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038-1019-10-000
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C 0 0 O O ° c ° c o n n (D A V m m o c 3 w m w m o o oZ j Z e Bi y' AGZ' 0 o. o , < W a o 1 3 z A m w CD 0 CD C w d 3 (M r � D mc� oa 3 v n � o m m (D 7 fD m fD n m m m n m a: 0 c� �: Z 0 1 0 y O N I 3y -o' mac p a - dao Son C y 0 7 0 0 CD CD O o a EL a) x > co C m o m m °a m �'of o o0 a �'' Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 430229 0 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: Sankovitz, James I Star Prairie Township 038- 1019 -10 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: / 06,0 _ 0 03.31.18.72 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 1006 Benchmark 0 1 z' CD Dosing � /„� Alt. BM 00 Aeration p Bldg. Sewer Holding SU t Inlet St/ t Outlet 9� <� TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Ve�tr .te�Air Intake ROAD Dt Inlet �- Septic ,I- I Dt Bottom /- �10D r > tbo l /._9 9,Z 3 Dosing W prw Header /Man. Aeration Dist. Pipe p Holding Bot. System PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cover p GPM Z Model Number Q 51 •4 11 0 0 TDH Lift Frictior�g Sys1 H_ es�ct 1 TDH� � Ft I. Forcemain Length !� D / ia. di Dist. to W l / UD SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSION No. Of Pits Inside Dia. Liquid Depth DIMENSIONS — 7 , s (j I SETBACK SYSTEM TO P /L� BL WELL LAKE /STREAM LEACHI Manufacturer: INFORMATION Type System: Of � t CH OR ' NI Model Number: tlU l DISTR SYSTEM Header/ nifold / Distribution � , x Hole Size , x Hole Spa Ven Air ntake Pipe(s) I ( O r 7 / AA Length 1 3 , Dia Length Dia Spacing 3' o u SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only � - , Depth Over Depth Over xx Depth of xx Seeded /Sodded xx MOched Bed/Trench Center Bed/Trench Edges Topsoil ® Yes H No Fal Yes re No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: K //' 2-1 ,�, , 0 3 Inspection #2: 1 / Location: 1188 County Rd H Star Prairie, WI 54026 (Government 3 T31N R18W) NA t 'e I R I O` - Parcel No: 03.31.18.72 1.) Alt BM Description Gu�Z�dd��d p 2.) Bldg sewer length = '�( (,4j VtQi(,cJ - amount of cover = 3� 4V kv- z C � Plan revision Required? Yes No Use other side for additional information. (� J ate Insepctor's Sign ure Cent. No. SBD -6710 (R.3/97) J Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 430229 0 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 Holders Name: City Village X Township Parcel Tax No: Sankovitz, James I Star Prairie Township 038 - 1019 -10 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range /Map No: 03.31.18.72 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number. DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia 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 Yes ❑ No ❑Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: / / Inspection #2: / ! Location: 1188 County Rd H Star Prairie, WI 54026 (Government 3 T31N R18W) NA Lot 6 Parcel No: 03.31.18.72 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? ❑ Yes FLO] No Use other side for additional information. SBD -6710 (R.3/97) Date Insepctors Signature Cart. No. J Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 NV i sconsin Personal information you provide may be used for second purposes p Madison, WI 53707 -7302 Department of Commerce [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not state owned.) Attach complete plans (to the county copy only) for the system, on paper not lznan -1/2 x 11 inches in size. County — F 9777;n - itary Permit Number ❑ Check if revision to previous appLitation StAte Plan I. D. Number L(30 ZZI I. Application Information - Please Print all Information ocation: Property Name 9n \ ,) �, / i a S y A I f� A� I .SfV i 0VJ T� C7 �T b S 3 T3 [,N, ,N, R 1,9(or) W Property Owner's Mailing Address of Number Block Number L ( os Z N f k' CAS PEST AVc- P City, State Zip Code Phone Number gubdivision Name or CSM Number SN 1 1ZW1 901 S"321 (yl�� > qtoH X 13 g II. Type of Building: (check one) ❑ City 0- 1 or 2 Family Dwelling - No. of Bedrooms: 0 Villa of �H 1Z T Nn t��E ❑ Public /Commercial (describe use):_ ❑ State-Owned Ne� ' r rl Road 1.1 .. �, _ C� . S �( b (�) Parcel Tax Number(s)638 A/ -two III. Type of Pe it: (Check only o ox on line A. Check box on line B if applicable) (.32- A) 1. ❑ New Repl 3. ❑ Replacement of 4. 