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HomeMy WebLinkAbout026-1040-50-100 Wisconsin.Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 515005 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: Regions Bank I Richmond, Town of 026- 1040 -50 -100 CST BM Elev: Insp. BM Elev: escription: Sectionfrown /Range /Map No: 1 66) r i j M ( GSA 13.30.18.194A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. 1 Septic Benchmark . Dosing prwl0� � 3, Alt 1� -c.... GpJ //7 9�• /� 5 14erntiorr Bldg. Sewer . I Holding SUHt Inlet TANK SETBACK INFORMATION SUHt Outlet TANK TO 1 r/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 7 56 / M6 1 3 g 13$ Dt Bottom Dosing 7 50 /od 1 � / / 3'9" Header /Man. n c G Aeration Dist. Pipe I J Holding Bot. System n 77', PUMP /SIPHON INFORMATION Final Grade 0 • 160 i S Manufacturer ; / ; De St Coves lt' / , 1' 5 9T• J Model Number l�? fr-• TDH 1 1-ift Friction � Logs O System He d� T 7 11 �Ft J I Forcemain Lengt i Dia. &I Dist. to Well / SOIL ABSORPTION SYSTEM BED /TRENCH Width / Length / No. Of Tren hes PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS /Q 1 \ SETBACK SYSTEM TO P/L BLDG WELL LAKE/ST REA LEACHING Manufacturer: INFORMATION CHAMBER OR Type 4TeL ( I Z 7 2QO UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold IDistribution Hole x Size �/ x Hole Spacing / nt to Air Ike \ Pipe(s) y„y Length S Dia \ Length Dia Z Spacing 7j Z SOIL COVER x Pressu Systems Only xx Mound Or t -Grade Systems Only Al Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Z Bed/Trench Center • 05 � Bed/Trench Edges ` Topsoil 1 I �•� s No e Q s No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 16 1 ' L1 1 (( 1 Inspection #2: / / Location: 1440 Cty. Rd. G New Richmond, WI 54017 (SE 1/4 SW 1/4 13 T30N R18W) NA Lot 1 G+ x P10%,) Parcel No: 13.30.18.194A 1.) Alt BM Description 2.) Bldg sewer length QJ �— ♦-� 5O / "]�� 01 Ck 5 •b�� - amount of cover = �`' Plan revision Required? Yes No Use other side for additional information. I ___ —1 -_ Date Insepcto s Signat Cert. No. SBD -6710 (R.3/97) �. Safety and Buildings Division Coul C� /1 t 201 W. Washington Ave., P.O. Box 7162 J 1-12 1 i sco n sin C Madison, WI 5 71 unitary P� 't Number (� Sanitary Permit Application filled in by Co.) 5 5 bo tau Transaction Number 5°� In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS are Pros Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for /\ ses in accordance with the Privacy Law, s. 15. 1 m , Stats. ` T� - C �� ( J� I. A lication Information - Please Print AU Informal ea Property Owner's Name �� N� % Parcel # property Owner's Mailing /I _ rLot 7 2 /C� I (�(. Go City, State // Zip ) Ph neN Section C <.�l,Q, — ` /Ol . UNTY EoW II. pe Building (check all that appl // Lo # Z I N G OFFI r Subdivision Name l or 2 Family Dwelling -Number of Bedroo Block # ) d' Z �� ❑ Public /Commercial - Describe Use l ❑ City of CSM Num r ❑Village of _— ❑ State Owned - Describe Use own of III. Type of Permit: (Check yon box on line A. Complete line B if applicable) A. ❑New System acement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS S stem/Com onent/Device: Check all that a l ❑ Nor- Pressurized In -Ground ❑pressurized In- Ground t -Grade [] Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treatment Area Information: S stem Eleva Design Flow (gpd) Design Soil Application dsf) Dispersal Area Require sfj Dispersal Area Propo 1 sf) y S.S' t� /G� ,d VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units New Tanks Existing Tanks /! / r /6 Ys / v `U 0, A Septic or Holding Tank Dosing Chamber tS VII. Responsibility Statement - I, the undersigned, ass uslbility for installation of the POWTS shown on the attached plans - Plumber's Name (Print) j Plum ature MP/MpKS Number I Business Phone Number 7 7- 67,.? 