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HomeMy WebLinkAbout032-1099-30-060 Visconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division^ INSPECTION REPORT sanitary Permit No: 463262 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: P zik, Jan I Somerset Township CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No /Ob e) 1`n l G 36.31.19. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark l 2 ( 166.77— /O b Dosing l � Alt. BM CTS Gor be.,L 3.05 A3. 6 Aeration w Bldg. Sewer 36 3 /o. R Is" -� Holding St/Ht Inlet / 2• u 2 TANK SETBACK INFORMATION St/Ht Outlet • U TANK TO - /L WEI L BLDG. Vent to Air Intake ROAD Dt Inlet /v l/\J k 4 W /3.0' 23- Septic , 2V Dt Bottom / 2 • 3 • , 6 g -q .� Dosing , , D � Head r /Man. _ — -7, q Z, ! / 1 9 • �fo Aeration \ J n Dist. Pipe ( v, ` 7 1 • IN' • �� Holding I Bot. System 7 ��L Final Grade ``77 PUMP /SIPHON INFORMATION . 'f" �• .aS->� . /Ul .S� Manufacturer�1/� -�C� Demand St Cover —� GPM Model Number 2 Co (� Ste. h v 4 7 T A TDH Lif� Fricti n L s ISyste Head TDH ��t J U Forcemain Lent Dia. 2 os Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width 11-engthNo. Of Trenches PIT DIMENSIO o. Of Pits Inside Dia. T uid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLD WELL LAKE /STREAM L ACHI Manufacturer: INFORMATION CHA OR Type Of System: � � y,,. f ,� �/ Model Number. DISTR N SYSTEM 7! / V - 7 — u q ' Cx ✓t �1 r .�• Header anifold Distribution x Hole Size x Hole Spacin Vent to Air Intake 3 / Pipe(s) Ia ` (/� 3 «fi > 1(� Length Dia Length Dia Spacing / SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed/Trench Edges To soil g p Yes n No I Yes i ;l No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: CP (� / ds Inspection #2: / / Location: 783 190th venue Somerset, WI 54025 (NE 1/4 NE 1/4 36 T31N R19W) NA Lot 4 1 0 / 6 w vhC ` Pa el No: 36.31.19. 1.) Alt BM Description�'1�2;�'�� 2.) Bldg sewer length = 2 / t - amount of cover = U4' / d I Plan revision Required? j Yes I / / n ' Use other side for additional information. l� � Date Insepctor's Sig Cert. No. SBD -6710 (R.3/97) Safety and Buildings Division County ` 201 W. Washington Ave., P.� Box -71 !j MW aa �O��I Madison, WI 537 -`716 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608)26 �32_�,2 Sanitary Permit Application N u mb er In accord with Comm 83.2 1, Wis. Adm. Code, personal information you pro de Q�C/+ �D Og may be used for secondary purposes Privacy Law, s15.04(1 )(m) ` J 6Proj� t Address ' different than mailing address) S 1 I. Application Information - Please Print All Information N N 7, Property er's Name jzw Prope er's Mailm kddress Property Location City, State Zip Code one Number -1J« V ° , V ' , Scion 1 le o e) T,,31 N; R o 11. Type of Building (check all that apply) P¢r g 1 or 2 Family Dwelling- Number of Bedrooms CLtitS. Subdivision? dam CSM Number O Public /Commercial - Describe Use 7 ❑ State Owned - Describe Use ❑City ❑Village f Township of 5 III. Type of Permit: (Check only one box on line A. Complete line B if applicable) 1 p� A. $,New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision Change of Permit Transfer to New List Previous Permit Number and Date Issued ❑ Before Expiration Plumber Owner IV. Type of POWTS System: Check all that a OS ❑ Non - Pressurized In -Ground ,1X Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ ingle Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Cham r ❑Drip Line ❑ ravel- s Pipe ❑ Pther ( xp ain) V. Dispersal/Treat ent Area Information: CD - D Design Flow (gpd) Design Soil Application Rate( sf) Dispersal Area Required ( Dispersal Area Proposed (sf) System Elevation bo Q - VI. Tank Info Capacity in Total NtImber Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units l A, D _ Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the undersignedq assume responsibility for installation of the POWTS shown on the attached plans. __T Plumber' ame (Print) Plum er's S' MP/MPRS Number ;B5 Phone Number r _ � / Plumber's Address (Street, City, State, Zip ode) / 4L 4L VIII. Coun /De artment Use Onl Approved ❑ sappr Sanitary Permit Fee includes Groundwater Date Issued I ui Agent Signature (No Stamps) Surcharge Fee) t El n Reason for �(p IX. Conditions pprova SYSTEM OWNER: 9 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by Plumber. 