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HomeMy WebLinkAbout018-1098-01-000V1~:sconsi~i De~artm~nt of Commerce PRIVATE SEWAGE SYSTEM Safety and fjuilding Division ~~' INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Stark, Chris & Michelle Hammond Townshi CST BM Elev: Insp. BM Elev: BM Descri t' , ~' 1~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ / / (~(,/ /~ Dosing ~~~ p~~ O Aeration Holding TANK SETBACK INFORMATION TANK TO ~ P/~ WELL BLDG. V! to Air Intake ROAD Septic > S~ / ~ !~~ Dosing a; Aeration Holding PUMP/SIPHON INFORMATION ~ Manufacturer ~ (~ Demand GPM Model Number ~~U ~ ~~ D TDH Lift Friction Loss^ Syste Head TDH Ft Forcem in Len h~~' Dia. ~ ii Dist. to Well - ` IN SOIL ABSORPTION SYSTEM ELEVATION DATA county: St. Croix Sanitary Permit No: 430198 0 State Plan ID No: 0 ~3 Parcel Tax No: 018-1098-01-000 Section/Town/R nge/Map No: 7 30.29.17.808 STATION BS HI FS ELEV. Benchmark ~.3 ~ ~~~. Alt. BM ~~ Bldg. Sewer 30 ~ Cif- a , t/ t Inlet ~~' ~'b SUHt Outlet ~ ~- Dt Inlet ~/ D Bo Header/Man. 2 ~~ Z, /aZ- Dist. Pi b +~ 6 ~ ~ ~ S ~,S'Z ~ 0 Z ~~ Bot. Syste ~. (/ ~ ~.~ J d~- (o Final Grade ~. ~ / b 3 , St Cover / ~ ~ p~ o Ciryt-hMti ~- ~ b a . BEDITRENCH DIMENSIONS Widtt~j / ~uJ C~J Length ~ r /l?_ No. Of Trenches ~ ~ PIT DI ONS No. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LE CHIN CHAM OR Manufacturer: Type Qf Sy~ /I-/t/ ~ ~ I I' d U Model NnrtAbe~GQJw` f S DISTR~I~O~N SYSTEM ~ ~~;,~ ~ (o 7ti~~~ o,~f 4 ~e.2 Heade Manifold F/ Distribution ~ / t / ~ x Hole Size x Hole Spa ing ~ 4 nt to Air Inta e Ve ~ ' I ~ pipe(s) ~ , (~ ~ +/ O y ~ n -ZV 1 ~h Length Dia Length Dia Spacing / 0 SOIL COVER ~ x Pressure Systems Only xx Mound Or At-Grade Systems Onfy '7tv~r~t,f,~ Depth Over ~- Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center I s-~-+"~' Bed/Trench Edges Topsoil L_~ Yes h~ No i~ Yes !~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~1 23 6 3 Le~~ction #2: / Z~/ Location: 755 150th St Hammond, WI 1~~ 1.) Alt BM Description = J /. CO~~ 2.) Bldg sewer length = 22 ~ - amount of cover = 54015 (SW 1/4 NW 1/4 30 T29N R17W) Emerald Acres Lot Parcel No: 30.29.17.808 r ~p~ (~ ~ ~~ ~6~--~ ~~ t~ Plan revision Required? Yes ' _~ to Use other side for additional information. SBD-6710 (R.3/97) u~~.e..d ~ Z" ,~~~~d Date Insepct 's Sig ature ~~ / ~'~'t~l.J' eye ~l ~ ` Pam Quinn From: Jansky, Leroy [Ijansky@commerce.state.wi.us] Sent: Wednesday, September 24, 2003 6:15 AM To: 'Pam Quinn' Subject: RE: Mound plan #883992 The reason the manifold was to be smaller is to ensure the velocity is 2 ft/sec or more in the manifold as per the component maniual requirements. We never used to worry about the 2 ft/sec and only about friction/flow loss in the manifold. The reason for the velocity requirement is to keep the pipes scoured clean of material. I'm not aware of any problems with manifolds having a solids buildup in them. So, this might be one time where we would be safe overlooking the requirement, and not making the installer dig up the system to make a change. The extra digging and possibility of soil infiltrating the distribution cell during the repair may do more harm than the fix is worth. However, the final call is yours. A copy of this mail could be placed in the file to back up your decision if you wish. Leroy G. Jansky, Wastewater Specialist DComm - Safety and Buildings 13 East Spruce Street Chippewa Fa11s, WI 54729 (715) 726-2544 Office (715) 828-5902 Cell (715) 726-2549 Fax Safety and Buildings Division County ~ ZO1 W. Wasltington Ave., P.O. Bo 62 ~e ~O'r ~ ~s~'~~Sln Madison, WI 53707 -- 716 f~ f , ~8) 266 3151 ~/ ' Sanitary Per it Number (to b filled in by Co.) ~ De aliment of Commerce - ( 1/~ D / Sanitar Permit A li ti State Plan I . D . Numbe r y pp on ca In accord with Comm 53.21, Wis. Adm. Code, personal information you provide p g ~ ( ' UD 3 ~ ! Z may be used for secondary purposes Privacy Law, s .(14(1)(m) -4 Project Address (if differeftt than mailing address) ~ SS ~ ~1 ~ I. Application Information - Piease Print All Information .