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HomeMy WebLinkAbout020-1404-07-000 0 CO) O 3 '0 0 d � �+ O c O O O 3 r* 0 T. 0 Z 0 M m v f(D o o w T " 10 t • (D y ro m � 3 m ow :3 CL r. > N N O_ = 7 N m X' I cn� N CL 3 Q n N a 3 Q 7 ul 0 ° R O f C O c N c p CL � J O 1 1 cn C- 0 - ° v>z v>zD tnz tnzD C D m 0 D co D y co a D D y C. C o o lc m o c o o m CL CL CL -4 F W N to D O O O O O O O c O O C w 0 3 c � • z Z C SS S S r ( N 1 -0 4i t N C CO) N CO) O d cn co 3 Ch o• > ? o > > m A m rn ° cc c cS c�i d m m CD m CD N N N .r :. O L1 8 3 N a rL th Z Z " 0 o _^ =i 7 p O Z� O Z� O o = o �� g <-a CD d CL CD 0i O N o O_ CD =� N CD w CD CL d a O0 7 Z CD 7 CD Z (D CD I Q. y a y c X .nr, 0j y AA_'i y 7 N y0 �1 d A 7 I j 3 j 33 .O•. fD Z N co a� m� o' a z �. �• ° i co 3 � co y z A m A `< N j Q K N\ D a 0 a a D� a a v o m o C� _ v m _ m' CD — 10 , o M o a j O. q N n y CD CD Oo d <. 00 a 00 CD 00•� II C W m °_ W 7 °. vCD Q� CD CD �a CL a C y CD �C �CD ti 03 0 3 a _ 0 ti o 0 o A 0 ° 0 o o° o ° 0 0C o ti disconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Safety and Building Division i INSPECTION REPORT Sanitary Permit No: 30355 GENERAL INFORMATION (ATTACH-TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)J. Permit Holder's Name: City Village X Township Parcel Tax No: Frank, Todd I Hudson Township 020 -140 CST BM Elev: Insp. BM Elev: BM D escriptio n: Section/Town /Range /Map No: I.tAx 29.29. TANK INFORMATION S ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS Septic Benchmark 20 - IZO•K� Dosing � , N Alt. BM Aeration Bldg. Sewer _ 9 .34. Itt Holding St/Ht Inlet 12-0 TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ` (. Dt Bottom k 15. r Dosing t t 4 .r 5 Header /Man. Aeration 4 Holding Bot ystem b 3.0 Y PUMP /SIPHON INFORMATION Fina Grade Manufacturer Demand Pt Cover GPM ep LO S Model Number TDH Lift t Friction Loss Sys em Head TDH Ft r1•o -. Forcemain Length 1 Dial! Dist. to Well SOIL ABSORPTION SO ION SYSTEM BED/TRENCH Width � Length No. Of Trenc es PIT DIMENSIONS No. Of Pits Inside Dia. Liquid DIMENSIONS 2_8' SETBACK SYSTEM TO P/L F3LDG IWELL I LAKE /STREAM LEACHING Manufactur INFORMATION CHAMBER OR Type Of System: UNIT Model Number: COY . 5G .. 2 DISTRIBUTION SYSTEM Header a if Distribution x Hole Size x Hole Spacing Ven It Pipe(s� Length Dia Length pia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Bed/Trench Center Bed /Trench Edges Topsoil Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / _ Inspectio Location: 423 Jack Pine Drive Hudson WI s Lo 7 5401 NE 1/4 1/4 T2 N R1 W WWo 6 ( SW 29 9 9 } Walden 1.) Alt BM Description = i 2.) Bldg sewer length = (p4 - amount of cover = 4 `t• ;� 1— 3-0 t , S• fs�. •�XS►U.�n� c��f►� et►�t Plan evision R qutr YesNo Use other side for additional information. L - -- ( tot C��S insepctor'sSignature SBD -6710 R.3/97) f Sb•�+tl ti -s$=� , `nil - � "� (:}�� o� • L ti ,� o=•,g , S•E ' � � � So't l ED Safety I nd Buildings Division County *Ai scon 20}O� gg W�asl ngton Ave., PO. Box 7162 G R D �' �AN L Midis i, WI 53707 - 7162 Satu ry Permit Number (to be filled in by Co.) Department of Comme ce Y 08) 266-3-151 ` _u 3 5 - Sanita y F I tl State Plan I.D. Number In accord with Comm 83. I, Wis. Adm. Coda, personal you provide _ may be used for secondary purposes Privacy Law, s15.04(1)(m) Project Address (if different than mailing addres I. Application Information - Please Print All h>formation /� /wr � Property Ow )er's Na me Parcel b Lot N /` - -- Bloc A0 z Property Owner's M ailing Address Property Location L_ ti C , / y/ ,SCCti0,1 � � 2 City, State 0ylo,'VI� 7 Code Phone Number ✓�D/ fs" 7 9� z r le one) II. T e of Buildin a pply) — T Z � N; 1:E or yp g (check all that � �h ,$_1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name - CSM Nunlbe ❑ Public /Conmtercial - Describe Use ❑State Owned - Describe Use 1} /ST L i� �(/ ❑City I_�Village kTownshill of ljfj III. Type of Permit: (Check only one box on line A, Complete line B if applicable) A. — OK New System ❑ Replacement System ❑ T eahuent /Holding Tank Replacement Ouly ❑ Other Modification to Existing System B. ❑ Permit Renewal Permit Revision ❑ Change of u Permit Transfer to New List Previous Permit Number and Date Issued - Before Expiration Plumber Owner �j p