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HomeMy WebLinkAbout030-2131-10-000 CROIX COUNTY PLANNING & ZON i June 2, 2010 G &K Homes P.O. Box 454 Code Administrat North Branch, MN 55056 715- 386 -4680 RE: POWTS Installation Inspection, Sanitary Permit #515192 Land Information Planning Location of Property: St. Croix County, Wisconsin 715 - 386 -4674 Municipality: St. Joseph Township Real Prop Subdivision or Plat: Settler's Glen 715 -3 677 NW 1/4 of SE % of Section 23, T30N, R20W Lot Number: 10 Re cling Address: 1435 Pioneer Circle 5- 386 -4675 Dear Jack: An inspection by county staff of the POWTS servicing the above referenced property was conducted on May 28, 2010. At the time of the installation inspection, this Private On -site Wastewater Treatment System ( POWTS) was found to be code compliant for a four (4) bedroom home. Included is the inspection report. If you have any question regarding this wastewater treatment system, please contact our office at 715.386.4680. Sincerely, Ryan Yarrington, OWTS Inspector #683475 I ST.CROIX COUNTY GOVERNMENT CENTER 110 1 CARMICHAEL ROAD, HUDSON, W1 54016 715- 386 -4686 FAX PZ @CO. SA1NT- CR01X. W1. US W W W. CO. SAI NT•C ROIX. W I. U S Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 515192 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: Bremer Bank I St. Joseph, Town of . 030 - 2131 -10 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 4� yZ 23.30.20.1064 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER � -/ CAPACITY STATION BS HI FS ELEV. Septic J�k Z Z50 Benchmark 97, a - 77 , 4 2- Dosing 1 / Alt. BM 0. 00 7�5b . t> pa st'^" Bldg. Sewer r ' - 7 q� ( / Z Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P WELL BLDG. Vy�t to Air Int ke OAD Dt Inlet ` Septic 33 `J6 Dt Bottom ' 7 ( . Dosing 3 48 / Heade0M t , Aeration Dist. Pipe .� 9a. Holding Bot. System IT O TA 1 2- Qkl PUMP /SIPHON INFORMATION Final Grade 3. Manufacturer 26 6 t L 4A,, errand St Coves� GPM iC �'1 •d �� ` Model Number /-/a TDH Lift / Friction nLos System Head TD Ft le 0 (�� Forcemain Length Z I lDia. / ( Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width ength 1111`7 o. Of Trenches DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 1 7 7 �"� Z / le A. SETBACK SYSTEM TO P/L BLDG i WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR j•ti / 4 7yp O � f System: `a � �' � UNIT Model Number: u' 0� DISTRIBUTION SYSTEM Z Ad lv��( Header /Manifo� �� Distribution \ x Hole Size x Hole Spaci Vent to it I e Al Pipes) \ � al'd O Lengt 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 COMMENTS: (Include Seeded /S ddded xx Mulched Bed/Trench Center N 0� Bed/Trench Edges Topsoil es 0 No Yes No ✓ ✓ c ode discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 1435 Pioneer Circle Ho�ulton, WI 54082 (NW 1/4 SE 1/4 23 T30N R20W) Settler's Glen Lot 10 Parcel No: 23.30.20.1064 1.) Alt BM Description = L i�' c `--- 2.) Bldg sewer length (� - amount of cover = (5 � / r 5, L � P.- S Co w e'�`'�. G a Plan revision Required? Yes ." No Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's ignatur 200or Cert. No. Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix • Safety and Building Division INSPECTION REPORT sanitary Permit No: ` 515192 0 (ATTACH TO PERMIT) GENERAL 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: Bremer Bank St. Joseph, Town of 030- 2131 -10 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: , %j A jZ . - �,-S ( 23.30.201064 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER t t A ,q CAPACITY STATION BS HI FS ELEV. Septic L //Z Zsd Benchmark a 4771 Dosing ` / Alt. BM AQj3tjpp., Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO Q' P , /L r WELL BLDG. Vrt toAi Int ke OAD Dt Inlet 1 � J Septic 33 Dt Bottom 17- 7. Dosing / / Header /Man. 33 y3.5 Aeration Dist. Pipe 4 z . tc It. •°r 5 Holding Bot. System .O 4 ?