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HomeMy WebLinkAbout034-1046-20-000 Apr-10-2012 01:31 PM St. Croix County Plan/Zoning 715-386-4686 1/1 ~ 0~ A( n7ni? Llh rlita Permit pp ~catt0n ST. CFIOIX COUNTY WISCONSIN Gpv Ina Croix County Sanitary Ordinanca PLANNING & ZONING DEPARTMENT O~~M P~ar, 1_ 119A a e may be used for secondary purposes ST. CROIX COUNTY GOVERNMENT CENTER G rlvaoy Law. S. 15.04(t)(m)) 1101 Carmichael Road 10 ~tv Hudson, WI 54018.7710 (715)388-4880 Fax (715)386-4688 Attach complete plans for the system on paper not lees than 8-112 x 11 Inches In size. County Sanitary Q Perm /it # [3 Check It revision to previous applicallon c. Application Information - Please Print all Information Location: ropsrty narNAame j T 1/aSw 1/4sec '96 l+I 41; *,4 t)$ r-t h a N R 15 E (orl6D Property Owners Malling Address Lot Number look Numbitr Ad C, I11 lty, t3t1 Zip C n o Ph~s~ Numor Q~Subdlvlalen Name or C5M Numbsr ype o u ng: c sck one) S / O , S 6l ~Ily Mvillage own of M"Z1 or 2 Family Dwelling - No. of Bedrooms: ~'e p ra0+~ 14~~~ L O PublldCommercial (describe use). ❑ State-owned Nearest Road Qd 'f'h If. Type of Permit: (Check only one box on line A. Check box on lino It applicable) arcs ax um or(s) A7 1Repair 2Reconnection 3,DNon-plumbing 4. ❑ Rejuvenation 0:54- t ~ f f6 _ _ ~QD sanitation ''ff ti) Permit Number IJTl Date Issued DjfX2 ~ State Sanitary Permit was previously Issued T IV. Type of POWT System: (Check all that apply) ❑ Non-pressurized in-ground nP-Mound it 24 in, suitable sole p Mound :9 24 In, suitable soil ❑ Mound A+0 ❑ Sand Filter ❑ Constructed Wetland ❑ Peat Filter Q Drip Una ❑ Pressurizsd In-ground ❑ Holding Tank Q Single Pave C3 Other ❑ At-grade Q Aeroblo Treatment Unit ❑ Recirculating V. Dla ersalr treatment Are Information: . Design Flow (gpd) 12. Dispersal Area 3. Dispersal Area 4, Soil Appllca8on Rate 5. Percolation Bata 6. System Elevatian 7. Final Grade Required FK / (Gals./daylsq.l (Min h) d ~ Elevation DD s . Tank Information Capacity In Gallons Total # of anu act rer Prefab Sit* Con- Steel Fiber- Now E.x1611ng Gallons Tanks Concrete strutted glass Tanks Tanks /L /Aso p ❑ ❑ ❑ - AP /IIJI D ll ❑ ❑ 0 ❑ Vii, ResponelbilityStatement I, the undersigned, assume responsibility for repaldr nnenctlon/r venatcorVinslailation of non-plumbing for the POWTS shown cn the attached plans. A license Is not required for tetrallft re air or the ins on of n . bin sanitation system. Plumber's Name (print) Plumher SI et pe): PRS No. Bualns6s Phone Number ono 94/0%, _ LS,f- ZbN~ Plumbe Address (greet, CiDBState, fp{od Gr ~.rrne S~f7~T'1 VIII. Count Use Only Z:t 81 nat roved Sanitary Permit Fee D 417i7;2- Approved Owner I Adverse ~1Z y . 4 atlon IX, Conditions of ApprovaVReasone for Disapproval: SYSTEM OWNER: Septic tank, effluent filter and dispersal cell must all be servfces / maintained as per managetrlent plan provided by plumber. 2 r A11,44ilback requ ems s: mts:t be rnaMtairred as pK app code / prd noAca co ell L C' o z r Neck ~ iL> 0 m T.L. Sinz Plumbing, Inc. E5609 7081 Avenue Phone: 715-235-2644 Menomonie, WI 54751 Fax: 715-235-2592 April 4, 2012 To Whom It May Concern: I visually inspected the sewer system at 2826 80th Ave. It was in working order and didn't show any signs of discharge to the surface of the drain field. If you have any other concerns, please call. Sincerel Todd L. Sinz President POWTS Maintainer ' CQ O O ~ c o , o ~aG IZP 41 OD `I i - y -All Dec-22-2011 10:39 AM St. Croix County Plan/Zoning 715-386.4686 2/2 ~zl off a x -r-+ u V 8 a A N p 3 I1 R t~ u ~N Dec-22-2011 10:39 AM St. Croix County Plan/Zoning 715-386-4686 1/2 -UnWA and buildingDMIliCamn,u°• PRIVATE SEWAGE SYSTEM county; .afrly and r3ulldksp DiNIIOn St. Cro)X INSPECTION REPORT san tay cm+ 479416 0 FORNERA6 INFORMATION (ATTACH TO PERMIT tats n 16 No: p~ol Infolml on you providr may be used for 400andW Pulpoew tPrIVSW Law, 3.15,04 (1xln)). Ames Arses Townwi p anal au o: ' item Also Springfield, Town of 034-1048.20-000 951 am v: Mp. glow. B olq 3• o ~n P of T 20.29.15.316A UAR INFORMATION ELEVATION DATA MANUFACTURER TA N 88 Hf FS ILEW Z.9'4 /fzZ let JttO ep a / encnn,ark /,65 101.65 /,06 as nA _p v 40 476 A-' guy. Ww-er In et 5 (6/. Z TANK SETBACK INFORMATION 'SVSt ouuet ` .7 /61.6j( TANK' Vent to lur e inlet , 7 .3 Eafna o Of Dt Bottom 0 11 „r ► V7 ea er an, •!r , L5 q'g •9 o nti SO L System * •'y l Z PUMPISIPHON INPORMAT ON Ana Grade 3•C1 1. g( I eF anu mr men t Cg '7 GPM c e er 6` ~.o f . 