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HomeMy WebLinkAbout026-1049-80-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division ` INSPECTION REPORT Sanitary Permit No: 488234 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: Germain, Gregory Richmond, Town of 026- 1049 -80 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: Pj {Y1 I . CS 17.30.18.253 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. 1 Septic Z • Benchmark 1460 ( so /a6.5 /ap Ra to k 5z5 Alt. F k Cb k�'. Aeration Bldg. Sewer , Holding St/Ht Inlet Z I IS 1163 SS St/Ht Outlet TANK SETBACK INFORMATION 3• YZ /63 . t9 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 166 (A0 7 56 / %750 Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Z. 49 3. Holding Bot. System C� PUMP /SIPHON INFORMATION Final Grade 9-Z7 `i7• Z3 Manufacturer Dema St Cover i$, f040 6 Mod umber T, 13. z z- '3 . Zg TDH Friction Loss System TDH Ft T 3, ON 93.2 Forcemain Length Dia. Dist. to Well -J - SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pf .,, Inside Dia. Liquid Depth DIMENSIONS \ INFORMATION SYSTEM TO P/L BLDG WELL LAKE /STREAM CHAMBER OR Manufacturer: �Z ��c�5 Type Of Syste f os� ' rW � i 7 75 / / UNIT Model Number :� �_ovWe DISTRIBUTION SYSTEM N t N = Z'9 o Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intakq ' Pipe(s) %-�— ` /0 44- r Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of d / odded 1 xx Mulched Bed/Trench Center 3 CIS Bed/Trench Edge s\ Topsoil N'11' xx Seede Yes M No Yes Ffi] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1557 100th St New Richmond, WI 54017 (SW 1/4 NW 1/4 17 T30N R18W) >35 acres Lot Parcel No: 17.30.18.253 1.) Alt BM Description = �, , �J ;�'- Cta: ,`S 4- LO,." 6 n 2.) Bldg sewer length = , O 1 - amount of cover = 1 ✓ d Plan revision Required? 0 Yes J )<No 6f / 3 Use other side for additional information. 2 �o SBD -6710 (R.3/97) Date Insepctor ignatur Cert. No. RECEIVED .� JUN 1 2 ' S turd Buildings vtsitm ottn - W. w ington Ave., P.O. Box 7162 -y Air M Wl 53767 - 7162 Sanitary Permit umber (W be fil in by Co ) =SI. CR01 COUNTY (rnrti�ztaiZ De artment of Com erce 3 S a nitary Permit Application s:aae Plan l D. Number In accord with Comm 83.21, Wis. Adm. Code, personal informatio t you provide may be used for secondary purposes i rivary i.aw, A S.irici jcmj Project Address (if ditferent Wan nailing address) L Application Information - Please Print AU Information S rro Owner`s Name iU Block 8 CCU (o W �f ��'o ,n , a53) Property Owner ad mg Property I ti �� ,-Q __ S Vs 10 %, Section `7 City, O{ Zip Code / y Phorx Number �r ��y 2 f� 1 1 I 3 2 r T JON. R" ll. Type of Building (check all that apply) l..p� t or 2 Family Dwelling - Number of Bedrooms ❑ Publio Commercial - Describe Use 41 C1 gt'Q�_4A. U State Owned Llcity Uvithtge ownship of ofi III. Type of (Check only one box on tine bte One B if applicable) A ' f l- l NWw Svaf�{n ��rr'' Rwdwa•n� ^t Q�rcMm n Troah+•...tJfJ•.lai ^ro Tawb v.. M �. n MI.e. 1 Iw'� ti,,, ,.u»'v,: w C••:•.•:•• rf B. ❑ Permit Renewal /❑_ Permit Revision ❑ Change of ❑ Permit Transfer w New Lid Previous Permit Number and Date issued Before Expiration Plumber Owner IV. Type of POWTS S Check all that a ppW IC14ot -Pressurized bWAmu ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. ofsuitable soil ❑ At -Grade ❑ Sires Pass Sand Filter r ❑ c�iu ctrl Rrty{I wErlwn.