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' N = = O. O 7 N = = O. O = � m < '7 m'O —N a !OA m �'7 m•0 PO a ! = A < • O O O N < ' O 'O O 'D M �a�N�W7� �mW?�3 a •< < m a $� . a ,� < m a • a C 3 v m �m d C 3 w am 3 w w °m om 3r?w ti 3� m c rr mo - T. c ° o 0 0 CD > O CD b ° CD 10 oq � c Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and�uilding F4ivision � I INSPECTION REPORT Sanitary Permit No: 430550 0 GENERAL INFORMATION (ATTACH TO PERMIT) tate Plan ID No: Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)]. 0 D = T / 5- 16 -# Permit Holder's Name: City Village X Township 'Parcel Tax No: rerrick, Lisa Springfield Townshi i CST BM Elev: Insp. BM Elev: BM escription: ection[Town/ nge /Map No: C c> a r Yc e &J 07.29.15. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Q1 C Dosing r c Alt. BM Aeration Bldg. Sewer Holding SUHt Inlet -- TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic (O Dt Bottom Dosing Lt •,e* Lt '1id Header /Man., 2 7 p t � ZC3 O 0 Aeration Dist. Pipe Holding Bot. System (A) i°' / 03. 19 OC nal Grade PUMP /SIPHON INFORMATION \= - t( (02 IZ" ; Manufacturer Demand t Cover , , 1, ^ e t GPM yr too del Number w j H Lift Friction Loss System Head TDH Ft -3t� s �q z ice' �. „�A �. � ►� 'f . ?q Forcemain Length 1 Dia. �� Dist. to Well n t SOIL MSORPTION SYSTEM /,, r p0 • s"i' Width I Lenq#th / I N �Of Trenelrea PIT DIMENSIONS No. f its Inside Dia. Li E ONS J SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHIN Manufacturer: INFORMATION CHAMBER R Type Of System: t i t l ips ` UNIT Model t ,i r DISTRIBUTION SYSTEM (�l Header /Manifold Distribution 11 x Hole Size 1 �� x Hole Spacing e to Air Intake Pipes) 4,[ Length Dia Length U1Q Dia I l Spacing +� �(• / SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only S Depth Over Depth Over xx Deptli of xx SeededlSodded 1 xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes L No Yes No COMMENTS: (Include code discrepancies persons present, etc.) Inspection #1: 1 t / 2 0 l am_ Inspection #2: i- C n 4-c,– n u c-- S '(6 c.k —.12 LJ 2 n i .z Location: 2751 110th Avenue Wilson, WI 54027 (NW 114 NE 1/4 7 T29N R15W) NA Lot 1 ( C " - parcel No: 01.29.15. r1 t� No . , 6c,, 4 ; # "t 3) 1.) Alt BM Description= -1, - T, C�,i watt <I,;, , a " 1 H Z.) Bldg sewer length = � — -- -amount of cover = 3� ` � � *�,' ` /.1Gc,� IL � p4ow -a.9 may` (Ale 14 Plan revision Required? q � q Use other side for additio I 1 Irlb��pcto Signature j�rt. No. D-6710 (R.3/97) f 4.,6C VW tsV% t S L j(1'IoUA d Sys e vt,. P� D <�V' 1' AA �l V AA r � I J og/ VEw►�y. I c� rn d a � C �o y x � �1 N i A � f - 22 § % e § 2 0 © c � ■ � \\ f�) � \(� § \� LL Cc \Im 3 ) ¢J) « 2 � o � 7 § E j N § a. co 7 \� E� \ {$ � § K k f / \ $ / } E % E_( @`CL }E \ § /f7 VZ 0 ] k d R ( , � LO . § $ W 2 ƒ 0 CL ¢ a u § z _ $ ) § \ � � j \ 2 2 a � ; § o g q 3 u i\ ) 0 I > ) 2 !§ % /k Co L Co \ £ 4 �/ § @ 2 k\k' \ o k} , © _ �f \ 2 0 S r,: / \ } Q o ) / \ « . L: / ed k (L � 0 U) 0 V Safety and Buildings PO BOX 7162 MADISON WI 53707 -7162 TDD #: (608) 264 -8777 N visconsin www.commerce.s i.us/s www.wisconsin.gov Department of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary March 04, 2004 CUST ID No.224617 ATTN: WTS Inspector LYLE J MYERS Z ING OFFICE NORTHLAND PLUMBING INC CROIX COUNTY SPIA E1556 STATE ROAD 64 1101 CARMICHAEL RD BOYCEVILLE WI 54725 HUDSON WI 54016 CONDITIONAL APPR AL PLAN APPROVAL EXPI • 03/04/2006 Identification Numbers Transaction ID No. 974148 SITE: Site ID No. 667883 Lisa Ferrick - Dwelling Please refer to both identification numbers, 110TH Ave I above, in all correspondence with the agency. Town of Springfield, St Croix County NW 1/4, NE 1/4, S7, T29N, R1 5W, Lot: 1 FOR: Description: New Mound System / 450 d / Revi ' n To 938805 Object Type: POWTS Component Man al Regulate bject ID No.: 944879 Maintenance required; 450 GPD Flow ate; 6 in Soil min in depth to limiting factor from original grade; System(s): Mound Component Manual - Versio .0, SBD- 10691 -P (N. 1), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01 /O1); Biof er The submittal described above has be reviewed for conformance with ap 'cable Wisconsin Administrative Codes and Wisconsin Statutes. The submi has been CONDITIONALLY APPRO D. The owner, as defined in chapter 101.01(10), Wisconsin Sta es, is responsible for compliance with all co requirements. No person may engage in or wor at plumbing in the state unless licensed to do so by t epartment per s.145.06, stats. The following conditions sh be met during construction or installation and prior to occupancy or use: co r, 1. This system is to be constructed and located in accordance with the approved plans and with the Mr, component manuals listed above. DI D sF'ph 2. This plan approval is based on the Interpretive Determination Approval granted by Leroy G. Jansky, 7� Wastewater Specialist, dated July 21, 2003, with Transaction ID No. 888116. SEE C, F 3. The dispersal area shall be chisel plowed to a depth of 12 —16 inches immediately prior to sand placement as specified in Mr. Jansky's approval letter. 