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HomeMy WebLinkAbout020-1450-12-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and'duilding 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)]. Permit Holder's Name: City Village X Township Grand Pro ernes LP Hudson, Town of CST BM Elev: Insp. BM Elev: BM Description: ~ ~ ~ ~~ ~~ TANK INFORMATION TYPE MANUFACTURER ;y„1 CAPACITY Septic ~„` lp /x~ Dosing ~ ( ~ ~ C~ c~C.J r Pa 1 SZ Holding TANK SETBACK INFORMATION TANK TO , IP~~ (~J WELL BLDG. V~t to Ai In J R D Septic S~ 2~ Z`+ Dosing - / ~(/ ~~ ~~ ~---- Aeration Holding PUMP/SIPHON INFORMATION Manufacturer c Jl ~ Demand G P Model Number ~ /~ ~ TDH Li~ ~ > FrictionQLos~Z i System ~~ /~J TD~ ~ F Forcemain Lengt~~ Zz Dia. / Z Dist. to Well SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. CrDIX Sanitary Permit No: 514888 0 State Plan ID No: Parcel Tax No: 020-1450-12-000 Section/Town/Range/Map No: 22.29.19.2882 STATION BS HI FS ELEV. Benchmark 2 . ~ /~ `~ 9 4`~ At".v~~-cam. ~~ ~ ~ I ~ . a Bldg. Sewer /'' Z ~ ' St/Ht Inlet 11..75 QQ ` 3 7 v ( SUHt Outlet \ ~ Dt Inlet 1 ~ Dt Bottom ',(r 7~iI~ Q11 '• Header/Man. ~ ~~ Dist. Pipe ~, ~ ~ ~ ' Bot. stem ,..--s b , Q~ ~ O q~~ -~~ J Final Grade 5.1 ~,a St Gov ~ ~ ~.~.. ~ ~, 9 ~ BED/TRENCH DIMENSIONS Width '~ Length ~ No. Of Trenches _ Z ~ re e PIT DIMENSIONS !` No. Of Pits ~-._ Inside Dia. Liquid Depth ~~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: l ] ~.~ ' INFORMATION CHAMBER OR t ~ J Type f System: r~~e,~`a~aQ, 5 ~~ ~~ UNIT Mo DISTRIBUTION SYSTEM Al.,~l~.. Header/Manifold /~ ~ Distribution Pi x Hole ize x Hole Spacing ~ / ~a T pe(s) th Di ~ S i L Length Dia eng a pac ng SOIL COVER x Prassure Svstpms Only xx Mound Or At-Grade Systems Only Depth Over Bed/Trench Center ~ 3 Depth Over Bed/Trench Edges` xx Depth of Topsoil xx Seeded/Sodded ^ No xx Mulched es 0 No • / \ COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 632 Roberts Lane Hudson, WI 54016 (NE 1/4 SW 1/4 22 T29N R19W) H/udson Estates Lot 12 Parcel No: 22.29.19.2882 1.) Alt BM Description = ~~ 1 ~ Go~~_ [~~,..,~ H.s ~ ~--oG~~ 2.) Bldg sewer length = 3.3 - amount of cover = ~ /D ~ ~ r- J~J ~T tG/. -.- _ Plan revision Required. ~ Yes ~/No ~ ~ - - - - I ~ /„ Use other side for additional information. ~_ ~_ i __ ___, ~~ --- _. Date Insepct s Signatur Cert. No. SBD-6710 (R.3/97) ~- 7 ~ 7 del Number: ~; ~~ ~ \^Y' ~/ ~ ~~ ~~ ~ Vent to Air I ake Z ~. ~ ~d Z~''Q K c~1'1~1'~CB.w'1.gOV Safety and Buildings Division Coumy _ ~ sca i 201 W. Wash' Ave., P.O. Box 7162 M di n GV 6 t n s n ~psrbtsrtt of C a so -7162 3~"~ Sanitary permit Number (to be fi ed in by Co.) omtneroat .,~ ~/ Sanitary Permit Applies i , 0.` In accordance i h C Sffite Transaction Number w t s. omm. 53.21(2), Wis. Adm. Code, submission of this form to the appropri emmental r J unit is required prior to obtaining a sanitary permit Note: A lication f f . pp orms or state-owned submitted to the Department of Commerce, personal information qe/~+~ see in accordance with the Priva law s. 1 S. l m Stets. y ~ V G tJ~ Project Address (if different than mailin~gad(dr~ess) . ~ L 2 ~ I A lication I f i ~ ~ b ~~~ ,1 /~7vv . n ormat on -Please Print All Information Pro Owner's ame f-~t- ~ ~ ,y "; ~ ~ 2008 Patoel #UZo-~ y5 a--la -moo Properly Owner's Mailing Address Property Location ~Lf~ ST.CROIX000CEY mU~Lf/(~ ~~ ~frL1`~ / pp l t (' Zia ~ G L .. ov . ot J Ci State tY> Zip Code ~ ~~ y., S~v '/y Section .~ /~' !~'! - - !~ ~ ~S'C ~ ~ .(/d.~ ~ 1 ~ ~ ~~~Q (~ om»l lI. Type of Building (check all that apply) of # T~~ N; R ~l~ ~ E or 2 Family Dwelling -Number of Bedroom 3 ~~~~ ~~- Subdivision Name / ^ Public/Commercial -Describe Use %? ¢C TZf Block # ,~ ~ri.L~$'c!!~1 ,~r,'G .> ~ . ~_ Ci of ty ^ State Owned -Describe Use CSM Numy ^ Village of ®Town of / ~~ ~~ !