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020-1472-00-005
Wisconsifl 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, 5.15.04 (1)(m)]. 'ermit Holder's Name: City Village X Township Jewett, Michael & Andrea Hudson, Town of ;ST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER ~~'S CAPACITY Septic ~i~ "7 ~ ,` et~-._ ~ •t $ /Zoo Dosing /O ~ ~ QJ `^ g t - ~~ ~~~ Holding TANK SETBACK INFORMATION TANK TO P/L ~' WELL BLDG. Vent to Air Dike (rf,~ ROAD Septic ~ ~ / ~~ /~ 7 ~ g, Dosing 75o i •7 `,^ ~'l~.- ~ ~ 7 /~ Aeration Holding PUMP/SIPHON INFORMATION ~ Is Manufacturer ~a~L~~ Demand M yy~~ Model Number ~ / N/ TDH Lif~ ~ ~ Friction Loss ~ System H~,atl/~ ~~~JJ~^-- TDHV Ft O Forcemain Lengt ~ Dia.Z ~ Dist. to Well t~ SOIL ABSORPTION SYSTEM BED/TRENCH Width ~ L~gth ~ No.~ renches DIMENSIONS ~GDDi SETBACK SYSTEM TO P/L BLDG INFORMATION Type Of System: ~ ~ (~ DISTRIBUTION SYSTEM ~_ - . tl _ ELEVATION DATA county: St. Croix Sanitary Permit No: 515242 0 State Plan ID No: Parcel Tax No: 020-1472-00-005 Section/Town/Range/Map No: 22.29.19.2994 STATION BS HI FS ELEV. Benchmark Z•,7~ /n?,' Alt. B~ / - JK v C..t~ ~•~p X17 ~~ Bldg. Sewe ~Z • ! y~ . L SUHt Inlet /~' ~~` L A b St/Ht Outlet Dt Inlet Dt Bottom Header/Man. ` Dist. Pipe ~' ~f.b 9/.7~ Bot. System r-.~5 lc~. z y!,!3 Final Grade ~ /d . Z 9 7, St C er v L' ~ ../ ~7` l~ ~tc~ `ti o,n,.o~ o~~ IT DIMENSIONS ~\ No. Of Pits ~~\ Inside Dia. _~~ AKE/STREAM LEACHING CHAMBER OR Manufacturer: i /~ /V UNIT Model Numbgr: (,~~ Zz-I-z I . Y~ a ` a~.(vo,icr Its Depth r [Q Header/Manifold Length ~Z Dia ~ Distribution Pipe(s) Length ~ Dia `Spacing ~ x Hole Size ~ x Hole Spacing Vent to Air Intake /' ~i SOIL COVER x Pressure Systems Only xx Mound Or At-Grade SYStems Only ~/•~'~ (.-~$t~ Depth Over / Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ~r ~~ Bed/Trench Edges ` Topsoil \ Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 835 Germain La~ Hudson, WI 54016 (SE 1/4 SW 1/4 22 T29N R19W) Ced/ar Wins Estates Lot 5 Parcel No: 22.29.19.2994 1.) Alt BM Description = 1 '~ / ~ OS~J~-- C~~: ~S b`7~ 2.) Bldg sewer length = ?>, ~ t - amount of cover = vC.~ / ~i.~Q~~- i S ~~/~- ~ • ~ 5t•'~~ Gs` re- l~ U 1G ~ ` ~C.r..G~ _ Plan revision Required? ~ Yes No ~ ( ! (~ ~ ~'Q S~~ Use other side for additional information. _ (, Date Insepctor's ignature Cert. No. SBD-6710 (R.3/97) ~-e~`~~r~r~ commercr3.Wl.gov Safety and Buildings Division County , S~ "' 201 W. Washington Ave. P.O. Box 7162 . GYo ' ~.~~~'~' ~ ~ Madison,53~-7,~i2 ~ Sanitary Permit Number (to be filled in by CoJ l~palrfiner>t of Commerce 1~; j 5/ Z Sanitary Permit Application "'~~~n ~ State Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate go v mental N unit is required prior to obtaining a sanitary permit. Note: Application fo ject Address (if different than mailing address) submitted to the Department of Commerce. Personal information you ro ur oses in accordance with the Privac Law, s. 15.04 Z m), Stats. de ma ry %~ t ~ 5 ~ I. A lication Information -Please Print All Information ~- f'nO1r' `~ Property Owner's Name y„1 n ~ (~ ~ ~ a ~ cal 11 Prop O~e~Mailing Address ~ PLANNING ~ ZQNINt3 QFFIC operty Location ~ ~ ! ~ aoc Z a.~ ,~ / • ovt. Lot ~ City, State Zip Code Phone Number _ . ~ y, ~ y. Section 2 z ~8 ~ j~ 2S , cam(circle o~~~~~e~ R ( ~ T ~ N II T f B ildi h ; -~-- E or 1b1 . ype o u g (c eck all that apply) Lot f! ~1 or 2 Family Dwelling -Number of Bedrooms ~ Subdivision Name Oi i~,~no~~Ia ^ Block A-v Ll1 •'.,/JS ~L Public/CommerciaE -Describe Use ^ City of ^ State Owne -Describe Use CSM Number ^ Village of t // LLB- ZI G c.I' ~ ~ ~;fown of ~~c~3U..I/ _. III. T ype of Permit: (Check only on box on line A. Complete line B if applicable) A. New System ~1 ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System (explain) B• ^ Permit Renewal ,a~Petmit Revision ^ Change of Plumber ^ Permit Transfer to New List Prev' us Permit Number and Date Issued Before Expiration Owner ~ IV, T e of POWTS S stem/Com onent/Device: Check all that a Non-Pressurized In-Ground ^ Pressurized In-Ground ^ At-Grade ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ Holding Tank ^ Other Dispersal Component (explain) ^ Pretreatment Device (explain) V. Dis ersal/'I'reat ant Area Information: se~s°G ~ 6 Design Flow (gpd) Design Soil Application Rate(gp D' al Area Required (st) Dispersal Area Prop d (sf) System Elevation 7 ~ 3 ~ g'72 ~ ~ L~ ~ VI. 'Tank Info Capacity in Total b of Manufacturer Gallons Gallons Units °~ c New Tanks Existln Tanks g l /' ~ ~ r 0 ~ chi ~ ~ •~~, Soptic or Holding Tank , asv ,- ~ ~ y- Dosing Chamber , VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS sh wn mi fhe attached plans. Plumber's Name (Print) Plumber's Signature PRS Number Business Phone Number "~ .°~ :~ ~e ~. ul,-, ~` ~---~ dam ~ < - 3~ r ~ Plumber's Address (Street, City, State, Zip Code) .~ V G GP- S6 ..~/ n .r ~ ~ VIII. Couu JDe artment Use Onl proved ^ D' Perm i t Fee $ Date Iss e d Issuing A Signature 1 ^ O~en Reason for eniaf ' Q V -~ ' ~ ~ ~{ ~ ~ " ~~ IX. Condition ofA,p rov ~geasons for Disapproval SV~~'fn~ t~WNaER: 1 3, { ~ tC•"`.: ~ -- ~. ~.¢, ~(' if 1tw ~j ; ~ 1: Septic tank, et'llGent liner and dispersal cell must all be services !maintained ~ as er a a ement l ~fSC Q '~'70 ~'~- • id d b l b p m n g ~ . p an prov e y p um er. 2. All s2tbackfiequirementsrnost be maintained ._... -.... ~ ................ ~,,.....y vnq ou P.Pc. nu..rnn urnn o ue x u .ncnes m SIZe SBl)-6398 (R. 02/09) Valid thru 02/11 1 J 1 . v~-_ C ~ 4 P ~ ~~. 3 C1q ~ Q ~7s ~ L~ LS'\ ~ ~~l~~i ~~~~ ~ is ~~ 1 A it Ln p``~ j ~ Wisconsin Department of Commerce ~ SOIL EVALUATION REPORT Page r of~ Division of Safety and Buildings in accordance wfth Comm 85, Wis. Adm. Code County f , C f T Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must indude, but not limited to: vertical and horizontal reference point (BM), direGion and Parcel LD. ~ iTG. lyy_/ " V ~ ~ ~ ~ ~ percent slope, scats or dimensions, north arrow, and location and distance to nearest road. t-v , ( - Please print all information. ~ / Review ~ _ Date / ~ Personal iMorrnation ou vide ma be used for seconds ur Y Pro Y ry P Poses (Privacy law, s. 15.04 (1) (m)).~ ~! t~.~ v'~ ' y Properly Owner Property Local ~ [ j Lot S~ Govt 1/4s~1/4 S ZZ T 29 N R E (or) W - ~ . „ Property Owner's Mailing Address iJ `1 l 3 s-~ Lot # v Block # Subd. Name or CSM# ' ~ F - c . v~ « . City State Zip Code Phone Number [] City ^ ~Ila a Town Nearest Road New Construction Use~Residential / umbe rooms ode derived design flow rate ~ Q GPD ^ Replacement ^ Public or erdal -Describe: ____ ______ __-_ __;___.__ ___ Parent material © ~ FI Plain elevation if applicable / ft. General oam,ents OIJNTY G [~P/~-t<~ p,~ SQL /!~ ~%2~ll and recarunerxiatrons: NNING & ZONING OFFICE ~ (/ ~.i~ ~ S~~SZ~~ System Type System Elevation Boring # ~ Boring ~- Pit Ground surface elev,p~ " J ft. Depth to limiting factor ~~ in. Soil lication Rate Horizon Depfh Dominant Color Redox Desrxiptron Texture Structure Consistence Boundary Roots GP D/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0~ Z ------- ~~-- ,rte ~ ~ ; v 2 - ,S ,----' ~ ~/~ / l 3 d 0 w ,~ J /~ ~~ ~~ Boring # ,~ B°nng l Pit Ground surface elev. © ~ ~ft. Depth to limiting factor ~~~in. Soil liption Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ftt in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 'Effluent #1 =BOO > 30 < 220 rttg/L and TSS >30 < 1 50 'Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Narrts (Please Print) lure CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 Jl ~.- J ~ 715-246-4516 Property Owner _ Parcel ID # Page of Bori # ^ Boring 9 ~~/~~ ~ ,t^1.E it Ground surface elev. < ~ ft. Depth to (imiting factor ~n• Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I ~ ~~ v --~~ s ~~-~ ~ / ~ 2 '~ ~ '_~ ~ (~ ~ ' a ~---- s ,-~- ^ 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 GP D/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Etf#1 'Eff#2 ^ Boring Bonng # Ground surface elev. ft. Depth to limiting factor in. ^ Pit Soil ication Rate Horizon 'lepth 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 'Effluent #1 =GODS > 30 < 220 mglL and TSS >30 < 150 mglL ' EftlueM #2 =GODS < 30 rrtg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD8330 (8.6/00) Property Owner ~ Parcel ID # Page of / / . i Boring # Up Boring ,knit Ground surface elev. ~ ~ ft. Depth to limiting factor in• Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfff Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 "Eff#2 in I . ~ ~) (/ /~ Z- `- S ~- ~Jr ~ U~ ~ // 2 ~ ~ ~ --~ G ^,~ - ~ .~ li - ~_ ~ .~---~ s ~ ~ ,,,, ^ Boring # U Boring ^ Pit Ground surface elev. ft. Depth to Limiting factor ~n• Soil liration Rate h l i t C D Redox Description Texture Structure Consistence Boundary Roots GPD/fF Horizon Dept in. or o om nan Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 U Boring Bonng # Ground surface elev. ft. Depth to limiting factor in. ^ Pit Soil lication Rate ' ti i D d Texture Structure Consistence Boundary Roots GP D/fF Horizon lepth in. Dominant Color Munsell escr p on. ox Re Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 `Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mglL 'Effluent #2 =GODS < 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. SBD-S3J0 (8.6/00) Soil Test Plot Plan Project Name Dave Alwin Shaun d Address 413 6th St. N Hudson Wi 54016 C #226900 Lot 5 Subdivision Cedar Win's Estates Date 12/10 SE 1/4 S W 1/4S 22 T 29 N/R19 W Township Hudson Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Wood Post (old shovel handle) System Elevation TBD *HRpSameasBenchmark Property Line Scale is 1" = 40' unless otherwise noted Germain Way B.M.* Pro 4 Bedroom House 35'T _ 95' 3% Slope ~B-1 -2 15' 386' Property Line / 96' 30' 3% Slope 20' 75' B-3 130' .o commerae.wl.gov afety and Buildings Division County ' W. Washington Ave P. B 7 ~ ~ ~ ~ ~~ '~ ' ~~ ~ ~,~'' n t Madison, S~/ i2 Sanitary Permit Number (to be filled in by Co.) ~ merrt of Coltirmerce 5i Z ~ Sanitary Perui~it Application State Tramaction Nu m ber In accordance with s. Comm. 83.21(2}, Wis. Adm. Code, submission of this form to the appropriate governmental unit i i ed i / ~ /~l'V' s requ r pr or to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to the Department of Commerce. Personal information you provide may be used for secondary Project Address (if different than mailing address) u ores in accordance with the Privac Law, s. 15.04 1 m Stars. ' ~~G / _ _ ~ ~^ _ I. A lication Information - Please Print All Info ation ~y ~ J C7P./ Property C~yYltel's Nape ~ 9,~~ ~ 1 Parcel t! ' 620 • /'~7Z• t10.Oa Property Owner's Mailing Address Properly Location - LJ ~ ~'7' ~ t~~. Sys l~.Gt,.N-C. ST. CRQIX GOUNTY ~. ~. 