2. All setback requirements must be maintained as per applicable code /ordinances Attach complete plans (to the County only) for the system on paper not less than SU2 x I I inched in size SBD -6398 (R. 01/03) , h I -• • �• d'^ _ �J�. .k, s's:fi.',*' r. �,i:' -da?r: e::a�•:J - "J» +sfw.`F_i: r5ir-MAYfw1r:' �T+ ,.r .r__..'4 _ey:E' tl�: ol It �) ',!•..' v?!+4 =.. 'r 1 211. - tL , :w ; e =i• .Pe :. ...�. � c::. \ � j „ y A , Y : � ,.,,: a.,'.F�;�r_' ryJ:C:;J.�.r' .. 'i% r ''�• "^ ^�:.: r w�riY•y.::�..� °i' ' " ,i�A�, : ,��-' •k : .t S, ,rs ,� alb ,.''� 'L• Y�' .'S•.� �1 `at• ',` _ ,` � . , r_, :•� .F•. •'.^a., yi :y • : :e� "„ 4 ;•'.' r. .��q' M• =!!:•, • - Yi• s45.,, 'y'�•'q. % : ;;5• s t{,;'F:; { � ^ ':`� s -' •} +. •:e `. '�i i.'R.�.. � �.! 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CONSTRUCTION ST CROIX COUNTY SPIA 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 12/09/2006 Identification Numbers Transaction ID No. 1086408 SITE: Site ID No. 692774 Jan M Pyzik Please refer to both identification numbers, 190TH Ave above, in all correspondence with the agency. Town of Somerset St Croix County NEl/4, NEIA, S36, T3 IN, R19W P O,�•• FOR: Description: New mound, 4 bedroom residence Object Type: POWTS Component Manual Regulated Object ID No.: 994280 Col` d tl0 Maintenance required; 600 GPD Flow rate; 42 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01) AP C DE T I The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Co SAFETY 1 and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in i chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Departmen er s.145.06, SEE CORRESP stats. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the design manuals noted above. • 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. Key Item(s) • A copy of this approval letter and index sheet shall be attached to plans that correspond with the copy on file with the Department. Changes to the approved plan must be submitted for review and approval. Failure to properly attach the approval and index page to plans that match the copy on file with the Department may result in enforcement action under s. 145. 10, Stats. (Note: the reviewer has attached a copy of the approved revised pages to the index sheet that was provided.) • The bottom of the distribution cell shall be level per the Mound Component Manual. The "D" dimension shall be a minimum of 6 ". The maximum finished slope of the mound surface shall be equal to or less than 3:1 per the Mound Component Manual. • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. KIM A O CONNELL Page 2 12/9/2004 Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(i). Consult the Department of Natural Resources for well setbacks and exceptions to the setbacks. • Insulate building sewer per COMM 82.30(11)(c). • Provide frost protection per COMM 83.43(8)(c). 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 r. 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. 