~ ~ Y : ~ ~ . Property Owner's Na me ;, , ,, . ~; ~~ eel Ar /~ ~ v ~ /~t !1 Block N Property Owner's M ailing Address Pro `/ perty Location v ~~ d S~ ~ City State Z i6, bi,Section , ip Code Phone Number ' ~~ ~ ~ ,,p (circle o ` / ~ II. Type oP Building (check all that apply} /l~ C/ T Q N; R~E or ~1 or 2 Family Dwelling -Number of Bedrooms Subdivision Name CSM Number ^ Public/Commercial -Describe Us. e ` '/ ~/y1(y~. / U- y .S ^ State Owned -Describe Use 'jd~",~„'r~ 9 ~.~ (p7 ~ OYt CdYL~'d-7itit,~/D~ 3 ^City ^Villageownshlp of1C,1a,.,~,, ,re ~ f ~ _ III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A' ~ New System ^ Replacement System ^ TreatmendHolding Tank Replacement Only ^ Other Modification co Existing System B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Numbet and Date Issued Before Expiration Plumber Owner IV. Ty of POWTS Svstera: (Check ail that apply} ^ Non -Pressurized In-Grourxi ,f Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sartd Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculatin S nthetic Media Filter r] Leaching hamber ^ Dri Line ^ Gravel-less Pipe ^ Other (explain) , V. Dis rsaUTreatraent Area Information: (~ Design Ftow (gpd) Design Soil Applic ion Rated pdsfj Dispersal Area Re fired {sf) Dispersal ea Pro sed (sf) System Elevati n ~ 6d ~ . ~ l.o ~I aC~ 6'~p ~,~f ~ ~8~, G/ VI. Tank Info Capacity i Total Nun ;'Ser i . Manufacturer efab Site Steel Piber Plastic Gallons Gallons of Units I ~ ~~~~ ~~~ Concrete Constructed Glass New Tatilcs Existing Tanks ~ ~/~ ~'" ~ Septic or Holding Tank /~S-~ / ~ .~S~Y r Aerobic Treatment Unit Dosing Chamber ,./ , ficJi ~',5-~'Y ~ VIL Responsibility Statement- I, the undersigned, assume responsibility for ' anon of the POWTS shown on the attachdd platys. Plumber's Na me (Print) Plumber's Si gnature ~ iP PRS Number Business Phone Nurrtber ' dv;~~~'1« 1~ ..~~~ ~~ 7 Q 7~s~,3 ~G' -pia ~ Plumber's Addre ss (St~eet City, S rate, Zig Code) ~ - - 1~~~ G~`~ ~ ~~" G~,. ` ~3`~Ql VIII. Yount /De artment Use Onl i pproved ^ Disapproved Sanitary Permit Fe includes Groundwater Surcharge Fee) ~ j ~ ~ D to Issu ~ Issuin Ag t Signatur o tamps) ^ Owner Given Reason for Denial ~ ~ (/ ~O . C/olnditions of Approval/Reasons/for~Disapproval __~_ g-~ ~ - _(~%c~u2 ~7I ~/p 3) ~,Q ~„ ~ ~~ ~~a~f ' ~~iY~~i ~GGr't~ ~ (.tfl~t ~~i:;~~~-UY~.o (iLC ~S?~-- ~ ~l~in~n.~.c1~ ~n. C~ur'L¢'`~ ~ ~~fz~=ClLuc~ C a ic~ ~ ~ll~~ t l ~ ~ ~ { , . Nvw ~crnl - f -c~ rytCC.v,~t.-ftLt~-~ ~ ~Q/i, Lya-'r~,-, ~ 3, .7'Z Cvu,~/ -~c``'`'`2. ~-~!z%~~t~t.`~'i / 2 I %V )G~G2~ / ~. G- if"X"~ P}~~ Wans {~ c:ounry oNy) ror the ayat on paper l less than Sl/2 x 11 yltcltes in s l\-i/J(/BD-6(398 `j!RY"'l.~O 1L+/034~ // // /-/~~~w, ci ~~~. C~3, (1/ 3 ~ ~ ~~ f'~%c:~Q~~ ~.. ~. ~' a ~. ~- ~ -~ S-- `% .rte/ ~~~I~~ .~ - C~ ~~, .~~c~~.r~ ~~~ ,~~~ ~z~ ~. ~ ~' i~.t~~~~v~ e ~ 4~- 1~~~ I ~~~~~ ~ T~° ~ ~ ~=.~ ~- `'. ~~ k Cg/~ los ,~~O~~I Department of Commerce t E ~~~~~ ~Y~E~X.,A 0 July 08, 2003 Si.( 'iiir;CU , CUST ID No. 267341 "' ARTHUR L WEGERER WEGERER SOIL TESTING & DESIGN SERVICE PO BOX 74 RIVER FALLS WI 54022 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/08/2005 SITE: Chris & Michelle Stark Town of Hammond, St Croix County SW 1/4, NW 1/4, 530, T29N, R17W Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 2648777 www. commerce.state.wi. us/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary ATTN: POWTSlnspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 ~~?)~ ~ ldentification Numbers Transaction ID No. 883992 Site ID No. 661309 Please refer to bofl~ identification nurrEbers; above, in all correspondence with the. FOR: Object Type: Mound POWTS 600 gpd Regulated Object ID No.: 910099 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. The following conditions shall be met during construction or installation and prior to occupancy or use: • Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explainin that eri 'n of the se tic tank outlet filter is required. The access opening used to service the filter shall terminate at or above finishe gra e wit a watertight cover. • The manifold diameter shall be 1 1/4 inch diameter to ensure a velocity of 2 ft/sec is maintained. ~ 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/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, ~' Leroy G. ansky, astewate ecialist (715) 726-2544 Voice (715) 726-2549 Fax lj ansky@commerce. state. wi. us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART'code; 7633 . . ~, ~ RECEIVED ' ..