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HomeMy WebLinkAbout020-1395-42-000Wisconsir.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) Permit Holder's Name: City ViAage X Township Carria a Homes Inc. Hudson Townshi CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic /~1JD Dosing ~ / ,.r~~ (D , V Aeration I.U Holding TANK SETBACK INFORMATION TANK TO ~!L WELL BLDG, Vent to Air Intake ROAD Septic ~~ / ~ ~/ ~,~ f Dosing t 3 ~ v~e.:.t.-F--an Aeration Holding PUMP/SIPHON INFORMATION r~ TDH Lift ~ Friction Loss Systevh H~a ~ . ~i Forcemain Len th~ / Dia.~ ~ Dist. to well SOIL ABSORPTION SYSTEM 22~ ELEVATION DATA STATION ~ ( I • su BS HI FS ELEV. q7 Benc$a~~ a~~ /D1,3 p 90 ~~01 Alt. BM 5.r 9G-qZ Bldg. Sewer p• ~ SUHt Inlet / I ~~ ~~ O~ SUHt Outlet /-r- Dt Inlet _~ ~~ Dt Bo '~ ~ Lv y 93 8~-yu He a Man. ,~ ~~ \ ~ R 3• ~ _~ Dist. e ~ .Z -~ . S-D 9 f Bot. Syst 1 ~ ~ 4 •d Final Grade • ~ 7 ~0'~ St Cover / rrG S d'-1- ~ ~ ~ ~ lp'~s~-rrn s) l ! ~Ct ~ -Lt e,,. BED/TRENCH DIMENSIONS Width ~ y - t Length ( l~ No. Of Trenches ~ PIT DIMENSIONS ,,~-~'~ No. Of Pits Inside Dia. Liquid Depth SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manuf cturer/• Ll J ~ INFORMATION HAMBER O 71 '~77~~[ r ~-•- Typ~Q f System: ~-N r ~V ~ ~ ~ ~ ~/ /~~ t r Mo el Number: /~ A DISTRIBUTION SYSTEM Header/Mq„nifpl Distrib~ I Hole Size Vent to Air Inta vs '' ~ ~/ S U1r~. SOIL COVER x Pressure Svstems Only Yz Mound Or At-Grade Svstems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded u ched Bed/Trench Center BedlTrench Edges Topsoil Yes ~ No 0 Yes ~ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: I ~ / ~ / ~ v Inspection #2: I / Location: 721 Regal Ridge Hu/d'son, WI 54016 (NW 1/4 SW 1/4 25 T29N R19W) Scenic Hills Lot 42~ Parcel No: 25.29.19.2436 7.) Alt BM Description = s~ ~ ~- R,elrl S-2 aPP ~ -~° I~N.C.+~~d~ ~/'--~' fit c~~, ~Sb `~ 2.) Bldg sewer length = ~,~ I 3y5~ Ili ~-~'~~G F~ " ~~~) Irl~-P.t<'l/~/~ 'T/ !'~~ - amount of cover = ~5 i -~~ G~ ~~ "~' 3 ~-~r Plan revision Required? Yes ^ No Use other side for additional information. Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) ~~~ G~^ ~ ~ ~ ~ /~~ ~~~~~ /- ~~ br;, rii~ru~ t~n-~j P'•fa.2 r Safety and Buildings Division 3A1 W. Washington Ave.,1'.4• Box 7162 ~consfin I-fadison, WI 5370? - 7162 ~ ~e e srtment of Commerce 4 z- Sanitary Permit Application In accord with Cotttm 83.21. Wia. Adm. Code, personal information you provide tpiy be usod for aecoadary tws Privacy Law a15 W(!xm) I. App4catioa Information -Please Print Alt iaftmaatlon Property Owner's Natter e County ,'~~ ra ~ ~ Sin-c-7Adttress /~ ~~ 1 oZf ~i ~ Sanitary Peratit 14umber ~'" ^ Cbeck if Revision ~~ J D5 State Pisa 1.D. Number _ / Parcel Number ~~ /~~ s ~a'G-( Properry Owaer's4'dailiag Address - ~' f,ya.fc~ ~~vGL I C UNTY ~SG+>',~:S o~L,'~T ~aJ Ti.R ~ 7 ~ Lot Number ~ Block Number City. State Zip Cade ~- Subdiviaion Nante CSM Number cr G ~ ': ~ ~ ls' S~ ~l`GIJd 7`t Y r SD ~ O ._..... II. Type of Building ( al{ that apply) ^City ~ ~ ~~~ ^~ ~1 or 2 Family Dwelling -Number of Bedrooms . ^ publidCornmercial -Describe Use ovmshi ~. d .mod r1/ career Road Q~ State Owned ~e d a.l ~ ' ~9 -C- ~ of pelt; (Check only one boa on line A (atttnbeting schtttne for itttsraal ttse?• Fot i ~ New a ^ Replacement System 3 ^ Teeplacetnent of 6 ^ Addition W --.._._. a~ictina system Chcolc if Saalntty Permit previously issued rv. of Permit: (Check all that apply}(nusnberlnp ~ ~,~~ _pr~~ ~~ 2101 Mound ~ [] ptesauriud in-Ground 41 ©Hoadtrsg Taak 45 ^ At-Grade ~' ^ '~°rob ~ ~ ~p~~ Arse y~~ ~ ~~ ~ or V'II. `~~' a ~-n S'c `1 a-~'- ~ pber'e Address (Street, City, (No Approved ^ Disapproved Stitrcbarge F~ ~ ~/ ~~y 1 ~ D ~~~ ^ t)waer Given Initial Adverse ~ ~ S'. Determiaatioa y~y'LG(',lr; ,$~,~5 1X. Conditions of Apptcoval/Reasoas for D oval ~~' ~"~" 0 ?~ ~ /~~'~ ~ .~ cees otaaa (to tea C~4 nob) for the a~en- 4a paper not ka>'than ESfZ x ll tcha to ai~e tree Bit me is for internal use) Cf~~ 3 ~.~C (Og ', l / L' /~~.,~''' 47 ^ Sand Filter ~' ©Constnt°ted Wetlatd ~ T `'`~~~~ ~ ~ Single p~ 51 ^ Drip Line Salt 49 ^ Recircula ~ ~ ^ Otkus ~ ,tit. G YS .s ta. ~ - . z Percolation gate System Elevation Final Grade 3~, J Soil Application Elevation y~~~ Rate(t?ala./DaY~~I•~~y (M~./iach) Propossd 9~. ~~ - 9~ ~~~ 9~ ~ ~ Mutufacturer Prefab Site Steel Fiber Plastic Total Number _ ~/BTSPFZ.