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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
L 463224 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:
Derrick, Steve Richmond Township 19,7-(0' 1 1 4 I r /
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No:
OC> cs7 15.30.18. j
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic � � / B ' Zd O Benchmark •C 164 •G /�
Dee+etj Alt. BM 5 1 43 1 C19. 4-7
Aeration Bldg. Sewer
`7• 97 -`I
Holding St/Ht Inlet ` s
TANK SETBACK INFORMATION St/Ht Outlet
TANK TO /L , WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic B ,i , 4Z -L-' zG DtBottom `r
Dosing `j Header /Man. CP
�.3
Aeration Dist. Pipe 2
Holding Bot. System `t T a/
PUMP /SIPHON INFORMATION Final Grade (v 5
Manufacturer Demand St Cover c t
PM �: \�t� 7 •��
Model umber
TDH Lift Friction Loss System He Ft
Forcemain Length Dist. to Well
SOIL ABSORPTION SYSTEM
BED /TRENCH Width / Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 9 '���',_ ,�_* N _.1 I--- %..— N -.—
SETBACK SYSTEM TO P/L BLDG 7 ELL LAKE /STREAM LEACHING Manufacturer: —
INFORMATION CHAMBER OR
Type Of System: ^ (� . j 1 UNIT Model Number: Jam` 'A
DISTRIBUTION SYSTEM - ZZ3 L Z Z = 41 7 ; ' ,_9
Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake
/' Pipe(s) \ \ I. -- � Ve.
Length 12 Dia - 4 Length Dia Spacing f
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 j' No Yes No
COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2:
Location: 1549 126th Street Ne ichmond, WI 54017 (NW 1/4 SE 1/4 15 T30N R1 8W) Cherry Knolls 1st Add Lot 22 Parcel No: 15.30.18.
L ��
1.) Alt BM Description - 7 -,�$^_ t I L " - J-b 5,_
2.) Bldg sewer length = Z( o i� 6 _ e, ' A5
- amount of cover = it
- - -�
Use revis
e others de for information. No
Re q uir ed? J 15
Date 4 Sig ture Cert. No.
SBD -6710 (R.3/97)
Safety and Buildings Division
N viscons i n 201 W. Washington Ave., P.O. T CI M adiso n S Sani Permit Number (to be filled in by Co.)
De artment of Commerce (fig) 6-31 h 3ZZ
Sanitary Permit Applicatio I.D. Number
In accord with Comm 83.21, Wis. Adm. Code, peisamal information puovi U 4 t
may be used for secondary purposes Privacy l.aw, sl5.04(lx �Rp�X OF (if different than mailing address)
a ,
L Application Information - Plante Print All Information
J210 M S?
Property Owner's Name Parcel # i.ot # Block #
s7 - " Pf,-62 i & 411_z
Property Owner's Mailing Address Property location
City, State Zip Code Phone Number
b S( —a�f ?— 519 u or cleone)
T 30 N; RZE �
ll. Type of Building (check all that apply)
❑ 1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name I CBM Number
❑ Public/Commercial - Describe Use l ` I s,
❑ State Owned - Describe Use ❑City ❑V' ownship of
I Type of Permit: (Check only one box on line A. Complete line B if applicable)
A New System 0 Replacement System ❑ TMeatnart/Holding Tank Replacement Only ❑ Other Modification to Existing System
B. ❑ Permit Renewal Permit Revision ❑ Change of ❑ Permit Transfer to New list Previous Permit Number and Date Issued
Before Expiration Plumber Owner
IV. Tym of POV TS :item: Check all that appl
Nan - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑
ir
Constructed Wetland 0 Pressurized W -Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic TIreatment Unit ❑ Recirculating Sand Filter ❑
- Recirculat i ng Synthetic Media Filter 01,eachingCbamber ❑ Dri line ❑ Gravel -less Pi ❑ Other lain
V. Din E!WnP eatment Area )information:
Design Flow (gpd) Design Soil Application Rate(gpdst) Dispersal Area Required (sf) Dispersal Area Proposed (st) System Elevation
DD l 0 7 1 9 9�'7/ 1 9 -r 0.
