the Oepaetmm+t of CaaraNee. Petaoeml ieStamatim you ~ ~~H is soardroce va0h dit Luw s. 15. ! s "~ 8 L - Please trit A11 ititorfa~adaa Rnepahr to /f _ ~ Propatq~ E)wner's Aiailiag Addnaie J ` ~Y ~0O C ~ ~ ?i I { /~ ~ r liilJ ~ 7 -, ~ Plaae Numbs ~/~ 5f ~ fir. SeclioA r~ f eita state ~{ t ~/ ~ ~~~ y , T Z~N: R I ~~orW >t th t l ) d 8 l ~# y t a a app tt~ (e te II. Type of ©t er2FaatifyDarolleay-Numberof8erkooms 83 b PubtirJCotneurcisl-ne.~beuaa SesLT 1Q,," 3 v eig+or ^ Sttae ovned - Describe t7ae Num O V'~saf 3S ~ 13 TownoP~F,,, ` ~~ lll. T ype oi1'ersait: (Cfeck Qtly t+re t+ex ea cote A. CospWe tine S if appfie ''~~ sysleta ©Replaeoannt System O Tir~neeMffio)dins Tank Only ^ OtlrsrModiRaRioa to fld~afR SY~ (~~~ S. O Pewit Reaawe) Before>a O Permit Rsvisiow O Cbaope of Mamba O PermiR Ttaeskr to Naw QMmer 6ict Ptavioas Petmit Noabx and Dae Isaad - lV. T afPOYYT3 aM that h. ~]4j~.olwirabie~ soH~ ~ +'~• fp''/ Naa-Prnts~simod6tO~ouad Q PrersaiaedbtGroaiM! O Mile ~ ~~ !~n Derv l O ~ TsNc ~ oa`sr Dispasat c«+parnt ( ! V. sasd/I'nao rtt~ Ana blantasda~ ! r Desiga Flow (~ Lkslpa Solt AppGeatioa itam(apdr[) DispaaY Amer Ra9Y~ (+~ ~ Aeea SyNaM Ebvsaiaa / , s-- r VL Taaic IaYo ~ tY ~ GWeas ll~fs ~ a t+.wra.ts Fiiwigraats ~t ~ $ ~ ~ Sspieor fioldis~ Tenlc VII. SEataassal L tie far iWaBatisr of the P'01Yf8 sreM'a sal file at+aeied ~a~s Nxee (PrSnt} ~w Sisramae MPANPRS Nuwber Plane Nrtdbr J ~ Waasber's Addnsr (Smeet. City State V L the O ~~ Penaa Foe ~ Dace ~ O owner aivea Reason far I1Qaial s ~ ~ U~ ~ GZ!a' ~,{~ .~-~~p~ppra+sntllttasaaaa br Dinpproval ~A C~d~ /Y10/~.C ~ ~[~~ G~Y~r/ ~ G~ Septic tank, effluent filter and ~ " dispersal cell must all be serviced /maintained ~~~O~Q. ~/ Q~ ~,~ ~,i~~~~~ ~~,~2~-`~ as per management plan provided by plumber. (~ _ ~" Alf setback requirements must be maintained '(~,~{~c,Uyt,o l~ii. 5~,~, CflLvyl, as qer i br~r~v.wa.e.aerMrtws.ce..ae~t~e•ww••tr~a..suasnir~~.~ .. , ~l (o a~'~Y},~1V ~o ah,Q vcti ~~~~~ UUK.i~J .~~ SBD-6398 (R. 01/4' Valid tM- 01/09 %~ •~-- f dr ' PLOT PLAN PROJECT Steve Guise ADDRESS 366 NE 1/ A NE 1145 21 /T 29 V!R 17 ~'V T! SYSTEM ELEVATION 95.0' 4'below grade CON~'ENTIOVAL XXX AT-GRADE MOUND SEPTIC TAVK SIZE 261 g111ons HOLDING TANK SIZE LOAD RATE .7 BENCHMARK V.R.P. Top Of 112" pipe ^ BOREHOLE O WELL ~ A.R.P. Same as Benchmark Hwy 12 Right of Way 2 Acres ~-MS ~.p ~~~,,~- ~'° , ~~ ,~ "~ 72 3Weeks ST i3 _ 3 99. S' r r------, ~ '~' o cam 6,.~~y- Pro Pole Shed/Office max 4 employees, 1 No catch basin, floor drain is for bathroom utility rao only! B-1 ^ ^ B-2 9 $. 5' 1% Slope ~B•M.* Calcs: 4 employees @ 13 gpd = 52 1 floor drain @ 25 gpd= 2S total gpd = 77 X 1.5 (peak flow)=1 16 gpd tank size = 116 X ~~~~ 2.D88 = 242 gallons, using a m weeks 261 gallon septic tank -1 gt use 8 chambers and 1 set of end caps cafe=l f 4" -- 10' Property Line St. River Falls Wi 54022 ammond J COUNTY ST. CRO1X ~~abY~ ~ p~ GI'D 116 L LIFT HOLDING TANK LIFT TANK SIZE DOSE TANK SIZE ABSORPTION AREA 165.5 ~ of chambers 8 ASSUME ELEVATION too Filter BFST GF10-8 7•d commerce.wi.gov i ^ isconsin Department of Commerce Safety and Buildings 3824 N CREEKSIDE LA HOLMEN WI 54636 TDD #: (608) 264-8777 www. co m me rce.wi. g ov/sb/ www.wisconsin.gov Jim Doyle, Governor Jack L. Fischer, A.I.A., Secretary July 02, 2008 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: 07/02/2010 SITE: Steve Guise Hwy 12 Hammond Town of Hammond St Croix County NE1/4, NE1/4, 521, T29N, R17W Identification Numbers Transaction ID No. 1554751 Site ID No. 739242 Please