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020-1053-20-100
Wisconsin Department of Comnf~rce , PRIVATE SEWAGE SYSTEM Safety and Euilding Division ' INSPECTION REPORT GENERAL INFOF~MATION (ATTACH TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: '~ J/ ,~n~ City Village X Township Weelman, Dean V~riG~VNlUti. Hudson Townshi CS'T BM Elev: Insp. BM Elev: BM Description: J TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic w~~~-r.v~". /o ~C~ Dosing ~ ~ ~-c~( 4~ - ~ „> _ ~ Aeration Holding - TANK SETBACK-INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic .~ 5a j ~ t~~ / r ~ --- Dosing Aeration Holding" " PUMP/SIPHON INFORMATION Manufacturer Demand PM Model Numb TDH Lift F ' ss System Head TDH F Forcemain Length Dia. is . SOIL ABSORPTION SYSTEM county: St. Croix Sanitary Permit No: 430083 State Plan ID No: /O / ~ ~3 Parcel Tax No: 020-1053-20-100 Section/Town/Range/Map No: 20.29.19.197E 10 ELEVATION DATA STATION BS HI FS ELEV. Benchmark ,f,~ l 0'7, ~c~o.v Alt. BM Bldg. Sewer (~, lal.3 SUHt Inlet ~,$ ~va,~ SUHt Outlet Dt Inlet Dt Bottom Header/Man. ia. ra 97.5 ist. Pipe Bot. System w_..st ~ ~ // ;~ r/. If L • 3 ''r .'3 S' Final Grade st Cover ~ ~ ~~ y 7 o ~ e A .ta" s '~ ~i . t g'!' ' BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 ~j, ~ _ S .~_ ~- SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufactured ~ ~ ~ ~ ~ ~6 INFORMATION CHAMBER OR s'~ r Type Of System: a ~ ~ S~ C~ ^ t ~ V / (p l~ ~ 1 U G.~' UNIT 3~ Mod`Number. ST~ V .r~. C. YLg C0. DISTRIBUTION SYSTEM Header/Manifold r ~ , ' ~ istribution / ) ~ pi x Hole Size x Hole Spacing Vent to Air Int~ke ""+- Q , I h~~Z ~ pe(s --_ L - ~ Lengt 9ia _ ength Dia Spacing V SOIL COVER x Pressure Systems Onlv xx Mound Or At-Grade Svstems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center 2_~ t o~~ ~/ Bed/Trench Edges ~" Topsoil ~ Yes [~ No [~ Yes No ;...~:1 ~- COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~O /~/_~ Inspection`#2: / / Location: 448 Jacob's Lane Hudson, WI 54016 (S 1/2 SW 1/4 20 T29N R19W) NA Lot 4 Parcel No: 20.29.19.197F10 1.) A{t BM Description = S ~ eo `o ~~ 2.) Bldg sewer length = ~ ~` - amount of cover = " Plan revision Required? ' Yes No ~ a ~ ~ ~- - - ~ --- ~ Use other side for additional informati `___ ~_~_____ SBD-6710 (R.3/97) Date Insepctor's Signature ~~~~ -_ -L- Cert. No. a r ~T Safety and Bttildings Division 201 W. Washington Ave., P.O. Box 7162 C~h' S% ~0 f 1~ ` ~S~Oi~~~~ Madison, Wl 53707 - 7162 (608) 266-3151 Sanitary Permit Number to be filled in by s.} - 0 J C . ~d G Department of Commerce State Plant .Number Sanitary Permit Application ~ rovide ti f ~ a on you p orma In accord with Cotnm 83.21, Wis. Adm. Code, personal in maybe used for secondary purposes Privacy law, s 15.04(1 xm) ect dress if different than mailing address) ~! ( ~~ ~l~'~r~~S ~Y!"''~ 1. Application Information -Please Pr1nt All Information a ~~ ~f053 2~ ~ Op Propert Owner's Name ~~~ U~ wt.~ Co~,~~~ ~. irW~~~~ Parcel # Lot k Bla.k a 2 0 - o ~ o- v Property Owner's Mailing Address Property Location ~ ~ -/ ~L ~ t T ~/, L~ SS D J~JL t.00 (G rE'S~ ~~ ,., S~ [,~, Section Zee Ci State ,, ,. lfr Wy ZCip~Code `~~~ Phonre Number ~p J'~~~17/~~ Q T Z-1 Ni R~,~IcEoleone) 11. Type of Building (check all that apply) ~ ~ ^,t + _ jf ~2~ d" L~ °~/~~"~ Subdivision Naurc CSM Number ~l or 2 Fanuly g -Number of Bedrooms ~~ ~~ ~ ?? ~ v 11Z ~32 ^ Pub ' ommercial -Describe Use ^D,S~ ~~~ ~ ' ~~~ ^City_^Village ~'ownship ofl~ ^ State Owned -Describe Use ill. Type of Permit: (Check only one boz on line A. Complete line B if applicable) A' New System ^ Replacement System ^ 'fYeatatent/Holding Tank Replacemwt Only 4 ^ Other ModiLcation to Existing System ^ Change of ^ Permit Ttaffi1ir to New list Previous Permit Number a~ Date Issued B. ^ Permit Renewal ~Permit~ _ ' Before Expiration Pluutber Owner /hJl ~[~{ 'p' ~$ b3 v~/ IV. T e of POWTS S stem: Check all that a 1 Non -Pressurized ln-Ground ^ Mound ? 24 in. of suiffible soil ^ Mound < 24 nr. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressiuizod ln-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatmatt Unit ^ Recirculating Sand Filter ^ Recimulatin S thetic Media Fih~er Chamber ^ Dci Lim ^ Gravel-less P' ^ Other lain) V. Dts ersallI'reatmentAree Information: d r ~v~ "' `r Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) ispersal Area Proposed (sf) Syste ~' v~ i Fibe i r Plast c Vl. Tank Info Capacity in Total Number Manufacturer Prefab Site Steil Conctrte Conswcted Glass Gallons Gallons of Units Ncw Exia[ing TarJrs TalJta $cp[ic ~r~r>k DOC +ooo ~~ ! ~Ct1 cT Aerobic Trca[mc[u Unit Duain~ Ctu+mbcr V11. Res nslbIIi Statement- 4 the under ed, ass nslhlli for lnstaUatlon of the POWTS shown on the attached lens. MP/MPRS Number $+,~in~cc Phone Number p 's Name (Print) PI s Sigziat ~ DAD L SAN t- r(n,(/n t~ 134 b Z~ "23-5= ZZ ~f Plumber's Address (Street, Ciry, State, Zip C ) ~ S'bo 9 7v d' '~' /h/~ IKf~1/ l' ~~7 ~ Vlll. oust /De artment Use Onl Sanitary Permit Fee (includes Groundwater Date issued Issuing A ent Si Stamps) Approved ^ Disapproved Surcharge Fee) ,~} J ~ ~ / r ` l ^ Owner Given Reason for Denial ~ ~ l - S S'F~'h 1X. Conditions of ApprovaUReasons for Disapprova STEM OWNER: n _ Ain~Z~~ ~~Ti4~ C'ST/~~4.~ 1 ~~3~0 !j 9t.J` / V Septic tank, effluent filter and ~ , ~,~~(.dn-o /,~~~~~- ~~,~~ dispersal cell must all b i D e serv ced /maintained as per management plan provided by plumber. (/~ ~,t ~ ~~ , t, ~ ~~yy~ All setback requirements must be maintained I~i "" as per applicable code/ordinances. ...•r ~... eh... err rz i I~1 Inehr~ to al<e Atra[a Compiccc p+au+ tw we a.uawar wy, .... •.~ -~-..... -- r, SBD-6398 (R. 01/03) • ~ ~~r J~ X11 I ~ ~ ~~ J M II ~-j2 it ~ MI_ r (` ~~ r ~ ~ o- ~ ~ 3 ~' ,~ ~3 ~- ~ ~ a -~ ~ J ~~ Oo O `~ ?~ ~ 'i ~ ~ ~~ ~~ ,..