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HomeMy WebLinkAbout020-1280-40-100 uf 3 co m ;t A r _ W O 0. n Z C C C A N P* _, k 0 • j, N N y . f i " O I A O O " lD N O n O N N N 3 '� 5.72 v = ? f0 O N N: 7 c r ru r 0 C 67:11$ co c CD • (a .o. N a a Om w 3 0 0 oco N a 4 Z a '< ooc 0rto o XI O O O. c o o c a o 3 • Cr. � • c n 1��11 u, a 13 13 13 . rt 4 gi o u) 73 444 E G N Z N c Co co o co O o > Q '0 00 7 . • Z d v w CD CD - 0 9 m .. N * 3 d o 0 1 1 a E z 3 .. o C -i Z 1 o c O O O 7 7 co O N * N z ' 7 0 N I •0 N C S. C p� N I O 3 m a a 7 z (6 -. -1 U) A Z CD v c _, 21 o 5 D V) -1 W M N O g .-6: o — Z A m co I 3 Z 0 A G) 1 N 0 - n 1 u) a d m. = 11 I '< co c r — c I o z a V O O m I S eT 1 m co = 4 m D a a fi O q I � o b N I co co O i CD d0 ;r EA O ti 1 00 a ` 1 N. 6 . cc.,kwn.neS24 County: Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM St. Croix Safety and Building Vivision INSPECTION REPORT Sanitary Permit No: 395207 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)). Permit Holder's Name: City Village X Township Parcel Tax No: Kuerschner, Jon Hudson Township 020 - 1280 -40 -100 CST BM Elev: Insp. BM Elev: BM Description: < 1 q2,6 ( cso -o lc 1 � r = estgw.A( ■ S54-f-- i* * TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Alt. BM / l ' SD ! ' Dosing Alt `A) I • Z (�'U . T' 200 -0 Aeration ■1 Bldg. Sewer I 1 5 ' 5 2 , 9 g. % Holding 1 St/Ht Inlet (p) VA), 11 qS 8 S St/Ht Outlet (44) l e I TA ETBACK INFORMATION 2ov- . e'S: ,o TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 1111. 1 Septic 3 0 f+ L *) 3 9 1 _� Dt Botto . J Header /Man. \ t i „ p-.- �„' G - o z 0�.3 8 1 Dosing wv"" Pipe 5:-/ sf Dist. Aeration P Bot. System s'" �� Holding c. L -4..:32. — Final Grade /�,,.r 40-rawA.•..•-.1 G► to t. ISo' 9. 8 6 PUMP /SIPHON INFORMATION -- t.d.ost --� `�'. 3 ) l l0 l 0. cro Ma facturer Demand St Cover ( 4'4.10 -- •M l Model mber TDH - , Friction Loss 1System I Head TDH Ft Forcemain Length II ia. Dist. to Well SOIL ABSORPTION SYSTEM (' \ ap.../..firs /4-4.4....-4-.. _ . .' Width Length f No Of Ts es PIT DIMENSIONS No. Of Pits Inside Dia. 1LiquidDepth DIME • NS ` " SETBACK SYSTEM TO P/L B G WELL LAKE /STREAM CHAMBER OR S.n tyyer S , r ` 40024._ INFORMATION Type Of System: l r [ i - 1..�11A; S ' f � / ' I c UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifoldket s Distribution x Hole Size x Hole S.acing Vent to Air Intake n� Pipe(s , Length ` Dia 4 Length Dia 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 Mulched Bed/Trench Center Bed/Trench Edges Topsoil A. Yes I No El Yes Ei No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 10 / 02 D( Inspection 142: -- 1 - --/----.- Location: 684 Edie Lane Hudson, WI 54016 (SE 1/4 NE 1/4 34 T29N Rr A Lot 21 _ Parcel No: 34.29.19.1642B 1.) Alt BM Description = 6w9w•i / ne.k Ie. r 8,6toi. l,._ (1 ) 2.) Bldg sewer length = + y Z- „FQ�, - . C sy�4.eH,. t 5 -- / -. - amount of cover = 90 �T�`� -t- �4 .......Aa a° J ei Si . U L Plan revision Required? El Yes No 1� ate- - ; , ago' Use other side for additional information. reg. ) Cert. No. Date Insepctor's Signature SBD -6710 (R.3/97) k I- 'F r‹.6.)10,. P • ' Cireck_ PC 1 .