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HomeMy WebLinkAbout032-2125-70-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 395271 GENERAL INFORMA -LION (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: M & G, Inc. I Somerset Town ship 032 - 2125 -70 -000 CST BM Elev: Insp. BM Elev: BM Description: I 6 (d f i TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. c! Septic Bench Mark a 'o -� dF = 3 '19 P3, I / A f t .. BM _ Bldg. Sewer - , S3 Holding - Ht Inlet / o '71 O J Z J TANK SETBACK INFORMATION St/ t Outlet ft} 92 g TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet r v )b !/"I Flthr/ r (� Septic / / Dt Bottom A.,' Dosing [-, i Header/M�art, 4� Aeration Dist. Pipe Holding Bot. Syste t �� 1 -q0 �-R Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St over f?,�v �0-�t/ GPM M odel umber 6 6 O/ – f03. /DO 1 TDH Lift Friction Loss System Head TDH Ft h yn77ai Forcemain L n th / Dia. Dist. to Well i ✓n vE I, f f s� v ' SOIL ABSORPTION SYSTEM n ' BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/ DG WELL � LAKE /STREAM L Manufacturer: INFORMATION Ty Of System" AMBER O YP Y CIr -33 6W UNIT Model Num DISTRIBUTION SYSTEM Header /Man'fold Distribution x Hole Size x Hole Spacing Vent t Ai I take �` , , ,2/, , Pipe(s) t o YV 1 1-engt Dia Length Dia Spacing SOIL COVER } es ure Systems Only xz Mound O. At - Grade S stems Only Depth Over Depth Over xx a Seeded odded xx Mulched BedlTJen Center Bed/Trench Edges Topsoil Yes [W No Yes No CdMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:�/ ZCJ / Inspection #2:iI —�# / 111 Location: 421 172nd Avenue Somerset, WI 54025 (SW 1/4 SW 1/4 5 T30N 19W) Chabre L�17 P/ Parcel 00.1 25 9.T1' , bo 1,. *m ;►C{if1 � 1.) Alt BM Description 2.) Bldg sewer length - amount of r = 3.) Contour Plan revision Required? ❑ Yes No Use other side for additional information. Date Insepctor's Siq nature Cart. No. SBD -6710 (R.3/97) � r � AIN j c � KJ r r r 1 47 2.1 2 E . Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 Personal information you provide may be used for secon purposes Madison, WI 53707 -7302 Department of commerce [Privacy Law, s. 15.04 - p (Submit completed form to county if not k state owned.) Attach complete plans (to the county copy only) fort ; on paper iiot lgs,s ih#n 8 -1/2 x 11 inches in size. County State Sanitary Permit Number ❑ C dk, evisio p ous appticati State'Plan I. D. Number - • c fx q a / 6339 I. Application Information - Please Print all Information Location: Property Owner Name _ Property Location C — /Jll �..]. - s`U 1/4 1/4, S S Tj ,N, R (or0 Property Owner's Mailing Address G UF Lot Number Block Number 13 5 - 9 uAr&'L_ City, State Zip Code Phon umbel ` t Subdivision Name or CSM Number II. Type of Building: (check one) ,/ �„j, a ��c� QQ,,,s ❑ city Pf 1 or 2 Family Dwelling -No. of Bedrooms: 3 ❑ Village ❑Public /Commercial (describe use):_ J$ Town of ❑ State - Owned E ET S D Nearest Road be Uc p Parcel Tax Number s 6'-?o 0 III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) , $ O , ig - i i A) 1. KNew 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System $) 11 Permit Number Date Issued A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) - ` In ❑ Non - pressurized In- ground PC Mound ❑ 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: 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 y 0 L 15 - 0 0- s 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 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ o0 VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (print) Plu e s Signature (no tamps): M RS No. Business Phone Number 7is -66 Plumber's Address (Street, City, State, Zip Code) 5 _ IX. County/Departme t Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued I s ' g Agent Sig 4 re A (No stamps) " J Approved 11 Owner Given Initial Adverse Surcharge Fee) h7_ p1b Dn"L_ - Determination 32- fQ 2W X. Conditions of Approval /Re sons for Disa proval. V �L j ITIA i A r' _ / q_ ,5 rJ� dr�xuu�^'� ` L 6ti 4- F't t`t 40 (f�UCXI SBD -6398 (R. 07/00) t a • ■■iiiii0iii■ ■ ■■■■ ■ t■■ = 00 SENSE ••;! fin ISESSISSISSI MEN 1I■■■■■■ii■iitiii��. ■ice PI■■■■■■■ ■■■■■■i■■ Q1■I ®■ ■■■■ IN= ■■� ■■■i■■ IN ■■■■■■■■0110101 r �► = �? , ■■■■®■,�■ , ; ..1- �. q.,► ■■■■■ �■■■it■i ■ ■■■S■■ R- INE � STD ■■ ■iiiii■i►�i/1 ■■ mil /■i �■ SON ■i■IN■i■ii Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 C www.commerce.state.wi.us/sb isconsin c � p � - www.vAsconsin.gov Department of Commerce Pd� scoff McCallum, Governor Brenda J. Blanchard, Secretary April 26, 2001 'trr TOO CUST ID No.221741 � - A 77V POWTS Inspector ZONING OFFICE DONAVIN L SCHMITT ST CROIX COUNTY SPIA 586 VALLEY VIEW TRL 1101 CARMICHAEL RD SOMERSET WI 54025 HUDSON WI 54016 RE: CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 04/26/2003 Transaction ID No. 633976 Site ID No. 628041 SITE• Please refer to both identification numbers, SITE ID: 628041, M & G Inc. above, in all correspondence with the agency. St. Croix County, Town of Somerset SW1 /4, SW1 /4, S5, T30N, R19W Subdivision: Chabre - lot 17 FOR: Description: Three Bedroom Mound System Object Type: POWTS System Regulated Object No.: 786946 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 (R.