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034-1072-10-025
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 579022 -6~ GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Midtlin , Bradley B. Springfield, Town of 034-1072-10-025 CST BM Elev: Insp. BM Elev: BM Description: SectioNTown/Range/Map No: 5/f M~ lop. 11AI4 fa3 f:6-4T-osr, 5U4T~ 46-11L 32.29.15.482A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic /Z G$ .700 NO0 Tg Benchmark q OZ• /OD. 40 Dosing w/ 0 ~ g(pTLA //l) Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet '11 ~Z /S 3~ S1 TANK SETBACK INFORMATION St/Ht Oe> 7 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD 9t•Inlet 'j 70 9~ 1 0 5T # 11 7 7 Septic + t I uboctlim # t fa >Zoo 5 OI,ITLGT t~ 2 7.0 77 Dosing Header/Man. f-08 Aeration Dist. Pipe Holding Bot. System `a.po /•5D Final Grade /3~ PUMP/SIPHON INFORMATION `V f5, M nufacturer and St Cover z qQ GPM Z W 1 &le J• SQ ` u yo sr* Model 11ber T*06 g @ CL -44 ar 3 30 n• O TDH Lift ion Loss System Head TDH Ft Forcemain Length IDia. Dist. to Weu SOIL ABSORPTION SYSTEM BEDITRENCH Width length A No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS D ~c ~D Z SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR C-Z FC.o' Type Of System: W4)VEiUTT,OA14L t-30' ->LOO( A)19f UNIT Model Number: / 114 DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia T Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over + Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil t Yes No F91 Yes No COMMENTS: (Include code discrepencies, persons present, et~c.r)l~ Inspection #1: 7 / 7,Z/(,f Inspection #2: u/G~f•~Jb s a tt,~/~af~~' VE /wf L4*Tbl~ PEER- go W-Pis, Location: 2891 Hwy 12 Wilson, WI 54027 (NE 114 NE 1/4 32 T29 R15W) >35 acres Lot Par I 2.29 15 482A - - SYS'VM &-1 M71lW INDRIZOA) UAS tityc o0W~ O,4A1~ IT" lf+f~op TV Qc 1.) Alt BM Description = *,+r v 0 t16W G61R'I5E 5044M. 56*6 haven W~./~+;i 0) .5)JA p Powfluz cwa-#j 2.) Bldg sewer length = ZOO (1atA•&W& "t) M/f IMW 1/2," j,6A10R i WJS• 56-MO D1= k,(2,(7.6,V /7vW R5 D - amount of cover = yZ04 f7 (fg t)Z(,y pENSE j 1A35 jPEGT-DRL hWp fob Lo~JW of L ot4l ~Rm 6icm l~', r~ 01,TH0 H J? 5 /xS GoAE C.Pjw ,010 6A(5?-/AJ(s cE POdc. R3AAJRat1E►> f Q W. Plan revision Required? ® Yes k No Use other side for additional information. ( Date Insepctor's Signature Cert. No. SBD 6710 (R.3/97) 1 (~~Lr /QywW1C4DJV f"~ Li" PIPC 12W ~ X ~IjIC.~1IWo fE(~1~~- .~O~swb ~it9t~C jri~1L ~f County Safety and Buildings Division St. Croix q``~~U 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) JUL 4 L Madison, 370 71 :ST. CROIX COUNTY ENT Io 5 J State Transaction Number Sanitary Permit Application In accordance with SPS 383.2 ](2), Wis. Adm. Code, submission of this form to the appropriate governmental unit k6 is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project the Department of Safety and Professional Services. Personal information you provide may be used for secondary Address (it'different than mailing address) u ores in accordance with the Privacy Law, s. 15.04(I)(m), Slats. ZVI 14, 1 z- 1. Application Informati n - Please Print All Information Property Owner's Name Parcel 4 Brad Midtling ojv- 1674- /0- ' 6 ZS Property Owner's Mailing Address Property Location 2891 Highway 12 Govt. Lot City, State Zip Code Phone Number NE'/s, NE 1/4, Section 32 Wilson W1 715-271-9756 T 29 N; R 15 West (circle one) 1. Type of Building (check all that apply) Lot # X I or 2 Family Dwelling - Number of Bedrooms 3 Block # This proposed sy'stew. -0.411 serve arc 3 hedrown, residential Home. Na City Village ge of CSM Number X Town of Spring Field III. Type of Permit: (Check only (me box on line A. Complete line B if applicable} G A. New System Replacement System Treatment/Holding Tank Replacement Only Other Modification to Existing System (explain) x $ Permit Renewal Permit Revision Change of Plumber Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS System/Component/Device: (Check all that apply) X Non-Pressurized In-Ground Pressurized In-Ground At-Grade Mound > 24 in. of suitable soil Mound < 24 in. of suitable soil Ho F_ ing Tan Other Dispersal Component (explain) Pretreatment Device (explain) V. Dispersal/Trea ent Area Information: Design Flow (gpd) Design Soil Application Rate pdst) Dispersal Area Required (sl) Dispersal Area Proposed (sf) System Elevation 450 d .7 643 s ft 650 s ft 91.5 ft VI. Tank Info Capacity in Total # of Manufacturer y Gallons Gallons Units a U U New Tanks Existing Tanks 72 0 0 72 U j~ w 6 r6AGO L cwiS v Grrtv Se tic Tank A i400 1 i, T - Y Lift Tank V11. Responsibility Statement- I, the undersigned, asjqwr_rr,.syojR-1MWy for i . allation of the POWTS shown on the attached plans. Plumber's Name (Print) Plu er's Signature MP/MPRS Number Business Phone Number Lewis Bork 253976 715-231-7375 Plumber's Address (Street, City, State, Zip Code) E7818 Count Road ,E Menomonie, WI 54751 VIII. County/Department Use Only Appi ° Di Permit Fee Da) Issue Issuin lent Si nature --0wne eason for De ' I $ 4-1.45 ~S IX. Condi e ns fr.Disapproval 3) sal Celt must al! be eetStce;I f maintained I G~ J .TC eA /1a it pw management plan provided by. plumber, n(a r . ~Iiclcralu}i~r~eretgmust,tae~traintai~a:. +d~n~ot~.- ~ G. t( ~P..+.d~91~ r/u~c.GUerc t t aVPIiM oodlr cMlilliKl1. } fit/ V SBD-6398 (R. 11/11) r w vX (0 o ~ r ol J \ RECEIVED P _ )x ~ u ~v In- V. Wdon Index and Title Page Project Name: Brad Midtling , Replacement In-ground non pressure Owners Name: Brad Midtling Owner's address: 2891 Hwy 12 Wilson Day time Phone: 715-271-9756 Project Address: same Legal description: NE % NE % 32 29 N15 W Township and County: Town of Spring Field, St. Croix County WI DSPS Site ID No.: Parcel ID No. Plan Transaction No.: Page 1 Index and Title Page 2 Data entry, Design Criteria and Sizing Designed Pursuant to Page 3 Plan View Cells Following manuals Page 4 Cross View Cells In-ground Absorption Page 5 Over view cells SBD-10705-P (N.01/01) Page 6 Tank Configuration Page 7abc System maintenance specifications /contingency Page Bab Filter specs Page 9 Tuff tight riser systems Page 10 Plot Plan All materials must comply with Page 11 Plot Plan Legend DSPS 384 and installed with the Manufactures specifications Attachments: LB soil report, Warranty deed, Tank service contract, l'an, De ' ne d ' stall plumber: Lewis Bjork License # 253976 Signature (Revised 2-24-2014) Page 1-10 r Data entry, Design Criteria and Sizing Residential strength waste water <30m1 FOG <220MG/L <150MG/L TSS Anticipated effluent for In-ground treatment and dispersal should be Bedroom Home 3 Estimated flow = 300 gpd 300 x 1.5 = 450gpd design Flow (Floor drains will serve finished floor in mechanical room.) Design Calculations In situ design loading rate .7 Depth to estimated high water >120 Depth to Bed Rock >120 Cross slope at system 8% Trench sizing 450gpd /.7 gpd per sq ft = 643 sq ft minimum effective area for medium sands. Install EZ-Flow, engineered aggregate in 3' wide cells. 643/5' credit = 128 linier feet of cell min. Propose 2 cells 65'in length. 130' linear feet Total proposed sq ft area 650 sq ft d EZ-Flow ESIN 450 Gallons/day .7 gallon per Square foot 50 Square foot each 10 Ez-flow =12 min we propose 13-10' EZ flows Page 2-10 In-ground cell pion view vent Final and original grade 96.5' 12" Sch 40 pvc pipe 6"--► Bottom of System 91.5' 65' Page 3-10 r Cell Cross Section View Final and original grade 96.5' vent or watertight cap f---- 4" Sch 40 PVC (DQL Bottom of System 91.5' 3' 3'min ' Page 4-10 r Over View cells O O 3' > 3' 3 65' O O 4" 30/34 PVC pipe Page 5-10 LB700 Design Sequence Septic 1400 gallon Lewis Bjork 700 tank Lewis Bjork 700 tank 5" Baffle Filter Page 6 POWTS OWNER'S MANUAL AND MANAGEMENT PLAN FILE INFORMATION Owner Brad Midtling SYSTEM SPECIFICATIONS Permit # Septic tank capacity 1400gal N/A Design Parameters Septic tank manufacturer Lewis Bjork LLC Number of Bedrooms 3 Effluent Filter manufacturer Orenco Filter N/A (100gpd/bedroom) Effluent Filter model MDW -FT0822-14BA Number of Commercial Units N/A Pump Tank Capacity Gal X N/A Estimated flow (average) 300 Gal/day Pump Tank manufacturer X N/A Design flow (DWF) estimated x 1.5 450 Gal/day Pump model X N/A Soil Application Rate .7 Gal/day Pretreatment Unit N/A Influent/Effluent Quality (NA Monthly average Sand/ Gravel Filter Peat Filter Fats, Oil and Grease (FOG) 30 mg/L Mechanical Aeration Wetland Biochemical Oxygen Demand (BOD5) 5220 mg/L XX Disinfection Other Total Suspended Solids (TSS) 5_150 mg/L Manufacturer: Model: Pretreated Effluent Quality Monthly Average Soil Absorption Component Biochemical Oxygen Deman BOD5 T ) :530 mg/L IDrip-Line In-Ground (non pressure) In-Ground (pressure) Total Suspended Solids (TSS) 5530 mg/L At-Grade Mound Fecal Coliform (Geometric mean) 5_ cfu/100m1 Other FMaximum Effluent Particle Size 1/8" diameter HDispersal Units -Manufacturer: EZ FLOW Aggregate cell(s) Model: 1203H Calculations: Soil Dispersal (EISA) or DWF _ Application Rate = Area Required Aggregate Trench Width) _ #Units or Total Length of Aggregate Trench(s) 7 1 =1 643 5 130 linear feet 450 Designed: 650' dispersal =130 linear ft Design Criteria "Design of Pressure Distribution Networks for Septic Tank-Soil Absorption Systems" Publication 9.6 (SSWMP manual) "ICC Flowtech Mound Component Manual" Version 1.2 "EZ Flow Mound Component Manual" Version 8/20/2007 SBD -10854-P (R.1/12) "At-Grade Component Manual Using Pressure Distribution" Version 2.0 SBD -10705-P (N.01/01)"IN-Ground Soil Absorption Component Manual' Version 2.0 SBD -10691-P(N.01/01) "Mound Component Manual" Version 2.0 SBD -10657-P (R.6/99) "Drip-Line Effluent Disposal Component Manual" SBD -10706-P N.01/01) "Pressure Distribution Component Manual" Version 2.0 Other- Maintenance Monitoring Schedule - Maintenance and Management Service Event Service Frequency Pump/Inspect tank(s), inspect dispersal cell(s), clean filter At least once eve 13 months X 3 years other Inspect pump and pump controls, alarm, pretreatment unit At least once eve 13 months X 3 years other Flush and pressure test laterals At least once eve 13 months X 3 years other I Start Up and Operation: For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a Septage service operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of the water-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwashers, ect. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable/fruit peels and seeds, bones and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non-biodegradable items such as baby wipes, tampons, sanitary napkins and others of this kind shall not be introduced to the system for they may cause premature failure to the POWTS. INPSPECTIONS AND MAINTENANCE: Inspection shall be made by an individual carrying one of the following license or certifications: master plumber, master plumber restricted sewer, POWTS maintainer or Septage service operator (per attached maintenance schedule). Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and check for any backup or ponding of effluent to the ground surface and test all electrical equipment such as pumps and alarms. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with effective locking devices to prevent accidental or unauthorized entry to the tanks. When the combination of sludge and scum in the tank exceeds one-third or more of the tank volume, the entire contents of the tank shall be removed by a Septage service operator and disposed of in accordance with chapter NR113, Wisconsin administrative code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufactures specifications. Solids washed from the filter shall be retained in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back-up of sewage into the dwelling or surfacing. ABANDONMENT: When a POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. SPPS 383.33 Wisconsin administrative code. - All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed - The contents of all tanks and pits shall be removed and properly disposed of by a Septage service operator - After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or other inert solid material. Page 7b CONTINGENCY PLAN: If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system. = A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area, render it unusable. Replacement systems must comply with the rules in effect at the time of replacement. There are two potential mound sites evaluated for replacement areas. 0 A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. 0 Mound and at-grade soil absorption systems maybe reconstructed in place following removal of the bio-mat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at the time. WARNING: SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TRATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MY BE DIFFICULT OR IMPOSSIBLE. COMMENTS: v tC11 Full Service Plumbing 715-231-7375 aq Your plumbing and Page 7c TEt MAY. 9. 2013.10: 58AM YAFri rst Supply LLC)ivisioN :oVq 36" 9641, 51~i P. LUU2/UU2 s SAFETY AND RADMS OM810N PVIXrrbhig Fhudttci Review Viscon` P.D_ blot 71 s2 ~ rMa.4VNmrien 59701 Deoartment of Commerce Covwnur Philip W. Albeit Secretary March 28, 2002 - ORENCO SYSTEMS INC BUSINESS DEVELOPMENT BILL CAGLE 814 AIRWAY AVE SUTHERUN OR 97478 Re. Description: SEWAGE TREATMENT APPARATUS + Manufacturer ORENCO SYSTEMS INC Product Name: 8• BIOTUBE EFFLUENT FILTER Model Number(s)- PT0822-148, F FP0822-14B Product File No. 20020129 The specifications and/or plans for this plumbing product have been reviewed and detenmined to be bn compliance wkt chapters Comm 82 through 84, V4iscarnsin Administrative Code, and chapters 145 and 160, Wisconsin SFdiut". The Department hereby issues an approval based on the Wisconsin Statutes and the Wisconsin Administrable Code. This approval is valid until the and of March 2 This approval is contingent upon oompliance with the following stipulation(s): • An access opening of sufficient size to allow removal of the filter must be provided over the outlet tee baffle of which this product is installed-'t'his access opening must 6errrdnate at or above grade- • Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter will be necessary. • When this product is installed in an Interior compartment, the discharge connection must be solvent cemented to a single four inch diameter schedule 40 PVC, plastic pipe (ASTM D-2865 or AM D-1785) which is solvent cemented to a four inch diameter schedule 40 PVC coupiing encased in the interior wall. • The influent holes on the of kmt filter shall be appropriately configured by the manufacturer so that the Influent holes are positioned between 65% and 75% of the tank's minimum liquid level. This shell be coordinated With the manufacturer or manufacturer's representatives by submital of appropriate tank drawings and/or dimensions. • The discharge rate of the fitter rust allow sufficient flow W prevent the tanks inlet from becoming submerged- • When this product is installed in an exterior compartment, the discharge conrwcWn must be solvent cemented to a single four inch diameter Schedule 40 (ASTM D-2685 or ASTM D-1785) or SDR 26 (ASTM D-3034) PVC plastic pipe which extends through the outlet opening of the tank to a point at least three feet beyond the undisturbed ground surrounding the excavation made fm the tank. When the boss stop is required to be removed, written permission must be obtained from the tank manufacturer prior to installation of the product The department is in no way endorsing this product Or any advertising, and is not responsible for any situation which may result from its use. Sincerely Michael J. SeckWith. C1PE Plumbing Product Reviewer phone: 608-266-6742 fax 608-267-9986 e-mail: mbeCkwlttl@commerMstate.wi.us Sn3D idi9A E (N.101e7) Fp Ref: OM290n ,MAY' 9_2013F 10: BA% Ptl ~F i r s t $ u p P.1 y-L LCD FAX NO, 541 453 2884 PiC. 5 l 81 3 01 Q a~ N ~ N t ? 2 3 C ~ m 4 71 NN Ei. r > Noce 787 P06%4 r Fax To Feem Tuf-rite Riser System Tuf-Tite makes a full line of Risers and accessories for Pre-Cast applications. Riser Lid - with Molded-in gasket. Available in 12",16", 20" and 24" diameters. Green Only. Concrete Lid - with handle. Use the Safety Pan to cast your own concrete lids. Safety Lid - May be used in place of concrete lid. Fits 24" Riser Pan only. Black Only. Safety Pan - Safety PanTM available for 16", 20 and 24" Risers. Green Only. 11. 6" Tall Riser - For septic tanks. Stackable in 6" increments. Available in 12",16", 20" and 24" diameters. 12" Tall Riser - For septic tanks. Stackable in 12" increments. Available in 20" and 24" diameters. Black Only. Tank Adapter Ring - For mounting riser or lid to tank when casting-in is not an option. a O O . IS-I Plot Plan Legend 1 4" PVC ASTM D 3034.42"Min. Cover where snow is not removed. 60" under the drive 2 24" inside diameter plastic manhole brought min.4" above surrounding grade. plastic covers with safety rings screwed down. 3 Precast concrete septic tank. 4 Effluent filter location. 5 Not Used 6 Not Used 7 Not Used 8 Not Used 9 4" PVC ASTM D-2665 -09 Schedule 40 Pipe . Entering and exiting concrete tanks min 10' in length. 10 Not Used 11 treatment/dispersal cell 12 Inspection wells Project: ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM , kel Owner/Buyer BRAD M I DTL I N G PiNfty Mailing Address , WILSON WI 54027 Property Address 2891 HIGHWAY 12 (Verification required from Planning & Zoning Department for new construction.) City/State W I LSO N, W1 Parcel Identification Number LEGAL DESCRIPTION Property Location N E i/,, NE 14 , Sec. 32 , T 29 N R 15 W, Town of S P R I N G FIELD. Subdivision Plat: , Lot # Certified Survey Map Volume , Page # Warranty Deed # $'9 / 3 (before 2007)Volume , Page # Spec house ❑yes0no Lot lines identifiable ❑yesE] no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards cot forth herein as stet by the Department of Safety And Professional Serlic-es and the Department of1\Twtural_ ReSources State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this for are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty d ed recorded in Register of Deeds Office. Number of bedrooms 3 SIGNATURE OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from thee and a copy of t fie v if reference is made in the warranty deed. KKtt (REV. 04/12) JUL ST. CROIX COUNTY S . C U COMMUNITY DEVELOPMENT ,OM UNITY LO ENT RECEIVED P-AJ Wisconsin Department of Comm rr , ; . SOIL EVALUATION REPORT S a' page l of 3 Division of Safety and Bui a in accordance with Comm 85, Wis. Adm. Code ROIX COUNTY County St.Croix Attach complete slt~ p~p~ /2 x 11 inches in size. Plan must include, but n lkttic`~I`~I1~~onerence point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location ❑ B Brad Midtling Govt. Lot NE 1/4 NE 1/4 S 32 T 29 N R 15 E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2891 US