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038-1071-20-000
i 0 CO) 0 3 - 0 n tz ' m o ft Ln N e� = CD y O (A Q . e v m N 0 0 w 0D `Ot CD :r ' N N 1 ' O oc m f°(° y 0 Mo 3 m ° > > C o m o O l� _ ° C v cn v D m 0 00 (D (8 A c a o IW p w 3 O ft L 0 O •P m• N N N co y 4 O) 00 M c W 3 a 000m ., 3 3 CD ° N N .. W N D D o c m O 0 7 N S O. V• "Im • W � a N O C 3 (p O (D co 6 A z 7 � (D O (D ID C G J CL z G r: ti a y z m C O A M fl y- O � O vi T ° lu p o = •C CL to o A- o << oy a m � Onom �o y � DS N y O(8 I wZ G O (D 7 (p A y N O N o Do-� y d ° v O O w 9 - y W w o c o A 7Z' w y 7 6 y 9cLo 3 �c Z r0 (D =' cd o m o np' y -� 9 `c N ° M o CA 3 ti b it 'm oo N 838839 St. Croix County KATHLEEN H. WALSH AFFIDAVIT OF STORM WATER REGISTER OF DEEDS ST. CROIX CO., wz MANAGEMENT & MAINTENANCE RECEIVED FOR RECORD Document Number Document Title 11/14/2006 03 :15PH Real Estate Owner ("Owner"): Christopher and Katherine House AFFIDAVIT Local Municipality ( "County"): St. Croix County, Wisconsin EXEMPT # On this 11 th day November. 2006the Owner agrees to ensure that the storm water management REC FEE: 11.00 facility(s) located on the property described below continue serving their intended purposes in TRANS FEE COPY perpetuit in accordance with the storm water man a g ement p lan and o p erati on and maintenance COPY FEE: 2.00 p rp ty ' � P P� CC FEE agreement filed as a requirement of the special exception permit approved by the Board of PAGES: 1 Adjustment on 10/30/2006, File #LU0052 /SE0103 a copy of which can be obtained at the St. Croix County Planning and Zoning Department This Affidavit applies to the following real estate, herein referred to as the "Property ": Lot 2, Certified Survey Map No 1241, Volume!!, Page 1241, Town of Star Prairie, St Croix County, Wisconsin Reoordmg Area Name & Return Address: Chris and Katie House PO Box 936 North Branch, Mu 55056 Through this Affidavit, the Owner hereby subjects the Property to the following covenants, Parcel No. 038 - 1071 -20 -000 conditions and restrictions: 1. The Responsible Party shall be responsible for the routine and extraordinary maintenance of the storm water management facility(s) in accordance with the operation and maintenance agreement on file at the St. Croix County Planning and Zoning Department. 2. The County, or its designee, is authorized to access the property as necessary to conduct inspections of the storm water management facility(s) to ascertain compliance with the intent of the storm water management plan and the practices and procedures prescribed in the operation and maintenance agreement. 3. Upon notification to the Responsible Party by the County of maintenance problems that require correction, the specified corrective actions shall be performed by the Responsible Party within a reasonable time frame as set by the County. 4. The County is authorized to perform the corrective actions identified in its inspection report or its notice if the Responsible Party does not make the required corrections within the specified time period. The costs and expenses of such corrective actions shall be the responsibility of the Responsible Party. 5. The terms and conditions contained in this Affidavit shall run with the Property and be binding upon the successors and assigns of the parties to this Affidavit. Upon the conveyance of the Property by the Owner or by any of the Owner's successors in title to the Property, the grantor of the Property in any such conveyance shall be relieved of the obligations provided for herein. Dated as the first day written above. OwnerSignature(s): (/f � L 4 AU Owner Name(s) Typed Here: Christopher B House Cfmk4ZA0r B 4 , %e- Katherine L House 1 Ga tne'rt1'le•, 1_• Nrn .. Acknowledgement STATE OF WISCONSIN) :ss r County of St. Croix} Personally came before me this 14 t}, _ 7ay of Noyember, 200 6the above namecG hristo P her House and t6 me-MA to be the person(s) who executed the foregoing instrument and acknowledged the same. � Kat h erine House (^� rPr•i Campbell.Deputy Notary Public, St. Croix County . W My commission expires: 12 /'31 2006 1 of 1 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Slifety and Building Division INSPECTION REPORT Sanitary Permit No: I 499250 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: House, Cris Star Prairie, Town of 038-1-4' -3 00 CST BM El ev; Insp. BM Elev: TM Description: Section /Town /Range /Map No: /bU �Y1n ( Gs 17.31.18. 53 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER � CAPACITY STATION BS HI FS ELEV. d9jy Septic Z,^ Benchmark 1 z;5 M Dosing a Alt BM e P,, - 750 R, Ga,.. 7_5 Jto . NO Bldg. Se er I,. j D7 • to I g . Holding St/Ht Inlet q d/ * ` 5 TANK SETBACK INFORMATION St/Ht Outlet `I -9b ME24 1 '-2✓ TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Sv J•1L Septic 1 30 1 / Dt Bottom 1 q/- '5(6 D sin ( f Header /Man. aC I /OZ � �•� /p ,71 Aeration Dist. Pipe Holding Bot. System Z 1 Z 3b j6 Final Grade `F �( b . 1,5 1 �a� • 7 r PUMP /SIPHON I NFORMATION Manufacturer ^� r Demand St Cover - 73 )06 7 • t(p /40 g�o LOP l GPM p� Co�i�. Model Number ) 3 1-4(o / � (�.,��. 3. ,? /do, 13 TD H Lift Friction Loss System Head TDH t Forcemain Length Dia. Z 11 Dist. to Well � SOIL ABSORPTION SYSTEM BED /TRENCH Width / Length I No. Of Trenc s PIT DIMENSIONS No. Of Pitt Inside Dia. Liqui Depth DIMENSIONS `_ �\ SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type f System: � i 2, / UNIT Model Number: / M \ Os / DISTRIBUTION SYSTEM Header/Manifold / Distribution It / x Hole Size .