~ III. T y tt: eek only one box oa line A. Complete line B if applicable) A. New System Replacement Treatment/FIolding Tank Replacement Only Other Modification to Existing System (explain) system l3. Permit Permit Revision Change of Permit Transfer to List Previous Permit Number and Date Issued Renewal Before Plumber New Owner Ex iration 1V. T /~ e of POWTS S stem/Com neat/Deviee: Check all that a Non-Pressurized In-Ground Pressurised In-Ground At-Grade Mound > 24 in. of suitable it Mound < 1fF in. of suitable soil Holding Tank ^ Other ispersal omponent ( in) ^Pretreatment Device I in) ~~ V. Dis ersaUi'reatment ref Information: sign Flow (gpd) Re Design Soil Application Rate(gpdst) Dispersal Area Required (sf) Dispersal Area P (sf) System Elevatirnr ~ / ~'I Jr~ - ~ j .. ~5~~ ~P s?~ l 4G ~ ,.,i , c ca i VL Tank Info Capacity in Total # of Manafacturer Material ~ 2 p -- Gallons Gallons Units _/ New Tanks Existing Tanks // / ~/, •/d~ ~~~ /1/ Lt/ Septic or Holding Tank `~ ~Cld ~ "~ ~ y ~ ~~ t/ ~ ~ ~~ Dosing Qtarnber ~ ~ ~ ~' Gd/J C VII. Res onsibility Statement- I, the andersigned, assume responsibility for iastallatioa of the POWTS a an tie attached pleas. Plumber's Name (Printl Plumber's Signs Number Business Phone Number Plumber's Address (Sweet, City, State, Zip C ade) ® ~~ c dL"" ~3' ~%vf r~ t~ VIII onn /De artment Use On pproved _ Disapproved Permit Fee Date 1 Ise ' g Agent ig _ Owner Given Reason for Denial S /~~ ~ ~ / D f/ `~ 0 ~ 1X. Conditions of Apptroval/Ressons for Disapproval ~ZL~~~/ Jj,, ,~ Lj D~~~ ,., , ~~ tz~j~~ ~G 7( ~~2~ R : SYSTEM OWNE 1 Septic tank, effluent filter and yiz~~~~e!y,,Q.n.~ dispersal cell must all be serviced /maintained as per management plan provided by plumber. rui ae wain i cy u~ ~ ~~ ~~ tip AirttlE'NybllM fed iabraFr fo the [:01m1y oary an paper oar reef man a >n x m r wmenea m mu as per applicable code/ordinances. ~~ 32 _~ SBD-0398 (R. 01/47) Valid Urrtm 01/09 ' ~, V `~ `r1 .11 ~ ~ ~ .~ ~ ~ ~ ~ ti a U `~ r~ ~l/ ~~ ~ ~ `~~ ; ` ~ Q ~ ~ h V `~ ~l SEPTIC-'TANK ~ p1;MP L~:Aj~".$~R CROSS S~:GTIQy ANA gP~{;ltll:til.LV1ti~ u~' CT' VENT PIPE ~ 12"~ ~1fN. 'A84VE GRADE ~ WEATN&RPROOF APpRQVED >_ 25' FROM DOOR, WINDQW OR JUNCTION HOX MANHOLE CQVER FRESH AIR INTAKE WITH CDNDUZT W! PADLOCK E ......~.-~ WARNING LABEL FINISHED GRADE y'7 ~„ D T RISER -~-~-~ ±+ ~~ MIN . _ ~~ ' NLET ......r" ~ ., ~~ ~ ' ~ S WATER TIGHT SEALS - GA TIGHT ~ ;~ p SEAL ' .~ , ~ PpROV£D ~ H ~ ' ~ IPR 3' T ' SAIID ~ ~ ~ OIQ PUMP flFF ELEV . ,,, ._ ~ T • D ~ 3 " AP~ROV ED. SEDDT NG UNDER TAN1C VAPPKVYtu aoi~rs wiTw ALM APPROVED PIPE QN 3' ONTO soc.xn sots. OFF ~~ RISER EXzT PERMITTED 4N L' IF TANK MgNUFAGTt1R £R HAS APPROVAL CONCRETE PAD SPECIFICATIONS SEPTIC /DOSE TANK MANUFACTURER s _'"~r T~ SIDES: SEPTIC ~,~,.._.. GAL. DOSE .. GAL . ALARM MANUFACTURER: , c ~ fly:' '~ __~.___ MODEL NUMBER: ,•_, n ~ v -...--~ SW ITCtI TYPE ; e PUMP MANUFAGTURER s C~ ~-~ """"' MODEL 13UMBER : e SWITCH TYPE: ~~'~"~ - REQUIRED DISCHARGE &ATE _,,,~j~,GPM NUMBER DOSES PER DAY: ,~,,,,.~._.,. DOSE V OI~ME FLO HACKG~s7-?._~. GAL" CAPACITIES: A = „~ INCHES --GAL B s 2 _ INCHES = ~+~ GAL G _$ INGHES = /~.. -GAL p ~ INCHES = _.~ CAI. PUMP ~ ALARM WIRING AS PER ILIiR ~;~•~~' Wp VERTICAL DIFFERENCE AETWEEN PUMP GFF .AND •DISTRIBUTION PIPE • • t MINIMUM NETWORK SUPPLY PRESSURFTI1fl0 FT. FRICTION FACT4~R •`• + ~~ = PERT pORCEMAIN k ,~„~ TOTAL DYNAMIC H Ft FEET "' F£ET .L~- FEET ~1-FEET • WIDTH ; D~I~AMETER ~_ Il3TERNAL DIMENSIONS OF PUMP TANK LL.IQUID ~~~.~-- 1C.~1~ ~~~~" ~ „ ~~ L3CENSE NUMSER~ 2?7Q~P4---~ DATE: SIGNED: ~Y I A If (~GOULDS PUMPS Submersible Effluent Pump 3871 E~ APPLICATIONS • Fully submerged in high grade carbine oil for lubrication and efficient heat transfer. ^ EP05 Impeller. Themroplas- tic endosed~design for improved performance. ^ Casing and Base: Rugged tfrermoplastic design provides superior strength and mrrosian resistance. ^ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ^ Motor Cover. Thermoplastic cover with irrtegra! handle and float switch attachment points. ^ rower Cable: Severe duty rated off and water resistant. ^ Bearings: Upper and hswer heavy duty ball bearing construction. Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIfICAT10NS • Solids handling capal~lity: 31a" maximum. • Capadties: up to ti0 GPM. • Total heads: up to 31 feet. • Discharge srze:ltlz• NPT. • Mechanical seal: carbon rotarylceramic-stationary, BUNA-N eiastomers. • 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 IiP, 115 or 230 V, 6U Hz, 1554 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; l0 foot standard length,l6/3 S1TOW with three prong grounding plug. Optional 20 foot length,1613 S3TW with three prong grounding plug (standard on EP05). Q 2000 Gourds Pumps Effective February, 2000 83871 Available for automatic and manual operation. Auto- matic models include Mechanical Float Switch assembled and preset at the factory. FEATURES ^ EP041mpeller. Thermoplas- tic Semi-open design with pump out vanes for mechanical seal protection. METERS FEE ro~- a x u a 0 a O AGENCY (LISTING tetiadkn5tandeidsAssodetlon (CSA Gsbed mode! numbers end in "F" or "C".) tioulds Pimps u tso Soot . 10 1z min "A"TM Goulds Pumps ITT Industries 00 ..............:......_.10 20 30 t Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT in accordance with Comm 85, Wis. Adm. Code 1209 Page 1 of 3 Tom Schmitt Attach complete site plan on paper not less than 8% x 11 inches in s¢e. Plan must County St Crooc include trot not limited to: vertical and hor¢oMal ref r n e i dir t BM ti d , po n e e c ( ), ec on an percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. 1 ~~ r ~ ~ ~ C ~~~C Please print all infonf-attion. Reviewed By , Date Personal irrrormation you provide~ay ( Law, s. 15.04 (1) (m)). S } E'" l operty , z Pr Owner , .::......:...:, w, ,,..,..~: ~, roPerly ~ P Location Grand Properties, LP Govt. Lot NE 1/4 SW 1/4 S 22 T 29 N R 19 W Property Owner's Mailing Add ~ ~ ~ Z ~ j 2 ~ ~ (~ Lot # Block # Subd. Name or CSM# ~ ~.~~ 712 Rivard Streeet, Suite 30 12 ` Hudson Estates Cily a ~g,~~;;tfiger#}fAwrtber J City J Village ii Town Nearest Road Somerset ~ G 0 0 Hudson Roberts Lane New Construction Use: ~ Residential /Number of bedrooms 3 Code derived design flow rate 450 f Replacement ~ Public or commercial -Describe: Parent material Outvvash Plain Flood pNain elevation, if applicable na General commetrts and recommendations: Area is suitable for a conventional system. Possible system elevation for Area 1 is 92.5'. Slope is 6%. ©. 7 ~l~f ~ ~~~~ GPD Boring # J Boring tl~ Pit Ground Surface elev. 96.06 tt. pepth to limiting factor 96+ in• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft~ 'Eff#1 *Eff#2 1 0-8 10yr32 none sl 1mp1 mvfr as 1f .4 .7 2 8-15 10yr4/6 none sil 2fsbk mvfr gw 1f .6 .8 3 15-30 7.5yr4~ none Is Osg ml gw - .7 1.6 4 30-96 10yr5/6 none s Osg ml - - .7 .5 ~~ ~ ~/ Boring # Boring !I' Pit Ground Surface elev. 96.06 ft. pepth to limiting factor 98+ in• Soil Application Rate Horizon Depth Dominant Golor Redox Description Texture Stricture Consistence Boundary Roots GP D/ft~ 'Eff#1 *Et1#2 1 0-7 10yr3/3 none I Zfsbk mft as 1f .6 .8 2 7-18 10yr4/4 none I 2msbk mvfr gw 1f .6 .8 3 18-27 7.5yr4/4 none sl 2msbk mvfr gw 1f .6 1.0 4 27-32 7.5yr4~ none Is Osg ml gw - .7 1.6 5 32-58 10yr5/4 none grs Osg ml a ---- .7 1.6 6 58-98 10yr5/6 none s Osg ml - - .7 1.6 ~ g * Effluent #1 = t3~D ~ ~ < 2?[S me1L ~rtd TSS >3n < 15n mcill * Effluent #2 = B()D < 3n ma/1 and TSS < 30 ma/L - - - -o -- .~--- - - -- .