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HomeMy WebLinkAbout040-1147-20-000 'Msconsin bepartm, or SOIL EVALUATION REP 3 ►ivislon of Safely an Build ngs L Page of pp kko►dan a with Comm 85,Ms. Adm. Code v Allach ronrplelr►silo tan o► pefQol'le� r 8 1/ x.11 inch County S�°•• C Q 1 �- Inrlude,but not IUnlle to:ve tf r es in size.Plan must �i� t co s rr1►U) direction and Parcel I.D. U percent slope,scale dp_rg V d locals, tistance 10 nearest road. a� ' 117' -.2 Q•Q�O 6i9�0v 9-ss U ase pNllf all Inf tte'vlewe Dale CY��1A{ a A r asonat IrdnmmOrnt yotr provide may hr used rot secon ary prnj+oses(r'rivary cm- 15.04 1)(m)). ProD1006'-perty Owner 'A - ,pro ��'���, � �6 J_► e- 1 1 A!J pert Location `� • Govt.L SS 1/4 dU414 S/3 46 N R20 Properly Owner's Mailing Address ��)W 27 2 4 • Cdv,. RD • cr , Lot q Block M Subd.Name or CSMp �y�E,� j ri relmGov)"' GdT .l- I� Cify Stale Zip Code Phone umber w � f,st Road #1 Pf,0 N W1 S yo/lr , his 38�o• /93Z City U Village Town Nearest Road T,Po y F. eovl - Pfd IJ New Construcflon Use: itesidential/Nurnber of bedrooms Code derived design now rate O GPD OReplatement El Public or commercial-Describe: Parcnl material_� f^MDy 0 Qr� Flood Plain elevation if applicable N General comments n• and recommendations! 13 Ep/i''41 p i S L• T SEASO,vi4�. > ,6-- sys Te"I W/W �*i2 3 a eoR,4fs �• �S r��/o W Boring 0 f�f��11 Boring /Q 3.3 2 6L'1 PII Ground surface etev. 1 11. Depth 10 limiting factor } ?p b In. Horizon bepih Dominant Color Redox bescripflon texture Structure Consistence Bounds Roots Son Application ate. In. Munsell Boundary GPD/It:.. Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 -1--- �� 9 Dl''P 3�3 zS Iff,< d,Q CS' 3 F . 7 /- 2- 61 CS O �. Z Boring b U Boring 2,2 pit Ground surface elev._ n. Depth Io limiting factor in. Horizon bench borrrUtanl Color Redo"bescripllon Texlure Structure Consistence Bounds Roots Soli Application Rate in. Munsell ry GPD/11 Glu.Sz. Cont.Color Gr.Sz.Sh. 'EINft 'EffN2 ioYR 3�3 GS s v,s .~ /• Effluent!!1 =13008>30<220 rng/L and TSS>30_< 150 mg/L •Effluent 02=BODE<30 mg/L and TSS<30 mgn- CST Na:M_e Print) Signature ���A', �L, _ � � — 1? �3 R t C ti'(" '�TWr1 (.(�(A C -' 2 CST 4 3?rS address Ulbricht&Associates Dale Evaluation Conducted Telephone Number a e Consultants FF 2-7 — c;,Q 0 �_ 715". 36 • Gig S 855 O'Neil Rd. Hudson,Wis. 54016 Nso, v as 9- To Ao ORIGINAL 5 s s Aso '41- U/7\ 00 r � . PA�er G-ov'r w r- z p►operly Owner . /y/•��i jN 7• Z-D • 000 r� Parcel lb N 3 noting 0 t_.1 noting Z3 page 2 of J I Pit Ground surface elPv. /Q4• n •� 90 . p beplh to lrr MV faclor M. Ilorizon Ueplh bominnnl Color Redox bescriplion Texture Structure Consistence Boundary 'Roots : Son Application Rale �• MunseN Qu.Sz. Cont.Color UPON Gr.Sz.Sh. 'Elf!!1 'Elf>r2 Z 0:& �oy,�,3j LS /� iP d,Q � 3 6 t7 io y,f .S, S 7c 7 A Z cS. - . 7 i•�: Uboring p t�' goring IJ hit Ground surface elev.--- n, beplh It1 Ntr►iling(actor flo►Izon — In.Ue Ih bornn anl color Redox Uescripllon Texture Soil Ilcalion lisle M• Munsen Structure Conslstence 13oundary Ro01s : Qu.Sz. Cant.Color Gr.Sz.Sh. GPOrn 'Elton 'EfNl2 r gorinq g Lj goring pit Ground surface elev. p beplh to Nmllinp factor M. llorhon bPplh Dominant Color "P.dox t)e-;rripllon Texture In, Structure Consistence Boundary Roots SON AppNca.1 Role Munsen Qu.Sz. Cont.color GPUrn Gr.Sz.Sh. 