~~ 1~ Q;" d ~~ J ~~ ~~ Y ~ V ~ ~ ~ ~~ d- 3 o 0 a ~. ~ J ~ `~ ~~ a,,. ~~ RECEIVED 1s97 Wisconsin Department of Commerce SOIL EVALUATION REPOR Pag t of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Q ~ ~ Q '] 00 Ce ified Soil Testing Cou ty Attach complete site plan on paper not less than 8%: x 11 inches in s¢e. Plan must •~ include, but not limited to: vertical and horizontal reference point (BM), direction and • percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Par I I . D. Z I N G 0 F j ' ~ 0-~7 Please print all information. Reviewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Wellman, Dean Govt. Lot SE 1/4 SW 1/4 S 20 T 29 N R t9 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 455 Overlook Pass 4 CSM# 561773, V 12, P 3292 City State Zip Code Phone Number _~ City Village , Town Nearest Road Hudson ~ WI 54016 715-381-5845 Hudson Jacobs Lane /+ New Construction Use::!; Residential / Number of bedrooms 3 Code derived design flow rate Replacement ~_ ; Public or commercial -Describe: Parent material loess over outwash Flood plain elevation, if applicable General comments and recommendations: install trench system @ 0.4 gpd/sq ft loading @ system elvation of 96.5 =--_ ~_ 450 GPD NA a Boring # . ~ Boring /f Pit Ground Surface elev. 100.0 ft . Depth to limiting factor ~ 108 in . Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots G P DIft' in. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 1 0-8 10YR 2/2 - sil 2 m gr ds gs 2f1m .5 .8 2 8-16 10YR 2/2 - sil 2 m sbk ds cs 1 m .5 .8 3 16-46 10YR 2/1 _ - sil 2 m sbk ds gs 1 m .5 .8 4 46-65 10YR 3/4 - sil 2 m sbk mvfr gs 1 m .5 .8 5 65-84 7.5YR 4/4 - sl 1 m sbk mvfr cs 1 m .4 .6 6 84-108 7.5YR 4/4 - s 0 sg ml - - .7 1.2 2 `/ ` 2 i Boring # Boring Pit Ground Surface elev. 99.7 ft. Depth to limiting factor > 110 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft' in. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-10 10YR 2/2 - sil 2 m gr ds gs 2f1m .5 .8 2 10-36 10YR 2/2 - sil 2 m sbk ds gs 1 m .5 .8 3 36-60 10YR 2/1 - sil 2 m sbk ds cs 1m .5 .8 4 60-80 10YR 2/1 - sil 1 m sbk ds gs 1 m .2 .3 5 80-110 7.5YR 4/6 - sil 1 m sbk mvfr - - .2 .3 s ~o D"tit 13 ~`: ~ ,7- 'Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 1 0 mg/L 'Effluent 2 = BOD < 30 mg/L and TSS < 30 mgl'_ CST Name (Please Print) Signature: CST Number Henry F. Grote - 222774 Address Certified Soil 'testing Date Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 10/3/2003 715-233-0398 - ~~ Property Owner Wellman, Dean Parcel ID # ~~ Page 2 of 3 Boring # - .Boring /' Pit Ground Surface elev. 99.6 ft. Depth to limiting factor > 96 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 1 0-11 10YR 2/2 _ sil 2 m gr ds gs 1f/m .5 .8 2 11-22 10YR 2/2 - 2 m sbk ds gs 1m .5 .8 3 2-40 10YR 2/1 - sil 2 m sbk ds gs 1 m .5 .8 4 40-54 10YR 2/1 _ sil 1 m sbk ds gs 1 m .3 5 54-72 7.5YR 4/6 - sil 1 m sbk mvfr cs 1 m .2 .3 6 72-96 7.5YR 4!4 - sl 1 m sbk mvfr - - .4 .6 Boring ~ Boring # --~ Pit Ground Surface elev. ft. Depth to limiting factor in. -- Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots = in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 i I Boring # ~ Boring '. Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell t1u. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I I I * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/Land 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.07/00) Certified Soil Testing Property Owner Wellman, Dean Parcel ID # Page 2 of 3 Boring # --~ Boring t%j Pit Ground Surface elev. 99.6 ft. Depth to limiting factor > 96 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 1 0-11 10YR 2/2 - sil 2 m gr ds gs 1f/m .5 .8 2 11-22 10YR 2/2 - 2 m sbk ds gs 1m .5 .8 3 ~2-40 10YR 2/1 - sil 2 m sbk ds gs 1 m .5 .8 4 40-54 10YR 2/1 - sil 1 m sbk ds gs 1 m .3 5 1 54-72 7.5YR 4/6 - sil 1 m sbk mvfr cs 1 m .2 .3 6 72-96 7.5YR 4/4 - sl 1 m sbk mvfr - - .4 .6 ~~~ '-~ 37.2" ~73.2~ ~„j Boring ~ Boring # ~~ Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 i ( I I Boring # ~ Boring ,w~ 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 ~ t t '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 608-266-3 151 or TTY 608-264-8777. SBD-8330 (R.07/00) Certified SDiI Testing ~ - s 0 ~ ~ d i n ~ ~' "s ~," t ~ 9 ~~ M f~ (~' ~ d ~ N N ~ ~ ~ ~ 9 J s a ~~ ^~ l~ s i d 3 t ,~ ~~ ~, ~~ f ~ j ~ t~~' ~ ~ ~ ~ ~~~ ~ S{{ o d ~ ~ M ~ ~ ~ ~ ~ ~~ ~ ~ ~ ° r. N ~~~ ~ j U ~1~.~ ~~r~ T ~ c k `J `J s ~ ~' ,~; cam( - d ~,i~~// ~~.. l./ S s t o .1,} • d J ~ r 9 ~ Q' ~ ~ ~ ~, ~ Mr~~J ~~ ~ I ,r o ~~ `~ ,~J ~;, M N' ~~ M~ 5~ ~O d J ! / p I C) S 1~ l~ 3 A , -, o pktc plrns (to the Coup y) for the system on r not Sl/2 i chce io Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 Camty ~.~ ~~0, / /` ` nsin i Madison, Wl 53707 - 7162 Sanitary Permit Number (to be filled;n by Co.) ~eo (608) 266-3151 !~ ?O ~~~ / J Department of Commerce Sanitary Permit Application State Pfan LD. N,um/ber ersonal information you provide Adm Code 83 21 Wi h C i /" , p s. . , t omm In accord w may be used for secondary p~aposes Privacy la Lxm) (i eremt than mailing address) dr ess Project Ad p L ~ formatlon -Please Print All Information ti l 1 A li on n ca . pp Property Ownei s Name _ A ~ ~ ~ J / ~y ~L~i~ a ~ 2003 Parcel # l.ot Block # '~ ~~ ( ~ / ( ~ ~ T. t ~: Property Owner's Mailing Addres ~ Property location i~-1- ; S ~'~ L ~~f/ V %, ~/~, 5'eetlOn City, to j'~' d/ Z~ijp Code / o~~ Phone Nuomber/~j // ~i 0 ~VV w A ~~C C O~1 Q^~ T /` ~ N. •J,1 E U~e) ~ ~ 1 1 Y~~- h l at app y) ~_~ 11. Type of Building (check all t Subdivisi ame CSM Number ~or 2 Family Dwelling - Number of Bedrooms ~ /+ ~(p ~ ~ -7 3 ~ Z- n ~,Z C• T ^ PubGc/Cotnmereial - Use /~ ~ -c ^Villagey~Township of City ^ State Owned- Describe Use _ Ill. Type of Permit: (Check only one bo line A. Complete line B if applicable) A' New System ----~- ^ Replacement System Treatment/Holding Tank Repla Only ^ Other Modification to Existing System B. ^ Permit Renewal iration Before Ex ^ Pemtit Revision ^ Plumber ^ Tra~fer to New list iou Permit umbeer]an~d- Issued ~ p J L 1V. T e of POW'I'S S stem: Check all that a 1 on -Pressurized ln-Ground ^ Mound >_ 24 in, of suitable soil Mound < 2 of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constricted Wetland ^ Pressurized ln-Ground ^ Holdin ^ Peat Filter bic Treatment Unit ^ Recirculating Sand Filter ^ Recirculatug Synthetic Media Filter Leaching ^ Dri Line ^ Gravel-less Pi ( lain) V. Dis ersa!