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020-1417-20-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety 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)j. ermit Holder's Name: -, City Village X Township Si or J b ~I~~U ~/~S-[~P/ p~ Hudson Townshi ST 8M Eiev: Insp. BM Elev: BM Description: /L~'L- /07r ~ t''~ \ ~ 5 TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~z ~r Dosing .-, ~ /~ G ~,.~ Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~. ~/ , }~ /~/ ~ Z / ~ Z ~ '~ Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Numb TDH ift Friction Loss System Head TDH Ft Force in Length Di st. to Well SOIL ABSORPTION SYSTEM ELEVATION DATA County: ${. CroiX Sanitary Permit No: 453447 0 State Plan ID No: Parcel Tax No: 020-1417-20-000 SectionlTown/RangelMap No: 20.29.19.2640 STATION BS HI FS ELEV. Benchmark ~ ~?j5 lc~."3S ~~ Alt. BM Bldg. Sewer r~.zs 1,7 ~Cr ~ 7 SUHt Inlet C~ St/Ht Outlet 13 ~Z . 4~ Dt Inlet Dt Bottom ~~ Header/Man. /6 '~ ~ ~ , Dist. Pipe /~ r ~~~ , O ~) Bot. System Final Grade St Cover .45 I ~ 11. L `7S . iS i 11. s ~ ~i5~ •~ ~~ 1 z , ~ 13.5/S BED/TRENCH Width ~ " Length , ~ ~^ No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liqui epth DIMENSIONS Z ~ .~ ~ ` ~~ ` SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER OR Manufacturer ,~.~r~ , ~ ~n1 T f . ype O System: ~ 1 ~~ / / J /- ~ ~ V A ) „/~ _ --" ' UNIT Model Number. arts ~~-~~~1 ~ j ~~/r ~ ~U DISTRIBUTION SYSTEM Si Header/Manifold ~ ~ ~ Distribution Pi x Hole Size x Hole Spacing Vent to Air ake h 26 Di L ~ pe(s) \ \ \ ~ .~ Z engt a Length Dia Spacing SOIL COVER x Pressure Svstems Onlv xx Mound Or At-Grade Svstems Only Depth Over i Depth Over xx Depth of xx Seeded/So d xx Mulched Bed/Trench Center BedlTrench Edges Topsoil ~ Yes ~ No ~ Yes [l, No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / ~ /_ Location: 422 Wren Ln Unknown (SE 1/4 NW 114 20 T29N R19W) The Glen Lot 46 ~ ~ ~ Parcet No: 20.29.19.2640 1.) Alt BM Description = ~~~~ ~" ~ '`'~'~ ~- `~~ ~~~ a ~ Ci ~'~ 2.) Bldg sewer length = ZG .~- '?- ^ ~ i1 - amount of cover = ~ ~Z Plan revision Required? ~Jl Yes ~j\No ~ i~~ ~ ` ~/I_ Use other side for additional information. \~ ( ~ SBD-6710 (R.3/97) Date -- -, Cert. No. Safety and Buildings Division County I ` ,r, ° ~„ 201 W. Washington Ave., Y.O. Box 7162 3~CY'O ~ K' lscons~n Madison, WI " Satitary Permit Number (to be filled in by Co.) Department of Commerce ~ ~ (~8) 31~E `'~---_ - 3 ~ ~ ~- °`' • Sanitary Permit ~ ' ri Stag Plan LD. Number , it In accord with Comm 83.21, Wis. Adm. Code, perso n you~prcafide~ t? •; ~~ ' ___ _ may be used for seeotxlary purposes Privacy Law, (1)(m} t ' ~~'~ _ Ftroject Address (if different than mailing address) I ' __ __ ST. I. Application Information -Please Print All Information _,___ ZON NG ~FFIJ J ~ cE r , ~ `~ 2 2 W 2~ L.}~I~f~ Property Owner's Na me ~~ ~ h ` Parcel N Lot /{ Block N ^~ Property Owner's M ailing Address ~20 Pro pe rty Location ~ ~ Section `~ '4 `~ City, State Zip Code Phone Number - ~ , ~ [ sN0- ~ s-s'~/j~ ~F'' p F„ ~ Js2' Q~J a (circle o ) l Td?Q N R /~ Eo>~ I II. Type of Building (check all that apply) : or 2 Family Dwelling -Number of Bedrooms ~ ~_~ ivision Name CSbI Number Subd ~~ Public/Commercial -Describe Use y Y ~~' ~.tJ ._ __ _ 1 i~ State Owned -Describe Use ~ T i ^City_i~VillageTownship of OcGts'~j/~ ~ ~------ ~ __ _~.._. _ III. Type of Permit: {Check only one box on line A. Complete line B if applicable) _ p2p - 1 1~ -Zfl~C~ • 2~ A' New System ^ Replacement System ^ Treatment/Holding Tank Replacement. Oniy -_~ ^ 0[her Modification to Existing System ~~~ L' t Previous Permit Number and Date issued i B. ^ Permii Renew Permit Revision U Change of i ermit Transfer to Naw Before Expiratio _~ Plumber weer ~~ _ ~5~~4 ~-1 ~~ ~ d9~?a~ IV. Type of POW'TS System: (Check alE that apply) __ ~ ~ ~ ~ j Non -Pressurized In-Ground~1 Mound > 24 in. of suitable sail ^ btound < 24 in. of suitable soil ~ ' At-Grade ^ Single Pass Sand Fitter ! i '^ Constructed Weiland r. Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter I I ^ Recirculating Synthetic Media Filter Leaching Chamber ~ Urip Line ^ Gravel-less Pipe ^ Od[er (explain) V. l3is rsallTreatment Area Information: _ _ Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (s ft Dispersal Area Propo yytem Elevation - - stir ~ VI. Tan Info Capacity in Total Number Manufacturer refa '; Si[e Stect Fiber. Pta Concrete Constructed Glass Gallons Gallons of Units 1 New Existing I Tanks Tanks Septic or Holding Tank A', (%r/ / _______ /tom, s ~ ~ Aerobic Treatment Unit T Dosing Chamber pQD i 1t ~ ~, A -- VIL RespOttslbiHty Statement- I, the tinderslgued, assame responsibility for ' tallatiun of the POWTS shown on the attached plans. ~ Business Phone Number Plumber's Na me (Print) Plumber's Si gnature PRS Number Plumber's Addre ss (Street, City, State, Zip Code) ~d 7~ ® ~S4y ~ ~ ~'~''~-`~,'' VIII. Count / e artment Use Only _ ~( Sanitary Permit Fe (includes Groundwater Date Issued I sui Agent Signatu a (No S- camps) - fa. Approved ^ Disapproved Surcharge Fee) i~Pl ____ ~ p O z ~ ~ i J~'~ ~V ^ Owner Given Reason for Denial _ _ IX. Conditions of Approval/Reasans for Disapproval -3~ ~~,~ ,Q ~~ ~~~ ~~~ SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced I majntained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances. complete plans (to the County CX•^94JUt}111.