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 manual, and section VI of the pressure distribution component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • A state approved 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 site must provide positive drainage away from the system area. DONAVIN L SCH 41Tf Page 2 4/26/01 r ' Special Note: The Index sheet and page numbers within the bound volume of pages do not correspond with each other. However, the data submitted within the bound set of plans is detailed enough for approval. However, future plan submittals must follow the department signing and sealing policy or they will be put on hold pending submittal according to department signing and sealing policy. 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 construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. 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 04/02/2001 FEE REQUIRED $ 175.00 -- FEE RECEIVED $ 175.00 Gerard M. Swim BALANCE DUE $ 0.00 POWTS Plan Reviewer - Integrated Services 608 - 789 -7892 Mon - Fri 7:15 AM to 4:30 PM jswim @commerce.state.wi.us W code- 7633 7 f �� Safety and Buildings T z � r (.� 4003 N KINNEY COULEE RD LACROSSE WI 54601 -1831 TDD #: (608) 264 -8777 I cousin w ww.comm www.vAsconsin.gov veww.wAsco isconsin.gov n.gov Department of Commerce Scott McCallum, Governor Brenda J. Blanchard, Secretary April 26, 2001 CUST ID No.221741 ATTN.- POWTS Inspector ZONING OFFICE DONAVIN L SCHMITT ST CROIX COUNTY SPIA 586 VALLEY VIEW TRL 1101 CARMICHAEL RD SOMERSET WI 54025 HUDSON WI 54016 RE: CONDITIONAL APPROVAL Identific N. 697 tubers PLAN APPROVAL EXPIRES: 04/26/2003 Transaction ID No. 633976 Site ID No. 628041 SITE• Please refer to both identification numbers, SITE ID: 628041, M & G Inc. above, in all 'correspondence with theagenc St. Croix County, Town of Somerset SWIA, SW1 /4, S5, T30N, R19W Subdivision: Chabre - lot 17 FOR: Description: Three Bedroom Mound System Object Type: POWTS System Regulated Object No.: 786946 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 (R.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 manual, and section VI of the pressure distribution component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • A state approved 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 site must provide positive drainage away from the system area. t DONAVN L SCIIMrrF Page 2 4/26/01 Special Note: The Index sheet and page numbers within the bound volume of pages do not correspond with each other. However, the data submitted within the bound set of plans is detailed enough for approval. However, future plan submittals must follow the department signing and sealing policy or they will be put on hold pending submittal according to department signing and sealing policy. 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 construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. 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 04/02/2001 FEE REQUIRED $ 175.00 _ FEE RECEIVED $ 175.00 Gerard M. Swim BALANCE DUE $ 0.00 POWTS Plan Reviewer - Integrated Services 608 - 789 -7892 Mon - Fri 7:15 AM to 4:30 PM jswim@commerce.state.wi.us WiSMART code: 7633 SCHMITT & SONS EXCAVA TING '00 586 Valley View Trail Somerset, WI 54025 715- 549 -6651 MOUND SYSTEM For: //VG E Address /. A //Z Legal ja) & S cO A _ d , - r 30 U-1 C 11/4/.31?& Township s sOe st= �- County: ' SEE CORRE`►, v C ntents Page 1 Soil Evaluation Report Page 2 Work Sheet - Design of the Distribution Cell Page 3 Work Sheet - Pressure Distribution Page 4 Plot Plan Page 5 System Cross Section Page 6 Pipe Lateral Layout Page 7 Dosing Chamber �Ae.-- 8 /� uiyh Gu2e c By: Dm4ul IV Address: Valley New Trail, Somerset, W1 54025 Tel 715 -549 -6651 MPRSW# 11Z7g1 Date Jp c oi n d � t � o nat�y � V �p A PR Of COMMERCEII +� 1AENS .�►� - pEPoo �S1 � GE SSE CC \ � � � � � , )& � I . �7�l� �� {��&� �,� � /�� }��� ti % } %q�� ��� ����f.