7 9 (r 3 e era i m s t t . 0 555 . % ! eradmtt to I -p 111112 Dist. to well $011. ABSORPTION SYSTEM en h No. f ran I No. Of Plss In• • o. qu •D DIMEN81ONS V ~ lNfOtsMATtcN ~ P ~ A CHAMBER Ok anal r•r UNIT unf r. 1 DISTRIBUTION SYSTEM A,,, 1 f e It r Pte on c4j If ! y Was[= x ol• pa np eg l r ntt71 1 Z& Lsrpa) t7` DI psdn % Iel 2 • ~J % l SOIL COVER X Pressure ss stems Only xx Mound Or At-Grade Systems Only a e/ op •r xx Dept of xx 3oeded/5 ddod xY Mul Bod/hanch tenter c Bed/Trand Edges Topsplt , ~ ~ Y•s (>~f No es ~'sll N° I COMMEN'T'S; (Indude ooda dlarrspendee. persons present, eto,) Inspeetlen 01- / ' 65 Inspe°tton *2:_,/ r ~J CL" I Loeations 41325 80th Av us Wllso 4WD 64027 (SW 114 SW 114 20 T29N R15W) NA Lot / Parcel No, 70.29.111.31 SA ~,ta 1 1.) At am Desalptlon ■ P 4/~.~ e.- L:L` 4- L-O~,R,eJ Now 2.) 81dp saw length * 477 4pllx t ' I n 0 Y` 141L, l` 1(.~ 1 lI/1II - amount of mvar m t: +.A, !r,KsJloBCd' \ I + 1 GcY 41 e{ia. rNIC.~ tJ Plan rovWon Required? (]Yes Use other side foraddiffanalinfonasy XINO aaaaTw (ttslo~ Oats Insspdoe Iena Cea No. v f k i i 01 N N 0 0 111 n -n El 9 ! EM EM I i I vu :u! DESIGN BY: Justen Revised 2-14-12 Great American Homes Tim Brunke 3/27/2012 715-235-4840 r...,~ ~ II!I Y '8 Y8'~18.4&8" `2 I I I'' 1.1 ICI I;I I;I I;I I'~I II 11 I'' II II I.I s I`I------------I ------------11 I'~I II I I I<~I ~ I I I`I o I;I I~~ II II I`I I> I`I i`I I`I I'I ;I ICI I`I N I:I IRI ICI 1 II II I I`~I II I I Fill I I I'I I:~I II ~ II I;I ~ I.,I w I I I °'I m ICI I I II I'. I I ~ I I' ICI I Ill I I I I~sl 1 1 :I ICI I'll "I'I II • I I I w "I 2Y 22' N' DESIGN BY: 1lm Brunkrunke Justen Revised 2-14-12 Great American Homes 3/28/2012 715-235-4840 i 24' •a 1ta'~ r-/ ts~ta• ---yam- tr k I ~ ~ gg ~ l ras'iHs-~-r-01e•-~~r-aans• y 4~ H 4 1 ~ ~ ~ ~ ' ninwr."y ~ y q ~ g S 40 b &ym ` 1Y 10 R a T- ~tR h~ 4 4 n 4 w a T-911'~F--6-81f1' M 4 ~ hS 1'-916'-~1~-r-t ~fa•~T-7' ~ '-t11/ 22 22 DESIGN BY: JUSteIl Revised 2-14-12 Great American Homes Tim Brunke 3/28/2012 715-235-4840 C 1 sconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix .afety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 479416 0 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Justen, Alan Springfield, Town of 034-1046-20-000 CST BM Elev: Insp. BM Elev: BM Description: Sectionf rown/Range/Map No: T 20.29.15.315A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. 7.q L4 /'D7.cpl /Clo Septic (:4, V. A, S Benchmark 1,05 101.05 ~Da Dosing z Ci- Alt. BM 9 'Q -7 AV Bldg. wer (7-- Holding St/Ht Inlet 5 ~dt ZA TANK SETBACK INFORMATION St/Ht Outlet (v ,-7 JbI IA-7. 74 TANK TO P/ WELL BLDG. Vent to Air Intake ROAD Dt Inlet 933 ' Septic 1 / / ► I Dt Bottom 5Z5 1 g t~' * Iz- 59.9 Dosing i ► Header/Man. Zoo 7 U Y 11-7 Aeration Dist. Pipe• d c~tl Holding T Bot. System 14 -7 7? - 2q PUMP/SIPHON INFORMAT ON Final Grade 1-3 ot, 9cy- it, ak Manufacturer / errand St Co er , S "7 /J5 1 7 GsU~ S ~ Model Number GPM • 6 5 36 66'A-. ~ 44.E 9 (0 3 TDH l,~ft,' Friction j ss clg System Head 50 TDH~ ~ ~t ~~jj Forcemain LentI Dia. ) 1 D6' SOIL ABSORPTION SYSTEM BEDITRENCH Width Length ! No. Of Trench PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS Np SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR Type Of Sys m: am ~ o v Z5J 131 ' `7 /j C.,~- UNIT Model Number. DISTRIBUTION SYSTEM VA-CA OK A, ze` x Hole SpacingVe t to Air Intake Header/Manifold Distribution ~S"paing-~I- x Hole Si Pipe(s) qq, Z6 Y k Z . y-Length Dia 3 Length Dia SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over ! Depth Over xx Depth of 1xx Seeded/S Sdded; xx Mulch d Bed/Trench Center 1 % Bed/Trench Edges 1 -7 Topsoil Yes No Yes ; No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / / b S Inspection #2: Location: 2826 80th Av ue Wilson WI 54027 (SW 1/4 SW 1/4 20 T29N R15W) NA Lot Parcel No: 20.29.15.315A 1.) Alt BM Description = - J~"'~ what i 4- ^Q e-k,5 r /0 ~Q II I Y`- f- l< 2.) Bldg sewer length = ~',~7 - amount of cover = +~-4i'~ n n 1 _ 1 I T - - - - -t Plan revision Required? Xn e] Yes o Use other side for additional informati -65_ - Date Insepctor' ignat Cert. No. l SBD-6710 (R.3197) Ilk Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 AW 011 i sconsi n Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 266-3151 Sanitary Permit Appl?i1t State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Cock, personal .2.