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HomeMy WebLinkAbout028-1054-03-070 n ■ o ■ -0 n 2 E § § ' § 2 c § FF m■ z z o# Q o n,, a 0 o o m : § w- «_±�E9 E� =B\ - % 2 { ®(\ ' Q 2 7 \ ] 0 ° ° ■ Cl c ; @ CD R $! E / E E § K 8 k CO w 0 © m v £ ■ m ,i } � § 2 § § § a a = CL / � � e : � / m C. 8 t: n r■ 2 ; & § % V ® 1 E �// 000�; .•, § § _ § 7 f c ■ ■ ■ ; 7 �k� ®� k N) \ \ T & A \ ƒ .. 0 0 § §/§ : C CL E ) _ -q CO) f ■ z , z 9 � { 2 ■ M d E § z k k CD ' $ ± 0 § � £ c 0 ƒ ' � ) � � $ a � � m � � � k o ® � � .. . , < § / E . 2 I � � n ■ s 0 c ® z } O 5 * } i_ E E » % $\m 0 \ \�f9/ \ Cl ( c ` \ Cl) § ° ® . ■ w� 0, © 7 / § f % § a c CD 0 CL $ $ \ CD :3z ooc� CL § § R n r co 0 0 R (A o k z el : 0 0 / � 0 \ � � I § CO & &� § { E ƒ ` \ [ / � \ _ § § C') c \ CD ƒ 3 2 0 t� { z E \ E � @ R \ E ! _ ? d � CL i Z 8 ! \ 2 # � m\ ' . f�/ £ \ e B 27 q' @ 2� � . \ � k § 0 . ) -0 ! �U Pk o @ � 7 Parcel #: 028 - 1054 -03 -000 09/15/2006 01:36 PM PAGE 1 OF 1 Alt. Parcel #: 13.28.17.353 028 - TOWN OF RUSH RIVER Current X , ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner ROBERT W & ELISABETH M BELKNAP O - BELKNAP, ROBERT W & ELISABETH M 2013 BEACON HILL TRL BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 2013 BEACON HILL TRL SC 0231 BALDWIN - WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 21.000 Plat: 2425 -RUSH WOOD POINT LTS 1/6 028'01 SEC 13 T28N R17W PT SW NW RUSH WOOD Block/Condo Bldg: LOT 03 POINT LOT 3 21.000AC Tract(s): (Sec- Twn -Rng 401/4 1601/4) 13- 28N -17W SW NW Notes: Parcel History: Date Doc # Vol /Page Type 06/21/2006 827979 WD 07/29/2002 685369 1935/591 EZ 12/05/2001 664068 1780/623 WD 08/07/2001 653127 1/64 PLAT 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/30/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 21.000 98,000 330,800 428,800 NO Totals for 2006: General Property 21.000 98,000 330,800 428,800 Woodland 0.000 0 0 Totals for 2005: General Property 21.000 98,000 330,800 428,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 567 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 405058 0 1 ATTACH TO PERMIT) ( GENERAL INFORAr.ATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m) -' � 8 &"S Id Permit Holder's Name: City Village X Township Parcel Tax No: Geissler, Rick I Rush River Township 028- 1054 -03 -000 CST BM Elev: f Insp. BM Elev: BM Description: OD �.� r J�per CST &MA I TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic S Benchmark �L� (L5� /x-50 li -ss j2.s3 �.D Dosing 1 c( Alt. BM fL � � \ � t r Aeration Bldg. Sewer - ----=j �0 — I 0 2.3 �l3 Holding SUHt Inlet 1`f 3 c1g. r TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic „L I I W t f Bt Bottom J� f 8 1$ Q 3• I Dosing /I IL I [ Header /Man. S• 20 r lao•0 Aeration Dist. Pie p A) 5 S 2 . Y Holding Bot. System i3. 99. 13 Q� PUMP /SIPHON INFORMATION Final Grade 3 Manufacturer Demand St Cover GPM Model Number CA an, TDH Lift Friction Loss System Head TDH Ft .( 334 0. 41 .(6 Forcemain Len; 2 _ D ia, c� Dist. to Well 0' ** I0*0 SOIL ABSORPtION SYSTEM BED/TRENCH Width Length No. Of Treneh" P BLLDD+Gwa IT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS �r (Z (__'„ Y p, co r— SETBACK SYSTEM TO 10 P/L l• WELL LAKE /STREAM LEACHING Ma of t rer: INFORMATION CHAMBER OR Ty a Of System: , ! ( �/ ' I UNIT odel � d DISTRIBUTI SY EM 1.1 /3• 0 Header /Manifold IlDistribution I I x Hole Size x Hole Spacing Vent to Air Intake 1( Pipe(s) 3 M (t w t L Dia_� Length Dia 2.0 Spacing ^_ /�b :21 SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over TBedp/ Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center rench Edges Topsoil ❑ Yes ❑ No No ❑ Yes ❑ 1 COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: �n "_ 7 Inspection #2: J / -2 Location: 2013 37th Avenue Baldwin, WI 54002 (SW 1/4 NW 1/4 13 T29N R1 7W) NA Lot 3 Parcel No: 1428 1 5 1.) Alt BM Description 2.) Bldg sewer length - amount of cover = �Z SBi (art, 3 t.ntt � � 12u} Sb� LOA. v - 'c�t�aQsa ., a, ?A-, �'^A q, �4_ Plan revision Required? ❑Yes No O � ' C� Use other side for additional informatio *- Date In se ctoe Signature Cert. No. SBD -6710 (R.3/97) Safety and Buildings Division Co ' ® 201 W. Washington Ave., P.O. Box 7162. ) N Madison, WI 53707 - 7162 Site Address / Department of Commerce q © // �I �" �� � IN Sanitary Permit Application Sanitary Permit Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑ Check if Revision m ay be used for secondary purposes Privacy Law, s15. 