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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 53$703 GEI��ERAL INFORMATION 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: Marek, Todd R. Richmond, Town of 026- 1137 -22 -000 CST BM Elev: Insp. BM Elev: BM Description: Q Section/Town /Range/Map No: la, 0 i7 0 20.30.18.978 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark W ee k,_5 0j 4- /Llo 3.75 103. 160 Dosing P� L _ 5 AlteM / 3 t' d JG. c (f cd • j�o . T Aeration Bldg. Sewer Holding St/Ht Inlet �.5 77- Z5 TANK SETBACK IN St /Ht Outlet - 7. 6 54 .7 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ! 2 . / > 3 � Dt Bottom Dosing Header /Man. Aeration Dist. Pipe I'll 75-31 J?. (01 95.0(. Holding rl-'► bra 5.75 q'g PUMP /SIPHON INFORMATION Lo,j 6�� 9 •' 9�. 29 Manufacturer Demand St Cover PM Model Number TDH Lift riction Loss System Head DH Ft Forcema nth Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width Lengthy No. Of Tre nches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS I vi i -ye Z i C _ A ql` SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer: T INFORMATION CHAMBER OR -�+� A� �al Type Of System: UNIT G6rtJe •� 1 3 1 �p7� 5 7 5 � Model Number: �� I 0�!Jp DISTRIBUTION SYSTEM J Ljeg o Zl 4-Z.Z_ s Header/Manifold Dis tion x Hole Size x Hole Spacing Ven� Air Ire [� L' Pip s N Length 7 Dia 4 Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of 7d/Sodded xx Mulched Bed/Trench Center Bedrrrench Edges �* Topsoil �- Yes '� No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 1091 148th Avenue New Richmondel 54017 (SE 1/4 NE 1/4 20 T30N R1 8W) Golf View Acres Lot 22 Parcel No: 20.30.18.978 1.) Alt BM Description = r. —_ J -C.— 2.) Bldg sewer length = 36 - amount of cover = L 1Z /f Plan revision Required? Q Yes No Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's ignatur Cert. No. Plat Plan ; project Name Todd Marek Address' P.O. Box 228 New Richmond WI 54017 Lot _ 22 Subdivision Golfvfew 10ste SS 1/4 NE 1 /4S 2 T $0 N /R W ,�._, Township Ri ❑ Boring PL Property Line County ST. CROIX Bfd or YRP Assume Elevation loo ft. Tap of walkout foundatlon ' *HRP as Benchmark Seale is I" = 40' linless otherwise noted Road 69 Pro 4 PYP Bedroom t ,J L PUSC 1 _ B -3 I 215' Propatty Line �3 B -2 �3 N fL 1a 987 �o s 5 V - 97' 90' Found Steel Fenco Post (told by owner q that is was the lot 420'P corner) too' r Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 538703 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: Marek, Todd R. Richmond, Town of 026- 1137 -22 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: 20.30.18.978 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet 1 TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION Type Of System: CHAMBER OR UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution r ole Size x Hole Spacing Vent to Air Intake Pipe(s) 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 ded xx Mulched Edges Bed/Trench Center Bed/Trench Ed ITopsoil xx Seeded /Sod g H Yes € No Yes No COMMENTS: (include code discrepencies, persons present, etc.) Inspection #1: / ! Inspection #2: Location: 1091 148th Avenue New Richmond, WI 54017 (SE 1/4 NE 1/4 20 T30N R18W) Golf View Acres Lot 22 Parcel No: 20.30.18.978 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? E] Yes F91I No TTI L Use other side for additional information. F — (R.3/97) Date Insepctor's Signature Cert. No. commerce.wi.gov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 s /'t/"!'\ n tom+ i Madison, WI 53707 -7162 Sanitary Permit Number (to be filled in by Co.) ti c epart o C ■ o aV m�m # eWe* 63 � / U Sanitary Permit Applie j n State Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this f _ ental unit is required prior to obtaining Application tofii�s f to -owned POW g a sanita q P Y P ermit. Note: A PP S are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal infcrmatio2 � may e u ndary p urposes in accordance with the Privacy Law, s. 15.04(1 )(m �O Q / C� �Q (� 1. Application Information — Please o ` , ( ` Property Owner's Name Parcel # — /-- Opp ©Zb- o3'� -22 - 866 Property Owner's Mailing Address uvjl NN Property Location a C) _ pow- 2 ��. GR�ti pN1Np ppF1C / x Govt. Lot T City, State r c one Number G y,, /, Section � 1 V) P j 9 N , W ( / fi t^„ (circle one) n/ � (�L� T �& N; R �_ E or® II. Type of Building (check all that apply) Lot # AI or 2 Family Dwelling- Number of Bedrooms � Subdivision Name_ d n G R Block # 3 ® LF V 16 k A l E-5 ❑ Public/Commercial - Describe Use k G ❑ City of ❑ State Owned - Describe Use j C Number ❑ Village of 2 f\ t 6 � Ce, 15 (�1/ ?