� � » � �2 © 6a�� f �� �• \� m� j\ }� /� \i �: gg���� /a��� � , � : �. � ������� w. � � � >y � � UT /LL /U1 Intl Ito : CAA /In JOV 4VOV 071 I, VV LAVI4I14%a tvjuv7 Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of • Bureafl cii Integrated services in accordance with S;q M WIJ% Wis. Adm. Code Attach oomplete trite plan on paper not 1065 than 8 1/2 x 11 inches In re, PI&I m t County Include, but not limited to: vertical and horizontal reference point (Br) direction aZ -'r percent slope, scale or dimensions, north arrow, and location and dl¢tance to nearest road:" Parcel l,D. tl APPLICANT INFORMATION - Please rint all irnv ation. -- P Reviewed by Date 7 Personal information you provide may be used for secondary purposes (Pflvac) UW, s. 15 Q4 (t)''JMJPr Y'lr' / 1 *1u ,art � ( y �►wner f ngiwly 1 4"" tun Z.\ GGvt: OI L jt /4S'Ga/ 1 /4,S T,N,R E (or) W Property Owners MAlling Address Lbt�RJ Block Subd. Name or CSM# tl � - City State Zip Code Phone Number ❑ city ❑ village ja Town Nearest Road Pi 0 WT I 5 61 1 ) 5'19 - 00 New Construction Use. Residential / Number of bedrooms 3_ Addition to existing building Replacement ❑ Public or commercial - Describe Code derived dally flow 6 a 0- gpd Recommended design loading rate � � bed, gpd /ttx - . 6 trench, gpdtW Absorption area required �� taed, ft2 e U a rm trench, It z Maximum design loading rate ' w ed, gpd/tt _trench, gpd/fi Recommended infiltration surface elevations) 7 G' -� Q ft (as referred to site plan benchmark) Additional deslgrVsdts considerations �a (f _ Q' 5V Parent material I 1 Flood plain elevation, if applicable /� �" ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank u= unsuitable for system ❑ s IR u E05 o u CIS C�g u I EIS O u 08 [e u [Is [�Pu SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh, Bed , Trench I n icy S , irn Z- - u Vo i C SL, 7 ror Ground b ` 6 J czp m e-VA elev. 9 60 0 ft. Depth to - limiting factor Rernarks• Boring # Z JAB- 17A6 to 6 S Ground n• Depth to limiting ? In. Remarks: CST Name (Please Print) Signatury . l _� - �-- Talvnhone No. Address Date CST r.urnber S s-; 0 —. PROPERTY OWNER v SOI DESCRIPTION REPORT Page l PARCEL I.D.# Boring # Horizon Depth Dominant GPI r Mottles Structure z ?, in. Munsell Ou. Sz. Cont, C Texture Consistence Boundary Roots Gr. Sz. Sh. (dad Trenc �. Ground ?L�� .iYw 3�_'s Cz�� , .s y lz �t /� f.�� - -- - 1..� n, - :5- �s 910 Depth to Nmiting factor m in. , Remarks: Boring # . Ground Way. It Depth to factor rn. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPO In. Munsell Ou. Sz. Cont- Color Gr. Sz. $h. Bed T,arwh Boring # Ground , elev. ft. ' Depth to GmiGng , factor in. Remarks: Boring # Ground slay. , tt. Depth to Ilmlting factor in . Remarks: SS"330 (R.9/98) Q2 /ZY %U1 TH( tu:Z4 FAX 715 ;'bU 4060 51 GKA q:V U!1 WjUU7 PAG E_L NAME ,� cl�r LO T# LZ LEGAL DESCRIPTION$;-i43w' /4,5.5 T30 .N.R %K F,. (or) 0 SCALE: 1 "`___ BM I LLEVATl0N_L0 ,> BM t DESCR(PTIONA L:, W / Jwea BM 2 ELEVATION,�c RM 2 DESCRJPT10Ntk&," : w 4S „ elw+ ,411:1,,ca. I SYSTEM ELEVATION `��o •U i ALTERNATE, I3LEVATI( N_ k I CONTOUR FLWATIOt J 4, an�� 0 �•n 0 � S ` CG ION T F r' ' � _ �~ u ATE = X. MOUND WORKSHEET A. SITE CONDITIONS { Evaluate the site and soils report for the following: • Surface water movement. • M PAR111'r rlrvalio ns and di,tilancr� mi Ibr silr s() Ilion �:I�il►r, i�nl��in:a anal :ovailablr :eras ran be deter mined. • 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 - % Occupancy — One or Two - Family Dwelling # of bedrooms. Public Facility - Daily wastewater flow Depth to limiting factor - inches In situ soil application rate used - gal/ft /day BOD value of effluent applied to component -3 2 Z mg/L TS value of effluent applied to component - 3 1 LAng/L Type of distribution cell - A Aggregate or _ Leaching chamber ( B. DESIGN WASTEWATER FLOW (DWF) One or Two -famil Dwelling. Y DWF = 150 gal/day/bedroom x # of bedrooms = 150 gal/day/bedroom x 3 # of bedrooms = 7 S (� gal/day Public Facilities. DWF = Sum of each wastewater flow per source per day x 1.5 gal/day x 1.5 = gal/day i k . I 23 of 38 C. DESIGN OF THE DISTRIBUTION CELL 1. Size the Distribution Cell i a. Infiltration rate of fill material =< 1.0 gaUft /day if BOD or TSS > 30 mg /L or <_ 2.0 gaUft /day if BOD or TS <— 30 mg/L I. II•ollo►u alra of di"II ii lmliuu i_cll - I ►c ogu wunlcwalci Ilow : 1.0 of 2.0 gal /W /day gal/day = gaUft /day ft 2. Distribution Cell Configuration a. Distribution cell width (A) _ _z_ feet ( <— 10 ft.) b. Distribution cell length (B) = Bottom area of distribution cell _ Width of distribution cell B = 7S� ft (Distribution cell area) —.7 ft(A) B= 7• ft c. Check Distribution Cell Length (B) Design Wastewater Flow _ Cell length (B):5 Maximum Linear Loading Rate A VS 0 gal/day = 0 feet = �_ gal/ft (Linear Loading