HWY 12 - - Part of >100 Acres City State Zip Code Phone Number []City Village ■ Town Nearest Road Wilson WI 54027 ( 7)5-271-9756 US 12 Spring Field- New Construction UseE] Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD EIReplacement Public or commercial - Describe: NA Parent material Till Flood Plain elevation if applicable NA -ft. General comments 385.30 (3) 2-3 Install new in ground non- pressure below 48" , Use .7 loading rate , Two cells ,'EZ-Flow and recommendations: C 11GINk" P1 Boring # D Boring Ground surface elev. 96.6 ft. Depth to limiting factor >120 in. Pit Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 1 0-6 7.5yr3/3 sl 3fgr mvfr cs 2f .6 1.0 2 6-12 7.5w3/3 - sl 2fsbk mvfr as 2f •6 1.0 sl 2msbk mvfr cs lm .6 1.0 3 12-19 7.5yr5/4 - 4 19-36 5yr4/4 sl 2msbk mvfr cs - .6 1.0 5 36-42 5yr4/6 m2p10yr6/2 scl Om mfi as - - - 7 1.6 6 42-120 7.5yr5/6 - s Osg ml - - 1 [P2] Boring# © Boring 6 >120 ' Pit Ground surface el ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ffF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 1 0-5 7.5yr3/3 - sl 3fgr mvfr cs 2f .6 1.0 2 5-13 7.5 r3J3 - sl 2fsbk mvfr as 2mf .6 1.0 3 13-20 7.5yr5/4 sl 2msbk mvfr cs lm .6 1.0 4 20-36 5yr4/4 sl 2msbk mvfr as - .6 1.0 5 3643 5yr4/6 m2p10yr6/2 SO Om mvfr - - - - 6 43-120 7.5yr5/6 1% s Osg ml - - .7 1.6 11 * Effluent #1 = BODS > 30 < 220 rn ll. a 30 < 150 Tj/L * E = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) nature CST Number Lewis Bork 253976 Address Date valua' Telephone Number E7818 County E, Menomonie WI 54751 8-11-2014 715-231-7375 2 3 Properly Owner Midtling Parcel ID # Page of [P31 Boring # Boring 96.4 >120 ■ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Red. Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-5 7.5yr3/3 - sl 3fgr mvfr cs 2f .6 1.0 2 5-12 7.5w3/3 - sl 2fsbk mvfr cs 2f .6 1.0 3 12-20 7.5yr5/4 - sl 2msbk mvfr cs 2m .6 1.0 4 20-34 5yr5/4 - sl 2msbk mvfr as - .6 1.0 5 34-42 5yr4/4 m2plOyr6/2 scl lmabk mvfr as - - - 6 42-120 7.5yr5/6 - CM )A s 0sg ml - - .7 1.6 1 IN ❑ Boring # Boring 61 ~U, C ¢ 3 Pit Ground surface elev. ft. 'bepth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtlf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring ❑ Boring # Ground surface elev. ft. Depth to limiting factor in. Pit Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 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. SM-8330Tes[ (R07Po0) s Y N QU 8 ! cq U ts, d ~ ~ C o (D ° N 0 otq C) 6s oq o C o 0 O N ~M Y Y n,~ c a c .m ca Eo t a mr m 3 O. N C 'O m m U 'v 3 c CU o U o 0 r> N y S M co c N a N -O A I= F: :tt m; 0 O O = E c 2 O O O O O N co z M N ~ E N 0 3 1 N C Z 020 O 7 0 E N N ) o O) N o L ~O N 0 -0 J -OO 0) 00 C ~ O C) E d: z O( v Z'0 o 3 c 0) C U N C b cm~ U O O p 3 ;CS O) N 7 c LL O O C N U. 0 N p N O N O U O C o 0 3'Z 3 0(D E 3N c (D a= Q)~ a N co It U 7 c I U Cl) M 7 N N N Z N Z O O ` E d C O W d co 0. m M FN Z C 0 c C7 6 O z d U V r C C/ 2 V' Z ~ I ` 7 7 F- C • "IVA ZP = O I . O Q Q O O Q Q © O S z z 2 z z N Z E E E E o ~o E C hN N y_ m U y_ (D > a a CL U c U N d ~ N ~ ~ ~ d L N (n O m cc a. a~~ -o`oa .0 _ U) U) U) E •ry j ~a..aaa c3~,aaa z LO o 5 ~ c N j' 0, o° 0 = 00 00 } N N N 0) O Z (10 U') O N co 00 _ E O O 75 0 0 = OJ r c4 n N 'O N V N N (D M a Y Q n ob Q ~m O N N N N N N ~ c' T a c c w c is oN 3 a) o 'o co o E o © o oaNO m c a0i c a °o C l L N m N C E O N G co y 0~ v C Imo' 4~-- 67 C 7 0) N O 7 N o of c N 0 z Q ~ ~ -o Z ry .c =5 E o; 'D m o O) 0 N W O ? U • Ya M N Q O N m O -C O co U) Z ° a. z F- N Z 2 F- cn 4i E V et d d d~ . d 0. y a EL i: CL ~1 A 0 aM, oU-)00 0 U)u ORIGINAL 1519 Wisconsin Department of CommerSOIL EVALUATION REPORT Page 1 of 3 Division of Safety and B ' S with Comm 85, Wis. Adm. Code Certified Soil Testing County Attach complete site plan on paper not les x 11 inches in size. Plan must St. Croix include, but not Iimitwlili Yer♦Me1R nzontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. 034-1072-10-> Please print all information. Revi ed By Date Personal information you provide may s. 15.04 (1) (m)). u~y~~ O L b 6,10 Property Owner Property Location Thompson, Stan/Mabel Govt. Lot NE 1/4 NE 19 S 32 T 29 N R 15 W Property Owner's Mailing Address Q Lot # Block # Subd. Nie 5Lr CSM# 2867 HW 12 ~J City Stat Zip d City Village Town Nearest Road Wilson WI -:744 AQA R400 Springfield HW 12 New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD 641 Replacement Public or commer is - Describe: Parent material loess w/ till *Q 4nXL Flood plain elevation, if applicable NA General comments and recommendations: possible 4' x 112.5' rock bed mound on 98.3 contour as upslope edge of rock w/ 2.5' sand fill w/ interpretive determination & state approval or holding tank ❑ Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor 10 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-10 10YR 3/2 - sl 2 10-30 10YR 4/3 c2p 7.5YR 5/8,5/3 sl lacks A+4" Boring # _ Boring V Pit Ground Surface elev. 98.8 ft. Depth to limiting factor 10 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 1 0-10 10YR 3/2 - sl 2 f sbk mvfr cs 1f/m .5 .9 2 10-16 10YR 4/3 f2d 7.5YR 4/6,5/3 sl 2 m sbk mvfr cs 1f/m .5 .9 3 16-30 7.5YR 4/4 f2d 7.5YR 4/6,5/3 sl 1 m sbk mvfr gs 1m .4 .6 4 30-40 7.5YR 4/4 f3p 7.5YR 5/8,5/3 sl 0 m mvfr - - .3 .4 lacks A+4"; structure determinations tentative due to frozen soils; verify in spring; interpretive determination required ' Effluent #1 = BOD5> 30 < 220 mg/L and TSS > < 150 mg/L Effl = < 30 mg/L and TSS < 30 mgr CST Name (Please Print) Signal r : CST Number Henry F. Grote ~411'--,~(~" 222774 Address Certified Soil Testing Date Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 1/5/2002 715-233-0398 Property Owner Thompson, Stan/Mabel Parcel ID # 034-1072-10-000 Page 2 of 3 7 Boring # Boring ✓j Pit Ground Surface elev. 98.3 ft. Depth to limiting factor 20 in. ` Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Co c Roots GPD1ft` Boundary in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2 1 0-13 10YR 3/2 - sl 2 f sbk mvfr cs 1f/m .5 .9 2 13-20 10YR 4/3 _ sl 2 m sbk mvfr cs 1M .5 .9 3 20-24 7.5YR 4/4 f2p 7.5YR 4/6,5/3 sl 1 m sbk mvfr gs 1 m .4 .6 4 24-48 7.5YR 4/4 f3p 7.5YR 518,5/3 sl 0 m mfr - - .3 .4 structure determinations tentative due to frozen soils; verify in spring 4 Boring # Boring 1!i Pit Ground Surface elev. 97.2 ft. Depth to limiting factor 10 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/T in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 1 0-3 10YR 3/2 _ sl 2 m gr mvfr gs 1f/m .5 .9- 2 3-10 10YR 3/2 _ sl 2 f sbk mvfr cs 1m .5 .9 3 10-19 10YR 4/4 c2p 7.5YR 4/6,5/8 sl 1 m sbk mvfr 7.5YR 5/3 gs 1 m 4 6 4 19-45 7.5YR 4/4 c3p 7.5YR 5/8 sl 0 m mfr - - 3 4 I OYR 6/2 lacks A+4"; structure determinations tentative due to frozen soils; verify in spring; interpretive determination required; horizon 3 occasionally parts o 2fpl F-1 Boring # f 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 P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I ' Effluent #1 = BOD s > 30 < 220 m9/L and TSS >30 < 150 m9/L Effluent #2 BODS < 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 s I ~T ~►M ~1'0 -KJp %o%,% U' w iL~1.~ l~,w 3i.i~,ti ,4Y2 k~?'-M~-;z t9•tsw i d.4444. 1 nn o S o L c~ ~.lw.~~~Q 45..E ,5,~ ~~sb ~ ~.Q Q,.,,;K•~~tae.o~ t'/4 > fop Sh~ 14, a., cvdt.s,) I 4f), Gee q a-~ 3 I de s a rA a & r ~ C4 `r °S r %j r j J, Cy s 0 c- t. u a V CIP f ' 3 d ...r ~ ~J _ ~ 'vNNNw 1 TTNN I y «TT~ wy r?NNyl~t~ mmm wA co~o~o° D_DDyTCyTDD rO f; • r9Tm TT 0 be 6% *1 T. 00 J c.l~ o SAFETY AND BUILDINGS DIVISION Field Operations Bureau 13 East Spruce Street INSPECTION REPORT Chippewa Falls, WI 54729 Nisconsin www.commercestate.wi.us Scott McCallurr4 Governor Department of Commerce Philip Edw. Albert Secretary Date of Inspection: 'April 30, 2002 Plumber Name and Address: Project Name: Thompson Use: Replacement Residential Legal Description: NE, NE, 32, 29,15W Site Number: Subdivision: Certified Soil Tester Name and Address: Municipality: Town of Springfield Henry F. Grote, CST 222774 County: St. Croix E4366 353`d Ave Menomonie, WI 54751 Plan Transaction Number: Sanitary Permit Number: Owner Name and Address: Stan & Mabel Thompson Wastewater Flow: 450 gpd 2867 Hwy 12 Persons Present: H. Grote, J. Sonnetag Wilson WI 54027 An onsite soils verification was conducted at the above referenced site as per district policy for all sites with less than four inches unsaturated soil below the bottom of the A horizon. The intent of this investigation is to confirm initial observations by the certified soil tester (CST) relating to the presence or absence and significance of redoximorphic features in the A horizon and subsoil. In-situ soil texture, structure, and consistence factors are also reviewed as they relate to wastewater application rates. Other site conditions such as percent and direction of slope, landscape position, land surface contour length, and surface water hydrology may also be noted and their effects are factors considered in the recommendations and conclusions portion of this report. If there are any questions regarding this report, please contact me. A typical soil pedon for this area can be described as: T-1 00-09" 10YR 3/2 sil, 2msbk, mfr, as. 09-11" 10YR 4/4 sil, 2mpl, mfr, cs, w/c2f 10YR 4/6 Fe Concentrations 11-16" 10YR 4/4 sil, 2msbk mfr, w/ c3d 10YR 5/5 and 6/2 Fe conc. and depl. Free water was observed seeping into the boring at 6 inches depth after 6" of snow melt two days previous. Peds above 6 inches were not saturated and it appeared that water movement was through soil macropores. Recommendations for this site include the possible use of a mound system designed to overcome limitations of a high level of seasonal soil saturation and slow permeability present in the subsoil. A soil saturation determination pursuant to Comm 85.60 must be completed by a CST and approved by the department to certify that this site has at least 6 inches of soil free of saturated conditions for seven or more consecutive days. Should a mound design be pursued for use at this site, the linear loading rate should not exceed 4.0 gpd/ft and the basal wastewater application rated should not exceed 0.2 gpd/ft2. At least 30 inches of sand lift must be used when applying septic tank effluent to the distribution cell. The longest portion of the mound must be orientated along the contour. A surface water diversion ditch must be constructed up slope of the mound to divert surface water around the mound structure. Lastly, the basal area should be chisel plowed to a depth of 12-14 inches to ensure that the platy structure is better able to accept vertical water infiltration. r!