1)(m I. Application Information - Please Print All Information RECEIVED stat� I.D. N,l2 � Pr Own op er Parcel Number ' Name XJU (� I�t� �e'1 S , APR 2 9 200 ma 8' -io��y 03 -DD Property Owner's M[ili 9 Address p Property Location Dori t ' 1 1� 1�- D ST. OFFICE Y 15 'k 0% b; S T�� N, R L"' City , State Zip Code Phone Number Lot N be Block Number S 91s Subdivision Name CSM Number H. U , ` I t✓ Jam- �gI -DID ki Type of Building (check all that apply) S L? (_� �ti titi , LL []city or 2 Family Dwelling - Number of Bedrooms ✓ y -L ' / �y ��, F � X7h� �� ❑village �- El Public /Commercial - Describe Use X i �� t{ "rt c' wnship i t ❑ State Owned / fi (' ,cLC - �cd - / >C / ',1� t N t ! /`° , �`1 �r ,- e t Road �� tZJ �?, Gr c` ":cry ✓ `1/ 26) / III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if a plicable) A ' 1 New 2 [1 Replacement System 3 11 Replacement of 6 El Addition to For County use S ste Tank Onl Existing System 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) 44 ❑ Non - Pressurized In- Ground 2111 Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 t -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation ,Final Grade Required Proposed Rate(Gals.1Days1Sq.F1.) (Min.11nch) Elevation - - , S ✓ -- --�� t o I , a.3 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks �' A Concrete Constructed Glass New Existing r Tanks Tanks Septic or Holding Tank 1- es -e�5 Dosing Chamber VII. Responsibility Statement - I, the undersigned, assume responsibility for n of the POWTS shown on the attached plans. Plum is Npw I Plumber' I MP S Number Business Phone Number Plumber's Address (Street, City, S , Zip Code) VIII. un /De artment Use Onl Approved ❑Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Is ent Signatu (No Stamps) Surcharge Fee) ❑ Owner Given Initial Adverse Determination -} �? _ ✓' u Z� lx. Conditions of Approval/Reasons for Disapproval N L v �� i ✓ l /'l r+ �, it ; t7 - /�� /� r? . r�( t_ � �/ rr !"/ L ; _%'✓ r- e — ., 77 cn- �``FL�',�f'� - -7� c.�E �t��" c <��c� 07 7-- <i� OF S. / -�• S. ��JiL} ' Rl; j' )J11147 /c'_L r Attach complete plans (to the County only) for the system on paper not less than 81n a 11 inches in size Safety and Buildings 4003 N KINNEY COULEE RD LACROSSE WI 54601 -1831 TD #: (608) 264 -8777 erc *iico nsin www.wisconsin.gov .wis c ons .wisonsin.gov Department of Commerce Scott McCallum, Governor Philip Edw. Albert, Secretary April 25, 2002 CUST ID No.3412 ATTN: POWTS Inspector HERB J PELKE ZONING OFFICE PELKE PLUMBING ST CROIX COUNTY SPIA N6298 STATE HWY 25 1101 CARMICHAEL RD DURAND WI 54736 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/25/2004 Identification Numbers Transaction ID No. 729568 SITE: Site ID No. 643764 Rick Geissler - Co Rd Y & 2013 37TH Ave Please refer to both identification numbers, St. Croix County, Town of Rush River above, in all correspondence with the agency. SW 1/4, NW 1/4, S13, T28N, RI 7W FOR: Description: Proposed Four Bedroom At -Grade System Object Type: POWT System Regulated Object ID No.: 848812 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 c,: installation and prior to occupancy or use: General Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "At-era&.C_nrr Manual Using a Pressure Distribution System for Private Onsite Wastewater Systems" SBD- 10570 -P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD - 10573 -P (8.6/99). • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • Comm 83.22(7) - 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. Owner Responsibilities: • Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. P0.1N �pnl�iti�',`lllr HERB 1 PELKE Page 2 4/25/02 Owner Responsibilities Continued: • The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made io 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, a Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Gerard M. Swim POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm WiS~T code: 7633 jswim@commerce.state.wi.us cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544 1 - C l c�' APR 2 .. Gs Private On -Site Wastewater Treatment.System (POWYS) Index and Title Sheet Owner. -,e e G rl-u e or.< " Project Name and System Type ' c Gue ss c E-t • y, •c. - 10yP- /;¢,nor' 4 rr y Location: - r ,Wvr Street Address r-� .*,v Legal Description ' o f �as.✓ 6C wrc _ Township/County Contents: Page 1: /.,ie r x r �Irz r Page 2• �..,✓ _:._ Page 3: A, W Al t 'r .1 60 G .d0.1f Yre r, eF mss - A rooms Page 4• Di.