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Home My WebLink About022-1084-50-300 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division' i INSPECTION REPORT Sanitary Permit No: 405068 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: Gray, David & Tania I Kinnickinnic Township 022 - 1084 -50 -300 CST BM Elev: Insp. BM Elev: BM Description: C 0 0 19 ' ; rt v TANK INFORMATION MEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 2 s� Benchmark i 107.0 /Oa Dosing Alt. BM 1, O Aeration Bldg. Sewer o- Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet �� septic \ � �� O � / Dt Bottom 3 - 6 l Dosing l / , �, Header /Man. � Aeration PD' Pipe 0 w / o S 0 lin Holding Bot. System PUMP /SIPHON INFORMATION F;j Grade Manufacturer �,� / / r mand St Cover S !� a •S � 4l/Yvl GP Model Numbtlf. 01 �1� TDH Lif „/ Fr' ss System Head TDH t �j � L,O Force I L77t Dia `� S SOIL ABSORPTION SYSTEM BEDITRENCH Width Length r No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Man u - r � INFORMATION Ty Of System: CHAMBER OR 0 4 . 4 -, j� - v Q q & UNIT Model Number: D IBUTION SYSTEM (� hd Header/ anifold Distribution �^ x Hole Size x Hole Spacing Vent to Air Intake /' Pipe(s) 4- /t�Y1 04 ---�� — ength Dia Length Diaacmg SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only 1A '` 0 f t" O-PI d Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ra !— Yes [ No J Yes I` ; No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: /41 a � Inspection #2: Location: 1029 River Drive River Falls, WI 54022 (NE 1/4 SE 1/4 29 T28N R18W) NA Lot 3 Parcel No: 29.28.18.1 J 56A30 1.) Alt BM Description = ' C � p o� �� C�INS� p-Q1I' a w 4 4,,4,, '/� / C' "� �ufuaR� 1n_ 2.) Bldg sewer length = �� 4 nee!- 0y61&-®. A4 - amount of cover Plan Use other side for additional Yes o Re quired? Information. L] 06- SBD -6710 (R.3/97) b ; Date Insepctoes gnature Cent. No. Safety and Buildings Division Cry _rte 201 W. Washington Ave., P.O. Box 7162 sc V Sloe Address ons�n Madison, WI 53707 - 7162 Dep artment of Commerce - i s` -d Sanitary Permit Number Sanitary Permit Application - 6 0 In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑ Check if Revision mav be used for secondary purpo Privacy sl5. 1 m I. Application Information - Please Print All Informati RECENED State Plan I.D. Number �/� y Owner's Name Parcel Number propert DA �� ' �� - MAY 0 6 2002 X22— ( C>b Property Owner's Mailing Address Property Location ST. CROIX COUNTY �.. n -1W ZONING OFFICE D',A 1� 0% S L T G�jN. R City, State Zip Code Phone Number Lot Number 37 Block Number i� !4 - d 7 / Z Subdivision Name CSM Number &q 3 z z Z s II. Type of Building (check all that apply) ❑City 1 or 2 Family Dwelling - Number of Bedrooms ❑Village ❑ public/Commercial. -�De / scribe Use , ownship t I ^j Z-- s ❑ State Owned ", , "��Y / n �'`��y Nearest Road M. Type of permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) For County use A. 1 New 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑ Addition to stem Tank Onl E stem B. ❑ Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) 47 ❑ Sand Filter 50 11 Constructed Wetland SSA 44,�Non- PressuriZedht -Ground 21❑ Mound -` « /�� 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. D' rsal/'IYeatment Area Information: Design Flow (gpd) Dispersal Area Dispersal Area r:. plication Percolation Rate System Elevation Final Grade Required /J � / ls./Days/Sq.Ft.) (Min./Inch) � Steel Fiber astic (� T Elevation oo VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Pl Gallons Gallons of Tanks /� ( Concrete Constructed Glass New Existing w1,7, aez A �(,�� ff/ Tanks Tanks r� Septic or Holding Tank ZSv � ZSo �� i r , ID Dosing chamber VII. Responsibility Statement- I, the and responsibility for installation of the POWTS shown on the attached plans. Plum Name (Print) P is S' MP/MPRS Number Business Phone Number /o�,� 7 /„r —Z�S = 24, s Plumber's Address (Street. City, Stag e) -7 szo Y 9 7o8 VIII,Coun /De artment Use Onl Sanitary Permit Fee (includes Groundwater Date Issued Is ' ent Signature (No Stamps) Approved ❑ Disapproved Surcharge l ❑ Owner Given Initial Adverse Determination IX. Conditions of Approval/Reasons r Dtsa� v ��- � /�� 8 D Z �j Tz- x.,•: ,.��..cLGt -l�� Attach complete p (to the y) for the system on less Was SU# 11 inches in Q, ,, _ ) t-f97� 4RRn -AI4R (R ()5 /01) 1n kJj Ln CP la 1 r � I ! Z b N G s U v ,1 WEATHERPRUJF WCKING COVER JtiNLT�o" QVIC D146 C.OV4�cT --� la. >, � IL TT f4lwlwlf f V7771177771. , ni,7rrrt �° PIQ6 3' P� U NOISTuRIED k5 SOIL_ 24u 2.D. II 4" 4° KAN U 0•LE i. 'K M /A" r D �'wuc pp,'icovLD ,..� . T �M"J WF'LES 4 o pin p � aL 3' ono • E c,T I O KS `^y ` i. �O uKr�:.nx� c 1 1 Cx,p Pw1P Co NZ,Rrr, . ,EPTiC. i _SPECIFI'CAT10Qs o Au.S /'\AUUt"ACTURCR: LuM9ER OF DOSES: 6 PEK 0A7 TA SIZE . � s' �5� Aso GALLOWS DOSE VOLUME G3 � 2- LAan /' I UFACTURCR: S v IIJCLUOING 5ACKIFLOW: MODEL WIJP`vDCR: ° ``' CAPACITIES: A= �$ WCHCS OR GALLOL,S 51•/ITCH TyPC; �'� w�b 5c IWCHE$ OR 3� (.ALLOT 5 JMP r1AQUFACTURC � �' MODEL QUMDEK, D• o INCHES OR cAL�O,�: JwiTC H TlJPC; b"�2�....�v �., 1 JOTC: PUMP A ALARM ARC TO OC MIWIh1UM 015CHARGt RATE 32 GPM IN5rALL 0 /ON 5EPARATC CIRCJI'"� RTICAL Di OfTWCCU PUMP OFF ` U0 01JTRIDUTI01J PIPE., _�, � FEET r ee 'aA/ 6 G X-$-,- �¢��?rtJ 7 r uM uETWORK SUPPLY PRftsURE FEET � ✓�� FE E T OF FORCC MA ° 1 f T IN X ._.._� �p rLFRICTIOU FACTOR, _ FEET . \h TOTAL OykJAMIC. HEAD = FEET �. TERQAL, DIMEW610►JG - Of TAWK: LEQGTH �3� ;W IDTH �� ;LIQUID RCPT �� Wi-5consin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings ' in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must County Include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. Lf - S0- percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information Re ' by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owners C PrK)OPrL L _ C.UO !�) p Property Location —tJW GeA -bet- S k� 1/4Mui1/4 S Z T Z,$ N R 11� V,(o W Property Owner's Mailing Address Block # Subd. Name or CSM# 1 0 C6 0 9 , TLLP- MOON3 ��IU C 3 \�Pcl O CS wI �0�3 City State Zip Code Phone Number City ❑ Village ® Town Nearest Road RtV%R. FALL % kJ1 I Skb3Z ( - 1 1S) 4ZS - IQ UP 1-- LK►r,jtO -VrAm kit C RIV��Z U�Z.1VL New Construction Use: 2 Residential / Number of bedrooms L4 Code derived design flow rate b00 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent r1 terial _- G LPrC. L Prx• O U Flood Plain elevation if applicable General comments / 11 M y A and recommendations: RHO M M ��JD L 4 CQIJ -S E 3'x r_ ZS LtWG h. ) 'o 13 U►.1 tj'S OF '"' l . Ll S i_ L'v ►ti t> _ s .`it. �`r� 1� 3e El Boring # ❑ Boring ® �Q ' .: -I pit .Ground surface elev. ft. Depth to limiting factor d 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 16q• - :312 1 S) I Z` Sbk, Yvt L°w �•� . S . ....: � Z3 -3 2 l O'-? 