N. Type of POWTS System: (C heck all that ap ply) - ✓ _ -_ / - Z Z - 1 Jel Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound G 24 in. of suitable soil ❑ At -Grade - - Single Pass Saud P +ilrer ❑ Consaucted Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ feat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Saud Filter ❑ Recirculating Synthetic Media Filter eaching Cha er ❑ Drip Gr P Gravel -less 1 pc ❑ Oth (explain) De l ersal /Treatment Area Illforjii5ltign: m I Line — - - - - -� si g Flow (ghd) Design Soil Application Rate(gpds0 Dispersal Area Required (st) spei Area Prop �(sl) System Elevatio - 0 Z S �� Z V1. Tank Info Capacity in Total Number Manuftleturer Pre ab i S to Ste 'I )CI' Gallo Gallons of Units 1 New lixisting hJ �� lOd Concrete Constructed Se Tanks l'aaks Septic or Floldin P g falilc Aerobic Treauuent Unit ) K Dosing CI)anlber X- � Plutrtber's Na Plan _ - - - -- VII. Res ponsibili ty Statement I, t he undersigned, assume responsibility f or irvstallation of the 1 OWTS shown on the attached me (Print) Plumber's 5i nature e i g MP /i�,RS Number Business Phone Number Plumb is Addre ss (Street, City, State, Zip C e) VII .County /lle artrnent Use O11 Y Approved ❑ Disapproved Sanitary Permit Fee (i icludes Grout water D1 Iss led ssuin -_ L Surcharge Pee) b u Signature o - tamps L1 Owner Given Reason for Denial . Co/ (/ STEM 8W'24f Approval /Reasons for Disapproval - --- - - - - -- �N 1 Septic tank, effluent filter and 'f D yy�_ u f u - fb h�C� dispersal cell must all serviced / maintained as per mina ement p nmvirJAH hv plumber. 2 A set ack requirements must be maintained as per applicable code /ordinances. Vah t'JYt 4o Le - 3 Attu ch complete Phil (to ill Coml 0111 r to s step on )a er lot less than $ / x 11 inche' ht sib Q� S D -6398 Gl y) -S fl- off- - bo ny Ek,+Aj ` i•c V i L� / tvN C'V 1a� B M P V1M(� I�� (XX.� G�fjlt�7t. � L 15�� �- ,•�1� -., � 1 � 3 � 2 � � D 1 S. 10 a` F/- o 4 Aj V6 ' fox m� Pc� 8 M r l P 4e4- con es 10o, 0 �� Ol 7- Combinat Septic Tank and P CHAMBER CRO55 SECTION A,�JD SPECIFICATIOQ5 vc T CA,? WCATHE K PKG ) — JUUC.TI( bo , ,'C.I, v[MT PK -----,— APPROVE FROM 0 00 9-1 .410joow OR FRESH A)k OiTAKE — V G F F PROVIDE AIRTIGHT SEAL APPROVED JoI�T A T. Tank constructior2 shall comply with A 83.15 and 83 .20 �' � i I > PUMP OF 15LOCK K15FP, F-YiT PERM17LD C)QLtJ IF TAWK MAMUFACTLJR�-W HAS SUCH A "fZO c E 1) _L SEPTIC f 5Pj7C,1F1CATJDK]S 005E _ 7,1, Q Kj MAQUFACTURZK.-- `—V—f7f W LM b Z K o P TA �I K i IZ Z GALI-OkJS DOSG VC)LLM[ lvIA�JUFACT`Uk�.R: k�nl CK F L 0 W: ALARn /`10DLL kJUMBLR: \Q, CAPACITIES: Az-23e SJc,,,OK SWITCH P Li MID i\AQLJ FAC.T U R I;: K, OR M O DE L M U M S - D NCI 3 OR 5W17CH TYPE. PUMP AMD ALAKr� TO aL MI INSTALLED QQ 5Ci),kRAf?1- YERTIChI WMUI`\ D15CKARGE RATE.- - - GPM I DIFF UJ . EKCC DF-TWUQ PUMP OFF AUD.DI5TJZIbu pipc.. QT Lai + MI1.11h1UM IIJETWORK SUPPLE PRESSURE . . . . . . . . . . . FL LT 7 + FEET OF FORCE MAIM X FACI'(DK_,,j 1�6 -EET ale- TOTAL C)'JQA,MIC- HL AD :_ i. E: T Pump chamber DIAMETER WTEKAJAL DIML J 10�JA OF TAKJK: LEtJGTH—.� L:,EP H BOTTOM AREA . -7 231 = PLOT PLAN pace 0 } Scale . 6.1 f C I DoT L.I - a i O F 1 ° 5ys e 1 eV. a , f 3� _C�' 8u�'r� o►= `Rft, - ]turn tom„ mss, JL Y t lZ:JiV -t�t LU cvn� - - - - lvP �Z-O� -6715- 425 -0165 220254 d3 _Z �-0 CST Signature Date Telephone Ldo. CST No. Job PTO. i ME40 series 4/10 HP Effluent and Drain Water Pumps Performance Curve MODEL ME40 EFFLUENT PUMP CAPACITY LITERS PER MINUTE 0 50 100 150 200 250 300 350 40 12 35 10 U) �j 30 UU L W Z 25 B Z Q ~ 20 6 J I6 a4k 15 ` Q 4 0 10 F' 5 2 0 0 0 10 20 30 40 50 60 70 80 90 100 CAPACITY GALLONS PER MINUTE S _ 6 F.E. Myers, A Pentair Company • 1101 Myers Parkway, Ashland, Ohio 44805 -1923 419/289 -1144 FAX 419/289 -6658 Telex 98 -7443 K3326 7/91 Printed in U.S.A. a ' V 0 O _ o c_ c/ C6 s!Z ! t g 21'L� ` c C c. C a i � u r L fly. W f ' Id3ANI U L Lac c 0 E _ o ~ U x H Q �7 x LL r� Z z N a CL , Q : a� Q � � G Z W t �o 8 � � 1 a a 0 X O N I : A • .. s• �di�i►a•`. MINi EU THIS �LOT LOL A �.a.�.�Fti,►j _a X 14 it I r �� Wisconsin Department fCor"f"Eifere SOIL EVALUATION REPORT Page of Division of safety and B ildings Pa nce ith Comm 85, Wis. Adm. Code Pe County Attach complete site pi non n 1/2 11 inches in size. Plan must include, but not limited o: vertical and h ce point (BM), direction and percent slope, scale or r imerY$ibr{s� d to lion d di and to nearest road. ? ^ _ ING N .