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026-1302-05-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 569596 0 (ATTACH TO PERMIT) GENERAL INFORMATION State Plan ID No: 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 Parcel Tax No: Haffner Construction LLC, Robin Haffner I Richmond, Town of 026-1302-05-000 CST BM Ele Insp.BM Elev: BM DW" tion: �. Section/Town/Range/Map No: b- .�� l .0 �S l �k y�CC 3m 07.30.18.1582 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic // , j_ �`.t� Benchmark ,' V Dosing h J Alt.B M ,Iq .� ,l�kh Aeration �Q �V �,� Bid .Sewer �c Holding SUHt Inlet If I!,\; St/Ht Outlet TANK SETBACK INFORMATION TANK TO rP/L , WEL BLDG. Vent to Air Intake ROAD DtInlet Septic `j 1 1 t tu� Dt Bottom f� C- ti Dosing Head e H Aeration q jz J44 Di t. Pipe Holding Bot.System VV ,qU/L z a U4 l p Final Grade ftCk,rw% PUMP/SIPHON INFORMATION Manufacturer t - / Demand t Cove . Q GPM C Model Number _ f ZC s TDH Lift �(� Friction Los System ale TDH Ft � � l� (� Forcemain Length bia. Dist.tg Well i SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length No.Of Trenchgs PIT DI�SIONS No.Of Pits Inside Dia. Liquid Depth 11 DIMENSIONS Z : SETBACK SYSTEM TO P/L BLDG IWELL LAKE/STREAM LEACHING V�1711�INFORMATION Typ�pf System: / 7 U CHAMBER OR 4 « DISTRIB UTION SYSTEMs�r! _ eader/M ifold Distribution it n � o e Ix Hole Spacin� Vent Air Intake r Pipe(s) r j Length Dia Length_ Dia Spacing 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/Trenc Center r + Bed/Trench Edges Topsoil Yes No Yes � No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1:.1 Inspection#2: Location: 947 165th Ave Neyv Richmond,WI 54017(NW 1/4 SE 1/4 7 T30N R18W) Ninety Fifth Street S'a Parcel No: 07.30.18.1582 1.)Alt BM Description= '� I/Lt c. I "U✓mot% j� j�� f/1—� 2.)Bldg sewer length -amount of cover= o Plan revision Required? ❑ Yes o Use other side for additional information. �__�_� ��'�>✓ _ __. SBD-6710(R.3/97) Date Insepctor's Signatu a Cert.No. CatmtY Z Safety and BuuNngs Division ✓O '-,�J/^ 201 W.Washington Ave.,P.O.Bout 7162 Sanitary Permit Number(to be filled in by Co.) sl�,y� Ai Permit Application state?raasaetiem Ntapba�- 1a aexordnsarw� '?9321(2),Mrs.Adm.Code,lion of this fame to dw appropriaste govermm W unit a required pi4 to obtamin a smitary pamnit. Note:Application fi w for 00.09 Cd POWTS ace sabmiKed m Project Address(if ducat than tooling address) the Demtmaot of Safety and Professional SeMes. personal•mf elation you provide may be used for Q vurmw in woordaw wilh the Law s.15. 1 m Sets. /✓v L >a bformation–Please Ptiat Au bdwuatioa property Oates Name Pucd# Property Location Property ownee� Address a S Govt Let City,state 10�ere Phone Number ec�'/,, yti T 2� R� IL Type of Banding(cheek all that a ) Lot# _?_J N. " E W Farmly Dwelling–Number of Bedmoms Subdivis»a N 6k, G� �tJ?w Block SY�I�I ❑PabtidCbmmercial–Describe Use ❑City of CSIvjh=ber ❑V�of [I State Owacd–Describe Use v A 6�-- e� �-z3 C M.Type of Permit: (Check only oni box on line A. Complete Use B ff applicable) A' New system ❑Reeplaoememt System ❑Tm",aNHolding Tank Reptacement Only ❑od.Modific om to Basting System(eaplam) B. ❑Permit Renewal,' Permit Revision j ❑ of Plumber ❑Permit Transkr to New list Previous Pest Number and Drte Issood Before Eviration / qww l IV. of POWTS S t u eeele au that = T 1`s oa-Preunei h,.43mtmd ❑Preasmi ted l i-ciro and ❑At-0 rade ❑Moaood>24 uL of sum MR ❑Mond<24 in of suitable soil �1i1 ❑Hofdmg Tack ❑0tba Dispersal Caaproext(espheio) ❑Pretreatment Device V.Din Vrrea Asia Inforsa Design Flow(9A DemS�APP ion R Id Area Req ys t E b J ^ 7, VL Tank Info �m TOW #units Of g • f t3 t3 � New rtdea1:Teote t -k)) At., Septic or Hdd'mg Tads Tag Chouber V, Sbetemeat–[, auasae for in stabation of the POWTS shwa na tie ate Plumber's Name(Print) 1?ltnnber' 11dP/1vQ'RS Number Business Phoa Number 4K"7 Pitmfber's Address(street,city,Sint:, Code) ` ) (�J•�/ VIR County eeitt use only A Permit Fee Date L Tssuiag Signadcre App s RexsaafaorDenial S 7 l f oval ��.� �� IX Co f n e re nt er 3 dispersal cell must all be se !gas!mairiieined as per management plan provided by plumbteT. ,a VV L.a,,.,r� tirinents ttlst ba t 2. AII`ti�a4k _, .. _._si. . . c as per COda/ardltltl'ti m. Mteei to aapbft pLas fir the srsltr sad sabfdt to the Cow od!"PaPw ast Lea am 3 w z 11 dashes is nee 4J6 jr- y SBD-6398(R•11/11) (',to A, C—q,�Q�. Soil Test and System PLOT PLAN PROJECT Haffner Construction ADDRESS P.O. Box 381 New Richmond Wi 54017 NW 1/4 SE 1/4s 7 /T 30 N/R 18 w TOWN Richmond COUNTY ST.CROIX MPRS Shaun Bird 226900 DATE 7/13/14 BEDROOM 3 CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT )00X HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE630 DOSE TANK SIZE HOLDING TANK SIZE . LOAD RATE .5 ABSORPTION AREA 930 # of chambers 46 IL BENCHMARK V.R.P. Top of steel fence post ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 91.0/89.5' 6' below qrade 165th Ave All piping shall be SDR 30/34,within 10' of tank,piping shall be Schedule 40. Scale is 1" = 40' unless otherwise noted Pro 3 Bedroom IV House -- 4 IV 45' �4. 4105' operty Line Huffc �ombo Tank 40 ; 93' 5 �`- 5971 20' B-2 17% Slope L 0' >6" Quick4 Standard of Co -eaching Chamber B-3 ith 20.0 ft2 of Area 4' L .6ft^2/pair of end caps 30' 34 Grade at System Elevation % 30' -1 456' Property Line Vents 5 B.M.* 60' Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 7/13/14 Owner:Haff ner Construction Location: NW1/4 SE1/4 S7 T30 N,R18W Lot 5 95th St. Site Richmond System type: In-ground absorbtion system(conventional) Manuals Used: In-ground absorbtion system (version 2.0) Pressure Distribution Manual (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance and Contingency Plan 7. Filter Specifications Sheet 8. Dose Tank Cross Section 9. Pump Curve 10.