� x Hole Spacing 0 Veryt to Air Intake r Pipe(s) ✓ Length 3 Dia r ' `� Length - -4 Dia , Spacing 3 5 SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over i Depth Over xx Depth of TxSeeded /Sodde xx Mulched Bed(rrench Center b /_ Bed /Trench Edges Topsoil \ Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 958 Brave Drip omerset, WWII 54025 (NW 1/4 SE 1/4 17 T31N R18W) Wigwam Shores Blk E Lot 2 Parcel No: 17.31.18.653 1.) Alt BM Description •'�- i 2.) Bldg sewer length = �b - amount of cover = Plan revision 7•'75 Use other side for in Yes No Ib� formation. _. 1 - Date Insep or's Sig ture Cert. No. SBD -6710 (R.3/97) . . ... ....... . com11 erce.M.90V Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 6T cip-00C 7j sconsln Madison, W1 53707-3162 *)iitary Permit Number (to be filled in by Co.) DepwUnent of commorce Sanitary Permit Application State Transaction Number In accords= with s, Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental — /3 Y'.3 S_ unit is required prior to obtaining a sanitary permit. Note: Application form for state-owned POWTS are pia-3 less (if different than mailing address) submitted to the Deparumm of Commerce. Personal information you provide may be used for secondary es in accordance with the Privacy Law, a. 15.04(1)(m), Slats. L cation Information - Please Print All Information P Owner'sNalm Parcel N Property IN, Owne Maii �— Property Location av City, State Zip Code Phone Number -~^ — - �,, Section ��_ V �_7 0 (circle one) N; R,--M--- E ord e of Building (check all that apply) Lot 2 Subdivision Nam or 2 Family Dwelling - Number 9 of Bedrooms Td� 4 6 _ ; h / lock k 7 commercial -- ro ,.— opubp Describe Use City Of -------------- > GSM Number Village Of ❑ State Owned - Describe Use __ V. I Type of Permit: (Ch only one box on fine A. Complete line B if applicable) system 11 Replacement System 0 TreatmentMolding Tank Replaccumt Only 0 Other Modificatiort to Existing System (explain) D. Change List Previous Permit Number and Date Issued B. El Permit Renewal Wfi�rrnit Revisi of Plumber ❑ Permit Transfer to New Before Expiration Owner 1 1yo Y3Te of POWTS lReyn;e eck all t hat . W --1L _7 Non-Pressurized In-Ground Pressurized In-Ground 0 At-Grade Mound > 24 in- of suitable soil ❑ Mound < 24 in. of suitable soil 0 [folding Tank ❑ Other Dispersal Component (exp lain Pretreatment Device Y. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area tired (90 Dispersal Area/roposed (s6 Sys tem Elevation CL I b"d 0 Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units New Tanks F_,xist —Tank—s-, 4go x Septic or Holding Tank `6--ing — ch.-bil V11. Responsibility Statement- 1, the undersigned, assume responsibility for i o f the POWTS shown an the attached plans. Plurnber's Name (Print) Plumber's Signature MP/MPRJS Number Business Phone Number Address (Street, City, State, lip _Cade) vu ount e artment Use 0 n ued fsaui7p�gAge4nt Si re Permit Fee Approved 11 Disapproved AIM ✓ Owner Given Reason for Denial - 7 ff,5"ibTftApprovalfReasons far Disapproval 1 Septic tank, effluent filter and hGLC1 AA_ dispersal cell must all be serviced maintained Ch4c-; as per management plan provided by plumber. 2. All setback requirements must be maintained t R aper ni teas tli In VAe'lL, L Ov �ZIW A41 7 X/ 3 — a 3 felt. — Wit S Ga se PT c Aov q q r E �t3_ P lot + - 75D sv riley P1 Ito Ldy �► o c h., t ni a s , s r U Safety and Buildings 10541 N RANCH ROAD commerce HAYWARD WI 54843 TDD #: (608) 264 -8777 t i sco nsin �.co mmerce.W.gov /sb/ www.wisconsin.gov Department of Commerce Jim Doyle, Governor M ary P. Burke, Secretary April 19, 2007 CUST ID No. 221057 AT7'N.• POWTS Inspector DANIEL C WORRELL ZONING OFFICE DANS PLUMBING & HEATING ST CROIX COUNTY SPIA 1756 150TH AVE 1101 CARMICHAEL RD SAINT CROIX FALLS WI 54024 -7533 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/19/2009 Identification Numbers Transaction ED No. 1383675 SITE• Site ED No. 723781 Wyman Anderson Please refer to both identification numbers, 9581 Brave Dr above in all correspondence with the agency. ROM Town of Star Prairie COnd 6 St Croix County NWIA, SETA, S17, T31N, R18W A P P IR FOR: Description: Mound, 3 bedroom residence _0EPgRTK1FW C Object Type: POWTS Component Manual Regulated Object ID No.: 1124650 f 5A' =ET Maintenance required; 450 GPD Flow rate; 25 in Soil minimum depth to limiting factor from original grade; w'�-� -- System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /O1) SEE COFRRE9 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Key Item(s) • 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. • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. I� f DANIEL C WORRELL Page 2 4/19/2007 • Maintain well and waterline set backs per COMM 83.43(8)(i). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. • Insulate building sewer per COMM 82.30(11)(c). • Provide frost protection per COMM 83.43(8)(c). A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall rovide a copy of this letter to the owner and any others who are responsible for the installation, operation or m ' tenan of the POWTS. Sincere Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 atricia L Shan o POWTS Plan Reviewer, Inte at Services WiSMART code: 7633 (715) 634-7810, Fax: (715) 63 -5150 , M -f 7:45 am - 4:30 pm pat.shandorf @wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726 -2544 , Friday, 7:00 A.M. To 3:30 P.M. MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Wyman Anderson mound Owner's Name: Wyman Anderson mound Owner's Address: Box 115 Mentor MN-56736 Legal Description: Nw1 /4 set /4 s 17 1:31 18w Township: Star Prairie County: St Croix T.S. m ally Subdivision Name: Wigwam shores Lot Number: 2 Blade Number. E 00 ER –�^'—' —I A f3 DIN Parcel I.D. Number. 038-1148- 90-000 'ONDE Plan Transaction No.: _ Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tame Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specimens pler R ao h q P(n1` Pfc� t�C� jg rt / /, . T.e Designer. Dan Worrell License Number. 221057 Date: 03/27107 Phone Number. 