� fl pMgc...�+nri ,..f rr .�A n rrominr ^- Ttmk O Pea cil n - rr�i� T:.°rrr°.^.t L� O R =circ :�wau b o_�., c:....- 0 Recirculating Synftft Media Filter OLeachinChamber ❑ ' lime iMiravewcss Pipe ❑ Outer ( sin) V. D reaft t Area Information: Design Flow (gpd) Design Soil Applitxtion Rate(gpdsf) Dispersal Area Requited (st) Dispersal Aux Proposed (sf) System Bkvatron a 1 7700 1 q3.-'-), VI. Tank Info Capacity in Total Number Matufacum Prefab Site Steel Fiber Plastic Gallons Gallons of Units V , � oncr I `ete Constructed Glace Tarim Naov F.xiuinR Tanks Tarim i Ttuic 0 " oPS AereWc Tieatatant lhr& &.Man inamwc VII. Ittespo Statement 1, respoasibillty for of the POW'l'S shown on the attached phnas. Pnba's Name Si /MP JwNumbcr Business Plwne Number Plumber's Address (Street City, State, Zip Code) P VIM CounVMMirtment Use Onl pproved ❑ Disa veil Sanitary Permit Fee r tiles Groundwater Date Issued u gait S' (No Stamps) Surcharge Fee) ❑ for Daniel � I IX. Conditions App v W �, " II SYSTEM OWNER: 3)t S -, Io X40 1 Septic tank, effluent filter and D�.� dispersal cell must all be serviced / maintained 6 1 - as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. Atireh pwpWe plans (to the County ody) for the sysaus an papeo art ten dun alit s I 1 inches in site SBD -6398 (R. 01/03) Pl ot Pk�� N wy S ec. l 13b►v ►21 g�J 15 r t oat ` • P� woo n N `e-� �`C�n►�,o �- j ot 7 5 � ars.� ---- i,� b - 7 d 9 3. u c v U��(;ez y ' 3 Go i 15 5 Y (oat`'• P� w�� �s 7' h - e -� C_ \'I.,, A., Wl� Sy ID u� log @ 9 u ' - s o�p �►'� � , w�� � �I h wm�� �dS� �°' � � /QO . R t`r 8w. - T� �c qq , 7 ��a ej r MACCnsingprbnentdCanine w� as. v+ IL EVALUATION REPORT Pape or RE EIV In uaw c , I I 4, ,���. Planwast `�'` GP fw"h " udbeoft"o aabwMit r:�UNTY puiag M AmAprs o4km ° s' Mw ST. G ..w _ ..r srwr�wrAr•ar � ISM MOM* r ` ovate S a i n 1vow 8 T 3 N R( E w ties s suaa N.wsar qc M ay ovai P TO e ILL -3 c lis 3 Nwr000AMbn tkwE3 R - 1 MiIMMA rdbedotaa< Coft 1 1 desbnfvMrale 5 BPD D Pweraa•aomm� -a.a�c �t.w woodw,tRar. rap -- d dadtt. D o ® ju Ptt ssYoe�w 7 / p�,lo,irgiotir ° op Me tloiilop D40, am"" A, -ftwofte Twsw hoofs �+. woo OL ooAC Cator o� sc sk '� '� sbk -3 0-5 7, !o S m StrK M r 7 i " Z 5 7,5', w — Sal- t7 >'� lw - 2. °'oft# Amplolmm IL omplh ID boomindw — bx New oo otsi.4 a.aeRa.a".,... saw. eo+�x tn. rtan. CAL OIL ceut otrar 8r. sz sk + o_ /v F 3 s , �► SDK ►m -�rr- e rn D w, Y►1 — /. Z 36 z • somtn = Koo as <M..pL mdTU 3-= : S Malt. tipat Or syeaas:: :s a or 1 • • �♦ + a _ 1 I _ P. �Y i ,. .� �31��!��- E�iit��i ®�il� ���i!i� 1��"�i�[�� � � _ i �. �...,. �. ®r ���� �����������®r �tr�■■������r��� e���r� r®���r �����r�s�s � � � t i _ Sri i r�s�s��s ��i®�����s���� � � � A i � �I 1p_ or G 'e����, s�,�l� �JLOV ���I7 r l 5 IOo 7C �cvnto�lc� �c 1\ k-�rnoA zv o / 7 S cf O�CJI Asa-» --ab 5 r / b A-0 k o� i EZ1203H evvovve "�•"•: • "• vovvvvv 'ti,. , `7 • :• *�..r::. ,� vovvvvv vovvvvv `. _ •1t, ,; vvevevv _, ., Vv .a,� ,. OOttetO :: WVTV 12 24 „ ! .