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HomeMy WebLinkAbout022-1080-80-025 (2) Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT sanitary Permit No: 430635 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)]. Permit Holder's Name: city Village X Township Parcel Tax No: Schlotte, Randy I Kinnickinnic Townshi CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: h T • - t:t 2 28.28.18. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic tom` Benchmark e v n.h G / Z.a G � g . e .•._ ii '� 3 .'� L 1D 1. $ 9 8 Dosing Alt. BM lc+� f.°+s 98.1 �.� � 5'6• �5- Aeration Bldg. Sewer Holding St/Ht Inlet 8.sa Af sy. 2� TANK SETBACK INFORMATION St/Ht outlet �\ TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 'a,°7— �- ZO Z S - Dt Bottom Dosing .� f0b Header /Man. Aeration Dist. Pipe �-' L •� 7.a3 9N•�3 Holding 7-- System P4 e ?. ck Z 53 _ `i �l - 7• 9 Z_ 1 9S.94 Olt PUMP /SIPHON INFORMATION Final Grade 94 86 Manufacturer e.rs Demand over GPM v - - T' - Model Number ,--_ TDH Lift Friction Loss System Head TDH F O Forcemain Length Dia. �, Dist. to Well 2S -,5cv Z N o T ✓ SOIL ABSORPTION SYSTEM 2 Ge�rov� o� t Pl— pr.o r fo A7+� BED/TRENCH Width ngth / X I Nb. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ?j IZy— t_> Z SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR Type Of System: .., r UNIT W- v�A t O L J N Model Number. DISTRIBUTION SYSTEM I – ] , 3 �- 32 c lz - t Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake r "t Pipe(s) Length � Dia � Length pia Spacin SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil �] Yes No " Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 9 / ZT Inspection #2: � w Location: 1117 Pine Ridge Drive River Falls, WI 54022 (SW 1/4 NW 1/4 28 T2 W) NA Lot 3 A j f Parcel No: 28.28.18. w f S `u✓ 1.) Alt BM Description = �f° r ` ^S �` s - d pO 040 2.) Bldg sewer length= 263' S - amount of cover= 7S� (co 0, � Pl ti ��_ ((4, ; y , � cv� r'O3 Plan revision Required? Yes i.:?J No p 1 -27 Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No. t 1* Safety and Buildings Division County `� an 201 W. Washington Ave., P.O. Box 7082 C_ F W i c onsin Madison, WI 53707 — 7082 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 261 -6546 30 63 Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.2 1, Wis. Adm. C onnation you provide may be used for secondary pu Privac Project Address (if different t I. Application Information - Please Print All Inf rmation „1-�jn e Property Owner's Name 11 i ' AareeF# Lot # Biock #- C_ fah �l eh� i� Sr.C Property Owner's Mailing Address ONING OFFICE Property Locati 5 k ) on City, late v „ Zip Code Phone Number V4, "11', Section -�-� - � . / s� i e G T N. R 1 L/ E or v II. Type of Building (check all that apply) p pLc.-� w.k _ _ l or 2 Family Dwelling - Number of Bedrooms r S . ❑ Public/Commercial - Describe Use S� ��- �`fi�tr1. l /p ❑ State Owned - Describe Use 2 3 K Z S • ❑City_❑Vill geArT wnship of 0 1 +►r w t c .J +► III. Type of Permit: (Check only one box on line A. Complete line B if applicable) `D . A ' V-New Sy ❑ Re System ys ep ys ❑ Treatment/Holding Tank Replacement On ❑Other Modification to Existing S B • ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner ,// IV. T a of POWTS System: Check all that appl lA Non - Pressurized In -Ground ❑ 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 