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I!waad #;1wJad # uol;eollddy esid sales # deW a ;ea leolao;slH a ;ea uoRMO NISNOOSIM '.liNnoo XIO2iO 'iS X ;uenna aNOWHOI2J MEIN EIO kiIO - LR :# I aoae d 1 L =10 L 39W INV ZZ:60 LOOZ /ZZ /80 000 Z V WZ :# I 83ae d " 1 • Wisconsin Department of Comnerce PRIVATE SEWAGE SYSTEM Safety and Building INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. ermit Holder's Name: X City Village Township Vew Richmond Golf Club I City of New Richmond ST BM Elev: Insp. BM Elev: BM Description: tTO. o 00•0 Cr � TANK INFORMATION TYPE O MANUZ R i CA ACITY • (@— Septic Vent to Air Intake ROAD Dosing riction Loss 3 System Head l . Aeration Forcemain Leng y Holding Lt TANK SETBACK INFORMATION TANK TO P/L WELL LDG .y/� Vent to Air Intake ROAD Septic riction Loss 3 System Head l . TDH Ft �• Forcemain Leng y Dosing Lt u 2- 1? r b BLDG Aeration Type Of System S !� 52 i O 8 � Holding St /Ht Outlet nICTDI011Tlnti CVCTFM [aAt C'. 11 P11MP /SIPHON INFORMATION Manufacturer a Dema L 9191. Model Number 160 I S Z TDH Li �,� riction Loss 3 System Head l . TDH Ft �• Forcemain Leng y I Dia ', - , a I Dist. to Well SOIL ABSORPTION SYSTEM BS HI FS Width I Length CHAMBER O No. Of Trt� DIMENSIONS f Alt. BM Model Nurn (- SETBACK SYSTEM TO P/L BLDG INFORMATION Type Of System S !� 52 i O 8 � 9 St /Ht Outlet nICTDI011Tlnti CVCTFM [aAt C'. 11 ELEVATION DATA County: St. Croix Sanitary Permit No: 499142 0 S to Plan ID No: o 7 Sp = 711s . ia. Parcel Tax No: GQ tion/To /Range /Map No: 04.30.18. STATION BS HI FS ELEV. Benchmark CHAMBER O cJ Yes No VD.o ` Alt. BM Model Nurn Bldg. S er � 1 � ( b IP • g t IP T 515 q l I St/Ht Inlet O 8 � 9 St /Ht Outlet Dt Inlet Dt QmdtmV µ,• II•S� 90• g�- Header/Man. , , erx Dist. Pipe r Q C /0, Sot. System q S i Fi al Grade r f Si over 'n }r 967- � �) 3, qv ce"'I 2-S- (t)2.s�) = Im PIT DIMENSIONS IN& Of Itits llnside Dia. iLiqu;d Depth JELL LAKE /STREAM LEACHING acturer: _ Length O Dia 2'o CHAMBER O cJ Yes No Yes No UNIT Model Nurn Header /Manifold I r Distribution t P�pe(s) 3.0 x Hole Size u 1 �Q I x e Spacing 2. S 3 Vent to Air Intake Length O Dia 2'o `' 1 I f �l� Length � 3 Dia Spacing cJ Yes No Yes No enll CnVGR n . c n..r., — 10--ti nr At- rrar1P SVStPnn% Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed /Trench Edges Topsoil Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Ins a Lion #1: � ( Insp ction #2: "`;' Location: 1164 State Hwy 64 New Richmond, WI 54017 (NE 1/4 NW 1/4 4 T30N R18 ) N of 1 No: 04.30.18. 1.) Alt SM Description = /cll �l ��\ Q/ 9 � 2.) Bldg sewer length = I a dto�"t��BN J - amount of cover = Plan revision Required? Yes No l Use other side for additional in for i on. ___ - -- -- - Date Insepctors Signature Cert. No SBD -6710 (R.3/97) , r 15 arc„ q ' 40 0 Wye Op 15 arc„ q ' 40 0 Wye Op SBD -6398 (R. 01/03) 1 i? Attach complete plans (to the County only) for the system on pape�ot ess 81/; z 1l inches in size �'( , t ,t v�,Qb ► atuJ ok- ceC (1µ Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 St. Croix isconsin Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 266 -3151 q 9 9/ Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you prove ' (0 =- may be used for secondary purposes Privacy Law, sI5.04(1)(m) 1 30 Te"qws. gyp., oject Address (if different than mailing addres 1164 State Hwy 64 1. Application Information - Please Print All Information Property Owner's Name Parcel # 1 Lot #at= Block # 0 1 New Richmond Golf Club G `�+ I Na Property Owner's Mailing Address cokpli I Property Location GRO`X SS 1226 18 Ave. Gov't lot NE '/4, NW '/,, Section 4 30 N; R 18 W City, State Zip Code >wX5mber New Richmond WI 54017 (715) 246 -6724 11. Type of Building (check all that apply) Z 9 ❑ I or 2 Family Dwelling - Number of Bedrooms X Public /Commercial - Describe Use Community based residential facility - 7 beds X City ❑Village OT- of New Richmond ❑ State Owned - Describe Use III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A, ❑ New System X Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. El Permit Renewal El Permit Revision 11 Change of 11 Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner / a IV. Type of POWTS System: Check all that apply q1 X fop 6 t-1 ❑ Non - Pressurized In- Ground ❑X Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation 897.0 gpd 1.0 gpd sq. R. -ASTM C -33 fill 897.0 sq ft 897.0 sq ft EISA 97.75' @ 12" above 96.75' contour VI. Tank Info Capacity in Gallons Total Gallons Number of Units Manufacturer 1 W �� ` Prefab Concrete Si a Constructed Steel Fiber Glass Plastic -t� / New Existing Tanks Tanks Septic or Holding Tank 1,800 _ 1,800 1 Wieser Concrete Combination X Aerobic Treatment Unit Dosing Chamber 1,10 1,100 1 Wieser Concrete Combination X VII. Responsibility Stat ent I, the nn ersigned, assume n lity for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' Sign MP/MPRS Number Business Phone Number James K. Thompson CIO �--- MPRS #30021 (715) 248 -7767 Plumber's Address (Street, City, S , Zip Code) 340 Paulson Lake Lane, Osceola, WI 54020 VIII. County/Department Use Onl Approved ❑ Disapprove —� Sanitary Permit Fee (includes Date Issued Issuing Agent Signature Stamps) Groundw urcharge Fee) icr " en Reason for Denial IX. Conditions of SYSTEM OWNER: - - - - - -� I 1. Septic tank, effluent filter and 9�C��$ SYS /B �''�� C&&^ dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained d� I as per applicable code /ordinances. ( 4w.r7`n re S -X SBD -6398 (R. 01/03) 1 i? Attach complete plans (to the County only) for the system on pape�ot ess 81/; z 1l inches in size �'( , t ,t v�,Qb ► atuJ ok- ceC (1µ C.sof ,zo9.03 " 1.o 6 2 C 5 20 1S/ 7M c v `a h 0 pra ��ofr,5.c.al cJ.'esu C.tm bi na --E.: on StpF�c �Na /y,Lc AZ -d.2s /le ,-ar< STo+ I-aw'7 ,t rrla�ce f/'ees WC!( Xesod e.rrg, ia°'r �-L� • c� Z), — - el p / A dd �tUn „ c�ctc�a sEox orclta uSe Foy... alo�E %a>7 . Assccnlccl e /Bµ / / (, // 1 '+E ♦ EX(SZT.,q grade elegy • e Hia� � /lei �c(nmond 60/� CoursL' /ets /r1 z, CSrrt za�y?88 nwyt/nE/y, V5 ACRE QARC E L XiS,Ej CcJ� �cnCr -(� 6rw s k r 7 t proposcd'Wo.,,d 2G.9g x / /9.os i.� /8.97,r iao.c�' /a feia /.r a E �� ';r i(' 3 9`w /%B or" /'ces ccd s. sue' % 0 p Q ' � o � ' r � ; r , r ' 9� 1 r 63, rl IAV � r � Q • 2 �. 