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HomeMy WebLinkAbout020-1400-04-000Wisconsin Department of Commerce PRIVATE 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 White on, John Hudson, Town of ;ST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER r S CAPACITY Septic ~ F Z I ~ e.~- i l ~•t.~ / Z. `J ~ Desrng Fiti ,/~ " / /[~ Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic $, ~ , )&- ~`~ ~~ I ~ 5 a ` - Dosing Aeration Holding PIIMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift F tion Loss System ad TDH Ft Forcemain Length Dia. Dist. to well cnu ARC~IDDTInAI CVCTFM ELEVATION DATA County. St. Croix Sanitary Permit No: 499110 0 State Plan ID No: Parcel Tax No: 020-1400-04-000 Sectionll'own/Range/Map No: 11.29.19.2494 STATION BS HI FS ELEV. Benchmark ~~ ~ ~ r / ~• ~ °r7•~ Alt. BM Bl~dg~. Se5 ~r ! ~~~ • 7 SUHt Inlet ~ ~, 7 St/Ht Outlet Dt Inlet ~ -~ Dt Bottom ~_ ~ Header/Man. rz.5 93• ~ Dist. Pipe f2 ~ t~~ ~ ~• r!OS Bot. System ~ 3 • ,l qz • 7 Final Grader 3 ~• 3 9 g• $+ StCover`~ ~ I/ ~ `1' ~~~~ JC BED/TRENCH IMENSIONS Width ~ Length ~ No. Of Trenches !~ PIT DIMENSIONS ` No. Of Pits ~ Inside Dia. ~ Liquid 4@pth D ~ (ems ~C~ ~`~ ! ~ ~ v SETBACK SYSTEM TO P/L BLDG W EL L LAKE/STREAM Manufacturer r~ ~~~, CHAMBER OR Jam' INFORMATION Type Of System: ~ / ~ Q / ~ /fj l UNIT Model Number: ~ nICTDIRI ITII'1AI CVCTFM V _ 11 / c7 T` I V 'r'- ~ J -' T ~ Header/Manifold // 1 Z ~ Distribution P~Pe(s) ` \ x Hole Size ~ x Hole Sp cing ~ Vent to Air li ke~f Zw 1 Length Dia Dia Spacing Length cnu rnvco __ .,____..__ ~.._......_ n..~.. .,., nn.,.,.,a nr er_r.r~.ro Cvcrams r~nro O+E v ~Q.~/~., Depth Over / Depth Over xx Depth of xx Seeded/S ded xx Mulc d Bed/Trench Center r Bed/Trench Edges ` Topsoil ~ Yes No Yes No r COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 763 Packer Drice Unknown (SW 1/4 SE 1/4 11 T29N R19W) Hopkins Estates Lot 4 Parcel No: 11.29.19.2494 1.) Alt BM Description = ~~•~ ~ ~° `~;'`•-- G~ ~ ~/~s ~' ~ Li~ Ov'~ 2.) Bldg sewer length = ~ y y - amount of cover = y ~Z ~ I C ~ !1(~ Z a ~5~ I ~•~~ U ~+ Plan revision Required? i J Yes i No ~ [,~ ~t/ U Gjj~~~J~ Use other side for additional information. I ___ ;__ _ I Ul9 _ - Date Insepc s Sign e Cert. No. SBD-6710 (R.3/97) _^~ ~ Safety and Buildings Division county ~, / ~ C „ 201 W, Wast)ingtpn Ave., P.O. Box 716 S D ~ J irscons~n iV);8~180t1, WI 53707 - 7i62 Sanitary Permit Number (to be filled in by Co.) ` Department of Commerce ~~,~, ~~31g~ p q i I fi' • Sanitary Permit App~~~ation __ State Plan i.D. Number _ , ~ In accord with Comm 83.21, Wis. Adm. Code, personsill infor n y rovide ____ ~ ~ may be used for secondary purposes Privacy Law, s 1 P ject Address (if different than mailing addre s) s I. Application Information -Please Print All Information . ~i ~(~ ~ P~t.~~lZ D 2 ~ l! ~ 1 Property Owner's Na me Parcel # Lot # ___. Block # ' ~~~,~ 1t, h~ e. ~ ~ Propetyy Owner's M ailing Address ~ ,~~ Property Location 1 ~ ~ ~~'3 ~~c Y REG sf 'k S i SW 'k ~ Ci S - , ect on , ty, tate Zip Cod Pho L ~ Gf.~~~J ~ ~l~ ~/ Av R .„(ciErole o T ~ ~ N II. Type of Builtling (check all that apply) T_ L1X C4 CR ~ ; _...____f S ~1 or 2 Family Dwelling -Number of Bedrooms ~ Subdivision Name CSM Number _ ~~^ ^ Public/Commercial -Describe Use _T ~_ I ~aP~~^f f ~y ~" '~-) State Owned -Describe Use ____~ ~Q.i'~'I~xS ^City_^Village ~ownship v£ ~~ i III. _ Type of Permit: (Check only one box on line A. Complete lute B if applicable) p 20 - ~ 027- p ~- , 2 A ~ ~ New System ^ Replacement System ? ^ Treatment/Ho2ding Tank Replacement Only T o Other lviodification to Existing System __ li • i ^ Permie Renewal C~ Permit. Revision j ^ Change of ^ Permit Transfer to New ! List Previous Permit Number and Uate Issued Before Expiration Plumber Owner __ IV. Type of POWTS System: (Check all that apply) _ Non -Pressurized in-Ground ^ Mound > 24 in. of suitable soil ^ Mound < 24 in- of suitable soil ^ At-Grade ^ Single Pass Sartd Filter ~ __ I ^ Constructed Weiland ^ Pressurized In-Ground ^ Holding Tank U Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ~~ i Recirculating Synthetic Media Filter Leaching Chamber Drip Line ^ Gravol-less Pipe C1 Other (explain) ~Y. Dis rsal/Treatment Area Information: 2) re +ti S r2 , Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (std Sy em Elevation ~ qfl Go"G ~ ~ ~~7 ~.S' ~ ,~ ~ c c!d C -. VI. Tank Info Capacity in Total '~ Number M anufacturer Pr fab Site Steel ,Fiber Plastic ! ~~ ` Cations Gallons of Uni ~ /~ab~c >4--- ~~ "o Crete Constructed ~ Glass New Existing ' I~i ~ ~~ T s Tanks ~ S' 'eptic or Holding Tank G _ / l ~ ems' G _ i Aerobic Treaunent Unit I j Dosing Chamber ~O, '„C~~X t/ /~ ~ VII. Responsibility Statement- I, the undersigned, assume respot>9ibWty for ' llatlon t1f the POWTS shown on the attached plans. Plumber's Na me (Print) Plumber's 5i gnature P RS Number Business Phone Iv'uinber r 1 Gt ' ~ I r ~ 7 ~ ~~~ f ' ~ ~'~ ' ~ ` !1 rlsY ' . J . 