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HomeMy WebLinkAbout020-1134-60-000l7 _.. ? O ~ Q A A ~ N N ~- O O Z'' ~ rn S37 O ~ N ~ A C r:> 3 o ~ ~ ~ <<c ~~ ~ ~ ~ ~ ~ ~ ~ N N (d% c c r. ~° V A cn O c S O Z o_ m ~ ~ ~ c (D Q m _. c m n ~ d O s ~~ ~' c~ U n N 7 (p (D O r3 7 1 S C1 S ~ ~ ~ ,_+ CD pnj ~ O ~ N N fl. ~ S O w 0 O ~ m ~ a co' ~ ~mm~' sn x,v m~~~ ~a~~ O ~ 1 N ~ N ~ O N ~ ~ ~ n V ~ N 3 o a m m w ~ ~ -~ o ~ ~' d ~ ,_ x- v m ... ~ a o x _. N ~ ~ ~ ~ • Fla O O 44 °o o- ~ V1 O C .di 3 ~ A ~ `G '0 ~ ~ ~ _ O A -I W O O ~ ~ t~A N Q° ~ ~ C A G N Q ~ A_ A tD m 0 0 0 0 0 ~ m' ~ ~ ~ ~ N N N f!1 2 b 0 Q a A ~ N y ~ d ~ ~ N - ~ ~ N 3 d ~ ~ 3 A •• o rn D M ~ m 'o o m N (n G a a m n ~ N p c a ~ ~ C. ~ '0 3 o ^' 3 (D 'O W p'7 C1 (D C fD <_ ~ T C 3 a ~ ~ o 3 () A ~ '~ 'O # ~ d •• A ~~ C O N d N O m cD O ~ w A O ~ m O ~ ~ O o ~ O N o c ~ -r a .. ~ m N 0 F :0 Q O m N 3 a D a a ~ -~ N 'P Z n a ~ ~ ~ ~ ° ~ Z A ;(1 ~ ~ A d fD A7 `~ :+ "t e~ hr R C m O y •~^~, L O ,i ti ~y 0 0 O~ A v ~ ~ v 11/13/07 Draft General Soils Map 2 TOWN OF STAR PRAIRIE W~E 0 0.5 1 2 Miles aos. •ssocunoxs ~~ e O...o.,. r.s.rm ~w.~ora.. ®~+r+ p wrr. W.... SOURCE: Soil Survey of St. Croix County, 1978. 2008 COMPREHENSIVE PLAN 145 Wisconsin Department of Commerce Safety and Buildir;g Divisio PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Troemner, Mark & Suzanne Hudson Townshi CST BM Elev: I Insp. BM Elev: BM Description: Op.p av.p' s- TANK INFORMATION " ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic ~` r l~ .E-~ SGT ~" Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ' Sd t ..~~~( I Dssn~tg a a ~r Aeration Holding PUMP/SIPHON INFORMATION.----~ Manufacturer Demand GPM Model Number TDH Lift Friction Loss ad TDH Ft Forcemain Length .. Dia. Dist, to well SOIL ABSORPTION SYSTEM/ 1 I l i• b_ __ _ /,. ~ ~ /~ir~. ~ D_ County: St. CrDIX Sanitary Permit No: 430561 0 State Plan ID No'. Parcel Tax No: 020-1134-60-000 SectionlTown/Range/Map No: 20.29.19.656 STATION BS HI FS ELEV. Benchmark ,, ~00 •~ r 0'Ib .o 0 Alt. BM Bldg. Sewer SUHt Inlet St/Ht Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe !3•s'~ i' Bot. System ( .Y 8's.6s' ' Final Grade ~ ~ , St Cover 5~'' Z ;-. ~ ~° 2.68` ST~'Ti off" ~`F4 .off BEDITRENCH Width / Length ~ No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ 6'B ~ ~ ~ L SETBACK SYSTEM TO P/L LDG WELL LAKE/STREAM LEACHING Manu~ctur~: ~~ ~-L INFORMATION CHAMBER OR _ , ''LL vv~~ J~ Type Of System: ~y l,.wtiv r ^U C~ ~~ -•~ UNIT Model Number: ~ ~ ~1 DISTRIBUTION SYSTEM Header/Manifold Distribution Pip s) x Hole Size x Hole Spacing Vent to Air Intake f Length Dia Lengt Dia Spacing , ~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Onlv Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes No ~ Yes ~] No ~. COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~~1~ 7j Inspection #2: / / Location: 416 Northview Pass Hudson, WI 54016 (NW 1/4 NW 1/4 20 T29N R19W) W~iLllow Ridge 2nd Addition Lot 47 Parcel No: 2,1029.19.656 1.) Alt BM Description = -~~ T ~~ _ ~~~~~~ W ~~ ~' U 2.) Btdg sewer length = ~ 7 + ~ ~~ C7tc+w+~ 't~uC9ti -amount of cover = ~_ _ n ~~ ~ _ ~ ~ . 3 `o-C~.. .~~.~ Plan revision Required? L~ Yes No ~• Z~ Use other side for additional information. _~ SBD-6710 (R.3/97) Date Insep o lure Cert. No. Safety and Buildings Division County ~ ~ ~ 201 W. Washin ton Ave. P.O. Box 716 sr ~scons~n Madi n ~~ED WZ mit Number (to be filled in by CoJ amtary P er Department of Commerce ( ~I ~ / r3~ S~ ~ Sanitary Permit Applica io1lNOV 1 S 2003 tate Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal info ation you provide may be used for secondary purposes Privacy Law, sl .04(1 CROIX COUNTY oject Address (if different than mailing address) F E et j Ut ~45s ~~ ) ~w o '~10Y ' I. Application Information -Please Print All Wolwation Property Owner's Na me Parcel ~ Lot ~ Block aM ~1 a r t ~- S ~, a, o rn ~ q 7 `- Property Owner's M ailing Address Property Location ~7 y,g ..y Section ~ k W Ciry, State Zip Code Phone Number , . d o w 5 4 6 1 ~~~ ?/ ~~, - ~ 9~ d (circle ne) R~E or T ~ N II. Type of Buil ng (check all that apply) ; ~1 or 2 Family Dwelling -Number of Bedrooms ~ Subdivision Name CSM Number ^ Public/Commercial -Describe Use ~.1 ] 1 (~ h~ r w ~ ~1 W 1~ i~ G ~ f'~tL1 ^ State Owned -Describe Use Z. 1C ~O~- ~"S ^Ciry_^Village Township p~S~j~ 22 III. Type of Permit: (Check only one box on line A. Complete line B if applicable) p p _ { i3 - (pp - prr~ ~ (oS(p A' ^ New System ~ Replacement System ^ TreatmenUHoldin Tank Re lacement Onl g p y ^ Other Modification to Existin S stem g Y B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Ty of POWTS S stem: (Check all that a 1 ) Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recircularing Sattd Filter ^ Recirculating Synthetic Media Filter each' g Chamber ^ Drip Line ^ Gravel-less Pi ^ Other (explain) V. Dis rsal/Treatment Area Information: -(~ Design Flow (gpd) Design Soil Application Rat gpdsf) Dispersal Area Required (sf) Dispersal Area oposed (st) System Elevation 4~~ t 0.7 ~~a.q z8 ~ ~ .o Vl. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic orileWiag-~dFik 50 ~ DO 0 /~ ~ / Sd a n 1 Lsc~ anc Y-,ua I/ Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Na me (Print) Plumber's Si gnature MP/MPRS Number Business Phone Number Carl ~ ~e15>° ~aoss~ gas a~ s Plumber's Addre ss (Street, City, State, Zip Code) I ~ ~~ `~ ~~llr Soo 2Z VIII. Count /De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater h F S Date Issued Issuing. ent Signature ( Stamps) ^ Owner Given Reason for Denial urc arge ee) ~ z~ ~, ~3 IX. Conditions of Approval/Reasons for Disapproval n 3 ~ ~'~~ S Y ~° ~-~-~-~.