8 c� Sod 9 , , , Sod 9 t commercemi.gov isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 www.commerce.m(i.gov/sb/ www.vVisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary August 14, 2006 CUST ID No. 30021 JAMES K THOMPSON A.C.E. SOIL AND SITE 18VALUATIONS 340 PAULSON LAKE LN OSCEOLA WI 54020 AM. PO WTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/14/2008 identification! Numbers Transaction ID No. 1307896 SITE: Site ID No. 716449 Arthur -Rose Community Based Residential Facility Please refer to both identification numbers, 1164 State Hwy 64 above, in all correspondence with the agency. Town of Richmond St Croix County NW1 /4, NEIA, S 4, T30N, R18W FOR: Description: Replacement Commercial Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1090251 Maintenance required; Replacement system; 897 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 101), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.0 1 /0 1) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be located and constructed in accordance with the enclosed approved plans and with the component manual(s) referenced above. • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the POWTS installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats.. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the tank/filter for maintenance purposes must be provided per Comm 84.25(7), Wis. Adm. Code. Comm 83.22(7) - A cony of the approved plans specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department which may include local inspectors. P.O.W.T.S. Conditionally A P P ROV D"' DEPARTMENI OF COMl�FRGE -. —r --w Aun null n1mr-V Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the components) utilized in the POWTS. Note: The natural gas utility must be contacted prior to the system installation. This is required to alert them of the proposed construction of the mound in an area where an easement for an existing gas line may be present. The count may require proof of this contact prior to issuing the sanitaryperinit. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at th e telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, rard M Swim POWTS Plan Reviewer, Integrated Services (608)789 -7892, Mon - Fri, 7:15 am - 4:00 pm jerry.swim@wisconsin.gov Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 WiSMART code: 7633' MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application�� INDEX AND TITLE PAGE��� 4� ��p Project Name: Arthur - Rose Community Based Residential Facility Owner's Name: New Richmond Golf Club Owner's Address: 1226 180th Street New Richmond, WI 54016 Legal Description: NW1 /4 NE1,4, Sec. 4, T.30N., R.18W. Township: City of New Richmond County: St. Croix Subdivision Name: CSM Vol. 20, Pg. 5001 Lot Number: 2 Block Number: na Parcel I.D. Number: Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Site Plan Page 9 Soil Evaluation Report Page 10 Design Flow Calculations Page 11 Existing POWTS information Designer/ James K. Thom Date: 1 07/25/06 License Number: 30021 Phone Number: (715) 248 -7767 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 3.0 (03/01/01) ui 1 5 \ ~n, y _-' Page 1 of 11 SEE COf� PONDEf�CE Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R) Residential or Commercial Design 59 Estimated Wastewater Flow (gpd) i Peaking Factor (e.g. 1.5 = 150 %) 897.00 Design Flow (gpd) 9.001 Site Slope ( %) 96.75; Contour Line Elevation (ft) 24.00 Depth to Limiting Factor (in) 0.601 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 100.00 Dispersal Cell Length Along Contour (ft) _ 1.00! Dispersal Cell Design Loading Rate (gpd /ft ........ _....._.... : 11-1i Influent Wastewater Quality (1 or 2) Pressure Disribution Information (c or e) c' Center or End Manifold 7 ­ 2 _ 991 Lateral Spacing (ft) 6 Number of Laterals 0.125! Orifice Diameter (in) (e.g. 0.25) 2.50! Estimated Orifice Spacing (ft) _ 2.00; Forcemain Diameter (in) 40.00! Forcemain Length (ft) 91.00 Pump Tank Elevation (ft) 6.50 System Head (ft) x 1.3 6.38 Vertical Lift (ft) 1.95 Friction Loss (ft) 14.83 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. op tions choice x x x x x 1 x 0.75 1.00 1.25 1.50 2.00 3.00 Treatment Tank Information 1800.001 Septic Tank Capacity (gal) Wieser Concrete Manufacturer Dose Tank Information 1099.941 Dose Tank Capacity (gal) 25.58 Dose Tank Volume (gal /in) Wieser Concrete Manufacturer Note: Sand fill (D) calculations assume a Table 83 -44 -3 in -situ soil treatment for fecal coliform of <= 36 inches. 8.97 Cell Width (ft) Are the laterals the highest point in the distribution Y network? Enter Y or N If N above, enter the elevation (ft) of the highest point. 7.48 ft'/orifice Does the forcemain drain back? Y Enter Y or N 6.52 Forcemain Drainback (gal) 94.31 5x Void Volume (gal) 100.83 Minimum Dose Volume (gal) 49.43 System Demand (gpm) Manifold Diameter Selection in. dia. options I choice 1.25 1.50 x 2.00 x x 3.00 Gallons /Inch Calculator (optional) 1099.94 Total Tank Capacity (gal) 43.001 Total Working Liquid Depth (in) 25.58 gal /in (enter result in cell B49) Effluent Filter Information PolyLok Filter Manufacturer PL -625 Filter Model Number Project: Arthur - Rose Community Based Residential Facility Page 2 of 11 11 Mound Plan View t 1/10 B Observation Pipe �' J K � _+ .6. A W :B i — r3l I L Mound Component Dimensions A 8.97 ft E 21.69 in H 1.00 ft K aft ft B 100.00 ft F 9.25 in 1 12.65 ft L 1ft D 12.00 in G 0.50 ft J 5.36 ft W 897.00 (ft Dispersal Cell Area 2161.99 (ft Basal Area Available 8.97 (gpd /ft) Linear Loading Rate 1 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 99.52 (ft) F 97.75 (ft) -Al Dispersal Cell Elevation G �irrrrirJ7�rrrrir rrrir. . Dispersal Cell 98.25 (ft) Lateral Invert :D 75 (ft) Contour Elevation Geotextile Fabric Cover See lateral details on Page 4 for number, size, and spacing of laterals. Laterals are equally spaced from the distribution cell's centerline in the distribution cell (AxB). Project: Arthur - Rose Community Based Residential Facility Page 3 of 11 9.0 % Site Slope Shading Key Dispersal Cell 1[] _Topsoil Cap o a, 1.5 ft ". ;; •;. s `' `` Subsoil Cap p • •• ASTM C33 Sand 16 ` F ❑5 .' Tilled Layer :':::•r: Aggregate d , � 0 o 0.5 ft Typical Lateral �'• 7 *— — A —� 75 (ft) Contour Elevation Geotextile Fabric Cover See lateral details on Page 4 for number, size, and spacing of laterals. Laterals are equally spaced from the distribution cell's centerline in the distribution cell (AxB). Project: Arthur - Rose Community Based Residential Facility Page 3 of 11 Center Connection Lateral Layout Daigram Force main connection via tee or cross to manifold at any point. Laterals are Identical S i T P S • = Turn -up V ball valve or I 4-----4J+x12 l Laterals & force main of PVC Sch 40 of ea n out pl u g per COMM Table 84.30.5 Holes drilled on the bottom of the lateral Dose Tank Information Number of Laterals Lateral Diameter Lateral Length (P) Lateral Spacing (S) Lateral Flow Rate System Flow Rate Total Dynamic Head 6 Orifice Diameter in Orifice Spacing (X) ft Orifices per Lateral ft Orifice Density gpm Manifold Length gpm Manifold Diameter ft Forcemain Velocity 0.125 in ft ft /orifice ft in ft/sec 1.25 2.53 49.34 20 2.99 7.48 8.24 5.98 49.43 2.00 14.83 5.05 Electrical as per NEC 300 and -- -► Comm 16.28 WAC — Tank component is properly vented Wieser Concrete Capacityl 1099.94 Volume 1 25.58 Manufacturer Gallons gal /inch Dimension Inches Gallons A 23.44 599.49 B 2.00 51.16 C D Total 7.06 10.50 43.001 180.70 268.59 1099.94 Project: Alarm Manuafacturer LevelArm Alarm Model Number DLV A B C D under to Disconnect '11 �_ Pump Manufacturer Zoeller Pump Model Number BN152 Pump Must Deliver I 49.43 gpm at 14.83 ft TDH Arthur - Rose Community Based Residential Facility Locking cover with warning label and locking device and sealed watertight 4 in. min. e – Alternate outlet location Forcemain diameter 2 in. Weep hole or anti - siphon device P, ump off elevation (ft) � 1 91.88 Dose tank elevation (ft) 91.00 Page 4 of 11 w Mound System Maintenance and Operation Specifications Service Provider's Name J. Thompson, POWTS INSP.