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020-1124-80-000
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ATE SEWAGE SYSTEM Safety and Building 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)]. ermit Holder's Name: City Village x Township K'eseth, Tom Hudson Townshi ST BM Elev: Insp. BM Elev: BM Description: 'A dll! 161CA~AAATIn61 CI ~vnTlnAl nnTe TYPE MANUFACTURER CAPACITY Septic 'rrl r* Z Sb ~`'S~ Dosing ' ` `-[ I 1 Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. ~~ Vent to Air Intake ROAD Septic `~lUD, 3 j'~ t ---- Dosing ~~ 61 ~• .~„ , ~ D ! Aeration Holdin PUMP/SIPHON INFORMATION Manufacturer Demand ~-S !5~ ` GPM Model Number l,]~ (7 -1• !' Lift Friction Loss 1 Syst m Head TDH Ft ~• q•`~`~ '3 •gs ~ •~ 19•a Forcemain Length 1 ia. y Dist. to Well ^• t 4 0 2 ~ it ~' SOIL ABSORPTI N SYSTEM county: St. Croix Sanitary Permit No: 405122 0 State Plan ID No: # ~` 3313 ~Ttr~l,~s. ~o. ~ Parcel Tax No: 020-1124-80-000 STATION BS HI FS ELEV. Benchmark ~ 9 03• ' ~ • p t Alt. BM Bldg. Sewer dtts Ht Inl t n~ Iz ~ ~6 • ~-1 St/Ht Ou t Dt Inlet Dt Bottom f2 , o ~y ~d ~ Header/Man. ~, ~ ~ oz• 33 Dist. Pipe .5•~, I lpz . 29 Bot. System 'L, Z 2. a lot •~O Ot•SS~ Final Grade r ~ W,u b¢.~ tz' St Cover BED/TRENCH Width Length No. Of ~ReheHes-- PIT DIMENSIONS No. Of Pits Inside Dia Liquid Depth DIMENSIONS ~ 2 ~ T '~I_ __ f SETBACK SYSTEM TO P/L LDG WELL LAKE/STREAM LEACHIN Manufacturer: INFORMATION CHAMBE R Type Of System: UN Model u DISTRIBUTION SYSTEM ~• tS I•leeder/ anifo ~ « Distribution ~! 1 x Hole $ize ~ x Hole Spacing Vent to Air Intake ~ ~ Length Dia Dia Spacing Length SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ~ Yes [] No ;~ Yes n No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #~ l~Z~`' Inspection #2: Location: 410 Krattley Lane Hudson, WI 54016 (NW 1/4 SE 1/4 7 T29N R19W) E gle Ridge Lot 3~ Parcel No: 07.29.19.564 1.) Alt BM Description = 2.) Bldg sewer length = G4~J - amount of cover '`I. ~1 K ,/ 3.) Contour = ~ V ~ / Z 0 + Plan revision Required? Yes JNo ~, ~'~ ~~~ ~ ~ Use other side for additional information. `~! L_ 3 ' f-~r/~~~`' --- ---- --~5~~ ! ~_ - 1 _ _- to p ~ 1 Insepctor's Signature Cert. No. SBD-6710 (R.3/97) ~ [ n)C~- ~ ~ ~~ ~ ~ , ~ 1 ~~ ~ • ` C IPYpAIIyJi- o~~- J Safety and Buildings Division County ~q ' ~ ' _ ~ 201 W. Washington Ave., P.O. Box 7162 . ` ~ p ~ ~ ,~''COn~~~ Madison, VVI 53707 - 7162 ' Site Address b y De artment of Commerce ~/~f3 Z- to ~ -o 'L S e ra l ~lD Sanitary Permit Application ~~ Permit Number in accord with Comm 83.21. Wis. Adm. Code. personal information you provide ^ Check if Revision ~~ ~ ?j tna be »sed for ses Law s15. 1 m _ I. Application Information -Please P-firt All Wormation p State Plan I.D. Number Property Owmr's Name ~ Parcel Number ~ ~ es e ~ ~ s 2002 oozo' ~i~ ,~D, property/Owners Mag' GOUNTY GROIX IGE ~ ~~ ~ T Property Location 1~ ~~ ` ~a ( , S ~ OFF S4 !6: S / T N, R City, State Zip Code umber Lot Number Block Number ~ ...~-- ~ ~~ rah ~` . ~ ~ ~y~~ Subdivision a CSM Number f ~',~ ~ ~ II. Type of Building (check all. that apply) ,, / ^City 1 or 2 Family Dwelling - Number of Bedrooms ~~.~ ~ _ ^Vglage ^ pubtic/Commersial -Describe Use ' ` 9 ®4'ownship R/G~ SD x ~P 7 ~-~~ ~ n ~~'`''~'' ~ /0/ ^ state owned /t'~p-ytm d G~a~• C2.~-~ 9 canes[ t~ it = O..S ~ rrwr, • ~ ai,ev ~3~o numsa,~ s t_° III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B iF app cable) A. 1 ^ New 2 ~ Replacement System 3 ^ Replacemet of 6 ^ Addition to For County use . m Tank ON Exis ' stem B. ^ Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check aD that apply)(ntunbering scheme is for internal tree) p~ ~~Ct? H ' [[~\ 50 Consaucted Wetland 44 ^ Non -Pressurized Lt-Gratnd 21~ Mouod 47 ^ Sand Filter Z2 ^ Pressurized In-Ground 41 ^ Holdiq Tank 48 ^ Sittgie Pass 51 ^ Drip Lim 45 ^ At-Grade 46 ^ Aerobic Treatment Unit 49 ^ Recinsulating 30 ^ Other V. Area Informat ion: Design Flow (SPd) Dispersal Area Dispetsal Area Sort Application Percolation Rate System Blevation Fine[ Grade ~ ~ D~ Required / Proposed 3 / ~ Rate(Gals./Days/Sq.Ft.) (Min.Mch) ~ ~ /ai evation ia3_..~ , ~D3 D , 99~ ~l_ d /D 6 . VI. Tank Info Capacity in Gallows .Total Gallons Number of Tanks Manufacturer wl~~~ ~ ~ Prefab Concrete Site Constructed Steel Fiber Glass Plastic Kew Existing ~ ~~ / Tanks Tanks Septic or Hold'mg Tank x _ ~D 1 1 e ~/~ !' Doaiug ~~' VII. .Statement- I, the , assume respon~blUty for POWTS shown on fhe attached plans. `'s Name (Print)~J ' p Signature ,Q MP Number 1 ` Business Pboae/N~umber (~ ~ ~ ~ ~ ~ '// 5 /~' h ~< c~ ~Y o 7 fT Pltrmbet's Address (street, City. ,zip coax) Cv ~ e ~c ~ ~ ~- ~~o? /De Use Approved ^ Disapproved ~~Y Permit Fee (iachMes Groundwater Date issued Agent Sigoature (No Stamps) ^ Owner Given initial Adverse . Surcharge Fee) _ , ~ J ~U 3 ~ ~~`-.~ Determination 3 a s: `-i'/ / d IR. Condkions of ApprovaURatsoas for Disapproval _ (y ~~ ~ ~~~C~-fry ~~~~ ~" v°" ~"~?n~~ - ~~-~~~.~}o~~•zd ~ m~ ~--~~v a~ i~~ `~ U _ '~~6Y~2-dzclY~l1J4~ yi,,u•o~" 7~ecvn 1~m C,~,Q,rc naaca ~p~ t~ tto the Cooit7 oub) for the"syttsa- m paper6to[ tat tmia gun rvu inches in tlxe ~ ~/(~2i A,/ SBD-639$ (R. 05!01) .. isconsin Department of Commerce May 15, 2002 CUST ID No.267341 ARTHUR L WEGERER WEGERER SOIL TESTING & DESIGN SERVICE PO BOX 74 RIVER FALLS WI 54022 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/15/2004 ATTN.