4. On page 6, based on recommendation #6 found in Jansky's letter mentioned above, landscaping up slope of the mound shall be incorporated into the mound design to divert surface water drainage around the mound system. 5. On page 6, the force main installation trench shall be no wider than 12 inches through the mound system's down slope area as specified in the approved mound system component manual. 6. On page 6, the well was not shown as specified in s. Comm 83.22(2)(a)3.c., Wis. Adm. Code. The well location shall conform to s. Comm 83.43(8)(i)., Wis. Adm. Code. I I LYLE J MYERS Page 2 3/4/04 A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. 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. Sincere l Fee Required $ 60.00 Fee Received $ 60.00 Balance Due $ 0.00 Aetere Private Sewage Pi n tegrated Services WiSMART code: 7633 (608)266-2889, M - F, 0630 - 1500 Hrs pepagel @commerce. state. wi. us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 l J Mound System Cover Page pg 1 of 6 MIEN CDACAETE Project Name: Ferrick -RDM Mound Owner's Name Lisa Ferrick Owners Address Legal Description NW %, NE ! %. SecF 7� T 29 N, R 15 W Township Springfield County j Saint Croix Subdivision N/A Lot# 1 ParcelID# Pending P9 • Table of Contents 1 Cover page 2 Mound Sizing Calculations BO GS. 3 Pressure Distribution Layout and Dynamics 4 Dose Tank CORRECTION NEEDED 5 Ma n ag e ment a and Contingency Plan SEE CORRESPONDENC E p to n y total # of pages: 6 .FN �4 F CO T r 4N R Designer Name: Lyle J. Myers - MP /License #: I. D.# 224617 k�sPON Date: 2/5/04 N Ph. #: 7156432520 Signature: Mound System Design Methods Used per "Mound Component Manual For Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD- 10691 -P (N.01 /01) per " Pressure Distribution Component manual for Private Onsite Wastewater Treatment Systems" (version 2.0) SBD - 10706 -P (N 01/01) Spreadsheet provided by: 3bAdvisement N12486 220th St, Boyceville, WI 54725 Ph: 715 -643 -6068 email: 3ba@3badvisement.com Mound System Page 2 of 6 Mound Sizing Calculations Project Name: Ferrick -RDM Mound Site Conditions _ Design of Entire Fill Project Type: j or 2 Family Dwel • Cell depth at upslope edge (D): 30.0 in. % Slope: P6in. % Cell depth at downslope edge (E): 30.6 in. # of Bedrooms: Distribution cell depth (F): 9.25 in. Depth to limiting factor: Cover thickness over edge (G): 6 in. Absorbtion rate of fill material: 1 gal /ft /day Cover thickness over center (H): 12 in. Absorbtion rate of in -situ soil: 0.2 gal /ft /day End slope width (K): Effluent quality Eff #1 Fill length (L): /09.Zft. Max BOD effluent value: 220 mg /I Upslope width (J): 11.0 ft. Max TSS effluent value: 150 mg /I Downslope width (Toe) (1): 16.0 ft. Fill Width (W): 31.0 ft. Design of the Distribution Cell Basal Area System Design Flow: 300.0 gal /day Basal area required: 1500 ft Distribution cell width (A): 4.00 ft Basal area available: 1500 ft Distribution cell length (B): 75.0 ft Area of Distribution Cell: 300.0 ft Observation Pipes Contour Elevation of Mound: 100.55 ft Location from end of cell (Z): 12.5 ft System Elevation of Mound: 103.05 ft _ Final Grade of Mound: — ID4 82 ft Mound Plan View yy Observation Pipes 7 TY B. k—K z Tilled Area/Fill Material Mound Cross Section Final Grade Observation Pipe Synthetic Fabric G ". Distribution Cell System Elevation b , ��ao F Cover Material Fill Material Invert �.. Tilled Area Slope � Forcemain System Contour Notes: Fill material to consist of ASTM C33 Sand Distribution cell aggregate to comply with Comm 84.30(6)(1) Synthetic Fabric covering on cell per Comm 84.30(6)(g) Distribution Cell to have minimum 6" aggregate below lateral and 2" above. I Mound System Page 3 of s Pressure Distribution Calculations Project Name: Ferrick -RDM Mound Lateral Layout Lateral /Manifold Design Lateral elevation: 103.6 ft Lateral diameter: VA In. Rows of Laterals: 11 Lateral spacing (S): ft Manifold type: center Lateral to cell edge: 2 ft Orifice diameter: 0.125 • In. Lateral discharge rate: 15.65 gpm # of Laterals: 2 System discharge rate: 31.31 gpm Distal Pressure: 5 ft Manifold diameter: -2- In. Lateral Length: 37 ft Manifold length: 0 ft Orifice Spacing /Distribution Forcemain Friction Loss Orifice spacing (X): 11.84 Inches Forcemain length: I 130 ft Orifices per lateral: 38 Forcemain diameter: 2 wJIn. Avg. ft /Orifice: 3.95 ft Friction loss in forcemain: 2.727 ft Lateral Side View Manifold Lateral Lateral x x x x x x x x x x x x 2 2 Lateral Length r Lateral Length Lateral Plan View Lateral Length Turn-up w /ball valve or cleanout plug 0 0 Orifices on bottom of lateral equally spaced PVC laterals and forcemain to comply with specifications per Comm 84.30(2)(e) Clean Out Detail Observation Pipes Clean -out plug Final Grade or ball valve -�,^- Water tight cap or plug Lawn M Sprinkler Box Slot Note: Closet Collar 6" Minlmu� may be used in Long Sweep 90 � place of 318" bar or two 