/, 1 2, fSL Ir .n 7 Qk , PUMP /SIPHON INFORMATION Final Grade ,3• 5(o • q Manufacturer wand St Cov ` ( G �► . Model Numbera TDH Lift` / Frictio nLos System Head TDI-J, Ft ✓✓ l (G Forcemain Length Dia. / / Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width OF Length No. Of Tren PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS - 3 2 lie A. SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Typ Of System: r 57 l A e A ) , UNIT Model Number: / , DISTRIBUTION SYSTEM ? }- ZZ �- `f A �� Header /Manifov Distribution x Hole Size x Hole Spacing Vent to it I e Pipes) �. �� Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mou Or At - G rade Systems Only Depth Over / Depth Over xx Depth of xx Seeded /S dded xx Mulched Bed/Trench Center -t-0 "1 �Z Bed/Trench Edges Topsoils No Yes E] No COMMENTS: (include c ode discrepencies, persons present, etc.) Inspection #1: ! / Inspection #2: ! / Location: 1435 Pioneer Circle Houlton, WI 54082 (NW 1/4 SE 114 23 T30N R20W) Settler's Glen Lot 10 Parcel No: 23.30.20.1064 1.) Alt BM Description = (:� L � " C J4,_ a� 2.) Bldg sewer length = G am • p, -- - amount of cover = / 541&q(� L d _z S C Plan revision Required? Yes No f � � Use other side for additional information. _ ____ __ Date Insepctor's ignature Cert. No. SBD -6710 (R.3/97) 66 0 comirnwoo Safety and Buildings Division County t 201 W. Washington Ave., P.O. Box 7162 �5 , scon sin n Madison, WI 53707-7162 Sanitary Permit Number (to be filled in by Co.) t �: , ,Doepwbnorktof .5 I 5 9 Z. Sanitary Permit Application State Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate govenunental Wk unit is required prior to obtaining a sanitary permit. Note: Applicatio r-sssl nv Project (if different than mailing address submitted to ; the Deparntent of Commerce. Personal information you rovWREeE1`1P' Ind ) , Duroom in rdance withthe Pri Law, s. 15, l m , Stats. n L A lion Information - Please Print Information I Property Owner's Naoe / Parcel # ' Psaperty s ae ing Adare P r acadon �� PLANNING & ZONING OFFICE �Q(p *-- Govt. Lot ` City, State Zip Phone Number V, - ;LE — '/., Section 2= ( ►' o rn 5 , q 7-- T 3 Q N; R2 E H. Type of ;Building (,check all that apply) b Lot # O or 2 Family Dwelling - Number of Bedrooms ,� ((�� Subdivision Nam fabeZ1 0.� Biock JC_ ❑ Public/Commercial - Describe Use ❑ City of CSM Number ❑ Village of ❑ State Owned - Describe Use own of J D's 4d p; ts Gear L--d/ 22-4- ZZ 644-4 in. pey Permit: (Check only on6 box on tine A. Complete line B if applicable) A System ❑ Replacement System ❑ Treaanent/Rolding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber [I Pernik Transfer to New Lm Previous Permit Number and Dace Issued Before Expiration Owner�� IV. Type of POWTS S tem/Com onent/Device: Check all that appl n- 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) ❑ Pretreatment Device (explain V. DispersOTreappat Area Information: ' .S' I ke r Des' Flow. (gpd) Design Soil Applicstion Dispersal Area Required f) Di Pro System ( System E n p 8 fI q/.0 VL Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units ' / _ g `al New Tanks Existing Tanks zl 'V mst� A i 4 � P, Septic or Holding Tank 1.r s'• Dosing Chamber J VII. Responsibility Statement - I, the undersigned, assume r for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's S' W[MPRS Number Business Phone Number I C�� 6 /2P 1 Phrnber's Address (Street, City, State, Zip Code) / e VIM /L J Coun /De artment Use Onl pproved Disapprov Permit Fee Date I ued Issuing t Signatuiro 'ven RWn for Denial / J • $ 7 � 1l 1 IX. Coadiggq "WayW#Aeasons for Disapproval 3� nrw, 1. Septic tank, eff UL filter and dispersal cell must all be services / main1ained yrtlGrn4u�tR. as per management plan provided by plumber, 2 Al � All setback teguirements must be maintained y /VO 111A 111A a; system and subtak to the County f ly on paper not less than IV n a 11 inches in du eahm i SBD -6398! (R. 01/07) Valid thm 01/09 PLOT PLAN PRPROJECT Bremer Bank ADDRESS 8555 Eaale Point Lake