• POWTS ZONING OFFICE ST CROIX COUNT 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Tom Kjeseth 410 Krattley Lane Town of Hudson, 54016 St Croix County NW1/4, SE1/4, S7, T29N, R19W FOR: Description: Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 851726 Safety and Bui{dings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi. us/sb www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Secretary R~CF~~F Mq y ~ Z CR~~ ~ , ~~oZ oN,N~ oFF°,~Fr>' ~ Q ~ ~' Identification Numbers Transaction ID No. 734313 Site ID No. 644688 Please refer to both identification numbers, above, in all comes ondence with the a enc . 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: General Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.O1/O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10706-P (N.O1/01). • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. C~t~vnally ~U V C®• Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat MT OF COMMERCE ~'TE,tf7 UILDINGS Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. tESPONDEN Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). ARTHUR L WEGERER Page 2 5115/02 • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installati on/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 maybe 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, l~'dSb1 Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@commerce.state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART codes 7633 cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544 TITLE SHEET FOUND SYSTEM FOR A ~ BEDROOri RESIDENCE Page \ of -1 This plan has been prepared in accordance faith the Mound Component Manual SBD-1057 P and the Pressure Distribution Manual SBD-10573-P Ccz. blg9.~ C~z. ~Lq~~ LOCATED IN THE PJW 1 /4 OF THE S ~ 1 /4 OF SECTION -1 , T Z°~ N, R ~ 6d, TOWiJ OF ~s~SUyJ , ST-C~Z-~ LX COUNTY, WISCONSIN. Lt1t --3 S _ -DF t~'PeG'l-~ __tZL ~ G ~ ---- --- INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEM i°IAI~TAGEi~1ENT PLAN PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEt7-CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 P(TI•iPING CHAPIBER CROSS SECTION PAGE 7 of 7 PUhIP PERFORI.IANCE CURVE PREPARED FOR PREPARED BY WEGERER SOIL .TEST = NG AND . • DES I G~V SERV = CE P.O. Box 74 421 Id.iiain St. River Falls, G]I 54022 Phone 715-425-0165 Fax 715-425-6864 Cpri~ 4 P-'F'p ~~~ ONE ~• ~~ CO~~ ~'q ,~ ~. ~' ~° ~~~ ~~ ~C °~~ ~~ ~: ~~~ ~~~ ~ •, ~.....y~ vj t ~~ e ~,;,,~ 1 I `. ~/w~._ ~t r .,,~,~ ~ ~-. S -11-e 2 JOB NO ., ~ ~-- L ~ 1 Mound System Management Plan page Z of ~ Pursuant to Comm 83.54, Wis. Adm. Code - Seotic Tank ~(~ /i ~/ ~,'~-~ The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the eptic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and utlet filter shall be as least once every 3 years by inspection. The outlet filter shall be cleaned as nece ensure proper op rat' The filter cartridges ou no a 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 (Ocfober-February) dictate that the mound be heavily mulched for frost protection. {nfluent quality into the mound system may not exceed 220 mg/L BODS, 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 point 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' component manual [SBD-10572-P (R. 6/89)] arid local or state rules pertaining to system maintenance and maintenance reporting. -- 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 shall 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 assessment shalt 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. ContinQencv 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 wastewaterto the ground surface, it will be repaired or replaced in its' present location 6y 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 ~, ~S - 3 i~ b - ~ 6 ~ O S~'_ L°..~LX The system installer at `~ ~S _ l~ Z. S _ ~,~} ~ wl~1G The tank manufacturer at ~pt) -3 2rS _$l[S b ~JlLS~1Z The effluent filter manufacturer at ~-D~- ~-Z.~~~7~Z. z,p~-~~~-L Ttie pump manufacturer at -- - lj3l~ - ~ 2.C~- ~~L~ ~~' GovC.,ps PLOT PLAN y 8~2r~ ~M~ ~o ~.U-J sh.~11,~~ ~1zg'iT L~j l~N~'1~ ~~SF~ x'10 vr.,~7 s ~T~ - ~C Page 3 of ~ w~,C - 1 S 7 S4' FRd ~I r~i~U M~- ~~~~~ 1..p1' l,L1vE 1S > - ~OOU G~~- ~1~~~ ~ ~'~ pv e ~~ \\ ~ ~ Gyr,l~ ~ S ~ ESL STTti-J 6 p -~z~ e~ ~, s' x ~ S ' L~-et-e}I o~ <~. ~ ; ~ G ~, ,~~ Boa ~~ Cp~~ Zb' ~ 5 b U rvuT C.Ov~~q-2.~- otZ ~ ~1, l ~ 1. Z ~ ~ \ b t S11! ~~ ~t'tS t~CCZ~S`El hq C)_ r Z-E4 i . 1 ~~~~ \ ' ~o~c ~1~\ \\ p~\` \ 10~ zb~ ~.3 3~i*-1-_tt__:190:>0':on, 3z`"-cR~-<, 1 ~ ~z.``1~~R, s`~Z ['T~, ,-_--- II1~1#Z -~°Z: ADC=$, cxv _~L3`' _T~.~ s~Z, Po ~T`. NOTES : ~ -~~ 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be ZZsp gallon capacity manufactured by Vv1~5~Z CU~ICP~T~~ ~~~i -~.~5' l U n 0 Gam. P w s ~ 2S ~ !~S o CU-~ 30 `1'~1rL w/ r~Y~f~ oo Z,i~B~z, ~ ~-~tZ .~ 4 , tsencn mark S ~_ S~~ P~$~ V E 5. Divert surface water around system to prevent ponding at the uphill side. Page Lf Or" ~ Approved Synthetic Covering AST~i C33 ' Medium Sand ~ ~3,~ Topsail 3 '' ' ~ _ •: istribution Fipe ~~ tG F ~ Elev. LD l- 7 o ~ e . y . % S1ape I ~ Distribution Cell of ~ Force Main 2" to 2 z" Aggregate From Pump CROSS SECTIOiy OF A MOUVD SYSTE;~i Linear Loading Rate= ~•RS GPD/LN FT Design Loading Rate= o•y3GPD/SQ FT -1 0.. •i• _,.. „ ~ -F~e--l~an._~ .. ~ ~ • c A ~ Ft. B b 1 Ft. I \ ~- Ft . J S Ft. K 8 Ft. L rc3 3 Ft. W Z ~ Ft. Z Flowed Layer ~D O • S Ft. E 0 •`d6Ft. ~F ~•~i Ft. G p, S Ft. ,~N \, p Ft . ~. -Observation Pipe ~ ~ K A a--~----X68---- --------- -------------- ------• - W ~ ~~-- --~------- ------- -----------------------I--a Force Main ~'-- -- - --- ------ ~ ~- t~cc~ss 8~ ;~ . Distribution ~ ~ ~ „ ~ ~~ Pipe Cell of z to 2 2 ~ a;gregate • Observotion Pipe {aae`sor securely) --• r .... _._ ..._..