5. 6. 11 Addition to System S stem acemen Tank Only Existing System $) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) ❑ Non - pressurized In- ground M�oun ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: A - -(C;o 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation 9s e 'rso ys I C/ - 1,6 SDI. s9 VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks /a3n 1c�c� 1 G10/ at2 ❑ ❑ ❑ ❑ Ltc &CcZ ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume responsibility for instyllation of the POWTS shown ched plans. Plumber's Name (print) ber's Si ure (nos ps): MtV2RS I Business Phone Number F 2232 '1"Z 715- 2.9y - I Plumber's Address (Street, City, State, Zip Cod F n._ 2qs r- ,R- V1 -SynG IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued I suin Agent Signature (No tamps) Ig Approved 11 Owner Given Initial Adverse Surcharge Fee) Determination 5� ` e 2CO3 _ X. Conditions of Approval l for �Disa��• oo - s sus �2 � C � �J C r U v %. a J V �" 1 a.Q VA . SBD -6398 (R. 07/00) r �_ - - - -- -- � PAGE 33 43 14:00 715248356--t. SUpERI�R ALJTCM�J`I� +E a q9.t -y' 11% .35.. V .-E- s C- .. f% - ..� t C. _ a { I r .00 s' wig ywa7 n C�1 Safety and Buildings 10541N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264 -8777 www.commerce.state.wi.us/sb www. wiscon s in.gov wisconin.gov Department of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary July 25, 2003 CUST ID No.223242 ATTN.• POWTS Inspector JEFFERY V FOX ZONING OFFICE CROSS COUNTRY EXCAVATING ST CROIX COUNTY SPIA PO BOX 295 1101 CARMICHAEL RD DRESSER WI 54009 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/25/2005 Identification Numbers Transaction ID No. 889146 SITE: Site ID No. 662473 Margaret Sankovitz Please refer to both identification.numbers, Cth H above, in all correspondence with the agency. Town of Star Prairie St Croix County Government Lot(s) 6, S3, T3 IN, R1 8W FOR: Replacement mound, 450 GPD Object Type: POWT System Regulated Object ID No.: 913161 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 -1 691 -P (N.01101) and SSWMP Publication 9.6, "Design Of Pressurized Distribution Networks For Septic Tank- Soil Absorption Systems." • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. Key Item(s) • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. ound Component Manual. • Limit activities in the area 15 beyond the down slope edge of the mound per M p one nt M JEFFERY V FOX Page 2 7/25/03 • Materials shall conform to the requirements of COMM 84. • Abandon failing system per COMM 83.33. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall. provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 r Patricia L S orf POWTS Plan Reviewer, Integrate ervices WISMART code: 7633; (715) 634 -7810, Fax: (715) 634-5150, M -f 7:45 am - 4:30 pm pshandorf @commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 .. .. .......... MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Margaret Sankovitz Owner's Name: same Owner's Address: 4057 N. Prospect Ave. Shorewood MN 53211 Legal Description: Gov Lot 6 S-3 T-31 N, R-1 8 W Township: Star Prairie County: St. Croix Subdivision Name: Lot Number: Block Number: Parcel I.D. Number: 038-1019-10-0000 co C Plan Transaction No.: *NDB ILDINS:� Page 1 Index and title _SPONDEN Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot Plan Page 9 Soil Test Designer: Jeff Fox License Number: MPRS 223242 Date: 07/07/03 Phone Number: 715-294-3141 Sic gnatu;.z�).,/./ Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 4.0 (R. 04/03) Page 1 of 9 Component Design Mound and Pressure Distribution n p 9 Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: and fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 83 -44-3 in -situ soil treatment for fecal 1,50 Peaking Factor (e.g. 1.5 = 150 %) coliform of - 36 inches. 