2 3 l 3 — .. L �. �S � k WI v `�' C_g - • �. f . � D 6r1 go tDKtZ S CIA - ).3 'y¢. SZ5. - .. C) 9g M i EC IVEO 7[ t/ # . E] Boring Bori - Z g � � �• I •' ; �. ZONING OFFIGE ® Pit Ground surface elev. ft. Depth to limiting factor ' -Soil'Ap i!2 trbn Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary is ` 1 -- .- D/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 6 -tq 10`1{Z31Z )4 -z tOY2 3 L3 - L 1eSbk m v fl;- 1 lzyly 0-5b►i rvly �►- C?S — , 7 �. z q j- 6) t 0 12 616 • Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) ignature . CST Number Arthur 'L Wegerer '� bS 3 220254 Address 4f e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number ... . 421 N. Hain St. River Falls, WI 54022 1 -10 -0) 715 -425 -0165 1 I Property Owner GW� / �"t U�- F� `,!1 1 Pi S k Parcel ID # E�-M/ h1 G Page Z of � Boring # ❑ Boring pit Ground surface elev. 9 - 6 ft. Depth to limiting factor E78 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 I •Eff#2 1 o -Z I i ui rz--3 L 3 1 es " YY1 \j w ell 2 Z1'-3y - 1 •5 1 1-2 y! — l --s ffi v �� e S - -� �• z 3 3\444 l o`2 IZ.S/ - `FS CS9 S Cl b$ -$6 I O�rfZSl6 Cglc� ns ym- 5!8 C) s9 m 1 _ s .9 I f 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 F-1 Boring # ❑ Pit Boring ❑ 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 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. SBD4330 (86(00) f PLOT PLAN Page 3 of 3 r Scale 1' = SQ' _ 5�, Iz.l v EIZ- - r-) n I U E _ a ' — � U �TtC\3 L.� '� 1'CZL'`P� �U �2 1 � ►T'L ri� loci, 1 60 ' 6. srrsI� L1A1E 1D 0 LA O a ti °lo r a1 In i o� J L oT y 2T�►•'1_- �k� - �- >_ .104.0'- RL__e- E1�11�2�,Jtil � O► _ V N'�2 _ �". R! V �- - _ _ . __ 9.9 -11 . Q►`► G tZOUh�D Sv Z �pcCL )9T �—u T . e U23�J ls'tZ 715- 425 -0165 220254 O L -Os — 3 CST Signature Date Telephone Ito. CST No. Job NO. 9EH SERIES SUMP /EFFLU ENT PUMP 11.65 8.95 O , 0 0 Specifications MODEL CAT. LISTING HP VOLTS SOLIDS SIZE RUNNING PERFORMANCE (GPM @ HEAD) SHUTOFF PWR. CRD. WEIGHT DIMENSIONS NO. NO. Pa. In.) AMPS/WATTS 5' 10 15' 20 (FL) P.S.I. (FL) (Lba.) (H z L x W) —� 9EH -CIM 509330 UUCSA 4/10 115 3/4 13.0 1000 71 68 60 49 32 13.8 21Y 21 9.11 x 11.64 x 8.94 9EH -CIM 509340 UUCSA 4/10 230 3/4 6.5 1000 71 68 60 49 32 13.8 20 27 9.11 x 11.64 x 8.94 9EH - CIA -RFS 509350 UUCSA 4/10 115 3/4 13.0 1000 71 68 60 49 32 13.8 20 27 9.11 x11.64x 8.94 9EH - CIA -RFS 509360 UUCSA 4/10 230 3/4 6.5 1000 71 68 60 49 32 13.8 20 27 9.11 x 11.64 x 8.94 FLOW- LITERS /HOUR Construction 0 1000 2000 3000 Motor Housing Epoxy Coated Cast Iron Impeller Material Poly Carbonate 30 10 Impeller a Closed Vane Volute ABS 20 7'5 W Power Cord SJTW -A X Mechanical Shaft Seal Nitrile with carbon and 5 ceramic faces a a 10 = Fasteners Stainless Steel 2.5 Shaft Stainless Steel Bearings Upper Sleeve and Lower ° 0 Ball Bearings 0 20 40 60 80 FLOW- GALLONS /MINUTE PUMP PERFORMANCE CURVE 115V 60HZ Little Giant Pump Co. PO Box 12010 ` Phone: 405.947.2511 Okla. City, OK 73157 Fax: 405.951.5674 ISO 9001 CERTIFIED www.LittleGiantPump 0 Form 995235 — 01/00 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer' Mailing Address �J <K S Property Address �-� ��I U i1- d �j"rlU /0 ° I V�2.1 V V' ✓ (Verification required from Planning Department for new construction) City/State l U `> i-J I—' Parcel Identification Number LEGAL DESCRIPTION Property Location Ic S'- 1 /4, ��►' /., Sec. T Z� N - RW, Town of IL �rUt� L h,iU f L Subdivision AI - , Lot # Certified Survey