`(bw<.may be used for secondary purposes Privacy La xm) Project Address (if different than mailing address) 1. Application Information - Please Print All Information ~Al O y Property ` s Na me ST_ CROIX OFFICE Parcel # 498t0 u ZONING 0 -1.o -got" (315-A) Property Owner's M -ailing Address Property Location S'°S" G SW A,XA%,l li,Secdon _2d City, State Zip Code Phone Number ' !/fit (circle ) B .Y = O T .4 ? N; R~_E o6 H. Type of Boil ' (check all that apply) ©1 or 2 Family Dwelling - Number of Bedrooms Subdivision N O I C`SM-Number ❑ Public/Commercial - Describe Use Ao+ '7~ ❑ State Owned - Describe Use - ❑City-❑Village [ATownship of L III. Type of Permit: (Check oaly one box on line A. Complete Mae B if applicable) A. rNew System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B List Previous Permit Number and Date Issued ❑ Permit Renews! ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New Before Expiration Plumber Owner tt i rv. Type of POWTS System: (check all that apply) Z 210I. ❑ Non -Pressurized In-Grand ❑ Mound > 24 in. of suitable soil (.Mound < 24 in. of suitable soil ❑ At-Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In-Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel4ess Pipe ❑ Other (explain) V. Dis tment Area Information: _ `1ra Design Flow (gpd) Design Soil Application Rate(gpdsf) ispersal Area Required (sf) ispetsal Area Proposed (A) System Elevation oa Gmo I~. I ~ ICI' D 5 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units / Concrete Constructed Glass New Existing -Wk ` Tanks Tanks "ge -Y,0') Septic or Fieltaieak _ ~G Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the' >undersigii" ed, assume irtsponfibility for installation of the POWTS shown on the attached plans. Plumber's Na me (Print) Plumber's Si gnature -M~P/MPRS Number Business Phone Number Fogerty Plumbing .z.~ - .~s- 960 P1umb,!LA e- V1RJtate, Zip Code) 7/S-~3S ; S 1 d-4 .Cwx Spooner, Wl 54801 dSi- o t, od cau. VIII. Co Only CS-I-VAP-1737 4 Approved ❑ Disa Sanitary Permit Fee includes Groundwater Date Issued Iss ' Agent Signature o Stamps) Surcharge Fee) ❑ O ~LE ven Reaso r Denial Z IX. Conditions o prow to ` nd~ n SYSTEM OWNER: 3)~ 5 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained .as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances. Attach cmplete plans (to the County only) for the system on paper not lea than 8112 x It imbes in size a a $ 0 0 V ~Q ► ► g O x oo MV] ib W Poo. 11 n ~ b b w o 6 a o0 o OV g g O b Q\ Safety and Buildings 10541N RANCH ROAD commerce.Wi.gov HAYWARD WI 54843 TDD (608) 264-8777 i s co n s i n www.commerce.Wi.gov/sb/ www.wiscoisconsin.gov Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary July 14, 2005 CUST ID No.221180 ATTN.• POWTS Inspector DAVID B FOGERTY ZONING OFFICE FOGERTY PLUMBING & PERK TESTING INC ST CROIX COUNTY SPIA 28288 MCKENZIE RD 1101 CARMICHAEL RD SPOONER WI 54801 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/14/2007 Identification Numbers Transaction ID No. 1151280 SITE: Site ID No. 700983 Allen Justen Please refer to both identification numbers, 80TH Ave & 280TH St above, in all correspondence with the agency. Town of Springfield St Croix County SW1/4, SWIA, S20, T29N, R15W FOR: Description: Replacement mound, 4 bedroom residence Object Type: POWTS Component Manual Regulated Object ID No.: 1026576 Maintenance required; Replacement system; 600 GPD Flow rate; 14 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD-10691-P (N.01/01); SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81)" F Ct1 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: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the design manuals noted above. • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. .Key Item(s) • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. DAVID B FOGERTY Page 2 7/14/2005 , • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • The existing POWTS must be properly abandoned per s. Comm 83.33 Wis. Adm. Code. • Insulate building sewer per COMM. 82.30(11)(c). • Provide frost protection per COMM 83.43(8)(c). A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions 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, operati aintenance of the POWTS. Sin re Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Patricia L f POWTS Plan R iewer, Inte rated Services WiSMART code: 7633 (715) 634-7810, a : 15 34-5150 M-f 7:45 am - 4:30 pm . pshandorf@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Allen Justen Replacement Mound Owner's Name: Allen Justen Owner's Address: 565 Old County Rd. B Woodville WI 54028 (715) 698-2039 Legal Description: SW1/4-SW1/4 Sec. 20 T29N-R15W Township: Springfield County: St. Croix Subdivision Name: NA Lot Number: NA Block Number: NA xsParcel I.D. Number: Pending Plan Transaction No.: o - E D 8IL4NGS Page 1 Index and title i Page 2 Data entry - Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications j Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot Plan Designer: Dave Fogerty License Number: MPRS# 221180 Date: 06/22/05 Phone Number: (715) 635-9609 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 3.11 (R. 06/01) Page 1 of 8 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 83-44-3 in-situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150%) coliform of 36 inches. 600.00 Design Flow (gpd) 6.00 Site Slope 96.35 Contour Line Elevation (ft) 14.00 Depth to Limiting Factor (in) 0.60 In-situ Soil Application Rate (gpd/ftz} Distribution Cell Information 100.00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpde) oint 1 Influent Wastewater Quality (1 or 2) Are the laterals the highFJ--y in the distribution Pressure Disribution Information network? Enter Y or N (c or e) c Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation ft 4 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 2.30 Estimated Orifice Spacing (ft) = 7.14 fe/orifice 2.00 Forcemain Diameter (in) 120.00 Forcemain Length (ft) Does the forcemain drain back? Y 86.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 19.57 Forcemain Drainback (gal) 11.93 Vertical Lift (ft) 90.29 5x Void Volume (gal) 3.03 Friction Loss (ft) 109.86 Minimum Dose Volume (gal) 1~1Q 21.46 Total Dynamic Head (ft) 34.60 System Demand (gpm) ,D Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 x 1.50 x x 1.25 x 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons/inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1250.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Concrete Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 750.36 Dose Tank Capacity (gal) Zabel Filter Manufacturer 20.28 Dose Tank Volume (gal/in) A100 Filter Model Number Wieser Concrete Manufacturer Project: Allen Justen Replacement Mound Page 2 of 8 Mound Plan View :Q: J 1/10 B Observation Pipe 3 _l K T'TrT A . • I Mound Component Dimensions ft K 11.42 ft A 6.00 ft E 26.32 in H [Aft B 100.00 ft F 9.50 in 1 ft L 122.83 ft D 22.00 in G 0.50 ft J ft W 26.69 600.00 (fe) Dispersal Cell Area 1875.00 (ft2) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 99.98 (ft) f.,.. G H I F Dispersal call 98.68 (ft) Lateral 98.18 (ft)--► Invert Dispersal Cell = = E Etev D ' ation . a i a i •,i, • i i • i, •J. •-i •-i •~i --i ~~i.~.i '-~i ~i. % .i..A?i. ~i. •i. ~i. yip ~i _1 -i _-i~•i 'i,~j. .i i i. i 'S -i -i i i =i 4 S i -i ,1. .i. i, ; i -i -..i., f'__1.~~~-4--~~4r. i.~~!.,; •i.~.r.: a,, ; i, ~i i i .i. 1. i ~ i. i J i .i, { i, i• l i,~A S :a• -i-_ ~l a - a•.1•..: a., A .a, { ;l i.,;{ i .4 :i•, i..i: i l ^.i. i• i,'~J. i i~'.~ 5 . } • - • - ~ 96.35 (ft) Contour Elevation 6.0 % Site Slope Geotextile Fabric Cover Shading Key Dispersal Cell See lateral details on 'H Pa e 4 for number, size , , , , ,r~_ , , : T Topsoil Cap o e 1.5 ft 9 © II1» Subsoil Cap N 0 5 and spacing of laterals. ASTM C33 Sand F Laterals are equally Tilled Layer Z 0.5 ft TYPica~ Lateral spaced from the distribution cell's 5mr 05 EDO Aggregate o centerline in the A distribution cell (AxB). Project: Allen Justen Replacement Mound Page 3 of 8 Center Connection Lateral Layout Daigram Force main connection via tee or cross to manifold at any point. Laterals are identical p S 4C W ~ • m Turn-up -!ball valve, or IE X -~~x12 xl2 +I Laterals 6 Force main of PVC Soh 40 cleanoutpiug per COMM Table 84.30.5 Holes drilled on the bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.40 ft Lateral Length (P) 49.20 ft Orifices per Lateral 21 Lateral Spacing (S) 3.00 ft Orifice Density 7.14 ft /orifice Lateral Flow Rate 8.65 gpm Manifold Length 3.00 ft System Flow Rate !21.46 4.60 gpm Manifold Diameter 1.50 in Total Dynamic Head ft Forcemain Velocity 3.53 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and Comm 16.28 WAC 4 in. min. Disconnect Tank component is properly vented FAftemate outlet ocation main diameter Wieser Concrete Manufacturer 2 in. Capacityl 