249~ , Crovt Lot City, State Zi Code p ~ ~' '/,, ,S~i,+ J %,, Section ~2 ,r/ / d/Gtss ,aL~~" ~ SSl a ~ ~J 2 ~I ' II. ~'ype of Bui ing (check all that apply) 0~ ~ Lot _ T . N; R~~_ E oC]A I or 2 Family Dwelling -Number of Bedrooms .s Subdivision Name / Block# GG~0.Y 7 n~J~ Pla.ti~ ^ i , Public/Commercial -Describe Use - - ,City of ^ State Owned -Describe Use CSM Number ^ Village of n Z IU Ib~` (.~.~ ~Z.~ Z ~ G ~~ own of ~!~ /l.~d~ III. Type of Permit: (Check on y one box on line A. Complete line B if ap cable) A_ New S stem y ~------. ^ Replacement System TreatmenUFlolding k Replacement Only ^ Other Modification to Existing System (explain) B. ^ Permit Renewal ^ Permit Revision ^ Ch e of P ber ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. T e of POWTS S stem/Com onent/Device: Check all a 1 Non-Pressurized In-Ground ^ Pressurized In-Ground ^ At rade nd > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ~~ .. ^ Holding Tank ^ Other Dispersal Component (explain) ^ Pretreatment Device (explain) V. Dis ersal/"I'reatmentRrea Information: 4, ~'~ p ~ ~. Design Flow (gpd) Design Soil Application Rate(ppdsfj / s rea Required (s~ 'spersa{ Area Pro ed (sf1 . ~ System Elevation ~Gd r ~ ~~ . ' ~~~ ~7Z, G'~~c ~a ~ c a~ ~ Vl. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units ' a ~ ° o '$ ~ ~ New Tanks Existing Tanks ~ / ~ /~ ~ //"/ ~ , ~; . ~ P. U ~ v1 ~ ~ h ~ ~ Ls. C7 ~ GL Septic or Holding Tank (r ~1 , lam. ~v ~ Dosing Chamber ~~~ .f.~ ~ ~ VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS wn on the attached plans. Plumber's Name (Print) Plumber's Signature P PRS Number Business Phone Number / r- ~ ~d~ /y~ 4SG' h ~L ~' rf- 07°l' 7 y' 'I!~- r-:~!,' " 3~~ Plumber's Address (Street, City, State, Zip Code) S ~ ~ 0~ ,~- VIII. Coun /De artment Use Onl Approved ^ Permit Fee Date Issued Issuing nt Signature ~ $y75 .~z31~ ^ O Ives Reason for Denial . iX. Conditt~~i~l~~casons for Disapproval 3 i G r~~ 1. Septic tank, efflGent filter and ~ ~~~ n ~ S 6 ~~ ~ ~~ `~ ~ ~ dispersal cefl must all tre servk:es7 maintained ~a.~.~.4,c,~ . - - s , ~ ~ N ~Je 1 ~.<~- a as r ~' '-' ec k ~ per r-anagement plan provided by plumber. {' ' ' ~`~'"~" 3. AI(setback requirements must be maintained Attach to coinp7e}6 pians7bFTlie system eud submit to the County only on paper not less than 8 1!2 x 11 inches in size SBD-6398 {R. 02/09) Valid thru 02/t 1 - , ~~ s~ ~.,~ P ~ «_ .,G ~`s'C 't~~ ~'/~Qo ~ G ~~ Vv ~ry v~ ~~ v "O ~~ i `l y ^ / .Q I' / ~~ ./ / ~ t~ i ~/ . D.. `` G~P~ il,. / ~/./ S./ _/ ,. ~~ ~ivt .cam /~ '7 °~l ®A it .~6d ~l /~ ~ ~ i, T~ ~/G ~B~ ,~ l.%, /~1~J/af~~jyy-~ ~ria~v~< -Tom(-~1rz-~,y°~ °.-P ~~ ~~~c~- ~~~ c 1~5-~ ~ ~ G w h s ~° / ~~~ p` ~d o~ ~ ~ `v ~ ~" `Yti l y ~ ~' ~~ ~ ,~,r + r ~ ~ ~ i ~. ~ y»'e~ ~ ~ ~~ tb _,~ ,~ ~ t~~~ CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Owner's Name: ,J/J ~`j~~ ~~~~~ -~. Owner's Address: 9~l.~ DPI ~~-e1f ~aR.-v-~-- l,J-''a.~~w~'1~ h?~t/ s`r/-~S Legal Description: ,S,r~ ~ S`iv/ ~ ,i~"c c ~ ~ 7`a? 4 ~/ ~ ~~~ ~-s'~ ~ - Township: ~u.~ .5is.,rJ County: s'~I'~ rr'G ~l,Y Subdivision Name: ~ ~~a ~ ~.'~U,i ' G's ~ Lot Number: Parcel ID Number. ~02~ " ~'~,~y-,~'o ` ~ ~~ Page 1 Index and title Page 2 Plot Plan Page 3 System Sizing &Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Sail Test & House Plans Designer/Plumber: j~..,~= ~,dc ~~ License Number: ~ ~ '~~ 9 Q _ Date: ~7 ~ /~ Phone Number ~`~-,~~'G-~f'i1~ Signature ~~-~ `~ Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01). Page 1 Soil Absorption System Cross Section ft 4" Schedule 40 Final Grade PVC Verrt Pipe ~ ~ ft With Vent Cap ~ Leaching •, ~ Chamber ~~ cam w ft V , System Elevation ~ ft ~ ft Soii Absorntlon System Plan View ~~ ft 3 ft ' Leaching Trench 1 ---~-ft Vent Or Observation Pipe ~ Chambers 4" Dia. Trench 2 Header Leachinra Chamber Specifications Manufacturer And Model ,~ .UF~~/T a ~ r ~lu%c'~~S E1SA Rating ~ ~ sq ft per chamber Soil Application Rate ~ ~ gpd/sq ft ap gpd Design Ffvw ~ ~ ? Soil Application Rate ~ ~S 7 LISA = /~' Chambers 2 rows of ~ chambers each. Page Z of Pt:1WTS C?WN~R~~ M~NI~~-~. ~ MANAGEMENT KLAN Pegs of ~SiON PARAMlbTERg ~.. , _~'~ Number o1 Bedrooms c{ Number of PubSc Facility Units, ~ ~, Estimated fbw (average) ~~-~ A Design #low (peaks, lEstimated x 1.5) ~~ Soil Application Rate al ~ Standard influent/Effiuant Quality Monthly avi>2t~p;~~ ` Fate, Oil & Grease (FOG)`.. S30 mglh Biachembal Oxygen Demand tBOQe) 5220 mg/L p NA Total Suspended Solids {T$S} 5150 mp/!. Pretreated Ef#luent Duality Monthly pt~erape Biochemical Oxygen Demand IBOD$) s:30 mq/1. Total Suspended Salkis ITSS) S30 mg(i. ~ ~ Feoel Coliform {geometric means S10° ~f~p/7QQ-ni Maximum Efflusrit Particle Sixe Kin dlA. Q ~ tither: t~ *Vaiues typiasl fat donwstic wastewater and septic tank offkiant. sP~ciFicanonis ~gp~tic Tank Gapaoity Z d al ^ NA $~ptiA Tank Manufacturer ^ NA ~~ t:ff~uent FAter Manufacturer ~ `, / ~ ©~ ~ DNA Ht~literit Finer Model , r'.m2 jg~ O NA P+arp~ Tank Capacity ~ al ^ NA Purt?p Tonic Manufacturer rc°S ~Y, p NA Pump Manufacturer ~,~4/ Q NA Pump Model ^ NA tAr~treatment Unit O NA~ ~:~And/Caravel F!lter ^ peat Fl(ter Q M*ahanicai Aeration ^ Wetland Q Rlainfeation ^ Other: 4 parasf Celilsi ~ NA q 1n-Ground {gravityi !