6 The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the I 1 1 installation, operation or maintenance of the POWTS. Sin Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Patricia L Shandorf POWTS Plan Reviewer, Integrated Services WiSMART code: 7633 (715) 634 -7810, Fax: (715) 634-5150, M -f 7:45 am - 4:30 pm pshandorf @commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: JAN M PYZIK Owner's Name: JAN M PYZIK Owner's Address: 448 HIGHLAND VIEW HOULTON WI 54082 Legal Description: NE - -NE -- SEC 36 - -T31 N--R1 9W Township: SOMERSET County: ST. CROIX Subdivision Name: CSM rs. Lot Number: 4 Block Number: natty ivtD Parcel I.D. Number: 7etIGS Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 PLOT PLAN Designer: KIM A OC NE License Number: 224263 Date: 11/1 04 Phone Number: 715 - 755 -3145 Signatur Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 3.0 (03/01/01) Page 1 of 8 _,.._..,u 16 002 I End Connectiotl Lateral Layout Diagram F d overthe q & B dimension P W = Turn -up VWball valve or c?leenoutpiug entioa) driped Pr+ the bottom of the iaterai vQUaglspaced $ neotlon Via tee of 01 0 ss to manifold at an 1 point_ Lateralf & far0a male pf PVC Bch f0 (per COMM Table 64 -30 -5) Number of Laterals 2 Orifice Diameter Lateral Diameter 4278 in 1.50 in Orifice Spacing (X) ft Lateral Length (P) 98.56 ft Orifices per Lateral Lateral Spacing (S) 3.00 ft Lateral Flow Rate Orifice Density ftZ /orifice 13.59 gpm Manifold Length System Flow Rate ft 27.19 gpm Manifold Diameter Total Dynamic Head 23 ft n Forcemain Velocity t/SeC.- Dose T sink Information Locking cover with vramillg label and locking device turd Electrical as per NEC 300 and O sealed watertight —1 Gomm 16.28 WAC l7i5connect 4 1n. min. �ank component is properly vented 4--- — Alternate outlet location ?fir '777q/ 3 W Gallons Foresmaln diameter Manufacturer 2 in 800.00 21.76 gal /inch A Dimension' ches Gallons Weep hole or an 79 452. ti - A 8 siphon device B 2 • 3.52 C D 8 .00 12 4.08 l t ` -�'tnp off e levation 186.67 08 l__ Total 36.76 800_ D 3" BedTin In er tank. Dose tank elevation ( it) =86.00 Alarm Manuffacuurer F EL ECTRO Alarm Model Number 100 Pump Manufacturer E GOULDS Pump Model Number PUMP Must Deliver 27.19 gpm at 23.$1 ft TDH PrOject,' JAN M PYZIK Page 4 of 8 , , g`► JJJ"'Cll -'��� i I � • I 1t a r. I, �. MA479•lsl'�',�'• r•.,^ �s'- 9., rnwi.>rs'!FR „ y7rt; - •,:': . M - , dY:Fr...w9•j �i,�1: ' :Y °1'.I "::.: � ^.+f:L'SJ.J e: :a�:;l:!LAr::.r4 �aili X'�. r.Y "� , �. «�•:..:rr.le+i.F'+wy...: a•�• , +. �;� .,i' .:C iris.' ' «G ✓J ., 4::. , . rwrr,r� u✓.XJirlu.h.gnl•r�wM•4wntlb,+ . .ry : 'k.li,� .'.ii. ��•v*�- ii�1•' :: .. -..:I. � .. „' �: - r.: Yl • : '..yam... .... : 1 r.,irvw,:rr.r,,..w,.swsM•M�W '11.iW ul iYl .. ,r ss �v W! i !G... 1. �. /• r.1 ri F,:f � :;.'St:';!L_ wJi Ijrl', •J1cs: .�.Y,s'. •: 1! Lyrl.,. �.,,, Yd,�hnw�r,.�w4.4rW,- �•iwrnwn.iw Ali „ ',: . r�s..,.� -.. i'�yA.. �_.Y�. .. �.., :.: Aii., �f s id - X,. ; q �•�i - :' r'.ti :,.�= i:yn:. •.�J ^r � 11.:; ?f.' "r: 1 �•.�. ..:1j. °,q, .,.4: 4, ���,}'j7 • cc4 :17N. 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Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 83 -44 -3 in-situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 % coliform of - 36 inches. 600.00 Design Flow (gpd) 4.20 Site Slope ( %) 98.05 Contour Line Elevation (ft) 42.00 Depth to Limiting Factor (in) 0.60 In -situ Soil Application Rate (gpd/ft) Distribution Cell Information 100.001 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /ft 1 I Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) E Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation ft 2 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) = 9.09 ft /orifice 2.00 Forcemain Diameter (in) 305.00 Forcemain Length (ft) Does the forcemain drain back? l� '_ � 86.00 Pump Tank Elevation (ft) Enter Y or N pb 6.50 System Head (ft) x 1.3 49.75 Forcemain Drainback (gal) 12.38 Vertical Lift (ft) 90.43 5x Void Volume (gal) 4.93 Friction Loss (ft) Q.p 140.18 Minimum Dose Volume (gal) 23.81 Total Dynamic 27.19 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 1.50 x X 1.25 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information 1260.00 Total Tank Capacity (gal) 1260.001 Septic Tank Capacity (gal) 52.00 Total Working Liquid Depth (in) WEEKS IManufacturer 24.23 gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.001 Dose Tank Capacity (gal) JZabel I Filter Manufacturer 21.761 Dose Tank Volume (gal /in) IA100 I Filter Model Number WEEKS