~C v r ~ R : SYSTEM OWNE 1 Septic tank, effluent filter and QI ; ~ ~ ~~ ~ ~ ,, ~ , , _~ dispersal cell must alt be serviced t maintained , ` ~~ er management plan provided by plumber. ~~-f - p~.,~ as ~ ~-- ~ 2~ p 2. All setback requirements must be maintained ~S as per applicable code/ordinances. Attach complete plans (to the County only) for the system on paper not less than 812 x 11 inches in sue SBD-6398 (R. 01/03) TYOew-rrr P,aPP.~~~~ ~' ,~ d ~ a ~ ~ o~ ILL '~t YJ ~J /SCa~~ `,,~ 4a ~ ~`~ ~~~ -----_ ~Bm# ~ IT> T'~P S,T, vn4n~ol~ ~vv~~ r-L. y 7, 0 5 ---, ~ d ~(`t -1 V I L W Qt~~~rc.~ 8~ ~(~ aaass~ ~ ,~-1~ ~Ca.~l,-^Y c.~,kw. bars aT CI ~ $~,d ~ e k b ' ,. T~oevnnY~ prdQP,~~~~ - La-~ qrl W'~11vu~ (Z-~~ • "~ ~~ a 1 'p I ~L ~~ 4a~S'y,c~ '~8~~~ ~,,,,~ 'P ''~ca~ as a ss ~ „/ ~ SCa~t ~ : 4a C`~ d~s r----__ C~uty ~=L, 97,05 -, W a~-t~ uiew Gass ~,,~,~1, tt BG, a ~Ga~~in~ C~kt++~o,~rs aZ" CI e aal~ b ~~~ Gs,~s l'"S t ~~ ~ slo.~~ `.~ ~' Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT in accordance with Comm 85. Wis. Adm. Code 1 SAID Page 1 of A.C.E. Soil 8 Site Evaluations County Attach complete site plan on paper not less than BY x 11 inches in size. Plan must St. Crouc include, but not limited to: vertigl and horizontal reference point (BM), direction and Parcel I D percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. . _ _.. _.. ~,..._-.__._ . . 020-1134-60-000 . i Please print aN inlbrmatia~ ~,; gy Da te I'efsanei inrormation you provide may be used for secandarY purposes (t~ivacy t.aw, s. 15.04 (1) (m)). ' / - /'V OV . 19 Property Owner ' Properly Location Mark A & Suzanne Troemner Govt. Lot NW 1/4 NW 1/4 S 20 T 29 N R 19 W Property Owne{s fvlatlirlg Address f Lot # Block # Subd. Name or CSM# 416 Northview Pass _, w... ._ _ _ , ~ 47 Willow Ridge Second Addition City State Zip Code Phone Number J City J Village 1/ Town N~rest Road Hudson ~ WI 54016 715-386-1920 Hudson Northview Pass 3 J New Construction Use: 1/ Residential /Number of bedrooms 3 Code derived design flow rate 450 It/ Replacement J Public or commercial -Describe: Parent material Glacial outwash Flood plain elevation, if applicable na General comments and recommendations: Install 2 trenches at elev. = 86.00' using 22 leaching chambers. Each trench to be 3' x 68.75',using 11 chambers per trench. GPD Boring # ~ Boring N Pit Ground Surface elev. 90.70 ft. Depth to limiting factor '112 in• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft~ in. Munsell Qu. Sz. Cont. Cobr Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-16 10yr32 none sil 2fcr mvfr as 2fmc 0.5 0.8 2 16-25 10yr4/4 none sil 2fsbk mvfr cs 2fm,1 c 0.5 0.8 3 25-41 7.5yr4/6 none sl 2msbk mfr cw 2f,1mc 0.5 0.9 4 41-48 7.5yr4/6 none Icos&gr 0 sg ml cw 1f 0.7 12 5 48. 