------- ' ' ~ PLATT VIETd OF A MOUYD SYSTE~4 Distribution Pipe Layout Place the holes at the bottom of the distribution pipes . at equal spacing. Remove alI burrs from the pipe and holes. Extend the end of each lateral up with the use of loner turn or 4f fitiinQ inches of the final grade. Terminate the ends of the laterals with a valvetthreaded cap o S~ .threaded plug. Provide access from final grade for the valve, threaded cap or threaded plug. " Page S of ~ T `-t P.1 G3 L . _ ~,iZnS S . S~.'C1 p T~7 pVC p~j~ Lateral Martifald ~~ C ~ ~--Lateral x ~.. x x a- - ' P 1'~ psl.l 1 F~7 ~ 4-- -- i Q- - PrC-Crtis soX - -o PVC wQ~ y~~ _ I P 3 ~ Ft.,/ ~. - Fiol a Diameter ~1$ Inch - S 3 Ft. - - Lateral 1 ~ InchEes) X ?~ InchPS~ Manifold " Z - Inches Force Main " 2 Inches ~, ~ of holes/pipe l~ - - Invert Elevation of.Laterals lbz.2 Ft. . _. ,~ ~ • Combination Sept.~.c~.Tank and - PUMP CHAMBER CROSS SECTIOIJ ANO SPECIFICATIOtJS ' PAGE ~ OF ~ L+~ sP ~t,>LJ P tPE w!-'rLCL~stH' zrrP - G~oE t 18'KIAI. • UJLET , Approved joint w/ PVC pipe i l I I L corsDutr ~ ( ~-- ~.. \`~; - -PROVIDE I AIRTIGHT SEAL I ( I ( I ~I i ( I ( ( 'I I I PUMP --~ '-~ D COUCRETE ~.LV . Of O.O O' -• a~ocx--. ti~ ou OFF ~- RISER EXIT PERMITTED OIJLy IF TAI.JK MAIrUFACTURCR I-iA5 SUCFI APPROVAL~3NAP~~F~ 6FD0e~4 SEPTIC f - SPEGIFICATI~f~1S DOSE TAl.1K _ MA-lUFACTURCR: wl ~S~ C~l..~e~ 1Jt1M6EA OF DOSES: S ` E ~ TA1JK 5-ZL : 1 2-SO ~Z S O GALL01J5 --- -P R oA„ DCS<< VDt_IIME r • ALARM MAUUFACTURCR: S"~ ~''~. -~T1Z.O SYS~T~'I~jS I~CLUOIAJG 6ACKFLOW: - tZ-a • ~ (,Att_OhtS MODEL -.1UM8ER: 1p l ~w CAPACITIES: A = Z S IAlCHCS OR ~I D3' ~ CALLO t , SWITCH T~PG: ~~~~~'7 US g = ~ IIJCHES'OR '3 Z' ~ ~ G~LLOUS F'UMP MAI.IUFACTURER: t~UV~-~S C= ~ IutHESOR 1~Z"Q'C CALLOUS MODEL 1JUMHER: ~~~•S - D=~3 IAICH ES ORZV4• ~O GALLD-JS SWITCH TYPE: ~ ~ Z ~ _ WOTE: PUMP AUD ALARM-ARE TO 6C 3•~ MI1JlMUM DISCKAR6E -RAE L( ~' ~Z M INSTALLED OA7 SEpARATC CIRCUITS yERTICAL DIFFEREIJCE DETWCEILi PUMP OFF AUO.-DISTR-HUTIO-J PIPE.. l l•`~EET -~ I'SIUIMUM IUETWORK SUPPLY PRESSURE , ~ ~ •SO FEET~S oxL 3 ~- ~~S _ . , FEET OF FORCE MAItJ X 3 'S~ F~pFCFR-CTtou FACTOR.. 3'x•1 FEET TorA1 oyuAMlc HrrAO = Z~•3 -F r - As per LZanufacturer 16.12 gal /in. Liquid depth ~$ `~ ..__ . . ;' - •VE-.!7 CAP ~ WEATHER Pft00F • JUi1CTI01J 8DX . ti C.I. VENT PIPC t .tPPROVED LOCKIAJG ~ IO' FAOM DOOR, ~MAUHQLE COVER wl~ :JtfJDOW OR FRESH 1 wA(ilJl-JG LAagE(•,• PS8~L T t~.h~ .. A ~ -~~oc~ - b c. CLEY.~I-0a fT.'-1'~ A~IUT~IKE --i 6K,~w. ~Z; ~,~ ~- 4 ` ;~. •~ r~ i Y' xlu. I ~' ~ 18' Ml ls. ~1 ~( V ~i Approved ~( joint w/ ,~ ALtiRM PVC pipe APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPEC{FICATIONS Pump: EP04 • Solids handling capability: 3/a" maximum. ,.--1 • Capacities: up to 55 GPM. • Total heads: up to 24 feet. '~ • Discharge size:lr/z" 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: 3/4"maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size:lliz` 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. 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, 115 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: l0 foot standard length,l6/3 SJTO with three prong grounding plug. Optional 20 foot length,16/3 SJTW with three prong grounding plug (standard on EP05). METERS FEET 10 9 30 s 25 0 7 a W s U 6 z 5 C 15 '~ 4 F 0 3 10 2 o~ 00 ~ u zu ;~u 40 50 GPM ~ ~ ~ ~ ~ ~ ~ 0 2 4 6 8 10 12 m'lh CAPACITY ~- Goulds ~E ~ °~ ~ Submersible Effluent Pump ~~ 3871 EP05 • 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. FEATURES ^ EP04 Impeller: Thermo- plastic Semi-open design with pump out vanes for mechanical seal protection. ^EP05 Impeller: Thermo- plasticenclosed 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 SA• Canadian Standards Association (CSA listed model numbers end in "F" or "AC".) ~ ; h' •~ ~SGPM: ~ Q. ; _ ___ _ _ -- _ - - ~ I f ` `l 3 ~ ~ ---- 1 1• 1 9 . ~.1 1 _ 1,8 ~ _ i ~ ~ ~ I i ! i ~ ~ ' ~ EP05`- ' ~ I I -- i ~ j ~ ~ ®1995 Goulds Pumps, Inc. Effective May, 1995 83871 Wisconsin Department of Commerce SOIL EVAL ATI Division of Safety and Buildings ' in accordance with Comm 85, Wis. dm. Code e,~AY ~ c ' ~ Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. P n muf;'t' inGude, but not limited to: vertical and horizontal reference point (BM), direc on and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance t near8~t ~@~IX OUNTY Please print all information. ZONING d Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location ~~ I ~sl/U2.- Page ` of 3 ~T- ~-RU LX ~ZD-1~Z~ - ~o Date ~. 110~3~0 I v ~ ~, C- SE~ ~ ^ °.,~.`~- ~ V~J 1/4 S ~ 1 /4 S ~ T Z- ~ N R ~ ~ E (o W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# ~, l0 kCZ-~T'`[~L~`t ~'~E 3S - ~~~ ~ IZ-tDG~' City State Zip Code Phone Number ^ City ^ Village ®Town Nearest Road ~Sr~) x.11 SLIU1~• (~lS )3$l- 1q~6 1`i'U~SO'N ~~~~T'R~-1 L~~ ^ New Construction Use: © Residential / Number of bedrooms ~_ Code derived design flow rate 0 ~ GPD ®' Replacement ^ Public or commercial -Describe: Parent material L y l'_-5 S ~. ~ ~- L Flood Plain elevation if applicable N ~ ft, ,General comments and recommendations: `P-~. ~U1~J~ lnJ ~ ~ ` K b ~ ' ~L9~1Z1.BV ~ U>~ L°~~1..(... , N'1 L hJ l h'I V 1ti-1 ~o u b 1= S ~A (~ Ll_ . Boring # U Boring ®Pit Ground surface elev. 1 ~ 1 • Z ft, Depth to limiting factor 3 d m. Soi{ Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 O -1 l0`~ 2 3 ~ ~ -" S•1 ~ Z~~g -- . v~1, V`~i- CS 2 v~ • S • 43 Z ~ -3v t0'21Z~~6 - s) I Z~nsbk ~~- c - • s •a 3 30-6) ~S`12.3~y C1 -1•S~!-z51$ s~ ~,.5 Oti,.1 ~~. - • 0 .-0 G~Uf~we~-R S~~~ y~ 3D" ~Q~A7t-`'~P ~Or- C~~~TTL~ ~ ~ru~ l~-U Boring # ^ Boring ~ ® pit Ground surface elev. 10 Z• S ft. Depth to limiting facto ~ Z- in. Soil Application Ra 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 ~ O -~l I.p`GVZ- 3~~ S L R Z h h'l ~'~1- cS 2 v •F • S - 8 z ~ - Z ~o ! - s i 1 Z~sb k wt.