~'" t ~ JU~i.'2 4 2003 TITLE SHEET FOUND SYSTEM SAFETY & BLDGS D1V^A ~ BEDROOM RESIDENCE Page ~ of This plan has been prepared in accordance Faith the Mound Component I4anual SBD-10691-P and the Pressure Distribution Alanual SBD-10706-P (N.O1/O1} (N.O1/O1) LOCATED Ii~1 THE S1-J 1 /4 OF THE IV1~] .l /4 OF SECTION 30 ~ T Zq N, R ~7 t•1, TOWi1 OF ~~1jv1~~ ~ (~'~', C,~o ~~ COUNTY, WISCOPISIN. Lo i 1 v~ L ^'l~t~~ ~ebZ~S - INDEX PAGE 1 of 7 PAGE 2 Of 7 PAGE 3 of 7 PAGE 4 of 7 PAGE 5 of 7 PAGE 6 of 7 ` PAGE 7 of 7 TITLE SHEET SYSTEM i°IA~AGEiIE1dT PLAiv PLOT PLAN PLAN VIE~7-CROSS SECTION DISTRIBUTION PIPE LAYOUT PUi4PIP1G CHAMBER CROSS SECTION PUMP PERFORI.1Ai~TCE CURVE PREPARED FOR s gg39g~ c t1-2 i s r~ ~ r~ ~Ct~~LE s'r~iS~ Z~,oO 1~vs1-l.C P~e.F, ___ PREPARED BY WEGERER SL~J S L . TEST S t~tG AND . • 33ES I G;V SERV = CE P.0. Box 74 421 I•d.ilain St. River Falls, T.]I 54022 Phone 715-425-0165 Fax 715-425-6864 ~.®.V~'.T,S. ~~~~~~~~~aft~r~y ~ s 1 ~. ~; . .-- >;=."e tv~u%~T OF CO y~NtERCE ;~uPi 01= Ski-E7Y AND BiJILDINGS r' !=<RtcP DcNCE ~-~ ~C alt's ~''~ r• • ~litMJfi ~ ' WEGEHEp • Da15 P :~ 6LLSWORTM .~ li --........---t'•4, S i ! ~ ~ V CORRECTION NEEDED SEE CORRESPONDENCE .roB No • ~ 3 -q3 ,' Mound System Management Plan Page Z of ~ Pursuant to Comm 83.54, Wis. Adm. Code Seoti--c .Tank The septic tarik shall be maintained by an individual certified to service septic tanks under 5.281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending Continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank; If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps.shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution S tem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February] dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg/L GODS, 150 mg/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing paint at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82-84 Wis. Adm. -Code, and shall maintained in accordance with its' re ortin ent manual [SBB-- )] arid local or state rules pertaining to system maintenance and maintenance P g ~~-1ob9t - ~ No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shalt be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessmenf shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump,. pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. . Questions about the operation or maintenance of this system should be directed to: The County Zoning Office at ~~_ ~eQ{~ _ 480 ST, ~a~l~ The system installer at The tank manufacturer at _3~-~-3~Z- s The effluent filter manufacturer at _ - ~~~ . Z.Z(. $'7 U Zpn-~,~ The pump manufacturer at ` 6 3~ - ~ ~- ~~~~ G~v~~s _______ PLOT PLAN ' Scale 1 "_ ~ O' ' ~ , ~! ~t ~~ 1 ,~ ~3;'~ i I ~ ~ ~~ ~' m or Page 3 of ~ Cl~v`n vy2 tr 10 ~ • 3 ~_ 8 o~~wt Or ~°1~-~- ~Z.. L O L. 4 ~~z 4gs \\ ~ ~ ~ k~ ~~\ ~ ~~' -~-~, 6 !o o\ IpS ~pP z~~~vc fi.K.,. e ~w~,+Z ~ a~~i ~~1 ~\ - `~-. ~oo:o' 0~ 1` ~ ~[ fl PVC.-Q11~E - -- - LUT t_1~~~ NOTES : ~ ~" 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation ipes with approved caps. ( Z required). 3. Septic tank to be ~Z.u~ ~8~0 gallon capac'ty manufactured by . 1til~S~Z Cp~,1C~Z~ r1,~Jlp tZOpl~00 -ti2 ~I~ ~~~UO ZP(B~'Z. N1L`~ 4. $ench mark 5 S~ ~vUN~ 5. Divert surface water around system to prevent ponding at the uphill side. ~~ y~ ti ,~~ _ a 99s~ Face ~ G -7 Aparoce= S;r.!t_~!etic Coverinc • ASTi~ C33 ' ~hkd~r S an d Tcpsoii -~-~ c.; • -J i 3 ~ Z, . °a Slope Distribution Cell of ~ Force Main Z" to 2 2" Aggregate From Pump CROSS SECTIO>y OF A MOUYD SYSTEM Linear Loading Ra ~ = q. , O GPD/IuY FT Desicn Loadine Rite=' o• -D /cQ FT _~_ .i. -e;= Tarr ~ ~ .. -- ~ E a-~----------------- A ~-6B--- ----- w ~ ~L_-_1 __ - _ --- . ~Oistrii7ution Pipe Observation. Pipe U-acybr securely) ' ' _ PLAri VIEW Or" A MOUYD SYSTE:4 A ~_ Ft. B ~7 Ft. I ~ Ft. J ~ Ft. K q Ft. L ~ Ft. W 3 O Ft. Distribution Fipe 0 G .Elev. lQ ~, Flowed Lcyer 0 ~•~ Fi. E ~.ZS Ft. F o- ~ Ft. G ~ •S Ft. H l.u Ft. ~Q •Observatian Pipe ~ K • __ _ I - - ~ --- '---= -- •1 --- ----------------------~--o Force Main -- • -=----! L ~~ _ _•-.. sow `Cell of ~" to 2i" aggregate Distribution Pipe Layout Pace S of ~ Place the holes at the bottom of the distribution pipes at equal spacing, Remove all burrs from the pipe and 'Holes. Extend the end of each lateral up with the use of long turn or 4~ ° fitting to a point within six inches of the final grade. Terminate the ends of the laterals with a valve,:threaded cap or . threaded plug. Provide access from final grade for the valve, threaded cap or threaded plus. T `t P_ 1 CTS L . ~,ZOS S S'~.