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HomeMy WebLinkAbout034-1077-20-200 n■ o s 10� c § 7 § \ ; ■ « 0 $ �t 0 ƒ { / 0 k \ # CA) ° j \ s m ( # § .� ) ._ \/ o$ R$ 2G) Qs; i` - 7 §� § S 2 G @ 3 ¥ a e ° ® co } k co E a © 7 ® I n \ F = y a \ § k / CD ® $ � 0 / \ § 2 n r cn . CA o c ~ � \ o 0 o I rt 0 / { § CO) 2 § 7 M k L § CL CD 2 , - \ Z § § o / o § . \ / CD cn ƒ ; a ° \ z CD : ( ; B / 0 t z CD 0 m CD k 0 F Z ƒ / � « CD - m�e � Q2§ //Z k . 2/} 23 }/ 3 � \ / tJ / 2 0 } < \ @/ ®� �` C _ Parcel #: 034 - 1077 -20 -200 06/21/2005 01:28 PM PAGE 1 OF 2 Alt. Parcel #: 34.29.15.515A -20 034 - TOWN OF SPRINGFIELD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner - JACKSON, JAMS R JAMES R JACKSON S ARRATT LESLIE A SHARRATT LESLIE A 3069 70TH AVE WILSON WI 54027 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 3069 70TH AVE SC 5586 SPRING VALLEY SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 40.200 Plat: N/A -NOT AVAILABLE SEC 34 T29N R15W PT NW NE & SW NE COM Block/Condo Bldg: N1/4 SEC 34;TH N 89 DEG E 492.21'POB;TH N 89 DEG E 830';TH S 00 DEG W Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 2234.56';TH N 72 DEG W 867.80';TH N 00 34- 29N -15W NE DEG E 1973.06'POB Notes: Parcel History: Date Doc # Vol /Page /, , Type 07/21/2003 731287 2324/140 'KI WD 07/21/2003 731286 2324/138 .1'b WD 08107 68'6 7 1�4 WD 05/3112002 680517 1902/23 '� WD more... 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations Last Changed: 06/25/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 12,950 117,550 130,500 NO PRODUCTIVE FORST LANC G6 38.200 68,750 0 68,750 NO Totals for 2005: General Property 40.200 81,700 117,550 199,250 Woodland 0.000 0 0 Totals for 2004: General Property 40.200 81,700 117,550 199,250 Woodland 0.000 0 0 Lottery redit: rY Claim Count: 1 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel #: 034 - 1077 -10 -100 06/21/2005 01:25 PM PAGE 1OF1 Alt. Parcel #: 34.29.15.514A 034 - TOWN OF SPRINGFIELD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * GERLACH, GERALD &WF& LAWRENCE &WF GERALD &WF& LAWRENCE &WF GERLACH 7473 LAMER AVE SO COTTAGE GROVE MN 55016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 5586 SPRING VALLEY SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 14.910 Plat: N/A -NOT AVAILABLE SEC 34 T29N R15 NW NE CC ,AS DESC Block/Condo Bldg: 1 6, 6/3 152 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 34- 29N -15W NE Notes: Parcel History: Date Doc # Vol /Page Type 05/0912001 645074 1636/152 LC 2005 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 05/26/2004 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 11.910 2,200 0 2,200 NO UNDEVELOPED G5 1.000 50 0 50 NO OTHER G7 2.000 9,550 3,200 12,750 NO Totals for 2005: General Property 14.910 11,800 3,200 15,000 Woodland 0.000 0 0 Totals for 2004: General Property 14.910 11,800 3,200 15,000 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 Parcel #: 034 - 1077 -20 -100 06/21/2005 01:25 PM PAGE 1 OF 1 Alt. Parcel #: 34.29.15.515A -10 034 - TOWN OF SPRINGFIELD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): = Current Owner " GERALD &WF& LAWRENCE &WF GERLACH GERLACH, GERALD &WF& LAWRENCE &WF 7473 LAMER AVE SO COTTAGE GROVE MN 55016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 5586 SPRING VALLEY SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 18.850 Plat: N/A -NOT AVAILABLE OSEC 34 T29N R1 5W SW NE N OF HWY 12 FRL Block/Condo Bldg: EXC AS DESC 1636/152 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 34- 29N -15W NE Notes: Parcel History: Date Doc # Vol /Page Type 05/09/2001 645074 1636/152 LC 2005 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 05/26/2005 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 14.000 2,650 0 2,650 NO AGRICULTURAL FOREST G5M 4.850 4,350 0 4,350 NO Totals for 2005: General Property 18.850 7,000 0 7,000 Woodland 0.000 0 0 Totals for 2004: General Property 18.850 11,400 0 11,400 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 - 1077 -40 -000 06/21/2005 01:26 PM PAGE 1 OF 1 Alt. Parcel #: 34.29.15.516 034 - TOWN OF SPRINGFIELD Current X i ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): " = Current Owner " GERALD &WF& LAWRENCE &WF GERLACH GERLACH, GERALD &WF& LAWRENCE &WF 7473 LAMER AVE SO COTTAGE GROVE MN 55016 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description SC 5586 SPRING VALLEY SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 38.140 Plat: N/A -NOT AVAILABLE SEC 34 T29N R1 5W 38.14A NE NW EXC PT Block/Condo Bldg: NWLY OF OLD RR R/W Tract(s): (Sec- Twn -Rng 401/4 1601/4) 34- 29N -15W Notes: Parcel History: Date Doc # Vol /Page Type 2005 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 05/26/2005 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 25.000 4,250 0 4,250 NO AGRICULTURAL FOREST G5M 13.140 11,850 0 11,850 NO Totals for 2005: General Property 38.140 16,100 0 16,100 Woodland 0.000 0 0 Totals for 2004: General Property 38.140 27,900 0 27,900 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 Wisconsin DWartment of Commerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings in accord with Comm 83.05, W is. Adm. Code Gustum Septic Service Aftach complete site plan on paper not less than 8'/ x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal ref direction and St. Croix percent slope, scale or dimernsions, north arrow, �` �rr` 6bto nearest road. Parcel I.D.