Loading...
HomeMy WebLinkAbout020-165-40-000 o o `~ ~ ~ J m o- ~ Z ~ Z ~ @ ~~ ~ _ A ~ ~ N ~ N N O O Q ~ ~ O 7 O 7 (p ~ N ~ ~ Q O I' ~ ~ S N v m m N ~ N 3 ._. O O ~ ~, O ~ m Z ; o 'r o o Al 0 0 W ~ ~ I~ O c rn m oc ca N (/1 c~~o m c m m N =~ D ~ o ~- ~. ~ Q ~w o N Q. ~ rn ~, z 0 ~ n~ rn ~ ~ ~ s o ~ o m co ~ ~ v a m 7 N (~ S m N O ffl ~ O ~ O ~- N~ o o d ~ g c i o v ~ ~ m m ~ ~, ~ ~ v ~ ~ ~ ~ ~ ~ v d ~ coo ~ ~ ~ - - ~ 3 r; ~ o -~ ~ u? ~~ ~~' o~ m ' ~ ~ o o N 0 n m m m ~ 3 ~`~ m ~ a N o o ~o '' N ~ m ='- a v °- m ° co ~ -~ W ~ i W p p ~. :-. O rn O Q. O 7 ~ 0 A CO ', t O ;ia O ~ 0 ~ A (O ~ Q fl. 7 ''. O A p N y ~ H y A '~. O .- C ~ ~ "- C w s a ~ ~ ~ Z D a m a v ~ D ~' a ~ -~ w 3 rO r ~ c ~ ~ ,"' o o ~ ~ ~ 7 i N O N N N r d -' c '< ° ° N o o rn rn c n h r o to c ~ ~ o n ~ a N .. `~ ~ ~ N 0 0 0 0 0 0 ~ `2 ~L ~L A I ~ ro ~ ~ ~ . f~q N N ~ I O ~ f~A A N A '' oo ~ D m ~ vv . ° ~ i '~ °f m I ~ ~ c m ~ ~ d N L d ~ ~ m ~ _ 3 ~ °' ~ .. ~ .. m N Z ~ o D o < D ~ a = ~ ~ ~ ~ ~ ~ ~ ~ v ~ o m ~ N fD N ~ y m ~ ro ~ ~ ~. ~ ~ ' ~ n a ~ A ~ ~ ~ _~ ~ a ~ Z O ~ o A ~ ~ O. ~ ~ c0 3 ~ ~- ! A ~ ~ '~, ~ i W ~ W ~ ~ ~ ~ J C ~ C ~_ A '~ '~~ _ 3 3 m ~ N ~ pl ~ I ~ .O ? I W W p~ A CD N ~, o D 3 ~ m ~° ° ~ ~ °~ ~ ~ 3 ~ ' y ~ a r. o' ' ° v c ~ a ~ w m Z ~ o p. a o~ ~ N ~ ~ v m aw m a ~ a a~ v, - ~ ~ m N Q N _. ~ ~ CD d ~ N -. a ~ ~ CD E!a O O 44 I 00 ~ Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM .~rFety 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)]. aermit Holder's Name: City Village X Township Eifealdt, David Hudson, Town of ;ST BM Elev: Insp. BM Elev: BM Description: SANK INFORMATION ELE ATION DATA TYPE MANUFACTURER CAPACITY Septic ~~r~a °~ _ ~.e,~c~, Cis Aeration a IU Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic S L , ~1 Do ' tom Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to well SOIL ABSORPTION SYSTEM /`7 /~/l~ County: St. CirO1X Sanitary Permit No: 499180 0 State Plan ID No: Parcel Tax No: 020-1165-40-000 Sectionlfown/Range/Map No: 17.29.19.1004 STATION BS HI FS ELEV. Benchmark Alt. BM Bldg. Sewer /'" SUHt Inlet ~~ SUHt Outlet ,.Q,~rs ~. Y, l l3~ 9d -J~ -~ ~ . Z 9 3 ~y Y.33 y3-~ ead /Man. Z ~ ~~~ q 3. 3 Dist. Pi r--~s~ Q-~~ 3.3 ~ Bot. System Final Grade S ~, ~ 9 7. S r ~.~'~-tGy t~l' ~ 3Z BEDITRENCH DIMENSIONS Width / Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth ~ ~ ~ ~. SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREA LEACHING Manufa ~ INFORMATION CHAMBER Typ Of System: v rlR~ ~ ~ / , ~ ~ i Model N r: DI~RIBUTION SYSTEM - ~~_ 6~(,~,~,yf/~,d-~, /~qo Header anifold Distribution ~ x Hole Size x Hole Spacing Vent to Ai Intak f ~ Pipe(s) /~~ ~! ~ tv 3~ Length Dia Len th Dia Spacing SOIL COVER l~fo ~tV`` ~ P1~ure Systems Clnly YY Meund Or At-Grade Systems Only / X N'` ~ vwv~~ ~~ Depth Over / / Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed(Crench Center ~~ ~1 ~ BedlTrench Edges Topsoil 0 Yes ~ No Q Yes 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~~/~~ Inspection #2: / / Location: 945 Sherman Lane Hudson WI 54016 NW 1/4 SE 1/4 17 T29N R19W Park View Estates IV Lot 87 Parcel o: 17.29.19.1004 1.) Alt BM Description = ST ~'~ ( ~ -~° ~G(~ '"~ (~-~~Y G~~~ 7 GL~ YLb 2.) Bldg sewer length = ~"~~(~tYUP/~-_ ~~ ~Z,~~~~~/~/y~~.~_, S~/,~,r4~jyyc~4G~~ -amount of cover = ~ ~ / Plan revision Required? Yes No /~j ,, f ~- Use other side for additional information. ~ ~ ~"' G2~~--'~`•~- ~~ J SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. Safety and Buildings Division County m m 201 W. Washington Ave., P.O. Box 7162 St. CroiX ~scons~n Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) (608) 266-3151 L1 ~ ~U Department of Commerce Sanitar Permit A lication N~ Plan LD. Number y pp In accord with Comm 83.21, Wis. Adm. Code, personal information you provi project Address (if different than mailing address) "C D may be used for secondary purposes Privacy Law, V G L Application Information -Please Print Ail Information 945 Sherman Lane Properly Owner's Name Parcel #: Lot# Block # David J. & Kimberl L. Eifealdt o20-1165-ao-ooo lot 87 Property Owner's Mailing Address gT, CR01X Property Location 945 Sherman Lane Nw '/., S~_'/., section 17 City, State Zip Code Phone Number T 29 N; R 19 W o(~~ ~f Hudson, Wl 54016 (715 386-0793 II. Type of Building (check all that apply) ~Xl or 2 Family Dwelling -Number of Bedrooms 3 ~~ Subdivision Name CSM Number Public/Commercial -Describe Use Parkview Estates 4`h Addition ^ State Owned -Describe Use OCityOViilage OXTownship of Hudson III. Type of Permit: (Check only one box on line A. Complete line B if applicable) `~' ^ New System ' eplacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System B• ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner / ~ ~ 3 . ~ ~ ~ ~~ D ' - W ~ 4 IV. T of POWTS S stem: Check all that a I , ^ XNon -Pressurized In-Crroun ^ Mound > 24 in, of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Crrade to a ass Sand Filter ^ Constructed Wetland ^ Pressurized In-Grou ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand F~lter ^ Recirculating Synthetic Media Filter aching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain) V. Dis rsaUTreatment Area Information: 34 Infiltrator " ick 4" Chambers at 19.1 . ft. EISA chamber + 2 r. end c = 661.0040 , ft. EISA Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) S stem E 450 gpd 0.7 gpd sq. ft. 642.86 sq ft 661.00 sq ft EISA ~ 91.00' VL Tank Info Capacity in Total Number Manufacturer Prefab Site tber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks septic or Holding Tank 1,000 1,000 1 Wieser Concrete - X Wieser Filter Canister to be X ed in series with Poly ~~ PL-525 effluent filter Aerobic Treatment Unit Dosing Chamber VII. Responsibility Stateme t- I, the and signed, assume respons r installation of the P4WTS shown on the attached plans. P[umber's Name (Print) lumber' ignature MP/MPRS Number Business Phone Number James K. Thompson ~----- MFRS #30021 (715) 248-7767 Plumber's Address {Stmt, City, e, Zip Code) 340 Paulson Lake Lane, Osceola, W1 54020 VIII oun /De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee (includes Groundw Surcharge Fee jU D to Issued y suing Ag t re s) ~ < ^ Owner Given Reason for Denial QQ • ---' a 5 ~ ~ ~ IX. Conditions of Approval/Reasons for Disapproval ~ ! `~ L_ ~ ~ 5~~~~ ~ ~d?