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HomeMy WebLinkAbout022-1008-30-000 r "is-onsin Department of Commerce . ., VATE SEWAGE SYSTEM C ounty: St. Croix � Safety and Building Division INSPECTION REPORT Sanitary Permit No: 420439 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)j. Permit Holder's Name: City Village X Township Parcel Tax No: Harmon, Kevin I Kinnickinnic Township 022- 1008 -30 -000 CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION 8LEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Z 9 Septic Be chmark ?i IQ S Dosing Alt. BM Aeration — Bld�.,�ewer 7 (�(��•- _ 1 5 `2 Holding St/Ht Inlet G •'S l St/Ht Outlet -- TANK SETBACK INFORMATION TANK TO P/L WELL G. Vent to Air Intake ROAD Dt Inlet S Septic J/ / D 1 Dt Bottom U lyf o,7 . Dosing / Header /M " y 3.3 /oa. Aeration Dist. Pipe Z 3 3 U.2 Holding Bot. System a1.0v4_ 4 o PUMP /SIPHON INFORMATION Final Grade S I �- s Z 03 7 Manufacturer v I D and St Cov c� GPM �� / 6� Model Number nL Q S __ 3 � - �• (o c/ 1 - 2 TDH n Lift Friction Loss System a TDH Ft f ed y9 ��• i - (,� Forcemain LengW,-^t Dia. h Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. Of Tr% Ves PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS f / .LSQid --- --- SETBACK SYSTEM TO / P/ G WE 1 LAKE /STREAM L CH G Manufacturer: INFORMATION Type Of System: CHA B OR /]^ Z. i Model Number: ye r DISTRIB ION (SYSTEM Kb U5•f a-te 11 h F Heade anifold Distribution x Hole Siz �/ x Ho le Spacing Vent to Air Intake Pipe(s) -I 2 it 1 5/ Z 1 S- Length Dia 7i 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 i Bed/Trench Edges Topsoil 1 9 p [ � Yes [&� No Yes Nr COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: 10/ Inspection #2: 16 Location: 1169 60th Ave River Falls, WI 54022 (NW 1/4 NE 1/4 4 T28N R18W) NA Lot 4 PQ __0 k -1 6 0711 Parcel No: 04.28.18.50/ 1.) Alt BM Description = Jl W �T e Y��� �'a knn'r'� T * rJ a Z - 7�.2dr 1%m/ 4 i r1 Saitlla�LO K �( �/ 6,w (/ 2.) Bldg sewer length - Q (J _ �'�•t - amount of cover = > 4 4 1 -/&K - A61AJ1 p 56(/ Gp y' 1�dr�Z✓�' 3.) Contour = (�, (p1 W, 7 0 M 6 Plan revision Required? Yes o t Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's 'gnature 1 oarcay uw 7 ! m 201 W. Washington Ave., P.O. Box 7162 Madison, WI 53707 — 7162 Site Ad ' o one �S � 604 A xe Department of Commerce . Sanitary Permit Application Sanitary Permit Number In accord with Comm 83.2 1. Vra. Adm. Code, persoml information You provide ❑ Check if Revision �ld D �� ! am be used for secoI purposes Prhilcy Law, s15.04(1 m Stan Phu LD. Nu L Application information - Please Print All Informs T AeA-NS # Parcel Number O7 2 E���D Property is blaoft Address 2 Property Location LJN" 3 Za02 '/f'�: S TL (/ E c*, State Zip ZONE Lot r a Block Number oppic Subdivision Name O r of Building (cbe& all that apply) 1 or 2 Famtly Dwcn t� - Number of Bc&wms �J ❑Vt'liage ❑ Public/Commercial - Describe Use ❑ State owned / nxu d J' X 7 5- ' o p Crrn , ? Nearest Ro.0 /�luJ r ' / f`l z+ VDr Com Complete line B if a 1%abie) III. T of Permit: (Check only one box on line A (numbering scheme for P PP A. 3 ❑ of 6 ❑ Addition to For County try ew 2 ❑ Rephuxment System Replacemem Tank B. ❑ Check if Sanitary Permit Pmviottaly leaned Permit Number Date hstud IV. Type of Permit: (Check all that app umbering scheme is for internal Use) �SC / �q au dZd 44 ❑ Non -pressurized In- Grotmd 47 ❑ Sand Filter 50 ❑ Constructed Wedand 22 ❑ Presstuized In -Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip ' - - 45 ❑ At- Grade 46 ❑Aerobic Treatment Unit 49 11 Rec° 30 ❑ V. Area Informatio Final Grade , Area ' Dispersal Area Sort Application Percolation Rate System IIevation 1 Flow WO Proposed ��� RaWGals./Days/Sq -FL) Z ✓ Elevation z VL Tank Info Capacity in Total Numb" Ivlamrfac Prefab Site Stec Fiber Plastic Gallons Gallons of Tanks /L Concrete Constnrd Glass New F Q Tanta Tanta Septic or HoUng Tads - �L) Dosing C umber VII. g�pp ib Stateat t- 4 the responstbllit9 for bntauat m of the PO shown on the attached plans. Plumber's Name (Print) Plumber' MP/MPRS Number Business Phone N upbFr i l Plumbees Address (Sheet. City. Same Vail. /Department Use Sanitary Permit Fee (mcludes Groundwater Date Issued signature o stamps) Approved ❑ Disapproved Surcharge Pee) ! oI • ❑ Owner Given hatial Adverse Determination J J� Ix. Condi I � l s of A pp or Di / sap �jf L � ,_ � , � _ �:�� � ��- �1'JD1T' �'lll�Sf/'10� !