/TreatmeotRrea In ormation: ~ . / Design Flow (gpd) Design Soil Application Ra p~ Dispersal Area Required ( Dispersal ed sf} System Elevation I Z ~b - p , l ~3 ! ~~ Vl. Tank Info Capacity in Total Ntrmber Manufacturer Prefab ite Steel Fiber Plastic ~ ,, n ,/ `O Concrete Cons ed Glass Gallons Gallons of Units , , / ~ / Ncw Ex' rig Vt' CGGtQX / Tanks riles Septic t~oh{ie~g'9'affk ~~ /~O~ r ~/ Aerobic Ttcatmcnt Unit Doming Chamber VII. Responsibility Statement- I, the and ed, ass r nsibiltty for installatlon of the POWTS shown on the attached plans. Plumbed' -Name (Print) Pl s MP/MPRS Number Buc_neec phone Number Plumber's Address (Street, City, State, Zi S'6o o ~ ~ ~io~~t~ G~/a ~~`? ~7 Vll Count /De artment Use Onl Approved ^ Disapproved Salutary Permtt Fee (includes Ground Surcharge Fee) ~f ZZ -S, .~- /Date Issued t!/ / /,3 !s g t Signa o Stamps) `t~ / _ U/ l/ ^ Owner Given Reasar for Denial IX. Condifions of Ap~provaUReasons for Disapproval /~ ,~- ~2/,,t ,_ ~~~ ' -M (~-a'~ D .'~I Se-c~ ~ ' l ~u"~~E~~~va~.tn.""'(/"A ~ S-yS-{~'N'` (.t,~ctiC die.. ~ ~~ d'f/ ~~ " ' I ' / ~~h • (./riG7Zf/t/ `~ ~~~lrrt.~t/ `r~t~V~l ~G~ IUV ~ G~/~ (.c~13 `"~~j~ , / ~ C-~/tl~. C~~~ ~ ~~~~~~a~ ~Yn.l~'~Z ->~n ~ Q~ .~.5~3 'a /a ~3. SBD-6398 (R. 01/03) 7'.L. Sinz plumbing Inc. E5609 708th Ave. ~C~"N ~~~~''~' ~~ ~ `/~ Phone: (715) 235-2644 Menomonie, WI 54751 Fax: (715) 235-2592 www.tlsinzplumbing.com ~ H ~~ i, ~Im+~ . ~., ~ r u i ~. ~-i v ~~ ~ ~ ~ l00 DaS /. ~3 ', 3~ ~ ZnJTwt/ a- a, ~X ~ ~ y2 ~~ S ro /Nti ~><~,GoE2 s ~~ s~~~- . ~ r ~-- s c 96.2 l S ~Lc~ ~~~ ~poo ~~ Z~~F l ~ ` /N ~p~L ~A~/cam /~jG /I ~OY7f ,~1 !i~ Oar' ~P'~4~bv r' Z~7."~0` .~i~col3`..~' ~~-~~ T.L. Sinz Plumbing Inc. E5609 708th Ave. ~~"N ~~~~"~' ~~ ~ ~"/~h'1 Phone: (715) 235-2644 Menomonie, WI 54751 Fax: (715) 235-2592 w~uw.tlsinzplumbing.com L //-~~' IV~N~ .,., ., r ~ i ~. -~ • ~p~ s~ ~o~~~z Pis ~. p3 ~~ 3~~ .ZnJT~v-l/ ~-a,7x b~y2 Sro iNG~~f~a-oE~s ~L/ s / C ` 9~-2 L ~ ~~ `~ ~j ~L /`-' ~I /~jG ~~ /c, ~- ,r /~ ~ rd ~Z~L~ ~~v YAP 2$~,`~o~ ~~t cot3',.~' L~l-~l ~ 'Wisconsin Department of Industry, SOIL AND SITE EVALUATION R E P O R T Labor ~'nd Human Relations bivision'ofSafeNB~Buildinas __~...:.~ ~~ ~~r, ~ .,~ .. r._ e~.Y n_a.. Page ~ of 3 1~1 UVVVIV ~~Illl ICI 11 \ VV.V V, •~~J.-/~4~i.. Vvvv \~/ COU~~~ 7 ,,qq 7 C ~R® I~ lan on er not less th lete site a Attach com but Plan must include / ~ f'n JT p p p p , ~ ~ . not limited to vertical and horizontal referen (BM), direction' f slope, scale or ` PARCEL I.D. # ~~ ' ~ ' laU' dimensioned, north arrow, and location an ~ nc ~ near r . ti y ' Q / d , ~,(`~• DATE VIEWE BY APPLICANT INFORMATION-PLEA RINT ~ IN ATI4N,.t ~ ~ / ( o PROPERTY OWNER: __t ~'~ ~ 0,~, ~"~ `. ~~ , L~l~'f J~ '~ i ~, if9 i`~ . , ROPERTY LOCATION OVT. LOT S~ 1/4 5~ 1/4,S~(~ T ~~ ,N,R ~~ E (or) W PR PERTY OWNER':S MAILING RESS -~~. ``~ LOT # BLOCK # SU D. NAME OR CSM # CI STATE IP CO E ~ ~ H ~ ^CITY ^VI .CAGE OWN NEAREST RO~yp ~ " /,,~<lia I S 1 l ®.Sc~fJ Jxt~$S C Nte p(] New Construction Use [-~'j Residential / Number of bedrooms ~j(,v-~, [ j Addition to existing building j ]Replacement [ ] Public or commeraal describe Code derived daily flow gpd Recommended design loading rate D. ~ bed, gpd/ft2 a'7 trench, gpd/ft2 Absorption area required bed, ft2 trench, ft2 Maximum design loading rate L~ .~7 bed, gpd/ft2/ $ Uench, gpd/ft2 Recommended infiltration surface elevation(s) ~A~~ 3 aF ~ ft (as referred to site plan benchmark) Additional design /site considerations Parent material Flood plain elevation, if applicable ft S =Suitable for system ONVENTIONAL ~~S ^ U M UND ~ S ^ U IN- Q ROUND PRESSURE ~S ^ U AT• RADE [~S ^ U SYSTEM IN FILL S ^ U HOLDING T K ^ S U U =Unsuitable fors stem SOIL DESCRIPTION REPORT Boring # •x: 4:. ~~ ~ ~`t .,.~. 2`"x'4' u> Ground elev. ~~~ Z ft. Depth to limiting factor 7 Boring # v<: n:.~:..`ti.:.~ Ground elev ~~ ft. Depth to limiting ~ f~ Depth Dominant Color Mottles T r t Structure Consistence Barxlar Roots GPD/ft Horizon in. Munsell Qu. Sz. Cont. Color ex u e Gr: Sz. Sh. y Bed Trer>ctt -33 ~~ ~3 I -- n, sloK ,~ ~ c.~ 2 0 , o,s ~~ 3-~< ~~o~e4 4 - s; ~ i ~ s~~ ~~~ . ~ 1~ o -z a ~ nn ,,II t~ ~lo.Z i/ ' 7Z ii Remarks: ~~ 1-~ J0~1,~2 / ~ rM Sb~. M r w ~~ ~.~ ~~ 7-~ poi/~ 4- 3 ~.. S Kj ~ ~` m'~r ,~ ~ ~ S .~ . Remarks: Name:-Please Print Phone: N QO ~~ Signatu ~ Gs1¢-, Date: ~~ /77 CSTNumber:~a~ I 0 7 66 PROPERTY OWNER ~M ~,^•~~~(.l'~1IarJ SOIL DESCRIPTION REPORT PARCEL I.D. Page ~ ~ ~ • Horizon Depth Dominant Color Mottles Texture Structure Consistence Barxlary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed rends 0'20 l d tl~ ~' L• ~ /I'1 ~r (~J Z a .4 a.s t [ $Z 2- IDY 4 4 ~ ~ ~ r' m~r Cw -' p , ,~ •~ 24 iC1 y 4 3 -- S ~" I ~ rn 1 -- .~ Remarks: ~ -7F~ ~d~i~ ~ ~ /yr ~' n~ ~ C~ - €O -Il9 py `' S ~' ~~ _` ~ Remarks: $; !1.3Z /Qli' 3~Z ~ ~ n., sb~ M~r w l ©.~4 o,s $ -sue /o~~ ~ 4 5 ~ c. 1 m Sb~ ,~~ s - o,z ~3 sue; -$1 ~o'/ 4 4 5~, ~ ,~, ~- rn ~ C~ ~ o ,4 ~ , 1-fZ ~~/ 4 S ~ ~ ._ D.7 ~.d Remarks: Remarks: SBD-8330(R.05/92) M~ ' ~ Yp~ ~\ Y 2 O o a ~ a _ ~ d ~ ~ ~ ~ ~ - £ ~ V Z ~ W *- ,~ gc ~~ _ _ -~~ ~ -p~ % ( ~ a ~aD` 1 ~~ ~ 1J -t-I 4 ~ 9 "•w ~' i ~o w ~ } ~ `~ N ~ 1 .~ ~M l O K1 ~ ~ ~ ~ ~) 4 ~, 1 ~ ~ ~ Q M ' • P ~ d Q `~ ~ 1 ~ ~ .: 1 Z ~ Q M m s~ w \n~ V, 1 q ~ 1 '£ W i / ~ ~` Q t ,Q z ,., ~_ 0 C 4c Q r~LE 3 e~ 3 0 f € ~ ~ R 4 A ,. 4 ~ ~ w qo ~ .~ ~ r_ 7 Z ~ J ~ _J N W Ni J ~ Q ~ ~ _a ~ ~ ~= ~ Q `° ~'~ ~ d J _Jl 4 Y` Q ~ ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMBNT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ~~ ~ ~ lAJ~' ' 1' V ~ ~ ~~ ~ ~ 'E.,f' ~ CQ ~ 4~SS Mailing Address Property Address 'Y (Verification required fmm Planning Ixpartrnent for new constructtoa) 6? ~ "~~ S3 ~ Za' City/State ~ ~~~' ~ . ~ ~` Parcel Identification Number SEC s.Y. DESCRIPTION ~ I cj ~ ~'0~ 1) p~~ .~+ ~ N_R ~W, Town of `~"~` ~ Prope~y I,ocattOn ~ ~ ~- Lot # Subdivision 3 a9 a j~ ~ ~ ~ ~ ,Volume ~ ~ .Page # Certified Survey Map # ~ Volume ~---3 .Page # ~~~ Warranty Deed # ~ ~ $~ Spec house ^ yes °@~ no Lot lines identifiable yes ^ ao SYSTEM MA]~ITENA.