~/ acrete Cottatr+tcted Glass Galioas of Tanks ~ ~.~^~, ~~~ tog - ~yclyriat4~li ~t0 ASP a l .~GS e v ~ ~~~ as~me for on of the pOWTS sltawa on the attatrhed tans. /t~II'RS Number Business Phone Number pitttaber'a Sigasttue e i ~~.,n.-. ., 715 3tf'~- ~/~/ SBD-6398 (R. US/O1} 1 .~ v h ~/y / /~,R~!/G f/~1, a u .~ ~` . `~ Y~ .v",V' ~i ~\~,~ \, ,'~ ,~ ~~ s 1.~~^' I liS ~ S, ~ ~'c ~~~r~ G _~ ~, r , ~~~ ~ ~` ~~ 4 0 ~ ~ ~ s ~ 1~ ~~~ 1 ~~c' ' ~~",~_ Ov~~~ / l ~I Wisowrsn Department o(Commerae - SOIL EVALUATION REPORT Division of Safe:y and i3uikl;ngs Page I of m accordance wdtr Gomm 85, Wis. Adm. Code ' i i 1 i t M s crop ze. rx~es n s 1 Attach complete site plan on paper not less than 8112 x an mus indude, but not limited to: vertical and horizontal and p~oei gyp, . ` percent slope, scale or dimensiwrs, north arrow, _ ~ nearest road. Please print aN i ;~, R ~~ . Persona! information You provide maY be used for " -' ~ ~ , s.1$:Q4`t1) (m)).. ~.(,(/Yr/J~~ ~ "J Q property Ouvner Prope . Locatron - ~'^ ICJ Y `. ii -~f JUG 2 _L ,V~,,! 114$1 114 S ZST Z~' N R f E(or property pNmer's 6Aai6ny /oddr+ess ST CRCN X ' Lot,#`- Biotic # Subd. Naur~e or CSNfIf CO ~ Z.© S-E i ~ ~ WC~'~-e WNTY .. ~~ S e City State Zp Code P dy ^ V~lage [,~ Town Nearest Road - - ~STi: I l wa.}-cr VY1,~.. ~'S"o ~Z ( s' ;. ~ ~~. - s ,•., n r~c0 ® New Consfrudion Use: ® Residential / Number of bedrooms 3 _ ~{ Code derived design flow rate D SO llo O Q GPD ^ Reptaoernent ^ Public or cornmer+ciat -Describe: Parent material OU ~-c.J0.S 1.~ Flood elevation if applicable !~v 9. ! O {L General comments S S ~ rYt L., l e. J 0.f •~ n - ~Z' ~ ~ ~ 7 ~~ ~, ~~ ~r ~ ~Y~: -, i C I ~~ , ~G~ I~G~~~- and recommendations: o v _ ~ _ I . ., -r ~ ~ ., - ,, , - ,~ , .-- ~~y , { - ~ t~- ~..~. r~ ~; ~ ~~ ~ ~t ~ ~ ~~ ~,/ ~ /_,~ r (~ ~2~.,7 ~i~~-'t•N~ - _G:.1 "YJ_ ~ i~ ~'Z~C_ L~ ~~ ~ ~~ ~,~)~+'l- ~ {-~, G?? L -L Cs ~.~; Z + ^ Borfig ~-- _~--~ ~., ~~ # ~ Pit Ground surface ~~ o ft Depth to limiting factor ~ I Jr in. Soft Rate Horizon Depth Dominant Cobr Redox Des n Texture Structure Consistence Boundary Roots GP D/fP , in. Mansell Qu. Sz. Cont. Cobr Gr. Sz. Sh. "Etf#1 'EtT#2 d-, 5~~ k ~~ ~ „r .5 . $ z i -4a - s-~ Z cbk ~s - .4 . ~ 3 40-u5 m5 ~ 5 - .1 /. Z . 2•~~ Boring # ^ Boring .. '~ "~ ® Pit Ground surface le S G U " fL ' Depth tD limiting factor 12-U in, ~ ~~ horizon Depth Dominant Color Redox n Texture SWdure Consistence Boundary Roots GP D/fC~ in. Mansell t]tr. Sz. Cont Color Gr. Sz Sh. _ 'Eff#'1 •Et'f#2 ~ v - _~ si .l 2 c. 1 ~ .~ 5 ~ s • ~fev 2. o - 2 ~~ j a t (~ `~ ~.~ rte..: ~ .... Sys - s ' Effluent #1 = ~D_ > 30 < 220 mall and TSS >30 < 1 50 mo/L ' Effluent #2 = BOD . < 30 mgll. and TSS < 30 mg/L CST Name (Please Print) S" nature CST Number e.r 253 D Address Date Evaluation Conduced Telephone Number i Property Owner 14.C' kG ~ ~ Parcel ID # . Page Z of 3 Bonng # ^ ~~ ®Pit Ground surface eIe : q~ ~ ft. Depth to limiting iac~or ~~_ in. Soil lication Rabe ri H D th Dominant Color Redox De n Texture Structure Consistence Boundary Roots GP D/fr? zon o ep in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh: "~ 'E ~ -~5 l~ ~ --- Sil Z bk -{'r ~5 Ivy ~ 5, • ~ 3 ~+2-~~ 1~ ryllo - rns. S y - . `t ~. 2 - -~ ~ ~ ~~ _. 3• " ~~ # ~ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil ication ~~ Horizon De th Dominant Cobr Redox Descxiptian Texture Structure Consistence Boundary Roots GP D/ft' p in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 *Eff#2 ^ Pit Ground sucFaoe elev. ft. .Depth to limiting factor in. Bonng # ^ ~~ Soil lication Rate Horizon th De Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots GP D/ff p in. Munsell Qu. Sz. Cont. Cobr Gr. Sz. Sh. •Eff#1 •Eff#2 " Effluent #1 =GODS > 30 _< 720 rrx~ll. arxS TSS >30 <_ 150 mglL ' Effluent #2 =13OD5 < 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. seD-ssso tR.mrooy Paoperty owner A.r k~ ~ i ParcellD# -- ~ z °~~_ Bores ~ ^ Boring 3 ®Pit Ground surface~~~ Depth to I'xniting factor _~_ in. soy Rabe Horizon Depth Dominant Colo Redox n Texuun: Structure Consistence Boundary Roots GPDIIf in. Mansell Qu. Sz. Cunt Colo[ Gr. Sz. Sh: ~~ ~ ~ z -)s -- 4Z i I I y - -- sit icl Z bk 2rrY,, -~~ ~s__ ~ ~~~ -- . 5 - g ~ 3 42-i 1D ~ylly - rnS _ 5 . ~ __. .- .`2 I-2 _.. _ `~ ~, ,~ __ . 