750.36 Gallons Volume 20.28 gal/inch A hole or anti- Dimension Inches Gallons B n device A 20.58 417.42 C B 2.00 40.56 P~ ump off elevation (ft) C 5.42 109.86 86.75 D 9.00 182.52 D Total 37.00 750.36 IF7 Do♦ se tank elevation (ft) 3" Bedding un er tank. 86.00 Alarm Manuafacturer S. J. Electro Alarm Model Number 101-01H Pump Manufacturer Goulds Pump Model Number #3871 EP05 Pump Must Deliver 34.60 gpm at 21.46 ft TDH Project: Allen Justen Replacement Mound Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name Tri-County Sanitation Phone 715 386-0114 POWTS Regulator's Name St. Croix Co. Zoning Phone 715 386-4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1250 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Freouency Septic and Pump Tank Inspect and/or service once eve 3 years Effluent Filter Should inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Inspect for ondin and seepage once eve 3 ears Other Insulate sewer i under drive per Comm 82.30(l 1 Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished Grade 6-8" Diameter Lawn - Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Allen Justen Replacement Mound Page 5 of 8 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01101) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the fiker 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 113 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. 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 compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Allen Justen Replacement Mound Page 6 of 8 i rage ul u NGOULDS PUMPS Submersible Effluent Pump EP04 w 3871 EP05 APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- • Bearings: Upper and lower grade turbine oil for tic enclosed design for heavy duty ball bearing Specifically designed for the lubrication and efficient improved performance. construction. following uses: heat transfer. ■ Casing and Base: Rugged • Effluent systems thermoplastic design provides AGENCY LISTING • Homes Available for automatic and superior strength and corrosion • Farms manual operation. Auto- resistance. 43 Cwu dtal stwxWds Assoda*m • Heavy duty sump matic models include Motor Housing: Cast iron (CSA listed model numbers end • Water transfer Mechanical Float Switch for efficient heat transfer, in "C" or "F".) • Dewatering assembled and preset at the factory strength, and durability. . SPECIFICATIONS ■ Motor Cover: Thermoplastic Go" fty" is ISO 9W FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. '!e" maximum. ■ EP04 Impeller: Thermoplas- ~ power Cable: Severe duty • Capacities: up to 60 GPM, tic Semi-open design with rated oil and water resistant. • Total heads: up to 31 feet. pump out vanes for mechanical • Discharge size: 1112" NPT, seal protection. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104 (40`C) Continuous METERS FEET 1407 (60T) intermittent. 10 • Fasteners: 300 series stainless steel. 9 30'-- sGrM • Capable of running dry without damage to a 25R components. 25 o Motor. v e 20 fi • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with s automatic reset. < 4 t s EPOS • EP05 Single phase: 0.5 HP, o 115 V or 230V, 60 Hz, 1550 3 10 RPM, built in overload with EP04 automatic reset. 2 • Power cord: 10 foot 5 standard length, 1613 1 SJTOW with three prong grounding plug. Optional 20 ° °0 10 20 30 40 50 GPM foot length, 16/3 SJTW with three prong grounding plug o z a s a to 12 m3/h (standard on EP05). CAPACITY Goulds Pumps ® 2001 Goulds Pumps ITT Industries Effective May, 2001 83871 ti • 0 O I _ 0 V ~ Q x - a v ► V v kp ~p ► S H O o o A. OU x SI M rA r 40 -off`' ~ ~w w b b w r 00 o 00 b 00 g in accordance with Comm 8,5 Code County . Attach complete site plan on rapt less I Plan t Include, but not limited to: aPd M). direction Parcel I.D. SI` - percent slope. scale or d' and locgdon and distance to t road. 20~~ Please p R Date Personal tIarrraoion you Provide may be used )L 15. (1) ow 2 p Property Owner G, ~C,NIN Loco' ©3~,/D ZO -67o Govt. Lot S 114 114' 1G T ,,:p- N R IS- E (o® S Property Owner's -ling Address Lot # # or CSIN# Ct~ S OL Stile Zip Code Phone Number ❑ City ❑ Town Nearest Road o~ New Construction Use: QrResidential / Number of bedrooms Code derived design flow rate 1400 GPD ❑ Replacement ❑ Public or conamerdal - Describe- Parent material L Flood Plain elevation if applicable ft. General comments S Z Z (o and recommendations: ❑ Boring # Q' Pit Ground scuface elev. ~G• ft. Depth to limiting facto 1 a in. ALF Appkatbn Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Board Roots GPDIR' in. Munsefl Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 LIP -5 411& 2- C Y.F -4 -Y L- A iv .7 L Y- z 7• s rL tic 3 , s - mSG v ?