ching Qfiamber ❑ ip Line ❑ G yel -less Pipe ❑ Othe (explain V. Dispersal/Treat ent Area Information: h ✓ U t G — Design Flow (gpd) Design Soil Application Rat gpdsf) Dispersal Area Req fired (so Dispersal Area Prop sed (SO tem Elevation 6© .S ) 60 ,2 IS 9S; 0 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New I Existing Septic Tanks he or Holdi Tank P g 1 : , 2 v(J 194 W i e e, 1JNC I l.. Aerobic Treatment Unit Dosing Chamber ,_ ©U' ] a . • I VII. Responsibility Statement I , the undersigned, assume )responsibility for installation of the POWTS shown on the attached plans. PI bet's Name (Print Plumber's Si tune MP/MPRS Number Business Phone Number i ��1 P e�s� •-� ' 12 Plumber's Address (Street, City, State, Zip Code) 1 0 4 2 S - Mou I=, (I b / 3 , 1 VIII. County /De artment Use Onl Approved El Sanitary Permit Fee (includes Groundwater Date Issued Is uing ent Signature Stamps) A a� Surcharge Fee) 2 50 — Ob Z � ❑Owner Given Reason for Denial J IX. Conditions of Approval/Reasons for Disapproval 3 \ A-r r — p / S SYSTEM OWNER. l t l , S,2_4 r1c 1 Septic tank, effluent filter and �" `^^ `^^°`� ' t^^ . dispersal cell must all be serviced / maintained as per management plan provided by plumber. ) �? '�� y` ^&01 � 2. All setback requirements must be maintained as per applicable code /ordinances. ')^'` t �' o CQ.Ct C� Ova r S Attach complete plans (to the County only) for the system a pa r not Itss than 81lL z 11 inches In size I SBD -6398 (R. 08/02) PLOT PLAIN PaoA of Scale 1' =S0 ' S C tf Ll T-E ✓ f� 1NS'T'P�LL Z DO S�j C�LZS� X 2 14 'x \ Lu vu G k:j Zp UnUL n o r- i ry Ft Liz -ice R Z lot GY , vc,�, -��„p N I 3C�• Y 1 A to) N tla ( i i 1 (��J N �I J i i L j ---t -' �- Lo U . o ' or j 1 1 , -f f>L� . a_ - fit q �' oiv 8 �r�v 11 or r-13n4 r � - r (fut�v WECERER SOIL TESTING AND c u ®ESIGN SERVICE P -0. BOX 74 - 421 N. MA)N ST, RWER FALLS M 54022 71 5- 42+s -01 M; Wi sconsin Department of Commerce SOIL EVALUATION REPORT Page , of ' Division of Safety and Buildings • in accordance with Comm 85, Wis. Adm ode Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan t AID County ST • include, but not limited to: vertical and horizontal reference point (BM), direction a Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest Z 1 G Please print all information. Re iewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1 (m)). - � J Property Owner operty Location �1 I Govt L0 1/4 %W /4 S Z8 T Z N R `t) E (o W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# City State Zip Code Phone Number ❑ City ❑ Village 0 Town Nearest Road 2t v �SZ ( cs L I s y o ZZ ( qZS 10- `s Ii j \, Q-\rLj rj)'j R-LO G(�- New Construction Use: [� Residential / Number of bedrooms _ _ Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent m aterial Flood Plain elevation if applicable General comments Z v sv ���� �,� 3 ' �.ZS' L.c� G w t hq ZU V)v tTS 0 � and recommendations: R 1)v F1. L�,.