715 -646 -2634 Signature: cl%ma Desowd Purim to fhe Mound Cornp xwnt Manual for POWTS Version 20 SDB- 10691 -P (N. 01101), and SSYVMP Publication 9.6 Design of Pressure Dishtwtion Networks for ST-SAS (01181) Version 4.0 (R_ 04/03) Page 1 of 7 1 Mound and Pressure Distribution Component Design Design Worksheet Site hrforrnation (r or c) Residential or Commercial Design Note: Sand ni (Q) calmdabons asstane a 300. Estimated Wastewater Flow (gpd) Table 83.44-3 i i �u soli � for terms cofform of <= 36 inches. 1 Peaking Factor (e.g. 1.5 =150%) 450.0 Design Flow (gpd) 2. Site Slope {°+) 100.131 Contour Line Elevation (ft) 25. Depth to Urnitinrg Factor (in) 0.60 In -situ Soil Application Rabe (gPdM i Distribution Cell Information 76. Dispersal Cell Length Along Contour (ft) = C 6.00 ell Width (ft) 1. Dispersal Cell Design Loading Rate (gpd/ft 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y (c or e) Center or End Manifold 3. ' Lateral Spacing (ft) If N above, enter the elevation (ft) Number of Laterals of the highest point. 0.1 Orifice Diameter (in) (e.g. 0.25) 3. Estimated Orifice Spacing (ft) = � � ft 2 /O fm A2- Forcemain Diameter (in) 60. Fonmmain Length (ft) Does the forcemain d Y 96. Pump Tank Elevation (ft) Enter Y or N 3.25 System Head (ft) x 1.3 9-791 Forrcemain Drainback (gat) 3-96 Vertical Lift (ft) 46.901 5x Void Volume (gar!) 1.27 Friction boss (ft) 56.681 Minimum Dose Volume (gal) 8.47 Total Dynamic Head ( ft) 31-461 System Demand (gpm) Lateral D Selec Man Diameter Selection in. dia. o bons `choice in. dia. options cho ice 0.75 1.25 x 1.00 1.50 x x 1.25 x x 2.00 1.50 x 3.00 2.00 x 3.00 x Gailonsftnch Calculator (optional) Treatment Tank Information 600. Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) 40. Total Working Liquid Depth (in) 'sec anufaclmr 15. gal/in (enter result in cell 849) Dose Tank Information Effluent Filter Information 750.001 Dose Tank Capacity (gal) ben JFilter Manufacturer 20.2Q Dose Tank Volume (galliin) 100 Filter Model Number wei ser Manufacturer Project: Wyman Anderson mound Page 2 of 7 a Mound Plan View -1110 B ..:.:.:..:.:.: :_ :.:_:_:.:.:_::::: :: :::: t • Pipe K }-- .. j AA ?� r 1. .ti • . . _ I ..- --- -.... --- • ....................... L Mound Component Dimensions 6.00 E 12.8 n H 1. K 8.3 B 75. F 9.2 in Z 7.6 L 91.5 11. G 0. J 6. W 19.71 450. ft Dispersal Cell Area 1 1021.9 (ft Basal Area Available L_ 6.fig ) Linear Loading Raise 1 7. (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Gr 102.82 (ft) --�► H G ♦ ] - i! lfllJlll !!ft /!�I /I!llllJd /JJfi.. i F Dispersal ceu 101 -55 {ft} Lateral 101.05 (ft) Invert Dispersal Cell 3 . Elevation a k,� a + 1 13 (ft) Contour Elevation 2.6 % Site Slope Geotextite Fabric Cover Shading Key V _ c +� 5 See lateral details on 9 Topsoil Cap ft ? Ldtera Page 4 tix number, size, Subsoil Cap i and spacing of laterals. aterals are equally 3 ASTAA C33 Sand t spaced from the Tilled Layer distribution chi's 5 Aggregate centerline in the cell VjO). A Protect Wyman Anderson mound Page 3 of 7 I t Center Connection Lateral Layout Daigram Fowe main ocaneo*mWa we or doss to mufold at any point Laterals are identical P S sw • =Turn -nprwi'balivalveor X— +�Ext2 W2� Lawats&force marnof PVC Sch40 ctsaavutplug per COMM Table 843t1•Ei Hales dtiMed an Ow bottom of the WWaL Number of Laterals Orffice Diameter 0.1 Lateral Diameter A36. Orifice Spacing (X) 3.2 Lateral Length (P) Orifices per Lateral 12 Lateral Sing (S) Orifice Density 9. orifice Lateral Flow Rate pm Manifold Length 3.0 System Flow Rate 31.46 gpm Manifold Diameter 1.5 n Total Dynamic Head 8.47 ft F©rcemain Verity 3.21 Dose Tank Information tovervvft warrAV label and kx&tirg device and sealed watesbW Electrical as per NEC 300 and �---- � 4 in mFn. < Alternate outlet location Tank component is vented B 4 Forc enmin dian%ter Geiser _. Manufacturer 2 in. Ca " 750.001 Gallons -- Volume 1 20.281 gallinch D Weep hole or anti - Dimension lnc siom device A 22.69 460.1 B 2.00 40.56 Pump oil elevation (it) C 2-80 56.68 97.5 D 9.50 192. Total 36.98 750.0 Dose tank elevation (it) 3" Bedding under tank. 96.8 Alarm Manuaaacturer Ilevelalarm Alarm Model Number jdIv � Pump Manufacturer koeHer Pump Model Number 1152 Pump Must river 31, pm at 8.4 TDH Pmject: (Nyman Anderson mound Page 4 of 7 F tJ 2 1 TT „ �! R R i i g . s r i . 4 i CONSULT FACTORY FOR SPECIAL. APPLICATIO aCt' +i? fii�.sii?t, ��e la', rl'ti'ill;:i71�. � � t � • � dvpiet„ ac, nv- '.41 ?4t mid suMRed will`s x onlaq swilclm!s are avaiaxb'`lt.. tot t'i?'3710 inn Ste'11 l , phase w �rlr: !ii }Sc pigSjy;;” <x* VcAn - at* - , ;evel 'b il, 3ahiI4,Aes afe Z-va r Rx Vil!'ill}ie za l ! ° Qv k -B•ox cavaifabf° frF {?tdii. our ;s'5 2 1 }yPt;)P "?.. Spe FM1420 �� ; ✓i a #';�`� i.S s��,C,a i [y"s1ft��le.rTi az 15211M sake's ;�Lr15tl '�3bt3�13 iarurl Sr�t.kfza< �- Pr §��E c '' ist v `. tm' Aask _. tri e ' aw ; S ELECTION 71O�2 (a IVE �, �. eta s ; :,`� sS f? f k cre;f �vtl t !nf it ;:� a aal n crsl_3y3 !f a ; <v5h u r.q .1ck -,! a a.. ';C _.. _.. u GR11TfE2P3 ., see Fii 71 i0i o , '. vred model Laa D Ufkal A.tlernot r lr-F as* ice: t afs. ?tz � Pao •mss n w arP k;o st"Wl as dooe 4- a gCvffi e � r � s Item-" uta { sCr� , AU ..7:•ctl'raf asJ w tea+ ?a ,ci: uw. to Ftrzw @ids mo ��''3r� .cs3t;. �,a6iza i %hRSC , ,J . iz �. � , �?� � a Y�n$re� %eta n '�K rof fffsC hh s..x �crlt l *€eu x4 £ t trio Ch INE ; ra6 laa f5cca pat"al 'Wety a» i }#oat #r A0 jOSHAi, car (4 ) RESERVE POWERED DESIG Fr unusual d;%{ dffions a resent safety factor is engineered imc the desig1'i of every 7- ci'.iier i wi*t }1. 1l L2 r0. 6C& 04 - 1 `7 � 2 2 6 r fi ajar, aY ZZ oo r. ua _ e #rer.