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HomeMy WebLinkAbout020-1005-20-000 7 ~ A 1 ~ 3 ~ ~ ~ N 1 p ~p 'C C ~, ~ 3 3 ~ ~ I 3 ^~ ~' - Cn Z Z N O 1 ~ d y O O Q i ' C ~ N ~ ~i O O C ~ i 3 O ~ q C O K , a N O a~ °' m m ~~ ~ m p CD '~+ ° ~ r ' o ~ o c a m m ~ N o ~ ~ S ~ N ~ ' ~ c°n N °- ~ 3 3 ~ 3~ m o -' r~ O~~ ~ `~ _ O 3 CD m N ~ n ', 7 n ~ ~ ~ n 0 ° ~ 3 a a o v ~ a o ~ fD 0 o 3 N N N f W 3 N N N W O I O m °= C o . i d A p m ~, Z D ~~ ~~ Z ~ D m a ~ m icR D N a ~ :2: D ~ Q W T U ~ rn rn ~ ~ a '-.' o o ~ ~ r ~ I -, ~ ~ ;, ' I O ~ v O m N ~' O C 2 2 ~, ' - o 0 '. z 0 0 0 0 0 Q -4 ~ ~ ~ ~ ~ '0 ~ ~ ~ ~ ! G W ~ j vi Vi cn ~ o ~ to v~ (n ~ o D ~ ~ O ~ 6 ~ O O O ~ a O o 0 0 0 O O ~ F ~ ~ N .~. N y m N ~ fD ~ N p '. ~. ~ ~ ? ~ y ~ ~ ~ ~' 3 ~ ~ ! 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I, ', ~ ~ m ~ v v `~° d ~ m m 3 - ., ~ - .~ .. ~* ° ° ° N C 3 d N O N O ~_ o O ~ ~ O ~ ~ n ~ O n ~ ~ ~ O O ~ Vl f/1 ,,,' C W d ~ 0 a a T ', I .. ~ rn rn .~ 0 o r '~ v ~ ~ ~ S 'I C O ( O 2 (" ) ~ V co co ' ' 3 o C a -! a_ N '~ ~ 4 ~ 'C 7 _ flt °Y O O O ~ ~ ~ ~ w Z N N to cn o D ~ ~ O o o ~ ~ ~ -' m ~ ~ y N 3 °' ~ N . ~ .~ ~ ~ D a ~ ~ ~ ~ m fD y ~ N ~ C ~ N~ fD ~ a ~ _ O A Z f~Y C ~ a ' I ;i~ z o it fA ~ v W ~ ~ ~ c ~ i ~ ~ ~ ~' !~~ y Z m ~ CD p W ~ 'I T C C. ~ o (~ ~ O Q' ~- ~~ . q U .' December 12, 1994 Mr. Craig Dahlstrom 350 Krattley Lane Hudson, WI 54016 Dear Mr. Dahlstrom: At your request, I conducted an inspection of the septic system serving your residence on Dec. 7, 1994. This property is located at the above address in Hudson Township, St. Croix Co. WI. Per Mr. Dahlstrom's statement, this septic system was installed approximately 25 years ago. Our records do not date back to the time this system was installed, so it is impossible to determine exactly what the system consists of or how many square feet of drainage area there may be. It appears that it is a below grade gravity fed system, which is located north west of the house. Most septic systems consist of a septic tank which traps the solids and greases from the sewage stream and then allows the remaining sewage effluent (liquid) to drain into a subsurface drainage area. Once the liquid reaches this point it seeps away by percolating through the soil surrounding the system. Failure results when the soil surrounding the system becomes plugged with microscopic bacteria and sludge, which form a clogging mat. As time goes on, this clogging mat becomes progressively thicker, allowing less and less liquid to seep away from the system. When this clogging becomes severe enough, liquid sewage is trapped in the drainage area, a condition known as ponding, and results in backup of sewage into the structure or the discharge of sewage to the ground surface. Although there were no obvious signs of clogging or of system failure, there were indications observed which are consistent with a failed septic system or one which will soon fail. These indications coupled with the system's age give reason to be concerned about the systems ability to function properly in the future. Because of this, I cannot guarantee or warrant that this system will function properly in the future. Typically, a septic system of this type must be replaced by the time it reaches this age. As this was a surface inspection of said system and did not involve any excavating, chemical analysis or direct observation of the systems components, there may be hidden defects in the system not discoverable by this inspection. In an effort to prolong the system's life as long as possible, I recommend that steps be taken to minimize the wastewater flow from the house which enters the system. For example, repair any leaking water fixtures and/or replace them with water conserving fixtures, reduce time spent in the shower, wash clothes and dishes only when there is a full load, use a washing machine with a suds saver feature, etc. I would also recommend that you have the septic tank pumped at a minimum of once every three years. Should have any questions or concerns that I can clarify for you, please feel free to contact me at this office between the hours of 8:00 am.- 5:00 pm., Monday - Friday. Sincerely, /s/ JamesTC. Thompson James K. Thompson Assistant Zoning Administrator cc: file enc. ~~ `~~ ~r ~~ ~I°• ~~ ~`""`~~. rr^rr^^rr - ,,,~~ ... • _ ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 SEPTIC INSPECTION / WATER TEST REQIIEST FORM Please specify desired test(s) & remit appropriate fee with application. Outside water lines are often turned off during winter months, making access to the home necessary. Please make arrangements with this office to insure that entry can be gained. 