•2kG�` 4�'��. fit G�`� cm the Y) ft � A on > t =11 a � at 93 3 �� *Wl,tl�t /,-�' awv,.. j'.3 , q3 �� /t/O�GGtis'�R/i'rC� SBD / - 63 (R. OS /01 PVe % (;rte smy lze �Ul rvf;V ' s y�r4e Fi l l 4W 7.1o` I PLOT PLAN PROJECT Kgvin Harmon - A DRESS 1007 99th St. Roberts Wi 54023 NW 1/4 NE 1 /4s 4 /T 28 /R 18 TOWN Kinnickinnic COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 8 /26/02 BEDROOM 4 CONVENTIONAL AT- E CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANKS E 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 600 # of chambers none BENCHMARK V.R.P. Top of 2" PVC Pipe ASSUME ELEVATION 100 Filt r Zabel A -100 ❑ BOREHOLE O WELL - H.R.P. Same as Benchmark SYSTEM ELEVATION 60th Ave Scale = 1 /4 11 = 10' w N Well is to meet all Grading is to be done to - o setbacks found in Comm. '� divert runoff away from -°a 83 system CD r CD Pro 4 Bedroom House 3% Area 15' Below System is IWO Slope to remain undisturbed v° Huffcutt Combo Tank 13- 98' �o = —- �,� Tank is to be properly GIB ' bedded and provided with •7 lockdown covers with 4a � approved warning labels �13.M. # 7 t7 B -1 B-2 9 9 300' Prop Line .SyS-f�. wi11 � C.(ou -r - kv So W Lai CST 2��1 a�u -,cam¢- r EROSION CONTROL PLAN COMMENTS: For Lot 4, 1169 60 Ave. Sanitary Permit — owner(s) Kevin Harmon 1. The main source for construction site runoff will be the house foundation excavation and any soil stockpiled until final grading and stabilization is complete. Septic system excavation/installation has minimal impact, but plan to apply seed and mulch as recommended in #4. 2. Divert contaminated runoff away from any drainage ditches or waterways by creating temporary earthen berms ALONG CONTOUR between construction activity and concentrated flows. Maintain existing vegetation between potential receiving waters (including ditches) and the house foundation & mound septic system excavation sites. 3. Construction equipment and vehicles must use only one stabilized driveway access off road that is designed for heavy equipment; this helps avoid muddy, rutted conditions that may allow contaminated runoff to reach waterways /drainage ditches. This includes cement trucks, well drillers, and other contractor's vehicles that access the property. If damage occurs during sand delivery for mound, have excavator re -grade the area and stabilize as part of mound completion. 4. Stabilize new topsoil cover over mound septic system with seed and mulch immediately after installation — do not wait for final stabilization and/or landscaping of entire site to cover exposed soils on the system. If weather will not permit seed germination, a heavy straw mulch cover will prevent erosion until grass /vegetation can get established. 5. If builder /excavator grades the site to create temporary berms (see #2) to contain sediment and leaves adequate vegetative cover to protect areas of concern, installation of silt fence MAY not be necessary. Again, use mulch or other cover materials to prevent erosion. Silt fence or other approved sediment control products will be required if sediment cannot be contained on Lot 4 with the berms. Septic system inspector will evaluate ESC plan effectiveness and make recommendations accordingly. Please feel free to contact me with questions or ask for assistance with erosion & sediment control installation. Pamela Quinn, Soil Erosion Inspector #665054 W o oC Ism 90 co g v o c z C S01 °09'33"W 5318.05' Z �O N O ZZ� o ' " m�P I'�' M O m go` 325.39' -1 0 ° n rn 4992.66' I� D CA z� - -- zoom m m N rnmT i m l ADZ - � O j O m Q I� �N l m O Z s _•I m tl�° O -4 X0 1 x O C'a NZ 10 N OZ Z = I� Q O (A > "i I �o O Z n Z O 4 m �� co rn � I m ° ' I� 0 0 p 4 1 0 Q o = I� v S01 °09'33 "W 325.39' i� i Z O I O O I m ro N r I = IG �� -0 o Z = I� N r iO o 0l Z �P �c z n m I m IGS o p mZ Z v _ t �� I 0 r I� N C DO O N L `° Z 1 _ I m rn _ v _ J °'' m G� �� n up I v m -4 ' (p D C ^ m N01 °09'33 "E M � w-' °' -1 .�.I 1 J 1 1 1 n 5. 91 I -L V IY V IP 0 1 0 Q i , �� r 0 o �,� O m C _ A o z K G) o S01 °09'33 "W 1 rn I II! O Z p O D �� mC m 0� �°_°O o w N Il1V X m m z m Z Z D p� -vO-N �-r— -_` A 0� D r ' - -n 0 C 0 0) V 7D O O O 1 4 O� V _ _ - W 0 ( m C: ° c r m c° co m p 0 t �' � Q ° 1��p C ZI rj) Z > z Dmq D O �v D�mw I IlVIJ —_ y o o -0 n p v S01 09 33'W 325.39 — — '- m r to —I m nj >u l m 'i = z K 0 r I I� y 0 C O l °� ��W `'� 1 33 °' 'b�n '� n Z Z I , I O ro � Icyl � n i r lr t�' '�' P � 4Ph CA) — ��� '0 i I� Z - - -- m-�'a : ro (A 0 , Z ' 157 4 % OD A 193.46' � D o S.T.H.-16-5" N01 °07'14 "E 5 70 ° OD 0 ) cp . 