7/✓ -oZ K Plumber's Address (Street, City, State, Zip , j2pde ) VIII. Conn /De artment Use Onl Permit Fee Date Iss Issuing mt Signature Approved �Y 'n t$ IX. Condit MPWW 250113 for Disapproval 3) �ondt�� io�'S A 1. Septic tank, effluent finer and M 4,1 � dispersal cell must all be sery c-es / maintained e4 as per management plan provided by plumber. n 2. AN setbwkrequirernerits must be maintained J� ♦'me�systeem and submit to the County 0151Y o�n� paper not Less than S W I I I i Shia �chb in GQ 4-.b. \ t��,�+ ,.Agi. I�R�+.+ vv111R t"�' /rssbs�A �� W�F"p • SBD -6398 (R. / 01/07) Valid thru 01/09 PROJECT Fannie Mae c %Mark Fouts PLOT PLAN ADDRESS 1021 Reois Ct. Eau Claire Wi 54701 SE 1/4 SW 1/4S 13 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 99.0' CONVENTIONAL BEDROOM 4 AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE .55 ABSORPTION AREA 1 100 h k # of chambers none BENCHMARK V.R.P. Top of Wood Corner Post ❑ BOREHOLE O WELL *H.R.P. Sameas Benchmark ASSUME ELEVATION 100' Filter BEST GF10 -8 2.6 Acre Parcel Cty Rd G Existing 4 bedroom house Cleanout to be installed as per code Scale = 1/4" = 10, �c:� Dell Old tanks are to be pumped and buried _ 6t �a uffcutt Combo tank Grading is to be done to divert run -off away from System B -3 9 99.5' . B -2 n 97.5' B -1 7% Slope Area 15' below � � B. M. * system is to remain L6 0 P y Property Line undisturbed PLOT PLAN PROJECT Fannie Mae c/o Mark Fouts ADDRESS 1021 Reais Ct. Eau Claire Wi 54701 SE 1/4 SW 1 /4S 13 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 99.0' BEDROOM 4 CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE .55 ABSORPTION AREA 1 100 # of chambers none BENCHMARK V.R.P. Top of Wood Corner Post ASSUME ELEVATION 100' Filter BEST GF10 -8 ❑BOREHOLE O WELL *H.R.P. Sameas Benchmark 2.6 Acre Parcel Cty Rd G Existing 4 bedroom house Cleanout to be installed as per code Well Scale = 1/4" = 10' Old tanks are to be pumped and buried Huffcutt Combo tank Grading is to be done to divert run -off away from system B -3 99.5' 99 B-2 97.5' B -1 IF 7% Slope Area 15' below system is to remain B.M.* undisturbed Property Line Safety and Buildings 3824 N CREEKSIDE LA commerce.wi.gov HOLMEN WI 54636 in Contact Through Relay sca ns i www.commerce.wi.gov /sb/ www.wisconsin.gov Department of Commerce Jim Doyle, Governor Richard J. Leinenkugel, Secretary October 02, 2008 CUST ID No. 226900 ATTN: POWTS Ins P ector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 10/02/2010 Transaction ID No. 1594520 SITE: Site ID No. 743046 Fannie Mae c/o Mark Fouts Please refer to both identification numbers, 1440 County Road G above, in all corres ondence with the a enc Town of Richmond St Croix County SETA, SWIA, S13, T30N, R18W FOR: Description: At -Grade / Four Bedroom /,Sloping Site Object Type: POWTS Component Manual Regulated Object ID No.: 1202883 Maintenance required; Replacement system; 600 GPD Flow rate; 36 in Soil minimum depth to limiting factor from original grade; System: At -grade Component Manual, Version 2.0, SBD -10854 (N.03/07), Pressure Distribution Component Manual- Version 2.0, SBD- 10706 -P (N.01 101); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during constnzction or installation and prior to occupancy or use: Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manuals listed above. • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component arm. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. ' PAPiMENT • The existing POWTS must be properly abandoned per Comm 83.33 Wise.Adm. Code. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the SEE COME requirements of See. 145.135 and 145.19, Wis. Stats. • Inspection of the POWTS installation is required. Arrangements for inspection shall bemade with the designated county official in accordance with the provisions ofSee. 