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HomeMy WebLinkAbout026-1126-49-000 Wisconsin Department of Commerce Count Safety and Building Division PRIVATE SEWAGE SYSTEM St. Croix INSPECTION REPORT Sanitar Permit No: 506120 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: Larrabee, John & Laurie I Richmond, Town of 026 - 1126 -49 -000 Description: Section /Town /Range /Map No: CST BM Elev: Insp. BM Elev: BM i,' , is r % , k 12.30.18.810 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic , ��„ Benchmark f Alt. BM Aeration Bldg. Sewer Z I le , Holding SUHt Inlet TANK SETBACK INFORMATION SUHt Outlet j `1 e TANK TO P /L, WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic < <„ Dt Bottom ' t Dosing Header /Man. Aeration Dist. Pipe , 4 Z v 4 { c Holding Bot. System ' PUMP /SIPHON INFORMATION Final Grade S• ��' �s'!� Manufacturer Demand St Cover GPM ,;.._•.._ ._ r ;- . 7- Model Number TDH Lift Friction Loss System Head DH Ft Forcemain Length Dia. Dist. to well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Liquid Depth Inside Dia. DIMENSIONS _ SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR I �` Type Of System: / UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold „ Distribution x Hole Size x Hole Spacing Vent to Air Intake ' Pi l 5 d-° r h__ ti Length c Dia Length Dia Spacing - "`- SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed Trench Center .' Bed /Trench Edges Topsoil No NI S Yes I w No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / / Inspection #2: Location: 1657 Waters Edge Drive New Richmond, WI 54017 (NE 1/4 SW 1/4 12 T30N R18W) Water's Edge Lot 49 Parcel No: 12.30.18.810 1.) Alt BM Description 2.) Bldg sewer length = ` - amount of cover = r Plan revision Required? Yes No Use other side for additional information. ` + j Date Insepctor's,Signature Cert. No. SBD -6710 (R.3/97) I 2 7 nLI; Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 EC; Madison, 13707 -7162 Sanitary Pet 't Number (to be illed n by Co.) State Transaction Number Sanitary Permit Applica ' on �- In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate mental unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWPS we Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary " - in accordance with the Privacy Law, s. 15. I m , Stars. . I Loi5 7 Wu t `P EA� e 00, L A 'tmtbn Information — Please Print All Lrformation Owner's Name / 1 # Property Owner's Mailing Address +' + , Location vt. Lot City, Statt Zip Code P y., S kA :, - ' /,, Section — ,,��.. stele °.Q,w , ! T N; R E W II. Type of Building (check all that apply) p k- ad Lot # Subdivision Name t3(1 or2'Family"DweHing— Number of Bedrooms __ SJIOW�t P1 °" BI ❑ Public/Commercial — Describe Use NA ❑ City of CSM Number ❑ Village of ❑ State Owned — Describe Use Town of Q4Q1(�� 2W* G e L l S w + 7 lg l o w5 ,v III. Type of Permit: (Check only one box on line A. Complete line B if applicable) New System ❑ Replacement System ❑ Treatrnent/Holi ing Tank Replacement Only ❑Other Modification to Existing System (explain) `�-- List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New r Before Expiration Owner IV. Type of POWTS S tem/Com nent/Device: Check all that appM ❑ 0rNon- Pre=ri'red In -Groin ❑ Pressurized In -Ground ❑ At -Grade ❑ Mound > ?A in. of suitable soil ❑ Mound < 24 in. of suitable and Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Diu rsaUTl eadnent Area Information: Design Flow (gpd) Design Soil Application f) Dispersal Area Requited (sf) Dispersal Area Proposed (sf) System Elevation to o S! VI. ink Info Capacity in Total # of Manufacturer Gallons Gallons Units w t j � "XI New Tanks Existing Tanks ✓ tG U in red 4. C, Septic Holding Tank O.O t 0 ©v �r , VII. Respo nsibility Statement - 1, the undersigned, assume respons iHty for installation of the POWI'S s e attached plans. Z s mbe Name (Prin Plumber's Signature RS Busness Phone Nur s Address (Street, City, State, Zip C ) 1q(,0. f g k. (� l ✓� Cell 01 VIIL Corn /De artment Use Onl Permit Fee Date Issuing t Signature Approved g g=; v. 7 c t n �for I � / ` IX. Conditions of Apppproval/Reasous for Disapproval SYSTEM OWNER: 1. Septic tank, efflttent finer told dispersal cell must pll be 560ftft / as per menaganent plats provided by plMAW. 2. Afl NOW* requirerttettts must be tltairttaNttid 81 system and submit to the Coady only on paper not ben than s 111 s 11 faebes In sire SBD -6398 (R. 01/07) Valid thru 01/09 ti ii-- 3 —07 8�r• = , fire f ;, en CC El IGO.` e"m gcLr Q to a� \ Ia ^ qr � 'yi 3 ( t /� �t�% ( y i f S c IX� i J Q c �} 9n- O,� �O- l ! a (o q � - co b �c lwllasef:s po) )OkSD.,S R S - 7 LA -)Je 3 '?, 3, —07 8w. = rtoe l l i t P,, C Et loc. ' fsm S 094r4 0 M r � n n C4 L� nt vvi� fonsan Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations Division of Safe & Buildings in accord with ILHR 83.05, W�Al rh. Code C NTY - 1110 (� St. Croix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. P Must 1 t4\4 not limited to vertical and horizontal reference point (BM), direction and % f e, scor P L I.D. # Vi dimensioned, north arrow, and location and distance to nearest road. = r 1 .� 2000 mending APPLICANT INFORMATION PLEASE PRINT ALL INFORMATIO S , i CPO ED BY DATE I0 �{ PROPERTY OWNER: RTY LO Derrick Construction Inc. G b t E 1/4 1 ,S 12 T 3 NR 18 E#or) W PROPERTY OWNERS MAILING ADDRESS LOT LOCO ; 6U8 AME OR CSM # U S � 1505 H . #65 49 �y CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE [2rOWN NEAREST ROAD New Richmond, WI. 54017 (715 246 -2320 Richmond I 140th. st. [x] New Construction Use [ Residential / Number of bedrooms 4 [ ] Addition to existing building ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate _7 ed, gpd /ft gpd /ft Absorption area required 858 bed, ft 750 trench, ft Maximum design loading rate .7 bed, gpd /11 trench, gpd /ft Recommended infiltration surface elevation(s) 95.90 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL I MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem I ®S ❑U RIS ❑U I 0S ❑U EIS ❑U RIS ❑U ❑S Cx7 SOIL DESCRIPTION REPORT ( - 3 I ?CDC) Depth Dominant