~ in-t3round tpressurizedi Q A'i=Grade ^ Mound ~ Iq pip-Etna ^ other: 1~Ir. d NA r O NA °~ o NA MAIN AIyCE BCtIEDiJLE i5arvlas Event .. Service Frequency inspect condition of rankle) At loos{ +Ansa eves; 3 a s tMaxtmum 3 years} ^ NA Pump out contents of tanklsi When ot~npirlpd illudgA And scum equals one-thtrd tYs) of tank volume ^ NA inspect dispersal rents} At le#Rt cncq ~vsry; ~ ~~ si {Maximum 3 yoarai ^ NA Glean effluent faker At ~~At 4~hf{ie wfyl)t'~+: ~ O month s) Q' MA Inspect pump. ;pump controls d~ alarm At leapt rinse ttlre~y: °'~ monthtsi C.3 .earls} ^ NA Flush {sterols and pressure test At igMAAt !riPc~ Av+AiY: '"~` monthtal ^ earls) ^ NA Other: At leaA AnDp ~vAtV ~ # -` ^ monthtsi ^ .earls} ^ NA Other: O NA AAAit11TENaNCE ~ISTRUCTlQNS inspections of tsnka and dispersal tails shall be rrta~da by an inc(ividwal carrying one of the following lieer-set or certffioationa: Master Plumber; Master Plumber Restricted Sealer; FtJVJT~ Inspeatar, PbWTS Maintainer; Septage Servicing. Operator. Tank inepectiana must include a visual inspection of the X~Ankis~ to ideni~fy any missing or broken hardware, identify any cracks or leeks, measure the volume of combined sludge and scum ar~d tip check for slnyr beck up or ponding of effluent on the ground surface. The dispersal cents) shall be visually inspected to eh~s{k thre +~fftu+ir4t l+ai,els in the observation pipes and to check far any pending of effluent on the ground surface. The pending of 4f~lu6Ci'l on the~p-ound sprface may ~dicate a failing candkbn and requires the immediate notification of the local ragulatary authgrity; When the combined accumulation of sludge and scum i~ sny tank ee}q~p1e one-third lY~) or more of the tank volume, the entire contents of the tank shall be rornaved "by a l3optag® $ervia~ng apera>titcir ar-d disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. A!t other services, including but not limited to the sgn+lainp o f dfflu4nt flltars, mechanical or pressurized components. pretreatment units, aril any servicing at intervals of 512 months; aheU bs pertctirlned qy ~"certified POWTS Maintainer. A service report shall be provided to the local ragulatary autharlt~ within 1Q days of completion of any service event. Page of STARTUP AND OPERATION • For new construction, prior to use of-the POWTS check treatment rankle) for the presence of painting products or other c em ca s that may impede the treatment process andlor dami~ge the dispersal cellfs)• if high concentrations are detected have the contents of the tankls) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditirns are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess ,wastewater will be discharged to the dispra'rsai csllisi in one large dose, overloading the cellls) and may result ~ ~ni cing Operate p o`rdtocrestoring effluent. To avoid this situation have the contents of the pump tank removed by a Septag power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal tails. Oo not drive or park aver, or otherwise disturb or compact, the area within 18 feat down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may•iaepgr easers, d n alrfal~s, ~ ~$! ~' sinfectantsf fat POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs, foundation drain ;sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is pemnanently taken out of Service the following steps shah be taken to insure that the system is properly and safely abandoned in compliance with chapter Gomm 83.33, Wisconsin Administrative Gade: Ail piping to tanks and pits shall be disconnected and thQ abandoned pipe openings sealed. • The contents of all #anks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping. all tanks and pits shall be excavated and removed or their covers removed and the void space filled will soil, gravel or another inert solid material. CONTINENCY PLAN if the POWTS fails and cannot be repaired the foNowing measures have been, or. must be taken, to provide a code complian replacement system: ant soil absorptio' ^ A suitable replacement area has been evaluated .and may be utilized for the location of a replacem system. The replacement area should be protecteid tore iattli e's and wellsmFe uIre t prime the replac~nan~x area wi required setbacks from existing. and proposed su t area. Replacement systems mui result in the need for a new said and site evsiuation to establish a suitable replacemen comply with the rules in effect at that time. D A suitable replacement area is not available duel eso ~ to acekpl ~ t~ fs ilia?Oh1NiloS s. Sarr+ng advances in POWT technatogy a holding tank maybe installed as a last r _ ~ ,~ of ,~ o,,,,,,.rc 9 . s-nil and si ~~ _ _ .mot ^ The Site il8 ~ t t~f nl~narnont A~ e a ^ Mound and at-grade soil absorption systems may be rec omr' ~w~ thelrules inleffect ~ that time the biomat at t1 infiltrative surface. Reconstructions of such systems must D Y < <WARNINO> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY C0111TAINA~ C RCUMSTAN ~1,/ DEATH MAY R 8U TY®RESCUE OF ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER PERSON FROM THE INTERIOR OF A TANK MAY BE i]IFFICU'LT OR IMPOSSIBLE. P01NTS INSTALLER POVYTS MAINTAINER ' Name Name ,~~~`~r~u ~-~ ,.y.