72 10yr5/6 none trat.s8~g 0 sg ml aw 1f 0.7 1.2 6 72-84 10yr5/6 none s 0 sg ml aw - 0.7 1.2 7 84-112 10yr5/6 none rat.s&g 0 sg ml - - 0.7 1.2 ~~ # J Bonng 1/ Pit Ground Surface elev. 90.05 ft. Depth to limting factor '~ 09 in• Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP Dlft~ in. Munsell Qu. Sz. ConT Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-8 10yr3/3 none sl 2fcr mvfr as 2f 0.5 0.9 2 8-21 10yr4/4 none gr sl 2fsbk mvfr cs 1f 0.5 0.9 3 21-42 10yr5/6 none rats&g 0 sg ml aw - 0.7 1.2 ~ 4 42-52 10yr6/4 none cos&gr 0 sg ml aw - 0.7 1.2 5 52-109 10yr5/6 none trat.s&g 0 sg ml - - 0.7 1.2 'Effluent #1 = BOD ~ 30 <_ 220 mg/L and TS >30 < 150 mglL nt #2 = BOD < 30 mg/L and TSS < 30 mglL CST Name (Pl~se Print) Sig ure: CST Number James K. Thompson ~- 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane. Osceola. WI 54020 6222003 715-248-7767 property owner Mark A. & Suzanne Trcemner parcel ID # 2~,~'6~ 020-1134-60-000 Page 2 of 3 Boring # ~ Bonng Pit Ground Surtace elev. 88.37 ft. Depth to limiting factor > 100" 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 0-8 10yr3/2 none sl 2fcr mvfr as 2fmc 0.5 0.9 2 8-22 10yr4/4 none gr sl 2fsbk mvfr cs 3f,1 me 0.5 0.9 3 22-36 7.5yr4/6 none Icos&gr 0 sg ml aw 1fm 0.7 1.2 4 36-76 10yr5/6 none s 0 sg ml aw - 0.7 1.2 5 76-100 10yr5/6 none strats&g 0 sg ml - - 0.7 1.2 Bonng # J Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Struciure Consistence Boundary Roots P lffz in. Munsell Qu. Sz. Cont. Cobr Gr. Sz. Sh. 'Eff#1 'Eff#2 ^ Boring # J BOf1ng J PR Ground Surface elev. ft. Depth to Limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots / in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Ef~2 'Effluent #1 = BOD ~ 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. .~9 o ~ ~ (~3 0 0 o~ ~„ u °' ~ES~f:~naf~d ¢leu~ a~ 5.9' oc~tle~ . y~Gn. '~Corade o~ S. T, \oatlc~ = 9G.~7.' d c le<!` ~ /~ ~ ~~ --- 0 a~`' o ~\ ~~AJe P~ F1r~:rE; ~~ 3 6 edfmx+ \ r~es~ec-s~t. I ~~ E~~sfi /,off ~o.P. Cork Sepf-'Gt~K ~`Xisfi.~~ d~ywells ^ So;J e /ct /u Q ~; o~ ,O; ~ • Ele%t~'on ~/c. /„ ~. T~ae.n n.~ ~Oro~o, /ot ~7, cJ:!/ow .F, d~~ z-~~4dd. ~o -- ~A1~.B.M. ~ To~oof ~!e-~ - 97os' ~~~ /- l?a,-t~ /; ems, R~,s~ 1~. 