Elmo Mn 55042 NW '1/4 SE 1 / 4S 23 /T 3 N 20 W TOWN St. Joseph COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 11/13/09 BEDROOM 4 CONVENTIONAL IN -GRO PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE765 DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 872 # of chambers 44 kk BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100° Filter BEST Filter ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark 280' Prop erty Line SYSTEM ELEVATION 91.5/91.8 5.5' below qrade 30' M. #2 - 50' 15' B.M. #1 Pro 4 2 -3'X 88 cells wit > acing Bedroom 1 House Q� B 90' 36' 10' 45' B- Huffcu om Tank -1 45' 3o e Vent of Corner B Plans Designed Using Conventional Powts Well is to meet all 45' Manual Version 2.0 setbacks required by WDNR Vent >6" Quick4 Standard -W of Cover Leaching Chamber with 20.0 ft2 of Area 4' Long 12" 5.8ft ^2 /pair of end caps 3 4" Grade at System Elevation 471' Property Line Pioneer Circle LfcicoPY PLOT PLAN PROJECT Bremer Bank I A ADDRESS 8555 Eaale Point Lake Elmo Mn 55042 NW F 1 /4 SE 1 /4S 23 /T 3 N/R 20 W TOWN St. Joseph COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 11/13/09 BEDROOM 4 CONVENTIONAL IN -GRO & PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE765 DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 872 # of chambers 44 BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 91.5/91.8 5.5' below qrade 280' Property Line 30' M. #2 B -4 50' 15 B.M. #1 Pro 4 2 -3'X 88' cells with >3' spacing 18' Bedroom B -2 House 90' 36' 10' 45' B -3 Huffcutt Combo Tank B -1 45' 3% Slope Vents Lot Corner B -5 Plans Designed Using Conventional Powts Well is to meet all 45' Manual Version 2.0 setbacks required by WDNR Vent >6 „ Quick4 Standard -W of Cover Leaching Chamber with 20.0 ft2 of Area 4' 12" 5.8ft ^2 /pair of end caps Long Grade at System Elevation 34" 471' Property Line Pioneer Circle RECEIVED PA I D Wisconsin Department of Commerce OCT 0 6 2009 SOIL EVALUATI EPORT Page J of Division of Safety and Buildings 61 i� @ &4R(o, with Comm 85. Wis. Adm. Coda �Wq ZONING OFFICE County � ` Attach complete site plan on papt�lt� �ftan 8 112 x 11 inches in size, Plan must Include, but not limited lo: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. — Z? Please print all Information. F*Viewed y Date Personal Information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). l ; ` G f �/Y��►� - I (7 �) Pr perty Owner cord. t• Property Localion • C t Govt. Lot 1/4 S G 1/4 S T N R E Property Owners Mailing Address Lot # Block # Subd. Name or CS # SG�F City StW Zip Code Phone Number 0 City ❑ Village Town Nearest Road 1,a c a �' ►aNetr C; A ❑ New Construction Use: <�.Residential ! Number of bedrooms Code derived des' n flow rat? __ __ GPG II Replacement 0 Public or commercial - Describe: �� � / Parent material QL�Q,r .. ^f `yr) OL tt Flood Plain e!evation if app ` tt General comments and recommendations: 5 vgej 3 —'�'r' Gtrt( 5 �.7� t'� r t rC.. H S ; T� • T, 1 9a,15 r .r. 4 g a.k5► 1 -F+ W -r- 1)) . 9 a' S l +t c7 : r,s 92.61 , . ?,L •3 ! / J Boring # o Boring ( # J 59 Pit Ground surface elev. _ ft. Depth to limiting factor ;1 0 In Soil Applica Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Etf#1 I 'Eff#2 1 0 -5 1 610 1 h �. a FSb k s ow ' 61 .13 a oY $ ----� IF L S� ,�, J � a , L m w • i, t o G ® Boring # Boring Pit Ground surface elev. T 3 ' 3 3 ft. Depth to limiting factor 1 a 0 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 I - 01 R /a �-. FS k 5 .�� t. , ? - 0 3 / tF w t� I -( S L S C w v -la S't s - L ' Effluent #1 = BOD > 30:5 220 mg/L and TSS >30 150 mg/L ' Effluent #2 = BOD 5 30 mg& and TSS _< 30 mcyt J T aine (Please Print Signature CST N 1 berat Evaluation Conducted Telephone Number n rya - c - A 6 i Property Owne 4r\ Boring 0 Boring Parcel ID # _ Page _Q of _ F-31 # i 7 Pit Ground surface elev. ft. Depth to limiting factor a� in. SoA Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh I I I 'Eff #1 'Eff #2 O -, 1CP L. F l a.