145.20(2)(d), Wis. Stat SHAUN R BIRD Page 2 10/2/2008 • Comm 83.22(7) A co of the a roved p l an s , d h' O �Y pp pl , specifications an t letter shall be on during construction and open to inspection by authorized representatives of the Department which may include local inspectors Owner Responsibilities: • Comm 83.52 Responsibilities. 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. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions shodd 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. Beginning October 1 2008, small wastewater holding tanks with estimated flows less than 3,000 gpd that are based completely on approved POWTS component manuals must be submitted to the appropriate governmental unit and will no longer be accepted by the Safety and Buildings Division for review. Please refer to s. Comm 83.22, Wis. Adm. Code for further information. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a co of this letter to the owner and an others who are responsible PY Y P for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II, Integrated Services WiSMART;code: 7633 (608)789 -7893 7:45 am - 4:30 pm Monday - Friday charles.bratz@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave RECEIVED New Richmond Wi 54017 715- 246 -4516 sEP 2 9 2008 SAFETY & BUILDINGS Date: 9/25/08 Owner: Fannie Mae c/o Mark Fouts Location:SE1 /4 SW1 /4 S 13 T30 N,R18W 1440 Cty Rd G Richmond System type: At -Grade Manuals Used: At -Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706 -P(N. 01 /01) Page# 1. Cover Page 2. At -Grade Plot Plan 3. At -Grade Cross Section 4. Pipe Cross Section /Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7 -8. Maintance and Contigency plan 9 -11. Soil test Shaun Bird ° #Jr ti ftr�jl Signature LWD License number 2 900 OF COMMERCE EY D DINGS SPONDENC J . µ, y' . 2:5 = PV C- FOM-F- 1 ...� 1 --- ---- ''" t t�esrrez�sr :a.s s,�►sa.,�swt. -� • �JEi.t TA6ti� l�D dD�C"�ltT�ewa 5' �6B j p 1 /6B i B /Z A , �� Ft- A&GA .G &TE Fabric Distribution Lateral Soil Cover s mi uu:mu.b observation --� Well { ,6V1tE� LAME2 s r2 —5 � A 5 WE Gross Section of i7iacot�sia At•¢s� IIait s►i,tla as Pisa Vi.ev and in Site Siugie Absorption Area ort s Slop $ Page Of !Distribution PiPe Vet�ji} for • Lateral lletw*rk ACce X Tutt[a -UP • a, PVC Force !lain PVC Distributio n Pipe * Last mole Should Be Next To ruff- up Hole Diameter ` 5 3 P � Ft. . ��G X inches Lateral Di ameter Z Inch(es) .= .� =. -- Inches Force Main Diameter # Of Holes /Pipe S Invert Elevation Of Laterals �/� � Ft. Signed: ..__._._. License Uxuber: Date: pump CHAMBER CROSS SECTLON AND SPEC! ICATIC)NS ' SEPTIC TA1�iK Wa P &ppp()V ED ER 141N . ABOVE GitRDE juNCT1014 BOX MOLE COV �n GI PIPE .12'v 0 OR wrTH COI+ IT WI P,ADIXX 6 ! I'gp�i DpflitL. p?.MNG I ASI: FRsh eon KIN GRADE 1 L /D ` IN GAS. '�_��•• `.�'� / te a' r 1 � f� ATM T;6 SERLS SFAL► t -JOINTS Y I 3 OM 8 1 SMIQ SolL APPt1 C r PIPE smIR 2 j . - -- SOIL Ptil F or _1XV , D BEDDING U tiDER TAN . co =? E PAD 3 a plppit 7 -7 SPyc3:T_1CA'T'XM SEPTIC I DOSE I+�LI3'FBEt DOSES PER DAY = �--- ilLl�iK �£ACRER - u E v O w KE F Lt S .. GAL, DOS / �-� J� S GAL - T"x S� 2E5 = . SEPTiC GAL . �,b • J IDLES . DOSE ry f-P�u4 CAPACITI A �� GAI►- 8 = 2 INCHES AI+A K 1�Fl�CT� 3 icE R � j= ✓ U MODEL �sot .�' INCISES = � ? - r GAL. sw I,TC1i TYPE: C PUMP iFwO3TJit£R z ATE PZP£ FEET PIODEL Z DG AS PER �• Y3 1W SWITO'R pz ' mm? � AL� i�JIR FEET ISCPARGE =�Ti( gEt}t3IRt3� pUMp OFF AND DISTR - - � FE£T E£N FACTOR - �r ,FEET VER'fICAj. Tt�F ORK pREggURE - - Fi; TIC j MINIi4 /' p FT1I0 1 FATAL DYNoIC MEAD f FEET FORC�I X DTH DiAir!!E'TER .... ---- L£I3GTH �.T 1 DOTER L DilIENgI4N5 01' PUKP Tt�irtK= L.IfluID � ~-- ""1' --- LICENSE IrI�1zBa � -- • Sent By: HP LaS6Net 3100; 1 71b -NO2 tit3Y/ i 6Aa -o-vo c.:xurw�x ' Fa" t im 9EH SERIES S UMP /E F PUMP 0 i Specif icatkes mu9e a9r9r 99■r61s mm t9< 711919f36 91 6 196f199M1tf9Mrl�) 9U PAT* � K IIf999 91 mi.W ras= 9 w tP ! 