~ ~ 8.1~ Phone ? ~ _ ~. ,_ s r2 Phone L SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Hama dame ~~. Gl'o.',~ Go.~ .~ ~~ ~ o~ ~` ,"~" ~',~"® Phone /~ ~ J~(o'4~('OS`O This document was drafted In compliance with chapter Comm 83,2212i(b)f f){d-&ffl and 83.5411). (2- 6 (3), iNiaconsin AdrMnlatrative Cade. ~GOULDS PUMPS Submersible Effluent Pump ~ ~~ 3871 E APPL{CATIONS • Fully submerged in high grade turbine ail far lubrication and efficient heat transfer. ^ EP05 Impeller: Thermoplas- tic enclosed design for improved performance. ^ Casing and Base: Rugged thermoplastic design provi~s superior strength and wrrosion reSlStanCe. ^ Motor Housing: Cast iron for effident heat transfer, strength, and durability. ^ Motor Cover: Thermoplastit cover with integral handle and float switch attachment poirRs. ^ Power Cable: Severe duty rated ofl and water resistant. ^ Bearings: Upper and lower heavy duty ball bearing construction. Specifically designed for the following uses: • Effluent rystems • Homes • Farms • Heavy duty sump • Water transfer • l)ewatering SPECIFICATIONS • Solids hand8ng capability: Ala" maximum. • Capacities; up to fi0 GPM. • Total heads: up to 31 feet • Discharge size: l'/:" NPT. • Mechanical seal; carbon- roWryJceramic-statronary, BUNA N elastomers. • Temperature: 104°F (40°C} continuous 140°F (60°C7 intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor. • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz,1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 NP, 115 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord:l0 foot standard length, 1613 S1TOW with three prong grounding plug. Optional 20 footlength,1b13 S1TW with three prong grounding plug (standard on EP05). ~ 2000 Goulds Pumps Effective February, 2000 83877 Available for automatic and manual operation. Auto- matit madelsinclude Mechanical float Switch assembled and preset at the factory. FEATURES ^ EP04 Impeller. Thermoplas- tic Semi-open design with pump out vanes for mechanical seal protection. METERS II FEE 10l" z u 0 r AGENCY LISTING ~' Carmen Staaderds Assadetlon (CSA tilted model numbers end in "F" a "C".) eouws~s~tso9om aegisoered. i o i z m~~n cAw4clTM Goulds Pumps ITT Industries ...._.._.. __ w QO ...............~............__'.O 20 30 4 .SEPTIC TAN~C ~ PUMP CHAMB ,k~ ,B' ~ xDN AND SPECTFICATIONS~ 4" Cx VENT PIPE 12" MIN. ABgV ~~ ~ w£ATHERPRQOF ? ~5' FRQM DOflR, WINDOW OR ~ JUNCTION BOX APPROVED FRESH AIR INTAKE ,,,. WITH CONDUIT MANHOLE COVER W 1 PADLOCK ~ FINISHED GRADE WARNING LABEI, 4" C I R I S ~~ ..~,_..~_.. 4 ,- MIN , 18 " I N . 6 " MAX . ._~ ,~ ~ .. •1 WATER TIGHT SEALS GAS- ; `ti ~..~ SEALT - `~ ~PPR4YE0 - JOINTS WITH ~APRa11ED + -- ~ ; ALM APPR{3VED PIPE ,.,...,, ~ ~ 3' oxTO 1NT0 St~IID ~ , ON SOLIQ SOIL ~ ~ TOIL PUMP OFF ELEV . ~° .. ; ..; :. -^~'-- QFp ~'~ RISER EXIT P£RMITTED QNLY IF TANK MANUFAGTURER ...., ,. HAS APPROVAL 3" APPROVED BE~?~~N~~ u~~ ~'+~ CONCRETE PAA SEPTIC / DOSE TANK MANUFACTURER: 1~ `Q,~e R, TANK S I DES : SEPTIC 1 ~t,''j p GAL . DOSE ~r_~-5~..-- GAL , ALARM MANUFACTURER: ~ t~,~.~ ,~,~m MODEL NUMBER: t,.'V SWITCH TYPE. ~ L PUMP MANUFACTURER : C~_tiv„~ ~,,, MODEL NUMBER : R ~ SWITCH TYPE: rn~eteC REQUIRED DISCHARGE RATE ~ GPM ~„(~~~~, DQ~~£S PER DAY : ? I~Q~~'~t~L~~E II3CLUDING F LOWBAC K : I ~ aI GAL . C.~PAC,~T~E~ - A = ~'~, _ INCHES = LI~GAL. B = 2 INCHES = ~ AL. C = O INCHES = ~~$ GAL• D = ~ INCHES = ~_,_,GAL. ~~~~' 8 ARM WIRING AS PER ILHR 1fi.23~ WAC VERTICAL DIFFERENCE BETWEEN PUMP Q~~ ~~tA D~,~~'R~~UTTON PIPE ._._~°~- FEET + MINIMUM NETWORK SUI'PLX PRESSURE .' . ~ ~ 2 • 5 FEET + FEET F ORGEMAIN X ~ b O F~'F ~ O Q .~'~'. ~'R~~'~I ON FACTOR • =FEET -~~Q-- ~--'_ ~,q~~~ ~~NAM~c xEA~ = FEET INTERNAL DIMENSIONS QF PUMP TANK; LE~G~'H ....~- ; WIDTH r--~' DIAMETER ~~c~ux~ , ''~""~~ "~.. ~ ~ C~,~L pee 1'~ SIGNED: ~a~~~''~'~'c~•---'---.. LTC~N'B~: NLi~`!~~~R~ L...l~.~ DATE: - 1/88 ST. CROIX COUNTY ' SEPTIC TANK MAINTENANCE AGREEMENT AND ii nnOWNERSHIP CERTIFICATION FORM OwnerBuyer ~ ~..1~.5. h~-~~ i 2c-~- '.~ C.~~, Mailing Address °l 't Property Address g ~-e~ w-eQQ e ~m~l~ 1 ~2 rl ~° .. wex~c~~v/ ~~ sSraS (Veri~fic` at~ion required from Planning , CitylState ~'~ ~S 0 n W ~ Parcel Identification Number LEGAL DESCRIPTION `' \ Property Location ~ ~ %4 , S ~ %4 ,Sec. ~~ , T a °t N R ~ `~1 W, Town of ~~~~C~/ `, 1 ~ / ~ ~- i Subdivision V~,J , vi S ~ S `~-~,~ ~-~- 3 ~p • /it7Z - ~ - Zip` v~J~SE~ Lot # ~. Certified Survey Map # `-'-~--~ ,Volume `-~ , Pag # Warranty Deed # ~ ~ ~ ~~ ,Volume r- ,Page # Spec house yes no Lot lines identifiable yes no .SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle waste .Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner ma' tenance responsibilities are specified in § Comm 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to'St. Croix County Zoning Department a certification form, signe by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site astewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is 1 ss than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage dispos standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, Sta1 Certification stating that your septic system has been maintained must be completed and returned to the St. Croix Department within 30 days of the three year expiration date. ` SIGNA OF APPLICANT ~•,, OWNER CERTIFICATION Uwe certify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the or property scrib d above, by v' a of a arranty deed recorded in Register of Deeds Office SIGNATU OF APPLICANT _• ****** Any information that is misrepresented may result in the sanitary permit being revoked by the Zoning Include with this application a stamped warranty deed from the Register of Deeds Office and a copy of the certi reference is made in the warranty deed. .