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Home My WebLink About020-1447-15-000 (2)o M ~ O qtl evj C O O N N v d 0~J a '~ a •~ N • V [r`-~wJ w MCI .~ ...i :~ A i ~ I ~ a E ~ a' I x ~ W ~ ~ ~ ~ ~ `- % ` O a. Z z ~ a m C U o z a v ~ ~ d Z ~ v~ F- a~ m v 0 U r a g t~ J U a L C O of ~ .- c N ~ cam- S ik ~' 3 ~ .Q E m ~~ L C U d ~ C ~ ~ ~ o ~ rn m C U N U .C ,? c~ ~ C 0 3 a Z ~ a Y d R m d co a ~ ~'cca` N lp (n ~~~~ o a a a N v ~ .J~ = o ~ ~ N ~ ~~ N .D O ~'-' ~ N -p d C 'n. w ~ ~ Vl C C O Y ~ O m ~ O ~ d ~, a a ~ = Y 7 O N V ~ o° ~ ~ N C O O ` E `o N ~ d 'p' ~ (6 dl ~ U U -aE ~p ~~ a~ 3 U a ~ O p 0 ~ C p N O y a Ql ~ fNq C N O_ L w ~ ~ .~ o Q .~ ~ ov_ -o~ m>> m °~'~'°. rya O G. U'- f0 Z o-'o ~ € c c ~3~a•y~° ._ ~ ~ C U N ~> O ~ Nw~'Ol~ 3 Q rn~3~ o ~ c w c m E N .3 N .c E a~ Y f0 7 ~ E > L a c°n V1 } _ O 7 ~ (.Y1 C _~ Q Z iA c v O `o U ..p+ N ~ ~ m ~ c ~ I I I I I 'o C f ~ I 3 I I 3 ~ I ~ I Z v! O ~. y ~ I a m I I ~ c 0 I ~ rn C ~ I ~ ~ N ~p i '] t N U ~ m 3 c 0 I C U ~ Z J ~ Y C d I H E R y I co a 'w ~ N d 4 I v° D D a I ~ O ~ O l o a a a N I~ = M I ~ ~ N J M N O I E ~ d C ~ Q. N N I ~ H c C O d I Y v 0] MV O I ~ a d f ~; a ~ = V ~ ~ O ~ U ~I p NI O P O N Q> Y (0 E 7 U m 0 .°o °;~ o a Z ~ o c y O p~ w C Q U c m E N .~ a N a p L U ~ a al ~ O Z a ~ m Q Z ~ 'O N C O ~, aUi -moo Z ~ Z .4 .sin Department of Commdree ~ PRIVATE SEWAGE SYSTEM y and Building Division INSPECTION REPORT .aENERAL lNFQRMATION (ATTACH TO PERMIT) Personal information y0o yrovide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's game: City Village X Township Bast, Kernon Hudson Township CST BM Elev: Insp. BM Elev: BM Description: ~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing ~} ~ r ~ s.t~ Aeration 2..-_e ~, s r ~, Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ ~~ y ~ ~,11 V ,ry~7 ._._ Dosing ~. Aeration -.. Holding "`°""' PUMP/SIPHON INFORMATION Manu cturer Demand GPM Model Numbe TDH Lift Friction System Head TDH Ft Forcemain Length Dia. Dis . SOIL ABSORPTION SYSTEM iJ~bo ~.~ s1 ~~-~ ELEVATION DATA STATION BS HI FS ELEV. Benchmark ~1.3~f td4.3 ice. ~~ Alt. BM Bldg. Sewer 8.~ 9~•SZ.., SUHt Inlet q.Z q5.~~ suHt outlet 9.~ ~ y ~ Dt Inlet Dt Bottom Header/Man. ,) -d?j 93.3 / Dist. Pipe Bot. System rl. ~ 9 :~.~f 5 Final Grade~~~s'7" ~•~ 9g.s~ St Cover -~ r. i`S 9•~ ~ •~ /00. g y BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 8v G•-~ v _I lX SETBACK SYSTEM TO P/L BLDG LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR : I ~ rq O ~ Type Of System: /~ ~ , SQL 7. ~ 7G ~ ~ fy~ i W N / /~ ( f 1 UNIT , Model Number: a ~f n~}/ L u rt V tin. ~ G~, • c k DISTRIBUTION SYSTEM r~ r~ ~- Vend/ob5 ~ n, 3'=' (G . Header/Manifold ~~ Length ~ Dia `">r Distribution Pipe(s) Length Dia Spacing x Hole Size x Hole Spacing _ Vent to Air Intake SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Onlv Depth Over ( Depth Over xx Depth of "" xx Seeded/Sodded xx Mulched Bed/Trench Center r--- S Bed/Trench Edges Topsoil 0~ Yes No I~'~ Yes n No 42. ~` o! COMME TS: (Include code discrepencies, persons present, etc.) Inspection #1: 9 /~' [_/_~ Inspection #2: / / Locatio~Hudson, WI 54016 (NW 1/4 SE 1/4 15 T29N R19W)-j18-asces.Lot M ~ ~ - Parcel No: 15.29.19.120 fl,,~Lt.) LbT cs ~ / J ~ bs ~/ i~ 1.) Alt BM Description = ,~,~~ y[~,u1 S"~,~ • - t ~- /moo 2.) Bldg sewer length = ~7.. ~ J f ~'~(~~'- " "~' -amount of cover = 4S r~ Plan revision Required? ~ Yes ~o Use other side for additional information. ~_,. __ _ ~ ____ SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. county: St. Croix Sanitary Permit No: 430477 0 State Plan ID No: Par TaxN~o:~ n p' !~{j l~ ~''~ 0 0-1027-40-000 Sect ownlRange/Map No: 15.29.19.E ~''tuvNY J`fl~o ~ ~ I , ~-= Y~ r `U W <.(.1 F~e~~-C ~~ ~ ~~~ ~ ~~- ~ l~~ 5~5~ 6~ ~ ,~~.~ 22 ~ /~~ \ Ve~n~~ ~..~-,~~~~" ~~~a ~ ~~~ /ice/may Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 County ST ~~~ ~ j~~jOns`~ Madison, WI 53707 - 7162 D 608 26 Sanitary Permit lvumber (to be ftll in by C .) ~ ) 6-3151 e artrnen# of Commerce ( ~~ ~~ O S~ n Sanitary Permit Application In accord with Comm $3.21. Wis. Adm. Code personal information id State Plan L~ um er 0 , you prov may be used for seconda /~ ry purposes Privacy Law, s15.(lA(1 y ~~'~1 Project Address (if different than mailing address) I. Application Information -Please Print All Info lion ~ ,. Pre typer Owner's Na me ~ "t (~~~ ~ ~ I yy~~ ~t tf ~,e3t/tJC% CJ ~~ ~ ~ Parse! q ot;y Bloc N .- ,. . ~ ~ ~ ~ Y Property Owner's M aifittg Address ~- t ~ ~\ j I ~, / ZQNING OF 4~ - lS~ Property Location ~~~ ~~y~ ~ City, State ZiR Code Phone Number 'S~ i~' •~'~.Section /S //~G~S~ ~''~ _ ~ ~ II. Type trf Building (check all that apply) n~~ ~~ ~ ~ ~ ~1 2 F ~ (circle o ) T ~~. N, R l ~ E o ! or amily Dwelling -Number of Bedrooms _ ~ ~ Subdivision Name CSM lumber ^ Public/Commercial -Describe Use _ _ ___ ~' G ~~~ f ~ ^ State Owned -Describe Use ~ ~JST t'i~~ ~02 f- ~ 3 ~` ^Ciry Vi[lag~ownship of7ZL~/~~Z(~~ I III. Type of Permit: (Check only one box on line A. Complete line B if applicable) _ A' ~~New System ^ Replacement System ^ "T'reauttenvHoiding Tank Replacement Gniy i ^ Other Modification to Existing System - B• ^ Permit Renewal Permit Revision Change of Permit Transfer tv New i List Previous Permit Number and Date Issued Before Expiration Plumber Owner I IV. T ) ~~- ~ of POWTS System: (Check all that a l ~.E.~~~_'~ -i7 ~ ~Z3 ~~ ~ L , ~ _ pp y rt,~ `~ ~- -- - ~, r.vn -rrGSSUnaep rn-VIOC1n0 u MOUItd > 24 in. of suitable soil L.i 1.4ound ~ 24 in. of suitable sail ^ At-Grade ^ Single Pass Sand Filter ^ onstructed Wztlantl ^ Pressurized In-Ground ^ Holding Tarilc ^ Peat Filter ^ Aerobic Treatment Unit `_~ Recirculating Santl Filter ^ Recirculating Synthetic Media Filter ._Lea~ching Cham ^ Drip Line ~ G_ravel-less Pipe ^ O ( p(ain) V, DispersallTreatment Area Infor afn lion: _ - ~~ -~/ -` ~ - Design Flow (gpd) Design Soil Applicaaun Ra sf) Dispersal Area Required (sf) Disperse! Area ed (sf) System Elevation ~ ~ ~ ~, (~/~ I VI, Tank Info Capacity in T Numbers Manufacturer Prefab Site Steel Fiber plastic I Gallons Gallons of Units ~ Concrete Constructed ;Glass '~ New Existing ~ ~,p ~ }~- ~ ~ ~ '~ ~ t~ ~ ~ ~ Tanks 'Tanks ~~._` - ~6y~ ~ i Septic or Holding Tantc l --_ Aerobic Treatment Unit -~~' `III Dusinf_._ g ~;hamber r `~ - I -~~~~ ' VII. Responsibility Statement- I, the tlrtdcrsigtted, assume respottslbiGty for ' Ration of the PCIWTS shown on the attached plans. Plumber's Na me (Print) Plumber's Si gnature iP.' iPRS Number Business Phone Number ~J .l~, r~ s u~ 'cc~ ~ _ ~ 7 9~~ Plumber's Addre ss (Street, CitCity,~Sjta~e, Zip Co~pde}~/ / ~~~~ ---'--~ ~C) ~7(~ .