# APPLICANT INFORMATION - Plea prfnt all ip�nnatfvn. Re ' Date Personal information you provide may be used for,6eCOtWary puro Law s. 404 (1) (m)). y I aq Property Owner f ' Property Location r. ,(;. Govt. Lot NW 1/4 NE 1/4 S 34 T 29 R 15 W Property Owner's Mailing Address I 3T CROX - Lot # Block # Subd. Name M# or S 774 - 7 3 LO rra r i1 .. �0, C4uNTY a n/a N/A City State Zip ode fCE [ City Village ETown Nearest Road co f f llu Springfield 70Th Ave. - 1 New struction Use: Residential? bedrooms 3 ❑Addition to existing building Repl Public or commercial describe rived dal y ow 450 gpd Recommended design loading rate .5 bed, gpdm .6 trench, gpd/ft Absorption area required 900 bed, RZ 750 trench, ft' Maximum design loading rate •5 bed, gpd/ftz .6 trench, gpd/W Recommended infiltration surface elevation(s) along 100.2' contour ft (as referred to site plan benchmark) Additional design / site considerations BM # = 100.0 BM #2 = 102.0' Part of 125.55 acres Parent material n/a Flood plain elevation, if a plicable n/a ft S= Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U= Unsuitable for system ED ® U ❑ S ❑ u ❑ S ®U ❑ S ® U ❑ S ®U ❑ S ® U SOIL DESCRIPTION REPORT Depth Dominant Color Mott Structure GPD/ft' goring# Horizon in Munsell Qu. Sz. Cont les Color Texture Gr Sz Sh Consistence Boundary Roots Bed , Trench 1 1 0 -4 10yr3/2 none sil 2mcr mvfr as 3f,lm 0.5 i 0.6 2 4 -7 10yr3/2 none sil 2msbk mvfr cs if 0.5 0.6 Ground 3 7 -11 10yr4 /3 none sil 2msbk mv fr cw - 0.5 0.6 elev 100.4' ft 4 11 -20 10yr4/4 none sil 1. 2msbk mvfr cw - 0.5 0.6 Depth to 5 20 -30 10 y r4/6 c2 -3d 10 /8 - 7.5 fir /g sil 2msbk m 0.5 0.6 limiting factor 20" Remarks: I. l0% cobbles 2 1 0 -6 10 yr3 /2 none sil 2mcr mvfr as 3f,lm 0.5 0.6 2 6 -12 10yr5 /3 none sil 2msbk mvfr cw if 0.5 0.6 Ground 3 12 -17 10yr4 /3 none sil 2msbk mvfr cw - 0.5 0.6 elev 9 9.4' ft 4 17 -21 10yr4 /4 none sil 2msbk mvfr cw - 0.5 0.6 Depth to 5 21 -30 1 4/6 c2 -3d 10yr5 /8 De - - p Oyr 7.5 /8 sil 2msbk mfr 0.5 0.6 limiting factor 21" Remarks: CST Name (Please Print) Signature: Telephone No. Tom Gustum --� 715.658 -1344 Address Gustum Septic Service Date CST Number Ref# N13450 937th St., New Auburn, Wl 54757 4/1/99 227618 1064 PROPEKrY OWNER. -G�eGerlach SOIL DESCRIPTION REPORT Cosa Page 2 of 3 PARCEL LDJ Gustum swtic Roots swisr- Depth Dominant Color Mottles Structure GPQ/fF [Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. �onsislence� Boundary � � Bed Trench 1 0-2 1 Oyr2/2 none sit 2mcr mvfr as 2f 2m 0.5 0.6 2 2-7 1 Oyr3/2 none sit 2msbk mvfr cs 2m,2co 0.5 0.6 Ground elev 3 7-13 10yr4/4 none sit 2msbk mvfr ew ImAco 0.5 0.6 100.7 ft 4 13-21 1 Oyr4/6 none sit 2msbk mvfr cw IM 0.5 0.6 Depth to c2-3d 10yr5/8 limiting 5 21-30 1 Oyr4/6 7.5yr5/8 sit 2msbk mfr 0.5 0.6 - - ------- --- -- factor 21" Remarks: elev Depth to limiting factor Remarks: Ground elew Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: PROPERTY OWNER. G en y Ge ri �cn _ SOIL DESCRIPTION REPORT Page __ 2 of 3 PARCEL LDJ GusWm sqst S nda-, Horizon Depth Dominant Color Mottles Structure �ort sistencej Boundary Roots in. Munsell Qu. Sz. Cont :7Texture Gr. Sz. Sh. Bed Trench 3 1 0 -2 1 Oyr2/2 no ne sit 2mcr mvfr — as 2f,2m 0.5 0.6 2 2 -7 10yr3 /2 none A 2msb mvfr cs 2m,2co 0.5 0.6 Ground---- - - - - -- _ - - -- - — - - -- _ - -- - -- -- - - - -- - -- - _ - - elev 3 7 -13 10yr4/4 none sit 2msbk mvfr cw ImAco 0.5 0.6 1002 ft 4 13 -21 10yr4 /6 non A 2 mvfr cw 1 m 0.5 0.6 hmn9 5 21 -30 10yr4 /6 c2 gyr°5 /g /t1 sit 2msbk mfr - - 0.5 0.6 factor 21' Remarks: --- - - - - -- elev Depth to - - - - - -- - - - - -- Gmiting -- - - factor Remarks: Ground elev Depth to limiting -- - ,_ -- - factor Remarks: Ground - elev Depth to limiting factor - -- i Remarks: n n Js 3 n (Z3 A \ 6� "T) in ..r Q — Q N S - � N A 6 N n � � �1 n Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division •' INSPECTION REPORT Sanitar Permit No: 405149 0 GENERAL INFORMATION (ATTACH TO PERMIT) st Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m) = �� I A• Permit Holder's Name: City Village X Township Parcel Tax No: Jackson, Jim I Springfield Townshi 034 - 1077 -20 -200 CST BM Elev: t Insp. BM Elev: BM Description: 1w .3 �o •�� �tze�SCt _ C57 g& TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM 7 II w , Aeration Bldg. Sewer 1 r (A) Holding St/Ht Inlet CA) St/Ht Outlet � TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic > SD 1 5-5 Q k Dt Bottom Dosing 1 L( `1 Header/Man.'J l 7� Aeration Dist. Pipe (--K) 2.Z 1 )aZ•A7 Holding Bot. System (K) Z I p IDS• 3� ` Final grade (Z`t PUMP /SIPHON INFORMATION (-- w « _ Manufacturer p Demand St Cover GPM Model Number .v _fin �>✓tE - 5 � t,,.