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HomeMy WebLinkAbout034-1056-95-000 wi.,cc County: nsin Departmant of Commerce PRIVATE SEWAGE SYSTEM St. Croix Safety a ,d Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 506101 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: Jahnke, Daniel Springfield, Town of 034 - 1056 -95 -000 CST BM Elev: Insp. BM Elev: BM Description: Section /Town /Range /Map No'. h C S T 25.29.15.399 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER IF CAPACITY STATION BS HI FS ELEV. Septic ,�� 6 Do(p Benchmark ldb t e,�• --- y • 5 l0`�• Dosing Alt. BM M rt (a t7�. Sz5 ���. Bldg. Sewer . 55 S 7.35 Holding V St/Ht Inlet ' $ . �� • 2 ` 7 TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom 1141 137, 37 1 37 ?2.3 82 - Dosing i Header /Man. 1/4 i3Z 3 17 3. /Z /6 t. 7S Aeration Dist. Pipe 3. I'7 /61•73 Holding Bot. System 3• 161 Final Grade PUMP /SIPHON INFORMATION Z • 1 /O .7 Manufacturer De r Demand St Cover. q z • ' Model Number Z , • • 5 / �� TDH Lift J $ Friction Lo$ System Heat TDH F . ,4 . .6 Forcemain Lenc QL i Di . ii Dist. to Well / Z SOIL ABSORPTION SYSTEM BED /TRENCH Width I Length No. Of rench PIT DIMENSIONS No. Of Pits Insid a. Liquid Depth DIMENSIONS �^ 9 � �` �� � SETBACK SYSTEM TO P/L /// BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION 78 CHAMBER OR O s Type tem: ( /0J UNIT Model Number: ov p5 DISTRIBUTION SYSTEM WeS{ r der /Manifold i� Distribution ♦ / f! ej x Hole Size x Hole Spacing � Vepo Ai� k. Pipe(s) 415 /i o 3a `�0 Sts � gth Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Ow-� Depth Over Depth Over xx Depth of 1 xx Seeded /Sodded xx Mulched Bed Trench Center f , Q Bed /Trench Edges \ Topsoil ' Q-• Yes No �es No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 7 / /_3 /o - 7 Inspection #2: - / 1 .3 / 6 - T M wSL Location: Unknown SW 1/4 E 1/4 25 T29N R1 5W) 40 acres Lot /►�a Parcel IN 25 9.15.399 1.) Alt BM Description 2.) Bldg sewer length = 3-7 r % f ) D - amount of cover = / � � ,,, C>4'&6 4Y{ I f t Q 5 j&7 O V' Plan revision Required? i I Yes at No Use other side for additional information. Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 St. Croix Vscons�n Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 266 -3151 Sanitary ermit Ap State Plan I.D. Number y hp 1364992 In accord with Comm 83.21, Wis. Adm. Code, personal information y vid Project Address (if different than mailing address) may be used for secondary purposes Privacy Law, s15.04(1 m) 3Z L I. Application Information - Please Print All Information P 70 7 ^ - Property Owner's Name r Parcel # Lot # Block # 034 - 1056 -95 -000 Na Na Daniel G. Jahnke - Property Owner's Mailing Address MAR 00 2 .uul Property Location 5413 Upper 183 Street W ST. CROIX COUNTY Gov't lot SW' /< SE' /.. Section 25. City, State Zip Code I Phone Number (circle one) Farmington, MN 55024 ) T 29 N; R 15 W II. Type of Building (check all that apply) X I or 2 Family Dwelling — Number of Bedrooms 3 v h tom: y > Subdivision Name CSM Number ( im ❑ Public /Commercial — Describe Use t rte" I f7/ Na — 40 acre p cl. i ❑ State Owned — Describe Use ce � ❑City []village X Township of Sprin fg_leld III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A ' X New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ change of 11 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 X Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground o mg Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate (gpdsl) Dispersal Area Required (s Dispersal Area Proposed (s System Elevation I Ogpd/sq.ft ASTM C -33 s 100.92' @11" above 450 gpd 0.6 d/s .ft native soil 450 sq. ft. 7� 450 sq. ft. /�{� 100.00' contour — VI. Tank Info Capacity in Total Number Manufacturer Prefab site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks i Septic or Holding Tank Wieser Concrete Combination 1,000 1,000 1 ST/PC X Aerobic Treatment Unit Dosing Chamber 600 600 1 X VIL Responsibility Statement- I, the undersigned, assume res ponsibility for installatio of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signs MP/MPRS Number Business Phone Number William Schumaker I I MP #227990 1 (715) 386 -3121 Plumber's Address (Street, City, State, Zip Code) 1070 Scott Rd., Hudson, WI 54016 1 1 VIII. Coun /De artment Use Onl proved qt rt ven �Rer Sanitary Permit Fee (includes Groundwater Date sued Issuin ent Si (No Surcharge Fee) en ial T ' l0 v( O p 3 - 7 6 7 IX. Conditions of Approval/Reasons for Disapproval 3\ r'av �Vlo� SYSTEM OWNER: J o I r ° . N�a 1. Septic tank, effluent Mer and n c� dispersal cell must all `�� as per management plan provided by plumber. 2. All setback requirements must be maintained /VO ' !` �.,,•_ t as per applicable Code / Ordinances. Attach complete plans (to the County only) Or the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) ■ So %� ec�z /lip �o�P;� A - oPo5 cd Inc u,1 d a f 2 /• i/3 r- 107. SO' 5,4Q c t,& a e�.2 -S3. l $.nf, : 6,radk Qw. bar) min *le / orovot , 6 - vo,4crq a;E F /a��o/ Sp ec/ �ocQ sc.>yysE!*� Scc. zs7 . F� E /. =ic�oy ' �. /,6'0., Tn. a fSPr , ��LCc✓ SE . C,- Co., c.J /. � r ` rs ■ 83 4cnGl, r►1&-k: Giude e /erra� " - �L.rOcc� srstc a..'+d� ,q, �L�r6' � •� � � .c�D' - c�rcQ EU b�e,� �' v�-L -t - - _ e -vim, ^' __ _ -- - � bac %vC Z "Sct • S/D j� `9 6.40 ' �Or•CFrIlQ,ii TJrc,�iZLC as 1 04e- c0."Or? f�op Osfd�r�o /Coco sy (�oposec� s .e {9G.71�' b;na S.r7e, 3 beclroon, , es,dcrce J �/ e�{ /ue„t cA40. 16 rua e bcv,6l;.� Seu�tt' sae /1 C� � /oCO14'on y b .3 .M �f �o�` flyc 0 / ZGE2I44 rapr7Pif ♦ �,ri sur%q g - ac/ a /ed` A Inc u ,7 daf zi.y.3;ri07.S'd' w/ 5 ;r9,I) dl's oz 1 ce. ff.'s�i :bu �• lQz`era /s -e /ter s if!z8 5,oa a ear a z. S3. A I . B. n(, : �'r �t d 2 eW. pro - 4�CAere 4A Flay S &re/ �cQ, SwYySerk,� Scc. �s T, ,29/(, C- e P are e. /sue 7;i. Ce., eJ /. t Irc r ` �.� dcnc j, rrlant�: Crude e /CrC a a� e/ sh . ASSu.n ed ���tt rna.irl 'Ci'en � � � ♦ e(e� /�. GtI.' 404, 6fd di36�/b�e e- a_ 6 z "suc.yo p. ✓,�. �9�.�0 �orc¢,na,•r%, 7 (a.$e as l� opased i �n /�cn s ,V. R'opose.d dw, /d;�� S:�e � 9G.7t'� 3 beolroon -, i y � e 10,41. e, ' I sews. P/opos tee!/ C t► J r/ d _�oCO�v'pn W b 0 �� ,o. Co. Safety and Buildings 4003 N KINNEY COULEE RD C0111111erCE.W1.gOV LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 i sconsi n www.commerce.wi.gov /sb/ www.wisconsin.gov t epartment of Commerce Jim Doyle, Governor Mary P. Burke, Secretary February 07, 2007 CUST ID No. 227990 ATTN. POWTS Inspector WILLIAM C SCHUMAKER ZONING OFFICE SCHUMAKER PLUMBING ST CROIX COUNTY SPIA 1070 SCOTT RD 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 02/07/2009 Identification Numbers Transaction ID No. 1364992 SITE: Site ID No. 722262 Daniel Jahnke Please refer to both identification numbers, 70 Ave above, in all comes ondence with the agency. Town of Springfield St Croix County - SW1 /4, SE1 /4, S25, T29N, R15W FOR: Description: Mound / Three Bedroom / Sloping Site Object Type: POWTS Component Manual Regulated Object ID No.: 1116724 Maintenance required; 450 GPI) Flow rate; 25 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01/0 1), 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: ` Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manuals listed above. SEE CoR • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 && 812c • 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 POWTS installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat WILLIAM C SCHUMAKER Page 2 2/712007 • Comm 83.22(7) 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 Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 