#4819 Phone (715) 248 -7767 POWTS Regulator's Name St. Croix County Zoning Phone (715) 386 -4680 System Flow and Load Parameters Design Flow - Peak 897 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 598 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1800 gal Maximum TSS 150 mg /L Soil Absorption Component Size 897 f: Maximum FOG 30 mg /L Type of Wastewaterl Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound inspect and /or service once every 3 years Should inspect and clean at least once every 3 years Test once every 3 years Should test month) Laterals should be flushed and pressure tested every 1.5 years Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished .......... .... aGrade 6 -8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box . . Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Arthur - Rose Community Based Residential Facility Page 5 of 11 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals (SBD- 10691 -P (N.01 /01) and SSWMP Publication 9.6 (01181)j and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump 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 a tank or component. 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. The operating condition of the septic tank and outlet filter shall be assessed at least once every 2.years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not 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 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 sludge and scum 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 a biennial 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. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every syears. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg /L BOD 150 mg /L TSS, and 30 mg /L FOG for septic tank effluent or 30 mg /L BOD5, 30 mg /L TSS, 10 mg /L FOG, and 10' du /100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continaency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Arthur - Rose Community Based Residential Facility Page 6 of 11 d 45 12 40 3 10 0 6 25 s 5 20 r E 0 . 4 — GALLONS PUMP PERFORMANCE CURVE MODEL 1511152/153 TOTAL DYNAMIC HEADIFLOW PER MINUTE EFFLUENT AND DEWATERING MODEL 151 152 153 Feet Meter Gal. Were Gal, Liters Gal. Liters 5 1.5 50 189 69 261 77 291 10 3.0 45 170 Bi 231 70 285 15 4.6 38 144 53 201 61 231 20 6.1 29 110 44 167 52 197 25 7.6 16 61 34 129 42 159 30 9.1 - 2 or 3 23 87 33 125 35 10.7 BN153 115 1 Auto 10.5 22 85 40 12.2 Non 5.3 1 - 11 42 Shut -off Head: 1 30 ft. g. 1m) 38 tL (11.Bm) 44 ft. (13.4m) 0145069 FLOW PT MINUTE 015 Model 151 <19. y3 p arr,. r►• I niM6tr+� 54/GP>1 (/ CONSULT F`�ACTORY FOR SPECIAL APPLICATIONS 6792 'l • Tuned dosing panels available. • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik -Box available for outdoor installations. See FM1420. • Over 130•F. (54•C.) special quotation required. 1511152/153 Series 151H521153 YODELS Control 6419don Yodel Volts -Ph I Mode Arrips Simplex Duplex N151 115 1 1 Nan 6.0 1 2 or 3 BN151 115 1 1 Auto 6.0 Included 2 or 3 El 51 230 1 Non 3.2 1 2 or 3 BE151 230 1 Auto 3.2 Included 2 or 3 N152 115 1 Nan 8.5 1 2 or 3 BN152 115 1 Auto 8.5 Included 2 or 3 E152 230 1 Nan 4.3 1 2 or 3 BE152 230 1 Auto 4.3 Included 2 or 3 N153 115 1 Nan 10.5 1 2 or 3 BN153 115 1 Auto 10.5 Included 2 or 3 El 53 230 1 Non 5.3 1 2 or 3 BE153 30 1 Auto 5.3 Included 2 or 3 O CAUTION an nstaliation of controls, protection devices and wiring should be done by a qualified rer,sed elettncian. All elecinoal and safety codes should be followed including the most recent Nauonai Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). Models 1521153 121/6 2 2 SELECTION GUIDE SK.2064 1. Single pggyback variable level float switch or double piggyback variable level float svAch. Refer to FM0477. Z See FM0712 for correct model of Electrical Alternator E -Pak. 3, Variable level control switch 10 -0225 used as a control activator, specify duplex (3) or (4) float system. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. — -- - -, - -- - - - - - -- wal TO Po. Box 16341 - - -- - -- Louisville, KY 40256.0347 Manufaclurersof, . I O SHIP TO: 3649 Cane Run Road ® �� Louisville, KY 40211-1961 Q ?YPUMC6 SvcE �,4�1.! Op hripJ/www.zoeller, com PUMP !O_ (502) 1 FAX (502) 774.3624 PUMP 0 Copyright 2004 Zoeller Co. All rights reserved p c Q . 7 // r 1-462 c v' a h d aria e el �PrdPo� `• �Add,� a pro,405Lo 61 7 'sel(l one &JLP/9X///6V crrm bi na.� an 4ep6c /a<e ,- aZ Srel Cs ► v( .2 a /s/7g8 20,903 �%O 4 � S. � Co✓'n�•r oFliouSe�o�•.•alvE:art. , / / I /// I \ J' 1 4 1 f � r r / f / rl ,r Ay r / , ! r 63 � / r Q � 4 `$z 1?1 rllz ZZ � O 4 yo {JJ v� ■ So, b &a6 � Ekr'Stt'ng � r'cxo(( e l ev.` • /o c�cd� o�e�. NEll- � /l e,-) K/ r l own a' Coo /,. Coulsar /ots /� 2, csm zo /y7e8 nwYo(o4FA S«. Ci + - Y of /4e.) /Q:cl mores �E.cro x Co. LrO/. ! 8 Q CRe PARC f�(uSky � k 0 t 1 t Qr 6 P lYl a — d,s /C'E /% S;K d,'sfribu�i�h /a f e,, - 4 /s a E /{ 19.3f/ w /�B o►'.''Ces S/aaced a.6 (-,% S /opc IAJ 1,azwn ; t o i Z "s�.�ORuC• I r ��arcer►ta;n ' ' �t t a pro,405Lo 61 7 'sel(l one &JLP/9X///6V crrm bi na.� an 4ep6c /a<e ,- aZ Srel Cs ► v( .2 a /s/7g8 20,903 �%O 4 � S. � Co✓'n�•r oFliouSe�o�•.•alvE:art. , / / I /// I \ J' 1 4 1 f � r r / f / rl ,r Ay r / , ! r 63 � / r Q � 4 `$z 1?1 rllz ZZ � O 4 yo {JJ v� ■ So, b &a6 � Ekr'Stt'ng � r'cxo(( e l ev.` • /o c�cd� o�e�. NEll- � /l e,-) K/ r l own a' Coo /,. Coulsar /ots /� 2, csm zo /y7e8 nwYo(o4FA S«. Ci + - Y of /4e.) /Q:cl mores �E.cro x Co. LrO/. ! 