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034-1029-30-200
/• 1 1� 1 1� ' 1 1�� 1 1 1 /' 1 1 - I I - - 'v Y aF $�'r OI�Q�X soo.��stf������'vi►� + ' '�Aq, s► r ��T 0 htTS . o f � , z TN, DAN '3240 . 9 0TH AVENUE' , • G'NWgOD 41 546 7 A ., r •� •• 1 • • . •� +,• . . w �. COUNTY OF ST. CROIX STATE OF WISCONSIN pA�E CHE T�::NLJ VNQE? �+1 ©: -: VENDOR: WINE, DAN 12/04/08 01028194 777777 ...... C� OESCfi.4PTlON V 3UCht�R "N:,O AM.0.U.NT PAED 12 -01 -2008 OVERPAYMENT OF SEPTIC PERMIT 00139518 25.00 4 ® i i - Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Div;,ion INSPECTION REPORT Sanitary Permit No: L LGICNERAL 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: M g'y'- ' , 1 - City Village X Township Parcel Tax No: Collins, Harold 1 j I Springfield, Town of 034 - 1029 -30 -00 CST BM Elev: Insp. BM Elev: Description: Section/Town /Range /Map No: / U 6).0 1 / ' 00 ` U rk" 4 I 13.29.15.204(, TANK INFORMATION -�o V TION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic B nch mar k Dosing A . BM �} Aeration Bldg. Sewer !w t q/ ---- -4 7 . Holding St/Ht Inlet y' 3 TANK SETBACK INFORMATION SUHt Outlet TANK TO P/L WELL DG. Vent to Air Intake ROAD Dt Inlet Septic �r Dt Bottom Dosing > , Hea an. 3.3 d' Aeration Dist. Pipe %°p , 4: 1 ,, G �� Holding Bot. Syste y, , Final Grade / � f PCJMPlSIPHON INFORMATION kQQg�_W �— %d Manufacturer /J - Demand Si co ver / �9 GPM Model Number � 1:3 I 1� TDH Lift �., rictigp ss I Syster Fad T�H � Ft Z' (J'-� Forcemain Ler3 gtr Dia. Dist. to Well --� lv 1 2 l V' S5 /Z1 � l4• ill S IL ABSORPTION SYSTEM 2Cpbw At S -- lost Width .� L Length No. Of Trenches PIT DIIIDI =NSI S No, Of Pits Inside ia. Li ui epth D ENS ONS SETBACK SYSTEM TO 7 P/L JBLDG WELL LAKE/ REAM EA NG Manufacturer. INFORMATION A C BER OR Type tem: O(/ + NIT Model Number. DISTRI N SYSTE _ ! ' 0424 0-w Her: r/Manifol Dist ' ution r x Hole Size x Hole Spacing Vent to Air Intake Pipe(s / �` �� rr ✓ /2 �� ,y�tRi Length Dia L th Dia Spacing 3. SOIL COVER ure Systems Only xx Mound Or AV-Grade SysteMs Onl �d Depth Over Depth Over ept of Seed /S) xx Mulched Bed /Trench Center I---- Bed/Trench Edges To rf b - -- Yes (] No [ ] Yes j No COMMENTS: (include code discrepencies, persons present, etc.) Inspection #1: ( 7i /�/ Inspectior/ /© Location: 3240 90th Avenue Wilson WI 54027 (SE 1/4 SW 1/4 13 T29N R15W) NA Lot l Parcel oo :: 13.29.15.204 1.) Alt BM Description = I o Q b� 3 m k �� � f/c' i a/ t 2.) Bldg sewer length 4. 40 LX,O'�J`' ��_ / !�! �ww// - amount of cove � v U �, �— ��ZQ (�`��G — �O �u4�1 a � U Plan revision Required? - Yes No I Use other side for additional information. ` __o- - - -_ _O_ Date Insepctors Sign Cert. No. SBD -6710 (R.3 /97) c ommerce , wi.gov Safety and Buildinl7 Division County t . ,. 201 W. Washington Ave., P.O. Box 7162 Madison, WI 5 3 7 07 -7 1 6 a scon s anitary Permit Number (to be filled in by Co.) Department of Commerce a 5/S aZ Sanitary Permit Application State Transaction Number In accordance with s. Comm. 83 21(2), Wis. Adm. Code, submission of this form to the appropriate! governmental 7 unit is requited prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS are submitted to the Department of Commerce. Personal information you provide may be used for — Prot Add 7dtflerent th g address) RurPO in accordance with the Priva Law s. 15.0 1 m Slats. �{J� 3 I. Application Information — Please Print All In ation Property Owner' me ! Parcel # Property Owner's ailing Ad ress Property Location L�o •f^°f ST. CROIX _ , City, State Zip Code Phon P Go t t. tmt U)Ood S V-, I t. , Y- G ' Q� .. _ , Section 1 ,3 — .(circle ot'p� �II. Type of Building (check al t at apply) of # T_ N; R �_ E o yV ,X1 or 2 F� Iv Dw®ro_ mberof BedMY Subdivision Name /V om r{, loc Public /Comtncruiibe Use , ❑ City of ❑ State Owned — DeFribe Use (� CSrtil Number ❑ Village of w ��D tJd1. 20 Town of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New System ❑ Replacement System El TreatmenU g Tank Re Holdin lacement p Only El Other Modification to Existing System (explain) B. ❑ Permit Renewal El Permit Revision ❑ Change of Plumber List Previous Permit Number and Dave Issued Before Expiration g R ermit Transfer to / r I TYP ofPO System/Compone Check all th' appl 1 ❑NO" -Pressurized In- Ground ❑Pressurized In- Ground ❑ At- Grade ❑ Mound > 24 in, ofsuitable soil Mound < 24 in. of suitable soil Holding Tank ❑ Other Dispersal Component (explain) 0 �l Pretreatment Device (explain) V. Dis ersal/I'rea ent Area Information: Design Flow (gpd) Design Soil Application • gpdsf) Dispersal Area Re uir s q Dispersal Are ( System Elevation VI. 'Tank Info 5 Capacity in Total # of Manufacturer I Gallons Gallons Units c New Tanks Existing Tanks 0 u U �' r _ o N 2 a Septi r Holding Tank aU in H h w'0 y I hosing Chamber x _ \'IT. R esponsibility �Plwnber Statement- 1, the undersigned, assume responsibi it) for 'nstahatio t e POW'1'S s r the attached plans. 's Name (Print] b Signature Iv PR umber Business Phone Number Plumber's Address (Street, City, State, ip Code) ys� 1A V\ v, ,� d _ VIII. Count /De artmen Use Onl s 9,5 Approved isappro Permit Fee Date I sued I Issuing A t Signature $ Overt rven Keason enial � a IX. Condi"P f #rMMtd easons for Disapproval n 1. Septic tank, effluent filter and 3) �''ry t�A�C. ecy., - 1S 0. 46 V1% dispersal cell must all be services / maintained as per management plan provided by plumber. 2 AN setback requirements must be meintainetl as per aooYcahta / ordinances Attach to complete plans for the system and submit to the County o on paper not Ics than 8 1'� 1 chees n�e SBD -6398 (R. 0 1!07) Valid thru 01/09 r — �i 1 _ ,� �r s� .. �.- , .... , a,,.v,, , .r,,.�..vw�w,s r •, �� ....i C y: ' 4..r. F \ \ V • • J� �� +� �i 38's+S:;:Lt� - 3C:3:i 9id6viit�l2G ;�� i;E; � � � T- 11111 1 ... d F i ......... {..... ............ ....... ... ...... .. ... - i a I �........ .... i . ... ....... .... .:..........._i..... _.....y... , .....................j.... I.... T 1 : � � t i . i ... I . i i ; i � r i _ V_.t" ......... .... ..... ..... .... .... .._'. 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"............... ..... .__.......L� j t I : I Clarence Glotfelty �'U Enviro -Tech Systems & Services N4955 Sunny Hill Road Weyerhaeuser, WI 54895 We I? --�Eyp IN V Franklin Electric INSTRUCTION MANUAL Upper Volute Seal: Vell m i u o d gasket a INTRODUCTION pp s 9 Power Cord: 16 AWG 3- conductor copper stranded Franklin Electric Submersible Effluent Pumps are designed for Cooling: The motor housing contains a cooling use in normal sump and general dewatering applications where oil to provide cooling for the motor and higher pressure is required. The pump is designed for pumping to lubricate bearings and seals. These non- explosive, non - corrosive liquids with up to 3/4" spherical pumps are capable or operating with solids. Do not use for raw sewage. the motor housing partially exposed Automatic operation can be achieved with the use of the RFS for extended periods of time, providing Remote Float Switch. Other accessories such as basins, check sufficient motor cooling and bearing valves and covers are also available. lubrication, however, for the best cooling All models have a 1 -1/2" NPT discharge. Do not over - tighten and longest motor life, the liquid level being pumped should normally be above discharge pipe into pump volute discharge. the top of the cast iron motor housing. UNPACKING: SAFETY GUIDELINES: Franklin Electric pumps are carefully packaged, inspected and tested to ensure safe operation and delivery. When you receive [I( your pump, examine it carefully to determine that there are �> no broken or damaged parts that may have occurred during Risk of electrical shock. This pump is supplied with a grounding shipment. If damage has occurred, make notation and notify the conductor and /or grounding -type attachment plug. To reduce firm from which you purchased the pump and they will assist the risk of electric shock, be certain that it is connected to a you in replacement or repair, if required. properly grounded grounding -type receptacle. SPECIFICATIONS: Read all instructions and safety guidelines thoroughly. Failure to 'ischarge: 1 -1/2" NPT vertical follow the guidelines