Rate) Linear loading rate for systems with in situ soils having an effluent application rate of < 0.3 2 gal/ft /day within 12 inches of fill is less than or equal to 4.5 gal/ft/day 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/day _ gal/ft/day Distribution cell length (B) = ft Distribution cell width (A) = ft (Distribution cell area) _ ft(B) Distribution cell width (A) = ft 24 of 38 'D. DESIGN OF ENTIRE FILL 1. Fill Depth I 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 fecal coliform. At least 12 inches if the in situ soil beneath the tilled area requires a depth greater than 36 inches for treatment of cddili)j III ) 1) Depth at up slope edge of distribution cell (D) = distance required by Table 83.44 -3 - distance in inches to limiting factor D = - 3 6 inches - Z- y inches D = inches (_> 6 or 12 inches, but not greater than 36 inches) 2) Depth at down slope edge of distribution cell (E) E = Depth at up slope edge of distribution cell (D) + (% natural slope expressed as a decimal x distribution cell width (A)) E = D + (% natural slope expressed as decimal x A) E = inches + x - 7 — feet x 12 inches /fl) i E = ../ Q 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 = 4( >_6) inches + A J inches + Z ( >_ 2) inches F = inches c. Distribution cell depth (F) for distribution cell with leaching chambers = total height of leaching chamber. F = inches d. Cover material 1) Depth at distribution cell center (H) ? 12 inches 2) Depth at distribution cell edges (G) >_ 6 inches 25 of 38 2. Fill length a. End slope width (K)= Total fill at center of distribution cell x horizontal gradient of side slope { K = {([(D + E) + 2] + F + H) x horizontal gradient of side slope} + 12 inches /foot K 17— inches / + 7. 0 Iinches) -f 21 + 9 �� inches + /7-inches) x 3 12 K= ft b. Fill length (L) = Distribution cell length + (2 x end slope width) L =B +2K L= 6V.3ft +(2x -ft) L=O 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)] } i 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)] J =( in+ in+ ( in) + 12 in/ft x 3 _ J= 5 A feet b. Down slope width (I) = Fill depth at down slope edge of distribution cell (E + F + G) x Horizontal gradient of side slope x Down slope correction factor { 100 i- [ 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 { 100 + [100 - (gradient of side slope x % of slope) or (value from Table 5)] } I = ( / 7. t f in + O f. S` in + / in) — 12 in/ft x 3 x 1*0 _ I= q ini- 12 in/ft x3x100+ I = / feet 26 of 38 c. Fill width (W) = Up slope width (J) + Distribution cell width (A) + Down slope width (I) W =J +A +I W L /ft+ ft+ ft W = QA 76 .. — feet 4. Check the basal area a. Basal area required = Daily wastewater flow - infiltration rate of in situ soil = gal/day = . S� gayft /day ft 2 b. Basal area available 1) Sloping site = Cell length x (Distribution cell width + Down slope width) = Bx(A +I) 6y3 ft x( 7 ft+ -10 ft) .I ft X. ft _ /C7 0 ft 2) Level site = Distribution cell length x Fill width =BxW ft ft ft2 V c. Is available basal area sufficient? X yes no Basal area required < Basal area available ft < Q ft2 27 of 38 I b. Basal area available 1 Sloping site = Cell length x Di p g g (Distribution cell width +Down slope width) Bx(A +I) fl x( A4- A) ft ft ft2 5. Determine the location of observation pipes along the length of distribution cell. Distance from end of distribution cell to end observation pipes = B -1- 6 Distance from end of distribution cell to end observation pipes = ( '/- 1. T 6 Distance from end of distribution cell to end observation pipes =./O-7/ft. i i 28 of 38 H / X. PRESSURE DISTRIBUTION WORKSHEET Information needed for Pressure Distribution Design: Daily wastewater flow gal/day Or'4pil ImIdillp L'11IMS1 Y/i System Configuration: 1. 7 ft. system width 2. - ft. system length Proposed Lateral Layout: 3. q number of laterals 4. �_ central or end manifold 5. ` ft. manifold length 6. ft. distal pressure requirement (Based on orifice diameter, see Table 1) 7. in. orifice diameter 8. ft. estimated lateral length Choose the Orifice Spacing: 9. in. orifice spacing divided by 12 to convert to feet. 10. number of orifices per lateral n= L /x +.5 Where: n = number of orifices 5 = 31 ' L = lateral length, in feet X x = orifice spacing, in feet Note: Networks with central manifold have laterals on each side of the manifold. Therefore the number of laterals are two times as many as a network with an end manifold. 21 of 28 r Re- evaluate the Lateral Length: 11. 