-11. Soil Test Signature License number 26900 Soil Test and System PLOT PLAN PROJECT Haffner Construction ADDRESS P.O. Box 381 New Richmond Wi 54017 NW" 1/4 SE 1/4S 7 /T 30 N/R 18 W TOWN Richmond COUNTY ST.CROIX MPRS Shaun Bird 226900 7/13/14 DATE BEDROOM 3 CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT )00( HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE630 DOSE TANK SIZE HOLDING TANK SIZE . LOAD RATE .5 ABSORPTION AREA 930 # of chambers 46 IL BENCHMARK V.R.P. Top of steel fence post ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 91.0/89.5' 6' below qrade 165th Ave All piping shall be SDR 30/34,within 10' of tank,piping shall be Schedule 40. Scale is 1" = 40' unless otherwise noted Pro 3 Bedroom House 405' Property Line 45' Huffcutt Combo Tank 40' 93' 5' 97' 20' B-2 17% Slope Vent 90, >6„ Quick4 Standard of Cover Leaching Chamber B-3 with 20.0 ft2 of Area 4' Long 12" 5.6ft^2/pair of end caps 30' 34" Grade at System Elevation 30' -1 456' Property Line en B.M.* 60' Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber 5.6ft^2 pair of end plates To be >1, above grade Finish grade elevation Typical Installation 97.0' Vent X/ Grade ken, 3' 4" 3' I� x/30/34 Septic Tank 5' Long 1 5' 5' Long 3611 Grade at System Elevation Grade at System Elevation Spacing 5' 2-3' X 94 ' Cells Same on other end Observation tubeNent At end of cell A B 23 chambers per cell System elevations: A-91.0' B 89.5' POWTS OWNER'S MANUAL $ MANAGEMENT PLAN Page or FILE INFORMATION SYSTEM SPECIFICATIONS Owner r ' Tank Manufacturer: ❑ NA Permit# Septic ❑Bose ❑ Holding Volume• 6j 0 (gal) DESIGN PARAMETERS Tank Manufacturer: L ❑ NA Number of Bedrooms' ❑ NA ❑Septi Dose ❑ Holding Volume: 6 3 o (gal) Number of Public Facility Units: Vertical Distance Tank Bottoms)to Service Pad:< (ft) Estimated(average)Flow: J (gauday)_ Horizontal Distance Tank(s)to Service Pad: 5 a, (ft) Design(peak)Flow=(estimated x 1.5): L (bay) Sp�ic Ong mechanics must be provided if vertical is>15 feet or J If horizontal Is>150 feet. SpscMc instructions to be provided on back. In Situ Sod Application Rate: (gavday/fe) Effluent Filter Manufacturer: ❑NA Standard(Domestic)Influent/Effluent Monthly average. Effluent Filter Model: Farts,Oil&Grease (FOG) s30•mglt. Pump Manufacturer: Biochemical Oxygen Demand (BOD5) s220 m91L . ❑ NA c ❑ NA T" ded Soft SS 's150 Ptimp Model: . 11� High Strength InfluentlEAluent Monthly average Pretreatment Unit (FOG) >30 mg1L �A Manufacturer: (BODa) >220 mglL /`�"" ❑Mechanical Aeration ❑Peat Filter A SS) >150 ❑biswection ❑Wetland Pretreated Effluent Monthly average ❑Sand/Gravel Filter ❑Other. (BODE) s30 mg1L ' AAA Soil Absorption hem Fecal Coliform eometric mean)) :5W- >f4:jn-Ground(gravity) ❑In-Ground(pressure) ❑ NA ❑At-Grade ❑Mound Maximum Effluent Particle NA e Size 35 in dia. ❑Drip-Una ❑Other. Other: NA Other: ❑ NA MAINTENANCE SCHEDULE S"ce Event Service Frequency Pump out contents of tank(s) hen combined sludge and scum equals one-third(Y3)of tank volume ❑When the high water alarm A activated Inspect condition of tank(s) •At least once every: month(s) (Maximum 3 years) ❑ NA Inspect dispersal cells) At least once every: Ej mornh(s) (Maximum 3 years) ❑NA Clean effluent filter At least once every: month [I s) NA inspect pump,pump controls&alarm At least once every: month(s) ❑ NA • s) Flush laterals and pressure test At least once every:. months) E3 NA Other: months) .❑year(s) At least once every: [3 s) p NA yeag Other: ❑NA MAINTENANCE INSTRUCTIONS Inspections of tanks and sod absorption systems shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer or Septage Servicing Operator (pumper). Tank inspections must include a visual inspection of the tank(s)to identify any missing or broken hardware, identify any cracks or teaks, measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on the ground surface. The soil absorption system shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of efiliient on.the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any treatment tank equals one-third(Ys)or more of the tank volume,the entire contents of the tank shall be removed by a Septage Servicing Operator(pumper)and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code: All other services,including but not limited.to the servicing of effluent filters,mechanical or pressurized components, pretreatment units, and any servicing at Intervals of<_12 months,shad be performed by a certified POWTS Maintainer. A service report shad be provided to the local regulatory authority within 30 days of completion of any service event. GMW-005(02/05) Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other chemicals or sediment that may impede the treatment process and/or damage the soil absorption_system, if high concentrations are detected have the contents of the tank(s)removed 5y a Septage Servicing Operator(pumper)prior to use Pump tanks may fill above normal highwater levels prior to startup or due to,pump failures. Start up or restoration of power under these conditions is not recommended,as the excess wastewater will bodischarged to the soli absorption system in one large dose causing an overload that may result in the backup or surface discharge of effluent and damage to the system. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator(pumper)prior to restoring power to**pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank. System start up shall not occur when soil conditions are frozen at the infiltrative surface. Do not drive or park vehicles over tanks or the soil absorption system. Do not drive or park over, or otherwise disturb or Compact,the are@ within 15 feet down slope of any mound or at-grade soil absorption.area. Reduction or elimination of the following from the wastewater stream may irnpr ive the performance and prolong the life of the treatment tanks and sal absorption system: acids, antibiotics, baby wipes-cigaretts butts, condoms, cotton swabs, degreasers, dental floss, diapers, disinfectants, fats, foundation drain(sump pump)discharge,fruit and vegetable peelings, gasoline, greases. herb ides, meat scraps,medications,ails,painting products,pesticides,sanfl�y napkins,solvents,tampons,'and water softener brine discharge. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to Insure that the system is property and safely abandoned in compliance with& Comm 83.33,Wisconsin AdMinistr$tive bode`.: • All piping to tanks,pits and other soil absorption systems shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator(pumper). • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space titled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant �repl ant system: suftabie replacement area has been evaluated and may be utilized for the location of a replacement sod absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure,lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area: *Replacement systems must comply with the rules in effect at the time of their permit issuance. ❑ A suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption system cannot be rehabilitated and barring advances in POWTS technology,a holding tank may be installed as a last resort ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. if no replacement area is available a Holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. WARNING TREATMENT TANKS, .PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK SUFFICIENT OXYGEN TO SUSTAIN LIFE NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE ADDITIONAL INSTRUCTIONS: POWTS INSTALLER POWTS MAINTAINER. Name Names Phone —� �— Phone SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY Name Name 5-- (1-19. 1/ - Phone 7 ° Phone 2j J This document was drafted by the staffs of the Breen Lake, Marquette and Waushera County POWTS regulatory agencies in compliance with sections Comm 83.22(2xb)(1)(d)&(f)and 83.54(1),(2)b(3),Wisconsin Administrative Code. FILTER CARTRIDGE INSTRUCTIONS STEP s Dry At tfie Nter canoe asdo the end of the outlet pipe to anwre it is centered under the wa m openig. If net,then Wthw kheert.cans pipe into the tank dwvu0h the Oude or solvent weld(gds)sddkWw ph"onto the caudal Pipe- STEP 2 While the Case is stlr dry fitted on the outlet pipe,meawre the length of'A-inch pipe needed tb braes the total•tD the tank end war o utildiny t he Optional proceed s aide> If side support nathod.is not udlmad, 5.7 E P.I For instaNsttons is the optlonel supownsatel side support: sohrent weld*e'A-inch pips onto the liar cafe. if'sid!support method is not udbW.proceed to step low; .`_��.uy� a�Onto the"Jtkt •.N M'^P Solvent M/!ld the liter pipe. Insert the titer �t,fir:'r the�e into the case,pressing down unt* the Aker locks into the bottom of y If a VRS switch is utilised:insert into the fter and lock by fuming dodmke,w. zs Mafntt�lantet=. . 1. The effluent Aker should be cleaned every time the septic tank is serviced. 2. Open the outlet access opening to inspect the tank and Nter• a 3. Rump the split tank o unpkty.lthakkhg Sur*to r/nwsre the sludge " layer on the bottom of the tank and not just the scum and effluent. 4. Once the effluent level has beers lowered below the invert of the ���D�on the Altsr handle to dislodge the S. Slide the cartridge up and out of the case for cleaning. 6. If a VU switch ci0t mcftd to an alarm is present,the w*ch should the rnnav/d by turnin4 as dadnvka W and cleaned +f �. with water only. ti 7. While holding the cartridge on k6 side(Iarg2 flat aurhWA facing ° dohen) over the access opw*gL rinse off the cartridge witA water i ably,malting sun all eptap materW is rinsed bask into the tank. & If VRS switch is utiliDed, by u turnkhg daclawb a O! nsartkhg into filter and h •} S. ticks cartridge back into the cafe,pressing down until the Aker •e • ' 10.Raplem and:scuts the 80ws5 Opening on the tank. Ga hr••.:N7.••r'•+hC•"S:6k'R:hf[.1 -1ti8-•'l r..:atret':.Q av:.kN�.V-'. ti WWWbe=VndftXDM 877•MLRLTUS(6534583) I Septic-Dose rTaink Cross Section And Pump Performance Specifications Tank i\+Iai�ufacturer Pump Mnnufacture'r Tank Model Number Pump Model Number apacity 3� Alarm Manufacturer Total Tank C Max.Bury Depth '� Alarm Model Number Switch Type '101 P .�C Feet D Fee l D is Head('r Manufacturer �-- yin Filter Manufac Total Filter Model Number Elevation Head J Distal Pressure N i�ss Minimum Puinp 'erformanoe Required orce M ' ss ' GPM. Ft TDH o j Ct L' ' - S Odtbet Manhole W.C Above Grade With Manhole Min.4"Above Grade I.•oclang Deg ice. Inlet Manhole With Locking Device <6"Below Cnlbde Sealed Watertight secumly Mounted Weather-proof 1 i Ju►cdon Box �-- •. ! -- ! Finished Grade "' rr . � •. .. .. t Vent Min. 12" Disconnect Above Grade Means With Vent Cap pudet Filter Inlet .n--- ----'— Inlet Baffle - A Capacity ;' Y41') Switch S and Reserve :; ;: Weep :X, ,1 ,., Tank Volume= ��� GPI Dimension, Inches Volume Gal. B Hole (reserve) Y. (alarm) 13' 2 :' Off Elevation y� / Ft (dose) C b' • J / �•J 0 11 + �:' Bottom (dead) D• p �.�� D Elevation Total :? '�•� Ft :• •,•a♦•�a�,.=;��r.t ♦a a a♦ f.1 1.i 1 t t.,<<1 a;a a[;,1,4 ♦ . i t ♦ i<1.• t ♦t ♦<.<♦,1 a t♦a,�t.<a.�♦;i 1>I•i♦•t/♦/1 a..1•a•♦•i 1.1•t:'1::'1.1 1't,i i♦•t a'♦•i.i i i r i i a 1 1 i i i 11 i•i 1 1 a't'i i i:'i:l a'1•/Ti•a•�ail 1•t 1./'t 1•It•/1 1<1//•1./•a't t,1 1• GENERAL INSTALLATION: The septicldose tank is bedded and beak filled in accordance with the manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer may not be exceeded without,prior Vwval. Manhole covers exposed to grade have an effective locking device(padlock) installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the tank excavation aihd she sleeve is sealed watertight. Electrical service complies with NEC 300 and Comm 16.28, 02105 U Page of Sent By: HP LaserJet 3100; 1 715 fib[ Ouz/ ; may-v-uv 3 J 9 EH SERIES SUMP/EFFLUENT PUMP 11.85 0 N� �e1�1981et8N1�/A IrMIR lags /Qr fM■rIIN< Nat@ NL tO v 1O OLk) W MIS Y If W 19 0!J RI 0w mare 9HOM 509350 WS 4M 115 914 13.0 100D 70 64 55 41 32 13.8 20' 24 9.11 IIIMXL94 MOM Me WO 416 280 39 95 1000 70 64 55 41 32 ml 20' 24 9.11 a 11b(Y Y.9( 9114 WO 5000 WM 440 115 9d 130 in 70 94 55 41 89 no 29 V 9.11 a 1M XUll em�n 91 ...4"0 M 8N 65 AM 70 1( 5k It 82 4i9 20 27 9.11111.9(x0.9( CanUmNOnbA(tei—'iMre 6f�tMN9wtlMWr�psaAFrBaFeoBfntlMUdnlYi9f oN�st bht�rtraawMlYirr�MOr(ipe:MSnsaR�• FLOW— Lt.TEK/HMR C 1cue" o saoa 2000 3000 McwHousing ECM- .Conted.Cast Imu 1mpe11er Ms�etial Poly-Carbonate 1a lmmUernM Closed Veae Volute AW __.__... M Power Cord. WTW A 20 Mechmk-4d Shaft Seal Nitrile with carbon and ' s ceramic faces � Fastcnus ._ _Stainless Steel ..._. _'ul Shaft 4tainktac Soeet z� B -� Upper Stmm and LAmer eatinSs ( I Ball Bearings 0 20 40 60 80 rLOW_ GALLOetS/s IMTE PUMP PERFORMANCE CURVE LIMB Gimt PitMP Co. usv bom P016%11818 UrhMew ta4401C 73137 PYaees N9+li7.1St!