0 Water (VOC's) $185.00 ,Septic $50.00 ~ Water (Nitrate & Bacteria) 45.00 D Nitrate & Bacteria retest $15.00 Owner:~~-~~q ~/~}~L ST/~~ m Requested by: ~~m_s. Address : ' ~f/cy L,¢k Address p n c.~ ' ZIP ry~~~ ZIP Telephone N4: (?/S) .3 8 G - p~ ~ ~ Telephone N4: ( ) Property address (Fire N° & Street) : 3So ~''~}°/Q,~/ty L~ ~r -e- Location:S~il '., 5~',, Sec. 7 T~N, R~W, Town of~L~Q/so h ~t~#3 Realty firm: Lock Box Combo: Closing Date:12~ -~~ TO BE COMPLETED BY PROPERTY OWNER 7~PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORM Water sample taplocation: Is the dwelling currently occupied? 11! Yes ^ No If vacant, date last occupied: tow Age of septic system: ~S ~ Septic tank last pumped by: ~~ ~ ~ Date: Previous Owner's Name(s):--~- Have any of the following been observed? ^Y ~ Slow drainage from house. ^Y ,~/ Sewage Back-up into dwelling. ^Y ,~t~ Sewage discharge to ground surface or road ditch. OY l~ Foul odors. Other comments relative to system operation: ~/o,~ y,'n y I certify that the above information is complete and true to the best of my knowledge. OWNERS SIGNATURE' ATE:Io?'G-9~ 1/94 OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION i~ ~'G 7~ ~ ,G l~ ~~~--- -i ~~~, TO BE COMPLETED BY INSPECTION AGENCY System design &/or permit on file? ^Yes ^No Soil series per SCS Soil Survey: sheet # T e of soil absor tion s stem: L~e~a~ grd ^At-Grd ^Mound Approx. size ~2 ' X ~j' a~/ ? r ty ^Dose ^Pressurized Ft . I 4~'Bed ^Trench ^Dry Wel l ^Holding Tank ^Outfall pipe OBSERVED DEFICIENCIES ^Other ^Unknown Septic tank ~~/ Setbacks: OHouse (y/~ OWell<%~^Prop. line ^Other D k Setbacks: ^House OWell ^Prop. line ^Other ^Locking cover ^Warning label ^Pump/Floats ^Alarm OElec. wiring Soil Absor tion S stem Setbacks: ^House ^Well~^Prop. line(r~~Other ^Ponding: rp~ ^ ischarge: l'~~ General commen s: ~ ~i~ c~ w w N 1O1..~ I-~ r• r• r• rt w rt 0 s T 0 y T 0 3 0 h v, N 0 a 0 n y a 0 v 0 y 0 0 T ~o N 3 S 0 H c~ v 0 a l I m ~_ C7 _~ O Z o ~ ~ ~ ~ S Z N 0 (~ 4 O 7 2 O ~ .~~ ~ O ~ m y ~ rn ~ C O CD ~ m m y to o'' y .-r ~ m r ~ av ~o ~ N O ~ ~ < ~ c-r c-r -^ ~ o v ,~, W +~ n o cn ~i ~i w r• ~ ~ Oq W ~D (1' N ~ ~ ~ ~. ~--1 ~ a c~ ~ N ~ ~ ~ w ~ c~ ~ ~ o ~ ~ c~ N ~~ , l ~ ^ \• r, ~ ~ ~ • n ~ rn ~ ~ p, c °' n ~ a Vf n o cu c n D "i a ~ a N :~, n ~ ~ w w r• ~ ~ ~ o G m o~ H ~ ~+ a. c-f ~ rn ~ ~ w r ~ w N ~ rt c~ ~ 0 v w w n C a 0 ~~ Voucher H CQUNTY OF ST. CROIX State of Wlsco~sln Check N TO: Craig ~ .Tudy Dahlstrom Vendor a`I Address 350 Krattley Lane I~udson, TUI 54016 (Complete for vendors without numbers) Account Name Zoning Fees Description Reimbursement for T!rater Test Invoice k Fund Dept Acct Obj Amt 100 00 47480 000 ~ 14.45 J ~n nr .1 l' TOTAL Filed , 19 • ~~~ r ~ ~ ~ ,. ,1~~5 4 i ~ i ~ ~ ~ --- rrnaauun^ •.;. - ~-' January 3, 19954 Craig and Judy Dahlstrom 350 Krattley Lane Hudson, WI 54016 ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 RE: Reimbursement for Craig and Judy Dahlstrom for Water Test Dear Mr. and Mrs. Dahlstrom: Enclosed you will find a check for the amount of $14.45. You cancelled a water test that you requested. The water sample was taken before you informed our office, so the amount of $14.45 will be reimburse to you. If you have any questions please feel free to contact our office. Sincerely, ~~Jackie Stohlberg Secretary js Enclosure ~.~ .-._ ~ ., f-.,~.. l - ~~~~ ~ " w O ~ I C ~ ` C ~ ~ ~ - 3 ~ ~ C ~. i.r ~ ID ~ w ~ ~ ~ ~ ~ ~ ,~ A ` 1 .~- ~ ~U O ~ n~ O O y O ~ ~ ~~',, C~ N ~ • ~' c ~ ~ N IV Q ~ _ I n. m m m ~ tO o ~ 3 N n ~ ~~~ ~ ~ N o 3 ~~ ~ -` ~ o p n ~ C A O 0 n = ~ ~ O ... NO ~ n C O ~ 3 D f 0 . -. f n a o o ~ ( ~ ~ y cc n ' ~, p ~ !~ ~ cn z D i ~ c ~ a o I m m D ~' a ~ I 3 W a ~ O rn rn~ ~ '~ ' ~' o o r , ~ ~ ~ ~ ' ~ ~ ~ , 3 ~ ~ ~ ~ N ~ ~ c '' ~ c 3 n' N ', ~ ~y-. ~ ~ '0 7 ', OOO ' ~ N ~ I ~ , O C 17 ~ W Z rye ~ ~ ~~ V) fA ~n j g D V y I .~ O Q vvv,o{ o ' =~ ; 'o I ~ 9 m N ~ n ~ ` i z ~ l~ 0 D 0 O D o l ~ N~ y N ~p C N /y,~ ~/ W f~D n I -L ~ ~ ~~ ~ Q ~ ~ M ~ a J ~ P ~ ~ ~ I ~ ~ cn -a ~ ~ ~ ~ a Z p ? 