Color Mottles Structure Roots GPD /ft Boring # Horizon Texture Consistence in. Munsell Gu. Sz. Cont. Color Gr. Sz. Sh. Boundary Bed Trends .................. Lj 1 0 -10 10yr3 /3 none 1 2msbk mfr cs 2m .5 .6 •� 2 10 -21 10yr4 /4 none sicl 2msbk mfr gw if .4 .5 Ground 3 21 -88 7.5yr4/4 none ms Osg mvfr na na .7 .8 elev. 99 ft. Depth to gS.go limiting factor "? +88" F-F Remarks: Boring # 1 0 -13 10yr3/3 none 1 2msbk mfr cs 2f .5 .6 ,S 2 13 -30 10yr4 /4 none sicl 2msbk mfr gw if .4 .5 3 30 -88 7.5yr4/4 none ms Osg mvfr na na .7 .8 Ground _ elev. 9 9.8 ft. Depth to limiting factor +88" Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. Ave. , NewRichmond, WI 017 Signature: Date: 6 -20 -2000 CST Number: m02298 PROPERTY OWNER Derrick Const. Inc. SOIL DESCRIPTION REPORT Page? il 3 PARCEL I.D. # _ending Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Barry Roots GPDT in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench `l<.•.3..•.:., 1 0 -12 10 r3/3 none 1 2msbk mfr cs 2f .5 .6 2 12 -22 10yr4 /4 none sicl 2msbk mfr gw if .4 .5 Ground 3 22 -86 7.5yr4/6 none is Osg mvfr na na .7 .8 elev. 99 ft. Depth to limiting f +86" Remarks: Boring # 1 0 -11 10yr3 /3 none 1 2msbk mfr cs 2f .5 .6 c; 7 4 2 11 -22 10yr4 /4 none sic 2msbk mfr gw if .4 .5 3 22 -33 7.5yr4/4 none is Osg mvfr gw na .7 .8 Ground elev. 4 33 -88 7.5yr4/4 none ms Osg mvfr na na .7 .8 99 ft. Depth to limiting factor +88" Remarks: Boring # 1 0 -10 10yr3 /3 none 1 2msbk mfr cs 2f .5 .6 ,5 2 10 -18 10yr4 /4 none sic 2msbk mfr gw if .4 .5 5 3 18 -30 7.5yr4/4 none is Osg mvfr gw na .7 .8 Ground elev. 4 30 -86 7.5yr4/4 none ms Osg mvfr na na .7 .8 99 ft. Depth to limiting fa Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(R.05/92) , PROPERTY OWNER Derrick Const. Inc. SOIL DESCRIPTION REPORT Page 2 i 3 PARCEL I.D. # _ending Boring # Horizon Depth Dominant Color Mottles. Texture Structure Consistence Bourxiary Roots GPD/t7 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tmnch 3 0 -12 10 r3/3 none 1 2msbk mfr cs 2f .5 .6 2 12 -22 i0yr4 /4 none sic 2msbk mfr gw if .4 .5 Ground 3 22 -86 7.5yr4/6 none is Osg mvfr na na .7 .8 •� elev. 99 ft. Depth to limiting /yy +8611 Remarks: Boring # E ,- 1 0 -11 10yr3 /3 none 1 2msbk mfr cs 2f .5 .6 •� 4 ' 2 11 -22 10yr4 /4 none sic 2msbk mfr gw if .4 ? .5 3 22 -33 7.5yr4/4 none is Osg mvfr gw na .7 .8 Ground elev. 4 33 -88 7.5yr4/4 none ms Osg mvfr na na .7 .8 99 ft. Depth to limiting factor +88" Remarks: Boring # 1 0 -10 10yr3 /3 none 1 2msbk mfr cs 2f .5 .6 .S 2 10 -18 10 r4 4 none sic 2msbk mfr gw if .4 .5 3 18 -30 7.5yr4/4 none is Osg mvfr gw na .7 .8 Ground elev. 4 30 -86 7.5yr4/4 none ms Osg mvfr na na .7 .8 •� 99 ft. Depth to limiting f + IA 6 „ Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) i STEEL'S SOIL SERVICE Gary L. Steel Derrick Construction, Inc. 1554 200th Ave. CSTM2298 NE4SW4 S12- T30N -R18W New Richmond, Wi 54017 MPRSW -3254 town of Richmond (715) 246 -6200 lot #49 Brushy Mound Lake This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shun as permanent lot lines were not established at the time the test was conducted. _N 1 -40' top of 1 pvc pipe @ el. 10 0 top of 1" pvc pipe C el. 100.40' �1 1 .