�p<ttt N6.tiil9ed LbrIG WlWW*L ttle l&mtPump.COm a ram 9"m--07M i Property Owner_ Parcel ID# Page of lz�] ng# ❑ Boring o— � Pit Ground surface elev. .� ' -� ft. Depth to limiting factor f 3 Oin. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 I 'Eff#2 /� ij off• f�/ - �- F-1 Boring# ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 •Eff#2 Boring# ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 I 'Eff#2 Effluent#1 =BODS>30 1220 mg/L and TSS>30<150 mg/L 'Effluent#2=BODS<30 mg/L and TSS<30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,please contact the department at 608-266-3151 or TTY 608-264-8777. sBD-8330(R.W00) PAS Wisconsin Department of Commerce �rj�. $ ELUATION REPORT Page of Division of$afety and Buildings �M in. dance wigtm 85,Wis. Adm. Code cc 1 S County c��• >�!Ly Attach complete site plan on paper not h 8 1/2 x 11 inches in size.Plan must include,but not limited to:vertical an zontal reference point(BM),direction and Parcel I.D. percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 6Z-(e Z -- O S Please print all information. Revi ed by Date Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). 7 /7 A� Property Owne Property Location �- Govt.Lot 1/4 1/4 S T 3 ON R/ � E( )W Props rs Mailing Actress Lot# Block# Subd. Name CSM# t is l s City Wte , Zip Code Phone Number ❑City ❑Vile Town Nearest Road v New Construction Use esidential I Number of bedrooms Code derived design flow rate GPD ❑Replacement 1 ❑ Pub' or comm al-DescrZb Parent material Uu�? L/ 6t✓Z) / t � Flood Plain elevation if applicable /y��� ft. General comments and recommendations: r (� SystemType � System Elevation--10—/-- q E] Boring j Boring# a rri Q pit Ground surface elev.L_z9ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. i 'Eff#1 I 'Eff#2 Z 0^ / I i II Z P Boring# ❑ Boring 1 Pit Ground surface elev.` ` ft. Depth to limiting factor L' �u in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 1 cJ Z 2_sl : qtzl r t t6 I Effluent#1 =BOD >30<220 mg/L and TSS>30<150 mg/L 'Effluent#2=BOD <30 mg/L and TSS<30 mg/L CST Nam(Please Print) Signatur CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 3 �c 715-246-4516 II I Property Owner Parcel ID# Page of ❑ Boring Boring # �— pit Ground surface elev. ' -� ft. Depth to limiting factor 3�rn• Soil ADDlication Rate Honor p Description Depth Dominant Color Redox Texture Structure Consistence Boundary Roots GPD/fF P in. Munsell Qu.Sz. Cont 'Eff#1 Color Gr.Sz.Sh. 'EM — 0-9 Pf ,- l y F-1 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/ff in. Munsell Qu.Sz. Cont Color Gr.Sz.Sh. 'Eff#1 'Eff#2 ❑ Boring# ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Sal ication Rate. Horizon 'lepth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu.Sz. Cont Color Gr.Sz.Sh. 'Eff#1 'Eff#2 Effluent#1 =BOD,>30<220 mg1L and TSS>30 1150 mgA- 'Effluent#2=BOD5 130 mg/-and TSS 130 mglL 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. , : � . � . . \\ 5 , %Zt %? � �« � � ƒ ^\ . . ~ �`\ . . . . : . i� � � � . . . . . �\ �� \� © . �� �� . �.. . . 9%<&2 .«�»a � y,�sexl�a«\«vv/• «»�w : ' ��r�:,����=a,4 Count Safety and Buildings Division -7L 1n I 201 W �- 1•� .Washington Ave.,P.O.Box 7162 Sanitary Permit Number(to be filled in by Co.) " '`"Y: �✓`�� Madison,WI 53707-7162 �� 2a14 PAI # ,' emit Applic i StateTransactionxvmb- In accordance with g� Code,submission of this form to the apps governmental unit is srquired prior a ' permit. Note:Application forms for state-owned POWs are submitted to Project Address(if different than marling address) the Depart>s>rni and Professional Sm ies. Personal information you provide may be used f secondary C purposes in acoordance with the P&ncy Law,s.15. 1 m Stats. 9�-7 L Appheation Information-Please Print All Inform a Property Owner's Name Parcel# Q i2 &S Property Owner's Ma"ing Addr= Property Limon / /59Z) ( � Govt.Lot City,State I Zip Code Phone Number A1W S-ion 7 1 C&�d -T N; R E Itj IL of Branding(check all that apply Lot# 1 or 2 Family Dwelling-Number of Scarti Subdivisirm Name PA., Bl i ❑ Public/Commercial-Describe Use ❑City of 0.1`J� G>ti ❑State Owned-Describe Use CSM N Village of 2 b l'a a- 23�z3 Gin„ of I (' III.Type of Permit: (Check only on box on line A. Complete line B if p' ) Z �,� 7 A ew System ❑Replacement S ❑Treat went/Holding etu Only ❑Other Modification to Existing System(explain) B• ❑Permit Renewal ❑Permit Revisi Change ❑Permit Transfer to New Previous Permit Number and Date Issued Befixe Expiration Owner / rL J t.IL T of POWTS S Aem/Com nm h a 1 f d ❑Pressurized In ❑ ❑Mound>24 in.of suitable soil ❑Mound<24 in.of suitable soil ❑Holding Tack ❑Other Dispersal Cauagrmeat(ezpl ❑Pretreatment Device(explain) V.Dispersaffreat9rent Area Information: Design Flow(gpd) Design Soil Application Rate(gpdsf) persal Area Required(sf) Dis Area Proposed(A) Elevati /t Y-50 . � l'-?J9 v +{(+ VL Tank Info Capacity in Total #of Manufacturer u Gallons Gallons Units New TS210 Existing Teaks Septic or Holding Tank Dig Cbwber VII,Responsibility Statement- the usiderligned,assume ability for installation of the POWTS shown oa the attached plans. Plumber's Name(Prin) Plumber's MP/MPRS Number Business Phone Number ?� G z -�� Plumber's City,State,zip Code) MIEL Conn /De artment Use Only 17 Permit Fee Date Issuing Signature t-et em Reason for enial s x,175 00 `117 I y 4;4=;�L IX CoaulN iAU! asous for Disapproval ,I 6e- dispersal cell must alh be s es t try as per management plan provided hy'OU �(a:� GA�¢.tM • 2. .; q> 1}ttiGettts mtts at Div Attach to wapide plans for the syslaa and sa the C"atilonlysm 11oper not leas th.aft in x 71 iacha in acre SBD-6398 (R-11/11) Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 6/16/14 Owner:Haff ner Construction Location: NW 1/4 SE 1/4 S7 T30 N,R18W Lot 5 95th St. site Richmond In-ground absorbtion system(conventional) Manuals Used: In-ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance and Contingency Plan 7. Filter Specification Sheet 8-10. Soil test Signature License ber#226900 PLOT PLAN PROJECT Haffner Construction ADDRESS P.O. BOX 381 New Richmond Wi 54017 NW 1/4 SE 1/4s 7 /T 30 N/R 18 W TOWN Richmond COUNTY ST.CROIX MPRS Shaun