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HomeMy WebLinkAbout032-2016-70-000 0 � 0 ' E �� 7 % k c k 0 ° / _ Q s z \ w o coo E ° ` ° § E - e :,- \ Cr R $ 2 \ §k§ 0 �E §§ § . k 3 § $ / U, ■ a ° 1 \ @ v ± � % §� � � _ 0 $§� CD @ z C', E /$ 7 7 0 n r■ . . k 2 M z 0 0 0 � o m 2 ` § : 3 % 3 I i Orq \ i / ° § / 0 ■ » \ 7 / \ z ƒ \ / \ CL ƒ im / / f , \ 2 / } 2 z E { . m / # z k m e $ / m � 7 � � � m CD > �� . % I \ 0 e ; m $ t � � S . � U � � q I � 2 7 0 \ . k t / . k � Parcel #: 032 - 2016 -70 -000 01/31/2005 08:29 M PAGE 10 1 Alt. Parcel #: 4.30.19.533B 032 - TOWN OF SOMERSET Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner MATTHEW P & JILL L GADDIS ' GADDIS, MATTHEW P & JILL L 596 170TH AVE SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description * 596 170TH AVE SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 6.140 Plat: N/A -NOT AVAILABLE SEC 4 T30N R19W PT SE SE COM SE COR OF Block/Condo Bldg: SW SW SEC 3 TH W TO W RM/ HWY "I" TH N TO N R/W TN RD, TH W 1252.32 FT TO POB; Tract(s): (Sec- Twn -Rng 40 1/4 160 114) N 417.44' TH W 626.16' TH S 417.44' TO 04- 30N -19W TN RD, TH E 626.16 TO POB ASM'T INC 032 - 2011 -70 Notes: Parcel History: Date Doc # Vol /Page Ty e 10/30/2000 632693 1555/03 07/23/1997 443/274 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 10702 181,200 Valuations: Last Changed: 07/24/20 3 Description Class Acres Land Improve Total State Reaso RESIDENTIAL G1 6.140 63,000 90,600 153,600 NO Totals for 2004: General Property 6.140 63,000 90,600 153,600 Woodland 0.000 0 0 Totals for 2003: General Property 6.140 63,000 90,600 153,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 204 Specials: User Special Code Category Amou t Special Assessments Special Charges Delinquent Charge Total 0.00 0.00 0.0 1 County: Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM St. Croix Safety and Buila'ig , bivision " ?' INSPECTION REPORT Sanitary Permit No: 395111 0 GENERAL INFORMATION (ATTACH TO PERMIT) S to Plan ID No: Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)]. # qq{ - Z?- = T�otiK. i�• Permit Holder's Name: City Village X Township Nrcel Tax No: Gaddis, Matt I Somerset Township 032 -201 -70 -000 CST BM Elev: Insp. SM Elev: BM Description: 4, .� ^ , `� ` 15 �� TANK INFORMATION ELEVATION DATA • � V TYPE MANUFACTURER CAPACITY STATION BS HI FS E EV. Septic Vt�C.J Benchmark Dosing � Alt. BM A"atiQp v Bldg. Sewer Holding Ht Inlet TANK SETBACK INFORMATION Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 3� r J Septic , 32. r Dt Bottom Dosing ' � � ] �f f ' � � Header /Man. 1 I r Aeration Dist. Pipe 22 I g Bot. System r o ,ID Final Grade PUMP /SIPHON INFORMATION y 1?-"+ s. Manufacturer n I Demand St over e- 0 GPM �2 Model Number 13 T I , f// C k 7� / �J DH Lift Friction Loss System Head 1 TDH Ft / l LO O L1 3.SV 3• ZS 3•to1- p ' Forcemain Len th Dia. Dist. to Well yS Z" ? r L30 f 1, 3 d SOIL ABSORPTION SYSTEM C3 8 i e o I `� . (08• o t a BED/TRENCH Width Length ( No. Of T s PIT DI NS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS r� ro b 1l�" • ��IS SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEAC Manufacturer: INFORMATION CH R O Type Of System:/ r UNIT Mo tuber: 7 ��[) � /mi / DISTRIBUTION SYSTEM I Header /Manifold Distribution I/ x Hole Size x Hole Spacing Vent to Air Inta e I/ Plpe(s) r/ 1 '2 .� / Length Di 2 -� 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 Do Yes No rjv� Ye ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: r/ q 0 Inspection #2: Location: 596 170th Avenue Somerset, WI 54025 SE 1/4 SE 1/4 4 T30N R19w) 043019533B N/A Lot 1.) Alt BM Description = 2.) Bldg sewer length = - amount of-co r = joi1w3, 3.) Contour = .b �N, �I• � s qb��L l Ian revision Required? f Yes No to 01 Use other side for additional information. l 3 SBD -6710 (R.3/97) Date Insepctor's Sigdature Ce . IyY 6 7 Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 'Wis consin Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Commerce [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not state owned.) Attach complete plans (to the county copy only) for the s not less than 8 -1/2 x 11 inches in size. -7 County. State Sanitary Permit Number ❑ Che si __. eViops plication State Plan I. D. Number 3 93 1 s � z2 I. Application Information - Please Print all Information �, c .; Location: Property Owner Name ,. N- ' Property Location T'i n nnni C Se 1/4 5 E 1/4, S T 70 ,N, R (or) Pro ner's Mail' + - Lot Number Block Number 5 e ?f! U 1 dN AW All City, State Zip C ne ItG Subdivision Name or CSM Number II. Type of Building: (check one) ❑ City CK 1 or 2 Family Dwelling - No. of Bedrooms: ❑ Village ❑Public /Commercial (describe use):_ ® Town of ❑ State - Owned © " e — Nearest Road 17 07f Acle Parcel Tax Number(s) III. Type of Permit: (Chec )"illy one box on fine A. Check box on line B if applicable) y. 3 . / f S3 A) 1. ❑ New 2. Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System B) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) ❑ Non - pressurized In- ground 2T Mound r � X y2 - li ❑Sand Filter ❑Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: - 2 A X 5 7 3 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation O©. o ,a D' 1.0 0 %5� /.0.7.92- VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks E i 1 420 - 0 P ❑ ❑ ❑ ❑ DfJ ✓ VIII. Responsibility Statement I, the undersigned, assume responsibili for installation of the POWTS shown on the attached plans. Plumber's Name (print) P m is Signature (no stamp MP S No. Business Phone Number lumber's Address (Street, City, State, Zip o e) s° 0' IX. County/Departmefit Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) Approved ❑ Owner Given Initial Adverse Surcharge Fee) Determination 2 OQ Z z X. Conditions of Approval /Reasons for Disapproval: i �eyci`sfK� ors {a� SAa,l/ !I. d oe✓ 6 QVJ i-1` 4r 4 Le IwS4a(W Q,,j SCVUiced pc,( iMar,�4ac4r JtGpr►nYY�cl�t�aT 5. SBD -6398 (R. 07/00) Safety and Bindings K + 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 AA - TDD #: (608) 264 -8777 www.commerce.state.wi.us/SB Department of Commerce Tommy 0. Thompson, Governor Brenda J. Blanchard, Secretary C November 21, 2000 CUST ID No.221741 ATTIC POW7SINSPECTOR ZONING OFFICE DONAVIN L SCHM1I "T ST CROIX COUNTY SPIA 586 VALLEY VIEW TRL 1101 CARMICHAEL RD SOMERSET WI 54025 HUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/21/2002 Identification Numbers Transaction ID No. 447227 Site ID No. 201643 SITE: Please refer to both identification numbers, Site ID: 201643, Matt Gaddis above in all corres ndence with the' ageti St. Croix County, Town of Somerset SEI /4, SEI /4, S4, T30N, R19W FOR Description: Two Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 769969 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10572 -P (8.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10573 -P (R.6/99). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • An effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The changes made to this plan on 11/21/00 by this reviewer were acknowledge and approved by the system designer. es $n er. Note: Any increase in the Total Dynamic Head may require the use of a larger effluent pump if the system is installed according to the approved design. f DONAVIN L SCHN= Page 2 11/21/00 A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of constructionfmstallation /operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, DATE RECEIVED 10/30/2000 FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 Gerard M. Swim BALANCE DUE $ 0.00 POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. to Fri. 7:15 AM to 4:00 PM jswim @commerce.state.wi.us WiSMART code: 633 r f r T ' � s,ft 6 ,9 j FF z ° °0 fur O�Y MA TT GADDIS Sw SE114 SE 114 S. 4T. 30 R 19 W. 596 170TH Ave. Somerset Township St Croix County Contents Soil Evaluation Report Work Sheet - Design of the Distribution Cell �s, �� Work Sheet - Pressure Distribution p0 • Plot Plan C j djtiOo . a Y System Cross Section �® Pipe Lateral Layout ` `,� o f �oMME �p pEFARStAE �y Dosing Chamber Ell otvIs'o� of Pump Curve N EE SEE CO RRE by Donavin L. Schmitt 586 Valley View Trail Somerset, WI 54025 715 -549 -6651 MPRSW 221741 10 -23 -00 �r 1016 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and - - - percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. 032- 2016 -70 -00 Please print all information. Reviewed By Date Persnnnl information ynu provide may ho used for necondary purpose,^. (Privi y I nw, s. 15.04 (1) (m)). I'i.quyily 6­1­1 1 1'I"j -11y I ". cil lni Bernstein, Edwin Govt. Lot SE' 1/4 SE: 1/4 S 4 T 30 N R 19 W Property Owner's Mailing Address Lot # Block # l Subd. Name or CSM# 596 17 Ave. I _ j City State Zip Code Phone Number I City 1 Village ✓I Town Nearest Road Somerset I WI 1 54025 1 715 247 - 3263 Somerset 1 170Th Ave. I New Construction User i/1 Residential / Number of bedrooms 2 Code derived design flow rate 300 GPD ✓1 Replacement I Public or commercial - Describe: Parent material Glacial Till Flood plain elevation, if applicable NA General comments and recommendations: This area is suitable for a mound system. The recommended system elevation is 101.15' based on the contour line established at elevation 100.15'. Boring # I Boring . ✓I Pit Ground Surface elev. 100.30 ft. Depth to limiting factor _____ 25_______ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots __ /ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 "Eff#2 1 0 -4 10yr3 /1 none I 2mgr mfr cw 2m .5 .8 2 4 -25 10yr4/4 n one I 2msbk mfr