45's 3J8" Bar Lateral Mound System Page 4 of 6 Septic, Pump and Dose Tank Project: Ferrick -RDM Mound Tank Information Dosage Volume Pump tank manufacturer: Wieser Concrete Forcemain drains back to tank? OQ Yes O No Pump tank size /model: W1000 /650 -MR Lateral void volume: 5.7 gal Pump tank gal /inch: 17 Dosage to absorbtion Cell: 28.7 gal Actual Pump Tank Volume: 646 gal Forcemain volume: 22.6 gal Tank bottom elevation (inside): 93 ft Total dosage: 51.4 gal Septic tank size /model: 1 W1000 /650 -MR - 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) 9.55 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: 2.73 ft Pressure loss from filter: � ft Total dynamic head (TDH): 18.78 ft Pump Tank Diagram Dose Tank Levels Wate rti g ht Lo cki n g Cove r In. Gal 4 Inch With Warning Label Minimum Grade Finished A Reserve 21.0 356.6 B Pump off to Alarm 2.0 34.0 Alternate C Total Dosage 3.0 51.4 Outlet Location Elect. per Comm D Effluent depth for pump 12.0 204.0 F e 1 1.11 and Total Capacity: 38.0 646.0 NEC 300 Weep Hole A or Anti- FLOW- LITERS/HOUR Siphon B 0 1000 2000 3000 Device C \ 30 10 Y y D w 7.5 20 i R 5 10 = 2.5 Pump must be capable of: 31.3 GPM and head pressure of: 18.8 Feet ° ° 0 20 40 60 8o Little Giant FLOW- GALLONS /MINUTE 9EH PUMP PERFORMANCE CURVE 115V 60HZ Mound System Management Plan pursuant to comm 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 out/tested 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. h � i • � w � 'c kA �i 1 4 N P_ y� � 3 I 9loo �Iv4 \v 02/27/2004 10:53 715-726 -2549 S &B CHIPPEWA =ALAS PAGE a2 768378 .f; 2 6 13 P 3 4 6 KATHLEEN H. W ALSH REGISTER F 0 DEEDS FLOWS AND LOADS ST. CROIX CO., MI AFFIDAVIT RECEIVED FOR RECORD 07/09/2004 02:25PH Legal Description: AFFIDAVIT N y Oo�/t La Section . A '� T 2 R/•5 W EXEMPT # 0 Lot 1 Block Subdivision or CSM �1 /9'fB 171-15i—P TRANS F EE: 11.00 Parcel ID as Township Svg /,t! . FiFGb CCPFEEEE: 2.00 Property Owner F 4E" /cK PAGES: 1 Msllln9 Addmas //a 4 41/E Clty, State, Zip GLZ- 'J 1UQ;tf . S aTY, W s4 6 J 3 I (we) do hereby acknowledge that the use of the private onsite wastewater treatment system (POWTS), as installed on the above described real estate Is based on the following flows and load& and NOT on the number of bedrooms as Is normally the case: occupants or 300 gallons per day, and an organic load of no more than _mg /L 60Ds 150 mg& TSS _______mg/L FOG (monthly average of each) I (we) hereby state that should the flows or load& increase beyond those indicated above, the POWTS shall be modified to conform to all applicable rules. I (we) also state that should the POWTS show any signs of failure as defined in s. 148.245 (4), Wis. Slats., by any component of the POWTS, said component(s) shall be repaired or replaced according to all applicable rules and regulations in effect at the time of the repair or replacement. Owner Nome (Print) subudbod an ewom o bef a me on thic date s Sr- . 7 o Notwiztd Owner 8 slur&_ N oaten c y 7 -3 ex iree: d am_ e1:2 5 Dratted By NOT�pUts A ( RAMSEY COUNTY ,j C " 'i►9 V" Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 N *6consin Madison, WI 53707 - 7162 Sanitary P mit ed in by Co.) Number (to be l -7 o s Department of Commerce (608) 266 3151 Sanitary Permit Application State Plan I.D. Number 77�� In accord with Comm 83.21, Wis. Adm. Code, personal information you provide �� / /����• �l� may be used for secondary purposes Privacy Law, sl5.04(1)(m) Project Address (if different than mailing address) 1 I I L Application Information - Please Print All Information RECEIVED d 7 le) - .i Pr Owner's Na me 1 Parc I M Lot Block # NOV 12 2003 Property Owner's M ailing Address ST. CROIX COUNTY Property Location ZONING OFFICE /.,Section City, State Zip Code Phone Number �� y T D 5 G�� circle o II. Type of Building (check all that apply) � N; RE r w X r Subdivision Name Number 1 or 2 Family Dwelling - Number of Bedrooms '/ J Public /Commercial - Describe Use 3� / Stale Owned - Describe Use D l� ��!� X (��, Ci[y_� Village Towns of - - - IA - /00 . h a I SPoe zl 111. Type of Permit: (Check o nly one box on line A. Complete line B if applicable) A. Y(New S stem — — y- ❑ Replacement System ❑ TreaunentlHolding Tank Replacement Only ❑Other Modification to Existing Sys en I t r ' B. � : -, Permit Renewal � ❑Permit Revision ❑Change of F] Permit Transfer to New List revio e i r at e I. e Before Expiration Plumber Owner Iv Type of POWTS System: (Check all that apply) 7 u p Non - Pressurized In Ground L1 Mound > 24 in. of suitable soil VI Mound < 24 in. of suitable soil iJ At -Grade ❑ Single Pass Sand Filter Constructed Weiland _'. Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ LeachiW Chamber ❑ Drip Line ❑ Gravel -less Pipe -J Other (explain) V. Dispersal /Treatment Area In formation: , gt� Design Flo%v �glxl) Dcsi cation <Ie( Dispersal) Area R rea � ` (sf) Dispersal A r used (st)� System Elevation ✓ - - VI. Tank Info a aci Total Number Manufacturer Prefab Site Steel Fiber PlaMIC Gallons Gallons of Um1IS z7^" 1 ` Concrete Constructed Glass I New Existing ,�GC��( � � /`�— _ Tanks )'auks Scp[lc or f loldlne Tmik LLJJ Acr�rcauncni Li i — — — �— Dosine Chamber�� - - �� — � e P V II. R Statement- I, the undersigned, assume responsibility for . - tallation of the POWTS shown on the attached plans umber's Na me (Prim[) Plumber's Si gnature P MPRS Number Business Phone Number — lui bet's Addre ss beet, City, Stat , Lip .ode) VIII. County /De artmentUse Only_ L. Approstd Disapproved Sanitary Permit Fee (includes Groundwater D' to Issued Issuing Agent ignatur �> tampsps y Surcharge Fee) 1� L) Ow ner Given Reason for Denial IX. Conditions of Approval /Reasons for Disapp all, ( �� 4-D Sy� - - - - -- lit -7 33 YSTEM OWNER: �vrlivt 3.f-L Q/1-L vY; _p�C� 1 Septic tank, effluent filter acid d7 1 C,w� dispersal cell must all be serviced /maintained J, A as per management Ian ro ' d b lumber - 0` , - I e County only) for the system on paper not less than 81 /2 x 11 inches it ze as per applicable code /ordinances. -� SBD -6398 (R. 01/03) '3 -C/ 3--/ D oT .AJ ED ID� L \\ C� Env mvT � \ i �,5� �E12RILK TGgN, 5v1 v� Fsot��e � C i` S PRr 7o tiI� F��L� 200 I � 1 Safety and Buildings PO BOX 7162 MADISON WI 53707 -7162 TDD #: (608) 264 -8777 Visconsin www.commerce.s i n.gov Department of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary November 07, 2003 CUST ID No.224617 ATTN: POWTS Inspector LYLE J MYERS ZONING OFFICE NORTHLAND PLUMBING INC ST CROIX COUNTY SPIA E1556 STATE ROAD 64 1101 CARMICHAEL RD BOYCEVILLE WI 54725 HUDSON WI 54p16 CONDITIONAL APPROVAL �,/r�_ 3 5-5-D PLAN APPROVAL EXPIRES: 11/07/2005 Identification Numbers Transaction ID No. 938805 SITE: Site ID No. 667883 Lisa Ferrick - Dwelling Please refer to both identification numbers, 110TH Ave above, in all correspondence with the agency. Town of Springfield, St Croix County NWI /4, NE1 /4, S7, T29N, R15W, Lot: 1 FOR: Description: New Mound System / 450 gpd Object Type: POWT System Regulated Object ID No.: 929241 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. This plan approval is based on the Interpretive Determination Approval granted by Leroy G. Jansky, C {w P. Wastewater Specialist, dated July 21, 2003. The following conditions shall be met during construction or installation and prior to occupancy or use: fADEEA 1.� On page 2, the following adjustment was made to the mound system dimensions based on DI recommendation #4 on Mr. Jansky's letter mentione ve: K =17.26 ft S COf R! L = 149.02 ft On page 6, based on recommendation #6 found in Jansky's letter mentioned above, landscaping up slope of the mound shall be incorporated into the mound design to divert surface water drainage around the mound system. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation /operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. LYLE J MYERS Page 2 11/7/03 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. ;Sincerel Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 fer Private Sewage Pla eviewer, , Integrated Services WiSMART code: 7633 (608)266-2889, M - F, 0630 - 1500 Hrs pepagel@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 SAFETY AND BUILDINGS DIVISION Integrated Services Bureau 13 East Spruce Street Visconsin INSPECTION REPORT Chippewa Falls, WI 54729 www.commerce.state-wi.us/sb Department of Commerce (715) 726 -2544 Date of Inspection: July 11, 2003 Plumber Name and Address: Project Name: Christensen Use: New Residential Legal Description: NW, NE, 07, 29, 15W Site Number: 662296 Certified Soil Tester Name and Address: Subdivision: Proposed 5 Lot CSM Eli M. Gottfried, CST221981 Municipality: Town of Springfield 124 1/2 Graham St County: St. Croix - -.._ __ Eau Claire, WI 54701 Plan Transaction Number: 88P1 16 OwiiIer Name and Address: Sanitary Permit Number: NA Kurt & Elizabeth Christensen 877 Benoy Rd Wastewater Flow: 450 gpd /lot Hudson, WI 54016 Persons Present: E. Gottfrie (715) 386 -6340 and E. Christensen An onsite soils verification was conducted at the above referenced site as per district policy for all sites with less than four inches of unsaturated soil below the bottom of the A horizon. The intent of this investigation is to confirm initial observations by the certified soil tester (CST) relating to the presence or absence of redoximorphic features in the A horizon and subsoil. In -situ soil texture, structure, and consistence factors were also reviewed as they relate to wastewater application rates. Other site conditions such as percent and direction of slope, landscape position, land surface contour length, and surface water hydrology may also be noted and their effects are factors considered in the recommendations and conclusions portion of this report. This parcel will be divided into five lots by a CSM. This report applies to specific areas and not to the entire area of each proposed lot. Lot specific reports will be submitted by the CST as interpretative determinations at a later date. This parcel