� , Gary L. Steel 6 -20 -2000 r RY PLAT OF BRUSHY M( 12' Utilit Easement � l OPOSED TOWN ROAD PR — -- LOT/19 / o x 8. .91675 SQ.FT. ,��, Q d/ o \ 1 2.10 ACRES / 8 A--OT 1.8 �4. B -5 1 994-3 58 -SQ.FT. o � ��, 0 �o B -� � '` x � \ 9 0 • 2.17 ACRES �' AZ o \ 0 F B�4 1001. �� o B- ° �v/ / x x �B -4 �� o mo LOT 49 ,00,.o \ 996.0 ! .. B -5 a - 88035 SQ.FT. - ° o B -2 -3 , <Z�/ 2.02 ACRES i o , 20 �o! O Eos B— 4 0 B —1 � • B — �M: h 10 01.3 O O O ` 99. y C LOT -7 B 4 _ -- r x ' 2 Q. • • ° ,00,.5 45 Q 2 - B �� x B 5 • B -1 �2 CR S, • 1 0-1 ° ° B 0 2 -. • t \ • / ��— \ 6�3 o o B -1 I \ o -3 Lp 48 B -4 O 1000.9 x \ B -5 2 I I 96187 .FT. : 1001.1 2.21 A RES OT 6 I c o 1002.4 -886 SQ.FTA x 2� 3 CRE ` 0 Wb✓�wrSSMYM �Awk.' sMu{ awrrw." �4+- bww+NwviryLL'MNMrwrWr+r. + Im LNr�rwv. .. s�ppys,, ��E } tv s2 wPfi3si it t ,fk W lgitF t 4a p9i MW 1{A y k If LSE. HW iik "1 "rb "q, I lk , 114'd. 11k CF § d ` a ui stiE 4 'ya!tct `4 v tie �` ?$ �• . a 84, 1.m, D! R66'4' �t !:w tnts;, k;mn� IM s �f13pU aeuu — J � r ( � �E � t1 �M r� 3?r, rtlo Ks e k Lots 6w 60 a 7 ')uAr Iif£1 x LANT lq L8t 0 d j I k n raf x e 0n w LQ x a fw:li TI ut �il }y C k �! "e -f• J: + t ri7.a- a j 2 n sux t r qq aF, ^�a � if. , it c i�4ff as d P I ✓ 1 iSAY611f ( Y k /j f s i3 t �t 1 Larr? � •� PTE � ��91���;�A,� �: ' C I� LQT48 Q & 4 51fk .WkA { I� [S d7 _ rrF 40ir 47 rr �- ! i I. I ' (AFfd • � -`" .I � � r n:!e I` s ] I 0 l�irJ, :�" o I C,T� iI I [g y ` i a CPT 11 4.At u ilk I — .i . ?-i �•' ^ -- kD17CIFWQ8i4M Y- � •P X71 s I` r t LOT N t v •• i �;. ':;< r; Q f i� l 4• t4fi1 1 10 F19 x r. r r � / tl4y r>•, ff 7ilVjn rr +, tCwM A?wn ,�.f9 ks"v v lot M1 9 1t3 - .. Itl7'„ Nw Err,.+w+ Nt - N9i'al7k1Y Ir,^ eow`�pRi, r „a1 s G 4VLL �� _ 61 k"�g3"1t b � 'g[ X Wd �V U f./ 4♦ \ f Y�6A� � CAXF f Wk I a€ 41 rl 1 .c 4 vE'E'f� k w ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer ab� 7 LAm o j E L.. -- x j'iA a> Mailing Address O PAaV'Vt fJ 2 0 k1'LJ4 /KOHL O Property Address 7 C.c.� 4T;� S 4 C----76 4E (V cation required from Planning & Zoning Department for new construction.) City /S #ate �'`r itto, /parcel Identification Number ©2!0 - ma ' 9 J Q LEGAL DESCRIPTION (!P Property Location W '/4 , ' S W % , Sec. 4), , T N R W, Town of / `L ca-0-1 Ma IV 0 Subdivision EM9 , Lot # J/9 Certified Survey Map # , Volume , Page # Warranty Deed # q`j C ✓' Volume - ?-' 0 6 - 7 , Page # Q3 Spec house yes no Lot lines identifiabl yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 113 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your 'septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certi fy that all statements on this form are true to the best of my /our knowledge. I/we am/are the owner(s) of the property described above, by vh t ee X warranty deed recorded in Register of Deeds Office. Namber f bed ooms �./ Wo 13 1 SIGNATURE OF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08105) i ( v�nr� + rrctL-Q-Q- EZ1203H TrT4rr1 P 01T TO ,' • h- •V1VT1 VVVVVVV VP1 '�•.