~ °'-~ CX~ t7u'"' _n _' 1 ~A- c~y ~~ I~~~ ~ eL 1~+-~ ~ ~ ttte lsystem n payer dot less't~81/2 x 11 incomes to sizeG~~ ^ / r , ~^/Jn S~ j -ti ~ a.~Qa .~ Parcel #: 020-1417-20-000 12/03/2004 03:49 PM PAGE 1 OF 1 Alt. Parcel #: 20.29.19.2640 020 -TOWN OF HUDSON Current ^X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * =Current Owner * JOHNSON CONSTRUCTION INC, GLEN GLEN JOHNSON CONSTRUCTION INC PO BOX 809 HUDSON WI 54016 Districts: SC =School SP =Special Property Address(es): " =Primary Type Dist # Description * 422 WREN LN SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 1.282 Plat: 1983-GLEN, THE 02 SEC 20 T29N R19W NW NE SE NW LOT 46 BLK Block/Condo Bidg: 6 LOT 46 6 THE GLEN Tract(s): (Sec-Twn-Rng 401/4 1601/4) 20-29N-19W NW NE Notes: Parcel History: Date Doc # Vol/Page Type 10/06/2004 776304 2670/360 W D 12/21 /2001 666080 17971613 W D 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 3701 77,200 Valuations: Last Changed: 06/06/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.282 59,700 0 59,700 NO Totals for 2004: General Property 1.282 59,700 0 59,700 Woodland 0.000 0 0 Totals for 2003: General Property 1.282 59,700 0 59,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 U, 2670P 360 Document No. II STATE BAR OF WISCONSIN FORM 2 - 1982 WARRANTY DEED SIENNA CORPORATION, a Minnesota corporation, conveys and warrai GLEN JOHNSON CONSTRUCTION, INC, a Minnesota corporation, the following described real estate in St. Croix County, State of Wisconsin. 77Es3~4 KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO. , MI RECEIVED FOR RECORD 10/06/2004 01:20PM WARRANTY DEED EXEIPT # REC FEE : 11.00 TRAIiS FEE: 285.90 COPY FEB CG FEE: PAGES: 1 Return to: Sienna Cc .Suite 608 Tax Parcel No: 020-1417-20-000 Lot 46, Block 6, Plat of The Glen in the Town of Hudson, St. Croix County, Wisconsin This is not homestead property. Exceptions to Warranties: Easements, reservations, and restrictions of record. Dated this ,~aay of ~~Z~l2KY,~/ , 2004. AUTHENTICATION Signature(s) (SEAL) SIENNA CORPORATION, a Minnesota corporation (SEAL) Marsha A. Pierce Assistant Secretary authenticated this day of 20! TITLE: MEMBER STATE BAR OF WISCONSIN (lf not, authorized by § 706.06 Wis. Stats.) This instrument was drafted by: Sienna Corporation ACKNOWLEDGMENT STATE OF MINNESOTA } }ss. Hennepin County ~ } erso Ny ca a before me this -~~ - day of 2004, the above named Marsha A. Pier e, the Assistant Secretary of Sienna Corporation, a Minnesota corporation, on behalf of the corporation, to me known to be the person who executed the foregoing instrurrla~t and ackyto~prledge~he same. Rath D. Nelson, Notafry public 4940 Viking Drive, Suite 608 Notary Public of Hennepin County, Minnesota. Edina, MN 55435 My Commission expires January 31, 2005 .vim ~~~r RUTH D. NELSON Signatures may be authenticated or acknowledged. Both are not - NOTARY PUEIUC - MINNtrsol'A necessary. a~* HENNEPIN COUNTY f Y'a+~~i ~ My Commission Expires Jan. St. 2005 " Names of persons signing in any capacity should be typed or printed below their signatures. ~~ yoAys,~llDe. a CppY ~~~ ~ .(J ~ ~D O li S/ /! ADO . d ~! ~ i ~~ ~V ~, b ~~ ~~ ~~ n -~,~ h~ ~ n~ i~ % ~ ~D ~ ~~ ~~ W~ ``f-~ .5'= -r ~~ ~~~ `` ~`Ap 4 ~t P \~ J I^ V ~! ~~~ ~~ bYisoauin Department of Commerce Division of Safety and Buildings /~L~JA"TIOI~ REPORT ~~ Page ~ of u~ awuwp~pc:C wnn wmrn,oa, vv~s. ream 7 ~.~?~ i ,~ , ((~~((~~~ Attach complete site plan on paper not less than 8 /2 x 11 inches iri siie /Plate must County y indude, but not limited to: vertical and horizontal re ren~~@@ ~o d'redion and ~~ percent sbpe, scale or dimensions, north arrow, a d IocaG 421 h~arest ad. ~~ ~~ ' " V' CE rint all inf rma o /o Re by Date Personal ' rovide ma be use seconds Y ry Purposes (Privacy l.aw, s. 15.04 (1) (m)). ` Z U . roperly Owner ~f S o ~ ti Property Location ~/•e ~ ~d /p p (~~ ~S ~ Govt. Lot r 1/4~(/LtJ1/4 S ZQ T ~~ N R ~' E (or)~l Pro Lot # Btock # Subd. Name a- CSM# ~~ a U~~~~~r ~ ~ ~~ ~ ~ ~~ ~- G-C~n City State Zip Code Phone Number ^ City ^ V Ilage ~ Town .Nearest Road oR ; n a Yh SS c9~ ~ .3.5-z 8` $ d r{ ,-~ ~ ~ New Construction Use: ~ Residential / Number of bedrooms ~_ `~~ Code derived design flow rate y SU /lo c~ Q GPD ^ Replacement ^ Public or commercial - Desrxibe: _ - ~-___. Parent material tl +~-~) ~ S ~ Flood Plain elevation if appligble .~~/ /-~ ft. General comments Sy s~f ~ ~ e ~ e ~ . Q~, o and recommendations: ll ~ ' J Bonng # ~ ~~ ~ in, pit Ground surface elev. Q9.D U ft. Depth to limiting factor _ Sal Rate Horizon Depth Dominant Co Redox Desrxipflon Texture Structure Consistence Boundary Roots GP D/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Effi't2 L ~~-~ u - S;c,l k rv~ 'r t5 - .~ `1 ~~ , r ~ I ~ t vv~ ~ . ~ i. o~ ~ . O a ~~# °ring ©Pit Ground surface elev. lGY • ~ ft. Depth to limiting factor 1 Z ~ in. Soil lion Rate Florizon Depth Dominant Redox Description Texture Structure Consistence Boundary Roots GP D/ft? in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Z Zli - y / - ,~< < z ~ 5 ~k ,nom ,~- < 1 ~1 ,~ Y . !~ <lS~a 0 • Effluent #1 = BOD_ > 30 < ~0 rrro/L and TSS >30 < 1 50 mall • Effluent #2 = BOD_ < 30 mall and TSS < 30 mall CST Name (Please Print) i lure CST Number Address ~ Date Evaluation Teleptrone Number ~11~ r`~~~5~. .~~~.~~~ >`t,/f~ Syoz ~ ~~"z.