has not been farmed for several years and is over grown with grass and weeds. During the preliminary investigation on June 10, 2003, with CST Tom Nelson, it was noted that many areas of the parcel had been disturbed, possibly by logging, and this made soil interpretive evaluations more difficult. Efforts should be made to avoid disturbed areas for detailed soil evaluations in the upper 12 inches of the soil profile. Nevertheless, several typical soil profiles can be described as follows: T -1 Lot 1 00 -06" 10YR 3/2 sil, 2m -cgr, mfr, cw. 06 -11" 10YR 4/4 sil, 2msbk, parting to 1m -cpl, mfr, cw /wf1f 7.5YR 5/6 rmfs. 11 -15" 7.5YR 4/4 scl, 2msbk, mfr, w /c2d 7.5YR 4/3 rmfs. T -2 Lot 2 00 -08" 10YR 3/2 sil, 2mgr, mfr, as. 08 -10" 10YR 2/2 sit, 2msk, mfr, cw 10 -15" 10YR 4/4 gritty sit, 2msbk, parting to 2mpl, w /c2d 10YR 5/6 and 6/3 rmfs. T -3 Lot 3 No redox features in the A- horizon T -4 Lot 4 00 -11" 10YR 3/2 sil 11 -15" 10YR 5/4 sil, 2mpl with c3f -d 10YR 4/6 and 5/3 rmfs. Christensen Site July 11, 2003 ' Page 2 of 2 Recommendations for this site include the possible use of mound systems designed to overcome limitations of a high level of seasonal soil saturation and slow permeability present in the subsoil. A soil saturation determination pursuant to Comm 85.60 must be completed by a CST and approved by the department to certify that this site has at least 6 inches of soil free of saturated conditions for seven or more consecutive days. Should a mound design be pursued for use at this site, the linear loading rate should not exceed 4.0 gpd /ft and the basal wastewater application rated should not exceed 0.3 d/ _ least 30 inches of sand lift must be used when applying septic tank effluent to u ion cell. The longest portion of the mound must be orientated along the contour. The mound shall be constructed to divert surface water around the mound structure as much as possible. Other considerations: 1. On slopes < 3% down slope basal area should be increased to prevent toe seepage. 2. Chisel plowing to 12 -16 inches depth is recommended to improve per colation_ 3. ystem locations are se a specs is ocations and those areas should be protected from damage during site development and building construction. If there are any questions regarding this report, please contact me. d royy sky, tewater ecialist Ljansky commer .state.wim E -mail 715/726 -2544 Voice 715/726 -2549 Fax cc: ®County ❑ Plumber ® CST ❑ Owner ❑ Other I SECEI ED Mound Syste ogpl & BLDGS• Cover Page pg t of s IBMTE Project Name: Ferrick -RDM Mound Owner's Name Lisa Ferrick Owners Address Legal Description 1 NW ' /<, N %. Sec�7� T 29 N, R 15 ( Township Springfield County Sa � t Croix Subdivision N/A Lot# 1 i sl� s. ParcelID# Pending 01 � y Table of Contents F y M Pg- ® E 1 Cover page (�und Sizing Calculations O CORRECTION NEEDED 3 Pressure Distribution Layout and Dynamics N� CF SEE CORRESPONDENCE 5 Management and Contingency Plan (�6 '�Ipt Map total # of pages: 6 Designer Name: Lyle J. Myers MP /License #: 1. D.# 224617 Date: 11/4/03 Ph. #: 7156432520 Signature: _�44 T Mound System Design Methods Used per "Mound Component Manual For Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD- 10691 -P (N.01/01) per " Pressure Distribution Component manual for Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD - 10706 -P (N 01101) Spreadsheet provided by: 3bAdvisement N12486 220th St, Boyceville, WI 54725 Ph: 715 - 643 -6068 email: 3ba@3badvisement.com Mound System ae 2 of s Mound Sizing Calculations Project Name: Ferrick -RDM Mound Site Conditions Design of Entire Fill Project Type: i 1 or 2 Family Dwelling V Cell depth at upslope edge (D): 30.0 in. % Slope: 1.1 % Cell depth at downslope edge (E): 30.6 in. m n # of Bedrooms: 3 Distribution cell depth (F): 9.5 in. Depth to limiting factor: 6 in. Cover thickness over edge (G): 6 in. O m' Absorbtion rate of fill material: 1 gal /ft /day Cover thickness over center (H): 12 in. P Absorbtion rate of in -situ soil: 0.2 gal /ft /day End slope width (K): Effluent quality i Eff #i Fill length (L): 138.5 ft. a r� Max BOD effluent value: 220 mg /I Upslope width (J): 11.1 ft. z a Max TSS effluent value: 150 mg /I D ownslope width (Toe) (I): 16.0 ft. cn o Fill Width (W): 31.1 ft. Design of the Distribution Cell Basal Area System Design Flow: 450.0 gal /day Basal area required: 2250 ft Distribution cell width (A): 4.00 ft Basal area available: 2250 ft ` Distribution cell length (B): 112.5 ft �►n�G� r LW �' rtr� q, p _ J l Area of Distribution Cell: 450.0 ft Ob ervation Pipes 1 Contour Elevation of Mound: F 100.60 ft Location from end of cell (Z): 18.75 System Elevation of Mound: 103.10 ft Final Grade of Mound: 104.89 ft Mound Plan View Observation Pipes Z _T A I Tilled ArealFill Material L ' Mound Cross Section Final Grade Observation Pipe Synthetic Fabric' ? ;. G Distribution Cell System Elevation F y P � I 3 Lateral Cover Material E Invert Q Fill Material Tilled Area Slope " "—Forcemain System Contour i