17 ~ w ~ ..a I 3 m ~ y Z O ~ 7 = d n " r, p n 7 ~ .. O1 TI C "m z ~ a ~ o I ~ ~ ~" z o ~ , Q ~ ~ - N m _ O O d ~ p+ ~, ~ t ~ C ? QA C N ~ -. (D a 7 n ~ < O I ' °' ° o ~ fOD N ~ ~. ~ fD 6q N ~ ~ R ~ C ` ila' O L ~ ti Parcel #: ~2U- Q05-2U- 0 04/22/2005 02:35 PM PAGE 1 OF 1 Alt. Parcel #: 07.29.19.1'I~C 020 -TOWN OF HUDSON Current X I ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * =Current Owner * DAHLSTROM, CRAIG A & JUDITH CRAIG A & JUDITH DAHLSTROM 350 KRATTLEY LA HUDSON WI 54016 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description * 350 KRATTLEY LA SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acre 1 540 Plat: 0241-CSM 01/178 SEC 07 T29N R19W PT SW SE LOT 3 CSM Block/Condo Bldg: LOT 3 1 /178 Tract(s): (Sec-Twn-Rng 401/4 1601/4) n / ",~„~~ 1~7~ 07-29N-19W SW SE Notes: Parcel History: Date .Doc # ~ Vol/Page Type ' -- z ~ 2004 SUMMARY Bill #: Fair Market Value: Assessed with: .S- ~ %sfia, 47616 222,100 ~ _ ~_ 3~ Valuations: Last Changed: 1 /2 /2001~~~ Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.540 34,000 137,800 171,800 NO Totals for 2004: General Property 1.540 34,000 137,800 171,800 Woodland 0.000 0 0 Totais for 2003: General Property 1.540 34,000 137,800 171,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 305 Specials: User Special Code 018-RECYCLING 001-WATER Category SPECIAL ASSESSMENT SPECIAL ASSESSMENT Amount 27.00 0.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 .+ 32945' 32945' ~~ ~ F1 ED 1 ~ SEP 2 9 ~ 975 iv /A~IFS O' GoNNEtt i Rtyhler of Deeds 6e. c-oGc c°,My, ~v ~ ~~.~ APPROVED h~ 166.50 w _ I _ 1.42 ACRES 3 + ~ M ~ -M _M o ~ -~ ~ ~ D . M ~ ( M Z 1 ~ ~ = i ~ i _ /EST LINE OF - ~ NE SE I/4 ~ _ POINT OF 0 BEGINNING o _ ~ M 030 4 0 6° w -o _~ M z POINT OF - BEGIN~VIN p _ Is 6°58 30 ~ 270 35 r~ i . S 89°3840 ~W 8.36 , ST. CROIX COUNTY , ~tP12EHEA1SiV'~ PARKS sg1~81131f3G 166.50 2 1.42 ACRES q I-= M ~ O ~ Z SW- SE SOUTH I/4 CORNER, SECTION 7, T29N, R19W CURVE DATA TABLE CURVE 1-2 R=539.96' Central Angle = 27°33'10" Chord = S69°49'05"W 257.16' Tangent Bearing = S83°35'40"W 160.77 1.54 ACRES ~ ~ ~ ~ ~ D 165.60 253°1530 ~0 ,~~. s- 3 _ ~ °~N _N ~ 4 ~ N TRUE N ~ 1.68 ACRES BEARIN ~ M ,/ ,31~ S 83°35 4Ci~W ~- 33p.21 ,H6v~a~et~o®~em®i .~~~,e``~`yG oNs~~ ®~®~~ '~ ~ ~ WALTER J. ~ G if e GREGORY p, ~ 5-1224 ~ ~ ~; RIVER FALLS, Try WIS. fa ~- ~ < 1 ~ NMN~~~••' 1p ®® ~~~ qN0 Su R`I~ s~~ ~~~ooeeee~a~4®°e CURVE ~-4 R=1876.86' Central Angle = 6°03' Chord = S86°37'10"W 198.09' Tangent Bearing = S89°38'40"W O . / o ~ ~ ,- _ ~, , a ~ , 0 ~~ ~'~ N X93 ~ 35•. SCALE 100 0 50 IC LEGEND SECTION CORNER MONUMENT p I" X 24" IRON PIPE WEIGHING 1.68#/LINEAL FOOT. LOT 1 R=1876.86' Central. Angle = 4°48'48" Chord = S87°14'16"W 157.63' LOT 2 R=1876.86' Central Angle = 1°14'12" Chord = S84°12'46"W 40.51' DESCRIPTION: A parcel of land located in the SW1/4 of the SEl/4 of Section 7, T29N, R19W, Town of Hudson, St. Croix County, Wisconsin described as follows: Commencing at the S1/4 corner of said Section 7; thence NO°13'40"E (true bearing) 324.04' along the West line of said SE1/4 to the point of beginning; thence NO°13'40"E 369.39' along said West line of the SE1/4; thence N84°48'30"E 659.36'; thence S21°56'E 314.53'; thence Westerly 259.65' along a 539.96' radius curve concave Northerly whose chord bears S69°49'05"W 257.16'; thence S83.°35'40"W 330.21'; thence Westerly 198.18' along a 1876.86' radius .curve concave Northerly whose chord bears S86°37'10"W 198.09'; thence S89°38'40"W 8.36' to the point of beginning. I certify that the^above-description and map are correct and that I have fully complied with Wisconsin Department of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM 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 Eb , L nn Elaine Hudson, Town of CST BM Efev: insp. BM Elev: BM Descriptiorr. TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~~,' < ~ ~ /~ ~ ~ b Aeration ~ y, B ~`~ Holding I TANK SETBACK INFORMATION TANK TO ~ WELL BLDG. Vent to Air Intake ROAD Septic ~/ / ~ ~~j Dosin ~ .~D / ~ tP ~' ~' 1 t Aeration Holding PUMP/SIPFI,ON INFORMATION B~ Manufacturer Demand GPM Model Number ~~ TDH Li~ ,~' Frictioq Lost, (, ~j System Head --~ TDH Ft l 0. D l , Forcemain Lengt~ 2 ~ Dia. Z ,. Dist. to Welly ELEVATION DATA county: St. Croix Sanitary Permit No: 506208 0 State Plan ID No: Parcel Tax No: 020-1005-20-000 Section/Town/Range/Map No: 07.29.19.11 C STATION BS HI FS ELEV. Benchmark ~. gs <o~-~ ~c~o - 6 Alt. BM ~' ~ to o~~ g8s3 Bldg. Sewer 6~0~ a. 9 SUHt Outlet ,/ Dt Inlet WI'~P / / `-1 ` ~a, ~ ~/ • / (]~ 0 Dt3ott~a~~li ~t~t' !