and the instructions could result in serious Handling Capabilities: 3/4" screened opening bodily injury and /or property damage.t Your effluent pump is equipped with a 3 -prong electrical plug. Housing: Cast iron The third prong is to ground the pump to prevent possible Volute: ABS plastic electrical shock hazard. Do not remove the third prong from the Impeller: Closed design with stainless steel wear plug. A separate branch circuit is recommended. Do not use an extension cord. ring When a pump is in a basin, etc., do not touch motor, pipes Motor: Single phase induction 1750 RPM, or water until unit is unplugged or shut off. If your installation with automatic reset thermal overload has water or moisture present, do not touch wet area until all protection Hardware: 300 Series stainless steel FIGURE 2. Bearing: Ball FLOW - LITERS /MINUTE Radial Bearing: Sleeve — Permanent lubrication 0 100 200 300 Shaft Seal: Mechanical, spring loaded, stationary 10 carbon with rotating ceramic seat 30 Impeller Seal: U -cup, Nitrile 8 Volute Seal: O -ring, formed Nitrile w Motor Housing/ 20 6 w o W FIGURE 1. = o 4 . -: _--- -- w 10 = 2 0 0 0 TnT • 63 0 20 40 60 80 FLOW - GALLONS /MINUTE A2 � p Safety and Buildings 4 N CREEKSIDE LA 382 commerce.wi.gov HOLMEN WI 54636 iscon Contact Through Relay www.commerce.vA.gov /sb/ Department of Commerce www.wisconsin.gov Jim Doyle, Governor Richard J. Leinenkugel, Secretary November 13, 2008 CUST ID No. 220728 ATTN.• POWTS Inspector CLARENCE L GLOTFELTY ZONING OFFICE ENVIRO -TECH SYSTEMS & SERVICE ST CROIX COUNTY SPIA N4955 SUNNY HILL RD 1101 CARMICHAEL RD WEYERHAEUSER WI 54895 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/13/2010 Identification Numbers Transaction ID No. 1608776 SITE: Site ID No. 744353 Dan Wine Please xefer tc b"A "dentificationnu�n�ers, 3240 90TH Ave abgve'em 4`11.eorres''ordence`with enc Town of Springfield St Croix County_ SE1 /4, SWl /4, S13, T29N, R15W FOR: Description: Four Bedroom Mound System / 4% slope Object Type: POWTS Component Manual Regulated Object ID No.: 1208499 Maintenance required; 450 GPD Flow rate; 18 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 101), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01 101) 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: Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of See. 145.20(2)(d), Wis. Stats. • The area within 15 feet horizontally down slope of the dispersal cell shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the effluent filter is required. Access to the filter for cleaning must be provided per Comm 84 product a" " - . S conditions. ,� • A co of the approved plans, specifications and this letter shall be on -site during constructi onen to nai't: 17 inspection by authorized re>iYesentatives of the Department which may include local in t i f ( U E DEPARTMENT OF COMMERCE DIVISION OF SAFETY AND BUILDINGS r CLARENCE L GLOTFELTY Page 2 11/13/2008 Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • 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). • 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 acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewer, Integrated Services (608)789 -7892, Mon - Fri, 7:15 am - 4:00 pm WxS , _s r oc7 jerry.swim@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. MOUND AND PRESSURE DISTRIBUTION - COMPONENT DESIGN R v JJA.* Kl Application „ INDEX AND TITLE PAGE co IQ o 0 Project Name: U m Owner's Name: 0.� ,t *-� o Owner's Address: �� �� AV z W Legal Description: y�l 5 k/L �'?) j i N 11 .� U) Township: `�j�� . • J A_ County: --�° ( ` 0 !�_ Subdivision Name: Lot Number. Block Number. Parcel I.D. Number Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve dnd specifications Designer 4 Desig License Num ber. �'� -0`7 rd/71 Date: Phone Number. 'Tim,(C¢ - Signature rsuant to the Mound Component Manual for POWTS Version, 0,,%T) ---` �tw.01, f, at-41 Pressure Distribution ./�nuoj 5BD 10700 -j Page 1 of V S CORkESPONGENLE . Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) Residential or Commercial Design Note: Sand fill (D) calculations assume a 3 00 Estimated Wastewater Flow (gpd) Table 8344 -3 in -situ soil treatment for fecal D Peaking Factor (e.g. 1.5 = 150 %) coliform of <= 36 inches. 75 C, Q:B9 Design Flow (gpd) Site Slope ( %) 97 ,5 Contour Line Elevation (ft) Depth to Limiting Factor (in) c In -situ Soil Application Rate (gpd/ft) Distribution Cell Information Dispersal Cell Length Along Contour (ft) = C�Cell Width (ft) D Dispersal Cell Design Loading Rate (gpd/ft Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Pressure Disribution Information network? Enter Y or N (c or e) r. I Center or End Manifold Lateral Spacing (ft) If N above, enter the elevation ft Ll Number of Laterals of the highest point. Orifice Diameter (in) (e.g. 0.25) Estimated Orifice Spacing (ft) = Q ft /orifice Forcemain Diameter (in) Forcemain Length (ft) Does the forcemain drain back? Pump Tank Elevation (ft) Enter Y or N Enter Y or N C System Head (ft) x 1.3 Forcemain Drainback (gal) ' Vertical Lift (ft) 5x Void Volume (gar Friction Loss (ft) Minimum Dose Volume (gal) Total Dynamic Head (ft) A System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia, options choice in. dia. options choice 0.75 1.25 1.00 1.50 1.25 2.00 1.50 X 3.00 2.00 � 3.00 Gallons /Inch Calculator (optional) Treatment Tank Information 250 1 Total Tank Capacity (gal) a.j Se tic ank Capacity (gal) S Total Working Liquid Depth (in) Manufacturer 1 gal /in (enter result in cell B49) Dose Tan P Information Effluent Filter Information 1:50 1 Dose Tank Capacity (gal) Filter Manufacturer Dose Tank Volume (gal /in) / Filter Model Number Manufacturer (,) n 5 04, - 154) Project: `� nn� Page 2 of is (,J Yom. Mound Plan View ..................................... 1110B.*.*. ........ Observation Pipe K A W B —40 .......... ... ......................................... ......................................... ......................................... ......................................... .................... ...... ..... .. .. ..... . ................................ ... ...... Mound Component Dimensions A ft E in H ft K ft BL— ft F in I a ft L f I (q c D in G ft J1 70 7 ft W ft (fe) Dispersal Cell Area (if) Basal Area Available (gpd/ft) Linear Loading Rate (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade /00. (ft) 1 F Dispersal Cell (11) Lateral Cell (ft) Invert .............. Dispersal Cell Elevation E D .... ............ 11 { } • i ' 7 ' • . • ?75 (ft) Contour Elevation % Site Slope Geotextile Fabric Cover Shading Key 71 T Dispersal Cell See lateral details on Topsoil Cap 1.5 ft Page 4 for number, size, and spacing of laterals. F2] Subsoil Cap 0 0 �¢ ASTM C33 Sand F Laterals are equally Tilled Layer 0.5 ft Typical Lateral _ spaced from the Aggregate distribution cell's i 0 centerline in th e A distribution cell (AxB). Project: Page 3 of Center Connection Lateral Layout Daigram Force main correction via tee or cross to manifold at any point, Laterals are identical 1 E P 2L •r Turn -up wf bell wive or I4- X —+ � .t2 d2 +I Laterals & force main of PVC Soh 40 clesnoutplug per COMM Table 84.30 -5 Holes drilled on the bottom of the lateral. Number of Laterals Orifice Diameter ./aS ./a in Lateral Diameter E k�3 Orifice Spacing (X) o ft Lateral Length (P) Orifices per Lateral Lateral Spacing (S) , .Q ft Orifice Density �, ft Lateral Flow Rate - _ gpm Manifold Length ft y n System Flow Rate 93 gpm Manifold Diameter /, S in Total Dynamic Head EI�N Fomemain Velocity .3 S j fttsec SEPTIC TANK AND PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS Locking Cover wdk warning Iebek. Access Weamer Proof Junction Box. coming, not top of cover. Efectr" as Der NEC 300 ano Vent Pips coming, Cetera at kern 4' Comm 16.28 WAC > 17 above grace above finothed Access opening, net top grace. � of Cover. must extend to : Maernwn Cover over Tank r 0 a Pont no greater than 6 bakm fawned grave. _ ^ onconnect 23' Min. Openng 18' inn. F— Aremato sutler location It 23 Min. Approved Face Main diameter Buidi g artken WA Men leflgin sewer <d t/8' � .f •✓ prow Cale � !� ,M Weep tale or anb . • \ I L(. 8 arpflbrn devae. 57 F i` .