~ -ate/ 7/S 7Go-az 3~ ~~ Properly Owner ~y ~ Y\ S ~ /~ Parcel ID # <O T 7 6 Page z of ~~ # ^ Bonng ® pit Ground surface elev..~q, p ~ ft. Depth to limiting factor t Z' in• ~I ~~ ate Horizon Depth [~minant Color Redox Descxiption Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 ~ o-~ tvyr /Z. S~ Z-n5~~k ~~ ~ 5 1~~ .~ /.o Z (p ` V ib- / yly '~ S L Zw~4jvlL ~( CS ~- , ~ . ~ _i2 +vy r K/ v ~ r~ I ~ '- ~ ~ 1~ 2 a ~~~ # ^ Boring ^ Pit Ground surface elev. ft. Depth to. limiting factor in. Soil' ication Rate Horizon Depth Dominant Col Redox Oesaiption Texture Structure Consistence Boundary Roots GPDifP in. Munsell Qu. Sz. Cont. Caor Gr. Sz Sh. 'Eff#1 •Eff#2 Boring # ~ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor ~. Sal ication Rate Horizon Depth Dominant Cd Redox Description. Texture Stricture Consistence Bourxlary Roots GP D/ft' in. Munsell Qu. Sz. Coat Color Gr. Sz Sh. •Eff#1 •Eft#2 Eflluerrt #1 = BOD, > 30 < 220 mglL and TSS >30 < 150 mglL 'Effluent #2 =BODE < 30 mglL and TSS _< 30 mglL 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. sao-esw~e.~nool PAGE~OF~ NAME ~vh~5o,n LOT# ~(.~ LEGAL DESCRIPTIONSr '/aN~/a,S T~oT 2~' N,K IK~ (ors v~y / SCALE: I"=_ ~d ~ ~~LEVATION~d BM 1 DESCRIPTION_~_p o-~~c~~i~~ ~oy~ S~" ~ l BM 2 ELEVATION BM 2 DESCRIPTION SYSTEM ELEVATION 9S ~ ~ ~ ALTERNATE ELEVATION ~~ CONTOUR ELEVATION /v ~~ ,V 13 l .\~ L~ a~ ~ ~ ~ 'z3 ~ U i~~ '~ DATE /O Z v Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division • INSPECTION REPORT GENERAL INFORMATION (ATTACH TO,PERMI,T) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: Sienna Cor City Village X Township Hudson Townshi CST BM Elev: Insp. BM Elev: BM Description: TANK IN FORMATION TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing 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 ELEVATION DATA county: St. Croix Sanitary Permit No: 453447 0 State Plan ID No: Parcel Tax No: 020-1417-20-000 Section/Town/Range/Map No: 20.29.19.2640 STATION BS HI FS ELEV. Benchmark Alt. BM Bldg. Sewer SUHt Inlet SUHt Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot. System Final Grade St Cover BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHA E OR Type Of System: uN T Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Svstems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center BedlTrench Edges Topsoil L~ Yes ~ No ~ i ]Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 422 Wren Ln Unknown (SE 1/4 NW 1/4 20 T29N R19W) The Glen Lot 46 Parcel No: 20.29.19.2640 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? 'Yes ~ ~ No -~' ' I ~ Use other side for additional information. i ------------------------- Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) ~ ( Safety and Buildings Division ~~~~~~;~ 201 W. Washington Ave., P.O. Box 7162 Madison, WI 53707 - 71 b2 De artment of Commerce {608) 266-3151 Sanitary Permit Application In accord with Comm 83.21, Wis. Adm. Code, persona[ information you provide may be used for secondary purposes Privacy Law, s15.04(1)(m) I. Application Information -Please Print All Information r~M. ~~~ . Property Owner's Na me _ i~ r+l/E.~- t~r ~ ~~ Property Owner's M ailing Ad ress County Sanitary Permit Number (to be fined in by Co.} 3 ~- State Plan LD. Number ^ Project Address (if Brent than mailing address} ~ ~f -Z IL,~Q-E~l MI6 Parcel # Lotj# locklock ~ff' 1 f i City. State ~ ~ Zip Code ~ Phone Number ~ i ''~,~~'k,Section ? G~ `~" ~~ /'~ .mil/ ~~ ,~ 1~rZ'~.~J~-..7~G1~0 (circle o II. Type of Buildfn tack all that apply) ~ N; R /~ E ~ ~l or 2 Family Dwelling - ber of Bedrooms _~ ~ t Subdivision Name CSM Number ~.~_~ >~ PubliclCommercial -Describe ~ ~// ~ /~~ J State Owned -Describe Use ~ ^City~LVillage~awnship of~,~a~ III. Type of Permit: (Check only one bo line A. Complete line B if applicabl ~I New System ^ Replacement System ^ TreannendNolding Tank Replac ent Only ~ Q Other Modification to Existing System B• ^ Permit Renewal ~~ Permit Revision ^ nge of ~l Permi ransfer to New Lest Previous Permit Number and Dale lssueri Before Expiration Plum I Owner ~ 1 1V. Type of POWTS System: {Check all that apply) Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil ^ Constructed Wetland ~ Pressurized [n-Ground ^ Holding Tank ^ Recircula[ing Synthetic Media Filter eaching Chamber L D, V. Dis real/Treatment Area Information: S' Deli n Flow (gpd) D ' < 24 Tn. of suitable soil ^ AI-Grade ^ Single Pass Sand Filter Filter h~ Aerobic Treatment Cnit ^ Recircula[ing Satrd Filter Gravel-less Pipe ^ Other (explain) ti ~ ~ < -~. !m t7 w._ w g estgn Soil Apphcanon Rate(gpdsf) Dispersa rea Required (sf~ ~~© ~, ~-~ VI. Tank Info Capacity in Total Number Manufacturer Gallons Gallons of Ututs New Existing Glass i aepuc w rialOmg "lank - _~.~ , Rt:rob,c Treatment Unit - I Dosing Chamber ._ j VII. Responsibility Statement- I, the tindersi ,assume re otlsibiGty t tallation of the W S w Plumber's Na me (Print) Plumber' i n o n t c plans. gna re PRS Nunt Phone Number ~' Plumber's Addre ss (Street, City, State, Zip e) VIII. Count /De artment Use O ~Appraved ^ Disapproved C Owner Give Boson for De i l Sanitary Permit Fee (includes Groun tar ate Issued Surcharge Fee~~~~ ~y in Agent Signa re Stamps) _ IX n a ~ v' . Conditiotts of Approv• Bosons for Disapproval - ~ ~ -- -- SYSTEM OWNER: 1 Septic tank, effluent filter and j dispersal cell must all be serviced /maintained I as per management plan provided by plumber. M 2. All setback requirements must be maintained as per applicable code/ordinances. plans (to the Comty only) for the system on paper not less than 81/2 z 11 inches in size yval SBD-6398 {R. 01/03) `_ '~ - ya .