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Galleon of Units Concrete Constructed Glass
New EXWQS
Talcs Tanks
septic or a f Arid f I ere
Aerobic Treatment Unk
Dosing Chamber
VII. Responsibility Statement - 1, them ass nsiblY for installation o(,the POWTS shown oa the atta ched plans.
Plumb Na me (Print) ( Plumber Si MP/MPRS Number Business Phone Number
7 oD0 v J /NZ 1/`�P 134 Z - 1I 27 ZC W tc
Plumber's Address (Street, City, State, Zip i
X66 7o P `'?'�/ p� o•un -r�� �✓� J 4
V 1111 Coon /De nt Use
❑ Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued issuing Agent Signature (No Stamps)
Sumchsrge Fee)
❑ Owner Given Reason for Denial
1X. Conditions of Approval/Rmons for Disapproval
Attack complete plats (to the Como only) for the system ea paper sot We date 91/3 s 11 iseka V size
SBD -6398 (R. 01/03)
I
/S
POWTS OWNER'S MANUAL &MANAGEMENT PLAN Page of
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner � Septic Tank Capacity ga l ❑ NA
Permit # Septic Tank Manufacturer <�GvJT ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer GAD ❑ NA
Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA
Number of Public Facility Units La iTA Pump Tank Capacity al NA
Estimated flow (average) '/dD al /day Pump Tank Manufacturer NA
Design flow (peak), (Estimated x 1.5) (PpD g al/day Pump Manufacturer NA
Soil Application Rate /7 al /da /ft2 Pump Model NA
Standard Influent /Effluent Quality Monthly average` Pretreatment Unit lh NA
Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand IBOD :530 mg /L n- Ground (gravity) ❑ In- Ground (pressurized)
Total Suspended Solids (TSS) :530 mg /L ❑ NA ❑ At -Grade ❑ Mound
Fecal Coliform (geometric mean) 510 cfu /100m1 ❑ Drip -Line ❑ Other:
Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA
Other: ❑ NA Other: ❑ NA
"Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA
MAI SCHEDULE
Service Event Service Frequency
❑ month(s) (Maximum 3 years) ❑ NA
Inspect condition of tank(s) At least once every: 7 �j - ears)
Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA
At least once ever ❑ month(s) (Maximum 3 years) ❑ NA
Inspect dispersal cell(s) Y Z / V gkyear(s) Ot
N
Clean effluent filter At least once every: ❑ month(s) 44 OrS NA_
year(s)
❑ month(s) NA
Inspect pump, pump controls & alarm At least once every: ❑ year(s)
' ❑ month(s) ❑ A
Flush laterals and pressure test At least once every: ❑ year(s)
❑ month(s) Other: At least once every: ❑ year(s)
❑ NA
Other: NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank
inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface.
The dispersal cellls) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding
of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment
units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
•
Page of
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals
that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents
of the tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at -grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should 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 and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS
technology a holding tank may be installed as a last resort to replace the failed POWTS.
❑ 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 GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name Name
Phone t5 -.– 7_3 r — _ Z_ I. Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Name Sr & ? Ayi v
Phone Phone 7 (, r — 9Aa
This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.5411), (2) & (3), Wisconsin Administrative Code.
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04/28/2005 08:09 FAX 7152352592 T L SINZ PLUMBING INC 16001
� Zxo - �(o`riCo
T.L. S'inz Plumbing Inc.
E5609 708th Avenue Phone: (715) 23S -2644
Menomoitiie, WI $4751 Fax: (7IS) 235 -2592
FAX TRANSNI[TTA�
Date: �-' c No. of Pages:
(including cover)
To: S 7 ' �_(ZL ;If-
Alta:
From:
Subject:
TA v5
Message: ti ff L l ,L
C
Signature:
04/28/2005 08:09 FAX 7152352592 T L SINZ PLUMBING INC 0 002
Safaty add Btdldinga Division Cowty p
201 W. Waahldgm Ave., P.O. Box 7162 J T c / )c
Madison, W1 53707-7162 Muiwy P=& Numbs (to be 09d in by Co.)
