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034-1008-50-000
Fi L~~ oo-F) County Sanitary Permit Application ST. CROIX COUNTY WISCONSIN Gp in accord with Chapert 12 St. Croix County Sanitary Ordinance PLANNING & ZONING DEPARTMENT tPersonal information you provide may be used for s%ontr~oses ST. CROIX COUNTY GOVERNMENT CENTER [Privacy Law. S. 15. 4 1 1101 Carmichael Road Hudson, WI 54016-7710 Sr O s. _ (715)386-4680 Fax (715)386-4686 Attach com a plans a system on paper not less than 8-1/2 x 11 inches in size. County Sanitary P it # 119 Check if revision to previous application 1. Application Information - Please Print all on a Location: W! Ice Property Owner Name 1/4 5.r 1/4, Sec n--x ~~L~► cry rti. MAR x N, R E(or)® k2 2013 Prope Owner's ailingAAddd-re/ss Lot Number Block Number cof City, State Zip Code Phone Numer Subdivision Name or CSM Number II Type of Building: (check one) L, amity ❑ Village Town of i~r 2 Family Dwelling - No. of Bedrooms: IN ❑ Public/Commercial (describe use): ❑ State-owned Nearest Road IL Type of Permit: (Check only one box on line A. Check box on line B if applicable) /0 7-4 Parcel Tax Number(s) WJ IV 11.0 Repair 2. Reconnection 3.❑Non-plumbing 4. E] Rejuvenation v A) c)39--/D0~'5o -vo Sanitation ~ B) Permit Number Date Issued State Sanitary Permit was previously issued l 3 a IV. Type of POWT System: (Check all that apply) ❑ Non-pressurized In-ground ❑ Mound a 24 in. suitable soil Mound 24 in. suitable soil ❑ Mound A+0 ❑ Sand Filter ❑ Constructed Wetland ❑ Peat Filter ❑ Drip Line ❑ Pressurized In-ground ❑ Holding Tank ❑ Single Pass ❑ Other ❑ At-grade ❑ Aerobic Treatment Unit ❑ Recirculating V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application Rate 5. Percolation Rate 6. System Elevation 7. Final Grade b O Required Proposed (Gals./day/sq.ft.) (Min./inch)-T Elevation VI. Tank Information Capaicty in Gallons Total # of Manufacturer Prefab Site Con- Steel Fiber- Plastic New Existing Gallons Tanks Concrete structed glass Tanks Tanks /260 ~/C 5cfZ /moo tla- H /ZOU / ~ ( 4Se~ ✓ 2vL ❑ ❑ ❑ ❑ C'X vp X 00 C c:, W ~ ❑ ❑ ❑ ❑ VII. Responsibi ity Statement I, the undersigned, assume responsibility for repair/reconnenction/rejuvenation/installation of non-plumbing for the POWTS shown on the attached plans. A license is not required for terralift repair or the installation of non-plumbing sanitation system. Plumber's Name (print) PI 's n7a~ture c sta ps : I MhP/MPRS No. Business Phone Number J O cG~ ~ 7 vC 175' z S Cd Plumber's Address ($treet, City, tate, Zip V/1 6 ) v , Uow ADZ Z ~~Z- 3z$-3795 12 VIII. County Use Only 17 110, ieep ved Sanitary Permit Fee Date Issued Issui gent Si at o s ps) Approved Owner itial Adverse Z ~J rmmation #,?z IX. Conditions of Approval/Reasons for Disapproval: $y"EMOWNERi' . 3 /4 d S eA X 24 I qiC ole. *%e a„ 1: Septic tank, effluent filter and • 7/J~- 3~(e '~~o $O a t w 3 OJT. dispersal cet[ must all be services / maintained R r as per management plan provided by plumber: 1 i! 2, A salback regwerrfeftts must be maintained 11111111 P r code r aodinaa~i~e ; l1~. seti,,ems. M its o SITE PLAN S W, SE,4,29N/R,15 W Springfield township St. Croix county i LEGEND 1 BM: 100.0' base of 3/4" PVC pipe Ll k~v, ~ 2 BM: 100.7' base of 3/4" PVC pipe r e IN pits 9 grade y Z" W. c/o clean-out C-/a - contour / No Comm 83 problems Scale 1" - 40' except where indicated 8? O 119 40 nn t ..'k w( ` I+\\ L/L } Qo.U vi", ~zr_-- System Elev. 104.5' , on contour 103.0' ~o f' a ~-anu o~ part of 39.3AC ~ ro` Gfa'~ i ~3r3 at" sc9~3o3 ?VZ`~ C ij C/o -10 0 60.1~nn„`~ rf~~ / l i x i DOO T]COPY X000 project: DERINGER page 6 of 8 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 515107 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you ptovide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Derin er, Jerald A. Springfield, Town of 034-1008-50-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: f g , CS 04.29.15.63A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark zoo Z DU Dosing / Alt. BM` Goy ho If . ktu- . TV AQr~iie r Bldg. Se a ~a s (x.r 3,x•7 daT Holding SUHt Inlet /~O•o S3 • Z dk TANK SETBACK INFORMATION SUHt Outlet \ TANK TO P/L WELL LBLDG. Vent to Air Intake ROAD Dt Inlet 0 Septic Dt Bottom / Header/Man. 5• u I ✓ Dosing 7 /OQ / /L9 /S. / /s, Aeration Dist. Pipe / /6q Holding Bot. System S -_7 1-63.5 i PUMP/SIPHON INFORMATION Final Grade 1.b ZS Manufacturer I Demand St Cove~ / . / 9~. GPM C'~ 1 Model Number ~~•t `6Z f5 Lk~ TDH Litt g Friction Los System ac TD H Ft i- l , J Z Z, 21 Forcemain Length _ Dia. 11 Dist. to Well SOIL ABSORPTION SYSTEM 01 Length No. Of Tren s PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth BED/TRENCH Width DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: CHAMBER OR INFORMATION Type Of System: `jot / UNIT Model Number: U DISTRIBUTION SYSTEM Header/Manifold 'I JIDistribution / rle Size j/ JxHoleSpacing Ve t Air ke Pipe(s) L s 3z y~ LDia 11:5 Length /61.6 Dia /t 5 Spacing 3 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/So del ed r Mulched Bed/Trench Center / Bed/Trench Edges Topsoil /A ~O es E] No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: g / 0 Inspection #2: Location: 2966 110th Avenue Glenwoo City, WI X54013 (SW 1/4 SE 114 4 T29N R1 5W) >35 acres Lot 1;1 '44. arcel No: 04.29.15.63A 1.) Alt BM Description = F•4a~ CoJ~~ /M' b~ 2.) Bldg sewer length = "aC A - amount of cover 1-11511 11 F/p ~..J C] Jr,- yZ Plan revision Required? ❑ Yes No Use other side for additional informati n. SBD Date Insepctor's ignature Cert. No. l -6710 (R.3/97) J 14 ~ee County 1*is11consin Safety and Buildings Diisi$t. CroiX 201 W. Washington Ave., . VAIK itary Permit Number (to be filled in by Co.) WI 6~~ Department of Commerce 608Madison,)2 66-3537015171 5-15 /6 7 State Plan I.D. Number State Sanitary Permit Application Trans 1D /6 M In accord with Comm 83.2 1, Wis. Adm. Code, personal information )DECEIVED may be used for secondary purposes Privacy Law, s15.04(1) Project Address (if different than mailing address) 1. Application Information - Piea nt All Information J u 2966 110th Ave. Property Owner's Name Parcel # Lot # Block # CROIX COUNTY Mr. Jerry Derin er S tNG & ZON NG OFFICE 0 04- 14049 - Sd - ODC~ Property Owner's Mailing Address Property Location 770 Franklin Street < X03 A-City, State Zip Code Phone Number SW ''/4, NSF. _'/4, Section 4 Baldwin, WI 54002 715/ T 29 N; R 15 W II. Type of Building (check all that apply) r Subdivision Name CSM Number X 1 or 2 Family Dwelling -Number of Bedrooms our ❑ Public/Commercial - Describe Use ❑ State Owned - Describe Use City_ Village XTownship of Springfield III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. X New System Replacement System Treatment/Holding Tank Replacement Only Other Modification to Existing SysUm B Permit Renewal Permit Revision Change of Plumber Permit Transfer to New List Previous Ppi 1jt~I~uglb~ an~ate Issued Before Expiration Owner '].fo Ito le IV. Type of POWTS System: Check all that apply) Non -Pressurized In-Ground Mound > 24 in. of suitable soil X Mound < 24 in. of suitable soil At-Grade Single Pass Sand Filter _ Constructed Wetland Pressurized In-Ground Holding Tank Peat Filter _ Aerobic Treatment Unit -Recirculating Sand Filter Recirculating Synthetic Media Filter Leaching Chamber Drip Line _ Gravel-less Pipe ❑ Other C.Qin V. Dispersal/Treatment Area Information: w Design Flow (grdy Design Soil Application Rate(gpdst) Dispersal Area Required (sf) Dispersal Area Proposed (st) System Elevation 600 0.4 J 600bed, 1500basel 624bed, 2288basel 104.5' VI. Tank Info Capacity in Total Numbe Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Concrete Constructed Glass New Existing Units L G Tanks Tanks Sep* or Holding Tank 1200 1200 1 Wieser Concrete X Aerobic Treatment Unit Dwiogchamber 800 800 combo X VII. Responsibility Statement- I, the undersigned assume respo ib' ' for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum is gnature MP/MPRS Number Business Phone Number Kent Hoke r MP224199 715/962-4155 Plumber's Address (Street, City, State, Zip C e) 200 Bremer Ave., Suite D , Colfax, W1 54730 VIII. County/ftartment Use Only pproved ❑ Sanitary Permit Fee (includes Groundwater Dateissuel Issu' gent S' ) ❑ Disap"Wied I/ Surcharge Fee) / 26 Od '~13 f 6 ~j er Reason for Derua I IX. Conditions of App~ppr.oval/Reasons for Disapproval A SYSTEM OWNER: 3) Lb•^~~~~ar~S J~¢a.i~l. /~ppCo 01 1, Septic tank; effluent filter and r 4 rr II dispersal cell must all be servtees / maintainer! L~'~-n, ! as per management plan provided by plumber. 