0 CiJ � s MfpdG1u`4__C[�_�LQ(D� -� APPROVED F ST. CROIX COUNTY y x O O m Plan Zoning and Parks Committee m00 NoAmS �o AUG 15Z001 xm rn ZZ i O If not recorded within 30 days of O appr N� l date approval shall be "n nae and void N THIS INSTRUMENT DRAFTED BY KEVIN REED JOB NO. 6011 -02 DATE: 6/20/01 REVISED 8/14/01 Vol. 15 Page 4150 Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264 -8777 *isconsin www.commerc .wis ons Department of Commerce www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Secretary September 17, 2002 CUST ID No.226900 ATTN.- POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING, INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/17/2004 Identification Numbers Transaction ID No. 787127 SITE• Site ID No. 650329 Kevin Harmon Please refer to both identification numbers, 60TH Ave above, in all correspondence with the agency.' Town of Kinnickinnic St Croix County NW1 /4, NEIA, S4, T28N, R18W FOR: Description: Mound 600 Gpd. Object Type: POWT System Regulated Object ID No.: 870064 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. The following conditions shall be met during construction or installation and prior to occupancy or use: Correspondence Notes: • This plan action is subject to designer notes / comments on the plan. • This system is to a cons ruc a an ocated in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" Version 2.0 SBD- 10691 -P ( N.01101) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD- 10706 -P (N.01101). • Comm 84.10, All materials used in this installation shall conform to the provisions of this chapter. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to CO3 it 1 inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of a construction /installation/operation. Y 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. a SHAUN R BIRD Page 2 9/17/02 Inquiries concerning this correspondence may be made to me at the 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, �- / Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Thomas E Devereaux Plumbing / POWTS Reviewer II , Integrated Services WiSMART code: -7633' (715)634-3026, 7:45 am - 4:45 pm Mon. - Fri. tdevereaux@commerce.state.wi.us cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544 e Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 8/26/02 Owner: Kevin Harmon Location: Lot 4 60th Ave System type: Mound System Manuals Used: Mound Component Manual version 2.0 (01/31) Pressure Distribution Manual version 2.0 (01/31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section /Pipe Layout 5. Pump Chamber Cross Section A -f 6. Pump Curve ,ioita�lJ' ij 7 -9. Maintance and Contigency plan 10 -12 Soil test ;ra T o alor u%I�Dlti , - rte✓" SP �NCE C, -79 -7 2-7 Signature License number M6900 8/26/02 PLOT PLAN PROJECT Kevin Harmon A DRESS 1007 99th St. Roberts Wi 54023 NW 1 /4 NE 1 4 /T 28 /R 18 TOWN Kinnickinnic COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 8 BEDROOM 4 CONVENTIONAL AT- E CONVENTIONAL LIFT HOLDING TANK MOUND )= SEPTIC TANK S E 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 600 # of chambers none BENCHMARK V.R.P. Top of 2" PVC Pipe ASSUME ELEVATION 100' Filt r Zabel A -100 ❑ BOREHOLE O WELL *H. R. P Same as Benchmark SYSTEM ELEVATION ,OV 60th Ave Scale = 1/4" = 10' W Well is to meet all Grading is to be done to v setbacks found in Comm. '� divert runoff away from "0 a 83 system CD w r CD Pro 4 Bedroom House 3% Area 15' Below System is Slope to remain undisturbed Huffcutt Combo Tank B -3 98 Z' Tank is to be properly B. bedded and provided with •7 lockdown covers with approved warning labels 14 B. M. # B -1 "7.�' B-2 99 300' Property Line Sys well b e clos �r *0 � 0A Lb4- l k , _(j F CS acc�,�- Date �,. �`? goo Non -Woven Filter Fabric 4" Observation Pipe Perforated Distribution Pipe Below Filter Fabric AST C -33 S o nd Topsoil - r Y. slope Ig� Bed O1 1 2 % Force Main ~ � . Plowed 2 Drain Rock From Pump Layer % Cress Section Of A Found S stem Using F � A Bed For The Absor tion Area G Ft. h ��� g Ft. 0, Ft. Ft L 4 0b servotion PiPs----\ 1 - - K e _---- Z! W a - - - -- 1 Force Main ° ,.. - - - -- -_ - - -- - - - -- ---------------- From PUMP W r2t o Distribution BDrai ORoctt �Z a Pipe I ` Permanent Marker 44Observation Pipe Pipe or Rods pi V1eM of Mound Urin A Bed For TAe AbsorPiion area PA G E 0 F .... _. - L Perbroted pipe oetait �0 i En. d . ' Perto►atea y + PVC P +pt NMss A On Ctotto�n. y`d�s Air* EA++spy Speeed t a/ 1 ococ r PvC Force IMan $! 