l J Charles L Bratz POWTS Reviewer II , Integrated Services WSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday -Friday charles.bratz@wisconsin.gov cc: James K Thompson, A.C.E. Soil and Site Evaluations (Plans sent to:) Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. F Fi MP iL MOUND AND PRESSURE DISTRIBUTION COMPONENT DESI N FB � Residential Application INDEX AND TITLE PAGE �00� Project Name: Dan Jahnke 3- bedroom residential mound Owner's Name: Daniel G. Jahnke Owner's Address: 5413 Upper 183rd Street W. Farmington, MN 55024 Site Address: XXXX 70th Ave. Legal Description: SW114SE1/4, Sec.25,T.29N., R.15W. Township: Springfield County: St. Croix Subdivision Name: Lot Number: Block Number: Parcel I.D. Number: 034 - 1056 -95 -000 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 Zonally Page 7 Pump curve and specifications , - Page 8 Site Plan k D Page 9 Soil Evaluation Report TOFCOWERCE LDtNGS < Designer: Bill Schumaker License Number: 227990 Date: 01/31/07 Phone Number: 715 - 386 -3121 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 3.0 (03/01/01) Pagel of 9 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: sand fu (o) calculations assume a 300.00 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. 450.00 Design Flow (gpd) 10.00 Site Slope ( %) 100.00 Contour Line Elevation (ft) 25.00 Depth to Limiting Factor (in) 0.60 In -situ Soil Application Rate (gpd/ft) Distribution Cell Information 90-001 Dispersal Cell Length Along Contour (ft) = 5.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /ft 1 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) c Center or End Manifold 2.50 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) 2.50 Estimated Orifice Spacing (ft) = 6.25 ft /orifice 2.00 Forcemain Diameter (in) 115.00 Forcemain Length (ft) Does the forcemain drain back? Y 85.50 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 18.76 Forcemain Drainback (gal) 14.92 Vertical Lift (ft) 36.11 5x Void Volume (gal) 3 2.18 Friction Loss (ft) 54.87 Minimum Dose Volume (gal) 2 23.60 Total Dynamic Head (ft) 29.66 System Demand (gpm) ' I L, Lateral Diam Selection Manifold Diameter Selection �1}� / in. dia. options choice in. dia. options 'choice - p V 0.75 1.25 x 1.00 x x 1.50 x x 1.25 x 2.00 1.50 x 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information 602.82 Total Tank Capacity (gal) 1000.001 Septic Tank Capacity (gal) 51.00 Total Working Liquid Depth (in) Wi eser Concrete Manufacturer 11.82 gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 602.821 Dose Tank Capacity (gal) Pol L Filter Manufacturer 11.821 Dose Tank Volume (gal /in) PL -525 Filter Model Number Wieser Concrete Manufacturer Project: Dan Jahnke 3- bedroom residential mound Page 2 of 9 Mound Plan View T 1/10 B • : Observation Pipe .0 J ..,,, e .,..�4:•.0 •. ; . ...•. .� ;;. ;?.:,• 5 ti. �.. A .......... . ............................... ........................ .......................... ... ......................................... .... ................................... ..... .................................. ............................ .................................. ......................................... .................. I ... I .................. ......................................... .............................. I .......... ........................................ ....................... I .............. I L Mound Component Dimensions A 5.00 ft E 17.00 in H i1ft ft K 8.75 ft B 90.00 ft F 9.00 in 1 ft L 107.50 ft D 11.00 in G 0.50 ft J ft W 21.43 450.00 ) Dispersal Cell Area 1 1478.57 (ft) Basal Area Available 5.00 (gpd/ft) Linear Loading Rate 1 9.