Loading...
HomeMy WebLinkAbout020-1472-00-006Wisconsin Depaiiment of Commerce PRIVATE SEWAGE SYSTEM Safety and Binding Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TC 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 Trust, Alwin Children Hudson, Town of CST BM Elev: Insp. BM Elev: BM Description: n TANK INFORMATION TYPE MANUFACTU R~" CAPACITY Septic t~c.w-t'f 2 ~' 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 PM Model Numb TDH Lift F ~ tion Loss System Head H Ft Forcemain L ngth Dia. Dist. to C/lll ARCCIRPTIflA1 RYSTFM T{L 1 -If4•fr. (/ r //le..._ !~'~ ELEVATION DATA County: St. Croix Sanitary Permit No: 499225 0 State Plan ID No: Parcel Tax No: 6Z6 ~ l~1ti - ~ Section/Town/Range/Map No: 22.29.19. STATION BS HI FS ELEV. Benchmark ,Q ~•~D al•1° f ~•O Alt. BM Bldg. Sewer ,A b'.'p ~ ,~ nsl~1 `~ • ISUHt Inlet SUHt Outlet r ~ 7 • ~~• 10/ 7 Dt Inlet Dt Bottom Header/Man. Dist. Pipe °~ G. 3a 3•~ 2. o' Bot. System , "1i D o t• RO' Final Grade 2 • y~ a~•~ I St Cover D f ice! • 1 ~ ~~ d r yV • ~+ s--~ ~ ~.~ 9g..8o DIMENSIONS Width 1 z Length Q, Q• No Of Trenches z PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufact / CHAMBER OR '~ (o INFORMATION Type Of System: ~NV' , e • .7 / !oo ~ / / UNIT Model Number S.v f11CTRIR11T1C11\I CVSTFM Header/Manifpld t/ Lengt Dia Distrib tion Pipe(s) Length Dia Spacing x Hole Size x Hole Spacing Vent to Air Intake ~ ~ S" ~ Cnll /'`/'\\/CQ __ .,____..__ c•..,.a,....... n.. r., .,., nn..~~.,.1 nr A4_(:rafla Cve}ams only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bedffrench Center Bed/Trench Edges Topsoil Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) inspection #1: NOII ~ ~ ~~ Inspection #2: %_ Location: 833 Germai ,Lpa~n~eHud on, WI 54 16 (SE 1/4 SE 1/4 22 T29N R 9~rJ) Cedar Wins Estates Lot 6 Parcel No: 22.29.19. 1.) Alt BM Description =~" t-'~~' ~ ~ ~~' ~~~ 2.) Bldg sewer length = ~-1 -amount of cover = l~ tr~ ~~ f C ml?~ • l D'~. ~ Q~~ ~ ~ StON Plan revision Required? Yes ~No ~~• ~6' ~ c Use other side for additional information. _ - Date Insepctor's Signature SBD-6710 (R.3/97) ~l S'z6 Cert. No. Safety and Buildings Division County~~ ~/ r 201 W. Washington Ave., P.O. Box 7162 ` ~ ~+^~ Madison, Wl 53707 - 7162 ~ Sanitary Pemni ~ umber (to be filled in by Co.} ~' (608) 266-3151 l .71a u~' I?epa a ommerce tary Permit Applic ionR E C E I V E D rovide ou ' l i f ~ pmt .D. Number n o Tn ac .~ Cotton 83 ? 1, Wis. Adm. Code, persona may be used for secondary purposes Privacy Law, sl p on y .04(1)(m) ~ Address (if different than mailing address) J T. Application Information -Please Print All Information ~ ~ 3~ ~~ ~ ~ ~ NTY t # - Block # Lo reel # ~ / Property owner's Name / n to / s ---- ~ / f N Property Locati property Owner's Mailing Address ~ y.,.S~%, section G ~~ ~. ~ City tau Zip Code / // Phone Number e~ // ~/ Vye ~- ~, L ~j T N. lj w ) TL Type of Building (check all that apply) Subdivision N e CSM Number ~ 1 or 2 Family Dwelling - Number of Bedrooms ~ R / ~ ~ ~~ ^ public/Commercisl -Describe Use ^City ^Vill ownship of , ^ State Owned -Describe