�rza 17 . t "IX 1 ; a ' a7J Mound ftg#M Maintenance and Qpera§on Speciifica#ions Service Provider`s Name {� E)atn Wo rrell Phon 7'! ___ ^ 5-6 45 2634 POWT'S Regulate s Nam Dan Worrell Phan 715- 646 2634 System Flow and load Parameters Design Flo 450 pd Maximum 118 in Estimated 300 gpd Maximum 220 mg1L Septic Tan 1000 gal Maximum 150 Soil Absoq 450 W Maximum 30 Type of W Domestic Maximum >10E4 100 mL Service Frequency Septic and Inspect and/or service once 3 Effluent Fi Should inspect and dean at least once 2M 3 rs Pump and Test once 3 years Alarm Should test month Pressure Laterals should be flushed and pressm tested every 1.5 ears Mound Inspect fur i and once e 3 ars Othe /Miscellaneous Constructh m and Mat WmIs Standards 1. Observation pipes are slotted and materials conform to Table Gomm 84.34 -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)(), Wes. Adm. Code. 3. All gravity and pressure pilling materials Conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a moll 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 Detall Finished +a!fwawwwwww■ ■awwwwaaaaraaw• OF . Grade �.. J� 64" Diameter Lawn -T- . __ Threaded Cieanout Sprinkler Valve Box Plug or Ball Valve Distributi Lateral ` "� Lung Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Wyman Anderson mound Page 5 of 7 Mound System Management Plan Pursumd to Comm 83.K Vft Achn. Code This system shall be operated in accordance with Corm 82-84 Wks. Aden Code. and shall frmintained in accordance with IW component manuals {SBA?- 10691 -P (i and SSIWAP Riblication 9.6 (01!81)) and local or state rides Pertaining to system maintenance and maintenance reporting. No one should erg enter a septic or pump tank since dangerous gases may be present that cmudd 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 POW TS components. Septic or pump tank manhole risers, mess risers and corers should be inspected for wearer tightness and sourndness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 84nches in diameter shall be secured by an effective locking device to print accidental or unauthorized entry into a tank or component Septic Tank The septic tannic shall be maintained by an individual caned to service septic tanks under s. 281.48, Stats. The contents of the septic WA shall be disposed of in accordance with WR 113, WhL Adm. Code. The opwaling condition of the septic tank and outlet flier shall be assessed at least arm every 3 yes by inspection The outlet titer stud be cleaned as necessary to ensue proper operation. The fiber cartridge should not be removed unless provisions are made to retam solids in the tank that may slough off the fitkv when rernoved from its enclosure. if the filter is equipped with an alarm, the filter shall be serviced 9 the alarm is activated Conan uousgy. intemrttent fiber alarms may irvftate surge flows or an impending continuous alum. The septic tank shall have is contents removed when the volume of sludge and strum in the tank exceeds 113 the liquid volume of the tank tf 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 maximurn scum and sludge accumulation in the tank. The add tim of biological or chemical additives to enhance septic tank periarrrrance is generally not respired. flowerer, If such products are used they shall be approved for septic tar* use by the Department of Commerce. PWW Tank The pump (dosing) fade shall be inspected at triad once every 3 years, AN area, alarms, and pumps shad be tested to verify proper operation. ff an effluent titer is instaAed within the tank it shag be inspected and serviced as necessary. Mourmd and Pressure OfteyutMn System No trees or shrubs shokad be planted on the moead. Plantings may be made around the mound's pr Ater, and the mound shag be seeded and mulched as necessary to prevent erosion and to provide some prom from frost pernetnadion. Traffic (ofimer than for vegetative maintenance) on the mound is not recomtnended since sod corpactiorn may hinder aeration of the idiltrafive surface within the mound and snow compaction in the wi nterwB promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulched as protection from freezing. Infkrent Quality aft the mound system may not exceed 220 mg& SM , 150 m9FL TSS, and 30 mg& FOG for septic tank ellluent or 30 malt SM , 30 nV& TSS, 10 mglf. FOG, and 10' dull00 ml- for nighty treated effluent, influent low may not exceed maximum design flow specked in the pe init for this instaffatioxm. The pressure distribution system is provided vdb a Austdrg point at the end of each lateral, and k is rem that each lateral be flushed of accumulated sours at least once every 18 months. When a pressure test is performed it should be compared to Ilia initial test when the system was irstalled to determine if onfice clogging has occurred and of orifice [leaning is reed to maintain equal unction within the dispersal cell. Observation Pipes within the dispersal tell shag be decked for effluent: pandmng. Ponding Weis shall be reported to the twirner, and any lewls move 6 inches considered as an impending hydraulic failure requiring additional more frequent m m`borig. CO#d rrgencV Plan N 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 fwmnp. purnp controls, aim or muted wiring becomes detective the defective component(s) shall be immediately repaired or replaced with a component of the sane or equal performance. ff the mound component fails to accept wash m inter or begins to discharge wastewater to the ground surface, i will be repaired or replaced in its' present location by kicreasirs basal area 9 tae leakage occur or by remora biologically dogged absorptiori and dispersal rmedia, and related ping, and replacing said componerits as deemed necessary to bring the system wit Pry qwrating condition. See Page 5 of this plan for the name and telephone number of your local POINTS regulator and service provider. Pro*tr Wyman Anderson mound Page 6 of 7 I c� c 5ep � f C- 0 - Z t' A 1010 P, M er - (" a . Piff tj }� l e IA J P _ 1 o