'Eliif i •EFR2 r 'Enluenf of =gobs>30<220 mgt and tSS>30< 150 mg/L 'Effluent q2=g()Us<30 nV/L and TSS<30 mgA.• 'Che Department of Conunarce is an equal njlportanily service provider qnd employer. If you need assisfahce to a r need material iri an Alternate formal,please contact the department 81609-266-3 151 or ITy 608-264-cce§7s services or Spp R11D nR 6MMr _ 87 I I. •1 \ d � � w 1 O \ G c ,( ° 0 Z w � I I' � o I' O a a o c -t I c m'€ 4 �� m y C c"O N y 0 0) C ON r p N O O C C O R a� N c Q y O M O m iy N CC'm V >W N .p I c'p O U) N I! 'O X— D V M-0 O_ O d X'O W T N N (D a) o y Q �o m -O stn-�°, y :3 o o o 0 o m o u ° ETa� 0 v Z E '� r c oo aciL c Zoe ° E'3 LL o y U 3 0 W � 3 v n CL -'`canm Q °c (D 0. omw rn I 3 0 0 N N .,,, O O.c0 O O w J 9 W Z In O d d l9 O � d m w 0 M � c O O c N AD O Z c > N N ( tS D o Q (mil y Q DI N 1� y N N `' �-a •� C O N t O Q Q O Z Z Z N � I N II O d 4 d m 3 �i C G a E E ' v 3 . R = aaa � a � a ;; o N J y > o rn O 0 rn Z v °� � o �) W O O N E N liN a' r o o LO m c Q o d Q z co 0 o o m y 5 _ E O co I Of � O 'O 'O 00 N O O m 7 V C C V n. O CIS CO Cr0 C QO G7 cO N N 30 c v O c 0 O O = U W N F- N N N a.+ 'O pp t � \ a a a L: CL CL Parcel #: 040-1147-20-000 02/08/2010 08:10 AM PAGE 1 OF 1 Alt. Parcel M 13.28.20.576B-6 040-TOWN OF TROY Current ❑ ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type #of Units 00 p Tax Address: 70wner(s,)L O=Current Owner, C=Current Co-Owner DOUGLAS D&ANN HARRIS MCMILLAN LAN, DOUGLAS D&ANN HARRIS 707 GOODRICH AVE ST PAUL MN 55105 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description *272 E COVE RD SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 2.160 Plat: �A-NAVA LABLE SEC 13 T28N R20W PT GL 2 COM 743 FT W OF Block/C NE COR GL1,TH S 1230 FT, W 340 FT, S 788 FT,TH N 67 DEG W 290 FT TH N 53 DEG Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) W 400 FT,TH N 70 DEG W 177 FT TO POB: TH N47 DEG W310 FT TH N 12 DEG W23 13-28N-20W FT,TH N 83 DEG W 370'MOL TO LAKE, SLY more Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 877/206 2009 SUMMARY Bill#: Fair Market Value: Assessed with: 33508 1,089,500 Valuations: Last Changed: 11/09/2009 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.160 643,800 425,600 1,069,400 NO 05 Totals for 2009: General Property 2.160 643,800 425,600 1,069,400 Woodland 0.000 0 0 Totals for 2008: General Property 2.160 639,900 409,700 1,049,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Total Special Assessments Special Charges Delinquent Charges 0.00 0.00 0.00 ` Safety and Buildings Division o �scona ! 201 W.Washington Ave.,P.tx�2� �e�xmit ��o P s�n Madison,WI 53701— Num ber(t by Co.) Department of Commerce (608)266-3151 Sanitary Permit App a W,DEIVED State Plan I.D.Number ti ,+ In accord with Comm 83.21,Wis.Adm.Code,personal i ormation you provide may be used for secondary purposes privacy La s15.04(l)(u>�•.-- Project Address(if different than mailing address) I. Application Information—Please Print All Information j Property Owner's Name NTY / - ne'sin� INU Parcel#� /f /Av Lot# Block# © �Property Owners Mailing Address Zd • �� ° � ��� Property Locattio''n''-- City,State c tp Code Phone Number �'' N�, Section v 1 A)) � ' r S u d b / - ��ci E rcle II.Type of Building(check all that apply)1 T N, R o 1 or 2 Family Dwelling-Number of Bedrooms Subdivision Name CSM Number /❑Public/Commercial-Describe Use ❑State Owned-Describe Use ❑City_❑Viilage Township of T °y III.Type of Permit: (Check only one box online A. Complete fine B if applicable) r A. ❑New System Replacement System FEDIuChange ng Tank Replacement Only ❑Other Modification to Existing System B• ❑Permit Renewal ❑Permit Revision ❑Permit Transfer to New L ist Previous Permit Number and Date Issued Before Expiration Owner IV.Type of POWTS System: Check all that apply) *'Non-Pressurized In-Ground ❑Mound>24 in.of suitable soil ❑Mound<24 in.of suitable soil ❑At-Grade ❑Single Pass Sand Filter ❑ Constructed Wetland ❑Pressurized In-Ground ❑Holding Tank ❑Peat Filter ❑Aerobic Treatment Unit ❑Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑Leaching Chamber ❑Drip Line ❑Gravel-less Pipe ❑Other(explain) V.Dis ersal/freatmentArea Information: Design Flow(gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required(sf) Dispersal Area Proposed(sf) System Elevation 3 " / t coy VI.Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units /� Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit Dosing Chamber VII.Responsibility Statement-L the undersigned,assume responsibility for Installation of the POWTS shown on the attached plans. Plumber's a(Print) Plumber�iat— MP/MPRS Number Business Phone Number �I�I�ICG� ZzCQ3`7 / 1�7 y�Z Plumber's Address(Street,Ci State, ip Code l Z Q �,� . Spl��� �— V1411 l,U/r SV7Ce VIII.County/Department Use Only ❑Approved ❑Disapproved Sanitary Permit Fee(includes Groundwater Date Issued Issuing Agent Signature(No Stamps) Surcharge Fee) ❑Owner Given Reason for Denial IX.Conditions of Approval/Reasons for Disapproval kj(, rt 7 SYSTEM OWNER: / j -�, C✓n�� ` l2 l . 2vh G 1 Septic tank,effluent filter and / y dispersal cell must all be serviced/maintained as per management plan provided by plumber. � / emit c (c_�*tZr�� Z All setback requirements must be maintained / % Jr as per applicable code/ordinances, Attach complete plans(to the County only)for the system on paper not less than Sin x 11 inches in size SBD-6398 (R. 01I03) fiu J,f ULBRICHT & ASSOCIATES CO. 2812 10th Ave. * Spring Valley, WI 54767 Reg.Designers of Engineedng Systems 715-772-3442 Private sewage Corwftnts PROJECT INDEX PLAN ID # .s ,� DATE OWNER :D0 L) /uC 101% 14AJ PHONE G/c� P/Q-36 ] _ ADDRESS o27 �. �o LEGAL DESCRIPTION ?,,wr of Gov r Z-o 7- Z. . 5 r Nom' 5�°T• /3, T�f��1 , �o �v . TOWN OF _ 'J-P-OS/ COUNTY s'+• C(�j/� CSTM LOCAL AUTHORITY/ SUPERVISION ,j 7'. `�j ,� CT� ,J�• �G` PROJECT DESCRIPTION: Ste, 77C s?stir . . DA Ly to to Bee'1 ;P °F 7441 ST4Z�9 ? 'fit-rN 70 T3/1 , Six — I.&c.�f s - -r4N& e gg, T lyt At times s �e �� Hess�,e,•z� �w.� Z4;v e k�� Xuv s/a1a 1*, iv- A-r- 1vh T sys7-�-y ��// /�c 9,e;4v.-,41 7a �:� M4Ste*— Ulbricht &Associates Z Z 4 3'?S Private Sewage Consultants 2812 10th Ave. Spring Valley, WI 54767 i P9•1 INFILTRATOR SIZING WORKSHEET P9.2 SYSTEM PLOT PLAN �/� P9.3 CROSS SECTION OF 'SYSTEM, WITH E Pg•4 1, 11 if ,f ELEVATIONS. !� .—�If P9.6 OWNER MANAGEMENT PLANS & of FILTER SPECS P9.6 (OPTIONAL) CROSS SECTION AND SPECS FOR DOSING TANK. PG- 7 (OPTIONAL) PUMP PERFORMANCE SPECS. The attached plans and specifications are based orl "In-Ground Absorption Component Manual For Private Onsite Wastewater- Trcai- an9- qUQ* MQ . " (Vaarai nn 7_n) CRfl_1 n7R_A(vn1 /n1 . m a -�z°`�,' n m CD 3 0 � c m� N Z �•r i a o � � ® o 0► jog � x � o � � �- t.A� c� m � OCf) X 0 O o ©. m � G� RIO� O m y 4441 OCO to O:r /rfzl�Z � ° cl, . 