~ b ~ ~y ~ FEZ , %s-_ ~ ,y~h~ 4, ~s ~- y ~ ~ ~. ~~ d ~ G'~~ ~~''~~~ ~~ ~~ i I f ~~ ~~~ .~ ~~ '~ ~' ~~~ ~ ~ 0 .r' f; , -~ \C U, ~, y ~.1, ~~~~ ~ '~ 'C hl G~QY i/' ~ ~- ~~~~ ~ ~~-~v~nti ~,~ ~~ ~1 I D O: ~.~~G~ ~1f1i1/~ G c Yom' ,(v ~ ~~ T~~~e~~ c akld ~~'~s~~" ~ ,. ~~ ~~ ~~. ~~ ~ \ . ~, ~A~' /~Y ~ . 4~ ~~ ~ ~ ~ ~' ` ~~ ~ V ~ ~ 1 ~ . ~~; ~~ 1~ ~ ' ~' \ -~ ' ,, '`~ ^~~ u ~s~~ S~v~ ~ / ~= 5'D ~~ ~~ ~ . ~~ - Z ~ ~?" ~~.~ q r C~~ i~ 1~ ~~ r~ ' ?~ ~ . .Wisconsin Department of C"ommerce SOIL EVALUATION REPORT Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper nottess than 8%: x 11 inches in s¢e. Plan must include, but not limited fo: vertical and horizontal reference point (BM), direction arxf percent slope, scale or dimemsions, north arrwv, and location and dbtar>ce to nearest road. Parcel I.D. Please print all i 6on. ~ R Personal infomration you provKfe may be used for rrdary'prirPoses (Privacy L.aw, s 15.04 (1) ~m)). Property Owner ~ Rr Location 1149 page 1 ~ 3 Steel Sal Service St. Croce Date ~7 y/ Sienna Corporation "`- ~' ~° ` `" ~ovt. Lo SE 1/4 NW 1/4 S 20 T 29 N R 19 W Property Qwner's Mailing Address ~ Lift # Bkfck # Sutxi: Name or CSM# 4940 Viking Dr, Suite 608 ~ _ 466 ~ nor The Glen City ,t ca/iilG State Zip C ~ m ~ ~ ~ City Village ~ Town Nearest Road ' MN 55435 ~s z ~.~s'- ZFa y Hudson Carmichael Rd. New Construction Use: Residential 1 Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement ,;, Public or commercial -Describe: Parent material Pitted outwash Flood plain elevation, if applicable nor General comments and recommendations: System elevation 96.55ft, trenches spaced and depth to code 3.50ft bebw grade 2 . S ~ a-c~cz t~ .mot ~ ~ ° ~- ~s ! - ~ Z . a Boring # Boring ' ~ ~ Pit Ground surface elev. 100.05 ft. Depth to limiting factor in- Soil,gpplication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz 'Elf#1 *Eff#2 1 0-10 10yt3/4 none sl 2msbk mfr cs 2c .5 .9 2 10-25 7.5yr4/4 none ~ osg mvfr gw 1f ~ 12 3 256 7.5yr4/6 none ms osg ml nor nor ~ 1.2 30" /_ n ~X lS/~ `~"l / 9 ~i lY "l l0 /~~ /_ ~Q,r„tiG~ ~ GLr~~ ~Q, ~YS~iTiVh 21.L/1~~6nS Boring # Boring Y Pit Ground Surface elev. 100.05 ft. pepttf to limiting factor ~ in. Sod Applicatan Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfft2 *Eff#1 *Eff#2 1 0-12 10yr3/4 none sil 2msbk mfr gw 2c .5 .9 2 12-22 10yr4/4 none sl 1csbk mvfr cs 1f .4 .6 3 22-46 7.5yr4/4 none cos osg mvfr cs nor .7 1.6 4 46-96 7.5yr4/6 none ml ~ osg ml nor nor .7 1.2 po . l yf, s ~~ 30 7 ~- . y ~~ tmuenr ~ r = rsvu ~ au < ~u mg~u aria l S5 >3U < ~ ~ mgit_ `Effluent #2 = BODS < 3o mg/L and TSS <30 mg/L SST Name (Please Print) Signature: CST Numtfer David J. Stec{ ~ ~ 248956 Address Steel Sa! Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 5401 9/20/2002 715-246-5085 Property Ovmer Sienna Corporation 1 3 1 R~rina # BOnng 1 Parcel ID # pending Page 2 of 3 `Effluent #1 = BOD $> 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS< 30 mg/L and TSS <30 mglL The Department of Commerce is an equal opportunity service provider and employer if you need assistance to access services or Borina # _; Boring - .. _ Borina # _ Boring - Page 3 of 3 STEEL'S SOIL SERVICE David J. Steel CST-POWTSM Lic. # 248956 Sienna Corporation SE1/4,NW1/4,S 20,T29,R19W Town of Hudson, St. Croix Co. The Glen tot # 46 1564 Cty Rd GG New Richmond, WI 5401? (715)246-6200 (?15) 246-5085 This soil evaluatiea was eond.ucted to satisfy azoning requirement,.it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the soil-test was condueted_ Legend 1" = 40' • =Benchmark El, 100.00Ft . , ~- I _ L l_ ~.~ _ '~'-- -.f %2" pvc pipe 1t Benchmark E1.99.1 SFt ~f'/2" pvc pipe orings Boring Elevations B1 =100.O5Ft B2 =100.O5Ft B3 =97.SSFt B4 =00.OOFt ~_~p~ 6 Z ~ ~ ~asr ~t ~rt t ,- 1 ~~ , 1 • 1 ` - -. ;ems . i, - '~ --~ 1 - ~' ~`. i _ - __ _-.- , ___-- -- r _ 1~-; - ~-- ~ r .. -xs'r '- 11 ; f r I i~ _ l _ ~ 417•-~ ; ~ ` ~ ' 'A.,- r ;_ + / -r p : r t ,• \,, ~ , ,_ ., ,~- ` } ~'' ~ ~ .~ t '84.1 _ `' ~, ~$~ .L - ri .45 as Y'/~ ~~ ~ ~. t:,, 'VJ .... -~~ ~ 1 .~$~ ~1r ~J •\ `1' i -- a ~ N ; 1 r 1. r Q^ r rl. r I \ t \ \ '_ oV rr •~ : ` _ >^ 1 - 71 :`~ lib ,o-`'~ , ~ ' ' "I ` ~ - - r - ,, _ , , _ ti% -..1 ` _.. ~ ~ I NJ 1 fi, 3J - ~ 1 at \ ~7 r r 1 i'~ r .. r' ' r _^ `~ • I I ` ~'` ~- \• s r 1, ,!l _ ~t y' ; _ , ~ as '.. ' .," , ~ 3 r~ ` r ,` \ ~ I VV . _ t ___ r 4 ~ .' ' 1 it ., A t ii 1~1, as -..ya ~... iaa 4 , 1 _'~. f ~ ,_` a.. i f,rr.. 3 _ __..296 ' . T~ . .. 1 ~ 1 `p ~ i - -xr- ' ~ ~j-i ~ `~ r 1. a ~ i r " ` I 1 `a a ~~ 1 • 1 4~3~ .. ti , `- .r; '1 tea'. ,}.; r .rti - - - \ _.208. ~._ ...~_- ~ _ .~ :.r 1 ;;~ -: > ~-:.y .' - -_. .. - -___.. ._ - '' ... _ X11 .:\ ~~ti ~ ~a a i __ ~` ~~ ~ I \ ' .a ~ 'a t t , t ~oJ 7 .C. r _- -- _ •dd ~~ fir, - ~...... '~ _ ~ .~ 0` ,... .'' ., :, ,, . ---- ,.: ,~ .a~ :. = ~ , r , , ,.. Z1;J : r ~_~ ,., .` r / ,-, ~... _.. .. r , i .,.rr , ,,. , ' , ~ ' ~ ~4 . _ 1• a ' r \: ~ ~,'. i ..' - a r i .. - f ~ .. 1 4~~ i ail r *A1 'n , . 1 ,a `' ' sI 1 ~w76 1 ~ ~~ ' ~~ I f a ' r a , r :r ,, .• ,..~,, , • 1 'rr 1 ~ * ,F-~ ~ n 1 E ¢ r } to ~ V r r r ~ `s r 1 a - A, ~ n I \, 1 1 r. r a ~yj ` - ~~ .rr rrr ~ ' i~ ~'~i I ~ AP 4 /~ ~~~ ~ I 1, ., \ \ a ,a• n • ` a .r V .r ~ 1 \\ ` as \ \ \a at ;;~ ~;' , ...f ~ Vii; ;, .., ~ 114`•; ~,a ~r , ; - -' . ........ i " ilk ~ ~~h``~^`d ~ ~~ rr ,`~~~;It ~~~ ,;, ,~ i!. t ,-._-- Q{t/icl~(r4~ STANDARD CHAMBER ~uick4 Standard Chamber SIDE VIEW FRONT VIEW MultiPort End Cap ' .: Qlick4 r~~. ~~ ^ ~ I ~ ' r f- • } SIUE VIEW Size(WxLxH}' _ ` 34'x52"x12" Effective Length 4$° invert Height grr TOP VIEW Size~WxLxN} .• ~:, _- 34"x16"x12" Invert Height 8" or 1.25" INFILTRATOR SYSTEMS INC STANDARD LIhA17ED WAj~;RAN~Y (u) Tree Slructurar uregnly C{ each rAt&nf>FU. end plate, wed,'Te ar~d oll•Br eccesswy rranulactunrJ by Inlilaalo, ! ".'oils"I. wlwn ir:;tallad and ppera{ad m a Iw n!ield Ot a`r (IR<ila aeptiC aysifSn in aCCUr[GN4`p'w Ih I Itlrator S t V.,i Jr ~', '".S d r:J1tOJ to It,e origural pv're;rkrsar ("Hpltlr. 'rgalydi tle}ectwe m lerals and witkminehip for orq year kam the da+a that I a .,solo: oErT t S as!rad {C LlC SE]Jlic Syaterl? CCnuninirx,( rha Ullrls, i.rJNderi, hpwrevar, trier if a 3epli( pemul is not reJUirpd by applicatYe law. thA warranty i+ariud wl8 begin upon Ilw dale Thal alstaaa(Ipn of !tra;antic system oammelacet. e ur sa its warranty rights Helder naval notify k]GNrato. m wntiny el Is Gcxpnrale Haade{Darters in Uld Sayhdp d,:, Qxlnsci~cul ,rnihm rrryeen (15} d]y^ i ha alivyed del(x%. M{Alrata will supply rpplacemo 1 Unds lor'Jn rs determiner by InGlValor to ba coverrxl by this (united Warranty. it Irl,rJtura kaditlfy sFRCIttC'ally axCi'JtleR !hB CO.;! Cf Yem(Wiil ant]for R161aI1i11i0n of Lha IJniF.. p ! - Hf rgiTFU WARI]gfJ'. AND RFa1FD1Ea~ IN Sl'EP.aRAGRAPIi (,'t) AiiF cXGLU hl.. niERlf ARE N`v 0 i HER WAFFNhTIES WI i H RESPECT "O lH( UNrCF'. WCLL'CriNG 'V(7 !M ,IE7'NARRANTIrS OF MCRCHANTAGI' I`. 1' ,R r ITtvfSS 1=UN A PARTIGU{.Aq F41H?OSE. (J Ir I Lintiled W'inlnly 9ha: lie vOiU It any par( o' Iltp Cha M1>E y„ie,n rarutarll UU '. A ypr',a other ~1 run Otlilr a.SU Thp I imllpd WeltdMy dries : Ot oz![ M to incrdan..~l, mncf ]uanliaf, sppCa, a er drecl damage.,, IriVr. or mall not c ',~{ rt rut pmdltias OI I(;ux]ated elan tat{ps, inGWding ki% Cf (r(,:Jur inn errC v if tx, Iat10.' anJ natprinl3 (waneead Costs ru other bsces or exnarrsa in .urrr±u ty the Holder or any inird pdrty SpeCiliCaily exrtt,ded (rorri um tor: War'ranly uwarayc, are damage to the Units due to ordc,ay w tar a:lo In;r•, n.faralipn, accident, misuse, abuse or ntr~llpct ai !r Ur it: the U lrr,ing suL•irx;lpo In vehic,e Eraarr: a• otl wndillars wit cn ,-0 no! perm !act `,r the inaWliatbn instniclions: failure to matr:ain ;hp mNl ml m ground n ,ers Sf.[ f y,^tl i in the installall0n insUUGI Orl ; [he piacemrnt O( in.rM' e Y;alBr:ala into tt1P, syslenr COnlailling tM Units; feilUfe OI ti re Vmis or the septa. 5ysfam due Ip improper siting or ir-rpro4er si;iryd.. excas=r.M water i=.age. improper grease dispose;, or imDropE^ operation; O' arty u(hpr avant rte[ Caused ry Inlillrator, This UmM1ed Wanarry shall be voirl d lne }+o{drx !ails to compry with all of the tents set forth in Ihis Limilod 'Warralay Further, in no event sr+all InSitrator he ra.3{xxisiWe hx -xry loss or damaye tc ir;e Hnldor, the Undo, or arty' Ulird pally rgsultulg frarn inst814Nion a sMp- menr pr frDm arty prudud liability :!alms c! Hc!der or airy thin party. F=x fiic Limited W'ar. aniy :o appy, t a Units must ba uistalled m aoeoMance wsth air sae conditions reGidred by state antl beat codas; all o!hfx appArante laws: and !n!~itralcr a irstahanpl 71a:ruelK"'s. tell IJp repreaen{arve al rnfdtratw Ms the ardfaxily to ch2nya or sx!ntd tors L'arnlor] WarrpclY Nn wanaoiy applies to arty parry Doter roan 11re onyx nal Hixder. The abcv< lepr9eprri9 the SrandarJ Lirmleti yVarraltiy ofleiau dy Infiq a9x. 4 - n Ivd nr rn iba nl ;Ip1ES s d t nuns ha:e diltarant warranty reyuaa• n .s, Any purClrasnr o: Ur,iis ..hO1Nd conlaUt YvillraiUr S ..+xrurat - MdaJyJartum in Oe '~ybroak, l-J vxx ]~CUr, prier ;o sucn purrhasa, lu oplaln a u1DY of tna appfbabie warrant}, atd SRould Wrefu!y read teal waranlq t,rxr ?o the pumns..e of Lnss. I t C U~r.~.,r~• i 'rrn cat. c SYSTEMS INC fnvlronmente! Onslte Wastewater So/utlons`" 6 business Park Load • I?O. Box 768 Old Saybrook, CT 06475 860-577-7000 • FAX 860-577-7001 800-221-4436 , • ,~ o-+v, vow, a,~r r,a~o; o,r th,ius; d,bnt7,(18; 5,839,644 G~nadian Patents; 1.329,959; 2,GG4,564 Other patens pending. infliralar, Equalizer and S'Ids'yVinder are registered trademarks of IDfilkator Systems Ir•~. infiliratw is a registered trademark rn Frat'y;e. Intiltrata Systems Inc;. is a registered trademark in Mexico. Contour, Contour Swivsl Cannociion, M+croLeachiny, Poly7aN, SnapLgck, ChamberSGt]cor, PosiLot,k, UuickCul, t~ickPla?, RELYCllDPAPER and Uuick4 are trademarks of in!il:ra(gr Systems Inc. ~ 20031nkltrator Systems inc. Printed in U S.A. StC f fUN VIEW ,+w.wrw'~.-.... ~ ~ ~, ~, ~...,,,,,.~...y ~ ~ ~ ~:~y ~+ ~ L' ~ `' ~._„~,_`"~ +C. ,~ 4~JTM. r. Z~ j ~.' ~t~ .fit . ~ «~ " ~ ~ ~ T Y, .. ~.A ~: r i ~ :.r.~..., .,,,,.,r ~' i~ ` ~ `'f EN^ cgpt 1?'' MIN . ASJV% G:~AD£ ~ ~`'r5' FRt~iK DQ(?R~ WyNDOW OR FRESH AIR INTAKE FIH'~SHE r'RA~;E ~.~{+ ~Irr.__ i t,. A';~%T •PPROV~~ 9IP~ 3, 'N't'0 S,'~t, I D ~O.L ~ "' G I R I ~ ER ~-- { 1 r.,..~...~...,~~ ~f s ~ !~ wAM'"R rIGH~ SEALS ~ $ d~ I'~MP CFF ,E~,EV . F T . ~ ~ C ~~D .IEAI'~?ERAROt~F auxcxzo~' i;^x '-~I;H CONDO::? CA5- ; , T1GHT~ SEAL ~" APFR~t~'EI~ BE~C:N'G L'tiDER TAhTK ~~~'?xC r DaS~ A:JK MAAnJfAC'I`.