_ Joyy G 0ansky, WfAtewater pecialist Ljansky commerce.state.wi.us E-mail 715/726-2549 Fax 715/726-2544 Voice cc: []County ❑ Plumber © CST ❑ Owner ❑ Other r j CERTIFIED SOIL TESTING, LLC Henry F. Grote CSTM, Licensed Designer E. 4366 353`d Ave., Menomonie, WI 54751 (715) 233-0398 FAX: (715) 233-0398 E-Mail: grotehCa_)uwstout.edu October 6, 2006 Stan Thompson replacement septic system On-site soils evaluation, 1/5/02 and state/county onsite, 4/30/02, indicate the potential for a replacement septic system. Additional work is required: 1. Some additional soils study to verify potential for an A+0" system. 2. Preparation of an interpretive report based on the work to date plus the additional soils study. 3. Submittal of the interpretive report to the state with appropriate fee. 4. Possible additional stat/county onsite visit. 5. If interpretive report is approved, detailed plan preparation for system design. 6. Submittal of plan to state with appropriate fee. 7. Following plan approval a sanitary permit must be taken out by a licensed plumber with St. Croix County. 8. Construction of replacement system. Wisconsin Certified Soil Tester Licensed Designer of Engineering Systems CSTM 222774 WI D 1699 - 007 w o r "o D z m m } z R' ~ O mm m ~ r ~ ~J1 m e m & o ..1~ 0D W O 00 ~ ~ 1 m z ~-Tl ° r Q m Q 71 M D o N m C7 C~ m p 00 zo z o C z Z Z m cn Cn c ~ ~ Z C) Oz m o C7 zoz m n O ' G7 ~ m z ~ 0 m ~ = m ~D m a 3 w~ ° m Q '0 a Lo. _ ° I m o ~g CDC CD (D o CD N ~ ° D o o ° o (D m o -3 r m = c o v m m = c m m m I Q s° F m o o o CD m n~ m v C: N O p D O O N N O m cn d C V/ O n ~ C7 3 m o = ~ ~ ~ m N ` x x vi N o~ v y O O cD ~m n < _ ^ o O ~ m v, ~ m o w a a .Z ~ N m a z o p O Q a O S N (D 'O - D j O 7 (D - N a N O co D m n~ m y cr 3 CD : p= ~m N o N E m a 5 r m v 0, Co 0 y (a~ v v (D D 3 CD v_ ID III zo m (n a CD F) 3 3 m o' m ct) ~ O m w m v m m m z C z o m o > > o m o m y z =1 m = w m ° 7 a- D D C1 m m m y z m N ~ zi 92 :j m -o CD a (D N m O O Z O D CD (n w o OL) r- w o o z z O z X 23 CD :3 CL a) m =r CD O o O ❑ El El a) =3 j = O O O ( Q ~ 7 6D i v~hl County Sanitary Permit Appiication ST. CROIX COUNTY WISCONSIN coO ut4 In accord with Chapert 12 St. Croix County Sanitary Ordinance PLANNING & ZONING DEPARTMENT Gip ~?jo~' Personal information you provide may be used for seco purposes ST. CROIX COUNTY GOVERNMENT CENTER [Privacy Law. S. 15.04(1)(m)j 1101 Carmichael Road Hudson, WI 54016-7710 (715)386-4680 Fax(715)386-4686 Attach complete plans for the system on aper note 8-1/2 x 1 es in size. County Sanitary Permi ❑ Check if revision to previous app i 1. Application Information - Please Print all Information Location: Property Owner Name n / C hik 1/4 1/4, Sec /J l~ G M N, R E (or W' Prope Owner's Mai ng A dress Lot Number Block Number sr.~R(ix ouNTY ity, State e~l Zip Code MISnA - Subdivision Name CSM Number k~r s ) N ~ II Type of Building: (check one) p ~ amity ❑ Village own of 1 or 2 Family Dwelling - No. of Bedrooms: 13, yam} 1,7f ae1,rx,~ Public/Commercial (describe use): -!QV' " S ❑ State-owned Ne rest Road If. Type of Permit: (Check only one box on line A. Check box on line B if applicable) ' Parcel Tax N ber(s) A) 1.0 Repair [.7%peconnection 3.0 Non-plumbing 4. ❑ Rejuvenation 03Y -40 71 ,16 Sanitation > 3 5d_r~ S) Permit Number Date Igs d y State Sanitary Permit was previously issued o2 9 j S O ~ 0 P yF 6 IV. Type of POWT System: (Check all that apply) ❑ Non-pressurized In-ground ❑ Mound ? 24 in. suitable soil ❑ Mound 24 in. suitable soil ❑ Mound A+0 ❑ Sand Filter ❑ Constructed Wetland ❑ Peat Filter ❑ Drip Line ❑ Pressurized In-ground Holding Tank ❑ Single Pass ❑ Other ❑ At-grade ❑ Aerobic Treatment Unit ❑ Recirculating Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application Rate 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed (Gals./day/sq.ft.) (Min./inch) Elevation VI. Tank Information Capaicty in Gallons Total # of Manufacturer Prefab Site Con- Steel Fiber- Plastic New Existing Gallons Tanks Concrete structed glass Tanks Tanks ❑ ❑ ❑ ❑ VII. Responsibility Statement 1, the undersigned, assume responsibility for repair/rec /rejuvenation/installation of non-plumbing for the POWTS shown on the attached plans. A license is not required for terralift r pai the installatio of non-p bing sanity n system. PtWer's Na (pant Plu be a / PRS R v iness P Number I~rr~ o? Plumber 's Address (Stree , City, Sta Zip Code) y /JA VIII. County :e Only L Disapproved Sanitary Permit Fee to Issued Issuing Age Signature tamps) Approved Owner Given Initial Adverse E etermination 22 S ' a6 , IX. Conditions of Approval/Reasons for Disapproval: sYSTEJ b J ~ R~n'lDVE OC,d I1'!OB/LE- /44,07 r- ~¢f ~/4 N6Z-uj UNiT, as per management plan provided by plumber. tt 2. All setback requirements must be maintained ,n~ r6lVAz'_ ylv~ I_J At ~4 GceQ'hii as per applicable code/ordinances. ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEC TANK This is to certify that I have inspected the sqAic tank presently serving the 1, 0- residence located at: o_ 1/4, 1/4, Section; Town N, Range 1_,_ W, Town St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of Comm. 84.25, and it (they) appear(s) to be functioning properly. Most recent date of service 7_ Di (if no, skip next line.) Approximate volume or length of time: gallons minutes Capacity: 3 66,0 Construction: Prefab Concrete Steel Other j' Manufacturer (if known): Age of T k (if known): a r (License umber Signature) (Print Name) 2?n (Title) (License Number) MP/MPRS -67 (Date) Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) wwv4p HOLDWO TANK SERViCWl CONTRACT s'CJ Tits oa►haot 18 mado belwwn ate p r PA O rj / Cr it ~►.~e .~,d r npT)-,~T7 S,~ ~r t~ on the 4provift Wo doantpdorta:) 7. n,. owner agrs ae • oop,, d this oonasct win the k po+brtanerttal ta>it itrel ties ttiprtad ri. +o re%*W in Ch. UM S t 8(4) (b), Vft. Adm. Code and va the cotnrty d- S rr elgtl (x 2 7M Omw 'o "br OPOMtO IWM the hO tUg UMN ae vkW by Cw pXgW Ud le ""*MID Mom wd "*n P W&* for ilia papose Of unickV the hOWk p~~~~,~q~ s). MW MW apnea to nqntWn the access mad or ddwsa ddw s ~ pumperDan $Sr,ice the hokbq lmn4s) with the p~pWg aq~ipmwrt. The owrurt'trrrttw Oomn tb pay #w chaepa Rased in mvl*w the hddutQ leuth as = **MY Mmd upon by ft owner and pumper. 9. The oumWoWMIO suDr*+6o ttre tacat gotarrrrrtsraul ur,h whieh treesiprad a Mta LHR 83-18 (4) (b). Wis. Adm. Cods, and to ihs hw ft ro=a==d by a. Countt . s report for uu. serv(otng of ur. ►wlding +,~nic(s? on a ~ ptyisIL . The t r ap+aae to hi kWo the folio *V In tlm aarmsrtnuat . a. The name said addraes of fir psnron rtylpwrta~le for b• . nwm srrrloh8 the boldirrp tank, . dltw owner d fire hoklnp iw* c. 'no mew= dAte PAmhonwmh he hokiq tank is fr+stai>ed; d Tfta mRfty V I rk number bawd for hofdwp Wk a. The dawn m wench ifw hd*V lank was aervks* f. In* vakrrnea in gdibns d the 0x*uds p.npeo Eton, ft bdd tp tsartk for oach,tw* ft g. 77te dkp=W aft to wMdt the to=wn's ban the hoMkV tarot were defaawd. 