3 • ~' ~~ # ^ Boring ^ Pit Ground surface elev. ft. Depth >b limiting factor in. ~ Rabe tior¢on Depth Dominant Cob Redox Descxiption Texture Structiune Consistence Boundary Roots GPDVff in. Mansell Qu. Sz Cont Cobr Gr. Sz Sh. ~Eff#1 ~ ^ Pit Ground surface elev.,~,ft. .Depth to limiting factor in. ~~ # ^ ~9 Sod Rate H i th D Dominant Redax Description Texture Strucxurie Consistence Boundary Roots GP DJfi? or zon ep in. Mansell Qu. Sz. Cont. Cobr Gr. Sz. Sh. * *Effli!2 • Effluent #1 =-BODE > 30 < 220 mglL and TSS >30 < 150 mgll. * Effluent #2 =BODE < 30 mglt. and, TSS <_ 30 mgA,. 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. SBDi330 (807/00) PAGE ~ OF~_ NAME 14 r K-e-, + LOT# yZ LEGAL DESCRIPTION,Vw `~4~f4,S2s TZq N,R I q E (or~ SCALE: 1"= yU , BM 1 ELEVATION SOD • ~ BM 1 DESCRIPTION~op o ~ I z Pic P'A~ BM 2 ELEVATION q ~, CQ ~ BM 2 DESCRIPTION ~ p a ~ ~ z j> UL Q ~ {~ ~ c.Z~ ~ i~ ~~ G~~ Q ~~ M ~ ~ , • i ~ Y Y~ T¢r S3 , a ~ . ~ '~ ~~ o s ~ -~ ~'~ ' ~ ~'` t ~ ~~ - ~ t:~ ~: ~~ ,_c~ ,. ~, g ~w .. ~.. ... .._ ~ ~~ '~flSCs~ .. ~,:- f a .g~ r~ r F • • { ~ .~M ~ ~ ~ ~ M~ ~~ ~~ ~ y ~~~ ,~ ~ ~~ ~~ ~ m :~~~ ~~ w ~ t'3 ~a~ ~~~ ,~ ~ ~ ~ ~ ~' ~ • ~ ~, ~' ~ ~ r-. ~ I i i ~~ W ~' h chi ~ Invest i 1'---i~ ~k ~~ i~ ;.. ~r i .. ~, . ,. ,.. ..,.. • ~ - ; Q- ~ IOC} ~ - ''~,~.• ~ ±~'. ~~;,~ / ~ ~• / ' i ~~ \ ~- ~ ~ ~ ~,. -- ~ " ~' %'r ; ~ ~ ' , ~ 99 ~ ~ ~~~ ~ X ~~ ~ ~t ~ ~ ~ ~ ~ ~~ ~/"~ ~'~ ~ ~ ~ 99 ~~.r~ ~ ~~, ~ r~ ~ 1 ~"'; ~ ~' %~ 3~ 6 ~ ~\ IJ ~ . / ~ )~% 03 l ~~° r ;~ , ~` 9 .4 '~ ,/ ~ ~ X/102 .4 237 `-~; 104 ~ X ~~~ ~ ~ ~. Q 1006 Q ~ ~-,", 14 ~,: ~~ C 1 x , •';. , 103 .8 ; ~ .. ,mpg ', •., ~ ~L r. t 0 .9 "-` ~ 1014. '. t q22. i , .5 A ~ ~ , ,.~:. ~ ~ .~ ,, , / / ,• o ~~ x x~ x x ! © 1 /r \ ~ ~ I - ` ~. ~~ f ~ ~~ ~ ~ ~ ~ ~ ~ ~~ ~ ~ J~ ~ ~~~~~ ~~ A~ ~~~ ` ~ ~ ; ~ / 1014 Q ~ 1 \ ~ /i ~ . ;~ ~ ~ k ~~ - ~ ~~ ~ ~~ ~~ ` l I ~ ~ ~ ~, ~ ~ \ ~ ~ 1 ~ 10105 - ~ _ ---~~ ~ ,, ~~ A ~,i ~~ )05.7 X ~ ~ ~ ~ `t' 10 7 , ~ ~ ~ j` ~ ~ ~ ~l ~i ~ ~ ~ l 1!~ y~ I ~ S,OU TH ~j.Pd ~~ 1 ~ ~ ` ----- t O t'~.>~ 1 ~~ ~ - - X ~\ ~,' ,~~ ,' ~~ ~~ ZONED 1~1/11%2~J~J1 14: J( 1!1'J~ob~lZb~ l~Jblll ill- IIUU'~ull ~"'~''a~ ~~~ •-- ~. i t ` ~ ERt~R10N C4NTFtUL .PLAIN CI-1T~CKL.1~'I' ~+ Check (.~ spproprtate boxes befow~ and pornpiste the xite diagram wtth necessary Intormatiort. Site characteristics North arrow, scale. and site boundary. Indicate and name adjacent streets or roadways. p ~ Location of existing drainageways, strearns, rivers, lakes, wetlands or wells. ^ • ~_ (_ocation of storm sewer inlets. ~' Localiort of existing and proposed buildings and paved areas. ; ~ 'Tits disturbed area on Ih9 lot. 1~I Approximate gradient and direction of slopes before grading operations.` ,gg Approxtmata gradient and direction of slopes alter final grading operations. ' p ~g~_ Uvetiand runoff (sheet flow) coming onto the site from adjacent areas. Erosion Control practices p ~ Location of temporary soil storage piles. f-Mte: 3a7 storage plies should be plat®d behind a sedmsnf lance, d f0 loot wipe vegetaf/tre strip, or should be covered with a tarp or more than 251eet I-vm any downsbpe road or drainageway. t"i (~} Location of access drive(s). ' '. f+lcrte: Access hou-d extend Irom~he ro ~sy 50 seat orto~lhe house loundatlon tcheverr isrless) ~~ Drives s p ~ Location of sediment controls (tiller fabric fence, straw bale fence or 10-fool wide vegetathre strips) that will pre- . vent eroded gall from leaving the site. • p ~ Lacalion rai sediment barriers around on-site atvrm sewer inlets. [~ •~( L~ooation of diversions. Note: Although not specifically required by cede, It is recommended that concentrated flow (drainageways) ba diverted (re-directed) around disturbed areas. Overland runoN (sheet flow) hom•adfacent areas greater than 10.000 s4 h. should also be diverted around disturbed areas, p d L.oCaiion of practices that will be applied to control erosion on steep slopes (greater then 12% grade). Note: Such practices Include maintaining existing vegetation, placement of add)tienat sediment fences, diversions, and re-vegetation by sang or by seeding with use of erosion canlrol mats. p a Lacgilon of practices that will control erosion in areas of concentrated runoff flaw. Note: Unstabr~zed drainageways, ditches, diversions, and -nlets should be4 protected from erosion through use of such practices as in-channel fabric or straw bale barriers, erosion control mats, staked sod. and rock rip-rap. When used, a given in-channel barrier should r-ot receive drainagbeelrosmtH ~~ !