-x - _ S S Slr ' ML .7 A le a Borhv Boring # u Pit Ground surface elev. Oe, JV ft. Depth to lanithbg factor in. Sol Application Rate Horizon Depth Dominant Color Redwc Descriptiar Texture MmwWre Co 01515 bce Boundary Roots GPDW in. Munsefl Qu. Sz. Cont Color Gr. Sz. Sh. •Etf#1 TJW2 IIA - L L z D Z- Q. 7j - O D G S GS .a i 3 Z-5- vie - sz- IF PL A I FA- MW • Effluent #1 = BODY > 30 < 220 mWL and.TSS >30 < 150 mWL • ElIluent, BOP,:! 3o mglL and TSS < 30 avll: • - ~*T Name (Please Print) W atue CST Number 2WW 0-2~ ~1111Z Z2 //0 ~ Telephone Number Address Fogerty Plumbing & Perk Testing don Coon ucted pFF ,N-9AO9 28288 McKenzie -5- Ys c a GS-i ' q,►x err 6 Parcel ID # Page ~ of 3 Property owner a Boring # ,ter Ground surface elev. ft. Depth to limiting factor Sol Appogggri Rate L~J Pit RAoxo*ts GPOW Cckw Redox Description Tewre Sftrx~ Cam Bounda<y Horizon DePtt+ Darrwrant Gr. Sz Sh. 'Eff#1 'EtF#2 in. Munsefl Qu. Sz. Cont. Color / - 0 4 t- 2 L L - ~ L fitJ L S y L ~ s x 7-7 3 goring s L xivc L. u~roas wW*W IVY" - /Z Boring # Pit Ground surface elev. ft. Depth to kniting factor in. Soil GPDIft? Rate Color Redox Description Texture suuc rwe Co~~ Borxrd~Y Roots Horizon Depth Dominant Gr. Sz. Sh. 'Etf#1 'Etf1t2 in. Munsell Qu. Sz. Cont. Color ❑ Boring # Pith Ground surface elev. Depth b f nov factor in. Sol GPDf IF fion Rate J" Roots Redox Description Texture Strums Consistence 8ot~da<y •Eff#1 'E1l#2 Horizon Depth D~~t Gr. Sz. Sh. in. Munsefl Qu. Sz. Cont Color • Effluent #2 =-BODs < 30 rtxyL and TSS < 30 m91t ' Effluent #1 = BODS > 30 < 220 mgll- and TSS >30:S 150 mglL at yer. If -o need assistanc to access services or The Department of Commerce is an equal opportunity service provider and emplo need material in an alternate format, please con department SDD-8330 (RAM) ~r . k ~o e .a ~ ~ V N .-.'D N O o V Q QQ r ? 00 ~p CID Cl- n N J ILD :3 003 ° a as v tb - N ~n, o o s r iA O' D - O 1. Parcel 034-1046-20-000 06121/2005 11:08 AM PAGE 1 OF 1 Alt. Parcel 20.29.15.315A 034 - TOWN OF SPRINGFIELD Current 'XST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): Current Owner * JUSTEN, ALAN & ANITA ALAN & ANITA JUSTEN 565 CTY RD B WOODVILLE WI 54028 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 2826 80TH AVE ~~N54- sol j n-tp- a'u~ SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC h m~ Legal Description: cre 39.000 Plat: N/A-NOT AVAILABLE SEC 20 T29N R15W 39A SW SW ESS 1A SW Block/Condo Bldg: COR Tract(s): (Sec-Twn-Rng 401/4 1601/4) 20-29N-15W Notes: Parcel History: Date Doc # Vol/Page Type 06/30/2003 727839 22921583 WD 07/27/2001 652274 1688/427 PR 2004 SUMMARY Bill Fair Market Value: Assessed with: 51117 Use Value Assessment Valuations: Last Changed: 05/26/2004 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 37.000 4,050 4,050 NO OTHER 7j~ G7 2.000 9,550 113,950 123,500 NO Totals for 2004: General Property 39.000 13,600 113,950 127,550 Woodland 0.000 0 0 Totals for 2003: General Property 40.000 72,400 113,950 186,350 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch 136 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 034-1046-10-000 0612112005 11:08 AM PAGE 7 OF 1 Alt. Parcel 20.29.15.314 034 - TOWN OF SPRINGFIELD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner ALAN & ANITA JUSTEN * JUSTEN, ALAN & ANITA 565 CTY RD B WOODVILLE WI 54028 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 20 T29N R15W 40A NW SW Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 20-29N-15W Notes: Parcel History: Date Doc # Vol/Page Type 06/30/2003 727839 2292/583 WD 07/27/2001 652274 1688/427 PR 2004 SUMMARY Bill Fair Market Value: Assessed with, 51116 Use Value Assessment Valuations: Last Changed: 05/26/2004 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 39.000 1,800 0 1,800 NO UNDEVELOPED G5 1.000 50 0 50 NO Totals for 2004: General Property 40.000 1,850 0 1,850 Woodland 0.000 0 0 Totals for 2003: General Property 40.000 1,900 0 1,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 034-1045-95-000 06/21/2005 11:08 AM PAGE 1 OF 1 Alt. Parcel 20.29.15.313 034 - TOWN OF SPRINGFIELD Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner ALAN & ANITA JUSTEN ' JUSTEN, ALAN & ANITA 565 CTY RD B WOODVILLE WI 54028 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 20 T29N R15W 40A NE SW Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 20-29N-15W Notes: Parcel History: Date Doc # Vol/Page Type 06/30/2003 727839 22921583 WD 07/27/2001 652274 1688/427 PR 2004 SUMMARY Bill M Fair Market Value: Assessed with: 51115 Use Value Assessment Valuations: Last Changed: 05/26/2004 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 25.000 2,850 0 2,850 NO PRODUCTIVE FORST LANC G6 15.000 25,500 0 25,500 NO Totals for 2004: General Property 40.000 28,350 0 28,350 Woodland 0.000 0 0 Totals for 2003: General Property 40.000 66,600 0 66,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 034-1046-40-000 06/21/2005 11:08 AM PAGE 1 OF 1 Alt. Parcel 20.29.15.316 034 - TOWN OF SPRINGFIELD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner ALAN & ANITA JUSTEN * JUSTEN, ALAN & ANITA 565 CTY RD B WOODVILLE WI 54028 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 20 T29N R1 5W 40A SE SW Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 20-29N-15W Notes: Parcel History: Date Doc # Vol/Page Type 06/30/2003 727839 2292/583 WD 07/27/2001 652274 1688/427 PR 2004 SUMMARY Bill Fair Market Value: Assessed with: 51118 Use Value Assessment Valuations: Last Changed: 05/26/2004 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 39.000 1,800 0 1,800 NO UNDEVELOPED G5 1.000 50 0 50 NO Totals for 2004: General Property 40.000 1,850 0 1,850 Woodland 0.000 0 0 Totals for 2003: General Property 40.000 1,900 0 1,900 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 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer CF wz / Mailing Address vl-A Property Address (Verification required from Planning Department for new construction.) cal a':~' ~ C-1 4 City/State Jid'901 d ( Parcel Identification Number /c7 .2 m raoo LEGAL DESCRIPTION Property Location'/a , _ Y4 , Sec. -2d , T -2 9 N R11- W, Town of 4) Subdivision , Lot # Certified Survey Map #ie✓yI , Volume- , Page # Warranty Deed # 7 -2- 7 FJ 9 , Volume :?Zq, 2 , Page # 5-x'3 Spec house yes Lot lines identifiable (dy no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the frmction 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 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 Iess than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Department within 30 days of the three year expiration date. 2~ * P/ /o/ OS- SIGNAAM OF APPLICANT DATE, OWNER CERTIFICATION Uwe certify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property e, by a of a warranty deed recorded in Register of Deeds Office SIGN OF APPLICANT DATE Any information that is misrepresented may result in the sanitary permit being revoked by the Zoning Department. Include with this application a stamped warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. I J 2292x: 583 727839 KATHLEEN H. WALSH STATE BAR OF WISCONSIN FORM I - 2000 REGISTER OF DEEDS Document Number WARRANTY DEED ST. CROIX CO., W1 RECEIVED FOR RECORD This Deed, made between Mavis Lindahl, a single person, 06/30/2003 09:36AK WARRANTY DEED EXERT # Grantor, and Alan Justen and Anita Justen, husband and wife as REC FEE : 11.60 survivorship marital property, TRANS FEE: 870.00 COPY FEE: CC FEE: PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (the "Property") (if more space is needed, please attach addendum): Recording Area Name and Return Address G T. M. Title Services, Inc. 315 E. LaSalle Avenue Barron, WI 54812 34-1046-10, -20, -40, -95 Parcel Identification Number (PIN) This is homestead property. (is) (II1t RA) The Southwest Quarter of Section 20, Township 29 North, Range 15 West (in the Town of Springfield), except 1 acre in the Southwest corner of the Southwest Quarter of the Southwest Quarter of Section 20, Township 29 North, Range 15 West. 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 highways, easements, restrictions of record, and any acts and/or omissions committed by grantee. Dated this & th day of June 2003 * * Mavis Lindahl * AUTHENTICATION * ACKNOWLEDGMENT Sigitature(s) STATE OF WISCONSIN ) ) ss. ) jrGa?i County authenticated this day~(it~N+u+Iq ~ Personally came before me this day of June 2003 the above named Q TAq: Mavis Lindahl, a single person, * TITLE: MEMBER STATE BF WISC*SIN - v-d be the pers (s a cuted the m g (If not, y fPt -6/. yo_Z• = to me Ina authorized by § 706.06, Wits _S} - 't~~'~•` tns d'acl,,, i e. ~ C THIS INSTRUMENT WA~tt~`" ~ Mark O. Dobberfuhl, LIDEN & 13OBBER Lu~.C. Notary Pu lie, State of isconsia PO Box 137, Barron, WI 54812 (715)537-5636 My Commission ispeirmanent. If not, state expiration date: (Signatures maybe authenticated or acknowledged. Both are not necessary.) 