70 �? _ c c w d C+ 3 at 1 � -c • iii + m _ _ v it 4z nr �' QN t C/n(-v..r-r 046. H- 4 ,-,, FT 1,v .,vsA,EcTio,-1 �rZ Iff iris -'2_ 9 tic G��G L, �'�9��,U T/t°�'��.mot/ � ✓� vj T�,�,1 y T 10A,) 6- 744 7-0,4�5 q0 .5 , ,fA OV av4P Gw.�cl�y pzj�' S j AK CA?Mcrry AJAI. y it'd j t�ii . M 3(� A out f OVER= See Reverse Side for Vent/ Observation Pipe Details. POWTS OWNER'S MANUAL & MANAGEMENT PLAN page of Z FILE INFORMATION SYSTEM SPECIFICATIONS Owner -DO 44 am/` /-' G �A.J Septic Tank Capacity gal ❑ NA ' Permit # Septic Tank Manufacturer (br ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ;�,A-a a-49_ ❑ NA Number of Bedrooms 3 ❑ NA Effluent Filter Model /I —/ O"a ❑ NA Number of Public Facility Units .EMA Pump Tank Capacity a00 jai ❑ NA Estimated flow (average) Q'U gal/day Pump Tank Manufacturer Z ❑ NA Design flow (peak), (Estimated x 1.5) 5 al/day Pump.Manufacturer l ❑ NA Soil Application Rate al/day/ft2 Pump Model � __7 — y�/e�'Nl7 Z ❑ NA Standard Influent/Effluent Quality Monthly average" Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODS) :5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) L5 150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BODr,) 530 mg/L 'Kin-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ NA ❑At-Grade ❑ Mound Fecal Coliform (geometric mean) _:104 cfu/100ml ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size Y. in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA 'Values typical for domestic wastewater and septic tank efflUent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: B month(s) y e (Maximum 3 yews) ❑NA ❑ ear(s) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: 11 month(s) (Maximum 3 years) ❑ NA I @ year(s) Clean effluent filter At least once every: 69 0 i yeas'h(s) ❑ NA Inspect pump, pump controls & alarm At least once every: IN month(s) p NA ❑ year(s) Flush laterals and pressure test At(east once every: ❑ month(s) M NA Other: ❑ year($)❑ month(s) At least once every: ❑ year(s) ❑ NA Other: ❑ NA, MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s)to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Ulbricht & Associates Private Sewage Consultants 2812 10th Ave. Spring Valley, Wl 54767 START UP AND OPERATION Page 2" of For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting_products or other chemical: that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the content,, of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored excess wastewater will bE discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge o) effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls tc restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins;tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. A The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS Private S wane ronsul#ants POWTS INSTALLER 2812 10th A\e. POWTS MAINTAINER Name ' Name Phone 71 s' -7 1.), Le Pho SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name EN I (.DJ-//�/V Name s�`• C�0/'X 201 N(r- Phone S (� 0 Phone ?IS- 3 -'16 O This document was drafted in compliance with chapter Comm 83.22(2)(b)0)ld)&(f)and 83.54(1),(2)&(3),Wisconsin Administrative Code. OWNER's MAINTAINCE .og SEPTI.0 SYSTEX PORTS (landowner) is reponsible for proper operation and maintenance ef. this system. Regular periodic inspections and