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HomeMy WebLinkAbout034-1007-50-050 « K o I \ � } e 9 \ / � G e i � z � D / N o §&/ � ) k m 2 2 2= ■ \ 7§ � \ \ z § .. $ z } 7 # 2 k © 7 S 0z k k 4) z © ®— j o / { E f . \ \ ) S � \ k k j z 2 t 2 Cl) n0 §k 2 ~ \ 7 ) & Lo c o a = ' Z > / k k k § # § a a a ' $ B } g g o u _E § § z w 2 § % \ 3 / E �<z f ■ z t f 2 2 2 m ^ ° _ \ m $ \ \ S } E — E c - ® \)$��o jj ƒ$ §� ■ = E 2< / c r d) a i & E R o�§ k g m CO « o z_ ■ e ■ i ' � ■ � ` \ ■ . ■ C W ) a k E2' k2 $ U CL 2 3 2 1 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix Sa'.ety and Building Division • INSPECTION REPORT Sanitary Permit No: 420769 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: Sanders, Jeff I Springfield Townshi 034 - 1007 -50 -050 CST BM Elev: Insp. BM E�ev: BM Description: Section/Town /Range /Map No: CST BM Elev: Insp. BM Elev: 7 04.29.15.53A20 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic An Benchmark O 0M I � Dosing � � Alt. BM Aeration Bldg. Sewer 18.91 • `f9 Holding St/Ht Inlet / St/Ht Outlet TANK BACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic / > / / i DtftRem-� •`D ?I S D Dosing a Header/ n. v S Aeration Dist. Pipe / Holding Bot. System Q Final Grade ,y � PUMP /SIPHON INFORMAT /(( Manufacturer Demand St over GPM Model Number 8w cam - TDH 1 1-iftq , Fricti ss Syst ea - TDH Ft Forcemain Length Dia. / ! Dist. to Well / SOIL ABSORPTION SYSTEM J► BED /TRENCH Width / Length No. Of Trenche PIT DIMENSIONS No. O Pits Inside Dia. th DIMENSIONS tLDG WELL SETBACK SYSTEM TO P/L LAKE /STREAM LEACHI Manufacturer: INFORMATION CHAMB InIA Type Of System: `� IT O t > ` ✓11 Model Number: DISTRIBUTION SYSTEM �(/ Header /Manifold Distribution r / x Hole Size x Hole Spacing Vent to Air Intake f II Pipe(s) I U l 0 Length Di Lengt Dia Spacin SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over t Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center I [ Bed/Trench Edges Topsoil - Yes No Yes No COMMENTS: (Include code discrepencies persons present, etc.) Inspectio #1: �� Inspection #2: / / Location: 2927 Cty Rd DD Glenwood City, WI 54013 (NE 1/4 NW 1!4 4 T29N R1 5W) , NA Lot ,2� ) Parcel No: 04.29.15.53A20 1.) Alt BM Description Awic 2.) Bldg sewer length - amount of cover =� Pu�-p Plan revision Required? Yes [.] No � ��� � �_ __� _L___ _ Use other side for additional rmation. S8D -6710 (R.3197) Date Insepctor's Signature Cert. No. MA, Safety and Buildin :, 1) vision County 201 W, Washington Ave i'.0. Box 7162 ,$cOnSin ) Madison, WI 53707 -- 7162 I Sanitary Permit Number (to be tilled in by Ca.) Department of Comme (608)266 - 3151 Zo ��C? Sanitary Permit Application State Plan I.D. Number _ In accord with Comm 83,21, Wis. Adm. Code, personal in: rmati rows. ID 3 maybe used for secondary purposes Privacy Law, 15.04E Project Address (if different than mailmg address) I. Application Information - Please Print All Information A p R 0 3 2003 a ¢071 Property Owner's Name Parcel # Lot # Block # � �� � ST. CRNG OFFICE CTY G, ZONING OFFICE -- Property Owner's Mailing Address Property Location l ' 8 ri � /V p L %., A&--'14, Section _ City, State Zip Code Phone NuMb - C i �Q _ 1 i 1 t� /3 --■ T C; / N; R ? E l r W \ 5 - 9- Z6 Ii. Type of Building (check al that apply) it] or 2 Family Dwelling - Number of Bedrooms SM Nutnbe O Public /Conunerciai - Describe U e 2 s (0!7 State Owned - Describe Use 1 K 90 u p of i1o.0 0 • (]City (]Village; ,[ownship r III. Type of Permit: (Check only one box on line A. Complete