2. All setback requirements must be maintained as per apply" code / ordinances. Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size 1 , • SITE PLAN SW,SE,4,29N/R,15 W Springfield township St. Croix county t LEGEND SAS! i BM: 100.0' base of 3/4" PVC pipe LA , vv 0 2 BM: 100.7' base of 3/4" PVC pipe a pits • grade 4 7- c/o clean-out -10 ~ contour ! 4 No Comm 83 problems Scale I" - 40' except where indicated Roir l v p 40 1 L/L ? op.a' W System Elev. 104.5' y ~o,, Ln ~tya on contour 103.0 part of 39.3AC 4v ~a w r~, .3_~.. ~ Sao anrer..y '10 ~ a ~ ( ~ D l~1 ~ %o ~ rj -ilk veh:cl<S l / C~ 1l o I f j~ 010 00 x RCOPY project: DERINGER p 9e page 6 of 8 ~4 wve" ~:v I J ~l G~ SVKVt ` ZG ~ •O I i SITE PLAN SW,SE,4,29N/R,15 W Springfield township St. Croix county LEGEND '(ZO 1 WA: 100.0' base of 3/4" PVC pipe LA ~ ~►rr K0 2 BM: 100.7" base of 3/4" PVC pipe 10 pits gip,,, 9 grade c/o clean-out \ c/o o' contour I No Comm 83 problems I Scale 1" - 40' except where indicated / L/L } I oo.o- ~lL System Elev. 104.5' on contour 103.0' ! f: part of 39.3AC i r / etiSke_'V1 M:01 S r \ o~, °oo project: DERINGER page 6 of 8 5d STt~,~m Z-9 l _ Safety and Buildings 141 NW BARSTOW ST FL 4TH • , commercemi.gov WAUKESHA WI 53188-3789 Contact Through Relay i sco n s i n www.commerce.wi.gov/sb/ Department of Commerce www.wisconsin.gov Jim Doyle, Governor Richard J. Leinenkugel, Secretary May 11, 2009 CUST ID No. 224580 ATTN: POWTS Inspector LORETTA LARRABEE ZONING OFFICE L & L PERC TESTING ST CROIX COUNTY SPIA N2089 CTY RD Y 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/11/2011 Identification Numbers Transaction ID No. 1663851 SITE: Site ID No. 667148 Jerry Deringer Please refer to both identification numbers, 2966 110TH Ave above, in all correspondence with the agency. Town of Springfield St Croix County SWIA, SETA, S4, T29N, R15W FOR: Description: Mound, 4 bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 1224975 Maintenance required; 600 GPD Flow rate; 19 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD-10691-P (N.01/O1), Pressure Distribution Component Manual - Version 2.0, SBD-10706-P (N.01/01); Commercial System The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in 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 Department per s.145.06, stats. 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 Systems VERSION 2.0" SBD-10691-P (N.01/O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" 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. p Cond'W. TS All holding/treatment tanks are to comply with Comm. 84.25(7)(a). diW;;OF Maintenance information must be given to the owner of the tank explaining that period RP is required. Access to the filter for cleaning must be provided per Comm 84 product apps dt6p11V CAF/' A Sanitary Permit must be obtained from the county where this project is locate rdance-Aith the requirements of Sec. 145.135 and 145.19, Wis. Stats. SEE Cr l LORETTA LARRABEE Page 2 5/11/2009 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. 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. 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(1). • 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. Beginning October 1", 2008, small wastewater holding tanks with estimated flows less than 3,000 gpd that are based completely on approved POWTS component manuals must be submitted to the appropriate governmental unit and will no longer be accepted by the Safety and Buildings Division for review. Please refer to s. Comm 83.22, Wis. Adm. Code for further information. 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. S' rely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Julia Lewis-Osborne + POWTS Reviewer 2, Integrated Services WiSMART code: 7633 (262) 397-6005, Fax: (608) 283-7481 julia.lewis@wisconsin.gov Private On-Site Wastewater Treatment System (POWYS) Mound and Pressure Distribution Component Design New Residential application L Cl~- Index and Title Sheet Project Name: DERINGER Owner: Jerry Deringer 770 Franklin Street Baldwin, WI 54002 Location: 2966 110th Ave. Legal Description: SW,SE,4,29,N/R15W Township/County: Springfield township, St. Croix county Previous Trans. Id. 9318580 Contents: Page 1: index and title Page 2: general information & lateral diagram Page 3: mound drawings Page 4: dose tank Page 5: pump information Page 6: site plan Page 7: management plan Page 8: contingency plan Attachment: soil test to state plan Designer's name and license no.: Loretta Larrabee license# 187., fill It, Address: N2089 Cty Rd. Y•••' a.'•.• . Menomonie, WI 54751 LopErra . * : • LaARASEE Phone: 715/664-8184 IV2 MENOMONIE Cell: 715/505-1628 vv~s:• E-mail: 1an1perctestingna-,wwt.net AI.O % '~11 mO Designer's Si ature: ikE'r ' ` Date: Aril 24 2009 I the undersigned submitted these plans under my authority -ly Mound component manual for POWTS Version 2.0 SBD-10691-P (N.01/01), and Pressure DistributionEo~ pD manual - Version 2.0 SBD-10706-P .01/01 MEICE Y AND SUILDINGS page, IRE~NDENCE GENERAL INFORMATION New Site Four bedroom home, 600ga1 DWF end fed system w/2 laterals 9% slope system area dispersal cell design loading rate 1.0 0.4 soil application rate linear rate 5.76 18" limiting soil factor orifice sq/ft. 10.50 1200/800 Wieser tank with Polylok 525 septic filter effluent quality #I LATERAL LAYOUT DIAGRAM (not to scale) End Fed System Number of laterals 2 orifice dia. 5/32in. (0.156) Lateral dia. 1 '/2" orifice spacing (X) 42in. (3.5') Lateral length (P) 101.5 ft. orifice per lateral 30 Lateral spacing (S) 3.9-ft. lateral discharge rate 16.20gpm Manifold dia. 1 1/i in total system rate 32.40gpm Forcemain dia. 2.0.in **see page 7 of 8 Mis. Construction for turn-up detail turn-up end on laterals at manifold for access of lateral at both ends for servicing ,,-_Valve box Pressure lug finish grad. P first orifice next to fitting X manif 1 1/ " S 3.0' (36") Orifices located on bottom of lateral I Last orifice next to fitting 1.5' (18") Force main 2" dia. project: DERINGER page 2 of 8 PLAN VIEW OF MOUND (not to scale) 3= 8.0' D= 1.50' (18") K= 12.5' required bed 600sq.ft A= 6.0' E= 2.04' (24'/2") B= 104.0' proposed bed 624sq.ft. I = 16.0' F= 0.83' (10") L= 129.0' required basel area 1500sq.ft. W= 30.0' G= 0.50' ( 6") proposed Basel area 2288sq.ft. H= 1.00' (12") observation pipe @ 21 ft. Observation pipe 8.0' W o 5 O A 30.0 6.0' K ( ~ _ 12.5' 104.0' I 16.0' L 129.0' I Mound Cross Section View (not to scale) Finished grade elev. 106.3' 1 Lateral invert elev. 105.0' H 2 Dispersal cell elev. 104.5' / 11/11111111 4 dispersal cell + 2" 44aterals a ggr - - A e ate bed 6" - - - - - - 3 - E D - tilled layer tilled layer contour 9% site slope elev. 103.0' Numeral Key 1 topsoil cap 2 subsoil cap 1.5ft. min. 3 ASTM C33 sand 4" min.dia. observation pipe 4 synthetic cover over cell with 1/4" slots, 6" min. height 5 aggregate closet flange --po. O.Sft. min. infiltrative surface I project: DERINGER page 3 of 8 COMBINATION SEPTIC TANK / PUMP CHAMBER (No Scale)' Approved Locking Manhole Cover Approved Gap, With Warning Label Attached Warning Label Weatherproof Approved _ Junction Box Vent cap lba d"~n 12" Minimum Final Grade - 4" Minimum 18" Minimum Quick Disconnect 1/4's Weep Baffle- , Hol e Approved Joint w/4=S1146 %Pt t A Extending 3' Onto Solid Soil Alarm ~ B 111 On Approved Joint w/.14-4 ScWPIPe- q7. Eu. C Extending 3' Onto Solid Soi Off -1-i Conc. Block 3" of Bedding Under tank-/ Note: _ RuMp, and, _Alarm Are On. Separate . Ci rc 2,o tea. Qw F = 120• C? ga S~I~+er~.ls - Q3~3 as M . vo; g - R 15 a Tank Manufacturer: e, o n Cr h ~f e l o l. 45 t 2g, S ~n n Tank Size-Septic/Pump: 200 ?C0 UP Gal i ons Alarm Manufacturer: S, r, C- ecVro Model Number: S --:r 1 Capacities: A 19 inches or 41.7-51. Gal Ions Switch Type: Me-6NCn~ca\ + B 2 inches or 4g Gallons ' Pump Manufacturer: R0.hkkAb + C -5i nches or Modei Number: 1 • ~,a Gal Ions S - tv + D 00 i nchegA or 222.4o Gal 1 ons _ Minimum Discharge Rate: 33 Total.....