�TZZ Y Town of 49 V 0 Ill. Type of Permit: (Check only o box on line A. Complete line B if applicable) A. MLY New S stem ❑ Replacement System g p y g Y (explain) ❑ Treatment/Holding Tank Replacement Onl Other Modification to Existing System ex lain ) 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 System/Component/Device: Check all that appl IL Non- Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatme evice (explain) V. Dis ersaVlrea entArea Information: Design Flow (gpd) Design Soil Application Rate( gp t) Dispersal Area Required (sf) Dispe ea Proposed Syst m Elevation 0 o # 7 1`% X36 �� 9 I VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units c ° y New Tanks Existing Tanks / r ! o � a U in m rn w C7 a Septic or Holding Tank 7- 5:0. ' Z, O Dosing Chamber VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the PO WTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP /N04 S Number Business Phone Number a U Z ?( q f - 7 7IS Plumbers Address (Street, City, State, Zip Code) cz_ulfW0 �q W ( oll V111. ount /De artment Use Onl Approved Permit Fee Date Issu l �� Issui Agent Signat e son for D $ �� 5 caner Giv enia IX. ConditiQQ%p�nf AA �� ���"�g Disapproval /� L SYSTEM e1CINNER: easons for Disa pp Th r�✓� /�21..� 1. Septic tank effluent flRef and rI ' r r *%C AL. " /► �' / dispersal cell must all be services / maintained /�; s'1�.. +L b tea• 4 v1 as per management plan provided by plumber. 2; AN $Sfbsck trogI emer►ts m st,be, rrakftlir ed o i e e p ans or a system and submit to the County only on paper not less than 8 1/2 x 11 inches in size SBD -6398 (R. 01/07) Valid thru 01/09 P Lo 4- A-/\,/ 3 /y� i w �L� rz �o sfi zs� V Lf 3 �,�vF�ctc�v,� -rte s 6 3 a aM z �'t p v e- lotfe r � 1 co N4~ Pg of b Private On -Site Wastewater Treatment System (POWTS) Index and Title Sheet Owner: '11 4 Project Name and System Type: CD 1� U . /N Q -2 a u , ) Location: Street Address L G 4 Z Z JOL W a t v�c�o Legal Description M.,9Nd a dLo CSC Township /County Design Criteria (Check one): Holding Tank Component Manual: In- Ground Soil Absorption Component Manual: • SBD- 10571 -P (6/11/1999) ❑ SBD- 10567 -P (R. 6/1999) • SBD - 10855 -P (3/2007) Version 2 C"BD- 10705 -P (N. 01/2001) Version 2 Contents: Page 1: f IV 0 C--K d- 41i= L� Page 2: Lb PL-A -Al Page 3: C%P-6 l 5' J - (5G - � — /o Page 4: IYU A-A) �L2i /✓ �" /© CA- A/ Page 5: L ! C Page 6: C t l Page 7: Page 8: Page 9: Attachments: S� C QUA /X fwCe -F NS yfz� c ILI Plumber/Designer: 64 N' A) 6(JO _ Signed: . vim Credential Number: A 2— Z_ (o Date: A2 3 N � ALL � �0 5fi 25 Y3 lnrF�ctc -c�� s � a3 a► am z I''z +6P P, L g -9 z o _ 3 ,�« v ic*4 " = ffo �'6• S u , ,,� u STANDARD CHAMBER — 52" Quick4 Standard Chamber 48 " 3 ,5 T _ (EFFECTIVE LENGTH) u� P e B B B 12" 8" 43 34" SIDE VIEW SECTION VIEW � Scm ,v { -°" R Z C C- L MultiPort End Cap R 0 16" 1 E M 34" SIDE VIEW TOP VIEW FRONT VIEW INFILTRATOR SYSTEMS, INC. STANDARD LIMITED WARRANTY (a) The structural Integrity of each chamber, and plate, wedge and other accessory manufactured by Infiltrator ("Units"), when iretaled and operated In a Iaechfield of an Oreille septic system In accordance with InPotretor's Instructions, Is warranted to the original purchaser rHolde') against directive materiels and wakmansW for one year from the date that the septic permit Is Issued for the septic system containing the Units, provided, however, that If a septic perrtlt Is not required by applicable law, the warranty period will begin upon the date that Installation of the septic system commences. To exercise its warranty rights, ladder must ratty IMYtralor in writing at Its Corporate Headquarters In Old Saybrook, Connecticut within fifteen (16) NflR ata�tlab excludes it* � of and/Or h Of the n by Intwrator to be covered by ors Urnned Warranty. . • THE UMtTED WARW WIY AND REMEDIES IN ES O MERCHANTABILITY IX OR FITNESS (e) ARE N THERE ARE NO OTHER W F1POSE WITH RESPECT T LU SYSTEMS INC TO THE UNITS, INCLUDING NO IM%Jm WARRANnIIFS OF MERCHANTABILITY OR FlINESS FOR A PAR'TICl1LAH Pl1RPOSE. (c) This Limited Warranty shell be void if arty pert of the chamber system is manufactured by anyone other then Infiltrator. The Unified! Warranty does not amend to Yecidental, consequentlel, sledded m lmdlect darnegee. lad Infiltrator anal nd bar Mtge for penalties or liquidated damages, kicluding lose of Environmental Onshe Wastewater Solutions"" production production and profile labor and materiels, ovedheau costa or other losses or expenses kXximid by the der or any third party. Specifically excluded from United "Wraray coverage are damage to the Units due to ordinary wear and tear, alteration, accident, misuse, abuse or neglast of the Units; the Units Ong subjected