line B if appiicalele) O — /OO — O - d A. 5� New System W y Replacement System ❑ Treatment/Holding Tank replacement On Other Modification to Existing System ie• Permit Renewal ❑ Permit Revision ❑ Change of ❑ Pettoit Tmnsfer to New Last Previous Permit Number and Date Issued Before Expiration Plumber Owner l IV. 7ype of POWTS System: LCheck all that a 1 0 Non - Pressurized In- Ground K Nound > 24 in. of suitable soi 9 Moan itable soil ❑ At -Grade ❑Single Pass Sand Filter LJ f Constructed Wetland ❑ Pressurized In -Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter 0 Leaching Chamb ❑ Drip Line ❑ Grav -loss Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: Design Flaw (gpd) Design Soil Applicati Rate(gpdsf) Dispersal Area Required (si) Dispersal Area Proposed (sf) System Elevation IdeO g VI. Tank Info Capacity in Total Number Manuf ictun:r Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New I Existing l Tanks Tanks i Septic or Holding Tank �® Aerobic Troahuent Unit D Dosing Chamber ' S-Z W 4) VII. Responsibility Statement I, the undersigned, assume responsibility for tastaltatia of the POWTS shown on the attached plans. l PI u ber's Name (Print) f Plumber's Si .ature MPAI IIRS Number Business Phone Number .J 2s zz V�/ 7 5 3 ZS�o Plum er's Address (Street, ity, State, i VIII. Coun /De artment Use Only_ ,KApproved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued su' g Agent Signatu tNo Stamps] Surcharge Fee) Q Owner Given Reason fo Denial 325 0 X. Conditions of ApprovaURea for Disapproval (�(� A,( te+..cQs�it�w ST°'�_ oy�'" ywrlA - �'iSt U s��s s wu•.� �- �x hna:� P� l_ .�t { Attach to ans ou ty oaty) for the syetem o atHlr mantes, tban 8112 r It inches la size SBD -6398 (R. 01/03) ' ; � Q.• fir- � � ��.J 1 .� y 4 � w `�� W ( `� 1 q � ��� � w � � `,� t� • �i K �' p�,y M Z "g' 13 M1 . ws i t s i f � 06 3 r.7' ti's � � � av �•�. (. � ire. e) •1. i 3 C•�•44.0 � � ='ss�: V I `L Safety and Buildings 141 NW BARSTOW ST FL 4TH WAUKESHA WI 53188 -3789 Nvisconsin www. co TDO #: (608) 77 mmerce.statem.wi, usi.us /sb Department of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary March 26, 2003 CUST ID No.224617 ATTN: POWTS Inspector LYLE J MYERS ZONING OFFICE NORTHLAND PLUMBING INC ST CROIX COUNTY SPIA E1556 ST RD 64 1101 CARMICHAEL RD BOYCEVILLE WI 54725 HUDSON WI 54016 I CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/26/2005 Identification Numbers Transaction ID No. 851703 SITE: Site ID No. 656989 Jeff Sanders Please refer to both identification numbers, County Highway Dd above, in all correspondence with the agency. Town of Springfield, 54013 St Croix County NE1 /4, NW1 /4, S4, T29N, R15W FOR: Description: Mound, 3 Bedroom Object Type: POWT System Regulated Object ID No.: 896388 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. 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 Private Onsite Wastewater Treatment Systems" SBD- 10691 -P (N.01101) and the 'Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10706 -P (N.01/01). 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 comply with the operation, maintenance and monitoring duties as described in section VIII of the mound component manual. A copy of this information must be given to the owner upon completion of the project. 