HomeMy WebLinkAbout026-1025-40-080 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
572881 0
GENERAL INFORMATION (ATTACH TO PERMIT) 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:
Oevering Homes LLC, aka Oevering Propertie Richmond, Town of 026-1025-40-080
CST BM Elev: Insp.BM Elev: IBM Description: ,,pp Section/Town/Range/Map No:
'f Ok S1 1Q 100.� °l 2• I 't7 CTr r� \ @ (C � 07.30.18.100A 08
TANK INFORMATION • �j .5 �J ELEVATIJ DATA
TYPE MANUFAC URER\ '
� - CAPACITY STATION BS HI FS ELEV.
b
Septic Benchmark
V' -Fc,v-ff— 1b0 0 - ` e y H. g °itoq tt�� p92 . /
__ Alt. BM . V 95 .�
F`
Dosing . E R kb g o� f-�undcdiclr�' 65
Aeration Bldg. ewer 5.9 I I , C)
Helding St/Ht Inlet -1 10 89.
St/Ht Outlet / /
TANK SETBACK INFORMATION l0
TANK TO n6/L WELL BLDG. Vent to Air Intake ROAD Dt Fnlet
Septic l l ' N/A 2(6' 6v ) \bb' Dotf6— - - -
Wi g, (�1 t$Header/Man. --ri U C2 9 2_
Aeration- Dist.Pipe u 71 B5 2
1.g7.ct $9'fr89•e
f-iclding -------- Bot.System M L g.-1,0-$$ 8.9 5 Ms. e N.b
Final Grade , L
PUMP/SIPHON INFORMATION J .5 �g -T
Manufactu - Dema • St Cover \ '1/ + _D c15. J
2
Mo•el Number f l
\--- /
TB H 'Lift Friction L SysteriN ead TDH Ft
Fo •-mai r ength Dia. Dist.to Well <-____________,
SOIL ABSORPTION SYSTEM
BED/TRENCH Width 5 I 'Length 1 (4 1Liquid
, No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Depth
DIMENSIONS
SETBACK SYSTEM TO W es+ BLDG WELL LAKE/STREAM LEACHING OR 't7 Manufacturer: I fit.I bees r_
INFORMATION CHAMBER
Type Of System: UNIT Model Number:
Cori Will %n 5u 5-1 N JA A tw;ck_ y • st• ?c u S
DISTRIBUTION SYSTEM
Header/Manifold 1 I I ifold Distribution x Hole Size x Hole Spacing Vent to Air Intake
Q Length � , Dia _I Length ' Dia Spacing - W L ST_ (,rl CIJ,
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over 1 Depth Over xx Depth of xx Seeded/Sodded xx Mulched
Bed/Trench Center v 1 ' J Bed/Trench Ws Tepseif
—I - Yes No � Yes El No
COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / / Inspection#2: / /
Location: 944 165th Aver New Richmond,WI 54017(NW 1/4 SE 1/4 7 T3ON R18W) Ninety Fifth Street Site Lot 3 Parcel No: 07.30.18.100A 08
1.)Alt BM Description= l � 0J�- nn
2.)Bldg sewer length= ' S�'� ��� (�r��nS � �dL�S
-amount of cover= 2.g 1I ��, 1 ',1 {�`� 1 @ fi Mp U� t nS Pt(---h^v
Plan revision Required? Yes 0, No I� ��/ A---. .._'
/;rJ,�/^Use other side for additional information. �J
Date fr IV nsepctor's Signature Cert.No.
SBD-6710(R.3/97)
PLOT PLAN
PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
NW 1/4 SE 1/4S 7 /T 30 N/R 18 W TOWN Richmond COUNTY ST.CROIX
SYSTEM ELEVATION 89.5/88.9 5' below grade 3/10/15 3
BEDROOM
DATE
CONVENTIONAL XX 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 chambers 'R"' z YJ
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' Scale = 1 /4" = 10
of tank,piping shall be Schedule 40.