to vahlde traffic or other condtkne ~ are rot permitted b ft ir,sialeticre instructions; failure to maintain the 6 Business Park Road • P.O. Box 768 munimxrm ground covers set IoM In the Installation instruct km the placement of improper materiels Into the system containing the ul ts; faire of time Units or to septic system due to Improper siting or improper sizing, excessive water raga Improper greens disposal, or Improper operation: or Old Saybrook, CT 06475 any other event not caused by Infiltrator. This UR*W Werwity shad be void ff the Holder rapt to drolly with al die the terms set IoM In this United Warranty' - 860 77 7 - - 5 000 FAX 860 577 7001 ment, or "ro m � product y �Ie'�p�rHm �r a � b"pa Mfto Lire Vftwttyto � �fm� °ir�sol In accordance 800- 221 -4436 with all site carxiitlons required by state and local codes; all other applicable laws; and Infiltrators Installation Instructions. (d1) No reprasentati" of InfiltretOr has the authority to charge or extend! this Urnfted Wa anty. No wema* apples to any party odw gram the spi- nal Holler. The above represents the Standard United Wananly offered by Infiltrator. A limited number of Bates and counties have dfiereret warranty requl e meets. Any purdmeser of Uni slmou ld contact Mptretces Corporate Headquarters In Oil Saybrook, Connecticut, prior to such purchase, to obtain a copy of the applicable warranty and should caretuy read that warranty prior to the purchase of hulks. U.S. Patents: 4,759,661; 5,017,041; 5,156,488; 5,336,017; 5,401,116; 5,401,459; 5,511,903; 5,716,163; 5,586,778; 5,839,844 Canadian Patents: 1,329,959; 2,004,564 Other patents pending. Infiltrator, Equalizer and SkieWinder are registered trademarks of Infiltrator Systems Inc. Infiltrator Is a registered trademark In Fran e. Infiltrator Systems Inc. is a registered trademark In Mexico. Contour, Contour Swivel Connection, Mkxol-eaching, PolyTutf, SnepLock, ChamberSpecer, Posil-ock, QubkCut, QuickPlay RECYCLED PAPER and Quick4 are trademarks of Infiltrator Systems Inc. 0 2003 Infiltrator Systems Inc. Printed In U.S.A. 0011203HP -0 Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number Number of Bedrooms Design Flow - Peak (gpd) p-�7 Estimated Flow - Average (gpd) O jJ Septic Tank Capacity (gal) Z Soil Absorption Component Size (ft g C/ Type of Wastewater Domestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) Cr V 4�1 o Maximum Influent Particle Size (in) 1/8 Maximum BOD (m /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once eve three ears. The inspection ection sh Y all include ude recording the levels of pondmg, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep- rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. pie ,- ig C[ 5a 1J pl- .9 6 - 7�s - 2, 7 45 AJ C Q6+6- 71.E 6 � 7 Z3 l / C O 3 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address K Z Property Address l V ( A (I-Q_ (Verification required from Planning & Zoning Department for new construction.) City /State Parcel Identification Number t /9 Z -// 3 7 - Z 2 pd O LEGAL DESCRIPPTION / Property Location ! � 1 /a , �' /a , Sec. , T 3 0 N R ! g W, Town of e- A" A/D Subdivision ' 2 d As 12- _ , Lot #_ Z Z— Certified Survey Map # / , Volume , Page # Warranty Deed # l l , Volume , Page # Spec house 4�9> no Lot lines identifiable es no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my /our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms !dA yy "o.� `o 4� l to SIGNATURE OF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) I I I I I II VIII II III 1111111 I I i I 8001225 Tx:4001062 STATE BAR OF WISCONSIN FORM 2- 2000 918391 Document Number WARRANTY DEED BETH PABST REGISTER OF DEEDS THIS DEED, made between Halle Builders Inc, a Wisconsin ST. CROIX CO., WI Corporation Grantor, and Todd Marek Construction Inc, a Wisconsin RECEIVED FOR RECORD Corporation Grantee. 06/29/2010 2.13 PM Grantor, for a valuable consideration, conveys to Grantee the following EXEMPT *: described real estate in St. Croix County, State of Wisconsin: REC FEE: 30.00 Parcel 1: Lot 39, Richmond Meadows in the Town of Richmond, St. Croix TRANS FEE: 159.00 County, Wisconsin. PAGES: 1 Parcel 2: Lot 27, Richmond Meadows in the Town of Richmond, St. Croix County, Wisconsin. Parcel 3: of 22 Golfview Acres in the Town of Richmond, St. Croix ty Couri Wi in. Recording Area Name and Return Address: Together with all and singular the hereditaments and appurtenances thereunto 026 - 1147 -39- 000 &026- 1147 -27 -000& belonging; And Grantor(s) warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, covenants, and conditions of 026- 1137 -22 -000 record and will warrant and defend the same. Parcel