�r L A r'r�t AL Lwl'oa f _. Page 5: c3 G / /G !� �I•✓.r��.yv G •t/.�ison. G it. rs - arc rie.✓ Page 6: Page 7: 0 u rs /Y.o.Juc.c �1A•✓.ys /�l�v � �'' ���:✓ Page 8s .... r: r VE O ft Page 9: DIVISION OF ft NCl $UILDINGS T Attach ments: now 06A's r SEE C01 RE SPO 'ENCE . �,/sE,o Sd6 losro - .Ar- l.iior �errpe.✓r.✓i' /ye..iw.►a �.ti.✓t !I ll it i1r�c�Brrru.d r� +- S,00 • 0 S'7 .r P I& st rriaas`i•:✓ - �arII�NI^.vr' �YRnleilL Fac �ot,/ _ . Plumber/Desi : 'gn �s Signed. l .Credential Numb '/Z Date: ��a z r L 4 .. IN Aia+x. \ o v a y ® ' : -Al R w A � e X a o n a I� • LAN VIEW Page_°£ Pages P I � , �• 5 • � Y ' • 1. • � �. ��c Fo�t ,r�i� -./ " t e 000 r 2 oo—p t: , .J.- -• , • ,l Ova Z,4 �� oCJt'itv�r�..✓ •vdtc,� Gi/°r�.c.✓ro LA r« .•.... D , /I N y V6 B. L��Ya 6B. . 1/2 B •• f As ft. ° •„ „ ft. Y .S' ft.. .'1/2$ z,&. - t• 2.. g o ^ f t.� L " ..1.. f t . 1/6B a .?.Z 7- f s C. f .. ft.. W b ft. Q e S D� , ��� �� • ' • � Distribution Lateral ::Fa b roc ,�«�jf .. 1''l'�A Qox Soil Cover .QbservatlOn �,, ♦ 12„ c . u Well 2 �, H _r rd If 00 z V400 • P OO �.,., �� t 6 •• Note: H is • meatured from directly below t N _, rj• the lateral to • . --1 A� finished grade. D A c H • • CROSS SDCTI°N l i R M � , k tht IL h b 'O Q A r r t lb \.. 0 O N C n .o a y 1 t~+ O r i I i �I i ' Page ..S Of 9 SEPTIC TANK E'PUMP CHAMBER CROSS SECTIOW AND SPECIFICATIONS 4" Cl VENT PIPE 12" MIN. ABOVE GRADE E WEATHERPROOF • /p� FROM DOOR, WINDOW OR JURCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MANHOLE COVERS W/ PADLOCK E fia,. rvoo WARNING LABEL t " MIN . 18 IN. � i INLET WATER TIGHT SEALS Zga�c GAS Ficrr, TIGHT I ��` /APPROVED /oo A • SEAL 1 JOINTS WITH APPROVED —}— I , ALM APPROVED PIPE PIPE 3' i ON 3' ONTO ONTO SOLID C �. SOLID SOIL SOIL' PUMP OFF ELEV 3T —i— OFF '� RISER EXIT • D PERMITTED ONLY IF TANK MANUFACTURER HAS APPROVAL, 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC./ DOSE TANK MANUFACTURER : r NUMBER DOSES PER DAY: t ae V. TANK SIZES: SEPTIC /,?So GAL. DOSE VOLUME INCLUDING �'`3 S. 7 = DOSE 7so GAL.. FLOWBACK: GAL. ALARM MANUFACTURER: S.•T. �•L�cr.►o CAPACITIES: A = INCHES = _ ,�iRk GAL. —" -' MODEL NUMBER: SWITCH TYPE: B = 2 INCHES .�,?..? GAL. PUMP MANUFACTURER: " / sicr• /D'YD/l � c,v C = INCHES AL. MODEL NUMBER: F (L; SWITCH TYPE: /1s�c.rer D = /o INCHES G_AL. REQUIRED DISCHARGE RAT yy,9 PM PUMP E ALARM WIRING AS PER ILHR 16.23 WAC VERTICAL DIFFERENCE BE UMP OFF AND D ISTRIBUTION PIP . B FEET + MINIMUM NETWORK SUPPLY PREE .. . . . . . 3 3 FEET ✓. + , . 2„4-• FEET FORCEMAIN X - . / r FT/200 FT. FRICTION FACTOR . FEET,, TA D TAL DYNAMIC HEAD = FEET . 4� INTERNAL DIMENSIONS OF PUMP TANK: LENGTH S / ; WIDTH 8/ �� ; DI TER –• LIQUID DI TH- y8" • yD�oir,� r/G Typical Application* High capacity sum /effluent, Sewage Typical Application* Sewage, Dewaterin Capacities to 120 GPM (7.5 Vs) Capacities to 140 GPM (8.8 Vs) Heads to 28 h (8.5 m) Heads to 28 ft (8.5 m) Bectrica) I I SV, le, 9.5FLA, 60Hz, 230V, le, 4.7FLA, 60Hz Electrical I I5V, Ile, I2FU1, 60Hz; 20OV, le, 6.8FLA, 60Hz, Motor 4/10 HP split phase w /thermal overload protection, 230V,1 e, 6.OFLA, 60Hz, 20OV, 3e, 4.1 FLA, 60 Hz, 1750 RPM 230V, 3e, 3.5FLA, 60Hz; 460V, 3e,1.8FLk 60Hz; Minimum Recommended Simplex =18" (457mm); 575V, 3e,1.4FLA, 60Hz Sump Diameter Duplex = 30" (762mm) Motor (single phase) -1 /2HP Split phase w /thermal overload Automatic Operation Diaphragm pressure switch (manual available) protection, 1750 RPM; (three phase) -1 /2HP Materials of construction Class 30 cast iron polyphase 1750 RPM Impeller Thermoplastic non-clog Minimum Recommended Simplex = 24" (609.6mm); Discharge Size 2* (50.8mm) Sump Diameter Duplex = 30" (762mm) Solids - handling 1.1/4" (31.8 mm) Automatic Operation Diaphragm pressure switch (single phase only) Power cord 10' , SJTW, (20' optional) _ (manual available) Superior Features • (arbon /Ceramic type 21 mechanical seal Materials of construction Class 30 cast iron • Oil filled motor w /automatic reset thermal Impeller Thermoplastic non -do overload for maximum protection _ Discharge Size 2" (50.8mm); 3" (76.2m optiona • Upper and lower single row ball bearing construction S olids handling 1_1 138.1 mm) • Piggy -bark plug available for easy maintenance _ Power cord 1 e -10' , STW -A(20' optional); 3e - 20', STW-A and replacement Superior Features • Carbon/Ceramic type 21 mechanical seal • Oil filled motor w /automatic reset thermal overload for maximum protection • Upper and lower single row ball bearing construction Crull *x E n= • Piggy plug available for easy maintenance and replacement 1 7 date confidently; p romise 9 30 Itz SP50 & SP50AB ly 6 Z 20 3 o SP4 yfli� -•.v 2 ei8lfl •`� 0 0 opacity -U.S. G.P.M. 0 20 40 60 80 100 120 1 40 Liters/Second 0 2 4 6 8 r POWTS OWNERS MANUAL MANAGEMENT PLAN Page_7_of 9 FILE INFORMATION SYSTEM SPECIFICATIONS Owner L Septic Tank Capacity /,DSO al ❑ NA Permit # # 0 Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms 100 d/bedroom ❑ NA Effluent Filter Model - /oo ❑ NA Number of Commercial Units NA rump Tank Capacity gal ❑ NA Estimated flow (average)* g al/day Pump Tank Manufacturer ❑ NA Design flow (peak), estimated x 1.5* Loo g al/day Pump Manufacturer y , to, Wric ❑ NA Soil Application Rate S gal/day ft Pump Model .SOP- yo ❑ NA Influent/Effluent Quality (NA❑) Monthly Average ** Pretreatment Unit [3 NA Fats. Oil &Grease (FOG) ❑ Sand/Gravel Filter ❑Peat Filter Biochemical Oxygen Demand (BO < 30 mg/L ❑ Mechanical Aeration C3 Wetland 5 220 mg/L ❑ Disinfection [3 Other: Total Suspended Solids (TSS) Manufacturer: Model: 5 250 m L Dispersal Cell (s) Pretreated Effluent Quality ❑ Monthly Average*** Biochemical Oxygen Demand (BODs) 5 30 mg/L 0 I -grade [3 Mound In-ground [3 ❑ n- ground (gravity) In- ground (pressurized) Total Suspended Solids (TSS) Fecal Coliform (geometric mean) < 30 mg/L ff bn_ - line ❑Other: lVau/Ioom] ❑Leachin g Chamber Manufacturer Maximum Effluent Particle Size 1/8 inch diameter Model Approval Stipulation *Wastewater Flow Verification on and calculations: Soil Application Rate Area Req. W (Other than bedroom based) Absorption Area Credit perunit W Minimum Number of Chambers ❑ Aggregate Desi Flow/Loading Rate= ft min ** Values typical for domestic (non - commercial wastewater Materials: all materials must comply with WI Adrr Code and septic tank effluent. COMM84 and be installed per manufacturers specifications ** *Values typical for pretreated wastewater. and approval letters. DESIGN CRITERIA ❑ "Wisconsin At -grade Soil Absorption System, Siting, Design & Construction Manual' (Converse et.al.1990) ❑ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual' Converse, J.C. and E.J. Tyler. Publication 15.22 ❑ "Design of Pressure Distribution Networks for Septic Tank -Soil Absorption Systems" Publications 9.6 ❑ "Design of Conventional Soil Absorption Trenches and Beds ". R.J. Otis - ASAE Publications 5 -77 and "Design Manual - Onsite Wastewater Treatment and Disposal Systems ". EPA 625/1 -80 -012 October 1980 eSBD - 10570 -P (R.6/99) "At -Grade Component Manual Using Pressure Distribution" ❑ SBD - 10567 -P (R.6/99) "In Ground Absorption Component Manual' ❑ SBD - 10705 -P (N.01101) "In Ground Soil Absorption Component Manual' Version 2.0 ❑ SBD - 10628 -P (N.6/99) "Recirculating Sand Filter System Component Manual' ❑ SBD - 10656 -P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual' ❑ SBD - 10572 -P (R.6/99) "Mound Component Manual' ❑ SBD - 10691 -P (N.01 101) "Mound Component Manual' Version 2.0 ❑ SBD - 10595 -P (R.6/99) "Single Pass Sand Filter Component Manual' ❑ SBD - 10657 -P (R.6/99) "Drip -line Effluent Disposal Component Manual" eSBD - 10573 -P (R 6/99) "Pressure Distribution Component Manual' ❑ SBD - 10706 -P (N- 01101) "Pressure Distribution Component Manual' Version 2.0 ❑ Drip-line Effluent Dispersal Component Manual for P P p Multi -flo Onsite Wastewater Treatment Units MAINTENANCE AND MANAGEMENT MAINTENANCE MONITORING SCHEDULE Service Event Service Frequenc Inspect condition of tanks At least once every ❑ months a s Maximum 3 s. Pump out contents of tanks When combined sludge and scum equals one -third 1/3 of tank volume Inspectdispersal cells At least o ❑ months j gr ears Maximum 3 s. Clean effluent filter t least once eve y [3 ear s Inspect controls & alarm At least once ev Etps ea s ❑ NA Flush laterals and pressure test At least once every ❑ months j M ears ❑ NA Valves At least once every ❑ months ❑ ears ❑ NA Other: At least once eve ❑ months ❑ ears ❑ NA Page 8 • ofd START UP 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. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your` POWTS. The installation of water- saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable /fruit peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non - biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. p Valves Valves shall be operated in the following manner: M "Alarms Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however, water should be conserved until any problems with the system are corrected to prevent back -up of sewage into the dwelling or surfacing. INSPECTIONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). p Septic Tanks Component Tank inspections must include a visual inspection of the tank 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 backup or surfacing of effluent . Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one -third (1/3) 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 NR113, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. lump Chamber/Treatment Tanks Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must_be, .. made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of the filter. Any service needs or repairs shall be promptly taken care of. r Page of p In- Ground GYavity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence bf surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. �Moun At -Grade n- Ground Pressure The i ction shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for. any evidence of surface seepage or discharge. Any discharge to.the ground: surface must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more.frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the system. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. 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 other 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: 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 structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil from existing and proposed structure, lot lines and wells. Failure to protect the replacement 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. E3 A suitable replacement area is not available due to setback and/or.soil limitations. Barring advances in POWTS technology a olding tank may be installed as a last resort to replace the failed POWTS. [B 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 replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. 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 GASES 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 G1wJKN0ai✓ Name I V .Cfd J'-4 Name Phone /S d4 7 - siu dr I Phone SEPTAGE SERVICING OPERATOR (Pumper) — ,, f LOCAL REGULATORY AUTHORITY Name Agency r, aoi a ficr Phone Phone 71S dt - 680 1417 Wisconsin Department of Commerce SOIL EVALUATION REPORT Pop 1 d 3 Division of Safety and Buildings in accordance with Comm 85 Wis. Adm. Code A.C.E. Sal & Site Evaluations Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must County St. Crobc include, but not limded to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. 028- 1019- 80 -000, IN 13.28.17.103A Piease print aN in/orroation. R D ata Persons §iforrnatbn you provide maybe used for secondary Puposes IPdmY Law, s. 15.04 (1) (m)l. i / Property Owner Property Location William & Ann Findlay Govt Lot S W 1/4 NW 1/4 S 13 T 28 N R 17 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM # 355 County Road Y 3 Proposed Plat City State Tip Code Phone Number I City J Village el Town Nearest Road Baldwin WI 1 54002 j 715 - 3088 Rush River I County Road Y New Construction Use: ✓M Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe: Parent material Glacial drift _ Flood plain elevation, N applicable na General comments / and recommendations: Site suitable for At - Grade system installed along 99.1 cont our ele ❑ 1 Bori # -j �+ng n9 - im Pit Ground Surface elev. 97.75 ft. Depth to limiting factor 38 11 in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/it� "Eft#'I 1 0 -17 1Oyr3/2 none sil 2fsbk mvfr cs 2f,1vf 0.5 0.8 2 17 -22 1Oyr3/3 none sil 2 f s bk mvfr cw 1f,vf 0.5 0.8 3 22 -32 1 Oyr4 /4 none sil 2fsbk mvfr gw 1 of 0.5 0.8 4 3248 1Oyr4 /4 none sicl 2fsbk mvfr cw ivf 0.4 0.6 5 3844 10yr5/2 f2d f2f 1 y & sl 2msbk mfr cw - 0.5 0.9 1 r6 / 2 _ 7 .5y� /8 & 6 44-52 10yr4/6 ml m2d 10yr6 /2 scl lthinpl mfi gw 0.2 0.3 7yr4/6 m f i �f IQW6/2 Om mvfi -2f, - 0.0 0.0 Boring # I Ong - -._ s' Pk Ground Surface elev. (9T 17 R Depth to limiting factor 42" in. Soil AWation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PDtr •Eff#1 1 0 -16 1Oyr3/2 none sil 2fsbk mvfr Cs 2f,1vf 0.5 ! 