refer to both identification numbers, above, in all corres ondence with the aQenc . FOR: Description: In-Ground /Commercial (Employees) Object Type: POWTS Component Manual Regulated Object ID No.: 1188901 Maintenance required; 116 GPD Flow rate; 105 in Soil minimum depth to limiting facbr from original grade; System: In-ground POWTS Component Manual, SBD-10705-P (N.O1/O1); Commercial System, 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: Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manuals listed above. • The leaching chambers must be installed in accordance with the manufacturer's printed instructions, the plan approval and Comm 83, Wis. Adm. Code system sizing criteria. If there is a conflict between the manufacturer's instructions and the plan approval, the plan approval and code requirements will take precedence. • The plumbing for this project discharges to a private sewage system. The approval covers only domestic/sanitary wastes directed into this system. The Department of Natural Resources must be contacted regarding the treatment and disposal of all industrial wastes Coed ~P~` SEE CORK • 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 • 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. SHAUN R BIRD Page 2 1!2/2008 • Inspection of the POWTS installation is required. Arrangements for inspection shall bemade with the designated county official in accordance with the provisions ofSec. 145.20(2)(d), Wis. Stat • Comm 83.22{7) A copy of the a nroved_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. NOTE: The mixing of sanitary wastewater with industrial waste that is to discharge to a POWTS s}stem is prohibited unless the plan has a written statement of concurrence from the Department of Natural Resources. Please contact the DNR for guidance on whether the wastestream they anticipate generating from the facility will be allowed to enter a POWTS that has a soil dispersal component or whether the wastestream will be required to enter a holding tank system All permits required by the state or the local municipality shall be obtained prior to commencement ~ constructionfinstallationloperation. 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, ~~~ . Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday charles.bratz@wisconsin. goy Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WSMART'code:: 7633 cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544 ,Friday, 7:00 A.M. To 3:30 P.M. RECEIVED ~uN 2 3 z008 Cover Page s AFETY & BUILDINGS Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 6!18/08 Owner: Steve Guise Location: NE1/4 NE1/4 S21 T29 N,R17W Hwy 12 Hammond System type: In-ground absorbtion system conventional) Manuals Used: In-ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-5. Maintanance and Co i g ncy Plan 6-8. Soil Test / Signature License rn ~.1>~4-A9.7 ~~~~~ ~naldy ~D ,COMMERCE ~C INGS 'C7NDENC •r-- f-d r- PLOT PLAN PROJECT Steve Guise AbDRESS 3661 NE l1a NE 1laS 21 IT 29 VIR 17 W TO SYSTEM ELEVATION 96.0' 4'belaw grade CONVENTIONAL XXX AT-GRADE CoNV~ B-3 MOUND SEPTIC TA_VK SIZE 261 gallons LIFT TANK SIZE DOSE TANS SIZE HOLDING TANK SIZE LOAD RATE . 7 AB50RPTION AREA 165.5 ~ of chambers $ BENCHMARK V.R.P. Top of 1t2" pipe ASSUD4E ELEVATION 100' Filter BEST CsF10-8 ^ BOREHOLE Q WELL a~g,g,p, Same as Benchmark Hwy ~ ?. Ri gh.t of R+ ay 2 Acres Vlleeks ST Pro Pole Shed/office max 4 employees, 1 No catch basin, floor drain is for bathroomtutility roo only! St. River Falls Wi S4Q22 ammond q covNTy ST. CROIX ~`~ ~ D~ GPD 118 7 ONAL LIFT HOLDING TANK 9 9.5' u Vents B-1 ^ ^ B-29$.5' 1 % Slope ~g • ~ •" m weeks 261 gallon septic tank Calcs: 4 employees @ 13 gpd = 52 1 floor drain @ 25 gpd= 25 total gpd = 77 X 1.5 (peak flaw)=1 16 gpd tank size = 116 X 2.D$$ = 242 gallons, using a - 1 .