gw 2m .5 � ( m2p 7.5y r5 /2 3 25 - 37 7.5yr4/4, 10yr 5/6 sl lmsbk mfr gw if .4 m2 7.5 'r5 /2 - - -- --- - -- - - - -- - - -- - - -- 4 37 -60 7.5yr4/6 �Oyr� /6 Icos Osg ml gw - - - - -- .7 �, y 5 60 -96 10yr4/6 m2 f0yr)6�6 /2 ms Osg ml - - -- -- .7 6 F2] Boring # I Boring ✓1 Pit Ground Surface elev. 95.60 ft. Depth to limiting factor __— _ 33- -- 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 1 0 -8 10yr3 /1 none sl 2mgr mvf cw 2m .5 .9 — 2 8 -21 10yr4 /4 none sl 2fsbk mvfr gw if .5 J 3 21 -33 10yr none sl 2ms mfr gw - - - - -- .5 4 33 -52 7.5yr4/4 "' I Oy kl/6 sl 2msbk mfr gw - - - - -- .5 J m2 I0 r5/2 5 52 -72 7.54/4 FOyr� /6 Is lmsbk mfr - - -- - - - - -- .7 * 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) Signature: - CST Number Thomas I Schmitt �.Kt rr �, � � -- ^�� 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number Somerset, WI 54025 9/6/00 715 - 549 - 6651 Property owner Bernstein, Edwin Parcel ID # 032-2016-70-000 Page 2 of 3 3] Boring # 1 Boring VI Pit Ground Surface elev. __. ft. Depth to limiting factor 27 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots _ -- GPD/ftl--,-, - _ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I *Eff#1 *Eff#2 1 0-5 10yr3/1 none sl 2rngr mvfr Cw 2m .5 .9 IF) I Oyr"I/ I 2r�hk invfr qW 21" .5 .9 3 16-27 10yr5/4 none sl Imsbk mfr gw if .4 .6 4 27-52 7.5yr4/4 m2p 10yr52 sl lmsbk mfr gw ------ .4 .6 I Ovr6/6 5 52-76 7.5yr4/6 m3p 10yr5/2 Oyj Is Imsbk mfr ---- ------ .7 1.2 F-I Boring # Boring I Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horimn Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Coal. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-I Boring # Boring I Pit Ground Surface elev. 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 Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 50 mg/L Effluent #2 = BOD -L30 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. Formal. nleHse conlact the denarimeni it 60R -266 -3 or'I'l'Y 609-264-R777. 7CLq� • _ G , 1 I f i 1 I ! i • 1 ! � I j �.� I j g i • : , , i I� I i a j 17 1 • I o lki, T0 • ,may ��( I 1 e � Ed J tai' / �Oe'll�f �' r I, I+ ' X. MOUND WORKSHEET A. SITE CONDITIONS Evaluate the site and soils report for the following: • Snrface water movement. 1 I. 11' .1. .. 11"'I . 1 1111 be determined. • Description of several soil profiles where the component will be located. • Determine the limiting conditions such as bedrock, high groundwater level, soil permeability, and set backs. Slope - _L,0 % Occupancy — One or Two- Farnily Dwelling # of bedrooms . Public Facility - Daily wastewater flow Depth to limiting factor ` inchcs In situ soil application rate used - , `� gal /11'Alay BOD value of effluent applied to component - ' ing /L TSS value of effluent applied to component - z o, "Type of distribution cell' - ( Aggregate or _ Leaching chamber B. DESIGN WASTEWATER FLOW (DWF) One or Two- family Dwelling. DWF = 150 gal /day /bedroom x # of bedrooms = 150 gal /day /bedroom x of bedrooms :30-c) gal /day Public Facilities. DWF = Sum of each wastewater flow per source per day x 1.5 gal /day x 1.5 = gal /day 23 of 38 C. DESIGN OF THE DISTRIBUTION CELL 1. Size the Distribution Cell a. Infiltration rate of fill material =<_ LO gal /ft' /day if BOD or TSS > 30 mg /L or 7.O h,a1 /ft' /clay if BOl or "14S < 11) mh /l , b. Bottom area of distribution cell = Design wastewater flow 1.11 or 2.0 gal /ft' /day gal /day - gal /ft' /day _ O C ` ft 2. Distribution Cell Configuration a. Distribution cell width (A) Iecl (< IA It.) b. Distribution cell length (13) — Bottom area ol'distribution cell Width ofdislribution cell B ft (Distribution cell area) : f fl(A) B = ;j.'c ft c. Check Distribution Cell Length (B) Design Wastewater Flow _ Cell length (13)<_ Maximum Linear Loading Rate • oo gal /day / j � feet = gal /fl (Linear Loading Rate) Linear loading rate for systems with in situ soils having an effluent application rate of ::- 0.3 gal /ft /day within 12 inches of fill is less than or equal to 4.5 gal / fUday Is the linear loading rate <_ what is allowed? x yes _ no If no, then the length and/or width of the distribution cell must be changed so it does. Distribution cell length (B) = Design Wastewater Flow ,= Maximum Linear Loading Rate Distribution cell length (B) = gal gal /ft/day Distribution cell length (B) _ ft Distribution cell width (A) = lt (Distribution cell area) _ ft(B) Distribution cell width (A) = ft 24 of 38 C�. DESIGN OF ENTIRE FILL 1. Fill Depth a. Fill depth below distribution cell (At least 6 inches if the in situ soil beneath the tilled area requires a minimum depth of 36 inches or less for treatment of Iecal colilorm. At least 12 inches if the in situ soil beneath the tilled area requires a depth greater than 36 inches for treatment of 1) Depth at up slope edge of distribution cell (D) = distance required by Table 83.44 -3 - distance in inches to limiting factor D = :Y (, inches - inches D= �/ inches (? 