Manufacturer Project: JAN M PYZIK Page 2 of 8 i Mound Plan View T 1/10 B 3 ::::::: J Observation Pipe 3 ... — 5 A W ....................... .i :: :.....:.......... B :. .. . .:•:•: .:•:•: .:•:•:•: L � Mound Component Dimensions A 6.00 ft E 9.02 in H 1.00 ft K 7.25 ft B 100.00 ft F 9.50 in z 7.01 ft L 114.51 ft D 6.00 in G 0.50 ft J 4.77 ft W 17.79 ft 600.00 (ft Dispersal Cell Area 1301.49 (ft Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 100.34 (ft) —♦ G ♦ H F ;: ' ' Dispersal Ce 99.05 (ft) La 98.55 (ft)--► Invert Dispersal Celt :.................... E D 3 Elevation :.:.::.:.:.:.:.:.:.:.:.:•:.. 98.05 (ft) Contour Elevation 4.2 °k Site Slope Geotextile Fabric Cover Shading Key $— Dispersal Cell See lateral details on 10 Topsoil Cap c 1.5 ft -#' Page 4 for number, Subsoil Cap ( size, and spacing of © ASTM C33 Sand 9 Z F laterals. Laterals are Tilled Layer C! 0.5 ft Typical Lateral equally spaced from 05 Aggregate o 1 the distribution cell's �--- A ♦ centerline in the distribution cell (AxB). Project: JAN M PYZIK Page 3 of 8 End Connection Lateral Layout Diagram Laterals centered overt the A & B dimension 0 = Turn -u p wl ball va lve or olean out pl u 9 P .I All laterals are identical IE X — }I Hal es drilled on the bottom of the lateral S equally spaced Force main connection aria tee or cross to manifold at any point. Laterals ec force main of PVC Sch 40 (per COMM Table 84.30 - Number of Laterals 2 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 3.08 ft Lateral Length (P) 98.56 ft Orifices per Lateral 33 Lateral Spacing (S) 3.00 ft Orifice Density 9.09 ft /orifice Lateral Flow Rate 13.59 gpm Manifold Length 3.00 ft System Flow Rate 27.19 gpm Manifold Diameter 1.50 in Total Dynamic Head 23.81 Ift Forcemain Velocity 2.78 ft/sec Dose Tank Information Locking cover with waming label and locking device and sealed watertight Electrical as per NEC 300 and --► Comm 16.28 WAC 4 in. min. Disconnect _ Tank component is properly vented E— Aftemate outlet location Forcemain diameter WEEKS Manufacturer �� 2 in. Ca acit 800.00 Gallons Volume 21.76 gal /inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 20.79 452.45 B 2.00 43.52 C P = ump off e levation (ft) C 5.97 129.95 � 86.67 D 8.00 174.08 D Total 1 36.761 800.00 Do se tank elevation (ft) 3" Bedding under tank. 86.00 Alarm Manuafacturer JSJ ELECTRO_ Alarm Model Number I HW 100 Pump Manufacturer GOULDS Pump Model Number WE0511 H Pump Must Deliver 27.19 gpm at 23.81 I ft TDH Project: JAN M PYZIK Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name K A OCONNELL Phone 715 - 755 -3145 POWTS Regulator's Name ST.CROIX COUNTY ZONIN I Phone 715 - 386 -4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1260 gal Maximum TSS 150 mg /L Soil Absorption Component Size 600 ft Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Freciuencv Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Moundl inspect for ponding and seepage once every 3 years Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished . • ..... • ...... •. • . • . • • • • . • • • • • • Grade 6 -8" Diameter Lawn Threaded Cieanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral - Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: JAN M PYZIK Page 5 of 8 ' Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01/81)] 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. 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 slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent fitter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed 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. Puma 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 as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 30 mg/L TSS, 10 mg/L FOG, and 10 cfu/100 mL for highly treated effluent. 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 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. 