~tJ ~G~~~/f'l% V `7L' SYSTEM OWNER: 1 Septic tank, effluent filter and LL '' '' G~t~~h~~~ ~~ CL-r /~~~ ersal cell must all be serviced /maintained ~T~`~~ dis p as per management plan provided by plumber. ~(11~3_ ~, ~ ~ ~~n/c~-- i d ~ ~'~'r~' tb i t b i t U ne n rements mus e ma a 2. All se ack requ i / ' ~ ~ ~ ~'~~~ as per applicable code/ordinances. ~(,fi XXX 7 v ~i1~7 Cav .~ ~ _ , ~( ~ y-- ,s ~d Attach complete plans (to the County enI ) ror the system on paper not Ins than 51/~ x 11 inches ~ size / ~ (/~ -S~/h ~ f,~~/~-o sy ~.~ qz ~~ `, a'~~ b~ ~ l SBD-6398 (R. Oll03) ~~~~ ~~ ~ vas f ~Q w,~f„ Z , ~ ~ 3 ~ L-~ IJZJ ~ .Soi/2~/a/ua~~~, p, E~ ~ /oCA~t~~i'op S~ ~ Q~~#~~ Er {e~ /c/~-,o ro~o., /off e 7 y ~ l~~ /'+C~diCuJ ESQ-~~S 5e e . / 7, 5 ~ . cra;,r ~o; ~.Ji .~~.z. o S~ai'~+-ian f ~e • J" ' /~s~~5 ,~ ~. s ~~% ~~~ T~roposeo/ ~%s p~rs~L/ ce //. ~vo(z~ ti~e,•,c~lsa~3XYJ ~3~r E°6a-/~ ~- argue may 9uS rv2// -----. `.~ 8"~a9c f~~ccd de$ fkn ~ I of /Y(an~{o/t caves ^ 96. /7' Oct/~ C/eve = 9.3.97. N>l $wa~e 99.0 i ' Q ~/ e '-- --_..J ~.ep Od~Lam E,Y/3~,~ /8 k,3~o'drs~'er E,r.s~ny o S,a/,-~,~. ,gssumed C't//. 7~a 6f /eCOn/lPG3 3 b.cal .~,-, / / ~ e2µ s~/~ll~. LZI' !~C'OrnPdn~ri~ ¢/2da: rQcsie%nCC ~f~~c..J:tsarCwC. ~ac/'/~,~ r rt ~'/au /-b/~rYP~ szs dl~K , ~ ~ PFC'/cc~rc ~ ~`/~ ,. 98.0 r- _ ~ '- .r ~i l se ~,' - j . } ~nc~~~/,~~~ PcoPoS.ed L,__ ~ of S~Df.•C ~n~ ToN dn,/cK. M _ ~ r,-_ ~ 8Z 97. o'~b~z5o~ ~' -~ , ' .~ ,, ,Z. O ' ~ , ' ~ ~S3 ^ Soi/e~/a/ua~~~-, p, E • Ex~~'~ ~ rad~ Q/2v' • /acre-~~~Oi'op Sfax Ei ~e4 /o/~- ~D rp~o. /o ~ 67 5! ~ ~v ~~ ~~dJeuJ E.SE~~S Sec . i 7, 5 E . e/'8ix C'o ; cJ/. 0 .S~esrh-fan ~e /1.O -- -----, a'~; ve may i -. ga~4,yc fe"~td ~ deb ra., ~ Sus ~~--- -~.~ 0 gara~2 moo, ~, ~J,¢cl c~ /Na-/'L! • Baf~`drn E,Y.s~ir ~8 k 3(~' e',Spei ~6,a1,-~ flssume~ Ct//. T 6C /LCOn/rPCZ 2/Zv.` ~Up. GPI' !~' C'am~di~.~ ~ a Leda: ~e~S.e~ c..J: cSafCwC. ~OG/'M, ~~/~R [/i Ley {~au- ~:YEer Con. Ste- wy /-b.(' PL SL S ,} / ~ ~'` ,~ O! ~T/ `` ~ 82 E,Yi S'GOiny / i 3 6.cal.~o.y, ~/ E,{'iszti~ LJe~~ ~Qesiq/cnCC ~\ i dtcK ~ ~ i E,Yis~fi ~ifslr~',• Canc r~ Wo ~,, p. P~o,~ s-ed~ ,S4o6~C ~n~ Tc~o da.~irK. aF /Yla..r.{o/i cover ^ 98. /p.'Ou~/e.E C/e~ = 9.3.97. F~~ ., ~ 97. o'C}pr~~Yie. ~ -'~ ~ ,' ~•~ ~~ ~'sys~, ~~~~~~6~-, Tvo (z~ t~c.,,cf,~ s a ~ 3 X xJ ~~ . r-i j"- ~ ~._~~ I Q a i f'l ~I i ,~~ / ~ ; \ i_ ~ p ~~ ~ n C i / C ~ \. _~ ~ I " ~ m -i ~ -- p o...._. D _ ~ f •®°~ Z --- ~ ~®® p ^®~ D m ^sa. ~ ..... ~ ..~~ ~ ~ ~ w~s~ -~ C7 D ~ e®e ~ ~ _ -- ~ b ~~® r~i m N ~.. -- ~, .~.~ m ~ m ^.•-. ~rA ^®~ ^~~. 3.~., cr ^A~~ .ter ~~ ~~ _ ~~~ x= ~x~.~~. a ' _ _ ~ ~^r z z ~ =o, _ > ~ " -+ ~ ~- ~ ~ti ~~ ~ ~. ~~ pG r C z~ J ~' A J Wisconsin Department of Commerce *'""""""'~ 301E EVALUATION REPORT Division of Safety and Buildings p~ ~rrn~vi~nr•w wHh ('runm RK UPc brim (:nriw 2005 Page 1 of 3 A.C.E. Solt & Site Evaluations County Attach complete ske anon pl paper not less than 8'/: x 11 inches in size. Plan must St. Croix irx:lude, but not limited to: vefical and trorizontal reference point (BM), direction and Parcel I D percent slope, scale or dimensions, north avow, and location and distance to nearest road. . . 020-1165-40-000 Please print all information, ie Date Personal ir~farmation you provide may be used for secondary purposes (Privacy Law. s. 15.04 (t) (m)). ` ~- Property Owner Property Location David J. & Kimberly L. Eifealdt Govt. lot 1/4 1/4 S 17 T 29 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or C5iU1# 945 Sherman Lane 87 Parkview Estates 4Th Addition City State Zip Code Phone Numbe Alage ~ Town Nearest Road Hudson ~ WI 54016 (715) 3$6-~ E E Hu on Sherman Lane New Construction U3e~ ~ Residential /Numb of ~ Co a derived design flow rate 450 GPD /f Replacement ;~ Public or commerci - De Parent material Glacial Outwash ST. CROIX COUNTY food plain elevation, if applicable na General comments and recommendations: Site suitable for conventional ispersal cell at 0.7 gpd loading rate. Existing dispersal cell elev. = 92.50'. New dispersal cell elev. to be = 92.50'. Boring # --~ bring '112" Pit Ground Surface elev. in. 98.51 ft. Depth to limiting factor Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P Iftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10yt3/3 none sl 2fsbk mvfr as 2f,1mc 0:6 0.8 2 10-23 10yr3/6 none Is Osg ml cw 2f,1mc 0.7 1.6 3 23-44 10yr4/6 none Is Osg ml gw 1vf 0.7 1.6 44-112 10yr5/6 none s 0 sg dl - - 0.7 1.6 ~ ' o,i2" ~2 " - ~ d ~z . ~ = ,~a „ o~, ~ 2 ,, ~, ~ Lo ding rate of horizon reduced to reflect reduced permeability associated with irr ular, ~scontinuous bands of 1 /b lfs. Boring # ~ Boring ~+~' Pit Ground Surtace elev. 97.89 ft. Depth to limiting factor >104" in. Sod ApptlcaGon Rate Horizon Depth Dominant Cdor Redox Description Texture Structure Consistence Boundary Roots P D/R' in. Munsell Qu. 3z. Cont, Cobr Gr. Sz. Sh. *Eff#1 'Eff#2 1 0-6 10yr3/3 none sl fill 1fsbk mvfr as 2vf,fm 0.0 0.0 2 6-11 10yr3/2 none sil 2fsbk mvfr cs 2f,1m 0.6 0.8 3 11-20 10yr4/6 none Is Osg dl gw 1vf,fm 0.7 1.6 4 20-34 10yr5/6 none s 0 sg dl gw 1 of 0.7 1.6 5 -104 10yr5/4 none s Osg dl - - 0.7 1.8 ~. 