~- ----- -- --- --~-- - -- - CST Name (Please Print) Signature: ~. CST Number Thomas J. Schmitt _~~`~ ~ 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 'I 1595 72nd St., New Richmond, WI 54017 4/13/04 715-247-2941 Pr'op`erty Owner Grand Properties, lP Parcel ID # Page 2 of 3 Bonng # J ~~ Pft Ground Surface elev. 93.76 ft. Depth to limiting factor 96+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 1 0-10 10yr3/1 none I 1mpl mfr as 1f .6 .8 2 10-22 10yr314 none sil Zfsbk mvfr gw 1f .6 .8 3 22-35 10yr4/4 none sil 2msbk mvfr gw 1f .6 .8 4 35-48 7.5yr4/6 none Is 1 msbk mvfr gw .7 1.6 5 48-96 10yr5/6 none s Osg ml - .7 1.6 ^ goring # ~ Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 ^ Boring # _J Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Sal Applicatbn Rate Horizon Depth Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots `Eff#1 *EfT#2 * Effluent #1 = BOD ~ 30 < 220 mg/L and TSS >30 < 150 mglL * Effluent #2 = BODS < 30 mg/L and TSS <30 mglL The Department of Commerce is an equal opportunity servicz 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 608-264-5777. ' Conducted by: _ Schmitt Soil & Site Evacuations Thomas J. Schmitt, CST 227429 1595 72nd St. New Richmond, WI 54017 Phone: 715.247.294 BM El. 100.00' T,o e Alternate BM El.~, j? ~' 7 Slope = _~~ Scale: 1" = 40' le -~ ~` Page 3 of 3 Conducted for: Name: Grand Properties, LP Address: 712 Rivard St. Suite 100 City, State, Zip: Somerset, W154025 Subd. Name Hudson Estates Lot No. /~ /VE" i/4, _Sj~ 114, S: 22 , T 29 N, R 19 W Township of: Hudson ,~ 1~1/C ~~~~ o ,~,+r ~.i ~/~C Contour Line El. ~~ ~~ q` ~~~ 5~~~ I I 8} ~G i ~~ ~ ~ ~f ~Y/l ~~ 1~ This soil report was done to fulfill a Zoning requirement. It may or may not be in a location that is suitable for your use. No permanent lot mazkers were in place when the test was conducted. Sao ~ ~' ~~ ~~ ~..1 cR°6"~` .~ PROPERTY OWNER: c~a Progenies. Lr D SfTE EVALUATION 1205 ~ 3 ~ ~ PARCEL I.D.# 'tom Schmitt REPORT MEMO Discontinuous silt inclusions were observed in B1 with redoxfeatures. The redoxfeatures in the silt are present because the smatter particle size of silt holds onto the water stronger than the surrounding sand, it even has a stronger hold than the force`of gravity trying to pull the water down. The water that flows into the silt inclusion will not seep out until the silt inclusion is completely saturated and cannot hold any more, then the force of gravity can start to make the excess water start to flow. This is why redoxfeatures (mottles) are present in the inclusion. The outwash sand that the silt inclusion is deposited into showed no signs of seasonal saturation or high groundwater. "`~ INSTALLERS** When a ilt inclusio (silt bail} is encountered, the chambers that are installed in the silt should not be counted. More chambers shout a added to the end of the trench in sand to make up for the lower gpd/sgft rate of the sift. This way the 0.7gpd/sgft rate of the sand can be used and the system is only enlarged as needed. 'CSC-~~'rCT T ~ 'f', n n ~ r n i. a .. t -- - - - _ :~ .., ~----1~ ~~t.,.f' ~ ~ l'^ -~, `"-~ S $ t~ c~ c V i 5 t 8~ ~~ p,nSL t S C. i nd%a-mil- ~ ~! 1 ~~ ~~ . d ~, 2~o S . ,.~,~, `S t5 ~ r ~ -t~,~ I°~-S ~ C ~p s~ ~~-~-~S ____--~, _------ 2. ~.~.rC~#'w~NNW WN W rT~' ~oC~-O~~ W NW CNG;~N~ODN~~UI.~..~ ~ Z '~ .~R~yy~~I~UIW~112~V~DVr WO~~OO~N'r,'"..~IWQp~pWTV~1~NV VN~CW W W~ ~~ ;•-'.I-+Lv' ~V',V.~,N+,~~~VD+V V~IV ~~C~UI VGA V'pN`~IN~ODO~AfV~G#~~4J V ~~NVW Q ~~ ~(aW~Of")NNUIO~Cl1"'~OCJI•-~ODQ~~N~ ?~ppWO~ NW W W~Gppp Iii #~ Ai pN ------------- N SQ~~ Q~~~~d~~ t~/LMS 3Hl d0 b/L3N 3H1 d0 3N11 1S3M ,b6'069 3~~L£~ZEo00S ,S l'Z84 ,6L'B r ~ ~ N ~~ O ~ a r' ~o • N~ n i „~• ~' pi~w ` pw ~ m W A5 u m D ~ ~ mo ' •~ NOm .~~ ` W ~4?~ • ~ • ~ m ~~ ~ .yam o ~ E 336 4?, ~ ' . :~~8 '~+~~4 •1,61' • ~ \ ~ `d 0 i N V ~ r ~~~~~. ; f w~~ ~~ ~.. `~-~4'~~ ~t: ~, ~ ~. is `1 N w . '• V N ~ O r o z ~ 1,059`-Cl~'~ ~ \ \ m m 0 z I n N~ ~ D 7D mD m i b0 a~~z I , OD N \~p ~ m ~1f8 - N p 0 ,~ ~ z I u- J . W ~ ~ O O ~~ ~ ~ ~ I ~ O ~ m i ~ ~ ~ ~ 3.4o,az.oos ~'~ m ~ N N m111~ rn ~ N ~ ~ w ~ ~ ~• z' ~ ~ w ~ w ,89'S4Z o I ~-~~ I • ,94'SS£ m 3„40,ZZ.OOS ~ H ~ __ .