�-1� �� `f•`f� ''(" TDH Lift Friction Loss System Head TDH Ft Xa, orcemain Length . Dia. Dist. to Well z n SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia Liqui epth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEAC anufacturer: INFORMATION CHAMBER O Type Of System: r UNIT Model Number: DISTRIBUTION SYSTEM ,,a{ l-k (, i. (y sa' ao L,, Header/Manifold Distribution x Hole Size t 1 x Hole Spacing Vent to Air Intake Pipe(s) ' 1 t j 11 Length Dia Length Dia 'Z • b Spacin /1 (0 2 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 Ll Yes No Yes No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1 Inspection #2: Location: 3069 70th Aver� Woodville, WI 028 (W 1/2 NE 1 )4 3�4,T.2- N R15W) NA Lot 1.) Alt BM Description= �"""'` 2.) Bldg sewer length= ) p 1 - amount of cover C ntour = t an ru,•,�larg r �or'e i "� a set's a� at ' r Sion eqw Yes - No per side for additional information. --� - n .�., ((�� gyp ' ' (R /97) , ,p ate C epctors nature` No. a�C = �3 _ 4 :a �� ,s3! (< �y Safety & Buildings Division Sanitar Permit A 201 W. Washington Ave. I'Y PP i � PO Box 7302 `� sconsin In accord with Comm 83.21, Wis. Adm. Code Madison, WI 53707 -7302 Department of Commerce Personal information you provide may be used for secondary purposes (Submit completed form to county if not [Privacy Law, s. 15.04(l)(m)] state owned. Attach com lete plans to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size. County State Sanitaly Permit her ❑ Check if revision to previous application State Plan I. D. NUMBER ST CROIX I. Application Information - Please Print all Information Location: Property Owner Name JIM JACKSON N Property Location /S W %2, NE 1/4, S 34 T 29 N, R 15 W Property Owner's Mailing Address Lot Number Block Number 6903 15 STREET JUN p 5 2002 NA G�� J !v) 7 - z Q , �o City, State Zip Code P one NBifiibCRO C Subdivision Name or CSM Number ST. PAUL, MN 55128 - 03 ��IING OFF CE y 0$ CtttQ,✓S II Type of Building: (check one) ac S,�(,,,, 1„�„.� 5 ity 1 or 2 Family Dwelling —No. of Bedrooms:3 ha ��, �,,, �,.,a S Village Public /Commercial (describe use): U Town of SPRING FIELD State -owned III Type of Permit: (Check only one box on lin . Check box on line B if applicable) Nearest Road 61 O STREET A) 1. X New System 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Addition to Parcel Tax Number(s) System Tank Only Existing System 034- 1077 -20 -200 B) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) Non - pressurized In -g and i X Mound ❑ Sand Filter ❑ Constructed Wetland Pressurized In -groun i'ki' 1 00 ' ❑ Holding Tank ❑ Single Pass ❑ Drip Line At -grade / ❑ Aerobic Treatment Unit � ❑ R irculating ❑ Other: 40 (o' tic -K i1) t 3 _ ` /• V Dispersal/Tieatment Area Information: 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation R 6. System Elevation 7. Final Grade 450 Required 900 Proposed 1140 Rate (Gals. /day /sq. ft.) (Min. /inch) N X9-3 =— levation Rate 0.5 101.3 103.2' VI Tank Capacity in Total # of Manufacturer Prefab iber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks 1000/600 COMBO 1 0 1600 1 SKAW X ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ VII Responsibility Statement I, the undersigned, assume res on ibility for installation of the P WTS shown on the attached plans. Plumber's Name (print) Plumb is ature tam ): MP/MPRS No. Business Phone Number EDWARD BERGII 2211,9 Z 715- 834 -6194 OR (CELL) 577 -6835 Plumber's Address (Street, City, State, Zip Code) 1422 PRAIRIE LANE — EAU CLAIRE. W1 54703 VIII County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Si at (No stamps) �(J Approved ❑ Owner Given Initial Adverse Surcharge Fee) 6 Determination 4 - 3 2S — , ' -- it 7tb Z IX. Condit' ns o Approval /Reasons for isAp oval: 1 04 CA ae�t_c� C644 COR OVS .j i W I N O N c r f- Q co', j col O (^ U v LLI 0 V) Q NY z p O 0 ° ~ ° U~ I o o { F a,n.mdtn U > J J p 0 o� Wo ( ( � z. �a00 a ° zZ Lil .room° m i=FW ? U : JZ Z 0 UU(n J ww m °'��om Z F O O U ° o ok m a x Z 0 m a s a y oJjy�oO` \ O a CD z (6 Z � x to Q 3 .. 0 n Z� a.o �E ®� U t W O C C E u w > a _ 1 Q� /n a w o tJ �c d o w ! z 00 U_ w N� O a 0 ( O LL. Z O ih N r') V) °� p� °O b� Z 1 �r� j .-� �U o I 3F w o o� — as wo y U Zm , (n V) } V) LLJ 200 �~ o Q LEA 0 U N J J NV g� aQ 2 JZ ° Ix O !N _l M m � N N� O� Q n U� O � � Zg F� ° a� U Z m3 OJT J Mw r o> > r w 0 > lk F-Q PAGE 3 OF 9 Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 N *isc ' onsin w ww.comrn www.wisconsin.gov www.wiscon isconsin.gov n.gov Department of Commerce Scott McCallum, Governor Philip Edw. Albert, Secretary May 16, 2002 CUST ID No.227819 ATTN. POWTS Inspector WILLIAM J BERGH ZONING OFFICE GEO TECH ST CROIX COUNTY SPIA 2667 113TH ST 1 101 CARMICHAEL RD CHIPPEWA FALLS WI 54729 -6575 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/16/2004 Id ID 1 i umbers Transaction D o. 734594 � SITE: Site ID No. 6282 Jim Jackson Please refer to both identification numbers, 3069 70TH Ave above, in all correspondence with the agency. Town of Springfield St Croix County W1 /2, NE1 /4, S34, T29N, R15W FOR: Description: Proposed Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 851850 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. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10572 -P (R 6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10573 -P (R 6/99). • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • 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(l)(a) - 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). P.O.W.T.S. Conditionally An n f1A1 it m __ WILLIAM J BERGH Page 2 5/16/02 Owner Responsibilities Continued: • 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. • The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Gerard M. Swim POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm WSMART code: 7633 jswim@commerce.state.wi.us cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544 Geo Tech Soil & Site Evaluation I i , • Cover Sheet 01, R A a ✓ y N V . JIM JA CKSON 690315` Street — St. Paul, MN 55128. -, MOUND COMPONENT � l e � y 3 Reference Component Manuals Mound Component Manual SBD -10572- P- P(R.6199) Pressure Distribution Component Manual SBD - 10573 -P (R. 6199) Job Location: W '/2, NE ' /4, Sec. 34, T29N, R15 W Town: Springfield County: St. Croix Designer's name and license #: William J. Bergh (License No. 1577 -007) I the undersigned state that these plan were desi d and submitted under my authority. Designer's signature: Designer's address: 2667 113 "' Stre Chippewa Falls, WI 54729 Designer's phone number: 715- 723 -5555 voice �..•"° " '�rrr�•,` 715 723 - 7535 fax S OnIS,`'•. °° 715 -577 -6838 cellular .• �' %j'• • WILLIAM �. Contents BERGH .•" Page 1 -cover sheet °• ° ° •,��► z •• ' ���••' Page 2- system calculations "o. Page 3- site plan Page 4- cross section of mound component Page 5- plan view of mound component & distribution lateral schematics Page 6- septic & pump chamber schematics Page 7- pump curve Page 8- maintenance /management & contingency plan Page 9- maintenance /management & contingency plan 1" rr r [X %J V 1: U DEPARTMENT OF COMMERCE page lof 9 IL DIVISION OF S ETY AND BUILDINGS SEE C0RRESPO bftt NCE SYSTEM CALCULATIONS USING SKAW COMBINATION TANKS one or two family dwelling with total of 3 bedrooms calculated at 450 qpd design wastewater flow LLR (linear loading rate) 6 pal /day /ft DLR (design loading rate) 0 gal /sgft/day 900.0 effective aggregate area depth to limiting factor 20 inches approximate system area cross slope —6.5% ep rcent forcemain length 30 feet using 2 inch - SCH 40 PVC manifold and /or header length 3_5 feet using 2 inch - SCH 40 PVC forcemain volume 4 alp Ions length of each lateral 37.00 feet using 2 inch - SCH 40 PVC total number of laterals 4 invert elevation 101.85' (bottom of lateral). orifice diameter o.1s7s tenths /inches 101.35' system elevation distance between orifices 24 inches or 2, feet total orifices per lateral 19 total orifices all laterals 76 lateral volume (each lateral) 6_._0 alg Ions 12.54 lateral discharge rate system discharge rate 50.2 gallons calculated at 3.25 distal pressure x 1.3 ft. vertical lift 7.5 feet friction loss in the forcemain 1.5 feet calculated at 50.2 gal /min discharge rate TDH (total dynamic head) 12.3 feet minimum pump or siphon discharge 50.2 gpm at 12.3 TDH (total dynamic head) pump manufacturer L. GIANT model number 9EH estimated dose volume 137.6 alp Ions 143.3 actual dose pump /siphon tank model 600 actual tank size 642.33 alp Ions septic tank model 1000 actual tank size 1039.35 alc� Ions manufacturer of tank /s SKAW. pump float on /off measurement 9 inches alarm float from bottom of tank 16 inches IL Page 2 of 9 o � � Y � o m Nw r J p° J c 0 M z Z �— U N° '< 55 D \vai0 b� 0 o ~OUN zoo O F N a m Q zZ I Q o 3 \0 J ®00OZ OF 3 F (n W j LL. LL. Q F Y v 00 N Q Z Z �LJ 0 :2 -0 o O m Z 2 c F_-_W – Z, U U N o W w Z) J w m y _j-1 0 m Ld OM Z) U o s Cti a -o m z i° �, do lO 4Y � DM— _0 �. c6 Z / XF Q �3 0 Z4 w v it Ll- W 0� a < M > a 0O Z O w�' U ( I Z O d Ow Q 0U L`1 F- O Q C) VX ( re) 3 I O E \� 00 O W �� O: O O N C O m O W W o d z d� �\ 00 I € U _ 0 W 0 Q d W 0 >-v 2 m _ �_ (nN 00 >- ar U ; a M 00 � O 0 U� w C7 U V) •- N 00 V)U �� aQ �a JZ O 3 V) O +�JM U L N 5s V)O O D O w ^ 0 G —= < =! � OZp N Zg 3 W 00 Q2 U F- O Z m3 - Hw r >> O D I Z W p Q PAGE 3 OF 9 MOUND COMPONENT CROSS SECTION (drawing not to scale) observation pipe(s) synthetic cover material soil to promote plant growth elevation at top of sand fill (bottom of distribution cell) 1 01.35' 12" orc,� c o nti ,o c, o � c a i 10 " �C i. t? C i7 o CS a�G .: c7.