8 Q CRe PARC f�(uSky � k 0 t 1 t Qr 6 P lYl a — d,s /C'E /% S;K d,'sfribu�i�h /a f e,, - 4 /s a E /{ 19.3f/ w /�B o►'.''Ces S/aaced a.6 (-,% S /opc IAJ Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D. percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Please print all information. Reviewed By Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location 1997 Page I of _4 A.C.E. Soil & Site Evaluations St. Croix 261 - 1285 -02 -200 _ Date New Richmond Golf Club (Jessa Nelson - buyer) _ Govt. Lot NW 1/4 NE 1/4 S 4 T 30 N R 18 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1226 180th Ave. 2 CSM Vol. 20, Pg. 4788 City State Zip Code Phone Number V1 City J Village J Town Nearest Road New Richmond WI 1 54017 1 (715) 246 -0266 New Richmond 1 1164 State Hwy 64 f/ New Construction Use: J Residential / Number of bedrooms Code derived design flow rate 598 GPD _f Replacement ✓J Public or commercial - Describe: Parent material Glacial till over limestone bedrock Flood plain elevation, if applicable na General comments and recommendations: Soil suitable for mound. 12" of sand fill to be placed on 96.78' contour, syst. el. = 97.78'. Gas line runs through system area - line must be relocated prior to installation M Boring # —I Boring V1 Pit Ground Surface elev. 96.51 ft. Depth to limiting factor 24 in Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ft' "Eff#1 "Eff#1 "Eff#2 1 1 0 -10 10yr3 /3 none sil 2fsbk dsh cs 2fmc 0.6 1 0.8 2 10 -16 1Oyr4/3 none sit 2fsbk dsh cs 2fm,1c 0.6 0.8 3 16 -24 1Oyr4/4 none sit 2fsbk dsh cw 2f,1m 0.6 ! 0.8 4 24 -36 7.5yr4/4 m1d Mg sci 2fsbk dh aw 2fm 0.4 0.6 5 ; 36 -56 10yr6/4 f2d 7.5yr5/8 LSBR Om mfi - 1fm 0.0 0.0 Limestone bedrock observed in Horizon #5 consists of >50% loose, fractured limestone fragements approx. 1"x1"x1" to a inlcx. volas between plates filled with 10yr4/4 Om sl & 7.5yr4/4 Om sci & 10yr5/4 Ifs. T 16 Boring # I Boring Pit Ground Surface eiev. 96.42 ft. Depth to limiting factor 35" in. Soil Application Rate Horizon I Depth in. Dominant Color Munseli Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDttN "Eff#1 "Eff #2 1 0 -8 10yr3/3 none sil 2fsbk dsh cs 2fmc 0.6 0.8 2 8 -15 1 Oyr4 /3 none sit 2fsbk dsh cs 2fm,1 c 0.6 0.8 3 15 - 29 1Oyr4/4 none sil 2fsbk dsh cw 2f,1m 0.6 0.8 4 29 -35 7.5yr4/6 none sl 1 msbk dh aw 2fm 0.4 j 0.7 5 35 -52 10yr6/4 f2d 7.5yr5/8 LSBR Om mfi 1 f 0.0 j 0.0 i i F Limestone bedrock observed in Horizon nsists ci >50% loose, fractured limestone fragements approx. 2 "x2 "x1" to 4'x6 "x1" thick. Voids be en plates fide with 10yr4/4 Om sl & 7.5 r Om scl & 10yr5/4 Ifs. Effluent #1 = BOO 5> 30 < 220 mg /L an TSS >30 < 15 mg/l- uent #2 = BOO < 30 mg /L and TSS < 30 mg /L :ST Name (Please Print) Signature p CST Number James K. Thompson �f 360 4ddress A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola 154020 7/19/2006 715 -248 -7767 Property Owner Ne w Richmond G Club Jessa — Parcel ID # 261 73 1 Boring # I Boring J Pit Ground Surface elev. —_ 93.35 ft. - 1285 - 02 - 200 Depth to limiting factor 24" in Page __2 _of _4 Soil Application Rate Horizon Depth j Dominant Color Redox Description Texture Structure Consistence Boundary Roots ', GPD /ft' Consistence in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 n. Munsell 'Eff#1 'Eff#2 1 0 -7 10yr3/3 none sil 2fsbk dsh cs 2fmc 0.6 0.8 2 7 -14 10yr4/3 none sil 1 2fsbk mfr CS 2fm,1c 1 0.6 0.8 J Pit Ground Surface elev. —____ Soil Application Rate I Horizon Depth Dominant Color Redox Description Texture ' Consistence Boundary Roots ' — GPD 'Eff#' 1 Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz, Sh. 3 14 -24 10yr4/4 none sil 2fsbk mfr mf 2f,1 m 0.6 0.8 4 24 -29 1 7.5yr4/4 m 1 d Mg scl 1 csbk mfi aw 2fm 0.2 0.3 I l I I 5 29 -50 I '; 10yr6/4 f2d 7.5yr5/8 LSBR Om mfi 1 fm ! 0.0 0.0 " x1' Limestone bedrock observed in Horizon � #5 consists of >50% loose, fractured limestone fragements approx. 2'x2 to 4'x6 "x1 "thick. Voids between plates filled with 10yr4/4 Om sl & 7.5yr4/4 Om scl & 10yr5/4 Ifs. 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. SHD -8330 (R OL00) A.C.E. Soil & Site Evaluations Boring ❑ Boring # —I _J Pit Ground Surface elev. ._— ___— ______ ft. Depth to limiting factor n. Soil Application Rate — Horzon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots __ 'Eff#1 'Eff#2 n. Munsell Qu. Sz, Cont. Color Gr. Sz. Sh. I I I � I ; i i I ❑ Boring # J Boring ft. Depth to limiting factor in. J Pit Ground Surface elev. —____ Soil Application Rate I Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' — GPD 'Eff#' 1 Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz, Sh. I l I I I 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. SHD -8330 (R OL00) A.C.E. Soil & Site Evaluations /a e 2 C5 M zO /5-/748 0 So, Ie /u a ♦ EX /sz�i�9 ��adF e /E� • /o cacd 6C4 /C Ile") ,�i'c4 mend /e es / 49 z, c S r►t zo /y 7B8 / OC4 tf2` /- 1285 o/( -2 City of ne.,J R'c.kmonp r , r , o r+ r Coocic6c�+�'a poo&o a v 3. e Corner / I r o ... o(e , 60y1. r Assu"'totd eleo. vlcczO' ,r I ri r n `82 � c ` u�cmdcal �6JruSk o a r i I 3o-'3 Design Flow Calculations JOH DESCRIPTION& Existing three - bedroom residence located within the municipal limits of the city of New Richmond service by conventional POWTS (see pgs. 11). Municipal sewer and water proposed to be extended to property within 5 years. New owner proposes to add 4 bedrooms to existing residence, creating an 8 bed Community Based Residential Facility with two employees per shift, 3 shifts per 24hr. period. New mound to be connected to proposed addition. Mound designed and constructed to accommodate entire daily flow of proposed facility. Existing conventional POWTS to remain in service until hydraulic failure occurs. Interior plumbing will be rerouted to mound at time of failure. 1. Total Daily Design flow (599 Gpd daily flow)(] 5 conversion factor) = 897 0 Cipd (8 bed spaces) (65 gal. bed space) = 520.0 Gpd daily wastewater flow (6 employees all shifts) (13 gal. /employee) = 78 Daily wastewater flow = 598.0 Gpd 2. Depth to limiting factor: 24" 3. Land slope: 2 4. Infiltrative capacity of soil at system elev.: 1 0 d /sn ft ASTM C33 med. Sand 5. Infiltrative capacity of native soil: 0.6en�f1. 6. Proposed Dispersal Cell area: 600 -,q- I area required 8 97 sn, I bed width (A) bed length (B) 105.00 SEPTIC TANK C'APAC'ITY CALCULATIONS: 1. Design wastewater flow = 897.0 gpd 897.0 gpd / 75 gpd = 11.96 gpd person equivalency 2. Minimum required capacity: 1 55 Gallons (897.0) + (11.61 x2* x 11.96) + (46.77 x 11.96) = 1,734.08 *(Requires a two year maintenance cycle) 3. Existing septic tank Capacity & Manufacturer: 1,000 gal Weeks Concrete S.T 4. Proposed S.T. capacity & Manufacturer: Wieser Concrete WI P1 R00 /I 100 - MR gal. se ti . ank /pump chamber PolyLok PL -625 effluent filter to be installed at septic tank outlet. Pg. 10 of 1 I LGsL�'r4sfntpart�n��'�i�r 4.30.18. 