~1~ER ',;NI~~ S ; SE'r'II C ~.,R DOS E sPECIFZ^A,TIv~~,'S 1.,... Paz, , ~~rtM MAN'JFAC?L'RER: "~ MOAEL Nt1M8ER: ~~w~~~"'~"'°' SWITCH TYPL: ._._~t~r' ~~`~""`"" ',..., ~, MANilFACI'tJR~: MOt~E:. NIJMSER SWITCH TYF~E: EQ'~;REA ~IBCKARGI" RA.T~M P:~ €~N ~ ~~ ~, '# ' ~ I ;err, A C'pR0'J ED ~A.AtHOi,E OG'J ~: W / PAL`-LOCK 6 WARNING •A8£I ._..,~ .~ M~ ~ . vAAPROVE~ JOIN`S t~STi~ ~''P~pVEQ PCP 3' ONTO so~.~a. soz~. &a RISER £'X~T P~RMI i TED C,'V:.,S IF TANK MA+VUFACTUREd~ HA5 APPROt'A; ~ON~REiE PAO h~M~ER EASES ?E.~t CAY: L~O~E V CLLI~~iE I1~C ~~3C~:NG ~La~sAc~c:__ 3A~~_~ ~A;~. ^AflAC I TI ~'S : A +~ `~! .i.*iC~?ES * .~i..,.~.CA L.. 8~ .,r,,,x , I ~iCHE S x ~~GA L. C ~ „~„ INCiiLS = l' GAS,. ~ a ,.,~i , ~ Ir'C H E s s ..~' .~G~.. ~t~A ~ . P'~MP E 4M w.~R11vG AS : ER ZZHR 16.23 '~h~ MR'F=CAL rJiFl'y~;~NCE 8E. Gs : Ah~ DIS7`P: BUiI ON FiPE , MINIMUM NETWAR~G SUPPLY PRESSURE ~.~ FEE^' ~,.~„ FEE2' FORCE~IAI~i x,~,,;~,~4 ii/w4Q~F", ~F'R:C2p~N FACiOR~ ~ ~ FEET ~'OTAL EZ'IvAMIC 2~EAn ~: ~ ~`rvT .wa ,Js~J~',~ ~rt'' r~Ma TA~i~: ~, . ..: -EtiG i y --------- W .~-,~ r 1 ~'~ "`i" A i' "~.,R,,.L ~ . ~~~ nA~;. ... ; __ --~,~-..M.~....._w [~GOULDS PUMPS • Fully submerged in high grade turbine ail for lubrication and efficient heat transfer. 3Q~~ EP04 o EP05 APPEICATtONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS • Solids handling capability: 3/." maximum. • Capao:ties: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size: t'/~" NPT. • Mechanical seal: carbon- rotarylceramic-stationary, 13UNA-N elastomers. • Temperature: 104°F {40°C) continuous 140°F {60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to COmpOnentS. Motor: • EP04 Single phase: 0.4 HP, 11 S or 230 V, 60 Hz, t 550 RPM, built in overload with automatic reset. •EP05 Single phase: 0.5 HP, 115 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: 10 foot standard length,l5/3 SJTOW with three prong grounding plug. Optional 20 foot length, 16/3 SJTW with three prong grounding plug (standard on EP05). 8~ 2000 Goulds Pumps ffteciive February, 2000 83871 Available for automatic and manual operation. Auto- matic models include Mechanical Float Switeh assembled and preset at the factory. FEATURES ^EP04 Impeller: Thermoplas- tic Semi-open design with pump out vanes for mechanical seal protection. Submersible E#fluent Pump Mt ^ EP05 Impeller: Thermoplas- tic encioseddesign for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ^ Motor Housing: Cast iron for efficient heat transfer, strenyth, and durability. ^ Motor Lover: Thermoplastic cover with integral handle and float switch attachment points. ^ Power table: Severe duty rated oil and water resistant. METERS fEE7 _ _. _ _ _ _ __ __ _; _.... , ~o 1. s a 0 w s L_ 25' _ _.. _.. .._: .._ .... ^ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY I.iSTING ~• canad{an stendeMs Aswdalioe (CSA listed model numbers end in "F" or "C".) Gou{ds Pumps ~ ISO 9001 Registered. -=----~ ......i... __ ~~--5 GPM 2.s ~ ~ L ~ Q 2 d 6 8 10 12 m~/h cAPaarv Goulds Pumps ITT Industries POWTS OWNER`S MANUAL & MANAC3EMENT PLAN P~9e o~ FIt.E INRORMA1riON Owner S (~,NN Ar ~$. Permit ~ ~ "~ DESIGN PARAMEI'SPtS Number of Bedrooms *-y` d NA Number of Public Facility Units O NA Estimated lbw leverage} ~Q'Q al/da Oeeipn flow {peak}, (Esttimated x 1.5! ~p X14 elide Sod Appikation Rate al/da lift Standard Inffuentitffluent t~uadty Monthly average'' Fats, Oil ik Qreass {FOG) SJO mgiL Biochembal Oxygen Demand {BODa} 5220 mglL Q NA Total Suspended Solids (TSS} 6160 mglL Preveated Effluent fau-siltty Monthly average Biochemical Oxygen Oamand (BOOS} 53O mg/L Total Suspended Salida fTSS) 530 mglL O NA Feoal Conform lgeometrlo mean) 510` cfu/i00m1 Maximum Effluent Particle Sizs yi in die. 0 NA Other: ^ NA "Vsluea typical for domestic wastewater and septic tank sffluerrt. SYSTEM 8PECIfICAT10NS l5eptic Tank Capacity ,Z ~ al DNA Septic Tank Manufaciur~ 0 NA Effluent Filter Manufacturer Z ~ ~ ,~ ,~ i0 NA Effluent Filter Model ~' DNA Pump Tank Capacity al DNA Pump Tank Manufacturer rrE,s ~ DNA Pump Manufacturer ~..e,u / DNA Pump Modal O NA Pretreatment Unit O Sand/Ciraval Filter O Maahaniaal Aeration O Dlatnfactian O ?eat Flltsr O Wetland ^ Other: O NA Dispersal CelNs} ^ In-Ground lgravityi O At-Grade ~ Drfp-Line ^ ~ Q fn-Ground (pressurized} O Mound ^ Other: Other: DNA ~sr' DNA Other: ^ NA MalNrf~NANCE facl~oul.~ Service Evert Service Frequsnoy Inspect condition of tankfs! At least once every: 3 s s tM~m 3 yea~si i~ NA Pump out cantenq of tankls} When combined alutipa and scum equals onsrthird (Ys} of tank volume ^ NA inspect dispersal cell{s! At least once every: 3 sarl~la) (MaxMnum 3 years} DNA Clean effiueni Piker At feast erne every: ~, ~ ~ s} O NA inspect pump, pump Controls ~ alarm At least once awry: ._--- ~~lai (3 la} DNA Flush laterals and pressure fast. At least onoe every: •-- ^ moA a! al DNA Off` At least ones every: ~ 0 ymeoand~t~ s} DNA ~~' O NA MAgNYENANCfi: INSTRUCTIONS Inspections of tanks and disp~;rsai Celia shall be made by an individual carrying one of file fodowinp iiaenaes or oertifbations Master Plumber, Master Plumber Restricted Sewer; POWTS Inspector, POWTS MaintaMer; Septage Servicing Operator. Tani inapectione must include a visual inspection of the tankis} to identify arty missing or broken hardware, identffy any cranks or leaks measure the volume of combined sludge