\A.� 1 a� • V I S Io�t� F P L 1 A S Gvt.; I i F , b Q t RY C L � es >msbk h c,� --_ - 1 A L-. — © Boring # Boring a Pit Ground surface elev. _ / �� g� h. Depth to limiting factor a � _ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /tf in. Munsell I Qu. Sz. Cont. Color Gr. Sz. Sh. 'Etf #1 - Eff#2 o R, L DYQY Y I i 4 `f , Y O F 't 0 Boring © Boring # Ground surface alev. .� ft. Depth to limiting factor _� in. Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistences Boundary toots GPD /ff In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. i I 'Eff #1 I 'Eff#2 c -r M CV F- LL�y L ' 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 cmployer. 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•r)JO (R.6=) - F f Property Owner Parcel ID # _ Page _QR_ of _ F3 -11 Boring # Boring pit Ground surface elev. ft. Depth to limiting factor In. Soil ApplicaUon Rate Horizon Depth Dominant Color gDescripUon Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Gr. Sz. S•Eff #1 'Eff #2 o- i to �. sbk des h tzw C -5b %c 1 s G ro SA SS 7�5 Q.� C I_ l vn k V © B # 0 Boring Q oring Pit Ground surface elev. _ / 7 r gI ft. Depth to limitin factor a � p g ' in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure I Consistence Boundary Roots GPO /tf in. Munsell Qu. Sz. Cont. Cofor Gr. Sz. Sh. 'Eff#1 'Eft #2 " R.3 L h Ot DYQY c i ---- © Boring # El Boring �• Pit Ground surface elev. h, Depth to limiting factor L2 in. Soil Application Rate Horizon Depth Dominant Color Redox DescrpUon Texture Structure Consistency+ Boundary boots GPDIff In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 I 'Eff #2 - . b 7 Ys L r4 — ' Effluent #1 = BOD, > 30:5 220 mg/L and TSS >30 < 150 mg/L "Effluent #2 = BOD, < 30 mg/L and TSS _ 30 mg/L The Department ofCommerce 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. sao•u�o ta.arooi "C%� ✓Sa , 1 � i i t i 1 1 i _ _ a _ UY VI_ I CL IV I , I _ v I , I ' I • 4 4a ( A + Vf t L O� oom C6 LO 416 oll 16. cr- r 'd 2 7 �" «- p 4 CD 90 J O F� low e,6 •9 4a 4a 3 �,����r�-•'1 /.j {,r ' M�]Pdlp4�GD_dG_p�]D3 OM�I N00°05'53"W 21 1E SE1 /4 284.80 280.86' 4 .... , ... . ..••...... ......................... •.•..•••...••.•...•. 1815.6T / o co 00 �� o ~: Cl W�° ►ri U� `. a TM 50 O Q II Q m rr p O O� m /' J 9 J 91 0 1W� LLI �- af 1 cr c1 ,r o 1 0 co W J J, J Z m 128_ co w _ W W w ..1....... ..... ° / a r co z Cn Lo 0 cis 0 0 1 / D SO 0 05'53'E 74.EW / - - 1 - 310 ai -- _ z �� � ^ NO � m / ,/ O 05 53 W I N 74.86 - Uzi ...e \ / m v . 101 a . U � d A \ / lL• / CM C9 J r �,�p y ° / / QA w m �o �� Dug /. / V w4 H4 w o CA) rn i T J O • .w,. w �i j c C6 Cf) J d y .tip. Q � $ W Septic-Dose Tank Cross Section And Pump Performance Specifications Tank Manufacturer ,,� Pump Manufacturer e Tank Model Number Pump Model Number S Total Tank Capacity S�S Alm Manufacturer 1� Q- S Max. Bury Depth Alarm Model Number Switch Type Filter Manufacturer Total Dynamic Head (TDH) - Feet Filter Model Number — Elevation Head �-- Distal Pressure Network Loss Minimum Pump f erformance Required Force Main Loss U a v GPM! 1 Ft TDH Total Outlet Manhole Min. 4" Above Grade With Manhole Min. 4" Above Grade Locking Device. Inlet Manhole Securely Mounted With Locking Device < 6" Below Grade Sealed Watertight weer - proof 1 Junc Box -- Finished Grade -0 Vent Min. 12" Disconnect Above Grade Means With Vent Cap Outlet Filter --�� - -_ -- _ -- _ -- Inlet a- Wet Baffle •: A ' /a" s and Reserve Capacity : ' Switch Setting Weep GPI Tank Volume = :; • B Hole Dimension! Inches Volume Gal. (reserve) A a `�`r �" C > • Off Elevation (alp) B 2 Ft Bottom (dose) C 0 > 2 D Elevation (dead) D l Ft Total 'i�S : ..:::.:•::: >: r---- X. INSTALLATION: The septic /dose tank is bedded and back filled in accordance with the GENERAL s ified b the manufacturer may not manufacturer's product approval specifications. Maximum depth of bury as p y device (padlock) be exceeded