30 ft. final lateral length I # of orifices x orifice spacing - 1/2 orifice = optimal length) s o spacing o 1 I x x, P . g 83 = 3 ©. P g Choose the Lateral Diameter: i 12. /� in. (Graphs 1 - 6) Calculate the Lateral Discharge Rate: 13. ), S gpm lateral discharge rate. Discharge rate per orifice x # of orifices per lateral = lateral discharge rate. b X / 7 - 2 , sy Choose the Manifold Diameter: 14. /Z in. (Table 5 ) Calculate the System Discharge Rate: 15., /6 gpm (# of laterals x lateral discharge rate) A l 12.3`/ Calculate the Force Main Friction Loss: 16. /00 ft. force main length 17. in. force main diameter (Table 6) 18. S a gpm system discharge rate (from #15) 19. 5, _ 03 ft. friction loss in ft/100 ft. x length = 100 ft. (Table 6) Calculate the Total Dynamic Head: 20. 3 .;R ft, system head. (Distal pressure #6 x 1.3 ft.) 21. O ft. vertical lift (pump off to lateral elevation) 22. S • 0 3 ft. friction loss (in the force main in feet #19) 23. ft. Total Dynamic Head (TDH) (sum of #20 through #22) i 22 of 28 Calculate the Dose Volume: C << 24..6• gal. based on system type. 0 92 - x `� J� /` 3 / 25. A 3 gal. - drain back Q . / ( 3_ X :f a O 26. B?5) Pump Selection: 27. s_ Q gpm pump discharge rate at TDH ( #23) (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. / Z in. tank bottom to "off' switch 2 6-R- a gal. 29. �_ in. dose volume (from #26) $7► �� s al. ( "off' to "on" switch) 30. 2 in. "on" switch to alarm switch 7 g al. 31. I in. reserve capacity 7�S•/•5 g al. (residential = 100 gal/BR) 32. 37 in. dose chamber capacity � al. 23 of 28 '■ la ■ ■ ■ •. LL iC 4 ■� Ir mom ■■ ■SIM■ISE ■ ■ ■■ ■ ■ ■■ ■■■■ IMMENSE INN ■■■ ■B■■■ ■■■■i 1 ■ ■■■■■■■ ■ ■■■■■■ ■lam ■ ■■■■■■■ ■■■■■■■■■ Q1U1 ®■ ■■■■ ■ ■i�� •- ■ ■■ ■ ■■1■� ■■■■■■■,O■ ■■■ ■■■■■■■■i■■■ ' ■� ; �o■■I�.��.. ■■■■■■■EW■MIN ■ ■■■■ MESMINVI ■■■ MEN �X6y.3 �ay� �' — SEi i/V L.&/V6 r Synthetic Covering Distribution Pipe M��liunt �ttn�t r-3 6P V lupsuil _.... �.. 3 E D u b % Slope Bed Of z 2 %2 Force Main Plowed Aggregate Layer (6 Below Pipe) p Cross Section Of A Mound System Using A Bed For The Absorption Area r 9. S G i A 7 Ft. N �rZ Signed: B c�3 Ft. License Number: K 9 D Ft. Date: 3 ;,[ D L 62.3 Ft. is J S. BY Ft. ' I Ft. ,i W ZZ,7 Ft. i I ` L a ' i Observation Pipe A � - - - - ------ - - - - -- -------------------- Is „ M ' Distribution Bed Of 2 — 2 %2 I. Pipe Aggregate •I Observation Pipe r-,, .� Permanent Markers 1 ; , Plan View Of Mound Using A Bed For The Absorption Area c 1ln 'V'/ —7 Faye Of ` r Pipe Detail tail For A Four Lateral Network e Alternate Position Of- j 11ATn0rrr'llmd Cap Force Main y / ` � I P j PVC force Main , PVC Distribution Pipe P 14,'Ho'ies Equally Spaced PVC Manifold Pipe On Bottom X S * Last Hole Should Be Next To End Cap P WO F t . Y $_ _Ft. X Inches Y Inches Signed: Hole Diameter 3 Inch License Number: ,��/7�� - -- Diameter ,� Inch(es) lateral Diameter . Date: , Hanitold Diameter /Z looses Force Main Diameter Z Inches J Holes Per Pipe Invert Elevation Of Laterals �7�� 00 Ft. FaT P P "St Mp,Eia. CkClIss r-CC AUG SpE • y`� 1.1 M � � V E N7 CAP 'P C.Z. VEMT PIPC WCAT FI£ RPROOi' APPROVED LOCKIMG I X r !A IJHOLE COVER - N ! AIR INTAKE GRADE I • CCAlDt11T• --� WAIN. � A INLET PROVIDE I 7 AIRTICPWY SEAL. f * A I I ' I ALARM I *APPROVED I ( ow JOINTS WITH I ! I:LEV ' T APPROVED PIPE ! 3 ONTO PUMP __1 OFF • D SOLID 501E 1 CONCRETE DLOCK RIS EXiT PERM17£ED OWL'S IF TANK MMILIFACTLIRER HAS SUCH APPROVAL SEPTIC E S PE C I F ItX1 OAl S Dose 1AUKI MANUFACTURER: hIUMbER OF IDpsEg; PER DAM TANK S!ZE: Roo - ......r.._._ GALLOWS DOSE VOLUME • LARM MMuUFACTuItE,I:: L- EyT- INCLUDING 6ACKPLOW. 73 ._�_ {'iALLOAtS AODZL WUM06R: ______L4? CAPACITIES: A a�. NJCRES OR � SWITCH TOPE: _ epzc yz�j d 6 ..�IIOCMt;S OR GALLOUS PUMtP MAMUFACTURLiR: --ZO C L a OR 8 GAILOAJS MODEL NUMBED r D INCHES OR `•`"�""' ALLOAlS SL.►PirCFt TbPE: G VR — WOT E: PUMP AND ALARM ARE TO OE MINIMUM DISCHARGE RAT �" Z' GPM INSTALLED 011 -PEPARATl: C ,itCuITS VERTICAL DIFFE&ENCE BET WEED PU CIO O13TRIIlt1TtOA1 PIPE.. � � FEET 1 ' � i,e u + MIAIIMUM NETWORK SUPPI.O PRESSURE . . . . . .. . . . _ �- t :2 / •�'j`" G,�V/ + L`2- FEET OF FORCE MAIN X t 0 .... S IFY ,0I,LFRICTtOU FACTOR.-- . FEEY TGTAL DOWAMIC N Ab IUTERAIAL iP'tEiUbtOIUG OF TAIJK: He,y� -- 60 - ;WIDTH - ;LIQUID DEPTH LiCER„15E AlUMitPa• ... HEAD CAPACITY CURVE f ' =' __�' i ^' - -. :F Ar r• _ _, y ip S. r_n MJJUIt Weight 1 Single 3• MODELS "140;4140" E-L.,ENT ANC oEt�.rLl l :_• l f 1 lr r :: �t'Ii l V 1- I_lrs I t t 1 T 3 ]i d4 A I zU A 1 I s 6 _ zo_ ° 4 —P U.S. CALLQNS 10 2C 3: M1U SO 60 %� 90 90 1 LItgRS -- - - - -� - - - - - -- -- f 8r, 160 2G 4 O ; j Fr pw crR ntmt,l-c CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duolex systems, are available and supplied with an alarm. • Mechanical alternators. for duplex syster ^s, are available with or without ! alarms. • Control alarm System- are available for 1 phase purr ps used it simplex r SK1524e system. See FM0732.' • 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 Singie piggyback varable level ;bat switch or double piggybacx variable level • Sealed Owik - Box available for oladoor installations. See Ff 1' 420, float witch. Refer to ;:M0477 • Over 130 ° c. (54`C.) special quotation required, 2. Mechanical alterna;ar M -Pak 10 -0072 or 104375, • Refer to FIt40806 for 200 F. aSlplications. 