Identification Number (PIN) This is not homestead property. Dated this. 28` day o June, 2010 Halle Bu' s I a is Corporation G * : WesK W. Halle * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) COUNTY OF ST. CROIX ) ss. authenticated this Personally came before me this 28th day of June, 2010 the above named Halle Builders Inc, a Wisconsin Corporation to * me known to be the person(s) who executed the foregoing TITLE: MEMBER STATE BAR OF WISCONSIN instrume tan kn w ded�th same. ,,,,,•,,,. (If not, �( authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY * Notary Public, State ot Wisconsin ? •� r : ��' ` C Robert L. Loberg My co ion is permanent. (If not, state Won te�/ Loberg Law Office sst7320 T (Signatures may be authenticated or acknowledtecl. Both are not necessary.) • ••�'••.`. �t Names of persons signing in any capacity must be typed or printed below their signature �'. ,.. • ' WARRANTY DEED STATE BAR OF WISCONSIN FORM No.2 -2000 1of1 N N7 LLji O Q� N NO ko w 3Z OC o GJ� t oll S�- tij %/ �� // /� (D v �o /� LO / / !� NO Z O ° p O I 4J CAF r- l r' l' lZ � �S �� �ci �ci / / / N LBN /;r h X00 � 60'65 1 ch / , N 0 M ��( r- N -/ O //� lv —/ ,00'g6l 3 .5£' 6 O N S CN 151 tO o 4) L C 0 rn o c a Z / / / o c W o .� SO S• ° b ti / ^ °° "o Q c W N Q -° / � / ��� S d�o� 0 � o� u r') O Oj / / > > L 1 000 N / \\ / / / \ � lss % cn LL _ C to /00 / ��,\ c U X j I •8� / / �o 0 2 ° cn A C14 C � Q '` / C 4 N ^ M N O C v� N �� 0� �� ,�, ' `j vi O M 00 rn i� rn I� u < <v // ��.OrnNv)O co 0 0 0 C-3 I 00 �O Cd N co !.CA h / v NN C-4 !0 M c9, O 00 o0 I O i t�1 O O M (D i� �� NNNstNM� N lr M 00 d, Qc N a0 O 'n ON I Ln - i) ;n p o a� O o,cD M I o -C c co 00 vi r�i Ki of I z UJo W w Z wwww3 W I Imo' 3n ]I Hl OtL �o���MLO to M V I , I (D ; a M M ci Q, I I �,;�, '� Ij � o U m 00 OC) Z Z(D z � - O I � Z o (1) V) z o I s• I < {, V 0 0 �o I ''�`� Q,�33www i �rnrn ( 3) 4 ) - 0 md'd' v) I�� ,* a o Z I^ '�, w V # oa 00oNrnrn �• ~c N 001�ON to N U (n Z Z Z Z Z cn (n J � z f .. r.. Q LLI �000000 I N ci o°,°r`iwoo0°o°o°c Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3 ivision pf Safety and Buildings .'D in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must �� C • r U1 include, but not limited to: vertical and horizontal cafe direction and Parcel I.D. percent slope, scale or dimensions, north arrow, d' to nearest road. �2sU / 3� . 2 Z —6 1Z Date Please pdfndt all \ R b Personal information you pmvide may he used Pu' P ' Y Lahr, S. 1 (1) (m ) )• / Property Owner ?`' Property Locatio 4-7 " ' M Govt Lot 1/4 f- 1/4 S g E (or Rt d e µ j ZQ T �? CS N s �/ Property Owners Mailing Address Sr (; � 9t. ` Block # Subd. Name or CSM# •o. Cox 1000 couwy Coot ( +ew Acres State Zip Num !, > n city ❑Village [Town Nearest Road tt ® New Construction Use: ® Residential / Number of bedrooms `� Code derived design flow rate 4 5 / Co DO GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material c- S ( - Flood Plain a if applicable /" - ft. General comments S f.Pm e (.e v 3 vv G o �+r 92 . o d and recommendations. - Boring # F I ❑ Boring ® Pit Ground surface elev. 9G ' � d ft Depth to limiting factor 1 t (n in. mil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM * in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Eff#1 'EMV I o -� to 5• I 2 abk I v�Q - lb 8 2 10 -z/ ! 4 1y - ) 2 C- – 8 3 ZI -Il ( q tx Os mt — – - 7 t•Z.. F-21 B # ❑ Boring $� oring ® Pit Ground surface elev. 9G • ft Depth to limiting factor 169 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Efr#1 *Eff#2 0-to io r•31 S' Z k 1 VC 5 $ Z Z-30 10 s' ( 2 rrtab k n4r c- s 3 ZL.)-I l0 14t (0 5 O vnl — _ . 2 q 3. 10 * Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) ignalure CST Number Ream Schu ker Z5330� Address Date Evaluation Conducted Telephone Number 2t t3 8UT' -" SomerseA \,j I 5tb2� s $ Property Owner N e 150 n Parcel ID # Page 2 of 3 Boring # ❑ Boring 1 1] Pit Ground surface elev. !?z.g1) ft Depth to luniting factor 116 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. 