450.00 Design Flow (gpd) 4.60 Site Slope ( %) 99.30 Contour Line Elevation (ft) 30.00 Depth to Limiting Factor (in) 0.50 In -situ Soil Application Rate (gpd/ft Distribution Cell Informatior 60.001 Dispersal Cell Ler 7.50 Cell Width (ft) 1.00 Dispersal Cell De 1 Influent Wastewa9 - :he laterals the hig� st oint e distribution Pressure Disribution Infor r S p g vork? Enter Y or N (c or e) a Center or End P C9 / 3.75 Lateral Spacin5 , J above, enter the elevation ft 2 Number of Laterals the highest point. 0.188 Orifice Diameter (in) (e.g. 0.25) 2.50 Estimated Orifice Spacing (ft) = 9.38 ft /orifice 2.00 Forcemain Diameter (in) 80.00 Forcemain Length (ft) Does the forcemain drain back? Y 91.00 Pump Tank Elevation (ft) Enter Y or N 3.25 System Head (ft) x 1.3 13.05 Forcemain Drainback (gal) 8.47 Vertical Lift (ft) 53.60 5x Void Volume (gal) 1.69 Friction Loss (ft) 66.65 Minimum Dose Volume (gal) 13.41 Total Dynamic Head (ft) 31.46 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 1.50 x x 1.25 2.00 1.50 x x 3.00 2.00 x -d 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1000.001 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser I Manufacturer gal /in (enter result in cell B49) Dose Tank Information Efflue Filte In formation _600.001 Dose Tank Capacity (gal) JZabel Filter Manufacturer 16.701 Dose Tank Volume (gal/in) JA100 Filter Model Number Wieser Manufacturer Project: Page 2 of 7 Mound Plan View T 1/106• :0, J l — . . . .... ... ' ' . . . . . . . Observation Pipe T '-T'.'.'.'.. . . . . . . . . . K L• L•S• wL•L•L•L••w L• L••. �L •L•L•L••e ° °w•S•L•L•L•L•L•L•L•L• • •L• • �� d•r•.• � •r• •• •••.. •. r.r. •.r.r.rwrwr.r•r..•r.r• ..r r.r. . ;•:L''••L'L•L'L' • L :L''•'L•L• °••L•'•••••L'L''''L'' L''•' A s •' }. r.r.r.r.,..r. r.r.r.r.r.:.r.: •:.r.r.:r.r., . . � •,:i.L. S :L:S.L.L.LwL.S. • .ywL••,. •.•L••.••e•L••••°.•L•'ti•'• ti••w•L• r r r r •,r • r•:• • •. • r r• ••r .••r;. ••r• • .' ••r r ••r• W :Lw LwS.e•.eL wt :Lw•.• i4 :• :ti teL: •4• • L. Le•4:tw• •ti :te•L: �� J B • • - F :: . : .. .. I o: L Mound Component Dimensions Down slope toe extension made. A 7.50ft E 10.14in H 1.00ft K 7.39 ft 50 B 60.00 ft F 9. in z 7.50 ft L 74.79 ft D 6.00 in G 0.50 ft J F 2 1 ft W 19.72 ft 450.00 (ft Dispersal Cell Area 900.00 (ft Basal Area Available 7.50 (gpd /ft) Linear Loading Rate 6.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 101.59 (ft) -► ... /1fr.... H G {r:r }��trr:.,. I F Dispersal Cell 100.30 (ft) Lateral 99.80 (ft)� Invert Dispersal Cell Elevation E D ... ..... -� 4 tom; � 99.30 (ft) Contour Elevation 4.6 %Site Slope Geotextile Fabric Cover Shading Key d n T Dispersal Cell See lateral details on ® Topsoil Cap o 1.5 ft r; . ,r j, j j j Page 4 for number, size, { }ff 0 0 5 r ° spacing S ubs oil Cap and s L :, L . •L• P 9 of laterals. ©0 ASTM C33 Sand F Laterals are equally d 0.5 ft Typical Lateral : :w• :w• spaced from the ® 0. Tilled Layer :s• -.- -..�• , .ti••e• Aggregate v c �•;ror :r:rara:.r: °�;L?tr distribution cell's centerline in the — A distribution cell (AxS). Project: Page 3 of 7 End Connection Lateral Layout Diagram Laterals centeted over the A &Bd"rnertsion +s Turn- up+dtballvelvearelonnoutplug i P r AN laterals are identical X I Holes dried on the bottom of the lateral S eq"4 spaced Force mast eonneodw Wa tee or cross to maniFokl at any point. Laterals & Force main of PVC Sch 40 (per COMMA Table 94.30-5) Number of Laterals 2 Orifice Diameter 0.188 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.54 ft Lateral Length (P) 58.42 ft Orifices per Lateral 24 Lateral Spacing (S) 3.75 ft Orifice Density 9.38 W /orifice Lateral Flow Rate I 15.73 gpm Manifold Length 3.75 ft System Flow Rate 31.46 gpm Manifold Diameter 1.50 in Total Dynamic Head 13.41 ft Forcemain