� o z � JU n rmati viewed b on. Y 'Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). /1/1 Property Owner d "ropertY Locatio TO�Zj T—QA Pro � C �%``n -�1/4 Sk? 1/4 S Z� T Z.9 N R 1 E (or (W e p Owner's Maili ng Address rtY Lot # Block # Subd. Name or CSM# City State Zip Code Phone Number ❑ City ❑Village [Town Nearest Road Sv N - -77's - c 1 rc 7 >v�ii D 1Z New Construction Use: ® Residential / Number of bedrooms ._ �j Code derived design flow rate Lo GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material G L A C 1 it L Flood Plain elevation if applicable � ) ft. General comments and recommendations: / X y3 Z S' l�J - 7 1, t i S OF 1 F-tL�Z p}Z L� •�� j 3oYf�lY� O F �� ,. ��Z ►��.� D , ( - g -a b ?� Nom.. —Y,3 owl P 9 3 Boring # ❑Boring ® pit Ground surface elev. �, 1 • S ft. Depth to limiting factor 'in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'E"2 rZ li ❑Boring # ❑Boring 7-7 ® pit Ground surface elev. 1 • l� ft, Depth to limiting factor 7 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 d -Z� 6`1 (L 3 L — L Ims b�c wi`� -� • S Z Zq - g 10`2 § Vl6 — S C) - , Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS _< 30 mg/L CST Name (Please Print) ignatWre CST Number Arthur L. Wegerer C -;(. Y3 - Z�-0 220254 Address W e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number 421 N. !lain St. River Falls, HI 54022 �Z_$_�3 715- 425 -0165 Property Owner Ll L Parcel ID # _ Z_� - � � b � - C5 - U vv Page Z ' of Boring # ❑ Boring ® Pit Ground surface elev. 1 - U ft. Depth to limiting factor - 7 9 6 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 1 0 - D 1p� IR 313 L Z >v2 k yvt`�1- C 1 �' • S - S )QMP- qf ❑ Boring # E] Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 Boring # E] Boring F ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L - 9 9 Effluent #2 - BOD s _ _ a < _ 30 mg/L and TSS < 30 mg/L Tlie 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 -8330 (R.6/00) PLOT PLAN Paae of � Scale 1'= �0 r' r 07 Ll,l - X L n aT�E : - nom TS 0r,Q) � a r- �. ACTIO v --r _ 3r 1�1 - _E1.. IU0 ON -��� < IZUJV [�[PC LOT CU YZkeTz �Z-fO X3715- 425 -0165 220254 ZO CST Signature Date Telephone Ito. CST No. Job NO. Wisconsin Department of Commerce of SOIL EVALUATION REPORT Page 1 Division of Safety and Buildings in accordance with Cemm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County • include, but not limited to: vertical and horizontal reference point (BM), direction and ` ` �? ,J 1 x percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel LD. - -)'- lu- �� -oo� Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Priva, i Law, s. 15.04 (1) (m)). Property Owner Property Location V, Geyt I nt "�,' 1- 1/4 S� 1/4 S Z�T Z 9 N R 1 q E (or W Property Owner's Mailing Address Lot # Block # I Subd. Name or CSM# City State Zip Code Phone Number r � u �� S S City Village (Town Nearest Road (115��1c1(� -Zg �! l�vp.Sb)V �slc T�>>v� New Construction Use: ® Residential / Number of bedrooms _ Replacement Code derived design flow rate [j p U [] GPD Public or commercial - Describe: Parent material G L C f�- L �V T">1J� Flood Plain elevation if applicable N 1� ft General comments and recommendations: j j ` Zt \ Ctr�t12 i� �' Boring # ❑ Boring ❑ pit Ground surface elev. 1 • C ft. Depth to limiting factor 7 a lb in. Horizon Depth Dominant Color Redox Description Texture Struc Consist Soil Application Rate ence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Eff #2 0`1 ) Boring # ❑ Boring ® Pit Ground surface elev. 1 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 b -ZY l6 IZ.3 L3 — L Zms b1 c �n`�1� • S I ' Effluent #1 = BOD > 30 < 220 m _ g/L and TSS >30 < 150 mg/l. ' Effluent #2 = BOD < 30 mg/L and TSS _< 30 mg/L . CST Name (Please Print) n Signa re CST Number Arthur L tlegerer �. 073 ZZ� 220254 Address W e g e r e r Soil Testing & Design Service Date Evaluation conducted Telephone Number 421 N. !lain St, River Falls, NI 54022 lZ —$ 715 - 425 - 0165 Property Owner 1'�Z F�ilf� Parcel ID # U�Z_t� — L� �L� - d1 — w Q Page Z - of j Boring # ❑ Boring ® pit Ground surface elev. y ft. Depth to limiting factor 7 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 1 o -3D Ip�Yt 3i3 Z � m`F� c �� •s -� C) s � n� I - .