Map # �� 3 S , Volume f . Page # `/ b 65 Warranty Deed # b C� , Volume _ � 3 S .Page # � 3 Spec house ❑ yes M no Lot lines identifiable N yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mastorplumber, 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 1/3 full of sludge - I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office with 30 da f e expiration date. 4 SIGNATURE OF APL ANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of the desc above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF AP ANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed / POWTS OWNER'S MANUAL at MANAGEMENJ PLAN Yage_. of 1 F LE INFORMATION SYSTEM SPECIFICATIONS Owner 1w Septic Tank Capacity 06 gal ❑ NA Permit # J r" Septic Tank Manufacturer �'l�4� ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer C3 NA Number of Bedrooms Lj ❑ NA. Effluent Filter Model liwo ❑ NA Number of Commercial Units ❑ NA Pump Tank Capacity Z5 gal ❑ NA Estimated flow (average) Zoo gal /day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) lgDO gal /day Pump Manufacturer {❑ NA Soil Application Rate gal /day /ft' Pump Model . ❑ NA Influent/ Effluent Quality Monthly average* Pretreatment Unit ❑ NA Fats, Oil lZ Grease (FOG) s30 mg/L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODs) :5220 mg /L ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids ( TSS) :5150 mg /L ❑ Disinfection ❑ Other: Manufacturer Pretreated Effluent Quality ' ❑ NA Monthly average* * Dispersal Cell(s) Biochemical Oxygen Demand (BODs) :530 mg/L AV In-ground (gravity) - ❑ In- ground (pressurized) Total Suspended Solids (TSS) -.530 mg/L ❑ At -grade ❑ Mound Fecal Coliform (geometric mean) :510' cfu /100ml ❑ Drip -line ❑ Other: Maximum Effluent Particle Size rs3 inch diameter * Values typical for domestic (non - commercial) wastewater and septic tank effluent. * * Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency inspect condition of tank(s) At least once every 3 ❑ mo nths [Yy ear(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one -third (%) of tank volume Inspect dispersal cell(s) At least once every 3 ❑ months lWyear(s) (Maximum 3 yrs.) Clean effluent filter At least once every l ❑ months 1W year(s) Inspect pump, pump controls ex.alarm At least once every ❑ months 16 year(s) ❑ NA Flush laterals and pressure test At least once every ❑ months ❑ year(s) St NA Other: At least once every ❑ months ❑ year(s) ❑ NA Other: At least once every ❑ months ❑ year(s) ❑ NA MAINTENANCE INSTRUCTIONS individual carrying one of the fol licenses or certifications: Mast d dispersal cells shall be made b an and g Inspections of tanks an p y m' g P lumber; Master Plumber Restricted Sewer; POWTS Inspector POWTS Maintainer; Septage Servicing Operator. Tank inspecdor must include a visual Inspection leaks, measure tt r broken hardware Iden an cracks ore , ecuon of the tank to Ident an missing o fY Y P ( ) fY Y 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 (%) 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 ch. NR 113, Wiscons Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreatement components, and any other maintenance or monitoring at intervals of 12 months or less 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. 