Use ITT. Type of Permit: (Check only one box on line A. Complete line B if applicable) ~ ~ / N~71- A. w System ^ Replacement System ^ Treatment/fiolding Tank Replacement my ^ Other Modification to xisting System List Previous Permit Number and Dau Issued B. ^ Permit Renewal vision ^ Change of ^ Permit Transfer to New Plumber Owner 2 (~~. Z~ i i rat on Before Exp TV. T of PO`WTS S stem: Check all that a of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Glade ^ Single Pass Sand Filter ^ d ^ Mound? 24 iu . Non -Pressurized In-Groun Constructed Wetland ^ Pressunzed Tn- and ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit. ^ Recirculating wand AAFilt~~er ~~ ~~^ Recirculating Synthetic Media Fil Leachin Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain) Gl~'~/ '~. T)is ersal(rreatment A Tnforma 'on: System Elevatio ication Rate(gpdsf) Dispersal Area Required (sf) Dispersal ~~ Proposed (sf) ign Flow (gpd) Design Soil A-p-pl De ~ 6 'Vl Tan~o Capacity m Total Number Manufacturer ~~ Prefab Si ~ tee Fber Plastic Concrete Constructed Glass Gallons Gallons of Units New F.~6stmg Tanks Tanks Septic ar Holding Tank Z Aerobic Treatment Unit DosmS Chamber VTY. Responsibility Statement- T, the unders' ~utne responsibility for installation of the POWTS shown on the attached plans. mbar u N Business Phone Plumber's Name (Prinyt)~ Plum stare MP/ivipRS N, u~mbger / ~ / ~ Plumber's Address (Street City, Slate, i od / - J ~~ / C~ LL/ < se Onl VIII. Conn /De artment U Sanitary Permit Fee ~ eludes Groundwater Date Lssued T uing ant Signature o ps) ~pproved ^ Dis Surcharge Fee) ~~~, J •' S ~~ ^ O en Reason for Denial TX. Conditio p r /.Q ,(„ ~n SYSTEM OWNER: ~, 1 Septic tank, affluent filter and dispersal cell must all be ~ervi -ed /maintained as per management plan provided by plumber. 2. All setback requiremehts must be maintained r a ueaF~~ts uvoc,oi.,~~ ~~.~ ~.+..... Attach complete plans (to the County only) for the system on paper not less than 81f2 x 11 inehea in aim SBD-6398 (12..01/03) Soil PROJEC'1- Alwin Children's Trust Account SE 1/4 SW 1/4S 22 /T 29 /~ .t and System PLOT PLAN RESS 413 6th St. N Hudson Wi 54016 X19 W TOWN Hudson COUNTY ST. CROIX MPRS Shaun Bird 226900 1 1 /13/06 BEDROOM 4 DATE CONVENTIONAL XXX IN-GROUND P SSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 900 # of chambers 36 ,BENCHMARK V.R.P. Top of Look out foundation ASSUME ELEVATION 100' Filter BEST Filter ^BOREHOLE O WELL *H.R.P. Same as Benchmark Plans Designed Using Vent Conventional Powts SYSTEM ELEVATION 92.0/91.2 5' below grade Manual Version 2.0 >6„ ARC 36 Biodiffuser of Cover Leaching Chamber with 25.0 ft2 of Area 11" Well is to meet all 5' Long setbacks required by 3 6„ Grade at System Elevation WIi~NR Scale is 1" = 40' unless otherwise noted 2-3' X 90' Cells with >3' Spacing Germain Way I 10% Slope ~ 1 ~.e,~ Pro 4 Bedroom House B.M. 60 40' y~ Replacement area use original soil test 100' Survey stake found 0' ST 10' B~ a, Line 15' ~ 1~ ~~ Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT Page of m accoroa~c:e wnn ~.omm