Vent
>6" Quick4 Standard
of Cover Leaching Chamber
with 20.0 ft2 of Area
5.6ft^2/pair of end caps
4' Long 12"
P3 34„
Grade at System Elevation
:edroom
House
30' it
ST,
295'
Property 94.5' 20'
Line
10' 92.5'
1
B-3
90' /I
2-3' X 94'
cells with>3'
spacing /@ /', /
p g 4 �� , 7% Slope
B-2 , 45' B-1
40' Vents ,
B.M.
50' 95th St.
�r y" County 4T C
i f '` Safety and Buildings Division /�
! ' 110, i U iU I J 201 W.Washington Ave.,P.O.Box 7162 Sanitary Permit Number(to be filled in by Co.)
vo;� i Madison,WI 53707-7162
yf iD COUNTY YPENT 5 -72 4$ '/
Sanitary Permit Application State Transaction
umber
In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to the appropriate governmental unit
is required prior to obtaining a sanitary permit. Note:Application forms for state-owned POWTS are submitted toiject o Address(if different than mailing address)
the Department of Safety and Professional Servies. Personal information you provide may be used for secondary
purposes in accordance with the Privacy Law,s.15.04(1)(m),Stats. �� /5•5/1/11,-e-'/5•5/1/11,-e-'I. Application Information-Please Print All In rm
Property Owner's Name Parcel#
Oe oP ci■IA 14,--e. W e/002r— *-0eW
Property Owner's Mailing ess Property Location
/ (/040 /�'" b'' J/i 3 3 t),P/iu)G/a £ SCcd /7
Govt.Lot
City,State !/ /, Zip Code / Phone Number ,t .‹. y4.y Section
l2ll!/2L 1(/1 )( 7 -� e one
II.Type of Building(check all that appl L t# T3C� N; R EV/
r 2 Family Dwelling-Number of Bedroo }} Subdivision Name
Ok• OA Svb m,
- lock��.."...-
❑Public/Commercial-Describe Use 61 6 v-5.e. (1 iet✓�
/ .-
❑City of
❑State Owned-Describe Use CSM Number ❑Village of f
/ own of /2/
Z. Q Sk• ( L� w l z 3 •EZ 3 G,...-,,. ifs c / iji !r
III.Type of Permit: (Check only one box on line A. Complete line B if applies 2 3"-a_
A.
stem ❑Replacement System ❑Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System(explain)
B. ❑Permit Renewal ❑Permit Revision ❑Change of Plumber List Previous Permit Number and Date Issued
❑Permit Transfer to New
Before Expiration Owner -j- ç.`'' jse--4•a,l 00.e.-, 21
IV.Type of POWTS System/Component/Device: (Check all that apply) ��-a A.`d�c c P/✓
on-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grade ❑Mound>24 in.of suitable soil ❑Mound<24 in.of suitable soil(1,-----10 e rs
❑Holding Tank ❑Other Dispersal Component(explain) ❑Pretreatment Device(explain) �n .
V.Dispersal/Treat ent Area Information: S-/ rt/)�c�/�•e/
Design Flow(gpd)J Design Soil Application Rat gpdsf) Dispersal Area Required fsfl Dispersal Area Proposed(sf) System Elevatf
�/-� 2 . -. 9vv 5'3 0 2 r., g a.f
VI.Tank Info Capacity in Total #of Manufacturer
}?
Gallons Gallons Units a °w' o 2
New Tanks Existing Tanks `'tl o y 0 °' m
g w gt4 F[ -e -- a y g 'u:3 A.Septic or Holding Tank L ALA__.: //
-Dosing Chamber /
VII.Responsibility State nt-I,the undersigned,assu, • esponsibility for installation of the POWTS shown on the attached plans.