Al lk 1 00 ,0 1 Jov i ��MA Dom. O c a 4 T t _ E a ` k i , . C L r t , _ i t e , - -- Q60 � SY I , f , _ t � r , �' — �*2 ,°rte 00 r+4 i {f'� �f _ J 6 -` — r } m i , I o 1 ff i +a T 01/05(2007 IE:12 1 9JfERIUR POMI -KAI,E VANZWWin osparer"I t of coma wme SOIL EVALUATION REPORT e: Saretyaead �- In eccordence +viii Comm 85. this. Adm. CWe Anacta =noes sea ; lndado, bid 10 Cited kc venU� "hofzcntsl twerenco po i (am) *ectot and Pam Ail. t�. poment slot. solo or dieaastonl. rrartb arrow. end itm&m and di unm to n►stest mad. ! " Please print all Information. Rbvtewad by Oete Ptprs�lttaPar�asgn xeu P��ee � #7 bo +aard !9+ aewsx�a�rr t�poaaa fPtk'srtax, s. tS�e! r3y{tt++rr� Ptop$zN LocBtton GQvL Lot h? IM SE U-IS T3 K iZ E { P y t agAd&es - s Lai # i"!k R I %b& Mw* or cSM# S wig zhi Godo Ptvono ttt;� cty O M-81M Town Nearest Road tt r` X11 i 5� 3 lei &A D ri o c. tVSw stttttt toy iha:($ R�stdenUai iNwr~bd�orbedrooms I Coda o.rW*O dastgn Now rate CPO 0RsP Pa;W9 tMaietlal t T #t•i�, * "� . flood Plain wovatk>m it' applicants tt. GQMIW WaWn"o s.:r Svc - �r 'i 7S � p► Qv,~ $s•^ .� �' /p /, # + fig p ll fs'rcund sudsea else. /�", x'11+ ft, Depth to Wakg zacr fct. Soo Worii,pn Cop* (Dcartfttsrtt poicr Red" 06z0fpticn Texture sitttcture Consistence 8wndary Roots in. Mun" tau. SL Cont. Cotta Gr. Sz. Sf- ' p-�5 + J ?it Gtound svefscv elev. �►e'* s H. Depth to finfAg facior $n R Sol 11014- t3ipig, 0"1Irtant cover I Aodwt D�sa9ptitm lextwf $Wet.® Gonrtstsrace eowtGt++y rtwta Q in- b'+uli3ao7l flu $Z com Cams . SL Stem I I 0i 'EM2 F " Lot ----- -- A ny /0 ' Eltauent #t a tD{ U z 9tD s 2r^0 malt and i95 7 3f7: 75C ragrl • €sluonr 92 a 000 3o AWL ariv 783 ,� 30 #tam #� zattaa nV- G CSTNtxraaec t S�z rm -t_ ,,,t j . flsft� alt3e #ion {:6rrlsitrGtet$ To"hoa* Masher @1/05/2007 15:12 1 SLlPERIOP NJTOMDT1k PAGE 43 pit Ground surface e1wv. _ 1 Z 9 j it n_ Pew iv welling i"tvr �_ 1n, Sol i omOtent Color Redox NwJP M 1�4'4tlC8 Stn. a ronstatcncr, F"' Rat (3F'd 1C Munson {lu. SL Cont. cow Of Sz. SA. 't:>$1 •EftN2 A 4-:41761 Oil 0 CJ pit C'wUfw sutieca elan_ l;, pt+otM+ to x"kr►g factor in. Sot Rate �takit"n Papist Dorelirttnt Redox Dostaiptivn Taxturt $Iru�turo Consistence BotmOary Aopts Gd'wr unsoY Qu. Sx. CvnL Color Gr. Sz. Sri. •l Ifttt • p i3antrg a t3oritiQ 0 F, wound surfo r# #ter. _ it. Depth to t wung IV= iii papa Cte Rost Redou i Ta4auro Sht+c�tura Consl3tetup BotuKfary Routs ►rt. Qu- St. cum color t r_ Si $tl 'EifN3 'Etrn7 ' Ell wg f) s OW, > 3Q < zM ftgq. am TSS > i5J mgt Eftent #2 = 90D, 38 mA wW T96 30 MO& The Peparmot orOpmmerce is an equal opportunity service provider and employer. If you need assistsnce io access services or need material in an alternate format. please contact the department 21609-266.3 1S t or 1 60$- 2644777. ror�.ca »ta.Faot 1 1 01/0512007 16:12 i SUA -Y.I_V ru!! 010" A - i ! � I — �i . � t- .� , 1 1, A � { • { x , { x , - _ a r a i . � 4 t , ,�agr�tri c in rerrs+��k — -E { � 8 1 1 + k ff , a i d a ' t S i c , a Tai —A a Z { � � � 1 ♦ i � - — 3 f d , Z s s r S a a _ , , a l 'Parcel #:- 038- 1071 -20 -000 04/19/2007 03:46 PM PAGE 1 OF 1 Alt. Parcel #: 17.31.18.295E 038 - TOWN OF STAR PRAIRIE Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - HOUSE, CHRISTOPHER & KATHHERINE CHRISTOPHER & KATHHERINE HOUSE 6214 374TH ST NORTH BRANCH MN 55056 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 5432 SOMERSET SP 8050 SQUAW LAKE RHAB & MANAGE SP 1700 WITC ��-? ,�/� a Legal Description: Acres: 784.0 0 lat: N/A -NOT AVAILABLE SEC 17 T31 N R1 8W PT SW NE LOT 2 OF CSM V Block/Condo Bldg: 5/1241 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 17-31N-18W Notes: Parcel History: Date Doc # Vol /Page Type 06/01/2006 826499 WD 07/23/1997 681/533 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations Last Changed: 10/13/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.784 79,100 400 79,500 NO Totals for 2007: General Property 0.784 79,100 400 79,500 Woodland 0.000 0 0 Totals for 2006: General Property 0.784 79,100 400 79,500 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 FILE co co DEC I t3 1982 ;— j jw nt c tHrt c 1 s �cp 36:.601 wboms CERTIFIED SURVEY MAP LOCATED IN THESWI /4-NEI/4BNW //4SEI11, SECT /ON 17, T.3 1N., R.18W,TOWN OF STAR PRA /RIB ST. CRO /X COUNTY, WISCONSIN APPRO + PREPARED FOR.' RALPH NUESEL DEC X9$2 21340 FONDANT FOREST LAKE MN S�U'4/'1/ SIVE `"S� AN -� COMP ::�iEN.,IVE PAC<`:S t.: t;NCS f 7"NG COMMITIEE co 6 kp 0 , 0G 0 /, ��s- S 4 "E- R r V , Rq _ N //6.40' 4029'58 "E' e B40 /6'W 1/6.,61' //8. P 1 3 3 � 4 R.A.-N84016'W 118.14' 01 1� ' L OT l� f ; y a o O N 55,898 SQ. FT. OR /. 283 AC. 7-0 LOT m � h� � . MEANDER LINE o r h \ LO T r 61, 000 SO. FT. OR /. 4000 AC. t TO R p 26,429 S0. FT. OR 0.607 AC." o' -, r d WATERS EDGE TO MEANDER L /NE Q +2 25,999 S0. FT OR 0.597 AC. �+ ' i., p 4, BOO S0. FT. OR0.799AC, h TO MEANDER LINE -�. ! TO WATERS EDGE 51' 34,150 SO. FT. OR 0.784 AC. \ w� R. A. /9/, i TO WATERS EDGE r� 191.49 R A. -116.69 ti // R.A. Q 111 0 ,. ____- �I -- NB7 27 50 W -- //8. 6, o R. A. - N87 426.53' 30'� " 426.59'-- _ v1 BRAVE OR/VE ��'3 3 � 4 a ��% (3) 3 b R.A. N87 °28'W PR/VAT N i N87027'50" W _ O` V IC /83.28' ` 48.00 48.0o' a 2 W W o �w o _ M o cam__ "' O 20 50 /00 162.40' BEARINGS REFERENCED To THE SOUTHERLY N87 "w 60.00' 60.00' LINE' OF BLOCK E, PLAT OF WIGWAM SHORES 282.40 RECORDED AS N67 MEASUREDAS N87027'50 " U A T T E D _ (PLAT SHOWS NORTH ON EAST LINEOF SE I14 SE L EGEND NOTE.' LOT 2 CONTAINS 5,478 SO. FT. OF O / "X 24 " IRON PIPE SET WEIGHING /. 68 LB.S /L. F. PRIVATE ROAD EASEMENT • I " IRON PIPE FOUND ( I. D) LOT 3 CONTAINS 5,433 SO. FT OF O / "IRON PIPE FOUND (O. D. PRIVATE ROAD EASEMENT 0 2" IRON PIPE FOUND LOT 4 CONTA /NS I2, 350 SO. FT. OF PRIVATE ROAD EASEMENT R.A. - RECORDED AS ON PLAT OF WIGWAM SHORES NOOCJC tlotey�e, THIS INSTRUMENTDRAFTED PREPARED BY.' p E •L BY JOSEPH P. NELSEN G. ROBERT SHEFFERS AND is z SEE REVERSE SIDE FOR ASSOCIATES INC. C On'" CERTIP7CATION 278 TOWERHEIGHTS COURT ��,$ :lti� WIS. CERrIF /ED SURVEY MAPNO. 