without prior gpproval. Manhole covers exposed to . grade have an effective: locking fittings, and installed. Piping at the inlet and outlet is of approved material, connected to the 7' S 40 PV watertigh bridge the tank installed. g u► The force main is sleeved with laid on stable soil to prevent settlin or sagg g. excavation and the sleeve is sealed watertight. Electrical service complies with NEC 300 and Comm 16.2:1. Page of 02/05 Li TOTAL DYNAMIC HEAD /CAPACITY LO = PER CAPACITY CURVE PER MINUTE t— W EFFLUENT AND DEWATERING M MODELS 53/55/57/59 25 Model 53/55/57/59 6 20 Ft. Meters Gal. Ltrs. w 5 1.5 43 163 � 15 10 3.1 34 129 } 4 15 4.6 19 72 10 Shut —off Head 19.25 ft. (5.9m) I c 2 5 3 15/16_ 6 5/32 –.I 4 5/8 1 1/2 —11 "/2 NPT U.S. GALLONS 10 2 30 40 50 3 is /1s LITERS 80 160 D -- r FLOW PER MINUTE 0 °M' 4 1/16 COANSU T FACTORY "F pECIAL APPLICATIONS 1 r Variable level float switches available. Variable level long cycle systems available. Available with special cord lengths of 15', 25', 35' and 50'. i Alarm systems available. 10, 1 1 /16 Duplex systems available. -1 3 3/32 sisaea SI Is aal Carr6ol Sslektion SELECTi01d GUIDE ut volts Phase Mode Amps Simplex Duplex CSA UL 1. integral float operated mechanical switch, no external control required. b153/55 & M57/59 115 1 Auto 9.7 1 Y Y 2. Single piggyback variable level float switch or double piggyback variable level N53165 & N57 59 11 1 Non 9.7 2 3 or 4 5 Y float switch. Refer to FM0477. BN53 t15 t Auto 9.7 Y Y 3. Mechanical alternator Wale 10-0072 or 10-0075. BN67 tt5 1 Auto 9.7 _ N Y 4. See FMO712 for correct model of Electrical Alternator. BE53/57 230 1 1 1 Auto 4.8 Y Y 59 230 1 Auto 4 8 1 -- -Y Y D53155 & D57/ 5. Variable level Control switch 10-02'25 used as a control activat with Electrical E5315 & D 57 1 59 230 1 Non 4.8 2 3 or 4 & 5 Y Y Alternator (3) or (4) float system. ' Single piggyback switch included. For information on additional ZoeNerpr0dudsrefertocat ogonP'gpybaccVarWeLevel FloatSwkhes, FM0477, Ali insia.lation of controls. protection devices and wiring Should be ac %� by a c ;ua ff s Electrical ARemator, FM0488; Mectanical Alternator, FM0495; su plSewage Wms, FM0487; and single Phase licensed eiectrician. All electrical and safety codes should be fall6 -d i! c' :ding the most recent r4ational El side C C Code (NEC) and the oupaticnai Safety;and H •a: _n Act fOSHA Simplex Pump ConbDtAlarm Systems, FM0732. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MA(L TO: P.O. BOX a� Louisvi#e.KY '. Maradacar►ersor.. SHIP To: 3649 Cane Run Road ��► ® Louiatt KY 40211.1961 iaurrPiau S N cE /939 ® (sa2) ns- 2731.178W) 928 -PUMP hrgo:OwwwaoeBercom P,/MP M. FAX (Sa2) 774 ,Wa - - -- a Copyright 2002 Zoeller Co. All rights reserved. Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Eff luent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 ntin cy Plan Option #1. If system fails, determine cause of failure, use alternate area and install new ste n tested replacement area. Option #2. Install system at a lower elevation, by removing chambers, removing biomat, and install new system. Option #3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 715 - 246 -4516 St. Croix County Zoning 715 - 386 -4680 Pumper Tom Mondor 715 - 246 -5148 Shaun Bird #226900 . i ST. CROIX COUNTY SEPTIC TANi, iVMAIlV'I'ENANCE A AND OWNERSHIP CERTIFICATION F RM Owner/Buyer -3 ar6t4t,4�6'dt� Nailing Address Prop erty Address (Verificxtiom requited From Planning & Zoning D for new M ) City /State Parcel Identification N LEg DESCRUTEON property Location Nu) V/...5 ' / +, Sec.?3 , T - LN W, Town of session f rot# / Certified Survey Map # Volume , Page # D eed # b C n V o l ume — _ ' , Page # °M W D � , sPeC house L150 no Lot hoes ientidable O no M S= MAINTENANCE AND OWNER CERTIFICATION , , W'Me to handle wastes. PropOr lmpropeac use and �maia bmtmuac of year h � ibiee �� s ooner , if ` - by a licensed pumper �t you P� �o rosintenswe