'Eft#1 'Eff#2 I U 42 3 :50 2 ryY k rn 14 S B Z - 1Z - -Lq 1 — si 4 tg 46 to t y po Ds r n _ i � • Z F-1 Boring # E] [3 [] pit Ground surface elev. ft Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roofs GPDM in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 g E] Borin Boring # Ground surface elev. ft Depth to knifing factor in. El Pit [ Sjd Applicefion 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 mg/L ' Effluent #2 = BOD c 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608- 264 -8777. sBD -030 (R07M) Property Owner N e -so r) Parcel ID# Page z of 3 F 3] Boring # ❑ Boring N Pit Ground surface elev. ft. Depth to limiting factor 110 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIfF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I b -12 3 2Ny k rn-�r �5 14 S Z !2 - r LA L4 — S; ( k /y p/d tO 14 ros A ps rn t 'Z Z a ❑ Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor 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 F1 Boring Boring # Ground surface elev. ft Depth to limiting factor in. ❑ Pit 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 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBD -8330 (R-07/00) PAGE_3 _OF 3 NAME LOT# Z Z. LEGAL DESCRIPTION 5e 1 � 4 ue1 4,S zo T3c),N,Pj $ E (or)9)- SCALE: 1"= qo BM 1 ELEVATION (GU' 0 BM 1 DESCRIPTION P o -r BM 2 ELEVATION 4 r Y 0 G ZU BM 2 DESCRIPTION • ,e Ql SYSTEM ELEVATION P Q 3,00 Gow •� 9Z. o 0 ALTERNATE ELEVATION p ,00Guw -r $80 CONTOUR ELEVATION �'o, 9 Sb, 9G ..ta i 9� 13 -Z 'S $'3 �J 4 �� r fo 4- S�Qt i SIGNATURE DATE �� �d " O / Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 430506 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: Halle Builders Inc. I Richmond Township 026- 1137 -22 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: CST BM Elev: Insp. BM Elev: 7 20.30.18.978 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS F ELEV. Septic Benchmark Dosing Alt. ,v ti r A A Aeration Bldg. ew Holding St/Ht let St/H utl TANK SETBACK INFOR ON TANK TO P/L WELL BLDG. Vent to Air Inta ROAD D Net Woe OF Septic t Bottom 34 \ Dosing ea der /Ma . Aeration t. Pipe Z 000, Holding Bo T. System Gr PUMP /SIPHON INFORMAT Final Manufacturer lipmand 00015over M Model Number GIR 000 TDH Lift Friction Loss System Head TD Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length . Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. 7 uid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) 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 xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes Lj No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / ! Inspection #2: Location: 1091 148th Avenue New Richmond, WI 54017 (SE 1/4 NE 1/4 20 T30N R1 8W) Golf View Acres Lot 22 Parcel No: 20.30.18.978 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? Yes 0 No Use other side for additional information. SBD -6710 (R.3/97) Date Insepctors Signature Cert. No I r - Sts *car wil •ildint s j7ividpfi a 2011 W. tiCl�iakdztj;t<ul .ttirrts., :L�:C3_�x `1F1S2 _S 7 ! si IV. udlk, W S`Itt�.d#21ratue __ �Ia rttnt�rtt a ctsrEim r ___ REC _ - EIVED. 1091 -4 aEmrtut Y?t�riuit 1�7tyttr /� 2 /y In etwurel wth Cr)nau E321. wu- Aciru. Cud ".. reiwxruI lrrl'n� "altI�� pr)Q�i}1itn ct� 2003 Check 2t Revipletxt - ✓ 5v 0 l., Atr� h1rarutu tlaxx Pleaw Out All Tr�i ti�tniiun _ :itztifix S?lwzi 11�.1�Tinztba j /� ' _ ST. CROIX COUN - f1' - PrUpc >rPy CJ-Lvuer'et l�Yiirnee _ __�__ _... _ _�___ _ •-- z�pp} M}6IC, parrt�Intiilxyr� n �__ _ D2lo - /� 3,7 -a-)a 1 ra ar f tiar�tea g rirlui(Itiii� �lret ti .. _�— __ _ _ __. —. .... rnpt� tyt}� L t�cuL nn. q-7 C 117" we w :lip C�utlt� PhD= i�imnbar ��._. 'N _ _ Ebuk KiMber N aTUO CSH Nu abar � l3. tY(ru ajajtly,} t� 1 or ;,p vat:niiy Drrelill12; •- t'turnber oi' tSatltnmtxs ? C '1+YXltigo �� 1<7 1 /Cmtj==tw •- :imsztibtsuse '�' �h roil — (17 Stuw tiwnul Itiit,turasC'k�{yttsl - _ e cif ru ��.t �_ 1 >eut: (ClIeck rr 'a 11ca Qrc lzno rt`. N 7 s i1 3� ial Pit t rurtE rxritr.} {Ceutt 'tc io TWO ]3, 'xr upplIcable.) � ^ ,. tl. N'tlw�_.�._ ._._..__..•_ —._. �}�11Zn1)taeetaernf a1' � U ,Adcliclurt Gx -.,_,., ,__...._..�.,__ � ..�._...�._._.,_.,.._.____._.. ...._.. ,_ f aux 2 >71tt^plae eerxetuk Sysirrrn J'au CJni 13icl6lixl r)tetu pur C;quuCy Ilse li' IrlLhetck ii' Sagit "j,1 "'wit i''mVIVIasly lstwd Per trdt Nllrttt)er ID 4t, iff sund of. 3'K) $ (Cllualc all that upply. NuxubeAzig lit f Intarital ua..) dd• iatyu F�rassttr�ed to Uruunrl L'i CI NJaund 47 t:1 Autd Hilter 30 0 C:on InMial.'4'tret@tud Li PIT39surlxlwi Ttt „ rrattttltci jb.t 1TCritiing'Iank 42S R lu L'{u;s :51 Ll RS U At (wade Uzdt 49 U lZuc rculatItIg 3U 00(rer Worn ttlGiot4�G — � h_ r - 1'9as11;�21�tuw (mad) i3irpersal Arm �. D18lleraw J iM* so Atnyllmflan 1... gluticti ;kalu � syxtorrt Blevutlgn Awl arader iictpllrtad / proiiusG 1 ✓ Itttta((lnls./�rtys /Stl. Elk.) oviln.lIda11) / 7 o Movniiun J J. Itif l rtt 0 - L w,5y l it `fatal Number T�t�mttacsfux4s � � Prefab 'Si¢� sted Pater plash -, cailctns Gallons rif'iftd U � f/ cuuurotc co wtivated GUM 'Vow watfill” VII. I?ic spttnsiltliity Stitteuttau tho ilttdet sf$utet2, otst trmxts riek irtavdbMV Zor nxt of the FaWTS s;T owa ou •tiro totalled pl uwt. P)urtliic r''s I+Ttittle (lxrInt) 'p1 gar s sigutttitrr� T n lvil' IPl " ' u11 to _ 7�iuisreira Pikee Vtunbtu- 1: n beer s Adchw (Strew,. e"lly. Sautes, Zip ( . ft*-* 0 ct✓ , �.._._....... M.., w_._._... ..