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 102.67 (ft) —► .fir /IVFrr... H G F 101.42 (ft) Lateral Dispersal Cell 100.92 (ft) — Invert Dispersal Cell Q Elevation E D ' . : :: 100.00 (ft) Contour Elevation 10.0 % Site Slope Geotextile Fabric Cover Shading Key. Dispersal Cell See lateral details on ❑ =Topsoil Cap _o 1.5 ft g � • .• .�... Page 4 for number, © Subsoil Cap ' ``" "� size, andsp of ASTM C33 Sand ` -° �4e• °. ° ." Z ,r•, "'y = =. , .. F laterals. Laterals are 0.5 ft "''a' Typical Lateral �. "•; :•;,` ® Tilled Layer ; ... ;• equally spaced from ❑.� 99 9 ....,... A re ate o � . the distribution cell's *-- — A —* centerline in the distribution cell (AxB). Project: Dan Jahnke 3- bedroom residential mound Page 3 of 9 Center Connection Lateral Layout Daigram Force main connection via tee or cross to manifold at any point. Laterals are identical I I P S •= Turn -up Y. ball valve or It- x— 1+x12 I 12 +I Laterals & force main of PVC sch 40 cleanoutplug per COMM Table 84.30.5 Holes drifted on the bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.125 in Lateral Diameter 1.00 in Orifice Spacing (X) 2.53 ft Lateral Length (P) 44.28 ft Orifices per Lateral 18 Lateral Spacing (S) 2.50 ft Orifice Density 6.25 ff /orifice Lateral Flow Rate 7.41 l gpm Manifold Length 2.50 ft System Flow Rate 29.66 gpm Manifold Diameter 1.50 in Total Dynamic Head 23.60 ft Forcemain Velocity 3.03 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and --- 10 Comm 16.28 WAC 4 in. min. Disconnect Tank component is properly vented -E Alternate outlet location Forcemain diameter Wieser Concrete Manufacturer 2 in. Capacityl 602.82 Gallons Volume 11.82 gal /inch A _ Weep hole or anti- Dimension Inches Gallons B siphon device A 29.07 343.59 C B 2.00 23.64 P � ump off elevation (ft) C 7.93 93.75 86.50 D 12.00 141.84 D Total 1 51.001 602.82 Dose tank elevation (ft) 3" Bedding uncTer tank. 85.50 Alarm Manuafacturer LevelArm _ Alarm Model Number DLV Pump Manufacturer JGoulds f Pump Model Number 13871 EP05 Pump Must Deliver 1 29.66 gpm at 23.60 ft TDH Project: Dan Jahnke 3- bedroom residential mound Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name Bill Schumaker �� Phone 715 -386 -3121 POWTS Regulator's Name St. Croix County Zonin Phone 715- 386 -4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1000 gal Maximum TSS 150 mg /L Soil Absorption Component Size 450 fe Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coli €orm >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound lns ect for ponding and seepage once every 3 ears Other Miscellaneous Con2truction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, are r in shown the mo und comp and a secu ed as �n u o p o nent 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: Dan Jahnke 3- bedroom residential mound Page 5 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code 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 84nches in diameter shall be secured by an effective looking 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 fitter 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 shalt 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 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. Ali switches, alarms, and pumps shall be tested to verify proper operation. If an effluent finer 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 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 BODE, 30 mg/L TSS, 10 mg/L FOG, and 10 cfu/100 mt. 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. 