~-~ 10 T~7 PVC, Lateri ~ C-Manifold Pv C i--- Laterl p ~_ ~- -- o- _ ~cc~.s -sox ~~~ -~ r~~~~ ---0 PVC w2~ ~ ~ ~ 'A - ~o P 31• S Ft. Hole Diameter ~~~ Inch • -- 5 ~ Ft. - Lateral I • Inch X ~ 6 InchPS Manifold ~• Inch s [ '~~ ~~ • -- Force Main " ~• Inches 1 # of holes/pipe l1 Invert Elevation of.LateraislOl.~Ft. Llk 0.~(_ ~I.SI k 6 ~ z`~.p 6 Gpj..~ ?~~-N v~Ew ---- ~. ~ _ ; ~ - Combination Septic~.Tank and , PUMP CHAMBER CROSS SECTIaId AAJO SPECIFICATIOIJS' PAGE ~ OF • • -- •VEIJ7 CAP ~~I WEATHER PROOF ' JUUCT101J 80X . ti C.I. VENT PIPC ~ .APPROVED LDCKIIJG ~ZO' FROM DOOR. MA1JF{OLE.COVER tvt~ :ilNDOw OR FRCSH ~ wAttNIIJG 4AgEC., ~3P~•, o>'J P tPE A~IIJTAKE ~ cor~e~tT w /r1•tt'Z~ s ttT- zrcp ~, s .. ~ % I ' Ftreitg~ 6`riw. ,~. t ~ ~ Y~HIN. ~ ~ ~~~ ~ ~,, ~ . tA1LET ~" PROVIDE I - . ~, `•'' ~j'"AIRTIGHT SEAL I III .~, I 1 eat-r~~ I~ i Approved Z~~. tt~~ _. A' ~ 'II Approved joint w/ fl-ISoo t joint w/ I II AL~,Rx PVC pipe PVC pipe a II II I I I oN c •I I CLEY.gI'g3 FT. ~ I PUMP ~ --~ OFF D • CO-.-CRETE t: RISER EXIT PERMiTfED OIJLy IF TA-JK MANUFACTURER HAS SUCH APPROVAL 3"APPRorF_ ~BbOt~ i tv4 SEPTIC f ~ SPECIFICATIC)1`IS . DOSE TA1.1~(S MALJUFI-CTUitCR: wt~~Z ~~ C ~~~ IJL1MgER OF DOSES: S PER D~-~ TAAlK SIZC : ~L~ IZAtI/800~-a-r;`'ll2 GALLOI~lS DOSE VOLUME Z ALARt'1 MAUUFACTURCR: S S-N~.~C~-1RA ~ys~'~k~J~ IA1CLt1011JG 6ACK/LOW: -~33 •y GALLOUs MODEL 1.1UMSER: ~~ L`+w CAPACITIES: A- ~~ 3 IuCHCS OR y~o. CALLOUS SWITCH T~PC: ~~~~~ $. Z IlJCHES'OR y S G~.LLO1J5 PUMP MAIJUFACTURtR: G~VL-1~S C=_~-WCHES OR ~3• GALLOtJS MODEL IJUMHER: ~~ -S • ~ D= l O I~HES OR ZLZ-TGALLOA75 SWITCH TYPE : __ ~~~ZC' [J(T_.~~ 3 ~ ~`1 tY~ ~ 8 0 0 . b _ WOTE: PUnP ANO LARM ARE TO bC MIiJIMUM DISCKARGERATE Z'~ "fib CpM INSTALLED OA! SEPARATE CIRCUITS VERTICAL DIFFERENCE DETWCEU PUMP OFF AUO..DISTRt6UT10N PIPE.. 1L"1•b7 FEET ~~-~ f KI-.IIMUM NETWORK SUPPLY PRESSURE , ~ ~ ~ ~ .rj ~- I~s FEET OF FORCE MAI1J X ~,b~FT ~ ~ ~ ~ ~ 1 ~ o FEET ~S.p K 1. S~ y ~OFLFRICTIOIJ FALTpR_, FEET 2Z~ ( TOTAL Oy1JAMIC HEAD = ~ 2'Z7FEET , I As per manufacturer 2-Z:Z.~ gal/in. Liquid depth 36 `' ~~ GOUIdS ~G 1 °~ ~ Submersible Effluent Pump ~~ ~ 3871 EP05 APPLICATIONS Specifically designed far the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water~#ransfer • Dewatering SPECIFICATIONS Pump: EP04 • Solids handling capability: 3/4 maximum. ~. , • Capacities: up to 55 GPM. ~ ~ • Total heads: up to 24 feet. • Discharge size: l'/i NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Pump: EP05 • Solids handling capability: '/4 maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size:l'/z' NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous. 140°F (60°C) intermittent. J • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP, i i 5 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: l0 foot standard length,16/3 SJTO with three prong grounding plug. Optional 20 foot length,16/3 SJTW with three prong grounding plug (standard on EP05). METERS FEET ~o 9 3 e 2 0 a w U a z 0 J FQ- 0 e 2c 5 1; 4 3 2 0 i( 00 ~V;_ N 3V 40 50 GPM 0 2 4 6 8 ~ 10 12 m~/tr CAPACITY m 1995 Goulds Pumps, Inc. • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Automatic models include Mechanical Float Switch assembled and preset at the factory. FEATllRES ^ EP04 Impeller: Thermo- plastic Semi-open design with pump out vanes for mechanical seal protection. ^EP05 Impeller: Thermo- plastic enclosed design for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ^ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ^ Motor Cover. Thermoplas- ticcover with integral handle 'and float switch attachment points. ^ Power Cable: Severe duty rated oil and water resistant. ^ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTING SP• Canadian Standards Association (CSA listed model numbers end in °F" or "AC".) ~ i - - C ~ I f ~,, r¢ ~~: 1 ~ ~ ~ ~ 1 ~r r ~~ -- - -,_ i i - i ' i. - - i ~ ---~ -- -~ -~. I ~ ~ ., , ! ~ I i - ~ j I Z~~• 0 ~ ~ ~ ~ ( i - - EPOS'- . _-~ j ~ I i ; I f i ' I Q E!tective Mav. 1995 ..Wisconsin Department of Commerce SOIL EVALUATION REPORT • Division of Safety and Buildings Page \ of in accordance with Comm 85, Wis. Adm. Code ' Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County ST. C.