� ►- Z F-1 Boring # E] Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 F-1 Boring # ❑ Boring El Pit Ground surface elev. ft. Depth to limiting factor in. F-Efffii Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#2 • Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L • Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service v' p q pp ty e pro tdcr 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 8 264 -8777 SB"330(R.6(00) Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 p S� �� / X eansi►n I4ladison,tWI 53707 - 7162 Sanitary Permit Number (to be filled in by Co ) Department of Commerce (608) 266 -3151 30 35 Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, s15.04(1)(irt) Project Address (if different than mailing address) I. Application Information -- Please Print All Informatio Property Owner's Na me Parcel // Lot O Block # ODD rAANK Prop 'ty Owner's M ailing Address Z UU1 Property Location 4 _'� 5' A) Sr. CROlx C uuNry /V /4, ,section City, State Zip Code t ��b / (circle ) H. Type of Building (check all tha I pply) � a PC S M I' N; R E of — 1 or 2 Family Dwelling - Number of Be oonis ; " Subdivision Name CSM Number ❑ Public /Commercial - Describ Use._ C�M1 b4�✓ae*� q ue Owned - esc b Us° 3 L ❑City_ ❑Villa 5o / e 4 l'o�Yuship of llw� C - III. Type of Permit: (Check only one box on ine A. Co lete lin B if applicable) New System ❑ Replacement System ❑ Tleatment /Ho ing Tank Replacement Only ❑ Other Modification to ystem B. ❑ Permit Renewal ❑ Permit Revision Change of ❑ Permit Transfer to New Lis r ious P nit in er a Date Issued Before Expiration Plut er Owner N. Type of POWTS System: (Check all that a ply) — —~ �bn - Pressurized In- Grouted > I of s 'tab Mound < 24 in. of suitable soil ❑ At- Grade ❑ Single Pass Sand Filt r ❑ Constructed Wetland ❑ Pressurized In- Ground 11 Hol ng Tat 11 Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand F'I ❑ Recirculating Synthetic Media Filter El Leaching Chain 11 Drt Line El Gravel-less Pipe ❑ Other (explain) � 4.� V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsi) Dispersal At c ) Dispersal Area Propos (si) System Elevation 7 ?s . I S VI. Tank Info Capacity in Total umber Ma facturer Prefab Site Steel Fibet astic Gallons Gallons of Units Concrete Constructed Glass New Existing fatil s Tanks Septic or Iloldiug'Pank Aerobic Treunuent Unit l Dosing Chamber _L VII. Responsibility Statement- I, the made signed, assume responsibility for installation of th OWTS shown on the attached plans. Plun is Na me (Print) Plum is Si gnatu e MPReff," Number Business Phone Number /Ur-G9 2`'6 Y� um er's Addre ss (Street, Cit State, Z, 72- ,S ode) L Zti� - (= - t VVIII. County /De artment Use Onl - Y " Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issu'n gent Signature o S ps) [ 250 ❑ Owner Given Reas n for Denia Surcharge Fee) l 7V IX. Conditions of Approval /Reas is for Disapproval SYSTEM OWNER' 1 Septic tank, effluent fil rand dispersal cell must all a serviced /maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. Attach complete plans (to the County only) fm the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) COPY NT g� LL 46 g3 Ike �1 GAIL -, LL �� p�.�� ��� C <<,� o � �� ��� $� � '� �� �� a� g�i �� `� � � � PS � �'�( � L v b1 �� � �" � �` "� � k � �`� �L -� �� �� 1472 wonsin Department of Commence SOIL EVALUATION REPORT page 1 of 4 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations Attach complete site plan on paper not less than 8'%x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. 