and scum and to cheek for any back up of pending of affluent an the around surface The dispersal cNi(si shall be visually inspected to check the efftuent levels fn the observation pipes and to check for any pondin~ of affluent on the ground surface. Ths pending of effluent on the ground surface may indicate a failing conditbn and requires the immediate notification of the local rsgutatory authority. When the combined accumulation of sludge and scum in any tank equals one-third tY~l or more of the tank volume, the entirE contents of the tank shah be remaved by a Septage Servicing Operator and disposed of in accordsnoe with chapter NR 113, Wisconsin Administrative Code. All other services, inrduding but not limited to the servicing of effluent filters, mechanical ar pressurized Components, pretreatmem units, and any servicing at intervals of s12 months, shalt be performed lay a certified POWTS Maintainer. A service report shall be provided to the local rsgutatory authority within f p days of completion of any service event. •apo~ ant2si2stutwpd ulauoasPM '(£) 8 iL} 'it}t+S'£8 pus i3}~8(R)itliq)iLIZL'E9 u+wo~ ,eldeyo y3lM aawttdwoa u{ poi;eJp ssn- luswila0p siy~, N4~ ~ 1 n'ti1•s, X 10~ ' _LS await vurety AtRiOH1nV A?lOtd'In03b 11fQ01 (l13dWnd} k}Ot~/!l3d0 ONIOIA~S 301/tdBS auoyd awsN l19NIr-tN11iW 81MOd ~ ~~a ~~, "•'I1,'r7 ewaN t!•3'1'MiSNI 8tMC1d S1N3WW00 '~-A(Oflia!!V '3'181SSOdW1 b017n0}ddid S8 AVW 3lN1/t d d0 lJOIl131N! 3fHt WOfll~t N08fkl3d tl d0 3~I~S9fd 't~n33!! AVW H1V~0 '830NV1SWnOdIQ AIMV a30Nn NNKt 1N8W1~3lIL li'3l~ilD fyO dWfld °Ottd3S d Il~.N~ lON OQ 'N30AX0 tNH101d~ASN1 k0/ONd s3$St/0 1VHt3'1 NIdtNOD AVW SSNVi tN3W1V3>il Ii~H10 ONV dwnd 'a1J.dSS < <ONiNlIVM> > •ewti lays is loo;}o ut satni ayi yitM Aldwoo isnu~ swslsAs yens ;o suo{lanilsuaaa~t •aae;iflS antlaii{~ul ayi 18 leuto~q ey1 ~a lenouaei 6u-MOtiat; eae~d ut peianilsuoaoJ eq Asw swalsAs uolidiosgs flog apeif3-ia pus punaW Q g. o v/ •awti leyl is i~}}e ut semi ayi y1{M Atdwaa ;snw swalsAs iuaweaatda~ •eaia iuau2aaeldai atgaltns a ysitgeisa of uotiantana alts pus (tog Mau a io; pogo ayi ut ilnsai ttlM ease iuswaastdei oyi loalaxl of ainitad •stt9M pus sautt iol 'ainioniis pasodad pue Bui3stxa woe} s~taegi9s paitnbei Aq uodn pa9uti~ut aq loo pjnoys pus uoilaedwoa pue aaueginislp woi~ p®;aeloid eq p~noys eaia iuawaaetdai ayl •weisAs uoiid,osga floe wawsasldai s ~o uotleaol ayi io; pazi{tin aq Aaw pus peientena uaaq ssy eoie luauaaae{dei atgeltns d :wa3sAs luoweoaldei iuettdwoa 9poo a optnoid al 'ue~tsi eq lsnw io 'uosq eney sa,nseau, t3wnno{lo; oyl pa~isdai aq iouuea pus s{te; S111AOd ayi ;I NV'td AON30NItN00 •latiaiew p;{os liaw ia~;iaue m toneie 'flog yliM petit} weds pion sy1 pue panouiai stenos itay3 io panouiai pue peisnsaxa s9 I#sys gild pus s~tutei l{e `6uldutnd ia~y a •toieiedp Bulainiag aBsideg a ~tq ;a pasods~p Al~edosd pue penouaai aq l{eys gild pue s~tuel l{e #o slu~iuoa eyl •pvtaes aBuluado adld pauopuage ayl pue paiaauuoasip 9q flays slid pus e~tusi o2 8utdld Ilr/ a :epoQ entlsilslutwptl utsuoaslM 'ErE'E8 wwaQ ialdeya yilnn eauel{dwoa ui pauopuege Ate;as pue A{i9doid si u~e2sAS ayi leyl amsul of ua~tel aq lleys sdais 8ulnnoryo; ayi aainias ;o lno ua~lei niiueuewiad sl io/pue site; S.LMOd ey1 'ue4M .kN3WN00N1/8t/ •auliq iauai;os ,elsnn pue :suodwvl :sul~tdeu niellues :sapiai2sad :sianpoid Buliutad :lio auotiealpau} adeios ;eaw aaplalgiay :assaif3 :autlose6 at3ullsad atge3atSan pus ilru} :ieieM {dwnd dwnst ulaip uollepuno; :2e; :slueioa;ugsip :siadatp :ssot; lsiuep :siaeaai8ep :sgeFns uouoo :swopuoa :sung 9ua,e8ta :s~dtM Agea :soils}gtiue :S1MOd Syi ;o a~.p ay1 Buotoad pue aauew,o;iad ayi ano~dwl Aeu, u,ea~zs laiennaisenn ayi wo,; Bulnnot{a; ayi ;o uolisutwtla io uotionpaa •se,e uolid~osge tios apei8-2s io punow Aue ;o sdots unnop 1a9; g t, utyilrv- ee,e ayi '2a@dtuoa ,o q~nislp asinniaylo is "iano ,lied ~o anlap iou op •sitaa tes~ad3tp pue s,tuel iano satatyan :tied io anlip iou oQ •~tusi dwnd ayi ulyltM stanal lswiou s,oisa, of s~oiluoa dwnd ayi 9utlsiado til{enuaw ul islsse of iaulelutey~{ SIMOd ,o ,agwntd a loaluoa ,o dwnd luani;;a 9yl of iea+od t3utioisei of ioi~d ioieiadp butalniaS at3aldag a Aq penawai 2lusx dwnd aye ;o slualuoa ayi 9nsy uollsnils sfyl pions off, •luanl~a ;a aBieyoslp aos~ns io dnilasq ayi ul linsei Aaw pus {sttt9o aye lfulpaoti9no "asop aii~st suo ut (s)pao tesi9dsip ayi o1 paBieyaslp 8R fltM ~algMaisenn s6eoxa ayl pelolsai st iannod uayM •stenat ~sia+~y6!4 tsw,ou anoge tit; Asw s~tusi dwnd saBalno ~annod Bul~nd •aoa;ins entisjlti;w ay2 is uwros; o,e suoyllPuoo flog uayM ,nooo loo tta4s do 1,Qls wals,tg '9811 02 3btid lOle,ad0 ~Liatni98 eABidaC a Acl p4nOUia, (f}),Ua; ayl ;o slua2uaa ayl ansy palaalep ate suatlenuaauaa y®fy ;l '(stfl9a lesiedslp ayl at3ewsp io~pue ssaaoid luawleail ayi apadwl Aau21ay1 stea~weya iaylo to sionpo~d 9uliuled ;a eauasaid ayi i°; tst,lus2 luawls7e» h~ya S1MOd syi ;o asn of iotid 'uotianiisuoa Mau iod NOI.~d~sdo ONV do J.lfibls la ~' ®6ed 'StMOd Pat!sl ayi aoatdai of iiosai teat a se palls3sui aq Aew Flu+l Bu, ploy s ,lllotouyoal S1MQd ut saouenpe Duuieg •suotlsl;tu!I t)os io~pue ~laegies of anp aigsttane iou s{ eai8 iuawaaetdai atgei!ns .y ~T C'ROIlC COU~7~' S'F~'I'YG 2AI~iK CP Afi~RB~NT . ~ LIPID OWNBR$Hlp c';SRTiFCG4't'ION FORM OwtnarlBuyer ~~~V'~A C'o,~ ~°~, r~ ~ir,~ wddrt~s ~, D Vr K~ ~ 2 : . Sv i ~'~ ~ Proporty AddrGSc fVarrficatioa required from P4eaas~ DapartmGOt rar eerov 5 C'~ty/Stata !