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 inspe th the designated county official in accordance with the provisions of Sec. 145.20(2)(d), WOaOsrR •� ill A copy of the approved plans, specifications and this letter shall be on -site during ction a n to inspection by authorized representatives of the Department, which may include loca t�?i rs. All permits required by the state or the local municipality shall be obtained prior to commencement oT construction /installation/operation. I LYLE J MYERS Page 2 3/26/03 i Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(l). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. zu Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Julia A Lewis- Osborne POWTS Reviewer 2 , Integrated Services WiSMART coder 7633 (262) 548 -8638, Fax: (262) 548 -8614 jlewis@commerce.state.wi.us cc: Leroy G Jansky , Wastewater Specialist, (715) 726 -2544 Mound System Cover Page Pg WHESER Project dame: Sanders Mound Owner's dame Jeff & Diana Sanders Owners Address 1583 Rutson Road Glenwood City, Wl 54013 Legal Description i , NW '14 Secr4 1 T -29 N. R -15 i'� Township Springfield r County j Saint Croix f J Subdivision NfA Lot# N/A Parcel 1D# RECEIVED Table of Contents MAR 2, 1 20® pg_ SAFETY & CLOGS. DIV. 1 Cover page 2 Mound Sizing Calculations 3 Pressure Distribution Layout and Dynamics 4 Dose Tank 5 Management and Contingency Plan 6 Mot Map total # of pages: 6 Designer Name: Lyle J. Myers MP1License #: l.D.# 224617 Date: 3/11 /03 Ph. #: 7156432520 Signature: A' Mound System Design Methods Usedg F . per "Mound Component Manual For Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD- 10691 -P (N.01l01) per" Pressure Distribution Component manual for P&,mte Onsite Wastewater Treatment Systems" (Vereron 20) SBD - 10706 -P (N (094030 t �C� Spreadsheet provided by. 3bAdvisement N12486 220th St, Boycevitte Wi 54725 Ph 715 -643 -6068 email: 3ba0 i Mound System P*p3of 6 Pressure Distribution Calculations Project Name: Sanders Mound Lateral Layout Lateral /Manifold Design Lateral elevation: 101.3 ft Lateral diameter. 1'h 'F In. Rows of Laterals: 2 Lateral spacing (S): ft Manifold type: Cerrter Lateral to cell edge: 1 ft Orifice diameter: o.i2s In. Lateral discharge rate: 7.83 gpm # of Laterals: 4 System discharge rate: 31.31 gpm Distal Pressure: 5 ft Manifold diameter. 2 In. Lateral Length: 44.5 ft Manifold length: 3 ft Orifice Spacing/Distribution Forcemain Friction Loss Orifice spacing (X): 28.86 Inches Forcemain length: Rin. ft Orifices per lateral: 1g Forcemain diameter: Avg. ft /Orifice: 5.92 ft Friction loss in forcemain: 1.259 ft I Lateral Side View Manifold Lateral Lateral II� x qr x t x x It x x x x 7 r x x x x 2 2 Lateral Length Lateral Length Lateral Plan View Lateral Length Turn -up w/ball valve or cleanout plug 0 0 f S 0 o L Orifices on bottom of lateral equally spaced PVC laterals and forcemain to comply with specifications per Comm 84.3%2 e) Forcemain connection via tee or cross to manifold at any point I � Clean Out Detail Observation Pipes Clean -out plug Final Grade or ball valve /7 Water tight cap or plug Lawn Sprinkler Box lot Mote: Closet Collar Lon Sweep 90 6" Minimum of 3/8 ba 9 P ortwo 45's 3M" Bar Lateral r- Mound System Page 4 of e Septic, Pump and Dose Tank Project: Sanders Mound Tank Information Dosage Volume Pump tank manufacturer: W ieser Concret Forcemain drains back to tank? OQ Yes O No Pump tank size /model: w1000/650-MR I :W1 Lateral void volume: 18.8 gal Pump tank gal /inch: 17 Dosage to absorbtion Cell: 90.0 gal Actual Pump Tank Volume: 646 gal Forcemain volume: 10.5 gal Tank bottom elevation (inside): 84,5 ft Total dosage: 100.5 gal Septic tank size /model: W1000 1650 -MR — W Pump and Filter Total Dynamic