Bird 226900 DATE 6/16/14 BEDROOM 3 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 933 # of chambe s IL BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100° Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark All piping shall be SDR 30/34,within 10' SYSTEM ELEVATION 102.5/102.0 5.5' below qrade of tank,piping shall be Schedule 40. „ , vent Scale is 1 = 40 >6„ Quick4 Standard unless otherwise of Cover Leaching Chamber noted with 20.0 ft2 of Area 12" t^2/pair of end caps 4' Long 3 4" yGrade at System Elevation 106' B-2 25 235' Property 45' Line 2 ' B-4 1 -3 Pro 3 B-5 Bedroom House 5 20' 30' 6% Slope ST B-1 Vents 108' 104'1009 2-3' X 94' cells with>3' spacing B.M. 130' 457' Property Line po- Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber To be >1' above grade 5.6ft^2 pair of end plates Finish grade elevation Typical Installation 108.0 Vent Grade Vent 3, 4„ 3, x/30/34 Septic Tank 1„ 5' Long 1 51 5 Lon g Grade at System Elevation 3699 Grade at System Elevation Spacing 5' 2-3' X 94 ' Cells Same on other end Observation tubeNent At end of cell A B 23 chambers per cell System elevations: A-1 02.5' B 102.0' ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address Property Address 1y-7 ��✓ 14- /gvL (Verification required from Planning&Zoning Depa nt for new construction.) City/State _ Parcel Identification Nuiaber 40 0 '_/SQ p1,-It/)S LEGAL DESCRIPTION Property Location 1/4 �/, , Sec.�, T„�(� N R1 W, Town of , Subdivision YS-/4_5:q4. Lot# Certified Survey Map#_ , Volume ,Page# Warranty Deed# 0/ 9 7al , Votume —, Page# Spec hoes ! no 1.ot lines identifiabl 00 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,it 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. I/we,the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth,herein,as set by the Department of Commerce and the Department of Natural Resources,State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St.Croix County Planning& Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this rm are true to the best of my/our knowledge. I/we am/are the owner(s)of the property described above,by virtue of a deed recorded in Register of Deeds Office. umber lbedr ms URE OF APPLICANTS � � DATE ***Any information that is misrepresented may result in the sanitary permit being n-voked 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.08105) Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other chemicals or sediment that may impede the treatment process•and/or damage-the soil absorption.system. If high concentrations are detected have the contents of the tank(s)removed by a Septage Servicing Operator(pumper)prior to use Pump tanks may fill above normal highwater levels prior to startup or due to pump failures. Start up or restoration of power under these conditions is not recommended,as the excess wastewater will bei-discharged to the soli absorption system in one large dose causing an overload that may result in the backup or surface discharge of effluent.and damage 1d the system. To avoid this sWation have the contents of the pump tank removed by a Septage Servicing Operator(pumper)prior toYeatoring mower to•he pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank. System start up shag not occur when soil conditions are frozen at the infiltrative surface. Do not drive or park vehicles over tanks or the soil*absorption system. Do not.drive or park over, or otherwise disturb or compact,the area within 15 feet down slope of any mound or at-grade soil absorption.area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the treatment tanks and soil absorption system: acids, antibiotics, baby wipes,-cigerett ImAts, condoms, cotton swabs, degreasers, dental floss, diapers, disinfectants, fats, foundation drain(sump pump)Discharge,fruit kmd vegetable peelings, gasoline, greases, herbicides, meat scraps,medications,oils,painting products,pesticides,san M,,,w,,v napkins,solvents,tampons,*and water softener brine discharge. ABANDONMENT When the POWTS falls and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with s.Comm 83.33,Wisconsin Administraihie t we:; • All piping to tanks,pits and other soil absorption systems shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator(pumper). • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or anther inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: Suitable replacement area has been evaluated and may be utilized for the location of a replacement soli absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure,lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. -Replacement systems must comply with the rules in effect at the time of their permit issuance. ❑ A suitable replacement area is not available due to setback and/or soil limitations. If the soli absorption system cannot be rehabilitated and baiting advances in POWTS technology,a holding tank may be installed as a last resort ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a sod and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank maybe installed,as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the.blomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. WARNING TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GAssEs OR LACK SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY ti RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE ADDITIONAL INSTRUCTIONS: POWTS INSTALLER POWTS MAINTAINER. Name �j j Name , Phone �-- _ CJ� Phone �. SEPTAGE SERVICING OPERATOR PER LOCAL REGULATORY AUTHORITY 1 Name � yt%I Name? 4( Phone 70 Phone �j w This document was drafted by the staffs of the Green Lake, Marquette and Waushars County POWTS regulatory agencies in compliance with sections Comm 83.22(2xbX1Xd)&(f)and 83.54(1),(2)&(3),Wisconsin Administrative Code. POWTS OWNER'S MANUAL $ MANAGEMENT PLAN Page d7f FILE INFORMATION SYSTEM SPECIFICATIONS Owner a n Tank Manufacturer: �, ❑ NA Permit# Septic ❑Dose ❑ Holding Volume: (gal) DESIGN PAROMETERS Tank Manufacturer: A Number of Bedrooms' 3 ❑NA ❑Septic ❑ Dose ❑ Holding Volume: (gal) Number of Public Facility Units: >9 NA Vertical Distance Tank Bottom(S)to Service Pad: (ft) Estimated(average)Flow: (gauday) Horizontal Distance