12 43 PRESCOTT, W/ " "" Volume 5 Page 1241 �,a ®�U1064 0 0 s � 0 � 77ƒ; � � T , cz z m F z c# _: @- o , ° m ° S ° # q $ _E ' m E U § 2 ■ \ 0 \ R » ' k0 �i��� ■ 9 1 � « @ a © co z > v� R E0 � 0 8 § E CO) 0 0 0 /� � "w' 0 § § § 8 ( ~ k / J B !to c \ / � .. 0 \ \ 7 � _0 � �- X B CD ` ` k i 3 - § § 2 CO ;a g- CL G.) R § 2 7 z 0 ® & £ 2 > E CL \0�22K D 9- RL \ c §DM 5� �% a) \]m 0 0 �� cn \ �E /k� t CL E§7 / ® W � LO. / ! § 0 = 0 I 2 CL \�Kk \ : , © 2 q N f 0 § 8 C 7 � ® S Safety and Buildings Division county MW = 201 W. Washington Ave., P.O. Box 7162 /—_ i sconsin Madison, WI 53707 - 7162 ejewctAddress 't Number (to be filled in by Co,) Department of Commerce (608) 266-3151 Z 50 Sanitary Permit Application Number In accord with Comm 83.21, Wis. Adm. Code, personal info on you provide � _ may be used for secondary p Privacy Law, 1 X (if different than mailing address) L Application Information - Please Print Ali Information 4 �cJ D �j r<i U2, 6 `1'0Q Property Owners Name R E C Parcel # Lot # Black # Property Owner's Mailing Address Property Loc NOV 200 City, State Zip Code / K J Section S l it - r If ki ��tio TY Y Ln T N :B of j• (015 V IL Type of Building (check all that apply) 6 � 510 \�� "� Subdivision Name 1 or amity DweV Number of Bedmoms Public/Commercial - Describe Use S ; v` �( A l l py •L' State owned - Describe Use Z , { - 7 1 G nd lage f J III. Type of Permit: ((heck only one box online A. diiplete line B i pplicable) A ew Sys Replaoement System Tree oldi milk Replacement Only Jv( O B • Permit Renewal Permit Revision Change o Permit Transfer to New List ous Permit Number Before Expiration Plumber Owner IV, of POWTS System: Check all that appl n x oudzed ln-Ground Mound> 24 in. of suitable soil Mow 24 rut. of suitable soil At -Grade Single Pass Said Filter Constructed Welland Pressurized In -Ground Holding T Peat Fd Aerobic Treatment Unit Recirculating Smd Filter Recimu Synthetic Media Filter g Chamber Line G a - less Pi Other(ex V. rsaVrreatment Area Information: Design Now (gpd)� Design Soil Appli on Rate(gpdsf) pusai Area R ( Dispersal Ara Proposed (sf� system Elevation VI, Tank Info Capacity in Total Nu Manufacturer Prefab Site r Sted Fiber Plastic Gallons Gallons of nits Concrete Constructed Glass NOW 8sisting Tana Tanks !✓ Za e l � u Septic or Holding Tank Aerobic Twatawnt Unit Dosing CWsub" VU Respondbifity Statement- I, the tuaderdp4 assume responsibility for installation of the N4ow, We attached Plum Plumber's Name (Print) Plumber's MP/MPRS Number Business Phone Number DAk I U16 — alo - 1 '71� - 4 Plumbers Address (Stied, City, State, tip Code) [ �$0 �. �fa F a L S �L 3/3l/Q VIIL Cou n se Oal ved Sanitary Permit Fee (includes Groundwater Date Own m Reason ofo Surrinarge Fee) UL Conditions of ApprovalMeasons & Disapproval SYSTEM OWNED: t. Septic teak, etruent filter and dispersal 961 must all be services / maintained as per nwwgement plan provided by plumber. 2. Al setback mgWrerrinnts must be maintained ere per applcable code / ordinances. Attach conviete plans (to the CountY oaty) for the sYsteO ON paper not teas than $In x 11 inches in sloe I • r ,K x I Q]YWC� I- A?'U'fZ ss 7:,rttsr.: vt>e, y-aa*tQW lbq f 'Plot PLAJ 15QVW LAO - N Wi5�YW 17T3)IU Jwjj ST pCOr-i e wfq wawa Sl o eS 61Ai I00,0 r ti k-2 t ® 61 9 q, 7 a-. J �-� �a'��e .6 ® 133 79,03 � s cts- AT � 97,® 8i too �O A U �- w l er 3 s y COPY 5 ;�v� �nN 5 l 6T5 D 1 1 000 �a I W - Tk „es -etr a w I Q-r -, I T f- 3 4 Q v tc t T05 a (_ow 0 l 7 w &,�_ � Ncl c-c, p5, s-ac h row w t I I a m q Got -� V'o w\� - ectc k - e pj IAI-Cf C IS IJ© oncJI/ A l ALA g6'i eravf [)( 10 W�5d5 17T31 -- &iJ j 5raf pCOri e 1,0-t a WI) wam ShD 611 100.0 �- ® Q! 99,7 - •�� 1a1. 3b a�� ® 83 79• 0 3 :5ySTerA �.L�-uAT(Otj 97,0 t01�g1 G�eo a�io 7 -41 QU!; wtew 5 0 y I T-e t'- 3 Li (l T A 06 �-NcA ca p5 la h row w 1 a t'_c�cctirlo cl 1� Y' aNT3 o t -eac �- tin well ut c rtcjNa j ✓'a vP (Jr Ive g T� ✓ r� i �P SzC ck�b 5 T 3i [ 6 LG,' Try? � t a v` Pro 13i'aLk C D a, tj W o ir tf 1 5,6 1 S ck vq-- ST- C e? /x PCX 1 t 5 q & -of .�1 cC41 - _715`_ '4 q1 Cc _ p O-t Re, Solt- pkpor k p C a � J � � V �119 ct (60 �o � D 72 RECE jkch es vl;mnsinDepretrnentof MAY 0 ATION REPORT Page _I of Division of Safety and Buildings i a ws. S j C P I ST. CROIX ac RO;X Y Attach complete site plan on pa not less than 8e. m include, but riot limited to: verti ca i Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nea Please print all Information. R Pemond Infomladon You Provide may be used for secondary PaPom (Pdv-Y Low. s. 15.04(l) (m)). Property Owner Property LocreG. W Y M A N A ve tJ Govt. Lot IJ W 1/4 $f 114 S r7 T 31 N R 1 E Property Owners Malftrrg Address Lot # Block # Subd. Name or CSW .-d, o /5' 2 E WI LTW Cfly State Zip Code Phone Nunber ❑ City ❑ Wage WTown Nearest Road MSn► �� rJ 56'73 s-� a �� v em New Construction User Residential / Nwber of bedrooms Code derived design flow rate A+50 GPD ❑ Replacement ❑ Public or comnerclal - Describe: Parent material Flood Plain elevation N applicable PJ I A -- R General oomrrrerlts and . Pro Add w s : R 58 Bra PC Ari ve m Boring # Boring Pit end surface elev. 191 ft. Depth to Waiting factor > 19 in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Rods GPDW in. Munaell Qu. SM Cont. Color Gr. Sz. Sh. -811#1 '1011#2 0 -4 '^ m+y - ' 0- + ."7 1 40 '7.5 1 S Q - ."7 1 • 7,5 ' ate# 0 Boring ® Pit Ground swface elev. 01 . 3 (p fL Depth to Nmiting factor /0 in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Str ucAure Consistence Bourxiary Roots GPDM In. Munsefl Qu. Sz. Cont. Color Gr. Sz. Sh - EW 'Eff#2 •5 1 �- V-32 . 