� a ', :f.....,w t��• V PP 12t1 711. j L .A� •. ^f . ty. }`tiA 104 2 24tt rt i »i K� N y y 111 14V TsV d VVV tr- -114 Y VL.J vve VV IF VVV `V ° 1 it 1/2 Circ. = 18.84" 4TS V IF Ira 141 111 OTT PV T.TVTTV, VT VVVV 4T1e VTT V T1TV ITVVVVTV VVVVVV1 r'TVVVTV VVVTVVTIVVTTVT TVVVTVV O. V V V V V T I T V V T 9 V V V w VV V V V" 4Li e 24 Bottom 36" Void V 12 -1 /2" DIA, olame � interface�a 11L19 E �F1 Void Cocffident in Aggregate given at 57.4 %. Sidewall (2 Side walls) 2 * I : !I O.D. of 4" Pipe a 4.625 inches 12in 3.14 Void voian c per linear ft. = 3.14' [3in /ft - 2.3t25m 1ft ; 0. 117 R' Bottom l$ 2.00 �� � O.D. ofcmtercy finder - T2.5 inches Tots! Solt Interface Area 5.14 SQ.,—& Void volume in aggregate of center cylindcr = 3.14 ( ft J _ 3.14 • ( m ft l 1 l it -574 = .422 ft' O.D. of outside cylinders= 12 inches Projected Trench Area Void volume in outside cylinders - 2.3.1 12 /� ft� • 574 a •901 fN Sidewali Height - 12 in. •2 = 2.00 Sq.Ft. 1 / Bottom � 3b in. � 3.00 Sq.Ft. Void volume at bottom between cylinders m [ 24in . � 6a� ll lf2it,it 12erlft) t12W,ft� Projected Trench Area s S.00Sq.Ft. Void volume at outside bottom comers (iR of void volume between cylinders) 0.215 12 - 0.108 ft, Total void volume - 0.117 + 0. 422 + 0.901 + 0215 + 0,108 a 1-763 cubic ft / ft Gallons per ft _ 1.763 X 7.48 - 132 rallons per linear ft 310 J1 X [o =So E e gregflt System H 0w riol Group al Park Rd. A8060 F8E PtlMiL frt203H- -rat SHEET: 1 of 1 I;W 2 01 POWTS OWNER'S MANUAL & MANAGOMENT TAN Pow of t9LE 7�ON SY$'f alt flv�er. �, Permit p V � - ' '^ ` a T r Septic Tank Cape-city 0 D NA Septic Tank Menufactwor El NA DEBM PABAMETBM Effluent. Filter #A nufacti 0 MA ssiter Gf. BG*0Q= ILA q Too L E3 NA Nmober of Pubdc F ty Units NA Ptunp Tank Cwadty D NA d fknro (average) Pamp Tank Mentdocturer; ::. gal D NA ' Design flow (Peak). (Eatknated x 1.5) ... DNA S� APPReaftn Rate i Ptnnp "Madam © NA 5tandaid lnfltient(5ffluent Cksolki Rllora i�r atntent Unk , Q NA Fats. On &Grease tFt3E3) 530 mg/L D Sand/Gravel Fgter D Peat Biter Moc emical oxygen Demand (BOW s220 ris ❑ NA ,,;. D �- Aeration D Wetland Totai Mispended & Aft frmmm 13 ❑ Others Motivated Efftmm r overage 0 14A Biochemical oxy Der+nand t8C3D,) ao mg/l 3�( na (gre„icsr� to In -G� ( d) Total Sued Solids ) 53D f - D NA {b3 At -Grade 13 Mami d I Fecal.CoGfo"n_l "Wo -,MQ` ~00trrl > t:7 i -i.#ne t3 Others Maxinnum Efthient Parttcie Size Y in die. D NA Other: 0 1►A Other: DNA DNA "Values typal for d0nMkS a wastewater and septic tank efflueei_ Other: D'NA ll/ANT�IANflE ..: .. .k"&* canditiort of tan'k(s) Alt least once every: (#Y[aida�urn 3 vows) L7 NA Pump out contents of.tafdctst VVhen cont*md sludge and scuan squats bmmMd . of tank vokx s < DNA Inspect dispersal ceNal At least armo evety.. S »t 0 NA Cieas effltietti titter At kt onceQ D NA every: .. Inspect punw. PAP contivis lip alatm At once E3 NA NA Q Flush laterals and pressure test At least once every: 0 month(e) © N:it