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 chemic that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the conter nr rka ranlr(s) ramovpd �y z tenwe servicing operator prior to use, ' r Page —of_ System start up shall not occur when soil conditions are (roan at the Inflitrative surface. During power outages pump tanks may fill above no highwater levels. When power Is restored the excess wastewater will be d'ucharged to the dispersal cell(s) In one large dose, overloading the cell($) and may result In the bacitup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septa¢e Servicing Operator -prior to restoring power to the effluent pump or contact a Plumber or POWT5 Malntalner to assist In manually operating the pump controls to restore ncrmal levels within the pump lank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise dlswrb or compact the area within 15 Net down slope of any mound or at-grade soil absorptlon area. Reduction or elimination of the following from the wastewater wtam may Improv the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butu; condoms; cotwn swabs; degreasers; dental floss; diapers; dlslnfectancs; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasollne; grease; herbicides; meat scraps; medications; oil; painting vroducts, pesticides; sanitary naokins: tamoonsi and water softener brine. ARAN DON EM ENT 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 ch. Comm 83.33, Wisconsin Adminhuadve Code: • All piping to tanks and plu shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator. • Aher pumping, all tanks and plu 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 falls and cannot be repaired the following measures have been, or must be taken, w provide a code compliant replacement system: O 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 not be Infringed upon by required setbacks from existing and proposed strucwre, lot lines and wells Failure to protect the r eplacement area will result In the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules In effect at that time. O A sultable replacement area Is not available due to setback and /or soil limlutloru. barring advatces in POWTS technology a holding tank may be Installed as a last resort to replace the failed POWTS. 0 The site has not been evaluated to Identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacenwnt area Is available a holding tank may be Installed as a last resort to replace the failed POWTS. O Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the t ns f such stems must.com With the Nits In effect at that time. Infiluative surface. Reconswa o o ry PlY < <WARNING> > S EPTIC , 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 TKIL INTERIOR OF A TANK MAY BE DIFFICULT OR t►anc�ccrar s. . ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name TL_ .4,(NZ Pjai- IAJ Na me 7! S qt j 2 1Zf3'6- /N C.... Phone E Z3S- Z0q Phone 7 /§' SEPTAGE SERVICING OPERATOR (PUMPER2 LOCAL REGULATORY AUTHORITY Name Agency ep7 f /®)e f� Phone f h n vm .I835PA STATE BAR OF WISCONSIN FORM 1 .2000 O6Q WARRANTY DEED 9`'EG S Document Number F r- COI OF DEEDS �7. t;KOTX Co., WI This Deed, made between Robert J. Kolashinski and RECEIVED FOR RECORD Randall P. Cudd and Yvonne R. Cudd, husband and wife 02-13 -2002 11:15 AM Grantor, WARRANTY DEED and David J. Gray and Tanis L. Gray as survivors EXdgPT R marital property CERT COPY FEE: COPY =EE: TRANSFER FEE: 164.70 Grantee. RECORDING FEE: 11.00 Grantor, for a valuable consideration, conveys to Grantee the following PAGES: I described