6 b ,~ ~~ ~~ ~2 S ~ ~~~ ~OV ~~~, Loading rate of horizon H#4 reduced tore et uced permeability associated with irregular, discontinuous bands of 10yr4/4 I s. "Effluent #1 = BOD 5> 30 <_ 220 mg/L a S >30 <_ 50 mg/L Effluent #2 = BOD < 30 mg/L and TSS < 30 -n9/l, CST Name (Please Print) Signatu CST Number James K. Thompson ~'-- 3602 Address A.C.E. Soil 8 Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane. Osceola. WI 54020 9/14!2006 715-248-7767 Property Owner David J. & Kimberly L. Eifealdt Parcel ID # 020-1165-40-000 Page 2 of 3 Boring # -~ Boring r~ Pit Ground Surface elev. 96.82 ft. Depth to limiting factor > 103" in. SoU Application Rate Horizon Depth Dominant Cotes Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Cobr Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10yr3/2 none sil 2fsbk mvfr as 2vf,fm 0.6 0.8 2 9-23 10yr4/4 none sl 2fsbk mvfr cs 2f,1 m 0.6 1.0 23-45 10yr516 none s Osg dl gw 1vf,fm 0.7 1.6 4 45-49 10yr4/6 none Is 0 sg dl gw 1vf 0.7 1.6 5 49-103 10yr5/4 none s Osg dl - - 0.7 1.6 ~~~~ ~~J ~~<~ O •b ~ ll! /. ~ ~~ ^ Boring # J Boring _j Pit Ground Surface elev. ft. Depth to limiting factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ^ Boring # --~ Boring ~f Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS <30 mg/L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.o7/o0) A.C.E. SON & Si6e Evaluations • ~oclL~.td/Oi'oP. Sfse..f'e Qt~ #-ZG~S E~ ~'e4 /o/~-,o rod, /off B7 5~ ~isb4 ~, %~~d1euJ Est-~~S ~ e . i 7, 5 ~ . L' /'Bi.Y C'o ~ cJ/, S!/1.0 ' 0 .5/~a~n-pan ,%~e $arnnJ e -----, ,~ c~~;ve~ay ~a~a~c ~ p' f'an~cd i ~ ~. d e~ ~lwn ~ 9 u~ N ~ - - - - -- J ~zn~i /Na.~',~1: Bait`-em E,r~s~~ /8 x .3~' e',3~e~ ° o 'S.o(;n ,QsSuinQd Ct//. Te 6C/eCOn/te[:Z`4 E~YiSt1in ~' e~eµ ~ m ¢/~da.~~ 3 6.~~,~e..-, ice. cv s;~' eo.~,oe~ .~ ~ Ex/S'L~i rJ ~ ~C/Yrf. ~~/'a !/i Ley 'F/acv. ,Qt s~~/<nCC ~ ` ~ (.ve /~ ~C dtcK ~ ~ ~ .98.0 ' i ~ r~ ~ ~ ~ ~. / ' - ~ ~ ~y -~ ~ , ,S40Ei~C ~a~ Tb~o i,~~_...,._. o,c /YIa..~.(d~ cvv~ ~ ~ --- • _.,_~,_-~: ~ 9T. o'Cbn~ou. __ , i \ _~ ~ ~ ~ y p~. 3 0~3 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/fez'` ~~ yi d ~ ~ ~'m ~/~y ~• ~~ e~/o~E Mailing Address 9 ~S ~~erma.~ ,(a r, ~ ~/~~c,ols ~ C,~7/. SS~~/>d Property Address ~2 (Verification required from Planning & Zoning Department for new construction.) City/State ~,~~ls~, c.J/. Parcel Identification Number ~-2.O' //~s S~-0~ LEGAL DESCRIPTION Property Location ~?Gc~ t/a , `-~ ~ '/a ,Sec. _[~, T _~N R~~W, Town of ~~~r- Subdivision l"a~~r/i~J ~5~,~.s ~~t~~%~o~ , Lot# 87 . Certified Survey Map # `- Warranty Deed # Volume ~ ,Page #~7 Volume ~U % ,Page # / Spec house yes no Lot lines identifiable yes 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 pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter I2 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify [hat all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms ~~, SIGN URE OF AP ICANT(S) 9 ~-sd;~ DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning 8r. 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) Conventional Septic System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code Ge eral The conventional septic system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall be maintained in accordance with component manual SBD-10705-P (N.O1/O1). All local and/or state rules pertaining to system maintenance and maintenance reporting shall be complied with. Septic Tank Septic tank servicing mechanics comply with Comm. 83.54(1)(e). Septic tank to be Iocated within 150' of service pad, with bottom of tank to be <_ 15' below service pad elevation. The operating condition of the septic tank and outlet fiber shall be assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in the tank exceed 1/3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48, Stats. If the contents of the tank are not removed at the time of a biannual assessment, maintenance personnel shall advise the owner of when service will be needed to maintain less than 1/3 scum and sludge accumulation in the tank. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be xemoved unless provisions aze made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated. Septic tank manholes risers, access risers, and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service, Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8 inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank abandonment shall be in accordance with Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Soil Absorption Cell Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for vegetative maintenance) over the system is to be avoided. Soil compaction may hinder aeration of the infiltrative surface within and above the system and will promote frost penetration during cold weather months. Cold weather installations (October-March) dictate that the system be heavily mulched for frost protection. Influent quality into the system may not exceed 224mg/L BODS, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for the installation. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner. Levels above 4 inches indicate an impending hydraulic failure requiring additional, more frequent monitoring. Effluent flow shall be alternated between dispersal cells on a two-year schedule by use of a diversion valve. Valve to be switched diverting effluent from dispersal cell currently in use to resting cell on a two-year cycle coinciding with septic tank inspection and maintenance. Contingencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. Excessive ponding within the dispersal cell will be eliminated by installing a new soil absorption cell to bring the system into proper operating condition. Questions on the operation or maintenance of the system should be directed to the installing plumber, Jim Thompson at (715) 248-7767 or the St Croix County Zoning Department at (7I5) 386-4680. ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the ~-~/ S ~` ,-m~~/v L. Ei~'e~/~l~ residence located at: nW '/4, SE '/4, Section ~, Town ~~' N, Range /y' W, Town of /~~cdsr~•-~ , St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of Comm. 84.25, and it (they) appear(s) to be functioning properly. Most recent date of service ~~p~. ~(, ~~ --TT Did flow back occur from absorption system? Yes ~ No (if no, skip next line.) Approximate volume or length of time: gallons minutes Capacity: ~'~a.~ Construction: Prefab Concrete ~ Steel Other Manufacturer (if known): ,-eS~/ ~r,cr.c-Ee. e o ank (if known): /8 s 7i-~o~~s 0.2 2 ~ ~ --~Q~,~s ~~~-~O-sum censed Plumber signature) (Print Name) /~ P~~S. (Title) S~ as a~ (Date) 3~ (License Number) I~LMPRS Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) ESTATES - --~ _____ ____ ~., ~r.. N 84 ~ u S7g~6 ~~ ~ ~' ~ coR~ As ss9°21'ao'w) ~°52~4~"VIf- _ - -- '~ ~__ _ ~. ~ - - ~ ! ~ ~ Sf39 208'1N 1332 ° ~'~ 157 ~ E I /4 COR. o' ~ ~ SECTION 17, 6S ~ W ~ ~rr) I T 29tJ~ R 19 W r- 85 ADDI1~10(ti 86 fc~ j m ----!! -- ~`~ W? ~ t~l ~ - _ o~ Q~ p ~ ~ ~~~ ~, z I ~~ r ° ~ !! ~ ~ v ~'~• ` N 89 52 40 W 412.00' ~' ° ~ ~ -------____-- POINT OF ~ ~~; -- _ _ _ -- -- -- _ _ -- - - - _~; •'; BEGINNING i~ ° ~~ ! ~ ,, ~ `.~. ! ~ ,~ 90 - - t19 ` ~ ~~- O ti { •~ I o ~ ~ Q~ 1.608 ACRES of ~ ~ 0 I 70,040 SQ. FT. ~j ~ t ~ f ~i ~ O i .~ m ! N89°52'40"W 412.00' h0 °~ ~ h ~ I ~" ~ p ~ ! \ O~ I r' I- 88 ~ s ~~~~ 92 ~; , o ~: i t o W ~ ~ 1.608 ACRES 70 040 St?. FT ' O G) ~ ~I !. 166 ACRES I ~ ~ to 50, 782 SQ. FT. O ' ~ ~ ! ~ O ' +n i ' ' N89°52'40 "W 412 00' + ' ~ ° 3 E N8CP ` ~ ~' , 206.C~~ - - - . _ _ ` - - - - i 1'~ ~ 110 -------~- ~0 ~ I ~ ~ + I - 206.00° - _ __ - , ~ ~ (x~ V I ~ ! , 1 g., I o ~ 3 t cn i z ~ p ~~ , ; ~ Q~ ; ~ 90 ~ ~ 89 I ~~ ~~~~ 9 ~ ~ O ~ ~ I ~ ! N 1.018 ACRES o ,r, _ O N 1.003 ACRES ~~ 1.019 ACRES C I 7 ~ l 44,338 Sid. FT. ~ 43,695 SU. FT. 44, 383 SQ. Ff. ~ I N 4249 87' i ao°S'%s ' (n 1 ~oP ' "..O ~~ . ----------- + ----~ ~ ~~ ---- 206.02 - -- ---- --- ---206.b2-- ~-. ---~..~ 189°15 14' E N89°15 14 E 412.04 - - - - ~ coo --- - - ---------- -= ~~ W _= - S89°!5'14" W 412.fl4' ~ ('~ - - - - - - ~ _ ~ ~a ~ { ~ - - - s 206.02' - -- - - - -- -- - - - - 2t~6.02' -- -- - - - ~ „ ~ C,3 I 0g ~ 0 Q ! ~ ~ ~ ~I z1 ~~ I QI -~1 o! WI ~~ --i Q JI ~i zi ~1 n ~' O 3 ~. ~ O N 4 ~ ~ i ~ d ~ m Z Q m N ~ sn ,P ~ ~ a ~ m ~ I N fl- ~ O ~ ur N ~ ~ _ CD n-« Cl O ~ cn ~ D ~ ~ N N 'D ~ c ~ ~ ~ (D ~ N I I N I A O N ~ N ~ ' c I o ~ ~ ~ ~' ~ m 0 ~ ~ 0 N C ~ Q ~ ~ ~ N O = I ti m O I o ~ 3 ~ i m ' I W ~ n 3 i Z rn ~ i O N I M v o. 7 Q O_ GL CD ~ ~j O~ 7 i a v {l1 Z _ O_ 61 (D n N O O (a N CD ~. n i ul O (D O 0 O CD p L ~ v,p g'oC~ 7 ~o ~ Cf 3 ~ N p fD 'O ~ ~ ~ 01 A i ~k ~ .. O ~ ~ O ' C J ~ ONO ~ O ', ~'i y N -` O ~ ,~ p ~ O ~ U7 ~ '. ~ O O /1 t d N ~ CD N ~' a .. w ~ ~ ~ '' N _ O CD ~ O) _ '' D W C ~ I ~ ~ N '' D O /i ! ' ' •• v ~ ~ ~ ~ v ~ N y ~ ~ -, ' Go v ~ ~ m y m _ ~ °~• m ~ m H m 3 ~' y ~ .. ~ 3 ~ .. N Z W Z ~. D n 3 ~ ~ i m a ~ 11 ~ c m ~ n ~ ~_ ~ ~ !I A Z n O c -• ~i ~'! 3 a A Z O .. ~ O O. ~ ~ Z ~ ' ~ ~ °o " cn 3 ' rn ~ tll ~ W G T C 3 O. ~. `• ~F~? - Forts - S T C - 104 ~~ AS BUILT SANITARY SYSTEM REPORT I OWNER ~ ~.yt ~f f,(~~,~/` TOWNSHIP y~~~~ SEC. ~ T N-R W r ADDRESS ~~ ~~ l~p~~ Z p Z.ST. CROIX COUNTY, WISCONSIN ~u ~ soh ~..~ ~ s-- ~~a ~ ~ SUBDIVISION~c~r K V i t~ ~Sfi~Ta 5 LOT ~ ~ LOT SIZE ~.. 2 /'~~a f/ S PLAN VIEW Distances and dimensions to meet requirements of IZI1R 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM v , ~* 8 ~ ~ara~ Dr;/a_ uJa~ c~'~X2y ~ Vla. I t ~ 3 ~ l -~!1 i ~ ~'`C - --- _ ~~-~I ~ - - /35 ~ ~ ys' 3 ~' a ~ ~ ~___._..___.... _ _ ~~ p ___ ._._~.~ INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used ~ "~~~~~~ s~ (~, ~e / Co~N ~,.~. Elevation of vertical reference point: ~Da• ~ / Proposed slope at site: 3 d/o S~ Lc PUMP CHAMBER ]~ Manufacturer: '~~/ Li uid Ca acct /i/ q P Y Pump Model: Pump/Siphon Manufacturer: Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Number of feet from building: (Include distances on plot plan). Pump Size, Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest- property line: Front, O Side, O`Rear,~ Ft.~ Number of feet from well: SOIL ABSORPTION SYSTEM Bed: ~c7~dac-~~oti¢ ~ Trench: i Width:f~ Length:~G Number of Lines: 3 Area Built: f~~S Fill depth to top of pipe: y~ ~ Number of feet from nearest property line: Front, O Side, Rear,O Ft. 3 7 i Number of feet from well: ~/~ Number of feet from building: Z y' (Include distances on plot plan). SEEPAGE PIT Size: Liquid depth: Area Built: Number of pits: Diameter: Bottom of seepage pit elevation: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Number of feet from well: Number of feet from building: Gallons per cycle: Front, O Side, O Rear, O Ft. Number of .feet from nearest road: Alarm Manufacturer: DE$gRTME~IT OF INDUSTRY, INSPECTION REPORT FOR LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS P.O. BOX 7969 MADISON, WI 53707 NW4j SE~,S17,T29N-R19W CONVENTIONAL ^ALTERNATIVE Town of Hudson ^ Holding Tank ^ In-Ground Pressure ^ Mound T .