ao, vvis. ram. ~.cwe r County Plan must Attach complete site plan on paper not less than 8 1/2 x 11 inches in size t ~ I ~ . indude, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Re 'wed by Date ! Personal iMortnation you provide may t>e used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~~(p /O~ Property Owner Property Location ~ ~ / ~ Lot ~ 1/41/4 S ZZT ~~ N R E (or Govt . ~ . Property er's Mai ing Ad ress Lot # Block # Subd. Na or CSfvl# l ~ 1 ` ~ State, Zip Code Phone Number City tllage Town Nearest Road New Construction Use: Residential /Number of bedrooms _~ Code derived design flow rate ~'C7'"n GPD ^ Replacement ^ Public or ce merdal -Describe: __._____ _I _____ ______ ___ Parent material Flood Plain elevation if applicable ~/,~ ft. General oomrnerrts RE and recorrurrendations: 4 2006 y'~, v~~/ ~ System Type ~ ~/V NOV 1 Syste Elevation J~' Boring # Bonng pit Ground surface ele __ ft. Depth to limiting factor -~-~-~ in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Etf#1 'Eff#2 Z _ 3 --- a -- OS m i ~~ qZ.a q ~. o ~ .z - z Boring # Boring '' JJ/, it Ground surface elev~~ ft. Depth to limiting factor 7~/~ in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 C ~ z. ~ a ~ ~ ~ .~ 6 ( may/ l ,(~/~/ ' Effluent #1 = BOD > 30 < 220 mglL and TSS >30 < 150 'Effluent #2 = BOD < 30 mg/L and TSS < 30 mglL CST Name {Please Print) Sig CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 ~~ ~~,_ ~~ 715-246-4516 Property Owner _ Parcel ID # Page of ^ Boring Boring # pit Ground surface ele . ` ' ft. Depth to limiting factor /~ b in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 ,1 j ~------_ ,~ ,~ ~ a Boring # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure ' Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 ^ Boring Bonng # Ground surface elev. ft. Depth to limiting factor in. ^ Pit Soil lication Rate Horizon 7epth Dominant Cdor Redox Description. Texture Structure Consistence Boundary Roots GP D/ft= in. Munsell Qu. Sz. Cont. Cdor Gr. Sz. Sh. 'Eff#1 •Eff#2 'Effluent #1 = BODS > 30 < 720 mglL and TSS >30 < 150 mglL `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 need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. 580.8330 (R.N00) Safety and Buildings Division 201 W. Washington Ave. . Bo 716 County /~ ` r ~ •~-' Madison, WI 5370 16 ry Permit Number (to be filled in by Co.) ,SCO~~,~ (608) 266-3 L f Gt 22, Department of Commerce Plan I.D. Number Sanita Permit A licatlon rY PP .- ~ ~ __---_ ersonal information you provide Code Wi Ad 83 21 C , p m. s. . , in accord with omm s be used for secondary purposes Privacy Law ma 04 roject Address (if Ifferen[ than mailing address) , y I. Application Information -Please Print All Information Q3 ~ ~~- Property Owner's ame /I f~ /+` atcel # ~t # Block ailing Addr Property Owner's M ss/ n roperty Locati o \) C L ( ~ / City, Stat f ~ ~~ `--~~ Zip Code ~ C7 ~ Phone Number q Ircl ne) T~ / N; ~~E r W II. T e of Building (check all that apply) Q~ S M t Subdivision N CSM Number 2 Family Dwelling - Number of Bedrooms '" N~ ~~ ~ r~,~- v J ^ Public/Commercial -Describe Use ` ^ ^V lavnship of ^ State Owned -Describe Use ~ ~ -1A III. Type of Permit: (Check only one box on line omplete line B if applicable) '4~ stem ^ Replacement System ^ TreatmenUHolding Tank Replacement Only ^ Other Modification to Existing System t Previous Permit Number and Date Issued Li B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New s Before Expiration - Plumber Owner IV. a of POWTS S stem: Check all that a 1 X O ^ on -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-Gr and ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recircu ing Sand Filter ^ i ~ Recirculating Synthetic Media Filter ~ g Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain) V. Dis ersal/Treatment Area nformation: Elevati Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) Syst ~ VI. Tank Info Capacity in Total Number ,t Manufacturer Prefab Site Ste Fiber Plastic Concrete Constructed Glass Gallons Gallons of Units W/ p~J ~~E~ rT New Existing PP {tyi j4er ~-t l Tanks Tanks Septic of Holding Tank ~ S' Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the undersigne a e responsibility for installation of the POWTS shown on the attached plans. MP/MPRS Numb Business Phone Number ' s a Plum is Name (Print, Plumber ~~ ~ ~ ~ ~ / Plumber~ess (Street,, State, ~ ~, J -~ ~ VIII. Coun /De artment Use Onl Sanitary Permit Fee (in des Groundwater Date Issued Issuing gent Signature o Stamps) pproved ^ Disapproved Surcharge Fee) ~ ... ~ ~ ^ O er Gi ial ~ ~'1i ~~ IX. Conditions rov I Z 1 S~ C ~'~'~ SYSTEM R: 7J ~ 1 Septic tank, efflui~nt filter and ~S ~~~9+~. 6~,. ~c~ dispersal cell must all be serviced /maintained ~ es per management plan provided by plumber. ~ S c~ (p .p o,,: r~Q o-~,~ ,;Q,~~1.t~ 2. All setback requirements must be maintained as per applicable code/ordinances. ~ ~~, ~ vr..Q, ~ Attach complete plans (to the County only) for the system on paper not less than gl/2 x I inches in siu SBD-6398 (R. Ol/03) PRO3ECT Alwin Children's Trust Account SE 1/4 SW 1/4S 22 /T 29 MPRS Shaun Bird 226900 CONVENTIONAL XXX IN-GROUND 1150' ~ ~C~T PLAN ((ADDRESS 413 6th St. N Hudson Wi 54016 ~ 19~ W TOWN Hudson COUNTY ST. CROIX R URE BEDROOM 4 HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATI'r .7 ABSORPTION AREA 900 # of chambers 36 ,BENCHMARK V.R.P. Top of 1/2" pipe ^ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 92.9/92.7 5' below grade Alternate Benchmark Top of lie" pipe 5" above grade @ 100.0' / ~ -~' Plans Designed Using ~ /~ Conventional Powts 386' Property Line Manual Version 2.0 ~c9b / / 4 9' / ~~1.B.M. ~, 190' 2-3' X 90' Cells with Well is to meet all setbacks required by ~O 10' B-1~ 85, >3' Spacing WDNR l ~~~ 10/25/06 DATE CONVENTIONAL LIFT ASSUME ELEVATION 100' Filter BEST Filter 3% Slo B-3 20' B-2 35' ~~ 30' ST Germain Way ,Vent Go Scale is 1" = 40' ~ unless otherwise ` noted >6" of Cover 11" 5' Long 36" Pro 4 Bedroom House ARC 36 Biodiffuser Leaching Chamber with 25.0 ft2 of Area Grade at System Elevation PROJECT Alwin Children's Trust Account SE 1/4 SW i/4S 22 /T 29 MPRS Shaun