0 CJ Plumber's Addre ss (Street, City, State, Zip } ~ ale C d / ~ / /' 1 ~ .~~ S ~ ®~ /7 aL ~G~ 4~d/I~ ~~ , ~ ~~~/ ~ VIlI. Count /De artment Use Onl __ ' ~ etudes Groundwater pate Issut=d ~ ssuin Agent Signatur (No Stamps) ~ Approved ^ Disapproved Sanitary Permit Fee ( Surcharge Fee) / J _ en Reas for Denial ~ ~l ~ / ~ b _ IX.Contiitiotu p /R -3~ D,-Qe, ~i\ f_-~.,~„-.. W'~ ~i~ dl~lr2~ _J~~- SYSTEM OWNER: ""~ J '~"`" """"`- 1 Septic tank, effluent filter and ~~ f~~~ Uo ~~. ~2 ~3, b,~9Q,vbg,,,,,~5 ~ di spersal cell must all be serviced / maintained l,~_ r _. , - ^ as per management plan provided by plumber. t9~ VV~p.Jv" ~~(~ps„~ n~~-~t ~ . ~ 2. All setback requirements must be maintained ~ ~ ~n as per applicable Gode/ordinances. `~) v 1 aQp~ -~ I _P~a.~.P , t^i~aS ~ ~~~ Attach ctiaeplete plans (to the County gnly) for the sy m ort paper a than 81/2 x t1 inche n sh~ee ~~ o / ~~~ (~ ~e ' l /~AJ Lc1 r ~~ 4.10 f-+ o ~ ~ r/s~ ~f `,-y,5` °^ .~' ~_ ~.f~i/ /? ~ J~G~~S/l~( 4 ' _,~ c 4 r ,- :~ 0 ~~ ~~~~ ~~ GpP ~ ~ b ~ A~ "1 ~ ~U °`Q1 Nv ~\~ `~ 3 y v ~~ ~~, ~~ a ~ ~,~ _ ~ ~ r ~, W .o _,~ `~~w.y.S:1f~ .v ~ ~~ ~~ ~ ~ ~v °p N~ ~~ ~, ~ 3 v 2S ' li'J-U ~~ a. .~ M ~- pL ~ ~ ~-~ 7 ~ 9~ I~j J 4 ~~ r 9.~~ ~ ~/3~0~ -~- >f ~ ~ iS l5 ~ 2 `~~ S6a, 1 ~-f"' ~e~ / ~ ~ -` _---~__._.j wisr~nsin Department of Commerce SOIL EVALUATION REPORT Page ~ of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County ~ Attach complete site plan on paper not less than 8 12 x 11 inches in size. Plan must ~ ~ ~ inGude, but not limited to: vertical and horizontal reference point (BM), direction and p~ I.p. percent slope, scale or dimensions, north arrow, and location and dist o arest road. ~ " Please paint all inform `v FQ Re "wed by Date Personal information you provide may be used fo nd (Privacy Law, s. 15. (1) {m)). 6 , I (I ~ ,, roperty Owner rr 1~ Prope Location ,~ SCE ~ VI/ 1*'f~e O' ~~? ~ 3 vt. Lo 1/4 S X1/4 S t l T ZQ N R ~of) W Pro ~~Ow~ r s M~~ r7 k ~ ~ ~ ~~ . CRC~X CO Lot # lock # Subd. /~p - M~ r ~r~~ S ~Yc-/ Village [Town Nearest Road New Construction use Residential / Number of bedrooms 3 ° Y Code derived design flow rate y~~~ ~d GPD Replacement ^ Public or commeraal -Describe: Parent material,,, QtJ ~~ ~ (~ Flood Plain eleva/tion if applicable ~/' ff. General comments ~5~~ .~~U , ~ ~ S r B~~ ~O rL?~ ~ ~/ and recommendations: Boring # ^ Boring Q Pit Ground surtace elev. ~ ft. Depth to limiting factor /2 6 in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/itz in. Mansell Qu. Sz. Goat. Color Gr. Sz. Sh. "Eff#1 "Eff#2 Z // 3 ~ ld y/~j Sc~ z~sb~ r ~,f - , (i r-- f 9a~~ ~s•~ III•(o Z Boring # U Boring p ~ pit Ground surface elev. / ~O d n. Depth to limiting factor /Z.~ in. Soil A ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1t1? in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 t -~ io r3/3 - S,' Z ~s,bk ~ C ~ °~ Z llo- `1 ~ < r /y S~ Z .s6~ r C - 3 y9-~~ ~. / ~ - ~ i z ~ q0• ~$ "Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L "Effluent #2 = BOD < 30 mg/L and TSS g 30 mg/L CST (Please Print) re CST Nurrlber ~G ~ zS33 0 ddress Date v u n acted Telephone Number Property Owner Parcel ID # Page _~ of 3 Boring # V Boring ~ Pit Ground surt~e elev. ~~• ~ ft. Depth to limiting factor ~~ in. Soil A ication Rat Horizon Depth Dominant Colw Redox Description Texture Structure Consistence Boundary Roots GPD/f~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 "Eff#2 f ~~~ 6 /Z -- 5~ I ~ S ~r ~~ L ~ Z :~'- / - :GI z /c '~ ~ S u 3g lei r ~ - C c VY~ ~ C S --~ • (o -t3 e ~ O vn -- ~ . '~- /• Z- a Boring # ~ Boring pit Ground surtace elev. ft. Depth to limiting factor in. Soil A ication Rate Horizon Depth Dominant Colw Redox Description Texture Structure Consistence Boundary Roots GP D/ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. Pit Sal A "cation Rate Horizon Depth Dominant Colw Redox Description Texture Structure Consistence Boundary Roots GP D/ff in. Munsetl Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 'Effluent #1 = BODS > 30 < 220 mglL and TSS >30 < 150 mglL * Effluent #2 = BODS < 30 mglL 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 608-2648777. SBLlffi30Test (R.07/00) PAAit ,,,,~,,. NAME LOT# LEGAL DESCRIPTION5tn1~/as~~/a,S 1~ TZQ,N,R // E(O~ SCALE: ~ " yo' BM 1 ELEVATION ~(~O. O BM l DESCRIPTION ~~Q ~},~ Z ~~ ~U~ ~, ~"Q ~ BM 2 ELEVATION ~'` T' ~ BM 2 DESCRIPTION `- I ,,pp ! SYSTEM ELEVATION ~i~s ~aw (a/L'T~~/' ~~ Q ~~1 c~~ 1~'~ r S1' 1 ~ I L q a o ~ r ~,.z 0~, ~ ~ 1 I I ID6~~ i _' SIGNATURE DATE 7-~y -OKJ SEPTIC TANkC ~ PL1MP Ci-iANSFR C~tuSa SECT?CN AN~3 SPLC'.iF:CATTO'~'S- ~..•.-.. • 4" CI -V-EI~T PIPE 12„ MIN. ABO'v'E GR,~DE ~ 4lEA7HfRPR00F > 75 ° FROM DCOR, WTNDCW OFt ~.IUNCTION BOX APPRCVED FRESH AIR INTAKE WITH CONDUIT MANHGLE CCVF,R bJ/ PADLOCK & FINISHED GRADE WARNING LABEL ~ " C i RISER -----~ _.•.. ~..._~,_,___ 4 " MIN . 1&" IN, r 61° MAX. ~~ ~_ ~'r s~ •.