-/( Ol 1.31 • .,,K„‘( - _ •„ - _ • oi, • 1,/:, 6-o • a i 1 41-S 1.8 s „ • 00 3 e • — 0 1141 4 ' -‘1:r11‘47Q _____2Z i_ag...„1 w._.._,... _.,_.- Safety and Fiingsivs ars Ccu.'s;Y 201 W. Waellgtot: Ave., 1 Box 7162 ..,_ :_. .1 ...,.._..__..... -_.. --1 1 Isconsin 1 : Mad4eod. WI 53707 - 73.1 Slts Address On r mont of C omlrifttrb tail Permit Number Sar tary� Permit Appl , . • , 39 s2.oi la mooed with Cerro 13.21, 'Wis. Atm. Cate. p * T , ovids 0 Cheek ;f Revision . L;.. . , _, - , ._. - * rill• e> cv 8gdp Dien .D, Ntuisbet L Application Informatics • kk s PdttI AU 4, i , 4. D [ENO per0al Nutntxa 3 a q , l - . is I3 rrorr a .mtl • -- , To.,�/ /(ue-A$c!ihor c' �itl 21 7a0 4 H- ` Oa irk'` /Q " /1 Property r' A ,� ?ropes Ail e f` ' ii ,o ss• s T a` IN R A City. MAN Phony > , / = loc;k Number e, , ; .t Naas CSM Number — a t 3 b • /104 ell , tL ''14 ci hi N 5- - ; " " c ev ,H �/, l G ' �! Ckity 7 II. Type at tiuilet�s (cheek A that e►l►ply) ..c IA ' 5 Q aMs i yi or 2 Dwellio - Number of Bedrooms , 4., ya „._ _.....,._ . i 0 Public /Coeetteredel - Web bs Ure A " dip I' v _ ., ' I Nearest load 4 0 Sum Owned r r �L _ '1 . ' i .e it 4,.././' ,-; c/' e- -- M. 'Typs • Permits (puck only one boz on !Sine A (Ru+aberfns ethane for Internal use). Complete line 811 apgl1ceb1s) - , i A or Caunt e re 1 New 2 0 Rapleoemeot System 1 3 0 Rsplt crntieac 0! 6 0 Additi a i sW - Nutobtlr lgxiada S ass Dutl Issuod B. 1 0 Cheek if Solon Plank Previously lined " Y V. Type at Celt pt}utt a plplYOiiber+i scheme-is for internal use) %, „ ff 44 N -Premised Iss4rouad LC Mound 410 Seed Piker 50 0 Coaslxu ed Wetland (,6 22 0 Prune !tied IspOround 410 IIoldlos Tank 410 Siaste Pau S l 0 Drip Line 43 0 A . 46 0 •is Treatment Zru Rect,; nulss{n ._. �... „Is Other - D 1 ..., - , e _ • fe Y Dl apNlat s • liaatOn ■ 1 ( , ...Moe Rego � Min Final Grade / y : 1 Elevat Required PrapProposed s1`k I S0 App ttaee(�la rDsyslsq.Pt., 1Vtia.Rncb) � /If, (! VS god add , 0 I ,r/Q- ; 0 v. 3 ! /0, / . �...._ ._ VL Task fie► . real Number Maaut'oatum VAS Site Steel Fib ar Plastic Woes Whales Coearrm . Cocsteswed Glass • E d eptia 4! 11111111 /0 • Ma r t . . e v ........ --- { j. .---"i VU. Stsussent. I. the taderdimet maps respossibi far et the PO IS shown ea tbt tlttu ii li • 1 Plumber's - ease Plumbar'e idea" Nine Sulam noes Number 14 '4 ••yr- Sc A k. i►a. o grey c "^"'1 Plum. 1 - •, • 1116te• 2 ,. •'' - ) /e7 5ca 4 ,. r ` .e^t / — � « . a • ,. . ` ! (. cam q • saw • to 1 : ( . Assoc SiSl�atur ( SA10 ca mps ,� ApppOVed © rid ... +' se Pee) 1 Cl Owner clivsa Saiclsi Advslttl • lis IL tet .7 7 C 1 _! IX. Coteiltis= of for 1 p `� �,, - Q 2 � -1 8- L- n_o 4 Stc 4 - �- Lail_ 34. S`A""Z S °� 6,e- ' • ' • •) *v � pt;.tl o `` t,,_L) s,6 . I • , . ,. � v+- ^-', ,, - i am ti • e � a 8K lltr�^"•� 1 t 4 viatti • • l B oa ' S a , re ..w.a.s (*Ada r�..'., . ire. 4 r Z I ■ ■ .,. 4 i 5-4- \ -sa rf 4 ril s, ° 1 A. 31 r 60 5491 d& • .., ,. r . • 3 �_ O O 0,1), Ca.t/ 9x 50 1,- . o 4 Z. \ P ■ 'yamXSd vei4tcS 14e.-44-e.5 , ba athey$ 4' ,3 Taro( G :2 s — — fit • y nowNIIMININMN 01 8' id 1 'A k N O N A 1 O. y Z rt o u 1 -e- .1 - '� / bad "1/9't 7!, l e8 F . • 3 ,-- .