Bird 226900 CONVENTIONAL XXX IN-GROUND [' PLAN DDRESS 413 6th St. N Hudson Wi 54016 N R 19 W TOWN Hudson COUNTY ST. CROIX 10/25/06 BEDROOM 4 DATE SURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 900 # of chambers 36 ,BENCHMARK V.R.P. Top Of 1/2" pipe ASSUME ELEVATION 100' Filter BEST Filter ^BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 92.9/92.7 5' below grade Alternate Benchmark Top of lie" pipe 5" above grade @ 100.0' / ~ -~' Plans Designed Using ~ /` Conventional Powts 386' Property Line Manual Version 2.0 ~p / 9' ~ / / ~ 90~ ~1.B.M. 3' ~ 2 ith X 90' C ll Well is to meet all ~ / - s w e setbacks required by ~~ 10' B-1~ 85, >3' Spacing WDNR l ants 20' B-2 ,Y30' ~ Germain Way Vent 3% 35~ ' 30' Slop B-3 ST ~, Scale is 1" = 40' unless otherwise noted >6" of Cover 5' Long~11 " Pro 4 Bedroom House ARC 36 Biodiffuser Leaching Chamber with 25.0 ft2 of Area at System Elevation t' . ~~CEI~/E[~ WlisconsinDeparlmentofComme ~,)~~ ji ~ AIL TI ORT Page / of~ Division of Safety and Buildings in accordance with Com is. Adm. Code County ~ ~ ~ ~ f ~D 1 . Attach complete site plan on pa not Ie~s1~41~xIl~Q~ IN~i~hes i size. Plan mus inducts, but not limited to: vertical nd horizontal reference in , direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. R ewes ~~ ~~ ,,,, ~ Date / ~ 7iv 6 l~ Personal information you provide may t>e used (or secondary purposes (Privacy Law, s. 15.u4 (1) (m)). C,(,~i' ~ ' " Property Owner ~ ~~ .~ ~-~~ ~ Property Lor~enn • ; Govt. Lot,~~ 1/4~'~1/4 S~~,T p~ N R 1 E (o W t• j Property Owner's Mailing Address Lot # Blod< # Subd. Name or CSM# ja1 ~y Sfate Zip Code Phone Number ^ City Village Town Nearest Road New Construction Use. Residential / Number of bedrooms ~_ Code derived design flow rate Y~~ GPD ^ Replacement ^ Public or commeraal -Describe: -------- -- ---'-- -_ Parent material ~~c~i.c/~-S~ Flood Plain elevation if applicable /~~~ !j' ft• General comments and recommendations: r.~ ~vri , ,.. Ong # U Boring Pit Ground surface elev.~_ tt. Depth to limiting factor ~~ in. Soil ication Rate Horizon Depth Dominant Cdor Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 31Z- S ~ ~ to s-- ~ ,-1Z Z lZ- ~ ,/ r J L ~ C ~ ~ " , l 3 y -~a S ~ m ~ ~ ~ ~>>~- ~ ? ,~ `~2. ® ~~ # U ~nng ~~ it Ground surface elev. t ft. Depth to limiting factor ~• Soil liption Rate t e T Structure Consistence Boundary Roots GP D/fF Horizon 1 Depth in. d~ ~a Dominant Color Munsell ~3~~ Redox Descxiption Qu. Sz. Cont. Color .__- ur ex Gr. Sz. Sh. c a c s ~ 'Etf#1 ~ 'Etf#2 ~~C? ~ /7--~~ ~/~ ~'~- ~ ~° `~ ~, _ _..an _ cn n . 'in ...nn n.vl TCC c ~n rrvill • Etfluent #1 = > 30 < ?20 mgll_ and TSS >30 < 150 CST Nine (Please Print) Bird Plumbing, Inc Shaun Bird Address 1008 192nd Ave, New Richmond, WI 5 17 CST Number 226900 Date Evaluation Conducted Telephone Number _ l ~ _ ~~- _ 715-246-4516 Property Owner _ Parcei ID # n n Page of ~~ # a ~n~ ,,Pit Ground surface elev. ft. Depth to limiting factor ~ in• Soil Rate ri fi re T xt Structure Consistence Boundary Roots GPO/ff Horizon l Depth in. ~Y ~ Dominant Color Munsell 0 3/2 p on Redox Desc Qu. Sz. Cont. Color ---` e u s Gr. Sz. Sh. ~ r ~r ~ 'Eff#1 'Eff#2 1 ~ 2 3 D r~ ~ ~ r c t_~.