9@� 1 509590 IROL AM 115 39 130 = 70 V 55 41 62 139 20 84 911 x1164xB94 U 1000 70 64 55 h 32 1i9 20 24 9.11 x11MA24 90( ' 0 NtiS► 4"40 ' 230 ti8 w n 9.11 x f1 B 11.94 991-04APS 509930 mm Oro 115 am 13.0 100D 70 64 A 41 19 ti9 20 27 911 164x194 0iR55 4P9 3N 86 1000 70 64 55 Co��os40op�RMeO— 'L911e6fi4u3>MPr��wtaW CpIwIx9Wi4L1Yii ppiillMyarfltiMl9i11 h9W9Mner�fo9Naow� FLOW- LITEn/m" structlOn o s000 2000 E Cast Iron Motor Houa. !!er Ma terial to tm Ile 30 volute Power Cord 20 73 M=hanic4l Shaft Sea! Nitrite with carbon and cera faces 5 Fasteners - Sssinlexs Seel 10 ` Shaft -- - —_ -- - -_ Stainless Seeel 2•5 H Upper Sleeve and LoWer Bal Hearings 0 0. 0 20 40 60 90 FLOW- GALLON". WE PUMP PERFORMANCE CURVE Lithe emmt nunp 115V 60"2 PAMs1791000wwbM MOK73137 l4osc. 433472511 • F*& 49.229.1559 Y.�dk www.uttleGLantftlpp.com 4 Form 9%M -07 .�- PLAN page of S OWNews MgNUAL a M OAG �prioNs QOWT gom S auzi� ❑ NA n°x a 0 o� a 144 o NA F tNoda n NA ump•� PT S D M,WW Of 00*0 � © NA Numw of units punnp Tank lam► � y � . EiirrnP � � G/� A ,,.( 0 NA �( C PA Pump Prs t Ut# O post !-aw so® sO Monthly avera3e p SandK Mml F9W o Wedand comw <3c � o M6dmnt al 13 000r. F�08 nor s20 mg & a ti - n geaia. tAI avarase." A (9 T0= Sjjp-ndod QTY O 1A�round � D M`�oun�d � cl Ow- glocheTOW wed S o>Ms Mean I1?Q D tin a � sna yplaowdoossM Fenat Co y inchaameter � Ma>dmum E>t1A pardde Stet Ystass txP 5ecvtce Ft�MuencY 1VtA1t4TENAN� S��u nths yaear(s) tM�murn 3 ors.) Ses+du Eve ank volume C l mo At feast once ever . uaTs one- ttrird (Ys) inspea conedon of tanks) When combined sludge and stun' e4 dam) (Max tuns g yrs - Purnp out eonte� of ta At least once every t3 months s) tnsped disPen o* U(s) M least once evert ❑ s ) O NA CTes� etlluent fir & $ At Wiest once every Q morttl�s s ) p HA W�pact purr+P. PAP At least once svefY a y aar(s} O NA C3 Rush faI and test At jeast once avert Q months II year{ss) ❑ t3A ad+�: At least oncs every one of the �°"� Goons" or IIIIIIIIIII� UMK of tanm C1'IOI cam shag be made by an tnd'evldual cSrrY �n9 � IaOVYrS � or SOPUW bcaisnn . leW bLqwcaans Pity M RestricAW $ews' - PO f th LQ ide roY any a* UP Nlssw � a visual inspeWon at tfse tan k( and as cheefc tot ant bsck ,mWdWsjnUStW my aadra or d- rsPereat of oombTA wed to d�edc�� e t 1s sha11 be I hardumm the $round - , of slftuen# a tt o try surer' The p WAVdb or pondtnl9 and ehodt tier ant Pd r etir+es the lmmedlaLs nofff°sfiOn of the IocaW ^°�'tafY to the oWwwafon p)P� tdon and re4 or nloje of the f8ttic �' R 9� MW a t n9 a and �m in any tank equns ° d'rst� °f to a000rdac ' dz 00 Whitt rite comber �n of etud9 � a Septatge Servjdng Operator. en" ooeb� of the tank shale be - t CWVOne�s, and any 113. Wbetz IM Ad code. r>ic� pressurized POWr'S em ponents. p� ppy� Mahimw Iftn, meths alt be P event. The � of GI � � of .'12 months os less sh of comp of al 9 ` with lod � tie P to i0e local regu�ry aunt ft � or atiw START UP AND OPERATION ent tank(! for lira high are For r0 aonab uc n- o dor to ue � � P�t� arldlar damago the d oed( ) dwmi�ls� the L Pr�� by a Septa9s servtdng of &I � to Low —' dt wMd I paw o( pprsditiorts are frozen the in�a� Surface r gf�d up stlall not �r l WAeR � �Y$ ElOi�nW hjghwa �r �Nels- W p�; is tec tored to mess Systein l�uin9 ova t P tank$ rtlSY p flOad� the CeQ(S) titay remitin the ceii�s} in one Lame dace. tank renurded by s v� be >p fiO Ww W this srtuation have the s Piuet:beect POLNTS MafitamerLa cr o[ or oor�ta badawor Serv�cj9 ppecawpdorW t normal levels within lEse pumR Itl ttlaruggy em per' - OYef OC fJ!'COltlp�#. . a YChid� Ow f� t3i3� f$S �- �ll0t��� arm 010 am Vad" t do � - 8o nog � vlm . � � m0`md or at- grade _ _ aid ft #tur,cl the Vra� #* Petf°n'[ta� M d P fe Red ac of btttis; condoms, cptton swabs< deg% d Of the Pawn