Other. other' � A' MAWTENAtw #NSTfeuc NS Inspections of tanks and dispersal ceNs sly be made by an kKOvkkW carrying one of the ogowkM tenses or Pkrrrtber mss: M Pl r>ber: star .,Ma Restricted Sewer; up POINTS krspector. POWTS Maintak+er, %3tme Servicing Operator. Tank I one nwiat inchide s v Inspection of the tank to.idenWy MW ades� or broken honlwars. Identify any rxsaks 0 leaks, meamtus the vohmm of � s and scorn and to Check for any back up - or pandstg =of sffkmnt an the wound s!Wfa_m The dbpars4 cWs) shall be vftuaffy ,kopopWd sD t ei�Ittlte et �nt layeis it the abeervafl of s on'pdpes and to check for any pcuMktg fiilsent on the ground stKface. The of efHttanfan th e ground stsface. may a faikng cortcbtiort and:requiras the imtrtedteta notif�on of the focal r authority. 1Nitert the canted acctunt>iation of �udga and sown, in any tank equals one - tided (Y or trlars•- of-ttae Ionk Vokay, ,the, an*e contaKs of the tank shad be renwved by a P, ptjgq:SWVIcb9 APerstor and domed of W occondanee With .e spier NR 113. - Adn*0strativa Cade. AN other serricas kw*xlkw but not titnited to the swWaing.of efflcmw filters. me l or prized aownponenm pnmreobvmmt units. and any sendcdng at intervah; of 512 nrorttha, shah bs>petfanned by a owdiied POWTS Maier. A aarviae repKtrt sited bs p +orided ttr Ute loc 'r+agutamory amity within 10 days of conpWom of any service event. START Up AND CATION that may kiwaft OW tirior use of Ow F(Aj m cl,16ck Of - tank(s) for the of p resence of + PoWing Products fired bYa sPepfieIpe a t# _ UN up shall-not occur whoo, me corgi ar+®iiomen at the irk . 4166� hav th contioft dirohsrged• ml me � �' When Per k rested the ameaga P tie To avoM V& aiu efts has the cot a t dw and �t ++sa * -in tie- backup or. a.— wa Win be i a Plan�ber or FINN t o Upeeator Hof Ilt pimp cormok to Do not drips or pwk oy, tonics trittie 15 teat down dope of OW a at ao i Do not drive or park over, or v�Oe dkturb #0 atom Am f fin ab don or d sw*gadon of the *4km ng from ;ha re"a"r tttrsnrn bab ra>eN irrprvve the � and y► s �,; - I ors: dsntd Prolong .the rite of me poop! waear, sad P de:r asnitary a waaer: a hinw.bi* e. '; oil; illMaen tare PANTS faibi han trot of service the prof�y and abandoned in ' :bal be tbat the system is eO!r+pRerwrt vMlh ao{tspwer CaaiAaa SS.33, = • AM Pipft no m" and Pits afar bed aMf to abatrdbrtad Pie • The cgnte M of a0 IN and Phs d+ri'brt removsA and properly dieposed.0 b s Oil to" • After parppkg, 65 tamps- and pits ahaa -be wwwoa ad and o4 gra wd or another inert solid nisi rid, �orad or their QOVars the %wid'sPics f1Uad vrhtt WINEMNOWC PLAN Tf the POlt M faba and carrrtot be rapaisri rho fieeetiles Have been. m. be.%bw4.to.pwvitfs- scode A surf le Wit. aria hss been _w Jalmoted a y mad far the °�- 71ae t�spisoerrrerrt ores should be p�� fi=n dos and toil :.. fat trporrby aefbaolot fium -sad . per D result to the mead t+ar a� � t�arrd a16i.a.