> ~~ # ~ Bonng ^ pit Ground surface elev. ft. Depth to liming factor in• Sal ication Rate i i D Te ture Structure Consistence Boundary Roots GP D/ff Horizon Depth in. Dominant Color Munsell on escr pt Redox Qu. Sz. Cont.-Color x Gr. Sz Sh. 'Eff#1 ~~ Boring Borng # Ground surhace elev. ft. Depth to Gmmng tatxor n ~. ^ Pit - Sal ication Rate T ture Str Consistence Boundary Roots GP DlfF Horizon Depth in. Dominant Cd Munsell Redox Destxiptice. Qu. Sz. Cont. Color exture uc Gr. Sz. Sh. 'Eff#1 'EfF#2 'Effluent #1 =BODE > 30 < 220 mglL and TSS >30 < 150 mglL ` EftlueM #2 = BODs _< 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. sen-a3w pt.~oor Soil Test Plot Plan Project Name Dave Alwin Shaun Address 413 6th St. N Hudson Wi 54016 CS #226900 Lot 6 Subdivision Cedar Win's Estates Date /12/05 SE 1/4 S W 1/4S 22 T 29 N/R19 W Township Hudson ~] Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 1 /2" pipe 5" above grade System Elevation 92.9/92.6 *HRPSameasBenchmark Alternate Benchmark Top of lie" pipe 5" above grade @ 100.0' 386' Property Line ~ ~b,( / ~ / * .M. / At1.B.M. 190' / ~ 85' 10 ; ~..a - ~ 20' / ~B-1 B-2 150' ~~ 98' ~ 3% ~ 35' 20' B-3 ~~ 97' Germain Way Scale is 1" = 40' unless otherwise noted . I • t ~ ~ ~ I o a ~ pNll~l~fn14 G3MInl i~[Ifx3~34 d05P 9~3 OCUJ57604 9 1 o DD 0570 _ LOT 2 d~ 2.61 AC. \ L.&O.-Y03.30 LOT 3 • ~NJDD QOO G~J I 2.71 AC. / ~4Q4C~~3 ~eo.~amso LOT 1 3.39 AC. Lsa-aasw \ \ ` / /~--==-_--- -0-- ~~ \ • / 2.35 AC. ~ ~ ~ , ~ , , „= ~ ; , __- 11 , __ -~ ~~as~ , A ~~ ~ ~ _ ... i ~ ~~ _ ~~~ \ --\~~ `: ~~`\~ ~~ ~ ~ ~\ . ~ ~ p ~ \~ \~~~aQ~~'wa.~,~ 1~\I\1~~ 1 ~ ORNNN6E EASfa41i 20 \ ~ ~/ LOT 5 g ~ ~ \~ O ~0 1111/111 1 1 ~ ~ ~ 1 ~ ~ 2.18 ~ ~ _ ~ ~,~~~~i LOT6 =~J v ~ ~ ~ ~ --- ----- 2.01 AC. ~ ' ~ ~ ~ LOT 8 ~ \ L.8.0.~.50 ~ _ -'\ ~ 2.66 AC. _ ~aa-sos.so • ~ ~ ~ '~ t.B.0.~91e.0o ~~~ ~\` GiINJO o `8'O'"903''0 ~~~ ~ ,-' ~ aw7~oew~wuE •- ~ ~qQq~ ----eaE~ ___ LOT7 ~ ~ ~~ dOOSP~ ---- 2.4d'AC=----- Lso..als.la taa-o1a1o 10o m ran.-alwao 1ao rn raoml ~~um I - - _ _ ~~ /'' L&0.~910.00 ~ ~' ~ ~ ' / 10o rn tna0 1x10 6005? 9 6030 ~ 909 ~ L,eo.als.lo PG1C~C~ 13~ / I 1 -- --- -- _- J -- I i r ` I T9 I I I I d o05P 9 ~1 ~_ ~ J REMOVE EXISTING DRIVEWAY CONNEC710N TO BADLANDS ROAD. ~ -- -- -- SCALE: 014 ~ Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in orderto extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4.Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 Co ency Plan Option # . If system fails, determine cause of failure, use alternate area and install new sysfem in tested replacement area. Option #2. Install system at a lower elevation, by removing chambers, removing biomat, and install new system. Option#3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 715-246-4516 St. Croix County Zoning 715-386-4680 Pumper Tom Mondor 715-246-5148 Shaun Bird #226900 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTTIFICATION FORM OwnerBuyer,~/~J ~ ~" Mailing Address ~~~ ~ v ~ ,v Property Address City/State s~~/.