�t? original grade 16" 21" elevation 100.0' ASTM C -33 6�� fill material tilled /plowed area 1.2' 5.4' 6.0' 24.3' N15 yards of rock required —95 yards of sand fill required N6.5% system area cross slope 1185 total basal area (sqft) Distribution cell 0.5" — 2.5" washed hard aggregate, 6" below & 2" above the distribution lateral All material and piping specifications as per the Mound & Pressure Distribution Component Manuals. page 4 of 9 PLAN VIFW OF MOUND COMPONENT ( All material 5peclficatlon5 per the Mound component Mau) forcamin 37,5' d 6.0' 10,1 75,0 O,I' 95,2' ob5mabim pipe distrd�ution cell C limit activ w5 m the area 15' l;gaid the olmdope edge of mound) ni5trbut►on laterals terminate 0,5' from the end of the JA buti cell Effective aggregate area Pa5al Asa#& area mmm mp red safe 450 minimum rap red % t 900 12151POPLMON �ATM(5) (topical) ( all disdwge orlfice5 are located on the center bottom Ime of the distribution lateral( s) ) threaded cap 2 distribution lahm'al threaded cap acce55 box 2 mamifdd acce55 box 37,0' MI 2h" 1 �I 1 x Y 74,0' d1 5c harge orifice d iamete r 3 16" X 5p acinq 24 " number of orifice5 per lateral 19 Y 5pacinq 24 f6tal number of orifice5 ( all laterals) - 76 X/ 2 Spacing 12" (Awrq ►dto5c,*) paqe 5 of SEPTIC /PUMP CHAMBER CROSS SECTION (DRAWING NOT TO SCALE) Final grade Access riser with locking cover (slope ground away from (cover must be properly marked risers for drainage) I with an approved warning label PP 9 ) Actual may depth increase OF power & alarm cable P Y P see COMM 82.30 (must use seperate power (11), (c) and (d). and alarm circuits) tank vent Externally mounted junction box 4 4" min. force main access riser 18" ml bottom of inlet invert +.. filtered reserve water level effluent } inlet alarm "f. on " t ee inlet baffle `� off approved effluent filter required on tank outlet 94.35' Minimum of 3" of suitable bedding beneath tank pump pad EFFLUENT FILTER ZABEL A -100 (OR EQUIVALENT) Tank manufacturer SKAW DWF (daily wastewater flow) 450 septic /pump chamber capacities 1000600 GALLON NUMBER OF DAILY DOSES —3.1 (DWF /actual dose volume) Alarm manufacturer S. J. ELECTRO (or equivalent FORCE MAIN (gallons) 4,9 Alarm model number HW 101 (or equivalent) ACTUAL DOSE VOLUME (gal) Type of float switch MERCURY (or equivalent) (total dose vol. — forcemain vol.) 143.33 CAPACITIES Effluent pump manufacturer LITTLE GIANT reserve above alarm 19 inches = 312.93 gallons Effluent pump model number 9EH alarm above pump on 2 inches = 32.94 gallons on /off measurement 9 inches = 148.23 gallons Minimum pump discharge rate (gpm) off to tank bottom 9 inches = 148.23 gallons 50.2 TOTAL 39 inches = 642.33 9 allons Vertical lift (pump off to lateral elevation) 7.5' PU CHAMBER DIMENSIO System head (distal pressure x 1.3 ft.) 3.25 length 55.00" width 69.00" ' ^tion loss in the force main —1.5 liquid depth 39.00 gallons/ inch 16.47 Jynamic Head (TDH) — 12.3 page 6 of 9 9EH SERIES Sump/EFFLUENT PUMP V4 - z r E� }t C TM , Specifications MODEL CAL SOLIDS SIZE RUNNING PERFORMANCE (GPM @ HEAD) SHUTOFF PWR. CHU. WEIGHT DIMENSIONS NO. NO. LISTING HP VOLTS (Dia.In.) AMPSIWATTS P.S.I. 5' 10' 15' 20' lH.l A) (Lis.) (H a L n W) 9EH -CIM 509330 UUCSA 4/10 115 3/4 13.0 1000 71 68 60 49 32 13.8 20' 27 9.11 x 11.64x 8.94 9EH -CIM 509340 UUCSA 4/10 230 3/4 6.5 1000 71 68 60 49 32 13.8 20' 27 9.11 01.64d.94 x 6.94 9EH- CIA -RFS 509350 UUCSA 4/10 115 3/4 13.0 1000 71 68 60 49 32 13.8 20' 27 9.11 x 11.64 x 8.94 9EH- CIA -RFS 509360 UUCSA 4/10 230 3/4 6.5 1000 71 68 60 49 32 13.8 20' 27 9.11 01.64d.94 x 8.94 FLOW- LITERS /HOUR Construction 0 1000 2000 3000 Motor Housing Epoxy Coated Cast Iron Impeller Material Poly Carbonate 30 10 Impeller T e Closed Vane Volute ABS fA W 7,5 Power Cord SJTW -A 20 Mechanical Shaft Seal Nitrile with carbon and I A 5 ceramic faces �3 a A 10 Fasteners Stainless Steel 2.5 Shaft Stainless Steel Bearings Upper Sleeve and Lower 0 o Ball Bearings 1111 1111 11111 1111 11111 0 20 40 60 so FLOW- GALLONS/ INUTE PUMP PERFORMANCE CURVE ��y �q ,,ur Rh 115V 60HZ s1711►I[`l i Little Giant Pump Co. PO Box 12010 ` Phone: 405.947.2511 Okla. City, OK 73157 Fax: 405.951.5674 ISO 9001 CERTIFIED WWW.LittleGiantPump.com Fonfn 995235 — O l /00 PAGE 7 OF 9 POYYTS OWNER'S MANUAL MANAGEMENT PLAN PERMIT NUMBER: Owner: Jeff Balsinger POWTS Maintainer: Geo Tech Soil & Site Evaluation — Chippewa Falls, WI 715- 723 -5555 Local Regulatory Authority: Chippewa County Zoning Department — Chippewa Falls, WI 715- 726 -7940 POWTS Installer: Bohl & Proulx Inc. — Chippewa Falls, WI 715- 723 -9655 Septage Servicing Operator DESIGN PARAMETERS Influent/Effluent quality (values typical for domestic (non - commercial wastewater and septic tank effluent) Fats, Oil and greases (FOG) <30 mg/L, Biochemical Oxygen Demand (BOD) <220 mg/L, Total Suspended Solids (TSS) <250 mg/L Soil loading rate (SLR) = 0.5 SYSTEM SPECIFICATIONS The components of this septic system are intended to serve a three - bedroom (450 -GPD) single - family residence. The