�T Z ��'�-e:�� C l� ►^-t � L 2S �l_''R_ ��z� . �� w1 OF 0 ' F1 Boring # ❑ Boring pit Ground surface elev. - L ft. Depth to limiting factor 79 4 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 o- V - I •S�-l11Z 1I — Z n -y i's `l fZ- 4 l S p S9 0 10251 — i O Sq 1 _ - S .9 Boring # Ban n . � pit Ground surface elev. ` ft. 8� 1 71 Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 cs b Ym \i t i , - ot L� • y - 1� I" 1•Sy4z y1 — 0 Sg. c> 0") Z� -(0 Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 _< 150 mg/L • Effluent #2 = BOD, < 30 mg/L and TSS < 30 mgA- CST Name (Please Print) Si natu CST Number Arthur L. Wegerer -4 03- 1Z -�j-3 220254 Address W e g e r e r Soil T e s't i n o & Design Service Date Evaluation Conducted Telephone Number 421 N. Main St. River Falls, UI 54022 -Z`'�- p3 715 -425 -0165 Property Owner Parcel ID # �c�� I k) G Page 2 of Boring # ❑y Boring 1! pit Ground surface elev. J ft. Depth to limiting factor Z in, Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I o -1 - ) .S YR3 L3 -- 1` 1 ) Of al 1� • q Z 1Q A - I -S `t2 3 4z a o U1 IL C) sq F-1 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 /ft� in. - Munsell Qu. Si. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 F-1 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 /ft' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg /L • 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 (R6100) • PLOT PLAN Paae of ' Scale 1' PrC a.4 a ' 7- l I LuT 3 3 ° �0 Fs I N rj l S u 1TPa3CE fl,-- wR UT rj 1 � , I BIZ, — 3M Z �v 0�� ' oru 1'" l its m h ( hL� . -- t 3r'1 tf-Z = fit. q8 • , or\j 3I �, (zE -374�z - 715- 425 -0165 220254 O3_ \Z6 -3 CST Signature Date Telephone Flo. CST No. Job PTO. PLOT PLAid Page of ... ' 1' 2 V ETR Ft,tLS, Lv 4� i� I t e ll ' ` tiZS Lu k�j ITL�_ Zo vrut T o T t N P �-7 ' R Cf,MF,�Zgs i I. � � 1 �U 1 _ � � 3r � 4 r 1 I'FZ - �?L, o'v 3 !y'' 2E- t�T , �t�ivJ PIPS -- N�� : �oT� ly a F � C� - Z.�S � fi � 'rcT ENV , q •5_p` WEGERER SOIL TESTING AND DESIGN SERVICE P•O, BOX 74 421 N. MAIN 8T, RIVER FALLS, M 540 71 S-4 X5-0 i M3 Combination Septic:Tank and PUMP CHAMBER CROSS SECTIOM AND SPECIFICATIOuS ' PAGE OF -VEUT CAP WEATHEK PROOF JUIJCTIOU 8OX 'i'C_I. VEIJT PIPC APPROVED LOCK IMG 1O' FROM DOOR. MAIJHOLE COVER c•J g��'1iafJ PIPg OR FRESH wA(trJl►JG LP.6EL. w /r1>tZrstti" �nP �, A�P_IUTAKE w ' F1 N ls�fl 6� riw • .. � `L S r � I � Y� 1'111.1. G D E I HJLET i'c PROVIDE —_— — '' � AIRTIGHT SEAL n ' Approved r--t -A I II1 Approved joint w/ �a _ \U�o� I joint w/ PVC pipe ALAA PVC pipe � I C I u CLEV;.?R- 81 F T I I I - 7 PUKP '—� � OFF D CO►JCRETE LV u • UC3 CLOCK l RISER EXIT PERMITtED OIJLy IF TA)DK MAIrL'FACTURER HAS SUCH APPROVAL 3`•AD �n REDO I N 4 SEPTIC E SPECIFICATIOKJS DOSE T Aki KS MA►1UFACTU;LER: "J (2 C ![ Z z W MBER OF DOSES: S' c .. P E R. D ,. TAMK :,IZC: - ?J 0 0 GALLOIJS DOSE VOLUME ALARM MA I 6AC)LFLOW GALLONS MODEL ►DUMBER: CAPACITIES: A= VDt3• 3 lA1CHE5 OR GALLONS SWITCH TyPC: B= IIJCHES'GR ��� S G�LLOU5 PUMP MAUU FACT URCK: h'1�1L-lZS C: 6 I N CHES OR \ "� GALLONS MODEL IJUMBEX' �O D= INCHES OR Z2"2 y GALLOUS SWITC �LZ� VIZ L/ MOTE: PU/1P AN�ALARM ARE TO 5E MIMIMUM DISCHARGE RATE_ ^_ GPM INSTALLED OIJ SEPARATE CIRCUITS VERTICAL DIFFEREUCE DE U TWEEIJ PUMP OFF AO.. \111\ �C�orj � �t@kl PIPE.. 11 FEET + MIIJIMUM METWORK SUPPLY PRESSURE , IV'�• FEET + l S FEET OF FORCE MAIN) X F � b 7 3 100 FGFRICTIO►J FAC TOR., FEET TOTAL OtJMAMIC. HEAD — ,_ S q FEET �As per manufacturer ZZ -Zy . gal /in. Liquid depth M E40 Series M"M 4/10 HP Effluent and Drain Water Pumps Performance Curve MODEL ME40 EFFLUENT PUMP CAPACITY LITERS PER MINUTE 0 50 100 150 200 250 300 350 40 12 35 10 W 30 W W Z 25 8 X 2 20 6 Q 0.15 Q 10 s7 5 2 0 0 O 10 20 30 40 50 60 70 80 90 100 CAPACITY GALLONS PER MINUTE 1101 Myers Parkway, Ashland, Ohio 44805 -1923 419/289 -1144 FAX 419/289 -6658 Telex 98 -7443 K3326 7/91 Printed in U.S.A. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page �_ of FILE INFORMATION SYSTEM SPECIFICATIONS Owner p ��I Septic Tank Capacity 0 0 g a l ❑ NA Permit # 4130&36_ Septic Tank Manufacturer S e y ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms L� ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units IINA Pump Tank Capacity 60 g al ❑ NA Estimated flow (average) g al/day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1. 6 gal /day Pump Manufacturer ❑ NA Soil Application Rate () r �j gal/day/ft' Pump Model ❑ NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit P�INA Fats, Oil & Grease (FOG) :530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODd :5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) :5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L Xin- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y. in dia. jd NA Other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA Sk ear(s) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell l�arss) At least once every: ❑ month) (Maximum 3 years) 13 NA 3 Clean effluent filter At least once every: ❑ month(s) ❑ N� ,&year(s) Inspect pump, pump controls & alarm At least once every: ❑ yearls) onth(s) E3 NA 3 � Flush laterals and pressure test At least once every: ❑ month(s) ❑ year(s) Other: At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third IY or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4/01) Page Z of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should d tt n by required setbacks from existing and proposed structure, lot lines and wells. F ailure to protect t re lace area Will r esult in the need for a new soil and site evaluation to establish a suitable replacement are ReplacemenTsystems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ( Vsi has s not b n valuated t able replacement area. Upon failure of the PO de ify a suit TS a so�emti�, ite �V A;nm v ust perfo ed t ocate a uitable r ement are no replac en area is ailab folding tank st as a last resort to replace th PO S. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name C.L i ( ' -� Name Phone 4 . Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name �, CtZ (K C&ti r -as-ooN Phone Phone 396. 6 Pn This document was drafted in compliance with chapter Comm 83.22(2)(01)(d) &M and 83.54(1), (2) & (3), Wisconsin Administrative Code. ST CROIX COUNTY SITTIC T MAIM1 AGIUMINUNT AND OWNIT"1111, eBRIVICATION FOIUA 7 TG Mailing Addicss tN r a j e�/ MM k, V S hopcily Address PI A/6- 9 P2w,5 (vairics(ion rcqui from P 1 Dqwtmcat for new construction) CARYiI.Statc Parcel ldca6ficaGoa Number I'l opa ty Location r4 1/,. s cc- a g T N-P, 1 W, Town of Subdivision Lot V v Ll trafi survey hf ff Volmno (0 Page (I 04� Watimn(y Deed G volumc i '7 p it I/ co Spat ha= ❑ yes no li Ycs ❑ no aecoea8d m tyv=cm M =arm Ift oasisft cc tmrvbz Oct � Y� oc sonars. if u� Y ow= ac= to =Lmk to SL Cko*m Z*dmg ?L =ffi=fimloaa. 