6 or 12 inches, but not greater than 36 inches) 2) Depth at down slope edge of distribution cell (E) r -_ I)epili at till slope edt!e ofdislrilxilion ccll (I)) i ('ib ual(jral slope exlxessed as a decimal x distribution cell width (A)) F = 1) + (% natural. slope expressed as decimal x A) E = inches + ( �'r_' x x 12 inches /ft) E = inches b. Distribution cell Depth for Aggregate Distribution cell. Distribution cell depth (F) for aggregate distribution cell = amount of aggregate below distribution laterals (6 inches min.) + nominal outside diameter of largest lateral + amount of aggregate over distribution laterals (2 inches min.). F = (?6) inches + j' inches + , 4 ( >_2) inches F inches c. Distribution cell depth (F) for distribution cell with leac chambers = total height of leaching chamber. ✓/'' F = inches d. Cover material 1) Depth at distribution cell center (1-1) > 12 inches 2) Depth at distribution cell edges (G) >_ 6 inches 25 of 38 I 2. Fill length a. End slope width (K)= Total fill at center of distribution cell x horizontal gradient of side slope K — ; (1(D + F) - 71 f F + 1 -1) x horizontal gradient of side slope) _ 12 inches /foot 11 tQ( I/ _uiclics i //, ) uwlicti) �(� ).. uichcs iuclIcs) x a 12 inclies /lt b. Fill length (L) = Distribution cell length + (2 x end slope width) L =B +2K -1 w x feet 3. Fill width a. Up slope width (J) = Fill depth at up slope edge of distribution cell (D + F + G) x Horizontal gradient of side slope x Slope correction factor { 100 _ [100 + (gradient of side slope x % of slope) or (value from Table 5)]} J = (D + F + G) x horizontal gradient of side slope x slope correction factor 100 _ [100 + (gradient of side slope x % of slope) or (value from Table 5)] in + '1'2 in + in) _ 12 in/ft x x 100 _ [ 100 + ( =3 = -x- )] ' J feet b. Down slope width (1) = Fill depth at down slope edge of distribution cell (E + F + G) x Horizontal gradient of side slope x Down slope correction factor ( 100 - [100 - (gradient of side slope x % of slope) or ( value from Table 5)]) I = (E + F + G) x Horizontal gradient of side slope x Down slope correction factor {I 00 [100 - (gradient of side slope x % of slope) or (value from Table 5)]} I = ( in + ': %' ' in + (,in) - 12 in/ft x x 100 [ 100 I = in - 12 in /lt x 3 x 100 1 ° feet 26 of 38 cr Fill width (W) = Up slope width (J) -f Distribution cell width �A) + Down slope width (I) W =J +A +I W = .ra' It -► J li f fl = 1, W feet I. l;hccl. llic lris�il �uw a. Basal area required -'' = Daily wastewater flow infiltration rate of in situ soil 5 0O gal /day _ , v gal/ft'/day c?p ft b. Basal area available 1) Slopint! site = ('.ell length x (Distribution cell width Down slope width) = Bx(A +1) ft x (_ ft + �/ft) ft x ft —ft 2) Level site = Distribution cell length x Fill width =BxW ;- ' ft2 c. Is available basal area sufficient? X yes no Basal area required < Basal area available ft 2 < f 27 of 38 b. Basal area available 1) Sloping site = Cell length x (Distribution cell width + Down slope width) = Bx(A +1) ft x ft 5. Determine the location of observation pipes along the length of distribution cell. Distance from end of distribution cell to end observation pipes = B - 6 Distance From end ol cell to encl observation pipes = 1� Il. G Distance Crom eiid ol'distribution cell to cnd observation pipes C 29 of 39 I% N WORKSHEET UTlO PRESSURE DISTRIB . X. Information needed for Pressure Distribution Design: gal/day Daily wastewater' flow = g Y e �.u�rAy System Configuration: 1 ft. system width ft. system length 2. — Proposed Lateral Layout: 3 number of laterals q_ _( ___ central or end manifold 5.` ft, manifold length 'stal P ressure requi rement 6. (Based on orifice diameter, see Table 1) . di ,.� . ft 7 in. orifice diameter ft. estimated lateral length Choose the Orifice Spacing: o !f ? r 9. y ip, orifice spacing divided by 12 to convert to feet. 10. number of orifices per lateral n =Vx +.5 Where: n = number of orifices L - lateral length, in feet x = orifice spacing, in feet have laterals on each side of the manifold. Therefore fi Note: Networks with central manifold of laterals are two times as my as a network with an end manifold* numb an • 21 of 28 l i C M Re-evaluate the Lateral Length: 11. D ft. final lateral length (# of orifices x orifice spacing - 112 orifice spacing = optimal length) Choose the Lateral Diameter: in. (Uraplis 1 - 6) Calculate the Lateral Discharge Rate: 13. f / gpm lateral discharge rate. Discharge rate per orifice x # of orifices per lateral = lateral discharge rate. / / /'/ �! Choose the Manifold Diameter: 14. in. (Table 5 ) Calculate the System Discharge Rate: 15. 