~ ~NL,ET -- ,1 WATER TIGHT SEALS GAS" ~ ~ r Ts.GHT ~ •~ ~AAPROVEO A SEAL ~ ~ JOINTS WITH APPROVED ~ ~ 'ADM APPROVED PIPE ON 3' ONTO 1N70 5(ILID ~ ' ~ ' SOLID SOIL 'OIL' PUMP OFF ELEV . FT. --~--- ~ -OFF '~'~ RISER EXIT PERMITTED 02vL~ IF TANK MANUFACTURER HAS APPROVAL 3" APPRCVED BEI~AING UN DER TALK CONCRETE PAD SPECIFICATIONS SEPTIC / DCSE TANK MANUFACTURER: ~~~~~~ TANK SIuES: SEPTIC I~,`j Q :SAL. ._._..._.. DOSE $ b ~, GAL . ALARM MANUFACTURER: ~~,~._ ,~ c~ MODEL NUMBER: 'pt,.~/ SWITCH TYPE: 't`c~~,0.c.. PUMP MANUFACTURER : Gti r _____.. MODEL NUMBER : ~ C9 SWITCH TYPE : i!'~e~C REc~LIRED DISCF•iARGE RATE ~~ GPM NUMBER DQSES PER DAY: DOSS VOLUME INCLUDWNG FLG4v$ACK: ,~ 9 GAL. CAPACITIES: A = oZ~, INCHES = CI~GAL. 8 = ~ TNCHES = ~a SAL. C = ~ INCHES = ~~ GAL. D = ~p INCHES = ~~o GAL PUMP ~ ALARM WIRING AS PER ILHR 16.23 WAC `~FRT%CAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIH~JTION PIPE _____~ FEET + MINIMUM NETWORK SUPPLY PRESSURE 2.5 FEET + ~~_ FEE? FORCEMAIN X~~bFT/iJ0 FT, FRICTION FACTOR ~~ FEET T.OT~I. AYNAMTC HEAD = _~~~r EFT ItiTERIVAL DIMENSIONS qF PUMP TANK: LENGTH .,...- ; WIDTH .--~• ; DIAMETER -+-` LIQUID ~ fig" c+'~I ~~.~ A~'.R )'~ ,_._ `~ IGNED : _1.i1,~,~~~.~'~-.:~z~'---~ LICENSE NUMBER : ~~,~ q q 17 DATE 1198 (gyp GOULDS PUMPS Submersible Effluent Pump 3871 EP05 APPL{CAT{ONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS • Solids handling capability: 31~"maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size: 1'Iz" NPT. • Mechanical seal: carbon- rotarylceramk-stationary, BUNA-N elastomers. • Temperature: 104 (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, t 15 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. •EP05 Singgle phase: 0,5 HP, 115 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: 10 foot standard length,lb/3 SJTOW with three prong grounding plug. Optional 20 foot length,1613 SJTW with three prong grounding plug (standard on EP05). ®2000 Goulds Pumps Effective February, 2000 83871 • Fully submerged in high grade turbine oil far lubrication and efficient heat transfer. Available for automatic and manual operation. Auto- matic mtxielsinclude Mechanical Float Switch assembled and preset at the factory. FEATURES ^ fP04 Impeller: Thermoplas- tic Semi-open design with pump out vanes for mechanical seal protection. {44ETER5 FEET :- 10 9 s 7 x v 6 zo- -°- s 4r 0 z s:_ _ . 1 0 0_ _. ^EP05 Impeller: Thermoplas- ticenclosed design for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ^ Motor Housing: Cast iron for efficient heat uansfer, strength, and durability. ^ Motor Cover. Thermoplastic cover with integral handle and float switch attachment points. ^ Power Cable: Severe duty rated oil artd water resistant. ^ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTING ~' Canadian Standards Association (CSA listed model numbers end in "F" or "t".) Goulds Pumps k tso Soot Reyisterea. r ~~ a ~~ w ,.. -., -- 0 2 4 6 B cAPAUTr 10 17 m'/h G,o~u_lds Pumps 4~J ITT Industries , .. ,.... i 25' _ .. _ ~..._ -~~ f~ ~scvnsiri Department of Commerce Division of Safely and Buildings SOIL EVALUATION REPORT P~~~~ .., aa..,,,..K...,.~ .......,.,...,..,.,.....,. ,,,.........,.~ minty I - ~ CJ ('O Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must . ~ itndude> but not Limited to: vertical and horizontal reference point (BM), dit`ection and percent slope, sale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. ~ Z, ~ ~ 6D ' Q ~~~ Please print all information. R ~ by Date Personal infom~ion you provide may be used for secondary 15.04 (1) (m)). l(,~ v~y~,i ~ ~ ~ (f Property Owner Location KFi'~t~G fJ ~~ S f vr. Lot ~E 1/4Sr 1/4 S I , T Z q N R J~ E (or) Property Owners Mailing Address APR `~ 2 Z O OZ of # Block # ~ Subd. Name or M# ~/ L ~ Qa c° ~ /<<~ faf~S City State Zip Code Phg~e ~RggtitCOUNTY ^City village Town Nearest Road I-~~~sor~ I S~~ol~ (,~sa~ f'~cK~~ d r. H New Construction Use: (Z( Residential / Number of bedrooms ~ Code derived design flow rate t'(S~O Q ~ GPD ^ Replacement LL~ ^ Public or commercial -Describe: Ap Parent material ©~T Lood Plain elevation if applicable ~ !'r ft General comments s Y.S~~ ~ O C7 l/~7 1'-'L~ vYhG~C ca~.~S -~- .~~~- h~ ~ y-Gv-cam Gs! Clhr2 and re mmenda6ons: ~ ~ U ~ , ~ ~ ~ ~~~ ~ ~ti -~ ~ ~ ~~ • C~,~~ / - /~ .~-~ if sys-~. ~ u~~"~~ -~ Pf (.(~- U~-- ~~"` a~ fz~.ff~/~~ul ~-GTn,~ Crr-rt,-.~'m~~/ for -~-~ / ZZ ~ Z~ Borin # ^ Boring ~ 9 ,•,.f /~i c2j 1 ~ .~ ~J l,Al F'II vwu~~u aunaac c~cr.[ ~+ aa. vcyu~ av nnnm~y ~ai.w~ ~ c, Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary. Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 "Eff#2 1 C3-i ~o X 3 2 -- ~ I zr~a b k ~ c s I v ~ S ,~ ~ z-~o ~o ---, l b s - , s , ~ ^ Boring ~ Boring # ,.r,a ,f,~ ~ ~ , i r ~J l~l t'tt v~annu+ ~~1Oa'c c~cv, i i - .+..~ ~a. vcNu~ av ~u~uw,y ~auv~ ~ ~ v in. Sal Application Rate tioriztxt 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 ~I 10 ( ZMG ~K W17Cr ~ S ~ V ~ S ~ ~ z I ~ ~ ~ ~ - Sll zwls~k ~- ~ - ~S ,~ 3u~iT ~ G `- 5 os w~ - - ~ 7 I~ Z ~~/ 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) _ Signature_ ., CST Number ~S ZIJ3 fsOf~ ~f >ow,e~sef c,~l ~'~yozs Z)~ Z47 ~(oa8- Parcel f D # Page ~ of ,~ Property Owner ~ G S Boring # ~ Boring Pit Ground surface elev. 9Z.4d ff. Depth to limiting factor ~ I ~ in• Sal Appligtion Rate t Consistence Boundary Roots GPDiflz Horizon Depth in. Dominant Color Mansell Redox Description Qu. Sz. Cont. Color Texture ure Struc Gr. Sz. Sh. 