3. See -M0712 for correct model of Electrical Alternator E -Pak. 4 1'sriabie evel control sw trh' 0.0225 used as a cortrol activator, spedfy duplex (3) or (4) float system. Four %41 tole J -Pak.. junction box for watertlghl connection or wired -in simplex 140 Series - 53!bn, 4140 Series - 73 lbs. ctl 2 rump oper2ton, 1C - 0002. _ 14014140'•' MOD _ _ J Control Sele _ � Mod em Model Voi ts•Ph Mode I Amps Simplex Simplex ___bup —_ �I N 1 Nd140 115 1�_ Non 150 10—, &5 2 or 3 +& 4 ! CAUTION „0 r E4 40 230 1 Non 5 i o t 3 C — _ = ur ? & 4 f31�' 40 94 40 115 1 }— Non 15. .5 _ _ 1_o 8 5 ,.. - -.� x s _� 4 J - All installation of controls, protection devices and wiring should be done by + -- electrician. All e a qualified licer;sed electrical and safety codes should be BE IidE4140 230 _l -1_ Firm L . 1_ =- _ 1 pr 1 & 5 _ 1 2 or 3 followed including the -post recent National Electric Code (NEC) and the rQA4n ,eel pumps we avallable with options 16sture sLlws. Seal Fad irdicatn, lutl availab a in NEMA 1 o NEMA O Occupati Safety and Heafth Act (OSHA), control panels. RESERVE POWERED DESIGN For unusual con1tions a reserve safety factor is engineered into the design of every Zoeller pump. -- °"' - -- - -- — — h1AIL T0: P.O. BOX 1634 / omsvifle, KY 40256.0341 Alencfac:urersof 0 % � SHIP TO: 3E49 Cane Run Road Q r � y Louisville, KY 407f ,•1961 Q414117r 17l/MP6 91NCE /9' • !f� J �a�� L u. (562,: 718.2731 • a (800�926 -PUAAP r, v,crm see oro� Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code 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. 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 sfnugh off the filter when rPmnvari from its enclnsure. If the filter is equipped with an alarm, the filter shall be serviced if III" 'Air1111I In o. JNttl"tI I t 111111 it I, it I MY It 0"I mi l- 111111 (111111 t1i'milh Ilms/ 1111 III oit$ hull 11, Itl twh u1 iIII Iml It111t 1111! 1 1',I II 1111IIIuUiI 111111111. I I11t septic tank shall have its contents renluved when the volume of sludge and scum 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 a triennial 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. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg /L BOD5, 150 mg /L TSS, and 30 mg /L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manual ISBD- 10572 -P (R. 6/99)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump 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 a tank or component. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions on the operation or maintenance of this system should be directed to your county zoning or health inspector. f - y .lr VIII. OPERATION, MAINTENANCE AND PERFORMANCE MONITORING A. The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make I►eriodic•, impec•.60 11 ' r c►f il►e c,c►n►I►cmenls, cA►ecking li►r surfin ce discharge. treated e luc;ia levels, etc. The owner or owner's agent is required to submit necessary maintenance reports to the appropriate jurisdiction and /or the department. B. Design approval and site inspections before, during, and after the construction is accomplished by the county or other appropriate jurisdictions in accordance to ch. Comm 83, Wis. Adm. Code. C. Routine and preventative maintenance aspects: 1. Treatment and distribution tanks are to be inspected routinely and maintained when necessary in accordance with their approvals. 2. Inspections of the mound component performance are required at least once every three years. These inspections include checking the liquid levels in the observation pipes and examination for any seepage around the mound. 3. Winter traffic on the mound is not permitted to avoid frost penetration and to minimize compaction. 