~ ~re~ ~ stareams (s~tr~ ems area, or one acre of paved area. tn-channel prgcflces gf with year-round llow.) [~ ~ Loc>gliQn of other planned practices oat >~Ireedy Holed.... 10/11(1J~J1 l~:~J/ 1l1~3ob4Lb~ I~J!dll OF FUJU'~Ufl ,• ~ .; Ittdlcate mrtnagoment strategy by checking (./y the approprtats box: ~ Management Strategit~s IJ:+!a~ ~J~I ~h S~e~-t ^ ~ Temporary stabiNzaUon of disturbed areas. IVofe: n !s recommended that disturbed Areas And soil piles IeR 1nacNve for extended paNOds of time be slat~ized by seeding (between April f sf And September 15th), ar by other Dover, such as Carping or muiching. ^ permartern stabilizalio~ of site by re-vegetation or ether means as soon as possible (lawn establishment). incRcate re-vegetation method: Seed ^ Sod- other O Expected date of permanent re-vegetation: . r~'h ~~ `"~ ~"~ ~--- . Re-vegetatlon rasponsibitity ot: Builder~_ t?wneNBuyer ^ is temporary seeding or muk~ing planned it site is not seeded by Sept. 15 or sodded by Nov. 157 Yes O No O D Use of downspout and/or sump pump outlet extensions. Note: !t Is recommended that Ilaw lrom downspouts aril sump pump outlets be routed through plastic drainage pipe to slatshe areas such as established sod or pavement. ^ ~ Trapping sediment during dewatering operations. Nate: SedimenWaden discharge wafer Irom pumping operations should be ponded behind a §ediment barrier untfl mast of the sediment settles out. pr er d) al of buildinmaterial waste so that Ilulants end debris are not carried ofi~ite by wind or water. ~ ~ ~ 9 po . ~, ~ i~ Maintenance of erosion control practices. ~, • Sediment Ndil be removed Irom behind sedfinent lances and barriers before tt reaches a depth that is epual to half the barrier's height. ~ . • Breaks and gaps in Sediment lances and barriers will be repaired immediately. Decomposing Straw bales wig be replaced (typical bale file is three months). Ali sediment that moves oil-site due to canstrtictton aallvity wilt be cleaned up before the end of the same workday. • All sediment that moves aH-site due to storm events wt~l be cleaned up betare the end of the next workday. • Access drives will be maintained throughout construction. • All installed erosion control practices wilt be maintained uritit the disturbed areas they protect are stabilized. For mare assistance vn plan preparation, rater to Chapters ILNR 20 & 21 of the Wisconsin Uniform DVveilin9 Cade, the bNA Wisconsin Construction Slte Seat Managomant Handbook, and UW-Extension publication Erosion Control for Home Baiiiders~ Ths Wisoortisin Uniform Dwelling Code and the tNlac~onsin Construction Slte Best Management Handtyoak are available through State of WlsconsM document Sales, 609/2613-3559. F.ivslorr Coabryl for Home Bvildera tC3W11001 i eon tae ordered through Extension f'ubiications, 608/262-3346 or the Qepertment pf Commerce, ®08/2~T-4406. ' w..r,.,,.r • .,war . ~ ~~ ~ j ../ ~ -- ~~ ~ r .~~ ~ ~ , T~ i . 6 .: 8 6 . l .. .. ~ / ~~~ ~ . , ~~ •~ ~~ /~ • I A~ 1. • ~ .• ,.. ~ ~ /~ • • ' ~ ~ j ~ ~ ~ ~ •~• ~ •, - ' f • .. •, ., • ~' ....~ ''~ . `~ .. s ro, ror vas ., ao~ ~c r t . j ~•.,, ....~. . • '*~~. ~ •.l ~ ~ ~. ... . ,,~ , 1 ~~ ~ ~r ~~ p~ tW ~Co0. t7 ~. I-C-It ~IIl~ ~ ~ 1 ~ i ~ ~~ ~ • 41 ,~ ~. ~- 2 1 ~~~ t~s A M ~ M IA ~..~ r • rim ~ +~.r.~' 1 i+~+~r-` 1 ~ -~~ • .~.~.. • ~,~ ~. ~p t • K> >0 M0. • .1! K-II ..~ ~. •,.~,.r.,..~~~ . • ~2~ FROt1 Schumaker Flumbinq FA; IdO. 71~.,.~65~121 'yep. 1~ ~1 OS:~iF'19 F4 . sr cRaIx Courrrjt ~~~~.~7 ' SP.PTIC 'TANK. NiAINTBNANCH ACIRLBMBNT AND . OWNItRSHIP CLRTIFICATION FORM OwnerBuyar "- ~~ pddl~ess ~ 75+0 5 •~~llwti..~v `5' v It/~, ~1i!/Gclz~. v- ~h SS'~'~ property ~d1~i.9$ • '/"/- r .~ ir.ti-cT c~~ i 'vc v Lai- i (Verification required from Plaaniag Dcpactmeat for tLew constntction) ~ry~r~ fN~ s C- Parcel Identification Number ~ ~~ ~ i FOAL DESCItIP1ZUH .~, ~.~ - / 315-1 ~~ --C~~ .j '~ .~i-'~~~ic~7) L19.4'/ v.t/ ~llr ~(j i/ I/~ %,, >~ y,, Sec. ~ S T~N- ~ Tows of D Sd Properly Location ,~ ~ R~~.~ Subdivision .5 ~ Lot # ~~: CerHitied Survey Map ~~ ~5 g 3 `~ . 