= inches or gao,~ Gallons Vertical Difference Between Pump Off and Distribution Pipe : 7,3 o Feet nol -1 kt Minimum Required Supply Pressure:. .6$0 : .1. , 55 Feet eet of Force Main x z,8 5 Friction Factor/100 Feet: + -/2 eet Winch Diameter Force Main Total Dynamic Head /,'Z y17Feet project: DERINGER page. 4 of 8 I F: Effluent: SE-40H Series 4/10 HP Submersible Effluent Pump - High Head, 3/4" Solids FLOW - LITERS/MINUTE 0 s0 100 150 200 250 35 10.0 30 Construction $ Motor Housing Epoxy Coated Cast Iron 25 Impeller Material Polycarbonate --ice 6.0 W Impeller Type Closed Vane W 15 °a Volute ABS _ 4.0 = Power Cord SJTW-A 10 Nitrile with Carbon Mechanical Shaft Seal and Ceramic Faces 2.0 5 Fasteners Stainless Steel 0 0.0 Shaft Stainless Steel Bearings Upper - Sleeve 0 10 20 30 40 50 60 70 Lower - Ball Bearing FLOW - GALLONS/MINUTE S7llrl~ s,,....r `1►Jti 11.65 ~ 5.65 V s 1.5" DISCHARGE 9.30 0 9.00 3.91 SCREEN TO PASS 3/4" SOLIDS Specifications SE-40H 509332 4/10 115 1.5" FNPT 13.0/1000 70.0 64.0 55.0 41.0 32.0 13.8 20' 24.0 509341 4/10 230 1.5" FNPT 6:5/1000 70.0 64.0 55.0 41.0 32.0 13.8 20' 24.0 SE-40H-AF 509351 4/10 115 1.5" FNPT 13.0/1000 70.0 64.0 55.0 41.0 32.0 13.8 20' 24.0 509361 4/10 230 1.5" FNPT 6.511000 70.0 64.0 55.0 41.0 32.0 13.8 20' 24.0 it SE-40H Series 4110 HP Submersible Effluent Pump - High Head, 3/4" Solids FLOW - LITERS/MINUTE 0 50 100 150 200 250 35 10.0 30 Construction 25 $ Motor Housing Epoxy Coated Cast Iron LA Impeller Material Polycarbonate 20 6.0 W Impeller Type Closed Vane 0 W 15 c Volute ABS a = 4.0 z Power Cord SJTW-A 1o Mechanical Shaft Seal Nitrile with Carbon 2 0 and Ceramic Faces 5 Fasteners Stainless Steel Shaft Stainless Steel 0 0.0 Upper - Sleeve 0 10 20 30 40 50 60 70 Bearings Lower - Ball Bearing FLOW - GALLONS/MINUTE Lam' 11.65 a57ClYlli ~+~.~,~q 3 5.65 i 1.5" DISCHARGE 9 30 o O 9.00 3.91 SCREEN TO PASS 3/a" SOLIDS Specifications SE-40H 509332 4/10 115 1.5" FNPT 13.011000 70.0 64.0 55.0 41.0 32.0 133 20' 24.0 509341 4/10 230 1.5" FNPT 6.5/1000 70.0` 64.0 55.0 41.0 32.0 13.8 20' 24.0 SE-40H-AF 509351 4110 115 1.5" FNPT 13.0/1000 70.0 64.0 55.0 41.0 32.0 13.8 20' 24.0 509361 4/10 230 1.5" FNPT 6.5/1000 70.0 64.0 55.0 41.0 32.0 13.8 20' 24.0 i r 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 component manuals 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 manholes risers, access risers and covers should be inspected for waxer 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" 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 slip off the filer when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. 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 personal shall advise the owner of when the next service needs to be done to maintain less than maximum scum and sludge accumulation in the tank. 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. Pump Tank Servicing East of system area, is side yard, enabling drive ability to pump tank for servicing. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings maybe 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 surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations dictate that the mound be heavily mulched as protection from freezing. 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 at least once every 18months. When a pressure test is performed is should be compared to the initial test when the system was installed to determine if orifice clogging has occurred, if clogging has occurred orifice cleaning is required to maintain equal distribution within the 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" considered impending failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or components shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank or its components become defective the defective components(s) shall be immediately repaired or replaced with a component of same or equal performance. If the mound fails to accept wastewater or discharges wastewater to the ground surface, it will be repaired or replaced. Increasing basal area if toe leakage or by removing biologically clogged absorption and dispersal media and related piping and replacing components as deemed necessary to bring the system into proper operating condition. See page 7 of this plan for the name and telephone number of your local POWTS regulator and service provider. project: DERINGER page 8 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name: H & H Plumbing LLC Phone: 715/962-4155 POWTS Regulator's Name: St. Croix County Zoning Phone: 715/386-4680 System Flow and Load Parameters Design Flow - Peak 600gpd Maximum Influent Particles Size 1/8in Estimated Flow - Average 400gpd Maximum BODS 220mg/L Septic tank Capacity 1200gals Maximum TSS 150mg1L Soil absorption component Size 600bed Maximum FOG 30mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/IOOmL Service Frequency 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 monthly Pressure System ---------------Laterals should be flushed and pressure tested every 1.5years Mound --------------------------Inspect for ponding and seepage once every 3 years Other----------------------------Initially filter should be checked yearly to determine service schedule Miscellaneous Construction and Materials Standards 1. Observation pipes, 4"min. dia. are slotted and materials conform to Table Comm 84.30-1, have a watertight cap and secured with water closet or 3/8" dia. bar as shown in 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 6. Lateral Turn-up to finish at grade or above, enclosed in a 6-8" diameter lawn sprinkler valve box or similar product. (lateral turn-up consists of a long sweep 90 or two 45degree bends same diameter as lateral) 7. Lateral Turn-up on end of distribution laterals after the last orifice. project: DERINGER page 7 of 8 I~ 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 component manuals 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 manholes 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" 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 slip off the filer when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 113 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personal shall advise the owner of when the next service needs to be done to maintain less than maximum scum and sludge accumulation in the tank. 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. Pump Tank Servicing East of system area, is side yard, enabling drive ability to pump tank for servicing. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings maybe 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 surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations dictate that the mound be heavily mulched as protection from freezing. 