~GQ « ~"(~ /"wit-~C -~`~`''.-~ /~~ •~r _~......_L~ _._.~._..~.t~'~~, ~6~ ~~~ VIII, ount /Department Use Only I Approvzd ^ Disapproved Sanitary Permit Fee (includes Groundwater Datcs Issued Issuing A nt Sig elute " rrps) ~ Surcharge Fee) ~ ~ [f ~ CI JZ ~ G~!2 ,~ /Gt ^ Owner Given Reasor. for Denial ~ / ~/ ~ ~ IX, Conditions of Approval/Reasons for Disapproval _ ~~ v ~'OLtf7~ /~ ' ~~4~.,. z ~~~~rn,t_~ ~0~~ ~ C'`~2~ t9.4~..' c~.Q ,~o-~ a~-m-~` ~ .r~~ ~n~ ~a I~~ ~' ~ y Attach com plete plans (to the County only) for the system oa paper not Icss than 8112 x 11 inches in size (~L ~'~ ~ z ~~,~ SBD-6398 (R. 01/03) ~Go ~ .~ ~ ~ ~= Y~ r `U ~l~ ~r~ ~~~~ ~~ ~ ,- ~~ ~~ ~~ h v v ~~ ~ ~~ vYrscansin Depertrnent of commerce Division oiSafetysrtd Bu>sdings ~~~~ AUach oomplets~aMe pfart on than 8112 x 1 itcluds. but not imi6ed tx and. horb:orttal r d percent sbpe, scale or dimen s, notov r~, p- print a~ ~~ t~ersond irform.aon r~ povla. t» ~~ ~ 01\ ~~5~ Property Owners Mailing Address EVALUATION REPORT Page ~ ot_ ; t15, Vtfis. Adm. Code Courtly In a¢s. irrt ( M), d Patoel LD. and ~ road. R by Date t.aw. a 15.114 (tl (m1)• G~~v ~' ~1~. ~ / Za PropeAy Lora Govt Lot ~ 1/4N l: 1/4 S T Z9 N R ~ E (ar), Lot # Bbdr # ~ ~+~+ ~^+A ~ CSAA# ^ city ^ Yllage ~ Town N8 ~t Road . J., ~J New Construction Use: ~{ Residential /Number of bedrooms ~ Cade derived design lbw rate ~Sz~~o ~ d GPD ^ Replacement ^ Public or commercial - Descxbe: Parent material lJV-~-+-Jti ~ ~ Fbod Plain elevation tlappligbie i!/~1~-- ft. General comments S ~~~ rv~ e` e J ~ g Z ~ and recommendations: ^ Bortng q Boring # ® Pit Ground surface elev. _ i ~`~ ~~ ft_ Depth to limiting factor ~~~~ in. Sod ication Rate ti i D Texture Structure Consistence Boundary Roots GPDlf~ Horizon Depth in Dominant Color Munsell p on escr Redox t]u. Sz. Cont. Cobr Gr. Sz. Sh. 'Eff#1 'Eff#2 . C'12.1 =- c~ s~ Boring # o Boring S~ - s~ 4r~ Pit Ground surface elev. ~' R. Depth to limiting factor ~ in. Soi tan Rate Horan Depth DominantCobr RedoxDescription Texture Structure Consistence Boundary Roots GPD!(tz in. MunseU Qu. Sz. Cont Cobr Gr. Sz. Sh. 'Eti#1 'Eff#2 Z ~ z ~ ~~. yi -- S ,'r/l Z~-rLl ~ l' ~ -- ' (o o - 5~ l 6 -' .S ~ S c ~ - Z 93. • Eflluer(t 1f'1= BOD > 30 < ZZO mg/l and TSS >3U c 79U mgrL GlIwO1N fK - ovY ~ JV ~~,yr V,d,u ..... _ ,,,, ...y- CST Name (Please Signature CST Number Z ress Date Evaluation Conducted Telephone umber 2I1 ~U~ ~i~,(~~--~- !, Gz-s - -0 7iS-7~oo ^GZ3- ~,.. ~g r e ~ of Pa ~~ ~ -~ ner O Parcel ID # g w property ^ Boring pv. ~~ Boring # l ft DeQ~ 1p imira'rg factor 1--~-=- b• Soi x~tion Rai Ground surface elev. Pit Redox pescriptbn . Texture Stmcture Consistence Boundary Roots GPDIPP •~t 'Etf#2 Horizon Depth Dominant Cobr pu. Sz. Cant Cobr in. MunseB , Gr. Sz Sh. ! ~ S t! • ~ ' a l `I ~G 3/Z ~ ~ ~ ~~ C , `?i ~ S ~ Z~ _ ~ C G~ ~( e z 7-:~ rY . - . ~ 1. Z .~ ~s~ [~ Boring ^ Boring # ft, Depth to limiting factor __ in• Sob A ication Rate ^ Pit :Ground. surface elev. ~- Roots GPD1fP Hor¢on Depth Dominant Cobr Redox pescription Texture Structure Consistence Boundary 'Eff#'1 •Eff#2 pu. Sz. Cont Cobr Gr. Sz. Sh. in, Mansell Boring in. ^ Boring # Ground surface elev. ft. Depth to limiting factor - SoH ~~ Ra' ^ Pit Horizon Depth pombant Cobr Redox Description Texture Structure Consistence Boundary Roots •E~GPD Ef~2 in. Mansell pu. Sz. Cont Cobr Gr. Sz. Sh. • EtHuent #1 = GODS > 30 <_ 220 mg1L and TSS >30 < 150 mgll • Effkient #2 =GODS < 30 mgf 1. and TSS S 30 mgll- The Department of Commerce is an equal oppoRUmry seance Provider and employer. If you need assistance TA access services or Heal material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. sso-assora.arroo- NAMF. l `v: `=~ T SCALE: I"= ~/ ~ r BM 1 ELEVATION 1 OU ' U BM 1 DESCRIPTION - ~c-3-1 ~o~ni1, c'3-~ S~'~~ BM 2 ELEVATION '- BM 2 DESCRIPTION SYSTEM ELEVATION ~ Z' ~y ALTERNATE ELEVATION CONTOUR ELEVATION r~ 1~v ~v ()., ~~ V~ ~~, 1 PAGE~OF~ ~~4 E 1 - -~ f W ~o T\ ~W :.r_ ___ ,-= uick~~ STANDARD CHAMBER ----- ---'--- -- 52"------ 4uick4 Standard Chamber ~ - --~--------4a- - r {EFFECTIVE LENGTH) ~~ H ~J ~i i~ f 9 @ I SIDE VIEW Stu t Ivry view MultiPort End Cap ~~c _ ~~ t ' ~~~ I i ~~---~ i r i I I ~ ! ., _ - I 11f ~ I } ~ ,l I ~\ /f ~j ``~ J Stl ~ ~ l` -- r~-y 1 ~ .,.. ' rt .__~ 1_,x!1-__ ----~-I----' ~_..~_~-~___i~~r ~..._.-__1`_ _34x..------------_----~ SIDE VIEW FRONT VIEW TOP VIEW s ~ 'b x .~~ V a. .r~ ~ ~ _ ~ ~ Y ~ . >`°' r ~: .c, `8 °~ `~ r s aM .~,~ ~ , .. ~;;~ . ,,, ~~. 1 'auick4 Standard~~hamber Norri~n~~ecitlcatl~r~s _x~(,. MultiPoa~ _End~~ap l~Qmnal Speciticatl~ns r • Size (W x L x H) - ~ ~ __ 34" x52' x 12" ., Size (WxLx H} >~'• ~ `~ •'~~ 34'x 16"~x 12" Effec#ive Length ~~ ' 48" Invert Nei ht 8" or 1.25'r Invert Height g'° IIVFILTRATQR S~~TE. 21~,.INC, ~TgIJbARD 41MITED WARRANTY iJ1 +e st JCtural rng,7rly or a u,-r hanlt.er, en,7 ~.n f. wcnlgc and )ttu r ac ~ wv mar k I -' t y Ir t If atcv ('Unhs L wt,fn ursta Kf a rU opeatBef ',n '. Mek1 W a r mate s;ta' sY, tar')'"~ accurcan~:a with IrL tra!u n insir ,l <m... r„ aYd Aril ;:. tYv onginal purchaser i'HOiUB t aga rash deRdPtlvB [ . x tt wows kvrs!tip ;or lYB YaM trexn ~,ha oato that ih9 5rt)14: perrrd rvuw; Yf II e YUCti. sY61ar11 0.vllaitung 1119 Vats', provxlrtd, nUweVe4 That t 3 s JptrC (e rnit at not reglvirod bS' applrGabkt law, the wand .!y (?grind call nery , i. ,on : r, dace !hat x,sta+lauon of the septic sy- rrr c[rnn,Br+ces T; n.rsg is µar inty Aphis, Hpldat must rd'. A i Jitiglor n wrt'ng at it Grrpo. alB tyr~3. q Jar10+~ ~n Qrr! $aybrcok, CArrrxx;tioUt wanrn Hrygrm (15) ddy CI lhg aiteyAd tlg ecr, InfiltralUr µi11 sUptNY tNacgment i a ICx Uni s dr f nrned tf Ir niltraurr !J hP. n>wE+rerf by ;his LiRxleo Warranty, In9t! dtCN c Igpipty SUBr:rIICaPy exclUURs IhB CA.t C I emova' anu•:v '.nsfallali+>rr n. -r: U: als, ,I ~I 1 1 It,FI'(:il WARRANT! ANO RFMEI]tES iN SV91'AnAGNAPH lu! AnL L ,r%l U;J !r } I rr: FJiE hrl%.11'i.F.H. NIAARAN', IE.i 'WISH NE;P(:.