4 MVATE SEWAGE SYSTEM _Labor and Human Relations INSPECTION REPORT Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Permit Holder's Name: ❑ City ❑ Village R Town of: CST BM Elev.: Insp. BM Elev.:� BM Description: / G �iJ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic A ir ir I to ntake A ROAD Dosing Inside Dia. v' Aeration 11 4 NA Hol DIME TANK SETBACK INFORMATION TANK TO P/ L WELL BLDG. A ir ir I to ntake A ROAD Septic Inside Dia. >xa /i✓ 11 4 NA Dosi DIME Bldg. Sewer NA Aeration SYSTEM TO St / , Inlet BLDG WELL LAKE /STREAM Holding St /�K Outlet SETBACK INFORMATION CHAMBER Type O , �"i J . PUMP/ SIPHON INFORMATION Demand Model Number M TDH Lift Friction S e TDH Ft FofZemaa - Dia. I Dist. To Well SOIL ARSORPTION SYSTEM ELEVATION DATA A930.0289 I / %= STATION BS HI FS ELEV. Benchmark No. Of Pits Inside Dia. �� /i✓ ` -= /''` `a DIME Bldg. Sewer SYSTEM TO St / , Inlet BLDG WELL LAKE /STREAM LEACHING St /�K Outlet SETBACK INFORMATION CHAMBER Type O , �"i J . -- Dt_ii-v+et Mo umber: Dt Bottom ti /�" • �� ��Cd HeadedHeader ftUQ 9 7709 Dist. Pipe 97 (� Bot. System ' Final Grade n 17 8 BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ` -= /''` `a DIME SYSTEM TO P/ L BLDG WELL LAKE /STREAM LEACHING Man SETBACK INFORMATION CHAMBER Type O , �"i J . r Mo umber: System: 'F�-a-n� ti /�" • �� ��Cd OR UNIT DISTRIBUTION SYSTEM Header /M -- Distribution Pipe(s) � , J x Hole Size x Hole Spacing Vent To Air Int 1 ake Length � Dia. Length � Dia. 7 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 ed BI0-f � Trench Center ! Trench Edges Topsoil E] Yes ❑ No Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) 77 � > -Z LOCATION: RICHMOND 4.30.18.40A ; ,� /J -� Plan revision required? ❑ Yes 2 r/ Use other side for additional information. SBD- 6710(R 05/91) Date Inspector's Sign County: err Q1DQTX Sanitary ermit o.: State Plan o.: Parcel Tax No.: M v & 0 lq 110 CAAIITADV DCORAIT ADDI 1PAT1nN1 SBD -6398 (formerly Plb -67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & t3unaings urvision, uwner, riumuer COUNTY In accord with ILHR 83.05, Wis. Adm. Code l STATE SANITARY MIT # –Attach complete plans (to the county copy only) for the system, on paper not less than I �7} 4 ❑ Check S'fz x 11 inches in size. if revision tdprevious application –See reverse Side for instructions for completing this application. STATE PLAN I.D. NUMBER I. AP PLICANT INFORMATION – PLEASE PRINT ALL INFORMATION. PROPER PROPERTY LOCATION =R '/a, S T , N, R (or PROP RTY OWNER'S AILING AD ESS LOT ## BLOCK ## CI STAT ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUM ER y , 0 II. TYPE OF BUILDING (Check one) CITY NEAREST R AD ❑ State Owned ❑ VILLAGE S�"I�Nj `� E] Public 0 1 or 2 Fam. Dwelling –# of bedrooms PARCEL TAX NUMBER(S) e 111. BUILDING USE: (If building type is public, check all that apply) 1 ❑ Apt/Condo 2. ❑ Assembly Hall 6 ❑ Medical Facility /Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales /Repairs 11 ❑ Restaurant/Bar /Dining 4 ❑ Church /School 8 ❑ Mobile Home Park 12 ❑ Service Station /Car Wash 5 ❑ Hotel /Motel 9 ❑ Office /Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ❑ New 2. ® Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System j B) ❑ A Sanitary Permit was previously issued. Permit # — Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 Seepage Trench 22 ❑ In- Ground 42 ❑ Pit Privy N 43 ❑ Vault Privy 13 Seepage Pit Pressure 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC RATE 6. SYSTEM ELEV. 7. FINAL GRADE ELEVATION REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals /day /sq. ft.) (Min. inch) 9 j Feet Feet VII. TANK CAPACITY in allons Total Manufacturer's Name . Site Con- Steel Fiber- Plastic Exper. App New xistin INFORMATION Gallons Tanks Concrete structed glass s Tank s Tanks Septic Tank or Holding Tank Lift Pump Tank/Siphon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber' ame (Print Plumber's ign ure: o ps MP /MPRSW No.: Business Phone Number: ' Address reet, City, State, Zip Co e): Plumber' S IX. C UNTY /DEPARTMENT USE ONLY ❑ Disapproved San Permit Fee (Includes Groundwater Surcharge Feel Defite Issued ssuing A nt nature ( Sta Approved ❑ Owner Given Initial � r`z Adverse Determination X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: SBD -6398 (formerly Plb -67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & t3unaings urvision, uwner, riumuer �c�/ 7 t /ec, cos i3a i PAGE OF C r USS J� C�I t)r1 p 1 �1 Vr17 �Y '> ftdM At( Inla1♦ And OChorvollon Pips I `1' Approved Vent Cop ►linlm— 12 Azov. final Glad. 20- d2' Aoovo P1pp _ 4' Cost lion To final Grad• Vent Plpa 1t rn Nor Or S Ee y l• O OIUrI0v110n -- o — Too 6 s ° ParlOralad Plpa bola. o — CQ,0ln0 TwnJnalinp At 60110. 01 System i G p r o p o ro % cl S'r�CkJ SOIL FILL 015TRIBUTIOVI PIPE APPROVED ,S19T1-IETIC COVCI 2" of 11GGR��AZE 11ATLRl�t oR 9" OF STRAW OR MARS" F1A,-j EL EV. OF �5G E1; (o OF ��z - 2 1 / AGGREGATE 7,25 - / DIS rR1F)�JTI0W PIPE TU BC AT LEAST lUCHE5 BCLOW ORIGIUAL GRADE AUV AT LCASTZO IAICHES BUT KIO MORE THAI) 42 IMCNCS BELOW FINAL GRADE M MMUM DSPrti OF E , T1 0 0 FKoM OR 6 D WILL BE _ I►J H X11 � c c s ruwrivm pq T OF FXCA\ rAoM 01 � 1 6WAL CjRAPf- WILL 6C �._� INCHC 5 s1G►Jfo: ! LICCUSC I.IUMBE DATE - - -- - - -- T T o STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER 9rdl ��•� �7 ��� ADDRESS C�l 7 SUBDIVISION / CSMf LOT f SECTION, T _N -R_ & W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM a INDICATE NORTH A le's-1 Provide setback and elevation information on reverse of this fora. Provide 2 dimensions to center of septic tank manhole cover- Wisconsin Department of.Industry, SOIL AND SITE EVALUATION REPORT Lab6rtfnd Hbmm Relations nivkinn of Rafaty R Ruildinm Page 1 of 3 III QVVVIV "ILII ILI 11l VJ.VJ, . .IJ. 1- � ---- • COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. Croix PARCEL I.D. # not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or dimensioned, north arrow, and location and distance to nearest road. BourrJary REVIEWED BY DATE APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION PROPERTY OWNER: PROPERTY LOCATION Paul 0 . Swenby GOVT. LOT NJ 1/41TF, 1/4,S4 T30 AR 18 >EQor) W PROPERTY OWNER' MA!I_ING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 1164 11 064 n/a n/a n/a CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE DOWN NEAREST ROAD Mew Richmond, 141. 54017 ( 715) 2.46 - 2223 Richmond Hy. 0,64 2 /m /sbk mfr g/w (] New Construction Use �,,4 Residential / Number of bedrooms 3 [ ] Addition to existing building Replacement [ ] Public or commercial describe Code derived daily Flow 450 gpd Recommended design loading rate n/r bed, gpd /ft . 5 trench, gpd/ft Absorption area required n bed, ft2 1000 trench, 11: Maximum design loading rate n/r bed, gpd /ft . trench, gpd/ft Recommended infiltration surface elevation(s) 0 6.74 -95.69 ft (as referred to site plan benchmark) Additional design / site considerations bed not recormiended -step down trenches at above elevations Parent material outwash Flood plain elevation, if applicable n/a ft S = Suitable for system U = Unsuitable fors stem CONVENTIONAL iaS ❑ U MOUND ia S E] U IN- GROUND PRESSURE laS ❑ U AT -GRADE as [I U SYSTEM IN FILL ❑ S EB& HOLDING TANK ❑ S E3�j SOIL DESCRIPTION REPORT Boring # .................. 