Head Pump Manufacturer: Little Giant Are laterals highest point? y Pump Model: 9EH if not, enter highest elevation: 0 ft Effluent Filter: Zabel A100 System head (distal x 1.3) 6.50 ft Vertical Lift ( "D" to lateral) 16.17 ft�� Note: Access opening of sufficient size to be provided to allow removal of filter. Opening to terminate at or above grade. Friction loss in forcemain: ( to D 1.26 ft-- Pressure loss from filter: �ft Total dynamic head (TDH): 23.93 ft Pump Tank Diagram Dose Tank Levels Watertight Locking Cover In. Gal 4 I With Warning Lebec inished A Reserve 22.1 375.5 �-- B Pump off to Alarm 2.0 34.0 Alternate C Total Dosage 5.9 100.5 Outlet Location Elea per Comm Minimum Grade D Effluent depth for pump 8.0 136.0 and r 16.28 Total Capacity: 38.0 646.0 e NEC soo Weep Hole A orAnti- Siphon B Device FLOV- LITERS /HOUR C K , 0 1000 2000 3000 %( 0/- _ � 30 10 5 � a a Pump must be capable of 31.3 GPM 10 2.s and head pressure of: 24.0 Feet 0 0 0 'o 40 60 80 Little Giant FLOW- GALLONSMINUTE 9EH PUMP PERFORMANCE CURVE 115V 60Hz Mound System Management Plan pursuant to cornm 83.54 w. A. C. page 5 of 6 Owner's Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make periodic inspections of the components, checking for surface discharge, treated effluent levels, etc. The owner or owner's agent is required to submit necessary maintenance reports to the appropriate jurisdiction and/or the department. Septic Tank: Septic tank(s) are to be inspected routinely and maintained by department approved individuals when necessary in accordance with their approvals. The use of chemical/biological "treatments" is not required or recommended. If such additives are used, make sure they are approved by Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & cleaned as necessary, with provisions to keep solids from passing the septic during removal. No more than 1/3 of the usable tank volume may be occupied by sludge /scum. 3 year inspection: If tank has greater than 1/3 volume sludge, tank contents must be emptied and disposed of in accordance with NR 113 Wisconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank, then the owner must be notified of when pumping should be done as to not exceed 1/3 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. Pump /Dose Tank If an effluent filter has been installed in the pump /dose tank, it must be removed & cleaned as necessary, with provisions to keep solids from passing to the mound component during removal. The pump, float switches and alarms must be inspected at least every three years for proper operation. Pump /dose tank should be routinely inspected to be watertight and of good repair. Mound and Lateral System The mound system component must remain free of ponded surface water prior to pump operation. If 4 inches or more water level is detected in the observation pipes, the owner must be notified of possible problems/failure. The designed daily flow capabilities of the component should never be exceeded. Trees and any other deep rooted vegetation should never be planted, or allowed to grow anywhere on the component. Activities OTHER than mowing /maintenance (i.e. excessive walking, pets, vehicles, etc...) could compress the component and reduce it's absorbtion capabilities and/or possibly cause it to freeze in winter conditions. Lateral distribution pipes should be flushed outitested every 18 months using the cleanout points at each end of the component to remove scum that may clog orifices. Performance