~~T IU ri rIW tS. IPdCL±IpytJG Nti)iMPLFEU WAR}LIMN=Sl:FR7,Ertr,~IF.N'TnEILi r`~.'.~F Fr7Nr~;;C=rC(iAiAHiIL'l.~t~}I RURPCAE. rx r _ i t C Vla 1 y sh:+ll 1' e r,d I any pan I r!,a i a +tc - tar, a ur '. r I ~ -'ic .,tnBr thn b)Nllraia~. Thg lim ':.] Wan.untV CN)ds -f t 1- t. rt ,H: Idr txle"JrY'O a' sOOC I ~r 'er.l ca naa _:. moll t - rr~l Lo ~ L .^r l x IYnE` :x ~i(futkntG;1 'turraya 1CI4Ylin1 `o5S Or N;+rl I n r Jr J r Ut ts.. labor anU atuials, overhBecl :n-::x w other easas o w; .rtsU r., n e,.: b: I'IC HrT'[kJr tlr any la'xd warty Syrer:if'.rally gY _ J p .worry !- n red Vrdnan(y AlvaatJ9 are d 11aCta c !!. 1 In::s due !O ordinary ~-rvA anU teer, ali9ra o , 3^.f. C:af I, nl'6VS8, abU6C nr nBt)io~;:t Ut rha LrWS ine Un r ~ eng sabioctad to vahic~n t NM rx ~1aJr conr111ipns vfikn a:a not pp mrtBd by the inslalFton irstnMtians~, la~lwe td fnaNNau) the mn mum ground ,,overs set icxth kt thB :nstatrg!on itLfrvCtro^s~, the r::Mrk>rnent of improper mate,.als into the system axdaufing thaw Units: faEum o+ tYe Ur,lts or the saptlc ytern dun a rmprope virx;g cr improper siz,ng, r,xcassrve vfater usago, improper greaya tllsposal, a im m r o ,tear ,thaw event rant causstl tw Inftl Irata 1h,s _"ru'etl Warrallry ;:hall Ce ,,o,a d thy tlciCtm tails to comply wah afi of Nye rBrms r;B; Iprlh in t~a~itg;1 nty. R rthe n xr Bvr d sh I in4Nrai r L rt~pone 1Na lur anY SoSt , .stn nee t h -i r.a. na !. r iL, m anY Ihlm parer rtislAtirg from a la'iatun o, s."dp. met • from anv ProJU r Gab utv aanms oI Ho ow w any !hrM parry Far N a it~l l1 array ,o apphr, the lJnits mxsi na inslaNed r acGO!d.Tl,;e w"h atl site GtilrutrJ s'BGtHrBO. ~ ,late a11d dJCa :lJrj96: aA M'tor dpplicane.aA.s: a:•'~d ulNilrator'S uUlaNatior Ins6ixt:ong, µ1t No rpl.MBSentaln+J gtdC Jirlralo~ nas Inn :,ul ionay to eltei eyn ix cxlcrw: This I_imitrnA Nr'sxr::nr; ,Vo vvartaiHy aPPriB:+ to anY p9nY otnpr Ihan the nnyr• rani I~tolacf. Tod hove rcpre6Bnl ,the StarlrJard L'r ' W Wa anlY oHe; xf by ro :1 s or. A I nhrJ raruier c+ stores a c J ,nGae hive dleerrnl warranty raglnre- nre IY n y [Vn; a;er ul Uni15 rx,ulo r•(1~ itaci IX.+alor's C o frt alr, rleedggarttlrS 91 Okt faYtxa:k, C Y1neGlit'ul, D'Y)r W surly Uurrftasg, td oblate-. a ,_o.y ,,, the applicable warranty, arri st+cuki caielJiiy •aad Thai wary„Sty prior !o ttw pt;rcna^x7 ~i Un,t:;, ' . U SYSTEM'S I N C IEnvrronrryentat Onsite Wastewater Solutlorts`" 6 Easiness Park Road • P.Q, 8Dx 768 Oid Saybrookr CT 06475 860-577-7x00• FAX 860-577-'001 ~sov-zzl-aass J.S fo2tet•Y5 4,7J9bfii;5,0.7041 5,156488' S3`bt?t7 54)1 ?10 )4i 1.49 ,,119(n3 5,716,163;5.588,778:5,839,844 t.anadtan Patent3 1 329,55) G04 584 Qttrer „atanls peniJrtaq I ~i!trutcr Fqua6iet and SideVYinder are regrSterec tradr r ark, of tot Iiraf4 `'ysfe. I nc... } dll warp, is a registered iradarrtark .n franca. InfllUawr Systems Irk;. $ a !e315t9r8d tfa(16rr`aIk lR Mer..,^,o. CLYnIOUf, COnloUf vWl/e} C~.onnOC(ICfi, IJ'ik:Nl.QaClfNlg, PUIyTUtf, $rk'I~t_OCk, CillarTil)er$paGtlr, Pasit.rx,'k, QlJickCut, fltuclcPfay R£trci£u PAPeR a'ad iJttu;k:4 'are tredr:marks of Infiltrator Sysir:ms tnc. ~' ZCJ6,5 Intiirator Syslerrrs kic. ?rutted in U.S.A, - POWTS OlNNER`S MANUAL & MANAGEMENT PLAN Page ~ of Z FILE iNFORMATiON Owner ~~3~`r~ ,Permit #' DESIQN PARAMETERS Number of Bedrooms ~ ^ NA Number of Public Facility Units ' ~VA Estimated flow (average) 'a al/da Design flow (peak), (Estimated x 1.5} ____ ~ ~ al/da Soil Application Rate ailda /ftZ Standard influent/Effluent Quality Monthly avarage* Fats, Oil & Grease (FOG} S30 mg/L Biochemical Oxygen Demand IBODfiP 5220 mg/L ^ NA Total Suspended Solids (TSS} 5150 mg/L Pretreated Effluent Quality Monthly average Biocheittical Oxygen Demand !600,) 530 mglL Total Suspended Solids ITSS} S30 mg/l ^ NA Feca! Caliform !geometric mean) 510` cfu/100m1 Maximum Effluent Particle Size Ya in dia. ^ NA Other: ^ NA *Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE SYSTEM SPECIFICATIONS Septic Tank Capacity S~ al ^ NA Septic Tank Manufacturer ~~~-~~, O NA Effluent Filter Manufacturer ~6~ ~ ^ NA Effluent Filter Modal ~ 4'Q ^ NA Pump Tank Capacity al ^ NA Pump Tank Manufacturer ~ fey, ^ NA Pump Manufacturer ~6A ^ NA Pump Model ~ ^ NA Pretreatment Unit ^ NA ^ Sand/Gravel Filter ^ Peat Filter ^ Mechanical Aeration ^ Wetland ^ Disinfection ^ Other: Disperse! Callls) ^ NA ^ in-Ground (gravity) ^ In-Ground (pressurized) ^ At-Grade ^ Mound O Drip-Line ^ Other: Other: ^ NA Other: O NA .Other: ^ NA Service Even! Service Frequency Inspect conditwn of tank{s) At feast once every: ~ month{s) (Maximum 3 years} ear(s) ^ NA Pump out contents of tank{s} When combined sludge and scum equals one-third iY,) of tank volume ^ NA Inspect dispersal cell{s} _ At least once every: month(s) (Maximum 3 years? .~ ~ ear{s) ^ NA Clean effluent filter At least once every: monthla) ~ ear(s} ^ NA Inspect pump, pump controls & alarm At least once every: ..o. ^ month{s) ^ year{s) ^ NA Flush laterals and pressure test At feast once every: ~ ^ monthisl O earls) ^ NA Other: At least once every: ^ month(s) ^ year{al p NA Other: ^ NA MAINTENANCE INSTRUCTIONS inspections of tanks and dispersal cells shall be made by an individual carrying one of tho following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septaga Servicing Operator. Tank inspections must include a visual inspection of the tankls) 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 cell(s) 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 affluent on the ground surface may indicate a failing condition and requires the immediate notification of the ksca! regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third tY3} or more of the tank volume, the entire contents of the tank shat( be removed by a Septaga Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Cade. Afl other services, including but not limited to the servicing of effluent filters, mechanical or pressurized Components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the tocsl regulatory authority within 10 days of completion of any service event •apo~ vnila~tsiu!wp~/ u~suo~siM 'i£) 9 iZ! 