~. Uc~Su~ (~~ ~~ a l for new construction.) system with the of Wisconsin. 'ounty Zoning ~l %UI~U DATE Her(s) of the ~i~ol/r~ DATE ~artment. ****** l survey map if SURVEYOR: DOUGLAS ZAHLER SkN LANG SURVEIINC 2920 ENLOE STREET HUDSON, M 51016 ENGINEER: KIP JOHNSON AU7H CONSULTING, MC. 2920 ENLOE STREET HUDSON, M 64018 OWNER: ALMN CHILDREN, LLC. 4T3 BM SmEET N. HUDSON, VA 51018 LOCATION SKETCH TOWN OF HUDSON COUNTY PLAT OF: CedarWin's Estates LOCATED IN PART OF THE SE1/4 OF THE SW1/4 AND PART OF THE SW1/4 OF THE SE1/4, SECTION 22, T29N, R19W, TOWN OF HUDSON, ST. CROIX COUNTY, WISCONSIN. DRAINAOe FJLBEMEMS NO OYNDx OR RE90ENT SHNL DO ANYIHWC NHIOI COUNTY TRFABVREFY6 CERTIFICATE WOULD NIERFERE wM OR CHMGE T11E OPERATON OF ME APPROVED COMPREHENB4E WATER STALE Oi w500NYN) ORNNAGE MID SOL FAOSON PLAN FOR TNS PLAT. COVNtt p' SC plp%K4 iNB NCULES BUT IS NOT uMITED TO BUILDING waN, oesmucTNC. Kmwa PwNG as L CMEAn 81IID. 9FIN0 iME pir EIECIFD, g11WTE0 ANO ACnxO EXGVATNO, OR PLINTNO N ANY POND ON 1RE49MCR dr SE 0101% CCUNtt. 00 HEPFDY CDIII)Y MAT TE RECOPDS IN NY CITCE SNOW NO UNMLDYFp TM SAIE9 MD NO UNPWO TALS pl TOWN BOARD RESOLUTION SPECUL ASSESSYMTS AS K ~^„+,,../.,...<r~ .+rn -ussO1RD ME IIND dLNNAGE EASEMENTS. WATOI DRNNAl9: DITCHES, WATER RUNWAYS, WATER CULVER75. BERYS OR GRASS SFEODIGS. INCIILFD IN 11E PUf Di OmMA1N'9 ESTAIEx PESOnTA MAT TE PLAT OF CEOMwNY ESTATES W ME roM Oi HUOSM. KMN ~~' S •IY ~\X 24 S' •\' ~~N 4+ 4' ~ ,.~~, o</~,ri~,el m-u-ni p-1LTn sMl. -r .~•~~<v~. DAre caNtt nvwWnm TOWN TREASURER'8 CERTIFICATE STALE Of WSCMSW) OWNtt d: ST. CRpNj55 A95ESSYENIS M OF1r.,(I"~~/...~_ M AM LAND WISUOFD N TE PUT a AReWS ESUTEx ; )is17 i~r'1 ~ ~ (o ~ 06 SYIM, OAre iREAAWER SECTION 22r T29N1 R19W ^r-~'~h% kpl(J° i ff y DRAINAGE .~. Aai~~~ Lr'RI EABEMENT y",~'i °a~~ TABLE •D' ~~~i~ IT9.or (j ~ / BEANAIC d3I 3 a Nu eY9'W se 11' p D9 ~ bsF o1JP• pyy l,1~ 0.! SXS1b5F 1343!' N 3~Ay 04 3e9T1'PSF 34.1• IQ' ~~R OJ 3lJ]e']SF 9333' I~ iR OB 5[bY10YF 1298' Tn~ Ol NJ9TBYB'W IN.JT' IA.r I~ .--SCALE IN FEET-1-? 100---- 1® - g LOT 1 E Sloo AgE3 ~ IN,eea sa Fr. La0. ~ 90.55 GTLQ4 N`.f' IItl~7,~~~G] LE'i~"TI'p51]~S' LQ~T :: DRAINADE 1\ EASEMENT \ TABLe-G• \ ~€RY1M LAN \ / BEANM~O OISI \ Ol SITSI'bF '0163' \ -' GP 55x°)b)F TAAI' \ / a) Mxe'19F 30.31' \ ~ ki a _ - ~ G BMTe'IDF ea OT \ ~ C3 N69SYY9F BS91' • ~ 4 ~ - ~ - Lx Na5'HYOTI' JIJ40' / ~ c~ SPO:ros1F rassr ~ ~ ~ / L ~ ~' ~ / `~ / / I t~EIT 1 ~ 1 1 ` ` ~ r° ~ -~ I is NOTE: A VARIANCE TO 1HE MA%IMUM LENGTH aF 1 , I~ I~ WAS GRANTED BY THE ~ ` ~~ ` ` CROIX CWNTY 5T . PLANING & ZONING ~ ` ` COMMITTEE ON JULY t " 28, 2005. 1 1 95E I .---- i II L4DT B I DRAINAGE h.EBT LWE d: TE SEt/{ Oi TIE Sw/1 LOT 2 imo AtlE4 IllroB 9n FT. LEa - 9DS.s CM9DPEN, LLC.. OwEFT, B HDEDY APPROVED RY TE IONN ROAM. rto6EnTF76Ellf o~ Gi 10911 OWR y 1]90 An 2610 AC I MEREWY GERTFY MAT TE fORECpNG IS A WPY ? A AESOWINYI A00P1FD BY 1NE lOW1 BOAAO ? ME TOWN OT MU030r1. 2roe Aa 2NS AE 2165 AG () ~~ 1Xx.M25C RTA aYE, IONN IpDTt xiXe Ac ro un Lois . 23JT A0. AN0IAOE ) ~ LImQ~JV'V~ ~- EaLQ4 d5~ I"ItlI~Q nl4~!tC~O. ____ ~~~ Ir.4113's`B' gl4~I~P1"G«SAJ ____ I ____ ____ ________ ~~_NDAM uNENa ME sY11/1 OF ME sEl/, LOT 3 ni,a ~. ~" LD.O. ~ 90x3 /..-..-..9T.. _. . ~~ a~~.. a ..... / a)AaucE /~Ob EASEYQ'1 i ~ .. .... ........ l'... aL / \ . `~a % ... OY / '.\ B.0. ~ 905.5 9NAx,N[Y ..E: I x WE._ aLxs L9.o.. 90x5 j c~~ '6 ~ ~ L0T9 L0T8 ~ ~ ei eiv ~m SFr. 1659 ADEs n1s19 sa Fr. LOT T ~'S Lxo. - erc s aR naD SEF NOTE BELOW LB.0. ~ 903E di 91x1 sEE NOTE snow 1X1 AdES Iw,lw sn rt, LaI 9 LEn -90x5 dl 915.1 s¢ Nore eELOw i .~! qa Q^. ~.. ~FJ .p V.O. w %11 IJLQ - 91x1 ` 5 1( PPAM/ACd EASGV[NT Y (C ; v ~ X.WE ~ 9111 I LOT 4 1]15 4CRE4 10115E 90. R. LOT S ~ Ixb Ap1E5 ale) sn Fr. SVRVEYOR'8 CERTIFICATE 4 OWCLAS 1 xA1MA, nE451FNm WSCMbTN TANG SIWVEYM, NDrmr mluv: M4r N 1181 Ca11PlYNfl wM ME PRON90N5 K MMT]1 xX 0' TIE WSCMSN STAro/ES AND TIE 9UBDN8M REDUUnals s 11E row aF NUDSdI. ND OLDI I~ir~ ~~ ' ME wEanaN aF MwN pEnmN. ue., awER a SND LAND, 1 NAM: 91RVEVID, tlMOm MD YAPPED ~ ~ p, ~- f2TMWNY ESTATE TUT SUM PLAT WWECRY - RmRESMR ALL Ex1ENOrt BOUXDMIES ANO TE SUBpN90N OF TE TANG SUIMreR AM TUT MR PUT R LOCATED W PMT CF TIE SD/{ Oi ME mµ MD PMT o nE sw/{ d• 11E sEl/1, SCCIKN xi TJM, R19W, roM CF HUDSON. ST. QM% OWNIY, wSCM9N, CMTAM9N0 x1.bx6 ACRES OF LAND; OESWBFD AS ipLp w LET o GOIYENCYL AT TIE SWM WMIEII CpWU p' 9AL SECTM ?2; TIMCE ALONG TE SWM TINE OF TE SpIMTETT OVMIER Oi SND gC1KW x1 SXS1'RTW A DMTANOE OF ]gap fEEf. TYNCE NOOZ9'OTA' A paTANtE a 37.m 1EEr ro ME xaM RN9Ir-d:-wAr o eADLArLS ROAD AND 111E PO91T CF 9EONNWG iMENCE ALMC SAID guar-DF-wAr Sa9slsrw A pSGNCf d: s).Oo 1EEr; nnT1X NoD~9'oT•W A p9TANCE a 1){ao REn MMCE 9MSnrw A DOTANCE K x82X ---~~-- fEEf TO TE EASE lWE V TE NAT K MUOSM ESTAIE$ T4NCE KpL 9Ap EAST LINE N00']0'N•W A pSTANCE OF 1110.N FFFR TNDICE KMO TIE NMM lWF aF SAL SOYREASf WARTA OE TIE SO1MwST WM1OL Of YCAM x1 N6YN'41'E A OSTANCE dF 6N.90 1FET ro TIE r10R1HTEST ~ ~ Ox ~ ~ R ~ ~ `I ~~ { I~ I.