— O bj i • Vita. vs4 - Al, r r 9�5 I //r 4 A , N • t \ N, 4 't--1 x4-0 rc hes yS -4.es Fe-4a mbeY5 %oLt 3.2 To re r e;2 / O I . a a rs 01 1 t O k y ■ n � ' ' S I c of Industry, SOIL AND SITE EVALUATION REPORT Page L of 3 man Relations iplikpartment o,...tet)! & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not Tess than 81/2 x 11 inches in size. Plan must include, but DTI C ®i X not Ii &to wihical and horizontal reference point (BM), direction and % of slope, scale or PARCEL LD. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION i' AT R ffG/r 41 P� A% S l GOVT. LOT SL 1%4 N 1/4,S34 T Z ,N,R /9 E (or) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. N,AME OR CSM ,;'.3 6 L - ,f' •- 57- N . '11 CIAPAY i-11 LL CITY, STATE ZIP CODE PHONE NUMBER °CITY °VILLAGE MOWN NEAREST RQAD 4.06 re dt,/ S o (75) 3 r /4u L5c1 o Em L,0 ( 1 New Construction Use PI Residential / Number of bedrooms 14 lust (J Addition to existing building j J Replacement ( J Public or commercial describe Code derived daily flow gpd Recommended design loading rate 6 S bed, gpd /ft ( 6 trench, gpd/ft Absorption area required bed, ft trench, ft Maximum design loading rate 6 • S bed, gpd /ft O . C trench, gpd/ft Recommended infiltration surface elevation(s) tt (as referred to site plan benchmark) Additional design / site considerations ►L E .Ui4s 10:r..1 toN( v : C'-5/ ilPe 4.644 L Parent material Flood plain elevation, if applicable ft Sit Suitable for s C M OUND IN-GROUND PRESSURE AT-GRADE SYSTEM FILL HOLDING K U= Unsuitable for system 1' S U ' S 1:1 U ❑ S 14 U ❑ S ,f8 U ❑ S o u ❑ S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Te xture Structure Consistence Bcurd ry Roots GP D/ftZ in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trends talall & V - 1`7 i6Yre 3A S, C, I r - , s b K fli r t.) l c D. Z C1...3 .2. .. Ground &> l7-40 /6y,2 4/4 s , t ,1 01 sb k A V Cr , ,„) , O.3 2. elev. /daft tg.? 4 © 7.s y.4/4 Fri s6 Ali C s -- OS 4, 4 . 5 Depth to ( 1D /i 4/6 AS S i nil 6.716.y ,1- limiting 5 f . 4,"1 - 10 . `f6. Remarks:, Boring # _ : A ®- $ 11 / -- L I tv 1 5L r p Cw : z iii (3. . L{ II e, z -l8� iC)1e3/3 5 L- / * z6r r>7-�r , 2 q r� I� d.� ;d. 3 • .1 '''-- 82 a- 46. /6Y4 VI- — C . 1 Iis6&. n't r 9w ' a g o - Ground ! b`It ft � ' _ `� € aQ / D'-'13i' /1;5 S4 nt / i O ® I- Depth to 4 `!�Y 4 '� . , n ■ limiting - '''S / � r� r w'i :) tt ' `� (' f /.1 r f' > .. _ --- 0.- ;.c.,s' ,. cT� ' 1.948 coluiA f Remarks: +� °- - , - IA CST Name:—Please Print Phone: ��� . ddress: p .. �� /«.v w i ���:_._�_�, Signature: Date: CST Number: g4 . 64/ $-- 22- PROPERTY OWNER SOIL DESCRIPTION REPORT Page_ PARCEL I.D. it Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounck3y Roots G D /ft- in. Mansell au. Sz. Cont Color Gr. Sz. Sh. 4 BeL+ tench ..,Iti , 4 o 1 /6)(1 3/2 L / ni s mk thy- CIA) 7.)1-, 0,4. ;‹ ..,( :.:' . .g, ct 19 / /kW? f S ' i r. SL , sr Ct,) / 6,2 (33 .z. Ground & t - 4' ld yk 414 S ,L C rh st.4 n1 v -r 5 1.4) — 0.2 03 ,.1- elev. $ 41\-kit - 7:s y>° 4/4 , — RS (.) ylqi cS — 0.'s " - Depth to €4 Kit -7s4 i 0< 4/4 ens SC4 nil — 0.7 1 61 .3- limiting C ,,,I r ow } Remarks: Boring # A I i--1 0---% /6 ..... L 1 ris thcr Cu) zr frAt- g, 6-/ iby181 5, / A sbK ,Sr ciLa 1 (),.2. 