3o-F3 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page ~ of FILE INFORMy4T10N. Owner ~~ Ste, ~~u Permit ~ DESIGN PARAMETERS Number of Bedrooms ^ NA Number of Public Facility Units ~NA Estimated flow (average) al/da Design flow (peak), (Estimated x 1.5) al/da Soil Application Rate . ~ al/da /ft~ Standard Influent/Effluent Quality Monthly average • Fats, Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand (RODS) 5220 mg/L ^ NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODs) 530 mg/L Total Suspended Solids (TSS) 530 mg/L ^ NA Fecal Coliform (geometric mean) 510'` cfu/100m1 Maximum Effluent Particle Size Y8 in dia. ^ NA Qther: ^ NA `Values typical for domestic wastewater and septic tank effluent. rueiw~NeNr_c cr_wFnr r~ F SYSTEM SPECIFICATIONS Septic Tank Capacity ~-~ (,~JEc 1 ^ NA Septic Tank Manufacturer (/ ~ O NA Effluent Filter Manufacturer ^ NA Effluent F'dter Model ~ -(v'^ ^ NA Pump Tank Capacity al ~lA Pump Tank Manufacturer ANA Pump Manufacturer A Pump Model ~ ~NA Pretreatment Unit ^ Sand/Gravel Filter ^ Mechanical Aeration ^ Disinfection ^ Peat Rlter ^ Wetland ^ Other: ~NA Dispersal Cell(s) '~`In-Ground (gravity) ^ At-Grade ^ Drip-Line ^ NA ^ In-Ground (pressurized) ^ Mound ^ Other: Other: ^ NA Other: ^ NA Other: ^ NA Service Event Service Frequency inspect condition of tankls! At least once every: 2 3 ^ ear( )(sl (Maximum 3 years) ^ NA Pump out contents of tanklsl When combined stud a and s um a uals one-third (YI of tank volume g q 3 ^ NA Inspect dispersal cell(s) At least once every: 2~ ~ ~ yea~(sl(s) (Maximum 3 years) ^ NA Clean effluent filter At least once every; Z ^ month(s) '~ year(s) ^ NA p pump, pump controls & alarm -Ins ect At least once every: ^ month(s) ^ year(s) ~ NA Flush laterals and pressure test At least once every: p ear(s) s) Y A Other. At least once every: ^ month(s) ^ year(s) ANA Other: [~, NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shalt be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tankls) to identify any missing or broken hardware. identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and dispoged of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent fitters, mechanical or pressurized components, pretreatment units, and any servicing at &ttervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be Rmvided to the local regulatory authority within 10 days of completion of any service event. Page ~ of 2 START UP AND OPERATION ' For new construction, prior to use of the POWTS check treatment tankls) for the presence of painting products or other chemicals that may impede the treatment process andlor damage the dispersal cell(s). If high concentrations are detected have the contents of the tankls) removed by a Septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • A(I