13 1 1 or 2.V; 3• vyR'tl / 5 VIA i I 5I �) % z 5 4V u EAktent 91= BOD > w < 220 alga. and TSS xv < 150 "V& - Effluent = BDD <_ 80 mg& and TSS < w ffQ& Csr ee n `Pl�e A") MT l b Yi G � 93 Nufftw Address lion Conducted Telephone Number 2 gig ia-�h,,�y,� 08 VAIA W 41 12-4 C1 (o 67/S) 772 .34-0 2. _.� � __9 y •.1 1.. 1 u Per S or3 . r SQvflw A = 11 ►�c�biM Fl-RK , �I2 5 �T 2'',q�o w Q � ri Q � E- V) V) (u w 3 LA r 9 9. --72. JN ��, B M t � 1 ao •oo 8S' 6' BM�2 JUL 101.91 Z2•.> j33= Rq.o3 /' --- lDo.3�- 3 q' C RRv� DR�v� c- l r G , VPRoT>Eo -TL� E7C�rc N 13c>> SUVTH D�' k3RAv�b,2 . 1:1 LED DEC 1 31982 AA= Of +Hat ftoldw C& Deeds 64 eak aom. 381601 CERTIFIED SURVEY MAP LOCATED IN TNE.S'WI14-NE1148•NW1 /45E/�, SECT /ON /T, T.3 /N., R. /8W, TOWN � � PROV OF STAR PRAIRIE, ST. CROIX COUNTY, WISCONSIN 'REPARED FOR DEC 131982 RALPH NUEBEL 21340 FONDANT S ,,x `w:• FOREST LAKE, MN -'4 _ /� CoM? _IiEt49VE PAR PLAWI NG " G ! •'-/ ZONING COMNUITEE V k 4 Q S 0 44 1 4 3 "E R.A.-N84° 16'W 116.51' LOT 0 P h �M �R� N 35 898 SP. FT OR 1.283AG.Ti7 h3 M O L O T O N MEANDER L /NE Q % � C\, V O Q &I ,429 SOFT OR O. --_ -- c 61,000SO_FT• -TO-, O Q -26 - -m MEANDERL /NE Q ` Q 25,9RWSO.FT OR0.59TAC. �M O m WATERS- ED6E d, y • �' . �� T. JRO T99ACv y 70 MEANDER LINE 34,800 SO. F TO WATERS £D6F 34,150 SO. FT. OR 0.784 AC• - TO WATER'S EDGE Iq A.-! /6 R. .69' Q � Q /9/.43 ` R.A - 118.33 yy - _ - -N 87 °27'50 "W -- fi 426.59'- ¢6 R. A. - N87 28 W 426.53' s6.To - 3° B DRIVE 6, ' g o %. � n , F • c cn s ue,, PR/ VATE v N 08 R.A.- N87028'W 2 6' _ V ,r --N87 0 27'50 "W -- 279.28 183.28, �1 t � 48.00' 48.00' Z Z o _ , 4 i 1 ==60 162.40' O 20 50 !00 6Q. 00' 6Q 00' gE 1!R/NGS REFERE/+/GEo TO THE 5'OU7 Y A/67 °27 �Fo' W 282.40 _ -� ai Ar nF W//,'WOM SHORES 1 1/0 6/20 0 6 MON 12:14 FAX 715 386 4687 ST CROIX CO REG OF DEEDS Q002/002 RATHI•L+'EII H. VA1SH REGISTER OF DEEMS ST_ Cit^Q11 CO- . V1 STA7Z B 1R Ol' W15CY3NStN FORM 2 -19W RIPCEaVED FOR itl}t` -URD rimumns N W tft tits/ @1 /2SN6 te8 c 5lAlt WARRANTY # DI .D Rix FETE: 11.86 TRANS FEE: 215.90 COPY FEE: CC FEE: PAGES: 1 Rmard-ng Arrn RJNWJ8WlxTd;PrAddVM Burnet T:tk 7330 Franco Ave- S. First Floor Edina, MN 55435 Pam► tdc�.���cnlipn Na. ' 03s- Ifni ZU —000 This Decd, made beRtweea WMAN 6MEl tSO_ N. A S7NT :J, PAR, bN. Grxator(s), convey and warrant to T P F O L. HOUSE HUSBAND AND IF as a i majita as Grantee(s), the following described real estate in S SM JL0-" GOUN'TY. State of Wisconsin. Lot 2, Cortifiod Survoy Map No. 1241, volume 5, Page 1241, Town of Star Prairie„ St. Croix County Wisconsin mc-eptions to warranties: Datcd: MAY 15, 20 (>fi WYNCkN ACKNOWLEDGEMENT STATE OF 11rMNESOTA ) COUNTY OF Vt&$ IINGTON1 Persons,IIy came before me on K&Y l5. 2(1062(?U6, the above earned WYMAN ANDERSON. A SINTCrX to me Down to be the person(p) who executed the foregoing instrument amt acknowledge the w# L(V±. Notary Pubbi; r Notarial Stamp or Seat � �,__.f tAi(r>rT.1AalbpfdK!®FE1► i�TAll►llidtZ.ItNT�p1y► . This instrument was drafted by- �rp�lileur�Azsl.fl� A#torney's Title of Stiilwater 18051 Nord western Ave. Suite 110 Stillwater, MN 55082 iii ST citoix CO UNTY SEPTIC TANK MAINTENANCE AdRMBONT AND OWNMSIn' CERTtFtCATION FORM A r7 L a c6t' ST Dr e awl PropcA AddroBs (VcgiftWm raqWXW ftm Fi * Zom DqmrUvzd IN zcw qtr t,) Citylstate 5 Prn( r a pW >sdcudfica oo Nmber j DEs�ox propmV Lomem j - sA , SE- 'A, Sec. , T -;I.N Rj%-w, TMO of gubdiv n rte . c survey Map# t v # Wirrianty Tad # vobmw # Sm loo ya Lot hum ideaaidahies �s ao LIMU ANCM AND OVVI'+t M ta�A QNt IMPWW we aP4 waintumat o of yo" c AYSUMA no Wd neott 3n its Mute Mwe to handle atastes. PfoPa' Mohanacce consists of ping OW the gap& teat cv y ftw yeses or saw, if neckd. by a hcomed pnMw What 7°a Flit iOo dw symn car: affect dse of tLa septic tease as a tt sent stage iB the weans disposal � oww w'bmw"m m p oos a� am Wcdfred in $C.omttt. 83.52(0) ad is C2mpbar 12 - SL C mm Coaaty SOOKY odmm . Tft pmp q awmx sgt+ m to abmg to St coxx Conaty B'Isuoning & Zoning DqgwOmW a Mbfiuhm f'aam. RPW by dx ear sad by a tnastsr pbmmbcr pwmy=n Numb ce stdcod ploambK or a hoovad parapet verifYWZ tbo (1) " 08 foe wasowow dispood system is is pauper aperati g conditm XzWw (2) dtff iDWelt' ► sad VW (d ==my)- the selft kaic iu leas thm 113 fm f of sludge. 1h, d. i A"Vw kbava read dw abwm aagoiremm % and as= to muniko tics Wwm'e aeeaaga viol the smn&g& set ftdL Bonin, as set by die Dq Wtmmt of COimM= and dw Dq=ftoM of NaMI d FAMM", Suss Of Wlwoasin. C sft% diet y&z mpae sy his been am m mA mast be c mwl@ d and noNved do "6t. Couaty P11"8 & within 30 days of dw Am ym exp Wirru 4atc. Iles oettitp dud an dammens an a& famm am tie to the best of myAW Ima'wledBCS- L%M a WOM &a uwB*S) of the ptnpaty dratix W arse, by anSw of a vattasty deed ommded is Regiskz Of > feeds Office, It' � S A`I'M OF APP WANTtS3 DATE * **A" isfir 8ast is WASW*rewaft aq look is the sas#ary paxod being nvolod by the 8 do Zn8 Dopm"mot * ** In*& wish ibis spplica" a iwor" werranty deed ham ft ftbW Of Ift& 02MOD and o go " of d* oart fwd sntvey arid► if ice is made in the wx aty dC& TO/ TO 39Vd S3VSP (IdVhi(I3 S09USZ199 0b:50 900Z/90/11 D19 Safety and Buildings 10541N RANCH ROAD commerce .wi.gov HAYWARD WI 54843 TDD #: (608) 264 -8777 i s e o n s i n www.commer isco sin.go / Department of Commerce www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary i April 19, 2007 CUST ID No. 221057 ATTN.