1 Ground elev. 98 .44 ft. Depth to limiting factor Boring # Ground elev. 99 ft. Depth to limiting tactor >8 Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence BourrJary Roots GPD /ft Bed Trends 1 0 -8 10vr3 /3 none L. 2/m /px raft t /w 2 /rl .5 6 2 8 -18 10yr4 /4 none scl 2 /m /sbk mfr g/w 1/m 10yr3 /4 none 3 8 -25 7.5yr4/4 none sl. 2 /m /sb]c mfr g/w 1/f 4 25 -65 10yr4 /6 none ls. 0 /sg mvfr g/w n/a .7 8 5 65 -78 10yr3 /4 none ST 1 /c /pl mfr n/a n/a n/p .3 Remarks: 1 0 -7 10yr3 /3 none L. 2 /m /gr rifr g/w 2/m .5 .6 2 7 -28 10yr4 /4 none scl 2 /m /sbk mfr g/w 1/m .4 �.5 3 28 -69 10yr4 /6 none I.S. 0 /sg mvfr p,/w 1/f .7 .8 4 69 -80 10yr3 /4 none sl. /c /p1 mfr na/ na/ r .3 Remarks: CST Name:— Please Print Gary L. Steel 715- 24 Address: 1554 h. AVe . Te Richmo d , WI. 54017 Signature: 8 -10 -93 Date: cstm 2298 CST Number: PROPERIYOWNER SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL I.D. # . Boring # 3 Ground elev. 9(. 44 ft. Depth to limiting factor >90 Boring # Ground elev. ft. Depth to limiting factor Horizon Depth in. Dominant Color Munseil Mottles Ou. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD /ft Bed Trend 1 0 -16 1 3/3 none L. 2 /m /,r mvfr /w 2/m ) .6 2 16 -27 10yr4 /4 none scl 2/m /sbk mfr g/w 1/m .4 .5 3 27 -38 7.5yr4/4 none sl. 2 /ri /sbk mfr g/w 1/f .5 1 .6 4 38 -74 10 r4/6 none ls. O/sg mvfr /w n/a .7 �.8 5 74 -90 1 r3/4 none sl. 1/m/pl mfr a/ na/ n/ .3 Remarks: SBD- 8330(8.05192) Gary L. Steel C.S.T. 2298 MPRSW -3254 14a 'It s��s. �4-- i.. 1 oo ' (L i) (mo-rK",', WEk'L. STEEL'S SOIL SERVICE Paul 0. Swenby NW',,NF S4- T30N -R18W j town of Richmond t ,_5�4 A,� -41 �, -�Z Gary L. Steel 8 -10 -93 1554 200th. Ave New Richmond, WI 54017 (715) 246 -6200 ID PM J Pi 0 ►3z V n, S,� 1997 Wisconsin Department of Commerce SOIL EVALUATION REPORT mo+• Page 1 of 4 Division of Safety and Buildings in accordance with Co m 85RECLC A.C.E. Soil & Site Evaluations Cou Attach complete site plan on paper not less than 8% x 11 inches in size Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), rection bpd, Par - I.D. percent slope, scale or dimemsions, north arrow, and location and dis to U96 1 2005 2131 1285 Please print all information. ST C Re By Dat Personal information you provide may be used for secondary purposes (Priv Law, s. 15.04 C OUNT , Property Owner Prope rty o New Richmond Golf Club (Jessa Nelson - buyer) Govt. Lot NW 1/4 N /4 S 4 T 30 N R 18 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1226 180th Ave. 2 CS Vol. 20, Pg. 4788 City State Zip Code Phone Number 0 City I Village J Town Nearest Road New Richmond I WI 1 54017 (715) 246 - 0266 New Richmond 1 1164 State Hwy 64 New Construction Use: I Residential / Number of bedrooms Code derived design flow rate 598 GPD I Replacement 01 Public or commercial - Describe: —�� r ra — Parent material Glacial till over limestone bedrock Flood plain elevation, if applicable na General comments and recommendations: Soil suitable for mound. 12" of sand fill to be placed on 96.78' contour, syst. el. = 97.78'. Gas line runs t hrough system area - line must be relocated prior to installation — Boring # I Boring Pit Ground Surface elev. 96.51 ft. 24" � n. Sal Application Rate 0 Depth to limiting factor ppl' Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont, Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots PD "Eff#1 'Eff#1 'Eff#2 1 0 -10 1Oyr3 /3 none sit 2fsbk dsh cs 2fmc 0.6 0.8 2 10 -16 1Oyr4/3 none sit 2fsbk dsh cs 2fm,1c 0.6 0.8 3 16 -24 1Oyr4 /4 none sil 2fsbk dsh cw 2f,1m 0.6 0.8 4 24 -36 7.5yr4/4 m 1 d Mg scl 2fsbk dh aw 2fm 0.4 0.6 5 36-56 1Oyr6/4 f2d 7.5yr5/8 LSBR Om mfi - 1fm 0.0 0.0 Limestone bedrock observed in Horizon #5 consists of >50% loose, fractured limestone fragements approx. z X1 - x11' to 4"xb'xr" tnlCx. voids between plates filled with 10yr4/4 Om sl & 7.5yr4/4 Om scl & 10yr5/4 Ifs. ]Boring# -=I Boring WJ Pit Ground Surface elev. 96.42 ft. 35" in. Soil Application Depth to limiting factor � ppl' cation Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots /ft' "Eff#1 I "Eff#2 1 0 -8 1Oyr3 /3 none sil 2fsbk dsh cs 2fmc 0.6 0.8 2 8 -15 1Oyr4 /3 none sit 2fsbk dsh cs 2fm,1c 0.6 0.8 3 15 -29 1Oyr4/4 none sil 2fsbk dsh cw 2f,1m 0.6 0.8 4 29 -35 7.5yr4/6 none $l 1 msbk dh aw 2fm 0.4 0.7 5 35 -52 1Oyr6 /4 f2d 7.5yr5/8 LSBR Om mfi - 1fm 0.0 0.0 Limestone bedrock observed in Horizon nsists o >50% loose, fractured limestone fragements approx. "x7x1 "to 4 "4"x1" thick. Voids be en plates fille with 10yr4/4 Om sl & 7.2)g Om scl & 10yr5/4 Ifs. ' Effluent #1 = BOD 5> 30 < 220 mg /L an TSS >30 < 15 mg/L vent #2 = BOO 5 130 mg /L and TSS s.30 mg /L CST Name (Please Print) Signature CST Number James K. Thompson `f 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane. Osceola l 54020 7/19/2006 715 -248 -7767 - Property Owner New Richmond Golf Club (]essa Parcel ID # 261- 1285 -02 -200 Page 2 of 4 Q Boring # Boring id Pit Ground Surface elev. 93.35 ft. Depth to limiting factor 24" in. Soil Application Rate Horizon Depth in, Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Stricture Gr. Sz. Sh. Consistence Boundary Roots 'Eff#1 *Eff#2 1 0 -7 10yr3/3 none sil 2fsbk dsh cs 2fmc 0.6 0.8 2 7 -14 10yr4/3 none sil 2fsbk mfr cs 2fm,1c 0.6 0.8 3 14 -24 1 Oyr4 /4 none sil 2fsbk mfr mfi 2f,1 m 0.6 0.8 4 24 -29 7.5yr4/4 m 1 d Mg scl 1 csbk mfi aw 2fm 0.2 0.3 5 29 -50 1Oyr6/4 f2d 7.5yr5/8 LSBR Om mfi - 1fm 0.0 0.0 Limestone bedrock observed in Horizon #5 consists of >50% loose, fractured limestone fragements approx. 2 "x2 "x1" to 4 "x6'W thick. Voids between plates filled with 10yr4/4 Om sl & 7.5yr4/4 Om scl & 10yr5/4 ifs. F I Boring # — j Boring _ Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots *Eff*1 *Eff#2 F I Boring # I Boring _Pit Ground Surface elev. ft. Depth to limiting factor in. Sol Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots *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) A.C.E. Soil & Site Evaluatlom CS e4 .2 0 1 , 178 < 6 1-46 C5 m . %1786 c a h n tk u>CIl"f KeSr�cnc� o � a i �j L / , , r \��� I ,I I Q r r � r , r 0 / ,♦ r , y , ,� of �ou3e/�oc...do�iaYl. ' i Assum e /cd` , / r / / � r r � , r tv n X 82 � ��L c Y rID A o � o 1 l 0so/ / 'la l e, a6,, , P,E ♦ EXiS �iaalQ elQ� 0 /o ca-. c v o�o / o, jca N 6-;;77 T Ile") Rc Armnol 6o />r Cyr rs� /ets /� z, csm za�y7eg nwN,16 ; Scc. e-; - OF ne. J k, *C-� fn a-d , 5 E. Cro 7 x Co .I Loo/. o � r O ' r r r 1 r r r r � r r r I r r r r 1 i r r I r 63 , �2 S /opc Qi 3 o-f 3 jul. 21. 