'Eff#1 'Eff#2 1 ~o -- Sal z fr C S f ~ s ~~ Z I - _; J-- ~ c ~ G - ~ r" o ~ - -_ ~ (~ Z rc ~~ Boring Boring # ^ Pit Ground Surface elev. ff. Depth to limiting factor in• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor _T, in. Soil Appl.~~ Rate Horizon Depth Dominant Color Redox Description Texture Struchue Consistence Boundary Roots GPD/RZ in. Mansell Qu. Sz. Cont. Color Gr. Sz Sh. 'Eff#1 'Eff#2 'Effluent #1 = BODS > 30 < 220 mglL and TSS >30 < 150 mgtL 'Effluent #2 =GODS < 30 mglL 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 608-2648777. ssn-s3so ~e.mroo) r . •. SCALE: 1 = ~ ~~ L ~ ~~ PAGE~OF .3 NAME ~CS r TOT# ~ LEGAT DESCRIPTIONSC ~SE 14.5 1 ~ T ~1 ,N,R, 1~( E(or).liy ~~~ ~ BM 1 ELEVATION IDG . o BM 1 DESCRIPT ~N (la 1' ~ ' n J rtQ '~' BM 2 ELEVATIO f OO. O _ ~ ~ BM 2 DESCRIPTIO Q i ~ ~~ ~ $~ ,' SYSTEM ELEVATION c ALTERNATE ELEVATION g`(~ (~ CONTOUR ELEVATION 9yS d d' Q,~• Sd 7 :. ~~r ec, / I - -}- ~~- C. i SIGNATURE ~~~~ ~ DATE / ~ ~ ,~ '. '~, ~ ~~ ~ ~ -es~ ~ ~~ a - ~ ; (row -. Z .. _ _ P ~- _ o -- ' ~ t C~ 1 ~ _ • Z -~ o ~ ~ / ° ~ ~ .~' O~tT1 ~ ~ i / _ .', . _- ~-~` ~ ~ ~iD ~ / / ~ ~/- ~ /~,/ i~ Yom, "~ ~ J '~~ Y ,, / j/ /,~ % jam' _ ~ O1r~ ~~ /~ ~'~ '~~ ~ J Z ~ I ~ r ~ r l cc ~ ' ~ / .1 ' . _. _ _\ ~~ ~ ~ ~ ~ ~ A' ~ ~ ~ .. ., ~_ ~~_ ,~ ~ ~' ~ - ~ ~ n it £- ~ ~ ,~ , . . L ~~ __ ~ .. ~ . , ", ,z " _ _ ~ _ ._. ..- _ - _ ~ ` ~ ~ ,-. T ~ ., - ~ - ~. ~ ~ ,~ ,. :OUNTY PLAT OF: 1 NS ESTATES /4 OF THE SE1/4 OF SECTION 11, T29N, R1aN/, TOWN TY, WISCONSIN; BEING LOT 2 OF A CERTIFlED 8URYEY I 3, PAGE 4!OE9 AT THE ST. CROIX COUNTY REGISTER OF I -------------------------- ------- --------0~1_tl._99- - - uaac wnr aF ias, 886'66'60•E 1267.74' Faev~mw-nsea 0 1 1 ~`'~ ~ ~ zm~ ~. ~. ae,.~so. Fr. ~waHO a~seo - .. ~ _ oeoicr-~o ro 7HE Puaui I ~ -6_Oo_4 _~____GU. OCI I I ~~ --------------------- i I - - L ~ -- --- --------- -- I ' II I I I NJ~1P6G~5t 71 QDD 61~1~ ---------------------~ °~ . ~' >~ ~ I p~¢ao~!n.~9119a~.~ -----------------------------------------------~ ~ I ~ ICI = I 9i I~~ ~ I ~ ' I ~ i ~ a $ ,- 9 ., ~ •~~ -- oRivr~ ~---- • ------- ;~ W 1 I a~I ~ s ~ I I ~ i ue; ,, ................... i i ,8 .. weso ~ ' ~ i,' ~ i . i, ~ ~ ~ I ~ ~ I 6fI I ~ ~ I ~ % i ' • 2 M.W.L.. tYi.00 '~- tm i - ' N Z //~~ / ' "' ' & EACRES 197 3M 80 FT I I ~ ' .' V i ~ . . . ~ I ~ Q~ _ yb lI.N.. lY6A . I ~ ! ~ '2... ' b ~.. % tassieso.Fr. i I ' $ I ; ~ ~ ~ , ~ ~ i _ i I I i ---- --- ~ %' 1 i ~ ~ ' I I I ~~ 60O 1~ 9 OO Ire C~°,.~.016 011 ~'~ ,~,, ~. M.,. BY..DINO sLEV.. Ys.e0 M.W.L . ! I I -----_--------- OY7.60 R 2.00 AIXE8 ~ =HWL. i m. `~~.11~9 H.W.L . \ FFIICHN~F~W1X 0~.~ aF~araan~ ...: w a~ s.2s' ~wr~rasnEw~nNOFnEa~H oFe~cnowi~ 1~1,_I~__._ +naP eecnaw n _ ~,- weae,u~~sa ~ l7,9298Q FT O ~~ : OY0.00 ! ! ' I I _____ ____-____- I I I ~ ! ! L (~ ~ S66.6,'S2'N, X60.6,' j a ~-~ i ~ ~ ~ --~ 9 I I ~ ~.~ u~ I I b ~. 9119 pCcl. !!C~ $ --- -- - -- I I I I - --------- ----~ II - . - . _ - . ` ---H9o~ II - . - . - L - - - - - - SHEETS nrs ~srnu~arr a~EO er r~awi ,bs wo. oo~m a~~ ~-nay -~ se oone~ eecnow n SCJILE IN FEET 1• ~ 100' t O 100 200 .~..~. STANL7ARp CHAMBER Quick4 Standard Chamber 510E VIEW MultiPort End Cap FRONT Vt£W 0.Y __ f y ,~ 1 ` ~..~_ __ SIDE VIEW Slm W x L x H) - % '`` '~r `3A" x ~2h x 12 `r'~ 'Sf Effective Length 49` fn Invert Height B• Fi~,~ITOR.$y_$jEMS ANC" ~YANUAgO LIMt7ED wARRaNT1( .et l ~ ti1r~,Clurat .1+!tt(;„V•i •M N.•r', il18, ()tl', (iY1 Ptpl~, wP'I~k GAd avn(rl RSIXy - I !+utKf IJy I I'll i ll i M,r>r, ;I IJ{IT~,OU .T w~ (dMYaleQ aY a k..M'Y,.flCkl n! an fi,ML10 rnfe'r 9Y6tWn m acrordancw wdl, erGit~etp'a N' , JcI u, n, k. nmt.~,hAf 1J Ir., u. "~+rW I•M,]layar i'I~IuMa 1 nHbl''~,' ciMtwtn<s .r:,:larces >ntl wtyrMm;r,grldr fuc ntr, yaar fvm IM date Thal the eefaw y>rNr~ d is'+s,",U 4" u," acUPc xYSU"n ,a ~'.4rlmq tlal Unha; ;;mvq.191Y, tr,warer, 1~, al " a ;optic lfetfrdl ." nd roau~,cd by aPDln:eilb law, Yq wr>,uny ymrK ri' pciir..>Iw u» Uato I. wl _ .,ndu;,or, d rna :ef+er'_ nYalpn cvnrnancos. Toe .A 48 war nniy ngny,. 1k14. a n>vu rwtrfy ht(A+ ,aW wnlirp a! ns .orl~prLMO +rwa r 'rn it < t .~ybrocJl. Gnr>n.x:tlcia .nH+41 falser r 1151 ;a ni the allgp,f JefeU N,Rhrakr wdl supldy relddc;~i'c- t writ„ i.„' Un~l< clelernvayU [ y k!GI ala Ic tR :WA:rfx1 Uy Yhi; lilYwbxl MAYIa'4Y. inryl alpr$ liabild) SPCriM1.:in4 ,:>tCartl@a ihp ct?6t Of nernC.a+ andlpl inslah4lan. 01 ryle ilrul>. u: ; t;r l,9,ETEC, wArl~cau~~ Atv6 RFMEDIC; mr Su;iPAr~AL;GUV'rt ta),y1?