Plumf's Name(Print) Plumbe'.; afore MP/MPRS Number Business Phone Nu ber
4,, ��, / 2Z6/v-0 7/f 17'
lumber's Address(Street,City,State,Zip Code),
/93 Z /20/e 5/. /164 , ' .c , /'7
VIII unty/Department Use Only
Permit Fee Date Issu d Issuing nt Signature
proved ❑ ► approv-4 J
❑ 1.; wen Reason for Denial $ 4175 -co 3/i'eo /5-
IX.Conditfilni£alptiBMN easons for Disapproval 3\ 4d, 'A?,,ota L. f Co J' ew `t �-%,,.G(�
1." Septic tank,effluent filter and J t rM0.�
dispersal cell must all be services/mainta`ine�( l,�,;1 '�" t_,,s�.A,✓nr 2 "
. as per management plan provided by plumber. )
2. as t setback requirements mustlae#ftaintained, y}) ,V__ 5-6 � - 44.£,ix,per pplicable'code/ordinances. '�/
/Attach to complete plans for the system and submit to the County only on paper not less than 8 1n x 11 inches in size
SBD-6398(R. 11/11)
Cover Page
g
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 3/10/15
Owner: Oevering Homes
Location: NW 1/4 SE 1/4 S7 T30N,R18 944 165th Ave Richmond
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 Specifications : eet
j
Signature
r
License numb: 26900
PLOT PLAN
PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
NW 1/4 SE 1/4S 7 /T 30 N/R 18 W TOWN Richmond COUNTY ST.CROIX
SYSTEM ELEVATION 89.5/88.9 5' below grade 3/10/15 3
BEDROOM
DATE
CONVENTIONAL XX 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 chambers '&`"
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' Scale = 1 /4" = 1 0'
of tank,piping shall be Schedule 40.
apVent
>6" Quick4 Standard
of Cover Leaching Chamber
with 20.0 ft2 of Area
5.6ft^2/pair of end caps
4' Long
Grade at System Elevation
Pro 3 34"
Bedroom
House
30'
ST,
295'
Property 94.5' 20'
Line
10' 92.5'
B-3
90'
2-3' X 94'
cells with>3'
spacing 7% Slope
•
B-2 1 45' B-1
•
40, Vents
B.M.
50' 95th St.
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 94.9'
ap Vent i Grade 41e. 40 Vent
3' 4" 3'
■ 30/34 Septic Tank
Oft5' Long 1„ 5' 5' Long
3 6” 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
23 chambers per cell
System elevations:
A_89.5'
B 88.9'
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of
FILE INFORMATION • SYSTEM SPECIFICATIONS
/444 Tank Manufacturer. ��T� ❑ NA
Owner �o vP_/I/i�
Permit# _33 ptic ❑ Dose ❑ Holding Voium� ) (gal)
Tank Manufacturer: NA
•DESIGN PARAMETERS .
• Number of Bedrooms: ❑ NA ❑ Septic ❑ Dose ❑ Holding Volume: (gal)
Number of Public Facility Units: ANA Vertical Distance Tank Bottom(s)to Service Pad:/, ��(ft)
Estimated(average)Flow: ACV (gal/day)
Horizontal Distance Tank(s)to Service Pad: ®i/ (ft)
Specific servicing mechanics must be provided if vertical is>15 feet or
Design(peak)Flow=(estimated x 1.5): ,4.1.1..) (gal/day) if horizontal is>150 feet. Specific instructions to be provided on back.
In Situ Soil Application Rate: yam_(gailday/ft2) Effluent Filter Manufacturer: /J 's--73 p NA
1 Standard(Domestic)Influent/Effluent Monthly average Effluent Filter Model:
Fats,Oil&Grease (FOG) s30.mg/L Pump Manufacturer:
Biochemical Oxygen Demand (BODO) 270 mg/L ❑ NA - 3'144-
Total Suspended Solids(TSS) 1150 mg/L Pump Model:
High Strength Influent/Effluent Monthly average Pretreatment Unit
(FOG) >30 mg/L Manufacturer.
(BODs) >220 mg/L ❑Mechanical Aeration ❑Peat Filter Is Its-
(TSS) >150 mg/L
❑Disinfection ❑Wetland
Pretreated Effluent Monthly average ❑Sand/Gravel Fitter ❑Other.