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(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 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Dan Jahnke 3- bedroom residential mound Page 6 of 9 .'M GOULDS PUMPS Submersible Effluent Pump 3 871 E PO4 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: • Effluent systems heat transfer. ■ Casing and Base: Rugged • Homes Available for automatic and thermoplastic design provides AGENCY LISTING • Farms manual operation. Auto- superior strength and corrosion C"' Canadian Standards Association • Heavy duty sump matic models include resistance. • Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron • Dewatering assembled and preset at the for efficient heat transfer Goulds Pumps is ISO 9001 Registered. factory. strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. '/4" maximum. ■ EPO4 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: V /z" NPT. seal protection. • Mechanical seal: carbon - rotary/ceramic- stationary, BUNA -N elastomers. • Temperature: 104 °F (40 °C) continuous 140 °F (60 °C) Intermittent, METERS FEET 10 - -. • Fasteners; 300 series , �� 30 - ��. - sGPM j stainless steel - 9 • Capable of running dry without damage to 8 �- 2.5 Fr components. .23,60 -A?' 25 °a 7 Motor: _ • EPO4 Single phase: 0.4 HP, U 6 20, 115 or 230 V, 60 Hz, 1550 a RPM, built in overload with o 5 15' automatic reset. -I 4 • EP05 Single phase: 0.5 HP, o EP05 115 V or 230V, 60 Hz, 1550 3 10 RPM, built in overload with _ EPO4 automatic reset. z • Power cord: 10 foot 5i standard length, 16/3 1 SJTOW with three prong grounding plug. Optional 20 0 00 10 20 b 40 50 GPM foot length, 16/3 SJTW with M;'1 MU0" s' -"Vly ��,Oe4jee-C✓ three prong grounding plug Qo (standard on EP05). o z 4 6 8 10 12 m' /h CAPACI Gou Pumps 2002 Goulds Pumps � I Industries Effective September, 2002 -1 O / 83871 I 01/ 26/07 FRI 12;03 FAX 715 386 4686 Z001 RIG I '- 2169 �.WE ATION REPORT Page l of 3 W+sconsin Department of Commerce � � .--- Certlfred Soil T esting Division of Safety and Buildings in a an Ef)e unty Attach complete site plan on paper not less than 8% x 11 inches In Ize. Plan must St . Croix _ Include, but not limited to: vertical and horizontal reference point (B ), di fiA "".� n and reel I.Q percent slope, scale or dimemsions, north arrow, and location and istance t 2005 Please print all information. v d Date SS � I I U Persorol infama9on you Provide may be used for secondary Purposes fP aey t aA7 vUN7Y - ' FI CE Property Owner �,1 f , n yy}ytQhJ LL rope oca 'on t 5 w_ J ahnke, Dan Govt. Lot _SW 114 S bd. E 114 5 25 T 29 N R Property owner's Mailing Address Lot # Block # Su�. �N(a�me or C S�M# 5 413 U p p er 183 rd St. W. _ 0� / — / a 3 aS Ci State Zip Code Phone Number t, City M Village fd Town Nearest Road Sp 70Th Ave. Farmington i MN 55024 651-341-1030 Code derived design flow rate 600 GPD {� New Construction Use: � Residential (Number of bedrooms 4 '—' Replacement t' Public or commercial - Describe: - Parent material loess o ver til _- Flood plain elevation, if applicable NA _ General comments and recommendations: install 6'X 104' rock cell mound on 100.0 contour as upslope edge of rock w/ 1' sand fill Boring # •'j goring 35 in. Sal Application Rate Ground Surface elev. 98.6 ft. Depth to limiting factor EE Pit Grou per Homan Depth Dominant Color Sz. Sh. or Redox pescriptlon Texture Structrxe Consistence Boundary Roots in. Munsell Qu. Sz. Gonl. Color �ff#1 Eff#2 sll 2 m gr mvfr gs 1flm 6 .8 1 0 -5 7.5YR 312 - -- mvfr cs 16 8 2 5-10 7.5 3/2 sii 2 f sbk - _. silt m sbk mfr cw 1 m 6 8 3 10-19 7.5Y R 414 --- M I 1.6 1m-I =' 4 7,5YR 416 =I 0 sg 7.5YR 4/6 f2d 7.5YR 513 is I 1 m sbk mvfr - tf 7 1.6 35 -55 f 1 roots tom Fil Boring # I Boring __ Pit Ground Surface elev. 100. ft. Depth to limiting factor — 25 In. Soil Application Rate r Structure Gonsistenoe Boundary Roots R' 2 Honzon I Depth t?aninani Color Redox DescxiPtion Textu a •Eff#1 G PQ P 'Eff# in, Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. sil ` 2 m gr mvfr gs 1f /m 6 8 1 0 -6 7. 