~-~'- nature failure to handle wastes. Proper maintenance Improper use and mamtenanceof Your septic system could result by a u~~ p~p~• ~t you put into the system P our the septic tank every threo years ar sooner, ed function of the septic tank as a treatment stage in the waste disposal cyst°m- ed by the owner and by a owner agrees to submit to St. Croix Zoning Department a catificatioa form, sign The PmP~Y lumber or a licensed pampa v°~Y~ that (1) the on-site wastewater disposal system nrastCrplumbcx,~ourneyn~aaPlumba+rostrict°dp d.y), the septic tank is less than i/3 full of sludge. is in proper operating condition and/or (2) after inspection and pumping (~ vate sewage disposal system with the standards 1/we, the undorsignod have read the above requirements and agree to maintain the pri tat of Natural Resources, State of Wisconsin- Ccrtificatia^ as set b the ent of Commerce and the Departm Office within 30 set forth, herein, Y leted and returned to the St. Croix County Zoning stating that your septic system has been maintained must be comp `da~ys of the year expiration date. S / /d ~ DATE ', SI A OF APPLI -~ - .,~. OWNER CERTIFICATION our knowledge. I (wt) am (are) the ownei{s) of I (we) certify that all statements on this form are true to the best of mi o D~ Office. e p ~, descn'bed above, by virtue of a warranty deed recorded in Regret /ISO ~ ~- DATE OF APPLICANT .««~•~ ••••f* Any information that is mis-represented may result in the sanitary peruut ~~ invoked by the Zoning Department. .. Ucatlon: a stamped warranty deed from the Reg~ater of Deeds office Include with this app map ~ reference is made is the warranty deed a copy of the certified survey 0$,;'2$/01 TUE 13:11 FAX 713 388 4886 ST CRx CO ZONING ~drr 1~0~1 POW['S QWN(vR`5 MAN1dAL ~ !`7P1P4~1yt1"1<t{~- !'LAN _.-- ~1Lfi INFgRMATlC3N Owner . ~/ If?GN lsertnit # Q c~3 nc~.r~v nsee~t~~rx>pt ~, za...~ «...r......~,~ Number of 13edraoms ~ DNA, Number of Commerda[ Units A Estimated flaw (average) ~„'o a gal/day Design flow (peak), (Esdmaced X l,s} ~D SaVday Soil Applitadon Rate ~ -~ gaVday/ft~ in![uent/fiffiuent Quality Monthly average" Fats, t7t18t Grease (FOG) s30 mg/!. Biochemkal Oxygen Demand {130Ds) x220 mg/L Towi Suspended Solids (T55) 51 50 mg/L Pretreated Effluent Quality ' ^ NA Monthly average*' Biochemical Oxygen Demand (BOt7s) <_30 rna:/L Tats! Suspended Solids {TSS) s30 mg/L Fetal Conform (geometric mean ~ 10' cfv/ 7 OOmt Maximum Effluent Particle Sine h inch diameter MAINTi:TiANCfi SCHEDt3LE Service Event Inspect condition of tank(s) Pump out contents of tank(s) tnspect dispersal cefi(s) Clean effluent filter Inspect pump, Pump Controls at:atarrn Flush laterals and pressure test ` SYSTEM Si+EG11•tcwrtuna Septic Tank Capadty Opal ( ~ NA Septic Tank Manufacauer ^ NA Effluent Fitter Manufacrturer ^ NA Emuent Fitter Model pp O NA hump Tank Capacity gat Pump Tank Manufacturer a Pvmp Manufacturer R Fump Model ~~ Pretreatment Unit ^ NA Q Saad/Gravei Filter ^ Peat Filter p Mechanttal Aeration ^ Wetland ^ Disinfection ^ tither: Manufacturer Dispe ai Cell(s) n-ground {gravity) Q ln-ground (pressurized) ^ At-grade ^ Mound brI -Etne ^ 4~er: * Values typkal for domest~ (non-commerdal} w711tewater and septic auk effluent. ++ ValuQS tyntcal for pretreated wastewater. Service Frequency At least once every 3 D months ear(s) (Maximum 3 yrs. When combined sludge and scum equals one-chtrd (Y~) of tank volume Ac least once every 3 ©months~Year(s) (M~ucirinut» 3 YYS•) At least once every _At least once every At least once every At least once every At kasL once every ^ months ~ year(s) O.~ /~ ^ merttttx ^ year(s) ^ NA 4 months l7 year(s) DNA D months ^ Year(s) ^ NA ^ months Q year(s) DNA Mgit~1TSNANCE lNSTR>;lG7tONS frtspect4ans of tanks and dispersal talcs shatlPOWTS lnsaector; POWT Malntainerf 5eptage Servicing tDperatar uTank inspection! plumber; Master Plumber ResuiRed 5ewe , must include a v(sua! tnsAertion of the na o}checkfor any ba k up or pondlntt of effluention the ground surfac& aThe dispersal h volume of combined sludge and scum a cell(s) shall be visually Inspected to theck the effluent tevefs to the afxarvatian pipes and to check for any pending of effluent on the ground surface. The pending of effluent on the ground surface may indicate a falling condition and requires the immediate nadtlcation of the loco[ regtrtatory authority. When the combined acan be re~mo edslby a Sep~ge Ser~d ~ O~ atariand d plosed o)f in accordance with ch.f NR 1 ~3, W'tscons contents of the tank sh Administrative Cade. The servtctng of effluent fitters, mechanical or pressurized pOWTS componenu, pretreatement components, and any ocher maintenance or Monltortng at lnt:rvals of 12 months or less shall be performed by a cerctfled POI+YTS Maintainer. A service report shaft txt provided w the locst regulatory author[ty wfth(n t 0 days of completion of any service event, START UP ANB OPSltAT10N For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting produar or other chemtc, that may impede ~ t~eatmenc process and/or damage We dispersal cell(s). tf hi¢h concentrations are detected have the conten~ n~ ri+e ranlr#SY1 r»movPd by a tentaFrt srrvicing operator pcio~ to use, U8!28lU1 TUE 15:11 FAX 715 X86 4686 ST CRX CO ZUNING ~OOi ~~ae .^_ ~...._. System start up shall not occur when Spil Condtilons are fCOtAtt dt ~ Int'pu+nlve iuti~ctt. During ppwtr outlets Dump sinks may flt{ above Hamra! hlghwatar levels. When power !s srestor+sd tht CxClii wutewatFr vv~tl be d'uchargrd tp tht dispersal eeA(c) to one fare dasc, ovsrloadlnE dif cell(s) aril may resuii fn the biClCitp Or sttrticr dtscbar~ v! eftlucnt. 