6 .z Ground 6Z 17'3C 1b\i 414 S .(- / a, b mV 'Cr (, .2 616 3 _ z.. elev. 13.3 C S 7:Y Q c2S S 1 AK. ft. j m CS 0,5 `d.6 .c Depth to BA- st:K /I yg 4 14 , _ A S 6 ,-,-, 1 " 4.7 d : g , limiting › 3 . Remarks: Boring # Ai 0-/6 j� yR 3 ? 1. 1 n., biz.- /ytr CIA-) 'Zvi 0 .4 0.; •1 M _ & /6-1? p yR 3/? 13,L. / n, s b;! r I r ,A /C 0. 2. 6,3 . Ground el 6z 19 - . i6ytq 4/4 —" S,- / rh s4.1K. /h4 A, -- (3..2 0. .2 ev. 6 3 . Y>e 4/4 - S / ` C.-$ d ` " ' /04.4 ft �� 7 .I4 S'S Ca J 0:� , s" Depth to $4_ l� .. S tby )4 4/4 — r/s S6 /hi 6.7.0.8" _ - 1" limiting facto I > ' L. . Remarks: Boring # ,St• - • , Ground I elev. ft Depth to - limiting . factor - Remarks: SBD- 8330(R.05/92) It - - lPi "-•--_, • , .. - - _ I-1 - - ,./N, .•.. Vo 0 t c..,P -- ‘7 ‘ --- '- ---> l 7- , 1 tl• \ L to c. m -.... ,-P- ,/i ,. . , -.. . E . . ,... \ ry rm •;s. v 1 , i C' +...-...._pm ( r. in 1 Ei c \i„.. , rN/ 1 Is 'is) .... - . ..... -. Z-. 1) ,- - -0 In rri o c• ( -.... E 3 / , z_... ______ ___.._.,„ -./ ; ra E1\ -{ C\ r: Is (-- II -,.. .... \1 I- N/ C> 1 L • 5�-- Wisconsin Department of Commerce SOIL EVALUATION REPORT Page / of _a Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County S , c ro it Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. a 'ewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ADS + 1 j , f Property Owner Property Location yam-A -- Govt. Lot SE 1/4,04J1/4 q T Z N R / 7 E (or)� Property Owner's Mai ing A Lot # Block # Subd. Name or CSM# 6 YS q K,k - / `s/u� , LAA 2-1 C lu- ray /' 11 City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road to fia,Ve 1 Mn ■ S53Y6 ( ) llvd•Sar'■ 1 Ed,' e L--' n-C at New Construction Use: ® Residential / Number of bedrooms 3 - 4 Code derived design flow rate LISQ /t ' dc) GPD ❑ Replacement 1 ❑ Public or commercial - Describe: II ilift■ Parent material 4;11 F •o 3 : • elevatio?tifa • - •le 1//4 ft. General comments tip " t% ? and recommendations: SyS erg &/ev. 7 / Sr5 Fes, s ,,e: , t . 00 n r�,c, - e! 4 4 1 R' 2 • SO _ .. - Boring # 0 Boring \- `f �-c'' © Pit Ground surface elev. 9 y N d ft. \ Depth to Iimitili ' Factor l j � in. \ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure , i�oni -nce Boundary Roots GPD /fe in. Munsell Qu. Sz. Cont. Color Gr. 8i:`8h: *Eff#1 *Eff#2 I a - R' i l y r . / / z — S ("/ 2 i P m cr (S ) v4 . • • Z. X -/ K M yf f73 _ -,C` 1 2'nad, r vr\--cr cs — . . 2 /s Zit I6yi" 7'/ --- froL / r`vho_s-{n At . -- - -- Boring # I J Boring Z EI Pit Ground surface elev. 9y9Q ft. Depth to limiting factor / 7 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /f€ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I 6- /D yr•3 /Z. — s,' ( Zryt u k PA---cr C5 he . • 5• Z- k -/Z 6 . 1 ( W 3 1 — s 1'/ Zmcv6k at -c( - C S -- •s' 3 1Z- - 15' /0yrS/ — rrai 1 m,e.. s 40 - — * 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) Signature CST Number Address Date Evaluation Conducted Telephone Number 0//3 g -a.cl --00/41 / w/ ,c zs F- /3 0/ ( )Lr7- yoo,' r - f • Property Owner Parcel ID # Page Z of 3 ❑ Boring FP ' / 3 Boring # Wu Pit Ground surface elev. p • 34 ft. Depth to limiting factor l - in. Soil Application Rate Horizon Depths Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff . • in. Munsell Qu. Si. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Z M1= — Ci1 ICJ -- III lira Boring # El ❑ 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 /fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring Boring # El 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 /fg 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. SBD -8330 (R.07 /00) PAGE 3 OF NAME & kw rSc-h► LY" LOT #Z' LEGAL DESCRIPTIONS ' LA % s 31 Z ►. 1. 1 • _ .05 / SCALE: 1"= yQ BM 1 ELEVATION /60- O BM 1 DESCRIPTION n .,/ b' /0"cl l- st -c-'t' N _t_ BM 2 ELEVATION /QD .D K BM 2 DESCRIPTION Vtai A (2 "Guk- +re -e— c-ec, Z SYSTEM ELEVATION `1P -S ALTERNATE ELEVATION /U ( -- CONTOUR ELEVATION 92 . S d 85.50 3 o. 513 4z.5 , s -; si ,ova "- • 4 1 SIGNATURE �'r DATE -/-? d/ Y u a a 4 I H ��t111n x 1t111 � ii � I ° � } iNillifl'ai: sh � .� C x o 1 CO ` 11100111 '1)1 N c4 .�i,a, ,H IN S - . g. }" ' N A% 1 a p ,11 1 � it ; � ro �' >, 1 Off (--- hignimg011 0, w 05 M 111,1111 II r 1 ii! '..54,-- rill ' ' ' < - V ki, if tli 1 ` X 0 6 �� w 3 II bC r ill i ''':-, -- ' '' -4 L.. 1. 0 I! / i cc .1.3, 1 it IC 1 ,'N, - -4--11i, / II I " . e g a ii li , ,ft , 1 .... i,... ; .),:,),„...., ,,, tzt i„,,,,,,, , IR '..„, r, ,—; 1 li ;! S2, ,--- - •-•• i Dui u I a n M I11 1 ,14 E 1 I 1 - -,, -; .-. .. _..�,.. J \ 'n wrap i i ipu .11.1 as U cts :..3 A: .�. ;? _._..._ " C e 2 � r ��.�` {1 0 oft _gyp _....-- ----�f � �QY 1 i it [�.w/i II 41 ._.7 3 7 .1 ii - - -- 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 (R.6/99). Table 1: System Design S . ecificatlons Sanitary Permit Number 9S o Number of Bedrooms 3 Desi • n Flow - Peak • • d) 45 Estimated Flow - Avera•e (gpd) �' u Se•ticTank Capaci (.al) %` Soil Absorption Component Size ( ) 5t,D �0 2 ' ,1 a ' . 0 ' r T pe of Wastewater Dome ' is 1 . S Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Des' • n Flow - Peak (, pd) &1 ` - "volt e, i f) Maximum Influent Particle Size (in) 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) — 150 Table 3: Maintenance Schedule Se•tic 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 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, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the Sept _. and outlet filter shall be assessed at least once every 3 years by inspection. Th= outlet flit= r §hall be cleaned as necessary to ensure proper operation. The filter cartridge - - - • of be removed unless provisions are made to 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 Plantings of deep - rooted trees and shrubs directly over of within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. Contingency Plan In the event of system failure, a new system could be Installed in an alternate area With the installation of a diverter valve, the existing system could also be reused after a period of three to four years. It is the property owners responsibility to maintain the alternate area free from any planting of trees, shrubs, etc. In case of failure of the original system, the alternate area will be needed. If any trees, shrubs, etc. have been planted on the alternate area, they will have to be removed at property owners expense. If alternate area is destroyed, there are other alternative systems that can be used, in which, could result in added expense to the property owner. Any tank abandonment shall be done in accordance with Wisc. Code 83.33. Any questions regarding this code, please contact your local Zoning Office or contact the Installing plumber. 