7 GaAA IRAS 1 ALL littt'f TO t��bl w - t� j� f � PVC Montt" Pipe 54-1 Ole, NO* awn pKirlbatlon Pipe Layout p Ft. R/ Ft. X Inches Y Inches Hole Diameter J`13o� Inch Si . Lateral " Inch License Numb '� v " Manifold o� Inches_ Date: �� Force Main " cam inches # of holes /pipe, Invert ElevAtion of Lateral sjQL-_ZFt. rage UT____- SEPTIC TANK 6 PUMP CIiAMBER CROSS SECTION AND SPECIFICATIONS WEATHERPRQOF 4" Cl VENT PIPE 12" MIN . ABOVE GRADE JUNCTION BOX APPROVED 2:25 FROM DOOR, WINDOW OR WITH CONDUIT MANHOLE COVER INTAKE W/ PADLOCK 6 FRESH AIR WARNING LABEL FINISHED GRADE .,..r. MIN. «. i► us.w• �a S.D. 29" xN . y C.Z. 4biEilwti+a! % '` t9 rr►ai. fift INLET GAS i {,CATER TIGHT SEALS 1 TIGHT, V ED A SEAL JOINTS VITN fluLlk _!_._ LM ApPROYEO PIPE APPROVED - B + ON 3 4 SOLID SOIL PIPE 3 ONTO SOLID � bb �T • -+— OFF SOIL PUMP OFF ELEV - l� D 3" AppROVED BEDDING UNDER TANK CONCRETE PAD 5PECIFICATION S t _' 1 Qom, SEPTIC / DOSE NUMBER DOSES PER DAY: TANK MANUFACTURER: GAL. DOSE VO111ME INCYITD 1 * 2 GAL• OWBA SEPTIC Z F L _�. -.--- K SZ2ES GAL. i TAN DOSE ���� _ �, ► � INCHES = 5101. . GAL. CAPACITIES: A - IN ALARM K,NUFACTUR£R: B = .2 INCHES = GAL. MODEL NUMBER. SWI'T'CH TYPE: f INCHES = � GAL- C = ► PUMP MANUFACTURER: oe D = INCHES = ��• MODEL SWITCHH TYP 1 N 16.23 WAC GPM PUMP B ALARM WIRING AS p" I LHRI / REQUIR£D DISCHARGE RATE �. 17,FEET 1' EN PUMP OFF AND DISTRIBUTI(�i PIPE FEET VERTICAL DIFFERENCE BETWE _ •7f FEET M UM NETWORK SUPPLY PRESS3 FT /100�FT..FRICTION FACTOR • FEET + n FEET FORCEMAIN X--- TOTAL DYNAMIC HEAZ�I £RI ___l, ,� t7 �T�y DiA INTERNAL DIMENSION OF PUMP TANK= LENGTH ' 1 - -•--"- LIQUID -- --- LICENSE NU MSER = SIGNED 1/88 TOTAL DYNAMIC HEAD /CAPACITY PER MINUTE HEAD CAPACITY CURVE EFFLUENT AND DEWATERING � 11 MODEL 152/153 MODEL 152 153 W Feet Meters GOI. Liters Gal. Liters 50 5 1.5 69 261 77 291 153 10 3.1 61 231 70 265 12 40 152 15 4.6 53 201 61 231 20 6.1 44 167 52 197 z 30 25 7.6 34 129 42 159 Q 8 9.1 23 87 33 125 35 10.7 -- -- 22 85 a 20 40 12.2 -- -- 11 42 Lock Valve: 38.0 ft. (1i.6m) 44.0 FL (13.4m) 4 oi4soe 10 0 J 60 80 1D0 20 GALLONS 6 1/4 LITERS 0 80 160 240 320 - 3 27/32 4 5/8 FLOW PER MINUTE 3 27/32 CONSULT FACTORY FOR SPECIAL APPLICATIONS _ 4 3 27/ ,,1� ® 32 • Tarled dolt paWs aVal•Iable. am avallWe acid wP*d YO • SeMmal altmaws, W duplex an alarm. 1 • Variwe level rxlrlw sw*dm are availaW fa coat 0%N st * Owe 1 I Doude ..c.. lc va is Me Ievei floats 2Vailabte for variable • 1 WW NDM and sw cycle W*d& urstaflatials. See FM1420. • Sealed Qwik43 x available foroutdoor • ow 13VF. (WC.) special WOtafim m*md' 1 lx 1/a 151H53 Series 5 1/5 1 Yodel VoI�Pf► 1>od — e 1 or3 slaox N152 115 1 0 tai3 ON152 115 1 A& 4.3 t 2or3 E152 230 .1 Non 43 aided 2or3 aE152 23D 1 Non 10.5 t 2or3 SELECTION GUIDE N753 115 1 ►Ur► 10.5 �IChided 2or3 level IW switch arc QUW PW v lelrei f W 8"153 115 1 A+d� 5.3 1 2or3 1. Sin* p �� E153 230 ; Ado �a3 iirAded 2or3 . Refer b FM0477. E Pak 80 230 2. See FMO712 for n=W Of Etectrioal A ca be d one by a q 3. Vafbbie level W 10-M used as a WnIMI SCWeio6 We* M la:h of c oatro ls, a e add be followed A � �} or i4) W sysffiIn boomed slod*W- nceiitMatto�f AUK(NEC1and1beocrriP�el SaW and RESERVE POWERED DESIGN of every zoeNer pump. For unusual Caldl*ms a reserve safety factor is eng'uleered P Ky . 203/7 end- StdP T& . 3649CmRunRosd �7 �� l;o jaft KY 4M14961 �JS • (A FAX (SM 774-M fe con M 2000 Zoeller Co. All rights reserved. CopYri9 ® Maintenance and Contingency Plan for a Mound System 3� Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Dose Chamber is to be pumped at the same time as the septic tank. 3. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 4. Once every 3 years the mound is to be inspected via the inspections pipes in the at- grade. The laterals are to be inspected via the cleanouts. 5. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 6. Pump and electrical components are to be checked at the time of the pumping. 7. Owner agrees to leave the area 15' below mound undisturbed. 8. The owner agrees to save this plan. 9. Trees, shrubs, and other similiar vegitation are not be planted on system. The system is not be driven over. 10. Effluent Quality is not to excede the requirements found in Comm. 83 Contingency Plan 1. Pump alarm goes off, call pumper and pump out dose chamber and septic tank if needed, then bypass pump float and try pump without float. If this works, float is bad, replace float. If pump still does not work, check power at the pump with a electrical device such as a hair dryer. If no power, check breaker inside house and call a electrician. If there is power, then pump is bad and needs to be replaced by a plumber. 