4. This apeernwht vr>N rernabt in egeot rutvl iha otMrta or pt+mpsr tam►M+aMe dris rxrttneot. In"event d e dww k► da cwwact. MO MW Won to fb a copy co tiny duugn to itrlt aervkce MOM or a Dopy of s rrew servk v contras *a iho Iwo parWWW W W* And ft County rtented WWw MW ten (10) btasbus stye frtxn the dale of Chwrrgo to oft esrrk» conlraat. OWA*)Ih- f" itl~wisrsarpnrarriy 9ubecrbeeanoswarr►tomeanthfaatw: r Tftwooft UAW NdftP t "PA wow wrqii*~ T A (P IS nowt. -77 A Drafted by u 1 1 1 ~ I I j ~ z JJ r J State Bar of W Foim 7-2003 f- TR USTFE. S DEED , Document Number n Document Name a ~I THIS DEED made between 'Stanley Thompson, as Successor Trustee of , I the`Mabel c Thompson Trust, dated November 10, 1,995 , (Grantor, ,whether one or more), and Bradley B. Midthng a single person y~ ' 3 ("Grantee," whether one or more i Grantor conveys to Grantee, without warranty, the follgwing described real estate, li 1 together with the rents, profits, fixtures and other appurtenant interests, in St Croix County, State of Wisconsin ("Property") (if more space is Area needed,,please attach addendum): i N gca, Adr TIP Northwest 1/4 of the Northeast 1/4, all in Section 3~, Township ;9, Range 15', ; St.'Croix `County, Wisconsni, except that arfas shown In Certified Survey Map in Ed' Realty itle, Inc 400 uth Sec S t Volume 18, page 4706 filed Feb 20; 2004 in Docutnent No. 754792. Sui 115 AND H WI 0116 t i jA Thy 0ortheast i/4 of the ortheast'1/4; Section 32, Tow s1up.29, Range 15, St. 034-1 20=02 ' 0.44-1 Croix County, Wisconsin; excepting 'that art'as shown in Lot 4 of Certified Survey parcel Ide ltifica on "ti a" IN)'! Jan 2066'm olume 20`of Ce ie Survey Maps, page 5139, as Document No. 815577, I AND tpartof the fast 112ofthe Southeast 1/4 of Section29,Township 29, Range 15 Grbcd as'followp; ;Qt}ttot:l: of Certified Survey rp;filed January 23, 1996rf iF in 1Jo~lume 11, page 3044; DocumentNo:''S38809, St. gooix County, Wisconsin. if ~ 1 Dated Jah Lk 9X 1 (SEAL) * ) -Stanley Tho son, Successo Trustee' i ~ i w ! AUTHENTICATION ACKNO GMENT f Signature(s) STATE OF WISCONSIN ) authenticated on CRn ) C4 ) kake Ir ~ * T Personally came before me on Y14 IrUU~ , TKI ,E: MEMBER STATE BAR OF WISCONSIN the above-named Stanley TIIn, as Succ oi- vgtee ' •tho (IManot, Mabel Thompson Trust dated lN vembex.l0, 1 S15 p authorized by Wis. Stat. § 706.06) to me known to be the perso s) who exe ted the f going instrument acknow edged the same! THIS INSTRUMENT DRAFTED BY: AB Brent K Johnson Lommen Abdo La WFirm, Hudson, Wisconsin p' ' Notary Public State of Wiicons My Commission (is permanent) expires:' d ' I' ) (Signatures may be authenocated or acknowledged. Both are not n ecess I ID NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD'~'CLEARL'Y . i TRUSTEE'S DEED ®2003 STATE BAR OF WISCONSIN j FO N 7--20Q:i • Type name below signatures -`+4 1 w i . Y } m USTEE,s ~ocu en b DEED ~r r,<~ er 9~ument,Ti je_ • [ h kk~~ I t P ~ e 1 ~ I ICI r I~ r 1 r K ~ i 4 , ~II f I w eC or j!' a b ACC, C` to yo~1 L L L~ fy, p tr 'k .'T..o 4 3 3 4r]0 2_~ s P~IldIntl f~a Yr i-,~ p 1 i v, ,,per r I ~ J N rs r ~ I: ~ s H At, ~r t K' yr ~Is page is part of this.~ al document _ p Q ~ ? I }X 1 not regk4e" s ~l rh i °inforrt~ ation' rn OrMr°infoF ust be com rnationsuch G Pletedbysubmitter do~ [ k4 dQC ant or the_ may granting ur"ent title 1 y be ► clauses; le b , . Y°urocu p aced on gal d~ , name & return E 1 ment'and additional escnption addr $2.09 to the recording of the ocument.etc. may be placed d. P N ~(if r " g fee. WiscQ~~ Note: Use of thi nr tp e t tatutes, 59: W this g~ of ~ ~rsF l n S 51 a Rpq' 9 e on 3 i i t( ~ Y ~ aF'~ 1' ~ i 't} 1 f 1 fi. t I ~ aJ~! ~G1~ 4 k C1l ~'E Sh F 5:1 t f v 1 J i\ I VE WN T i _ ) r1o V t ~ lY ~ t i ' i t a' i 11111 Y ! ~l ! Ali t r 1~ Parcel 034-1072-10-025 04/05/2007 03:26 PM PAGE 1 OF 1 Alt. Parcel 32.29.15.482A 034 - TOWN OF SPRINGFIELD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 01/03/2006 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - MIDTLING, BRADLEY B BRADLEY B MIDTLING PO BOX 67 WILSON WI 54027 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 2891 HWY 12 SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE SEC 32 T29N R15 40A NE NE_E_XC CS_M Block/Condo Bldg: 20-5139 l.~ Tract(s): (Sec-Twn-Rng 401/4 1601/4) 32-29N-15W Notes: Parcel History: Date Doc # Vol/Page Type 01/30/2007 843513 TD 02/10/2004 753914 2507/186 EZ-1 07/23/1997 1150/265 QC 07/23/1997 1031/327 TI 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 05/23/2006 Description Class Acres Land Improve Total State Reason Totals for 2007: General Property 0.000 0 0 0 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 RECEIVED Ot, t - 42006 VOL 20 PAGE5139 KATALSER H. REGISTER OF DEEDS $T. cRorxCovNTY ST. CROIX CO. MI RECEIVED R ft PR ECO '!Dl CERTIFIED SUR~I' 'i `ft CERTIFIED SURVEY HAp LOCATED IN PART OF THE NE 1 /4 OF THE NE 1 /4 AND IN PART OF THE CECERTIFEE-z FI 13.A0 SE 1 /4 OF THE NE 1 /4 OF SECTION 32, T29N, R1 5W, TOWN OF COPY FEE : 3..6 SPRINGFIELD, ST. CROIX COUNTY, 1MSCONSIN. PAGES: 2 PREPARED FOR: LEE & BETH STENZEL, 2867 HWY 12 NORTHEAST WILSON. WI 54027 CORNER IIVYYY SECTION 32 OWNER: V`~1~P~i N STAN THOMPSON pQ ~~I 10ABTHOMPSON TRUST vN~i 33' PCCE ~A~~ C1 S89 54 28 V 100.00 cy'~1"~152 DRIVEWAY 33.00' r SOUTH LINE THE 33' NE 1/4 OF TH NE 1/4 LNORTH LINE OF TH . B c SE 1/4 OF THE'NE 1 C m c~~+v8 S. v LOT 4 8 $ z ~ m It rn 5.794 ACRES R80104 ~Q .396 So. FT. 9 ((252 TOTAL AREA ) g l § UR , I a 5.334 ACRES :q ( ~ {t _e-to N (232,353 SQ. FT.) $ N s ign i ~ - EXC. R/W m I (W zg' N a. en r" OD T "0 4 N Ni DODGE x Z C _ 9-2.84 = 'tn N m CLEAR LAKE U Wi Irn m f-7~ pQ•~oe ; ~~,o a q Z2-a S 6 6' e N N89'54'24"E 436.94' aq N ump LATTED LANDS O 33 SCALE IN FEET 1" = 100' 33. X s6t,T pED V S04s is OPG. 4x32 -r CORNER 4 SECTION 32 100 O TOO LNL LEGEND FOUND PK NAIL EACH PARCEL SHOWN ON THIS MAP IS SUBJECT TO FOUND 1` OUTSIDE STATE, COUNTY AND TOWNSHIP LAWS, RULES AND DIAMETER IRON PIPE REGULATIONS (I.E., WETLANDS. MINIMUM LOT OT SIZE, ACCESS TO PARCEL, ETC.) BEFORE PURCHASING OR SET 1" OUTSIDE DIAMETER BY DEVELOPING ANY PARCEL CONTACT THE ST. CROIX O 18' LONG IRON PIPE, WEIGHING COUNTY ZONING OFFICE AND THE TOWN OF 1.13 LBS. PER PLINEAR IPE. FOOT SPRINGFIELD FOR ADVICE. A SOIL BORING THIS INSTRUMENT DRAFTED By. WILLIAM KANE JOB NO. 6556-01 DATE: 11/21/2005 SHEET 1 OF 2 Vol 20 Page 5139 Parcel 034-1072-20-025 05/0112007 04:44 PM PAGE 1 OF 1 Alt. Parcel 32.29.15.483A 034 - TOWN OF SPRINGFIELD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 02/20/2004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - MIDTLING, BRADLEY B BRADLEY B MIDTLING PO BOX 67 WILSON WI 54027 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 37.020 Plat: N/A-NOT AVAILABLE SEC 32 T29N R1 5W 40A NW NE EXC CSM Block/Condo Bldg: 18-4706 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 32-29N-15W Notes: Parcel History: Date Doc # Vol/Page Type 01/30/2007 843513 TD 02/20/2004 754791 2513/417 TD 02/10/2004 753914 2507/186 EZ-1 07/23/1997 1150/265 mor OTC 2007 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 04/14/2006 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 36.020 4,850 0 4,850 NO UNDEVELOPED G5 1.000 50 0 50 NO Totals for 2007: General Property 37.020 4,900 0 4,900 Woodland 0.000 0 0 Totals for 2006: General Property 37.020 4,900 0 4,900 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 034-1065-60-000 05/0112007 04:44 PM PAGE 1 OF 1 Alt. Parcel 29.29.15.449B 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): O = Current Owner, C = Current Co-Owner O - MIDTLING, BRADLEY B BRADLEY B MIDTLING PO BOX 67 WILSON WI 54027 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 19.825 Plat: 3044-CSM 11/3044 SEC 29 T29N R15W PT E1/2 SE1/4 BEING Block/Condo Bldg: LOT OL1 OUTLOT 1 CSM 11/3044 19.825 ACRES Tract(s): (Sec-Twn-Rng 401!4 1601!4) 29-29N-15W Notes: Parcel History: Date Doc # Vol/Page Type 01/30/2007 843513 TD 2007 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 04/14/2006 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 19.820 2,700 0 2,700 NO Totals for 2007: General Property 19.820 2,700 0 2,700 Woodland 0.000 0 0 Totals for 2006: General Property 19.820 2,700 0 2,700 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 o CO) 0 l 3 m o d L1 c tOD n IC 'O ~ • o sk r ^ T (D 0 " 3 i d N O 0 j .0 N CCO~ • j. Cf C Cn O c j z 3 O W 7 to fD O CL 0 O ro m n fn N 3 Ial O~1 O w C `OG ~ ~ O ~ lr m p C CL S?o CD a y W Cy O ON o O N ONO CD CL 000000=! 09 CA o o 3 c T I i 0 000; v c v o 0 o t_n CD _ :3 CD ? CD y 0 N CD V a 3 I z OO D D O a I ElF CD CD :3 x c II w m OZ ~ A Z 0 ; A Z O d i ~ 7 Z -I C4 W M M N CL ~ z O I 3 I m ~ z I ~ ! a W to N C- D G o cn .Cn. E 7 ~I O =r CO O C _ a z CL I 3 D p M O CA CD C fi CL Cn y w A CCDD O a (a b d R p d N `v V 7 N O X p j a ~ 'r N CL RINGFIELD R.29N --R.15W 37 I , pp • • SEE PAGE 9 us /c p m h ~Picha/-d Thoin6,son ~mr' " tly w /o/ram /th • b CC c• P ~ y C ~ D • r poi Edwri/ s % V'Q f.27anna /ai s s b C tl a en 0 J U ~Tohr~ F3uf/ec • 1~ 1~J0 Karnes 4¢eo ~C'Ch Vtl~p 44,ss 9 byN ~pU Tia en 9dyce ~j0o '0 J •j r7o.y 43s i7omos JQ4 C10b~: .y~0 'Ott F • Mecwin Cry \\a Q1%+J 4qd /os.cs lY ~~p \.l y tlw~ /73.3 fCatJJel/(/G 6¢SgC Dtl ~ ,\\p, L tl V V /`1c!/•ec /ro U ~ q q~0; V~J 'w o~~ 0 64~ Qtl • Cha/e • B.3oB 4o K%foh b.C ,.Z7ow o!/us '-o- ~~rs ° tl (0~ ^ E/dog 23Iynnis • T s' '7 Y*s 0 Lee • Oo~FO '~9C .l`l'C f tTanrca QIT.'I/' / b`~ s 40 Cp ph y\1Q 0 v^e:rn tl X10 v C5 9~r~is~ ¢ou/f 99 l .Up 9 C Zf ro Moncc~ d Emi/ C ~•Vyg \c F~V v~V Gee C tl /2e 4Do/ r7n Q li° ~o F Margie /so eSfr. y C 9 k, 114 tl Ol OJw ~lw ~{•~T0 cSeirn ~V 80 9 ~b~ h Tor•dheim /eo F•O D 4 • _1~ ~otl` ~~C 'p • r 9.s VS°o ~v`~ ~ W` ~ 92 V~ ~ A r. QQ ~ 7! r • . z79 JAS / 4 N s rn Lawrcnc< .Posse L v ~ cbbo a h. t 966/e .moo . tl , 4 Ph %N:9 Har/¢n E K nnc fb /~hson azs Ho ~en Thoiser7 ~D g~ cTo hnsw7 • Jh~.so r. e/a/ jp' ~%rnn W. 20 Yerne S s Q 80 /20 /.ao N zo ft n 119 MtYton Ma/earn 'r d -uce zO J~ ara- n/c/sos ~tlq r`~°.n.s°n 0) Geana G estate o on'ts i 7.f4 B .o/¢ C' U Qr~i l f M ka rY s. ~TOhn "b t Fr" o tToh nson z+o ~o.C~ rza qo ~9^ Ba • H/rsc Comnn, vet ~4 sy rUO do// r~nd/•cw W I I .Per's U.~p Vq* Ha /d ~ a 9z.rs b ~ V • 3 5 /y Kcc n;t ~ ~ ~ W~ yryGa ssoyi~ ,a pp ~ C o R~ ~ .c. .9nd~cw ~ Tohn .bra • f CufuciQ C U ~ % C /oo C ~ Q Rers l r Te k- U 0 tl ~i o ° V,~i s.B . s Qtl q c¢o = 80 • go eo zo4.7q tl~b Q~ C.di~A aco w_ r~ t>z nC~ lu \ ¢ tl F~ d~ 0 ~~t/ tns .s . w E • V~ V V Wcr{ ~P 3q ~Z4~1 /yFYRYn e/ ar•~s4. • 1r~73 • r. r 0 • ~ tCnG u~ ECtr-/,P ~j/Ce I6D.