'Volume ~ .Page # ~Yarrantiy Reed # (- ~ ~ ~ ,~ .Volume _ .Page # Spec house ^ yes ~. no Y.ot lines identifiable ~ yes ^ no ~YBT~M MAYN'I'~NANGi~ Improper use and rnaiabeaauce of your septic System eaald result in its premature failure to handle wasoes. Proper maintenance consiats of pumping out tTze septic tank every three years or sooner. if needed by a licensed pumper. What yon put into five system can affect the function of the septic tank as tt trcatmGnt stage in the Wasto disposal system. a oertificaflon form, sigu>'d by the o~rner >tad by a The property owner agrees to submit to St. Crohr Zoning Department ~8 that (1) flue oa-sito arastewatetdisposa-1 s3'stom z~rphunbtr, jourreytaan Plumber, restnobcdphtmber or a licensed pamper 3s is proper vpcrating oondltion and/or (2) atlrr arspocHon and pampiag (tf' Y). the septio tank la less than t/3 firll of sledge. I/we, tho undersigned have head the above rcquirtments and agmo w maintain the private sewage drsposat sgatam with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsht. Certificadon stating that your septic system has been mai~ained r>atrst be completed asrd returned to the St. Cro3a County Zottlag Offioe within 30 days of tl~e throe year izntioar date. SIG ATURB OF APPLICANT P DATB nwlvF~t, CER')CIFICA,TIOrt I (wc) oerilfy that sli statements on this foam are tine to the best of my (our) knowledge. the pro descn d above, by virtue of a warranty deed recorded in Re&istor of Deeds Otlice. SX A OF APPLICANT I (we) am (are) the owner(s) of AA'I'l? -- «•«t#4 Any information that is mis-represented may result in the sanitary pcmnit being revdked by the Zoning Departrneut. «««««« t• Inatude with tlLis :ppltcRtion: a statugcd warranty dud from the Register of Deeds office a copy of the certified sarvey map if reference is made in the warranty dud ~~ f~ ~- ~'~ei~h~ ~~m~ ...:::, stem Management Plan >P~l~ Private Onsite Wastewater Treatme Boll Absorption Component ~fo~b.~~ 5gptic Tank And Gravity In-Ground Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Trmeaint 3yatem (PQWTS} shad include information and procedures for maintai ifie d~p$ ant, agent, the param®ters of Comm 83 and 54, and the conditions of approval by or governmental unit. The approved plans and permits for system are on file at the aunty zoning ar health department. This management plan complies with Comm 83. astavUSte TreaCitnon~ent 8y tem$nBBroCund 5011 Absorption Component Manual for Private Onsite W 10567-P (R.6/98). tic Tank and! r service once eve a e~~ ~ , Dutlet PAter Ins ect once a e and clean at least once Soil Abso son Went ins c 3 ears Ic Tank The septic tank shalt be maintained by an individual certified t4 service septic tanks under s. 281.45, Stets. The contents of the septic tank shat! be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Raiding Tanks, Pumping Chambers. Grease % Interceptors, Seepage Beds, Seepage Pits, Seepage 7renchss, Privies, or Portable Restrooms). The op$ra#ng condition of the septic tank and outlet filter shall be assessed at least once every 3 years by Inspection, The outlet Triter shat} be ct®aned as necessary to ensure proper operation. The fetter cartridge s~°~ ~e Ater when~reti'toved from its enclosure.d if the retain solids in the tank that may sloug s /G Table 3: M»~lntenance gchodute ., AA~~ .~,:_ ~ INBnaQ$ment Pia far a Septic rte^K aro Soi, Aas~rptjon Component . fllhrr !# equipped with an alsrm, the tutor ~hstl t7e aervlcad It thm alarm ~~ activated t~ntinua~.~sly. Irtterrn~ttent l~itrr atsnris rrt~ty #ndiCat! zur~e flows or an impandinq continuou:alarm, The sipde tank ehrli have Ib eontert~ removed when the voiums of arum and sludge In the tank exceeds S!3 th~l iigbld voiuma of the tank if the ppnter~ Of the tank an not removed at tha Mme of en a:easment, rNlntenance peroorutei shag ~dvlsi ttu Cy~y"Nr ~ whan the t~sxt se+~v+c~ ne+rd~s to b+r p~erfotmed to malntun iess than maximum scum and SiudQe acgmtutation in the ttsrnk, Manhole risen, aoc~ss r#sers and coven should be Inspected br water tightness and ecsandneev. opsnlr~s rued for NrV1oe tttd aasaamimt sha#! bs sealed wetartlpht upon the oompl~ian o! service. Any opening deemed unaaurtd~ dNeodN. ~' eubjert ~ fitiktn must be npi+~sd.. Exposed acaouis open#r~s praatsr then 8-inches to d~rr~r shall be secured ~y, an ,eReative ia0ldnq dev#ee to prevent aoefdental or urNwthxx~ed on#ry #te lank. No area should antler s sapfla or o~sr hwt~t a' holdht~- tank 1Ror any , w~fhouf tii~r ~ l4utl wt~h o>tl~t +~"+ ~' ~ a aonllfieeai spsae. ~~ ~~lrnu,~hen w'~ ~ ~ °" ~wtllr~inl ~` h0i~ik lank l~tty ~~ ~ rstaut ~' • p~orr lharln- #hi b~rlor of ~ lank nuy tb~ dll ~' ~pOt~blr. Tank *bandonrnNt a!'