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 at least once every 18months. When a pressure test is performed is should be compared to the initial test when the system was installed to determine if orifice clogging has occurred, if clogging has occurred orifice cleaning is required to maintain equal distribution within the 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" considered impending failure requiring additional, more frequent monitoring. Condngencv Plan If the septic tank or any of its components become defective the tank or components shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank or its components become defective the defective components(s) shall be immediately repaired or replaced with a component of same or equal performance. If the mound fails to accept wastewater or discharges wastewater to the ground surface, it will be repaired or replaced. Increasing basal area if toe leakage or by removing biologically clogged absorption and dispersal media and related piping and replacing components as deemed necessary to bring the system into proper operating condition. See page 7 of this plan for the name and telephone number of your local POWTS regulator and service provider. i project: DERINGER page 8 of 8 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/ZyW A *n q e Mailing Address 7 7Q ,Q an K /,i, A 78 JA w; fi kz j T 002 Property Address 29 6 to 1/0"' Ave., (Verification required from Planning & Zoning Department for new construction.) City/State ~~~nr~~oc~ Parcel Identification Number 0a - l00$-So-000 LEGAL DESCRIPTION Property Location 1/4 , _SE_'/4 , Sec. T _Ay N R /5 W, Town of ApR 1 n o iG /J_ Subdivision Lot # . Certified Survey Map # -7y' Volume , Page # Warranty Deed # ~z ' , Volume , Page # 'i Spec house Q Lot lines identifiable ye ~ 393 ~4.~ . SYSTEM MAINTENANCE AND OWNER CERTIFICATION ~*Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system Owner maintenance responsibilities are specified in §Comin. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Numb f bedrooms ~1'/ IGNAT AP LICANT( DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) Wisconsin,~,ldpartment of Comie6eme ' PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No. 430569 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: Z(otj _ JC~~ City Village X Township Parcel Tax No: Derin er, Jerry Springfield Township 034-1008-50-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No. 4.29.15.63A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet SVHt Outlet TANK SETBACK INFOR ION TANK TO P/L WELL 'illiiiiiiiiBLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Botto Dosing He rlMan. Aeration Ist. Pipe Holding Bot. System Final Grad PUMP/SIPHON INFORMATION 10 Manufacturer D nd Co G Model Number TDH Lift Friction LE5 m Head DH Ft Forcemain Length ist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length Of Trenches PIT DIMEN NS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P BLDG WELL LAKE/STREAM \MBEIR NG Manufacturer: INFORMATION OR Type Of System: Model Number: DISTRIBUTION SYSTEM Header/Manifold NngtgE stributi x Hole Size x Hole cing Vent to Air Intake pe(s) Length Dia 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 Bedlrrench Center Bed/Trench Edges Topsoil L7] Yes F] N Yes 7N. COMMENTS: (I ude code discrepancies, persons present, etc.) Inspection #1: Inspectio\:/ Location : 2966 0th Avenue Glenwood City, WI 54013 (SW 1/4 SE 1/4 4 T29N R15W) NA Lot Parce15.63A 1.) Alt BM De ription = 2.) Bldg sewer length = - amount of cover = Plan revision Required? Yes (M] No Use other side for additional information. SBD-6710 (R.3/97) Date Insepctor's Signature Cert Nc r Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7082 ST, C41 G lvisconsin Madison, WI 53707 - 7082 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 261-6546 1, 3 d S(O N;7;~umber Sanitary Permit Application y 3l 0 S In accord with Comm 83.21, Wis. Adm. Code, perso may be used for secondary purposes Privacy w, s 1 I V E D Project Address (if diff t than mailing address) REOE 1. Application Information - Please Print All Informatio NOV 4-Q- 2001 , o w c"C J f I: Property Owner's Name 3 P eel # 1 ~p Block # tl if' ST. CROIX COUNT /01 A 3•! • ( Property Owner ailing Address P Locat' &3A I Y (l l y' Section 11 City, State Zip Code Phone Wmb t 5((circle one GZ\ W r \ S 4 Trt N; R EorW ) II.f Type of Building (check all that apply) L r Subdivision Name CSM Number 61 or 2 Family Dwelling - Number of Bedrooms ) ❑ c/Commercial - Describe Use !v A ❑ State ed -Describe Use 1sT `LC. v ❑City ❑Villa a Township of Sof s )c~ i, III. Type of mit: (Ch k only one box on lyre A. Complete ne if appy le ' A. 49,New Syst ❑ Replacement Syst ❑ Treatm t/H ing Tan ep ` ment Only ❑ Other Modification to Existing System List Previous Permit Number and Date Issued B. ❑ Permit Renewal Permit Revision ge of P it Transfer to New Before Expiration umber er IV. Type of POWTS S stem: %Lk all that I ❑ Non -Pressurized in-Ground IRMoun 24 in. of su d < 24 in. of suitable soil El At-Grade 11 Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In Gtoun Holding Tank rine Filter' ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Ch er ❑ D ' ❑ Gravel-less Pipe ❑ Other (explain) V. Dispersal/Treat ent Area Information: Design Flow (gpd) Design Soil Applicatl n Rate( dsf) 'JWpersal Area Re ired (sf) Dispersal Area Pro sed (sf). System Elevation OCR i'.o ;ZF D~ 1,i 1, ber Manufactur / efab Site Steel Fiber Plastic VI. Tank Info Capaci n Total Gallons Gallons Units ~ Concrete Constructed Glass New Existing jj~ d Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit Dosing Chamber R fsc) VII. Responsibility Sta`t'ement- I, the dersig d, assume responsibility for installation of the TS shown on the attached plans. Plumber's Name (Print) lu i re MP/MPRS Number Business Phone Number Plumber's Address (Street, City, S Zip C !fl C_ ~Ii -752 VIII. oun epartmen se Only pproved ❑ D/er ved Sanitary Permit Fee (includes Groundwater Date sued ssu Agen Sign re amps) Surcharge Fee) a- ❑ O0' ivenReason for Denial Iq 36 , IX. Conditions of pproval/Reasons for Disapproval 3 rrr~ e OilZ910 3) d S TEM OW S° ~~y~,~, S Ct c%~ L4 eptic t effluent filter and C)q - / of Va4.1 ?9-f/K f Ispers cell must all be serviced/ maintained- 4 s per management plan provided by plumber. J f 2. II setback requirements must be maintained pr 1,~/ ~ fl ° v t'1 g" as per applica le code/ordina"0611momplete plans (to the County only) for the system on paper not less than 81/2: I hes In - ,.cQ~ ►ir~s SBD-6398 (R. 08/02) i ~.Q.•. Pale of PLO, PLAN y0' Scale V x xl J41 r oc~- c4~ wi M ~1 /{r\1\ ~ QJV V:CQ 7~ ~Z.\ ya4 IUD $►~1b) rr --aD _M a•1 oy -Lk sJ~ 'o Go~Youv. cam. to3•p c~ J-0 fit' w. a : _ St o iQ dw br~,aw, ~O 9 - F-LANm,.CN.q"-r~K~4,_'~~"esq. at. LOD. _ CL 10 `EA- P~vE . ~ p~ 3~0' uVeS 4- rnQ wnd v I q 314 ATM STt { I Z ~ 1 0.3 °F aPPRoYa~ ~~'~EQ J STM l~gSEE CORRESPONDENCE PA(OE 2 Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD (608) 264-8777 vlhsco'nsin www.commerc .*wis state.wi.us/sb .gov Department of Commerce Jim Doyle, Gov r ory L. Nettles, Se tary 00 October 28, 2003 5410 ATTN.' POWTS Inspector PAUL R KOEHLER ZO OFFICE KOEHLER SEPTIC & PLUMBING OI UNTY SPI E5678 704TH AVE 101 CHAEL MENOMONIE WI 54751 U I 54016, CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES' 0/28/2005 Identificatio umbers Tran tion ID No. 9 805 S Sit No. 667148 Deringer Bffase refer to bo dentification numbers, 11 Avenue 06ove, in all cone ndence with the agency. Town Springfield St Croix unty SW1/4, SE S4, T2 , R15 FOR: Description: Pro ed our Bedr o Object Type: POW stem Regu ect ID N 27039 The submittal described ab e s been reviewed for c formance with a icable Wisconsin Administrative Codes and Wisconsin Statutes. Th ub ' al has been CO ITIONALLY ROVED. The owner, as defined in chapter 101.01(10), Wiscons Statu is respons ' e for complia with all code requirements. The following conditions shal a met . g nstructio installation and prior to occupancy or use: • This system is to be constructe oc rdance with the enclosed approved plans and with the "Mound Component Manual for Priv nsi astewater Systems VERSION 2.0" SBD-10691-P (N.01101) and the "Pressure Distribution Com nent Manu r Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10706-P (N /01). • Limited activities are allowe the area 15 feet down slop the component area. Soil compaction, excavation, vehicular traffi nd other similar activities that im t the treatment and dispersal are prohibited. • A state approved efflue filter is required. Maintenance information st be given to the owner of the tank explaining that peri lc cleaning of the filter is required. Access to th ter for cleaning must be provided per Comm 84 prod approval conditions. • A Sanitary Pe must be obtained from the county where this project is located in ordance with the requirements See. 145.135 and 145.19, Wis. Stats. • Inspectio f the private sewage system installation is required. Arrangements for inspection s be made with the desi ated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • Co 83.22(7) - A co of the approved plans, specifications and this letter shall be on-site durin gliffs-truction and open to inspection b authorized representatives of the Department, which may include loc inspectors. .i`a 1.. Cc:t261`6-oIt al, ; PAUL R KOEHLER Page 2 10/28/03 ,A Owner Responsibilities: • Comm 83.52(1)(a) - 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(1). • 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. 