~ l~ include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Please print all in orm~-'¢`~`'c~`~•---r R sewed b Date Personal information you provide may be used for se nda u oses P v~F~ r`1 P rP i cYzaw, s. 15. ~1) (m)) 'v /- `2 ~,~I:~~~ Property Owner , .. Prop rty Location ~Z.. V ~~'`~ ~ C.~'~' ~i..L.E` r' ~ ~ ~QQ~ t Sw 1 /4 1.1~v'1 /4 S 3 ~ T Z. ~ N R 1 `1 E Property Owner's Mailing Address ~ ~~;,> Lot Block # Subd. Name or CSM# Zg- ~ ,vc ~~r-r--;cr= ~ '~Y`'1 ~ZPr~~. 'Pte.Ct~S City State Zip Code Phone Number City ^ Village [~ Town Nearest Road LfTlt~ CPVVA'Dx~ Mtn SS 1t~ c 6s -) 487- 6 t3 b ~"~lM 0`rJ~ 1SV `n} ST- New Construction Use: ® Residential / Number of bedrooms ~ Code derived design flow rate ~ ~ Q ^ Rep{acement ^ Public or commercial -Describe: ~~~"""'Y~~'"-~-- Parent material \~ ~-`.- Flood Plain elevation if applicable General comments and recommendations: ~S ~OR1~/G ~~U~-~ ~ ~OU~ `~~ ~ UU tiO ~~,,~~~ ~ ~~ ~E tnJ OZp~. ~ ~~V~pL ~1 ~~°~~T~L,~ ' D ~ S Tp.-,~ c.L3~~ ~1J ~~- W1 pU)~ ~' P12-c~ 1~ S ~ l-~k.( L GPD I ft. I ^ Boring # ®Boring ^ pit Ground surface elev. ~~ ft, Depth to limiting factor 3 Z in. Horizon Depth Dominant Color Redox Description Texture St ure nsistence Boundary Roots in. Munsell Qu. Sz. Cont. Color r. Sz. Sh. ~ O - {O 1 O`11~. 3 ~ -- S L ~ Z 4.b`rt ~ 1- CS lv `~' Soil Application Rate GPD/ftz 'Eff#1 'Eff#2 ~ ~ • ~ -~ Z_ 3 lo`~l~z-3 16 CZ P 1.S ~.rZ y 1 ~ S ~ Z y'~1 Sb ~Z 1-~,'I~-S- - ~ S - 9 ~ Z r+ /G ^ Boring # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting far•.tnr Horizon Depth in Dominant Color M Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ftz . unse{I Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~ 8 ~ Q3 w ti L~ i~ Se Z 2 S uT' 1Z-17- 01 - S ~ ~ ~i ~ ~ •t- s I _ C l~uG o _ f C.E. ~ Ffflitun f $1 - CAn ~ en . nnn __~ _ - o - - . --- ...a _ _.._ ..,.. - .... _- ~.... ~~ ~y,~ r=uwani rrc = rsuu5 < 3U mg/L and TSS < 30 mg/L CST Name (Please Print) Signa re CST Number Arthur L. Wegerer ~ O 3 -°~3 220254 Address C,l e g e r e r S o i l Testing & Design S e r v i c e Date Evaluation Conducted Telephone Number 421 i1, iiain St. ~iverr'alls, [1I 54022 6_ Ja-p3 715-425-0165 Wisconsin Department of Commerce SOIL EVALUATION REPORT • ~ Diviston of Safety and Buildings Page \ of in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County ST C~ l~ include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, sple or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner I Property Location ~~-u ~ ~ Lcx~ ~,~~ `~`~C r Govt:-tbt S~ 1/4 3~11~1/4 S 30 T Z g N R 1'1 E (or(~ W F~roperty Owner's Mailing Address Lot # Btock # Subd. Name or CSM# zoo ~ R.v ~ e P~ ` l - I ~~-~.~~ ~et~.~~-s C~tY State Zip Code Phone Number ^ City ^ Village ®Town Nearest Road ~~-~ C~avPm~ Mtn ss ~t-~ i c6s ~ ~ 487- 6L3 b ~~i~W1M~`f.~~, ~ 1SV `~{- 5T- ~ New Construction Use: ® Residential / Number of bedrooms ~_ Code derived design flow rate __ L Q Q ' ^ Replacement GPD ^ Public or commercial -Describe: ~ Parent material ~ L.~. Flood Plain elevation if applicable General comments ft• and recommendations: ~S FOR-IdVG ~p~Up~-~ ~ ~~U~~ ~ ~ r~~~~~ ~ lS TP~.~ c-~: 3~~ ~'1J Baring # ®Boring _ ^ Pit Ground surface elev. Lp v . ~ ft. nanrM r~ limi+inn f~rfi.. 3 Z Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots Soil Appliption Rate GPD/ftz ' ' Elf#1 Eff#2 I 2 o-to 10-3Z »~~z3~ 10"1,2y1y -- - spy s~c~ Zw~ab~ Zwt sb m~- ~`~- c_s cs ~v~ - .~ ~ ~ .~ ~ ~ 6 3 Z_ 3 10`'1 ~z-316 CZ C' ~ .5 ~.2 y 1 ~ s I Z ~ Sb l~z ~vt,~-t- - • S . 9 I-t n o_ :__ tionng ~ " ---...~ ^ Pit Ground surface elev. ft. nenrn -n rR,~r~r,~ ~~,,,~ Horizon Depth Dominant Col Soil Application Rate in. or Munsell Redox Description Texture Structure Consistence Boundary Roots GPD/ftz Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff# 2 ~ 8Z Q3 w ti w 3 ~ Se 2 ~z ~ ~ s ~,-s- ~, ~z-1~ - fly . S O ~1 ~j ~ f~ '1~ S I _ ~ tom' D _ [ Cr~ . ' Effluen t #7 = ann ~ sn ~ mn .