piping to tanks and pits shaft be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or. must be taken, to provide a code compliant replacement system: ^ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at Thai time,-. ^ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. alua ' a o ing ank ~~ X12 AJ~ CONS'TIZClG~LO~ be ' e a~ ~f1p~18 TTi~ ^ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO N07 ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Name ~~~ 5~ Phone '~-~ i-f ZS~• 2 ( ~ POWTS MAINTAINER Name Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Phone Name ~ ~ ( 2Ulll !N Phone ~(S'- 3~CC~- (O (~ This document was drafted in compliance with chapter Comm 83.22(21(b1(1)(d)&(fl and 83.54111, 121 & (31, Wazconsin Administrative Code. 11; 19109 TFIU 14:90 FAi 7154258466 BETTElvDORF [~j001 11l1~3/~sa~l~ 11:.x` 1715J1~E.~„~7a E1r`S3,'41 TT1U 49'b6 Fd~ ,15~:b84tl6 F,:,~~r ~t~ aras BE~lE~l1RF ^~ROI7~ C1y~l~'tTY ~c rx re w ~, ~ - ~i?VVr~ Ch'R1YFlCAT14N FO . . ~i~/ ~~ ~~~~ .~ F~•taE t~Z IQ~QOY 5~0%~ ~~ c~~~:: ~ ~. ~~ ~-~~~~ ~rrar_* ,Plrepacty Locsdaa '~., ~ %:. 5ee_ ~ 1' Z ~!' N.P~~V', rowrn. of ~G~ 5~d~~siva ltd ~I13~ •~~ P1 J.ot ~ ~,..,,.. • ~"`~ r ~~- ~ . Gertd~e+d 51tt'~"e7 Msp # - `- _ Yolepmo + , ~F,~ Wse'rssty Deed +~' ~:q/D ~ . Vole ~, ` (~~ - ~+eFe ~ 1 , 3 Z ~ _ ---~- Spec hove O y~s~~ Lot Z+ad ia~+~le~'~s v no T1~v++~~+~~°O~ ~' ~~u~m cesutc 1R scS p~owgseereiaiT~e~ t,asva3c~a~s.Ys~ e of p aart ttie aegoe emle, ~y n '~' wx+~ it ~eds~d ~n 413eeerr+dpa~=- Wbas Yw pest imKs bee a7s~ am ~slbs raolre~on et the tic eoo$: rs e _ .~ ape is' ~t er~e-dnp+~ "[Lc piespexty dr+surt mss ao W~ll,~c ea ~~[ ZaR~± T~~r } ~' r'~ ~ bw ~ eed~ aed by a. ~+•~ t-~?~el~P~;• se~ia~.dOMd~ err ~ tlat~ezaet~it~~ lil t~1e ce~'e~o~sd ~~ b ~ eraocz aogd'ream aod/ot t'tl ~a4 sad omsoiu,~ (i[ae.lre 9ep~ °~ +~ ~°` t~ flW °i~ Y~rfC YAM ~ ~ e~ ~ =19e4~ ~'iA~3 •~YO TO ~ ~e'rllY~IV L4113g! 1310 a'YPiYa ~~ til! >GSp1~9 tsc feTd~ btan~i4 sa set by ~ Drpu~e+Kaf'~Ee +1nd the ,Dr7asvaesi•of Nsmst Ra~e~ 3'ee!a eef ~ise:oasip. %es0'Sisooa ~ ~aepeic Lem bas ~4ee'q mslaru[be ee:atpksCd sad w 7~eo $C C~e~k Zonim~ U~ ruid~a ~4 fwys of ebe mo,eo 7~cate cxi,iplCi~aa .3~c~a. '. /~ -/ ^J7_-.~, S1~G~TArt7i3E. +oP wi'PLI1Ca,1Y t ! IuATE ~Yfrr~rw n ~ : >r+~~ .~ c~~ ~ ~t~? or I fnej eery spas e!t ~ oa •e~ss:+ro'i~~*_ ~.a~e cv ~ best. v€ m3- try ~1ei'0a6e- ~ pmpee;q _~. by ~iitoc aQ: i ' ~ s+eoord~d ~,Re~itux erf Delpas ~ . ~iA1~JF,B, of ~rP :l~w'+~-'t L~'!~ v .~.~... qiy ua ~ is ~ ~ ~ ire 7' ~t ~C rerivY.dti7'' t~°;~.»mt Yip- ..`.