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(s) 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 absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: JAN M PYZIK Page 6 of 8 NGOULDS PUMPS Submersible ", MODIL Effluent Pump 1 11 1 WE Series PROSURANCE AVAILABLE FOR RESIDENTIAL APPLICATIONS. APPLICATIONS ■ Shaft: Corrosion - resistant, Single phase (60 Hz): can be operated continuously stainless steel. Threaded • Capacitor start motors for without damage when fully Specifically designed for the design. Locknut on all models maximum starting torque. submerged. following uses: to guard against component • Built -in overload with ■ Bearings: Upper er and • Homes damage on accidental reverse automatic reset. lower heavy du ball b • Farms rotation. • S1TOW or STOW severe duty construction. bearing •Trailer courts power • Motels ■ Fasteners: 300 series oil and water resistant p ■ Power Cable: Severe duty stainless steel. cords. Schools •'/3 and 1 /2 HP models have rated, oil and water resistant. • Hospitals ■ Capable of running dry Epoxy seal on motor end • Industry without damage to NEMA three prong provides secondary moisture •Effluent systems components. grounding plugs. • 3/ HP and larger units have barrier in case of outer jacket damage and to prevent oil ■ Designed for continuous bare lead cord ends. operation when full wicking. Standard cord is 20'. SPECIFICATIONS p y Three phase (60 Hz): O ptional leng are available. p 9 Pump Class overload protection p submerged. Cl 10 ld ■ 0 -ring: Assures positive •Solids handling capabilities: MOTORS must be provided in g P maximum. separately ordered starter sealing against contaminants Discharge size: 2" NPT. ■ Fully submerged in high- unit. and oil leakage. • Capacities: up to 140 GPM. grade turbine oil for lubrication • STOW power cords all have AGENCY LISTINGS • Total heads: u to 128 feet and efficient heat transfer. bare lead cord ends. p Tested to UL 778 and TDH. ■ Class B insulation on ■ Designed for Continuous ® CSA22.2108 Standards • Temperature: ' /3 -1' /z HP models. Operation: Pump ratings are By Canadian Standards 104 °F (40 °C) continuous ■ Class F insulation on 2 HP within the motor manufacturer's CM us Asso ciation 549 140 °F (60 °C) intermittent. models. recommended working limits Goulds Pumps is ISO 9001 Registered. • See order numbers on reverse side for specific HP METERS FEET voltage, phase and RPM'S 40 130 available. sw - r I - _- _ sERiES: WE 120 t SIZE: 3 l0" SOLIDS RPM: 3500 & 11 1750 0E FEATURES ; - a H -- + _ ; ;._ . -► 5GPM - 30 100��_ 1 ■ Impeller: Cast iron, semi- 90 - ; open, non -clog with pump -out w 25- 80' vanes for mechanical seal _ - a 20 70 p - t j # _ - -- p rote c tion. Balanced for > Q H _ smooth operation. Silicon 60 -- bronze impeller available as a 0 ` ` an option. ° 40 15 50 _ - ■ Casing: Cast iron volute type 10 ( __ -.-- - - --------- for maximum efficiency. 30 , - 2o 2 "NPT discharge. 5 j -'�` ", _ -_ ■ Mechanical Seal: SILICON 10 W- r j CARBIDE VS. SILICON o o CARBIDE sealing faces. 0 10 20 30 40 50 60 70 80 90 100 110 120 130 { 140 150 160 GPM Stainless steel metal parts, 0 5 10 15 20 25 30 35 m /hr BUNA -N elastomers. CAPACITY G Pumps © 2003 Goulds Pumps ITT Industries Effective July, 2003 www.goulds.com 03885 <& [ qGOULDS PUMPS Submersible . COMPONENTS -- Effluent Pump 7 Item No. Description 1 Impeller 2 Casing 3 Mechanical Seal 5 6 WE Seri 4 Motor Shaft 5 Motor a 6 Ball Bearings 8 3 I 7 Power Cable 8 Casing 0 -Ring 1 2 -� MODELS PERFORMANCE RATINGS (gallons per minute) Order No. HP Volts Phase Max. Amp. RPM Solids Wt. (lbs.) Order WE0311L 115 10.7 N0. WE03L WE03M WEOSH WE07H WE10H WE15H WEOSHH WE15HH WE20H WE0318L 208 6.8 HP 1 /3 1 /3 Y2 A 1 1 Y2 1 2 WE0312L /3 230 4.9 1750 56 RPM 1750 1750 3500 3500 3500 3500 3500 3500 3500 WE0311M 115 10.7 5 86 - - - - - - - - WE0318M 208 1 6.8 10 70 63 78 - - - 58 - - WE0312M 230 4.9 15 52 50 70 90 - - 53 - - WE0511H 115 14.5 20 27 35 60 83 98 123 49 90 136 