2006. 12:37 CITY OF NEW RICHMOND No. 7407 P. 2 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND 64 d OWNERSHIP CERTIFICATION FORM Owner /Buyer LyiS jl� 1 Mailing Address ''u32 u 64. P 1, AA/ f j 5 // 3 Property Address (Verification required from Planning & Zoning De ent for new construction.) (0a �� ` J City /State Iva.�w ACkttnnimJ , � Parcel tdentifieataon Number 2(p I 2eS - . 0 mm e � LEGAL DEK a Property Location N U) %, N F- t/a , Sec. q , Subdivision Certifled Survey Map Warranty Deed # : `f : Volume , page # SYSTEM MAINTENANCE AND OWNER ERTIFICATION 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 sootier, 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 maintenance 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 Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber 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 113 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 Planning R Zoning Department within 30 days of the three year expiration date. Uwe certify that aU statements on this form are true to the best of my /our knowledge. Uwc am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms M Z�qi_-0b SIGNATURE OF A PLICANT(S) DATE "'Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. ,.. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. T 36 N R—ILW, Town of AeW 1(:C1 (40V Lot # 2- 90 2-1 5 5 (REV. 08105) `1 832749 KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO., MI RECEIVED FOR RECORD DOCUMENT NO. 08/22/2006 10:45AN EASEMENT UTILITY EASEMENT AGREEMENT EXOPT # REC FEE: 13.00 TRANS FEE: COPY FEE: CC FEE: PAGES: 2 The undersigned, New Richmond Golf Club, Inc., (hereinafter Grantor) in consideration of the sum of One Dollar ($1.00), and other good and valuable consideration to the Grantor, receipt and sufficiency of which is hereby acknowledged, does hereby grant unto Kristin M. Pitchford and Thomas R. Pitchford, husband and wife their successors and assigns, hereinafter called Grantees, an easement with the right, privilege and authority to repair, and maintain the existing septic sewer line but no additional or replacement septic sewer line, over, across, under and upon the following described lands RECORDING INFORMATION located in the City of New Richmond, St. Croix County, Wisconsin: ................................ ............................... NAME AND RETURN ADDRESS A strip of land 15 feet in width on either side of the septic effluent line ThoPlas R. Schumacher located within Lot 2 of Certified Survey Map recorded June 29, 2005 in a ke Norman, S.C. Volume 20, Page 5001, Document No. 798950 as depicted on Lot 1 of the i dwin, • Box 54 WI 54002 Certified Survey Map recorded on August 16, 2006 in Volume 21, page 5258, Document No. 832290 being located in part of the NW '/, of the NE '/< of Section 4, Township 30 North, Range 18 West, City of New Richmond, St. Croix County, Wisconsin / �) -oa- (Parcel Identification Number) The grant of the easement herein contained shall also include the right of reasonable access to the easement across the surrounding property of Grantor for the purpose of exercising the rights granted herein and which may be reasonably necessary for the repair or maintenance of the existing septic sewer line, but excludes the right to remove from the easement any trees or shrubbery without the written permission of Grantor. Except as otherwise provided herein, Grantees shall, restore the lands subject to this easement to as near their original condition as it is reasonably possible and remove from the easement all debris, spoils, and equipment resulting from or used in connection with the maintenance and repair. This easement is deemed to be appurtenant to Lot 1 of Certified Survey Map recorded August 16, 2006 in Volume 21, Page 5258, Document No. 832290 being located in part of the NW '/< of the NE %. of Section 4, Township 30 North, Range 18 West, City of New Richmond, St. Croix County, Wisconsin The Grantor shall not be responsible for any injury to persons or property caused by the maintenance of the septic sewer lines. Grantor agrees with Grantees, their successors and assigns, that the Grantor is the owner of the i of 2 above - described premises and has the right to sell and convey an easement in the manner and form described. This instrument and the covenants and agreements contained herein are permanent easements and shall run with the land and are binding upon the Grantor, its, successors and assigns. Dated: August 18, 2006. (SEAL) + istin M. Pitchf • Thomas R. Pitchford R t nH AUTHENTICATION THIS INSTRUMENT WAS DRAFTED BY: Thomas R. Schumacher BAKKE NORMAN, S.C. Baldwin, Wisconsin *Names of persons signing in any capacity should be typed or printed below their signatures. N 'c d Golf Club, c (SEAL) *By: L. Lawrence Williams, President ACKNOWLEDGEMENT STATE OF WISCONSIN ) ) ss. ST. CROIX COUNTY ) Personally came before me this I 81 day of August, 2006, the above named , to me known to be the persons who executed the foregoing instrument and acknowledged the same. Notary Public, County, Wisconsin My Commission is permanent. (If not, state expiration date 2of2 Signature(s) of Kristin M. Pitchford, Thomas R. Pitch f r nd L. Lawrence William Authen i ed i 8 day of tgu� *Thomas Schumacher TITLE MEMBER STATE BAR OF WISCONSIN (If not authorized by § 706.06, Wis. Slats.) THIS INSTRUMENT WAS DRAFTED BY: Thomas R. Schumacher BAKKE NORMAN, S.C. Baldwin, Wisconsin *Names of persons signing in any capacity should be typed or printed below their signatures. N 'c d Golf Club, c (SEAL) *By: L. Lawrence Williams, President ACKNOWLEDGEMENT STATE OF WISCONSIN ) ) ss. ST. CROIX COUNTY ) Personally came before me this I 81 day of August, 2006, the above named , to me known to be the persons who executed the foregoing instrument and acknowledged the same. Notary Public, County, Wisconsin My Commission is permanent. (If not, state expiration date 2of2 a, 83271+7 State Bar of Wisconsin Form 1 -2003 WARRANTY DEED Document Number N Document Name THIS DEED, made between New Richmond Golf Club, Inc., a Wisconsin Corporation ( "Grantor," whether one or more), and Thomas R. Pitchford and Kristin M. Pitchford, husband and wife, as ( "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 County, State of Wisconsin ( "Property") (if more space is needed, please attach addendum): Part of the NW '/4 of the NE' /, of Section 4, Township 30 North, Range 18 West, City of New Richmond, St. Croix County, Wisconsin described as follows: Lot 1 of Certified Survey Map recorded August 16, 2006 in Volume 21, Page 5258, Document No. 832290 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., MI RECEIVED FOR