components include: a Skaw model 1000 /600 septic /pump tank with a Zabel A -100 effluent filter and a Little Giant 9EH effluent pump, alarm & controls and a 75' x 6.0' distribution cell within a mound POWTS component. All components must comply with WI Adm. Code COMM 84 and be installed per manufacturers specifications and approval letters. DESIGN CRITERIA SBD — 10572 -P (R.6/99) "Mound Component Manual" • SBD — 10691 -P (N.01 /01) "Mound Component Manual" Version 2.0 • SBD — 10570 -P (R.6/99) "At -Grade Component Manual Using Pressure Distribution" ❑ SBD — 10567 -P (R.6/99) "In Ground Absorption Component Manual" SBD — 10705 -P (N.01 101) "In Ground soil Absorption Component Manual" Version 2.0 SBD — 10573 -P (R.6/99) "Pressure Distribution Component Manual" ❑ SBD — 10706 -P (N.01 /01) "Pressure Distribution Component Manual" Version 2.0 MAINTENANCE & MANAGEMENT Inspect the condition of the treatment tank(s) and dispersal cell(s) a minimum of every three years. The septic tank contents must be removed in accordance with Chapter NR 113, WI Adm. Code when the combined sludge and scum equals one -third (1/3) the tank volume. The effluent filter(s), effluent pump, controls & alarm and distribution lateral(s) should be inspected annually to ensure maximum performance. Lateral inspection /maintenance should include flushing of the laterals and pressure testing. START UP For new construction prior to use of the POWTS check treatment tank(s) for 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- servicing operator prior to use. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of wastewater will affect the performance and longevity of your POWTS. The installation of 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, and 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, dishwater, etc. The 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 be 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, condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics (medications), solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain regular steady flow by spreading the laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the unit may cause it to freeze up. ❑ Valves Valves should be operated in the following manner ➢ Alarms Alarms should be tested on a regular basis by the homeowner. If an alarm sounds, contact an individual licensed to serve POWTS. There is normally a one day reserve capacity 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 surface discharge. Page 8 of 9 INSPECTIONS Inspections shall be made by a person carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule) ➢ Septic Tank Component Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks of leaks, measure the volume of combined sludge and scum and to check for any backup or surface discharge of effluent. Access openings used for service of assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental of unauthorized entry into the tank. The outlet(effluent) filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank during cleaning. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating property. ➢ Pump Chamber /Treatment Tank(s) Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must me made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of the filter. Any service needs or repairs shall be promptly taken care of. ➢ Mound, At- Grade, In- Ground Pressure The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the 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. COMM 83.33, Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe opening sealed. - The contents of all tanks and pits shall be removed and properly disposed of be a Septage Servicing Operator. - After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or other inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system. ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure(s), lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. • A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. • 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. Mound and At -Grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. WARNING SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OF OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. Page 9 of 9 RECEIVED 1246 Wisconsin Department of Commerce SOIL EVALUATION REP RT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis, Adm. Code MAY 2 4 2 0 Po Tec i Soil & Site Evaluation County Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must Croi include, but not limited to: vertical and horizontal reference point (BM), direction and parcet6AlING OFFICE percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. -200 Please print all information. viewed By 654- - . _ n 1 Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). c /r+ ZGO Property Owner Property Location JACKSON, JIM a a Govt. Lot NA 12 NE 1/4 S 34 T 29 N R 15 