real estate in St. Croix County, State of Wisconsin (the "Property ") (if more space is needed, please attach addendum): Part of the NE 1/4 of NW 1/4 and Part of the SE 1/4 of NW 1/4 of Section 29, Township 28 North, Range 18 West, St. Croix County, Wisconsin described as Recording Area follows: Jot -3 of Certified Survey Maps file April Name and RatumAddress 19, 2001 in Vol 15 Page 4065 No. 643225. Affjo t: �aa- lob y-- s o -300 Parcel Identification Number (PIN) Together with all appurtenant rights, title and interests. This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements and restrictions of record. DAtgd this th ay Feb ua 2002 * Pgndall P. Cudd *Robert K lashinsks` � 9 a *_ onne R. Cudd AUTHENTICATION ACKNOWLEIAs l STATE OF WISCONSIN �''n F Signature(s) St. Croix County. ) authenticated this day of Personally came before me this 5th day of February , 2002 the above named * Randall P. Cudd.Yvonng R. Cudd t TITLE: MEMBER STATE BAR OF WISCONSIN Rober J. Kolashinski (If not, to me known to be the person s who executed authorized by §706.06, Wis. Stats.) the foregoing insupment an4 ackngw the same. PHIS INSTRUMENT WAS DRAFTED BY * _ Randall P. Cudd Notary Public, Ftate of Wisconsin My Commission is permanent. (If not, sta to expiration date: (Signatures may be authenticated or acknowledged. Both are not nece .) 'Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1 -2000 lentury 21 Premier Group 706 19th St, Hudson WI 54016 -2161 phnner (711) 196-9107 F— (715) 796.!,651 RnndnllP Cndd T4847656 7.Fx l r a Randall P. Cudd and Robert J. Kolashinsld Located in part of the Northeast 1 14 of the Northwest is and part of the Southeast % of the Northwest % of Section 29, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin. OWNER'S ADDRESS ------- - -------- -- N 1080 RMOVE MOON DRIVE RIVER FALLS, 41854022 331313 BEARINGS ARE REFERENCED LEGEND NO" 114 CORNER! I ►,' I I TO THE EAST WEST 114 sECWN29 7'28 N ! :W , SECTION LINE OF SECTION 29, O 1' x 24' IRON PIPE SET R 18 W(FOUND I 4I T28 N, R 18 W, ASSUMED AS (MIN. WT. -1.13 LBJLIN. FT.) BERNTSEN I I I I I N88 °i3"E FOUND 1 " IRON PIPE "' �13 ALUMINUM MONUMENT) SCALE: 1' =3D0' ET CONCRETE (P.K.) NAIL S W �� IN BITUMINOUS PAVEMENT 8 C b2A2 SECTION CORNER MONUMENT 100 0 100 200 300 0 ( NOTED) 13 1136.68"' I LINE Qi N I (R= I RECORDED AS �, -'t. Ig CERTIFIED UNP LATrED _LANDS - ` MAP VOE , [ DEDICATED R OAD AM LUM 7 ( �`�'� ' � r W z. -- --------- CENTERUVE TO THE PUBUCI N SSW6C E 'd _. 6 �' y aI RIVER DRIVE (13,668sq.1Lor0.314at. 51.02 321' _ -- 6r3oa1 6s __ LOT 4 PAGE 1902 (R =N ;- `— NORTHRWLM _ RIVER DRIVE - Pi 88 °32'51 " 1 - �, 1 � CERTIFIED SURVEY MAP �-( �(tf� _. Gov Gov 296.67166.31' � �!� P - - -- - - - - -- r - 8 1 1 VOLUME 9 PA DRIVE 4t $ 9 q•O �_N88'3251'E fi11123.91'- y - ------ -___ -• ---- ---------- GE 2543 BUILDING 1 i � LINE SE1p-NW1/4 -$� LOT 1 4 100 �° 100 LOT 2 LO I Lg CEREIFIED SURVEY MAP S. LMIE NE 1/4•NW1 N. C /4 296.07 66' 2%.07 �!! 1 , e 9 88 W S 88 W 59201' a _ _V_41UME ¢,_ PAOE 1754 AREA LOTS I AND 2- - 96,896 SQUARE FEET OR 2.224 AC. (87,128 SQUARE FEET OR 2000 ACRES (R= N90°00'00 "E 33.60) 10a q THR1WLAVETSTRIVERDRIVE N 8)1°03 E EXCLUDING TOWN ROAD RIGHT OFWA)7 33.01- 1 SEE DETAIL (PAGE 3 OF 4)—{ 11 2 I 3 EASEMENTPERDEED j�h 1 AREA LOT 3• VOL. 582 P. 486 AND °O j '� EASEMENT PER CO; _ 97,007 SQUARE FEET OR2227AC. C.S.M. VOL. 1, PAGE 152 VOL. 714 P. 405 Z N (87,217 SQUARE FEET OR 2.002 ACRES NORTH LYE y Ki� �og�11Si�RTIFIED S�/RVEY._A�!aP £ !2 EXCLUDING TOWN ROAD RIGHT OF WAY) C.S.M. 1q� �+ VOLUME r3, PACE 1519 W • m ." 