020 - 1083 -30 -000, ID#29.29.19.334C Please print all information. Reviewed By Date Personal information you provide may be used for seconday purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Midwest Const. & Development Of Hudson„ INC. Govt. Lot NE 19 SW 19 S 29 T 29 NR 19 W Property Owner's Mailing Address Lot # Block # I Subd. Name or CSM# P.O. Box 932 7 Plat Of Walden Woods City State Zip Code Phone Number J f City I Village $M Town Nearest Road Hudson I WI 1 54016 715 -760 -1149 Hudson I Glenna Drive Id New Construction Use: 01 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement _ . j Public or commercial - Describe: Parent material Glacial outwash Flood plain elevation, if applicable na General comments and recommendations: Install 3 trenches using 29 high capacity infiltrator chambers four feet below grade at elev. = 93.0', 95.0' & 97.0' on 97.0', 99.0'& 101.0' contours. Boring # j Boring Pit Ground Surface elev. 99.20 ft. Depth to limiting factor >88" in. S61 Application 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 1 0-8 1 Oyr3/3 none Is 1 msbk ds cs 2fmc 0.7 1.2 2 8-15 10yr4/3 none Is 1msbk ds cs 1fmc 0.7 1.2 3 15-41 10yr5/4 none s 0 sg dl gs if 0.7 1.2 4 41 -88 10yr6/4 none sr s Osg dl - - 0.7 1.2 Horizon #3 contains approximately 10% gravel & cobbles. o Boring # j Ong 01 Pit Ground Surface elev. 94.04 ft. Depth to limiting factor >94 in. Soil Application 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 1 0-13 1Oyr3/3 none sl 2fsbk ds a 2fmc 0.5 0.9 2 13 -27 1Oyr4/3 none sl 2msbk ds cs 2f,1mc 0.5 0.9 3 27 -34 1Oyr5/4 none s 0 sg dl gs if 0.7 1.2 4 34 -94 1 Oyr6 /4 none sr s, Osg dl - - 0.7 1.2 I * Effluent #1 = BOD 30 < mg/L and T >30 < 150 mg/ • Effluent #2 = BOD . 30 mg/L and TSS <_30 mg/L CST Name (Please Print) Sin James K. Thompson S-- � 2 d2CO3 C ST Number 3602 Address A.C.E. Soil & Site E ate Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020 9/152001 715 - 248 -7767 dv Property Owner Midwest Const. & Development Parcel ID # 020 - 1083 -30 -000, ID# Page 2 of 4 F3] Boring # J Boring Id Pit Ground Surface elev. 98.17 ft. Depth to limiting factor >98" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots DIfF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *VIM *Eff#2 1 0-31 1Oyt3/3 none sl 2fsbk ds cs 2fmc 0.5 0.9 2 31-48 1Oyr4/3 none sl 2msbk ds cs 2f,lmc 0.5 0.9 3 48 -81 1 Oyr5 /4 none s 0 sg dl gs if 0.7 1.2 4 81 -98 10yr6/4 none sr s Osg dl - - 0.7 1.2 F41 Boring # Boring Pit Ground Surface elev. 97.07 ft. Depth to limiting factor >91" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh_ *Eff#1 *Eff#2 1 0 -21 1 Oyr32 none Is 1 msbk ds cs 2fmc 0.7 1.2 2 21 -39 10yr4 /4 none Is 1msbk ds cs 2f,1mc 0.7 1.2 3 39-73 1Oyr4/6 none s 0 sg dl gs if 0.7 1.2 4 73-91 1 Oyr5 /4 none sr s Osg dl - - 0.7 1.2 Horizon #3 contains approximately 10% gravel & cobbles. F-51 Boring # I Boring Pit Ground Surface elev. 103.27 ft. Depth to limiting factor >92" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -10 1Oyr3/3 none Is lfsbk ds cs 2fmc 0.7 1.2 2 10 -29 10yr4 /4 none sl 2msbk dh cs 1fm 0.5 0.9 3 29 -74 1 Oyr4/6 none gr s 0 sg dl gs - 0.7 1.2 4 74 -92 1Oyr5 /4 none s Osg dl - - 0.7 1.2 Horizon #3 contains approximately 10% gravel. ' Effluent #1 = BOD 30 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOD < 30 mg/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. property owner Midwest Const. & Development Parcel ID # 020 - 1083 -30 -000, ID# Page 3 of 4 6] Boring # Ong to limit factor 0" in. t 1 Pit Ground Surface elev. 88 + ft. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDff- in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-70 10yr32 none Is 1 msbk ds gw 2fm,1 c 0.0 0.0 2 70-91 10yr4/4 none Is 1 msbk ds - - 0.0 0.0 H #1 contains high amount of organic matter, maldng area unsuitable for POWTS installation. F Bonng # 0 pit Pit Ground Surface elev. 88' + ft. Depth to limiting factor >98" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -36 10yr3/2 none sl 1 msbk ds cw 2fm,1 c 0.5 0.9 2 36 -50 10yr4/4 none SO 2msbk ds gw 1fm 0.5 0.8 3 50-60 10yr4 /4 f2f 7.5yr5/8 sil 1 msbk ds aw - 0.5 0.8 4 60 -98 10yr5/4 none s 0 sg dl - - 0.7 1.2 H #1 contains high amount of organic matter. Reodx. features described as H#3 are a result of the greater matiric potential of finer sit over coarser underlying sand and is not indicative of groundwater. ❑ Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD <30 mg/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. ' ■ so � ✓alua�'orPi� N Sec. 9, T- 01' s�r,, 56. Croix G dS 8y 64, S 9 ■ � e Q3 ol 4- Y�� VI 2/7 r o3. co �l1rrr Eou. � 8Z 8� Q3, 60 QS.CO' A U, 6. b ar . EIS = t00 Co. 99oo CSC -d =- SaG Pg. VOI A.C.E. S & Site Evaluations James H. Thompson 340 Paulson Lake Ln. Osceola, Wl 54020 (715) 248 -7767 To: Zoning - Attn: Kevin fax# 715- 386 -4686 From: Jim Thompson Date: Sept. 22, 2003 # pages including cover sheet: _ 5 If fax is incomplete or illegible, please contact Jim Thompson at telephone number listed above. Kevin: Attached is the soil evaluation report that I have on file for lot 7 of Walden Woods in the Town of Hudson. I remember this site because the slopes are so difficult to work with & the lot lines were hard to establish. If you have any questions give me a call. Ji �. S��� ���. SEP -2.2 -2003 07:58 AM R.C.E. Soil & S' @ E "al. 715 248 7764 P.01 e � s 1472 801E EVALUATION REPORT p . 