-- D I A.eoaeB.v. [Or Bad and teckkm tank somakg to mnk9aehaars awalkatiae AnCran Irks as necessary to nepan buoyan rates• Note: AN pipe and vent materials comply with Comm 84. Tank Manufacturer. Doses Per Day: Tank Sizes: Septic Gallons GPD/ # of Doses: e ��galbn_ 5*.s0PAY Pump 5D— Gallons Bac:WloW. la , igallons 75) 16 y Gallons Per Inch: Total Dose Volume: Ale galloris I Liquid Level: (, a`7 Required GPM: j Pump Manufacturer. [_e Dimensions inches Gallons Pump Model: y B r Alarm Manufacturer5 o f e.0 C s L ct� D , Alarm Model: M Lo I t) Total c J Vertical Difference between pump off and distribution pipe i J Minimum Required Supply Pressure (0 for dosed conventional) _ Feet of force main x friction factor 1 100 x i Piro: �! he Total Dynam - _J Oy mlc Head 4 - 8 3 7 pb g Mound S Maintenance and Operation Specifications Service Provider's Name 'Zw;e � Phone 715 POWTS Regulator's Name X Count Zonin Phone 715 &Qf Sy stem Flow and Load Parameters Design Flow - Peak 3ob gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average gpd Maximum BOD5 220 mg/L Septic Tank Capacity gal Maximum TSS 150 mg/L Soil Absorption Component Size ft Maximum FOG 30 mg/L Type of Wastewaterl Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect once a year and clean once every 3 years Purnp and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals flushed and pressure tested once every 1.5 years Mound Inspect once every 3 years Other Miscellaneous Construction and Materials StatndardS 1. Observation pipe materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 3. Tillage of the basal area is accomplished with a mold board or chisel plow. 4. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion. Lateral Turn -up Detail Finished " ••.•• so wool Grade Threaded Cleanoul 6" Diameter Lawn Plug or Ball Valve Sprinkler Valve Box Distribution Lateral Long Sweep go or Two 45 Degree Bends Same Diameter as Lateral Project: page a Pro i U)) Ae— N I • J • ew Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code Septic Tank , The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution Svstem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil conpaction may hinder aeration of he infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulched for frost protection. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure testis peformed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [SBD- 10572 -P (R. 6/99)] and local or state rules pertaining to system maintence and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. Continuencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be repaired or replaced immediately with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions on the operation, n ma'ntence of this system should be directed to your county zoning or health inspector. �roJ(1 -j U i her �3 8ia!8'9i VOL 20 PAGE 5111 HATHERM H. WALSH REGISTER OF DEEDS ST. CROIR CO.. NI RECEIVED FOR RECORD 11/23/2005 03:00PH CERTIFIED SURVEY MAP NO. 5111 CERTIFIED SURVEY MAP REC FEE. 13.00 VOLUME 20 , PAGE 5111 PAG 3'00 PAGES PART OF THE SOUTHEAST QUARTER OF THE SOUTHWEST QUARTER, SECTION 13, TOWNSHIP 29 NORTH, RANGE 15 WEST, TOWN OF SPRINGFIELD, ST_ CROIX COUNTY, WISCONSIN _LA_N_DS_ UNPLATTED North line. - - - -- of SE /SW NW corner l N89'02'59 " 1207.41' / LOT 3 SE /SW LOT 2 236,641 sq.ft. 5.43 acres PREPARED FOR: 906,398 sq.ft. 891,970 sq. ft. inct. r -o -w DANIEL WINE `�� �, 20.80 acres 20.48 acres 00 1160 260th ST. �° ' incl. r - o - w not incl. r - o - w,` Glenwood City, WI �o �� / w 227,750 sq. ft. ^� ' " 5.23 acres OWNERS: i /' �aenterli DANIEL WINE 473.05' ne or not incl. r -o -w HAROLD Y - 'run N89'11'O6 "E N Z / 75' setback tine 324./ 0. O zo N89'71'06 "E 0 I Z t A Z A A O W °p r+ 0 00 - - LAgT 1 0 LOT 3 435,600 sq.ft. soil tests z N �„� I�y 1 rn 0 10.00 acres OD o. Im l� C incl. r -o -w o 'a w to w 'rn A madel Sc NN soil test's \l76nd DRAFTED BY: „° barn j Joel A. Brandt ° g r ad JB SURVEYING LLC 421,510 sq. ft. ° �; 9 966 Rustic Rd 3 9.68 acres -.Z L , o o_ Glenwood City, WI not incl. r -o -w r ° „ w shed a w w building setba li _ _ _ — , _ _ _ _ �" — — — — — - - S88'59'42 "W .68' w SW corner proposed existing 33.00' SE /SW 29.00' d veway $ 30.5T driveway 32.13' 272.33' 461.J 1305.71' 473. 59. 274.00' 99. 00, � 589'11'06 "W — \_ _ S89'11 06"W _4 3_05 _ S89' 6 "W� _589'11 06 W POD S89'11'O6 90th AVE. / South 1/4 Corner Southwest Corner centerline — — — proposed Section 13 -29 -15 589'11'06 "W 1206.71' driveway Section 13 -29 -15 Found Survey Mork Nail 2611.42' Found I' Iron Pipe UNPI.ATTED LANDS Note: Each parcel on this map is subject to State and County laws, rules and regulations (i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office for advice. tiV SCALE: 1" = 250' JOEL A. ! MANOT YYEOS 0' 250' 500' ©LEWAPOOO CITY , LEGEND Q \x\05 North is referenced to the ._...,.,..Government Corner (as noted) South Line of the Southwest Quarter of Sec. 13 29 - 15, o.......... Set 3/4" x 18" iron rebar which bears S89 °11'06 "W weighing 1.502 lbs. /lineal ff. Page 1 of 2 (St. Croix County Grid System) Vol.20 Page 5111 111, 111 3 * 8 4 7 5 7 5 2 847575 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 04/02/2007 11:45AN WARRANTY DEED EXEMPT II REC FEE: 13.00 TRANS FEE: 1020.00 Parcel ID: 0341029 -30 -100 PAGES: 2 034- 1029 - 30-200 034- 1029 - 30-300 This Deed, made between Winifred S. Collins, a single woman Grantor(s), and Daniel Wine and, a single man, Grantee($). Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate In Saint Croix County, State of Wisconsin: B„m TM Ard*r Land Tftle, Inc. 8850 Teleoorn Drive Sdie 181} A certain tract or parcel of land in Saint Croix County, Indlenapols, IN 48278 In the State of Wisconsin, described as follows: Lots 1, 2, and 3, Certified Survey Map No. 5111, as recorded in Volume 20, Certified Survey Maps, p. 5111, being part of the Southeast Quarter of the Southwest Quarter of Section 13, Township 29 North, mange 15 West, Town of Springfield, St. Croix County, Wisconsin. Property Address (for Informational Purposes Only): 3240 90th Ave. Glenwood City, WI 54013 This (is) (is not) homestead property (clrcle one). Together will all and singular the hereditaments and appurtenances thereunto belonging; and Grantor warrants that the tine is good, indefeasible in fee simple and free and clear of encumberances except: 1 of 2 r Safety and Buildings'Division County IV ' W 201 W. Washington Ave., P.O. Box 7162 Madison, WI 53707 - 7162 ���S�n Sanitary Permit Number (to be filled in by Co.) Department of Commerce c; A (608) 266 -3151 . Sanitary Permit A a s - EI VED State Plan I.D. Number In accord with Comm 83.2 1, Wis. Adm. Code, persona inform u provide may be used for secondary purposes Privacy w, sl ), b a C ll (� Project Ad ress (if different than mailing address) 7 7 A � I. Application Information - Please Print All Information ST. CR -3 z z/O / -3 0 Pro Owner's Name 7 'arcel !1 ^�� Block g Property Owner's Mailing Address r'( /� , e Property Location Q � l 7 _ _ Cr., Z City, State Zip Code S � >%, Section_ _ I Phone Number II. Type of Building (check all th t pply) (I X 1 or2 Family Dwelling -Number of Bedrooms ✓ 0 _ Subdivision Name CSMNumber El Public /Commercial - Describe Use �- ❑ State Owned - Describe Use (/1 i iy, (� ❑City ❑vi aTownshi Ill. Type of Permit: (Check only one box on line A. Complete line B if applicable) rl A. New System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: Check all that appl ❑ Non - Pressurized In- Ground El Mound _> 24 in. of suitable soil ( Mound <24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter �0/ Constructed Wetland El Pressurized In ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit El Recirculating Sand Filter El Recirculating Synthetic Media Filter 11 Leaching Chamber ❑ Drip Line ❑ V. Dispersal/Treat ersal/ C:, ^vel -less ipe ❑ Other (explain) t` I'reatment Area Information: Design Flow(gpd) Design Soil Application te(gpds� . Dispersal Area Requir (sf) Dispersal Area Pro 0 .. ..�;//j� p (sf) System Elevation VI. Tank Info Capacity in Total Number Manufacturer Pr b Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Hetding�nxk y 0 P - 1 50 I Aerobic Treatment /\ --� .. 