Visconsin
ri
Department of Commerce (609) 266.3151
Sanitary Permit Application •, ston PUP LD. Nrm bra•
In a®ed with Cmw 93.21, Wis. Adm. Code, pees W in're - 44 oa you pmvlde
may b: used for sae®dmy puTP Pdacy le.r. sl s.WlXm) PmJst Ad&w (if dIffrsem thm meilm addmu)
! 1. Applleadan Information - Please Print AL Information 157q,9
hapsty Own is Name Paroxl lcr # Black H
5;7 dt YcJG 2l �lL `L
Ptopasty Ovi= Mailing Addtsss pfq=ty i matioea
i L4:3 0 �f 0 0,-%- i o2 D 6--
City, state Zip Cade Phaw Number
jv )e.LJ leans)
T
11. Type of Building (cbw4 all thud apply)
❑ 1 or 2 Family Vw4U%- Nrmbrr of Ba bwms Subdivision Name Cam Number
❑ pubwcmtmamlal - Desaibe Use
❑ - q= t9wnad - Dcumibc Use ❑City ❑VilL6e ❑TowasLlp of
LL1. Type of Permit: (Cbeck only one box on line A. Complae •)loo B It appliaablo)
A New Syah. ❑ Replaoaaaam $yam - ❑ Thatate Waldlag Tank ltepla=9d Oa(y ❑ Olbar Imadwadan to ExisttoB sysltrm
B. ❑ Permit ltmewal Pemolt Ravisim ❑ Change of [I Fwait Taosfc to New ust Piaviow Permit Numbs sod D.te lssued
Befew Farpb dm Pb=*W tanaez
IV Tmw of POWTS Systcw Cbmk all that a pBW
�tJ Nat - Reumbomd h ❑ mac d ? 24 im of suitable soli ❑ Mamd < 24 la of suitable soil . f+tzirv& ❑ SIM00 Paw Sand Filter ❑
Ccasnuaed Wetland [)'Ptawaiakf Took
13 past Four [I Aerobic Tmatment Unit [I Rmhculad^Ag Sand Filter ❑
ltaeareila Media Fllta tlttraha ❑ L tw [I Gavel -less PI ❑ Odw ( lain
V. al/hoeatmeat Aron o q Q, .�,
Dwalp
N o - (mod) Da4a Still Applecahat Rstc(gpdsi) Dlspeasal k a MRWnd (30 E $ F;V= d (d) System Elevation
00 d 7 e -71 ;.ro.
V1. Tanit Info I Capacity i Total Noaaber ManuSetw-' Pnrfab site Steal Frbc Plastic
Glallms CiWOU of Units Crmcrete Camstat*d (tlass
New I Bnia<ioa
rents rsrJrs
Amebic Tmm..w Unk
VAW oW cb.a ba
V11. RaponsibM SW meet- 1, tan nn &rv" WpwAl far Im OdWloa 4 Obe POWrS sanwp ® tae atbohed PWIXm
Piumbds Name ) Pk=bW 8i MP/MPRS Number s „ -:nK- Phone Nuatber
'� - �"Lf l� Q+-1 y - 71 s- a:). - 2 C V
Plumbs': Addmu (Stns!, CRY. Sage. Zap
V11.1. Coon t Us - * Znhr
❑ ,�pptoved ❑ DLsaplaoved �y Pemott Fee (iacludcs eaeuaeltvater Darr Issued Loaning Agent Sigo�taa (No Stamps)
5o�hstge Fee)
❑ Owmt oivm Rearm law Denial
IX Conditions of ApprovaYRrasons for DbsppivvW
Attach mssylsti alts (M tea taoWSry salt) Tor tar ryalm psq► oat bas than atA III laebw V sirs
SBD -6398 (R. 01/03)
04/ 08:10 FA 7152 352592 T L SINZ PLUMBING INC Z003
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of
/'FILE INFORMATION SYSTEM SPECIFICATIONS
' Owner Septic Tank Capacity �oa al O NA
Permit # Septic Tank Manufacturer �� ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer r Gib ❑ NA
Number of Bedrooms Cl NA Effluent Filter Model ❑ NA
Number of Public Facility Units ANA Pump Tank Capacity al Q NA
Estimated flow (average) al /day Pump Tank Manufacturer O NA
Design flow (peak), (Estimated x 1.5) al /day Pump Manufacturer ❑ NA
Soil Application Rate i 7 allday /ft2 Pump Model O NA
Standard Influent /Effluent Quality Monthly average' Pretreatment Unit NA
Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) 5150 mg /L C] Disinfection ❑ Other:
Pretreated Effluent Quality Monthly average Dispersal Call(s) 0 NA
Biochemical Oxygen Demand (BOD 530 mg /L C'�round (gravity) C3 In-Ground (pressurized)
Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound
Fecal Coliform (geometric mean) :510' cfu /100ml ❑ Drip -Line ❑ Other
Maximum Effluent Particle Size Y. in dia. p NA Other: ❑ NA
Other,
❑ NA Other: ❑ NA
'Values typical for domestic wastewater and septic tank effluent. Other ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
ff month(s) (Maximum 3 years) ❑ NA
Inspect condition of tank(s) At least once every: 7 AR ear(s)
Pump out contents of tank(s) When combined sludge and scum equals one -third %) of tank volume ❑ NA
eve ❑month {s1 (Maximum 3 years) ❑ NA
At least once
Inspect dispersal ceills) ever Z � � Ai=year(S)
. �/! v❑
Clean effluent filter At least once every: / ❑ monthis) p_ �3 NA � �$ earls)
❑ month(s)
Inspect pump, pump controls & alarm At least once every: Q year(s)
O NA
' ❑ months) ❑ NA
Flush laterals and pressure test At least once every: ❑ year(s) /
Other: ❑ rrta r(s) (❑ NA
At least once eery: ❑ y ear(s)
Other: ❑\N A
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications!