• q 40 95 s v%/mar; S^, lean Ea /Ff7/c< • A rb5 c3,F ~ wr'diJ p C Cj/or-r2 _ V%/mGn ~1 .9r/ - tar a ' a V • V h~ yob asfiys ~obe, fly /99 ER CJo C. "w"• T 0 `C 79 D wrrY //%/mar • ~ clon~s k ch - • may g /60 6 rmrc /00- 9 on S f 16 y •l /acio. 6 Inc MCCa N+ • tlC~ Uhp Uy ~ h H¢ o/d Fsetty OF Cassius E.,p Lccv/. n CC QCK ~.C C F .Brandt f!/van ~ an c5ondst cvn n l obJ~ W r~Zfeq 0 ~ 0 /zo ~ ,Booth V Ginccn-t /eo cSfn.-+/ayy l V CK +n• 4 D Eva ~ 0 ~ 79 6o V . fsQ ah f`1a y /Vyhur ~qQ 4 `h .Ur/son b ` a24 Bo F f zoo EFh! Chace<s Ly- Fi¢.scrs-Z~ • /10 ~.~y k • to 't~0 Y tl ecn My°cs M°Gc a JF /z o f L cx r-laho~ R M W ` J .4o v.,i a. 7f• yooxs 9 o 4Y, J ` r 6b /ZO etUX O N •L Ghas PP ay rPosa//a l C q/b_ • • a ~ l~ .b¢ y d ao Maho rey tl tl ecs t BO fo ~cr-w/n ~ V ~Pa/ h t SyCG/ a O ald 2 y 0 W 0 4o Gee. P Mahoney l 79 V Drnn/s tl \ \ eta/ UV o2osem¢rie Bo B°iC''yc J f~ usan U ecJ`6Mar- ~9ian f,l¢t.5y Rio, !~✓ebv ~ ~ ~ T/+n np.s°/7 .Pa¢seh CA ~dQ 4 iy OC17 c • t3/oo.n'y b ~ Co/bcrack Cn C o ,-I ~ BO ~Oj rbo N whoa ` /9o n/ hus /bo r8akke f 4~ g~ m too < Bo G¢ son w (o v rent !y°e .v. s a° 9.4e7 . C y 0 Ka~.Fbc<nrrrc l C` V l 9 tl ~ V V uan ' Cho ie s Sher-/ey /`1 ff¢~ /d f RM Ker~ceffi E. C{ Q '~09~ 4 ~ Mai f Gach~r s Ma.so c..Y• ~ru~ V ~Bettq Q~ D i /ss Wv~~ 0a ~ h.r~ h~0 h• ,Dow O%lac e !•o Bo et~rx e e ¢i l 0 l Tho ~SOrr h V D /v/r7 W J s Lee a /so .Dor/a/d C Wia1 tl ~l~ uy' 0 • t, F • r;so I~•C Lac - k INacnrr- \ • ,aa v cry /bo end McGee i~ o /o%il tl VuZ~ V77(a C • 0 5 U ! ~Oy Cha /GS RO. • • ~ J 39.9 Ba • 1,• w , C O Le~2oyy ffranc h Q~re e, V d 0 !7era N.ItGR[N V \ j %0 f S 3"an Mand.~ q eial r f1oPP Tu .Qobcrf 0`C Oa a 60~ Sam Edrrwnd9 Ra. ,or/n sen C V ll~ c5' Coornb , ° SS ~Y l \ l Serm as o eta/ VA) 14 Y y V Z Ct /88.3 C¢ / N etfy C tl 0 tl tl D 4o a~d rzo Jr` kk~~ V ? K~ tso~ c Gsa ies 1~,~ /seeo ~ t0 e.F -lq V burg .Tjow tl V 3U z9 Fo res} Q 4o toy tl O' C/Qude f ..y a $crTuY!' Ed.r°h VW C Kac/ 2 ~Q • ~V~ ~~rveaa /YCee/8o p Love • Bo S'weit3ec e t Kath. c ,v < • ° U/fa is /a7 ChariBO ~ :Lame a Bo B„~ s •.0 O/ 'v r< :Mary Slow o rPoBe ~c~r ~ ~ 9 0 0 • F a ~ bet CO M /7/0~ EY: RM08 V.• F Loss 0 UVCV //tB/ /moo ~TOh~.ron zr3•~U0 r son ¢ Ne%o ~g 4s ai.~ ~~LMc~ra e ~10D ~DO V`y W f[eo//ra.po 0o R /P ioz7n ze9 ~ e/ /bo Qo Q~ ~ W 0~ jQtl r7ufs °0 oo ,~1bJ Uk Bo Heinarr- s ~ ~ .ao Lar• y s .rb.s ~ .eon. .re . • • E/manor- • c/c.~ r° - ~ • L/oyy ti'o/1 4o go • 0 QCIV MOck. B/ U a-~ C'ic ~d ~i • J' on ~9. • Eu /7e • C fCa'ro% ~ 3\1 eSe/mar- 3S L4wi-er7CC 47 iSOn ~ by .Ds_ai.S 0 • O/son cSta :9 NN Thor/Pson /z//s~ '~Y• a 9 ec/a ar- /i C Wayne ~y y. ch E' bbs bes; L salt svar,ba yh ~C 0 w 1 ~ La, zs0 Bo • V ~i a.2 /os ef'eir r. ~+u 1 V . So Bo /r'° n ~Q ~c ~ Maynard 0 `0 U C . 'l J C Eit/arid C z8o D V P a C ~ U 0 C y r Pus rah e ~ " /:icon r/ f,B, ° ~ 9~./s C y HeJ e rPobrr-t n o r'/o~1ha V b '.rrn ock~ That- v Ci `C Lar or, Ge ricbson p L:.»astori< chgc tltl\ iTohn t of WV °f ~'{C /2O C l 1\ 0 ,h~ .DOrodhy k° w~ Ed aid W C D M Co, I c, so a~ tSauc rs @'~ ~ 7~'-hwa:9Ba rib. 4ez so 4G ~ .~Pav t6e>`f ,'.0 OZ9 • ;i rYeriry /~2 M Kaha/iy 4 • r . ~f' 60 9 Geo. tl~ .C I ve's n9 C'vj+ str 's z ~'/96BR ek d ' A6ordcn 79 V ~V o lady for Ma ub/s I c., rpE; v. /97y r y • ~ Re "f Q~~ 38.ds f SEE PAGE 23 ~$tCcoix Cornfy,ws- STEINER SALES & SERVICE, INC. . We can Make your worth WATER SOFTENERS SURGE Phone: 684-3261 l Baldwin, Wisconsin Parcel 034-1072-10-000 09/21/2006 04:24 PM PAGE 1 OF 1 Alt. Parcel 32.29.15.482 034 - TOWN OF SPRINGFIELD Current ! ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 01/03/2006 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner MABEL A TR THOMPSON O - THOMPSON, MABEL A TR 2891 HWY 12 WILSON WI 54027 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ` 2891 HWY 12 SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 32 T29N R15W 40A NE NE Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 32-29N-15W Notes: Parcel History: Date Doc # Vol/Page Type 02/10/2004 753914 2507/186 EZ-1 07/23/1997 1150/265 QC 07/23/1997 1031/327 TI Bill Fair Market Value: Assessed with: 2006 SUMMARY Use Value Assessment Valuations: Last Changed: 04/14/2006 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 36.000 5,050 0 5,050 NO UNDEVELOPED G5 2.000 100 0 100 NO OTHER G7 2.000 9,550 173,200 182,750 NO Totals for 2006: General Property 40.000 14,700 173,200 187,900 Woodland 0.000 0 0 Totals for 2005: General Property 40.000 15,400 173,200 188,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 143 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 034-1072-20-025 09/2112006 04:27 PM PAGE 1 OF 1 Alt. Parcel M 32.29.15.483A 034 - TOWN OF SPRINGFIELD Current ,X, ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 02/20/2004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - THOMPSON, MABEL A TR MABEL A TR THOMPSON 2891 HWY 12 WILSON WI 54027 Districts: SC = School SP = Special Property Address(es): "='Primary Type Dist# Description SC 0231 BALDWIN-WOODVILLE AREA 1 SP 1700 WITC \ 1 I „ 1 Legal Description: Acres: 37.020 PI : N/A-NOT AVAI E SEC 32 T29N R15W 4 A NW NE C CSM Bloc ondo Bldg: 18-4706 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 32-29N-15W Notes: Parcel History: Date Doc # Vol/Page Type 02/20/2004 754791 2513/417 TD 02/10/2004 753914 2507/186 EZ-1 07123/1997 1150/265 QC 07/23/1997 1031/327 TI 2006 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 04114/2006 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 36.020 4,850 0 4,850 NO UNDEVELOPED G5 1.000 50 0 50 NO Totals for 2006: General Property 37.020 4,900 0 4,900 Woodland 0.000 0 0 Totals for 2005: General Property 37.020 5,550 0 5,550 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount III Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT -NER' 4_ N 77A0 .ff mod), , TOWNSHI z,IM yr4AEC. "SA T21N, R' W 0. ADDRESS Gri~lc•o,~ / I SYGd7 , ST. CROW CO TY, WISCONSIN. "3DIVISION LOT LOT SIZE fpR ;oL 3 R'a n S PLAN VIEW 6-t -Distances & dimensions to meet requirements of H62.20 _ . Hwy ~ SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM s - cop *PIT 8 v'CHT X30, • ?TIC TANK(S)v~0~ MFGR. srot)j C6 c)zz CONCRETE STEEL 1®Lv~~~ NO. of rings on cover Depth DRY WELL .NCHES NO. of width length area J no. of lines width length area depth to top of pipe JREGATE _u RATE N~ AREA REQUIRED AREA AS BUILT :claimer: The inspection of this system by St. Croix County does not imply complete % _pliance,with State Administrative Codes. There are other areas that it is not possible/ inspect at this point of construction. St. Croix County assumes no liability for tem operation. However, if failure is noted the County will make every effort to -ermine cause of failure. _'ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. • `"INSPECTOR DATED -pZ PLUMBER ON JOB u TX )rk G~ C mot. LICENSE NUMBER ~T 9 O 72 1 `REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM i S antitah y PeAmit State SeptA c NAM N5Z&x - Township St. CAa ( X County Location 7;! 6 0 Sec ion Ajoz # SubVvi,6ion SEPTIC TANK Size 3C)00 gattons N mb o compaAtmenta Distance 4Aom: We t ~uti ding 611 1.20 stope HighwateA PUMPING CHAMBER Size gait u Manu6actuneA Modet Numbers 1014 HOLDING TANK Size Zoo ga,-.2ons NumbeA o6 CompaAtmentz PumpeA Atatcm System _T_,_J~ D-i,stance 6AOm: Wett'lS-o{ Building/ ~l12% Atope_ HighwateA CA-1 Z ABSORPTION SITE Bed TAench Di,stanee AAom: We Building 120 .scope High aten ABSORPTION SITE DIMENSIONS Width o xtreneh it jRe tined aAea { Length o6 each tine epth Aock befow Life in 7~/ NumbeA o6 tite/s ep h o6 Aock oven. tite tin Tota.E .length o6 . tin it D p-th o 4 -tite b etow gAade in i Dia fiance bewee~t tine S lope vAench in. pert 100 it p EzL Totat absotcption atcea iit Type o4 Coven: PapeA at stkaw R' PIT DIMENSIONS Numb etc o6 part, GAavet aAOUnd pits yea no Outside diameteA it Depth below .Lnte,t it Totat abaoAption aAea bit AAea Aequi. Led it INSPECTED BV TITLE APPROVED DATE 198 REJECTED DATE 198 REASON FOR REJECTION f : ~Z +.f ~ i s ' i "40 14 ,N r J~ OP. ~I l - f PLB 6 State and County State Permit # Permit Application County Perini 41 for Private Domestic Sewage Systems County Algr:zldak *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: B. LOCATION: ;k F- 4 , _/a, Section , T2~2 N, RL IC a (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# y y)e Village Township ~ gL C. TYPE OF OCCUPANCY: Commercial *Industrial *Other (specify) Variance Single family Duplex No. of Bedrooms No. of Persons D. SEPTIC TANK CAPACITY Total gallons No. of tanks HOLDING TANK CAPACITY 3r49,00 Total gallons No. of tanks Prefab concrete X_ Poured-in-Place Steel Fiberglass Other (specify) New Installation X Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate Total Absorb Area sq. ft. New Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed: Length Width Depth Tile depth (top) No. of Line Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land-- v: 04ff Distance from critical slope WATER SUPPLY: Private X Joint ❑ Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than present owner: 1, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Certified Soil Tester, NAME d T& iQ it ~;/4~ C.S.T. # GS f~ and other information obtained from (owner/builder). Plumber's Signature, - MP/MPRSW# Phone Plumber's Address n „!n ' Gg PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca- tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors property. If well has not been drilled please indicate. • f . i E 3 f E s 3 j Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application X-&*V-00 Fees Paid: States. ICY County 1'0 Dat .7 00 Permit Issued/RejeeTod (date) 2-r- Po Issuing Agent Name Inspection Yes.,k -No State Valid* Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 7/1/78 H 1'. 