• POWTS Inspector DANIEL C WORRELL ZONING OFFICE DANS PLUMBING & HEATING ST CROIX COUNTY SPIA 1756 150TH AVE 1 101 CARMICHAEL RD SAINT CROIX FALLS WI 54024 -7533 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/19/2009 Identification Numbers Transaction ID No. 1383675 SITE: Site ID No. 723781 Wyman Anderson l �-� Please refer to both identification ' 9581 Brave Dr �l E numbers, above, in all correspondence Town of Star Prairie V � wd'i 1 with the agenc St Croix County / NW1 /4, SE1 /4, S17, T31N, R18W WA (a'— FOR: Description: Mound, 3 bedroom residence Object Type: POWTS Component Manual Regulated Object 1D No.: 1124650 Maintenance required; 450 GPD Flow rate; 25 in Soil minirnum depth to li niting factor from original grade; System(s): Mound Component Manual -Version 2.0, SBD- 10691 -P (N.01/01) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. Tlu� stem is ter be n tructe l aid laud p�acco l ce t tie enclosed approved plans andi witikhe component i �(s) reft r nce above. The owner, as defined u7 chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Key Item(s) • 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. • 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 DANIEL C WORRELL Page 2 41/19/2007 the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(i). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. • Insulate building sewer per COMM 82.30(11)(c). • Provide frost protection per COMM 83.43(8)(c). A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include. local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Patricia L Shandorf POWTS Plan Reviewer, Integrated Services WISMART code: 7633' (715) 634 -7810, Fax: (715) 634-5150, M -f 7:45 am - 4:30 pm pat. shando rf @wisconsin. go v cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726 -2544 , Friday, 7:00 A.M. To 3:30 P.M. Parcel #: 038 - 1148 -90 -000 04/19/2007 03:37 PM PAGE 1 OF 1 Alt. Parcel #: 17.31.18.653 038 - TOWN OF STAR PRAIRIE Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 5 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - ANDERSON, WYMAN WYMAN ANDERSON Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 958 BRAVE DR SC 5432 SOMERSET SP 8050 SQUAW LAKE RHAB & MANAGE SP 1700 WITC Legal Description: Acres: 0.000 Plat: 2617 - WIGWAM SHORES SEC 17 T31 R1 8W LOT 2 BLOCK E WIGWAM Block/Condo Bldg: E LOT 02 SHORES NKA PT OF LOT 2 CSM 5/1241 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 17 -31 N-1 8W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 657/219 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/1112000 Description Class Acres Land Improve Total State Reason Totals for 2007: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2006: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 W(- ()'1005 VP-f(' Sit) Ne I- la --GE, hoo 5 e- cw, so' -4 � a� Wisconsin Department of Comme SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Coda County <ij. ' Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must J' Include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D, Q, percent slope, scale or dimensfons, north arrow, and location and distance to nearest road. ® Please print all Information, Re vio ad by Date Personal Information you provide maybe used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location DJ M a- r RECEIVED Go . Lol p to 1/4 1/ S 11/ T31 N R E (or nW Pro arty caner' Mailing Address Lot # Block # Subd. Name or CSM# D �+�? c,- Ci�ty Slate Zip Code Phone um er City ❑ village Town Nearest Road 1 M of :5 � ( ST) CROIX COUNTY Ar I ► e-- row 4" r' 0 G. New Construction Use: C, Residential / humDer or D Code derived design now rate GPD ❑ Replacement ❑ Public or commercial . Describe!_ Parent material — ON ON P-e. iL, 4 L� Flood Plain e,evation if applicable ,_ �_ h• General comments J - - - "— and rawmmandauons:.�r 5 \' q- i1e, - 2 S' r- to $t-4 +•-A- )3 1 t!bws� p>1 /0 t' 131 G0.1+10a0-, I I I Boring If ❑ Boring � 06 ' `/ r . — 0 pit Ground surface elev. De _ 6 ft. Depth to limiting factor In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /tf In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Etf#1 'Eft#2 -1 q 0` 9, L, D- 5-- j aw I , 7 a / �-I 5 LS 0 -S L rY a 1. V -, [- . 5 5 L_ Boring # ❑ Boring ® 0 pit Ground surface elev. /1> 1 3 it, Depth to limiting factor ___�:_1._._ In. Soft licaiion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fP In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Eft#1 'Eff#2 1 041101A L FS btt I A5 0-\,d IJ I n -al v x. 1 — f5 (Z `f �... � o ' Effluent #1 x BOD > 30 < 220 mg/L and TSS >30 < 150 mg& Effluent #2 = BOD < 30 mg& and TSS 5 30 mg& T Narne (Please Print Signature CST Number Address Data valuation Conducted Telephone Number :5 Yoh. I Property Owner � G G<t' N Parcel ID q Pa90 _ of © Boring # ❑ Boring Ai-2 1 / pit Ground surface elev. � M. Depth to limiting factor / In. SoU IicaUon Role Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff In. Munsell Du, Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 r a -a5 S� a -S '� ^. �..�.� I a 3 d5-.10 7 s't �' 1 `�� !nos It v+= LO In Boring # ❑ Boring ❑ pit Ground surface elev. h. Depth to limiting factor _ in. Soil Rate Horizon Depth Dominant Color Redox Descriptlon Texture Structure Consistence Boundary Roots GPD /tf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Etf#1 'Etf #2 El Boring # Boring ❑ pit Ground surface elev. ft. Depth to IimiUng factor in. Soil Appocauon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P /tf In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'EH#2 'Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD 5 30 mg/L and TSS < 30 mg/L Tile 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. S0D•r)10(It.1�00) I ,.fit •. I � '�� � __ _ _ . - _ _ _ Oiler %,w4 #off F _' of c p�I I S .x _ 4 ' - - Soy lot __ -_ _ -. i i � I - -- _ __ _ _ _ _ -_ ._ _ -.._ _.. -- _ - -- - - 1 - ' _._ � i � � ' I _ i -- _ - - -- r - - � __. I ._ ^ -. __ _ ___-� � __ _ _' I - - -- _ ._ _ - __� I _� - �_ - -�:, __ _ _ f � -- - - _ - - - - - -, -- - - i - -, -- -_ _ -- -- -- - - - _- _- -- -,�... __ _ -- - -� .. i � -- - -- �_._ -- - r � � � G ' i ' - -. i i I - _ - _ - -- - - _. i I ! 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