312 -i- -- 2 6 12 !, 7.5YR Sill 2 f sbk mvfr cs 1 m 312 6 � _ - 3 10YR 414 siI 2 m sbk mfr cs 1m _.. r — _ �, 25 -31 10Yr 4l3 c2d 10YR 612 P, tcl 2 f s bk mfi cs - 4 6 4 Q 0 5 131 -35 7.5YR 4/6� f2d 10YR 612 cl - 0 m mfi 7 — r c2d 7.5YR �m1 1.6 6 35 -45 10YR 4!4 l OYlt 6/2 s 0 sg - ~- Effl e # = O D < 30 mg /L and TSS < 30 m9L • Effluent #1 = BOD 30 _< 220 mg /L and TSS > < 150 mglL ' ^ T Number CST Name (Please Print) Sign ur 2227 4 Henry F Grote Date Evaluation Conducted Telephone Number Address Certified Soil Testing 12 /312004 715 233 - 0398 E. 4366 353rd Ave., Menomonie, WI 54751 01/26/07 FRI 12:04 FAX 715 386 4686 [ 003 Property Owner Jahnke, Dan Parcel ID # 75oring Page 2 of 3 # Boring _ __ IN Pit Ground Surface elev. 100.4 ft. Depth to limiting factor 3 7 in. Soil Application Rate Horizon Depth Dorninant Color Redox Descroon Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh, 1 0#1 'Eff#2 0 -5 7.5YR 312 _ sil 2 m gr mvfr gs 1f /m .6 .8 5 -9 7.5YR 3/2 _ sil 2 f sbk mvfr f cs 1 m .6 .8 i 3 9 -37 10YR 4/4 - s(I 2 m sbk Mfir gs if ' .6 .8 4 37 -50 10YR 4/4 f2 7.5YR 5 /8,5/3 sil 1 m sbk mvfr - - .4 .6 j j ❑ Boring # Boring — Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture I Structure Consistence Boundary Roots '_ - . in. Munsell Qu, Sz. Cont Color Gr. Sz. Sh• 'Eff#1 'Eff#2 i i I ❑ Boring # ffj, Boring M Pit Ground Surface elev. ft, Depth to limiting factor _ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' in. Munsell Qu, Sz. Cont. Color Gr. Sz. Sh, - Eff#1 - E ff# 2 I r � i I -__ I i I i Effluent #1 a 600 30 < 220 mg/L and TSS >30 < 150 mg /L • Effluent #2 = GOD :E 30 mg /L and TSS < 30 mgiL The Department epart ent 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 -9730 (R.o7r00) Certified Sal Testing 01%26'07 FRI 12:04 FAX 715 386 4686 2002 J 17 r� QO 0 o f M --- - - --�j ri p O ' 9 • I r a v � y o _ s 1 a f 7 / d % P� O Leo CA ©� 0 2169 Wisconsin Department of Commerce j c4bjL9 ATION REPORT P age 1 of 3 Division of Safety and Buildings in acc dan �� unty Certified Soil Testing vvith ��' Attach complete site plan on paper not less than 8% x 11 inches in ize. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (B ), direction and percent slope, scale or dimensions, north arrow, and location and istance �A* aj. L0 05 rcei I.D. -a �° Please print all information. 0UNTY vi ed Date Personal information you provide may be used for secondary purposes (P vary La� I FI CE I I 0 Property Owner �, ,/1 ^ _ , ice ropey location Jahnke, Dan r r Govt. Lot SW 1/4 SE 1/4 S 25 T 29 N R 15 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 5413 Upper 183rd St., W. (Z 2 D� / — j g3 a 5 b c� City State Zip Code Phone Number City I Village id Town Nearest Road Farmington MN 1 55024 651- 341 -1030 Springfield 1 70Th Ave. New Construction Use: JM Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD i Replacement Public or commercial - Describe Parent material loess over till Flood plain elevation, if applicable NA General comments and recommendations: install 6' x 104' rock cell mound on 100.0 contour as upslope edge of rock w/ 1' sand fill Boring # .: Boring Pit Ground Surface elev. 98.6 ft. Depth to limiting factor 35 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -5 7.5YR 3/2 - sil 2 m gr mvfr gs 1f /m .6 .8 2 5 -10 7.5YR 3/2 - sil 2 f sbk mvfr cs 1m .6 .8 3 10 -19 7.5YR 4/4 - sil 2 m sbk mfr cw 1m .6 .8 4 19 -35 7.5YR 4/6 - Is 0 sg ml cs 1M .7 1.6 5 35 -55 7.5YR 4/6 f2d 7.5YR 513 Is 1 m sbk mvfr - if .7 1.6 -- 7 J 1 f roots to 47" Boring # 1 1 Boring id Pit Ground Surface elev. 100.0 ft. Depth to limiting factor 25 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/tt' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2 1 0 -6 7.5YR 3/2 - sil 2 m gr mvfr gs 1f /m .6 .8 2 6 -11 7.5YR 3/2 - sil 2 f sbk mvfr cs 1m .6 .8 3 11 -25 10YR 4/4 - sil 2 m sbk mfr cs 1m .6 .8 4 25 -31 10Yr 4/3 c2d 10YR 6/2 sicl 2 f sbk mfi cs - .4 .6 5 31 -35 7.5YR 4/6 f2d 10YR 6/2 scl 0 m mfi cs - 0 0 6 35 -45 10YR 4/4 c2 d 7.5 6/2 /6 s 0 sg ml - 7 1.6 Effluent #1 = BOD 30 < 220 mg /L and TSS > 0 < 150 mg /L " Effl a #2 - OD < 30 mg /L and TSS < 30 mgL CST Name (Please Print) Sign a ur CST Number Henry F, Grote 2227 4 Address Certified Soil Testing Date Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 12/3/2004 715 - 233 -0398 Property Owner 7ahnke, Dan Parcel ID # Page 2 of 3 ❑ Boring # Boring Pit Ground Surface elev. 100.4 ft. Depth to limiting factor 37 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 0 -5 7.5YR 3/2 - sil 2 m gr mvfr gs 1f /m .6 .8 5 -9 7.5YR 3/2 - sil 2 f sbk mvfr cs 1 m .6 .8 3 9 -37 10YR 4/4 - sil 2 m sbk mfr gs if .6 .8 4 37 -50 10YR 4/4 f2p 7.5YR 5/8,5/3 sil 1 m sbk mvfr - - .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 = in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' in. Munsell Qu. 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 -8330 (R.07/00) Certified Soil Testing Property Owner 3ahnke, Dan Parcel ID # ' Page 2 of 3 3 ] F Boring # A Boring Jig Pit Ground Surface elev. 100.4 ft. Depth to limiting factor 37 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure ffConsistence Boundary Roots QPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 0 -5 7.5YR 3/2 _ sil 2 m gr fr gs 1f /m .6 .8 5 -9 7.5YR 3/2 _ sil 2 f sbk fr cs 1 m .6 .8 I 3 9 -37 10YR 4/4 _ sil 2 m sbk mfr gs if .6 .8 4 37 -50 10YR 4/4 f2p 7.5YR 518,5/3 sil 1 m sbk mvfr - - . 4 .6 I F -1 Boring # Boring ld Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ❑ Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDMI in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 I Effluent #1 = SOD 5 > 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 -8330 (R.07 /00) Certified Sal Testing s 7 L 1 Q 9 f Cq f v � , f M IF r Y s Q o J � JA �, X Parcel #: 034 - 1056 -95 -000 03/09/2007 08:58 AM P 1 O 1 Alt. Parcel #: 25.29.15.399 034 - TOWN OF SPRINGFIELD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owners O = Current Owner C = Current Co -Owner DANIEL G JAHNKE O - JAHNKE, DANIEL G 5413 UPPER 183RD ST W FARMINGTON MN 55024 ri SC = School P = Special Address(es): ' = Prima Districts: S S Property ry Type Dist # Description SC 5586 SPRING VALLEY SP 0100 CHIP VALLEY VOTECH I Legal Description: Acres: 40.000 Plat: N/A -NOT AVAILABLE SEC 25 T29N R1 5W SW SE 40A Block/Condo Bldg: Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 25- 29N -15W Notes: Parcel History: Date Doc # Vol /Page Type 12/22/2004 783254 2720/377 WD 07/23/1997 1050/559 WD 07/23/1997 854/533 2007 SUMMARY Bill M Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 04/14/2006 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 33.000 4,150 0 4,150 NO UNDEVELOPED G5 2.000 100 0 100 NO AGRICULTURAL FOREST G5M 5.000 4,500 0 4,500 NO I Totals for 2007: General Property 40.000 8,750 0 8,750 Woodland 0.000 0 0 Totals for 2006: General Property 40.000 8,750 0 8,750 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 I Mar 06 07 02:06p Justin Everts 651 748 -3611 p.l FFW : 5CHLMKER PLUM81 N5 FRX NO. :715385Z3121 Mar. 06 2M7 12 = 41PM PI 5T. CROIX COUNTY SEPTIC "TANK MA INTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owncr- Buyer Mailing Address I'roperty Address ) A 4 (Verification reauircd from Pl nning Rc 'Zoning Department for new construction.) City /State P arcel Idci ication Nwiibcr 6 3 �D $ -' LEGAL DES iPTIION 39? Property Location 5 LU' ' Sec. , T �N R J,�J W. Town of S n'4 jA Sabdivisior. Wt Il Certified Survey Map # , Volum Warranty Deed # 76 3 Z S Volume Z 7 ZV Pale # 3 7 Spec louse yes no Lot lines idunti5able yes nn , SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system conldrestilt in its premature failure to handle wastes. ProNr ttwintenancc