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank
inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface.
The dispersal call(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding
of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one -third (Y3) or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment
units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority Within 10 days of completion of any service event.
I
04/28/2005 08:10 FAX 7152352592 T L SINZ PLUMBING o INC 0 004
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Safely and Buildings Division County
201 W. Washington Ave., P.O. Box 7162 1
� Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.)
(608) 2T a �
Department of Commerce IP plan D. Number
Sanitary Permi Applicatio " " ` A
e In accord with Comm 83 2t, Wis. Adm.Cormatioa s ro Ad ress (ifdiffero tt than maili address)
may be used for secondary purposes , .04(t \ 4_ I
1. Application Information - Please Print All Information
j , s�9 ia� .sT•
t;L_ocati_.. Lot It Block N
Property owner's Name t
TXv l
Property Owner's Mailing Addreu
X38 T 6r- NO , �. Sf' ��.. Section
City, State Zip Code Phone Number
1 ,,,(circle )
tZ! w Rtc tnnnnd �v 1 �� - 7 St T N: R �lf E o&
IL Type of Building (check all that apply) Subd ision Name / CSM Number
or 2 Family Dwelling
-Number of Bodrootns
❑ PubIWCommercial - Describe Use
❑ State Owned - Describe Use - D ) S l
" 2 3 ❑City ❑Villag e�l'ownship of �
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
ty ❑Other Modification to Existing System
❑ Replacement System ❑ TreatmentMolding Tank Replacement On
List Previous Permit Number and Date Issued
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New
Before Expiration Plumber Owner
IV. Type of POWTS System: Check all that appl
N � SU [p Ground ❑ Mound >_ 24 in. of suitable soil ❑ Mound < 24 in of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter 11 ❑
Constructed Wetland ❑ Pressurized ❑ Holding Tank (I Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter
Recirculating Synthetic Media Filter ing Chamber ❑ Dri Line ❑ Gravel- Pipe ❑ Other (explain)
V. Dis rsal/Traatment Area ' 1
persa Area Propos em Elevation
Design Flow (gpd) Design So' i n lice Dispersal Area Requi aired (s Dis 8`7/ �- O
1 04A9 �� Prefab Site 5 iber Plastic
W. Tank Info C Total Number Manufacturer Concrete Constructed Glass
Gallons Gallons of Units
New Existing
Yanks Tanks
$epiieorJd,wwki•F.nk IZSb
Aerobic Treatment Unit 0t07VO E
Dosing Chamber,��
VII. Responsibility Statement - L the ande eel, assuine asIbIlity for installation of the POWTS shown an the attached plans
MPlMP12S Number Business Phone Number
Plumber's Name (Print) PI s Si
MAP
Plumber's Address (Street, City, State, Zi e)
bo 7 .0 Jr E Ia.yrr�9iG wz
VIII. nt y /De artment Use Onl
Sanitary Permit Fee (includes Groundwater Datel teed Issuing Agen ig re � Disapproved Surcharge Fee) (L
❑ Owner Given Reason for Denial
1X. Conditioi of Approval/Reasons for DisapprovalL, f f . >'A I
a4Z� , (�In / ,, L �vl 17P7 T
l/ �—
Y E M 3 S2 a / v_5 P/ e ka vgh; 1
1 Septic tank, effluent filter and O � / j /� w v t � Q �q�! 9T J
dispersal cell must all be serviced / maintained /pp� en X12 �t �`!l�
er mana nt Ian ro eel by DlumhPr
2. All setback requirements mus ine - fin
to plans (to the County aaly) fs S t them tlrl ha��`
SBD -6398 (R. 01/03) X9449, 3(' z
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TANK SIZI<: �2,�b �_�� 6Ai..LOUS ,003E VOLUME
�I PUWUFACTl4Ki.R: S k`1�a IPJCLIJOI14G SACKfLOW „! 3Z GALLONS
Maor-L NUHet+t: �'� "' CAPACITIES: A= 30 WCKES OK S GALLOWS
SWITCH T� ►C :_..� g �24 tUCMCs cR ,14• GALLOu5
UMP MAAIUPACTIIKGR: „�...` Ge OR 120 GALLOWS
MODEL NUMDER: 3G D� 6 IMCNE.S OR 1 ' 1 ' 0 GALLOWS
SWITCH TAPE: DOTE' PUMP AND AL&KM ARE, TO DL
1'tl111MliJ� CISGNJk1lGC RATE Pr1 lN5TAI,LLO OW 5EPARATE CcKCL;I'rS
ERTtCAL DIFFMI14ce 6ETW[ty PUMP p> STRIOIJTIpi,J pIPE- !Z
FEET
. �,. P E
MIMIMUM WETWORK SUPPLI PKESSUKE _ .J - "mil FEET
FEET OF rORCC MAIM K x'31 FEET
11 % I
ooftfRiCTIOU FACTOR
TOTAL 01iU#,#%jt MEAD — - 13 FEEr �V\
TERWAL. DiMEWS,au` ors rAwK: ZEM67ht _�
__ �W DTH -.-. l ;L,4CuID DCPTH
F 4N l V R
Td Wd00:60 TOOF 2F 'h'eW 8620 ZEE! STZ ON Xdd EINIlS81 IIOS QBIAli6BO : WONA
Performance Wholesale Products Page: 6350 -1
' Section: Performance Data
Data Dated: January 2001
RPM: 1550 Discharge: 1 -1 /Z" Solids: 3/4"
12 40
9 30
W
V1 U..
tz
W Z
-- 6 X20
o =
o SHEF30
3 '
0 0
Capacity -U.S. G.P.M. 10 20 30 40 50
Liters/Second 0 1 2 3
The curves reflect maximum performance characteristics without exceeding full load (Nameplate) horsepower. All pumps have
- a service factor of 1.2. Operation is recommended in the bounded area with operational point within the curve limit. Performance
curves are based on actual tests with clear water at 70° F. and 1280 feet site elevation.
Conditions of Service:
GPM: TDH: 19 6 ? 0 HYDROMATIC
RECE .._._ ._
Wisconsin Department ofCom' erce SOIL EVALUATION REPORT p 1 of 3
� Divisiiyn of Safety and Building ' pD
A Pla a"ak�W Cornm 85, Wis. Adm. Code
County St. Croix
Attach complete site plan pape 1 U2x 11' as in size. Plan must
include, but not limited to: v 'cal a be poi (BM), direction and Parcel I.D. Pending
percent slope, scale or di cati d distance to nearest road.
Please print all information. Re Daft
Personal information you provide may be used for secondary purposes (Privacy law, s. 15.04 (1) (m)). Y ' a
Property Owner Property Locatio
Steve Derrick Govt. Lot 1/4 SE 114 S 15 T 30 N R 18 E (or)W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
1438 County Rd G 22 - I Cherry Knolls 1st Addition
City State Zip Code Phone Number DCity []Village own Nearest Road
New Richmond I WI 1 54017 1 ( ) County Rd G
E] New Construction UseE] Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD
0 Replacement Q Public or commercial - Describe:
Parent material Loess over outwash Flood Plain elevation if applicable NA ft.
General comments This site is suitable for a conventional below grade system
and recommendations:
a El Boring # 11 Boring
Pit Ground surface elev. 99.05 ft. Depth to limiting factor >90 in.
Soil Applicaition 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
1 0 -11 10yr3 /2 - sil 2msbk mfr as 2f .6 .8
2 11 -22 1 4/4 sil 2msbk mfr cw if .6 .8
3 22 - 7.5yr4/6 is Osg mvfr c - .7 1.6
4 32 -90 7.Syr5l8 s Osg ml _ - 7 1.6
2 Ong # Boring 98.45 >90
0 pit Ground surface elev. ft. Depth to limiting factor in.