1 of 4 MVlsovlain Dspellfrlar� d CaalMrlsroe A.C.E. Shc 8 oat. Evdleallorr+ Dhdsion of W* and BuAd O N sooadleloe *& Cam 06, vllls. Adm. Code Afth aoelpMla ails PW an Peed not less lhom 61st a 11 kWh" in alas. Plan mull �� St. Cfobt include, Out nd Wild d b: narlird end hcrimnfsl Msrstlss pdnl Imo, #I'c'on'rd p I.D. peroalr siapee. arms a dflnameione, north I1tn1W, ed k mkm V4 diwww b naotesl load. 020. o ID M28.2 0 p .1 � 9.3'J 4 C Plloose petit all Md wwwwbn. 91► `f 2 3 Fseo'Iwr Inruww•wr Iw r=++i� nap Ir arse to► wraond'y pafpoa (PtMra�r lam, �• 15.01(1) hula F "IV Oren Properly Lora>Alen �_ L01 NE 7l4 3W 1M S 29 T � _ N R 19 W Midw CO na t 8 O drelo me Of H I NC. _. Ld • 9bdc # stood. Name or CSW p� a; r° M Ad 7� Plat Of Walden woods P.O Sox 93 Now" Road city Zip Code Phone Number' Clly Vllage /Town Hudson 1 WI 1 54016 715 - 780-114 Hudson fin °° Use: Rowd'ntiei / Number d bedrooms _4_ Code derlwed design flaw FOP 60 GPO Now Coatrtrudion � Raprec'rnarlt Public or oommardd - Daarids. Parwi Iflatw w Glac outtl _ _.. .. _ Flood play+ sWA&n, N applicable _ , ns _ ww mrrlrrtero . Install 3 trenches using 29 high caPSCRY illfrlt la r chambers four feet below grade at WW. = 93.0','85.0' & 97.0' on 870, 99.0'& 101.0' conmum. 9,6v a is p it Boak Ground Surface elev. 99 0 ft. Depth to limiting facto► s88" . .in. Sail App�bn Rats Morm Deplh Domirwnl a Raft D raiplion educe Truchas ' term BMWEY Rook in. Mweell W. Sz. Cont. Cob Gr. Sz. Sh. f1111 on 1 0.13 10yr3r3 non Is 1 msbk do as 2frne 0.7 1.2 2 8-15 10yra/3 none Is lm da CS 1fmC 0.7 1.2 3 15 10yrsm none S 0 sg dl gs if 0.7 1.2 4 41 10yIS/4 none sr s * 060 - - 0.7 1.2 #3 ocnlalrne Daft # Pt Surface dew. _ , 94.04 R. to limiting factor l;ell APPios4o^ Floriaon DWh Dwkwsll Color exlura Structure Co►laislerloa Wmdrry Room 7�0.7 in. Mlmael Qu. Sz. Cora. Color Gr. Ss, 8h. 1 0-13 10yrm none al 2N* ds n 2ffnc 0,9 2 1a-27 10yr4/3 none /d 2mebk ds cat 2f,1me 0.9 3 27 -34 10yr5/4 none s 0 s0 dl 98, 1i 1.2 4 34-94 10yre/4 none or s Dag dl - - 0.7 1.2 SOD 30 t nIpIL an EflkrerR #1 : d TSS *30 t nl 150 mg/L • EfIlu' 92 =110D 4,30 nlgA. and TSS - m41L _ 220 s' - CST N~ GST NMne (PNIIYe P") fur's• Jarnes K. Thomps 3602 - Addreee A.C.E. Soli 3 39s Evakiatlons _ Deb Evaluation Condua Sd ?akplr'ne Natteer 340 Paulson tabs Lane Osceola, W154020 9/152001 715 - 248 -7767 SEP -22 -2005 07:59 AM A.C.E. Soil & Size E"al. 715 248 7764 P.02 pl omw mutest ow st ®D!YllOprnent Parse 10 9 020- 1083 -30 -000. ID# Pop __ Z __of � Q S ; Pk "'0 Ground Surboo QW. _. R llmltlnp War X98" ,�pp�pp, ANN t brixon Oaplh DomkW color Re# Oasorgfee TadlMe SNUS Uue Rael� In. MuneeA Qu. 6z. cam. cow or. at 6h. 'EfIR7 "Efllr2 1 0-31 10yr"I n one e1 21W* de ca 2fmc 0.5 0.9 2 3148 10yr4/3 none 51 2rnsbk de as 2f,1 me 0.5 0.9 3 48-81 10yr5/4 none • 0 eg d go If 0.7 1.2 4 81-98 1OyrQ/4 none of s Osg ell - - 0.7 1.2 'o s 6orNlp 9 7.07 h. Depth to Ni ft taus >91" in. Rd Pk Ground SuAaoe etay. _.. �pp� PFwm Oepth Dominant color Radon oaaaphon Texture Stn CAUFe CarfeisW" samd.ry Rack Qmw in. munsell Gu. Sz. Cem. Color Or. Sz. Sh. "Efd1 'EM12 1 0-21 10yrw none Is 1 mebit ds co 2fmc 0.7 1.2 - 2 21-39 1 Dyr4/4 none Is 1 msbk do es 2f,1 me 0.7 1.2 3 39-73 10yr419 none e Ogg IS go if 0.7 1.2 4 73-91 10yr514 none we 08 9 d - 0.7 1.2 ttori>rnrt 03 ow *Wm apprw&nd* 10% grown! A cobblaa. F I Boring a M � 103.27 lt. DepM to IMrlklrtg %dw >92 In. Pk Ground Sur ailay. Sail Appliotian Rate Horizon Depth slant color whn Saucgra Cargfstatoe tlaxtdory in. iMsisell Qu. Sz. Cont. Cola Gr. Sz. M. 