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Ntlld AONSJNI1N00 •leualew p!los lsau! sayloue so lanesB 'qos yl!M Pall!} coeds p!on eyl pue panowas ssanoo s!ayl so panowas pue paleneoxa aq pays sl!d pue s>{uel !Ie 'Bu!dwnd se~b •soiesedp Bulo!nse$ 86eidag a Aq ;o pesods!p h~sedosd pus panowas aq llsys slid pue s~luei pe ;o sluaiuoo ey,~ • •paleos sBu!uedo adtd pauopuege eyi pue paioauuoos!p eq !lays si!d pue s~luei of Bu!dld 1!br • :epos an!lesis!u!wPV u!suooslM 'E£'E8 wwo~ saideyo yi!M aoue!idwoo u! pauopuege hla;es pue hlsedosd ,i walsAs ayl leyl esnsui of ua~{el eq {{eys sdals BUIMO{{o} eyi aa!nsas ;o ino ua>fei hliueuewsad s! sa/pue spa; S1MOd eyi uay/y~ 1NSWNOONtlBtl •euuq sauai;os saienn pue auodwei aulxdeu hsel!ueSa~ndodwns•su a po oue~ ano a!o auo!ieo!paw adesos ieew aap!olgsey :aseasB :aullose6 aBupaad algelaBan pue i!ns; aaie~n ; } q P :S1MOd ,s u!s! ssede!p 'sso!} leiuep :ssasaes8ep :sgenns uoiioo :swopuoo :sung eiiese6!a :sadlM hgeq :solio! iiue .ie; lueioe} P ~ enadwl hew weasls saiennaise^^ eyi wos; Bu!~nollo; eyi ;o uo!leulw!le so uo!lonpaa ayi }o a}!{ ayl 6uolosd Poe souewso}sad eyi •ease uondsosge l!os apesB-ie ~ s~ueWSeno sal~,yen Ksedpio en!sp iau od ease eyi 'loedwoo so gsnls!p es!nnseyio so 'seno used so snap iou ap •sl!ao !essads!P P •~usi dwnd ayi ulyi!M slenal lewsou esvises so sagwnld a ioeiuoo so dwnd ;uanl};a ayi of sennod lone o1 •iuenl;;a of slosluoa dwnd eyi gwlesado hilenuew u! ls!sse onoweg ~Uewdwnd a4 ;o siuaiuao eyi aney ua!ienl!s s!t{l p• e hq ~ gu! a seno 'esop •Ssel auo u! islllao lessedslp eyi of pe8seyos!P Bu!salsas of so!sd soiesedp 6u!o-nseS e8sidag ue s ea eyi Pe 4 }o e8seyos!P aae}sns so dn~loeq ayi u! iins•s hew p (1U 8i euusou enoge 11!; hew s~uel dtssnd saeeino sesaod Bul~nQ eq {{!rn seleMalseM sseoxe eyi pasolses s! sennod uayM •slenal saienny y ! ~ w eyi ie uezos; ese suo!ilpuao Ros ueynn snoao iou Neys do iseis weishg •aoe;sns an!iesil.~ noway (sl~luei ayi ~o •esn of sa!sd soiesadosOU!Ug s B~,ddiuewl es eyi eP~w! h'su1 ieyi s ea essads!p eyi e8ewep /P o esn of solsd 'uo!ionsisuoo nneu ~~ s uei lUeW1easi xoayo 51MQd eyi } O (1N`d dt1 ,~fiS shay pa~aeleP ace Su0118iluaouoo ybty }t '( 1N NOI1Vtl3d slueluoo ayl o aouasesd eyi so; t !it ~,g~,.,,a.,~ ,avio ,a sianpasd 6u!w!ed } Z ~p ±- 9~ed S'1' Cltt)TX CUUN'I'Y SEI'"I'IC 'TANK MAINTENANCE AGREEMEN'T' ,_-.. AND --. OWNERS[[[[' CERTII:ICA'I'ION CORM (2~rer/;layer ~~~~~'~ 1 J~""S ~_ ~ ~ V ' ~ 7 Mailirr; Address Property Address CitylSlal~ ~1 r ~ • . -_ ~ (Verification required from P{arming Department for new construction) ~~ Lo ~ !o ]r7 •2 0 - a-z~ Parcel Tdenti[ication Number 10 ~~ ~- ~ ~ ' ~~ ~ ` 0'"~ ~ • JO L7 • ~O •QG'~ ~"`~ LCGAL llLSCItI~''i' S ~o I're;~crty L7calion ~ ,, Sec. T' N-R ~ W, 'T'own of ~`S~ ~ Subdivisictu N~1~ ,Lot ~t ~/~ Cerlia~;:d Snrve I1~>jtl t !~ /" /~ Volume G~I'N1, Cp,v-fj~/I-q-T ,Page # c~ ~ ' ci # t~ ~ ~ S Z3 ,Volume ~ ~ `~~ ,Page # S~ / Spec house U yes U no Lol lines idenliCaUle~yes O no 5YS'~'~A~t N1AlN't~NANC_+ linproper use end maintenanceof your septic system could result in its premature [allure to hanJle wastes. Proper maintenance consists of pnnrping oat the septic tank every three years or sooner, if needed by a licensed pumper. What you pal into the system can affect t{te Cirnetion of the septic tank as a t-eatrnent stage in the waste disposal system. Y1~e property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mastcr'h{unr`acr, ~rnnneynran plnmbet, restricted plumber of a licensed pumper verifying that (I) the on-site wastewaferdisposalsysrem is in proper rperating condition and,'or (2) after inspection and pumping (if necessary), the septic tank is less tfran f/3 fait of sludge. l/wc, the uj,dcrsigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set Coril-, ircrein: as set by the DepaNrent of Commerce and the Department of Natural Resources, State of Wisconsin. Cerli[{cation staling tint ya-r septic systcrn has been maintained must be completed and returned to lire St. Croix County Zoning Office within 30 drays cJ'ti t e ree year expiratio- . off. ~y a j w ~ ._ .. / / A sfc3ta'~rt_-itr. (~r AppLfc N"r ~~•f~~ t~wy~_r: c_E>t~~~~r~cA•><'~oN_ ~;we) certify that aft statements rnr this form are tare to the best of my (our) knowledge. the pr . r escribed above, irhre arranly deed recorded in Register of Ueeds Of[ice. _ , 5 iNA'i UR:!? OC APPLICAN"C l (we) ant (are) the owner(s) of 13G~~ ``~-O ~. / / DA'CR • • • «" A:nY information that is mis-represented Wray result in t{-e sanitary permit being revoked by the Zonimg Department. *'"r'r'"• • incimle a~tNr this application: n staurpcc{ warranty deed frbrn She Register oC Ueeds office ' a copy of the certified survey snap if reference is made in the warranty decd , ~- ... ' Safety and Buildings Division County ~. s ~ ' G~~/`~ ,~ ~ 201 W. Washington Ave., P.O. Box 7162 SCOT ~SII ~ Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (~8) 266-3151 30 ~~ ~. • Sanitary Permit Application n I.D. Number State P I a ~ Q . - N~" In accord with Comm 83.21, Wis. Adm. Code, personal information you provide , may be used for secondary purposes Privac Law Proje~lddress 'f diff ent than mailing address) ,~ ,. I. Application Information -Please Print All Inf ati n 1 aT1~C7 ~lq• ~ a.ues Property Owner's Na me ~ ~~ s y~i Parcel # Lot 11 ~ Block N 3~s T- ~'~R ~av T ~ . ,, o Property Owner's M ailing Address ~ ~,.~{ i~} r 1C;>_ Pro ga , I~ 5~ er. Section '/ ~ ~ City, S11tate ~T U~S'O ~ ~/• Code d ~ Phone Number ?l~' ?~ ~ ? 7 s , ' ~ 2 ~ ~ fi (circle one) ~ R ( E or T N c~ t~ II. Type of Building (check all that apply) ~ ~_ ; ~ ~ r_ SM N b di i i C N ~1.or 2 Family Dwelling -Number of Bedrooms um er v s on ame Su b ~~_ n A ~~~ ~~ ~~ ~ ~ s ^ Public/Commercial -Describe Use ' " t p~ ^ State Owned -Describe Use .2 ~ ~ ',Sa`-+ ^Village T wnship of ^City o _ ~ t i / ~~.5~ III. Type of Permit: (Check only one box on line A. Comp ere e B if applicabl A' New S stem y ^ Re lacement S stem p y ^ TreatmenUHoldi Tank Replac ent Only ^ Othe Modification to Existing System B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ it ransfer to New Lis r ous P rmit tuber a Issued Before Expiration Plumber Owne ~'~~' lV. Type of POWTS System: (Check all that a pl ) Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil ^ Moun < 24 in. f suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ P t Filter erobi c Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip L' ^ Gravel-less i ^ Other ex lain) V. Dis ersalJTreatm t Area Information: - t30 ' Design Flow (gpd) Design Soil Application Rate(gpdsf) rsa Ar Required (sf) Dispers Area Proposed (sf) System Elevation . Cot7v . 