Tank(s)to Service Pad: �(ft) Specific servicing mechanics must be provided if vertical is>15 feet or Design(peak)Flow-(estimated x 1.5): (gal/day) If horizontal Is>150 feet. Specific instruction to be provided on back. In Situ Sod Application Rate: — (galidaylf?) Effluent Fdter Manufacturer. ,�� �, p NA Standard(Domestic)Influent/Effluent Monthly average.. Effluent Fitter Model: Fats,ON 3 Grease (FOG) s30•mgk Pump Manufactturer: NA Biochemical Oxygen Demand (SOD$) s220 mg1L (� NA Total SURWXW Solids SS 's150 nyt Pump Model: High Strength Influent/Effluent Monthly average Pretreatment Unit (FOG) >30 mg/L- Manufacturer NA ((TSS) >150 mgA. ❑Mechanical Aeration ❑Peat Filter SS >150 ❑Disinfection ❑Wetland Pretreated Effluent Monthly average ❑Sand/Gravel Filter ❑Other. (SODc) s30 mg/L Soil Absorption System (TSS) s304mgA. A "14r Ground(gravity) ❑In-Ground(pressure) ❑ NA Fecal Coifform(geometric mean) 510 ✓0 1 Maximum Effluent Particle Size 36 in dtia. ❑ NA ❑ t Grade ❑Mound ❑Drip-une ❑der. Other: NA Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Pump out contents of tank(s) 74RrWhen combined sludge and scum equals one-third()&)of tank volume ❑When the high water alarm is activated Inspect condition of tank(s) At least once every: months) ('Maximum 3 years) ❑NA Inspect dispersal coh(s) At least once every: ?> month(s) (Maximum 3 yen) ❑ NA 0 month's) NA Clean effluent fitter At least once every: s Inspect pump,pump controls&alarm At least once`every: month(s) NA O yews) Flush laterals and pressure test .At least once every:. month's) NA Other: At least once eve ry: O s mort 1s) NA Other: NA MAINTENANCE INSTRUCTIONS Inspections of tanks and soil absorption systems shall be made by an Individual carrying date of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer or Septage Servicing Operator (pumper). Tank inspections must include a visual inspection of the tank(s)to identify any missing or broken hardware,identify any cracks or leaks, measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on the ground surface. The soil absorption system shall be visually inspected to check the effluent levels in the observation pipes and to Check for any ponding of effluent on the ground surface. The ponding of effluent on•the ground surface may indicate a falling condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any treatment tank equals one-third(%)or more of the tank volume,the entire contents or the tank shad be removed by a Septage Servicing Operator(pumper)and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code: All other services,including but not limited to the servicing of effluent filters,mechanical or pressurized components, pretreatment units. and any servidng at intervals of S12 months,shall be performed by a c artified POWTS Malntalner. A service report shad be provided to the local regulatory authority within 30 days of completion of any service event. GMW-005(02105) ., . FILTERCARTRIDGE INSTRUCTI®NS Irditsdation STEP s Dry lit the e'er ues orris the aid of the outlet pipe to&nuns R is cantered under the a con apN+lal. 1 f nub,lien ettlwr heat nrKS pipe bhto the tank ipe dvD"b the mdfat Or solvent Wald(*A)pdilklonal pipe ants the outlet STEP 2 While do case a stiM dry lltted an the outlet pips,rrwasure the length Of 46-inch pipe nsadad to braes the fNter to the tank end wall if utiQ"the optional supple r ental rdd!support.If side support metlrod.is not utilized, Proceed to step Dour: !Mp 3 For insWitions utllfsing the optional gupplamentai side Sup port: sehlont Wald the-1-inch pipe onto the 1Mhr case. Iff side Support method is not utib",proceed to shop four, Solvent Wald the ft#er case onto the outlet ~ ; earbidgs hits the cue, pips. Insert the liter the use. prt�nuq down until the Ater lodes into the bottom of i If a VRS switch is hulloed:ineeit r docicahke 9W. lute i tr and IOCiC�/tumirg . PwlWe WOM 1. The*nkwnt Alter should be donned every tiro the septic tank is serviced. 2. Open the outlet am*"opening to Inspect the tank and titer, 3. Pump the septic tank coMph**,rnakhg sure to remove tlw sludge " layer on the botte n of the tank and not JW the scum and a lumL <. Once the efAhmht level has been lowar"below the invert of the \ outlet Pipe,finv*f Pius UP on t?w Altar handle to dislodge the cartridge ham the use. S. Slide the cartridge up and out of the cars for deeming. 6. V a VRS switch amnectsd to an alarm is present,the aw7tch ` should be rarnoved by �. with water only. turnnq cohrrda►dorJnyisa 90'and daanad 7. While holding the cWtridge on its side(large not surface facing down)over the access operainl,rinse off the cartridge with water ,L only.mold g aura and*sprats nMtWW b dha d bad*hto the tank. If VRS switch is utNbW,r*Phae by inserting into fifer and ` turning ckmkwiea 9w. • M�' S. the Altar etas bade into the case,pressing down untlf 10.1taplace and SOMM the arses*opalhing On the tank l:a lr•.tat'sr-•*�alC"C I�M'R:IKK r1YE-"7 r.:liMl':.L`:�'.ikH.t A't ww%Uxuarandtr.xon 877•MLfU?M(653-4583) DOCUMENT No. STATE BAR OF WISCONSIN FORM 1-2003 8 2 3 6 6 4 8 WARRANTY DEED TX:4193665 997210 BETH PABST THIS DEED,made between One Corporation,a Wisconsin corporation REGISTER OF DEEDS ("Grantor"whether one or more)conveys and warrants to Haffner Cons ' tion, ST. CROIX CO., WI LLC,a Wisconsin limited liability company("Grantee",w ether one or more), the following described real estate in ST CROIX County,State of Wisconsin: 06/13/2014 4:12 PM EXEMPT#: NA REC FEE: 30.00 TRANS FEE: 51.00 PAGES: 1 Lot 5,Plat of Ninety Fifth Street Site in the Town of Richmond,St.Croix County,Wisconsin. RETURN TO St.Croix County Abstract&Title Co.Inc. 219 S.Knowles Avenue New Richmond,WI 54017 Tax Parcel No: 026-1302-05-000 This is not homestead property Exception to warranties: Municipal and zoning ordinances and agreements entered under them,recorded easements for the distribution of utility and municipal services,recorded building and use restrictions and covenants,and further except 2014 real estate taxes. Dated this 13th day of June,2014. One Corpor n,a Wisconsin corporation . homas .Mews,its ary/Treasurer AUTHENTICATION ACKNOWLEDGMENT Signatures authenticated this day of STATE OF WISCONSIN 20_ ss. COUNTY OF ST.CROIX * TITLE: MEMBER STATE BAR OF WISCONSIN Personally came before me this day of June,2014,the (If not, above named One Corporation,a Wisconsin corporation,by authorized by§706.06,Wis. Stats.) Thomas D.Mews,its Secretary/Treasurer to me known to be the person(s)who executed the foregoing instrument and acknowledge the sa e. � THIS INSTRUMENT WAS DRAFTED BY Robert L. Loberg/Loberg Law Office * t Notary Pub 7c St.Croix County,Wis. 1418325/alp sip My Commission is permanent. r � q; (Signatures may be authenticated or acknowledged. Both are If not,state expiration date: �17 �`��� not necessary.) '��-_ `�TAY .