~- ~~ - - S - e 3 ~Z S3 ~o~ rz 3~~b ~- ~- -z s ~r ~ s 18 _ s )' I o ~, m v`fi- - • o • Z ~ I~-o~YP~..ti1~.-fit I s~-vr~-~-~ ~ c~. ~g 1 I I I I I I ' Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 moll • Effluent ff2 = BOD_ < 3o mall and TSS < 3n mnn CST Name (Please Print) S' na a CST Number Arthur L. Wegerer ~, OZ-~0~ 220254 Address 4tl e g e r e r Soi 1 T e s t i n¢ & Design S e r V i C e Date Evaluation Conducted Telephone Number 421 id. %iain St. t2iver Falls, tTI 54022 S-~-OZ ~~715-425-0165 Property Owner ~~, ~~ L~ 11 Parcel ID # ~ ~0 , l 2.y - ~u Page Z of Boring # ^ Boring Pit Ground surface elev. L(J b • ~ 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 ~ a-~ ~o~~z3!`/ .sil Z-F9~- wtu CS zv~ ~S -8 Z ~- ~ 3g 38-~I loH R ~l6 l0`~2 Y - 1 ~•S yR S ~ si 1 si ~ zw/ sb>z ~ m`f~ ~u~>- C~ - _ - s a v _ 9 ~ Z 3 v ~ ~ 1.1J~T - 1vLsQ~}Z s+t'ivt~ t~no t'v . goring # ^ 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. Soit 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 = BODs > 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 = BODa < 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.6/00) PLOT PLAid Scale 1' = UO ' y ~~2~ MME Page 3 of 3 `~v~i-C-- 1S__~ S4A FIu11~1 MrStiM~~J~ ~s ' ~tz.c~-1 mks . ~/ ~ve~~sr wT r/i~~ ~s X s~'n.C '1~rJlrt. ~o ~.~ sk-~-~ C.ohTTOV1Z ~ ~Or ~~ ~~- ~ ~ ~ ,, 0~~ ~ `c~-vuSFx WIO ~rr~~ s» - ~ t,' l~ .~~t STT--v 6 _ S'K 7S ' L''~}i `~ ~ \, ~ \ D l S1v CLQ 1Zi-Lg ~tZisFl ~.t \ ~ 1 ~~ ~~\~ \ \ ~d. \ h'~ ~o ~ BM ELI ~i~ ~~ ~ ~/ VFuTS ~ of o \\ ~ . Z ~S ~ • 13r1'!f Z Z6~ 'J 100 `. '~ ~.3 ~~s ~3tZ.L,,~ K ~o`? 3~~4-1- ~'t ~ 100 : n ' on. 3 Z~t~ i ~ ! z" ~ ~R S`~ZZ P i ~ -_ ^,,_ S-q-02 715-425-0165 220254 OZ._Ip~ CST Signature Date Telephone A1o. CST T~lo. Job PdO. Wisconsin Department df Commerce SOIL EVALUATION REPORT Division of Safety and Buildings , in accordance with Comm 85, Wis. Adm. Code C Page l of ounty ~1-- e~ ~X ~ Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ~~ . 1 `Z,~ ~ ~0 Please print all information. Reviewed by Date Personal infom~aGon you provide may be used far secondary purposes (Privacy Law, s. 15.04 (1) (m)). , ~~~ ~'~ ~' SE~ ~t ~evt-l=eE- ~ W 1/4 S ~ 1/4 S ~ T Z- ~ N R ~ ~ E (o W Property Owneds M L 0 L1 ailing Address lz-l~-~TTL~'~ l~~ ~ Lot # 3S 81ock # - Subd. Name or CSM# , Crty ) 501 State Zip Code Phone Number 1 3 S~I ~1 ~G l = ^ City ^ Village ®Town IZi D G ~' Nearest Road . ~I $l-1q~6 o , (~lS) 1~~Sp~ ~`r~TT~.~-r Lf~~ ^ New Construction Use: © Residential ! Number of bedrooms ~_ Code derived design flow rate 0 ~ GPD Replacement ^ Public or commercial -Describe: Parent material ~- c1 ~ S ~ ~ L L Flood Plain elevation if applicable N n ft General comments and recommendations: yvl. bU1'~T~ I.v / g ' X b ~ ' ~ `512.(,$ V 1 U~ L°-(~ZL , ~''.~~- EZ-~.v . L o t. Z Boring # ^ Boring ` ® Plt GfOUnd surface elev. t ~ ~ • ~- ft. I~Pnfh to limitinn fnrfnr ~ Cl Horizon Depth i Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ftz n. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 0-~ 10~t? 3~~ -' s~) I Z~~g--. mv~- CS 2v~ . S •43 Z 3 ~-3v 3D-61 to~IZ~l6 ~SKfZ.3ly Clc~.1•S~ifZ51$ s) I s~$~S Zmsbk c7tti, Yn.`F1- Gh~. c~ - - •s •D .e .~ ~ G 1.)M7 5~1~~0(; Y~- 3a" PrT`~P 6F C~1 l-4v LZ.U a Boring #' ^ Boring Pit Ground surface elev. l O Z- S N ne...a .., r,.,.,~,....:_,,.,.. U ~ --r- -- ~~~~- ~ --~-~ ~ - ~~~~ Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I ~ -`7 ~o~t~z 3cu ~ S ~ f Z`~ ~- rn~~- ~S z v ~ ~ s - 8 Z ~ -~. Z ~o ~ R yl b - s i 1 Z~sb k `M.~- c1.J - - s • e 3 ~Z s3 ~o~rz3~.b ~-l~ ~ sir ~ s1s s )'I o m U~ ~ • o • Z eo P~~-y S~-v~~ c~.~g ' 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) Si na a CST Number Arthur L. GJegerer ~, OZ-LO~ 220254 Address 4d 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 ;.d. lain S t . River r alls, [•II 54022 S -9 -D Z ~~~715-G•25-0165 Property Owner 1Z`, ~ L~ l~ ParceliD # O Z.O - ~ l ~ ~J - ~" ~ Page ~ of 3 Boring # ^ Boring 3 ~ Pit Ground surface elev. LU b• ~ 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 ~ a-~ ti~~~Z31y - s~- 2~9~ ~lv ~s Zvi •s .a Z X38 1~tiIZ4~/6 - si 1 ZWisb~z m`f'1- C~1 - ~ S - 8 3 38-~I 1~Y2 5~~3 `F~`~ ~•S~IR S~~ s~ ( ~~ VnU`Fl- _ e v ~ 2., 3 v ~ ~ we,- - rvL~ s~v~R ono rv 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 (n. 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 =BODE < 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. SB0.83J0 (R.N00) PLOT PLAi1 Scale 1' = y0 ' y ~~~.r'1 ~M~ ~~~ G P~~ ~ s~`rie ~Pn~. LD ~PZ'RU~J S~-,~~~~ 1-`,Z~Yrr ~~.j ~,N~'L`, 1~}-~juSEk 1ti10 vn,L7 s 1TLs' - ~( ~~`~ CST Signature ~o~rOv2 fit, I~LZ' ~ ~'t~ k1 Or- ~-C. ~ tZ. l~ ~7. O•~~~~ To ~r ~ ~ ~~ Page -3 of 3 `I ZS ' ~lZ-C~i ~'f~)w~cS. ---- ~v~,~sr wT ~i~~ is >_-. .~~1 ~ ~ 6 1~v~f~5 S'X ~S ' L~~i~l ~` ~~ , , 1 ~b~ '~5 b0 rvoT C-ow~t~q-e.; oiZ ~ b 1ST11Z.~ T1i-1,9 ~tZis'Fl ~. ~ ~ ,.~ `,~ \~ 1 1 \ \ ~ ~~. ~ ~p~ ~ ~ $M ~- ~ ~~ ~ ~~ ,~o~o ~ ~ , Z ~S, • ~r1 i~{- 2 ' ~p0 zb` ~~ _ ~ K $.~ ~'~ ,o~~% 3'M~1-_t?'-t_100_Cl_'_on,:.32~`~1-~, ~ t LZ"l~LR. S~Z~'LCSt-~- G-, Y'-1 ~EFZ-=~Z.. ~~ C ~ ~c~ -~3 y ~~ S-t`~.L P o sT'. S- q-02 715-425-0165 220254 O Z._Ip~ Date Telephone ITo. CST I~1o. Job r10. a ~ ~scons~n Department of Commerce May 15, 2002 OUST ID No.267341 ARTHUR L WEGERER WEGERER SOIL TESTING & DESIGN SERVICE PO BOX 74 RIVER FALLS WI 54022 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/15/2004 SITE: Tom Kjeseth 410 Krattley Lane Town of Hudson, 54016 St Croix County NW1/4, SE1/4, S7, T29N, R19W FOR: Description: Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 851726 Identification Numbers Transaction ID No. 734313 Site ID No. 644688 Please refer to both identification numbers, above, in all correspondence with the agency. 