Velocity 3.21 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and - -► Comm 16.28 WAC 4 in. min. Disconnect � i Tank component is properly vented E-- Alternate outlet location Forcemain diameter Wieser Manufacturer —r 2 in. Capaciltyl 600.00 Gallons Volume 1 16.70 gal /inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 19.94 332.95 C B 2.00 33.40 Pump off e levation (ft) C 3.99 66.65 –t 1 91.83 D 10.001 167.00 D Total 35.93 600.00 iF Dose tank elevation (ft) 3" Bedding under tank. 91.00 Alarm Manuafacturer I Tank Alert —� Alarm Model Number 101 V r Pump Manufacturer Zoeller — - Pump Model Number IN 98 1 Pump Must Deliver I 31.46 gpm at 1 T ft TD Project: Page 4 of 7 r Mound System Maintenance and Operation Specificatio Service Provider's Name Jeff Fox —� Phone 715- 2943141 POWTS Regulator's Name Polk County Zoning Phone 715 -485 -9279 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1000 gal Maximum TSS 150 mg /L Soil Absorption Component Size 450 fe Maximum FOG 30 mg/L Type of Wastewaterl Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Ins t for ndin and seepage once eve 3 ears f�l Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished • .............. ................ Grade Threaded Cleanout 6-8" Diameter Lawn Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Page 5 of 7 I Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD- 10691 -P (N.01 /01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once Every 3 years by inspection. The outlet fitter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filler when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent fitter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shalt be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Colo weather installations (October- February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD 30 mg/L TSS, 10 mg/L FOG, and 10 cfu/100 ml for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Page 6 of 7 it TOTAL DYNAMIC HEAD /FLOW 3 718 6 1/4 �{ a 5/B LU PUMP PERFORMANCE CURVE PER MINUTE Uj LL MODEL 98 EFFLUENT AND DEWATERING • I , 6/8 MODEL 98 • -- 25 � + + 4 3/16 Feet Meters Gal. Liters 6 5 1.5 72 273 w 6 20 10 3.1 61 231 1 1/2- 1/2 NPr = 15 4.6 45 170 U 15 20 7.1 25 95 y 4 Shut -off Head: 23 ft.(7.0m) n J F 10 0099778 _ O 2 4 3/16 0 10 20 30 40 50 60 70 80 GALLONS 8K1102 LITERS 0 80 160 240 FLOW PER MINUTE 009971A CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and • Variable level float switches are available for controlling single supplied with an alarm. and three phase systems. • Mechanical alternators, for duplex systems, are available • Double piggyback variable level float switches are available with or without alarm switches. for variable level long cycle controls. • Refer to FM1922 and FMO806 for temperatures above 130° F. Standard all models - Weight 39 lbs. - H.P. SELECTION GUIDE Control Selection to ral float operated mechanical switch, no external control required. 98 ties Model Volti ies Mode M4.7 Simplex Duplex 1. In g P 2. For automatic use single piggyback variable level float switch or double M98 115 Auto 1 4 piggyback variable level float switch. Refer to FM0477. N98 115 Non 2 or 3 4 3. See FM1228 for correct model of simplex control panel. D98 230 Auto 1 4 4. See FM0712 for correct model of duplex control panel or FM1663 for a E98 230 Non 2 or 3 4 residential alternator system. CAUTION For information on additional controls, Zoeller products refer to catalog on Piggyback Variable Level Switches, All installation , p rotection devices and wiring should be done by a qualified FM0477; Electrical Alternator, FM0486; Mechanical Alternator, FM0495; Sump/Sewage Basins, FM0487; licensed electrician. All electrical and safety codes should be followed H including the most and the occupational tY Single Phase Simplex Pump Control, FM1596; Alarm Systems, FM0732. recent National Electric C ode (NEC) RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16347 LouisviAe, Ky 