£ f:x(:1a;;;;vL 1 i d~tit AA{; hxi r3:iiF,,? WAitF?AIvT,ES Wtlh NESFrECT ;;> fi;r uN(f L~. I~N~JLWfNr;, rip tMPUEP WAI9RAMIL'S Ur MEACFiM!"n6ty1TY GIL fhNr;•,;;, i !.H. A PN1tiGULAR fUFPC+SL--. tr-_ FY~,„~ iJnrled Wun,y~,ly Slwtd be volt? d arty Pan ::f tYra t harnL>F+ aYStem r: niaR,t:a:lnrutl ;,y Yry'r •u OU1Fr Ih,p~ kHdk+leX 1ne LinUkid WarraNV clues ~., ¢'ru YI to a' tcleraa l rcrwxarraruial_ afasL.yal or erdreor tlTma(1us. xH~,hJmr 9naf not n" IcaLdp Gtr prlwh" ~ or rqunY'alua d'unapns rufuairq ka5.°. of I~, t L un nC V Cl1S id:or a:v' male.rd6, Orel!,ea(f ,O: L' W clhor qy RL'°. Or AY.(X3f'3.8+rICU:/sill I:Y 411E Fitl[1hr nr any ete:'f rN,IY :l(!tYJfl[a"y F' L YYn irrm i i, N.' VV:r-:r,ly C4verlyfr are dam~jll to iMl lJnil!i Ch"> W orW urry wea nn<t hy,r. i!t at rrr, arc~da.v, all5uye, 8l",au ar n.,Ntecr u1 Pw l h ets'. iw C6L?s c>~„r3 4R,Nrte,1 to •,e: x:k 1rtWw a Whal ~,urlaLp,rs vAVn mn na rye:, nII1M by v,r, ~n~l,ylalk"r t,r~,ua,u:.s, IaNuro le rnw a..;r, ,ne mm^nlrm ~rnur•~d ^,cvere~ ,al lmh !n the aKleeaYion n¢Vr+chlrfw; tha Ixawmmt N impraper ,,:alanel; ~,nlu the syetara tw,lan~rp hre Unhe. Wwe of ttla t Inds or the SCj1'Ir: :yRlnrY..:IJb to u,yyropr yilyl0 M imW'oper .awrra, oncu¢.ve wetM u.4,yp, ir'wrona Qrvea6a UWU,'wa. c eni,rocafr gyyratkin. a arty c.lLSx gvent nd t-:nrsuc hV frt~Wakn, 11x6 LlNtetl WanaMy N,"M tw vt>kt h Il,e HdcY:r tr+s rn aHngly w,N all ,>< l1g 1BnY19 eat torlh M the: L Wdta[1 JV,ir.,Lnv: r „~,mer, e; no e~elll ,n;;a h•,laf•alor he reapalelttle nv any l~;s a aaraaya w uw Hcllsr, ehe .~nils, Of any Ulire yi,7ty rexffl;,g (rent intarLiWnll ,x rsylip• ;Went n, from al,y 1mx7+;rt liaGlNy Ciaen8 r>1 Holder or am #kd ;Wiy, For Ihis lifnibxJ Wat'anly to aPp6r'. ttw tNldS nar5t be ingW-bd tt ah`o~ }yK~e w61r al! she cordltions rcrl:ureq try sla+e iV`n hraV coMCl ih ether 11fV1YWUlk burs. i/+tl h1JiIn8iM'~ i\S{aA~7tatq hrYINCb4r15 '~ 71 Pin r,liRl};p ~,Ia1N~ M hddlralor I•ea !.'1[, .'fl•IlUrdy In rharl~e q CY!f1r16 1rM^, ~,r:lldl Waira".y. hJJ wa niallY afrW'It5 to Rl,y iiartY lyhe' t11dn Iha p'I~. :la ~"JlLlar. -1r` a(5(rve rV('.'(>,SdnLS the ,`tl8.llii7ret''. hl Lled WiefarllV ~; IIIP.hi,i bl Ir,WIrG*A: A G11111r1(1 r"nTL:F 7f SlllbS :,nrf r^"u Vw2.'. IrIVe dlll(eeM wu:,anly ray,ae- ri,plttg M;y (iacnamr cx 14,d5 5lpuh] c:vercl etadrak""9 (:,vy,rale linxYUUaner6 m p_I S~,ytxt.J, Gt, rr[x;h;,lf, lxrrx tr, a,rlt t'+rMV,•V. io obtain a V.'Iry V' I'lu ArIPIiG'Ndu Wau'yhY. nr Kl _^vl"1'Jff) C.irelwy toad +ha,. Wu:''ra:lfy :it10/IL Ir"y t=ut:h;fS+•!.' ijr~IV TOP VtEvV 4a~>~omslnat ~~ecmca{~ons~.~~sr 8" or 1.25" SYSTEMS iNC :J EnvJron»~enhN Onslta Wul+nwtrr Soluticurr" G Business; Park Road • P.O. Box 768 Old Saybrook, CT 06475 860-577-7000 • FAX 860-57y-7601 800-221.4436 1:: f„tu115:41,gGr,;;-0?'C14t:S,t;,g,dBEi;G.~fU91t5,4G1,t16:S,n< t ~ ..,611 ,g3 6,7 EUi:,55r38?iB ~TilJ,8a.1 t'ir.~x~laly ~ dtnn s, l 329.4F9 ' (i04r564 y3theY paterl;s peluSu~y. IALI ul Epu31[Z8r r7flll Std6Wilk.4t, are rcylsleled'fadema!kS of Btftltr;agr St a l s Inc. 6q ulru rS ,, eyyst~e,1 Ira<I~rrrk in trance. fnlrh:atC! Systems irlf. ru r,, arryli ;+a,iatn3rk .n trlexd:o. %CNdour. CorMOVr Svnval Corx!e%t 9i 1. A4i r~?k naetmly I'v~rTvlt. :=,I r;~pLnck, :hr7rrilerS0~6cor. Pc~YLoek, GuickCul, C1uiCkPlav RECYCLED PAPfN secnoN vtcw POWYS OWNER'S MANUAL & MANAGEMENT PLAN ?age ~ of 1=r~E iNFOaMATioN ~~~k~~ ~s L ~ Owner' «r ~ h ~ ,~ Permit !/ Rq I/~ DEStGN pAIiAMETERS Number of Bedrooms ^ NA Number of Public Facility Units ____T~ NA Estimated flow (avaragei a da Design flow {peak}, {Estimated x 1.5i ~ d O ai/da Soil Application hate _ elide Jftt Standard Influent/Effluent auallty Monthly averapa" Fats, Oil & Grease (FOG) ~ s30 mgdL Biochemical Oxygr~n Demand ($OD~;i ~ 5220 mg/L ^ NA Total Suspended Solids iTSSi <_150 mglL Pretreated EfNuent Duality Monthly average Biochemical Oxygen pemand {<3pDei S30 mg1L Total Suspended Solids {TSSI <_30 mg/L DNA Face! Coliform (geometric mean) 510" cfu/1QOml Maximum Effluent Particle Size Y8 in dia. ^~NA Other: ^ NA ~~JRIl3eS typlGaf fOr dUYrfNStiG wastewater and septic tank effluent. MAINTENANCE SCHt:DULE SYSTEM SPEC~iCATiONS Septic Tank Capacity ~~S d al ^ NA Septic flank Manufacturer >~ ~ ~S~R~ ^ NA Effluent Filter Manufacturer ~a,,,tD ~~ O NA Effluent i=liter Model (-~ i,~D ^ NA Pump Tank Capacity g Q ~ ~ l~l ^ NA Pump Tank Manufacturer ~ ~~ Se R. ^ NA Pump Manufacturer ~, 0 ~1 ~ ~ ^ NA !'urnp Model ~PO~ ~ ^ NA Pretreatment Unit ^ SandlGravel Filter ^ Mechanical Aeration d Disinfection O Peat Filter ~ Wetland ©Other; A Dispersal Cellfat ~in•~3round (gravityi Q At-Grade ^ prip-Line ~~...~. ^ NA O In-Ground Ipressurizedi ^ Mound ^ Other: flihtlr: _ fdA fltYiw: , Other: ~A Service Event Service Frequency Inspect condition of tank{s} _.__ .___ ___ At Isast once ever y ~ monthts} ~ yearis) (Maximum 3 years) L7 NA Pump out contents of tankls} Whan combined sludge and scum equals one-third i'r;i of tank volume ^ NA inspect dispersal celllsi _ ~.,,, At least once every: `~ ^ monthis3 7R yearis) (Maximum 3 years) ^ NA Clean effluent fitter ---. ____ ~ At least once every; ~-~ . ^ monthisl ~yearia? C7 NA Inspect pump, pump controls & alarm ____ _ __ Flush laterals and pressure test __._ _ ~ _ _-- ~~ At !east once every: a~ At least once every: ,,.., __.,_.