�..._..�...._..�.�,..______. ..�.�..__._._. �- _._...._.._.._._.�...` - 01tappro tve Sao wy 1 Pee {.im es GruundtNor . ` S Slgnatxuu r ups} Apisrrivcs'i f3wrs�r (�lvcu. ittitlai t�tiwcsts - s''urctutrge Pad} SYSTEM OWNER: dispersal cell must all ')` i'' mai i81t1 @a llUtynttlylilu'tlilaynki�rutiq j9altCi'ugClasst)siul$Y,(x 'iy, ttcliusitteixp '" as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. SBD -6398 al, 0.5101.E St"n1,E'Szo736/V 9- 1, -7/ 4T Z Z )J`� `7 3- o Q' �a B� Z 41 9ys- qx-c SPAT s zo 7 66 Aj t w z z /v 7/ LaT 22 p e. m E7 (0 O c� \Sty- - LO/23/2003 14:34 715 467227 HALLE BUILDERS INC PAGE 03 OF 3 NAME i So r� LOT# Z e LEQAL DESCRIPTION sr I/A y /•,S zo T NjV S E for SCALE: V'= 4r4 B TION� } • Q I DESCRIPTIONS BM2ELEVATION 2o BM 2 DESCRIPTION-ib id jz ,9%c -- Aled SYSTEM ELEVATION_ 6,v ?Soo Gou.•r 42,00 ALTERNATE ELEVATON aef o.o k e � & O CON'T'OUR ELI;VATIOI t oZ. To Q 5! sa � • o Pic Z. CA �0 f � Stvpt f r ;. SIGNA'�I.JRE� "` ,- DATE S� /d " d / ST CR0IK CCOIJNTT SEPTIC ':'ANK MAINTI:?NANCE AGREEMENT A.1IM OWt CERTIFICATION FORM Mailing Address Property Address l (Verifiw,atiou rcgoircd frost t Planning Npaitnent for new City/State Parcel Identification Number 02 (o it 7' Z -- c o L EGAL, DESCIU T_IQ Pro i.,actrtzoia Gk-_ '/e 'i', C. ;Z6 T_ 1�l -R� ���. Town of , QC! Subdivision - -- - - _ Lot ## ZZ ...._ e M �l�S /7 . -.. Page # 3� .._.__• Certified Survey p 7 . - Warranty Deed # � e7 � � , Volume I9 �! 3 Page Spec house 0 yes a no Lot lures identifiable EJ yes M no SYSTE MAL 9ENAN Improper we and mainte=nceof your se.l pe wstety could result in its premature failuxeto handle wastes. Prop - ""ratan — cc' consi5ts of pimping out the septic tank every till ie years or sooner, if iieadedby a licensed pumper. What you put into the system can affect t3ae function of the siTtie tame as a tre,� anent stage it dry: Nvaste rllspdsal syetr+nt. 'The property owner agroes to svibuiit to St. oil zoning Lyepu m=t a cortiflc.atxcku form, signed by the own and b a masterpluxriber, joUrneym1antiltutber, restrietedpl. umber or a lieeilssdillunper versfyirig that (1) the oil -site wastewaterdisposal system is in ptoficr operatxvg condi.tinti and/or (2) after in: �ection aAd pum )big (if tseeessary), the septic tit k is lass than 1/3 full of sludge. Uwe., the urtdersigned have read the above req+u v I! ftrnts and aveo to rttaintain the private sewage disposal system with tlxe standards set fpttb. laereirr, as set by the llieparhnettt of Ca ?j, tP and the Llepartir>,e utafN3tural ResottreeR, Ststo Of Wi300"ir1. Cl:t't;'eation stating that your septic system has been maintalnel 4 tit 0 be comrieCbii lad ttturned to the St. 00ix County Zoning Offiox witiXn 30 days of'the (:tree y at expiration date. 42 / ZI / o S A rD" OF APPLICANT DATE i OW NER C EIt�'� FYCA�I 0 N I ( ceTbfy that all statements do this A im, are txue to thin best of m (o ur) ImoxvIedge. I (we) am (.are) th m e f the irk eri d 5C bed above, by virtue, of a wa m► lty decd recorded iu Rtgktei of Dee office. i A) / 23 4 S ATURE OF APPLICANT DATE A informati that is finis represeattd rrc ay result in the s rnitary permit b8hig rovoked by the Zoning Department. tntlude %itlt atis application- a stamped wane tuty deed from Uie Register of .Dee& aff ce a copy of the a rtified wrvay inap if Werence is tttade in the %varrauty deed _ POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page� 2 i P( 1„E INFOR "17Qf1( I a SYSTEM SPECIFICATIONS Owner Septic Tank Capacity — 1_ oe O a G NA Segtic Tarok Manufamurar 13 NA O Si ER$ Effl Fi Man Z D _ NA Number of Sedtmems " ? Q KA Efflu F ilter Ma _._. _,. _... A /00 f NA NurF of Public Facility U XNA Pump 'Tank Capacity 0 NA EsstiFnated flow (average) 3 O O _ Q--flLday Pump Tan Ma nufactur e r p NA D eslan 'fl ow (pe (Estima x 1.5) tt ,,� 0 aUda Pum Manufact 0 NA _�- .___._- .......,..... ...__..Z.,_..._.. is _. _�..._ _.... Bci! Application Rate J. �7 galld Pft4 Pump Model R NA Standarei InflusnWEffluent Quality Monthly hly average* Pretrearoment L(nit A Fats, Oil & Grease (FOG) :930 mg /L 0 SandlGravel f=itter 13 peat Filter Elltsohemical Oxygen Demand (800 5220 mg /L 0 NA 0 Moohsn(aal Aeration p Wetland Total Suspend+sd Sol , s {TSB) . !9100 m g/l. 0 Disinfection Q Other: Piatmated Effluent Quality Monthly average � Dispersal Csalifs) Q NA Biochemical Oxygen Demand (SOD.) aO mg1L �n- Ground {slrevltvl 0 In - Ground (pressurized) Total Suspended Solids $TSS) 530 nog /L NA Ci At Grade 13 Mound F spal coliiforrn (guarnetrlc Hence) 570" cfLi/70Qm 13 l;(riprl fife t7 Otfter: Maxtrnurn Effluent Particle Size Y in