40256-0347 Manufacturers of . . [ SHIP TO. 3649 Cane Run Road Q 0 ® Louisville, Ky 40211 -1961 rjaL/TY Po MPi4 5NCE 1 -9 ,7J PUMP !O. ( 502) 778-2731.1(800) 928-PUMP hupJ /wwwzoeller.com FAX(502)774-3624 © Copyright 2002 Zoeller Co. All rights reserved. CA cl " -V Tf tp r� r 3 0 � D w. tt� C7 07/03/2BD3 14:00 715246358E SUPERIOR AUT&CTIVE PAGE 02 womrow Depamwent of Cvm— SOIL EVALUATION REPORT DVNNA Of so* tied eumaw i &= wdm co vah Come S& Wis, Adm. Ca" �* com &* plan an peiw not km than & V2 x 1 Indus In Ab*- PW mud W.dL%cl M tot kyA@d 1c: varbowl and ha ftonw ndwem* Pww (W dlroc"" end Polaw to. pw*w s6w. Bowe or do"Onslone. north BMW. VA 10M"M MW dMW" M MMUM coed Oil- ) 0 - 10 - phem prW all InfoMOftil. RvvkwAd by DOW p wft ym wovww M" be wed for mmxwwv W"w Mft-Y LA-- M I Sze (1) (m))• I Rap" Owner TijWrtyLoostion Govi. Lot 6 - 1/4_ 114 6 3 T 3� N R E m ��;�M4 - -� 0 Bk)ek* StAKLNelsworcam Property Owner's MmVV A4&m W,r 405 hru _j -ASK, A)Cbft r RKM t+JMLW Q 154 wer aTown Neemet Reed IMAJ 1. st- I 04 1 Nil )SCA -A,31 1 c a r Ca 13 Mom Qxwmjm%� P usw*. R%Iwdw" I of bo&am CW* dt, 00090 flow MIS 1460 POW "Imm" kiin awyetion it appkmble '". ^, & 3 C4 A4- Vi a: o2 to 7'$ kkl I wd nK*mffwr4M,$, Y- 99.g/' m S p Ground -daw eiov. ft. to urreft %am in. $*H AMAcMm Pift Hoeg" Depth Dwirm" caim Rfid0K CM c 4-1 k Sb OVOWONS boundary Rawaft In. Muns" Qv, u OWL coiw Or, $L Sh, Ask 7s 19 %-1 1 7.5 IK"14 st, ;SL RESIU, L IF S GK 8\ CW hi F 19 4 lq F 1 '76 If. 4 1 f54. p www "Wo aw.- R. nwm to Iff"Q iacwr In. SON Applomw DOM Omkon COW Redox Description Tam" smxue camster" bwadery Roots in. MWOO OLL &- Cont. Color Gr. Sz. Sh. ► 0 10'YR 3 1.a FSL- RFS8'K as QM FSL RPSK S 4 6 Q -- I m T slll 6v� 4 F-5CL 1 0 M 49 b OF SIR • Eflkim 4M 5, 30:5 =0 ffq& and TW 310:5150 rl%VL Eftwt ig ■ Mpp,.S 30 m & and TW 130 ffVL w Name p" CST Nuff4w Ad*au oat& V%jkjjWm Co - rdW=w Nwnbw S�ar P��Nf;e wl Z40,56- 15 -,R4 -35$$' 07/03/2003 14:00 Y mm 7152483566 SUPERIOR AUTOMOTIVE PAGE 04 pmpwwoww Ch -j PO"O# pow of x 13 rrltat.w tLr"� M Pit oro rd surrac..wr. q $ >t a m tirnBnp %dor ... _ �► Hob= Depth Dmnirwg Color Redm DsscrOw Tsllt3bre 31nua<re CWWNA M Boundary Roats In. WkNow Cu. SL Coat. Corer car. ow- sti. 'EM�1 •EtwM2 � ,s -ao . a s s w l ab-30 iS A 4 14 a L I F3B & C0 Iv 3a 1.5 IR 41q p I F 7.51 t FSCL ❑ Pit Qr*und wr%" dw. � _. fL D"ft b wor g b mr w. ftftm Depth DmfIlkh nt Rw*w Dow "m To*" Shuwve t"wwh*K a Boundary Rods t3PW1! In. Mullow Ou. Si. Cut Color Or. Sa. Sh. 'EM 'EiJMf2 Be"S r❑ 1Q U Pit Bound wrtaw elev. !t. Depth 10 Yrttipnp IOChor a,. Sall bMjgMM Ride Not= D*M Dwbw t Redoa OaeaipIw Terdure St uch" ConsWW= Boundary %ots In. 1A M" Qu. SL Cant. Color Cir. 9tt- Sh. 'EltIIFi 'EflW2 EtAusnt ii1 BOD > 3D K 7iD mplL end TSt3 >fl0 150 RAIL " Etausnt 42 ■ SM, S 30 ffg& Ord TW 130 ore The Department of Commerce is an equal appornwity service provider and employer. If you need assistanco to cress mrvicos or need material in an alrernaw Yortw, plass cons wt duo de parhnent at 608- 266 -3151 or TTY 6M2"4777. ssaai�sre:�xt� 07 /D3 /2003 14: DO 71524:33595 SUPERIDR AUTljMO—FIVE PAGE 33 X31 �9.�Y Vl d S -�1... .... CA LA r� a � tpc + 91c �^- fi a r r t l o t I � e 1, � ` y Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County .-�- Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must Q include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 0 — Q — 00 0 0 Please print all Info mafip F iU Reviewed by Date Personal information you provide may be used for second ry purposes (Privacy Law, s. 15.04 ( ) (m)). Property Owner t „ ; > a perty ocation M 0. Govt. Lo 1/4 1/4 S 3 T N R I E (or W Property O er's Mailing Ad ess f# Block # Subd. Name or CSM# 5 I IV ) i C d raS c.c.s' : City State Zip C de Phone Number ❑ City ❑ Villpe [gTown Nearest Road M S3 a t 1 ( '// 94 it - 5 138 �+r - _% t-, t_ ❑ New Construction Use:IA Residential ! Number of bedrooms Code derived design flow rate y5 © GPD [� Replacement ❑ Public or