~~ ~ '~~ Header/Man. ~~~ 1 1 V1~ ~.2 ~ ~• Dist. Pip ~M.~.•o S o Ovt ~pt~l~4-5 ~ ~ g`. s Bot. System / 3 r 2/ b Final Grade ~f ~z~~ r< < , m~ s s.~ g .Z~ y 3.6 St Cover ~ ~ ~ ~ C ~ 0 p) SOIL ABSORPTION SYSTEM Z j ~ ~.l r I1Ph ~~ 0 ~( - ,(G~~ I BED/TRENCH DIMENSIONS W idth ~ I Len th~ ~ No. Of Trenches s ~1 r PI NSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK SYSTEM TO P/L E BLD WELL LAKE/STREA LEACHIN Manufacturer: n - INFORMATION CHAMBER O Y ~1 Typ f System: ~ r ~ ~~, ~ ~ ~ I U Model Number: DISTJ216UTION SYSTEM n-vt i~,J~a~`"~,d ead /Manifold Distribution ~J r n-_n~ r x Hole Size x Hole Spacin~ Vent to Air Intake Len th Dia Len th Dia S acin SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Svstems Onlv Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulch Bed/Trench Center Bed/Trench Edges Topsoil ~ Yes 0 No Yes ^ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/~/ t/ ~ Inspection #2: / / Location: 350 Krattley Lane Hudson,-~WI~54016 (SW 1/4 SE 1/4 7 T29N R19W) NA Lot 3 ~Q Parcel No: 07.29.~1~9.~11_0~ 1.) Alt BM Description =~~ 0~ l> % ~%~,(Q/~. ~t J ~~ ,~~~. ~~ ~ ~G%t-~`-~`_ 2.) Bldg sewer length = ~ ~~s~ --~liil,~-r~. ~~~'_C!- `.,"-' ~t-G?~Y~~ C/1'~-- - amount of cover = y ~~ h ,1-~ ~ ~ ~ ~ ~ ,~~q~/! j s~•~(~ G(/~ Plan revision Required? ^ Yes No I ___ -- .-._ _ _.._ __- _ -__. __ _ `- _ c-7~~~j _ l Use other side for additional information. ! __~ ~ ~__ ~ ~ _i _ ~~~~~~-- I ' ~ ~ `~_ v C SBD-6710 (R.3/97) Date Insepctor's Si nature Cert. No. W -~.` 3 vd ~•~.L(vl ed ~ cOmmercewi.gov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 St. CTO1X ' S~O ~"'~ ~ ~ ~ Madison, WI 7-7162 Sanitary Permit Number (to be filled in by Co.) Sanitary Permit Applicatio stateTransaction,Na j'V In accordance with s. Comm. 83.21(2}, Wis. Adm. Code, submission of this form to the ap 'ate go tal if different than mailing address) Project Addres unit is required prior to obtaining a sanitary permit. Note: Application forms for state-o PO are b i h D d ~/~ ~~ C1 ~~/~ su m tte to t e epartment of Commerce. Personal information you provide may be used ndary ,~-^~ - Same ~ ~ ~Z oses in accordance with the Priv Law, s. 15.04 1 m Slats. U I. A lieation Information -Please Print All Information Property Owner's Name Parcel # L. Elaine Eb MAY 2 5 Z U 0 7 020-1005-20-000 Property Owner's Mailing Address Property Location ST. CROIX COUNTY 3S0 Krattle Lane Govt. Lot City, State Zip Code Phone Num r SE ''/s, SW '/., Section 7 (circle one) Hudson, WI 54016 (71S 386-2614 T 29 N; R 19 w II. Type of Building (check all that apply) LOt # ^ 1 or 2 Family Dwelling -Number of Bedrooms 3 3 Subdivision Name Black # Na ^ Public/Commercial -Describe Use Na ^ city of ^ State Owned -Describe Use CSM Itlum~ t /S- ~ ~# ^ V' age of Z ~ 7 CSM Vol. 1, Pg. 178 Town of Hudson lIh Type of Permit: (Check onl o ine A. Complete line B if applicable) A' ^ New S tam ys Re lacement S p ystem Treatment/i-Iolding Tenk Replacement Only ^ Other Modification to Existing System (explain) B• ^ Permit Renewal ^ Permit Revision ^ Change of Plumber ^ Permit Transfer to New List Previous Permit Number and Da Issued ~ Before Expiration Owner ~ / ~' 7 ~ ~ N. T e of POWTS S tem/Com onentJDevice: Check all that a t Non-Pressurized In-Ground ^ Pressurized In-Ground ^ At-Grade ^ Moupd > 24 in, of suitable soil un < 24 in of suitab soil ~. o ~ ~ ~~ ~fetre ce lexp-~~~i~c.~ a't-' W r ~ ~!~ ^ Holding Tardc ^ Other Dispersal Component (explai>t~;~'~lHs~ ~ V. Dis rsai/Treatment Area Information: 46 Infiltrator "Q-4 W" chambers 20.0 s .ft EISA /chamber + 2 'r end 5.8 EISA = 931.60 s , ft. Design Flow (gpd) Design Soil Application dsf) Rt Dispersal Area Required (sfj Dispersal Area Proposed (sf) System Elevation 450 d 0.5 in-situ soil 900.00 . ft. 931.60 s . ft. 87.50 ~ VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units ~ ~ New Tanks Existing Tanks ~? o a U .°~_' o rn U ~ r/~ ~ ~ ij. C7 ~ A. Septic or Holding Tank QQ 1,000 1 UnknOWn - (, QQ/).a ~ X Dosing ~"'~ 7S0 Wieser Concrete X VII. Responsibility Statement- I, the u dersigned, ass responsibility fo lion of the POWYS shown on the attached plans. Plumber's Name (Print) Plum Sign MP/MPRS Number Business Phone Number James K. Thom son 3--- 30021 71 S 248-7767 Plumber's Address (street, City, State, Zip Code) 340 Paulson Lake Lane, Osc WI 54020-5413 VIII. Coun /De artment Use Onl approved ^ Disapproved Per~mi/t Fee t/t~ ~ ~ ~ Date~j ued ~ ~ I ing Agent S' ` ~~ ~ ^ Owner Given Reason for Denial 7 ~ ~ / "' 1?