Soil Apprication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 - Eff#2
1 0 -9 10yr3 /2 sil 2msbk mfr as 2f .6 .8
2 9 -29 1 4/4 Sil 2msbk mfr cw if .6 .8
3 29- 7.5yr4/4 - sl lmsbk mfr cw if .4 .7
4 / 36-90 7.5yr5/6 - s Osg ml - - .7 1.6
5 . a'
*
Effluent #1 = BOD > 30 220 mg/L and TSS >30 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg1L
CST Name (Please Print) Signature _� CST Number
Thomas C Nelson
��� �—` 227387
Address Date Evaluation Conducted Telephone Number
1432 120th Street, New Richmond, WI 4/1/04 715 -246 -2454
Property Owner Derrick Parcel ID # Pending Page 2 of 3
Boring
1- 7 Boring # E] Pit Ground surface elev. 98.05 ft. Depth to limiting factor y90 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Lure Consistence Boundary Roots GPDhF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Efr#1 'Eff#2
1 0 -10 10yr3 /2 - sil 2msbk Mfr as 2f .6 .8
2 10 -22 1 4/4 - sil 2msbk mfr cw if .6 .8
3 22 -32 7.5yr4/4 - ifs Osg mvfr cam' if .5 1.0
4 32 -90 7.5yr5/6 - s Osg ml - - .7 1.6
F-1 Boring # Boring
Pit Ground surface elev. ft. Depth to limiting factor in.
Sal ication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/R
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Etf#1 "Efr112
❑ Boring # Boring
Pit Ground surface elev. ft. Depth to limiting factor in.
Sal Appkation Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Efr#1 "Efi#2
" Effluent #1 = BOD > 30 <_ 220 mgA- and TSS >30:5 150 mg/L " Effluent #2 = BOD < 30 mglL and TSS < 30 mglL
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- 833OTed (R.mroo)
Cherry Knolls 1st Addition.
lot 22
NW Lot corner 100' 6 OF
BM1
BM2
21
29'
l og 173'
B2
7B1
98'
2%
slope 131'
B3
Scale 1" = 3
89 , 0'
BM1 Top of iron pipe 100.W
BM2 Top of conduit pipe 99.95'
B199.06
B2 98AU
B3 98.05'
Thomas Nelson
227387
Nort
r
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of 2
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner .5rEVE b C ;� C Septic Tank Capacity a l 13 NA
Permit # a� Septic Tank Manufacturer /C�UCC 13 NA
DESIGN PARAMETERS Effluent Filter Manufacturer W o�_6 ❑ NA
Number of Bedrooms q ❑ NA Effluent Filter Model ef�y o — rijgE ❑ NA
Number of Public Facility Units A Pump Tank Capacity a l ❑ NA
Estimated flow (average) () gal/day Pump Tank Manufacturer ❑ NA
Design flow (peak), (Estimated x 1.5) 600 gal /day Pump Manufacturer ❑ NA
Soil Application Rate '77 al /day /ft2 Pump Model 3 b ❑ NA
Standard Influent /Effluent Quality Monthly average* Pretreatment Unit NA
Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BOD 530 mg /L ❑ In- Ground (pressurized)
Total Suspended Solids (TSS) 530 mg /L NA ❑ At -Grade ❑ Mound
Fecal Coliform (geometric mean) 510 c 100m1 ❑ Drip -Line ❑ Other:
Maximum Effluent Particle Size Y. in dia. ❑ NA Other: ❑ NA
Other: E3 NA Other: ❑ NA
* Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Z ❑ month(s) (Maximum 3 years) ❑ NA
Inspect condition of tank(s) At least once every: ear(s)
Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA
Inspect dispersal cell(s) At least once every: 2,-2 ❑ months) years) (Maximum 3 years) ❑ NA
Clean effluent filter .415 /V�-��� ❑ year (s) At least once every: �� m ) ❑ NA
lsl
l�
- 0 - month(s)
) ❑ NA
Inspect pump, pump controls &alarm At least once every: ❑ yearar((ss) )
Flush laterals and pressure test At least once every: .13 months) ❑ NA ❑ year(s)
Other: At least once ever ❑ month(s) ❑ NA
y: ❑ year(s)
Other: ❑ NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank
inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface.
The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding
of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment
units, and any servicing at intervals of :512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
Page 2 of 2
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals
that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents
of the tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at -grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or.must be taken, to provide a code compliant
replace nt system:
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 and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS
technology a holding tank may be installed as a last resort to replace the failed POWTS.
T
alua ' a o ing ank
be ' e ai e �fZD}dl'�5 i�T
Die- A16W 40NS"TK(lC-qlD
❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
< <WARNING> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name -7 1, S) /'j -Z-- Name
Phone - 7/ S — Z 3 `� Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Name s'T', C l d U N / ZDll�l
Phone Phone —7/S— 3�(�_ (0 (7
This document was drafted in compliance with chapter Comm 83.22(2)(b►(1)(d) &(f► and 83.54(1), (2) & (3), Wisconsin Administrative Code.