~T !) - - iE1re A I fx ALpL Spl W 1] M M TE SWTIEASTSWOIMIER NMSwIWM~ ~ r I ~ 1 ~ H pSTANCE aF ]aEro EEFT ro TIE SEST LYE aF TE PLAT OF NF1LY ESTAre3; nNY E ALMO sN0 w9T lWE spIZSTYE A p9TANCE 6 niN PEEP ro TIE R NORIIEMf CONIFII OP TOT 1 Of A mI1W1FD .a I I y I9° SIRILEY YM RCNIIOED M AV1WE 14 PACE M)1 AT TIE FT ppN GpWTY REp31ER OF O®S o)ILEa TYHCE AIDNO nE NpIM LYE aT SAL Lm '~ • -- T n --- I~ 1 SNSrmw A psTMTF aF NI.IS IFET ro 111E M N MYESf w1EN Oi S D OT 1 MM E I K ; E M OO A L C KONG ME KST IlllE K SAL TOT 1 8]SS]'lYN A I ~_ psrMlX d: ID).lo 1EET ro 111E POPIT a aRYAnwe v A x5).00 Tom RAOVS pWSE. 'YNJ MAr EASiF%r, ~M ~ M ~ ~ I(.~T Y S O RO TIA T S SIT{YOe•9r ANO YGSURES le0.N PEER MMOE SWTNMY KO1I0 TIE MC 6 SAp pIRVE AIL SND (LEST UNE A pSTANCE 0' 16319 R]T ro ME Pawr v TANGENC TIIDIOS KpL LAST suD wBT Y L ~ sooaE'm'E A oBTMa a ITwoD TEEr ro nE r a aEpxwNc 3~ ~~ ~a ------- DA~ TN wru/na~ A~ aAlrr 91wD 'E1 E1 L4'~T 2: xallE ma sIR¢r ~ OS W 49.41 NuOSON. w Blurs a °: P'~°°ro DRAINAGE j EASEMENT I L4CLDT 9 C.G.~,. tlR+7 TABLE •E' I / BEAYde dsr. I 'y~cUL.~~UII'rl. [fie"( EI 58951 b3 "N Zm 11'1 - -- Ex N)IT6'IJF 19I.6J'r----- . _--_ EJ SJ9nJ J3T )1BJ' I 1 EASEMENT • .. -•'-- '• --------.-'_-" SB9 S1 27 W 28235 ~------ ~ P TABLE I I / BC'APP'0 PST 1 ~ I ! . SB93J7]•W 1)S1B' I I w~ ~ I I I f? NIJ'IS'!JF IJS N' I I O NIJW'SSF ,4x AO' I I ' i ~~-Qe T~rc~Qw~ ~ ~ ~ r~a!QLL. ~u~u~Q~v NlJ[UJST BAOB FS SBSJ9'!JF JA38' $ - _- -- --- FB sJSV)ew Jr.eD' I I I 1 ~ V r I ~ ~ I . hie I ~ ~~ I B LANDS ROAD g NO ~ ~'° -----~ ACCLSS g I I y J' SW 0011. I - scc. xx 339,.0x' - - - ~* 58851 27 W m - - - - - ]oaol' . _ SMSI'9TW x59).03' Q V TRAVTIID COIIfRLYS ~ ®{ GDR. SOUM UNE OF TIE Sw/1 SEC, 71 6T CROIX COUNTY PUNNING AND s: ' 20NIN0 COMMITTCE RESOLUTION ~ t ' Q,Q . Ijp 9( If b IR:CJ O.L^1'.E',Ilg~ RESOLVED, MAT TIE PLAT K C®MWN'S ESTATES W TE roM CF HUDSON. KWN pYDI1M. LLC., _ _ ~ 9LY COUNtt SECTpI CORNER Yp11WdT L1wNOEUU~ Owi°I, w HEREBY AFRm4ER By TE SL lAp% Cdwtt PLANNNO AIL xOMINi CDIMIIiE£ ND 1• W1510E pAYETF ROH NPE / // //J/q,, ~~ / ~~~9~I~ q ~ ~~/~- p J ~p11R0E DAYER]I Up1 (..~L!/I, ~(~p-CL~• ~ !/(p ® FpMO PIf MAW PERSpI .. ! ~I ogre 9ET x-3/S' WTIOE pAlElE11 eY IS' UNO WON / l / D WPE RF1bW10 195 IRE PER WFM RfDi / / GL / ` ~ / 7_ //- D( All OMFR LOT CDRrUs YRO~N PIPE MMO I.i] LBS PEA YNEMBFOOT lM0 L ~ OIRECIOR GATE ............ .. w91pN0 8E1BMK (Sp MOM PoMi-OF-WA1~ -' -- - Iz wce ulwtt EAmIMr CURVE DATA TABLE (ALL lMOM9 ARE W EEEn EXSnNO EDIfE O1rw P06N9 CnW CAW U M CNar6 Tan9nnl BwY,n U~ T T ~ I PROPOSED p9wWAY rl y/Y/DdIDIM1 'D2 1 ~~ # N `IL0901A q YA OP hp SUNVE+ # 8a9~$a REGISTER'S OFFICE ST. CRODL CO. WI~SJ,,~ ~ ReRir.Of bwNPll~~ y YZ~_/.1.f0~444 q!tP e~~µlloEdu wYD~bis~ ~ yA,9,N(eew µ. w91E.h rt9n. G..g9,nploY.r.1 CORPORATE OWNER'8 CERTIFICATE OF DEDICATION Kwx wLwM, lu, A cGRPORATON wLr aRDAYxxD Arm EWS11N0 uxDEn AND By Nn11E a nE uws a 1NE sure a wsmlMx, AS AMER. L'OFS HEREBY CEIIIM'Y 11UT 9AD OOMaRAnM CAUSED ME IAHD DEEpOBED M TNS NAT ro ee R111N:1ID, pRD®. YAPPED MO OEOIGIED A9 REPRESMIED M TITS FIAT. KWN MIIDRM, LU:., DOES NRTYA CEAIYY MAT T64 PUT B pEpxRm BY SxX.10 OR Rx38.lx ro BE MUDSM AMO ST. ptp% GWNTY PIAMHNO AMO ZOHIIO COIUTIEE W WMESS WNAEOT. SYD KMW pEDMN 1L0., NM CMSEO MESE PRESMIiro BE 90AT BY DAND KWIC. BE90DIT. w THE PRESMCE a: KW LBTDREN, LLC ~~~/~ ~~ DAWD KwN, GENT NuIMr/ Lel Anq WA BnrYO 9 Lr,gU m9WIl In q„1 Oul (X4x'N7MITN'N•E) (180.N) 1631))DEXS3'00•E) (NOOZ9'N'Wj w J ' \ l 1 CI x5)AO XRYRe• 51)Yx'OB'W 180N N.15 ST643'19Y/ 9a04YO)S C2 x]].00 xTN'{T S)5'X'b].6'E 11LSS Ixi90 NM99'M•E BepITMT: M.W.E. ~ 9015 HIM WATER DEVAINW . I..- STAre p COUNtt Df~~~ •+~I, n5 G 18).00 SIYTM' SMRe'xe•E IN.eI 119.58 360YT0{•E Ne)SI'tYE s ARC 1F114M AL PFRSMKLY 0.WE 86011[ ME TUSZ~AY M 60.00 ISWTO• NISTx'%'E 61.X 029] NB)S4'Ix'E NxxSOOx•E CS wD0 x)ase'xn bxxros'N'E 11108 3)).le N22'S0'02'F N6)TI'X'W ( ) RECOPOFD KJlUrlO ANO/gE p5TAN0 x008. OAMD KMN, PRF90DIT OF TIE ABOVE NXOwI ro BF 11E PEIISON wL ECpHEO TIE fOREC 1 ° ro YE E MD 3 W.W 60T6'xY NSRSx'N.6•E 60.11 8180 NxxSO'O2'E Ne243'31•f IOTEST ecanwo d'ENWC -TIE V 0. ~ 9615 T) YC IOIORN W BE sIM PIIE90MT M xND CO ] 80.00 NS)YI• SJITS'NJI'E 62N 01.1) N8xS6']I'E ESITTOB•E 80.00 8p4x']Y Sx6'IS'bx•E 60.61 )0.80 SS1TTOe•C SOOZ{'X'E . LOWEST wNDOW M DOOR fLEVAnM. NOTE: SmUCMRES MAY BE AFFECTED BY MULTPIE LB.Q (LOWEST BUIIDNC ACNMOWEDOEO TUT NE EIEWIm TIE iOPFAT91 W PRE90DIT M TE 0® OF SAL CORPOMTM S Ny"' ""__'y '_.In S 90.00 81T9'D1• 5231{11.6.11 6LM T1.E5 SOO]I']6'E SXSI'x5'w ' ' ' ' ' • OPENNG) RESTIEICTONS DET'OLNG UPON mE PUCDIENT OF ME SmUCIURE •- i ` 0 80.00 62A1 SY Y13671s W 9LN 88.96 55011 W M97S1 ]6 TS w ' • ' ' ' ' ' • ON EACH LOT BUILDER SHALL BE flE590H8B1E FOR DETDWININO PROPER NOTMY PUBl1C, o '? HC b xi00 NYH W 01.33 8x.9] NBTM 10 M69S3 N ]6 W 38)SI Ix W C) x]].00 b11MN• N86Re'36'W x01.)8 20x6) Se)S{Yx'W NepITTI•W ) x31110 $tT21• 98TTS25'w 151.)1 13).)1 5eTS1T2'W M]lWxTw SmUCTBE EIEVATON AND APRLOPNAre SNE MADW° ALL EIEVATMS ME RFrtAD10D ro TIE NMM NEERCNI VEATCK DANY 61985 ~..