'to ivotd this situation haul the cdnuns:s of die patnp Uttk removed (ty a ~~p~Pr's ServklnE Op+eratvr,prloc t4 rKLCctnx power to the effluent pump ar contact a Pturnber or J'OW?S MiintaJrter to ass>st in manually opsrattr~ tFta Dump Controls w rrstore normal levels within the pump tank. Do not drive or parse ~thtcles over t3rttcs and dispersal cells. Do riot drive or puk ovrr, Or athetwfse QfSWrb or compact, the area v~chln 15 feet Gown slope of eny mound or at-!ride soil iDsotptbn ir@i. Reduction or +Umination of tht [alfowfAg (r4tr1 rite wutewater vtreani ~Y fsntptovs ~ per[orn'iinre and ~a"a ~ Ufa os' c'x POWYS: arttltalotla; baby wipes; clEuvtxv buttst tondorm; tottdp twvibc; dt;reissrs; dental Ross; dtapersj dWn[sttartu; fat; founGit,on dratn tsump pump) water, fruit and ve4etab(e in+ftness ~ssoNrnr; Reuel herfaiCfQes; mint sccrap:; rnedicitwns; ot5; pilnttnR vroQutt3: pesticides; sar+iwrv napkins; timtsons, tnd water Sofitntr J7ririe. AJ3AN l?QN EM lEN7 When the ?C7WT5 (ails andJor is ppmsanentty tak+n out o[scrvlct the fvlfOwtrit; Seeps shaft bo taken iv insurt that tht system is property and ;rif+lY abindotud In canpllanee with ch. Comm 93.3, Wiscortsln AdrnMhtratiw Code: • Ali plpln~ cv un{ct and pits shat) bt dlscvrtrract+d :nd flit sba:ndor+sQ ptM oWN+~ jsakd. + The eontenrs of alt tanks and pits shill be removed artd prc+perty dtspostd ql by a Sept~e Servictn; Operator. • Atte~ tsurnpir& ass tanks and pltt shall tse excavated and remavsd or thtlr covers removed and the void space fllted with sail, !ravel or anothar inert svlld matrrfal. CONTtNGirNG'1' PLAIN l f tha POW'TS falls anct cannot be repaired rise totlavrlnE mexsurcs have peen, or must fx taken, to pro~de a roar comp{fant rep nt system; `~~ sultiblc r~epfiCerr-ertt area hay been evaluated sod myy be uuJJud for tht Jot•.atten ota npiaeemsnt salt il>•sorouon system. The r+pfatement area should be prbcecu4 from d{sstutQantt and competllon and should not be {nfrirt~ad upon tyy required setbacks tram exi:tlne and prorloseQ stn+ctor+, {vt ttn~a and wefts. ~atfure w prot+~Ct tilt replacement arra wiU resulc trt tht Head for a t~ew salt and t1t+ evdlUdtlotl tp estabfls{l a suttitrte replactmem ar~ca. Rtptatemrnt rysterns rnwc tampiy with tt-s rules In effect it tJut tJtne. (a A suttaa7lc reptatement area Ji nOt ivillible due w !!'tpdCk• aridlpr soft tftilkaLlCtti. f~errlt>sE pdYariC~es fn P04Yf5 technolvict' a hotGtn= sink maybe ishsta9ed Its a fawt r+e9ort W reptaa tlhr liRfd isOWTS• ^ The site his Rot bten t;viltsated to IdentJy a a~+ttabte npiatemsrrt uea. Upon faslJare of tie ~~ a sou and site evaluation must t>t per'.ormed to locaoe a sulubla replact:seieert area It n0 ttpJitstttl!>t1tlree ti ivsllible p hotline tank may bs ltutat{ad as a last resort W replace ttte failed POWYS, p )"sound and at-grade soli absorption systems sYtiy be recensuvaad In place foltowlnE removal of tJ1¢ bivmat at the lnnitratlve surface. Reconsrntatons of such rystems must.camp~j with the tuks In si'fect at that same. < < WAIRNINC'r > > SEPTIC, PUMP AND O~TKER TREATMENT TANKS MAY. COUiYAri"i i.E7HAL GASSES A1+ID/OR iNSUfF1sJG1EJKT OXYGEN. OG NOT EtJYbR A iE[*TlC, Pur1r of>< OTH~ TR6ATMirNT TANK i11w1D~R ANY CiRCUM37I-NCE5. oEATN MAY RESU~r, RESGUfc Of A PERSON fRQM Yi#l6 IJKTl6R10R 4fK A TANK MAY ii D{Ff;iGL(I.T CiR il.iDf~iilRl i. AOat`flC>•INAL COMMJrhITS POWT3 INSTALLER Name /i11. i+hone sf~fr'TAGE SERYICfl+4G OPERATpft -fir Mlatl;R Nima Phone irQ1M'J'S MAiNTAlNER Name L NZ G,dSl~' ~Ntr Zq G TORY AvTN /~rrc7 D/fG G° < .- Pb 8~~ STATE BAR OF WISCONSIN FORM 1 -1982 5• t 1 ~J WARRANTY DEED DOCUMENT NO. Volt 1~1~`3 PacE f ~7 _ . _ _ - r, ~ ...~...-,.. ,.._...., - "This Deed, made between John t1. Dudinya!c and Delot~s S. .~,i.l+~vlXrii r,i+j _Dudinyak, husband and wife and each in his o her Fi+.'4brF.:::J separate right .~u~. 6 i~9~ Grantor, and Dean tJ. tJellrtan and Janet tt. taellrtan• husband and at 2:30 P.(t.j wife. as survivorshia marital property ;y~~J~} 4~ikfL q;;,~t c! ~~_ Grantee, ~-- W1[riesSettl, That the said Grantor, for a valttab~ txntsideratiort conveys to Grantee the foUtnving described real estate in St • CIO1X TNIS SPACE RESERVED FOR RECOROiNG DATA COUttI); SIaIe Of WiscOrtSin: NAME ANO aETURN ADDRESS Part of Sl~l'~ of SF.'~ and the SF,'~ of Sll~ of Section 20-29-19 lfeywood b Cari, S.C. described as fellows: Frota the Southeast corner of said 204 Locust Street, P.O. Box 229 St•1T of the STs1 ga North along the East line of Said (ftldson, Ilisconsin 54016 St7'~ of the STs~ a distance of 558.2 feet; thence f:est along the centerline of old STIf 1112 a distance of 502.0 feet to she point of beginning for parcel to be conveyed <~erein; thence continue along said centerline a distance of 856.0 feet; thence N 1 degree 13'F, a distance of PARCEL 4DENTtFICATKAi NUMBER 424.8 feet; thence Fast a distance of 84~-.0 feet; thence South a distance of 417.5 feet parallel to said East line to the point of beginning; the South 33 feet of said parcel being used for pttblic road. F.XCrPT that. part of the above described land conveyed to Richard t~l. Hancock by the tfarranty Deed recorded in Vol. "479", Page 221, Doc. No. 308116. s T-- This i s not homestead property. tt17d (is not) Together with all and si: gular the hereditaments and appurtenances thertumo belonging; And warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easetients, Covenent9 and restrictions of record. and will warrant and defend the same Dated this I >; ~ day of Aa~us t ~ ,19 96 ~./V V'~ • ~ ~ i (SEAL) (SEAL) ytgnaturcZs) - ~ / ss f~ t~ ~a•- Count authenticated this day of , 19_ Personally came before me this ~ ~r day of Ar.v,r4*- , 19y~ ,the above named t.,t,a_~-.n~ak and Delores S. Dudinyak TITLE: MEMBER STATE BAR OF WISCONSIN (lf not, authorized by §70ti.06, Wis. Slats.) THIS INSTRUMENT WAS DRAFTED BY Ifeywood b Cari, S.C., Samuel :2. Cari 204 Locust St, Hudson, IJI 54016 (Signatures may be authenticated or acknowledged. Both are not necessary•.) iu. ttt+rr ~ una.M~__~ tae own to be the person who executed tfie foregoing iasutlment and acknowledge the same. tya~ pu County; YJis+ Air commission is permanent. (If na, state expir~non date: 7- ~.~ -,.~60 .) • Names of pt rzons stgnmg in sny capuity should 'uy typed or printed below thole signatures. SLATE BAR OF WISCONSIN WilCOtKR1 Legal Blank Co.. Inc. WARRANTY DEED Form No. I - I%2 M~kvaukae. w~a 2 ~; 's' ,~ ~; :T ~~a ' 4 w ' ta_ 'f ~: .• t~ ~. i ''-~.