4. A good water conservation plan within the house or establishment will help assure that the mound component will not be overloaded. Names and phone numbers of local health authority: St. Croix County Zoning 715- 386 -4680 Name of service contractor in case of failure. or malfunction: Schmitt & Son Excavating, 7115 -549 -6651 Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of %fety and Buildings In accordance with Page � of Bureau of Integrated Services GQ►ffln'1, 83Og, Wis. Adm. Code 0 Attach complete site plan on paper not less than 8 1/2 x 11 inches in ''e Plan m t .4, County include, but not limited to: vertical and horizontal reference point (BY), direction ar d `l percent slope, scale or dimensions, north arrow, and location and diPtance to nearest road." Parcel I # g APPLICANT INFORMATION - Please print all information. Review b Date Personal information you provide may be used for secondary purposes (Privac w, s. t 5.Q4 (f) (AjTi, `r 3 Z Property Owner Property Loc 2 \ \ Govt. Lot .5� 4/4 " S'cJ 1 /4,S S T j N,R E (or) W Property Owner's Mailing Address tit;.._ .Block# Subd. Name or CSM# 1 - j- a City State Zip Code Phone Number ❑ City ❑ village Town Nearest Road New Construction Use: JVResidential / Number of bedrooms 3 Addition to existing building Replacement ❑ Public or commercial - Describe: Code derived daily flow 6 C3 6 gpd Recommended design loading rate bed, gpd/ft 6 trench, gpd/ft Absorption area required /20y bed, ft 0010 trench, ft m design loading rate 5b ed, gpd /ft G trench, gpd/ft Recommended infiltration surface elevation(s) 9 i'- SD Ma rred to site plan benchmark) Additional design /site consider ations -A �Ma 0ocnr-cl-f ii � �`' 5- 0 4 / Parent material I I Flood plain elevation, if applicable S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill HoldinnE;U U = unsuitable for system ❑ S U 0 S ❑ U ❑ s [4 U 1 0S [D U ❑ s le U ❑ S SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD /ft rr W g in. Munsell Qu. Sz. Cont. Color G S Sh Trench Texture r. z. . Consistence Boundary Roots Bed , x �udr u, Z _ a I - T" I C 5L - QS elev. nd 3 3 1 6 m , 4 60 0 ft. Depth to limiting factor Z in. Remarks: Boring # S LS S I 0-M 1 f Z Z , CS ;G s 3 3 e Yga-S 1 6 C ZpT a 4 US Ground elev. }•3o ft, Depth to limiting fr , or . in. Remarks: CST Name (Please Print) Signatur .� Telephone No. Y� k 6Z_ Address Date CST Number � � - -5 s 5 330 � SOIL DESCRIPTION REPORT PROPERTY OWNER Page H of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 hew in. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench �¢C c Z Zu to / s l I ,,k Ground 2 N " q 6 L Z►�. _ =) LS elev. 4sb n. R ; Depth to limiting factor. Z _ in. Remarks: Boring # Ground elev. n. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench Boring # Ground , elev. ft. ' Depth to limiting ; factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) ` a PAGE OF_I_ NAME LOT# (-1 LEGAL DESCRIPTIONSw ' /4Sw' /a,S S Tao ,N,R 1 E (or) 0 t SCALE: 1 BM 1 ELEVATION ((5C> • U BM 1 DESCRIPTION •. Qovbl.e Q„ (3: Ccti W1 two, BM 2 ELEVATION &)Q- O BM 2 DESCRIPTION C, „ A SYSTEM ELEVATION ALTERNATE ELEVATION CONTOUR ELEVATION, . S S J ACS v v C•3 P DATE SIGNATURE I ST CROIX COUNTY SEPTIC "TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/I3uyer ' iN A -� - Mailing Address 13s NW AT P, kek Property Address (Verification required from Planning Department for new construction) ttylState _ Ci � Orn fst Parcel Identification Number 03�- ,P1�S -76" _ -- -� _ _] _._ LE GAL DESCRIPTION Property Location _W_ ' /., _ ty _ V" Sec. T3� -P Town of L�jaW��yS� , a_d1V1S[0n �67 17 C n��f --- - - - - -- n ,� Certified Survey Map # , Volume �^ , Page # Warranty Deed # b5 `3`d 13 Volume ,Page 9; �3 Spec housed yes ❑ no Lot lines identifiable yes ❑ no SYSTEM MAINTENANCE m could result in its premature failure to handle wastes. Proper maintenance Improper use and maintenance of your sep s ste o p Y Y 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. The property owner agrees to submit to St. Croix 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. 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. Certificatior. 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. / /o ST ATURE OF APPLICANT DATE OWNF,R CERTIFICATION 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) o the ro rt de d a v v .. e , Register of Deeds Office. scnb bo c b virtue of a arrant deed recorded i P Pe Y Y Y g 2 / 2 0 SIG ATURE U APPLICANT DATE ' * " ** 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 decd Gom the Register of Deeds office a copy in the warrant deed of the certified survey ma if reference is mad h y pY Y P II 02/19/01 MON 16:05 FAX 715 386 4687 REGISTER OF DEEDS 003 e STATE BAR OF WISCONSIN FORM 2 - 1998 CS Z3 �10 45:3L Z3 WARRANTY DEED KATHLEEN H. WALSH REGISTER OF DEEDS Document Number .y.(I! -. ... - -.• ST. CROIX CO., WI 1588 PAGC 47 -- RECEIVED FOR RECORD This Deed made between RICHARD - 0 STOUT and - .TAMET p emnrtm I ..... { 02-19 -2041 4:00 DPH _. hu And w i £P, -� i N Y Grantor, DEED CERT COPY FEE: and M.. &. , G, .ZNC..,...