~11 be +n acaardancr with Comm d8•~3~ wls. Adm. Cade when tree tank la no 14n~r used ~ a RCiWCt3 eat+ponent. Ths soli al~ption component servir~ this struatura ie desi~nad to accept domes~a wast,~vater from a rrstdentla# fsa#rily. The Iltrdts os operstton of this oamponertt are shown In Table 2, 't'he tan~evlty vt a soil absorption ctm~ponent depends Y on prot~r and ~me-y malntansnos, and system uN wltil#n or below the 1#mlb of niiable o~arstion, ©aod water ooneervett#on preci#cN by ali oaa~pants srxt the irutsikctlor9 of water conserving plumbing fixtures 8re icey fi~bors ~ e~cbettdlrt~ thi useful Ilfie olP tittle oornpan~t. Tha e~oit atxorption component's operat~n must be aaseead by inapeedion st least ores every three yeah. The inspst~lon shstt inaluds reoofding !hs lev~s of pondina, it any, in the oIl~rervation pipes, ~d s vssust Inspsodon f~ any ev~snca of surface seepage or d~acher~s from thil 4otnpOna+'-t. 4n staaply stopl~ sites, arses of eroelan ehoulei ~ idontifled and reporteei to tt» owner for repair. The surhtca discharge of domat#c wastewater or sewage from the system is propibltad and consldeted s hurtan haaith has~d, Trafllc around cr over tl» soli absorption cx?mpontr+t should be avoided parttCUierly during winter rzronths, The compaction or removal of snow covar coat the porvent ray lead to hydrau~c ttilura by treetlrts. This type of faliws is usually t~npcnry~ but is d#fRault or irr:passit~le to repair ~tlt waathgaoar-dinMnto tphe soil lard d wp*rssel nett ~tchomay e~ t~ c~xrtponerEt wail educed oxyp tt1Cr0 lnt9nee, tAnd ~lrlief, C~!lrilG ~o~lhQ o! fhb evil. 7 ~- tvtanegtmtnt PRen for a Septia lank and 93+oi1 Abtorpt~on Cotnpontnt Piartt~` of deep-rooted trees and shrubs directly aver of whin ten fat of the corrtPonarn should be •~roided airtctd rapt inp'uaon into ~ comyon~nt mAy otis#n# meter '~ torittnpenay P~r+ t+n the event at sytt'm teituro, a new `yttrm cfluld ~ tn~rtted in en sltanate urea e~f threat o lnstariiatian M a diverter valve, the ~6xiftlnq system could else be reused e~ a P~ tour seen. !t is the property owr~'s rosponeit~Riity to maintain rile tit~ate ~'N ftM from any pt~i-"~ of tray, ahrubes, eto. hwe ~ pterrted ort~the a ti ~~aru t~ w~l haul ~ ba eny tr+ta, property owners exper~te, !t ettemate area is desMoyad, there ate other elter~euve tystemt thet aen be used, in which, oa~d result in added ta~r+a to ~ Prf- ~~~ ~1a~codtn~~ e~~o~ta~ct y~o~r 1oQai~S 0lfloa o t t~ irutal plumber. ~ f ° c~ ~~i5~ 3`b1.'~+at 1630 Highway 10 NE Spring Lake Park, MN 55432 783.-9846 i _ . Z Standard Features: • Marvin aluminum clad windows and patio doors • Paneled steel entry doors • _Certainteed asphalt shingles • Dead bolts on entry doors (except garage service door) • Microwave circuit • All bedroom ceilings wired • 2 phone prewires • DBL stainless steel kitchen sink • 40 gallon hot water heater • Hardboard sheathing • Mirror over all vanities • 2 outside water spigots • Oak rails • Vinyl siding with. aluminum fascia and soffit • Oak Princeton trim • Flush oak doors ' • Custom oak flat panel cabinets (standard interiors) • Polished brass orbit style hardware • Concrete sidewalk and stoop • Asphalt driveway Dishwasher • _Carpet $18.00 per yard • Vinyl $1$.00 per yard r • Lighting $1,500 allowance A large rambler featuring an impressive master suite with whirlpool and walk-in closet, a spacious family room is highlighted by custom cabinetry flanking the gas remote fireplace. A huge kitchen dinette combo with bayed windows. A three car garage, hip roof and brick accents add to this home's appeal. THE POOLEY 1546 SOFT. a ~ `~' i ~~.,~ ,~ MAIN LEVEL 1344 SOFT. Builder License +ra005867 DESIGN The Dooley :N . ~ ~~~,16G2P~~289 " ` ~ ~ 648604 REGISTER OF DEEDS ~ar~ti~ ~cc~ ~ ST• CROIX CO., WI RECEIVED FOR RECORD . - oa-le-tool 1~:IS vn y..:~ . .. i M -EEB CERT CWY FEE: ' CST FEE: . TRiWSFER FEE: 990Q,00 RECORDING FEE: 11.00 4pGES: 3 RaeoNise Ales • liae~ aid Aetafu Addrstt L.a,.l T:~1~, arc . 19OO S'~lvcr t.o.ke fZoc.. Alcw $r~~tyo SS/t n , MN Z OZo- tObq--7o -oon ! an:d Idm4fiauos Number RII~q C~ZO--tO6Sl-gp--vvp. - O'20 ~ 1 O(oy _cjp - vw v zv - io~o - vo - ~,a 020- to7o -~v_n~ ' V Z o -) a -7f.7 - Z o- cx~ lfT$IS PACg IS PAST OP THIS LEGAL D0002IENT - DO NOT RFXOVEw 7LL iotoewdoo mut3e co~ptK.d 6j~ Wmielee~ ~~ fhle ar dr ~~ eflrref, 4pf ~aalpffw, dw e~~ nlww adenw d ~r rt/rr4~1. Oder ~aewmtoll alek (~. eJd1b eewr '"q k!