2c"1/4" t›S• �C.e.. (1 Ls)38t..t40% • , wr f- .a� -IL ? K, ) ( ls) 3% 6- 3 I a ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND O WNERSHIP CERTIFICATION FORM Owner/Buyer , Mailing Address (off k'f\ s s 3 l Property Address � � .' - Za.Sd t1 1 (Verification required from Planning Department for new construction) (/l City /State 7 4/e, ,.C:ce J Parcel Identification Number 0:• d- la ' L ' /d -/de LEGAL DESCRIPTION Property Location St' '/<, "lid 1/4, Sec. 35' , T pig N -R C ' Town of tfGc41.$' Subdivision CA eviry ' //' , Lot # 2 Certified Survey Map # 5 WS , Volume 1 , Page # 3 • Warranty Deed # c /C 7( , Volume f 7 f , Page # 7/ • Spec house ❑ yes !Dino Lot lines identifiable k yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. 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. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, joumeyman plumber, restrictedplumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 da s of the three year expiration date. 3 /t1 /0( G ATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the roperty described above, by virtue of a warranty deed recorded in Register of Deeds Office. /i3 / O( SIGN TORE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed VOL iG79111a 11 6S 1.O - 7S STATE BAR OF WISCONSIN FORM 1 - 1998 KATHLEEN H. WALSH REGISTER O WARRANTY DEED ST. CROIXCO. , W D ocument Number RECEIVED FOR RECORD This Deed, made between Patrick L. Yuengst and Corrine E. Yuengst, husband and wife, Grantor, and Jon T. Kuerschner, Grantee. 07 -13 -2001 9:30 AN Grantor, for a valuable consideration, conveys and warrants to Grantee WARRANTY DEED the following described real estate in St. Croix County, State of Wisconsin EXEMPT N (the "Property "): CERT COPY FEE: COPY FEE: TRANSFER FEE: 234.00 RECORDING FEE: 12.00 PAGES: 2 Part of the SE 1/4 of the NW 1/4 of Section 34, Township 29 North, Range 19 West, further described as follows: Recording Area of Certified Survey Map filed in Volume 13 of Certified Survey aps, Page 3598, as Document Number 596685 Name and Return Address DAVID J. ESTPEEN 304 LOCUST ST. TOGETHER WITH a non exclusive access easement as set forth on said HUDSON, WI 54016 Certified Survey Map, SUBJECT TO an access easement reserved unto the Grantors and 020 Pazcel Identification Number (PIN) appurtenant to Lot 20 of said Certified Survey Map, and as described on the reverse side hereof as the "Easement for Ingress & Egress," This is not homestead property. (is) (is not) SUBJECT TO an easement for drain field, reserved by the Grantors herein, for the benefit of said Lot 20 of said CSM, and as further described on the reverse side hereof as the "Easement for Drain Field." Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements and restrictions of records. Dated this / �S" day of June, 2001. 1 - * * ' atrick L. Yuen: MAIIIIIEWI * * Corrine E. Yuen 1� AUTHENTICATION ACKNOWLEDGMENT Signature(s) Corrine E. Yuengst STATE OF WISCONSIN ) ) ss. St. Croix County ) authenticated this 15th day of June , 2001 Personally came before me this / ' day of June , 2001 the above named Patrick L. Yuengst * William J. Radosevich 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.) instrument and acknowledged the same. au , Y§ ' THIS INSTRUMENT WAS DRAFTED BY _"'� .. a r,~-e William J. Radosevich, Attorney at L aw * n LLB , 1) 502 Second Street, Hudson, WI 54016 Notary Public, State of Wisconsin My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) 3 1 3 /C 8 •) * Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co., Fond du Lac, W STATE BAR OF WISCONSIN 800.655 -2021 WARRANTY DEED FORM No. 1 -1998 V01. (�I. �JPAGE 612 Easement ForIngress & Egress A permanent easement located in the Southeast one quarter of the Northwest quarter, Section 34, T 29 N - R 19 W, being part of Lot 21, Certified Survey Map recorded in Volume 13, Page 3598, Document Number 596685 as recorded at the office of Register of Deeds, St. Croix County, Wisconsin. Commencing at the North one quarter corner of Section 34, T 29 N - R 19 W, thence along the East line of the Northwest quarter, recorded S 00 15' 37" W, 1974.96 ft. Thence along the North line of Lot 20 of said Certified Survey Map, recorded S 89 52' 14" W, 379.65 ft. This being the Northeast cor- ner of Lot 21. Thence along the Easterly line of Lot 21, recorded S 11° 44' 06" W, 250.04 ft. This being the point of beginning of this easement. - Thence continuing S 11° 44' 06" W along the Easterly line of Lot 21, 157.50 ft. Thence along the Southerly line of Lot 21, recorded S 74 38' 07" W, 100.00 ft. Thence N 23° 28' 58" E, 196.90 ft. Thence N 89 52' 14" E to the Easterly line of Lot 21, 50.00 ft. This being the point of beginning of said easement. This easement contains 11,520 square feet or 0.264 acre. Easement For Drain Field A permanent easement located in the Southeast one quarter of the Northwest quarter, Section 34, T 29 N - R 19 W, being part of Lot 21, Certified Survey Map recorded in Volume 13, Page 3598, `, Document Number 596685 as recorded at the office of Register of Deeds, St. Croix County, Wisconsin. Commencing at the North one quarter corner of Section 34, T 29 N - R 19 W, thence along the East line of the Northwest quarter, recorded S 00 15' 37" W, 1974.96 ft. Thence along the North line of Lot 20 of said Certified Survey Map, recorded S 89 52' 14" W, 379.65_ft. This being the Northeast corner of Lot 21 and the point of beginning of this easement. Thence along the Easterly line of Lot 21, recorded S 11 44' 06" W, 76.46 ft. Thence S 89 52' 14" W, 174.58 ft. Thence N 00 07' 46" E to the North line of Lot 21, 75.00 ft. Thence N 89 52'.14" E [recorded bearing] along the North line of Lot 21, 190.00 ft. This being the point of beginning of said ease- ment. This easement contains 13,671 square feet or 0.313 acre. Ll' 4 ■ ge lye a y North-South 1/4 section line. , re, '' iVicY Q soo.0.37'►v NO0'13 3?" •1nHNSUN ,9t4 96 15'37"W ��� 332.61' 3163 B9 S1/4 Corner 'MC :SON S� QN 1 .