5 * Names ofpersons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1 - 2000 INFO-PRO (800)655-2021 www.infoprofonns.com 1 • SPRINGFIELD PLAT T-29-N R-15-W E i See -P.;.112 For Additional Names. (Landowners) GLENWOOD PAGE 56 ' 3000 3100 3200 3300 . 2800 2900 - DD Johnny r-1 Steven I e & 1 20 scant Sutler & Mona Bxl Annis a1 $ ~ ffi 156 -lames ' 1 d3 40 3 29I 102 I S Richard gum,; zm u ■ r u+ Haines a D m.o. Q I~ wddl.a~ 60 esw~ 4100 169 Seim a~r $ e°o 4p 40 ^ >W t 160 90 I 120 n.aa D & JoU I C Eric & Julie a Fran- 11 omm 60 y b I ~ a Fonts o Ler o Knuth PP - Waldo Michael elf ayn xs ^ 00 80 & Donna iiC Udc Gloria I IGer Maian ~g I 92 Thomas Seim c= 128 5"9 - m ~ o I ~ i~ a~ s e 440 ■ a ° ~F 5 s US R s9 & an 120 p n o. - - 4 - I I +6 m 160 v e 1-P - g ~1 a Fmh 110th AVE Robert 1 & Soule ` 30 21- ` I & m° zo 20 I Crockett 10-S 80 79u 64 140 20'1 cc ~ & I n 37 dan ~ p g Donald Ia,~a Shells Margaret e Forrest Rahal _ Verne a = Odi sn O McCOO- 75 Malceln Grm~aa Leroy & Do d arru gp ohns ou 3 69 11.0d m t Haines N 'd w e I gW1a 40 S Sehn Joanne Howard N 240 111 y o, Robert P to M I I Foreste Graham oe d N " & Pamela 41 a x 1 7 1 enntier 93 Drewl 99 31 a .+3 N u 1 JAI Io L Y1- GLE » I n imy Pada r Idmffi Harold C~ S~~I ovi Pamela Betly V 7 F 5 m 3s MOe sl.an`on a oendall Jarvis randt GP I A V ~ 40 58 40 48 ^40 j1QQth Fae wangs: E a Gds Yaar wayne aW s Le4Yis I - V Jerry ffi EvelYn errs err ffi rang vaas adce 37 40 y terse is ang m6 40 40 Ymg Inc 67 tenfl 39 " r Joseph & 1'. sB~ ns .on ffi Edward & " u°', L. 8 ISM w FS Z W ` James & I 8 St hio & dac 5 Donna ler Wollack > w 5 Steven Gessle~r Jr 60 4 ` 3 Carol 224 16 VBlman Caroms s sum McCarthy & Rebecca $ I ~iy Chong Farms vasqu u 160 Nyhus Eau Sham Betty Her Inc must sffiR r Sash 120 Q Gaffe Frye Brame nB 60 w Creek 120 etal t Lyons 1-m Ih, Barry 3 318 S ven 120 on amar sMuy I rn 40 ames V rnls Warren 1~1 r Mc°"bj 90th Htahone9 Rs 74 ~v,a Frye e H 37 gagg Fern 713 E 40ke za 40 AVE 120 - rlan& 40 90th AVE DO - fa 040 r.s mood sSusm A 52 rhoma: ruce efu s Karen am a~e Nelson Fi; ~i » D ar Mahoney B Peterson 7suYang FMi her 1 R G&G C'~ 39 n`f an I O ~••,i 90 Hmn s Smith pp a 36~~ pq 120 lZ Jack w 9 33 39 s tooann / A60. dams 21 0 'w I C- & Nan -M y P Oe1.~ a aoo M Bl om~ so 85th !oR`n`A AVE v 100 r4 Sm1um Barry3S Bruokow o aoo L 160 m~ 16 1 Iaormu o aM',ma o o~imson20 ltll D1ar11affieuleY honev s CaH'Od r6 A! gg I IDDi 3 04 00 ' 3 k3 a6 LffiE 20 Ronald 120 i'r`on 60 p I G s 1Naaa " & Kay a& g ~ ` Mavis D S 90 del u xo~s Deban -e Leona ~ Heath 3 a' I Meech a,; 120 15 9 1m - ;1~ 159 K°~ F McGee Curry 31 S0 80th AVE I;F locker- d, William & r t, Mellon 9 lion 97 I br ao 401 L - 4- . ~ William 40 ° I mamas 80th AVE Charles m"m°ed. oMeua M 60 Krueger aa>*le so _ Hoppe o gp 38 m 29aoaesr tl l~°l` 40 60 sa~uu s EC 3O 40 lave Donald 1 e (`one oo c5 W i°ghnron2n BO i w 38 O j cs El 9 ~ redcrick I 9lmplement 1 y$s~ O > M 4t S tJ' ro of w:1, 189 Lenertx 4S o~ cCo 109 DUN 40 - Gerald 9 E; 36 d 127 12 rn 2 taa 90 Lo. DD ' o hnson xa., C Iiso D as oo E ertes sky islust D5 G 0 u r Robot 72 n nd 4 D.I. s L I L: 50 r 40 361 e' y Snyd<r AVE Heime NZ6 W1 Q Robert ~3 @Ta fl: _ 70t Kubnd` 0 1 64 ZdZ r t1N _ 'M 3 6 40 - -1 l, 2 s orchard Hagen g'^ Reuben Donald Mabel Larry & G 100 tswrer~ 21 Bl p Hermaoson s NN Thompson Eleanor - 35 u r i78 Mate 40 Trust Z07 M" l C T 6t q~+, ~ w 1 Ater 3A.100 156 Sha erh°f OvIla p" A ~ BS Stang P 4 Sizzle 42 35 6 F- 79 75 ~L sC 4' udo It ^ G~ ~ ~ I SO ay 13 RFFK e~ 5 19 E l Avis David tee ^ F- Frances ° b EEicMka ssn E18and Ellef- Mary y ^ LE son Stenzel t Kromrey 0 vraa~ t 'Mark AuCe L. 114 1 N ~~9a yip y Se°3 xg°r° A°° N 168 uo~3a °if eh° a s~ooo ' ~'r- 451z '39r i 44 f6^G al ;F a t En 90 a 3r cn ~I r9.. ao 60th AVE CADY PAGE 24 S oodville ' NR 'S 05' l Warehousing cx Tt WILSON, WI and Distributing, LLC Dry, Refrigerated, Frozen C Dry Vans -Reefers -Augers -Hoppers -Brokerage Phone: 715 698-2442 and Cross Docking_ Fax: (715) 698-2962 107 Hagen Drive • Woodville, Wl 54028 Toll Free: 1-800-219-6926 Phone: (715) 698-2712 • Fax: (715) 698-2714 ':G 42