` ttltl vo `'H' vvo 4.625 v v V t1 vvo vVv vv vvo 1 �+ 1O D)�,1 O t V vvv v 1/2 Clxc. 1 vvv Vtt vvv otv vvo vvv vovvvvv otvvv v -• e VVVV V O VVVVV VVVV VVV Ve VtetV O V00000 VtVV VVVV VV VV eVVvttVV VVVVVVV vVVVVavVVVVVVVV vovvvvv 24 ------ - ® BOMDnt • 36 Void Volume SoIJ tnterface Area In. to EL :?g Ft Void Coefficient in Aggmgate given at 57.4%. y 18.84in O.D. of 4" pipe = 4.625 inches Sidewa)l (2 Sidewails) 2 3.14 IZin = Void volume per linear ft. = 3.14 •( 23125in )' tft a 0.1 l7 ft l 12i / ft J ' Bottom 2.00 O.D. of center cylinder —T2.5 inches Total Soil Interface Area 5.14 SQ.FT Void volume in a y 6.25in _ 2J 125in 1 aggregate o f center cy = 3.14 • 3.14 ' 2in /ft 1 • .574 = .422 W 112id /ft) ( t ) O.D. of outside cylinders - 12 inches Projected Trench Area Void volume in outside cylinders = 2.3.1 bin y �t2in /fo •574= •901 ft Sidewall Height - 12 in. '2 - 2.00 Sq.Ft. = Void volume at bottom between cylinders = (( tam 6m bin 12in /ft ' Bottom 36 in. - 3.00 Sq.Ft. t2/fc ( 12 6i 'Jl '0.215 ft ProJected Trench Area 5.00 Sq.FL /Jl Void volume - at outside bottom corners (112 afvoid volume between cylinders) 0.215 / 2 - 0.108 ft' Total void volume — 0.117 + 0.422 + 0.901 + 0.215 + 0.108 - .763 cubic ft J it Gallons per ft = 1.763 X 7.48 = 2 ealtens per li near f. 36 YA tr Er�S Aggregate Trench System EZ1203H EZ�,�`Zow Ring lndustrial Group 65 Industrial Park Rd. Oakland, - W 8 aN 060 SCALE FILE HAMe; EZt2o3H -vat SFIEET: 1 of , 11 —a7—Ot , POWTS OWNER'S MANUAL & MANAGEMENT PLAN page -J of ALE INFORMATION Ow SYSTUA S�FlCATIONS Owner Permit # r [Eff Tank Capacity al D �3 NA Tank Manufacturer 0 NA t� RON PARAMETERS Effluen Fitter Manufacturer Q NA Number of Bedrooms 13 NA t Filter Model L O NA Number of Public Facility Units NA Tank Capacity � ❑ NA Estimated flow (average) ai /da Tank Manufacturer ❑ NA Design flow (peak). (Estimated z 1.5) ai/d Pump Manufacturer O NA Soil Application Rate r ai/da /h� Pump Model ❑ NA Standard influent/Effluent Quality Monthly average- Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg /L 0 Sand /Gravel Filter 0 Peat Filter Biochemical Oxygen Demand (BOD 5220 mg/L 0 NA 0 Mechanical Aeration 0 Wetland Total Suspended Solids (TSS) r:53O mg/L ❑ Disinfection 0 Othe Pretreated Effluent Quality Monthly average Qispersa► 6ell(s) ❑ NA Biochemical Oxygen Demand (SOD.) mg /L in- Ground (gravity) 0 In- Ground (pressurized) Total Suspended Solids (TSS) mg/L 0 NA gAt -G rade ❑ Mound Fecal Coliform (geometric mean) 510` cfu /1 OOmt 0 Drip -Line iD Other: Maximum Effluent Particle Size Y in dia. 0 NA Other. 0 NA Other. ❑ NA Other. 0 NA "Value typical for domestic wastewater and septic tank effluent. Other. ❑ NAJ MAflItTENANCE SCHEDULE Service Event Service Fhm Inspect condition of tank(s) At least once every: ❑ rrtortita(s) (Maxkrium 3 Veers) 0 NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank vohame ❑ NA Inspect dispersal cell(s) At least once every ❑ month] s) ( Maximum 3 yams) ❑ NA Clean effluent filter At least once every: ❑ month(s) ❑ NA ears) Inspect pump, pump controls & alarm At least once every: 0 month(s! 13 NA ❑ ear(.} Flush laterals and pressure test At least once every: ❑ month(s) Q NA Other E3 yearfs) At least once every; ❑ nunithfs) Other: veer($) f7 litX► ❑ 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 ResWcted Sewer; POWTS Inspector; POWTS Mainta'aner, 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 cells) 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, Mail be performed by a certified POWTS Maintalner. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION gage of For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that m8Y knPede the treatment process and /or dame" the dispersal ceNis). If high concentrations are produced have the contents Of the tank(s) removed by a septWe servicing operator prior to use. System start up shall not occur when soli conditions are from at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess.wastewater d charged to the dispersal will be MOO) in one twos 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 !'ktmber or POWTS Maintaater 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 strewn 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; gasoliae ;. grease; herbicides: meat scraps; medications; oil; pig produce; pesticides; sanitary napkins; tompmas; 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 at he system ' ann9_ eps that t y 1s Property and safety abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • Ali 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 wad 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 &rfringed upon- by nmWff d setbacks from existing and proposed structure, lot lines and wells. Failure to protect the repiacenent area will result in the need for anew soil and site evaluation to establish a suitable replacement area. Replacementsystains must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Bening 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 avail eplacemen clue a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and "rade soil won systems may be reconstructed in place following removal of the biomet at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that rime. < <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 COMMi3NTS POWT$ INSTALLER POWTS IAAWTAMIER Name Name Phone C Phone SIFFAGE OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name S O Phone phone c Taws document was dratted in compliance with Comm comPn chapter m 83 22t libil7lldl &lfl and 83.54(l), (2) A 131, Wisconsin Administrative Code. . ST. CROIX COUNTY SEPTIC TANK MAINTENANCE E AGREEMENT AND OWNERSHIP CERTIFICATION FO RM Owner/Buyer p e Mailing Address O0'V�^ Property Address (Verification required from Planning & Zoning Department for new construction.) City /State Parcel Identification Number oa( �,� g 0 . eY 2 LEGAL DESCRIPTION ©01.(0 I 0 �{q -7 Q K Property Location t,t) %4 IUtJ `/4 ,Sec. ---, T _3) R_18 W, Town of Subdivision S , Lot # Certified Survey Map # -- Volume Page # ' Warranty Deed # ,Volume _j / ,Page # d Spec house yes Lot lines identifiable 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 fo owner and by a master plumber, journeyman plumber, restricted plu, signed by the proper operating wastewater disposal system is in o condition after inspect nd pumpin p r veri necessary), 1) the on -site and/or m less than 1/3 fu of sludge. p p g m ber or a licensed a {i f ary), he septic tank is 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 re f the turned to the St. Croix three year