6 0, ` gpm (# of laterals x lateral discharge rate) Calculate the Force Main Friction Loss: 16. / 00 ft. force main length 17. 1 in. force main diameter (Table 6) 18. o , $' gpm system discharge rate (from #15) 19. Z. ', ft. friction loss in ft/100 ft. x length 100 & (Table 6) Calculate the Total Dynamic Head: 20. �3 j . system head. (Distal pressure #6 x 1,3 ft.) 21. 1 0 ft. vertical lift (pump off to lateral elevation) 22. ft. friction loss (in the force main in feet # 19) 23. o, ' / ft. Total Dynamic Head sum of #20 thro #22 yell (�� � ) 22 of 28 1 ~ Calculate the Dose Volume: 24. gal. based an s y stem tYPe . 25. / f gal. - drain back 1(s !4 j . l �rn� su Intel h.►et vslinnc 004 + 1175) pump Selection: 27. ' . ' gpm pump discharge rate at TDH ( #23)l (not less than system discharge rate, #15) • Dose Chamber Sizing: (sizing of dose chamber serving a sand filter may have different requirements- See component manual or manufacturer's or designer's specifications for sizing criteria. ) 28. i p' switch gal. n• tank bottom to ` of ____ �-- 29. in. dose volume (from #26) ( "off" to "on" switch) 30 in. "on" switch to alarm switch ______g 31. in. reserve capacity d al. (residential = 100 gal/BR) 32. _ in. dose chamber capacity __g al- t 23 of 28 i 4 ; < %. / E )l•I; ire e- ��iZy eUi G[ Tr )5�e c i S4�cE pvc_ 4 , c. C L E t f ? � � � , ' � •� �.,.; is . ✓.-� (� C. �o�; I X�0 jjlG ` j r r ' Paste _ Of _ i E ' I L i= ./v 6 r/r c c r - Lt. Synthetic Covering ' Distribution Pipe ASrM c33• 9Atub r"• 6 lopsoll J "LA —J F t E 1. p 3 ' b fe % Slope Bed Of Z�— 2 %2 Force Main Plowed Aggregate Layer .1. (6 Below Pipe) E '1 Cross Section Of A Mound System Using A Bed For The Absorption Area F- G A ` 7 Ft. Signed: g �'', Ft. License Number: �� /ZVI, K �; Ft.q�iZ L Ft. GI - ( � Date: J ,a5" Ft. � .39 ' F , o Ft. t2 _ sy s;c�� W Z4 44' I L Observation Pipe ir -=------------ - - - - -- -------- - - - - -- - - - -. F ------------- lr- j - - - --- --- - - - - -- ' Distribution Bed Of i — 2 1 2 Pipe Aggregate •I Observation Pipe Fo , Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area N;"'; . Page Of Distribution Pipe Detail For A Four Lateral Network Iorce Main .\ P PVC Distribution Pipe PVC Force Main P Moles Equally Spaced PVC Manifold Pipe On Bottom X S J �� X X" 2 * Last hole Should Be Next To End Cap Y PFt. Zb.B S Ft. X Inches Y 1 Inches Signed: it)'n L _Z27— 1 Hole Diameter Inch License Number: 0 2 Lateral Diameter / .�j Inch(es) Dal e: Mani fold Diameter _ 1114dies Force Main Diamete Inches a doles Per Pipe�� Invert Elevation Of Laterals jy'S'i! "I C1: %G/:l ' • PAGE OF PUMP CHAMBER CROSS SECTION A►JD SPECIFICATIONS ' VENT cA 4 %.Z. VENT PIPC WEATHER PROOF APPROVED LOCKING .IUMCTIOAI DOX MANHOLE COVER • dry' I w�ii1 ui��w, ►f 1 4imuuw UK 1 KL.bit 1 / "HI►1• 18IIA(14. I AIR INTAKE I GRADE I 4 MIN. CONDUIT -- ' - - - -- 10 "MIN. \�� - - - - -- • PROVIDE I IIJLC AIRTIGHT SEAL I I i APPROVED JOIWT A I III APPRbVLD JOINT$ w /c.z. PIPE I 1 w /c.�G. �IPc I II ALARM LXTENDING 3' CKTENDIN6 3' I I ONTO' SOLID WIL. ONTO 50L.ID $01 L o I I ON i C LLEV. — / FL PUMP -- - __J OFF 0 I COMCRETE BLOCK ! . i 3" AP PRWOD RISER EXIT PERM11TED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL gSppl SEPTIC E SPEC.IFICATIONJS i OOSE JAL ,6Fx I s. NUMBER OF DOSES: 4' (° PER DAu TANKS MMJUFACTURER: TANK WE: GALLONS DOSE VOLUME QQ CLUDING BACKFLOW: O� S GALLONS ALARM MANUFACTURLR: �'`F�v�r —f* �'t✓uE -AR MODEL NUMBCR: DLV �ACITIES: A= 19 INCHE509 •j GALLONS SWITCH TYPE: IUCNES OR ,y��, G�ILLOAIS PUMP MANUFACTURER: INCHES OR S I � CPALLOLIS MODEL NUMBER: y� D - —— INCHES OR , GALLONS SWITCH TYPE' MOTE: PUMP AVID ALARM ARE TO BE 68.2/.8. G�.vi MINIMUM DISCF ARGE RATE GP INSTALLED OM SEPARATE CIRCUITS VERTICAL DIFFEKEMCE DETWEEIJ PUMP OFF A0,10..01STRIBUTION PIPE.. _ FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . 1 -5 FCET(3, 6 + X00 FEET OF FORCE MAIN X 1• F Y o iTFKICTIOU FACTOR.. -) 2 ' 3 FEET _ TOTAL QyIJAMIC HEAD = ®j FEET C 2 0•4-�; } 1, fi�Flc,HT i. .. ✓ �!7 Ili . INTERNAL. D E.N510N�i OF TANK: h W ;WIDTN �LIgU10 DEPTH SIGNED: LICEOSE NUMBER: DATE. * w HEAD CAPACITY CURVE nnl nrvnMl� Irnll /( nr natr Ll MX MODELS "140/4140" I I rULNI nlvD OLWAILRING _ It. Meters Gal, Ll's. 1 14 5 152 91 344 45 - 10 3.05 84 318 i I' 1 15 4.57 76 288 - 1 40,41 40 20 G 10 68 257 40 12.14 21 79 a 25_ _____ ___— ..._ —_ ___— __... _.. -_. _. -._. 