0.8 2 16-25 1 Oyr4 /4 none sil 2% mvfr Cw 1 f,vf 0.5 0.8 3 25-42 7.5yr4/4 none gr. sl 2msbk mfr Cw - 0.5 0.9 4 42,-48 7.5yr4/4 f2f 7.5yr5/8 gr. sl 2msbk mfi Cw - 0.4 0.9 5 48 - 1Oyr7/4 m2p 7.5yr5/8 fs Om mfr gw - 0.4 0.6 6 58-67 1Oyr8 /4 m1p 7.5 S.S .B.R. Om mfi g w - 0.0 0 .0 Horizon #s . is of Osg is when disturbed. Effluent #1 = BOD y > 30 < 220 mg/L and TSS kv <_150 mg/L Effi BCO <_30 mg1L and TSS < - W mg/L. CST Name (Please Print) Sig CST Number James K. Thompson v 3602 Address A.C.E. Sol & Site Evaluations to Evaluation Conducted Telepharre Number 340 Paulson Lake Lane, Osceola, WI W16 5/15/01 715 -248 -7767 fi property owner William & Ann Findlay parcel ID # 028 - 1 019 -80 -000 ID# _ Page 2 of 3 D� 3 Boring # !� Pit Ground Surface step. - 100.29 - ft. Depth to limiting factor _ 44�7-- in. Soil A R� Horizon Depth Dominant Color Redox Desrxkriion Texture Structure Consistence Bou rtdmy Roots GPDIfF 'Eff#1 *Eft j 0 -16 1Oyr3/2 none sit 2fsbk mvfr Cs 2f,1vf 0.5- 0.8 2 16 -22 1Oyr3 /4 none sit 2fsbk mvfr cw 1f,vf 0.5 0.8 3 22 -34 1Oyr4/4 none sit 2msbk mfr aw - 0.5 0.9 4 34-4 7.5yr4/6 none strat. s Osg ml Cw - 0.7 1.2 5 ' 44 7.5yr4/6 m2f 7.5yr5/8 strat. s Osg ml - - 0.7 1.2 - - - Groundwater seepage observed at W. - - - F4 # Bones A Pit Ground Surface elev. 96.15 ft. Depth to limiting factor ZQ" in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence 7 ass ary Roots GEDIF 'Eff#1 'Eff#2 1 0 -8 1Oyr3/2 none sil 2%bk mvfr 2f,1vf 0.5 0.8 2 8 -14 1Oyr4 /4 - none sil 2med.pl mvfr 1f,vf 0. 5 0.8 3 14 -20 1Oyr4/4 none sil 2msbk mvfr Cw 1vf 0.5 0.8 4 20 -26 1Oyr4 /4 f2d 7.5yr5/8 sil 2msbk mvfr g w 1vf 0.4 0.6 5 26 -36 10yr5 /4 t2d 7.5yr5/8 & f2 f 10yr6/2 sit 2msbk mfr aw - 0.5 0.9 - - 6 36 -50 7.5yr4/4 none s! & gr. 1 thrn ! mfr 0.2 0.3 -- Groundwater seepage observed at 36". -- - - 5 Baiq # Boring 101 Pit Ground Surface elev. 98.04 ft. Depth to limiting factor X 28 "'' in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 'Eff#1 *EtT#2 1 0 -15 1Oyr3/2 none s i l 2 fsbk mvfr cs 2f,1vf 0.5 0.8 2 15 -28 1Oyr3/3 none sit 2fsbk mvfr Cw 1f,vf 0.5 0.8 3 28 -32 1 Oyr4 /4 f2f 7.5yr5/8 sil 2msbk mfr Cw - 0.5 0.9 4 32-48 1Oyr4/4 m2d 7.5yr5/8 sit 2m mfi cw - 0.4 0.9 5 48-57 1 Oyr7 /4 m2p 7.5yr5/8 fs Ord= - mfr gw - 0.4 0.6 6 57 -65 10yr8/4 m1p 7.5yr5/8 S.S.B.R. Om mfi - - 0.0 0.0 Horizon #6 consists of Osg fs when disturbed. * Effluent #1= BOD 30 < 220 nVIL and TSS >30 < 150 mgIL Effluent #2 = SOD < 30 and TSS < The Department of Commence 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. MAY -07 -2002 04:37 PM R.C.E. Soil & Site E "al. 715 248 7764 P.01 � , w ;ll;Q•n �d /� y Pry F6. 3a -0 iot 3 � p�oposcd p /�� sw, n w, 5cc. 13, T,,, of ■ .So, %Obserlvkb'on N .sue : "¢40' t l t. : Top aF 36'ec -bar. i�le = Icip.59' X I / Co. IQo� y,, l . 1 I '1 Q // am lot Cones I > 2.W' ICioin Sy 6en Am-%. q - I I I i I a� m6w. Assumed ekY. RECEIVED MAY 0 7 2002 ST. CROIX COUNTY ZONING OFFICE R �' /$//7 PRELIMINARY PLAT FOR: RUSH WOOD POINT LOCATED IN THE SOUTHWEST 1/4 OF THE NORTHWEST 1/4, OF SECTION 13, TOWNSHIP 28 NORTH, RANGE 17 WEST, TOWN OF RUSH RIVER, ST. CROIX COUNTY, WISCONSIN NORTHWEST CORNER OF SECTION 13 SET PK FROM \• \ \ \ \ \\ WT• I I I / \ COUNTY TIE U ,e: WNED BY: I I / ~ ^ \ UNPL TT \ \ \ \\ O/ // / r i 6AND12AMBERG / — — 0� D Y' / NORTH UNE OF NE SW 1/�4 OF NW`t/4 WSECt" 13 v / / &�,& / �3 3' / 1�PS_ / 11 89'19 2' W 131889' \ \ 1lN C — 1 _ 590. � 772 /3.9fi A RE 5 �E04C D To ® ® N I 5 , I �i e - 'i{ 4 FT / `� ; — — — LOT I I I �_� I> r F I 9 - 2 / � —/ —/ / _ 23465 SO. / FT. I I L ± I? I / . / —� / ` n /\ \ 5.39 ACRES I y \ I - 5235'x N.S. 203125 � FT. / \ I \ / F -4 t 87 � 1 S& IFTE I 8 141 So. FT. JA 2.P1 ACf2Ep A \2. 2 ACRE � loid Icy ��6�;��. y- ts�„r1 I -S I 1 I B I/ /1 913 / )_– I x V 980.58 /266 {52' — —�� \ . \ / — J / df i ,r_ SUI LOT 3 — \ I — — / _ Y \ I I I f/ � / u � cs ` ! _ I 914973 so. // I J N z ss SM4 CRE / r / / t � 14 /III /� // —s MI // I /9.E T( €I 1111 / /I � \, — \� ''I I I / / /� a /� Zt 1 1 i oEq°IC'> Z( 19P ./ // \ \J I I I I I / // I i p / R( M M M (A f/ // / _ / I // M O0 — / ' —�� — �— — —� — — — — — — — — — / T S59'20•SS•E / F �`– — — 3945.15' / R / / 89'20'38' E 1316• owNED Y• EAST 1/4 CORNER OF N — \ �o�c: �c+�?uRe / sou3n LINE Sw}/4'OF THE NW y/4 OF SECTION 13 N�EI►� SECTION a �o1n+D 3' F 1 h/4 60LtIR OF SECTI0N1b� / / / / UNPLAI�D/ / ALUMMIUM YONUAIENT 0 P.K. NAIL i ME - P L E � RUSH WOOD POINT ER CouN1Y zmm AND couNTY SURVEYORS OFFICE SUBDIVISION 145 UNTY HIGHWAY AND LWCD P.O. Yox Street Land en REVISED PER CO P.O a i 252 Lad Surveyors TOWN OF RUSH RIVER, WI RELEASED FOR REVIEW WoodvWe. WI 54025 Construction Managers REVISION DESCRIPTION: Bur: 715 - 595 -344 Pa:: 715- 595 -5441 PRELIMINARY I 1374 Wisconsin Department of Commerce SOIL EVALUATION REPORT page of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Sal & Site Evaluations Attach complete site plan on paper not less thar1.