2. If mound fails, determine cause of failure, test another area or remove pipe and sewer rock, retill soil, install new mound system. 3. Replace any other failing components as needed. Important Phone Numbers Plumber: Shaun Bird 715 - 246 -4516 Pumper: Tom Mondor 715 - 246 -5148 St. Croix County Zoning 715 - 386 -4680 Shaun Bird #226900 8/26/02 LAN Page / 7/ POWTS OWNER'S MANUAL & MANA SEE D NS SYSTEM FILE v4FORMAMN S. Tank Capacky ✓rg' ga t 0 NA Owner r Septic Tatdc Macttfi 0 NA Pem 2 Eta Fitter Nth a NA pF (qd pA'RAMETERS a NA E Ftlr Mom DNA of Bedtog" Units pmnp•Tank C jl O NA NMW of pump Talk M� d tow �j _ manUb011m U NA D flow "84 (Estimated x 1.5) Pump � Z D NA Rate ' tNK Soft A tom► Monil>fy arerage' � Fib 0 w F a pi s3< Grease (FOG) Sao 01911- o � Aeration tilo M*W OMy�en Demand (Boa s22o - a Disinfection ° Otlter: Taal Sum Solids (M) 5150 �trer -` jA Q Irk -round (pmssudzeM Sochern p t�ualh► j'' ( SO D,) mg to iramd�(9) Mound AWrade °i ,aed (M) A nom" o a Other: Fe O C (geonnetric mean) Sac dulloond Partite Size K �chdcametef • �damestict� .na Maximum EftkceM v� forp'� MNNTEt"CE 'SCHEDULE Service Frequency $erAce Event a months S) (Maximum 3 yrs.) Of tanik(s) At least once every 3 of tank volume inspect condition When combined sludge and scum equals one-third ( out contents A tanks) t7 njoan s) (Maximum 3 yrs.) Pump create) At least once every -3 At least once l nsped dispersal o months s e every tin aMuent iia At least once 0191Y 3 a esxuths Y (s Inspect ° ect PUMP. Pte' controls A alarm 3 O month y�ts) ° NA Flush laterals and pressure test At least once e At least once e At ° months o year(s) ° NA oabr y o mks o yes (s) a NA At least once mil► odw. CE INSTRUCTIONS an one of the foaowing kareS or MAINTENAM of tanks and d.i ceps shad be made by Inspect >�ovvrs Maw; septage Inspections Maw Plumber R Sewer. ppWTS s to Men* any mfg 'Or WOW, Masher alarm must lncude a vista inspedion of the d scum and to check for any back up Serer Tank �• measure volum of combined sludge to check to ettkre1t Web y any cracks surface mss) shall be g d Ott on the hardwaM or P of etfluea grtwnd for any Pow of effluent on Ste growul a #w l o ca l regulatory audux*- the o a fa�9 condition and equals or more d the tank the b4cate 9 a eon of sludge and scum any Opp and disposed of in accordance When co t ft �C shall be removed by a Septage e�cate contents Code. - its, and any 113. Wiscon lhnsl or P�� POWTS pOy�g Maintainer - The n eill m onitor i ng of 12 a 10 d o of any mice event Gum � shah be proved to the local regtrlato(Y OPERATION t s) for the p � Pam �� or �eC STARTUP AND OPERA Use of �WTS � the dispersal °eqS f at are concen trations For new constrh . P rW d etected cow the bn� removed by a sePt�e smvidn9 to - Page �av/ System start up shag not occur wharf soiroondfions are frozen at the irdWsative Surface. Per pump t� may fill above normal hVmater levels. When power is rOSIXed the exOM Durim, wasbewa�wN be aged fo the cell(s) In one large dose. overloading do cad(s) and may n in the badarp or surface di of effilarlL To avoid this scion halve the contents of the pump tank ranxwed by a She Servidng Opetatr priorI& Mstaft power to the eminent pump or contact a or POWTS MaIntalner to the pump controls m restore normal levels within the pump . assist in Do not drive or Park vehides over bucks and dispersal ceps. Do not drive or park o W. or otherwise disturb or compac the area wo m 15 feet down el of any mound or atVrade sop absbrptbn area. Reduction or:eknination of the MOWN from the wastewater dream may hprave the Pwbmwm and Pnokx9 the pfe Goss; diapers; of the POWfS: � � _ b� cm donors' cotton swabs: derma disinfectants: fat; founde&n dm1n ( ) water; fruit and vegetable peagW gasoline; herbicides: most scraps; medications: oll; 00" P peockler. sanitary nap unVons: - and water sollener brine. ABANDONMENT that redeem out servmoe the fodowtng steps shall t e taken to Insure at the WW" the PoWrS fails W" IS Awn is p and dafdy abandoned in compliance with ch. Comm 83.33. Wisconsin Administrative Code: All piping to terra and pits shad be disconnected and the abandoned pipe oper*mgs sealed. • lime contents of all tanks and pits shelf be removed and properly disposed of by a • Ater pluming. all tanks and pit shad be w=vated and removed or their covers removed 'end the void spraoe tied with M% gravel or anDilM kmxt sold taatecK CONTINGENCY PLAN If the POWTS tads and cannot be repaired the 9 measures have been. or must be haka% to Provide a code comP6ant replacement