consists of ptimaping eat the aaptac any m the disposal syatcm. Own= MainteMot the system = affect the of Ste septic tank as a treataaent stage responalIA ties are spxi6ed is §Comm. 83.52(1) and in C bspter 12 - St Croix Sanitary fi its submit to St Croix County plsmaiag 8t Department a ccrhf cation form, signed by the �° ply o wner agroes hmaber or a li pear g that (1) the on. -site owner and by a mast ar phimber, jonmyman Pte+ r0 iabed p a P (if nwosaary). the septic tank is wastewater disposal system is in proW opwa�ig comdmon and/or (2) after inspect on /3 M of less t1�.1 shwa. have read the above requiremen and agree to ma=n M the p� sew d � system with the Vwe, the uaAaftod o f Naeuai Resources, State of Wisconsin. sundards set forth, bre vb6 as set by the Depasomeux of Commerce and the md tCdn�Cd to the st. C roix County Pb=mg & Certification stating that your saptie system has been m mmwd most be C Zoning Department widAu 30 drys of dM three YOU warden date. J 1/we cediPy that all stateaae u on this fora are true to the best of my /oar knowledge. T/we am/axe tine Owner(s) of tin property described above, by virtue f a warranty deed recorded in Rogtster of Dec ds Office. Number of bedrooms _ I, DATE IGNATURE OF (S) *• *An. omutioa that is misrepresented may result in the savitary permit being "ked by the PUnning & Zoning g D * ** IacWde with this application a recorded warranty decd from the Register of Deeds Office and a copy of the oatified sarvey MOP if reface is made in the warranty dead. I (REV. 08/05) II Sheriff s Deed * 8 7 6 5599 9 3 Document Number Document Title 876599 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 06/12/2008 08:OOAM SHERIFFS DEED EXEMPT t 14 REC FEE: 15.00 PAGES: 3 Recording Area /s Name and Return Address Lindquist & Vennum P.L.L.P. (KDK) 4200 IDS Center 80 South Eighth Street Minneapolis, MN 030 - 2131 -10 -000 Parcel Identification Number (PIN) This information must be completed by submitter: docu title, name & return address, and PIN (if required). Other information such as the granting clause, legal description, etc., may be placed on this first page of the document or may be placed on additional pages of the document. Note: Use of this cover a e adds on t p g e e o your document and 2.1H1 the re fn f .Wisconsin Statutes 59.43 2m WRDA 1-113 1-113 Rev. 1/8/2004 page Yo to a cord gee . ( ) 1 of 3 SHERIFF'S DEED ON FORECLOSURE Wisconsin Statutes § 846.17 Case No. 07 -CV -822 WHEREAS, pursuant to a judgment of foreclosure and sale rendered in the Circuit Court of St. Croix County, Wisconsin, on December 18, 2007, in an action between Bremer Bank, National Association, plaintiff, and Grundhofer Construction Co. Inc., JeromeT7 - Grundhofer, Lois E. Grundhofer, and W.B. Martin Lumber Co. Inc., defendants, after due advertisement, the mortgaged premises hereinafter described were sold on April 29, 2008, to Bremer Bank, National Association, the highest bidder (Grantee), for the sum of One Hundred Two ousand wo undred Ninety Two and 43/100 dollars ($102,292.43) (Purchase Price), and WHEREAS, the Grantee is now entitled to a conveyance according to law, NOW, THEREFORE, the undersigned in consideration of the payment to the Sheriff of the Purchase Price, receipt of which is hereby acknowledged, conveys to the Grantee the following real estate in St. Croix County, Wisconsin: Lot 10, Settler's Glen located in the Town of St. Joseph, St. Croix County, Wisconsin. Dated this 29th day of April, 2008. g), dz�e Dennis D. Hillstead, Sheriff St. Croix County, Wisconsin Doc# 2640168 \I 2of3 STATE OF WISCONSIN ) ) ss. COUNTY OF ST. CROIX ) On April 29, 2008, before me came Dennis D. Hillstead, known to be the person and officer who executed the above conveyance, and acknowledged that he executed the same as such Sheriff, for the uses and purposes therein set forth. Notary PuVlicU State of Wisconsin Public My Commission: State