expiration date. County Planning & Zoning Department within 30 days Uwe certify that all statements on this form are true to the best of my /our knowledge. Uwe am/are the owner Property described above, by virtue of a warranty deed recorded in Register of Deeds Office. (s) of the Number of bedrooms ,3 IGNA OF APPLICANT(S) / �/ < *, p DATE Y Information that is misre resented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** g nclude with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey ma if eference is made in the warranty deed. p REV. 08105) W j, DOCUMENT NO PRANI THIS SA 1 :Z REiERVED FOR Ri DATA WATY THIS STATE BAR OF WiSCONSIN FORM 2-1962 UEGISTa'S off ,CE VOL ST CRU . kA A47 R"Id tw F Vftrnon,J. .Ger%ain and P8 Germain, -- husband - and -wife, I . MAY 16 1995 as joint .tenants. - .. . .. .. . ........... I .... 11 .. ....... ..... . ..... ... .. . . at 9:00 A ?J ... .. .. . .. ....... . ... ..... ... . .... .......... ....... ' 01 ---- -------- - conveys eys and warrants to .. Gregoxy .... Germain .... Ir d ...... ............ ........... .... . ...... ..... .. ...... ..... ....... - . . .... . ..... ....................... ------- ...... ........... . . ........ .......... ... ..... .. ........ ..... ........ I ...... ........ ---- ------- ---- ----- Sa o .................... . ..... . ....... . ... ....... ........ j jC 'TO ......... . arm Credit Services .................... ... . . .. . ..... ....... . ..... 186 County Road "U" i; the following described real estate in ... .. .. St.-Croix ... ..............Count : 'River Falls, W1 54022 State of Wisconsin: West Half of Northwest Quarter (Wj of NW}) of Tax Parcel No: .............. ............. Section Seventeen (17), Township Thirty (30) North, Range Eighteen (18) West, EXCEPT North 830 feet thereof, AND EXCEPT Lot I of Certified Survey Map in Volume 8 of Certified Survey Maps, page 2119. q EFL EXEMPT iI This ........... homestead property. (is) (is not) Exception to warranties: it Dated this . ... ....... ........... .... day of . ...... Ma 5 -9 AMMS Viewer Page 1 of 1 T 1 1 � jk h° A i http: //72.21. 230.178/ website /LRPortal /ARCIMS/MapFrame.asp ?PIN= 6/19/2006 y � t NF RICHMOND PLAT T30- 30 -W A W 55 S XKd.' © Farm Se Home Publishers, Ltd. See Pages 115 -116 For Additional Names. ( STAR PRAIRIE PAGE 66 900 STA N A .xy �. - 4 B KG Dade) ucn ,r K X ar 3f ^ .`vs`g ewlo3 _ &Leona $0 71llotti �PV' �� rlk w,ka o zs Ism coon ,is gamer m to Inc 64 AVE : 3 a ^"x n s' z re<roe Donald Fred 8, 4 Told l 1 i RK C"e"I Ruth Marayn ermem 10 obo 1 ,� T+o �. 41 fi ( Powers E McCabe tU 69 Bill �{ er,ry Mary 3 nsm� 138 Nehhrh V wrvr+ma< bust 8 1 t a 77 PG 13 _ .,c a,a � `�. s %, � � ' •� r wy fariy y a g 7 to71h ' .ate € .. °� 4 r Gerald Jr PT I Our �. �' .b 13 team g I Kiakhoefer 1 Adeline d Emund I , vah FLIP By �W 1 �` AVE - ty. Eg 194 Robs Germain Kell 370 k„M t3 a'. o DCCI O 180 Y �:�� �' u 1 159 159 H _y Lanus 20 Ioc 195 q - ' DonaH D,B,D &K �' # $: Derrick atbe.t 20 Rolling emnaa a oaael Dalton x 3 % ' ' De ininnent IN 25 n ao Hills Dalrou 80 _ tf� x � LP 55 aM Dairy 40 ao ao ,,. Inc 266 Adel'me lames , ,�,�^R r'��`� John Munn, 3 B S 'v' M Pat Krattley ing ` • \ Kobs & Clea 41 ` `� � ? 