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. • The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. /Note: Due to the fact that two buildings are sharing the same POWTS, the owner(s) must identify all the persons responsible for the operation and maintenance of the POWTS. Per Comm 83.22(2)(b)5, Wis. Adm. Code, this documentation must be recorded with the deed for the property and be present to the county when applying for a sanitary permit. If this information has not been recorded with the deed for the property, a sanitary permit can not be issued. 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. Sincerely, 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. 7:30 am to 4:15 pm jswim@commerce.state.wi.us WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 Henry F Grote , Certified Soil Testing sAF Jerry Deringer -Mound Crl ° 2003 pp nn Transaction # D~©yS D Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Mound, SBD-10691-P (01 /01) Pressure Distribution, SBD-10706-P (01/01) Location: SW 1/4, SE 1/4, Sec. 4, T 29 N, R 15 W Town: Springfield County: St. Croix Date: October 22, 2003 Owner: Jerry Deringer Address: 770 Franklin St. Baldwin, WI 54002 Plumber: Paul Koe ler Signature: - 77- License # MP 225410 Attachments: 6748-Plan Approval Application SBD-8330 Affidavit for two structures (pending) page 1: cover 2: design criteria & calculations 3: plot plan 4: system cross section 5: plan view, lateral detail 6: pump tank exit detail 7: pump curve m 8: system management CFp ARTMEHT of CO,JIPa",FfiCE lvis4jN ' FETY ANC 161 UiLV1?CGS Ski C;GRRES Of IPE G'-- page 1 of 8 Design Criteria Residential Wastewater Contaminant Load: 30 mg/L < BODS < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L Bedrooms x 100 gal/bedroom/day x 1.5 gallons/day hydraulic load Desi n alculations In situ designed loading rate Zb gallons/sq. ft. per day Depth to estimated high ground water in. Depth to bedrock s-n in. Cross slope at system `t % Force main length ft. of Z in. Manifold/header length 3 ft. of Z in. Drain-back gallons Lateral length 6r @ ft. of t~ Z in. Lateral elevation 05• o ft. @ bottom of lateral /Ils in. @ 4'8 ° in. ( 4`•O ft.) Spacing Lateral hole size 3 holes/lateral 5 Z holes total •S Lateral volume gallons Total lateral discharge rate 3 4'3 z gallons/minute @ ft. head Network pressure compensation losses ft. Elevation difference ft. f Friction loss ft. @ gallons/minute Total dynamic head t~•31. ft. Pump/siphon 573 gpm @ t ft. of head Manufacturer Model # t 2 Dose volume 1 ° 4• • g gallons Lift/siptton tank z» m gallons Septic tank gallons Effluent filter Measurement pump on and off to • in. Height alarm from tank bottom I in. Reserve capacity gallons specs.calcs.res :y Page of e` i 9 R.VY ~PJM'.h ~~~0~ 1'\qq Page 3 of PLOT PLAIT y0' Scale 1' too t"Ist U" 10~ ~-z M a-z loci goy w.t I~ nS_~-oo~ PP' "x 35b' uVP-54- a-~ rno u-ylj v 113q S-r-i-l 12- CORRESPONDENCE - fOA(OE Z °F APPRoVAU ~~Tr"EQ SEE 4L 0%0% 06 IL Z„ (t9 ~tiZ a o.a , 11-looo, s m O 1 l•s' R.o4' x'13 ` w y w..Sl, ~ b S..bco:1 s46`.S1 ' r Ci • 6 -1' K. Cl ' ti 2 •1~ 104.0 ~1Z.3' IZB.b' y1 ` tDQo .2`to 12 `3v 844 . O b 1 Q.v~ v •.'4~ a e, l l 1 ~ O o~ o o+ e. k. eA 1aF4.r46`S ~•QVCS~4,o•.~~ 4 0' l 14.0' l2.01 sb• o V V ~w 4~t~ (\~J~I 'YKr4.1~r j~ Y: K~•+~r( I[~y~y, 6S5. 4 'J Y O a•, `Y aA w/ V Mk V L ~00 6 ♦ wiV \ f.~+'~7 • S~IV / ~ 0 1 e.g o 1 Qr w.~ tsi•.•.'S °,'.r b 0~ o.+. \ : ~ ~ ~-gi.0~~ ~w y..'Y m . J { y.................m•...::i .r.Na.v~.r1+••~_._i•/I..~'~ _ 11 F ct ' ~ Mnlra TVA IL_ WEATI;IERPROOF , J'1NCTIQN t LDCKIWG COVER 8aa i; lvAi1'Nnu~ AABEC . r< QUICK 014C,044ACT-1 PIVLr 3' qT0 kNOISTUReED 411 c~-o \ SDI 24" Z.D. I YEtdT MMtUG1E I3 1 /AiLi T ' ~T ~ ~wctc = _ _ Za~•~ N~ 4.. PvL ppPQOVtD A s~1, qn SKET 30a,rt'J WFLE OWTO .L PIPS % Z' 1 ~ tyc~sZLalb. 16~ GROUKo F l.ev , g8•o ow PUMP v co~E->i-F . 6t.0C"C SEPTIC t SPEGIFI'CATIOKI5 DOSE TAWAS MAMUFACTURCR: ~ 1 ~lih IJLJMSER OF DOSES: PER DA.1 TAWK SIZE: GALLOWS DOSE VOLUME ALAR►1 MJWUFACTUR,LR' S~ F\"'~~O INCLUOIWG SACK/LOW. CA~-LOWS MODEL WUMb'EK: 10\ CAPACITIES: A= Zq•-~ WCHES OR C%ALLOU5 SWITCH TtJPLS "~6 B= Z IWCHE5OR ~Z 2 "LLOUS PUMP P1AQUFACTURER: C IULHE5 OR CALLOU5 MODEL AJUMDER: \52' Dow INCHES OR 14~'° g GALL0IJS SWITCH TYPE: MOTE: PUMP AMD ALARM ARE TO CE MIIJIMUM DISCHAR" RATE GPM INSTALLED OW 5EPARATE CIRCUITS VERTICAL DIFFEREItICE DETWEEIJ PUMP OFF AWD 013TRIbUTIOW PIPE.. FEET 1 + MIuIMUM AIETWORK SUPPLY PKEZSURTTE✓,. . . . . F L C T + FEET OF FORCE MAIN Z• X S$ F loort<FKICTIOW FACTOR.FEET TOTAL OtiW04IC HEAD %V16 FEET Q IIJTERMAL, DIMEW510►Jt OF TAIJK: LE►J6TH `Z i 1• , 'WIDTH LIQUID DEPTH g ~F TOTAL DYNAMIC HEAd/CAPACITY HEAD CAPACITY CURVE PER MINUTE EFFLUENT AND DEWATERING V) N MODEL 152/153 W w MODEL 152 153 50 Feet Meters Gol. Liters Col. Liters 153 5 1.5 69 261 77 291 12 40 152 10 3.1 61 231 70 265 0 15 4.6 53 201 61 231 a _ 20 6.1 44 167 52 197 L) 30 25 7.6 34 129 42 159 0 8 30 9.1 23 87 33 125 20 35 10.7- - - - 22 85 a ° 40 12.2 11 42 4 Lock Vcive: ,38.0 Ft. (11.6,,)144.O Ft. 3.4m)! 10 - 0145M 0 20 40 60 80 100 GALLONS LITERS 0 s 1/4 80 160 240 320 3 27132 4 5/8 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS 3 27/32 e • Timed dosing panels available. 3 27/32 • Electrical alternators, for duplex systems, are available and supplied with an alarm. T • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Owik-Box available for'outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. 1521153 Series 'z 1521153 MODELS Control Selection T _ V Model. Volts-Ph Mode Amps Simplex Duplex 52 115 1 Non 8.5 1 2 or 3 _BN 152__ 115 1 Auto 8.5 Included 2 or 3 ; _ I s,2064 J1 52 230 1 Non 4.3 1 2 or 3 ~BE152 230 1 Auto 4.3 Included 2 or 3 N153 ! 115 1 Non 10.5 1 2 or 3 BNts3' its 1 Auto 10.5 Included 2or3 SELECTION GUIDE E153 230 1 Non 5.3 1 2 a 3 1. Single variable level float switch or doublet back variable level float BEi531 230 1 Auto 5.3 Included 2 or 3 piggyback p 99Y switch. Refer to FM0477. CAUTION 2. See FM0712 for correct model of Electrical Alternator E-Pak. All installation of controls, protection devices and wiring should be done by a qualified 3. Variable level control switch 10.0225 used as a control activator, specify duplex (3) licensed electrician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA), or (4) float system. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16347 Louisville, KY 40256-0347 Manufacturers of . . Z Y-A SHI P TO: 3649 Cane Run Road Louisville, KY 40211-1961 QUaur.' PUMPS SA'CF lff& 03628-PUMP http://Www.zoeller.com YIP TO (502) 77FAX'502) 78074-4 © Copyright 2000 Zoeller Co. All rights reserved. I< System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, Koehler Plumbing, 715-235-5790, or the St. Croix County Zoning Office, 715-386-4680, should be contacted for assistance. General Proper functioning of an on-site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or compartment to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. I . If the septic tank is installed prior to sheet-rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2 Install water-saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly. 