(BOD5) s30 rng/t Soil Absorption System
(TSS) , 530 mg/L A (gravity) ❑In-Ground(pressure) ❑ NA
m(geometric mean) 51 Q Mound
Fecal Colifor (9 ) At-Grade ❑
Maximum Effluent Particle Size 'ry in dia. ❑ NA ❑Drip-Line ❑Other:
Other. >rkp.. Other:
NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
7--.',441 en combined sludge and scum equals one-third(Y,)of tank volume
Pump out contents of tank(s) '0 When the high water alarm is activated
Inspect condition of tank(s) At least once every: 5;0 month(s) (Maximum 3 years) ❑ NA
ar(s)
At least once ev ❑month(s) (Maximum 3 years) ❑ NA
Inspect dispersal cell(s) �' par(s)
onth(s) ❑ NA
Clean effluent filter At least once every: / tear(s)
❑month(s) NA
Inspect pump,pump controls alarm At least once every: ❑year(s)
❑month(s) ❑ NA
Flush laterals and pressure test At least once every:. ❑year(s)
Other: At least once every: ❑month(s) NA
❑year(s)
Other: 0 NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and soil 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 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 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 (th)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 55.12 months,shall be performed by a certified POWTS Maintainer.
A service report shall 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 roduds, solvents or other
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting p
chemicals or sediment that may impede removed treatment process aServicing d/ d damage. h(pumper)absorption
use If high concentrations are
detected have the contents of tank(s) under these
Pump tanks may fill above normal s theex�wastewater Will be discharged to the failures.ol absorption systemt n one large dose causing an
overload is not recommended,
overload that may result in the backup or surface discharge of effluent and damage o restoring r to the p avoid p this
or contact a Plumber
contents of the pump tank removed by a Septage Servicing Operator(pumper)P
9
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. d the
Do not drive or park vehicles over tanks or the soil absorption system. Do not drive or park over, or otherwise disturb or compact,
area within 15 feet down slope of any mound or at-grade soil absorption area.
tanks Reduction soil it elimination pti of system:em:acids,from antibiotics,wastewater by wipes, igarette butts the
condoms performance
`�on swabs, degreasers,the float
tanks and soil absorption system acids, eases, herbicides, meat
diapers, disinfectants, fats, foundation drain (sump pump) discharge, fruit and vegetable peelings, gasoline, greases,
scraps,medications,oils,painting products,pesticides,sanijA 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 properly
and safely abandoned in compliance with s. Comm 83.33,Wisconsin Administrative Code: openings sealed.
• All piping to tanks,pits and other soil absorption systems shall be disconnected and the abandoned pip e
• The contents of all tanks and pits shall be removed and properly disposed of by a Septa a Servicing Operator(pumper).
P PAY Ps Y 9
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil,
gravel or another inert solid material.
CONTINGENCY PLAN a code compliant
If the POWTS fails and cannot be repaired the following measures have been or must be taken, to p
replacement system:
suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system.
ee replacement sfr and should
roposed structure,from
lines and wells. Failure a to protect the replacement areag�l by
the need
setbacks from existing P with the rules in
for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply
effect at the time of their permit issuance.
❑ A suitable replacement area is not available due to setback holding tank may limitations. If the
installed as a last absorption system cannot be
rehabilitated and barring advances in POWTS technology, g Upon failure of the POWTS a soil and site evaluation
❑ The site has not been evaluated to identify a suitable replacement area.
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 s absorption n�s�m systems May be reconstructed thtr rced in effect afollo following removal of the biomat at the infiltrative
surface. Reconstructions
WARNING TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK
n*„..t
SUFFICIENT OXYGEN OR RESCUE LIFE. EVER
OFRA ANY TANK TANK MAY NOT STANCE. DEATH MAY
OT BE POSSIBLE
RESULT. ESCAPE
-r
ADDITIONAL INSTRUCTIONS:
POWTS INSTALLER POWTS MAINTAINER ' .
Name ' � 3
��� / Phone .7/d'—o2
Phone r7/�f". .d-/. –C�
SEPTAGE SERVICING OPERATOR(P PER)
LOCAL REGULATORY AUTHORITY ■
Name j/J2 ?�, /
Phone "7/,j— o C7 °
Phone � /.�= ',2)2/_/ -y,-z)
This document was drafted by the staffs et the Green Lake, Marquette and Waushara County POWTS regulatory agencies in compliance with sections
Comm 83.22(2)(b)(1)(d)&(f)and 83.54(1),(2)&(3),Wisconsin Administrative Code.