50 are 40 3 @ A T LE etal Rth 114 :r ndal. _ - Lori - ' 28 ��. bd' �T; 4�x�.. _ T a oc DM C 3 80 a �. a 160 A VE E M rtta & a Storkb F - a K `'°'° 167th ak a o Iva 15 15 Marilyn i I40 40 38 z w„„g<. v 35 ND r T endrik a Felber' > Kevin a Doris i �ti: 3 John orwn 160 1 <x`t-� Kathrine Osbome Inr 33 an I"c a. oe.<kk anDyk caro>aa rya ' a Stork 76 ,°� 37 70 7p za 19 f- ss mg;, 40 a3 80 Georg e I 1 f 6 my K7 ry L G a Davidr V i M , 1 Dan o Steven 3onnson Bas yl Kr ro Tammec 125 `B A Derrick N Farms O David <_'� LLC I 1 °O ° 312 Inc & J ii11° I 187 ----stone Ma x Steven b b V Rkk.,d & 138 • .. Waldroff ,5,8 a sK R dY � ` oK a iz Derrick °• °' `' 80 160 a , Mix Joe 474 t I 75 - -.. __ -_ W _. nc 105 I __ ___ r 63 m n^ G 4 •� as - - a 4 Thomas air KS &Gail 3 eo 3 &7 F 3 a Leverty 1'• 12 R bha >: t N �» 166 J a 55 z ohn Leland °• H rid k .:. 27 I= vmoyk - A � �� �, . -:' Murray � Langrless Z Charles ar ` "eovt autuu a N s 2 . m:: ]60 . 5 160 ;k•' Thomas& I� Polfu 20 M t8a N 105 a by 1� b KO 10 stephens 116 1 Richard Dv s len & Trust 140 1 3 z a Th. W Ifs 80 �� William & ren §�. eo Roos Nel .. I `. 75 Cynthia: o asel 5 - r s oe 4 40 +" - Feller a,o H VanDyk 5 z was eouee�-'¢ y a 1 Richard 137 ; 1 160 Y f.00ck B y MMO tae S-' ` & anet ramuy a arri Gilhs 80 140111 AVE • � . 3 130 45 .e. ao _ z a , . z er s 140': -5� Steven :Hendrik a DCCI z Derrick VanDyk 139_ 220 m - v a - ' VanDyk ' ay ' 4 Richard & Lisa s u °coy & FHI311d tl a irnarlak r' / Farms ` .t nut g Gerrit & -Robert Kroll 80 s ai �5t s m aROmde oan& cAFr- 8 Inc 40 Gerru °,te anOy Patricia - r, t e,w" Inc 288 VanDyk eai G;'.n VanDyk Az< ca ° em t 154 7 / Patrick Ie>at eo 134 Derrcc a Is - �s S S - & Janice g 158 €g g MP 6 y - �' 8 Ball 118 n 13 ag O ura Resue 130th AVE she & )can ohn P t H oman<k Ev L &s Fred & N r,` rup Dale & ,�leY Nickelson a. :fP ° e< 25s P au Balth = 40 Herman ooa� 39 Claudia s Keller latish awata cks Quan .. 4 �.. ° so Trust w 328 Antts`h unk, 1 ', An B a0 0 :35 r� 40 230 7&F 2 J ?-a x weham. Craig & n.x le Ken G rte Gerrit & Iw t ` Hobert. ^ Dawn acne, Richard K 13 ` °u"'"•` K 1 aria v v Wachter '"za Henr Derrick John t 3-ske Patricia N I- + Judy � "' y 157 Nickelson Inc a1MLbe 3s ' 400 k L David& -i�ca 7 Derrck o wo 100 x<ua 3s 120th 65 160 135 m " S Donna s +u�,. {c no. "a tr F .:, ... ... ... .1 . .. .... ... .:.. ..: .....:... ..' � - .. ., -... -... ... 1, . -. .,..:. ... ; E .. �.., :.. WARREN PAGE 32 MINGTW FLETC H 1 O ffices Law Specializing in Real Estate 126 South Knowles Avoitie Needs, Your J. FLETCH • Way WWI Broker ' CSP, ABR, GRI 715 -760 -1189 800- 260 -6030 • ®hiss {� oNO n m O 3v �1 3 ° c 1 3 _ V n M ' ° c M I r: I '•' j � O cn $ � 2 in z N -4 C) z T. ui Z O A C) ;o O �1 • 3 G V fD O 5. C A N OD y S W c p 0.4 } r / 1 z a CD y CL :3 y y 3° l to C Q . @ (D 1 aD a c m m n 0 3 a o f° ° r► g c w c CD m CD N a a J m D a s y 7 W O 7 W 3 n C, a s o O CD CD 00 "Ilia, CD z y OD OD F O O) G7 f C 1��1 A o Z C 0S O CS O O O O O 3 � • A O V1 •U -i y i a O - L V Co m N N G7 CO) (A N l cn m o ani � _ Co o y v < » CL (D M N D(D 0 D @0 0 0�. O a o CD cn @ CD m m � CD y y y 'O C CD CD C CD N G C w a a d 7 3 7 l z CD cD N 7 +_ -4 N o -n o p z » N y a y a A 3 cn W CD o a CL Z II c 3 I 0 0 rr j z w N w Z CD v C4 w y I I � 0700 a 0 D 3 n n CD Co CD M o `G v Cn O n OD O T w0 CD m CD 0 ° 0 a Co 71 S y O O cn ? CD W �_ y CD O y `1 a y G N y �mCL ?