Monitoring: Performance monitoring must be done at least once every three years following the installation or at the time of a problem, complaint, or failure. Contingency Plan: If the septic tank, pump tank or any of their components therein (including floats, alarms, pumps, etc) become defective, the defective tank or component must be replaced immediately to ensure that the system can operate as designed. If the mound component cannot accept wastewater or ponds wastewater to the surface, the component must be repaired or replaced in it's current location by either: extending basal toe to provide added absorbtion area; or by removing the clogged bacterial mat,aggregate cell, and distribution piping within the mound and replacing said components in order to return system to proper working order as required. t'•+S 4+v t i � � �v � t. i � ti u�� i t• S •�. q %� I ; I i I M } �t�, C ass5 � r f tSW� l �4•o�� -a .� , 4eFe..e "ORIGINAL ' 1566 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Certified Soil Testing Attach complete site plan on paper not less than 8%: x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimemsions, north arrow, and location and dis ce to nearest road. Parcel I.D. CSM Pending Please print all into ,oz- 6'316a d iewed By Date Personal information you provide ma es (Privacy It, s. 15.04 (1) (m)). 0 1 Property Owner 20 02 Property Location Sanders, Jeff & Diana 3 Govt. Lot NE 1/4 NW 1/4 S 4 T 29 N R 15 W Property Owner's Mailing Address ( Lot # Block # Subd. Name or CSM# 1593 Rutson Road �oL,G� City State ip C d�(Ik ber City Village 0 Town Nearest Road Glenwood City WI 715 - 265 -4486 Springfield CTHW DD ►J New Construction Use: 0 Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement J Public or commercial - Describe Parent material till Flood plain elevation, if applicable NA General comments and recommendations: install 4' x 112.5' rock bed mound on 100.0 contour as upslope edge of rock w/ 0.9' sand fill FT] Boring # .j Boring Pit Ground Surface elev. 99.0 ft. Depth to limiting factor 26., in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -5 10YR 3/2 - sl 2 f sbk mvfr cs 1f /m .5 .9 2 5 -9 10YR 3/2 - sl 2 m sbk mvfr cs 1 m .5 .9 3 9 -26 10YR 4/4 - sl 3 f sbk mvfr cs 1 m .5 .9 4 26 -35 10YR 4/4 f2d 7.5YR 4/6 sl 1 m -c sbk mvfr cs - .4 .6 5 35 -45 10YR 6/4 - s 0 sg ml cs - .7 1.2 6 45 -50 10YR 6/6 - scl 0 m dh cs - 0 0 7 50+ SSBR F2 ] Boring # _j Boring Pit Ground Surface elev. 100.0 ft. Depth to limiting factor 27 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -5 10YR 3/2 - sl 2 f sbk mvfr cs 1f /m .5 .9 2 5 -11 10YR 3/2 - sl 2 m sbk mvfr cs 1m .5 .9 3 11 -27 10YR 4/4 - $l 2 m sbk mvfr cs 1m .5 .9 4 27 -32 10YR 4/4 c3p 7.5YR 5/8,5/3 sl 2 m sbk mvfr cs - .5 .9 5 32 -50 10YR 6/4 - s 0 sg ml - - .7 1.2 side seep @ 43" " Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L " Effluent #2 = BOD L' S < 30 mg /L and TSS < 30 mg CST Name (Please Print) i ature: CST Number Henry F. Grote 222774 Address Certified Soil Testing Date Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 5475 6/11/2002 715- 233 -0398 Property Owner Sanders, Jeff & Diana Parcel ID # CSM Pending Page 2 of 3 3] Boring # j Boring feg Pit Ground Surface elev. 100.0 ft. Depth to limiting factor 26 _ in. Sod 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 -7 10YR 3/2 - sl 2 f sbk mvfr cs 1f /m .5 .9 2 7 -26 10YR 4/4 - sl 3 m sbk mvfr cs IM .5 .9 3 26 -37 10YR 4/4 f2f 7.5YR 4/6 sl 2 m sbk mvfr cs 1m .5 .9 4 37 -44 10YR 4/4 - s 0 sg ml - - .7 1.2 horizon 4 @ field capacity F-1 Boring # _j 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 GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 Boring # j 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 GPDM in. Munsell Qu. Sz. Cont. Color G►. Sz. Sh. 