15 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH j P.O. BOX 309 MADISON, WISCONSIN 53701 ~r REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION: [r c'/4, N'/4, Section ZA-, T^ R L?i (or) W, Township or Municipality Lot No. Block No. County _ s r G ° I K Subdivision Name Owner's Name: S ;r0 h 4xy Mailing Address: R jW/ S',(VO s4 7 TYPE OF OCCUPANCY: Residence X No. of Bedrooms Other b7o16 r L~ He M E EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS q SOIL MAP SHEET SOIL TYPE IZ. 5 /Kv b 15Yk PERCOLATION TESTS TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS ICHARACTERN INCHES SINCE HOLE HOLE AFTER INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN P- No Ar_x Ta ..t R Ks P- P- SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) B- 8,&4AV Log iK4 6 ~L B_ Mo jr4 rd 6 e( PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the locationand square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy. Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. H C, R k ~ a yF ~ IV AII 11 AA 19-5 Tr go Lr_- G L ' ao d 3a i F ~ 9 ' I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the pries U / and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. Name (print) Stephen L. Aaby Certification No. 1101 Address Box a% Woodville,, W1 54028 Name of installer if known ABby Plumbing Hsating & 9106t • Inc CST Signature. COPY A -LOCAL AUTHORITY ~~i s11'.x.1Ytr: rr s. 80029 0 This agreement, made and entered on this day -of JOW a 1 O, .by and between the Township of P. ddress WRERE?S: An application has been made for a sanitation sy gmiign, Pe foUgwing described property: J U L 6 PLUNW31MG SEC110H Vi EREAS: Septic tank drainage does not meet the minimum standards of the ordinance of St. Croix County and state codes. VfrEEREAS: The owner agrees to install a holding tank for septic tank purposes purposes. y NCW TY.EREFORE: For and in consideration of the issuance by the Town- ship of , of a permit for the above premises, the parties do hereby %greefphd bind themselves as follows: 1. Owner agrees that they will conform to all the rules and regulations pertaining to a holding. tank system. They agree that anytime said township deems it necessary to pump out said tank, the owners shall have some pumped out in 24 hours, or township will have said work - doneand charged to owners and place same on their tax bill as a special charge. 2. The Township reserves the right to assess a bond if they desire to cover any possible pumping charge in the sum of $ , 6 A . IT IS UNDERSTOOD that this agreement shall be binding on the owners, their heirs and assigns. IN )XITI•NESS WEEREOF, the parties have hereunto set their hands and seals the day and year first above written. state of Wisconsin oepartmont of . Township of a Industry. Labor & Human Relations Division of Safety & Buildings This document is a full, true and correct copy. of the original on file and of record in my Developer office p or owner certified 190 c By- STATE OF WI..CONSIN SS: _ COUNTY CF ST. CRS) - Subscribed and sworn to before me this =,day of 64,A a 191h -~Z 7 Az_ St COOL X COUNTY Y W I S C O N S I N 796-2239 Z0N{NG OFFICE ~ :f~l III tM Pobt 0 -i,"ce Box 227 Hammond, W r 54015 O W N E R P U M P E R A G R E E M E N T PLEASE BE ADVISED, That unt.i.t you ate again not.ij.ied, I wit.t contxact with A~''~~ 06 ennm tLt`~ (gi4 con,a.in, ( Pumper) , box the puxpoa e o6 temov.ing a.t.t wabte jxom the dan.itaty 6y.6tem to be .toeated on the ptopexty and 6u-tute home 6 ite- r ~ Located in St. Cxo.ix County, W" conb.in, Townbh.ip 06 t yt being in the .F % of the N-i_% of Sec. (Ox mote j u.t.ty d ea crib ed a.a A o.t"towa : ) Dated this ~ day o j (OWNER) State o j W.ia eo n.6 in ) - 3d County of St. Cxo.ix) Pexeonnattyappeaxed be one me Q *7 "day o6 192- o me nown to T-e-the the above named , to--me- pex.bon who e eeute ~t e o going bttument and acknowledged the .same. K- r, f%UAr./V►~~TL hexe.inbe6oxe te6exted to ad Pumpex, 1okn .in the above agreement .to the extent that I have a contract with Owner a.a above atated. fdolkltPUMPER 1 CZ AMC l T77 AG.RF-AV ENT This agreement, made and entered on this c day .o 1 by and between the Township of p ddress ' _ Lao '-h VEEREP. S: In application has been made for a sanitation system on the following described property: M EREAS: Septic tank drainage does not meet the minimum standards of the ordinance of St. Croix County and state codes. - VMBREAS: The owner agrees to install a holding tank for septic tank purposes purposes. NGT THEREFORE: For and in consideration of the issuance by the Town- shiF of of a permit for the above premises, the parties " do hereby gre d bind themselves as follows: t 1. Owner agrees that they will conform to all the rules and regulations pertaining to a holding tank system. They agree that anytime said township deems it necessary to pump out said tank, the owners shall have same pumped out in 24 hours, or township will have said work doneand charged to owners and place same on their tax bill as a special charge. 2. The Township reserves the right to assess a bond if they desire to cover any possible pumping charge in the sum of $s3~_• IT IS UNDERSTOOD that this agreement shall be binding on the owners, their'heirs and assigns. IN Iii ITNESS WFIERE:OF, the parties have hereunto set their hands and seals the day and year first above written. . Township of n Developer or owner _je~" C_ STATE OF VrISCONSIN) SS' _ COUNTY CF ST. CRS) Subscribed and sworn to before me this day of u,/r e , ia8a. 7 -2, ~y plb 100 12/78" ILA, Dete)d w And ~teturn U~ ' s pp Portion Of This Form With MS - f_ Any Return Correspondence MAIL. M SON, x DATE; August 18, 1984 r PROJECT: ianl ey Thompsai! 1044, Tank Sec . ~r own of Springfield" a y Mr. Howard L. Hittlestadt St. Croix Colsrl>`y d G i E Route 1 Sox 189 Knapp, WI 54749 PLAN I r~ Ut 6.1# 80-02901 DETACH.HERE t 4r r- ..r,...:... . «.~.wa-.....~.,o...w...:.. .......Y-,.:w.r....y.....{.`I......a..,1.i.,.~.....cn.M+a`.,..tM.+liliK+rwl. - ~ Stanley Thompson Residence. 80-02901 A IOJ9CT NAME PLAN 117. This is to acknoarr rec sipt-of your plans and specifications for the above•indicated Wit.' 1 i Prelirrrtinary`review- indicates the plan review fee required is $ fi ` Y + ~f~ f~~ ~F 11 j Plan accepted for review. Fee received is $ q Fee is being returned because of Overpayment . -0 .,Underpayment. Providing one of the two categories above is checked, remit correct fee in one pa ment. C'a No fee has been remitted. Plans submitted with no fees will be held in abeyant. Plans being returned.. ~ Additional information required. SEE BELOW. « } t. Plan x t ❑ Additional information shall be submitted in triplicate unless specifically noted. Plans not cFear, llegible or permanent: i Ali- ❑ Y c : a~ r information witted shall be signed, sealed or stamped in accord with coon H 62:25(40, M. e t~, 1 r! Affidavit ll. Alternate sewage Disposal Systems (Mound Systems) x~ ,lt i 4,, y 'LAi ,L PLB 108 (Application for use of an alternate system). County onsite required (1 copy). El Design calculations for pressurized distribution b i Cross section of mound- F-1 Pipe lateral layout. ❑ Plan view of alternate. v1ta,. III, Private Sewage Disposal Systems I; El Ground slope with 2' contours in entire area of soil absorption system extending 25' on all skies. Ft , Elevation of permanent reference point (benchmark). ,f4; ^ ❑ Location of area suitable for replacement system provide soil test data. F ❑ Plot`plan showing lot size and all lateral distances from sewage disposal system or holding tank to bldgs, isxt r a . tc. Construction detail of'septic, holding or Iift pump tank if site constructed on tank manufacturer if -pretty. f ► 1E ; F< Construction detail and cross-section of soil absorption system. ' Soil boring ~'d=percolation test on EH 115•completedby certifiedsoil tester'(1 copy). M ❑ Complete data relative to anticipated use of'bidg ❑ 3 copies af, PLB $0 enclosed f Deed restriction required 0 copy). IV.; Holding Tanks ❑ Profile of holding tank Holding tank agreement signed by owner and local unit of government (sample enclosed) ❑ Reason for installing holding tank soil test or statement from county O'copy).; , r V. Lift Rump force mandischarge, head and gallons pumped per cycle C3 Size, . j. f Calculations f depth -total lift f. ❑'Detail`& model of pump or automatic siphons including size; pump curves, dtawdown and average flow:rate GPM. F-1 Cross section of lift pump tank showing pump(s) or siphon(s). VI. Systems In Fill (Fill must be placed prior to plan submission) - ❑Totai area filled (fill-to extend 20' beyond edge of-trench before side slope biegin): Depth and type of fill. ❑Copy of onsi4 report by county or district plumbing sype t isor. ❑ Length" of time fill has been in place. i - - a - - - - - --r - - w -r•- w - f _ - M - - - - - MJ+........Y;W 1 T F -AA Department of Industry, Labor & Human Relations 'c of Wisconsin Division of Safety & Bldgs. s state Of Bureau of Plumbing Platting & Fire Protection P.O. Box7969 Madison WI. 53707 Tel. 608-266-3815 IN AL L CORRESPONDENCE REFER TO PLAN IDENTIFICATION NO. NAME OF PROJECT TYPE OF APPROVAL STREET AND NO. CITY OR TOWN COUNTY STATE ZIP OWNER C co r ° Gentlemen: rT~ \t Examination of plumbing plans and specifications for the