servicing is necessary for the safe healthy operation of, this syste1n. The owner is required- by code to submit all necessary maintenance/inspection reports to the controlling ,authorities.. SPECIFIC "Qu' ACT AGENTS � Governmental authority/ inspectors: * Licensed -installer, responsible for maintenance "Users., manual : providing an operation/ _ * Licensed service f inspection -agent other than installer: Electrician, for pump, electric contro3s. Viring units. d S fez IMPORTANT OWNER MAINTEPJAP+lCE RE UIREMEhiTS 3 • Hinter traffic area shall {sledding, shovetring, etc. ) across the not be permitted, or frost can/will penetrate into- . the cell. freezing up the system. Discontinuos use in the Winter, {a vacactlon trip, resulting in no water -use) can- also lead to freeze ups. 2 Water consesva t-ion -needs to be- exercised! - Or system h be hydrol callg overloaded and destroyed. This sys�em was _ designed for a maximum wastewater flow of 116`0 gals. daily. 3. i'OWTS are not designed to accomodate wastes from a disposal unit, or an other gart�age,. . Any introduction of such waste�materialsuwill ov waste. destroy this system. erload and If a Power 011tage. occurs, or a pump fails, it may result in a temporary { 3' overload of effluent being Pumped into the cell. which may adversely imp, the cell (leak ge) • It is recommended that a licensed allowing the Pumper empty the dosing tank, Consult Pump to return to dosing the correct amounts . your installer 'immediately for advice, 5• Neglect of the vegetative"'cover erosion preventive {the cells insulation traffic also ) can 3ead to fai _ure. Compaction or heavy can destroy t he system. It IS NECESSARY TO REGULARLY WATER THE VEGETATION system' A SYSTEM! !theystetn beneath IS NOT su€Fieient alone to Effluent in I` �.covsr, maintain a Fs• Periodic inspections by the owner; or h necessary. by pipes and is agents, is into the system: on the mound basaltareave been incorporated inspection Pipes) , cleanout terminals on the' level Laterals: at each ti pressurized out= The filter- system- for flushing and cleaning the laterals around 'Cover in the tanks (via a lacked above person €manhole) . only a licensed should be performin properly in' qualifiiecl severe safety g this work which involves health systems treatmentscell shall Calso befreent PQnding in the regularly inspected. /�a pp TNIa NACt N91""D 1011 agCOaD/NO DATA 1 YIZO i I UOGuMIw''d7 N©. ��"���� STATE BAR OF WISCONSIN rt)RM 2 lids I - q,E� REGISTER'S OFFICE R�RO X C�0.,�1M I Mt►rzolf George B, -Mai zolf,,.J?.�-,. Helen Tune �i iiam_J. . . -. ... .. JUl3 01990 Male:ich,, Thome -�+... Mar'zglf, .Geraldine E. Kelley and 11:30 A Ot -ro zolf. Grantors_ . _.. ... ... ....... ................. Rieha.rO.A..- Mar........ .... M N,i 1 2^ R•9 of Dwal" deHaa3.:_.�....... . . and............ ...... conveys and tvarranU to ._ - tl Ann Harris N1cMi11a.n, .1nis�°j and `'w�-d'e, as-.survivors �.... . mcirital property-,..Grant.ess.. ._... ... ......_ ..................... _ .. .. -- - _ - a [T.aN To I. A 12 . -5t....Croix_.... ....... the following deuribed real estate In Ta:Parcel No: •- -------------------- Stale of Wisconsin: Croix Township 28, Rrn0Q 20, St. Cpmiencina at a point on the North line of said That pa-t of GovQrnmQnt Lots 1 and 2. ommencn 13. County. Wisconsin. described as follows' East 1 ;t� of said Government Lot 1• a)distance due Government Lot 1. a distance of 743.0 .feet West of the Northeast corner of said G��recnme Lot 1: thence South. parallel with the (to a point to 1230.0 feet (said last rdescribedthencehduenSouth. a�distance�of 788 stance of 290.0 feet: West. a distance of 34,,.0 feet. be known is point "A'): thence North 67 degrees 1G minutes West. a 7? 