'Eff#1 'Eff#2 * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. S1313-8330 (R.07 /00) Certified Soil Testing I f - ' , V ( \ y — Q� i i �- ` � : a. N 0. J �L M� �Z � \� � O 4 � 1 R y 1 • �3 4 . � �'.'� ,�F� T� Sn• +.+. ti F• Nw . �j. - 2 A. -.A 1 tug h Zt S C- OA l" 130 %! 3 0 3 K .� Q lZ �ac K4�o� t' i 1radL /�a��• Al F� f ra �... t S.S %e I QE�� • (} ST CROIX COU:� •' ' SEPTIC TANK MAWrENAN(',.I :. ,1_GREF.Iv N'I' AND OWNBRSJUP CUTIFICATION FORM owner/Buyer �e �'�' g �e �►'n "... S�.n. cC �' ��., i Qa" ' Cty i'&M VYV • (V� n toqub*d ocnfr laP adug DOPsrtmeat for t& uv cafsatriuo#ott) City /State „� "Wes �..� l Pucel Identification ]+ t=bet i ter �><. DLrBt.�RPTI.QN a L At � Sec. T, ,N -I:. W, Town cf Lot # �..;�.,..... SubdivWon Cermed SUM MAP # t r �' . Volume WtI"uty Deed # - ,. --- --•- -! . Volume �? , _� .T page # � 7 Speo house 0 yes g-to Lot lines ideatiWlc aYes a no i zwmarj of your tic system caald t it it!; premun f sure to handle wastor. Proper =dutenaucc �m� tie tank awry three yaw or soon", if twiI&A by a Wowed pumper. Wbat Y OU put into the System condsts of p�PWs oat 00 sa a troatttuat sago is the waste digxmw system. out affect to ! of do :optic tank x mzAta a certification form, aim by the owner sud by a The try Dauer agrees to sitbruit to Et. +Croix ZauutiB Dep e1 flat Q1 the o wastenterdispoW system toseter�# a p er ' c�V1UMba oeurodpuaap v i/ 19xu of sludge. is in 1 � eonditioa andJor (2) after emotion � P+�p� (it tiea0ssary), the septic tsAlc � less lite o &Wul qMtM aids dw standards iuive red the above requkenmts and awes to trssia'n of Nadal Reno �rtifieatit n UaO, ti3e �� t of 4,WHM0e and the DOpartiiae utros� Stara o! W O within 30 set lath, berets, a: got by the h tr�ai�a►taiaed mat 100 oompiet0d and �' to the fit. Gcoax Ca MW ZoWgB stating abet rem ° m yi of the throe yeax ucpiratk a date. U 3 -- DATE SICINA'I' E OF AppLiCANT Q �� �•trxt ' A JL -- CATION that all statements an this farm era true to the best of my (our) � Offlce0• I (we am ( arc) tho awnar(s) at 1 (") ' recorded in l7,el sister of D00cis pm p�,y dea�lbed about, by Yiriue of a warranty deed 7n — DATE 8If3NA NRE OF APt't.rCANT ,wry b fonmWon that is aiis- represented may ICeSttit in the iil .IltA ry P atASit ��g revoked by rho ��& pep�icat. as Uietude With this appuCe a stamped warcatity deed tom *c Mgt of Deods oo[os deed a Dopy of flu mad =Vey t� if tnt a is made in flu waxra►nty J 2007P 371 STATE BAR OF WISCONSIN FORM 1 - 1999 KATHL H . >i�pLSH WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX Co., MI This Deed, made between Donald Praschak and Madonna RECEIVED FOR RECORD Praschak, husband and wife, 10 - 10 -2002 11:50 An - - ---- ---.__ -_ __- -- -. -- -- WARRANTY DIED Grantor, and Jeffery A. Sanders and Diana M. Sanders, husband and wife, EXEMPT # g as survivorship marital property,_ REC FEE: 11.00 TRANS FEE: - -- COPY FEE: CERT COPY FEE: Grantee. PAGES: 1 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix _ County, State of Wisconsin (The "Property"): Recording Area Name and Return Address Part of the Fractional Northeast Quarter (NE 1/4) of the Northwest Quarter (NW James H. Krave Attorney at Law 1/4) of Section 4, Township 29, Range 15, T wn of Springfield, St. Croix P.O. Box 304 County, Wisconsin, described as follow Lot fCertified Survey Maps, Glenwood City, WI 54013 -0304 recorded September 26, 2002, in Vow ^ 80, Doc. No 034 - 1007 -50 -000 Parcel Identification Number (PIN) This i s homestead property. (is) (is not) Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements and encumbrances of record. Dated this day of October -- 2002 D Praschak __._.. -.,... 