ST CROIX COUN'T'Y
' SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICA'T'ION FORM
o
Mailing Address 14 1 a
Address i.�t X1.
Property artment for new construction)
(Verification required from Planning DeP
City/State « ��
w o Parcel Identification Number �^
T,EGAL DESCRIPTION
R, c�mcn d
N E '/4, 5L '/4, Sec. is 'I' 3 N- R.I W,� wn of
property Location —
�c H 4115 Lc� �.z 1�4
Lot # zZ
Subdivision adct
Certified Survey Map #
Volume _, Page #
ZS bo Page #
Warranty Deed #
,Volume
Spec house X yes ❑ no Lot lines identifiable A y es ❑ no
SY STEM MAjNTEN emature failure to handle wastes. Proper maintenance
Improper use and maintenance of your septic system could result in its ed Y b a licensed pumper_ What you put into the system
consists of pumping out the septic tank every three years or sooner, if need
can affect the function of the septic tank as a treatment stage in the waste disposal system.
The property owner agrees to submit to St. Croix Zoning
= cut a certification form, signed by the owner and by a
verifying that (1) the on -site wastewater disposal system Dqw
master plumber, journeyman plumber, restrictedplumberor a licensedpumper tic tank is less than 1/3 full of sludge.
is in proper operating
condition and/or (2) after inspection and pumping (if necxssary), septic
to maintain p 1 s
is and agree the private sewage dispose sy stem with the standard
�, the undersigned have read the above requirements eut of Natural Resources, State of Wisconsin. Certification
set forth, here' as set b ent of Commerce and the Departm Office within 30
that ti teen maintained must be completed and returned to the St Croix County Zoning
T &ja of thin y eXpirion date. / / D
Wt
DATE
OF APPLICANT'
OWNER CERTIFICATION knowledge, I (we) am (are) the owuer(s) of
I (we ce that all state ents onathis form are true to the best of my (Our)
the r above, by a of a warranty deed recorded in Register of Deeds Office.
' DATE
GNA OF APPLICANT
rnu b e i ng 't
revoked by the Zoning Department .
00 Any information that is mis- represented may result in the sanitary pc
m
warranty deed from the Register of Deeds office
••
include with this application: a stamped ma if reference is made in the warranty deed
a copy of the certified survey p
U- 2 5 8 0 P 0 8 3 K ATHLEEN H. W ALSH
STATE BAR OF WISCONSIN FORM 7 - 2000 REGISTER OF DEEDS
TRUSTEE'S DEED ST. CROIX CO.. WI
Document Number
RECEIVED FOR RECORD
WILLIAM H. DERRICK and MARY ANN DERRICK 05/25/2004 09:10AN
TRUSTEES DEED
as Trustee of WILLIAM H. AND MARY ANN DERRICK LIVING EXEMPT It
TRUST DATED JULY 10, 2002 REC FEE: 13.00
for a valuable consideration conveys, without warranty, to STEVEN J. TRANS FEE: 60.00
DERRICK a married person COPFEEEE:
PAGES: 2
Grantee, the following described real estate in ST. CROIX
County, State of Wisconsin (if more space is needed, please attach addendum):
SEE ATTACHED
Recording Area
Name and Return Address
STUART J. KRUEGER
RODLI, BESKAR, BOLES & KRUEGER, S.C.
219 NORTH MAIN STREET
RIVER FALLS, WI 54022
26- 1045- 90-050 26- 1045 -80 -080
26- 1045 - 90-050 26- 1045 -95 -000
Parcel identification Number (PIN)
This is not homestead property.
NY$) (is no
Dated this a� day of MAY 2004
• MA Y NN DERRICK WILLIAM H. DERRIC
Trus a Trustee
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN )
) ss.
ST. CROIX County )
Personally came before me this day of
authenticated this day of MAY , 2004 the above named
WILLIAM H. DERRICK and MARY ANN DERRICK.
TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing
(If not,
authorized by § 706.06, Wis. Slats.} instrument acknowl ged the same.
e
HE {D1 L. LUTZ
THIS INSTRUMENT WAS DRAFTED BY w —emu_
STUART J. KRUEGER Notary Pub t , e ISCONSIN
RODLI, BESKAR, BOLES & KRUEGER, S.C. My Commission is permanent. (If at, state expiration date:
(Signatures maybe authenticated or acknowledged. Both are not necessary.) 0142 _ )
' Names of persons signing in any capacity must be typed or printed below their signature.