die. 0 NA, Other 0 NA Other: Id,A t7 MA * Values typluat for dameatin wastewater and septir, tank efflue , other. Q NA MAIM A111NCE.S PIE i E servine Event Service Frequency rnorit is lnapect condition of tank(t) At least once every; y8� ( Maximum 3 years) C! NA Pump out oontett of tankfs) When cambIried sludge and spurn equate one-third tY of tank volume E3 NA Inspect dlepersaf cell(s At least once every: � year( rrthls} {Maximum 3 yosrs) M NA _ _ L73 st) 'Clean effluent filter At least once every: `> month {5 © NA _ r3 ear (s) Inspect pump, pump oamtrols & alaFm At leant once every" nscrnth(s) 0 NA _ Mush laterals and preasure test At least onus every, -� s Q NA 1~f yearts) Other: At least once, sv�:l+y, � � mEn —ih(s) fl NA 1 yearls) 1I NA MAINTENANCE INSTRUCTIONS Inspectlons of tanks and dispersal cells shall be made by an Individual o arrying one of the 'Following licenses or certifications Mastar Plumber; Master Plumber restricted sewer; POW-TS Inspector; POWTS Maintainer; septege Servicing operator. Tank irApaetions must incrlude a visual inspection of the tankiss) to Identify an mi ssing or broken hardware, identify any creaks or ]asks, measure the volume of combined sludge and scum and to chock for any back up or panning of effluent on the ground surface - The dlsAareal 0811(s) shall be viauaffy ittspested to abeck the o(fluent levels In the observation pipes and to chmak for any panding of ,effluent on the ground surface. The ponding of affluent on the ground surface may indicate a falling conditlon and requires the Imm adlate notifroade n of the local regulatory authurity. When tinn combined aacumulation of sludge and scum In any tank equals one - third f3j or more of the tank volume, the entire contonts of the tank shall qe removed by a Septuge Servicing Operator and disposed of in auoordance with chapter NE 113, Wisconsin Administrative Code. All other gervloes, including but not limited to ilia servissing of effluent filters, mechanical or pressurized components, pretreatment unit's. and any servloing at Intervals of !+13 monthst, shall be perfor -mad by a certified POWTS Maintalher. A servlee repast ahall be provided tc the local regulatory authority Within 10 days of completion of any vervice event. OMW 14101) 511W UP AMID OPERATIGIV Page PQr new oonstruotlaon riot w . , h to use .esf that, . Pfl�l11T�s oh snk tt'aaratmerst taatak {era 'fo► T.l•ria prr3adncQ of stn r ©dts o Cs �B A � or der olgerr►resstas that may Impade the teebtme"i urdaess arrdlcr rls1rad96 tka trarpa9ra al call{sl. It high concentrations are da'tuoted- have the chntents of the tank(a) removed by a septeas sarvitsing Operator piclor , ro use. Systam Start up shall not cauur•wtian sail conditions are frrrataan at the irefllrr8 , ve surfia3c;a. During power out pump tanks, may fill above' levels. When pavver Is restated the &vuws Wa$taWtiter will be discharged to the disperse) cellis) in sire la iVe doses, ovorloading the veil {al and mrAY result In the backup car suer - illadharge of effluent, to avoid this eituagon haslaa the d0htrarat3 of the pump tank reninvad by a Saptage Sarvioing Operater prior to festorlhg power to the effYuerit pump or contact a Plumber or POWTS 1111ralntzainer to assla3t In manually operating the rani dotitrols 'ray p !R p p restore raoftal levels within the puntip tank, DO rlOt drive Or park vehicles over taatke and d1sparsal calls. Do not drive or parts ovary or otherwise disturb or c eimpaot the area within 16 feet down slope of arty mound or at-grade Boil al*orption area. Reduction or ellminatican of the flailaxvrrlrrg From this Wastewater tstresin hasy Im prove the performance and prolong the life of that POWTS: antiblotio$; baby wipes; c1gaaratte butts; uandoms; cotton swabs; degrassars; dental f{ose; ,diapers; disinfectants; fat; foundation drain. (sump purrtp) water; fruit and vaget;able praeilttgs. gHsollne; grease; harblaidea; meat scraps; medloatlona,' all,' painting products; pk%ftloides; sanitary napkins; tampons; arid water su'itener brine. ABAND ONMENT When thn POWTS falls and/or is permanently taken cut of servias than following steps shall lie taken to Insure that than eylataam Is Properly and safely abandoned in campllance w1tb chapter G "omrn $3.33, W- 1sconsin Administrativa Cots= • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. a The contahts of all tanks and pits shall be reiruaved Ethel properly disposed *1 by a Septage Senrlclne Operator. • After pumping, all tanks and pitta shall bra a xcevatod arid removed or theslr uovers removed ✓arid the void space filled with died, }travel or another heart solid material. CONTINGENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or must be Takers, to provide ae coda oampliant roplFZ system: plecterrtent area has been evaluated and orally he ut{fi�ed for than location of a replacement will a bsorption em. iris replauemant -areaa should be protested fromAleturbanoe and compaction and should-,11at..iJe jtft%od °vpdn -by required sgtbuoks from westing and proposed structuPra, lot lines and wallet. lWlura To protest the ratplaosmasnt area will recau'It In this need for a raeW soil and alto aavaluatlon tc establish as suitable roWacaament arena. ReplacxmAnt systams mast comply with the rules in affect at that time. (a A suitable replauemem: area is not available due to setback andfor sail liniltatibns. 80-ring advances in PO technology a holding tank may be irrstallad as a last resort to rep the failed POWTS, The it h not bag ev listed to idan a a Itabla rein sar•nent rea. Ups a Of thb a soil and alts evat on ust be arforrn to loan • suitable splala ram area.. !' no r acarnent ifa is available a holding tank array a In d ' a last rasor I ace the failed S. t� l3 mmd and at -grade sail absorption systarns may be reconstruutad in plaos following removal df the b{l,mat at the lnfilttative surfaa a. kocanstrmovena of such sywte ins must comply with The rules in effect at that tams. < <WARNING> > SEPTIC. POMP AND OTHIM TfiFATMEl1T TANKS MAY CCUTAIN LETMAI. 43ASSIPS AND /OR INSUPPICIENT OXYGEN, DD NOT ENTER A SEPTIC, PUMP OR OT H911 TAEATIVIEllT TANK CINDER ANY CiIRCGlMsTANM. DSATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFIf>:UVr Opt IMpOSSI8t,E: 8RDITION O Miill ` ENTS P VVT$ INSTALLER PGVVT i MAliti- TAINER Marne Nsl maa Pho" ( ° �o �1 _ i'hone . 89 -P AE I;ER ING OPERATOR {PUMFER} 1.,QCAi CQUI.ATaBY AUT HOR" Name Na ha S7; lYO i�fTrane S -e �0 Thla &Ournam vwav drafted In compliance vrrith ahopter Comm &(3). WlwwAWh ACltfi r6tmxIVaa Cods. U 1993P 213 STATE BAR OF WISCONSIN FORM 2- 1999 6 6 6 3 0 3 WARRANTY DEED KATHLEEN H. NALSH Document Number REGISTER OF DEEDS ST. CROIX CO., MI This Deed, made between Hillvale Development Limited Liab ility RECEIVED FOR RECORD Partnership, a Minnesota Limited Liability Partnership 08 - 07 -2002 10:40 AM WRRRPNTY DEED Grantor, and H alle Builders, Inc., a Wisconsin Corporation EXEMPT A REC FEE: 11.00 TRANS FEE: 84.60 _ COPY FEE: CERT COPY FEE: Grantee. PAGES; 1 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area O lot of Golfview Acres in the Town of Somerset, St. Croix County, Name and Return Address n. t 026 - 1137 -22 -000 Parcel Identification Number (PIN) This is not homestead property. (7E) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this W-—�Iay of A ugust 2002 Hillvale Development Limited Liability Partnership ' * Richer elson * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) _ ) ss. County ) authenticated this - , day of Personally came before me this day of August 2002 the abov named Hillvale Development Limited Liability Partnership a Min Limited Liability Partnership TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me n wn to ins m t k bet a w pe t th (s) who executed the foregoing I�e a sl ame authorized by § 706.06, Wis. Stets.) TFIIS INSTRUMENT WAS DRAFTED BY * {f A ttorney Kristina Ogland Notary Public, St f Wisconsin Hudson, WI 54016 _ My Comr�i on i9 ent. (if not, state expiration dat (Signatures may be authenticated or acknowledged. Both are not necessary.) l * Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Company, Ford du Lac, WI WARRANTY DEED STATE BAR OF WISCONSIN Traci: L Turner eOMS -2021 FORM No. 2 - 1999 NUt81'1_' PUDIIC State of 10/23/2003 14:34 7152467227 HALLE BUILDERS INC PAGE 04 r t t J ' W i Ww— "Jim Mon O ©C3 s J 1 H 1 i LLL LL LLL rc LLL "' LL 10/23/2003 14:34 7152467227 HALLE BUILDERS INC PAGE 05 4 4� 0� S O M H X 333 M ' f M M M 1 _ -'" - -- - -- - - - -- I J it I I 1 I { II � 1 II I II 1 !► � ii 1! 1 I( 1{ 11 11 t_--J - - 1 1 I r - ( r {( - -- T - -- --1 II 1{ Y A l l t R I M !&2 /203 14g4 25246727 m ±E BUILDERS INC mE a . # � ■| . « IL ■ 4w \@ _ _ jptp _ - �■ d & �— k � • - ■- � "swim -- � ■ � •! � § .! • | |� ! ) ■ � ■ - } � � � ■ & � _ - la/23/2003 14:34 7152467227 HALLE BUILDERS INC PAGE 07 t of the SW 114 of the 1v1lr' 114, o;r Section 21, and rf of the NE 114 of the 20, aat l Sotaheasterly of e. 4e firmer Chicago, St. P4MIAL, M% e(zpo a ftd L, St. Croix County, Wisconsin. -- -` - West lin �:fA L�1Vr -� SEE S1 TET I OF 3 ��� "f NW 1 /4 T- N , 5 .N00 A N00 "W M ti $1 2 L 87,328 s 4 .f: ° 2.00 acres Ln O cn a � \ d o 22 ~ 87,373 sgJt. w �80o S ` 2.01 acres f4 126 sq• ft. )0 acres 1 6 � �' � � 945. .S'25YR �0� k4. ,� c4 %. \ i i 945.3 10QYR / 170 I r O \ C3 \