7 ~S7 8 Seer ~/f}•v c~S.~, VI. Tank Info Capacity in Tota~ Number Manufacturer Prefab Site Steel Fiber as tC Gallons Gallons of Units ncrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank ~ ~ •1 ~ o~ / L /. , ~~^S'~ L(J Aerobic Treatment Unit ~~ Dosing Chamber VII. Responsibility Statement- I, the undersigned, as a responsibility for installation of the POWTS shown o he attached plans. Plumber's Na me (Print) Plumber's Sig re MP7MPRS Number usiness Phone Number R. 2~L~(2i cGtj- ~ a z ~3 ~S S• 77a • 3~lyZ. Plumber's Addre ss (Street, City, State, Zip Code) 2 ~!Z to '~- .¢U S~~t'~,vG- U~//.~ L~j/. 5174 VIII. Count /De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued s g Agent Signatur o Stamps) ` ^ Surcharge Fee) ~ ~/'~ t, ~/ j O Z O T Owner Given Reason for Denial wI JJ IX. Conditions of ApprovalfReasons for Disapproval SYSTEM OWNER: 1 Septic tank, effluent filter >~nd dispersal cell must all be serviced f maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances. Attach complete plans (to the County only) for the system on paper not less than 81/2 a 11 inches in size ~$s ~.p,C !~ ~ ~ SBD-6398 (R. 01/03) 1. ~(or ~ " • Ulbr~cht ~ Associates Priv,:,~e ~=swage Consultants 2E? ~~ ~~ ~ ;th Ave. S~z~i,•'~y Valley, WI 54767 r ,. - /~ _---- ,~ ~ y~ ~ $ ~.~ i Y~ ~` ~~ ti ,~ ~ Y7 ~ ~o, `5 ~a Diy1 ~o~ a 3 r q~' sT• • 5`~ ~~ y~ 0 .moo ~ ~ ~ ~ ~ ~ . ,,~ '~i ~ ~ 'i ~i ~ ~ ' ~ i i 3 ~ ~ ~ ~ ,~ ~ ID ~ ~~~ ~ ~/ G~~ ~Z ~,,,,~~~ ,~' .. rte' ~ ` ~~$° ~' ~ 5~ y sc~ ~'~ , ^ T ~ l~~' p.1~- / THIS POWT SYSTEM SHALL ~/ INCORPORATE PER COMM. 83.44(2)c A PROPER ZABEL FILTER MODEL # A l~0 ja~~~ xa~o-• Zo ~''~0/~°S~`v ~o•~..~ I o -~ , ~. U~.RR1C1-fT ~ ,~1~~CJ~i~iT~S CC?. - ":~ 655 iJ'Neii Road • Hudson, Wi 54016 715-386-8185 PROJECT INDEX PLAN ID # Aeg..Des1g-rers or Engineering Systarr Frivafe SewZtge Consultants r DATE pG~• l~' ~3 OWNER /4G~'/ /V~.y ~~7 S~ .PHONE 71,s- ~~~p' X71 ~ ADDRESS / y~ G/}' ~A'R~ ~ ~,/ j~DSOc> ~~.. S~OI ~ ---- LEGAL DESCRIPTION y~ ~'~s _ -sW/~t1~, J`~• ~s• ~1' y N ~ / 9 !.~ TOWN OF ~VO.So'~ CsTta ~. Z//`!/liG~i 7" ~ ZzCe 3-? S COUNTY `5~" C~~ LOCAL AUTHORITY/ SUPERVISION 5r G/P~l,+C GTY Zo.~ ~'.vG-- PROJECT DESCRIPTION: CP 6~ ~~l-s'• p/zl)~ D~S~ : oZ . /3io f,~~ ~~5~ Cells . ~. ~~ r~ct~.~-- Ulbricht & Associates Private Sewage Consultants 2812 10th Ave. Spring Valley, WI 54767 - Pg.l INFILTRATOR SIZING WORKSHEET Pg.2 SYSTEM PLOT PLAN Pg.3 CROSS SECTION OF SYSTEM, WITH ELEVATIONS. Pg . 4 ~, ~~ ~~ ~~ 'U ~ T R1 y ~. ~~ ~ ~-~ o M ~` `~ ~' • O J ~~ ~ 0 O `,. C ~. ~N o= . ~, m ~_ ~ `° Q ~ O .~r O W a o ~- ~ d ~~ o~ ~j ~ r ~ ~ ~ ~ ~ ~ y ~ n ~~~~ "~ ~ -~ ,~ ~°~ ~ `^ y y ~° ~+, ~~ '-~ _ `~ ~ - .` 0 h m ~' ~~~ ~ ~ .; ~. ~° ~ w ~ ~` ~~ 1 ~~ y ~~ ~{ C ~n ~ II 0 S `~ Ulbr~cht ~ associates Pri~~;;,~ ~=swage Consultants 2~' ~ ~: ,4 nth Ave. S~~~s~~y Valley, WI 54767 / ~~ s c,~,~e ~ ~ = zv Wo ~y ,~ .~r..~___~ `.___..r_ ..a_~ _~.____ , ,~ ._--~ ~ "P 5~ 5 B ~ ~~ ~ ~ Y" ~` ~` ~~ ~ ,1 Yy ~ ~~}~ 2~ - ~ ~~ `5 ~~ p,~~r / Q 3 ~/ ~~' ST• r • ~ 5~ 0 ~ y, ~~° ` i~ i, .~ ~ ~~ ~ ,~. , ~~ ~i~~ ~~ i i 3 ~ ~ ~~ ~ ~d ~1 0 ______~ ,. ~ 9 0 o, ~~. ~~ i / _ ~~. . 1 ~ ~/r y New ~~ o. ~~~~ ~ • d .SC~ t`%G ~~ ~~ 5 ~ i ~ "j D T ~ ,~~. ~~ / THiS POWT SYSTEM SHALL / INCORPORATE PER COMM. 83.44(2}c A PROPER ZABEL FILTER MODEL # ~ f d0 Zo I -- ---- --- ---- ---I P~C'o~dS~7~ I I ~ / - ~i~-- • I O -~ ~9~Pr~'d v~ ~~ ,~ y~ --1-- L~ ~~L ~°l9~f'~1~ Ti~Pt='t~ rr~ t~ _. - - ~ .r 1~. Sys T~~ ~i~v, 9ySD ~,~'o SS Sic ~~o~ ©~ Tr'~~G~ls ~fUs~ . ~: ~~~~,. Coq ff~li4 c r ~~' ,~~~~Elurv~~° rf ~'DD~L 3 '~C G 'Q2 " .~ ov~ Lv~~ .3/• l Sly ~T, ~p/~.pav c~,~c~~~ ~' S~~ T~'a~1 • ,.-~ 19Pf',~r~~l> Usti T c,~1° ~ U,v !NS'~~c Tlov ~~~, ~t~ i I(// ,~ ___ ~._ C,f/cvG~tr~'D ~ i S~~NGG ~~~ ~ ~ 5 i ~.t~r ~' .gip • C ~~ lvsp~c T/~,~ ~,~ It// ~~ sue. yro ~~~~ 9~~-DL ~9 r- --~~ -- - _ - OWNER's~MAINTAINCE pE ~<•~ SEPTIC SYSTEM POWTS (landowner maintenance of ~ is reponsible for servicin this system. proper °peration and 9 is necessar Regular periodic inspections system• The owner Y for the safe health and maintenance is required by code Y °peration of. this /inspection reports to the to submit all necessary controlling ,authorities. SPECIFIC CONTACT AGENTS .~T. ~/Q0~!( Gov ~ Governmental authorit p/~ Y/ i nspectors : Z-CJ~t1~ iV (1.' ~~ -Y"~ * Licensed installer maintenance ~~ ,~ ~ responsible for Users manual: Providing an o peration/ * Licensed s.erv~rCe / ins pection agent other than T1P/- CT~ 5,4. installer• ~i 7->9-T/O.V l'3C,v /~~/~Gr,~iV * Electrician, for pump, electric " 3~(p ~/3 a controls, wiring units: IMPORTANT OWNER MAINTENANCE RE UIREMENTS 1• Winter traffic area shall (sledding, shove~rin the not be permitted g• etc.) across the cell, freezing u the or frost can/will winter. (a vacaction p system. Discontinuos penetrate into lead to freeze .trip, resuitin use in the ups, g in no water use) can also Z• Water conservation hydrolicall needs to be`~exercised! designed y °verloaded and des(:ro Pd, Or system can be .for a maximum wastewater y" This sv flow of stem was 3• POWTS are ~ gals• daily, not designed disposal unit, or a to accomodate wastes Any introduction ny other unnatural from a garbage. destro of such waste sources of waste. Y this system, materials will overload agd 9' If a power oiita in a temporar ge occurs, or a pump fails ' cell, which ma °verload of effluent it may result recommended y adversely impact thebcelg pumped into the allawin that a licensed pumper em t (leakage), It is Consultg the pump to return to.dosin p Y the dosin your installer 9 the correct amounts, immediately for advice. 