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer_ r, j( z .
f
Mailing Address/'5 3 �e s 4 - u�tee fi
ecie6/
Property Address
(Verification required from Planning&Zoning Dep t for new construction.)
City/State, _.-_._.___.__.�__ Parcel Identification Number �� G -
LEGAL DESCRIPTION
Property Location . /n , $ %a, Sec. 7 30 // Q
N Rl_U W Town of 2/
Subdivision _
-__ -- _—, Lot
Certified Survey Map#______
---- `Volume/ l g
_ _____, Page# 779'3
93
Warranty Deed#
•
_ - ---.___ __ _, Volume _ , Page#
Spec house CP no
Lot lines identifiable
no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three years or sooner,if needed,by a licensed u p
the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Ownermaintenanceou put into
responsibilities are specified in§Comte.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,
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 he septic tank n by the
less than 1/3 full of sludge. P P g(if'necessary), the septic tank is
Ifwe,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 Depariznent 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 Coun Pl
Zoning Department within 30 days of the three year expiration date, h' arming&
I/we certify that all statements on this form re true to the best of my/our knowledge. I/we am/are the owner(s)of the
property described above,by virtue of a warranty d d recorded in Register of Deeds Office.
_____3
Number of bedrooms
IGNAT OF APPLICANT(S) _ _A.-�_1---
DAT. ,
***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning&Zoning Department. ***
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed.
(REV.08/05)
,otir
4CARTRIDGE STRiITIJS
FILTER
77
Installation
STEP 2 Dry fit the filter case onto the end of the outlet pipe to ensure it is
centered under the access opening. If not, th additional er insert
a pipe onto the outlet the
tank through the outlet or solvent weld (glue)
pipe.
STEP 2 While the case is still dry fitted on the outlet pipe,
measure the length
of 3i4-inch pipe needed to brace the filter to the tank end wall if utilizing the
optional supplemental side support. If side support method is not utilized,
proceed to step four.
STEP 3 For installations utilizing the optional supplemental side support " , Syr
solvent weld the 3/4-inch pipe onto the filter case. If side support method is not +4�
utilized, proceed to step four.
��
STEP 4 Solvent weld the filter case onto the outlet pipe. Insert the filter
� �
cartridge into the case, pressing down until the filter locks into the bottom of
the case.
STEP 5 If a VRS switch is utilized: insert into the filter and lock by turning
clockwise 90°.
Maintenance
time the septic tank is 4 - t :-
1. The effluent filter should be cleaned every *.� � �,,� i,
serviced. '; � ,
2. Open the outlet access opening to inspect the tank and filter.
3. Pump the septic tank completely, making sure to remove the sludge gr
layer on the bottom of the tank and not just the scum and effluent. , '
4. Once the effluent level has been lowered below the invert of the
outlet pipe, firmly pull up on the filter handle to dislodge theq
cartridge from the case. k �"E F,
5. Slide the cartridge up and out of the case for cleaning. r,<-,; >
6. If a VRS switch connected to an alarm is present, the switch 8:!• 'y
should be removed by turning counterclockwise 90° and cleaned
with water only.
7. While holding the cartridge on its side (large flat surface facing °x
down) over the access opening, rinse off the cartridge with water ,; L '. + {,u
t
only making sure all septage material is rinsed back into the tank. � � , `•
8. If VRS switch is utilized, replace by inserting into filter and
b !� `
turning clockwise 90°. �e
9, Insert the filter cartridge back into the case, pressing down until ��
the filter locks into the bottom of the case. ..m Y , , .,-., t,.
10.Replace and secure the access opening on the tank.
BEAR ONSITE''FILTER CARTRIDGE-FIVE-YEAR LIMITED WARRANTY ... _ .._...
BEAR ONSITE'"Filter Case-Lifet,me Limited Wa anty
i 'R5t
e
- f n la oa 3'3' ' t '^
S'':01! i ) ill 6 c E x
�
t* a r n � i i'wf ' 1 b o-' x u y
. ✓
z t * .. , a rt.. ..