45 13.72 5 19 � t k VMve: 4f = 6 20 — — 1 I z 15-- i 1 SK1524A 0 13.4 0 to- bauble - - - -' -- - -- — -- -- - - - - -- - -- - -- - .. -..._ __ -- - - - -- - -- W elght 13 lbs. 11 1 I I.';. (:AII IIN I II) 7(1 Sll 4ll 'fI1 1,() /II 7111 '.)11 II)ll 1 111 I III HIS 1 HO IGO 74( .570 4U(1 0 FLOW PER MINUTE 010940 is sz� CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and supplied with an alarm. Mechanical alternators, for duplex systems, are available with or without 1 alarms. •, Control alarm systems are available for 1 phase pumps used in simplex sK,5z4s system. See FM0732. 1 1 • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable SELECTION GUIDE level long cycle controls. 1. Single piggyback variable level float switch or double piggyback variable level • Sealed Qwik - Box available for outdoor installations. See FM 1420. float switch. Refer to FM0477. • Over 1307. (54 °C.) special quotation required. 2. Mechanical alternator M -Pak 10 -0072 or 10 -0075. • Refer to FM0806 for 200 F. applications. 3. See FM0712 for correct model of Electrical Alternator E -Pak. 4. Variable level control switch 10 -0225 used as a control activator, specify duplex (3) or (4) float system. 5. Four (4) hole J -Pak, junction box, for watertight connection or wired -in simplex 140 Series - 53 lbs. 4140 Series - 73 lbs. or 2 pump operation, 10 -0002. 14014140 * ** MODELS Control Selection Model Model Volts -Ph Mode Amps Simplex Duplex N140 I N4140 115 1 Non 15.0 1 or 1 &5 2 or 3 & 4 CAUTION E140 tEA140 230 1 Non 7.5 1 or 1 & 5 2 or 3 & 4 All installation of controls, protection devices and wiring should be done by BN14N4140 115 1_ Non 15 1 or & 5 2 or 3 a a qualified licensed electrician. All electrical and safety codes should be BE14E4140 230 1 Non 7.5 1 or 1 & 5 2 or 3 & 4 followed including the most recent National Electric Code (NEC) and the ' *' Double seal pumps are available with optional moisture sensors. Seal Fail indicator light available in NEMA 1 or NEMA 4X Occupational Safety and Health Act (OSHA). control panels. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. DOX 16347 Louisville, KY 40256 -0347 Manufacturers of. . SHIP TO: 3649 Cane Run Road Z #I. Louisville, K;' 40211 - 1961 QU.4UTY P//MaS �,l�Nb - E `c/ ✓d „ r C O (502) 7784731 • I f800) 928-PUMP FAX (502) 774 -3624 1016 f ` Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal referen erection and percent slope, scale or dimemsions, north arrow, a a cjiist� nearest road. Parcel I.D. ,, 032 - 2016 -70 -000 Please print all 1 ►fir Ton. r •• , we y Date Personal information you provide may be used dary pu Property Owner Propp' Location Bernstein, Edwin G&W TT SE 1/4 SE 1/4 S 4 T 30 N R 19 W Properly Owner's Mailing Address U Lot . #', i Block # Subd. Name or CSM# 596 170th Ave. �K� 'ti ST cfiOt a f City State Zip Ph @ ' JCE City _j Village 6el Town Nearest Road Somerset I WI 1 540 -7 5-247-32Q ,' Somerset 170Th Ave. J New Construction Use: 6,e, Residentiak/ oms 2 Code derived design flow rate 300 GPD Replacement Public or commercial - Describe: Parent material Glacial Till Flood plain elevation, if applicable NA General comments and recommendations: This area is suitable for a mound system. The recommended system elevation is 101.15' based on the contour line established at elevation 100.15'. Boring # Boring J Pit Ground Surface elev. 100.30 ft. Depth to limiting factor 25 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/it' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 1 0-4 10yr3 /1 none I 2mgr mfr cW 2m .5 .8- 2 4 -25 10yr4/4 none I 2msbk mfr gw 2m .5 ✓ ✓ 3 25 -37 7.5yr4/4 m2pp77.5�5/2 sl imsbk mfr gw if .4 ✓ p 4 37 -60 7.5yr4/6 m2 yr /6 2 Icos Osg ml gw - - - - -- .7 ✓ ` �i 5 60 -96 10yr4 /6 m2pOWIg5 /2 ms Osg ml - - -- - - - -- .7 ✓ Boring # I Boring V1 Pit Ground Surface elev. 95.60 ft. Depth to limiting factor 33 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 1 - 0 -8 10yr3 /1 none sl 2mgr mvfr cw 2m .5 .9 ✓ 2 8 -21 10yr4 /4 none sl 2fsbk mvfr gw if .5 ✓ 3 21 -33 10yr5 /4 none sl 2msbk mfr gw - - - - -- 5 ✓ M ✓ 4 - 33 -52 7.5yr4/4 "' 1 6/6 sl 2msbk mfr gw - - - - -- .5 5 52 -72 7.54/4 m2p0yr6 /G /2 Is imsbk mfr - -- - - - - -- .7 * Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD s30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signatur _ CST Number Thomas I Schmitt ��xr,, �.�. 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number Somerset, wI 54025 9/6/00 715 -549 -6651 Property Bernstein, Edwin Parcel ID # 032 - 2016 -70 -000 Page 2 of 3 3 ] F Boring # -) Boring V11 Pit Ground Surface elev. 100.30 ft. Depth to limiting factor 27 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-5 10yr3 /1 none sl 2mgr mvfr Cw 2m .5 .9 2 5 -16 10yr3/3 none 2fsbk mvfr gw 2m .5 .9 ✓ 3 16 -27 10yr5 /4 none sl lmsbk mfr gw if .4 ✓ .6 ✓ 4 27 - 7.5yr4/4 m2 010yr52 sl imsbk mfr gw - - - - -- .4 .