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. 9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. If septic or pump tanks are no longer used, they must be properly abandoned. 1 I . If construction timing and weather could create a frozen infiltration system, weather-proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. Maintenance 1. The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back-washed into the septic tank to remove accumulated material. 4. Periodic observation pipe inspections should be made by the homeowner to examine the state of the in-situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down-slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run-off into the system area. 11, Warning: Do not enter septic, pump or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and/or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 D+vision of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must ST • CM ~ X include, but not limited to: vertical and horizontal reference point (BM ' Parcel I.D. percent slope, scale or dimensions, north arrow, a ry~ds r ,r lea re road. 10 08 - So _ 04 0 Please print all info atlOn. t+G iewed b Date Personal information you provide may be used for second pure ri a j,00Q.04 (1) m)). l I I It q#3 Property Owner C Property L cation S~R'~~ ~~Rl~C~~1Z ST.CROD, 'C - TY W 1/4 1/4 S T Z9 N R 1S E(o W Property Owner's Mailing Address o Block # ruNa-me or CSM# F[LPNYZ-LL&) S71. - I - State Zip Code Phone Number ❑ City ❑ Village K Town Nearest Road ,-j I Sg1At ~S) 6aq-ZZSB s 2-- w E L-1) I Ll Z Th 6Q Z, IL New Construction Use: ® Residential / Number of bedrooms. Code derived design flow rate Od GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material L,Ot-r-,3 O V z T1l L Flood Plain elevation if applicable Q A . ft, General comments t 0 UAJ11-) k1 G X LU D LS and recommendations: 0 T1Zl}3vT) Ohl 0 ~L( . k4 F- F 1-1 Boring # 0 Boring pit Ground surfaceelev. ft. Depth to limiting facto l~ 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 o -1 ~ 1 D`~1 IL 31 z YY1 \j CS 1 ~ • S . $ Z lo_tiq ~o~tZ3lb - St 1 Z`~ Sbk tin~>^ c~ lv-£ •S 3 tiq-36 7sL-tR-4~~6 Pt~z•SLt S~8 51~1 ~CSV~" mt% J F Boring # ❑ Boring ® pit Ground surface elev. `t ^ Z ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 I ) o1-1 cZ 313 - St 1 Z-PS bk rn v~l- C S ) . 8 Z )t -!Y-az va- Y)- Ids asbiz ynvf~ Cw 1~~ .6 3 z~ So ~.SYtz ~I b FL~F-SK2 sie l~Si d~ Ykv`PI- - • o , Z Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 150 mg/L ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Sig ture CST Number Arthur L. Wegerer 044L OZ-92) 220254 Address W e g e r e r S o i l Testing & Design S e r vi c e Date Evaluation Conducted Telephone Number 421 N. 1-lain St. River Falls, HI 54022 '715-425-0165 Property Owner Y 1G Parcel ID # 3 - o U g - Q Page Z of 3 a Boring # ❑ Boring ® Pit Ground surface elev. - S ft. Depth to limiting factor 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 O -9 l p-1 RL 31 Z S 11 Z'~' 6 iz V4 v FL- CS l~ S - 8 Z a -1 to,c2 316 - st Z shk vh P►- lv -s - g L/ Z4 3S -7 .SLYQ-V16 ~•SKR- Spa _3j L1 lcsbk mA, - . Z -3 ❑ 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 GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#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 GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 < 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. SBD-8330 (R.6/00) Property Owner x.16 Parcel ID # d - ! 0 U ~1 - u Z 3 Page of Boring # ❑ Boring ® pit Ground surface elev. 1 Q S ft. Depth to limiting factor -~:2- in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 In. fvtunseli Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 o q ~b~t 2.31 z - Sit Z-O--~b k h~i U`~t. cS 1~ S . 8 Z a- t t per{ 2 316 - SO 1 Z 6vt vn Ctti► 1 v'F -5 - 8 3 15:-Z IZ? e-%3 bk m Uf 14 .6 lcsb k vn~- . Z • 3 ❑ 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 GPD/ft2 In. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'Eff#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 GPD/ft2 in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Effluent #1 = BOD5 > 30f 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. SBD-8330 (R.6/00) • PLOT PLAN Page 3 of Scale 1' _ LA0' 016 % 100 $~41 ~o DoT t)LS`Y~ OR l~ Sri p~ 2 iZ2 5, loa 7~/ 0 A goy B o'rM P1 C )F- e-eLL ~T't,. ,10 ~1 • S ' _9 ST IR ` ~ z S-l3-DZ 715-425-0165 220254 DZ_q 3 i CST Signature Date Telephone Ito. CST Alo. Job rro. 5 P 7 9 4 6 5 1 5 Document Number DocumentTitle KATHLEEN H. WAL.SH REGISTER OF DEEDS ST. CROIX CO., MI i RECEIVED FOR RECORD 11/13/2003 08:45AN AFFIDAVIT EXEMPT # REC FEE: 13.00 TRANS FEE: S e C p 2q COPY FEE: 1 f CC FEE: PAGES; 2 w S Recording Area Name and Retum Addnu S,e c w PT n~ w S~ az 089- 100$-- o-Oooo I An ~ un, o0 Ot) Pared IdenhBcadon Number MM /.100~ T hi. information mug b. °°o,pt«ed by wbmimr. t aUl lire A at &va drontina clauuur, lariat duedpdm. sir. may .Ut Wb Use oluh4 aovrr placed on d~ir- If &"Mand ~ (Y ^a4~d1. Ocher, nwaWow such Pals add. am page to your dorwnent b. P ad on addlda.ral Ma ~d+s and ,#2.tX! ro rhs neondtnt "Monsi, Sb.araea, 59.S17. 1gRDA 2ffl6 . . .1 2 4 5 5 P 4 8 0 AFFIDAVIT Per Comm 82.22 (2)(b)2.b RE: Transaction # Return to: I, Jerry Deringer, hereby certify that I am the owner of two structures on property owned by me and I am responsible for mai ptenance to the ge is s stem serving o structures. r Description of Property: 7-0 -m L 39.3,4. &CE~, 4 09- Z9./S. & 3A C.s-rv UY -At"O3y-1001 ,0 _00o County: St. Croix Township: Springfield Property Address: 110`h Ave.. Property Description: pv&m(rS W '/4 of SE '/4 of Section 4, T 29 N, R 15 W ~}CCEPT" Pb 3 $ The proposed POWTS system opera 'o d maintenance will be my responsibility. Signature: _ Jerry Bringer 770 Franklin S. l 2 Baldwin, WI 54002 Date:. 1 ro D0 Subscribed and sworn to before me this / U --day of 66a&)o `I Notary Public County, WiscoWin flotary Public-State of 1Isconsin My conL•nission expires ray Conunission Expires June 20.2W4 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner uyer 1~> C- I /J CZF, Mailing Address -7-70 FAIMI- Bbd S7! Property Address Q 6 0 4-1t4 Aye • l S1 o I VJt S+ o~ 2 q7(, 110* kA., . (Verification required from Planning Department for new construction) City/State Parcel Identification Number 03(4 ' 100f ' 5-0-C50v LEGAL DESCRIPT/I,O/N ` ! o ~3A Property Location W '/4, -5 E Sec. T11 N-R 1$ W, Town of St ZIA -F(ELb Subdivision , Lot # 3~j•3 Certified Survey Map # . Volume..Page # Warranty Deed # ~ -7 ~s . Volume 1 gq (0 , Page # 3 3 G1 Spec house ❑ yes 0 no Lot lines identifiable l~( yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeymanplumber, restricted plumber or a licensed pumper verifying that (1) the on site wastewaterdisposal 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 sot 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. 3 days of year expiration date. SI F LICANT DATE OWNER CERTIFICATION (we) 'fy that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of q9ti the pro rly 'bed above, by virtue of a warranty deed recorded in Register of Deeds Office. Y SIGNATURE OF APP CANT 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 Oct 28 03 09:42a. priscilla koehler 715-233-3542 p.3 AFFIDAVIT Per Comm 82.22 (2)(b)2.b RE: Transaction # Return to: I, Jerry Deringer, hereby certify that I am the owner of two structures on property owned by me and I am responsible for maintenance to the septic system serving both structures. Description of Property: County: St. Croix Township: Springfield Property Address: 110"' Ave.. Property Description: part of SW '/4 of SE S/4 of Section 4, T 29 N, R 15 W The proposed POWTS system opera o a d maintenance will be my responsibility. Signature: Jerry eringer 770 Franklin S. Baldwin, WI 54002 Date: Subscribed and sworn to before me this day of LU~V Notary Public 1 County, Wiscongin C,.u rotary Fu.:,.6 St_ iG, Zc 4 My commission expires J 1 9 6 $ P 3 3 9 6. 