WE0518H 208 8.1 25 - - 48 76 94 117 45 87 133 WE0512H 230 7.3 30 - - 35 67 88 110 40 83 130 WE0538H 200 4.9 3C 35 - - 20 57 82 103 35 80 126 WE0532H 230 3.3 0 40 - - - 45 74 95 30 77 121 WE0534H 460 3 1.7 T 45 - - - 35 64 86 25 74 116 WE0537H 575 1.4 - 50 - - - 25 53 77 - 70 110 WE0511 HH /2 115 14.5 60 = 55 - - - - 40 67 - 66 103 WE0518HH 208 1 8.1 60 - - - - 30 56 - 63 96 WE0512HH 230 7.3 i 65 - - - - 20 45 - 58 89 WE0538HH 200 4.9 70 - - - - - 35 - 55 81 WE0532HH 230 3 3.6 75 25 - - - 25 - 51 74 WE0534HH 460 1.8 80 - - - - - - - 47 66 WE0537HH 575 1.5 90 - - - - - - - 37 49 WE0718H 208 1 11.0 100 - - - - - - - 28 30 WE0712H 230 10.0 WE0738H 200 6.2 DIMENSIONS WE0732H /4 230 3 5.4 WE0734H 460 2.7 3 /d' (All dimensions are in inches. Do not use for construction purposes.) WE0737H 575 2.2 70 WE1018H 208 1 14.0 WE1012H 230 12.5 3500 WE1038H 1 200 8.1 11 1121, WE1032H 230 7.0 WE1034H 460 3 3.5 RO ATION I� 5/4 WE1037H 575 2.8 WE1518H 208 1 17.5 16 WE1512H 230 15.7 2" NPT WE1538H 200 10.6 8 /z' WE1532H 230 9.2 WE1534H 460 3 4.6 WE1537H 575 3.7 1 KICK -BACK �, WE1518HH 1112 208 17.5 80 /a WE1512HH 230 1 15.7 WE1538HH 200 10.6 WE1532HH 230 3 9.2 WE1534HH 460 4.6 WE1537HH 575 3.7 WE2012H 230 1 18.0 WE2038H 200 12. WE2032H 2 230 11.6 6 83 WE2034H 460 3 5.8 WE2037H 575 4.7 Goulds Pumps and the ITT Engineered Blocks Symbol are Goulds Pump registered trademarks and tradenames of ITT Industries. PRINTED IN U.S.A. SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. <& ITT Industries ���ll��jjj D i \3 1 � � ro � - 'a.w. ��... � A' w.. -... .'. � :riw. -l• .w.; -v a. ..+Waaa �WY25W�'+.tis'Y.1 '.Kt'y ".`. =v�.. _.. �� .J.. � .....�. �u 1 - 1 l/ S � \ U e a k3 s 7 77 3. 6'97 KA' l AL7sFA H GE 4810 REGISTER OF DEEDS ST. CROIX CO. NI RECEIVED FOR WORD -eD OB/1312004 82t10PM w CERTIFIED SURVEY MAP REC FEEL 13.00 CA COPY FEEt 3.80 + PAGES: 2 v g 4 U l�f_ - LATTED � I �� N y O N a LANDS I LOT 1 C.S.M. I � , !° o z C ! (SOO-30.41-W) V(�L _b� PG_ 1531 4 NOO'24'46 "E 1324.50' 129S.71 28.79 ' 0 8 6• E 331 m --a I '� y "'� V► N N c M �� r g ow 0 - D -4 CIA a I S 662 4�wE `'� 2 vn J I w m C J CA ! } ? co too --� m 1'11 go lit ,d �r cn BEARINGS ARE REFERENCED TO THE S00'14'42'E 446.35' EAST LANE OF THE NEi /4 OF ACTION 413.35 33.00 —+ M. ASSUMED TO BEAR SO0'1; 42`E � (NOO'08 _ — S00 41 E z p (� • 2'16.84 0 4 9 111 1 �' I• :, I C � i Ds � � �. „ v •t �r w $� m L .� �o 1 ' N 07• n Z5f� m • �u m [q v I r� N d i'IS' t > >o H > 1 1 z cv C r�i aC� r, u I �• m • , t o m Z W��v� �' �S t ® v►v Q i �l NII �N ® I6 TAX i � jQ8 �! 33, ' m N � Z Q > C 00 285' r PROROSEW a` to 5e ° -1 z Q i •' DRIVEWAY y m Q -- -—- e --- - { - -3 t 1 r^ j > m a Q 2207.23 SOOT 4'42t'S.4Si Q a �'� rEAS;T th Street" NE OF THE NEl /4 1 �► UNPL ATTED LANDS I 1 SHEET 1 OF 2 SHEETS say- � 4' 42' E 2655.84 Vol 18 Page 4810 t , y 1440 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel's Soil Service Inc. 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), di and percent slope, scale or dimensions, north anew, and location and distan Parcel I.D. Pending Please p►htrfisifcre viewed By Date Personal information you provide maybe used for secondary purposes (Privacy Laue (mp. Property Owner n Property Location Lemire, Duane Govt. Lot na NE 19 NE 1/4 S 36 T 31 NR 19 W Property Owner's Mailing Address r Lot # Block # Subd. Name or CSM# 755 190th Ave 4 na CSM Pending City Statd- -Z� M6fie Number J City _J Village 1M Town Nearest Road Somerset WI 1 54025 1 715 - 247 - 3870 Somerset 1 80Th Ave New Construction Use: 16 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD ,_J Replacement _] Public or commercial - Describe: Parent material End moraines and ridges of ground morarines Flood plain elevation, if applicable na General comments and recommendations: Mound design, system elevation 99.05ft, based on contour line elevation 98.05ft M jo Boring # Boring Pit Ground Surface elev. 99.15 ft. Depth to limiting factor 