STATE BAR OF WISCONSIN
TRUSTEE'S DEED FORM No. 7 - 2000 INFO -PRO ( 800)655 -2021 www.infoproforms.com
U 2580 P 08�i
PART OF THE NORTHWEST QUARTER OF THE SOUTHEAST QUARTER AND PART OF THE NORTHEAST
QUARTER OF THE SOUTHEAST QUARTER OF SECTION 15, TOWNSHIP 30 NORTH, RANGE 18 WEST, TOWN OF
RICHMOND, ST. CROIX COUNTY, WISCONSIN AND DESCRIBED AS FOLLOWS:
COMMENCING AT THE NORTH QUARTER CORNER OF SAID SECTION 15; THENCE, ALONG THE
NORTH -SOUTH QUARTER LINE, SOUTH 00 °12'54" EAST A DISTANCE OF 2654.31 FEET TO THE EAST -WEST
QUARTER LINE; THENCE ALONG SAID EAST -WEST QUARTER LINE, SOUTH 89 EAST A DISTANCE OF
10.31 FEET; THENCE SOUTH 00 °00'34" wEST A DISTANCE OF 4.24 FEET TO AN IRON PIPE, BEING THE
MONUMENTED CENTER OF SECTION 15 AND THE POINT OF BEGINNING OF THE PARCEL TO BE
DESCRIBED; THENCE, ALONG THE NORTH LINE OF A LAND CONTRACT RECORDED IN VOLUME 699, PAGE
295 AT THE REGISTER OF DEEDS OFFICE OF ST. CROIX COUNTY, SOUTH 89 °49 - 40" EAST A DISTANCE OF
939.05 FEET; THENCE SOUTH 00 °00'23" EAST A DISTANCE OF 221.02 FEET; THENCE SOUTH 26°20'21" EAST A
DISTANCE OF 405.03 FEET; THENCE SOUTH 19 °49'46" EAST A DISTANCE OF 66.31 FEET; THENCE SOUTH
27 °39'09" EAST A DISTANCE OF 462.82 FEET TO THE NORTH LINE OF CHERRY KNOLLS; THENCE ALONG
SAID NORTH LINE, SOUTH 56 °15'44" EAST A DISTANCE OF 196.99 FEET; THENCE SOUTH 84 °47'17" EAST A
DISTANCE OF 479.73 FEET; THENCE, ALONG THE ARC OF A CURVE CONCAVE TO THE SOUTHEAST, A
DISTANCE OF 142.43, SAID CURVING HAVING A RADIUS OF 367.00 FEET AND A CHORD THAT BEARS SOUTH
03 °43' 12" WEST A DISTANCE OF 141.54 FEET; THENCE NORTH 86 °39 EAST A DISTANCE OF 796.72 FEET TO
THE WEST LINE OF SAID LAND CONTRACT; THENCE, ALONG LAST SAID WEST LINE, NORTH 00 °00'34" EAST
A DISTANCE OF 1225.08 FEET TO THE POINT OF BEGINNING.
INFO -PRO (800)655 -2021 www.infoproforms.com
RRr KNOLLS IST. ADL
(A COUNTY PLAT)
part of the Northwest 114 of the Southeast 114 and part of the Northeast 114 o
Section 15, Township 30 North, Range 18 West, Town of Richmond, St Croix Count;
:W
N
UNPLATTED LANDS SEE SURVEYOR 4
- --
AT TED E D L N D S REPORT ON THIS AREA o
ist -West 114 Line - S89'44'10 ° E 5301.80-
S89'49'40 "E 939.05'
452.14 i 96.84' - 191.58'
North line of Lond Contract ��� a-j
Volume 699, Poge 295 i �w� ,6 0•
I = N O
LOT22
�T 2l �aao 78,930 sq. ft. O N
^9 sq. ft. �' 1.81 acres rte, o of O
1 acres o. o� `; � LOT m
• h '�
95,896 sq. ft.
• �" � 2.20 acres
�s• •
S' • • ' '� 's" "F,
3y F .30' Droinoge
• / / �� j ,i Easement ,�
"
. • c4 N79.50, 47 E
• 243?
al 7. ft.
_ _
I .6
o
e s
• � ` IObDI� tJd�
O �
1 M O► 1 ' •
' LOT 24 .0.
78,549 sq. ft. �� LOT 27
' h
,,°j •o``� h G '� 1.80 acres F 79,589 sq. f
5 "E o �.• ^„`� o •� 1.83 acres
r <v '
ZI 4
,r 5
.o� ^o : ^ S7�274�E
/ A ��. • 2 an o