&14x, size. Plan must St. Croix include, but not limited to: vertical and horizontal referenda pbipt County M direction and Parcel I.D. percent slope, scale or dimensions, no arrow, andioatiiom dls to nearest road. 028 - 1019 -80 -000, IN 1 3.28.17.103A Please pgnt`allInfor iti FA1\�} � I Review B y Date Personal information you provide m ror W— (P (Privacy ASS .04 (1) (m)). G Property Owner TV j oloeq Location William &Ann Findlay vt. Lot SW 1/4 NW 1/4 S 13 T 28 NR 17 W Property Owner's Mailing Address 4# �Blocl Subd. Name or CSM# 355 County Road YUN��G / 3 Proposed Plat City Stye �5� cP umbel �� J City _f village r Toren Nearest Road Baldwin WI 30 Rush River County Road Y 0 New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 GIRD I Replacement J Public or commercial - Describe: Parent material Glacial drift over weathered sandstone bedrock Flood plain elevation, if applicable na General comments and recommendations: System elev. = 99.30' at 12" above 98.30' contour. j� + Boring # Boring _. Pit Ground Surface elev. 9 ft. Depth to limiting factor 40" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft *Eff#1 *Eff#2 1 0 -15 1Oyr3 /2 none sl 2 fsbk mvfr a 2f,1m 0.5 0.9 2 15 -25 1Oyr4/4 none sil 2fsbk mvfr cs 2f,1m 0.5 0.8 3 25-40 7.5yr4/4 none si 2msbk mfr cs 1f 0.5 0.9 4 40j52 1Oyr7/4 m2p 7.5yr5/8 vfs Om mvfr aw - 0.4 0.6 5 52-68 1Oyr8 /4 m1p 7.5yr5/8 SSBR Om mfi - - 0.0 0.0 Boring # Boring Pit Ground Surface elev. 98.30 _ ft. Depth to limiting facts 32" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft' *Eff#1 *Eff#2 1 0 -10 1Oyr3 /3 none sl 2fsbk mvfr as 2f,1m 0.5 0.9 2 10 -16 1Oyr4/4 none sil 2fsbk mvfr cs 2f,1m 0.5 0.8 3 16 -24 1Oyr4/6 none gr. sl 2msbk mfi cs if 0.5 0.9 4 24 -32 1 Oyr7 /4 none vfs 1 csbk mvfr gw - 0.4 0.6 5 32-61 1Oyr8 /4 m1p 7.5yr5/8 SSBR Om mfi - - 0.0 0.0 * Effluent #1 = BOD 30 < 220 mg/L and TSS > < 150 mgA- * E = BOD < 30 mg/L and TSS <-O mg/L CST Name (Pkme Print) Sig re: CST Number James K. Thomp 3602 Address A.C.E. Sal & Site Evaluations D e Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, W1540 4/3/01 715- 248 -7767 P 2 of 3 Property Owner William &,Ann Findlay Parcel ID # 028-1019-80-000, ID# P 3 ] F Boring # Boring — 1I Pit Ground Surface elm 96.53 ft. Depth to limiting factor 24" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 1 0 -10 10yr3/3 none sl 2fsbk mvfr as 2f,1 m 0.5 0.9 2 10 -24 10yr4/4 none sl 2fsbk mvfr cs 2f,1 m 0.5 0.8 3 24 -30 10yr4/6 f2d 7.5yr5/8 s Osg ml cw - 0.7 1.2 4 30-47 10yr7/4 c2d 7.5yr5/8 vfs 1 csbk mvfr gw - 0.4 0.6 5 32-61 10yr8/4 m1p7.5yr5/8 SSBR Om mfi - - 0.0 0.0 F—I Boring # Boring Ph Ground Surface elev. ft. Depth to limiting factor Soil Application R in. ate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 Boring # J Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD& *Eff#1 *Eff#2 * Effluent #1 = BOD 5 > 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 devartment at 608 - 266 -3151 or TTY 608- 264 -8777. �. 3 oC3 w ;f I�am (r la pt^oid. P; E ♦ E /eda.�%o� lot 3 O e ' rd oc5c d 5wnw Sec. 1,3, 7. of r' A55uottd Ble w.' , p i "Y ; � OCIP i q1 ' Elev. - 97c+o' 43 1 ' (del 0 1 37 11 APR 3 :45PM HUDSON PLANT, 6 72- 5267 Apr 18 '02 11: NO. 905 P. Qf .1 /1 ..n' �.. 7 15 672 5267 ST CROIX COUNTY SEPTIC TANK MAIIV'i'FsNAN ACaRREMENT ' AND �';� OWNERSHIP CERTIFICATION FORM Orvner/Buyer K _c '9 A 4-k. Maili Mddm. $� ;� 0 o JQ eQ S a •.. Vol Property Address aOk 3 3 7 tU 144 R-wA" P E C4 A t S, 11, 0 T S L l 0 d� (VeOcation required from Pl#nu* Department ft n e w caustmetion City/State U �� Parxl Identification Number � 105`} — 03 -- 2 � j LE "L bESQ R=12N Z'rapetty Location ` %, /� ,Sec► T �1. I W. own of �►'1 1� Subdivision 5 ) i Ir + wco Lot 0-3 Certified Survrj Map # . Page # Waffaaly Beed # w 0 Volume �, g� page # to a Spec house M yzv no Lot lines idcutifiable I&L yes O no Imprppa w-c, and miotenaaecof yaps septie system could Temlt is' its preantaremm to baadle wastes. Proper m4intenancc copsisd of put Wbg Out the septic tank every three yars at sooner, If needed by a licewed ppmpa. What you put into the system oast affect *0 Aw iat of to septic dale as a treakment ado is the waste