- 07 n.....1.,., .. L~-..-..a-.. .. Tft SAFETY & BUILDINGS DIVISION BUREAU OF PLUMBING State Plan 1.0. Number. (11 assigneA) NAME OF PERMIT HOLDER. ADDRESS Of PERMIT HOLDER: INSPECTION GATE: Gw ~- ~~a-- ~~ j~ Sam Miller Route 1 Box 282 Hudson Wr 54016 . ~ • BENCH MARK (Permanent reference point ) DESCRIBE IF OIF FER ENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELE V.. Name of Plumber: MPlMPRSW No.: County: Sanitary Permit Number: 102813 Dou Strohbeen 54 2 SEPTIC TANK/HOLDING TANK: MANUFACTURER LIOUID CAPACITY: TANK INLET ELE V.. K UTLET ELE V.. WARNING LABEL LOCKING COVER . ~~~ .~~ + .~/~ PROVI ED'. YES ^NO PROVIDED. ^YES NO BEDDING. VENT DIA.'. VENT MATL: HIGH WATER ALARM NUMBER OF FEET FROM ROAD: ) If PROPERTY LINE: Jam" ` WELL' ~ C BUILDING ~ ' ` VE TO FRESH AIR INLET ~~ ^YES NO ^YES ^NO NEAREST / J J J V DOSING CHAMBER : MANUFACTURER BEDDING'. LIOUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL PROVIDED. LOCKING COVER PROVIDED. ^YES ^NO ^YES ^NO ^YES ^NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PR OPER7Y WELL BUILDI N(~ VENT TO FRESH AIR INLET (DIFFERENCE BETWEEN FEET FROM LINE PUMP ON AND OFF) ^YES ^NO NEAREST Check the soil moisture at the depth of plowing SOIL ABSORPTION SYSTEM LENGTH. DIAMETER MAreRIAL AND MARKwa . or excavation. 1 if soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue,) MAIN cvcrcaa. • •v• WIDTH. LENGTH. NO. OF DISTR PIPE SPACING. COVER INSIDE DIA ss PITS LIDUIU BED/TRENCH DIMENSIONS ~ ~ ~~ TREN~ES ~ I M Efl1AL'. PIT DEPTH GRAVEL DEPTH FILL DEPTH DISTR PIPF DISTR. PIPE DISTR. PIPE MATERIAL: NO. TR. NUMBER OF PROPERTY WELL BUIL DING VENT TO FRESH BELOW PI~ f I ABOVE~VER. ELE V.INLET ELEV. ENO: ~ PIPE FEET FROM Lllyi~ ~ ~~f1 (~~ D ~~ AI IaW ~ ~ NEAREST -~ Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE ADIAGRAMOFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. ^YES ^NO SOIL COVER TEXTURE PERMANENT MARKERS OHSE RVATION WELLS ^YES ^NO ^YES ^NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES. ^YES ^NO ^YES ^NO ^YES ^NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LE NGTH. NO. OF LATERAL SPACING. (TRAVEL DEPTH BELOW PIPF. FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL NO DISTR DISTR. PIPE DISTHIBU TION PIVE MATE HIAL. & MARKING ELEV. ELEV.'. DIA.. ELEV.'. PIPES DIA.'. ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING. DRILLED CORRECTLY COVER MATERIAL. PLAN SCAL LIFT CORRESPO ^YES ^NO ^YES COMMENTS: PERMANENT MA RKERS: OBSERVATION WELLS. NUMBER OF PROPERTY uNE WELL'. ~` ^YES ^NO ^YES ^NO FEET FROM NEAREST U s3 . ~~ ~~ V w~~ ~~ 1~ ~~~ o.~ r~. I ~} ;j ~ ~ ~, ~ ~, ~ SI ~ Sketch System on ~ PQ„S , Reverse Side. 1 DILHR SBD 6710 IR. 01/82) ,~ Retain in county file for audit. SIGNATURE ,.J / TITLE J,. ~ f4A Zoning Administrator SANITARY PERMIT APPLICATION couNTY ~ DILHR Code Adm Wis cord with ILHR 83 05 I . , . . n ac ~.d...M,.o~.,.~.,,~...o~ STATE SANITARY PERMIT # ' ~ a ~3 -Attach complete plans (to the county copy only} for the system, on paper not less than STATE PLAN I.D. NUMBER 8'/z x 11 inches in size. -See reverse side for instructions for completing this application. PETITION ^ ® I. APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION. NO YES FOR VARIANCE PROPERTY OWNER PROPERTY LOCATION i• ~~l" '/a ,SE '/a, S T , N, R/9 E (O PROPERTY OWNER'S MAILING ADDRESS ~~~ ~ ~ Z Z- LOT~iNUMBER v BLOCK NUMBER yS~UB~ dIVISION NAM.E~-,y. ~. CD~(~ V/~tu7 ~/R I t.S CITY, S/TATE ZIP C/ODE L~C/ O ,~ 70/ PHONE NUMBER /,S~ 3~"x7101 CITY NEAREST ROAD, LAKE OR LANDMARK O VILLAGE: ~4~s~~ ~~+ IQOR'~ II. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family OR ^ Public (Specify): III. PURPOSE OF APPLICATION: (Check only one in #1 • Check # 2, 3 or 4, if applicable) 1. a. ,~ New b. ^ Replacement c. ^ Replacement of d. ^ Reconnection of e. ^ Repair of an System System Septic Tank Only an Existing System Existing System 2. ^ A Sanitary Permit was previously issued. Permit # Date Issued 3. ^ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ^ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in #1 and only one in #2) 1. a. ~ Conventional b. ^ Alternative c. ^ Experimental 2. a. ^ System- b. ^ Holding c. ^ Pit Privy d. ^ Vault Privy e. ^ Mound f. ^ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. ®See a e Bed b. ^ See a e Trench c. ^ See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): ~ (p~s 5~ ~~ (py$ ~'T 7 7 ~ Feet i~I ,Private ^Joint ^ Public VI. TANK ; CAPACITY in allons Total # of r' N me f t M Prefab. Site Con- Steel Fiber- Plastic Exper. INFORMATION New xistin Gallons Tanks anu ac ure s a Concrete glass App Tanks Tanks structed Se tic Tank or Holdin Tank t/~~ ~~ ~ c,/ ^ ^ ^ ^ Lift Pum Tank/Si hon Chamber VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name (Print): Plu tier's Signatur • (No Sta ~~,,r) MP/MPRSW No.: 'Z ~t il ~ ber: Business Phone Num r~o~c S D ~^'^" ""'`' / q- „ r/ -+ Z l ~~~ Zy /^~~ l Y~ am Plu tier's Address (Street, City, State, Zip Code): Namepf Designer: ~` ~ ` ~~~ 1 r 1 ~~~tliC~~ ~ ~ ~~ ~~ r 'l~ '^'~' '~' " . SOIL TEST INFORMATION VIII Certified Soil Tester (CST) Name CST # CST's ADDRESS (Street, City, State, Zip Code) Phone Number: IX. C LINTY/DEPARTMENT USE ONLY I~qtpI~ ^ Disapproved Sa nary Permit Fee ~ Groundwater rcha r g Fe e e ate ~ Issuing Agent Signature (No Stamps) L~ Approved ^ Owner Given Initial ! " ~~ ` ~~ ~ ~ ' / ~ \ ~ / / ~i~~ " Qry ~~ ~ ~' Adverse Determination ~-"~~~ w X. COMMENTS/REASONS FOR DISAPPROV L: ` ~ _ ~ f~N ~~ ~. /vUC. ~ ~ ~ y ~~, ~~~ , ~ ~~ SBD-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION TO THE APPLICANT: 1. This sanitary permit is valid for two (2) years; 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable; 3. All revisions to this permit must be approved by the permit issuing authority. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation; 5. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years; 6. If you have questions concerning your private sewage system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 608-266-3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description where the system is to be installed; II. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in #1. Complete #2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in #1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for a//septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. Responsibility statement: Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8% X 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; dosing or pumping chambers; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturgr; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form. ? GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was the result of over 2 years of steady negotiation and public debate. The groundwater bill Ground aia/ ter - included the creation of surcharges (fees) for a number of regulated practices which WiSCOn~iC1`5 can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried reasure is used in your building is returned to the groundwater through your soil absorption o system or the disposal site used by your holding tank pumper. The monies collected through these surcharges are credited to the groundwater fund. adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398 (R.03/86) APPLICATION FOR SANITARY PERMIT STC- 100 ,This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, ("spec .house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Oo-ner of Property ~ m ~ZJ ~~~ Location of Property ~f ~r> _k S ~ __~C, Section ~/ 2_ , T a~N-R / f~I Township _~{cc1 so r~ . Nailing Address ~ ~2 ~ / Op ~r ~ ~. 8',Z Address of 81te S h a ~ r„ a ,,, ,C ,Q /a/~~ yi a ~ E s ~li~d ~ ~ . Subdivision Name _ l~i,~ U;~~ .~~-t-~ firms ~._ '. Lot tiveeber _~~ 7 Previous Amer of Property ~ui~~ / ~~/"~ Total Sise of Parcel ~ -~ a Y> ~ ~ Q / ~. Date Parcel was Created 3 ~~ ~ g Are all corners and lot lines identifiable? Yea No Is this property being developed for resale (spec house) T ~_ Yes No volume ~~ and Page Number / Z as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Wartantp Deed which includes a Document number, volume and Dane number, and the !i Seel of the Register of Deeds. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description reEer- ences to a Certified Survey Hap, the Certified Survey Map shall also be required. PROPERTY 0(VNER CERTTEIGITION i Iwel centi.6y .that a-f.E a.ta.temen.t~s on xh,i~s ohm cute `hue za xhe be~sx o6 my (oun) hnauCed_ge; .U1Q,t 1 IWeI am ~ah0.1 .tho lt1AfNOh~A n[ tG~ r,w,.....,..~.. .l.......:r_-~ _-- .' r• F..,. r,~ K V-~ ~~/ ESTATES F~URl'H-~ ADDlTf4N . :~ .. ' At St~IC1VISICM !~G'GATED.~ IN 7NE ;yE'+~-•SV~/~- k~ NWI~S~bii. ScCTIG`N I7, T29N. , R19 tN. , 'rctr'tIN ~c~-. ~[~osc~v. Sr. cox coui~rrY, vr~scatis)N ... .i. ."!` ~ ... . y . .. +. ... ,..h.... exyeTlrltaTS or 7o~rxr]ir,~tsulllex ' • $TA'3'= OF 7-ISCCNSL+t) u.~,,r;-r.... • ar.. (aaz cac~:x I', Hererly A. Joboioi~~.bdia3 t1e daly slecled, quttllllad''aad aetlab ?trw Traasu:es °I tha Town of iiudeon, do tsreatfy eestLfy that In secosdaoa• :ooorda !a my o((Sae, L+tea• are aA ttnpnW tasaw or'syaeW asearsraeats as of ..''. •. oa ray ltu-d iaatuded to the Plat o[ Park Vlrns tetstee Fourth Addirioa. ~ '••- S '~ e ~ ~ , >~itor~tJ Beverly, haso owa reasarer .Tt7t-'( 60ARD R SOLUTION • 112301.YED. that the Plst of park Yteir Estatre Fourth Addition in the Sown of Nucleon, Dset'rl F., ?/err and Beve A, tYert, nwnerr, !s hereby approved by the '1'o~w B rd+ • . • ppsoved own sman ' /•• ~ ~ ~ y . D ipned uwo t.~utrma~ a aearbv ee:ttiy that th+ fereloiaq !s 1 copy of :a revolution adopt.d Gy the Town • Board of tM Town of tludswt. • Date own Clerk O1M;tERSt CdATiFIC,ATE OF DED(CJITION As o+rnera, we hereby c•rtif- that w° eaur•d the land d•.erfb•d on thi: Plat to b• eurveyad, :l sided, trapped a>ad do gated as reore+ented an thle Plal.. W • Elsa eertily tSet :.".te e''let l• regalred by 3. Z~6,10 or S, 230, 12 to Ge rubmltted to tine fo{IuwlaR for appru•n1 or ob;ectlun: Arperttn,tot c( Development liegastm.nt of Induetry, Labor and Human Relations, Town o! Hudson. City o! Hndwa wad 5t, Croix County, VJ;TN_SS the ha:Kt sod eeal o! Bald owners this _!-• •t day of ,.,,~f~w• In~revence oL _ ~_ ////~~ •11J r•L!t L Yr Crt tl.veay y+..wer sTATS of wlscoxslu) aT, CROIX COUNTY ) ~3 Nessonllly came betose me this .'• •' day °t // .+ /'~ • ~ the above name! Darrel t:, Nest ood Bevesly A, Wert, to me known to 6e the prrecns who executed the fore~oinR lostrurnent and sottaoaledbed the same. Notary public Yr • i•,.