't Dosing Chamber VII. Responsibility Statement I, the anders' ed, assume re s onsibility r install tion.of the POWTS shown on the attached plans. PI tier's Name (Print) b Signature /MFRS umber Business Phone Number r t 8 583 Plumber's�Address (street, ity, Sta , ZI e) /V .L5 ; / _S 915 QUASe VIII. un /De artment a Onl Sanitary Perm Fee ee include PProved Disapproved ry (includes Groundwater ___ Date Issued ng A Si � ps) Surchar a Fee � g ) t� ❑Owner Given Reason for Denial IX. Cond itions of Approval/Reasons for Disapproval kk S' - B nWNfR ( 7dispersal pc tank, effluent filter and cell must all be J@rvic2d /maintai IF as per management plan provided by plumber L 2. All setback requirements must he maint� as per applicable code /ordinances. ae& Cwt 3. Y3 . Attach complete plans (to the Couoty only) for the system on paper not less than 8112 :11 inc n io aize� S t SBD -6398 (R. 01/03) ..... ..... :_....._.",___ .. ......_... ....... ✓/nw _ ..... ............ .......... . ... } M _ --------- _...._. _ a RAC Nei _�.e� • ; _... , Y w_ , i R , ; 1 ••----- •+- -.- .-._.. _.,,�,_____ _ i _rte � �'�" : i t i r i i r- _ i i , i -.— . , - - _ ...... - -- - - -- - _- , J { , a(?L,L.a4eLl LL � w . ......... ? : : Clarence Glotfelty Enviro-Tech Systems & Services N4955 Sunny Hill Road '� Weyerhaeuser, WI 54895 CLU FL r Safety and Buildings PO BOX 7162 Co11m111e1'Ce.Wl.gov MADISON WI 53707 -7162 TDD #: (608) 264-8777 i s c o n s i n www•comm www.vAsconsin.gov www.wisconsin.gov Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary August 25, 2005 CUST ID No. 220728 ATTN: POWTS Inspector CLARENCE L GLOTFELTY ZONING OFFICE ENVIRO -TECH SYSTEMS & SERVICE ST CROIX COUNTY SPIA N4955 SUNNY HILL RD 1101 CARMICHAEL RD WEYERHAEUSER WI 54895 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/25/2007 Identification Numbers Transaction H) No. 1188428 SITE: Site ID No. 703476 Dan Wine - Dwelling aA, Please refer to both identification numbers, 3240 90TH Aver L above, in all correspondence with the agency, Town of Springfield, 54013 St Croix County SE1A, SW 1/4, S13, T29N, R15 , Lot: 1 FOR: Description: New Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1035534 Maintenance required; 600 GPD.Flow rate; 18 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.01 101); Biofilter 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. 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: 1. This system is to be constructed and located in accordance with the approved plans and with the component manuals listed above. 2. The soil test plot plan does not show all of the lot lines or provide the parcel size as specified in s. Comm 85.40(3)(a)4., Wis. Adm. Code. 3. On pages 2 and 4, the following adjustment was made to the total dynamic head (TDH) as specified in the approved pressure distribution component manual: a. Lateral flow rate = 5.754 gpm co' - "" � System flow rate = 23.06 gpm Friction loss = 5.1 feet A F , i TDH =17.6 feet DEPT Force main velocity = 2.35 ft/sec DIVISi t iFf 4. On page 3, concerning the mound system cross section, the slope is actually 7 percent. SEE COQ CLARENCE L GLOTFELTY Page 2 8/25/2005 ' 5. On page 4, concerning the pump switch settings, the total liquid depth of the dose tank is actually 45 inches. 6. On page 8, the lot lines or the parcel size were not shown as specified in the approved mound system component manual. This approval assumes that the actual lot line locations will not impact any part of the onsite sewage system and that the entire system is located on the same parcel as the residence it serves. 7. On page 8, 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. 8. On page 8, the system plot plan must show two -foot contours or other appropriate contour interval within the system area as specified in the approved mound system component manual. The single contour line shown does not satisfy this requirement. 9. On page 8, the dwelling will actually have four (4) bedrooms. 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. i Sincerely Fee Required $ 175.00 Fee Received $ 175.00 n Balance Due $ 0.00 P e ter�a g Private Sewage Plan wer , Integrated Services WiSMART code: 7633 (608)266-2889, M - F 630 - 1500 Hrs pepagel@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 MOUND AND PRESSURE DISTRIBUTION "COMPONENT DE21 I��/ Commercial Application VE[� INDEX AND TITLE PAGE 4 00 1 8 Zoo 5 Project Name: Y ( S �� BOGS, Owners Name: Owners Address: Legal Description: St= YZ I SU-) Yc/ 5 z -,H Township: �r County: ?►- I ?`� X Subdivision Name: _._.._..__ -___ ..._...... Lot Number. - "- Block Number Parcel I.D. Number Plan Transaction No.: Papp Index and title Pa e 2 Data entry Mound drawings Lateral and dose tank / WPag System maintenance specifications w rit rn - Page 6 Management and contingency plan CORRECTIC'N NEEDED Page 7 Pump curve cind specifications SEE CORR aG� Designer itr QM o ° -�,� License Number. r Date: — per one Number. -7 IS k Sl ed SP8 Signat • T, Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SOB- 10691 -P (N. 01/01), and 's SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 4.0 (R. 04/03) Page 1 of Gs 3Pp r_ I l Mound and Pressure Distribution Component Design , Design Worksheet Site Information (r or c) (' j Residential or Commercial Design Note: Sand fill (D) calculations assume a DO I Estimated Wastewater Flow (gpd) Table 8344.3 in -situ soil treatment for fecal D Peaking Factor (e.g. 1.5 = 150%) colifom, of — 36 inches. 0.00 Design Flow (gpd) Site Slope ( %) 8 Contour Line Elevation (ft) Depth to Limiting Factor (in) In -situ Soil Application Rate (gpd /ft`) Distribution Call Information Dispersal Call Length Along Contour (ft) _ ®Cell Width (ft) r, O Dispersal Cell Design Loading Rate (gpd/ft Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution I Al Pressure Disribution Information network? Enter Y or N (c or e) Center or End Manifold Lateral Spacing (ft) If N above, enter the elevation ft Number of Laterals of the highest point. Orifice Diameter (in) (e.g. 0.25) 3 Estimated Orifice Spacing (ft) _ ft /orifice Forcemain Diameter (in) Forcemain Length (ft) Does the forcemain drain back? )V Pump Tank Elevation (ft) EnterY or N Enter Y or N 5 System Head (ft) x 1.3 — ,� Forcemain Drainback (gal) 8 oiloy Vertical hft (ft) 5x Void Volume (gaq(y1 5 Xy) x . p9;L n ion oss mi Minimum Dose Volume (ga!) ' Total n ' Y System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 1.00 1.50 1.25 2.00 1.50 3.00 2.00 3.00 Gallons/inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) o ;1iln I Septic Tank Capacity (gal) yy. Total Working Liquid Depth (in) Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information Dose Tank Capacity (gal) _ Filter Manufacturer Dose Tank Volume (gal /in) 5 T ` I Filter Model Number Manufacturer Project: Page 2 ofB i MOUND PLAN VIEW observation pipes (typical) T ' 1/68 _ A= 6,0 ft I J = ft W B I = ft I K K= ft 1/68 = .j ft LSP VVA typ. obs. pipe (anchored securely) I = down slope dimension = absorption cell (AxB) J = up slope dimension = plowed area (LxW) K = end slope dimension 6 .. MOUND CROSS SECTION subsoil cap D = in lateral topsoil H E = 3 in invert Via ft - __ -- - -- F _ in elev. - - - - -- :F G = 6.0 D in T ASTM C33 H = 12.0 in Sand Fill E Sys. �ft = elev. E =ft contour Q slope Fp Q D = upslope fill depth plowed layer g �P E = downslope fill depth Note: Absorption cell media will consist F = absorption cell depth of aggregate and pipe with laterals G = subsoil + topsoil depth at cell wall centered across AxB media. The cell H = subsoil + topsoil depth at cell center media is covered with geotextile fabric. Designer notes: J Project: Transaction Number: Page 3of g a Center Connection Lateral Layout Daigram Fora main connection via tee or cross to manifold at ang point. Laterals are identical r i IE P S •- Turn-up udball valve or olanoutplup IE X- -��Ed2 xt2 +I Lxaals !f force main of PVC Soft 40 per CONtIN Table 84.30.6 Holes driled an tfie bottom of the lateral. Number of Laterals Orifice Diameter in Lateral Diameter in Orifice Spacing (X ft Lateral Length (P) ft Orifices per Lateral Lateral S acin S) ft Orifice Density zo ft /orifice eras F Manifold Length - ft e MID M r :;L,0 in o a ynamic Forcemai SEPTIC TANK AND PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS r� ��'' �•> �� (� ��� � Locking cover with warning soar. ACCeaa Wewher Proof Junction Box. Vow Pipe openag, not too of cover. Electrcat as ow NEC 300 and 12' above grade must extem at teear !