5. Neglect erosion of the vegetative preventive cover (the cells traffic also ) can lead to failure. insulation ~ REGUL can destroy t he Compactfou ABLY WATER TtfE VEGETATIONSYstem. It IS or heavy the ystem OVER NECESSARY TO gr beneath IS NOT sufficientA SYS'f'EM~~ Effluent covwr, alone tp in 6• maintain a Periodic inspections b f nt~ss~rY. Inspection ht the owner, or his ana...._ .. . r.Y E"~ V~rsconsin t?epartntent of Commerce SOiL EVALUATION REPORT Page j ~ 3 Qivislon of Sa#ety and Buildings ...........a_..Y....... ,._~_ e • --- --~--- ------ __.._.. _.., ..~..._,....,...... Attach oompleis sltep~an on paper not less than 8 1/1 x '! t inches in size. Plan must County s - 7 ' ~~ 0 /' include. but not limited tor: vertical and horizontal reference point (BM}, direction and pett:ent stage, scale ar dimensions; north arrow, and loca6an and distance to nearest road. Pasoel i.D. ~' ~~ ' Please print ail Infon~nation. R Personal lnformatian You t~kie rrray be used for seonn~ry prxposses tPm+~Y t.aw, s. t5_oa (t) (m)). ~ ~ ~f'Z 3 / G Property Owner KEi V v r1~1 j -~14'S ~ Property Location S /~ N ~ ~s 2 ~ ~ ~ Govt. lol , 1J4 14 S T E (or) w tit R P --ry Owner's Mai' Add ~~S G~ ~~Yie 6~~ Lot # 8lodc # ` Subd. Name or CSM# P~i~ T~ o ~ ~~ ~4 ~2 5 ~Y State Zp Code Phone Number ~SoN ~~• SYoi4 (?~S > 3~G•~?7S [] t;ity ^ Uiilage (Town Nearest #2oad vOsb ~v J3~+-K~ti t~~2 . ~-~" Cor+s#ructivn Use: ~Residerltial i Number of bedrooms Code derived design Aow rate da GPD Q Replacement Q Public or cbmrneraal -13escx~e: . ' Parent material _ /o~ss cy~ Sf}~y0 y o~{~!!~-S~ )"food 1'lais, efevetion if applicable ' - ~ ~T ft. Gem and rr3cx~amnendaticxss: lQ~I°~'r}- TE"S'T~ S!, ~' T~c /--2_ I ~~ /~ti Div j~/Pd vv p r /~ Pit Groand surface elev. ! I - % ~ ft. Oeplh to tknibceg €ac~ ,7~ ~SL_ ~. t3epf~h Dart Redox Desa~Fon Texttxe slruch,re Ccxrstster>ce t3oundauy Roots GP D/tr= ~- Mur>se~ Qu. Sz Coat. Cotor Gr. Sz. Sh. 'Etf#1 "Etf#2 3 ' 3 ~~ Y ~~ D c . --1 ~• Z 0- /D S ----- ~, ~-- __ 9 . sv .8 ~-~ ~ ~ Pit Gawrsd sexface elev. ~,,,~ ft. tep,a, to f~r~ `ID ~,. soa Rate t~ortmn QePth Dorrunant Col - Redox Qescriplion Texture Struchne Cartsistence Boundary toots GPf3(fg ~. Munsea Qu. Sz. Cont. Cc>tor Gr. Sz Sh. 'E>i#1 'E1T#2 / ~ ~ ~o ~ afshJ~ ,~~ c~, s z nor ,3 SiL /~ ~~ .z •3 o• io Gz M° S /! v Lt a s . Z vtgey D.P.u. ~c DNS .>' tmuent sz = ttvu > ~ < zz0 mgtt and TSS >30 _< 150 mgJL ffiuent #2 = BOD < 30 and TSS < 30 mglL . CST tJarrte Print) Addr+ass gate Evaluation Condlx~eri Telspha-e Number' ' a~ ~ -6 S •~7~ • 3 L/ Gd Z Private Sewage Consultants 2812 10th Ave. Spring Valley, WI 54767 ~~ ~5,~~ `~~~a ~---~- P,+operty owner ~~ ~ ~ ~ Parcel 1D # ~~' ~s ~- 3 Page or ~;_} .. 1,29-pqt tiRriJfloSVflaCeeleV. n. vepurcvmruuryrauw - - na. SOt~ Rate Horizon DeP~ t7txtti~ant Redox Description Texture Struct+xe Consistence 6our+dary Roots GP pAfg In. Munsed Qu. 5z. Cant Cokx Gr. Sz. Sfi. 'Eti#1 'Etf#2 ~ D • io y,P3~3 S~ 2 s~~ S c~ 3 S ,p s -------- /L Z S ~-f ~~v / . s !S • o /o~ /c' c i ova r-s si~G h~~sh<< v ~ S --- . z. . 3, S ~a~~ s/ ~ s ©, • 7 ~• . ~' 9~ t ~--9 # ^ 8arins 5~4'•'~/qS ~ ~.___._.j (J Plt cifoitnu ~~ etev, re, vepur w rsrxtn'tl cac un a r. So& ip6ion Rate Horizon Oeptlt Dominatd Redox Desaip6on Texture Struciwe Consistence Boundary Roots tSF DtftT h Mtmsell t1u. Sz. Coot Color Gr. Sz Sfi. 'EtT#1 'Eff#2 Pi! Ground surface elev. ft. tlep~h,i~o 1nttritirg factor ~. • Sod Rate rizon H De ot »Orrdnant Redox Description Textur>3 'Strticttrte Consistence Boundary Roots o p in. Mansell - Qu. Sz. Coot Golan ; / Cr. Sz Sh. 'Eff#i 'Etf#2 _, i-`-`1 ~ Borina ssorny rr Ground surFace elev. ____,__,_- ft. t7eptn to rm+rtu+9 raczor n r• ^ Fit ~ Ticxi2on DepEtt oanh,ant ftedox Oesat TexturE Structure Cons'sstenoe Boundary Roots i<t. Munsetl t'1u. Sz. %Gokx tx. Sz Sfi. Sod gate GPDt1f `Ef#f1 'EtT#2 i ' l=fffuertt #1 =BODE > 3t) < 220 mgli. and TS5 >30 _< i50 mg-t. ' Efliuerrt #2 = BC?U5 < 30 mgA. and TSS _< 30 mgiL i ., -,,. . .N ~ ~r ' 5 cq-/..e~ ~ = Z.v -. ~ ~,~-cam' /j~'TS d -_ ro.~ ~v-v~ ~s .r--- ~~ ~ t5 ~~ y~ ~ Q ~, ~ Y7 ~ d~ a W ~~ ~~ D~ ~~ ~ e ~y~~~ ~D f ~o r 3g -D • o ~Z i 2 d rJ~ ~~ ~ ~ t ~ ~~ ~~~ ~q5 '' ~ P~o~os~~v U 1952P 5y9 STATE BAR OF WISCONSIN FORM 11 - 1982 LAND CONTRACT Individual and C°ryocatt (TO BE USED FOR ALL TRANSACTIONS WHERE OVER DOCUMENT NO. f25,00D LS FINANCED AND IN OTHER NON-CONSUMER ACT TRANSACTIONS) 667523 KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD Contract band between STE57EIV L. SATZREf1 and 0b-20-20Q12 9 s 30 AM CAPE L. BAK~, husband and laife LEWD CONTRRCT ("Vendor", i EXEUPT N whether one or more) and 1CFL'2IQ(Yd 7. ST REC FEE: 13.00 TRANS FEE: 3296.60 ("Purchaser", whether one or more). ;; COPY FEE Vendor sells and agrees to convey to Purchaser, upon the prompt and Eull performance CERT COPY FEE: of this contratt by Purchaser, the following property, together with the ren[s, profits, ~; PAGES. 2 fixtures and other appurtenant interests (all called the "Property"), in St. Croix County, State of Wisconsin: 1~ 1/4 of the SE 1/4 and the 1NJ 1/4 of the SE 1/4, ~' THIS SPACE RESERVED FOA RECORDiNO DATA all in Section 15, Towrtshlo 29 Plorth, Rdnge 19 West, I~ NAME AND RETURN ADORE S / !~ EXC~'i a parcel described as: ~'~ ~c -~'cU~ Beginning at the E 1/4 corner of said Section 15; thence ~((oQ' S00°47'33"E, along the east line of the SE 1/4 of said ',, ~~i `~ ~~~~ Section, 407.27 feet; thence S89°OQ'15"!a 535.46 feet; .W.uo'z- thence S14°10'34"17 93.31 feet to a point on a 90.00 ° zo io2~=20-060', 20=1027-30-000 ~~~cul~ve3doo3cavahose chord bears NS4°32'~33.5"Wangle and measures 35.41 feet; thence northwesterl alon the and 20-1027-40-000 Y ~ PARCEL IDENTIFICATION NUMBER arc of said cuzve, 35.71 feet; thence N14°10'34"E 76.12 feet; thence NO1°07'26"4T 400.07 feet to the montmteslted-south line of Certified StlrVey ?1aq rewrded in Voltmte 1, Page 217 at the St. Croix County Register of Deeds Cffit~; t~Lenoe :138°51'13"E, along said south line, 570,78 feet to the point of beginning. Described naroel contains 5.37 acres (233,855 scl" feet). ??arcel shall be subject to a ?private road easement that is to be shown on the orovosed subdivision. Parcel is subject to all easestents, restrictions and covenants of record. Phis i5 not