above-mentioned project has been completed. In accord with Chapter 145, Wisconsin Statutes and Wisconsin Administrative Code, the plumbing plans and specifications are approved contingent upon com- pliance with the stipulations indicated on the plans. Please review your code for the requirements of each code section noted. The architect, professional engineer, registered designer, owner or plumbing contractor shall keep at the construction site one set of plans bearing the stamp of approval of the department. In the event installation of the plumbing improvements or system has not commenced within two years from this date, this approval shall become void and new application shall be made for approval of these plans before work may commence. In granting this approval, the Division of Safety and Buildings does not hold itself liable for any defects in plans or specifications, plan omissions, examination and reserves the right to order changes or additions should conditions arise making this necessary. i This approval is based on Wisconsin Administrative Code requirements. It shall be necessary to obtain and fulfill the permit require- ments of the city, village, township or county in which this installation is to be constructed. Failure to obtain local permits will auto- matically void this acceptance. Sincerely, James Sargent-Bureau Director PLANS REVIEWED BY: DATE: PI Plumber H & R (2) cc: ZSgD-6099 WS Owner DI LHR y Mfg. Rep. Bur. of Health Fee. & Services DI L (N. 06/80) Rec. & Env. Services i Plb. j-A WISCONSIN DEPARTMENT OF HEALTH & SOCIAL SERVICES Division of Health - Section of Plumbing & Fire Protection Systems ON-SITE WASTE DISPOSAL INSPECTION REPORT Name of Premises Street City County ' rI+ 1 G Master Plumber Address t L_ tAJI 5 Owner Address t 6U a ❑ County Permits ❑ Appropriate State Permits 6X?C -1`3 p Type of Building: ❑ Public Q Single Family or-Dupes-- 00~ 61U !~}~G CHECK APPROPRIATE BOX FOR VIOLATION TYPE OF TREATMENT SYSTEM 2rBuilding Sewer ❑ Conventional Soil Absorption System ❑ Septic Tank ❑ Conventional System-in-fill NrHolding Tank ❑ Alternate Mound System ❑ Seepage Bed E Holding Tank ❑ Seepage Trench ❑ Seepage Pit ❑ Experimental System BRIEF, FACTUAL COMMENTS AND SKETCH- ~a < 3 i ._"~rii,..~" 4 <`i'$'1'- ~ '="i _ .i~_ ~~t-, '~w _~1~ _ - ~ •n!•-r 3 I, g 41 -T tt J r ~ r . [ r I [ -42 ' _ f n z t - -lz. r' 4 4A ? ~'`.V'~' t •r L./ ...d..~u."L,.~..^ /J r, s.'Gm_.-.c.%' i'" YI [ " 3 . llz~ p } 3 € ❑SEE ATTACHED DISCUSSED WITH PLUMBER ( ) Yes ('Y) No SIGNATURE (Voluntary) II DATE OF INSPECTION I/6N 222 uU Signatw f Inspect White - Inspector Yellow - Local Inspector Pink - Plumber or R ponsible P ty M i A WISCONSIN DEPARTMENT OF HEALTH & SOCIAL SERVICES - Division of Health Section of Plumbing & Fire Protection Systems ON-SITE WASTE DISPOSAL INSPECTION REPORT Name of-Premises Street City County Master Plumber .3 Address Owner, Address County Permits ED Appropriate State Permits -Type of Building: ❑ Public Q Single Family or- rplex CHECK APPROPRIATE BOX FOR VIOLATION TYPE OF TREATMENT SYSTEM Building Sewer ❑ Conventional Soil Absorption System ❑ Septic Tank ❑ Conventional System-in-fill QHolding Tank ❑ Alternate Mound System El Seepage Bed 15Holding Tank ❑ Seepage Trench ❑ Seepage Pit ❑ Experimental System BRIEF, FACTUAL COMMENTS AND SKETCH: , f i • r , t y t t ' S, a J ? g 9 e . •__T_ jI x t s ❑SEE ATTACHED DISCUSSED WITH PLUMBER ( ) Yes ( ) No SIGNATURE (Voluntary) DATE OF INSPECTION Signature of Inspector White - Inspector Yellow - Local Inspector Pink - Plumber or Responsible Party hhhh, A HT pp,,,~~,}}`~~~ AND F#R 1P1St'~ 1'0N S A~y Retum CorreWndenCe MAIL AO16,01 DATE: ..July 21, ,1980 PROJECT: e~ f \ Stanley Thompson - Residences,,. Holding Tank NE1/4, NE1/4, Sec. 32, 'ii%t RISK, ~ Mi. Howard L. N ttlestadt Town of Springfield, WI Route. 1, Box 189 St. Croix County Knapp, WI 547-49 .x 80-02901 PLAN I D,, # i D&ACHAEAE t ; 'r w t fPR.,,y►...-,,.,~.s .:i . ~..i.. A.,...._,...+..-....,-.:.:,.w+.r:....w:,,...-......,.....-r:.,.•.r"..a.-w-+u.-.+. w..... ..~..~..w-~~..- .r' ~ 40. Er PRodECT NAME Startlq Thompson Residence PLAN ID. # 80-02901 This is to acknowl receipt of your. Mans ant! specifications for the abgve-indicated profit. Preliminary review indicates the plan review fee required is $ Q Plan accepted for review. Fee received is $ ri.rn Fee is being returned because of ❑ Overpayment ❑ Underpayment. Providing one of the two categories above is checked, remit correct fee in one payment. No fee has been remitted. Plans submitted with no fees will be held in abeyance;. Plans being returned.- Additional information required, SEE BELOW. 1. Plan Submission 0 Additional informationu `shall be submitted inlriplicatevniess speclically noted. ❑ Plans not clear, legible or permanent. )MI information submitted shall be signed, sealed or stamped in accord with Section H 62.2S(2~(a) Wisconsin ' v1* Codek XAffidavit enclosed. 4 11,. •Alfeate sewage Disposal Systems (Mound Systems) °b f MPLS 108 (Application for use of an alternate system): ~y D County onsite required (.1 copy). ❑ Design calculations for pressurized distribution y Q Crass'section of mound: Cl Pipe lateral layout. ❑ Plan viewof alternate. . i [11. Private Sewage Disposal Systems ❑ Ground slope with 2' contours in.entire area of soil absorption system extending 25' on all sides. i Elevation of permanent reference point (benchmark). - IT'l. ocatiion of area suitable for replacement system - provide soil test data. - El Plot pian showing lot size and all lateral distances from sewage disposal system or holding tank to bldgs, lot lines, well, watercourse', etc. ❑ Cc>wiruntion detail of septic, holding or lift pump tank if site constructed or tank manufacturer if precast. 4truction detail and cross-section of soil absorption system. 0*l bdr gand percolation test on EH 1-15,vampleted by certi#W&oihtester (1 copy). iy data relative to anticipated use of bldg. ❑ 3tcopies of.PLB 60 enclosed. C~Ded restriction required (1 copy). 111 `Holding Tank's Pr6filepf holding tank. „ l Htldtr~ ,tztnk agreement signed by owner and local unit of government(sample enclosed).. ~ j Rs",for installing holding tank soil test or statement from-county (1° copy):. 4% l V. -.Lilt 1, timo l C 414tdt4t` its for total lift pump discharge, head. and gallons pumped per cycle. 84rk i th,,& depth of force main. iw fi. ,jOetsl1;9 model of pump or automatic siphons includhV sine, pump curves; d awdown and average flaw rate GPM. ssssection of lift ump tank showing pump(S) or si;phon(s): vl,'Sys lit iff tfill.must be placed prior to plan submission) 4 : DTats f i (fill to extend-20' beyond edw of a rench.:before:side, SAope tlagini ❑ Depth and type of fill. ❑ Copy of onsite- report byt upty or district plumbing&upervisor ❑ Length of time ilI has be8n in place. I - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - j i { 4 ' 0 vi 0 i 3-0 0 0 m c 0 r: ~ O ~s ~ Chi O N y ~ o< cn ~ A ryl N I _ v a Z d` N aD fQ p O r-p /(mil Q. N N N PL A N ^S .l O 1 O 0 0 C 7 6 0 D M o 0 CD a ~ cNi, C o Gi M D C ? CD C", 0 -0 z m =r C) ID, W j I ~ 0 r- N o c a 0 v M o O O ~r 0 CA N A° ;i a -ovv o co m - w N 3 d A N ~ -4 0 zCD z m o c' 0 D a m m m N N N (D N C F fc CD N W @ a z 3 ET Z y N A V 7 Z -I w W ~ m N CD ~ z I {+Z 0 A 3 CCCJ~ m A W a I Z a N ii 0 II o I, ~ o ra o dQ V 69 A v ~ ' O O a ti ti r c Lo - o -7 Its VOL. 1S PAGE 4706 KATHCEEiI H. REGISTER OF DEEDS ST. RECEIVED RECORD 02/20/2004 12:55PH j CERTIFIED SURVEY HAP REC FEE: 13. 0 CERTIFIED SURVEY MAP PAGES.--2 LOCATED NEI/4 IN THE SWi 41 OFOTFHEH E //1/OF ShECTION 32, T29N R15W. TOWN OFISPRINGFIELD. ST. CROIX COUNTY, WISCONSIN. BEARINGS REFERENCED TO THE NORTH WI. D.O.T. APPROVAL NO. 55-17- - 3 90 y - z cooy LINE OF THE NW114 OF SECTION 32, ASSUMED TO BEAR 589055'46`E. OWNER OF NE1/4 NOTE: NO NEW LOTS HAVE BEEN CREATED. THE -N- 4 9:4 M364 PURPOSE OF THIS MAP IS TO SHOW THE ENTIRE pK1110T i OF 2829 HWY "12" PARCEL OF LAND OWNED BY VOBEJDA AFTER THE CERTIFIED SURVEY MAP WILSON, WI. 54027 PARCEL TO THE SOUTH WAS ADDED. OWNER OF LANDS VOL 4, PG. 3M. DDFn UNPLAITEO_I ANN STAN M S0N NI/4 CORNER I Sd9050'131E MABLE 2891 TTH ~~p i2 RUST U.S. HWY 12 SECTION 32 00 • WILSON, WI. 54027 ~n NORTH LINE OF THE NWi/ %_.4j j NTH LINE OF c I HE NEi/4 - - - 1 S8905546E' TEi T 1328 28 7 1320.07' S892576°50'13"E 0' STATE MtISCONSIN SETBACK-LINE FROMI RZG_HT--MIA "1$ .66' ' 9i NW CORNER, 10~ CROI7( COUNTY BUIWZn16 SEi9ACiC LINE g66.20 E•- - ..1 SECTION 32 1 SSE ECTION rn LOCATION OF DRIVEWAY LOT 1 ` 2,947,836 SQUARE FEET 1 1 ( 67.673 ACRES ) INCLUDING RIGHT-OF-WAY 2.901.837 SQUARE FEET I ljlji EXCLUOI G1 R 6FIT OF-WAY 1l UN I I~ POND N U .44 ti`s F 61~ t ~ ~i Q ~ ~ 1 W I F-1 LOCATION ) ~ OF BBUUILDINGS ~ i W IH `wa¢ S89059'38"E 1328.02' L - 17' SDUTH LIME OF THE NE114 OF TI-E NW i/4 NORTH LINE OF THE SEI/4 OF THE NWI/4 4 T 1111 4 VM.UME ~~yy "ADD-ON P DESCRIBED IN 1 J T 7 SCOUNTY REGiBTA i 1 OF DEEDS. I *C, ~ I 1 66 I 1141 12' N89°50'32'W -1393M' i'- i UNPLATTED LANDS LEC.FA4D 2 - - INDICATES SECTION CORNER POSITION GRAPHIC SCALE 1"=300 ( ESTABLISHED FROM TIES OF RECORD r - INDICATES 1.25" ( OUTSIDE DIAMETER ) O - IND~ZCATES I" XJDIS' IRON PIPE WEIGHING o Sao so0 900 - 1L~C1II INDICATES /FEN E LIAESET. THIS INSTRUMENT DRAFTED BY: JOSEPH W. G'RANBERG SHE 2 Vol 18 Page 4706 I > Ao r ~ A -~1 ON f4 r o P% ° c • = n X o Z 70 W2 H ~'to ,in q 'Cf 4 T ~ ~ ~ o00 o Z } ~y u T r`Z► i M 11 N i 3 f, 13 x' p ~ A 74 r- I i