~ •,,~: ~' `; ... _'' ~~•5 ,l ~'~ -:jr ~._ . t ~` i-„{ . ~, t , ~_ • 4. ~, ~,. , .w ~4' a. , LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF HUDSON COMPUTER NUMBER 020-1053-20-100 Parcel Number 20.29.19.197E-10 OWNER NAME: First DEAN W & JANET M Last WELLMAN PROPERTY~DB R _ eet Name-- Type SD Apartment 448 JACOBS LA SECTION '/440 Line Description Line Description- TOTAL ACREAGE 3.000 PLAT CSM 12/3292 LOT4 BLK 01 SEC 20 T29N R19W PT SW SE & 15 02 SE SW BEING PT LOT 2 CSM 16 03 11/3128 NKA LOT 4 CSM 17 04 12/3292 18 05 ~~ 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1-General, F4-Prev. Parcel, F5-Next Parcel, F7-Valuations, F8-History, F10-Exit ~; 7 's. j 5617'3 ~ O ~~ ~~L~~ ~ JUL 0 1 1997 ~ ~~r;~.w p~p~eco~o ~ ,~ s~c~ca . C ER T I E I ED S UR l/E Y M,4 P Located in the Southwest quarter of the Southeast quarter and the Southeast quarter of the Southwest quarter of Section 20, Township 29 Noeth, Range 19 West, being Lot 2 of that Certified Survey Map recorded in Volume 11, page 3128, Town of Hudson, St. Croix.County, Wisconsin. Owner: I ~ Dean Wellman ~ CERTIFIED...SURVEY MAP , V ll e3/2e 455 Overlook Pass I ....................... ~ Hudson, Wi:.. DoT / ss' I ............. I S 00'10'36"W 419.57' ~ ~ 386.12' 3.45 ` `,~q1/1//q~j~b 130, 660 Sq, ft. (3.00 Ac .) . ~1 I I ~ ~OHNSYN ~ Including right -of -way . ~ ,~ I ~ I = S- y 889 120,201 Sq.ft. (2.76 Ac.) ~ N• I QI ~ N W S N f Excludi~g~ight-of-way. ~ i ml ~ J •~ ~ ~ O7 ~ N N I ~~ '9N •" •'~~ ; o ~ Ll ~ I .i II O ~ o o i ~ 1111~ ~ a JUN 2 6 97 :~ i, m I ~ z~ :m ~ ~ Iv N J ST. CROIX CGUNTY €W :~ (~,~ Comprehensive Plannin , N 33.49-I~ ~ ~ SE Corner g a Zonin and 3B@ 9B' ~ 3 ~ Section 20 . n Parks Committed 00' 48' 31 "E 422.47,:' to O ~ If not recorded "..~ , ~-- m 100' -}I ~ I 2 ~ within 30.days of '"~~ , ` .. I O I ~ Q. J ~ approval date Q1 i rn ro / approval, a Ib~ ~ nullanli~~ ,07 Sq.ft. (3.00" Ac:) Iz ~ ~ ; W~ N Including right-of-way., v _~ I ~ o , ~: ~ 120,243 Sq.ft. (2.76 Ac.`) ;~ I Z ~~~ m ~ ~ Excldding ri. ht -of -way, ~ ° N I ~ o m ~ c I ti ~ Q; ~ N 0.': h~ rn dl o L ~ . ~ D m W o ~ .I V ~ =~ i o I ~ a :3 . • • N00°12'52"E 5260.15'• •• • •:m ~ I ~ Q ~ ~, - Umi I N I I ' S6T.80' ° 39+ .95~' N 01 58 13 E 4 5 ' S ` , NOO°1252"E S1 /4 Corner N1 /4 2 .49 Corner I ~ I Section 20 SeCtlOn 2O IJNPLATTEO LANDS ~ s s, ~ Bearings referenced to the~'South line ` ~~ LEGEND of the Southeast quarter of Section 20, assumed to be 589°55{59"E. -~ ~~ Masonry nail at Section corner: r. ` ~ Description. A parcel of lead located inshe Southwest quarter of the Southeast quarter and the Southeast quarter of the Southwest quarte=.of Suction 20, Towiiship[p 29 North, Range 19 West, Town of Hudson, St. Croix County Wis- consin, described as follow:: Commencing at the South quarter corner of Section 20 (bungs iefecenced to the South line of the Southeast quarter of section 20, assumed to be South 89 degrees SS minutes 59 seconds East); thence North 00 degrees 12 minutes 52 seconds East 567.80 feet along the North -South quarter section lino to the Point of Beguuwig; thence North 89 degrees SU'mitiutes 30 seconds West 24.87. feet; thenco North Ol degree 58 minutes 13 seconds East 425.49 feet;: thence South 89 degrees 18 minutes 27 seconds East 612.05 feet; thence South 00 degrees 10 minutes 36 seconds West 419.57 feet; thence North 89 degrees 50 minutes 30 seconds West 600.47 feet to the Point ofBe- ginning, wntaining 261,367 square feet (6.000 acres) more or less, and lining subject to all easements, restrictions and covenants of record. I, Harvey (3. Johnson, registered Wisconsin Lead Surveyor, hereby certify that under duectioa of Dean Wellman, ownei, I have surveyed and, mapped the'abgye descriied property; that such plat is a true and correct representation of the exterior boundaries of the lead surveyed and that I have fullx complied with tho provisions of Section 236.34 of the Wisconsin Statutes, tho St:Croix County Subdivision Ordinance, and the Town of Hudson Subdivision Ordi- nance to the best of my,pmfessional Imowledge, understanding and belief ,~`NIINi1y/// 6`,~~~.~~caGOlys~~,~~~ . HARVEY Q. 1"! Harvey o n 5-1899 : ~ + JOHNSON = . Johnson Surveying, Ina ~ ~; -' = 5-1899 216 Meadow ]hive Notth : ~ BUDS ON, ~ xudson, Wtswnsm s4o16.. Sy ~ ; , W IS, r, ~ ~• ,,~ ~ ~ iu~iito ~~~~ Each parcel shown on this map is subject to state, county, and township laws, rules and regulations (i.e., wet- lands, minimum lot site, access to parcel, etc.) Beforo purchasing or developing any parcel contact the St. Croix County Zoning Office and tho appropriate town board for advice. ,., ;, • o ~`D1 TUE 15:11 FAX 715 386 4686 ST GRX CO ZONING ~dr~ ~ ~l POWi'S OWNER'S MANI.IAL ~ MAPlgytl`''!e{v- riw~ri II~IFURMATI4N Nll•lMf llseeur.TS'tZlt• YL.llvas a ~"ti-~~~~~ Number of Bedrooms 3 a ~'• Number of Commerdai Units '°` Estimated flow (average} ~p a gai/day t)esle'-1 flaw (peak), (Estimated x i.5) ~~ gat/day Soil Application Rate ~ gaVday/ftz influent/Effluent Quatiry iHondlly average` Fats, Oil 8t Grease (FOG) s30 mg/L Blochemkal Oxygen Demand (80Rs) <220 mg/L ToWI Suspended Solids (TSS) 51 SO mg/L Pretreated Effluent Quality ' ^ NA Mvnthiy average" Biochemical Oxygen Demand (BQlZs) <_30 mg/L Total Suspended Solids {TSS) 530 mg/L Fecal Coiifofm (georsietric mean ~ 10' cfu/ ] OOmI Maximum Effluent Particle Sine A inch diameter C1r SCHEDULE Service Evtnt inspect condition of tank{s) Pump aut contents of tank(s) inspect dispersa! cell(s) Clean effluent fliter inspect pump, pump controls BL:atarm Flush laterals and pressure test _~ Ort,er~ SYSTEM SPEGlrIC:Hrivn~ Septic Tank Capadry opa i ~ NA Septic Tank Manufacturer DNA Effluent FI(ter Manufacturer ^ NA EP(luent Filter Model pp ^ NA Pump Tank Capacity gal Pump Tank Manufacturer A Pump Manufacturer A Pump Model ~~ Pretreatment unit ^ NA ^ Sand/Grave( Filter ^ Peat Fitter ^ Mechantca! Aeration ^ Weiland ^ pisinfection ~ Ocher: Manufacturer Dispe al Celi{s) n-;round (gravity) Q fn-ground (preuurized} ^ At-grade ^ Mound ^ ()rl -fine D other: * Values ryGlta! for domestic (norrtommerclal) w#newater and septa unk effluent. • * Values typical far pretreated wastewater. Service Frequeaty At least once every 3 ^ months ear(s) (Maxinsum 3 yrs. ) Wften combined sludge and scum equals one-third (Ys) of tank volume Ac least once every 3 ^ months~Year(s) (M~udrt»t!