___.._..._~..___ ^monthts) [~yaar{sl G` month(s1 _ ^ year~si ___ ~iA ~A Otna-: ~~---~' At least once every: -- y '-"" Q monthlel T A~ Q y~{sl __ ~lA Other: CIA MAINTENANCE INSTRUCTIgNS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Masser Plumbe- Restricted Sewer; POWT5 Inspector, PDWTS Maintainer; Septage Servicing Operator.. Tank inspections must include a visual inspection of the tanklsl to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal eeilisi shall be visually inspected to check the effluent levets in the observation pipes and to check for any ponding of effluent on the ground surface. The panding of effluent vn the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. Wren the combined accumulation of sludge and scum in any tank equals one-third (Y~) or more of ;he tank volume, the entire contents of tho tank steal! be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurised components, pretreatment units, and any servicing at intervals of <_12 months, shall be perforrrred by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. 'epn~ enixB,3Siu~eupy uiSUO~s~M '(El'8 iZl '!l}1'9°B8 pua !;1'94plIL1f91!ZFZZ'E8 suwo,,axdaya yxln~ eau~i~dwu~ ui peye,p sere. iuewnaop s~y,~ _~ ~ ~~ -S euoyd AliaoHtnd ~aolvin~la 7d~o~ -~~ • auoyd ` 5 aweN ili3dWnd) >dOlVa3d0 0NI01Aa3S 3J111d3S a3NtV1NIVW $1MOd t3~111d1SNl S1MOd _ S1N3W WOO 1VNOtltdaV 3i91SSOdWt a0 11fTOl~dlQ 98 ,It/W kNdl d ~Q aOla31N; 3H1 w0?Jd NOSa3d lON oO~ N~JAXO 1N310 ~dflSNI~~IOdaNd S3SSt/D 1VH13~ NId1NQ~ /lt/W S Nbl 1N3W1d3a1 a H O aNVtdWl1d~011d38 < < ONINabM > > •au.u3 leyl le 1oa~}a u( saint ay1 yilM AidwoS isnw swals~ts yans;o suoilanJisuooeb •aoe}.ms an!1pJ1i!}u( ay1 le iewo(q eyl ;a (enawe~ Buinnopo; aoeid w pelonalsuooea eq Aew sul83sAs uo!ldJOSge pos apeJB-le pup punoW ~ 'S1MOd palls; ayi aoeidaJ of 3JasaJ ise{ e s ~tlei q ~eew ~{uex Bulpioy a aigel?ene s! ae,e luawaos!dsJ ou #I •®sJe luauueostdeJ a!geltns a aiaoo{ ai peu:,o;tad aq uo{iwn!ane axis pus {ids a S1MQd oyi ;o e,n!!s! ucd(f •ea,e iueuieas{d•J algei{ns a ti;l;uapi of peleniene ua iou se e=Is oyl ~~~~ 'S1Mfld pal1e~ ayi eae(deJ al isosa# ise~ a se pa((elsu( eq Aew ~luai Bu(pioy a /~Boiouyael S1PAOd ur seouenpe Buweg •suo!lel!wii icas Jo/pue Koegias of anp a~ge(!ene lou s! eaJe luaweoe(de~ a(gel(ns y 0 •aw?3 leyl is 30a;;a u! sa!nJ syl yl!nn A!duaoo isnw swalshs luawaaelda~{ •eeJe luewsoe(daJ e(gel-ns a yai!gelsa of uo(leniene e1(s pue i(as nneu a Jo} paeu ayl u! linsa~ p!nn eaJp 1uau.raoe!da, Ay1 loalad of eJniied •s!ienn pue sau!t iol 'aJnionJ3s pesodoJd pue t3ulls!xa woJ} s~ioegies pannbea ,~q uodn paBuiJ;u{ aq iou pinoys pue ua!loedwoa pus •ouaq.nls~p woi; pvioaioJd aq pjnoys eaJe 1uAweaelde, ey j •uiaisAs uoaidiosge {{os 1uau,aaeida, a }o uo{ieoo{ ayi Jo; pez{pin aq tisu~ pue paisn{ene ueaq say ea,e wewaoeltla, aigei!ns y :welsAs 1~aweaeidaJ iueiidwoo apod p ap(nad of 'ua~el eq isnw Jo 'ueaq aney samst:ew t3u!nnoiioj ay1 pa~iede; aq louueo pue siie; SiMOd ay3 }{ NVId JlaN3DNI1N00 •ie(aalew piios Uaui ~ayloue ao ieneJf3 'i!os ylinn pep!} weds pron ay3 pue penowaJ s~enoa #!ay3 Jo panowa~ pue polen.gaxa aq iieys s1!d pue s~iuel pe 't3u!dwnd ;a1}b ,oie,edp Buiain,ag aEeideg s nq ;o pasods{p ni,ado,d pus panowaJ ®q pays slid pue s~iuex pe jo siuoiuo:, ayl • •paieas sl3u!uado ad!d pauopuege syi pue palaeuuoos!p ®q (!eys si!d pue s~uei of 6wd?d ftd • :epa~ aniie~is(uiu#py u(suoas4M `£E'ES wwo~ ~aldeya ylinn eoue~(duaoo ui pauopuegs ~t(a~es pue ~l(~adold sr wais~ls ayi ley1 a;nsu! of ue~iel aq R(eys sdais t3u(nnopo~ ay3 eoin#as ;0 3no ua~ygl ~t~luauewaad si #o/pue s((et S1MOd 841 uayM 1N3WNOONV8IV 'aufJq JaUel}08 JaleM pue ;8uodwei ;su~Xdeu A,exrues :sapid{lsed :sionpo,d Sultu!ed :{~d :sua{ieaipau, :sdeJOS ioaw ;sap!a!q,ay :assa,6 :euitase6 :s8ulls~•d elgeieBan pue i~rt,} :,aienn !duJnd dwns) u{exp uo!iepunoj :te} :siueiav;u+s~p :s,ade{p :seai; i83uap ;s,aseeJBep ;sgenas uoiYaa ;swopuoo :sllnq ailaJa~B!o :sadina ngey :soiio!giiue ~S1MOd aye }o a}!i ayi 6uotaJd pue oouewao}tad ayi anoadu,l l~gw uJeaJie xeisnnelsenn ayi u;o,; Bu!nnoiiU} ayi }o uoileu{w!ie ao uailonped •ee.~e uoildaosge pos epeJt3-le r?o punow ~tue }o adols unnop lea; g t u(yl,nn ee~e ayi 'loeduloo Jo gxnis-p as(an;aylo Jo 'tend ~#ed ;o an(ip tau as •s((eo ~es.~ads(p pue s~(uel :and saiaiyan (Jed io ani.