-~CJ~'o~.l L(/ ~ Parcel Tdetstii~ieadoa Ncunbet 4~7~ - l `-~'t~- - Zo - c~O ~. Z6'-~O) LrGAL.A~S __ ~ Ptnperty I..ocation Y., ,~ r., Sec ~, T 'Z.~~ N_R~/~iiy~ Toara of N!/C~So nJ~ Subdivss~oc ~ 7 _ T~ ~ L ~J ___._ __. _._.._.._.~ ~~ # _ ~ Cetti.~itd Surrey Map # .-.~.-----_„__r__.._... . Vasumt ___„^__._,,,,,,,,, Pala # Warrsnty bead # (~ (o ~ . ~ U _ ______ , Votume ,~ '~ . Pago ~ t ~ ....,: spec hnttsc ~ yes O no L.at L'nCS idrnd$able ~ yes ^ po SYS'~M t1~A.IN'IEHAN ' Igipro~pet use aad raaialeturreof your Ieiadc ryst~.tn weld mint ut i!x ptrtmsttstes falluce.tu luadinw~stes. FYOpe:rtw~iatpwaee aoralsta of pumpiaa out tl~e septic txak every tiara ywsrs oc t+oa~eey if needed by a liraascd pumper. Riha~t you ytrt iota tfsa eyteem oa a&.et tt-e lbacdoa of the rxittic esaJc as t ttrxt~owat tLe~e im the wtiate diapoat t3rstca-. 'I~a property o•vaa sgrea to cabmir to St. t:Yaix T.oo~rc Dcpaetmeat a eaeril~.a~an totter ;it,~ by tEu: owner and by a ~rP, jouroeyasaoPi+sraber, rer~ietodplurabes or a iic~,p~a~opeit'vtcilyiui that (!} the oa-eitc tvastawR'Dec dttpeaal rysee+a is to Proper opastsng cead:tioo and/or ~1) after aad pvnaPi,r,E {if aeeecsuy}. the lepl5e'taak ii twee risen 1~! full e! iiud~a ~ ~e essd~eoci~sed hsve read tAC ebavs ~~cme+sits ag7nse W asaisataia ttte ptiv~te t+cwtgc ditiPofri! 1i~RtetA with rb Nandssdt cat far$ bcrtiia. as sst by the Deptrttsseat of Coa~rme sad the aepi<ttmeat of Nattrt>li 8eaau<ca„ 8ttte of Wtaeoosin. Csrtisauiaa ~~ ~N6 teptfe systt:a lygbocn caa" be rna~lctu! sod ret~tttied to rbe 5t 4oix Coctaty Zoaittg Offiat ort~ SO ds~..vf ekrrx ~c ae~isat.e(v'daca ~~~~ DA E i ) ccrtiry that eti t+ ruts a tlsix rorna ire txur to Os<; best o[ ray (aur} fonow[e3~o~ I (we7 am (eras the owne~t) of t#s darn abov s warraary decd recorded is ltuyctet of Decd`t Oilier. ' ~~~ ~ ~ YL D < •••••• Assy iaformsti,u is ceus~septesznredi cosy result in tbt cttilt~yyrttA,it baias revakxdby tl~scZoait~ pop~i. •••••• •• Ipctudc ~i~b tlsis appliestlost: s ctarnt>ed wamapty $eod 5tuen the AlaictM[ of ~ctdt o$'iCt a copy of rite eecdfsad sastvey mast if ttf~~onct: it trade io the w~csmry dud TO 1 ~. P , 0? $TATN BAR bF WISCbN51N FARM t - J498 .....-.~...~ ~I' i(( WARR~A3fN1T^fX REED A ~ooo,.ee~f ..ti,_~....~t.--._ __ .. _ Ynt_ 1 f J 1 PA,! 6~.J This LleCd, lnsdeAetwet:n Bane Cot'Qotation. _. a_._Fliiln6aora COrPOratiOA -- ....-•-- _._. '~ .___. Crxn<oa .rnd .Sienna Corporation u~Mtlln!l.t~b.B_ C~3, ora +Qg____.,,,, _ Grantor. for s vaGi+ble ronslderarlon. wrtvcyc Gucribod real ua4te n, St . Croix (tlu 'Proycrty')- -~- See Attached Exhibit A -.---.- _., Grantee. w Cnntee the fallowurg _ County. grate of Wtscofufn 66t$U+8C7 FEQISTEk 0~ DEEDS 9T. CROIX CO., 4It RfCEIVEI fO1 f~CORD i2-21-?DO! 3:30 PM YARkAifIY 1E@D CCODY f£E: COPY FEES YRWISFER FEFs 9163./0 iN6 FfF: `7.00 RernMaq Arrr. Nerve entl ~fietvn Arldrees U ni~r~tl ~HtE, ~'I~ 5mf~+ar~i ~s~ Si.~ite,'~oi I~ivtne -4~o~nka ~~ 653' 2o-lo4e-ao-ooo Parcel Mo+titlcilion IVUriher fPttN --..~ Th1t i® nat hotneueed property. (fY} (lf nol) 20-1048-ti0-000 20-1048-90-000 20-1049-90-000 z0-loso~-oo-ooo 20-1050-80-000 20-1OS2-20-000 20-1052-?0-000 Togctncr wxrh alt ppurtensnt riahta. Utie ana tnterasts Grantor warra,a5 thrt the t:r1e to the Propony as good. tndtfea.tb;c 1n fee simple and free and t:lcer of utemnbrarxt:s ,:xt:ept See Attached L'xhibli B. Datcu tnt: 20th _• _ day ~ Decambtr 2001 ~i flena rpuratioA _ ~_ (SEA[.) M, ~ b~ , 't Jo M. Nassef ti Its of Exetutivt: Offi ~ (SF~1L) ~~ -- j; ._ - .- .___~. ~, jig A L"THENTICATION t~ i( StRruture(s) +F - --- ACKNOWLEDGMENT Minntcota State oTiNttceostrfn- autnenticatoa hits ~.. tf;,y ~ .. Pennrwily carrtr 6elhre the thfa {~ _ _ December __ _ ` -- Joha K. Nasaeff, Chlt '~ -•-~ of Bana Car oration, , li _ _ _ -- _ - p------ __ _ cozpo[ation ', TITLE. MEMBER STATE HAR OF WISCONSIN - mw krwrrrr l0 be a pert authorired by g7oF.ob. Wts. Stets.} ,nstrt,ment and ~ ~~ TtitS tuS7l7UMCNT WA$ DRAFT ii EO OV - IE LockYit]ga Grindal Law T'irtn -~`~ `I~ ---1.L2t~.eapal~is~~AY-costae-Sauti~- (SEAL) .-.__... tSEAt} u. ~_ day ut tttc about, na,r,e,t 'tv_e • Off ~~ csr ~ata .... __to _~wtw,, en.wted the toreptwtr, 11A11AY L QAtI,AWsp waanrateonw~wa wsaaa _ ' ~ ~ G1 No~•}~pulillc, 5tmmte of Wtsconsm --~ - ~' ~! ... r-itiy cornmisuttrr La pGSnu,tcnt (If nut. sgre grpMadUtt daq• 1 (Stgnatut~es ntry be autrtrnrlcated 6r stkrwwi,dged Hoth s,L rout Jttriuiry 33 nccessuYl _~. ..._.._-~~ ~~ __ . 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Z O ~ Z ~ N ~ O N O N O O' C ~i ~ M ~ (D ~ d > > W ~ a 3 ° I o :' I m Z I ~ f I N ~ y od m ~ a r'n ~ ai ov'm coo a I m ~~ ~~~ o: o m ~~ ~~~ o o ~ fl.°- m a~ 'm ° as m' a~ o=i c x~ ~ N~ o y z xcn ~ m o N Z a N y -~ im m O C O ~~ a m N N cim ~ O C O ? °' a m I c S~ N S~ N, N N I N ~~ m N O O y> >~ a O ~ y~ ~° ~ ~CD~ ~° ~m~ -~ -~~ 01 ~ ,~ 7 'O A N O K N N~ O (~ t/r w~D p~ ~3 ~ O c~ m m~ O ~~ ~ ~ 3 . ~ o ~ 3 • ~ o I an ~ °~ an ~ ~ n •~ ~ o m~ m o m~ m~ ' m~ ' o m m m O m 1 C fOA f~D C ~ C N W C ~ m m a (p m ] m a (/1 x Ol ~ x N I 7 7 fD N O O ~ O O °o °o ~- °o °o ~- 3 ~ v d c ~ c ~ n ~ ~ ~ N^' ~ ~ ~ ~ ~ .. 1 ~ ~ ~~y O C O N ~ ~• d ~ Q N O ~ A 7 ~ ~ O `Al ~ N J r~~r~ 1 O R ~ O irk, O O ~ 'O C ~ 3 ~ c ~• ~ l~l °.*~, rn N 7 ~ ~ ~ A ? ~ ~ ~ .~ A ~ ~ m N O t0 Z A ~ ~ ~ a i A b A w N 0 O W Gro I~ ti ~yy N ~1