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 6903 15TH ST RIN NA NA METES & BOUNDS City State Zip CMPAnt Mm6er y City ja Village J1 Town Nearest Road Saint Paul I MN 55128 651- 503 -0645 Springfield I 70TH AVENUE New Construction Use: NJ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Id Replacement JM Public or commercial - Describe: Parent material BEDROCK Flood plain elevation, if applicable NA General comments and recommendations: Recommend 16" sand fill mound component. Place upslope edge of 75'x 6.0' distribution cell along the 100.0' contour. Soil loading rate = 0.5. System elevation = 101.35'. Boring # JS Boring jo Pit Ground Surface elev. 99.5 ft. Depth to limiting factor 0 — in. F Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 "Eff#2 1 0 -8 10YR 3/2 none loam 2 m sbk mfr as if 0.5 0.8 2 8 -20 10YR 3/4 none loam 1 m abk mfr cs if 0.4 0.6 3 4 10YR 3/2 -3 clf 7.5YR 513 loam 1 m sbk mfr cs -- 0.4 0.6 7.5YR 5/3 4 24 -30 -- -- SSBR 0 m cemented -- -- 0.0 0.0 Boring # 19 Boring Pit Ground Surface elev. 98.0 ft. Depth to limiting factor 2 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 1 0 -5 10YR 3/2 none loam 2 f sbk mfr cs if -m 0.5 0.8 2 5 -7 10YR 4/3 none loam 1 m sbk mvfr -fr gw if 0.4 0.6 3 7 -22 10YR 3/6 none loam -sl 2 m sbk mfr cs if 0.5 0.9 4 22- 4 10YR 3/3 c2f 4 6 7.5YR 4/6 sil 0 m mfr cs -- 0.0 0.0 5 24 -32 -- -- SSBR 0 m cemented -- -- 0.0 0.0 * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg /L ' Effluent #2 = OD < 30 mg /L and TSS < 30 mg /L CST Name (Please Print) Signature: CST Number William J. Bergh 227819 Address Geo Tech Soil & Site Evaluation valuation Conducted Telephone Number 55 2667 113th Street, Chippewa Falls, WI 54729 5/2/2002 715- 723 -55 JACKSON JIM 034-1077 Property Owner Parcel ID # Page 2 of 3 3 ] F Boring # Boring ig Pit Ground Surface elev. 100.0 ft. Depth to limiting factor 30 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -9 10YR 2/2 none sl 2 m sbk mfr gs 2f -m 0.5 0.8 2 9 -16 10YR 3/2 none loam 1 m abk mfr gs 2f -m 0.4 0.6 3 16 -30 10YR 3/3 none loam 1 m sbk mfr cs 1f -m 0.4 0.6 4 30 -36 -- -- SSBR 0 m cemented -- -- 0.0 0.0 ❑ 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 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 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 PD 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. -8330 (R.07 /00) Geo Tech Soil & Site Evaluation 3 o) °� W 15 G — z r�zZ U ° I = o (/) O v vai L' �► C . 1 a� ^ Cl zoo �' II y (D W U � V) N Y Z 0 W Q 0 I_p H 3�cn F NCL mQCn _ > J J p O r_ ` J ® N N Z V W ~ y a�i00Q Q Z Z W M -coomZ 2 cFF� — UoaaU� Z 0 UU VI— +1 - 4 m C71 � O J W pm 0 Q oW W ~ z 0 V) o i am cn U Q D 0 J_ N _Z Q C7 = W O D r W O> PAGE 3 OF 3 ST CROIX COuNTX SEPTIC WANK MAWrENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer kS01ti Mailing Address - 690 /S /4 SS 1 zF Property Address 3 o!o - �o Av-t.��L c U r w n (Verification required from Planning Department for new construction) City /State. 29. Ir. isl k - zo Parcel Identificattion Number 14 - 14 -1-4- LEGAL DES n o To s� acs Nopert Looatioa sec. y _ T N R ,LLW, Town of . Via ie Subdivision - ---- Lot # K)/A . C.erMed Survey Map # Volume ` Page # � T"'" Warranty Deed # (0jo 57-1 "Volume l90 2 . Page # 2 -3 Spec house 0 yes JI no Lot lines identifiable 0 yes O no SYS NTENANCF COMis" Of Pumping use maintenance of your septic system could "c "Wt in its premature failure to handle wastes. Proper maintenancc pumping out ut the septic rank curry 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. The property owner agrees to submit to &_ Croix Zo ' D mastcrrplumber, ] 'otrsne Yman Pl � eparnntnt a certification forrq signed by a► 13ie o y res ner and b to 1� cted plumber or a licensed pumper verifjrirtg that (1) the on - site wastewater Y a is in proper operating condition and/or (2) after inspection and put" ° PwS (� if necess disposal system �Y)� � txptic 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 set forth, herein, as set by the Department of Commerce and the Department of Natural Reno system with the standards stating that your septic system has been maintained must be co leted �, State of Wisconsin. Certification and returned ed to the Sk clays of the three Year expiration date. �� County Zoning Office within 30 SIGNA OF AP LICANT DATE R CERTIFICATION I ('are) certify that all statements on this form 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 decd recorded is Register of Deeds office. SIGNATURE OR PLICANT S / el 0 2 DATE «'••" Any information that is this -re presentcd may result in the sanitary permit being revoked by the Zoning Department. iMriss `• Include with this application: a stamped w arrant y eed tY from the .e a gister of Deeds office Of the SPY certified survey ma if Y P reference is wade in the warranty deed ■ � � ONIKOZ 03 INN IS 9991 99C STL %83 09 :tT Hill ZO /tT /SO n � ri 05/31/02 FRI 13:45 FAX 715 386 4687 REGISTER