� ��. ►.wilt the rules In m that tkrb. l traust i� A saaltabie ' wm" is not avaikbie true. im in POWTS 'fndf r. s�oi �. B+irg ; advances Y s boldjrrg tapir ntey be add as a IM issmt tta rea - ps Ute Mn. .falled -P © Tha .sits heat: not been evak�dso Wa y a sui6e � arse. evdummon Muni be perkmaaed o'l�s a adadds replsasntsnt arse. -lf m UPwr failure of the POINT$ a SON and site aW be i as a lest mu4rt �p spi ce the felled t ease is avaifafrie a bolding u LT Mound and at -grade soil milmilme %some, om bwamormagag dve awiace, Raa:at of ash systerra place t8 rentovd of life bisque at the mm =Ph/ with th c <M> > e arks in affect at that time. rflM!► Iifrp OV#M TIMATMW TAB MAY COMTAf11 NIiSUFAf T C"CV li, 00 NOT 'IN 10 A 8044. . lEltiAL �INONOR .. � T TA AT a TIiNOW OEATO MAY'R10KT. RBOCtlE OP A �fBrOlt EJF A Two iiMY IIE NS`A OR l.E. lrirtae , - - tfiorie moos p� WCALItA1f /�lanre � -. t�lanae Phoire it d6=mnmM was ohalaed in colppienpe rrb dater rma • �ftltqW sM`HB.�), t�l A lei, Wl400radn Admi`niseradve Code. START up s1jID ppffMIMS c0nBvUe*,,' pdoi` to ilea of.'" 5 c wak �� at thot Mwence may ode the t skis) fo r the of the tass� �!ed bx a srop�,. afa r ff 1 °t p nA Cais tspwser r prior to me. - are date�fed ham the Syatsrn start up . shah not occur sod � bower out loess ara.ia tea. '� Ito the fNBhwater WflgerlL To av hog d • °� ' rind is wed the , fi r W-M be PtMV POWW to the afflu Pumper of "°e6ore'ia'nat tt p Atnrdw or PCP*M to a � °f - o P a rotk V dUk Ptatip t w D D no ddwe 1 or Park over tanks and real . tails. Do nest drisAe or do�rrs sl°pe of any ar said lion' asp. Park over, or O#Mmwiw dhe or pct, the ar pq � irons n, w e i m p ro ve the Asa *NmdWion drab �P i� a+re�oer; a _ d e Abe a of the oestnsdesss; aanitarlr aaplsinsst p so bran �= MINN etxaps, ARMIDOMABIIT' When do POWTS fafls a asslaan vac of sww1ce the fallowaW 18110 be P"Mdv and safer► anal in oovnsp o n tD ineuns that the strstam is • AN p%*M to tanks ana Pim :bae be and the abessdonad p� . eked. Ths aar�reantts tanks a.W Vft sholl be raaayssld and PrqPerM dbpm � a - sag flPerstoc. • After Punspirp,, as t=*G and pieta Mall be swowra� amJ �. Gravel ir vel or anod"w mt ioisi anatnd. av qd iArlwf the +sold apace feud wtth W the MWFS tails and wisterm- cannot tee r+spairscf the n+ s have bwm- CK gust be. tatkan, .tn - paovids. a +rode ant Nletem- T� bcetnent eras should a� may he Uliliaed for the of a - mVd aaYao Iran Ahmrbanos aAd coq and ohm" in then need tar w sad Pte_ seed skin`s i+ey tat issss "MW vre�, � , +i�on by 4wAuaaion•ao :n p scat'd+e ra� ,ind - ai6e - ` - . s ekes.. �t:aroa w� -- sue► skistatsR tsllraa! that _ must El A suiEabls t er+sa tai 0106106IMs d. tQ aestbaalc- srsd/,or soe BwIft , aftanosa in Pcr*lrr8 Y a �+B tank gnat► la i�eid •as a i�t to oft to rem Use- taSett PQWTS, © The -sins has: rwt been OWNIU1014d. to • miust be pertala Y !• Upqn fallure of the POWT$ a and and sica may be l as a lea a M no � ate. * t area is avaifalrle taste .e+sPiaoa the . Q" Mound and at may bee - aovw& a piece e Reran ys must comply with the rubs in effect at that tsme. 1&4 biorr�at at the. . SMqIC6,VWAP'AtalD•Ovw! TINEMA -TAlr M MAY Moo A ar3Pr�c. oo tRwur o� aT[Elf ° OM�!i" -> 0.VML G o)clrfllEbl. llior ffXW_TE i TAiIA[ CULT t.