`~ "' ~"sidoas wig ~s >ds~ s ! , ~ ' •~re{lsroo zw * u[ Leads e~E .','+ • ~ eo~1y irE` ^ ;'. ` saR-:"1;7 ~ if s'~s ~ is d~ 3r.a4 11.'1"i09 MoN 10:41 FAX ?154258466 BETTENDORF 11f 1 ~r ^_s5r2:; 1a;1~ 171F3~.b2•:7a ~~d~i UJt ! Tt N: ~joo2 S~ '•f' tree, ~1~41~,CZ`y~ ~'~E1rj~Q ~ ~cevr~xr arv . W 4~1tRANTY DEED cr..: .a,... ... .. ~. r•.. +~- . dam, ~... At~ir"'Ti 'S 0rrric r SI~DD~C'i'1LVW ~: ~~~ ~.= This~boed made b~awren DavtD M- K1tErtZ sn+~.~ANET i ~UL Z L }090 C. KRF.tiZ. hrasbarsd and wife, Grantoe~s, and ~I.A7tK JI , ...._ ,,~;. '!''°-`?~LYIvR wed SUIr4~V'~ A. TltOlcMNElt, husband and wilt l0: i5 aly~ . , a `~ s: s+cutiivor +p rt+u~tal property, Gra.~tees. ~ f/.xt. :_` •~ ' , .;; W7t~eth. Tto3t the sand Grrantors convty to Grantees the ~ ~~ Callbwint deaeribtxl rr~t ei+.~te ul St. Croix Cowsrp. S~att of ~ Wixonsin: ,p ~~ .. '~ Lot 4?. illow Ridge Znd ,~dditio++ in Town of Nudxm, Si. Curia Camiy. Wisconsin. • i'nIs is Iromeuead ptflpexty. -,, . Tngettrr vntR alt and cingulzr tilt ~editamenu aAU appuruenances ii+c~tnza 'vaun~in~, i~t Md Grantors ~astiot that the tide is good, indefeasible in fae si»lpfr and frt~e and clear of - encuv+nran.~s. ana viii warrant rnd aeiena s~yne_ t~a~od ~'ti; .1.1Lh. d<`,y vt Y~.y, S'1~`. ~ ~':'~~'-~ ,, Qsvid M. Knot $ + ~ ~ ~ tStr~aL) C. ~renY STATE DE' WISCONSIN ,, Y ~~ ,,~ sr. cxotx covl+rrY . pa~oaaliy cane bef;gre n-e this 15cL duly of 7uty, 1696, the abc,Vo eamad ACID tM. kREN2 ;~ !F` and 7ANET C iCREN'2. busbes~ a+~d u++f:, rn me known W peTSOns who ed the fote$Otng ~:~ ~ irsttr+ttlenr awd acknowiectgtd the same. ,~ G it. ,~,1,, 6l :~, Dtaodt, ~lolin _ ~~~sn ~~~, kofsy3 P1i1711C ]~tosarp Publie, State of WifCOn~it1 $t~e of V~isooosin My Goe:trniss9an expires: ,~Z,arge ~.~ ::`~~ THLS LY.STI:UMIIYT D;w'FT)rD >I;Y: ~'~ To- ai: ltobctt W. Mudd, ALWrrley ;y•. ' MUDGE, F'ORTEIt, LUNUI=tN aC SEQUIN, S.C. ~ Ill) Sxora! 5t:eec. P.O. Box t3{1Z i~tbC[ ..~, ~~.; Iiudsan, Wiseo~+san Seib ~ .T' t ~'~~Y%iY.4s'TY1 ~''~l~y~~~e'~'. ~'M•.a•Y~J~•+•1Y'',~ Y~~ •~~~~'~~:~_~:.~'z'IJS'Yi~+ ~Y=i'r~.~-~~*•~'~ ~.. ...._ ._ .._ ~._~-__.__ .... i~w~: -..- tw:.. 11!1?!g3 MOB' 1D:41 FAS 1154258466 BETTENDORF ~ qq3 11f13f'_l3U~ iJ:15 1715?1Gb__7a iaA~~tl~ti IPb:: F';~~ ~^, ~~ a v*`~ ~. ~ L `~' ~ ~ ,IP r~ ~ e,, ~ - 4 r r~o U~vPL .~ AN+ ~, ,~ ~ ~~ ti r .................._......___..------ __..._......_ ~ _ ~~ r '~ . 1 1 ~ d~ OUTLOT ~ ` sir/%~ /~i~l o~! ,..SCCfiai! /e' "'~ .~ ~9 °S9 ~7 1~Y 9G~.G+d R 1~ ~' ~~ Sy ° ~ 7 ~' ~ 1 oZ ~ :a,~' ~j$ r °~ ~ 4 ~ ~ ~'d ~S '~ ~ 4S t $ o° ,8 ~ . ~ o m ~9 ~ Off. Q O ~ ~.V' :ARi~I' ~gtsrysNr C ~ / ` -~ ' r il? Oivli~v7~l16~ /9~ c. '~, . .~ .19'9.50 %'~' ti ~ ~ ~ '~ J ~ l 4„ $, ~'~_~,. ~ -fr ~.. to ,~ W°~ ~e~ `• ~'" ~~-~ `'k ~~~~ •, ~sx Y ~ ~'.. ~ ±~?`x.33 ~$ few 4 $ 4~°~f~A° ~~ to ~ ~° ` ~ _ . ~ ~° r.. _