• Comm 16.28 WAC , above firtahed grade. z.• Aecess opening, not top of dinar. must w to a poke the n Maximum Cover over Tank no greater tha 6 � below finished grade. * Disconnect zr Min. opening I ' t8'mn <.— Atemate 1 outlet I kcau n II ope ApPrewtl Face Main oianater6�° DP�9 it eeklars filter — I }— ones Main Length L.Cil (V- I � - - Il i • • OW h alo or nd - 5-T1100 I D Punpoetaen.0 w 1 Does Tares Elva. 10 1 ow aria backs tank Wcordktg to maalactuers sosedkwom Anchor tall as necessary to negate taayard fmce` Note. All pipe and vent materials comply with Comm 84. Tank Manufacturer. 7 "`- Doses Per pay: ( Tank Sizes: Septic v Gallons GPD/ # of Doses: Z0 gallons Pump .,Q Gallons Backfiow: i gallons Gallons Per Inch :12 t L Total Dose Volume: f" ► gallons Liquid Level: Required GPM: &=.# - Pump Manufacturer. a �l mensions I Inches Gallons Pump Model: Al { t A B Alarm Manufacturer. (� 0 Alarm Model: 0 i Total Vertical Difference between pump off and distribution pipe Minimum R squired Supply Pressure (0 for dosed conventional) ` $EE �Jr�i� c LJCiVI.G /? Feet of force main x &5 friction factor/ 100 Total Dynamic Head C- �� /, Mound S I tem Maintenance and Operation Specifications Service Provider's Name Phone 715 POWTS Regulator's Name /t�ix Count Zonin Phone 715 ( System Flow and Load Parameters Design Flow - Peak gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average gpd Maximum BOD5 220 mg/L Septic Tank Capacity .6 gal Maximum TSS 150 mg/L Soil Absorption Component Size ft Maximum FOG 30 mg/L Type of Wastewater LE c Maximum Fecal Coliform 1 >10E4 1 cfu /100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect once a year and clean once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals flushed and pressure tested once eve 1.5 years Mound inspect once every 3 years Other Miscellaneous Construction and Materials Statndards 1. Observation pipe materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. All gravity and pressure piping materials conform to the requirements in Comm B4, Wis. Adm. Code. 3. Tillage of the basal area is accomplished with a mold board or chisel plow. 4. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion. Lateral Turn -up Detail Finished ......................•• .............................. Grade 6" Diameter Lawn Threaded Cleanaut Sprinkler Valve Box Plug or Bali Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: : _ Page > d- 8 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code _Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil conpaction may hinder aeration of he infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulched for frost protection. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure testis peformed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [SBD- 10572 -P (R. 6/99)] and local or state rules pertaining to system maintence and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tang. Continaencv Plan. If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be repaired or replaced immediately with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions on the operatiorl t_ence of this system should be directed to your county zoning or health inspector. r Pt �s 4 13/16 7 7/16 W W HEAD CAPACITY CURVE MODELS 137/139 L+- 6 1/8 4 MODELS 137/139 Ft. Meters Gal. Ltrs. e 5 1.52 93 352 0 4 13/16 zs 10 3.05 79 299 2 15 4.57 64 242 ° y e ' 20 6.10 36 136 ° 1 1/2' - 11 I/2 NPT 3 1 s 25 7.62 8 30 4 137,139 30 9.14 10 Lock Valve: 26 ft. s I 13 o U.S. GALLONS 10 20 30 41 50 60 1 70 80 90 100 110 r LITERS 80 160 240 320 400 I I 4 0 FLOW PER MINUTE 514173 009921 CONSULT FACTORY FOR SPECIAL APPLICATIONS o Three phase pumps are available in 200/208V, 230V or 460V. • Variable level control switches are available for controlling single and three • Electrical alternators, for duplex systems, are available and supplied with phase systems. an alarm. • Double piggyback variable level float switches are available for variable Mechanical alternators, for duplex systems, are available with or without level long cycle controls. alarm switches. 4 Over 130 °F. (54 °C.) special quotation required. • Combination starters are available for 3 phase pumps. • Refer to FM0806 for 200° F. applications. Control alarm systems are available for 1 phase pumps. 137 Series - 47 lbs. 139 Series - 51 lbs. SELECTION GUIDE Single Seal Control Selection Lisen s 1. Integral float operated 2 pole mechanical switch, no external control required. Model Volts -Ph Mode Amps Simplex I Duplex CSA UL M137/139 115 1 Auto 10.7 1 or 1 &8 - -- Y Y 2. Single piggyback variable level float switch or double piggyback variable level N137/139 115 1 Non 10.7 2 or 2 & 7 3 or 5 & 6 Y Y float switch. Refer to FM0447. 8NI37 115 1 Auto 10.7 " Y Y 3. Mechanical alternator M -Pak 10 -0072 or 10.0075. Refer to FMO495 D137/139 230 1 Auto 5.8 1 or 1 & 8 -- Y Y 4 E1371139 230 1 Non 5.8 2or2 &7 3or5 &6 Y Y . Combination Starter. Refer to FM0514. H137/139 200 - 208 1 Auto 6.2 1&8 Y N 5. See FM0712 for correct model of Electrical Allemalor E - Pak. 11371139 200.208 1 Nan 6.2 2& 7 3 or 5 & 6 Y I N 6. Variable level control switch 10.0225 used as a control activator, specify duplex J1371139 200.206 3 Non 2.6 2&4 3 &4 or 5 &6 Y Y 1137 39 230 3 Non 2.6 2 & 4 3 &4 or 5 &6 Y Y (3) or (4) float system. 6137 1 460 3 Non 1 1.4 2 &4 3 &4 or 5&6 N N 7. Four (4) hole J junction box, for watertight connection for hardwired simplex G139 460 3 Non 1 1.4 2&4 3 &4 or 5 &6 N N operation, 10 - 0002. No molded plug "Single piggyback switch included. 8. Two (2) hole J -Pak, for Watertight hardwired Pconnection or splice, 10.0003. Pumps must be operated in upright position. CAUTION Three phase units require a control switch to operate an external magnetic or combination starter. All installation of controls, protection devices and wiring should be done by For information on additional Zoeller products refer to catalog on Combination starter, FMOS14; a qualified licensed electrician. All electrical and safety codes should be Pl ggybackVarlablelevei Float Switches, FM0477: Electrical Alternator, FMO486 Mechanical Allema- followed including the most recent National Electric Code (NEC) and the tor, FM0495; Alarm Package, FM0732; and Sump/Sewage Basins, FM0487. Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL f0: P.O. BOX 16347 ZLouisville, KY 40256 -0347 Manufacturers of.. Z ® LL L. / 1 SHIP v , K Cane l Road Louisville, KY 40211.11-1 961 /Jv,���PuaPS S MCE ��4747 I PL/" !O. (502) 778- 2731.1(800) 928 -PUMP FAX (502) 774 -3624 �� e. 7 W5 . .... ..... . .. ... . ..... . ... . ............ .......... ........... ....... ...... ot. ..................... ............ ................... 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I _nsin Deoartment of Commer Q 501 EVALUATION REPORT �/� Pr,,n I r, 3 Divjsion of Safe a ^^ " - �`75 - -- w - etr` Comm 8 Vic mrr vode Courlty St. Croix i Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must i i include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. Z end _�� percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 03 Please print all Information. rRewea) Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 1 .. i to �� Property Owner Property Location ■ Dan Winc Govt. Lot SE 1/4 SW 1/4 S 13 T 29 N R 15 E (or) Property Owner's Mailing Address Lot # Block # Subd. Na or �� CS �� M "" # /� / t fb 1160 260th Street 1 U & /UL G��`�ca -1 — �/ City State Zip Code Phone Number [] City Village ■ Town if Nearest Road Glenwood City I W[ 1 54013 ( 7) 5 688 - 9282 90th Avenue 0 New Construction Use;D Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD © Replacement Public or commercial - Describe: Parent material Loess over Glacial till Flood Plain elevation if applicable N ft. General comments This site is suitable for a mounds stem with limitations being at 18 inches and recommendations: Y• 1 17 Boring # ® Boring Q Pit Ground surface elev. 99.15 ft. Depth to limiting factor 18 in, Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I 'Eff#1 'Eff#2 1 0 -9 10yr3/2 sil 2msbk dsh as 2f .6 .8 2 9 -18 10 r sil' 2msbk dsh cw If .6 .8 3 18 -26 10yr4 /4 Cf5yr5 /8 sil I msbk dsh _ _ ,4 .6 2 ]Boring# ® Boring 96._5 18 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. Munseii Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -8 10yr3 12 sil 2msbk dsh as 2f .6 ,8 2 8 -18 1 O - A 2msbk dsh ew 1 f .6 .8 3 18-28 IOyr4 /4 Cf5yr518 sil lmsbk dsh - _ 4 6 ' Effluent #1 = BO D > 30 1 220 mg/L and TSS >30 < 150 mg/L " Effluent #2 = BOD < 30 mg/L and TSS _< 30 mg/L CST Name (Please Print) Signature CST Number Thomas C Nelson -- ' Oe 227387 Address Date Evaiu lion Condu Telephone Number IA17 17llth Ctrnnt Afnnr Dinhmn ».l 1TIT Q �r u O (� 71 C ')AA 14,;A Property Owner Wine _ Parcel ID # fending Page 2 of 3 3 Borin # Boring g Pit Ground surface elev. 96.20 ft. Depth to limiting factor 18 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 l 0 -8 IOyr3 /2 - sil 2msbk dsh as 2f .6 .8 2 8 -18 10 r4/4 - sil 2msbk dsh cw if .6 .8 3 18-27 10yr4 /4 t2f5yr5 /8 sil Imsbk dsh - - . 