42 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 *Eff#2 1 0-12 10yr312 none sl 2msbk mfr gw 1f .6 1.0 2 12-42 5yr3/4 none sl 2msbk mfr gw na .6 1.0 3 42 -100 5yr3/4 f1f 7.5yr5/6 sl om mfi na na .2 .6 Boring # _ I Boring 16 Pit Ground Surface elev. 99.15 ft. Depth to limiting factor 54 in. Sail Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftx in. Murrsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 `Eff#2 1 0 -13 10yr3/2 none sil 2msbk mfr gw 1f .6 .8 2 13 -32 10yr312 none sit 2msbk mfr gw na .6 .8 3 32 -54 10yr4/4 none sicl 2msbk mfr gw na .4 .6 4 54 5yr3/4 f1f 7.5yr5/6 sl om mfi na na .2 .6 " Effluent #1 = BOD 5 > 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD < 30 mg/L and TSS S mg /L CST Name (Please Print) Signature: CST Number David J. Steel - '�� 248956 Address Steel's Soil Service Inc. Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 6/18/2004 715 - 246 -6200 I Property Owner Lemire, Duane Parcel ID # Pending Page 2 of 3 a Boring # Boring Pit Ground Surface elev. 94.85 ft. Depth to limiting factor _ 44 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 -12 10yr3/2 none sil 2msbk mfr cs 1f .6 .8 2 12 -35 10yr4/4 none sicl 2msbk mfr gw na .4 .6 3 35-44 5yr3/4 none sl 2msbk mfr gw na .6 1.0 4 44-96 5yr3/4 f1f 7.5yr5/6 sl ore mft na na .2 .6 F-1 Boring # J Boring j Pit Ground Surface elev. ft. Depth to limiting factor in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Ef1#1 *Eff#2 ❑ Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots QP 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 S mg/L and TSS -1.30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608 - 264 -8777. IN Page 3 of 3 STEEL'S SOIL SERVICE INC. David I Steel 994 200 Th St CST -POWTS Duane Lemire Baldwin,WI 54002 Lic. #248956 NEl /4,NE1 /4,S36,T31N,R19W Bus .(715) 684- 5680 Town of Somerset, St. Croix Co. Fax (715) 684 -3449 CSM Pending Lot, 4 Legend 1 = 40' ♦ =Benchmark Ele. 100.00ft Top of 3/4" PVC Pipe • = Alt Benchmark Ele. 100.05ft Top of 3/4" PVCPipe ❑ = Borings Boring Elevations B = 99.15ft B2 = 99.15ft B3 = 94.85ft B4 = 00.00ft 72 p3Y / W, VI) v ia �S h S� Ho C 1 ak 01 0 �f goo • v v 1295.71 :28.79 ffi6 ' I m L2 a 0 • o o�rn�= m cc g Fi E �� ox I Z c N cn m 33 z j r I� o C m n m yy H cs m to I zr 'm: z � : I m0 IU m > Ir ;,m r I 00 ;z b F : m ! d r. 14 (n z 1� oN j N I 0D v cn r w {s o U) 0 IA ��"0M 0 z ° y I S00'30'45nE cn A a I° o o� r 662.84 . rn rn Qt g En m z I ► .. .. z z m _n •0;r I o m �r;o I ' n z w oo c(0 ., s i(b jrfnj N I ( I 8:0 p O z m r� ° , $ (A l m , Cri - n Q I -4 tv 0 ) ,c ' > m z N Z N : cn i Z N C 0o I cn d m Z BEARINGS ARE REFERENCED TO THE I I cn . EAST LINE OF THE NE1 /4 OF SECTION S00'14'42 "E 446.35' to y 36, ASSUMED TO BEAR S0014'42 "E 413.35 :33.00' ' n p ado 0 O ► n O cOp OZ tit I f M,6 x 00 08 56 W Z --I - u! I �N op „ E O C7�m Np D I ' to m SOO S ") 4 41 a c— _1'° �, i ' p Z z O • 216.64' w Fn c - ob y � ► �, & w to rn I ; Nl�l I C woo a ,rn s N N o,I 1. � p O M 2! o C • , ''ll /�. of I 0 m �c �� ��tn tern —v-n r- Ir .I iO vw w "�w$zmQ' r '•'v. w 1 3 O N� p m mo y 1,,,.1 p 00• co cn v I= ZA 0 X z D �w- -1 o c G to I 1 ' w OD `' , I• 0 v O 'I U! I (5) m v� �D NZ p' �v m� m Ib`� r pvp (,,'1' ►'�A.1A7�A0 I I� Z O A O o C A r s I ►� i41i1�' rn N � O p C I S 0 C Z 1. H. N -1 I m -� Lin me z� Inw+'' N ' worn z �n Zoo zr- �m I� 1 6 6'�Z A m rn c� ► y — K v - m • PROPOSED z _ o Z " m c g m $ DRIVEWAY 3 3'� g >;v 8 .: g= 220 i S00'14'42 "E 415.49' rn _ o rn o I c to r S00'14!4 4 48.61 Z �Oth Street p m -� W n o EAST UNE OF THE NE1 /4 I (A UNPLATTED LANDS SHEET 1 OF 2 SHEETS SOO 14'4 "E 2655 .84' O r ST CROIX COUNTY _ SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Ownef yef �j Mailing Address Properly address B�E/2SE- (�'erifTcation required from Planning Department for new construction) City /Statc lJy-� Parcel Identification Number LEGAL DESCRIPTION Property Loctttion 1/ ' / Sec. , T_ -R W, Town of Subdivision � .