commer - Describe: Parent material s I t' t ` Flood Plain elevation if applicable ft. `` General comments - 2 S ++S g G s "� 1 - $ /, a S Q t� e� " 7S ' 'f P. N C. 5 F or 1 ; s re- P l &C el- Vi�T', and recommendations: F l: F -f-- "f",a. I5 NttAe -g.. Unkr�ow i ' [] Boring Boring # Ea Pit Ground surface elev. ,o 3. e'� 9 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 6 -1 J0 *1 R. L d�5b r 0j 5 d .S +. QL y1 -s3 S Ry 1., m 5 6K- 1 0� S- 6L IfSb k— F �► ''" Boring # ❑p Boring � Z � ER Pit Ground surface elev. /b r o / ft. Depth to limiting factor S in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 r 7.5 `i ----- S �-- Sb V- n1 G w FS b k. r C * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L CST Name (Please Print) Signature CST Number H 0_k 0 1 7 `F �v Addd e s Date Evaluation Conducted Telephone Number / SBD -8330 (R07 /00) Property Owner h KO U -t ; — Parcel ID # Page of F-31 Boring # ❑ Boring q7 -90 Pit Ground surface elev. • 7 ft. Depth to limiting factor IS 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-V 101 R z a F*5b W. M Fv- a 5 a wA ':5 C;). -;ZV 7.5 L- a F5bk- M FV_ C w ►M is , $ - 39 YA V N M Y - et--j 1VF L . 1 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # ❑ El Pit Boring Ground surface elev. ft. Depth to limiting factor 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 * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. SBD -8330 (R.07 /00) w s 4 il' � 7C r In o o V .. !' I . L 00 i a s r - 0 A � rr r r �- Rio tA Z P 9D Loki -� -� r 64 i 4 Wisconsin Department of Commer .J ll L ) OSVIL VALUATION REPORT Page of Division of Safety and Buildings in a ylnth Comm 85, Wis. Adm. Code County S , cro Attach complete site plan on pap es n size. Plan must include, but not limited to: vertical and horizontal reference point (B ), direction and P I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. e wed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ` b Property Owner Property Location (( 1' 1g0�je�v�1�0�J Govt. Lot b 1/4 1/4 S 3 T 31 N R �� E( r) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# L105 Aj , cos ec-4 A Qt, C' State p Code Phone Number ❑ City ❑Village Town Nearest Road S oc oo � I(y 1 ) 4 - o11 sg I a h ' r 1 co R a ❑ New Construction Use: % Residential / Number of bedrooms Code derived design flow rate y SO GPD Replacement ❑ Public r commercial - Describe: Parent material Q I RCi 41 i I I Flood Plain elevation if applicable ft. Genera( comments I/ • r "� and recommendations: 5 VQ �- �a X 75 S ��' I o •�� ` Ou 0.—�- 99.8i , F f Boring # ❑ Boring Ground surface elev. Depth limiting ft De to fa ctor ®Pit 1f'._L�I2t- P 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. "Ef1#1 "Eff#2 I (J'-8 10y 3 /a FSL RFS BK A as am ,5 oZ % -1 7,5 y F5L a Sa d Sk CO 1 . 3 16 -30 )\'SlRql L I E SGK d C v F , y 30- ,S JR 41q I FTS YK 4 FSc.L ® Boring # ❑ Boring �{ Pit Ground surface elev. / r ft. Depth to limiting facto in. Soil TGPD/fF ate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Ef2 I 0-10 IoYR a FSL aFSQ 6S\ a awe a o -lq s 3 SL a S S Q W w\ , s , F K dh c I 3 19 -30 ,5194y I FSL. 1F SaK dh eW 1vF 30- 1CS ! 1F`1,5y j* 8 ESCL- 0- dvh " Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L " Effluent #2 = BOD < 30 mg/L and TSS 1 30 mg/L CST Name (Please Print) o Signature CST Number n . S ar aal`ly Address l Date Evaluation Conducted Telephone Number aci ST , Sar Pro;Nr; w1 5y oa - l -03 715 -ay8 -358$ d a - f r/1Gt,w r e� Property Owner • ;Z Parcel iD # Page of 5 Boring # ❑Boring Pit Ground surface elev. 9 *0- % ft. Depth to limiting factor _ in. Sal 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 (3-9 0yR 3 A FS1_ a SB d SV� a s am , s ,g a 9 -aO IS R 3 /a F L &FS9K cis Cw Im ,S 3 @0-3a 15 IS 4 FSL I F56 6k 0-0 v F 4 .6 3a �,5 yR y F I F 7.s y e s FScL dvh — F-1 Boring # C] Boring 11 pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft� in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 F -1 ❑ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit r*Eff#1 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#2 Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mg& and TSS 130 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 (RO7/00) (3 g9,bY' 99. 