RECORD 08/22/2006 10:45AN WARRANTY DEED EXERT t REC FEE: 11.00 TRANS FEE: 1020.00 COPY FEE: CC FEE: PAGES: 1 Recording Area Name 261 - 1285 -02 -000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) ;Tantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Easements. highways, utility rights, reservations and restrictions of record. Dated August 1$, 2006 Golf Club, L. Lawrence Williams, President (SEAL) (SEAL) * AUTHENTICATION Signature(s) L. Lawrence Williams authenticated-m August IO * Thomas R. Schumacher TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) 'PHIS INSTRUMENT DRAFTED BY: "T homas R. Schumacher of Bakke Norman, S.C. 1 Box 308 New Richmond WI 54017 ACKNOWLEDGMENT STATE OF WISCONSIN ) ) ss. COUNTY ) Personally came before me on the above -named to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. * Notary Public, State of Wisconsin My Commission (is permanent) (expires: ) (Signatures maybe authenticated or acimowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ®1003 STATE BAR OF WISCONSIN FORM NO. 1-2003 *. T name below signature. 1 of1 LOT-1 II I C S. M_ r J +„ VOLUME_20 ^ _ PAGE _50_0_1 _ i 1B 1 COUNTY, WISCONSIN; BEING PART OF LOT 2 OF 771E I U III - A4414N 8 Z3 2 2 9 01 VOL 21 PAGE 5258 XAT913MN M. VXEM — REGISTER OF DEEDS ST. CROIX CO. VI RECEIVED FOR RD 08/16/20M 09:15AN CERTIFIED SURVEY MAP REC�FEE:t 13.00 CE SURVEY MAP PAGES: 2 LOCATED IN PART OF THE NORTHWEST QUARTER OF THE ? NORTHEAST QUARTER OF SEC77ON 4, TOWNSHIP 30 NORTH, ^ RANGE 18 WEST, CITY OF NEW RICHMOND, ST. CROIX o COUNTY, WISCONSIN; BEING PART OF LOT 2 OF 771E p CER77RED SURVEY MAP RECORDED IN VOLUME 20, PAGE 5001 N PLAT OF I- - GEORGE NORMAN DR. (180TH AVE.) - - - - - - ---------------- - - - - -- -North Me of the Northeast Quarter R - - - - - -N89 0 4721 E 2652.28- - - - - - �' �------ - - - - -- �, - - -- 1989.21 - -- -- - - - - - �---� - - - - -- -� 6 3.07 =� — 4I 1— -- - — — — — �ER OF SE MW 0 I i TraVeled Center Line -' nIDRIrIEASr carrNER- ' � w� Or SEC7701V 4 4 FOUND SURVEY NAIL -j Wi I I My CALCULATED POSI770N '6 w U LOT 2 I ` i C. S. M. �' 209.03 110 1 r 1 I FIDUSE I 1 I l \\ I I I.f 10� I LOT 1 \ N h 4 � I' 1 < I � I I � DRIVEWAY I 4 I 1- 10 JY V _20 1 � E 5001 _ t 11 - _ yENTV SEP77C EFFLUENT LINE \ SEE NOTE- Stu 1 i y, � U p- 0 N � E N J ti o n '47 20'E 452.25 -- S89 4 1 2 ; 0__W 10 �I E M I N Building 1 Setback 1 , SOO ,_,,,.. „I c 1I � ' i Line + 3 5. 00 1 iL 2 SW Caner- - , — — ' .. .. ... . . . .. . .. .... .. .. . .�P Lot 2 o 589 47 20 "W 561.04 —� ° a a p -Traveled N89.46'S2 "W 660.95 p — 1— �twyn�_ - - -- S._T_H. 64 _ ^_ South line of the Northwest- -' �b H Quarter of the Northeast Quarter LOT 1 LEGEND C. O SET 1 " (O.D) X 18” IRON PIPE - VOLUME 5, - N£IGHING 1.13 LOS/LINEAR FOOT. PAGE - 1471- 0 FOUND I (O.D.) IRON PIPE p FOUND SECnON CORNER ...... °........... 30' BUILDING SETBACK LINE SHEET J OF 2 - - - - - - - - GENERAL U7ILITY & DRAINAGE EASEMENT OWNER: NEW RICHMOND GOLF CLUB, INC AREA LOT 1 308:823 SQ. FT. 2 7.021 ACRES J i EXCLUDING R. D. W. 264,113 SO. FT. p; 6.063 ACRES NOTE: Septic system easement will 0 -; be provided by separate SI document. GENERAL UTILITY & DRAINAGE EASSWENT Utilities within this easement to be installed by subgrade boring to limit surface disruption. The preservation of the existing vegetation buffer is required. 200 100 O 200 SCALE.• 1 INCH - 200 FEET C4 w `'S 711fs+ JAMES M. * WEBER _ S-1804 l SPM G Q' u Jam es M. Weber, S -1804 Passe Engineering, Inc. 2003 O Neil Road Hudson, Wisconsin 54016 715- 381 -1150 Date: Iof2 Vol 21 Page 5258 W Bearings are ? referenced to the ^ north line of the o Northeast Quarter p of Sec. 4- 30 -18, N assumed to bear N89 4721'E LOT 2 I ` i C. S. M. �' 209.03 110 1 r 1 I FIDUSE I 1 I l \\ I I I.f 10� I LOT 1 \ N h 4 � I' 1 < I � I I � DRIVEWAY I 4 I 1- 10 JY V _20 1 � E 5001 _ t 11 - _ yENTV SEP77C EFFLUENT LINE \ SEE NOTE- Stu 1 i y, � U p- 0 N � E N J ti o n '47 20'E 452.25 -- S89 4 1 2 ; 0__W 10 �I E M I N Building 1 Setback 1 , SOO ,_,,,.. „I c 1I � ' i Line + 3 5. 00 1 iL 2 SW Caner- - , — — ' .. .. ... . . . .. . .. .... .. .. . .�P Lot 2 o 589 47 20 "W 561.04 —� ° a a p -Traveled N89.46'S2 "W 660.95 p — 1— �twyn�_ - - -- S._T_H. 64 _ ^_ South line of the Northwest- -' �b H Quarter of the Northeast Quarter LOT 1 LEGEND C. O SET 1 " (O.D) X 18” IRON PIPE - VOLUME 5, - N£IGHING 1.13 LOS/LINEAR FOOT. PAGE - 1471- 0 FOUND I (O.D.) IRON PIPE p FOUND SECnON CORNER ...... °........... 30' BUILDING SETBACK LINE SHEET J OF 2 - - - - - - - - GENERAL U7ILITY & DRAINAGE EASEMENT OWNER: NEW RICHMOND GOLF CLUB, INC AREA LOT 1 308:823 SQ. FT. 2 7.021 ACRES J i EXCLUDING R. D. W. 264,113 SO. FT. p; 6.063 ACRES NOTE: Septic system easement will 0 -; be provided by separate SI document. GENERAL UTILITY & DRAINAGE EASSWENT Utilities within this easement to be installed by subgrade boring to limit surface disruption. The preservation of the existing vegetation buffer is required. 200 100 O 200 SCALE.• 1 INCH - 200 FEET C4 w `'S 711fs+ JAMES M. * WEBER _ S-1804 l SPM G Q' u Jam es M. Weber, S -1804 Passe Engineering, Inc. 2003 O Neil Road Hudson, Wisconsin 54016 715- 381 -1150 Date: Iof2 Vol 21 Page 5258 1. o N _ � pp 3 � E u a b v 0' ~ � a j Q' --j v O p � ji e 8 J y FS o � LOT 2 I ` i C. S. M. �' 209.03 110 1 r 1 I FIDUSE I 1 I l \\ I I I.f 10� I LOT 1 \ N h 4 � I' 1 < I � I I � DRIVEWAY I 4 I 1- 10 JY V _20 1 � E 5001 _ t 11 - _ yENTV SEP77C EFFLUENT LINE \ SEE NOTE- Stu 1 i y, � U p- 0 N � E N J ti o n '47 20'E 452.25 -- S89 4 1 2 ; 0__W 10 �I E M I N Building 1 Setback 1 , SOO ,_,,,.. „I c 1I � ' i Line + 3 5. 00 1 iL 2 SW Caner- - , — — ' .. .. ... . . . .. . .. .... .. .. . .�P Lot 2 o 589 47 20 "W 561.04 —� ° a a p -Traveled N89.46'S2 "W 660.95 p — 1— �twyn�_ - - -- S._T_H. 64 _ ^_ South line of the Northwest- -' �b H Quarter of the Northeast Quarter LOT 1 LEGEND C. O SET 1 " (O.D) X 18” IRON PIPE - VOLUME 5, - N£IGHING 1.13 LOS/LINEAR FOOT. PAGE - 1471- 0 FOUND I (O.D.) IRON PIPE p FOUND SECnON CORNER ...... °........... 30' BUILDING SETBACK LINE SHEET J OF 2 - - - - - - - - GENERAL U7ILITY & DRAINAGE EASEMENT OWNER: NEW RICHMOND GOLF CLUB, INC AREA LOT 1 308:823 SQ. FT. 2 7.021 ACRES J i EXCLUDING R. D. W. 264,113 SO. FT. p; 6.063 ACRES NOTE: Septic system easement will 0 -; be provided by separate SI document. GENERAL UTILITY & DRAINAGE EASSWENT Utilities within this easement to be installed by subgrade boring to limit surface disruption. The preservation of the existing vegetation buffer is required. 200 100 O 200 SCALE.• 1 INCH - 200 FEET C4 w `'S 711fs+ JAMES M. * WEBER _ S-1804 l SPM G Q' u Jam es M. Weber, S -1804 Passe Engineering, Inc. 2003 O Neil Road Hudson, Wisconsin 54016 715- 381 -1150 Date: Iof2 Vol 21 Page 5258