of Wisconsin THIS INSTRUMENT WAS DRAFTEI) BY AND SHOULD BE RETURNED TO: William P. Wassweiler (MN #232348) Kirstin D. Kanski (MN #0344676) Lindquist & Vennum P.L. L.P. 4200 IDS Center 80 South Eighth Street Minneapolis, MN 55402 (612) 371 -3211 Doc# 264016811 3of3 r Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County C Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 1 percent slope, scale or dimensions, north arr ally distance to nearest road. O ,3 o I " Please print all Info Re Y Date Personal information you provide may be used for i econdary purposes (Pri acY Law, s. 15.04 (1) (m)). Property Owner i7; ? d �' f l f1 P rty Location C [fir �1 Lot /v 1/4 1/4 S Z T 30 N R E (or Property Owner's Mailing Tess L4 # Block # Subd. Name or CSM# City State Zip Code Phone Number ❑ City ❑ Village [ Town Nearest Road I , oa kc - I h- $2 ( C65 I ) 4 39 - 2t. 1 y _ S 3S [ New Construction UseQ Residential / Number of bedrooms —'— Code derived design flow rate GPD ❑ Replacement I [] r J 4 S h Public or commercial - Describe: _ Flood Plain elevation if applicable /(-/ ft. Parent material 0 0 7k General comments S ys�e V , �� 3 6 and recommendations: F 1-1 Boring # ❑ Boring (' I ® pit Ground surface elev. T� ft. Depth to limiting factor � � $ 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. - Eff#1 'Eff#2 ( V Z 1_ ( qH C5 3 -gi )0 , JrLt I -z .3', y2'' - M all a- Boring # El Boring ® Pit Ground surface elev. �'7� ft Depth to limiting factor 13 �• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fly in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 'Eff#2 I 0 _ Z I 2m�. C 1V 5 2 , - � 51' 1 Z — 9 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) S' ature CST Number 9 Address Date Evaluation Conducted elephone Number 2-11 3 W� Somerse+ , l�Jt 5 ZS _ /�� 0 z �� 15� 2-q - '4U)S Property Owner Parcel ID # .. F- Boring #• ❑ B ng � Page of 31 '` ' ' ❑ Pit Ground surface ellev. ' r ev. ' ft, Depth to limiting factor In. Horizon Depth Dominant Color Redox Description Texture Soil Application Ra P Structure Consistence Boundary Roots GPD/it In. Mansell Qu. Sz. Cont Color G�. Sz. Sh. 'Eft #1 •Eff#2 • � -1 l� 2. • �S -I• 2 c 1 v� . 5 �_ 2 t - SIBr- C F-1 Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rai Horizon Depth Dominant Color Redox Description._, .Texture _Structure Consistence Boundary Roots GPD /W In. Munsell ou. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 •Eff/i2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. R Depth to Gmitiog factor in. Soil Application Rats Horizon Depth Dominant Color Redox Description Texture . Structure Contence Boundary Roots GPD /ff sis In. Munsell (2u. Sz. Cont. Color Gr. Sz. St 'Elf#1 •E11`42 Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 1 SO mg/l. • Effluent #2 = BOD < 30 mcyl, 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. ssa1330(IL07ro0) i l Propi'tty Owner. •I:' : , I.T. Parcel ID # Page 1 of Boring # F] QorYng ❑ Pit Ground surface elev. ' f R Depth to limiting factor t in. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary oil Appllplion In. Munsell Qu. Sz Cont Color ,: rY Roots GPD /ftz Gf. Sz Sh. 'Eff #1 'Eft F -1 Boring # �] Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Horizon Depth p Soil Application F p Dominant Color Redox Descri don . _ Texture Structure Consistence Boundary Roots GPD /t= In. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff #t 'Eff a Boring # ❑ Boring ❑ Pit ' Ground surface elev. R Depth to limiting factor in. Soil Application Rz Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP /ftu in. Munsell Qu. Sz. Cont. Color Gr. Sz. SV, 'E1f #1 'EffN: - ' Effluent #1 = BOD > 30 < 220 rng/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/4 and TSS < 30 mg /t. The Department of Commerce is an equal opportunity Service provider and employer. If you need assistance to access services OF need material in an alternate format, please contact the department at 608- 266 -3151 or TFY 608 -264 -8777. SBD -8370 (807/00) ' • 4 PAGE OF 3 NAME �Q rr� "`�` LOT # ./0 L EGAL GAL DESCRIPTION dl w y4j�F Y S Z -5 T 30 N R Zo E(or4� SCALE: I"= yC> BM I ELEVATION U BM I DESCRIPTION -,p (::If BM 2 ELEVATION �(`�• O BM 2 DESCRIPTION SYSTEM ELEVATION SYSTEM TYPE CONTOUR ELEVATION J ' i I � q n f r 1 i 12`� A 010�o SIGNA DATE r wy .y: LOT a . UM ASS z� 130.890 SO. FT. Ig IN LOT 9 I •' aY I / .. 