__ COPY FEE: �i TRANSFER FEE: 134.90 RECORDING FEE: 10.40 Grantor, for a valuable ccnsideration, conveys and warrants to Grantee the following ,II described real estate in St. Croix County, State of Wisconsin: Rouording Arne Lot 17, Plat of Chabre, Town of Somerset, - - - - -. -- St. Croix County, Wisconsin. Name and Return Addres I f � I I 032-2125-70-000 Parcei lcientlflcation It imbor mm Th.s is not _ hornemead property, ± (is) (is not j II I� r, !ti �i 'I li I ' Exceptions to warranties easements, restrictions, r s -(:.)f -way and covenants of record. i I Dated this 1 6th day or February 2001 ��c r ,f + Richard 0. Stout Janet P. Stout j -- .._._..__.... ,...,, _ (SEAL) (SEAL) 'i AUTHENTICATION At_ KNOWLETUGit.tENT State of Wibconsin, S t. Croix s> _ Coun v authenticated this day of Personally came before me this........ _ 1 6 _h day of February 2001 the above named b ard.. .0 R t t` h .,,,..... t. QllL and Ja P _.. stout _...- -._.._ 11'I'LE: MEMBER STATE BAR OF WISCONSIN _ - -- _ to Qf nat, me known to be the persoiO who execrated t' foregoing authorized by §706A6, Wis. Stats.) trbj� instrument and acknowledge the same NGttiry U l .I THIS INSTRUMENT WAS DRAFTED BY Janet P. Stout 330.4 nw - fukee Tr � ., ........._.__ Hudson, WI $4016 Notary Public, Stat f Wiscomsi. — My commission s permanent. (If nr t, st. expiration .late; (Signatures may be authenticated or acknowledged. Both are not necessary,) — — * Names of persons stjning iri any capacity /oust be typed or printed be3ow ::ter elgnswre. STATE BAR OF WISCONSIN Wrscor 's legal Blank Co , ink WARRANTY DEED FORM No. z r max Mnwsuwae, wis OF - 46 1 WINDOW 4 C HALB R E 0 .! IMUM FIRST ELL VA TIYATDN 11 RST ELEVATION IE SW1 /4 OF THE SW1 /4 AND PART OF THE SE1 /4 OF THE SW1 /4 LOT N `" LOT Y56.0 LOT 3 "W o 19W, TOWN OF SOMERSET, ST. CROIX COUNTY, WISCONSIN. LOTH 9180 LOT6 9670 o p LOT 6 967.0 u• 1 j,Oq! LOT i LOT7 WA \ LOT a WA C.S.Y. IN VOL 6. 1M 1689 \ A 10 ON o ------------ - - - - -- _C.SJL_ — IN\ VOL. B.--- PG._R146 LOT 11 Wei \ \ LOT 12 9011.0 N01fTH LINE OF TH221/2 OF THU 2W7/4 LOT 13 WA 50'W 21 .94, LOT 14 no 0 LOT Is 970.0 Y/ 0. LOT 16 970.0 R LOT 17 972.0 LOT 111 972.0 LOT 19 WA Z LOT 20 9990 /. Z LOT 22 21 954 A Z Wj LOT � am0 3 S� LOT 23 9660 lDT 24 9700 2.000 AC11lH 131770 6Ni FT 3.001 ACE° _' 1.074 so Fir 120]'01 SOFT 120707.20 00 FT �? S� � 7.000 SITE N 13060 W FT SEFTJC SDE Q9 z A y 7 b SEPTIC WE ib � 0 . 20 b A e 'a ; DRAINAGE b b EASEMENT OZ b f [� H.W.L. 963.00 K A e _ Z iA 3 • ` H.W.L. = 964.00 2 2.000 ACRES �\ g Iso.6s so wr I S EAS MINT \ g y \ A NO MGA13LE f B (B WETTAND m - 1' 2N 4i Ry, Iw./r s6.Tr 1es.sr 1/w.2s - Z � I •'R w ® N N4470 E 7"Ar T ROAD _ 1, _ 2 @W"I 0• IN 76Ar 1h V 147.6 aoa6 so SEPTh SITE A A A 13 18 16 H.W.L SM. 14 SLOW ACRES ACPIE8 Iaona sO TR '1 ly`�`�'j��� • so 130022 goo Fir 12p232� g .�� • � . V srrr6 SITE ` it 4 ( r 15 ss S y ,..17 4 1 7 a B 3000 ACRES A 19 ° 12°222 so Fr SAM e 21000 ,A`L : H.W. = 966.00 1 , A SITE 016.00 r WAY SETBACK PER TRANS 233 N , 1 1 V 0 ACCESS 4ZO, ST bus a ' N89' 1813' E� 1815.88 SOUTH UFE OF TIE SWtA PROPOS 810 64 STATE TRUNK HIORWAT ------------------------ D.O.T. NOTES PER TRANS 233: As owner I hereby restrict all Lots and frocks so that that no owner, possessor, SCALE IN FEET 1' = 100' user, licensee or other person may have any dgM of direct vahlcular Ingress nom or egress to arty hlg Nina within the rlAMot- y of ga State Trunk Hlghivay'W 6 64', as shown on the land division map; it is ehgressty 100 0 100 Y00 300 intended that this restriction constitute a restriction for the bereft a the public as provided In s.236293, Stats., and shall be enforceable by the department or its assigns. No P EA OR BU NO PO OR Blt6 ®GIBIFS ARE TO BE PLACED SUCH THAT THE INSTALLATION YYDItD The lots of this lend division may experience noise at levels exceeding DISTURB ANY SURVEY STAKE, OR OBSTRUCT VISION ALONG ANY LOT LINE OR STREET L9E. the levels in s. Trans 406.04, Table 1. These Wells; are based on THE DISTURBANCE OF A SURVEY STAKE BY ANYONE IS A VIOLATION OF SECTION 2.M federal slandsrd9. Owners 0f these IOU are respo for abati OF WISCONSIN STATUTES. UTILITY EASEMENTS AS HEREIN SET FORTH ARE FOR THE USE OF PO g UB PLIC BODIES AND PRIVATE PUBLIC UTILITIES HAVING THE RKIVn TO SERVE THE AREA noise sufficient to protect these 1019. EACH PARCEL SHOWN ON THIS MAP (ILAT) W SUBJECT 10 STATE COUNTY, AND TOWNSHIP LAWS, RUES AND REGULATIONS V.E , WETLANDS. MNMUM LET SIZE ACCESS TO PARCEL, ETC) BEFORE PURCHASING OR DEVELOPING ANY PARCEL OF LAND CONTACT THE ST CAM COUNTY ZONM OFFICE AND APPROPRIATE TOWN BOARD FOR ADVICE SHEET 1 o f 2 SHEETS