•
'. . It)04,
�9Era 1e:
■
VOL 19 PAGE 4992
KAT/MEER H. WALSH
CERTIFIED SURVEY MAP ST CRO X CO.DEEDS
WI
RECEIVED FOR RECORD
Located in port of the Northwest Quarter of the Southeast Quarter of Section 7,6/06/2005 04:30PR
Township 30 North, Range 18 West. Town of Richmond, St. Croix County, Wisconsin.
CERTIFIED SURVEY RAP
NQ47N 7/4 CORNER REC FEE: 13.00
SEC. 7 ao-Ja COPY FEE: 3.00
RECEIVED (FOUND 3/4-/RON RERUN PAGES: 2
/ 2
It N -°-, UNPLATTED LANDS OF OWNER
APR 2 4 MN 1 a0 N
�1 L EAST-HEST 1/4 LN4E
CRE1a �"'� N89'37'47"E 297.32'
,LIFIL Oc g •
I-/ ` i i 2 64.50' m
c ry --1 z 1 t • 1 .4• a E ° f ° `' 32.82' 2 c&3
`5_ 'A-
' A = 0 g 33 LOT 1 m8
8 n o ° : �, w w I TOTAL AREA: v+ C ace m
,5 m o a1 0100 97,959 SQ. FT. o cn v z
o m w "' •'c do .C":"' 2;25 ACRES °° o
$ "7-1 'N AREA EXC. R-O-W: ' ^j -1 S �.,
�+ a a 87 285 SQ. FT. Na iM '
a z 2,00 ACRES t,, p °m c`^��
��3 m n -,
n s ' °o foaoD' NO TH c
wb B s zo iN r�— W 29 .37 • C7 z�m
a ' a c. 1 Iw . i� Y 64.50' ! t 4.1)
$8z
-, N Z `� YE ' O ?
$ n^03 C p' 31.87' s6'.XJYNT DR/ AY u-
7• o A 'V N EASEMENT 4 O Z 1
o$ ny D 0 w LOT2 wg PI
0 ° w o TOTAL AREA: o 3;
m' °.m• v ` o I o 97.648 SQ. FT. °
$o H n �_ I Q I° 2.24 ACRES 160 0 150
a.S B.N o +�. AREA EXC. R-0-W: �.�
87,285 SQ. FT. GRAPHIC SCALE Er c/1 tom. rn 2.00 ACRES SCALE IN FEET: 1 inch = 150 feet
Q
I
S.°°o NJ W 1589'37'47•
"W 295.43'
A A
3^'•c �aiw w 'J -- I i `��* 264.50'
m gee+
Ta CL �$,,, ��cor , w '��3o.s3' .SLOT 3
c'H * , • TY R. 41 :.i N N t TOTAL AREA: 1 �+'
x. OODGE I co m -4 95,928 SQ. FT. �_
° • v •aa) 9 2.20 ACRES tll
•'•CL Eli.ASCE. «? tO. a AREA_EXc,• -e W: t�
'a. ' c 87,287 S J`
Z
e O gUR as �. 2.00 AC " PROPOSED
nsMM j ,�.-,30.12' DR/YEWA Y tom. so'JOINT ORJVEWA Y D
C.— G-° S \ ,'t , 351 68' EASEMENT FOR£075 -,•
LOTS 3AND 4 M
N00.32'03"W J S89'27 57'W' 381.80 t re Dx� e r1
• 66.00' - N89'27.57"E 382.00'1 D
�`
Section Corner Monument o •'• 35 .04' v • v
of Record - LOT 4 ° `1
Set 1" .x 18" 0,0. Iron Pipe wt. I t,i 28.96' N o°ji N 0
444
• 1.13 pounds per linear foot n? DRIVEWAY
Building Setback Line ' D DR/►><WAY TOTAL AREA: /V $�'
9 CA 1,311 SQ. FT. to r4
(100' from Right of Way) r' 2.10 ACRES
n� : AREA EXC. R-0-W: N rn
w a' 87,237 SQ. FT. w XI i
a �°-5.08' : 2.00 ACRES N
JOB # W1057SO43 fl � 377.64' " _ _ . _. --
Prepared by. i z 589.17'31"W 382.72'
I souni LIVE OF T!/E NW1/4-SE1/4
CIIP
JEO Consulting Group,Ina ■ 1
tA N N UNPLATTED LANDS
Phone No. (715) 246-4319 II° '
w Prepared for and of the request of:
Fax No. (715) 246-3830 Dave and Porn Kieckhoefer
P.O. Box 325 SOUTH 7/4 CORNER 943 170th Avenue ammo
New Richmond, WI 54017 SEC 7-30-18 New Richmond. WI 54017
Sheet 1 of 2 (FUNNY ALUMINUM
COUNTY MLWUMENTJ Drafted by. Jesse H. Suzan
Vol 19 Page 4992
1009197
BETH PABST
REGISTER OF DEEDS
DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1-2003 ST. CROIX CO., WI