dystern: D A suitable reptaoement at+� has been eva l ua ted and may he utilized for the location of a replacement sop absorption . The replacement area should be protected from drsttubance and compaction and should not be kddnged upon by required s etbacks from ema.Stumg and Proposed strucWe. lot lanes and wells. Fallrre to protect the T am win result In the need for a new sop and site +evaluation 10 establish a sudabie area. Rat systems must comply with the rules in effect at that tine. replacement 17 A stdtabis replacement am is not available due to settNx* and/or soil Crmkations. Barring advances in POWTS jechnobgy a ho l may be installed as a last resort to replace the faded POWTS- The ske has not been evaluated to identify a suitable repkmnent area. Upon fague of the POWTS a sop and site ev aluation must be pe iomried to Wale a suitable replacemen area. I f no mplacernent area Is available a hittk may be installed as a W resort recormstnnded 9 removal of the bit mat at and at -grade sop ! " the irdarad v e Sum- Recons s of such systems must co mply with the ndes In atlas at that time <<WARNING>> _ SEPTIC, PUMP AND OTHER TN�EATd1ENT TANKS MAY CONT LETHAL GAS SES ANDIO WSU FFLCIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP Oft OTHER OF TANK MAY pLFFNt�'U4�T pidPOSS16LF. MAY RESULT.. RESCUE OF A PERSON FROM THE ADDITIONAL- COMMENTS POWTS INSTALLER POWTS MAINTAINER Name i Name 11,011 / Phone ✓ � � Ptmone -�-- ..S ✓ LOCAL REGULATORY AUTHORITY SEPTAGE SERVICING OPERATOR IN C n Agency Name phone Ptmone and Sus d w spendea. This docun"" T b dow nwd � &aRed by floe SO& of the Green t do Mfr aM Nfausl�ara County Code. Use of tlds don nor do r of ch. Cann 83xtt�NX1Xd" and 83.5gi). M & (3). �0nd" GMW (21ot) guarantee the perramanae of the POWYS' Wisconsin Department of Commerce SOIL EVALUATION REPORT �! �1Q age , of Division of Safety and Buildings v in accordance with Comm 85, Wis. Adm. Code � County �^�- . C. r01 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. p� percent slope, scale or dimensions, north arrow, and to ar�d distan o nearest road. Z� lt�p 30 ( � Please print all inf evie by Date u provide may be used for se po es (Pc w, s.15�94 1) (m)). D Personal information yo p y d� Property Owner r- Property otion 2 er n _ vt. Lit /�t 1 1 /4AtE 1!4 S y T N R /� E(or 111 Property Owner's Maili Address of #' _ Block # Subd. Name or CSM# ST CAOM City State Zip Code Ph mbg MW4G i Nearest Road b 5�ka23 ( O [ja) New Construction Use: Residential / Number of bedroo Code YSa/ 0(1 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material ` ood Plain elevation if applicable General comments $ Irf ��^ e � �' /0 and recommendations: C bU e(e Ag r - Boring # Boring [ pit Ground surface elev. 99, 26 ft. Depth to limiting factor 2U in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'EfM "Eff#2 0_ 3 — s; I 2 c� I v 5 •8 m4' 3 ( CZP 7. y l� Ls I rny� rl Efl Boring # Boring ® Pit Ground surface elev. Depth to limiting factor Z 2,. in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /f1? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 `Eff#2 I 10-0 I I 3)3 — Si ffN-p IX > < * Effluent #2 = BOD < 30 L and TSS _ > < 1 m L _ � < 30 mg/L 'Effluent #1 BOD 30 _ 220 mg /L and TSS 30 _ 50 g/ _ CST Name (Please Print) Ignature CST Number Address Date Evaluation Conducted Telephone Number Property Owner v(�1(1.IL- Parcel ID # Page of FN Boring # ❑Boring E4 Pit Ground surface elev. 9$ ft. Depth to limiting factor 2 - 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 I *Eff#2 ry� C-S C �P F—I Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I ❑Boring F—I Boring # Ground surface elev. ft. Depth to limiting factor in. El Pit Soil 5GPDIfF on Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 Eff#2 F 1 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. SBD -8330 (R.07 /00) it K ty - PAGE 3 OF � - NAME V a v -\ b c c LOT# LEGAL DESCRIPTION 4JW ' /- OP-1 <,S y T ZY ,N R 19' E (or4 SCALE: I' ( a 1 X BM I ELEVATION BM I DESCRIPTION {rip 0 Z T %p e BM 2 ELEVATION ` BM 2 DESCRIPTION ,d p_ d � l 1) c- p c SYSTEM ELEVATION z o ALTERNATE ELEVATION N 14 CONTOUR ELEVATION g 0 ii A yyl a lti Z o n ep N 4� DATE Gr SIGNATU I Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264 -8777 \ *iscons�n www.commerce.state.wi.us /sb Department of Commerce RECEIVED www.wisconsin.gov Scott McCallum, Governor HP 2 3 2002 Philip Edw. Albert, Secretary ST. CROIX COUNTY September 17, 2002 ZONING OFFICE CUST ID No.226900 ATTIC POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING, INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVA EXPIRES: 09/17/2004 Identification Numbers L Transaction ID No. 787127 SITE• Site ID No. 650329 Kevin Harmon Please refer to both identification numbers, 60TH Ave above, in all correspondence with the agency. Town of Kinnickinnic St Croix County NW1 /4, NE1 /4, S4, T28N, R18W FOR: Description: Mound 600 Gpd. Object Type: POWT System Regulated Object ID No.: 870064 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. The following conditions shall be met during construction or installation and prior to occupancy or use: Correspondence Notes: • This plan action is subject to designer notes / comments on the plan. • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" Version 2.0 SBD- 10691 -P ( N.01 /01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD- 10706 -P (N.01 101). • Comm 84.10, All materials used in this installation shall conform to the provisions of this chapter. A copy 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. 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. SHAUN R BIRD Page 2 9/17/02 Inquiries concerning this correspondence may be made to me at the 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, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Thomas E Devereaux Plumbing / POWTS Reviewer II , Integrated Services WiSMART code: X633; (715)634-3026, 7:45 am - 4:45 pm Mon. - Fri. tdevereaux@conimerce.state.wi.us cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544 SEPTIC TANK MAM MANM AGREEMBUr AND OWNBR.S'M (arMCA11014 FORM MuTmg Aaa /�< q 5d (Vcdac nquW f= rig Dom fw um cuymtdo %f7r1rG�� 'on Number O ZZ_ / dU� -30- O�x� D8 H l ��//C 'r.. �!C V., Sam TA W. To of wn i Property ,Lr� .� Lot # _�• Sdpdvision Cardfied s urvey Map # 9' - �3Z7, , , 1 5 , . vow . Pap# f� wt Did ;i.2 — vom #/ OF Spec bom p . Lot 1'mes ido ab� Q no useand fyait� +es.Pr oowift ofprmwkg Got fire septic to& away tWwy=U or saooati if aeededby a Scom edpmI juba iat+a ttre symmm ptal�cttha oftbe septic tss�tc � a stage m Ere waste db 1bc pmpotty � a�aoes to sabaoit t+o St. � ?� D a cetdC�oadotm, aigaed by 16e chmoc and by a pb A acat~oeamdp�(Y) 8reoa�caae6caa�onli�pool is i►pcapo�ooa�ioaand/ar(� atiorandpamip� C¢ his liossthOm 1/3 $dtafalodge. yam, &G, ed bwc and �w aba�a md tD aetyoc hocip. as aet go am odmo�sEbe Coa d� �D /ha St. Cba�a 9Z iW � the oa► data. 1 2 0 Z- `� DA � CVF APPLICANT i (me) Cect Y that all s an S& fam am am to the best of (O D O! I (me) am (am) �° ohs) 'of above, by vbdse of a �y deed=ooK&d� �-- DATE OF AP`PLTGANT A won that is m "spmcn edmay remit in the nnftuypommlbcbg makedby to DVUWMOL UcWde wltb tW mW gm� a wamramy dwd fiom tba of Deeds odsae a Copy of do =Wftd saicv+ey asap if MEMMM i mach in the wm=W deed jj DOCUMENT NUMBER via KATHLEEN H. WALSH wA'RtwNTx bEE� REGISTER OF DEEDS S CROIX CO., WI RECEIVED FOR RECORD Roger VanBeek and Sandy VanBeek, husband and wife, Grantor, conveys and 1 - 13 - 2001 1:15 PM warrants to Kevin C. Harmon, a single person, Grantee, the following described real estate Croix County, State of Wisconsin: WARRANTY DEED EX�MpT 0 Lot Four (4) of Certifi _ a . 'Lrvey Map in volume Fifteen (15) of CERT COPY FEE- .. pa q 2 41 a filed in COPY FEE: St. Croix County Register ofTeeds office on August �200T, being TRANSFER FEE: 90.00 located in the Northwest Quarter of the Northeast Quarter (NW4 of NEk) REC ORDING FEE: 11.00 of Section Four (4), Township Twenty Eight (28) North, Range Eighteen P AGES: 1 (18) West, Town of Kinnickinnic. Grantors reserve to themselves and their heirs and assigns a right of first refusal to purchase this property upon the same terms as may be NAME AND RETURN ADDRESS offered by any bonafide third party purchaser to the Grantee. Grantors shall have 10 days after receipt of written notice of the terms of any third party offer to give written notice of their intention to exercise II ``OJT this right of first refusal. This right of first refusal shall expire / upon substantial completion of construction of a residence on the lot. AI„Jr W it lQa 3 022 - 1008 -30 -000 k' Parcel Identification Number This is not homestead property. Exception to warranties: All easements, restrictions and rights -o£ -way of record, if any. Dated this /Y day of November, 2001. (SEAL) (SEAL) Roger V Beek c dy ang k (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATq OF WISCONSIN ) COUNTY ) authenticated this day of 20_ Perso nall cam before me this Yday of November, 2001 the abo e n d Roger VanBeek and ndy VanBeek (ssnneture) to me no o be the persons (s ho A�sa-.