anttmiod drams wate �tsnd � � saf�erler os mac k aw da W P�,ctr � sani�ry nap tampons; ID km" Agp,NQON�F -t'lT taken out of service the folfn st sse8_ et the Codee WhM tine POWTS 61 in ooti�piranc8 wi th ch. Comm 83.33. w � is a abandoned 0" pmP�Y and th coaled sl m All P to tanks and Pits SW and propefi' of by a GMPtMe - -qwv k ft O TT�e aor>trn� cf 9z tanks and pft ztmff be Mmove d and mmoved Or thew r cove=g anvw"4md the VOW *PQ ex Alter �+ ail tanks and p a s t fsalT be eXK= tilted Walt soil, 912w8l CommGENCY PLAN g fowMg measures have been. or' must be t� 10 pmide a code It Ile POWT'S fads .d ca uwt be repaired . aornprent n evaluated and may be utilized for the tocaWn o a coal t should ,01 E3 A�� area should be Protected from ds- st�rri�anoe� and wells, Faslur a to Setba� from e;dsVng and proposed struustructure. be i *hVed upon 2[ Suirdble the ptotea alga wig tie.Wit in the need for a new so and sit 6val �hKWnenL s must comply with the rotes in t ih POWYS' D A suimble n ®pfacerssent area is not a�var7abie'due to setback andfor soi[ fIfnitaWns. Barring a tank May be kited as a last resort m replace the u pon POWfS- - a suitable replacement area. Upon reps the PO c rn s is a s tedux*w a vaiia t ale a ne site tras not been. to ielenta area is alNe a ✓ she evaluation must be p to locale a suitable � �eANTS no r+e+P�oe<s'e� r tank rnW be wed as a last resort to replace In Ptaos f00oWhs8 of the bromat at Mmzndand atrgrade soil ° ' 5 be recoastru ith the rotes in erectatfiattirrse �:strtaDe. tc�Jorss of such systarns must camplY w «YtFARfi[tNG» TA NKS MAAY CONTAN LETHAL GASSES ANDIoR MSUFFICM(r OXYts'M SEPTIC, PLMP AND OTHER 3R"TM ff TREATMENT TANK UNDER ANY CIR0JWTMCES. DEATH MAY 00 i40T ENTE{t A 3CPYIC„ pUMp OR OTHER 00 m T_ , RESCi1l: OF A PERSOItI FROM THH VC ERIOR OF A TAN MAY BE DIFFICULT OR lWfPOSSI ADDCfit ?IVAi.. COM�N� tAfI'S iNSTAL.t.ER POVYTS MAINTAINER PO N ame u.• �L Name S1i rz u .✓ 121 S [ Phorte Phone � +GE SERVIC111tG OPERATOR LOCAL REGULATORY AM HOW Y SEPT A Agency jL. 6cL /7 Phone — a / Phone '% s J smd s th>� "se°ts Tt is decvrnmrgVW 46diod bY. the sbfb of the QUM trs W IvtaMuede surd Wtusl= CourstY ZArlUsg ttne m j& =n nquwwnwft of dr. Comm 83.22"XtX and 83 -WI). (2) & (3). Wisoxmb Adink=26" Coda. Ua's of fist doaamV does trot g=sararfiec tht perJoanaaoe of da PolVrs. CBAW (7IDt? f DECEIVED Wisconsin Department of Comi nerce SEP 2 6 200 SOS EV ATION REPORT Page of Division of Safety and Building 5T. CJK8Wo �hm@T*Ith Comm Wis. . Code j Attach complete site plan on NiIJG OFFI E es in siz Plan County S T . C f I' )- include, but not limited to: vertical and horizontal reference point (BM), dire to ares 'on a Parcel I.D. 0 26 - , percent slope, scale or dimensions, north arrow, and location and distance (/ Please print all information. Reese Date ,r� 1f Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1 (m)). tJ Property Owner Property Location Govt. Lot G 1 /45 1 /4 S T E (o W Property Owner's Mailing Address I Lot Block # Subd. Name or CS (j / 2 / D .e a City StatC7 Zip Code Phone Number [:1 city ❑Village Wown Nearest Road Cla- ( ) 2la ❑ New Construction Use: Residential I Number of bedrooms Code derived design flow rate L77� GPD placement i ❑ Public or commercial - Describe: __— Parent material Flood Plain elevation if applicable / I L ft. General comments and recommendations: System Type "Z C/ System Elevation l • Z2 Boring # Boring 'e Pit Ground surface elev. Z1 ft. Depth to limiting factor �_ in. Sal Appl ication 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 0 U 1 z I'-- ej ® Boring # ❑ Boring ® pit Ground surface elev. 46 / ft. Depth to limiting factor Y_ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 ' Effluent #2 = SOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Si re CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 "-) S'— 0 2 715 - 246 -4516 ti t Property Owner _ Parcel ID # Page of F�1) Boring # ❑ Boring �- J pit Ground surface elev. � ft. Depth to limiting factor C�PL,- in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 Gc es— _,7 -� sik y �a 7 lm � rn 'Ofw 6 4- 1-1 104 A , Boring # ❑ Boring Ground surface elev. ft. Depth to limiting factor in. P n9 El Pit -- go — ilApplication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 E] Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil ication Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 - Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg& and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBD -8330 (8.6/00) Property Owner Parcel ID # Page of Boring �-` Fi IL � # Pit Ground surface ebv. , Depth to lirr►idrg factor in• 1 799 A Rate Ficrtaon Depth Dominant Redox Description Texture Struck" Cwaistenoe Boundary Roots GPOlff 'Eff#1 `Etf#2 in. Munse9 Qu. SL Cont. Color Gr. Sz. Sh. 3 a � c s a , _ J .-- M r yz v E ❑ Bo" Bori # ❑ Pit surface elev. ft. Depth to limbV factor in. Rate Horizon Depth Dominant Cow Redox Description Texture Structure Consistence Boundary Roots GPI in. MunseM Qu. SL t:ord. color Gr. SL Sh. 'EB#1 -E f#2 El e« # °m Ground surface sl m CM ay. _ ft. Depth 6n9 I^ Rate Sol Appicogn ❑ Pit. Horizon Don wt Redox Description. Texture Structure Consistence Bax►dry Roots GPM m. MunssM Qu. Sz Cont. Color i r. Sz. Sh. 'Eff#1 • Effluent #1 = BCO > 30 <_ 220 nglL and TSS >30 5150 r g& • Eftent 92 ■ SOD, 1 30 nV& and TSS 1 30 n*41. The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material is an alternate format, please contact dte department at 608- 266 -3131 or TTY 608- 2648777. seo.uwtR.sroo> Soil Test Plot Plan Project Name Fannie Mae c/o Mark Fouts Shau rd Address 1021 Regis Ct. Eau Claire Wi 54701 K"RfM #226900 Lot -- ---- Subdivision ---- ---- Date 9/25/08 SE 1/4 S W 1/4S 13 T 30 N /R W Township Richmond ❑ Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Wood Corner Post System Elevation 99.0' *HRPSameasBenchmark 2.6 Acre Parcel Cty Rd G Existing 4 bedroom house Well Scale = 1/4" = 10' ST DW B -3 8 99.5' Fl F1 B-2 97.5' B -1 7% Slope B.M.* Property Line ST. CROI K COUNTY SEPTIC TANK MAINTENANCE AGREEMFIN'T AND OWNERSHIP CERTIFICATION FORM Owner/Buyer ,* N tiILR-1 a /@ Ai mkiing Address loo-1�` Property Address H c7 for new construction) (Verification from Planning 8t Zomg Dept City /State Parcel identification Number T,F c�AL DES m-TMON .�� 1/. - '/4 , Sec. `r ✓ 0 N R � W, Town of Property Location Lot # __1__. Subdivision ,r Page # Certified Survey Map # � , Volume � Z- , 'Warranty Deed # G 0 p �� , Volume , Page # Spec house no Lot lines i yes no SYSTE 'TENAN� AND O "i°- CERTIFICATION Improper use and mamtenaace of YOW septic system could result in 0 to �e was"M Proper task every three y or sooner, if needed, by a licensed pamaiper• Whitt u mm moaiatcnaace consists of paumpaag out the septic Owner e the system can affect the unction of the septic task as a treatment stage in the waste disposal responsibilities are spocified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ounce' a certification form, signed by the 'Thor pw p�, owner agrees to submit to St Croix County Planning dt zoning Department • that (1) t tc he on-s owner and by a master phm*W. jotaaeyMM pier° restr plumber or a licensed pumper v8 the tic teak is wastewater disposal system is in praper operating condition and/or (2) afcr inspection and pumPm8 (if necessary), sep tic less than 1/3 full of sludge: � �� the private se�rage disposal system with the have read the above r and agree to of Wisconsin Lwc, the unde as the DeparMM t of Commerce and the Departmen of Newral Resources. standards set forth. heroin, as set by has been maintained must be completed and rvh=ed to the St. Croix County Planning & Certification stating that your septi s y� Zoning Department witbin 30 days of the three year exp iration date- Lwe certify that all sffi on this foma are true to the best of my /our knowledge. 