-~ _ --~~~.Sl'OZ ~~~' r Sg , BAD 18l N~~~ ~ , fZ ZSl : "~~ Z ~ r CD ~ ~ 'l, V N ~ r ~ 0~ ~ 1'~ t~~~,H • 8,6, m ~ V O m O n ~+ .~ ° Nn~ sse_ o :~ m~ ~ w ~ m O ~o i • • ~~ ao~ . ~~ ~ ~~ ~m zZ -o i m~ aNi -~ ~o y N I~ 7-, m ~b 0 W I I~ ~~ ~~ ~~ d o ~r ~~ I~ __r. ~. .... ~.._.. .._ sT. CRo~.at: GUVIV'i'x SEPTIC TANK MAYNTLNANt~L AOREEMEN'I' AIq'D OWNERSHfP CERTIFICATION FORM . Buie . ~~ ~ ~ ~/~~~ ~~~~~ 7 ~-~ ~ ~ ~~ Mailing Address __ _,~ Proxrtv Adcirost3 ~ `~ ~ ~ ~~S ~~ 1~ ~ (Verification required from Planning & Zoning Dcpatttntnt for new ooastnlction.) City/State ~ U ~ ~ o ~ ~ ~ Parcel Identification Ntmtber ~~~~.-~a _ UUU ~ 2~PZ) Property Location 5 (~ '/. ,~ ~ '/. ,Sec. ~, T ~N R~W, 'T'own of l~ U~So ~ Subdivisirnt ~uc~SQy~ ~~~~cv ~' ~ ~ . Y,ot # /~. Certi$ed Survey MAp #~ _ ~~., Volume .-..~_, Page # warranty Deed # ~ r"SG `~~~ ,Volume 2 *zr~~ ,Page # __.. Spec house yes ;, nod Lot lines identifiable yes no SYSTEM Mp-YNTENAI~iC$ AND 4Y~!~r.~.~.E~~SATIOIN lmprvper use and maiatcaaace of your septic system could result in its prrrnaiuro faihao to handles wasua. Proper maintenance consists of pumping out the septic tank every three years or soonar, if tteedod, by a litxmod pumper. What you put Imo the system can affect the function of the septic tank ac a oreatment stage isl the waste disposal system Owner tnaimenaizee respottst~ilities arC specified in §Comm. 83.52(1) anal in C.haptet 12 - St. GYoix County Sanitary Ordinance. The prvpcrty uw~wr a~rass to submit to St. Croix Cotu~ty Planning & ?.ontt~ Aepattmeat a certlflcation form signM by the dwner sad by a rnrster phLtnbec, jouraoyman plunlbnr, rostrictcd plumber or s Ucorsed pumper vuritying that (l) the on.sitc waxtewatcr disposal system is in proper operating condition and,'or (2) aRrr inspnctiou and pttatping (if ttoeossary), the septic task-is less than 1 /3 fuEl of s}udgo, Uwc, the undtrsigued have read the above requitctneats and agree to maiataia the private sewage disposal system with the standards sec forth, herBin, as set by the Departrncrtt of Commerce and the Tloparttnent of Natural Reaotuces, Stan of Wisconsin. Cutification :testing thst your aaptic systxta hss baen maintained must be completed artd returned to the St. C'~otx Calmly Plamting dt Zoning De~partn~,ent within 30 days of tha three year expiraticm date. tlwe certify that all statetnenm an this form are true to the bwst of my/enr knowledge. Uwe a:dare the owner(s) of the property described above, by virtues of a warranty deed recorded in Register of Deeds Office. Number of bedrt~oms 6~ i~7i a~ ., .~ , ._ SIGN OF APPI,ICAN'T(S} ~ ~ HATE "`Any infarnoation chat is misrepreseatod may result in the sanitary penttit being revoked by the Pluming &Loning Department. "' Include with this application a recorded waaartry deed fratn the Register of Deeds t~ce sad a copy of the certified stu~~ey reap if reference is tnadt in the warranty deed. POWTS OWNER`S NfANUAL & MANAGEMENT PLAN FILE INFOf#MATION owner ~~ Z ~ ~ T7'~`DKi; Permit # 1 1]E~tEt;M PAI~A~iETERl; Number of 8edtaams ~ 0 NA Number of Public Fac~ity Units ^ NA Estimated flaw leverage) ~ ai/d Desig,~ flaw (Reek), !Estimated x 1,51 ~'Q alld Soil Application Rate Q, ~/ /f~ Standard lnfluentlEffkamt (luaftty Monthly average • Fats, Oil & Grease {FOG) S30 mg/i. S€achamica! Oxyget- Demand tBODs) 5220 mg/L Q NA Total Suspended Solids ITSSI S7 SO mg/l. Pretreated Effluent Quality Monthly average Biocherrdcal Oxygen Demand ig~yDb} 530 mg/~ Total Suspended Sol'uls ITSSI S30 mg/I- O NA Fecal Caliform lgaomeuic mean? 510' cfu/100m1 Maximum Effluent particle Size Ye in die. Q NA other: ANA *Vakrea typical for damestk: wastewater and septic tank effiuerR. Page __L._ ~ ~/ i cw- ~ tr s ~ - - ~ i Septic Tank Capsdtl- d~~Q ~ CI NA Septic Tank Menufactwar ~rC is t] NA Effluerrt Filter Marwfactwer Po I lsaC D Na Effk~ent Filter Model ,,s t7 NA Pump Tank Capaolty al 0 ~ Pump Tank Marxtfacwrer shy O NA pump Manufacturor G~.a i7 NA Pump Model ~ ©.NA pretreatrrtant Unit ^ NA p SandlCiravel Flker O Peat Rater p Mechanical Aeration ~ Welland O Dislnfeation O Other. Dispersed Celilsl O NA D in-Ground i9mvihrl ^ in-Gro~d i0ress~srizad) O At-Grade p Mom D Drip-Line O other: Ottrsr. O NA purer: Q NA Other. 