• • ' j „t. , W i•consin My eommiselon expires~J i . ~~~~~ blasy ~tsch, Votary Pubtle ~ ' ~~,- CLRTIFLCATt:OF TOYJN CLERK :~-.3TATI:OF Wt5CON91N) ' ,, ST: CROIX COUNTY ) ,, I, Rtta ;brne, belnY the duly appointed, quatUled and seNnb Town Clerk of the • 'Loan of ..:+deon do heeeb • C, !fy that eo to o! this Ptat wets torwstdad ar ,r re/ requirrd by u, 2lb, t2 on the~day o[ ~.!( , 1964, and that within the Zq•day !troll vet Fy e, 27b,12 (]) (no obJecti ne to the plat have boon Illed) (all ;7i,)wc:ic+ns to she ; )vt iravs been mst), Date itlt Horne, own Gleek .: . , ~ . • , ~ r ~T ~J+ ~ V ~ ` ~ • N y S ' fir. .„i . , :. ' ' ~. . ~ SDitl-ltlOiwxS CS3iTI1ZCJIT=.: ' '•Si. F;.•i4': ^/'~ !..lpata4 =. lt~teai. AeQlaterod Tlilaeeaais l.aad 3uzveyor. twseeLy artily to the leN et ney psolaaaieaal knovl.djt~ aadrsetaod>s>; asd edaeft TAN 2 Uwn~e rerveyed. dtr~ded sad rioappW Psrl Vtew £atatea:t'ovrth /ldditioo,. located iw tlw NSl/1 of tiu SY/ l/4 aad tlr N'M 1! 4 0l the 5a1/4 0[ Srttioe't7, T24Tt, It 19111, Toaa.of Hodeoa. 9t. Creiu Coasty~ Wi.~eoesiai Ttu-t I hero nno4e eue11 surrey, iw,d dtrialow aad pint by tla disuctbn of Darzsl E. >t<erCwad DarrzLy.A. Vrert, aroaart o! wid lwnci, deserlb«I at fotlwt: ' ~ GommoactaQ at,tba 1CI/4 cosnar o! said 5"actiew I?; fleece Si9K M~"1M (aassmed besslap rafoseated'!o tlw ugwnm.ated Y,l-ST :I FST 1 /4 Seetloa Lice sl 3.ettoa 1 T. b«az4y saaansed SN)•22bt"N) (zeaordel ar 3r11i-t 1x40"7y ow flat Gaztlct+d Srrz.y irlar raoerdei to Yelraae l~ Ps li4)~ 1]]2,9at aloe: sold E.t3T-W!!T"1}i Srctloo 11aet . tlauoe ti0"Oir30"'M-227.tJ+~so tie t+~+K o[ i tlenor NM32x40"i[ 412.JOt; fleece., NO'06J]0"s 212.Otft to ti+ 3faaLerly sljlt-at-'wey ltwe of Cswa L/l1 Lao~i tlsoe. rrar324a'x K.OOt a1onS cold rl lt•o.[w~.sy ltas: thecae SO'Obt]0"1r 2l1,90t; !hones S?!']beS2!'W 194.~Sx; ehanae S89'~St14"ty 276.Tt+t; tlesoe Y?!'S?WS"11i 142.171: thraee 3d9"lSeld"!1 s3r,00r;.tianc+ NP06t30"L IO~.tWti tb+aea i0y'1St14"Mi ]14,00'1 tienea ' •I NO'!vj70"EcLSS,00xitie.oe 9s9"JS•U"w 66,OPt tl-ewea 80't1Ltl0"1Af' !16„'1]x: fleece-, . 3i9'ISx14!!p~ lSl.00a1 ebense :10'37xS1"1f 34.111x: theste ati9'22b9"9t Itt.,oxi tluoee 30'06al0~'M 204.dAti ti+eee N4fg'1lx14"Z iSJ,00x; tlwsne 30'06x30"11. ]li, 97x1 tSaeae !V1!'13r14"3:130.OO~.thesee ioetl.watarly 66.23x alet~ the aso.ot w 3i3.90x radiw curmreowcsv. Rortlerat.rlr xlrta chord facers 34'30'30"'1` bit!?~i theos. V 1ylSxl{"C v?,01x1 tk+awv 3esliraatez1y,136,Sbx a[ona tle ar~C eta 3L?.OOt sadloe eerw cooeave Yastleaet•r1~vr sloes elxard booze 924 03x0E"7r 13:3.31 x; tbeaee i3R 23x30""1.' 143, 14a; tlaewes 1Q?t36x3W's 160.%x1 tiewca N8}~1Sx14"SL43.OOx; tbeaee.a0'06'3t"ir 10e,00x; tbauee ¢S3r36t7u!'+IR 2S9.Ifxi Ihaaee iovtbeuterly 9~.14t al the ern of a 217, OOx ' redtav~srrs.oetreat+e Nosibasaterly.,~rTwee sherd b+w=^ a7r0 ~lS"C 9S.3a'i t\seea !iJ?!!tiT14d'1c.92Q.Mri thaate Nertheastwziy 91.21r slont the ase'ed a.300Jh3x radius ees+isoww llortitwNasiy s+eou eliozd baase Ntdr32N0"L9Q.iSxi tb.aru North . weeterlr91;41redota~ tlw am et w 30t-.00x rsdlusi a•urre nonewre Nostlwetnrlr .xtwse chord benre Yd'3Tt26'^A 91.09x: tbesee NO'04t]0"Z 150.00': tbrwee Nt9'LSn14 ^•. 4?i.035y fiance 1iV06b0">c ti34.S6x te.tbe poL+t of besiaainq. , TAwtsuai-rlet lea tarreat repre~ratalion et aL tla rxtertes taoeodeaies of el. toed wtr•veyo4 aad Md esbdlvletoa thereed made, tad Zhee I tubs tally oo~Urd +rith tLa provlelowa of G"bwpter 236 of ttu 1!f ixeowaLn ~- tie lebdlrtelae tint ZoalnO ltexalatlrna e[ St. Cre1x Ceuwtyx tae :'owe u[ ~ ---'- tlxdeeia ~le/dlrtelea Osdlaanee, wed tla Glly ~[ Hodroa iubdirlalen wad 7t.trl,ed or N. »eaace~ lw et:arayley. ttdrt~dias at+et ataal.pLa~ el. same, Deted elli~~,,, day oI Z1~',{]_. 1984 ~t'J.ti!~i R rlred t t 15th da of Aprit. I9l4, once s. each~13'~i ~~ 421 Ikxoad atroat J,t ~ 3?' liedt+0ar lrleconeln B~OIi t' ~.' 1ire, t; is ~ ~• couHTT Txleeacfnsaxs esxTlnenTS 'ti4 aTnTZ o!- r/lacoH3114) ~ atl~'~ ss. cxotx rociH~x ) I, L4try Jeow L,lrernwsex balaag duty deetedx gwlitled end saa.ai Srnuurrr of 11.. Crols Coetaty, do bereby errslly tbet the' reaorde !n my otnce shoo m uaredrrmed tau texas etad ae oopald tease ez speatat saaeeertwMe ae o[ ~~- ~~' d/_ sltertted tlv leads taaladsd !a the Plat o[ 1'nrk Vlew ICatatee Toarth Addtian. f. p. fir ~ ~ +.~Gt.~t~'t./ . . D+tte unty Treaaw.r . i zot'n»c co=,tatrt~css >tzaol.urloa ?Me plat le hereby approved by the 5t. Crolx County Comp»hensive Parka, ixlanotnR aad T.onlnl Gomrnfttae, I>atr Gt-sli'lt,y ' ~1~3-s4_ Date - .. .. _s~Y_.-._. Admlxi at rat or j. ~. +. •: STC- 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER~/y/ ~JJi~~~2/ ROUTE/BOX NUMBER' ~~#/ ,Ba~.''~2~~ Fire Number ~' CITY/STATE /~l~G/So~1 ~`.~ ZIP ~~D~~i PROPERTY LOCATION:~34, SE ~, Section, T -z.g N, R%:~~~ Town of~~cfsps-r', St . Croix County, Subdivision i~U~~~uJ~.. Lot number'~87 . Improper use and maintenance of yout' septic system could result in its premature failure to handle waskes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function bf the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents m_.Y. be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit!to St. Croix County 7.oning a certification form, signed by the owwner and by a master plumber, journeyman plumber, restricted plum'~ber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent app',roximately 30 days prior to three year expiration. I/WE, the undersigned, have read th'e above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as'I set by the Wisconsin Depart- ment of Natural Resources. Certification form must be completed and returned to the St. Croix Count',y Zoning Office within 30 days of the three year expiration date.',, ~..