OF DEEDS 0 001 ■ �V��RI2ANTY DEED 6 8 S 1 R OF DEE Cl� . OIX NCO. ; 11I M. TATS DEED, made between GERALD E. GE1tLACH and RE ST CR D X08 RECORD MARGARET GERLACB, husband and wife, and LAWRENCE F. GERLACH and MARY E. GERLAC�I, 05 -31 -2002 10:10 AM Husband and wife its GRANTOR and JAMES R JACKSON, a single than as GRANTET. R XEI�PT # DM 1? GRANTOR, for a valuable consideration, an in 3.00 REC FEE: 13.00 • P'AR L&L SA E: SATISFACTION of that certain Land TRANS RANS Contract dated April 30, 2001 and recorded May 9, 2001 Rpy FEE: In 'volume 1636, Page 152, Instrument No. 645074, St. CHR7 FEE: FEE: Croix County Register of Deeds, St. Croix County, WX PAGES: 2 Conveys the following described real estgte situated in St. Croix County, State of Wisconsin: Twenty acres located on the East one - half of that part of the After Recozrd4ng Mail TO; Northwest Quarter of the Northeast Quarter (NW W. NE 1i) Mr., James ft, Jackson And the (Southwest Quarter of the Northeast Quarter (SW 6803 15th Street '/4 NE 74) of Section 34, Township 29 North, Range 15 Wcst, Oakdale,' MN 55128 Town of Springfield, County of St. Croix, State of Wisconsin, and more particularly described as follows: : part of 0 - 077 -10 & Commencing at the North Quarter corner of said Section 34; Part of 034 - 1077 --20 thence NW43 E 492.21 feet along the north line of said Northeast Quarter (NE /4) to the point of beginning; thence NOSP43 E along said north line of the Northeast Quarter (NE Vs) 830.00 feet; thence 900'16 2,234.56 feet to a rerod; thence N12 ° 44'27" W 867.80 fact to a rerod; thence N00 0 16 1 40" 1,973.06 feet to the point of beginning. Said parcel contains 40.08 acres more or less, and is subject to any easements or restrictions of record. All other terms and conditions of the above described Land Contract shall remain in lull force and Effect. This is not a Homestead Property , This Instrument was drafted by: ffo `5 t 7 James R. Jackson -� 6903 IS* Street � -^�J s �� 0 Oakdale, MN 55128 V 0 /q� a_ U 1902P 023 68 ion 17 KATHLEEY H. VALSH REGISTER OF DEEDS ST. CROI)l Co., VI RECEIVED FOR RECORD 0 5 - 31 -2802 10 :10 AM WARRANTY DEED IIiiRM#IM(iY DEEP EXEMPT # 17 THIS DEED made between GERALD E. GERLACH and TRAM FEE: 13.80 MARGARET M. GERLACH, husband and wife, and TRAYS FEE: COPY FEE: 3.00 L F. GERLACH and MARY E. GERLACH, CERT COPY FEE Husband and wife as GRANTOR and JAMES R. PAGES: 2 JACKSON, .a single man as GRANTEE. GRANTOR, for a valuable consideration, and in PARTIAL SATISFACTION of that certain Land Contract dated April 30, 2001 and recorded May 9, 2001 In Volume 1636, Page 15x, Instrument No. 645074, St. Croix County Register of Deeds, St. Croix County, WI Conveys the following described real estate situated in St. Croix County, State of Wisconsin: Twenty acres located on the East one -half of that part of the Af ter Record$,ng Mail TO: Northwest Quarter of the Northeast Quarter (NW 1 /. NE 1 /a) Mr. James R. Jackson And the Southwest Quarter of the Northeast Quarter (SW 6103 15th Street 1 /. NIA %) of Section 34, Township 29 North, Range 15 West Oakdale,' MN 55128 Town of Springfield, County of St. Croix, State of Wisconsin, and more particularly described as follows: art of 0 - 0 - 0 & Commencing at the North Quarter corner of said Section 34; part of 03 1077 thence N89 E 492.21 feet along the north line of said Northeast Quarter (NEl /4) to the point of beginning; thence N89P43 E along said north line of the Northeast Quarter (NE 1 /) 830.00 feet; thence S00'16'40 "W 2,234.56 feet to a rerod; thence N'lt44 W 867.80 feet to a rerod; thence N00 0 16 1 40" 1,973.06 feet to the point of beginning. Said parcel contains 40.08 acres more or less, and is subject to any easements or restrictions of record. All other terms and conditions of the above described Land Contract shall remain in full force and Effect. This is not a Homestead Property a This Instrument was drafted by: James R. Jackson 6903 15 Street � 1k Oakdale, MN 55128 / U 1902P 02�f Page 2 of 2 Dated this day of May, 2002 Signatur Signature j *Ge E. Gerlach awvrence F. Gerlach al Signatures iguature "'^ = ^' s *Mar r at M. Gerlach *Ma E Gerlach ACIC KO'WLEDGEMENT State of (A �j County of VV Personally Came before me this 1 day of 2002, the above named Gerald E. Gerlach and Margaret M. Gerlach, known to me to be he persons who executed the foregoing instrument and acknowledged the same. — Public Esmy DEANNA L. ROTHBAUER Notary Public • M y Commis erm siou is aneut (If not, state Minnesota . Expiration date Commssion Expires Jan. 31.2005 State of IYIN County of Personally Came before me thi , day of 2002, the above named Lawrence E. Gerlach and Mary E. Gerlach, known to me to be p sons who executed the Foregoing instrument and acknowledged the same. Notary Public My Commission is permanent if ot, state Expiration date -W DEANNA L. ROTHBAUER t Notary Public Minnesota My Corrmssion Expires Jan. 31.2005