~ ew dtr wsp k need .w ad~rtrlet LON~101L VAt lA« ~/ Ollf ~/~ M rMlr wolf alf ~, M de /YM~wK . I.~ PQ~V q de ~~~~ .fI~OCf. SY.Sl7, pJtDA 71916 ~' ~, DOCUMEiNT NO. I+ .. ~ ~ ~, ~YARRJ-tPTT D13HD p,. A%~~ •TAT[ OI WIfCONe{N-TORN • • ,y • ' • ~~' ~~~~`~E~,,, ~'1 TNII IFAC[ nbMV[O FOn n[COnOINO DATA PEARSO~ hus Made b .RICHARD N; _ PEARSON and JEAN M. r nd and v{~ife .....» ........................................ ..........__... _..»..__........_........_..........»t ...................................................................~...... .... g s St Croix .._.._............»...;. rantor...._ of......._~........_.._...._.._ ......................._...._..... Count WixonsiR, ....... h~teb conveys and wartants to..._CARRIAGE IIOMFS~XXI, I :, a ,• Mlnn~sota corporation, ........_.........._ ..................». ashingEon ~~ g ......_ .:............»..........___.._......»...._......_...........Coanty, for the sum of;~ Qt1,~..[?41~~1..pnd_ noj100._ j~1 ~00~„ and, othec_.good _and valua6le_ ±j„[,,,,,N „ 1 nti~c1 T~ t /t; ~ansid~l~~i~lszn .......».. , Y~13 i9c'c s, t ~ r, t<<i<< l~. ........ ......... ........_ ................_........ ; JSIt '1 the following tract of land in... $t.,.„1:.1:O1,~ ...................................^__._._.,.. County, ~ T'/1 L Wisconsin: .A~~...Q~_.k~?~..[`IoSkh!~!~St..i2t?arter_„((3J~A;~, and_.,(VOr.~~_Half (N~) of the Southwest Quarter (SW;t) of Section Twenty-Five (25), Township 7Wenty-Nine (29) Nocth, Range Nineteen (19) West, St. Croix County, Wisconsin, except IDt One of Certified Survey Map filed June 29, 1994, recorded in Volume L0, Page 2782, St. Croix County Register of Deeds, as Document No. 518944. See Attached Exhibit A Parcel Identification Number This is not homestead property ID Witness Whereof the said grantor. s.. have.».. heceunto set.........thei[ hands... and seals.... this ........... » ............._........... day of.........Y.............»................._....., A. D., YOC..2Q01 atnNED AND affiALDD IN PRtttENCE 06 (SEAL) (SEAL) / ...................................._..................................._...................(SEALI SStt,,cc ~Mp~{,n~n~ to Washitif ton y y •••••~•-•••••~•- ••••••~••••.•__.........Count . Personal! came before me, this.7~:.''~; .day of.»~.`:.~._......_..., A. D., (4`.(._20,01 the above named .»RICEi,ARD ,N._ EARSON dnd JEAN M. PEARSONr :husband and wife, ................... . to me nown to be the pecso ...... who executed the foregoing instrument and acknowledged the same. "~ -' - ........... . A = ..................... Tltli tNeT1tUMLNT w; o AIT r RaCMOUNTAIN Richard J. Ga~rLe~, (~~2~64 NorwRT °•.~ T pal(; :MINNE90TA 880 Sibley MemO[ial Hwy,, 1114 atewL Notary Public, . ~ ' NQ.A~' .... ............_ County, Wis. My Comm. Esplren,Mii. St, 200(. -1736 My commission (etl ....._..__......._......_..........._.._...»._.._._... /~aeeot~f~ld~tt dN~ Wi,celnla Starnes p.oTidn {het d3 hutntmeate to b recorded dull keee plaialT pintsd er trva+dteee ehercon V a, aranteq, witnetua and notatr. SrNion )9.11! delilulr cegeita that tha aatlw er the Felten wile, a pverm tueW eatecT whuh. drtttad each inwronn;ne, dull le giMCd, tYlka'rFten, romped w wrklen ehtreoa le • IeaiLk maener.) WARRwNTY DEED STATE OF WISCONSIN mteeerotn Lend BI-nk QomoanF P'ORa( Ne. a YltwankH, wb. t Jeb ~JS11 ) .:. ~ ~n,.1G62P~<< 291 EXHIBIT A Parcel Identification Numbers 020-1069-70-000 020-1069-80-000 020-1069-90-000 020-1070-00-000 020-1070-10-000 o2a i o~0-20-000 117-M-COrporatiotl Minnesota Uniform Conveyancing Blanks (1978) ___ _ Miller/Davis Co. ° St. Paul, MN 651-642-1.988 sTaTE of MINNESOTA ss. Affidavit Regarding Corporation COUNTY OF ..__-------__.___-----_---__.__..-- --_-- and being first duly sworn, on oath says(s) that: 1. ('They are) (____he is) the -._._---------_--- ------------------------- and the -__-. ---.-. respectively, of - __.--. _, __-:_` ~arriage~iomes.XXl,1nc --- ~--= a _ ~ -Minnesota___-.__ _ corporation, the corporation named as -------------------- -----.____--_-~__ - _~ __.-_ -- --- in the document dated _-_~ _.________~~___, and filed for record ~- --- as Document No. _~__^-~____-__~__ (or•in Book --_ of -___ --- _- ------ Page ._-_ _____.