~ g t use 8 chambers and 1 set of end caps tale=1 ~4" -- 1 O' Property Line Z•d Crass Section of Quick 4 Standard-W Leaching Chamber Typical cross section fvr 1 of 1 veils Quack 4 Standard-W To be >1' above grade Leaching Chamber with 20.a ft2 of Area per Chamber S.$ft^2 pair of end plafies Typical lnstallatian Vent /~ Grade ~''3a134 -.~ From Septic Tank Grade at System Elevation lntial Grade Elevation 99.2' Finish grade elevation .~A ~, 1-3' X 34' Cell Same vn other end Observation tubeNent ~ - 5' ~i-~ A 8 chambers per cell System elevations. A__95. a 0'd ~LZ~0~ ZO 9Z d~ vYiKOOnsin Department of Commerce SOIL EVALUATION REPORT Page ~ of Division of Safety and Buildings m accoraance wnn ~.ornm o~, vvis. from. ~,cfuu County t Plan must Attach complete site plan on paper not less than 8 1/2 x 11 inches in size I . indude, but not limited to: vertical and horizontal reference point (BM), di 'on a I,p, ~1 --`~ percent slope, scale or dimensions, north arrow, and location and distan ne t ro ~ v / Please print a o~~~,,,,~~VEp a 'wed by Date - Personal information you provide may be used for econd~ry"'purposes (Privacy Law, s. PropertyOwner )~OQ S JUN 3 0~ U Pro ertyLocation ~ r~ C / T ~/~ /4 S ~ N R E W Go Lot~(/ 1/4 / p p (o Prope Owner's Mailing Address ~-S . CROIX COUNT Lot Block # Subd. Name or CSM# U~ T ~'~ NING OFFICE Ctty State Zip Code m r ~ City ^ Village wn Near st Road D (7 ~) 5-66 / ~ ~ New Construction Use: (~ Residential I Number of bedroo ^ Replacement -~ublic or commeraal -Describe Parent material ~LQi7.~~Pi ~ ti . General corrxnerrts and reoorrurrenaaticv,s: ~---' System Type ~a ilil/C~~i,~L~1 derived design flow rate oot~'lain elevation if applicable /y`~ ft. ~3e1e~~ra:.~Qi System Elevation ~~ GPD n ~~# ~ring ~~ ~~~. r • 1 - VIUUIIU DUI IGGC CItlV._~V ~ ic. ueNuiwurreaiiy raciv~ n~. Soil ication Rate Horizon Depth Dominant Cdor Redox Description Texture Structure Consistence Boundary Roots GP D/fr? in. Munsell Qu. Sz. Cont. Cdor Gr. Sz. Sh. 'Etf#1 'Eff#2 l ~ ~~/z S .~^ r ~ ~ r~- s.- ~---- ~ ~ . O ~ ~- ~ s~ ~ ~i ® ~~ # O Bonng it Ground surface elev. ft. Depth to limiting factor 7,~~ in. Soit lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 -lS , 31-z_ ~~ L --^ 6 'Effluent #1 = BOD > 30 < 220 mglL and TSS >30 < 150 mglL 'Effluent #2 = BOD < 30 mg/L and TSS < 30 rxyL CST Alentg {Please Print) Sig r CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 5401 ~ ~ ~~ ~~ 715-246-4516 Property Owner _ Parcel ID # Page of ®Boring # ^ Boring °~ "~it Ground surface elev~~' / ft. Depth to limiting factor ~n• Soil lication Rate Horizon Depth Dominant Cdor Redox Description Texture Structure Consistence Boundary Roots GPDlft` in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 ~ ~ 3 ~ ~~ ~~ ~ ~ ~; 3 ~ ~- -s © i ~~ ~ L // ~I Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure ' Consistence Boundary Roots GPD/ff 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 ication Rate Horizon 'depth Dominant Color Redox Description- Texture Structure Consistence Boundary Roots GP D/f~ in. Munsell Qu. Sz. Cont. Cdor Gr. Sz. Sh. •Eff#1 'Eff#2 • Effluent #1 =GODS > 30 < 220 mglL and TSS >30 < 150 mglL • Effluent #2 =GODS < 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. seo-e3~o (fr.