WARRANTY DEED RECEIVED FOR RECORD
03/18/2015 8:02 AM
THIS DEED,made between One Corporation,a Wisconsin corporation EXEMPT # NA
("Grantor"whether one or more)conveys and warrants to Oeverin Homes LLC, REC FEE: 30.00
a Wisconsin limited liability company("Grantee",whether one or more .the TRANS FEE: 360.00
following described real estate in ST CROIX County,State of Wisconsin: PAGES: 2
SEE ATTACHED EXHIBIT"A" **The above recording information
verifies that this document has
been electronically recorded
&returned to the submitter
RETURN TO
St.Croix County Abstract&Title Co. Inc.
219 S.Knowles Avenue
New Richmond,WI 54017
026-1302-04-000
026-1302-07-000
026-1302-12-000
Tax Parcel No: 026-1153-14-000
026-1153-15-000
026-1153-16-000
026-1025-40-070
026-1025-40-080
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 2015
real estate taxes.
Dated this 11 day of March,2015.
One Corporation,a Wisconsin corporation
y: Thomas D.Mews,'reasurer
AUTHENTICATION ACKNOWLEDGMENT
Signatures authenticated this day of STATE OF WISCONSIN
20
COUNTY OF ST.CROIX s ss.
*
TITLE:MEMBER STATE BAR OF WISCONSIN
Personally came before me this.17_ day of March,2015,the above
(If not, named One Corporation,a Wisconsin corporation by Thomas
• authorized by§ 706.06,Wis.Stats.) D.Mews,Treasurer to me known to be the person(s)who
executed the foregoing instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY
/
g Law Office
/Loberg
Robert L.Loberg •Notary Public-St.€rout ty,his. awe !mot,
1522528/asc yv ,U
My Commission is permanent.
(Signatures may be authenticated or acknowledged. Both are If not state expiration date: ,, -r -' iY i =
not necessary.) °
'Names of persons signing in any capacity should be typed or printed below their signatures. i Al
Form No.1-21103
WARRANTY DEED
St. Croix County 1009197 Page 1 of 2
EXHIBIT "A"
Parcel 1: Lots 4,7 and 12,County Plat of Ninety Fifth Street Site in the Town of Richmond,St.
Croix County,Wisconsin.
Parcel 2: Lots 14,15 and 16,Plat of Glen View in the Town of Richmond,St.Croix County,
Wisconsin.
Parcel 3: Lot 2 of Certified Survey Map filed June 6,2005,in Vol. 19 of C.S.M.,pg.4992,as Doc.No.
796820 located in part of the NW% of the SE'/of Section 7,Township 30 North,Range 18 West,Town
of Richmond,St.Croix County,Wisconsin. TOGETHER WITH AND SUBJECT TO a 66 foot joint
driveway easement as shown on said C.S.M.
Parcel 4: Lot 3 of Certified Survey Map filed June 6,2005,in Vol. 19 of C.S.M.,pg.4992,as Doc.No.
796820 located in part of the NW%of the SE'/of Section 7,Township 30 North,Range 18 West,Town
of Richmond,St.Croix County,Wisconsin. TOGETHER WITH an easement benefitting said Lot 3
and further described in Easement Deed dated May 25,2005,recorded June 6,2005,in Vol.2816 of
Rec.,pg. 111,as Doc.No. 796819.