~ g33 ~ 9 rif ti aired from Planning & Zoning for new construction.) (Ve tca on req - , parcel Identification Number LEGAL DESCRIPTION ) • ~~ r~ C-c/ 1/ , Sec. 2 Z T ~N ~~w~ Property Locauo Subdivision Town of _7~~ _, Lot # ~• -- ,Volume ,Page # Certified Survey Map # 928n ~ ,Vol ~ 2~~~ , Page# S~-Z 'gVarra~aty Deed # Spec house ~ no Lot nest entifiable es no SYSTEM M[A,IlYTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handPe wastes~P aP oII ut into maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed umper: Y P the system can affect the function of the septic tank as a trea P enc stage in the waste dy posal sys~~n~w'n~ maintenance responsibilities are specified in §Comm. 83.52(1) and in Cha ter 12 - St. Croix Count Sanitary The property owner' agrees to submit to St. Croix County Planning & Zoning Department a certification form, Ssit~ by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper venfymg that (1) wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), ~ sepuc tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. CIOiR County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify. that all statements on this form are true to the best of mylour knowledge_ Uwe am/are the Owner(s) of the ~irope describe e, by virtue of a warranty deed recorded in Register of Deeds Office. /~~~~ i __ s'' DATE SI ATURE OF APPLICANT(S) *** Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zotung Departmer-t.*~* Include with this application a recorded warranty deed from the Register of Deeds Office and a cogy of the certified survey map if reference is made in the warranty deed. (REV. 48/05) ..` U 2787P 572 792801 liA?HLEfi}I H. >tA1.SH ~ ' State Bar of Wisconsin Form 2-2003 REGISTER OF DEEDS ST. CROIX CA., NI WARRANTY DEED RECEIVED FOR RECORD Document Number Document Name 04/21 /208.5 09:30AM 11ARRAH?Y DfiED EIIEMP'1 # THIS DEED, made between Amy E. Roettger formerly Amv E. Alwin. REC FEE: 13.00 TRANS FEE: 779.70 ("Grantor," whether one or more), COPY FEE: and Alwin Children, LLC, a Wisconsin Limited Liability Com~a~ CC FEE: PAGES: 2 ("Grantee," whether one or more). Recording Area Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant Name and Return Address interests, in St. Croix County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): See Attached Exhibit "A". ~~l_l~.\ 1 C~'U t L CA1) ~ 020.1059-30-000 Parce] Identification Number (PIN) This _ homestead property (is) (is not) Excepti(o~n(s to warranties: Easements, restrictions and rights-oi way of record, if any. Dated -1 r~ ~ ~~) S (SEAL) * *Aroy E. oe tger formerly Am . Alwin (SEAL) (SEAL) * * Signature(s) _ authenticated on AUTHENTICATION * TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stet. § 706.06) i ACKNOWLEDGMENT STATE OF \~ ) ss. _ ~ ~~ COUNTY ) Personally came before me on the above-named Am E. Roett er formers Am E. Alwin to me nown to be the persons who executed the foregoing THIS INSTRUMENT DRAFTED BY: ins nd aclcn led the same. Attorney Kristine Oeland ~ Hudson. WI 54016 Notary