3.000 ACRES : • •�� C? / 130.699 S0. FT. L.B.O. =905.0 E. TIES 05.0 .......... ................. ........`�'y, ........... M. 28r nlk I , I ,nr IN V / .. .....................r ............. ..: y J / / STORM WATER I y PETENTION AREA 1 S2' L 1 O 2 17 RES H.W.L. =903.0 c� ' L.B.O. =905. .�� � - 471 . • � 'b t�3'4yg�p - I� • 1t� LOT 11 • f 3.000 ACRES 130,891 SO. FT. L.B.O. =905. 1 / I H.W.L. =903. N LOT ST•QRM WATER / A REtENTION AREA i / M AN SO. FT. y L.B.O. =905. Z N om° iE NWIA OF THE SE1 /4 — \ \ ,�\ H.W L. =903.0 4 a lz �� 3 0 ti O v> N Q c y 0 C O C N t N o C U C CL I U O° a ° C C Z O 7 f6 C LL 0 3 0 ° ° I 3a a CD aD I Q z .n v I � � I C) W z H 1 : 1 3: a m N 1— z II 0 Z', a C w 0 a C W o N N a _ I N � N co N O N • C N O O z S z N ++ o d C Ln ID E \vim N Ri Q IR y li A �3 0 ooa. .ate (D ° o N to N o = al 'm R U a a a a v g d rn 7 O fn N O N O to J U o ° z a z LO M _ ' w O a I U) v °-' Q n in � o I O p C I - ' Y m C L ' ° CO N ` W M N O N C N N = N O O O O N >- N Q M Lo 7 C a 00 ftf co N U) m O Z N z O !i A j E_' �a�. • a 7 5 m r 0 m 9 0 r A 0 C o00 - 111111111111 Ilill Ilill 11111 Illfl IIII il[III 1111 IIII 9 1 2 4 2 8 2 STATE BAR OF WISCONSIN FORM 1 - I998 912428 BETH PABST I Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI { 030 - 2131 -10 -000 RECEIVED FOR RECORD Parcel Identification Nutnber (PIN) 42/262010 04:00PM THIS DEED, made between Bremer Bank, National Association, a WARRANTY DEED EXEMPT National Banking Association under the laws of the United States of REC FEE: a 13.00 America, Grantor, to Jason E. Terwey and Lydia L. Terwey as survivorship TRANS arital prop, Grantee, FEE : erty 165.00 Grantor, for a valuable consideration, conveys to Grantee the following PAGES: 2 described heal estate in SL Croix County, State of Wisconsin the i SEE ATTACHED EXHIBIT A Thisis not homestead property. Recording Area Together with all appurtenant rights, title and interests. f Title Recording Services, Inc. 598441 Grantor warrants that the title to the Property is good, indefeasible in 79 Western Ave N fee simple and free and clear of encumbrances ex St. Paul, MN 55102 12y { exc ept; ST. CROIX A TSMART BASIC IIIIIIIIUII >NIIINII�llIII oil IN1111MI Wo '� I Dated this F'ebrUexcjj o Bremer B Nation Associatio It By: Bradley R Krogm v `(SEAL) (SEAL) Its: Vice President (SEAL) (SEAL) r AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF MINNESOTA i j COUNTY OF iSll i r1L1 i authenticated this Personally came before me this r� yi ZO 2009, the above named Bradley R. Krogman, the Vice President of Bremer Bank, National Association, a National TITLE: MEMBER STATE BAR OF WISCONSIN Banking Association organized and existing under the laws of (If not, the United States of America, to me known to be the I authorized by § 706.06 Wis. 3tats.) person(s) who executed the foregoing instrument and THIS INSTRUMENT WAS DRAFTED BY acknowledge the same. Attom Gre Booth TAMMY ANNE LUND 1054 CentarviIle Circle NOTARY PUBLIC - MINNESOTA Vadn als Heights MN 55127 My Commission Expires Jan. 31, 2013 _ (Signatures may be authenticated or acknowledged. Both are not necessary,) 'Names of persons signing in any capacity must be typed or printed below their signature. Notary Public, fMinnesota. My commission is permanent. (If not, state expiration date: 0 13 GGV DG 1 � 1 of 2 I Exhibit A I Lot Ten (10), Settler's Glen, located in the Town of St. Joseph, St. Croix County, Wisconsin_ I I I I j i 1 1 f 1 { 1 I 1 1 i 1 1 E i I i r i i 2 of 2