• �Irry X711}lull t4t��V �V8roix'N'unW 997210 Page 1 of 1 Form No.1-2003 i \7�48� c N':89'24'43" E I� � 1 z 12 i�A �; cres w t 1 q. (( ` Iv 1 1 I I sq. ft. LOT 3 7 L4 1.5 6 acres A po 66' Cp JJ J,3 ,>039 0 g U- ` ; N 89"27'57" E 381.8 .26'.', 09,e I N89'27'57"E 376.94' Z 8� S89'27'57"W 378.10' OI Z — —353 4,— _ 25, 6 95_r. 1.58 acres J 68,814 s ft. I W 'O l lu o N ' sx�boss q c ! o . ...........�...........................N N.... W.E.=975.0 5 N N w sa ra� v°r 6aJ4' 4 m NB917352 2.01 acres 2.00 acres N; 87,549 sq. ft. cn H.W.E.-969.6 c o �N L.8.0.=9770 0 Cr+ DR, GE: ( 87,237 sq. ft. N DRAINAX , EAsE ENT IA5' +ti L.8.0.=971.6 Si EASEMENT\o 5 08' !80' 10662'-878.64 44.28' - 969.9 I \ 456.72' 16084' 377.64' s 6' S89'17'31"W 883.72' South Line of the 33 33 o Northwest 114 of 0(,4 the Southeast 114 w South 114 Corner Section UNPLA TIED LANDS W C 7-30-18 (Found Aluminum ��`�'rt►' �'� � 1 County Monument) n . L&A pp— I Wisconsin Department of Commerce LUATION REPORT Page Of - Divisic3 of Safety and Buildings in an ((''FFJJ\\� Attach complete site plan on paper not less than 8 112 In nch REi2�"�i�rl3d/�D County S7L- Cr / inducts,but not limited to:vertical and horizontal referoint(BM),direction and Parcel I.D.� )�, _ ?� SUs� scale or dimensions,north arrow,and I and,��$t�n tckne r cad. slope, ,Ur percent �' HUl1 G « - Date Revie by Please print all inform .Personal information you provide may be used for secondary es 99"."Y1x�t�l4R Y-1) /Z OS ZU Property Owner � l INC- f Locati Govt.Lot W 1/4:51F—1/4 T ��N R E( W props is Mailing Address,/ lot# Block# Subd-Name or M# hyvne /3?J x 7 j� O, CR state zip code one Number ❑City ❑Village Town Nearest Road/ O in..r?/s-P.'i�" t Tl�aZJ (�/_3-jam"�0?�•2. �i��n�d� /3�.5�1` ew Construction Us sidential/Number of bedrooms Code derived design flow rate Jti GPD ❑Replacement ❑ Public or commera�I-Describe: ------ -- ww /•y Flood Plain elevation if applicable T Parent material S� �5 n y Generaloonments WCW ts•;agt'��v- and recommendations:: $ys,e.w � 00.5)l 170. 7 ❑ Boring J n/ (2,6 a Ong# Pit Ground surface elev. I v 6' Oft• Depth to limiting factor ( L in. Soil Application Rate Horizon FDepth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f*Munsell Qu.Sz. Cont.Color Gr-Sz.Sh. 'Eff#1 'Etf#2 0 ' - 19 - ❑ Boring a Boring# .pit Ground surface elev. r_�ft. Depth to limiting factor 13 4 m• � lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 `Eff#2 AIX- tt ►I b 'Effluent#1=BOD >30<220 mg/L and TSS>30<_150 mg/L Effluent#2=BOD <30 mglL and TSS<30 mg1L CST Name(Please Print) Si CST Number 226900 Bird Plumbing, Inc. Shaun Bird Telephone Number Date Evaluation Conducted P Address 715-246-4516 1008 192nd Ave, New Richmond, WI 54017 —1 r • t, Property Owner Parcel ID# Page of ® Boring# ❑ ring D it Ground surface elev. (o a• "ft• Depth to limiting factor in soil Application Rate Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIfF Horizon Depth •Eff#1 'Eff#2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 0-) ks o Z d t Ito v Boring# Bonier 3 D 141 Ground surface elev. 0 ft• Depth to limiting factor L_ in. Soil Application Rate AN bon Texture Structure Consistence Boundary Roots GPDff Horizon Depth Dominant Color Redox Description •Eff#2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 175 _ ,AID- Boring Boring / O Boring# Ground surface elev0 h z ft. Depth to limiting factor ( in. Pit Soil ica6on Rate. Roots GPDIfF Horizon Depth Dominant Color Redox Description. Texture Structure Consistence. Boundary 'Eff#1 'Eff#2 in. Munsell Qu.Sz. Cont Color Gr.Sz Sh. _ 2- .�� i D ' •Effluent#1=BOD3>30<220 rrgll.and TSS>30_<150 mg& 'Effluent#2=BODS<30 mg&and TSS<30 mglL 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. SOW330(8.6/00) r_ . Soil Test Plot Plan Project Name P.C. Collova Bldrs. Inc. Sha ird Address P.O. Box 489 Somerset Wi 54025 c #226900 Lot 5 Subdivision 95th St. Site Date 8105 NW 1/4 SE 1/4S 7 T 30 N/1118 W Township Richmond Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Iron System Elevation 100.5/100.7 *HRpSameasBenchmark Alternate Benchmark Top of 1/2" pipe @? 100.3' Scale is 1" = 40' unless otherwise noted 106' B-2 25' 45' 235' Property Line 2 1 JF.J S' B-4 1 B-5 -3 O.ti 5, B-1 108' _ 104 100 n 457' Property Line VV i L104S M 'PuowgO!d maN V 001 =4aQI S SZ£ xa8 '0'd 18m HI l o 'IS 800 OiINO3 0£0£-911Z (SlL) 'ON xod '130 31YI8d08NId 3H1 ONO DNISV 8nd 3 0.38 '(X10210 ON 3211 10O1N00 6l£4-94Z (SlL) ON auotyd '130810 ANY ONIIV4 'SONY-113M 210 ONIS1H08nd 380338 '('013 n8 'S 0 Ol SS3000 '3ZIS 101 WnWINIW 'SONVl13M '3'I)SNOLLOl1103N ONO S31n8 'SMVI dIHSNM01 ONV kiNn00 '31119 Ol 103renS 3UV dVW SIHL NO WAOHS Sl30NVd 3HL :Cq pa�oda�d arlVDS DIHdV*dD 'M,£O,Z£.00N 8138 Ol 03WnSSV SI HOIHM V£40SL50N1 K BJd,M9VN ..NOVI 'L N01103S!0 cull 4/l glnoS 41JON 3H1 01 03ON383338 381 SDNIHY38 ut papnl0ul spuel M,LS.L2.68S M,Le109.96S M,L1,60.89S ,96'691 ,ee'ELi ,02,16.2t, 00'esa S 101 'SON1033S SSV80 80 SW838 's183A1n0 sluawssasse laload M,LE,05.96S M.19,00.61S M16619S.2CS 190'BTT ,LVETT ,94,64.12 00'ee2 9 101 831VM SAVMNm 831VM 'S3HO1I0 30VNIVNO aolyo Rtu ul spioo M,[S,00.6TS 3.42,E2.O1S M,S'Eb.BLbOS ,L2'BIl ,8S'6TT SG42.62 001EE2 L lUl 831VM S1N3W3SV3 391NIV80 ANY NI ONLLNOId Janowtvutloepi 80 ONIIVAVOX3 80 ONI1113 '9NI8311V 'ONLL0n81s80 M,LS,L2.68S 3,42,E2.01S M,S'91,2E.6ES 109'99E 180'906 ,12,lr.66 00'EE2 00 'NOdn ONIOlIne 01 0311WI1 ION SI In8 S30nl0Nl SIH1 3.62,E2.0TS M,89S9.68S M,L1,91.6ES ,69'692 105'682 ,22.61.66 00191 co '1Vld SIM 800 NVId NOIS083 110S ONV 3OVNIV80 3,K,99.88N 3,62,MT0 A,9'ET,00,08N ,Ee'2L 129'2[ ,62,19.LT 001EE2 6 10l 831VM 3AISN3H38dWOO 03AO8ddV 3H1 d0 NOLLV83dO 3,62,60.10 3,99,L9.M 3,2T,10.99N wT21 ,64'221 ,6E,90.0E oo'EEa of 101 3W 39NVH0 80 HIM 383d831N1 OInOM HOW _ --",..., -- __ I ,.. —. s,,,,,_ _ _ L ONI_HIJ,NV_00 IIVHS 1N301S38 80 83NMO ON 3 burveyor,nereoy cattily am oy tns avectton or e.t..t.ORove • t✓ tapped thti County plat'of Ninety Fifth Street Site,located in part `'�`w ryy �� (wilding Setback lbs. per linear foot) SEC. 7, T. JO N., ND,W. � `, �eNep._I/� ' q TOWN OF RICHMOND, 3r and art of the Sbuthwest Quarter of the Northwest Quarter all ` . 