4 .6 F-1 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 /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring F-1 Boring # Ground surface elev. ft. Depth to limiting factor in. Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Q u. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 -264 -8777. SBD- 8330Test (R.07 /00) 625 Fourth Avenue South ,. Minneapolis, Minnesota 55415 ` L f LUTHERAN ®BROTHERHOOD January 29, 1998 Vicky L Wine 429A Highway 35S Hudson WI 54016 Contract 2606225 Dear Ms Wine, This contract contains the Guaranteed Increase Option Benefit. This benefit provides the opportunity to increase the face amount of the contract, without proof of insurability, at various times. If you choose to take advantage of this option, you may do so between February 5, 1998 and May 5, 1998. Please refer to the rider page in your contract for specific details. In addition to the right to increase insurance coverage, we will provide $25,000.00 Term Insurance during the period the additional increase option is in effect. This term insurance will expire on May 5, 1998. If you elect to increase the face amount of this contract according to the terms of the Guaranteed Increase Option Benefit, a special credit of $1.25 per $1,000 of increase is available. This credit will be applied to the cash value of your contract. For further information and help in taking advantage of this offer, please contact your Lutheran Brotherhood representative: John A Bostrom LUTCF PO Box 146 Menomonie WI 54751 Telephone (715) 235 -9170 Si cerely, Don Yager, Manager Policy Service Department GIOAG 0- 0008577 00360 + I = �a . Den Wine s�a1e BM1 Top of Iron pipe 100,00' 002 Top of iron pipe 95.30' Lot 1 8199.15' 132 86.25' w 95.20' i i or a B b y ea 5,2 e Thomas Nelson -� 2V387 625 Fourth Avenue South Minneapolis, Minnesota 55415 ` L LUTHERAN ®BROTHERHOOD January '5, 1997 Vicky L Wine 429A Highway 35S Hudson WI 54016 KEEP THIS NOTICE WITH CONTRACT 2606225 COST OF LIVING BENEFIT AUTOMATIC INCREASE NOTICE EFFECTIVE ANNIVERSARY DATE: February 5, 1997 AMOUNT OF INCREASE: $2,000.00 NEW FACE AMOUNT: $58,000.00 The face amount of this contract increases automatically as of the effective date shown above. An additional premium of $11.00 will increase the annual premium to $319.01. The face amount and premium are increased by the same percentage. As consumer costs rise, the Cost of Living Benefit is designed to meet the need for additional insurance coverage. This increase in coverage is based upon the Consumer Price Index and is made without proof of insurability. Your billed premium has been increased in the same proportion as the increase in the face amount. This premium change will continue the pattern of funding you established in the past. It is a good idea to annually review your needs, current premiums and amount of coverage with your Lutheran Brotherhood representative. You have the option to decline the increase. To do so, written authorization signed by the contract owner must be received in our office prior to the effective date. If this increase is declined, the benefit will be removed from the contract and no increases will be offered in the future. If you have any questions or would like assistance with any part of your financial program, please contact your Lutheran Brotherhood representative: John A Bostrom LUTCF, PO Box 146, Menomonie WI 54751, Telephone (715) 235 -9170. Marsha Cameron, Manager Universal Life Section Policy Service Department COLAI 2A 0- 0008577 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP Q Owner/Buyer y /�a ✓�r "'U' ! Mailing Address /l60- agu" , + Property Address (to 70 ,�,�" � 2dd X1 J (Verification required from Planning & Zoning Department for new construction.) City /State Parcel Identification Number O 3�- /M- - 30-Ood o LEGAL DESCRIPTION Property Location p y F ' /4 , SW '/4 ,Sec. I �j , T jd_N R _jc,_W, Town of " Subdivision MAt g ( , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # Volume �� , Page # Spec house yes no Lot lines identifiable (yes no 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 §Comm. 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. I /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I /we certif hat all statements on this form are true to the best of m /our knowledge. I /we am/are the owners fY Y g owner( s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Numbe bedrooms N O^t U 4- ( ,4 9 / 3d / os SIGNATURE OF APPLICANT(S) 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) POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page _J_ of w FILE INFORMATION Pv SYSTEM SPECIFICATIONS Owner Septic Tank Capacity a l ❑ NA Permit # Septic Tank Manufacturer ,� ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model I on ❑ NA Number of Public Facility Units Pump Tank Capacity -SID ga l ❑ NA Estimated flow (average) gal /day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) gal /day Pump Manufacturer ❑ NA Soil Application Rate �..( al /day /ftz Pump Model 8 ❑ NA Standard Influent /Effluent Quality Monthly average Pretreatment Unit NA Fats, Oil & Grease (F G) <_30 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BO ) <_220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L ❑ In- Ground (gravity) ,In- Ground (pressurized) Total Suspended Solids (TSS) :530 mg /LJ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) < 100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in di ❑ NA Other: l� NA Other: NA Other: J; NA *Values typical for domestic wastewater and septic tank effluent. Other: 4A MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 y ears) ❑ NA years) Pump out contents of tank(s) When combined sludge and scumequals one -third (Y of tank =volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 ears) ❑ NA fj'Ib year(s) y Clean effluent filter At least once every: (� Q month(s) ❑ NA years) Inspect pump, pump controls & alarm At least once every: 0 year(s)month(s) ❑ NA Flush laterals and ressure test At least once ever ❑ month(s) ❑ NA P y' year(s) Other: At least once every: ❑ month(s) NA ❑ year(s) Other: A MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of <_12 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. III Page Z of Z/ STAR UP AND OPERATION Fbr new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process acid /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in maniially operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. h site ha not n evaluated to identifeplaceme Upon failur e of the PO and site ey t cation us a rformed to ate a e area. If no re a is available a holding tank may be insta ed as a I t re to replace tTS. Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name �� Zw�C �✓` Phone Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name Phone Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. I 88/29/2066 01:18 17156501072 C7 a .