7975a srnre BAR OF WAR RRANTY DEED 2.2000 REGISTER OF DE DNS Document Number ST. CROIX Co., YI This Deed, made between Allan D. Krafve and Cynthia G. Krafve, RECEIVED FOR RECORD husband and wife as joint tenants 05_22-2002 1:30 PM Grantor, and Jerald A. Deringer and Elizaeth A. Deringer EXOPPT ► REC FEE: 11.00 TRANS FEE: 474.00 COPY FEE: CERT COPY FEE: Grantee. PAGES: 1 Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum: The W 1/2 of SE 1/4 of Section 4-29-15 EXCEPT commencing 1320 feet Recording Area East of Southwest corner of said SE 1/4; thence North 254 feet; thence Name and Return Address 53 feet; thence 200 feet; thence East 186 feet; thence South Thomas A. McCormack 454 feet; thence West 33 feet to Point of Beginning. 102010th Ave. C eAc` i S yip PO Box 2120 Baldwin, WI 54002 7T1.~-~ 034.1008-40 03~- (t)vg- &0-COO 034.1008-50 Parcel Identification Number (PIN) This is not homestead property. OW (is not) Exceptions to warranties: all easements and restrictions of record Dated this Q:Z its l day of f t w 2002 U * • Ilan . Kra -NI ri 3e r A s is G. Krafve AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ) ss. St. Croix County ) authenticated this day of PerssonAlly before me this cZ44 day of _ 2002 the above named Allan D. a and Cynthia G. Krafve, husband and wife as * joint tenants TITLE: MEMBER STATE BAR OF WISCONSIN to me town to be th on s) wh etc #;-t~W*2. ' om (If not, fA9 9 g authorized by § 706.06, Wis. Stars.) ins m nt e e Ms" % . •t THIS INSTRUMENT WAS DRAFTED BY * 7~ t d • ► Thomas A. McCormack Notary Public, State of W:scon 1 1 Baldwin, WI 54002 My Commission is permanent. ( jCpiratioddate: (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. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2 - 2000 INFO-PRO (800)055 2o2t www. Moprotorms.com LEGAL ST. CROIX COUNTY WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF SPRINGFIELD COMPUTER NUMBER 034-1008-50-000 Parcel Number 04.29.15.63A OWNER NAME: First JERALD A & ELIZABETH A Last DERINGER PROPERTY ADDRESS: Hse # 1/2 PD --Street Name-- Type SD Apartment SECTION 4 TOWN 29N NGE '1.160 '/.40 Line Description Line Description TOTAL ACREAGE 39.300 PLAT LOT BLK 01 SEC 4 T29N R15W SW SE EXC 15 02 P63B 39.3A 16 03 17 04 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1-General, F4-Prev. Parcel, F5-Next Parcel, F7-Valuations, F8-History, F10-Exit i i I LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF SPRINGFIELD COMPUTER NUMBER 034-1008-60-000 Parcel Number 04.29.15.63B OWNER NAME: First CRAIG M Last LINDSTROM PROPERTY ADDRESS: Hse # 1/2 PD --Street Name-- Type SD Apartment 'Zq - I (o I i o SECTION 4 TOWN 29N RANGE 15W 1/4160 '/.40 Line Description Line Description TOTAL ACREAGE 0.700 PLAT LOT BLK 01 SEC 4 T29N R15W .703A IN SW 15 02 SE COM 1320 FT E OF SW COR 16 03 SE 1/4, TH N 254 FT TO POB: 17 04 W 153 FT, TH N 200 FT, E 153 18 05 FT, TH S 200 FT TO POB 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1-General, F4-Prev. Parcel, F5-Next Parcel, F7-Valuations, F8-History, F10-Exit li (ELD PLAT T-29-N • R-15-W ilk 46 M See Page 112 For Additional Names. GLENWOOD PAGE 56 ID 2900 3000 3100 J_ 3200 3300 Iri BBrlan & J 20 i g 4g a vV v p Oar Mona j l F Nowhry 156 James ay 7 Inc 20 4!1 - : z ~I g « n u 40 Teigen 3 29 102 a g Ia..se Dow leew Doak q r~ oo xaoa- G aO r` > b- 40 oho I 16 0 9 Iy dK~ -4 60 r- 40-N ° Eric & Julie it 60 v ff- 2 '>u x Leroy ~a Knuth Waldo i; I a MC-.--.- & Seim 80 Donna °v o T-I Gloria Gar I ~ a. 92 w, Thomas Allan Rott 3 v, m U F Gardner I& Ma ayne Marian I & Ka 128 159 N 202 iFinde Wakh IN 40 9 V _Ij y a ¢ 24 40 Otto o 120 • r c a ShaNe Robert - - - U v & Sonie nWIA. 30 Za Ryan R , Crockett t - ro ~ 80 7` 9'= 6,} 140 20 I 1;' (n < 20 20 I ~ Richard ¢ Troy & 90 0) A 4V ~ o Bruce & Donald L e Johnson Mcconn $e ~ M ret I & Do r rrL4 I F_ rrest Hall,- N 40.4 IN 80 37 69 120 Illu 0 o c&P I Wayne De-k 3 oo Robot P 10 Mccar- Foscrry m 4! & Pamela thy 40 III ~ I 0 V L la GLE 118 C~° ~ ~a I 7 & 1 He lid ~ ' Ith eaendaBR lar a-ela d Brandt GP ro R ovlch 3 w CA Hoff. rn Cj 48 40 40 U V 40 IF 0 Gina Yang ul & t Herr & Fae Herr & long Yang anke Wayne ua Tour Yang Farms as~u- i cCu- Lewis 401 aog 40 ang 40 40 Inc 67 s- 39 u a N is M 3 37 140 a cnu& R S~,- 8 2 s o Joseph & w q Der Lo Wayne a Susan 7• reras Strehlo Yr 60 I w o z go ^ I , -1 V .4 Yang a, -`6 James & I 8 1 3 Carol o 16 ims Carlos & Ruth Steven M ~~~yyy o BeaHr Chong Farms vasqu r 60 cCarthy & Nyhus Rebecca 00 . 1 Brandt OB He Inc T S&K a Sarah 120 etal 1 ~79 60 Boyd 120 , Lyons 37 N Ferns 318 S en g 120 on a cw p °"a"` & Ma Thmp- a 0 F Clo d o f~ 40ke M~ 40n AVE Mahoney I 128 • 73 m . E r>br James Thomas Bruce isuefu n* g mono JeSusan Debra x & Shelia Mahoney a4ltl Peterson Yang Eli K'a n / >a+ g Made Nelson Ln Maho- I A 120 Scott 140 79 39 174 40 "tal1O G&G Cl) 19 NU)i 39 ney 40 O &C , nd Cieh~Bc J> ri 0 ha Lockerby semey Thmn-oft Smith Lo arm / I9on 21 NA. W- L LP P B~e "I'm so 85th colburn ab 39 Msnaeti 3 Qua- Adam & 40 ner 120 eal 40 I m AVE 160 100 4 Smith 35 Z L : _1 0 d 119 & Mary 5 Hardwood d~4- 40 s7 a ohnson K;il~dwar f ado ro ap .0 00 c F E 2e Ronald 12` O ~n Lesl X60 Mahoney 0~ 14u S 0 a 140 _0 1hl g ,n nnmia 40 o to Hu & Dian, gh Debbyan Leona JMY & c`~ `n Bob ; A24 75 - ^ S p°q 3 159 K d McGee C 0033i- Heath 3 y ai I Locker- i r 40 Hq by 4o Y 1-80- ~i 80 80th WE AVE N i rtm&e Charles Plx Bowie - _ - yy_ OMean o 2Mya°aehr Z at ,man 40 60 ahers i1 it ^ 40 80 40 40 x u 60 40 I °y ulianne & I Smith o Donald ag o°o 1 Is: Lavern Donald Z;1 "7 M nick ~ sp c IImplement G oo ` W JohnsNola on on Finde I r w 127 V N 109 26 12 t b 4o Lois Q Gerald v E erhes siy p 3 Johnson I N Socha. 40 40 78 F21 I r Robert 72nd 4 Dale W1 ~T ~ Y Snyder AVE & Kim W1 ON ~u11 0 r 1h. e31 36 Helinke 40 o44ZJ T. 50111 40 3~ Yw Mabel Larry & Richard Gerald & .40 Thompson Eleanor 20 35ag`" a ,o Jill I - 40 Trust 207 Mousel T 61 v 00 etal gy oIl ~ 120 A 0I I44 156 c~~I Sten`e 1 oo ~NI a & 3 Keith & &M h ha 5.16. 42 M 35 13 hll - y _ Kromrey 105 u n HFFk 8 2 so I I; p 39 Iaroia Ann t ~y g 168 0 ° awes & 5 G wam~r 1 Mark Alice t Cheryl N x a `B Debora s O a VOIZ I Grady .D Trust Ci doom 4o Pbilupi e f H .aad 45 '39 y w 40 m a 39 - Z, amnions 4 60th AVE rAnV PAr_IP 2e Safety and Buildings Division County ` 201 W. Washington Ave., P.O. Box 7162 i Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) aOnS,n Department of Commerce (608)266-3151 L+3as6Cr Sanitary Permit Application State Plan I.D. Number In accord with Comm 53.21, Wis. Adm. Code, personal information y `rovide t S V 0 S may be used for secondary purposes Privacy law, sl 5.04(1)(m) Project Address (if different than mailing address) 1. Application Information - Please Print All Information I ' ~76b Property Owner's Name Parcel # ~ Lot # Block # 6~1- )Da too ? ~ 1 ~'t R Property tO~wne 's Mailing Address 1 c 1 Property Location/ jVW/) ` ~N t 7/b / 0 t' r t4~i T~11 J <Z0 y., J~ j/., Section ( City, State Zip Code Phone Number 2 37 3 \ WSJ W~ tlL~C7Z TT~N; R I IorWe) IL T e of Building (check all that apply) or2 Family Dwelling-Number of Bedrooms Subdivision Name CSMmber ❑ Public/Commercial - Describe Use ❑ State Owned - Describe Use ❑City_❑Village4*ownship of d f^'~~'!t Id ti.. . III. Type of P rmit: (Check only one box on line A. Complete line B if applicable) A. [Dew System ❑ Replacement System Only El TreatmenUHoldin Tank Replacement ❑ Other Modification to Existing S stem I'll B. ermit Renewal ❑ Permit Revision Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued ? ? Before Expiration ' Plumber Owner J U~ 7 q> IV. Type of POWTS System: Check all that apply) ❑ Non -Pressurized In-Ground ❑ Mound > 24 in. of suitable soil mound <24 in. of suitable soil ❑ At-Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In-Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel-less Pipe ❑ Other (explain) V. Dis ersaVrreatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation 6,o-o , a b Z~8 a3o~ s VI. Tank Info Lew city in Total Number Manufacturer Prefab Site Steel Fiber Plastic llons Gallons of Units Concrete Constructed Glass Existing Tanks Septic or Holding Tank t Aerobic Treatment Unit Dosing Chamber 25-0 t x VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumb is Name (Pri t) Plumber's ig re MP/MPRS Number B smess Phone umber Plumber's Address (Street, City, State, Zip Code) VIII. County/Department Use Only ❑ Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) ❑ Owner Given Reason for Denial IX. Conditions of Approval/Reasons for Disapproval Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD-6398 (R. 01/03) G O N O d F 3 d 0 d ~ ~ fJ C 7 C 7 O Z (D (D 0 V *k m z- Z O A p (n z 2 n O A (n fn OA A t • O 01 O OW N ~ CS O M C O ~ CJ a) -0 n CD p C3a rn cp d CaD O. tt'z w cn cQ p r~+, CD - O (D CO > = N C, ° O ^ N c 3 -7 CD y ` N Q 6 y 10 3 a w R °o _ 0 CD CD E O N v C N CD --A D 1 O ° ° O N N D 3 a O co z (p N N j O p D) L 3 O N N p _ O co W N o I CO _ 2 (O ` Mr, c i' C O O O 1~11v Ln (T O) O D ` cy, z .0 CD o o o coo v> n 0 fp co °w O ° CL < 3 Q CD CL _ l►1 c V V cD V V cOD !