'titfol 'Elf*2 1 0 10y 3 none Is ltsa de c8 2fine 0.7 1.2 2 10-29 1Oyr414 none d 2msbk dh os 1fm O.S 0.9 3 29.74 1 OyWa none gr s 090 to gs - 0.7 1.2 4 74-82 10yr5/4 none = Os9 IS - - 0.7 1.2 Hoban S3 aonlelra apptwholaly 10% gravel. Mier* #1 z BW 30 < ?20 mg& and TSS *30 c 180 aWL • Mier* 02 a 000 a 30 we& and TSB -9 110 ffQ& The Acpartment of Cornmctoc is an equal opportunity service provider and employer. V you need aaaislance to =am ass Aam or need material in an alternate format, please oontact the devarttnant at 608-266-3151 at TTY 608 -264 -111M. SEP -22 -2005 07:59 AM A.C.E. Soil & Size E "al. 715 248 7764 P.OS Property Owner "mutest tit a meet Pmed it) A 020- 1083 - 3L0- 1D* Pipe 3 of 4 ,, Eil 9or4+p i it s 88' + it. Depth b knWrp ftdK __ _ In. Soy Appy xkn Rib a PI Grwrnd 6uT+ee atsv. Houma Depth Tmdtse S��° tanoe Root 'Etf91 .6m DomilrrA Radst D�alptlon in. Mansell Cu. S:. Colt. OWN Gr. SE Sh. 1 0-70 10yrm none is lmsbk de 9w 2fm,1c 0.0 0.0 2 7"1 1Oyr4/4 none is lmsbk d o - - 0.0 0,0 Het �nmine !dp!► arrrolrrt oT argerrlc mmrbar, Irwklna arse taleul�ls Ilor !3 inseaNetlon- 7� BorkrO a pit Gro surtarx elev. t3 8', + ft. Depth to SlnNIN motor _ >96" M. Say AWlcdm Rafe Hotiavn Depth Dominaril Odw Pad= Dascriptwn Talllurs skudub Raab in. IMlrlsell Ou. Sz Cod. Color Gr, U. Sh. 'EMI •EIM 1 0-38 10yraQ none sl 1 mcbk do cw 2fm,1 c 0.5 0.9 2 36-50 10yr4/4 none ai 2msbk de 9w 1fm 0.5 0.8 0 3 50-60 10yr4/4 2f 7.0r" sy 1 m sbk do aw - 0.5 0.9 1 4 60-88 1 OyrS/4 n one 6 0 Gg dl - - 0.7 1.2 T Het oontakrs high aeaaad of orgmrtia mattef, Reoabc. taelUfem dematEed es t 1R3 sre ■ rermil of the greater mellrte potendd of Itrrsr sY o>rer ooerar underi ft mend and is not tndsmtlre of parndlMafM. e Pit Ground Sulfaae slow. ft. Depth to Yrr►MM1g facRrr In. Sai AppicmhW Rote fbiran Depth Domhmf Color Red= O;upfan Tachme S lnawtlre CaA*Mnaa Baaa4ly Roots in. VAucsel Ou. SR. Cont. Cobs Gr. S2. Sh. •Ef�11 'Effe2 i • Efom t a1 : DOD s s 30 220 nq/L and TSS >30 a 150 mglL ' EMuwd 82 ■ 80D -�_!0 mall. end T66 � 30 mgll The Dopsttaront of Commerce is an equal opportunity eerviee provider and emplrryer- if YOU treed arvis mw fo Omm serviam or nood material in an git umm format, ok sm aoetaot the departn+ent at 608 - 26&3151 or TTY 609-2644777. SEP -22 -2003 08:00 AM A.C.E. Soil & Site E "al. 715 248 7764 P.04 • ■ Soil ��a /ct af%d/i Pi � �of 7, 5 t . Cr0 it Cb y �.Jl. DS \ 8 y s c9 kscw�l�e.d el _/� 83 bZ m AU.. b 7opoF �c�.r Efur z quo, m, 5 a � SEP -,22- -2003 08:00 AM A.C.E. Soil & Size Eval. 715 248 7764 P.05 A.C.E. Sd'Jd & Site Evaluations jam" S. Thompson 340 P aulson Lake La. Osceola, WI 44020 (71 9) 205 -7767 To: From: — Jim Thompson Date: S 2 # pages including cover sheet:-j F40. If fax is incomplete or illegible, please contact Jim Thompson at telephone number listed above. Kovin: . Attach©d is the soil evaluation report that I have on file for lot 7 of Walden Woods in the Town of Hudson. I remember this site because the slopes are so difficult to work with & the lot lines were hard to estamish. If you have any questions give me a call. This k t 6�:rie Private Onsite Wastewater, Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (8.6/99). Table 1: System Design Specifications Sanitary Permit Number 0 SS Number of Bedrooms Desi n Flow - Peak (gpd) Estimated Flow - Average (gpd) Septic Tank Capacity (gal) Soil Absorption Component Size (ft2) 0Oomefic Type of Wastewater Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Compone Design Flow - Peak (gpd) Maximum Influent Particle Size (in) 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years I Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Pits, Seepage Trenches, Privies, or Portable Seepage Beds Seepage P , a Pg a p9 Restrooms). The operating condition of the se and outlet filter shall be assessed at least once every 3 years by inspection. Th outlet filters all be cleaned as necessary to ensure e rovisions are made to p er The filter cartridge sh a remove n ss p retain solids in the tank that may slough off the filter when removed from its enclosure. If the Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 Management Plan for a Septic Tank and Soil Absorption Component - Plantings of deep- rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. PI_ 1 71s -273s� co - 715 6 � 4 7 c° 1s - 3g�` � 6�v -71 �oN�N� X 7 3 — 6747 3 7J5 510 ST CRODt COU>!1TY S9MC TANK MAIINTBNANCB AGREBMANT , AND OWN]�RS W CBRTIF Q*M0N DORM ELa n c P Msiong Address Jac& Pine 1�ri vQ Propocty Address ant for nea►Roustcuorioe (vea cation mqubred from Planning Depsm� �_,__.