/J...- ~ `; IX. Conditions of ApprovaUReasons for Disapproval ,~' T~~ ~,G~ ~lt~ ~ ~~ ~ ~~ SYSTEM OWNER : 1 Septic tank, effluent filter and ~,p, ce~~o~ ~ ~~2~~~ G dispersal cell must all be serviced /maintained _~~ n„ ~,~ ~~~~.~-~. i~ OK. as per management lan rovided b l mb """`' p p y p u er. Q ...'Armen YO'eAmpgtb`7bty6t• system submit to We Coeaty Daly oa paper eat less then 8112 z 11 ~L^/~~~~ " ~/~"!~/~ as per applicable code/ordinances. c~~~.yL J //~, r ~ X71.1 SBD-6398 (R. 01/07) Valid thru 01/09 ~ ~j ~ 7~J"/` /~~ J~oi/gdG~U~'occnd~a6l1~S5 $u~fsi.~le t~o~-.pryaosc.c/ sys~,~.r, 4lYA, E,Yi Sfi o4:tp~Sa/ cc1/. ~ O Ektint 66y~~o~., /e~3, esMdaP/ ~A. /78 scvl'~~E Scc. 7, ~~X ~p /yw. T. a,^ f/a-dso+~, S~ • Chit' Co, cJ/ Proposed c.~,~s..-r C~-,c,re_,Ee /~• Bozo-ices-tea-coo wl.A~SO-rY(,P,oc~.,~~v ~~,n bcr F'/+~ w a,E /ow~,~o d~ 3cfw~r. 92.0 - - ~ , °' °' ,~ '. • ,, ~ .~ ~~ /~ ~. 1.-Yy~~ C 'TG` EXiSfi 9G, o _ _ _ I `~ ~ . ` ~c rce ma; ~t . . . ~. shed ~ ~ ~ ~ ~0 ~ ~9' Z"d ~ (~ ~,y j Oeet' Pool ~', ~h '~ ~rcema;.~ Ztn ~YIUe/' i 3 brdre~'n ra•'sw ~ ~ ~~ l i ~ c, ` ~ hyg.~ ~ ~~ -~ ~ - -bR _ ,, ~~ VG'S i 0-K Z ~~ ~, - _ _ _- -- ~s1~ OYfS cr~ g! . ' - yoo;------- - _~ '~ti~~' --- e~ g . - - Propo seal ~~slotisa..! eel/. Tcvo (z~ ti'~s~tS a~ .~5/ ;'r 9;/~w/13 S,r,G''/z5- `45/~ G ~iwn ~sacf ~r~ (~G t~o25a/~ 2o3.9n o~ ~ / ~--- 7~ra~/cy ~G ~~~~J n !r1 /GO. ?lo' • EXi's fi.~ ~~~de ¢.lcd. Sc.~~ fxi.6le t1..-. /.xc~ascd SyS~t.~.., a~cA. ,P . ~/ • EX.'sf: c~l.:tp«Sa/ c.c.s/. ~ O Ek-:.~c E"by p~o~., /ot3, 'CSrf c~o~ / ~ . /7B sca.1Y~SE Sec. 7, ~~~ ~ iyw, 7~. or' fk~dSon, 5~• 'C-~it Coy cJ/ Proposed ~c7,~es~r C~-~c,re.,Ee ~ Lazo-~~s-zo-moo ' ~ 'IO.O .* -, ,, c. - ., Ew3finq ~4, p' I ` ~~ ~ ~ • 'Force r-'lct~ n . wcl/ d "' ~ 1 ~. ~~. '~_ ~i~fr` ~cPAJ~e.P. til ~. ~~~ ~. outlabin/v~ Q•t.ZS~I -~•~ ~~ p Shed ~n /~ ~ ~' ~ ,4 lE, b,n/, a /'~aJ40 + ~~ /'Sit/ ~~ ~ zs9q~•,i,9! Z~ Kl . .s~•y ~ Oset~ Ped~ ~, r_ 1 ,~ ~rGGrYLa~.a `o CLYII.~ o~ar'c~E~ Ej'~s-Et'~ Dcc,~ ~~ {~, ~ u; ~. ~fF'lue..-ri r 3 btdreyy,,~ /'a.sta! ~~ ~ ~ ~1~1C, ~Ps.ad4ic.~ 8"~~1 ' J- ~~ gee= _ --- .--' ,- P. ~c. e{~/u~~ /,~n -- P~O-~---- - - -'"-- bz , °~8^ ~, ~- b - - - _ .,~ ~ _.- s~~- eG=o ; - - - ProPo sew! ~,spcrsa./ ~~l/. Tr,~o (z~ G'LnclsS a~ 9S/~r 95~'w/13 S,-,4`ffr "Q-5~'c ~ u,~ ~socr ~.yc~ (t~G bozsa/~ ~3'o Sysf~n•, e/ui: to be - 87sd.' X03.90 o~ / / 5--_ 1~ra.~~cy ~,, e -~ ~GO,2~ Eby 3 bedroom Dose Conventional Pump Chamber Calculations Force Main: Diameter: Length: Flow rate: Friction loss - forcemain: (135'x 1.94ft./100ft.) = 2.62 ft. Friction loss - effluent filter: Sim/Tech STF IOOA 2. Total dynamic head: Min. supply pressure: 0.00' Vertical lift: 7.50' Friction loss: 2.62' ~-- Total dynamic head = 10.12' 3. Pump selection: Manufacturer: Goulds Model number: 3$85 WE03M Pump will discharge approx. 33.0 gpm @ 10.12' TDH ~_ 4. Dose chamber: Wieser WLP 750 - MR - 37 50" Ca~~20 28 gal /inch (760 50 gal actual) Sizing: A) One day holding capacity: 18.50" = 375,18 g al. B) Alarm setting: 2.00" = 40.56 e al. C) Dose volume + flow back: 5.00" = 101.40 g al. (450ga1.x20% Design flow ) +(,164)(135') = 112.14 gal. Max. Dose D) Reserve storage: 12.00" = 243.36 gal. TOTAL 37.5" = 760.50 gal. Dose Tank Information Electrical as per NEC 300 and --- Comm 16.28 WAC Disconnect . ~_ 2" 135' ~~2 34.0 al. /min. 2.62' O.SO, Locking cover with warning label and locking device and sealed watertight i 4 in. min. ~---`. Tank component is properly vented Wieser Concrete Ca aci 760.50 Volume 20.28 Manufacturer Gallons gal/inch A B C D Dimension Inches Gallons A 18.50 375.20 B 2.00 40.56 C D Total 5.00 12.00 ~ 37.50 101.38 243.36 760.50 tank. Alarm Manuafacturer ; LevelA_ rm_ _ _ _ __.. Alarm Model Number DLV F- Alternate outlet location Forcemain diameter ~ 2 in. Weep hole or anti- siphon device P• ump off elevation (R) ~}.O~ D• ose_ tank elevation (ft) 83.0' _ ___ Pump Manufacturer ..Zoeller Pump Model Number BN53 ~ ~ PUMP PERFO NCE CURVE MODE 53/ /57/59 ~ s 20 w ~ 15 z 4 o ~D. o T ~ 2 5 0 10 20 30 40 50 GALLONS 3 Z . Q Gt~u.~diTl~a. LITERS 0 80 160 FLOW PER MINUTE TOTAL DYNAMIC HEAD/FLOW PER MINUTE EFFLUENT AND DEWATERING MODEL 53/55/57/59 Feet Meters Gal. Liters 5 1.5 43 163 10 3.0 34 129 15 4.6 19 72 Shut-oft Head: 19.25 ft.