�/ ��Sh� Lot # Certified Su; vey Nlap # 7// q7 , Volume ,� Page # - -:Z Warranty Secci # `7 72 7 0 Z Volume's , Page # Spec house `yes ❑ no Lot lines identifiable yes O no SYSTEM MAINTENANCE improper use and maintenanceof your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pun ;pin, out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the runction 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. I /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expir on date. SI A UKE Of APPLIC T DATE OWNER CERTIFICATION I (we) certify that all statements on tills form are true to the best of my (our) knowledge. I (we) am (are) the owners) of Ile properly described e, by virtue of a warranty deed recorded in Register of Deeds Office. IG ATURE OF APP ICANT 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 deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed 'f 99aauuy Pp �� 8 11 t,1 �v col�auvt URM Y999 '7 7 2 7 rh 2 STATE BAR OF IS F 2 - KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., MI This Deed, made between Dame LeMfre and Marilyn LeMirg. RECEIVED FOR RECORD husband and wife Grantor, 98/26/2064 MGM and Jan PyAk and Linda P ulk Grantee. WARRANTY DEED Grantor, for a valuable consideration, conveys and warrants to Grantee DDPT # the following described real estate in St. Croix County, State of REC FEE: 11.0® Wisconsin (if more space is needed, please attach addendum): TRANS F££: 360.00 Part of W A NE 1 /4 and NW 1 /. NE 1 /. Sec. 36- T31N -R19W described as COPY FEEL CC FEE: follows t of Certified Survey Map recorded in V ol. 18 o f Certified PAGES: 1 Survey Maps, page as Doc. No. 771697. St. Croix County, Wisconsin. Recording Area Nam and Return Address K' -01 ::i 1 1i 4 OGLAND f - INEY AT LAW .'.0, BOX 359 W! 54016 Part of: 032 -1099- 10-100 Parcel Identification Number (PIN) This is not homestead property (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of August , 2004 * * Duane LeMre * ------ *–.Marilyn *_ Marilyn AUTHENTICATION ACKNOWLEDGMENT Signature(s) Duane LeNre and Marilyn LeMire •.._ _ _ ._.._. STATE OF husband and wife ) ss. _ ................................ ..... ........._..................... _. ......... _. ........ CA_ _, —__ County ) authenticated this day of August ----1 — Personally came before me this day of ......... ....:....._. .... ............... ............ the above named * Kristi naOgiand •---------------- ______._- _.____.---- ___ -.. TITLE: MEMBER STATE BAR OF WISCONSIN (If not. _ _ _ _ _ – - - - -_ to me known to be the person(s) who executed the foregoing authorized by $ 706.06, Wis. Slats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY Atto rney Kristin Hudson, WI 54016 Notary Public, State of 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. Information Profeuiomis Co.. Fad du Lac, wl STATE BAR OF WISCONSIN 80a6S3 9021 WARRANTY DEED FORM No. 2 -1999 3 77 1 6517 VOL 18 PAGE 4810 KATH 3WF M. WALSH REGISTER OF DEEDS ST. CROI Co. II I RECEIVED FOR RD OB/13/2004 02ti0PM N z g CERTIFIED SURVEY MAP REC FEEL 13.00 COPY FEEL 3.00 v PALM 2 s g UNPLATTED I v I LANDS LOT 1 C.S_M_ I I = C (SOO "W) I VOL. 6� PG_ 1531 I r CC NOO'24'46 "E 1324.50' ; ,hr- v r- - 1295.71 28.79 - ' I m O Rc Of n F r5 z cl Fn 662.84 Al m Z I .16 IC .., ... z z M O I Co f lO,9 rn N � ►b I �o a � v ; O O vNO C; O 8 0 ;� v O i t9 S." I j M 8 co Z gs � Z C BEARINGS ARE REFERENCED TO THE IC/1 EAST UNE OF THE NE1 /4 OF SECTION SOO'14'42 "E 446.35' 36. ASSUMED TO BEAR S0014 - E 413.35 33.OW, I _ _ (NOO'08'56'W) M IN S0014 41 -9!i E I O • 216.64 I I I -.z _ I N w° � L Z m 'N„ ((yy � �n� Iw I m w 22 m � � � ; b I n , � i � �Ili��� � > '� � S 2 4> 52 Z p -+ s,� z s s s r4i ' I ao PROPOSED ER � .. m CIO - -- -285' g - -- -O ----3 9'_ � X. m 'r sc 4 - X. g Q 2207.23' i SOO'14'42 41'5.49' w . _ . CIL M 80th Street AST UNE OF THE NE1 /4 S UNPLATTED LANDS ! I I SHEET 1 OF 2 SHEETS SOO'14 2655.84 Vol 18 Page 4810