St. Croix County 1009197 Page 2 of 2
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Property Owner Parcel ID# Page of
Boring# II Boring
-it Ground surface elev./ `S ft. Depth to limiting factor 1(2- 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
1 a—il /67/3h-- — 51 �, .r, c,-- a„/ . fro'
2- 11-00 /aic/ e-t 0).t.,-1-bb f� i , t ) ,6
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7)9 , -tk z6i6 ,-1 I
----1■1-9(0
Boring# ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
I 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# Ground surface elev. ft. Depth to limiting factor in.
❑ Pit 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
Effluent#1 =BOD5>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD5<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.
SBD4 330(8.6/00)
RECEIVED
APR ` 5 2005
Wisconsin Department off„. ST.CROIX 0�'}�1EVALUATION REPORT Page A of 3
Division of Safety and Buildings e ZONING OFFICE
in accordance o mm 5 4Jis. Adm. Code It
r
County C
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must t�
include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D.
percent slope,scale or dimensions,north arrow,and location and distance to nearest road. zr,j w"': ' 026 70 L :7U-C4 '0
Reviewed vie Date
Please print all information. Re lJ(/ (MIA)
Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). (� �..- I -7 , yd
Property Owne � � �� Property Location
✓a..- / 614,4 Govt.Lot /N O 1/4j 1/4 S ,,.13v N R / g E(oG
Property Owner's Mailing Address, , Lot# Block# Subd. Na e CSM# /(fq cl /401 2---
Number '1 Nearest Road
City State, Zip Code Phone 0 ❑V'llage � Tor�JP
5o rst i IS`fD2s�(74r2r41--317. R;�ir��-C.� 1 95 --I.
'New Construction Use: esidential/Number of bedrooms Code derived design flow rate 4/J-27 GPD
❑Replacement ❑ Public or commercial-Describe: ___--___--- —
Parent material e4C /avl— Flood Plain elevation if applicable /1,// ft.
General comments
and recommendations: St s k e N', 61 g't S g g 9 f
i/, !,/
Boring# Boring C
J —
I Pit Ground surface elev.L 2: i ft. Depth to limiting factor /1 10 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Co.Sz. Cont.Color Gr.Sz.Sh. *EMI *Eff#2
I 0-1t. i0/,.3+-L 5/ /air- r1 ' 1' s''. ck • 6 r.-
Z ►Z-L IOr s/y C. J c .s 1,t< jr dc- ft )
( - 4 .
3 yg- 2.s r; Vi.� ,( sot.-1e rri f:s 1-/yid / 6 t, u
Boring# .' `•ring C ''
r1 Pit Ground surface elev. /I' _ ft. Depth to limiting factor ! Oa in.
I 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
i CI-1i- l at;l -L 1. t3.�,r- mi- c do" / 6 It
Z /z-Y2- /Of/ /1 L ht< f / . 4 L
3 9d---//v 7'19,,e- - S I c ros'bl< hi) Ai) nil 4- . 6 i. 0
' S it b�c� H
L
1?3 9 'l•Effluent#1 =BODS>30<220 mg/L and TSS>30<150 mg/L `Efflue #2=BO;<30 mg/L and TSS<30 mg/L
CST Name(Please Print) Signature CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted Telephone Number
1008 192nd Ave, New Richmond, WI 54017 — //2, 715-246-4516
Property Owner Parcel ID# Page of
2 Boring# Boring
it Ground surface elev. o--
ft. Depth to limiting factor 1 12 in. 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 'Eff#2
1.-1/ j 677 311_ 5/ cl r� / c, 0 1
2- //-4t) /o c/ -- f 02v-ci / 1 �'3 z s tAl
) E)
1 •
� —A 46. E
e v: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. • 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
'Effluent#1 =BOD6>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD5<30 mg/I_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(8.6/00)
Soil Test Plot Plan
Project Name P.C. Collova Builders Inc. Shau re
Address P.O. Box 489 4
Somerset Wi 54025 CST" #226900
Lot 3 Subdivision Date 4/21/05
NW 1/4 SE 1/4S 7 T 30 N/R18 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 89.5/88.9 *H R pSame as Benchmark
1
Scale is 1" = 40'
unless otherwise
noted
295'
Property 94.5'
Line
92.5'
10' B-3
90'
7% Slope
B-2 45' ° B-1
40'
B.M.
50' 95th St.