---- ._..... I _ } fil I '* 1 I >i P w I � ' I I 4' -0" W-O' k 4' -0' 1 D ro o°o b CI 8 t - E i tltl /L7 /LtlUO ui. 10 „) F 1 3 O' SAIL r Parceh #: 034 - 1029 -30 -000 09/06/2005 04:12 PM PAGE 1 OF 1 Alt. Parcel #: 13.29.15.204 034 - TOWN OF SPRINGFIELD Current [X1 ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-owner BARRY M & MARY B MAHONEY O - MAHONEY, BARRY M & MARY B 3240 90TH AVE GLENWOOD CITY WI 54013 Districts: SC = School SP = Special P . Address(es . * = Primary Type Dist # Description * 3240 90TH AVE SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A -NOT AVAILABLE SEC 13 T29N R1 5W SE SW 40A Block/Condo Bldg: Tract(s): (Sec- Twn -Rng 401/4 1601/4) 13- 29N -15W Notes: Parcel History: Date Doc # Vol /Page Type 23/2003 740876 24 WD 08/20/199 1450/255 2005 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 05/25/2005 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 37.000 4,800 0 4,800 NO UNDEVELOPED G5 1.000 50 0 50 NO OTHER G7 2.000 9,550 13,400 22,950 NO Totals for 2005: General Property 40.000 14,400 13,400 27,800 Woodland 0.000 0 0 Totals for 2004: General Property 40.000 14,400 114,050 128,450 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 135 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 U 2830P 467 7987 1 5 STATE BAR OF WISCONSIN FORM 1 - 2000 WARRANTY DEED KATHLEEN H. WALSH Document Number REGISTER OF DEEDS ST. CROIX CO., MI This Deed, made between Barry M. Mahoney and mars RECEIVEn FOR barbara mahoney, husband and wife 06/27/2005 01:09PH Grantor, MARRANTY D and Harold L. Collins and Winiferd S. Collins, husband and wife REC FEE: 11.00 TRANS FEE: 494.40 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 Southeast Quarter of the Southwest Quarter (SE% of SW4) , gamllQp13 , Township 29 North, Range 15 Recording Area West, Town of Springfield, EXCEPT the Easterly 99 Na feet thereof. Return to: e Title One Premier Group 706 19th St. South Hudson, WI 54016 rt -of 3 7 034- 1029 -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 24th day of June 2005 y Inky * Barry M. Mahoney * Mary 8 bara Mahoney * * AUTHENTIC r V- S'C ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) ) ss. RMANY St. Croix County. authenticated this day � "" , * Personally came before me this AL day of N>► PUBLIC Z► June the above named Barry M. Mahoney and Mary Barbara Mahoney TITLE: MEMBER STATE BAR OF C gG - (If not, to a known o 664he who executed authorized by §706.06, Wis. Stats.) fore and knowledged the same. THIS INSTRUMENT WAS DRAFTED BY jL 14A Michael H. Forecki, Attorney N teof 1 Eau Claire, Wisconsin My Cotnnlissio permanent. (If net expirati date: (Signatures may be authenticated or acknowledged. Both are not necess .) *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 3452 Oakwood Hills Pkwy Ste 1, Eau Claire WI 54701 -7928 Phone: (715) 835 -3029 Fax: (715) 835 -4112 Michael H. Forecki 8803S.zfx Produced with Zipl`onnTM by RE FormsNet, LLC 18025 Fdteen Mile Road, Clinton Township, Michigan 48035, (800) 383 -9805 U 2 4 16 P 2 3 2 74Q!Ig -7 E, 4l STATi BAR OE WISCONSIN FORM 2 - 2000 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX CO., WI This Deed, made between Raymond M. Mahoney and Marie C. RECEIVED FOR RECORD Mahoney, husband and wife 09/23/2003 08: 20AN WARRANTY DEED EXEMPT # 17 Grantor, and Barry M. Mahoney and Mary Barbara Mahoney, husband and wife REC FEE: 11.00 TRANS FEE: COPY FEE: CC FEE: Grantee. PAGES: 1 Grantor, for a valuable consideration, conveys and wan to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum:) Southeast Quarter of Southwest Quarter (SE 1/4 of SW 1/4) of Section Recording Area Thirteen (13), Township Twenty -nine (29) North, Range Fifteen (15) Name and Return Address West. (-'t t `.:-k 0.n y_ baldwl n This deed is given in partial satisfaction of that certain Land Contract qq D µph SV + between the parties dated December 30, 1996, and recorded August 20, 5q 00 2 - 1999 in Volume 1450, Page 255, Document No. 608925, office of the Register of Deeds for St. Croix County, Wisconsin. 034-1029 -M Parcel Identification Number (PIN) This is not homestead property. tis) (is not) Exceptions to warranties: Easements and restrictions of record, and except any liens or encumbrances created or suffered to be created by the sets and defaults of the grantees, their heirs, successors or assigns. Dated this day of , 2003 * Ra mon . Mahone * * Marie C. Mahoney AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ) ss. St. Croix County ) authenticated this day of Personally came before me this .?5 day of a /,t d mA f , 200 the above named Raymond M. Mahoney and Marie C. Mahoney * �N1tiHIJ�y� TITLE: MEMBER STATE BAR OF WISCg1A� (If not, a . • • .�G v,- to me known to be the person(s) who executed the foregoing * '�jnstrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) * •, Ix THIS INSTRUMENT WAS Dl&[''I;ED BY* Thomas A. McCormack • • $otary Public, State of WISCONSIN Baldwin, W1 54002 : d' •• �$A Commission is permanent. (If not, state expiration date: Si atures may be authenticated or acknowle B n t e S� � ) C Bn Y g a ♦ , �_ I 6 4j, Gass * Names of persons signing in any capacity must be �9r ow their signature. ST BAR OF WISCONSIN WARRANTY DEED FORM No. 2 - 2000 INFO -PRO (800)655-2021 www.infoprofortns.com I YI 1450P = 2.55 STATE BAR OF WISCONSIN FORM 11 — 1982 �Ca8925 i KATHLEEN H. WALSH LAND CONTRACT Individual and Co REGISTER OF DEEDS ST. CROIX CO. WI (TO BE USED FOR ALL TRANSACTIONS WHERE OVER DOCUMENT NO. $25,000 1S FINANCED AND IN OTHER NON-CONSUMER I�' _ ACT TRANSACTIONS) II RECEIM&FOR RECORD Contract, by and between Raymond M. Mahoney and 1� - - -, I 08 -20 -1999 10 :00 AK Marie C. Mahoney, husband and wife I' LAND CONTRACT ( "Vendor ", i EXEMPT # CERi COPY = li whether one or more) and Ba M. Mahoney and Mary Barbara COPY FEET Mahoney, husban an w e, o ng as su vors p j TRANSFER FEE: 351.00 i, marital prope y RECORDING FEE: 12.00 ( "Purchaser ", whether one or more). PAGES: 2 Vendor sells and agrees to convey to Purchaser, upon the prompt and full performance j I! of this contract by Purchaser, the FOR RECORDING DATA following property, together with the rents, profits, j fixtures and other appurtenant interests (all called the "Property "), in i' __- n S isconsin: Southeast Quarter of Southwest Quarter (SE's of 5W) and THIS SPACE RESER _.. Soli a Of Southeas o ion NAME AND RETURN ADDRESS 'I Thirteen (13), North Half of Northeast Quarter (N' of n d ;NEk) of Section Twenty —Four (24), except West (W) Two (2) rods of Northwest Quarter of Northeast Quarter (NW'j of NEa) of said Section Twenty —Four (24). is North Half of Southeast Quarter (N)j of SEk) of 'Section Twenty -Three (23), Township Twenty -Nine 034- 1029- 30 -60 -70 North (T29N) , Range Fifteen West (R15W) PARCEL IDENTIFICATION NUMBER I . 034- 1052 -60 -70 034- 1053 -10 -20 i. j i This is not homestead property (is not) Purchaser agrees to purchase the Property and to pay to Vendor at a place designated by Vendor the sum of S 117, 000.00 in the following manner: (a) E 0.00 at the execution of this Contract; and (b) the balance of $ 117,000-00 together with interest from date hereof on the balance outstanding from time to time at the rate of SleVeri 7% percent per annum until paid in full, as follows: monthly payments of principal and interest in the amount of $890.00, commencing one month from date hereof and on the same date of each month thereafter. i Provided, however, the entire outstanding balance shall be paid in full on or before3ft two (2) allPW r8 after the date of death of Raymond M. Mahoney and Marie C. Mahoney. Following any default in payment, interest shall accrue at the rate of _ 8 % per annum on the entire amount in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance). Purchaser, unless excused by Vendor, agrees to pay monthly to Vendor amounts sufficient to pay reasonably anticipated annual taxes, special assessments, fire and required insurance premiums when due. To the extent received by Vendor, Vendor agrees to apply payments to these obligations when due. Such amounts received by the Vendor for payment of taxes, assessments and insurance will be deposited into an escrow fund or trustee account, but shall not bear interest unless otherwise required by law. Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any amount may be prepaid without premium or fee upon principal at any time after Janu 1 19 98 !i j In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long as the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be treated as unpaid principal) is less than the amount that said indebtedness would have been had the monthly payments been made as first specified above; provided that monthly payments shall be continued in the event of credit of any proceeds of insurance or condemnation, the condemned premises being thereafter excluded herefrom. i Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except: I i Purchaser agrees to pay the cost of future title evidence. if title evidence is in the form of an abstract, it shall be retained by Vendor until i, the full purchase price is paid. ? a t e o Closing Purchaser shall be entitled to take possession of the Property on 19 ' • Cross Out One. i. STATE BAR OF WISCONSIN Wlscon&n Legal Blank Co., Inn. LAND CONTRACT — Individual and Corporate Form No. 11 — 1982 Mawaukas. Wis. © 0 10 g s ' ° 2 % k � � 2 M ®2 E 7 _ m z a z = g = z s z o� _�. e o . \ a, o n, a cn o a 0) - *, _ :3 E @ M, , / E s E ; M § 0 + \ 0 9 EE 22E E: ®G ƒ «8 # / £ § 3 { , § & ; & } , L Q \ C) -0 / \ \(� / \ o k ro to A § . 0 ° 2 @ z« z> E @ z« z >% � E 5 >s >® E a >G A S 2 } \ 3 _� 2 \ k _� o CD \ \ � \ \ } / Q i g ch 0 � 2/= g o CO) cy : z z 0 0 0 / - - r-3 ) � � ) ) $ v � E E E E w - ; . w IQ . 7 , CL CL z z 7 { .. / o / o �� CD \ / \ / / \ CD f f \ = m g / / \ B 2 y 9 z (D -1 CO) & 3 C . 0 0 ° 0 ` 2 z { / \ E w � 2 § @ CL § 7 m ; §F .C/)� 7 z «� � > > \ 0 \ 0 CL / [ . . � a . @ . � ( � . 7 k 0 \ 7 CD , f f ° f f * © � . ; 8 B\ 8 8 i � 2 U _.2625 P 520 77v1Im 30 ;! STATE BAR OF WISCONSIN FORM I - 1998 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., MI Document Number This Deed, made between Raymond M. Mahoney and Marie C. RECEIVED FOR RECORD Mahoney, husband and wife, 07/28/2004 10200AN MARRA 11 DEED Grantor, and Barry M. Mahoney and Mary B. Mahoney, husband and wife, REC FEE t 11.00 as survivorship marital property, TRAMS FEB s COPY FEHt CC FEEL PAGESt 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (The "Property"): - -� Rccordin Area Name and Return Address South West Quarter (SW 1 /4) of the South East Quarter (SE I /4)Section 13, James H. Krave Township 29, Range 15 West. Attorney at Law 1'O Box 304 This deed is given in partial satisfaction of that land contract dated December Glenwood City, VA 54013 -0304 30, 1996, recorded August 20, 1999 in Vol. 1450, Page 255 -256 as Doc. No. 608925. 0341029- 60-000 Parcel Identification Nu er (PIN) This is not horn stead property. (is) (is not) Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements and encumbrances of record. Dated this 23 day of July 2004 jol ond M. Mahoney s Marie C. Mahon AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) Raymond M. Mahoney and Marie C. )SS. County. ) Mahone Personally came before me this day of uthenticl is d f J , 2004 the above named + James H. Krave, Attorn at Law ITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, instrument and acknowledge the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY James FL Krave, Attorney at Law Glenwood City, Wisconsin 54013 -0304 Notary Public, State of Wisconsin (Signatures may be authenticated or acknowledged. Both are not My Commission is permanent. (If not, state expiration date: necessary.) ) -Names of persons signing in any capacity should be typed or printed below their signatures STATE BAR OP WISCONSIN WARRANTY DEED FORM No. 1- 19" INFORMATION PROFESSIONALS COMPANY FOND DU LAC. W1 800-653-202 t O N 0 m f r G �1 O m (D C C, 3 H. m m m o A til • rr cn m m z o A n m m v z ° I 'I Cl 0 • N cn "..� CO J O 0 - C3 N C O V7 7 M. IV ? N (D SD A m 3 p O m c0 .7_ \` C. ° N N a C N O v 0 m Vt N O Q �;# 3 7 N N Q :J N d IV O CO -D 3 O CD 10 O C3 3 (Q m 00 Co e h a C t3 OT h w O n N V (�A N N N O 7 O O m O O (D Cp O m U> v D a (n v_� v D m m 3 0 �;::; � U a ° � y Ic a D Q 3 f D I V Q 3 N c CL p m C- ° G) N Ow o°o N .O. a c �• °0 3 CL a O O O a a O O O n • < N z m C r O O CJi N fV !C m m . d 'NO A O D m (D - y w '', f° lV Ln d d w = 3 m (D m !I D D o D D o O -o Q p O c O c j m a Z a !ti• mN� v, (D m ro (h c m s I -p n C N m N N ElF F 3 3 p A CD z _ -I to CD O V7 O C N = C A Z h Co g N 0 C N _ 7 3 a C" D- z S 'O 7 .. N O O m m N (A °-'• c m N w C CD z o m m, W z a� 0 3 0 3 ;o (n a O '' O to N N N z N z H C CD A A w I �,. 1 m7 N Q KO < a v a CL CD a _. O 'C (D C O "n a 3 'n • C N v C N C CD (A O N 7 S N (n 0 0 N z d m Z d 3 CD _ (h CD U) < 2 N_ a O 5 y N CD cr ` CD CD c C �. N a O Q C CL �_ m a 3 p d m ° = w 3 n < 6 m a ° C ° s N (p X O co CD `G C a N CT v m- m Q 3 0 m R O m N • O � � � i A p p w N (=D b w O EA O /k c 0 2 % q E 2 7 ƒ z F z \ t 9 9 » 3 , / \ { E \ C. E ¥ ° ' ƒ § © f / { ED E Q / �0 kiok /2 O E E q ! 8 @ CS a © . / > ¢ �� \ 2 = > 0 oa: 2 ƒ E k' g 0 CA ° 0 rr 0 0 o y " . ® z \ § ■ CA q % > § § ƒ o § . / �. / . 7 \ 7 2 7 / t m � q § & CL ] $ z 7 � ^ : E =Gk M(Z§ // § \ CA : 5£ % } . E 2 O E »2EE L eo —ED 2 R2�= LM 7 . ED ƒ _° W / gi § � , � ®3 i \\� ƒ3 ® �f /0) . \ } � 0 M / $ k E « Parcel #: 034 - 1029 -30 -200 06/09/2006 05:44 PM PAGE 1 OF 1 Alt. Parcel M 13.29.15.204C 034 - TOWN OF SPRINGFIELD Current I] ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 06/27/2005 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - COLLINS, HAROLD L & WINIFERD S HAROLD L & WINIFERD S COLLINS 1160 260TH ST GLENWOOD CITY WI 54013 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description ' 3240 90TH AVE SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 20.800 Plat: 5111 -CSM 20 -5111 034 -05 SEC 13 T29N R1 5W PT SE SW CSM 20 -5111 Block/Condo Bldg: LOT 02 LOT 2 (20.8 AC) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 13- 29N -15W Notes: Parcel History: Date Doc # Vol /Page Type 11/23/2005 812891 20/5111 CSM 06/27/2005 798715 2830/467 WD 09/23/2003 740876 2416/232 WD 08/20/1999 608925 1450/255 LC 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 04/14/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 12,950 109,250 122,200 NO UNDEVELOPED G5 18.800 15,500 0 15,500 NO Totals for 2006: General Property 20.800 28,450 109,250 137,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 13 8 1 4E3 --30 1 VOL 20 PAGE 5111 REGISTfiR OF DEEDS -9 CROI R CO. , W:r RECEIVED FOR RECORD 11/23/2005 03:00PIy CERTIFIED SURVEY MAP NO 577 CERTIFIED SURVEY ne VOLUME 20 , PAGE REC FEE: 13.09 5717 COPY FEE: 3.00 PAGES: 2 PART OF THE SOUTHEAST QUARTER RECEIVED OF THE SOUTHWEST QUARTER, SECTION 13, TOWNSHIP 29 NORTH, RANGE 15 WEST, 2 5 TOWN OF SPRINGFIELD, ST. CROIX COUNTY, WISCONSIN LANDS ST DS _ UNPLATTED ��� North line of SE /SW NW corner N89'02'59 "E 1207.41' / SE /SW LOT 3 LOT 2 236,641 sq.ft. PREPARED FOR= 1 906 ,398 sq_ft. 891,970 sq- ft. 5.43 acres 00 DANIEL WINE �� incl. r -o -w 1160 260th ST u �� 20 - 80 acres 20.48 acres Glenwood City, wi n incl. r -o -w not incl. r -o -w,' �. e i m OWNERS: �� \ 227,750 sq. ft. DANIEL WINE -- acres 4 5.23 acres HAROLD 473.05' ne dr no inc(. r - - N89'11'06 ° E Z setbock pine 324. O l L4 324. N89.1 V06 ;; ni 'C1 G+ O O? w ' k � LOT 3 Ic o 435,600 sq.f t. soil tests 91 0 10.04 acres w ( mad DRAFTED BY_ soil Tests \�on j a bb Joel A- Brandt o barn Z JB SURV LLC 4 ta%O�SOY 0 sq. ft. tO g 1�� o v 966 Rustic Rd 3 9 -acres co J o 0 Glenwood City, WI ncl- r -o -w o Im r w shed +` cw u bul setboc li SW corner S88'59'42 "W 1206.68' SE /SW 29.00' d �, g 30.57' drive oy 461.32' 32.13' 272.33' 1305.71' 47 459.66 274.00 99.0 589'11'06 W_ \_ 589'11 06 W 4 3_05 _ S89 "W ^� _589'11 06 W P S89'11'06� Southwest Corner centerline 90th AVE_ / South 1/4 Corner Section 13 -29 -15 S89'1 1'06 "W 1206.71' drive ay Section 13 -29 -15 Found Survey Mark Nail 2611.42' Found 1' Iron Pipe UNPIATTED LANDS Note= Each parcel on this map is subject to State and County laws, rules and regulations IV (i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel contact the St. Croix County Zoning Office for advice. 6 SCALE: 1" = 250' W .AEL A, MANOT s ' b•2EW 0 250' 500 extiwv000gTV, 1N1 North Is referenced to the LEGEND ''i�S Q` \pS South Line of the Southwest -.- Government Corner (as noted) Quarter of Sec. 1 3- 29 -15, MAID o._ - - -- -..Set 3/4" x 18" iron rebar , which bears sag °11•o6••w weighing 1.502 tbs./lineal ft. I (St. Croix County Grid System) Page 1 of 2 V01.20 Page 5111 I