~,.~ .,a T~~ _.,,, -_.._ ---~ _ ..,,~~~e,~ Arthur L. ~~~egerer ~,~A ~I ~~~.~ ddress 4:iegerer Soil Testing & Design Service 421 i~. %iain St. diver calls, F7I 54022 uuuern rrc = tsvus < 3p mglL and TSS < 30 mglL O 3 _Q ~ CST Number I 220254 6- ~~-03 715-425-0165 Page z- of Z $•S T' I.UT Lt~.J ~` ~I ~~ ~I ~~ ~~ i ~ Q ~~ -m or c~v`Nvti2 ~, ~Oo .3 ' ~ZJ' ~ n`~-o~ or- ec~.~ o Q O `~J '~ .. ~ , ~ `WM,~ AtT Ol' ~1S~V2~3 't'1t1S Ar2.~q ~ `' 3.3 ~•z 9~s ~ ~S \~\ , ~~ ~ ~'~ f ~0 ~ 5i ~ ~~ ~~ 9 3.~9s y ~3~ ~~ . -- ~~.-1._- '~-~ ~Oo:o. ow ~`~ tit t9 PVC Qct~E-,- , --- _ _- -- ----_- -1- tU i L i,v~~ ~- ~-l _03 715-42 I- - R 5 •1G5 220254 ~3 ~3 CST Si nature g Date Telephone Ido. CST Alo• Job PJO. PLOT PLAid Scale 1'=`10' PLOT PLAi1 Pale _Z-- of ~ Scale 1'=`10' t I i `I I I I C~ ~~ n; ~;~ ~I ~~ ~s1" l.uT LI,U ~ ~ ~~ -m ar 1`N wt ~, e ~ ~~-~-z ~ a~~~ J~ 0\ -~~----~-_1-00.p. oN _l<<-~ii9 PVC-Pf~~E---.--_-_ --'- _ ~U i L ~,ut~ ~. CST Signature ~-tQ-_.c~3 715-425-0165 220254 03-9.3 Date Telephone Ito. CSTr1o• Job P10. ~3 o~jy~,t OF °~c:''LL o CEO `~~ C~1~L~~Pr2T 07~ ~ ~ \\ ~ZS'TVR-~3 "C~.f~ S Pc'IZ~ ~ `' 3.3 ~ Z g9 s ~ ~S ` ~\~ \ ~~ ~ y~ ~ ~ 9 3.~9s ..+ - Wisconsin Department of Commerce D~vision`of Safety and Buildings SOIL EVALUATION REPORT Page 1 of 3 S/~" ;- .~' , County ~' ' ~ ' . Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must ,.- w r I X ~, ~•% include, but not limited to: vertical and horizontal reference point (BM), direction and t l l di i rth d l i Parcel LD. ;'~ ' • ~~'C~R1'~CO ~,K~ percen s ope, sca e or mens ons, no arrow, an ocat on and distance to nearest road. ~. Please print all information. eviewed Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Locatio ,' w ` NTY ~ ~ICj'~(.tl'Z~ ,~~ Govt. Lot sw . 1/4 ^/w 1/4 S ' ~ T,, ' N RFC r)~ Property Owner's Mailing Address Lot # Block # Subd. Name or CS ;'~; ~ - --` -:--` (353 ~ - e Ir- 1 ,Eht ESE ~ City State Zip Code Phone Number ^ City ^ Village ~ Town Nearest Road I-~ttd5on l-l~ ,5`fbl~v (-11~ )5`19-!0 7 I e ~'J't i'Yl~a/~-c%( ~ ~ °Y~' S7~ [t~ New Construction Use: [~ Residential /Number of bedrooms ~ Code derived design flow rate G/Sa ld 4 ~ GPD ^ Replacement ^ Public or commercial -Describe: ~ Parent material i~ ~ I Flood Plain elevation if applicable /~/ / ft. General comments S y S ~ P ~~ U~ /~~ •~ Q 'and recommendations: 9~ ~6' ~o-~-b~~ e(eJ. ' Boring # ^ Boring ©Pit Ground surface elec. ~<'--4~_ ;t. Depth to limiting factor ~31 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 - I z. lD r 312 5i' / 2,,,., /< rn~r c s 1 v-~ . S • ~' z 12-~{ lD l`iL Sicl 2m 5.b < m~'r ~~ - . ~ 3 I -c~ lD r 3/~ C2~ 7.5 r ~/~ 5~ Zmsbl~ -.fir - _ - 5 - ~ ^ Boring Boring # d ® Pit Ground surface elev. ~~~ ft. Depth to limiting factor 29 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 v-i/ lb r 3~2 s,/ l~ ~ ~ v~ . 5 . ~ Z l/-L9 ~b ~l`f - ~~l r mt-'r Gs -- ~ Gf 3 Z 9-3~ ~ r 3~~ e2l~ 7 5 /co S~ 2m~k-- r -- . S - ~1 * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) ignature CST Number edam ~°Schrtmc~Cer ~~ --_-~~~ Z 3-309 Address Date Evaluation Conducted Telephone Number _ 2 !13 ~ ~, ` . ~m ers-~ ~ , GPI ~ s~d2~ ~ 2 -- ~ ~- a ~ ~7~.~) 2 ~ 7^ `~~~ JIiL-bS.SU tKU //UU) w .• Property Owner ~ 1tt~l )~ ParcellD # Page ~ of Boring # ^ Boring ~O Z ® Pit Ground surface elev. ~~JD• ft. Depth to limiting factor 3 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I d-Iz Iv r312 Sil ~ e lv~' . 5 ~ 8' Z IZ 32 ID yr y~~ - ~Ic-~ m m c~ - . ~ -3 32-`i I ~ 31 t~ C ~. 5 ~ y l L Zm ~< _ . 5 - `~ ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 =GODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) Property Owner ` ~7~1)t Parcel ID # Page L of -3 3 Boring # ^ Boring ®Pit Ground surface elev. ~~o•/e~ ft. Depth to limiting factor ~ Z in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPO/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 I 0-Iz Iv x312 it k ~'' ~ 1v~' . 5 - g" -3 3Z-`-t l ~ 31 C ~ ~ 5 r" ~tl L Zm ~< _ - - `~ ^ Boring # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz 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. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 `Effluent #1 =GODS > 30 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SB0.8330 (R.07/00) ~„ .. . PAGE~OF~ 1`T b~ ~ y ~" LOT# ( T L DESCRIPTION Sw ~ Nw ~ ,S 3 4 T L q N.R. ~ ~'• E(or)~ SCALE: 1"= Y~ BM 1 ELEVATION /yp • O BM 1 DESCRIPTION •~•o p a ~ (~ ~ (J ~ P,"Q e BM 2 ELEVATION 9T. y~ BM 2 DESCRIPTION,.~,p a_~ ,,~ c. SYSTEM ELEVATION Jl~O~ ~ ~ ALTERNATE ELEVATION~~ CONTOUR ELEVATION _ l ~• S~d N ~. -~-~ l Sec • 3 a ~D ~` \9~ a \~] b ~` SIGNATURE O~ ~'~ DATE /Z. - / `1'" o! -~- -_ 2 ~ y~ 0 6 8 ~t _. _ ~ - _ ~~. _ i . - - - - - - _. ~ - KATNt EEH H IiALSH . St. Croix County Occupancy Ai~davft Name - (Owner) Typed or printed being duly sworn ,states, under oath, that: 1. ~~ is the owner/part owner of the following parcel of land located in St. t~oix County, Wisconsin, rxorded in Volume 2A 7 I Page 3~ Document Number 7u t ~ St. Croix County Register of Deeds Office: REGISTER OF. DEEDS ._ .- ST; CROIX -CB,:.. _"tfI_ _ RECEIVED FOR RECORD 08/04!2003 09:45AM AFFIDAVIT EXEIPT # REC FEE: 11.00 TBAHS FEE: COPY FEE: CC FEE: PAGES: 1 ame and urn Address A parcel of land located in the '/. of We _'/. of Section H ei S -+ ! ('~, ¢/lP 5'f79~2~ T N - R W, Tows of St. Croix 2 ~4? /2,u v~-ic i~/qt? /? ~ 1)d County, Wisconsia., being duly described as follows (include lot no. and L ~ ~ f'H-Q C A Ngel.e ~ P-W S~ 1 1 y subdivision/CSM or detailed legal description): ,(, (J I £~ ~ah7 - l0-C3 a) Cyu) Csol ~`/~'~~ i2C1 ~~ ~ C r2E S ~ Ld -~' ~ Paroel Identification Number (PIN) As owner of the above descnbed property, l acknowledge that the septic system serving this residence is sand for a ,~ bedroom home, or a design flow of gpd. The design flow is calculated by assuming 150 gpd for 2 hdividttals per bedroom. There are currently '3 occupants living in this residence: _ occupants are permitted based on the design flow. Therefore the septic system serving this residence is Dude compliant. However, l understand that if there are intentions to exceed the number of pemmitted occupants, the system will need tD be modified to aooomodate any increased wastewater flows and/or oorttaminarrt loads. 1 also acknowledge that i will make this information available to any future parties interested in purchasing this property. Dated this ~ day of ~ U r,.t~ 57 ~- _ ~ au~»NH:ac~ his day' of ~C~.~.:~-,~ ~"~,._~-5--,_ .. _~ • -i • 3~ 10/y _.'~~ Atrlwowt.EOCINt: 3't~,,, .: ~. STATE OFWISCONSlN ) "*~,•+~'"`'..'.- r•..,: < .,:w.i~r.irs -_ ~ _ - --Persdnrigaoamiebefo~stmsft~ . _: =`--~ft;A=~_. =- ~~ r, a, ~ ~ sew 5'fc! ~• b~ TITLE: MEMBER STATE BAR AF WISCONSIN _ ~ trot _ _ _ --- -tome known to-lap the pe~sun(s) wha execxrlled the foregoing authorizedtxY§-7QB.06. w1s: Stats.} ~ _ ~ .instrument arxt aclcnoMAedge the same: --_ _ - . T~itSINSTRtlMENT WASDRAFTEDBY - - ---- -- _- ^~'4,~,•s sT~-R K ~d~-2,~~•-.-,obi . cJ~~ Notary Pudic, State of yNiseonsin (Sipnahrres may be authenticated or adcra~Medged. Both are not My Comrassion s permanent. If nW, state e~iraUon date: necessary.) Gate: ~ d 'THlS PARsE I.S PART OF THIS f.EGAL DOCUMENT - lb NOT REMOVE" TNs kM~crrnsHort rtnat bs oarpkted by su6rtirMr and PIS ryipt:kad). Ofhsrlrtlbmwfionsuch asthe tlranGNry eawas. NeJi~ dssrxipfiar, etc. gray bs pUcsd or this Iht pygs dlNs dbcurrrsrrt ormay w paosd «, adoitflonslppss d tYa doourrrsnr. ~~ Use d trala cor~rpspe adds ores pops b raw docurttaK and ~,,t>D ~ fhe racnrdra lbs. fM1titCOrtsNr Staf uNa, t~ Si7. FRQt~I ~cF,i_imd4<.cr F' 1 ~_imL i r-~q Uwr,ot'I$uyer C' ~- V a Mailing Address `~ ~~~ ~ys'~t Property Addreas Y (VorillcatioA ragtaxrod &atn Plantzictg Deparnnaut fat. new Ciry/$tate l~tx~t,,,,Q,~C~ w,. PgrceZ Idantsi`icatir~r. Number ~/ ~' /~ ~ ~~~~~~ Praiserty I~oc~Cian .S~ T/a, N w '/,, ~t*c. 30 , T ~ ~I~R I ~ ~~ Town of ~o~ ,f~a~ r~.o-n,d Subdivision ~ --~ ~.at ~ ,,,~~ Certified Snrrrey iVtap # _ _ ,~ -- _ . Volume ..Page # _...__ v1•~arrattty Deed ~ ~ 1 Z ~J ~ , Volume Z D ~ ~ ,Page # 3 Sd Spec house ~ yes ono Lot lines ideniaablo ~, yes ~ zka Ytaproger utso end maintenanceai yowr septic system ceuld result is tts premature failtzra to handle wastes. Yzaper mai,utc.~c: c~n.xi~t9 of puz~ing out the septic taalc every th:-ee yeans or aoos~er; sf needed by a licensed pumper, What you puk inrc the syet~:~ cau affect tba fttsctiea of ti=e a+agtia tarok as a tt~atnaeat ata~e in tlu waste disposal system. 