51 z wesruNE s ° CERTIFIED- ZI LOT 4 C.S.M. - - ' LAUREN Cg `•" 1, 172,808 SQUARE °S6 'StIRVEYMAA MU 1�KIV FEET OR 26.924i9C. �� :i13 ; (1,161,544SQUARE F CERTIFIED 1 0 UME 1 f M R o FEET OR 26.655 ACRES �� RIVE ~ _ 4 V _L _ _tom a wi s ' , w EXCLUDING TOWN 1 ROAD RIGHT OF WAY) N- - o y SURVEY MAP PAGE,162 �q �� g o Q 0 3 SyVOLUME i, PAGE 2Q UNPLATTED (R =NOD"DPOD "E, S CORNER SWCORVERC.S.M. _ NPLATTE_ •----------------------- S89 °48''4 - LANDSS -N 88'13'3 2613 -V ! N89 1295.37' SOUTHLI _.1_— �S7 C�— npNLBJ�,�' EASEMENT PER -N W13'3D° E 934.W- t EAST•WEST 114 SECTION LME C.S.M. VOL. 1, P. 204 (R ' S 90'DODD' EAST 114 CORNER o (R- S 89 - E N x•31) SECTKW 29, 5204.07' T2 A(R 18 W WEST 114 CORNER ----- ------- ---- ----- -- NPLATTDLANS s W A I M MONUMMEN7) SECTION 29, T 26 N. R 18 W (FOUND BERNIBEIV ALUMINUM 8 e MONUMENT) " Y DATED :I- IB- 20ApP[ROVED X13 REVISED:3- �42�1CaUlxCOUNTY " "SO 114CORNV? P nnir,,o 1CRUI� SECTION 29, T28N, R 16 W (FOUND SERNTSEN ALUMINUM MONUMENT) MAR 21 2001 THIS WSTRUMEN T DRAFTED BYJERALD L. LARSON SHEET 1 OF 4 II not raver a ,.,,, a' approval date approval shall to null Ard ,Wd Yn1.1835PVT 539 STATE BAR OF WISCONSIN FORM I- 2000 6 Z fl 6 Q WARRANTY DEED KATHLEEN H. WALSH Document Number REGISTER OF DEEDS +T. CROIY CO., WI This Deed, made between Robert J. Kolashinski and RECEIVED FOR RECORD Randall P. Cudd and Yvonne R. Cudd, husband and wife 02 -13 -2002 11:15 AM Grantor, WARRANTY DEED and David J. Gray and Tania L. Gray, as survivorship EXEHPT I marital property CERT COPY FEE: COPY FEE: TRANSFER FEE: 161.70 Grantee. RECORDING FEE: 11.00 Grantor, for a valuable consideration, conveys to Grantee the following PAGES: I described real estate in St. Croix County, State of Wisconsin (the "Property") (if more space is needed, please attach addendum): Part of the NE 1/4 of NW 1/4 and Part of the SE 1/4 of NW 1/4 of Section 29, Township 28 North, Range 18 West, St. Croix County, Wisconsin described as Recording Area follows: -? ^* of Certified Sur April 19, 2001 in Vol 15 Page 4065 No. 643225. Name and Return Address . 2f. /o C IS /c'tic�e�L 1��2'zc,� 0 2a - log V— 50 -,3oo Parcel Identification Number (PIN) Together with all appurtenant rights, title and interests. This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements and restrictions of record. this Ath ay Feb ua 2002 . r * FWndall P. Cudd *Robert K lashinski * _ onne R. Cudd • % AUTHENTICATION ACKNOWLEDisj i t,O.o STATE OF WISCONSIN � W�S,; Signature St. Croix County. ) authenticated this day of Personally came before me this 5th day of February . 2002 theabovenamed s Randall P. Cudd,Yvonne R. Cudd TITLE: MEMBER STATE BAR OF WISCONSIN Robert J. Kolashinski (If not, to me known to be the person s who executed authorized by §706.06, Wis. Stats.) the fore oin instrpment an ackn le d the same. THIS INSTRUMENT WA.S DRAF'T'ED BY 4 s Randall P. Cudd Notary Public, State of Wisconsin�� My Commission is permanent. (If not, stg to expiration date: (S ipatures me be authenticated or acknowledged. Both are not neces .) *Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM Na 1 -2000 Intury 21 Premier Group 706 19th St, liudson Wl 54016 -2161 Phnom (7 15) IM -9707 Fax OM IAA. -6651 Randall P Cndd T4R476% 7.FX