Notes: c- l`h SEL PLO--) bE t�7►{ iz" -1� Fill material to consist of ASTM C33 Sand Distribution cell aggregate to comply with Comm 84.30(6)(1) Synthetic Fabric covering on cell per Comm 84.30(6)(8) Distribution Cell to have minimum 6" aggregate below lateral and 2" above. FROM : NOPTHLAND PLUMBING, INC. FAX NO. : 715- 643 -2520 Nov. 07 2003 08:16AM P2 Mound System Pvc 3 of s Pressure Distributior'i r:ralculations Project Name: Ferrick -RDM Mound Lateral Layout Lateral /Manifold Design Lateral elevation: 103.8 ft Lateral diameter L � E � J In. Rows of Laterals: F1 lateral spacing (S): ft Manifold type: { center Lateral to cell edge: 2 ft Orifice diameter: o.i2S + In. Lateral discharge rate: 11.95 gpm # of Laterals: 2 System discharge rate: 23.89 gpm Distal Pressure: 5 ft Manifold diameter. Z In_ Lateral Length: 55,75 ft Manifold length: Oft Orifice Spacing/Distribution Forcemain Friction Loss Orifice spacing N: 23.47 Inches Forcemain length: 110 ft Orifices per lateral: 29 Forcemain diameter: 2 _ In. Avg. ft 7.76 ft Friction loss in forcemain: 1,400 ft Lateral Side View Manifold Lateral �� Lateral x x 7 1 4 x Latara ength Lateral Length I` Lateral Length Twn•up wlball valve or dean out plague a Ofaices on bottom, of -- lateral equally spa PVC laterals and tcrcemarn to cori4* with spacific &ions per Comm 84- 30(2)(9) Clean Out Detail Observation Pipes Clean -out plug Final Grade ortar3llvehde Watar tight Carp fr or plug Lawn Sprinkler Box lot Note: Cbset Collar 6" Minimum rrep be umd in Long Sweep 90 m ar place of M" b orA�+a 45'E Latersl 3,11° Bar FROM NORTHLAND PLUMBING, INC. FAX NCI. : 715- 643 -2520 Nov. 07 2003 08:17AM P3 Mound System Pap,. 4 & 6 Septic, Pump and Dose Tank Project. Fernck - ROM Mound Tank Information Dosage Volume Pump tank manufacturer: _ Wie Conc F orcemain drains back to tank? Q Yes O No Pump tank size /model: W100 MR 7 v 1_at void volume; 11.8 gal Pump tank gal /inch; 17 Dosage to absorbtion Cell: 58.9 gat Actual Pump Tank Volume: 646 gal Forc;emain volume: 19.2 gal Tank bottom elevation (inside): 93 ft Total dosage: 78.1 gal Septic tank sizelmodel: t W1 0001650 MR _ i Pump and Filter Total Dynamic Head Pump Manufacturer: /-r4 ,rat 6l� Are laterals highest point? y Pump Model: 9 z5 H FA 9 13Km 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) 9.60 ft Nate access opening of sutfioiant size to be provided to allow remover of filter opening to !srminate at or above grade. Friction loss in forcemaim 1.40 ft Pressure loss from filter. �ft 7ota l dynamic head (TDH): 17,50 ft Pump Tank Diagram Dose Tank Levels 7 Locking Cover In. Vaal .1 inch With Warning Lobel A Reserve 19,4 329.9 Finished ?Minimum GradE B Pump off to Alarm 2.0 34.0 �Iterneit7� , C Total Dosage 4.6 78.1 Outlet LocatiCZn Elect per Comm D Effluent depth for pump 12.0 204.0 16 2e end 7 atal Capacity 38.0 646.0 orcemern NEC 3 Weep Hole A a' Anti ' Siphon 8 Device C F OW- LITERS/HOUR h too 2000 3000 I G 3a Io 61 W 7Z W to x Pump must be capable of: 23.9 GPM and head pressure of: 17.5 Feet 2.9 I i l0Z 0 0 o EM 40 eo e0 -� Little Giant FtU - GALLONS /MINUA 9EH PUMP f ERFORMANCE CURVE 115V &0HZ Mound System Management Plan pursuant to comm 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 chemicaUbiological "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 rempin 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 out/tested 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. o7 .A1 ED6E i j541 5 P Rrtil� 7oW I � �2 Wis-consin Dep;rtmentofCommerce SOIL AND SITE EVALUATION Page Of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 'h x 11 inches in size. Plan must include, but County St. Croix not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to the nearest road. Parcel ID #.Q * APPLICANT INFORMATION -Please pri ail i tfermation._, viewed // Date: Personal information you provide may be used for secondary purpos s (Priva. MOM ``( �Y Property owner: " Property location Kurt and Elizabeth Christensen , 2003 Gov't lot: NW 1/4 NE 1/4 S07 T29 N, RI Property owner's mailing address: Lot # Block # Sabel. Name or C 9 ` 417 J y� 1 877 Benoy Road �_ _ _ - - - m y Y 1 NA NA 3 �f p City / State / Zip Code Phone number: -` -y city Village own Nearest Road Hudson / Wisconsin /54016 715- 386 -6340 Springfield 110 Avenue ® New Construction Use ® Residential/Number of bedrooms Unknown Addition to existing building: NA ❑ Replacement Public or commercial - describe Code Design Flow Rate: Unknown - must be appropriate size for the contour and soil restrictions Parent Material: Glacial Till - ground moraine General Comments and Recommendations: Soils are somewhat poorly drained aqualfs or glossoboralfs underlain by clay loam. Redox features are the result of perching above the dense clay loam layer. A long narrow mound SAS is recommended for this site with 2.50 foot of sand fill. ON -SITE REQUESTED DUE TO THE PRESENCE OF REDOX FEATURES AT SHALLOW DEPTH. SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Redox