•• Yr COMWSRM : p ""C~p~y 9 xum usYZ]' Nsrozlxs•W Baez sD.93 xnTrzrw aTro1•w m le).DO X•N'Ir n)sse'na•w ssM M.ss Nerc~Tw•w ie9s9•w•w nua ulspulYxr OIAFTm er wwAY NME .Tae xn awe-M DALE ol/xo/xaoe l State Bar of Wisconsin Eorm 1-2003 WARRANTY DEED Document Number Document Name THIS DEED, made between Alwin Children LLC, a Wisconsin Limited Liability Company, ("Grantor," whether one or more), and Michael W. Jewett and Andrea M. Jewett, husband and wife as survivorship Marital property, ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other. appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): Lot 5, Plat of CedarWin's Esates in the Town of Hudson. l~`c~~~~SS' -~4-050 020.1059-20-000;020-]060.20-000;020-1059-65-000; Parcel [dentification Number (P1N) This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Roadways, Easements and Restrictions of Record. Dated August 31, 2007 *David D. Alwin, President (SEAL} (SEAL) (SEAL) * * Signature(s) AUTHENTICATION TH authenticated on l}BUC STATE OF WISCON * TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: Michael H. Forecki, Attorney Eau Claire, Wisconsin - (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 NO. 1-2003 ` "type name below signatures. 1 of 1 ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. St. Croix COUNTY ) Personally came before me on August 31, 2007 , the above-named David D. Alwin to me known to be the person(s) who executed the foregoing ins ent and ackno~+vledge the same. * Connie S. Smith-C/,/ Notary Public, State of Wisconsin My Commission (is permanent) (expires: 1/16/2011 Ilifil ifiii Iliii 1111111111 Illli ilil 1lilll liil lilt * 8 5 9 9 2 2 1~ 859922 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 09105/2447 11:00AM WARRANTY DEED E1<ENPT 11 REC FI:E: 11.00 TRANS FEE: 315:00 PAGES: 1 Recording Area Name and Return Address Michael and Andrea !ewer[ 9413 Redwell Lane Woodbury, MN 55125 T ` ~ I~I~~~ Wisc.nsinDepartmentofComme IXCDU~IL ATIO ORT nivisim of Safety and Buildinos ~',T. CRO Page ~ of in accordan b, wis. Aam. t,oae ~ County ~ ~ ~ f '' 9 ~ Attach complete site plan on paper not Tess than 8 1/2 x 11 inches in size. Plan must indude, but not limited to: vertical and horizontal reference point (BM), direction and north arrow, and location and distance to nearest road. scale or dimensions ercent slope parcel I.D. •~ l;3-' ~ '( ~ ~"- 1 ~' l,d,~ `=~ , , p Please print all information. eview D~a®te personal information you provide may be used for secondary purposes (Privacy Law, s. 15.u4 (1) (m)). ~ Y Properly Owner ~~ ~ ~--'~'~'~~'" ~ Property Lorarinn Govt. Lot ~~ 1/4,~,S~,:t)1/4 S~~,T pC N R E ( W ~ t Property Owners Mailing Address Lot # Block # Subd. Name or CSM# ,~ ; 2 de Phon Number ~ ~~~ o City State Zip C ^ City village Town Nearest Road 7 ~ New Construction Use. Residential / Number of bedrooms ~_ Code derived design flow rate ~~-~ GPD ^ Replacement ^ Public or oommeraal -Describe: -------- -- ---°-- - Parent material ~G.c..~L-zc/a`-S~ _ Flood Plain elevation if applicable /~~ r7' ft• General cortmter><s recommendations: an d / 1 ,..v - - ~] Boring Boring # Pit Ground surface elev ft. Depth to limiting factor ~ dln• Sal ication Rate t T Structure Consistence Boundary Roots GP D/ft' Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Cdor ure ex Gr. Sz. Sh. 'Etf#1 'Eff#2 // ®r l2 S r ~ ~ - ~ ~- ~J /n ~ -~l 1 ,~ t' I (J Boring Boring # 3 it Ground surface elev. ~ ft. Depth to limiting factor ~^• gal ication Rate d B Roots GPD/f~ Horizon Oepth in. Dominant Color MunseA Redox Description Qu. Sz. Cont. Caor Texture Structure Gr. Sz. Sh. Consistence ary oun `Eff#1 'Eff#2 b~ r 3/ _--- i ~ r , D ~ ~ ~ ,~ , r S/ __~ ~ _ ~. w 1 II I' D lL d TSS lL 30 m ..-m.._ _. ~, _ cnn ~ o n ~ ~~n mnn and TSS >3~ < 1 g < an 50 i `Effluent #2 = B00~ <_ 30 ntg GS T N~r-e (Please Print) - - - - - s' CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 5 17 ~ ~ -., f ~- ~~ 715-246-4516 s Property Owner _ Parcel IO # ~-~ _ n Boring n r ! i '~ ,-~ Page of ~~~y,. Pit Ground surface elev. ft. Depth to limiting actor m. Soil ication Rate i ti t re T Structure Consistence Boundary Roots GPDIft= Horimn Depth in. Dominant Color Munsell on p Redox Descr Qu. Sz. Cont Color ex u Gr. Sz. Sh. 'Eff#1 'Eft#2 tl 12 r-1 n Boring ~„~ n ^ Pit Ground surface elev. ft. Depth to limiting factor rn• Sal ication Rate t T Stnx~ure Consistence Bourxlary Roots GPD/fE Horizon Depth in. Dominant Cdor Munsell Redox Description Qu. Sz. Cont. Color ure ex Gr. Sz. Sh. 'Eff#1 'Eff#2 [~ Boring ~~ # Ground surface elev. ft. Depth to limiting factor in• ^ Pit Soil ication Rate t R GPD/ff Horizon Depth in. Dominant Cd Munsell Redox Desription. Qu. Sz. Cont. Cdor Texture Structure Gr. Sz Sh. Consistence Boundary oo s 'Eff#1 ~~ 'Effluent #1 = BODs > 30 < 220 mglL and TSS >30 < 150 mglL ` EfrlueM #2 = BODS < 30 mglt. 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. SBD-1330 (R.6AD0) ' Soil Test Plot Pl Project Name Dave Alwin n Bi Address 413 6th St. N Hudson Wi 54016 ~ STM #226900 Lot 5 Subdivision Cedar Win's Estates p 12/12/05 SE 1/4 S W 1/4S 22 T 29 N/R19 W Township Hudson Boring ~ Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 1 /2" pipe 5" above grade System Elevation 90.4/90.0 *HRpSame as Benchmark Alternate Benchmark Top of 1~2" pipe 5" above grade @ 100.0' Scale is 1" = 40' unless otherwise noted ~~