Pu lic, State of My Commission (is permanent) (expires: (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ®2003 STATE BAR OF WISCONSIN FORM N0.2-2003 " Type tuune below signatures. INFO-PROTM Legal Forms 800-655-2021 www.infoproforms.corn Tracy L. Turner Notary Pubiic State of Wisconsin U: 2787P 573 EXHIBIT "A" The West 100 feet of the South 207 feet of the E 1/2 of SE 1/4 of SW 1/4 of Section 22, Township 29 North, Range 19 West, St. Croix County, Wisconsin EXCEEPT that part to Town of Hudson in Vol. 926, Page 613, Doc. No. 476872. Also, that part of SE 1/4 of SW ~4 of Section 22, Township 29 North, Rangge 19 West described as follows: Commencing at the S 1 4 corner of said Section 22; thence North 90 degrees 00 minutes 00 seconds West, a distance of 655.00 feet; thence North 00 degrees 00 minutes 20 seconds East, a distance of 207.00 feet to the Point of Beginning; thence North 00 degrees 00 minutes 20 seconds East a distance of 732.98 feet; thence South 89 degrees 59 minutes 10 seconds East a distance of 307.00 feet; thence Southwesterly tv a point 288.00 feet North 90 degrees 00 minutes 00 seconds East of the Paint of Beginning, thence Westerly to the Point of Be inning EXCEPT that part to David D. Alwin in Vol. 2604, Page 121, Doc. No. 767103. (Parcel I~ - ` - LOT 3 LOT Z 2.706 ACRES ' 2.61o AcR~s 117,860 so. FT. 113.704 9Q fT. LB.O. =905.5 LB.Q -903.5 >* ._..._..~'. _.. LOT 4 . ,,,,, , 235 ACRES ~ ~; ~. ... 102.155 SQ. FT. laIPMNAE.IE l' EASIz'A/E]YT ~ ' - ~~ •~t a ,~ ~\ 20' INIOE ~~. ~ t~?`,qs. ~ ~ EASEMENT H.OkE. • ••' ~ ~ ..... ,• ~ ~ ~ Z4 334. C3 ,d~~ t '~ ~~, 15.5 DRA/NAGE - ..... \ -\ ~~ ~•..••, -\ LOT 5 ~•EASEA/ENT G" - 21#E ASS '''' ~ .............~ I N f H.W.E. = Z \ 96.4*7 SQ. FT. 903.5 of ~ ~ ~ C L8.0. =905.5 ~ 7r ~~~..~-. 4 LOT6 ,,~ 1 ~.- LOT 7 2.391 ACRES 104,160 Sc~. Fr. L8.0. =905.5 OR 915.1 SEE NOlE BELOW ',.f4 f-.s.,. L.B.O. = 915.1 ~ 1.1 ' /A6E EASEMENT F" ~ i~ iV :E = 913.1 ~~ i i 012 ` ~ s , 9a. ~. a~. ~.e.o. - 9oQS oR 916.0 '~ ~..~\ soE Nom e~w EAvr ~E"~\ t..4.0. - ~'' - 916.0~ EZ ' H.W.E. _ ~~, \ tree ss~ cs 914.0 0 a N wv v ~ w ~. T.r . r r.. I •~ ^,~1 (N89'50'46"E 491.34') ~"~'~~~ ~°^ DRAINAGE ~ ~~~ ~ EASEMENT ~ ^ M ~~h _L~OO ~ ~ C~ _~ _[~l _~~J_ ~A aE FINE D/sr. ~Oo ~o ~ ©pC~o ~~~~ E1 S89~105"w 230.74' ~ ----------------- E2 N7176'13 E 191.63' r ., _ E3 S391~5'35 E 77.8.3' I I ---------------T------~ ~~~~.~ ~~~1~~~ ~ c~vip 3~~ d r_ I 0 c .. ~ ! c o ~ ~ 3 ~ '* `~1 I 'v ~ ~ 3 " m ~ o ~ # ~ ^ \ 1 ~" :.. I ~ n 3 _y f~D N N O ~~ 2 ~'', ~ C N ~ ~• p j ,~ ~' a ~ 5 5. c .+ > > m y , cc N ~ n ~+ co p \ I N a m Q Q y ~~ ~~ ~ I ° ~ ~ 1 o ~~ ~~~ 0 ~~ O ~ ~ O ~ 7 N d d - .. C ~ !~ v w (n z D ~ ~ ! ~ a ao e~ m co D ~' a w `C c a W ~ I ~ ~ r. o m ~ ~ I ~ a ~ °' ~ • o °o °o ri n r w 3 M Q • z O O O y ~ ~ a 3 c~ to to ~ m I -- ~ ~ ~ v v, _ m a ~ ~ d z o ~ y c O D ~ ~ ~ ~ ~• y l~1 ~ ~ ~• ~ ~ N d ', ~. ~ m Q 7 j m ' ~ -+ -1 N A Z O I ~' c ~ 70 ~ n i' Z ~ I ? I .. W~ f0 ~ N m N N o, ~ GO -' z c g A c to ~ 3 N m ~ Z N _ ~ a Q ~ c G O - ~ C o a I N ~ c A O A Z C N O a ~ O ~ :" ~ ~ R N O ~ O - ~