(5.9m) ooa~~ r~ 1o v1e 11 12 NPT CONSULT FACTORY FOR SPECIAL APPLICATIONS • Variable level float switches available. • Variable level long cycle systems available. • Available with special cord lengths of 15', 25', 35' and 50' • Alarm systems available. • Duplex systems available. Sin eSsd Co ntrd Sdectlon Usbn s Yodel Vdb Phase Yode Am Sim ex Du ex CSA UL M53/55 & M57l59 115 1 Auto 9.7 1 --- Y Y N53/55 & N57/59 115 1 Non 9.7 2 3 or 4 8 5 Y Y • eN53 115 1 Auto 9.7 Y Y • BN57 115 1 Auto 9 7 --- N Y ' BE53r57 230 1 Auto 4.8 Y Y D53f55 & D57/59 230 1 Auto 4.8 1 _ _ _ _ _Y Y E53I55 8 E57/59 230 1 Non 4.8 _ 2 _ _ 3 or 4 8 5 _ Y Y " Sngle gggyDadc swlxh inducted. sxase SELECTION GUIDE 1. Integral float operated mechanical swdch, no external control required. 2. Singk; piggyback variable level float switch or double pggyback variable level float switch. Reter to FM0477. 3. Mechanical aftemata'M-Pak• 10-0072 or 10-0075. 4. See FM0712 for correct model of Electrical Alternator. 5. Variable level control switch 10-0225 used as a control activator, with Electrical Alternator (3) or (4) float system. • CA FarinfarmationonadditionalZoeRerprodtrdsrefertocatalogonPiggybadcVariableLevelFloatSwitdtes, FM0477; All installation of controls, protectlon devices and wiring should be done try a qualified F]ectricalAlterrtator,FM0486;MechanicalAlterrrator,FM0495;SunprSewageBasins,FM0487;andSinglePhase licensed electrician. All electrical and safety codes chould be followed including the Sirrplex Pump ControVAlazm Systems, 8.10732. most recent National Elecfdc Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MaL ro: Po. eox 16347 ` Louisville, ICY 4 02 56034 7 IAanufacNrers of.. ~ ~~~ SHIP TD: 3649 Cane Run Road ® Louisv(Ils, lcv 40211-1961 ~~irr Put+PB SA'CE /9.99 • httpJ/www.mallercom PUMP !O_ (502) 778-2731. 1(800) 928-PUMP FAX (502) 7743624 © Copyright 2004 Zoeller Co. All rights reserved. SySte,---, (' ,toss 5¢~f;on T 9' . 9/. ~s ~ 93, ~s' 5~=6~~~ 87.SD a Trench lrlstallzt.ion D~t~iil Sys[em 5~+~ - 1 below grade. _~ rM ~~li~~ ~ /E ¢~tolti ~eT P.~. Inspection opening or vent ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK Tl1is is to certify that I have inspected the septic tank presently serving the • E/a%~~ Eb residence located at: S~ '/4, rI~J ' 4, Section ~_, Town. ~.9 N, Range~W, Town of ccAlS~ , St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of Comm. 84,25, and it (they) appear(s) to be functioning pr ---~_~ Most recent date of ~7~.~~ ~ servic Did flow back occur from absorption system? Yes No ~ (if no, skip next line.) Approximate volume or length of time: gallons minutes Capacity: ,/ ~p~ Construction: Prefab Concrete ~ Steel Other Manufacturer (if known): ~d~,-~ Tank (if known): G~.ri~i~a~n ,~~ ' f~~ i.censed Plumber Signature) ~iyt~°S ~ ~ orn~~~ (Print Name) rat. ~°,Q. s (Title) ~~ (Date ~ 3~~1 (License Number) MP/MPRS Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes) or licensed disposer (NR 1 13 Wisconsin Administrative Code) Wisconsin Department of Commerce SOIL EVA TION REPORT Division of Safety and Buildings in accordance with Comm 5, .Code 2077 Page 1 of 3 A.C.E. Soil 8 Site Evaluations Attach cem ete sfte anon pl pl paper not less than 8%= x 11 inches in size. Pt i cl d b t t li i i d ri f an m t County St. Croix n u e, u no m to: vert te cal and ho zontal re erence point (BM), direction a percent slope, scale or dimemsions, north a and location and distance to nea d. Parcel I.D. 1005-20-000 Please print all fo Rev wed B Date Personal information you provide may be used secondary pu ~C'r~ 1) (m)). ~ ~ /~ D• 7 Property Owner ~ Pro rty Location L. Elaine Eby ~ ~ ~ Go Lot SE 1/4 SW 1/4 S 7 T 29 N R 19 W Property Owner's Mailing Address Lo # Block # Subd. Name or CSM# 350 Krattley Lane ;p 3 CSM Vol. 1, Pg. 178 City State Zip Code Phone Number J City _J Village ~ Town Nearest Road Hudson ~ WI 54016 (715) 386- Hudson Krattley Lane _;f New Construction Use: ~' Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD 1/ Replacement _j Public or commercial -Describe: Parent material Glacial Outwash Flood plain elevation, if applicable na General comments and recommendations: Site suitable for conventional dispersal cell at 0.5 gpd loading rate. Recommended system elevation to be 87.50'. Boring # ~ Boring I~/ Pit Ground Surface elev. 92.78 ft . Depth to limiting factor > 104" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10yr3/3 none sil 2fgr dsh cs 3f,1mc 0.6 0.8 2 9-21 10yr4/6 none sl 1fsbk mvfr cs 2fm 0.4 0.6 3 21-38 10yr4/4 none sil 2msbk mfr cw 1vf,f 0.6 0.8 4 38-104 Oyr5/6 none s & gr 0 sg dl - - 0.7 1.6 Cobbles & gravel comprise approx. 