~p 1ou o0 '~us1 dwnd ayi uiyi!nn s!anai iewiou eJOisa; of sioaiuoo dwnd ayi. 6u!leJado ~tlienusu; w is!sse e1 Jau{elu!slry S1Mpd io J®quan{d a loeiuoa Jo dwnd luani}}e ay3 of Jannod Eiu{,ois®, ox ,o{,d ,ole,adp 6u{o!nJeg el}e;des a ~cq penow6J dual dulnd ayi la slueiuoo ayl aney uo+,lenxis siyi prone of •;ueni~}a ;o eB,eyos{p aae;Jns ,n dn~{oeq ayi u! i{nsa, h.ew pue fslllao ayi 9u!peoiigno 'asop eB,el auo ui (s)ped iesxatlsip ayi of pet3Jeyosip eq II?N+ Ja;eM®isenn ssaoxa a41 peJOisaJ si Jannod uayM •aianal ~te3eMy9!y !suJ~ou anoge It!; Aew s~iuei dusnd se6eino Jeenod t3u!mQ °aae}Jns an(la#3I(~u( ay3 1a uaza; aae suoj3ipuoo (tos uaynn moao lou ((eys do laels u-s3sAg •asn of idled Jolexado Bu!o(n;as e8eldas a /~q panowai (s(~(uei ay3 ~o slueluao ay1 aney paloelep ate suwlQ~luaauoo y6(y }i 'ts111ao Igs~ds!P e43 at3eu;ep Jo/pue seeded iuaw3esJ1 syi epadw! Aew leyi s!eoiu;ayi ;aylo JO slonpad Builuied ;o a3uesaJd ayi Jo} (s}~usl luew3paJ1 ~osyo 31Mpd 8yl ;o vsn o1 Joud 'uo!1onJisuoo nnau lob _ _ _ ;~ aa~d Nalvaaao oNV ~n seals FROM : SCHUh1A1tER PLL~ 1 NG FAX NO. :715386.3121 tang. 01 2006 1l : 46AM Pi 9T. CROlX COUN?Y SBPTIt^ TANK MAINT~NANGE Al3REBME.NT . Al+~p ~~ ow7vERSxIP c>ritTTFr~ATJTC~N >;~oRM (honer/Auyer -.__r_.___~ Mailing Adds ~ --' ~ ~ -`mo`w--LS-.-----~-~L~~.----~ . t/ PropcnY A tens ~ ._ / `` ~ t ~ ,~ s a .- w! s ~~(~5/__6 , - {VtnrGration *eyuirod from lrlat~ & hoeing Ilepsatrneat for new cauetruction j,:.~.. -- . _. City'State v w ~ -. _ _ _Parcel Ide~rification Number OZo - I ~fuo -0~f- ~~0 2~q ~ 1 1.EC Property Locdtiorv`w ~/. , $•~ !~, , ~. 1! , T ~ 9 N R,%~1v, Town of < a -v ~,. Subdivision ~f~~f~~F ~.P T ~,,,~, ._. , J,ot # ~_. c~rtlnea sgrv~y Msp ~ w..~__. ~----- .____.~ vo~t~me ~ __, Page # _----- Warrssety Reed # -~~ ~~+~ , Vpl~uma /~?_ 4' __, Page # 1~.. _ spec hdwte yes nu I,ot lines identifiable y~y~no SYSTEM MAINTENA,I~TCE A1VD UW~IY~R C~R'~,'~~~,ZN inspraper use and nsuntsnance of ynur septic system could restth in its hrtrrruurt: failwc to handle waytca. Proper tnaiutenatt~;e coas:sb of purt~fitrg out the septic tardc ~verY stoats years or 3oouttr, if ttrukd, by r licorteed pttruprr. What you put into nc~ system cart N(tect the furtctio» of the septic rank aS a troatmaN a~ in the wt<sre disposal system. Owner tnaintettan~.e respottsil+ilitiea arc specifted in §Counn. 83.52(11 std iu Chapter l2 - St. t:tvix County Sertitery U-dirtance. The property owttrr agrt>ra to submit ro St_ Cratx County ling dt Zanirtg Depatment a ctsnf' rcatior+ fonrti sinned t-y tl:e ,~~vnrr anti by a ttteSter ptumbet, ~outneytnan ~lunrixt, rectrit~d plttinber or s lieented pttmpet verifying that {!) tht o:t•stte wastrwates dtspotal system is in proper operating condition ttt~JOr (2) sAer inspr~tiou and ptutiping (ifetceesarv), the septic rack .s lesu th;ut 1:3 full of'sludge. Uwe, tht: trrtdraxigt>zd have read tl,z above mgrtuemetttc and arse to maintain the private sewage dispose! system with the standards se: forth, hett:ia, as sot by the bepartrrront otCor>mrerce and the Department of Nattual Rt~oruces, State of Wiscatuin. Certification sratieg tb.r your aeptie syrtem Iran brten ntsintaitted moat be eorrtpleted and retttraed to the St. Croat County Plertning qtr Zoning Depar tmer,t within 30 days of the three year expMttion date. li we certify than all startsntents oA this furrti ere true to the beet of my+aur t:nowledge. Litre arn/are thr ownert.l oi' -hr property described above, by virttu of a warrbmy deed teeaided ~ itegtater of I?eeda Uffice. Nuegber f bedroo ~ __ _ __ _ SI A1'URE OF APPLICANT(S) ~.Z!_~, 17ArF ••~`Any ntfutmstion that iR tnisrepteaenttd may rewlt in the sanitary pmmir being ttvoled by the Planning do lonirg Aerartrnent, ~ °• it-cludt with this application a rerorded warranty deed from the Itegi,tter of Deeds Uffice and a copy of the rrrtitie4' nut ~~ey ttt<-p if releretrce ix rtx-dC in site warranty deed. (REV. 08/t18 ~ ~~?~~r~ 1s~ STATE 8AR OF WISCONSIN FORM 2 - 1982 WARRANTY DEED ' DOCUMENT NO. TCprnnn T Ract anr3 i)r,nalrl -T ~peoy Ra4t conveys and warrants to _JQhn J. _ ~}~ Kc~th~yn~. 'Whitegon (ht,Gl,anra an$_ w, fe] -- - 6 8 3 6 8 6 I{ATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO. , MI RECEIVED FOR RECORD 07-09-2002 8:30 Alt HARRAt(TY HEED EXERT is REC FEE: 11.00 TRANS FEE: 236.70 COPY FEE: CERT COPY FEE: PAGES: 1 THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN AOOR ESS the following described real estate in ~ St. Croix County, ~F~G State oC Wisconsin: Lot #4 Plat of Hopkins Estates in the Town o Hudson, St. Croix County, Wisconsin o~n-anl~_RO-nnn PARCEL IQE'NTIFICATION NUMBER ~~ ` ~ . )' !, r. r~ This homestead property. (LS) 3 Exception to warranties: EaSement5, restrictions and rights-of-way of record, i_f any. •- Signature(s) _ day of AUTHENTICATION t ' Jul .A.D.,,j9/2002 `'~ v ;l CSEAL) 1,.~.. „ ~' ; , (SEAL) ' Donalda J. -'S g~x'j$ast _ -,_ (SEAL) (SEAL} authenticated this day of 19 Tll'LL-: MCMBCR STAY[ 8AR OF WISCONSIN (If not, authorized by §706.06. Wis. StatsJ THIS INSTRUMENT WAS ppAFTED BY Kernon J. Bast (Signatures may be authenticated or acknowledged. Both are not necessary.) ~j 'Names of persons signing in any apaeity should by typed or printed below (heir signatures. ~~~ - III STATC• OAR OF \VISCON$IN3fC~dra ~. Burks WARRANTY DEED ~xonsin Laga1 Blank Co.. Inc. - Form No. 2 - 1982 MNwat/c~ wq ACKNOWLEDGMENT State of Wisconsin, lI } ss. t _ rp i ,r County 111 Persona[!y came before me [his 8th day of July , ]t(j/ 2 0 Q t3,e above named _ Kernon J_.