�_..._. 1 fyity/Sts<to Parcel Identification Nttm r rrratr. DL%M2TIOIY ozo - i �p - ® Property Locadan %+, S'l!J %. See. 2L T 'J � •�L.W, Town of 11' diV1P10p S Lot #• . .5 # • 1 P� Volume - ,FaRa # Cartified Survey Map _ / # �a Wurnaly Deed # S*fio *Y3 yes, • la y Ono fattare to bacdle waato Pwpecmtiaoonsnoe no -; , impEVpecttse and maiatenanceofyocr aepdcsysteta mould result in itsprernsm+s Wi•ut Y� pat inoo � ryatem coos m.af pp q cat ul the 1%910 unit every three yean soocar� it neededby s ltoeascdpumper affeettbe lhecdon of the septic tack as a treatment stage in the waste dim 4te The ppraepetty owner Urces to,submit to St. Croix Zoning DepsMt It Qertitioatioa form. sip44 by the owner *d by a =& ftph=t" ' joumsy= PIUM$04 ZrAWOW PlomlberoraHocwedpuatperverit b6 Oat (1)a.on 00 w at%wateftoadoetem ig in pqw opasft condition and/or (2) aQer inspection and pamP4 (if nooeuary ar aeptio tack is mess than W M of sludge. 1w; the aadonigaed have read the above rcgair==% end ISM to waiataia the private se.vaga disposal s t tie ae sat � hmin a set " the Depu Mt of Commerce and the laeputment of Nt►tttrat Resourm. State 9f W IL Sce 0 :*sting that SO,* system has beet maintained must be oompteted and resumed to the St. Croix County Zoning s=hzA= date. _ c 1 la- StCS2D► C C.Wr DATB QVMR I (we) certify that all statements on this fort are true to the best of my (our) knowledge. 1( we ) am (UV) the pre" dnaibetl above. by virtue of a warranty deed recorded in Roglstar of D4eds Office. DATE S1EiIZATUR� tyl? t►PP • •.aw•. Any information that is mis- rapresected rcay result is the sanitary permit boiag trevokod by tho Zoning Deps:tme°t• +w ss with this applicstlorii a stamped wammty deed "M the Resister of Deed: office a copy of the cad" tu:vc)► scup if apt OW0 is made in the war *uV deed J 2272P 564 '725 STATE BAR OF WISCONSIN FORM 2 - 2000 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX CO., WI This Deed, made between Renton, Inc., a Wisconsin corporation RECEIVED FOR RECORD 06/12/2003 10:30AK WARRANTY DEED EXEMPT # Grantor, and Todd C. Franck, a married person REC FEE: 11.00 TRANS FEE: 360.00 COPY FEE: CC FEE: Grantee. PAGES: 1 Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum:) Recording Area lot ,Plat of Walden Woods in the Town of Hudson, St. Croix County, Name and Return Address onsin Scenic Title & Abstract, Inc. 220 Locust Street Hudson, WI 54016 20- 1083 -10 -000 Parcel Identification Number (PIN) This is not homestead property. (?is) (is not) Exceptions to warranties: Easements, restrictions, and rights -of -way of record, if any. Dated this c�20/'k day of December $ 2002 RENTON, INC. * * Jeffrey arre * * Stephan . Bouton AUTHENTICATION ACKNOWLEDGMENT Signature(s) cott ECkhOlm STATE OF WISCONSIN ) a U ) ss. State of ISC ST. CROIX County ) N authenticated this Personally came before me this v day of December 2002 the above named Renton, Inc., by Jeffrey Warren, its President and Stephan E. * Bouton, its Secretary and Treasurer. TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Stats.) ins ent ackno ed a same. THIS INSTRUMENT WAS DRAFTED BY * /i4 wt Lommen Nelson Law Firm - Brent R. Johnson, Esq. Notary Public, State of WISCONSIN Hudson, Wisconsin My C ;sio is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) • .., .) * Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN INFO -PRO (800 )855 -2021 www.infoproforms.com FORM No. 2 - 2000 •� =-�- WALDEN WOODS � �JQ W „��.y e'y��-�, AWWA�IATI°MTOWMRlW1MM1N OlTM MlK A1O Mllf WTM MMNVT11t - _x pa _Ri ��.o Cx�T °IIMKAILN MQIgM1T. TRx4ReYY. lOM1OI M10WM, R. C110�[001M1T.YMOOI�YA m MNW.wa\ (fie_ MIOAI� IOR p•1�, w ouvannfv.9P\��c j lwP� ' Yr� IQl 1lLA �.� �'i.. n••�.��r'gw.�°r��wTr ^� �"�.w�w•�w..n �� �' s.wa .ice � �' 1� '`/ � I aL ma. • ,ur�we - T� i • i , �'Z ° ,r_�� ; flit • / I . I � :m.:�� w, �s: :,a ... �„: �.� :� max'- aar -I'= / -° --------- �• 1 I y ! / / eaweMl�f l.e r , �--- ---- M:: :°._". ......I x\lAr — war. - ; rr ``�, wATr ilxa wxlir KSti ; Nis! I MIA .l4tt ----------------------- 'i w�rxavxels$TS