'fie praprr•.y awxtot agrs~os to subnaii to St_ C*oix Zoning ~egnrtmet:t a certificaiioa ~'ornct, signed by the owa_er sea ~y ,xa srez pluttabtir, jd~su plumber, zoa~trietedvlu:nbas ar a Iioeasad p;;~par vGri.~j'ing tkat Lt l the 4n-site wsatewatrrdispUSal sy3rPr i~ in proper opm~atit-g catiditian and,'at (2) at~.er i~xpeatior and pumping (if necessary), the septic tatxk is less than 113 full of sisidg2 L~•~e, tha umdexsigaad have rend the abc+ve rega:iremants and agiec to rxtaintaiu tau prieate sewage disposal syate~ wit.' the 6tana.::l set fe:'tYi, herein, as asaE Isy the I~epattmoct of COmmGrcC and the Dtpastmca: of Nettt:ta: Rcsourcrs, State of"Wisconsin. Ceriifictttio saaricg fat your roptiC system Z~,as boon maisttAiaed moat be carsspleted sttd ratxuxiGd to the St. ~.~raix CoGrty~ Zonis Qfflce within 3 i days of the thc+eo ya~tr eap' tzars date. 5~3 Sit3NATiJ~ bF A~~.ICANT DATI~ ~,VVNi~R CEi~ C~1TI~ON I (wa) certify tbet sll slatcttents an ilaia form ace true to tea best of any (our} kzto'a~lydgc. the roperty daBCribed a ve b virtt;Y of a v~rartaaty decd retarded ;n Register of Deeds Qfticc. SIGN:~T>LfRS QF d,PPL:ICAN`1' T (we} az:r (zee) the o;~ner(s o %~~~~.~ l?A"l'E i•~n~«r ~y iufcorm4tio.~ that is mss-aepresesmad xas,~ :esuit iri tfte sanitary° }~eu:rst bdirg revoked by tlse ~onitzg Degatc,~ent. • «'""'. FA;~ hJO. 71538^1:'1 t'1dy. 28 cC1L1? l=11: ~1F'P'1 P ST CCi.CD1X CQU>"I'~' SEPTIC 7A:~k ~IAIhTENA~CE AG~.EE,'~1EiL'T A'vT3 ta'UV:~iERSHXp CEIZTIFICAT,nN FORM •« lssciude aftt< tbl~ agpiicatioa: a stxxnPed wazrauty decd forts Ilse Ra~iatar of Dee@c oftca a copy of tIu testified eutvrry map ix reference is made in the waz~ra~tty did 7 2071 358 701235 ~~ - STATE BAR OF WISCONSIN FORM 2 - 1998 RATHLEEH H. MALSH WARRANTY DEED REGISTER OF DEEDS ST. CROIR CO., WI Document Number RECEIVED FOR RECORD _._ __ _ 12/06/2002 09:00AM This Deed, made between _ RTf N ~~ TIT anA .TaNF.T v STCLUT, EXERT t fitrcha nrl anr7 tui fcr___ REC FEE: 11.00 _ __._, Grantor. TRANS FEE: 128.70 and f"uAZSTOPHFR W STnRK anA MTC'HF.T.T.F. R_ RTARK_ COPY FEE: ___huchanA and wife, CERT COPY FEE: PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following 'j described real estate In S roix County, State of Wisconsin: j Fict ording Arya _.._ _.__ Lot 1, Plat of Emerald Acres, Town of Hammond, Name and Return Address St. Croix County, Wisconsin, ~ ,/~ ,}~,r\ `~ _, ~ ~y ~.c~ 1'~ul,Um(J,U~t,-7)KU,xL,-L~`31 ti~l,i~' ~37~77_f __-_ ,--- 018-1067-10 000;0181067-30~p00 018-1067-40-000;0181067-501 00 ~~ Parcel Itlenlification Number (PIN) ;~I r/ h This 15 riot homestead property "~ (J 0 : (is) (is not) ~ ~/ ~ ~'; / D {~ 1lfetro Legal Sendces EDIl2ET 374771 .4 „3667 l4'D 1486'_4 Exceptions towarranues: easements, restrictions, rights-of-way and covenants of record. !-. Dated this ~~--' dayo-f `November 2002 O "~~ ~' ~ \`~`^" (SEAL) / '( ' ~'~~ (SEAL) Richard O. Stout Janet P. Stout Signature(s) _ authenticated [his day of s TITLE: MEMBER STATE BAR OF WISCONSIN ([f not, authorized by §706.06, ~A'IS. Stats.) _ THIS INSTRUMENT WAS GRAFTED BY Janet P. Stout __.'~353~taatukee Tr_ Hudson, WI 54016 (Signatures may be authenticated or acknowledged. Both are not necessary) AUTHENTICATION (SEAL) ACKNOWLEDGMENT (SEAL) State of Wisconsin, ss. St. Croix County Personally came before me this ~ <ri h day of the above named ~pet~- StOllt ~~ /1tt1 1 QAOT__.____ to me known [o be the person 3 who executed the foregoing instrumented acknowledge the same. Nola Public. Statte o Isconsln My ommfsslogps p~rtta~nepf._(]j~ot, state expiration date: ' Name of persons signing in any capacity must be typed or printed below their sigtmturc. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., inc. WARRANTY DEED FORM No. 2 - 1998 Milwaukee, ws. r T W m n m Z - ~66'6E6 3,.6 L.£ L°OON 239.40' G~~ pl CSI QI LwJI I a; - ~I ~ ~ o ~ _ a~ o ~ $ o ~~: ~ ~ i W V ~I m~ rcg ~ oI IA ~ a~ ~I ~ NO .. of ° lit I ~ 3'± `r ~ ~ Z ~ QI o; ____~_________ 236.3li' ~~ WQ ~~ ~~ No n~ N ~~~ sot°~ 1'31' N W m O Z ~~ __r____________ ~, i ~ $_..g .._.._:.~. _I._.. ~"~ 239 37' 716.92' X00°13'19"E 2276.02' ~y gT LINE ~ NI OF THE NW1 /4 150TH STREET S00°13'19"V1/ 356.29' 17 9.41' ~' , oa i ~ i ~I ~ t ~ Z ~ O I ~ g~ Q ~i ~ V - I ~ °I al Q~ ~~ 3Ni OiO i I d~ a~ ~0~~~ ~ \ a ~ ~e