6V=d by tau , ov= sad bT 11 is FOM `T=f'v9 CoaMOa and/or {`I) ucoctet ). d= iq)&t=k is 1= than U3 W of lrladg V*"- dC "4=*Cd bAVC md the abaw rorj tad &CMe to mailbil fie P6rta� wsjft, d*s2l sy'sf= Wid the standards I fort, by Me DTab=ut of tad &c DTawkedofit��p== 0mocadoa gu6nt taut YOM WIC tY%tcm 1= to= miiaizrs , =iA be o a d rc t 6 St Ckoix Comty Zcainc office wwa 30 &Y's of the (In= year cxVintion date. I �Aa 6 3 .TGNALIM6F. Oe APrIJOAM DATE OVVN1m4,. (w caffy that an CfAt==ft an this form gM t ( the best O f M y ( 431r ) hWVAC*. I ( &M (err) th OWUCr(S) OC 16 pmpaty dcscnW above, by vi O r it wu= flood jt70Q A.,,d i & off Dee& 4 a, il rs or ArrucANT, DATE AllY infomls-'Clon %bit Is wkAqnrscafo4 may M in the mniWy Pemit being mvokcd by thr, Toning DcPlrtm�l- Incl %% this 8 01 1 licaUccl: s Vmp:)d watunty dood fiom the Rc&W of I)cc& offivoc- I COPYOI the mtirv mty trap if refatam Is madc in the winsmy dcrd ST. CROIX COUNTY - WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 • Fax (715) 386 -4686 EROSION & SEDIMENT CONTROL PLAN Parcel #28.28.18. vendin Site: 111 Ridge — 7 Pine dge Dnve, Lot 3 (Ktnmckmntc owner (s) Randy Schlotte Under St. Croix County Zoning Code 17.70(3)(b)5: "The (Zoning) Administrator may attach reasonable erosion prevention conditions to a permit approved for issuance." Comm. 21.125 also requires the building permit applicant and/or landowner to follow erosion control procedures and maintain them until the site has been stabilized. The owner is responsible for notifying all contractors performing construction on this site that an Erosion & Sediment Control (ESC) Plan is in effect and the following activities will be required in order to maintain compliance with the plan: 1. The primary source for construction site runoff will be the house foundation excavation, driveway, and any soil stockpiled until final grading and stabilization has been completed. Septic system installation adds to temporary disturbance, but establishing cover on exposed soils will prevent erosion. Plan to apply seed and mulch as recommended in #5. Maintain existing vegetation wherever possible to minimize sediment movement. Surface drainage is to the west, with >100 feet of buffer between the pond and the proposed house and mound system construction. 2. Route contaminated runoff into vegetated buffer areas on owner's property by creating temporary diversions graded ALONG CONTOUR between excavation areas and any potential receiving waters (this includes road ditches). Do not allow diverted runoff to be directed onto neighboring properties. (See specification sheet for temporary diversions provided by Zoning Dept.) 3. If builder /excavator grades the site to create temporary diversions (see #2) to contain sediment and leaves adequate vegetative cover to protect areas of concern, installation of silt fence MAY not be necessary. Silt fence or other approved sediment control products will be required if sediment cannot be contained on owner's property with the diversions and vegetative buffers. The POWTS inspector and building inspector will evaluate ESC plan effectiveness and make recommendations to owner for any action required to comply with applicable regulations. 4. Construction equipment and vehicles must utilize a stabilized driveway access off public road for heavy equipment; this includes cement trucks, well drillers, and other contractor's vehicles that access the property during construction. This helps avoid muddy, rutted conditions that may allow contaminated runoff to reach waterways and/or drainage ditches. Property owner must repair damage to ditches resulting from multiple access points and sediment tracked on public roadways must be removed at the end of each workday. 