0 feet. to the thence North 53 degrees 40 minutes West. a discWest 4a distance ofola point to to mown 47 degrees 10 as point 'B" ): thence North 70 degrees 10 minutes feet; thence tiorth 12 ct-grees 40 minutesWest.th° actual point of beginning of the tract of land to be de3cribed: thence North minutes West. a distance of 310.G . � a:ona said Easterly shore line a d tance of 23.5 feet: thence odueL es thenceaSouther3YV b�aringoNorth 89 degrees 39 Easterly shore line of distance of 210 feet. more or less. ni a point in a line minutes West from the point of beglnnin�hetpotnt of South begenn�na�ees 39 minutes East. tt distance of 49' feet. more or less. o (LEGAL DESCRIPTION CONTINUED ON BACK) IM-N z Q 00 This -_.iS. riot homestead property. FEE (is) (is not) if any. Exception to warranties: Easements, covenants ar:d other restrictions of record, day of .-. .. Dated this ._(SEAL) __..(SEAL) —/1--/ , ThomaS. A. Dahle, as Referee for-t_e ---------- _.. above named Grantors (SEAL) (SEAL) ................. %CKNOWLZDGmZNT A'QT13BNTICATION STATE OF VISCONSIN sa. Signature(s) �.. ..... __. ...County h ......---•-------•---•-----.._...•-- r ----day of .............................................................. -••-•-•-•--'- Personally came before me this --•-----•- Ray of._._..--- ..... 19 --....._.., 19.90-_ the above named authenticated this ••••--° - -- - -----. .._---------- --I.,.... ------------- TITLE: MEMBER STATE BP_R OF WISCONSIN . ..... . ....-.....-. - --- -_---_ who executed the -- --- -- person (If not,----by__ ••------• -Wis. Stata.) to me knowr to be authorized by 706.06• foregoing instr•iment and acknowledge the same. Jenrlfcr A.G,gin THIS INSTRUMENT WAS DRAFTED BY jyn� 'l Notary P-itlic r -. State of Wisconsin ...........................................___ ......-. - .. � COL❑tV, W Is. Thpmg .A.._Ileh]z i�'G _ FIiSCQ _qdn--------- ----- -------- Notary Public expiration Vic Commission is Permanent.(If not, state r Hud - 31 (Signatures may be suthentiaated or acknowledged. Both date: 7 are not necessary) -Names of w•rons signing in •nr mvD itT should be tYJ ed or Lrin:�d brinw :n.•r .ignac..rv. Stock No. 13004 STATE B.+R or wiscoNSIN FORM No 2— I',62 V ♦ ". ; CAD Co s thfr With "d ok"at ts: yx>!►D ZAMwr FOR 1802 cibeddtract Of la.ts gibed fatla�sr X:, - e9a to and �cesls from above desc for Ind tton 13. ?ovnshlP 29, Range ib�d lit Qoverro eent Lots i tind 2. pf al feet♦ nt iving West of and o South a distance demo s SO.tt feet road easeme Point '�►': thence do there terminating. Al at the above described PO government IA sines pglssl to the South line of said g� a dists�e of 67 degrees 10 minutes Yest. a dI tO the t being 15.0 feet on either side of the following described easement described Doint '11': thence Nor a distance of .6 fsett above desc !h 53 degree' 40 minutes Pest feet: thence Nor . ees l0 minuo�s310�0•feet:sthe North iZ d�N described Point '8': thence !lath 70 degrees thence North 47 degrees 10 minutes West.,# distance 40 minu