homestead property. (is) (is not) Purchaser agrees to purchase the Property and to pay to Vendor at 347 Bakken Road, Hudson ATI 54016 the sum of 8~-, 082.135.00---------- in the following manner: (a) 5 200 000.00----------- a[ the execution of this Contract; and (b) the balance of S 482.1 ;5.00------------- ,together with interest [tom date hereof on the balance outstanding from time to time at the rate of Seven (7$ ) -------percent per annum until paid in full, as follows: P-bnthly ~avr~nts of interest only in the atrount of $5,145.79 cam~encinq September 15, 200? arid continuing on the 15th day of each month thereafter for a period of twe (2) years fro^.1 execution '~ereof, with a balloon oavrlent of orincinal and interest due orl or before Aur?ust 15, 2004. The terms and conditions as set forth in the Purchase Agreement between the above tDarties shall survive the closing of this transaction. Provided, however, the en[ire outstanding balance shall be paid in full on or before the d'S~ day o[ Allg11St, 2004. ~ (the maturity date). Following any default in payment, interest shall accrue at the rase of 7 % per annum on the entire amount in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance). Purchaser,~ttfess-txcasediryi+etedor, agrees to pay ntonrhfp~m'ttrtdvr blyamitipate>fcennual taxes, special ' assessments, fire and required insurance premiums when due.-io-tlreextrnc-trceYve~'b}rbFrtdrn-'dettdoragrees'ro"appl}rpaymettts~athese ftmtf-ot~rtts[eeactomn-trtrr'shall'tterbearltttetes['vMess'orhetvalserequtted'b9'iaor. - Payments shall be applied first to interest on the unpaid balance at [he rate specified and then to principal. Any amount may be prepaid ' wi[hou[ premium or fee upon principal a[ any time after C10SintT" ,-1g-="'1'pR7LttEnZtCapt£TSS15R>53yRtfSi'CS[~f[tTtf~l wirhuurpcirrrasiort-nPblcntinr"- In the event of any prepayment, this contract shall not be treared as in default with respect to payment so long as the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be treated as unpaid principal) is less than the amount that said indebtedness would have been had the monthly payments been made as first specified above; provided that monthly payments shall be ' continued in the even[ o(credit of any proceeds of insurance or condemnation, the condemned premises being thereafter excluded herefrom. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except: Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall be retained by Vendor umil the full purchase price is paid. Purchaser shall be enti[led to take possession of the Property on elosiTlg. :o)pot , STATE BAR OF WISCONSIN Wisconsin Lo°d Blank Co.. Inc. LANG CONTMCT - Indiridual and Cocpocate Form No. 11 - 1982 Mlhvaukea. Wis. U_1952P 550 Purchaser promises to pay when due all taxes and assessments levied on the Property or upon Vendor's interest in it and to deliver to Vendor on demand receipts showing such payment. Purchaser shall keep the improvements on the Property insured against loss or damage occasioned by fire, extgnde~ ivne.SraKe Aepe Vdlue and such other hazards as Vendor may require, without co-insurance, through insurers approved by Vendor, in the sum oC E UU11 tIZ'~71 but Vendor shalt not require coverage in an amount more than the balance owed under this Contract. Purchaser shall pay the insurance premium when due. •The policies shall contain the standard clause in favor of the Vendor's interest and, unless Vendor otherwise agrees in writing, [he original of all policies covering the Property shall be deposited with Vendor. Purchaser shall promptly give notice of loss to insurance wmpanies and Vendor. Unless Purchaser and Vendor otherwise agree in writing, insurance proceeds shall be applied [o restoration or repair of the Property damaged, provided the Vendor deems the restoration or repair to be economically feasible. Purchaser covenants not ro commit waste nor allow waste to be committed on the Property, [o keep the Property in good tenantable condition and repair, to keep the Propetty free from liens superior to the lien of this Contract, and [o comply with all laws, ordinances and regula[ioru affecting the Properry. Vendor agrees [hat in case the purchase price with interest and other moneys shall be fully paid and all conditions shall be fully performed at the times and in the manner above specified,Vendor will on demand, execute and deliver to the Purchaser, a Warranty Deed, in lee simple, of the Property, free and clear of all liens and encumbrances, except any liens or encumbrances created by the act or default of Purchaser, and except: Purchaser agrees that time is of the essence and (a) in the event of a default in the payment of any principal or interest which continues for a period of 4.7 days following the specified due date or(b) in the even[ of a default in performance of any other obligation of Purchaser which continues for a period of 45 days following written notice thereof by Vendor (delivered personally or mailed by certified mail); then the entire outstanding balance under this contract shall become immediately due and payable in lull, at Vendorts option and without notice (which Purchaser hereby waives), and Vendor shall also have the following rights and remedies (subject to any limitations provided by taw) in addition [o those provided by law or in equity: (i) Vendor may, at his option, terminate this Contract and Purchaserk rights, title and interest in the Property and recover the Property back through strict Foreclosure with any equity of redemption to be conditioned upon Purchaser'; full payment of the entire outstanding balance, with interest thereon from the dale of default at the rate in e[Iect on such dale and other amounts due hereunder (in which even[ all amounts previously paid by Purchaser shall be forfeited as liquidated damages for Failure to fulfill [his Contract and as rental Eor the Property if Purchaser fails to redeem); or (ii) Vendor may sue for specific performance of this Contract to compel immediate and full payment on the entire outstanding balance, with interest thereon at [he rate in effect on the date of default and other amounts due