consists of pultrping out the septic lank every three years or sooncr, if needed, by a. licensed pumper. wlrar you put into the system CM) affect the function of the septic tank as a treamient stage in the waste disposal system. Owner maintenance resransibilities arc specified in §Comm. $3.52(1) and in C_liapter 1.2 -St. Croix Ooanty Sanitary Ordinance. The property owner agrees to submit to Sc. ( County Platming & ;oWiing IJcpartment a ecrtificanna form, signed by the owner and by n rnastcr phunbez, journeyman plrunber, resUieted plumber or a licensed pumper veri fyinr that (1) the on - site wastewater disposal system is in proper operating condition atidlor (2) after inspection wid pumping (if necessary), the septic tank is less than 1/3 full of Otmige. 11we, the raider ibned have read the above re uirc- inents and a gree t 4 g o maintain the private sewag disspossl system with fire standatdi set forth, herein, as net by the Departntetlt of COnvaerce and the Dc azirnent of Natural Resn i �. P u es, State pf WtSC Or[SiJi. t. :Cftircation Ciati.ng that your Ceptic sys'tein has been rruirntained must be coillpletell ailtl rc ui racd to file St. Croix County Planning qtr Zoning Department within 30 days ortlic three year expnation date. I/we certify that all statements on this fora are tnie to the (lest of rnviour knowledge. I/wc auVase flit owner(s) ofthe property described above, by viifite of a warranty deed recorded in Register of Deeds Officc. I rag 0 7 U:RE OIL APPLICANI(S) DATE ** *Any information that is misrepresented tray result in ilic sanitary permit being revokcxt by the Planning & Zoning Department. * ** Inchide with this application a recorded wananry deed frnm thie Register of Deeds 01lice and a copy of the certified survey niup if tultacncc is nude in tho warranty deed. tl 7 4E3 3 �--- t:-5 4- U L 7 Z O P 3 7 7 KATHLEEN H. WALSH REGISTER OF DEEDS STATE BAR OF WISCONSIN FORM 2 - 1998 ST. CROIK Go. MI Document Number WARRANTY DEED RECEIVED FOR RECORD This Deed, made between Jill. A. Mcnk and William J. Krueger, joint 12/22/2004 10: 30AN tenants Grantor, and Daniel G. Jaltnkc Grantee. WARRANTY DEED Grantor, for a valuable consideration, conveys and warrants to EXEMPT # Grantee the following described real estate in St. Croix County, State of SEC FEE: 11.00 Wisconsin: TRANS FEE.- 459.00 copy CC FEE: PAGES: 1 I Recording Area Name and Return Address - Daniel G. Jahnke 5413 Upper 183rd Street W Farmington, MN 55024 I 034 - 105(1 -95 Parccl Identification Number (PIN) This is not homestead property. (is not) The Southwest 1/4 of the Southeast 'r<, Section 25, Township 29 North, Range 15 West, Town of Springfield, St. Croix County, Wisconsin. Exceptions to warranties: easements, restrictions, and roadways of record. Dated this K/ 7] _ Q a 5 ,2004 I * * 11 A. Menk * * Wi Bann J. kru4e AUTHENTICATION ACKNOWLEDGMENT Sil_nature(s) STATE OF �J w ) ss. County. ) authenticated this day of - Perssonal1v came before me this j day of 4 1 .4. ,._ -,( • ,t , 2004 the abgve rtaitted.,, Jill A. Menk and William J. Krueger, ioint tenatl[�s.SN / %i TITLE: MEMBER STATE BAR OF WISCONSI (If not, to me known to be the Derson(s) who execuse"lja- Pcue%ie7 r .t __ authorized by 5706.06, Wis. Stats.) instrument and acknowledeed the same. '- �i. i �Q /� p N THIS INSTRUMENT WAS DRAFTED BY 1 4 -44 'a • ' ,? •'� d�•�. " Louis .J. Andrew .Jr. � * Andrew Law Offices S.C. Notary Publi , State of _ Cti rE,�� ti My m C �� mission is Dermanent ' (If n expiration date ` (Sienatures may be authenticated or acknowledeed. Both are not ) [ - .� • Names ol'persuns signing in any capacity must be typed or printed below their signature. Information Professionals Co., Fund du tae, WI STATE BAR OF WISCONSIN 300- 655 -2021 WARRANTY DEED FORM No. 2 - 1998