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: General Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.O1/O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10706-P (N.O1/O1). • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include Local inspectors. Owner Responsibilities: Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi. us/sb www.wisconsin.gov RECEIVEp Scott McCallum, Governor hilip Edw. Albert, Secretary ~a ~ ~ 5 2002 sr. cROlx couNrv ZONING OFFICE ATTN: POWTS Inspec ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WT 54016 ( ' ' ARTHUR L WEGERER Page 2 5/15/02 • Comm 83.52 Responsibilities. 'The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/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 maybe 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 1'or the installation, operation or maintenance of the POWTS. Sincerely, Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@c ommerce. state. wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544 DocUMEVT r:o. 'STATE BAR OF WISCONSIN FORM 1- i9llf WARRANTY DEED _-~~~.~- yon 1037 02 This Dead, made between ..Sam-•E.__Miller1__a__aingle_,persl ......................•-------••-•--- ---..............-•--------•------•------- -------•--.... Grantor, and....Thamas_ iI._-Kjeset:h,-and- Karen_-S._ Xjese*-h,~_ 6usband_ and-_ „-,,._wife_as•survivorship•,marital_•propertT_--- ----••__- ------..•- .................................. .........--•----••-•---•--• ....................--------•--... _, Grantee. Witnesseth, That the said Grantor, for a vabsable consideration...-.. conveys to Grantee the following described real estate is .._ St,_•CioiX•---••_••..- Cornty, State of Wixonsin: TNIf i1ACi RiliRV[D IOR R[COROINO OArA r `_CJST~R';i .~~ ~~' •4y .,r, ~'~.-t;~ ?ecb br ~eaond SEP 2.7.E?I39~ ~ .~ R[TURN i0 Lot 35, Eagle Ridge in the Toes of Dodson. Tu Parcel No:.. 3b41a o i This _....s- not--•-•------ homestead property. H~ (is not) Together with all and singular the hereditaments aid appurtenances thereunto belonging; And.._......_ Sam E. Miller aarrsntq that the title is good, indeieaaible in fee simple and free and clear of encumbrances except warranties, easements, covenants sod restrictions of record and will warrant and defend the same. Dated this .......-.°~.'..3 ~ --September .....................................• 19.93... ..............•---°-•-•----.._ day of ...----- .....--••---------------•---...---.._.....--•--•----....-------------(SEAL) ~~..•~ .----................-----..........(SEAL) .__Saa E. Miller --------°--•----------••-----•--•---------•----•-------•------•---- (SEAL) s AIIT>EIBNTICATION Signstara(s) antheaticated this ...__.._day of ........................... 19._..__ -------•-•----•-•--...--•--........--•-•----------------••----.... (SEAL) ACSNOWLSDGMBNT STATE OF WISCONSIN ss. ST. CROIX._...-----_- -.Coanty. „~ ---------- --.--- a a Personally came before ma this ...-•-----......day n! ----Se-ptgmbgr .............•-----, 19.93_. the show aamod San E. Miller„_-s___single__peraon••--____-_•_-_•____ -------------------- TITLE: MEMBER STATE BAR OF WISCONSIN ___. - - - N. --•______________________ _~~_______________.__ .1. -__._..._._._.___.___....._ __.~...___._r.. .,... . , snthorized by 4 706.08. Wis. Stats.) ------------•---------~...__....:_:.°::.i !'°_--` :....................- tr me known tyr be tlii p~ierson ._.._: _.-: Rho ezeented the foregoing went rlua saikne ~ edge the same. TNIa INSTRUMENT WAf DRAFTED aV ~ : ~ _ n I1 AlratyoQsl..~i..~Ax]L~..SAG.,__bY_.g~i4!)'il_~,__Casi ~ I P.O. Box 229, Hudson, iIZ 54016 ' ~ ~' :,--- ---•=-': ~:.~ ......................_.. ---•• ..................................................•--.....-•-•---------•-- Notary Pabtic .~::.5~,~:Croi~ :..:..-----._..Coanty, Wie. (SIgnstures may be authenticated or acknowledged. Both NY Commission is Went. ~If' sot, state ezi-iration --- --• --------- . .. .~r'rma...... • .,, ~~ ~S'113uycr ~Di Mailing Address 1~~~ Propcriy Address ST CROIX COUNTY SEPTIC TANK MAINTLrNANCe AGRLL~MBNT AMID (vuifi«tiou required e~ ~/~/ ~~ CERTIFICATION FORM ~. 1, (~itylStaLc s~~to~~ Ors ~ ~ Parcel ~EGA.L X? ~'SCIi.X'P~ON Dcpartnr~at for ncvv canshu<xioa) Idcutification Numbs ~ ~~ ~ ~ ~ /, ~b l L~~'1 ~~~~~ ~~~ Property Locatioa ~~~ %, ,~ yy ~. ~ T ~~N~t/,~,W, Town of _~~: ~E.~~.~__ i Sabdivisioa /l 1 ~` rat ~ ~. ~crtified Satvtp Map # Voltmic . Page # _ w~ Hera ~€ Sa ~ ~~'~ va PJ Ise ~ rage ~ ~~ Spy. ~ ~ ~ ~ tAt iii yak ^ ~ - ~ a. sr:~er~~~rc~ - am~sffoct.Qica~Q,~e ~9~eya~aao°°r{ifir~dodbjr~~i1D~ :w~y~p~.~~ 'I'BS=~ar~meatscageia~a~Eea~~, . _ • ~I'°.00P~9`~+c~gaocst+~ t~bmit'to St ~i~, ~' - ~. ~, ffi~eo~oesaad s di~arn~,erors Qrit Qrcoa~iuEeiaazae~ix is inaP~'s~ac(~ ~,~ (¢.~ ~ ioss~n Ii~~ 3d~rdg~ .~ ~~L~e,aatl6realohe ~~~~ ~ aad~oeMa~n~epdrir6eso~~~~Qres~oditds b7' ~'Gbamraoemdl6cDgaoEmomtafl~I~a[gScs6~ofWisoonsu~ ~ ~.~ odma~beoompid~odandretueoodtot[~eSGQ~oic'Cou~y?~mia~Offi,oc~a30 ~3i1~~ ~.rE OWtQ~ ~~r`A.