hereunder, in which event the Property shall be auctioned at judicial sale and Purchaser shall be liable for any deficiency; or (iii) Vendor may sue at law (or the entire unpaid purchase price or any portion thereof; or (iv) Vendor may declare this Contract a[ an end and remove [his Contract as a cloud on title in a quiet- «tle action if the equitable interest oC Purchaser is insignificant, and (v) Vendor may have Purchaser ejected from possession of the Property and have a receiver appoimed [o coUec[ any rents, issues or profits during the pendency of any action under (i), (ii) or (iv) above. Notwithstanding any oral or written statements or actions of Vendor, an election of any of the foregoing remedies shall only be binding upon Vendor if and when pursued in litigation and all costs and expenses including reasonable attorneys fees of Vendor incurred to enforce any remedy hereunder (whether abated or not) to the extent not prohibited by law and expenses of title evidence shall be added to principal and paid by Purchaser, as incurred, and shall be included in any judgment. Upon the commencement or during the pendency o[ any action of foreclosure of this Contract, Purchaser consents to the appointment to a receiver of the Property, including homestead interest, [o collect the rents, issues, and flrofits of the Property during the pendency of such action and such rents, issues, and profits when so collected shall be held and applied as the court shall direct. Purchaser shall not transfer, sell or convey any legal or equitable interest in the Property (by assignment of any of Purchaser's rights under this Contract or by option, long-term lease or in any other way) without the p«or written consent o[ Vendor unless either [he outstanding balance payable under this Contract is Eirs[ paid in full or the interest conveyed is a pledge or assignment of Purchasers interest under this Contract solely as security for an indebtedness of Purchaser. In the event of any such transfer, sale or conveyance without Vendors written consent, the entire outstanding balance payable under this Contract shall become immediately due and payable in full, at Vendor's option without notice. Vendor shall make all payments when due under any mortgage outstanding against [he Property on the dale of this Contract (except for any mortgage granted by Purchaser) or under any note secured thereby, provided Purchaser makes timely payment of the amount then due under this Contract. Purchaser may make such payment; directly [o the Mortgagee i( Vendor fails [o do so and all payments so made by Pumhaser shall be considered payments made on this Contract, vendor may waive any default without waiving other subsequent or prior default of Purchase. All terms of this Contract shall be binding upon and inure to the benefits of the heirs, legal representatives, successors and assigns of Vendor and Purchaser. (If not an owner of the property the spouse of Vendor far a valuable consideration joins herein to release homestead rights in the subject Property and agrees to join in the execution of the deed to be made in fulfillment hereof.) Dated this j ~ day of AucrLtist iajg[ 2002 K ~ (SEAL) Steven L. Bakken (SEAL) Cav L. Bakken AUTHENTICATION signature(s) Steven L. Bakken. Cave L. Bakken Kernon J. Bast, Donalda J. Sneer-Bast authenticated ~ ~ day of ~ lA~~_v~ ~. TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by 8706.06, Wis. S[atsJ THIS INSTRUMENT WAS DRAFTED BY t ~~~~ (SEAL) .~ernon J. t 1 (SEAL) Donalda J. >~Bast ACKNOWLEDGMENT State of Wisconsin, ST. CROIX County. ~ Personally came before me this day of Aurlust, 2002 , ~ ,the above named Steven L. Bakken and Caye L. Bakken, husband and wife and 'Cernon J. Bast and Donalda J S*~eer-Bast to me known to be the person who executed the foregoing instntment and acknowledge the same. Attorney Barrv C. _T~tndea i a-I:Z ~7Sfd- HtxlSOn PTI 54016 Notary Public, St• lx County, Wis. (Signatures may be authenticated or acknowledged. Both are not My commission is permanent. (If no[, stale expiration dale: necessary.) , 19 .) • Names of persons ageing in any capacity shook be typed or printed below their agttatnm. LAND CONTRACT - lndivldual and Corporate - Smtt Bar of W[scomin, Form No. Il - 1981 ii..,L-~..,1. ~~, ~ ~ i.~yl~. rely vv. ... W / ` E S ~. ~ a NO LAKEo Manufacturer of Commercial Refrigeration Equipment (715) 386-2323 (800) 955-5253 727 Second Street • Hudson,Wisconsin 54016 ®1997Cfad CailnB~~W~kx t SI. Clwd, MN SQJDI 0 o. a N au a ~3 o~ 500 See Page 44 .~cc ra~c i~ • REFRIGERATORS •FREEZERS • WALK-IN COOLERS/FREEZERS • MILK COOLERS • ICE CREAM FREEZERS • PIZZA/PREP TABLES • BEVERAGE EQUIPMENT • ENVIRONMENTAL ROOMS • LABORATORY REFRIGERATORS/FREEZERS • REFRIGERATION SYSTEMS 28 ~ ~~ . ,,~.P,~, ~~ s 7- Unlimited Hunting p,iy~g~ Club lnc 1 A 27.99 67 z'a D&K ' 73 $' r `~ ~ gee^r ~ ~ ~a ~,c,e s ` 'fti1DSON (~) 0 0 V'i N o°~q a N O O aD All Your Family Protection Undr One Roof IT PAYS TO COMPARE! AMERICAN FAMILY AUTO HOME BUSINESS HEALTH LIFE In Hudson See: Steve McDonald 1820 Crestview Drive Steve McOoaald Hudson, Wisconsin (715) 386-9494 N W E 5 JGG rAb'G 1J ~ ti ti 1 ~I u .--i q fdane C c*1 un µA ~ eq S 1. Mutton HIII Rtl p+ /~2. Hutton HIII CI N 2"!3. McDiarmid `t d v OA UJ Comie & Joan Zevenbergen AMISH OAK FURNITURE Highway 63 (715) 684-4707 Baldwin, WI 54002 ATTIC TREASURES RESTORAT{ON Ail Types of l=umiture "I'll Strip For You!" • Repairing • Regluing • Refinishing • No Dip Stripping • Spoke Duplicating • Caning T.291~. - R.19W. l~~tivN ~~ T `S ~ v ~~~ . ~~r,~e`an--------- es a ~ P~~ae~e 1 2 776 7 7 9 sso~ 898, ®777 780781 ~~'9~,, 77~ ' ~ a o O ~ `~ 12 S Q ~ x LOT 14 2.05 ACRES ~ ~ (1.92 AC.) Z 0 / ~, /- 4 5 ~ ~ . so°oo 7 515 ' ~ ~ 6 --- ___~ x x G 4 5 ss o02oo°E 514 2~ 1, " a ~ - 80' RAD TEMP. 7~2 7 3 ®784 ~ LOT 15 ~ 2.70 ACRES `~ (2.70 AC.) 181 x x x W~ N V' M O O r I S1/4 CORNER SECTION 15 '""~452~~ - -' 451 461 ~~' ,% - 792' /~ -~ + ~~~~ j -: -, 2 /' -: -,~ . ,, - ,, 788 x 789 .• ~ ,% + ~- ~; /~ ,L~~. 16! 513 ~ ~ ~ ~ -787 ~-~ ,~ + i ®786 ®785 + LOT 16 1 3.45 ACRES (3.13 AC.) N N6, Nx, x ,~p I (N~ M 995.09' 381.29' 4 71 166.11' 4 ~ -x x--®---x .g x x. 529