- 3 yrs.) At least once every ~ ^ months ~ Year(s) ~~ ~ /t'~~ At least once every O montf>.s ^ Year{s) C] NA At least once every ^ months O year(s) ^ NA At least once every ^ months ^ Year(s) d NA At feast once every ^ months Q Year(s) ^ NA MAlt~1TENANCE !NS'f'Rt<tCTlONS inspections of Unks and dlsperaai cei Seweir POWTS inspector; POWI' M ntalner;f Septage Servicing Operatar~Tank inspectiv Plumber; Master Plumber Restricted , must include a visual inspettfon of the ~d to checkfor any back ip or ponding of effiuentlon the grow d sutfaeee The tit perre f volume of combined sludge and scum an and to check far any ponding of effluent on cell(s) shalt be visually inspected to theck the effluent levels in the observation Pipes the ground surface, The ponding of effiuent on the ground surface may indicate a failing condition and requires the immediate notlflcation of the local regulatory authority- When the combined accumulation of sludg $en~scuS rvidng Operatoriand d plosed o)f to a<tordance with ch.tNR 1 ~3, W'xons contents of the tank shall be removed by a P ~ Admintstrative Code. The servicing of effluent Alters, t4rvals o~l2rmonths arless shall be performed by a certified pOWTS Ma ntalner.nY ether maintenance or monitartng at M A setVtt:e report shalt bQ provided to the local regulatory authority within S 0 days of completion of any service event. START UP AND OPE>itATIOtN for new construction, prior to use of the POWTS check treatment tank(s) fall hl¢h concentratioru are detected have the con ein~ that may impede ~ ceatment Process and/or dunag+e the dispersal Ceii(s). nr rke ranrrfs'E ramovPd by a sentaae servicing opQrator pe+or to use. Y! (31 F~« _.~...._ System start up shall not occur when SOiI condltlvns are ffOZ+t1 at tttt (nfifuatlvt it+rftic+. During pnrvtr o~uees pump anks may fill above normal htehwater levels. When pvwtr es restor+sd the excess wutewater Hriii be d'uchargCd to tht dispersal eti!(I) lit one verge da~se, ovsrloadlrrg tilt cNl(:) arsd mary resuii M ttx batdctip or surtacr dlscharer u! eRlucnt. Yo lvvld this situavon have the tonc+ncs of ttla part-D vnk rertwved by a ~pcae'a Servfting Opentor•prlar to restoctnr power to the effluent pump or convect a Plumber or pQ1N'TS Malntakrer Lo v~sist in man>safly operaurtg ttft pump Controls cu restore ncrm~l levels within the pump tank. DO not drive or perk vthfcles ovtr tanks ind dispersal cells. Do rwt dove ar park vvrr, Or atherwlss dlSWro or compact, the area within 1 S [eet Ovwn sicpe of any mound or at-trade toll absorption aa~a. Reduction yr rllminadon of tht foilowin>t front tilt vYititewat~ iWat't+ ~Y tmD~ ~ ~ri~A andiaper3 dWntaeeanuf etof ttx PpWTS: antibiotics; baby wipes; clgaretG{ butts; Condoms; Cottop swatx; de$reasen+' dents foun6at~on dratn (sump pump) water; fruit ind v~tgetsble p~etiinesl Cist~loe: greasef herbicldss; m+x scraps; medicacwns; oil; nalrstlnR croducts: aesdcides: sanitary napkins; tamaons. and water Sofuner br{ne. A$AN pON EM EN7 when the POWTS !ails andlor is pemtanerrt3y rakQn our of service the [olfowU{E Sueps shall by taken to iruurt that the system is properly and sifelY abandoned {n ctxnpUance with tn. Ct>mm 83.53, Wiscollsln Ndrntnt~tratlva Coda{ ,ail plpltre tv Unks and p(tt shall bt Qlscorrrrvcud :nd the sbandorsed pip+ openln>~s tsakd. The contenrs of alt tanks and pits stud be removed ancf prc+perty did v[ by a SepLaxe Servkln; Operator. Ahe~ pumpin¢, air tanks and piu shall ba excavated ~tnd removed or thtlr coven removed an4 the void space filled with sail, eravei or mother inert solid metrrlal. CONTINGENCY PIraN If the ijOWY'S faits xrri cannot be repalrtct the Iollowirt~ measures haul been, or mtut be taktrn, to prarldt a colt compliant re nt system; `~~~ suttablc reptacerr-ent area has been evatuate6 ind may lx uu(Ixed for the toatlon of a TepJaesrnant sell ibsorpuor~ system. The rtplatemcnt area should be protkcu6 from dlsturb3nct and cornpattion and should not be Infrtrt>;ed upon o•,• rewired setbacks from txtsdng and proposed strWC't++r'e, l0[ lines and wells. fallurv to protect the replacement arra wll~ «sulc ir'i tnt need for + new soil ar{d >ttt evafuattar- t0 escabitsh 7 sultaMe replacerr~nt ir'td. 1!a{ptacement rysterns rnwt t:omisiy with the ~lss In enact it tint time. Q A Sllitd0l! reptiCettllnt area lS not iwllible dYt t0 !tt$dClt• artid/Or soli titnkatlatti. 6+~rrftt~ edVaJ{0!S lit POKRS t2Chrli~iv$7" a holding tank maY lye ittstalied a lut rssort to rsptaa thr litis6 POW"C'S. Th sl tWS not cwluate to tlfy s re !tt t1Do ure of the a soli and site ev d mu br r'orme to I ve Iv replac area. if n0 plat rit a IS aYall t-~-bolding tank may be talk s a last r replace failed P S. p Mound and at•gr'pde sat( absorption sysurmi may be reconsuvued to plate foitowlns; removal Of th¢ biomat at tht InlliuatWe surface. Reconswatorts of such sSnums tntjst.~coa{p!y with Liss rukl In sffat it that dme. < <w,VtNING> > SEPTIC, PUMP AND Q-TKER TREATMENT TATlICS MAY_CONYAI)~! 1GETHAL GASSES AND/OR iNStSF1+iG1El'tT OXYGEN. OC NOT ENTER A SEPTIt, PlI?iP Qlt OTNElt TRtEATM'RN7 TANK UNOrcR AHY CiRCUMS'raNt:ES. DEATH M1lY RESU4T~ RESGUf aF A prR;ON fIROM T1~E 11eTtt.K1OR OIL A 7'A7~tK MAY if: DIPPIGULT 4R {1+i~t1iG1Rl i. A.Otii7tC>NAL COMMENTS POVYTS INSTALLER Name /i11.-- Phvne ~ TEt'TAGE SERYIGiNG OPERATOR PLtMPER Name yr,rm. ~QMfTS MAINTAlNBR Nine (i NZ G,a~" ~~/~-- ~PfsorN ~ 2'S ~' '~ ~~ ti,0 ~ R G i~ATORY Au't'N /~enc7 0/ ~ G° < n ~b , ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mailing Address Property Address 1.~~ ~~ ~~$ ~J~`~ ~a Vl (Verification required from Planning Deparnnent for new City/State ~ ~~~%-'~ , ~ ~ Parcel Identification Number LEGAL DESCRIPTION ~ • .~,~~ ~ ~ ~.t.