-._---_ -_.--------_-) in the Office of the (County Recorder) (i~[g~t~tlrlx~cR~C~g of .___...__.._..___ __._.__.__-_ ___.St. Croix__.- ._ _...._ ____---_ ..._._. County, Minnesota. 2. Said corporation's principal place of business is at ... _....._..._.__ ._.____._ -.__.._ __.__-._^_.-..-_--__--------------- - --.---- -- and said corporation's previous principal place(s) of business during the past ten years (has) (have) been at: 3. There have been no: a. Bankruptcy or dissolution proceedings involving said corporation during the time said corporation has had any interest in the premises described in the above document ("Premises"); b. Unsatisfied judgments of record against said corporation nor any actions pending in any courts which affect the Premises; c. Tax liens filed against said corporation; except as herein stated: 4. Any bankruptcy or dissolution proceedings of record against corporations with the same or similar names, during the time period in which the above named corporation had any interest in the Premises, are not against the above named corporation. 5. Any judgments or tax liens of record against corporations with the same or similar names are not against the above named corporation. 6.. There has been no labor or materials furnished to the Premises for which payment has not been made. 7. There are no unrecorded contracts, leases, easements or other agreements or interests relating to the Premises except as stated herein: 8. There are no persons in possession of any portion of the Premises other than pursuant to a recorded document except as stated herein: 9. There are no encroachments or boundary line questions affecting the Premises for which Affiant(s) (has) (have) knowledge. ' Affiant(s) know(s) the matters herein stated are true and make(s) this Affidavit for the purpose of inducing the passing of title to the Premises. ;• .. Carria e.Homes,~ ~ ~ '~ ~ . Subscribe d sworn to before me this ; ~ -_ ____ __ . , .. 2001... Slav of G ~) . _ ~!2.~ c~~..,_c~a ..... ~: i~ , ~ ~ r .DOCUMENT NO. ~. THIS INDENTURE, Made b RICHARD _N : , PEARSON, and : JEAN. M. PEl~1R.SON...husband .and._c~ife............ .................................................................. ~ grantor. S.. of....St,:. Croix County, Wisconsin, h~reb conveys and warrants to_...CARRIAGE. HOMES .XXI, . INC:.•..a.. M~nn~sota -corporation • ......................................•--..........-•---............._----•--.....~.. , .............. ..........~ i ~i2S~~ .........County, or the sum of ~~ ,_,and other good,_and valuable j R'AILItANTY D~IDD STATE OF WlSCONS{N-FORM 9 TNI/ /PACt R[/BRV[D MOR R[CORDINO DATA RETURN TO __ _ _ _ _ _ __... the following tract of land in....~~:.._Ci:Q~ .............................................Coua ~- ~ :~. - .. . _ .. , Wisconsin: .i1~.~...Q~..~~?~..N4ii~hWe~~,_,Q~~~tr~r,,,~~_ ar}d,__~1or~h..iia_, f (N~) of the Southwest ~ Quarter (SWsd) of Section Twenty-Five (25), Township Twenty-Nine {29) .North, Range Nineteen (19) West, St. Croix County, Wisconsin, except Lot One of .Certified Survey Map filed June 29, 1994, recorded in Volume 10, Page 2782, St. Croix County Register of Deeds, as Document No. 518444. Ia Witness Whereof the said grantor. S.. haVe...... hereunto set`......_..their,._..,,,.,, hand 5... and seals.... this ......._. .._..._.._.... day of... ~aY.--•--......---• ....................... A. D., ~5~..2QD~ BIONSID AND aDALED IN PnE91CNCI, OF ,i ........................:............................................................................. ,.; Minnesota (SEAL) (SEAL) ................................................................................Y (SEAL j .: ~ ~ ~ 120,091 SQ FT • 2.757 ACRES 14.65'. 584"E 250.00' f ro ' ~ •. S84 • 444.26' ~6b6'F 4'39.26' ,, j , h ,~ c,~ ~ i~s.oo' • ~• ~/ .' 8T ~ i • 96, 775 SQ Ff I . ' 2.222 ACRES .. ~1ti • ~ a ~`~,, ' ~ 98,886 SQ FT ~ ~ G~ 2.270 ACRES ~° 90,281 SO Ff ~ ~• ~~~~~ __~~~^~ ~ 2.073 ACRES ~i~y~ ~ ~ ~ H.W.L. =991.9 ~ ,-. \ v~ ~ ^~ •• ~x ~ } H.W.I~~~ ~ C? •--•-- 9 1 j 1002.0 ~~, ~ ` ~ 588°58'14"E 336.83' - - ' C~~ ~_ 1 • . ~ ~' Regal Rldge -- ' I ~ • _ - N88°58'14"W 338.83' . 1014.10 /,'y ~~ ~' . ~ .............. . ~~% ~, i i 42 l``,v~~~ 104,073 SQ FT 2.389 ACRES ,~ ~ s5,s1a SQ Fr 2.202 ACRES W v ~ ~ ~, ~1 SOUTH LNVE OF THE N1/2 OF THE SWi /4