~oor Soil Test Plot Project Name Steve Guise Address 366 Vorwald St. River Falls Wi 54022 Lot ------ Subdivision NE 1/4 NE 1/4S 21 T 29 ShBi ~ #226900 -------- DateU6/18/08 N/R1 ~ W Township Hammond Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 112" pipe System Elevation 95.0' *HRpSame as Benchmark Scale is 1" = 40' unless otherwise noted Hwy 12 No catch basin, floor drain is for bathroom/utility room only! Prnnarty I ina ^ B-298.5' B.M.* Scale=1 /4" = 10' t+Yisconsin Depertrrtertt of Comrrterce Division of safety and Buildings In BCCOrOance WIRI Wrnm OD, vv15. fWm. wa@ ~ ~ Plan must er not less than 81/2 x 11 inches in size nt l te site lan on Attach o a I p . p A p o e irtdtxfe, but not limited to: vertical and horizontal reference pant {BM), direction and Paroei I.D. percent slope, scale or dimensions, north arrow, and locatwn and distance to nearest road. Please print all information. Reviewed by Date Personal adametion Y~ P~~de ~Y pe used tot setondery purpaes (Privacy law. s. 15.04 (1) (m)). Properly Owner Property Location ~ 2 N R E { W r T Govt. Lot ~/~ 1/4 /~ /4 S p Owner's Mailing Address Lot # Block # Subd. or CSM# Uo ~ '' Sfate Prtone Number O Cih O village ~N Road ~~,, s~ ~ z Flew Construction Use:[] Residential / Number of ^ Replacement ~ubucA~a commercial - ._~' Parent material ~LL~i~d~lG~,~ Germrad oommenls and recorrwrrartdations: system type ~~ ~-~/e~~ SOIL EVALUATION REPORT Page of _ de derived de Ign flow rate ~ U ~ GPD 7 ~~~~, i lain elevatwn if applicable /!~/ _ R ~r~~~~f~~c~i- System Elevation~~ ' a Ground stutiaoe elev. t<. De~h to Nmiortg Paccar in. SoU icadon Rate # ~~ Floriaor- Depth Dominant Redox Description TeutRtna Stnxttrre Consistence Boundary Roots P D/IF in. MtxtseN (lu. Sz. Coot Color Gr. Sz. Sh. 'Elf#1 •Etr#2 ~' ~- uJ 2 Chi t# ~ ~^^~ 90 ~ n~ 1~ " t it t3rounrJ trlJrraoe elev. ! ~ • ,~ a. t~epat to umttxtg rector ~- m. Soli ication Rate Floriaon Depot Dominant Cokx Redox Deaaiption Textrire Structure Consistence Boundary Roots GP D/fP in. Murtsefl Qu. Sz. Cont. Color Gr. Sz. Sh. 'Etf#t 'Eff#2 -/S 31-L ----'~ ~ -'-' p-- • Etlluer-t #1 = BOD_ > 30 < 220 ntolL and TSS >30 < 1 50 mall. • Effluent #2 = BOD_ _< 30 mdt. and TSS < 30 rn9IL CST Nettle. (Phase l'~tl CST Number Bird Plumbing, Inca Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 5401. .._-~ .,...~ 715-246-4516 Parcel ID ~ ~ ~ property Owner ~4 # ~ t3onng // J "~->Zit Grorxxl surface elev.` ! • ft. Depth to 9 ~~ ~. Sod Ra Redox Desaiption Texture Stnichxe Car~tanoe 8oundarY Roots G Horizon Dam Do+t Gr. Sz. Sh. 'Efft~1 ~'Etf#2 ~. MunseA Qu. Sz. Coot Color l , ~ 3 ~ ,.---- s ~~ # ^ Pi Ground surface elev. R Depth ro 9 factor in. Redox Texture ~~~ Consistence Bourxlary Roots Fbrizon Depth Oorninsrrt C,r. Sz Sh. in. Munse~ Qu. Sz. Coat-Color ~'~ ~ Q P~~ Ground surface elev. ft Deptlr ib ~rniting facSOr -.--- in. Horizon '~eptir Opminsrrt Redox Dssaip~on. Texturo Stnxhue Consiaterrce Boundary Rooffi in. Mrraell Qu. Sz. Cont. Color Gr. Sz. Sh. • Eflkient #1 = BODs > 30 _< 220 mall. and TSS >~ 5150 m~A. • E ~ = BOD, 5 ~'~ and TSS 530 m9n- The Department of Commerce is an oqual oppoctunrty seance provider and employer. If you aced assistance to access services or need material in an alternate format, Please contact the department at 608-266-31 S 1 or 'I`IY 608-2648777. ssosasotr~oo~ Project Name Steve Guise Address 366 Vorwald St. River Falls Wi 54022 Soil Test Plot Plan Shaun Lot ------ Subdivision -------- NE 1/4 NE 1/4S 21 T 29 N/R17 W ~] Boring Q Well PL Property Line BM or VRP Assume Elevation 100 ft. Date 6/1 Township Hammond County ST. CROIX Top ofi 112" pipe System Elevation 95.0' *H R pSame as Benchmark Scale is 1" = 40' unless otherwise noted 2 Acres Pro Pole Shed/Office max 4 employees, 1 i floor drain No catch basin, floor drain is for bathroom/utility room only! Hwy 12 B - 3 99.5' B-1 ^ p B-298.5' 1% Slope ~B•M•* Scale=1 I4" = 10' Line sic. CROrx cpuNT~ SEPTIC TANK MAINTENANCE AGRBENIENT AND OWNER.SI~ CERTIFICATION FORM OwnerlBuyer Mailing Address property Address O r` (Vearif~ieaftioa regttirtd from Planning & Zotun=° Department City/State I ~~~rn'~ "~'~ w~ -- Par'ceI Identification Number Z ~- w construcoion.) 6l g /~~s-~ o- -32~.~) LEGAL DESCR~'r'ION .1~i ~ ~„~ . T Z'q N R~W, Town of Gt Property Locarion ,~_ lea ~ ~ ~a ,Sec. 1 . _ Lot # t Subdivision 'Volume ~ page # `~~ Certified Survey Niap # ~ `5 ~~ f ~~ ,Volume ~=- P~'e# - w~t~ Deed # _ Spy house yes ~ Lot lines identifiable ~~ no S.~,S M.~I1~TY'ENANCE AND O'GVNER CERTT~7CATIUN Tmpropcr use and maintenance of your septic system could result in its premature failure to ~-~ was ,~~ u put into maintenance consists of pumping out the septic tank every three Years or sooner, if needed, b $a licensedO~er ~ntenance the system can affect the functioa of the septic tank as a ixeatmcnt stage in the waste disposal ysurn. responsibilities are specified is §Comm. 8352(1) and in Chapter 12 - St. Caroix County Sanitary Ordinance- to submit w St. Croix County Planning & Zoning Department a ceroification~form, signed by the 'The PmPenY owner agrtes lumber, restricted plumber or a licensed pumper verifytttg that (1) the on-sits tewatex disposal systc~ ins ProP«' oPeratv°g condition and/or (2) after inspection and gumpin$ (if nec~arY), the sepTxc tank is less than 1/3 full of siudgs. ee to maintain the privets sewage disposal system with the Uwe, the undersigned have read the above requiroments and agr r of Natural Resources, Ststc of Wis~nsi~n. standards set forth, herein, as set by the Department of Commerce and the Deparrmen Certification stating that your septic system has been maintained must be completed and returned to the St Croix County Platming & Zotung Department within 30 days of the three year expiration daft. Uwe certify that ail ~tanements on this form are true to the best of myfour knowledge. Uws am/are the owner(s) of the ve, by virtue warranty deed recorded in Register.of Deeds Offics. ,.:,. S ATURE OF APPLICANT(S) ~ DATE #'~* Any information that is misrepresented may result in the sanitary psrmit being revoked by the Planning & Zoning DeparanenL*** Triclnde with this application a recorded warranty decd from the Register of Deeds Office and a copy of the resti5ed survey map if reference is made in the warranty deed- (&E'V'. 08/05) ER'S NfAI1U~- $r MA~A~EM~ PUki'~ pfl1fi~'t'S t31~ ~vsTE~asP---~ ~of8 ~~d lloMr (sue) ~. ~.- ~w°" w~ ~~~ ~, C~°'s~-',-1 ~ ~ $~ ~ Sdidr s { ~} ___.. ~` istSpe~tCOn~n of taNgs3 pump out canterr<ts ~ tenicts} tnspeCt ~P~cisi.,. i~'s) ~~,~~~ -----"---_- i afacoe e> putrep, 7>a~ ~ ~ servte~ ~~R PttntA~Tank . L7 ~ ""''._.. ~ PwYtP Tsn~c M~~ ~ ~ ~~~ ~ ~ b+~or hr °- ~ ~F~ ~ a~ Air t:] wattand s3o rt>~. D lute ' a other ~ ~ o ~ ~~~~? ~ o t~ t~ ~ a,~ l a wt ~ o wa . NA NA' y ~„ar;,ge-- a1: ~~ ~ • p ~ {pressurtaedj v other Oomt is e ' .,.,,~ ~ y lnchQtem~ .. vstues arv~ torte ` j ©man~ Rt least once evesY and sccsrt+ squats when Qprnbtned sludge .