Description Texture Structure Consistenc Boundary Roots Soil Application Rate in. Munsell Color Qu. Sz. Cont. Color Gr. Sz. Sh. e GPD /FT Pit 1 Eff# I Eff#2 Ap 0-8 IOYR 3/2 NA sil 2fsbk mfr aw 2f 0.5 0.8 Ground Bt 8-10 1OYR 4/3 fl hi and low sil w/ cl 2mabk mfr aw If 0.5 0.8 Elev (ft.) 100.60 C 1 10 -28 5YR 4/4 m3p 7.5YR 5/8 scl 1 fsbk vmfi as NA 0.2 0.3 Depth to C2 28+ 7.5YR 4/6 m3p 7.5YR 5/8 cl massive vmfr NA NA NA NA limiting factor- in. 8 Remarks: Mixing of A/B horizons in Ap horizon; C horizon - v. dense. Standing water at 29 ". Boring # Ap 0 -6 l OYR 3/2 NA sil 2fsbk mfr as 2f 0.5 0.8 prt 2 E 6-8 10YR 4/3 NA sil w/ cl 2fpl mfr gw 1 f 0.2 0.3 Bt 8-16 7.5YR 4/3 f2d 7.5YR 5/6 sicl Ifsbk vmfi NA NA 0.2 0.3 Ground Elev (ft.) C 16 -26 5YR 4/4 m3p 7.5YR 5/8 scl w/ gr massive 100.44 Depth to limiting factor- in. 8 C - saturated. Standing water at 26 ". CST Name: Eli M. Gottfried, Gottfried Environmental Signature: =L Tel. No. 715- 833 -1400 Address: 124 -1/2 Graham Ave. Eau Claire, WI. 54701 Date: 27 June 2003 CST # 221981 SOIL DESCRIPTION REPORT Property ownet Christensen Parcel lD# Boring # Horizon Depth Dominant Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate in. Munsell Color Qu. Sz. Cont. Color Gr. Sz. Sh. GPD /FTZ Pit 3 Eff# 1 Eff#2 Ap 0 -7 IOYR 3/2 NA sil 2fsbk mfr ai If 0.5 0.8 Ground Bt 7-16 7.5YR 4/3 fl d 7.5YR 5/8 A with cl 2fsbk mfr gw 1 f 0.5 0.8 Elev (ft.) 100.5 C 16 -26 5YR 5/6 m2d 7.5YR 5/8 scl Ifsbk mvfi as NA 0.2 0.3 Depth to limiting factor -in. 7 Remarks: C - v. dense; standing water at 26" Boring # Horizon Depth Dominant Redox description Texture Structure Consistence Boundary Roots Soil Application Rate in. Mansell Color Qu. Sz. Cont. Color Gr. Sz. Sh. GPD /FT Eff# I Eff#2 Ground ENV NIENTAJ T Elev (ft.) p D. Box 1 Grah kvenue Depth to Eau Cl re , WI 5j 702-1645 limiting IA 4W factor- in. Remarks: Boring # Ground Elev (ft.) Depth to limiting factor- in. Remarks: Boring # Horizon Depth Dominant Redox description Texture Structure Consistence Boundary Roots Soil Application Rate in. Munsell Color Qu. Sz. Cont. Color Gr. Sz. Sh. GPD /FT` Eff# 1 Eff#2 Ground Elev (ft.) Depth to limiting factor- in. Remarks: i � o a . L I � Q 1 Z — 4i °o U) o C � C C) 1 5 N i clj W (� W W U Q VJ C) O � \ L. O CO � O I � O � � I I_ O CU � I k r - � r /O O o O c J O T- a� N x L 2 N L LO O U m V WU') m O O cv (n >. — }. �ti�•� Cu c�00 Q � J N N M Q� .0 �?j Q E� �� L L c Z U _ > N Y UJ Na.352 P002/002 ST C> O IX COUrrrti1 SEPTIC TANK DdAWY'$MANC9 AORR SIT A2d'C+ OvvwwH]P CLR IFECATION FORM f�wtlGrfguy'Cr �/S ���' tit Mailing Addrtss �5✓ � /�dp /,�•- �oS [�J_!_.. s` - - Properly Addrats C,2 '7 :f �` �J (Veririeatioo raui:od fratn Ptatrs&S papwm ent Aw nssi cow trtssti9b)—, :aty+�5tittC C �� f�ltrrtal Iso ifimoon Nuttiba � �,SCIiYF N. W, Town of Prapaty Loc ation .�L.+ �,L• SubdivWao LAS 0, CarliCsd Snrvey Map # 7 3 9 �c��,�_ . Volmaa 17 p #�.G -�-. —. Wamnty Dmd * _ �/ b7 ° Page spar house O yes It no Lot lines idaatifiabIt Ym O no SMSM T ImWapa use sad majawAaaaw d yasr sepoe eyrAwn eovA rmolt is is PME1 tie fttihue to beadle weatss. pirooa rte♦siateaartCo �aasiati of pta�piat out W septic tads CvftY tares yew or Mope . if oma" by o livaaNd �� �e �a 1� 409 1ba aysieas cat a!t'icct the &Adaa of the septic tmk as a t:aataieot sage is I* wWe disposal NOWAL I'lsa p:opet:!� o mw Nees r submit to St Onebt ?.eo- t o C"""m fee% s►ppad by at ewaar sad by e m"Wr plumber, jovsaeytaaa plwabcr, tesatete+dph adwas a per wsiLl► 9 IMt U) Ibe oo.atte w►ssts+t►asardispaal eysteer S is ptaper operariag u0r.0itioa aad/ar (2) eihx kopeedoa trod Pwpipi (if wemmY), the septic teak i; tea teens in Aru of stodge. :iwe, the uadcss�6nad },eve sesd stress requirements sad e4tfs. ea tassiat�is the patisat� 6aW &IF syMM wbh the idD6ddi as: fort& hersia. as son by cbe D of Commesct ua rho zqmdmmu of Natroal Raxearrss. Sett el Wieapasio. Ce&Ocadm .tstiot d"t your septic system bss boa' uaaiaWAW swat be amplemd sad netutct d a Ow b`t. Cult COtM Z m rditista 30 do of ibe Itres 7zw Cats4evion date. K . rr A7tJItP br APrucAwr i9ATE gwNIS'R CETt'T7FIC&m N I fyz) t CRRY d w all rtat00e4r4 as Ais fom ut ryas to the bas of uty (OW) bowk4J* j (we) no (*ft) t� ewttar(�) of etc roperrf cscrbsd air�t+e: by versus of a wase:iaty dtod teoofdad +:+ Re=iata of petuis OlTtee• 4 NATUAS O AIT&JC^NT •. -•• • Any WparvAVIRM IJ+s ;r mUs- mprosm od way result ip dte a.aitary pmetlt berets mrokadby the Zo"B ant. • • • ••• •y 9"tuie .ritb this ■pvliastia% cued watessry dad ftm an Ret&$W of Demds em" s ebpy of for eorliWd aiOsey trtale if nfer=W is =a & is thr wwwwry died T07AL P.02 r 11- -4 2 4 11 P 2 2 'q STATE BAR OF WISCONSIN FORM 1- 2000 7 `♦ CD 7 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX Co., W I This Deed, made between Kurt Christensen and RECEIVED FOR RECORD Elizabeth Christensen, husband and wife 09/16/2003 61t25PH Grantor, WARRANTY DEED and Rick Ferrick and Lisa A. Ferrick , husband and EXEMPT t wife as survivorship marital property - REC FEE: 11.00 TRANS FEE: 132.00 Grantee. COPY FEE: Grantor, for a valuable consideration, conveys to Grantee the following CC FEE: PAGES : 1 described real estate in at Croix County, State of Wisconsin (the "Properly ") (if more space is needed, please attach addendum): Lot 1 of Certified Survey Map recorded in Volume 17 page as ocumen o. inq a part of e Nor wes ar r o eas Quarter Recording Area (NW's of NE'k) , Section 7, Township 29 North, Range 15 Name and Retu _� rh �� West, Town of Springfield --;— • ; L Grantor, his successors and assigns, reserves an 7b V easement for ingress and egress over the West 66' of �4 5yo d said Lot 1. Property is also subject to the following restriction: No improvements shall be ' constructed within 50 feet of the Southerly, Easterly, or Westerly lot lines. art of: Parcel Identification Number (PIN) Together with all appurtenant rights, title and interests. This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Roadways, Easements, and Restrictions of Record. Date s 11th y of September , 2003 * Kurt Christensen *Eliz th Christensen * * AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) P ) ss. St. Croix County. ) authenticated this day of Personally came before me this j,ith day of 1(AY V. September 2003 the above named * Kurt Christensen and Elizabeth Christensen TITLE: MEMBER STATE BAR OF SIN (If not, I6 � to me known to be the person a who executed authorized by §706.06, Wis. Stats.) 1 the foreg ' i ledged the same. THIS INSTRUMENT WAS DRAFTED BY Michael H. Forecki, Attorney NoWyfu StateofWisconsin Eau Claire, Wisconsin My Commission is permanent. (If not, state expiration date: L (Signatures way be authenticated or acknowledged. Both are not necessary.) December 12 2004 , 1. *Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1-2000 omey Michael H Foroeki 1830 Brackett Ave, Eau Claire WI 54701 -4627 Phone:(715) 835 -3029 Fax: (715) 835 -4112 Title One Premier Group T4630859.ZFX Reduced with ZipForm- by RE ForrtsNst, LLC 18025 Fifteen Mile Road, Clinton Township, Michigan 18035, (800) 3830805 J 2339P 29l 732'91Q>t9 STATE BAR OF WISCONSIN FORM t - 2000 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX Co., WI This Deed, made between Daniel G- Schmit and Pamela RECEIVED FOR RECORD J. Schmit, husband and wife; Troy M. Schmit and 07/30/2003 01:30PM Terri L. Schmit, husband and wife Grantor, WARRANTY DEED and Kurt Christensen and Elizabeth Christensen, EXEMPT It husband and wife as survivorship marital property REC FEE: 11.00 TRANS FEE: 534.00 Grantee. COPY FEE: Grantor, for a valuable consideration, conveys to Grantee the following CC FEE: described real estate in St. Croix County, State of PAGES: 1 Wisconsin (the "Property") (if more space is needed, please attach addendum): The West Half of the Northeast Quarter (W-t of NE , Section 7, Township 29 North, Range 15 West, Town of Springfield including Lots 1, 2, 3, and 4 of Recording Area Certified Survey Map recorded in Volume 17 on page Name and Return Address 4571 as Document No. 731948. Title One Premier Group, Inc. 706 19th Street South Hudson, Wisconsin 54016 034 - 1014 -20 -000; 034- 1014 -30 -000 Parcel Identification Number (PIN) Together with all appurtenant rights, title and interests. This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Roadways, Easements, and Restrictions of Record. Dated this 25th da f July 2003 -47—, * iel G. Schm' *Tr M. Schm't *Pamela J. Schmit * Terri L. Schmit 411TWENTICATIF O� aY pV�l; . ACKNOWLEDGMENT (,y STATE OF WISCONSIN ) Signature(s) 2' `' ) ss. St. Croix County. ) authenticated this day o Personally came before me this 25th day of July 2003 the above named Daniel G. Schmit and * 9 Pamela J. Schmit and TITLE: MEMBER STATE BAR OF �y M. Schmit andZerri L. Schmit (if not, to me known to be the person a - who executed authorized by §706.06, Wis. Stats.) the foe in i e knowledged the same. THIS INSTRUMENT WAS DRAFTED BY * V/ P alm Michael H. Foreeki, Attorney otary Public, State of Wisconsin Eau Claire, Wisconsin My Commission is permanent. (if not, state expiration date: I ( Signatures may be authenticated or acknowlcd ed. Both are not neces r 12 *Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1 -2000 ttomey Michael H Forecki 1830 Brackett Ave, Eau Claire WI 54701 -4627 Phone*. (715) 935-3029 Fax: (715)8354112 Kay Palm T3960714.ZFX Produced whh ZlpFormI by RE FormsNet LLC 19025 Fifteen Mile RoW, Clinton Township, Michipen 40035, (900) 393 iL 1i%1f3 %03 1i:�� N0.337 P002'003 A t CD 4 w N M M i 0 iq Y I Ir R t� �o n w ul < x N .r O Q m p 1 1 Ali = pw w a n» 111 73 1 948 VOL T OL99H H. 7SH REG NN I LL S EE T EE E NN R OF D� ST. CROIX CO.. NI RECEIVED FOR RECORD 07/24/2003 10:55AM CERTIFIED SURVEY MAP BEARINGS ARE REFERENCED TO THE Z REC FEE: 13.00 NORTH UNE OF THE NE1 /4 OF SECTION COPY FEE: 3.00 7, ASSUMED TO BEAR N90'00'00'E. PAGES: 2 N aparp_ I ( W EED .--------- ----- - - - - -- - - - - -. NORTH. 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