� .6 5 - 52 -76 7.5yr4/6 m3p 10yr5 /2 Is imsbk mfr - - -- - - - - -- .7 ✓ 1.2 ✓ 10 /6 F -1 Borin Boring # Pit Ground Surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # -i 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 D in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD 5 > 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. nlease contact the denartment at 609 -266 -3151 or TTY 608 -264 -8777. -- I I _ 3,3 t I _ r -- - - -- 0 0 0 I i .I�pQ I I I ` I a� I I �I _ _...f 7F - - - -j - +- i _ I I ' I I I I I I I I K'4,+.rc• "�` .'. Ed la �� GT big. �/ ?j a r I I awn T r w, I I I , _ i i I r i : j • i : j : ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the NAr7' s /!LL �ArJoij residence located at: .E 1/,, 5J:F 1/,, Sec. q_ , T _,3D_ N, R __L�__ W, Town of ��r? ' St . Croix County, Wisconsin. Upon inspection, I certify that I have found the tank.and baffles to be in good condition, and it appears to be functioning properly. Last time serviced ,S'pg/NG of & I 6a / Did flow back occur from absorption system? Yes Nom (if no, skip next line. Approximate volume or length of time: gallons minutes Capacity: 115 Construction: Prefab Concrete _ Steel Other Manufacturer ( if known) : Age of Tank (if known) : ignature) (Name) Please Print n sz A 19yl (Title) (License Number) 7—,Z—O/ (Date) Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank, to the best of my knowledge, will conform to the requirements of ILHR 83, Wis. Adm. Code (except for inspection opening over outlet baffle). Name 00 WA0W Ye-llyxol Signature MP /MPRS .7-:Z/ 2 y ( . ST CROIX COUN'T'Y SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer _ l7A T ce Zi- Al�Di s Mailing Address 711" A VE Property Address A (J�F - t (Verification required from Planning Department for new coastructioa) City /State c_F,0/`7F4SE7 tj)j - Parcel Identification Number - 3 2 -, O16 - 70 -000 LEGAL DESCRIPTION Property Location S&: V4, E V4, Sec. , T AN -R-L9—W, Town of subdivision AIA Lot # ZPA' • . Certified Survey Map # Volume , Page # Warranty Deed # , Volume . Page # Spec house ❑ yes Prno Lot lines identifiable ET'yes ❑ no SYSTEM ALL NTENANCE 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. p � m , g The owner a to submit to St. Croix Zoning Departm ent a certification form, signed by the owner and by a mastcr 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. 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. Certificateon stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. S * ATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. (1 01 Z,4� 7 lZl Ql I PRATM OF APPLICANT DATE *s «s «« Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. •• Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed Page of MANAGENMNT PLAN This Private Onsite Wastewater Treatment System (POWTS) has been designed and is to be installed and maintained in according to Comm 83, Wis. Admin. Code, the in- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems (SBD- 10567 -P; June 11,1999), 1. This POWTS has been designed to accommodate a maximum daily flow of 300 gallons of domestic wastewater -per day. The quality of influent discharged into the POWTS treatment or disposal component shall be equal to or less than all of the following: a monthly average of 30 mg/L fats, oil and grease a monthly average of 220 mg/L BOD 5 a monthly average of 159 mg/L TSS. Wastewater shall not be discharged to the POWTS in quantities or qualities that exceed these limits or that result in exceeding the enforcement standards and preventative action limits specified in ch. NR 140 Tables 1 & 2 at a point of standards application, except as provided in Comm 83.03 (4)m Wis. Admin. Code. 2. The owner of this POWTS is responsible for system operation and maintenance. The following maintenance shall occur within three (3) years of the date of installation and at least once every three years thereafter: 1. The septic tank shall be pumped be a certified septage servicing operator, licensed under s2.81.48, Wis. Stats, unless inspection by a licensed master plumber or other person authorized to make such inspection, finds less than (1/3) of the tank volume occupied be sludge and scum. More frequent pumping may be necessary to prevent solids from exceeding one -third (1/3) if the volume of the tank.. Wastes shall be disposed of by the pumper in accordance with ch. NR 113 Wis. Admin. Code. At each pumping the pumper must visually inspect the condition of the tank, baffles, rizers, and manhole cover and verify that any required locks are present. 2. The soil absorption component(s) shall be visually inspected by a licensed master plumber, certified septage servicing operator or POWTS inspector. Inspection shall check for evidence of discharge of sewage to the ground surface and for ponding of effluent in the distribution cell. 3. The tank filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. The filter cartridge shall not be removed unless provisions are made to retain solids in the tank. Cleaning of the filter at more frequent intervals may be necessary. 