0 !~ -- -- - Service Event 8aevtero mmrrthlsl ~, S ~! ' ^ NA inspect aandltion of tank(sl At least once every: and scum equals one-third lfr,1 of tank volume (] NA Pump out contents of tanktsf When combined sludge every: e t l mof ~ts1 t g yearal L7 NA inspect dispersal caUtsl . onc eas At monthtsl d NA Clesn eff~ent faker At least ante every: s! monthtsl ^ NA inspect pump, pump controls & alarm At least once every: `'r-"- p (a1 ' Q reronthtsl DNA Flush laterals and pressure test At least once every: '`- O tai t7 n,onthis) O NA other: At least ante every: _____ p ypartsl O NA MAINTENE-NCE INSTRUCTIONS one of tfre folbvving liaenaes or aartHioatiom inspections of tanks and dispersal cells shall be made by an individual c~anryTiersg Maintabert ~ Servicing opmM~, Tan Master Plumber; Master Plumber Restricted Sewer: POWTS .Inspector; hardw~~ M~fy ~„y crooks or Peaks an of the tanktsM to ~ onY ~ °f ~~ of t an the ground surface inspections must include a visual inspecti ndin measure the volume of oombhred sludge and scum and to check far any back up or p p~ ~ to ~sok for ,emY Po The dispersal ceU{sl gall be visually inspected to check the affluent levels in the obaeN a faitirr9 condkiorr and requlrea tb of effluent on the ground surface. Tha paw augtttority uent on the ground surface may indicate immediate natificatlon of the kcal regulatory ~ ~® of the tank volume, the eMi~ When the c~rnbq~e,d accumuiaNon of sludge and scum in arty tank equals one-third tY,l NR 11 O orator end disposed of in accord~e ~~ ~~~ contents of the tank shalt be removed by a Septage ServicinA P 1Niscansin Administrative Code. ~ponenta, pretreatrne AN other esrvices. int~ldht9 but not limited to the servicin~t of eff byre oertitied ~~ ~. unite. end any serviain9 at intervals of 512 months, shall be pert event. A eetvice report shau be provkfad to the local regulatory authority within 1Q days of comPlMl~ of any senriae START up ANn t~PERATIt)a For nsw construction, prier to use of the PQWTS tl~i~~ that may impede the treatment process and/or d ... of the tankls) removed by a septage servicing opeiiflr System start up shall not occur when soil conditicil~i~ -~ DurMg power outages pump tanks may fdt above .' ,. ~ =~ discharged to the dtapersal cetll$1 in one large dt~`'~ effluent. To avoid this situation have the coreterl.1Q power to the effluent pump ar contact a Plutnbar`: ~' .. restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispel~~1, within 15 feet down slaps of any mound or at-gratl~ I~p r~~ . ~'.. 'r--'~ e Reduction or elimination of the foNowing from th~l. pOWTS: antibiotics; Asby wipes: cigarette butts-:~ `~ foundation drain trump pumpl water; fruk and ` 'i painting products; pesticides; sanitary napkins; to " Pape _ ~of~/ ~~~~~ 4'tllr °!he prosence of painting Products at Other Oherrtioela ~,~~~~~~: If high concentrations era detected have the contents i'tltlve surface. j. . pn power is restored the excess wasteunratar will be • ! ~d ma resuh Irr the backup- or surtaoe discharge of ~,:, y by a Septage Servloing Operator prior to restoring '. ~. ` ' j-ti` .obi assist in manuaNy operating the pump controls to ~!~: ~Olv4~ ~+r ~tlrk over, or otherwise disturb or compact, the area l~prove the performance and prolong the life of the •, .degreasers; dental flora; diapers; disinfectants; fat; . ; ~• ~ ~ grease; herbicides; meat scraps; msdicatiana: oil; ABANDONMENT ~. When the POWYS fags and/or is permanently taka~ ~i~s~ ~ 'IkMrl~ ~fil 'itg steps shall bs taken to insure that the system is properly and safely abandoned in camp}ience wig :~{Iilf~i ~Ansin Adrrimistrative Code: a Ali piping to tanks and pits shall be diacattitilhll.,d ~~1~ ~ipe openings sealed. +~ i'he contents of all tanks end pits ahae be ' ~'~ ~ S +'~fi'~tl.