~ON - I (~) °~~Y ~ vi oa ttus fomr arc fiat to the b«t of u~Y (~ tomov~odg~c. I (vre) sera (are) fire oarnrt{s) of ~ 1ry of a flood ~;~ in ~ of Roods Offiaoo- 1 szc~ru OF . ~ _ ~ ,~~i0 ~ DATE ssss~ ~ ~ ~ is mis-rcpctix~odma Y t~1t is ttrc sanitary pcomit bciug rctrolccd yy ~ ~S - ••••• • ss Indudc with th{s ~r4cx(ton: a spy stood 4nm tiuc a Dopy of lire cutifiod ' of Doody otI•ioo ~Y ~P ~ tdoronoe is made in the wacsanty dcod ` STC - 104 ' AS BUILT SANITARY SYSTEM REPORT OWNER~~ ~LL-YR, ADDRESS~p x Z g ~~ , F~-w~s o v. w ~ Sy o I ~ SUBDIVISION / csM# ~A ~ L E ~I D 6 E LoT #~S SECTION~_T 2 9 N-R~~ Town o f f I t,~ ~~ O n ST. CROIX COUNTY, WISCONSIN ~.PA tr ~ j. ~„~,~ P VIE ~~~ SHOW EVERYTHING WI IN 1 F SY EM .wAY ~ ~u2~ a ~~ ~ , 7 (~ e a ~,~3L' ~-- - - ---_-: _ . l ~0 9~ /Z V y~ ~j 9 l ~~ -- - ! c'~ - ~ ~a ~~ ~' ~ ~ ;~ ~ f s \'~ ~ ~~~~~ ~s"~ ; ~` ~ ~o~ %0 5101 \ ~~I ~„~_,~ ~ ~ Is'_~~ ~es'f' ,, o yo-~ ~~ -,< ,, INDICATE NORTH ARROW'' Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK' e~ or' ~«,.eaD ~~~ ~`' ^ ~~ ©~2~h ~~ ALTERNATE BM: pp o~ NoK 3 ~- ~Du.~ ~'r! / )`- .~ O, O z_ T SEPTIC TANK / PUMP CHAMBER / :HOLDING..TANK INFORMATION Manufacturer: ~„~S~,,i Liquid Capacity: f~ ~ ac-~ Setback from: Well /DS ~ House ~¢ ~" ~ Other Smc~'{h lof~.'~c. /04 ~ Pump: Manufacturer -- Model# -- Size - Float separation _ Gallons/cycle:- Alarm Location Width: S ~ ~:SOZL ABSORPTION SYSTEM Length ~S ~ Number of trenches Z- Distance & Direction to nearest prop. line: 4~d '`~ Sou ~:_ Setback from: well : /~60 , House Other Soo ~'to S~,e~ ic_ ~a-~t K i I ELE~TATIONS Building Sewer `~ ST Inlet : G,~ $' ST outlet ~~ S g PC inlet ~~ PC bottom .._- Pump Of f -~ Header/Manifold ~~ . y ,~ Bottom of system;N2, l3. L g ~~ Final grade $' ~~ Existin Grade gr DATE OF INSTALLATION: PLUMBER O N JOB : ~ -Crz.~~~~E~ .-e!~`~~"'t LICENSE NUMBER: 1"! ~ ~ ~i '`f ~~i INSPECTOR: .; .F:, , 3/93:jt L:~tts~r`~IsrYh~i~2rtr~d~hi~st~r7. 29.19.5~~~r~a7E~~~V1~i~G~E ~~STTLEY Labor and Human Relations INSPECTION REPORT Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Permit Holder's Name: ^ City ^ Village [Town of: CST BM Elev.: ~ Insp. BM Elev.: ~ BM Description: /1 TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~P~~~- ~~~ . 2S~ Dosing Aeration Holding TANK SETBACK INFORMATION ~~ TANK TO P/"L WELL BLDG. vent to Air Intake ROAD Septic ~~~' ~ S ' /l~ NA Dosi n NA Aeration Holding PUMP /SIPHON INFORMATION Ma Demand Model Number ~ - GPM TDH Lift Friction L S m Ft Forcemain Length Dia. Dist`To`V~tt---- SOIL ABSORPTION SYSTEM ELEVATION DATA A9300042 c,~//~9ifj~~ STATION BS HI FS ELEV. Benchmark / ~G1J,Ol?~ ~ ~~~.~ ~ Ddar 107,~D~ Bldg. Sewer St/aft Inlet ~,~~~ /Q afl' St/yFE Outlet 58~ ~ ~ ~ Dt Inlet Dt Bottom Headerti> ~~ ~ yJ S7w Dist. Pipe /~ ~~ i~~~.~' ~ ~~ Bot. System ~ ~~ ~' 9~ 33 Final Grade 8,9D g~, ~ ~ ~ / o~/ a-~ 5,7. a~,l~~e Cs~~.~~ G~~ ld3•~D BED /TRENCH Width / Length ~ No. Of Trenches PIT o. Of Pits Inside Dia. Liquid Depth DIMEN I N '~ ~ DIMENSI N SYSTEM TO P / L BLDG WELL LAKE /STREAM LEACHING urer: SETBACK INFORMATION TypeO /!~ i1: C ! ~ i ` ~ ~~ CHAMBER OR UNIT Mode Num er: System~Qr ~~, ~f d DISTRIBUTION SYSTEM Header / PRare+feld i/ ~ Distribution Pipe{s)~ // ~i ~ x Hole Size x Hole Sp ntake Dia. ~ length ~ Length ~ Dia. 'T`" Spacing ~~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over ,/ ,, Depth Over ,i qs xx Depth Of -__., ., xx Seeded I Sodded _,. x Mulched p wench Center - ~D ench Edges ~ ~ ~ Topsoil ^ Yes - o es No COMMENTS: (Include code discrepancies, persons present, etc.) ~"'/~z ~~~'~''~t~''~ ~"~'~~~~~f~'`~'~'~~``'~r ~r~`-'~ LOCATION : HL/J,DSON 0 ~ .2,9.19 .~ , NW , SE , LOT 3 5 , KRATLEY LANE n -fit ~/9~. 9~ ,1 C.~~ ~-~7~ ~ ~/1 12.x_ ~~~ ~ `~" P ,, ~~ ~~ ~ ` ~~;! n^( ''G--' f_.~~ '~ 1'~~~ ~~~' ~ ~~~,r err '.~. <r Qi-~~, f~~ -, ®" Plan revision required? ^ Yes ~O ~ '.j Use other side for additional information. ~ ~ 3 d SBD-6710 (R 05/91) Date Inspector'sSignatur Cert. No. ~= _ _ ~ SONITORY PERMIT ePPLICOTII~N ' ~o1LFIR -- -- -- - - -- - - - -- ----- - - -- - -- -- - - - - - - In accord with ILHR 83.05, Wis. Adm. Code .e,.....,,.e, ,..,...,_.,o,. couNTY ` -Attach complete plans (to the county copy only) for the system, on paper not less than STATE SANITARY PER r' y 8i4 x 11 inches in size. y ^ Ch k if revision to previous application -Se@ reV@rSe Sld@ for IflstrUCtIOnS for Completing thls application. STATE PLAN I.D. NUMBER I. APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION. PROPERTY OWNER ~ ~~ PROPERTY LOCATION R ~ p E ( W S TL~ N ~/~'/ / tit.+-- ae ~ , , a . a, PROPERTY OWNER'S MAILING ADDRESS , LOT # BLOCK # ~„ CITY, STATE ZIP CODE PHON E NUMBE R SUBDIVISION NAME OR CS NUMBER ~ J } ''~ 11. TYPE OF BUILDING: Check one CITY ~ NEAREST ROAD ( ) State OWned O VILLAGE ~!' O fat ^ Public ~.1 or 2 Fam. Dwelling--#~ of bedrooms ~ A CELTAX NU BERG III. BUILDING USE: (If building type is public, check all that apply) ~~©- r ~ Z ~ -~ $(~ 1 ^ ApUContio 2 ^ Assembly Hall 6 ^ Medical Facility/Nursing Home 10 ^ Outdoor Recreational Facility 3 ^ Campground 7 ^ Merchandise: Sales/Repairs 11 ^ Restaurant/Bar/Dining 4 ^ Church/School 8 ^ Mobile Home Park 12 ^ Service Station/Car Wash 5 ^ Hotel/Motel 9 ^ Office/Factory 13 ^ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ~ New 2. ^ Replacement 3. ^ Replacement of 4. ^ Reconnection of 5. ^ Repair of an System System Tank Only Existing System Existing System B) ^ A Sanitary Permit was previously issued. Permit # - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ^ Seepage Bed 21 ^ Mound 30 ^ Specify Type 41 ^ Holding Tank 12 ~ Seepage Trench 22 ^ In-Ground 42 ^ Pit Privy 13 Seepage Pit Pressure 43 ^ Vault Privy 14 ^ System-ln-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE h ~ppar 9~ oo ELEV/ Mi /i TION ) n. nc { ~D REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) ( ;;70~ ~P Z1t.~ r ~ ~ ..,a q O ~, (o 7SD 7'S Feet t~'t ~• Se Feet VII. TANK CAPACITY in allons Total # of ' N Prefab. Site C St l Fiber- Plastic Exper. INFORMATION New istin Gallons Tanks ame Manufacturer s oncret on- ee glass App Tanks Tanks structed Se tic Tank or Holdin Tank o~Q ~ WC ~~ 1 ~+Y' Litt Pum Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onaite sewage system shown on the attached plans. Plumber's Name (Print): ~~ ~t Plumber's Signature: (No Stamps) MP/MPiiSW No.: Business Phone Number: Plumber's Addrese~.