__Bast and Donalda J. _SAaPr-Rant to me known to be the person~___ who executed the foregoing instrument and acknowledge the same. 1 Notary Public, County, Wis. My commi Ion is permanent. (If not, state expiration date: ~~~~~.~ubflc , 19 n _ _ ~i~ ~~ Q 3 ~= III N <wQ Lj 7/I a-A 1/l 01^F W 3 .~/t R~ 014-i a/c a e a~a-s _wlt/1 K or .~vs/I K a . ~~a ~_ ? ~~ i. n 0 II t ii 1~ r ~~ ~ 1 • ` 1 i I ~ ` u- ` ~ it _ r'~ -~ >~ i, ~, >s~ ~ r 4 a~i ~ \ .i~ / iii ~.1 ~~ ~ ~ , ~ ~I ® 3 1 n I ~, ~ .~ ~ i ar 1 .r/~ F~ 1 s^. qS ~ I ~ •~ ,,r ~~ ` ~ I \ • I ~ P 1 1 ~ / ~C/t -.tl '. ~~+ 1 1 ~ ~ ~ " p-.o--L--L J ~ ~ '~ e : ~ `'`~ i ~ ~ --- ~ • ~ ` = ~ ~ • ` ? i ~ . ~ -g r r e~ g •, 1 1 1 ~~ e ~~ ~ ~.~ •• 11 v ~ is ~ CII ~ ~ ~~ ~ ~d T tt ~__~~ 1 ws 1 . ~ ~ . ~ - ~ a.,l~ ~" ° a ~~„ gg • •ti n ~ a \ ; LO t 1~ ~ , , d (7M0-illy! p 1 .c/~ sr a..uv.~ .Tf l r .!I/c rur vrs _~ .di a-.t~ - - sn a-s~ 4 ~ .t/L O ~ 01~^L .M~rf/1 R a -~ ~_ ~~, I _. ~l~J`) ~+ ~./1 \~~V 'V [~ MAP OF' ~NER V WITEGON LOT 4 OF THE PLAT OF KINNEY RD HUDSON, ST. CROIX CCSON, WI 54016 IRVEYOR SIN FLANUM p~tHLAND SURVEYING, INC. ~; HWY "65" =RTS, WI 54023 ~ NE 715-749-1718 LEGEND O 1" X 24" IRON PIPE SET WEIGHING 1.13 LBS. PER LINEAR FOOT ~ 1" IRON PIPE FOUND 12' UTILITY EASEMENT • • • • 50' ROADWAY SETBACK CURVE DATA TABLE NUMBER C1 RADIUS 233.00' CENTRAL ANGLE 26°27'50" CHORD BEARING N62°40'23"E CHORD LENGTH 106.66' ARC LENGTH 107.62' SCALE IN FEET 1" = 100' Wisconsin Land O 100 200 above described and by me or under my map Is a correct JOB NO. 02-83 oundarles to the best DATE: 11-20-02 ~- COUNTY PLAT OF: '~ HOPKINS ESTATES LOCATED IN PART OF THE SW1/4 OF THE SE1/4 OF SECTION 11, T29N, R19W, TOWN ~ I OF HUDSON, ST. CROIX COUNTY, WISCONSIN; BEING LOT 2 OF A CERTIFIED SURVEY MAP RECORDED IN VOLUME 15, PAGE 4098 AT THE ST. CRODC COUNTY REGISTER OF I DEEDS OFFICE. I I ~ I ~-- - ° ° _ ___ __ ° 0 0 M~PL~,C^1~?4CD___6Q1~~ TOP OF7'NgNPPE ~ v~=S`- UNE OF THE SW7140E THE SE11a OF SECTION 11 p~~~d ~a b°_9990-_P(~o ~ __ - --' wIOTH -___ __ _ FENCE 1St/-3017TH U$.O.S. DATUM OF IB®~ I I _ FENCE 2+/- SOURI OF LOT ~~ ELEVATON ~ 91538 I-- ~ IDT CORNEA S89°55'S0'E 1287.14' aTZar sa.or ~'n FENCE e'+l-SOUTH ~ I I OFt1[TCOw+ER i PI -- lao I ~' l I 7 R H.W.L = i .. .2.08 ACRES .~. 1 O 88450 ~ ~ ~ ~ i ~ ~ i ~ 89.741 SD. FT. ~ 3.13 ACRES ~ 2.03 ACRES I I ~ ~ .BUILDING ~_ 736,185 SQ. FT. 88433 SO. FT. p . = 897A 8i `~ ! I I MIN.B ~ - _~ ELEV. I I `~ ? I w rurzeKSwaoasr ...............~...............: i ~ I € ezr Ne 1 ~ ~ _ + i p' i w 0 2.58 ACRES $ $ (~ I 172.607 SO. Fi. ~ ` ~ ! __ _ _._._._._._. ._. _ ._._._._._._._._., ~; ' I ~ I MIN. BUILDING '~ 10 ~ !~ '~-'~ _ ! ~: ELEV. =88250 ~ • ` ~ .................... I N~ I I I 1. F p MIN. BULDING ~•~iJ' / / I ! •V' ELEV. =882.60 i ~ ~ ~Q ~ ' I I 2 - ' 2 H.W.L = ~- 140 ~ 1 _ % ice' ~-• i p ,,//[[ [A ~ 3.16 ACRES 893.OD p I I `~'\ j ~ ~ ~.~ SL 137,561 SO. Ff. ~ ~ I "/ MIN. BUILDING I p i I I I. / ~ ELEV. = 895A ~ , LAC I ~ H.W.L = ~ ~ 3 ~ i ~ I ~ ~ ` 88050 _ / 2.84 ACRES i I i r _ _ _ _ -"~ ~ / 723.518 SO. Ff. p i i ~ MIN. BUILDIN(' I 7' • • ..... ... _ - -'"-~ ~ i ELEV = a995o NBD'S13TE5W M• .~ ~ ~ /.-. - H.W.L. = 1 I ~• a 2.00 ACRES :; ' m~ 89750 ~ 87.323 SO Ff - H.W.L = ! I ~ BUBDING _ _ _ _ _ I ~Fl. =88750 ~ J ~ . ~ ~ \ MIN. BlNt1NNG I .. ELEV. =895.0 ! I LS .. .... I I MIN. BUILDING ~ ! - i I ai. $ ~~~= ELEV. a 5~ ~ 2 ~4 m 389°51'32'W 359.81' I I z ~ ~ 1 G. Fr. ~ P,, ~ ~ ~ i i ~ ~ a lJ .. 93,85050. Ff. EiFV.BU88550 a EXISTING DPoVEJ I I N d04 9 m ~ c~~o~o oa , I ~ ~ m C~1° 9 Q, PO° -QC~ I i _-_ H.w.L = c I I i ... e635o o S FENCE ox+/- sOlrrH 7p I of uTr CORNER ~~. .o9.lr ~------------- S89°81'321N 972.23' FENCEZ+I-soDrH I I i. NORTH UNE OF 7HE SOUTH 198 FEET OF THE SW1N OFTHE SEtI. OF SECTION 11 OF 1.0T COFNE/1 I r draaaa~~~--n~o~ ~ ~~ ~ m p_caac~ca oa_ne_9~a5_a~e_o~~ ~ ~ I M B ~SOUM UNE OF 711E SEl/° OF SECTION 11 _- -- -_ _. _~ ~ - ~. f N99'S13TEBal5.T8 t UDDTY FASBAENTS NO POLE DA eIXiED CABLES ARE TO BE PUCED SUCH THAT THE 115fALUT10N WgIAD pS(UfiBANY Si.RVEY SfA/~ OR OBSD1l1Cf NSION NDND ANY Ulf LkJE aA STREET UNE THE pSRXIBAFILE OF A SDRVEY SfN(E BY ANYONE ISA MOUTON OF SECTION 7JS32 OF WISCON9N $iATUIES. Uf1UIY EASEMENTS AS HERBN SET FORM ME FpiTHE 115E OF - PUBLIC 80pE5 AND PT4VATE Pl1BlX: Iff1UDE5 HANNG THE RIOMf TO SERVE TMEARFA EACH PARCEL SHOWN ON iH$ MAP (FIAT) IS SUBJECT TO STATE COVNTY AMI7UMSHP UWS, RULES ANO REODUTIOFLS P.E. WETUNCS, MNMUM U]T 9ZE. ACCESS TO PARCEL ETC). BEFORE PURCHASING qi OEVEIDRNO ANY PARCEL OF UT1D CONTACT 7FIE 5T. CROp COUHI`r ZONPX3 OFFICE AHD APRiOPfVATE TOMS BCW D FOiI ADJICE NOTE: Np pMJFA OR PF90EF7T SW V1 DO NMMNG WyJCN WOULD INTERFERE WfM OR CHANGETNE OPEAATgN OP THE APNiOVED COMPREHENSAIE WATER ORAbJAOE AND 901E EROSION PLAN FOR T/16 PUT. THLS INCWDES BUT IS NOT UMDED TO BUIIDNG 11P011, OBSD{1CTING ALTERMG FSJJNG, OR ETfCAVATSJG OR PUNf5i6 N ANY PDND EASEMENTS, WATER DiWNAGE 0(fCHE3, WATER RUNWAYS. WAT81 WLVERiS. BEFIMS Ofi GRASS 5EIDRIGS. SHEET ~ OF 2 SH EETS THIS INSTRUMENT DRAFTED BV MICHAEL ERICKSON JOB NO.00-07 OATS: 573-02