~' ~ ~r~>~ rs7-ilf~f~sed of by a Septaga Serolck-$ Operator. .:.. • After pumping, all tanks end pits shall be ~!- ;+t. h+~-~'/N their covers removed and the void apace filled with soli, Qravel or another inert solid material. iCONT'MMt~NCY PLAN . If the i'Q fails and cannot be repaired the fWlp,~.` .. ~ r ` .•.~1nt~ , or must be taken, to provide a code compliant reptacem system: A suitable replacement area has bean evfil ~ ,~ .:Mrs , , , }1~~~~ for the aoatlon of a replacement soli absorption ^ A suitable reptacemerMt area is not avai~ll technology a holding tank may be instalbd ~~AO The site not en evaluated to ideriti>{~ evaiuatlon be performed to locate a ~; may b ails s a last roaort to replace.tf D Mound and at-grade soil absorption systel^ inilltretive surface. Reconstructions of such ttr soil limitations. Barring advances in POWYS • ~ ` ~; ,". •, flied PQWTS. •, '' ,~ , ~`~ ; ~. Upon failure of the PC)WTS a soil and site d. If no repfaceanent area is avaHabla a holding tank .F.. in place fallowing removal of the .biomat at the ~. the rules in effect at that Lime. < <WAi~lllNO> > ~ .>~.~ ' . SEpTtC, PUMP' AND CITHER TREATMENT TANKS , r •; '~ ~ ~ ; . td1ITER A SEPTIC, PUMP OR C?THER TRF,ATMENT,'~` ~ ~ ` .' . ~. y-• ~ ~ ~ ANOIOR INSUFFICIENT OXYGEN. DO NOT '~ ~ ~ITANCES. DEATH liA'AY RESULT. RESt,dIE OF A pEtiSCN FROM THE MI1'ERItNt OF A TANK MAY ilk :- ADDITIONAL COMMENTS ~, ~.~ POYVT8 NISTALLER Pfame ~ ( ~ G Phone `T /!' .r. ~ g .• / a ~,..~. sePT>a-QE ssllvtclNa ot~aroa 1PU 1 Nalt~, See. ~ Q ~' T_ Phone This document wag drafted In rotnpliance with chapter Cornni ~T~;,~It~~l system. The replacement area should be i ~ .,end compactbn and should nvt be irtfringod upon by required setbacks from existing and propob~. `walla. FaNuro to protect the re lacement area will }. F Y l T'i'.1'' ~ p result in the deed for a neW sap and site avii~ ~,; ~ ~ ~ 1}pbte replacement area. Replacement systems must comply with the rules G't effect at that time.:` f .'.:~ ,: ," ; ` . .. ~~~ . sT C i~.o r Gv. ~ Z ~ i~T . ~~ff~ rlina,.~. ~,Ital t 1, l2t & {3i. Wisconsin Administrative Cade. -7-73 S(o i - Plc U 2~i87P 113 STATE BAR OF WISCONSIN FORM 2 - 1994 Document Number f WARRANTY DEED This Deed, made between Willis D. Savadge. Grantor, and Grand Procerties LP Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): See Attached Exhibit "A". ?'StZj~37 KATHLEEN H. YALSH REGISTER OF DEEDS ST. CROIX CO. , NI RECEIVED FOR RECORD 01/07/2004 I1:LSAl1 MARRANTY DEED EXERT # REC FEE: 13.00 TRANS FEE: 3240.00 COPY FEE: CC FEE: PAGES: 2 Recording Area Name and Return Address ~ ~~~03--~~~~~ 020-1058-80-000 020-1059-00-000.020-1059-10-000.020-1058-90-000, Parcel Identification Nu ber (PIN) This is ~~ homestead property (is) (is not) Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. Dated this ~~ day of /l~'l ~ G~_ . * - --_^_ * Willis D. Savadg -- AUTHENTICATION i ~ ACKNOWLEDGMENT Signature(s) _____ STATE OF w _ ) ss. ~j(Q~~i County ) authenticated this day of _ _ ~ Personally came before me this day of _ ~ jn the above named - -- - --- `ttttrrr,~, Willis D. Savadge, * -_ __ - ~~~~~`, SAS?F ''~, _ __ TITLE: MEMBER STATE BAR OF WISCONSIN ~~~~ o / ~' _._ . _._ (If not, ~ ti . ~ ~ ~j td '~ ~'~nown to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Stats.) =~; ~ •~ ~/~nstt~ent and acknowledged a same. THIS INSTRUMENT WAS DRAFTED B~ ~• ~'j~-, ,' Attorney Kristine Ogland "%~,f'• • ~` Hudson, WI 54016 '~i,,,,, S!N • s~~ tary Public, State of /,SC ~/IV - ntttit -- My Commission is peor~manent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Botlt are not necessary.) , iii 9 _~__~` .) l~ * Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co., Fond