~ '/, Sec. r~~i T ~ N_R_! f _W, Town of ~~~7 ~ property Location /4, , Lot # ~ . Subdivision -~ ~CU ~ ~ ~ ~ .Volume ~ ~ ,Page # ~ "~~ (~ Certified Survey Map # ~ ~ ~ Volume ~ ~ ~~ 3 Page # ~~~ Warranty Deed # ~ ~ ~ - Spec house O yes ~ no Lot lines identifiable' yes ^ no SYSTEM MAINTENANCE Improper use and maiatenaaceof your septic system could result in its premature failtue to handle wastes. Proper maintenance consists of Pumping out the septic tank every throe 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. The property owner agt+xs to submit to St. Croix Zoning DoPartm°at a ~~~tion form, signori by the owner and by a ~pl~~, jotnneymanplumber, trstrictedplutnbex or a licensodpumperverifyrng that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) aRez inspoctioa and pumping (if nocessary), ~ septic teak is less than 1/3 full of sludge. I/we, the undersigned hsve read the above acquirements 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 Wisconso~ within 30 stating that your septic system has been maintained must be completed and returned to the St. Croix County Zotung days of the year expiration date. ~~ / ~~c~3 -~-~- DATE SIG A OF APPLICANT' OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (wc) am (are) the ownec{s) of ,the p~?operty described above, by virtue of a warranty decd recorded in Register of Deeds Office. ~ 5 /r5 /d.~ `~""- -- DATE t~CiNA OF APPLICANT •••••~ • • • • • • Anytnformation that is mis-represented a~ay result in the satutary pemut betng revoked by the Zoning Department. •• Include with this applIcatlon: a cramped wantanty decd from the Register of Deeds office a copy of the certifiod stuvey map if reference is made in the warranty deed ' 561`7`73 C ER T I F- I ED S UR ~/E ~' Mai P Located in the Southwest quarter of the Southeast quarter and the Southeast quarter of. the Southwest quarter of Section 20, Township 29 Noeth, Range 19 West, being Lot 2 of that Certified Survey Map recorded in Volume 11, page 312$, Town of Hudson, St. Croix.County, Wisconsin. Owner: Dean Wellman I 455 Overlook Pass I "CERT/F/ED...SURVEY MAP V fl P. 3128 . : ........................ I Hudson, Wi.. m 0 m 0 ~' ~ N ~ ~ .ci 2: a ; (0' J. W z ~~ N m si ° w~ N ~: ~: ~ ., ~~ ~ (U J; LOT l I 6 6' S 00'10'36"W 419.57' i I ~ 386.12 ' 3.45 `,Oh~1111Np~~,I ~2 I l .~`~~ ~~CON ~~4 J I I ~~~ ~ S/ ~~i I ~I ~ I I ~~,~ HARVEy ~: 130,660 Sq.ft. (3.00 Ac.) W~ ~ S_~rvsON ~ ~ Including right-of way. I ~ ,. 899 120,201 Sq.ft. (2.76 Ac.) I Q~ ~ H WSON F Excludi~gt~,ight -of -way . ml ~ J I •~'i ~9 .,,,yN` S.,.. ,.~ o a I a ~s No ~~ .+ r+ ~I~~ S U ~I m I 00 1 t4P~i~OV~~~' ®7r 3 I I ~ ~~ i m I ~~, ~, Jll~1 2 6 97 ~ I. (V ST. CROIX COUNTY w ~ I~ ~ ~ SE Corner Comprehensive Pfannin9 :y 33.49-I 3 ..Section 20 Zonin and 388.98' ~ n ~F a ~ _ Parks Committel~l 00' 48' 31 °E 422.47,:' ~o O y ,_,.,.. .. (~ I o i I[ not recorcfed ~ ~ .. :.•~-- /00' -+~-I~ O c within 30 days of _"~ . ~ ( ~ approval date ;', i Im ° cspprova{ afi Ib~ I Z ~ I nullantf•~~ +07 Sq.ft. (3.00 Ac:) pp . Including right-of -way ., I ~ o : M 120,243 5q.ft. (2.76 Ac.) I Z ~~ ti Excluding right -of -way, rnl ~ m I Q ~ N ~~' c' I N m I z .z .I ~ I :a ~ ~ v ~, t~ I ~ Q ~ ° ~I • N00°12'52"E 5260.15'• -• • •:~ ( ~ I ~ I `t N ~"~ ~i of Des: ~. St.Ccol:cCo,~ 391.95' N 0~'S8'13"E 425.49' N 1 /4 Corner Section 20 UNPLATTED LANDS Bearings referenced to the~`South line of the Southeast quarter of Section 20, assumed to be S89°55x59"E. l CALF /N FEET /"_ /oo' I 567.80 1 ~ 3354 IVOO°12'52"E'~ COrner I ~ Section 20 ~ s s' I I ~.. I '. .. .' I LEGEND Q. Masonry nail' at. Section corner . ~" Section°~corner monument,,. Berr~tsen cap. o " 1 "..Iron pipe weighing 1 , 68 pounds per lin. foot seb, STATE BAR OF WISCONSIN FORK I - 1982 ty,q r~~~~ ' • ,, a~ .t WARR ANTY D E E D n ~' ( ~ DOCUMENT NO. VEIL 1.1`3 PACE I~JI /~ _ 'this Deed, made between John il. Dudinyak and Delores S. ~i.l'+~~iYCi r,~+~~ Dudinyak, husband and wife and each in his or her 6+.'aatE;~J separate right ~~V~i-. s i~gr, ~ Grantor, _ ~ and Dean [7. [7ellrtan and Janet tt. idellman. husband and dt 2:30 P.('.j wife, as survivorship marital property ,~~~..~ ja,~~!~ F.,1,;•zr ci ate.: s Grantee, - ---- .. WtlneSSelh, "Ihat the said Gtarttor, for a valuab~ wruidetatiun mmeys to Grantee the lulluwing described real estate in S t . Croix THI$ $DACE RESERVED rOR RECORDING DATA County, Sla[e Of WtsconSln: NAME AND RETURN ADDRESS Part of SFI'~ of SF,T and the SEZ of S[l~ of Secticn 20-29-19 Ileywood b Cari, S.C. described as fr.llows: Fron the Southeast cornec of said 204 Locust Street, P.O. Box 229 S[•1T of the SGT ga North along the East line of said lIt-dson, IJisconsin 54016 Sidi of the SE; a distance of 558.2 feet; thence f:est along the centerline of old STI[ 1/12 a distance of 502.0 feet to she point of beginning for parcel to be conveyed 'ierein; thence continue along said centerline a distance of 856.0 feet; thence PI 1 degree 13'F, a distance of ~ARCEI !DENTIEICATgN NUMBER 424.8 feet; thence Fast a distance of 844.0 feet; thence South a distance of 417.5 feet parallel to said East line to the point of beginning; the South 33 feet of said parcel being used for public road. EXCEPT that part of the above described land conveyed to Richard TI. tlancocic by the [darranty Deed recorded in Vol. "479", Page 221, Doc. No. 308116. $ TjtA~J$p~R 1 FED This i s rto t homestead property. dud (is not) Together with all and si^gular the hereditaments and appurtenances thereunw brlanging; And warrants that the title is good, indefeasible in fee simple and free and clear o[encumbrarrrs except easenen[s, CovenanCs and restrictions of record. and will warrant and defend the same. Dated this / ~ ~ day of `J~ xl~ . ~--~ ~ (SEAL) 19 96 • John ti. Dudin ak _ ;_i (SEAL) • Delores S. Dudinyak AUTHENTICATION Signature(s) authenticated this day of 19_ TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by §70ti.06, Wis. Seats.) f HIS INSTRUMENT WAS DRAFTED BY ileywood &Cari, S.C., Samuel 't. Cari ACKNOWLEDGMENT (SEAL) (SEAL) State of YV:fJSlt2fl11cliiS Florida / ss t'~- County. Personally came before me this / ~'r day of A"~.+a * I9 y o ,the above named ak and Delores S. Dudinyak btY mt nown to be the person who executed the (ongoing i~ument and acknowledge the same. r ~?'; a• r ` ~;4 i~,~' }i~. `! '1; ~~#- R 4 ~,`1 ~~ , '~~ ~r~ ~: .. Y~•' ~~ ~. `. t s t' .... . ~'f ~.