�Y •AN OL I EAT" MAY .T. OF IC M><k7rOR QF A TAtit[ >iifflY tlE liMpglLT ON INAP . use Phans Ptsorae mean 'LOCAL LOCi4t li�fiKA11<llpY "Wive " W T Ahtsae- - s dsonsaent vrais dratoad iR complaws wla aim~ QMM 8&2= } and83.5W1f: f2i � i31. VMloi�onsis IW*nfigmand" Code_ 81¢04 -+45 j 8 7 4 'P 3 3 6 KATHLEEN H. WALSH REGISTER OF DEEDS Document Number WARRAN DEED ST. CROIX CO., WI RECEIVED FOR RECORD THIS DEED made between Brushy Mound Partners, LLP, a Wisconsin Limited Liability Partnership ( "Grantor') and John R. 08/25/2005 10:15A?i Larrabee and Laurie E. Larrabee, husband and wife, as survivorship marital property ( "Grantee "), WARRANTY DEED WITNESSETH, that the said Grantor, for valuable consideration EXEMPT # conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin: REC FEE: 11.00 TRANS FEE: 100.50 COPY FEE: Recordinq Area CC FEE: Lot Forty -nine (49), Plat of Waters Edge in the Township of Name and Retu Richmond, St. Croix County, Wisconsin. Brushy Mound Partners PO Box 445 New Richmond, WI 54017 026- 1126 -49 -000 (Parcel Identification Number) This is not homestead property. Grantor, Brushy Mound Partners, LLP, a Wisconsin Limited Liability Partnership, is an affiliate of Derrick Homes, LLC, a Wisconsin Limited Liability Corporation. Grantor develops land and Derrick Homes, LLC is a home construction contractor. Grantor agrees to sell this lot to Grantee on the condition that Derrick Homes, LLC will be the builder of the home for Grantee. If Grantee does not commence construction With Derrick Homes, LLC as the contractor /builder within two (2) years of the date of sale of this lot to Grantee, Grantee gives Grantor the irrevocable right to re- purchase the lot for the same price as Grantee paid Grantor for it when Grantee bought it from Grantor. If Grantee desires to sell the lot to another purchaser before constructing a home upon this lot, Grantee gives Grantor the right of first refusal to re- purchase the lot for the same price as Grantee paid Grantor for it when Grantee bought it from Grantor. Dated this 241h day of August. 2005. ' Ro 1 D rick , " M aeI R. Steverlb AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ST. CROIX COUNTY Personally came before me this 24th day of August 20Q5, authenticated this _ day of 20_ the above named Michael R. Stevens and Ronald L. Derrick, as partners of Brushy Mound Partners, LLP, a con ' Limited Li _ity Pa ership tome known to be signature the p(e who uted the foregoing instrument and type or print name acknowledg the s TITLE: MEMBER STATE BAR OF WISCONSIN tin (If not, re PAMELA J. RUTLEDGE authorized by ' 706.06, Wis. Stats.) type or print name P la Rutled try PVbft Notary Public St. Croix County, Wisconsin. Shft 4 if Vftmiiln THIS INSTRUMENT WAS DRAFTED BY My Commission Expires: July 27th 2006 Brushy Mound Partners *Names of persons signing in any capacity should be typed or PO Box 445 printed below their signatures. New Richmond, WI 54017