~4 • cD O O O Z O O O !Nd p `Z `L o m v N C f~R cad y a n O U~1 N ai = w f U) V C O n a) c V O O p a) m m m vi UJ N a m n y C 3 7 3 - N A z co 00 w A O 33m?=m a o• 3 CD CDmTd ? .1 cn 0 ;u (D CD 0) 3cCDos 3 3 3 m a C a o p~ (D O W <p = 3 m n 3 3 :1 co c= cD CD = CD CD C6 -i cn c z O A Z n O 0 C) CL CD o~ m o a o ° 0 (A A 7 C CL O W CCD W (DD Z 'o m 3 ° 3 1 3 a;o q y a) O O O co V7 Q m 3 3 m O S U! Z CD fN CD 4~, y O A W p) N N~ Q •o m o a C 3 CD ID * X T O CL G y y A p F a) m C 'O X= O C CD n (D = - 3 O n o 0" N 3 = y O CL O j 0 O' O d yo m aco0 CD y O CL =r 7~ Q y CL CD 0. C' EP - C - O O (CD cD 3 n 6 N - p p j C N~ CD CL = CP y t0 0 CD O. y Z O S N N s N 2 = N O r w pa. b =r (D :E 0 d O (D cO N CD x O i O (D O ~ EA 0 ffl 0 oQ 3 I~ ~Plb. X67 10/69 Wisconsin Department of Health and Social Services Division of Health PEFSffT APPLICATION for PRIVATE D(k4ESTIC SEWAGE SYSTEMS 0?9 ~ /lo'w` A. OWNER OF PROPERTY l TYPE OR 1~ BLACK INK Name A~dress (Street, City, Zip Code) County B. LOCATION OF' PROPERTY WK RE SYSTEM WILL BE CONSTRUCTED ALTERED R EXTENDED Check One: v!,C i _ LJ v CITY VILLAGE TION : TOWNSHIP ;241 IC16 -j C. IS LOCAL PERMIT REQUIRED FOR THIS FORK?~ YES NO ~7, PERMIT NUMBER D. SEPTIC TANK ~CJAPACITf.!3 Gallons NEW INSTALLATION REPLACEMENT ADDITION d J 4 / 7~1ele 611 MATERIALS: Prefab Concrete Pou4d in Place Steel Other NUME3ER OF TANKS TO BE INSTALLED: E. TYPE OF OCCUPANCY _ Check One: One or Two Family Residence Commercial Industrial Other Specify ' Number of Persons to be Accommodated LO Number of Bedrooms F. A?PLIANCES, ETCt Food Waste Grinder YES _ NO Automatic Clothes Washer YES NO Dishwasher YES _y NO Automatic Potato Peeler YES/ NO Other (Specify) _ G. EFFLUENT DISPOSAL SYSTEM NEW EXTENSION /r_ ADDITION REPLACEMENT Tile Size No.Lin.Feet Trench Wi p Depth Numb of Lines `30 7 Seepage Beds ngth~O ' Wfdt Depth Tile Size No. Lines Seepage Pitt Inside diameter Liquid Depth P E R C O L A T I O N T E S T Test Depth Character of Soil Hours Water Test Time Drop in Water Level Inches Ii nutes Number Inches Thickness in Inches Since Hole in Hole Interial Second to Next to Last To Fall 1st Wetted Overni ht in Minutes [1+gt ?eriad Last Period Period One Inch Example _ P- 0 36" To Soil 10" C1a 2611 25 es or no 30 1/2 1/2 1/2 60 RECORD DATA FROM MINIMUM OF 3 TEST HOLES i Compute eize of absorption are, in accord with H 62.20 Wis. Adninistra ive Code. S O I L B 0 R I N G S- Minimum 3611 Botlow Pro osod Absorption System _ oring Total Dept}: Depth to Ground Water Depth to Bedrock umber InobAs Observed Estimated Observed Estimated Character of Soil with Thickness in Inches xample 1 0 72" 72" Black To Soil 1211• Cla 18"• Sand 18"• Gravel 2411 RECORD DATA FROM MINIMUM OF 3 BORE HOLES COMPLETE OTHER SIDE y \ I, the undersigned, hereby certify that the percolation tests reported on this form were made by me or under by supervision in accord with the procedures and method specified in Chapter H 62.20 (3), Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. NAME R f P 19ZI R// 7 TITLE (Type or Print) REGISTRATION NO. or MASTER PLUM ER LICENSE No. 7 ;~~5~ ADDRESS ! f ~V Cu'Q() L~ / DATE 2 2 zo___ SIGNATURE MASTER PLIJ7U ER MA&ING APPLICATION ` f MP Signature: License Numbers MP RSW (To be Completed by Issuing Agent) Date of Application 117 Fee Paid Permit Issued (dat 7 Permit Number 1s.~li1`~7 Agent (name) i t,t , . Pori Town, Village, City, County, etc. (Specify) Notes The application cannot be considered for filing until all of the above questions are answered and the fee paid. Agents will forward application, the fee of $10.00 and Copy (b) of the Permit (yellow copy) to the Division of Health. Checks and money orders should be made payable to the Division of Health. Do not write in space belay - FOR DEPARTMENT USE ONLY DATE RECEIVED ACCEPTED BY RETURNED _ (Initials) (Date) see Corres.T FEE RECEIVED VALID. NO. PERMIT NO. I 3 (Yes or No) REVIEWED BY APPROVED DATE (Initials) (Yes or No) COMMENTS: r- ,SPRINGFIELD T 29 N-R• 15 W 37 DD SE, PAGE 49 v I D A y RChtz rrL mom s~ Thom~n C ~ ~ l~ ~ U y o ~ U • • p r1 0~ cC cToL,~> • .Tn ~ Ec/ f U vm;~ 0 4.Danncz P~ ~ l ° y C C1 0 ti v e ° l ~J h moy /709 /er- Tie en .9 ~~C'°, y ~C /3/s aae'~ y~ Q~ °C~t~w \Jti~ ~U ~~ye Haines d h.0 ~ ~Q\.~ 0 °p ~ 43. /o 3.6s - F v\ .Thou P c Ma.r/.c o, U C p J\ F C C 6a od »7,3 /`7`Gee wd.CO J 0 Ct d ~ . Gf7cz~/ y Cac°/ ~OtF, ~ ~ ~~n OZ \i~~ 4,0 °y K ~ ~ Dzo CUo~ ~ ~ V~ ~ d.v Daw _ -.a a4on w on ~ c h M r/rn • d E ~ % ~ ~ ~ _s C o. ,Bed ~ o ~ h /t/on~a.d ~ t W C 'I~in ~1 WC ,64.x9 V~ 40 `0 `9 t0 • VVfan 77C t.~ o v ~ ~ Se7m ~ W oy ~a E vUVO MathOC d y 28 v~h ~ Jo.dhe.i7-7 y h. v o rho F~ v C t Se. N Bo C o u / s J e vF h~~ :y cQ ~,,~lT°' 9~~' C. /99 ll~C z/9 I~o\v 9 ~y v~~ v/and'3.s ,Pose//o_ Rus5 e//• X30 /~Yd 3j 0 /foCr7 /~zwr~ •Vc/or Tacobsor7 P` ° 20 • anenc ohnson /7°C /~,n T/7orser7 an h sorr o G/e W /z ° /0 79 Be o /4o zo acyF- E/n es7' Leon- Me/ an Ph:/s sz /ya/ce:n and /yan~sa,7 ,8n.c • /-eona,d• ,ems JN"k /yrs.John a0 i Ne/son h v roof /zo Sri a C Jo/>n~son - / .S'e6/ .Horde// 1 Zoo \ J 40 qp 0 •Wscoos7 /24 /moo 1 osc/7 V f~a r d c tl C viy>/ s /via • Cons o C Ro°s!e \o b v `l For r. y 9744 Les/ie ~ f,3ef ~errr7if v v~ ~ F~ ~ 1Rrso o U~.h y /h Bras- , ° .C. //a worf~i• Jh .~7 d~ ufur7~z q ti C W . ~ll~-~ U t U 0 4o hn .p /76.s /arse- 80 .zo47a U qCC o -a. J 4 \ C C\~ Ms 9oM~Ee • / 4o Bo Bo • y etch WP 7z 3 U F/rh/e . re's - .i .e • • So/J 90 /r/ P c Bn~ AA +o s ~i F o r y e/yam ne d cas f 3 x gene e ~/,/m n, S : v Ea./E/71ce • o~ l~ ll/iscons,n re. '4c 4o 40 V~ Fh 40 4o a/f4o v//mccn /ZO p h V COn~s. Comm. • ~e ao e/u% o h ~ U +q tl f/a ~,.s • Ci/en f/`7 / E./f~. 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Ma Dow tl Wi//in.E /er \ d d C C W a C cTohs7o~ conq~ ~ d i/6er7~- 14ci 0 rl/o ~ar~ 7g Ca/✓irs AVS ZQ.cial, r2o : ~ a ~l o- y V U ~ ~o/i ,-Y`'Los y .bei 'Y • ,so,r Qj /1/P .sow 4.3 n Sc t~ rlaa . e k o 3 1~1~~ a o j~ rrsn~ Bo s ,iG 64 . y ~J /077 n o% ¢ `5 l~ : /ao ~G ~9 • 4o n ~ ~ ~ P ebe 7 Eho • w/ s W°a%~ roz Jr. ro Q //ern>ar7 - an TsonP • 0 ~Puf/7 • y • /fe- 9 • Ceip • • C 773 ~sor7 ~4 n 9a • Q ofjnsor~ L L's es W-- man bbs d3/'' vas /7 .Det~n f 0 Ine`j (/ir v .Se/me.- 12/14"~ 'a: MegeC ¢T n Eze m Wayno 'Y y 34 9>/ NN 717om/osor7 V y ~/scn ~O3 O .Z42 k- ambau9h ~ o o%sar7 Sfar~ ~ 3 0• ,cn do da I"' /60 ~O e e 32 ZB° J n M ' . /os ayna,d G, Wi/son f,B. C 7D, Eit/and o C C J0 •~c~da y /ph S o ,Pock f fL.me - aC y tl 96.1 0 c.- rXurisa. v I?'x C'Liar/es .c,Fso~ C d C G 9 s.bne a., chei- y n o Jahn s Al " Es a o 7 °acc 128 t > 1~s 1, • a 12 r o. <o 10 o w zxg UC o v h u NV .Dorn/hy `Q\ /%ary. Bo /Bz . q¢ John R J ` W hIC17 • v C~ ~ aucrs \ 6* NJ 117WI~q • ,Bauer V J [iWeink,e / h>~ ~ o 'q/~V D. as 1 e /97z Ra ~Efard r/aP, vb/s., Inc. SEE PAGE 23 S~ Croix Counfy Wi s WILSON ELEVATOR CO. KOOIMAN MOTOR SPORTS PHONE: WILSON 772-4764 VALLEY ELEVATOR Suzuki Snowmobiles PHONE: 778-5734 Feeds- Seeds PHONE: 684-1615 and Blackhawk Fertilizer ® BALDWIN, WIS. 54002