60 '- Building Setbaek Line ST. CROIX COUNTY, W7 p �S f �C�S./� (100' from Right of Way) NOT TO SCALE I,in the Town of Richmond,St Croix County,Wisconsin, a �'( ,� a FOUND 2-3/8 O.D.IRON PIPE 1 RIPLEY '�,. R- RECORDED AS 170TH A,VENUE e~i a +" - - J Section 7; thence,on an assumed bearing along the S•2371 Proposed Driveway Location 0 _ _ _ o _ 100 degrees 32 minutes 03 seconds West a distance of 1312.36 +• � • � 12' Utility Easement Line N W W N E ° north-south Quarter line,North 00 degrees 32 minutes 03 RICHMOND �� Denotes Drainage Easements I 1 North 89 degrees 27 minutes 57 seconds East a distance of ►� �►(`►. h L.B.O. Minimum Elevation of } m 35 seconds West a distance of 295.82 feel;thence North 00 op'�A��•a • WIS. 0�0 1% Lowest Building Opening - m - i of 660.00 feet;thence North 34 degrees 22 minutes 24 rO a." �� H.W.E. 100-Year High Water Elevation 4 rn forth 88 degrees 55 minutes 58 seconds East a distance of ,�`� O URV���� Benchmark 9 To of Iron ! $ W s 17 seconds East a distance of 1384.52 feet;thence,South 89 f�et off t 1,` ® monument as noted S E i of 863.72 feet to the point of beginning. Containing 883,264 i town Road)along the most westerly line of the above described ALL OTHER LOT CORNERS MARKED WITH A 1" and covenants of record. I I x 18" IRON PIPE (WEIGHING 1.13 LBS. PER 160TH A 7EIJUE North 114 Corner Section LINEAR FOOT) UNLESS OTHERWISE SHOWN. resentation to scale of the exterior boundaries surveyed and the I 7-30-18(Found 314"Iron Rerod) e Complied with the provisions of Chapter 236.34 of the / 996.8 UNPLA TIED LANDS ce of the County of St.Croix and the Town of Richmond in / I I 983.6 - - I ,0 N 88'55'58" E 491.40' 163.4 K 327.95' Cost west 114 Line I I =983.0 2005 I ^. H. -98J. 996.J ° 2.41 acres e 10 104,995sq.ft. �n 2.55 acres T L.8.0-989.9 July organized and existing under and by virtue of the laws of the State of I I 111'170 sq.ft' 1 hereby consent to the surveying,dividing,mapping and dedication of the I I I� L.B.O.=985.0 LOT � ss�tnt e above certificate of P.C.Collova Builders,owner. I I --_- y z Drive Easement�, N ao'8835169,E I has caused these presents to be signed by I I m*,9D��� Minnesota,and its corporate seal to be hereunto affixed I I t a d0s• i6Q0a'` nT �� I I • NFIa'S5'S6'E 155TH I- A VENUE,k N I + i Yi' See'S5'S6•W - % --j Date W 2o.T6' G � Z Iw I I 2.18 acres cn O I !' O I� 2005,above named ,to me known to be the o En' I I I C rn 95,05Jsq.ft. � t-i i O ,wledged the same. (A I O I I m Q I ..... N m LOT 2 1 I I wwoo-in O I I I - I y I 1 e I rq l It, 1.81 acres O, - - 244'35 998.9 I (Wit I I I� N 6626.40,' l p I• Ihl a Y',{ 1 u 264.97' N 69'24'43"E MITTEE I g E in the m i � fj eby I ^i I U 1.89 acres- 1 1 II I Z 'ommittee. p 82,485 sq:.ft. w 7 @ 1.58 acres cog ly -• I i0N 67,952sq.ft. 0054 "z>?52 IRl 03'a•oy. I V LN 89'27'57" E- 381.80' / 407.06' 189'27'57•E - A667 AVE Z - -f 'E in the Town 407.06' S69'27'57•W / ,proved by the I o "2 9 -353:04'- 25.06' s I O I t �Y sL 9tesj4n 6et 1.58 acres I N 1 13 �• N j1 79' 68,814sq.ft, I� W by 2y0 N N ' ') J `d ) I ° 1•�$"t / 2a ms aoa N27 wN 1e .. . S 3n adopted by Ne0. $t'f \A6s' Q 2.01 acres 0 W 2.00 acres ��`aa 87,549sq.ft. I cA 87,2J7sq.ft. ` L B.0 977 0 - �� L.9.0-971.6 \���e' 989.9 5 B'� 878.64' 456.72' 44.28' 164 e4 377.64' % R, I I 589'17'31"W 883.72' I { North-South 114 Line South Line of the Z Nothwest 114 of w I No the Southeast 114 South NPTIED LANDS outh 1/4 Corner Section _ULA u rn 7-JO-18(Found Aluminum aing town treasurer I I I County Monument) ordance with the d special ny of the land I �� CURVE TABLE CURVE RADIUS DELTA I ARC CHORD CHORD BEARING TANGENT BEARINGS CI 167.D0 99'51'21' 291,05' 255,59' N39'32'16,5'E N89'27'S7'E N10'23'24'W NOTES: I C2 233.00 99.19'22' 403.91' 355.20' 1 N39.16'17'E NIO'23'24'W N88.55'58'E nCh o : g T n c \ -0 \ } ! I (D 7 , ki { \ ¥ \ \ \ 7 \ \ g Q + } \ 0) N)m \ ' E G) ` 4 2 \ a 4 f } / { 0 \ / / D } ® ^ D ° 6 / ' ■ / \ 0 2 z z > ( % @ 0 © > } E \ a CL a l \ � 0 . § \ 0 § j g IV § § § 2 2 2 z a \ \ o=r 3 < Ch 0 � » \ 7 � ) � 7 / \ / Q / \ a G § ° / lu > o / = t , � ` . j \ / 2 \ . ° \ « z $ ® \ M & £ \ z 9 % \ \ § / , 3 / , 2 \ Cl) -4 { \ � > j . : /k\_\0ƒ k\2 /p/}= 0 CL § \ § f/ ( , {\ . \ a - tCh ! EG y CD ; \ { \\ f 22 \ k \k . \ . ~ � f \ � § ± < § / . � \ 0 � � \ Parcel #: 026-1302-05-000 03/05/2008 10:20 AM PAGE10F1 Alt. Parcel#: 07.30.18.1582 026-TOWN OF RICHMOND Current X ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 02/21/2006 00 0 Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner 0- PC COLLOVA BUILDERS INC PC COLLOVA BUILDERS INC PO BOX 489 SOMERSET WI 54025 Districts: SC= School SP= Special Property Address(es): '=Primary Type Dist# Description '947 165TH AVE SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 2.010 Plat: 10-098-NINETY FIFTH ST SITE 026-06 LOTS 4/12 SEC 7 T30N R1 8W PT NW SE; FKA LOT 4 CSM Block/Condo Bldg: LOT 05 19-4992 NKA LOT 4 CSM 19-4993; NKA 95TH STREET SITE LOT 5(2.010AC) Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 07-30N-18W NW SE Notes: Parcel History: Date Doc# Vol/Page Type 02/21/2006 819000 10/0098 PLAT 06/16/2005 797821 2824/120 WD 06/06/2005 796820 19/4992 CSM 06/06/2005 796819 2816/111 EZ-1 more 2008 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/09/2007 Description Class Acres Land Improve Total State Reason UNDEVELOPED G5 2.010 14,500 0 14,500 NO Totals for 2008: General Property 2.010 14,500 0 14,500 Woodland 0.000 0 0 Totals for 2007: General Property 2.010 14,500 0 14,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch#: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00