� ' Sec or. Section 34- 29 -19S� Mt) 7 < Y„ s ° 4N p Su q - ' � �• PLAT OF CHERRY HILL . m ° a, `" 1LCD7T' 20 6 t 0 s PI 195109 sq.ft. (4.479 ac) S 00'03'20'E 210.00' la ;1- -- 1 00' , Qs' 1 . 171220 eq.ft. (3.931 ac) Y , I Z' ° excluding easement W' 1 I Z' 9 a; a Q. 'CU r - � ; v, I 6 ..: 7 6.46 1 s a /14. �a os "+v. _ ACCe 0, Imo, 6 1-11 4 0 . � • ss ...J: c IZi �, ° c sr,. • m: v ~' a ^' CO a N89 ° 52' 14" c 1 S 7 .5p - -Cg! : W. 1 1 Fes' +� Q -I . In .� r �0,4 Y9 r d { 1 q; °' .s � , LOT 21 N 9g • - s , • �% 6 W; I Cr! o 0 3 '1 Z ' ,r1 V1 ► w 87556 eq.ft. (2.410 A Q ° l zj, — . - d o., ■ 1 i .Li —75,40) 1-. 1 ; 1 ILI w - 1K00 ,4'3o c, 1 j , a4 1 __ = N 00'14'28'E 443.00' � 4 t0 6 r. • ? 1 s u Q PLAT OF CHERRY HILL ( Le end • � 4 1 i Qj us 4 g ! 0 1 Yi -.II ° 1 "X24" Iron pipe weighing 1.68 1 • a, ibs /lin. foot set. ® ' a y'� f • 1" Iron pipe found. 11 I Bearings referenced to . • 2" Iron pipe found. the plat of Cherry Hill. - North - ? o ao .. © 6 6 ' la' Previously recorded South 1/4 Section line assumed N i 37 „ je• . 4 . information. S00 ° 15'37 "W . "'' -''� I SCALE IN FEET I'° 100' 0 100 200 300 Ow ... This instrument drafted by 4982596 t,,'I 1, 0 -,..., 7cQ1 c• 2- L. ? : t ti 2109E2 : 01 6005981 =S T Lt e;l1ti3� X IOaa 1� • WOa� dS? � S0 S 002 -z. si"1N I /v t ' N !� � u 1 V °` FILE ' '0 ti T tF CERTIFIED SURV EY MA P Located in the Southeast quarter of the Northwest quarter of Section 34, T29N, R19W, Town of Hudson, St. Croix County, Wisconsin, being Lot 7 of the plat of Cherry Hill. Pat Yuengst 536 Lemon St. North , otisl �11 UNPLATTED LANDS 4A. Wi. 54016 ,,`4 " ,Q/v s �� � '' North -South 1/4 section line. • i° soo °l5'37'W , ,, L 4 HARVEY G. * `, ', 1974.96' S 0015' 37 "W N00°15 '37"E e. JOHNSON 4. 132.81' 3/63.89' .. `S - 1698 N1 /4 Cor. S1 /4 Corner I HUDSON s I ,;. Sed. 34 Section 34-29-19t WM r • a p ,, 0 "OZ N p SU" ' pii d, . 1 ' 1 111 1 ■ b 0 o 'y PLAT OF CHERRY HILL ds In 9 8 , 0) O ff ' I } N LOT 20 I 6 6 o o 195109 sq.ft. (4.479 ac) S 00 "E 210.00' I ` I p; x 171220 sq.ft. (3.931 ac) kJ ; Z' excluding easement J 1 W' 1 Q� iu ' .4._ ` Z 1 9 -.I. In u; Q i I m '3.5,z, m: --I: 1 h: Z w 1• S (/): - . 1 a) 1�44'O �: r 0 1JI � 407 W o, ZI W• - `C.' 1 Oo ' 5.4 ' t m: d I I S " ° 4q'06 ; � 0 IT iss I .° c' 'I N t a 1 Q� md� lL ®7T 27 3 • \ v OIICC _ y : \ cc W! � W z ,g.i r 87556 sq.ft. (2.010 ac) - .,o \ 1= al I x ti- \: \� m 1 V1 1 N 6 g Vt.- LEI o br 1(/ (N00 14'30 ° E) ' ` W \°„ % • N 00 445.00' \ to \� Y" l�'s p►* �n r4 PLAT OF CHERRY HILL :. `r, ;. rn \ h Legend -- - - - - -- - - -- - - -- ., \ % v)._ 33' 33' Is II IQ o 1"X24" Iron pi weighing 1.68 ,,, , I , ,, ,;,;'Intl .1q o \ \ 1' � lbs /lin foot set. 0 \ 20 • 1" Iron pipe found. —��—°* • 2" Iron pipe found. Bear ' referenced 1:0 ,,I , f r J the plat of Cherry Hillsr.: No 50 s 6 6 I (a) Previously recorded South C/4 Section line•asssurne& '�i? °aQ s „� information. S00 ° 15'37 "W. itW `'v•,,el . 1 E / / SCALE IN FEET l"' 100' . O 100 200 300 ' AMP' hew. This instrument drafted by ',.! 4982596 VoI.13 Page 3598