disposal system. The p0aperly ownee 440000 to lubMit to St. CrO* Zoning Dep2Mwa0 a caNatiQA itttm, signed by d w owner sad by a mpaterplaruber. jouiaaY+�ttPlwrlb0r, mMioWplumbsr at a liccnsadpumpervwifying tbat(I) tits pp - sit0 wuwwaterdkpou1 system is in POOW wratib., condition an*cw (2) alt inspection and pwnping (if aeceswyb dw septic tank is less than 1/3 full of sludge. JIM, the undersigned bare Dead the above rcgAir= mta and sgm W maiwtain the priyate sewsp diA wl system with the standuds set ft* hangs, as Oct by the Llsputrfai of Cownewe and the D4puftout of Natural Resources, State of Wiscoctsitt. Cecdlieatiom stating that your Sep! is sy,stepr has bect maintained must be cotapleted ind relairted to the Sc train County Zoning OfAM within 30 632 of the thre year 'oa date. A m 2.7 SIONATM OF APPLICANT DATE rl i r O MMR ( ) Y Hutt AU shtm=ft on this f*M are true to the but of MY (ow) knowledst. 1(we) eta (are) the oweer(s) of the ro" des; e d above, by virtue of a wManry deed recorded in Register of Deeds Office, 41 / /1 a'-- SIGNAM0 OF APPLICANT DATE Mors•« Any infotmadon that is mis.reprsmte4my t+esult in the saai ta ry pertWt being revoked by the Zoning Deparment. *Vo one •'' Include with this application: s 0=1*4 warranty deed front the Rgjswr of Deeds office A copy of the certified survey chap if reference is made in rho warraAry deed RECF IUED TIME APR, 113, it I.?aW PRINT TTMF APR- 18- 12;33PM APR.19.2002 8 :20AM HUDSON PLANT N0.915 P.2i8 fflPAGE623 STATE BAR' W1 BIN FORM 1 - IM 6Es4tt76$ w ARRANT'Y DEED 'REOIS '�a 0p DEEDS S CROI Co., NI j This Deed, made between Miller M. EIpd y and Ann . RECEIVED FOR RCM I or and Ke Grantor, and i2 -QS -8003 b030 AM y M. Geissler, hushand and wlh as guwivora in tngrf g aronsrty Grantee. iIAWTY DEED Grantor, for a valuable consideration, oonveys and warrants to iXEMP i Grantee the following described real estate In County, State FE r FEEL of Wisconsin (the "Property") (if more space Is needed, please attach TRARAR9F FEE 264.76 =LotThrNMae'3PRush a�CO lls FEET 11.00 Wood Point Addition to the Town of Rush d in the Southwest Quarter of the Northwest Quarter (SW 14 of NW %) of Section Thirteen (18), Township Twenty -sight (DS) North, Range Seventeen (17) Wsst• Rsoaiding Area Name and Retum Adder! Robert J. Richardson $233 McKay Avenue P.O. Box an Spring Valley, Wi 44747 Together with all appurtenant rlgttls, title and Interest!. Paroli IdentlRorlion umber (PIN) Ulm Is not homestead property Grantor warrants that the 00e to the Property Is good,; Indefeasible In fee simple simple and free and clear of encumbrances except saeanants, restrlotions and rights of way of word. Dated ibis f L ._ day of ygy,mber _ ,2001 ' " �� Wllllsm I M. Findley _ " Ann LyAse AUTHENTICATION ACKNOWLEDGMIENT Signature(a _ STATE OFFS� WISCONSIN L. ) /"% X County as• euthentlaated day of Personally acme before me 4h e day of November above named X115 WIIIIam M. Findlay and Ann se t�l V TITLE! MEMBER STATE BAR OF N of not, to m ream to a Me personfe) who executed the foregoing eulhoAsed by 1 700.00 ? We. �„ In meet tf cknowledgod tM THIS INSTRUMENT W Y RO BI[RTJ. RICHARD80N rn At ,M SPRING VALLEY WI _ Notary Public, State of U /�s My Commission is perms ant I( f not, state � des: (Signature! may be *WwmtloWd w d Both are not Z •) - -% ama persona stgnkV in any asps nvm b sbW or below th0 r ltgnature bbnreroon;;;;; cue co., Pond N La% NA e= EAR OA WJZN r TOO e�.ppZ1 WARRANTY DM BORN No.1.11M 04!10/2002 17:13 7152354841 GREAT AMERICAN HOMES PAGE 03 t 4 � 4 �7 rn o Tt � A I E3 4 13 $ M E t ova `, ONE t 4 4 4 rn Z N y 04/10/2002 17:13 7152354841 GREAT AMERICAN HOMES PAGE 05 ow "r aer rt.�k ei ur r 1 3 t.vc z 7j MIS ool 5 1w rip i ii ♦ i � r . i ov ' r t z A W 04/1012002 17:13 7152354841 GREAT AMERICAN HOMES PAGE 04 3 I r--------- - - - - -1 I I 11 II II II II • I SI II 11 � I I i I II it f I I I NLV wvr «err yi -4 4 o ,� �; w I Wf '21 PAO rt Hj � I • � I — � f '-� I I II z I 11 i I I I . 4i I�. I I �A it i �I — — -- — — -- — - -J I rr r. dv t it r D 2 04/18/2002 10:53 7152354841 GREAT AMERICAN HOMES PAGE 03 mom RUSH WOOS POINT Q ac W 'iIM 14 VOWN il0ii 111, R/MM '17 'V9ST. `Ii OF - i� w�rslpF f � 110T xc f xs AaOcs s„",m. cift"mot" �. Lf)T Z. r LOT 5• - �-'-. pq Sao ma sz AcKs All tt f sew s ' — s LOT 3 LOT 4 -. , sa 4 ! f >i sic lrom f � v oa sT�e or �[clo" A �ec iwr s� • t � y alt Iftyr .� !$Mbp V ` aff.6 ' •Poet_ Q*8* 7& f .... I S JIDS I