_ a 53 y m CD !/1 n m C) 3 CD b 7 Oh It, N O O A CD N V 69 O o 0 ~ O � � � O O L O L ti r Parcel #: 026- 1049 -80 -000 04/03/2006 11:35 AM PAGE 1 OF 1 Alt. Parcel M 17.30.18.253 026 - 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 GREGORY GERMAIN O - GERMAIN, GREGORY 1557 100TH ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1557 100TH ST SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 39.000 Plat: N/A -NOT AVAILABLE SEC 17 T30N R18W 40A SW NW 430/349 EXC Block/Condo Bldg: PART TO C S M 8/2119 Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 17- 30N -18W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 1122/047 WD 07/23/1997 846/49 07/23/1997 430/349 2005 SUMMARY Bill M Fair Market Value: Assessed with: 95693 Use Value Assessment Valuations: Last Changed: 06/20/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.000 18,000 95,300 113,300 NO AGRICULTURAL G4 27.050 3,300 0 3,300 NO UNDEVELOPED G5 10.950 11,000 0 11,000 NO Totals for 2005: General Property 39.000 32,300 95,300 127,600 Woodland 0.000 0 0 Totals for 2004: General Property 39.000 32,400 95,300 127,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 125 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ,ER , TOWNSHIP, EC. T JC N, R _ W O.ADDR$SS , ST. CRO�1''XCOUNTY, WISCONSIN. '3DIVISION LOT LOT SIZE . PLAN VIEW -Distances S dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHI 100 F EET OF SYSTEM 1 . 71 u �G gad ^TIC TANK(S) MFGR. CONCRETE ` STEEL NO. of rings on cover O Depth '' DRY WELL INCHES NO. of width length area y no. of lines Z width 21 _ , _ length z area Ly�R ` depth to top of pipe a_ "' 3 ZS` -'a RATE t AREA REQUIRED 4:� %O' AREA AS BUILT 4" claimer: The inspection of this system by St. Croix County does not imply complete % _pliance with State Administrative Codes. Th-re are other areas that it is not possible inspect at this point of construction. St. Croix County assumes no liability for .tem operation. However, if failure is noted the County will make every effort, to :ermine cause of failure. 'ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.,, ! 'INSPECTOR DATED d PLU11BER 01J.1;1 6B _ LICENSE fiMMER z REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM San.Lxany Penmi4l_� State Septic n -. NAME ,(��%i' ,,_-"ownship e, St. CAO i,X C un i 53 Locatio % 04 �1�J Section 0 T N,R W SEPTIC TANK I Size Z gattons. Number of CompaAtmentz � Dist FAam: wett ce it. 12% oA gneateA ztope �� _ Buitd.i.ng it. Wex.2and6 Hig hwaten 2' Q It. DISPOSAL SYSTEM Distance FAam: Wett ix. 12% oA gneateA ztope /ov fi t. Building it. Wettandb Ft. HighwateA J - 00/6 t. FIELD DIMENSIONS: Width o6 ttench � � it. Depth of Ao ck below tite Z in. L T— �. Length of each tine � it. Depth of Aock oveA tite 2 i n. u� - `2"y1lumbeA. o6 tines Dept o6 tite below grade gin. U Totat .length of tines c�1 it. Stope ob ttench in pet 100 it. Dis between ti nes r,, _i t. Depth to b ed&ock Totat absoAbtion area ,jt2 Depth to gAoundwateA Requ�Aed area 6 t 2 PIT DIMENSIONS: Numb et o6 pits 4 G avet anaund pits yea no Outside diametet epth below intet it. 2 Totat ah oAbtion