11we am(are the owner(s) of the property described above, by virile of a warranty deed recorded in Register of Deeds Office - Numb Mboolms DATE SIGNATURE OF APPLICANT(S) ***** *Any information that is misrepresented may result in the sanitary Permit being reu'°ked by the Plamung & Zoning DeP n A ** 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) Ilflll IIIII IIIII IIIII IIIII 11111 IIII 111111 illl fill 8 6 8 0 3 r} 9 1 868030 KATHLEEN H. WALSH SHERIFF REGISTER OF DEEDS Document Number DEED ST. CROIX CO., WI Drafted by: Duncan C. Delhey RECEIVED FOR RECORD 01/31/2008 09:30AM Return to: Gray & Associates, L.L.P. SHERIFFS DEED E1(E Attorneys at Law , 600 North Broadway REC FEE : # 11.00 CC FEE: 3.00 Suite 300 Milwaukee, WI 53202 PAGES: 1 26- 1040 -50 -100 Parcel Identification Number RE: Regions Bank MVa Union Planters B v. ! Robert T. Milbrandt, et. al., Case No. 07 -CV -370 Pursuant to a judgment of foreclosure entered in this matter, the subject premises was sold at auction to the highest and best bidder, Regions Bank d/b /a Regions Mortgage, successor by merger to Union Planters Bank, N.A.. Therefore, the sheriff does hereby grant and convey unto said successful bidder, all of the following described land, located in the County of ST. CROIX, State of Wisconsin, to wit: Lot 1 of Certified Survey Map recorded in Volume 12 on page 3441 as Document No. 578105 being a part of the Southeast Quarter of the Southwest Quarter (SE '/, of SW '/.), Section 13, Township 30 North, Range 18 West Town of Richmond, St. Croix County, Wisconsin. a SHERIFF - (Strike the inappropriate title) STATE OF WISCONSIN ) )ss COUNTY OF St. Croix County) Personally came before me this _ _ day of 1 IVO , 2007, the above -named , personally known to me as the officer described above, and who executed this document as the sheriff or on behalf of the sheriff of this county. ':ary J. Martell ,, Mary Public —� � ,Notary Public St::,., of Wisconst'n ST. CROIX County, Wisconsin My commission expires N -1; 24 01(7 1 of 1 FILED 578105 APit 2 9 1998 ► C R KATHLEEN H. WALSH Rei6erofDeeds SLC *CO CERTIFIED SURVEY MAP T Ln Located in port of the Southeast Quarter of the Southwest Quarter of Section 13, Township 30 Nor Range 18 West, Town of Richmond, St. Croix County, Wisconsin. ' • w. Prepared for and at the request of: Gar Baillar CENTURY 21 1237 Knowles Avenue North / New Richmond, WI 54017 3 / OWNER: � RMi1 � • 98 AL� f. Steven J. Derrick '- 1438 County Road "G" JOHNSON New Richmond, WI 54017 8--1 AMERY. qL TOT A AREA: < 40 y 114,518 SO. FT. / 2.63 ACRES ii�N4) StJr -*O' AREA EXCLUOIN - I? n W ; 95,875 SO. FT. / 2.20 ACRES UNPt,ATTED LANDS nu4.�ua,wmer NO3� • _ _ _ OF_ _OWNER .T 1 ��f Q -24' �\. S87 24'55 "E 583'43' 4 106.3 ' 34' Ev` NBW35'50 "E �� 130.64' ". 111,37' ` WELL GARAGE 2 ID 1 1 SEPTIC i> z VENTS U o iv !> r� m Ir`♦ V Q NJ . 0 jD I (A C3 C; N lA N N I0 W ly i 0 BU %LD/NC I S£78ACK LINE m 10 O CA It 0 �M 0 S LOT 1 w rn # I V I� N89'03'26'11V 354_82' :Ll 634.35* En - CENTERLINE { C T.N. "G N8908'15'W dL- S - Y --N89 0815 W - - 355.85---- - ��'' -` o --- - -- -- N89'08'15'W 2622.29' -- - - - - -- v sounyorsr CORNER - -- ^ — _ SOUTH L /NE OF THE SW 1/4 O F SE 1 3 (FIV S ,Ia-18 COUNTY TRUNK HI (FND SURVEY NA /L) NK _ _ - _ AY V - UNPLATTED LANDS SOU1H 114 CORNER SEC. 13 -30 -18 (f - ND SURVEY NAIL) NOTE: The parcels) shown on this map Is /are subject to State, County and Township laws, rules and regulations (i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office and the appropriate Town Board for advice. LEGEND County Sectinn Corner Monument of Record • Set 1" x 24" Iron