~_ At least once ewr~ Ax feast onoe sve+Y ,at feast once eNerY qt keast Dress every ILt test onor e!veeY At least ance e~rery G (~exlcntua 3 y~•i ~ olLanKvotur~e (Mauclmuee 3 ys:-3 t3 nsocsehs ~ns~ D morel ~ ~K$) ~ trtA 11 moot fl yeeK~ Q NA ~ mouths II yraRs) Q NA Q ~~ g yes{s) L3 NA r~wKTtr7~~ ~~~ ' bs ~~' ~ ~ ~ ~~ or:s ~ ' Sept ~ y«~ic6 and his std R+ ~aHVer POD tt or btu ~. P~ember: ~ife s vbusd ~ °t 31ssa laN~c(ay to l~re~ for any b~edc uP ~ Tank 6~ap the rol~sse of ooaei7lned sludge ~ b d~eidc life eRllt,eert la+tsls ett8-' o~ cr Tl>c despen~ owe} st>s11 tfa v~rfaoQ. 'Tl~e of eft on tt~s ~ ~ ~ ~ ~~~~~ledm ~ o¢ the loot rr~*~ ~1O groom ~_ ~ ,fin ~ ~ od`.Ukt taNc vdu ~he~e~~~~sep~e~~~~a"~~'NR e ot> 0# 1lle talc eh~ be r+ett+avad ~ ~ ~; atfd 8ny ~ 13, ~ ~~~ t;od~ of SUt~ POIAtTS ~portel~. p Blau i~ ~ ~ ~ pj.'~2 r~ottthS Ot tttSS stla~t 56'~ . ey,~~, -~ler n~ ar ~ ~ ~ row, at~,~ity wi~in 1t~ ~ ~ comps ~ ~' ~~ ~~~~: ~,~nr ~p arm ot~noK t~lecx ~atrnerttlaric~s3 fortha psi arse for cierlr co~• ~ ~ e3d` the Pa~$ erldlor a the d'sp"°~t s~s~' if huh d2'td ha-~e ate vatata~s ~ remav~ed by a septege servtc~g °D w `¢s. r ~ •_ .. stlail no[ ocarr when s~'f cortditior~s are frozen at the 'sn~raWe se:rtace. y~rt up ~rsks mskY ~ above normat teigtsvraGer ;evets. When Po-M+ac' is re~Dt~ed the e~ooess ' ~~ per oudaQes t~P celtCs) in one ~ dose, atiretfoadsctg tiye o~8~ ~ it'say resztit in the wSt be + bD tt'e da~noid tt~s situation !save the ~+~ ~ the t~ tarsk rertsov+ed tsyr a t ~ ~ ~r'PUyYgr tD She ettlcrartt pump or ~r~ 8 ~~ tsr' POWTS to ~` ~ ~~ ~ 'cortCDts fi0 teSLCne tlOrmai fevets vvittrirs the Pump ~. a~+ martt~y ~ ' - ~. pp rat drnre of patlc cntei', flt ~ dis~ub ar compact, Do not drive ca' patio v+~fticles °~ ~ dispe+c~al _ file etas r~fn i5 feet down sbpe ~ ~Y !u at-gratde sit a6 sorpi?on at~a- of the ~ fiom ifre v~rastewat~ sfieam may impttinre ttte pertcm~at~oe and Pro~3 the Redd ~ er~t~ ~~ btffis; condoms; ~tton swabs; degteasexg: ~ mast . e~f tfle = ~~Y vraber, fatitand vegetat>te p~ ~ d~ ~ t+ocrrida~ dca~t {sxattp p~Pl . s ~ ~ ~ p~,due~a; ~ ~ry rsapiciris: tampons:'and water soRaner brim. taken oc~t of service the foIIo~ing steps shall ~ ~~ ~ ktsxt2 that tine ~s s~rtdfor 7ts~oorsapttance wilts ch_ Cotrsrss 83.33 Win ~~ C'Ode' is properijrahd sahciy Ali P~9 ~ tanks aYSd Pits stsaA be discr~ntiecbed and tfse abandoned Pipe ~-~ se~- ,.. Trie oontier+ts of act tacsks sued ~ ~.~ removed and proDe1'tY disposed Of tsy a Septsge'9 ~~ s After p3. ~! tanks and Pits shalt ~ excavated attd removed or ttsetr ors r•°r'd ttta v~ sp®cer fated waft soli, Brave! ~ ano~r inert solid risatetiaL . . CANTfNGENCY PLIiiN the t+ottowthg measures have been, or mast tee tiD provide a code !f the P01M~5 tans 2rc~d ~~ ~ CO +~~ n~[IL Sy5bPJ7f. _ A stsirabte replao'~~ has ts+een evafuaxed and may be u~¢ed for the. tocaSiots of a ~t rtot awn - .~ ~cerrsent Brea shoutd be proceed from disturbance and oorn Setj~ frossz e~astrng and proposed saru~. ~ ~ and webs. FasTur+e th be infringed csp~ by m esotbttsts a suitable ~~ ,the h~ 9tea w~ result in the need for a new soil and site ~evalu2~iorf must aampty with the rotes in effect at f>sat tirste. re~giacement any. Rerplaoement sysLerns adwdrices in POYt~S D A suitable r+epiaoe~t eras is not avarTable' due t0 setback and! arCe slue fad ~- ~ $ tsotdittl3 tank, rnaY #se li~led as a #ast resort io rep . a The sibx tray not i~eesy, end ~ idenfifjr a su"Rahle reptacecnent area. Upon f211trie of Qre PC)VVTS a 9oa.artd iKi loc8ae a' Suitable replacement area. if tso ~ area is avalraflle a. site