tea West• a distance of 30.0 feet and there terntlr3ting• loan Parcel #: 040-1147-20-000 06/12/2006 10:45AM PAGE 1 OF 1 Alt.Parcel#: 13.28.20.576B-6 040-TOWN OF TROY 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-MCMILLAN, DOUGLAS D&ANN HARRIS DOUGLAS D&ANN HARRIS MCMILLAN 707 GOODRICH AVE ST PAUL MN 55105 Districts: SC=School SP=Special Property Address(es): '=Primary Type Dist# Description 'n SC 2611 SCH D OF HUDSON WITC (-� l/� SP 1700 C Q / xQ Legal Description: Acres: 2.160 Plat: N/A-NOT AVAILABLE SEC 13 T28N R20W PT GL 2 COM 743 FT W OF Block/Condo Bldg: NE COR GL1,TH S 1230 FT,W 340 FT, S 788 FT,TH N 67 DEG W 290 FT TH N 53 DEG Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) W 400 FT,TH N 70 DEG W 177 FT TO POB: 13-28N-20W TH N 47 DEG W 310 FT TH N 12 DEG W 23 FT,TH N 83 DEG W 370'MOL TO LAKE, SLY more... Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 877/206 2006 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.160 639,900 409,700 1,049,600 NO Totals for 2006: General Property 2.160 639,900 409,700 1,049,6000 Woodland 0.000 0 Totals for 2005: General Property 2.160 639,900 409,700 1,049,6000 Woodland 0.000 0 Lottery Credit: Claim Count: 0 Certification Date: Batch#: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Cha 0 00 Total 0.00 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM 6,12 • P/D Owner/Buyer :P O (r' M C A t 1 ,f vv 7/ 5 51 f Mailing Address 76 / Property Address 1-72- F. (.Q�-e /2!2- 1j` VpSe^.) (t)f S. S Y 0((00 (Verification required from Planning&Zoning Department for new construction.) City/State Parcel Identification Number 0/'/'0 /N7' I LEGAL DESCRIPTION p v Property Location S 1/4 ,N� '/4, Sec 3 ,T �o N R W, Town of T��J Subdivision PAle 7- ® U T . 49 M"i-% �&� 5 , Lot# N Certified Survey Map# N/ , Volume ge -- Warranty Deed# ���/ , Volume _,Page#- 20 Spec house yes no Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner,if needed,by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system Owner maintenance responsibilities are specified in§Comm.83.52(1)and in Chapter 12-St.Croix County Sanitary Ordinance. The property owner agrees to submit to St.Croix County Planning&Zoning Department a certification form,signed by the owner and by a master plumber,journeyman plumber,restricted plumber or a licensed pumper verifying that(1)the on-site wastewater disposal system is in proper operating condition and/or(2)after inspection and pumping(if necessary),the septic tank is less than 1/3 full of sludge. Uwe,the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth,herein,as set by the Department of Commerce and the Department of Natural Resources,State of Wisconsin. - Certification stating that your septic system has been maintained must be completed and returned to the St.Croix County Planning& Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. Uwe amlare the owner(s)of the property described above,by virtue?of a warranty deed recorded in Register of Deeds Office. N mber of rooms ✓ GN URE OF APPLICANTS) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning&Zoning Department.*** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV.08/05) ; �7Mev Ta Ulbricht &Associates Private Sewage Consultants 2812 10th Ave. Spring Valley, WI 54767 EXISTING NEW ® i EAST ELEV TION EAST ELEV TION } } } M-- • n 1 AN V'N 'o Ll -� b - o . d � 1 ` o e\ w � w