Pipe weighing a minimum of 1.13 pounds per N TH linear foot. Drafted by. Kristi A. EyIandt 100 0 100 JOB #98023 (R14) Prepared by. A & E GRAPHIC SCALE LAND SURVEYING de CIVIL ENGINEERING SCALE IN FEET: 1 inch = 100 feet Phone No. (715) 246 -4319 BEARINGS ARE REFERENCED TO THE SOUTH LINE OF THE 109 East Third Street, P.O. Box 325 SW 1/4 OF SECTION 13, TOWNSHIP 30 N., RANGE 18 W. New Richmond, WI 54017 WHICH IS ASSUMED TO BEAR N89'08'15'W. Sheet 1 of 2 Vol. 12 Page 3441 r CERTIFIED SURVEY MAP Located in part of the Southeast Quarter of the Southwest Quarter of Section 13, Township 30 North, Range 18 west, Town of Richmond, St. Croix County, Wisconsin. SURVEYOR'S CERTTF'TCATE I, Ronald F. Johnson, a Registered Wis(ionsin band Surveyor, herehy certify that by the direction of Steven J. Derrick, I have surveyed, divided and mapped part of the Southeast Quarter of the Southwest. Quarter of Section 13, Township 30 North, Range 18 West, Town of Richmond, St. Croix County, Wisconsin described as follows: Commencing at the South Quarter Corner of said Section 13; thence, on an assumed bearing along the south line of the Southwest Quarter of said Section 13, North 89 degrees 08 minutes 15 seconds West a distance of 634.35 feet to the point of beginning of the par.( -el to be described; thence, continuing along said south line, North 89 degrees 08 minutes 15 seconds West a distance of 355.85 feet; thence North 00 degrees 09 minutes 37 seconds East a distance of 304.54 feet; thence North 88 degrees 35 minutes 50 seconds East a distance of 111.37 feet; thence North 03 degrees 51 minutes 10 seconds East a distance of 30.24 feet; thence South 87 degrees 24 minutes 55 seconds East a distance of 106.34 feet; thence South 83 degrees 43 minutes 34 seconds East a distance of 130.64 feet; thence South 00 degrees 58 minutes 23 seconds p of beginning. Containin be n East a distance of 323.77 feet to the p g g 114,518 square .feet (2.63 acres). Subject to the right -of -way for County Trunk Highway "G" along the south line of the above described parcel and subject to all easements, restrictions and covenants of record. I also certify that this Certified Survey Map is a correct representation to scale of the exterior boundaries surveyed and described; that I have complied with the provisions of Chapter 236.34 of the Wisconsin Statutes and the Subdivision ordinance of the County of St. Croix and the Town of Richmond in surveying and mappi»g the same. Ronald F. Joffnson Reg. No. 1186 Date '^ A & E Telephone # (715) 246 - 4319 Land Surveying & Civil Engineering P. o. Box 325 New Richmond, WI 54017 Epsom Ga ���y RONAW F. JOHNSON Y. i N� SU R'J Vol. 12 Page 3441 Sheet 2 of 2 �� y Parcel #: 026- 1040 -50 -100 09/29/2008 08:21 AM PAG 1 O 1 Alt. Parcel #: 13.30.18.194A 026 - TOWN OF RICHMOND 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 O - REGIONS BANK REGIONS BANK 1900 CHARLES BRYAN RD CORDOVA TN 38016 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description " 1440 CTY RD G SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 2.630 Plat: 3441 -CSM 12 -3441 SEC 13 T30N R18W PT SE SW BEING LOT 1 Block/Condo Bldg: LOT 6 CSM 12/3441 2.630AC Tract(s): (Sec- Twn -Rng 401/4 1601/4) 13- 30N -18W Notes: Parcel History: T e _LLUaO 8 868039 SD 01/06/1999 595143 1393/194 WD 01/06/1999 595142 1393/193 C mor .. 2008 SUMMARY Bill #: Fair Market Value: Assessed ith: 0 � !� 2f Valuations Last hanged: 09/09/2008 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.630 53,200 141,300 194,500 NO 05 Totals for 2008: General Property 2.630 53,200 141,300 194,500 Woodland 0.000 0 0 Totals for 2007: General Property 2.630 43,200 124,400 167,600 Woodland 0.000 0 0 Lottery Credit Claim Count: 1 Certification Date: 09/15/2005 Batch #: 05 -13 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00