evaluation mast tae p ho~irtg tarsk etay be inked as a Past resort to reptacae ttse fatted POWTS. rerrtova~ o f ~a biornat at II Mocutd eyed at~srade soa a65ocPttOn syst+e~s ~y ~ reoonsWCxed in place fnifov+ing the trsfdII'ativ~e sus~c'a, Reoors~ of suds systems must comply wilt's itse rites in effetx at !teat tirs~ «VlfAftNlNts7'> TANKS MAY CQ~fTAM LETHAL (;A,S.St:.S ANflIOR WSE7FF[C[EHTOXYGEN. SEpT(C, PWYIP AtriD i0'fHER TREATMENT 00 HOT EEdTER A SQ'TIC, t~tJlfitP QR OTHER TREATMEAiT TANK UNDER At+tY Cg~Ct~S"rANCES. DEATK MA RESULT_ ,RESCUE OF A PERSON t'ROi9d THE tNTEIi,IOR OF A TANK MAY BE DIFFICULT OR IHP.OSSlBL.E. ADDt'nONAL COMMENTS povrrs INST PoWTS MAi1~TTAt1~iER Name Q Name u,,,.~ ~ / Phone ~ ,~'~ '~ SEPTAt3E SER1IiClNG QpERATOR t_Ot:At_ RFGUL4Tt3RY 1iEltNORJY'Y Horne r"~ a9~~ - r Phone 'J,~ _ c,2 - Ptsons l .~ --. ~- ~~ ~rtrt sart~ ~- ~ rsteets a'ral6ea br. tt>r ~ of in. c;a[sea [ate. ~ and WsasFrara county ?~ ore rn+rdaum, ~ at' ds. Coasra }(1Xd~ eyed 835~{I). C1} $ f3). Wcsoorssin AQtsWst ~+^r~6 Cock. Us's of tlJr doattranc ~ rs~ rµW (~1) g~acaee ttsE p~fonrsirsca attfse POWf~. State Bar of Wisconsin Form 1-2003 WARRANTY DEED Document Number Document Name THIS DEED, made between John Eric Larson {"Grantor," whether one or more), and Steve H. and Judy A. Guise, Husband and Wife as Survivorship Marital Property. ("Grantee," whether one or more). Grantor for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): LOT ONE (1) OF CERTIFIED SURVEY MAP IN VOLUME THREE (3) OF CERTIFIED SURVEY MAPS, PAGE 809, AS DOCUMENT NUMBER 357138, FILED IN ST. CROIX COUNTY REGISTER OF DEEDS OFFICE ON MAY 29, 1979, BEING LOCATED IN THE NORTHEAST QUARTER OF THE NORTHEAST QUARTER (NE'/. OF NE'/.) OF SECTION TWENTY ONE (21), TOWNSHIP TWENTY NINE (29) NORTH, RANGE SEVENTEEN (17) WEST, TOWN OF HAMMOND. St. Croix County, Wisconsin. (tilt! !il{i it{{i il{I{ iNli INIi !i!{ ililil Ili( {iN * 8 6 6 4 4 3 1 86G443 KATHLEEN H. WALSH REGISTER DF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 01/02/2008 14:30AM WARRANTY DEED EXfMPT 1 REC FEE: 11.00 TRANS FEE: 45.00 PAGES: 1 Recording Area /! Name and Return Address Josepph D. Boles Rodli, Beskar, Boles, Krueger & Pletcher, gg C. P.O. Box 13$ 018-1045-90-000 Parcet Identification Number (PIN) This is not homestead property. (a~ (is not) Grantor warrants that the title to the Property is good, indefeasible, in fee simple and free and clear of encumbrances except: easements, restrictions, and rights of way of record, if any. Dated ~ E~ ~,+~,e. 31~ Zia Z (SEAL) « hn Eri Larson (SEAL) AUTHENTICATION JJ Signature(s) . ~: '~~N ~~ t L G.~ SGn' authenticated on n -~Lc c Cti,,,r ~~ 3 j~ ~D'~. J~ G2i.-~..-- TITLE: MEMBER ST TE BAR OF WISCONSIN {If not, authorized by Wis. Stat. § 706.06 ) THIS INSTRUMENT DRAFTED BY: ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. COUNTY) Personally came before me on the above-named John Eric Larson (SEAL} to me known to be the person{s) who executed the foregoing instrument and acknowledged the same. Joseph D. Boles Notary Public, State of WISCONSIN Rod[i, Beskar, Boles, Krueger & Pletcher, S.C. My commission (is permanent) (expires: (Signatures msy be authenticated or ackoowiedgcd. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATION TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ~200J STATE BAR OF WISCONSIN FORM NO. t-2003 'Type name below signatures. INFO-0RO"' Legal Forms • (800)655-2021 • unoprofortna.com 1 of 1 (SEAL} A Parcel #: 01$-1045-90-000 o7/osi2oos 11:06 AM PAGE 1 OF 1 Alt. Parcel #: 21.29.17.321 D 018 -TOWN OF HAMMOND Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O -GUISE, STEVE H & JUDY A STEVE H & JUDY A GUISE 366 VORWALD ST RIVER FALLS WI 54022 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description * 1785 HWY 12 SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 2.420 Plat: 0809-CSM 03-0809 018/1979 SEC 21 T29N R17W PT NE NE BEING LOT 1 Block/Condo Bldg: LOT 01 CSM 3/809 2.42AC EZ-U-1207/099 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 21-29N-17W NE NE Notes: Parcel History: Date Doc # Vol/Page Type 01/02/2008 866443 WD 05/10/2005 824940 QC 01/06/2005 784315 2726/590 WD 12/18/2000 635392 1568/27 WD more... 7(1(1 S2 CI IMMeRV Bill #: Fair Market Value: Assessed with: ---- ------------- 0 Valuations: Last Changed: 07/19/2007 Description Class Acres Land Improve Total State Reason COMMERCIAL G2 2.420 10,900 10,000 20,900 NO Totals for 2008: General Property 2.420 10,900 10,000 20,900 Woodland 0.000 0 0 Totals for 2007: Genera! Property 2.420 10,900 10,000 20,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 f FORM N0, 985•A X G.MIIIMCYIIyIq~ r~ o ! ~ 5~ ED ~+, o919Ig ~ ~, poyn,r ~ kkres i~ W6~,._~ hs . h CERTIFIED SURVEY MAP ~E COR. SEC.21 NE COR. SEC. 2l, NO°02`44"E T29N, R17W ~ ~ ~-CENTERLINE uS. HIGHWAY "!2" BEARINGS REFERENCED TO / EAST LINE OF SEC. 21 R.O. W, LINE ~ ~ " NORTH / R.O.W. L / N E ~o SCALE 1"= l00` / ~ ~; 0 50 100 200 ~ / m N \ `~ _ ~,~/ APPRt?~IED DSO . i ~ S° ~~'~~ MAY 2 ;? 1979 3 / / '~ ~ ST. CROIX COU: • TY O ~, / ~QMP.tEHENSIVE PARKS FIANrUNG / h / AND ZGNING COMMITTEE ~ v o y ~ / o ~ APPROVAL Or TiiiS FAiNOR SUsp;ViS}CIv Z / ^~ dOES NJT MEAN AP~':CVAL FpR s I e NG T ~,- -. 3 ~ a~ ~ ~ %~ ~~ 1 ~ 1~ ~~ ' z _ _ a ~l 2.42 ACRES ~ I (TO R.O.W. Lt NEJ l 1 1 ~ j ~, j .~~ ' i~ Uy 50.0 ~ ~ `~~ 230.00` ~°° ~I ~ S2°15`15"W 280.00` i U L I SITE OR SEP,IC ,,;;,:cAA. REFER TO H62.20. CURVE DATA TO R.O.W. LINE CENT. 37°48`04" RADIUS /096.00 CHORD BRNG. N68°50`43"W CHORD 710.05 ` NOTES THIS PARCEL NOT TO BE USED FOR RES/DENT/AL PURPOSES r t'V 1CQ ; i CERTIFIED SURVEY ~ I, Bradley J. Canaday, registered land surveyor, hereby certify; That in full compliance vrith the provisions of Chapter 236.34 of the Wisconsin Statutes and the provisions of the St.Croi_x County Subdivision Ordinance and under the direction of Duane Lewis , owner of said land, I have surveyed, divided, and mapped said parcel of land, that such plat correctly represents all exterior boundaries and the subdivision of the land surveyed; and that this land is located in the NEB of the NE~ of Section 21, T2~N, R17W, Town of Hammond, St.Croix County, Wiscansin, to-wit: Commencing at the NE corner of said section; thence N$9°01101t1i~' 1112.121 (bearings referenced to the East line of said section, assumed bearing iJ0°0214411F,); thence S2°15115"W 50.001 to the point of beginning; thence continuing S2°15115l1W 230.001; thence S$7°44145"E 671.761 to the southerly right-of-way line of U.S.II '112"; thence westerly 723.091 along sand right-of-way line, also being the arc of a 1096.001 radius curve concave southwesterly and whose long chord bears N6$°50143t1W 710.051 to the point of beginning. Said parcel contains 2.42 acres of land. ;- Bradley ana ay=--- ~~ Wis. RLS 1462 Dittloff Engineering Co. P~iver Falls, VdI 1•., y i• .• .• ~~, a ~. N.,W~'w:,.ry..ay4. p .~i '~R~r ,,, ~rt.~_ '~~ f ~ ~ a ~`~~ ~ CA~~d~^ (iAY s3 v-1~,o2 ~ ~' ' R1VcR FALLS ~ ~ r~' VV;S. d ~ m ~f a. ,~ ~O ~ti .:..,:., Job T;' 79-30 Volurie 3 = :~~:-e 8Un