(Street, City, State;Zip Code /J O 1 c v ~i ~ ~/ / 4 ~ ~ G f / 9 ~ '~ ~ , L r /` i ~ l / ' ` e .t~ ' ~ DC. CO NTY/DEPARTMENT USE ONLY Disapproved rmit ee (Includes Groundwater San~fa Surcharge Fee) a e ue Issuing ent Sign a (No mp Approved ^ Owner Given Initial ~ / (~J~~j//~ / ' Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly PIb~7) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety 8 Buildings Division, Owner, Plumber .. INSTRUCTIONS .. . . , ,..~ .: , ~ . _ __ ~ ~~ t: A sanitary permit is valid for two (2) years. , 2 Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety 8 Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being. served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete tine B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in #1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for a// septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, License number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8'/z x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points;. C) complete specifications for -pumps and controls; dose volume; elevation differences; friction loss; pump performance curve;-pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. ~.- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) ,.~/°r 6~~j m~~i~r ,1r~~t'r'° Lea ~~t /P~'d !~ ~,,, ~d ~`"~ ~J~_ ...•~~~~taa~/.~r/'f~',•.rrr~~li~~dD~~e4eJ~'r` ~~~~~r~ ~~', ~d ~) lR. ~ ~ ~. "erg ~ oP O~ ~~ouh~ ~Qon 7Qi~~ ~C~~ J ~~a ~ o ~/' a ~ k a- .r~ .. ~ / W R, r .. I /` ~qX x~ e~ Q~ \ ~` s --- --- . 3.W ~l3a. ~aN s a: Zq+~X Sp t~ ~I A Lot 3 S` 5`.9H 1Q~~~s yL• . ~ __ I ~i ~t ~~~ , ~. ~~ u. ~ ~ Aa ~l t/Z ~~--~ .~ ~' ~~JC . ,~ ~ ~ 1 ~ l ~ ./a rc I ti~ ~3 4 c Y ~ y G +`, s~r~ Ip ~;~~ ~`~ ~ ;~ ~f~ I9~'t ~. 57 N f ~~ r '~ ~ ..r ~a~.r, v was r~ "~ ' N~ ~ _.9c_~. `~ -~ 0 ~~, ~ Q s ~ o- ac 0 4 y ~ ~ -_ -- +t h t~, ~~~ N"? , '~ ~ ~ ~ i, .~a1~ ~. ~~ ,t ~ ~ ~. ~1 ~T `` ~ ~~ ~ ~ ~ ~~ ~ ~~ ~ ~~ t~,~ .~ r .'~ ~ a: ~ ~~ M 1 '~ 4. ~ ~ t i ~ f `" -~. -~ '~. -sR s d 4~ h ~~ s ~_ a _. ,~ ~ ~ '~ ~ ~ I4 3 O I ~ ~ 1 ~ a ~~ ~ e , ~ 4 ?~ ~ L `N I !~ S i, 9! I . „ •~ ~. • . ;'' a Wisconsjn Department of Industry, SOIL AND SITE EVALUATION R E P O R T .•Labor and Human Relations Division of Safety & Buildings Q~Q • in arrnrri with II NR AZ n~ Wic Aram (:nrtc Page ] of 3 _ ... __...,.........._.....,....,,., ..,............,.,.., COUNTYc ~~ C ~ ~ x Attach complete site plan on paper not less than 8 1/2 x 11 inches in size Plan must include but ` ' . , not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: Qjr4M ~ /LLC~ PROPERTY LOCATION GOVT. LOT iN ~ 1/4 5 ~ 1/4,S 7 T Z9 ,N,R i9 E (or) W PROPERTY OWNER'S MAILING A RESS ' ' ~~ OT # ~ BLOCK # SUBD. NAME OR M # ~ ~ ~b~Z g ~dG L 1C ~ ~G Ls CITY TA~T,~E~`~~ ZIP ODE PHONE NUMBER ~U~'x~Al ~l S~o) b ( ) ^CITY ^~IyLAGE OWN fl5c~ NEAREST ROAD L '~ 2dTT i N tJ y r [~ New Construction Use {!•~ Residential / Number of bedrooms frf,~K ] ]Addition to existing building j ]Replacement [ ] Public or commercial describe Code derived daily flow gpd Recommended design loading rate "~ bed, gpd/ft20.~ trench, gpolft2 Absorption area required bed, ft2 trench, ft2 Maximum design loading rate ~- bed, gpd/ft2Q .S trench, gpolft2 Recommended infiltration surface elevation(s) iJi~P'E'~"i°~uc.N _ 9~.~ ft (as referred to site plan benchmark) Additional design /site considerations f ~ W ~2 i r~r.~:t~ - 93.7Ca Parent material Flood plain elevation, if applicable --~ ft S =Suitable for system U=Unsuitablefors stem CONVENTIONAL ~S ^U MQUND S ^U IN-(jROUND PRESSURE S ^U AT-GRADE ~S ' ^U SYSTEM IN FILL ~S ^U HOLDING TANK ^S QlU SOIL DESCRIPTION REPORT Boring # ~ ° „•.`>>. Ground elev. 9.39 ft. Depth to limiting facto Boring # ~~~tt;~,,.:< ::: '~ Z t ~~; h,.~,...~:.~ Ground elev. 9g .4~ ft. Depth to limiting factor //~ ! 7 Horizon Depth Dominant Color Mottles Texture Structure Consistence Baxtdary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trertctt Remarks:-~_- N®i '~~ccalf--M~~ ~~ ~~ B ~-~~` ~a~ 3 3 `-- ~ ~,~ 1 ~ -- 0.6 C, 7-i f2 S Y 7 ~ - ~5 c~ -~ w, 1 C I - .S C iz =134 z.s y 7 ~ `- ~, ~ ,~ ~ 1 ~ -- ~, 6 Remarks: ~~ ~ NOT ~~Cdr'-9 /h i; ~ul~~"~ CST Name:-Please Print ~1,~,Qve~ ~~~~~ Phone: ~~~_ 4 ~~® ddress: ~ ~ S4~ t _ / ) ISignature_~/~~~r~~` D ~ Date: A/~,,,/Q~ CST Number:~~ A I Q °tT'Vre ~e '7 I ~'J' PROPERTFOWNER J~~`'! ~~ttc~~ SOIL DESCRIPTION REPORT Page ~ of • PARCELI.t).# LeT 3$ L~'d,Z,(.t~ iBG~' Boring # ,~,.. . ~3:<<.:<.. ~N v 4~ ~:~< Ground elev. 9~ ,7 t ft. Depth to limiting factor `7.67 Boring # ~:.~y~ "~j' ~-> `'~ ~>: }{ _: Ground elev. i5_O~ft. Depth to limiting facror Boring # `~w{ ~:. ~:•~.~ Ground ~ev •~2ft. Depth to limiting ~tor o~ Boring # :•:•.,x.,,, '""~~< A ~# ~`. 4.. Ground elev. ft. Depth to limiting factor Horizon Depth Dominant Colar Mottles Texture Structure Consistence Boundary Roots GPDift in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trend ~ ~ ~~-34 Jav~e ~- 4 -~ ~,~ ~ ~, 4~K m~~~. c i _ 0.6 Remarks: ~~A npdr l~~~o ri!/~ t+'k~~t,D B, U-~~ ,,~ 4 4 - ~,~ ~~ ab~ M„t,~ C ~ o.Sp.6 6S -67r 2.S 3 2 ~ z N P°~ 5 , -.~-~ sb~K r~,~;' / n~ ~ ry P ~ ~ ~S y~e 4 3 ~-- f~is ~ ~ 0.7 Q Remarks: - - ~ a - ~ A ©-~ JoY~ 3 Z ~. ~i..~~- cr m~. ~ ~ ©.4 .s ~ ~, -~9 ray,2 d- ~,C ~~m 4~~ ~v~' ~ 1 .5 ~U.6 -~~. 7 S Y~ 3 ,^ ~ '~si t~ fa s b l~ n~ ~r ) Q-7 J~ . Remarks: Remarks: SBD-8330(R.05/92) `~ ~ ! L Ir 1°-1 Iw 1~ 1 b~~. 4~ Dn L w s 7 ~ roc'` a .~ ~~ ~ i ~~~ ~ a v. ~~ ~ G ~i Pa`s 3 e~ 3 ~ ~ Sd~~ M~c.