0 _ ,. J* • + Madoo�a Praschak AUTHENTICATION %,rj•.A(/gti�G ? ACKNOWLEDGMENT �F WISCONSIN ) Signatures) p�rrfpQFt§ttt`vvv )Ss. � Croix County. ) y� Personally came before me this Q day of authenticated this day o f October, 2002 the above named Donald Praschak and Madonna Praschak s TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, - instrument and acknowledge the same. authorized by § 706.06, Wis. Slats.) THIS INSTRUMENT WAS DRAFTED BY J ames H. Krave, Attorney at Law Glenw City, Wisconsin 54013 -0304 Not t'ib , State o ikonsin (Signatures may be authenticated or acknowledged. Both are not My Comm1 ion is permanent. (If not state expiration date: necessary.) } r AfUCU� .._3_-._.. - - >•) *Names of persons signing in any capacity should be typed or printed below their signatures WARRANTY DEED STATE BAR OF WISCONSIN FORM N. I. 199E INFORMATION PROFESSIONALS COMPANY FONO M LAC. WI 800- 655 -2021 r.� " APPRO`rr. - ST. CROIX COLIN 6 9 1 9 9 9 Planning Zonir%n -4 o - VOL 16 PAGE 4380 _ SEP 2 6 2002 REGISTER OF DEEDS if not recordeo - ST. CROIX CO., vI approval date approe�,i RECEIVED FOR RECORD null 09 -26 -2002 1:30 PM CERTIFIED SURVEY M 1 . 53 MAP Located in part of the Fractional NE 1/4 of the NW 1/4 of Section E Township 29N, Range 15W, Town of Springfield, St. Croix County, Wisconsin. Prepared for: Owner: Drafted by: ; Jeffrey A. Sanders Donald Proschok Bradley J. Bohlen l o�� 1593 Rutson Road, 2943 CO.RD. "DD" Glenwood City, WI. 54013 Glenwood City, WI. 54013 U z �a,I �N ..— .— • -- -. -- L - A I F TE D LA NDS Zaj l =_N 89 °59' 33" E 2635.83 - - — V) 0 THE NORTH LINE OF THE(o w (�� -- �J�n IT 1 FRA TION N A� W 1/ Y J.CJ111 n THE NW OR.N 89 °59' 33" E 1317.92 - ' r b SEC. 4- 29N -15W N _ _ o RK;HT -OF -WAY_ _ ) ' olo (SURVEY NAIL — - ._._.. -- •- - -. —. � PARCEL D ESCBI9EQ8Y_ WARRANT bllEfHEB M N N 89 °59' 33" E 261.04 �t -� ut fi� — ..... I .................... ...... BRADLEY I . BUILDING,..SETBACK.NE_ 100' �ROIYI . ..... .-. B OHLEN 82375 NORTHFIELD, MINN, Q SURV� R +I $: � � I I W I LOT 1 I P TOTAL AREA = o ? 130521 SO.FT. (?i I (3.00 ACRES) H ion 7 I o' (� S 89 33" W 261.04' SCALE IN FEET LLI . T (1 = 100) . ,.1, V I ! . .... I _E � - - - -L. A N,.: ?_:r THE BEARINGS SHOWN HEREON ARE BASED ON THE ASSUMPTION THAT N THE NORTH LINE OF THE FRACTIONAL I' LEGEND: NW 1/4 OF SECTION 4- 29N -15W I O DENOTES A SET 1" BY 24" IRON PIPE WEIGHING HAS A BEARING OF N 89 °59' 33" E. I A MINIMUM OF 1.13 LBS PER LINEAL FOOT 1 1 • DENOTES A FOUND 1" IRON PIPE MONUMENT --- ' -- - - - - - (a DENOTES A FOUND ST. CROIX COUNTY MONUMENT s , (SURVEY NAIL) !' r l� t A NOTE: The parcel (s) shown on this map is (are subject to State, County, and Township laws, rules and regulations i.e. wetlands, minimum BOHLEN SURVEYING I lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office and the appropriate 1215 Henryy SL 31462 °e. Town Board for advice. Prescott. WL 54a�2 1 N-& F r,4 A6L 55067 Plwrro /For. Pn«m: (soy s4s -nse I Revised: 9/19/02 (715) 262 -3550 Fox (5d7) —7799 Date: 8/20/02 File number: S1 -1 -02 SHEET 1 OF 2 SHEETS Vol. 16 Page 4380