~ '~ S I GI~.D-,- -.. DATE ! ) "~ St. Croix County Zoning Office P.O. Box 98- Hammond, WI 54015 715-796-2239 or 715-425-8363 H z H 9 r r a H --~ 0 z d 9 H hn H O z x H ro Sign, date and return to above address. DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS 'INDUSTRY, DIVISION HUMAN REDATIONS PERCOLATION TESTS (115) MADISON WI 53707 (H63.0911) & Chapter 145.045) LOCATION: SECTION: TOWNS IP/ t-Ffi14 LOT NO.: BLK. NO.: SU DIVISION NAME: OUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: .5 t• Cry, ~`~c .S ~ .'6l ~.~ _ __ ~w~_ ~r~ sd~ 4J~~ ~ c~ 6 sd.~ h~ RATING: S= Site suitable for system U= Site unsuitable for system ~l . C'~ DATES OBSERVAYIONS MADE PROFILE DESCRIPTIONS: PER OLATION TESTS: _a s _~ ~ CONVENTIONAL: ®$_ ~ U MOUND: ~~-S ~ U IN-GROUND-PRESSURE: ~ S ^ U SYSTEM-IN-FILL ^ S ®.U HOLDING TANK: ^ S ~U RECOMMENDED SYSTEM:(optional) Cdk ye.~to~~~ ~!~'X 3 If Percolation Tests are NOT re wired DESIGN RA E: Q If any portion of the tested area is in the under s.H63.09(5)(bl, indicate: ~~ Floodplain, indicate Floodplain elevation: PF~„OFII,tE DESCRIPTIONS BORING NUMBER TOTALI DEPTH.FfQ, ELEVATION DEPTH TO GROUN OBSERVED DWATER.iAi6+FE3^ EST. IGHEST CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) I Q / 2 ~0 ~ ` • . . /~~L ~ ac f B- .2 ,p` pl.3` 4a~` ~ .Q' B/Si ~ s S Si O S B- 3 0~ D' /d ~ • ~ p /./ 8/ s/, . ? B,, t/, . ~ Bs, /s, I.3 Bn~rt, r . ~ . ~ , d ~/si, . Qc s s /, ~ .t Bh ~.r /-s; • ~,9~n~,. s B- Y . d ~ DC9 ~ a~L 7 •0 B- PERCOLATION TESTS TEST DEPTH! WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER Ii1GFF6s AFTER SWELLING INTERVAL-MIN. PERIOD 1 PE OD 2 P RI PER INCH P- y 3' o ~ L ~ P- Z 3, t' o ~ c 3 P_ a~ ~~ P-_ P- p_ ~ , ~ f PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions 'su1'table are Iry 'c a scale or distances. Describe what are the hori- p p+ad. Shoyv, ~ a e e~' on at all borings and the direction and percent zontal and vertical elevation reference points and show their location on the lot ~ of land slope. ,' ~ ~ "! /%Fn. !t F, ~ ~ ~ SYSTEM ELEVATION q~• ~' ~,~r ~ ~'~ys~~rgG lc:a ~,,CeG-e.~~ __ ~~ ~ i ~. ~-_.~ a(~_7`~ ~G_~r~~r~.s~r ~~.. ' I a ~~ __~... ' ~ 4 ~' _ ~~-~ ~~ 3 i ~ i _ __ 3 3 I ,___ i ~ _ r, ~ _ ~_. ~_ I _ 1 _~.,,, ,_____, _ ~r ( ~ __ i ~ , € ~ ~ ~ i 4 i __ ~__. __~ e._mm ~~ r INSTRUCTEC}NS FAR COMPLE~`6N F{)RM °~ 35 - aBD - 6395 • Tc~ be a cor~tplete anti accurate sail test, your report ntust~irtcllicle: , 1. Complet~a legal descriptiafr, y 2. Ttsa use section must ~learEy±jridicate,wl~ef#ier"~t!-~is is a residence or con-amercia9 prrrject,< - - ' MAXIMUM number o~" bedrooms or coz°nrnercial use f~lanned; 4. Is this a nevv or re ~i =nt system; - ~ Con~ptete`the 3uitabii,,~, rating boxes. A SITE iS SR1dTA8LE FOF~ A }-#t7L~7iNCa TANK ONLY CF ALL •t~T~ER SYSTEMS A'; . F~#.1LEC~ OUT E3AS~D O SbIL GONDiTIONS; 6. PL,EA,SE t~se the.abbrf;viatic~ns shown hark:. for trvritiitg profile descriptions and contpletirag the plot plan; 7. MAKE A LEGI~3LE taiagram accurately locating your test locations. Drawing to scale is preferred. A ~Sep3ratt; Sht~f't rra8ybe~.xl3et~ if dP.SireC'~;.. - - ~. Mal<@ St,irEP yt~Ur ~SP.nCf-'1rT'farlf BnC~ VHI"t!C<31 eleVi3'tfQr3 rBfPrenCP. r.10311~rlre Clearly ShOWlI, atlCl arB (:1e1-rTianf'tlt; 9. Complete all appropriate boxes as to dates, nan7es, addresses, flood plaint data, percolation test exep- tlOrl, iT apprcrl3rlate; 14. if The informa ~ i~ rt {such as flood plain, e(evatic>rt} does not alapiy, place N.A. in the appropriate box; • 11 . Sign the f+~~~~ ` .'I-ce your current acJdress and your certificatiort number; 12. Make legi~ ~ _ and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LC3CAL AUTI-~: '~!`TY WITHtN 30 DAYS QF COMPLETIOl~I. ~+:6EVId~T1~NS CSR CR fI[t~`C}IL TESTERS .A c~i1 Separates and.l'extures ether Syrrstaois . st - ~~e ;cver 10") Bit - Eiecirock cob -- C, ~'~:~ {S- 1€i"~ SS -~- Sanelstone gr _~ G {under 3"; LS - LirTtestol; ~s _ ~ r_:. -High ~~rt ter ~ . _.... cs ....... (; ~ '',rc; __ Peres~l '' , ; Kate; _ .r_ '. reed s - I 1 _ t~tl - ~r„~r . fs - F Blc#c, -- Built . '`sl - S - ..~ ~ _- L ;s ate ~l -- ~.: :+fTt Bn - BYt?lntn 'sil -- S ' Lc:~tnt BI -- Black si - ~;t ~y -- Gray ~cS -Clay Loarrt Y -Yellow sci - S I ~ . r Loarn P -~~ F.- ~` ' • slcl . ~ :! Loam ntot -- Iz.' ~.`~ • SC wj -- sic -- `~ C:' fff - f ~..v, fine, fa ~ ! ' ~ p't - - r7tl7t - Many, mHtiiC; ' # rt~a -- ,,. d -distinct' p -prominent . k~1JtJ?w -- a-Iis~h wvai= : 'earl, ~F. tares .f ~vs +~t: ;.~ rt~st>osa! 13M - E ch PU` . ~ ~ VF~P ` t ~ t~. Pttlnt ..~ Z ~ ... .. ~ ` O _ ~• o 8 ~, .:~ ~~ a a A. ~ ~ a z 0 0 00 3 ~ ~ u d w >~ ~~.. ~° 4 -- © :, r ~ ~ ~ ~ ~- ~ d a C~ ~ ~ _ W Q 0 ~ J ~ J ~ -1.' }' ~ s ~ ~ 4 ~ ~ ~ ` ~~ l~ ~ ~ ~ > a ~ ~- ~ ~ `Y' '~ ~ 3 ~ b d !- ~ ~ it ~ ~ c ~ d ~ ~ ~, \ ' ~ ,~ ~ -~ J .~ N ~- ~ ~ J ~ ~ -----~ y ~~~~ o~ ~ ~ o~ ~~ ~ ~-~ ~- ~ ~ d ~ L ~ [1 d i +- s 1~ L I ~ ~~ aQ ! ~ ~ O 0 `~ c~ ~ ~ e N ,~N s~ W H k J ~N J o / ~ ~ 3 ° ~ ~ J a o q ,oL/ 3. I 7 J. 3- ~~- r. ~ :... d J ~~ a ~ ,~ ~, ,,, a s ~. t d s c o ,t- ti .~ ' H 0 4 ~ 'r ~ ~ ~ ~ .~ eX ~ ~` , ~ ~ ` ~ ? ~"~ . ~ d ~'. ;~ ~~; . _ ~~ r7r?_ ;r ,~ =~ , :~ . t; ~~ :;;4 ~~-" ~. J ~ , P' ~.. d ~~ ~„ u- s. T ~~ .. ~0 1 ; _ s h ~~ •~ . ~, J .~ J a A -~ .J T -a ~~'~ d 0 .~ s 0 -E- J d H ,~ A- 0 c'i y ~ ~ ~ ~ 0 ~ ~ ~~ ~ d N~ ~t d ~ ~_ ~ '\ 'S tf'1 s ~= 0 ;v '- dJ c9 - as Q Q f"--` TI ~j~ ~ I I ~! ! i~ ~~ !~ ,~ i~ C I a~ _i! .. ~~~