4. Any pump, alarm or related electrical connections shall be visually checked for defects and tested to confirm that they are operating properly. 5. Reports for all system maintenance shall be submitted to St. Croix County Zoning in accordance with Comm 83.55, Wis. Admin. Code. 3. Defects or malfunctions identified during maintenance described in item #2 above shall be repaired in conformance with Comm 83, Wis. Admin. Code. 4. Anytime a failure or malfunction occurs, it shall be reported to the owner of this POWTS. Repair or connection of such failure or malfunction shall comply with Comm 83, Wis. Admin. Code. 5. No one should enter a septic or other treatment tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within these tanks may contain lethal gases and rescue of a person from the interior of the tank may be difficult or impossible. 6. No product for chemical or physical restoration or chemical or physical procedures for POWTS may be used unless approved by the Department of Commerce in accordance with Comm 84, Wis. Admin. Code. 7. In the event that this POWTS or a component of this POWTS fails and cannot be repaired, the following contingency plan is proposed: The failing component shall be replaced. This may require a new soil evaluation to determine where a new soil absorption c component can be. 8. If this POWTS is replaced, or its use is discontinued, it shall be abandoned in accordance with Comm 83.33, Wis. Admin.. Codc. 9. Name and number of local health agency Sr Croix County Zoning - 715 -386 -4680 10. Name of service contractor in case of failure or imalfunction Schmitt & Sona Excavating 715 -549 -6651 I _ k 7/ VOL STATE BAR OF Wt'SCONSIN FORM 2 -1999 eb. Zma45 4 apl WARRANTY DEED KATMIEN'-H.' ;lilhLSFI Document Number REGI$TER..IOF DEEDS-. ST. CRpIX,CO;', WI.. This Deed, made between Edwin Bernstein and Gloria RECEIVED F09 *T11. "• Bernstein, husband and wife, __ -- 1 9 4a -2000 � _ — WARRANTY DEED ERT Grantor, and Matthew P. Gaddis and Jill L. Gaddis, husband and C EXEMPT N ERT COPY FEE: wife, COPY FEE: TRANSFER FEE: 468.00 -� RECORDING FEE: 12.00 RAGES: 2 Grantee. 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 (See Attached Exhibit "A ") ..Name and Return ' dress till , �• k a . 32- 2011 - 70.000; 032 - 2016 -70 -000 % ,r „( A LYarcel Identification Number (PIN) This is homestead property. (is) NX00 Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this "ZA qA— day of September _ 20001 Z 1 + Edw /n �_ Bernstein — ♦ + Gloria Bernstein AUTHENTICATION ACKNOWLEDGMENT Signature(s) Edwin Bernstein and Gloria Bernstein STATE OF WISCONSIN ) ss. County ) authenticated this2 tsf a day of September 2000 Personally came before me this day of �� �•`_� __ the above named + Kristina Ogland TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing ( If no[, instrument and acknowledged the same. authorized by 0 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY _ Attorney Kristlna Ogland Notary Public, State of Wisconsin Hudson, W 54016 My Commission is permanent. (if not, state expiration date: (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. iro —nun Profs "ais Company. Fond au Lac. wn 800- — WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2 . 1999 A, , VOL 15 §5►AG 04 EXHIBIT "A" A parcel of land in the Southwest Quarter of the Southwest Quarter (SW 1/4 SW 1/4) of Section Three (3), and in the Southeast Quarter of the Southeast Quarter (SE 1/4 S8 1/4) of Section Four (4), all in Township Thirty (30) North, Range Nineteen (19) west in St. Croix County, Wisconsin described as follows: Commencing at the Southeast corner of the. Southwest Quarter of the Southwest Quarter (SW 1/4 SW 1/4) of Section Three (3) Township Thirty (30) North, Range Nineteen (19) West; thence West to the line of the right of way on the West side of County 'Drunk I; thence North to the North right of way line of the Town road running West; thence West on the North right of way line of said Town road for 1252.32 feet to the nine" of s,� <_s�t� then North parallel with the West right of way line of County Trunk I for 417.44 set; then ast parallel with the North right of way line of the Town for 626.16 f t; thence South, parallel with the West right of way line of County foeet to the North right of way line of th w n road; thence East oa orth right of way of the Town road for eet to the la inning, the East 17.68 feet being in Section Three (3) and the West 608.4 set being in Section Sour (4), St, Croix County, Wisconsin. W W N c m n1 1'n 1'n LO LIJ W I --.-- f i� � 1