au Lac, WI STATE BAR OF WISCONSIN 800-ti55-2021 WARRANTY DEED FORM No. 2 • 1999 0x/28/2008 10:20 7152472670 MIKE GERMAIN REMAX PAGE 03/03 GEA~NT(?R 1~lII..LIS D. SAVADt3~E GRA~T'Z'EE: GRAND PR4PERTiES, X.P ADD~QNAL PARCEL #'S:020-1459-10-000, OZO-1058-9Q-000, 02Q-1458-Sd-000 LEGAL DESCRIPT"lON: ll~a! pert ~ ~` SVIf % 22, T ip 29 North, Range 7 Court#Y. Wisconsin desan as fflUc>yus: Co menr.;n0 at the 5W c tt~ertoe t~9°57'27"E, mad beacing, along a South Ilhe of $eid ~ ~ f~ 01` beBin~9~ n9 the SE comer of at caertatn CertFFed S~ 4192; ~ter~e NOO°32`39 - slang the fast Ur~ of avid Certified S~sve Y of said SW 'Jti a ce of 493.73 tp the NE comer of S89°48'23"IIY, along the North line oaf sAfd rMied Survey llAsip, NOQ°32'31"W, a distance of 1447.58 feet; iV69°49'03"E, a dish the NW 3r crf said SV1f ! of Section ?.2; thence FI00°32'31'1N, along feet ~ ~ lntersediQh wit the East-West q~r fine of said Set~iOn FWest quarter i~ a of 13Q1.t)9 to its Int~erse#ion section 22; thence S 9'tf7"E, along said North-South gyarter line, tbmer of ~sald NE Y of %:, thence S89°A4 1"UV, along said So intersection wi#h the 1N Pine of the E ~ of $E % of said SW along said West tine, a Istartce crf 1397.44 to said South litre S$9°59'27"W. ~rlang said South 6ne, a distarr , Of fi49.27,fe~et to the p . West, Taws of Hudson, St, Cron that of said SW 'Y• of Section 22; %, a distatrcs of 92.51 feet to Map recoMed In Yol, 75, Page ~P~ ~n9 ~ lUast fine of the SW aid Certi#led survey Map: thenos a t~istance of 89.26 feet; ice race of 31.25 tact to the last isrte of mid West Pine, a distance of ~69U.84 Z2; thertae 1Y89°37's6"E, along said ~ the Narfh-South pastier title of said ~ distance of 1318.T1 feet to tha SS rn~, a distance of sas.go fit to ifs of Sedion 2Z: thent~e SUO°3~'61'E, rf the SW' % of Sewn 2Z: thence Ant of begtnnirtg. 05/28/2008 10:20 7152472670 MIKE GERMAIN REMAX PAGE 02/03 EXHIBIT. A _ , That part of the SW '!. of Section 22, Township 29 North, Range 19 West, Town of Hudson, St. Croix County, Wisconsin described as follows: Commencing at the SW corner of said SW 'l. of Section 22; thence N89°5'1'27"E, assumed bearing, along the South line of said SW '!, a distance of 1298.51 feet to the paint of beginning, being the SE comer of that certain Certified Survey Map recorded in Vat. 15. Page 4192; thence N00°32'31"W, atang the East line of said Certified Survey Map. being the East line of the SW 'f. of said SW ~<, a distance of 493.73 feet to the NE comer of said Certified Survey Map; thence S89°48'23"1N, along the North line ~- of s$id Certified Survey Map, a distance of 31.25 feet; #hence N00°32'31"W, a distance of 1447.58 feet; thence N89°41'03"E, a distance of 31.25 feet to the East line of the NW %. of said SW %. of Section 22; thence N00°32'31 "W, along said West line, a distance of 690.94 feet to its intersection with the East West quarter line of said Section ~ 22; thence N$9°37'56"E, along said East West quartec line a distance of 1301.09 feet to its intersection with the North-South quarter line of said Sectlcn 22; thence S00°25'07"E, along said North-South quarter line, a distance of 9318.71 feet to the SE vamer of said NE 3; of SW'/.; thence S89°44'41"W, along said South line, a distance of 649.90 feet to its in#ersection with the West line of the E 'l of the S>~ '1• of said SW '/. of Section 22; thence S00°30'51 "E, along said West line, a distance of 1317.44 feet to said South line of the SW '/ of Section 22; thence S$9°51'27"IN, along said South line, a distance of 849.27 feet to the paint of beginning. .` ' °°"""'"'` HUDSON ESTA ~` ~ ^~` TES ~ cWOaac srrr nip" ~° s~ia LOCITlD !N TBd Ndf/t OF TBB Sflfjt, PIRT OF T8d Sll/t OF TP8 SIf/<, PART OF . r sums TBd NIIf/t OF TEd SI1/t, /~yD PART OF TBS S-'1/t Ol TB6 Sit/t, Aye py SdCTION ~. 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