- the fore of i strument and a d �s.m: er [ncaa or rvoea TITLE: MEMBER STATE BAR OF WISCONSIN tsi mcu re (If not, authorized by §706.06, Wis. Stats. ) - 412 z` T ea THIS INSTRUMENT WAS DRASTED BY: Notary Public % .9 7 — . (, �C. U �I County, Wis. Stuart J. Krueger My commission is permanent. (If not expiration date:) Bear, Boles 6 Krueger, S.C. P.O. sk P.O. Box 138 River Falls, WI 54022� — h 6 6 112 PmE WALSH KATHLEEN H. w l7 REGISTER OF DEERS D ST. CROIX CO., WI RECEIVED FOR RECORD VanBeek and Sandy VanBeek, husband and wife, Grantor, conveys and 1I -19 -2001 1:15 PH ants to Kevin C. Harmon, a single person, Grantee, the following YARRANTY DEED ribed real estate in St. Croix County, State of Wisconsin: EXEMPT 0 CERT COPY FEE: Four (4) of certified Survey Map in Volume Fifteen (15) of COPY FEE iiied Survey Maps, page 4150, as Document Number 653876, filed in TRANSFER FEE: 90.00 RECORDING FEE: 11.00 Croix County Register of Deeds office on August 15, 2001, being PAGES: 1 (ted in the Northwest Quarter of the Northeast Quarter (NW4 of NE's) )ection Four (4), Township Twenty Eight (28) North, Range Eighteen West, Town of Kinnickinnic. itors reserve to themselves and their heirs and assigns a right of NAME AND RETURN ADDRESS be %t refusal to purchase this proper pon the same teea Gr ♦� aced by any bonafide third party purch it have 10 days after receipt of written notice of the terms of any rd party offer to give written notice of their intention to exercise `7 3 s right of first refusal. This right of first refusal shall expire �a d�tr W� n substantial completion of construction of a residence on the lot. fN O/- Z a'K 022 - 1008 -30 -000 Parcel Identification Number .s is not homestead property. :eption to warranties: easements, restrictions and rights -of - way of record, if any. :ed this r day of November, 2001. (SEAL) (SEAL) e jd 3er ?Ve (SEAL) (SEAL) ACCT AUTHNNTICATION STAT OF WISCONSIN ) gnature(s) ) ss. � COUNTY ) .thenticated this day of 20_ Personall c before me this LL k day of November, 2001 the abo e n d Roger VanBeek and ndy VanBee si nature to me no o be the persons(s ho a cgtee for of i trument and a d9�G �/ ��// (Name Printed or Tviced) gi atura :TLS: MEMBER STATE BAR OF WISCONSIN :f not, Jc+,G . ( N Printed o T ec ithoriaed by 5706.06, Wis. Stats.) County, Wis. Mna-, Notary Public II8 � WAS DRArM HY: My commission is permanent. expiration date:) :uart J. Krueger )dli, Beskar, Boles 6 Krueger, S.C. Od ,o. Box 138 Ever Falls, WI 54022 3 653576 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO. WI RECEIVED FOR REED 08 -15 -2001 9:00 AN DOT NUMBER 55 - 65 - 3298 - 2001 COPY FEE: 3.00 RECORDING FEE: 12.00 O � PAGES: 2 m_m ?m � � . Z BEARINGS ARE REFERENCED TO THE D m NORTH LINE OF THE NE1 /4 OF SECTION z P4 W 4, ASSUMED TO BEAR N89 O O m m w I I �>� � nm m 9 I -� r m rn � 1P CD (D� A °o° allo 2N 0cn O o o z C S01 °09'33 "W 5318.05' ? i 0 y ? r cf) J r Z OZ o i n m- I� M r- m 0 In M �mC-0 325.39' - -j0 -uoz a cn c 0 4992.66' O m c x 0 z I� - -- � m N rn�m fA I Do'm DZ -� 0 O 70 z m z 19 ON m I 0 O O () O I; C,) N N r 1 v 0 Z II O - �I UOi 40"' I mm 0 °, i Sn? C/) z Z 1D p 4 m to �" 0) 0700 1 mm 0 m rn Z 0 7o O ,� 1 o I I -4 � (n z 8 D 4Ph C to X 0 C = i� v S01 °09'33 "W 325.39' i� Cl) Z Ill r�N 2 IQI �m Z c I o I� 0 _ _ °' r 1 z �� {cam Z 0 m 1 : m '� wo � D DI w O Oo ;� Z C O 1 v N I� C 0 1 0 0 I� N� DO ` N T' p Z .a o � m I m rn� 01 - — T _ J m GJ m 1� 0 I ° z (9 g N O C IT! N01 °09'33 "E� Co- 1 0 Ln i: > r O o III�J I� m A 3: N o Z g m o S01 °09'33 "W 0 0) I1 0 Z C 0 m b W F m ro p o r0°n� mz m O0) v - C N ^ z 0 vO 17 z Z N M Of_ N j 0 q m z m m - f Q z 0 Cn � O o r\ 1 - A m D _�� p p0 �n00 m��D 1 v --- �n —nnn- -r� O 0 OT. Zm Z Z O�� 00��� 1 v � D Z Z y Z 3)q m -i m w I ° _ y o c) m m m CO S01 °09'33 "W 325.39' — — — — m m 0 o �Dy 0 mm to CC r O9 = p m rf, N I j i� i� i0 C •� m O OO c - N J 0 1 00. I � I� I � n Z r0 D3 - I W (O D I 3) QV I I O I ro z - P 0� rl++' IL�S I!� �n 0 w m — m�i 'p Z A ..............�,/a y - q I Z �15 G 7.4 ' L OD q 193.46' ' cr' o S.T.H. "0 — N01 °07'14 "E Ln 0) m N . CA) S) MG�pdQ`u4[ Q dGQ__ o_ APPROVED v F ST. CROIx GOUNTY = G C 0t m m Planning Zoning and Parks Committee moQ N °N=� 1 Z AUG 0 15200 1 9 %M ` o ..L ` �0 P, m if not recorded within 30 days o 0 ,L �S apgroral date approval shatl be nun and void N THIS INSTRUMENT DRAFTED BY KEVIN REED JOB NO. 6011 -02 DATE: 6/20/01 REVISED 8/14/01 Vol. 15 Page 4150