5. Stabilize new topsoil cover over 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. Erosion control matting can be applied any time of year and, if installed properly, will provide protection even if seed germination is delayed. The owner of record during site construction will be responsible for compliance with the ESC Plan. Please feel free to contact me with questions regarding erosion a im t co of ' llation. _ Prepared by: Pamela Quinn, Soil Erosion Inspector #6650Lt ` GG •'�;•: Owner acknowledgement of ESC Plan requirements: / /20 t� U 2 9 3 0 P 6 15 - 7ti-28 ?2! STATE BAR OF WISCONSIN FORM 2 - 2000 KATHLEEN H. WALSH REGISTER OF DEEDS Document Number WARRANTY DEED ST. CROI X CO., WI This Deed, made between Steven G. Cudd and Gail L. Cudd, RECEIVED FOR RECORD husband and wife Grantor, and Randall Schlotte and Therese M. Schlotte 10/08/2003 09:10AN husband and wife as survivorship marital property Grantee. WARRANTY DEED . Grantor, for a valuable consideration, conveys and warrants to Grantee EXEMPT # the following described real estate in St. Croix County, State of Wisconsin (if REC FEE: 11.00 d, please attach addendum): TRANS FEE: 277.50 LOT THREE 3) mF CERTIFIED SURVEY MAP IN VOLUME COPY FEE: SEVENTEEN if 7) OF CERTIFIED SURVEY MAPS, PAGE 4619, AS CC FEE: DOCU MENT NT NUMBER 741211, FILED IN ST. CROIX COUNTY PAGES: i REGISTER OF EEDS OFFICE ON SEPTMEBER 25, 2003, BEING LOCATED IN THE SOUTHWEST QUARTER OF THE NORTHWEST QUARTER (SW 1/4 OF NW 1/4) OF SECTION TWENTY EIGHT (28), TOWNSHIP TWENTY EIGHT (28) NORTH, RANGE EIGHTEEN (18) WEST, TOWN OF KINNICKINNIC, FORMERLY PART OF LOT 1 OF Recording Area CERTIFIED SURVEY MAP IN VOLUME 6, PAGE 1746, AS DOCUMENT NUMBER 419476, FORMERLY KNOWN AS LOT 3 OF Name and Return Address CERTIFIED SURVEY MAP IN VOLUME 2, PAGE 345, AS Joseph D. Boles DOCUMENT NUMBER 338318. Subject to Liberty Road right of way. Rodli, Beskar, Boles & Krueger, S.C. P. O. Box 138 River Falls, WI 54022 -0138 Part of 022- 1080 - 80-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: easements, restrictions and rights of way of record, if any. Dated this 6th day of October 2003 - _4� _ * * Steven G. Cudd * * Gail L. Cudd AUTHENTICATION ACKNOWLEDGMENT Signature(s) Steven G. Cudd and Gail L. Cudd STATE OF ) ) ss. County. ) authenticated this Ath day of October , 2003 . Personally came before me this day of ( N - � � (9 the above named * oseph D. Boles TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by §706.06, Wis. Stats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY Joseph D. Boles - Attoreny at Law River Falls, WI 54022 Notary Public, State of My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) I ,) • Names of persons signing in any capacity must be typed or printed below their signature. INFO -PRO (800 )655 -2021 www.infoproforms.com STATE BAR OF WISCONSIN WARRANTY DEED FORM No. 2 - 2000 4 CURVE DATA TABLE Curve No. Radius Central Angle Arc Length Chord Length Chord Bearing 1 -2 80.00' 124 173.71' 141.54' S63 "E Lot 3 80.00' 57°11'16" 79.85' 76.58' S29 0 48'18 "E Lot 4 80.00' 67 93.86' 88.57' N87 "E Tangent Bearings: At 1 =S01 0 12'40 "E At 2= N54 "E DESCRIPTION A parcel of land located in the SW '/4 of the NW '/4 of Section 28, T28N, RI 8W Town of Kinnickinnic, St.Croix County, Wisconsin, being