~~- 3s '~ S ~d~,C E ~i ~ Z PI G/L/~._ -_ vt 6p •~ s N 0 ~. D ~ N ~~ \ ~, \ i~' ~ ~ ~° ~ ~ y ~z .~ a ~~ ~ 2 'N V'~ Q %, C b ti ~ ~ I J s p ~ ~ ~,I o .~~i ~ +~ ~~ ~\ . ,, t X35 ~!._k..C. ~,~ 'L t,~ i~GS ,; .. ,.. ti E ~ ,~° c- ' _.__f_. .._.--- -... -•~ . _.._ __ I _ • . ~ ° r.T^" _.....,_..»..._,._., r S 6. fl : ..___~~ ~_.^ -,11~ '-: 4 42 ~~ Z~ ~.i 9 fl ~ 59 JO~.~ f T :. 1 0' ____._--~~D~--- ago. a o' .,~~, eo P'j• I sL , ~ r~• I ,d .wc.nc~s::r:n,.erryx..;~:;r,''fV t `~~ Qri t ~ ~~.3 't4, ~P +~ i.? IAA v l1 ~ ~ a n ~ - .• ,~yd.CFl{'t"s ~ 164 ACRQS e J S I 1 3 r~i.ei s.3 ~ C< a\,~C~ .P'', ra '" c` 1 ~ ~ ~ ~ SZ I t1 -. t L`\ g ,. ~ ~~-. \ .... ~1 _ -. .. ~ •.'` i. ~-~1. ` ~`'r - V ~.1• j / -^'~~'-1'i--~- _ _ .......3.87 •s 3~~'_E 97ULi }i ~ ci I S~ 1 Wi. .,~•~, ,i , r n ~ 6, _:..r~~ -.-~_.~.,y,s~/ ~`y-yam' 1.. ~_ `~,,j / 1 r ~, ~~ ' :^~' ,~.. ;y <~r.Aiv;,l;i ;r..r.1GDETv ;i -:i a~ ~ ~ / \ 1 ' `.r t..; "~~~,~ stir >cT~i,~G l.h~iD SU, / \ ;v i 1, 1 -~'.~• ~4EY0~~' ~ ~ r~; w,~ ' r,_ ~,:r' i1.,i ','ti i 5 3i?','i-! ~h. OF / ~ / "~~ I1 ~_ -, ..,, r, ' ~ ~y+btlv san~" c ~~ -r~}~~::: `~f~;> I~?75 \`~'~~ ~ i ' `~ c++I %i n . '-T ~ r~J r:.V'SLU i6ii:. "N.i7H UAr OF UC 7pGTPt,/ i~ / r ~• ~ , ._ - L~ , ~'{ 7679 1 ~ \ ~-~ t ill AINr g I r~, .~ r ~p- I W LO n `„ , -,- 1 ':;.- cy + >h••dy'xJ..C 255 „i ,I ro i D4ACRES , t I I ', •:.7: :,,...... ~1 ~ 1 yl ' / ~. 41•t~ ~~a ,, • _ {{ 1 6: Y~ • _ . ., ~ ~% G , . 1,, ~. ! ~ ~ , ' t IB-` -.. +F a ti vt t : ., i..;.: : ~ ``' ~ -. '•r,. r,;'F_ 'i / i 3 O \` ,.. 'r l - ~ „! ~~ Cy '/ ~ •~ ~ ~~~, 7~,i ~ _ ~ 5? Cd ? "~ S r ` ~ ~ ~ + ' .fr ~~ `~ ='U ( ~^~Ck r i t Y .J ..! ! . J m . " •AE~5TC1a :IW%- }AA` 1 / i r ! S T C - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER~A~CY1 ~f~~~~eY- . ADDRESS. ~®~ ~Z ~~- FIRE NUMBER ~"~~ CITY/STATE ~~ ~1On-- ~t ZIP. sl~~~G PROPERTY LOCATION :~1/4 „~~ 1/4 , SECTION 7 , T,~_,N-R~ TOWN OF_ ~Lc~GSOr'l , St. Croix County, ' SUBDIVISION.r•r~d--Ip,~G+'c~-~-• , LOT NUMBER3,,~_. 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 septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60~ of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, .restricted plumber or a licensed pumper verifying that (1}, the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix Co. Zoning Officer within 30 days of the three year expiration date. SIGNED:,`~~~. DATE : ~ ~' Z ~ - 1 St. Croix co. Zoning Office 911 4th St. Hudson, WI 54016 ' S T C - 100 This application form is to be completed in full and signed by the owner(s ) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor , ( spec house) , then, a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of property -5/9 M /it,.//d Location of property Nu/ 1/4 SF- 1/4 , Section 7 , T-2 7 N-R / D Township lost Mailing address &ex ' Z P Address of site '67` "/ ast. /y /4044- Subdivision name ,a. /e- elf i_ Lot no. t _47— Other homes on property? yes X No Previous owner of property Total size of parcel -S• 91/ f4C ec.r Date parcel was created Are all corners and lot lines identifiable? )( Yes No Is this property being developed for (spec house) ? )( Yes No Volume60 and Page Number s3 as recorded with the Register of Deeds . INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER & THE SEAL, OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process . If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. • PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No. 4/9 3(0 %4/ , and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of County Register of deeds as Document N o. yr-f'.�(o 9/ 7 4 gnature applicant Co-applicant -4- z0 — 7 Date of Signature Date of Signature ~, oocuMErvr rvo. WARRANTY DEED I " `=' SATE BAIL Oh WISCONSIN hOILM 2-1082 ~93~~4 ~.-_. • - - ~----.... ..-- ----~---......_._.~.__~._---.iCL ~~~PAGE -~~~ ----------.. ...:[~ V~x°n.-~... Kattre...and. ~osella..Kattre, ..husband..and _vrife.. conveys and warrants to .......:~tl.r" Miller a~•sn•~le -erson ~~~~ tho following described real estate in St • CY'OiX .,,.,..County, ........................................ State of 1Visconsin: T1115 SPACE AESERVEO FOR RECORDING DATA ~R~,GISTER'S OFFICE ST. CROIX CO., WI Recd for Record ~~ JAN 61993 ~ "~` 11:30 A. ~ ~s ~~ Register of Deeds --R ETUI7N TO-~- ---v -------~-~~~ Tax Parcel No:.....- ........................ Lot 35, Eagle Ridge in the Town of I-Iudson, St. Croix County, Wisconsin. ~_~6. Q~ F.EE Tllis ......15 Y10~•.,.--_•- homestead property. (is) (is not) Excelltion t~ ~vurranties: easements, restrictions and rigYits-of-way of record, if any. li u,is '~ ~~ ............ day or L~cernber :>92 ................................ I G ~ ---• ....... ........................ V ,~ M / ............................... ...... . ... Lavern I. Kattre ..-Ros~11~,..Kattr.~ ............... .................................................................... (SEAL) AUTHENTICATION signature(s> __- Vern I. Kattre, Rosella Kattre ~- A:cerrber 92 aUtilellti at d till ~.-~ay Of ........................... Ifl...... Kri tina land TITLE: MEMBER STA'I'E BAR OS' WISCONSIN (IC not, ...---• ........................................•-••---...... uutllorized by § 70G.OG, Wis. StaLs.) ................................................................. (5 I:A L) r .................................................................. ACKNOWLEDGMENT STATE OI' WISCONSIN ss. ......................................COUnty. Personally camo before me this ................day of ---------------------------------------•--~ 19.----•-- the above named to me known to be the person ............ who executed the furct;oing instrument and aclutowledge the same. -.