a ea it z - A AAea A uited t2 INSPECTED BV L C TITLE I APPROVED ,DATE �, �tJ 197u. j REJECTED ,DATE ,� 197 I v, EH 115 W ISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES t ' DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 ' MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION:, A014, Section 1-7, T,?V, R J E (or) W, Township or Municipality & , /, u�tsT Lot No. , Block No. County ✓e �,sf' '/ Subdivision Name Owner's Name: V P r' /�� 2 J r ,,rrt a► i Mailing Address: TYPE OF OCCUPANCY: Residence L—' No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT DATES OBSERVATIONS MADE: S IL BORINGS 1?,—PERCOLATION T STS 1/ 7 SOIL MAP SHEET 1 SOIL TYPE /S PERCOLATION TESTS , TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE CHARACTER OF SOIL SINCE HOLE HOLE AFTER INTERVAL NUM- INCHES THICKNESS IN INCHES MIN /IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P -1 3 o I 3 G G ,s P --, 34 f 3 &/ 6 5 P 3 L .� IS SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) B x > >z S s BY t' > Z Z2 Z ry r ti 5 B ` , r ,4 7 7 �� - rs ' PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the locationand square feet of suitable arenas— Indicate numb s uare feet of ab or area needed for building type and occupancy. I e scale or distances. Give horizontal and vertical reference poi ts. Indicate slope. S �N x L i � m I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. Name (p rint) 1 � Certification No. I (p Q �j c Address n- 7s c. L ez l/ 5 Name of installer if known CST Signature COPY A —LOCAL AUTHORITY State and County State Permit PLB67 # ✓ �'' Permit Application County Per 't # 4 for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: B. LOCATION: ��('/ 4, Section L7 , T� N, R 14 E (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Towns A t nt�.,A C. TYPE OF OCCUPANCY: Commercial *Industrial *Other (specify) *Variance Single family l- Duplex No. of Bedrooms 3 No. of Persons ;7 — D. TYPE OF APPLIANCES: Dishwasher 4— YES NO Food Waste Grinder YES I-NO # of Bathrooms Automatic Washer YES -' NO Other (specify) E. SEPTIC TANK CAPACITY Total gallons No. of tanks *Holding tank capacity Total gallons No. of tanks New Installation Ll- Addition Replacement _ Prefab Concrete �--� *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) _L S�2) � �"3► _��' - Total Absorb Area ��� sq. ft. New L-- Replacement *Fill System Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches Seepage Bed: Length $;Z h Width Depth '3 L "Tile Depth :Ly " No. of Lines -:2 Seepage Pit: Inside diameter Liquid Depth Tile Size Percent slope of land Distance from critical slope I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH -115 prepared by the Certif' d Soil Tester, Tester, NAME 7/ G h tt t �� l�l/ /�d,�f� �� C.S.T. # and other information obtained from (owner /builder). Plumber's Signature Zol, MP /MPRSW# �D �� Phone #, V Plumber's Address 71, ' PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with O 62.20, including well). IC I i q3 Do Not Write in Spac Bel 9w F R DEPARTMENT y�( � Date of Application - Fees Paid: State_jC my Date Permit Issued/ r (date) Issuing Agent Name Inspection Yes o Valid# Date Rec'd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 6/1/76