Lot 1 of Certified Survey Map recorded in Volume 6 of Certified Survey Maps, Page 1746, more fully described as follows: Commencing at the NW corner of Section 28, T28N, R1 8W: Thence S00 °57'00E along the west line of the NW'h, 1428.73' to the POINT OF BEGINNING: Thence N88 0 47'20 "E 657.63'; Thence southeasterly 173.71' along the right -of -way line of Pine Ridge Drive, also being the arc of a 80.00' radius curve concave northerly and having a long chord that bears S63 "E 141.54'; Thence N88 °47'20 "E 106.25'; Thence S01 *08'14 "E 514.14'; Thence N90 "W 891.18' to a point on the west line of the NW '/4 of said Section 28; Thence N00 0 57'00 "W along said line, 561.31' to the point of beginning. Contains 11.31 acres subject to Liberty Road right -of -way and any and all additional easements, right -of -ways or conveyances of record. SURVEYOR'S CERTIFICATE I, James M. Weber, registered land surveyor, hereby certify: That in full compliance with the provisions of Chapter 236.34 of the Wisconsin Statutes and the provisions of the St.Croix County Subdivision Ordinance and under the direction of Steven Cudd, owner, I have surveyed, divided and mapped the hereon described parcel of land and that this map is a correct representation of the boundary thereof. Dated this day of J \ ,2003. —V"' J James M. EBER Weber S -1804 Landmark Surveying, Inc. IP VA vin do SUa �� Note: The parcels shown on this map are subject to State, County an own laws, rules and regulations (Le. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any lot, contact the St.Croix County Zoning Office and the Town of Kinnickinnic for advice. Sheet 2 of 2 2003046 This instrument drafted by Jim Weber Vol 17 Page 4619 741211 VOL 77__ PAGE 4619 XATH EE`11 H. W7l ZR - -- -- REGISTER OF DEEDS ST. CROIX CO.. WI RECEIVED FOR RECORD 09/25/2003 08:00AM CERTIFIED SURVEY MAP REe PEE, ..00 a.a. vv COPY FEE: 3.00 CERTIFIED SURVEY MAP PAGES` 2 LOCATED IN THE SW 1 ,1 4 OF THE NW 1.14 OF SECTION 28, T28N, R 18W, TOWN OF K I NN I CK 1 NN I C, S T. CRO I X COUNTY, WI (BEI LOT I OF C. S. K VOL UW 6, PAGE 1746). ESEEPARED FOR NOTE: BEARINGS ARE STEVEN CUDD APPROVED REFERENCED TO THE NEST BT CROXCOUNTY � �LINE OF THE NW 1 PI� nMng Zonlnc and Packs COMM ilt 1ECORD BEAR INS ). SEP 2 5 2003 NW CORNER OF SECTION 28, T28N, R I BW. If not romood within 3o days of I ( FOUND ALUMINUM CAP approval date approval shall be MONUMENT). null and void �PQ a �1 P..I.NI�...R � R.G. P• I�ml 5 �� Q,• G.• a,. I g w I �f 33- 1 33' I �F. I -y 331 -F 33' J .40' N88.47' 20'E 887.85' Q I rt 824.83 a o N88 20'E y t I 33. HIGHWAY SETBACK L INE�;S 106.25' :c I LOT 3 I rA =_ 6. 16 ACRES a N AMNAME 268,309 S0. FT. 5.74 AC. EXC. R/Wa ;y = �� POND 250,052 SO. FT. •�` :O Z $gyp m: I.QT...i ''- is I w � : � � LOT 4 ^^ z la t at• 5.15 ACRES v , of 0 ' 3R 224, 239 SO. FT. + I` -� Z• g\ 3 �Oa' S. 14 AC. EXC. R N6 223, 982 30. FT. j I I� 838. 18' 3 T II 33. oo' N90 00'W 891. 18' . CER . T IF I D MAP VOLUAC 2 PAGE 345: I� ................... . G pV �O W li4 OF SECTION T2 R18W. (FOUND ALUMINUM SGOMS CAP MONUMENT). JAMES M. O• SET I' O.D. X 18' IRON PIPE WEBER NE IGHING J. 13LOS PER L (NEAR FOOT. 6.1"4 EY, 0- I' 1RON PIPE FOUND. �' VA O Q 1''200' JAMES M. WEBER S -1804 O I oO 200 400 SHEET I OF 2 LANDMARK SURVEYING, INC. 2003046 THIS INSTRUMENT DRAFTED BY JIM WE8ER DATED Vol 17 Page 4619