3► _ �: .. r LA c m - 4- f �► — N I , Sw asP�c CA 1 3 os �1 a C) za lo s 4 l lI per► Ira � r Q + Ck 02/ 10:42 7152473038 BELISLE EXCAV T=hk3 I PAGE 01 ST CROIX COUNTY - SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Al1ARGARL SA0 (f) VJ T Z Mailing Address 410�`7 1 IK(J - PCOT AVE SttO'(.£Wl�VIJ QZIl Property Address I f � g C , a in 7 Verification required from Planning Department for new construction)S City /State t, - f —l E Parcel Idt;ntification Number EGAL JQEkgRjEnM / Property Location nrU '/ (o V. Sec. T I N - �� W, Town of <T PRRI: (t= Subdivision , Lot # Ctrtifted Survey Map # � Volume ,Page # Warranty Deed # Volume 1 160 , page # � 2Z Spec house ❑ yes ❑ no Lot lines identifiable O yes 0 no SMEM MAINTENANCE _ Improper use and maintenance of your septic system could result in lrs prcrnattue 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 systctn can affect the function of the $001c tank as a rrea=eni stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a cer4lftcation form, signed by the owner and by a masrerplumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (l) 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 tba standards set forth, herein, as set by the Department of Commerce- and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system hAS be ima.ined must be completed and returned to tote St. Croix County Zoning Office within 30 �Ys a three year expirati de- e SICrNA OF ICA DATE 0 ER CE TI IC TION I (we) certify that all state nts on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of the pry erty described above y ue of a varranIy deed recorded in Register of Deeds Office. A OF I DATE "` *• Any inform that is mis represented may result in the S a nita p ermit being revok b the Zoni De an ncnt. ry tx 5 Y B P •♦sr*. •� Include with this application: a stampr_d warranty deed from the Registor of Deeds office a copy of the certified survey map if reference is made in the warranty deed !D DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1 -1982 596821 W ARRANTY DEED KATHLEEN H. WALSH -oL 1400PAc[19 ? REGISTER OF DEEDS ST. CROIX CO., WI This Deed made between Richard J. Mathews- RECEIVED FOR RECORD Jr •.a..MzD....... - - -- ... - ° ..................._.._- 02- 01-1999 9:30 AN --------------------------- --- ------------- ---------- -- --- ..... - -----....... -- --- --- - -..., Grantor, WARRANTY DEED - - -- •- •- ----- - - - - -- ...................... ..........------- ........._..................... and ... R.ichard__J...k??t hevs ... and- _1?aXY..Ar)n..Mathews1_........ E CE ER RT P COPY FEE: 16 and -.- their., succe_S.SRrs.,_- _rustees...of- the Richard_. COPY FEE: J.__ Mathews ... arid. Mary ._Ann..M.athelas..Revocable ------ ...... TRANSFER FEE: RECORDING FEE: 10.00 Tx. us. t..c latgd..- tzv ne ... 2. 4 ...... 1. 99- Z --------- -........... •---------- - - -.., Grantee, ! PAGES: 1 Witnesseth That the said Grantor, for a valuable consideration...._. ............................................ . ---------------- ................................................... RETURN TO j conveys to Grantee the following described real estate in . -_. t.....CLf). }4........ Atty. Matthew J. Linn f - County, State of Wisconsin: i 2327 N. Murray Avenue ; Milwauke e, WI 53211 I l T. Parcel No: 0 3 8 -1019 - 10 An undivided one half (1/2) interest in and to a strip of land extending one hundred thirty two feet eastward and westward and between south shore of Cedar Lake and road now located in section number three (3)- in township number thirty one (31) north of range number eighteen (18) west, meaning to convey a strip of land extending from said south shore of Cedar Lake to roadway and extending eastward from the center line of the main portion of the building erected by Marry M. Williams 55 feet and westward from said center line 77 feet. Also a strip of land extending between the south shore of Cedar Lake and the road now located in sec. 3- 31 -18, and between west line of that certain land transferred to Harry W. Williams as described in the foregoing paragraph and west line of east half (E 1/2) of lot number six (6) in said section number three (3). Also commencing on west line of east half (E 1/2) of lot number six (6) in section 3 -31 -18 at a point where the road running east and west along south shore of Cedar Lake mosses said line; thence running south twenty (20) rods; thence east eighteen (18) rods; thence north to south line of said road; thence northwesterly to place of beginning. Also a strip of land bounded on north side by Cedar Like and running southward six hundred ninety six (6%) feet and extending westward for a distance of one hundred eighty five (185) feet, from east line of west half (W 1/2) of lot number six (6) in section number 3- 31 -18, meaning to convey a strip of land six hundred and ninety six (6 %) feet north and south and one h r 85 feet east and west located in northeast corner of W 1/2 of said to , all being in lot number (6) six I num er n to wn s hip number thirty one (31) no er - C2l1J 1K);st. HarrylGl. NM ams owns colFa land garage, and well located on the above described property. This .........1S riOt - -- homestead property. (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And.... CQ. ZAX 1tOx ........... .................................. ............................................. —.... ............................... warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except municipal and zoning ordinances, recorded easements for public utilities serving the property, recorded building and use restrictions and covenants, and general taxes levied in the year of closing. and will warrant and defend the same. Dated this .. .................... .................... _ day of .......... !,V.. - --- -- -- 19..FP � �- - ----- -----(SEAL) ...... ............... .... ...........— ...... --......(SEAL) Richard J. Mathews ,_ ,- .M. -D. ................................................... -- -----• --- --- - -- -- .(SEAL) . -•• - ---- (SEAL) i ' ................................ ............................... « ..................... ---- -- -- -- ---- ------. ------------------- j !' AUTHENTICATION ACKNOWLEDGMENT Signature(e)R... chard J. Mathews, Jr., M.D. STATE OF WISCONSIN .................. ............................... ........................... es. W,/ pp -------------------- ------------ - - - - -- Count authenticated this etj day of..A ' R j6 . -, 1921 Personally came before me this .............. ..day of ............ ......................... . ..... 19 ........ the above named ......... - --- -- e ---- - -- --- ------------------ ----- '..... -- --- --------•--•-- ------- ................--•--------................----- -......-- ---- ---- °............. TITSAR WISCONSIN (If not , - -- • ------ ......................... ...---••-...._................................... ............................... authorized by § Wis. Stats.) to me known to be the person ....- _ -. - - .. who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY _•- i; ......... . ......................... ............. ............. ................... Mat:thew_J_,- __I AttQ�ngy__At__Law « ........................ 2327__N._, Murray_Ay...Milw. I. WI 5 . 3 . 2 . 1 . 1 Notary Public .............. - - -- ..County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (if not, state expiration are not necessary.) date: ......................... . ..• - -• - --...-----•------- ----- 19 ......... •Names or Persona signing in any capacity should be typed or printed below their signatures. WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank C. Inc. FORM No. 1- -•1982 Milwaukee. Wis.