40% of Horizon 4. Boring # Boring Pit Ground Surface elev. 94.18 ft. > 118" in. Sal A lication Rate Depth to limiting factor pp Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIfr= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 10yr3/3 none sil 2fgr dsh cs 3f,1mc 0.6 0.8 2 8-22 10yr4/4 none sil 2fsbk mvfr cs 2fm 0.6 0.8 3 22-69 10yr5/4 none Ivfs 0 m dsh cvv 1vf,f 0.4 0.6 4 69-118 10yr5/6 none s & gr 0 sg dl - - 0.7 1.6 * Effluent #1 = BODS> 30 < 220 mg/ and TSS >30 < 1 0 mg/L uent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signatu CST Number James K. Thompson _ S-- 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Os ola, WI 54020 5/8/2007 715-248-7767 Property Owner L. Elaine Eby Parcel ID # 020-1005-20-000 Page 2 of 3 Boring # ~ Boring ~/ Pit Ground Surface elev. 88.76 fl. Depth to limiting factor > 102" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10yr3/3 none sil 2fgr mvfr cs 2fm,1c 0.6 0.8 2 9-24 10yr4/4 none sil 2fsbk mfr cs 2fm,1c 0.6 0.8 3 24-36 10yr4/4 none sl 2msbk mfr cw 2fm,1c 0.6 1.0 4 36-54 10yr5/6 none s/Is & gr 0 sg dl cw 1fm 0.5 1.0 5 54-102 10yr5/6 none s & gr 0 sg dt - 1f 0.7 1.6 H#4 contains a mixture of 0 sg 10yr5/6 s & 0 sg 7.5yr4/6 Is. Loading rate reduced to reflect restricted permeability of horizon associated with textural inconsistency within horizon. Stones, cobbles & gravel comprise approx. 40% of Horizons 2, 3 & 4. ^ Boring # Boring Pit Ground Surtace elev. ft. Depth to limiting factor in. Soil Appligtion Rate Horizon Depth Dominant Color Redox Description Textun: Stricture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ^ Boring # --~ Boring Pit Ground Surface elev. fl. Depth to limiting factor in. Soit Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODS> 30 < 220 mg/Land TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/Land 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) A.C.E. SOiI & Si02 EValUati0f15 /GO, 7~' n M SGi%Qda.~ ~occnd ~a 6t /!SS sys~t~.-, arcA, (~ ~ . y E~'i'sfi d,;so~isaf o ~- ccr/, ~ O Ektint Eby~~o~., /oL`3, ~rf ~~ / /~ . /78 Scc~Y~.SE sc~. 7, ~z~~ ~? /9w. T. of /~.~ #oso-ia~s za-aoo L?Xi,Sfin wcl/ Shod ~ b - --- __ _ --~ yoo; _ _ -' - _ - - _ w~ - - - B6o: _ - - 9,x.0__- ,`~ ~o.a- ~•. ~ `. `. 9 , ~o'- ~ '. `. .~ ~ ' . •. lG.O , ' ` `. ~ `. era s,~ i'• '`, ~`• ouEloEJ~rv2~a~-2.25' '•~, ~ ~ ~ ~ ~ AIE. B.M.= aka ~ %''--+ ~`~ sy~zy~ .~~ 3Ewy j Diet' o~~o~' E'X,'sf;.~ ~ 3 brdrw-,~ ~ ~Sidtry~. K1 . Pte/ ~~` D ~' ~, /'q, J4f 1~ 8'~~ j -~---J' ., ,~;~, .' ~ ' clW, =/~.c~0,, I 9G.o~----- -' - ~dz , __ „_. _ __ ~ - _~ r --- --f_------ -- , -- _ , , _.. __.. , 8 / ~ - --- ~03.9~ ~~~,~~~y ,L~~e . 3 oF.3 Dose Conventional POWTS Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General 'The conventional septic system shall be operated in accordance with Comm 82-84 Wis, Adm. Code, and shall be maintained in accordance with In-Ground Soil Absorption Component Manual SBD-10705-P (NO1/On, All local and/or state rules pertaining to system maintenance and maintenance reporting shall be complied with. Sgntic, Tank The operating condition of the septic tank and outlet filter shall be assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in the tank exceed 1/3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48, Slats. if the contents of the tank are not removed at the time of a biannual assessment, maintenance personnel shall advise the owner of when service will be needed to maintain less than 1/3 scum and sludge accumulation in the tank. 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. Septic tank manholes risers, access risers, and covers should be inspected for water tightness and soundness. Access openings used for service and assessment 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 the tank. No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank abandonment shall be in accordance with Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Pump Taek The pump (dosing) tank shall be inspected at least once every two 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. Soil Atibsorption Cell Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for vegetative maintenance) over the system is not recommended. Soil compaction may hinder aeration of the infiltrative surface within the system and will promote frost penetration during cold weather months. Cold weather installations (October- February) dictate that the system be heavily mulched for frost protection. Influent quality into the system may not exceed 220mg/L BODS, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for the installation. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner. Levels above 4 inches indicate an impending hydraulic failure requiring additional, more frequent monitoring. 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. Excessive ponding within the dispersal cell will be eliminated by removing biologically clogged adsorption and dispersal media and replacing said components as deemed necessary or by installing a new soil absorption cell to bring the system into proper operating condition. Questions on the operation or maintenance of the system should be directed to Jim Thompson, the master plumber in charge of the system installation or your county zoning inspector. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/]~ ~ . ~~QiA e ~O V Mailing Address .3~d iC /'Gi ~~~es~ ~r~e.. Property Address . ~-rYI~. (Verification required from Planning & Zoning Department for new construction.) City/State f~~ ~Sr~-iy ~/. Parcel Identification Number __0,20 ' /~5 ' ~ ~~ ~ ~~C~i LEGAL DESCRIPTION ,, // Property Location SE '/a , /~~ t/a ,Sec. 7 , T _~N R1~W, Town of h`u~sor~ Subdivision - ,Lot # 3 Certified Survey Map # 32 9 5~5 7 ,Volume ,Page # / 7Cg Warranty Deed # 83S8s'~ ,Volume ,Page # Spec house no Lot lines identifiable yes 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. Uwe certify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Numb of bedrooms .3 SIGNATURE OF APPLIC T(S) _S/z_so 7 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) State Bar of Wisconsin Form 1-2003 WARRANTY DEED Document Number ~~ Document Name THIS DEED, made between Mark T. Joseph, a single person ("Grantor," whether one or more), and Lunn E. Eby, a single person ("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 3 of Certified Survey Map recorded in Volume 1 on page 178 as Document No. 329457 being a part of the Southwest Quarter of the Southeast Quarter (SW'/4 of SE'/4), Section 7, Township 29 North, Range 19 West, Town of Hudson, St. Croix County, Wisconsin. 83554 KATHLEEN H. NALSH REGISTER OF DEEDS ST. CROIX CO., MI RECEIVED FOR RECORD 10/03/2006 03:05PM MARRANTY DEED EXERT # REC FEE: 11.00 TRA>iS FEE: 735.00 COPY FEE: CG FEE: PAGES: 1 Recording Area Name and Return Address Wisconsin Assured Title, LLC 1810 Crest View Drive, # 1 B Hudson, WI 54016 _ 1,18 ~1~`-+ . 0 020-1005-20-000 Parcel Identification Number (P1M This i S homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Roadways, Easements, Restrictions, and Rights of Way of Record Dated September 29, 2006 * * Mark T. 3oseph (SEAL) (SEAL) * G ~; * a.~ r r ,. AUT ~TION ' ~~~~~' ACKNOWLEDGMENT ~: Signature(s) „ , ... STATE OF WISCONSIN ) authenticated on "' ~ ~,~ ) ss. St. Croix COUNTY ) .-,; " <. _ j` fir,' * -•,g?;'~` .~; Y ~ Personally came before me on 29th day of September, 2006 , TITLE: MEMBER STA ` 1- SIN the above-named Mazk T. Joseph, a single person (If not, -~ to a known to be the persons who executed the foregoing authorized by Wis. Stat. § 706.06) ins a wled ed th ,` THIS INSTRUMENT DRAFTED BY: * Richazd K.Y. Lau - Redmon Law Chartered Notary Public, State of Wisconsin 2217 Vine St., Ste. 204 ~ Hudson, WI 54016 My Commission (is permanent) (expires: ~ ~ 0 ) ~~(r_ ~~Q}~ (Signatures may be authenticated or sclcnowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ®2003 STATE BAR OF WISCONSIN FORM NO.1-2003 ~ Type name below signatures. 1 o"f 1 .. 329457 L v~~~7t 11 ~0 C~ ~ 1 FriEv SEP 291975 ~ IA~ES O' CoNI~(,~ Reakfer of Deede ~ 6ti Crotc County, Q Wfecon~ 9 ~ '~ ~tPPROYED ` ST. CRO1X COUNTY dt I~t~~L PARKS 69~tt3I>~G ~~ ~ 160.77 166.50 166.50 .~---; 165.60 15~30~~ ~ . ... ~ -~~. ~ ~ 2 3 _ 4 ' a °~ ~ N ~ w ~ N O N TRUE ~ 1.42 ACRES ~ 3 1.42 ACRES ~ "- 1.54 ACRES _ N ~ 1.68 ACR1=S BRING _~ ~ 'M ~ o M..... to " ~ M M t0 O ' J ,, ,f Z Z . 1 f ~ ~ M Z -~~ >, _ ; L N ~ O WEST INE OF THE SE I/4 $W_ $E o -'~~~' POINT OF ~'' , . ~~~ h .o BEGINNING O /~`~~ 2 , ~ N r~i o `' ~0~ 3 126:31 203.90 1 ,93 F .~ , ~6 - - -- -~------ - ~ ~~ 330.2 S 83°35 40 W 6 ~~~ 9° 3 SCALE 03 ~~oeaa o®p~® 100 0 5o I0C Q 0 ~~ `eo ®,0s ~S ~ y POIN ~it ~°.~s- .,i"""""' T OF ~~' ~~ w MONUMENT WEIGHING 0